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UNDERGROUND TANK FILE 1
Hazardous Materials/Hazardous Waste Unified Permit . CONDITIONS OF PERMIT ON REVERSE SIDE Permit ID #:: 015-000-001920 CHEVRON DOWNTOWN FOO LOCATION: 2317 L ST This ~.nnit is issued for the followin_a: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials [] Risk Management Program [3 Hazardous Waste On-Site Treatment TANK HAZAR DOU~.:'S UlilS~A~G~ " ~' ~ *~' '"~' -~, ~AP~ ~.~, DISPENS~NS~ONITORING 015-000-001920-0001 GASOLINE ~':'~ ~'~ '~': ~d~~)S'~ SENSOR 015-000-001920-0002 GASOLINE ~',' ~ ~.~ · ' : ...... ::":' ~ ' ' ~ ~ 015-000-001920-0003 GASOLINE ~ ~ ~; ........... ~":';;;~":~ ' '~': ~'%' Issued by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Approved by: Expiration Date: RalpffHucy, D~: Office of Evironm~Scrviccs "" June 30. 2003 Issue Date :.0B/28/01 07:45 ~66! 0576 BFD HAZ :tIAT 002 MONITORING SYSTEM CERTIFICATION For Use By All Juri.vdic'nons Wit/dn [h~' State of Cul~fornia Attthority Ciled: Cht~pter 6, 7, Health and Sq/~ty Code,. C/ropier 16. Divixir.,~l ), Tt'tl'e 23, C~tl~brnitt Code of Re,qtdationx This form must be used to document testing and se~icing or,monitoring equipment. A ~parare certification or rep,s ~ust be prepared for each mgnitoring system control BOj~ by the technician xeho performs the work. A copy Of this t~rm must be provided (o the tank system owner/operator, The owner/operator must submit a copy of this lb~ rd [l~e local agency regulating UST systems within 30 A. General Information ~ · -~ Facility' Contact Person: ff~ ~__ : Conrnct Phone N'O.: (, ga'/ )~3 '-- O3 t ~ MakemodelofMonitoringSystem: ~--~../~'/~ ~_ ~ateofTesdng/Se~icing: ~/Z~/ O~ B. Inventory of Equipment Tes[e~Certified ~ ~heck the appro date boxes indicate s eeiflc e ~pment ~specte~se~iced: 2 ,, to .... ~ q .. . . ............. , ......... Tang W: '~/' ~~m ~ ~'~ ' Tank ID: '~ {<~'~~ "~'",% ~-Tank Gauging Probe. Model: ~mul~ Space or Vault Sensor, Model: ; ~nnul~ Space or Vault Sensor. Model: ?'O -- ~ Piping Sump / Trench Sensoffs). Model: ~ Piping Sump / Trench Seasoft0. Model: '2~ '3~ ,~el Sump Sensor(s), Model: chanical Line Leak Detector, Model: ~1 Electronic Line Leak Detector. Model: ~ Tank Overfill i High-Level Sensor. Model: ID Other (specify equipment type and model in Section g on.Page 2). ~.~J,n - ' ' augin[ Probe. Modeh Space or Vau t Sensor. Mode. ii~ Piping Sump ,' Wrench Sensor(s). Model: ~q:'/37o ---7'- ."] Fill Sump Sensor(s). Model: · ~Mech,mical Line Leak Detector. Modeh -,.' ' .~"/['~']t~ Electronic Line Leak Detector. Model: Taok Overfill / High-Level Sensor, Model; O~her (specif,v equipment type and model in Section ~ on Page 2)~ DispenSer ID: /_/7 . ' .......... _Cl~,~ispenser Cont~nment Sensor(s). Modeh ta~"-S hear Valve(s). Dispenser Containment Float(s) and Chain(s), ~,ispenserContainment Sensor(s). Modeh ~'~hear Valve(s). Dispenser Cor~tainment Float(s) and Chain(s). r~.,,J>ispenserContainment S*nsor(s). ,Model:. Shear Valve(s). .'-IDispenser Containment Float(s) and Chain(s). e 1 Sump Sensor(s). Model: chanical Line Leak Detector. Model:' ,/'(_~L/oth'- ~ Electronic Line Leak. Detector. Modeh ~ Tank Overt'ill / High-Level Sensor. Model: [.3 diker (specify equipment type and model in Section E on Pa~.e 2), C24~-T0a,k Gauging '[~-obe. Modeh ~ liiff-~nnular Space or Vault Sensor. Modeh ~-Pipi,',g Sump/Trench Sensor(s). Model: r-1 Fill Sump Sensor(s). . Nlodeh .l~.'vlechanical Line Leak Detector. Modeh Q Electronic Line Leak Detector. Model: Q Tank Overfill / High-Level Sensor. Model: j [] Other (spec!fy equipment type and...m..odel in Serlio. n. E on Pa~e 2). Dispenser ID: Q~ispenser Coat,)lament Sensor(s). Model: ~:F S hear VaJ ye(s). .~ Dispenser Conta/nment Float(s) and Chain(s). Dispenser ID: ?,,,Dispenser Containment Sensor(s). Model: i~ Shear Valve(s). IQ Dispenser Containment Float(s) and Chain(s). 'Dispenser ID: _~.~~ 9.,~sp~n.~r Con,~ment se~so<s). Modck _ ~ Shear Valve{s). cl Dispenser Containment Float(s) and Chain(s). "If the facili .ty contains more tanks or dispensers, copy this form. Include information for ever)' 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' g,~delines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this Information is correct and a Plot Plan showing the layout of monitoring eqtttp~q~ent, For any equip~.n.n.n.n.n.n.n.n.n~t empable of generating such reports, I have also attachedacopyoftherepo~.'_.~checkalttdl~tappty): i;ii~b'~.vstem se t.u p ~'~A~ory ~,r~ Technician Name (print): .~/d ~.~,4<~ Signature:_ Certitication No.: ~'.,,2',~ ~.~ Licen:;e. No.: Testing Company Name: Site Address: .~'~'z:~' '~- Monitoring System Certification Page I nf 3 Date or Testing/Servicing: _~///~Jr.:/V.;, ~ 03101 09/28./01 07:45 0576 BFD HAZ 3L-iT DIV{ MONITORING SYSTEM CERTIFICATION P'or Use By All Juri,vdic'nons Wt't/tt;l ;he State q/C'ulifornia .4uthurity Cited: Chap:er 6..7, Health ant] Safety Code: Chapter 16. Division 3, Title 2.t, Culi. fornia Code of Re,gtdations This form must be used to document testln~ and servicing of!monitorinG' eqmpment. A separate ceFtific,,.qtion or report must be prepared for each m~.nitoritm .system control p..a. pe.._[ 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: ,Z~,t.,r4/~4.d site Address: .... ~ 7 ~_ Facility Contact Person: ~.~) , , Make~odel of Monitoring System: ~ B. Inventory of Equipment Teste~Certified Check the,..appro ~ 1clare boxes to indic~? spe~ig~.~pment ~speete~se~ice~: ~n-Tank Gauging Probe, - Model: ___ ,.~ D .~mul~ Space or Vault Sensor, Model: ~ Piping Sump / Trench Sensors), Model: ~ ~ill Sump Sensor(s). M~eh ~lechanical Line Le~ Detector. Model: D Electroni~ Line Leak Detector. Model: ~ Tank Overfill i High-Level Sensor. Model: ~ Other (specify equipment t~e ~d model in Section E on Pa~e 2). , ~ In-Tank Gauging Probe. ~ /- Modeh - ~ ~lnul~ Space or Vault Sensor, Modeh ~ Piping Sump / Trench Sensor(s). Model: ~11 Sump Sensor(s). M~el: ~ Mechanical Line Le~ Detector. Model: '~~ - ~ Elec~onic Line Le~ Detector, Model: ~ ~ Ta0k Ore. Il / High-Level Sensor, Model: ~ Other (s~cifv equipment type and model in Section E on Page 2).~ Dlspe~er ID: City: ,~ "'O~~ Zip: _, ,¢?.~,..~ er/ Contact Phone No.: (~/) ~'ff '~/O Date ofTesting/Semicmg: ~ / 2~/.p ~ .s~"~n-Tank Gauging Probe. - Model: ~/ Q Annular Space or Vault Sensor, Model: , t ~ Piping Sump / Trench Sensor(s). Model: l l Sump Sensor(s). Model: ~ echanical Line Leak Detector. Model:'--~.,.~.~.&'~ Q Electronic Line leak. Detector, Modeh C] Tank Overfill / High-Level Sensor, Model: r.30tker (specify equipment.type and model in Section E on Pa~.e 2). Tank iD: C/.,] [n-T~k Gauging ~obe. Model: __ C3 Annular Space or Vault Sensor, Model: r-I Piping Sump / Trench Sensor(s). Model: __ D Fill Sump Sensor(s). Model: [] Mechanical Line Leak Detector. Modeh ~ Electronic Line Leak Detector. Model: ~ Tank Overfill / High-Level Sensor, Model: [] Other (specify. equipment type and.?0del in_Section E on Pa,~e 2). Dispenser ID: Ul Dispenser Containment Sensor's). Modeh ~ Q Dispenser Comainment Sensor(s). Model: t2 Shear VaR'e(s). ~ UI Shear UI Dispens~tainment ~oat(s) and Chain(s). ~ ~ Dispenser ~ment Float(s? ~d Chain(L), Dis~nser ID: ~ t Dispenser ~D: Q Shear Valve(~). ~ J Q She~r Valve(s), ,Q Dispenser Comai~m~nt Roaffs) ~nd Cha~ ~ Q Dispenser Comainment ~at(s,) and C~s). Dispenser ID: ........ ~ ~ Dispenser ID: ___ ~ ~ Dispenser Containment Sensor(s). Modeh _ ~ Dispenser Containment Sensor(s). ~odel: ~ Shear Valve(s). Shear Valve(s). ~Dispenser Containmem Float(s) and Cl~ain(s). ~ ~ Dispenser Ccnt~nment F'loar(s~ and Chain(~). -If the ~acili~ contains more tanks or dispensers, copy this [o~. include info~mtlon tot every ~k and dispenser at the hcility, C. Certification · I ce~ that the ~uipment idenS~ in t~s document w~ l~pect~se~ieed in accordance with the m~ufac~em' g~gdelin~, At~ched to this Ce~fication is I~omfion (e.g, ~nufacmrem' theorist) neeessa~ to correct and a Plot Plan showing the layout of mo~to~ng eqffipment, For any eqffipment ~pable of generating such reporu, I have also attached a copy of the repom; (check MI that appO): ~ System set.up ~ Alarm history report Technician N~ne (prinS~ ~ Signature: Certification No,: ~ Licenue, No.: Testing Company Name: _~No,:(. Site Address: ~Da~vi~: / Page 1 of 3 03/01 Monitoring System Certification ,09,'1~8/01 07: ~16 "~6 ;26 0576 BFD HAZ ~t,4T D] ~003 D. Results of Testing/Servicing Sol'tware Version [nstallech Z/r-'', a~~''' Cot flete the following checklist; s ~ a ,No*, ! ~s the ;udit,~e aa,-m o~,e,aiionar;' . ......... .,~l"Yes O No'~ is the visual ala~ operational? -~es ~ No* Wer'e all sensors visually inspected, thncti'on'al(~s~ed, and confi~ed operaiona?', ., ~Yes Q No* Were ail sensors Mstalled at lowest po'ia 0f secondly containment and positioned so that other equipment will not interfere wkh thei~ p~o~er o~era~on'? .... Yes Q No~ ff al~s ~e relayed to a remote monitoring' stadon, is all communications equipment (e,g. modem) ~N'/A operational? '~es ~ No* For pressurized ~Jping systems, does the turbine automaticaJ'ly'shut dow'n if the ~iping seconda~ ~ontainment ~ N/A monitoring system detects a leak. &Hs to ope~ or is eJecr;icaHy disconnected? If yes: ~h~ch sensors inmate positive shut-down? fCheck ~ll that opplvl ~Sump~rench Sensors' ~ Dispenser Containment Sensors. Did ~Sconfirm positive shut-down due to leak~ ~ sensor ~zHure/disconnectton? ~; Q No. Yes' Q~o* ~ For tank systems that udlize the monitoring system as the primly unk ore. Il w~ing devic~ (i.e. no ~ N/A mechanical overfill prevention valve i~ installed), is ~e overfill w~ing al~ visible ~d audible at the tank ~ fill point(s) ~n~ operating properly'? If so, at what ~rcent of tank capac~ty,does the al~ ~igger? . . % Yes* ~No Was any monitoring equipment repiaccdl If yes, identify specific sensors, probes, or other equipment re~iaced ~,, ~, , ,, ap,d,l,ist ~he ,m,anu~'actu?~ name and m~el fo~ all replacemen~ pros in Section E, below.. Yes* ~No Was liquid' found inside any secondm, contanment systems de,~igned as d~ systemS? (Chec~ all that apply) ~ / Pro~uqt; ~ Water. If y~s, describe causes in Secdon E,.below. ~Y~ Q "~o*' Was monitoring system set-up.r?~ew~ to ensure, ?roper settingsq &ttach set up repons, if ~2plicable ,~es ~ No* Is all monitoring eguipment operational per manu[act~ev's specifications? * In Section E below, describe how and when these deficiencies were or ~41l be corrected, £. Comments: Page 2 of 3 o3/ot ' 09/28/01 07:47 26 0576 BFD HAZ ,1iAT D~ 004 F. In-Tank Gauging / SIR Equipment: .'~ Check this box it' tank gauging is used only tbr inventory control. i:1 Check this box ii" no tank gauging or SIR equipment is ins'tailed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Co~ ~)lete the following checklist: No* Were :ill tank gauging probes visually inspected t'Or damage and residue buildup? ' No, Was accuracy of system product level readings tested'? -- No* Was accuracy ~}'system water level rea~ngs,~;~ted'? ........ No* Were all probes reinstalled pr~rly'? No* Were all items on the equipment manufacturer's mai'ntenance checklist completed? * In the Section H, below, describe how'and when these deficiencies were or will be corrected. G. Line Leak Detectors (LED): /2 Check this box it'LLDs are not installed. Con flete the follow!rig checklist: '~S' ~ r~o* ':'"~O~ equ'iwnent's~art:up or' at'au'al ~'~il~ent'ce.~'ca[ion, was ;~le~l~ si~ulat;'d to verify L~D ~erforv~nce? CI N/A [ (Checkall thatupplv) Simulated teak rate: ~ g.p.h.; '~ 0,1 g,p.h; O 0.2 g.p.h. _~!~-Y/es Q' '~o* Were all LLD's confirmed 'operationfil ~md accurate wish. in reg. ulato~ require~ents7 .... C2'/Y~es El 1'%* Was the testi'hg apSaratus properly c~libraed? 12'~Yes Q No* t5o~'mechani~'al L~LI~S, does the LLD restrict product flow if it detects a leak'? ~ N/A l__ . '-.,' Yes ~*1 For electronic LLDs, does the tur'bine' automatically 'shut off if the LLD d~tects a leak'?. ~ N/A '~' * For'electronic does the turbine automa~ca]ly shut off ir' any porti'~n of the monitoring system is disabled Yes .~N/i LLDs, ' " or disconnected'? Yes Cl ~e~ '"For electronic LLD~,', does'the tu'rbine autometic~lly shut OFF if any p'c~rtion of the r~nitdring sYstem malfunctions c-fi'N/A or fails a test'? ~'4/es C2 N ?or'electr°~ic LLDs, have all accessiDle wiring connections been visuall'iS'inspected? .... 2"~Yes U 'No* Were all items on the equiprnent'manufacmrer's main't'~er~anc¢ checklist completed? * In the Section H below, describe how and when. these deficiencies were or will be corrected, H. Comments: Page .3 of 3 o31oi Monitoring System Certification Site Address: UST Monitorjng Site Plan / Date map was drawn: ///~/~/dP ~ Instruction If ou alreaa haves diagram ttlat shows'all requi}ed information, YOu mhy"i~lude 'it,'raih~r'than}this ;ag'e, w/th your locations, of th~"foii0~ng equiP~ht, if insta~ed{??~i~hit~n~g~`s.~tem.`~...~:~!``i~:~...~}~:?~.~i~.~!!~ri~.:`g~ annular spaces, sump'~', diSpefis'er' pans; SPill containers,, or"bther s~conda~'~'6ntai~hi ireasl 'mechahic~l Or'"eledz6nic !ine'leak In ~ space pr6vided, note the date this site Plan detectors;, and in-tank liquid level probes (if used'for leak dete~tion),..i i": i":'i:::; ..... t ' .'.'.'.':" .' ":'.'. ..... was prepared. ' .... ' ............. ~' ':":" i i:" O5'0O ALARM HirSTORY REPORT , ..... SENSOR ALARM ...... L 4 :SUPREME SOUTH STP SUMP FUEL ALARM NOV 26, 2002 8:26 AM FUEL ALARM DEC 28, 2000 9:56 Aid Fi]EL fiL~M DEC 28, 2000 9:43 tim ALARM HISTORY REPORT ...... SENSOR ALARM ....... L 2:UNL-SUP SOUTH ANNULAR SPACE FUEL ALARM NOV 26, 2002 8:10 AM FUEL ALARM DEC 28, 2000 9:55 AM SENSOR OUT ALARM JUN 10, 1999 8:02 DOWNTOWN CHEVRON 2317 L STREET BAKERSFIELD CA.93301 805- NOV 26.. 2002 q'5°.. ¢ AM SYSTEM STATUS REPORT L I:FUEL ALARM ALARM HISTORY REPORT - .... SENSOR ALARM ....... L 5:PLUS SOUTH ANNULAR SPACE FUEL ALARM NOV 26, 2002 O:30 AM FUEL ALARM DEc 28, 2000 9:55 AM SENSOR OUT ALARM JU~ 10, 1999 8:02 AM i' ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ALARM HISTORY REPORT ...... SENSOR ALARM ..... L 3:UNL SOUTH STP SUMP FUEL ALARM NOV 26, 2002 8:22 AM FUEL ALARM NOV 9, 2002 B:02 AM FUEL ALARM AUG 20, 2002 9:18 AP1 ALARM HISTORY REPORT ..... .SENSOR ALARM ...... L I:PLUS SOUTH STP SUMP FUEL ALARM NOV 26, 2002 9:43 AM FUEL ALARM NOV 26.. 2002 8:34 AM FUEL ALARM AUG 20, 2002 9:16 AM I N-TANK SETUP T I:SUPREME PRODUCT OODE THERMAL ¢OEFF TANK DIAMETER TANK PROFILE FULL VOL 1 .000700 127.50 I PT 8104 FLOAT SIZE: 4.0 IN, 8496 WATER WARNING · 2.0 HIGH WATER LIMITi 3.0 MAX OR LABEL VOL: 8104 OVERFILL LIMIT : 90~ : ?293 HIGH PRODUCT : 95~ : 7698 DELIVERY LIMIT : 10~ : 810 LOW PRODUCT : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 2.86 MANIFOLDED TANKS T#: NONE LEAK MIN PERIODIC: 10~ : 810 LEAK MIN ANNUAL : 10~ : 810 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : I KIN COMMUNICATIONS SETUP PORT SET, TINGS: COMM BOARD : 1 (RS-232) BAUD RATE : 1200 PARITY : EVEN STOP BIT : 1 STOP DATA LENGTH: 7 DATA AUTO TRANSMIT SETTINGS: AUTO LEAK ALARM LIMIT DISABLED AUTO HIGH WATER LIMIT DISABLED AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EXTERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARM DISABLED RS-232 SECURITY CODE : 005001 RS-232 END OF MESSAGE DISABLED EV1 SETUP - - ~OV 26, 2002 9:'38 AP1 sYSTEM UNITS U.S .... sYSTEM LANGUAGE DowNTOWN GHEVRON '2 17 L STREET 805- sHIFT TI~E t : 6:30 ~HtFT TII~E 2 : DIsaBLED SRIFT TIME 3 : t2:00 sHIFT TIME 4 : 8:05 TANK pERIODIC RBLED D I sABLED LI NS pERIODIC wARNINGS ABLED ~E ANNUAL wARN I NGS D I SABLED pRINT TC VOLUMES ENABLED MP COMPENSATION TE _~ ~ ), 60.0 VALUE (D~ ~ STICK HEIGHT D I SABLED M-pROTOCOL DATA FORMAT ~E I G BT DAYLIGHT SAVING TIME ENABLED sTART DATE APR ~EEK ~ SUN sTART TIME 2:00 AM END DATE OCT ~EEK 6 SUN END TIME 2:00 AM RE-DIRECT LocAL PRINTOUT D I sABLED sYSTEM SECURITY cODE : 000000 T 4 :PLUS PRODUCT CODE : 4 THERMAL COEFF :. 000700 TANK DIAMETER : 120.00 TANK PROFILE : I PT FULL VOL : 8029 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: $.0 PlAX OR LABEL VOL: OVERFILL LIMIT HIGH PRODUOT DELIVERY LIMIT 8029 90% 7226 95% 7627 10% 802 LOW PRODUCT : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 0.60 MANIFOLDED TANKS T~: NONE LEAK MIN PERIODIC: 10~ : 802 LEAK MIN ANNUAL : IOF, : 802 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NQTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 T 3:UNLEADED PRODUCT CODE : 3 THERMAL COEFF :.000700 TANK DIAMETER : 127.50 TANK PROFILE : 1 PT FULL VOL : 12041 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3,0 MAX OR LABEL VOL: 12041 OVERFILL LIMIT : 90% : 10837 HIGH PRODUCT : 95% : 11439 DELIVERY LIMIT : 10~ : 1204 LOW PRODUCT : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 1.10 MANIFOLDED TANKS T~: NONE LEAK MIN PERIODIC: 10~ : 1204 LEAK MIN ANNUAL : 10% : 1204 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF · PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TsT sIPHbN BREAK:OFF DELIVERY DELAY : 1MIN T 2;FLU~ IUCT CODE : 2 MAL COEFF :.000700 ~ DIAMETER : 95.00 TANK PROFILE : 1 PT FULL VOL : 10145 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 10145 OVERFILL LIMIT : 90% : 9130 HIGH PRODUCT : 95% : 9637 DELIVERY LIMIT : : 1014 LOW PRODUCT : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 0.73 MANI FOLDED TANKS T~: NONE LEAK MIN PERIODIC: 10% : 1014 LEAK Mllq ANNUAL : 10% : 1014 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 1 MIN T ?:DIESEL PRODUCT CODE : 7 THERMAL COEFF :.000450 TANK DIAMETER : 120,00 TANK PROFILE : 1 PT FULL VOL : 12044 FLOAT SIZE: 4,0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT 3,0 MAX OR LABEL VOL: 12044 OVERFILL LIMIT : 90~ : 108J9 HIGH PRODUCT : 95~ : 11441 DELIVERy LIMIT : 10~ : 1204 LOW PRODUCT : 500 LEAK ALARM LIMIT 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 1.60 MANIFOLDED TANKS T~: NONE LEAK MIN PERIODIO: 10~ : 1204 LEAK HIM ANNUAL : I0~ : 1204 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 KIN iT 6:SUPREME RODUCT CODE : 6 THERMAL COEFF :.000700 TANK DIAMETER : 120.00 TANK PROFILE : 1 PT FULL VOL : 8029 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 8029 OVERFILL LIMIT : 90~ : 7226 HIGH PRODUCT : 95~ : 7627 DELIVERY LIMIT : 10~ : 802 LOW PRODUCT : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 0.96 MANIFOLDED TANKS T~: NONE LEAK MIN PERIODIC: 10~ : 802 LEAK MIN ANNUAL : 10~ : 802 PERIODIC; TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 MIN T 5:UNLEADED PRODUCT CODE : 5 THERMAL OOEFF :.000700 TANK DIAMETER : 120,00 TANK PROFILE : I PT FULL VOL : 12044 FLOAT SIZE: 4,0 IN. 8496 WATER WARNING : 2,0 HIGH WATER LIMIT: 3.0 PlAX OR LABEL VOL: 12044 OVERFILL LIMIT : 90%' : 10839 HIGH PRODUCT : 95~ : 11441 DELIVERY LIMIT : lO~ : 1204 LOW PRODUCT : 500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT : 0,00 MANIFOLDED TANKS TU: NONE LEAK MIN PERIODIC: 10~ : 1204 LEAl( MIN ANNUAL : lOX : 1204 PERIODIC TEST TYPE QUICK ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 MIN IN-TANK DIAGNOSTIC PROBE DIAGNOSTICS T 2: PROBE TYPE MAGI SERIAL NUMBER 877975 ID CHAN = OxCO00 GRADIENT = 351.6300 NUM SAMPLES = 20 CO0 1350.0 CO1 21504.1 C02 21504.0 C03 21504.0 C04 21504.0 C05 21504.0 C06 21504.0 CO? 21504.0 C08 21504.0 C09 21504.1 ¢10 21504.0 Cll 45618.3 C12 19356.3 C13 18502.3 C14 18907.8 C15 19379.2 C16 19304.8 CI? 19326.4 ¢18 45619.9 SAMPLES READ =121638702 SAMPLES USED =121623032 IN-TANK DIAGNOSTIC PROBE DIAGNOSTICS T 3: PROBE TYPE MAG1 SERIAL NUMBER 372892 ID CHAN = 0x¢000 GRADIENT = 349.8400 NUM SAMPLES = 20 CO0 1336.1 CO1 33663.0 C02 33663.0 003 33663.2 C04 33663.0 C05 33663.0 C06 33663.0 CO? 33663.0 C08 33663.0 C09 33663.0 CIG 33668.0 Cll 4302?.4 012 20494,8 013 18361.5 C14 18321.? C15 18325.? C16 18200.4 CI? 18275.? C18 43028.9 SAMPLES READ =12061405? SAMPLES USED =120591615 RELAY SETUP R i:POS SHUTOFF SOUTH TYPE; STANDARD NORMALLY CLOSED LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM SOFTWARE REVISION LEVEL VERSION 16.05 SOFTWARE~ 346016-100-F CREATED - 98.08.21.18.55 NO SOFTWARE MODULE SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS IN-TANK DIAGNOSTIC PROBE DIAGNOSTICS T 1: PROBE TYPE MAG1 SERIAL NUMBER 372893 ID CHAN = OxCO00 GRADIENT = 350,2500 NUM SAMPLES = 20 CO0 1314,0 CO1 24649.1 002 24649,4 003 24649.3 C04 24649,2 005 24649,? 006 24649,1 CO? 24649,3 008 24649.3 009 24649.2 ClO 24649,2 Cll 43168,? 012 2023?.3 C13 18422.3 014 18484.4 015 19013.4 016 18930,2 Cl? 18855,8 018 43169.9 SAMPLES READ =121870877 SAMPLES USED =121855948 LEAK TEST METHOD MONTHLY : ALL TANK WEEK I MON START TIME : 1:00 AM TEST RATE :0.20 GAL/HR DURATION : 2 HOURS LEAl( TEST REPORT FORMAT NORMAL LIGUID SENSOR SETUP L I:PLUS SOUTH TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 2:UNL-SUP SOUTH TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 3:UNL SOUTH TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 4:SUPREME SOUTH TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 5:PLUS SOUTH TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE IN-TANK LEAK DIAGNOSTIC PROBE DIAGNOSTICS T, 1: PROBE TYPE MAG1 SERIAL NUMBER 972893 GRADIENT = 350,2500 NUM SAMPLES = 61715 COO 1325,3 CO1 23406,2' 002 23406,2 003 23406.2 C04 23406.2 C05 23406.2 006 22728 4 007 22728.4 C08 22728 4 009 22728.4 CIO 22728 4 Oil 43169.2 C12 19551 5 C13 17954.9 014 18027 8 015 18381,0 016 18255 3 017 18170.2 C18 43170 4 IN-TANK DIAGNOSTIC PROBE DIAGNOSTICS T 6: PROBE TYPE MAG1 SERIAL NUMBER 3a4s32 ID CHAN = OxOOOO GRADIENT = 351.0200 NUM SAMPLES = 20 CO0 1330.1 COl 332?8.6 C02 332?8,2 003 332?8.2 C04 33278.1 005 332?8.2 C06 33277,6 CO? 33278,1 C08 33277.9 C09 33278.1 CIO 33278.1 Oil 44279,8 C12 14949,3 013 17048.1 014 19436.8 C15 19568.5 016 19572.3 Ol? 19550.5 018 44280.? SAMPLES READ =1991462 SAMPLES USED =1991176 IN-TANK DIAGNOSTIC iOBE DIAGNOSTICS 4: PROBE TYPE MAG1 SERIAL NUMBER 384833 1D CHAN = OxCO00 GRADIENT = 350.6200 NUM SAMPLES = 20 COO 1342.0 CO1 29557,7 C02 2955?,6 C03 29557,5 C04 29557,6 C05 29557,3 C06 29556,? CO? 29557,2 008 29556.9 C09 29557,1 CIO 29556,6 Cll 44400.3 C12 17374.? C13 16898.8 C14 18934.3 C15 19132.5 C16 19146,8 CI? 19137,6 C18 44402,6 SAMPLES READ =1991666 SAMPLES USED =1991352 IN-TANK LEAK DIAGNOSTIC PROBE DIAGNOSTICS T 2: PROBE TYPE MAG1 SERIAL NUMBER 377975 GRADIENT = 351.6300 NUM SAMPLES = 61879 CO0 C02 19186 C04 19186 COG 15745 008 15745 ClO 15745 012 18713 C14 17798 016 18031 C18 45621 1350 3 COl 19186.0 0 C03 19186.0 0 C05 19186.0 I CO? 15745.1 1 C09 15745.1 I Cll 45620.6 0 Ct3 17688,7 ? C15 18073.4 ? 017 18054,9 1 IN-TANK, DIAGNOSTIC PROBE DIAGNOSTICS T ?: PROBE TYPE IDAC1 SERIAL NUMBER 384133 ID CHAN = OxCO00 GRADIENT = 351.3700 NUM SAMPLES = 20 CO0 1325,0 CO1 18567.0 002 18566.6 C03 18566.8 004 18566.3 C05 18566.? C06 18566.2 CO? 18566,? 008 18566.4 009 18566.4 ClO 18566,3 Cll 44004.1 012 16885,9 013 14842.4 C14 14874,0 C15 14757.3 016 14953.1 Cl? 15321.5 C18 44004,2 SAMPLES READ =1991793 SAMPLES USED =1991411 IN-TANK DIAGNOSTIC PROBE DIAGNOSTICS T 5: PROBE TYPE MAOl SERIAL NUMBER 384142 ID CHAN = OxOO00 GRADIENT = 351.3300 NUM SAMPLES = 20 CO0 1318.4 COl 22433,2 C02 22433.4 C03 22433.8 C04 22434,1 005 22434,? 006 22462.? CO? 22463.0 008 22463,? C09 22463.9 ClO 22464,3 Cll 44844,6 · 012 18241.3 C13 16897.3 C14 16711.4 C15 17056.0 C16 17169,7 Ci? 17277,1 C18 4484'6.1 SAMPLES READ =1991773 SAMPLES USED =1986060 TANK LI~AI( TEST HISTORY T 2 :PLUS LAST GROSS TEST PASSED: NOV 4, 2002 1:00 AM STARTING VOLUME= 8094 PERCENT VOLUME = 79.8 TEST TYPE = STANDARD LAST ANNUAL TEST PASSED: NO TEST PASSED FULLEST ANNUAL TEST PASS NO TEST PASSED LAST PERIODIO TEST PASS: MAR 4, 2002 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 3017 PERCENT VOLUME = 29.7 TEST TYPE = STANDARD IN-TANK LEAK DIAGNOSTIC PROBE DIAGNOSTICS T 5: PROBE TYPE MAG1 SERIAL NUMBER 384142 GRADIENT = 351.3300 NUM SAMPLES = 19734 CO0 1518.5 COl 21081.6 002 21031.6 002 21031.6 004 21031.6 COS 21031.6 C06 25928.0 C07 25923.0 C08 25923.0 009 25928.0 CIG 25923.0 Cll 44845.1 C12 18168.4 C13 18389.3 C14 17148.4 C15 17342.1 C16 17205.2 C17 17340.9 C18 44846.1 LEAK DIAGNOSTIC PROBE DIAGNOSTICS T 3: PROBE TYPE MAG1 SERIAL NUMBER 372892 GRADIENT = 849.8400 NUM SAMPLES = 61078 CO0 1836.2 CO1 26988.6 002 26988.6 C03 26938.6 C04 26928.6 005 26938.6 006 25266.1 007 25266.1 008 25266.1 009 25266.1 CIG 25266.1 Oil 43028.6 012 20069.0 013 18227.4 C14 18165.9 015 18092.9 C16 17948.2 C17 18014.9 C18 43030.$ FULLEST PERIODIC TEST PASSED EACH MONTH: MAR 4, 2002 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 3017 PERCENT VOLUME = 29.? TEST TYPE = STANDARD AUG 2, 1999 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 4858 PERCENT VOLUME = 47.9 TEST TYPE = STANDARD OCT 4, 1999 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 6445 PERCENT VOLUME = 63.5 TEST TYPE = STANDARD NOV 1, 1999 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 386? PERCENT VOLUME = 38.1 TEST TYPE = STANDARD IN-TANK LEAK DIAGNOSTIC PROBE DIAGNOSTICS T 6: PROBE TYPE MAG1 SERIAL NUMBER 384832 GRADIENT = 351.0200 NUM SAMPLES = 25130 CO0 1330.1 CO1 17856.8 002 17856.8 C03 17856.9 C04 17856.9 C05 17856.9 C06 17799.6 CO? 17799.6 C08 17799.'5 C09 17799.6 CIO 17799.5 Cll 44299.4 012 14586.1 013 14041.0 C14 14485.0 C15 14747.1 C16 15261.8 C17 15538.0 018 44299.8 IN-TANK LEAK DIAGNOSTIC PROBE DIAGNOSTICS T 4: PROBE TYPE MAG1 SERIAL NUMBER 384833 GRADIENT = 350.6200 NUM SAMPLES = 61987 COO 1342.3 CO1 18037.2 C02 18037.2 C03 18037.2 C04 18037.2 C05 18037.2 C06 22846.9 CO? 22846.9 008 22846.9 009 22846.9 ClO 22846.9 Cll 44401.4 012 17256.8 013 15896.4 Ct4 16129.? Ct5 16449.8 016 16640.1 Cl? 16684.5 018 44403.1 TAN~ LEAK TEST HISTORY T 3:UNLEADED LAST GROSS TEST PASSED: MAY 6, 2002 1:00 AP1 STARTING VOLUME= 3142 PERCENT VOLUME = 26.1 TEST TYPE = STANDARD LAST ANNUAL TEST PASSED: NO TEST PASSED FULLEST ANNUAL TEST PASS NO TEST PASSED LAST PERIODIC TEST PASS: SEP 3, 2001 l:O0 APl TEST LENGTH 2 HOURS STARTING VOLUME= 3214 PERCENT VOLUME = 26.7 TEST TYPE = STANDARD FULLEST PERIODIC TEST PASSED EACH MONTH: MAR 6, 2000 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 3032 PERCENT VOLUME = 25.2 TEST TYPE = STANDARD APR 2, 2001 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 2701 PERCENT VOLUME = 22.4 TEST TYPE = STANDARD JUN 7, 1999 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 5173 PERCENT VOLUME = 43.0 TEST TYPE = STANDARD AUG 7, 2000 I:00 AM TEST LENGTH 2 HOURS ., STARTING VOLUME= 2703 ".: PERCENT VOLUME = 22.5 " TEST TYPE = STANDARD SEP 3, 2001 1:00 APl TEST LENGTH 2 HOURS STARTING VOLUME= 3214 PERCENT VOLUME = 26.7 TEST TYPE = STANDARD OCT 2, 2000 1:00 AM ]'EST LENGTH 2 HOURS BTARTI NG VOLUME= 3019 PERCENT VOLUME = 25.1 ' ['EST TYPE = STANDARD FULLEST PERIODIC TEST PASSED EACH MONTH: MAR 6, 2000 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 3579 PERCENT VOLUME = 44.2 TEST TYPE = STANDARD APR 3, 2000 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 2881 PERCENT VOLUME = 35.6 TEST TYPE = STANDARD JUN 4, 2001 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUIdE= 3235 PERCENT VOLUME = 39.9 TEST TYPE = STANDARD AUG 7, 2000 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 3026 PERCENT VOLUME = 37.3 TEST TYPE ' STANDARD OCT 4, 1999 1:00 Aid TEST LENGTH 2 HOURS STARTING VOLUME= 2854 PERCENT VOLUME = 35.2 TEST TYPE = STANDARD IN-TANK LEAK DIAGNOSTIC PROBE DIAGNOSTICS T 7: PROBE TYPE MAGI SERIAL NUMBER 384133 GRADIENT = 351.3700 MUM SAMPLES = 25050 C00 1324.5 C01 19398.6 C02 19398.5 C03 19398.6 C04 19398,5 C05 19398.5 006 19387.9 CO? 19388.0 C08 19387.9 C09 19388.0 ClO 19388.0 Cll 44022.? C12 16791.6 C13 14553.9 C14 14586.? C15 14567.2 C16 14969.3 el? 15236.0 C18 44023.4 TANK LEAK TEST HISTORY T 1 :SUPREME LAST GROSS TEST PASSED: NOV 4, 2002 1:00 Aid STARTING VOLUME= 5021 PERCENT VOLUME = 62.0 TEST TYPE = STANDARD LAST ANNUAL TEST PASSED: NO TEST PASSED FULLEST ANNUAL TEST PASS NO TEST PASSED LAST PERIODIC TEST PASS: JUN 4, 2001 1:00 AM ..... TEST LENGTH 2 HOURS STARTING VOLUME= 3235 PERCENT VOLUME = 39.9 TEST TYPE = STANDARD ALARM HISTORY REPORT , SYSTEM ALARM ..... .PAPER OUT NOV 22, 2002 3:57 PId PRINTER ERROR NOV 22, 2002 3:57 PM BATTERY IS OFF JAN 1, 1996 8:00 Aid SYS SECURITY WARNING JUN il, 1999 9:58 AM ALARM HISTORY REPORT .... IN-TANK ALARM ..... T I:SUPREME OVERFILL ALARM OCT 25, 2002 4:19 AM OCT 23, 2002 6:54 PM APR 12, 1999 3:00 AM LOW PRODUCT ALARM DEO 24, 2001 10:58 AM DEC 5, 2001 9:16 PM JUN 26, 2000 9:07 PM HIGH PRODUCT ALARM JAN 2, 1999 10:18 AM INVALID FUEL LEVEL DEC 24, 2001 12:11 PM DEC 5, 2001 9:06 PM JUN 26, 2000 8:38 PM PROBE OUT DEC 21, 2001 2:48 PM DEC 21, 2001 2:4? PM SEP 1, 2001 3:38 AM DELIVERY NEEDED OCT 10, 2002 8:51 PM AUG 5, '2002 -3:22 PPI APR 22, 2002 4:07 pM T 6:SUPREME LAST GROSS TEST PASSED: No T, ST PASSED LAST ANNUAL TEST PASSE NO TEST PASSED FULLEST ANNUAL TEST PASS:,::.:: NO TEST PASSED LAST PERIODIC TEST :'ASS::.",': NO TEST PASSED FULLEST PERIODIC TEST PASSED EACH MONTH: TANK LEAK TEST HISTORY T 7 =D I ESEL LAST GROSS TEST PASSED= NO TEST pASSED LRBT RN~URL TEST NO TEST PASSED FULLEST ANNUAL TEST PASS NO TEST PASSED LAST PERIOD,lC TEST NO TEST PASSED FULLEST PERIODIC TEST PASSED EACH IdONTH: ! t-4R.K L.b;RK TEST H I STORY 4 :PLUS '. LAST GROSS TEST PASSED: NOV 4, 2002 1:00 AM STARTING VOLUME= 6011 PERCENT VOLUIdE = 74.9 TEST TYPE = STANDARD LAST ANNUAL TEST PASSED: NO TEST PASSED FULLEST ANNUAL TEST PASS NO TEST PASSED LAST PERIODIC TEST PASS: NOV 4, 2002 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUIdE= 6011 PERCENT VOLUME = 74.9 TEST TYPE = STANDARD FULLEST PERIODIC TEST PASSED EACH MONTH: NOV 4, 2002 1:00 AM TEST LENGTH 2 HOURS STARTING VOLUME= 6011 PERCENT VOLUME = 74.9 TEST TYPE = STANDARD TANK LEAK 'rEST HISTORY T 5:UNLEADED . LAST GROSS TEST PASSED: NO TEST PASSED LAST ANNUAL TEST PASSED: NO TEST PASSED FULLEST ANNUAL TEST PASS. NO TEST PASSED LAST PERIODIC TEST PASS:· NO TEST PASSED FULLEST PERIODIC TEST PASSED EACH MONTH: IN-TANK ALARM · T 4 :PLUS OVERFILL ALARM NOV 9, 2002 3:41 AM OCT 26, 2002 10:39 PM HIGH PRODUCT ALARId OCT 26, 2002 10:41 PM IdAX PRODUCT ALARM OCT 26, 2002 10:42 PPI ALARM HISTORY REPORT .... IN-TANK ALARM T 5:UNLEADED OVERFILL ALARM NOV 22, 2002 4:02 PM NOV lB, 2002 ?:22 AM H~H~M HISTORY REPORT .... IN-TANK ALARM T 3:UNLEADED SETUP DAT~ WARNING JAN 2, 1999 10:20 AP1 OVERFILL ALARM OCT 27, 2002 10:34 PM OCT 2. 2002 2:56 PM AUG 22. 2002 8:49 AM LO~ PRODUCT ALARM NOV 13, 2002 6:41 PM NOV 7, 2002 7:09 AP1 NOV 2, 2002 1 '30 PI"[ SUDDEN LOSS ALARM AUG 5. 2002 2:39 AM APR 1, 2002 1:53 AM JAN 7, 2002 ~:0~ AM HIGH PRODUCT ALARM OCT 27, 2002 10:36 PM DEC 6, 2001 l:SS PM INVALID FUEL LEVEL NOV 13, 2002 7:01 PM NOV 7, 2002 7:26 AM NOV 2, 2002 12:36 PM PROBE OUT OCT 17, 2002 5:49 PM OCT 17, 2002 2:47 PM OCT 17, 2002 10:59 AM DELIVERY NEEDED NOV 16, 2002 5:04 PPi NOV 13, 2002 5:27 PM NOV 6, 2002 8:27 PM MAX PRODUCT ALARM OCT 2?. 2002 10=40 PM IN-TAN: ..... i"?, T 2:PLUS OVERFILL ALARId NOV 5, 2002 8:25 AM OCT 27, 2002 10:42 PM OCT 23, 2002 7:03 PM LOW PRODUCT ALARM DEC 12, 2001 3:47 Aid DEC 10, 2001 3:00 Pld OCT 26, 2001 4:46 PM SUDDEN LOSS ALARM OCT 1, 2001 1:46 AM JUN 4, 2001 2:19 AM PlAY 7, 2001 1:38 AM HIGH PRODUCT ALARM NOV 5. 2002 8:27 AM MAR 25, 1999 -9:12 Aid JAN 2, 1999 lO:lB AP1 INVALID FUEL LEVEL DEC 12, 2001 5:44 AM DEC 10, 2001 3:14 PM OOT 26, 2001 4:~7 PM PROBE OUT SEP 21, 2002 10:52 PM DEC 21, 2001 2:50 PM JUN 11, 1999 9:52 Aid DELIVERY NEEDED OCT 10, 2002 3:36 AM SEP 29, 2002 2:34 PM SEP 3, 2002 5:57 PM AL~Rfd HISTORY REPORT ..... SENSOR ALARM ~ 3:UNL SOUTH STP SUMP FUEL ALARM NOV 26, 2002 8:22 AM FUEL ALARM NOV 9, 2002 8:02 AM FUEL ALARM AUG 20, 2002 9:18 AM ALARM HISTORY REPORT O ..... SENSOR ALARId ..... L I:PLUS SOUTH STP SUMP FUEL ALARM NOV 26, 2002 8:34 AM FUEL ALARM AUG 20, 2002 9:16 AM FUEL ALARM DEC 28, 2000 9:56 AM ALARM HISTORY REPORT IN-TANK ALARM T 6:SUPREME ALARM HISTORY REPORT SENSOR ALARM L 4:SUPREME SOUTH STP SUMP FUEL ALARM NOV 26, 2002 8:26 AM FUEL ALARM DEC 28, 2000 9:56 Aid FUEL ALARM DEC 28, 2000 9:43 AM ALARM HISTORY REPORT ..... SENSOR ALARM ..... L 2:UNL-SUP SOUTH ANNULAR SPACE FUEL ALARM NOV 26, 2002 8:10 Aid FUEL ALARM DEC 28, 2000 9:55 AM SENSOR OUT ALARM JUN 10, 1999 8:02 AM ALARM HISTORY REPORT .... IN-TANK ALARM T 7:DIESEL OVERFILL ALARM OCT 23, 2002 5:49 AM HIGH PRODUCT ALARM OCT 23, 2002 5:51 AM DELIVERY NEEDED NOV 20, 2002 2:38 AM 09/28/01 07:45 ~661 326 0576 Make/Model or Monitoring Sy;tem:~ B. Inventory of Equipment 'l'este~Cerfified Check th~.app?ptlat~ ~oxes to indicate speeffic eq~pme~.~ ~speete~seNice~: ~ In-Tank Gauging Probe, ~ Model: __ ~Piping Sump / Trench SensoKs). Model: Q Fill Sump Scarer(s). M~eI: O Mechanical Line L¢~ Detector. Model: ~ Etec~onic Line Leak Delector. Model: ~ Tank Overfill / High-Level Sensor. Model: ~ Other (specify,eq uipment t~e ~d model in Section g on Page 2);. _ ln-Tank Gauging Probe. ' Model: . . ~mul= Space or Vault Sensor. Modeh ~_ ~ping Sump / Trench Sensor(s). Model: ~ Fill Sump Sensor(s). M~eI: ~ Mechanical Line Le~ Detector. Model: ~ glec~onic Line Le~ Detector, Model: ~ ~ Ta0k Ove~ll / High-Level SensOr, Model: ~ Other (s~ciN equipment woe and model in Section g on Pa~e 2). Dlspemer ID: ~penser Cont~nment Sensor(s). Model: ~She~ VMve(s). ~ Di~eqset Containment ~oat(s) and Chain(s). BFD HAZ 3IAT DIV 1~002 MONITORING SYSTEM CERTIFICATION For Use By All J,tri.s'di(.'nr;ns Witttt'.,~ ~he State e;f C'cll~forniel Authority Cited: Chap,'er 6.7. Health' anc] Sq/~ty Code.. C}mpter /6. Divixirm 2. Title 23, CaliJbrnia Code of Re.qulatio,~s This form must be used to document testing and se~icing ot'~monitoring equipment. A separate certification or repo~ ~ared (or eac~0~ torin~ system control ~ 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 ~opy pt' th~s tb~ to the local agency regulating UST systems Tithing0 days of test date. : A.. General Information . Contact Phone N'o,: Date of Tesdng/Se~icmg: .///~ ,¢~ Di, nser m: 3/q ,Zl D~penserContainment Sensor(s). Modeh ~ear Vah, e(s). ff..J Dispenser Cor~taJnment'Float(s) and Chain(s). Dispenser ID: '~-'~ .... r~ ~,,~'penser Con--tn,~nmen t Sen sor(s)'-~--,',Si o'~ e'-[:"~ i]..I/;~S hen r "qDispen. ser Containment Float(s) and Chain(s). -If the faciliw contains more tanks or dispensers. enser Containment Sensor(s). r Valve(s). ,2 Dispenser Contai~n~,f~nt Floa~4s/ and Chain(s). Dispenser ID: ~ US Dispenser Containment Sensor(s). Modeh ."1 Shear Valve(s). [] Oispen.?er Containment F'loat(sI and Chain(s). copy this form. Include infommlion for ever3.' tank and dispenser at the facility. Tank ID: * _._.,~:::~"'¢.,'t,,~-¢~ __..~.../0~.,¢> ~ [.3 In-Tank Gauging Probe. Model: E!P~'finula; Space or Vault Sensor. Model: ~'~; 9' ::~ ,, ~Q4"~'ping Sump / Trench Sensor(*). Model: · .- .- .- .-~' L/ .~, ~' ___ ~ Fiji Sump Sensor(s), Model: [] Mechanical Line Leak Detector. Model:' [] Electronic Line Leak.. Detector. Model: ~1 Tank Overfill / High-Level Sensor. Model: ~ Otker (specify equipment type and model in Section E on Page 2). ~ I~Ta~k Gauging Probe. Model: ca-~,rmutar Space or Vault Sensor. Model: ~'*~'"~ ~----'~'~ E~Piping Sump / Trench Sensor(s), Model: 0 Fill Sump Sensor(s). Model: C] .Mechanical Line Leak Detector. b'lodel: [] Electronic Line Leak Detector. Model: ~ Tank Overfill / High-Level Sensor. Model: I r'l Ot.he~' (specify. equipment type and model in Section E on Pa~e 2). Dispenser ID: .... ~/{~::~ ........ ~,J.~ispenser Contamvt(ent Sensod, s). Model: lifS hear Val ge(s). '2 Dispenser Cpntaif~ment Float(s) and Chain(s). _ Dispenser ID: Model: (2. Certification. I certify that the equipment idend/'ied in.this document ,,'as Inspected/serviced in accordance with the manufacturers' gtfidelines, Attached to this Certification is Information (e.g, manafac~rers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring eqtttp_.~ent. For any equipment capable of generating such reports, [ have also attached a copy of the reportir(.~eck all tI~_. apply): ~stem set,up, Technician Name (print): /O~.~ ~~.-t¢.~ .... Signature:_ [/'..a'7,~ Certiticadon No,: q7~-?'¢~ License, No.: ~ Testing Company Name: ,,~i'"°'~,3"~r/'~ ./9~O-Cl/ Phone No.:('.~'/' Monitoring System Certification Page I of 3 03101, 07:46' '~661 0576 BFD HAZ 31AT Dig" 003 D, Results of'resting/Servicing Software Version ~staUed: Complete the followin checklist; C] No.~ ' Is the visu..._.9.al alarm., ope.r,ational? ' ' , ........ ~ ffes C~ No* Were all sensors visually inspected.? t'uactional_]ly tes.t.ed..and confirmed operational? · ~Yes {~ No* Were ail sensors installed at lowest point of secondary containment and positioned so that other equipment not interfere with ~.heir proper 9peration'!_ _ [] Yes ?,~* If alarms are relayed to a remote monitoring' station, is ali' ~'ommunications equipment (e.g. 'modern) ~ N/A operational? (~ff:Yes' Q No* 'FOr pressurized piping systems, does the turbine automatical'ly's~ut"~0wn if the piping secondary coniainme'nt ~ N/A I monitoring system detects a leak, fails to operat~[~..~r is electrically disconnected'?. If yes: which sensors initiate positive shut-down? (Check all that apply) [] Sump/Trench Sensors: ~ Dispenser Containment Sensors. _ Did you.qonfirm positive shut-down due to !eaks ~ sen. sor failure/disconnection? t~es: 121 No., . [] Yes _~kNo, I For tank systems that utilize the monitoring system as the Primary tank overfill warning de, ice (i.e. nc> ti~N/A mechanical overfill prevention valve is insralled), is the overfill warning alarm visible and audible at the tank . fill. poin. t(s) an__d 0perating properlz? If so, at. what percent of tank capacity does the alarm tr. igg.~t? ~% I~1 Yes* ~0 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 arts in Section E, below. ,"q Yes* ~'~"'o Was liquid found inside any secondas-y containment Systems designed as dry systems? (Check all rhat"a/~ply) D Product; r~ Water. If yes, describe causes in Section E, below. )es,,,,t ia o w= , ._. monitoring system set-up reviewed to ensure proper settings'.* Attach set up repons, if applicable .. I: K[ Yes ] No'" Is all..monitoring .e~y!.p..m..e. nt operational per manufacture~,'.s specifications? ....... * In Section E below, describe how and when these deficiencies were or gdll be corrected. E. Comments: Page 2 of 3 03101 09/28/01 07;47' '~661 0576 BFD HAZ MAT ~004 F. In-Tank Gauging / SIR Equipment: .'a Check this box it' tank gauging is used only for inventory control. 'q 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. Corn )lete the folloWing checklist: Vis [ ,~>* [ Has all input wiring been inspected lbr proper eats' and termination, including testing for ground fauhs? Yes ~ No'~ ~1 tank gauging p~bes visually inspect'ed for damage and rekidue buildup? Yes c...3 No* Was acc~ product ievel readings tested'? Yes ID No* / Was accuracy of system~ readings, tested? Yes ]U_.I No*/ Were all probes reinstalled prooedy?'"'"'"'-~ '" Yes"LID No* Were all items'on the equipment: '"~'manufacturer's'"~tenance ch'~klist comp'lei;d?' ', describe how'and when these deficleneies were or will be corrected. G, Line Leak Detectors (LLD): Cl Check this box ifLLDs are not installed. Corn dete the follow!ag chee.klist: J:~/Yes ~' No* ~For equipment start.up or annual equipment certification, was a leak simulated to verify LLD performance, C3 N/A (Check all that apply) Simulated leak rate: [~'~g.p.h.: CI 0.1 g.p,h; ~ 0.2 g.p.h. , l~'"'Yes ~ No* Were all LLD~ confirmed operational m'~d accurate within regt~latorv requirements? [3"~s CI No* 'Was the testing apparatus properly calibrated? [~"Yes ~ No* ~'o~"mechani~al LLI'~s, does the LLD restrict product flow' if it detects a leak? ,'n N/A t I.~ Yes ~i ~'~J'r electronic r,LDs, does the turbine automatically shut or'if the LLD d;tects a leak? ~ Yes ~N/A For ele~onic LLDs d;es the"iu'rbine"automatically shut off if any porti'~)n of the monitoring system i's disabled or disconnected? ~ Yes ~,,,blo* For electronic I'.LD~"does the turbine automati'cally shut off if any pc~rtion of the rn~nitoring system malfunctions {~' N/A or fails a test'? "~ 'Yes ~ * ~/' '~N/,~ For electronic LLDs, have all accessible wiring connections been visually inspected? ~[' Yes .Z] No* Were' all items 4'n the equipment manufactm'er's maintenance checklist completed? * In the Section H, bel.ow, describe how and when. these deficiencies were or will be corrected. ti. Corrmmnts: Page 3 of 3 03/01 Monitoring System Certification Site Address: UST Monitoring_Site Plan Instruction If you already have a diagram' that shows-all reqUired information, .you m~y"ificlude 'it, raiher"than'~s page, w/th your Monitoring Sy~i~'iC'~ifiC~'~i;~'?.':' On YOur.'" ~t'~.'~'i~!~;':sh~ locations, of the 'foiioxiAng equipment, if installed~]!:?fi'iahitaring ~s~)~tem.,~'~! pan'e!S;.~'.se~Prs..~Oin[[9,r~.:..g.~,.ann,u_i2 spaces, sump}', dis-peris'er' pans; SPill containers, °r °ther S~c°ndar;j ~6ntai~i~f ~/reas:, mecnahieat or'etectrom¢ detectors; and in-tank liquid level probes (if used for leak detection), In ~'6"Space providedl note the date this site Plan · .. . · . ... ',;,,,: ..... ~.: · v' : :.'.' ! ....... ' was prepared. ' ' ..... ~:::..: ' ?. .'.?:~: .:~. ~ .' . .:..'~ '? :...:... · .. Page of :' /:'"" ::':.:i.::' :".(: ?::':': ' ;') :::' :i'i"' ':" "? "i::...' .::':. · , .' OS,'Oo · ...'"... ". '..-~ ""."; '"' .~.."i:'~?'~;?-.-",%.~f:: ."W'2'% '. ; · !' .. '..' "' ~'~ ..... "': ::~':' '"" ' '"':':. ~...?~".'.:~'~ ~" ' ..: '~:.5;".:." :' : :' '*' '?'.:;::" 'i~::;"~,~;q,~:':?!~¢?.;'.~4:~' '" '~'"~'~"'" ~ ~":~' '~"~':""~:~"'"./:' .'~'"".;, · : , .'. '' ' : ' '.' ~ :' ' :,.,, ,.. ':. :~..':q;:;;g. · :"': ":' ":'::" '? ""':' ~: :"~,'; ":~: ;';:!'~';;':"'.~'.::: '::: :'"i .:' ' .' ':' ...."::']":" '"'" : "'.. ,:.. ':. '.. 2.o. ",~.',: ,.':.~,L¢,k'/;¥N.',:,'~,'".L;.z~':."~'~.".:';.:t~.' '.TM '~:>.'."~ ~':',::;' .:"" , : " $YSTEM UNITS U.S. SYSTEM LANGUAGE ENGL I SH SYSTEM DATE?TIME FORMAT MON DD YYYY HH:MM:S$ xM CARDLOCK CHEVRON 2317 L ST. BAKERSFIELD SHIFT TIME ! : DISABLED SHIFT TIME 2 : DISABLED SHIFT TIME 3 : DISABLED SHIFT TIME 4 : DISABLED TANK PERIODIC WARNINGS DISABLED TANK ANNUAL WARNINGS DISABLED LINE PERIODIC WARNINGS DISABLED LINE ANNUAL WARNINGS DISABLED PRINT TC VOLUMES ENABLED TEMP COMPENSATION VALUE (DEG F >: 60.0 STICK HEIGHT OFFSET DISABLED H-PROTOCOL DATA FORMAT HEIGHT DAYLIGHT SAVING TIME ENABLED START DATE APR WEEK 1 SUN START TIME 2:00 AM END DATE OCT WEEK 6 SUN END TIME 2:00 AM RE-DIRECT LOOAL PRINTOUT DISABLED SYSTEM SECURITY CODE : 000000 SENSOR ALARM ..... L l:B9 NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:51 PM ..... SENSOR ALARM ....... L g:87 NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:53 PM CARDLOCK CHEVRON 2317 L ST. BAKERSFIELD NOV 26. 2002 3:04 PM SYSTEM sTATUS REPORT ALL FUNCTIONS NORMAL SYSTEM SETUP SENSOR ALARM ..... L 2:89-87 NORTH ANNULAR SPACE FUEL ALARM NOV 26, 2002 2:46 PM ..... SENSOR ALARM L 6:91-DIESEL NORTH ANNULAR SPACE FUEL ALARM NOV 26, 2002 2:47 Pti SENSOR ALARM L 4:91 NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:49 PM ...... SENSOR ALARM ...... L 5:DIESEL NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:50 PM NOV 26, 2002 3:04 PM · ...... ~ SSFTWARE REVISION LEVEL VERSION 16.05 SOFTWARE~ 346016-100-F CREATED - 90.08.21.18.55 NO SOFTWARE MODULE SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS LIQUID DIAGNOSTIC L 1:89 NORTH SAMPLES: 5 LOW REFI= 792 HIGH REFI: 5365 VALUEI= 100137 L 2:89-87 NORTH SAMPLES= 5 LOW REFI= 791 HIQH REFI= 5351 VALUEI= 100034 L 3:87 NORTH SAMPLES= 5 LOW REFI= 791 HIGH REFI= 5363 VALUEI= 99859 L 4:91 NORTH SAMPLES= 5 LOW REFI= 791 HIGH REFI= 5360 VALUEI= 100128 L 6:91-DIESEL NORTH SAMPLES= 5 LOW REF1= 791 HIGH REFI= 5366 VALUEI= 98925 L 7: SAMPLES= 5 LOW REFI= 791 HIGH REFI= 5864 VALUE1= 14743654 L 8: SAMPLE~= E I~UID SENSOR SETUP L 1:89 NORTH TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 2:89-87 NORTH TRI-STATE (SINGLE FLOAT> CATEGORY : ANNULAR SPACE L 3:87 NORTH TRI-STATE (SINGLE FLOAT) · CATEGORY : STP SUMP L 4:91 NORTH TRI-STATE (SINGLE FLOAT> CATEGORY : STP SUMP L 5:DIESEL NORTH TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 6:91-DIESEL NORTH TRI-STATE (SINGLE FLOAT> CATEGORY : ANNULAR SPACE OUTPUT RELAY SETUP R I:POS SHUTOFF NORTH TYPE: ...... STANDARD NORMALLY CLOSED , LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM ,UNICATIONS SETUP PORT SETTINGS: COMld BOARD : 1 <RS-232> BAUD RATE : 1200 PARITY : ODD STOP BIT : I STOP' DATA LENGTH: 7 DATA AUTO TRANSM I T SETT I NOS: AUTO LEAK ALARId LIMIT DISABLED AUTO MI~W ~AT~P LIMIT AUTO OVERFILL LIMIT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIIdIT DISABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DISABLED AUTO EXTERNAL INPUT ON DISABLED AUTO E×TERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARM DISABLED RS-232 SECURITY CODE : ~N~ RS-232 END OF IdESSAGE ALARM HISTORY 'OAT ..... SENSOR A ...... L 2:89-8? NORTH ANNULAR SPACE FUEL ALARM NOV 26, 2002 2:46 PM ALARM HISTORY REPORT ...... SYSTEM ....... BATTERY IS OFF JAN 1, 1996 8:00 Aid ALARM HISTORY REPORT ..... SENSOR ALARM ........ L 3:8? NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:53 PM ALARM HISTORY REPORT ...... SENSOR ALARIfl ..... L 1:89 NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:51 ALARM HISTORY REPORT ..... SENSOR ALARM ...... L 6:91-DIESEL NORTH ANNULAR SPAOE FUEL ALARM NOV 26, 2002 2:47 PM ALARM HISTORY REPORT ..... SENSOR ALAW- .... L 4:91 NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:49 PM CARDLOCK CHEVRON 2317 L ST. BAKERSFIELD NOV 26, 2002 3:05 PM ALARM HISTORY REPORT ..... SENSOR ALARM L 5:DIESEL NORTH STP SUMP FUEL ALARM NOV 26, 2002 2:50 PM SYSTEM STA'rus REPORT ALL FUNCTIONS NORMAL ':/~]~,CB, January 2002 Page ~ of_ "? _ Secondary Containment Testing Report Form This form is intended for use by contractors performing periodtc testing of UST seconda~y containment systems: appropriate pages Of thls form to report results for all components tested. The conipteted form, written te~'t procedure2', and printouts from tests (if applicable), should be provided to the faciliO' owner/operator for submitud to the local regulatoD: agenqy. 1. FAC!LI~ INFp,~ATION Facili~ Ad,ess: Z~m. ~ Faci~ ~ntact: I Phone: Date Local Agency Was Notified &Testing: Name of Local Agenc3,] In-qpector Of?resent during testmgY: 2, TESTING CONTRACTOR INFORMATION ,Com,.pany Name: 'dt~to,qg~r. Tectmician Conducting Test: Credential-q: ~'CSLB Licensed Contractor ~ SWRCB Licensed Tank Tester e...- 6~ ~"1 .~icense Number; ~ q 7 License Type: Manufacturer Manufacturer Tr,aining Component(s}, Date Training Expires 6 3. SUMMARY OF TEST RESULTS ' ~ ............ ! No't ! Re'pair~ Component Pass Fail~TestedN°t RepairSMade Component /ass Fail ( Tested ,','lade O O O O O 0 O O ~ I ~ O O 0 O 0 O If hYdrosta- tic 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 itt t/tis document are accurate and in full compliance with legal requirements Technician's Signature: ~.,~ ~ Date: It SWP. CB, January 2002 pag¢_~.~oC 7 , 4. TANK ANNULAR TESTING Test Method Developed By: ~'Tar~k Manufacr.::~- 0 Industry Standard ,q Professional Bngin¢cr ~, O~er (Spec!5') :_ - Te~t Me~od Used: E Presto ~ Vacuum . Hydrostatic ~ Other (Spec~) Tank Is Ta~ Exempt From Tested?~ E Yes ~ No ~ Yes ~o Q Yes ~ No Q Yes E No~ T~ Capacity: l0 Tank Material'. Ta~ M~ufac~er: ~'~ Pr~uct Stored: ~.,~/~J [ ~~'~/Oi~' a _ Wait ~e be~e~ applying stag test: Test End Time: C~e in Read~g (R~-R0: Pass. ail ~eshold or Criteria: -- Test Reset; ~ Pass ~ Fail ~ Pass D Fail ~ Pass ~ Fail U Pass G Fail -Was sens°r pr°perly replaced and ~Yes 0No UNA ~Yes ~No CNA I~Y~ CNo ~NA ~Yos ~No O'NA verified ~fional aft~ }ester? ,. Comments - (include information on repairs made prior to testin& and r¢cornmend_.ed folloW-up for failed tests.) ~ Secondary contairmaent systems where the continuous monitor/nd automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic contairunent testing, (California Code of Regulations, Title 23, Section 2637(a)(6)) SWRCB, January 2002 Page ._~ of_ ~ 5. SECONDARY PIPE TE$~ING Test Method Developed By: i~l'Piping Manufacturer [3 induslry Standard· [] Professional Engineer ~ Other (Specify) 'l'e~t Method Used: ~ Pressure ~ Vacuum ~H~,drostati¢ 0 Other (~.pe.c05,) "', 13quip[nent Resolution: ~ O~'2. ~' '--- Test Equipment Used: ~c.o . $ - 5"r~ ' Piping Manufacturer: tlg tO t~ t /'~.o ~0 t.~to vi/~e~ ~ ~ t~/ lr / ,C O j~ ~ l~ t/ ! ~ o NI , Length 0f Piping Run: '~ ;5'cs ~ M~thod and location of 'r'~'r~3ooT' -O=~T~oo-/- Wait time bem'een applying pressure/vacuum/water and ~ 0 ,~ ~ ~ starting te,t: Test Result: ~ Pass ~ Fail ~ Pass ~ Fail ~ Pass ~ Fail ~ Pa~s O Fail Comments -.(include information on regatrs made pr.~?r to re. sting, and recommended f. ollow-u~.,/br failed, tests) SWRCB, January 2002 Page 6. PIPING SUMP TESTING Tesi Method Developed Byi ~ Sump Manufactmer U Industry Standard D Professional Engineer [] Other ($PeC~tg) Test Meth'od Used: [3 Pressure ~ Vacuum ,~Hydmstatic ~ Othe~,(Specify) Equipment Resolution: "2'_. Sump Diameter: ~./4/ °' ..t--/~t" Height from Tank Top ~o Top of H'eight fr°m Tank T°P t° L°~:e~' "[ i] Electrical Penelxation: t ~I Co,,aifion of s-rap prio.r to testing: ~'ocxO PorfionofSumpTested~ * Z4" ~ 'Z.e'W" ~ -~ ~_.~" + 7_..q.." Does turbine shut do'~'a when sump sensor dete¢l~ liquid (both ~Yes ENo QNAi ~l. Yes ENo .qNA ~"Yes UNo DNA l~Yes ONe UNA product.and water)'?' Turbine .~hutdown resporme time ~ to .~;. -- · -- _ i~'systemprogrammed for fail-safe JgYes ONe ~NA ,l~Yes ENo ENA ~Yes ONe ;~NA ~x'es ENo ENA shutdown?' . Was fail-safe verifled to be ,~Yes [3No CNA .lg. Yes C~No GNA j~¥es ~No ONA 2i~Yes ENO El'dA operational?' , ~" -- Wait time between applying' ' pressure/vacuum/water and starting I ~3 nn , Test Start Time: qt: 9_ e4. Test Duration: ..... 1 ~.__LaA ~ v~1. l <,[ e., t r,d ! ] ,<; ~, ~ l .ff ~q, aa __ -Test Result: a Pass [] Fail ] t~' Pass [] Fail .~ Pass (2 Fail ,~ Pass [2 Fail Was sensorremovedfortesti~g? ~r'Yes ~.No C, NAI ,~Yes ENo ENA [ .l;Z~res DNo....tuNA ,~Yes [}No ,miNA Was sensor properly replaced and-- ,d3i, Yes UNo 2 NA i ~cs []No ~2NA i ~Yes t'3No ~NA ~(Yes [2No ~ NA verified fimctional after,, testing? , ~ ..... Comments - (inchtde information on re[naars made prior to re~'fing, arm recommendedJbllow-ulv,/br.failed test~.') ~ If the entire depth of the sump is not tested, specify how much was tested. If the answer to any of the questions ind/cated with an asterisk (*) is "NO" or "NA", the entire sump mus~ be tested. (See SWRCB LG-160) SWRCB, January 2002 Page ._~ of_~.... 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING ~Test Method Developed By: ~KT/DC Manufacturer .3 Industry Standard ~ Professional Engineer [20~er (S1)eclfy) ~ Test ~ethod Used: [-1PreSsttre ,3 Vacuum ~ Hydrostatic. [3 Other (Specif39 Equipment Resolution: ~ Oo Test ,E, quipment lJsed:, ..~ ,o ~_e~.~.a ._.?$ - _K-r.</ ......... , ....... ..-.,; ._~ ...... ...................... _ ,-,,..r--UDC # / ,5', - t 6 u~c # t? - Lc~ uno # I CrDC # UDC Manufacturer: ....... ~r~,,/~Zo,,~ .... ~o. t~/.~2,o la -- UDC Material: ?t-,~ ~-/~_ pz~ .~7'/~ .... Height from UDC Bottom t~; Top -~ -e- ! ~ ofHith~s~ Pipin§ Penetration: -' ~ ~-" -~ " - Height from UDC Bottom to ..~. ~ .. .~. (~ .. ,,L°west Electrical P~ne~ation: -~ ,. , ' ... Condition of UDC prior to Portion of UDC Tested' ' ~ ,~t~" ~ 3o" ._ Does turbine shut down when UDC,ensordptectsliquid(both ~Yes ~No ,It'NA ayes DNo ,tfLNAi OYes ?2No ~NA OYes ONo ~.NA product .and...wat. er)?'I [ TUrbine shutdown response time ~/-q ~'/.q .[ ] .. Is sys'iem programmed for fail- safeshutdov~?' ,~Yes 9No 0NA ~'Yes ONo UNA CYes []No []NA ~Yei ~No []NA Was fail-safe Verified to be /~Yes O, No ONA l~Yes ~No UNrA UYes rZNo [2NA []Yes UNo f2NA opera, tional?' . ........... Wait tithe between applying pressure/vacuum/water and starting cest (~ o M , ,~ ~ ~,, ,v~) Test Start Time:" ~: [ q ,a M . ¢/: t c~ ~ ~ _ "Initial Rea~ing (Ri): ~g. n :~ 8 3" 5. (~ ~) I ,3 Test End T~e: g; ::l/4 ^ t,, I;I '. g ~- .~ L., Test Duration: 15' ~,W /~ ~ ~ _ ~ange in Reading 'iRt-R,): - ...0O°'7_ o- _.. OO O ~ ~- .... Pass/Fail Threshold or Criteria: --~ · c~O 2." '~. o o %.. ' ' Test Result: ~ Pass [] ~'.a[l I~' Pass ~ Fail ~ Pass ~ Fail [~ Pass ~ Fail Was sensor removed for.testing? ~ Yes [3'No ~NA [] Ye.q.. ~ No ~:NA . ~ Yes.. 0 No 0 NA , ~ Yes [] No ~ NA Was ,ensor properly replaced and verifie, dfunqtlonalaf'tertesfing? ~¥es [[]No ~[NA UYes 2No ,~NA, ~Yes,._~No.,,rNA_ 'rYes ~No Comments-- (include itlform~_ation on repa[rs.made prior to testing, and recommpnded fo.l(ow-u, p for,failed tests) ~ If tho entire depth of the UDC is not tested, specify how much was tested. If the answer to a_kqSf of the questions indicated with an asterisk (*) is "NO" or ';NA", the entire UDC must be tested. (See 8WRCB LG-160) SWRCB, January 2002 Page ._~ of 8. FILL RISER CONTAINMENI SUMP TESTING Facility is N e er ntai~ nt Sumps Fill Riser Contain,eat S-raps are Present, but were Not Te?ted' ~ ....... -Te;t Method Dev~'i~Ped By: [] Sump/~lanufacmrcr [] Industry Standard U Professional Engineer ~ Other (Specify), Test Method' Used: D Pressure D Vacuum E Hydrostatic C) Other (Specif?.? ...... Test Equipment Us'ed; Equipment Resolution:. Sump D~ameter ..... .... --' Sump .Depth: Height from Tank Top to Top of Highest piping Penetratio.n: Height from Tank Top to Lowest ,,~ Ele. ctriea,1 Penetration: _.. .,./" ./ I , .. Condition of sump prior to .... Sump Material: i .... press~re/vacuam/waier and Tes~ $~an Time: Initial Read)bp (R,); ,,, / I x'k ..... TesT End Time: ' /! ' "._~ ..... Final Re, adin~ (R~): _L ./ ~ , ..... Test Duration: ,, . ..... Ch~n~e/~ Reading (R~-R~): Pa,,,dFai! Threshold or Criteria: ,/ .., Test Result: [] Pa~ [3 Fail ' j .~ Pass "rn Fail ~ Pass El Fa, il , [] Pass 13 Fail i~'there a sensor in the .qump.~? E ~es ~"'i%] O Y~,s. ,~ No E Yes [5 No U Yes D No ' Do~ the aensor alaml when either product or water is O Yes ~ No [3 NA E~ Yes E No E NA E Yes .U No E NA D Yes ~.'3 No ¢NA detected? Was sensor removed for testing'? E Ye~ E No E NA [3 Yes ~ No"-E NA [] Yes E No L-)NA .~ Y..es [] ~o. []'NA Was sensor properly replaced and verified fimctio~,l, after test/nfl!, ri Yes '~ No ~ NAt C: Yes , ~ No E 1'4~,~ ,? Yes,, E No E NA, [21 Yes ill No U. NA Co m m ents- (i~cl:~rl~ in, forms tio~'t o n reps it~' m adc .prior '..o textin,g, a~' d reco m m et~ ded,fo ilo w- uD./b r failed tests) SWRCB, Sanuary 2002 Page~ of_~7 9. SPILL/OVERFILL CONT.IlNMENT BOXES ' Not'~ ................ Facilit~ is . quipped With Spilt/Overfill Containment .Boxes ~' Spi!l/Overfill Containme.nt Boxes axe Present, bu,t were .No, t Tested U ....... Test Met. hod Developed By:' ii'Spill Bucket Manufacturer ~ Industry Slal~dard .... 2, Professional Engineer c .o~r (Sp,ci~) ..... Test Method Used: " .~ Pressm-e C Vacuum '~Hydrostati¢ U Other (SpeciJ~') Spill tto.~_,,~_.~ # ! Spill Box # ~ ; Spill Box Ct ~ Spill Box # ~ t2 " .12- " ~'--- Bucket Diamemr: ,/~_. " . ........ .l 2" S~k~ D~ik t 3,." 13 "' ! 1 3_" / 3" '"Wait time between applying ....... pressure/vacuum/water and 1o ,,~ . ~t~ ] D I~ , ~,~ ]0 ~.,~ , ~ I ?0 starting tes~: = . ~_Final.l~eading.(Rr): '2.., 7"7~3 _~_ . 3;..~'gS~ "'... q/, X'X'rq_" ~'. /ZIP...." TestDuraoon: /~'._ ~/~.~ ... l~ ~.~ ,~ /~ ~k.,~-~ ~.<~ ~'LS.m cMngeinReading(l~r'R0: --. OOC~.~ "* I '/-, ~rlOI" ~ - · OOO /. Pass/Fail Threshold or '-~ Oo"z ' ' -~' ' ' '~- · Oo ~ '" "~ o o Z ' Criteri~a.L _ __ ~.., _, . o O2_ .~ _, _ ---- , Test Result; .18 Pass ' [~ Fail 1~' Pass ~ Fail 1~ Pass O Fail ~..Pass ~ Fail Comments - finclude informatio{'t o,_~ repairs made prior fo testing, and r¢comm endedJbl!ow-u? for failed rcs. ts) .a4. o,v' ~' . DONNTONN CHEUR£ 2317 L STREET BAKERFEILD CA 93301 1-661-322-0660 !1/26/2002 5:81 PM SUMP LEAK TEST REPORT SUMP-3 TEST STARTED 4:24 PM TEST STARTED 11/26/2002 BEGIN LEVEL 6.1210 IN END TIME 4:40 PM .... ND DATE 11/~6/~08~ END LEVEL 6.1293 IN LEAK THRESHOLD 8.802 IN I' TEST RES]LT PASSED DOYNTOWN CHEVRON 2317 L STREET oMK:.'~FEILD CA 93381 11/27/2882 8:34 AM SUMP LEAK 'TEST REPORT D I3-16 TEST STARTED 8:19 AM TEST STARTED 11.2,.200z BEGIN LEVEL 6.0383 Itl END TIME 8:34 AM END DATE 11/27/2802 END LEVEL 6.8381 I~ LE~K THRESHOLD 8.082 IN TEST RESULT PASSED D 17-20 TEST STARTED 8:19 AM TEST STARTED tl/27/2002 BEGIN LEVEL 5.6713 IN END TIME 8:34 AM END DATE 11/27/2882 END LEUEL 5.6785 IN LEAK THRESHOLD 0.082 IN TEST RESULT PASSED OOWNTOWN CHEVRON 2317 L STREET ~AKERFEILD CA '93381 1-661-322-0660 11/26/2002 4:40 PM SUMP L. EAI< TEST REPORT SUMP-i TEST STARTED 4:24 PM TEST STARTED 11/26/2082 BEGIN LEUEL 6.1210 IN END TIME 4:48 PM END DATE 11/26/2002 END LEUEL 6.1283 IN LEAK THRESHOLD 8.802 IN TEST RESULT PASSED SUMF'-2 TEST STARTED 4:24 PM TEST STARTED 1t/26/2082 BEGIN LEUEL 6.8200 IN END TIME 4:40 PM END DATE 11/26/2002 END LEVEL 6.0198 IN LEAK THRESHOLD 0.082 IN TEST ~I''~ ,.b.)JLI PASSED SUMP-3 ~ ._,TMR,~D 4:24 PM T~T c ~ T~ TEST STARTED 11/26/2002 BEGIN LEVEL 3.4640 tN END TIME 4:40 PM END DATE 11/26/2082 END LEVEL 3.4686 IN LEAK THRESHOLD 8.882 IN TEST RESULT INCREASED SUMP-4 TEST STARTED 4:24 PM TEST STARTED I1/26/2002 BEGIN LEVEL 5.2511 IN END TIME 4:40 PM END DATE 11/26/2002 END LEVEL 5.2314 IN LEAK THRESHOLD 8.882 IN TEST RESULT PASSED DOWNTOWN CHEURON 23!7 L STREET ~AKERFEILD CA 93301 1-661-322-0660 11/26/2082 3:30 PM SUMP LEAK TEST REPORT OFB-i .m- o~MR,ED 15 PM TEST STARTED 11/26/2802 BEGIN LEVEL ~.~,7o IN END TIME 3:30 PM END DATE 11/26/2082 END LEVEL 2.7773 IN LEAK THRESHOLD 8.882 IN TEST RESULT PASSED OFB-2 TEST STARTED 3:15 PM ~T ~ 11/26/2002 TED, o,~RTED BEGIN LEVEL 5.5258 IN END TIME 3:30 PM END DATE 11/26/2002 END LEVEL 3.5259 iN LEAK THRESHOLD 0.002 IN ,EoT °COl! ~ PASSED OFB-3 TEST STARTED 3:15 PM TEST STARTED 11/26/2082 BEGIN LEVEL 4.5569 IN END TIME 3:30 PM END DATE 11/26/2002 END L.EUEL 4.5569 IN LEAK THRESHOLD 8.802 IN TEST RESULT PASSED OFB-4 TEST STARTED 3:15 PM TEST STARTED 11/26/2082 BEGIN LEVEL 4.12t3 IN END TIME 3:30 PM END DATE 11/26/2802 END LEVEl_ 4.1212 IN LEAK THRESHOLD 8.002 IN TEST RESULT PASSED DOWNTOWN CHEVRON 2317 L STREET BAKERSFIELD CA.93301 805- NOV 13. 2002 1:48 PM STATUS REP©RT ~LL FUNCTIONS N©RMAL INVENTORY REPORT T 1 :SUPREME VOLUNE = 4987 (]ALS ULLAGE = 3117 G~LS 90% ULLAGE= 2306 GALS TC VOLUME = 4982 GALS HEIGHT = 75.37 INCHES WATER VOL = 0 GALS WATER = 0.00 II',ICHES TEMP = 73.8 DEG F T 2 :PLUS VOLUME = 6368 GALS UL Ia~i~iE = :3777 (;;ALS 901~L. LAGE = 2?62 TO ;'q~DLUI"iE = 6:360 GALS HEIGHT = 57.09 INCHES WATER VOL = 0 ,::;ALS WATER = 0.00 INCHES TEMP = 76.9 DEG F T 3:UNLEADED VOLUME = 2576 GALS ULLAGE = 9465 GALS 90~ ULLAGE= 8260 GALS TC VOLUME = 2573 GALS HEIGHT = 33.99 INCHES WATER VOL = 0 GALS I..d~TER'~ '~ = O. 00 INCHES TEMP = 74.2 DEG F T 4 :PLUS VOLUME = 5952 GALS ULLAGE = 2077 GALS 90% ULLAGE= 1274 G~I.S TC VOLUME = 5878 GALS HEIGHT = 83.84 INCHES WATER VOL = 0 GALS WATER = TEMP = 77.7 DEG F T VOLUME = 10263 GALS ULLAGE = 1781 ,:gALS 90% ULLAGE= 576 G~LS TC VOLUME = 10185 G~LS HEIGHT = 95.36 INCHES WATER VOL = 0 ,:gALS WATER = 0.00 INCHES TEMP = 70.8 DEG F T 6:SUP'REME VOLUME = 5374 GALS ULLAGE = 2655 GALS 90~ ULLAGE= 1852 (gALS TO VOLUME = 5296 GALS HEIGHT = 76.16 INCHES WATER VOL = O GALS WATER = 0,00 INCHES TEMP = 8~.8 DEG F -T ~ESEL VOLUME = 5:349 G~LS ULLAGE = 6695 GALS 90~ ULLAGE= 5490 GALS TO VOLUME = 5298 G~LS HEIGHT = 54.72 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 80,7 DEG F CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~c~]rG~ ADDRESS ~ ["1 [~" FACILITY CONTACT INSPECTION TIME INSPECTION DATE il' { 2 BUSINESS ID NO. 15-210- 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 Verification of quantities Verification of location k., Proper segregation of material Verification of MSDS availability Verification of Haz Mat training Verification of abatement supplies and procedures ~ / 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 ~ No Questions regarding this inspection? Please call us at (66 I) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business Site ~tesponsible Party Inspector: _~ ~~~-"~ CITY OF BAKERSFIIELD FIRE DEPARTMENT OFFICE OF ENVIlRONMENTAL SERVICES UNIFIED PROGRAM ~NSPECT]ON CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 FACILITY NAME INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [~ombined [] Joint Agency Type of Tank Type of Monitoring I~ Multi-Agency [] Complaint Number of Tanks Type of Piping ~k} [] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file V · Permit tees 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 Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Business Site Responsible Party 0~ C~AL USE E2 Postage $ r~ Certified Fee ; ~ Postmark Return Receipt Fee Here ~ndor~oment Required} r~3 Restricted Delivery Fee I--I (Endorsement Required) r'u Total Postage & Feea ~ I~31 Sent To ~a'~;:'~;~;'~'"";~'~i;i~'"~';~'""¢'5~b'i ................... ' Certified Bail 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 Mall. [] 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 additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article 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, delivery may be restricted to the addressee or addrsssee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". B If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking, if a postmark on the Certified Mail receipt is n?,~eeded, detach and affix I~-~ with I~stage and mail. IMPORTANT~ this receipt and present it when making an inquiry. PS Form 3800, April 2002 (Reverse) 102595-02-fV1-1132 [] Complete items 1, 2, and 3. Also compl'ete item 4 if Restricted Delivery 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 mailpiece, or on the front if space permits. 1. Article Addressed to: DOI4'NTOI4'N CHEVRON 2317 L STI~EET BAKERSFIELD CA 93301 7002 0860 PS Form 3811, August 2001 0000 nature [] Agent Addressee . 1641 6407 Domestic Return Receipt 102595-02-M-0835 i 3. Service Type I~ Certified Mail [] Express Mail [] Registered [] Return Receipt for Merchandise [] insured Mail [] C.O,D. 4. Restricted Delivery? (Extra Fee) [] Yes ' address If YES, enter delivery address below: [] No B.&KERSF~ELD FiRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES 1715 Chgs~er Avenue, Suite 300 E~skersfleM, CA Ihl .... 'tl,,,fl.il,,',,,,ll,hl.,'l,t,.llll, ..... Ihl,l,ll,,,! October 31, 2002 Downtown Chevron 2317 L Street Bakersfield CA 93301 REMINDER NOTICE CERTIFIED MAlL FIRE CHIEF ,RON FRA2E 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 F~ S~E~ s~mncEs · .~'.~e.~. s~mnc£s 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester 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 RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). 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 insure that the systems axe capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last six months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 311 20021 will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (66 I) 326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services · Complete items 1,2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to~ou. · Attach this card to the back of the mailpiece, or on the front if space ~'ermits. 1. Article Addressed to: USF BESTWAY 4901 LISA MARIE CT BAKERSFIELD CA 93313 B. Received by (Printed Name) [] Agent Delivery D. Is delivery address different from item 1 ? [] Yes If YES, enter delivery address below: [] No Merchandise 4. Restricted Delivery?'(Extra Fee) · [] Yes 7002 0860 0000 -PS Form 381 1, August 2001 1641 7091 Domestic Return Receipt 102595-02-M-083~'I OFF O AL Postage $ r-1 r'~ Certified Fee Postmark Return Receipt Fee (Endorsement Required) Here ~ Restricted Delivery Fee r--I (Endorsement Required) I'U Total Postage & Fees ~_1sent To [ USF BEST~IAY I Ji;~i;Si~'tT/~;2; ............................................................................. I°rpOB°xNo. 4901 LISA MARIE CG i. · BAI(ERSFIELD CA 93313 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 additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article 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, 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 Mai~,,receipt ~ desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is noJ~ded, detach and affix label with postage and mail. IMPORTANT:~ this receipt and present it when making an inquiry. PS Form 3800, April 2002 (Reverse) 102595-02-M-1132 October 31, 2002 USF Bestway 4901 Lisa Made Ct Bakersfield CA 93313 REMINDER NOTICE CERTIFIED MA~ FIRE CHIEF RON FRA. ZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 933Q1 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 Frae S~E~ SEm~CE$ · ;~r~om~ SERWCE$ 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakemfleld, 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 RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). 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 insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last six months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform ,this tesh by the necessary deadline~ December 31, 2002, will result in the revocation of ,your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services September 30, 2002 Downtown Chevron 2317 L Street Bakersfield CA 93301 FIRE CHIEF RON ~RAZE 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 · ENVtRONMENT*I. 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) 326-0576 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 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). 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 insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last five months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services California ReglOnalcentralWatervalleyQU.ahtYReg, on ontrol Board Robert Schneider, Chair Winston II. Hickox Secretary for Fresno Branch Office Environmental Intemet Address: http://www.swrcb.ca.gov/-rwqcb5 Protection 3614 East Ashlan Avenue, Fresno, Califomia 93726 Phone (559) 445-5116 · FAX (559) 445-5910 Gray Davis Governor 3 September 2002 Regional Board Case No. 5T15000836 Mr. David Bird SulliVan's Petroleum Company, LLC 1508 18th Street, Suite 222 Bakersfield, California 93301 UNDERGROUND TANK RELEASE, DOWNTOWN CHEVRON STATION, 2317 "L" STREET, BAKERSFIELD, KERN COUNTY You submitted Expanded Groundwater Assessment Work Plan At The Sullivan Petroleum Company, LLC Downtown Chevron Service Station (Work Plan) dated 9 August 2002 and prepared by Central Sierra Environmental, Bakersfield (CSE). The Work Plan proposes the installation of two additional groundwater monitoring wells to determine the lateral extent of impacted groundwater off-site. We approve the proposed .monitoring well installations. We request that you install one additional monitoring well south of the site. Petroleum product floating on groundwater and high concentrations of gasoline constituents, including the fuel oxygenate methyl tertiary butyl ether (MTBE) have been detected in groundwater samples collected from monitoring and SVE wells on-site. We request that you expedite the remediation of impacted soils to prevent the spread of impacted groundwater. We approve the proposed installation and operation of the SVE remediation system by our letter dated 23 July 2001 and subsequent letters. Summaries of the project, the Work Plan, and our comments follow. Pro, ject Summary By a letter dated 28 June 2001, the City of Bakersfield Fire Department (CBFD) referred the subject case to our agency for regulatory oversight. The site was reconstructed as a convenience store with retail fuel sales and reopened during early 1999. Product reconciliation records for April 1999 indicated a potential re[ease. A cut in product piping was discovered at two locations. Subsequent investigation has detected petroleum product floating on the water table and gasoline-range hydrocarbons (TPH-g) at concentrations up to 5,300,000 micrograms per liter (gg/L) and MTBE concentrations up to 4,100,000 gg/L in groundwater beneath the site. The lateral extent of impacted groundwater has not been defined. Depth-to-groundwater during two monitoring eyents has ranged from approximately 113 to 115 feet below ground surface (bgs). Calculated groundwater flow direction during these events has been toward the southwest with a slope of approximately 0.03 feet per foot. California Water Service Company well 007-07, a municipal well, is approximately 11000 feet southeast of the site. A detailed Project Summary is included in our letter dated 4 March 2002. California Environmental Protection Agency ~ Recycled Paper Mr. David Bird -2- 3 September 2002 Work Plan Summary CSE proposes to install two monitoring wells (MW4 and MW5) in (downgradient) positions southeast of the site to further define the laterat extent of first-encountered groundwater impacted by petroleum hydrocarbons. MW4 and MW5 will be standard-construction 2-inch diameter monitoring wells screened from 100 to 130 feet bgs. MW4 and MW5 will be installed in "L" Street near the northeast and southeast comers of 23rd and "L" Streets, respectively. The monitoring wells will be installed using a dual-wall percussion air rotary drilling rig. Soil cuttings will be logged and field-screened for volatile organic compounds (VOCs) with a photoionization meter (PID). Soil samples will not be collected. MW4 and MW5 will be developed, surveyed, and added to the existing monitoring network. Gr_0.gn~wat~r $.,.arnp!e.s wil! be analyzed for TPH-g by EPA Method 8015M, benzene, toluene, ethylbenzene, and xylenes (BTEX), MTBE, tertiary butyl alcohol (TBA), di-isopropyl ether (DIPE), ethyl tertiary butyl ether (ETBE), tertiary amyl methyl ether (TAME), ethylene dibromide (EDB), and 1,2-dichloroethane (1,2-DCA) by EPA Method 8260. CSE will begin work within 45 days after Work Plan approval by the Regional Board, issuance of monitoring well permits by the Kern County Environmental Health Services Division, and encroachment permits by the City of Bakersfield Department of Public Works. An Expanded Groundwater Assessment Report will be submitted to the Regional Board approximately 60 days after the work is completed. Comments Based on review of the above-summarized reports, we have the following comments: Gasoline range petroleum constituents, including MTBE, have migrated through the permeable sandy/gravelly site soils and have been detected in groundwater beneath the southern portion of the site. Floating petroleum product 0.25 feet thick was measured on groundwater in SVE well VW-1 d during the 26 November 2001 and 28 March 2002 monitoring events. MTBE and benzene have been detected in groundwater samples at very high maximum concentrations of 4,100,000 and 72,000 [tg/L, respectively. The lateral extent of impacted groundwater has not been defined. We approve the installation of monitoring wells MW4 and MW5. Please submit a report of findings documenting the installations by 3 December 2002. Concentrations of TPH-g, benzene, and MTBE up to 46,000, 110, and 23,000 gg/L, respectively, have been detected in existing well MW3, 85 feet west-southwest of the release point, and crossgradient to groundwater flow. We request that one additional downgradient monitoring well be installed south of the site along the south side of 23rd Street to further define the downgradient extent of impacted groundwater to the west. Please submit a map showing the proposed location of this additional well by 3 October 2002. The Second Quarter 2002 groundwater monitoring report is due by 1 October 2002. U:\UGT~JDW_files~002 Correspondence\City of Bakersfield Cases'~Dwntwn Chevron MWWP 8-02.doc Mr. David Bird 3 September 2002 MTBE may be transported in groundwater greater distances away from the release point than other gasoline constituents due to its relatively high solubility and Iow adsorption to soils. We reiterate our requests of 4 March and 19 July 2002 that you expedite soil remediation to minimize the migration and spread of gasoline and MTBE in site soils and groundwater and potential impacts to the downgradient municipal well. We understand that you are currently installing the soil vapor extraction (SVE) remediation system. Please contact this office at least five days prior to SVE system startup. You need to be aware that Sections 2729 and 2729.1 for Underground Storage Tanks were added to the California Code of Regulations requiring you to submit analytical and site data electronically. Enclosed is our letter (Required Electronic Deliverable Format for Laboratory and Site Data Submittals to Regulating Agencies) explaining how to obtain information to implement the requirements. As of the date of this letter, we have not received the required electronic data submissions for your site. We request that. you.con[act this office, at least five days prior to fieldwork. If you have may questions regarding this correspondence, please contact me at (559) 445-5504. JOHN D. WHITING Associate Engineering Geologist R.G. No. 5951 Enclosure: Required Electronic Deliverable Format For Laboratory and Site Data Submittals... CC: Ms. Barbara Rempel, SWRCB, UST Cleanup Fund, Sacramento, w/o enclosure ~ Mr. Howard Wines 111, City of Bakersfield Fire Department, Bakersfield, w/o enclosure Mr. Mark Magargee,. Central Sierra Environmental, Bakersfield, w/enclosure U:\UGTXJDW_files\2002 Correspondence\City of Bakersfield Cases\Dwntwn Chevron MWWP 8-02.doc August 30, 2002 Downtown Chevron 2317 "L" Street Bakersfield, CA 93301 REMINDER NOTICE 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 RE: Necessary secondary containment testing requirements by December 31,2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). 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 therea~er, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services CITY OF BAKERSFIELD '¢J~ ~-~(POq/.~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) [ ]NEW FACILITY [~M~LD~'I~IO,9~N OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY FACILITY NAME ~ ~~ EXIS ~ · FACILITYADD~SS ~]~ Z 9~' CITY /~E~'~vZ~2 ZIPCODE ~'~O~ SS ,-~6 ~Wx o~ APN ~ TYPE OF BUSINE ~ _ . _ Oo TANKO~ER _~ ~c_[~t~ ~~OC~o~ ~ PHONENO. ,~ ~O o ADD~SSI~Oq {%~ ~ ~ CItY ~mttk~x~ ZIPCODE ........ ~ ~'. ~-~ ~~~C,~' - CA LICENSE NO. ~q ~ I ~ PHONE NO. ~ ~ - O & ~O BAKERSFIELD CItY BUSINESS LICENSE NO. BRIEFLY DESC~BE THE WO~ TO BE DONE ~~~ ~ ~Q~ ~m~C '~ WATER TO FACILITY PROVIDED BY DEPTH TO GROUND WATER t t-¥.~, _+ om-SOIL TYPE EXPECTED AT SITE NO. OF TANKS TO BE INSTALLED r~> ARE THEY FOR MOTOR FUEL SPILL PREVENTION CONTROL A. ND COUNTER MEASURES PLAN ON FILE YES NO YES NO SECTION FOR MOTOR FUEL TAN?NO. _~_~. ,~# VOLUME UNLEADED ~:9 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 IAPPLICATION DATE 'FACILITY NO.: · NO. OF TANKS FEES $ 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 FO .R/~, HAS BEEN COMP LETED UNDER PENALTY OF PERJURY, AND TO THE BE~,KNOWLEDGE, IS TRUE AI~ CO?~ECT* ' ~ APPROVED. By:r' ' TmS ae~HCAT~O~ B~COM~S A e~I~ July 30, 2002 Downtown Chevron 2317 "L" Street Bakersfield CA 93301 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 ~H' Streel Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661 ) 395-1 349 PREVENTION SERVICES FIRE SAFETY SERVICES * ENVIRONMENTAL 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) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAX (661) 326-O576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31, 2002 of Underground Storage Tank (s) Located at the Above Stated Address. Dear Tank Owner / Operator: If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). 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 insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Sincerely/~, Steve Underwood Fire Inspector Environmental Code Enforcement Officer D June 30,2002 Downtown Chevron 2317 "L" Street Bakersfield, CA 93301 REMINDER NOTICE FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (66 t) 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 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2317 "L" Street. 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 will be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1, 2001 will 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. st~erwoad~~') Fire Inspector/Environmental Code Enforcement Officer Environmental Services SU/kr D May 29, 2002 Downtown Chevron 2317 "L" Street Bakersfield, CA,93301 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 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 2317 "L" Street REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in Califomia 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. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/kr enclosures 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 Sullivans Security 2317 L Street Bakersfield CA 93301 RE: Necessary Secondary Containment Testing Required by December 31, 2002 REMINDER NOTICE Dear Tank OwnedOperator: 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. Sincerely,, Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures ROM : SUNSET MECHANICAL Construction & MECHANICAL Continuous Monitorinc fTEsT DATE /,2/$! fO,/ F NAME PHONE NO. : 805 3220660 Jar,. 02 2002 03:49PM P5 (661) 871-1788 Device Certification -- ~..%o,,.,r~/. ~r~ - FACILITY NUMBER Z,. cooE ¢~.,3o / MAKE AND MODEL OF MONITORING SYSTEM d.~--~@ ,,'"J,~"~ ~ TANK 1 TANK '2 TANK 3 TANK 4 Contents of Tank ....... Ca. PaCi!Y °!,Tank ........ Type of Produ.c_t Line (Gravity, Suction, Pressure.).. INDICATE LOCATION OF THE MONITORING SENSORS TESTED BY PLACING A YES OR No IN THE APPLICABLE BOX; Annular Space Sensor Sump $~nsor Dispenser Containment Sensor Electronic Overfill/Level .... ~;'~ Electronic In-L.i.ne Leak .Detector Mechanical Line Leak Detector In-Tank Gauging Device INDICATE THE FOLLOWING BY PLACING A YES OR No IN APPLICABLE BOX' Does the Monitoring System have audible and visual alarms~ ~_~ ~ ~...~ Ooes the turbine automatically shut down if the system detects ~,, a leak, fails to operate or is electronically disconnected? /~.~ ,~"~'~> /~.~ ts the ,monitoring system installed, to prevent unauthorized tampering? /~'~.~ /~ _ ~5 Is .... 'the ,,re°nit°ring, ......... system operable as per the manufacturer's specifications?. ~"~5 ~--5 ~ Which continuous monitoring devices Initiate positive shut down of the turbine? CERTIFIED TESTER'$ ID# SIGNAT1JRE OF CERTIFIED TECHNICIAN PRINTED NAME oF.CERTIFIED TECHNICIAN TESmN~ COMPANY NAME ,~ TELEPHONE CERTIFICATION DATA FROM : SUNSET MECHANICAL PHONE NO, : 805 3220660 3an. 02 2002 03:47PM P2 UNSET Consfiruction & MECHANICAL (G I) 871-17 G Continuous Monitorin ~1 Device Certification TEST DATE .~o3/~//~;;~/ FAClLI~ NUMeER c,w ~~[~ z,~ Co~ ~o / CONTACT PERSON MAKE AND MODEL OF MONITORING SYSTEM TANK I TANK Contents o'f Tank ..... Capacity of Tank ...... ,, ~,~ Type of Product Line (Gravity, Suction, Pressure) INDICATE LOCATION OF THE MONITORING SENSORS TESTED BY PLACING A YES OR NO IN THE APPLICABLE BOX: Annular Space Sensor ......... Sump Sensor .......... ~'~ Dispenser Containment Sensor ......... Electronic Overfill/Level ....... .~& Electronic imLine Leak Detector Mechanical Line Leak Detector In-Tank Gauging Device ~ , ........ ~r=~----~ INDICATE THE FOLLOWING BY PLACING A Yes OR No IN APPLICABLE BOX: Does the Monitoring System have audible and visual alarms? ~/~_.~ ~"~..~ ~=, ~_._~ ~:~, Does the turbine automatically shut down if the system detects a leak, fails to operate or is electronically disconnected? ~, ~'~g.._~ ~C'~.~ ~ Is the monitoring system installed to prevent unauthorized t~m..pering? ~'~.~. [r"~,¢---~ ~t~(~'~ ~' ~ Is the mon. i.t0r!n.g system op.erable as per the manufacturer's spe. cifications? ~r~:, ~'~.5 ~-'~_~ ~d~-.~ Which continuous monitoring devices Initiate positive shut down of the turbine? CERT~F~EO TESTER'S ID# SIGNATURE OF CERTIFIED TECHNICIAN PR~N'r~D NAME OF CERTIFIED TECHNICIAN TESTING COMPANY NAME & TELEPHONE CERT F CATION DATA .DObJ NTOI,.,I l..J OHEL.,'R,:) N 2317 L o , ~ ,~TREE1 BaI::[ERSF I ELD Ca. 9 ~ :301 805- DEC i3..2001 8:45 AM FUNCT I,:]:,NS N,:)F-tM~L .INVENTORy T I :I::'LUS VOLUPIE = 49?'5 ULLAGE 517 Iii '-'"' 90% ULLAGE= 4155 GaLS TC VOLLI["IE = 4971 GaLS HEIGHT = 46,78 INC;HES klaTER \,"OL = Ci GaLE N~TER = Ci. Ci0 INCHES TEPlP = 68.1 DEG F T 2: UNLEADED VOLUME = 28:::9 C;aI.S ULLAGE = 915'.2' GaLS 90~:'; ULLAGE= ?947 G&LS TC VOLUI"IE = 288'7 G~LE; HE~4~ = 3E.89 INCHES b~',,.,,'OL 0 GaLS bJ~T~ = O. O0 I '4CHE:S TEMP = 69.7 DEG F T 3 :SUPREPIE V©LUPiE = 171 I GaLS ULLAGE = 6:39:3 GaLS 90% ULLAGE= 6S82 TO VOLUME = 1'709 HEIGHT = :321,66 INCHE',:J ~t~7'ER VOL = 0 GaLS bJRTER ~ O. O0 INCHES TEHP ~ 71].2 DEG F 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 Section 2: Underground Storage Tanks Program Routine I~[ Combined [] Joint Agency Type of Tank Type of Monitoring [] Multi-Agency. Number of Tanks ~ Type of Piping ./-~¢,~ [] Complaint [] Re-inspection OPERATION C V COMMENTS / Proper tank data on file 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 xvith 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 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME dLtJlr, mt ADDRESS c-~-'3 i "/" FACILITY CONTACT INSPECTION TIME INSPECTION DATE { PHONE NO. {o~,~ o 0~[O BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES 'l Section 1: Business Plan and Inventory Program Routine [~[Combined [21 Joint Agency [21 Multi-Agency [...] Complaint [21 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 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 ~Io Questions regarding this inspection? Please call us at (661 ) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Business Site.gesponsible Party Inspector: ~ _~P'~ _~ SITE/FACILITY FORM NORTH SCALE~ % ,~' ~' BUSINESS NAME: . JT~-~ ~ (CHECK ONE) SITE DIAGRAM UNIT ~ ..: OF FACILITY DIAGRAM ( Inspector's Comments): -OFFICIAL USE ONLY- - SA - SITE BIAGRAM (Requir~ tams) 1. Address: Identify principle buildings by the Street numbers. 2. Street(s), -Alleys, Driveways, and Parking Areas adjacent to the property. Include the street names. 3. Storm Drains, Culverts. Yard Drains 9. Lock (key: 10. MSDS Storage Box 11, Railroad.Tracks 12. Fence or Barrier a. Wire b. Masonry c. Wood 4. Drainage Canals, Ditches. Creeks, 5. Buildings a. Frame construction b. Masonry construction c. Metal construction d. Access Door 6. Utility Controls a. Gas d, Gates 13. Pomerilnes 14. Guard Station 15. Storage Tanks: Identify the capacity in gal. a. Above ground b. Undergrouud 16, Diking or Berm b, Electricity iT. Evacuation Route c. Mater ?. Fire Suppression Systems: a, Fire Hydrants 18. Evacuation Area: Identify the location where employees mill meet. b. Fire Sprinkler Connections 19. Outside Hazardous Masts Storage c. Fire Standpipe Connections 20. Outside Hazardous Material Storage d. Water Control Valves for protection systeus Outside Hazardous Material Use/Handling e. Fire Pump 8. Fire Department Access Type of Hazardous Material/Wants Stored or Used (See Below) TYF~ OF HA;ARDOUS MATERIA~ F - Fl~able g - Explosive L = L/quid R - Radlologlcal C - Corrosive 0 - Oxldlzer G - Gao P - Poison Water Reactive T - Toxic S - Solid a - Cryogenic D · Waste B - Etiological Example: glae~able Liquid - FL FACILITY DIAGRAM (Required Items in addition to the abo~a) 1. R/sore for Sprinklers 8. Fire Escapee 2. Partitions 9, Air Conditioning Units 3. Stairways: Indicate the levels served from highest to loeest. 4. Escalator: Indicate the levels served from hlgheat to 5, Elevator {1. Attic Access 7. Skylights 10, Windo~a 11. Inside Hazardous Waste Storage 15. Inside Hazardous Materials Storag~ ia. Inside Hazardous #eteriais Use/Handling 14, Smwer Drain Inlets 1 D January 22, 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 Sullivan's Security 2317 "L" Street Bakersfield Ca 93301 RE: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update Dear Underground Storage Tank Owner: You will be receiving updates from this office now, and in the future with regard to the Senate Bill 989, which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will be forced to revoke your permit to operate, effectively shutting down your fueling operation. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning now to retro-fit your facilities. If your facility has upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326-3190. Steve Underwood, Inspector Office of Environmental Services SBU/dm CONTINUOUS_.MONiTORiNG DEVICE CERTIFICATI~ FACILITY # BSSR JOB # , ~" ......... .: %: ~.~ ........ ~ ~NTACT PER~N .'h'".,.: ':~:"..'..,,',.,~':, :"':',.' '" ;"'" ~ ~PE ~ ~~M pp~ I SEN~RS ~ ~iT~ N ~ - - TANK ~ 4 TANK ~ 5 TANK ~ 6 ~ ...... ' ..... ~ '' TANK ~ 1 TANK ~ 2 TANK ~ 3 ., ~,,~ , ,:, . ,. ~ ,"'.'.,:.:::~m':,.:,~':,..':'r.,?,,:',,~,'..~ ' ~ v~Lenb~b ~u~ ~,.',, ~ · - O~ q ~ ~Oq P. O1 . ,: ..',:',. ',,' ,r~,':*' ] ", ,',:':~:' ,,,~.,. ,'; ~' '~'' ,. : :-'. ',:.:. .. ~RTtFIED TESTERS i~ , I ,,0 ~ TIME ~ SITE ,~ . ......... $1("~,IATUI:~E (~ ~ERTtFIED TECHNICI,n,~ :PRINTFJ3 NAME Of-' TECHN ClAN , CC~~ BSSR,:INC. 661.588-2777 : J)RRECTION NO CE BAKERSFIELD FIRE DEPARTMENT N° 1 0 3 3 Sub Div.~-~-~ ~"7 "~." ~T Blk. . Lot You are hereby required to make the fo]lowing corrections at the above location: Cot.J } Completion Date fox' Corre~tions~-J~]~/~ Date Inspector 326-3979 DOW N CHEVRON 2317 L STREET BA}(EP, SF I ELD CA. 93301 NOV 28. 2000 1 ;2;3 PM SYSTEM STATUS REPORT T 2:SUDDEN LOSS ALARM INVENTORY REPORT T I :PLUS VOLUME = 2918 GALS ULLAGE = 7227 GALS 6212 GALS 2915 GaLS HEIOHT = 31.34 INCHES WATER VOL = 0 GALS --WAT-ER - =':- -8< EIO qN(~HES~ T VOLUME = 5539 GALS ULLAGE = 6502 G~LS 90% ULLAGE= 5297 GaLS TC VOLUME = 5536 GaLS HEIGHT = 59,75 INCHES WATER VOL = 0 C;,qLS WATER = O. O0 INCHES TEMP = 67.7 PEG Y T 3:SUPREME \/OLUME = 3024 (2ALS ULLAGE --' 5080 GaLS 90% ULLAGE= 4269 GCqLS TC VOLUME = 3022 GP, LS HEIGHT = 50,96 INCHES WATER VOL = 0 WATER = O, 00 II'4CHES TEMP = 67.1 DEG F CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ADDRESS ,.D :3 1 "l" FACILITY CONTACT INSPECTION TIME ,.ST gl~ INSPECTION DATE PHONE NO. (o 3f '03 i0 BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [21 Routine [~! Combined [21 Joint Agency 1~ Multi-Agency [2i Complaint [21 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 Emergency procedures adequate ,L / Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand / C=Compliance V=Violation Any hazardous waste on site?: Explain: Questions regarding this inspection? White - Env. Svcs. Yes ~] No Please call us at (661) 326-3979 Yellow - Station Copy Pink - Business Copy Business Si~esp~,~, Party Inspector: CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME INSPECTION DATE Section 2: Underground Storage Tanks Program [] Routine [~ Combined Type of Tank _t(~t01~' Type of Monitoring [] Joint Agency [~ Multi-Agency [] Complaint Number of Tanks Type of Piping F'-/c [] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file L// Pen~it tees current V Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations V 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 dr' 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 May l7~,2000 C~Evron Chevron Bakersfield Fire Department 1715 Chester Ave. Bakersfield, CA 93301 Attn: Steve Underwood Re: Permit to Operate Application Downtown Chevron 2317 L Street Bakersfield, CA 93301 Phone 805 638 0310 Fax 805 638 0224 Dear Mr. Underwood, t~:~~.~._/~ Enclosed are our completed forms A, B & C for our facility located at 2317 L Street, Bakersfield. Should any further information be needed please feel free to comact me at 638-0310 Sincerely, David Bird Retail Manager CITY OF BAKERSFIELD OFt :E OF ENVIRONMENTAL SI~tVICES 1715 Chester Ave., Bakersfield, CA 93301 (66'1) 326-3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE I. FACILITY IDENTIFICATION , I One form per tank II. INSTALLATION [3 Check all that apply * The installer has been certified by the tank and piping manufacturers. The installation has been insped,~l and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE tAME OF TANK OWNER/AGENT (l:~l) Fo~m C ;El 1. BAF~STEF_L [] 6, FR~COt,~A~WI100~ METHANOL i MATERIALS ANO 'E:] 2. STAINLE3.~ STEEL [] 7, OAJ. VA,NIZED ~ co..osioN !~"~. ~ CO~P^T~ wrm ~ [] ~. PROTECTION . i[3 4. ~ROL,~ [] e. ~meL~mc~) []~. OT~-R '] 5. S'TEELW/COA~ [] 9. CATYK:)OK:P~OTECTIO~ 4~4 [] 3. CONTff,~tkO~8 D~PENt~R PAN ~ ~ AUTO 5HUT OFF FOR OISPENC~ER + AUDIBLE AJ,~O VI~flAL ~ [] 8. NON~ 44,9 IX. CJ~qERK)~ERATOR SIGNATURE DATE 474 , PCF (7/gO',, S:\CUPAFORMS~.~WI~Ct~;t.V~F :' I"'YPE OF ACTION ~] t. NEW SITE PERMIT (Check one ,~m only) CITY OF BAKERSFIELD i FFICE OF ENVIRONMFNT, SERVICES l?lS-Chester Ave., Bakersfield, CA 9J301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY ,,~3. RENEWAL PERMIT [--] 5. CHANGE OF INFORMATION (SoeCtin/change. [] 4. AMENOED PERMIT Iocat use Only) [] 8. TEMPORARY SITE CLOSURE [] 7. PERMANENTLY CLOSED SITE [] 8. TANK REMOVEO I. FACILITY I :SITE INFORMATION BUSINESS NAME (Same a~ FACILITY NAME o~' D~A - DOng I~sin~ As) 3 NEAREST CROSS STREET 401, BUSINESS g~. GA~ ~I'ATION C~ 3. FArM [] 5. COMMERCIAL TYPE [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER FAClUTY ID # FACILITY OWNER TYP~ [] 1. CORPORATION [] 2. INDIVIDUAL [] 3. PARTNERSHIP [] 4. LOCAL AGENCY/DISTRICT* [] 5. COUNTY AGENCY' [] 6. STATE AGENCY* [] 7. FEDERAL AGENCY' 4.02· TOT~J. NUMBER OF TANK~ REMAINING AT SITE i 4o4. DY. ~ 40~. ·": IL PROPERTY OWNER INFORMATION : - ;' CITY [] 3. PARTNERSHIP [] 4. L0~ AGENCY / DIST'F~2T [] S. COUNTY A~Y 409. 411. I ZIPCOOE?~h'~O) 412. [] 6. STATE AGENCY [] 7. FEDERAL A~ 413. TAJqK OWNER ~ 414. N 415. TANK OWNER TYPE [] 3. PARTNER,.~IP 416. 419· [] 4. LOCAL AGENCY I DISTRICT [] 5. COUNTY AGENCY [] 7. ' N. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER · ' : ' ' ,' ' V. PETROLEUM U8T FINANCIAL RESPONSIBILITY ~NOICATE METHOO(S) [] 10. LOC4M. GOV'TMECHANISM [] 99. OTHER: [] 1. ~J,.F~ [] 4. SURETY' BOND 4~I~%-/:"~"T~TE FUND [] 2. GUARA/~rEE . r-] 5. LEfHFJ~OFCREDIT [] 8. STATEFUNO&CFO L~:i iI=R [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD 422. VI, LEGAL NOTIFICATION AND MAILING ADDRESS C~ec~ one Ix~x to in~Ic~e whk~ ~ at~euicl I~ u~,ed for legal n~itllca~ and mailtng. ~ Legainoclflcalic~mandmai~ng~wglbee~'tllol~elankow~m-~bax l~,'2iac:tmc~ed. FACILITY [] 2. PfROPERTWOWNER [] 3, TANKOV~.R 423. VII. APPLICANT 81GNATURE STATE UST FACILITY NUIdBE. R (Fo~ uae 4~. 1~ UI::N3~kO~ CERTIFICATE NUIvI~_.~ (Fo~Io,~l ute o~0') dPCF (7/99) S:\CUPAFORMS~sw~cb-a.wpd CITY OF BAKERSFIELD OFi~E OF ENVIRONMENTAL SI~VICES `1715 Chester Ave., Bakersfield, CA (66'1) 326-3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE I. FACILITY IDENTIFICATION BUSINESS NAME (Same aa F~ClLITY NAME o~ ~ - ~A~) One form per tank II. INSTALLATION Check a/I that app/y * The installer has been certified by the tank and piping manufacturers. The installation has been insped,-~l and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. Ail work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE ,NAME OF TANK OWNER/AGENT (1~) 7/°0 · ......... F~w~ C _~i CiTY OF ~AKER~FIELD i~' - ~ OFFICl OF INV1RONMENTAL ~ERVICE~ I ' ~1"715 Cll~lter Av~,, kkimflild, CA 93301 (641) ~l~llTg UNC~ FK~K)U('~ SYST~ T'YP'E '~1. I~ESSU~E I'*'1 2. SUCTION CONSTRUCTIO~%/,[~ t. Sh~K~LEWALL · M.~NuFACTURERI~' 2. ()OU~I.E W~J-L J ~J.~KJFACTURER [] 3. LIN~.D T~.NCH n 9~, OTHER [--1~. U~'<~ 4~1 PRESSURE r"l 2, SUCTION r-') 3. (34~Avl',r.y ,[~. SINGLE WALL [] 9~. :2. DOUBLE WALL [] ~g. OTHER M,ANUFACTURE R [] 1. ~RE 3--~rEEL [] 6. FP~° ~ATI~ W'/10(O~ ~4~')-LA.~N~L [] 2. STAINLESS STEEL [] 7. GALVAN~Z]~O S'I'~J. ,~3. Pt~kSTiCODMPATII~.LEWll'H CONrFENTS [] 8. F1.JF-X~LE(N~34~E) {-l~. OltdER J::] 5, STEEL W/C.OATI~G [] 9~. UN~C~'40~/~ 46 ~ PIPtNO ~4N~3L~ ~ ~l'fl~3 4M PRESSURIZEO PfP~NO (C~ M ~t e~,): ~ 1. ELEC'T~ L~ LE~D~CTO~3-OGi:~''ITE'~'T~[THA~TOPUI~HUTOFI~I~)R [] 2. MONTHLY0~O~HI'~r [] 3. ~ ~NTr:O~'TY ~ (O40~'0 CONVENT~NAL SUCTION SYSTE)~ [] 5. D~JLy,/tSU,~gNfTOR~K3OFPUla:qI~SYSTEM+TR;~-':ALP'~N~~ TEST (0.1 C~°~) ,SAFE SUCT~3N SYS'TEMS ( NO vALVF--S ~N _m~__ _nW O,RO~k~ ~X V1TY FLO~. L~ 9. B~tAL ~rE~ TEST (0.1 GPH) DATE INSTALLEO 4~ [] 3. CON1~$ ~ PAN ,~ ~?rTH NJTO 8,HUT OFF FOR DISPENSER + AUC~E~..E ~ 'vl~U.4& ~ [] ~. ~ ~g IX. OI~N~EK)PERATOR SIGNATURE S:\CUPAFOR~WIRC-t~ B '~''~/'''~ [ ' 'FICE OF ENVIRONMENT,, SERVlCES 1715'Ehester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY TYPE OF ACTION (Check one dem only) [:::] 1. NL~V SITE PERMIT · ~. RENEWAL PERMIT [] 4. AMENOEO PERMIT [] 5. CHANGE OF INFORMATION (SOecB&/c/t4~g~ - local use only). [] 6. TEMPORARY SITE CLOSURE [] 7. PERMANENTLY CLOSED SITE [] 6. TANK REMOVEO I. FACILITY / SITE INFORMATION BUSINESS NAME (~ame al FACILITY NAME a~ DJiA .Doing Bus~e~ AS) 3 FACILITY ID # NEAREST CROSS STREET / 401. FACILITY OWNER TYP~ [] 2. INDIVIDUAL BUSINESS ~ STATION [] 3. FARM [] 5. COMMERCIAL TYPE [] 3. PARTNERSHIP [] 2. mSTRIBUTOR E] 4. PROCESSOR [] 6. OTHER 403. [] 4. LOCAL AGENCY/DISTRICT' [] 5. COUNTY AC-ENCY' [] 6. STATE AGENCY' [] ?. FEDERAL AGENCY' TOTAL NUMBER OF TANKS I Il flcJlty on Indian Ree4~mii~ ~ REMAINING AT SIT? tn~lllndl? ' : IL PROPERTY OWNER INFORI~TION : ~ b3E o.3 PROPERTY OWNERTYPE [] 2. INOW1OUAL [] 4. LOCALAGENCYIDISTRJCT [] 6. STATE AGENCY 413· ~"~*'"~TION [] 3. PA,RTN~.~-flP [] $. COUNTY AGEt~Y [] 7. FEOERAt. ,AGENCY · ':::...' '.. IlL TANK OWNER INFORMATION "' . '~.~!; 9 MAILING OR STREET AO0~SS 415. 416. [] 2. INON1OUAL [] 4. LOCAL AGENCY/DIS~ [] 6. STATE AGENCY 420. ~TION [] 3. PART~IP [] 7. FEDERAL AOENCY · IV. BOARD OF EQUALIZATION IJST 8TORAGE FEE ACCOUNT NUMBER TY(TK) HQ14J4IIl J.,l_ljJ Call(g16)322,9669ifquestlonsarlse 421. : '. · ' .:,' .~.~ ' V. PETR U UST FINAN IAI. RESPONSIBILITY INOICATE METHOO(S) [] 10. LOC~. GorY'MECHANISM [] 99. OTHER: [] 2. GU~ . r-J 5, LETTER OF CREDIT [] 8. STATE FUNO& CFO Lei re.R [] 3. IN~UR.ed~.~E [] 6. EXEMPTION [] 9. STATE FUND a CD 422. VI. LEGAL NOTIFICATION AND MAILING ADDRESS C. heckor~l)oxloi~lk:Jewt~/~ftaddre~hou~ll)e~fotlegaln(~fl(:~t~at~ma~'~. ,,~'~r~ILITY [] 2. Pf~OPERTYOWNER [] 3. TAHKOWNEFI 423. VII. APPLICANT SIGNATURE STATE UST FACILITY NUMBER (For/o~a/uae on/y) 428. i 998 UPQRAD~ CERTIFICATE NUMBER (For k~al uae on/y) 4~ JPCF (7/99) S:\CUPAFORMS~sw~cb-a-wpc CITY OF BAKERSFIELD OFI~E OF ENVIRONMENTAL SI~JVICES Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE I. FACILITY IDENTIFICATION One form per tank 8USINES~,,HAME (Same as FACILITY NAME 04' C~ - DO~g BuNrt, e~ A~) FAC L~ D II. INSTALLATION Check all that apply * The Installer has been certified by the tank and piping manufacturers. The installation has been inspec*~ and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. Ail work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE i ...... --~ DATE ........................... ~-,~84~ ~4ddE OF TANK OWNER/AGENT (p~) ~o~m C UNO~RGIqOUNO P~f~N(t [] 3. LIN~ TRENCH r'"] ~. o'rl~ 4~o []~. 4~1 PRESSURE [] 2. SUCTION [] 3, 13~AVTI"y 4 ~J/l. SINGLE WALL [] 95. UNC4N~OWN [] :2. I:X:)U~,LE WALL [] ~;J. OTHER ~AC~RER ~ 1. ~RE ~EEL ~ 6. F~ ~ATI~ ~ 2. STAINLE~ S~EL ~7. ~V~O ~ 4. FI~R~ ~ 9. ~E ~ 5, STEEL WI ~AT~ ~ ~. U~ OATE INSTALLEO 4~ 4~z co~r~KK~C),~e~S~O~+~ANOV~.,~ [] S..T~.NC~/~O~ [] 3. ~8 ~ ~ ~ ~ AJJI'O ~HUT OFF FOR OISPENS~R * AUO~I~ ~ VI~A.L ALAJ~ [] 6, ~ 46g IX. O~NEEK)PEEATO~ SIGNATURE !PCF (7/90) S:\C U pA FORM,.~..~WR~/~" ' FYPE OF ACTION [] 1. NE~/SITE P~RMIT (Check one dem only) CITY OF BAKERSFIELD :FICE OF ENVIRONMENTP~SERVICES 1715 Chester Ave., Bakersfield, CA 93-301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY 3. RENEWAL PERMIT [] 4. AMENDED PERMIT [] 5. CHANGE OF INFORMATION (SoecB'y c~r, ge. local use only) [] 8, TEMPORARY SITE CLOSURE [] 7. PERMANENTLY CLOSED SITE [] 8. TANK REMOVED I. FACILITY I SITE INFORMATION BUSINESS NAME (Same aa FACILITY NAME o~ ~ - Doing 8usinaa~ As) 3 °ool I L NEAREST CROSS STREET 401. BUSINESS ~'1, GA~ STATION [] 3. FARM [] 5. COIvg~RCIAL TYPE [] 2. DISmlSUTO. [] 4. P~OC~SSOR I-I 8. OTHE. ~03. FACILITY ID # FACILITY OWNER TYP~ ~e-~. CORPORATK)N [] 2. INDIVIDUAL [] 3. PARTNERSHIP [] 4. LOCAL. AGENCY/DISTRICT' [] 5. COUNTY AGENCY' [] 6. STATE AGENCY' [] 7. FEDERAL AGENCY' TOTAL NUMBER Of: TANKS REI~&INING AT~ ~7 'lf o~er of UST a pubac agency, name a~ supe,'v~ o~ aivt~, sec~3n o~ c~flce w~nic~ ~)era~ee I~e UST. {T'h~ i~ ~e oonmct pe~<~ for u'm tank reoon~.) IL PROPERTY O~NER INFORMATION ': ;' 410. r STATE 411. OWNER TYPE [] ~. PARTNERSHIP [] 4. LOCAL AGF_NCY I DISTRJCT [] $. ~ AGENCY PHONE ZIP COOE 412. [] 6. STATE AGENCY 413. TANK OWNER NAME MAILING OR STREET kOOf~SS TANK OWNER TYP~ [] 2. INON1OUAL [] 3. PA~TIqERSHIP 417. I~STATE 418. I ZIPCODE [] 4. LOCAL AGENCY / DISTRICT [] s. CO~JN'W AGENCY [] 8. STATE A~NCY [] 7. FEDERAL 415. 416. 419. TY ('I'K) HQ J 4 · . N. BOARD OF EQUALIZATION UST 8TORAGE FEE ACCOUNT NUMBER :. ' ' ' V. PETROLEUM UST FINANCIAL RESPONSIBILITY 421. INDICATE METHOD(S) [] 10. LOCAL GOV'T MECHANISM [] 9g. OTHER: [] 1. 8ELF-IN~UR~D [] 4, SURETY BOND ,~. STATE FUND [] 2. OUA~ITEE . [] 5. L~OFCR~DrT [] 8. STATEFUNDaCFO LI::I IIcF~ 422. [] 3. IN~URAJ'4CE [] 6, EXEMPTION [] 9. STATE FUND & CD VI. LEGAL NOTIFICATION AND MAILING ADDRESS Chec~ o~el~3xloi~llc~ew~nk~ addrea~3u~dl)eu~ed faglegatn<Xt6calJc~m andm~ling' J~l~'",¢. FACILrTY [] 2. Pf~OPERTYOWNER [] 3. TANKOWI~--R 423. VII. APPLICANT SIGNATURE ~tion: I oer~y that I~e Informalfon I~'Ov~,cl~ aco.~le Io ~e NAME OF' ^PPt. l~ (pnnO "~TATE UST FACILITY NUMBER (FO~/o~/uae o~y) jPCIc 42~. [ 1~ UP(~:~kO~ CERTIFICATE NUMI~_R (For k~al uae or~y) S:\CUPAFORMS~w~cb'a*wpc ~'- '* CITY OF BAKERSFIELD OFI~E OF ENVIRONMENTAL Si~VICES O 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 BUSINES.~NAME (Same~as FACILITY NAJ~-ee~ - Deang I~ A~) UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE I. FACILITY IDENTIFICATION One form per tank II. INSTALLATION Check all that apply The installer has been certified by the tank and piping manufacturers. The installation has been inspec*,-xl and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: III. TANK OWNER/AGENT SIGNATURE '~ME OF TANK OWNER/AGENT (;~m) 1 Po*m ¢ ....IT~I~_ ~ crrY OF ~AKERSFiELD it ~ ~' OFIqCl O~ INVRONMENTAL ~ ' iIJJTI$ ClIIItI¢' Av~,, lakerlfleld, CA 13301 (~1) -- CONSTRUCTiON/,[:] L SINOt. l= WALL [] 3. LINEDTR~CH ['-] ~. OTH~,R 4~0 [] 1, SINC,.LEWALL r-'] 96. UNK.NOW~ · MANUFACTURERI,~. OOU~LE WALL [] (~. UN~ ,~2. DOUeLE WALL [] 9g. OTHER ; J MANUFACTURER 4~1 M.~4UFACTURER BARE STEEL [] 8. FlIP COMPATIBLE W/100% ME~L STAINLESS STEEL .~. GALV~O ~ R_ASTIC COMPATIBLE W1TH CONTENTS [] 8. ~ (HI~3~) [] 99. OTHER O~SPe~ERCONT~'~e. NT [] 1. m.O~T~T~TaitU~O~ltt~VN.V~ DATE IN3TALLEO [] 3. CONTI~$ 04~ ~ ~ ~ ~O~ OFF FOR D~R ~' AUDBLE ANO VI~UAL A~ [~ 8. NONI~ ' 4~g IX. OWN~I~JOPERJ~TO~ SIGNATURE S:\CUPAFORMS~WRC~&W?~': TYPE OF ACTION [] 1. NEW SITE P~RMIT (Clleck one dem only) CITY OF BAKERSFIELD FICE OF ENVIRONMENTP ISERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY e~3. RENEWAL PERMIT [] .5. CHANGE OF INFORMATION (,..~oec~/change - J--] 4. AMENOED PERMIT local use only). [] 6. TEMPORARY SITE CLOSURE J-'1 ?. PERMANENTLY CLOSED SITE [] 8. TANK REMOVED 400 I. FACILITY / :SITE INFORMATION BUSINESS NAME (~em® aa FACILiT~ NAME or OJJA - Doing Bus~e~ ~) 3 BUSINESS ,,J~J'-I":'I:~K~STATION r-J 3. FARM [] 5. COIv~,~ERCIAL TYPE [] 2. DISTR,eUTOn [] 4. P~)GESSOR [] 6. OT~E. 4o3. TOTAL NUI~R OF TANf~ REMAINING AT S~ ¢ FACILITY ID # FACILITY OWNER T'YF~ [] 1. CORPORATION [] 2. INDIVIDUAL [] 3. PARTNERSHIP 'lf owner o~ UST a ix~b#c age~'y:, n~,rm o~ supe,*vimx of r'-] 4. LOCAL AGENCY/DISTRICT' [] 5. COUN13' AGENCY' [] 6. STATE AGENCY* [] 7. FED~ AGENCY' ' '" : - IL PROPERTY OWNER INFORMATION [] 3. PARTNER.,~IP [] 4. LOCALAC-~/DI~ [] 5. COUNTY AGENCY 412. [] 6. STATE AGENCY 413. IILTANKOWNERiNFORJdATION. ;!. ';, .' .. 415. OWNER NAME CITY~,~t~ ~ 417. [~._STATE 418. I ZIP CJ3DE 9 ,,.~ ~O jl 419. TANK OWNER TYPE 1.jj~,~ [] 2. INOIVtOt.JAL [] 4. LOCAL AGENCY/DISTRICT [] 6. STATE AGENCY 420. T~ON [] 3. e~sH~e [] 5. cou~rrYAC, a,~Y [] 7. ~DeRALAGENCY TY ('rK) HQ J414 ' . IV. BOARD OF EQUALIZATION U8T STORAGE FEE ACCOUNT NUMBER ::.. '... r'. : .:~...,~.. · V. PETROLEUM UST FINANCIAL RESPONSIBIUTY 421. ~NOIC~TE METHO0(S) [] 10. LOCAL GOV'F MECHANISM [] 99. OTI-IER: [] s. SELF4NSURED [] 4. SURETY BOND ~"rr-S~TE FUND [] 2. GUARANTEE . [] 5. LETTEROF CREDrT [] 8. STATEFUND&CFO Lei,e.R [] 3. INSURANCE E] 6. EXEMPTION [] 9. STATE FUND & CD 4'~'~' VI, LEGAL NOTIFICATION AND MAILING ADDRESS Chec~ ~ ~ ID ifl~llcate wtdctl adcireaa ~ I~e uled fa~'.legal ~ m~d mailing. [] 1. FACILITY [] 2. PI:JOPERTY OWNER J--J 3. TANK OWNF-R 423. VII. APPLICANT SIGNATURE STATE UST FACILITY NUMBER (Fae'/m~/uae 428. 1~98 U~ CERTIFICATE NUIHIIER (Far,ocli uae on/y) JPCF (7199) S:\CU PAFORMS~sw~ct)-a-wpd Permit Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the [ollowing: ~t~ ??i?i~., ~ii~:.!! :~?~::~:'"::;i '~ili!i{:~.. :~ii!!!iiii,~. iiiii~?~::~iii[i:i}::~Di;iO~Be[ground Storage of Ha~rdous Materials PE~IT ID ~ 015-021-001920 ~*~'~* ~= ~ ~? '~* ..... ~%:~' .... ,~ ~C,, ....... :~,. ~*~%,~,,~4~-:4:: ............. ,~, · :,:~ '. :-..' J~ ~.~t ..... ':~ "-~',~s~ ', ..... ~-" i LOCA~ON 2317 ~L...'.~ S~ :~ ............ :~:~'~~FI~D ~'-,,. ". ~ I ~ ............... ~:"~ ~:'~ · . ' , ~ ....... ~ $. ............... ~ z'~i ' ~ ' 'e ~" ".~z ,J~ 14 ~'- -,~ ~;~: '" ' ..... ~ '~:? ~ ~:~;T~N~ PIPING PIPING PIPING TANK .~A~OUSSUBSTANCE CA~C!yY ~:~AL _g~]~,?: TANK '~?"::~"~ '~:?,. ~8~:.': TYPE "~MX~TER!~L ~ITOR TYPE METHOD MONITOR -~""~ "::A I~ D~lex P~SSU~ ALD 0001 G~ol~e 12,000%. ~al~.,,. 1998.,,"..::'~:- DWS F 0002 G~oline 8,00~:....:':::.~.:.,:.~Gai~,.,~ :~:~:;~?:~,~i~9~8~.~?, ~',::~.;~;',. :;:~E%~,~,,~ .?..:" :~LD DWFlex P~SSU~ ALD 0~03 Gasoline 8,000 '"~:;..'Gat~,,;'.'~. ~, .,~i~8~ ,~,~ .... ~ ........ ~ ............... ....~,.,: .~ ....... ALD D~lex P~SSU~ ALD '":::';:~t~:~:,::~;:~.¥.~,." .d ?' =:' .d gt.=~*~t~'=''' Issu~ by: O~CE OF E~ON~AL 5~ B~e~el~ CA 95501 Voice (805) 32~3979 F~ (80S)~2~576 ExpkationDate: dUn~ ~O~ ~O00 TYPE OF ACTION ~'N (Check one ilem only) EW SITE PERMIT ' FFICE CITY OF BAKERSF i D OF ENVIRONMENTA r SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 [] 3 RENEWAL PERMIT [] 4 AMENDED PERMIT UNDERGROUND STORAGE TANK FACILITY Page __ of __ [] 5 CHANGE OF INFORMATION (State type of change) [] 7 PERMANENTLY CLOSED SITE [] 8 TANK REMOVED 400 [] 6 TEMPORARY SITE CLOSURE I. FACILITY I SITE INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) NEAREST CROSS STREET 401 BUSINESS '~1 GAS STATION [] 3 FARM [] 5 OTHER 403 TYPE [] 2 DISTRIBUTOR [] 4 PROCESSOR [] 6 COMMERCIAL [] 4 LOCAL AGENCY/DISTRICT* [] 5 COUNTY AGENCY' [] 6 STATE AGENCY' [] 7 FEDERAL AGENCY* FACILITY OWNER TYPE CORPORATION [] 2 INDIVIDUAL [] 3 PARTNERSHIP 402 TOTAL NUMBER OF TANKS Is facility on Indian Rese~'ation or 'If owner of UST a public agency: name of supervisor of REMAINING AT SITE trustlands? division, section or office which operates the UST. (This is the contact person for the tank records.) 404 [] Yes '~l~No 405 406 :' II. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME 407 PHONE ,~,a~7 408 MAILING OR STREET ADDRESS 409 CITY 410 STATE 411 ZIP PROPERTY OWNER TYPE n~;~'1 CO RPO RATIO N 412 [] 2 INDIVIDUAL [] 4 LOCAL AGENCY/DISTRICT [] 6 STATE AGENCY 413 [] 3 PARTNERSHIP [] 5 COUNTY AGENCY [] 7 FEDERAL AGENCY PHONE TANK OWNER NAME MAILING OR STREET ADDRESS 414 415 416 i CITY r..JA 419 TANK OWNER TYPE CORPORATION [] 2 INDIVIDUAL [] 3 PARTNERSHIP [] 4 LOCAL AGENCY / DISTRICT [] 5 COUNTY AGENCY [] 6 STATE AGENCY [] 7 FEDERAL AGENCY 420 · , ' ' ' IV. BOARD OF EQUALIZATION U TSTORAGE FEE AccO NUMBER :' · TY (TK) HQ 4 4. - . Call (916) 322-9669 if questions arise V, PETROLEUM UST FINANCIAL RESPONSIBILITY 421 INDICATE METHOD(S) [] 1 SELF-INSURED [] 2 GUARANTEE [] 3 INSURANCE [] 4 SURETY BOND [] 5 LETTER OF CREDIT [] 6 EXEMPTION [] 7 STATE FUND [] 8 STATE FUND & CFO LETTER [] 9 STATE FUND & CD [] 10 LOCAL GOV'T MECHANISM [] 99 OTHER: 422 VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate which address should be used for legal notifications and mailing. Legal notification and mailing will be sent to the tank owner unless box 1 or 2 is checked. FACILITY [] 2 PROPERTY OWNER [] 3 TANK OWNER 423 VII. APPLICANT SIGNATURE Certification:~,,I,.ce[tify/t,l:~l the inform ati~o~,~ p?~ed herein ,s~ accurate to the besl of m y knowledge 424 PHONE 425 427 STATE UST FACILITY NUMBER (For local use only) 1998 UPGRADE CERTIFICATE NUMBER (For local use only) (Formerly SWRCB Form A) July 1. 1998 P:\USTFAC-A.FM4.wpd CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank Page __ of __ I. FACILITY IDENTIFICATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) FACILITY ID # ~l ~ ~2. OI~ '"~ (Jl.~ TANK ID # · '11. INSTALLATION Check 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 City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: I certify that the information provided h.h.h~ein is tru~ s, .72:F & accurate to the best of my knowledge DATE / 465 TITLE OF TANK OWNER/AGENT 464 466 (Formerly SVVRCB Form C) F CITY OF BAKERS FFICE OF ENVIRONMENT SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per malahal per bu#~ing or area) [] ADO [] DELETE E] REVISE 200 Page __ of ~ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME ~ DBA - Doing Business As) 3 CHEMICAL LOCATION 202 CHEMICAL NAME COMMON NAME CAS # 201 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) [] Yes [] No MAP # (optional) 203 GRID # (optional) 204 II. CHEMICAL INFORMATION 1 I 2O5 207 TRADE SECRET [] Yes ~No 206 If Subject to EPCR~. refer to iinstrucfions EHS' FIRE CODE HAZARD CLASSES (C~nplete if requested by local fire c~ief) TYPE '~p PURE [] m MIXTURE [] w WASTE 211 *i PHYSICAL STATE [] S SOLID ~l LIQUID [] g GAS 214 210 RADIOACTIVE [] Yes [] No 212 CURIES 213 LARGEST CONTAINER 215 FED HAZARD CATEGORIES [] 1 FIRE (Chec~ all {hat apply) ANNUAL WASTE 217 AMOUNT UNITS* [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH MAXIMUM 218 AVERAGE DAILY AMOUNT DAILY AIvlDUNT []ga GAL [] c~ CU FT [] lb LBS [] tn TONS · If EHS, amount must be in lbs. [] 5 CHRONIC HEALTH 216 219 1STATE WASTE CODE 220 221 t' DAYS ON SITE 222 STORAGE CONTAINER (Check all that apply) I-1 a ABOVEGROUND TANK (~ UNDERGROUND TANK [] c TANK INSIDE BUILDING [] d STEEL DRUM [] · PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] g CARBOY [] k BOX [] o TOTE BIN [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224 : STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT [::] c CRYOGENIC 225 : 226 2 230 3 J 234 4 / 238 III. SIGNATURE PRI~E REPRESENTATIVE~;~', //L~,/T/~/~[~4~--SIGNATURE 227 [] Yes [] No 228 229 231 [] Yes [] No 232 233 235 [] Yes [] No 236 237 239 [] Yes [] No 240 241 243 [] Yes [] No 244 245 DATE 246 OES FORM 2731 (7/98) P:~OES2731.TV4.wpd CITY OF BAKERSFI ,D FFICE OF ENVIRONMENTAl'SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 Page __ TYPE OF ACTION ~[~1 NEW SITE PERMIT [] 3 RENEWAL PERMIT [] S CHANGE OF INFORMATION (State Iype of c~ange) [] ? PERMANENTLY CLOSED ON SITE Check one ilem only [] 4 AMENDED PERMIT r'-] 6 TEMPORARY SITE CLOSURE [] 8 TANK REMOVED LOCATION (Optional) UST Tank 429 1 I. TANK DESCRIPTION TANK ID # DATE INSTALLE? (YEAR~.MO) 430 433 TANK MANUFACTURER TANK CAPACITY IN GALLONS 431 434 COMPARTMENTALIZED TANK ~(es [] No If'Yes'. complete one form f~ ~bach compartment. NUMBER OF COMPARTMENTS 432 435 only) TANK USE 437 J~l MOTOR VEHICLE FUEL (If marked, complete Vehicie Fuei Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 95 UNKNOWN TYPE OF TANK II. TANK CONTENTS VEHICLE FUEL TYPE 438 ~la REGULAR UNLEADED [] 2 LEADED [] 5 JET FUEL [] lb PREMIUM UNLEADED [] 3 DIESEL [] 6 AVIATION FUEL [] 1c MIDGRADE UNLEADED [] 4 GASOHOL [] 99 OTHER COMMON NAME (from Hazardous Materials Inventor/page) IlL TANK.CoNsTRuCTION · , .... ~' : [] I SINGLE WALL [] 3 SINGLE WALL WITH 439 CAS # (from Hazardous Materials Inventory page) [] 5 INTERNAL BLADDER SYSTEM 440 441 Check one item only ,,[~2 DOUBLE WALL [] 95 UNKNOWN EXTERIOR MEMBRANE LINER [] 4 SINGLE WALL IN A VAULT [] 99 OTHER TANK MATERIAL (pdmary tank) Check one item only TANK MATERIAL (secondary tank) Checf( one item only IN 11::HIOR LINING OR COATING Chec~ one item only [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 1 RUBBER LINED [] 2 ALKYD LINING '~] 4 STEEL CLAD W/FRP [] 3 FIBERGLASS [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] 4 STEEL CLAD W/FRP ~'3 FIBERGLASS [] s CONC~:TE [] 8 FRP COMPATIBLE W/100% METHANOL [] 9 FRP NON-CORRODIBLE JACKET [] 10 COATED STEEL [] 95 UNKNOWN [] 99 OTHER [] 95 UNKNOWN [] 99 OTHER [] 3 EPOXY LINING [] 5 GLASS LINING [] 4 PHENOLIC LINING [] 6 UNLINED OTHER CORROSION [] I MANUFACTURED CP ~3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN PROTECTION IF APPLICABLE Check one,item only [] 2 SACRIFICIAL ANODE [] 4 IMPRESSED CURRENT [] 99 OTHER [] 95 UNKNOWN oTHER 442 443 445 SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) I ¢~ t~ OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) / ¢:~,g~ ~ 446 447 Check all that apply DROP TUBE Wes [] No 448 ~)1 ALARM STRIKER PLATE '~es [] No 449 [] 2 BALL FLOAT FILL TUBE SHUT OFF VALVE IF SINGLE WALL TANK (~ all that apply): IF ~UBLE WALL TANK (~ ~e it~ ~ly): 450 ~ 1 VISUAL (~SED ~RTION ONLY) D 5 ~NU~ TANK ~UGING (~O) ~ 8 VISUAL (SINGLE WALL IN VAULT ONLY) ~ 2 AUTO~TIC TANK ~UGING (ATG) ~ 6 VALSE ZONE ~ CONTINUOUS INTERSTITIAL ~N~ORING ~ 3 CONTINUOUS ATG ~ 7 GROUNDWATER ~ 4 STATISTI~L I~ENTORY RE~NCILmTION (SIR) + ~ ~ OTHER BIENNIAL TANK TESTING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 452 GAS TANK FILLED WITH INERT MATERIAL? 453 ESTIMATED OATE LAST USED (YR/MO/DAY) July t, 1998 Formerly SWRCS Form B P:\USTTNK-B.CM3.wpd CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES Chester Ave.. Bakersfield, CA 93301 (805) 326-~'/9 UST - TANK PAGE Page .. O~ __ ABOVEGROUND PIPING INFORMATION ~2 PRESSURE r-] 3 GRAVITY UNDERGROUND PIPING INFORMATION ~2 PRESSURE 3 GRAVITY [3 SYSTEM TYPE [] t SUCTION 454 [] 1 SUCTION 455 [] 1 SINGLE WALL [] 95 UNKNOWN [] 1 SINGLE WALL . [] 3 LINED TRENCH [] 99 OTHER .~ONSTRUCTION [] 2 DOUBLE WALL [] 99 OTHER 450 ,~2 DOUBLE WALL [] 95 UNKNOWN 454 [] 0 FRP COMPATIBLE WI 100~ METHANOL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS [] 8 FLEXIBLE [] 99 OTHER [] 5 STEEL W/COATING [] 9 CATHODIC PROTECTION 455 [] 1 BARE STEEL [] 2 STAINLESS STEEL ABOVEGROUND PIPING INFORMATION MATERIALS AND CORROSION PROTECTION r-11 BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS I'"1 95 UNKNOWN F-l*4 FIBERGLASS ~ 8 FLEXIBLE [] 99 OTHER [] 5 STEEL Wi COATING [] 9 CATHODIC PROTECTION 456 I :i(check all that apply). ....,~:!~¥::: :.: ..... ~:_.........i~i:.. '.. UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 456 .iT~SSURIZED 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 SINGLE WALL PIPING 457 PRESSURIZED PIPING (Chest< 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 (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ~3'4 DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: '~5 SELF MONITORING VITY FLOW: 6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): [] 2 MONTHLY 0.2 GPH TEST [] 3 ANNUAL INTEGRITY TEST (0.1 GPH) [] 4 DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check all that apply): [] 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] 7 SELF MONITORING GRAVITY FLOW (Chect< all that apply): [] 8 DALLY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chect< all that apply): ~(7 CONTINUOUS TURBINE SUMP SENSOR W1TH AUDIBLE AND VISUAL ALARMS AND (Cheok o~e) ~'a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] 13 AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION [] c NO AUTO PUMP SHUT OFF .~ 8 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [~ 9 ANNUAL INTEGRITY TEST (0.1 GPH) F"] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (check o~e) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] 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 (Chec~ 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 EMERGENCY GENERATORS ONLY (Check all that apply) [] 10 CONTINUOUS SUMP SENSOR WITHOI)T AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS .,~ 11 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 13 DAILY VISUAL CHECK 462 464 DISPENSER [] 1 FLOAT MECHANISM TNAT SHUTS OFF SHEAR VALVE [] 3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER CONTAINMENT [] Yes [] No [] 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS :>DAILY VISUAL CHECK IX. OWNEI~OPERATOR SIGNATURE ~(E~O~ 0~ E R/O p i~'~0 R ~..~ 463 TITLE OF OWNEI~OPERA~TOR IP~mit NumDef (For local uSe o~ly) IPem~lt Approved Pe~mil Expiration Date July 1, 1 ~ga p:tuSTTNK-B.CM3.wpd Formerly SWRCB Form B CITY OF BAKERSF~LD OFFICE OF ENVIRONMENTA-L SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 I-I ADO I"'! 0ELETE r"] REVISE 200 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per material per building or area) Page __ of ~ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business AS) 3; CHEMICAL LOCATION -'F.~ji-iTY i~'~ ..... ~i~~ ---i MAP # (opt/onal) " II. CHEMICAL INFORMATION CHEMICAL NAME COMMON NAME CAS # 201 CHEMICAL LOCATION [] No 202 CONFIDENTIAL (EPCRA) 204 203 GRID # (o,ot/onal) 205 207 TRADE SECRET L.J Yes o 206 If Su0ject to EPCRA. re er to iinstructions EHS' [] Yes f~o ~l! FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) TYPE ~ p .uRE [] m M~tURE PHYSICAL sTAtE [] s sOuD ~ uau~D FED HAZARD CATEGORIES [] 1 FiRE 1--1 2 REACTIVE (Chec~ all that al~ply) ANNUAL WASTE 217 I MAXIMUM AMOUNT I DAILY AMOUNT UNITS' [] ga GAL [] w WASTE 211 I RADIOAcTIVE [] Yes [--I g GAS 214] LARGEST CONTAINER [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH 218 AVERAGE DAILY AMOUNT [] ct' CU FT [] lb LBS [] tn TONS * If EHS. amount must be in lbs. 210 [] NO 212 CURIES 213 215 [] 5 CHRONIC HEALTH 216 219 STATE WASTE CODE 220 DAYS ON SITE 222 221 STORAGE CONTAINER r-I~ [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check all thatapply) ABOVEC;~OUND TANK [] · PLASTIC/NONMETALLIC DRUM UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL ORUM [] I~ SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT 224 [] ba BELOW AMBIENT [] c CRYOGENIC 225 STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT ........... ~,.,~, .:... .,~,..:,~,:.>.~-.::.? ;- .... .'.': ;.: '..,. ',. ,~,::,,.~:~. .:~?::.':~ 'i '' 'o "...:'.::~',: ::.; .:;.;.~:.,:~ ':.'. -:.: ?"~' -':' ..... · ...... ..... :... YoWT.... :.:-:.' ?;::::~:?~; :~::s!: :::' .:::! ..' ::. '.'....: .:.' '.~:':'.;i' HAZARDOUS ~OM~ONENT 1 226 2 230 3 234 4 238 IlL SIGNATURE SIGNATURE 227 [] Yes [] NO 228 231 [] Yes [] No 232 233 235 [] Yes [] No 236 237 239 [] Yes [] No 240 241 243 [] Yes [] NO 244 245 DATE 246 P:\OES2731, TV4.wod DES FORM 2731 (7/98) CITY OF BAKERSFIiiD FICE OF ENVIRONMENTAL'm3ERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 TYPE OF ACTION Check one item only ~NEW SITE PERMIT [] $ RENEWAL PERMIT [] 4 AMENDED PERMIT BUSINESS NAME (Same as FACILITY NAME ~ DBA - Odng Business As) LOCATION (Opt/onal) c~ Page __ of [] 5 CHANGE OF INFORMATION (Slale type of c~enge) [] ? PERMANENTLY CLOSED ON SITE r-] 6 TEMPORARY SITE CLOSURE [] 8 TANK REMOVED UST Tank - 1 429 TANK ID # DATE INSTALLED (YEN=//MO) , ADDITIONAL DESCRII~'ION (P~' local use only) 430 433 I. TANK DESCRIPTION TANK MANUFACTURER TANK CAPACITY IN GALLONS 431 434 COMPARTMENTALIZED TANK II,Yes [] No If 'Yes'. complete one form f~ each compartment. NUMBER OF COMPARTMENTS 432 435 II. TANK CONTENTS VEHICLE FUEL TYPE 438 [] la REGULAR UNLEADED [] 2 LEADED [] 5 JET FUEL [] lb PREMIUM UNLEADED [] $ DIESEL [] 6 AVIATION FUEL [] lc MIDGRADE UNLEADED [] 4 GASOHOL [] 99 OTHER 1' TANK USE 437 MOTOR VEHICLE FUEL (If marked, complete Vehicle Fue~ Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 9s UNKNOWN COMMON NAME (from Hazardous Materials Inventory page) 439 CAS # (from Hazardous Materials Inventocy page) 440 .. · : , ' ' "'~:,:~ :IlL TANK CONSTRUCTION ~. ',i:' .. ':: :i [] 1 SINGLE WALL [] 3 SINC~E WALL WITH [] 5 INTERNAL 8LADDER SYSTEM 441 .~ EXTERIOR MEMBRANE LINER [] 95 UNKNOWN DOUBLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER TYPE OF TANK Check one item only TANK MATERIAL (pdmary tank) Check one ilem only TANK MATERIAL (secondary tank) Check one item enly [] 1 BARE STEEL r'] 2 STAINLESS STEEL [] 1 BARE STEEL [] 2 STAINLESS STEEL '~4 STEEL CLAD W/FRP [] 3 FIBERGLASS [] 4 STEEL CLAD W/FRP ..~/3 FIBERGLASS [] 5 CONCRETE [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] 8 FRP COMPATIBLE W/100% METHANOL [] 9 FRP NON-CORRODIBLE JACKET [] 10 COATED STEEL [] 95 UNKNOWN [] 99 OTHER [] 95 UNKNOWN [] 99 OTHER 442 443 INTERIOR LINING OR COATING Check one item only OTHER CORROSION PROTECTION IF APPLICABLE Check one item only [] 1 RUBBER LINED [] 3 EPOXY LINING [] 5 GLASS LINING [] 95 UNKNOWN []2 AI~D LINING [] 4 PHENOLIC LINING 06 UNLINED ~ OTHER ~ ~--.. ~ FIBERGLASS REINFORCED PLASTIC [] 4 IMPRESSED CURRENT [] 1 MANUFACTURED CP [] 2 SACRIFICIAL ANODE [] 95 UNKNOWN [] 99 OTHER 445 SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) / ? ? ~ OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) {~'~ ~ 446 447 Check all that apply DROP TUBE ~es [] No 448 ~ ALARM STRIKER PLATE es [] No 449 [] 2 BALL FLOAT :~ FILL TUBE SHUT OFF VALVE . ,'....~., .~, ;~:..~':~.~ ,,? :.o ~.~,~,,-; ' .~.-~7.~-~,'~..~,~<~,.~.~,~. ~;:.~'~'~: ~:~.:,.~ ...:,~,~]~,;~:~ ~,.~ :~ ~ ;; ~.x' '<<~-~,~.-...~ ,: ..... : ..... ~ :' ,:,.':- ~: ;, : '.,~.-~ ~,. IF SINGLE WALL TANK (Check all that apply): l'--J I VISUAL (EXPOSED PORTION ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 3 CONTINUOUSATG [] 4 STATISTICAL INVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING [] 5 MANUAL TANK GAUGING (MTG) [] 6 VADOSE ZONE [] 7 GROUNDWATER [] 99 OTHER IF DOUBLE WALL TANK (check one item only): 450 [] 8 VISUAL (SINGLE WALL IN VAULT ONLY) [] 9 CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 451 ESTIMATED QUANT~REMAINING 452 GAS TANK FILLED WITH INERT MATERIAL? 453 ~3al [] yes ~10 ESTIMATED OATE4~D (YR/__.I~O_/DAY) July I, 1998 Formerly SWRCB Fo~'m B P:\USTTNK-B.CM3.wpd 'l ,.,~ CITY OF BAKERSFIELD ~b t OFFICE OF ENVIRONMENTAL SERVICES W ~ 5 Chester Ave., Bakerefleld, CA 93301 (805) 326-3979 UST-TANKPAGE ~1 P~e ~ ~ ( MATERIALS AND CORROSION PROTECTION [] 1 BARE STEEL [] 2 STAINLESS STEEL UNDERGROUND PIPING INFORMATION -~TEM TYPE [] t SUCTION [] 2 PRESSURE [] 3 GRAVITY 454 [] 1 SUCTION ~2 PRESSURE [] 3 GRAVITY 455 [] 1 SINGLE WALL [] 95 UNKNOWN [] 1 SINGLE WALL [] 3 LINED TRENCH [] 99 OTHER ~.ONSTRUCTION [] 2 DOUBLE WALL [] 99 OTHER 450 '~ DOUBLE WALL [] 95 UNKNOWN 454 [] 1 BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] 7 GALVANIZED STEEL :¥.i.:,::. ' ..: VL.' PIPING CONS'rRUCTION ABOVEGROUND PIPING INFORMATION [] 6 FRP COMPATIBLE WI 100% METHANOL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE wrrH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS I-] 8 FLEXIBLE [] 99 OTHER [] 5 STEEL W/COATING [] 9 CATHODIC PROTECTION 455 [] 3 PVC COMPATIBLE WITH CONTENTS [] 4 FIBERGLASS i(~,~J'~LEXlBLE [] 5 STEEL W/COATING 11 9 CATHODIC PROTECTION [] 95 UNKNOWN [] 99 OTHER 456 ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 457 SINGLE WALL PIPING 456 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 PRESSURIZED PIPING (Chec~k 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 VISUAL ALARMS 2 MONTHLY 0.2 GPH TEST ~/3 ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: r~4 MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY DAILY VISUAL TEST (0.1 GPH) SAFE SUCTION SYSTEMS: ~5 SELF MONITORING RAVITY FLOW: 6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING [] 2 MONTHLY 0.2 GPH TEST [] 3 ANNUAL INTEGRITY TEST (0.1 GPH) [] 4 DALLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check all that apply): [] 5 DALLY VISUAL MONITORING OF PUMPING SYSTEM [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] 7 SELF MONITORING GRAVITY FLOW (Chec$~ all that apply): [] 8 DALLY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING ~;~/ESSURIZED PIPING (Check all that apply): CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Chec~ one) ~ a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION [] c NO AUTO PUMP SHUT OFF AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Check all that apply) PRESSURIZED PIPING (Chec~ all that apply): [] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (c~ec~ one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION [] c NO AUTO PUMP SHUT OFF [] 11 AUTOMATIC LEAF, DETECTOR [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEMf [] 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 []~,0 CONTINUOUS SUMP SENSOR VVITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS ~1 VISUAL ALARMS [] 15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) I AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 16 ANNUAL INTEGRITY TEST (0.1 GPH) [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 17 DAILY VISUAL CHECK [] 13 DAILY VISUAL CHECK ~, ~ n,~ . ~.-,~-~;~., ,~:,~ ..... ~:~*:~ ~: ~.~,::~,':~-~'~;~+~ : ~ ~,,~:~ ,' ::~:.~ ~:~'~'~:/~ ~':~:'~'~':~ .... :::~ h.::, '- ,.: ..: ............ ~:~::?::~.: ?.:~::~: .... .~ .:- ~.~,:.,. :.,:::~?;~(4~4~ ~}~II~D~RENS~R~.CONTAINMENT :; ~ ~%~ ~, ~;,~;~ :. ~(?~ ~ ~, ~ ~ ~: ..... DISPENSER ~ 1 FLOAT MECH~ISU T~T SHUTS OFF SH~R V~VE ~ 3 ~INUOUS DISPENSER PAN SENSOR ~T~ AUTO SHUT OFF FOR DISPENSER CO~AINMENT ~ Y~ ~ No D 2 ~INUOUS ELEC~ONIC SENSOR + AUDIBLE ~D VISUAL ~S + AUDIBLE ~D VISUAL A~RMS ~ 4 DALLY VISUAL CHECK I certify th.,,~'th~ inf~tio~ provid~4'n is true &~:urate to the best of my IkXn 'owlOeclg~e. ER~OPERATOR SIGNATURE i! NAi~,U=e...O~-a.,OWNER/OPERA~,q~,~ 463 TITLE OF OWNER/OPERATOR IPenT, it Number (For local uSe only) Pe~nit Approved Expiration Date 462 464 July I. 1998 p:~uSTTNK-B.CM3.wpd Formedy SWRCB Form 8 CITY OF BAI RSF D OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per material per building or ama) [::] ADO r"l OELETE [-] REVISE 200 Page __ of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA * Doing Business As) 3 CHEMICAL LOCATION 201CONFIDENTIALCHEMICAL LOCATION(EPCRA) [] Yes [] No 202 ~ ~F~ii'iT~ ib ~ ~: ?~ ' .... i MAP#(opt/onaO 203 204 CHEMICAL NAME COMMON NAME II. CHEMICAL INFORMATION 205 207 2O9 TRADE SECRET FI Yes ~Lj~lo 206 If Sui~jec{ to EPCRA. refer Io iinstYbctions EHS' CAS # FIRE CODE HAZARD CLASSES (Complete if re(~uested hy local fire chief) 2~o TYPE ~p PURE [] m MIXTURE [] w WASTE 211 RADIOACTIVE [] Yes [] No 212 J CURIES 213 *i PHYSICAL STATE [] S SOLID ~1 LIQUID [] g GAS 214 LARGEST CONTAINER 215 FED HAZARD CATEGORIES (Chec~ all that apply) ANNUAL WASTE AMOUNT [] 1 FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH 217 MAXIMUM 218 I AVERAGE DAILY AMOUNT I DAILY AMOUNT UNITS' [] ga GAL [] cf CU FT [] lb LBS [] ~1 TONS * If EHS. amounl must be in lbs. [] 5 CHRONIC HEALTH 216 219 STATE WASTE CODE 220 · 221 DAYS ON SITE 222 STORAGE CONTAINER (Check all that apply) [] a ABOVEGROUND TANK ~ UNDERGROUND TANK [] c TANK INSIDE BUILDING [] d STEEL DRUM [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] g CARBOY [] k BOX [] o TOTE BIN [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224 STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT [] c CRYOGENIC 225 226 227 [] Yes [] No 228 229 230 231 [] Yes [] No 232 233 235 [] Yes [] No 236 237 239 []Yes []No 240 241 . 243 245 3 234 4 238 PR~OF~~RESENTATIVE IlL SIGNATURE SlGNATE/ [] Yes [] NO 244 DATE 246 OES FORM 2731 (7/98) P:\OES2731 .TV4.wpd FICECITY OF BAKERSFIIiiD OF ENVIRONMENTA'E' SERVIC ES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 TYPE OF ACTION Check one item only NEW SITE PERMIT [] 3 RENEWAL PERMIT [] 4 AMENDED PERMIT BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) LOCATION (O. otionaO UST Tank - 1 Page __ of ~ [] 5 CHANGE OF INFORMATION (Stale lype of change) [] ? PERMANENTLY CLOSED ON SITE [] 6 TEMPORARY SITE CLOSURE [] 8 TANK REMOVED 429 / I. TANK DESCRIPTION TANK ID # 430 DATE INSTALLED (YEApJMO) 433 ADDITIONALIDESCRIPTION (For local use only) TANK MANUFACTURER TANK CAPACITY In GALLONS 431 434 COMPARTMENTAUZED TANK ~t'ea [] NO If 'Yes'. complete one form for each compartment. NUMBER OF COMPARTMENTS 432 435 II. TANK cONTENTS TANK USE 437 ~)1 MOTOR VEHICLE FUEL (if marked, complete Vehicle Fuel Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 95 UNKNOWN VEHICLE FUEL TYPE [] la REGULAR UNLEADED )lb PREMIUM UNLEADED [] lc MIDGRADE UNLEADED [] 2 LEADED [] 5 JET FUEL [] 3 DIESEL [] 6 AVIATION FUEL [] 99 OTHER [] 4 GASOHOL COMMON NAME (from Hazardous Materials Inventory page) 439 I CAS # (from Hazardous Materials Inventcxy page) 440 · " .' ::. :.'!LTANK.CONsTRuCTioN .:',:':: ' .:": :' TYPE OF TANK Check one item only [] I SINGLE WALL 1~2 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR MEMBRANE LINER [] 4 SINGLE WALL IN A VAULT [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN [] ~9 OTHER 441 TANK MATERIAL (pdma~ tank) Chec~ one item only TANK MATERIAL (secondary lank) Check one item only [] 1 BARE STEEL [] 2 STAINLESS STEEL J~4 STEEL CLAD W/FRP [] 3 FIBERGLASS [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 4 STEEL CLAD W/FRP ,~ 3 FIBERGLASS [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] 9 FRP NON-CORRODIBLE JACKET [] 10 COATED STEEL [] 95 UNKNOWN [] 99 OTHER 442 [] 95 UNKNOWN [] 99 OTHER 443 INTERIOR LINING OR COATING Check one item only OTHER CORROSION PROTECTION IF APPLICABLE Check one item only SPILL AND OVERFILL Check all that apply [] 1 RUBBER LINED [] 3 EPOXY LINING [] 5 GLASS LINING [] 95 UNKNOWN 444 [] 2 ALKYD LINING I--1 4 PHENOLIC LINING [] 6 UNLINED 4:~'~9 OTHER [] I MANUFACTURED CP ,~3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN 445 [] 2 SACRIFICIAL ANODE [] 4 IMPRESSED CURRENT [] 99 OTHER SPILL CONTAINMENT INSTALLED (YEAR) / c~,~ ~ OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) 446 447 DROP TUBE ~Yes [] No 448 Z~l ALARM STRIKER PLATE c~es []No 449 ;~2 BALL FLOAT ~:3' 3 FILL TUBE SHUT OFF VALVE IF SINGLE WALL TANK (Chec~ all that apply): [] I VISUAL (EXPOSED PORTION ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 3 CONTINUOUSATG [] 4 STATISTICAL INVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING [:]5 MANUALTANKGAUGING(MTG) [::]6 VADOSEZONE []7 GROUNDWATER [] 99 OTHER IF DOUBLE WALL TANK (Checfc one item only): 450 [] 8 VISUAL (SINGLE WALL IN VAULT ONLY) ~)9 CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 452 GAS TANK FILLED WITH INERT MATERIAL? 453 qal []Yes ~0 ESTIMATED DATE LA,~.,~,,,...~.Q.,IYR/IVlO/DAY) July I, 1998 FotmeHy SWRCB Form B P:\USI'TNK-B.CM3.wpd CITY OF BAKERSFIELD A OFFICE OF ENVIRONMENTAL SERVICES ~ Chester Ave., Bakerlfleld, CA 93301 (805) 326-3979 UST. TANK PAGI ABOVEGROUND PIPING INFORMATION -~TEM TYPE ;ONSTRUCTION MATERIALS AND CORROSION PROTECTION [] t SUCTION [] :2 PRESSURE [] 3 GRAVITY 454 [] 1 SINGLE WALL [] 95 UNKNOWN [] 2 DOUBLE WALL [] 99 OTHER 450 [] 1 BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS [] 8 FLEXIBLE [] 99 OTHER [] 5 STEEL W/COATING [] 9 CATHODIC PROTECTION 455 -'(Check all ifiat a0olv) ~ · :: UNDERGROUND PIPING ~NFORMAT~ON [] 1 SUCTION ,~ PRESSURE [] 3 GRAVITY [] 1 SINGLE WALL ~] 3 LINED TRENCH [] 99 OTHER 1~ OOUBLE WALL [] ~s UNKNOW. [] I BARE STEEL [] 2 STAINLESS STEEL [] 6 FRP COMPATIBLE W/100% METHANOL [] 7 GALVANIZED STEEL 455 454 [] 3 PVC COMPATIBLE WITH CONTE.NT/~ [] 95 UNKNOWN [] 4 FIBERGLASS ~,8 FLEXIBLE [] 99 OTHER [] 5 STEEL WI COATING [] 9 CATHODIC PROTECTION 456 I". (~:heck all that aPPly). ABOVEGROUND PIPING INFORMATION SINGLE WALL PIPING 457 PRESSURIZED PIPING (Chec~ 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 (0.1 GPH) [] 4 DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Chec~ all thal apply): [] 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 456 PRESSURIZED PIPING (Chec~ all that apply): ,,~1 ELECTRONIC LINE LEAK DETECTOR 3.0 Gl:q-I 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 (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ~/4 DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] 7 SELF MONITORING GRAVITY FLOW (Chec~ all that apply): [] 8 DAILY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chec~ all that apply): [] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (cflec~ one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] I~ AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION =E SUCTION SYSTEMS: 5 SELF MONITORING GRAVITY FLOW: 6BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING ESSURIZED PIPING (Check all that apply): . 7 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Chec~ Me) ga AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] c NO AUTO PUMP SHUT OFF [] 11 AUTOMATIC LEAK DETECTOR [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYS'~EM: [] 13 CONTINUOUS SUMP SENSOR + AUDIBLE AND VlSUAL ALARMS EMERGENCY GENERATORS ONLY (Ches~ 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 DISCONNECTION [] c NO AUTO PUMP SHUT OFF AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Chec~ all that apply) [] 10 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS ~]/11 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 13 DAILY VISUAL CHECK DISPENSER [] 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 3 CONTINUOUS DISPENSER PAN SENSOR WITH, AUTO SHUT OFF FOR DISPENSER CONTAINMENT [] Yes [] No [] 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS [] 4 DAILY VISUAL CHECK I ceflify Lha~.,.~ in~q~matton pro/.~ed herein IX. O~E~OPE~TOR SIGNATURE is t~a~rale Io the ~t ~ my kn~ge. . ' / //~/37 R 462 464 Permit Number (For local uSe only) Permit Approved Permit Expiration Date July 1, 1998 p:~USTTNK-B.CMS.wpd Formerly SWRCB Form B CITY OF BAKERS; LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 FACILITY INFORMATION Page Of BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 BUSINESS PHONE 102 SITE ADDRESS CITY ~:~ Pd CuE. t~.-.~'~- t ~--. L,,-,'~ 104 CA DUN & BRADSTREET 103 ZIP ~'3~0~ ~o3 SIC CODE 107 (4Digit #) COUNTY '~/-*~, ~r,,t ~08 OPERATOR NAME lo9 OPERATOR PHONE OWNER NAME OWNER PHONE OWNER MAILING ADDRESS ~'~ 113 114 STATE (2_,A ~5 ZIP c~3~C~ { ~6 CONTACT NAME ~)O[t~ j~E~t5/--iS, y ~l? CONTACT PHONE ~C~-- (.,,5'~-O3iC) .s CONTACT MAILING ADDRESS ~--~' 119 CITY 6AV-t~g-~Ci.F_.c.'~ 12o STATE ~ 12~ ZIP q3~D[ ~22 NAME .~ I~A I,~! ~ E.r,tSL F' ~/ ~23 NAME '~ A~ ~_.. 1~, p..~) 129 TITLE t',~P,~{,~(:r~l~ 125 TITLE ~F.'-r'~ lC.- Fu[~. ~j~ ~-.~ ~, ~.E,~... 130 BUSINESS PHONE ~O5' - (o~-O'~O 12S BUSINESS PHONE 4~. -'5,=1~- ~"~ I"'1 131 24-HOUR PHONE ~o~' - ~ - ~'~3 I 127 24-HOUR PHONE %05 ' c{-~ c~ - ,-~q 00 132 PAGER# ~o5' c~-/c~ -5~J 12s PAGER~ ~ -~- ~0 133 Ce~fl~tion: Based on my' ' of ~ose individuals responsible for ob~ining ~e info~aOon, I ce~i~ under penal~ of law that I have personally examined and am fami ,~qu,ry the information is true, accurate, and complete. s~E~ ~Oy~OR ~/~' familiar with the inllSrmation ~bmitted in this inventory and believe DATE / / 134 NAME OF DOCUMENT PREPARER 135 --~ --~--~ OF OWNEPJOPrr..~TO~ 136 TITLdOF OV(~NER/OPERATOR 137 0ES FOI~M 2?30 (7/9~) P:\OES2730.TV4,wpd CITY OF BAKERSF LD FFICE OF ENVIRONMENTPffL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per matenal per building or area) [] 0ELETE I'~ REVISE 200 Page __ of ~ I. FACILITY INFORMATI°N. · BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 CHEMICAL LOCATION 'F.~fl:.iY~'ib'~ ~ ~ ~?.':' - .... :1 MAP # (optional) II. CHEMICAL INFORMATION CHEMICAL NAME COMMON NAME 201 CHEMICAL LOCATION CONFIDENTIAL (EPCRA) 203 I GRID # (optional) ~lye~ [-~No 205 TRADE SECRET [] Yes 207 CAS # 2O9 2O6 If Subject to EPCRA, refer ~o iinstructions EHS' 2O2 204 FIRE CODE HAZARD CLASSES (Complete if requested by local fire cflief) 210 TYPE '~p PURE [] m MIXTURE [] w WASTE 211 RADIOACTIVE [] Yes [] No 212 CURIES 213 [] s SOLID ~1 LIQUID [] g CAS 214 LARGEST CONTAINER 215 PHYSICAL STATE FED HAZARD CATEGORIES [] 1 FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE r"l 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 (Chec~ all that apply) ANNUAL WASTE 217 219 STATE WASTE CODE 220 AMOUNT MAXIMUM 218 I AVERAGE DALLY AMOUNT DALLY AMOUNT UNITS* [] ga CAL [] ~ CU FT [] lb LBS [] tn TONS 221 * If EHS. amounl must be in lbs. DAYS ON SITE 222 STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check all that apply) ~b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT 224 STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT [] c CRYOGENIC 225 ; %VVT i':??.i ::::::?::::::::::::::':::.::' : ':":' :'. i::..':i:~::.~i~::i : : ::. ~::-i'.::ii!:iii~.i'..!!:: : i?. iii~ i!~ i :.'!:'?:~ilEHS ~:~':' "' ..' CAs# ": 227 [] Yes [] No 228 229 231 []Yes []No 232 I 233 235 []Yes[]No 236 I 237 239 []Yes []No 240 241 . 243 1 226 2 230 3 234 4 238 []Yes []No 244 245 III. SIGNATURE SIGNATURE / DATE 246 OES FORM 2731 (7/98) P:\OES2731 .TV4.w~d TYPE OF ACTION Check one item only ~INEW SITE PERMIT CITY OF BAKERSFI D FFICE OF ENVIRONMENTA SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 UST Tank - 1 Page ~ of [] 7' PERMANENTLY CLOSED ON SITE [] 8 TANK REMOVED 429 RENEWAL PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION (Slate type of c~ange) [] 6 TEMPORARY SITE CLOSURE BUSINESS NAME (Same as FACILITY NAME of DBA - Doing Business A~) LOCATION (Optional) I. TANK DESCRIPTION TANK ID # ADDITIONAL DESCRI~ION (F~ 1~ use ~) 430 433 TANK MANUFACTURER TANK CAPACITY IN GALLONS 431 434 COMPARTMENTALIZED TANK ~Yes [] No If'Yes', complete one form for eact't compartment. NUMBER OF COMPARTMENTS 432 435 II. TANKCONTENTS TANK USE 437 ~1 MOTOR VEHICLE FUEL (If marked, complete Vehicle Fuel Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 95 UNKNOWN VEHICLE FUEL TYPE [] la REGULAR UNLEADED '~lb PREMIUM UNLEADED [] lc MIDGR~DE UNLEADED [] 5 JET FUEL [] 2 LEADED [] 6 AVIATION FUEL [] 3 DIESEL [] 99 OTHER [] 4 C_~SOHOL COMMON NAME (from Hazardous Materials Invantory page) 439 [ CAS # (from Hazardous Metedals Inventory page) .:::,,iii. TANK. CONSTRuCTioN .. 44O TYPE OF TANK Check one item only TANK MATERIAL (pdmary tank) Chec~ one item only TANK MATERIAL (secondary tank) Check one ilem only [] 1 SINGLE WALL ~2 DOUBLE WALL [] 1 BARE STEEL [] 2 STAINLESS STEEL [] I BARE STEEL . [] 2 STAINLESS STEEL [] 3 SINGLE WALL WITH [] 5 INTERNAL BLADDER SYSTEM EXTERIOR MEMBRANE LINER [] 95 UNKNOWN [] 4 SINGLE WALL IN A VAULT [] 99 OTHER ~/4 STEEL CLAD W/FRP [] 5 CONCRETE [] 3 FIBERGLASS [] 8 FRP COMPATIBLE W/100% METHANOL [] 4 STEEL CLAD WI FRP ~3 FIBERGLASS [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] 9 FRP NON-CORRODIBLE JACKET [] 10 COATED STEEL [] 95 UNKNOWN [] 99 OTHER [] 95 UNKNOWN [] 99 OTHER 441 442 443 INTERIOR LINING OR COATING [] I RUBBER LINED [] 3 EPOXY LINING [] 5 GLASS LINING D.95 UNKNOWN Check one item only [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED 'J~99 OTHER OTHER CORROSION PROTECTION IF APPLICABLE Check one ilem only [] I MANUFACTURED CP [] 2 SACRIFICIAL ANODE /'~FIBERGLASS REINFORCED PLASTIC [] 4 IMPRESSED CURRENT [] 95 UNKNOWN [] 99 OTHER 445 SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) 446 447 Check all that apply DROP TUBE li~.yes [] No 448 ~'1 ALARM STRIKER PLATE ~r~es [] No 449 [] 2 BALL FLOAT '~3 FILL TUBE SHUT OFF VALVE .... · ~,:,,,~.~,, :~:~:~,x~;~,:,~.,:::~ ~ +-,~.~,..,~:~.:,-, ~ ~:~?;,~<~::~,,~,:',".~. :~,~:;, :~ :~-,~;~ ~ ~ -::-:' ~,,~:;.:.~,:~'~":~::'?~,,'~'~!~?!:~t'~t!~,::;~'::. :¥~,::;" ,,.,:!.'..~ .,-~,,-:,.:,.'~ :: '' .~:~ : : ~%;' ;~:~.-~.~ IF SINGLE WALL TANK (Chec~ all that apply): ["'J 1 VISUAL (EXPOSED PORTION ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 3 CONTINUOUSATG [] 4 STATISTICAL INVENTORY RECONCILIATION (SIR) BIENNIAL TANK TESTING [] 5 MANUAL TANK GAUGING (M'FG) [] 6 VADOSE ZONE [] ? GROUNDWATER [] 99 OTHER IF DOUBLE WALL TANK (check one item only): 450 [] 8 VISUAL (SINGLE WALL IN VAULT ONLY) ~;~ CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE,.~,~ED (YR/MO/DAY) 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 452 qal GAS TANK FILLED WITH INERT MATERIAL? [] Yes ~ 453 July L 1998 Formedy SWRCB Form B P:~USTTNK-B.CM3.wpd ,) CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES m . Chester Ave., Bakerlfleld, CA 93301 (805) 326-3'~Ir9 1 UST - TANK PAGE ~TJ 1-- TYPE ,~ONSTRUCTION MATERIALS AND CORROSION PROTECTION ABOVEGROUND PIPING INFORMATION [] 1 SUCTION [] 2 PRESSURE [] 3 GRAVITY 454 [] 1 SINGLE WALL [] 95 UNKNOWN [~ 2 DOUBLE WALL [] 99 OTHER 450 [] 1 BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS [] 8 FLEXIBLE [] 99 OTHER [] 5 STEEL W/COATING [] 9 CATHODIC PROTECTION 455 (Check all that a~olv) ' [] 1 SUCTION UNDERGROUND PIPING INFORMATION / ..a'2 PRESSURE []3 GRAVITY [] I SINGLE WALL [] 3 LINED TRENCH [] 99 OTHER .~ DOUBLE WALL [] 95 UNKNOWN [] I BARE STEEL [] 2 STAINLESS STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] ? GALVANIZED STEEL 454 [] 3 PVC COMPATIBLE WITH CONTENTS [] 4 FIBERGLASS J~ 8 FLEXIBLE [] S STEEL WI COATING [] 9 CATHODIC PROTECTION [] 95 UNKNOWN [] 99 OTHER 45O ABOVEGROUND PIPING INFORMATION SINGLE WALL PIPING 457 PRESSURIZED PIPING (Chec~ all ~hat 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 (0.1 GPH) [] 4 DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Chec~ all that apply): [] 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 456 PRESSURIZED PIPING (Chec~ all that apply): ~1 GPH TEST WITH AUTO PUMP SHUT OFF ELECTRONIC LINE LEAK DETECTOR 3.0 FOR LEAK, SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS MONTHLY 0.2 GPH TEST ANNUAL INTEGRrPf TEST (0.1 GPH) ~(~NV4 EDNTIONAL SUCTION SYSTEMS: AlLY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] ? SELF MONITORING GRAVITY FLOW (C_~ec~ all that apply): [] 8 DAILY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Ched( ail that apply): [] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (chec~ one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION .,~FE SUCTION SYSTEMS: 5 SELF MONITORING GRAVITY FLOW: ~6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING hESSURIZED PIPING (Ched( all that apply): 7 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND {~Chec~ one) a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] 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 (Chec~ ail 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 DISCONNECTION [] c NO AUTO PUMP SHUT OFF ~/~ AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Chec~ ail that apply) [] 10 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND (~1 VISUAL ALARMS AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) 1 [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 13 DAILY VISUAL CHECK DISPENSER [] 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER CONTAINMENT ~Yes [] No [] 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS DAILY VISUAL CHECK IX. OWNER/OPERATOR SIGNATURE of my knowledge. 463 TITLE OF OWNER/OFIERATOR 462 464 IPa'mil Number (For local use only) Permit A~proved Pea-m;;. Expiration Date July I, 1998 P:~USTTNK-B.CM3.wpd Formerly SWRCB Form B t CITY OF BAKERSFIELD FFICE OF ENVIRONMENTAL SERVICES atar Ave., Bakemfleld, CA 93301 (805) UBT - TANK PAGE SYSTEM TYPE CONSTRUCTION MATERIALS AND CORROSION PROTECTION ' : ~" :' VI;* PIPING CONaTRUCTION (Check, ell th'~t I~DIv) AEOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION [] I SUCTION [] 2 PRESSURE [] 3 GRAVITY 454 [] 1 SUCTION ¢E~ PRESSURE [] 3 GRAVI'Pt' [] t SINGLE WALL [] 95 UNKNOWN [-'1 1 SINGLE WALL [] 3 LINED TRENCH [] 99 OTHER WALL r-] 99 OTHER 450 "~ DOUBLE WALL [] 95 UNKNOWN 2 DOUBLE [] 1 BARE STEEL [] 6 FRP COMPATIBLE W/100% METHANOL [] 2 STAINLESS STEEL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS '~8 FLEXIBLE [] 99 OTHER [] 5 STEEL W/COATING [] 9 CATHODIC PROTECTION 456 · ':? ';. "! .':: · :" '-:.~!~?'?! :,;:VII:'~tPI~GLEAKD~ECTIO! .:i(Check a I that aPPly)· ·" ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 457 SINGLE WALL PIPING 456 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Chec~ ail that apply): [] 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK, i~/ I ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WTTH AUTO PUMP SHUT OFF SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND [] I BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] ? GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS [] 8 FLEXIBLE [] 99 OTHER [] 5 STEEL W/COATING [] 9 CATHODIC PROTECTION 455 455 454 [] 2 MONTHLY 0.2 GPH TEST [] 3 ANNUAL INTEGRITY TEST (0.1 GPH) [] 4 DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check ail thai apply): [] 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] 7 SELF MONITORING GRAVITY FLOW (Chec~ ail that apply): [] 8 DAILY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING VISUAL ALARMS ,~ MONTHLY 0.2 GPH TEST ANNUAL INTEGRITY TEST (0.1 GPH) /4 ENTIONAL SUCTION SYSTEMS: DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRrTY TEST (0.1 GPH) FE SUCTION SYSTEMS: 5 SELF MONITORING GRAVITY FLOW: ~/6 BIENNIAL INTEGRITY TEST(0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): [] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL Al. ARMS AND (chec~ o~e) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] 13 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 (Chedx 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 [,,ESSURIZED PIPING (Checf< all that apply): 7 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check< one) ~3' a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION [] c NO AUTO PUMP SHUT OFF ~/8 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) :9 ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Chect< all that apply) [] 10 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS · ~1 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 13 DAILY VISUAL CHECK DISPENSER [] 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER y TAINMENT es [] No [] 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS ~4 DAILY VISUAL CHECK 462 464 IPermil Number (Far local use only) Permit Approved tPe~mil Expiration Date July 1, 1998 Formerly SWRCB Form S P:~USTTNK-B.CM3.wpd TYPE OF ACTION Check o~e i[em o~ly · ~I NEW SITE PERMIT CITY OF BAKERS1 ,D OF ENVIRONMEN! .ERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 Page __ of [] 5 CHANGE OF INFORMATION (State type of change) [] 7 PERMANENTLY CLOSED ON SITE [] 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE [] 8 TANK REMOVED III [] 3 RENEWAL PERMIT BUSINESS NAME (Same as FACILITY NAME or DBA - Oo/ng Business As) LOCATION ( OptioneO UST Tank - 1 429 1 TANK ID # DATE INSTALLED (YEAR/MO) ADDITIONAL DESCRIPTION (For local use only) I. TANK DESCRIPTION 430 433 TANK MANUFACTURER TANK CAPACITY IN GALLONS /2! ,~,~ 431 I COMPARTMENTALIZED TANK dYes [] No 432 If 'Yes', complete one rorm for each compartment. 434 NUMBER OF COMPARTMENTS 435 II. TANKCONTENTs TANK USE 437 ~'"1 MOTOR VEHICLE FUEL (If marked, complete ve~hicle Fuel Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 95 UNKNOWN VEHICLE FUEL TYPE [] la REGULAR UNLEADED [] lb PREMIUM UNLEADED [] lc MIDGRADE UNLEADED [] 5 JET FUEL [] 2 LEADED [] 6 AVIATION FUEL 3DIESEL [] 99 OTHER [] 4 GASOHOL COMMON NAME (from Hazardous Materials Inventcxy page) ~:,; Iil. TANK.CONSTRUCTION 439 I GAS # (from Hazardous Materials Inventory page) TYPE OF TANK Check one item only [] I SINGLE WALL .~2'~ DOUBLE WALL [] 3 SINGLE WALL wrrH EXTERIOR MEMBRANE LINER [] 4 SINGLE WALL IN A VAULT [] 5 INTERNAL BLADDER SYSTEM [] g5 UNKNOWN [] 99 OTHER 441 TANK MATERIAL (pdmary tank) Chec~k o~e item only [] 1 BARE STEEL [] 2 STAINLESS STEEL ~ 4 STEEL CLAD WI FRP [] 3 FIBERGLASS [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL TANK MATERIAL (secondary tank) chec~ one item only [] I BARE STEEL [] 2 STAINLESS STEEL INTERIOR LINING OR COATING check one item only [] 4 STEEL CLAD WI FRP '~/3 FIBERGLASS [] 5 CONCRETE [] 8 FPP COMPATIBLE W/100% METHANOL [] 9 FRP NON-CORRODiBLE JACKET [] 10 COATED STEEL [] 1 RUBBER LINED [] 2 ALKYD LINING ~3 EPOXY LINING [] 4 PHENOLIC LINING [] 95 UNKNOWN [] 99 OTHER. [] 95 UNKNOWN [] 99 OTHER. [] 5 GLASS LINING [] 95 UNKNOWN [] 6 UNLINED ~'/99 OTHER 442 443 OTHER CORROSION PROTECTION IF APPLICABLE Check one item only [] 1 MANUFACTURED CP [] 2 SACRIFICIAL ANODE ,~'3 FIBERGLASS REINFORCED PLASTIC [] 4 IMPRESSED CURRENT SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) / c/"7 ~;~ Chec~ all that apply DROP TUBE ~Yes [] No 448 STRIKER PLATE ~'~es [] No 449 [] 95 UNKNOWN [] 99 OTHER 445 OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) [] 2 BALL FLOAT ~i~3 FILL TUBE SHUT OFF VALVE 447 IF SINGLE WALL T~K (Ch~ ail ~at apply): IF ~UBLE WALL TANK (~ ~e item ~ly): 4~ VISUAL (~SED ~RTION ONLY) ~ 5 ~NUAL TANK ~UGING (~G) ~ 8 VISUAL (SINGLE WALL IN VAULT ONLY) AUTO~TIC TANK ~UGING (ATG) D 6 VALSE ZONE 9 CONTINUOUS INTERSTITI~ ~NITORING CONTINUOUS ATG D z GROUNDWATER STATISTI~L I~E~ORY RE~NClLIATION (SIR) + ~ ~ OTHER BIENNIAL TANK TESTING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 452 GAS TANK FILLED WITH INERT MATERIAL? 453 [] Yes ~ ESTIMATED DATE LA~ 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING ~ ,~a, July 1, 1998 Formedy SWRCB Fom'l B p:\USTTNK.B.CM3.wpd CITY OF BAKER I LD OF ENVIRONMENT'A'L SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per matedal per builc#ng or ama) [:::] ADD [] DELETE [] REVISE 200 Page __ of __ I. FACILITY INFORMATION. BUSINESS NAME (Same as FACILITY NAME ~ DBA - Doing Business As) 3 CHEMICAL LOCATION 201CONFIDENTIALCHEMICAL LOCATION(EPCRA) [] Yes [] No 202 MAP ti (optional) 203 GRID ti (optional) CHEMICAL NAME II. CHEMICAL INFORMATION 2o5 · ~) i ,~SF-~.-.- 207 COMMON NAME ~ ~ / C,.~¥~DL-C~T~[<~- CAS ~ ~ FIRE CODE H~RD C~SES (~plete if r~u~t~ by I~l fire ~i~ TRADE SECRET [] Yes ~No 206 If Subjecl to EPCRA. refer to iinstmc~io~s EHS' [] Yes ~)No 208 r~s. :':::!~;, -...i:i 210 . TYPE c~p PURE [] m MIXTURE [] w WASTE 211 RADIOACTIVE [] Yes [] No 212 CURIES 213~: PHYSICAL STATE [] s SOLID '~1 LIQUID [] g GAS 214 LARGEST CONTAINER 215 FED HAZARD CATEGORIES [] 1 FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 (Chec~ all that apply) ANNUAL WASTE 217 MAXIMUM 218 t AVERAGE 219 STATE WASTE CODE 220 AMOUNT DALLY AMOUNT I DALLY AMOUNT UNITS* :]~/ga GAL [] cf CUFT [] lb LBS [] tn TONS 221 DAYSONSITE 222 * If EHS. amount must be in lbs. STORAGE CONTAINER [] a ABOVEGROUND TANK [] · PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check all that apply) :~b UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX r"] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224 STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT [] c CRYOGENIC 225 227 226 2 230 3 / 234 4 I 238 [] Yes [] NO 22e IlL SIGNATURE 229 231 [] Yes E] No 232 233 235 [] Yes [] No 236 237 239 [] Yes [] NO 240 241 243 245 []Yes []No 244 SIGNATURE (.,ri-F- v/z ~ ,,,/ DATE 246 OES FORM 2731 (7/98) P:~OES2731.T'V4.w~d CITY OF BAKERSI LD FFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per material per ~u#ding or area) E] ADO [] 0ELETE i-~ REVISE 200 Page __ of __ I. FACILITY INFORMATI°N· BUSINESS NAME (Same as FACILITY NAME o~ DBA - D~ng Business As) 3 CHEMICAL LOCATION 201CONFIDENTIALCHEMICAL LOCATION(EPCRA) [] Yes [] No 202 204 ~ ~ .... 1 MAP ti (optional) 203 GRID # (optional) CHEMICAL NAME COMMON NAME II. CHEMICAL INFORMATION 205 207 CAS # 209 TI:~DE SECRET [] Yes ,~O 206 If SubjeCt t0 EPCRA. refer to iinstmctions EHS' [] Yes ~ 208 FIRE CODE HAZARD CLASSES (Complete if requested by I~x:al fire chid) TYPE ~p .?URE [] m MIXTURE [] w WASTE 211 PHYSICAL STATE [] s SOLID I LIQUID [] g GAS 214 210 RADIOACTIVE [] Yes ~No 212 CURIES 213 LARGEST CONTAINER 215 FED HAZARD CATEGORIES [] 1 FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 (Check all that apply) ANNUAL WASTE 217 MAXIMUM 218 I AVERAGE AMOUNT DAILYA~OU~ iDAILY AMOUNT UNITS· [] ga GAL [] cf CU FT [] lb LBS [] tn TONS 221 · If EHS, amount must be in lbs. 219 STATE WASTE CODE 220 DAYS ON SITE 222 STORAGE CONTAINER F-la [] RAIL CAR 223 (Check all ~hat apply) ABOVEGROUND TANK [] e PLASTIC~'NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE q UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER [] c TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAC-ON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224 STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOWAMBIENT [] c CRYOGENIC 225 *"*'% w'r :i,:ii';,:?!:;.i:i ;":; ':? :::'!:'.: ':*'"..:'.-'; i~? ': :i"i!: i; i" i";::'=I .:. ' :; ;':, ' ~i::~HAZARDOUS COMPONENT! i :; ;{':' ~!::~*::i~;?? ;!~i!i!:i~!i ?i i !:?~?:::EHS~}:~::~: ~'::: :'~ "' "":':.::'7 .'": ,. ' CAS #' }': '" { I . 226 2 230 3 234 4 J 238 227 [] Yes [] No 228 229 231 []Yes []No 232 , 233 235 [] Y~ [] No 236 237 239 [] Yes [] NO 240 241 243 [] Y~ [] NO 244 245 IlL SIGNATURE · PRINT NAME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 246 OES FORM 2731 (7198) P:~OES2731.TV4.w~0d TYPE OF ACTION Check one item o(tly CITY OF BAKERSF i D FFICE OF ENVIRONMENTAnE SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 .~I NEW SITE PERMIT [] 3 RENEWAL PERMIT [] 4 AMENDED PERMIT BUSINESS NAME (Same as FACILITY NAME or DBA - OD/rig Business As} LOCATION (Optional) Page __ [] 5 CHANGE OF INFORMATION (State type of c~ange) [] 7' PERMANENTLY CLOSED ON SITE [] 6 TEMPORARY SITE CLOSURE [] 8 TANK REMOVED UST Tank - 1 of 429 1 I. TANK DESCRIPTION TANK ID # 430 DATE INSTALLE~) (YE.A. FUMO) 433 ADDITIONAL DESCRIPTION (FOR local use only) TANK MANUFACTURER tanK CAPaciTY In ~LLONs 431 434 COMPARTMENTALIZED TANK ~'es [] No If "Ye~'. complete one form for eac~ compartment. NUMBER OF COMPARTMENTS t 4~2 ~5 · II. TANK CONTENTs " VEHtCLE FUEL TYPE 438 ,,~la REGULAR UNLEADED [] 2 LEADED E] 5 JET FUEL [] lb PREMIUM UNLEADED [] 3 DIESEL [] 6 AVIATION FUEL [] lc MIDGRADE UNLEADED [] 4 GASOHOL [] 99 OTHER TANK USE 437 ~1 MOTOR VEHICLE FUEL (If marked, complete Vehide Fue~ Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 95 UNKNOWN COMMON NAME (from Hazardous Materials Invanl~y page) 439 CAS # (from Hazardous Materials Inventory page) 440 · ' .. :.:,',.,111. TANK.CoNSTRuCTioN i . :': ' · [] 1 SINGLE WALL [] 3 SINGLE WALL WITH [] 5 INTERNAL BLADDER SYSTEM 441 2DOUBLE WALL EXTERIOR MEMBRANE LINER [] 95 UNKNOWN [] 4 SINGLE WALL IN A VAULT [] 99 OTHER ~4 STEEL CLAD W/FRP [] 5 CONCRETE TYPE OF TANK Check one item only TANK MATERIAL (pdmary tank) Check one item only TANK MATERIAL (secondary lank) C,~ecX one item only [] 1 BARE STEEL [] 2 STAINLESS STEEL [] I BARE STEEL [] 2 STAINLESS STEEL [] 3 FIBERGLASS [] 8 FRP COMPATIBLE W/100% METHANOL [] 4 STEEL CLAD WI FRP -~[ 3 FIBERGLASS [] 5 CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] g FRP NON-CORRODIBLE JACKET [] 10 COATED STEEL [] 95 UNKNOWN [] 99 OTHER [] 95 UNKNOVVN [] 99 OTHER 442 443 INTERIOR LINING OR COATING [] I RUBBER LINED [] 3 EPOXY LINING r-I 5 GLAss LINING [] 95 UNKNOWN Ched4 one item only [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED ~J9 OTHER OTHER CORROSION [] 1 MANUFACTURED CP ~3 FIBERGLASS REINFORCED PLASTIC E] 95 UNKNOWN PROTECTION IF APPLICABLE Che~ one item only [] 2 SACRIFICIAL ANODE [] 4 IMPRESSED CURRENT [] 99 OTHER 445 SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR) } <~ q ~ OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) ! ct ~ 446 I I '- 447 Check all that apply DROP TUBE ~'Yes [] No 448 ~1 ALARM STRIKER PLATE .J~Yes [] No 449 [] 2 BALL FLOAT J~3 FILL TUBE SHUT OFF VALVE · '~:' .7' ::,-~ ~,~ ~, ;;~-~:~,~,~c:~' ,, .~: ::,.' ~>:~,? ~×:. :~:~2'.~;~;,~ ~ ~,~, ~,'..~,,'.".~; -~ .,: ' '~ ~ ~?,~'~, ,'~: :~:~,~,~,,'.,:',~. :,,;::.<,~ ~?,'..~,.;~' ~'~'.,~.r,~k... , ~'.,'~.,",-,'....',- ..-'..'.., ,,,,.: '.~,.'~ ,.: IF SINGLE WALL TANK (Che~ all that apply): [] 1 VISUAL (EXPOSED PORTION ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 3 CONTINUOUS ATG [] 4 STATISTICAL INVENTORY RECONCILIATION (SIR) BIENNIAL TANK TESTING [] 5 MANUAL TANK GAUGING (M'FG) [] 6 VADOSE ZONE [] 7 GROUNDWATER [] 99 OTHER IF DOUBLE WALL TANK (Check one item only): 450 9VISUAL (SINGLE WALL IN VAULT ONLY) CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 452 GAS TANK FILLED WITH INERT MATERIAL? 453 ESTIMATED O~SED (YR/MO/DAY) July 1, 1998 Fo~nedy SWRCB Fo~m B P:\USTTNK-B.CM3.wpd SYSTEM TYPE ;ONSTRUCTION MATERIALS AND CORROSION PROTECTION [~]! SUCTION CITY OF BAKERSFIELD ~ OFFICE OF ENVIRONMENTAL SERVICES t Chester Ave., Bakemfleld, CA 93301 (808) 326.331'9 .~ :.!.. :...i~. Vi~::PIPING CONSTRUCTION ABOVEGROUND PIPING INFORMATION .,~2 PRESSURE [] 3 GRAVITY 454 450 [] I SINGLE WALL [] 95 UNKNOWN '~ DOUBLE WALL [] 99 OTHER [] 1 BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] ? GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS [] 8 FLEXIBLE [] 99 OTHER D 5 STEEL WI COATING [] 9 CATHODIC PROTECTION 455 UST - TANK PAG/g~ll~j (Check all thai abolv~--~ ~'")" ' ' "':'?': :": ' [] 1 SUCTION ~J~;~ESSURE~"~-~ [] 3 G~VI~ 455 [] 1 SINGLE WALL [] 3 LINED TRENCH [] 99 OTHER .~ OOUBLE WALL 95 UNKNOWN []1BARE STEEL []2 STAINLESS STEEL 454 [] 6 FRP COMPATIBLE W/100% METHANOL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTE~ [] 95 UNKNOWN [] 4 FIBERGLASS ~8 FLEXIBLE [] 99 OTHER [] 5 STEEL WI COATING [] 9 CATHODIC PROTECTION 456 .~.' :~'. ~¥.'.:~:':~i~i~'~:!'":...' '¥~,: .. ' =:.: :":. · ' : ~':::': · ':~;'"':. ;:': ' .:": ~'::. i:.~?~'.i:::Vll~' PIPING LE~K' DETECTIO! I'" :(check· all ~at aPPly) '"'. :?::~;~:.~: ~::'''~ ::'?:: :'::~:::' '?' '::.':' ': : · ::: ~::'' ABO~GROUND PIPING INFOR~TION UNDERGROUND PIPING INFOR~TION SINGLE WALL PIPING 457 SINGLE WALL PIPI~ 456 PRESSURIZED PIPING (~ ~1 that apply): ~SURIZED PIPING (Ch~ all that apply): ~ 1 ELECTRONIC LINE L~ D~ECTOR 3.0 G~ TEST ~ A~O ~MP SH~ OFF FOR L~ ~ 1 ELECTRONIC LINE L~ D~ECTOR 3.0 ~H TEST ~ A~O PUMP SHUT OFF SYSTEM FAILURE, ~D SYS~M DIS~NNECTION + AUDIB~ ~D ~SU~ ~S FOR L~ SY~EM FAILURE, AND SYSTEM DIS~NNECTION + AUDIBLE ~D VISU~ ~ [] 2 MONTHLY 0.2 GPH TEST [] 3 ANNUAL INTEGRITY TEST (0.1 GPH) [] 4 DALLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Chec~ all ~al apply): [] 5 DALLY VISUAL MONITORING OF PUMPING SYSTEM [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] 7 SELF MONITORING GRAVITY FLOW (Chec~ all that apply): [] 8 DAILY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAJNED PIPING ~2 MONTHLY 0.2 GPH TEST ~3 ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: .~4 PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY DALLY VISUAL MONITORING OF TEST (0.1 GPH) SAFE SUCTION SYSTEMS: ~5 SELF MONITORING .~'I'~ FLOW: 6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chec~ all tha~ apply): [] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (cflecI; One) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] I) 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 (Chec~ all that apply) j~ESSURIZED PIPING (Chec~ all that apply): 7 CONTINUOUS TURBINE SUMP SENSOR WITH. AUDIBLE AND VISUAL ALARMS AND (~C~ Dna) ~ AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION 9[] c NO AUTO PUMP SHUT OFF 8 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Chec~ all that apply) [] 14 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND []~10 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS I .~ VISUAL ALARMS [] 15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ,=]ll~ 11 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 16 ANNUAL INTEGRITY TEST (0.1 GPH) [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 17 DALLY VISUAL CHECK I [] 13 DALLY VISUAL CHECK DISPENSER D 1 FLOAT MEC~NISM T~T SHeS OFF SH~R V~ ~ 3 ~INUOUS DISPENSER PAN SENSOR ~TH A~O SHUT OFF~OR DISPENSER NTAINMENT ~ ~ NO ~ 2 ~INUOUS ELECTRONIC SENSOR + AUDIBLE ~D VISUAL ~S ~ + AUDIBLE AND VISUAL A~RMS ' ~. DAILY VISUAL CHECK '~. I ~ify tha~ inf~all~ pr~n is t~& a~rate to the b~t of my IX.kn~ge.O~EWOPE~TOR SIGNATURE * * SiG~ )~F WNE~OP}~~,, ~OR DATE // /~/*~ / j 462 NA~O~E~OPE~TO, ~,~ 4. TITLE OF O~E~O~E~TOR 4. IPermil Number (For local use only) Permit Approved Expiration Data July 1, 1998 p:~USTTNK-8.CM3.wpd Farme~ty SWRCB Form 8 CITY OF BAKERSF~.~D OFFICE OF ENVIRONMENTA"L SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per matehal per butlcling or area) [] ADO [] DELETE [] REVISE 200 Page __ of __ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME ~ DBA - Doing Business As) 3 CHEMICAL LOCATION 201CONFIDENTIALCHEMICAL LOCATION(EPCRA) [] Yes r-~ No 202 2O4 II. CHEMICAL INFORMATION CHEMICAL NAME COMMON NAME 203 GRID # (optional) 205 207 CAS # 2O9 TRADE SECRET [] Yes ~ 20~ If Subject to EPCRA, refer to iinslructions EHS* I--I yes [~ 208 / FIRE CODE HAZARD CLASSES (Complete if requested by local fire cttie0 ~ PURE [] m MIXTURE TYPE 210 [] w WASTE 211 RADIOACTIVE J-'J Yes [] No 212 I CURIES 213 PHYSICAL STATE [] s SOLID ~LIQUID [] g GAS 214 LARGEST CONTAINER 215 FED HAZARD CATEGORIES [] I FIRE [] 2 REACTIVE [] 3 PRESSURE RELEASE [] 4 ACUTE HEALTH [] 5 CHRONIC HEALTH 216 (Check all that apply) ANNUAL WASTE 217 MAXIMUM 218 I AVERAGE 219 STATE WASTE CODE 220 AMOUNT DALLY AMOUNT [ DALLY AMOUNT DAYS ON SITE 222 UNITS* [] ga GAL [] d CU FT [] lb LBS [] tn TONS 221 · If EHS. amount must be in lbs. STORAGE CONTAINER [] a ABOVEGROUND TANK [] e PLASTIC/NONMETALLIC DRUM [] i FIBER DRUM [] m GLASS BOTTLE [] q RAIL CAR 223 (Check all that apply) cc UNDERGROUND TANK [] f CAN [] j BAG [] n PLASTIC BOTTLE [] r OTHER TANK INSIDE BUILDING [] g CARBOY [] k BOX [] o TOTE BIN [] d STEEL DRUM [] h SILO [] I CYLINDER [] p TANK WAGON STORAGE PRESSURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT 224 STORAGE TEMPERATURE [] a AMBIENT [] aa ABOVE AMBIENT [] ba BELOW AMBIENT [] c CRYOGENIC 225 1 226 2 230 3 234 4 238 III. SIGNATURE 227 231 []Yes []No 228 I SIGNATURE []Yes []No 232 233 235 [] Yes [] No 236 237 239 [] Yes [] No 240 241 243 [] Yes [] NO 244 245 DATE 246 OES FORM 2731 (7/98) P:~OES2731 .TV4.w'pd TYPE OF ACTION Che~4 one item only CITY OF BAKERSFIrii D 'EFICE OF ENVIRONMENTA' SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 {~__.J- NEW SITE PERMIT E) 3 RENEWAL PERMIT [] 4 AMENDED PERMIT BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) LOCATION ( Optk)nal) Page __ of [] 5 CHANGE OF INFORMATION (State type of ahange) ["] 7 PERMANENTLY CLOSED ON SITE [] 6 TEMPORARY SITE CLOSURE [] 8 TANK REMOVED UST Tank - 1 429 TANK ID # o5' 3 /z.//3 / I. TANK DESCRIPTION 430 433 TANK MANUFACTURER TANK CAPACITY IN GALLONS 431 434 COMPARTMENTALIZED TANK ~.,"lfes [] No If 'Yes', complete one form for ~ compartment. NUMBER OF COMPARTMENTS 432 ADDITIONAL DES(~RIFrrlON (For local use o~ly) TANK USE 437 ~v'~"MOTOR VEHICLE FUEL (If marked, complete Vehicle Fuel Type) [] 2 USED OIL [] 3 CHEMICAL PRODUCT [] 4 HAZARDOUS WASTE [] 95 UNKNOWN II. TANK CONTENTS VEHICLE FUEL TYPE 438 [] la REGULAR UNLEADED [] 2 LEADED [] 5 JET FUEL [] lb PREMIUM UNLEADED [] 3 DIESEL [] 6 AVIATION FUEL ~ MIDGRADE UNLEADED [] 4 GASOHOL [] 99 OTHER COMMON NAME (from Hazardous Metedals Inventory page) · :..,,-~HI. TANK. cONSTRUCTION 439 I GAS # (Eom Hazardous Materials Inventory page) 440 TYPE OF TANK Chec~ one item only TANK MATERIAL (pdmary tank) Chec~ one item only TANK MATERIAL (secondary tank) Chec~ one item only [] 1 SINGLE WALL .1~ DOUBLE WALL [] I BARE STEEL [] 2 STAINLESS STEEL [] 1 BARE STEEL [] 2 STAINLESS STEEL [] 3 SINGLE WALL WITH EXTERIOR MEMBRANE LINER [] 4 SINGLE WALL IN A VAULT [] 5 INTERNAL BLADDER SYSTEM 1"195 UNKNOWN [] 99 OTHER ~D4 STEEL CLAD WI FRP [] 3 FIBERGLASS [] 5 CONCRETE [] 8 FPP COMPATIBLE WI100% METHANOL [] 4 STEEL CLAD WI FRP 3 FIBERGLASS [] S CONCRETE [] 8 FRP COMPATIBLE W/100% METHANOL [] 9 FPP NON-CORRODIBLE JACKET [] 10 COATED STEEL [] 95 UNKNOWN [] 99 OTHER [] 95 UNKNOWN [] 99 OTHER 441 442 443 INTERIOR LINING OR COATING [] I RUBBER LINED [] 3 EPOXY LINING [] 5 GLASS LINING [] 95 UNKNOWN Che~k one item only [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED ..~ 99 OTHER ~,J O,~... OTHER CORROSION PROTECTION IF APPLICABLE Check one item only [] 1 MANUFACTURED CP [] 2 SACRIFICIAL ANODE ,,,~3 FIBERGLASS REINFORCED PLASTIC [] 4 IMPRESSED CURRENT [] 95 UNKNOWN [] 99 OTHER 445 SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR). OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) 448 ~"~ALARM 441 Chec~ all that apply DROP TUBE ~f~s [] No 448 STRIKER PLATE [] No 449 [] 2 BALL FLOAT FILL TUBE SHUT OFF VALVE IF SINGLE WALL TANK (Check all that apply): [] 1 VISUAL (EXPOSED PORTION ONLY) [] 2 AUTOMATIC TANK GAUGING (ATG) [] 3 CONTINUOUSATG [] 4 STATISTICAL INVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING E) 5 MANUALTANKGAUGING(IVn'G) []6 VACOSE ZONE [] ? GROUNDWATER []99 OTHER IF DOUBLE WALL TANK (Check one item ~lly): 450 [] 8 VISUAL (SINGLE WALL IN VAULT ONLY) [] 9 CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 452 ~ ~ ~3al ESTIMATED D~ GAS TANK FILLED WITH INERT MATERIAL? [] Yes ~ 453 July 1, 1998 Fo~lnedy SWRCB Form 8 P:\USTTNK-B.CM3.wpd CITY OF BAKERSFIELD - il t~5 OFFICE OF ENVIRONMENTAL SERVICESi I ·Chester Ave., Bakemfleld, CA 93301 (805) 326-~-"~Z~ 9 UST-TANK PAGE 2~ Of ~'Check all that ai~olv) · ..;: ..'-.:: -,'.~-'~.~?--- -,"?.¥~;,pliilNi).~:ONs?RUCTIoN ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SYSTEM TYPE [] ! SUCTION [] 2 PRESSURE [] 3 GRAVITY 454 [] 1 SUCTION i~3RESSURE [] 3 GRAVITY 455 [] 1 SINGLE WALL [] 9.5 UNKNOWN [] `i SINGLE WALL [] 3 LINED TRENCH [] 99 OTHER ONSTRUCTION [] 2 DOUBLE WALL [] 99 OTHER 450 ~ DOUBLE WALL [] 95 UNKNOWN 454 [] t BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] ? GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS [] 8 FLEXIBLE [] 99 OTHER [] 5 STEEL WI COATING I'-I 9 CATHODIC PROTECTION 455 MATERIALS AND CORROSION PROTECTION [] I BARE STEEL [] 6 FRP COMPATIBLE WI 100% METHANOL [] 2 STAINLESS STEEL [] 7 GALVANIZED STEEL [] 3 PVC COMPATIBLE WITH CONTENTS [] 95 UNKNOWN [] 4 FIBERGLASS <:~i~'"FLEXlBLE [] 99 OTHER [] 5 STEEL WI COATING [] 9 CATHODIC PROTECTION 456 PRESSURIZED PIPING (Chec~ all tha,l 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 ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 457 SINGLE WALL PIPING 456 PRESSURIZED PIPING (Chec~ 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 [] 2 MONTHLY 0.2 GPH TEST [] 3 ANNUAL INTEGRITY TEST (0.1 GPH) [] 4 DALLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Chec~ all that apply): [] 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM [] 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: [] 7 SELF MONITORING GRAVITY FLOW (Check all that apply): [] 8 DALLY VISUAL MONITORING [] 9 BIENNIAL INTEGRITY TEST (O.1 GPH) SECONDARILY CONTAINED PIPING VISUAL ALARMS ~L/'2 MONTHLY 0.2 GPH TEST '~3 ANNUAL INTEGRITY TEST (0.1 GPH) NVENTIONAL SUCTION SYSTEMS: 4 DALLY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) ,~FE SUCTION SYSTEMS: 5 SELF MONITORING GRAVITY FLOW: ,~6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chec~ all that apply): [] 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (chec~ one) [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] I~ 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 (Chedx 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 .PRESSURIZED PIPING (Ched( all that apply): 7 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (chec~ one) '1~'a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION [] c NO AUTO PUMP SHUT OFF 8 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) 9 ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Chec~ all that apply) [] 10 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS 1~11 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) [] 12 ANNUAL INTEGRITY TEST (0.1 GPH) [] 13 DAILY VISUAL CHECK DISPENSER [] 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER CONTAINMENT ~3:'Yes [] NO [] 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS 'q DAILY VISUAL CHECK 462 464 IPermit Number ( Fo~ local use only) IPermit Approved I Permit Expiration Date July 1, 1998 Formerly SWRC8 Form B P:~USTTNK-B.CM3.wDd FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION DATE Section 2: Underground Storage Tanks Program . ..Routine I~ Combined {221 Joint Agency [] Multi-Agency [] Complaint ~[~Re-inspection Type of Tank Number of Tanks o/k pe of Monitoring Type of Piping OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current ~__.... Ot~6 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? (~) No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) AGGREGATE CAI Type of Tank Number OPERATION .X.>'N'~ COMMENTS SPCC available J SPCC on file with OES J Adequate secondary protection J Proper tank placarding/la,~ Is tank used to di~e MVF? If y~4~oe~'ank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: ~.. ~(~J ?"~"~ Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Business Site Responsible Party March 29, 2000 Sullivans Security 2317 "L" Street Bakersfield, CA 93301 Dear Underground Tank Owner: Your permit to operate the above mentioned fueling facility 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 arrangements to have the new forms A, B & C completed and returned to this office by May 15, 2000. For your convenience, I am enclosing all three forms which you may make copies of. Remember, forms B & C need to be filled out for each tank at your facility. Should you have any questions, please feel free to contact me at (661) 326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dlm Enclosure ,! State of California State VVater Resources Control Board Division of Clean Water Programs P.O. Box 944212 Sacramento, CA 94244-2120 (Inslr~ction~ on reverse) CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM I am required to dcmonst~te Financial Responsibility in the required amounts ~s specificd in Section 2807, Chapter 18, Div. 3, Title 23, CCR: r---~ $00,0oo dollazs per occun'mce or ~-~ I million dollars pe~ occurrence [-~l million dollan annual aggegate or [-'-'~2 million dollus a~nual &ggtept¢ B. Sullivan Petroleum LLC Article 3, Chapter 18, D/vision 3, Title 23, California Code of Regulations. The mechanism, used to demonstrate financial responsibility as required by Section 2807 are as follows: Name and Address of Issuer Mechanism · ::Coverage Coverage C. Mechanism State UST Fund Chief Financial Officer Letter State UST Cleanup Fund P.O. Box 944212 Sacramento, CA 9424-2120 Sullivan Petroleum LLC Post Office Box 5007 Bakersfield, CA 93308 hereby certifies that it is in compliance with the requirements of Section 280 7, Number ii.: ".:::.; N/A for UST Cleanup Fund · ::' Amount $995,000 Per Occurance and Annual Aggregate $5,000 Per Ocouranoe and Annual Aggreg~e Period State UST Cleanup Fund Continuous Annual Corrective Action., YES YES N/A for this mechanism Third .party comp~.. YES YES Note: If you are using the State Fund as any part of your demonstration of financial responsibility, your execution and submission of this certification also certifies that ~'ou are in compliance with all conditions for participation in the Fund. L}. Fac~l~, Name Facd,~- N~me F. S~n~ure of W~meu e~er~/~..'~ CFR(Revised 04/9~) Oildale Chevron Fatality Add~ess 1501 North Chester Avenue Bakersfield, CA 93308 2317 "L" Street Bakersfield, CA 93301 Downtown Chevron ~'~Y~'"" 1300 Niles Street ' Niles Chevron Bakersfield, CA 93306' F~h~ Add~s~ Copies FILE: Original - Local Agency Nam~ sad T~fle of Tank Ow~ o~ O~m'a~x Facility/Site(s) The Chief Financial Officer or the owner or operator must sign, under penalty of perjury, a letter worded EXACTLY as follows or you may complete the letter by filling in the blanks with appropriate information: LETTER FROM.CHIEF FINANCIAL OFFICER I am the Chie~f Financial Officer for Sullivan Petroleum, LLC (Business name, busincss addrcss, and correspondence address of owner or operator) Post Office Box 5007, Bakersfield, CA 93308 This letter is in support of the use of the Underground Storage Tank Cleanup Fund to demonstrate financial responsibility for taking corrective action and/or compensating third parties for bodily injury and property damage mused by an unauthorized release of petroleum in the amount of at least $ 15.000 per occurrence and $ 15,000 annual aggregate coverage. (Dollar Amount) (Dollar Amount) Underground storage tanks at the following facilities are assured by this letter: Oildale Chevron 1501 Niles Street, Bakerfield, CA 93308; Downtown Chevron 2317 "L" Street, (Name and address of each facility where tanks for which financial responszl?li~ty is being demonstrated is located.) Bakersfield, CA 93301; Niles Chevron 1300 Niles Street, Bakersfield, CA 93306 ° Amount of annual aggregate coverage being assured by this letter ......... : ............................................ $ Total tangible assets ............................................. $ Total liabilities ................................................... $ Tangible net worth (subtract line 3 from line 2. Line 4 must be at least 10 times line 1) ..................... $ 15,000 2,248,840 1,961,954 286,886 I hereby certify that the wording of this letter is identical to the wording specifi.ed in subsection 2808.1(d)(1), Chapter 18, Division 3, Title 23 of the California Code of Regulations. I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. Executed at Bakersfield, California (Signa~ ~ - Tim Sullivan (Place or Execution) (Printed Name) President and CFO (Title) CITY OF BAKERSFIELD c~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK STARTING DATE FACILrrY NAME FACILITY TYPE OF BUSINESS TANK OWNER ADDRESS CONTRACTOR ADDRESS PHONE NO. WORKMAN COMP TY~. or A~P,.,C^TION (CHIC,0 I ~Wr^C,.~ I ~O~C~UO~O~ ~C~ ~ ~w ~ ~S~.,.~UO~ ~~C~ ~O~SEDCO~UO~ ~ -/~-- F~ ~coos ~~ I PHO~ NO. ~ ~ ~~ ~CODE ~~ / CA LIC~SE NO.~ c~~ ~ ~ COD~/~ B~~ C~ BUS.SS LIC~SE NO. ~, ~/'~ p~DESCmE ~ WO~ TO BE ~ ~. ~ ~ 2 ~ ~,~~ ~/[~ ~ D~ TO GRO~ WA~ ~ ~'~ SO~ ~E ~EC~ AT S~ ~~ NO. OF T~ TO BE ~STAI.I.RD ~ ~Y FOR MOTOR ~ ~ ' ~S NO SP~ P~ON COBOL ~ CO~R ~~S P~ ON ~ ~ 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 THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATrACHED CONDITIONS OF TH/S PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. TH/S FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS ..... }~~V~ BY: -,~d~PLICANT NAIv;iE ~RINT) APPLICANT SIGNATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES (' 1715 Chester Ave., Bakersfield, CA (805) 326-3979 INSPECTION RECORD POST CARD AT JOB SITE Ciw, Zip Ci~, Zip Phone No. P~ ~ ~ ~ ~ 0 { ~ 6 INSTRUCTIONS: Please call for an inspector only when each group ofin~ons with the same nuraber ar~ ready. They will nm in c.~ms~miw ord,- beginning with numb~' 1. DO NOT cover work for any numbered group until all items in that group ar~ sign~ offby the Pemfilling Amhority. Following th~ instru~iom will reduce the numi~x of required inspection visits and therefore prevent assessment of additional fees. TANKS AND BACKIHLL INSPECTION DATE INSPECTOR Backfill of Tank(s) Spark Test Certification or Manufactures Method Cathodic Protec6on of Tank(s) PIPING SYSTEM Piping & Raceway w/Collection Sump Corrosion Protection of Piping, Joints. Fill Pipe Electrical Isolation of Piping From Tank(s) Cathodic Protection System-Piping Disp~r Pan SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION Liner Installation - Tank(s) Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Detector(s) Leak Dete~or(s) for Annual Space-D.W. Tank(s) Monitoring Well(s)/Sump(s) - H20 Test Leak Detection Device(s) for Vadose/Groundwater Spill Prevention Bones FINAL Monitoring Wells. Caps & Locks Fill Box Lock ( Monitoring Requirements Type CONTRACTOR CONTACT '~ ¢.J'd~ C~JO~ PHONE # CITY OF BAKERSFIELD c~ OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) [ INEW FACILITY [ ]MODIYICATION OF FACILITY [ IIqEW TANK INSTALLATION AT EXISTING FACILITY / STA TINOD^TE f,,-- 7-- ?/ ., ETIONDATE. -~7- FACILITY NAME ~t2~x~A/7~ f-.~l~t/~A~r_J(IS~(~ FA~ILrrY EF~Mrr~qo. T~E oF Busn~ss. ~./.~ r~/',~,' -- ~ ;~ ' ADDRESS ~'.~ ! 7 ~Z .~' ¢'f. crrY ,~'//'~Y).,-; ~.,~.yf'_ zip CODE ~_z_ COm'RACTO~ ~ C Z=-,4.-7~'~'~(,:$~ e C^ LICE~SE NO. ~'+'27¢~ ADDRESS P'/¢Z,,' ~.~A',~¢,~,,ff ,r'7- crrY~~ Zo zap CODE ?HONE NO. ~--¢ ¢~' - 7'Z'O-~ BAICEmSFm. r.n c.r!Y BuSh, mSS L~C_E~SE Np.' WORKMAN COMP NO. ,~,o ~ ,fA e-- INSU~R ~ .f¥'.,~,Z-d.. Cw~ TO ~AC~ ~O~ BY ~ ~-~ ~ ' D~ TO GRO~ WA~ ~ ~¢~ SO~ ~E ~EC~ AT S~ NO. OF T~ TO BE ~ST~ ~ ~Y FOR MOTO~ ~ * ' .~S NO 8P~ P~ON COBOL ~ CO~R ~~S P~ ON ~ ~S 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) OF KNOWN) FOR OFFICIAL USE ONLY · THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMrr AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PER/IJRY, AND TO THE BEST OF MY KNOWLEDGE, IS ~'/~VEI~ BY: -,~PPLICANT lqA~E (P~) AI~P-L~CANT $IONATURE % THIS APPLICATION BECOMES A PERMIT WHEN APPROVED PIPE JACKET® Observation Pipe (rigid piece of TP0200) Dispenser Pen Multisided Sump Pipe Jacke'teis e secondary containment system f0~s{~el or FRP underground piping. It is designed to perform as a guttering system, providing containment of the primary piping run fr~om under the dispenser to the submersible pump; including all swing joints or flexible connectors. Any leak in the primary Will fl~3W from the high end of the system to the Iow end where teak detection may be installed. (Note: For steel primary piping with s0Cke~t weld. fittings, please consult TCI Customer Service Representative.) MF0401 MF0201 MF0301 TR4150 TR4200 TR6400 0C0200 0C0300 0C0400 [] Telescoping Pipe A combination of rigid and flexible polyethylene pipe that telescopes for containment of primary pipe runs. Four 15' lengths of both rigid and corrugated pipe (120LF) per box. Part # Description, Packaaina Unit Price Box Price TP0200 "A" (3.9") Pipe for 2" Primary Pipe 8/box (120 LF) 5.00 600.00 TP0300 "B" (4.9") Pipe for 3" Primary Pipe 8/box (120 LF) 6.50 780.00 TP0400 "C" (5.9") Pipe for 4" Primary Pipe 8/box (120 LF) I 1.50 1,380.00 [] Tee Fitting Fitting used to contain primary tee fitting. Fitted with three compression seals. Part # Descriotion Packaging Unit Price Box Price MF0201 "A" (3.9") Tee Fitting w/clamps 8/box 60.00 480.00 MF0301 "B" (4.9") Tee Fitting w/clamps 5/box 95.00 475.00 MF0401 "C" (5.9") Tee Fitting w/clamps 2/box 225.00 450.00 [] Flex Seal Seals used to join telescoping Pipe Jacket for containment of primary pipe, Part # Description Packa(~inq Unit Price Box Price CS3900 "A" (3.9") Flex Seals w/clamps 24/box 14.00 336.00 CS4900 "B" (4.9") Flex Seals w/clamps 20/box 15.00 300.00 CS5900 "C" (5.9") Flex Seals w/clamps 12/box 20.00 240.00 [] Test Reducer Reducer used to seal primary pipe to telescoping rigid secondary pipe when performing air pressure test· Fitted with air stem. Part # Description Packaqinq Unit Price Box Price TR4150 3.9" x 1-1/2" Test Reducer w/clamps 8/box 23.00 184.00 TR4200 3.9" x 2" Test Reducer w/clamps 8/box 22.00 176.00 TR4300 4" x 3" Test Reducer w/clamps 8/box 22.00 176.00 TR6400 6" x 4" Test Reducer w/clamps 4/box 29.00 ' 116.00 [] Terminating Reducer Reducer installed to terminate and seal primary pipe to telescoping rigid pipe. Part # Description Packaging Unit Price Box Price TR0154 3.9" x 1-1/2" Terminating Reducer 8/box 17.00 136.00 TR0204 3.9" x 2" Terminating Reducer 8/box 15.00 120.00 TR0304 4" x 3" Terminating Reducer 8/box 15.00 120.00 TR0406 6" x 4" Terminating Reducer 4/box 24.00 96.00 TR4004 "B" (4.9") x "A" (3.9")Term. Reducer 12/box 15.00 180.00 TRhO04 "C" (5.9") Sump Entry Boot 6/box 35.00 210.00 [] Observation Cap Cap used to provide sealed access on zoned observation well. Part # Desc~ Packaging Unit Price Box Price OC0200 Observation Cap for "A" (3.9") pipe 12/box 12.00 144.00 OC0300 , Observation Cap for "B" (4.9") pipe 12/box 14.00 168.00 0C0400 Observation Cap for "C" (5.9") pipe 4/box 16.00 64,00 Page 10 - U.S. Price Manual 04/26/99 11:14 '~'805 3~2,~6. 0576 B~I) ~ IIAT l)~¥ ~00~ ~ ~~ ~'~ ~--~~ .... '-' CERIIFICATiON OF FINANCIAL R'ESpo'NSiBILI~" , ~ . _ Rpr 28 99 04:09a Hensle~ 393-5028 p.1 Chevron DATE: FACSIMILE COVER SHF~ET 4/27/99 Downtown Chevron 2317 L Street Bakersfield. CA 93301 Phone 805 638 0310 Fax 805 638 0224 COMPANY NAME: PHONEfFAX: 326-0576 ATTN: FROM: SUBJECT: NLrMBER OF PAGES: (Including Co.er Page) Steve Adam I4~n~l~ Certification of Financial Rest~onsibilit~ 2 Sullivan Petroleum Company, LLC Fax Number: (805) 392-0165 Sullivan Petroleum Company, LLC E-mail addre~: z~lpet~lightstmed, net Comments: This menage, is intended only for the use of the individual or entity to which it is addressed md may comnin iufu~,uaIion that is lUrivile{~d, confidential and exempt from disclosure under applicable law. If~e reader of this message is not gae intended recipient, ~r the employee or agent responsible for delivery of the me~ to the intended recipient, :mu are hereby notified that disseminatim, distribution or copying of this communication is strictly prohibited, ff you have received this c~mmunicafion in aa'or, please notify us i~lucaediateiy by telephone, and reuma the ofigimal message to us at the above address via the U.S, Postal Service. Thank You Rpr 28 9B 04:09a R4~da~Hensle~l , · 393-5028 04/28/99 ll:14 ~"326 0~76 B~ ~Z MAT D[ ~ '~~ i.. -~~~~ .. · .:?...:l ,~,-.:~: .... .l::~.~: ~:~:~:.: .. '-' CERiiFiCATJON OF FINANCIAL RESPONSIBILI~ Feb 24 99 !1:58p 02/10/99 14:35 R.~d a_i~l~-I e n s 1 e ~ , ~8~~57fl. _ BFD t{AZ MAT DIV 393-5028 ~]015 p.11 EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This mo~mri~ prosram must t~ lr, gpt at th~ UST locaaon at all runes. ~ informaUon on U~i$ momm~g program am couscous ofU~ o~rating permit The pvrmit hol~er must notify ~ Offic~ of Envimmmmmi ,~uviu:s wi~n 30 days of any. ~ang~s to the mo~tormg !~c~1~, unless required m otnam approval before mair~g the change. Requital i~ Sectio~ 2632(d) ara12641{b) CC~L Facility Address ~-~ ffan unauthorized release occurs, how will [he hazardous substance be cleaned up? Note: ff released hazardous substances reach the environment, increase the fire or explosion l~-*nt, are not cleaned up Eom thc s~condary comaMmcat witb~ 8 hours, or deteriorate the secondar~ containment, then the Office of Environmental Sentices must be notified within 24 hours. '~-?~-D,..,~ ot~ , G~,'~,-.'~ ~-r~ ,1~,r~ Describe the proposed methods and equipment to be used for removing and propedy disposing of~ny hazardous substance. ,~,~c,~,,~ ! f~,- ~c ~ ~;~, / ~.c ~ l)~gritg thc Iocstion ired avglability of the required cleanup ~quipment in it~ra 2 above. Describe thc maintenan~ schedule for the cleanup equipment: List the name(s) and title(s) of the p~'son(s) responsible for authorizing any work necessary under the response plan: Feb 2~ 99 1!:58p 02/10/99 14:35 ~dl~d~ensle~ BFD HAZ MAT DIV 393 -5028 p.12 ~0t6 WRITTEN MONITORING PROCEDURES UNDERGROUND STORAGE TANK MONTI'ORING PROGRAM Describe the trequmcy ofperfoflning the monitoring: Tank ~** ~ ~ Pipins v*, ~-~f Bo What m~J~ods and equipmeat, identified by name and umdel, will be used for pe~ the monitoring: Dcsc~il~ the location(s) where the monitoring will be performed (f:a~ plot plan bc attached): ~j List thz name(s) and tide(s) of the people responsible t'or per~rmiug the moni~riug md/or maiatais~ the equ~pmem: Eo Fo Reporting Format Ur monitoring: Tank Piping Describe the preventive maintenance schedule for the monitoring equipmem. Note: Maintenance mnst be in accordance with ~e mannfncturer's maintennnee sdmdnle but not less than every 12 months. Describe the training necessary for the operation of UST system, includin8 pipin&,,Iai Ibc monitoringeqtdpment: I ~ ?,:~Se -'rle-,,l~ I~t~ o,~ ~.~r ~ .0 L D FIItE February 9, 1999 FIRE CHIEF RON F RAZ. E ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICE8 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 TRAJNING DMSION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 Sullivans Security Fuels 2317 "L" Street Bakersfield, CA 93301 RE: Compliance Inspection Dear Underground Storage Tank Owner: The city will start compliance inspections on all fueling station~ 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. Sincerel , Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure Cert. No.00810 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 in the tbrmat 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 intbrmation may be added as deemed necessary by the local agency. This permit is issued on this 2nd day of November, 1998 to: CHEVRON FOOD MART Permit #015-021-001920 2317 "L" Street Bakersfield, California 93301 Permit 'to OPerate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ........ ~,,~:i~?7777~.~,!,.,~,i~,~.~,,,~ ........ This permit is issued for the following: .~/~f*~*i i ~/~,.!!:'~ ......... '~'~[i;;~i[[L :~iii!i!!ii~, [!iiii~ii~%;iiiil;~;U~e[ground Storage of Hazardous Materials ~ ~, ". ~ ~' ~ '= 'm ~ ~.. ':'.. ~rq h ' ~. ' ~. ' g"~; ~ ~. '"',-~[ ~:.. %.'~ ~' "* ~,~. ':""=".~:"2"~ ~[q [' ' =~ ~, ~ ~ '..'"--.~= 5~ "'-· ~.r27 ~:1 " · ~,' ',' ~ ~ ~ · e'~ fi, ,' "~'~ TANK H~A~US SU~TANCE CA~'[TY ~.'~AL ~{~}~ ~ANK ~=' :&' ~4 ::,TA.N~R PIPING PIPING PIPING ~{:.:::::J':~= 5::',, f~~' TYPE '~'ATEmffL ~ITOR TYPE METHOD MONITOR il"'nm ~ ~, .~ ' '"' a;~'- .~ =~.:.' ~P. '.. 1998.d'"..:,: ;~"~ DWS F e:'.~" -=~ .... '~ ~iX!:,~:~?a.~", ~=,. -""::,..e ::x;'~%i%,.,~, ,,. :,,- :~gn U~lex P~SSU~ ALU 0003 Gasoline 0004 Diesel 12,000 G~I<i;~: 5-':':-:I998~,d:~2:;~ ~,:~*'~¢ , .,.,,.,o~, .... ALD D~lex P~SSU~ ~D I~u~ by: O~CE OFE~O~AL ~ ~CE$ 1715 CheAer Ave., 3rd Floor B~e~el~ CA 93301 Voice (805) 32~3979 ~ <~0~,, ~p~.on~,~: June 30~ 2000 CA Cert. No.00810 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 in the tbrmat 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 intbrmation may be added as deemed necessary by the local agency. This permit is issued on this 2nd day of November, 1998 to' CHEVRON FOOD MART Permit #015-021-001920 2317 "L" Street Bakersfield, California 93301 SENSOR ALARM ..... L '2~NLEAI-~EI-~ SV~MP F UE"LI~ALARM JAN 14, 1999 9:24 AM ..... SENSOR ALARM ..... L 6 :SUPREME-DIESEL ANNULAR SPACE FUEL ALARM JAN 14, 1999 9:25 AM ..... SENSOR ALARM L 1 :PLUS STP SUMP FUEL ALARM JAN 14, 1999 9::34 AM SENSOR ALARM ..... L 4:SUPREME ST/iUMP F UI:~LARM JAN--14, 1999 9:36 AM ..... SENSOR ALARM L 5:DIESEL STP SUMP FUEL ALARM JAN 14, 1999 9::37 AM ..... SENSOR ALARM L 3 :PLUS-UNLEADED ANNULAR SPACE FUEL ALARM JAN 14, 1999 9:37 AM (-;ARDLOCK CHEVRON 2iL STREET 805 JAN 14, 1999 10:01 AM SYSTEM STATUS REPORT L I:FUEL ALARM L 2:FUEL ALARM L 3:FUEL ALARM L 4:FUEL ALARM L 5:FUEL ALARM L 6:FUEL ALARM REPORT T I:PLUS VOLUME = 4358 GALS ULLAGE = 3671 GALS 90% ULLAGE= 2868 GALS TC VOLUME = 4358 (]ALS HEIGHT = 64.04 INCHES WATER VOL = 0 GALS ---MATER · =--O~O0 INCHES TEMP = 59.? DEG F T 2:UNLEADED VOLUME = 9399 GALS ULLAGE = 2645 GALS 90% ULLAGE= 1440 GALS TC VOLUME = 9400 GALS HEIGHT = 87.42 INCHES VOL = 0 GALS = 0.00 INCHES ' TE = 58.9 DEG F T 3:SUPREME VOLUIdE = 6230 GALS : ULLAGE = 1799 GALS 90% ULLAGE= 996 GALS '. TC VOLUIdE = 6230 GALS ':' HEIGHT = 86.94 INCHES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 57.9 DEG F T 4 :DIESEL VOLUME = 8106 GALS ULLAGE = 3938 GALS 90% ULLAGE= 2?33 GALS TC VOLUME =- 8106 (--:ALS HEIGHT = 76.52 IN¢:HES ~I ',,;OL OGALS 0 O0 INCHES TEMP' = 58.0 DEG F SENSOR ALARM ..... L 4:SUPREME STP SUMP FUEL ALARM JAN 14, 1999 9:58 AM SENSOR ALARM ..... L J:UNLEADED-SUPREME ANNULAR SPACE ALARM 4, 1999 9:59 AM ..... SENSOR ALARM ..... L I:PLUS STP SUMP ALARM 4, 1999 10:oo AM ..... SENSOR ALARM L 2:UNLEADED STP SUMP FUEL ALARM JAN 14~ 1999 10:05 AM ..... SENSOR ALARM L 5:PLUS ANNULAR SPACE FUEL ALARM JAN 14, 1999 10:07 AM SENSOR ALARM ..... L 4:SUPREME STP SUMP OUT ALARM 4, 1999 4:82 AM ..... SENSOR ALARM L 4:SUPREME STP SUMP SENSOR OUT ALARM JAN 14, 1999 4:32 AM ..... SENSOR ALARM ..... L 4:SUPREME STP SUMP SENSOR OUT AEARM--- JAN 14, 1999 4:40 AM ..... SENSOR ALARM ..... L 4:SUPREME STP SUMP SENSOR OUT ALARM JAN 14, 1999 4:58 AP1 ..... SENSOR ALARM ..... L ~UPREP1E SEN'~ OUT ALARM JAN 14, 1999 5:31 AM L 4:SUPREME STP SUMP SENSOR OUT ALARM JAN 14, 1999 5:31 AM CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N°_ Locatio. ~ ~1'7 L Sr Sub Div. Blk. . Lot You are hereby required to make the following corrections at the above location: 907 Cot. No t,J.s,o~- ~.rocz~ oR. f:'eou,0¢ .Ad'wo Completion Date for Corrections_. / /ZI /~ Inspector 326-3979 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT Location ~ -~ t '~ ~ ~ ? Sub Div. Blk. Lot You are hereby required to make the following corrections at the above location: Completion Date fo,' Correctionsx~/~: '~' ?2 ,~ .~/'/~ I~$p~¢tor 326-3979 CITY OF BAKEP~IELD OFFICE OF EN%r~ONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (805) 326-3979 ci~,. ap ~ b,ddJ' . q..~,o I INSPECTION RF.~RD POST CARD AT $O8 SITE ghh,,,.c ~F fi~-~) l~l IH$1~CT/ON DATE Cathadi~ Pto~:don of T~k(s) Hpi~ & Rm:oway w/CoHecdm Sump Ele~ri~l lsoladoa of Pil~ Finn Tank(s) Cathodic l~'~eetim S.v~m-Pipins Dispens~ PIPING SECONDARY CONTAI~.'MF..VL OVERFILL PROTEt.-flON. LF. AK Li~er [m~llxioa - Tank(s) Lina [mtall~ - Piping Vault With Produa Con.bio Se. ale~ Level Gauges oe gemo~. Flo~t Pr~dua ¢omp~dble Fill Produa ~ Le~k Dete~s) ~ Darvon(s) for .eumml Spa~e.D.W. T~k(s) Monitoring Well(s)/Sum~s) - H20 Tm L~--t l)ete~on Doice(s) fo~ Spill MOmtormg Wdk C~.~_ &~ Fill Box L_~_k FINAL '~ ' ~ Bakersfield.Fire Dept OFFICE'OF ENVIRONMENTAL SEI:i~cE$ . UNDERGROUND STORAGE TANK PROGRAM PERMIT APPLICATION TO CONSTRUCT/M_QDIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) ~ NEW FACILITY Q MODIFI'C'ATION OF FACILITY E3 NEW TANK INSTALLATION AT EXISTING FACILITY STARTING DATE O"~'x..~ /~-" ,~,~' PROPOSED COMPLETION DATE ,,~4,-~'~. ~' FACILI~ NAME ~~ ~ ~~ EXISTING FACILI~ PERMIT No. FACILI~ADDRESS ~ ~/~ ~ ZiP CODE ~PE OF BUSINESS ~~ ~~ ~/'~,' ~~ APN TANK OWNER ~,~ ~X~ ~o. ~Z~ PHONE No. ADDRESS ~ ~.~,~~ CI.~ ~,~4~ ZlPCODE CONTRACTOR ~ ~ ~~/~ ~ ~ CA LICENSE No. ADDRESS ~ ~. ~~ ~M¢ ~ / CIW ~~~ZIP CODE PHONE No. ~-~~/~? BAKERSFIELD Cl~ BUSINESS LI~ENSE No. ~ ~~ WORKMAN COMP~ No. Y/~-'Z/~--¢7 INSURER ~'~ BREtFLY DESCRIBE THE WORK TO BE DONE ~~Z ~ ~ ~ ~ /~/~ ~ wATeR TO FAC~U~ PROviDED ~Y- ~P/- ~ ~P DEPTH TO ~OUND WATE~ yy[Po ~M ~OIL ~PE ~xPECTED';~;SIT5 s~ No. OF TANKs TO ~E iNsTALLED ~ A~E THEY FoR MoToR FuEL '~YEs Q SECTION FOR MO;OR FUEL TANK NO. VOLUME UNLEADED ~ PREMIUM DIESEL AVIATION SECTION FOR NON MOTOR FUELSTORAGE TANKS TANK No. VOLUME CHEMICAL STORED CAS No. (no brand name) (if known) CHEMICAL PREVIOUSLY STORED THE APPLICANT HAS RECEIVED. UNDERSTANDS, A ND WILL CO MPLY WITH THE AFFACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE. LOCAL ANO FEDERAL REGULATIONS. THIS FYRM HAS BEEN COMPLETED UNOER PENALTY OF PERJURY, AND TO THE BEST OF: MY KNOWLEDGE. IS TRUE AND CORRECT. APPJ~OVE'D" Bt¢:- J~ APPLICANT NAME (PRINT) APPLICANT SIGNATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ~ooo south Ch,~g ~v*,,.~ ~ (805) 834-3t39 CA LIc f~42735-A DISPENSER ~ K~ING LEGE~'r~ I1 I nterprise 3000 South Chester Avenue, #31 Bakersfield, CA 93304 (805) 834-3 ~ 39 CA Lic #742735-A TANK PIPING KEYING LEGEND A. 36" w/'r Traffic Box B. W/T fiberglass turbine sump C. Wfr bulkhead fittings D. Extractor body E. Fiberglass pipe F. 1 ' rigid AC conduit G. Class I junction box H. EYS seal I. 1" rigid DC conduit J. Monitor sensor K. Drop tube L. Drop tube poppet valve M. Turbine motor N. Turbine head O. Vapor cap & adaptor ?. DAV tank Q. TC Enviroflex prima~ piping R. TC Enviroflex seeonda~ piping S. W/T monitor traffic box T. Monitor probe U. Fill cap & adapter V. Ovgrspill box MANUFACTURER PART # lC 711 r ~ ~ II ,q-t/