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UNDERGROUND TANK
· .P-F~:R&~iT APPLICATION FOR~ii~EMOVAL OF AN :~i~ .,c' d. ~,47_ ._ p'EltM,T'~o---- -- UNDERGROUND STORA(~NK : i~ HAZARDOUS MATERIALS DIVISION UNDERGROUND STORAGE TANK PROGRAM SITE INFORMATION ~ ~ .. ' S-~~.~ /~[£C.-.~-/~r~ ADDRESS ~/.Z~./~eSe~a../~. ZiP CODE ~ ~~ APN FAC~LI~NAME K~m:~' R'~ep~, CROSS STREET ~//o~ ~, TANK OWNER/OPERATOR I('~o~q~ ~ ~c~ · PHO~ENo. ~&/-~ MAILING ADDRESS /ll~o~4.~u~. CI~ ~rs~'~'e[~ ZiP CODE ~o/ CONTRACTOR INFORMATION COMPANY Kc~rn -~'r~,¥iro~.w'tej/~'~ 5¢J"V', PHONE No.(~'0~) 5';¢'c?-¢-Z:Zd LICEhSE No. ADDRESS 'P. O, C50,% 5-a37 CITY ~L~.~r~¢Ce[dr ZIP CODE INSURANCE CARRIER '7~/,,n,~..r~ ,~ ~;),'~_.ed' WORKMENS COMP No, PRELIMANARY ASSEMENT INFORMATION COMPANY )~rn ~'rwb'o~'x~q.e~4-¢i -._~8f¢, PHONE No.c/~5'~'~5'.~c~-~'ZZD LICE,NSE ADDRESS ~.0, ~,,<: ~'7,_d~37 ' ClTY:/?~.k-~.rs¢,'ctd. ZIP CODE INSURANCE CARRIER .?-Z'/yr~C. rt. ,¢ &j;j~er' WORI4MENS COMP No. TANK CLEANING INFORMATION COMPANY /<'~rn Er~lir©~_w~e.~-(-zc/ .~'~;r-u /c..¢--. PHONE No, ADDRESS '~.o, ~ x ~ 7 - CITY '~~'e.{~ ZIP CODE WASTE TRANSPORTER IDENTIFICATION NUMBER ~ ~2q¢ffG¢~ · NAME OF RINSTATE DISPOSAL F~ILI~ ~; b~ 0;~ ~ ~t'~,.'~ff · ADDRESS ~ ~~ ~V~.. CiTY ~-~5¢,'~ZIP CODE FACtLI~INDENTIFICATION NUMBER ~'~ qZO¢~,~ i2'7 TANK TRANSPORTER INFORMATION COMPANY k~r~ ADDRESS '-'-P.O. '~,~-f.. ~'".:~'7 CITY _'~j__¢,_]c~r~.,L'~:~.{~ ZIP CODE TANK DESTINATION TANK INFORMATION TANK No. AGE VOLUME CHEMICAL DATES' CHEMICAL STORED, STORED PREVIOUSLY STORED THE APPLICANT HAS RECErVED, UNDERSTANDS, AND WILL COMPLY WffH THE ATTACHED CONDfflONS OF THIS PERMff A~qD ANY OTHER STATE, LOCAL AND FEDERAL, REGULATIONS. /?/'3 /.~n' ./ . . -. . . ... A~ APPLICANT NAME (PRINT) APPLICANT SIGNA¢~RE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED Make checks payable to "C~y of B(d~ersl~eZd" h~ORTH \ SCALE: BUS It;ES:'.; N,\HE: FLO(.)R: OF DATE: / / FAC[L!TY f .... JOEL A. HEINRICHS COUNTY ADMINISTRATIVE OFFICER KERN COUNTY'.. ADMINISTRATIVE OFFICE scoTr JONES Assistant County Administrative Officer WILLIAM C.. DOUGLAS Employee Relation.,~ Officer October 23, 1995 City of Bakersfield Fire Department Office of Environmental Services 1715 Chester Avenue Bakersfield, CA 93301 Attn: Howard Wines Dear Per our telephone conversation on October 20, 1995, enclosed is a copy of the County's Certification of Financial Responsibility for all underground storage tanks owned by the County. The original of this form is on file with the County Environmental health Services Department. If you have any questions or need any further information, please feel free to contact me. Fred A. Plane Deputy CAO FP:dr\tankscit.fin Enclosure cc: Robert Perry, Risk Management Charles Conner, Communications Division David Baumstark, County Administrative Office 1115 Truxtun Avenue, 5tlr'Floor BAKERSFIELD, CALIFORNIA 93301 (805) 861-2371, FAX (805)325-3979 R.E. HUEY HAZ-MAT COORDINATOR (805) 326-3979 FIRE SAFETY SERVICES & OFFICE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVE. * BAKERSFIELD, CA * 93301 SEP 2 6 1995 FINAL NOTICE!I! R.B. TOBIAS. FIRE MARSHAL (805) 326-3951 REVOCATION OF UNDERGROUND STORAGE TANK PERMIT WILL FOLLOW IN 30-DAYS IF'VIOLATION PERSISTS Pleeee be aware that failure to provide the financial responsibility document to this office within 30 daye, will reeult In your Permit to Operate being revoked (25285.1(b) California Health & Safety Code). Dear Underground Storage Tank Owner: Our records indicate that your business does not nave a Certification of Financial Responsibility on file with this office. Our records also indicate that you have been issued at least one warning letter prior to this notice. Please forward either a copy of your existing State approved mechanism to show financial responsibility or else complete the attached Certification for Financial Responsibility form and return it to this office within 30 days. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resulting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability. The Underground Storage Tank Clean Up Fund (USTCF) may be used as the mechanism to cover the remaining accidental release liability. The total amounts of financial responsibility required '(check boxes from section A of form} are as follows: If you do?t sell product from your tanks, and you pump !ess than 10,000 gallons per month, check "$5~0,000 per occurrence". For owners of 101 or more petroleum underground storage tanks, check the "2 million dollar annual aggregate" box. All other need only check the "1 million dollars annual aggregate". If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician, at 326-3979. Sincerely, Hazardous Materials Coordinator REH/dlm attachments. ~MORANDUM Joseph E. Drew County Administrative Officer TO: Distribution DATE: June 6, 1994 FROM: ~Fred Plane Deputy CAO S~: UNDERGROUND STORAGE TANKS Attached for your information is the statement of financial responsibility for underground storage tanks operated by your department. This information has been filed with the Environmental Health Services Department and the State Water Resources Board. If you need any further information, please contact me. Distribution: Karen Geye, General Services Department Mike Parker, Fire Department Dave Price, Airports Department Ron Errea, RMA Daphne Washington, Waste Management Department Lee Willeford, KMC cc: Robert Perry, Risk Management Attachments .CERTIFICATION OF FINANCIAL RESPONSIBILI ~ ~~~ 8~ T~ ~NIN~ p~M (~~~) ~orksheec County o~ ~ern 1 million Test 111~ Truxcun Avenue ~Ch ~ ~ per Bakersfield, CA 93301 N/A occurrence 1 y~ y~ y~ ~ ~te ~te: If ~u e~ ~i~ ~ ~M F~ ~ a~ ~ of ~ ~~n of ~1 ~~, ~ur ~n a~ s~n of th= ce~t~ a~ ~ ~ ~u are ~ ~m~ ~ afl ~ ~r ~~ ~ ~ F~. ~ a~ached F~ Nme ~-}1-~ Count~ of Kern-Joseph ~. *~.~ ~'~ ~ ~i~t*., -~LL~ ~ 5-31-94 Sharon Pierce ~i~ f~ ~ site. A. ~ ~M - ~ the ~ilte ~. I. W M T~ W - Fut~ ~ of either t~ z~ mr or h ~retor. w ~t~ C. ~im T~ - IMi.te ~!~ Stile K ~iEI) e~ ~i~ = to ~ fi~fei ~ibill~ .lt~r . ~tli~ in t~ f~li ~lltln, G CFR, PiK ~, ~ H, ~tln ~.N th~ ~.1~ (b Fi~iii I~lbllf~ bi*, for ~ t~omtlm), or Klm ~.1, ~tv 18. 01vlllm 3, Title ~, =. ~ of I= - List iii m ~ ~flm of ~i~ ~ i~ivl~ls imi~ c~. ~tm I~ - List i~ti~i~ ~r for e~ ~tm ~. i~ie: imw~e ~[1~ ~r or file Wr is t~i~t~ ~ ~-~G or ~. (If sin Silts CIK ~ (Stets f~) iee~ bl~.) ~ ~t - ]~i~te Et of cMr~ for e~ t~ of ~iMI). If ~ t~ ~ ~im ii i~t~t~, total ~t mi 1~ of Ii--iii rmiblii~ for ~ feci ~ t ry. ~ P~i~ - i~icite the effKti~ Mil(l) of Iii Ii--iii ~iMi). (Stite'F~ ~r~ G~d M cmti~ . ~q is ~ mtntiin ~ltw ~ ~in eligible to cmti~ ~rtici~tim in the f~.) Cor~tiw ~tim - i~i~te ~ or ~. Dm the wifi~ ft~il[ Kmtl pr~f~ cMr~ for corrKtive Kti~? (If ~i~ Stile f~, t~i~te ~-.) Thj~ Pirty - i~iclte yes or ~. Dm the ~tfJ~ fJ~iai ~iM provi~ coverl~ for ~tim tht~ ~rty cmitim? (if ai~ State F~, i~iCltl ~-.) Provi~ al~ facility ~/or site ~ I~ ~r~ses. D. Facility - lnformtim E. Signature Block - Provide signature end date signed by tank o~ner or operator; printed or typecl name and title of tank o~ner or operator; signature of witness or notary end date signed; end printed or typed name of uitne~s or notary (if notary signs ss witness, please place notary seal next to notsry, s signature). I~ere to Nail Certification- PLease send original to your Local agency (agency I,dho issues your UST permits). certificatio~ at each facility or site listed on the form. Keep · cq:Jy of the ..Quest icfls: if you have questions on financial respoemibiLity requirements or on the Certification of Financial Responsibi L ity Form, please contact the State UST CLeanup Fund at (916) 227-&307. Note Penalties for Fa~Lureto L with Financial R ibili R irements: Failure to comply may result in: (1) jeopardizing cLainmnt eligibility for the State UST CLeanup Find, and (2) Liability for civil Penalties of uP.to $10,000 dollars leer day, per Lr~erground storage tank, for each day of vioiatio~ as stated in Article 7, Section 25299.76(a) of the California Health end Safety Code. WORKSHEET FOR .',RIIX'IClPAL FL'~ANCIAI. TEST .2. PART h BASIC L~ORI~IATION 1. Total Revenues a. Revenues (dollars) Value of mvanu~s e. xcl-~e~ liquidation of i,,v~im~ts ami issuan~ of deb~. Value includes ali general fund operating and non- operating revenues, as well as all revenues from ali other govemmanr%i funds including en~eprise, debt service, capilta/projects, and special revenues, but excluding tevanues to funds held in a trust or agency, capaei~. b. Subtract interfund transfers (dolla.,s) c. Total Revenues (dollars) Total Expenditures a. ExpenditUres (dollars) bo Value ennsists of the sum of genereJ fund operatm! and non-operet/ng expenditures including interest payments on debt, payments for mtitem~t of debt principal. and total expenditures from ali oth~' govemmmm funds includ/ng enterpt/se. debt service, capi~ projects. ~ spec/al Subtract interfund transfers (doLlars) Total Expenditures (doUars) Local Revenues a. Total Revenues (from lc) (dollars) b. Subtract total intergovernmental transfers (dolia,-s) c. LocaJ Revenues (doUars) . Debt Service ao Interest and fiscal charges (dollars) Add debt retirement (doLlars) Total Debt Service (dollars) -- bo 726~259,315 10,079,927 .716,179,388 741,802,931 10,656,028 731,146,903 716,179,388 375,524,602 340?654,786 7,002,290 4,296,700 11,298,990 PART H: '7. .8. Total Funds (Sum of amounts held as cas& and invesmmnt securities from all f~nds, excluding amounts held for en~ioyee retirmn~nt funds, agmcy funds, ami trust funds) Population (Persons) APPUCATION OF TEST Total Revenues to Population a. Total Revenues (from lc) b. Population (from 6) c. Divide 7a by 7b d. SubHmct 417 e. Divide by 5,212 f. Multiply by 4.095 Total Expenses to PopU~on a. Total Expenses (from' 2c) b. Population (from 6) c. Divide 8a by 8b d. Subtract 524 ¢. Divide by 5,401 f- Multiply by 4.095 Local Revenues to Total Revenues a. Local Revenues (from 3c) b. Total Revenues (from lc) c. Divide 9a by 9b d. Subtract .695 e. Divide by .205 f- Multiply by 2.840 53,526,836 610,000 716,179,388 610,000 1174,065 757,065 0.1453 0.595 731,146,903 610,000 ~1198.601 674.601 0.512 __ 340,654,786 716,179,388 0.4757 -0.2193 -1. 070 -3.038 10. 11. 12. 13. Debt Service to Population a. Debt Service (from 4d) b. Population (from 6) c. Divide 10a by 10b d. Subtract 51 e. Divide by 1,038 f. Multiply by - 1.866 Debt Service to Total Revenues a. Debt Service (from 4d) b. Total Revenues (from lc) ¢. Divide lla by llb d. Subtract .068 e. Divide by .259 f- Multiply by - 3.533 Total Revenues to Total F. xpenses a. Total Revenues (from lc) b. Total Expenses (from 2¢) c. Divide 12a by 12b d. Subtract .910 e. Divide by..899 f- Multiply by 3.458 Funds Balance to Tota/Revenues a. Total Funds (from 5) Total Revenues (from lc) Divide 13a by 13b Subuact .891 Divide by 9.156 Multiply by 3.270 11.?02.990 61 o. ooo 18.523 -32.477 -0.0313 O. 058 11,298,990 716,179,388 0.0158 -0.0522 -0.202 0.712 716,179,388 _ 731,146,903 0.980 0.070 0.0779 0.269 53,526,836 .. 716,179,388 0.0747 _ -0.8163 -0.0892 -0.292 KERN COUNTY OWNED UNDERGROUND STORAGE TANKS Number 160028 160026 120007 060023 010006 540002 090005 120003 390022 230001 450034 040009 010027 520025 53O001 Jessie Street 1350 Norris Road 128 E. Coso Street Ridgecrest, CA 1830 Flower Street Industrial Farm Road 301 S. Oswell Street Lost Hills Airport Lost Hills, CA 101 E. Roberts Lane 101 Universe Avenue 11018 Kernville Road Kernville, CA 140 E. Las Flores Ridgecrest, CA Description De?artment Diesel/Emer. Generator General Services 1 Gas General Services 1 Diesel 1 Waste Oil 1 Diesel/Emer. Generator 1 Gas General Services 1 Gas General Services 1 Gas. General Services 1 Diesel/Emer. Generator 1 Diesel/Emer. Generator General Services 1 Diesel/Emer. Generator General Services 3 Diesei/Emer. Generator KMC 2 Diesel/Emer. Generator Sheriff 1 Gas Kern Sanitation 1 Aviation Gas Airports 1 Gas Fire 1 Diesel 1 Gas Fire 1 Gas Fire 1 Gas Fire 1 Diesel 450023 '520019 590016 230028 330103 440018 510029 560008 160029 6OO023 580008 630025 410013 520026 14670 Lost Hills Road Los Hills, CA I Gas 1 Diesel 16001 Walker Basin Road 1 Gas Walker Basin, CA 1953 Highway 58 Mojave, CA 2214 Virginia Avenue 2420 Symonds Drive Pine Mountain Club, CA 2424 7th Street Wasco, CA 24700 Highway 58 Keene, CA 26965 Cote Street Boron, CA 2731 "O" Street 28946 Bear Valley Road Bear Valley Springs, CA 2980 Desert Street Rosamond, CA 301 Campus Drive Arvin, CA 325 Campus Drive Shafter, CA 4500 Lake Isabella Lake Isabella, CA Gas Diesel Gas Diesel 1Gas~ 1Gas 1Diesel 1 Gas I Diesel 2 Empty 1 Gas 3 Gas 1 Gas 1 Gas 1 Gas 1 Diesel 1 Gas I Diesel I Gas I Die_sel Fire Fire Fire Fire Fire Fire Fire Fire Fire Fire Fire Fire Fire Fire 520001 050092 33O102 610015 640010 380019 32OO22 050105 510030 010013 330104 5309 Navajo Avenue Soutane, CA 6400 Fruitvale Avenue 729 West End Drive Frazier Park, CA 800 S. Curry Street Tehachapi, CA 8225 McKee Road 1 Gas 1 Diesel 1 Gas 1 Diesel 1 Gas 2 Gas 1 Gas 1 Diesel ~g~aal~Hwy ~. 1 Diesel 9443 Taft Hwy 1 Gas Landco & Marlin Ct Gas Diesel Glennville Fire Station 1 Gas Glennville, CA 1 Empty 1401 Skyway Drive 2 Gas 2 Diesel 1801 Mettler Frontage Mettler, CA 1 Gas Fire Fire Fire Fire Fire Fire ' Fire Fire Fire Airports Fire 3 UNDERGROUND STOOGE TANK INSPECTION ~l~ersfield Fire , Haz~?dous Materials DivisiOn Date Completed Operating Permit: Business Name: Location: Business Identification No. 215-000 Number of Tanks. I Type: Containment: (Top of Business Plan) Lines: CONTACT INFORMATION Owner: Emergency Contacts: Monitoring Program Adequate Inadequate ! RECORDS Maintenance r'l Testing InventoryReconcilia~on [3 [3 RESPONSE PLAN Emergency Plan Violations: Business Owner/ White. Haz Mat Div Pink - Business Copy All Items O.K. Correction Needed 380019 1993 TANK FACILITY ANNUAL REPORT KERN COUNTY FIRE DEPARTMENT ' Period From: 1/1/93 to 12/31/93 Facility: KCFD Station 65 - Rosedale Major modifications to this facility? If yes, Permit #BR-0070 Date 4/1/93 No [ l Yes [ X ] ! Repair and Maintenance Summary 4/1/93 1 (MVF-2) underground tank removed; no other underground tanks left at this site -'-- e Fuel Changes N/A Operator's Name: Michael R. Parker Administrative Services Officer Kern County Fire Department RECEIVED JAN ll 1994 HAZ. MAT. DIV. Signature: 1993 TANK FACILITY ANNUAL REPORT KERN COUNTY FIRE DEPARTMENT Permit: 380013 Period - From: 1/1/93 to 12/31/93 Facility: KCFD Station 65 - Rosedale B. Major modifications to this facility? If yes, Permit #BR-0070 Date 4/1/93 No [ l Yes [ X ] Repair and Maintenance Summary 4/1/93 1 (MVF-2) underground tank removed; n._..~_o other underground tanks left at this site ~ Fuel Changes N/^ -~ Operator's Name: Michael R. Parker Administrative'Services Officer Kern County Fire Department RECEIVED JfiN11 1994 H^Z. MAT. DIV. FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF CI'TY of BAKERSFIELD "WE CARE" June 9, 1993 2101 H STREET BAKERSFIELD, 93301 326-3911 Kern County Fire Department 5642 Victor'Street Bakersfield, CA 93308 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT: Station No. 65, Kern County Fire Department at Greenacres. PERMIT ~ BR-0070. Dear Sir, This is to inform you that this department has reviewed the results for the preliminary assessment.associated with the closure of the tanks located at 'the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment performed and requires no further action at this time. If you have any questions regarding this matter, please contact me at (805)-326-3979. Sincerely, Hazardous Materials Coordinator Underground Tank Program REH/dlm ~(ERN EN¥IRONME~AL SERVICE May 7, 1993 Ralph Huey CITY OF BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIALS DMSION 2130 "G" Street Bakersfield, California 93301 REGARDING: Dear Mr. Huey: Underground Tank Removal, Permit Nos. BR0070 and BR0071 Project No. E-962) (KES Regarding the above referenced _underground tank removals fo~C~ty-Fire~7 Depa~Gr.-~e-~ac_r. es_Station_No._-65~ and Fire Warehouse on "O" Street, Bakersfield, ~i~6mia we are forwarding the following items for your records. 1. Soil sample analysis results Zalco Laboratory Numbers 35323-5 through 35323- 7 and 3S383-1 through 35383-12. 2. Sample chain of custody documentation and site sample location map. 3. Uniform Hazardous Waste Manifest Nos. 92712101, 92712102, and 92712103. 4. Receipts for dry ice from Brandco. S. Non-Hazardous Waste Hauler Record No. 111131 and 111132. 6. Certificate of Destruction (Golden State Metals No: 10464 and 10469). Feel free to contact Mr. Frank Rosenlieb or the undersigned should you require additional information regarding this project. Sincerely, C~/a~G C~ETT, Lead Technician DCC:bd Enclosures Post Office Box 5337, Bakersfield, California 93388 · (805) 589-5220 / In California ° (800) 332-5376 ZALOO LABORATORIES,. INC. AnalyCioal ConsulCincj Seevices Kern Environmental Services P 0 Box 5337 Bakersfield, CA 93388 Attention: Craig Cornett Laboratory No: 35323 Date Received: 4-1-93 Date Reported: 4-9-93 Corrected Report: Sample: Soil Sample Description: Kern County Fire Department, Job #E-962, Rosedale Highway 35323-5 2 Feet Under Tank, G-1 35323-6 6 Feet Under Tank, G-2 Sampled by Craig Cornett on 4-1-93 4-12-93 Volatile Aromatic Hydrocarbons Benzene Toluene Ethyl Benzene Xylenes Method: EPA 8020 Date Analyzed: 4-6-93 Minimum Reporting Level = 0.005 Total Petroleum HydrOcarbons as Diesel Method: DOHS Luft Manual Date Analyzed: 4-8-93 Minimum Reporting Level = 10 mg/kg JE/~cw' 4309 ArmoUr Avenue (805) 395-0539 -5 mg/kq, < 0.005 < 0.005 < 0.005 < 0.005 -6 mg/kq < 0.005 < 0.005 < 0.005 < 0.005 mq/kq < 10 mq/kq < 10 :i Bakersfield, California 93308 FAX (805) 395-3069 ZALC;O LABORATORIES, INO. · Analycioal ~, Consultinoj Seevioes Kern Environmental Services P 0 Box 5337 Bakersfield, CA 93388 Attention: Craig Cornett '~ Laboratory No: 35323 Date Received: 4-1-93 Date Reported: 4-9-93 Corrected Report: Sample: Soil Sample Description: Kern County Fire Department, Job #E-962, Rosedale Highway 35323-7 2 Feet Under Pump, G-3 Sampled by Craig Cornett on 4-1-93 4-12-93 Volatile Aromatic Hydrocarbons Benzene Toluene Ethyl Benzene Xylenes Method:·EPA 8020 Date Analyzed: 4-6-93 Minimum Reporting Level = 0.005 -7 m~q/kq < 0.005 < 0.005 < 0.005 < 0.005 Total Petroleum Hydrocarbons as Diesel Method: DOHS Luft Manual Date Analyzed: 4-8-93 Minimum Reporting Level = 10 mg/kg mq/kq < 10 4309 Armour Avenue (805) 395-0539 Bakersfield, 0alifornia 93308 FAX (805) 395-3069 Z 'So frO O~U n-' · o~ ~o iq__. 104.64 TANK DISPOSAL FORM GOLDEN STATE METALS, INC. 1 P. o. Box 70158. 2000 E. Brundage Lane Date .~,~:~/.~;~L/,~ ,19 Bakersfield, California 93387 Phone (805) 327-3559 · Fax (805) 327-5749 Contractor's/- Scrap Metals, Processing & Recycling License No. Contractor's Phone No. ~'~ ~ q --~ ~---~. c:~ ("3 CONT. C O.: DESTINA~ON: G.S.M. ; 2000 E. BRUNDAGE LANE · BAKERSFIELD, CA 93387 WEIGHT cERT NO' , EHSD PERMIT NO. ~~~ ~ I~~~LLONS SERIAL NO. NET TONS COUNTY: ~ 'ss0 ........ '2.~. ~,'~'~~&PECTION DRY (AccEPT), OR [] RESIDUALS PRESENT (REJECT) _~ LEL READING DISPOSAL FEE SCRAP VALUE OTHER All fees incurred are per Icad unless specified. Terms are net 30 days from receipt of tank. Contractor's signature represents acceptance of terms for payment, and confirms that tank removal complies with State laws. I 1000 - 6 ft .61 2000 .97 3000 1.32 5000 2.42 7500 3.28 9000 3.82 12O0O 4.93 . ,*,. ,,, ,.,~ ,., ,.,.,.~,.:,, ,., .~.. ............................................ ============================================ TOTAL CERTIFICATE OF TANK DISPOSAL / DESTRUCTION ,F/OR/CERTIFY THE RECEIPT AND ACCEPTANCE OF THE TANK(S) AS SPECIFIED ABOVE. ALL MATERIAL SPECIFIED WILL BE COMPLETELY CRAP C/_CL, P RPOSES O 'Y. $ea~ of Coliforn;a'-Envlr°~nmental Protection Agency Fa~m Appra~'cl OMB No. 2050-0039 (Expires 9-30-94) ~ ~ or ,~,pe. Form des;gned for use o~ eli~ (12.pitch) fy~ewt#m'. Sacramento, California See Instructions on back'of page 6. Deportment of Toxic Substances Control UNIFORM HAZARDOUS 1. Generc~or's US EPA ID No. Mar~es~ Document No. 2. Page I Informc~ion in ~ne shaded areas · is not required by Federal law. WASTE MANIFEST C )lClOlOIOl?lOIC lqlll -J I1 --I I O ~4~"J~/~: ~:~'t3' Generator's Name~,~,and Mailing Address//t,.~C~~ ~"-'~ ('/'~J"~/"lq/ '~'"~ I~~ 8'~P' ~'"'/~ J~"/~ ~' O,,/ ~ ~~~~ "" 4. Generator's ~o~ (~) ~l__~~ I 5. Transpo~er 1 Company Name 6. US EPA ID Number ~. S~i~i i~(~'~: 7. Transpo,er 2 Company Nome 8. ~S EPA ID Number E;':S~.~FI.I~:~:,.:,:~"~.~:~:~; 9. De6g.o~ed Fo611~ Name and Si~ Address 10. US EPA ID Number 11. US DOT ~script~n (including Pro~r Shipping Name, Hazard Class, and ID Numar) J 12. Contalnem ~ Tot~ 14. Un~ - ~.~ d. ~f r~.als ~ ~ ~ ~ ~ ~ ~ ~ . J ,~ I I I I I J 15. ~cial Handling InSfru~ons and Addil~nal tnform.;~ ~/~ ~P: ~ 16. GENERATOr'S CERTIFI~TION: I hereby ~re n~ ne co~ten~ of%e con~gnme~ are ful~ ~d oc~.ly ~i~d above by pro~r shipping ~e and .... I~ed, packed, marked, and labeled, and are in all res~ in pro~r cond~i~ for trons~ by high~ according to appficab~ federal, ~e and intern~onal la~. If I om a large qu~nti~ gener~or, I ceHi~ ~ I hove o program in place to reduce ~e volume and toxici~ of waste generated to the degree I have determined to be ~onomical~ pro~icable and ~at I hove ~l~ed ~ pro.cable me~od of tre~ment, storage, m disposal currently·available to me which minimizes ~e pre~nt and lucre ~reat to human heaffh and ~e environment; OR, ff I am a small quanfi~ gener~or, I have made a good fai~ effo~ to minimize my waste generation and sele~ the best waste management me~od ~at is available fo me and that I can afford. Printed/Typed Name Sign~re~ / ~ Month Day Year 17. Tronspo~er 1 ~ckn~w[e~eme~t of Recei~t'~f M~er~t~ - / v ' ' ~ ' ' ' Pri~Name , __ Si~re~/ . G __ J Mo~ Day Year Prin~d/T~ped Nome Signo~re ~o~h Day Yeor 1~. ~screpon~ Indlc~ion Space - :. ?- :. .... - ..... - ....... . Prlmed/Tvped Nome " , . -.':".- Slg~?-:~-~;_=~:-'---~'-~--~:'=': ......... ~". ....... J ~ ' ~ --::: Year DO NOT WRITE BELOW THIS LINE. Whlfe: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. DT$C 8022A (7/92) To: P.O. Box 3000, Socram~to, CA 95812 EPA 8700--22 "tc~e of ~.4~lifom~----Em4ronme~ol Protection Ager~r C~ ~rm A ;gf~,a OM~' NO. ~0SO-00~9 (Exp;,,~ 9-a0-94) See Instructions on ba page 6. O~o,me,. of Toxic Subst .... s Control PP p'~ose prira or ~,,pe. Form designed for u~e on elife (12-pitch) ypewri~r. Sacramento, California I. Oenerator's US EPA ID No. Manifest Document No. 2. Page 1 Inforrnatio~ in fne shoded areas UNIFORM HAZARDOUS .. is not required by Federal Iow. WASTE MANIFEST ClA~.IC~OI~71OIqlglOI9 I I ~-I Ia~O ~._%~ '3. Generator's Name and Moiling Address' CO~,/~'~ O ~1~ ~C""~-~ W - ~ ~ " ' ~; ' "" ! ' 5. Transpo~er 1 Company Name 6. US EPA ID Numar ~"Sl~.T~6m~ar'~ 7. Transporter 2 Company Name 8. 0S EPA ID Numar /E~':~t~.~~L;~:;~:~::~t;)~'/'~:'.~'_'L 1 1. US DOT ~ription (including Proper Shipping Name, Hazard Class, and ID Number) No. Ty~ Ouant~ Wt/Vol b. I I 15. ~ecial Handling Instru~ons and Addit~nal Inform~ion 16. GEHERATOR'S CERTIFICATION: I hereby decl~e'~'~e con~n~ ot ~e co~fignme~ul~n~ ~ccura~ely de. rind above by proper shipping name and are clos~il~ed, packed, morked, ond la.led, and are in oll res~ in proof c~d~ for fr~ by highw~ accordi~ fo applicoble ~ederal, s~e and inter~nal ~. Il I am a large quanfi~ gener~or, I ce~ify ~af I hove a progrom in ploce ~o reduce '~e volume ond loxici~ of wosle genero~ed ~0 econo~,ically p~a~iceble ond ~a~ I hove seleded the pro~icoble me.od ot lteolment, sloroge, or disposol currendy ovo~lable ~o me which minimizes ~reat ~o humon heal~ ond ~e en~ronmen¢; OR, i~ I am a small quanfi~ gener~or. I have made a good fai~ effofl fo minimize my was*e generofion and seled ~he best waste management me. od ~m is avoilable ~o me ond that I can afford. Printed/Typed Nome I Sig~~r Z.3~ Month ] Day ~ Year ~ 17. Transpo~er 1 Acknowledgem~nl of Receip~ of M~eriols . 18~Transpo~ ~Ac~nowJedge~ent of Receipt of Materials ~ Prin~ed/Typed Name ~ ISigna~re 19. ~screpan~ Indic~ion Spoce 20, Focili~ ~ner or Operator Ce~ficafion ot r~eipl ot ~azo'rd~s m~riois co~r~ b~ ~is monitest exceff os ~ed in~ 19. · -" ...... · ' DO NOT' WRITE BELOW THIS LINE. White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. DTSC 8CY22A (7/92) To: P.OJ Box 3000, Sacramento, CA 95812 EPA 8700---22 BAKERSFIELD FIRE DEPARTM HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326,3979 TANK REMOVAL INSPECTION FORM CONTRACTOR LABORATORY '~LcO TEST METHODOLOGY PRELIMANARY ASSES~TCO. CO2 RECIEPT ADDRESS 9~50 PERMIT TO OPERATE~ CONTACT PERSON ~OFSAMPLES %~' k ~ CON~T PERSON '- LEL% 02% PLOT PLAN CONDITION OF TANKS CONDITION OF PIPING CONDITION OF SOIL COMMENTS ' INSPECTORS NAM~ zALcO LABORATORIES, INC. Analycioal Consulting Services Kern Environmental Services P 0 Box 5337 Bakersfield, CA 93388 Attention: Craig Cornett Sample: Soil Sample Description: Laboratory No: Date Received: Date Reported: Corrected Report: Kern County Fire'Department, Job #E-962, Rosedale Highway 35323-5 2 Feet Under Tank, G-1 35323-6 6 Feet Under Tank, G-2 Sampled by Craig Cornett on 4-1-93 35323 4-1-93 4-9-93 4-12-93 -5 -6 mq/kq . mq/kq Volatile Aromatic Hydrocarbons Benzene < 0.005 < 0.005 Toluene < 0.005 < 0.005 Ethyl Benzene < 0.005 < 0.005 Xylenes < 0.005 < 0.005 Method: EPA 8020 Date Analyzed: 4-6-93 Minimum,Reporting Level = 0.005 Total Petroleum Hydrocarbons as Diesel Method: DOHS Luft Manual Date Analyzed: 4-8-93 Minimum Reporting Level = 10 rog/kg mq/k_g__ mq/kq < I0 < 10 Jim Etherton ..... .. Lab Operations- Manager .......... JE/ccw 4309 Ammour Avenue [805] 395-0539 FAX [805] 395-3069 ZALO0 LAEBORATORIES, INO. Anmlycical Comsu[Cing Services Kern Environmental Services P 0 Box 5337 Bakersfield, CA 93388 Attention: Craig Cornett Laboratory No: 35323 Date Received: 4-1-93 Date Reported: 4-9-93 Corrected Report: 4-12-93 Sample: Soil Sample Description: Kern County Fire Department, Job #E-962, Rosedale Highway 35323-7 2 Feet Under Pump, G-3 Sampled by Craig Cornett on 4-1-93 Volatile Aromatic Hydrocarbons Benzene Toluene Ethyl Benzene Xylenes Method: EPA 8020 Date Analyzed: 4-6-93 Minimum Reporting Level = 0.005 -7 mq/kq < O. 005 < O. 005 < O. 005 < O. 005 Total Petroleum Hydrocarbons as Diesel Method: DOHS L~ft Manual Date Analyzed: 4-8-93 Minimum Reporting Level = 10 mg/kg mq/kq < 10 JE/ccw 4309 Armour Avenue lB05] 395-0539 Jim/Ethert0n _.---~ - .... Lab Operations Manager. Bakersfield, California B33~]E) FAX [805] 395-3069 Well,' Tank No. P.O. BOX 5295 · BAKERSFIELD, CALIFORNIA 93388 (8o ) 8 - 22o N.°' 111131 Field or Area NON-HAZARDOUS WASTE HAULER RECORD TO BE USED FOR NON-HAZARDOUS WASTES ONLY GENERATOR I (Generator Must Complete) WASTE TO BE DISPOSED 1 Type ¢/,~D~ ~.~. o ~,~,'~ Name ~~ oF- ~E~-'~ D(~, Generating Location~2o Field V;~ ~ Special Handling Instructions: Address City, State, Zip ~~'~ ~ ~33~ ~ ~ Gloves ~ Goggles ~ Other Phone ~~ ~6 ]~2¢~ Quantity ¢~ Order Placed By ~,) ~ ¢- ~~ ~ DESIGNATED FACILITY Signature of Authorized Agent ~ Name _~ dLD~ Dine ~-/~ ~ ~' City, State, Zip ~ Title ~33o7 Bbls. Phone TRANS~ORTE'R ' [ (Hauler Must Complete) Ticket # Unit No. _~.~- /. Name /~. R ~ [] a~ Address ?. ~, Bo)¢ g33~ Pick Up Date ~-/-~ Time /~¢'~¢) ~ PM NOTE: This form to be used in lieu of the Calffornb Department of Health ~rvlces City, State, Zip ~~~. ~ ~3 ~ ~ Hazardous Waste Manifest for NON-HAZARDOUS wastes only. Phone ~-¢~~ REMARKS: "1', Signature of Authorized Agent or Driver" Date _ ~!' ~ ~ j~ ~ ~' ~ ¢ ~ DISPOSAL FACILITY i (Facility Operator Must Complete) Quantity Received / Bbls. Date , 'i Address /~'O, '.~( /','~¢/,,r-~ Time [] PM Phone _~.).~,,¢,2-.;7,]~'T'~ / Disp. Ticket # Signatur/of r~uthC~zed Ag~t¢'_ . . Date DISPOSAL ME'FHOD: [] Surface Impoundment [] Landfill [] Other '. [] Injection Return Copy To: GENERATOR UNLESS OTHERWISE SPECIFI'ED NOTE: It is not necessary to send copy to Dept. of }-laatth Services. NO HAZARDOUS FEES SHOULD BE LEVIED · '~t~4 c~ ~-,c~llfarn~-~.vir°~me~al Protec~io~ ~ -- ~ Appm~ ~B ~. ~9 (~ 9-3~94) See Instructions on bac page 6. ~ of rox~ ~b,a~,s c~,,o~ I. Generator's US EPA ID No. ASan;fest Doc~nent No. 2. Page I info~ ~ ~e ~o~ areas UNI~RM HA~RDOUS ~ ~ ~uJred by F~eral law. WASTE MANIFEST 5. Trans~ner 1 Company No~ 6. US EPA ID Numar ~ Tmm~/s ~1)' ~'~ ' ~ ~-' ~- - ': .... '.' 7. Tronspooer 2 Company No~ 8. 0S EPA ID Numar E,'~ T~~a~:~g- :~'.';U--. - 9. ~gn~ed F~ili~ Name and S~e Address lO. US EPA ID Mum~r ~' ~ F~ lD~.~,i~l:~..~ --:.~5-5;=.. . 1 I. US ~T ~ription (including Pm~r Shipping Name, Hazard ~ass, and ID Number) 12. Comai~n l~at / 14. Un~ ~:~'~.~-~ r. "*.- ' .... : ~A/~,... *. - II I IIII - ~ ~~:.. =,, ~ '~ 16. GmERATOR'S ~RTIR~nON: I ~reby d~ me co~ of me co~gn~ful~n8 ~r~ely d~ri~ a~ by prol~r ~Jppi~ name and are ~k~, marked, ~d ~, and am ~ all ~ ~ p~ c~fi~ fm ~ ~ high~ accord~ ~ appt~ab~ festal, ~me and ~I ~. If 1 am a ~rge quant~ ge~r~or, I ceffi~ ~ I ha~ a pr~ram in place to reduce ~e volume and toxlc~ of waste ge~rate~ to ~e degr~ I ha~ 8eterm~ed to ~on~,kol~ pr~ceb~ ~d ~m I ha~ ~d ~e ~a~cable me~o8 of tre~menf, storage, or ~spoml curremJy ava;table to mc whith min;mlzes ~e pre~nS and future ~r~ to human hea~ and ~e ~mm~; ~, ~ I am a small quan~ g~r~o~, I ha~ ma~ a good {a~ effort to m~?ize my wa~e gener~on and seleo the best waste mona~ment me~o8 ~ is a~ilable ~ me and ~ I can afford. Pri~ed/Typed Name[ ~~' Mo~ Day Year 17. Transpo~er I Acknowledgem~t at R~eipt of ~e~bls 18. Trans,,er ~A~w~dge~nt of R~e¥t of M~eHah - Pr~y~d Nome ~ SignOre Mo~ D~ Year ,, , ] ] I J I 19. ~sctepan~ lndic~ion Space 20, Facile' ~er or ~r~or Ce~fic~ of ~e{pt of h~ard~s m~eriais co,red by ~is manifest axce~ as ~ed ~ 19. , , DO NOT WRITE BELOW THIS UNE. TSDF SENDS THIS COPY TO DTSC WlTHIN 30 DAYS. P.O. ~x 3000, Sac:ramenm, CA 95812 ~PE~MIT AIA~E REMOVAL .OF AN iii AP P LICATIO N UNDERGROUND STOP TANK Bakersfield Fi~-e Dept. HAZARDOUS MATERIALS DIVISION UNDERGROUND STORAGE TANK PROGRAM SiTE INFORMATION ~r~ . /~ " ' SITE ~re.e. rt~cre~ /~/r6 ~~ ADDRESS ~~~ ZIP~ODE , ~~ APN FACILI~ NAME ~r~ Om:~' R'r~e oE, CROSS STREET ~.//~c~ TANKOWNER/OPERATOR I~o~ ~ ~ PHO~ENo. MAILING ADDRESS Ill~o'~H ~ve. Cl~ CONTRACTOR INFORMATION COMPANY /~rn ADDRESS ~,O, ~o~ INSURANCE CARRIER PHONE No.(~'~) ..4~?-6'-ZZ~ LICENSE No. 5/_~ CITY /::~/.~.~'£fd( ZIP CODE' WORKMENS COMP No. V/¢-,;T~'.z. -2/.-~ ~-- PRELIMANARY ASSEMENT INFORMATION COMPANY J~rrt ~'rw~ro~w, te~-~.-/ ADDRESS ~-O, ~x~ ~-. iNSURANCE CARRIER ~[~ PHONE No. L"¢~5-~5-~-,5"Z~Z)~LICE,NSE ' ciTY :;~z~.k~s~'c. td ZiP CODE WORKMENS COMP No, TANK CLEANING INFORMATION COMPANY J~'~r~q ~'rtv{r©~w-~e,,rt-~./ .~'ezr-Udc.~--.- PHONE NO. ADDRESS ~.o, ~ ~ ~ ~ 7 '- CI~ ~~'eJ~ ZIP CODE g~o t WASTE TRANSPORTER IDENTIFICATION NUMBER ~ NAME OF RINSTATE DISPOSAL FA~ILI~ ~Fb~ O~j ~ ~.r~'~¢ . ADDRESS ~ ~~ ~V~., CITY ~~5(,'¢~ZIP CODE FACILI~ INDENTIFICATION NUMBER ~ ~~ / 27 TANK TRANSPORTER INFORMATION COMPANY ~~~( ~er~ PHONE No.('~O~)~?-~ L~EN~E No.~3~732 ADDRESS ~0, %ox ~,~7 CI~ ~~Rdd ZPCODE ~'~ - TANK DESTINATION ~b~n ~ ~ TANK INFORMATION · TANK No, AGE VOLUME CHEMICAL DATES CHEMICAL STORED STORED PREVIOUSLY STORED IH IS F~OR M H~A/S ~.~LETED U ND ER PENALTY OF PE R JURY, AND TO THE BEST OF MY KNOW,:~E,~A~/fORRECT. / ~~ APPLICANT NAME (PRIN~ APPLICANT SIGNA~RE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED Make checks payable to "Cil3, o[~al~ersl~e~d" .{' DBA O~NER ADDRESS' KERN COUNTY ENVIRONMENTALHEALTH DEPARTMENT INVESTIGATION RECORD ~%DDRESS ASSESSORS ' PARCEL CT CHRONOLOGICAL RECORD OF INVESTIGATION. DATE , I Fac i ! [ ty []Permit to '~Construction P ..... , .... []Permit to ~ba~, '~:-" ~Permit Applica t ic:- ~Appl ication to ' ~Annual Report Form~ -- Data ~4o. of Tanks Date · / , . Tank Sheets, Plo+ ~la~s'. v- -- t-aa-k s ( s ) D a t e []Copy of ~r'itten Contract Between Owner & Operator ~Inspection Reports [-]Correspondence - Received Date Date Date []]Correspondence - Mailed Date Date Date ~ Unauthorized Release [] Abandonment/Closure [-]Sampling/Lab Reports []MVF Compliance [-] STD Compliance [i]MVF Plan Check []STD Plan Check []MVF Plan Check ~.STD Plan Check RePorts Reports Check (New Construction Check (New Coqstruction ~New Consk~'uct ion) (New Conssruction) (Ex sting Facility) (Ex sting Facility) Checkiist) Checklist) ~]"Incomplete Application" Form l--]Permit Application Checklist [-]Permit Instructions ?]Discarded_ ~_jTightness Test Results [-lMonito~ing Well C,>astruev.~.on []]Environmental Sensitivity· Data: [-]Groundwater Drilling, Boring Logs ~,'.Location of Water We~!s . " ' ' ~ Cond i~s ~Statement o~ under-rou~: u ~_ ~Plot P!ar~ Featurinc ?,~! Environmentally ~Photos ~Constructio--: Drawings ~Half sheet showin~ ~ate ~Mi sc e I laneoos Da te Date Da ~ ~ Data/Permits Permit H. 1. o o o 10. 11. HM21 Tank, is: Tank Material · ~ Carbon Steel ( ) Stainless Steel ( ) Concrete ( ) Unknown Primary Containment Date Installed Thickness (Inches) Tank Secondary Containment.. ( ) Double-Wall ( ) SynthetTc Liner ( ) Other (describe): ( ) Matedal Tank Interior Lininq (~ Unlined ( )Unknown Tank Corrosion P~'otection ( ) Galvanized ( ) ( ) Tar or Asphalt (.) TANK'INFORMATION FO {FILL OUT SEPARATE FORM FOR EACH TANK) FOR EACH SECTION. CHECK ALL APPROPRIATE BOXES_ ( ) Vaulted (-) Jacketed ( ) Double-Wall ~ Single-Wall ( ) Fiberglass-Reinforced Plastic ( ) Other (Describe) CapaCity (Gallons) ( ) Fiberglass-Clad Stu ( ) Lined Vault Thickness (Inches) ( ) Uned (describe) Manufacturer ~ None Manufacturer: Capacity (Gallons) ( ) Unknown Fiberglass-Clad - () Polyethylene/Vinyl (Wrapped or Jacketed) Unknown .... '.~ None ( ) Other (describe): Cathodic Protection: ~ None ( ) Impressed Current System ( ) Sacrificial Anode System Describe System and Equipment: Leak Detection, Monitorinq, and Interception * (Must be described below) a..Tank: ( ) Vapor Detector * ( ) Uquid Level Sensor * ( ) Conductivity Sensor * ( ) Vadose 2' ................ U-Tube v Visual In,, Sensor; ir Regular ! Daily Ga~ None *Describe Ma~ b. Piping: ( ) Flow-Res ~ " ( ) Monitorin ( ) Had-Cut< '~) Unknown '-~,--- .... 'Describe Mak Tank Tiqhtness Has This Tank Been Tightness Date of Last Tightness Test __ Test Name Tank Repair ( ) Ye Date(s) of Repair(s) '--' Describe Repairs Overfill Protection (Must descdbe below) ( ) Operator Fills, Controls, & Visually Mo~ ( ) Tape Float Gauge ( ) Float ( ) Capacitance Sensor ( ) Seatec ( ) Ust Make & Model fo._Ir al_Jl Devices 'Describe other Protection System Pipinq a. Underground Piping: ( ) Yes ( ) Thickness (inches) Diameter ~ b. Type of pipin9 System Post-it'"routing request pad 7664 ROUTING - REQUEST Please [] READ [] HANDLE --] APPROVE and ~ FORWARD [~] RETURN ~ KEEP OR DISCARD ~ REVIEW WITH ME Co No (_¢¢~ Unknown Material Manufacturer ( ) Pressure Underground Piping Corrosion Protection: ( ) Galvanized ( )~,.Fiberglass-Clad ( ) Impressed Current ( ) Polyethylene Wrap ( )~EIectricsl Isolation ( )Vinyl Wrap ~ Unknown ( ) None ( ) Other (describe): Underground Piping, Secondary Containment: ( ) Double-Wall ( ) Synthetic Liner System ( ) None ( ) Make & Model (describe): Suction ( ) Gravity Approximate Length of this Pipe Run Unknown Sacrificial Anode Tar or Asphalt RANDALL L. ABBOTT DIRECTOR DAVID PRICE !II ASSISTANT DIRECTOR Environmental Health Se~,./cea Department STEVE McCA! ! I:'y, REHS, DIRECTOR Air Pollution Control District WILLIAM J. RODDY, APCO Ptanning & Development Services Devanment TED JAMES, AICP, DIRECTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT PERMIT TO OPERATE UNDERGROUND HAZARDOUS STORAGE FACILITY Permit No.: 380019C State ID No.: 19838 Lssue~ to: KERN COUNTY FIRE DEPT. STATION 65 No. of Tanks: 1 Location: 9420 ROSEDALE HIGHWAY BAKERSFIELD, CA KERN COUNTY FIRE DEPARTMENT 5642 VICTOR BAKERSFIELD, CA 93308 Operator: K~RN COUNTY FIRE DEPARTMENT Facility Profile: Substance Tank Tank Year Is piping Tank No. Code Contents Capacity_ Installed Pressurized? 1 MVF 2 REGULAR 580 UNKNOWN UNKNOWN Issue Date: November 4, 1991 Expiration Date: November 4, 1996 This permit is granted subject to the conditions and prohibitions listed on the attache, ct summary of conditions/prohibitions Title: DSii:~eo tM, ~nC~ifjnmen tel Health 'C~~ Department -- POST ON PREMISES -- NONTRANSFERABLE 2700 "M" STREET, SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) S l-a g FAX: (805) 861-3429 ttAZARDOUS UNDERGROUND STORAGE FACII,ITY PERMIT SIJMMARY OF CONDITIONSfPROHIBITIONS CONDITIONS/PROHIBITIONS: 1. The facility owner and ope~rator ~ust bd f~mili~t with all conditions specified within ~hi~ permir and mu.si meet any additional requiremenm to monitor, upgrade, or close the tank~ and a~odated piping imposed by the permitting authority. 2. If the operator of the underground storage tank is not the owner, then the owner shall enter into a written contract with the operator, requiring the operator to monitor the underground storage mn~; maintain appropriate records; and implement reporting procedures as required by the Department. The facility' owner and operator shall ensure that the facility has adequate financial responsibility insurance coverage, as mandated for ail underground storage tanks containing petroleum, and supply proof of such coverage when requested by the permitting authority. 4. The facility owner must ensure that the annual permit fee ia paid within 30 days of the invoice date. The facility will be considered in violation and operating without a permit ff annual permit fees are not received within 60 days of the invoice date. o The facility owner and/or operator shall review the leak detection requirements provided within this permit. The monitoring alternative shall be implemented within 60.days of the permit issue date. The facility underground storage tanks must be momtored, utilizing the option approved by the permitting authority, until the tank is closed Under a valid, unexpired permit for closure. Any inactive, underground storage tank which is not being momtored, as approved by the permitting authority, is considered improperly closed. Proper closure is required and must be completed under a permit issued by the permitting authority. The facility owner/operator must obtain a modification permit before: a. Uncovering any underground storage tank after failure of a tank integrity test. b. Replacement of piping. c. Lining the interior of the underground storage tank. 10. 11. The rank owner must advise the Environmental Health Services Department witbi. 10 days of transfer of ownership. Any change ia state law or local ordinance may n__,~ce~s_ itate a change in permit conditions. The owner/operator will be required to meet new conditions within 60 days of notification. 12. 13. AEG:jrw The owner and/or operator shall keep a copy of ail monitoring records at the facility for a ~ninimum of three years, or as specified by the permitting authority. They may be kept off site if they can be obtained within 24 hours of a request matte by the local authority. The owner/operator must report any unauthorized release which escapes from the secondary containment, or from the primary containment ff no secondary containment exists, which increases the hazard of fire or explosion or causes any deterioration of the secondary containment within 24 hours of discovery. 2 MONITORING REQUIREMENTS:(mm2sunk) 1. All underground storage tanks designated as 'MVF 2 within Page 1 of this permit shall be monitored utilizing the following method: Standard Inventory control Monitoring (Tank gauging five to seven days per week). Kern Coun-~Eifvironmental Health-Services Department forms shall be utilized unless a f~cility T6rm can provide the same information and has been reviewed and approved by the Environmental Health Services Department. (Monitoring shall be completed in accordance with requirements summarized in Handbook UT-10.) AND bo All tanks shall be tested annually utilizing a tank integrity test which has been certified as being capable of detecting a leak of 0.1'gallon per hour with a probability of detection of 95 percent and a probability of false alarm of 5 percent. The first test shall be completed before December 31, 1991, and subsequent tests completed each calendar year thereafter. All tank integrity tests completed after September 16, 1991, shall be completed under a valid, unexpired Permit to .Test issued by the EmSronmental Health Services Department. If present, all suction piping shall be' monitored for the presence of air in the pipeline by observing the suction pumping system for the following indicators: The cost/quantity display wheels on the meter suction pump skip or jump during operation; b. The suction pump is operating, but no motor vehicle fuel is being pumped; The suction pump seems 'to overspeed when first turned on and then slows down as it begins to pump liquid; and do A rattling sound in the suction pump and erratic flow, indicating an air and liquid mixture. All underground storage tanks shall be retrofitted with overspill containers which have a minimum capacity of 5 gallons; be protected from galvanic corrosion, if made of metal; and be equipped with a drain valve to allow the drainage of liquid back into the tank by December 1998, or as specified by the Environmental Health Services Department. All equipment installed for leak detection shall be operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks (at least once per year) for. operability or running condition. o An annual report shall be submitted to the Kern County Environmental Health Services Department each year after monitoring has been initiated. The owner/operator shall use the form provided within the Handbook UT-10. If present, all pressurized piping systems shall install pressurized piping leak detection systems and ensure that they are capable of functioning as specified by the manufacturer. The mechanical leak detection systems must be capable of alerting the owner/operator of a leak by restricting or shutting off the flow of hazardous substances through the piping, or by triggering an audible or visual alarm, detecting three gallons or more per hour, per square inch, line pressure within one hour. If .present, all pressurized Piping systems shall be tested annually unless the facility has installed the following: ao co A continuous monitoring system within secondary containment. The continuous monitor is connected to an audible and visual alarm system and the pumping~y~m:. .... -- The continuous monitor shuts down the pump and activates the alarm system when a release is detected. The pumping system shuts down automatically if the continuous monitor fails or is disconnected. The first test shall be completed before December 31, 1991, and subsequent tests completed each calendar year-thereafter. KERN ,*J'":~-~:~'~:EN~JRONME.~HEALTH SERVICES DEPARTM~Nr~' :. ....... ... : ':. .2700 ".r4'~ STRL~,~.p/SUITE 300, BAKERSFIELDJ~,-,-,/g~'301 (805)861-3635 COUNTY RE[SOU RCE Ivi A N ~., G E i"-1 F N T. UNDERGROUND HAZARDOUS SUBSTANCE STORAGE ~ INSPECTION REPORT * PERMIT~ 001~'~ .TIME IN 2.~_.~..~.TI UT "~i ~ NUMBER OF TANKS: ........ L..] ........... TYPE OF INSPECTION: ROUT~INE=_._.~! REINSPECTiON ............ COMPLAINT ............. FAC~,' ~ .~_ .............................................. ~ ...................................................................................... FAC"ILITY ADDRESS:g420 ROSEDALE HIGH~AY ................................... // BAKERSFIELD, CA ON~ERS.--J~M~:KERN COUNTY FIRE DEPARTMENT OPERATORS NAME-MIKE PARKE.R_~ ~_~.~_=. SERVICES OFFICER ........ ~ ........... . , ~. , ~__F~___ ~ ~__ ---~r-~--..], __ / .'~ ',~ ..... ~ ...................................... ; ........ --~ ~/.....~. ~ - . -- ITEM VIOLATIONS/OBSERVATIONS 1.PRIMARY CONTAINMENT ~NITORIN6: a. Intercepting an directing system OStandard Inventory Control c. Modified Inventory Control d, In-tank Level Sensing Device e. Groundwater Monitoring f. Vadose Zone Monitoring. SECONDARY CONTAINMENT MONITORING: b.' Double-Na3~ed tank c. Vault · a. PressurizeO _¢10¢~. c. Gravity OVERFILL PROTECTI ~>~' ~0~ i.~'J TIGHTNESS TESTING .~. NEW CONSTRUCTION/Mt ?. CLOSURE/ABANDONMENT 8. UNAUTHORIZED RELEASE 9. MAINTENANCE, GENERAL ,., ,~,x/~'~l ,/~t/~[5 ~Z~.-¢FP~I;~ ~YT~,' /ft~ OPERATIN~ CONDITION C ..... ..... ..... :__-;:: ........ ;.. ' · APPROXIMATE RE INSPECT ~-~...D/~TE REPORT RECEIVED BY:._.~~. ....... 7 Facility Name: --. MONITORING AI FERNATIVES QUESTIONNAIRE FOR MVF 2 FACILITY TANKS K Facility Address:~ Owner's Name: Owner's Address: Operator's Name: ~ Permit Number(obtained from the facility profile sheet): Number o1~ Tanks which have been assigned the MVF2 Code: All information' has been received and reviewed and the following summarizes the monitoring alternative which I have picked for the MVF 2 tanks at this facility. I realize that the monitoring alternative must be approved by the local agency before implementation. (Place an X next to the alternative picked). VISUAL MONITORING will be utilized. (I can inspect the exterior of all tanks, without using extraordinary perso .rme! protective equipment). IN-TANK LEVEL SENSOR will be installed in each tank, which are capable of detecting a leak of 0.2 gallons per hour. The sensor will be used to test the tank monthly. The facility will ALSO COMPLETE A BIENNIAL TANK INTEGRITY TEST(testing every other year), utilizing a licensed tester who's method has been certified to detect a leak of 0.1 gallons per hour. IN-TANK LEVEL SENSOR has been installed in each tank, which is capable of detecting a leak of 0.2 gallons per hour. The sensor will be used to test the tank monthly. The facility will ALSO COMPLETE A BIENNIAL TANK INTEGRITY TEST (testing every other year), utilizing a licensed tester who's method has been certified to detect a leak of 0.1 gallons per hour. Provide the following information on the system installed: System Manufacturer: System Model No.: Date Installed: -- SEE PAGE 2 FOR ADDITIONAL ALTERNATIVES -- MONITORING ALTERNATIVES QGESTIONNAIRE FOR MVF 2FACILITY TANKS - Permit No.: o VADOSE ZONE MONITORING will be utilized ALONG WITH ANNUAL TANK INTEGRITY TESTING. The' facility will submit a proposal to the department for approval of the number, locations and design of monitoring wells which will be utilized to monitor the underground storage tank systen~s. Each monitoring well will be equipped with a continuous monitoring device. VADOSE ZONE MONITORING will be utilized ALONG WITH ANNUAL TANK INTEGRITY TESTING. The facility has already installed monitoring wells, and would like to utilize them. A plot plan of their locations and a drawing showing their construction are enclosed. The facility does/does not have continuous monitoring equipment installed within each well. Provide information on the monitor which has been installed within each well: System Manufacturer: System Model No.: Date Installed: MODIFIED INVENTORY CONTROL MONITORING (tank gauging 2 days per. week) for underground storage tanks which have a tOtal tank capacity of 2,000 gallons or less, that do not have metered dispensers; ALONG WITH AN ANNUAL TANK INTEGRITY TEST utilizing a licensed tester who's method has been certified to detect a leak of 0.1 gallons per hour. STANDARD INVENTORY CONTROL MONITORING (tank gauging 5-7 days per week) for underground storage tanks which dispense product from metered dispensers; ALONG WITH AN ANNUAL TANK INTEGRITY TEST utilizing a licensed tester who's method has been certified to detect a leak ot~ 0.1 gallons per hour. Name of person completing this form: Title:'-~"'~ r~ ~,'r'"- ~ ~C"~J, ~ ~-rc_ Date: AEG:ch green~tueation Division ot Environmental Heal Appl ication 1700 Flower Street, Bakersfield, .C~_ 93305 ~ APPr:ICATION FOR PERMIT TO CIPERATE UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY ~ Type o~f Application (check): ~]New Facility [-]Modification of Facility C~x/sting Facility ~]Transfer of Ownership A. Emergency 24-Hour Contact (name, area code, phone): Days .~l--Z~'~ · Facility Name ~i~ ~. ~'~-~7~. {~ ~ ...... No. of T~_~ks. Type of Busine~ (c'h~'C'k)[ '~]Gaso'~:i-he-.Station ~)ther (describe) ~'~D .. Is Tank(s) Located on an Agricultural Farm? ~]Yes ~ Is Tank(s) Used Primarily_for Agr%cul~ural Purposes? [qYes 3~tNo Facility Address ~'~ ~f0~G(~/e_ ~10C~, Nearest Cross St. T Owner AddresS'- O~rator ~dress (Rural Locations 0nly) Contact Person Zip Q~j T lephohe Contact Person Zip Telephone Soil Characteristics' at Facility Basis for Soil Type ar~ Groundwater Depth Determinations / ~,/~~ ' CA Contractor's License No. C. Contractor Addr ess Zip Telephone Proposed Starting Date, Proposed C~pletion' ~te Worker's Ccmpensation Certification ~ Insurer D. If This Permit Is For Modification Of An Existing Facility, Briefly Describe Modifications Proposed Tank(s) Store (check all that apply): Tank ~ Waste Product Motor Vehicle Unleaded Regular Premium Diesel Waste [] .O [] Chemical C~mposi~ion of Materials Stored (not necesSary for motor vehicle fuels) Tank ~ Chemical Stored (non-co~m~ercial name) CAS ! (if known) Chemical Previously Stored · (if' 'different) Ge Transfer of Ownership Dete of ~--ansfer Previous Facility Name I, Previous Owner accept fully all obligations of~.permit No. issued to · I understand that the Permittirg Authority may review and .~ify or terminate the transfer of the Permit to' Operate this ~dergro~d storage facility upon receiving this c~npleted form. This form has been c~mpleted under penalty of perjury and to the best of my knowledge is .Signature {3ate 1700 Flower Street Bakersfield, California 93305 Telephone (805) 861-3636 UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY· ENVIRONMENTAL HEALTH DIVISION HEALTH OFFICER Leon M Hebertson, M.D. DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Raichard PERMIT~38OO1 9C. I'SSUED = JULY 1, 1986 EXPIRES: .JULY 1, 1989 NUMBER OF TANKS= FACILITY: I OWNER: KERN COUNTY FIRE DEPT. STAT[ON 65I KERN COUNTY FIRE DEPARTMENT 9420~ ROSEDALE HIGHWAY I 1025 GOLDEN STATE HIGHWAY BAKERSFIELD,.CA I BAKERSFIELD, CA 93301 TANK # AGE{IN'YRS)' SUBSTANCE CODE PRESSURIZED PIPING? 1 UNK MVF 2 UNK NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PERMITTING AUTHORITY MUST BE MET DURING THE-TERM OF THIS. PERMIT NON--TRANSFERABLE * * ~" POST ON' PREMISES DATE PERMIT MAILED: SEP 1 Z 1986 DATE PERMIT CHECK LIST RETURNED: ~ (FILL OU~ SEPARATE FORM EACH TANK) ~' 'FO-R EACh SECTION, CHECK ALL APPROPRIATE BOXES Ho 1. 10. Tank is: rqVaulted [-]Non-Vaulted [qDouble-Wall [2~.'ingle-Wall ~ Material [~carbon Steel [2]Stainless Steel [-]Polyvinyl Chloride [q Fiberglass-Clad Steel B '~:'iberglass-Reinforced Plastic [] Concrete [] Aluminum [] Bronze_~]~pk~ Other (describe) Primary Containment Date Installed Thickness-- (Lnches) Tank Secondar~ Containment [~]Double-Wall [] Synthetic Liner [2]Other (describe): []Material Tank Interior Lining .----[~Rubbe r [-]Alkyd []Epoxy [']Other (describe): Tank Corrosion Protection [] Lined Vault Thickness (Inches) []Phenolic [2] Glass Capacity (Gallons) Manufacturer Manufacturer: Capacity (Gals.) DClay [~'0n 1 i ned~known ---~Galvanized ""[-]Fiberglass-Clad [qPoly~thylene Wrap [~Vinyl Wrapping []Tar or Asphalt~j~_known ~.'.'z~one [-]Other (describe): Cathodic Protection: ~one []Impressed Current System [~]Sacrificial Anode System Describe System & Equil=nent: Leak Detection, Monitoring., and Inte. rception ~ a. Tank: []Visual (vaulted tanks only) [~Groundwater Monitoring' Well(s) [qVadose Zone Monitoring Well(s) []U-Tube Without Liner []U-Tube with Cc~apatible Liner Directirg Flow to Monitoring We.ll(s)* [] Vapor Datector* [] Liquid Level Sensor* [] Conductivit~ SenSOr' [] PreSsure Sensor in Annular Space of Double Wall Tank [] Liquid Retrieval & Inspection From U-Tube, Monitoring Well or Annular Space l-Il%ally Gauging & Inventory Reconciliation [] Periodic Tightness Testing [] Other b. Piping:' [2]Flow-Restrictirg Leak Detector(s) for Pressurized Piping' []Monitoring Sump with Race~ay []Sealed Concrete Raceway []Half-Cut Compatible Pipe Raceway []Synthetic Liner Raceway ['[None ~[Dknown []Other *Describe Make & Model: Date of Last Tightness Test Resul~ of Test Test Name. Testing Ccmpany Tank ~ Tank Repaired? []Yes DNo --~Unknown Date(s) of Repair(s) /~ .. Describe Repairs Overfill Protection []Operator Fills, Controls, & Visually Monitors bevel ~ [-]Tape Float Gauge [qFloat Vent Valves []Auto Shut- Off Controls '.~kno~n 11. Piping a. Underground Piping: ~'~es [-]No ~Unknown Material Thickness' (inches~ Diame~r ' - Manufacturer , [~Pressure l~.~uction ~Gravi~y ~--~-6~imate Length of Pipe laan b. Unde.rground Piping Corrosion Protection : ~Galvanized []Fiberglass-Clad ~Imp~essed Current [-]Sacrificial Anode ~'~.Polyethyle_ne. Wrap [2]Electrical Isolatio~ []Vinyl Wrap ~Tar or Asphalt c. /~Double-Wall [2]Synthetic Liner System [~.~one, ~l~nknown Un~4~ground Piping, Secondary Contair~ent: · ~ []Other (describe):