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HomeMy WebLinkAboutUNDERGROUND TANK-C-01/05/93 '~ADVANCED ENVIRONMENTAL CONCEPTS INCo J ENVIRONMENTAL CONCEPTS WITH DESIGN IN MIND CHRISTIAN R. BELLUE ~ PROJECT ENGINEER EIT #XE072451 805 / 831 - 1646 4400 ASHE RO,'AD. #206 FAX 805/831-1771 BAKERSFIELD, CA 93313 BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY HOPPERS ADDRESS. 2700 0 ST OWNER HOPPERS PERMIT TO OPERATE# CONTRACTOR HOPPERS CONTACT PERSON DENNIS JOHNSON LABORATORY #OFSAMPLES TEST METHODOLOGY TPH-GREASES. OIL & METALS PRELIMANARY ASSESSMENT CO. ADVANCED ENVIRONMENTAL CONTACT PERSON CO2 RECIEPT LEL% 02% PLOT PLAN CONDITION OF TANKS CONDITION OF PIPING CONDITION OF SOIL COMMENTS 10/21/92 DATE JOE DUNWOODY INSPECTORS NAME SIGNATURE BAKERSFIELD FIRE DEPARTMENT July 10, 1996 FIRE CHIEF MICHAEL R. KELLY ADMINISTRA11VE SERVICES 2101 'H' Street BakersfielO, CA 93301 (805) 326-3941 FAX (805) 395-1349 SUPPRE~ION SERVICES 2101 'H" Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 (805) 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 (805) 326-3979 FAX (805) 326-0576 TRAINING DIVISION 5642 Victor Street Bakersfiela, CA 93308 (805) 399-4697 FAX (805) 399-5763 Charles R. Klassen Victor Leasing 136 Easton Drive Bakersfield, CA 93309 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED AT ~.Q.Q STREET. ~PERMIT #BR-0152. Dear Mr. Klassen: This is to inform you that this department has reviewed the results for the preliminary assessment associated with the closure of the tanks located at the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment perfor, med and requires no further action at this time. If you have any questions regarding this matter, please contact me at (805) 326-3979. Sincerely, Howard H. Wines, III Hazardous Materials Technician HHW/dlm cc: Jason Castillo, RWQCB Gina Blankenship, MP Environmental Services ;'.'..:-June 21,~ 1:996, -~ . [ ,' CA 93301', A~n.,MarkTurk ...... .-. ,..~-:,., ,:.,-:.: , ~, -:,.... ...... . ,, _-.,~:.,...~ · . ..:. ~. · ': ~,.2700Q. Str~t,,~ "'" , ~zfidditi0nal'infomati0fi f0r,~oti~ files, Pl6a~e do:not h~itate-.to~mntact?me.' ~.:, ;..,': '. ~?.;u '.,', ;.:, ,,, .,',- ..... i-.:~;: "} ,:'.'.' - ):.":::,: ;,2.'":, :..~. ~ha~(y0u -'-- aggm:sgon~/, .. ~ T'",":."'~' :' ~ '-":'? . .... , .. . .... ~ .> ).,t; ,.,,', ';.. "E' G~naBlanken~hm'-'~:. ,,'- ,. ' ~' '-' -. ',-'. ' ;' , '~-- ,':~-"':' :.,: ' - ~ .... : - :~;. -' '- '-~ ': .~?,M-.PEnmromen~l Semcesi-Inc. :,.: '"..'},- - ' .... '' ' : E' ' [ ....':-: ¢. 'i ". , . .....,._ . - .... ~ . . . . ..,' ..., _,'.'" :.:~.~ , , '~" ' {~s~:¢,~,: ;:' SMITH- GUTCHER AND ASSOCIATES, INC. Consulting Geologists Post Office Box 60706 Bakersfield, California 93386-0706 (805) 871-3207 (FAX) 805 871-3698 June I1, 1996 Ms. Gina Blankenship M P Environmental Services, Inc. 3400 Manor Street Bakersfield, California 93308 Subject: Underground Storage Tank Removal Victor Leasing Property 2700 Q Street, Bakersfield, California Dear Ms. Blankenship: One underground storage tank (UST) was removed on May 28, 1996 from the property located at 2700 Q Street in Bakersfield, California. The property is situated in the southeast quarter of Section 19, Township 29 South, Range 28 East, M.D.B.& M. at the southeast corner of the intersection of Q Street and Espee Street, A location map is included as Attachment 1. A site map is included as Attachment 2. Two buildings are located on the property. One building faces Q Street. The other building is situated to the southeast along Espee Street. The tank was located near the southeast end of the building along Espee Street (Attachment 2). The tank was made of steel, had a volume of 10,000 gallons, and was buried about 4 feet below grade level. A dispenser was located over the east end of the tank. It was reported that the tank was about 30 years old and had been out-of-service for about three years. The tank was used solely for the storage of diesel fuel. The tank was rusted, but no holes were observed. No evidence of product release into the soil beneath the tank Was noted. The tank abandonment was witnessed by Mr. Mark Turk of the City of Bakersfield Fire Department. MS. Gina Blankenship M P Environmental Services, Inc. June l 1, 1996 Page 2 Four soil samples were collected from beneath the tank for chemical analyses. The samples were collected using a hand-driven core sampler that holds one 2-inch diameter by 2-inch long stainless steel liner. The core sampler was driven into native soil gathered with an excavator bucket using a hand-actuated impact hammer. The liner was then removed from the sampler and immediately covered with Teflon seals and polyethylene caps and taped shut with duct tape. Each liner was then labeled and placed in a polyethylene sample bag. Each sealed sample was placed in an ice chest and retained in a chilled state on blue ice for transport to a State certified laboratory. The core sampler was thoroughly scrubbed, washed, and rinsed between sample collections: Samples VL#1 and VL#2 were collected from depths of 2 feet and 6 feet beneath the bottom of the east end of the tank. Samples VL#3 and VL#4 were collected from depths of 2 feet and 6 feet beneath the bottom of the west end of the tank. Chemical analyses were conducted by BC Laboratories in Bakersfield, California. The samples were analyzed for total petroleum hydrocarbons (TPH) as diesel using EPA Method 8015 Modified and for benzene, toluene, ethyl benzene, and total xylenes (BTEX) using EPA Method 5030/8020. No contaminants were detected in. any of the samples (Attachments 3 through 6). The chain of custody record is included as Attachment 7. The numbers on the laboratory reports that range from 71 to 99 are quality control data that do not indicate the presence of organic constituents. The actual results are "None Detected" for every analyzed constituent.' Based on these results, no significant diesel contamination associated with the UST exists at the site. No further investigation of the site should be required. If you have any questions or if we can be of further service, please feel free to call. SMITH- GUTCHER AND ASSOCIATES, INC. Ms. Gina Blankenship M P Environmental Services, Inc. June I l, 1996 Page 3 TFG/tg Yours truly, Attachments (7) C:lI~'PR'TN60WILF..$~'ILE$961lTCTORP,'V,,4 SMITH- GUTCHER AND ASSOCIATES, INC. ..... , ....... ~o ~ .no" ,,~u,, ~1 ,.,, .,~.%. I ~ ~ -% -- ' ~' ~ *?' :,' .. '~7':.-t~--- --- I ~__~, '*;~", '-~ .... : . , '11~q7,,;~7 .%- W- .... ~o-'-~i~ ~'~- . - ....... :::7 . . ,, ,. : ,; ~ o .:,,.~'...k.'.,; i. :: '~,.~..___J..I.:_ .. ... ,. LL_I ~: ~___J._.~I~t,I-L.':I~--.---- ~.~'?;''N,~.' ......... ~'"' ic~.. L:I~ ~,,. '(\':!.!.~?;~ ........ Il ill ~ ' ~, .... r-. ..... .'-::,~-~-~r-~'-~r-'~[ ILL'. :: .,/~O ".':. ";~'~.~ ~,/..;:?. ~:,-' ~~ .,:iVY..~,IlI~I~ ~_~_.// .-_4/-~W/,,,I~ ~% ~ ~,~.: '..:~ ~..r,~ ' ' './.~ -',,~: . -- : .,~ '~.-" ~t,, . --,11 II~ ,~ ~1 II -~-'¥%~/ . ';I-~. ' .- ..- ~=~ ' ' , w=-:--:: " ~b~-~.'a :s..~-~-~-_ ~2EE// ' .... ; ~' ~. ' ~'; ~' ',c: : " '~ '. ' o, ' ': ..... ~'~,.& ' ~"7~'.>-~-: ~' ~"-":~ ' ..... TTM ~ '~ ~LQL-IZ ~~ ,-_1~~EZ ,.T~ 1/'--':~L,. 1 -~ ~__~.j.~/~ ~-.%~_;: ~-: ~ ~ ---,.C~7_L,~EJE'~q-~T-FII-1EJlD '~';~ L~_ll-x :r~-lr-r~.rC SCALE 1:24,000 1 ',4 0 1 MILE i i i I I I I ! I I I 1000 0 1000 2000 a000 4000 $000 6000 '/000 FEET I~/ I--I l-"'! I I ; ; I I CONTOUR INTERVAL 20 FEET DOTTED LINES REPRESENT 10-FOOT CONTOURS NATIONAL GEODETIC VERTICAL DATUM OF 1929 LOCATION IVlAP VICTOR LEASING PROPERTY 270° Q STREET~ BAKERSFIELO~ CALIFORNIA Source of Base. Map: U.S.G.S. Oil Center, Calif., Lamont, Calif., Oildale, Calif., and Oosford, Calif. 7i/~ Minute ToPographic Quadrangles, i 954, ph0lorevised 1968 and ! 973. ' Attachment I I SITE MAP -VICTOR LEASING PROPERTY 2700 Q STREET, BAKERSFIELD~ CALIFORNIA CHAIN-LINK FENCEj ESPEE STREET BROKEN ASPHALT AND DIRT LOT X X METAL BUILDING FORMER TANK LOCATION SCAL£: 1" SOIL SAMPLE LOCATION -4- BROKEN ASPHALT AND DIRT LOT CHAIN-LINK FENCE~ SMITH. GUTCHER AND ASSOCIATES, .INC. - MAY 1996 II Attachment 2 LABORATORIES Purgeable Aromatics and Total Petroleum Hydrocarbons Page SMITH-GUTCHER and ASSOCIATES, INC. P.O. BOX 60706 BAKERSFIELD, CA 93386-0706 Attn: TOM GUTCHER 805-871-3207 Date Reported: 06/10/96 Date Received: 05/28/96 Laboratory No.: 96-06083-1 Sample Description: VICTOR LEASING SITE: VL ~1 EAST END ® 2' SAMPLED BY TOM GUTCHER Sample Matrix: Soll Date Collected: Date Extracted-8020: Date Analyzed-8020: Date Extracted-8015M(d) : Date Analyzed-8015M(d): 05/28/96 ® 03:39PM 05/30/96 05/30/96 05/31/96 06/04/96 Constituents Analysis Reporting Results Units Practical Quantltatlon Limit Benzene Toluene Ethyl Benzene Total Xylenes Surrogate .% Recovery Total Petroleum Hydrocarbons (diesel) Surrogate % Recovery None Detected mg/kg None Detected mg/kg None Detected mg/kg None Detected mg/kg 99. 0.005 0.005 0.005 !%~'? 0.01 ~"~ '~-~ ,' '~ None Detected mg/kg 10. 87. % 64-137 TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015 Individual constituents by EPA Method 5030/8020. ~,'..:. California D.O.H.S. Cert. 11 : , ~, ~ ::',. .~, Stuart G. Buttram i~.:::.:'!~ :. ,'~ ..~ :...,~ Department Supervisor ~ ~ ~'~ Afl results listed In this report are for the exclusive use of the submitting party. BC Laboratories, lng. assumes no responsibility for mpml Ilteretlon, separation, detachment or third party Interpretation. 41C:N:) At;les Ct. · Eaekerefield, CA 9330B · IBC)5] 327-4911 · FAX lB05) 327-191B LABORATORIES Purgeable Aromatics and Total Petroleum Hydrocarbons Page SMITH-GUTCHER and ASSOCIATES, INC. P.O. BOX 60706 BAKERSFIELD, CA 93386-0706 Attn: TOM GUTCHER 805-871-3207 Date Reported: 06/07/96 Date Received: 05/28/96 Laboratory No.: 96-06083-2 Sample Description: VICTOR LEASING SITE: VL ~2 EAST END ~ 6' SAMPLED BY TOM GUTCHER Sample Matrix: Soil Date Collected: Date Extracted-8020: Date Analyzed-8020: Date Extracted-8015M(d): Date Analyzed-8015M(d): 05/28/96 ~ 03:42PM 05/30/96 05/30/96 05/31/96 06/04/96 Constituents Analysis Reporting Results Units Practical Quantitatlon Limit Benzene Toluene Ethyl Benzene Total Xylenes Surrogate % Recovery Total Petroleum Hydrocarbons (diesel) Surrogate % Recovery TEST METHOD: None Detected mg/kg 0.005 None Detected mg/kg 0.005 None Detected mg/kg 0.005 None Detected mg/kg 0.01 85. % 70-130 None Detected mg/kg 10. 71. % 64-137 TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015 Individual constituents by EPA Method 5030/8020. California ~1186 Stuart G. Buttram Department Supervisor A~b. chment 4 .... ,'i All results listed In this report are for the exclusive use of the submitting PO~/. BC laboratories, Inc. assumes no responsibility for report slteretlon, separation, detachment o; thl;d party Interpretation. 41 O0 Atlas Ct. · Bakersfield, gA 93308 · {805) 327-4911 · FAX (805) 327-1918 LABORATORIES Purgeable Aromatics and · Total Petroleum Hydrocarbons Page SMITH-GUTCHER and ASSOCIATES, INC. P.O. BOX 60706 BAKERSFIELD, CA 93386-0706 Attn: TOM GUTCHER 805-871-3207 Sample Description: VICTOR LEASING SITE: Sample Matrix: Soil Date Reported: Date Received: Laboratory No.: 06/07/96 05/28/96 96-06083-3 VL ~3 WEST END ~ 2' SAMPLED BY TOM GUTCHER Date Collected: Date Extracted-8020: Date Analyzed-8020: Date Extracted-8015M(d): Date Analyzed-8015M(d): 05/28/96 ~ 03:45PM 05/30/96 05/30/96 05/31/96 06/04/96 Constituents Practical Analysis Reporting Quantltation Results Units Limit Benzene Toluene Ethyl Benzene Total Xylenes Surrogate % Recovery Total Petroleum Hydrocarbons (diesel) Surrogate % Recovery None Detected ms/kg 0.005 None Detected ms/kg 0.005 None Detected ms/kg 0.005 None Detected mg/kg 0.01 98. % 70-130 None Detected ms/kg 10. 80. % 64-137 * .?:. ?- TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015 Individual constituents by EPA Method 5030/8020. California D.O.H.S. Cert. ~1186 Stuart G. Buttram ' ~;/,'.'~:-':~; Department Supervisor '~ '~'' ~ :'~ .~. ~ ': :~.~.:~ Afiachment 5 All results listed In this report s~ for the exclusive use of the submitting psdy. BC Laboratories, Inc. ass~Jmes no responsibility for repod ilforstlon, sepsratlon, detachment or third.party Interpretatfon, LABORATORIES · Purgeable Aromatics and Total Petroleum Hydrocarbons Page SMITH-GUTCHER and ASSOCIATES, INC. P.O. BOX 60706 BAKERSFIELD, CA 93386-0706 Attn: TOM GUTCHER 805-871-3207 Date Reported: 06/07/96 Date Received: 05/28/96 Laboratory No.': 96-06083-4 Sample Description: VICTOR LEASING SITE: VL ~4 WEST END ~ 6' SAMPLED BY TOM GUTCHER Sample Matrix: Sell Date Collected: Date Extracted-S020: Date Analyzed-8020: Date Extracted-8015M(d): Date Analyzed-8015M(d): 05/28/96 @ 03:52PM 05/30/96 05/30/96 05/31/96 06/04/96 Constituents Benzene Toluene Ethyl Benzene Total Xylenes Surrogate % Recovery Total Petroleum Hydrocarbons (diesel) Surrogate % Recovery TEST METHOD: TPH by D.O.H.S. Individual practical Analysis Reporting Quantitation Results Units Limit None Detected mg/kg 0.005 None Detected mg/kg 0.005 None Detected mg/kg 0.005 None Detected mg/kg 0.01 86. % 70-130 None Detected mg/kg 10. 83. % 64-137 / L.U.F.T. Manual Method - Modified EPA 8015 constituents by EPA Method 5030/8020. Stuart G. Buttram .. Department Supervisor '":::ii:!",!!} Att~ichment 6 All results listed In this report are for the exclusive use of the submitting party. BC Laboratories, Inc. assumes no responsibility for reporl alteration, separation, detachment or third part~ Interpretation. ,4,1 O0 AclBs (DC. · EBekersfield. (DA ~.'=1308 · (8055) 3~7-4911 · FAX [805] 327-1 91 8 Location of Samplin,q Samp!,e Collector Client C~: -- C~ny: Smith-Gutcher ¢~ Associates, Inc. C~: ~ Tel~: ( ) Tet~o~: (805) 871-320T Te[~: ~0~) ~ Bitting to pretty ~r ~Sitti. to saute cottector ~ Bitting to Relinauishedbv: ~~:~~ Comoany: Smith-Gutcher and Associates, Inc. Date andTime:o~/~D~ Relinquished by: Company: Date and Time: Received by: Company: Date and Time: SMITH - GUTCHER AND ASSOCIATES, INC. GOLDEN STATE METALS, INC. P. O. Box 70158 · 2000 E. Brundage Lane Bakersfield, California 93387 Phone (805) 327-3559 · Fax (805) 327-5749 Scrap Metals, Processing & Recycling N? i 7i0 TANK DISPOSAL FORM Contractor'sL -[J · License No. Contractor's Phone No. x0. ..... JOB SITE: DESTINATION: G.S.M. 2000 E. BR HAULER: WEIGHT CERT. NO: EHSD PERMIT NO: COUNTY: DISPOSAL FEE ~SCRAPVALUE ~OTHER QTY GALLONS SERIAL NO. NET TONS 250 .14 550 .24 1000 - 6 it .61 2000 .97 3000. 1.32 5OOO 2.42 7500 3~28 9000 3.82 12000 4.93 TOTAL TOTAL represents acceptance of terms for payment, and confirms that tank removal complies with State laws. CONTRACTOR'S SIGNATURE / ~^ ~ CERTIFICATE OF TANK DISPOSAL / DESTRUCTION ~TI~I~5 IS ~'CERI~Y THE~E~EIPT AND ACCEPTANC~OF THE TANK(S) AS SPECIFIED ABOVE. ALL MATERIAL SPECIFIED WILL BE ~T~ED F~ SC~ ~,YCUIN~U~O~hLY. .' / / COMPLETELY WHITE-- Con,actor Copy · YELLOW ~ Rle Copy · PINK-- ~rma~nt Copy WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity wes weighed, measured, or counted by a we hmaster whose si natur i .... fe~c~_:g_~.z?~l__'~a~uth~rity_.o! .accu.ra.c.y, as prescribed by Chapter 7 (commencing with Section 12700~ of D v ~n 5 of 'th~ r. ..... .gr;. ~.e._:s__o_n_t_h?~ce~rt,f}cate, wh_o ,s, a ~Ur~l~.;~[~r~ oy [ne UlVl$1on o~' Measurement Standards of the CaNforma Department of Food and Agriculture. ' GOLDEN STATE ~,~-c.,-., o WEiGHMASTER CERTIFICATE .... "'"G'-'~8~2 TRUCK SCALE * * * ~ I N T A K E * * ~ . Purchased From: TICKET M.P. ENViROnMENTAL SERVICES .............. gA 9a308 #: T85747 METALS 92387 ......... ,,uuc: i.C. ~ 5028 ur~ver Order COMMODITY ................................................................................... GROSS TARE NET ADJ REASON PD WT RD ~,,T RD TANKS H720A 309~0B 10780 10780 0 0 .00 TOTA!S ~mon ~ro.n ~n-nA ... - .................................. GROSS WEIGHMASTER: R.HERNANDEZ.DEPUTY TARE WEIGHMASTER: R ....... n~ TV .,.HE~NANu~.~,U,, : u=,e In n./oo~o¢ INET TONS ,~oT ~, i Time In Cu.,D~R SIGNATURE .~00 ~ Date Out 05/88/96 ~ Time Out !5:06 A~'SCALE 1 B-~A~E'-:"' ' 8 C=SCALE 8 D=SCALE ~ M=MANUAL WEIGHT WEIGHTS NOT SPECiFiED ARE iN POUNDS BAKERSFIELD FIRE DEPARTMENT OFFICE, OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 CERTIFICATION STATEMENT OF.TANK DECONTAMINATION N~me Contracting Co. an authorized agent of here by attest under penalty of perjury that the tank(s) located at :~,,'~ r? ,,,V -~' Address being removed under permit#,. ,{'>~ ii'~-(~> l':~"~,~l~, and has been cleaned/decontaminated properly and a LEL (lower explosive limit) reading of no greater than 5% was measured in~ediately following the cleaning/decontamination process. Date Name (print) Confirmation by: ~i~ty of Bakersfield State'oJ CalHorhlo--Environmental Protection Agency Eorm Approved OMB No. 2050~)039 (Expires 9-30-94) Please print or type. Form designed tar use on elite (12-pitch) ~/pewriter. See Instructions on ba~ck o,JJ~age 6. 1. Generator's US EPA ID No. UNIFORM HAZARDOUS, WASTE MANIFEST 3. Generator's Name and Mailing Address 136 EASTON DRIVE BAKERSFIELD, CA 4. Generator's Phone (80~ 861--8529 93303 Manifest Document No. 5. Transporter 1 Company Name 6. US EPA ID Number MP ENVIRONMENTAL SERVICES, INC. 7. Transporler 2 Company Name 8. US EPA ID Number Department of Toxic Substances Control Sacramento, California 2. Page 1 of ! Information in the shaded areas is not required by Federal law. 9. ~gnated Facili~ Name and Situ Address 10. US EPA ID Number CROSBY AND OVERTON 1610 W. 17TH ST LONG BEACH, CA 11. US DOT ~scription (including Proper Shipping Name, Hazard Class, and ID Numbe0 N~N RCRA HAZARDOUS WASTE, LIQUID 12[ Containers 13. Total Quantity !5. ~ecial Handling Instru~ons and Additional Inform~on SITE ADDRESS 2700 Q STREET,BAKERSFIELD GLOVES AND GOGGLES ER PHONE 800-458-3036 PROFILE # 17937 SCH 96-28-05-14 16. GENERATOR'S CERTIFICATION: I hereby deClare that the contents of Ihe consignment are fully and accurately described above by proper shipping name and are classified, packed, marked, and labeled, and are in all respects in proper condition for transport by highway.according fo applicable federal, state and international laws. If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR, if I am a small quantity generator, I have made a 'good faith effort to minimize my waste generation and seled the best waste management method that is available to me and that I can afford. . :~ i~, Month Day 1 Acknowle& ReCei of Materials · '~ Printed/TypedName ts,g ture L Month oo, 2l P~o 19. Discrepancy Indication Space DTSC 8022A (7/92) EPA 870(022 Certification of receipt of hazardous materials covered by this manifest except as noted in Item 19. Signature To: Day Year TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. P.O. Box 3000, Sacramento, CA 95812 A BAKERSFIELD FIRE DEPARTMENT_ ZARDOUS MATERIAL DIVI$It 2130 G Street, -- Bakersfield, CA 93301 (805) 326-3979 TANK REMOVAL INSPECTION FORM FACILITY \.;36~ ~ ~)A\uP ~ ADDRESS OWNER ~,%~. h~:~ PE~IT TO OPE~TE~ CO~CTOR ~. ~ L=~u%~~. CONTACT PERSON ~BO~TORY ~ OF S~PLES TEST METHODOLOGY ~H b,k~3 ~X~ ~ PRELI~NARY ASSES~ENT ~0.=~;~-~~CONTACT PERSON~ CO= RECIEPT/ LEL% PLOT PLAN CONDITION OF TANKS CONDITION OF PIPING CONDITION OF SOIL ~j~/Co,g/c~c~) ,, DATE INSPECTORS NAME S I GNAm-~R~ HAZARDOUS MATERIALS DIVI,~N U~ERGRCUND STORAGE TANK P~GRAM PERMIT APPLICATION FOR REMO-VAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE ADDRESS ,~-'/CO ~ ~-rlA~--F ZIP CODE (~)~DJ APN FACILITY NAME L~.'~<,T~-Y.~ \J-A~_~ ~ CROSS STREET TANK OWNER/OPERATOR LJ~C_'-T-E~ I ~..-'~1-G\~ PHONE No. L~¢__/~") ~q,~- MAILING ADDRESS ~ ~'~::~ ,,O~;L CITY CONTRACTOR INFORMATION COMPANY?Y~ I~t,~.V'(~)~tna~,,JTRL.,~_~,_~ PHONE No. ~.~') ,-~'11~1 LICENSE No. L01~)-7~) ' ADDRESS ;~r4cz:~ f'~-A~oP,.. ~ CITY ~ ..GR~FI~ZIP CO"~ '~---'~ INSURANCE CARRIER ~'~,~TI~,q~C)~---hn~TV WORKMENS COMP NO. PRELIMANARY ASSEMENT INFORMATION COMPANY __%m ~-T~-~_-_~L,n'c_~---'~_ ~F_~F_~ LS'L'.'5 PHONE NO. [,~5')~)'71 '~)z_~ LICENSE No. ,.~t ADDRESS ~L__~'~"'/'/-~ Di~T~.~oh.J ~ CiTY "~R~j:'~,~z3 ZIP CODE INSURANCE CARRIER __~_ ,~?E '~-L~,~,E) WORKMENS COMP No. \ ~.~-'/'-7~-qL~ TANK CLEANING INFORMATION COMPANY 1~9 ~(;2.D~mEN-FR-L. ,~_~I-Z~.V~, ,--.~"-~_- PHONE No. ~)~ ADDRESS ~ ~'~/~,,~O,P~ .~T CITY '~EJ~'FiELD ZIP CODE ~'O~ WASTE TRANSPORTER IDENTIFICATION NUMBER L._/C.. 7_.-~ / ~--'I~.A ~© NAME OF RINSTATE DISPOSAL FACILITY ~__.i3,_O,S~"J ~ ADDRESS /L01D bL). i-1~¥1_. ~ CITY LDt,.~,~b-Y~p, ZIP CODE FACILITY INDENTIFICATION NUMBER TANK TRANSPORTER INFORMATION COMPANY I~f) ~__~d',~.D~q~-~k~--RU ADDRESS &;~C'~ '~A~'P-._ ~-~ TANK DESTINATION PHONE No. (~:Z:~..')~3-)]5l LICENSE No. CiTY "~A~__.-L~IF~,~©ZIP CODE TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED PREVIOUSLY STORED :' ii '. :':. ::;.i.i,:.:';:i :.:':::i:i.::f:ii:i:::-.::i:i:i:F]i:i:.'::::: ::... :.: :. ================================================ ::'::::::~:]!:!i~ ======================================= .:: ...:..:::~:.~ :....:: .: · · I THE APPLICANT HAS RECEIVED, UNDERSTANDS. AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOW, E~ ,Dc~E, IS~'RUE ANb CORRECT. . . ,. ~-R~ED "" , UCA r ,ME THIS APPLICATION BECOMES A PERMIT WHEN APPROVED Complete terns )r 2 for additi ~'' Complete items & h onai services, I al~i~l~.Wish to receive the · Print your name - -' follo~services (for an extra return this card to you. ess on the reverse of this form so that we can fee): · Attach this form'to the front of the mailpiece, or on the back if space 1. [] Addressee's Address does not permit, · Write "Return Receipt Requested" on the mailpiece below the article number. · The Return Rece pt will show to whom the article was delivered and the date I 2. [] Restricted Delivery delivered. ~ Oonsult postmaster for fee. 3. Article Addressed to: / 4a. Articl~ Number ~- ~506 VZC~OR L~ZNG CO. [ ~se?ice Type .... 1400 ~SION DRI~ ~ R~;e; ~ ~ Insured B~RSFIE~, C& 93309 ~Certified ~ COD { ~ Express Mail ~ Return Receipt for ~]~ ~ [ /. out, of Delivery / / - --~ I o. ~aor~ 's Address)On y it requested ~ ~ ] and fee is paid) December 1991 wU.S. ~PO: ~e~-7~ D~MESTIC RETURN RECEIPT UNITED STATES POSTOSERVlCE Official Business PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE, $300 Print your name, address and ZIP Code here CITY OF BAKEltSFIELD FIRE DEPT · OFFICE OF ENVIRO~TAL SERVCIES 1715 CEESTEE AVENITE, SUITE 300 BAKEESFIEIJ), CA 93301 P 390 214 506 Receipt for. Cert'f~ed Mail No Insutanc~%,-~verage Provided ,os~ Do not use for InternationaJ Mail Certified Fee CO. · ON DRIgI~ CA 93309 & Date Delivered g ~ to Whom, ..~ and Addressee's Address · ~ & Fees ge 1.10 BAKERSFIELD FIRE DEPARTMENT May 2,1996 FIRE CHIEF MICHAEL R, KELLY ADMINIS/RATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 (805] 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 (805) 326-3979 FAX (805) 326-0576 TRAINING DIVISION 5642 Victor Street Bakersfield, CA 93308 (805) 399-4697 FAX (805) 399~5763 Victor Leasing Co. 1400 Easton Drive Bakersfield, CA 93309 CERTIFIED MAIL NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE Dear Sirs: It has come to our attention that you currently own property located at 2700 "Q" Street (APN 002-113-01-00), in Bakersfield which contains at least one underground storage tank. The tank has not been properly permitted and has been out of service, therefore, you are in violation of the following sections of the Uniform Fire Code as adopted by the Bakersfield Municipal Code, Chapter 15.64: Section 7902.1.7.2.3, Uniform Fire Code (1994 edition). "Underground tanks which have been out of service for a period of one (1) year, shall be removed from the ground in accordance with Section 7g02.1.7.4 and the site shall be restored in an approved manne¢'. In order to avoid regulatory action, you must either properly permit and bring the tank(s) up to code, or else apply for a proper abandonment and removal of the tank within 14 days of this notice. If you have any questions regarding this notice, please call 326-3979. Sincerely, Howard H. Wines, III Hazardous Materials Technician HHW/dlm cc: Carl Hernandez, III, Assistant City Attorney 1) 1994 TRW REDI Property Situs:2J~00 Q STREET, BAKERSFIELD CA 93301-2573 APN : 002-i13-01-00 County: 'Kern CA Census: Map Pg: 22 7-~2 New Pg: Tax Rate Area:000-1001 Property Tax :$1,206 Exemption : Owner :VICTOR LEASING CO Mail :1400~EASTON~ DR;BAKERSFIELD CA 93309 . ' Last Sale Transfer Date:02/28/75 Documenti' # ~ :48811944 Document Type: Price First TD i' : : Junior TD f : Lender ~ : Seller , : Title Company: County Use:3200 Lot Size : Bldg Class: ~ Lot Area : Flood Panl: i., _ Zoning : Flood Zone: i, Heat '. :f Park Type : Air-Cond :, Legal :LP/cITY ABBR HOMPK TRW-REDL (C)! 1994 Prior Sale Use:HEAVY INDUSTRIAL Assd Land:S36,488 Assd Imp :$53,274 Total Va1:$89,762 Assd Year:95 %Improved:59% Bldg/Lvarea: Yrblt/Eff : # Stories : # Units : # Buildings: Pool : Condition : Paved Pkg : The Page & Grid reference is copyrighted by Thomas Bros. Maps <TM> >> RepOTted'data believed to be reliable but accuracy is not guaranteed Plan must show the following: N "2.. :' 5' :..': bulldin '~ ~;;;-",-'":~ F~t;:;! '? ?!: ...'~ i.?;,U.;~:.;i;:.i..::.:' ::: ~..::?~.. 3. location of tahks, piping, a6d dispensers 4. utilities 5. SCALE - .~ ~. 6~" ::~:-"water wells (If on site)"~, ?'~.:'.~:;, ';: .... , ::...'"~: ..... ~.-: ~ .... 7. ?' d~y other relevent.in=f6~atiOn '" ...... ' ..... ' ...... Bakersfield-Fire De~p~ · PERMIT No../:-F" '{ HAZARDOUS MATERIALSD~BION,, .: ..... UNDERGROUND· STORAGE TANK. PROGRAM·. " · ~:::: ...... .'.-. PERMIT APPLICATION FOR REMOVAL OF ANUNDERGROUND STORAGE TANK SiTE HOPPER TRUC~ SHOP ADDEEsS 2700 ~ Sfirea~ZiP~ODE -93301. 'APN 005-010-' FACILI~NAME HOPPER INC. '' CROSS STREET ESPEE STREET ' 02-01-3 TANKOWNEE/OPEEATO~ HOPPER INC. .PHONENo. 861'7000 MAILINGADDEESS P.O. BOX 2900 CI~BAKERSFIELD ZIP CODE 93303 CONTRACTOR INFORMATION COMPANY HOPPER INC PHONE No. 861-7000 LICENSE ADDRESS 301 ESPEE STREET CITY RAKER,qF-TET';DZIP CODE 933(31 INSURANCE CARRIER UNI£ARE INSURANCE CO_ WORKMENS COMP No. uAhg-OTq2-05f)]]. PRELIMANARYASSEMENTINFORMATION CONCEPTS INC. · .. STATE 368-2027-2 COMPANY ADVANCED ENVIROMENTAL PHONE No. 83],-1646-" ' ,LICENSE No.F~.n 77-0234808 ADDRESS 4400 ASHE. ROAD SUITE 2;0'6 INSURANCE CARRIER SUN LIFE' OF'CANADA TANK CLEANING INFORMATION COMPANYMP VACUUM ADDRESS 3400 'MANOR STREET WASTE TRANSPORTER IDENTIFICATION NUMBER 2895'- CITY, ~ ZIP CODE WORKMENS COMP-No.1 nn ~ A'v5 PHONE No. 393 CITY ~ ZIP CODE CAT000624247 NAME OF RINSTATE DISPOSAL FAC L TY ADDRESS 240i GIBSON FACILITY INDENTIFICATION NUMBER TANK TRANSPORTER INFORMATION COMPANY HOPPER INC. ADDRESS 30], ESPEE STREET TANK DESTINATION GOLDEN STATE GIBSON ENVTROMENTAI, CITY ,- -, ZiP CODE 93 ? 08 .CAD980883]]7 . CA3531 PHONE No. 86]-7000' LICENSE No.~mnnm 05n035 SCRAP METAL TANK INFORMATION TANK No.. AGE VOLUME 1 20yrs. 500qals ,CHEMiC·AL STORED WASTE OIL DATES CHEMICAL STORED PREVIOUSLY STORED NONE THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS.OF THIS PERMIT AND ANY OTHER SIAIE. lOCAL AND FEDERAL REGULAIIONS. ~':.:" -. :[: '...':'. i.: .,.,."" ., THIS APPUCATION~BECd'MES 'A pERMITWHEN Ap. pi~OvED:',i ........ .... '-'; MAKE OHEOK8 PAYABLE TO THE "CIT~ OF BAKI::RSFIELD" CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S.D. JOHNSON FIRE CHIEF January 5, 1993 2101H STREET BAKERSFIELD, 93301 326-3911 Dennis Johnson Hopper Steel and Fabrication P. O. Box 2900 Bakersfield, CA 93303 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED AT 2700 "Q" STREET, IN BAKERSFIELD, CALIFORNIA. PERMIT ~ BR-0063 Dear Mr. Johnson: This is to i~form you that this department has reviewed the results for the preliminary assessment associated with the closure of the tanks located at the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment performed and requires no further action at this time. This letter does not.relieve you of any liability for past, present, or future operations. In addition, any future changes in site use may require further assessment or mitigation. It is the property owners responsibility to notify this department of any changes in site usage. If you have any questions regarding this matter, please contact me at (805)-326-3797. Sincerely, Underground Tank Program mADVANCED ENVIRONMENTAL CONCEPTS INC., November 24, 1992 Mr. Dennis Johnson HopPer Steel and Fabrication P.O. Box 2900 Bakersfield, California 93303 DEC B 1 1992 By Subject:. Tank removal documents required for closure of [{] 500-gallon underground storage tank from 2700 Q Street, Bakersfield. California. Dear Mr. Johnson: Advanced Environmental Concepts, Inc. [AEC) Is pleased to present the enclosed tank removal documents for your records. Following are laboratory results, rlnseate disposal manifest, dry Ice rec~)lPt, and a site diagram. Soil samples Collected from 2 feet and 6 feet beneath the center of tank Invert Indicate acceptable concentrations of total recoverable petroleum hydrocarbons (TRPH) and CAM 17 metals. Please forward the enclosed documentation copies AEC has prepared for you to: Mr. Ralph Huey Bakersfield City Fire Department 2130 "G" Street Bakersfield, California 93301 Based on Information obtained during the tank removal, AEC believes that Flopper Steel and Fabrication will be granted closure for the site. If you have any questions, or require additional Information please do not hesitate to contact AEC at your convenience. Sincerely, Advanced Environmental Concepts, Inc. drogeologistDistribution: 2/Adressee l/Bkfd File · Er4vIRONMENTAL CONCEPTS WITH DESIGN IN MIND 4400ASHEROAE).#206 · BAKERSFIELD. CA93313 805/831-1646 * FAX 805/831-1771 ASSOCiATED LABORATORIES 806 North Batavia- Orange, California 92668-~14/7~1-6900 CLIENT Advanced Environmental Attn: Chris Bellue 4400 Ashe Road Suite 206 Bakersfield, CA 93313 Concept FAX ?14/558-1209 LAB NO. G41488-01 REPORTED 11 / 17 / 92 SAMPLE Soil IDENTIFICATION Hopper Steel & Fabrication BASED ON SAMPLE As Submitted LIMITS CAM INORGANICS TTLC STLC (mq/kg) Antimony 500 15 Arsenic 500 5.0 Barium 10,000 100 Beryllium 75 0.75 Cadmium 100 1.0 Chromium, Hex. 500 5 Chromium, Total 2,500 560 Cobalt 8,000 80 Copper 2,500 25 Fluoride 18,000 180 Lead 1,000 5.0 Mercury 20 0.2 Molybdenum 3,500 350 Nickel -- 2,000 20 Selenium 100 1.0 Silver 500 5 Thallium 700 7.0 Vanadium 2,400 24 Zinc 5,000 250 Hydrocarbons EPA 418.1 by: ESB/ql The reports of the Associated Laboratories are confidential property of our clients and may not be reproduced or used for publication in part or in full without our written permission. This Is for the mutual protection of the public, our clients, and ourselves. RECEIVED 11/10/92 S1 @,2' TTLC (mq/kg) 3.31 ND< 1 95.2 0.52 0.13 ND< 0.1 7.67 7.40 7.66 1.50 ND< 5 0.08 ND< 0.5 5.23 ND< 1 ND< 0.1 ND< 1 32.2 35.1 12 mg/kg TESTING & CONSULTING Chemical · Microbiological · Environmental · C-I ASSOCiATED LABORATORIES 806 North Batch, ia. Orange, California 92668. 714/771-6900 CLIENT Advanced Environmental Concept Attn: Chris Bellue 4400 Ashe Road Suite 206 Bakersfield, CA 93313 FAX ~14/558-12~9 LAB NO. G41488-02 REPORTED 11 / 17 / 92 SAMPLE So i ! IDENTIFICATION Hopper Stee 1 BASED ON SAMPLE As Submitted & Fabrication RECEIVED 11/10/92 S2 @ 6' Hydrocarbons EPA 418.1 ND<10 mg/kg ASSOCIATED LABORATORIES, by: Edward S. Behare, Ph.D. Vice President ESB/ql NOTE: Unless notified in writing, all samples will be discarded by appropriate disposal protocol 30 days from date reported. The reports of the Associated Laboratories are confidential property of our clients and may not bo reproduced or used for publication in part or in full without our written permission. This is for the mutual protection of the public, our clients, and ourselves. l OM TESTING & CONSULTING Chemical · Microbiological · Environmental · Client Project Nome Project Address "L..~o dL ~'T- Proje~.Contact Date/ / !TTL Project Il/~/~' ~ Analysis Requested Clie~nt Proiect # Turn Around Requested: [] Immediate Attention [] Rush 24-48 Hours [] Rush 72-96 Hours ,~Normal [] Mobile Lab Page l of /' Lab Use Only Sample Condition as Received: Chiihd [] yes E3 no Sealed [] yes [] i Date// 0 Received by Laboratory (signature) Date ~ ICOmpany Time Company Time J Compq Additional Comments Reli ished by (signature) Laboratory Sample ID Sample Location Date Time Sample Container/Oomments Number 5x-G' o' ,, ,, ,, " ,, [7:~ 5 8 I ......... _.- ~,, ~%~V. ._ ~/j, ~ ~. ~~ Total Number of Containers State, of Cal;forn;a---Environmenfal Profecfion Agency ~ " Form~ .Ap~ proved O^~,~ Nlq. 2050-4)039 (Expires 9-30-94) . · ' P/ease' print o~ype;' Fan-in deigned f~r use ~n efite (~W O'pewr;ter. : · UNIFORM HAZARDOUS: I..Generator's US EPA ID · .WASTE· MANIFEST '::: " . 3. Generator's Name and Moiling Address :, . . . , ': ..',~o.?~..~ ~-~E.a: ~;. ~/4:~&'~-~,~, ~' ' '"" ' , '.'' :;' ': ....... }" ' 6: US · .. :. ,:.:.'. ,.'.' : ......... . .... ,.,,.~ .:~: ... ~i~ ~: ,' Company Name ' :"" '" ' ' ~" ' ".. ~" 8. US EPA ID Number ~. ', ,'' . ... · .. f'HO. OF.' ~.~u ..-" · 1 I. US ~T Descri~t~'~ ( "d~ding P~; Shlp~ N~i, H~rd C a~ ID N&mger) :'" See instructions on bc Page. 6' : :'.: '. ~i~..~*~oi'Zox~:s.b,t ..... ' · · ' ' . ~crb~tO, Coliforn;a ... Man,ifes~ D~umenf No. , 2. Page I Informatlo~ in ~e ~aded areas · ':'(~ '~; ":.' ' is not required by' Federal law.: '. .. ::: ,'. ~ ,-.. '~Ya;...a.,na.'a~'ea, aha are in all &s~ i~ gro~, ~:~n-i;:,: ~e?.ons,gnm~m are.tully and accurately de~cr bed aK.,~-- ~.- --:- ' . . /Z i:,'? ": "~,'~:a:' :,;::: :" ;' :"' ;~;h:'::;/.;.;~;/~7.:.?;il;:,i-?:::~i' ?'-:':':?;~:;'~:i":~;:~ .~:,"~!""?~ ',!~,?'],b. ~!'.i.~ :"-'fa" ~?"~!;;" .'..: . arge q~am~ ~e~r~0f .~:?¢ ~ I,h~e.a ~r~ram Iff place fo reduce ~e · re~ to h .... hea~ and ~e ..ro~ OR. ~ I a,' ,~ff~ I. ,haye made ,a go~ fa~ ~ffO" t~ mlnlmiie D.O.T. A 105 *lP CA 7948 RP. FED.'.~ I.D~ DRY !CE J~RocESSCHARGE$:~ .:' ,i :.:!.:i '~.. CO~ CYLINDERs ';.':: *. HELIUM CYLiNDErS ~.;~:.:.. '..,~. NITROGEN CYLINDERs ~::~;;~".' · DELIVER [] CASH -,~ [] CHARGE.. [] WILL CALL - -~- [] DELI~/~R "- · Amount,,,~.: AVAILABLE ON REQUEST, x, MIT.,TO~&._,O.. .,,B_~I~ ~AKERS~iEL~t~CA ~3302.;1~ ICE UNTIL FULLY PAID FOR AND VENDEE SHALL BE'RES~NSIB WILL SURRENDER SAME U LE FO~ SAME ~ LE-IN HIS ~N DE.ND IF IN DEE U T- :~SSESS ON AND ~mum AHEH ~ DAYS, ALSO COLLECTION.COSTS=.[un,, ~,~';7~;~'~,~: WHICH.IS I~.PER, *~:~ DAYS FROM DATE, OF, S~IPMENT~:~TG~ :~A~~ER NO~.:'R~R~E0~ E*"__ ~GEOF 14.~ PER CYLINDER PER MONTH F~ ALL" TIM~ ~'~'~.'~.?~'~O. ~AKE :A:~RENTAL FROM THE DISTRIBUTOR WH CH '~EMURRAGE CHA~GE' T"' ..... ~u ~'~_L~'~u~.~CYL NDER iS'.AWAY*'~ CUSTOMER SHALL PAY ~OMPTLY ON DEMAND TO TH' ~ I~=TO PAY, ON :DEM~ ',THE'." FOR LOss OF OR DAMAGE T~ ANY ~ SAI~ ~H~C~ ~ ~I~L~ED,VALUATIONS ~D RAT ~E~VE~: THEREOF TO THE CUSTOMER AND~'~ ~ ~UL[ING ~ ' ' '~ JS ES Bakersfield Fire Dep~ AZARDOUS MATERIALS DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 328-3970 UNDERGROUND TANK QUESTIONNAIRE RECEIVED FEB 1 9 1992 Ans'd ............ Il. FACILITY/SITE No. OF TANKS ~' ~ DBA OR FACILITY NAME NAM[ OF OPERATOR HOPPER STEEL & FAB SAME AODRE~ NEAREST CRO,~ STREET PARCEL No,(OPTIONAL) 301 ESPEE STREET CITY NAME STATE ZIP CODE BAKERSFIELD, CA F' BOX TO INDICATE z~CORPORATION ~INDIVIDUAL ~PARTNERSHIP [~LOCALAGENCYD~TRICT~ I~ COUNTY AGENCY ~ STATE AGENCY [~FEDE~,LAGENCY TYPE OF BU$1NE~J~ 1 GAS STATION ~J 2 DISTRIBUTOR IKERN COUNTY PERMIT O,,FA,. ':::,,'PROCE'.'OR ,OTHE. 0600-tSC 7 ~'..~ EMERGENCY CONTACT PERSON iPRIMAR,Y) DAYS: NAME (LAST, FII~T) PHONE No, WITH AREA CODE *F~ 805 861 7000 EMERGENCY CONTACT PERSON (SECONDARY) optional DAYS; NAME (LAST. FIR~T~ JOHNSON ~ DENNIS PHONE No, WITH AREA CODE 805 861 7000 NIGHTS: NAME (LAST. FIRST) PHONE No. WI'iN AREA CODE NIGHTS: NAME (LAST, Ftl~'r') PHONE No, WItH AREA CODE -H~ '8~)5 393 7477 JOHNSON, DENNIS 805 854 2409 II. PROPERTY OWNER INFORMATION (MUST BECOM?LETED) - NAME CARE OF ADORESS INFORMATION HOPPER STEEL ~ FAB TO INDICATE [] PARTNERSHIP MAILING OR :STREET ADDRESS P.O. BOX 2900 CITY NAME BAKERSFIELD III, TANKOWNER INFORMATION (MUST BE COMPLETED) NAME CARE OF ADDRES~ INFORMATION HOPPER STEEL & FAB LOCAL AGENCY ~ STATE AGEHCY [] COUNTY AGENCY tm,,..] FEDERAL AGENCY STATE ZiP CODE PHONE No, WITH AREA CODE CA 93303 805-861 7075 MAILING OR STREET ADDRESS P.O. BOX 2900 CITY NAME -- BAKERSFIELD ~/8OX J~ INDIVIDUAL TO INDICATE J~ PA RTNERSHIP STATE j ZIPCOOE CA 93303 ~ LOCAL AGENCY r~ STATE AGENCY J~ COUNTY AGENCY C~FEDERAL AGENCY PHONE No, WITH AREA CODE 805 861 7000 OWNER'S DATE TANK No. INSTALLED 4 4-1-72 VOLUME 10,000 GAL ~ o, 0. DO YOU HAVE FINANCIAL RESPONSIBILITY? Y/N 'TYPE PRODUCT IN STORED SERVICE DIESEL Y/N Y/N Y/N Y/N Y/N YIN TANK DESCRIPTION COaPLETE, EMS - SPECIFY IF UNKNOWN ~' [ A. OWNER'S TANK I. D. # 4 S. MANUFACTURED UNKNOWN C. DATE INSTALLED(MO/DAY/YEAR) 4-1-72 o. TANK CAPACITY iN GALLONS; 'JO.,, 000 III, TANK CONSTRUCTION MARK ONE tTEM ONLY IN BOXES A, B, ANOC, ANDALLTHATAPPI-IESlNBOXD A. TYPE OF [] 1 DOUBLE WALL [] 3 SINGLE WALL WiTH EXTERIOR LINER [] 95 UNKNOWN SYSTEM 'E~ 2 SINGLE WALL [] 4 SECONDARY CONTAINMENT (VAULTED TANK3 [] 99 OTI-iER B,. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL · [] 3 FIBERGLASS MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM (PrimaryTank) [] 9 BI~ONZE [] 10 GALVANIZEO STEEL [] ~ UNKNOWN ] 4 STEELCLAD W/FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLE W/FRP ] 99 OTHER [] 1 RUBBER LINED [] :2 AI.J'(YD LE, I~G [] 3 EPOXY LINING C, INTERIOR [] S GLASS LINING [] $ UNLINED [] ~ UNKNOWN UNING .- is UNtNG MATERIAL COMPATIBLE WITH 100% METHANOL ? YES ~ NO~ ] 4 PHENOLIC LINING [] 99 OTHER O. CORROSION [] 1 POLYETHYLENE WRAP [] 2 COATING PROTECTION, [] 5 CATHODIC PROTECTION [] 91 NONE []. UNKNOWN [] 99 OTHER IV, PIPING INFORMATION cmcu~ A IFASQVEGROUNDOR U IFUNOERGROUNO, BOTH IF APPLICABLE A, SYSTEMT~fPE ~ ~.L 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER A U 2 DOUBLE.WALL A g 3 L:;,IED TRENCH A U 95 UNKNOWN A [J 99 OT~ER B.-CONSTRUCTION A ~_ I SINGLE WALL -C. MATERIAL AND .... A_~ i B~.RE_~STEEL A U 2 STAINLESS STEEL A U 3 POLYVtNYL CHLORIDE (PVC)A U 4 FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A g $ CONCRETE al~.=~7 STEEL~/CQ~TI-ti~ ...... -~ U 8 100% PROTECTION A U 9 GALVANIZED sTEEL A U 10 CATHoDIc pROTECTION . A. 1.1 95 UNKNOWN A U 99 OTHER D, LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR [] :2 LINE TIGHTNESS TESTING [] 3 INTERSTTi'IAL MON,oR,NG [~g g~ OTHER NONE V, TANK LEAK DETECTION J[] 1 VISUAL CHECK [~ 2 INVENTORY RECONCILIATION [] 3 VAPOR MONITORING [] ~, AUTOMATIC TANK GAUGING [] 5 GROUNO WATER MONITORING ~'~6 TANK TESTING [] 7 ,NTERSTmALMONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER L TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOV~q~ IA. OWNER'S TANK I. 0.~ ! B. MANUFACTURED ~Y: C. DATE INSTALLED (MO/DAY/YEAR) I D. TANK CAPACITY IN GALLONS; III, TANK CONSTRUCTION MARK ONE ITEM ONLY IN gOXES A. S. ANOC, ANDALLTHATAPPLtESINBOXD A. TYPE OF [] 1 DOUBLE WALL SYSTEM ~ 2 SINGLE WALL [] 3 SINGLE WALL WITH EXTERIOR'LINER [] 95 UNKNOWN ] 4 SECONDARY CONTAINMENT (VAULTED TANK) ~ 99 OTHER B. TANK ~ ~ SARE STEEL MATERIAL ~ 5 CONCRETE (Primary Tank) [] g · BRONZE [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 10 GALVANIZED SYEEL [] g5 QNK. ICWN ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ,~ 8 100% METHANOL COMPAT1BLEWIFRP 90 O~;ER [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING C, INTERIOR L.~ 5 GRASS LINING [] 6 UNLINED ~ 95 UNKNOWN LINING IS LINING MATERIAL COMPATIBLE WITH 100% ME'1'HANQL ? YES ~ NQ~ 4 PHENOLIC L!NING 99 OT~ER 0. CORROSION [] I POLYETHYLENE WRAP [] .2 COATING PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE ] 3 VINYL WRAP [g5UNKNOWN ] 4 FIBERGLASS REINPORCED PLASTIC ] gg OTHER IV, PIPING INFORMATION cmCLE A IF ABOVE GROUNO OR U IFUNOERGROUNO, BOTHIF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A g 2 PRESSURE A ~ 3 GRAVITY A U 990T~ER B. CONSTRUCTION A~)~ SINGLE WALL A U 2 DOUBLE WALL A ~J 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C, MATERIAL AND CORROSION PROTECTION A~)~ BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIOE (PVC)A U 4 FIBERGLASS PIPE A 0 .5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COAT1NG A g 8 100% METHANOL COMPAT~BLEW/FRP A U 'g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D, LEAK DETECTION [] t AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING ~ 3 INTFr. RSTiT~.L MONITORING [] gg OTHER V, TANK LEAK DETECTION . ~______j , VISUAL CHECK ~3 INVENTORY RECONCILIATION [~ 3VAPORMONITORINGr~4 AUTOMATJCTANKGAUGING [] 5 GROUNDWATERMONITORING TANK TEST,N IN RST,T,ALMON,TOR'NG []., NONE [] .. U.KNOWN .0 OTHER Bakersfield.Fire D~ .. HAZARDOUS MATERIALS ION ~. UNDERGROUND STORAGE TANK PROGRAM PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK SITE INFORMATION SITE HOPPER TRUCK SHOP ADDRESS 2700 Q StreetZipCODE 93301 APN 005-010- FACILITY NAME HOPPER INC. CROSS STREET ESPEE STREET 02-01-3 TANK OWNER/OPERATOR HOPPER INC. PHONE No. 861-7000 MAILING ADDRESS P.O. BOX 2900 r ClTYBAKERSFIELD ZIP C'ODE 933.03 coNTRACTOR INFORMATION COMPANY TA(hPP1~P Ti',,fC'_ PHONE NO. ADDRESS 301 ESPEE STREET- INSURANCE CARRIER UN~,qARE INSURANCE R61 -7oflo LICENSE No.250252 CITY BA~.R.qFT~.T,DZIP CODE WORKMENS COMP NO. UA(15-0792-O50] PRELIMANARY ASSEMENT INFORMATION CONCEPTS INC. STATE COMPANY ADVANC~gD ENVTROMENTAL PHONE No. 831-1646 LICENSE No. F~.r~ ADDRESS 4400 ASHE' ROAD ~UITE 2'06 CITY BAKERSPTELDZIPCODE9 INSURANCE CARRIER SUN LIFE OF CANADA WORKMENSCOMP NO.l~?~v~ 368-2027-2 77-0234808 TANK CLEANING INFORMATION COMPANYMP VACUUM PHONE No. 393-1151 ADDRESS 3400 MANOR STREET CITY BA~F,R~FTF, T~D ZiP CODE q'~RnR WASTE TRANSPORTER IDENTIFICATION NUMBER 2895'- C. AT000624247 NAME OF RINSTATE DISPOSAL FACILITY GIBSON ENVIRO~ENTAL ADDRESS 2401 GIBSON CITY BAT~I~,RGt~TI~.T,D ZIP CODE93308 FACILITY INDENTIFICATION NUMBER CAD 9808831. 17 'TANK TRANSPORTER INFORMATION CA3531 COMPANY HOPPER INC. PHONE No. 861 -7'0n(} LICENSE NO.T~C, Thnm ~ n~nn?5 ADDRESS 301 ESPEE STREET CITY RAT<F,R~qt~TI~..T,Ih ZIP CODE93301 TANK DESTINATION GOLDgN S?ATE 'SCRA~ HETA~ TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED PREVIOUSLY STORED 1 20yrs. 500qals WASTE OIL NONF. THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS, ~ R~E'BY: ~ APPLICANTNAME(PRIN~ - '~ ~AN'SI~jURE ..... :,_TH~S_~.~PLICATIOR BECOMES A PERMIT_~H.E~._APPROVED .... '-" MAKE CHECKS PAYABLE TO THE "01~ ./ Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3970 UNDERGROUND TANK QUESTIONNAIRE I. FACILITY/SITE No. OF TANKS 4~' ~ gSA OR FACILITY NAME ' NAM[ OF OPERATOR /~ ~..L.,,NEAREST CRO~ STREET PARCEL No,(OPTIONAL) ~SFIE~ D ~ CA ;~; RECEIVED FEB 1 9 1992 Ans'd ............ BOX TO INDICATE ~[CORPORATION [~ INDIVIDUAL [~ PARTNERSHIP ~ LOCAL AGENCY DmmlC~ ~ COUNW AGENCY {~ STATE AGENCY (~ FEDERAL AGENCY IYPE OF BUSINE~ GAS STATION ~ 2 DISTRIBUTOR ["13 FARM [~ 4 PROCES3OR ~5OmER ~ EMERGENCYCONTACT PERSONiPRIMARY) DAYS: NAME (LAST, FI~"~T) PHONE No. WI~'I AREA CODE ~ 805 861 7000 KERN COUNTY PERMIT o6oolsc /Y ? d' EMERGENCY CONTACT PERSON (SECONOAR~ oottonal DAYS; NAME (LAST, FIRST) JOHNSON, DRNNIS PHONE No. WITH AREA COOE 805 861 7000 NIGHTS: NAME (LAST, FIRST) PHONE No. WITH AREA CODE NIGHTS: NAME (LAST, FIRST) ·PHONE No. V~lrN AREA CODE 4~ 805 393 7477 JOHNSON, DENNIS 805 854 2409 II, PROPERTY OWNER INFORMATION (MUST BE COM?L,':TED) NAME CARE OF AOORt~ INFORMATION HOPPER STEEL ~ FAB " -270;- .... n~'~TL~ (--di~2'~ 'i'J~;12-;' TO INOICATE ~ PARTNERSHIP [~ COUNW AGENCY MAILING OR STREET ADDRESS .... P.O. BOX 2900 CITY NAME BAKERSFIELD ~.~ STATE AGENCY I~ FEDERAL AGENCY ' STATE jZIP CODE PHONE No. WITH AREA CODE CA t 93303 805-86.1. 7075 III. TANKOWNER INFORMATION (MUST. BE COMPLETED) NAME CARE OF ADORES3 INFORMATION ' ' HOPPER STRI~.T, & FAB MAILING OR STREET ADDRESS V"' BOX J~ INDIVIDUAL (~ LOCAL AGENCY [~ STATE AGENCY P.O.BOX 2900 TOINOICATE QPARTNERSHIP ' ~COUNW AGENCY ~FEOERAL AGENCY CIW NAME STATE j Zl" CODE j PNON~ ~. WITH AREA ~SFIE~ ~) 93303 ~ 805 861 7000 TANK No. INSTALLED 4 4-1-72 DIES~ ' Y~/ N ~GAL :L N YIN Y/ N Y/N DO YOU HAVE FINANCIAL. RESPONSIBILITY?, YIN TYPE HOPPER INC = Hazmat Inventory List of 3 Materials Hazmat Name / Hazards Fac..Unit: MAIN OFFICE & PAINT SHOP <1> PAINT · Fire, Immed Hlth, Delay Hlth Liquid 400 High GAL 02-001 <2> LACQUER THINNER /~ ev~Imme ~~th Liquid 100 High GAL 02-002 <3> GASOLINE ~ Liquid 20,000 Moderate · Fire, Immed Hlth, Delay Hlth ( GAL 02-003/ <N> Add New Hazmat <Key> Modify Existing Hazmat <O> Find/Order/Focus <PgUp/Dn> Scroll. <R> Delete a Material <C> Fac. Units <P> Print <Esc> E STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIs FORM FOR EACH FACILITY/SITE MARK ONLY ~ 1 NEW PERMIT ~ 3 RENEWAL PERMIT ONEITEM [~ 2 INTERIM PERMIT ~ 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [~ 7 PERMANENTLY CLOSED SITE ~ 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR ADDRESS NEAREST C ROSS STREET PARCEL # (OPTIONAL) CITY NAME STATE ZIP CODE SITE PHONE # WITH AREA CODE CA ~ [~OX TO INDICATE I'---I CORPORATION r-"] INDIVIDUAL [~] PARTNERSHIP ~ LOCAL-AGENCY [~ COUNTY-AGENCY I'---I STATE-AGENCY ~ FEDERAL-AGENCY DISTRICTS . EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optional DAYS: NAME (LAST. FIRST) . PHONE # WITH AREA CODE DAYS: NAME (LAST. FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST. FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE I1, PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) NAME . CARE OF ADDRESS INFORMATION MAiLiNG OR STREET ADDRESS ,," box t~ indicate r~ INDIVIDUAL [~] LOCAL-AGENCY [~ STATE-AGENCY [~ CORPORATION ~ PARTNERSHIP ~ COUNTY-AGENCY ~ FEDERAL-AGENCY CITY NAME STATE ZIP CODE I PHONE # WITH AREA CODE I II1. TANK OWNER INFORMATION - (MUST BE COMPLETED) NAME OF OWNER MAILING OR STREET ADDRESS ICARE OF ADDRESS INFORMATION ~' box to indicate [~ INDIVIDUAL ~ CORPORATION · I--"] PARTNERSHIP STATE ZIP CODE CITY NAME ~ LOCAL-AGENCY I--"] STATE-AGENCY [~ COUNTY-AGENCY [~ FEDERAL-AGENCY PHONE # WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (916) 739-2582 if questions arise. TY(TK) HQ ~- . V. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. ICHECK LEGAL NOTIFICATIONS AND BILLING: I. [] II. [] II1. [] ONE BOX INDICATING VVI.-IICH ABOVE ADDRESS SHOULD BE USED FOR THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY COUNTY # JURISDICTION # FACILITY # LOCATION CODE - OPTIONAL CENSUS TRACT # - OPTIONAL SUPVISOR - DISTRICT CODE - OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION. FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FORM A (9-90) FORO033A-R2 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [] 5 CHANGE OF INFORMATION [~ 7 PERMANENTLY CLOSED ON SITEI ONE ITEM [~ 2 INTERIM PERMIT [] 4 AMENDED PERMIT [~ 6 TEMPORARY TANK CLOSURE [] 8 TANK REMOVED t DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # B. MANUFACTURED BY: C. DATE INSTALLED (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: II, TANK CONTENTS ~F A-1 IS MARKED. COMPLETE ITEM C. UN'LADED [] UNLEADED ~ 3 CREMICAL PRODUCT ~ 95 UNKNOWN ~ 2 WASTE ~ 2 LEADED ~ gg OTHER (DESCRIBE iN ITEM g. BELOW~J I D. IF (A.1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. ~: III. TANK CONSTRUCTION MARKON~ITEMONLYINBOXESA, B, ANDO, ANDALLTHATAPPLIESINBOXDANDE A. TYPEOF [] 1' DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL '-- [~ 4 SECONDARY CONTAINMENT (VAULTED TANK) [] 99 OTHER B. TANK [] 1 BARE STEEL MATERIAL [~ 5 CONCRETE (PrimaryTank) [] 9 BRONZE [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 10 GALVANIZED STEEL [] 95 UNKNOWN ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLE W/FRP ] 99 OTHER [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING C. INTERIOR LINING [] 5 GLASS LINING [] 6 UNLINED [] 95 UNKNOWN IS LINING MATERIAL COMPATIBLE WITH 100°/o METHANOL ? YES__ NO__ ] 4 PHENOLIC LINING ] 99 OTHER D. CORROSION [] I POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE [] 95 UNKNOWN [] 99 OTHER E. SPILL AND OVERFILL SPILL C~ONTA~IINMENT INSTALLED (YEAR) OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) IV. PIPING INFORMATION CIRCLE A IFABOVEGROUNDOR U IF UNDERGROUND, BOTH IF APPLICASLE A. SYSTEMTYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION A U 1 BARESTEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A U 4 FIBERGLASS PIPE A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100°1o METHANOL COMPATIBLEW/FRP A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D, LEAK DETECTION [] 1 AUTOMATIC LINE LEAK DETECTOR [] 2 LINE TIGHTNESS TESTING [] 3 INTERSTITIAL MONffORING [] gg OTHER V. TANK LEAK DETECTION . [] 1 VISUAL CHECK [] 2 INVENTORY RECONCILIATION [] 3 VADOZEMONITORING [~ 4 AUTOMATIC TANK GAUGING [] 5 GROUND WATER MONITORING [] 6 TANK TESTING [~ 7 INTERSTITIAL MONITORING [] 91 NONE [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION 1, ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF 3. WAS TANK FILLED WITH SUBSTANCE REMAINING GALLONS INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D.# ~J~ II I I I 'il PERMIT NUMBER PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE FORM B (7-91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A. UNLESS A CURRENT FORM A HAS BEEN FILED. FOROO34B-R5 CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT 2101 H STREET S. D. JOHNSON BAK~.RSFII~.T,D FIR~. DI~.PARTM~.NT BAKERSFIELD, 93301 FIRE CHIEF 326-3911 HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 CERTIFICATION STATEMENT OF TANK DECONTAMINATION I, GRgG g~4Nb Ot"v7 an authorized agent of name HOPPERS here by attest under penalty of contracting co. perjury that the tank(s) located at 2700 Q ST and address being removed under permit# BR-0063 has been cleaned/decontaminated properly and a LEL (lower explosive limit) reading of no greater than 5% was measured immediately following the cleaning/decontamination process. 11/09/92 date name (print) signature