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HomeMy WebLinkAboutUNDERGROUND TANKHAZ~~OUS ~2~^~s TIME CHARGED BUSINESS/DEAPRTMENT NAME: ~~ION ADDRESS: PROJECT DESCRIPTION: PROJECT NUMBER: 19% DATE: NAME: TIME CHGD: COMMENTS: PROJECT COMPLETION: DATE: Hazardous Materials/HazardoUs Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ........... ~;~,~,~;~?~?~,,~,~,~ ............... This permit is issued for the following: ~/?'?}i:}'~!~i!!!?'~:~:":';iiil}ii}iilL j!!i!ii~ iiiilJi?~i~!i}~ii~e~ground Storage of Hazardous Materials PERM IT ID. 01 S-0214)01788 ?[ ~i ~. :~: ~;~ ~ ;::'~' ..:=~4~ ~.~ ~!¢~?~:::~~k~::~P. ageme nt Program LOCATION 3360 PANAMA HAZARDOUS SUBSTANCE GASOLINE GASOLINE GASOLINE ~TAN I 12,000 PIPING PIPING METHOD ONITO PRESSURE ALD PRESSURE ALD PRESSURE ALD Issu~ by: Bakersfield Fire Department OFFICE OF ENVIR ONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326~3979 FAX (805) 326-0576 Approved by: Expiration Date: June 30; 2000 ~ I CA Cert..o. 00867 City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information inthe format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 2na day of November, 1998 to: CHEVRON SS//1849-206561 Permit//015-021-001788 3360 Panama Ln Bakersfield, California 93313 -- W~.O-. Number - 9-70108- ' ' . ,' .1.0.~ -dia--., 12,.000 gal:ion : . .705~8.5 -- Repaired~damage to ' -~-Double'Wa:I1 II .- . - --~ -. - ' - ' -'---':-' ' *'--- - 'one rib. - ian~ roPair ~ - . ' -'_-?etro . - : --: Contract0rj" DsT'.~uilders . , -On the abovedate, Xerxes C0rpo~atio~ dis ched an authorized repair-crew t pect'an ._ the'Uhdefground Storage.Tankstistbd a~oVe: - ':' - .~ -_'. .... :-The .repair. o~ retrofit w0~k .waS' done. , , .in-..&ccordance. ~ _With~*Xerxes;:--- ,.. field repai~:*pro~0ddres- using ~at~'rlals~ ,~ .... :.called oat under U.k'i (Unde~nters L~ - ~ bora/o'~ manufac~udn~ spocifications:, ..... '..: ' '-._ '.~lh°S°v~xtan~S passoo.aS.P.s:i.~2~ .: ~ -. ab tost. ....... a~o(tho work was po~Orm°dand'will Contin~o iOb ~....~,~,,,e~x~s' w~rrant~- ..~. · .NOTE: Xe?xes:.warranty-on thegb-tadks-will not-'~tad:anew;-hdwever,it Will COntinUe.for'th'e duratJ°n-&s: ~ .'. :. -:~ ~tated'in the~odginal Warranty :'baSed.-UponLth~'date:of original, pUrchase: .In addition:,' there .w . -' .--fi: o'no voai warranty~Oh 'mated~ls-a~d wOrkm~hsbip.for th~ ropair~ dono-on ihosetan~. ~:T~i~ -'-: ". :" .will: be_ i~.::~'ffect- as. long ~as- thb.tanks'are '-(or'weFe') i:nstalled' in '~ccordhnCe-w~th'. xe-r~es "':~.- sP~ci~icationS:and"Pu~lished' installation inst~ucti°nS..~o u sflofii~-alWay c°nSui~ 'State and; }ocal: ~o~es 08/17/2004 01:30 PM .... Tmnknolo8y eoe6764051 1/1 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES q00'-']'~t×-fu.~ ~-cBakersfield, CA (/~.~) .~.2.~ APPLICATION TO PERFORM A TANK TIGHTNESS TEST ADDILESS PERMIT TO OPERATE OPERATORS NAME or 'AmC IS PIPING GOING TO BE TESTED TANK #' VOLUME CONTENTS N.'~ME ~ PIqONE ER OF CONTACT TEST METHOD~ NMvlE OF TESTER CERTIFICATION it DATE & TIME TEST IS TO BE CONDUCTED_ [{~ ~,~,,,-1 '. APPR. O V'ED BY F'I..ICANT ,UST Aqenc¥ Name City of Bakersfield Office of Facility Number Chevron Products Company Facility List: Co-Op 3 Party Stations NAME ADDRESS CITY 4/26/2004 STATE ZIP Emergency Serv ces 98109 / 201527 / ..... 203576 /~ 206561 CHEVRON STATIONS INC#i920 1131 OAK ST CHEVRON STATIONS INC.1830 6601 MING AVE CHE~/RON 'STATIONS INC#1842 ~. 1 i 25 COFFEE RD CHEVRON STATIONS INC 1849 3360 PANAMA LN BAKERSFIELD BAKERSFIELD BAKERSFIELD BAKERSFIELD CA 93304-1063 CA 93309-3446 CA 93308-5747 CA 93313-3695 ( iV Chevron Products Company Marketing IdES Permits PO Box 6004, L2375-B3 San Ramon, CA 94583 Tel 925-842-9002 Fax 925-842-9585 cbittle @chevrontexaco.com Charles Bittle HES Permits Chevron April 30, 2004 City of Bakersfield Office of Emergency Services-UST 1715 Chester Ave., Third Floor Bakersfield CA 93301 RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS Please find the following documents enclosed: 1) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron FacilitY List under your jurisdiction These documents meet the financial responsibility requirements for all UST's owned by Chevron and have previously been submitted directly to the State. If you have any questions · feel free to contact me. Sincerely, Charles Bittle HES Permits Enclosure Chew'onTexaco Corporation 6001 Bollinger Canyon Road San Ramon, Ca 94583-2324 Tel 925 842 3232 Fax 925 842 6047 John Watson Vice President and Chief Financial Officer April'30, 2004 Chevron?e×aco UST FINANCIAL ASSURANCE To Whom It May Concern: I am the Chief Financial Officer of ChevronTexaco CorPoration, 6001 Bollinger Canyon Road, San Ramon, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State progrmn by this guarantor: all underground storage tanks owned by Chevron U.S.A. Inc. are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other 'EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure ({}{}264.143 and 265.143) Post-Closure Care ({}{}264.145 and 265.145) Liability Coverage ({}{}264.147 and 265.147) Corrective Action ({}264.101 (b)) Plugging and Abandonment ({} 144.63) 104,080,132 80,555,940 8,000,000 25,849,286 5,130,800 California State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment 212,996 755,681 66,000,000 0 0 April 30, 2004 Page 2 Louisiana State Program Closure 3,577,265 Post-closure Care 867,643 Liability Coverage 1,000,000 Corrective Action 0 Plugging and Abandonment 0 Total 296,029,743 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. April 30, 2004 Page 3 o o 4. 5. 6. 7. ALTERNATIVE II Amount ofannual.UST aggregate coverage being assured by a test and guarantee Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test and guarantee Sum of lines 1 and 2 Total tangible assets Total liabilities Tangible net worth Total assets in the U.S. 8. Is line 6 at least $10 million? 9. is line 6 at least 6 times line 3? 10. Are least 90% of assets located in the U.S.? (If"No", complete line 11 .) 11. Is line 7 at least 6 times line 3? 12. Current assets 13. Current liabilities 14. Net working capital (subtract line 13 from line 12). 15. Is line 14 at least 6 times line 3? 16. Current bond rating of most recent bond issue 17. Name of rating service 18. Date.of maturity of bond $ 2,000,000.00 $ 296,029,743.00 $ 298,029,743.00 $ 81,218,000,000.00 $ 45,175,000,000.00. $ 36,043,000,000.00 $ 30,523,000,000.00 Yes No X X X X $ N/A $. N/A $ N/A $ N/A AA Standard & Poors February 15, 2008 April 30, 2004 Page 4 Yes No 19. Have financial statements for the latest fiscal year been filed with the SEC, the Energy Information Administration, or the Rural Electrification Admihistration? X I hereby'certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana was added to make disclosure more complete. J~ceWats°n President, Finance April 30, 2004 April 30, 2004 Page 5 GUARANTEE Guarantee made this April 30, 2004, by CHEVRONTEXACO CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. ("CUSA"), of 6001 Bollinger Canyon Road, San Ramon, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). 2. Guarantor owns or operates the following underground storage tanks covered by this guarantee--all underground storage tanks owned by Chevron U.S.A. Inc. in the following states: Alaska Arizona California Florida Georgia Hawaii Oregon Texas Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from' the Director shall fund a standby trust in April 30, 200~1 Page 6 ¸6. accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the Operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above- identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course off employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; April 30, 2004 Page 7 (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 30, 2004 CHEVRONTEXACO CORPORATION Vice President, Finance Assistant Secretary April 30, 2004 Page 8 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 4O CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFR part 280 are as follows: Financial test and corporate guarantee of ChevronTexaco Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2004 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2005. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 30, 2004 CHEVRON U.S.A. INC. By~ Se~tcr C~rinsel By Judli:h L. Geisler Legal Analyst Secon~ry Containment Testing R~ort Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner~operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: CHEVRON 206561 Date of Testing: 05/18/04 Facility Address: 3360 PANAMA LANE BAKERSFIELD CA 93313 Facility Contact: TERRI - MANAGER [ Phone: (661) 396-7047 Date Local Agency Was Notified of Testing: 05/14/04 Name of Local Agency Inspector (if present during testing): NONE PRESENT 2. TESTING CONTRACTOR INFORMATION Company Name: Advanced Fuel Filtration Systems, Inc. Technician Conducting Test: BRADLEY S. LARSON Credentials: [] CSLB Licensed Contractor [] SWRCB Licensed Tank Tester: License Type: General A - Haz ] License Number: 769519 Manufacturer Training Manufacturer Component(s) Date Training Expires VISUAL TEST 3. SUMMARY OF TEST RESULTS Not Repairs Not Repair$ Component Pass Fail Tested Made Component Pass Fail Tested Made 87 FILL SPILL BUCKET [] [] [] [] [] [] [] [] 87 VAPOR SPILL BUCKET [] [] [] [] [] [] [] [] 89 FILL SPILL BUCKET [] [] [] [] [] [] [] [] SgVAPORSPILLBUC~T [] [] [] [] [] [] [] [] 91 FILL SPILL BUCKET [] [] [] [] [] [] [] [] 91 vaPOR SPILL BUCKET [] [] [] [] [] [] [] [] If hydrostatic testing was performed, describe what was done with the water after completion of tests: WATER WAS RETURNED TO AFFS CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician: BRADLEY S. LARSON Date: 05/18/04 Technician's Signature: SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes [] Spill/Overfill Containment Boxes are Present, but were Not Tested [] Test Method Developed By: [] Spill Bucket Manufacturer [] Industry Standard [] Professional Engineer [] Other (Specify) TAG Team Specifications Test Method Used: [] Pressure [] Vacuum [] Hydrostatic [] Other (Specify) Test Equipment Used: VISUAL TEST I Equipment Resolution: +/-0.002" Spill ~ucket Manufacturer: OPW - POMECO ~;~!~?~ Spill Box # 87 FILL [ Spill Box # 87 VAPOR I Spill Box # 89 FILL Spill Box # 89 VAPOR Bucket Diameter: 12" 12" 12" 12" Bucket Depth: 12" 12" 12" 12" Wait time between applying pressure/vacuum/water and N/A N/A N/A N/A starting test: Test Start Time: 12:20 12:20 12:20 12:20 Initial Reading (R0: Test End Time: 13:20 13:20 Final Reading (RE): Test Duration: 1 HOUR VISUAL LEAK '1 HOUR Change in Reading (RE-Ri): VISUAL LEAK Pass/Fail Threshold or Criteria: TestResU!t:~. ' ' ... , : : []. Pa~s':,"[]Faii!il :': ['"]~paSs. []Fail ' [] pass [] Fai! ' [] Pass. [] Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) SPILL/OVERFILL CONTAINMENT BOXES Facility is Not Equipped With Spill/Overfill Containment Boxes [] Spill/Overfill Containment Boxes are Present, but were Not Tested [] [] Spill Bucket Manufacturer [] Industry Standard [] Professional Engineer Test Method Developed By: [] Other (Specify) TAG Team Specifications Test Method Used: [] Pressure [] Vacuum [] Hydrostatic [] Other (Specify) Test Equipment Used: VISUAL TEST ' Equipment Resolution: +/-0.002" ' Spill Bucket Manufacturer: OPW - POMECO FILL Box ,~?~,~i~,~ ~,~,,~, ,~ Spill Box # 91 # 91 VAPOR Bucket Diameter: 12" 12" Bucket Depth: 12" 12" Wait time between applying pressure/vacuum/water and N/A N/A starting; test: Test Start Time: 12:20 12:20 Initial Reading (R~): Test End Time: 13:20 13:20 Final Reading (R~): Test Duration: Change in Reading (Rv-R0: 1 HOUR TEST VISUAL PASS Pass/Fail Threshold or Criteria:, ' .~ ~'~: I t~ ~'~ ~i~ Comments - finclude information on relgairs made prior to testing, and recommended follow-ulg for failed tests) March 2, 2004 WAYNE PERRY, 1NC. Environmental Remediation, Construction and Consulting Inspector Steve Underwood City of Bakersfield Fire Dept. 1715 Chester Ave. Third Floor Bakersfield, CA. 93301 SUBJECT: SB 989 COMPLIANCE TESTING AT CHEVRON STATION # 20-6561 LOCATED AT 3360 PANAMA LANE & WlBLE ROD. IN THE CITY OF BAKERSFIELD, CA. Dear Inspector Underwood, Below please find the secondary containment testing results for the above-referenced site. These results are being sent to you per the requirement of SB 989. Included with this submittal are the following: CONTRACTOR: WaYne Perry, Inc.; License No: 300345 TECHNICIAN: Corey J. Sinclair · SB 989 Testing Results & Procedures Components Tested Component Date Tested Type of Test Pass / Fail Manufacturer Performed Regular (87') Vapor Bucket OPW- Pomeco 02/03/04 Hydrostatic Pass Premium (91') Fill Bucket OPW- Pomeco 02/03/04 Hydrostatic Pass If you have any questions regarding the attached results please contact the undersigned at (714) 826-0352. Sincerely, ~ Fgay~ Rodolfo ¥. R'abio Project Manager Attachments - SB 989 Testing Results & Procedures CC: Judy Bowe- Chevron Products Company Sam Stevenson- Chevron Products Company Dealer- Station Manager 8281 Commonwealth Ave. Buena Park, California 90621 Phone (714) 826-0352 Fax (714) 523-7880 SWRCB, January 2002 Page / of__ Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for qll components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner~operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: ~-~~6r/'AO/q ~. ~2x9 --~'g$/' I Date of Testing: tg,-~-oF-- e~,¢[' Facility Contact: MI3c t Phone: Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (ifpresent during testing): 2..TESTING CONTRACTOR INFORMATION Company Name: ~SJ~)~x~ ~-4,~ , Technician Conducting Test: -.{ ~ ~ Z ~ ~ q..r--~.. Credentials: ~/CSLB Licensed Contractor [] SWRCB Licensed Tank Tester Manufacturer Training Manufacturer Component(s) Date Training Expires 3. SUMMARY OF TEST RESULTS Not Repairs Component Pass Fail Not Repairs Component Pass Fail Tested Made Tested Made 0 0 O' O 0 0 0 O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O' 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 If hydrostatic testing was performed, describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's Signature: Date: ~> ~--~'= ~ ~::' ~' · SWRCB, January 2002 Page 2 of ~ 9. SPILL/OVERFILL CONTAINMENT BOX~ES FaciliW is Not Equipped With Spill/Overfill Containment Boxes [] Spill/Overfill Containment Boxes are Present, but were Not Tested Test Method Developed By: [] Spill Bucket Manufacturer x~//~Lndustry Standard [] Professional Engineer [3 Other (Specify) Test Method Used: [] Pressure [] Vacuum ~ydrostatic [] Other (Specify) Test Equipment Used:/34j~ 6[~J(/k (.j~Lp(j . -J~0Jffl¢3~ ~'~?T)~ CJA,zoq ~,-:~' I Equipment Resolution: ~ ~~ ? S ill ..... Bucket Depth: Wait time between applying f pressure/vacuum/water and starting test: Test Start Time: Initial Reading (R~): Test End Time: Final Reading (R~): Test Duration: Change in Reading (RF-Rx): ~:~. Pass/Fail Threshold or Cdte~a: Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) Sec°hdary Contain~nt Test Panel Test Parameters Test Status Function Menu Test ~Site ;Status Chevron i ~S~i~ig-i'~. .... i' Pass!_F,a~I Restart [ 3360 Panama Ln. Change Bakersfield, CA 99999 i0.00007 SaveI Return J Product ............ 187b Vapor Bucket j~ Test Results Type le.~843-: iiii ii!! "' " · ~Tank Sump. Fill I I Ill IIII ~ , Test Start Time I l l lli ',III .... [Tue, Feb 03, 2004 9:54 AM } I 16.3842- IIIIi. l', ',', t Test End Time. t · ,,,,, ,,,, , .... . ............. ._ ..... ~-_~__ . , Feb 03, 2004 10:06 AM J i e, ls.3a41 .......... -tt-PP--H-H----- ............. -- ..... ~--~-- Length (lin) Limit (in) ~ -~ ......... -HWP--H-FF ..................... ! ~' ........ u...~j~: ._~__j_::! ~ --- --- ' i~2 I looo~o 1" " '"""" --~-- ' · Test Result I ...... ,,,,~ ~,, ~, 16.3840---: ...... ~-~ ................. / ........... imest passed. I i ......... '-~--~ ................. ~ ....... :;-- , ......... -I-FI-F--H-W ................. ~ .......... Comments '. ......... -PH-P-WWt- ............. , .... ~ .......... - .... ~-----H-H-- H-t-H- ............ -I----~---~- ....... " 16'3839-r :: 'r r 09:54:48 AM 09:57:00 AM 10:00:~0 AM 10:03:00 AM 10:06:48 AM i 02~03~2004 02~03~2004 0210312004 02~03~2004 02~03~2004 Test Time Secofidary Containq nt Test Panel Test ,Parameters Test Site 3C3heVron 60 Panama Ln. Bakersfield, CA 99999 Product i91 Fill Bucket Type lTank Sump Fill Test Start Time ,Tue, Feb 03, 2004 10:12 AM Test End Time ITue, Feb 03, 2004 10:24 AM Length (min) Limit (in) 0.0020 Test Result iTest passed. Comments Test Status Status fSa~i~g..~ Change Pass/Fail Test Results 13.972; 13.9727- 13.9725- 13.9724 10:12:11 AM 02/03/2004 10:15:00 AM 02/0312004 10:18:00 AM 02/03/2004 Test Time Function Menu Restart] 1 Abort1 'Save Return 10:21:00 AM 10:24:11 AM 02/03/2004 02/03/2004 D June 10,2004 Chevron 3360 Panama Lane Bakersfield, CA 93313 FIRE CHIEF ~O,'q FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661 ) 852-2170 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 852-2170 PREVENTION SERVICES FIRE SAFETY SERVICES · ENVHIONMENTAL SERV1CES 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 . VOICE (661) 326-3979 FAX (661) 852-2171 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 852-2172 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Dear Sir: Our records indicate that your annual maintenance certification on your leak detection system will be past due on 05-23-04. You are currently in violation of Section 2641(J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days to either perform or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/db Mat:l 14. 04 11:3S~ , Flavored Fuel Fil~r-~ion A_ DVANCED...FUEL FIL TRA TION TESTING NOT!,F,.ICA TION ~.C.a. lifolllia Corporate Office 1451 Magnolia Corona, CA 92879 9O9-520-9270 714-476-4587 Cell 909-520-9275 Fax TO: Ralph Hue~/- I~akefsfield Fife Dept TELECOPY NUMBER: 661-326-0576 FROM: Judy Bowe ,, , .... DATE: 5/1412004 TIME; 1130 NO. OF PAGES INCLUDING COVER: 1 ORIGINAL TO FOLLOW: NO COMMENTS: Advanced Fuel Filtration will be at the following locations: I D~;.£ I "=-- I ,.',i' S,.E,,,,--O ^OD~ES$ I ~=ST.~'.E 5118/04 1100 CHEVRON 206561 3360 PANAMA LANE MC SP OKT$ Advanced Fuel Filtration - Leaders in UST Environmental Testing CONFIDENTIALITY NOTICE - This message is inten(~ed for thc use of the individual or entity for which it i~ addres,~l and may contain information that is legally privileged, confi0ential, and exmt~pt from disclosure. If the reader of this messaage is nol the intended recipient, you are hereby notifiedthat any dissemination, distribution, or copying of this communication is stdctly prohibited, If you received.. this communication In error, please notify us immediately by t~,!ephone to arrange for the relum of the original material. CHEVRON USA CSI--1849 $860 PANAMA LANE BAKERSFIELD CA.9880~' SS-28651PH--896-7047 FEB 25, 2004 11:22 AM SYSTEM STATUS REPORT ALL FUNt,.TION~, I IqVENTORY REPORT T I:SUPREME VOLUME = 5151 GALS ULLAGE = 6698 GALS 90% ULLAGE= 5518 GALS TC VOLUME = 5145 GALS-- ' HEIGHT = 52.75 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 61.4 DEC F T 2 :PI. US VOLUME = 2783 GALS ULLAGE = 9066 GALS 90% ULLAGE= 7881 GALS TC VOLUME = 2980 GALS HEIGHT = 84.19 INCHES, WATER VOL = t GGL~ WATER = 0.00 ~;HES TEMP = 61.1~ F T 3:UNLEADED VOLUME = 5116 GALS ULLAGE = 6730 GALS 90~ ULLAGE= 5545 GALS TO VOLUME = 5114 GALS HEIGHT = 52.49 INCHES WATER VOL = 11 GALS WATER = 0.8~ INCHES TEMP = 6~,4 DEG F FACILITY NAME CITY OF BAKERSFIEI~D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAl, SERVICES UNIFIED PROGRAM INSPECTION CItECKLIST 1715 Chester Ave., yd Floor, Bakcrsticid, CA 93301 O.~q~-.\/ ~ O,'k3 ...~...'('X]ICC ....~d'v'l INSPECq'ION DATE Section 2: Underground Storage 'ranks Program Routine ~ Combined ~ Joint Agency [21 Multi-Agency [2i Complaint Type of Tank '~ Lk~ ~ Number of Tanks Type of Monitoring O_.L. ~ Type of Piping Re-inspection OPERATION C V COMIMENTS Proper tank data on file "/-,.I Proper owner/operator data on file Pcnnit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on tilc with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? Pink - Business Copy ,.f'~ Sit([ld'spo~ s itble ~a,'ty UNIFIED PROGRAM I~NSPECTION CHECKLIST SECTION I Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: {661)326-3979 FACILITY_NAME INSPECTION DATEINSPECTION TIME ..... c ............................................. ADDRESS PHONE No. No. of Employees FACILITYCONTACT Business ID Number 15-021 - Section 1: Business Plan and Inventory Program [] Routine ~ Combined [] Joint Agency I'1 Multi-Agency [] Complaint i"l Re-inspection C V ( C=Compliance '~ OPERATION 'COMMENTS \ V=Violation / [] APPROPRIATE PERMIT ON HAND [] BUSINESS PLAN CONTACT INFORMATION ACCURATE ~ [] VISIBLE ADDRESS [~ [] CORRECT OCCUPANCY [] {~ VERIFICATION OF INVENTORY MATERIALS ~ [] VERIFICATION OF QUANTITIES ~ [] VERIFICATION OF LOCATION ~' [] PROPER SEGREGATION OF MATERIAL ~ ~ VERIFICATION OF MSDS AVAILABILITYE ~ [] VERIFICATION OF HAT MAT TRAINING '~ [] VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~1~ {~ EMERGENCY PROCEDURES ADEQUATE ~. [] CONTAINERS PROPERLY LABELED ~, [] HOUSEKEEPING ~ [] FIRE PROTECTION ~1 [] SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: [] YES [] NO EXPLAIN: ~-~-~~~QuEsTIONS REGARD~G THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 .Z_~_~(/i ~ Badge No, '- B~siness~ite Re.~onsible Party White - Environmental Services Yellow - Station Copy Pink. Business Copy · Complete items 1, 2, and $.~Also cdmplete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can tatum the card to. you. a Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: 3hevron 60 Panama Lane akersfield, CA 93304 2. Art{do Number (Trensfer from sew/ce labe/) Ps Form 3811, August 2001 [] Addressee e.'~e~,eu2y.,(~nt~ ~~,~). I c. ~ o~ Do~iv~ D. ~ ~N~ ~d~ d~m~ ~m ~m ~? ~ Ye8 ~ YES, e~er delive~ add~ ~low: ~ N0 3. Service 3ype  Certlfled Mail ~ M~I ~ R~I~ ~ R~m R~ for M~handl~ ~ In~ M~I ~ C.O.D. ~ 4. Restricted Delivery? (Extra Fee) [] y~ 2260 0004 7~652 2785 } Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE IIII First-Class Mail Postage & Fees Paid usPs Permit No. G-10 Sender: Please print your name, address, and ZIP+4 in this box ° Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite $00 Bakersfield, CA 93301 Postage Certified Fee Return Reclept Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Posta~~ Postmark Here Chevron ocPooox~, 3360 Panama Lane "~:'~*:~ Bakersfield, CA 93304 Certified MailJ~vides: · A mailing receipt (es~e~)~ cunt' 'Oce~ u~od Sd. · A unique idantifler;.~or your mallplece "'~ · A record of delivery kept by the Postal Sewlse for two years Im _l~orfent Reminders: · Certified Mall may ONLY be combined with Firet. Class Mall® or Prlodty Malle. · Certified Mall Is not available for any class of Intemaflonal mall. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mall. · F. qr an additional fee~a Return R. eceigtmay be requested to provide proof of collvery, lo obtain Return Heceipt service, p~ease complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee.. Endorse mallplece "Return Receipt Requested". To_rec~..ive a fee waiver for a ouplic~, te return receipt, a USPSe postmark on your c;ertified Mall receipt is requlrea. · For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mallplece with the endorsement "Restricted-Delivery", · If.a postmark o.n t.h.e Ce. rtifled Mall.receipt is desired,please pre_sent the arti- cle at the poet onice mr postmarmng. If a postman( on the [;ertified Mall receipt is not needed, detach and affix label with poetage and mail. IMPORTANT: Save [his receipt and present il when making an inquiry. nternet access to oelivery information is not available on mail addressed to APOs and FPOs. D FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES · ENv[qoNMENTN~. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-o576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 December 12, 2003 CERTIFIED MAll. Chevron 3360 Panama Lane Bakersfield, CA 93304 RE: Propane Exchange Program Dear Owner/Operator: The purpose of this letter is to advise you of current code requirements for propane exchange systems, such as "Blue Rhino" or "Amerigas." This does not apply to large propane tanks, only propane exchange systems. Over the past two years this office has noted a dramatic increase in the propane exchange system in the city of Bakersfield. It has also been noted, with great concern, that many of these installations are a clear violation of the UFC (Uniform Fire Code) and represent a danger to public health and safety. Accordingly, procedures for storage of propane cylinders awaiting use, resale or exchange, have been adopted through BMC (Bakersfield Municipal Code) and adoption of the 2001 UFC. The procedures are as follows: Storage outside of building for propane cylinders (1,000 pounds or less) awaiting use, re-sale, or part of a cylinder exchange point shall be located at least 10 feet from any doorways or openings in a building frequented by the public, or property line that can be built upon, and 20 feet from any automotive service station fuel dispenser. (Note distance from doorways increases when cylinders are over 1,000 pounds cumulatively.) Cylinders in storage shall be located in a manner which minimizes exposure to excessive temperature rise, physical damage or tampering (Section 8212, California Fire Code, 2001 Edition). When exposed to probable vehicular damage due to proximity to alleys, driveways or parking areas, protective crash posts will be required as follows (Section 8001.11.3 and 8210, California Fire Code, 2001 Edition): 1) 2) Constructed of steel, not less than 4 inches in diameter, and concrete filled. Spaced not more than 4 feet between posts, on center. To: Owner/Ol~rators of Propane Exchan Re: Propane Exchange Program Dated: December 12, 2003 Page 2 of 2 3) 4) 5) Set not less than 3 feet deep in a concrete footing of not less than a 15 inch diameter. Set with the top of the posts not less than 3 feet aboveground. Located not less than 5 feet from the cylinder storage area. Exceptions: Cylinders storage areas located on a sidewalk which is elevated not less than 6 inches above the alley, driveway or parking area, with not less than 10 feet of separation between the curb and the cylinder storage area. "No Smoking" signs shall be posted and .clearly visible (Section 8208, California Fire Code, 2001 Edition). Resale and exchange facilities must be under permit to verify compliance. All existing facilities will be checked and when compliance is confirmed, a permit will be issued. All new propane exchange systems must be permitted prior to installation. You will have 90 days (March 4, 2004) to comply with the procedures outlined. Once compliance has been confirmed, each exchange system will be issued a permit, which will be placed on the exchange system. Sites not conforming to current code, will be "red tagged" and must be taken out of service immediately. You should contact your Blue Rhino representative, Mr. Taylor Noland, or your local Amerigas representative. They are aware of current code requirements. If you do not have a propane exchange system, please disregard this letter. Should you have any questions, please feel free to contact me at (661) 326-3190. Steve Underwood Fire Inspector/Petroleum/ Environmental Code Enforcement Officer SWRCB, January 2002 Secondary Containment Testing Report Form This form Is intended for use by contractors performing periodic testing of UST secondary containment .systems. Use the appropriate pages of this form to report results for all components tested. ;Tie completed form. written test procedbre$, and printmtts from testa. (if applicable), should be provided to the facility owner/operator for zTtbmittal to the local regulatory agency. *' 1. FACILITY INFORMATION .'Facility Name: CHEVRON 206561 t Date of Testin$: 7-23-03 Facility Address: 3360 PANAMA LANE, BAKEI~Fm. LD CA 93301 Facility Contact: CLERK I Phone: 661-396-7047 Date Local Agency Was Notified of Testing: 7-18-2003 Name of Local Agency Inspector (ifpresent during testing): NONE 2. TESTING CONTRACTOR INFORMATION Company ~ Advanced Fuel Filtration Systems, Inc. Technician Conducting Test: IASON HERMOS~ Credentials: [] CSLB Licensed Contractor [] SWRCB Licensed Tank Tester License Type: General A - Haz ] License Number: 769519 · - Manufacturer Traininn Manufacturer Component(s) Date Trai~iag Expkes INCON SUMMARY OF TEST RESULTS' Component Pass Fall Not Repairs Tested Made Component Pass'Fall Not Repairs .... Tested .87 FiLL SPILL BUCKET '[] [] [--] 1,3 ......... [~ ['-] ['-7 [-7 87 VAPOR SPILL BUCKET [] [] .[] [' I I ~[] [] [] 9~ vAPoR SPILL BOC~T [] .~ I--I [] -- -- ...... I2:[] a3 [] 7 If hydrostatic testing was performed, describe what was done with the water after completion of tests: WA'rm< WAS RE'fURNED TO ADVANCED FUEL CERTIF/CATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTI[NG To the best of my Imray,ledge, the facts stated in this document are accurate and in full comp~ance with legrtl requirements Technician: JASON HERB4~OS.!LLO Date: 7-23-2003 Signature: Original ,han,,d ,written signature on hard copy test report f'de in AFFS oflice~ Corona~ C~ SWRCB, Sanuary 2002 SPILIdOVlgRFILL CONTAINMENT BOXES Spill/Overfill C?t ', ,a~ment Boxes are Present, but were Not Tested [] Test Method Dgveloped By: [] Spill Bucket Manufacturer [] Industry Standard [] Pro'fe~nal Engine -. [] oth . Test Method Used: [] Pressure [] Vacuum [] Hydrostatic ,Cf ,,Test Equipment Used: 1NCON''' [ Equipment Resolution: +/-0.002" Spill Bucket Manufactm~: OPW POI~tECO ~...,.':~,':~?i~'.a ~:.,. ;~..b~"'~:"'::' .'~'~' ~':': ....; .:~ .... i.~¥!i~'O¢~¢.'~... ~:,.~ ..".':'~'c. ~:,, ~.~:' ~'pili Box # 87 PILL Spill Box # 87 FILL Spill Box # 87 vAPoR Spill llox # 87 VAPOR B.ucket DiatomS: ..... 12" 12" 12" 12" Bucket Deplh: 12" 12" 12" 12" Wait time between applying ......... pressure/vacuum/water and ~ Mllq S MTN 5 lVllN S starting test: Test Start Ti~e: .'.' 12:19 PM ~2:37 PM Initial Reading (Rx): .893S .8932 VISUAL FAILURE Test End Time: 12:3~ PM 12:52 PM Final Reading (Ri,): .8926 .8934 Test Duration: 15 ~ .......15 MIN 1S MTN I$ Change in Reading (RrR0: -,0009 +.0002 Pass/Fail 'lT~-¢~hold or Criteria: ~:/-0.002" +/-0.002- +/-0.002- +/,0.002~ · .TestRes~flt:.? ".:'...:.:'.?:!.v.?..::'- -:::!:~/~i~..:i,!;,~!::F~l!!??[!.~.i.i.~,~!~t~:.i;!!.i..~!Fnii~:~:: .....:.. :.: ....... ..,.....:-, ., .,..... Comments .,,fi.,w. lude itFformation on repairs m~de prior to testing, and recommende_4 foliow.ui~ for. fatled tests) SWRCB, January 2002 SPILL/OVERFILL CONTAINMr. NT BOX~'..~ Facility is Not Equipped With Spill/Overfill Containmen[ ~o---x~s ~]- .... ' ..... Spill/OvediH C. qn.tainment BOxes are Present, but were Not Tested [] Test Method Developed By: [] Spill Bucket Manufacturer []~nd~ Standard [] Professional Engine Test Method Used: [] Pressure [] Vacuum [] Hydrostatic .... Other CSpec ) Test Equipment Used: INCON [ E ui ment Resolution' +/-0.002" Spill Bucket Manufacturer: OPW POMECO Bucket Diameter:__ , , 12" 12" 12" 12" Bucket Depth: 12" 12" 12" 12" Wait time between applying pre~'ure/vacuum/water and 5 MIN 5 MIN ~ MIN ~ MIN starting test: Test_Start T'.~:.. 12:02 PM 12:19 PM 12:02 PM t2:19 PM Initial Reading (R0: 2.4942 2.4805 1.9723 1.9643 Test End Time: 12:17 PM 12:~$ PM .... 12:17 PM 12:$~ PM Final Reading (R~,): ..... 2.4934 2.4801 1.9716 .......... 1.9637 Test Duration: 15 MIN 1~ MIN 15 MIN 1~ MIN Change in Reading (Rv-K0: .......... -.0008 -.0004 -.0007 -.0006 Pass/Fail Threshold or Criteria: +/-0.002" +/-0.002" +/-0.002" +/-0.002" Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) e SWRCB, lanuary 2002 . SPILL/OVERFILL CONTAINMENT BOXES Facili~ is Not EquiPPed With Spill/Overfill Containment Boxes [] ' .... Spill/Overfill Comainment Boxes are Present, but were Not Tested [] ..... Test Method Developed By: [] Spill Bucket Manufacturer [] Industry Standard [] Professional Engine ,-. ,, ,, [] ot~er Test Method Used: [] Pressure [] Vacuum [] Hydrostatic [] o~er Test E~ip~ant Used: INCON [ .Eguipm~nt Resol,,u,~,?n: +/-0.002" Sp~ Bucket Manufacttm~: OPW POMECO Bucket Diameter: 12" 12' 11' 12" Bucket Depth: 12" Wait time between applying pressure/vacuum/water and 5 starting lest: Test ~tart Time:.. , ....... 12:02 PM 12:19 PM Initial Readint] (Ri): 2.4449 2.4421 Test End Time: 12:17 PM 12'.35 PM Final Reading (RF): VISUAL FAIL ....... 2.4435 2.4415 Test Duration: Change in ..l~a, ding (Rv-l~): =.0014 -.0006 Pass/Fail Threshold or Criteria: -~/-0.002" +/-0.002" +/-0.002" +/-0.002 Comments - ~nclude information on repairs made t~or to testing, attd recommended follow-up for failed t BSSR, Inc. 6630 Rosedale Hwy., # B, Bakersfield, CA 93308 Phone (661) 588 Fax (661) 588-2786 MONITORING SYSTEM cEfiTIFICATION· This. fo~'rn must be-used ~to document testing and servicing of mohit°ring equipment. A separate certification or report must prepared for eacl:/'~oni.to, ring system control panel by the technician who performs the work. A coPY of this form must be provided to the tank system owner/operator. The'owner/operator must submit a copy of this for~ to the local agency regulating UST 'systems within 30 days of test date. ". ' :' '::.. : % :A. General Information · '.. Bldg. No.: City: _Bthl zip: ..q%%O Facility Contact Person.-' . Contact'Phone No.: ( 66 [ ) Make/Model of Men/toting 'System: ' --" --/0 ~)q,g.2qO '- 022 .._ D,~e of Testing/serVicing: 5O B. lnventory0fEquipmentTested/certffied:." Check the appropriate boxes to indicate specific equipment inspected/serViced:. ' ~n-Tank,'Gauging Probe. ' .... . Model: ": ' ' .. [ li~n-Tanl~'Gadging Probe. Model: ~'rAnnular Space or Vault Sensor. Model: . ' ~ {~"nnUlar Space'0ffVaUlt Sensor. Model: .B~_iping Sump / Trench. Sensor(s). Model: .~ifl,t %~%.q ~. !i · [W'grjping Sump'/TrenchSensor(s). Model: ~'~lechanical Line Leak Detector. Model: iZ[r~ ,j ac [iYMechanical Line Leak Detector.......':M0del: El Electronic Line Leak Detector, . Model: 121 Tank Overfill I High-Level Sensor. Model: D Other (specify equipment type and model inSeetion E on page 2~- Tank ID:' {J'~.} ~_ ~'~ ~)[ ;_ L.~ ' . lil~Tfi-Tank Gauging Probe. Model: ~nnular Space or Vault Sensor. Model: ~ ?leP ing Sump / Trench Sensor(s). Model:~q'q3 80 "_~ fi'~ 1 Sump Sensor(s). _ ..... Mod~l: ~iqq-~ chanieal Line Leak Detector. Model: ~Z.~'I2~ C! Electronic Line Leak Detector. Model: -: '~ ' ri Tank Overfill / High-Level Sensor. Model: .......~1 Other (specify equipment.. ~t~.e, ,.. and model in Section,~ ,, E...,.eh Page 2). . DenserID;- ispenser Containment Sensor(s). Model:~:qq .~0 ' -~,_~'~" ~i~Shear Valve(s). 121 Dispense[.C~tajnmen~ Float(~). and Chain(s).' senserID: ~ ~ . . . . ispenser Containment sensor(s). Model: hear Valve(s).. IZI Dispenser Cgntainment Float(s) and chai,n,(s).. , Dispenser ID: 121 Dispenser Containment Sensor(s). Model: ~ Shear Valve(s). 121Dispenset C.0_.n_ !..a..!nment Fig.at(s) and Cha!nls). . 121 Electronic Line L~ak Detector. Model: / I21 Tank Overfill / High-Level Sensor. Model: D Other (speCify equipment type and model in'Sectign E on Page 2). Tan k' ID: ' ::!:ii.. ":~ F1 In-Tank Gauging Probe. Model: ~1 Annular Space or Vault Sensor. Model: t21 Piping Sump / Trench Sensor(s). Model: [3 Fill Sump Sensor(s). Model: [3 Mechanical L, jffe Leak Detector. Model: IZl Electronic ~,ih, e Leak Detector. Model: ~ Tank Overffil'fHigh-Lev,el Sensor. Model: ~ Other (speei~ ~ipment type and model in Dispenser ID: _ ~'~[)ispenser Containment Sensor(s). Model: Ill'~hear Valve(s). 13 Dispenser Containment Float(s) and Chain(s). Diso;nse iD: ' hiSpenser Containment Sensor(s). Model: ear Valve(s). ~ .D.!spen~cr Containment Float(s) an,d' Ch.a.!n(s). '-DiSpenser ID: E! Dispenser Containment S~nsor(s). Mc~deI: E! Shear Valve(s). [21 Disp, enser Containment Float{s) and Chain(s}. se..~.t!?n ~ ;n Page 2); *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I ,xrtify that 'the equipment identified ia this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers* checklists) necessary m verify that this information is correct and a Plot Plan showing the layout Of monitoring equipment. For any equipment capable of generating such reports, I have also attache~.d~_ copy of the report; (check all that apply): D S sy_~esn set, up ~ ~ Alarm history report Teclmician Name(print): certification No.: ,,, 555- Te.sting Company Name: . Site Address: {-.%65~ (2) Page I of 3 03/01 Monitoring System Certification D; R~sults of Testing/Servicing SSftware Version Installed: .' i th. C) bg~ Corn alete the following checklist: , ... operat~o.nal? ~ Qe.$' [] No* Is'the visual alarm operatio, nal? .... - ' ~.Yes [] No* Were 'all. sensors visually inspected,' ~.n. etion..a!!y tested, and confirmed operational? ' ' [~Yes [] No* Were all sensors installed at lowest Point of secondary containment and positioned so that other equipment will <.. not interfere with their proper operation7 --' . O Yes" []'.No* If alarms are relayed to a remote monitoring stati0n;..;is' all communications equipment (e.g. modem) For.,. ,P.r.~e, ssurized piping systems, does the turbine automatically shut doTM'if the pipin~ secondary containment [] .?/A mOmtoring system detects a leak, fails to opera, te.; or is electrically disconnected? If yes: which sensors initiate ' pos/five Shut-down? (Check all that~apPly)< 5VSump/Trendh Sensors; ~:~l~Dispenser Containment Sensors. Did y. 9u .confine. positive shut-down due to leaks and sensor f.ailure/diS¢on~nection? gl~es; r-I No. ~Yes {3' No* For tank systems that utilize the n~onitoring system as the primary tank overfill warning device (i.e. no ~ N/A mechanical overfill prevention valve is installed),'.is ~the.overfill warning alarm visible and audible at the tank fill point(s) and operating Prb. porly? If so, atwhat percent of tank ~apacity does;..the a~]a_rm,trigger? ~ t~) % yeS, I~i'.No Was any monitoring equipment replaced? If yes, identify specific sensors; probes, or other equipment'replaced ., ..... ' ,and list the manufacturer name and model for ail r~placement pa~t~,s in Section, E_~, below. ' -. _.YES* ~il. NO Was liquid found inside any secondary .containment. Systems:d~igned as dry systems? (Check all, that apply) ': .'" ~.:':, ~:'i~ ~.Product; {2 Water, I/yes, desen'be iCauses in SectionE, ibeld&/ .. I~Yes 13""No* ,Was monitoring system set-up reviewed to ensur~ p.rop.e.r settings? Attach set uP re(om, ifapPiicable .' ~yeS ~ ..No, ... Is an mom'toting equipm, ent operafiOn.a!.per,m, ~ufaq.turer's spic,fi. Cations?. * In Section E below, describe hOW and When' these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03/01 In-Tank Gauging / SIR Equil ~' [] Check this box if tank is used only for inventory control. [] Check this box if no tank gauging or SIR equipment ii installed. Tl~s section must be completed if in-tank gauging equipment is used toperform leak detection monitoring. ~'Y'[§ ~i Cl No*:". H_a~ all in~ut wiring'been ~spected for proper entry and termination,' including t'esfing for ground faults? ' :~Yes tn No* Were all tank gauging pr0~es visuall~ inSpected for.dam. ~age and residu~ buildup? "' ~ :~Yes tn No* Was accuracy of system product level readings teStedTs " ~Yes icl No* Was accuracy °fsystem water level readings,tested* ~Yes :tn .No* Were ail probes reinstalled.properly?. ' 1~i Yes tn No*' Were all items on the equipment manufacturer's maintenance checklist co~npleted? ' ':~ ~ ...... ' . '"~ ~ . ' ..... , , , .., ....... ,, , ,,,, ,,, * Inthe Section H, below, describeh6w and when these deficiencies were or will be'corrected~ ~ ) G~ Line Leak Detectors (LLD: ~. 121 Check this box if LLDs are not installed. '~ .... Corn }lete the following checklist:- ' ~' tn N/A (Check all that apply) Simulated leak rate: 4~ g.p.h.; ~ 0.1 g.p.h; 121 0:2 g~p.h, {~!~res''' Cl No* Were all LLDs ~0~ed operational a~d accurate within regUlatory requirements? " ~'Yes 2 121 No* Was the testing apparatus properly cah'brated? I~l~Yes ~ No* For mechanical LLDs, does the LLD r~'strict product flow if it det~cts a leak? : IZI N/A '121 Yes ~ No* For electroni~"LLDs, does' the ~urbine autom;tically shut offifthe LLD detects a l~ak? {g N/A CI .'Yes ,.{21 I~o* Fo; ele~troni~ LLDs, does the turbi~'e automatically shut Off if'any portion of the'm~nitoring system is disabled I~i N/A ' ' .... .~" or disconnected? FI yes ~ No* 'For electronic LLD'S} does the turbine .automatically shut:"off if any Portion of the monitoring !systgTM ~ N/A malfunctions or fails a test? ' ' '"121 Yes..:. ~ i51o.*.. For electronic LLDs, have all accessibl; wiring connections bee~n v. iSually inspected? 12~yes r'l~ N0,,.,~ :Were all items.on the equipment manufactur~r'i~'maintenance checklist completed? .......... * In the SectiOti'H,~bel0w, describe'how and when these defieienci~.~ere or will be corrected. H. Comments: Page 3 of 3 Moni~tosing System Certification UST Monitoring Site Plan Site Address: ~'~"~)60 ¢~¢~b'3~'-'~_1~ i~, L-tM .. .:':' '... :4 ..................... . ................ "'"I" ~. :::::: :. :::: :"'::: :':: :~.TORE:::::: :'::::::::::::: i:l: ========================================================= ~... .... ~~ ....,~~-.... ~...... .................... ~. ' ~ t ...... .:-¥' ~' . ................... ""~'"' ........... Date map was drawn: Instructions If you already have a .diagram that. shows all required information, you may include it, rather than this page, with your Monitoring System :Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sUmps,. dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors;, and initank liquid level probes (if used .for leak detectic~n). In the space provided, .note the.date this Site Plan was prepar~ed. Page __ of __ 05/00 JUN ~ D"" Postage $ i:~ Ceffifled Fee Pos'm~k Return Reclept Fee (Endomement Flequlmd) Hem t-"l Restricted Delivery Fee L.r) (Endorsement Required) Total Postage & Fees :~ c~ l Sent To ~-~ I ~t~_z ............... r,- '~'K~.~ .......... '; [o.~.~..~.~.~ ........... ~.~....~.......~.~...?...! ................ Certified I~giLProvides: ~,~ · A mailing~ (es~e,~/) ~oo~ eunl' '~o6S u~Jo=l Sci · A unique Id~r for your mallp[ece ? · A record of delivery kept by the Postal Service for two years? Important Reminders: · Certified Mail may ONLY be combined with First-Class M,.'.~ile or Pr or ty Mail®. · Certified Mail Is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mall. For valuables, please consider Insured or Registered Mail. · For an additional fee, a Return Receiptmay be requested to provide proof of delivery. To obtain Return Rece pt service, please cbmplete and attach a Return Receipt (PS Form 3811) to the article and add aPPl cab e postage to cover the fee.. E..ndo. rse .mailplece ".Retu..m_R__eceipt Requ.ested". To receive a fee waiver for a oupl~c,ate return receipt, a u~P'~:ie postmark on your Certified Mail receipt is requlreo. · For an additional fee delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted'Delivery". · If a postmark on the Certified Mail rece pt Is desired, please present the arti- cle at the post office for postmark ng If a postmark on the Certified Mail rece pt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. · Complete items~l, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we ca~,~ return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: BRUCE CARPENTER CHEVRON #206561 3360 PANAMA LANE BAKERSFIELD CA 93304 2. Article Number (Transfer from service labl . 7002 3150 X ~ / Y/¢ ~/~/)// [] Agent %~ ./.~ Y ~~"~ DAddressee D. Is d~ive~ add~s'different f~m~em ~? ( ~ ~es -- If YES, enter delive~ address below: ~ No 3. Service Type ~'Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 0004 9985 4155 PS Form 3811, August 2001 Domestic Return Receipt 102595.02-M-1540 Posta~ge & Fees Paid USPS Permit No. G-lO · Sender:Please print your name, address, and ZIP+4 in this box · Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 June 5,2003 Bruce Carpenter Chevron #206561 3360 Panama Lane Bakersfield Ca, 93304 CERTIFIED MAIL FIRE CHIEF ~ o D,i ~ P. AZ E ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661),326-3941 FAX (661) .395-1349 PREVENTf~N SERVICES FIRE SAFE'Pr SERVICES · ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 9'3.301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Failure to Perform/Submit Annual Maintenance on Leak Detection System at the above stated address. Dear Business Owner: Our records indicate that your annual maintenance certification on your leak detection system was past due on May 22, 2003. You are currently in violation of Section 2641(J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days, July 5, 2003, to either perform or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/rs T n olo 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 ~ Date Printed and Mailed: 06/02/2003 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 05~23~2003 Order Number: 3129144 Dear Regulator, Enclosed are the results, of recent testing performed at the following facility: CHEVRON 206561 3360 PANAMA BAKERSFIELD, CA. 93304 Testing performed: Leak detector tests Monitor Certification Sincerely, Dawn Kohlmeyer Manager, Field Reporting Tan ax: TA, K,OLOG¥ CERTiFiCATE OF TEST ,G 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 05~23~03 WORK ORDER NUMBER: 3129144 ., CUSTOMER PO: 4623662 CLIENT: CHEVRON U.S.A. SITE: CHEVRON 206561 P.O. BOX 2292 3360 PANAMA 145 S. STATE COLLEGE BLVD. BAKERSFIELD, CA 93304 BREA, CA 92822-2292 JUDY BOWE MANAGER (714)671-3214 (805)555-1212 TEST TYPE: TLD-I Product Pipe Tightness Test Results ~ ID~ ~:~ ~:~!: :%~=~0~C:~==~? ........ i~ ~MA~RI~'~ '~ ~EE ........ ::::::: I~I~:~::~ ~i~:.~=:,,.: ::~,~ ': ~:.~: ~ 89 I PLUS DW FIBERG PRESS~E 87 2 REG ~E~ DW FIBER~ PRESS~E 92 3 SUPR~ DW FIBER~ PRESS~E Existin~ Line Leak Detector Test :~:c:::: ~'~";?~y~?~?~,~?~:~ ~~RER :~: .'Mo~rEE~ :: :'::SERI~g:,.~ R~SOET~ M~:U~U~E~} ~;~ MODEL# ~ :: ~SERI~'~ 89 i FE PET~O FXlV 10401-8864 P 87 2 n/a P 92 3 FE PETRO n/a P New Replacement Line Leak Detector Test ~ ~ ~:~?~ ~/~ ~[<~;~<REP ~GED LEAK DE~CTOE~J~: :'~ ~: ~: :::: ~ ~ ~:~ "~ REP~CED LEAK DET :~TOR~ For o~cr detailed r~oA info~ation, visit ~.tanknolo~.com and select ~-Linc R~oAs-W~, or contact your local Tanknolo~ o~cc. Tester Name: RICHMOND PHILLIPS Te~nician Ce~ifi~tion Number: 91-1071 Printed 06/02/2003 08:43 KOHLMEYER INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/23/03 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER:3129144 CLIENT:CH~Wv'~ON O. S .&. AUSTIN, TEXAS 78757 (512) 451-6334 SImE:Ctl~v~ON 206561 Tank ID: 89 1 Product: PLUS Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: DW FTS,~t~; COMMENTS Tank manifolded: NO Vent manifolded: No Vapor recovery manifolded: Overfill protection: YEs Overspill protection: Installed: A~; CP installed on: ! Bottom to top fill in inches: 168.5 Bottom to grade in inches: 176.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DOAL Stage II vapor recovery: ]~T.~C~ Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: End (in) Bubble Ullage NOT TESTED COMMENTS New/passed L.D. #1 Make: ~;~ ~ZT~O Model: S/N: Open time in sec: ¢. oo Holding psi: Resiliency cc: zoo rest leak rate mi/m: ~sg. o Metering psi: Calib. leak in gph: 3. oo Results: Failed/replaced New/passed Failed/replaced L.D. #1 L.D. ~2 L.D. ~2 NOT TESTED COMMENTS Material: DW FZ 2S~'~ ............................................ I Diameter (in): Length (It): Test psi: Bleedback cc: Test time (Tin): Start time: End time: Final gph: Result: Pump type: Pump make: NOT NOT NOT NOT TESTED TESTED TESTED TESTED PRESSURE FE PETRO COMMENTS Impact Valves Operational: o-t~K~ow~ INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/23/03 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER~12 9144 CLIENT:CHEVRON U. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:CHEVRON 206561 Tank ID: 87 2 Product: REG ONLEAD Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: DW FTBERe COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: YEs Overfill protection: YEs Overspill protection: YES Installed: ATe CP installed on: / Bottom to top fill in inches: 172.0 Bottom to grade in inches: 176.0 Fill pipe length in inches: 49.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: BALANCE Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: End (in) Bubble Ullage COMMENTS NOT TESTED New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. ~2 Make: Model: S/N: Open time in sec: 4. oo Holding psi: Resiliency cc: Test leak rate mi/m: zsg. o Metering psi: zo Calib. leak in gph: 3.oo Results: ~,ASS COMMENTS NOT TESTED COMMENTS Material: DW Diameter (in): 2.0 Length (fi): 175.0 Test psi: Bleedback cc: Test time (min): NOT Start time: End time: Final gph: Result: Pump type: PRES SUaE Pump make: FA PETRO NOT NOT NOT TESTED TESTED TEATED Impact Valves Operational: ~OWN INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/23/03 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER~129144 CLIENT:CH~-W~ON O. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:C~--"~RON 206561 Tank ID: 92 3 Product: Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: ~ COMMENTS Tank manifolded: Vent manifolded: Vapor recovery manifolded: Overfill protection: Overspill protection: Installed: CP installed on: Bottom to top fill in inches: 176.0 Bottom to grade in inches: 182.0 Fill pipe length in inches: 52.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DO~ Stage II vapor recovery: ~cs Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS Bubble NOT TESTED End (in) Ullage New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. ~2 L.D. ~2 Make: Fa PETRO Model: S/N: Open time in sec: 4. oo Holding psi: ts Resiliency cc: 21o NOT Test leak rate mi/m: zsg. o Metering psi: ~.o Calib. leak in gph: 3. oo Results: COMMENTS COMMENTS Material: Diameter (in): Length (fi): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: DW FIBERG 2.0 175.0 NOT TESTED PRESSURE FE PETRO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: tmKNO~ ~!~ ~~ ai~ONITORING SYSTEM CERTIFICATION ~ ~e By All Jurisdictions Within the State of Californi~ ~ ' ~ Authority Cited: Chapter 6. 7, He~fff/~ and Safety Code; Chapter 16, Division 3 Title 23, C'g~ornia Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitoring system contro panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CHEVRON 206561 Site Address: 3360 PANAMA City: BAKERSFIELD CA Zip: 93304 Contact Phone No: 555-1212 Facility Contact Person: MANAGER Date of Testing/Service: 05/23/2003 Make/Model of Monitoring System: TLS-350R Work Order Number: 3129144 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: 1-91 Tank ID: 2-89 MAG-1 [] E~ In-Tank Gauging Probe. Model: E~ Annular Space orVault Sensor. Model: 409 ] Piping Sump/Trench Sensor(s). Model: 352 ] Fill Sump Sensor(s). Model: 352 [] Mechanical Line Leak Detector. Model: FE-PETRO MLD ] Electronic Line Leak Detector. Model: [] Tank Overfill/High-Level Sensor. Model: MAG-1 --1 Other (specify equipment type and model in Section E on page 2). Tank ID: 3-87 X---] In-Tank Gauging Probe. Model: MAG-1 X'~ Annular Space or Vault Sensor. Model: 409 X'~ Piping Sump/Trench Sensor(s). Model: 352 X'~ Fill Sump Sensor(s). Model: 352 X---] Mechanical Line Leak Detector. Model: FE-PETRO MLD ~] Electronic Line Leak Detector. Model: X---1 Tank Overfill/High-Level Sensor. Model: MAG-1 Other (specify equipment type and model in Section E on page 2). Dispenser ID: 1/2 X-~ Dispenser Containment Sensor(s) Model: 322 X~I Shear Valve(s). '~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 3/4 ~ Dispenser Containment Sensor(s) Model: 322 X---1 Shear Valve(s). ~1 Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/6 ~ Dispenser Containment Sensor(s) Model: 322 X~] Shear Valve(s), ~ Dispenser Containment Float(s) and Chain(s). * If the facility contains more tanks or dispensers, copy this C. Certification PRINTED NAME:RICHMOND PHILLIPS COMPANY: Tanknology In-Tank Gauging Probe. Model: MAG-1 Annular Space or Vault Sensor, Model: 409 Piping Sump/Trench Sensor(s). Model: 352 Fill Sump Sensor(s). Model: 352 Mechanical Line Leak Detector. Model: R J- FXlV Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: MAG-1 Other (specify equipment type and model in Section E on page 2). Tank ID: In-Tank Gauging Probe. Model: Annular Space or Vault Sensor, Model: ~] Piping Sump/Trench Sensor(s). Model: '--~ Fill Sump Sensor(s). Model: ~] Mechanical Line Leak Detector. Model: '-~ Electronic Line Leak Detector. Model: ---1 Tank Overfill/High-Level Sensor. Model: --] Other (specify equipment type and model in Section E on page 2). Dispenser ID: 7/8 ~ Dispenser Containment Sensor(s) Model: 322 X'~ Shear Valve(s) =-'] Dispenser Containment Float(s) and Chain(s). Dispenser ID: ~] Dispenser Containment Sensor(s). Model: --~ Shear Valve(s). ~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: "~ Dispenser Containment Sensor(s). Model: ~ Shear Valve(s). "-1 Dispenser Containment Float(s) and Chain(s). form. Include information for every tank andldispenser at the facility. I certify that the equipment identified in this document was inspected/serviced in accordance with the manufactu'rers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): System set-up report; [] Alarm history report [~] SIGNATURE: PHONE NO: (800) 800-4633 page 1 of 3 Based on CA form dated 03/01 ~itoring System Certification Site Address: 3360 PANAMA Date of Testing/Service: 05/23/2003 D. Results of Testing/Servicing Soft'were Version Installed: 112.02 Complete the following checklist: [] Yes [] No" Is the audible alarm operational? [] Yes [] No" Is the visual alarm operational? [] Yes [] No" Were all sensors visually inspected, functionally tested, and confirmed operational? Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not []Yes []No" interfere with their proper operation? [] Yes [] No" [] N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] Yes [] No" [] N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) [] Sump/Trench Sensors; [] Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? [] Yes [] No For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical [] Yes [] No" '[-'~ N/A overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ~ [] Yes" [] No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes" [] No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. [] Yes [] No" Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes [] No" Is all monitoring equipment operational per manufacturers' specifications? * In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: replaced bulb on panel page 2 ot 3 ~itoring System Certification site Address: 3360 PANAMA Date of Testing/Service: 05/23/2003 F. In-Tank Gauging ! SIR Equipment [] Check this box if tank gauging is used only for inventory control. [] Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the followin( checklist: [] Yes [] No" Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No" Were all tank gauging probes visually inspected for damage and residue buildup? [] Yes []No" Was accuracy of system product level readings tested? []Yes [] No" Was accuracy of system water level readings tested? []Yes []No" Were all probes reinstalled properly? [] Yes [] No" Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) · [] Check this box if LLDs are not installed. Complete the following checklist: For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] Yes [] No" [-~N/A (Check all that apply) Simulated leak rate: [] 3 g.p.h [] 0.1 gp.h E~0.2 g.p.h [] Yes [] No" Were all LLDs confirmed operational and accurate within regulatory requirements? [] Yes [] No" Was the testing apparatus properly calibrated? [] Yes [] No" [] N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes []No; [] N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] Yes E~]No" [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? [] Yes []No" [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? [] Yes []No" [] N/A For electronic LLDs, have all accessible wiring connections been visually inspected? [-~ Yes []No" Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: page 3 of 3 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE:05/2 3/03 ., WORK ORDER NUMBER~12 9144 CLIENT:CH~.VRON D'. S .A. SITE:CH~.'v'RON 206561 COMMENTS Placed sensors on correct side of sumps PARTS REPLACED i ~Veeder Root ~anel bulb HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) Printed 06/02/2003 08:43 KOHLMEYER SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459~- 1459 TEST DATE: 05/23/03 CLIENT: CHE~"P, ON U. S. ~.. WORK ORDER NUMBER312 914 4 SITE: CHEVRON 206561 STER m z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. PANAMA LANE 2K PLUS 2K REG ~12K SUP VV~E Printed 06/02/2003 08:43 KOHLMEYER Work Order: 3129144 SITE SAFETY CHECKLIST, SERVICEAGREEMENT& OPERATOR VERIFICATION FORM ' Site Name: ....... Address: S~e ~: City~ItZip: Dale: ~ ~ '" Pints & MaleriaTS Pr~i~: Arr~l T~e al Silo: ! ~p=ture ~me from , '"'i >' -~ I ! , '..',,? /I XC / PRE-TEST PROCEDURES 1. ~ Discuss salety procedures Wilh site personnel, 2. ~1 Prior to'fuel deliVeries lhe comp ete'tank system mUSl be placed back'irito WOrking. Order, 3., O Ail pumps, dispensers, and electrical breakers of the product(s) tO be tested must be disabled durir~g the test(s}, 4. El Secure entire woik area with. 28" cones, flags, and ,"Caution rape. 5. Q: ¢Place fire exllnguishe/'s'and "N° Smoking' signs in · "the. Work area ' ' '. 6. l;l Turn Off.and secure the circuit breaker,(s) of the product to.be.teStedwilh lockout de,'ices'and tagS, .~' P~aco .'Out Of service;' bags on the dispenser noZZles el the pmducl(s) to be tested. 8.! [21 Ve)ify proper Lockout/ragout procedure is complele by Iryi.ng to ~perate pump~I · .9. o close bali valves or check valves'on the product piping to be test.ed. '~0, ~ .Remove the electrical "baypnet" conni~lot from ~' pOS1;TEsT PROCEDOFiES,' · , BUn 'all pumPs':a ~nd verily there ~e no leal~s undei::d!s~aqo~'or. E~t~a~ SYa~ , Ta~olo~y-~E 8900 Shoal Creek, Builder 200 Austin, Texas 78757 Work Order: 31.2 91.44 ~h'STEt; LIN IT:-; U ~S~ D~gl'E~ T H'~E t:ORt'I~T PV3N DD St..t ~ FT T SHIFT TIHE ~H1FF TIME ~ DI~ABLEI, ~5~IFl' TINE ~ DI~BLED EN~B~D E~BI pE~l OD l'i? TiL~T D t S~BI~ED PRI ~r ~? UOI,UMk~ E~BLED · TI~P C(~JPEt:S~¥r ION ~AI.I}E <DEG F )1 6f~.O HE 1 ~E-D I RE('~" {_~Cf.',L I:'R I ~rotrr b I C'Ob~ : OOOOO0 POF.'T I!;Eq'T l 1~3E;: · QOPII'~ BOAR, l), : 1 BAUD R~TE f 9600 PARITY : EVEN ~';TOP BIT : I'STOP i'iUTL,~ TE;F'dJJ3M I T ::~E3~I t~>d: I) I F~BLED l~u'ro HIGH {,JATER L:IHIq' D } SaI~LED . ALITO .OVERFILL LICIT aUTO 1:.(~ D I S~BEED a~ro DEI,Ib'E~Y END D'iEaBLED atto E:,~'ERNF~L 1NI-'UT DIY~I:E[," "' a~O EgTFERt~]L INPUT OFF b I ~BLED D I ~BLED D l ~LED RS-- 2:3:? :~;EC UR [ TY CODE ; OOOOOO D i T I ::6;UI:~RFJ"IE PRODUOT CODE : 1 ;I'!tEP~'t~L,' COEFF : .uO0?O0 T&I~K ~IF~IETER : 12'0.00 'I~I,4:~ P~F{ LE : 4 .FULL VOL : i i049 90,0 I~H VOL ': 9894 60.0 I~:H VQL : 6143 Fi..o~-tT SIZE: ,I..,O IN., 8496 tAATER bI~RN I'NC; : 1 HIGH ~TER LIMIT: 2,0 ~,( OR L~BEL VOL: I I OXlE~F l LL Llr'llT : 90% : t 0664 : 11256 DEL I V~RY I..1 tilt : .l.Ob~ P'ROpUCT : 500 l.~{( ~L~RH L 1M I T: I O E3IJDDEN L~ L'IHI'r: 25 T~NK T ! LT : O. O0 Pi~NI FOLDED TANK~ 947 I:'ER 1 OD I C 'fE~T TYPE ANIqlJ~L T[~T FAt L PEklODIC TBS~ Fall. c;Ro~ 3'ElsT Fall ' ALARM DISABLED ~HH 'rEST ~:~VER~G I t~:;: Ot~F I:'E~ 'F[~T tW~aO 1 NO: OFF T~14I'. TEST ,NOT I FY: OFF DEI.IVE~Y D~~ : 15 MIN T- 2: PLUS PP, ODuc'r CODE '{'Hg[Z)tq~-IL COEI~F T[:~lqF. D 1 [AMETEE T/4NK PROF ILE FULL 'qOL 60.0 IN~ll VOL 30~0 INCH VOL L' 20. O0 4 PTS I 1 9094 o 14:3 23t3 FL,Offl' SIZE: ,1.0 I1'1. 8,V3i:; WATER WARNI NO : t41O)..I WATER LIMIT: l~q?< OFt' L~BEL VOL: OVERF I L~ LIMIT DEL 1 VERY L I M 1T I . 0 2.0 1849 90~ 0664 95,'~ 1356 947 508 1 O. O0 LEAK rtl N AIINIIJfiL : H,% : 947 I,,EkIOD'IO :TFd$1' TYPE b~NNIJo~I., Tf-~T [-'a I L A~RR D fSRBLED PER I OD I (1 TES'F. Fa 1 L ~L~RM D IS~BLED GRO~ TE~T FR[L ~I~tRH K, I SA[II.ED 'I%NK TEST: NdT 1 FY: OFF PRODI.I(3 (lObE · TH~L COEFF I'R~ O I~ETER' T~tNE P~F [kEJ FULL VOL 90.0 It~H VOL 60.0 l~H VOL 3g,O ! ~;H VOL : 15 M1N :. 000'700 138.. O0 4 I 1846 9894 614;:I 2;~13 Fl.o~-r sIz~: 4,c~ IN. 8496 tatZ~TER I~RN 1 rag : 1. O II I (itt I triTER L 1H 1T: 2. ill ~< Ol~' L/.JI~EL ¥OL: I 1~46 OVERFILL L1HIT : : 1066 t HI GH P~b~ ; 95% : I 1253 DBL'IVE~Y LIHIT : : 94V LEaK ~l:,aiN' I..iHIT:: 500 lO SUDDEN LOSS LIMIT: I~1 FOLDED TANKS TO: NONE Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texds 78757 Work Order: 3129144 I'E~ l OD 1,7 TEF;T I :'i:~ 1 L, 'i'~N< *f~[' NOTIFV: OFF TI'~I< TEa' ~1F;HON BK'Enj: :C,~F DELIVEN'~ DEI.fiV .: 15 MIN o)r 2t,. ~3Tf~fl' T IHE : DIF3~.~Ic~LEI) DURATION : 2 HOUPB ' I, 2 ;9i) ':FILL D HL. FUr. IjI~3(';~}It~II~fF[NC, L'~:fI'IS£~L)R';F : ' I'.; ] l> I {~1~; Sl:.ll~ll'~' L 4: L~9-I4NNt. ILHR TR I '":5:Ti~TE {:$ l IqGLE L 5:8',~'1'II.L ,SI..IMt:' DLI~I. EL'i'. DI~F/.IPII I~.~l'l ¢~:;, C/qTE~-~RY : p I I> 11,~.; :TLHic I)L},qL FI,T. DI:~(:F:IMI N/*TINc; (¥~TEC;ORy : ;!iTl' 'SUHI:' 1. ?: ~7-4qNNUL~4R I:, 8:'i:~7-F!I.L SLIMI' [qJ~L FLT. D t SCRi1ti NWI'I N3 L 9: BT-.%'TI', SIRtP DLK~I.. FI2r. HIGH ~"~-,U 'C,k' l.I I :DI~,;PENSEF: !e'eN :3-4 ~ DLIfil. FI..T. DISCRIMI N~TINJ:; "(¥I?E,;;OP.Y : DI$1-;EN:-~;ER l"~qN [.13:I,ISI>EN~SKR PAN 7-8 DUAl. FLT. DI C/.ffFZ;OR¥ : D I SI4:It,S;EI.L I?fiN oUTPUT RE~W ~ I :92 :'::;ttlITDOIJN 'r'vPE: NOFfl~g:LLV CLOBED T I iHIC3H tA~TER ~AL/~RM L t Oil I D SENSOR L I':FUEL I. 2:FLIEL ~LARM L $:FLtEL ~D4RM I I 0 :YUEL 1.1 ~':FUEL ALARM I. 10: FUEL L .O:~ENSOR OUT fil.fi~ I. 1 t; SE~OR OUT LI 2:SEN~;OR OUT LI 3:SENSOR OUT aL~ L i ;S~ORT ALARM L ~:$~RT fiL~RM L 3:~RT ~LnRM L! 1 :S}io~cr ~R~ LI 2 :~HORT L 2:HIGH LiOUID L 3:HIGH LIOgID I,tO:H1GH LIQUID LII:HI. GH LIDU1D ~L~ L J 2: iii OH L I.OU1D ~t3:HIGH L IOLIID L t :LiOUID I. IOIJlb SENSOR fil.MS L 4 :FUEL L. %: FUEL L &:FUEL ~ I-IQ:FUEL Li I :FUEL ~ LI2:FtJEL 1.18: FUEl_ I,. 5:~E~R OUT L 6 :$Et~R OUT · LI 0 :~E~O~ OUT i,I I :$E~SO~ OUT L 12;$E~0~ OUT L~ 3 :MEr~R OUT L 4 :SHORT ~1 L fi:SHORT LI 2 :S~RT LI a:g~RT L 5:HIGH LIOUIDr~I.~K'{:I L 6:H!GH LIQUID LIO:HIOH LIQUID LII:HIGH LIQUID L12: HIE,;H LIOLIID LI3:HI,OH LIQUID L 5:LIOUID R 3:8?=SHUTDO~N T?PE~ STANDARD NORMALLY C[,O~ED 1N-T,qNK ~ T 3:HIGH h~TER, P,L~:$Rtq: T ~: LOW PRODL~:T ~I:.~RM I.. lOt. l.t D SEIx~30R L 7: FUEL ~1.~ 'L 8: FUEL &L~RpI {.. 9:FUEL RI~ L I O :FUEL &l~ L 1 l: FUEL Li2:FU~ L B:~R OUT 7: SHORT L B;~HORT fiL~RM L ~:~HOR'r' fiL~RH t. I 0: SHORT ~L~RM L I 1 :BHORT Lt 2 :BHORT Lf3:SHO~T L e':H'I;OH LLOurD ~LfiRM L 9':HIGH L.IQUrD fiLfiRPI LI 1 :HIGH LIOUI, D L12:HIOH LI~UI;D LI~:HIGH'LIOUrD L 7:LIOU1D ~RNIT.~3 L B:LI'QUID L 9:LIOUID Wi~RNING LIO:LIOUID WARNIN] LII:LIQUID NARNIN~, LI2:LIOUrD bJ~RNI'NO LIS:LIQUiD WARNING Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3129144 I<ECONC I L. Ijl' [ Ol't k;lTrBP (i~ir¥(~'k;¢!'lF: DAILY *' O:;1N,; T 11'11]: 2:O0 ~k!'l'O SHIFT gl ,;LOSI rig T l t~: D 1 ~t.[[/) Z;H 1 VT ~1,1 CI.OB t 11,3 TIME: Di~B[ PER 1 OD IC ~E'C:O ~&~' 1L. I ia't' t O H ' ~ ' ' PlOIqTHL?/ ~LA~P!: BUG CLOT FttEL ~LT[~ 'fAN}( r~I;' EMPTY BgKKRSF.'I ELD Oh. 20S5 PH- ::96 ..70WJ aLL FttI'tCTION~; ftC, lq'iFiL I I4VEI'tTO[?[ REPORT T t ;:::LIPRq?.tlE VOLI.~'LE 7'~2¢ GAI.;S I,d~TER ~ 5. ';~4 11q(~HEL3 TEMP 9B.I DiG F T 2: PLUS VQLUIIE ; 'J301 C~'~LS HEIGlfl' Cbl, 74 i kI~TER VOL = 703 (~E ' ~?I'EF: .= ~; ~'~,q l I'~P ~. 98'.7 DEG F tILl,AGE = ~!4'll GF~I,S 9[:~; UL,[ ,~OE~ ' k~'tTl:F: vOl. ........ I N-'Tt4I'.IK aL~4RM ...... HI(;It b/~-~TER' AD~RM P1HY L-!FI. ~0t)9 t 0: 52 AH ....... i ri-T~NK ALARM T I: t~'~; 23.. 2003 10:52 ..... [ N-TP, NI{ ALAt;.'It ..... tlIGH ~TER MAY 2:3. ....... I Il. 'D ~NK AI..~.tRM .... HIGH 'ItP, TER 14LgRM' .MAY 23. 7,003 IO:'52 T :q: :Iai.EliDED FtlC;tl 1.4FfI'ER aIFtFilqlNG /'~f~ ~3, 2003 11]:52 Ct41~J~N [B~ t:;:{}l ' 1849 336~"i pA~'~ El3 - 3ft651 Pti 'J96 ~'/,1;'1't;11 STATUS REP',:;.I-:T T 1: HIGtt 14ATEI,} g[gBl T t :lllott MATER !4~iF;NI Nig T 2 .'. tt I (;H bh4'l'E~ fd.~M :HIGH !daTEK 14Rt;:NI : H t GH HATER : H'l fir I~TER 14FiRI',I 1NG C:HEVBoN I. IS~ ~KERSF1 ELD CA; 9J;304 P~Y 21i. 2003 I0 f.4VSTEI'i ST¢,¢fb.'q REPORT T I :HIGH I~ATER T I :HD,2H IAgTER T 2:ttlGH t&~TI::~ T 2:IIIGH ~rER ~NII(; T 3:HI(IH WATER b~RNI:NG ...... [ N-TA~K, ~LARI'] T I :SU['REME HIGH ~R' AI~Yl ~V 20, 2003 10:52 O~;RF I L,L ALARM MAY 29, 2002 111.18 AM MAY 1'1, 2001' 11':51 AM LOH PRODUCT MRY 23. 2083 I'0:29 H I Git PB)DI&'~ ~L,A:RM M~Y 29. 2002 11:08 May 23. 200~ 10:~4 aN HAY 23, 2003 10:28 AM [,EI,,IVER¥ NEEDED MaY 23, 2003 t0:29 AH BaR 5. 2003 5:42 PM SEP 1, 2002 7:06 PPI ' T '2: PLUS I~qy 27j. 2003 lO:G2 0VERF 1LL ~Y 23. 2003 I0:31 a~Y 29. 2002 1 LOH PRODUCT ~Y 2~. 2003 10:2~ f~IY 23, 2003 IO:25 AM Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3129144 HI(IH P[X.:,[dl('r AI..~4F:M M{,¢~ 11, 2001 I1: 11$1~I, 1D FUEl. Iq~Y ~:3, 200;3 MaV 2S. 200:3 IO: MAV 2:3; 2003 IO:27 M~V ¢9~ ?00:3 10:52 L(31J TLiMF' ~RN I F'I~Y 29. ~:O02 AL~21 HIGTOkY F2t.:iI:'Q~T T 2: [:'L~ H(W 20, 200;.; I0: MAY ~3, :?003 I't~y 23..S'i)03 i0:25 H i GH IsRODI~CT ~LAI~'M r'{~',' Il. 2001 11:5~ AM ~Y, 2(t. 2003 1 u: 28 ~.~t P~X~BE OUT ~',~ 23/ 200:3 IO:.:P5 HI q;H Hit'I'ER !,Jli~N.l:N(: ~,tY 23'.' 2002' ]0:2V t:tH ~¥/'..2~; 2od3 10:25 r~M DEC 2. *,:T 02 I: 47 FSI Pk'W, 29, .:20112 I ' T 2 HIGH W(fJ'E~i MAY 23. 2003 lO:t,2 ~Y 23. 2003 10;31 AM MAY k'3 · ~01)3 1 MaY 23, 2003 I H t ,:;H pF:ODt>."r t-t~V 2:3. 2003 10: ~'? lt. 2001 I NV~I.I D FILE[ t'~'4Y 2~, 200U IO:2E; aM r~v 23. 2003 1 ['RQBE OUT HAY 23; 20U3 i0:45 MaY 23. 2003 I i] 133 ¢¢1 l'~V gQ, 2003 10:27 AH PlAY ;73-, 7t]03 10:57 AM DEl,. I VErY NEEDED Play 2-3. 21303 10:27 ~4 DEC ;'; 2002 t :47 PM Lx:~d TEMp I,,I~RN I M¢-¢¢ 29. 2LU~2 t l:4i ¢41-,r~RPl Ill STORV T 2: PLLLS tIIGIt k~TI~R ~LaRM Hay 23. 2003 10:52 OtqERF,I I.L gLARM I~Y 23, 2003 10:31 Ploy 29~ 2r~02 i I :3~ P!~W 23. 2~03 I~W 23~ 2003 t HI'GU P~OD~Tf PI;~Y 23. 2003 l 0 ::~ 1 ~Y tl. 2001 11 I'Nw¢iLtD FUEL LEVEL ~¥ 2'3;. '2[103 H/W 23. 2~03 10:25 t*~*BE OUT PIRY 2:4..2~03 10:45 M¢:6' 2~;i. 2003 ~qV 20, :2j)03 10:2? HIOII m'rER I,JARNINC ~V 723/'2003 10:52 ['ELI t,'Ekv NElCDED HAY 23~ 2003 10:25' AM Di:C 2. 2002 '1:47 LOId TEM~, ~?N:I l~V 29. 2~02 11.:4~ .... IN TgNE ALg~H ....... T :l: UNLEADED ,,:3, 200~ 10:59 ()~ERF ILL ~aLgR PAY 2:3. 2003 10;31 lq~v 4~ 2003 Io.~" PM ~PR I. 2003 8:15 ~iY 23, 20(i3 10:27 OCT 9:21102 2:4? PM SEP 23, 20~2' 2:05 PM Il IOtl PRODUCT aPR 174; 2002 I INVALID FUEL LEVEL M~Y 23. 2003 10 I'If~R 0. 2002 ~:43 I'M NO~ 16. 2OO1 12:25/ PM ['ROBE OUT MAY 23. 2t]0:3 10:4g I'~V 23~ 2003 10: I~v 23..2003 10:26 H [ 0ii WATE~ ~ikN I HgV 23. 2003 I0~52 DELIVERY NEEDED, ()CT Il. 2002 8:O6 Pffl O,?T 9, 2_002 I :02' PF'I ..... 'SE~OR aLr~ ........ ~NNUI~R SPRCE FUEL HgY 23, 2003 9 FUEL ~LRRH ~ ~Y~I H I~rORV. RE.JRT L.-,':'"92~F1LL SUMP PtgY 23:. 2000 9:Ig AM I*I~V 22; 2002 825'4 PH ~l~R?r :HI~ORY REP.0RT ...... =": }SENSOR L a:92,;STp '8IJMp Li ~/{ i D Wr~RN r~' ~W 23. :]2o03 9:lg AM FUEL 'ALARM SENSOR o~ aLa~ a(-,0R~ ttfSTORY REPORT ...... SENSOR akg~l FUEl, FH.~RM FUEL Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 'vVo~k Order: 3129144 LI O:,I:,I;SF'~J~E~: PAN I .5' L I qUl D ~laRl~ I ~3 I'l~'d ~Q. 2'UO~ I I :46 Lll :DISFEN;'~4ER Pt:~lq U..4 [ t Ot I1D ~IARIq I NC t~W 23. 2011:~ 9:33 aM LIULI[D I~IV Z~; 2002 1 l :45 D 1SPE~ ~'~ 2',3. 2003 9:33 FUEL ....... 1 N-'rRNK i'~L.aRPI --: ..... T 2: Pi,i,~:~: I~NOBE OUT I~Y 27~. 2t)UL~ 10:57 ~M BhV.'EPSF] EI,P Cg. 933.04 SS- 2 r.165 t PH-396-?04?. 10:59 SYSTEM .%'TKrL6 REPORT T ?: LOIJ TF. I1P bJ~P.N 1 I,[; I f, iVENTORY Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Wonk Order: 3129144 T 2: VOLMIE 3:3'/6 ULLm ;E = 8,V13 HEI,;;HT = 39.13 llqOtil~'; T 3: I,~NI..EPd ~ED VoLUMt:; = 649.,1 I*,¥*TER = O. Vt; t ~K'tlE~ 'I'EMP = 9,1.'/ D[3.; F ~:; -7'06~ l J:" H.. 3'J6-'YFJ4? Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 05/16/02 THU 17:02 FAX 5123807188 Tanknology-Gulf Coas~ ~ oo6 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bak~eld, CA (661) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST/ SECONDARY CONTA~ TESTING NUMBER OF TANK$ TOBi~TEST~D~ IS PININO OOINO TO BE TESTED ~.~S:. 2ff TANK # VOLUME ,.~CONTENTS ~ . I~-I~ ,, ~' ~~<o _ APPROVED BY DATE SIGNA~ OF APPLICAN~ Chevron Products Company ESH P.O. Box 6004 Attn: Permit Desk San Ramon, CA 94583-0904 Tel 925-842-9002 Fax 925-842-9585 ibrar~,chevron texaco.com Benny Brar Permit Specialist April 24, 2003 City of Bakersfield Office of Emergency Services-U 1715 Chester Ave., Third Floor Bakersfield, CA 93301 (hevron RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS Dear Sirs:, Please find enclosed the following documents: 1) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron Facility List under your jurisdiction These documents meet the financial responsibility requirements for all USTs owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Benny Brar Enclosure ChevronTexaco Corporation 601) 1 Bollmgcr Canyon Road San Ramon, Ca 9458,3-2324 Tel 925 842 3232 Fax 925 842 61)47 John ~Valson Vice President and Chief Financial Officer April 30, 2003 ChevronTexaco UST FINANCIAL ASSURANCE To Whom It May Concern: I am the Chief Financial Officer of ChevronTexaco Corporation, 6001 Bollinger Canyon Road, San Ramon, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective act. ion and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $I,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor. All underground storage tanks owned by Chevron U,S.A. Inc. are assured by this financial test: A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§§264.143 and 265.143) Post-Closure Care (§ §264.145 and 265.145) Liability Coverage (§§264.147 and 265.147) Corrective Action (§264.101(b)) Plugging and Abandonment (§ 144.63) 85,937,394 83,679,196 8,000,000 27,223,479 5,340,0OO California State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment 209,640 743,779 66,000,000 0 0 Louisiana State Program Closure Post-closure Care 4,968,415 853,978 April 30, 2003 Page 2 of 7 Liability Coverage Corrective Action Plugging and Abandonment 1,000,000 0 0 Total 283,955,881 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. April 30. 2003 Page 3 of 7 ° 4. 5. 6. 7. ALTERNATIVE II Amount of annual UST aggregate coverage being assured by a test and guarantee Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test and guarantee Sum of lines 1 and 2 Total tangible assets Total liabilities Tangible net worth Total assets in the U.S. 8. Is line 6 at least $10 million? 9. Is line 6 at least 6 times line 3? 10. Are least 90% of assets located in the U.S.? (If"No", complete line 11.) 11. Is line 7 at least 6 times line 3? 12. Current assets 13. Current liabilities 14. Net working capital (subtract line 13 from line 12). 15. Is line 14 at least 6 times line 3? 16. Current bond rating of most recent bond issue 17. Name of rating service 2,000,000.00 283,955,881.00 $ $ $ $ $ 285,955,881.00 77,069,000,000.00 45,755,000,000.00 31,314,000,000.00 28,870,000,000.00 Yes N__~o X X $ N/A $ N/A $ N/A $ N/A AA Standard & Poors April 30, 2003 Page 4 o1'7 18. Date of maturity of bond February 15, 2008 19. Have financial statements for the latest fiscal year been filed with the SEC, the Energy Information Administration, or the Rural Electrification Administration? Yes N._.9.o I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana was added to make disclosure more complete. esident, Finance April 30, 2003 April 30. 2003 Page 5 or'7 GUARANTEE Guarantee made this April 30, 2003, by CHEVRONTEXACO CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and ali third parties, and obligees, on behalf of CHEVRON U.S.A. INC. CCUSA"), of 6001 Bollinger Canyon Road, San Ramon, CA. RECITALS Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). 2. Guarantor owns or operates the following underground storage tanks covered by this guarantee: Alaska Arizona California Florida Georgia Hawaii Louisiana Nevada Oregon Texas Utah Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. April 31). 2003 Page 6 of 7 In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed .the coverage limits specified above. IfCUSA fails to satisfy a judgement or award based on a.determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR pan 280, subpart H for the above- identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; April 30. 2003 Page 7 of 7 (d) (e) Property damage to any property owned, rented, loaned tO, in the care, custody, or cofitroi of, or occupied by CUSA that is not the direct result of a release from a petroleum undemround storage tank; Bodily damage or property damage for which CUSA is obligated to pay damages bylreason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing ageJ any or all third parties, or by CUSA. tcy, by I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 30, 2003 CHEVRONTEXACO CORPORATION By ceWats°n President, Finance By Assistant Secretary CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements ofsubpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFR part 280 are as follows: Financial test and corporate guarantee of ChevronTexaco Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2004. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 30, 2003 CHEVRON U.S.A. INC. By Assi~ By J~dith L. Geisler Legal Analyst -Wor'ic Order: 3127281 WA~ WATi~R WATI~ll WATF~ HEIGHT Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 SB 989 RY RESULTS Tan TEST DATE: 01/23/2003 WORK ORDER NO.: 3127281 CLIENT: CHEVRON PRODUCTS, USA SITE: CHEVRON 206561 P.O. BOX 2292 3360 PANAMA 145 S. STATE COLLEGE BLVD. BREA CA 92822 BAKERSFIELD CA 93304 KELLY GARCIA 7;1.4-671-3249 Tank Interstital Tests PLUS REG UNLEAD SUPREME Piping Interstital Tests i Sump & Under-Dispenser Containment Tests .~, ~ M~UFAC~RER 1/2 Phil-Tire Pass 3/4 Phil-Tire Pass 5/6 Phil-Ti~e Pass 7/8 Phil-Tire Pass Tanknology representative: Se~ices conducted by: KEN MINTON WESLEY COULTER PLUS REG UNLEAD SUPREME SECONDARY CONTAINMENT TEST RESULTS Wo~k Order: 3127281 SUMP TESTS Type Tank or Disp Manufacturer Model or Diam.NVidtlVLength: Depth Test Method Start Initial Level Finish Final Pass/ # Matedal (" ) (" ) Time Level Chan,qe Time Result Fail Dispenser Sump 1/2 Phil-Tite Fiberglass 25 x 49 27 VPLT 1205 9.5 " +.00068 1217 -,022 gph Pass Dispenser Sump 3/4 PhiI-Tite Fiberglass 25 x 49 27 VPLT 1207 9.75 " +.00012 1219 -.012 gph Pass Dispenser Sump 5/6 PhiI-Tite Fiberglass 25 x 49 27 VPLT 1208 9.25 " +.00004 1220 -.002 gph Pass Dispenser Sump 7/8 PhiI-Tite Fiberglass 25 x 49 27 YPLT 1210 9.25 - +.00015 1222 -.008 gph Pass Comments: Water measurements were taken from the bottom of the sump to the top of the water level. TEST DATE:01/23/03 CLIENT:CHEVRON PRODUCTS, USA 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 WORK ORDER NUMBER312 7 2 81 SITE:CHEVRON 206561 COMMENTS Arrived on site at 11=30 A.M. for CA reg SB-989 secondary containment retesting. PARTS REPLACED HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) Printed 02/12/2003 08:53 CCHAPA SITE DIAGRAM ~ 'l'ankno/ogy 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 01/23/03 CLIENT:CHEVRON PRODUCTS, USA WORK ORDER NUMBER3127281 SITE: CHEVRON 206561 STER IO < r13 z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. {~12K PLUS O~ {~12K REG O~ 12K SUP (~~ W~E PANAMA LANE Printed 02/12/2003 08:53 CCHAPA CHEVRON USA 0SI-1849 3860 PANAMA LANE BAKERSF l Eld) CA. 93304 BS- ~651Pt-P.396---7047 JAN 29., 2003 1:84 PM SYSTEM STATUB RE] ALL FUNCTION~i NORNAL INVENTORY REPORT T' 1 :SUPREME VOI..UME = 1791 gALS ULLAGE = 10058 gALS 90~:: ULLAGE= 8873 gALS TO VOLUME = 1787 gALS HEIGHT = 25.06 INC, HEB WATER VOL = 00ALB WATER = 0.00 INCHES TEMP = 62.8 BEg F T 2 :PLUS VOLUME = 2837 gALS ULLAGE = 9012 OALS 90?.,,; ULLAGE= 7827 gALS TO VOLUME = 2840 gALS HEIGHT = 34,64 WATER VOL = 10 WATER = O. 78 TEMP = 58.6 DEg F T 3: UNLEADED VOLUME = 4950 GALS LILLAGE = 6896 GALS 90% ULLAGE= 5711 GALS TO VOLUME = a954 GALS HEIGHT = 5l .26 INCHES WATER VOL = 10 GALS WATER = 0.79 INCHEg TEMP = 58.8 BEG F CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME INSPECTION DATE [-~? '19 __~ Section 2: Underground Storage Tanks Program Routine [~Combined 121 Joint Agency Type of Tank Type of Monitoring l~] Multi-Agency [21 Complaint Number of Tanks '-5 Type of Piping !)tt/~' Re-inspection OPERATION C V COMMENTS / Proper tank data on tile Proper owner/operator data on file / Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations ("' Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Complianc~ d=Violatio.n Y=Yes N=NO Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy UNIFIED PROGRAM I{~SPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 INSPECTION DATE._ INSPECTION TIME g~c~to~x ,~r~t (oR l'g q'~.5 .............. ~ PHONE No. No. of Employees ' ADDRESS 33~o ~~ L~ ~-~7 .... ~(_0 ......... Business ID Number .. FACILITYCONTACT 15-021 - ?~::"' ..~; :'-" ~': ! ?:: ~: ::.':." .SeCtion ~1~ BusinesS Planand InVentonj program Routine ~j~,,Combined i-I Joint Agency [] Multi-Agency [] Complaint [] Re-inspection C V (~C=Compliance)OPERATION ~. V=Violation APPROPRIATE PERMIT ON HAND --[~ BUSINESS PLAN CONTACT INFORMATION ACCURATE ~'///~'~ VISIBLE ADDRESS ]'"~[]' ' CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION ZI/"• PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITYE VERIFICATION OF HAT MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES [~'/"l-I EMERGENCY PROCEDURES ADEQUATE --~'{~ CONTAINERS PROPERLY LABELED --~7'c[] HOUSEKEEPING f FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?; [] YES [] No EXPLAIN: COMMENTS Inspector PLEASE CALL US AT (661) 326-3979 Badge No. White - Environmental Services Yellow - S{ation Copy Pink - Business Copy January 22, 2003 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSlONSERVlCES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFE~ SERVICES · ENVIRONMENTAL $ER~ICE$ 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Chevron 3360 Panama Lane Bakersfield CA 93304 RE: Upgrade Certificate & Fill Tags Dear Owner/Operator: Effective January 1, 2003 Assembly Bill 2481 went into effect. This Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your window) and the blue fill tag on your fill. You may, if you wish, have them posted or remove them. Fuel vendors have been notified of this change and will not deny fuel delivery for missing tags or certificates. Should you have any questions, please feel free to call me at 661- 326-3190. Sincerely~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave,, Bakersfield, CA (661) 326:-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST/ SECONDARY CONTAINMENT TESTING FACILITY ~-4~ P~0~I ~ 6 ~ PERMIT TO OPERATE # OPERATORS NAME ff_/,-F.-4/(c0~. ~'~rV'fi0,4~-. ~-'~c. OWNERS. NAME ~f'~ £ NUMBER OF TANKS TO BE TESTED ,_~ IS PIPING GOING TO BE TESTED TANK # VOLUME CONTENTS ~ )2~ o00 ~7 7_ ~ z~ 0o0 3 .~z, Ooo TANK TESTING COMPANY s,~ & PHO~ NUM~ER OV CO~rACT ~SOS N~ OF ~R OR SPEC~ ~SPECTOR C~CA~ON ~ W~ I~ DATE & TIME TEST IS TO BE CONDUCTED q24~0 APPROVED BY DATE SIGNATURE OF APPLICANT o0 CITY OF BAKERSFIELD -~)c ~/~l OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK ADDRESS J'] ~ PHONE NO. '~ 4L~) WO~MAN COMP NO. B~EFLY DESC~BE THE WO~ TO BE ~NE TYPE OF APpLICATIO~'(~HECK) [ ]NEW FACILITY ft,'fMOD[FICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY START[NGDATE ~ ~,'7L' PROPOSED COMPLETION DATE ,=~-~..-O'?.. FACILITY NAME ~ ~'$ ~,O ~'e~E' ~ EXISTING FACILITY PERMIT NO. FACILITY ADDRESS '~t> ~.t~ t~ f.~&tO~ CITY ~}~~-t4Ei.~ ZIP CODE TYPE OF BUSINESS ~,~S'OL4~.i'~ ~ "~-~. .~-L,~T(' APN~ TAN~ O~ER ~~ PHONE NO. ADD,SS. ~ a, ~ ~~ C~Y..g~ Z~P CODE ~ CONT~O~ ~t~, ~0~~ CA L~C~SE ~O. ~ C~TY ~~ Z~P CODE ~OL RA~EaSF~ELD C~TY ~USmESS L~CESSE ~O. WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE NO. OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE YES NO YES NO SECTION FOR MOTOR FUEL TANK NO. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION TANK NO. VOLUME SECTION FOR NON MOTOR FUEL STORAGE TANKS CHEMICAL sTORED CAS NO. CHEMICAL PREVIOUSLY STORED (NO BRAND NAME) (IF KNOWN) FOR OFFICIAL USE ONLY APPLICATION DATE FACILITY NO. NO. OF TANKS ~FEES S [ THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULAT IONS. THIS FORN~S BEEN/J~O~P LETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS APPROVED BY: APPLICANT NAME (PRINT) / APPL'ICANT SIGNATURE THIS APPLICATION BECOMES A PERMIT VVHEN APPROVED STOPAC;E I I C~EVRON'S PANAMA LANE N o 5 ~.DHIC .SCALE 20 VICINITY MAP SITE DATA SCOPE OF WORK DISPENSER SUMP TEST FAILED AT ALL POSITIONS. REPAIR METHOD: EXPOSE SUMP, SEAL WITH SUMP FLEX RD-1750, BY VORTEX APPROVED BAKERSFIELD F~RE DEPAFrT~NT OFFICE OF ENVIRONMENTAL SERVICES NOTE: A~p~ ~i~ to plans ~. a~ for cons~ction and/or installation theF~ subj~ to fi~jn~on ~ a~ta~. Dat~ GROUND & GRADE PLAN SERVICE STATION #20-6561 3360 PANAMA LANE & WIBLE RD. BAKERSFIELD, CA £hevmn ~A~: 05/05/07 SCALE:: FIL[NAM£: 206561 I A Tanknolo 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 05/29/2002 Order Number: 3122892 Enclosed are the results of r~ent CHEVRON 206561 3360PANAMA, Leak detector tests Monitor Certification Sincerely, Dawn Kohlmeyer Manager, Field Reporting Date Printed and Mailed: 06/04/2002 testing performed at the following facility: CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST DATE: 05/29/02 TEST TYPE: TLD-1 CUSTOMER PO: 4611514 PURPOSE: CO~LI/~qCE WORK ORDER NUMBER: 3122892 CLIENT: CHEVRON U.S.A. P.O. BOX 2292 145 S. STATE COLLEGE BLVD. BREA, CA 92822-2292 JUDY BOWE (714)671-3214 SITE:CHEVRON 206561 3360 PANAMA BAKERSFIELD, CA 93304 MANAGER (805)555-1212 The following test(s) were conducted at the site above in accordance with all applicable portions of Federal~ NFPA and local regulations Line and Leak Detector Tests 89 i PLUS y p 87 2 ~G ~ y p 92 3 S~ y p Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. Tanknology representative: Test conducted by: KEN MINTON RICHMOND PHILLIPS Reviewed: Technician Certification Number: 91-1071 Printed 06/04/2002 08:33 CCHAPA INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/29/02 CLIENT:CHEVAON U.S.&. Tankno/ogy 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER:~122892 AUSTIN, TEXAS 78757 (512) 451-6334 SlTE:CHE'v'AON 206563. Tank ID: 89 Product: PT.OS Capacity in gallons: 3.3-, 849 Diameter in inches: 3-2o. o0 Length in inches: 245 Material: DW FIBERG COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: Overfill protection: Y~s Overspill protection: Installed: ATe CP installed on: / Bottom to top fill in inches: 168.5 Bottom to grade in inches: 176.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: 4, o 0 Stage I vapor recovery: DUAL Stage II vapor recovery: BALANCE Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: Bubble NOT TESTED COMMENTS End (in) Ullage New/passed Failed/replaced L.D. #1 L.D. #1 Make: V~U~O~T~--SS VA~O~T,-SS Model: LD2000 LD2000 S/N: z2z~78 zosz336 Open time in sec: 4 o00 Holding psi: 22 Resiliency in mi: 175 /'est leak rate mi/m: 189. o Metering psi: zo Calib. leak in gph: 3.00 3.00 Results: PASS FAIL COMMENTS New/passed Failed/replaced L.D. #2 L.D. #2 NOT TESTED COMMENTS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: DW FIBERG 2.0 175.0 NOT TESTED PRESSURE FE PETI~O NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: u-ta~ow~ Printed 06/04/2002 08:33 INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/29/02 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBERS122892 CLIENT:CH~',/3~ON O.S.&. 'AUSTIN, TEXAS 78757 (512) 451-6334 SlTE:CI-IEV~ON 206561 Tank ID: 8? 2 Product: ~G Capacity in gallons: 11,849 Diameter in inches: 120. oo Length in inches: 245 Material: DW FIBERe COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: 3rss Overfill protection: 3r~s Overspill protection: Installed: ATe CP installed on: / Bottom to top fill in inches: 172.0 Bottom to grade in inches: 176.0 Fill pipe length in inches: 49.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: BALANCE Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: Bubble NOT TESTED COMMENTS End (in) Ullage New/passed L.D. #1 Make: FE PETRO Model: S/N: Open time in sec: 4 o oo Holding psi: Resiliency in mi: Test leak rate mi/m: 189 Metering psi: Calib. leak in gph: 3. oo Results: COMMENTS Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #2 L.D. #2 NOT TESTED COMMENTS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: DW FiBERG 175.0 NOT TESTED PRESSURE FE PETRO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: TJ-t~'~OW~ Printed 06/04/2002 08:33 INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/29/02 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBERS122892 CLIENT:CHE'v'~ON O.S.&. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:CH~-"v'~.ON 206561 Tank ID: 92 3 Product: soP~ Capacity in gallons: 11,849 Diameter in inches: 120 o 00 Length in inches: 245 Material: ~ FIBERe COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: ¥'¢s Overfill protection: ~s Overspill protection: Y~s Installed: ATe CP installed on: / Bottom to top fill in inches: 176.0 Bottom to grade in inches: 182. o Fill pipe length in inches: 52. o Fill pipe diameter in inches: ¢ o 0 Stage I vapor recovery: DUAL Stage II vapor recovery: BALANCE Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: Bubble NOT TESTED COMMENTS End (in) Ullage New/passed L.D. #1 Make: F- PETRO Model: ~ S/N: Open time in sec: 4. oo Holding psi: 14 Resiliency in mi: z65 ]'est leak rate mi/m: la9 Metering psi: lo Calib. leak in gph: 3. oo Results: ~,ASe COMMENTS Failed/replaced New/passed Falled/replace~ L.D. #1 L.D. #2 L.D. #2 NOT TESTED COMMENTS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: DW FIBERG 2.0 175.0 NOT TESTED PRESSURE FE PETRO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Printed 06/04/2002 08:33 TEST DATE:05/29/02 CLIENT:C~EI/RON U. S .A. 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 WORK ORDER NUMBER3122892 SITE: CHEV'RON 206561 COMMENTS PARTS REPLACED i LEAK DETECTOR - VAPORLESS HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) Printed 06/04/2002 08:33 CCHAPA SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/29/02 CLIENT: C~I~'I/~O~ O...~ .-~. WORK ORDER NUMBEP,3122892 SITE: C['Z~'wv"~.ON 206561 STER ITl Z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA.. ~12K PLUS ~12K REG PANAMA LANE ~12K SUP W~E Printed 06/04/2002 08:33 CCHAPA ~-~' 'r~rJ~o~l:3~j~ J~IITORING SYSTEM CERTIFICATION ~ ForWBy All Jurisdictions Within the State of California t Authority Cited: Chapter 6. 7, Healtl~nd Safety Code; Chapter 16, Division 3 Title 23, CallTffFhia Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitorinq system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CHEVRON 206561 Site Address: 3360 PANAMA City: BAKERSFIELD CA Zip: 93304 Contact Phone No: 555-1212 Facility Contact Person: MANAGER Date of Testihg/Service: 05/29/2002 Make/Model of Monitoring System: TLS-350 Work Order Number: 3122892 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced  nk ID: I [._~ank ID: 2 In-Tank Gauging Probe. Model: MAG-1 ~ In-Tank Gauging Probe. ~ Annular Space or Vault Sensor. Annular Space or Vault Sensor. Model: 409 Piping Sump/Trench Sensor(s). Model: 352 Fill Sump Sensor(s). Model: 352 Mechanical Line Leak Detector. Model: LD-2000 Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: MAG-1  Other (specify equipment type and model in Section E on page 2). nk ID: 3 In-Tank Gauging Probe, Model: MAG-1 Model: MAG-1 Model: 409 Piping Sump/Trench Sensor(s). Model: 352 Fill Sump Sensor(s). Model: 352 X---] Mechanical Line Leak Detector. Model: MLD ~] Electronic Line Leak Detector. Model: X---1 Tank Overfill/High-Level Sensor. Model: MAG-1 ~] Other (specify equipment type and model in Section E on page 2). Tank ID: X-=] Annular Space or Vault Sensor, Model: 409 X--'1 Piping Sump/Trench Sensor(s). Model: 352 X---1 Fill Sump Sensor(s). Model: 352 .~ Mechanical Line Leak Detector. Model: MLD Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: MAG-1 Other (specify equipment type and model in Section E on page 2). -"] In-Tank Gauging Probe. Model:  Annular Space or Vault Sensor. Model: Piping Sump/Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: ] Electronic Line Leak Detector. Model: [] Tank Overfill/High-Level Sensor. Model: [] Other (specify equipment type and model in Section E on page 2). Dispenser ID: 1/2 X-~ Dispenser Containment Sensor(s) Model: 322 X~ Shear Valve(s). '~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 3/4 [] Dispenser Containment Sensor(s) Model: 322 ]Shear Valve(s). [] Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/6 r~ Dispenser Containment sensor(s) Model: 322 [] Shear Valve(s). Dispenser ID: 7/8 [] Dispenser Containment Sensor(s) Model: 322 [] Shear Valve(s) ~ 'Dispenser Containment Float(s) and Chain(s), Dispenser ID: [] Dispenser Containment Sensor(s), Model: [] Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: ] Dispenser Containment Sensor(s). Model: [] Shear Valve(s). O Dispenser Containment Float(s) and Chain(s). --'] Dispenser Containment Float(s) and Chain(s). * If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C, Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): System set-up report; ~1 Alarm history report [~] SIGNATURE: '~'~' ~' PRINTED NAME:RICHMOND PHILLIPS COMPANY: TanknoJogy PHONE NO: (800) 800-4633 page 1 of 3 Based on CA form dated 03/01 Mc~ring System Certification Site Address: 3360 PANAMA Date of Testing/Service: 05/29/2002 D. Results of Testing/Servicing Software Version Installed: rl/a Complete the following checklist: [] Yes [] No Is the audible alarm operational? [] Yes [~ No Is the visual alarm operational? [] Yes [] No Were all sensors visually inspected, functionally tested, and confirmed operational? ~ Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not [] Yes [] No * interfere with their proper operation? [] Yes [] No * [] N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] Yes [] No * [] N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) [] Sump/Trench Sensors; [] Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? [] Yes [~ No [] Yes [] No * [] N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? 90 ~ [] Yes* [] No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* ! [] No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) [] Product; ~ [] Water. If yes, describe causes in Section E, below. [] Yes [] No * Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes [] No * Is all monitoring equipment operational per manufacturers' specifications? n Section E below, describe how and when these deficiences were or will be corrected, E. Comments: replaced mechanical leak detector on 89 grade...all leak detectors passed...system is operational per R. Phillips page 2 of 3 Mot~oring System Certification Site Address: 3360 PANAMA Date of Testing/Service: 05/29/2002 F. In-Tank Gauging ! SIR Equipment [] Check this box if tank gauging is used only for inventory control. [] Check this box if no tank gauging or SIR equipment is installed. ThiS section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: [] Yes [] No * Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No .Were ail tank gauging probes visually inspected for damage and residue buildup? [] Yes [--1No II Was accuracy of system product level readings tested? []Yes ~--'lNo Was accuracy of system water level readings tested? [] Yes []No Were all probes reinstalled properly? [] Yes [] No Were all items on the equipment manufacturers' maintenance checklist completed? .. * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD)' [] Check this box if LLDs are not installed. Complele the following checklist: For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] Yes [] No [~N/A (Check all that apply) Simulated leak rate: [] 3 g.p.h [] 0.1 g.p.h E~]o.2 g.p.h [] Yes [] No Were all LLDs confirmed operational and accurate within regulatory requirements? [] Yes []No * Was the testing apparatus properly calibrated? [] Yes [] No * [] N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] Yes E~No * [] N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? [] Yes : []No * [] N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? [] Yes []No * [] N/^ For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? F-~ Yes []No* [] N/A For electronic LLDs, have all accessible wiring connections been visually inspected? E~] Yes []No *i Were all items on the equipment manufacturers' maintenance checklist completed? · In the Section H, below, describe how and when these deficiencies were or wilt be corrected. H, Comments: page 3 of 3 Work Order: 33.22892 m'STm DA'r~r IM~. ,Ep,_~!aT CHEURON., 3360 P~' 'L~ B~KE~FI ELD ~-20651PH-396~047 ~HIFT'TI~ 2 : DI~L~ S~I.~ Tl~~ : DI~ 8HI~ TINE 4 : DI~ SHI~ BIR PRI,~O~8 E~LED' ~ILY B1R ENRB~ D ! ~L~D ANNUL ~ ~NIrG DIbBLeD PRI'~ IC VOLTa ENgBL~ Ta~ O0~gTlON V~L~ (D~ F )': 60.0 RR-D I ~CT L~L PR I NTO~ DI~ED ~DE : 0DODO0 I;~-B- 232 SECURI~ CODE : 000000 :END OF SABLED ! N-TANK SETUP T 1 :SUPREME PRODUCT CODE THERMRL COEFF : .O0070O TANK DI~ETER :' 120.00 Tg~ P~F I L~ : 4 F~L VOL : 11849 90.0 INCH ~L : 9894 60.0 I~H VOL : aO.O I~H VOL : FLOAT SIZE: 4,.0 IN, 8496 ~TER b~Nl NG : I,.0 HIGH k[qTER LIMIT: ~X O~ L~. VOL: 1184~ OVErt LL LIMIT : RICH P~DU~ : : I 1256 I)EL I V~y L IS,IT : 947 L~ R~D ~' : 500 ~ g~RM Li~IT': t0 8ODDEN LO~ L I ~ t T: 25 'F~ TILT' : O.oO ~NI FOLDHB T~K8 DELIVERY LIMIT LOO PRODUCT : ,LEt~ ~L~RM LIMIT: SUDDEN LOI~t ' L I M IT: TRNI{ TILT ~NI FOLD~ T~. TP: NONE 11::256 9~7 5oo 10 o. OO LF~K, SIN ANNUAL : 8~ : 947 PF_J~ 1 OD I c TE~T ANNUAL' T~T FAiL ~N DI P~RIODIG 7~ FAIL· ~ D I ~AB~ G~ T~ F~I:L ALA~ D I ~AB~D AN~ T~T AV~AG I NG :. oFF PE~ T~T AVER~[~: OFF TANK TEST NOTIFY: ' O~ rout- T~T ~IDHON ~EAK:OFF Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3122892 T ~': UNLI:i~DED PRODUCT CODE : 'i*}!ERDg~L 'COEFI-' .'OD0700 T~qNK DI~ETE~ : 120. TaNK P~FILE" ,: ,4 FU~ '~L : 11846 90.0 I'I~H VOL : 9894 · 60.0 I~:H VOL · '3O.'O'I:~H ~OL : 23!8 FLOat f;IZ£: 4.0 IN. · I~aTER I~RNI NG : i. 0 H.I~H t4g~ LIH!T: ~X. OR ~ VOL: 1 -OVERFILL LiHIT ,: 90~ aI,GN P~D OCT : 9~ : 11 94~ LO~ Pied UCT : ~gK, gLg~M L I ~t T: 10 ~t, IDDEN E~ LIMIT: 25 T~NK TILT . : 0.00 MGNI ~LDED TANKS F4,7. P~I~ i OD I C IEgT TYPE' E:TA~IDhR'£, ~U:~RM D~$~m.ED G~)~g TEST FgI k aNN TEst AVEP~I NG: OFF I~ER ~'1'. aversely: OFF Li(~UtD ~$ENSOR :SETUP ~- 9~.-bTP :Si:JMP DUaL FLT, DI:SC'RIHINATI~ CATEGORY : STP L 4.: 89 ~RNN~.~R 5:89-FILls SL~P FliT. DI~Rt:HI Mal'I.N*3 G~TEGORY : PIPING SUMP L 6: ag--STP DU~L FLT. 'I~I~2RI MI HAT/Nlg I. 7': 87¢ANNbEaqR TRJ..EffATE /TSINGLE FLOAT ) ¢~TI?E,0R¥ : ~NNUI~R SPACE [, 8:07~FI:L1, S~q.P DU~I. 'FLT. D I SCRIM i NaT1NG ,CPiT~QR\' : PI'P,I~ S~ L 9:87-:~~ PlthL FLY. 'HIGH' .V~POR l,I l :[.,ISPE~cER P~N 3-4 bt~,5i FLT. D I sORt m i N~!'r i ~a; C~'!:D'3OR~? .~ D'I,~PE~kqER PAN L:I 2:51SI:q:.~&4EP PA,N 5-6 DUAL FLI'. DI~::IeiMJI,~TING ,,7~TEGOR~ ': DI~PEI't:;~ER PAN Lt~:'i)P,:;I:~ENSEi~~ PAN 7-8 Dt~L :FLT. D I!~R I ~I Nat I NG Yv/~:~ ............. r~OP.I.~,'~LL¥ OPEN I N-T.A~g< .ALARMS T I:HIGH I,~TER ALARM T I :LOW PRODIJOT '~3L~iRM MOULD sE~R A~ L i :EUEL L 2 ;FUEL L 3 :FUEL L 1 I :F~ aLg~ L 2:SEN~R O~r A~RM LI 1 :~ENSOR OUT: ['! 2: SEN~)R OUT :-g~l LI S:SE~ OUT AL&~' L 2;SttO~ ALA~ L/O :SHORT Li.t :sno~, ~L~RM LI 3 :SHORT L 2,:HIGH LI,~UiD-AL~ L 3:NIGH [lOUID Lt O:HI~H LIQUID LII:NIGH LlOUID LI2:,HIGH LiatHIGH LI'~UID R 2 :'S9-SH~D©WN T~ZpE. , , , . STANDARD NORMALLY OPEN IN-TANK-ALARMS. T 2;H'ICH ~TER-ALARM T 2:LO~4 PROD~.gLAF~! L I OOlb. SEMSOR ~LMS L '4: FUEL hi~R~. k 'S:FUEL ~L~ k 6:FUEL ALA~ L 10 :FUEL Li2;FLJEL A~RM LI 3:'FIJEL ~t~RM ,L 4;BE~ OUT L .5: SE~R OUT h .6.:~R: 'OUT bi 1 :SEt. OR O~ L 1'2 :SENSOR O~ LI'3 ~SEN~OR: Ob~ A~RM .L 5:SHORT Al,ARM :L ' ~: SHORT · 1. I 0 :~SHORT LI I :SHOR~ gLa~ L 5~HIGH LIOUtD ALA~t {.lO:HIGH LIOUID LI.I :HIGH LIOUID LI2:'H1GH hlOlllD g~m L:13:HIGR LiOn? A~RM L 4:LIOUID :bg~N'INt~ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3122892 LIOUID WARNING MAY' 29,2002 10:57 3:LOW P~DUCT ALARM I1 :'FUEL '~M. '8.:SEI~R oUT ALA~ ~i~ ~SE~I~W OUT 8:SHO~T '9.~SHO~: ALA~ ':HIGH LIQUID 'A~f c~:~ :.HI GH '1' JOU] D'.g ' :LIQUID ~WARN I ~ J :LIOUID [,k%RNIKEg L 6:Sg~S'I'I~,SUI'tP HIGH, LIOUID,ALg~ HAY 29.200210:54 AM' ~,sUMP . LIQUID I.~qRNING m~ 29,, 2002 10:56m 3360'P~N~q.LANE BAKEF~BFIEED CA.93304 SS-:~0~51PH-~96~7047 P~¥ 29f: 2002 10:5? ~' T I:BUPR~ VOLaIE ~ 441;2 ~hES UEL/:.gJE ~ 7437G~1~ 90~ ULL~-~E= 6252 Gg~$ TC VOLUME = A$$~ C~LB .= 47,2~ I~*3H~ ~a'r~ VOL ~ 0 '¢~S ~mT~ = OL00 I~ T~P = '75.6 DEG F T 3: LINLE6DED VO!,IIME = 5~06 t G~LS. UI.i:RG~ = 2785 ~S 9~4 U~i~E= tGOO ~LS TC VOL~ ,- 8925 C~LS ItEIGHT = .82.71 Wt~TER VOL =, 12 GALS I,~'FER = O; 90 1 NCH~ T~P ~ ~1,4 DEG F SENSOR'ALARM ?~8?~ANNULRR ANNUL/4R-.SP~CE MAY 2e. 2002 10:58AH ...... SEN~OR ALARM ...... PIPING SUMP LlOOlD ~hRNING t'~? ~9, 2002 II:.OI.A/,~ · L. 2:92~FtLL SUMp' ' PIPING ~Uffip . LIOUID WARNING MAY-29. 2002 11:O3.F~ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3~22892 T 2:PLU~' OVERFILL .MA~.'~%'2002:'.1.1':.~6~ MAY. 71' 3: UNDFJ~DPD PROBE':OLrr · ~AY ~9. 2002 i11:31 A~¢I T 2:PLUS: pROB~;'otrr MAV'29:, 200~'11r40 ~ 2002 l;l:l.l Akl T 3:: IJ NLI~D~I) ' M~V 29}, 2~02 ~i:32 ¢-4¢,~ I.'2:PLUS 'LOW-TEMP:WARNiNG MAY.,29; 2002:'1:1:4t ~H. 'r..,~.:sup~mE m¥.:~¢;. ~o82 ;It:iS ~M. ,OVERF I I~L ~LAR~ 29; 20i:~? 'K OUT '29.; '2002 1 i :33 L13:D'I~REN~ER:'P~N7-8 ~ISPE~SER, PAN, LIOUIDWA~NING; MAY 29, 2002:~f:1:42 ~' LII.:DISPE~SER.':PaN DfSPEI~ER,:P~N . LIOU[D WARNING MAY 29; 20112 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3122892 LNCR~E. END VOLUME = 107~4 NATER = 1.50 TEMP ~ -89:~'DEG GRO~ I NCREASE,~ 1310 'lOC: :NET ]t'~RE~IE~, I~VO MAY '2% 2gg~ I?:05 PM VC)Lt..IIP,E = l I 12¥ WATEP. 2167 INCH~ TEMP 8u.g DE~ F ,.;lXLS;S 1 ~%~:RE~SE= 1514 TO: NET 1N.~/REAI~E= i 4QO I N-TA~LK P, LARM$ T .1 ;HIGH i,~¥~TE~ ALARH T I':Lgt~ PROD~r AI.ff~,~ 1.1 ~uI D SE~R a~ L 1 :FUEL ALARM L ~: FUEL L 3:F~ LI 0 :F~ A~RM LI'I :FUEL AI~M LI2;~UEL ALARM L! 3: FUEL L I :SE~R OUT ], 2:SE~R O~ A~RM t, J:SE~OR OUT LI.O:SE~)R O~ ALARM .L13:SENSOR O~' ~LA~ L ~2 :S~RT L 9:'SHO~ ALA~ L10:SHO~ LH :S~RT Lt'2 :S~RT L I ~ :S~RT A~RM :L 2,: High 'LIQUID ~ 3;HIGH LIQUID A~RM LIO=HI~H Lt~UID Lll;HIOH LIgOID ~R~I I.t21HlOH IJeUID Lt ~; HIGH L i~U I D RLA~M L 1 :LIQUID :I, 3:LIODtD k~%RNI NC 'LIOiLiOUID.~RNi LI 1 :LIaUID LI 2:LIOUID U, IA~Nt L 13: L i 0~l P ~ARN 1 R, 2: ~fPE: STANDARD NOR~LI.Y CLOSED I N-TAME LIOLil I) !?~NSOR, ~LMS L 4 :FUEL; ~I~RM L :B :FL~L tl I'~FUEL A~RPI Ltg :F~EL fll~RPI L 4 :~E~OR ~ ~L~M L 5 iSE~O~ OUT ~LfiRM l~ a:~O~ OUT. LI 0 :SE~oN OUT Ltt :SE~OR OUT A~RM LI 2 ;SE~OR Ol~ L.I a;SE~R OIE AI.~RM L ~: ~ttORT L. 5:S~RT L 6:S~RT ALARM Lit :~RT ALARM LI~: a~RT L 5:HIGH LI,QI.HD ~LARH Ll'O:RI~tt LI~UID ALA~9 LI'I :HIGH I.I~UID AL.aRM LI3:HIGH LIQUID ~RM Li 3: ttt gH I, i OiJ I D Al,ARM L 4:LIQUID ~lql L 5;LIQUID b~RN1NG I, B:LI~UtD I.~NING .'LIa:LIPUID ~RNI NO LII:LIa~ID ~RN1NG R 3:87LSH~iFL~WN TYPE: STANI~D NORMALLY'CLOSED IN-:-TaNK ALARMS T 3:HIGH"WATER,AI.~%~i T 2:LOt~ PROD~;-T ALARM LIQUID. SENSOR L ?:FUEL. aLaEtH 'L ,8:FUEL L 9:F~EL AL~ LIO:FUEL A~ LIt:FUEL aLa~ LI'~:FUEL A~ LI~:FUEL L tZ:~ENSOR'OUT aLaRM .LIO:$ENSOR-OUT LI2:SENSO~.OUT A~RM Li3;MENSOR OUT ~M L 7;SHORT Li'O:~HORTAL~RM LII:SHO~ aEaRM Lla:SHORT ~L~RM LI3:SHORT ~L~M L 8:HIGH LIQUID A~RM L 9;HIGH LIQUID LIO~HIOR lIQUID Lit:HIGH LIQOlD ALARR Lt'3;HIORLtQUlD L Z:LIQOID L 9:L!QUIO WABNI~ klO:LIQUID LI2iLtQVI9 WA~NtN~ ALARa I:IaTORY ~EPORT .... IN-T~NK aLF~M- .... OVERFILL AL~ MaY 29. 2002. 11:18 MAY ~. 200! 11:5! AN HIGH PR©DUCT RLAR~ MAY 29. 2002 1I:08 MAY Il. 200i ii:51 INVALID FUEl. LEVEL M~Y 29. 2002 ll:lt PROBE Ot~ MAY ~9:, 2002 1t:19 MAY 29. 2002 1I':i5~I MAY ~% 2002 ;il:lO AM DELI%~;;RYNEEDED 2001 ti:.49 a'-t Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3122892 LIQUID WgRNi I'IG. :OVEREi LL AI,A~ PaY: 79., 2002 HIGH, Pi~ODU~ g[~l P~0~E OUT yY29, '2002 1 29; 2002 1.1133 AM DELIVER~ N~DED D~ 16, 2601 D~ 151 200i :.: .4 'SENSOR AI~_'RM L 2!92-F'~Lt SU . . P I,R:I':NG SUI~P I¢,I~UID WARgJ ~ 'HAY :29~' 20~2.:t1.:'02 ~ ~y 2,2.~ ' 2:002 18154 ~ MAY.,29. 2002 10:57 FUEL ALARM PLAY: tl. 200[ !1147 LIOUID' WARNI NO '~V:ll. 2001. 111'42 6PR ~_+ 2082 LOW PROD~ NOV ,'27~ 2~01 ~ 22, 20O'f SEP '1[,. ~OOl 101;52 PM HIGH PkOD~W Mt~R 8,'2002' 31/4~ 'MAY :29; :2002 1 [ :~;'I AM ~R. 8~ 200~ 3141 PM .gPt~ 22i' 2002 8: d~ .28~ 20OI DEC '271. 2001 5:4/i MAY: V1.; 2001 Ii :50 ~W ~i:, 2001 ..... :: .... :SE~so~,,~Lar~I = ..... :..:. L ,Z': 87 ~AN N ULAR 8NNUI~.'SPACE:" MAY 29;:.2pe2 101158 ~'~*~V 11,:200] 11 BURL, MAY !!- .......... · SENsoR:. A~ARM. - .... .L O;87.-FILL ~SUHP. P~PING S~i '" LIQUID ~%R~H MG' 1~.22;.2002 8:36 ~ ~6~ L~OUlD ~t;ARH ~ [t,. 28Ot 12102 P~ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3~22892 L 9: 87-$~rP ,SUMP STP LIOUI D IdthRNl NO MAY 29, 200~.' 10:56 SEFISOR. O~T AL~ ~V 14, 2001 .~V I i:, 2001- 1,t:45 ..~ mm.0~V' :Rr.-.pom' :---.~SOR. AhaR~i" ..... LbO:DISPENSER PAN !~2 DIBPE~R}'~ ' ~V 29;: ~200~ i 1'746 AM H i'¢H' I,IOU t D '=HgY' 22; ,2002 -,e::.2O D I SPEWER :.ORE' '29~ '..2002 I. I :'~5 ~PI :LIOUI:D (~Ni NG .SENSOR Ol.~ ALA~ ~ l.l. 2001 '.12:.1.7 PM AIJ-'tRM~ tt!DTOR¥ REPORT LI3-:D:ISPENI~tlJ~ P~N' 7-8 DIaPErER PAN · !~Y 29., 2002 ~Y Il. 200i 12:28 gL~R~ 'HISTORY ~E~ OTHE~ 'LI:5::. "'""- OTHER T 1 :SUP~EhE u~., vo~ ~, T 2::PLUS , , ~OL~E ~ 8759 c~/s q~ -,.' .... , 3081 to 1 ~HES 6D:d;;'H H[STOR!{ RE~oR~ :I:,12:DtSPENSFz~ P~N 5=6 .D I:~3pE~ER 7PAN L ~ OU1D k~ARNI t~ :Ptg~' 29, 2002 1:1¢4~ ~'1 ~Y 'ti-2001 1~:~7 ~ S~N~R 0U~ ~h MAY ll~ 20al t~:2a ~i Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Tanknology 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 05/22/2002 Order Number: 3122702 Date Printed and Mailed: 06/05/2002 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 206561 336O PANAMA BAKERSFIELD, CA. 93304 Testing performed: Secondary Containment testing Sincerely, Dawn Kohlmeyer Manager, Field Reporting SB-980ECONDARY CONTAINMENT SU~IARY RESULTS TEST DATE: 05/22/2002 WORK ORDER NO.: 3122702 CLIENT: CHEVRON SITE: CHEVRON 206561 P.O. BOX 2292 3360 PANAMA 145 S. STATE COLLEGE BLVD. BREA CA 92822 BAKERSFIELD CA 93304 CRAIG MORGAN 714-671-3282 Tank Interstital Tests PLUS Xerxes PASS REG UNLEAD Xerxes PASS SUPREME Xerxes PASS Piping Interstital Tests SUPREME Smith PASS RE~JLAR Smith PASS PLUS Smith PASS Sump & Under-Dispenser Containment Tests ~M~ SUPRE xerxes Pass SUPRE Xerxes PaSS RE~UL xerxes Pass i~EGUL Xerxes Pass PLUS x~rx~s Pass PLUS xarx~s Pass 1/2 Phil-Tire Fail 3/4 Phil-Tire Fail 5/6 Phil-Tire Fail ? / 8 Phil-Tire Fail Tanknology representative: Services conducted by: KEN MINTON DAVID LASKY PLUS Xerxes PASS REG UNLEAD Xerxes PASS SUPREME Xerxes PASS SUPREME Smith PASS RE~JLAR Smith PLUS ~2h P~S NAME: CHEVRON 206561 SITE ADDRESS: 3360 PANAMA SECONDARY CONTAINMENT TEST RESULTS 206561 05/22/2002 REASON FOR TEST: SB-989 Compliance WORK ORDER 3122702 BAKERSFIELD CA 93304 IGroundwater Level(" from grade): ANDINTERSTITIALTESTS Dia. Depth Start Initial Finish Final Pass/ Tank Product Tank Size Material Manufacturer Test Method (" ) (" ) Time Level Time Result Fail 1 PLUS 11849 120 DW FIBERG Xerxes 58 Vacuum 1855 10.00 "Hg 1955 9.77 "Hg PASS 2 REG UNLEAD 11849 120 DWFIBERG Xerxes 61 Vacuum 1849 10.10 "Hg 1949 10.06 "Hg PASS 3 SUPREME 11849 120 DW FIBERG Xerxes 62 Vacuum 1837 10.21 "Hg 1937 9.77 "Hg PASS 4 5 6 7 8 Comments: LINE INFORMATION AND INTERSTITIAL TESTS Tank Product Dia. Len. Material Manufacturer Volume Test Method Start Initial Finish Final Pass/ (" ) {feet) (gallons) Time Level Time Result Fail 1 SUPREME 4.00 175 DW FG Smith 57 Pressure 1849 5.05 psi 1949 5.03 psi PASS 2 REGULAR 4.00 175 DW FG Smith 57 Pressure 1903 5.06 psi 2003 5.06 psi PASS 3 PLUS 4.00 175 DW FG Smith 57 Pressure 1856 5.04 psi 1956 5.08 psi PASS 4 5 6 7 8 Comments: Test Date: 05/22/2002 SECONDARY CONTAINMENT TEST RESULTS WorkOrder: 3122702 SUMP '_ __ Type Tank or Disp Manufacturer Model or Diam./Width/Length Depth Test Method Start Initial Level Finish Final Pass/ # Matedal (" ) (" ) Time Level Chanqe Time Result Fail STP Sump SUPREME Xerxes Fiberglass 48 62 VPLT 1946 13 .00001 2002 -.002 gph Pass STP Sump REGULAR Xerxes Fiberglass 48 61 VPLT 1953 15 " .00000 2012 -.007 gph Pass STP Sump PLUS Xerxes Fiberglass 48 58 VPLT 1959 16 -.00056 2028 .008 gph Pass Dispenser Sump 1/2 PhiI-Tite Fiberglass 25X50 24 VPLT 2100 , gph Fail Dispenser Sump 3/4 PhiI-Tite Fiberglass 25X20 24 VPLT 2105 , gph Fail Dispenser Sump 5/6 Phil-Tire Fiberglass 25X20 24 VPLT 2109 ' gph Fail Dispenser Sump 7/8 PhiI-Tite Fiberglass 25X20 24 VPLT 2115 · gph Fail Fill Sump SUPREME Xerxes Fiberglass 48 62.5 VPLT 2233 21.5 · .00015 2246 -.009 gph Pass Fill Sump REGULAR Xerxes Fiberglass 48 57 VPLT 2210 16 , -.00011 2230 .005 gph Pass Fill Sump PLUS Xerxes Fiberglass 48 60 VPLT 2225 26 · .00009 2240 -.008 gph Pass Comments: All disp sumps levels dropped too fast to determine leak rate or initial level. All elect penetration boots are ripped on underside. 4,¸ 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE:0 5 / 2 2 / 0 2 WORK ORDER NUMBEF{312 2 7 0 2 CLIENT: CHeWy-EON SITE: CZ4~'v'RON 206561 COMMENTS One 55 gallon drum left on site provided by Joe Rhodes. Two hours labor repairing clam~s on electrical entry hoots. All dispenser pans £ailed testing. PARTS REPLACED HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) Printed 06/05/2002 08:48 CCHAPA SITE DIAGRAM ~ 'ran~ 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/22/02 CLIENT: CI'I~'VROI~' WORK ORDER NUMBER3122?02 SITE: CI-I~'VRON 206561 STER .< m z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. PLUS 2K REG PANAMA LANE SUP W~E Printed 06/05/2002 08:48 CCHAPA D May 29, 2002 Chevron 3360 Panama Lane Bakersfield, CA,93304 FIRE CHIEF RON FR.AZ.E ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (66t) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 3360 Panama Lane REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California Law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1, 2002. section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1,2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1,2001 shall be tested by January 1, 2003 and every 36 months thereafter. REMEMBER!! Any component that is "double-wall" in your tank system must be tested. Secondary containment testing shall require a permit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures · Complete items 1, ~d 3. Also complete - item 4 if Restricted~l~fvery is desired., . · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpie~e _~,, or on the front if space permits. 1. Article Addressed to: BRUCE CARPEN'I~ER CI~'VRON PRODUCTS CO P 0 BOX 6004 SAN RAMON CA 94583 [A~asei~[Cleb'.rly) B. Date of Delivery 1 ? 2002 C. Sig~ ,~ " · [] Agent X [] Addressee D. is delivery address ~fferent from item 17 [] Yes If YES, enter delivery address below; ~o 3. Service Type [~ertified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 7001 0360 0002 5244 6813 PS Form 3811, July 1999 Do~n'6sUc ~{b~h ~ece~pt 102595-99-M-1789 · Sender: Please pnnt your,r~ame,-~:IMress,~nd ZIP+4 in this- box,-·:-.-:: BAKERSFIELD FIRE DE.PART~ENT OFFICE OF ENV~RCN~ENTAL SERVICES 1715 Ch~.ste. r Avenue, Sui'~e 300 R~k, srsfie~d, CA 93301 Postage $ o 34 Certified Fee 2 o 10 Postmark Return Receipt Fee (Endorsement Required) o 50 Here Reetr{cted Delivery Fee (Endorsement Required) Total Postage & Foes $ 3.94 [Sent To BRUCE CARPENTER ~E'~'~:'"';;' ............................................................................ ~/o~o~o,~~. o ~ox ~oo~ Certified Mail Provides: · A mailing receipt · A unique identifier for your mailpiece · A signature upon delivery · A record of delivery kept by the Postal Service for two years Important Reminders: · Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. · Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. · For an additiona fee a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please comp eta and attach a Return Receipt (PS Form 3811) to the art c e and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS postmark on your Certified Mail receipt is required. · For an additional fee, de very may be restricted :t~ the addressee or addressee's authorized agent. Advise the cler~ormark the mailpiece with the endorsement "Restricted Delivery". · f a postmark on the Certified Mail race pt s desired, please present the arti- c e at the post office for postmarking. If a postmark on the Certified Mail receipt is r~Bl~eeded, detach and affix label with postage and mail. iMPORTAN~I~I~e this receipt and present it when making an inquiry. PS Form 3800, January 2001 (Reveme) 102595-01-M-1047 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 ~H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave.' Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 D May 13, 2002 Bruce Carpenter Chevron Products Co. P. O. Box 6004 San Ramon, CA 94583 Certified Mail NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Failure to Submit/Perform Annual Maintenance on Leak Detection System at Chevron//1849, 3360 Panama Lane in Bakersfield, CA Dear Mr. Carpenter: Our records indicate that your annual maintenance certification on your leak detection system is past due, May 11, 2002. You are currently in violation of Section 2641(J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days, June 13, 2002, to either perform or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Porr Jr., Assistant City Attorney April 30, 2002 City of Bakersfield Fire Department 1715 Chester Avenue, Third Floor Bakersfield, CA 93301 Chevron Products Company, Inc. po 6o evr San Ramo~3-0904 Benny Bral~ Licenses/Permits Specialist Phone No. 925-842-9002 Fax No. 925-842-9585 RE: FINANCIAL RESPONSIBH_,ITY FOR UNDERGROUND STORAGE TANKS Dear Sirs: Please find enclosed the following documents: 1) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron Facility List under your jurisdiction These documents meet the financial responsibility requirements for all USTs owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Sincerely, Benny Brar Licenses/Permits Specialist Permit Desk Enclosure: as stated April 30, 2002 Page 11 ChevronTexacO CERTIFICATION OF FINANCIAL RESPONS]BII.1TY CHEVRON U.S.A. INC. hereby certifies that it is in complianc~ with the requirements of subpart H of 4O CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFK part 280 are as follows: Financial test and corporate guarantee of ChcvgxmTexaoo Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guarant~ .covers taking corr~tive action and compensating third parties for bodily injury and prolyxty damage caused by either sudden accidental releases or nonsudden acoidental releases or accidental rel~; April 30, 2002 · CHEVRON U.SA. INC. /,/~udith L. Geisler 04/30/02 TUE 14:04 [TX/RX NO 8561] April 30, 2OO2 Pag~ 11 ChevronTexaco CERTIFICATION OF FINANCIAL ~ONSIBII.ITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFK part 280 aro as follows: Financial test and corporate guarantee of ChevrenTexaco Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April, 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guanmtee covers taking corr~x~ive action and compensating third parties for bodily injury and propexW damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases: April 30, 2002 · CHEVRON U.S~,. INC. x/~udith L. Geisler 04/30/02 TUE 14:04 [TX/RX N0 8561] April 30, 2002 Pag~ 11 ChevronTexaco CERTIFICATION OF FINANCIAL RF. SPONSIBH,rFY CHEVRON U.S,A. INC. her~,by certifies that it is in compliance with ~c r~quiremeats of subpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFR. part 280 aro as follows: Financial test and oorporate guarantee of Ch©vronTexaco Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for ~he period commencing April 30, 2002 and which is anticipated to be nmowed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental roleases~ April30,2002 · CHEVRON U.S.A. INC. /'~udith L. Geisler 04/30/02 TUE 14:04 [TX/P~ N0 8561] April 30, 2002 Page 11 ChevronTexaco CERTIFICATION OF FINANCIAL RESPONSIBH.rrY CI-IEVRON U.S.A. INC. be .r~by certifies that it is in compliance with tho requirements of subpart H of 4O CFR part 280. The financial assurance mechsni.~ns used to demonstrate financial responsibility under subpart H of 40 CFK part 250 aro as follows: Financial test and corporate guarant~ of ChevronTexae, o Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commerl~ing April 30, 2002 and which is antioipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guanmtee covers taking co~ action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsuddem accidental releases or acei&,-ntal r~leases: April30,2002 · CHEVRON U.S.~- INC. 04/30/02 TUE 14:04 [TX/P,X NO 8561] April 30, 2002 Page 11 ChevronTexaco CERTIFICATION OF I~'INANCIAL RESPONSIBII.ITY CHEVRON U.S.A. INC. be .r~by certifies that it is in complianc~ with the re~iuirements of subpart H of 40 CFR part 280. The financial assurance mec2mnisms used to demonstrate financial responsibility under subpart H of 40 CFR pm 280 aro as follows: Financial test and oorporate guarantee of ChevnmTexaco Corporation in the mount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guarantee covers taking corrective aotion and compensating third parties for bodily injtuy and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidontal releases: April 30, 2002 .CHEVRON U.S.A. INC. ,,/Judith L. Geisler 04/30/02 TUE 14:04 [TX/RX N0 8561] April 30, 2OO2 Page 11 ChevronTexaco CERTIFICATION OF lrlN~~ ~ONSIBII.rI'Y CI~VRON U.S.A. INC. be .ruby oertifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFK part 280 aro as follows: Financial test and oorporato guarante~ of ChevronTexaoo Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anfioipated to be renewed annually, with li~e next renewal scheduled to occur during the first 120 days of 2003. Said guarantee covers taking corrective aotion and compensating third parties for bodily injury and property damage caused by either sudden aocidental releases or nonsodden accidental releases or a~idontal role, as~: April30,2002 · CHEVRON U.S.~ INC. 04/30/02 TUE 14:04 [TX/RX N0 8561] April 3O, 2002 Page 11 ChevronTexaco CERTIFICATION O1~ leINANCIAL RESPONSIBH.1TY CHEVRON U.S-A. INC. he .~by certifies that it is in compliance with the requirements of subpart H of 4O CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFK pa~ 280 are as follows: Financial test and corporate guarantee of ChevronTexaco Corporation in the amount of $1 million per occurrence, $2 million annual aggroga~, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with thc next renewal scheduled to occur during the first 120 days of 2003. Said guanmtee .covers taking corrective action and compensating third parties for bodily injury and pwperty damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases: April30,2002 .CHEVRON U.S.A. INC. 04/30/02 TUE 14:04 [TX/RX NO 8561] April 30, 2002 Page 11 ChevronTexaco C'K-'R'FIIqCATION O1~ I~'IN~~ ~ONSIBII,rrY CI-~VRON U.S,A. INC. bemby certifies that it is in compliance with tho requirements of subpart H of 40 CFR part 280. The financi~ assurance mechani.~n.~ used to demonstrate financial responsibility under subpart H of 40 CFK part 280 aro as follows: Financial test and corporate guarenteo of ChevronTexaco Corporation in the mount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with thc next renewal scheduled to occur during the first 120 days of 2003. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental role, ases or accidental releases: April30,2002 · CHEVRON U.S.A. INC. Senior Counsel " 04/30/02 TIIE 14:o4 [TX/RX NO 8561] 001 ChevronTexaco Corporation 575 Market Street San Francisco, CA 94105-2856 Tel 415 894 3232 Fax 415 894 6017 John Watson Vice President and Chief Financial Officer ChevronTexaco April 30, 2002 UST FINANCIAL ASSURANCE To Whom It May Concern: I am the Chief Financial Officer of ChewonTexaco Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate fmancial responsibility for taking corrective action and compensating third parties for bodily injury and property damage mused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor -- all underground storage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test. A financial test and guaramee are also used by this guarantor to demonstrate evidence of f'mancial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§ §264.143 and 265.143) Post-Closure Care (§ §264.145 and 265.145) Liability Coverage (§§264.147 and 265.147) Corrective Action (§264.101 (b)) Plugging and Abandonment (§ 144.63) 91,323,697 80,968,710 8,000,000 22,164,100 t,562,960 California State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment 207,359 735,685 66,000,000 0 0 04/30/02 TUE 14:01 [TX/RX NO 8560] April 30, 2002 Page 2 ChevronTexaco · Louisiana State Program Closure 4,914,355 Post-closure Care 844,687 Liability Coverage ~,000,000 Corrective Action 0 Plugging and Abandonment 0 Total 277,721,553 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "gomg concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. ALTERNATIVE Il 1. Amount of annual UST aggregate coverage being assured by a test and guarantee $ 2,000,000.0Q Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a fmancial test and guarantee $ 277,721,553.00 3. Sum of lines 1 and 2 4. Total tangible assets 5. Total liabilities 6. Tangible net worth 7. Total assets in the U.S. 279,721,553.00 77,354,000,000.00 43,614,000,000.00 33,740,000,000.00 32,629,000,000.00 8. Is line 6 at least $10 million? Yes N___9_o 9. Is line 6 at least 6 times line 3? 10. Are least 90% of assets located in the U.S.? (If'~No", complete line 11 .) X X 11. Is line 7 at least 6 times line 3? X 04/30/02 TIlE 14:01 [TX/RX NO 8560] U,~/~u/uz 'ru~ Iz:57 FAX 1 415 894 5640 CHEVRON CORP. ~003 April 30, 2002 Page 3 ChevronTexaco 12. Current assets 13. Current liabilities 14. Net working capital (subtract line 13 from line 12). 15. Is line 14 at least 6 times line 3 ? 16. Current bond rating of most recent bond issue 17. Name of rating service 18. Date of maturity of bond $ N/A $ N/A $ N/A $ N/A Standard & Poors October 11 2004 19. Have financial statements for the latest fiscal year been filed with the SEC, the Energy Information Administration, or the Rural Electrification Administration? Yes Nc> I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisi~ina was added to make disclosure more complete. /_.'Watson ' ' -Vice President, Finance April 30, 2002 04/30/02 TUE 14:01 [TX/RX NO 8560] TUg 12:57 FAX 1 415 5640 CHEVRON CORP. April 30, 2002 Page 4 004 ChevronTexaco GUARANTEE Guarantee made this April 30, 2002, by CHEVRONTEXACO CORPORATION, a business entity organized under the laws of the Slate of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively refelTed to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. ("CUSA"), of 575 Market Street, San Francisco, CA. RECITALS I. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee underground storage tanks at various facilities in the states off Alaska Arizona California Florida Georgia Hawaii Louisiana Nevada Oregon Texas Utah Washington This guarantee satisfies 40 CFR part 250, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt ora notice of cancellation of this guarantee and the Director of the implementing agency has determined or 04/30/02 TUE 14:01 [TX/RX NO 8560] 'rue 1z:58 FAX 1 415 5640 CHEVRON CORP. April30,2002 Page 5 O05 ChevronTexaco suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions 'of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. IfCUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instmcfions t~om the Director, shall fund a standby Wast in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt 6f the notice by CUSA, as evidenced by the retum receipt. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply'with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above- identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; 04/30/02 TUE 14:01 [TX/RX NO 8560] 12:58 FAX 1 415 5640 CHEVRON CORP. April 30, 2002 Page 6 006 ChevronTexaco (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or ent~ustment to others of any aircraft, motor vehicle, or watercraft; (d) Property damage to any property owned, rented, loaned to, in the care, custody, or conl~ol of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 30, 2002 CHEVRONTEXACO CORPORATION Vice President, Finance Assistant Secretary 04/30/02 TUE 14:01 [TX/RX NO 8560] U'&/~U/UZ TUE 12:58 FAX 1 5640 CHEVRON CORP. April 30, 2002 Page 11 007 ChevronTexaco CERTIFICATION OF FINANCIAL RESPONSIBII JTY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFR part 280 are as follows: Financial test and corporate guarantee of ChevronTexaco Corporation in the amount of $ i million per occurrence, $2 million annual aggregate, for the period commencing April 30, 2002 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2003. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 30, 2002 cHEVRON U.S.A. INC. J.~ffrey ~ojcher Senior Counsel By //Judith L. Geisler Legal Analyst 04/30/02 TUE 14:01 [TX/RX NO 8560] ,0 D April 17, 2002 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661 ) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 ~H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Chevron 3360 Panama Lane Bakersfield CA 93304 RE: Necessary Secondary Containment Testing Required by December 31, 2002 REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1, 2002. Section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1, 2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. Secondary containment testing shall require a permit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Since~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures D FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661 ) 395-1349 SUPPRESSION SERVICES 2101 UH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 -- April 5, 2002 RE: Chevron Service Station #20-6561, 3360 Panama Ln in Bakersfield Dear Mr. Roehl This is to inform you that this department has reviewed the result of the preliminary site assessment report dated December 31, 2001associated with the soil sampling performed at the above referenced facility.. Based upon the laboratory analytical results of the soil samples collected during this phase of investigation at the site, adsorbed-phase TPH as gasoline, BTEX, MTBE, TBA, DIPE, ETBE, and TAME concentrations were not observed in the soil at the site. Nothing in this determination shall constitute or be construed as a satisfaction or release from liability for any conditions or claims arising as a result of past, current, or future operations at this location. Nothing in this determination is intended or shall be construed to limit the rights of any parties with respect to claims arising out of or relating to deposit or disposal at any other location of substances removed from the site. Nothing in this determination is intended or shall be construed to limit or preclude the Regional Water Quality Control Board or any other agency from taking any further enforcement actions. This letter does not relieve the tank owner of any responsibilities mandated under the California Health and Safety Code and California Water Code if existing, additional, or previously unidentified contamination at the site causes or threatens to cause pollution or nuisance or is found to pose a threat to public health or water quality. Changes in land use may require further assessment and mitigation. If you have any questions regarding this matter, please contact me at (661) 326-3979. Sincerely, RALPH E. HUEY, Director Prevention Services Howard H. Wines, III Hazardous Materials Specialist Registered Geologist No. 7239 Office of Environmental Services cc: J. Whiting, RWQCB ")'3 '- -~, ., --'.- l U 4 q ........ -"--,-..'o-7047 F~B 5, 2002 9:29 AN T 1 :SUPREf,.,IE VOL UI"IE ; 1P 79 (:';aLS ULLAGE 1 Of:'?f:l. 90~'~; ULLAGE= 9085 TC VOLUP1E = 1 579' HEIGHT ,_,.: t0aTE~ VOL ':'" ' ~ .... 1' NCHES = 0 ,?aLS TENP = 61.2 DEG F T 2 :PLUS VOL UNE ULLAGE = 24:2,9 GaLS ~225 .... '- ' Q~LS Tu VOL. UNE = 343S GaLS HEIL~HT = 31.15 INCHEf3 ~AT~. = 0 C;AL, S k~aT~' ~ = 0.00 INCHES TEt"I~ ~_' = 60.0 DEG F T :3: UNLEADED VOL UP1E 7 ..U./__. L a~2E _ 464 f.; G'/itLS - 7200 L';ALS ~O~; 0LLAOE= 601 5 GF~LS TO VOLat,~E = 4640 (~aLs HEIGHT = 49.00 INCHES aaTE~ VOL = 0 O~I.S'- ~TE~ = 0,00 l fICHES TENp = 61.6 DEG F' FACILITY NAME ~:~Oct~c~ ADDRESS ~3(,,~ ~ttna oxt,,. FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION DATE PHONE NO. ~d~ 1' .3¢(,,TM BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES 9 Section 1: Business Plan and Inventory Program ~ Routine [~j Combined I~ Joint Agency I~ Multi-Agency ~ Complaint l~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate L / ,-- Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures Emergency procedures adequate L. / Containers properly labeled L / / Housekeeping Fire Protection Site Diagram Adequate & On Hand r,., / C=Compliance V=Violation Any hazardous waste on site?: Explain: Yes ~No Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business Sit~ es77y Party Inspector: FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program [] Routine [~ Combined Type of Tank 0Wl=' Type of Monitoring [] Joint Agency [] Multi-Agency [] Complaint Number of Tanks ~ Type of Piping /'kill=~ [] Re-inspection OPERATION C V COMMENTS Proper tank data on file {,.,, Proper owner/operator data on file 1~ Permit tees current ~. Certification of Financial Responsibility {~ Monitoring record adequate and current ~ Maintenance records adequate and current 1~~" Failure to correct prior UST violations C Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance ~ V=Violation Y=Yes N=NO Inspector: Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Business Site Responsible Party October 19, 2001 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Mr. Mark Magargee, CHG, RG Holguin, Fahan & Associates 2820 Pegasus Drive, Suite 1 Bakersfield, Ca 93308 RE: Chevron Station #20-6561 at 3360 Panama Lane Dear Mr. Magargee: This is to notify you that the work plan for the above stated address is satisfactory. Please give this office 5 working days notice prior to the commencement of work. Please be advised that any work done that is not performed under direct oversight by this office will not be accepted, unless previously approved. If you have any questions, please call me at (661) 326- 3979. Sincerely, Howard H. Wines, III Hazardous Materials Specialist Registered Geologist No. 7239 Office of Environmental Services H HW/dlm cc: E. Roehl, Chevron Products Co. S:\USTFORMS\UST.L3 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 05/11/2001 Order Number: 3116909 Date Printed and Mailed: 05/24/2001 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 206561 3360 PANAMA BAKERSFIELD, CA. 93304 Testing performed: Leak detector tests Monitor certifications Sincerely, Dawn Kohlmeyer Manager, Field Reporting CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING Tan 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST DATE: 05/11/01 TEST TYPE: TLD-1 CUSTOMER PO: 4597966 CLIENT: CHEVRON U.S.A. P.O. BOX 2292 145 S. STATE COLLEGE BLVD. BREA, CA 92822-2292 JUDY BOWE (310)694-7349 PURPOSE: COMPLIANCE WORK ORDER NUMBER:3116909 SITE:CHEVRON 206561 3360 PANAMA BAKERSFIELD, CA 93304 MANAGER (805)555-1212 The following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations 89 1 87 2 92 3 PLUS REG UNLEAD SUPREME Line and Leak Detector Tests Y Y Y P P P Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. Tanknology representative: Services conducted by: KMINTON RICHMOND PHILLIPS Reviewed: Technician Certification Number: 91-1071 Printed 05/24/2001 08:33 CCHAPA INDIVIDI TANK INFORMATION ST RESULTS TEST DATE: 05/11/01 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3116909 CLIENT:CH~.VRON o. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cH~.VRON 206561 Tank ID: 89 Product: PLUS Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: DW ~"IBERG COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: ~s Overfill protection: YES Overspill protection: 'z~s Installed: ATG CP installed on: ! Bottom to top fill in inches: 168.5 Bottom to grade in inches: 176.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: BALANCE Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS Bubble Ullage NOT TESTED L.D. #1 Make: F~. PETRO Model: S/N: n/a Open time in sec: 4. oo Holding psi: Resiliency cc: Test leak rate mi/m: ls~. o Metering psi: zo Calib. leak in gph: 3. oo Results: pass COMMENTS L.D. #1 L.D. #2 L.D. #2 NOT TESTED COMMENTS Material: DW FIBERG Diameter (in): 2.0 Length (ft): 125.0 Test psi: Bleedback cc: Test time (min): NOT Start time: End time: Final gph: Result: Pump type: P~S SUR~ Pump make: ~ PET~O NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: m~"K~OWN Printed 05/24/2001 08:33 TEST DATE:05/11/01 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3116909 CLIENT:CH]&-v-AON U.S.A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cHEVRON 206561 Tank ID: 8"/ 2 Product: :t~G Capacity in gallons: 11,849 Diameter in inches: 120. O0 Length in inches: 2~,5 Material: DW COMMENTS Tank manifolded: NO Vent manifolded: No Vapor recovery manifolded: ~s Overfill protection: 3t-J~S Overspill protection: ~s Installed: ATO CP installed on: / Bottom to top fill in inches: 1'/2.0 Bottom to grade in inches: 176.0 Fill pipe length in inches: 49.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DO~.L Stage II vapor recovery: Start (in) End (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Bubble Ullage Test time: Inclinometer reading: VacuTect Test Type: NOT VacuTect Probe Entry Point: TEs~J~]:) Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Make: Model: S/N: Open time in sec: 4. oo Holding psi: Resiliency cc: ?o Test leak rate mi/m: leg. o Metering psi: Calib. leak in gph: 3. oo Results: ~Ass NOT TESTED COMMENTS COMMENTS Material: DW FT]~.RC- Diameter (in): Length (It): 125.0 Test psi: Bleedback cc: Test time (min): NOT Start time: End time: Final gph: Result: Pump type: Pump make: NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Printed 05/24/2001 08:33 INDIVID TANK INFORMATION RESULTS TEST DATE: 05/11/01 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3116909 CLIENT:cHEVRON O. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:CHE~v'RON 206561 Tank ID: 92 Product: s trgz~,_N~ Capacity in gallons: 11,849 Diameter in inches: 120. O0 Length in inches: 245 Material: Dw FTB~.RG Tank manifolded: No Vent manifolded: No Vapor recovery manifolded: Y~s Overfill protection: YI~S Overspill protection: Installed: ATG CP installed on: ! Bottom to top fill in inches: 1'/6.0 Bottom to grade in inches: 182.0 Fill pipe length in inches: 52.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: Stage II vapor recovery: COMMENTS Start (in) End (in) II Bubble Ullage NOT TESTED Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Make: FE PETRO Model: S/N: Open time in sec: 4. oo Holding psi: Resiliency cc: Test leak rate mi/m: zeg. o Metering psi: zo Calib. leak in gph: 3. oo Results: PASS COMMENTS NOT TESTED COMMENTS Material: DW FIBERC- Diameter (in): 2.0 Length (fi): 125.0 Test psi: Bleedback cc: Test time (min): NOT Start time: End time: Final gph: Result: Pump type: PRESSURE Pump make: ~ P~.TRO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Printed 05/24/2001 08:33 SITE DIAGRAM ~1~ 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/11/01 CLIENT:C[-D~¥'R. ON O'. S WORK ORDER NUMBER3116909 SITE: CHEVRON 206561 STER rn Z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. ~12K PLUS PANAMA LANE {~12K REG ~12K SUP V~E e) Printed 05/24/2001 08:33 CCHAPA Test Date: 05/11/2001 ONITOR SYSTEM CERTIFI~i~TION TANKNOLOGY Work Order #: 3116909 Client: CHEVRON U.S,A. Site: P.O. BOX2292 BREA, CA, 92822 CHEVRON 206561 3360 PANAMA BAKERSFIELI), CA, 93304 Overall System Operation The pumps; Shut down automatically if the system detects a leak, fails to operate, or is electronically disconnected. The system has functioning audible and visual alarms. The circuit breaker for the system is properly identified. The system is certified operational per manufacturer's performance standards. [X ] Yes [ ] No IX ] Yes [ ] No [ ] Yes [X ] No [X ] Yes [ ] No Product Tank Monitoring: [ X ] Double wall [ ] Single wall Make: VEEDER-ROOT Model: FLOAT Type: ANNULAR SPACE LIQUID How many: 3 Operational: (Automatic tank gauge, annular space vapor probe, annular space liquid probe, hydroguard system, vadose zone monitor well, groundwater monitor well) [ X ] Yes [ ] No Comments: 3-atg operational. Product Piping Monitoring: [ x ] Double wall [ ] Single wall Make: VEEI)ER-ROOT Model: FLOAT-LIQ Type: SUMP LIQUII) SENSOR How many: 3 Operational: (Piping sump liquid sensor, piping trench liquid sensor, electronic line pressure sensor, mechanical line leak detector) [X ] Yes [ ] No Comments: Other Monitoring Systems: Make: VEE1)ER-ROOT Model: FLOAT-LIQ Type: SUMP LIQUID SENSOR How many: 7 Operational: IX ] Yes [ ]No Comments: 3-fill sumps 4-disp pans. Technician: RICHMOND PHILLIPS Technician Signature: UST Agency: City of Bakersfield .~ :.:.~: >~:~<~.-:~i~-:~-:*~*:*'*'*~ ~, ~ - . *~:~>* ~.×~-~×' ~ ~"*~ ~ .~ . ....~ .:~.:<.* * ~. ~ ~:~:~.~..~.~ .~.~.~.'.%~.*~** '~ ~ ~ ~ *'~:':':~.~:~*~.,~ ~.~:~:~::~ :~:~:~:~:~:~::~ :~:~:~:~:~::~: ~:: ~ ~::: STEVE R THORNE, INC. 91536 3 Party 2700 OSWELL ST BAKERSFIELD CA 93306-2702 (661) 871-1200 CHEVRON STATIONS INC#1920 98109 STEVEN R. THORNE,INC. 99702 CHEVRON STATIONS INC.1830 201527 LUBE MANAGEMENT CORP 201921 CHEVRON STA~'IONS INC#1842 203576 CHEVRON STATION INC 1857 205673 CHEVRON STATIONS INC 1849 206561 Co-Op 1131 OAK ST 3 Party 5201 OLIVE DR Co-Op 6601 MING AVE 3 Party 6601 MING AVE Co-Op 1125 COFFEE RD Co-Op 13003 ROSEDALE HWY Co-Op 3360 PANAMA LN BAKERSFIELD, ca 93304-1063 BAKERSFIELD, CA 93308-2919 BAKERSFIELD CA 93309-3446 BAKERSFIELD CA 93309-3446 BAKERSFIELD CA 93308-5747 BAKERSFIELD, CA 93312-0000 BAKERSFIELD, CA 93313-3695 (661) 324-7621 (661) 399-9056 (661) 831-1270 (661) 588-9066 (661) 587-9593 (661) 396-7047 ChMffoN Chevron April 30, 2001 City of Bakersfield Fire Department 1715 Chester Avenue, Third Floor Bakersfield, CA 9330 ! Chevron Products Company, Inc. PO Box 6004 San Ramon, CA 94583-0904 Carmelita Garcia Licenses/Permits Specialist Phone No. 925-842-9002 Fax No. 925-842-9585 RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS' Dear Sirs: Please find enclosed the following documents: 1) Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) Chevron Facility List under your jurisdiction These documents meet the financial responsibility requirements for all USTs owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Sincerely, Carmelita P. Garcia Licenses/Permits Specialist Permit Desk Enclosure: as stated Chevron Chevron Corporation 575 Market Street San Francisco. CA 94105-2856 John S. Watson Vice President, Finance April 23, 2001 UST FINANCIAL-ASSURANCE To Whom It May Concem: I am the Chief Financial Officer of Chevron Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate 'arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor -- all underground storage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure ({}{}264.143 and 265.143) Post-Closure Care (§{}264.145 and 265.145) Liability Coverage (§ §264.147 and 265.147) ,..,rrective Action (§264.101 (b)) Plugging and Abandonment (§ 144.63) $ 116,960,130.00 $ 56,990,555.00 $ 8.000,000.00 $ -0- $ -0- 145631 / F:XJULIVB34DB01 !.DOC Califomia State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment Louisiana State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment $ 202,890.00 $ 719,850.00 $ 66.000.000.00 $ 4.808.560.00 $ 826,500.00 $ 1.000,000.00 Toml $ 255.508,485.00 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concem" qualification from an independent auditor on his financial statements for the latest completed fiscal year. Page 2 of.4 ALTERNATIVE II 1. Amount of annual UST aggregate coverage being assured by a test and guarantee Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 4. Total tangible assets 5. Total liabilities 6. Tangible net worth 7. Total assets in the U.S. 8. Is line 6 at least $1C 9. Is line 6 at least 6 times line 3? 10. Are least 90% of assets located in the U.S.? (If"No", complete line 11.) 11. Is lin.e 7 at least 6 times line 3? 12. Current assets 13. Current liabilities 14. Net working Capital (subtract line 13 from line 12). 15. Is line 14 at least 6 times line 3? 16. Current bond rating of most recent bond issue 17. Name of rating service 18. Date of maturity of bond $ 2,000,000.00 $ 255,508,485.00 $ 257,508,485.00 $ 41,116,000,000.00 $ 21,339.000,000.00 $ 19,777,000,000.00 $ 20,673,000,000.00 Yes N__9_o ' X X X X $ N/A $ N/A $ N/A $ N/A Standard & Poors October 1, 2004 Page 3 of 4 19. Have financial statements for the latest fiscal year been filed with the SEC, the Energy Information Administration, or the Rural Electrification Administration? Yes No I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana was added to make disclosure more complete. Vice President, Finance April 23,2001 Page 4 of 4 GUARANTEE Guarantee made this April 23, 2001, by CHEVRON CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. CCUSA"), of 575 Market Street, San Francisco, CA. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96Co). 2. CUSA owns or operates the following underground storage tanks covered by this guarantee, underground storage tanks at various facilities in the states of: Alaska Louisiana Arizona Nevada California Oregon Florida Texas Georgia Utah Hawaii Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising fi.om operating the above-identified underground storage tanks in the amount of $1,000,000100 per occurrence and $2,000,000.00 annual aggregate. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA faiis to provide alternative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered by this guarantee, the guarantor, upon instructions fi.om the Director, shall fund a standby trust fund in accordance with th4 provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor-upon written instruc"!,,ns from the Director shall fund a Page 1 of 3 o o o standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95Co) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above-identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the retum receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; Page 2 of 3 (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 23, 2001 CHEVRON CORPORATION By /o/hn S. Watson Wice President, Finance By Assistant Secretary Page 3 of 3 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpan H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 18, 2001 and which is anticipated to be renewed annually, w/th the next renewal schedUled to occur during the' first 120 days of 2002. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 18, 2O01 CHEVRON U.S.A. INC. By Counsel Judith L. Geisler Legal Analyst CUSA UST FINANCIAL RESPONSIBILITY April 23, 2001 bce: J. M. Bauer L. T. Brown J. P. Casey R. Cochran H. P. Davis Jr. K. J. Diaz A. G. Fredeluces C. P. Garcia (2 copies) M. Leong P. T. Liang S. E. Merritt A. R. Mom D. A. Newell I. O. Ng W. C. Ishimoto J. M. Randall A. M. Rutter D. T. Sherman S. W. Strader Arizona Dept. of Environmental Equality UST Section Attention Brian Kelley (replaced Jeff Schmidt) 3033 N Central Avenue Phoenix, AZ 85012 (602) 207-2214 April 30, 2001 RE: - CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND TANKS- To Whom It May Concern: Chevron Corporation hereby certifies that it is in compliance with the requirements of Underground Storage Tank financial responsibility regulations. This certificate covers all tanks in the States of California, Alaska, Arizona, Florida, Georgia, Hawaii, Louisiana, Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by Chevron Corporation. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chevron is the amount of $1Million per occurrence, $2 Million annual aggregate. Said guarantee covers taking corrective action And compensating third parties for bodily injury and property damage caused By either sudden accidental releases and non sudden accidental releases or Accidental releases. This guarantee is renewed annually (within the first 120 days of the year): Copies of the renewed certificate and a complete list of the facilities are sent to the governing agencies yearly. Sincerely, By: Notarized by: ~a Licenses/Permits Specialist Susan R. Weber, Notary OHEVE'©N USA C;.:.':] -1. 849 8360 I:¥;~I'~,AHA I..ANE B?':iRE-;RSF i ELI) C:A. 98:3114 F.;',3-<206t:.: 1 t>i.t. :396 - 704 ?' JAIq 4.. 2001 9:44 S¥'STEI"I STthTUS AI.,L FUIqOTION'S Iq(;'}~['qAL. 1 I'IVE NTOI,::"r' T I :SUPREI"IE VOLUME ULLAGE = 8725 '=' 90% LII_.I.A6;E = 7540 TC VOLLIME = 8122 HEIGHT .... WATER VOL WATER' ~-- 0 TEMP = 60,7 DE T 2: F'LLIS ~ VOLLIME = 3836 GALS ULLAGE = 8513 GALS 9Ox [fl.LF¥3E;- 732-..'13 GALS '['C VOI. I.IME = 8,'3861 C-;~d_S HEIGHT = 38.81 INCHES WATER VOL = 0 GALS WA'I'ti~' = 0.00 ! IqCHES -TEI"IP = 59,7 DEC; F T :3: LINLEal}£[:, VOI_.UME = 5294 UI..I.~4GE = 6552 90% ULi_AQE= 5867 (.-;ALS TC V,'.DLIJ?.'IE = 5299 GALS HEIGHT = 511:1.80 INCHES W~.vrER V{)L = 12 GaLS WA"['E}:! = ill. 89 I TEMP := 58.6 I)EG F FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program Routine J~l Combined [] Joint Agency Type of Tank .J00J['~ Type of Monitoring [] Multi-Agency [] Complaint Number of Tanks ~ [] Re-inspection Type of Piping 060 f= OPERATION C V COMMENTS Proper tank data on file L/ ~ Proper owner/operator data on file Permit fees current Certification of Financial Responsibility V'- Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS sPcc available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Xl3m'~n~ss Site Responsible Party FACILITY NAME ~¢~/ ADDRESS FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 I I INSPECTION DATE ,13lo PHONE NO. 6 ~a | - 3 qb * '70 q~' BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program Routine ~1 Combined 1~1 Joint Agency [~l Multi-Agency ~ Complaint ~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials Verification of quantities Verification of location Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures L~/ Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: Explain: Yes ~o Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy ~siness Site,Responsible Party Inspector:~ ~ 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 1715 CHESTER AVE., 3RD FLOOR BAKERSFIELD, CA. 93301 Test Date: 05/19/2000 Order Number: 3112329 · performed at the following facility: Sincerely, Dawn Kohlmeyer Manager, Field Reporting CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING rank ,gy 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST DATE: 05/19/00 TEST TYPE: TLD-1 CUSTOMER PO: 4584312 PURPOSE: COMPLIANCE WORK ORDER NUMBER: 3112329 CLIENT: CHEVRON U.S.A. SITE: CHEVRON 206561 P.O. BOX 2292 3360 PANAMA 145 S. STATE COLLEGE BLVD. BAKERSFIELD, CA 93304 BREA, CA 92822-2292 JUDY BOWE MANAGER (310) 694-7349 (805) 555-1212 The following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations 89 1 87 2 92 3 Line and Leak Detector Tests PLUS HEG UNT ,1~,]I~D SUPREME P P P Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. Tanknology representative: KEN MINTON Services conducted by: RICHMOND PHILLIPS Reviewed: Technician Certification Number: 91-1071 Printed 06/07/2000 08:49 CCHAPA INDIVID&L TANK INFORMATION AN -'I EST RESULTS TEST DATE:05/19/O0 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3.1.12329 CLIENT:CH~.VAON U. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SlTE:cHEVAON 206561 Tank ID: 89 Product: PLUS Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: DW ]~TB~.R~ Tank manifolded: No Vent manifolded: NO Vapor recovery manifolded: 3rgs Overfill protection: ~rgs Overspill protection: ~-gs Installed: ATG CP installed on: / Bottom to top fill in inches: 168.5 Bottom to grade in inches: 176.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: ]~T.~C~. COMMENTS Start (in) End (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Bubble Ullage Test time: Inclinometer reading: VacuTect Test Type: NOT VacuTect Probe Entry Point: ~ES~gD Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS New/passed L.D. #1 Make: F~. Model: S/N: bj256 Open time in sec: 4. oo Holding psi: Resiliency cc: Test leak rate mi/m: zsg. 0 Metering psi: Calib. leak in gph: 3. oo Results: PAss Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #2 L.D. #2 NOT TESTED COMMENTS COMMENTS Material: DW FIBERG Diameter (in): 2.0 Length (fi): 125.0 Test psi: Bleedback cc: Test time (min): NOT Start time: TESTED End time: Final gph: Result: Pump type: :~R~SS~ Pump make: ~E P~.TRO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Printed 06/07/2000 08:49 INDIVID . L TANK INFORMATION AN TEST RESULTS TEST DATE: 05/19/00 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3112329 CLIENT:cHI~.~ON U. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cH~..VAON 206561 Tank ID: 87 2 Product: ~EG Capacity in gallons: 11,849 Diameter in inches: 120. O0 Length in inches: 245 Material: DW COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: Y~s Overfill protection: 3rss Overspill protection: ~s Installed: ATe CP installed on: / Bottom to top fill in inches: 172.0 Bottom to grade in inches: 176.0 Fill pipe length in inches: 49.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DU~ Stage II vapor recovery: Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS Bubble Ullage NOT TESTED New/passed Failed/replaced L.D. #1 L.D. #1 Make: RED JACK~ T Model: FXlV S/N: Open time in sec: 4.00 Holding psi: Resiliency cc: ?o Test leak rate mi/m: lag. o Metering psi: Calib. leak in gph: 3. oo Results: ~ASS COMMENTS New/passed Failed/replaced L.D. #2 L.D. #2 NOT TESTED COMMENTS Material: DW F IBF. RG Diameter (in): Length (fi): 125.0 Test psi: Bleedback cc: Test time (min): No~ Start time: End time: Final gph: Result: Pump type: PRESSURE Pump make: :~ ~:~TAO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: ~OTm~T Printed 06/07/2000 08:49 TEST DATE:05/19/00 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3112329 CLIENT:cH~,VRON U.S.A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:CHI~.VRON 206561 Tank ID: 92 3 Product: so~A,~tv~ Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: DW COMMENTS Tank manifolded: ~TO Vent manifolded: No Vapor recovery manifolded: 3rgs Overfill protection: Overspill protection: Installed: ATe CP installed on: / Bottom to top fill in inches: 176.0 Bottom to grade in inches: 182.0 Fill pipe length in inches: 52.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DOA~ Stage II vapor recovery: ]~AZC~CE " Start (in) End (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Bubble Ullage Test time: Inclinometer reading: VacuTect Test Type: NOT VacuTect Probe Entry Point: T~STED Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS New/passed Failed/replaced New/passed Failed/replaced LD. #1 L.D. #1 L.D. #2 L.D. #2 Make: FE PETRO Model: S/N: bj225 Open time in sec: 4. oo Holding psi: Resiliency cc: z6o Test leak rate mi/m: zag. o Metering psi: Calib. leak in gph: 3. oo Results: PASS NOT TESTED COMMENTS COMMENTS Material: DW FIBERG Diameter (in): 2.0 Length (fi): 125.0 Test psi: Bleedback cc: Test time (min): NOT Start time: End time: Final gph: Result: Pump type: PRESSURE Pump make: FE PESO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Printed 06/07/2000 08:49 SITE DIAGRAMI 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/19/00 CLIENT:CI-I]~/:~ON LT. $ WORK ORDER NUMBER3112329 SITE: CI-I~V1AON 206561 STER m z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. (~) e12K PLUS (~ e12K REG PANAMA LANE VV,~E A e} e} Printed 06/07/2000 08:49 CCHAPA Test Date: 05/19/2000 [ONITOR SYSTEM CERTIFI~TION TANKNOLOGY ~ Work Order #: 3112329 Client: CHEVRON U.S.A. Site: P.O. BOX 2292 BREA, CA, 92822 CHEVRON 206561 3360 PANAMA BAKERSFIELD, CA, 93304 Overall System Operation The pumps; Shut down automatically if the system detects a leak, fails to operate, or is electronically disconnected. Thc system has functioning audible and visual alarms. The circuit breaker for the system is properly identified. The system is certified operational per manufacturer's performance standards. Operational: Product Tank Monitoring: [ x ] Double wall [ ] Single wall Make: VEEDER-ROOT Model: FLOAT Type: ANNULAR SPACE LIQUID How many: 3 IX ] Yes [ ]No Ix ] Yes [ ]No [X ] Yes [ ] No [X ] Yes [ ] No (Automatic tank gauge, annular space vapor probe, annular space liquid probe, hydroguard system, vadose zone monitor well, groundwater monitor well) [X ] Yes [ ] No Comments: 3 ATG's operational Product Piping Monitoring: [ x ] Double wall [ ] Single wall Make: VEEDER-ROOT Model: FLOAT Type: SUMP LIQUID SENSOR How many: 3 Operational: (Piping sump liquid sensor, piping trench liquid sensor, electronic line pressure sensor, mechanical line leak detector) [X ] Yes [ ] No Comments: Other Monitoring Systems: Make: VEEDER-ROOT Model: FLOAT Type: SUMP LIQUID SENSOR How many: 7 Operational: [X ] Yes [ ]No Comments: 3-fill sump sensors and 4 dispenser pan sesnors. Technician: RICHMOND PHILLIPS Technician Signature: April 30, 2000 CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUNDTANKS To Whom It May Concern: Chevron Corporation hereby certifies that it is in compliance with the requirements of Underground Storage Tank financial responsibility regulations. This certificate covers all tanks in the States of California, Alaska, Arizona, Florida, Georgia, Hawaii, Louisiana, Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by Chevron Corporation. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chevron is the amount of $1 million per occurrence, $2 million annual aggregate. Said guarantee covers taking corrective action And compensating third parties for bodily injury and property damage caused By either sudden accidental releases and non sudden accidental releases or Accidental releases. This guarantee is renewed annually (within the first 120 days of the year). Copies of the renewed certificate and a complete list of the facilities are sent to the governing agencies yearly. Sincerely, C. P. Garc/~a, Environmental Compliance, Permit Notarized by: ~-~(/~ <~ ~ Susan R. Weber, Notary D 'T April 4, 2000 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICF..~ 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 ENVIRONMENT.a4. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3979 FAX (805) 326-O576 TRAINING DMSION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX (8O5) 399-5763 Chevron Products Co Mr. Brace Carpenter P O Box 2833 La Habra CA 90632 Dear Mr. Carpenter: You have been identified as the compliance coordinator for the facility/facilities referenced in the attachment. The permits to operate this facility/facilities will expire on June 30, 2000. However, in order for this office to renew your permit, updated forms A, B, & C must be filled out and returned prior to the issuance of a new permit. Please make sure that you are sending the updated forms which are indicated by the date 7/99 in the lower left hand comer. Please complete and return to this office by May 15, 2000. Failure to comply, will result in a delay of issuance of your new permit to operate. Should you have any questions, please feel free to call me at 661-326-3979. Sincerely~ Steve Underwood, Inspector Office of Envimmental Services SU/dam attachment Facility Name Chevron Chevron Chevron Chewon Address 3~a/fi-~L-~e, Bakersfield, Ca 93313 1125 Coffee Road, Bakersfield, Ca 93308 6601 Ming Avenue, Bakersfield, Ca 93309 1131 Oak Street, Bakersfield, Ca 93304 TYPE OF ACTION (Check one item only) .E~D PROGRAM CONSOLIDATED FO~ ..- TANKS UNDERGROUND STORAGE TANKS - FACILITY (one page per site) Page 1 of 7 [] 1. NEW SITE PERMIT [] 3. RENEWAL PERMIT [] 5.CHANGE OF INFORMATION [] 7.PERMANENTLY CLOSED SITE [] 4. AMENDED PER/vflT specify change local use only [] 8. TANK REMOVED [] 6.TEMPORARY SITE CLOSURE 400 I. FACILITY / SITE INFORMATION CHEVRoNBUSINESS NAME (same as FACILITY NAME or DBA- Doin~ BusinessAS)sTATiONS INC. #206561 31 FACILITY ID# NEAREST CROSS STREET 3360 PANAMA LANE, BAKERSFIELD, CA 93304 / WIBLE ROAD 401 BUSINESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCIAL TYPE [] 2. DISTRiBUTOR [] 4. PROCESSOR [] 6. OTHER 4o3 TOTAL NUMBER OF TANKS REMAINING AT SITE 3 404 Is facility on Indian Reservation or trustlands? [] Yes [] No 4o5 FACILITY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 3. PARTNERSHIP [] 4. LOCAL GENCY/DISTRiCT* [] 5. COUNTY AGENCY* [] 6. STATE AGENCY* [] 7. FEDERAL AGENCY* 402 *frowner of UST is a public agency: name of supervisor of division, section or office which operates the UST (This is the contact person for the tank records.) 406 II. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME MCDONALDS CORPORATION 4o7 I PHONE 818-594-0525 MAILING OR STREET ADDRESS 21300 VICTORY BLVD. SUITE 800 408 409 CITY 410 I STATE nll ZIP CODE hi2 WOODLAND HILLS [ CA 9136'7 PROPERTY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY ,$13 m. TANK OWNER INFORMATION TANK OWNER NAME 4~4 PHONE 41`5 CHEVRON PRODUCTS COMPANY 925-842-9002 MAILING OR STREET ADDRESS 416 P.O. BOX 6004 CITY 417 STATE 418 [ ZIP CODE 419 SAN RAMON CA I 94583 TANK OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 420 [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY(TK) HQ 44- I 0 I 3 I 1 I 9 [ 1 I 3 I Call (916) 322-9669 ifquestions arise V. PETROLEUM USX FINANCIAL RESPONSIBILITY 421 INDICATE METHOD(s) [] 1. SELF-INSURED [] 4. SURETY BOND [] 7. STATE FUND [] 10. LOCAL GOVT MECHANISM [] 2. GUARANTEE [] 5. LETTER OF CREDIT [] 8. STATE FUND & CFO LETTER [] 99. OTHER: [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD 422 VI. LEGAL NOTIFICATION AND MAILING Al)DRESS Check one box to indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank owner unless box 1 or 2 is checked. [] 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK OWNER 423 VII. APPLICANT SIGNATURE Certification - I certify that the information provided herein is true and accurate to the best of my knowledge. S~Nfl ATURE O,~F APPLI~_ T ~ IDATE 424 PHONE 42.5 ~ P~n ~-~ 3-7-2000 562-694-9195 NAME OF A t) 426 427 Bruce Carpenter STATE UST FACILITY NUMBER (For local use only) 428 TITLE OF APPLICANT RESH SPECIALIST 1998 UPGRADE CERTIFICATE NUMBER flor local use only) UPCF (1/99 revised) 171 Formerly SWRCB Form A  D PROGRAM CONSOLIDATED FOI~ TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page 2~ of ~7 TYPE OF ACTION [] I NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE (Check one item only) [] 7 PERMANENTLY CLOSED ON SITE [] 3 RENEWALPEPdvlIT (Specify reason - for local use only) (Specify reason - for local use only) [] 8 TANK REMOVED 430 BUSINESS NAIME (Same as FACILITY NAME or DBA- Doing Business As)CHEVRON STATIONS INC. #20656 1 3 I FACILITY ID: [iJill Il LOCATION WITHIN SITE (optional) 431 I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 1 XERXES If"Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 5-5-1997 12,000 ADDITIONAL DESCRIPTION (For local use only) 438 II. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 [] 1. MOTOR VENICLEFUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JETFUEL (if marked complete Petroleum Type) [] I b. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE UNLEADED [] 4. GASOHOL [] 99. OTHER [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazaxdous Materials Inventmy page) 441 CAS# (from Hazardous Materials Inventoxy page ) 442 [] 4. HXZARDOUS WASTE CHEVRON SUPREME UNLEADED 8006619 (Includes Used Oil) [] 95. UmCUOWN III. TANK CONSTRUCTION TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. SIGNLE WALL IN VAULT [] 99. OTHER TANK MATERIAL - primav/tank [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPTIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FPP) TANK MATERIAL - seeondmy tank [] 1~ BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLAS S [] 8. FRP COMPTIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FPP) [] 10. COATED STEEL [] 5. CONCRETE TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 ~ OTHER CORROSION [] 1 MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) [] 1 SPILL CONTAINIvlENT 1997 [] I ALARM [] 3FILL TUBE SHUT OFF VALVE [] 2 DROP TUBE [] 2 BALL FLOAT [] 4EXEMPT [] 3 STRIKER PLATE IV, TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK (Cheek all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING CMTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING [] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING (SIR) BIENNIAL TANK TESTING [] 99 OTHER IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (Y1UMO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 I TANK FILLED WITH INERT MATERIAL? 457 gallonsI [] Yes [] No PROGRAM CONSOLIDATED UNDERGROUND STORAGE TANKS - TANK PAGE 2 TANK Page 3~_ of 463 VI. PIPING CONSTRUCTION (Check all that apply) UNDERGROUND PIPING ] ABOVEGROUND PIPING SYSTEM TYPE [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458I [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 459 CONSTRUCTION [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN 462 MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER MANU'FACTURER A.O. SMITH 46l MANUFACTURER [] 1. BARE STEEL [] 6. FRP COMPATIBLE w/100% METHANOL [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [ [] Unknown [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 1. BARE STEEL [] 2. STAINLESS STEEL [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 4. FIBERGLASS [] 5. STEEL W/COATING [] 6. FPP COMPATIBLE W/lO0% METHANOL [] 7. GALVANIZED STEEL [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 9. CATHODIC PROTECTION [] 95. UNKNOWN 465 VII. PIPING LEAK DETECTION (Check all that apply) (A d UNDERGROUND PIPING SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHLrr OFF FOR LEAK, SYSTEM FAILLrRE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) CONVENTIONAL SUCTION SYSTEMS [] 5. DALLY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING ,~scfiption of the monitoring program shall be submitted to the local agency.) ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DALLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check all that apply) [] 5. DALLY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST (0. I GPH) SAFE SUCTION SYSTEMS CNO VALUES IN BELOW GROUNDPIPING): [] 7. SELF MONITORING GRAVITY FLOW [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] 7. SELF MONITORING GRAVITY FLOW (Check all that apply): [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALAR2MS AND (Check one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION I-lc. NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION [] t2. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARlvlS EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARIvIS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 17. DALLY VISUAL CHECK [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION []c NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LEAK DETECTOR [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SLrlVIP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 17. DALLY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT DATE INSTALLED 468 1997 [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 4. DALLY VISUAL CHECK [] 5. TRENCH LINER / MONITORING [] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I certify that the infonnation provided heroin is true and accurate to the best of my knowledge. 470 SIGNATURE OF OWNER/OPERATOR Bruce Carpenter Permit Number (For local use only) 473 DATE 3-7-2000 TITLE OF OWNER]OPERATOR RESH SPECIALIST Permit Approved (For local use only) Permit Expiration Date (For local use only) 472 475 Ui~,IED PROGRAM CONSOLIDATED TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page --4 of 7 TYPE OF ACTION [] 1 NEW SITE PEKMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE (Check one item only) [] 7 PERMANENTLY CLOSED ON SITE [] 3 RENEWAL PERMIT (Specifyreason-forlocaluseonly) (Speeifyreason-forlocaluseonly) [] 8 TANK REMOVED 430 CHEVRoNBUSINESS NA_ME (same as FACILITY NAME or DBA- Doing Business As)STATiONS 1NC. #206561 3 FACILITY ID: I I I I I iiiil] I I 1 LOCATION WITHIN SITE (optional) 431 I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 2 XERXES if "Yes", complet .... page for each compartment. DATE INSTALLED (YEAR/MO) n35 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 5-5-1997 12,000 ADDITIONAL DESCRIPTION flor local use only) 438 II. TANK CONTENTS TANK USE 439 PETROLEUM TYPE ~o [] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED ["l 2. LEADED ["] 5. JETFUEL (lfma~kedeomplete Pe~'oleumType) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] I c. IVffDGRADE UNLEADED [] 4. GAS OHOL [] 99. OTHER [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS# (from Hazardous Materials Inventory page ) 442 [] 4. HAZAm~OUS WASTE CHEVRON PLUS UNLEADED 8006619 (Includes Used Oil) [] 95. Uma~OWN III. TANK CONSTRUCTION TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. SIGNLE WALL IN VAULT [] 99. OTHER TANK MATERIAL - primasy tank [] 1. BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 (Cheek one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPTIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FRP) TANK MATERiAL - secondary tank [] 1. BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPTIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FRP) [] 10. COATED STEEL [] 5. CONCRETE TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 448 OTHER CORROSION [] I MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Cheek one item only) [] 2 SACRIFICIAL ANODE (For local use only'-'-) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check ail that apply) [] 1 SPILL CONTAINMENT 1997 [] 1 ALARM [] 3FILL TUBE SHUT OFFVALVE [] 2 DROP TUBE [] 2 BALL FLOAT [] 4EXEMPT [] 3 STRIKER PLATE IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK (Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING [] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING (SIR) BIENNIAL TANK TESTING [] 99 OTHER IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE ESTRvlATED DATE LAST USED (YRJMO/DAY) 455 I ESTIlvlATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 [ gallons [] Yes [] No PROGRAM CONSOLIDATED UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI. PIPING CONSTRUCTION (Check all that apply) UNDERGROUND PIPING. ABOVEGROUND PIPING SYSTEM TYPE [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458 [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY CONSTRUCTION [] 1. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER 46o [] 1. SINGLE WALL [] 95. UNKNOWN MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN [] 2. DOUBLE WALL [] 99. OTHER ~-VACTU~R A.O. SMITH ~NDVAC~R [] 1. BARE STEEL [] 6. FPP COMPATIBLE w/100% METHANOL 2. STAINLESS STEEL [] 7. GALVANIZED STEEL I [] Unknown [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 461 [] 1. BARE STEEL [] 2. STAINLESS STEEL [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 4. FIBERGLASS [] 5. STEEL W/COATING TANK Page --5 of~7 459 462 463 [] 6. FRP COMPATIBLE W/100% METHANOL [] 7. GALVANIZED STEEL [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 9. CATHODIC PROTECTION [] 95. UNKNOW]q 465 VII. PIPING LEAK DETECTION (Check all that apply) (A descriplion of the monitorin~ program shall be submitted to the local asency.) UNDERGROUND PIPING SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) CONVENTIONAL SUCTION SYSTEMS [] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): [] 7. SELF MONITORING GRAVITY FLOW [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTrNUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILU1LE AND SYSTEM DISCONNECTION []c. NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION [] 12. ANNUAL INTEGRITY TEST(0.1 GPFY) SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Cheek all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION [] 16. ANNUAL iNTEGRITY TEST (0.1 GPH) [] 17. DAILY VISUAL CHECK ABOVEGROUND PIPING SINGLE WALL PIPING 46? PRESSURIZED PIPING (Check all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Cheek all that apply) [] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] 7. SELF MONITORING GRAVITY FLOW (Check all that apply): [] 8. DAILY VISUAL MONITORING [] 9. BIENNL6~ INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSU]~ZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL AL~S AND (Check one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION []¢ NO AUTO PUM~ SHUT OFF [] 11. AUTOMATIC LEAK DETECTOR [] 12. ANNUAL ~WEGRITY TEST (0.1 GP~ SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC L~E LEAK DETECTOR (3.0 GPH TEST) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 17. DAILY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT DATE INSTALLED 468 1997 [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS [] 4. DAILY VISUAL CHECK [] 5. TRENCH LINER / MONITORING [] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I certify that the information provided herein is tree and accurate to the best of my knowledge. DATE 470 3-7-2000 NAME OF (print) BRUCE CARPENTER Permit Number (For local use only) 473 TITLE OF OWNER/OPERATOR RESH SPECIALIST Permit Approved (For local use only) Permit Expiration Date (For local use only) 472 475 ., U-~IED PROG~ CONSOL~A~D FO~ TANKS UNDERGROUND STORAGE TANKS - TANK PAGE 1 (two pages per tank) Page ~6 of 7~ TYPE OF ACTION [] I NEW SITE PERMIT [] 4 AMENDED PERM/T [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE (Check one item only) [] 7 PERMANENTLY CLOSED ON SITE [] 3 RENEWALPERM/T (Specify reason - for local use only) (Specify reason - for local use only) [] 8 TANK REMOVED 430 BUSINESS NAME (8ameas FACILITY NAME°rDBA-D°ing Business As) 3 I FACILITY ID:cHEVRON STATIONS INC. #206561 [ [ I [ l LOCATION WITHIN SITE (optional) 431 I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.) TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434 3 XERXES If"Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS ,137 5-5-1997 12,000 ADDITIONAL DESCRIPTION (For local use only) 438 II. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 [] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. IETFUEL (Ifma~kedcompletePatroleumType) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL [] 2. NON-FUEL PETROLEUM [] I c. MIDGRADE LrNLEADED [] 4. GASOHOL [] 99. OTHER [] 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Invento~ page) 441 CAS~ (from Hazardous Materials Inventory page ) 442 [] 4. H~ZARDOUS WASTE CHEVRON REGULAR UNLEADED 8006619 (Includes Used Oil) [] 95. UNKNOWN III. TANK CONSTRUCTION TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Cheek one i~m only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN [] 2. DOUBLE WALL [] 4. SIGNLE WALL IN VAULT [] 99. OTHER TANK MATERIAL - primary tank [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COIvlPTIBLE W/100% METHANOL [] 99. OTHER REINFORCED PLASTIC (FRP) TANK MATERIAL -secondal3, tank [] 1. BARE STEEL [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445 (Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPTIBLE W/100% METHANOL [] 99~ OTHER REINFORCED PLASTIC (FRP) [] 10. COATED STEEL [] 5. CONCRBTE TANK INTERIOR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER (Check one item only) (For local use only) 448 448 OTHER CORROSION [] 1 MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER (Check one item only) [] 2 SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (local use only) 451 OVERFILL PROTECTION EQUIPMENT:YEAR INSTALLED 452 (Check all that apply) [] I SPILL CONTAINlviENT 1997 [] 1 ALARM [] 3 FILL TUBE SHUT OFF VALVE [] 2 DROP TUBE [] 2 BALL FLOAT [] 4EXEMPT [] 3 STRIKER PLATE IV. TANK LEAK DETECTION (A description of the monitoring program shall be submitted to the local agency.) IF SINGLE WALL TANK (Check all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454 (Check one item only) [] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING CMTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING [] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING [] 4 STATISTICAL iNVENTORY RECONCILIATION [] 8 TANK TESTING (SIR) BIENNIAL TANK TESTING [] 99 OTHER IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YR/MO/DAY) 455 ] ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons [] Yes [] No SYSTEM TYPE CONSTRUCTION MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN MANUFACTURER A.O. SMITH PROGRAM CONSOLIDATED TANK UNDERGROUND STORAGE TANKS - TANK PAGE 2 VI, PIPING CONSTRUCTION ~Check all that apply) Page ~7 of 7__ UNDERGROUND PIPING I ABOVEGROUND PIPING [] I. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458[ [] 1. PRESSLrRE [] 2. SUCTION [] 3. GRAVITY 459 [] I. SINGLE WALL [] 3. LINED TRENCH [] 99. OTHER a60 [] 1. SINGLE WALL [] 95. UNKNOWN 462 [] 2. DOUBLE WALL [] 99. OTHER MANUFACTURER 463 461 [] 1. BARE STEEL [] 2. STAINLESS STEEL [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 4. FIBERGLASS [] 5. STEEL W/COATING [] 1. BAKE STEEL [] 6. FRP COMPATIBLE w/100% METHANOL 2. STAINLESS STEEL [] 7. GALVANIZED STEEL I Unknown [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [] 4. FmERGLASS [] 8. FLEXIBLE (HDPE) [] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 6. FPP COMPATIBLE W/100% METHANOL [] 7. GALVANIZED STEEL [] 8. FLEXIBLE (HDPE) [] 99. OTHER [] 9. CATHODIC PROTECTION [] 95. UNKNOWN ,165 VII, PIPING LEAK DETECTION (Cheek all that apply) (A UNDERGROUND PIPING SINGLE WALL PIPING 466 PRESSURIZED PIPING (Cheek all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PLrMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 3. ANNUAL INTEGRITY TEST (0.1GPH) CONVENTIONAL SUCTION SYSTEMS [] 5. DAILY VISUAL MONITORING OF pLrMP1NG SYSTEM + TRIENNIAL PIPING *scription of the monitoring program shall be submitted to the local agency.) AB OVEGROLrND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Cheek all that apply): [] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST.~VITH AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS. [] 2. MONTHLY 0.2 GPH TEST [] 3, ANNUAL INTEGRITY TEST (0.1GPH) [] 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check all that apply) [] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM INTEGRITY TEST (o.1 GPH) SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): [] 7. SELF MONITORING GRAVITY FLOW [] 9. BmNNIAL INTEdRITY TEST (0.1 Gel-r) 'SECONDARILY CONTAINED PIPING PRESSURIZED PIPINGi(Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Ch~ck one) [] a. AUTO pLrlVI~ SHUT OFF WHEN A LEAK OCCURS [] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): [] 7. SELF MONITORING GRAVITY FLOW (Check all that apply): [] 8. DAILY VISUAL MONITORING [] 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TL~BINE SLrMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b. AUTO PUMP~, SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION I-lc. NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC L~NE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION [] 12. ANNUAL iNTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS ~UMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Cheek all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PU'MP SHUT OFF * AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION [] 16. ANNUAL iNTEGRITY TEST (0.1 GPH) [] 17. DAILY VISUAL CHECK [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION []c NO AUTO PUMP SHUT OFF [] 11. AUTOMATIC LEAK DETECTOR [] 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ~ONLY (Cheek all that apply) [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF * AUDIBLE AND VISUAL ALARMS [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH) [] 17. DAILY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT DATE INSTALLED 468 1997 [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALAILMS [] 4. DAILY VISUAL CHECK [] 5. TRENCH LINER / MONITORING [] 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I certify that the information ~provided herein is hue and accurate to the best of my knowledge. ~,~~ ,~ IDATE3-7-2000 470 SIGNATURE OF OWlqER/OPERATOR ~ NAME OF OkVNE~(print)d TITLE OF OWNER/OPERATOR 472 BRUCE CARPENTER RESH SPECIALIST Permit Number (For local use only) 473 Permit Approved (For local use only) Permit Expiration Date (For local use only) 475 STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COUPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM 72F,,f~,,~.- .,lt".B I. SITE LOCATION STREET CITY COUNTY II. INSTALLATION (mark all that apply): ~-~r"~The installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. ~'"'The installation has been inspected and approved by the implementing agency. ~T'~AII work listed on the manufacturer's installation checklist has been completed. [~'he installation Contractor has been certified and licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent C~,~'~/-~/,,~:~,,~,'",~=',,~,Z~z,~'~ ~Z~ Date PrintName Z.,/g ,/v',,~'Z~,4,~'Y Phone ~ LOCAL AGENCY ,USE ONLY' STATE COUNTY # JURISDICTION # FACILITY # TANK # FORM C (6/95} THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C8 STATE OF CAUFORNiA i. STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION " ' FORM C ~ COMPLETE A SEPARATE FORM FOREACH TANK SYSTEM I. SITE LOCATION STREET COUNTY I1. INSTALLATION (mark all that apPly): . ~The installer, has been certified by the tank and piping manufacturers. -' [] The installation has been inspected and certified by a registered professional engineer. .[~"~Theinstallationhas been inspected and approved by the implementing agencY. ' ~ All work listed on' the manufacturer's installation checklist has been completed. [~"'"~he installation Contractor has been certified and licensed by the Contractors'state License 'Board. [] Another method was used'as allowed by the implementing agency. (Please specify.) III. OATH * I certifythat the infOrmation provided is true to the best of my belief and knowledge. Tank Owner/Agent ~--/V/G-/~/JP'~:~/b".~',/~'/'?~;~'z'~ ~ Date Print Name /_ ./g /F,,~Z~:Z~,&F'Y Phone ~ · LOCALAGENCY. USE ONLY' STATE COUNTY#. ',FORM C '(~95) JuRIsDICTION # . FACILITY # TANK # THIS FORM MUST BEACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FORO03$C8 STATE OF CAUFORN]A STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COUPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET CITY /'~/¢,,~,e5/;/,~'~',~ COUNTY II. INSTALLATION (mark all that apply): ~ The installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. [~'~The installation has been inspected and approved by the implementing agency. ~ All work listed on the manufacturer's installation checklist has been completed. E~'""¥he installation Contractor has been certified and licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) II1. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent ~'-.,,~',,'F"~-".Z~?,,¢/,~',Z'~/?'Z::;~Z..,~'.~"--,c [~',~:) Date PrintName Z.,,~7 //,,q,,'~/,,/~y Phone (~.,2 LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # FORM C (6/95) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FORO035C8 STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET CITY COUNTY .,~'~ II. INSTALLATION (mark all that apply): ~"~The installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. [~he installation has been inspected and approved by the implementing agency. ~;;;;~11 work listed on the manufacturer's installation checklist has been completed. [~~The installation Contractor has been certified and licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify,) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent ~T/V/J~//E'Z~,~' ~'/~'~:2~ ~'~ c ~../F. /v',~z;~x/~'~/) Date cZ-/,5"- Print Name .Z'.~7, /'~Z:~/-J~'Y Phone (_~.,Z) ~'Y'- LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # FORM C (6/95) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR~35C8  ' * ~r STATE OF cAUFORNIA O~ ~'. STATE WATER RES~)URCES CONTROL BOARD · CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION 'FORu C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SiTE LOCATION STREET II. COUNTY INSTALLATION (mark all that apply): ~ The installer has been 'certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. [~he installation has. been inspected and. approved by the implementing agency. ~----~Ail work listed on the manufaCturer's installation ch'ecklist has been completed. [~The installation Contractor has been certified and.licensed by the Contractors'State License Board,. [] Another method was used as allowed, by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent ~',~/,z,~'~,,,~,,~-,~,~ ~,'~C~ ¢' ,~'.~F. /¢~Z~,~F',/3 Date ~-/,5"- c)~ Print Name .~', .,~, J,V,~,~,4/~' ~' Phone (~'~,,Z) ~; ~V'- ~_~ LOCAL AGENCY USE ONLY STATE TANK I,D. # FORM C (6/95) COUNTY # JURISDICTION # FACILITY TANK # THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COUPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET COUNTY II. INSTALLATION (mark all that apply): ~ The installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. [~The installation has been inspected and approved by the implementing agency. ~-~-~AII work listed on the manufacturer's installation checklist has been completed. [~he installation Contractor has been certified and licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent C,~¢¢¢./,¢'~-/V ,~',4¢~z/~ ,,~0 ¢- ,,r..4~. /v',~,C~'/F,/~ Date ~./,~- Print Name ~*.,,~(~, /~,,~/'JZ~F"/ Phone (~-~) (~- LOCAL AGENCY USE ONLY COUNTY # JURISDICTION # FACILITY # TANK # STATE FORM C (6/95) THIS FORM MUST SE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FORO035C8 STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COUPUANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I, SITE LOCATION STREET ,,R'.~ CITY /~A~m~e~/F, tD COUNTY ./-~.,~,~',,'z/ II. INSTALLATION (mark all that apply): E~"~he installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. E~'~he installation has been inspected and approved by the implementing agency. ~ All work listed on the manufacturer's installation checklist has been completed. [~"~'The installation Contractor has been certified and licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent ~~Y~~t~ ~) Date ~----/-/,5"-~'~ PrintName Z.,47. /Y',4;~,,,'~'c/ Phone Address ~=~.~:~, ,~'~,,~ ~ ~-~'-~ LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION it FACILITY # TANK # FORM C (~951 THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & g UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C8 . ~,* STATE WATER RESOURCES CONTROL BOARD ·: CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM.c COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM* I. SITE LOCATION STREET. ..W'.:~ CITY /-d~C,~'/F/e ~,/~-,4 D COUNTY II. INSTALLATION (mark all. that apply): I~?,~The installer has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. · ~'~The installation has been inspected and approved by the implementing'agency. ~-'-~' All work listed On the manufactureCs installation checklist has been completed. ~'~The installation Contractor has been certified'and licensed by the Contractors State License Board. [] Another method was used as allowed, by the implementing agency. (Please specify.) III. OATH I certify that.the information provided is true.to the best of my belief and knowledge. Tank Owner/Agent ~/~--f./~~~ ~'~ 'Date ~/-/_~--- Print Name Z o ,47.' ./'//~,~,4,,'F'V Phone (53.2.) LOCAL AGENCY.USE ONLY STATE COUNTY# TANKI.D.# ~ FORM C (6/95) 'JURISDICTION.# FACILITY # TANK # THIS ~ORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY 'FORO035C8 · ,, STAT~; OF CAUFORNIA STATE WATER RES~OURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR U, NDERGROUND STORAGE TANK INSTALLATION ',, FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET ~ CITY /~,~,e;~.~,~-//~'A D COUNTY II. INSTALLATION (mark all that apply): i--~/The in~taller has been certified by the tank and piping manufacturers. [] The installation has been inspected and certified by a registered professional engineer. ~ The installation has been inspected and approved by the implementing agency. ~ All work listed on the manufacturer's installation checklist has been completed. I--~-'*-The installation Contractor has been certified and licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent ~/x~'~'~L~F~ ~) Date ~/-/ Print Name ~, ,~, /,/~,~,,(/~'V Phone (..~g.2) ~ LOCALAGENCYUSE ONLY STATE COUNTY# TANKI.D.# ~ FORM C (~95) JURISDICTION # FACILITY # TANK # '.~ THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FORO035C8 · P.O. Box 6001 o San Ramon, CA 94583-0904 March 1, 2000 1715 Chester Avenue Bakersfield, CA 93301 Dear Steve, I have received the Notice of Violatio~ompliance letter dated 2-13-2000 for the station located at~_360 Pa~ Let me apologize for the difficulty you have had with this facility. Normally, this )e of event does not occur at our stations. However, this site has had some with management and we are in the process of correcting them. The name is John Watson and if you experience any more problems, please all of the requested documentation for this site to Charles Bittle at the should have occasion to request additional information for any of our operated stores, please call. Bruce Carpenter Compliance Specialist 562-694-9195. SENDER: · Complete items I and/or 2 for additional services. · Complete items 3, and 4a & b, · Print your name and address on the reverse of this form so that we can return this card to you. · Attach this form to the front of the mailpiece, or on the back if space does not permit. · Write "Return Receipt Requested" on the mailpiece below the article number. · The Return Receipt will show to whom the article was delivered and the date delivered. 3. Article Addressed to: ATTNI~IACER CHEVRON SERVICE STATION 3360 PANAFIALANE BAKERSFIELD CA 93304 I also wish to receive the following services (for an fee): 1. [] Addressee's Address 2. [] Restricted Delivery Consult postmaster for fee. 4a. Article Number P 024 368 643 4b. Service Type [] Registered [] Insured ~ Certified [] COD ~ [] Mail [] Return Receipt for Express MerchaR~ise ,~ ~: 7. Da~Deliverl.~_ ~ ~0 5~" Signature (Addressee) 8. Addressee's A~ldN~s (Only if requested  and fee is paid) · . 6. ature (Age :3/ ' , ~ PS Form 381 1, December 1991 ~u.s. GPO:lee3--352-714 DOMESTIC RETURN UNITED STATES POSTAL SERVI,~?c~\~~~~ Official Business ~ USE TO Print your name, address and ZiP Code here ~,~RSF~ELD FIRE DEPARTMENTr ..... ~ ~NV~RONM~NTAL SERVICES ....... '~ ~r Avemte, Suite 300 [:~aKersfi,e!d, CA 93301 D February 13, 2000 ~ ~ttlEF RON FRAZE 2101 eMc~Md, ~ ~1 VOICE 2101 'l,r' 8~ FAX ((~1) 3~-134~ 17t~ C~m'Ave. vOiCE ENVIRONMENTAL ~ERVICE~ 1715 Cl~ltm' Ave. B~emfl~/, GA 933O1 VO~E (ea~) a;~a~ FAX (~) ~,~osT~ V(XCE (t~) aee.4~7 F:,~((M~) ~-~ Attn: Manager Chevron Service Station 3360 Panama Lane Bakersfield CA 93304 CERTIFIED MAIL Re: Failure to submit documentation NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE Dear Msnsger: A routine inspection was conducted on January 13, 2000. During that inspection numerous violations with regard to documentation were found. A correction notice was issued giving you 30 days to make corrections. You have failed to respond and are now in violation. These are as follows: 1) 2) 3) F~iltire to p~rformdsubmii annual maintenance on leak detection system, per 2641 (J) Title 23 CCR. Failure to submit written routine monitoring and spill release procedures, per H & S code, Title 23 CCR. Submit and return forms A, B and C. This office requires the above mentioned documentation w/thin 30 days which will be March 13, 2000. Failure to submit documentation will result in re~ocation of you permit to operate. Should you have any questions, please feel free to call me al (661) 326-3979. Sincerely, Ralph Huey of Environmental Services Steve Underwood Inspector SU/mv CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST DATE: 05/13/99 CLIEN:F: CHEVRON U.S.A. P. O. BOX 2833 LA HABRA, CA 90631-2833 JUDY BOWE (310) 694-7349 TEST TYPE: TLD-1 CUSTOMER PO~562306 PURPOSE: COMPLIANCE · WORK ORDER NUMBER3205348 SITE:CHEVRON 206561 3360 PANAM]k BAKERSFIELD, CA 93304 MANAGER (805)555-1212 The following test(s) were conducted at the site above in accordance with all aFplicable portions of Federal, NFPA and local regulations PLUS REG UNLEAD SUPREME Line and Leak Detector Tests Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. Tanknology representative: Services conducted by: TODD PARKER DAN MARINESCU Reviewed: Technician Certification Number: Pdnted 05/20/1999 09:43 KOHLMEYER INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/3.3/99 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3205348 CLIENT:cHE'v-~ON O. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cIt~'~ON 206563. Tank ID: 89 Product: PT.US Capacity in gallons: 11,849 Diameter in inches: .1.20.00 Length in inches: 245 Material: DW ~'~BERG cOMMENTS Tank manifolded: No Vent manifolded: NO Vapor recovery manifolded: YES Overfill protection: Overspill protection: Installed: CP installed on: / Bottom to top fill in inches: 3-68.5 Bottom to grade in inches: 3-'/6.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: 4. o Stage I vapor recovery: DO~.T, Stage II vapor recovery: Start (in) Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: End (in) II Bubble Ullage COMMENTS NOT TE S TF.D New/passed L.D. #1 Make: ~,= Pg~o Model: MLO S/N: a~58 Open time in sec: o. o¢ Holding psi: t7 Resiliency cc: t4s Test leak rate mi/m: tag. o Metedng psi: z4 Calib. leak in gph: 3.oo Results: pJ~ss COMMENTS Failed/replaced New/passed Failed/replar L.D. #1 L.D. #2 L.D. #2 NOT T~STED COMMENTS Material: DW FIBERG Diameter (in): 2.0 Length (ft): 125.0 Test psi: Bleedback cc: Test time (min): NOT Start time: '1~ $ TE, D End time: Final gph: Result: Pump type: PRESSURE Pump make: ~ ~o NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Ot~K~ow~ Printed 05/18/1999 12:51 INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE: 05/13/99 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER32053¢8 CLIENT:ci.~--'-v~ON U. S .&. AUSTIN. TEXAS 78757 (512) 451-6334 SITE:clt:~v~ON 206561 Tank ID: 8? 2 Tank manifolded: ~0 Bottom to top fill in inches: 172.0 Product: ~G otrr_,EA~ Capacity in gallons: 11,8A9 Diameter in inches: 120.00 Length in inches: 2~5 Material: DW FIBERG COMMENTS Vent manifolded: NO Vapor recovery manifolded: YEs Overfill protection: Overspill protection: Installed: CP installed on: ! ./ Bottom to grade in inches: 176.0 Fill pipe length in inches: 49.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: ~c~ Start (in) DiPped Water Level: Dipped Product Level: - Probe Water Level: Ingress Detected: Water Test time: Inclinometer reading: VacuTect Test Type: VacuTect Probe Entry Point: Pressure.Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: End (in) Bubble Ullage NOT TESTED COMMENTS New/passed Failed/replaced New/passed Failed/replar L.D. #1 L.D. #1 L.D. ~2 L.D. ~ Make: ~ JACKET Model: ~x~ S/N: Open time in sec: o. os Holding psi: 3.6 Resiliency cc: 23s Test leak rate mi/m: ~e9. o Metedng psi: 12 Calib. leak in gph: 3. oo Results: NOT T~STED COMMENTS COMMENTS Material: DW FIBERG Diameter (in): Length (fi): 125.0 Test psi: Bleedback cc: Test time (min): ~o~ Start time: ~ s TE~D End time: Final gph: Result Pump type: Pump make: NOT NOT NOT T~STED TESTED TESTED Impact Valves Operational: OI~'KNORN Printed 05/18/1999 12:51 INDIVIDUAL TANK INFORMATION AND TEST RESULTS TEST DATE:05/13/99 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3205348 AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cl~'1~ON 206561 CLIENT:cK[~RON O. $ Tank ID: 92 Product: Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 Material: DW Tank manifolded: NO Vent manifolded: No Vapor recovery manifolded: Ove~ll protection: Overspill protection: Installed: CP installed on: / Bottom to top fill in inches: 176.0 Bottom to grade in inches: 182.0 Fill pipe length in inches: 52.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: s3~.~c~ COMMENTS Start (in) ' Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water Bubble Test time: Inclinometer reading: VacuTect Test Type: NO~ VacuTect Probe Entry Point: ~STED Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: COMMENTS End (in) II Ullage New/passed L.D. #1 Make: Model: S/N: Open time in sec: o. o4 · Holding psi: Resiliency cc: Test leak rate mi/m: ts~. o Metedng psi: 3.2 Calib. leak in gph: 3. oo Results: PASS Failed/replaced New/passed Failed/replac' L.D. #1 L.D. #2 L.D. #2 NOT T~STED COMMENTS COMMENTS Material: DW ~IBERG Diameter (in): 2.0 Length (ft): 125.0 Test psi: Bleedback cc: Test time (rain): NOT Start time: TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: Fi[ PETRO NOT NOT NOT TESTED TESTED TESTED Impact Valves Operational: Pdnted 05/18/1999 12:51 SITE DIAGRAM 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/13/99 CLIENT:CI.I~v~OIq [7. S WORK ORDER NUMBER3205348 SITE: Cl{~"¥~ON 206561 STER m Z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. 12KPLUS ~12K ~12K REG W~E PANAMA LANE SUP Printed 05118/1999 12:51 KOHLMEYER ~)NITOR SYSTEM CERTII~ TION E ENVIRONMENTAL CORPORATION Test Date: 05/13/99 Work Order #: 3205348 Client: CHEVRON U.S.A. Site: P. O. BOX 2833 LA ltABRA, CA, 90631 CHEVRON 206561 3360 PANAMA BAKERSFH~LD, CA, 93304 Overall System Operation The'pumps; Shut down automatically if the system detects a leak, fails to operate, or is electronically disconnected. The system has functioning audible and visual alarms. The circuit breaker for the system is properly identified. The system is certified operational per manufacturer's performance standards. PrOduct Tank Monitoring: [ X ] Double wall [ ] Single wall Make: VEEDER-ROOT .Model: _ . TLS-350 Type: ANNULAR SPACE LIQUID How many: 3 Operational: (Automatic tank gauge, annular space vapor probe, annular space liquid probe, hydroguard system, vadose zone monitor well, groundwater monitor well) [X ] Yes [ ] No [X ] Yes [ ] No [X ] Yes [ ] No [X ] Yes [ ] No IX ] Yes [ ]No Comments: 3-ATG ALSO OPERATIONAL. Product Piping Monitoring: [ X ] Double wall [ ] Single wall Make: NONE Model: Type: MECltANICAL LEAK How many: 3 Operational: (Piping sump liquid sensor, piping trench liquid sensor, eleclxonic line pressure sensor, mechanical line leak detector) [X ] Yes [ ] No Comments~ 3-TURBINE SUMP SENSORS ALSO OPERATIONAL. Other Monitoring Systems: Make: VEEDER-ROOT Model: Type: ~IIMP LIQUII} SENSOR How many: TLS-350 7 Operational: [ X ] Yes [ ] No Comments: Tills ARE 3-FILL SUMP AND 4-IHSPENSER PAN. DAN MARINESCU T~chnician Signature: CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK SYSTEM MONITORING PROGRAM FACILITY INFORMATION SHEET Facili .ty: Chevron Products Company Service Station #20-6561 3360 Panama Lane Bakersfield, California 93304 UST Owner: Chevron Products Company 1300 South Beach Boulevard P.O. Box 2833 La Habra, CA 90632-2833 (310) 694-7300 UST Equipment Tanks Tank # Type Tank Tank Storage Capacity Type 1 Gasoline 12,000 2 Gasoline 12,000 3 Gasoline 12,000 D/W Fiberglass D/W Fiberglass D/W Fiberglass Monitoring Classification New New New Spill Containment' POMECO POMECO POMECO Piping For Tank # Piping Type Piping Operation 1 Pressurized D/W Fiberglass 2 Pressurized D/W Fiberglass 3 Pressurized D/W Fiberglass Monitoring Classification New New New Note: "Existing" -- Installed prior to January 1, 1984 "New" -- Installed after January 1, 1984 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0102 Rev. 7/29/96 CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK SYSTEM OWNER/OPERATOR AGREEMENT Owner Certification Chevron Products Company, as the owner of the underground storage tank system located at 3360 Panama Lane, Bakersfield, California 93304, I hereby certify that: We have entered in to a written agreement with the operator of the UST system at the referenced location. This agreement is contained in our contract with the operator. The operator of the UST system at the referenced facility is responsible for and will perform all monitoring, record k~eping, and reporting requirements for the UST system as outlined in the documents listed below. The .operator has been provided a copy of the Permit to Operate the UST system at the facility. The operator has been provided a copy of the provisions of Health and Safety Code Section 25299. ' o The operator has been provided a copy of the California Code of Regulations Title 23 - Waters Division 3 - State Water Resources Control Board Chapter 16 - Underground Storage Tank Regulations, May 1994. We understand that we are required to notify the UST Program of the City of Bakersfield Hazardous Materials Division, in writing, of any change of operator within thirty days of any such change. Owner: CHEVRON PRODUCTS CO. We hereby certify that the preceding monitoring plan for underground stOrage tank systems will be implemented at our service station located at 3360 Panama Lane, Bakersfield, California 93304. To the best of our knowledge, all information contained herein is true and correct. ' ' ~ (/~~ ~~ Date'~ /~/~f~ Signature: JI Michael W,elt , . Specialist, Envirorm~ental Safety & Health ,,..~ompliance 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0107 Rev. 7/29/96 CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK SYSTEM OWNER/OPERATOR AGREEMENT Operator Certification As the operator of the Underground Storage Tank system installed at 3360 Panama Lane, Bakersfield, California 93304, I hereby certify that: I am, or represent the individual, finn, trust, partnership, association, or corporation that is in control of and has the daily responsibility for the operation of the UST system at the referenced facility. o I have enteredinto a written contract with chevron Products Co., the owners of the UST system I am operating. I understand that this obligates me to Perform monitoring, record keeping, and reporting requirements as outlined in the documents listed below. _ I have received a copy of the Permit to Operate the UST system at the'facility. 4. I have received a copy of the provisions of Health and Safety Code Section 25299. o I have received a copy of the California Code of Regulations Title 23 -Waters Division 3 - State Water Resources Control Board Chapter 16 - Underground Storage Tank Regulations, May 1994 Signature: Ro'be~t O. S~uthwickv- Area Manager Chevron Stations Inc., Facility Operator Date: ~/ <~/ '7/~ Facility Manager: -..5')~r'~ ~, ~7~/77 Print and Sign Name Facility Manager: QA u0~ ~ ¢qo g& Print an/:l Sign Name Date: W/~//q 7- Date: ~'/70/c/~ Facility Manager: Print and Sign Name Date: / / 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0108 Rev 7/2g/96 Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: Facility Manager: ON SITE OPERATOR CONTACT Print and Sign Name Print and Sign Name Print and Sign Name Print and SignName Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Print and Sign Name Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: /. / Date: / / Date: / / Date: / / 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-O 108 Rev. 7/29/96 CHEVRON PRODUCTS COMPANY MONITORING PROGRAM FOR "NEW" UNDERGROUND STORAGE TANKS Monitoring of underground tanks constructed pursuant to: Califomia Code of Regulations Title 23 -- Waters Division 3 -- State Water Resources Control Board Chapter 16 -- Underground Storage Tank Regulations- May 1994 Section 2631 Shall be implemented pursuant to: California Code of Regulations Title 23 - Waters Division 3 -- State Water Resources Control Board Chapter 16 - Underground Storage Tank Regulations o May 1994 Section 2632 (C) (2) (A) and Section 2632 (C) (2) (B) Monitoring Frequency. Continuous Methods and equipment t° be used: Condition of secondary system: Type of substance stores: Method of monitoring: Dry Volatile Continuously operated electronic liquid level indicator Monitoring equipment Control Unit Make: Veeder Root Model: TLS - 350 Liquid level probe - Gasoline Tank Interstitial Space: Make: Veeder Root Model: VR: 7934380409 Location monitoring to be performed' At Facility- inside all underground tank(s) interstitial space (3) Person responsible for performing the monitoring; Chevron Stations Inc., Facility Operator Persons responsible for maintaining the monitoring equipment Chevron Products Company Marketing Operations-- Maintenance Department 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0101 a Rev. 7/29/96 Visual monitoring of the tank monitor alarm box is performed daily by the dealer or a designated employee. Chevron also requires that the tank monitoring equipment operational and alarm condition be documented daily by using a "USTEcluiprnentMonitoringLog". This log is also required to be used to document when equipment problems are reported to Chevron Maintenance and is to be.kept as part of the station monthly inventory reconciliationrecords and on site at all times. Please see the attached site map for the location of all equipment at the site. The electronic monitoring devices are maintained according to manufacturer's recommendations. The dealer will also perform inventory reconciliation according to the procedure outlined in the Inventory reconciliation section of this plan, as stated in detail in Section 2626 of the copy of the California Code of Regulations, Title 23, Division 3, Chapter 16 dated May 5, 1994 that is attached to the dealer's copy of this plan. Daily and monthly inventory reconciliation is required by Chevron Policy. Training will be given to the.dealer of record, Chevron Stations Inc., which includes information regarding: how to self test the electronic monitoring equipment, what the equipment monitors, how to tell when the alarm goes off, how to perform inventory reconciliation, record keeping requirements and procedures to follow in the event of alarm activation, leak, suspected leak, or other emergency. Chevron requires that all station employees be trained ~md ~amiliar with tank alarm systems and reporting requirements, however training of the dealer's management and employees on the above mentioned subjects as well as the completing and.filing of any further documentation outlining such training, as may be required by the City of Bakersfield Hazardous Materials Division, will be the responsibilityofthe dealer of recorck In the event of an alarm activation, the operator may have cause to suspect a leak and is required to investigate. In the case of a monitoring equipment malfunction (e.g., green lights not on, lost power, etc.), operator is required to notify Chevron immediately for equipment maintenance. In the event of a leak, the operator will notify the Chevron Territory Manager (or other Retail Management), and will take the following actions: 1. Shut down the tank or product line. 2. Contact Chevron Maintenance Dispatch. 3. Contact the Fire Department or local Emergency response agency, if warranted. 4. Keep employees, customers, or bystanders away from any gasoline. In the event of a suspected leak, Chevron specifies procedures and mandates the use of a "Suspected Leak Activity Log" for investigation in case of an inventory tolerance problem, and equipment alarm, and/or if there are any other reasons to suspect a leak. When circumstances occur to the point where this log needs to be used, it is to be kept as part of the monthly inventory reconciliation records as proof that suspected leak situations were investigated. In the event of an emergency, the operator will follow their site Emergency Response Plan which consists of 1) Emergency Response Procedures: 10 Steps to Safety During an Emergency, where employees know what to do in the event of a fire, spill, or an observable leak. 2) Site map, where employees know the location of critical equipment (e.g., emergency shut-off switches, etc.). And 3) Emergency Contact List, where employees know who and how to contact all appropriate people in the event of an emergency. 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0101 a Rev. 7/29/96 ~VRON PRODUCTS COMPANY~ MONITORING PROGRAM FOR "NEW" UNDERGROUND PIPING Monitoring of underground piping constructed pursuant to: California Code of Regulations Title 23 -- Waters Division 3 - State Water Resources Control Board Chapter 16 - Underground Storage Tank Regulations - May 1994 Section 2631 Shall be implemented pursuant to: California Code of Regulations Title 23 -- Waters Division 3 -- State Water Resources Control Board Chapter 16 -- UndergrOund Storage Tank Regulations- May 1994 Section 2636 (f) (1) and Section 2636 (f) (2) Monitoring Frequency. Continuous Methods and equipment to be used: Condition of secondary system: Type of substance stores: Method of monitoring: Dry Volatile Continuously operated electronic liquid level indicator Monitoring equipment Control Unit Make: Veeder Root Model: TLS- 350 Automatic line leak detector Make: Veeder Root Model: TLS 350 Liquid level probes - Tank fill/turbine sumps and gasoline dispenser containment boxes Location monitoring to be performe& Make: Veeder Root Model: VR: 794380-208 At Facility- inside all underground tank fill (3) and turbine containment sumps (3) and under gasoline dispenser containment boxes (4) Person responsible for performing the monitoring Chevron Stations Inc., Facility Operator Persons responsible for maintaining the monitoring equipment Chevron Products Company Marketing Operations -- Maintenance Department 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0102a 413197 RESPONSE PLAN If the unauthorized release detection system is activated the facility operator will be responsible for: Determining the source: UST and/or pipeline (if possible) Discontinuing operation of the system (if necessary) Telephoning Chevron ProdUCts Company IMMEDIATELY Week Days: Chevron Products Company Maintenance: (800) 423 - 6911 Week Ends and Holidays Days: Petro Services Nights: Chevron Products Company will be responsible for: (800) 400 - 4790 ° Initiating unauthorized release determination IMMEDIATE =LY. Initiating cleanup procedures IMMEDIATELY (if necessary). Contacting agencies within 24 hours. Person responsible for work authorizatiog Roger W. Cleworth, Maintenance Supervisor, or a designated representative Hazardous substance will be removed according to all laws and re[~'lations regarding haz~dous substance handling, transportation, storage and disposal. Equipment Chevron uses to remove hazardous substance will be owned and operated by a state licensed contract hauler. Chevron will use the hauler with the best response time. Maintenance of all equipment used by haulers is the hauler's responsibility. At a minimum, Chevron reserves the right to dispatch proprietary transport vehicle from the Van Nuys, California bulk storage facility. All unauthorized releases will be removed from the secondary containment within 30 days. This response plan outlines required dealer actions and Chevron's response if the facility's unauthorized release detection (tank monitoring) system is activated'. Chevron requires that all station employees be trained and familiar with tank alarm systems, reporting requirements and in the use of clean up equipment, however training of the dealer's management and employees in the alarm systems and in the use and maintenance of any on site clean up equipment as well as the completing andfiling of any further documentation outlining such employee training, as may be required by the City of Bakersfield Hazardous Materials Division, will be the responsibility of the dealer. 6 Signature: J. ~lichael Welty ~ x [ 6.~.~'~mpliance Specialisl~, Environm~htal Safety 20-6561 3360 Panama Lane Bakersfield, California 93304 & Health Date: 4/3/ '7 NW-O 104 Rev. 4/3/97 CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK MONITORING EQUIPMENT PREVENTATIVE MAINTENANCE SCHEDULE Veeder Root- TLS-350 Underground Storage Tank and Pressurized Piping Monitoring System Preventative maintenance frequency. Annually Performed by: Veeder Root Certified Representative Annual maintenance checklist Inspect Hardware Inspect panel for loose wires. Inspect for intrinsic safety cover in place. Inspect for touch screen mounted and enclosed properly. Inspect for CPU operation. Test Operation of Operator Interface Terminal (OIT) Test all screens for live data. Re-enter date and time (even if currently correct). Test Tank Level Monitor and Printer Calibrate product and water readings to physical measurements (stick readings). Print out inventory report. Test Pump Control Interface and Link Leak System Start line test for each product. Note pressure rise for each product. Note pressure at which each check valve seats. Verify pump shutdown. Verify emergency stop shuts off all submersible pumps. Test External Alarms and Remote Communications Individually simulate each alarm condition and Verify the event on the OIT. Verify dial tone at telephone extension on modem module. Verify modem operation. Site Documentation Verify installation manual is on-site. Verify maintenance log. Certification Certify the TLS-350 has been checked according to manufacturer instructions. Certify the system is operating properly. Verify with appropriate agency that certificationhas been completed. NOTE: All functions listed in this preventative maintenance schedule may not be present at each specific site. All functions present at each site will be maintained according to this program. 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-O 104 Rev. 4/3/97 UNDERGROUND STORAGE TANK SYSTEM OPERATOR TRAINING REQUIREMENTS The training required to operate the underground storage tank system and monitoring equipment located at referenced facility is as follows: ' Underground Storage Tank System Orientation session on the operation of an underground storage tank system topics include: underground storage tanks, double wall piping, overfill prevention, spill protection and monitoring systems. Chevron Service Station Maintenance Guide is provided to each operator. This guide provides in depth instruction on the operation of an underground storage tank system. Underground Storage Tank and Pressurized Pipe Monitoring S_ystem - Veeder Root TLS-350 ~ Operators are given an orientation session during system start-up to familiarize them with the operation of the unit. The Veeder Root TLS-350 Installation and Operation Guide is provided to each operator. This guide provides in depth instruction on the unit. 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0104 Rev. 4/3/97 I I II I! PANAMA LANE 0 D Febmaryl3,2000 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 Attn: Manager Chevron Service Station 3360 Panama Lane Bakersfield CA 93304 CERTIFIED MAIL Re: Failure to submit documentation NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE Dear Manager: A routine inspection was conducted on'January 13, 2000. During that inspection numerous violations with regard to documentation were found. A correction notice was issued giving you 30 days to make corrections. You have failed to respond and are now in violation. These are as follows: 1) 2) 3) Failure to perform/submit annual maintenance on leak detection system, per 2641 (J) Title 23 CCR. Failure to submit written routine monitoring and spill release procedures, per H & S code, Title 23 CCR. Submit and return forms A, B and C. This office requires the above mentioned documentation within 30 days which will be March 13, 2000. Failure to submit documentation will result in revocation of you permit to operate. Should you have any questions, please feel free to call me at (661) 326-3979. Sincerely, Ralph Huey of Environmental Services Steve Underwood Inspector SU/mv COIJRECTION NOTICj ; BAKERSFIELD FIRE DEPARTMENT N° 681 Location ~/~t,_dl'OV', ,~qelxhe,_ SJrO. Jdo'l,x Sub Div. 3qb '* -/d((~ Blk Lot You are hereby required to inake the following corrections at the above location: Co~'. NO I Completion Date for Correetio~ ~' I3Z~ ~~ ~ Inspector 326-3979 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME O.~tO'tO~x ~C~l~d~t~ ~r{r~t.~ INSPECTION DATE ADDRESS ~,~'(~E) I_~ataat~& lxat~ e_ PHONE NO. 3fO 7oYq FACILITY CONTACT BUSINESS ID NO. 15-210: 'INSPECTION TIME NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program {~Routine [] Combined [] JOint Agency [] Multi-Agency [] Complaint [] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy Verification of inventory materials b/ Verification of quantities Verification of location V~ Proper segregation of material Verification of MSDS availability V/'' Verification of Haz Mat training / Verification of abatement supplies'and procedures Emergency procedures adequate Containers properly labeled Housekeeping Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: [] Yes [~}'lqf0 Explain: Questions regarding this inspection? Please call us at (805) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business S~Responsible Party Inspector:. _~.~t_, FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE I - t Section 2: Underground Storage Tanks Program [~Routine [] Combined [~1 Joint Agency Type of Tank B~t~ Type of Monitoring C~ [] Multi-Agency Number of Tanks Type of Piping [] Complaint [2] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on tile Permit fees current Certification of' Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAPACITY' Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: _~ [d~ Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Business Site Responsible Party Chevron Chevron April 30, 1999 Bakersfield Fire Department UST Division 2130 G. Street Bakersfield, CA 93301 RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND TANKS Dear Sirs: Please find enclosed the following documents: 1) Proof of Financial Responsibility 2) "Certificate of Financial Responsibility" These documents meet the financial responsibility requirements for all USTs owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Chevron is responsible for the following facilities in your jurisdiction: CHEVRON SS// STREET ADDRESS CITY 90705 9700 Rosedale Hwy. Bakersfield 91536 2700 Oswell Street Bakersfield 93978 3100 Niles St. Bakersfield 95325 2525 White Lane Bakersfield 98109 1131 Oak Street Bakersfield 99702 5201 Olive Dr. Bakersfield 201238 8100 E. Bnmdage Lane Bakersfield 201527 6601 Ming Avenue Bakersfield 203576 1125 Coffee Road Bakersfield 205673 13003 Rosedale Hwy. Bakersfield 206561 3360 Panama Ln. Bakersfield Sincerely, C. R. Carffie'id Marketing Assistant Retail Compliance 925-842-9002 Enclosure April 30, 1999 RE: CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND TANKS To Whom It May Concern: Chevron Corporation hereby certifies that it is in compliance with the requirements of Underground Storage Tank financial responsibility regulations. This certificate covers all tanks in the States of California, Alaska, Arizona, Idaho, Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by Chevron Corporation. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chevron is the amount of $1 million per occurrence, $2 million annual aggregate. Said guarantee covers taking corrective action And compensating third parties for bodily injury and property damage caused By either sudden accidental releases and non sudden accidental releases or Accidental releases. This guarantee is renewed annually (within the first 120 days of the year). Copies of the renewed certificate and a complete list of the facilities are sent to the governing agencies yearly. Sincerely, C. R. Canfiel0jEnvironmental Compliance, Permit Notarized by: x~_ ~.~ Susan R. Weber, Notary SUSAN g. WEBER "O Com .. # o5977s NOTARY ~BL~- C~OR~ ~ Chevron April 26, 1999 Chevron Corporation 575 Market Street San Francisco, CA 94105-2856 Martin R. Klitten Vice Pr,esident, Finance UST FINANCIAL ASSURANCE To Whom It May Concern: I am the chief financial officer of Chevron Corporation, 575 Market Street, San Francisco, CA. This letter is in support of the use of the financial test of self-inSurance and guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases and/or nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor -- all underground storage tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§§264.143 and 265.143) Post-Closure Care (§§264.145 and 265.145) Liability Coverage ({}§264.147 and 265.147) Corrective Action (§264.101(b)) Plugging and Abandonmem (§ 144.63) $ 141,190,186.00 $ 49,662,705.00 $ 8,000,000.00 $ -0- $ 2,666,400.00 California State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment Louisiana State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment $ 198,699.00 $ 701,566.00 $ 66,000,000.00 $ -0- $ $ 4,640,059.00 $ 797,537.00 $ 1,000,000.00 $ $ -o- Total $ 274,857,152.00 This guarantor has not. received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. Page 2 of 4 ALTERNATIVE II 1. Amount of annual UST aggregate coverage being assured by a test and guarantee 2. Amount of corrective action, closure and post-closure care costs, liability coverage, and plugging and abandonment costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 4. Total tangible assets 5. Total liabilities 6. Tangible net worth 7. 'Total assets in the U.S. 8. Is line 6 at least $10 million? 9. Is line 6 at least 6 times line 3? 10. Are least 90% of assets located in the U.S.? (If "No", complete line 11.) 11. Is line 7 at least 6 times line 3? 12. Current assets 13. Current liabilities 14. Net working capital (subtract line 13 from line 12). 15. Is line 14 at least 6 times line 3? 16. Current bond rating of most recent bond issue 17. Name of rating service. 18. Date of maturity of bond $ 2,000,000.00 $ 274,857,152.00 $ 276,857,152.00 $ 36,355,000,000.00 $ $ 19,506,000,000.00 16,849,000,000.00 $ 19,622,000,000.00 Yes No X X X X $ N/A $ N/A $ N/A $ N/A AA Standard & Poors August 15, 2004 Page 3 of 4 19. Have financial statements for the latest fiscal year. been filed with the SEC, the Energy Information Administration, or the Rural Electrification Administration? Yes No I hereby certify that the Wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California and Louisiana was added to make disclosure more complete. M. R. Klitten Vice President, Finance April 26, 1999 Page 4 of 4 GUARANTEE Guarantee' made this April 26, 1999, by CHEVRON CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC. CCUSA"), of 575 Market Street, San Francisco, CA. RECITALS Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). CUSA owns or operates the following underground storage tanks covered by this guarantee, underground storage tanks at various facilities in the states of: Alaska Louisiana Arizona Nevada California Oregon Florida Texas Georgia Utah Hawaii Virginia Idaho Washington Kentucky This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. On behalf of our subsidiary, CUSA, guarantor guarantees to implementing agencies and to any and all third parties that: In the event that CUSA fails to provide alternative coverage within 60 days after receipt of a notice of cancellation of.this guarantee and the Director of the implementing agency has determined or suspects that a release has occurred at an underground storage tank covered' by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. Page 1 of 3 In the event that the Director determines that CUSA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. If CUSA fails to satisfy a judgement or' award based on a determination of liability for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising from the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified above. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CUSA pursuant to 40 CFR part 280. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part. 280, subpart H for the above-identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8. The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an employee of CUSA arising from, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use,. or entrustment to others of any aircraft, motor vehicle, or watercraft; Page 2 ~f 3 (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; (e) Bodily damage or property damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreemem entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. I hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 26, 1999 CHEVRON CORPORATION M. R. Klitten Vice President, Finance By Assistant Secretary Page 3 of 3 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON .U;S.A. INC.' hereby certifies that it is in compliance with 'the requirements of subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 26, 1999, and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120'days of 2000. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 26, 1999 CHEVRON U.S.A. INCA By ]~r~ 1b. Rob~'ts Senior Counsel By /~udith L. Geisler Legal Analyst CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U:S.A. INC. hereby certifies that it is in compliance with the requirements of. subpart H of 40 CFR part 280. The financial assurance mechanism used to demonstrate financial responsibility under subpart H of 40 CFR part 280 is as follows: Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence, $2 million annual aggregate, for the period commencing April 26, 1999, and which is' anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of .2000. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 26, 1999 CHEVRON U.S.A. INC.. gri~n P'. Roberts Senior Counsel /Judith L. Geisler Legal Analyst CUSA UST FINANCIAL ASSURANCE April 26, 1999 bcc: J. M. Bauer L. T. Brown C. R. Canfield G. F. Cooper H. P. Davis Jr. A. G. FredeluceS M. Leong P. T. Liang D. E. Ludlam L. J. Marshall S. E. Merritt A. R. Mora D. A. Newell I. O. Ng W. C. Ishimoto D. T. Sherman E. A. Thompson R. A. Wondolleck Permit Desk, Chevron Park L-1338 (2 copies) Arizona Dept. of Environmental Equality UST Section Attention Brian Kelley 3033 N Central Avenue Phoenix, AZ 85012 (602) 207-2214 ,0 D February 9, 1999 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVlCE~ 2101 'H' Streel Bakersfield. CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H' Street Bakersfield. CA 93301 VOICE (805) 325-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (805) 325-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (805) 325-3979 FAX (805) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 Chevron/McDonalds 3360 Panama Lane Bakersfield, CA 93307 RE: Compliance Inspection Dear Underground Storage Tank Owner: The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, underground storage tanks and monitoring systems, and hazardous materials inspection. To assist you in preparing for this inspection, this office is enclosing a checklist for your convenience. Please take time to read this list, and verify that your facility has met all the necessary requirements to be in compliance. Should you have any questions, please feel free to contact me at 805-326-3979. Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure D February 9, 1999 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 Chevron 3360 Panama Lane Bakersfield, CA 93313 RE: Compliance Inspection' Dear Underground Storage Tank Owner: The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, underground storage tanks and monitoring systems, and hazardous materials inspection. To assist you in preparing for this inspection, this office is enclosing a checklist for your convenience. Please take time to read this list, and verify that your facility has met all the necessary requirements to be in compliance. Should you have any questions, please feel free to contact me at 805-326-3979. Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure April 3O, 1998 RE: CERTIFICATE OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND TANKS To Whom It May Concern.'. Chewon Corporation hereby certifies that it is in compliance with the requirements of Underground Storage Tank financial responsibility regulations. All tanks in the States of California, Alaska, Arizona,. Idaho, Nevada, New Mexico, Oregon, .Texas, Utah and Washington owned by Chevron Corporation are covered by this certificate. The financial assurance mechanism used to demonstrate financial responsibility required under State and Federal regulations is as follows: Corporate guarantee of Chewon is the mount of $1 million per occurrence, $2 million annual aggregate. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases and non sudden accidental releases or accidental releases. This guarantee is renewed annually (within the first 120 days of the year). Copies of the renewed certificate and a complete list of the facilities are sent to the governing agencies yearly. Sincerely, S. L. Belier, Enviro~[nental Compliance, Permit Notarized by:~t. Susan R. Weber, Notary SUSAN R. WEBER Comm. # 1059775 Chevron UNDERGROUND STORAGE TANK QUARTERLY INVENTORY RECONCILIATION REPORT ACCOUNT NO: 1849/206561 FACILITY NAME AND LOCATION: CHEVRON STATIONS INC. 3360 PANAMA ~ Title 23, Califo.rnia Ad_ministra.tive Code (C. AC)', Section 2646 .(e; requires the owner or ol0era~or o£ an unaerground s~oraqe tank utilizing . inventory reconciliation as part of the required monitoring and leak detection system to submit on a .quarterly ~b.asis a statement to ~he local agency under penalty of perjury, .t~at either, the invents_fy-reconciliation clara is within' allowable variations or a listing of the dates and variations that exceed the allowable variations. This form or a reasonable facsimile, when completed. will satisfy the quarterly reporting requirements. Please return a copy of ~t~.is f~rm~_to th9 %fnd.erg.round gt.orage .T_ank Pr am within thirty (30 days of DATE: ~ cI v o s ^r,o s - / For the calendar quarter ending , at .the facility indicated 9_Ix?v-, ._.re.c. ords...for, a.l. 1 _. underground tanks monitored by inventory reconcxlla~:lon lncllcace chat. a® be F~ample All inventory variations were within the allowable limits of Section 2644, CAC. Inventory variations in pxcess of the allowable limits of Section 2644,_C~q h~e .oc~grrgd on .the following days, in the listed 9~°~9~s,.zg~ cn~.~Axo~ngunaeFgroun9 s~orage tanks (use back side oz repor~ 1£ aaalclonal space Is neeaed}. Tank Tank Size l .D. (Gallon.) Dates 1/30/90 2/9/90 2/28/00 3/'7/90 #000 10,000 Unleaded Va.ri- +125 -130 ~,150 +1.'/$ atio~ 9001 Date. Vari- ation Date. #002 &tion Date. #OO3 ation Tagk Facility Owner/Opera* I certify, under penalty of perjury, that all variations (if any) exceeding allowable limits for the quarter ending , are indicated above and were investigated in accordance with the requirements of Title 23, CAC, Section 2644. Che~k One ¢1) Ltn~; San B~rnardino County sAp_geles County n. Dteqg'Co.untF nt~& cou~ Kern County -/ ~/' QTR. VAR IAI~E LO~ AUG-28-87 13:05 FRC)M-~CHEVRON STATIONS INC liD: 18188107423 B-g~D~ROU~TD STORAGE TANIr @UART~RLY INV~ORg R~CO~CILIATION RF~PORT ACCOU~T NO: ~ '~ 2~ FACILITY NA~E kND LOCATION: ._c~woN STA'rZ0~s ]:~Co MA~.LNG ADDRESS: CI~%T~ON STATIONS iNC. 17890 CASTLETON STREET. SUITE I00 CITY OF INDUSTRY, CA 91748 Ti'cie 23, California Administrative Code ,'<.k¢~, Section 2646 (e} requires the o'~r~e~ or o~erator of an underground '-;>;"*~.' .'-.:;~-- t-a~ uti!iz~ng inventory r~c.~jn~i!iatlon ~s part of the required .~:~::a~,]tc~/,~iJ ~nd l~ak detection system '~ ~'<L~.~:,~.t on a ~uarterly basis a state.cut %<> tl~<'.~~ i,~c?~ agencv ~nder p~na!ty ~-.~ '. :: -"~ ~y ~ that either: ~e inventory ~'~.co¥~c i ;~ ~. ~C. 5.::.:D ~ata iz ~i~in · ' ~ ...... >:"a~ variations~ This fo~ or a reasonable f~,..= ~.i:':." .~?y ,~e ~arterly reporting ree~irement~. ?:~<"..':t~.e: ~.xiz:r~.C, ~ -. _. ': ~i.: s~;, ~;:',,¢~ Undergro~d ~tprage Ta~ Pr~ra~ within ""'~ ~' ...... ' ...... ':'"' ~-'~.....~ .::~ ~2~ch calendar ~arter, (March_ 3i. June k~v~ntory va~ .~'._iuns in excess of the allowable lim~its of Section g644~ CAC flare ~curz:e~ on the i'ollowing day~. nn the-li~t,~ umounts~ for the following undeF~rou~d storage ta~$ (use ~ck si,ge ~f report if ad~itionai ',space IS .~,~-:edeO). :k Size · ~ Ions) Dat~ 03 vari-. or perjury, that all variations (if any) _xceedlng I certify, under ~enal~y ..... ~ ' allowable limits ~or ¢:~:~e qc~rter ending ~~_~ _~, are inOicated abo~e an~ were investigated in accordance with-~f~_~-~qu~!~'~ments of ~*~"le 23~ CA(.~ Section 2644. Kern Co~t~ OTR.. ~,~, _ .VARIANCE LC~ STATION · L(~ATION~- DATE REGUL~ SUPREME UNL£AOEO DI£~L FUEL CERTIFICATE OF U~RGROUND STORAGE TANK S~EM ~rlE ,~:T~I~NG. !~ · m~' TANKNOLOGY-NDE /~/~/~T:.~ ~ ~oo s,o~ c~x, ~u~o,~G ~oo //~" ~ ~ ~ ~¢~~ AUSTIN, TE~S 78757 //r~ - ~ ~/~11~ · (~) ~-~4 /~, ~ ~ ~ /////~ F~ (~ .~.-~.~.:,. /~//~ TEST TYPE: ~ PU~POSE: co~z~c~ ~:~ ~ ~A~[: o~/~/~ ~o~o~[~Nu~[~: ~zo~o~ CLIENT:- CHEVRON U.S.A. SITE: P. O. BOX 2833 LA HABRA, CA 90631-2833 CHEVRON #206561' 3360 PANAMA BAKERSFIELD, CA 93304 ATTN: JUDY BOWE /he following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations Tank Tests 4,.' F' TAN K -~;,?¢:2 ~ ':~,~,.,:' ,~ PRODUCT 89 1 PLUS 87 2 ~G ~ 92 3 SUP~ 11,84g ll, 849 11,849 120.0 120.0 120.0 PAS S 89 87 92 i PLUS 2 REG UNLEAD 3 SUPREME Line and Leak Detector Tests ~:;,~,~: ~LINE RESULT ~:::I,?~,~:~K DETEcToR TANKNOLOGY-NDE appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, da5, or night, when you need us. TANKNOLOGY-NDE Representative: KEN MINTON Reviewed: Test conducted by: HENSLEY D BARBOUR JR Technician Certification Number: ALERT Printed 05/27/97 16:24:30 I DVI~ I E TEC TE EP T TANKNOLOGY-NDE TEST DATE: 05/19/97 WORK ORDER NUMBER: 3102023 CLIENT: C["~VRON U.S.A. SITE: C['~VRON #206561 Tank ID: 89 Product: PLUS Capacity in gallons: 11,849 Diameter in inches: 120.00 Length in inches: 245 COMMENTS Material: DW FTBERG Tank: NO Manifolded Vent: NO V/R: Y~S Impact Valves Operational: Bottom to top fill in inches: 168.5 Bottom to grade fill in inches: 176.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: . 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: PSI at tank bottom: Eluid level in inches: UFT/OFT: Fluid volume in gallons: Tank water level in inches: Test time: Number of thermisters Specific gravity: Water table depth in inches: Determined by (method): Leak rate in gph: COMMENTS Result: New/passed L.D. make: Model: S/N: Open time in sec: Holding psi: Resiliancy cc: Test leak rate ml/min: Metering psi: Calib. leak in gph: Results: COMMENTS Failed/Replaced L.D. COMMENTS Test time: Ullage volume: Ullage pressure: Results: DATA FOR UTS-4T ONLY: Time of test 1: Temperature: Flow rate (cfh): Time of test 2: Temperature: Flow rate (cfh): Time of test 3: Temperature: Flow rate (cfh): Material: DW FIBERG Diameter (in): 2.0 Length (ft): 125.0 Test psi: Bleedback cc: Test time (min): Test 1: Start time: Finish psi: Vol change cc: Test 2: Start time: Finish psi: Vol change cc: Test 3: Start time: Finish psi: Vol change cc: Final gph: Result: Pump type: P~$SUR~ Pump make: ~ PETRO COMMENTS 8900 SHOAL CREEK, BUILDING 200, AUSTIN, TEXAS 78757 (512) 451-6334 Printed 05/27/97 16:24:34 IVID L ' LINE E DETE~ P TANKNOLOGY-NDE TEST DATE: 05/19/97 WORK ORDER NUMBER: 33.02023 CLIENT: CHEVRON U.S.A. SITE: CHEVRON #206561 T~nk ID: 87 2 Material: DW FIBERG Product: [~.EG UNLEAD Tank: NO Capacity in gallons: 11,849 Manifolded Vent: NO Diameter in inches: 120.00 V/R: YES Length in inches: 245 Impact Valves Operational: COMMEI~TS Bottom to top fill in inches: 172.0 Bottom to grade fill in inches: 176.0 Fill pipe length in inches: 49.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUra. Stage II vapor recovery: SALANC~. PSI at tank bottom: Fluid level in inches: UFT/OFT: Fluid volume in gallons: Tank water level in inches: Test time: Number of thermisters Specific gravity: Water table depth in inches: Determined by (method): Leak rate in gph: COMMENTS Result: New/passed L.D. make: Model: S/N: Open time in sec: Holding psi: Resiliancy cc: Test leak rate ml/min: Metering psi: Calib. leak in gph: Results: COMMENTS Failed/Replaced L.D. COMMENTS Test time: 10: 00-10: 30 Ullage volume: 2,106 Ullage pressure: 1.50 Results: PASS DATA FOR UTS-4T ONLY: Time of test 1:10:00-3.0:3.0 Temperature: Flow rate (cfh): 0. 200-0.3.00 Time of test 2:3.0: 3.0-3.0:20 Temperature: Flow rate (cfh): 0. 200-0.3.00 Time of test 3:3.0:20-3.0:30 Temperature: Flow rate (cfh): '0. 200-0. 005 Material: DW FIBERG Diameter (in): Length (ft): 3.25.0 Test psi: Bleedback cc: Test time (rain): Test 1: Start time: Finish psi: Vol change cc: Test 2: Start time: Finish psi: Vol change cc: Test 3: Start time: Finish psi: Vol change cc: Final gph: Result: Pump type: ~'~ESSU'RE Pump make: FE PETRO COMMENTS 8900 SHOAL CREEK, BUILDING 200, AUSTIN, TEXAS 78757 (512) 451-6334 Printed 05/27/97 16:24:36 LNDIVIDUA J. TOR T TANKNOLOGY-NDE TEST DATE: 05/19/97 WORK ORDER NUMBER: 33.02023 CLIENT: CHEVRON U.S.A. SITE: CHEVRON #206561 Tank ID: 92 Product: SUPREME Capacity in gallons: 11,84 9 Diameter in inches: 120. O0 Length in inches: 245 COMMENTS Material: DW FIBERG Tank: NO Manifolded Vent: NO V/R: YES Impact Valves Operational: Bottom to top fill in inches: 176.0 Bottom to grade fill in inches: 182.0 Fill pipe length in inches: 52.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: BALANCE PSI at tank bottom: Fluid level in inches: UFT/OFT: Fluid volume in gallons: Tank water level in inches: Test time: Number of thermisters Specific gravity: Water table depth in inches: Determined by (method): Leak rate in gph: COMMENTS Result: New/passed L.D. make: Model: S/N: Open time in sec: Holding psi: Resiliancy cc: Test leak rate ml/min: Metering psi: Calib. leak in gph: Results: COMMENTS Failed/Replaced L.D. COMMENTS Test time: Ullage volume: Ullage pressure: Results: DATA FOR UTS-4T ONLY: Time of test 1: Temperature: Flow rate (cfh): Time of test 2: Temperature: Flow rate (cfh): Time of test 3: Temperature: Flow rate (cfh): Material: DW FIBERG Diameter (in): 2.0 Length (ft): 125.0 Test psi: Bleedback cc: Test time (min): Test 1: Start time: Finish psi: Vol change cc: Test 2: Start time: Finish psi: Vol change cc: Test 3: Start time: Finish psi: Vol change cc: Final gph: Result: Pump type: PRESSURE Pump make: FE PETRO COMMENTS 8900 SHOAL CREEK, BUILDING 200, AUSTIN, TEXAS 78757 (512) 451-6334 Printed 05/27/97 16:24:38 ,, v,..o. TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 F~ (512) 459-1459 TEST DATE: 05/~9/97 WORK ORDER NUMBER: 3[02023 CLIENT: C~E~ON U.S.A. SITE: C~E~ON ~206561 P. O. BOX 2833 3360 P~ - ~ ~, ~ 90631-2833 ~RSFIE~, ~ 93304 A~N: ~Y BO~ CONTACT: ~:~- .~,~.~ ~.:~ ~?~." :,~.~;~.~:~ ~.,~',~ ~:~ :'~'~ ,~.'? :;:~:~.:?: :DY~MiC~CK.,PRESSURET~:;~,~:~:~:~ ~.~:~ c~ I c~ I ~ I c~ I ~ I fail c~ c~ c~ c~ c~ fail ~G ~ 1 0.12 0.70 1.40 FAIL latteral piping inside of disp. is full of fuel. vapor pipe. PLUS I 0.10 0.58 1.20 FAIL see co~ents for first test. SUP~ i 0.13 0.62 1.40 FAIL see co~ents for first test. ~G ~ 2 0.09 0.50 1.12 FAIL see co~ents for first test. (s~e dispenser) PLUS 2 0.10 0.52 1.08 FAIL see co~ents for first test. (s~e dispenser) SUP~ 2 0.10 0.48 1.05 FAIL PRESSURE DECAY TEST 89 ~ 2.00 ~.95 ~.90 ~.84 ~.8~ 1.75 ~.?~ 5359 ~S 87 2 2.00 1.95 1.90 1.84 1.81 1.75 1.71 5359 PASS 24 nozzles. TANKNOLOGY-NDE appreciates the opponuniD, to se~e you, ~d looks fow~d to working with you in the future. Ple~e call ~y time, day or night, when you need us. TANKNOLOGY-NDE Representative: Test conducted by: Reviewed: Technician Ce~ification Number: ~RT ,, v^,o, TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/19/97 WORK ORDER NUMBER: 3102023 CLIENT: CHExrP, ON U.S.A. SITE: P. O. BOX 2833 - ~ I-IABRA, CA 90631-2833 CHEVRON #206561 3360 PANAMA BAKERSFIELD, CA 93304 A3q'N: JUDY BOWE CONTACT: PRODUCT, · ,~, DISPENSER ...... ..... ~> ~= ,,,~:.,~(DRYPRESSURE) ....... ~ ,, ~,~ ~?;;',:;;'?:~T~PRESSURE)'"' ;,:(. ";1:7; i 20 40 60 80 100 Pass/ I 20 ~'¢:.,~.': ...... cfh ] cfh I cfh ] cfhI cfhI fa / ~I I cfh I cml fail see comments for first test. (same dispenser) SUPREME 3 0.10 0.45 PLUS 3 0.07 0.39 REG UNLEAD 3 0.05 0.43 SUPREME 4 0.05 0.37 PLUS 4 0.06 0.39 REG UNLEAD 4 0.07 0.39 REG UNLEAD 5 0.12 0.38 PLUS 5 0.09 0.42 SUPREME 5 0.06 0.37 SUPREME 6 0.03 0.29 PLUS 6 0.06 0.33 REG UNLEAD 6 0.07 0.37 REG UNLEAD 7 0.04 0.37 PLUS 7 0.05 0.34 0.95 0.87 0.90 0.86 0.84 0 86 0 87 0 89 0 80 0 71 0 73 0 80 0 85 0 75 PASS PASS PASS PASS PASS PASS PASS PASS PASS PASS PASS PASS PASS PASS. PRESSURE DECAY TEST 92 3 2.00 1.95' 1.90 1.84 1.81 1.75 1.71 5359 PASS 1.71 5359 TANKNOLOGY-NDE appreciates the opportunity to serve you, and looks foward to working with you in the future. Please call any time, day or night, when you need us. TANKNOLOGY-NDE Representative: Reviewed: Test conducted by: HENSLEY D BARBOUR JR Technician Certification Number: ALERT CERTIFICA TEST DATE: 05/1-9/97 STAGE II VAPOR RE-'COVEF~'ESTING TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 WORK ORDER NUMBER: 31-02023 CLIENTi CHEVRON U.S.A. SITE: CHEVRON #206561 P. O. BOX 2833 3360 PANAMA ' LA HABRA, CA 90631--2833 BAKERSFIELD, CA 93304 A'I-I'N: JUDY BOWE CONTACT: PRODUCT :~'::.!~' '~. :: ¥:?~ ::~ ;.;.~DISPENSER.. ,:, :: ~,:!:::~,: ~ :.::'~::~::tDRY~:.P:RESSURE)...~:-:?~',':~:¥ :: :~. I ;:: ~!~RESSURE). -- :-' ':::~::~'1 · ::'L- 4~'. ;'.,: :~ :'~;~?~: :~ ::~:~ ~ ~ ~: ~:: :,~ ?:. ~::. :~ :. '~ ~L ~, ;:%: :::: '~ ? ':<: :~:i nc~ ~ :.~ fl ~ ~:~::~::,~:g:: ~:~:{;? ~1~ ~ :~:.';: ~ ';: J nc~:.ot ~m~ M fl ~:m~: .' ,~} ~- ~.~.?. 20 40 60 80 100 Pass/ I 20 40 60 80 100 Pa~/ c~ I c~ I cml cml ~1 f* I ~m I cm I c*'l cm Icl, I fa SUP~ 7 0.06 0.39 0.83 P~S SUP~ 8 0.07 0.37 0.85 P~S PLUS 8 0.06 0.35 0.78 PASS ~G ~ 8 0.07 0.44 0.95 PASS PRESSURE DECAY TEST 1.71 5359 1.71 5359 TANKNOLOGY-NDE appreciates the opportunity to serve you, and looks foward to working with you in the future. Please call any time, day or night. when you need us. TANKNOLOGY-NDE Representative: Reviewed: Test conducted by: HENSLEY D BARBOUR JR Technician Certification Number: A.T. gRT SITE DIAGRAM TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/19/97 CLIENT: CHEVRON U.S.A. WORK ORDER NUMBER: 3102023 SITE: CHEVRON #206561 STER rtl Z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. (~ ~12K PLUS (~ ~)12K REG PANAMA LANE W~E Form 1 Source Test Tesults Static Leak Test Date: 05/19/97 GDF Name and address: Stage II system (check one): Stage I type (check one): Time: 08:00 Application No. 206561 3360 PANAMA Vapor Balance [X ] Vacuum Assist [ ] Type: Two point [X ] Manifolded? Yes [X ] Coaxial [ ] No [ ] Tank # 1 2 3 Product grade supreme plus regular Actual tank capacity (gallons) 11849 11849 11849 35547 Gasoline volume (gallons) 10126 10319 9743 30188 Ullage (gallons) 1723 1530 2106 5359 Initial pressure of UST, inches H20 2 2 2 6 Number of nozzles served by tank 8 8 8 24 Test location: (A) Stage I vapor !coupler of(B) Stage II riser Initial Pressure, inches H20 (2.0) :Pressure after I min. (inches H20) Pressure after 2 min. (inches H20) Pressure after 3 min. (inches H20) Pressure after 4 min. (inches H20) Final Pressure after 5 min. (inches H20) Allowable Final Pressure: Table IA, Table 1 B, Equations 9.1, 9.2 Test Status [Pass or Fail] ,. Tests Conducted By: HBARBOUR Test Company: NDE ENVIRONMENTAL Tests Witnessed By: Date of Tests: 05/19/97 Form 2 Summary of Test Results Dynamic Pressure Performance Date: 05/19/97 Time: 08:00 Application No: GDF Name and address: 206561 3360 PANAMA Quantity 5359 (gallons) of gasoline introduced into Stage II riser. Stage I1 system type: (Manufacturer and Executive Order number) Riser 40CFH 60CFH 80CFH PASS Riser 40CFH 60CFH 80CFH PASS No. .16" .35" .62" or No. .16" .35" .62" or MAX MAX MAX FAIL MAX MAX MAX FAIL Did gauge needle pulsate or peg at any flow rate during test? No [ ] Yes [ ] Indicate location of storage tank(s), condensate pot(s), and location where gasoline was introduced into the vapor return system on reverse side of this page: Tests Conducted By: HBARBOUR Test Company: NDE ENVIRONMENTAL Tests Witnessed By: Date of Tests: 05/19/97 Date: · 05/19/97 GDF Name and address: Notes: 206561 Reverse Side of Page Work Order #: 3102023 3360 PANAMA CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK SYSTEM MONITORING PROGRAM FACILITY INFORMATION SHEET Facility: Chevron Products Company Service Station #20-6561 3360 Panama Lane Bakersfield, California 93304 UST Owner: AUG 2, 8 1997 By~ ~ ~d~/.{ Chevron Products Company 1300 South Beach Boulevard P.O. Box 2833 La Habra, CA 90632-2833 (310) 694-7300 UST Equipment Tanks Tank # Type Tank Tank Storage Capacity Type Monitoring Spill Classification Containment 1 Gasoline 12,000 2 Gasoline 12,000 3 Gasoline 12,000 D/W Fiberglass D/W Fiberglass D/W Fiberglass New POMECO New POMECO New POMECO Piping For Piping Type Piping Operation 1 Pressurized D/W Fiberglass 2 Pressurized D/W Fiberglass 3 Pressurized D/W Fiberglass Monitoring Classification New New New Note: "Existing" -- Installed prior to January 1, 1984 "New" -- Installed after January 1, 1984 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0102 Rev. 7/29/96 CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK SYSTEM OWNER/OPERATOR AGREEMENT Owner Certification Chevron Products Company, as the owner of the underground storage tank system located at 3360 Panama Lane, Bakersfield, California 93304, I hereby certify that: We have entered in to a written agreement with the operator of the UST system at the referenced location. This agreement is contained in our contract with the operator. The operator of the UST system at the referenced facility is responsible for and will perform all monitoring, record keeping, and reporting requirements for the UST system as outlined in the documents listed below. The operator has been provided a copy of the Permit to Operate the UST system at the facility. The operator has been provided a copy of the provisions of Health and Safety Code Section 25299. o The operator has been provided a copy of the California Code of Regulations Title 23 - Waters Division 3 - State Water Resources Control Board Chapter 16 - Underground Storage Tank Regulations, May 1994. o We understand that we are required to notify the UST Program of the City of Bakersfield Hazardous Materials Division, in writing, of any change of operator within thirty days of any such change. Owner: CHEVRON PRODUCTS CO. We hereby certify that the preceding monitoring plan for underground storage tank systems will be implemented at our service station located at 3360 Panama Lane, Bakersfield, California 93304. To the best of our knowledge, all information contained herein is true and correct. Safety & Health Signature: 71~Ii~. ~ /.......~ompliance Specialist, Envi~n.n~ental Date:~]-/~/77 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0107 Rev. 7/29/96 CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK SYSTEM OWNER/OPERATOR AGREEMENT Operator Certification As the operator of the Underground Storage Tank system installed at 3360 Panama Lane, Bakersfield, California 93304, I hereby certify that: I am, or represent the individual, firm, trust, partnership, association, or corporation that is in control of and has the daily responsibility for the operation of the UST system at the referenced facility. I have entered into a written contract with Chevron Products Co., the owners of the UST system I am operating. I understand that this obligates me to perform monitoring, record keeping, and reporting requirements as outlined in the documents listed below. 3. I have received a copy of the Permit to Operate the UST system at the facility. 4. I have received a copy of the provisions of Health and Safety Code Section 25299. o I have received a copy of the California Code of Regulations Title 23 -Waters Division 3 - State Water Resources Control Board Chapter 16 - Underground Storage Tank Regulations, May 1994 Signature: Robert O. Southw~ck - Area Manager Chevron Stations Inc., Facility Operator Date: gT~ ~/ ~-.,~ Facility Manager: ~5~Tar-~-rt_ '~-~,'7/.~~~~ Print and Sign Name Facility Manager: Facility Manager: Print and Sign Name Print and Sign Name Date: o'"/,,~/q -~ Date: / / Date: / / 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0108 Rev. 7~29~96 ON SITE OPERATOR CONTACT Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Facility Manager: Print and Sign Name Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / Date: / / 20-6561 3360 Panama Lane Bakersfield, California 93304 EX-0108 Rev. 7/29/96 CHEVRON PRODUCTS COMPANY MONITORING PROGRAM FOR "NEW" UNDERGROUND STORAGE TANKS Monitoring of underground tanks constructed pursuant to: Califomia Code of Regulations Title 23 -- Waters Division 3 -- State Water Resources Control Board Chapter 16 -- Underground Storage Tank Regulations- May 1994 Section 2631 Shall be implemented pursuant to: California Code of Regulations Title 23 -- Waters Division 3 -- State Water Resources Control Board Chapter 16 -- Underground Storage Tank Regulations- May t 994 Section 2632 (C) (2) (A) and Section 2632 (C) (2) (B) Monitoring Frequency: Methods and equipment to be used: Condition of secondary system: Type of substance stores: Method of monitoring: Monitoring equipment Liquid level probe - Gasoline Tank Interstitial Space: Location monitoring to be performed: Continuous Dry Volatile Continuously operated electronic liquid level indicator Control Unit Make: Veeder Root Model: TLS - 350 Make: Veeder Root Model: VR: 7934380-409 At Facility - inside all underground tank(s) interstitial space (3) Person responsible for performing the monitoring Chevron Stations Inc., Facility Operator Persons responsible for maintaining the monitoring equipment Chevron Products Company Marketing Operations -- Maintenance Department 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0101a Rev. 7/29/96 Visual monitoring of the tank monitor alarm box is performed daily by the dealer or a designated employee. Chevron also requires that the tank monitoring equipment operational and alarm condition be documented daily by using a "USTEquipment Monitoring Log". This log is also required to be used to document when equipment problems are reported to Chevron Maintenance and is to be kept as part of the station monthly inventory reconciliationrecords and on site at all times. Please see the attached site map for the location of all equipment at the site. The electronic monitoring devices are maintained according to manufacturer's recommendations. The dealer will also perform inventory reconciliation according to the procedure outlined in the Inventory reconciliation section of this plan, as stated in detail in Section 2626 of the copy of the California Code of Regulations, Title 23, Division 3, Chapter 16 dated May 5, 1994 that is attached to the dealer's copy of this plan. Daily and monthly inventory reconciliation is required by Chevron Policy. Training will be given to the dealer of record, Chevron Stations Inc., which includes information regarding: how to self test the electronic monitoring equipment, what the equipment monitors, how to tell when the alarm goes off, how to perform inventory reconciliation, record keeping requirements and procedures to follow in the event of alarm activation, leak, suspected leak, or other emergency. Chevron requires that all station employees be trained and familiar with tank alarm systems and reporting requirements, however training of the dealer's management and employees on the above mentioned subjects as well as the completing andfiling of any further documentation outlining such training, as may be required by the City of Bakersfield Hazardous Materials Division, will be the responsibilityofthe dealer of record. In the event of an alarm activation, the operator may have cause to suspect a leak and is required to investigate. In the case of a monitoring equipment malfunction (e.g., green lights not on, lost power, etc.), operator is required to notify Chevron immediately for equipment maintenance. In the event of a leak, the operator will notify the Chevron Territory Manager (or other Retail Management), and will take the following actions: 1. Shut down the tank or product line. 2. Contact Chevron Maintenance Dispatch. 3. Contact the Fire Department or local Emergency response agency, if warranted. 4. Keep employees, customers, or bystanders away from any gasoline. In the event of a suspected leak, Chevron specifies procedures and mandates the use of a "Suspected Leak Activity Log" for investigation in case of an inventory tolerance problem, and equipment alarm, and/or if there are any other reasons to suspect a leak. When circumstances occur to the point where this log needs to be used, it is to be kept as part of the monthly inventory reconciliation records as proof that suspected leak situations were investigated. In the event of an emergency, the operator will follow their site Emergency Response Plan which consists of 1) Emergency Response Procedures: 10 Steps to Safety During an Emergency, where employees know what to do in the event of a fire, spill, or an observable leak. 2) Site map, where employees know the location of critical equipment (e.g., emergency shut-off switches, etc.). And 3) Emergency Contact List, where employees know who and how to contact all appropriate people in the event of an emergency. 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0101a Rev. 7/29/96 C~VRON PRODUCTS COMPANY MONITORING PROGRAM FOR "NEW" UNDERGROUND PIPING Monitoring of underground piping constructed pursuant to: , California Code of Regulations Title 23 -- Waters Division 3 -- State Water Resources Control Board Chapter 16 -- Underground Storage Tank Regulations - May 1994 Section 2631 Shall be implemented pursuant to: California Code of Regulations Title 23 -- Waters Division 3 -- State Water Resources Control Board Chapter 16 -- Underground Storage Tank Regulations- May 1994 Section 2636 (f) (1) and Section 2636 (f) (2) Monitoring Frequency. Continuous Methods and equipment to be used: Condition of secondary system: Type of substance stores: Method of monitoring: Monitoring equipment Automatic line leak detector Liquid level probes - Tank fill/turbine sumps and gasoline dispenser containment boxes Location monitoring to be performed: Dry Volatile Continuously operated electronic liquid level indicator Control Unit Make: Veeder Root Model: TLS-350 Make: Veeder Root Model: TLS 350 Make: Veeder Root Model: VR: 794380-208 At Facility - inside all underground tank fill (3) and turbine containment sumps (3) and under gasoline dispenser containment boxes (4) Person responsible for performing the monitoring Chevron Stations Inc., Facility Operator Persons responsible for maintaining the monitoring equipment Chevron Products Company Marketing Operations -- Maintenance Department 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0102a Rev. 4/3/97 C~VRON PRODUCTS COMPANY O UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE RESPONSE PLAN If the unauthorized release detection system is activated the facility operator will be responsible for: Determining the source: UST and/orpipeline(ifpossible) Discontinuing operation of the system (if necessary) Telephoning Chevron Products Company IMMEDIATELY Week Days: Chevron Products Company Maintenance: (800) 423 - 6911 Week Ends and Holidays Days: Petro Services Nights: Chevron Products Company will be responsible for: (800) 400 - 4790 Initiating unauthorized release determination IMMEDIATELY. Initiating cleanup procedures IMMEDIATELY (if necessary). Contacting agencies within 24 hours. Person responsible for work authorizatio~ Roger W. Cleworth, Maintenance Supervisor, or a designated representative Hazardous substance will be removed according to all laws and regulations regarding hazardous substance handling, transportation, storage and disposal. Equipment Chevron uses to remove hazardous substance will be owned and operated by a state licensed contract hauler. Chevron will use the hauler with the best response time. Maintenance of all equipment used by haulers is the hauler's responsibility. At a minimum, Chevron reserves the right to dispatch proprietary transport vehicle from the Van Nuys, California bulk storage facility. All unauthorized releases will be removed from the secondary containment within 30 days. This response plan outlines required dealer actions and Chevron's response if the facility's unauthorized release detection (tank monitoring) system is activated. Chevron requires that all station employees be trained and familiar with tank alarm systems, reporting requirements and in the use of clean up equipment, however training of the dealer's management and employees in the alarm systems and in the use and maintenance of any on site clean up equipment as well as the completing andfiling of any further documentation outlining such employee training, as may be required by the City of Bakersfield Hazardous Materials Division, will be the responsibility of the dealer. · o Signature: ~7 ~1~~~1~ Date:~ J/Michael Welty ,,~l~Jompliance Specialist, Enviro~ental Safety & Health 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0104 Rev. 4/3/97 i CHEVRON PRODUCTS COMPANY UNDERGROUND STORAGE TANK MONITORING EQUIPMENT PREVENTATIVE MAINTENANCE SCHEDULE Veeder Root - TLS-350 Underground Storage Tank and Pressurized Piping Monitoring System Preventative maintenance frequency:. Annually Performed by: Veeder Root Certified Representative Annual maintenance checklist. Inspect Hardware Inspect panel for loose wires. Inspect for intrinsic safety cover in place. Inspect for touch screen mounted and enclosed properly. Inspect for CPU operation. Test Operation of Operator Interface Terminal (OIT) Test all screens for live data. Re-enter date and time (even if currently correct). Test Tank Level Monitor and Printer Calibrate product and water readings to physical measurements (stick readings). Print out inventory report. Test Pump Control Interface and Link Leak System Start line test for each product. Note pressure rise for each product. Note pressure at which each check valve seats. Verify pump shutdown. Verify emergency stop shuts off all submersible pumps. Test External Alarms and Remote Communications Individually simulate each alarm condition and Verify the event on the OIT. Verify dial tone at telephone extension on modem module. Verify modem operation. Site Documentation Verify installation manual is on-site. Verify maintenance log. Certification Certify the TLS-350 has been checked according to manufacturer instructions. Certify the system is operating properly. Verify with appropriate agency that certification has been completed. NOTE: All functions listed in this preventative maintenance schedule may not be present at each specific site. All functions present at each site will be maintained according to this program. 20-6561 3360 Panama Lane Bakersfield, California 93304 NW-0104 Rev. 4~3~97 UNDERGROUND STORAGE TANK SYSTEM OPERATOR TRAINING REQUIREMENTS The training required to operate the underground storage tank system and monitoring equipment located at referenced facility is as follows: Underground Storage Tank System Orientation session on the operation of an underground storage tank system topics include: underground storage tanks, double wall piping, overfill prevention, spill protection and monitoring systems. Chevron Service Station Maintenance Guide is provided to each operator. This guide provides in depth instruction on the operation of an underground storage tank system. Underground Storage Tank and Pressurized Pipe Monitoring System -- Veeder Root TLS-350 Operators are given an orientation session during system start-up to familiarize them with the operation of the unit. The Veeder Root TLS-350 Installation and Operation Guide is provided to each operator. This guide provides in depth instruction on the unit. 20-6561 3360 Panama Lane Bakersfield, Califomia 93304 NW-0104 Rev. 4/3/97 I I N 8W98'3g= W II I ! II II II PANAMA LANE McDONALD'S PIPING PLAN CORPORATION  ~ oo4-aOle 3360 PANAMA LANE !BAKERSFIELD, CA 93313 CERTIFICATE OFOIDERGROUND STORAGE TANI~STEM TESTING (512) 451-6334 ~ F~ (512) 459-1459 ~ . RT CLIENT: CHEVRON U.S.A. SITE: CHEVRON #206561 P. O. BOX 2833 3360 PANAMA LA HABRA, CA 90631-2833 BAKERSFIELD, CA 93304 ATTN: JUDY BOWE The following test(s) were conducted at the site above in accordance with all applicable p~d~e,m ~FJXA. an&]~( il regulations 89 1 87 2 92 3 Line and Leak Detector Tests PLUS PEG UNLEAD SUPREME Tanknology-NDE appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. TANKNOLOGY-NDE Representative: Services conducted by: KEN MINTON HENSLEY D BARBOUR JR eviewed: Technician Certification Number:. 1189 ,~- TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/30/97 WORK ORDER NUMBER: 3102186 CLIENT: C[..[EVRON U.S.A. SITE: CHEVRON #206561 P. O. BOX 2833 3360 PANAMA LA HABRA, CA 90631-2833 BAKERSFIELD, CA 93304 ATTN: JUDY BOWE CONTACT: ~ I 4o I so I so I~oo IP~sz c~ J c~ I c~ I cfh I cfh I fail ~G ~[~ [ . 0.04 0.52 [.20 d&s~e~se= Ea~led afte~ PLUS i 0.10 0.48 1.20 FAIL SUP~ I 0.09 0.57 1.30 FAIL ~G ~ 2 0.09 0.56 1.30 FAIL PLUS 2 0.08 0.55 1.20 FAIL SUP~ 2 0.11 0.60 1.40 FAIL ~G ~ 3 0.06 0.42 0.92 P~S PLUS 3 0.08 0.42 0.92 PASS SUP~ 3 0.08 0.44 0.95 PASS ~G ~LE~ 4 0.05 0.40 0.90 PASS PLUS 4 0.08 0.35 0.77 PASS SUP~ 4 0.06 0.36 0.85 PASS ~G ~LE~ 5 0.04 0.38 0.83 P~S PLUS 5 0.09 0.42 0.89 PASS PRESSURE DECAY TEST I I 1 TANKNOLOGY-NDE appreciates the oppoAunity to sclc you, and looks fow~d to working with you in the future. Picot call any'time, day or night, when you need us. TANKNOLOGY-NDE Representative: Test conducted by: ~N MINTON ~ENS~Y D ~O~ ~ Reviewed: Technician Cediflcation Number: [ [ 89 TA. K" ~3~.OG---GY--N D'~ '~' 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/30/9'7 WORK ORDER NUMBER: 3102186 CLIENT: C~W. VRON U.S.A. SITE: CF, EVRON #206561 P. O. BOX 2833 3360 PANAMA LA MABRA, CA 90631-2833 BAKERSFIELD~ CA 93304 ATTN: JUDY BOWE CONTACT: .~,'~'~ ~ ~',~:~ ~:: ~ ~;: ~ ~'~ D¥~M1C"B~CK~PRESSURE: ~:i ~! :i i?!~ ~ ~';~ "':' ~' ~i'~' ~VA~OR~BEOCKAGE'TESTI ~ ~ ~.-~...,.~,:~ ,~, ,~ ~i ..... ~:i;. DISP~SER ..~:,,,,~ ......... (DRY; PRESSURE) ,~ o~: :~,;..::: ::!: ::~I~ ~'~!:; ~:::~:,~:::?' ~(W~_~PRESSU ~RE);{~,~ 2~ [ 40 I 60 I 80 I 100 I Pass/ 20 40 60 80 100 Pass/ cfh c~ ] c~ c~ dh fail c~ c~ c~ cfh cfh ] fail SU~ 5 0.06 0.37 0.80 ~G ~ 6 0.0~ 0.37 0.90 ~ASS PLUS 6 0 . 06 0 . 33 0 . 73 PASS SUP~ 6 0.03 0.29 0.71 PASS ~G ~ 7 0.04 0.37 0.85 PASS PLUS 7 0.05 0.34 0.75 PASS SUP~ 7 0.06 0.39 0.83 PASS ~G ~ 8 0.07 0.44 0.95 P~S PLUS 8 0.06 0.35 0.78 PASS SUP~ 8 0.06 0.40 0.87 PASS PRESSURE DECAY TEST TANKNOLOGY-ND~ appreciates thc opportunity to sclc you, and looks foward to working with you in thc future. PIc~e call ~y time, day or night, when you need us. TANKNOLOGY-NDE Representative: Test conducted by: ~ ~IR~O~ ~g~S~ D ~O~ ~ Reviewed: Technician CeAification Number: TANKNOLOGY-NDE ~ (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/30/9? ' ~ORKORDER NUMBER: 3102156 CLIENT: CHEVRON U.$,A. / SITE: C}{EVRON #206561 PARTS REPLACED HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) TEST DATE: 05/30/97 CLIENT: CHEXrRON U.S.A. STER I0 m z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. SITE DIAGRAM TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 WORK ORDER NUMBER: 3102186 SITE: CHEVRON #206561 PANAMA LANE ~) e12K PLUS W~E CERTIFICATE OF UNDERGROUND STORAGE TANK~JYSTEM TESTING TESTDATE: 05/01/97 TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST TYPE: VPLT WORK ORDER NUMBER: 3101760 CLIENT: CHEVRON U.S.A. SITE: CHEVRON #206561 P. O. BOX 2833 3360 PANAMA LA H.ABRA, CA 90631-2833 BAKERSFIELD, CA 93304 AT-I'N: JUDY BOWE The follox~ ing test(s) x~ ere conducted at the sile above in accordance xvith all applicable portions of Federal. NFPA and local regulations Tank Tests TANK NUMBER PRODUCT 1 PLUS 2 kEG UNLEAD 3 SUPREN~E TANK CAPACITY (Gallons) 11,849 11,849 11,849 TANK DIAMETER (Inches) 120.0 120.0 120.0 TANK RESULTS PASS PASS PASS VOLUME CHANGE (gph) 0. 027 -0. 043 0.047 ULLAGE RESULT PASS PASS TANK NUMBER Line and Leak Detector Tests PRODUCT PLUS PEG UNLEAD SUPREME A 0.006 0.002 0.003 VOLUMECHANGE (gph) B C UNE RESULT (P=pass, F=fail i=inconclusive) A B C D P P P LEAK DETECTOR PRESENT YES YES YES LEAK DETECTOR RESULT PASS PASS PASS TANKNOLOGY-NDE appreciates the opportunity to serve you. and looks fonvard to ~'orking with you in the future. Please call any timt night, when you need us. TANKNOLOGY-NDE Representative: Test conducted by: KEN MINTON DRAGAN PESIC day or Reviewed: Technician Certification Number: TANKNOLOGY-NDE TEST DATE: 05/01/97 WORK ORDER NUMBER: 3101760 CLIENT: CHEVRON U.S.A. SITE: C[-Di:V~ON #206561 Tank ID: I TANK INFORMATION Bottom to top fill in inches: 168.5 Product: PLUS Material: DW FIBERG Capacity in gallons: 11,849 Tank: NO Diameter in inches: 120.00 Manifolded Vent: No Length in inches: 245 V/R: Tcs Impact Valves Operational: COMMENTS Bottom to grade fill in inches: 176.0 Fill pipe length in inches: 45.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DU~M. Stage II vapor recovery: ~MJu~c~: TANK TEST RESULTS Test Method: V~L? LEAK DED-CTOR RESULTS Test method: PSI at tank bottom: Failed/Replaced L.D. 2.00 Fluid level in inches: 73.50 UFT/OFT: UFT Fluid volume in gallons: 7,606 Tank water level in inches: 0.00 Test time: 14:59-19:10 Number of thermisters 5 Specific gravity: 0. 747 Water table depth in inches: 3.90.00 Determined by (method): HO~R WSLL Leak rate in gph: 0. 027 COMMENTS Result: PASS New/passed L.D. make: ~ PETRO Model: S/N: Open time in sec: 2. O0 Holding psi: 28 Resiliancy cc: 240 Test leak rate ml/min: 189.0 Metedng psi: 11 Calib, leak in gph: 3.00 Results: ~Ass COMMENTS ULLAGE TEST RESULTS Test Method.'o~S-4T Test time: 3.3: 30-14: 00 Ullage volume: 4,243 Ullage pressure: 2.00 Results: PASS DATA FOR UTS..4T ONLY: Time of test 1:13: 30-3.3: 40 Temperature: 73.20 UNE TEST RESULT5 Test type: .~K-88 UNE A B C Flow rate (cfh): 0. 200- Time of test 2:3.3:40-13:50 Temperature: 73.20 Flow rate (cfh): 0. 200- Time of test 3:3.3: 50-3.4: 00 Temperature: 73.10 Flow rate (cfh): 0. 200- COMMENTS TANK ONLY, DOESN'T INCLUDE ANY PIPING. Material: DW FIBERG Diameter (in): 2.0 Length (ft): 3.25.0 Test psi: 50 Bleedback cc: 3.40 Test time (min): 30 Test 1: Start time: zl: oo Finish psi: 47 Vol change cc: 9 Test 2: Start time: z1:3.0 Finish psi: 49 Vol change cc: 3 Test 3: Start time: lz :20 Finish psi: 50 Vol change cc: o Final gph: 0. 006 Result: PASS Pump type: P~SSt.m~ Pump make: Y¢ P~.TRO COMMENTS 8900 SHOAL CREEK, BUILDING 200, AUSTIN, TEXAS 78757 (512) 451-6334 INDIVIDUAL~ANK/LINE/LEAK DETECTOR TANKNOLOGY-NDE TEST DATE: 05/01/97 CLIENT: CHEVRON U.S.A. ~RT WORK ORDER NUMBER: 3101760 SITE: C[-~'v'RON #206561 Tank ID: TANK INFORMATION Bottom to top fill in inches: 172.0 Product: Capacity in gallons: Diameter in inches: Length in inches: COMMENTS R.~G UNT,=.AZ~ Material: DW FIBERG 11,849 Tank: NO 120.00 Manifolded Vent: NO 245 V/R: YES impact Valves Operational: Bottom to grade fill in inches: 176. o Fill pipe length in inches: 49. o Fill pipe diameter in inches: 4. o Stage I vapor recovery: DUAL Stage II vapor recovery: EUU. A~CE TANK TEST RESULTS Test Method: VPLT LEAK DP-.~P--CTOR RESULTS .Test method: PSI at tank bottom: 2.00 Failed/Replaced L.D. Fluid level in inches: 73.50 UFT/OFT: UFT Fluid volume in gallons: 7,607 Tank water level in inches: 0.00 Test time: 15:18-19:23 Number of thermisters 5 Specific gravity: 0. 745 Water table depth in inches: 190.00 Determined by (method): MONTR WELL Leak rate in gph: -0. 043 COMMENTS Result: PASS New/passed L.D. make: FE PETRO Model'. S/N: Open time in sec: 2.00 Holding psi: 29 Resiliancy cc: 260 Test leak rate ml/min: 189.0 Metering psi: 3.2 Calib, leak in gph: 3.00 Results: PASS COMMENTS ULLAGE TEST RESULTS Test Method: COMMENTS Test time: Ullage volume: Ullage pressure: Results: DATA FOR UTS-4T Time of test 1: Temperature: Flow rate (cfh): Time of test 2: Temperature: Flow rate (cfi3): Time of test 3: Temperature: Flow rate (cfh): ONLY: UNE TE~T I~ESULT5 Test type: PTK-88 LINE A B C Material: DW FIBERG Diameter (in): Length (fl): 3.25.0 Test psi: 50 Bleedback cc: 3.50 Test time (min): 30 Test 1: Start time: zz :oo Finish psi: 49 Vol change cc: 3 Test 2: Start time: 11: lo Finish psi: 50 Vol change cc: o Test 3: Start time: 11:20 Finish psi: so Vol change cc: o Final gph: O. 002 Result: PASS Pump type: PRESSURE Pump make: FE PETRO COMMENTS 8900 SHOAL CREEK, BUILDING 200, AUSTIN, TEXAS 78757 (512) 451-6334 ~TAN ' T--~ REPORT INDIVIDUAl. K/LINE/LEAK DETECTOR TANKNOLOGY-NDE TEST DATE: 05/01/97 WORK ORDER NUMBER: 3101760 CLIENT: CF,~'v'RON U.S.A. SITE: C~-D[VRON #206561 Tank ID: 3 TANK INFORMATION Bottom to top fill in inches: 176.0 Product: suPZ~.gMg Material: Dw FIBERG Capacity in gallons: 11,849 Tank: NO Diameter in inches: 120.00 Manifolded Vent: NO Length in inches: 245 V/R: Impact Valves Operational: COMMENTS Bottom to grade fill in inches: 182.0 Fill pipe length in inches: 52.0 Fill pipe diameter in inches: 4.0 Stage I vapor recovery: DUAL Stage II vapor recovery: BAZJ~NCE TANK TEST RESULTS Test Method: v~.T LEAK DF.¥E. CTOR RESULTS Test method: Failed/Replaced L.D. PSI at tank bottom: 2.00 Fluid level in inches: ?4.00 UFT/OFT: OFT Fluid volume in gallons: 7,669 Tank water level in inches: 0.00 Test time: 15:29-18:23 Number of thermisters 5 Specific gravity: o. 7 60 Water table depth in inches: 190.00 Determined by (method): MOt,~R W~LL Leak rate in gph: O. 04? COMMENTS Result: PASS New/passed L.D. make: ~ PETRO Model: S/N: Open time in sec: 3.. 00 Holding psi: 28 Resiliancy cc: 240 Test leak rate ml/min: 189.0 Metering psi: 11 Calib. leak in gph: 3.0o Results: PASS COMMENTS ULLAGE TEST RESULTS Test Method.'UTS-4T Test time: 3.2: oo-12: 30 Ullage volume: 4,3.80 Ullage pressure: 2.00 Results: PASS DATA FOR UTS.4T ONLY: Time of test 1:3.2: 00-3.2: 3.0 UNE TE6T laJSSULTS Test type: UNE A B Material: DW FIBERG Diameter (in): 2.0 Length (ft): 3.25.0 Test psi: 5O Bleedback cc: 140 Test time (min): 30 Test 1: Start time: lZ: oo Finish psi: Vol change cc: Test 2: Start time: 11 :lo Finish psi: 50 Vol change cc: 0 Test 3: Start time: 3.1:20 Finish psi: 50 Vol change cc: 0 Final gph: 0. 003 Result: PASs Temperature: 74.20 Flow rate (cfh): O. 200- Time of test 2:12: 3.0-3.2: 20 Temperature: ?4.20 Flow rate (cfh): 0.200- Time of test 3:3.2: 20-3.2: 30 Temperature: 74.10 0.200- Flow rate (cfh): COMMENTS Pump type: P~SSb'R~ TANK ONLY. DOESN ' T INCLUDE A~Y PIPING. Pump make: ~ PETRO COMMENTS 8900 SHOAL CREEK, BUILDING 200, AUSTIN, TEXAS 78757 (512) 451-6334 iii ~'~NKNOZO6Y-N~ 8900 SHOAL CREEK, BUiLDiNG 200  AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/0:1/97 WORK ORDER NUMBER: 3:10:1760 CLIENT: CHEVRON U.S.A. SITE: CHEVRON #206561 COMMENTS ULLAGE FAILURE IN VAPOR RECOVERY OR VENT LINES. THREE HOURS STAND-BY UNTIL FIRE MARSHAL INSPECTION OVER. PARTS REPLACED QUA NTITY DF. SC RI PTION , i i HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED ."i ' ' ~ ' . ~ * HELIUM'PINPOINT LEAK TEST RESULTS QUA NTITY DF. SC RI PTION SITE DIAGRAM TANKNOLOGY-NDE 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 05/01/97 CLIENT: CI-[~,,'V'ROiq U'. S. ~.. WORK ORDER NUMBER: 3101760 SITE: C [-[EV'RON #206561 STER ITl Z C-STORE CHEVRON # 20-6561 MC DONALD'S 3360 PANAMA LANE BAKERSFIELD, CA. PANAMA LANE 12KREG VV'~E SENSOR ALA],~M UPREME TURBINE SUMP STP ~tJMR ~ HIC;H LI~UI9 aLaRM MA~' 1.. 1997 9:03 .iF E FII..L SUI'~F' / PI):'!I" .; ~? --------' ...... SE I,ISOR. aLARM L 5:PLUS FILL S.UMP P I P t I'4G SUMP ~ HIGH LIQUID ALARM STP ',.:,UPi[' ------ FI [ GH L I QU [ b ALARM MA'¥' 1, 1997' '3:06 APl L 8: UNLEADED ..~IF' HIGH LIC4UID ALARM MA\" i., 1997 9:06 AP1 ..... :?EN,~OR ALARM L I $,ii~i~,',3PENSi-'R PAN 7-8 D 1 ~N~ER F'~N HIGH i_,lO~ ID M~Y 1, 199'7 9:0'~ AM ..... ~I930R ALARM ..... L12:DISPFMfSER PAN 5-~, O f ~PIiI',~f~ER PAN H[C;H L/6]U[D ALARM PlAY 1.. 199'7 9:10 AN oEN~OR AIAII1 DISPENSER PAN HIGH L l C~t,J [ D MAY 1, 1997 9:11 AM .......... SE i'4,'BO]~ ALARI"! .... LI0:DISPENSE}~ I:"AM 1-2 D I SI:'EI'iSER PAN HIGH LI.qUID ALARI"I PlAY t. 1997 9:12 AM ..... SENSOR RLARM D l ~PE NS_'ER RIGH LI~OID MAV 3. 199'7 6::09 AH CI' I£VRON U,c~A O~.:.i J - 1849 3.%~2CI [:'ANAPIA LANE E:P,K~S~ 1 ELD, CA, 93304 $S- 2'0~,5~, 1 PH-396-7047 t'iF~'Y' 3, 1997 8:09 aP1 :_;Vt ,'l'}]"l E;I'~['t}F; REPORT al I Fl. tN('l'I6~lq;_~ NOt?I"I~J BAKER,,j~i~ELD CITY FIRE DEPARTM~.~..NT OFFICE~!= ENVIRONMENTAL SERVi~$ INSPECTION RECORD POST CARD AT JOBSITE ADDRESS CrTY, ZIP PHONE NO. OWNER ADDRESS CITY, Z~P PERMIT # INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same number are ready. They will run in consecutive order beginmng wiffi number 1. DO NOT cover work for any numbered group until all items in that group are signed off by the Permiffing Authority. Following these instructions will reduce the number of required inspection visits and therefore prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION I DATE I INSPECTOR Backfill of Tank(s) Spark Test Certification or~anufactures Cathodic Protection of Tank(s) PIPING SYSTEM ' Piping & Raceway w/Collection Sump · ~._ Corrosion Protection of Piping, Joints, Fill Pipe Electrical Isola~on of Piping From Tank(s) O~. Cathodic Protection System-Piping SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETEC~ ION 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 Spece-D.W. Tank(s) Leak Detection Devk=e(s) for Vadose/Groundwater FINAL Monitering W®lls, Caps & Locks ~'/,.~/'~ 7 t,~ ~ Fill Box Leck Monitoring Requirernents ~.'/..~/~, 7 ~ CONTRACTOR LICENSE # CONTACT PHONE # Bakersfield Fire Dept ~. O~FICE'OF ENVIRONMENTAL SERVICES UNDERGROUND STORAGE TANK PROGRAM PERMIT No. PERMIT APPUCATION TO CONb'"TFIUCT/M_ODIFY UNDERGROUND STORAGE TANK. .1'YP ~ OF APpLICAtION (CHEC~ ~NEW FACIUTY IZl MODIF[C'AI'ION OF FACIUTY ~ NEW TANK iNSTALLATION AT i STARTING DATE PROPOSED COMPLETION DATE FACILITY NAME ~.~4~ron /.t~c. 6~m ~ [c~ EX~STING FACIUTY PERMIT No. FAClLITYADORESS 3:~/eo PR,~W ~ ZIP CODE TYPE OF BUS~NESS ~A$ $'/'A ~'ZON/~g.~T/t ~,~ ~'/F~o.~ M,~Ar' APN TANK OWNER ~.H~t,,',~. o~v PHONE No. ADDRESS 13oo $, ~.~c.A ~/v~V CITY ~ N,4a,~A ZIP CODE CONTRACTOR ~LS-/' ~ u ~*i~¢sr-_,G ...~ CA LICENSE No. ~/O,D ADDRESS ~g. ~' 7~'[' "- CITY W',~m,'n5~-~' ZIP CODE PHONE No. ('7i~/) ~- ~c/o~' BAKERSFIELD CITY ]3USINESS. LICE~NSE, No. HO 5D.~-~,~I- £-o WORKMAN COMP: No. W~l-~,~lJ~O"Ol INSURER /I/~-s4/~,~ 0~--~'~. /: [/~-'¢/~ 8REIFLY DESCRI~E THE WORK TO BEDONE ..~.'~/', .... c',~ ,:;' ~-./ :~,,~.~ . F,/:~d:, ~,~ WATER TO FACILITY PROVIDED BY- DEPTH TO GROUND WATER _~,-ezut-,- ~.~,, --' ~ A~* SOIL TYPE EX~ECTED~k~SiTE ~ No. OF TANKS TO BE INSTALLED ~, ARE THEY FOR MOTOR FUEL -~L.YES Q NO ,' SECTION FOR MOTOR FUEL REGULAR PREMIUM DIESEL TANK No. VOLUME UNLEADED AVIATION SECTION FOR NON MOTOR FUEl. STORAGE TANKS TANK No, VOLUME CHEMICAL STO~ED CAS No. (no Orancl n~me) (If known) CHEMICAL PREVIOUSLY STORED THE APPLICANT HAS RECEIVED. UNDERSTANDS. AND WILL COMPLY WITH THE All'ACHED CONDITIONS OF THIS PERMIT AND A NY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. THIS FO'RM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, t$ TRUE AND CORRECT. APPLICANT NAME (PRINT) APPUCAN! SIGNATURE THIS APPUCATION BECOMES A PERMIT WHEN APPROVED 2-18-1997 10=23AM FROM 714- 8936428 P. 1 ,,,,. dst- builder's DAT~: T~LECOPY TRANSMI~..%L SEEET PLEASE DELIVER TEE FOLLOWING PAGES TO: P~ONg N'UMBER: ~O~AI. NIFM~ER OF PAGES: FROM DST- BUILDERS - FAX NUM~EE: 714- 893-6428 IF YOU DO NOT XEC~IV~ ALL OF THE PAGES SENT, PLEASE CALL BACX AS SOON AS PO$S%BLE AT : 714-894-557~ COMMENTS: YOU. 2-18-1997 10:23AH FROH 714 8936428 Notice of Tank Repair I I ~.,,-~ "~ I I IIIIIIIIL. I I II .ILIIL I Customer Chevron Products Company Date February 17, 1997 P.O. Box W, ..Sect 454 00nta~ Matt Turner Concord, California 94524 Location Chevron Station ~2065 Panama and wi=%ble "Date of Repair February 17,.....~.%9.7 Bakersfig~d. CA 90632 S.A. Number 6993 W.O. Number 970108 TankSize(s) U.L. No. Work Pedormed: I0' dia,.~ 12~000 qa~9.n 705985 Repaired damage Double Wall II one rib. [x~ tank repair [~ retrofit Contractor: DST Builders Are Tanks: E~] installed '~ above ground Phone: (714) 894-5574 *On the above date, Xerxes Corporation dispatched an authorized repair crew to inspect and/or repair the Underground Storage Tanks listed above. The repair or retrofit work was done in accordance with Xerxes' field repair procedures using materials called out under U.L. (Underwriters Laboratory) manufacturing specifications. These tanks passed a 5 p.s.i.g, air test after the work was performed and will continue to be covered under Xerxes' warranty. NOTE: Xerxes warranty on these tanks will not start anew; however, it will continue for the duration as stated in the original warranty based upon the date of original purchase, in addition, there wilt be a one year warranty on materials and workmanship for the repairs done on these tanks. This warranty will be in effect as long as the tanks are (or were) installed in accordance with Xerxes' written specifications and published installation instructions. You should alway consult state and local codes when installing underground storage tanks. authorized signature ~<ennet'~ D. V0"i;~ ..... February 17, 1997 date