The URL can be used to link to this page

Home My WebLink AboutUNDERGROUND TANK FILE #2Hazardous Materials/Hazardous Waste'Unified Permit CONDITIONS OF-PERMIT ~ON' REVERSE SIDE Permit ID #:: 015-000-000563 AM PM MINI MARKET #6218 This =ermit'ls issued for ~.the followinq: . [] Hn~rdous Materials Plan' [3 Underground'Storage of HazardOus Materials E] Risk Management Program E) Hazardous Waste On-Site Treatment LOCATION: 4203 MING AVE TANK I HAZARDOU 015-000-000563-00011MIDGRADE UNLE, 015-000-000563-00021 GASOLINE ARCOi 015-000-000563-00031 GASOLINE ARCO] 015-000-000563-00041 GASOLINE ARCOi ~ONITORING iUTOFF · IUTOFF ~UTOFF .. 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 Approyed by: L Ralpl~Huey, DI~ i Office of Ev~Services -~ Issue D-ate Expiration Date: June 30. 2003 ICA Cert. No. 25501 City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (661) 326-3979 An upgrade compliance certificate has been issued in connection with the operating permit fOr the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information inthe format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. This permit is issued on this 28th day of March, 2001 to: ARCO AM/PM MINI MARKET #6218 Permit #015-021-000563 4203 Ming Ave. Bakersfield, Califcrnia 93309 For Usc ~. Ail J, risdicl~'on~ Y~thin thc ~at¢ of California .A~tthori.~ Cifcd: Chapter 6. 7, Health and Sa.f¢.~. Code; ChaPter 16, ~'v~ion $, Title 25, California Code of .~e~alah'on~ This form must be used to doc~'~ent testing and seI~icing ofmorEtol4ng equipment. A sep~ate ce~ca~on ox ~epo~ mus~ be p~ep~e'd fo~ each mo~to~g system consol p~el by ~e teC~ci~ who pe~o~s ~e work. A copy offs fo~ must be p~o~ded to ~e.t~ system o~er/opetatox. The o~e~/ope~ato~ must sub~t a copy offs fo~ to ~e loc~ agency ~e~a~g UST systems ~ 30 days of test date. A. Gener~ Informa~on. Faci~ty Name:: [ ARCO PRODUCTS COMPANY ~ Se~ce Sta~o~'~-~:?-'~i~- ...................................... ~ Si~e Ad.ess: J4203 M~G AVE j City~. BAKERSFIELD ~ Zi~_.J93309 __F~£i_.h_'ty Contact Person; I ~, k/~T, c_,o~ I~¢S !--C9.ntactPh°ne'N°'; ~ Make/ModelofMonitofing_S_,ystem: 1 ~J_J~=~o~-r~,~_~oW ~T~ ~j~-o I Date of Testing~ervice: B. Inventoryof Equipment Tested/Certified Check the appropriate boxes toimlicate'specific equipment inspected/Serviced: TanklD: I ~3 TanklD: J ~-~ ~ ~_n_:TankOau[~_g_p_robe: Model: : ~n-TankOaug~gProbe: !Model: ] ~SS~renchSensor(~: J Model: } ~ f~agS~renchSensor(~): I Model: : ~ch~c~e, Le~Detector. , Model: : GKI~ ~ech~c~eLe~Detector. ~ Model: : _ ~n-T~Oau~gProbe: J Model: ~ ~=~Spaceor.Vi~Smsor: j Model: i ~0~ ' ~Spac, or Va~t Sensor { Model: ~ ~PiPigS~P~renchSensor(e: j M'odel: j ~ '"' ' : ~ ?ipmg S~p~rench Sensor (s): J Model: i ~T~'Ove~i~-level.Sensor: ~Model: i ' ' "- tO'er, Spe¢~ e~p. t~e ~d model a'Sec~n E on Pa~e 2 i O~er, Spec~ eq~p. t~e ~d model ~ Sec~an E on Page 2 ~ispenserC0nt~entSensors: ~Model; ~ ~ :~DispenSer~~entSenso~sJ: Model; Dispens.erOont~ent Fl°a~s) md Ch~s) .......... J ~ispenser'Cont=ent Fl°a~s) ' Jisp.~nser ~: { ~ - ~ .Dispenser ID: J ~ - ~ ~ ~he:~ V ~ve(s):__~ispenserCont~ent Sensors: il Model: .... i{ ~ Y ~ b~; er~ont~;nt Senso~: :' ~ ',~he ~:V ~.e(s). ii Model: } ' .: . : . ~ , j D!s~Cont~ent Sensors: i Model: :i ~ :~Dis~enenser Cont~ent Sens0~..~_:s- J Model: ~ Dispenser Cont~ent F!oa~s) ~d Chis) .... ~ D~spenser oont~nt Floats) ~d *If the facility contains more tanks or dispensers, copythis ,form, Include reformation for every tank and dispenser at this facility. C. Certification- I certify that the equipment identified in this document was inspected~serviced in accordance with the manufachm~' guidelines.. Attached. io this Cerfifica~n is information (e,g~. manufacturers' checklists) necessary to.verify that this information is ¢oxrect ami a Fief ~ shewi~. ~ laYeut of~ito~i~ eq.~:, ment For ~uy~e~ment c~paMe ofgenerafin~ such report, i.._Technician Name (P_rint~._ ! ~-~ ~_~ , __S_.ijgna.ture: i 'Certification No.: t O(~ ~ ~ ~E)tSgctt ~' { License N~.i' .......................... i ~~.~ Pace'l ors M~ni~ri~ System Certification Site Address: ~5218:4203 MING AVE, CA 93309 Date of T e sti~_~____er~icin~: D. Results of Testhg/Servicing Software Version Installed: I Complete the foll~wiag checklist: ~Yes ~ No* IS the audible alarm operational? ,~[Yes~i No* Is the visual alum operational? j~yYes ~No* Were all sensors visually inspecte d, functionally te sted, and c onfirme d op erational? es No* Were all sensors installed at lowest.point of secondary containment and positioned so that other equipment will not interfere w/th thek proper operation? Yes ·-- ow if alms are relayed to a remote monitorin§ station, is all communications equipment (e.§. mode/nj ~N/A operational'?. ~ ~ No* For pressurized piping systems, does the turbine' automatically shut down if the piping secondary containment · moni.'t, oring system detects a leak, fails to opes otis electrically diseonn__~eeted? If yes: wh/ch sensors initiate postttve shut-down? (Check ali that aIJ1vly~umplTranch Sensors~spen~r C~o, ntainment Sensors. Did you conFam positive shut-doWn due to leeks and sensor fdlure/disconneCtion?~s; ~ No. Yes ~No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning dann visible and audible at the tank fill poinl(s) and op crating properly?. If so, at what percent of tank capacity does the alarm trigger?. .... Yes* ~No Was my monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below~ Yes* ~No Was liquid found inside my secondary containment systems designed as dry systems? (Check Product; ~Water. If yes, describe causes inSectionE, below. ~! No* Was monitoring system set-up reviewed.to ensure settings? proper ~ No* Is all monitoring equipment operationa! per manufacturer's specifications? '* In Sectie~ E below, descr~e how and wheat these deficiencies were or ~ill be corrected. I 1~.. Comments: t Page 2 of 3 03~01 Address: 6218:4203 MING AVE, CA 93309 ~ F. In-Tahk Gauging / SI~ Equip ~ C.~aeck this box if tank is used only for inventory control. ~heck this box if no tank gauging or SIR equipment is installed. This section mustbe completed ii'h-tank gauging equipment is used to per~orm leak detection monitoring. (,.:oml)lete t~te louowu~ cn~ .... ,; ~.Yes ~ No* Has~ut~gbeenmspectedfo~proparen~dte~a~o~mclu~gtes~gfor~o~dfa~ts? Yes ~ No* Were ~ t~-~ ga~-g probes ~su~y respected for d~age ~d ~esidue b~dup? Yes ~ No* ~ Was acc~acyofsystemproductlevelrea~stested? Yes '~' No* Was acc~acyofSystemwaterlevelrea~gstested? Yes ~ No* Were ~robes ~e~st~edproperlf Yes ~ No* Were ~ items on ~e eq~pment m~act~ar's m~ten~ce chec~st completed? * Inthe Sectiox H,below, descr~e how ~td when these deficie~tc~es were or wfllbe co~ G. Line Leak Detectors (LLD): ~ Check this box ifLLDs are not installed. t2olltl)lete tlt~ IOUOW~ ~Yos ~ No* For eq~pment stoup o~ ~u~ eq~pment ce~ca~o~ was a le~ s~ated to ve~ ~ peach,ce? N/A (CheCk MI tha~ap~ly} S~atedle~rate: ~3 g:p.h.!; ~0.1 g.p.h.a; ~0.2 g.p.h.2 Notes: 1. Req~ed for eq~ment stoup ce~cafion ~d ~u~ ce~ca~on. 2. U~ess m~dated by loc~ agency, ce~cagon'req~ed o~ fox elec~o~c ~ stoup. ~es ;'~ No* Were ~l]_Ds C'O~ed o~era~on~ ~d accwate ~re~ato~req~ements? ~es ~ No* Was ~e testi~E app~atus properly c~bxated? ~es ~ No* FOrmech~c~s, does ~e ~ re's~ctproductflowgit detects ale~ Yes ~No* For elec~o~c ~s. does ~e twbme automaPc~y shut office ~ detects a le~ Yes '~o* For elec~o~c ~S. does ~e twb~e a~tomaPc~y Shut offF ~y po~on of~e mo~to~g system is ~sabled ~.N/A 0r ~s.q.o~ected? Yes ~N0~ ' F°r.elec~o~c.~S, does ~e t~b~e automaPc~yshut offFmYpo~0n of~e mo~to~g sy'stemm~cPons ~N/A orris a test? YesI '~/A~., For elec~o~C ~s, have ~ accessible ~g co~ec,ons, been ~su~y ~spected? ~Yes :~ No~ Were ~ items on ~e eq~pmentm~act~er s m~ten~ce chee~st completed? !n t~ Sacra H, below~ ~sc~e how ~d w~a ~se ~Es ~ or ~ be co~c~a H. Co--ants: ~ P~e 3 of 3 03~1 l~lo, nitori~ System Cerfifi~:ation UST Monitoring Site Plan ~.'.: ....... x/c,~_..x',,. · - -I ..... ~&,cx,¢'...~.,.¢ .,,.. ..... ~, . . ._,-, ........ .~. ........x.'.~.~-.%. '1 ....... -~*. :.C~ .~,.~. (~)c... ri... ~ .... ~"',~.~.'~::: :. :'h~. :"~::::": ::': :: :: ::~: :u:,,,:: ::::::::::::::::::::::::::: Instructions If you already have a diagram that shows all required information, you may include it, rather than.this page, with your Monitoring System Cert/fication. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page I of / O~liO SYSTEM UNIT~ SYSTEM D~TE./T I HE FOrMaT HON DD YYYY HH:MM:~B xH fi~OO ~M~PH B~KEESFIELD Cfi. BHIFT TI~E I : SHIFT TI~E 2 : SHIFT TIM~ ~ : SHIFT TIHE 4 : DISABLED T~NK PERIODIC D I S~BLED · / T~Nk ~NNU~L ~RNINO~ . D I SaBLED LINE PERIODIC D I ~BLEB D I PRINT TC VOLU~ES ENABLED TF. PIP COHPENSATION i VALUE (DEG F ): 6Q, STICK HEIGHT OFFSET[ DISABLED ~ DAVLIGHT SAVING TIME ENABLED START DATE APR WEEK I BUN START TIME 2:00 AM END DATE, OCT MEEK 6 SUN END TIME 2;00 AM S¥ST~'I SECURITY CODE : 000000 COMMUNICATIONS SETUP PORT SETTINGS: NONE FOUND RS-232 SECURITY CODE : ~ ! b i;:;/iE! i::, ' L I;ROL-u?-ANNUI.~R TRI-STATE (SINGLE FLOAT) CATEGORY ; ANNULF~ SPACE L 2:RUL-B?-STP TRI-STATE (SINGLE FLOAT) CATEGORV : PIPING BUMP L S:RUL-8?-FILL TRI-STATE (SINGLE FLOAT) CATEGORY : STP BUMP L 4:RUL-BT-TK.2-ANNUL~R TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE L 5:RUL-B?-TK.2-SYPHON TRI-STATE (SINGLE FLOAT) CATEGORY : STP SL~IP L 6:RUL-BT-TK.2-FILL TRI-STATE (SINGLE FLOAT) ~'ATEOORY : PlPll'~ SUMP I. ?:RUL-8?-TK.3-ANNULRR TRI-STATE ~SINGLE FLOAT) CRTEGORV : ~NNULAR SPACE l_ B:RUL-B?-TK.S-SYPHON TRI-STATE (SINGLE FLOAT) CATEGORY : PIPING SUMP L 9:RUL-BT-TK.B-FILL TRI-STATE (SINGLE FLOAT} CATEGORY : PIPING SUMP LlO:SUP-92-ANNULAR TRI-STATE (SINGLE FLOAT) CATEGORY : ANNULAR SPACE Lll:SUP-92-STP TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUHP LI2:SUP-92-FILL TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L1B:MPD-I~2 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN LI4;MPD-3~4 TRI-STATE (SINGLE FLOAT) ,TATE~OPV : DIOPRN~EP PAN LI6:MPD-7~8 TRI-STATE (SINGLE FLOAT; CATEGORY : DISPENSER PAN L17:MPD-9~IO TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L1B:MPD-II~I2 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN s, UTPUT RELAY SETUP I:REGULAR-UNLEADED-8? STANDARD HoRMALLY CLOSED LIQUID SENSOR ALMS I. I:FUEL ALARM L 2:FUEL ALARM L 3:FUEL ALARM L 4:FUEL ALARM L 5:FUEL ALARM L 6:FUEL ALARM L ~:FUEL ALARM L 8:FUEL ALARM L 9:FUEL ALARM LIS:FUEL ALARM LI4:FUEL ALARM L15:FUEL ALARM LIS:FUEL ALARM L17:FUEL ALARM L18:FUEL ALARM L I:SENSOR OUT L 2:SENSOR OUT L $:SENSOR OUT L 4:SENSOR OUT L 5:SENSOR OUT L 6:SENSOR OUT L ?:SENSOR OUT L 8:SENSOR OUT L 9:SENSOR OUT L18:SENSOR OUT LI4:SENSOR OUT LIS:SENSOR OUT LI6:SENSOR OUT LI?:SENSOR OUT ALARM ALARM ALARM ALARM ALARM ALARM ALARM ALARM ALARM ALARH ALARM ALARH ALARM ALARM L I8:SENSOR OUT ALARM L 1 ;SHORT ALARM i 2 '~.H.Sh'.~ ~,l A~,~1 ?.. ,.'.: .c;HC-Ri' ~.,~ .E~',:I': L ~'} :~-:l"iON'i' ;'~L;.':'.';:I': '... ,'~ :;.:;!'JO.',,Fi' L ".-' '. ::, H:.,F' :' L B :SHORT L 9 :SHORT ALARM LI 9:SHORT ALARM L14 :SHORT ALARM L 1 §: SHORT ALARM LI 6 :SHORT ALARM LI 7 :SHORT ALARM L1 @ :SHORT ALARM R 2:SUPER-UNLEADED TYPE: STANDARD NORMALLY OLOSED -92 LIGUID SENSOR aLMS LIO:FUEL ALARM LII:FUEL ALARM LI2;FUEL ALARM LIB:FUEL ALARM LI4:FUEL ALA.RM L15:FUEL ALARUM LI6:FUEL ALARM LI?:FUEL ALARM LIB:FUEL ALARM LIO:SENSOR OUT Lll:SENSOR OUT LI2:BENBOR OUT LIB:SENSOR OUT L14:SENSOR OUT LIS:SENna OUT LI6:SENSOR OUT LI?:SENSOR OUT ~ARM ARM ALARM AqARM AU~RM LIB:SENSOR OUT ALARM LIO:SHORT ALARM LII:SHORT ALARM LI2:SHORT ALARM LIB:SHORT ALARM LI4:BHORT ALARM ! LiB:SHORT ALARM LI6:SHORT ALARM LIT:SHORT ALARM L18:SHORT ALARM R B;ALARM TYPE: STANDARD NORMALLY OPEN LIQUID SENSOR ALMS ALL:SENSOR OUT ALARM ALL:SHORT ALARM SOFTWARE REVISION LEVEL VERSION 18.01 SOFTWARE~ B46018-!IOO-B CREATED - 99.07.2~.19.14 NO SOFTWARE MODULE t.£~[O[;!,' ,1'1. ~'~l'~' 'I}':';T:'~ .. ~','E:'t"~lq ~,I.~PI"J ....... P~R Gu'[ OCT 17, 2009 11:$2 AM PRINTER ERROR OCT 17, 2003 Il;B2 AM BATTERY IS OFF JAN 1, 1996 8:00 AH CLOCK IS INCORRECT APR 6, 200B 3:01 ~q ALARM HISTORY REPORT ..... SENSOR ALARM L I:RUL-BT-ANNULAR ANNULAR SPACE FUEL ALARM OCT 30, 2002 10:46 AM FUEL ALARM <)CT 30, 2002 10:44 AM FUEL ALARM {:CT BO. 2002 10:~? AM ALARM HISTORY REPORT ..... SENSOR ALARM ..... L 2:RUL-8?-STP PIPING BUMP FUEL ALARH OCT 30. 2002 10:29 AM ALARH HISTORY REPORT ..... SENSOR ALARM ..... L 9:RUL-B?-FILL STP SUMP FUEL ALARM APR 14, 2003 8:46 AM l'dEL ALARM ;.,~%L 15, 2003 4:06 AM i'UEL ALARM FEB 12. 2009 1:19 ~1 ALARM HISTORY REPORT SENSOR AL&RS L 4:RUL-87-TK.2-ANNULAR ANNULAR SPACE FUEL ALARM OCT 80. 2002 10:69 AM FUEL aLARM OCT BO, 2002 10:48 AM FUEL ALARM OCT BO, 2002 lO:B7 AM STP SUMP FUEL ALARM OCT 30, 2002 10:9 AM FUEL ALARM JUN l, 2002 7:21 PM SENSOR OUT JUN 1, 2002 6:48 PM ii [; ~'1','.;'1~:'/ .":~': F' :' ~' p, .... '.=.i-'i'-~';Oj;. ,%!.~I~N ...... k i 13; ~uP"92~ANI'4UL~R ANNUL/:~ SPACE FUEL ALARM OCT 30, 2002 10:53 AM FUEL ALARM OCT 30, 2002 10:42 FUET. ~I-~RM OCT 30, 2002 t0:32 AM ALARM HISTORV OAT ..... SENSOR ALA~PI ...... L &:RUL-8?-TK.2-~ILL PIPING SUMP FUEL ALARM DEC 20, 2002 4':1~ ~H FUEL ALARM DEC 20, 2002 FUEL ALARM NOV 9, 2002 1:58 AM 8:i2 AM HISTORY REPORT --- SENSOR ALARM ..... ~. 8:RUL-8?-TK.3-SVPHON PIPING SUMP F:JEL ALARM [:~B 12, 2003 12:42 PM ?'JEL ALARM bEC 20, 2002 5:04 f'dEL ALARH (:,CT 30, 2002 10:31 AM ~.~L...%RM HISTORV REPORT ..... SENSOR ALARM i-~l;SUP-92-STP ;5'i'P SUMP F'dEL ALARM DEC 25, 2003 3:52 PM FUEL ALARM OCT 30, 2002 10:31 AH FUEL ALARM IflRR 12. 2002 9:30 AM I END ~( ~i ~ ~ ~ I ~LRRM H I STORY REP~)RT L 7 :RUL-87-TK.~' "'~-ANNULAR ~NNUL~E SPACE j FUEL ALARM ~nT 30. ~00~ 10:5 ~ ALARM H I STORY REPORT ..... SENSOR aLARM L 9;RUL-8?-TK.3-FILL PIPING SUMP FUEL ALRPJ'I APR 15, 2003 12:06 AM FUEL ALARM NOV 9, 2002 9:29 AM FUEL ALARM OCT 30. 2002 10:30 Riff ALARM HISTORY REPORT SENSOR ALARM L12:SUP-92-FILL ~TP ~UMP FUEL ALARM APR 14. 9009 9~70 AM ........ 6~!:H~Ok ~LF~I ...... LIS:MPD-5~6 DISPENSER PAN FUEL ALARM OCT 30, 2002 10:34 APl FUEL ALARM MAR 12, 2002 10:09 ~M FUEL ALARM DEC 10, 1999 11:07 AM MAR 12, 2002 10:11 AM ALARM HISTORY REPORT ..... SENSOR ALARI ..... LIS:MPD-I~2 DISPENSER PAN FUEL ALARM ' OCT 80. 2002 10:3i AM FUEL RI.RRM MAR 12, 2002 10:09 AH FUEL ALARH DEC 10, 1999 11:0 ,~LARM HISTORY REPORT ..... SENSOR ALARM ~ [6:MPD-?~8 :,ISPENSER PAN ~-'UEL ALARM OCT 30. 2002 10:35 AM ~UEL ALARM ,:'~UG 21. 2002 2:25 PH FUEL ALARM MAR 12, 2002 10:11 AM ALARM HI~TORY REPORT ..... SENSOR ALARM L17:MPD-9~tO [,ISPENSER PAN FUEL ALARM COT SO, 2002 lB:3B AM PURL ALARM MAR 12, 2002 lO:Il AP1 PUEL ALARM PEC 10o 1999 11:08 APl ALARM HISTORY REPORT ..... SENSOR ALARM LI4:MPD-3~4 DISPENSER PAN FUEL ALARM OCT 30/ 2002 10:3~ AM FUEL ALARM 11:2~/ PM JUN l, 2002 / FUEL ALARM / MAR 12. 2002 10:~9 AM RLhRM HISTORY REPORT SENSOR ALARM ..... LI6:MPD-7~8 I:U~L ~-~i.~,ld': ALARM HISTORY REPORT ..... SENSOR ~LARM L18:MPD-II~t2 DISPENSER PAN FUEL ALRRI~ OCT ~0. 2002 IO:S~ AM FUEL ALARM JUL 19, 2002 10:30 AM LIg: OT REP. SENSORS L. i '-", :I'If-L' · b ~£ ~'1":'...,. iZN;';~F' I:,'"~N FUEL ALARM MAR 10, 2004 12:02 PM I. 9': I;.'tjL--5;? -T!.;. '.::-..'~.l,tNi. II .Ri';! Ai,INI II .~-'.D. 91.'Ri:'E FUEL ALARM MAR 10, 2004 12:10 PM ..... SENSOR ALRRM LIO:MPD-tI~12 DISPENSER PAN FUEL ALARM MAR lO, 2004 12:0~ PM ..... SENSOR ALARM L 8:RUL-8?-TK.3-SYPHON PIPING ~UMP FUEL ALARM MAR 10, 2004 12:11 Phi ARCO AM~PM 4203 MING AVE. BAKERSFIELD CA. 661-834-1076 MAR 10, 2004 9:26 AM SYSTEM ~TATUS REPORT bI~PEN~£R PAN FUEL ALARM MAR 10. 2004 12:01 .... SENSOR ALARM ..... !.~7:MPD-9~IO bi.SPENSER PAN Fi,EL ALARM !'~R 10, 2004 12:04 PM ..... SEN~OR ALARM L 6:RUL-87-TK.2-FILL PIPING SUMP FUEL ALARM ~AR 10o 2004 12:05 PM ..... SENSOR ALARM 1.. 9:RUL-B?-TK.B-FILL ~.'IPING SUMP ~UEL ALARM :-i,4R 10, 2004 12:12 PM ..... SENSOR ALARM L ~:RUL-87-FILL BTP SUMP FUEL ALARM MAR 10, 2004 12:13 PM ..... ~ENSOR ALARM LI4:MPD-3~4 DISPENSER PAN FUEL ALARM MAR 10, 2004 12:01! PM ..... SENSOR ALARM ..... ~ L 5:RUL-BT-TK.2-MYPHO~ .... STP SUMP FUEL ALARM MAR 10. 2004 12:06 PM ..... SENSOR ALARM ...... L D:RULI87-STP PIPING SUMP FUEL ALARM MAR lO, 2004 12:13 PM ..... SENSOR ALAR~ L16:MPD-7~8 DISPENSER PAN FUEL ALARM MAR 10. 2004 12:0~ PM SENSOR ~LARM ..... : RUL-G?-TK. 2-ANNULAR RItMtlI..AI~ SPACE 0. :.,F,f.~.~ t 2: (;'.' .1-.H ..... SENSOR ALARM L 1 :RUL-BT-ANNULAR ANNULAR SPACE l"t/-Sl~ I O, '.:'uG-I : :.": I 5 f1"l FUEL ALARM MAR 10, 2004 12:16 PH L ,i: Rig.- ~'S-TK. ANNULAR SENSOR OUT ALARH PIRR 10, 2004 12:§0 PM ..... ':'E'';':~;';~ ~ ;[.; tI~:I'! ..... L ! (J: S:';,JP' ~,:'-I=,?~FII IL ..qP. ~:iNi=oJt.,%i.: '".':: f '~.( ? i.". ~ENSOR ' OUT ~I. LARI"I MAR 10, 2004 12:50 PM ..... SENSOR ALARM LIl:SUP-92-STP STP SUMP FUEL ALARM MAR 10, 2004 12:ltl PM ..... SENSOR ALARM ..... L §:RUL-BT-TK.2-BYPHON STP SUMP SENSOR OUT ALARM MAR 10, 2004 12:50 PM SENSOR ALARM ..... LI1;SUP-92-STP STP S~P SENSOR OUT ALARM MAR 10, 2004 12:50 PM ..... SENSOR ALAR~ ..... L12:BUP-92-FILL STP BUMP FUEL ALARM MAR 10, 2004 12:18 PM ..... SENSOR ALARM :. G:RUL-B?-TK.2-FILL PIPING BUMP .tENSOR OUT ALARM MAR 10, 2004 12:50 PM ..... SENSOR ALARM :.I2:SUP-92-FILL ~;-rp SUMP ;{:IiNSOR OUT ~LARM I-tAR 10, 2004 12:50 PM -- SENSOR ALAF~ ..... L I:RUL-B?-ANNULA~ ANNULAR SPACE I SENSOR OUT ALARM _MAR LO, ~004-12:60 PM --- ..... SENSOR ALARM ..... L 7:RUL-BT-TK.3-ANNULAR ANNULAR SPACE SENSOR OUT ALARM MAR 10, 2004 12:50 PM ...... SENSOR ~LARIq L)3:MPD-I~2 DISPENSER PAN SENSOR OUT ALARM MAR 10, 2004 12:50 PM ..... SENSOR ALARM ..... L 2:RUL-8?-STP PIPING SUMP SENSOR OUT ALARM MAR 10, 2004 12:50 PM ..... SENSOR ALARM L 8:RUL-B?-TK.8-SYPHON PIPING SUMP SENSOR OUT ALARM MAR 10, 2004 12:50 PM ..... SENSOR ~LARM ..... L14:MPD-3~4 DISPENSER PAN SENSOR OUT ALA~ M~R 10, 2004 12:50 PM ..... SENSOR ALARM ..... L 8:RUL-87-FILL STP SUMP i SENSOR ALARM ..... L 9:RUL-8?-TK.B-FILL PIPING SUMP SEHSO~ OUT ..... SENSOR ALARM ..... LIS:MPD-5~6 DISPENSER PaN SENSOR OUT Al.A~["I SWRCB, January 2002 'Page ~ of ~ Secondary Containment Testing Report Form This form g~ intended, for use b), controctors pe.rforming periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner~operator for submittal to the local regulatory agency. 1. FACILITY ]NFORMATION I Date of Testing: ~- tO - ~-q' Ii, Facility Name:;"~?~To ~ ~7'-{~V:5- . Facility Address: c{ Lo-5 e~,~o~ ~,~ e-l Facility Contact: I.-~L~ ~ |~o~--~ [ Phone: ~ ate Local Agency Was Notified of Testing: Z~ ~ [--/t?__-3 . amc of Local Agency Inspector (if present during testing): t~ 1~ tO 2. TESTING CONTRACTOR INFORMATION Company Name: ~ Technician Conducting Test: ~redentiais: ,'2~SLB Licensed Contractor '~ SWRCB Licensed Tank Tester ~5 C--~iO " License Number: ... Manufacturer Trainin~ Manufacturer Component(s) . Date Training Expires 3. SUMMARY OF TEST RESULTS :Not Repairs Not Repairs Component Pass FailI TestedMade Component Pass FailTested Made ~57~,-~ ~ Ii3"-[] [] [] [] [] [] [] ~¢_ ~r~ 'o O O O O O O c~ ~ ~ D D 'D D D D D B~ ~ O O O O O O O o o o o o o o ~1 ~d ~ O D O O O O O 0 0 0 O 0 O O O - 0 O 0 O 0 0 0 0 0 0 0 0 0 0 0 0 O O 0 [,0 0 'O 0 If hydrostatic testing was performed, describe what was done with the water after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's ( · ..... SENSOR ALARM ..... LI6:MPD-?~8 DISPENSER PAN SENSOR OUT ALARM MAR 10, 2004 12:50 PM ..... SENSOR ALARM ..... LI?:MPD-9~IO DISPENSER PAN SENSOR OUT ALARM i'~AR 10, 2004 12:51 PM --- SENSOR ALARM .... :I8:MPD-11~I2 91SPENSER PAN ~NSOR OUT ALARM !'l~R 10, 2004 12:51 PM ARCO AMxPM 4208 MIN~ AVE. BAKERSFIELD CA. 661-854-1076 MAR 10, 2004 12:59 PM SYSTEM STATUS REPORT ALL FUNCTIONS NORMAL SWRCB, January 2002 Page ~z_ of 'Z- Facility is Not Equipped With Spill/Overfill Containment Boxes Spill/Overfill Containment Boxes are Present, but were Not Tested Test Method Developed By: Spill Bucket Manufacturer Industry Standard Other 6~pecify) Test Method Used: Pressure Vacuum Other (Specify) ~ II S~ ~Box # ~'?T 'Spill Bucket Diameter: ~\ Bucket Depth: Wait time between applying pressure/vacuum/water and sta~ing test: Initial Reading (R~): Final ~eading (R~): Test Duration: Change in Reading (Rv-Rt): Criteria: Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) · ~,, ~co proclu~ Mechanical Leak Detector Test Data Sheet Station #: 6218 Date: 3/10/2004 Time: 2:00 PM Address: 4203 MING AVE BAKERSFIELD Test Information Product Manufacturer ~Model Full Operating Pressure (psi) Line Bleed Back (mi) Trip Time (sec) Metering Pressure (psi) F/E Holding Pressure (psi) Test Leak Rate (ml/min) (gph) PASS or FAIL Comments: This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor: TAIT ENVIRONMENTAL SYSTEMS Technician ,-'"~o~ .~~_,~-. Signature: ~ Lic# ~.~) 02-24-04 03:$8pm From-TAIT E H~[IKI~MEEHT^L 714-$60-8237 1'-098 P.01/01 F-K64 F'E:]] 24 ~004 1~8 BKSFI. D FZI~E~ PIqEVt:HTTON [BE1%)~-~1'7~' 07,-21-04 I't ~OBM Fr QE-TAIT E~ IltOll~T~L 1'i44fl418! T-OI~ P.~1/01 F-ail 02-~3-04 11:05~m Fr.;-TAIT T^L ?14-56n-8237 T-055 P.01/01 F-521 SEP 2S 2002 lO:S2 9KSFLI] FIRE PREV£NTIOH (66,1]0S2-21'72 CITY OF BAKERSFIELD OFFICE OF ENVIRON1VIENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM FUEL MONITORING CERTIFICATION ......... a :~.,. ;~,';;. ' ;. ,- ,,~- · : ,.... TANK# ~ , DATI~ & ~ TF.3T ~S TO BE CONDU~ APPROVJ~D 3Y ................ pATI~ FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3r" Floor, Bakersfield, CA 93301 INSPECTION DATE Section 2: Underground Storage Tanks Program Routine ombined [21 Joint Agency ~ Multi-Agency Type of q~ank ~')k.~ ~ Number of Tanks Type of Monitoring . C_ k-~k Type of Piping k.~ 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 V Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No x~ .. Section 3: Aboveground Storage Tanks Program TAIX'K 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 (661) 326-3979 While - Env. Svcs. Pink - Business Copy FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 Section 2: Underground Storage Tanks Program · [~l Routine Combined [~ J~nt Agency [] Multi-Agency Type of Tank (~-iS'k.~) ~-:-- Number of Tanks Type of Monitoring k L.~ ~ Type of Piping ~.~")~ ,'~ (~' ~9 Complaint [] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data ou file 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 T~\NK SIZE(S) AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS S fCC available S~CC on file with OES Ad, equate secondary protection Pn!per tank placarding/labeling Is t~nk used to dispense MVF? if yes~ Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: ?~'?'-';-~;v~O.... ,],~1..4 'C..~--- Office of Envir(~ili'ie~tal Services (661) 326-3979 White - Env. Svcs. Pink - Business Copy ' ~u~i~e"s~'Site Res~ons~le Party INSPECTION CHECK LIST 1) Are fill boxes cleaned? 2) Is there excessive spillage on island? 3) Are all "No Smoking"- "Turn Off Engine" signs in place? 4) Is the address number visible and 1" x 5" numbers? 5) Is the ESO (Emergency Shut-Off) visible? 6) Are there Propane Tanks or Tank(s) at facility? 6a) Is it recorded on customer chemical inventory? 7) Is there a Fire Extinguisher on dispenser island? 7a) If not on Island is there an Extinguisher near front door? 8) Are Extinguishers mounted? 9) Is Extinguisher 2A20BC rated? 10) Does UST Facility have a cooking hood? 11) Has it been serviced and free from grease build-up 12) Are there any extenSion.cords being used for permanent wiring? 13) Is there minimum of 30" in front of breaker panels? 14) If illuminated exits are all the lamps working? 15) Are co2 cylinders chained? 16) Are any exit doors being blocked? 17) Does the fuel monitor device indicate any problems? 18) Is there a sticker onthe fuel monitor showing service date? 19) If UST site has cathodic protection is rectifier working? 19a) Has it been serviced within (3) three years? 20) Does customer have MSD's sheets and Emergency Response Procedures? 21) Does customer have adequate training records? 22) Is there sufficient absorbent material (kitty litter) on site? 23) If customer has'waste oil is it labeled and have secure lid? G:~HAZXSHARED\CORRESPONDENCEk2003-10\iNSPECTION CHECK LIST sUnderxvood.doc r~- Postage :1" Certified Fee i ~i.~_1Rotum Reclept Fee (Endorsement Required) Rest~cted DeWe~y Fee (Endorsement Required) rLI Total Posta Postmark Here ~ r~,~,-~-~:-~ 4203 Ming Avenue "'] [~;~'?~;~ Bakersfield, CA 93309 Certified Mail Provides: ~,eu) ~oo~..~.r'oo~""o. sd La A mailing receipt · A unique identifier for your mailpleoe · A record of dallve~y kept by the Postal Service for two years Important Fteminders: · Certifie~J Mail may ONLY be combined with First-Class Maile or Priority Mmle. ~* Certified Mail Is not available for anyclass of international mail. · NO INSURANCE COVERAGE IS PROVIDED With Certified Mall. For valuables, please consider Insured or Registered Mall, · For an additional fee~a Return Receiptmay be requested to provide proof of delivery. To obtain Return Receipt .se. nflce,.ple..ase c~..mp.l.eta an.a att~.ch a Re .,t~n Receipt (PS Form 3811 ) to the article ana aaa appdcame postage to c~ver me fee. Endorse mailplece "Return Receipt R. equ.ested". To r_~.~e .a.f.ee..walve. r ~o.r a duplic~, ta return receipt, a USPSe postmark on your [;enmea Ma~ recetp ts requ~rea. · For an additional fee, delivery may be m. strlcted to the ..a.ddressee..or addressee's authorized agent./[dvlse the clem or mark the m~mplece with xne endorsement "RestrictedDelivery". · If a postmark on the Certified Mail recei~ is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and maiD. IMPORTANT: Save this receipt and present it when making an inquiry. Internet access fo delivery information is not available on mall addressed to APOs and FPOs. · 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 you. · Attach this card to the back of the maillSiece, or on the front if space permits. 1. Article Addressed to: AM/PM 4203 Ming Avenue Bakersfield, CA 93309 [] Agent [] Addressee by ( Printed Name) C. Date of Delivery D. Is delivery address different from item 17 l"l Yes If YES, enter delivery address below: [] No 3. S~rvice Type I~ Certified Mail [] Express Mail LJ Registered [] Return Receipt for Merchandise [] Insured Mail [] C.O.D. 4. Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (Transfer from service label) 7003 2260 0004 7652 2655 PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-154( UNITED STATES POSTAL SERVICE rFirst-Class Mail |Postage & Fees Paid /USPS _ . I,Permit No. G-10 · Sender: Please print your name, addresS, and ZIP+4 in this box · \ ~q~ rt BakersfjelO Fire ..... oa, ment 1715 Chester ~,.,,gri~..;t..~e 300 Bakersfieia, GA ~0~ D December 12, 2003 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY GERVtCES · ENttiRONMENT~L SER~ICES 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 CERTIFIED MAIL AM/PM 4203 Ming Avenue Bakersfield, CA 93309 RE: Propane Exchange Program Dear Owner/Operator: The purpose of this letter is to advise you of current code requirements for propane exchange systems, such as "Blue Rhino" or "Amerigas." This does not apply to large propane tanks, only propane exchange systems. Over the past two years this office has noted a dramatic increase in the propane exchange system in the city of Bakersfield. It has also been noted, with great concern, that many of these installations are a clear violation of the UFC (Uniform Fire Code) and represent a danger to public health and safety. Accordingly, procedures for storage of propane cylinders awaiting use, resale or exchange, have been adopted through BMC (Bakersfield Municipal Code) and adoption of the 2001 UFC. The procedures are as follows: Storage outside of building for propane cylinders (1,000 pounds or less) awaiting use, re-sale, or part of a cylinder exchange point shall be located at least 10 feet from any doorways or openings in a building frequented by the public, or property line that can be built upon, and 20 feet from any automotive service station fuel dispenser. (Note distance from doorways increases when cylinders are over 1,000 pounds cumulatively.) Cylinders in storage shall be located in a manner which minimizes exposure to excessive temperature rise, physical damage or tampering (Section 8212, California Fire Code, 2001 Edition). When exposed to probable vehicular damage due to proximity to alleys, driveways or parking areas, protective crash posts will be required as follows (Section 8001.11.3 and 8210, California Fire Code, 2001 Edition): 1) 2) Constructed of steel, not less than 4 inches in diameter, and concrete filled. Spaced not more than 4 feet between posts, on center. Letter'o: Owner/Operators of Propane Exchange Re: Propane Exchange Program Dated: December 12. 2003 Page 2 of 2 3) 4) 5) Set not less than 3 feet deep in a concrete footing of not less than a 15 inch diameter. Set with the top of the posts not less than 3 feet aboveground. Located not less than 5 feet from the cylinder storage a/ea. Exceptions: Cylinders storage areas located on a sidewalk which is elevated not less than 6 inches above the alley, driveway or parking area, with not less than 10 feet of separation between the curb and the cylinder storage area. "No Smoking" signs shall be posted and clearly visible (Section 8208, California Fire Code, 2001 Edition). Resale and exchange facilities must be under permit to verify compliance. All existing facilities will be checked and when compliance is confirmed, a permit will be issued. All new propane exchange systems must be permitted prior to installation. You will have 90 days (March 4, 2004) to comply with the procedures outlined. Once compliance has been confirmed, each exchange system will be issued a permit, which will be placed on the exchange system. Sites not conforming to current code, will be "red tagged" and must be taken out of service immediately. You should contact your Blue Rhino representative, Mr. Taylor Noland, or your local Amerigas representative. They are aware of current code requirements. If you do not have a propane exchange system, please disregard this letter. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, Steve Underwood Fire Inspector/Petroleum/ Environmental Code Enforcement Officer Oct-23-ZO03 From-O'NELVENY & I~ERSLLP LA1/2 +213430540? O'MELVENY & MYEIL~ LLP T-6ZO 002/003 F-105 W&$}IINCTON, D.C'. {rlO~ G KONG ,~ll6Nc' ll',i 'fOIC)'O October 23, 2003 Vl,,A FACS!MILE ~213) 894-6436 William Carter, ]~q. Assistant U.S, Attorney Public Corruption and Government Fraud Section Joseph Johns, Esq. Assistant U,S. Attorney Office of the U.S. Attorney 312 North Spring Street Los Angeles, California 90012 ot~R }'IL~ .~I~MB[~il 038,609-00.} Wgl'l'£ R'S OLK£CT ~:~-43o-6o78 WglI'ER'S £-MRIL ADDKr.:~S: Deaz Bill and Joe: Pu~uant to ou~ agreement, this letter provides notice that ARCO is going to perform work at the following site. On~Monda~,_Ocmbcn22,~2003, ARCO will begin construction at the following site: /~ARCO Station No. 62 ~ 8 ~, 4203 Ming Avenu~St_in_e~~/ Pro. j~: Enhanced Vapor Recovory System ConWactor: SJW Contact: Tom Schrair2 562-290-8859 We expect that ~he scope of work will involve thc cutting of asphalt or concrete. 0ct-23-2003 From-O'NELVENY & MYERSLLP LA1/2 +213430640T T-620 P.003/003 F-lO5 Please give me a c~ll if you have any questioas. Very t~ly yours, Belinda M. Vega for O'MELVENY & MYERS LLP Leslie Alford Kathleen J. Giles Rea E. Mo~esld Carl W. Sjoberg Amy Crrccn Steve Uuderwood BMV:ml 0¢~-23-2003 From-O'~LVENY & ~ERSLLP L^I/Z +Z13430640T T-620 P.O01/O0~ F-lO5 O'Melven__v & MYers LLP 400 South Hope Street Los Angeles, CA 90071-2899 FAX TRANSMITTAL DATE: October 23, 2003 RE: ARCO #6218 TO: William Carter, Esq. - Office of thc U.S. Attorney Joseph Johns, Esq. - Office of the U.S. A~omey Kathleen J. Giles - Fed. Bureau of Investigation Ron E. Modjeski - U.S. Env. Prot. Agency Leslie Alford- Water Resources Cttl. Bd. Car] W. Sjoberg-LA County Dept. of Public Works F:626-458-3569 Amy Green-UST Compliance Program Steve Underwood-CUPA FROM: .% Belinda M. Ve~,.!- O'Melveny & Myers, LLP F: 213-894-0141 F: 213-894-0141 F: 310-996-4482 F: 626-583-7533 F: 916-341-5808 F: 661-862-8701 F: 661-326-0576 T: 213-894-3547 T: 213-894-4536 T: 310-477-6565 T: 626-583-7528 T: 916-341-5810 T:626-458-3539 T: 661-862-8700 T: 661-326-3979 T: 213-430-6078 If you did not receive all pages, please call Ruth de la Rosa at 213-430-6336, or our fax department at 213-430-6357. OMM File No.: 038,609-004 OMM User ID No.: 08937 [.^2'604540-i CITY OF BAKI~SFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 INSPECTION RECORD POST CARD AT JOB SITE Phoneno. ~t~( ' ~q, I0~_ City, INSTRUCTIONS: Please call tbr an inspector only when each group of inspections with the same number are ready. They will run in consecutive order beginning with number I. DO NOT cover work tbr any numbered group until all items in that group are signed offby the Permitting Authority. Following these instructions will reduce the number of required inspection visits and theretbre prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION I DATE I INSPECTOR ~N/[~ Backfill of Tank(s) ~ ~ Spark Test Certification or Manufactures Method ~t I~ Cathodic Protection &Tank(s) PIPING SYSTEM ~[,j~, Piping & Raceway w/Collection Sump Corrosion Protection of Piping, Joints, Fill Pipe Electrical Isolation of Piping From Tank(s) Cathodic Protection System-Piping Dispenser Pan SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION Liner Installation - Tank(s) Liner Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Detector(s) Leak Detector(s) for Annual Space-D.W. Tank(s) Monitoring Well(s)/Sump(s) - H20 Test Leak Detection Device(s) for Vadose/Groundwater /'~,,/ Sp. IPreve..o. Bo×es 'k,J,, /o.Oe-to3 FINAL Monitoring Wells, Caps & Locks Fill Box Lock Monitoring Requirements Type ~ltll.t ~ {.... / {~ "~ ~""~,-~ ~' (I Au,hodzafion tbr Fucl Drop ~l~ CONTRACTOR ~O LICENSE~ ~lgO,~ _ CONTACT Odl, li~,l JJU~eN PHONE// CITY OF BAKERSFIELD 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 [~]~4ODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY STARTING DATE PROPOSED COMPLETION OATE FACILITY NAME ~ ~ ~ F~ ~ ex~sr~AC~UTy ~e~r ~o. FACILITYADD~SS ~ ~ ~ CITY~~ ~ ZIPCODE ~ TYPE OF BUSINESS ~ ~ ~ ~ ~ ~ ~ ~ ~ ~,~ ~ APN ~ TANKO~R ~ ~g~t ~&~T ~,~ , ~ PHONENO.~~ ADDRESS ~ Q~.~?a, ~ng ~'~6 Cl~ L~ ~n~ ZIPCODE~ CONT~OR-~b~b i <~. I~~ CAHCE~SE~O. ~AO~ PHONE NO. ~ ~ ~- ~ ~ ~- ~ ~ BA~RSFIELD CI~ BUSINESS LICENSE NO. WOR~ANCOMPNO.~~a- ~ INS~ER ~6~ ~a~ ~ BRIEFLY DESCRIBE THE WO~ TO BE DONE ~ ~ ~ ~a~. ~p~a~ WATER TO FACILITY PROVIDED BY I¥~ DEPTH TO GROUND WATER ~lt~ SOIL TYPE EXPECTED AT SITE NO. OF TANKS TO BE INSTALLED b- { {~- ARE THEY FOR MOTOR FUEL SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE YES NO YES NO SECTION FOR MOTOR FUEL TANK NO. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION TANK NO. VOLUME SECTION FOR NON MOTOR FUEL STORAGE TANKS CHEMICAL STORED CAS NO. CHEMICAL PREVIOUSLY STORED CNG BRAND NAME) (IF KNOWN) FoR OFFICIAL USE ONLY APPLICATION 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 REGULATIONS. THIS F ~9t~VI HAS BE ~,~QOMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS APPROVED BY: .APPLICANT NAME (PRINT) - A~PL~A~T S[~ATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED WNO suMP ('r~.) SUUP (TYP.) Off ~ Ct~P.) INSTALLATION NOTES: I~roR~ ST~i.'~T 0,' ~ CUTTING. R~¥F.~.~J~ TO ~ ~T E~ ~ ~E K ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~0 ~ w/ ~t AT ~ T~ ~~ ~0 ~ ~ ~ ~ ~ ~ ~ ~TS AT ~ T~ ~ ~-t~-B ~. ~. ~ ~-102-8 ~* ~~ ~ PAtH ~ ~0 ~T~ TO ~TCH ~ ~T ~0. APPROVE[D BAKERSFIELD FIRE DEPARf3~ENT OFFICE OF ENVIRONMENTAL SERVlCF~ NOTE: AcceL:~ance applies toi.' plans as subnfitted and ~r co~'~uction an~/or installation thereon, subiect to). ,~'~,~1 insoe~ Jo, l~ an,,d-acceptance. ' Underground Service Aled Call: TOLL 1-800 227-2600 TWO WORKING OAYS BEFORE YOU DIG FUELING POSITIONS NOZZLES EQUIPMENT LIST - ~.> MULT]-PQ~I' SIuI. L CONTN~£NT ~ & FRAME (~) Ipt~l~ I ~ RCC:O~:RY ~ CONTNMtd~NT. 5 GN.LON CAST mON, W,/0P-~N VN.~ ~t.uG ~'~ FACE SEN, AOM~T[R, ~ I R~SL~R. AI'G Rt'S£R. Jr FR.I. R~(R ~) THR~.N~D Pf~SSU~ VENT (~ 13- x t2' BN.LFLO~T MANUr*CTU~R aO0a. I ~),~m' I PGU£C0 521 6~,21B-E~- 164042RT052 0PW 6 t VSA- '-----------------~ 61~..- 1020-E~ 0PW 17lIT-ErR 1711T-70~5 OP~ 15C-2100 ISC-2100 ~ ~ Fe~...400-*- "~A-400 6 ISN. P-'Z~R S I.~M.P- 1020-E'eR GoW 1SC-2100 I.~:-2100 ~ W/ ~RNN OPW 61.J~C-4400-[VR SIJSK-4400-~ 61T ~1T-7,.~ 2 ~,~a~ -44,3J 53~4~.-3120 53~ML-3120 ~R-7~O0~ t-OOt N.N~M VR-~5-OOt SttWC~ laSER oR,a~ VA4.~) ) ATG C4P Nql0 laNG Kn FaC~ SE~L (KYo,e) z~< ~ STAGE I VAPOR RECOVERY & FILL DETAIL (GASOLINE) ._,~ m ~ OVERFILL ALARM,~,~ TYPICAL TURBINE ELEVATION 06218 TK1 -1 For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6. 7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ARCO PRODUCTS COMPANY Service Station No.: 6218 Site Address: 4203 Ming Av,.veenu, e~o~ Person: -,j~r~'~.~ ~C_~,gv~...f'/~-/ Facility Contact ~ ' Make.oriel of Monito~g System: ~~ ~ ~ Tc5 Z~/~T~ Date of Testin~Se~ice: B. Invento~ of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment ins ~ected/serviced: Ta~ m: ~ 7 Ta~ m: ~ 7 5 City: Bakersfield Zip: 93309 Contact PhoneNo.: ~- t ~ ~ / ~ ~ l~In-Tank Gauging Probe: Model: ~nnular Space or Vault Sensor: Model: ~t?iping Sump/Trench Sensor (s): Model: ~ill Sump Sensor (s): Model: C 5 '_3 ~Mechanical Line Leak Detector. Model: ~.OZoevO F1Electronic Line Leak Detector Model: C1Tank Overfill/High-level Sensor: Model: [2]Other, Specify equip, type and model in Section E on Page 2 L~' 7 [~In-Tank Gauging Probe: Model: / [~Mmular Space or Vault Sensor Model: /9- 7 I~iping Sump/Trench Sensor (s): Model: [~[Fill Sump Sensor (s): Model: I-IMechanical Line Leak Detector. Model: I-lElectronic Line Leak Detector Model: [-1Tank Overfill/High-level Sensor: Model: F-1Other, Specify equip, type and model in Section E on Page 2 Tank ID: ~ ~ [~[In-Tank Gauging Probe: Model: {0 ~ [~fAnnular Space or Vault Sensor: Model: ~t~ - 7 [~Piping Sump/Trench Sensor (s): Model: 6~--.3 ~Fill Sump Sensor (s): Model: &~' ' ~ [~Mechanical Line Leak Detector. Model: LqT/.~voO F1Electronic Line Leak Detector Model: fi]Tank Overfill/High-level Sensor: Model: F1Other, Specify equip, type and model in Section E on Page 2 Tank ID: ? / I~['ln-Tank Gauging Probe: J~Annular Space or Vault Sensor J~Piping Sump/Trench Sensor (s): J~Fill Sump Sensor (s): [~Mechanical Line Leak Detector. I-1Electronic Line Leak Detector F1Tank Overfill/High-level Sensor: Model: Model: Model: Model: Model: Model: Model: [2]Other, Specify equip, type and model in Section E on Page 2 Dispenser ID: I-1Dispenser Containment Sensors: Model: [~ Shear Valve(s). [~(Dispenser Containment Float(s) and Chain(s) Dispenser ID: ~'~ ~ -/ -~ Contmnment Sensors: Model: V1Dispenser ' ! hear Valve(s). ispenser Containment Float(s) and Chain(s) Dispenser ID: [ ~ - I ~t I-lDispenser Containment Sensors: Model: ~hear Valve(s). ]~fDispenser Containment Float(s) and Chain(s) iDispenser ID: F'lDispenser Containment Sensor(s): Model: ~Shear Valve(s). [~Dispenser Containment Float(s) and Chain(s) Dispenser ID: UlDispenser Containment Sensdr(s): Model: {~-Shear Valve(s). E~Dispenser Containment Float(s) and Chain(s) Dispenser ID: { 5- - / g; fi]Dispenser Containment Sensor(s): Model: [5~Shear Valve(s). [~Dispenser Containment Float(s) and Chain(s) *If the facility contains more tanks C. or dispensers, copy this form. Include information for every tank and dispenser at this facility. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): [-I System set-up ~ Alarm history'repor4 Technician Name (Print): ,~--d'1>6~2~~-~ Signature: Certification No.: "/6 ~' OO qt) I License No.: 588~:--9~- Testing Company Name: TAIT ENVIRONMENTAL SYSTEMS Phone No.: (714) 560-8222 Page 1 of 3 03/01 Monitoring System Certification Site Adc[re~s: D. Results of Testing/Servicing Software Version Installed: SS #6218, 4203 Ming Avenue, Bakersfield Date of Testing/Servicing: Complete the following checklist: [~/Yes [] No* Is the audible alarm operational? [~Yes [] No* Is the visual alarm operational? [~]~Yes [] No* Were all sensors visually inspected, functionally tested, and confirmed operational? [~Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? [] Yes [] No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) [~N/A operational? [2~Yes [] No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] N/A monitoring system detects a leak, fails to opera~ or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) [~]~Sump/Trench Sensors; [] Dispenser Containment Sensors. Did you confn'm positive shut-down due to leaks and sensor failure/disconnection? E~es; [] No. [] Yes []/No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no [] N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ?7??% [] Yes* [~No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [~No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. -~J'~es [] No* Was monitoring system set-up reviewed to ensure proper settings? [~ Yes [] No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03/01 Site Address: SS #6218, 4203 Ming Avenue, Bakersfield F. In-Tank Gauging / SIR Equipment: Date of Testing/Servicing: [~Check this box if tank gauging is used only for inventory control. [] Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. }lete the followin checklist: [] Yes [] No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No* Were all tank gauging probes visually inspected for damage and residue buildup? [] Yes . [] No* Was accuracy of system product level readings tested? [] Yes [] No* Was accuracy of system water level readings tested? [] Yes [] No* Were all probes reinstalled properly? [] Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box ifLLDs are not installed. ~lete the followin checklist: eg~"Yes [:] No* For equipment start-up or annual equipment c/~rtification, was a leak simulated to verify LLD performance? [] N/A (Check all that apply) S~mulated' leakrate: [:It3 g.p.h.t; [] 0.1 g.p:h.Z; [] 0.2 g.p.h.- Notes: 1. Required for equipment start-up certification and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. [~'"Yes [] No* Were all LLDs confirmed operational and accurate within regulatory requirements? es [] No* Was the testing apparatus properly calibrated? [~ Yes []' No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] N/A [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled [] Yes Fl/Bio* [~ N/A or disconnected? For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions [] Yes [] No* ~"/N/A or fails a test? [] Yes [] No* For electronic LLDs, have all accessible wiring connections been visually inspected? / ~'/N/A [~ Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 03/01 Site Address: SS #6218, 4203 Ming Avenue, Bakersfield Date of Testing/Servicing: Monitoring System Certification' UST Monitoring Site Plan Date map was drawn: ~'~ / i l / O ?. Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page lof / o5/oo BP WES~OAST PRODUCTS LLC MECHANICAL LEAK DETECTOR TEST DATA SHEET Station # Address Date TEST INFORMATION Product Manufacturer Model Full Operating Pressure (psi) Line Bleed Back (mi) Trip Time (sec) !Metering Pressure (psi) F/E Holding Pressure (psi) Test Leak Rate (ml/min)(gph) 'PASS or FAIL Replaced All Failed Leak Detectors Yes tf No, Replacement To Be Completed By (Date) No N/A /. This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturer's procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a Iow flow threshold trip rate of 3 gph at 10 PSI. Contractor Technician Signature Inspected By: APC-3325 (9/02) 05-04-03 05:14pm From-TAIT EHVIROI~NTAL r14-560-823T T-193 P.01/01 FZR£ PR£¥£HTZOH (GGZ) F-546 CITY OF BAKE~~D OFFICE OF ENVIRONIVIENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326;-3979 APP~CA~ON TO PERFORM FUEL MONIT.OP. ING CERTIFICATION .... '.. .- ~ .'~,. ;'"r.'l.'. , - . ', · ~ ..... : .. APPROVt~ BY ................... .DATE .S.I. ON.~ .TOI~ OF APPLICANT ARCO AI'.I~PM 4203 MING AVE. BAKERSFIELD 661-834-1076 JAN 28. 21103 1:51 BM STATUS }~:EPORT ALL FUNCTIONEi NOF;tMAL I IqVEI,ITOR"x: REPORT NO ACTIVE TAN}(~ ARCO 4'.-202 MIN~:i AVE. BAKERSF I ELD 6~94-1 076 JAN 20., 2003 I :51 PM ~¥'$TEI"I STATUS REPORT ALi, FUt~CTIONS I~ORMAL INVENTOR?' REPORT NO ACTIVE TANKS 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 [] Joint Agency Type of Tank Ok) ~' Type of Monitoring d_/_t,x [] Multi-Agency . [] Complaint Number of Tanks Type of Piping 4}60 t~ Re-inspection OPERATION C V COMMENTS Proper tank data on file ~, Proper owner/operator data on file 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? lfyes, Does tank have overfill/overspill protection? C=Complianle~=Violatiop Y=Yes N=NO inspector: w~J ~~~b-~ Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Business Sit~ Respons~l~ UNIFIED PROGRAM !I~PECTIO" CHECKLIST~~ SECTION 1 Business "Pla 'n" ~nd' Inventory ~;°~'ram J Bakersfield Fire Dept· Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME /-~ INSPECTION DATE INSPECTION TIME ADDRESS · PHONE No, No, of Employees FACILITYCONTACT Business ID Num~)'~;' ..................... 1 $-021 - ~: ' Section 1: BuSiness Plan and InVentonj'program [] Routine 'l~Combined [] Joint Agency [] Multi-Agency [] Complaint [] Re-inspection C V C=Compliance '~ OPERATION v=violation APPROPRIATE PERMIT ON HAND BUSINESS PLAN CONTACT INFORMATION ACCURATE VISIBLE ADDRESS CORRECT OCCUPANCY [] VERIFICATION OF INVENTORY MATERIALS VERIFICATION OF QUANTITIES [] VERIFICATION OF LOCATION PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITYE [] VERIFICATION OF HAT MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES [] EMERGENCY PROCEDURES ADEQUATE CONTAINERS PROPERLY LABELED HOUSEKEEPING FIRE PROTECTION COMMENTS SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE9: [] YES EXPLAIN: Inspector PLEASE CALL US AT (661) 326-3979 'S-- Badge No. White - Environmental Services Yellow. ~at~n Copy -----'~-- ~/~~-BusinessSite-~ Pink - Business Copy MONIT&NG SYSTEM CERTIFICi ION ~' , For Use By All Jurisdictions Within the State of California Authority Cited} Chapter 6. 7. Health and SafeO~ Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ARCO PRODUCTS COMPANY Site Address: 4203 MING AVE Facility Contact Person: Make/Model of Monitoring System: City: Contact Phone No.: B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment insI Tank ID: ~ -2 lected/serviced: Service Station No.: BAKERSFIELD 6218 Zip: 93309 Date of Testing/Service: Tank ID: oc'~7 I-lin-Tank Gauging Probe: I~Annular Space or Vault Sensor: []~iping Sump/Trench Sensor (s): ~Fill Sump Sensor (s): I~]Mechanical Line Leak Detector. I-IElectronic Line Leak Detector -ITank Overfill/High-level Sensor: Model: Model: '7~)'/~_ ,~ Model: Model: Model: Model: Model: I-IOther, Specify equip, type and model in Section E on Page 2 Tank ID: ~ -7 F'lln-Tank Gauging Probe: Model: I~Annular Space or Vault Sensor: Model: I-,','APiping Sump/Trench Sensor (s): Model: ~Fill Sump Sensor (s): Model: F1Mechanical Line Leak Detector. Model: -IElectronic Line Leak Detector Model: I-]Tank Overfill/High-level Sensor: Model: I'-lOther, Specify equip, type and model in Section E on Page 2 Dispenser ID: !- <, [~]Dispenser Containment Sensors: Model: ~ Shear Valve(s). I"lDispenser Containment Float(s) and Chain(s) Dispenser ID: ]- '/ [~Dispenser Containment Sensors: Model: [~ Shear Valve(s). F1Dispenser Containment Float(s) and Chain(s) Dispenser ID: I-rlDispenser Containment Sensors: [] Shear Valve(s). Model: I-lin-Tank Gauging Probe: Model: 71Annular Space or Vault Sensor Model: I-PlPiping Sump/Trench Sensor (s): Model: 7lFill Sump Sensor (s): Model: FIMechanical Line Leak Detector. Model: FIElectronic Line Leak Detector Model: F-ITank Overfill/High-level Sensor: Model: l--IOther, Specify equip, type and model in Section E on Page 2 Tank ID: ~ / F-lin-Tank Gauging Probe: Model: ~Annular Space or Vault Sensor Model: I~Piping Sump/Trench Sensor (s): Model: DIFill Sump Sensor (s): Model: [~Mechanical Line Leak Detector. Model: I-IElectronic Line Leak Detector Model: F1Tank Overfill/High-level Sensor: Model: FIOther, Specify equip, tTpe and model in Section E on Page 2 Dispenser ID: ~, - J~ I~lDispenser Containment Sensor(s): Model: ?'t~ SJO'-/~ 1[~] Shear Valve(s). I-IDispenser Containment Float(s) and Chain(s) Dispenser ID: ~Dispenser Containment Sensor(s): Model: '7't'~ [~ Shear Valve(s). I'-IDispense{ Containment Float(s) and Chain(s) Dispenser ID: ~-r~- [~Dispenser Containment Sensor(s): [] Shear Valve(s). Model: ~70q/-J~- DY I-]Dispenser Containment Float(s) and Chain(s) FlDispenser Containment Float(s) and Chain(s) *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at this facility. C. Certification - l certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers~ checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (cl~ek all that~/y): i~! System set-up I~-Alarm history~ 1~ Technician Name (Print): ]~-- ap~ Signature: Certification No.: ~/fi. ~c)['- ' License No.: 588 098 Testing Company Name: .TAIT ENVIRONMENTAL SYSTEMS Phone NO.: (714) 560-8222 Page 1 of 3 03/01 Monitoring System Certification Site Address: SS #6218, 4203 MING AVE, BAKERSFIELD D. Results of Testing/Servicing Software Version Installed: I ¢- OI :hecklist: Date of Testing/Servicing: Io -J o ~omplete me iOIIQ'WI]I~ I~lll~J.l~ll~l,. ~ Yes [] No* Is tile audible alarm operational? [] Yes [] No* Is the visual alarm operational? [~1 Yes [] No* Were all sensors visually inspected, functionally tested, and confirmed operational? ffi Yes [] No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? [] Yes [] No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ~ N/A operational? ~ Yes [] No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) ~ Sump/Trench Sensors; ~ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ~E] Yes; [] No. [] Yes [] No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ~] N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ????% [] Yes* [~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. [] Yes* [] No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) [] Product; [] Water. If yes, describe causes in Section E, below. [] Yes [] No* Was monitoring system set-up reviewed to ensure proper settings? [] Yes [] No* Is ali monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03/01 . Site Address: SS #6218, 4203 MING AVE, BAKERSFIELD Date of Testing/Servicing: F. In-Tank Gauging / SIR Equipment: [] Check this box if tank gauging is used only for inventory control. ~1~ 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. Com dete the following checklist: [] Yes [] No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? [] Yes [] No* Were all tank gauging probes visually inspected for damage and residue buildup? []' Yes [] No* Was accuracy of system product level readings tested? [] Yes [] No* Was accuracy of system water level readings tested? [] Yes [] -No* Were all probes reinstalled properly? [] Yes [] No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): [] Check this box if LLDs are not installed. Corn ~lete the followin checklist: ~1' Yes [] No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? [] N/A (Check all that apply} Simulated leak rate: ~ 3 g.p.h.~; [] 0.1 g.p.h.2; [] 0.2 g.p.h.2 Notes: 1. Required for equipment start-up certification'and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. [~' Yes [] No* Were all LLDs confirmed operational and accurate within regulatory requirements? ffi Yes [] No* Was the'testing apparatus properly calibrated? I~ Yes [] No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [] N/A [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A [] Yes No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled Z] N/A or disconnected? [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions ~ N/A or fails a test? [] Yes [] No* For electronic LLDs, have all accessible wiring connections been visually inspected? .~. N/A ~ Yes [] No* Were ali items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when' these deficiencies were or will be corrected. H. Comments: Page 3 of 3 03/01 · Sit~ Address: SS #6218, 4203 MING AVE, BAKERSFIELD Date of Testin~Servicing: Monitoring System Certification UST Monitoring Site Plan Date map was drawn: / O / ~ * /o'~,~. Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical'or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page of __ 05/00 ARCO Products Company Mechanical Leak Detector Test Data Sheet Station # 6218 Date {0 ' ?O 20 ~ Address 4203 MING AVE,BAKERSFIELD Test Information Product Manufacturer Model Full Operating Pressure (psi) Line Bleed Back (mi) Trip Time (sec) Metering Pressure (psi) F/E Holding Pressure (psi) Test Leak Rate (ml/min)(gph) PASS or FAIL Comments: This letter certifies that the annual leak detector tests were performed at the above referenced facility according tO the equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a Iow flow threshold trip rate of 3 gph at 10 PSI. Inspected By: Contractor Technician Signature TAIT ENVIRONMENTAL SYSTEMS Lic# Revision 5/01 D January 22, 2003 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 S~TY s;mnCES. F.W~O..~.~r~. SERWCES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Av~. 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 93.308 VOICE (661) 399-4697 FAX (661) 399-5763 AM/PM 4203 Ming Ave Bakersfield CA 93309 RE: Upgrade Certificate & Fill Tags Dear Owner/Operator: Effective January 1, 2003 Assembly Bill 2481 went into effect. This Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your window) and the blue fill tag on your fill. You may, if you wish, have them posted or remove them. Fuel vendors have been notified of this change and will not deny fuel delivery for missing tags or certificates. Should you have any questions, please feel free to call me at 661- 326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ARCO July 10, 2002 Inspector Steve Underwood Bakersfield Fire Department 1715 Chester Ave. 3ra Floor Bakersfield, CA 93301 BP West Coast Products LLC 4. C. enterpo,~te La Palina. C. aliforn,a 90623- ! ()66 Ma~ling .Address: Box 6038 Ar~esia. California 90702-6038 Fax Subject New Environmental Specialist Dear Insp. Underwood: Per our phone conversation today, this letter is to advise you that I will be handling any Environmental issues relating to the ARCO stations in Kern County. I have attached a list of stations that fall under my responsibility. If you need further information do not hesitate to call on me. Please feel free to contact me with any questions or concerns. Sincerely, Michael D. Wilson Office (714) 670-5321 Cell (714) 815-2455 UNDERGROUND STORAGE TANK SB 989 COMPLIANCE REPORT 341h STREET CAR WASH 301 920 34TH ST. 3aTH STREET ARCO 481 1102 34TH ST. 7 11 807 1701 PACHECO RD 7 11 808 4647 WILSON RD 7 11 1885 7 11 817 711 1884 711 AT&T 1274 A-1 FOOD STORES 2203 AIRPORT BUS OF BKSFLD 145 AM / PM 1220 AM / PM 1880 AM I PM 564 AM / PM 629 AM / PM 1415 AM ! PM 1416 AM / PM 563 AM / PM 566 AM / PM 1899 AM / PM 417 AM / PM 1898 AM / PM 265 AM / PM 1903 PLAZA ARCO) 1007 B.A.R.C. INDUSTRIES 9600 BRIMHALL RD. DWFCS DW FLEX 3601 STOCKDALE HWY. DW FLEX 4101 CALLOWAY DWFCS DW FLEX 525 W. COLUMBUS DWFCS DW FLEX 1520 20TH STREET DWFCS 1200 'H' STREET DWFCS DW FLEX 1800 GOLDEN STATE HWY DWFCS DWF 3333 UNION AVE. DWF DWF 2301 'F' ST. DWF DWF 4010 WlBLE RD. DWF DWF 6450 WHITE LN DWF DWF 4800 FAIRFAX RD. DWF DWF 900 MONTEREY DWF DWF 4203 MING AVE DWF DWF 1129 UNION AVE. DWF DWF 2800 PANAMA LN. DWF DWF 1701 BRUNDAGE LN. DWF DWF 3125 CALIFORNIA AVE. DWF DWF 2698 MT. VERNON AVE. SWFSC SWL 7651 ROSEDALE HWY. DWFCS DWF 3220 MING AVE. DWF DWF 1402 2240 SO. UNION AVE. DWFCS DWF 917 :631 BAKER ST. SWF 1843 5201 STOCKDALE HWY DWF 2378 1501 FEUZ ST. DWF 7987 3001 SILLECT AVE DWFCS DWF DWF DWF DWF DWFCS DWFS DWF 2 YES / 1998 SW 3 NONE DWFCS DWF 3 YES / 1997 DWFCS DWF 2 YES / 2001 3 3 3 1 BAKER STATION MOBIL BAKERSFIELD AUTO SPA BAKERSFIELD CITY SCHOOLS BAKERSFIELD HEART HOSPITAL BAKERSFIELD MEMORIAL HOSP 1121 420 34TH ST, BAKERSFIELD POLICE DEPT 1050 1601 TRUXTUN AVE. BAKERSFIELD P.O.P. 131 715 SUMNER ST. BAKERSFIELD REGIONAL REHAB 1021 BARBER HONDA 606 BEACON LIQUORS 281 BILL WRIGHT TOYOTA 1085 BP OIL BROOKSIDE MARKET BROOKSIDE MARKET AT THE OAKS CAL MAT INSPECTOR S. UNDERWOOD 5001 COMMERCE CENTER 450O WIBLE RD. 6495 S. UNION AVE. 5100 GASOLINE ALLEY 572 2 OAK ST, 1756 4700 COFFEE RD. 2197 8803 CAMINO MEDIA 579 529 DOLORES DWF DW FLEX DW FLEX DWF DWF DWF DWF DW FLEX DWF DWF DW FLEX DWFCS DWF DWBSF DWF DWFCS YES / 1998 YES / 2001 YES / 1998 YES / 2001 N/A YES / 2001 1 YES / 1990 4 YES / 1998 7/10/2002 3 YES / 1998 6/5/2002 4 YES / 1993 6/18/2002 3 YES 1 1999 3 YES / 1995 YES 3 YES / 2001 4 YES / 1999 4 YES / 1997 6/13/2002 4 YES / 1999 5/28/2002 4 YES / 2001 3 YES / 1998 NO 2 YES / 1990 NO 3 YES / 1998 4 YES / 1997 ? 1 YES / 1996 5/16/2002 3 YES 5/1 6/20O2 3 YES/1996 2 YES/2002 2 N/A 2 N/A 1 YES/2000 I N/A I N/A I YES / 1998 3 YES / 1998 4 4 YES / 1996 5/29/2002 3 YES / 200O 5/30/2002 FLEX ~ NONE OFS S:IUNDERGROUND STORAGE TANK REPORTSIUNDERGROUND STORAGE 0-23-02 04:~3pm From-TAIT ENVg~NTAL SEP 25 2002 10: 52[ ~KSFLD FTRE: PRI-'VEHT!OH 'r14-660-0237 T-161 P.OS/08 F-$65 CITY OF BAKERSFIELD OFFICE OF EN~IRO~NT~ SERVICES 1715 Chester Ave., Bakersfield, CA (6~1) 326'397~) APPLICATION TO PERFORM FUEL MON~T.O~G CERTIFIC, ,A. TION _/~co b,~-/_,~ ~ ._. ADDRES '~' BEI. SHIRE ~'--'~'" --w ~' .SERVICES, INC. PMB 269 25422 Trabuco Road 11105 Lake Forest, CA 92630-2797 (949) 450-1010 Fax (949) 450-1177 September 18, 2002 City of Bakersfield Fire Department 1715 Chester Avenue, 3rd Floor Bakersfield, CA, 93301 ATTENTION: Steve Underwood VIA UPS 2"a Day Air RE: SECONDARY TESTING RESULTS - SB989 COMPLIANCE ARCO Facility No.: Facility Address: 06218 4203 MING AVE, BAKERSFIELD, CA 93309 Per Califomia Water Resources Control Board requirements, attached are results from secondary containment testing performed at the subject facility. Please note all secondary components have passed testing requirements. Test Date Pages 05/10/02 2 07/30/02 2 08/21/02 2 ARCO is committed to the compliance of all environmental laws that govern the safe operations of its facilities. Should you have any questions or concerns regarding testing activities at this facility, please do not hesitate to call Michael D. Wilson, BP Environmental Compliance Specialist for this facility at (714) 670-5321, or myself at (949) 450-1010. Sincerely, Jim Brown Project Manager Belshire Environmental Services, Inc. Underground Storage Tank System Secondary Containment Certification Form Facility Address: Tanks, Piping, & Spill Buckets Page__ of~ Testing Contractor: Contractor Address: ~(a~ UST,4 nn Mar Space Tank #1 Tank #2 Tank #3 Tank #4 Product .87 89 91 D 87 89 91 D 87 89 91 D 87 89 91 D Capacity ~.~c~c9 n~lgestStart Time ~ ', c4v 12) C~ ~, ~'~ ~ [~. ~ .~ ~: ~ Initial Pressure ~ 0 ~ i ~ ~ ~ ~ ~ ~ I 0 ~ Final Pressure ~ O~.ON [ ~~ [ ~ ~ ~ ~ ~ ~ Test Results ~ F~ ~. F~ ~ F~ ~ F~l Signature ~ ~ ~ .~ ~ SpillBucke~ Overfill #1 Overfill #2 Overfill #3 Overfill #4 Manufacturer Irt Time (to) Water Level Time (h) Water Level Time (t2) Water Level Time (tn) Water Level Time (t4) .... Water Level ;estResuits ~ Fail ~ Fail Pass '~~ Fail Rev. 11/01 White - Original Secondary Piping Line #1 Line #2 Line #3 Lifie #4 Product (~9 91 D 87 89{~D ~89 91 D 8(~ 89 91 D Piping Type ~Siphon '~ Siphon Primary ~ Prim_a~ ~iphon Manufacturer Test Start Time Initial Pressure Test End Time Final Pressure e t, e ults Signature Secondary Piping Line #5 Line #6 Line #7 Line #8 1~89 91 D 87 89Q~D 87 89 91 D 87 89 91 D Product Piping Type Primary~.l ~i~p~h°n-Prim~ Primary Siphon Primary Siphon Manufacturer Test Start Time i ~)- ~,, O~'- ~-:OO Initial Pressure Test End Time /~'-'Of-o ~ Final Pressure ~ D 1~ ~ Fail Pass Fail Pass Fail Test Results Pass Signature ~- ..~:~---~ Y~llow - Arco Environmental Compliance Pink - Contractor Underground Storage Tank System Tarbine Sumps, Fill Sumps and Und~ 8~onda~ Con~inmeat Certification ~orm ~age~ of _, .... , ....... _ _ ~ .. ~~~ ............. Manufnttnrer ~_~art Ti~ (t,) ~ater Level Time(tO Water ~vel Time (ti) Water Level Time (is) Water ~ Time (t~) Water ~vel 4 UDC Manufacturer Start Time ,Wat~ ~vel Water ~vel Wa~r ~vel Time (h) Water ~el ii Manu~cturer S~ Time (k) Water ~vel Time (tO Wa~r ~cl Time (t~) Water Level ~me ih) Waler ~vel Time (tO White- OfiP. Jnal UDc Manufact. rer Start ~, ,Wgter ~vel. Water ~vei ~ .8'0 '" ~ 0 3 _ . wa~r ~vel ~ D } ~ ~ . Tim (ti) .. Time(tO ' Trot Ruul~ ~ Fail ~ Fail Pus Fail P~s F~! Yellow - Arco Environmental Compliance Pi~ - Contractor UndergroUnd Storage Tank System Secondary Cnntainment Certification Form Turbine Sumps, Fill Sumps and Under Dispenser Containment Page__ of__ Testing Contractor: ~ ,o_~"'~ ~'~-..~~-~,l- Test Date: "~--~ 2.(~...'~-.. Turbine Sumps ~s9 9t v ~ 89 91 ~ s7 s9 (~o ST'S9 9~ o ID (norlh, slave, crc.) Manufacturer Start Time (t0) Water Level Time Time (t,) Water nevd Tim. (t,) TcstRcsults ~ Fait ~ Fail ~ Fail Pass Fail II) (1/2, 3/4, cie.) i~anufacturer ~: ........ Water Level ~ter Level ~'~ ~¢C9 C~ ~ ~L__.. Water Level Time (t~) Water Level TeslResulls ~ Fail ~ Fail ~ Fail Pass Fail Rev. I 1 I01 White - Ori~,inal Fill Sumps 87 89 91 D $7 $9 91 O 87 89 91 O 87~89 91 D ID (north, slave~ etc.) Manufacturer Start Time (to) Water Level Time (t~) Waler Level Time (tt) Water Level Time (t~) Water Level Time (tn) Water Level Test Results Pass Fail Pass Fail Pass Fail Pass Fail Signature UDC ID (1/2, 3/4, etc.) Manufacturer Start Time (to) Water Level Time (h) Time (t~) . ::::~.:...,.V Water Level · '"" · : '::.,;.![.~, Time (t~). -,;. Water Level _ Time Water Level Test Results Pass Fail Pass Fail Pass Fail Pass Signature Yellow - Arco Environmental Compliance Pink .- Contractor Tanks, Piping, & Spill Buckets Page~ of Underground Slorage Tank System Secondary Containment Certification Form ~{ Facility Address: __L'~_e~5 ~,~(~,~"~ ~., Testing Contractor:',~. ~'..l~v ?~.~/~..~.~t ,,~/ Test Date: Contractor Address: ~.{~_ (~,,)..~T~,.,,-~,'~¢'x' UST Ann uhtr ~ ~ace Tank #1 Tank #2 Tank #3 Tank #4 Product 87 89 91 D 87 89 91 D 87 89 91 D 87 89 91 D Capacity Manufactnrer ~t Start Time lnitia} Pressure Test End Time Fiual Pressure Test Resulls Pass Fail Pass Fail Pass Fail Pass Fail Signature .Spill Buckets ~-, .... i Overfill#1 t Overfill#2 Overfill#3 Overfill#4 Product ~~D 87 89 91 D 87 89 91 D ~ 87 89 91 D Manufacturer rt'Time(to) Time (t,) Water Level Time (~) Water Level Time Water Level ~ Time (t,) Water Level Test Results ~ Fail Pass Fail P~s Fail Pass Fail Signature ~~ / Rev. 11/01 Wl~ite - Original Secondar, v Pipin~ Line #1 Line #2 Line #3 Line #4 Product 87 89 91 D 87 89 91 D 87 89 91 D 87 89 91 D Piping Type Primal3, Siphon Primary Siphon Primary Siphon Primary Siphon- Mannfacturcr Test Start Time Initial Pressure Test End Time Final Pressnre Test Results Pass Fail Pass Fail Pass Fail Pass Fail Signature Secondary .Piping .,,~/~-_~ ..... .~ .- -r-"nLiue #5 I Line #6 Liue #7~i Line #8 Product 87 89 91 D 87 89 91 D 87 89 91 D 87 89 91 D Piping Type Primary Siphon Prima~ Sipl~on I'Hma~' Siphon Primary Siphon Manufacturer Test Start Time Initial Pressure Test End Time Final Pressure Test Results P~s Fail Pass Fail Pass Fail Pass Fail Signature ~ Yellow - Arco Environmental Compliance Pink - Contractor Underground Stnrage Tank System Secondary Containmen! Certification Form Tauks, Piping, & Spill Buckets Page____ of ___ .... , . . - - , · c,,.,,,,.,,,. ~da,',,,:~~O Te~.~~ ' r,,[, ~ : ~¥e/' . ........ J. UST A .nular Space Tank #1 'ranit #2 Tauk #3 Tauk #4 Product 87 g9 9i D 87 8~) 9l ~-- 87 89 91 D 87 89 91 D Capacity M antlfactu rer Test Start Tinle Initial Pressure Teal Eud Time Final Pre~sure Test Results Pass Fail Pass Fail Pass Fail 'Pass Fail Signa!ure 3.'.pill Buckets Product Manufacturer Start Time (to) Water Level O~m'lill #1 87 89 91 D Overfill #2 Secondary Pil~ Product Piping Type ( Manufacturer Test Start Time lnifial Pressure Test End Time Final Pressure Test Kesuits Signature Overfill #4 ~eco!ulary Piping 87 89 91 D Overfill #3 8'/ 89 91 D 'rime (h) Water Level Time (h) Water I,evel Time (ts) Water Level Time (tn) Water Level 'rest Results Pass Fail Pass Fail Pass Fail Signature Rev. '11/01 White - Original Line #1 (~89 91 D Line #2 87 89~ D Siphon Line #3 (..~ 89 91 D ~,nary Siphmi Line #4 ? _ Line//5 . Line #6 ' .. Line'#7 Line Product ~89 91 D 87 89 91 D 87 89 91. D 87 89 Pipiag Type Primary Prima~ Siph~hi' Primaq, Siphon Prima~ Manufacturer T~t Start Tinle ~ i-(~'O ___ Initial Pressure ~.~ Final Pressure ~/' Test Results ..~.. Fail P~s Fail 'Pass Fail Pass 87 89 91 D ~ D iphon Faili Pass Fail ~-L-~ · 7., Yellow -Arco Environmental Compliance Pink d Contractor U.dcrg,'.und Storage Tanlt System Turbine Sumps, Fill Sumps ami Under Dispenser Conlainment Seco"daD' Co.luimncn! Certificalion Form Page of [Turbine Sumps .r~ .?orih, sla__.___v_L, e~,...) faelurer 89 91 ~- 87 fi9 91 D 1t7 89 91 D Start Time (to) Water Level Time Water Level Time Water Level Time (tn) .. "' Water Level Time (h) 'Water Level Pass Fail Pass Fail Pass Fail Test Ilesulls Pass I/ail Siguah.-e ui)C ID (1/2, 314, crc.) Manufadnrer Starl Time Water' Level Time (h) Water Level Time (ti) Water Level Time (t~) Water I.evel, Time Water Level Test Results Signat.re I~ev I I/OI 5: Pass Fail Fill Sumps ID (north, slav~ crc..) Ma,,u f.'~cturer Slart Time (to) Water I.,evel Time (ti) Water Level Time (ti) Water Level 87 ~9 91 D g7 89 91 Ti.,.nc (la) Water Level Time (t4) Water Level Test Results Pass Fail Pass Fail Pass Fail Pass Fail Signature While - Ori.inal UI)C ID (IlL 3~4, cie,) Mauufacturer Start l'ime (t.) Water Level Time Waler Level Time (t~) Water Level Time (h) Water Level Time (t~) Water Level Test Rcsnlts Pass Fail Pass Fail Pass Fail Pass Fail Signature ~ Pink - f'~nnh'a~.tnr Yell.w -.- Arc. n r~nvirnnmenlnl Cnmnllanee ~ . O (J~ · O D ENVIRONMENTAL .SERVICES, INC. PMB 269 25422 Trabuco Road #105 Lake Forest, CA 92630-2797 (949) 450- I010 Fax (949) 450-1177 September 11, 2002 Via UPS 2nd Day Air City of Bakersfield Fire Department 1715 Chester Avenue, 3rd Floor Bakersfield, CA, 93301 ATTENTION: Steve Underwood RE: PRELIMINARY TEST RESULTS - SB989 COMPLIANCE ARCO Facility No.: Facility Address: 06218 4203 MING AVE, BAKERSFIELD, CA 93309 Per Califomia Water Resources Control Board requirements, attached are results from secondary containment testing performed at the subject facility. ARCO is currently coordinating necessary repairs to satisfy testing requirements. Once repairs have been made, your agency will be notified of all scheduled re-testing. Test Date Pages 05/10/02 2 08/21/O2 2 ARCO is committed to the compliance of all environmental laws that govern the safe operations of its facilities. Should you have any questions or concerns regarding testing activities at this facility, please do not hesitate to call Michael D. Wilson, BP Environmental Compliance Specialist for this facility at (714) 670-5321, or myself at (949) 450-1010. Sincerely, Belshire Environmental Services, Inc. Tanks, Piping, & Spill Buckets Underground Storage Tank System Secondary Containment Certification Form Facility #: ~ City: Facility Address: Page~ of TestiugContractor: ~/..~"]'-4t~[~_ ~'-~'~O~_~.~,, TestDate: Contractor Address: C-'/(O~ 3 ~, ~4/I~.,,~ ~=~'~r Tech. Name: UST Annular Space. Tank #1 Tank #2 Tank #3 Tank #4 Product .87 89 91 D 87 89 91 D 87 89 91 D 87 89 91 D Capacity Manufacturer Test Start Time ~,~ ', C.~ C) ~ ~.~ ~ ~ ~- ~ ~ ~ ~ ~' Initial Pressure Test End Time Final Pressure Test Results ~ F~ ~ F~ ~ F~ ~ F~I Signature Spill Buckets Overfill #1 Overfill #2 Overfill #3 Overfill #4 Product 87 89 ~)D .~ D (~)g~ ~ D ~89~91 D Manufacturer ~-P~ - Start Time (t0) Water Level Time(tO Water Level Time (t2) I 0 ~o~ Water Level Time (t3) '-,:~ Water Level Time (t4) Water Level Test Results ~ Fail ~ Fail Pass '~ ~ Fail Rev. 11/01 White - Original Secomlary Piping Line #1 Line #2 Line #3 Lii~e #4 I Product 91 Piping Type ~ Siphon ~ Siphon Primary ~ Pr~.~n Manufacturer ~., ~ t~ Test Start Time ~'~' ,3~ I,,~: ~ l l -~ ID Initial Pressure '~{)~'t ~ ~%"-~9~'i Test End Time ~ ~ "-~oQ, I ~t ~ i~) Final Pressure (c.)/~<~i ~-~.~~~ ~ . ~a.t ..~_~_2~ Test Results P~ss'j~ Pass ,~) ~/~ Fail Signature ~ ~' ~ ~ : Secondary Piping Line #5 Line #6 Line #7 Line #8 Product Q~89 91 D 87 89Q.~D 87 89 91 D 87 89 91 D Piping Type ~ Prim~ Primary Siphon Primary Siphon Manufacturer Test Start Time Initial Pressure Test End Time Final Pressure ~).~) Test Results Pass ~_~ ~ Fail Pass Fail Pass Fail Signature Ydow - Arco Environmental Compliance Pink - Contractor Turbine Sumps, Fill Sumps and Under Dispenser Containment Underground Storage Tank System Secondary Containment Certification Form '[ Facility#: (_O)[o~-~"~ City: Facility Address: Page of __ Testing Contractor: Contractor Address:~/9 Xg-'~ Test Date: Tech. Name: _ ~5 07-,' Turbine Sumps O 89 91 D "~O8~,~D (~ 89 91 D 87 89 ID (north, slave, etc.) Manufacturer Start Time (to) Water Level Time(tO Water Level Time (t2) Water Level Time (t3) Water Level Time (tn) Water Level Test Results Signature Manufacturer Start Time (to) Water Level Time (t,) ~l~ ~ ', ~O Water Level IQ Time (t2) 7: I 0 7 53 Water Level O Time (t3) --}~' Water Level Time (tn) Water Level Test Results Pass C1~ Pass 6~ Pass ~:a~ll l~ss~ Fail Signature Rev. 1 i/01 White - Original Fill Sumps s7 89 ~ D (~ 89 91 D (~ 89 91 D ~ ~89 91 D ID (north, slave, etc.) Manufacturer Start Time (to) Water Level Time (t0 Water Level Time (t2) Water Level Time (t~) Water Level Time (t4) Water Level Test Results ~ Fail Pass Fail ~ Fail Pass Fail S,,n ture uvc ID (l/2, 3/4, etc.) Manufacturert / · - Start Time (to) Water Level Time (t,) Water Level Time(h) Water Level Time (t3) Water Level ~.'. Time(tn) Water Level Test Results (~ Fail ~ Fail Pass Fail Pass Fail Signature Yellow - Arco Environmental Coml~liance Pink - Contractor Undergrouud Storage Tank System Secondary Conlainmenl Certification Form Facility Address:._7~ /_~. Tanks, Piping, & Spill Buckets Page____ U,5 T A tut Mar !?pace Product Capacity Manufacturer ]'est Start Time Initial Pressure Tesl End Time Final Pressure Test Results Signature ,~ dll Buckets TaM{ #1 87 89 91 D 'rank 02 87 89 91 D Tauk #3 87 89 91 D Tank #4 87 89 9{ D Pass Fail Pass Fail Pass Fail 'Pass Fail O~erlill #1 Overfill #2 Overfill #3 Product 87 89 91 D 87 89 91 D 87 89 91 D Manufacturer Slart Time (to) Water Level 'rime (t0 Water Level Time 6:) Water i,evel Time (ts) Water Level Overfill #4 87 89 91 D Time (tO Water Level 'rest Resulls Pass Fail Pass Fail Pass Fail P~ss Fail Signature ~yecondaty PilLb~ Line #1 ProductI Q~)89 91 D Piping Type ~ SiNmn Manufacturgr Test Start Time ._~: (~ lnifiaIPressure - .~ ~Ol"" ~ Test End Time ~' ~ Line #2 Sipho,: Line #3 Line #4 Fail S. econdaf~in~ __. Line#5 Line #6.. l., "Line'#7 Line#8 _ Product (~89.91 D lit 89 91 D 87 89 91. D 87 89 91 D- PipingType l'rima~ Prima~ S~phonPrimaq, Siphon Prima~ Siphon M.an u faetu rer ?'.7,"' .. ..... Initial Pressure ~i.~ .... ~'~"'~ I Signature ~ ..... j : Pink ~' Contractor Rev. '11/01 White -O,'iginal Yellow- Arco Environme,~tal Compliance Undcrg,'ound Storage Tank System Secondary Containmenl. Certificalion Form Turbine Sumps, Fill Sumps anti Under Dispenser Coulainment Page__ of N Turbine Sumps 87 8991 D 87 89 91 D 87 89 91 D 87 89 91 D ID (north, slav~, etc.) Mauut3clurer Start Time (to) Waler Level Time (t0 Water Level Time (t~) Water Level Time (ta) .. '. _Water L~vel Time (h) Water Level 'rest Resulls Signature Pass I:ail Pass Fail Pass Fail Pass Fail Fill Sumps ID (nodh, slave, e;c.._) . Manufacturer Stall' Time (to) Water I,,evel 87 89 91 D 87 89 91 D 87 89 91 D 87 89 91 D Time (t,) Water Level Time (ti) Water Level T L,.I! e (t~) Water I,evel Time (t~) Water Level Test Results Pass Fail Pass [;ail Pass Fail Pass Fail Signatu re ubc 11.3 (IlL 3/4, crc.) Manufacturer Start Time (t) Water' Level Time (1i) Water Level Time (t~) Water Level Time Water I~evcl. Time (tn) Water Level Test Results Ui)C IF) ( 1/2, 3/4, etc.) Manufacture,. Start Ti,ne Water Level Time Waier Level Time Water Level Time (t~) Water Level Time (t~) Water Level Pass Fail Test Rcsnlts Signature Yellnw -.. Arc.n Envh'nnm*-.ntnl (~nmnliance Signat.re Rev I 1/fll While - Ch'i,,inM Pass Fail Pass Pink - (;m~h'actnr Fail Pass Fail Pass Fail Au~: 14 0;;' 04:4Bp bp pol No. o~ Pages: SB 989 TESTING PROGRAM AGENCY NOTIFICATION SHEET Agency Name: Pemon Contacted.' Time Contacted Comments/Requirements Nofifcation For: Initial Test: Repairs: Re-test: Nofifcafion Method: Fax ~ E-mail: Verbal: Tank Ahnular Fill Sumps Secondary Piping /'~ Spill Buckets Turbine Sumps UDC ~ [de.~"ibe componen~ and aot/cSpated repai,~J Contractor Name: D/sl~but~on: Jul 26 02 01: 1Bp p.1 No. of Pages: bp SB 989 TESTING PROGRAM AGENCY NOTIFICATION SHEET Notifcation For: Initial Test: Repairs: Re-test: Name: Person Contacted: Time Contacted Comments/Requirements Notffcafion Method: E-mail: Verbal: (meck el: ~ompone~s reel apply) Tank Ahnular _ · Fill Sumps Secondary Piping ~ Spill Buckets Turbine Sumps ,,/ UOC Contractor Name: Notification Made By: Contact: (Na'-n~ of Jnciivick/al} ~'- ~q Phone: Diseibut[on: Odgina! to Agency C01~/to Bleshire Envir~qme~tal Se~vice~ No. of Pages: p.1 bp SB 989 TESTING PROGRAM AGENCY NOTIFICATION SHEET :Agency Name: Person Contacted: Time Contacted Comments/Requirements Notifcation For:. Initial Test: Repairs: Re-test: Notifcation Method: Fax \ E-mail: Verbal: Testino_ ScoDe (~eck all componenl~ ~hat Tank Ahnular Secondary Piping Turbine Sumps Fill Sumps Spill Buckets UDC ~ (de,scribe c~nponent~ and anticJpa~ed repairs) ARCO Contact: Phone: Distribution: Originat to Agency CopY to Bleshim E~vin~me~tal Se~ices CITY OF ILAKgl~FI~I~ ~ ~/~(31 ~-"/~/ Oe e.wvmo~vmvr^L seuv~c~:s 1715 tghest~r Ave~ Bakerslield~ CA (661) 326-3979 P~,Mrr IIrI~ICATION TO CONSTRUCT/MODIFY UNDID/GROUND b'TO!~GE TANK NO. YOI,,UME AVIATION C1~'~ pREVIOUSLY ~UE ~ ' ~ . ', . ,~ ,~ :, , ~ ~CA~ON ~O~ A ~ ~ ~~ ENVIRONMENTAL .SERVICES, INC. PMB 269 25422 Trabuco Road 11105 Lake Forest, CA 92630-2?97 (949) #50-1010 Fax (949) 450-I 177 June 5, 2002 Via UPS 2~ Day Air City of Bakersfield Fire Department 1715 Chester Avenue, 3rd Floor Bakersfield, CA, 93301 ATTENTION: Steve Underwood RE: PRELIMINARY TEST RESULTS - SB989 COMPLIANCE ARCO Facility No.: Facility Address: 06218 4203 MING AVE, BAKERSFIELD, CA 93309 Per California Water Resources Control Board requirements, attached are results from secondary containment testing performed at the subject facility. ARCO is currently coordinating necessary repairs to satisfy testing requirements. Once repairs have been made, your agency will be notified of all scheduled re-testing. Test Date Pages 05/1 O/02 2 ARCO is committed to the compliance of all environmental laws that govern the safe operations of its facilities. Should you have any questions or concerns regarding testing activities at this facility, please do not hesitate to call Michael D. Wilson, BP Environmental Compliance Specialist for this facility at (714) 670-5321, or myself at (949) 450-1010. SincereJy, Project Manager Belshire Environmental Services, Inc. Underground Storage Tank System Seconctary Containment Certification Form Product Capacity Man ufa eturer' Test Start Time Initial Presanre 'res1 End Time Final Pressure Test Results Signature Spill Buckets Product [- Tank#1 i87 89 91 D .i Manufacturer Start Time (to) Water [.,eve} Time Water Level Time Water Level .Time'O,) Water Level Time (t0 Water Leve! Test Results Signature Rev, I 1/~ 1 Overfill #1 87 89~)D Tanks, Piping, & spill Buckets Page~ 8f~ Overfill#4 Overfill gl Overfill fl3 Seconda~.Piplng Product Piping Type Manufacturer Test Start Time Line #1 ' ._~9 91 D ~'Siphon Initial Presaure Test End Time ' 1 Final Pressure Signature Line 87 89 ~) D Line #3 ~r~89 9I'D Ptimm3' ~ Li~e//4 $99113 " ~,o o- Pass "~ i~ ~.~_ Fail Whit~ - Original Secondary Pipbtg Line #5 - Line #6 ] Line 07 Line #8 Product ~)89 91 D 87 89 D , 87 89 91 D 87 89 91 D Ptim_aq ~t~b. on. Pfim~ ?dm~' Siphon Prim~' Si~ Piping Ty~ ~ ~ Mann ~a ctu Test End Time ~ ~ Final Pre. ute ~ ~ Test Results Pass Fait Pass Fait ~, Pass Fait Y~tow -Arco Enyh'qnmenta] Compliance Pink- Contractor Underground Storage Tank System Turbine Sumps, Fill Sumpa and Under Dispenser Containment Secondary. Containment Certification Form Faetlit. yAddre.~: q_.~tO~ V'~X'CVx.~ Page of ~ Manufacturer ~Start Time (~) : Water Level iWater Level Water Level Time (q) Water Level T~me (h) Water Level UDC Manufacturer i;lar' Time (t') Water ~vel Water Level Time Water Levd .Time Water Time (h) Wat~T ~vel Fill Sumps . lp taorth, slave, etc.} Mana/aeturer Start Time Water Level Time (tx) Water Level ~lime (h) Water Level Time (tj) Water Level Time (h) Water L~vel Test Resu Signature R er. 1 I/01 White - Clr[~inal 87' 89 '~-D O~D q tx'; {~} ~9 91 D _ - Pass Fail ~ ~9 9t D Manufactar~r Start Time (rd Water Level Time (h) Water Levd %-: Veltow- Ama I~nxdmnmemal Cnmnlianee. P{nk- Pnntramnr D May 29, 2002 AM-PM 4203 Ming Avenue Bakersfield, CA,93309 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 4203 Ming Avenue REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California Law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1, 2002. section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1, 2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. REMEMBER!! Any component that is "double-wall" in your tank system must be tested. Secondary containment testing shall require a permit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. 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 AM/PM 4203 Ming Ave Bakersfield CA 93309 RE: Necessary Secondary Containment Testing Required by December 31, 2002 REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1, 2002. Section 25284. I (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 66 !-326-3190. Steve Underwood Fire Inspector/Environmental Code Enforcement Officer SBU/dm enclosures No. of Pages: bp Notification Date: SB 989 TESTING PROGRAM AGENCY NOTIFICATION SHEET Nofifcation For: Requested Test Date: ARCO Fac*: Address: State: Initial Test: Repairs: Re-test: Agency Name: ~/~rZ~(.-/~) ~ £(=~ Notifcaflon Method: Person Contacted: J~'- ~"V ~~-'' ('_Jn ~~0 Fax ~ E-maih Time Contacted Verbal: Testing Scope (check all comp~nent~ that apply) Tank Annular .~". Fill Sumps . Secondary Piping ~ Spill Buckets Turbine Sumps ~ UDC (describe component~ and anticipated repairs) Contractor Name: Contractor Phone: Notification Made By: Contact: {Name of Individual) Phone: Distribution; Original to Agency Copy to Bleshire Environmental Services ARCO ARCO Products {~pany Environmental Health'"'~ Safety 4 Centerpointe Drive La Palma. California 90623-1066 Mailing Address: Box 6038 Artesia. California 90702-6038 April 22, 2002 CERTIFIED MAIL #: 7000 1670 0007 16 i 3 4753 BAKERSFIELD FIRE DEPARTMENT P.O.BOX 2057 1715 CHESTER AVE. RE: LEAK DETECTOR AND MONITOR CERTIFICATION TEST RESULTS ARCO Facility No.: Facility Address: 5526 6218 900 Monterey 4203 Ming Ave Bakersfield, CA Bakersfield, CA Test Date: March 11, 2002 March 12, 2002 This letter is to notify you that at the above facilities the Leak Detector and Monitor Certification Test passed the systems test as noted in the attached results. ARCO is committed to the compliance of all environmental laws that govern the safe operations of our Facilities. Feel free to call me at (714)-670-$402: 5551,~ Sincerely, Nora Koskemnaki Enviromnental Compli,'mce APC-71 ~6 ARCO Products Compat~y Is a Olws~orl Ot Atl,trltlcRichfie/dCompany (10-96) MONITORING SYSTEM CERTIFICATION · For Use By All Jurisdictions Within the State of California Authority Cited: Cha?tei' 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitorin~ system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy Of this form to the local agency regulating UST systems within 30 .days of test date. A. General Information/,] _ ,,~ Facility Name: ~ . ' /'~'~._~,~ ~ ,. t [,yBldg.N0.: Facilky Contact Person: Contact Phone No.: (.__). Make/Model of Monitoring System: O¢.rJe_r ¥T/-~' 7550 Date of Testing/Servicing: B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced: Tank ID:c '7 '1 Tank ID: 'Y'? [] .In-Tank Gauging Probe. Model: [ ?~ In-Tank Gauging Probe. '2V""/~jeg7" ~/'t7 ~' . I ~ Annular Space or Vault Sensor. ~ ' : [ ~ Piping Sump/Trench Sensor(s). ~ ¥ ..~ o'-TO& ! ~,~ill Sump Sensor(s). I Ut Mechanical Line Leak Detector. Annular Space or Vault Sensor. Mqdel: Piping Sump / Trench Sensor(s). Model: Fill Sump Sensor(s). Model: [] Mechanical Line Leak Detector. Model: El Electronic Line Leak Detector. Model: [] Tank 'Overfill / High-Level Sensor. Model: [] Other (specify equipment type and model in Tank ID: ~ Section E on Pa~e 2). [3 In-Tank Gauging Probe. Model: {~1~ Annular Space or Vault Sensor. Model: Piping Sump / Trench Sensor(s). Model:'7~ ~"Sq'O 13 Fill Sump Sensor(s). M~el: ~q~ D Mechanical Line Le~ Detector. 'Model: D Electronic Line Le~ Detector. Model: ~ Tank Oveffill / High-~vel Sensor. Model: ~ OO~er (specify equipment type and model in Section E on Pa~e 2). Dispe~er ID: '~'--' ~ Dispenser Containment Sensor(s). Model: ~ Shear Valve(s). ~ Dispenser Containment ~oat(s) and Chainrs). Dispenser ID: ,.) ~ - ~ Dispenser Containment Sensor(s). Model: ~'S ~ear Valve(s). ~ Dispenser Containment Float(s) and Chain(s). Dispe~uer ID: ~ ~- ~ Dispenser Containment'Sensor(s). M~el: '~ Shear Valve(s). ~Dispenser Containment Float(s) and Chain(s). *If the facility contains more mq~ or dispensers, copy this lb~. Include Model: Model...~.'.'.'.'.'.'.'~)~. 4/'~',~"~5'.- 5,t~ Model:'~'~-t' '~---ZO~ M~el: ID Electronic Line ~ Detector. M~el: D Tank Oveffill / High-Level Sensor. Model: ID Other (s~ecif7 equipment ty~e and model in Section E 0n Pa~e 2). Tank m: ~/ D In-Tank Gauging Probe. Model: ~, Annul~ Space or Vault Sensor. Model:~7~ff '- ~' ~iping Sump / Trench Sensors). M~el:~¢~5 *O "' ~O '~ '~ Fill Sump Sen~o~s). M~el~ 3q~ ' ZO ~ _ ~ M~hanical Line Le~ ~tecmr. Model: D Electronic Line ~ak Detector. Model: D Tank Oveffill / ~gh:Level Sensor. Model: D Other (speci(v equipment type and model in Section E on Pair 2). ispemer ~: · Dispenser Cont~nment Sensor(s). M~el: ~f~¢a~O~ ~'Shear Valve(s). ' ~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: ~- ~ ~ Dispenser Containment Sensor(s). Model:~ff~:'- ?~9~ ~ Shear Valve(s). ~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: /~- /~ ~ Dispenser Containment Sensor(s). Model: ~q~'~ ~ . ~'Shear Valve(s). . ' ~ Dispenser Cont~nment ~oat(s) and Chain(s). nformation for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document ,,vas inspected/serviced in accordance with the manufacturers' · guidelines- Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equ. ipment. For any equil~ment capable of generating such report, s, I have also attached a copy of the report; (check ali that apply): -,~ System set-up ~, ~xlar~tory report Technician Name(print): John Cou2~ant /- Signature: '' ~,; Testing Company Name: Scott Co. o'[: C~] ~'Fo-r-n'~ a Phone No.:( 510 ) ~qq-9"qq'~ X 385 Site Address: Date of Testin~Servicing: / / Monitoring. System Certification Page 1 of 3 03/01 D. Results of Testin~Servicing Software Version Installed: /~". ~ /' - Complete the following checklist: Yes [] No* Is the audible alarm operational? Yes (21 No* Is the visual alarm operational? ~" Yes ID No* Were all sensors visually inspected, functionally tested, and confirmed operational? /~Yes ID No* Were all sensors.installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes ID No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ID N/A operational? /~Yes ID No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment [] N/A monitoring system detects a leak fails to operate, or is electrically disconnectedV If yes- w ' ~ n~r~r~ inlti.~t~, positive shut-down. (Check all that apply).~: Sump,rrrench Sensors;/l~ Dispenser Containment SensorS. Did you confirm positive shut-down due to leaks and sensor failure/disconnection?,,,~ Yes; ID No. [D Yes tD ,No* For tank systems that utilize the monitoring system as .the primary tank ove~rfill warning device (i.e. no Ig(, N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible ,and audible at the tank fill point(s) and operating properly? If so. at what percent of tank capacity does the alarm trigger? % ID Yes* ~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ID Yes* ~ No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ID Product; ID Water. If yes, describe causes in Section E, below. ~ Yes Cl No* Was monitoring system set-up reviewed to ensure proper.settings? Attach set up reports, if applicable ,'~ Yes [] No* Is all monitoring equipment operational per manufacturer's specifications? In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: Page 2 of 3 03/01 F. In-Tank Gauging / SIR Equipment: [] Check this box if tank gauging is used only for inventory control. yCheck this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: []. Yes (2 No* Has all input wiring been inspected for proper entry and termination, including }esting for ground faults? [] Yes 12 No* Were all tank gauging probes visually inspected for damage and residue buildup? FI Yes [] No*- Was'accuracy of system product level readings tested? [] Yes [] No*"' Was accuracy of system water level readings tested5 12 Yes [] No* Were all probes reinstalled properly? CI Yes [] 'No* Were' all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): 12 Check this box ifLLDs are not installed. Coml~lete the followine checklist: t~ Yes '(2 No*' For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Cl N/A (Check all thor apply) Simulated leak rate:,~3 g.p.h.; [] 0.1 g.p.[~; [] 0.2 g.p.h. [] Yes 'C} No* / Were all LLDs confirmed operational and accurate within regulatory requirements? r,~ Yes F1 No* Was the testing apparatus properly calibrated? [] Yes {2 No5 F~r mechanical LLDs, does the LLD ~estrict product flow if it detects a leak? [] N/A 12 Yes [] No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? '[] Yes [] No* For electronic LLDs, docs the turbine au£6matically shut off if any portion of the monitoring system is disabled [~ N/A or disconnected? [] Yes [] No* For electronic LLDs, does the turbine automatically shut off if any portioh of the monitoring system malfunctions {~/NIA or fails a test? [] Yes Ul No* For electronic LLDs, have all accessible wiring connections been visuall~ inspected?"' ~J~'N/A . Yes. [] No* Were all items on the equipment manufacturer's maintenance checkli'st completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 r 03/01 '~~ARCO Products Company Mechanical Leak Detector Test Data Sheet Station # ~E/~"-' Date _c~_~72 ~ 7.. 19 Ad.ess ~~ ~t~ _~ Test I~ormation Product Manufacturer Model Full Operating Pressure (psi) Line Bleed Back (ml) Trip Time (sec) Metering Pressure (psi) F/E Holding Pressure (psi) Test Leak Rate (ml/min) (gph) PASS or FAIL Replaced All Failed Leak Detectors Yes tf No, Replacement To Be Completed By (Date) No This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge tree and correct. The mechanical leak detector .test pass/fail is determined using a low flow threshold trip rate of 3 gph at l~:f_~I. Inspected By: Contractor Technician Signature Lic# APC-3325 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM A TANK TIGHTNESS TEST/ SECONDARY CONTAINMENT TESTING FACII JTY ADDRESS t"120 ~ PERmT TO OPERATE # OPERATORS NAME ~/Z£ OWNERS NAME NUMBER OF TANKS TO BE TESTED TANK # ! VOLUME IS PIPING GOING TO BE TESTED "~)' CONTENTS TANK TESTING COMPANY ,'r~dL~/~tZ ~-Tgoi~-uzy) MAIl.lNG ADDRESS /--/(_o ~'~ dk3, J~//f;/-F-~_4'~ ,~/o/ NAME & PHONE NUMBER OF CONTACT PERSON/'3///d&,/~/2f-~.,w~n TEST METHOD ,~f., /27,Y75 NAME OF TESTER OR SPECIAL INSPECTOR /¢Jr~/~ /W-W. OW/We CERTIFICATION# DATE & TIME TEST IS TO BE CONDUCTED DATE ~IIGNATURE OF AppLIcANT Apr-IO-ZOOZ 03:4?pm From-ARCO +714-870-3095 T-463 P.O03/O0~ VlONITORING SYSTEM CERTIFICATION ~ysc~m ~=lop~racor. ~ ow~t~p~or ~ub~a ~p( of ~ fo~ (o ~ la~ agency t~gulaCing U~T sys~ wi~ia ]0 B. Invento~ o~~ed A~nular $ pa"-- ar V~ul~ ~soz. Tank O~fl~ / Hi~Ycl Scna~. Mo~l: '_ ~.T~k G,m~ing ~o~, Model: Annul~ Stile or Vaul~ gc~r, Modcl:~~ -~ ~I Sump ~c~a). ~l~q'~ ' gO ~ M~ical Linc L~ ~ctor. Mo~l: In. Taok Gauging Probe. . Annuls' Spl~ ar Pipin~ S~mp /Tm=ch $easorCs). Mo~: Sump Scnsoffs). Ete~nic Lhc L~k Detector. MO~I; Tn~k'O~r~ll I High-L~l ~: "~ ' - Ia,Ta~ O~S~e&e. ' M~I: ....... Mech~icM ~n= ~ec~nI= Line ~ ~tcc~o~ [] Thnk O',=ffgl I Hi;h-Level ,%ll~or. M~lol: ...... ~ Trak Ov~ ill / ~-~cl Sc=ar. ~ qis~ C~n~man~oattsl and Chaiats~ .... ~ ~sp~n~r Con.~inment Maa~a) a~d Chain(si. ~Di$~qc Contiln~nc ~o~3) ~d ChdarO. ~ ~ Dispenser (~oqC/~m~ ~Oa~[z) anl *ltthe r~ility ~aa mo~ aO~ or diapason, c~' mis ~o~. lnclu;~ i~tian for e~ t~ ~d dia~as= a ~ f~ili~. , iuidel~u, At~e~ to ~s CergEcafl~ is t~e~on {e,g ~n~acturer$' ,~ee~J nec~ ~ v~ :hut ~rr~t and o Plot ~lan aho~S ~e l~out of ~S eg~ipm~t. For ~y eq~munt ~pnbl~ of geo~g =ch attn~ae~y~er~o~;(~ht~aRrA~a~lyJ: ~:'atem set-up Moni~orlng Syale~n Cerltflcatioll 8/l;'d cJ~E'ON OD l.tOOS 14dEI :£ ~00~ '0t '~tdld Apr-IO-ZOOZ 03:48pm +714-670-3095 T-d63 P.DO~/O0~ From-ARCO PROD~4~ F-OOZ ~is s~cdon m~t be completed if in-:~ g~ugin~ eq~pm~t is used co pc~o~ 1~ dcmc~on mo~todng. Cam~ )1o~ ~e ~oIla~n~ ~he~ist: O' ~ ~ No~' Was ~y of ~yst~m ~r~uc~ l~va rc~ing~ c~? , Q Y~ Q 'No* Wc~'i im~ on'ac c~ui~m~uf~m,~r's min~an['~ ~c:k~st ~pl~ted? · In the Seclion It, below, dcscrlbe how and w~¢rt these defici~ncics were or will be corrected. G. Li~te Leak D etectar~ ~LLD): 0 Chack tills b~ if LiDs Complete thg foUowiu~ eheckl/at: ~ Y,~ j-~ 'No* We:; ~ll ~Ds con~d oP~tlon~ ~ ~:cur~e'wl~in :c~lato~ rcqukcm=nte? ~ Y~ [ ~ No~ ~0r ~ch~nic~[ ~Ds, do~ theL~ ~tac:produ~ flow if'k dot;ets a leak~ ' ~ Y~ ~' ~No* For ~loc~ ~,, 60~ th~ m~i~ ~utonmtlcaliy ah~t off :f ~; LLD dc~c~ a lea~ ~]~ Y~ ] ~ No ~°r el~n/~s, d~a ~e cu~in~ ~to:~ally ~ut off if ~y portion of ~e mo~mr~ ~y~ h ~sabl~ [[ ~ Y~'~ ~ NO" For ~l~nic LLDS, do~ ~ m~inc ~o~mdc~y shut off If ~y ~or~°n of ~ mo~itori~ system ~funcdons * I~ ~e Secgon ~, b~ow, d~be how ~nd when t~csc de~cienci~ ~ere or wiU be corrected. It, ComlnenL~: l~nge il of 3 8/9 'd 98E 'ON O~ J..I. OD$ L, ldt~T Apr-lO-2002, 03:4?pm From-ARCO PRODU~i~ +714-6~0-3095 T-463 P.O04/O0~ F-OOZ D. Results of Testing/gervlcing Nos [s,~e audible atnFn Ol~md~al? not ~m~e~ ~j~h ~r pm~ ~radon? ~ NIA ~dve s~Ut~o~? CCheck ;;1 t~: ~pO~$~m~ch Se~on~ Di~=s~ ~n~mcnt Yes ~_No* ~cr tank sysz~ ~at uMi~ ~e moMt~g system as .the prim~ e~k or.Il w~ ~ce (j.~. ~N/A ~ani=~ ore. Il p~a~on ~lue i$ irs~[c~, is ~e t,v~ll wamn~ al~ viaible ~d audible at thc ~, fill poinc($) and operatinl ~rly? If so? at wh~t pe~ent of lank capaci~ ~ t~al~ ~gg~? ~ .... Y~ ~ N~" W~s ~y moMcofing cqu}pment replaced? lfy~. id~fify ~ifi~ s=nso~s, prob~, or o~er equipm~l !p~ list ~ manuf~t~r, nam~ an~ mo~l ~r all ~Ia~m~at pure ~n S~fion ~. bc~w. Yes* ~ N° W~ liquid fouAd i~i~e any ~a~a~ ~ ~Mnmem $~t~ desired ~ d~ s~tc~? (C~ck ull that apply) Prodgc~: ~ Wa?f.. If~. describe ca~e; ~ Sc~fioA ~. N~lo% ~. Y~ = No* W~ monit~Mg.:yq~ :cc-up ~cw.d ~~~tdn~? A~mh ~o~ ~.rcpo~. ~f applicable .... YQ$ ~ No~ ~ all monitoring ~uipmcnt epc~o~ p~c manufacturer:,? E. Comments: . - - 8/fi'd 98~'0N OD ±£03S Wdl::'T :E ~00~ '0"1: Apr-IO-2OOZ~ 03:4?pm From-ARCO PROD~ ,ak '~FARCO Products Company +?14-670-309~ T-463 P.002/005 F-O02 Mechanical Leak Detector Test Data Sheet Address ~ ~ ~ ..... Test Information P.~placcd All Failed Leak Detectors Yes __ No __ N/A If No, Replacement To Be Comple~d By (Dm) ____ / This Ieturr certifies that th~ annual leak mr rests wer~ p~'~ormed at th~ above referetx~ facility according to the equipmont m~nufacmr~ procedu,'es a~l limitations and the r~suits as listed are to mY knowlexlgc trt~ and correct. The m~h.~ni~al leak cl~c~or t~st pass/~ail is d~lan'ak~d using a Iow flow i:'~ ~::,. ','..:. ,420:3 I'11I"1G FYdE. BPd,(E~$F [ ELD 661 --2~:34- 1076 FEB 6. 2002 I I'.I',.?ENT,:SR'~" REPORT aCTIVE TaN}(S ,4203 I"IlNG aVE. BF~E EF:SF I ELD 6fi, 1 -ff134-1076 FEB 6, 2002 8:cll AP1 SYS'?Etq S'¥~TIJ$ REPORT ,hI..L FUNI;:T r¢,,,,'EiqTORY REPORT gOT IVE CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., yd Floor, Bakersfield, CA 93301 FACILITY NAME ~l't0 ,~. ~)a'X. ADDRESS ~t~03' i~Un~, ~ FACILITY CONTACT ~SPECTION TIME INSPECTION DATE PHONE NO. ~-~q" 10'dm, BUSINESS IDNO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program Routine [~Combined [~] Joint Agency {~ Multi-Agency ~l Complaint {~] Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy t.., Verification of inventory materials Verification of quantities x.~ 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 Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy B--" ine /l spons le 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 .~t 0 INSPECTION DATE Section 2: Underground Storage Tanks Program Routine [~ombined Type of Tank Type of Monitoring Joint Agency [] Multi-Agency [] Complaint Number of Tanks 6t Type of Piping OO]~ [] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file k.., Permit fees current Certification of Financial Responsibility [./4 Monitoring record adequate and current [., Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: ...Z ~ Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy ~ponsible Party UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page of I. IDENTIFICATION FACILITY ID # I i. BEGINNING DATE (Agency Use Only) I 01/01/02 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3. Arco Facility No. 6218 loo. I ENDING DATE lol. BUSINESS PHONE 1o2. 661-834-1076 BUSINESS SITE ADDRESS 4203 Ming Ave. CITY 1o4. CA Bakersfield DUN & BRADSTREET 106. 09-720-0401 103. ZIP CODE los. 93309 SIC CODE(4digit#) lO?. 5541 COUNTY los. Kern BUSINESS OPERATOR NAME lO9. I BUSINESS OPERATOR PHONE 11o. Prestige Stations Inc. I 661-834-1076 II. BUSINESS OWNER OWNER NAME HI. I OWNER PHONE BP West Coast Products LLC } 714-670-5402 OWNER MAILING ADDRESS 1 ~3. P.O. Box 6038 CITY u4. I STATE us. ZIP CODE Artesia I CA 90702-6038 III. ENVIRONMENTAL CONTACT CONTACT NAME t 17. CONTACT PHONE lis. Carlos Rodriguez 714-670-5402 CONTACT MAILING ADDRESS 1 ~9. P.O. Box 6038 CITY 120. STATE 12~. ZIP CODE 122. Artesia CA 90702-6038 -PR/MARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 12y NAME 128. Sue Tire ARCO MAINTENANCE TITLE 124. TITLE 129, Station Manager MAINTENANCE BUSINESS PHONE 125. BUSINESS PHONE 130. 661-834-1076 (800) 272-6349 24-HOUR PHONE* 126. 24-HOUR PHONE* 131. Same (800) 272-6349 PAGER # 127. PAGER # 132. N/A N/A ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF OWNER/OPERATOR OR DESIGNATED REPRESENTATIVE DATE 134. NAME OF DOCUMENT PREPARER 135. ~,.~/~.~ ~t' ~t>~ae~'b,~.~r. 12/26/01 David Chambers NAME OF SIGNER (print) 136. TITLE OF S1GNER 137. Carlos Rodriguez Environmental Compliance Specialist * See Instructions on next page. UPCF hwf2730 (1/99) - 23/29 http://www.u nidocs.org Rev. 04/17/00 TYPE OF ACTION (Check one item only) U~IFIED PROGRAM CONSOLIDATED FOR~ TANKS UNDERGROUND STORAGE TANKS- FACILITY (One page per site) [] 1. NEW PERMIT Page of [] 3. RENEWAL PERMIT [] 5. CHANGE OF INFORMATION [] 4. AMENDED PERMIT (Specify change) Name Change [] 6. TEMPORARY SITE CLOSURE [] 7. PERMANENTLY CLOSED SITE [] 8. TANK REMOVED 400. BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3. I FACILITY Arco Facility No. 6218 ] ID# NEAREST CROSS STREET Stine/Ming Ave. FACILITY/SITE INFORMATION 401. FACILITY OWNER TYPE [] 4. LOCAL AGENCY/DISTRICT* 402. [] 1. CORPORATION [] 5, COUNTY AGENCY* 403. [] 2. INDIVIDUAL [] 6, STATE AGENCY* [] 3. PARTNERSHIP [] 7, FEDERAL AGENCY* BUS1NESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCIAL TYPE [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER TOTAL NUMBER OF TANKS 404. I Is facility on Indian Reservation REMAINING AT SITE [ or trust lands? 4 [] Yes []No 405. * If owner of UST is a public agency: name of supervisor of division, section or office which operates the UST. (This is the contact person for the tank records.) 406. II. PROPERTY OWNER INFORMATION PROPERTY OWNER NAME 407. } PHONE 408. BP West Coast Products LLC I 714-670-5402 MAILING OR STREET ADDRESS 409. P.O. Box 6038 CITY 410. [ STATE ] ZIP CODE Artesia CA 90702-6038 412. PROPERTY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 413. [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY HI. TANK OWNER INFORMATION TANK OWNER NAME 414. PHONE 415. BP West Coast Products LLC 714-670-5402 MAILING OR STREET ADDRESS 416. P.O. Box 6038 CITY 417. ISTATE 418. IZIP CODE 419. Artesia ] CA I 90702-6038 TANK OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY/DISTRICT [] 6. STATE AGENCY 42o. [] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY (TK) HQ 44- I I I I I I' ' '1 Call (916) 322-9669 if questions arise V. PETROLEUM UST FINANCIAL RESPONSIBILITY 421. INDICATE METHOD(s) [] 1. SELF-INSURED [] 4. SURETY BOND [] 7. STATE FUND [] 10. LOCAL GOV'T MECHANISM 422. [] 2. GUARANTEE [] 5. LETTER OF CREDIT [] 8. STATE FUND & CFO LETTER [] 99. OTHER: [] 3. INSURANCE [] 6. EXEMPTION [] 9. STATE FUND & CD VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank owner unless box I or 2 is checked. [] 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK OWNER 423. VII. APPLICANT SIGNATURE Certification: I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNATURE OF APPLICANT DATE 424. [ PHONE 425. ff___~.~.., :.~ d>~'~-~,._ 12/26/01 I 714-670-5402 426. 427. NAME OF APPLICANT (print) Carlos Rodriguez STATE UST FACILITY NUMBER (Agency use only) (See Data Element 1, above. 428. TITLE OF APPLICANT Environmental Compliance Specialist 1998 UPGRADE CERTIFICATE NUMBER (Agency use only) 429. UPCF hwf2730 (1/99) - 24/29 http://www.unidocs.org Rev. 04/17/00 01-ARE-003: Bakersfield Site List 12/27/01 00371 12698 MT VERNON COLUMBUS/MT VERNON BAKERSFIELD CA " 193306 00583 !3220 MING AVE WIBLE RD/MING AVENUE BAKERSFIELD CA 93304 01960 11701 BRUNDAGE LANE "H" ST/BRUNDAGE BAKERSFIELD CA 93304 03054 11129 UNION AVE CALIFORNIA/UNION AVE BAKERSFIELD CA 93307 03090 3333 UNION AVE 34TH/UNION BAKERSFIELD CA 93305 05365 4010 WIBLE RD wHITE LANE/WIBLE RD BAKERSFIELD CA 93309 05420 6450 WHITE LANE ASHE/WHITE LANE BAKERSFIELD CA 93309 05496 4800 FAIRFAX AUBURN/FAIRFAX BAKERSFIELD CA 93306 -- 0-5526 900 MON-T~REY BEALE/MONTEREY BAKERSFIELD CA 93305 05751 2800 PANAMA LANE DENNEN/PANAMA BAKERSFIELD I C~ 93313 06218 ~3-MING-A~TE ..... ~ STINK/MING AVE BAKERSFIELD CA 93309 06353 3125 CALIFORNIAAVENU'CALIFORNNOAK BAKERSFIELD CA 93302 06356 2301 F STREET 24'~H/~: BAKERSFIELD CA 93301 Page 1 CERTIFICATE OF INSURANCE Name & Address: Policy Number: Period of Coverage: Name of Insurer: Address of Insurer: Name of Insured: Address of Insured: See Attachment 7.A and 8.A for names and addresses of each covered UST location. Contact facility representative or Jeff Hall at MJLRSH (312-627-6000) for copies of all UST waste facility liability endorsement policy/ numbers. January 2002 through January 1, 2003 Insurance Company of North America 195 Broadway, New York, NY 10007 BP America Inc. 200 E. Randolph Drive, Chicago, IL '60601 Certification: Insurance Company of North America, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tank(s): (see Attachments 7.A and 8.A) for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases arising from operating the underground storage tank(s) identified above. The limits of liability are $ 1,000,000 per occurrence and annual aggregate $ 2,000,000, exclusive of legal costs, which are subject to a separate limit under the policy. This coverage is provided under (policy number). The effective date of said policy is January 1, 2002. The Insurer further certifies the following with respect to the insurance described in Paragraph 1: so bo co Bankruptcy or insolvency of the insured shall not relieve the Insurance Company of North America of its obligations under the policy to which this certificate applies. The Insurer is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or a damaged thirdparty, with a right of reimbursement by the insured for any such payment made by the Insurer. This provision does not apply with respect to that amount of any deductible for which coverage is demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95280.102. Whenever requested by (a Director of an implementing agency), the Insurer agrees to furnish to (the Director) a signed duplicate original of the policy and all endorsements. do Cancellation or any other termination of the insurance by the Insurer, except for nonpayment of premium or misrepresentation by the insured, will be effective only upon written notice and only after the expiration of 60 days after a copy of such written notice is received by the insured. Cancellation for nonpayment of premium or misrepresentation by the insured will be effective only upon written notice and only after expiration of a minimum of 10 days after a copy of such written notice is received by the insured. .~ The insurance covers claims otherwise covered by the policy that are reported to the Insurer within six months of the effective date of cancellation or nonrenewal of the policy except where the new or renewed policy has the same retroactive date earlier than that of the prior policy, and which arise out of any covered occurrence that commenced after the policy retroactive date, if applicable, and prior to such policy renewal or termination date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. I hereby certify that the wording of this instrumen~ is identical to the wordin9 in 40 CFR 280.97(b) (2) and that the Insurer is licensed to transact the business of insurance in one or more states. Authorized Representative of Insurer December 21, 2001 195 Broadway, New York, NY 10007 Address of Representative Obp Attachment 8.A Financial Assurance for Corrective Action and Third Party Compensation for Underground and Aboveground Storage Tanks Owned, Operated or Guarantbed by BP Amoco Corporation or Subsidiaries Regulated by State Administered Programs Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: BP Amoco Chemical Company Chocolate Bayou Storehouse Alvin, TX 2,600 gallons FRP Diesel Fuel 1982 BP Amoco Chemical Company Chocolate Bayou Administration Alvin, TX 2,000 gallons Steel Emergency Diesel Fuel 1982 BP Amoco Corporation Naperville Site Naperville, IL (see tank listing at office) Amoco Production Company 4502 E. 41st. St. Tulsa, OK 40,609 gallons Diesel Fuel Amoco Production Company Tulsa, OK 10,000 gallons Diesel Fuel 1991 Am~co Production Company 7575 N. Lakewood Tulsa, OK 3,000 gallons Diesel Fuel Amoco Production Company, Westlake I 501 Westlake Park Blvd. Houston, TX 10,000 gallons Fiberglass Diesel Fuel 1982 Page 17 2001 Financial Assurance 12/26/Ol BP Amoco Chemical Company Chocolate Bayou Storehouse Alvin, TX 4,000 gallons FRP Gasoline 1969 BP Oil Company Toledo Refinery Oregon, OH 10,000 gallons Fiberglass 1990 Amoco Production Company 4502 E. 41st. St. Tulsa, OK 40,609 gallons Diesel Fuel Amoco Production Company 4502 E. 41st. St. Tulsa, OK 500 gallons Waste Oil and Oily Water Amoco Production Company Earth Science Lab 11611 West Little York Houston, TX 4,000 gallons Fiberglass Diesel Fuel 1984 **Shirley Tse, FIARSH, maintains copies of ALL UST facility liability endors~entpolicies. 312-627-6247'* Attachment 8.A (continued...) Financial Assurance for Corrective Action and Third Party Compensation for Underground and Aboveground Storage Tanks Owned, Operated or Guaranteed by BP Amoco Corporation or Subsidiaries Regulated by State Administered Programs Location: Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: Location:. Capacity: Construction Material: Substance Stored: Installation Date: Location: Capacity: Construction Material: Substance Stored: Installation Date: California, Nevada, Washington, Arizona, Utah and Oregon UST facilities (see tank listing at regional office) BP Exploration (Alaska) Inc. Anchorage, Alaska 15,000 gallons Fiberglass 1984 BP Chemicals Green Lake Facility Port Lavaca, TX 7,600 gallons Fiberglass reinforced plastic Unleaded Gasoline 1981 BP ;~noco Chemical Company Joliet Truck Terminal Joliet, IL 10,000 gallon Fiberglass Diesel Fuel 1993 BP Exploration (Alaska) Inc. Anchorage, Alaska 4,000 gallons Fiberglass 1984 Amoco Pipeline Bryan, Texas (see regional office for tank listing) BP Chemicals Green Lake Facility Port Lavaca, TX 7,600 gallons Fiberglass reinforced plastic Diesel Fuel 1981 **Shirley Tse, MAR~H, maintains copies of ALL UST facility liability endorsement ~oliciea. $12-627-6247'* Page 18 2001 Financial Assurance 12/28/01 Name: Address: Policy Number: Period of Coverage: Insurer: Address: Name of Insured: Address of Insured: Endorsement Number 4 Underground Tank Endorsement Per list attached Claims Made PLIG 20308175 1/1/2002- 1/1/2003 INA Surplus Insurance Company 1601 Chestnut Street Philadelphia, PA 19101-1484 BP America Inc. Mail Code 2304 200 East Randolph Drive Chicago~ Illinois 60601-7125 This endorsement certifies that the policy to which the endorsement is attached provides liability insurance coverage for the following underground storage tanks in: Per list attached for taking corrective action and/or compensating third parties for bodily injury and property damage caused by either sudden accidental releases or non-sudden accidental releases or accidental releases. The limits of liability are $1~000~000 each occurrence $2,000,000. annual aggregate exclusive of legal defense costs This coverage is provided under policy number Glaims Made PLIG 20308175 The effective date of said policy is January 1~ 2002 The insurance afforded with respect to such occurrences is subject to all of the terms and conditions of the policy, provided however, that any provisions inconsistent with subsections (a) through (e) of this Paragraph 2 are hereby amended to conform with subsections (a) through (e). bo de Bankruptcy or insolvency of the insured shall not relieve INA Surplus Insurance Company of its obligations under the policy to which this Endorsement is attached. INA Surplus Insurance Company is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or a damaged,third-party with a right of reimbursement by the insured for any such payment made by INA Surplus Insurance Company. This provision does not apply with respect to that amount of any deductible for which coverage is demonstrated under another ~ .. mechanism or combination of mechanisms as specified in 40 CFR 280.95-280-102. Whenever requested by a director of an implementing agency, INA Surplus Insurance Company agrees to furnish to the Director a signed duplicate original of the policy and all endorsements. Cancellation or any other termination of the insurance by INA Surplus Insurance Company will be effective only upon written notice and only after the expiration of 60 days after a copy of such written notice is received by the insured. The insurance covers 'claims for any occurrence that commenced during the term of the policy that is discovered and reported to INA Surplus Insurance Company within six months of the effective date of the cancellation or termination of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40GFR 280.97Co) (1) and that INA Surplus Insurance Company is licensed to transact the business of insurance or eligible to provide insurance as an excess or surplus lines insurer in one or more states. rRbbin'R. Soss Assistant Vice President AGE Excess & Surplus Insurance Services, Inc. 1601 Chestnut Street Philadelphia, PA 19101-1484 ' 'ARCO Products Company :or Certification Inspection This letter certifies that the monitor(s) is/are in place, the probes are in correct position and the system is operating properly, g- ?- o / Station # &,3/8'_ _,--. _ Date 19 Address .-~'/"/'~"5'~ ~ 6- //57 v'~: Type Inspection: /3 r~ ,r:~--rz4'r*-,o-t'<> Annual t.-"'"'~ Permit Recheck Leak Type & Model of Monitor System Function Tanks Annular Space Pass Fail N/A Regular -~'""'" Midgrade Supreme Waste Oil Other Z""~ Product Lines Turbine Sump In-Line Pass Fail N/A Pass Fail N/A Regular "'/"'" /'"/ Midgrade z,-"' Supreme Waste Oil Other Pass In Tank Fail N/A Fill Sump Pass Fail N/A z.-"' When monitor is turned off or in alarm, is there positive shutdown of turbines? If No, were precision product line tests performed? Yes~ No Monitor Panel . Is the monitor panel mounted and labeled correctly? / Does monitor alarm horn function properly? Is panel accessible and visible to station personnel? Yes /.---'" No . Replaced all failed probes? Yes No If No, probes to be replaced/repaired by (Date) _~('7-e- e-~ '-' /P,>t'''° ~' tq4 O, ~/'3e'-b.~-~a- N/A ~ / / Inspected By: APC-3324 (8~96) Contractor Technician Signature n~rARCO Products Company Mechanical Leak Detector Test Data Sheet Station # ~ Z~ g~ Date Address ~3 * r' ,~//,/~ .~'e- ~" /~-~c<"~-Z.D 19 Test Information Product Manufacturer Model Full Operating Pressure (psi) Line Bleed Back (ml) Trip Time (sec) Metering Pressure (psi) F/E Holding Pressure (psi) Test Leak Rate (rnl/min) (gph) PASS or FAIL Replaced All Failed Leak Detectors Yes If No, Replacement To Be Completed By (Date) No_ N/A / / This letter certifies that the annual leak detector tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge true and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold trip rate of 3 gph at 10 PSI. Contractor Technician Signature Inspected By: Lic# APC-3325 (8/96) B D May 3, 2001 AM/PM Mini Market #535 4203 Ming Avenue Bakersfield, CA 93309 Dear Business Owner: 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 Enclosed, please find the Site and Facility Diagram Instructions packet. When your Hazardous Materials Management Plan and Inventory were submitted it was lacking the diagram portion. Please draw and submit the diagram(s) of your facility by June 8, 2001. The diagram should include the following: 1) 2) 3) 4) 5) 6) 7) 8) 9) name of your business; business address; indicate which direction is North; the cross streets neighboring business addresses (within 300 feet) entrances and exits location of utility shut-offs; location of the nearest fire hydrant; portions of the building protected by automatic sprinkler system; and most importantly the location of the hazardous material(s). If you have any questions, please feel free to call me at (661) 326-3658. Thank you for your assistance. Sincerely, RALPH E. HUEY, DIRECTOR OFFICE OF ENVIRONMENTAL SERVICES Esther Duran, Accounting Clerk II Office of Environmental Services ED\db Enclosures q )RRECTION NO CE BAKERSFIELD FIRE DEPARTMENT N° 1085 Location )4 lye9 3~{~t ~OR& Sub Div, q3(93 ~t~. & Sik. ,. Lot, You are hereby required to make the following corrections at the above location: Cot. n~-.~etion_Date for ~°;reCtL~.~ /~J//c~.ff./~ ./ /1 Inspector 326-3979 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME bt'~o ADDRESS q203 FACILITY CONTACT INSPECTION TIME INSPECTION DATE PHONE NO. ~.3q'/0 BUSINESS IONO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program [~l Routine [~l'Combined [~ Joint Agency [~ Multi-Agency ~l Complaint [~ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address Correct occupancy L, / Verification of inventory materials [j / 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=C°mpliance V=Vi°lati°n ~ ~~ c~~. _~'ff__ Any hazardous waste on site?: [~l Yes [~l No Explain: this inspection? Please call us at (661) 326-3979 Bu~j less S~e~esp0nsibl~ pa~y Ques6ons reg~ding White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector:_ ~,-/// -- [~~ __ 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 [~ombined Type of Tank Type of Monitoring [] Joint Agency [] Multi-Agency [] Complaint Number of Tanks 6/ ~t,.IM Type of Piping ~ [] Re-inspection OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit fees current Certification of Financial Responsibility 1,/" 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 T se of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: _& ~t/~ff~'") Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy Businefls Site Responsible Pa ty ~~ARCO Products Company tor Certification Inspection letter certifies that the monitor(s) is/are in place, the probes are in correct position and the system is Operating properly. Station # Address ~/~ 0 / Date ~- ~' o / 19 Type Inspection: Annual t/ Permit Recheck Leak In Tank Fail N/A Type & Model of Monitor System Function Tanks Regular Midgrade Supreme Waste Oil Other Fill Sump Pass Fail /....-- Annular Space Pass Fail N/A Product Lines Turbine Sump In-Line Pass Fail N/A Pass Fail N/A Regular Midgrade Supreme , ~,Vaste Oil ~Dther / "~ Pass When monitor is turned off or in alarm, is there positive shutdown of turbines? If No, were precision product line tests performed? Yes ~ No~ Monitor Panel Is the monitor panel mounted and labeled correctly? Does monitor alarm horn function properly? Is panel accessible and visible to station personnel? N/A z,/No ~ Replace~d all failed probes? Yes -- No~ N/A ~ If No, probes to be replaced/repaired by (Date) ._Ct'7'e e~,.,tp,>t-~ t~t tq-4 OtS/-~e'%ic'~a Inspected By: APC-3324 (8/96) Contractor Technician Signature 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. Bakersl'ield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 AM/PM 4203 Ming Ave Bakersfield Ca 93309 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 furore 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 3 l, 2003, which is the deadline for compliance, this office will be forced to revoke your pernfit 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. Sincerely, Steve Underwood, Inspector Office of Environmental Services SBU/dm 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 [~ombined [] Joint Agency Type of Tank ~ Type of Monitoring [] Multi-Agency z./[] Complaint Number of Tanks Type of Piping 430./~ [] Re-inspection OPERATION C V COMMENTS Proper tank data on file / Proper owner/operator data on file Permit tees current Certification of Financial Responsibility [/t Monitoring record adequate and current Maintenance records adequate and current L~ Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S). AGGREGATE CAPACITY Type of Tank Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector: _~~~ Office of Environmental Services (805) 326-3979 White - Env. Svcs. Pink - Business Copy ,8~usiness 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 ~'~ ADDRESS t'/c~0 3 FACILITY CONTACT INSPECTION TIME INSPECTION DATE PHONE NO. BUSINESS ID NO. IS-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 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: [~l Yes [] No Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs. Yellow - Station Copy Pink - Business Copy si~es~ Si~e ResP~O2ble Party Inspector: :.~ d~'a~ TYPE OF ACTION I ChecR one ~tem only) [] 1. NEW SITE PERMIT !~_~F CITY OF BAKERSF~'ELD ICE OF ENVIRONMENT~ 171:5 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY [] 3, RENEWAL PERMIT [] 4. AMENDED PERMIT [] 5. CHANGE OF INFORMATION ($pectly cltange. local use on/y) [] 8. TEMPORARY SITE CLOSURE Pa~e ~ of [] 7. PERMANENTLY CLOSED SITE [] 8. TANK REMOVED I. FACILITY / SITE INFORMATION BUSINESS NAME_(Same as FACILITY NAME ~ OBA- Deing 8uaness As) 3 N~REST ~ROSS STREET J ~1. ~. ~S STATION ~ 3. FARM ~ 5. ~MMERC~L BUSINESS ~PE ~ 2. DISTRIBUTOR ~ 4. PROCESSOR ~ 8. O~ER ~3. FACILITY FACILITY OWNER TYPE 2 ' CORPORATION · INDIVIDUAL [] 3. PARTNERSHIP [] 4. LOCAL AGENCY/DISTRICT' [] 5. COUNTY AGENCY' [] 6. STATE AGENCY' [] 7. FEDERAL AGENCY' 402. TOTAL NUMBER OF TANKS REMAINING AT SlTE~ 404. Is fac~lRy o~ Indian OY- ~ MAILING OR STREET ADDRESS 'If ow~er of UST a public a~ancy: name of suPet~so- of di~, section pt office wflic~ poetries ~e UST. (This is the c~tact per~ f~' ~e ~a~k rm.) II. PROPERTY OWNER INFORMATION [] 2. INDIVIDUAL [] 3. PARTNERSHIP [] 4. LOCAL AGENCY / DISTRICT [] s. COUNTY AGENCY 411. I ZI,~C~OOE [] e. STATE AGENCY [] 7. FEDERAL AG~ 412. 413. IlL TANK OWNER INFORMATION MAILING OR STREET AD(~RES~), O ' ///,~::L-l~ CO RPO RATIO N [] 2. INDMDUAL [] 3. PARTNERSHIP 415. 416. [] 4. LOCAL AGENCY / DISTRICT [] ,5. COUNTY AGENCY [] 6. STATE AGENCY [] 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION U~T STORAGE FEE ACCOUNT NUMBER TY(TK)HQ 4 14 Call(g16)322-96691fquestlonsarlse 421. V. PETROLEUM U~T FINANCIAL RESPONSIBILITY ' ' INDICATE METHOD(S) ~?. ~LF-INSURED ARN~rEE [] 3. INSURANCE [] 4. SURETY 8OND [] $. I.J::IIEROF CREDIT [] 6. ;XEM;mON [] 7. STATE FUND [] 8. STATEFUND&CFO LETTER [] 9. STATE FUND & CD [] 10. LOC,~ GOV"r [] 99. OTHER: VI. LEGAL NOTIFICATION AND MAILING ADDRESS C~e<:~ Me box to im~lcate whtc~ ~ ~d ~ ~ f~ I~ n$fl~ ~ m~flng. ~ 1. FACIL~ 0 2. ~O~R~ O~ER ~NK O~ER 4~. L~ ~fl~a ~d m~ ~ ~ ~t to ~ ~k ~ un~ ~ 1 ~ 2 ~ ~. VII. APPLICANT SIGNATURE , Ce~iflcallon: I certify m~ I~e Inf~,~:~)l]o~ provided h~n ts ~e and ~rate to me ~t ~ my ~ge. ~ 425. ~ME OF A~i~ (p~t) /// v ~ / 426. ] TITLE OF A~I~ ~ ~ 4~. ~TATE U~T ;ACILI~ NU~ER (~r ~ uM o~) 428. 1~ U~DE CERTIFI~TE NU~R (For ~al use ~) 4~. UPCF (7/99) S:\CUPAFORMS~swrcb-a.wpd 1715 ~e~ler A~e., Baker~flel~ CA 93~(6~1) 3~ 3979 -'~ '~' UNDERGROUND STOOGE TANKS - T~K PAaE ~ L TANK DE~:~ntON ?~u~ ~ TY~E ~ TAM( 0 4. ~IIGI,,EWALLINAVA~A.'r 0~. uwNOWN O~. ~~ O L F/~COMPA'n~Evm(X)~),~ETtW, K~ O~6. UNKNOWN ~'~NK WTE~O~ U~N~ O t. MUeIe~LIED O Z EIK~XYLNN~ I'i ~. (XM~ UI~ ,~. UNmOWN Me O z )um)~ O ~. wu)M~ 0 L tNJNED OT~A 0 v. O~ UPCF (7~) S:~CUPAFORM~qv~CB-~.WPC 0 2. HONTHLY0.2(~HTE~r , CONV~ ~ ~ [] S. OAfl.yvt~U,~L.~C~PUMI~N~SY~TEM~,TI~EI~IL~.~~ TEST (0.1 (3PH) ~I~N~ERCONTAINMENT r"l 1. IX, OWNER/OPERATOR ~IGNATURE TrrI.E OF/C~NER,~.RATOR 474 i Fi'~G~'~'~le(iror~'~uMWl~ 475 UPCF (7/1g) ,S:~CUPAFORM,.~I~WAC~,~ C '~~. qM'ICE OF ENVIRONMENTAi~:R¥1CE$ 1715 C'll~ster Ave., Bakersfield, CA 933~[~(661) 326-3979 UNOERGROUND STORAGE TANKS - T~K PAGE 03. ~~ (~-~~7 (~~-~ ~) TANK IL TA#X CON~NUGTmN 441 0 & AWAnON ~ ISIS. 0~, Os. [] ~. SI4GLEW, M,LWITH~BLADOERSYSTEM ~e. OT)EA ~ COM~AT~E m~ 00~ s~W~. Om. OT~E~ I~TE 14'r, ldJ,ZO My TAM( T~ITI40 VI~JAL (8INGLE WALL IN VAUI.? ONLY) CONTINUOU~ INTERSTITIAl. MOMTORJNG ") 3. MANUAL MOI4TOItlNCi TANK CLQSURE MFONMATION I IIIRJ CLOeURI IN PLAC~ TAM( FU.~D WtTH M,RT M~TIJIIAL? UPCF (7/9g) ~:~CUP~J~OI~I~C~'v~c (,,...,,~ SYSTEM TYP[ '-~. p~F__~ ~] 2. ~uCTION TANK 0 ,. P~ESSU~E 0 2. SuCTCN 0 3. O~VTTY ~J 0. FRPCOMPATI~EW/1O01b I~)~O4. CONSTRUCT)O' ,1""1 ~. ~NGLEWAU. I"'"1 3. I. JNEDTAL"W:~ 1-19e. OTHER 4t0 I ~ '.~* ~FACTURER .... 4~1 :~.w.s,~o:O 2. STX~LESSSTEB. 0 7. CW.v,w~Z~DS?E~. CORROSION UNDERG/K)UND PIPING ii~GLE WALL ~ P~ESSURb?.EC)/~NG (Check M l'-I 1. ELECT/K)McUNELEA~DETEcTO~3'OQI~HTE~TWIT~'4L/TOPUIAP~)I'n'(34~FO~ I--I 3. A/MUAL~TE,IT~].I(31~ CONVENTIONAL SUCTK)N SYS'TEka: ~1 S. DAII-YVI~UALMONITOI~NOOFPUI4F/IOsYS'TEM*TRIBIIALFI=/4OINTEORITY TEST (0.1 ill e. mENNk~T-cST(0.'~ (Sl~) lo. C, ONT1MJO~ TU~NE SUI~ MN~R WITH AUO~E AND VISUM. ALMM8 A/O ((::~c~ ~N 13. 14. ~M~~~ ~e. ~ ~ ~(o.t 17. ~LY ~ ~E~ ,:'...".. O~J,,I~.RCONT)UI, IAENT 0 1. RU2AT~THAT~HUT~(:X~M'IE~VALVE OATE INSTALLED ,me C] 2. CONTWUOUI~I~NMNI(~I*AUI:~"___~ANDVmU~-ALAmMS 0 & TAINOHUN~A/MONn'O~/IO '~. CONTi~._~M~i_~_ ~;.~.~%.~_../~.NMi~0RwrrHAuTO MiUTOFF FOR01SPENSE~.)~JOIOLE)~DVI~U..M.~ 0 & NONE ,MO IX, OWNER/OPERATG~ $1(3NATURE i c~fy mm me ~nn~ ~mv~d W i ru~ Ind IccuIM tO N ~4M al mY kmwil~ge. UPCF (7/9~) rr~ OF o~To~,. S:~CUPAFORIVlS~WRC~B.WPI~ ;~~ ~CE OF ENVIRONMENTA~RVICES 171~ Glrester Ave., Bakersflel~ CA 9~(661) 326-3979 UNDERGROUND STOOGE TANKS - T~K PAGE J UOC..ATK~N WIT)~I ~rl M / I-I ~. ow4M OF U~FO~aAnON) O e. raM~J~V ~rE [] ?, PEmMNTt. Y C&OMO ON (.1~ch~.~M~e~my) C:] 8. TAM(~AOV~O TANK 0~. o~ I'ANK INTEI~O~ LJNIN~ EXTW IW UI~ · ~ F~BEI~31..~3,11PLA3nC 0~. O~NO~ 0 s. co~m~ O~.w Om. OTHER IF I~UI WALL TM( ON TANK ~nX ~(C~(~eM~ ---I 4~ TANK FlU.~ WITHIN~ MATIM.? UPCF (7/90) crTY OF BAKERSFIELD '-~~~ OFFICE OF ENVIRONMENTAL Cheerer Ave., eaki~lfleld, CA ~3301 (~1) 33~T1 TY~~ES.qURE I'1 2. ~ ri t. P~ESSU~E r'l ~. S~NGLE WALL Ltl ?,OOUm. E WAU. M~UFACTURER C] z ST)UN~ESS C] 3. PLASTCCOMPATmLE~ATHCONTENTS C] S. STEEL W/ COAT~NG VI. PlqNG LEAK DETECTION , f'J s. DALY'A~UALMC)Nm3~NGOFIRJIA=IN~SYITEM*T/IM4ALFIFI4OI(IC-(I~'TY TEST (0.! GPH) 0 g. BF. NN~KVTEO~TEST(0.10PH) lO. COm~NUOUS TURSINE SUi4) W WITH AUO~LE AND VtSUN. ALId~S AND ((:;~c~ r"l & AUTO PUMPSI~rroiq=WALEAK _OCC~__.m~ DI~I:~.N~.RCONTA/NMENT 0 I. tq.,OAT~THATI'IUT~OJ~I4P. A.RVALV~ !0 4. CONVEHTION~ SUCTION SYSTEiM (CAKk M Mt apply). 0 s. CWLYV~W. MOMTOR~OFPI'WOAJO~SYSTEM I-I e. TR~.NN~WTC-O~YTEST(0.10PH) SAFE SUG'nON S"vIT'cI~ (NO VALVES IN BELOW GROUNO PFING): 0 14. CONTINIJOU~JMP~N~O~MTHOUTAUTOPUMP~NUTO~Rr*AIJOIL~ANDVI~UAL ALARMS C] 15. AUTOW, TCUNE~AXOETECrOA~.OOPHTES'r) ~,, OWNER/OPERA?OR SlON~TURE 474 I PennllE.Wmlml31m(FotJo4MuM(m)Y) 472 475 ' UPCF (7/9g) $:~CUPAFORM~8~.tMK:~ / ~ (~CE OF ENVIRONMENTA~:RVICES 1715 clrester Ave., Bakersfield, CA 933gT(661) 326-3979 DATE IN~T~ ~ ~ ( ~ L TANK DESClILI~ION TANK u,.UjjF,, .~ I0 0o0 ?Nd(USe 430 I TANK CONTENTI '"=, N;,12LM T~ 4 ~: IUN2~MD 0 z ~E~e. I. TANK C~I~IlUGTION I rc/~,,,,,M(,,vy) 0 z ~AN.F. MS'nSL 0 & FRPCOidaAI'I.EIM't00%I~'THANOL 0 1~ CO~TED bi-.-, ,M 0 t ~AS~q.(IXPOIDPq3NTIONOI~LY) f-I 2. AUTOM~TJGTANK~qUOINO(ATO) C] a, CONTUqUGUOAM f-i 4, ST~T~STIC~ Idw~rroNy Iq~:~NCIUA~ (Siq) * I'1 & MMUnL?N4(GAU~NG(MTG) C] L I:]w r'! 1. ~ISU~(~W~LEW)JJ. IN V~II.I' ONLY) ~ CONTINU04~ INTEA~ MONiTOAING 0 3. MANU~.MONrrOm~O 4~7 UPCF (7/90) S:~CU PAFORM~q'6'RC~'~.WPC Ci'-lY OF 8AKER~F!F-L-n ' OFFICE OF ENVIRONMENTAL Clleller Ave.. lakmtfleld. CA ~330t {~t) Ci ,. mESSu~E C] 2. ~ O 3. ~vwY ~ 2. ooue~wA~ ~. OT~.~ {~ ~, ~ ~ a. FRPCOMPATI~EW/100101~NANOL 0 2. ST~TEEL 0 T. ~v~~ I-] 3. ~COM)A~W~H~S 0 & F~.EX~LE()O=E) Ow. o~ I-I 4. F~KRr.,U~t ri ~. ~T)~OOC ~:)TEClY)N ~ 5. C~Lyvt~UALMO~iTOI~O~PUMPI~SYSTEM*~PI=I~WTEO~ITY TE~ (0.1 GPN) ~'~ S~IX3N S'T~, UdS (NO VALV~ IN eELOW ~ PlPI~ r"l ?. SELF MOMTOeM~ MCONOANLY C(NITNNED W PT~SSURI2~DFI~I~(Che~MMNNMy): ((:2w~ oM) I--I ~ .aUTO PUkF $HU'r OFFWHENA LEAKOCC:UR$ 13. BIB~ENCY OENENATOI~ ONLY (C/w~ II M IA,~ 14. C] 3. ,V4NU)L~TE~(OJ ~ O 4. 0~I.YV~U~C~ECX I'1 s. 0 · ~ e. mO~aALe~TC~WTYTEST(0.1 ~ ~Y ~ ~ [] c NOAUTO PUl4'S~UTOf~ ~ ~2. ANNUAL~TEST(0J BiB~ENGY GEIMIATONI ONLY (Ch~ M M N~) C] ~4. IX. OWNFJ~OPERATO~ $1ONATURE UPCF (7/99) 4TI S:~CUPAFORMS~~.~c CITY OF BAKERSFIELD C~:ICE OF ENVlRONMENTAIL~VICES ~ . 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE BUSINESS NAME (Same as FACILITY NAME et O~A - Doing ~uiJnel4 Aa) I. FACILITY IDENTIFICATION One form per tank II. INSTALLATION Ct~ck all t~at al~ * The Installer has been certified by the tank and piping manufacturers. The installation has been inspec*~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 conb'actor 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. IlL TANK OWNER/AGENT SIGNATURE · CITY OF BAKERSFIELD C~ICE OF ENVIRONMENTAIL.~VICES 17-15 Chester Ave., Bakemfleld,-CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS · INSTALLATION CERTIFICATE OF COMPLIANCE - I. FACILITY IDENTIFICATION One form per tank BUSINESS FACILITY ID II. INSTALLATION Check all ~at apply · The Installer has been cerlflted by the tank and piping manufacturers. The installation has been inspec~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 CITY OF BAKERSFIELD ~ ~.~,~. q~ICE OF ENVIRONMENTAI..~IRVICES 17-15 Chester Ave., BakersfleldFCA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - INSTALLATION CERTIFICATE OF COMPLIANCE I. FACILITY IDENTIFICATION 8USINI=S~ NAME (S~nl II FAClU'I'Y NAME One form per tank Page -- of ~1 II. INSTALLATION Check dl ~at al~ * 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 Tn'LE~O~TANK CITY OF BAKERSFIELD ,~ ''~. C~:ICE OF ENVIRONMENTAI.~VICES ~ , . r tT'I5 ChesterCERTiFiCATE(661)Ave., 326-3979Bakersfield-CA= COMPLIANCE93301 UNDERGROUND STORAGE TANKS-INSTALLATION Or , One form per tank - I. FACILITY IDENTIFICATION IIUSINES~ NAME (Same as FAC.,I~qY WE M D~A - O(W~ euaJr4M Aa~~_____~ /~ .~/.~ II. INSTALLATION CMtck all t~at apply * The Installer has been certified by the tank and piping manufacturers. The installation has been inspec~,~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. III. TANK OWNER/AGENT SIGNATURE D r April 4, 2000 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICE8 2101 'H' Street Bakersfield, CA VOICE (805) 326-3941 FAX (805) 395-134g SUPPRESSION SF. RVICF..8 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 PflEVEN11ON SERVICE8 1715 Chester Ave. Bake~fleld, CA 93301 VOICE (805) 326-3951 FAX (8O5) 326-O576 ENVIRONMENTAL 8EIb/ICE8 1715 Chester Ave. Bakemfleld, CA 93301 VOICE (805) 326-3979 FAX (8O5) 326-O576 TRAJNING DIV~ION 5642 Vtct~ Ave. Bakersfield, CA 93308 VOICE (805) 3g9-4697 FAX (8O5) 399-5763 Arco Environmental Compliance Best Shaman P O Box 6038 Artemia CA 90702 6038 Dear Compliance Coordinator: You have been identified as the compliance coordinator for the facility/facilities referenced in the attachment. The permits to operate this facility/facilities will expire on June 30, 2000. However, in order for this office to renew your permit, updated forms A, B, & C must be filled out and returned prior to the issuance ora new permit. Please make sure that you are sending the updated forms which are indicated by the date 7/99 in the lower left hand comer. Please complete and return to this office by May 15, 2000. Failure to comply, will result in a delay.of issuance of your new permit to operate. Should you have any questions, please feel free to call me at 661-326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dam attachment Facility AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM AM/PM Address 2301 "F" Street, Bakersfield, Ca 93301 1129 Union Ave, Bakersfield, Ca 93307 3333 Union Ave, Bakersfield, Ca 93305 2698 Mt. Vernon Ave, Bakersfield, Ca 93306 4010 Wible Road, Bakersfield, Ca 93309 6450 White Lane, Bakersfield, Ca 93309 4800 Fairfax Road, Bakersfield, Ca 93312 900 Monterey Street, Bakersfield, Ca 93305 2800 Panama Lane, Bakersfield, Ca 93313 1701 Brundage Lane, Bakersfield, Ca 93304 3125 California, Bakersfield Ca 93304 Arco Individual Contacts AM/PM' AM/PM AM/PM AM/PM 13001 Stockdale HwY, Bakersfield, Ca 93312 4100 California Ave, Bakersfield, Ca 93309 2612 Buck Owens Blvd, Bakersfield, Ca 93308 7851 Rosedale Hwy, Bakersfield Ca 93308 MARK ONLY ONE ITEM STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE ] 1 NEW PERMIT ] 2 INTERIM PERMIT [] 3 RENEWAL PERMIT ~"~5 CHANGE OF INFORMATION [] 7 PERMANENTLY CLOSED. SITE E~ 4 AMENDED PERMIT [] 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) N~REST CROSS STREET PARC~ ~ (OP~ON~) ¢ ~X ~CORPORATION ~ INDIVlDU~ ~ PAR~ERSHIP ~ LOCAL-AGE~Y ~ COU~-AG~CY* ~ STA~-AG~CY' ~ FEDEX-AGENCY* TO INDICA~~ DIS~ICTS * ~ o~er of UST ~ a pubb age~. ~mplete the fol~w~g: ~e ~ s~e~or ~ d~. ~n or office ~ operates the MST ~ ~ ¢'FINDIANI'OFTANKSATSI'I E'P'A' I'D''(optional)I ~PE OF BUSINESS 1 GAS STATION ~ 2 DISTRIBUTOR RESEBVA~ON EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY) - optional IDAY~: ~N.AME (LAST, FIRST) P. HONE # WITH AREA CODE II. PROPEB~ OWNEB INFOBMATION- (MUST BE COMPLETED) III. TANK OWNER INFORMA~ON - (MUST BE COMPLETED) IDAYS: NAME (LAST, FIRST) PHONE # WITH AREA CODE PHONE # WITH AREA CODE i / CITYNAME ~ST~ [ ZlP~ODE ~ I P~NE~WI~AREACOD~ / IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER - Call (91~ 322-9669 ff quesbons anse. V. PETROLEUM U.~T-,FINANCIAL RESPONSIBILITY - (MUST BE COMPLETED) - IDENTIFY THE METHOD(S) USED I ¢' box to ind'~'E~I SELF-INSURED E~ 2 GUARANTEE ~ $ INSURANCE ~ 4 SURETYBOND E] 5 LETTER OF CREDIT l'--I 6 EXEMPTION r--] 7 STATEFUND ~ 8 STATE FUND & CHIEF FINANCIAL OFFICER LETTER r-'-] 9 STATE FUND & CERTiFICATE OF DEPOSIT E~ 10 LOCALGOV"r. MECHANISM [~ 99 O~4ER. VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. THIS FORM HAS BEEN COMPLETED UN~ PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT ITANK ~WNER'S NAME(PRINTED & SIGNATUI~E)'"~ //// --I TANK OWNER'~TITLE I DA~I"'~ MONTI"IfDAY/YEAR L~3CAL AGENCY US{: ONLY / COUNTY # JURISDICTION # FACILITY # F-F-I IIII IIII111 LOCATION CODE o OPTIONAL CENSUS TRACT # - OPTIONAL SUPVISOR - DISTRICT CODE - OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION - FORM B. UNLESS THIS IS A CHANGE OF srrE INFORMATION ONLY. OWNER MUST FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM A (6-95) STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EA,.~ TANK SYSTEM, MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT ~ CHANGE OF INFORMATION ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE DBA OR AC,L,..AMD W. ERE TA.K,S ,.STALLEO; I. TANK DESCRIPTION COMFLETE ALL ~TEUS - SPEC~ ~ U.~.OW~ II, TM ~ CONTENTS ~ A-1 is MARKED, COMPETE ITEM C. ] 7 PERMANENTLY CLOSED ON SITEI ] 8 TANK REMOVED B. MANUFACTURED BY: D. TANK CAP^CI ,N GALLONS: A. MOTOR VEHICLE FUEL 4 OIL B. C. [] la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIAn'ION GAS [] 2 PETROLEUM [] 80 EMPTY [~I PRODUCT [] lb PREMIUM UNLEADED [] 4 GASAHOL [] 7 METHANOL /[~ lc MIDGRADE UNLEADED [] 5 JETFUEL [] 8 M85 [] 3 CHEMICAL PRODUCT [] 95 UNKNOWN [] 2 WASTE 2 LEADED [] 99 0THER (DESCRIBE IN ITEM D. BELOW) D. IF (A. 1)IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. #: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A, TYPE OF ~/~ 1 DOUBLE WALL SYSTEM [] 2 SINGLE WALL B, TANK [] 1 BARE STEEL MATERIAL [] 5 CONCRETE (Primary Tank) [] 9 BRONZE [] 3 SINGLE WALL WITH EXTERIOR LINER [] 4 SINGLE WALL IN A VAULT [] 2 STAINLESS STEEL [~ FIBERGLASS [] 6 POLYVINYL CHLORIDE[~ 7 ALUMINUM [] 10 GALVANIZED STEEL [] 95 UNKNOWN ] 5 INTERNAL BLADDER'SYSTEM [] 95 UNKNOWN ] 99 OTHER ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLE W/FRP ] 99 OTHER C. INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY UNING [] 4 PHENOLIC LINING LINING OR [] 5 GLASS LINING '~ 6 UNLINED [] 95 UNKNOWN [] 99 OTHER COATING is LINING MATERIAL COMPATIBLE~WITH 100% METHANOL? YES__ NO__ D, EXTERIOR ~ 1 POLYETHYLENE WRAP ~'~ 2 COATING [~ 3 VINYL WRAP ~ FIBERGLASS REINFORCED PLASTIC CORROSION ~ ~--~ ~ ~ PROTECTION [_._J 5 CATHODICPROTECT[ON ~L~ 91 NONE ,..t.o. ~__~ 95 UNKNOWN ~ 99 OTHER ' ,I,/,.I,/.o~/~} .................. SPILL CONTAINM~NT~F~STALLED (YEAR) ~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) v/~r~",~4~'~v i:. ~PILI. AInU UV~-HI'ILL, etc. DROP TUBE YES~~'~ NO '~'~R~ER 15LATE YES NO DISPENSER CONTAINMENT YES ~ NO__ IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A tJ I SUCTION A,~2 PRESSURE A U 3 GRAVITY A tJ 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U I SINGLE WALL A~ DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A ~ FIBERGLASS PiPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC~.~i~OTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION r~ 1 MECHANICAL UNE LEAK ~ 2 UNE 'flGHTNESS~ ~3 CONTINUOUS [NTERSTmAL ~ 4 ELECmONIC NEE 5 AUTOt~TIC PUMP ~ I I 0ET~C'~OR [---.-J TES~'ING ~ t~ONITOR[NG I I L~K ~T~CTOR [] SHU'rOOWN L--.J 99 OTHER V. TANK LEAK DETECTION [] i v SUAL CHECK [] MANUAL ,NVENTORY [] VADOZE [], AUTOMATIC TANK [] GROUND WATER [] ANNUAL RECONClUATION MONITORING GAUG,NG MONITORING TESTING .I ~ CONTIINUOUSINTERSTITIAL ~ ~ SI" ~ 9 WEEKLY MANUAL ~ 10 MONTHLY TANK ~ 95 UNKNOWN ~ 99 OTHER ~ MONiTORiNG TANK GAUGING TES~NG VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) I1' ESTIMATED DATE LAST USED (MO/DAY/YR) I2' ESTIMATED QUANTITY OFSUBSTANCE REMAINING-- , GALLONS I3' WAS TANK FILLED wlTHINERT MATERIAL ? YES[] NO[] ] THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY,~/NJI~ TO THE BEST OF MY KNOWLEDG~-~ IS TRUE AND CORRECT LOC O COMP W COUN~ ~ JURISDICTION ~ FAClLI~ ~ TANK 8 PERMIT NUMBER ~ PERMIT APPROVED BY/DATE ~ PERMIT EXPIRATION bATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLIED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT P~N. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGU~TIONS FORM B (6-95) STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORMFOR E~ CH TANK SY STEM. -- /. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT /~ 5 CHANGE OF INFORMATION ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT ~]]] 6 TEMPORARY TANK CLOSURE I. TANK DESCRIPTION COM~LET~ A~L ~TE~S - II, TANK CONTENTS IF,-~ ~S ~A~K~O, CO~PL~ tTE~ C. ] 7 PERMANENTLY CLOSED ON SITEI ] 8 TANK REMOVED / D. TANK OAPAC,TY ,N GALLONS: I0~ 000 ~ [] la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIATION GAS ~ MOTOR VEH,CLE FUEL [], O'L S. C.~'~-~--lb PREMIUM UNLEADED 4 GASAHOL 7 METHANOL PETROLEUM [] 80 EMPTY PRODUCT [] lc MIOGRADE UNLEAOED [] 5 JET FUEL [] 8 M85 [] 3 CHEMICAL PRODUCT [] g5 UNKNOWN WASTE [] 2 LEADED [] g90THER(DESCR1BEINITEMD. BELOW) D. IF (A. 1) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C.A.S. #: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, ANDALLTHATAPPLIESINBOXDANDE A. TYPE OF ~ 1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER [] 2 STAINLESS STEEL [~3 FIBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 10 GALVANIZED STEEL [] 95 UNKNOWN B. TANK [] i BARE STEEL MATERIAL [] 5 CONCRETE (Primary Tank) [] 9 BRONZE ] 4 STEEL CLAD W! FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLE W/FRP ] 99 OTHER C. INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING LINING OR [] 5 GLASS LINING ~ UNLINED [] 95 UNKNOWN [] 99 OTHER COATING is LINING MATERIAL COMPATIBLE/WITH 100% METHANOL? YES__ NO~ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP E~ FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION ~ 91 NONE.,.,,,,,~a ./~' [] 95 UNKNOWN [] 99 OTHER . ,.,il,...' /t ... SPILL CONTAINMENT IN,~I~ALLED E. SPILL AND OVERFILL, etc. DROP TUBE YES _[_~_ NO (YEAR) ~'JJ~;~" '~/ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR)L,//%-~. ~t~"'J - ' ~'RIKER/PLATE YES NO DISPENSER CONTAINMENT Y~S ~ NO__ IV. PIPING INFORMATION C,RCLE A ~F ABOVE GROUND OR U ,P UNDERGROUND, BOTH ~F APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A~,~2 PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER A t~.,~ DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 1 BARES'I'EEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)A(,~ FIBERGLASS PIPE C. MATERIAL AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODICPR~O~TECTION A U 95 UNKNOWN A U 99 OTHER ~ 1 ME~'HANICAL UNE LEAK ~ 2 ENE TIGHTNESS ~r~]'~NTINUOUS>~' INTERSTITIAL [] 4 ELECTRONIC UNE 5 PUMP D. LEAK DETECTION ~ O~T~CTOR ~ TES~NG ~'~ MONITORING LEAK OETECTOR [] AUTOMATIC SH~JTOOWN [] 99 OTHER V, TANK LEAK DETECTION [] I~.~J~AL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUAL TANK { RECONCILIATION MONITORING GAUGING MONITORING TESTING ~,~..~7 CONTINUOUS INTERSTITIAL [] 8 SIR [] g WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER ~ MONITORING TANK GAUGING TESTING VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF,P-.E.~JURY, ~T~ THE BEST OF MY KNOWLEDGE,,.~S TRUE AND CORRECT ITANK OWNER'S NAME ' D T / LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPO~M~ OF THE FOUR N[IMBERS BELOW I COUNTY # JURISDICTION it FACILITY # TANK # STATE I.D.'# PERMIT NUMBER I PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR~.~H TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [~ 5 CHANGE OF INFORMATION ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE I. TANK DESCRIPTION COMbLETE ALL ~TEMS - SPECIFY IF UNKNOWN c. DATE INSTALLED (MObAY. EAR, I I1. TANK CONTENTS ~F A-1 ~S MARKED, COMPLETE ITEM C. ] 7 PERMANENTLY CLOSED ONSITEJ [] 8 TANK REMOVED D. TANK CAPACITY IN GALLONS: A. ~1 MOTOR VEHICLE FUEL [] 4 OIL B. C. ~.)la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIATION GAS b PREMIUM UNLEADED ~ 4 GASAHOL [~ 7 METHANOL [] 2 PETROLEUM [] 80 EMPTY ~[~1 PRODUCT [] lc MIDGRADE UNLEADED [] 5 JET FUEL [] 8 M85 [] 3 CHEMICAL PRODUCT [] 95 UNKNOWN [] 2 WASTE [] 2 LEADED [] 99 OTHER(DESCR1BEINFrEMD. BELOW) D. IF (A. 1)IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C.A.S. #: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPUES IN BOX D AND E A. TYPE OF ~11 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR LINER [] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN SYSTEM [] 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER B. TANK [] 1 BARE STEEL MATERIAL [] 5 CONCRETE (Primary Tank) [] 9 BRONZE [] 2 STAINLESS STEEL [~ 3 FIBERGLASS [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ]. 8 100% METHANOL COMPATIBLE W/FRP ] 99 OTHER C. INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING LINING OR [] $ GLASS LINING ~;)6 UNLINED [] 95 UNKNOWN [] 99 OTHER COATING ,S LINING MATERIAL COMPATIBLE WITH 100°/. METHANOL? YES__ NO__ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~ 4 FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE . [] 95 UNKNOWN [] 99 OTHER *-~ __ E qmH A~n mmDmH .,~ SPILL CONTAINMENT IN.~TALLED (YEAR) ~.~1~)/~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) I,/~,~ J~ ........................ DROP TUBE YES ~,,,~ NO STRIKER PLATE YES NO DISPENSER CONTAINMENT YES ~' NO IV, PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEMTYPE A U 1 SUCTION A~,~.~ PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL AU~2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE(PVC)~U ~ C. MATERIAL AND FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING ~A O-- 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION [] 1 MECHANICAL LiNE LEAK [] 2 UNE TIGI~NESS ! .~ONTINUOUS INTERSTmAL 4 DETECTOR TESTING ~ MONITORING [] ELECTRONICLEAK DETECToRLINE [] 5 AUTOMATICsHuTDOWN PUMP [] 99 OTHER V. TANK LEAK DETECTION [] I VISUAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE [] 4 AUTOMATIC TANK ~--m5 GROUND WATER [] 6 ANNUALTANK RECONCILIATION MONITORING GAUGING MONITORING TESTING ~ CONTINUOUS INTERSTITIAL [] 8 SIR [] 9 WEEKLY MANUAL [] 10 MONTHLY TANK [] 95 UNKNOWN [] 99 OTHER MONITORING TANK GAUGING TESTING V~. TANK CLOSURE INFORMATION (PERMANENT CLOSURE ~N-PLACE) 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF I 3, WAS TANK FILLED WITH YES [] NO SUBSTANCE REMAINING GALLONS INERT MATERIAL ? TH/S FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJUR~.~D TO THE BEST OF MY KNOWLEDf~. IS TRUE AND CORRECT I TANK OWNER'S NAME - (///. --- I(PR'NTEO & SIGNATURE) V~ ~l~J' S J..~%~J~ ~ ~l~'~'-~ ,,LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOS~ O~THE FbUR NUMBERS BELOW COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D # I I I I I I I PERMIT NUMBER I PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95) STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR E~CH TANK SYSTEM. i MARK ONLY [] I NEW PERMIT [] 3 RENEWAL PERMIT [~ 5 CHANGE OF INFORMATION ONE ITEM [] 2 INTERIM PERMIT [] 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE I. TANK DESCRIPTION COMhLETE ALL ~TEMS - SPECIFY ~F UNKNOWN II, TANK CONTENTS ~F A-1 IS MARKED, COMPLETE ITEM C. 2MOTOR VEHICLE FUEL PETROLEUM ] 3 CHEMICAL PRODUCT ] 4 OIL ] 80 EMPTY ] 95 UNKNOWN D. IF (A. 1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED I 7 PERMANENTLY CLOSED ON SITE~ I 8 TANK REMOVED D. TANK CAPAC,TY ,N GALLONS: ~ PRODUCT ] 2 WASTE ]~la REGULAR UNLEADED [] 3 DIESEL [] 6 AVIATION GAS [] lb PREMIUM UNLEADED F'---1 4 GASAHOL ~1 7 METHANOL [] lc MIDGRADE UNLEADED [] 5 JETFUEL [] 8 M85 [] 2 LEADED [] 99 OTHER (DESCRIBE IN ITEM D. BELOW) C.A.S.#: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, ANDC, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF 1 DOUBLE WALL SYSTEM L_a 2 SINGLE WALL ] 3 SINGLE WALL WITH EXTERIOR LINER ] 4 SINGLE WALL IN A VAULT ] 5 INTERNAL BLADDER SYSTEM [] 95 UNKNOWN ] 9g OTHER B. TANK [] 1 BARE STEEL [] 2 STAINLESS STEEL ~) 3 FIBERGLASS MATERIAL [] 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] 7 ALUMINUM (Primary Tank) [] 9 BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLEW/FRP ] 99 OTHER C. INTERIOR [] 1 RUBBER UNED [] 2 ALKYD LINING [] 3 EPOXY LINING LINING OR [] 5 GLASS LINING [~ 6 UNLINED [] 95 UNKNOWN COATING ~s LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES__ NO__ ] 4 PHENOLIC LINING ] 99 OTHER D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP ~ FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [~ 9, NONE ,~.~, .... I [] 95 UNKNOWN [] 99 OTHER. ................. SPILL CONTAINMENT II~I~'ALLED (YEAR) V~,K{i[,~ ~ OVERFILL PREVENTION EQUIPMENT INSTALLED E. ~FILI. ANU UV~'HPII. L, etc. DROP TUBE YES V NO ' ~TRIKER PLATE YES NO DISPENSER CONTAINMEN~ YES V NO__ IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION J~ PRESSURE A U 3 GRAVITY A U 4 FLEXIBLE PIPING A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U~2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A ~ FIBERGLASS PIPE C. MATERIAL AND C0RROSlON A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLEW/FRP PROTECTION A U g GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER U.E ~G.~NE~ r--~5 CON~.UOUS ,.TERS~A~ [] ~ E~EC~0.,C UNE [] s A~o~T~c .u~. ~ D. LEAK DETECTION [] 1 DETECToRMECH'~NICAL UNE LEAK [] 2 TES'RNG L~,,~--~ MONITORING /.~K DET~CTOR SHUTDOWN [] 99 OTHER V. TANK LEAK DETECTION [] 1 VISUAL CHECK [] 2 MANUAL INVENTORY [] 3 VADOZE [] 4 AUTOMATIC TANK [] 5 GROUND WATER [] 6 ANNUALTANK ~ CONTINUOUS INTERSTITIAL RECONCILIATION MONITORING GAUGING MONITORING TESTING ~_Tz MONiTORiNG [] 8 SiR [] 9TANKWEEKLYGAuGINGMANUAL [] 10 TESTINGMONTHLY TANK [] 95 UNKNOWN [] 99 OTHER VI. TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) 1. ESTIMATED DATE LAST USED (MO/DAY/YR) 2. ESTIMATED QUANTITY OF I 3. WAS TANK FILLED WITH Yl::.~ ~ NC) I~ THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AN~)'~7/9___ THE BEST OF MY KNOWLEDG~..~IS TRUE AND CORRECT I TANK OWNER'S NAME . \ ~ ~ J//// ~_..---~--~I~ATE~ ~ I(PRINTED & sIGNATURE) ~7~ ~~ ~~ I ~ ''1~----~ LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED.~F THE FOUR NUMI~ERS BELOW ~,// COUNTY # JURISDICTION # FACILITY # TANK # STATE I.D:# ~ I II IIII II PERMIT NUMBER PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B (6-95} STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL B CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET CITY COUNTY I1. INSTALLATION (mark all that apply)' //The installer has been certified by the tank and piping manufacturers. (~ The installation has been inspected and certified by a registered professional engineer. [] The installation has been inspected and approved by the implementing agency. yAIIwork listed on the manufacturers installation checklist has been completed. ,~"The certified or licensed by the Contractors State License Board. installation Contractor has been [] Another method was used as allowed by the implementing agency. (Please specify.) II1. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent ~) V~rp. ,~,... Date~~/j'' ?f , '/~0~ PrintName ~J'~..%l"/,,PC '~'~IWI/~ Phone [/~/~)~"~(/'""~Y~)7 Address LOCAL AGENCY USE ONLY STATE COUNTY .9 JURISDICTION # FACILITY # TANK # FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C7 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BO, CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION I1. INSTALLATION (mark all that apply): j,~ The installer has been certified by the tank and piping manufacturers. {~ The installation has been inspected and certified by a registered professional engineer. [] The installation has been inspected and approved by the implementing agency. /,,{~'- All work listed on the manufacturer's installation checklist has been completed. .,,,~]'~ The installation Contractor has been certified or licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) II1. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent AI~,~ V~.,~ Address /~ ~ 1'~' ~//~ 'W~ -~Y" Date Phone ( LOCALAGENCY USE ONLY STATE COUNTY Ct JURISDICTION # FACILITY ct TANK ct FOR~ C (7/9~) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C7 CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION II. INSTALLATION (mark all that apply): The installer has been certified by the tank and piping manufacturers. E~ The installation has been inspected and certified by a registered professional engineer. The installation has been inspected and approved by the implementing agency. All work listed on the manufacturer's installation checklist has been completed. ~ ~,/~The installation Contractor has been certified or licensed by the Contractors State License Board. Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowled,]¢,~ Tank Owner/Agen] //~¢.~0 Date)~ Print Name. Vu~l~ ~--"[.,~1/~ Phone ( ~ I, ~ 70 "'-~-[//¢"~' Address ~¢¢,J'~)0~/1~ 'pC. ! L.-,,~ p~-/...~ ~ ? ¢/2 LOCALAGENCYUSEONLY COUNTY Ct JURISDICTION Ct FACILITY Ct TANK Ct STATE FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C7 CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET II. INSTALLATION (mark all that apply)' /The installer has been certified by the tank and piping manufacturers. f--I The installation has been inspected and certified by a registered professional engineer. [] The installation has been inspected and approved by the implementing agency. /.~.AII work listed on the manufacturer's installation checklist has been completed. '"The installation Contractor has been certified or licensed by the Contractors State License Board. ~ Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent Print Name Address I LOCALAGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C7 Winston H. Hickox Secretary for Environmental Protection State Water Resources Control Board Division of Clean Water Programs 2014 T Street · Sacramento, California 95814 · (916) 227~4411 Mailing Address: P.O. Box 944212 · Sacramento, California · 94244-2120 FAX (916) 2274530 · Intemet Address: http://www.swrcb.ca.gov/-cwphome/ustcf Gray Davis Governor FEB ] 7 2000 Chris Winsor Arco Products Company P O Box 5077 Buena Park, CA 90622-5077 UNDERGROLrND STORAGE TANK CLEANUP FUND PROGRAM, NOTICE OF ELIGIBILITY DETERMINATION: CLAIM NUMBER 015168; FOR SITE ADDRESS: 4203 MING AVE, BAKERSFIELD Your claim has been accepted for placement on the Priority List in Priority Class "D" with a deductible of $10,000. We have completed our initial review. The next step in the claim review process is to conduct a compliance review. Compliance Review: Staff reviews, verifies, and processes claims based on the priority and rank within a priority class. After the Board adopts the Priority List, your claim will remain on the Priority List until your Priority Class and rank are reached. At that time, staff will conduct an extensive Compliance Review at the local regulatory agency or Regional Water Quality Control Board. During this Compliance Review, staff may request additional information needed to verify eligibility. Once the Compliance Review is completed, Staff will determine if the claim is valid or must be rejected. If the claim is valid, a Letter of Commitment will be issued obligating funds toward the cleanup. If staff determine that you have not complied with regulations governing site cleanup, you have not supplied necessary information or documentation, or your claim application contains a material error, the claim will be rejected. In such event, you will be issued a Notice of Intended Removal from the Priority List, informed of the basis for the proposed removal of your claim, and provided an opportunity to correct the condition that is the basis for the proposed removal. Your claim will be barred from further participation in the Fund, if the claim application contains a material error resulting from fraud or intentional or negligent misrepresentation. Record keeping: During your cleanup project you should keep complete and well organized records of all corrective action activity and payment transactions. If you are eventually issued a Letter of Commitment, you will be required to submit: (1) copies of detailed invoices for all corrective action activity performed (including subcontractor invoices), (2) copies of canceled checks used to pay for work shown on the invoices, (3) copies of technical documents (bids, narrative work description, reports), and (4) evidence that the claimant paid for the work performed (not paid by another party). These documents are necessary for reimbursement and failure to submit them could impact the amount of reimbursement made by the Fund. It is not necessary to submit these docltmettts at this time; however, they will definitely be required prior to reimbursement. Compliance with Corrective Action Requirements: In order to be reimbursed for your eligible costs of cleanup incurred after December 2, 1991, you must have complied with corrective action requirements of Article 11, Chapter 16, Division 3, Title 23, California Code of Regulations. Article 11 categorized the corrective action process into phases. In addition, Article 11 requires the responsible party to submit an Califoraia Eaviroameatal Protectioa Ageacy ~ Recycled Paper Arco Products Com[ 2000 investigative workplan/Corrective Action Plan (CAP) before performing any work. This phasing process and the workplan/CAP requirements were intended to: 1. help the responsible party undertake the necessary corrective action in a cost-effective, efficient and timely manner; 2. enable the regulatory agency to review and approve the proposed cost-effective corrective action alternative before any corrective action work was performed; and o ensure the Fund will only reimburse the most cost-effective corrective action alternative required by the regulatory agency to achieve the minimum cleanup necessary to protect human health, safety and the environment. In some limited situations interim cleanup will be necessary to mitigate a demonstrated immediate hazard-to pubt-ic-hea-t-t-h;- or the-environment.-Program-regu'l'ations-allow the~resp'ffn~ibl~pff~to-h~n-deitake interim remedial action after: (1) notifying the regulatory agency of the proposed action, and; (2) complying with any requirements that the regulatory agency may set. Interim remedial action should only be proposed when necessary to mitigate an immediate demonstrated hazard. Implementing interim remedial action does not eliminate the requirement for a CAP and an evaluation of the most cost- effective corrective action alternative. Three bids and Cost Preapproval: Only corrective action costs required by the regulatory agency to protect human health, safety and the environment can be claimed for reimbursement. You must comply with all regulatory agency time schedules and requirements and you must obtain three bids for any required corrective action. Unless waived in writing, you are required to obtain preapproval of costs for all future corrective action work If you do not obtain three bids and cost preapproval, rebnbursement is not assured and costs may be rejected as ineligible. If you have any questions, please contact me at (916) 227-4411. Sincerely, .... C~-i~'ni Review Unit Underground Storage Tank Cleanup Fund CC; Mr. John Noonan RWQCB, Reg. 5 - Fresno 3614 E. Ashlan Ave. Fresno, CA 93726 Mr. Howard Wines City of Bakersfield Fire Dept. 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 ........... C, ,,al~Tornia Environmental Protection Agency ~ Recycled Paper 7146705420 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK iNSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYS'rEM II. INSTALLATION (mark all that apply): The installer has been certified by the tank and piping manufacturers. [] . The installation has been inspected and certified by a registered professional engineer. The installation has been inspected and approved by the implementing agency. All work I{sted on the manufacturer's insta{lation 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 implementing agency. (Please specify.) III. OATH Tank Owner/Agen~t Print Name. [ I certify that the inlormation provided is true to the best of my belief and knowled/Q~ LOCAL AGENCY USE ONLY COUNTY # JURISDICTION # FACILITY # TANK # STATE FORM c (7~1 THIS FORNI MUST 8Et ICCOMPANIED ~Y PERMIT aP~LICAIION ~0~ ~ $ ~ UNLE~ THEY H~VE B~N FILED PREVIOUSL~ FOROO35~,' 81/11/2888 11:25 714~705420 MS5 D~PY ~6E 19 STATE 01:' Ct, LIFORNIA STATE WATER RESOURCES CONTROL t~O~,FID CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION il. INSTALLATION (mark all that appty): ..~,~"~he installer has been certified by the tank and manufacturers. piping [] The installation has been inspected and certified by a registered professional engineer. ~ The installation has been inspected and approved by the implementing agency, ~ All work listed on the manufacturer's installation checklist has been completed. ~ The installation Contractor has been certified or licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) Iii. OATH I certify that the information provided is true to the best of my belief and knowledge, Date Phone LOCAL AGENCY USE ONLY COUNTy .e JURISDICTION # FACILITY it TANK # STATE FORM o (7/el) ' THIS FORM MUST BE aCCOMPANIED BY PERMIT iPPLICATION'F~"I~'iVIS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR~35c_,7 11:25 7146705420 H$£ DEPT · STATE Ol~ ~F~l:llqO A STATE WATER RESOURCES COh'TROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C PaGE 20 COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM SITE LOCATION STREET I!. INSTALLATION (mark all that apply): jThe installer has been certified by the tank and piping manufacturers. ~ The installation has been inspected and cedified by a registered professional engineer. ['"'-] The installation has been inspected and approved by the implementing agency. yAIIwork 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 implementing agency, (Please specify.) iff. OATH certify that the information provided is true to the best ol my belief and knowledge. Print .ame ,.~j~_.,% 'J"~' ~.,'~ V1/1~_ Phone LOCALAGENOYUSE ONLY STATE: TANK I,D, # FORM o (7.'~1) COUNTY ~ JURISDICTION # FACJLFFY ~ TANK # THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS UNLESS HEY HAVE BEEN FILED PREVIOUSLY FOROO35c? 81/11/2888 7145785428 HSE DEPT STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C PAGE 21 COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM i. SITE LOCATION STREET CITY ~A[¢ ¢'-z~'~ ~-,q~ COUNTY II, INSTALLATION (mark all that apply): /' The installer has been certified by the tank and piping manulacturers. [] The installation has been inspected and certified by a registered professional engineer. ~ The installation has been inspected and approved by the implementing agency. AiI work listed on the manufacturer's installation checklist has been completed. '~he installation Contractor has been certified or licensed by the Contractors State License Board. [] Another method was used as allowed by the implementing agency. (Please specify.) i11, OATH certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent LOCAL AGENCY USE ONLY STATE COUNTY # JURISDICTION # FACILITY # TANK # ' ' ..... Fo~u c (7~) THIS FORM MUST BE ~D 8Y P RMJT APPLICATION OR~ ~ & B ~NLESS THEY HAVE B~EN FILED PREVIOUSLY 81/11/2888 11:25 7145705420 NeE DEPT PAGE 22 MARK ONLY ONE ITEM STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK: PERMIT APPLICATION. FORM A COMPLETE THIS FORM FOR EACH FACIUTY/SITE E~ I NEW PI~RMIT ] 2 INTERIM PERMIT RENEWAL PEFtM~T ~'C"ANGE OF INFOF~MATION [] ? IPER~ANENTLY CLQ$1~D. SITE I. FACILITY/SITE INFORMATION & ADDRESS - (MUST BE COMPLETED) " ~EARES1' cross S?~EET ~COR~O~ON ~ INk, UAL ~ PA~E~HIP ~ LOCAL-AG~CY ~ FEDE~-AG~' ffo~refU~TI;epubl~aga~,~bte~ef~bw~g: ~a~e~er~d~ s~bno/~ope~eat~UST .... , FARM ~ 4 PROCES~R ~ S ~HE~ OR mUST ~OS EMERGENCY CONTACT PERSON (PRIMARY} (~SL FIR~ ~ __ PHOHO W~R~CODg EMERGENCY CONTACT PERSON (SECONDARY) - optional IDAYS; NAME [LAST. FIRST~ NIGH S: NAM~Sb~.~ST) PHONE ~ WiTH AREA CODE PHONE # WITM AREA CODE IL PROPERTY OWNER INFORMATION - (MUST BE COMPLETED) III. TANK OWNER' INFORMATION -(blUST BE COMPLETED) IV. BOARD OF EQUALIZATION MST STORAGE FEE ACCOUNT NUMBE~ -/Call (916~, 322-9669 if questions anse. V. PETROLEUM U.~T-RNANClAL RESPONSIBILITY- (MUST BE COMPLETED} -IDENTIFY THE METHOD(S} USED ~ ~ ~ATE~&~FR~ALOFFI~RL~R ~ g STA~&CER~F~TEO~SIT ~ 10 LOC~GO~,MECHAN~M ~ ~s O~ER I VL LEGAL NOTIFICATION AND BILLING ADDRESS Legal netilication and billing will be sent lo the tank owner unless box I or II is checked, JCHECK ONE BOX INDICATING WHICH A~OVE ADDRESS ~HOULD BE USED FOR L~QAL NO~'IFIGA~ON$ AND ~ILLING: L [] Ii. Iii,, 1'H15 FORM HAS BEEN COMPLETED UND~iII~ PENAL TY OF PERJURY~ AND TO THE BEST OF MY KNOWLEDGE, 15 TRUE AND CORRECT JT~tNK'I~NER'S N.,M~EIPRINTED & SlGNATU~E)'~ ///1 ~"JYANKCiWNER'JlJT11TLE . ~ a · J {3~ MON'I'I.b13Ay,~EAR [I J'IIID FORM MUST BE ACCOMPANIED BY AT'LEAST (1) OR MORE PERMIT APPLICATION - FORM B, UNLESS ~lS IS l CHANGE OF SITE INFORMATION ONLY. OWNER MUST FILE THIS FORM W~ THE LOCAL AGENCY IMPLYING THE UN~RGROUND STOOGE TANK REGULATIONS 01/11/2000 11:25 7146705420 BSE DEPT PAGE 23 I~IARK ONLY ONE ITEM STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM COMPLETE A SEPARATE FORI~I FO~CH TANK SYSTEM. ~ 2 INTEmN PE~T ~ 4 AMENDED P~R~IT ~ 8 TEMPO~RY TANK CLOSURE TANK DESCRIPTION coubL~s ~L ~s - sPsc~ ~ UN~.OW~ ii, TANK CONTENTS ~P A-1 ,s M^RK~D. DOM.L~,T~ C. ~ ~ ~TOR V~(C~ FUEL ~ ~ OiL DETR~EUM ~ 80 EM~ ~ 3 CHEMICAL PRODUCT ~ ~S UNKNOWN MANUFACTURED BY: PERMANENTLy CLOSED ON SiTI~ TANK REMOVED D, TANK CAPACITY IN GALLONS; PRODUCT ~ lc MI~R~E UNLADED ~ 5 J~TFUEL 8 Ma~ WASTE ~ ~ ~ADED 9~ ~E~ (DE~BE ~ ~ O. ~O~ D, IF {A~I~ I$ NOT MANKIND, ENTER NAME OF SUBSTANCE ~TORED C, A. $. #: IlL TANK CONSTRUCTION ~ARK ONE ITEM ONLY JN BOXES A. B. AND C, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF r~ 1 DOUBLE WALL [] 3 SINGLE WALL wr}'?J EXTERIOR LINER ~ ~ IN~RNAL B~DDER SYS~ ~ g5 UNK~ SYS~M ~ 3 SINGLE WALL ~ 4 SIDLE WALL IN A VAULT ~ g9 OTHER MATERUtL [:~ 5 CONCRETE [] 6 POLYVINYL CHLORIDE [] ? ALUMINUM [] 8 100% METHANOL COMPATIBLE W/FRP (P~lalaq/Talk) [] g BRONZE [] 10 GALVANIZED STEEL [] 95 UNKNOWN [] gg OTHER C, INTERIOR J~ I RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY lINING [] 4 PHENOLIC LINING ~A~G IS UNING MAT~R~L ~MPA~DLE WITH fO0% ME~ANOL ? YES- NO__ O. EXTERIOR ~ I POLYETHYLENE WRAP ~ 2 COATING r~ 3 VINYL WRAP ~ FIBERGLASS REINFORCED PLASTIC CORROSION PROTEC~ON ~ 5 CA~OD[CP"OTEC~ON ~ 9, NONE · ~ ~ 95 UNKNOW~ ~ ~e OTHER ," EQUIPMENT INSTALLED (YEAR~~ , ~ANUO ~ J , ' DR~U~E YES [~ NO 'ST~IKERP~TE YES N~, ,_,, DISPEN~E~CONTAINMEN~'~ES ~,, NO IV. PIPING INFORMATION c~.cL~ ~ mF ~aOVE e.OU.~ o~ U tF UNO~RGROU.D, ~OTH IFAPPUCABLE A. SYSTEM ~PE GRAV~ U 4 PIP~NG U B. CONS~UC~ON n U i 5INGLE W~L A ~ DOUDLE WALL A U 3 UN~D TRENCH A U 95 UNKNOWN U OTHER C. MA~R~LAND ~ u ~ enne s~ A U ~ ~TAINLES~ STEEL A U 3 POL~NYL CHLORIDE (PvC}A~ FIBERG~SS PIPE CORROSION ~ U 5 ALU~NUM A U 6 OONCRET~ A U Z 8TEELW/COA~NG A~8 lo0% METHANOL COMPATIBL~W;FRP PROTECTION A U 9 GALV~IZ~ STE~ A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER V. TANK LEAK DETECTION ~OR)~ T~K GAUGING ,, TESTING VI. TANK CLOSURE INFORMATION {~nu~s.~ CLOSU.~ ~-~ 1. EBTI~TED DATE ~ST USED (M~AY~R) 2. ~TI~T~D QUA~IW OF ~ 3. WAS TA~K FILLED WITH y¢~ ~ ~ ~ THIS FORM HAS BEEN COMPLIED UNDER PENAL ~ OF PERJUR~ AN~ THE BEST OF MY KN OWLEDG~ IS TRuE AND CORRECT ,,, /---, COUN~ ~ JURISDICTION ¢ FACILi~ ~ TANK ff STATE .D; III1 II I I "'I ....... 1'] L I ['[' II THIS FORM MUST BE ACCOMPANIED BY A PERMmT APPLICATION · FORM A, UNLESS A CURRENT FORM A H'AS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FOR~ SHOULD BE ACCOMPANIED BY A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCy IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS 01/11/2~00 11:25 7146705420 HSE DEPT PAGE 24 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR E..~H TANK SYSTEM. MARK ONLY [] 1 NEW PERMIT [] 3 RENEWAL PERMIT [~5 CHANGE OF INFORMATION ONE ITeM [] 2 INTERIM PERMIT [] 4 AMENDED PERUrr [] 6 TEMPORARY TANK CLOSURE I. TANK DESCRIPTION co.N~re ~L ITemS - SPEC,rr,F pNKNOWN i" A. OWNER'S TANK I. D. # c, °ATE ,N ALLED(M DAY AR) I II. TANK CONTENTS IF A. 1 IS MARKED, COMPLETE iTEM C. E~ 7 PERMANENTLY CLOSED ON [] $ TANK R~I~4ovED MANUFACTURED D. TANK CAPACITY IN GALLONS: A. ~'1 MOTOR VEHICLE FUEL [] 4 OIL B. C. ~1a R;C_~.AR UNLEADED ~ 3 DIESEL ~ ~ A~ON G~ ' b PREMIUM UNLADED ~ 4 GASAHOL ~ 7 METHANOL D. IF (Al) IS NOT ~KED. ENTER N~E OF SUBSTANCE STORED C. A, S. ~: IlL TANK CONSTRUCTION MARK ONE ITEM ONLY IN I~OXES A. B, ANDC. AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF E~1 DOUBLE WALL [] 3 SINGLE WALL WITH EXTERIOR UNER [] 5 INTi~RNAL BLADDER SYb-q'EM [] 95 UNKNOWN SYSTEM ~ 2 SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] Sa OTHER TANK [] 1 BARE.~'EEL [] 2 STAINLESS STEEL [~ 3 FI~ERG~SS ~ 4 S~ELC~D WIFISERG~SSR~NFORCEDP~STIC MATERIAL ~ 5 CONCRETE ~ 6 POL~NYL CHLORIDE ~ 7 ALUMINUM ~. 8 100% METHANOL ~MPATiBLEW/FRP (Prlma~Te.k) ~ ~ BRONZE ~ 10 GALV~JZED STEEL ~ 95 UN~OWN ~ Ba OTHER C. INTERIOR [] ~ RUBBER LINGO [] 2 AL~'D u~Ne [] a EPoxY U~Ne [] · PHENOLIC LINING OR [] 5 GLASS LINING ~;a~6 UNUNED [] 95 UNKNOWN [] 99 OTHER COATING ts LINING MATERIAL COMPATIBL~.. WITH 100% ME'~-IANOL? YES__ NO~ D. EXTERIOR [] 1 POLYETHYLENE WRAP [] 2 COATING [] 3 VINYL WRAP [~ 4 F[t~ERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECTION [] 91 NONE . · [] 95 UNKNOWN [] 99 OTHER .~ E, SPILL AND OVER~ilJL etc SPILL :ONTAINMENT~N~AU_ED (YE-~a~RI ~,J~l~) ~ ' OvERFiLL PREVENTION ~QU PMENT [NS'I:ALLP-O (YF~0,,R}' ~'~',~ ~J ,, , · DROPTUBE YES ~/.. NO STR1KERPLATE YES NOn~_.. DISPSNSERCONTAINMENT YES ;., ~'~I~,,/' NO IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U [F UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A u 1 SUCTION A ~1~2 PRESSURE A U 3 GRAVITY A U 4 FLEXII~LE PIP:NG A U 99 OTHER A ~J~E DOUBLE WALL A U 3 LINED TRENCH ~ U 95 UNKNOWN A U 99 OTHER H B. CONSTRUC1]ON U I SINGL~ WALL ®, C. I~TERIAL AND a u 1 BARE STEEL A U Z STAINLESS STEEL I U 3 POLYVINYL CHLORIDE (PVC) I~i*ERGLASS PIPE CORROSION A u 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/ COAT~NG A ~'-8 100% METHANOL COMPATIBLEW/FRP PROTECTION ~ U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U g9 OTHER D. LEAK DETECTION [] ~ v~c~lc,~ u.E La~ [] .~ La~ T~.~a=~S i---La/c°a~a'~ ~,~[a~A: I---1 ~ =~cmo~= :~ ~ S *UTO~.C V. TANK LEAK DETEC~ON 6 ANNUAL T~K ~ 1 VISUAL CH~OK ~ 2 .ANUAL INVENTORY ~ 3 VADOZE ~ 4 AUTOMA~'C TANK ~ 5 GROUND WATER ~ RE~NC[MATION MONITORING GA~tNG MONITORING WEEKLY MANUAL ~ 10 MONTHly TRNK ~ '5 UNKNOWN ~ 1~ ~NTIN~USM~iTORiNG I~S~TI~L ~ e SIR ~ 9 TANKGAUGIM~, TESTIN~ V~, TANK CLOSURE INFORMATION (PERMANENT CLOSURE IN-PLACE) 1' ESTIMATED DAI~ LAsT USED (MO/DAY/YR) I2' ESTIMATED QUANTITY OFSUSsTANCE REMAINING 1._____~...__GALLON$ ] 3. WAS TANK FILLED WITHiNERT MATERIAL ? LOCAL AGENCY USE ONLy,. THE ~ATE I.D. NUM.E~ ,S. COMPOS~0, TH~,,F~UR NUMBERS BELOW ~ COUN~ ff JURISDICTION e FACILI~ ~ TANK THIS FORM MUST BE ACCOMPANIED BY A PERMIT AppltCATION - FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACGOMPANIEO BY a PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS 81/11/2888 11:25 7146785428 HSE DEPT PAGE 25 STATE OF {3ALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B COMPLETE A SEPARATE FORM FOR EA,~ TAN.K SYSTEM. MARK ONLY [] , ~EW PERMIT [] ONE ITEM [] 2 INTERIM PEJRMIT [] DBA OR FACILITY NAME WHERE TANK IS INSTALLED: 3 RENEWAL PERMIT [~ CHANGE OF INFORMATION 4 AMENDED PERMIT [] 6 TEMPORARY TANK CLOSURE I. TANK DESCRIPTION COMPLETE ALL,TEMS- A. OWNER'S TANK I, D, t~ II, TAI CONTE~S i~ A-1 IS MARKED, COMPLETE IT~ C. ~PECIFY IF UNKNOWN ] 7 PERMANENTLY CLOSED ON SITE~ ] 8 TANK REMOVED B. MANUFACTURED BY*: D. TANK CAPACITY IN GALLONS: [] ~ PETROLEUM [] BO EMPTY [~1 PRODUCT lb PFIEM~U UNLEADF~) 4 GASAHOL ~ 7 ME~ANOL ~lcUIDGR~EUNL~ED ~ 5 JETFUEL ~ a M~ ~ 3 CHEMICAL PRODUCT ~ g5 UNKNO~ ~ 2 WASTE 2 LEADED 99 ~ER(D~CRIBEIN~EMD. 8~O~ D. IF (A. 1)18 ~T ~RKED, ENTER NAME OF SUBSTANCE STORED C.A.S. e: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN I~OXES A. B, ANDC, AND ALL THAT APPLIE$1N SOX D AND E &. TYPE OF ~/~ 1 DOUBLE WALL LINER SYSTEM L_J e SINGLE. WALL ] 3 SINGLE WALL WITH EXTE~OR ] ¢ SINGLE WALL IN A VAULT B, TANK [] 1 BARE STEEL [] 2 STAINLESS ST1-'EL [~ FIBERGLASS MATERIAL [] ~ CONCRETE [] 6 POLYVINYL CHLORIDE~"~ 7 ALU/~INUM (P~ma~Tank) ~ 0 ~ONZE ~ 10 GALVA~ZED STEEL ~ e5 UNKNOWN ] 5 INTERNAL BLADDER'SYSTEM [] g$ UNKNOWN ] 99 OTHER ] 4 STEEL CLAD W/FIBERGLASS REINFORCED PLASTIC ] 8 100% METHANOL COMPATIBLEW/FRp [] 99 OTHER C. INTERIOR [] 1 RUBBER LINED [] 2 ALKYD LINING ~ 3 EPOXY LINING LINING OR [] 5 GLASS LININ(:~ ~ 6 LINUN~=D [] 95 UNKNOWN COATING is LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES~ NO~ [] 4 PHENOLIC LINING [] Sa OTHER D. EXTERIOR [] I POLYETHYLENE .WRAP [] 2 COATING [] 3 VINYL WRAP ~ FIBERGLASS REINFORCED PLASTIC CORROSION PROTECTION [] s CATHODIC PROT~CmON [~ al NONE .~] es UNKNOWN [] sa OTHER , --: ........ = eDI/l aJ~ ~tlgB~.~ ... 8PILLCONTAINM~N~RTALLED (Y~R) ~ ~,~ .,.~ u.~nr, u~, =~. DROP TUBE YE~ NO IV. PIPING INFORMATION c,.cLE ~ IFABOV~ROUNDOR U IFUNDARGR~D, BOTH IF APPLICARL5 I. SYSTEM WPE a U i SUCTION I PRE.ORE A U 3 GRAVI~ A U 4 ~EXI~LE PIPING A U 99 OTHER B, CONSTRU~ION A U 1 SINGLE WALL A D~B~ WA~ ~ U 3 LINED TRENC~ A U 96 UNKNOWN A U 9g O~ER C. MA~RIAL AND A u 1 BARE STE~ A U 2 5TNNLES$ STEEL a U 3 POL~INYL CHLORIDE (PVC)A ~ FIBERG~' PIPE CORROSION A U 5 ALUMINU~ A U 8 CONCR~E A U 7 STEELW/COATING A U 8 1~% ~ETHANOL COMPATIB~W/FRP PROTECTION A U 9 OALV*NIZSD STE~L A U ~0 ~T~?D~TEOTION A [ ~5 UNKNOWN A U g~ OTHER TEaTI~ V. TANK LEAK D~ECTiON J ~ I~SUALCHECK ~ 3 --"UALINV~TO.Y = 3V~OZE ~ 4 AUTOMAT]CTANK ~5 GROUNDWATER ~6 ANNUALT~K "ECONC'LIATIO" MONITORING GAUGING MONITORING ~STING .J '~ ~NTINUOUS"TERSTITIAL ~ 8 SIR ~ g WETLY MANUAL ~ 10 MONTHLY T~K 95 UNKNOWN ~ 9' OTHER [__~ MONITORING . TS~ ~AUGIN~ T~STIN~ VI. TANK CLOSURE INFORMATION (PE~M~ENT CLOSUR~ SUBSTANC[ RE~INING ~G~EON5 INERT MATERIAL ? THIS FORM HAS BEEN COMPLETED UNDER PENAL ~ OF PERJURY,~ TO ~E BEST OF MY KNOWLEDG~ IS TRUE AND CORRECT I T~KOW,~n'S~A~ ......... . ~ ~ / ' I ~;3 ~ ' 't ~OUN~ STATE I.D:~ P~MIT NUmBeR PE~IT~PROV~D BY/DATE J PEMBIT EXPIRATION DATE tNlS FO~ ~U~T ~E A¢C~MP~IED B~ A PERMIT *P~LI¢ATION - FOra A, UNLESS A ¢~RRENT FORM A HAS BEEN fiLED, FO~ ~ MUST BE COaPL~ED FO~ IHST~L~TIO~S. THIB FO~M SHOULD BE ~¢¢OMPAN~ BY ~ ~LOt PBK FILE T~I~ FO~M WI~ TH~ L~L ~ENCY i~PLEa~NJlN6 THE gN~GRO~D STORIQE TAHK ~EGU~TIONS 81/11/2888 11:25 7146705420 HSE DEPT P~GE 26 STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM B COMPLETE A SEPARATE FORM FOR E~CH TANK SYSTEM. MARK ONLY F-] 1 NEW PERMIT ~ 3 RENEWAL PERMIT ~SB CHANGE OF iNFORMATION ~---] ONE ITEM [] E INTERIM PERMIT 4 AMEND;D PERMIT TEMPORARY TANK CLOSURE [] 0DA OR FACILITY NAME WHERE TANK IS INSTALLED: ~ ~ ~ ~ {~" L TANK DESCRIPTION ¢OMk~TE AiL ITEMS - SPECIF'( IF UNKNOWN A. OWNER'S TANK I D # ~_ C, DATE INSTALLEO (MO/DAY/YEAR) D. TANK CAPACITY IN GALLONS: ,. TAN CO.TENTs 'A-,,.MAR ED. LOMP ETEI. i 10'" 7 PERMANENTLY CLOSED ON SITE/ 8 TANK REMOVED i~_. ' .... . [~ la' 'REGULAR UNLE,~DED ~ 3 DIESEL [~ 6"~VIATIONGRS ~1, MDGR~E UNL~OED S JET FUEL ~ 8 ~5 ' ~ a CHEMICAL PRODUCT ~ 9g UNKNOWN WAST~ ~ 2 LEADED ~ O~R (~BCRI~ IN ITEM ~. BELO~ D. IF (a.l) 18 NOT MAR~D. ENTER NAME OF sUgST~CE STORED C. k S. ~: IlL TANK CONSTRUCTION MA,~ ONE ITEM ONLY IN BOXES A. I~, AND C. AND ALL THAT APPLIES IN I5Ox D AND E A, TYPE OF {~ 1 DOUBLE WALL [~] 3 SINGLE WALL WITH EXTERIOR LINER [] 5 INTERNAL ~,LADDE. SYSTEM [] 95 UNKNOWN SYSTEM [] Z SINGLE WALL [] 4 SINGLE WALL IN A VAULT [] 99 OTHER e. TANK [] ! BARE STEEL [] ' STAINLES<= STEEL ~ FIBER{3LASS [] 4 STEELC~D W/FI~ERG~S REINFORCED MATERIAL ~ 5 CONCRETE ~ 8 ~LWINYL CHLORIDE ~ 7 ALUMINUM ~ 8 100% METHANOL COMPmlBLEWIFRp C. INTERIOR' [] 1 RUBBER LINED [] 2 ALKYD LINING [] 3 EPOXY LINING [] 4 PHENOLIC LINING COATING IS LININe MA~RIAL COMPATIBLE WI~ 1~ METHANOL? YES_ D, EXYF-HIOR ] 1 POLYETHYLENE WRAP [] 2 COATING ] 3 VINYL WRAP ~ FIBERGLASS REINFoRcED PLASTIC CORROSION PROTECTION [] 5 CATHODIC PROTECT3ON ~ gl NONE , ,,~1 la ~ [] 95 UNKNOWN ~ 99 O~ER ....... % / ' '"'1/A.~ .... mc..... ~LL CO~AINME~Y IN~LLED (Y;AR} ~-- ~ OVERF;LL PREVENTION EQUIPM;NT INSIALLEO (YEAR) ~/ :. ~1 ...... MV~n.,~b, ~,~. DROP TUBE YES ~_ NO -' S~RIKER/P~TE YES NO DISPENSER C~TAINMENT Y~S ~ NO. IV, PIPING INFORMATION c,Rcm A IF~BOV~ GROUND OR U IF UNDERGROUND. BOTN IPAPPLICABLE A. SYS~M~PE ~ U 1 SUCTION A~2 PRESSURE A U 3 GRAVI~ A U ~ FLEXIBLE PIPING A U gg OTHER B, CONSTRUCTION A U 1 SINGLE W~L A ~ DOUBLE WALL A U 3 UNDO ~ENCH A U 85 UNKNOWN A U 9g OTHER C, MATERIAL AND A u 1 BARE$~EL A U ~ STAINLESS STEEL ~ U a POL~INYL CHLORIDE(PVC)A~ FIB~RG~5S PIPE CORROSION A u 5 ALUMINUM A U 6 CONCRETE A U 7 S~ELW/COATtNG A U 8 100% M~HANOL COMPA~BLEW/FR~ PROTECTION A U 9 GALVANIZED STEEL A U 10 CA~ODI~CTION A U g5 UNKNOWN A U 99 OTHER D~TE~OR TE~TtNG ~ MO~T~6 ~ ,~K OET~CTOR ~ ~W~ ~ g~ Q~ER V. TANK LEAK DETEOTION ~ 2 ~UA 'NV~NTO"Y ~ ~ VADOZE 4 AU?OBATIC TANK ~ ~ G"OUNO WATER ~ 6 ANNUALT~K RECONClUATI~ ~ITOmlNG GAUGING MONITORING ~S~NB tl~ CO~NUOU~INTERSTITI~MoNffORiNG ~ 8 Sim ~ g WEEKLY MANUAL 10 EO~HLY TAN~ ~ g5 UNKNOWN ~ 9g OTH~ TANK GA~ING TES,~NG VI. TANK' CLOSURE INFORMATION (PER.~NT CLOSURE IN-PLACE) !I'EST]MATEDDATELASTUSED(MO/DAY/~YR) J 2, ESTIMATED QUANTITY OF J 3. WAS TANK FILLED WITH YES m NOm ........ [ -- I ' aG LL SJ N~RTMATE.mAL7 ~ ~I[ FORM HAS BEEN COMPLEED UNDER PENAL ~ OF~URY, ~ THE ~EST OF MY K NOWLEDGE~S TRUE AND CORRECt LO~L AGENCY USE ONLY T~ STATE I.D. NUUBER mS COUPO~F ~FOUR N[e.ERS BELOW mi mm m ~mm J COUNTY # JU_MI$DICTION e FACILITY # TANK ii STATE I.D/# ~ Ill i I i lI' I I.] I1 [.. I I [tl IPERMIT EXPIRATION DATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION · FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED, FORM C MUST BE COMPLETED FOR INSTALLATIONS. THIS FORM SHOULD BE ACCOMPANIED By A PLOT PLAN. FILE THIS FORM WITH THE LOCAL AGENCY IMPLEMENTING THE UNDERGROUND STORAGE TANK REGULATIONS FORM B [6-951 417 Montclair Street , Bakersfield, CA 93309 , 800-339-9930 or 805-631-3870 : FINAL TEST RESULTS: ALERT 1000 / ALERT ULLAGE 1050X / AES PLT-100R / AES SYSTEM II CUSTOMER ADDRESS: WORK ORDER: 4215 SITE ADDRESS: Scott Co. of California ARCO %6218 1717 Doolittle Drive TEST DATE: 12-10-1999 4203 Ming Avenue San Leandro, CA 94577-0655 Bakersfield, CA SITE CONTACT: Paur Ferreira PHONE ~ER:510-895-2333 TECHNICIAN: Doug Young PHONE N~ER:800-339-9930 LICENSE:99-1076 WATER IN BACKFILL: 0.00" DATE & TIME OF LAST FUEL DELIVERY:24+ hours TANK INFORMATION: (WETTED) TANK i TANK 2 TANK 3 TANK 4 PRODUCT TYPE: Regular Supreme TOTAL GALLONS: 10000 gallons 10000 gallons PRODUCT LEVEL: PERCENT FULL: TEST METHOD: WATER IN TANK: TANK MATERIAL: P.S.I.@ BOTTOM: TEST DURATION: FINAL LEAK RATE: TEST RESULT: TANK INFORMATION: ALERT 1050X ALERT 1050X ALERT 1050X ALERT 1050X (ULLAGE) U/F ONLY ULLAGE GALLONS: START PRESSURE: END PRESSURE: TEST RESULT: PRODUCT LINES: AES PLT-100R AES PLT-100R AES PLT-100R AES PLT-100R LINE TYPE: Pressure Pressure START TIME: 7: 05a 7: 30a END TIME: 7:25a 8:00a TEST PRESSURE: 50 psi 50 psi FINAL LEAK RATE: -0.003 gph -0.001 gph TEST RESULT: PASS PASS MECHANICAL LEAK DETECTORS: Red Jacket FTA Red Jacket FTA Red Jacket FTA Red Jacket FTA MODEL: SERIAL NUMBER: CHECK VALVE PSI: BLEED OFF ml: LEAK RATE TESTED: TEST RESULT: A) These systems and methods meet or exceed the criteria in USEPA 40CFR parts 280, NFPA 329-87 and all applicable state codes. B) Any failure listed above may require further action, check with all regulatory agencies. ~///~//~/~-.-~-~ /z-/~ Date: ~9 I Manufacturer Cer tification No: Techn'~iaqs~s~gnature.~ -'f Alert: ALTX123 and/or AES: 86116 D~c 08 99 ll:20a CONFIDENCE UST SERVICES, INC. USeServices,. Inc. "Compliance With Confidence" 661-631-3872 p.! December 8, 1999 VIA FACSIMILE (661) 326-0576 CITY OF BAKERSFIELD Office of Environmental Services Underground Storage Tank Program 1715 Chester Avenue, Third Floor Bakersfield, California 93301 To Whom It May Concern: Please accept this as notification of product line testing scheduled, as follows: December 10, 1999, at 7:00 a.m. Arco #6218 4203 Ming Avenue Bakersfield, CA 93309 Should you have any questions, please feel free to contact me at (661) 631-3870. Thank you for your attention herein. Yours truly, CONFIDENCE UST SERVICES, INC. 417 Montclair Street · Bakersfield, CA 93309 (805) 631-3870 or (800) 339-9930 FAX i'80~1 BAKERSFIELD CITY FIRE DEP~ENT OFF~ OF ENVR:IONMENTAL S.!INI~ CES INSPECTION RECORD POST CARD AT JOB,SITE NO. TANK~ AND BACKFILL PIPING SYSTEM SECONDARY CONTAJNMENT, OVERFILL PROTECTION, LEAK DETECTION NAL o CONTR~'tOR 07/14/99 10:42 326 0576 BFD HAZ MAT DIV ~002 CITY OF BAKERSFIELD '~ ~/~ OFFICE OF ENVIRONlVIg~NTAL SERVICES 171S Chester Ave., Bakersfield, CA (80S) 326-3979 PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK ~OF APPLICATION_ (CHECK) [ ']HEW FACILITT ~]MODIFICATION OF FAC/IATY [ ]HEw TANK I~STAr~ATION AT EX~TI~ .OF TA~O~ PROPOSED COMPLETION DATE EXISTING ]~AClUIT pERMIT NO. ~crr~ CA LIC..ENSE NO, zm CO~_9~ BRIEFLY I~$CI~E THE WORK TO BE DON]/ L WATER TO.FACRITYFROVIDED BY .C,~ ~ ~ . DEFI'HTO'GROUNDWATER ~ t,~ w~ SO]I, ~~~AT~ NO. OF T~ TO BE ~T~ ~ ~ ~ ~ ~Y ~R ~R ~ ~ ~ ~ ~~ON CO~L ~ CO~ ~~ ~ ON ~ ~ ~ NO S~ON FOR MOTg~ ~ S~ ~) ~ ~o~ T~S APPLICATION BECO~ A PE~IT ~EN ~PRO~ D II T February 9, 1999 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICE8 2101 'H' Street 8akemf~eld, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (805) 326-3951 FAX (8O5) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (805) 326-3979 FAX (805) 3260576 TRAINING DMSION 5642 Victor Ave. Bakersfmld. CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 AM PM Mini Market #6218 4203 Ming Ave Bakersfield, CA 93309 RE: Compliance Inspection Dear Underground Storage Tank Owner: The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, underground storage tanks and monitoring systems, and hazardous materials inspection. To assist you in preparing for this inspection, this office is enclosing a checklist for your convenience. Please take time to read this list, and verify that your facility has met all the necessary requirements to be in compliance. Should you have any questions, please feel free to contact me at 805-326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIA~ DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326J3979 APPLICATION TO PERFORM A TIGHTNESS TEST PERMIT TO OPERATE ~ OPERATORS NAME A~c~ ~~ NUMBER OF TANKS TO BE TESTED ADDRESS OW RS NAME IS PIPING GOING TO'BE TESTED TANK# VOLUME CONTENTS TANK TESTING COMPANY~%L TEST METHOD ~c_~ NAME OF TESTER~n~o~ STATE REGISTRATION # DATE & TIME TEST IS TO BE CONDUCTED DATE ~GNATURE OF APPLICAN~ FACILITY NAME Arco ADDRESS q~o.3 #4t6a FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301 INSPECTION DATE PHONE NO. gSq' BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES Section 1: Business Plan and Inventory Program l~Routine }~l Combined I~ Joint Agency [21 Multi-Agency [~ Complaint ~1 Re-inspection OPERATION C V COMMENTS Appropriate permit on hand L/ Business plan contact intbrmation accurate V Visible address x/ Correct occupancy ~/ Verification of inventory materials ~t Verification of quantities k/ Verification of location %/ Proper segregation of material V/ Verification of MSDS availability V' Verification of Haz Mat training L/ Verification of abatement supplies and procedures ~/ Emergency procedures adequate V~ Containers properly labeled ~/ Housekeeping ~/ 5 ~-~'c O~4.t.qu~sAcr..r ncctt 'fo be actu~ttd Fire Protection qr "~(l~,o~ t~ ~t~ e4~,tt Site Diagram Adequate & On Hand V' C=Compliance V=Violation Any hazardous waste on site?: Explain: Yes I~ No Questions regarding this inspection? Please call us at (805) 326-3979 White- Env. Svcs. Yellow - Station Copy Pink - Business Copy BuSinqsi Site/~. espons~eParty Inspector: _11~. //~~ FACILITY NAME ~o P~,x {)th CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE .9,[11¢/q~ Section 2: Underground Storage Tanks Program [~Routine [] Combined Type of Tank 0WP: Type of Monitoring [] Joint Agency [] Multi-Agency [] Complaint Number of Tanks Type of Piping tgt4/ [] Re-inspection OPERATION C V COMMENTS Proper tank data on file t// Proper owner/operator data on file b/ Permit tees current b,/ Certification of Financial Responsibility I,,,/ 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 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 Busine~ Site 15,.espons~e ~a~y BAKERSFIELD FIRE DEPARTMENT February 13, 1998 fll~ CHIEF MICHAEL R. KELLY ADMINISTILMIVE 2101 'H' Street Bake~fleU, CA 93301 (805) 326-3941 FAX (805) 395-1349 SUPPI~ESSlON SEIt~/ICES 2101 'H" Street Bake~fleld, CA 93,301 (80~) 326-3941 FAX (805) 395-1349 PI~/EN11ON SEEVlCF. S 1715 Chester Ave. Bakersfield, CA 93,,a0 I (805) 326-3951 FAX (805) 326-0576 ENVIItONMENTAL SERVICES 1715 Chester Ave. Bake~fletd, CA 93301 (805) 326-3979 FAX (80,5) 326-0~76 11~AINING DlVlSK)N 5642 Vlcto~ ~treet Bakersfield, CA 93308 (805) 399-4697 FAX (805) 399-5763 AM PM Mini Market 4203 Ming Avenue Bakersfield, CA 93309 RE: "Hold Open Devices" on Fuel Dispensers Dear Underground Storage Tank Owner: The Bakersfield City Fire Department will commence with our annual Underground Storage Tank Inspection Program within the next 2 weeks. The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire Department now requires that "hold open devices" be installed on all fuel dispensers. The new ordinance conforms to the State of California guidelines. The Bakersfield Fire Department apologies for any inconvenience this may cause you. Should you have any questions, please feel free to contact me at 326-3979. Sincerely, Steve Underwood Underground Storage Tank Inspector cc: Ralph Huey n~'ARCO Products Company Mol ~r Certification Inspection This letter certifies that the monitor(s) is/are in place, the probes are in correct position and the system is operating properly. Station # Address ~'~)~ Type & Model of Monitor ~'O~ ~,.."l.t_,-,~ System Function Tanks Regulart~L.A Midgrade Supreme Waste Oil OtheKMI-7_.. Pass Annular Space Fail N/A Date ,zk-I'~ 19~ Type Insp.ect~n: Annual v' Permit Recheck Leak In Tank Pass Fail Product Lines Turbine Sump In-Line Pass Fail N/A Pass Fail N/A ~3ss Regularu,~l ~ _L._ ~ Midgrade Supreme ~ ~ ~' Waste Oil >4. Othen,.,IqC.'L.., ~ ~ Fill Sump Fail N/A When monitor is turned off or in alarm, is there positive shutdown of turbines? If No, were precision product line tests performed? Yes Nob~ Yes ~ No Monitor Panel Is the monitor panel mounted and labeled correctly? Does monitor alarm horn function properly? Is panel accessible and visible to station personnel? Replaced all failed probes? Yes ~ No / N/A ~ If No, probes to be replaced/repaired by (Date) Inspected By: APC-3324 (8/96) Contractor .~L~ ~'3' Tech nicia~--t~d~l~~__.' S~gnature ~ ~~'ARCO Products Company Mechanical Detector Test Data Sheet Station ' daress Date Test Information Product Manufacturer Model Full Operating ~ess~e ~si) Trip T~e (sec) Me~fing ~ess~e ~si) F~ Holing ~ss~ (psi) Test ~ ~ (~n)(~h) PASS or FA~ Replaced All Failed Leak Detectors Yes No __ N/A If No, Replacement To Be Completed By (Date) / / This letter certifies that the annual leak detector' tests were performed at the above referenced facility according to the equipment manufacturers procedures and limitations and the results as listed are to my knowledge tree and correct. The mechanical leak detector test pass/fail is determined using a low flow threshold trip rate of 3 gph at 10 PSI. Inspected Byi Contractor ~ Technician' Lic# Signature APC-33~5 Business Namei /~('¢~ Am Location: Business Identification No. 215-000 Station No. Shift __ Arrival Time: ~kersfleld Fire Dept. OFFIng OF ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 Date Completed (Top of Business Plan) Inspector ,5~ d~cc~'oe~'c Departure Time: Inspection Time: Address Visable Correct Occupancy Verification of Inventory Materials Verification of Quantities Verification of Location Proper Segregation of Material Comments: Adequ.ate Inadequate Verification of MSDS Availablity Number of Employees: .. Verification of Haz Mat Training Comments: Verification of Abbatement Supplies and Procedures I=1 Comments: Emergency Procedures Posted Containers Properly Labled Comments: Adeq ate Inadequate Verification of Facility Diagram Housekeeping Fire Protection {~,, Electrical Comments: UST Monitoring Program Comments: Permits ?~ 13 Spill Control 13 Hold Open Device ~ 13 Hazardous Waste EPA No. Proper Waste Disposal Secondary Containment Security Special Hazards Associated with this Facility: Violations: Business Owner/~anager PRINT NAME ,~NATURE ~::f(~t - ~ All Items O.K Correction Needed White-Haz Mat Div. Yellow-Station Copy Pink-Business Copy UNDERGROUND STORAGE TANI SPECTION Bakersfield Fire Dept. Office of Environmental Services Bakersfield, CA 93301 FACILITY NAME ~4t"C'~ ./)~ ~/~ BUSINESS I.D. NO. 215-000 FACILITY ADDRESS q'~&3 /~;/ hdc. CITY (~'{,{ ZIP CODE FACILITY PHONE NO. ~3q' ~7(,, ID~ ID~ ID~ INSPECTION DATE ~1~/9 7 { ~ ~ , ~ Pr~uct Pr~u~ Pr~u~ TIME IN TIME OUT dM ~[d ~ ~ Inst Date I~st ~te Insl ~te INSPECTION ~PE: I ~ I I ~? ROUTINE FOLLOW-UP Size Size REQUIREMENTS yes no n/a yes no ~a y~ no ~a la. Forms A & B Submiffed lb. Form C Submiff~ lc. O~rating F~s Paid ld. State Surcharge Paid ~e. Statement of Financial Res~nsibili~ Submiff~ lf. Wriffen Contract Exists ~een Owner & O~rator to O~rate UST 2a. Valid O~mting Permit 2b. Approved Wriffen Routine Monitoring Pr~edure 2e. Unauthoriz~ Release Res~nse Plan 3a. Tank Integrity Test in Last 12 Months 3b. Pressurized Piping Integrity Test in Last 12 Months ~. Suction Piping ~ghtness Test in Last 3 Years ~. Gravi~ Flow Piping Tightness Test in Last 2 Years~ ~. Test Results Submiffed Within ~ Days ~ 3f. Daily ~sual Monitoring of Suction Pr~uet Piping ~ ~. Manual Invento~ R~onciliation Each Month , / ~. Annual Invento~ R~onciliation Statement Submiffed ~[ ~. Meters Calibmt~ Annually ~ .~ 5. Weekly Manual Tank Gauging R~ords for Small Tanks ~ 6. Monthly Statistical Invento~ Reconciliation Results 7. Monthly Automatic Tank Gauging Results 8. Ground Water Monitoring 9. Vapor Monitoring 10. Continuous Interstitial Monitoring for Double-Walled Tanks 11. Mechanical Line Leak Det~tors 12. El~tronic Line Leak Detectors 13. Continuous Piping Monitoring in Sum~ 14. Automatic Pump Shutoff Capabili~ 15. Annual Maintenance/Calibration of Leak Detection Equipment 16. Leak Det~tion Equipment and Test Methods Listed in LG-113 Series 17. Wriffen Records Maintained on Site ~O 18. Re~ed Changes in Usage/Conditions to Operating/Monitoring Pr~edures of UST System Within ~ Days 19. Repoded Unauthorized Release Within 24 Hours ~. Approv~ UST System Repairs and Upgrades 21. R~ords Showing Cathodic Protection Inspection 22. Secured Monitoring Wells 23. Drop Tu~ INSPECTOR: OFFICE TELEPHONE No.~J '..3-2(, "37~;;~O--- -- , FD 1669 (rev. 9/95) ARCO Products Corn Environmental Compliance 4 Centerpointe Drive La Palma, California 90623-1066 Telephone 714 670 5300 Mailing Address: Box 6038 Artesia, California 90702-6038 May 15, 1996 Certified P 858 949 808 Bakersfield Fire Department Hazardous Materials 2130 G Street Bakersfield, CA 93301 Attn: Re: Ralph E. Huey Monitor and Leak Detector Certification ARCO//6218 4203 Ming Road Bakersfield, CA .% This letter is to notify you that the leak detectors and continuous monitor at the site referenced above passed the annual certification tests as indicated in the attached results. ARCO is committed to the compliance of all environmental laws that govern the safe operation of underground storage tanks. Feel free to call me at 714-670-5423. Sincerely, Linda S. Andrews, PE Senior Engineer Environmental Compliance APPC-7116-A ARCO Products Company is a Division of AtlanticRichfieldCompany (3-94) ~ ~'~ARCO Products Company Monitor Certification Inspection This'letter certifies that the monitor(s) is/are in place,' the probes are in correct position and the system is operating properly. Address Annual ~'~ Permit Recheck . Leak Type & Model of Monitor System Function Tanks Annular Space Pass Regular Midgrade Supreme Waste Oil Other /41:~S kc/C Fail N/A In-Tank Fail C OITLiTIerltS: Product Lines P,.e~malar Nfid_m-ade Supreme Waste Oil Turbine Sump aiI N/A in-Line Pass ~-"~~ rz:~ Paze t of 2 Fill Sump N/A Reviaion 12.t95 ....... Monitor certification inspection (conti~'d) '- When monitor is turned offor in alarm, is there positive shutdown of turbines'? Yes ~ If'No, were precision product line tests performed? Yes .... No Comments: -- " Sensors / Probes Are sump sensors suspended within one inch of sump bottom? Are' doub-l~ walled FPP sen~0rs in}{~lled 15?or~erl~-i~ Monitor Panel Is the monitor panel mounted and"i~ibeled correctly? .. Does monitor alarm horn functiOn properly? " Is panel accessible and visible to s;ation persov, nel? Comments: " - Inspected Bv: Contractor Technician Signature Paae 2 of 2 Re¥i~ion 12/95 ARCO Products Company Mechanical Leak Detector Test Data Sheet Station # Address Test Information ,~..' Product Manufacturer Model :Full Operating Pressure (psi) Line BleedBack (ml) Trip Time (sec) I F/E Holding Pressure (psi) Test Leak Rate (reFrain) (gph) PASS or FAI2~ ' i , Th. is ierter certmes that the aP. nual teak de:ec:c.r tests ';.'ere oe,~ormed ar the above rerere.ncez ~ccord~n~ ~o the equ~pmen~ *, ,~=~- ..... ~ ' s:d" ' - ..... ~ · ~no~dae tree and co.eot, i neme..=:=.=~- .... ,_=..;~" u ~ ...... ...... , zest pass/fei} is ee..~...,ea'~ -,- us;-~,..= a iow flow tp~e~i'd trio rate of 3 gph ar !0 PS!. InsDec'red By: ,', , Signs.lure R:vision 12195 · ARCO Products ,~RCO Products Company/3rd floor 4 Centerpointe Drive La Palm, CA 90623-1066 June 14, 1995 Bakersfield Fire Department Ilaz. Material Div. 2130 "G" Street Bakersfield, CA 93301 Attn: Ralph E. Huey P 221 161 650 Monitor Certification ARCO#6218 4203 Ming Avenue Bakersfield, CA This is to notify you that the leak detectors and continuous monitor at the site referenced above passed the annual certification tests as indicated in the attached results. ARCO is committed to the compliance of all environmental laws that govern the safe operation of underground storage tanks. Please feel free to call me at (714)670-5406. Sincerely, David S. Cho Environmental Compliance Engineer APPC-7116 ARCO Products Company is a Division of AtlanticRichfieldComDany (6-92) LEAK DETECTORS TEST CH. ART Location , ~--vice Company _ Date Type of Leak Detectors Tested Check Appropriate Manufacturer(s) THIS ~ TO CEI~I~ T~A.T TEE ANNUAL LEAK DETECTOR TESTS MERE I='EP~OKME;D AT THE ABOVE REFEEENCED 2A~I'LITY. TEE METHOD USED TO TEST THE Lw.~d~ DETECTORS IS APPROVED E~, AND EXCEEDS TEE EXISTING SPECIFIC.&TION, ACCORDING TO I~iE MANUFACTURER. Monitor Certification Inspection This letter certifies that the monitor is in place, the probes are in the correct position and the operation of the system. FACILITY DEALER ADDRESS TYPE. AND MODEL OF MONrro~ £o.o_.~ gT~; ~ SYSTEM FUNTION · ^ss X FAIL N/A USED OIL PASS FAIL N/A IN LINE PASS SUMPS MONITOR PASS _ PRODUCT LINES ' FILL SUMPS FAIL N/A FAIL__ N/A ' PASS.7~ FAIL__ N/A__ WHEN MONITOR IS TURNED OFF OR IN ALARM DOES THE TURBINE SHUT DOWN? YES ~ NO IS THE CONSOLE LABELED CORRECTLY? YES_~ NO INSPECTED BY: TECHNICIAN te Underground Hazardous Materials Storage Facility Issued By: HAZARDOUS MATERIALS DIVISION 1715 Chester Ave., 3rd Floor Bakersfield, CA' 93301 (805) 326-3979 ::~:.:......'...~ :::::.!.: .... I.. ~ ~. ....... '~_3~J ~- .... -::..:' .::~'., '-. !i:~: .~,~v'~ ' Approved by: Ralph E. Huey, Hazardous Materials Coordinator UNDERGROUND'STORAGE TAN~I~I$~ECTION .*~ , · .' 'iii~?//;Bakersf, ield Fire Dept. · ilil Bakersfield, CA 93301 FACILITY NAME R~,OJD ~J~J ~IT~ ~2, ~ BUSINESS I.D. No. 215-000 ~ FACILI~ADORESS q~o~ ~% / CI~ ~~,~ ZIPCODE ~g~ RE-INSPECTION DATE. . OFFICE TELEPHONE NO. FD 1~9 INSPECTION DATE ~/ /~ ~/~ ~ TIME IN TIME OUT ROUTINE REQUIREMENTS la. F~s A & B Su~ ld. State Surcharge Pai~ 1 e. Stateme~,.~a~~si~l~ ' lf. W~en C~tm~ Exists ~n ~er ~. ~lid O~mtin~ Pe~ ~. Appmv~ W~en Ro~ine Monitoring Pr~ure ~. Tank Int~r~ Test in ~st 12 Months ~ 3b. Pr~ur~ Piping Int~ri~ Test in La~ 12 Months ~. Suction Piping ~ghtn~ T~t in Last.3.Yea~ ~. Gmv~ FI~ Piping ~ghtn~ T~ in La~ 2 Y~m /"~. Dai~ ~sual MonEoHng of Su~i~ Pr~uct Piping ~. Manual Invento~ R~ncil~tion Each M~th ~. Annual Invento~ R~ili~tion Statement Su~ ~. M~ers Calibmt~ Annually 5. W~kly Manual Tank Gauging R~rds for Small Tan~ 6. Monthly Statisti~l Invento~ R~nciliation R~uRs 7. MonthN A~o~tic Tank Gauging ResuEs 8. Gmu~ Water ~nE~ing 9. ~r Mon~oring 10. Continuous IntemtRial MonRoring f~ D~b~Wall~ 11. M~hanical Line Leak D~tom 12. El~tronic Line Leak Det~tom 13. Continuous Piping ~nRoHng in Sum~ 14. A~omatic Pump Shrift Ca~bil~ 15. Annual Mainten~n~Calibmtion of Leak Det~ Equi~ 16. Leak Det~tion Equipment and T~t Me~s List~ 17. Wr~en R~ords Main~in~ on S~e 18. Re~ Changes in U~ggCondAions to O~mti~A~ Pr~ures of MST S~tem W~hin 19. Re~ Una~ho~ Relea~ W~hin 24 Houm ~. Approv~ UST S~tem Re.irs a~ U~rad~ 21. R~ds Sh~ng Cath~ic Pmt~ti~ Ins~ ~. S~ur~ Mon~oflng Wells 'Ua&rground Hazardous Materials Storage Facility State I.D. N( ~it N~ Tank Number Issued By: Approved by: .::.~i':" :: i: !: .:.:?":':"':':.::::~: -)., i~. '~!i:-' :::::::'::::*:: '*.**"'..**'-'"':~::::. ~ ~ ~ · .~ ~,' ~.~-~ · .::!?'.:: ~ ~ i' :L:::':::.;:' :i~!~:::::i~!!~:., :..':: ~ii:,. ;~!~:~?'*' ========================= .'"'"'...-'-':':::~::::.. .... ,:~'::'!:! i~/::':';~li!ii!:i;::.':' '~i:;:;;!!?~':.!!!!?~(~:~i~::..:~?i?';;il C 0 N DITI 0 NS;:O Fi!~iP:EI1/Oil~ ;;!;!!lO N;!~!'.:R E V E R S E SIDE Substance C~:a6:!~%.::?'' ~n~'i~ii:~8?:::::..~:?.:?Type M0'h:!{~:i~:~?:~:~:~;~: Type u~ ~o~ ~ ?~:::~ ~:~ .......... ':;--...:':?;~F~:?~:~ .;:::?.' :: :~ ~'~ :::::::::::::::::::::::: /?~;::~;;::::~?'~:'::~::~:~ :.... ....... · .... . .............. · ..:..:,.::: ~ .... ... .... -. ......... ::,.......~: :;..::: ~.~ ....&:....-..............~ ............ ...%.:~:? ~ /.? .:?:: .?:......-..::~? ~ ~-a u~ ~, ~ ~ ~; ~ ~ t'~:':27~_ '~:;~;~.:: ~ _':::Z':'::?,~.?~: .... ..:.7 ..?.)....¢' ' ~[.~'~:~ ..?:::?:: ..... ~:D ~ :- t ...:'? .: : :" " ~ f ..:(.'.'" .::~?:('...?" ~':),,., Bakersfield Fire Dept. ===================================::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::: .... ?~ ~,~ "~ Piping Method HAZARDOUS MATERIALS DIVISION 1715 Che$1er Ave., 3rd Floor Bakersfield, CA' 93301 (805) 326-3979 Piping Monitoring Ralph E. Huey, Hazardous Materials Coordinator UNDERGROUND STORAGE TANK UNAUTHORIZ. (LEAK) / CONTAUINATION SITE REPORT COMPANY OR AGENCY NAME REPRESENTING [] OWNER/OPE~RATOR [] REGIONAL BOARD I ' ' [] LOCAL AGENCY []~OTHER ADDRESS ADDRESS ADDRESS CROSS STREET LOCAL AGENCY AGENCY NAME CONTACT PERSON PHONE REGIONAL BOARD PHONE · ., : [] UNKNOWN (2) [] UNKNOWN DATE DISCOVERED [ HOW DISCOVERED [] INVENTORY CONTROL [] SUBSURFACE MONITORING [] NUISANCE CONDITIONS DATE DISCHARGE ~EGAN METHOD USED TO STOP DISCHARGE (CHECK ~-L THAT APPLY) · .I .I oI - PI~ ,I ' ,I [] UNKNOWN [] REMOVE CONTENTS [] CLOSE TANK & REMOVE [] REPAIR PiPiNG HAS DISCHARGE BEEN STOPPED ? [] REPAIR TANK [] CLOSE TANK & FILL IN PLACE [] CHANGE PROCEDURE .~'; YES [], NO IF'YES, DATE - SOURCE OF DISCHARGE CAUSE(S) .~ ~ [] TANK LEAK [] UNKNOWN [] OVERFILL [] RUPTURE/FAILURE ~ SPILL o~o [] P,P,NGL~K ~-'OTHER'~' ,.. [] COR,OS,ON ~ UNKNOWN [] OTHER . [] UNDETERMINED [] SOIL ONLY [] GROUNDWATER [] DRINKING WATER - (CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) CHECK ONE ONLY r-) NO ACT,ON TAKE" [] PREL,M,NARYS,TEASSESSMENTWORKPLANSUBM' ED [] POLLUT,ONCHARACTER, T,ON ~I [] LEAK BEING CONFIRMED [] PRELIMINARY SITE ASSESSMENT UNDERWAY [] POST CLEANUP MONITORING IN PROGRESS [] REMEDmAT,ON PLAN '[~: CASE CLOSED(C~E~UP ~M~TED'.OR U~NECESS~R~ [] CLEANUP UNDERWAY CHECK APPROPRIATE ACTION(S) [] EXCAVATE & DISPOSE (ED) [] REMOVE FREE PRODUCT (FP) [] ENHANCED BIO DEGRADATION ((TI c30 [] CAP SITE (CD) [] EXCAVATE&TREAT(ET) [] PUMP & TREAT GROUNDWATER (GT) [] REPLACE SUPPLY (RS) < [] CONTAINMENT BARRIER (ce) [] NO ACTION REQUIRED (NA) [] TREATMENT AT HOOKUP (HU) [] VENT SOIL (VS) [] VACUUM EXTRACT(VD) [] OTHER (CT) GROUNDWATER TECHNOLOGY, INC. 4101Alken Street, Suite B-l, Bakersfield, CA 93308 (805) 589-8601 September 16, 1991 Fax: (805) 589-8605 Mr. Joseph A. Dunwoody Hazardous Material Specialist Hazardous Material Division Bakersfield City Fire Department 2130 G Street Bakersfield, California 93301 RE: Work Plan Addendum, ARCO Facility No. 6218, Bakersfield, California Dear Mr. Dunwoody: Soil borings for the subject site assessment have been completed. Three of the borings in the area of the original dispenser islands were found, based on field screening instruments, to be free of contamination. The work-plan sampling program indicates that two samples from each of these borings, the deepest sample and the one yielding the highest PID reading, will be analyzed. We instead propose that, because of the absence of contamination in the three borings, only the deepest sample be analyzed. Three samples from boring B10 which was completed in th~ vicinity of the former tanks will be analyzed to provide greater definition of hydrocarbons in that area. Thank you for your consideration in this matter. Because of the need to analyze the samples promptly, we will assume a positive response to our request if you haven't contacted us by September 19. If you have any questions or comments regarding this addendum please contact Jon Parker or myself at (805) 589-8601. Sincerely, cc: Kateri A. Luka, ARCO Products Company Offices throughout the U.S., Canada and Overseas rncon ASSOCIATES Consultants in Wastes Management and Environmental Control RECEIVED 5EP (} 5 HAT ~&T. DIV. Bakersfield Fire Department Hazardous Materials Division 2130 "G" Street Bakersfield, California 93301 Re: Updated Owner/Operator Agreement: ARCO Facility No. 6218 ' 4203 Ming Avenue Bakersfield, California AUgust 28, 1991 Project 805-96.09 Dear Bakersfield Fire Department: EMCON Associates (EMCON) has prepared this packet on behalf of Mr. Fred Seguin at ARCO Products Company (ARCO). Enclosed is the ARCO Owner/Operator Agreement information packet for the operation of underground storage tanks, including the current monitoring procedure used at the above referenced ARCO facilities within your jurisdiction. If there are any additional information needed to update your files, please call Mr. Fred Seguin at (213) 404-5310. If you have any questions regarding this transmittal please contact me at (818) 841-1160. Sincerely, Senior Geologist enclosure cc: Fred Seguin - ARCO Mail to: P.O. Box 7894, Bud:~ank, Califonfia 91510-7894 3300 N. San Femando Blvd., Burtmnk, California 91504, (818) 841-1160 Printed on recycled paper GROUNDWATER TECHNOLOGY, INC. RECEIVED 2 1 1991 HAZ. MAT. DIV. 4101Alken Street, Suite B-l, Bakersfield, CA 93308 (805) 589-8601 August 21, 1991 Fax: (805) 589-8605 Mr. Joe A. Dunwoody Hazardous Material Specialist Underground Tank Program City of Bakersfield Fire Department 2101 H Street Bakersfield, California 93301 RE: Transmittal, Boring Logs and Laboratory Analysis, ARCO Facility No. 6218, Bakersfield, California. Dear Mr. Dunwoody: Enclosed are copies of lithologic logs of soil borings B1 through B4 which were drilled at the above referenced site. Also enclosed are laboratory analytical reports for samples from those borings. These items are being sent as you requested in a letter to Groundwater Technology dated August 19, 1991. If you have any questions or comments regarding these documents please contact Jon Parker or myself at (805) 589-8601. Sincerely, GROU~WATER TECHNOLOGY Project Geologist enclosures: Log legend Lithologic logs B1 through B4 Laboratory analytical reports Offices throughout the U.S., Canada and Overseas FIRE DEPARTMENT S D JOHNSON FIRE CHIEF CITY of BAKERSFIELD "WE CARE" August 19, 1991 2~01 ~ STREET BAKERSFIELD. 9330t 326-3911 Jonathan D. Parker Groundwater Technology, Inc. 4101 Alken Street, Suite B-1 Bakersfield, CA 93308 RE: Site characterization work plan for the Arco facility located at 4203 Ming Avenue, Bakersfield, CA. Dear Mr. Parker, In order to completely evaluate the work plan submitted to this office for the above stated facility, the following additional information is required: 1. Lab data for soil borings 1, 2, 3, & 4 2. Boring logs for soil borings 1, 2, 3, & 4 Please. forward the requested information to this office as soon as possible. If you have any questions, please call me at (805) 326- 3979. Sincerely, Joe A. Dunwoody Hazardous Material Specialist Underground Tank Program ARCO Products Co.any ,, D~vls~on of Atlantic Richheld C~ffpany REGULATORY~AGENCY: BAKERSFIELD FIRE DEPT. SS# 6218 - PSI# 535 AMENDMENT TO LESSEE PMPA FRANCHISE AGREEMENT/DEALER/PREMISES LEASE OPERATION OF UNDERGROUND STORAGE TANKS This Amendment, dated ~. /~¢, ,lg %[, is attached ,o, incorporated in and made a part of the Lessee PMPA Franchis(~ Agr~ementJD~aler/Premises Lease ("PMPA Agreement"), in effect as of the date of this Amendment or, if applicable, to become effective concurrently with this Amendment, between ARCO Products Company ("Franchisor') and _ ?rest%~e Stat-ions Inc. #535 ("Franchisee"), covering premises located at · 4203 H±ng Ave. ~ Bakersf-[eld CA 93309 The parties agree as follows: 1. The parties have entered into this Amendment to comply with legal requirements imposed on Franchisor and/or Franchisee in order to operate the underground storage tanks at the above-referenced location. 2. Franchisor has provided Franchisee a copy of: (a) California Health and Safety Code Section 25299 or an approved summary concerning civil and criminal penalties for violating terms of any permit to operate these underground storage tanks and revelant statutory and regulatory requirements. (b) The following listed documents, a copy of which is attached and initialed by Franchisee: 3. Where Franchisor has provided Franchisee a copy of the permit to operate these underground storage tanks, Franchisee has read and understood its responsibilities as operator under the permit and agrees to do the following: (a) Monitor the underground tanks as specified in the permit to operate and otherwise required by law; (b) Maintain appropiate records as required by the permit to operate and make such records available to the federal, state and local government agencies and to Franchisor; JUL 2 3 1991 i ,-~DMIN. SERVICES UST C~ Le~lll PARSSA 1 of 2 (c) Follow all reporting procedures as required by the permit to operate and as otherwise required by law; (d) Mail, when submitted, to Franchisor, at the address specified in paragraph 1 of the PMPA Agreement, a copy of all reports submitted to government agencies; (e) Follow all operating procedures as provided by Franchisor; (f) Immediately report to Franchisor all suspected or confirmed releases from these tanks and connected piping system, unusual operating conditions, release detection signals and environmental conditions suggesting a release may have occurred, and any spills and overfills that are not contained and cleaned up; (g) Properly close the underground tanks as required by the permit to operate and as otherwise required by law; and (h) Comply with all federal, state and local legal requirements relevant to the operations of these underground tanks and all amendments to any permit to operate. 4. Except as herein amended, all of the terms and conditions of the PMPA Agreement, as previously amended or supplemented, remain in full force. IN WITNESS WHEREOF, Franchisor and Franchisee have executed this Amendment. WITNESS: WITNESS ARCO Products Company a clJvision of Atlantic Richfield Company Franchisor By: Manager Prestige Stations Inc. By:. ,..;/;....F ran c h i s e e ' s Name DATE: UST PARSBB 2 of 2 25299 (a) Any operator of an underground s~orage tank shall De liable for a civil penalty of not less =ban five hundred doli~ or more =ham five =housand dollars ($S.O00) per day for any of =he following: (1) Opera=es an underground s~orage tank which has no= been issued a permit. (2) Fails =o moni=or the underground storage =ank, as required by =he permit. (3) Fails to maintain records, as required by Sec=ion 25286. (4) Fails =o repo~c an unauthorized release, as required by Sections 25294 and 25295. (5) Fails =o properly close an underground storage =ank, as required by Section 25298. (b) Any owns= of an underground s20rage ~ankshall De liaOle Car a civil penalty of not less ~han five hundred dollars ($500) or more than five ~/~ousand dollars ($5,000) per day for any of =he following= (1) Failure to obtain a permit as specified by this chap=er. (2) Failure =o repair an underground tank in accordance wi=h =his chapter. (3) Abandormen~ or improper closure of any underground Storage tank subject ~o =he provi~ons of thk~ ¢~apter. (4) Knowing failure ~0 2aka reasonable and necessary s~eps assure ~ompl4Ance wi=h ~his chapter by ~he operator of an underground storage task (c) Any person who falsifies any moni~oring records required by =his chapter, or knowingly fails to repoL~c an unauthorized release, shall, upoD convic~ion, be punished by a fine of not less than five ~housand dollars ($5,000) or more ~han tan thousand dollars ($10,000), or by imprisonuen~ in ~/le county jail for not ~0 exceed one year, or by bo=h ~a~ fine and imDrisormen~. (d) ~ny person subject to Section ~.1 who fails to transmit the information as required by Section ~9~.1 shall be liable for a civil penalty of ~ot more than one thousand dollars ($1,OOO). (e) In determining both the civil and criminal penalties imposed pursuant to this section, the court shall consider all relevant circumstances~ in~luding~ but not limited to the extent of harm or potential harm caused by the violation, the nature of the violation and the period of time over which it occurred, the frequency of past violations and the corrective action, if any, taken by the person who holds the permit. (f) Each civil penalty or criminal fine imposed pursuant to this section for any separate violation shall be separate and in addition to any other civil penalty or criminal fine imposed pursuant to this section or any other provision of law and shall be paid to the treasury of the local agency or state, whichever is represented by the office of the city attorney, district attorney, ~r Attorney General bri~ging the action. (g) In addition to the state and any city or county implementing this chapter pursuant to Section ~5~83, a city or county specified in subdivision (a) of Section ~5~.1 may also levy and collect penalties under this section. (h) This section [specifically subsection (d)] shall remain in effect only until January 1, 1~1, and as of that date is repealed, unless a later enacted statute which is enacted before January 1, ~1~1 deletes or extends that date. SS# 6218 HAZARDOUS MATERIALS MONITORING pLAN ARCO PRODUCTS COMPANY FACILITY WITH DOUBLE CONTAINMENT UNDERGROUND STORAGE TANKS ARCO FAC 6218 ADDRESS 4203 Min~ Ave. Bakersfield CA 93309 1. MONITORING METHOD Underground storage tanks(UST's) and lines are monitored by a continuous electronic leak detection system which consists of an alarm panel, sensors and associated electronics. LiqUid sensors are installed in the annular space of each tank and product line piping sump. Whenever a sensor detects the presence of a liquid there is both a visual and audible alarm at the control panel. 2. ROUTINE MONITORING PROCEDURE On a daily basis the facility operator shall: Inspect the control panel for visual and audible alarm signals and that unit is operating. Inspect island and tank fill areas for signs of spillage or petroleum sheen· Record the inspection observations on the Daily Visual Monitoring Log (Form APPC-765 attached). LEAK'RECORDING '~'tD REPORTING PROCEDURE Whenever an alarm is activated station personnel are to immediately: Contact ARCO Maintenance or its designated agent by telephone. If any vis/ble indications of petroleum products or vapors are noticed call 911. Ce Make an entry in the Recordable Discharge Log (Form APPC-765-1 attached). Dm Complete the Recordable Discharge Log when and as the source of the alarm is known. RECORDS RETENTION All monitoring and leak recording logs are to be retained at the facility for three years· ~MMP ARCO Produc~Company O SS# 6218 INITIA~DLR. ~y Visual Und~rgroun¢ Storage Tank Monitoring ARCO f&Cili~ Syttem co~lt~ Int~t~ ~mmlntl 1 2 3 4 7 10 13 14 '' 'NOTE: IF ALARM CONDITION EXI$1'~ IMMEDIATELY NOTIFY ARCO MAINTENANCE OR ITS AGENT DESIGNATED ANO MAKE ENTRY ON ALARM ACTIVATION/DISCHARGE LO(] ARCO Pro~' ' Complny O RECORDABLE DISCHI *' I~OG DOUBLE CONTAINMENT UNDER~.,,~OUNO STORAGE TANK SYSTEM ARCO FaCility no. OeldeflFfanchlsee OI Dl~:ov~y II~tmlM Io DalWl*lme I)e~cdplkm ol cqm(llllool CogTecllv~ Ktlogt laimm O' , t~l~e&e 1l. Fewest ile~leetlel, leaee~ lete~t el4 T~ele Seerel (I) Till I~ll~t llllPlltl IWlIfll ~llllllPlll~l Illllel keliee ~II ~ till iPlilll deoePtleo Iii eoedilioeo lilt ~ee~ eleeelee Mi IIe~W ~1 ~ W~ill ~OON/ nd eee4ll~Me .i~ ~1~ Ileeelee e~l leel IFle~ ~ ~1111111. (e) (4) kellee r~l] ir llll mPtll%l ielefllee tie immel% feleft INlirlll IN tM ~Nll Iltlll, ~ lille lelff, If (I) Tie N~LI oNIioiItoi il8~ i/elude, Jul lit le Xl/lted U, lO. I (3) (6) (?) SS# 621ONITIALS (8) (9) uflderiPoufld erotism toni operator lad 21-hour eoerleflcY person. Tho halo sad telephone nulPar oF the person llk~fll the but not liuitad to, undoriround storsle toni mhd osPseity, history or repolPa, smd operation methods stoedordp set Porte in Su~aoettoe 2631(o) sad (])(1) and (2) or iPtia~e 3 er ta~o su~ebo~tor, or, iF apDXleo~lo, SuUseetioB 2633(e)(I) mud (2) or irtiele 3 itohdords set rorll in Se)smells. ~631(e) mud (J)C3) or sod eatRodie protee~loo methods (If splliss~le). vita reopeut to ~u~UlS or other lasdtsrts. laaludia$, ~ut not ~lmited to, the ro~ovinl ,here prouedures~ 10.2 SS# 6218 INIOLS CD) Set~e ommm~&n~ ~oeot&enm mod oetao4m mn4 onn~m&m ~rooedu~eo; CE) Vzdooo zone oom~Ln4 ~oeztLonm zed om&bode mod oom~ym~m orooedurnm; CF) Ground miter colics) %eeo&Leal, eenoiruot~oa and oroeeduPno~ mad (G) F~eeueaey end emmet&tv&my er ney mon~%o~iak me&nod tko mile or mBO lUlOPVlln~ or too div~llOn, IOlt~On, or (i) i p~tnelle~ emeeutt~o errione mt uo ~e,e~ or underfrouad mtormio toni(m) &8 Xoeolet~ oseae~ o) Toe mDlX~emtioa mnm~ ~ meeomoaaled Uy ~ne Fee met by toe :ool~ afoney. iutno~ty: NhSC-IS~99.3 te~ereaee~ ~&~ 2S]66 i~m) &o m oonditioo of ely Ooru%t to opermie on undorlround 10.3 SS# 6218 INOALS: (1) ?~e $~orele o~ new ~lz~rdoul ~uOa~ln~e~ (2) G~anie~ ~n denS,or,nS ~roaedure~ underlround 8~orile CO) A~ · oondLtZon or lay ~ermLt to o~er~te ia underlround lay un8ut~or~zed ro~esfe ooourrenooa, so dorLned ~n Art~o~e SubaeotXoua 2652(b) and 3 yemro m~m%% ~o m~o~ ~o ~Bo l~m% miemey, reS%one% ~mrd, Sto~e Beard, or duXy outBorisod representative u~n d~ond dur~ may m~to ~am~eUoa. ~mitorl~ rooordo LneZudo~ (2) flomttor&n8 equip/oat o/X&~f/l~om /ed mm~u~ommmoo reoordlt ~eOoro~oPy or ~n ~e shee~l; (5) Tho Z~lo oF 8ZZ reed~nio equipleat, Irouad vo~er eZevBtiono, remuXtm; end (6) The resurge or tnvon~ory (d) i po~t~ ~o operate ~oouod lO.ii SSf/ 6218 INITIO: DLR. the proviaLooe of theee regulations; The underground etorage taoa ouner ehall opply to the local agency for pOrlit faneuil it loiot 180 diyl prior to the axpirotion of the perlit. (e) The label egenoy shell have' .$~.-meMd~ nf~leq~t eote~lo~ea a (f) Pe~Lta Bay be transferred to nee underSround 8Corale tank sunera ~f t~e nee underground storase task ovner does not choose any oond~t~ous of the permit, the transfer lo ref~oterod u~ the local alenoy u~t~n 30 days of Beanie La oenersn~, and any neoeooary eodLF~eaCion8 are Bade ~o ~he ~n~orea~Lon ~n ~e ~n~/al ~rtL~ due ~o ~e ohanse ~u ounero~lG. · looal asenoy uny ~ev~ev, Bad,Fy, or ~ereina~e ~he pereX~ ~o operate ~he undersround aCorase ~ank upon reoe~vLof the ounere~Xp transfer request. (S) The l~oal asenoy ahalX no~ reneu an underground o~orase ~anK pe~l~ unless ~e underground a~oraie ~an~ has been Lnapeo~ed uLC~Lo ~he prLor 3 years and the ~opeo~lon revealed ~haC ~e uoderfround s~orafe ~anK o~plLeo Article 3 or ~ o~ t~t8 subehapter, aa a~pltaa~le, and a~ exio~nf pe~l~ oondl~lona. Tho lnapeo~ou s~a~ oonduo~ed as 8~o~r~ ~n ~he appropriate ouboeo~ton of Chap~er 6.T of Division JO o~ Oho Hee~h and Sare~y Code. ~r ~ ~uapeetiou revealed noneoapliane~ ~hen the loaal aleno7 Bust verify by a fallen-up lnspoeCiOU ~hat re~u~red eorreet~ono nave Ueen ~eplemented before (h) ~hio 30 days of reaeivinl aa lnopeat~on report frog either the looal aseney or the opeolal lnopeotor, t~e pe~lt holder shall fLle u~t~ Cna looal afeney a plan and tine so~edule lapleaent any required uodifioatLona to C~e underfround 8teresa tank or to tnb non,tarSuS plan needed to achieve o~lianoe with e~thor irt~ole 3 or irtiole ~ of thie plan ned Clie schedule snail 810o Implement all of Cbs roaouendet~oum of tUB s~,aXoI ~ul~eetar. Tbs lanai 8seney may ezup~ ~no 2epleueu~a~on of any or ~he inooeo~or'o reoonenda~lon8 booed on a deeono~ra~on ~y peml~ ~o~der ~o ~Ue ZooaZ 8ionoy'o sea,arcadian ~o~ Failure to re, lament tUB reeoumendotLoa wtll no~ eaume au unauthorized release.: Authority: H&3C 25299.3 Reference: H&SC 25284, 2S28S, 25288, 2S289, 25293 10.S August 6, 1991 Kateria Luka Arco Products Company P.O. Box 6411 Artesia, CA 90702-6411 RE: Laboratory results from preliminary site assessment conducted at the Arco facility located at 4203 Ming Avenue, Bakersfield, CA. Dear Ms. Luka, Upon review of the 'recently submitted laboratory results from your facility, .this office has determined that the extent of the contamination plume has not been adequately defined. This office requires (in accordance' with chapter 6.7 of the California Health and Safety Code and chapter 16, Title 23 of the California Code of Regulations) that further assessment be done to define the vertical and horizontal extent of the contamination plume. Please submit a work plan for further assessment, to this office, with in 30 days from receipt of this letter. The work plan should follow guidelines found in: Appendix A - Reports, Tri - Regional Board Staff Recommendations for Preliminary Evaluation and Investigation of Underground Tank Sites; January 22, 1991. If you have any questions, please call me at (805) 326-3979. Sincerely, Joe A. Dunwoody Hazardous Material Specialist Underground Tank Program cc: John Parker, GTI. GTEL ENVIRONMENTAL LABORATORIES, INC. Southwest Region 20000/300 Mariner Avenue Torrance, CA 90503 Client Number: 2153500607 Project ID: Arco SS#6218 Work Order Number: T1-O2-397 February 27, 1991 Mr. Jon Parker Groundwater Technology, Inc. 4101 Alken Street, Suite B-1 Bakersfield, CA 93308 Dear Mr. Parker, Enclosed please find the analytical results report prepared by GTEL for samples received on 02/22/91, under chain of custody number 72-6266. GTEL is certified by the California State Department of Health Services to perform analyses for drinking water, wastewater, and hazardous waste materials according to EPA protocols. A formal quality control/quality assurance program is maintained by GTEL, which is designed to meet or exceed the EPA requirements. Analytical work for this project was performed in strict adherence to our QA/QC program to ensure sample integrity and to meet quality control criteria. If you have any question concerning this analysis or if we can be of further assistance, please call our Customer Service Representative. Sincerely, GTEL Environmental Laboratories, Inc. Rebecca Hsu-Chou,Ph.D. Laboratory Director GTEL Torrance, CA Page 1 of 2 T102397. DOC Client Number: 2153500607 Project ID: Arco SS#6218 Work Order Number: T1-02-397 Table 1 ANALYTICAL RESULTS Aromatic Volatile Organics and Total Petroleum Hydrocarbons as Gasoline in Soil EPA Methods 5030, 8020, and Modified 8015a GTEL Sample Number 01 02 03 Client Identification B1-20' B2-20' B3-20' Date Sampled 02/22/91 02/22/91 02/22/91 Date Extracted 02/25/91 02/25/91 02/25/91 Date Analyzed 02/25/91 02/25/91 02/25/91 Detection Limit, Analyte mg/Kg Concentration, mg/Kg Benzene 0.005 <0.005 <0.005 <0.005 Toluene 0.005 < 0.005 < 0.005 < 0.005 Ethylbenzene 0.005 <0.005 <0.005 <0.005 Xylene, total 0.015 <0.015 <0.015 <0.015 BTEX, total ........ TPH as Gasoline 10 <10 <10 <10 Detection Limit Multiplier 1 1 I a. Test Methods for EvaluatingSolid Waste, SW-848, Third Edition, Revision 0, US EPA November 1988. Modification for TPH as gasoline as per California State Water Resources Control Board LUFT Manual protocols, May 1988 revi- sion. GTEL Torrance, CA T102397. DOC Page 2 of 2 GTEL ENVIRONMENTAL LABORATORIES, INC. 4080- Pike Lane Co.cor~. C^ 94520 800-54~*3~2~(,nOA> ~~S~S~UE~ . .... 72- 6266 ~,v,~o.a~.,,~ 415-685-7852 800-423-7143 (Outside CA) ANALYSIS REQUEST LA~ORA~O~I[5. Project Managen Phone ~ .~- ~o ~/ D n I "~ ' Project Numbe: Project Name: g ~attestthattheproperfieldsampling ' SamplerName(Print): ' - ~ ~ ~1~ ' procedures were used dunng the collection ,~ / / ~ O, ~ m ~ ~ 9 ~ 0 Field Source GTEL' ¢ Matrix · Method Sampling ~ ~ D ~i ~ ,o'o o o SPECIAL HANDLING SPECIAL DETECTION LIMITS(Specify) REMARKS: EXPEDITED 48 Hours ~ -- OTHER ~ (~) BUSINESS DAYS ~ Q~QC CLP Level D Blue Level D SPECI~ REPORTING REQUIREMENTS ~b Use. Only Storage Location RECEIVED MAR 0 7 1991 SMC Laboratory Analytical Chemistry Client Name: Groundwater Technology, Inc. Address : 4101Alken Street, Suite B-1 Bakersfield, CA 93308 Attention : Maura Hanning Date samples received : 3-5-91 Date analysis completed: 3-6-91 Date of report : 3-6-91 Project Site: ARCO SS ~6218 RESULTS OF ANALYSIS: 985 ID: B4-20' Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene TPH (Gasoline) ugm/gm ND ND ND ND ND ND ND MDL,ugm/gm 0.005 0.005 0.005 0.005 0.005 0.005 0.005 ND 1.0 Method of Analysis for BTXE: EPA 8020 Method of Analysis for TPH (Gasoline): EPA 8015 MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ugm/gm = micrograms per gram (ppm) ND = None Detected Stan Comer Analytical Chemist 3155 Pegasus Drive P.O. Box 80835 · · Bakersfield, CA 93308 · (805) 393-3597 Bakersfield, CA 93380 · FAX (805) 393-3623 FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF CITY of BAKERSFIELD "WE CARE" August 28, 1991 2101H STREET BAKERSFIELD, 93301 326-3911 Groundwater Technology, Inc. 4101 Alken Street, Suite B-1 Bakersfield, CA 93308 Attn: Stephen Bork RE: Site characterization work plan for the Arco facility located at 4203 Ming Avenue, Bakersfield, CA. Dear Mr. Bork, This is to notify you that the workplan for the above stated address is accepted pending the receipt of the following information and addendum: 1. A site map showing all three proposed boring locations; A minimum of four(4) soil samples from each soil boring will be submitted to the laboratory for analysis, two(2) samples with the highest PID readings and two(2) consecutive 5 foot samples "0" PID readings. Please give this office 72 hours notice prior to the commencement of work. If you have any questions, please call me at (805) 326-3979. Sincerelv~ / Hazardous Material Specialist · Underground Tank Program Log Legend Unified Lifhology Symbols* Soil Construction Symbols Class. Group** Grovel ~ [~ Neat Cement, o~ aa° Sandy GW,GP ...... Grout C::)O ~ Sil,y GM ~ Bentonite C)(~)i ~ ~ Filter Pack Clayey GC Natural Kill S o n d I'.~©:1Cobbly SW AsphoH Poring, I' ''''''''''''''''':''''''~ ~ Concrete :-:-:-:-:":-:-:-:-:-:-:':" S ~ Clayey SC ~ Well .Screen Silt ~ Sample Types .... ~ SS - Split Spoon .... Pebbly --_-~~ ML,MH CC - Continuous Core - - - - ~!;~ Sandy CG Cuttings Grab ~ Cto~w Fluid Levels Cloy ~ Cobbly Wa~er Product Pebbly S - Sand ~ . '~:==::~ CL,CH M - Silt I !~ Sandy C - Clay ~ Pt - Peat ~ Silly W - Well Graded P - Poorly Graded L - Liquid Limit < 50 H - Liquid Limit > .50 Peat Organic 0 - Organic "Modified from Compfon, 1962. Project ARCO SS#6218 Location Ming & Stine, Bakersfield, CA Dote Drilled February 22, 1991 Surface Elevation Screen: Dia. Length Casing: Dia. Length Drilling Co. Sierra Pacific Exploration Driller J. Miles Drilling / Lithologic log Boring/Well No. B1 Owner ARCO Products Company Project Number 215-.350-0607 Total Depth 20 Feet Depth to Water Slot Size Type Drill Method Hollow-Stem Auger Logged By M. Harming ~ Well ~ o ~ Samples J v Const. ~_ o Description / Soil Classification ~_ ~ ~ _c o_ .=. (Texture, Color, Structures) o_ = ~ Number ~o - ,,I,I, . ............. Sand, medium to coarse grained, well I1,1,1 ;~;~:~;~;%P' ............. sorted, subrounded, loose, dark yellowish - !,1,1, ::::::::::::::::::::::::::: brown, dry, very permeable, no petroleum - ~, I, ~ ::::::::::::::::::::::::::: 5: I, ll, i 6 B1-5' S , , 4 ::::::::::::::::::::::::::: ::::::::::::::::::::::::::: I,l,l[ ?:':':':'::':':':':':':': Sand, medium to very coarse grained, ' ' ],1, ;;~:~;~;~ ;W moderately sorted, subrounded, loose, 0~ ~ 0'$~ .............. ~oderote yellowish brown dry, very ~ 6 B1-1 3 (:~:~:~:~:E:~:~:~:~:~:) ' - ~ 5 ;~:~:~:~:~:~:~:~:~:~:~:~:~ permeable, no petroleum odor. - I, I, :"'-':' ""'""'"": ............... - , I, J ::::::::::::::::::::::::::: l,l,, :::::::::::::::::::::::::::: Sand, medium to very coarse grained, - , I, I :::::::::::::::::::::::::::: ;W moderately sorted, subrounded, loose, 15% I~I[:, , 7 B1-15'SS 4 ~;;;;~;;~ .............. moderate yellowish brown, dry, very - t,I, 5 ~:~:?~:~:~:~:~:~:~:~:~ permeable, no petroleum odor. , ~, ~ ~ :::::::::::::::::::::::::::: - I, 1, :::.-:.-::::.'.':: - ,I,I ~;~ Sand, medium to very coarse grained, I,I, ~;~[~W moderately sorted, subrounded, loose, - ,l,l ::.:.:.:.:.:.:.:.:.:.:.:.::. moderate yellowish brown, dry, very 20~ I, I, 5 B1 -20' S5 4 z':':':':':':':':':':':':': - 5- permeable, no petroleum odor. _ 25Z - Page 1 of 1 III TECHNDLDGY Project ARCO SS#6218 Location Ming & Stine, Bakersfield, CA Date Drilled February 22, 1991 Surface Elevation Screen: Dia. Length Casing: Dia. Length Drilling Co. Sierra Pacific Exploration Driller J. Miles Driling / Lithologic log Boring/Well No. B2 Owner ARCO Products Company Project Number 215-350-0607 Total Depth 20 Feet Depth to Water Slot Size Type Drill Method Hollow-Stem Auger Logged By M. Hanning ~. Well ~ o e ~ E Samples J ~ --%- Const. o_ u o_ o ~ Description / Soil Classification ~ ~ _c (Texture, Color, Structures) a. = n Number ~ o o o - ,I,I, ~:!:!:!:!:!:!:i:i:!:!:!:!:~ Sand, fine to medium groined, well sorted, I,I,I .~!:i:!:!:!:!:!:!:!:!:!:!:!:tSF subrounded, loose, dark yellowish brown, - ,I,I, ".:.:.:.:-:c.?:.::.:-': dry, moderately permeable, no petroleum ,I, I, ""'""'"'"'"""'"-'- odor. 5 - I, I, I.3 B2-5' SS 3 .............. ::::::::::::::::::::::::::: - 1, I, 3 ::::::::::::::::::::::::::: - ,,i,i, ..............-. ::.-.-.-. - Ii111 ¥:::::::::::::::::::::: Sand, medium to coarse grained, well _~ ~,'' ::::::::::::::::::::::::::::::............................ sorted, subrounded, loose, moderate ~-~ :"'"'"'"'"'""'-'-': yellowish brown, dry, very permeable, no 10- ~ ~- 2 B2-10'SE : ::::::::::::::::::::::::::: -,~ 3 ::::::::::::::::::::::::::: petroleum odor. , l, [' 6 ::::::::::::::::::::::::::: -- I , I , :-.:..........-...: .............. I,I, ::::::::::::::::::::::::::: Sand, medium to coorse grained, well 15- 1,1, 2 B2-15' ~':':':':':':':':':':':':"~SP sorted, subrounded, loose, moderate ,I,I SS : _.:::::::::::::::::::::::::::_ yellowish brown, dry, very permeable, - I, I, 5 ::::::::::::::::::::::::::: .............. no petroleum odor. , l, I 6 ::::::::::::::::::::::::::: -- I, 1 :...........:.......: ............ - ,I, ~:i:i:i:i:i:i:i:i:!:i:i:i:~ Sand, medium to coarse groined, well - II ;':':':':':':':':':':':':';SP sorted, subrounded, loose, moderate '' ::::::::::::::::::::::::::: yellowish brown, dry, very permeable, 20- ,I,I 2 B2-20' SS 5 ~"'""'"'""'""'""~ no petroleum odor. _ 9 - 10 25Z Page 1 of 1 Project ARCO SS#6218 Location Ming & Stine, Bakersfield, CA Dote Drilled February 22, 1991 Surface Elevation Screen: Dia. Length Casing: Dia. Length Drilling Co. Sierra Pacific Exploration Driller J. Miles Drilling / Lithologic log Boring/Well No. B3 Owner ARCO Products Company . Project Number 215-350-0607 Total Depth 20 Feet Depth to Water -- -- Slot Size -- Type -- Drill Method Hollow-Stem Auger Logged By M. Hanning -2 Well .--. o -~ Const. E Samples J a_ .o_ 0 Description / Soil Classification -~ '-' ~ ~- (Texture, Color, Structures) c~ ~ ~ Number ~ o ~ o I, I, ~ '.:.:.:.:.:.:.:.::.:.:.:.:.': - ,I,I, ~:i:i:i:i:i:i:i:i:!:i:i:i:!~ Sand, very fine to medium groined, well I, I,I ::!:!:!:!:!:!:!:!:!:!:!:i:!:SF sorted, subrounded, loose, moderate - ,1,1, ::::::::::::::::::::::::::: yellowish brown dry, very permeable, no ,I, I, 4:i:i:i:i:i:i:i:i:i:i:i:i:~ petroleum odor. 5 -q !1, I, I ~{:i:{:i:i:::i:i:i:i:i:i:i.~ _ I, 1, 2 B3-5' SS 5 i:i:}:i:i:i:i:i:}:i:i:i:i:i , I, I 3 - I,I, -'-'.'.'-'-'-'-'-'.'-'-'-'.'- - ,I,I :~:':':':':'::':':':':':'~ ............... Sand, medium to coarse grained, well _~l~J: ~}:!:!:!:!:!:!:!:!:!:!:!:iSp sorted, subrounded, loose, moderate 10-,~ ~f-o 2 B3-10'SS 3 ~:!:!:!:!:!:!:!:!:!:i:!:!:}~ yellowish brown, dry, very permeable, no - 4 ~ii{iii{i!i!i{i!i!iii{i!i[~ petroleum odor. I, I, I 5:2:21:2: ,I,1 ::::::::::::::::::::::::::: Sand, medium to coarse grained, well - 1,1, ::::::::::::::::::::::::::~::F sorted, subrounded, loose, moderate 151 iii!, 2 B3-15'!SS 4 '~:i:i:i:i:i:!:i:i:i:i:i:i:~ ...............yellowish brown, dry, very permeable, no - I, I 6 {:i:i:i:i:i:i:i:i:i:i:i:i:~ petroleum odor. ~, ~, 6 ~.:.:.:.:{::-:-:{{-2 ~ , :"'"'"""'"""'""~ Sand, medium to coarse grained, well -- :~ , ~ , h l,I ::::::::::::::::::::::::::::: sorted, subrounded, loose, moderate - I,I, ~'.'.-.'.'.'.-.'.'.'.'.'.'~ ::::::::::::::::::::::::::: yellowish brown, dry, very permeable, 20~ I,I 2 B3-20' SS 5 '"""""'"""'"'"": no petroleum odor. ~ 6- 7- - 25- Page 1 of 1 TI:'CHNBLOGY Project ARCO SS#6218 Location Ming & Stine, Bakersfield, CA Dote Drilled March 5, 1991 Surface Elevation -- Screen: Die. -- Length Casing: Die. Length Drilling Co. Sierra Pacific Exploration Driller J. Miles Drilling / Lithoogic log Boring/Well No. B4 Owner ARCO Products Company . Project Number 215-550-0607 Total Depth 20 Feet Depth to Water Slot Size Type -- Drill Method Hollow-Stem Auger Logged By M. Hanning -~ pi ~ E Sam es _~ co v Const. a_ o o_ o © Description / Soil Classification ~ ~ ~ (Texture, Color, Structures) ~ = ~ Number ~ o ~ o - , I, I ~L~;~;~;~ petroleum odor. - ~:~:~:~:~:?~:~:~:~:~:~:~?~P sorted, subrounded, loose, moderate 10% B4-10'SS ~ ~]]]]~;~ yellowish brown, dry, very permeable, - ~ ~ 4 ~ no petroleum odor. ...............moderate yellowish brown, dry, very - ~:~:~:~:~:~:~:~:~:~:~:~:~ Sand, medium to very coarse grained, - ~ SS ............... ~ moderately sorted, subrounded, loose, - 6_ permeable, no petroleum odor. 25~ Page 1 of 1