HomeMy WebLinkAboutUNDERGROUND TANK FILE #2JOB CARD
POST CARD AT JOB SITE
Bakersfield Fire Dept.
Prevention serVices
900 Truxtun Ave #201
Bakersfield, CA 93301
Tel: (661)326-3979
ADDRESS A ~
CITY BAKERSFIELD
PHONE No. ~ ' '
PERMIT No.
NSTRUCTIONS: '
PLEASE CALL FOR AN INSPECTOR ONLY WHEN EACH GROUP OF INSPECTIONS WITH THE SAME NUMBER ARE READY. THEY WILL RUN IN CONSECUTIVE
ORDER BEGINNING WITH NUMBER ONE. DO NOT COVER WORK FOR ANY NUMBERED GROUP UNTIL ALL ITEMS IN THAT GROUP ARE SIGNED OFF BY THE
PERMITTING AUTHORITY: FOLLOWING THESE INSTRUCTIONS WILL REDUCE THE NUMBER OF REQUIRED INSPECTION VISITS AND THEREFORE PREVENT
ASSESSMENT OF ADDITIONAL FEES.
INSPECTION I DATE [ INSPECTOR
:" TANKS AND~CKFILL
BACKFILL OF TANK(S)
SPARK TEST CERTIFICATION OR MANUFACTURES METHOD
CATHODIC PROTECTION OF TANK(S)
PR, MARY P,P,NG 5L ¢¢I , .
SECONDARY PIPING '~ ~ ¥~ ~1
TYPE OF PIPING ~ FLEX IBERGLASS
CATHODIC PROTECTION SYSTEM-PIPING
SECONDARY CONTAINMENT, OVERFILL P~TECTION~ bE K DE iCTIO
CO~TI~DODS VA~OR MOnITORInG
ENHANCHED LEAK DETECTOR TEST
~ODUGT kiWI k~AK
LEAK DETECTOR(S) FOR ANNUAL SPACE-D.W. TANK(S)
MONITORINGWELL(S)/SUMP(S)'H20TEST-~'~ ~'~
MONITORING WELLS, CAPS & LOCKS
FILL BOX LOCK
MONITORING REQUIREMENTS TYPE ~:~_ ~~~
AUTHORI~TION FOR FUEL DROP ¢ [~
CONTRACTOR _~i~___( ~-_~_~_i____~-----~_MJ~¢---~L~-':'-~-"~- ............................. LICENSE No. ~__~/~_~_~_¢_~__:_~'~-'
CONTACT .... 3_/~ ~.., ........ ~ ........................................... L PHONE NO. __~ _~ff~_-__~__~_~___.
fd~743
- ALL FuNcTIONS NORMAL
t t,lk/ENTOR'¢ REPORT fF~
T t :SUPREME GALS
.3764
,/OLUME = 786,3
i3LLAGE . _~ 6700 GaLS
~C'~VOLUME = 33.50 INCHES
HEIGHT = l '2 Gf~LS
t4ATER VOL = 0.83 INCHES
wATER = 66.0 DEG F
TEMP
T '2 :pLUS qf4LS
vOLUME = 48t 8 -
ULLAGE _~.= 6809 GALS
qO% ULLAGe= 5646 G~LS
~C VOLUME = 4796 GALS
= 40.00 INCHES
HEIGHT 0 GALS
t.,~'TER VOL : O. O0 I t. ICHE~
WATER = 66.4 DI
TEPlP
T 3:REGULAR 7093 GALS
~ '40LUME ~ 7086 GaLS
53.72 INCHES
HE IGHT 0 GRLS,
wATER VOL =
b~RTER = 0. O0 I NCHE¢
T'EMP = 61 . 3.' D. Ei}. F
UNIFIED PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
Section 1: Business Plan and Inventory Program
Routine 1~ Combined [~ Joint Agency ~ Multi-Agency I~! Complaint ffl Re-inspection
{' C=Compliance '~ OPERATION COMMENTS
\ v=violation
APPROPRIATE PERMIT ON HAND
CORRECT OCCUPANCY
VERIFICATION OF INVENTORY MATERIALS
VERIFICATION OF QUANTITIES ..........................................................................................................................
VEriFiCATiON OF MSDS AV*~L*B~UWE
VERIFICATION OF A6ATEMENT SUPPLIES ANO PROCEOURE8
EMERGENCY PROCEOURES AOEQUATE
SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?: ['1 YES ~1 No
EXPLAIN:
QUESTIT,~GAR~/~,~NSp~.~ON? PLEASE CALL US AT (661)
Inspector Badge No.,
326-3979
.....
White . Environmental Services Yellow - Station Copy 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
INSPECTION DATE
Section 2: Underground Storage Tanks Program
[] Routine [~Combined [] Joint Agency
Type of Tank ~O1~
Type of Monitoring ~6V%
[] Multi-Agency [] Complaint
Number of Tanks _3
Type of Piping ~'
[] Re-inspection
OPERATION C V COMMENTS
tank data on file
Proper
/
Proper owner/operator data on file
Permit tees current
Certification of Financial Responsibility
Monitoring record adequate and current /
Maintenance records adequate and current r,
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=Compliance ~V=Violation Y=Yes N=NO
Inspector: ~.~;XJ (d~
Office of Environmental Services (805) 326-3979
White- Env. Svcs.
Pink - Business Copy
Business Site Responsible Party
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (805) 326-3979
PERMIT APPLICATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK
TYPE OF APPLICATION (CHECK)
[ ]NEW FACILITY [~fMODIFICATION OF FACILITY [ ]NEW TANK INSTALLATION AT EXISTING FACILITY
STARTING DATE
FACILITY NAME ~ I Lt
FACILITY ADDRESS c~'7Ot~ ~ c~-nDAL~_~ 14~,t-/CITY
TYPE OF BUSINESS Cc~rhlea_~
ADDRESS q?.n6 .~c~'~-~ crrv
CONTRACTOR ¢~z~ -
ADDRESS ~'O~
PROPOSED COMPLETION DATE
O__. ~4 ~.\l IV_C) r-4 EXISTING FACILITY PER_Mrr NO.
ZIP CODE
APN#
ZIP CODE
CA LICENSE NO. "[,~4
ZIP CODE
PHONE NO. ~ ~ I - ~_ ~_-7 - ~ % ~ I BAKERSFIELD CITY BUSINESS LICENSE NO.
WORKMAN COMP NO. ,ca, O 4- -- } '""( - 1 7_ INSURER
BRIEFLY DESCRIBE TH~ WORK TO BE DONE ~P rwtfl ',a~. ~,et~'v"e'~
WATER TO FACILITY ~ROVIDED BY
DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE
NO. OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL " YfiS ~ NO
SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE YES NO
SECTION FOR MOTOR FUEL
TANK NO. VOLUME
UNLEADED
REGULAR PREMIUM DIESEL AVIATION
TANK NO. VOLUME
SECTION FOR NON MOTOR FUEL STORAGE TANKS
CHEMICAL STORED CAS NO. CHEMICAL PREVIOUSLY STORED
(NO BRAND NAME) (IF KNOWN)
FOR OffICIAL USE ONLY
THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF
THIS PERM1T AND ANY OTHER STATE, LOCAL AND FEDERAL REGULATIONS.
THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO TIlE BEST OF MY KNOWLEDGE, IS
u~dm com~
APPROVED BY: APPLICANT NAME (PRINT) ,/~ICANT/,/SIGNATURE
THIS APPLICATION BECOMES A PERMIT WI-IEI~/APPROVED '
Jul 24 03 10:33a lanzen Hill
S~68814G? p. I
CITY OF BAKERSFIELD
1715 Chester Ave., I~ ~ersfield, CA (661)
APPLICATION TO PERFORM'A TANK TIGHTNESS TEST/
SECONDARY CONTAINM~NT TESTING
,ad)DRF, SS_ - ' - I
p~ TO OPERA~ #~~~~i~'~
OPERATORS NAME~
OWNERS NAME~
NUMB~ OF T,~qI~ TO BE TES~~ IS PIPING ~OINO TO BE ~~~
VOL~ ~~S
MAILINO ADDRF.~S . " '
NAMB & PHONE NUMBER OF CONTACT PERSON
TEST METHOD.
NAME OF TESTER OR SPECIAL INSPECTOR__
CBRTIPICATION #-- CONDU~~~4
DA~ & ~ ~ IS ~ BE
~PRO~ BY DA~
3ul 24 03 lO:lga ranzen Hill 559688146?
,~ Page: 1
Franzen-Hill
Construction, Maintenance & Testing for Fueling Facilities & Lubricating Systems
Secondary Containment Testing Report Form
1. FAClUTY INFORMATION
!Facility Name: Rosedale Chevron J Date of Testing:
Facility Address: 9700 Rosedale Hwy Bakersfield
Facility' Contact: Nirmal , J661-589-9011
ate Local Agency Was Notified of Testing: , I~)/1 /~3,~ ,~ WO~
Name of Local A. gency Inspector Present: .~r~'.P/.~),0 ~/~l,~(".t)', I~!.~...~.
o~. 7
10/30/02Jl
1104411J
2. TESTING CONTRACTOR INFORMATION
Company Name: Franzen-Hill Corp. T, ulare, Ca~. ~-
Technician Conducting Test: '[~*.~,.I i ~.[ ..... I ~'.%'/**' ,~/.r' ~-, ./ ~ ~*~. !.,~i'.! ~*~ ~/~/', ~ ~ !/"
Credentials: /* CSLB Licensed Contractor ' DSWRCB LicensedTank Tester
License Type and #: A,8, C-611D40 HAZ LIc~ 304147
Training by Manufacturer
Manufacturer Componen['s) Date Training Expires
Environ, APT Piping and Testing Oct--03
;mlth Fiberglass, EBW Piping and Testing
l'otal Containment, VeederRoot Piping and Testing
Incon, Giibarco EMC, Monitor Systerr
Piping and Testing Oct-03
3. SUMMARY OF TEST RESULT~
'~'umber of Tanks Tested: Number of Piping Runs Tested: '
Number of Submersible Pump Sumps Tested: NUmber of UDC Boxes Tested:
Number of Fill Sumps Tested: Number of Overfill Boxes Tested:
Component Paaa Fall Comment.
/'.~
Signature:
Customer Signature:
Date: /c/-- 7r..a~.~-.
Date:
2080 South Union Ave. Bakersfield, Ca. 93307-4154 PH. 661-834-1100 FAX 66t-834-4216
www.franzen-hill.com
Jul 24 03 10:
~anzen Hill SffG8814G7
p.3
Page: 2 OP.. 7
· TANKANNULARTES'TING
Test Method Developed By: [] Tank Manufacturer [] Industry Standard [] Professional Engineer
[] Olher (Specify)
Test MethOd Uses:' [] Pressure [] Vacuum [] Hydrostatic
[] Other (Specify)
Measuring Equip. Used for
Tank Capacity: .-.
Tank Material:
rank Manufacturer:
=induct Stored:
Wait time applying pressure/
vacuum/water and starting test
Test Start Time: ,~ -
Initial Reading (Ri):
l~est End Time: ~,'
FinaJ Reading (Rf):
Test Duration:
Change in Reading (Rf-Ri):
Was sensor removed for testing?
wA/as sensor properly replaced
after testing?
Commenl~(include inf~aUon, on repaim made prior to testing) . ~ ~ , , .. ~ .
t/fl
" ~ I ' '
SWRCB
~anzen Hill
Page: 3 oP. 7
Developed By:
Uses:
6. SECONDARY' PIPE TESTING
[] Tank Manufacturer ! Standard
[] Other (Spec~y)
[] Pressure [] Vacuum
nal Engineer
[] Hydrostatic
lq Other (Specify)
Used for Testing:
Manufacturer:
,Diameter:
ng Run:
Product Stored:
and location of piping-ruJ
applying pressure/
and
Time:
Readi
End Time:
Reading (.__Rf):
Duration:
In Reading (Rf-Ri):
Threshold
Cemmm~-{include information on repairs made
~/~ ~ ~ ". ! ' . ,,'" ~:-, / ......... ",_~ ., .
· ;".";' ?.,,:' ~ : ';..-:.: 'i J, .. t~::.' ~.' !',' ~':"
SWRCB
3ul :~ 03 10: ISa
nzen Hill
S~G8814G?
p.5
Page: 4 of': 7
6. SUBMERSIBLE PUMP CONTAINMm~FF:
·
TeSt Method Developed By: [] Tank Manufacturer [] Industry Standard [] Professional Engineer .
D Other (Specify)
Test ;.~'~hod Uses: [] Pressure [] Vacuum [] Hydrostatic
O Other (Specify)
~ unlp~ / 8ump # Sump .--:
Sump D~ameter:
Sump Depth: ~'"~
Sump Material:
Height P, or~ Tank Top to Highest ..,..
Piping Penetration: . .'~'
Height from Tank Top to Highest ?/'''
Electrical Penetration:
Condition of sump prior to testing: . .. "
Portion of Sump Tested (I) ,- ..
Does turbine shut down w~,en ~.'"
sump sensor detects either ,."
>roduct or water? .:.'
Turbine shutdown response time(2) ./ -
Is system programmed for fall-safe ./~
shutdown?
Was fail-safe verified to be
operational? .../
Wait time applying pressure/
vacuum/water and starting test; ,..'
Test Start Test: / '"
Initial Reading (Ri): ,/'
~est End Time: /'
Final Reading (R0: ,/
Test Duration:
Change in Reading (Rf-Ri~:
~Pass/Fail Threshold
, t'ng?
Was sensor replaced after testing?
C¢~n, Iltent~(iqclude information on repairs made prior to testing.)
t If the testing method does not test the entire depth of the sump, specify how much of the sump was tested. 'Methods not
testing the entire sump should ~nh/be used if Ihe monitoring system provides tail-save turbine shutdown.
2 With the submemible pump running, place the sensor in product (discriminating sensors should also be placed in water).
The time between placing the sensor in product and the turbine shutting down is the response time. This should be done if
the secondary containment testing method used does not test the entire volume of the sump
SWRCB
,Jul 24 03 lO:20a
~anzen Hill
p.S
Page: 5 of:. 7 '
T. UNDER-DI8PENSER _r~_NT~.~,LM__u_~iT
Test Method Developed By: [] Tank Manufacturer ~J4ndustry Standard [] Professional Engineer
[] Other (Specify)
Test Met. hod Uses: [] Pressure n Vacuum l~J"lydrostalic
[] Other (Specify)
Height from UDC Bottom to
Height from UDC Bottom to
Lowest Electrical Penetration:
Condition of UDC prior to testing:
Portion of UDC Tested (~) ' ~..~.j ~ i/}, ~/~ ,.~.~'?
Does turbine shut down when'
UDC sensor detects either
)roduct or water?. ·
Turbine shutdOwn response time(2)
'Is system programmed for fail-safe -
Was fail-safe verified to be
operational?
Walt time applying pressure/
Pass/Fail Threshold ,
1
Gomment~-(include information on repairs made prior to testing)
1 If the testing method does not test the entire depth of the UDC, specify how muctl of the UDC was tested. Methods not
testing the entire UDC should only be used if the monitoring system provides fail-save tu~ine shutdown.
:2 With the submersible pump running, place the sensor In product (discrimina§ng sensors should also be placed in water).
The time between placing the sensor In product and the tufolne shutting dewn is the response time. This should be dona if
the secondary containment testing method used does not test the entire volume of the UDC.
SWRCB
Jul 24 03 10:20a
eanzen Hill S~G881487
p.?
Page: 5 of: 7
7. UNDER-DISPENSER CONTAINMENT (IJDC) TE~TING
rest Method Developed By: [] Tank Manufacturer l~ndustry ~tandard n Professional Engineer
[] Olher (Specify)
Test Method Uses: [] Pressure [] Vacuum I~-Iydrostatic
[] Other (Specify)
Measuring Equip. Used for Testing:
UDC Manufacturer:
Height from UDC Bottom to
Highest Piping Penetration:
Height from UDC Bottom to
Lowest Electrical Penetration:
Condition of UDC prior to testing:
Does turbine shut down when *' "
UDC sensor detects either
)roduct or water? ¥,% '.~ ~'~ ? ~:
Turbine shutdown response time(2)
Is system programmed for fail-safe
Was fail-safe verified to be
Wait time applying pressure/
vacuum/water and starting test ' ,~. ' .' ....
Chan~ie in Reading (Rf-Ri): , ~')T), ~ q ..... , ~.~ ,.?
PaSs/Fall Threshold ....... ':: . ,';;0 '~-
Was sensor replaced after testing? .* "~I,~ /
Cemme~s-(include information on repairs made prior to testing) U!//..,
~ If the testing method does not test the entire depth of the UDC, specify how mu~h of the UDC was tested. Methods not
testing the e~tlre UDC should only be used if the monitoring system provides fail-save turbine shutdown,
2 With the submersible pump running, place the sensor in product (discriminating sensors should alSO be placed in water).
The time between placing the sensor In product and the turbine shuffing down is the response time. This should be done if
the secondary c. onteinment testing method used does not test the entire volume of the UDC.
SWRCB
Jul
2~4. 03 10:~1a
zen
Hill
Franzen-Hill
System Design, Construction & Maintenance
p.8
of:. 7'
Secondary Containment Testing Repor~ Form
1. FACIM~ INFOR~TION
2.TESTING CONTRACTOR INFORMATION
Tulare, Ca.
Technician Conducting Test:
/ CSLB Licensed Contractor
D Icense an es.er
Manufacturer
Environ, APT
Training by Manufacturer
Component's)
Piping and Testing
Date Training Expires
/o -/o
Smi~s Filter, EBW
Piping and Testing
Total Containment, VeederRoot
Piping and Testing
..Econ, Gilbarco EMC, Mon. itor System Piping and Testing
3. SUMMARY OF TEST
Number of Tanks Tested: ~ Number of Piping ~~
Runs Tested:
~lumber of Submersible Pump Sumps Tested: Number of UDC Boxes Tested:
~umber of Fill Sumps Tested: Number ~f Overfill Boxes Tested:'
Compm~ent ~;~aa~ia~B~i~-~l Cc,~-~.~
T" ,¢~,,.,,¢- -D ~ ..
,¢,/t c;, ,..,,,.., [] ~
.,)....'] '" /-.,,,2 . ',
Technician's Signature:
SWRCS
1100 North J Street, Tulare, California g32741559.-688-29771800.655-34361559.688..1467 FAX
www. frenzen-hill.corn / construction(~franzen-hlll.com
Page: 2 of: 7
4. TANK ANNULAR TESTING
Tank # Tank
Tank Materiak
Tank Manufacturer:
Product Stored:
Wait time applying pressure/
vacuum/water and starting test,
Test Start Test:
Initial Reading (Ri):
End Time:
Final Reading (Rf):
Duration:
in Reading (Rf-Ri):
sensor removed for testing?
sensor properly replaced
C, omments-(include Information on repairs made prior to testing)
SWRCB
3ul ~ 03 10:~2a
zen
Hill 5~6881467
Page: 3 of:. 7
5. SECOND,M~Y PIPE TESTING
I~est Method Developed By: ~irTank I~lanu~cturer I~'.ndustry Standard n Profes'~ional
Engineer
IL
' I-I Other (Specify)
Iest Methc~ Uses: ..... ]~'Pressure ' [] Vacuum [] Hydrostatic
S~' -d~f~iiT [] Olher (Specify)
i[[!l' T~i .lpln,g ~un# I Pip ng Run#?_ Piping n#~'-~
tlpIPiping Manufacturer: A.
P~Piping Diameter: -~.
Length of Pipin~ Run:
roduct Stored:
Me,od and location of piping-run
isolation: ~xJ t~PLO G-Cio (..~ e.~"> /5.~iI ~4~,~
IlWait ti e ap , yi.o
I~mcuum/water and startin~ test
Irrest Start ~l'est: '~ % '5 o ~..,,-, ' ?- '5 o [7 ~,'~
II nitia Reading (RiI: ~'/) 5, ~ ,~' ~ .,~ '~ "
Jrrest End Time: "
IlFinal 'Reading (R0: ~' ¢,.~ ,.~ C) '"
IITest OuraUon: >.o '*)(~ ~,,,,j ' '
IlChan'ge in Readin~l (Rf-Ri): ' .,.-,..t/ _ __
Threshold /° o'~ ~ "1 ,~ ~ ........
p. lO
C~mmenl~-(include Information on repairs made prior to testing)
SWRCB
Jul
~4 03 lO:~a ~anzen Hill S~GIBBI,~G?
p.11
Page:4 o~ ?
6, SUBMERSIBLE PUMP CONTAINMENT SUMP TESTING
Test Method Developed By: [] Tank M~r~Ufacturer .l~lndustry Standa~ ~[ Profe~ional Engin~r "
D ~er (Sp~i~)
~t Met~ Uses: ~ Pressure ' ~ Vacuum ~ Hydrostatic ' '
D O~er (Spe~) ~ ~ ~
Sump Diameter: ~ b ~ ' ~ = ~
Sump Depth: ..........
Height from Tank Top to Highest
Piping Penetration: ~O~ ~ ~G ~ 5-~ '"
Height ~m T~k Top to Highest ~ ~
~ndition of sump pdor to testing: Bo ~ 0o~.~ ..... 3
PoAion ~ Sump Tesmd (~" ~
~oes turbine shut do~ when ...........
sump sensor detects either
)rodu~ or water?
Turbine shutd~n response time(2)
Is system programm~ for ~il-safe
shutdown?
Was fail-~e verified to be
operational?
~ait lime appl~ng p~su~ ....
vacuum~ater and starling t~t:
Test S~A Test: ..... _
Initial Reading (Ri): ..,
Test End Time: "'
Final Readin~ (~): ' '
T~t Duration: ....
Change in Reading (Rf-Ri~: · ,,, "
Pass/Fail Threshold .......
~as sensor mpla~d, affe~'te~ting*
C~mmenl~-(include information on repairs made prior to testing)
I
2~th ~e submemlble pump mnnl~, place ~e s~sor In p~u~ (di~minating ~s ~uld al~ be plac~ in ~ter).
time ~en placi~ the ~ In pmdu~ ~ the ~rblne shying ~ Js ~e ms.rise time. This should ~ do~ if
~a~ ~ntainm~t testing me.od us~ does not ~est ~ entire ~lume of ~e sump
SWRCB
.Jul ~4 03 lO:;~3a
~an:,en Hill S~G8814G'~
p.12
Page: 5 of:. ?
?. UNDER-DISPEN8ER CONTAL""
Test Mefll~:~J Develop~J By: ~ Tank Manufacturer [] Industry Standard [] Professional Er~gineer
[] other (Specify)
Test Method Uses: [] Pre~ssure [] Vacuum ["1 Hydrostatic
I"1 Other (Specify)
UDC Manufacturer:
IUDC Material
UDC Depth:
Height from UDC Bottom to ' '
Highest Piping Pe,netration:
Height from UDC Bottom to '
Lowest Electrical PenetratiOn:
Condition of UDC prior to testing: -"
~ortion of UDC Tested (1)
Does turbine shut down when
UDC sensor detecls either
)rod uct or' water?
Turbine shutdown response time(2)
Is system programmed for fall-safe '
shutdown?
Was fail-safe verified to be
operational?
Wait time allying pressure/
vacuum/water and starting test
Test Start ]=est: -- "
~lnltial Reading (Ri): '"
Test End Time:
Final Reading (Rf):'
Test Duration:
Change in Reading (Rf-Ri):
Pass/Fall Threshold
INas sensor removed for testing? I
Was sensor replaced after testing?
I
Comment~(include information on repairs made prior to testing)
1 If lhe testing method doe~ not lest the entire depth of the UDC, specify how much of the UDC was te~led. Methods not
testing the e~ltire UDC should only be used If the monitoring system provides fail-save turbine shutdown.
2 With the submersible pump running, place the sensor in product (discriminating sensors should also be placed in water).
The time between placing the sensor in product and the turbine shutting down is the response time. This should be done if
the secondary containment testing method used does not test the entire volume of the UDC.
SWRCB
.Jul 2~ 03 10:
nzen Hill 881'~67
p.13
Page: 6 of: 7
FILL_ RI~ER CONTAINMEN'
Test Method Developed By: El Tank Manufacturer ~ Industry Standard B~.Professlonai Engineer
[],Other (Specify)
Test Method Uses. [] Pressure [] Vacuum i~1 Hydrostatic
~ Fill Sump-ii Fill Sump
S~mp Depth: ' ~ ~ ~'
Height from Tank Top to Highest
Condition of sump p'~'ior to testing: {]o~ ~' ~/o~ ~'_ F.'o ~ ,%
Portion ~)f sump Tested..
~Vai! ti,~e applying pressure/
vacuum/water and starting test:
Test Start Test:
Initial Reading (Ri):
Test End Time:
Final Reading (Rf):
rest Duration: ·
".3hange in Reading (Rf-Ri):
Pass/Fail Threshold '
:)oas the sensor alarm when
either product or water is
dectected?
Was sensor removed for testing?
Was sensor replaced after
~esting?
Commentn-(include information on repairs made Prior to testing)
SWRCB
~u! 24 03 ~O:~4a
zen Hill
5~68814G7
p.14
CUSTO~4~R NAME:
JOB NAME:
WORK ORDER #:
JOB SIT~ :
Franzen-Hi11
SB-989 TESTING CODE ENFORCEMENT AGENCZES WORKSHEET
Rosedale Chevron
Rosedale Ch~v~QD
li0441
9700 Rosedale Hwv Bakersfield
CODE ENFORCEMENT ~ER:
INSPECTION PERFORMED:
DATE: TIME IN:
SIGNATURE
TIME OUT:
· ' Complete items 1, 2, and 3. Also complete
:item 4 if Restricted Delivery is desired.
I' · Print your name and address on the'reverse
[ so that we can return the card to you.
I · Attach this card to the back of the mailpiece,
or on the front if space, permits.
· 1. Article Addressed to:
NIRMAL GILL
ROSEDALE CHEVRON
9700 ROSEDALE HWY
BAKERSFIELD CA 93312
~PS Form 315'l'l,.August 200 ..... w J
[] Agent
[] Addressee
/(PrintedName) lC. Date of Delivery
D. Is delivery address different from item.1 ? [] Yes
if YES, enter delivery address below: [] No
:1'3' Service Type
~1 [] Certified Mail [] Express Mail
J [] Registered [] Return Receipt for Merchandise.
~-~ J [] Insured Mail [] C.O.D. -
J 4. Restricted Delivery? (Extra Fee) I-I Yes
2ACPRI-03-Z-0985
UNITED STATES POSTAL SERVICE
First-C ass,Mail
Postage & Fees Paid
usPs
Permit No, G-10
· Sender: Please print yeur name, address, and ZIP+4 in this box ·
Bakersfield Fire Department
Prevention Services
1715 Chester Avenue, Suite 300
Bakersfield, CA 93301
' I.-J RetumReclept. Fe~.. ~ I Here
N~MAL G~L
' ROSEDA~ C~VRON
' ~ ~ ~7oo ~os~= ~r : ........
I,~
i ~ [~ BA~RSF~LD CA 93312 : ........
May 8, 2003
Nirmal Gill
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield, CA 93312
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
FIRE SAFETY SERVICES * EN~qRONMENTAL SERVICES
1715 Chester Ave,
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
PUBLIC EDUCATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326-0576
FIRE INVESTIGATION
1715 Chester Ave.
Bakersfield, CA 93.301
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
Failure to Complete SB 989 Secondary Containment
Repairs & Retest
FINAL REMINDER NOTICE
Dear Underground Storage Tank Owner & Operator:
Since January 1, 2003, this office has sent you monthly reminders
advising you of a failed SB 989 test. In that letter, this office also
requested an update with regard to repairs of your system.
This office further explained that repairs of your system are a
condition of your permit to operate. Please be advised that you must
have your system repaired and retested by June 15, 2003. Failure to
comply may result in further enforcement action up to, and including
revocation of your permit to operate.
This office has extended every courtesy with regard to sending
contractor information as well as one on one visit's
Should you have any questions, please feel free to call me at 661-326-
3190.
Sincerely,
Ralph E. Huey
Director of Prevention Services
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
APR--18--05
FR I : 5~ ~ROM ' B . $ . $ . R . I NC . P . 01
'. BSSR, Inc.
6630 Rosedal¢ l-fwy,, ~ B, Bakersfield, CA 9~3308 Phone (661) 588~2777 Fax (061) 588-~86
MONITO NG SYSTEM CERTIFICATION
't3fi~. go.cra must b~ used 'to document t~st~'g and so. icing ~f mohitoring equipment. ~.~epa. raJ~ ¢crti'~atio~_.~r_ ro~fl mu~:.
:~ ' '} ' for ~ch mo~tofine system control~a~l by fl~e g~ue~n who p~rfor~ ~e work. A oopy of this fern m~t be provided
~ :..'~'~2i~';sy~!~,'ownedo~rat~.'. ~e owner/operator must submit a copy of o g Y
· , :choral Informa~on
Contact Phone 1'4o.: (.~.(,)..~__ .)_.....~..~ 7' q ~t L
Date ofTcstlng/Servicing: ~..~j_~ I~_~
:probe,.
Vault Sensor,
Line Leak Detector. Model:
I High-Level $~ri$or, M,'~I, d: ...........
· mb&l ....
S~n,or. Model:g 5qOt~ q
L~ak D~ector. MOd~:
/ Hi 5~nscr,
5~etion E on
~il~ln-Tank Gauging P~0be, " Mod. d:
Mechanical Line Leak Detector, Mode. l:
~leearonie Line Leak ~t~etor. Model: ~.~LL-q~:XZ_i:aI:L]~
Tank Overfill I High-Loyal ~¢n~or, Model: · ·
ln'S~tlon g
Sen~orO),
t
· 'i: and Chain
and
Tank ID:
CI In-Tank Gauging Probe,
[2 Annular 5pa~e or Vault Sensor.
CI Piping Sump / Trcnoh Sensor{s),
C! Pill Stop 8ensoKs),
~ Mech~ical Line ~ak D~tc,tor,
Model: ........
Mo&l:
Model: __....,....___,~.~
Meal:
Model: ..... ..,
0 Electronic Linc Leak D-teeter, Model::. ...........
Cl Tank Overfill / High-Level Sensor, Modch
,del in
O Dispenser Containment Sensor(s), Model: ......... --
F.9~ h car Valve(s).
Dispenser ID: ..~..~M~6 ......
O Dispenser Containment Sensor(s). Modeh
~hCat valw(s),
CI Dispcns~ Containmoni $cn./or(s), Model:'_...__
~heat Valve(s),
Containmcnt
. qf r3~ facility iontgns m6te ta~ks 0r di'~pin~s,'Oopy this fo~, Includ~ into~ation ~r ew~ tank ~d dis~n~ at the hcility,
,.,.:~,~'.,1 :! : r' ' ' :'
· 'i~,y: ~.¢,:g~, . ,. ~fv ~at tht tauln~at idcafifl~ in ~ docameat was inspect~/~lc~ ia ac~ord~ca with ~e
' ~'~O~maflon ~ correct ~d a Plb'.t P~n showing mc ~ayout OI monnonn$ ~qu~pm.u. v Y ~ r , . - , , ,
' '. ~epo~ I have al~ a~A~ a ~py of the repo~ (chc~all th~t a~t~): O S~m S~-up~ O~a~ his~ report ,.
Pag~ I of'3 0~/01
~ ~h~k this box if no I~ gau$in~ or Sl~ c~u~pm~t l~ install~d'
~his s~c~on must b~ completed if in-t~ ~auging equipment is usc~ ~o pcrib~ le~ detection monitoring-
,~i~ ~l~e Le~ De~tor~. (~L) ~ Check ~ box · ~LDs m'e not ~tall~d.
~te the .follow!ul~ che, cklist., .... :..: -,-~~a l~k simulated to verify LLD .p~ -
~'~1%* Fbr e~,ipm~t ~.up~.or ,an~,~_u~ ,,eq~uj~.=~,'-e.~.~,,"~l-'0,1 g.p.h; Kl 0.2 S.p.h.
ill N/A (Ch~ck all that a~p~yJ ~tmam~¢a ic ........... .
~ and ac~wat¢ within re~latory req~ire~cn, ts?
........ ~perly calibrated? _ . _ · ·
'1.:.. ~ "Ilo* ~aratus propertycnilor,~!~;~._...~. _=__.
........ ~' ~.,~. +1,~ Tl.r~ re_~trict nfOdll(;t IIOW ti' tt ClOtC~t$ ~. le.a~;c
~ For tlteolla~ltcat ~.,L~Ja, vv~ ~,,~, ,,,.,,.-. ~tItC~ r
, ~i ~/A ,: · ' .......
.7.':i '~1 BIo' FOr electioni~ LIDs, ~i~es the iu~bhte auto~ti~-~tl{},h~t off if the LID detects a leak?
._ E) I~/A , ' ' . .... ' .... - ....
"KI'No* Fo~ ~l~ct~onl'.c LI',~$, does the turbine aUtomativally shut off if' ~y portiou"~f
..~.. N/A or di~cmmcctCd?
'.'~. I~/A ,~functions or fails a
',. ;.0.". No" For el¢ctromc LLDs, ~¢ all acccss~i~ wi~$ coim~ctio-s t~on Vi;uall¥ inspected?
~-~':'.~[ No* W,~r~ a~l it~ms.'on ~h~-~'"~"~"~""'~'~t'a&w~r'a main~a"M ~h~lis~
~ei~ou H, beloW, describe how and When these deflc
Page :~ of 3
Ol/Ol
i~lPR-- 1 8--0::~ F R I
:55 FROM ~. S. $. R. iNC. P. 03
Results of Tosttn~$¢rvicing
checklist:
~i: O No* Is the vlsual almm~ opc~t,.oual? . ~- .......... '
r. :, Cl Nb'* Were all s~_.ii_'s6ri v'isi:.,~!)y ins~o~.d., fiu!~.U,.'or,~Uy_ tested, and¢.gllfi~.e, di.opcratlonal?
!;'::! 0 No* Were all son~ors his'tailed at loWest point ofSe, condary containment and positioned so that other ¢~il;;~cnt will
not interfere with their proper operation?
i.i Cl. NO* It' alarms ar~ rela¥od to a r~mot~ moniton.~ slat~o~, ~ all commumcations equ~m¢-t (e.S, m~m)
~:ii El ~/'.A ' mo~i.to~'g system cl**t~ ~ le.~, t'~ls to. opm'ate, or is ¢~e. ctncan7 msco~_.?. ~¢~'t ~es,. w. mc~ ? .c~sors mma~¢
ii: ' ' positi'v~:~ut.~fown?:=' (Che¢~ ~ll t/~ ~/~) I~,.'SSmp/Trmcb $~sors; ~ ~pcns_cr_~'.o~nm.mn~¢.n.t ~cnsors,
i Did you co~fl_rm pn_s_it._~vc _~h,.*.!-down due to leaks and sensor t'ailurc/(lisco~anc~._fi_pp?.....t~rYc~ ~o ........... .
:'O1' No,, For-tar~ systems float utiU.~ the '~i~on;ng system as the pri~a~t ta~i~ overfill warhing dcvlcc (i,¢, no
i Ei' N/A mech~i~" "cal'0v~rfill prc.v~Mton valve is inst~lj-cd), is th~ overfill war~mg at,~rm visi~l~ nnd audibl,~ ~ ~c
beloW, de~rlbe h~w ired when the~e defl~ie~ci~ were or will be em~'ccted,
03101
APR-- i 8--05 FR I : 55 ~ROM I~ . $ . $ - R . I NC . P . 04
System Certifieatiort
UST Monitoring Site Plan
:s~. ',:~,~,'~,: c1700
...... ~ '~'{'~'!f ...... ~ ..... - ' "'
...':'. ............................ ' .... [ il',
....... .....
·:~.: ~ · . , , , , , , ............... .
:. ~.,: ~,... ....... ================================== ......
. ~-~ ..... ?'~... .......~.~ ..... ~' 'i '~' '
..................... ~0~ .
'l. '..~]- I~1 ........ l~l .............. ~ , x :: , ;.
'1" ..... t:!;::l ........ "l,i,l I~ht ...............
..... . ........... : .....
,.l...~,~] ...... : :~: :,'- :' :/~ .............. ,.,~ ......
,, ....................... ,
'~.. ,..;... . .............................................
..... : ......... ~... .......................
1"" :z~ '~ ..... ('% ....
, · '.. ' ; ~e' ' ~r .... :s~e ............ ~ ............
· I ............ . .~ .~ .~ ~ ......
! ................. '':::'':: : ::..~..,rl~ ...... ' ....
' ' '.. ~.~~ ~,s~ ~6 8~.v,~.., ~.w~ ....... ~ ......
~... :..~vj ~ ..... ~ ..........
.'........~.: ,,
, a dla that shows all required information, you may include it, rather .than this page. with your
l~r~.~.~k~a, dy.hav~ ' gram ._ _ · ....... ,-- ~,,,~,.,-ul l~vo of tanks and i lng. Clearly identify
"... :'.':,'. '"~:'.':' · ex~ciiication, un your site plan, snow ,,L~ ~ ......... ._ut P P , .
~!}~!}~!~ ,S?~m ,C.~in ~ 'hi m,rtt, if ins.tailed: monitoring system oontrol panels; se,,nusors' m. om~nn.g ta.nk.,ann, u.i_a,r.
l.o~.~.o.g~ 9.? ,the ..folio g q P~:
.. ;. ~,,.:,..,..~m. ...... arm s [11 oontalri6Ts, or other sooo~dary oo , . . .
'..spi~i?,:~i!r~ps.,.4isp .~..s.~ P '". P '-- -. . ' n In the s ace rowdcd, note the dat~ this $~te Plan
~ ff used for leak dctect~o ) p P
a~,~,'i~i~,:iSn~l 'iriltanlc'lxquid .level probes ( .
0,6/00
Page ..___ of
· Complete items 1, 2, and 3. Also complete ignature
item 4 if Restricted Delivery is desired.
· Print your name and address on the reverse ' -- [] Agent
SO that we can return the card to you.
· Attach this card to the back of the mailpiece,
or on the front if space permits.
~dressed to: D. Is delivery address different from
. _ If YES, enter delivery address below: [] No
EDA VRON
, ~/UOROSEDA , ~ : . . ,
"BAKERSFIEL~LEcAH~93'~ I ' : =
3. Semice Type
~2~_ ' ~ ~ Ce~ified Mail ~ Express Mail
....... ~ ~ Registe~d ~ Return Receipt for Me(ch '
...... - ............... -'" -- ~ .~ured Mai~ a C.O.D.~ · andlse
~~ ~ 4. Restricted Deliver? (Extra Fee)
~ ~ 7002 2410 0002 1974 9978 I
Domestic Return Receipt
· ' 102595.02.M.1
· Sender: Please print your ~ame, address, and ZIP+4 in this box
Bakersfield Fire Department
Prevention Services ..
1715 Chester Avenue, Suite 300
Bakersfield, CA 93301
~ Postage
Iru
I-1 Certified Fee
~ Return Reciept Fee
(Endorsement Required)
I~1 Restricted Delivery Fee
~-R (Endorsement Required)
Postmark
Here
R
OSEDALE CHEVRON
9700 ROSEDALE
t~AKERSFIELD CA 93312
D
Tina FlOyd
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield, CA 93312
CERTIFIED MAIL
FIRE CHIEF
RON FRAZE
~)MINISTRATWE 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 SER14CES · ~L SERVICES
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-O576
FIRE INVESTIGATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
TRAINING DlVlSION
5642 Wctor Ave.
Bakersfield, CA 93308
VOICE (661) 399-469'~
FAX (661) 399-5763
NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE
Failure to Perform/Submit Annual Maintenance on Leak Detection at
the Above Stated Address.
Dear Business Owner:
Our records indicate that your annual maintenance certification on your leak
detection system will be past due on March 14, 2003.
You are currently in violation of Section 2641(J) of the California Code of
Regulations.
"Equipment and devices used to monitor underground storage tanks shall be
installed, calibrated, operated and maintained in accordance with
manufacturer's instructions, including routine maintenance and service checks
at least once per calendar year for operability and running condition."
You are hereby notified that you have thirty (30) days, April 12, 2003 to either
perform or submit your annual certification to this office. Failure to comply
will result in revocation of your permit to operate your underground storage
system.
Should you have any questions, please feel free to contact me at 661-326-3190.
Sincerely,
Ralph Huey
Director of Prevention Services
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services ~
SBU/dc
MAR-- I ?--03 MON 10 : 34 FROM B . $ . $ . R . I NC .
P. 01
,po )
SIGNATUtt.E OB APPLICANT
I'lar- ~0 0:3 !l:~l~a
?
Pai~ 1
p.1
10 03
I 1:
SYSTEM CERTIFICATION FORM
"rtu,i;d~e sumi~
Pag~ 2 of ~.
10 03 l:i.:~Ga
p.3
P~e 3 of~
Ilar 113 03 11 :~'7a
~/zd/2083 1¢:18 6618363],77 I~DW:NE TESTING S¥CS P~l~ 84
CITY OF BAKF3tSFIELD
OFFICE OF ENViRONIvIENTAL SERVICE~
1715 Chester Ave., Bakm'sfle!a; CA (661) 326.3979
TANIC #
A~PLICA,'rION TO PE, RFOITJ~ A TANK '13G~$ TE~T/
· ECONDARY CONTA]~ T~O
SECONDARY SYSTEM CERTIFICATION FORM
Tm'bi~ Sumps
SUmp lv, O~.?7_ Suiap,2 ~to$ fl? Sump 3 ~/ $~,4,,
of Wa~r . '
SECONDAR~ SYSTEM CERTIFICATION ~ORM
UDC TF~TING '
OI~PENSE~.I ' DISPENSER 2 DISPENSER 3 .DISPENSER 4
~GHT OF
WA~
DI$t:~RN '.,.~R,.5'I oISPENsER 6 DISPENSER 7 DIsPENsE_~8_-
~AL
WA~R
T~
HEIGHT
Ps8e 3 of ~
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
FIRE SA.':ETY SER~CES · ENVlRONI,I~NTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
PUBLIC EDUCATION
1715 Chester Avb.
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
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield CA 93312
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.
Sincerel~
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
I · Complete items 1, 2, and 3. Also complete
.' item 4 if Restricted Delivery is desired.
· Print your name and address on ~he reverse
~ so that we can return the Card
· Att,~h this card ....... to you.
I or ~n'the fr~-. ~ ~_ ~_e oacK ot the mai p ece
. v,,, ,, ~p~ce perm ts.
gnature
I 1. ArticleAd(~ressed to:
i'
[ CHEVRON (ROSEDALE CHEVRON) '~
9700 ROSEDALE HWy
BAKERSFIELD CA 93312
3. Service Type
; J"l 'Certified Mail
I...... ,r ~ Registered
, - ................. j [-1 Insured Mail
!---_________
· 4 Restrict ·
~ ~ ~ ed Delivery? (Extra Fee)
':-"~S Form ........ =,u,, ~eceipt ~
/"7 Agent
B. Received I Name)
D. Is deliver different from item 17 r-i
If YES, enter delivery address below: J-I No
r-i Express Mail
I-'l Return Receipt for Merchandise
[] C.O.D.
ID Yes
102595-02-M-0835
UNITED STATES POSTAL
· Sender: Please
, a~ldress, an
%,
G~10
BAKERSFIELD FIRE DEPARTMENT.
OFFICE OF ENVIRONMENTAL SERVICEs
1715 Chester Avenue, Suite 300
II'h'"ll"'lhlh,,,,,ll,hh,,I,h,,illh,,,,,Ihhhlh,,i
0~ C~A
Postage $
Certified Fee
~ .Return Receipt Fee Postmark
[r. naorsement Rsquired) Hem
Restrfcted Delivery Fee j
(Endorsement Requi~_~_J
l!BAKERSF/ELD CA 93312
·
December 1, 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
FIRE SAFETY SERVICES * ENV1RONMEh"rAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
PUBLIC EDUCATION
1715 Chester Avb.
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326-0576
FIRE INVESTIGATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
Chevron (Rosedale Chevron)
9700 Rosedale Hwy
Bakersfield CA 93312
CERTIFIED MAIL
FINAL REMINDER NOTICE
JANUARY 1, 2003 DEADLINE
Dear Tank Owner/Operator:
You will be receiving this letter on or about December 1, 2002. One
month from today, January 1, 2003, your current underground
storage tank(s) will become illegal to operate. Current law would
require that your permit be revoked for failure to perform the
necessary Secondary Containment testing.
In reviewing your file, I see that you have received "Reminder
Notices" since April of this year. This is your last chance to comply
with code requirements for Secondary Containment testing prior to
January 1, 2003.
Should you have any questions, please feel free to contact me at 661-
326-3190.
Sincerely,
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326"3979
APPLICATION TO PERFORM A TANK TIGHTNESS TEST/
SECONDARY CONTAINMENT TESTING
FACILITY
ADDRESS
PERM1T TO OPERATE #
OPERATORS NAME
OWNERS NAME
NUMBER OF TANKS TO BE TESTED
TANK #
VOLUME
IS PIPING GOING TO BE TESTED
CONTENTS
APPROVED BY
DATE
SIGNATURE OF APPLICANT
ROSEDALE CHEVRON
9700 ROSEDALE HWY.
BAKERSFIELD..CA.93312
805-589-9011
NOV 14. 2002 2:35 PM
SYSTEM STATUS REPORT
FUNOTIONS NORMAL
tORY REPORT
TI:SUPREME
VOLUME = 1605 GALS
ULLAGE = 10022 GALS
90% ULLAGE= 8859 GALS
TO VOLUME = 1588 GALS
HEIGHT = 18,63 INCHES
WATER VOL = 0 GHLS
WATER = 0.00 INCHES
TEMP = 75.2 DEG F
T 2:PL'US
VOLUME = 2815 GALS
ULLAGE = 8812 GHLS
90% ULLAGE= ?649 GALS
TC VOLUME = 2785 GALS
HEIGHT = 27.35 INCHES
VOL = 0 GALS
= 0.00 INCHES
= W~.? DEG F
T J:REGULAR
VOLUME = 3435 GALS
ULLAGE = 8192 GALS
90% ULLAGE= 7029 GALS
TC VOLUME = 3408 GALS
HEIGHT = 31.40 INCHES
WATER VOL = 0 GALS
~dATER = 0.00 INCHES
TEMP = 73,! DEG F
FACILITY NAME {~O.tte(a~,t
ADDRESS qlO0
FACILITY CONTACT
mSPECTION TIME
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
INSPECTION DATE I{- [ q-O "~... ·
PHONE NO. ~'~'~ - q'O [ [ :'
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES "7
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 adeqdate
Containers properly labeled k/' I~Ct~ ~tqq¢~' ~(O~ dlfllt~tfi~, PtOtl~. ('
Housekeeping
Fire Protection ~L
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous wasteton site?: []~ Yes ~ No
Explain: bQ'!h~ttt~ ~t~'. ~
Questions regarding this inspection? Please call us at (661 ) 326-3979
White - Env. Svcs. Yellow - Station Copy Pink - Business Copy
Busin~~~ n,~ble. Party
'nspector:~'~-', ~,~'d(,~
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
FACILITY NAME ~O~drt[~_. ~---~O¢OI'X
Section 2: Underground Storage Tanks Program
[] Routine [~Combined [] Joint Agency
Type of Tank OtJ3~
Type of Monitoring cA L/'/'I
INSPECTION DATE
I~ Multi-Agency~
Number of Tanks 3
Type of Piping gJad~'
[] Complaint
[] Re-inspection
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file
Permit lees current
/
Certification of Financial Responsibility ~-,
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations .
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S) AGGREGATE CAPACITY
Type of Tank Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on file with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
If yes, Does tank have overfill/overspill protection?
C=Compliance V=Violation Y=Yes N=NO
Inspector: ._
Office of Environmental Services (805) 326-3979
White- Env. Svcs.
Pink - Business Copy
· · Complete items ~, 2, and 3. Also complete
item 4 if Rest'~icted Delivery is desired.
· Print your name and address on the reverse
so that we can return the card to you.
· Attach this Card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
[] Agent
[] Addressee
( Printed Name.) ~ C 13ate of De[iv~/
I
Is delivery address different from item 17 [] Yes
If YES, enter delivery address below: [] No
CHEVRON
9700 ROSEDALE HWY
BAKERSFIELD CA 93312
_.Service Type
z~ Certified Mail [] Express Mail
[] Registered [] Return Receipt for Merchandise
[] Insured Mail [] C.O.D.
· Restricted Delivery? (Extra Fee) [] Yes
7002' 0860 0000 1641 6-377
PS Form 3811, August 2001 Domestic Return Receipt
102595-02-M-0835i
· Sender: Plea.s..~e.X~t~j~.~name, addre4~,~R(~ ~llP+,~m ~h~is~o~_.
Postage
Certified Fee postmark
~ Return Receipt Fee Here
r ~ {Endorsement Required)
r .=,..t,~ Delivery.Fee~
C3 (Endorsement Requ~reol
rlJ Total Postage & Fees
~i~;~fe,=P+ BAKERSFIEI3) CA 93312 '
October 31, 2002
Chevron (Rosedale Chevron)
9700 Rosedale Hwy
Bakersfield CA 93312
REMINDER NOTICE
CERTIFIED MAIL
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
F~E SM:E"t~ SERVtCES· F.H'~IRONMEKrAL SERIflCE$
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 (6~1) 326-0576
FIRE INVESTIGATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
RE: Necessary secondary containment testing requirements by December 31,
2002 of underground storage tank (s) located at the above stated address.
Dear Tank Owner / Operator,
If you are receiving this letter, you have no._3t yet completed the necessary
secondary containment testing required for all secondary containment
components for your underground storage tank (s).
Senate Bill 989 became effective January 1, 2002, section 25284.1 (California
Health & Safety Code) of the new law mandates testing of secondary
containment components upon installation and periodically thereafter, to
insure that the systems are capable of containing releases from the primary
containment until they are detected and removed.
Of great concern is the current failure rate of these systems that have been
tested to date. Currently the average failure rate is 84%. These have been
due to the penetration boots leaking in the turbine sump area.
For the last six months, this office has continued to send you monthly
reminders of this necessa~ testing. This is a very specialized test and very
few contractors are licensed to perform this test. Contractors conducting this
test are scheduling approximately 6-7 weeks out.
The purpose of this letter is to advise you that under code, failure to perform
this test~ by the necessa~ deadline, December 31, 2002~ will result in the
revocation of your permit to operate.
This office does not want to be forced to take such action, which is why we
continue to send monthly reminders.
Should you have any questions, please feel free to call me at (661) 326-3190.
Sincerely',
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
September 30, 2002
Chevron (Rosedale Chevron)
9700 Rosedale Hwy
Bakersfield CA 93312
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 SAFE*W SERVICES* ENV'tRONMENTAL SER~qCES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
PUBLIC EDUCATION
1715 Chester Avb.
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326-0576
FIRE INVESTIGATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-O576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
REMINDER NOTICE
RE: Necessary secondary containment testing requirements by December 31, 2002 of
underground storage tank (s) located at the above stated address.
Dear Tank Owner / Operator,
If you are receiving this letter, you have not yet completed the necessary secondary
containment testing required for all secondary containment components for your underground
storage tank (s).
Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety
Code) of the new law mandates testing of secondary containment components upon installation
and periodically thereafter, to insure that the systems are capable of containing releases from
the primary containment until they are detected and removed.
Of great concern is the current failure rate of these systems that have been tested to date.
Currently the average failure rate is 84%. These have been due to the penetration boots leaking
in the turbine sump area.
For the last five months, this office has continued to send you monthly reminders of this
necessary testing. This is a very specialized test and very few contractors are licensed to
perform this test. Contractors conducting this test are scheduling approximately 6-7 Weeks out.
Thc purpose of this letter is to advise you that under code, failure to perform this test, by thc
necessary deadline, December 31, 2002, will result in the revocation of your permit to operate.
This office does not want to be forced to take such action, which is why we continue to send
monthly reminders.
Should you have any questions, please feel free to call me at (661) 326-3190.
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
D
August 30, 2002
Chevron
9700 Rosedale Hwy
Bakersfield, CA 93312
REMINDER NOTICE
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
ENVIRONMENTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
RE: Necessary secondary containment testing requirements by December 31, 2002 of
underground storage tank (s) located at the above stated address.
Dear Tank Owner / Operator,
If you are receiving this letter, you have not yet completed the necessary secondary
containment testing required for all secondary containment components for your
underground storage tank (s).
Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health
& Safety Code) of the new law mandates testing of secondary containment
components upon installation and periodically thereafter, to insure that the systems are
capable of containing releases from the primary containment until they are detected
and removed.
Of great concern is the current failure rate of these systems that have been tested to
date. Currently the average failure rate is 84%. These have been due to the
penetration boots leaking in the turbine sump area.
For the last four months, this office has continued to send you monthly reminders of
this necessary testing. This is a very specialized test and very few contractors are
licensed to perform this test. Contractors conducting this test are scheduling
approximately 6-7 weeks out.
The purpose of this letter is to advise you that under code, failure to perform this test,
by the necessary deadline, December 31, 2002, will result in the revocation of your
permit to operate.
This office does not want to be forced to take such action, which is why we continue to
send monthly reminders.
Should you have any questions, please feel free to call me at (661) 326-3190.
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
July 30, 2002
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield CA 93312
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "H' Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
FIRE SAFETY SERVICES · ENVIRONMENTN. SER~ICE$
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
PUBLIC EDUCATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326-0576
FIRE INVESTIGATION
1715 Chester Ave.
Bakemfleld, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
REMINDER NOTICE
RE: Necessary Secondary Containment Testing Requirements by December
31, 2002 of Underground Storage Tank (s) Located at
the Above Stated Address.
Dear Tank Owner / Operator:
If you are receiving this letter, you have not yet completed the necessary
secondary containment testing required for all secondary containment
components for your underground storage tank (s).
Senate Bill 989 became effective January I, 2002, section 25284.1 (California
Health & Safety Code) of the new law mandates testing of secondary
containment components upon installation and periodically thereafter, to insure
that the systems are capable of containing releases from the primary
containment until they are detected and removed.
Of great concern is the current failure rate of these systems that have been
tested to date. Currently the average failUre rate is 84%. These have been due
to the penetration boots leaking in the turbine sump area.
For the last four months, this office has continued to send you monthly
reminders of this necessary testing. This is a very specialized test and very few
contractors are licensed to perform this test. Contractors conducting this test
are scheduling approximately 6-7 weeks out.
The purpose of this letter is to advise you that under code, failure to perform
this test, by the necessary deadline, December 31, 2002, will result in the
revocation of your permit to operate.
This office does not want to be forced to take such action, which is why we
continue to send monthly reminders.
Should you have any questions, please feel free to call me at (661) 326-3190.
Steve Underwood
Fire Inspector Environmental Code Enforcement Officer
D
June 30,2002
Chevron (Rosedale Chevron)
9700 Rosedale Hwy
Bakersfield, CA 93312
REMINDER NOTICE
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 ~H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3951
FAX (661) 326-0576
ENVIRONMENTAL sERviCES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
RE:' Necessary Secondary Containment Testing Requirement by December 31,
2002 of Underground Storage Tank located at 9700 Rosedale Hwy.
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, lo ensure
that the systems are capable of containing releases from the primary
containment until they are detected and removed.
Secondary containment systems installed on or after January 1, 2001 will be tested
upon installation, six months after installation, and every 36 months thereafter.
Secondary containment systems installed prior to January 1, 2001 will be tested by
January 1, 2003 and every 36 months thereafter. REMEMBER! Any component
that is "double-wall" in your tank system must be tested.
Secondary containment testing shall require a permit issued thru this office and
shall be performed by either a licensed tank tester or licensed tank installer.
Please be advised that there are only a few contractors who specialize and have
the proper certifications to perform this necessary testing.
For your convenience, I am enclosing a copy of the code for you to refer to. Once
again, all testing must be done under a permit issued by this office.
Should you have any questions, please feel free to contact me at (661)326-3190.
Fire Inspector/Envir0hmental Code Enforcement Officer
Environmental Services
SU/kr
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 mailpiece,
or on the front if space permits.
1. Article ~dmss~ to:
Nirmal Gill
Rosedale ~hevron
9700 Rosedale Hwy
Bakersfie%d, CA 93312
Number (Copy from service label)
0360 0002 5244 7070
-~-"D~-i~ffere tn"~m it~,rl~ 17 r"l Yes
I -If YES, enter delivery address below: r-]No
1 3. Service Type
~ I~ Certified Mail [] Express Mail
~ [] Registered [] Return Receipt for Merchandis~
[] Insured Mail [] C.O.D.
4. Restricted Delivery? (Extra Fee) [] Yes
102~t
PS Form 3811, July 1999 Domestic Return Receipt
OFFIOE OF ENVIRONMENTAL
17~ 50hest~r Awnue, S~ite 900
Bakersfield, CA 9~301
~ Postage $ ~. 34
ru Certified Fee 2 ·
Ltl Postmark
Return Receipt Fee ]_ o 5 i Here
i~ (Endorsement Required)
r-'t Restr cted Delivery Fee
r-1 (Endorsement Required)
r"l Total Postage & Fees $ 3.94
Irt [Sent To
~g~'~o?~o°."4 9700 Rosedale H..w.y. ...............................
r~- City, State, ZiP+ Bakersfield CA 12
D
July 1, 2002
Nirn tal Gill
Rose'dale Chevron
9700 Rosedale Hwy
Bake~rsfield, CA 93312
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
Dea
CERTIFIED MAIL
Failure to Obtain Permit Prior to the Placement of the Above Ground
Propane tank installed at 9700 Rosedale Hwy
NOTICE OF VIOLATION &
SCHEDULE FOR COMPLIANCE
Mr. Gill:
On Thursday, June 27, 2002, I issued a "Red Tag" (cannot use) on your newly installed
propane tank for failure to obtatn a permit. ..
I have received, since then, a copy of your permit application through the building
depahment and for this office. However, before a permit can be issued the following
~tems need to be corrected in order to meet code. These are as follows:
'2.
3.
Shut-Off'.)
4. Placards around tank indicating "No Smoking, Turn Off Engine."
I fi fi
Once these corrections are completed and visua ly veri ~ed, I will con ~rm with Mr.
The tank currently is too close to the public side walk. (It is to be measured
from the beginning of west end of curb no___~t the east end next to street).
Your emergency shut-off switch need to be 75' from the tank. Your diagram
shows 79'. You also need to account for moving the tank in your
measurement.
A sign must be posted with letters large enough to see. ("Emergency LPG
Bell of the City Of Bakersfield Building Department that he is satisfied, I will
be happy to sign off on your permit.
ld you have any questions, please feel free to call me at 661-326-3190.
.'rely,
John
then
Shot
Sinc
Ralph E. Huey
D~rector of Preventton Servtces
Stev~ Underwood
Fire Inspector/Environmental Code Enforcement Officer
SBUidc
D
May 29, 2002
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield, CA,93312
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 9700 Rosedale Hwy
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 ChesterAve..
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
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield CA 93312
RE: Necessary Secondary Containment Testing Required by December 31, 2002
REMINDER NOTICE
Dear Tank Owner/Operator:
The purpose of this letter is to inform you about the new provisions in California law
requiring periodic testing of the secondary containment of underground storage tank
systems.
Senate Bill 989 became effective January 1, 2002. Section 25284.1 (California Health &
Safety Code) of the new law mandates testing of secondary containment components
upon installation and periodically thereafter, to ensure that the systems are capable of
containing releases from the primary containment until they are detected and removed.
Secondary containment systems installed on or after January 1, 2001 shall be tested upon
installation, six months after installation, and every 36 months thereafter. Secondary
containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003
and every 36 months thereafter.
Secondary containment testing shall require a permit issued thru this office, and shall be
performed by either a licensed tank tester or licensed tank installer.
Please be advised that there are only a few contractors who specialize a~d have thc 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/dm
enclosures
M~r 26 02 03:37p Franzen Hill 6851460 1487 p.
MONITORING SYSTEM CERTIFICATION
For Use By All Jurisdictions Within the State of California
Authority Cited: Chapter 6. 7, Health and Safe~ Code; Chapter 16, Division 3, Title 23, Cal~ornia Code of Regulations
~is fo~ mast b~ used to document testing and se~icing of monitoring equipment. A separate ce~ification or repofl must be prepared
for each monitorin~ system con~ol panel by the tec~ician who perfo~ th~ work. A copy of this fo~ must be provided to th~ ta~
system o~erloperator. The o~mer/operator must sub~t a copy of this fo~ to the local agency regulating UST syste~ ~in 30
days of test date.
A. General Info~ation /
Make.oriel of Monitoring System: s? .' -'.:'.;' Z [6 ~ ' :.;,s~ ~ ~':: Date of Testin~Se~icing:
B. Inventory of Equipment Teste~Certified
Check the a ro Plate boxes to indicates critic e ui ment ins ected/se~iced:
~Tank Gadging rrooe. · -~ ;_ ~
~lar Space or Vault Sensor. Model: 3 ~ ~ a~ p~.~ ~nular Space or Vau]t Sensor.
~[ Sump Sensor(s). Model: ~.~ .¥~fftt ~ill Sump Sensor(s).
O Mechanical Line Leak Detector. Model: N
D'E~ecironic Line Leak Detector. Model:
~ Tank Overfill / High-Level Sensor. Model:
= ~h~~ mentt e~nd ~d~l in Section E on
TanklD' ~ <°~ ~ 4//~//~ '1
~-Tank Gauging Probe. Mo&h f
~Annular Spac~ or Vault Sensor. Model: ::~
~ping Sump / Trench S~nsor(s). Model: ~
~Fill Sump Sensor(s). Model': ~'/-
~ Mechanical Lint Leak Detector.' Model: ;~t~ ,.
~ctronic Line Leak Detector. Model: ~bL~ '
~Tank Overfill / High-Level Sensor. Model:. ~ c'-> > c ......
~ Other (specify equipment t~e and model in Section E on Page 2).
~ Dispenser Containment Sensor(s). Model: '~L~
~e~"Valve(s). ' ~SoR.5...
~ispenser Containment Float(0 and Chain(s).
Dis~nser ID: ~ ~ :}
~ser Containment Sensor(s). Model: .7~ ~-~
~r Valve(s). ,::,,¥g:::~/." , .
~Dispenser Containment Flora(s) and Chain{s). '"
Model: ,-2q ~ ? /
Model:
Model: f" .' . ",': ;:"~' '~'."'"~'~
0 Mechanical Line Leak Detector. Model: ~',.3 :'
~'~eclromc Line Leak Detector, Model:
~-Tank Overfill / High-Level Sensor. Model: -::~ ~ '~..> ""
~ O~ ~if cui mentt e and model in Section E
Tank ID:
rU In-Tank Gauging Probe. Model:
O Annular Space or Vault Sensor. Model:
lq Piping Sump / Trench Sensor(s). Model:
~ Fill Sump Sensor(s). Model:
~ Mechanical Line Leak Detector. Model:
~ Electronic Line Leak Detector. Model:
r'l Tank Overfill / High-Level Sensor. Model:
[] Other (specify equipment type and model in Section E on Page 2).
Disp. gn-ser ID: '7 ~r g
[~'~spenser Containment Sensor(s). Model: ,':
':g' ,~Yr', z< : ,; ')"
[:~"S, bear Valve(s). "" . .... :'5
12~Dispenser Containment Float(s) ,and Chain{s). :0 ?-L':i!!> ,,
. ,:> ...,~. ,..~,
D~soe. nser ID. ~ ..' '-'
~'~spenser Containment Sensor(s). Model:
? S/hear Valve(s). ~'.~,::'.:& ':!...
.~ Dispenser Containment Float{s) and Chain(s). ' ,
Dis]~gnserlD: !~ ,~: 1%.
)is~eUser ID: > 3 ~,, '" .' .' .,'0 ~'Dispenser Containment Sensor(s). Model: 5: ::' ' '.:~ '"
~'.~spgnser Containment Sensor(s). Model: : ": ....
~,~'~r Valve(s). . ::, ...~/.;::.)~..! ~.~hear Valve(s). ..:':::" ,"."-:'
~l'Dispenser Containment Float(s) and Chain{s). 70 ~':~ Iii Dispenser Containment Float(s) and Chain(s).
· If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility.
C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'
guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this infnrmatiou
correct and a Plot Plan showing the layout of monitoring e4uj~nt. For any equipment c~able of generating such reports, 1 have also
attached a copy of the rent,t; (cheek all that apply): ~'~ystem set-up .~ 24~1~ armsx~ist.~orff..~llO t
Technician Name (print): ~ f~ ~ ^ t ~.~ Signature: :, .'~,
Certification No.: '~, ~// '7/. License. No.:
/-'.-'L'~ ,' .....
· , : r o.e No.:(
Testing Company Name: '~"'(' ,'~i ~': :.' ',~f'-> - { i~f,; . " ~"
Site Address: 1[ 0 0 [',.1 "-C" ./:._ / '::;' ? ~. ,: :.:,., c, /; "'ir'~'::? 'iL..
· ,.~ -.. > ........ '.. q.: .'. 7' {.." Date of Testing/Servicing: ..__.~_~
Monitoring Sy~em Certification
\
Page I of 3
03/01
Mar 26 02 03:37p Franzen Hill 6851460 1467 p.3
D. Results of Testing/Servicing
Software Version Installed:
so that
not interfere with their proper operation?
El Yes El No*... If alat'ms are relayed to a remote monitoring station, is all communications equipment (e.g. modem)
j'![~ operational?
[~/Yes ~1 No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment
El N/A monitoring system detects a leak, fails to operate,.,9.~is electrically disconn_fi~ted? If yes: which sensors initiate
positive shut-down? (Check all that apply) ~.-'~ump/Trench Sensors; )~l"Dispenser Containment Sensors.
Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 't~ees; El No. ..,
El Yes - For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
~ mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank
fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? %
0 Yes* ~'N0 Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced
j and list the manufacturer _n_ome and model for all replacement parts in Section E, below.
El Yes* IZI'~No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) El
Product; El Water. If yes, describe causes in Section E, below.
El" ~s~'' El lqo* Was monitoring system set-up reviewed to ensure proper settings? Attach set up.reports, if applicable
.~2"~res El No* Is all monitoring equipment operational per manufacturer's specifications?
* In Section E below, describe how and when these deficiencies were or will be correc
E. Comments:
Page 2 of 3
03/01
Mar 26 02 03:37p Franzen Hill 6851460 1467
F.' In-Tank Gauging / SIR Equipment:
O 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 monitorLng.
c.o~mp.lete me xonowmg .cnec~,,, . . . ..
, gl ~S D No* Has all input wir~g been i~pectcd for proper en~ and te~nation, including testing for ground faults?
~ ~es ~ No* Were all rang ga~ging probes visually inspected for damage and residue buildup?
~Xes ~ No* Was accuracy of system product level readings tested?
~/Yes D. No* Was acc~acy of system water level readings tested? . .
~$ 0 No* Were all probes rcinsmlled properly?
~./~es ~ No* Were all ite~ on ~e equipment manufacturer's maintenance checklist co~leted?
* 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.
e~et'he followin cheekligt:
~es D No* For equipment sta~-up or a~ual e~uipment ~cation, was a leak simulated to veri~ LLD perfo~nce?
D N/A (Check all dzat apply) Simulated leakrate: ~3 g.p.h.; ~ 0.1 g.p.h; D 0,2g.p.h.
~'"'~ No* Were all LLDs confi~ed operational and accurate within regulato~ requirements?
~Yes ~ No* Was the testing appara~s properly calib'rated?'
Yes D No*--. For'mechanical LLDs, does the LLD res~ict product fl0w if it detec~ a leak?
es ~ No* For elec~onic LLDs, does the ~bine autonmtically shut off if the LLD detects a leak?
~ / '~ N/A
~es .~ No* For elec~onic LLDs, does the ~rb~ automatically shut off-if any po~on of the monitoring system is disabled
'" 0 N/A or disco~ected?
Yes D No* For elec~onic LLDs, does the turbine automatically shut offif ~y portion of the monitor~g system ~l~ctions
/ ~D" N/A or fails a test?
~Yes ~* For electronic LLDs, have all accessible ~ring co~ectiom been visually i~pected?
~ef 0 N/A
~ No* Were all ite~ on the equipment manufac~rer's maNtenance checklist completed~
* In the Section H below, describe how and ~vhen these deficiencies were or will be corrected.
H. Comments:
03/01
Page 3 of 3' '"O{~ 0~{~=
Mar 26 02 03:38p Franzen Hill 6851460 1467 p.5
Monitoring System Certification
Site Address:
UST Monitoring Site Plan
Date map was drawn:'__/__/__
Instructions
If you already have a diagram that shows all required information, you may include it, rather than this page, with your
Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify
locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular
spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak
detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan
was prepared.
Page __ of __
Mar 26 02 03:38p
Franzen Hill
ROSEDALE CHEVRON
9700 ROSEDALE HL,tY.
BAKERSFIELD.CA.93312
805-589-9011
MAR 14. 2002 10:51 AM
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
........ SENSOR ALARM ......
L 5:PLUS FILL SUMP
PIPING SUMP
FUEL ALARM
MAR 14, 2002 10:57 AM
...... SENSOR ALARH .....
L 7:REGULAR TURBINE SUMP
STP SUMP
HIGH LIQUID ALARM
MAR 14, 2002 11:05 AM
PRESSIJRE LINE LEA}< ALARM
Q 3:REGULAR
PLLD SHUTDOWN ALARM
MAR 14, 2002 11:05 AM
..... SENSOR ALARM .....
L 8:REGULAR FILL SUMP
PIPING SUMP
Fb£L ALARM
MAR 14, 2002 Il:D5 AM
LIL~UID SENSOR SETUP
L 1 :SUPREI'IE TURBINE suMP
DUAL FLT. D [ SCR [ Pll NAT 1 NG
6851460 1467
R,,)SED~L]-~IEVRO N,
9700 ROSL~LE HW~'.
BAKERSF I ELD. Cfi',. 93312
805-589-901 l
MAR 14. 2002 10:48 AM
SYSTEM STATUS REPORT
Q 2:PLLD SHUTDOWN ALARM
IN-TANK LEAK DIAGNOSTIC
PROBE DIAGNOSTICS
T 1: PROBE TYPE M~GI
SERIAL NUMBER 220690
GRADIENT = 353.1600
NUM SAMPLES = 20345
COO 1370.5 COl 10237,8
C02 i0237.8 C03 10237.8
C04 10237.@ 005 10237,8
C06 ~1354.2 CO? I1354,2
C08 11354,2 C09 11354,2
C10 11354.2 Cll 44565.9
012 20555.8 ¢i3 2107~.8
C]4 21168,6 Cl5 2i279.6
C16 2t301,8 Cl? 2Ill5.I
C18 4456?.2
PRESSURE LINE L.E~K DInG
MAR 14, 2002 10:49 AM
:PLUS
DISPENSING ENABLED
DISPENSING
PUMP ON
HANDLE ON
27.467 PSI
A,,'D COUNTS
LOW REF =
HIGH REF =
SENSOR =
3735 CNTS 545 CNTS
886 ,..NT~
p.6
Mar 26 02 03:39p Franzen Hill 6851460
SENSOR ALARM .....
L 4:PLUS TURBINE SUMP
STP SUMP
HIGH LIQUID ALARM
MAR 14, 2002 10:43 AM
PRESSURE LINE LEAK ALARM
O 2:PLUS
Pi. LD SHUTDOIdN ALARM
PIAR 14.'2002 10:43 AM
ROSEDRLE CHEVRON
9700 ROSEDALE HWY.
BAKERSFIELD.CA.93312
805-589-9011
MAR 14. 2002 10:47 AH
SYSTEM STATUS REPORT
Q 2:PLLD SHUTDOWN ALARtl
ROSEDALE CHEWRON
9700 ROSEDALE HWY.
BAKERSFIELD,CA.93312
805-589-9011
PRESSURE LINE LEAl( DIAG
MAR 14. 2002 lO:50 RM
0 2:PLUS
0,20 TEST DIAG
CURRENT TEST:
- --T I ME--PRESS-'RfqMP RATE
MAR t 4
5:05 AM 35.3 0.005184
4:49 APl 35.3 0.00B187
PREVIOUS DATA:
---TIME--PRESS-RAMP R~TE
HAR 13
1:28 PM 33.1 0.010247
1:12 PM 32.5 0.011857
12:50 PM 32.8 0.013136
12:35 PM 32.2 0.016820
MAR 12
11:24 PM 37.9 0,014270
11:09 PM 39.4 0.018346
ROSEDALE CHEVRON
9700 ROSEDALE HHY.
BAKERSFIELD.,CA.93312
805-589-9011
MAR 14. 2002 10:50 AM
SYSTEM STATUS REPORT
CATEGO,
L 2:SUPREME FILL, sUMP
TRI-STATE (SINGLE FLOAT)
CATEGORY : PIPING SUMP
L 3 :SUPREME A[,JNULAR
TR I -STATE (S INGLE FLOAT 5
CATE(~ORY : ANNULAR SPACE
L 4:PLtJS TURBINE SUMP
DUAL FLT. DISCRIMINATING
CATEGORY : STP SUMP
L 5:I:::'LUS FILL SUMP
TRI-STATE (SI NGLE FLOAT)
CATEGORY : PIPING SUMP
L B:PLUS ANNULAR
TR I -STATE ( $ INGLE FLOAT }
CATEGORY : ANNULAR SPACE
L 7:REGULAR TURBINE SUMP
DUAL FLT. DISCRIMINATING
CATEGORY : STP SUMP
L 8:REGULAR FILL SUMP
TRI-STATE (SINGLE FLOAT)
CATEGORY : piPING SUMP
L 9: REGULAR ~NHULAR
TRI-STATE (SI NGLE FI.OAT)
CATEGORY : ANNULAR SPACE
I,,I~4R 14. 2002 10:47 AM
SYSTEM STATUS REPORT
2:PLLD SHUTDO~N ALARM
Mar 26 02 03:39p
SYSTEH SETUP
MAR 14, 2002 I0:29 AM
SYSTEH UNITS
U.S.
SYSTEM LANGUAGE
ENGLISH
SYSTEM DATE/TIME FORMAT
MON DD VYVY HH:MM:SB xM
ROSEDALE CHEVRON
9700 ROSEDALE HWY.
BAKERSFIELD,CA.93312
805-589-9011
SHIFT Tilde 1 : DISABLED
SHIFT TIME 2 : DISABLED
SHIFT TIME 3 : DISABLED
SHIFT TIME 4 : DISABLED
SHIFT BIR PRINTOUTS
ENABLED
DAILY BIR PRINTOUTS
ENABLED
TANK PERIODIC WARNINGS
DISABLED
TANK ANNUAL WARNINGS
DISABLED
LINE PERIOD1C WARNINGS
DISABLED
LINE ANNUAL WARNINGS
DISABLED
PRINT TC VOLUMES
ENABLED
TEMP COMPENSATION
VALUE (DEG F ): 60.0
STICK HEIGHT OFFSET
DISABLED
H-PROTOCOL DATA FORMAT
HEIGHT
PRECISION TEST DURATION
HOURS: 12
DAYLIGHT SAVING TIME
DISABLED
RE-DIRECT LOCAL PRINTOUT
DISABLED
SYSTEM SECURITY
CODE : 000000
Franzen Hill
S851460 1'%67 p.8
L 4:PLUS TURBINE SUMP
][)UAL FLT. D ISC:R 1M 1 NAT I NG
C.:A'rEGORY : STP SUMP
LIOU1D SENSOR SETUP
L I :SUPREME TURBINE SUMP
DUAL FLT, D I SCR I M I NAT I NG
CATEGORY' : STP SUMP
L 2:SUPREME FILL SUMP'
TRI-STATE (SINGLE FLOAT)
CATEGORY : PIPING SUMP
L 3:SUPREME ANNULAR
TRI-STATE (SINGLE FLOAT).
CATEGORY : ANNULAR SPACE
L 4:PLUS TURBINE SUMP
DUAL FLT. DISCRIMINATING
CATEGORY : STP SUMP
L 5:PLUS FILL SUMP
TRI-STATE (SINGLE FLOAT)
CATEGORY : PIPING SUMP
L 6:PLUS ANNULAR
TEl-STATE (SINGLE FLOAT)
CATEGORY : ANNULAR SPACE
L 7:REGULAR TURBINE SUMP
DUAL FLT. DISCRIMINATING
t.~TEGOR¥ : STP SUMP
L 8:REGULAR FILL SUMP
TRI-STATE <SINGLE FLOAT>
CATEGORY : PIPING SUMP
L 9:REGULAR ANNULAR
TR I-STATE (S INGLE FLOAT >
CATEGORY : ANNULAR SPACE
........ SENSOR ALARM .....
L 6:PLUS ANNULAR
ANNULAR SPACE
FUEL ALARM
MAR 14. 2002 11:20 ~
PRESSURE LINE LEAK aLGRM
0 2:PLUS
PLLD SHUTDOWN ALARM .
MAR 14. 2002 11:20 ~'I
...... :-3- E I'-ISOR ALARP' ......
L 9 :REGULAR ANNULAR
P, NI',IULRR SPACE
FUEL RLARM
M/%R 14. 2002 ll :3,9 AM
PRESSURE LINE LEaK ALARM
Q 3:REGULAR
PLLD SHUTDOWN ALARM
MAR 14. 2002 11:39 APl
Mar 26 02 03:391:
ROSED~LE CHEVROI'I
9700 ROSEDALE FtWY.
B~KERSF I ELD, C~. 9331
805-589-9011
M~R 14, 2002 11:44
S%'SI'EI°I STATUS REPORT
Q 3:PLLD SHUTD£:'HN ALARM
ROSED~LE CHEVRON
9700 ROSEDALE HWY.
BAKERSFIELD,¢~.93312
805-589-9011
PIeR 14. 2002 11:45 AM
LEAK TEST REPORT
T 3:REGULAR
PROBE SERIAL ItUM 197578
Franzen Hill
6851460 1467 p.S
..... SENSOR ~LARM ...... :
I. I:SUPREME TURBINE SUMP .'
STP SUMP .:
HIGH LIQUID ALARM
MAR 14, 2002 11:58 APl :
ROSED~LE CHEVRON
9?00 ROSEDALE HUY-
BAKERSFIELD,C~.g3312
805-589-9011
HAR 14, 2002 12:00
SYSTEM STATUS REPORT
Q I:PLLD SHUTDOWI'I ALARM
ROSEDRLE CHEVRON
9700 ROSEDALE HHY.
BAKERSFIELD.CA.93312
805-589-9011
MAR 14.. 2002 12:02 PM
LEAK TEST RERORT
T I:SUPREPIE
PROBE SERIAL N~-I 220690
NO TEST DATA AVAILABLE
NO TEST DATA A~/AILRBLE
..... SENSOR ALRRI,1 .......
L 2:SUPREME FILL SUHP
?I~IN~ SUMP
FUEL ALARM
MAR 14, 2002 11:54 AM
...... SENSOR ALARM
L 3:SIJPREME ANNULAR
ANNULAR SPACE
FUEL ALARM
P~R 14. 2002 11:56 ~M
PRESSURE LINE LEAK ALARH
G I:SUPREME
PLLD SHUTDOWN ALARM
M~R 14. 2002 11:56 AM
ROSEDALE CHEVRON
9700 ROSEDALE HblY.
BRKERSFIELD,CA.9~212
805-589-9011
MAR 14. 2002 12:01 PM
SYSTEII SI'¢4TUS REPORT
Q I :PLLD SHUTDOHI'I Al. ARM
ROSEDALE CHEVRON
9700 ROSEDALE H~Y.
BAKERSFIELD,CA.93312
805-589-9011
MAR 14, 2002 12:02 PH
PRESSURE LINE LEAl( 'rEST
HISTORY
G i:SUPREME
LAST 3.0 GAL/HR PASS:
MAR 14, 2002 12:02 PPI
TANK LEAK TEST HISTORY
T t:SUPREME
LAST GROSS TEST PASSED:
NO TEST PASSED
LAST ANNUAL TEST PASSED:
NO TEST pASSED
FULLEST ANNUAL TEST PASS
HO TEST PASSED
FIRST 0.20 GAL/HR PASS
EACH HONTH:
FEB 2, 2002 12:12 ~t'
JAN I, 2001 10:22 PM
FEB l, 2000 1:35 AM
JAN 1, 1999 11:20 PM
MAR 6, 1998 12:50 PM
FIRST 0.10 GAL/HR PASS
EACH MONTH:
LA~T PER I OD l C TEST PASS
I'lO TEST PASSED
Mar 26 02 03:40p Franzen Hill 6851460 1467 p. lO
ROSEDALE CHEVRON
9700 ROSEDALE
E~KERSFIELD.CA.93312
805-589-90ll
MAR I4, 2002 12:02 PM
SYSTEM STATUS REPORT
ALL FUHCT I ON,S NORIdAL
INVENTORY REPORT
T I:SUPREME
VOLUIdE -= 2986 GALS
ULLAGE = 8641 GALS
90~ ULLAGE= 7478 GALS
TO VOLUME = 2966 GALS
HEIGHT = 28.48 INCHES
~IATER VOL = 0 GALS
WATER = 0.00 INCHES
TEMP = 69.4 DEG F
T 2:PLUS
VOLUME = 4417 GALS
ULLAGE = 7210 GALS
90~ ULLAGE= 604? GALS
TO VOL~'IE = 4415 GALS
HEIGHT =.37.55 INCHES
~ATER VOL = 0 GALS
WATER = 0,00 INCHES
TEMP = 60.4 DEG F
T 3:REGULAR
VOLUME . 7749 GALS
ULLAGE = 3878 GALS
90~ ULLAGE= 2715 GALS
TO VOLUME = 7736 G~LS
HEIGHT = 57.78 [~3HES
WATER VOL = O GALS
~ATER = O,O0 INCHES
TEMP = 62.S DEG F
ALARM HISTORY REPORT
...... SYSTEM ALARM .....
PAPER OUT
t'~R 14, 2002 10:31 AM
PRINTER ERROR
MAR 14, 2002 10:~1 AM
BATTERY IS OFF
JAN 1. 1996 8:00 ~
R~'IOTE DISPLAY ERROR
MAR 4. 1998 2:11 ~
ALARM HISTORY REPORT
..... IN-TANK ALARM .......
T I;SUPREME
SUDDEH LOSS AL~RPI
DEC 16, 1999 9:38 PM
DELIVERY NEEDED
FEB 23, 2002 5:05 PM
FEB 20. 2002 10:41 PPI
FEB 7, 2002 ~:48 PSi
ALARM HISTORY REPORT
.... I N-TANK ALARM
T 2:PLUS
LEAl{ ALARM
MAR 9, 2001 3:18 PM
MAR 9, 2001 2:48 PM
LOW PRODUCT AL.ARId DEC 16, 2001 4:30 PM
DEC 31, 1999 2:42 PPI
SUDDEN LOSS ALARM
PlAY 4, 1998 10:!8 AM
MAR 6, 1998 10:10 APl
INVALID FUEL LEVEL
DEC 16. 2001 4:30 r-?'l
DEC 31, 1999 2:42 PM
PROBE OUT
MAR 4, 1998 5:22 PM
MAR 4. 1998 5:19 PI"1
DELIVERY NEEDED
JAN 18, 2002 6:09 PP1
DEC 16. 2001 lO:gO PM
ALARM H/STORy REPORT
.... IN-TANK RLfiRM .....
T 3:REGULAR
SETUP [)~TA WASHING
M~R 4. 1998 11:21 AM
OVERFILL ALARM
NAR 7. 2002 9:05 PM
JaN 5. 2002 1:17 APl
DEC 19, 2001 12:25 A~
LO~ PRODUCT RL~RM
5AN 22. 2002 8:03 p~
~N le. 2002 6:19 PM
DEC 23. 2001 6:02 PPi
SUDDEN LOSS ALRRM
DEC 7, 200! 4:30 ~
NOV 14. 1999 7:58 aa
OCT 16, 1999 1:50 ~
HIGH PRODUCT ALARM
MAR 7. 2002 9;ID PM
NOV 23. 2001 5:I0 ~M
NOV S- 2001 ! :28 AM
I N~AL I D FUEL LEVEL
JAN 22, 2002 8:01PH
Ja~ 18. 2002 6;28 p~
DEC 23. 2OOl 5;59 PM
PROBE OUT
MAR 4, 1998 I1:21 APl
DELIVERy NEEDED
MAR 9, 2002 8:26 PM
FEB 28, 2002 5:57 PH
FEB 25. 2002 1:04 PPi
Mar 26 02 03:40p Franzen Hill 6851460 1467 p.11
cOMiqUNI CAT I ONE SETUP
pORT SETTINGS:
COMM BOARD
BAUD RATE
pARITY
STOP ~IT
DATA LENGTH:
2 (RS-232)
9600
EVEN
1 STOP
? DATA
AUTO TRANSMIT sETTINGS:
AUTO LEAK ALARM LIMIT
DISABLED
AUTO HIGH WATER LIMIT
DISABLED
AUTO OVERFILL LIMIT
DISABLED
AUTO LOW pRODUCT
D1SABLED
AUTO THEFT LIMIT
DISABLED
AUTO DELIVERY START
DISABLED '
AUTO DELIVERY END
D1s~BLED
AUTO E~TERNAL INPUT ON
DISABLED
AUTO EZTERNAL I~UT OFF
DISABLED
AOTO SENSOR FUEL ALARM
DISABLED
AUTO SENSOR WATER ALARM
DIS~LED
AUTO SENSOR OUT ALARM
DISABLED
RS-232 SECURITY
CODE : 000000
RS-232 END OF MESSAGE
DISABLED
IN-TANK SETUP
T I:SUPREME
PRODUCT CODE : 1
THERMAL COEFF :.000700
TANK DIAMETER : 92.00
TANK PROFILE : 4 PTS
FULL VOL : 11627
69.0 INCH VOL : 9438
46.0 INCH VOL : 5814
23.0 INCH VOL : 2190
METER DATA : NO
FLOAT SIZE: 4.0 IN. 8496
WATER WARNING : 1,0
HIGH WATER LIMIT: 3.0
MA× OR LABEL VOL
OVERFILL LIMIT
HIGH PRODUCT
DELIVERY LIMIT
11627
10464
95%
11045
12X
1395
LOW PRODUCT : 500
LF~K ALARM LIMIT: 32
SUDDEN LOSS LIMIT: 50
TANK TILT : 0.00
MANIFOLDED TANKS
T~: NONE
LEAK MIN PERIODIC: 0~
:
LEAK MIN ANNUAL
PERIODIC TEST TYPE
STANDARD
ANNUAL TEST FAIL
ALARM DISABLED
PERIODIC TEST F~IL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 3 MIN
RI.ARM HISTORY REPORT
..... IN-TANK ALARM .....
T 3. REGULAR
SETUP DATA WARNING
MAR ~.. 1998 11:21 AM
OVERFILL ALARM
MAR 7, 2002 9:05 PM
JAN 5, 2002 t:t7 RM
DEC 19, 2001 12:25 APl
LOW PRODUCT ALARM
JAN 22, 2002 8:03 PM
JAN 18, 2002 6:19 PM
DEC 23, 2001 6:02 PM
SUDDEN LOSS ALARM
DEC 7, 2001 4:30 AM
NOV 14, 1999 7:58 AM
OCT 16, 1999 1:50 AM
HIGH PRODUCT ~LARM
MAR 7, 2002 9:10 PM
NOV 23, 2001 5:10 RM
NOV 5, 2001 1:28 AM
INVALID FUEL LEVEL
JAN ~
2~, 2002 8:01 PM
J~N 18, 2002 6:18 PM
DEC 29, 2001 5:59 PM
PROBE OUT
MAR 4. 1998 11:21 AM
DELIVERY NEEDED
MAR 9, 2002 8:26 PM
FEB 28, 2002 5:57.PM
FEB 25. 2002 1:04 PM
)
ALARM HISTORY REPORT
..... SENSOR ALARM .....
L I:SUPREME TURBINE SUMP
STP SUMP
HIGH LIQUID ALARM
MAR 14, 2002 11:58 RM
HIGH LIQUID RLARM
JAN 25, 2001 10:44 AM
.iG. LIOU,D
Mar 25 02 03:41p
Franzen Hill
ALARM HISTORY REPORT
...... SENSOR ALARM
L 2:SUPREME FILL SUMP
PIPING SL~IP
FUEL ALARM
MAR 14. 2002 11:54 AM
FDEL ALARM
MAR 6. 2001 6:47 PM
F~EL ALARM
JAN 7, 2000 11:39 AM
ALARM HISTORY REPORT
SENSOR ALARM
L 2:SUPREME FILL SUMP
PIPING SUMP
FUEL ALARM
MAR 14. 2002 11:54 ~M
FUEL ALARM
MAR 6, 200t 6:47 PM
FUEL ALARP1
JAN 7. 2000 11:39 AM
6851460 14B7 p. 12
FUEL ALARM
MAR 14. 2002 11:20 RM
FUEL ALARM
JAN ?. 2000 11:59 Aid
FUEL ALARM
MAR 10, 19"'39 1:21 PPI
ALARM HISTORY REPORT
..... SENSOR AI.ARM ......
L 4:PLUS TURBINE SUMP
STP SUMP
HIgH LIQUID ALARM
MAR 14. 2002 10:43 AM
HIGH LIQUID ALARM
JAN 25, 2001 10:47 AM
HIGH LIQUID ALARM
JAN 7, 2000 11:56 AIq
ALARM HISTORY REPORT
..... SENSOR ALARM ......
L 7:REGULAR TURBINE SUMP
STP SUMP
HIGH LIQUID ALARM
MAR 14. 2002 11:05 AM
HIGH LIQUID ALARM
JAN 25, 2001 10:46
HIGH LIQUID ALARM
JAN 7, 2000 11:12
ALARM HISTORY REPORT
..... SENSOR ALARM
L 5:PLUS FILL SUMP
PIPING SUMP
FUEL ALARM
M~R 14, 2002 10:57 AM
FUEL ALARM ;
MAY lO, 2001 2:44 PM
FUEL ALARM
JAN 7, 2000 11:56 APl
14V 88:1I 000~ 'A
14~ I~:1[ O00E '& NWC
....... FIM~q~ ~OS~l~S .....
Mar ~G
OE 03:4~ip
RL/ARI9 H I b-~rOR¥ REPORT
..... SENSOR ALARM .....
L B:REGULAR FILL SUMP
PIPING SUMP
FUEL ALARM
IqAR 14, 2002 11:05 AM
FUEL ALARM
MAR 3. 2000 9:25
FUEL ALARM
JAN 7, 2000 10:59 AH
ALARM HISTORY REPORT
..... SENSOR ALARM ......
L 9:REGULAR ANNULAR
ANNULAR SPACE
FUEL ALARM.
MAR 14, 2002 11:39 APl
FUEL ALARM
JAN 7, 2000 11:01 APl
SENSOR OUT ALARM
MAR 10, 1999 1t:56 AM
Franzen Hill
T 2:PLUS
PRODUCT CODE : 2
THERMAL COEFF :.000700
TANK DIAMETER : 92.00
TANK PROFILE : 4 PTS
FULL VOL : 11627
69.0 INCH VOL : 9438
46.0 INCH VOL : 5814
23.0 INCH VOL : 2190
METER DATA : NO
FLOAT SIZE: 4.0 IN. 8496
WATER WARNING : 1.0
HIGH WATER LIMIT:
19~ OR LABEL VOL: 11627
OVERFILL LIHIT : 90~
: 10464
HIGH pRODUCT : 95~
: 11045
DELIVERY LIMIT : 12~
: 1~95
LOW PRODUCT : 500
LEAK ALARM LIMIT: 32
SUDDEN LOSS LIHIT: 50
TANK TILT : 0.00
MANIFOLDED TANKS
T~: NONE
LEAK M I N PER I OD I C: 0%
: 0
LEAK lglN ANNUAL ·
PER I OD I C TEST TYPE
STANDARD
ANNUAL TEST FAIL
ALARM D I SABLED
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
ANN TEST AVERAGING: OFF
PER TEST AVERAGING: OFF
TANK TEST NOTIFY: OFF
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : 3 19iN
6851460 1467
p.13
T 3 :REGULAR
PRODUCT CODE :
THERMAL COEFF :.000700
TANK DIAMETER : 92.00
TANK PROFILE : 4 PTS
FULL VOL : 11627
69.0 INCH VOL : 94~8
46.0 INCH VOL : 5814
23.0 INCH VOL : 2190
METER DATA : NO
FLOAT SIZE: 4.0
IN. 8496
WATER WARNING : 1.0
HIGH WATER LIMIT: 3.0
MAX OR LABEL VOL:
OVERFILL LIMIT :
HIGH PRODUCT :
DELIVERY LIMIT :
LOW PRODUCT :
LEAK ALARM LIMIT:
SUDDEN LOSS LIMIT:
TANK TILT :
MANIFOLDED TANKS
T#: NONE
11627
90~
10464
95~ .
11045
12~
1395
500 .::
50
0.00
LEAK MIN PERIODIC: ON
: 0
LEAK BIN ANNUAL : O;i
: 0
PERIODIC TEST TYPE
STANDARD
ANNUAL TEST FAIL
ALARM DISABLED
PERIODIC TEST FAIL
ALARM DISABLED
GROSS TEST FAIL
ALARM DISABLED
ANN TEST AVERAGING: OFF
nr~ TEST AVERAGING: OFF
'F~NK TEST NOTIFY: Oil
TNK TST SIPHON BREAK:OFF
DELIVERY DELAY : ~ BIN
liar 26 0~' 03:42p
JAN 1, 19S6
START TIME : DISABLED
TEST RATE :O.2D GAL/HR
DURATION : 2 HOURS
LEAK TEST REPORT FORMAT
NORMAL
PRESSURE LINE LEAK SETUP
Q I:SUPREME
PIPE TYPE: FIBERGLASS
LINE LENGTR: 260 FEET
0.20 GPH TEST: ENABLED
0.10 GPM TEST: DISABLED
SHUTDOWN RATE: 3.0 GPH
T I:SUPREME
DISPENSE ~ODE:
STANDARD
SENSOR: NON-VENTED
O 2 :PLUS
PIPE TYPE: FIBERGLASS
LINE LENGTH; 260 FEET
0.20 GPH TEST: ENABLED
0.I0 GPH TEST: DISABLED
SHUTDOWN RATE: 3.0 GPH
T 2:PLUS
DISPENSE MODE:
STANDARD
SENSOR: NON-VENTED
Q 3:REGULAR
PIPE TYPE: FIBERGLASS
LINE LENGTH: 260 FEET
0.20 GPH TEST: ENABLED
0.10 GPH TEST: DISABLED
SHUTDOWN RATE: 3.0 GPH
T 3:REGULAR
DISPENSE MODE:
STANDARD
SENSOR: NON-VENTED
Franzen Hill
LINE LEAK LOCKOUT SETUP
LOCKOUT SCHEDULE
DALLY
START TIME: DISABLED
STOP TIME : DISABLED
LIQUID SENSOR SETUP
L I:SUPREME TURBINE SUMP
DUAL FLT, DISCRIMINATING
CATEGORy : STP SUMP
L 2:SUPREME FILL SUMP
TRI-STATE (SINGLE FLOAT) "
CATEGORY : PIPING SUMP
L 3:SUPREME ANNULAR '
TRI-STATE (SINGLE FLOAT).
CATEGORY : ANNULAR SPACE
L 4:PLUS TURBINE SUMP·
DUAL FLT. DISCRIMINATING
CATEGORy : STP SUMP
L 5:PLUS FILL S~-IP
TRI-STATE (SINGLE FLOAT>
CATEGORY : PIPING SUMP,
L 6:PLUS ANNULAR
TRI-STATE (SINGLE FLOAT)
CATEGORy : ANNULAR SPACE
L 7:REGULAR TURBINE SUMP
DUAL FLT. DISCRIMINATING
CATEGORy : STP SUMP
L e:REGULAR FILL SUMP
TR I -STATE
CATEGORY : PIPiNG SUMP/j
L 9:REGUL~R ANNULAR
TR I -STATE ~
L~R
6851460 1467
p.14
Q I:SUPREME
I N-TANK ALARMS
T 1 :HIGH WATER ALARM
T I :LOW PRODUCT ALAR['
LIQUID SENSOR ALMS
L I:FUEL ALARM
L 3:FUEL ALARM
L i:HIGH LIQUID
Q ~:PLUS
IN-TANK ALARMS
T 2;HIGH ~ATER ALARM
T 2:LOW PRODUCT
LIQUID SENSOR ALMS L ~:FUEL ALARM
L 6:FUEL ALARM
L 4:HIGH LIQUID
O 3:REGULAR
IN-TANK ALARMS
T 3:HIGH WATER ALARM
T 3:LOW PRODUCT ALARI~
LIQUID SENSOR ALMS L 7:FUEL ALARM
L 9:FUEL ALARM
L 7:HIGH LIQUID ALARI'
RECONCILIATION SETUP
AUTOMATIC DALLY CLOSI
TIME: 2:00 AM
AUTO SHIFT ~1 CLOSING
TIME: DISABLED
AUTO SHIFT ~2 CLOSING
TIME: DISABLED
~UTO SHIFT #3 CLOSING
TIME: DISABLED
AUTO SHIFT ~4 CLOSING
TIME: DISABLED
PERIODIC RECONCILIATIJ
MODE: MONTF
ALARM:
TEMP COMPENSATION
STANDARD
BUS SLOT FUEL METER
TANK MAP EMPTY
· Complete items 1, 2, and 3. Also COmplete
item 4 if Restricted D '
· Print our ,, ..... ehve~ is desir
,so t~ we'f-':'~ ~.d add~ess on t~d'
· Att~,- .L. ~, return the c~--. reverse
-~. [n~s card to th~ ~-;~ [o YOu.
or on the front jf space permits.
~au~ ot the mailpiece
~SF[~ CA, 93312
I 2. Article NUmber (Co/3v from,
7000 1530 O,
._ ~ . Domestic Return Receipt
A. Received by (P/ease Print C/ear/y)
Del/very ,
"---' , [~] Agent
different from item 17 J~]
Jf YES, enter del/very address below: J~ No
~ Certified Mail [~ Express Mail
~ Registered t'-'l Return Receipt for Merchandise
4. Restricted Del/very? (Extra Fee)
102595-99-M~ 1789
UNITED STATES POSTAL SERVICE
I First-Class Mail
~ Postage & Fees Paid
I USPS
[Permit No. G-10
· Sender: Please print your name, address, and ZIP+4 in this box ·
BAKERSFIELD FiRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Avenue, Suite 300
Bakersfield., CA 9,3301
2. ~0
~.50
Postage
Certified Fee
Return Receipt Fee
(Endorsement Requiredl
Restricted Delivery Fee
(Endorsement Required)
1'ora! Postage & Fees
3.94
9700 ROSKD/~c.gltI,1Y
C~ 933X2
postmark
Here
D
February 20, 2002
Nirmal Gill
Rosedale Chevron
9700 Rosedale Hwy
Bakersfield, CA 93312
CERTIFIED MAIL
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
NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE
Failure to Submit/Perform Annual Maintenance on Leak Detection
System at Rosedale Chevron, 9700 Rosedale Hwy
Dear Mr. Gill:
Our records indicate that your annual maintenance certification on your leak
detection system is past due. January 25, 2002.
You are currently in violation of Section 2641(J) of the California Code of
Regulations.
"Equipment and devices used to monitor underground storage tanks shall be
installed, calibrated, operated and maintained in accordance with manufacturer's
instructions, including routine maintenance and service checks at least once per
calendar year for operability and running condition."
You are hereby notified that you have thirty (30) days, March 22, 2002, to either
perform or submit your annual certification to this office. Failure to comply will
result in revocation of your permit to operate your underground storage system.
Should you have any questions, please feel free to contact me at 661-326-3190.
Sincerely,
Ralph Huey
Director of Prevention Services
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer
Office of Environmental Services
cc: Walter H. Porr Jr., Assistant City Attorney
i~_ACORD.
CERTIFICATE CI~-. lABILITY INSURANCE
~'RODUCER
MONTGOMERY INSURANCE AGENCY
5500 MING AVENUE SUITE 253
BAKE RS F I.E~L D_Q~. CA 93309 iNSUI~RS AFFORDING cOVERAGE
-- ..~RER~ allied insurance com a_p_~gy_
INSURER C:
INSURER D:
I~NSURER E:
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY ,aND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE cOVERAGE AFFORDED BY THE POLICIES BELOW.
DTHE POLICIES OF li~'~LISTE BE~ THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO'WVITHSTANDING
ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT VVITI-I RESPECT TO VVHICH THIS CERTIFICATE MAY SE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
· OLICIES. AGGREGATE LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~ EFFECTIVE ~MRATiON I.l~n's
TYPE OF INSURANCE POUCY NUMBER ~T E?~--~Q"~ ~'~--~:~]~-'~ EAC~ OCOJRRENCE $1000000
GUERAL UABIUTY FIRE DAMAGE (A~y one tire) $ 3 0 0 ! 0 0 0
X COMMERCb~. GENERAL L,aBIurn' MEO EXP (A~y one pemon) $ 5 f 0 0 0
,Icicle ~-~O~R ,1, 000 000
-a '- _acp7 801013551--- -- 122001 _1.22002 ,ERSON~ & ~V,"~R¥
........ -2:- GENERAl. AGGREGATE s 2,0 0 0,0 0 0
L
.RoDuc~s-coMP~oP~ ,2~ 000,000
GEN'L AGGREGATE LIMIT APPUE$ PER:
PRO-
~ ~ COMBINED SINGLE LIMIT $
AUTOMOBILE I.I/~ILITY <Ea ~,~) 1 ~ 000 ~ 000
NE' AUTO
BODILY INJURY $
ALL OWNED AUTOS (per person)
SCHEDULED AUTOS
a x .,REO~OS acp7801013551 122001 122002 ~OO,L~,NJUR~
Per accide~)
X NON-OWNED AUTOS
PROPERTY DAMAGE ; $
(Per accident)
~ AUTO ONLY- EA ACCIDENT $
GARAGE UABIUTY EA ACC $
~_..~ ANY AUTO AUTO ONLY: AGG $
~ -.SACH OCCURRENCE $
EXCF.~ UA~LFrY A~GREGATE $
'1 OCCUR ~'[ CLNMS MADE
..~ DEDUCTIBLE
, WORKERS COMPENSATION AgD E.L EACH ACCIDENT S
' EMPLOYERS' UAmUTY
E.L DISEASE- EA EMPLOYEES
a OTHER
DESCRJP11ON OF OPERATION~;I.OGATIORSNE#ICLE&'EXc LUeIONS ADDED BY EROu K~. ~-..;.-N1 mr ;~NAL PRCv'' ....
CERTIFICATE HOLDER ~I~ADDmONAL t,,SUREO; iNSURER LETTER: ~ CANCEL.LA11ON
SHOULD ANY OF THE ABOVE DF~CRIBED POLICIES BE CANCELLED BEFORE THE EXFISATIOB
3 0
C T T ¥ 0 F BAKE R S F I EL D ,~TE T.ERm~. T,E/~Um~ InsuRE. ~.L' E.D.VOR TO ,~ ....
OFFICE OF ENVIRONMENTAL SERVICES NOTICE TO THE CE~I~d~iFIcATE HOLDER NAMED TO THE LEFT' BUT FNLURE TO DO SO EHALL
WlPO~E HO O~/A'TION OR LIABlUTY OF ANY KJED UPON THE INSURER, ITS AGENTS
1715 CHESTER AVE REPR,siE;~¥AF./NEs'
BAKERSFIELD, CA 93301 - /) '/~ /
ACOKO 2S-S (7/m9
I~' ~CORD
PRODUCER
CERTIFICATE I~.~.iLIABILITY INSURANCE
DATE (MM/DD/YY)
12/21/2001
...... ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
~/~" ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
MONTGOMERY__INSURANCE~ ---~ HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5 0 0 ~G Av~.N~-su_~?s 2 5 3 ~ ~TE. ME CO~.~E ~O.DED .Y ME POL,C,ES .ELOW.
5
BAKERSFIELD, CA 93309 ~ INSURERS AFFORDING COVERAGE
(66~) 832-9311 ~-ax (661) 832-8620\
,SDRED I Rosedale Chevron I ,~su.E~ Allied Ihsurance
Nirmal and Kiranjeet Gill
~ 9700 Rosedale ' / ,~.ERC:
~ Bakersfield. CA 93313 /
~ / INSURER E:
COVE~Z~ES I~X
THE POLICIES OF I~I~RANCE LISTED BELOW HAVE BEEN IS~JE~TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, ~OR CONDITION OF ANY C~ONTR'ACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN THE INSURAN-'~E~A~=. ORD~ POLICIES DESCR BED HERE N IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDHY~ DATE (Mh~'D D~"V~ Mh~TS
GENERAL UABIUTY EACH OCCURRENCE $ 1000000
X C':~ERC.^L GENEF~L '~,~ FI~ ~'~GE (~.~ O.O"~.) s 1000000
-~ A~-~01013551 12}~0i~-- 12202001 .~.m~L&~,mu.¥ $1000000
G~.~.~TE E 50000
OEN'L AGGREGATE LIMIT APPM E8 PER: PRODUCTS - COMP/OP AGG ,1000
I POLICY F-~ PRO' ~-~LOCflECT
Ea accident)
$
DEDUCTIBLE
RETENT ON $ $
A Building ACP 7801013551 12202001 12202002 $500000
A Contents ACP 7801013551 12202001 12202202 $200000
CERTIFICATE HOLDER I I AOmT',ORAL IRSUREO; INDURER LETTER:
CANCELLATION
City of Bakersfield. Office
of Environmental Services
1715 Chester Ave.
Bakersfield. CA 93301
ACORD 26-S (7/97)
gHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRitTEN
NOTICE TO THE CERI'IFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KiND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
r 2 for additional services.
· Complete items 3, and 4a & b.
· Print your name and address on the reverse of this form so that we can
return this card to you.
· Attach this form to the front of the mailpiece, or on the back if space
does not permit.
· Write "Return Receipt Requested" on the mailpiece below the ar
· The Return Receipt will show to whom the article was delivered and the date
delivered.
I~¥ SUTTON CHEVRON
~700 ROSEDALE ~
BAKERSFIELD CA 93312
mature (Addressee)
(Agent)
nber 1 991 ¢~u.s. GPO: lg93--352-714
I also wish to receive the
following services Ifor an extra
fee):
1. [] Addressee's Address
2. [] Restricted Delivery
for fee.
Article Number
P 024 368 635
Service Type
[] Insured
[~ Certified [] COD
[] Express Mail [] Return ;eipt for
ssee's Address (Only if requested ~
and fee is paid)
DOMESTIC RETURN RECEIPT
USE
Print your name, address and ZIP Code here
· ·
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 Ohester Avenue, Suite 300
Bakersfield, CA 93301
P 024 368 6
,.-~Recei~ for
Certified Mail
No Ins~J~..~overage Provided
DO not. us~ ~oi~nternational Mail
iSee Reverse)
-s~o~ S~TOS C~mOS ~
P O. State and ZIP Code
'~ERSFIE~ CA 93312
~o,~o ~ .32
Ce~ified Fee [. [0,
~pecial Del~e~ Fee
~esUicted ~l~ew ~
to ~om & Date ~l~ered
~eturn Receipt Showing to Whom,
Date, and Address~'s Address
& Fees ,,
~ostmark or Date
D
September 14, 1999
Ray Sutton Chevron
9700 Rosedale Hwy
Bakersfield, CA 93312
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1949
SUPPRESSION SERVICES
2101 "H" Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
PREVENTION SERVICE,S
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
CERTIFIED MAIL
RE: Failure to Submit Maintenance Verification on Leak Detection System
NOTICE OF VIOLATION &
SCHEDULE FOR COMPLIANCE
Dear Mr. Sutton:
A compliance inspection was performed on July 28, 1999. The
purpose of this inspection was to verify compliance with both the Uniform
Fire Code & Title 23 of the California Code of Regulations (CCR).
A correction notice was issued for you to provide evidence of annual
maintenance on your leak detection system, per CCR Title 23, Division 3,
Chapter 16, Section 2461 (J).
You were given 30 days to submit your documentation or schedule the
necessary testing. You have failed to respond and are now in violation.
Please submit the proper documentation within 10 days, September 24, 1999.
Failure to comply will result in further enforcement action.
Should you have any questions, please feel free to contact me at 326-
3979.
Sincerely,
Ralph E. Huey, Director
Office of Environmental Services
by:
Steve Underwood, Inspector
Office of Environmental Services
~UGL~4-t999
c el
Fsx :
, Products Comp~,_ ;
8100 2HOAL CREEK, BUILDING
AU2TIN, TEXAS
(51;~) 4.$1
PAX (5t2) 451~-1451t
COMMENTS
Sep 17 '99 09:19 PO1
694 7077
WORK ORDER NUMBER'3204,g 65
StTE: C~.~V'~.O~ 90705
P. 05
Fax : Sep 17 '99 09:19 PO2
CF, e_,,{ F'roduct~ Co~mn9 694 70?? F'.~1 '"'
CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING
8g00 SHOAL CRI[F.K, BUtLOtNG 200
AUSTIN~ TEXAS 78757
(512) 4Sl -6334
FAX {81~) 4~g-1459
TEST RESULT SITE :SUMMARY REPORT
?JEST DATE: O3/0B/99
'TEST TYPI[:
CUSTOMER I~0;¢S61275
CUt~NT: CI~VRON t~.S.A,
.P. O, ~OX 2833
Z~ IIA~, CA 90631-2833
JUDy
(3'10) 694-'/34'g
PURPOSE: COIE~ L T~NC.~,
WORK ORDER NUMt]ER3204865
SITE; CH~:V~I:~ 9070~
9~00 ~OS~D~ ~
B~FIELD, CA 93312
12k
~2k: 2
L2k 3
Line and Leak Detector Tests
., . . ~,. ... ,,,= ",.=,:=?~:~ , .,..
~,~.' .. ...:.~,~ .~.=.~ ...... =..:~..~=. ..... ... ,'~.~:.':.~' ,~ ..~[~.,. ~ ':
..... ~:.~ ........... .....
Ta~fiology repreaen~tlve: Se~i~s conduc[e~
CL:~ PO~R ~IC~ ~HILLZPS
Printed 031~ gft§g9 ~ 7:37 KOHLMI~YER
RLIG-g4-1~99
12:'~3 Cheuron P~'r~duc*.$ Comp~.nB 562 694
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
~0 EHOAL CREEK, BUlLDJNG 200
AUSTIN, TEXA~ 78757 (512) 451
WORK ORDER NUMBER32 04865
SIT E: ClfZV'pZ::~ 90705
P, 04
iTank ID: .1.2.1~
!Product: :iize
COMMENTi~.
Bottom to top fill in inches:
Bottom to grade In inches',
Fill pipe length in inches;
Fill pipe diameter in inches:
Stage I vapor recovery:
Stage II vapor recovery:
Dipped W'eter Level:
.Dtpped.Prold~ct Lever:
"Probe Water· Level:
Ingrees Detected:. Waz~'
Toot time:
ln"ctln'ometer reading:
VilcuTect Test. Type:
VoouTeoi'P~be Entry Point:
,l~elsurl ·Set Point:
Tank W~ter 1,8v®l In Inehea:
We~r table dept~ in ind~ea:
Dete~lnea .by
Relult:
COMMENTs
NeW/paieed
L,D. #1
Make:
Model:
~IN:
O~an time in
Holding
Resiliency cc;
Test leak rate mi/m; ~es. o
Metering psi:
Callb. teak in gph: 3,oo
Results:
Failed/replaced
L,D, #1
OOMME~TS
New/passed
L,Do #2
Failed/replaced
L,D, ~3
GOMMEN~8
Dtemater (in):
Length (It):
Test psi;
Bleodb$¢k cc:
Teat time (rain):
', Start time:
End time:
Final gph,:.
Reoult:
, Pump typI:
taump m~Re:
2,0
1.o0. o
TF,~T~D
NOT NOT NOT
T~STED ~TED I~g~%T~D
Valves Operational:
INDIVIDUAL TANK INFORMATION AND TEST RESULTS
T£$T DA~f;,o3/oI/99
Id00 SHOAL CREEK, BUILDING 200 WORK ORDER. NUMBER3204.865
AUSTIN, TEXAS 78767 (512) 45t-6334 SITE',CMI~V]~O~I' 90705
P. 03
Tank manifolded:
Vent manifolded:
Vapor recove'.5, minimized',
~e~ll pro~ctJa~:
~e~pill pmte~lon:
Ins~lled:
CP ~stelted on:
Bottom to top fill in Inches:
Bottom to grade in inches'.
Fill ptpe length in Jnctles:
Fill pipe diameter in inches:
Stage I vapor recovery;
Stage II vapor reoovery;
92.0
Dipped Water Level',
'Dipped Pr0iluet Level;
Probe V~ater Level:
Ingre~:~ ,Defeated: Water
.; Test time:
[..n~flnometer reading:
.~a~UTe~ Te~t Type:
Veo~Te~ Probe ;nt~ Po~
',':.Pres~uM Bat Point:
'Tank~tet level i~
Datelines by ('method):
Result',
. Bubble
~OT
UIiI~
NeW/palled
L,O.
. Make;
Model', ~..~.o.
Open t~me in sec:
Holding psi;
Tl~t leak rate ~m;
Metedng psl~
Cilib. leak In gph:
Result:
Felled/replaced New/passed
L,D. #~ L.D, ~/2 L,D.
¢OMMENT~
Material:
DfamIter (in):
Length (It);
Test ps1:
. ElleeffbIck cc:
Test.time (mini:
Start time:
End time:
DR'
~.0
loo.o
Fax :
Product ~ Comp~n~
AUG-04-1993 12:42
INDiViDUAl. TANK INFORMATION AND TEST RESULTS
TE~T DATEio3/oe/g~ 8900 ~HOAL ~RI~K, BUILDING ZoO
Sap 17 '99 09:24 P0i
694 ?0??
P. 02
WOI~K ORDg,':: ;'ItJMB£R3A04865
¢OMMENT~
Tank manifolded:
Van! manifOlded: No
Vapor ~accvery msnlfolded:
Ove~[I prc~ron; ~S
~er~pi, prote~e~: ~
Installed', A~
CP installed on: /
Bottom to :op fill in irlches;
Bottom te grade In inches;
Fill pipe length in inches:
Fill pipe dismeter in inche~:
Stage I vapor recovery'.
Stage II vapor recovery:
92.0
Di;p~d:Wa~er Level:
Dtpped~Pro.duct Level',
P(ebe .W'ater Level:
Ingre~{l Detected: Water
TaM time:
ldcltn~meter reading:
Vec.uTm~ Test Type:
va~Te~ Probe EM~ Point:
' ~ pressure 8et P=tnt;
Tank W~r level in Inches:
Water ~le, depth In
'DeClined by
Result
Material',
Diameter (in}:
Lanl~,.h
Test
$1eadback
.~ 'Test time (rain):
.;
Start time;
End time:
Flnat
ReSult;
Pump type:
Pump
.;
COMMENT&'
zoo. o
Newlpaseed
L.D.
Make:
S/N:
Open time in sec:
Holding psi:
Resiliency
Test lea~ ra~ mere: ~e~. o
Metering psi:
Celib. leak in gph: 3
Results:
Failadlmplaced NeW/passed Failed/replaced
L,D, ~1 L.D. #2 L.D. ~Z
t~oT
NOT NOT NOT NOT
T~T~D T~S~D T~T~D TESTED
Impact Valves Operetl=nal;
Printed O3119/199~ 17:37
FACILITY NAME ~0~/
ADDRESS q¢OO 0.0 a'dc
FACILITY CONTACT
INSPECTION TIME
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
INSPECTION DATE
PHONE NO. ,~. ~q *
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
Section I:
[~Routine
Business Plan and Inventory Program
[] Combined [] Joint Agency [] Multi-Agency
[] Complaint
[] Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact intbrmation accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability I/'r
Verification of Haz Mat training
I
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?: ~ Yes ~0
Explain:
Questions regarding this inspection? Please call us at (805) 326-3979
While - Env. Svcs. Yellow - Station Copy Pink - Business Copy
i~. siness S it ¢/~e~ponskl~Party
n spec tor :~' _/'~"~,4~'"fi~
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 [] Combined [] Joint Agency
Type of Tank 003¢'
Type of Monitoring d.~vt
~ Multi-Agency
Number of Tanks
Type of Piping '0(.0
[] Complaint
[] Re-inspection
OPERATION C V COMMENTS
Proper tank data on file V
Proper owner/operator data on file
Permit fees current
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release? Yes No t/
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
~iness Sit-e---l{e sp on s i,~l~ar ty
April 30, 1999
Bakersfield Fire Department
UST Division
2130 G. Street
Bakersfield, CA 93301
r..h~ron -
Chevron
RE: FINANCIAL RESpONsHIILITY FOR UNDERGROUND TANKS
Dear Sirs:
Please find enclosed the following documents:
1) Proof of Financial Responsibility
2) "Certificate of Financial Responsibility"
These documents meet the financial responsibility requirements for all USTs owned by Chevron and have
previously been submitted directly to the State. If you have any questions feel free to contact me.
Chevron is responsible for the following facilities in your jurisdiction:
CHEVRON SS// STREET ADDRESS CITY
190705 9700 Rosedale Hwy. Bakersfield
91536 2700 Oswell Street Bakersfield
93978 3100 Niles St. Bakersfield
95325 2525 White Lane Bakersfield
98109 1131 Oak Street Bakersfield
99702 5201 Olive Dr. Bakersfield
201238 8100 E. Brundage Lane Bakersfield
201527 6601 Ming Avenue Bakersfield
203576 1125 Coffee Road Bakersfield
205673 13003 Rosedale Hwy. Bakersfield
206561 3360 Panama Ln. Bakersfield
Sincerely,
C. R. Canfield
Marketing Assistant
Retail Compliance
925-842-9002
Enclosure
April 30, 1999
RE: CERTIFICATE OF FINANCIAL RESPONSIBII,ITY FOR UNDERGROUND
TANKS
To Whom It May Concern:
Chevron Corporation hereby certifies that it is in compliance with the requirements of
Underground Storage Tank financial responsibility regulations. This certificate covers all
tanks in the States of California, Alaska, Arizona, Idaho, Nevada, New Mexico, Oregon,
Texas, Utah and Washington owned by Chevron Corporation.
The financial assurance mechanism used to demonstrate financial responsibility required
under State and Federal regulations is as follows:
Corporate guarantee of Chevron is the amount of $1 million per occurrence,
$2 million annual aggregate. Said guarantee covers taking corrective action
And compensating third parties for bodily injury and property damage caused
By either sudden accidental releases and non sudden accidental releases or
Accidental releases.
This guarantee is renewed annually (within the first 120 days of the year). Copies of the
renewed certificate and a complete list of the facilities are..sent to the governing agencies
yearly.
Sincerely,
C. R. Canfiel~jEnvironmental Compliance, Permit
Notarized by: ~-~/.~_l ~' ~'t,_
Susan R. Weber, Notary
Chevron
April 26, 1999
Chevron Corporation
575 Market Street
San Francisco, CA 94105-2856
Martin R. Klitten
Vice Pr,esident, Finance
UST FINANCIAL ASSURANCE
To Whom It May Concern:
I am the chief financial officer of Chevron Corporation, 575 Market Street, San Francisco, CA.
This letter is in support of the use of the financial test of self-inSurance and guarantee to
demonstrate financial responsibility for taking corrective action and compensating third parties
for bodily injury and property damage caused by sudden accidental releases and/or nonsudden
accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00
annual aggregate arising from operating underground storage tanks.
Underground storage tanks at the following facilities are assured by this financial test or a
financial test under an authorized State program by this guarantor -- all underground storage
tanks owned by Chevron U.S.A. Inc. in the United States are assured by this financial test.
A financial test and guarantee are also used by this guarantor to demonstrate evidence of
financial responsibility in the following amounts under other EPA regulations or state programs
authorized by EPA under 40 CFR parts 271 and 145:
EPA REGULATIONS
AMOUNT
Closure (§§264.143 and 265.143)
Post-Closure Care (§{}264.145 and 265.145)
Liability Coverage (§{}264.147 and 265.147)
Corrective Action ({}264.101(b))
Plugging and Abandonment ({}144.63)
141,190,186.00
49,662,705.00
8,000,000.00
-0-
2,666,400.00
California State Program
Closure
Post-Closure Care
Liability Coverage
Corrective Action
Plugging and Abandonment
Louisiana State Program
Closure
Post-Closure Care
Liability Coverage
Corrective Action
Plugging and Abandonment
Total
$ 198,699.00
$ 701,566.00
$ 66,000,000.00
-0-
$ 4,640,059.00
$ 797,537.00
$ 1,000,000.00
$ 274,857,152.00
This guarantor has not. received an adverse opinion, a disclaimer
concern" qualification from an independent auditor on his financial
completed fiscal year.
of opinion, or a "going
statements for the latest
Page 2 of 4
o
4.
5.
6.
7.
ALTERNATIVE II
Amount of annual UST aggregate coverage being assured
by a test and guarantee
Amount of corrective action, closure and post-closure care
costs, liability coverage, and plugging and abandonment
costs covered by a financial test and guarantee
Sum of lines 1 and 2
Total tangible assets
Total liabilities
Tangible net worth
'Total assets in the U.S.
8. Is line 6 at least $10 million?
9. Is line 6 at least 6 times line 3?
10. Are least 90% -of assets located in the U.S.?
(If "No", complete line 11.)
11. Is line 7 at least 6 times line 3?
12. Current assets
13. Current liabilities
14. Net working capital (subtract line 13 from line 12).
15. Is line 14 at least 6 times line 3?
16. Current bond rating of most recent bond issue
17. Name of rating service
18. Date of maturity of bond
$ 2,000,000.00
$ 274,857,152.00
$ 276,857,152.00
$ 36,355,000,000.00
$ 19,506,000,000.00
$ 16,849,000,000.00
$ 19,622,000,000.00
Yes No
X
X
X
X
$ N/A
$ N/A
$ N/A
$ N/A
AA
Standard & Poors
August 15, 2004
Page 3 of 4
19.
Have financial statements for the latest fiscal year. been
filed with the SEC, the Energy Information
Administration, or the Rural Electrification
Administration?
Yes
No
I hereby certify that the Wording of this letter is identical to the wording specified in 40 CFR part
280.95(d) as such regulations were constituted on the date shown immediately below, except that
information concerning California and Louisiana was added to make disclosure more complete.
M. R. Klitten
Vice President, Finance
April 26, 1999
Page 4 of 4
GUARANTEE
Guarantee' made this April 26, 1999, by CHEVRON CORPORATION, a business entity
organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA
Regional Administrators and/or state agencies implementing underground storage tank regulation
for the states listed in Paragraph 2 (hereinafter collectively referred to as the "implementing
agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. INC.
CCUSA"), of 575 Market Street, San Francisco, CA.
RECITALS
Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d)
and agrees to comply with the requirements for guarantors as specified in 40 CFR
280.96Co).
CUSA owns or operates the following underground storage tanks covered by this
guarantee, underground storage tanks at various facilities in the states of:
Alaska Louisiana
Arizona Nevada
California Oregon
Florida Texas
Georgia Utah
Hawaii Virginia
Idaho Washington
Kentucky
This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for
taking corrective action and compensating third parties for bodily injury and property
damage caused by either sudden accidental releases or nonsudden accidental releases or
accidental releases arising from operating the above-identified underground storage tanks in
the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate.
On behalf of our subsidiary, CUSA, guarantor guarantees to implememing agencies and to '
any and all third parties that:
In the event that CUSA fails to provide alternative coverage within 60 days after receipt of
a notice of cancellation of this guaramee and the Director of the implementing agency has
determined or suspects that a release has occurred at an underground storage tank covered'
by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby
trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to
exceed the coverage limits specified above.
Page 1 of 3
In the event that the Director determines that CUSA has failed to perform corrective action
for releases arising out of the operation of the above-identified tanks in accordance with
40 CFR 280, subpart F, the guarantor upon written instructions from the Director shall
fund a standby trust in accordance with the provisions of 40 CFR 280.108, in an amount
not to exceed the coverage limits specified above.
If CUSA fails to satisfy a judgement or' award based on a determination of liability for
bodily injury or property damage to third parties caused by sudden and/or nonsudden
accidental releases arising from the operation of the above-identified tanks, or fails to pay
an amount agreed to in settlement of a claim arising from or alleged to arise from such
injury or damage, the guarantor, upon written instructions from the Director, shall fund a
standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such
judgement(s), award(s), or settlement agreement(s) up to the limits of coverage specified
above.
Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee,
the guarantor fails to meet the fmancial test criteria of 40 CFR 280.95(b) or (c) and (d),
guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA.
The guarantee will terminate 120 days from the date of receipt of the notice by CUSA, as
evidenced by the return receipt.
Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding
under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after
commencement of the proceeding.
6. Guarantor agrees to remain bound under this guarantee notwithstanding any modification or
alteration of any obligation of CUSA pursuant to 40 CFR part 280.
Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply
with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for
the above-identified tanks, except that guarantor may cancel this guarantee by sending
notice by certified mail to CUSA, such cancellation to become effective no earlier than 120
days after receipt of such notice by CUSA, as evidenced by the return receipt.
8. The guarantor's obligation does not apply to any of the following:
(a) Any obligation of CUSA under workers' compensation, disability benefits, or
unemployment compensation law or other similar law;
Co) Bodily injury to an employee of CUSA arising from, and in the course of,
employment by CUSA;
(c) Bodily injury or property damage arising from the ownership, maintenance, use, or
entrustment to others of any aircraft, motor vehicle, or watercraft;
Page 2 of 3 .
(d)
Property damage to any property owned, rented, loaned to, in the care, custody, or
control of, or occupied by CUSA that is not the direct 'result of a release fi.om a
petroleum underground storage tank;
(e)
Bodily damage or property damage for which CUSA is obligated to pay damages by
reason of the assumption of liability in a contract or agreement other than a contract or
agreement entered into to meet the requirements of 40 CFR 280.93.
9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing
agency, by any or all third parties, or by CUSA.
I hereby certify that the wording of this guarantee is identical to the wording specified in
40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately
below.
Effective date: April 26, 1999
CHEVRON CORPORATION
M. R. Klitten
Vice President, Finance
By
Assistant Secretary
Page 3 of 3
CERTIFICATION OF FINANCIAL RESPONSIBILITY
CHEVRON U.S.A. INC. hereby certifies that it is in compliance with 'the requirements of
subpart H of 40 CFR part 280.
The financial assurance mechanism used to demonstrate financial responsibility under subpart H
of 40 CFR part 280 is as follows:
Corporate guarantee of Chevron Corporation in the mount of $1 million per occurrence,
$2 million annual aggregate, for the period commencing April 26, 1999, and which is
anticipated to be renewed annually, with the next renewal scheduled to occur during the
first 120'days of 2000. Said guarantee covers taking corrective action and compensating
third parties for bodily injury and property damage caused by either sudden accidental
releases or nonsudden accidental releases or accidental releases.
April 26, 1999
ByCHEVRON i~~a.b~~ U.S.A. I~i~
Senior Counsel
By
/~udith L. Geisler
Legal Analyst
CERTIFICATION OF FINANCIAL RESPONSIBILITY
CHEVRON U:S.A. INC. hereby certifies that it is in compliance with the requirements of.
subpart H of 40 CFR part 280.
The financial assuranCe mechanism used to demonstrate financial responsibility under subpart H
of 40 CFR part 280 is as follows:
Corporate guarantee of Chevron Corporation in the amount of $1 million per occurrence,
$2 million annual aggregate, for the period commencing April 26, 1999, and which is
anticipated to be renewed annually, with the next renewal scheduled to occur during the
first 120 days of .2000. Said guarantee covers taking corrective action and compensating
third parties for bodily injury and property damage caused by either sudden accidental
releases or nonsudden accidental releases or accidental releases.
April 26, 1999
CHEVRON U.S.A. INC.
By B~ri~~~.~R~obert'~~~
Senior Counsel
/Judith L. Geisler
Legal Analyst
CUSA UST FINANCIAL ASSURANCE
April 26, 1999
bcc:
J. M. Bauer
L. T. Brown
C. R. Canfield
G. F. Cooper
H. P. Davis Jr.
A. G. FredeluceS
M. Leong
P. T. Liang
D. E. Ludlam
L. J. Marshall
S. E. Merritt
A. R. Mora
D: A. Newell
I. O. Ng
W. C. Ishimoto
D. T. Sherman
E. A. Thompson
R. A. Wondolleck
Permit Desk, Chevron Park L-1338 (2 copies)
Arizona Dept. of Environmental Equality
UST Section Attention Brian Kelley
3033 N Central Avenue
Phoenix, AZ 85012 (602) 207-2214
R D
February 9, 1999
FIRE CHIEF
RON ;RAZE
ADMINISTRATIVE SERVICE8
2101 'H' Street
Bakersfield, CA 93301
VOICE (805) 326-3941
FAX (805) 395-1349
SUPPRESSION SERVICES
2101 'H' Street
Bakersfield, CA 93301
VOICE (805) 325-3941
FAX (805) 395-1349
PREVENTION SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (805) 326-3951
FAX (805) 326--0576
ENVIRONMENTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (805) 326-3979
FAX (805) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (805) 399-4697
FAX (805) 399-5763
Ray Sutton Chevron
9700 Rosedale Hwy
Bakersfield, CA 93312
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.
Sincere,/~,
Steve Underwood
Underground Storage Tank Inspector
Office of Environmental Services
SBU/dm
enclosure
April 30, 1998
RE: CERTIFICATE OF FINANCIAL RESPONSIBII,ITY FOR UNDERGROUND
,TANKS
To Whom It May Concern:
Chewon Corporation hereby certifies that it is in compliance with the requirements of
Underground Storage Tank financial responsibility regulations. All tanks in the States of
California,. Alaska, Arizona, Idaho, Nevada, New Mexico, Oregon, .Texas, Utah and
WaShington owned by Chevron CorpOration are covered by this certificate.
The financial assurance mechanism used to demonstrate financial responsibility required
under State and Federal regulations is as follows:
Corporate guarantee of Chewon is the amount of $1 million per occurrence,
$2 million annual aggregate. Said guarantee covers taking corrective action
and compensating third parties for bodily injury and property damage caused
by either sudden accidental releases and non sudden accidental releases or
accidental releases.'
This guarantee is renewed annually (within the first 120 days of the year). Copies of the
renewed certificate and a complete list of the facilities are sent to the governing agencies
yearly.
Sincerely,
S. L. Belier, Enviro~ental Compliance, Permit'
Notarized by:}{'~ ~0~~
Susan R. Weber, Notary
CHEVRON PRODUCTS COMPANY
UNDERGROUND STORAGE TANK SYSTEM MONITORING PROGRAM
FACILITY INFORMATION SHEET
Facility:
Chevron Products Company Service Station #9-0705
9700 Rosedale Highway
Bakersfield, California
UST Owner:
Chevron Products Company
6001 Bollinger Canyon Road, Bldg L
P. O. Box 6004
San Ramon, California94582-0804
(510) 842-9002 {* For inquiries regarding the content of this plan, call (562) 694-9129 }
UST Equipment
Tanks
Type Tank Tank Monitoring
Tank # Storage Capacity Type Classification
Spill
Containment
1 Gasoline 12,000 D/W Fiberglass New
2 Gasoline 12,000 D/W Fiberglass New
3~ Gasoline 12,000 D/W Fiberglass New
PHILTITE
PHILTITE
PHILTITE
Piping
For Piping Piping
Tank # Operation Type
1 Pressurized D/W Fiberglass
2 Pressurized D/W Fiberglass
3 Pressurized D/W Fiberglass
Monitoring
Classification
New
New
New
Note: "Existing" -- Installed prior to January 1, 1984
"New" -- Installed after January 1, 1984
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0101
Rev. 12/17/97
CHEVRON PRODUCTS COMPANY
UNDERGROUND STORAGE TANK SYSTEM
OWNER/OPERATOR AGREEMENT
Owner Certification
Chevron Products Company, as the owner of the underground storage tank system located at 9700
Rosedale Highway, Bakersfield, california 93308, I hereby certify that:
We have entered in to a written agreement with the operator of the Underground Storage
Tank system at the referenced location. This agreement is contained in our contract with
the operator.
The operator of the Underground Storage Tank system at the referenced facility is
responsible for and will perform all monitoring, record keeping, and reporting
requirements for the Underground Storage Tank system as outlined in the documents
listed below.
o
The operator has been provided a copy of the Permit to Operate the Underground Storage
Tank system at the facility.
The operator has been provided a copy of the provisions of Health and Safety Code
Section 25299, January 1997.
o
The operator has been provided a copy of the California Code of Regulations
Title 23 - Waters
Division 3 - State Water Resources Control Board
Chapter 16 - Underground Storage Tank Regulations, May 1994.
We understand that we are required to notify the Underground Storage Tank Program of
the Bakersfield City Fire Department, in writing, of any change of operator within thirty
days of any such change.
Owner:
CHEVRON PRODUCTS CO.
We hereby certify that the preceding monitoring plan for underground storage tank systems will be
implemented at our service station located at 9700 Rosedale Highway, Bakersfield, California 93308. To
the best of our knowledge, all information contained herein is true and correct.
Signature: ~'7~ ~c~~~~'
michaelWelty\ \ \
pliance SpecialI~, Envir~ntal Safety & Health
Date:/ //~/7(~
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0101
Rev. 12117~97
CHEVRON PRODUCTS COMPANY
UNDERGROUND STORAGE TANK SYSTEM
OWNER/OPERATOR AGREEMENT
Operator Certification
As the operator of the Underground Storage Tank system installed at 97,00 Rosedale Highway,
Bakersfield, California 93308, I hereby certify that:
1. I am, or represent the individual, finn, trust, partnership, association, or corporation that is
in control of and has the daily responsibility for the operation of the Underground Storage
Tank system at the referenced facility.
I have entered into a written contract with Chevron Products Co., the owners of the
Underground Storage Tank system I am operating. I understand that this obligates me to
perform monitoring, record keeping, and reporting requirements as outlined in the
documents listed below.
I have received a copy of the Permit to Operate the Underground Storage Tank system at
the facility.
4. I have receix)ed a copy of the provisions of Health and Safety Code Section 25299.
I have received a copy of the California Code of Regulations
Title 23 -Waters
Division 3 - State Water Resources Control Board
Chapter 16 - Uhderground Storage Tank Regulations, May 1994
Signature:
Ray-Sutton, FacfiJity Operator
Date:
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0101
Rev. 12/17/97
CHEVRON PRODUCTS COMPANY
MONITORING PROGRAM FOR "NEW" UNDERGROUND STORAGE TANKS
Monitoring of underground tanks constructed pursuant to:
Califomia Code of Regulations
Title 23 -- Waters
Division 3 -- State Water Resources Control Board
Chapter 16 -- Underground Storage Tank Regulations- May 1994
Section 2631
Shall be implemented pursuant to:
Califomia Code of Regulations
Title 23 .- Waters
Division 3 -- State Water Resources Control Board
Chapter 16 -- Underground Storage Tank Regulations- May 1994
Section 2632 (C) (2) (A) and Section 2632 (C) (2) (B)
Monitoring Frequency:.
Continuous
Methods and equipment to be used:
Condition of secondary system:
Type of substance stored:
Method of monitoring:
Overfill protection:
Dry
Volatile
Continuously operated electronic liquid level indicator
* Positive Shut off installed in the fill tube set at 95% of tank's
capacity '
* Audible high level alarm set at 90% of tank's capacity is
programmed into system control panel
Monitoring equipment
Control Unit
Make:
Model:
Veeder Root
TLS 350R with TLM
Liquid level probe -
Gasoline Tank Interstitial Space:
Make: Veeder Root
Model: VR: 794390-409
Location monitoring to be performe&
At Facility - inside all underground tank(s)
interstitial space (3)
* Note: Tank Level Monitor (TLM) s used for inventory control and not for tank monitoring
Person responsible for performing the monitoring
Ray Sutton, Facility Operator
Persons responsible for maintaining the monitoring equipment
Chevron Products Company -- Marketing Operations -- Maintenance Department
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0101
Rev. 12/17/97
Visual monitoring of the tank monitor alarm box is performed daily by the dealer or a designated
employee. Chevron also requires that the tank monitoring equipment operational and alarm condition
be documented daily by using a "UST Equipment Monitoring Log" (see attachment A). This log is
also required to be used to document when equipment problems are reported to Chevron Maintenance
and is to be kept as part of the station monthly inventory reconciliationrecords and on site at all
times. Please see the attached site map for the location of all equipment at the site.
The electronic monitoring devices are maintained according to manufacturer's recommendations.
The dealer will also perform inventory reconciliation according to the procedure outlined in the
Inventory reconciliation section of this plan, as stated in detail in Section 2626 of the copy of the
California Code of Regulations, Title 23, Division 3, Chapter 16 dated May 5, 1994 that is attached
to the dealer's copy of this plan. Daily and monthly inventory reconciliation is required by Chevron
Policy and reconciliationrecords are to be kept on site at all times.
Training will be given to the dealer of record, Ray Sutton, which includes information regarding:
how to self test the electronic monitoring equipment, what the equipment monitors, how to tell when
the alarm goes off, how to perform inventory reconciliation, record keeping requirements and
procedures to follow in the event of alarm activation, leak, suspected leak, or other emergency.
Chevron requires that all station employees be trained and familiar with tank alarm systems and
reporting requirements, however training of the dealer's management and employees on the above
mentioned subjects as well as the completing andfiling of any further documentation outlining such
training, as may be required by the Bakersfield City Fire Department, will be the responsibility of the
dealer of record.
In the event of an alarm activation, the operator may have cause to suspect a leak and is required to
investigate. In the case of a monitoring equipment malfunction (e.g., green lights not on, lost
power, etc.), operator is required to notify Chevr6n immediately for equipment maintenance.
In the event of a leak, the operator will notify the Chevron Territory Manager (or other Retail
Management), and will take the following actions:
1. Shut down the tank or product line.
2. Contact Chevron Maintenance Dispatch.
3. Contact the Fire Department or local Emergency response agency, if wan'anted.
4. Keep employees, customers, or bystanders away from any gasoline.
In the event of a suspected leak, Chevron specifies procedures and mandates the use of a
"Suspected Release. Activity Log" (see Attachment B)for investigation in case of an inventory
tolerance problem, and equipment alarm, and/or if there are any other reasons to suspect a leak.
When circumstances occur to the point where this log needs to be used, it is to be kept as part of
the monthly inventory reconciliation records as proof that suspected leak situations were
investigated.
In the event of an emergency, the operator will follow their site Emergency Response Plan which
consists of 1) Emergency Response Procedures: 10 Steps to Safety During an Emergency, where
employees know what to do in the event of a fire, spill, or an observable leak. 2) Site map, where
employees know the location of critical equipment (e.g., emergency shut-off switches, etc.). And
3) Emergency Contact List, where employees know who and how to contact all appropriate people
in the event of an emergency.
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0102
Rev. 7/29/96
Attachment A
Facility No.:
Equipment:
UST EQUIPMENT MONITORING LOG
Month/Year:
Equipment
Date Operational? Alarm Status O.K.? Comments Initials
01 Yes[] No[] Yes[] No[]
02 Yes[] No[] Yes[] No[]
03 .Yes[] No[] Yes[] No[]
04 YesVI No[] Yes[] NoVI
05 Yes[] No[] Yes[] No[]
06 Yes[] No[] Yes[] No[]
07 Yes[] No[] Yes[] No[]
08 Yes[] NoVI Yes[] No[]
09 Yes[] No[] Yes[] No[]
10 Yes[] No[] -Yes[] No[]
11 Yes[] No[] Yes[] No[]
12 Yes[] No[] Yes[] No[]
13 Yes[] No[] Yes[] No[]
14 Yes[] NoVI Yes[] No[]
15 Yes [] No [] Yes'[] No[]
16 Yes[] No[] Yes[] No[]
17 Yes[] No[] Yes[] No[]
18 Yes[] No[] Yes[] No[]
19 Yes [] No [] Yes-[] No []
20 Yes[] No[] Yes[] No[]
21 Yes[] No[] Yes[] No[]
22 Yes[] No[] Yes[] No[]
23 Yes[] No[] Yes[] No[]
24 Yes[] No[] Yes[] No[]
25 Yes~ No[] Yes[] No[]
26 Yes[] No[] Yes[] No[]
27 Yes[] No[] Yes[] No[]
28 Yes[] No[] Yes[] No[]
29 Yes[] No[] Yes[] No[]
30 Yes[] No[] Yes[] No[]
31 Yes[] No[] Yes[] No[]
,, In the case of alarms (e.g., buzzer sounds, red lights on, etc.), or if you have other reasons to suspect a leak (e.g., unusual system
occurrences, etc.), you must investigate and track your activities using the "Suspected Leak Activity Log".
· If the equipment malfunctions (e.g., green lights not on, lost power, etc.), or for cathodic protection systems that are not operational or
show abnormal status, contact Chevron Maintenance Dispatch.
Chevron Review (Name/Signature)
Date:
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0102
Rev. 7~29/96
Attachment B
Suspected Release Activity Log
Facility No.
If Applicable: Tank No.
If Applicable: Equipment
Maintenance Release No.
Tank Product
Month/Year
Initiating Circumstances (e.g. inventory out of tolerance, alarm, etc.)
(EXAMPLE)
Action (Cross out actions that do not apply and/or list additional actions. Assign numbers to each action.) Date Time Initials
Re-gauge tank and re-check inventory calculations.
Check accessible portions of the product system for'leaks.
Check meter calibrations.
Contact Chevron Maintenance.
Note: Dependin~g upon ~mt~at~ng c~rcumstances, file with ~nventory reconciliation or UST equipment monitoring paperwork.
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0102
Rev. 7/29/96
~HEVRON PRODUCTS COMPAN'~
MONITORIN~"'PROGRAM FOR "NEW" UNDERGRDUND PIPING
Monitoring of underground piping constructed pursuant to:
California Code of Regulations
Title 23 -- Waters
Division 3 -- State Water Resources Control Board
Chapter 16 -- Underground Storage Tank Regulations- May 1994
Section 2631 , ,
Shall be implemented pursuant to:
California Code of Regulations
Title 23 -- Waters'
Division 3 -- State Water Resources Control Board
Chapter 16 -- Underground Storage Tank Regulations- May 1994
Section 2636 (f) (1) and Section 2636 (f) (2)
Monitoring Frequency:. Continuous
Methods and equipment to be used:
Condition of secondary system:
Type of substance stores:
Method of monitoring:
Volatile
Continuously operated electronic liquid level indicator
with positive shut down of turbines and dispensers
Monitoring equipment
Automatic line leak detector
Control Unit
Make: Veeder Root
Model: TLS 350R
Make: Veeder Root
Model: TLS 350R with PLLD
'Liquid level probes -
Tank turbine sumps:
Tank fill sumps:
Make: Veeder Root
Model: VR: 794380-352 (discriminating)
Model: VR: 794380-208 (non-discriminating)
Gasoline dispenser containment boxes -
Level Sensor Controller:
Stand Alone Level Sensor:
Make:
Model:
Model:
Beaudreau (non-discriminating)
BE1404 - 1 - CON
BEI 406 - OLS
Location monitoring to be performed:
At Facility - inside all underground tank fill (3) and
turbine containment sumps (3) and under
gasoline dispenser containmentboxes (6)
Person responsible for performing the monitoring.
Ray Sutton, Facility Operator
Persons responsible for maintaining the monitoring equipment.
Chevron Products Company -- Marketing Operations -- Maintenance Department
9-0705
9700 Rosedale Highway
Bakersfield, California 93308 ·
NW-0102
Rev. 7/29/96
CHEVRON PRODUCTS COMPANY
UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE
RESPONSE PLAN
If the unauthorized release detection (tank monitoring) system is activated the facility
operator (Dealer) will be responsible for:
Determining the source: UST and/or pipeline (if possible)
Discontinuing operation of the system (if necessary)
Telephoning Chevron Products Company IMMEDIATELY
Week Days: Chevron Products Company Maintenance: (800) 423 - 6911
Week Ends and Holidays
Days: R.L.W. Equipment
Nights: R. L. W. Equipment
Chevron Emergency (Spill) Information Center (24 hours):
(805) 834 - 1100
(805) 834 - 1100
(800) 231 - 0623
Chevron Products Company will be responsible for:
Initiating unauthorized release determination IMMEDIATELY.
Initiating cleanup procedures IMMEDIATELY (if necessary).
Contacting agencies within 24 hours.
Person responsible for work authorizatio~x
Roger W. Cleworth, Maintenance Supervisor, or a designated representative
In the event that a release occurs inside a motor fuel dispenser cabinet and triggers a sensor to shut
the dispenser down and/or trigger an alarm, the dealer is to contact Chevron Maintenance, or the
after hours contractor ide-~tified above, immediately. Using the station on site clean up equipment
and procedures, the Dealer is to clean up any visible spill that may have penetrated through the
dispenser cabinet to dispenser island(s) or driveway(s) and block off access to, or attempted use of,
such dispenser(s). Chevron Maintenance, or the after hours contractor identified above, will
respond to all dispenser calls within 4 hours. Chevron Maintenance, or the after hours contractor
identified above, will pump out, or otherwise remove any hazardous substance from the under
dispenser secondary containment within eight hours, as specified in California Health and Safety
Code, Chapter 6.7, Section 25294, dated January 1997.
Hazardous substance will be removed according to all laws and regulations regarding hazardous
substance handling, transportation, storage and disposal.
Equipment Chevron uses to remove hazardous substance will be owned .and operated by a state
licensed contract hauler. Chevron will use the hauler with the best response time. Maintenance of
all equipment used by haulers is the hauler's responsibility. At a minimum, Chevron reserves the
right to dispatch proprietary transport vehicle from the Van Nuys, Califomiabulk storage facility.
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0104
Rev. 12/17/97
CHEVRON PRODUCTS COMPANY
UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE
RESPONSE PLAN
(continued)
With the exception of under dispenser containment, as previously outlined, all unauthorized
releases will be removed from the secondary containment as quickly as possible, but not to exceed
a maximum of 30 days, per Section 2632 (d) (2) and 2634 (e) of the California Code of
Regulations, Title 23, Division 3, Chapter 16, dated May 1994.
This response plan outlines required dealer actions and Chevron's response if the facility's
unauthorized release detection (tank monitoring) system is activated Chevron requires that all
station employees be trained and familiar with tank alarm systems, reporting requirements and in
the use of clean up equipment, however training of the Dealer's management and employee.q in
the alarm systems and in the use and maintenance of any on site clean up equipment as well as the
completing andfiling of any further documentation outlining such employee training, as may be
required by the Bakersfield City Fire Department, will be the responsibilityofthe Dealer.
elty. ,. .\
:~pliance Specialist, Environm~Safety & Health
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0104
Rev. 12/17/97
CHEVRON PRODUCTS COMPANY
UNDERGROUND STORAGE TANK MONITORING EQUIPMENT
PREVENTATIVE MAINTENANCE SCHEDULE
Veeder Root - TLS-350
Underground Storage Tank and Pressurized Piping Monitoring System
Preventative maintenance frequency. Annually
Performed by: Veeder Root Certified Representative
Annual maintenance checklist:
Inspect Hardware
Inspect panel for loosdwires.
Inspect for intrinsic safety cover in place.
Inspect for touch screen mounted and enclosed properly.
Inspect for CPU operation.
Test Operation of Operator Interface Terminal (OIT)
Test all screens for live data.
Re-enter date and time (even if currently correct).
Test Tank Level Monitor and Printer
Calibrate product and water readings to physical measurements (stick readings)~
Print out inventory report.,
Test Pump Control Interface and Link Leak System
Start line test for each product.
Note pressure rise for each product.
Note pressure at which each check valve seats.
Verify pump shutdown.
Verify emergency stop shuts off all submersible pumps.
Test External Alarms and Remote Communications
Individually simulate each alarm condition and
Verify the event on the OIT.
Verify dial tone at telephone extension on modem module.
Verify modem operation.
Site Documentation
Verify installation manual is on-site.
Verify maintenance log.
Certification
Certify the TLS-350 has been checked according to manufacturer instructions.
Certify the system is operating properly.
Verify with appropriate agency that certification has been completed.
NOTE: All functions listed in this preventative maintenance schedule may not be present at each
specific site. All functions present at each site will be maintained according to this program.
9-0705
9700 Rosedale Highway
Bakersfield, California 93308
NW-0106
Rev. 7/29~96
UNDERGROUND STORAGE TANK SYSTEM
OPERATOR TRAINING REQUIREMENTS
T13e training required to operate the underground storage tank system and monitoring equipment
located at referenced facility is as follows:
Underground Storage Tank System
Orientation session on the operation of an underground storage tank system topics
include: underground storage tanks, double wall piping, overfill prevention, spill
protection and monitoring systems.
Chevron Service Station Maintenance Guide is provided to each operator. This
guide provides in depth instruction on the operation of an underground storage
tank system.
Underground Storage Tank and Pressurized Pipe Monitoring System -- Veeder
Root TLS-350
Operators are given an orientation session during system start-up to familiarize
them with the operation of the unit.
The Veeder Root TLS-350 Installation and Operation Guide is provided to each
operator. This guide provides in depth instruction on the unit.
9-0705
970ORosedale Highway
Bakersfield, California 93308
NW-0106
Rev. 7/29/96
$ 89' 49'10' £
185.00' -
//'
(9'-0' x 20'-0'")
I
2'
(.~) ~2.ooo c.~ ~'~,eL Cfm.)
oou~z w~a-L, r/o. U/O --
(?} 1' ELgC.
(T~P. Or 3)
To wxr~ so~ot¥ ~E -c-~o uo. & z ~=c's
(2e'-o* TO ~P)
WATT~ ~ --
,]
ROSED_ALE
I
3/4'
COND.
,11
~' r/o
recdv~r~
/
~'~- PiPE TRENCH
7'-0'
N
HWY.
HWY. 58
.(
LEGEND
GROUND & GRADE PLAN
SERVICE ~I'ATION 1~ 9-0705
9700 ~ HWY. & CN.LOWAY
BAKE~ELD, CA.
Chevron
SCA~ 1'-10'-0'
1715 CHESTER AVE., BAKERSFIELD, 'CA
(805) 326-3979
93304
APPLICATZON TO PERFORM A TICHTNESS TEST
PERMIT TO OPERATE
NUMBER OF TANKS TO BE TESTED__
IS PIPING GOING TO BE TESTED
TANK~ VOLUME
TANKNOLOGY-NDE CORP.
TANK TESTING COM]PANY
DATE & TIME TEST IS TO BE CONDUCTED
CONTENTS
27576 Commerce Center Dr. #109
~DDRE$$ Temecula, CA 92590
'-APPROVED BY: I ~ATE
~APP]~ICANT
BAKERSFIELD
FIRE DEPARTMENT
February 13, 1998
RI~ CHIEF
MICHAEL R. KEM.Y
ADMINIffiRA11VE SERVICES
2101 'H* Street
Bakeafield, CA 93301
(805) 326-3941
FAX (805) 395-1349
SUFPIlffiSlOfl SERVICES
2101 'H" S~eet
Bakessfle~, CA 93301
(805) 326-3941
FAX (805) 395-1349
~EVENllON SElL'VICES
1715 Chester Ave.
· Bakersfield, CA 93301
(805) 326-3951
FAX (805) 326.0576
ENVIRONMENTAL SERVICE~
1715 Chester Ave.
Bakersfield, CA 93301
(805) 326-3979
FAX (805) 326-0576
1EAINING DIVISION
5642 Victor Street
Bake~tletd, CA 93308
(805) 399-4697
FAX (805) 399-5763
Ray Sutton Chevron Inc.
9700 Rosedale Hwy
Bakersfield, CA 93312
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
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 1~ Combined [] Joint Agency
Type of Tank lt'd~'
Type of Monitoring eL.~
[] Multi-Agencz~ [21 Complaint
Number of Tanks ..~
Type of Piping 0{J.~ ~
[] Re-inspection
OPERATION C V COMMENTS
Proper tank data on file %,,,,
Proper owner/operator data on file ~
Permit tees current L.,,
/
Certification of Financial Responsibility
Monitoring record adequate and current 1.~
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.
~~.' . INA A
Pink - Business Copy L../~rty
'-'"'-- M .
FACILITY NAME
ADDRESS q)/3O
FACILITY CONTACT
INSPECTION TIME
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
INSPECTION DATE
PHONE NO.
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
Routine ~j~ Combined I~ Joint Agency [~ Multi-Agency' ~ Complaint I~ 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?: [~] Yes
Explain:
Questions regarding this inspection? Please eau us at (661) 326-3979 Y
Pink- Business Copy Inspector:
White - Env. Svcs.
Yellow - Station Copy
AM ~C--EHTERPRISES
66166~7052
P.O:~
g.. rise~
?~c~ F. Ikhorn St,'eet
Bakersf/eld, CA
($81)
Lic # 742735.A
/ · I II '" ~ III I III II1'1 I
.p'
,,2-1B-2001 4-: 12PM FROM WILSON PAVES
Wltson, Paves & jLssoc[ates
Insurance Agency,
2300 Bahamas Drive
Bakersfield CA 93309
~SURED
Rosedale Chevron
Nirmal Gill
9700 Rosedale Hwy
Bakersfield
ASSOC 6613279266 P. 2
THIS CERTIFICATE IS ISSUED AS A MAI iE, R OF iNFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX'TEND OR
ALTr~R .THE COVERAGE AFFORDED BY. THE POLICIES BELOW-
COMPANIES AFFORDING COVERAGE-
'
A Allied Insurance Group
COMPANY
COMPANY
¢
CO~RaJ, i¥
THIS tS TO CERTIFY THA~' ~HE POLICIES OF INSURANCE USTED BELOW HAVE ~EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO0
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY coNTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
cERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCF~BED HEREIN I$ SUBJECT TO ALL THE TERMS.
COMMERCIAL GENERAL LIABIUTY
-- Cl~S MAD~ ~ OCCUR
OWNER'S & cONTRACTOR~ PROT
LIABILITY
~NY AUTO
ALL OWNED AU~'OS
SCHEDULED AUTOS
HIRED ,~UT~
NON-OV~ED AUTOS
GARAG~ LI~ITY
EXCE~ LIAB~ITY
UMBRELt~ FORM
OTHm~R THAN Uk~clEI.LA
VVO~ COMPENSATION AND
EMM. OYER$' LIA~UTY
THE PROPRIETO~J ~ (NCL
pAMTN~XECUT1VE
OFFICERS N~:
AcPT8007901~9
12/20/00
ACP7800790139
12/20/0.0
12/20/01
)AMAG~[
AUTO ONLY - EA ACCIDENT
THAN AUTO ONLY;
EACH ACCIDENT
A(~(~REGA"iE
;ACH OCcuRRENCE
AGG;~GA'~
Et. EACH. ACCIDENT
EL DBEASE - POLICY LfMCf
EL DISEASE - EA EMPLOYEE
Cl~/ of Bakersfield, Off/ce
of Environmental Services
1715 CheSter Ave
: BaKersfield CA 93301
................. ,x..,.'-'"x',:,:.:,: ., ..::::::.:::; :~;::;9:~:::: :¢,;::;-i:!:~:~:¢4::~'i:~i!:! ~;.4
:%....... ................... ........ : ......... .............. :..,. ..........................................
SHOULD ~ff OF 'THE ABOU~ OE~I~O POLICIES ~ C~L~O ~ORE ~E
-- 1~ DAYS ~ NO~CE TO ~E C~[~ HO~R N~ED YO ~E ~.
OF ~ ~ND UPON ~E C~Y. 1~ AGEN~ OR R~R~TA~. .
2-15-2001
,,~
FROM WILSON PAVES ASSOC 6613279266
P. 3
EXHiBiT B
· The Chief Financial Officer or thc owner or operator must sign, under penalty of perjUry, a letter
worded EXACTLY as follows or you may complete this letter by filling in the blanks with
appropriate information: ' ' '
LETTER FROM CBIEF FiNANCIAL OFFICER
, I am the Chief FinanciaI Officer THREE GILL, INC., 9700 ,R0$EDALE HWY
(Business rmmc; ~ addt~s, and correspondence.address of owr~r or op~tor.~.
BAKERSFIELD, CA 93312
This letter is in support of the.use of the Underground Storage Tank Cleanup Fund to demonstrate .
financial responsibility for taking corrective action and/or compensating third parties for bodily
injury and property damage caused by an unauthorized release of petroleum in the amount of at least
$ 5,000 per occurrence and $ 5,000 annual aggregate coverage.
(Dollar Amount) (Dollar Amount)
Underground storage tanks at the following facilities are assured by this letter:
ROSEDALE CHEVRON, 9700 ROSEDALE HWY BAKERSFIELD, CA 93312
(Name and address of tach facility tbr which financial responsibility is being demolmtxat:4.)
Amount of annual aggregate coverage being assured
by this letter ............................ . .......... , ............... ' $ 5,000
2.Total tangiblc assets .................................... : ...... '. $ l, ooo
3. Total liabilities ................................................... $ {,'~ '~ 10 CDO
4. Tangible net worth (subtract line 3 from line 2.
Line 4 .must be at least 10 times line 1) ..................... $
!
I hereby certify that the wording of this letter is identical to the wording specified in subsection
2808. l(d)(1), Chapter 18, Division 3, Tide 23 of the California Code of Regulations.
I declare under penalty of perjury that the foregoing is tree and correct to the best of my knowledge
and ~belief.
Executed at
BAKERSFIELD, CA
~../Place of Execution)
f
UST oL.R R.v~sm ~s Page 29
2-1 r-,-2001
A:13PM FROM WILSON PAVES ASSOC p.A
6613279266
CERTIFICATION OF FINANCIAL RESPONSIBILITY
FOR UNDERGROUND 8TO.GE TAN~ CONTAINING PE~OLEUM ....
Or ~
B. TH~E~.~.G~LL ~NC. ~ hemby ~fie~ ~et'it i~ in compliance wi~h ~e requirements of See~on 2~7,
A~cle 3, Chapte~ ~8, Di~ion 3, Title 23, California C~e Of
The mechanisms used to dem~st~te financial mspon~ibillty as ~ui~ by Sec~on 2807 am as follows:
STATE STATE UST CLE~UP FUND N/A FOR $995,000 STATE
UST P.O. BOX 944212 UST CLE~UP PER UST YES YES
FUND' SAC~NTO, CA 94244-212 ~ FUND OCCU~N~',E CLEW-
eD UP
~NUAL FUND
ACGEEGAT
CHIEF THeE GILL INC. N/A'~OR $~,000 ANNUAL
FIN~CIAL ~YO0 EOSED~E ~ THI.S PER
OCCUEEENC ~
OFFIC~ B~EFIELD, CA 933~2 MEC~NI~M
LETTEE ~' ~
~NNUAL
aGGREGATE ·
N~te: If you are u~ing lhe ~tate Fund as any pa~ of ~ur de~tion of fina~ial ms~nsibili~ your execution end submission "
ROSEO~E CHEVRON "CA 9331.2
FILE: Odg'[r;a~T'[~:~i'Age ncy
Copies.- Facility/Site(s)
Page
8900 Shoal Creek Blvd, Building 200
Austin, Texas 78757
Phone: (512) 451-6334
Fax: (512) 459-1459
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
INSPECTOR STEVE UNDERWOOD
1715 CHESTER AVE., 3RD FLOOR
BAKERSFIELD, CA. 93301
Test Date: 11/28/2000
Order Number: 3114452
/// Enclosed are the results of recent testing perf~,rmed at the following facility:
// CHEVRON 90705
I 9700 ROSEDALE HVVY
~ BAKERSFIELD, CA. 93308
~ Testing performed:
% ,_eak detector tests
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
TEST DATE: 11/28/00
CLIENT: CHEVRON U.S.A.
P.O. laOX 2292
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
TEST RESULT SITE SUMMARY REPORT
TEST TYPE: VacuTect PURPOSE: COMPLIANCE
CUSTOMER PO: 4592106 WORK ORDER NUMBER: 3114452
145 S. STATE COLLEGE BLVD.
BREA, CA 92822-2292
JUDY BOWE
SITE:CHEVRON 90705
9700 ROSEDALE HWY
BAKERSFIELD, CA 93308
1 1
2 2
3 3
Manager
(310) 694-7349 (805) 589-9011
The following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations
Tank Tests
:.:::.::::~:.~i~:.~:~:~:.~:.~::~i~::~::~:.~:.~:.~:.~:.~:~::~:.~:.~:.~:~:~:~:~:~:~:~:]:~:~:~:~:~:~:::~:~:~:~:~:~:~:~:~*:~ ............................................ l / 0 0 0 0 / PAS S
SUPREME 11 , 627 92.00 PASS
PLUS 11,627 92.00 PASS 0 . 000 PASS
REGULAR 11 , 627 92.00 PASS 0. 000 PASS
SUPREME
PLUS
i 1
2 2
3 3
Line and Leak Detector Tests
0.000
0.000
0.000
p N P
p ¥ P
Tanknology appreciates the opportunity to serve you, and looks for~vard to working with you in the future. Please call any time, day or
night, when you need us.
Tanknology representative:
KEN MINTON
Reviewed:
Test conducted by:
ALBERT J. QUEIROS
Technician Certification Number: 1448
P rinted 12105/2000 09:14 CCHAPA
TEST DATE:il/28/00 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER311AA52
CLIENT:CHEVRON U. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:cH~.VRON 90?05
Tank ID: i i Tank manifolded: NO Bottom to top fill in inches: 92.0
Product:
Capacity in gallons: 11,62?
Diameter in inches: 92. Oo
Length in inches: 409
Material: DW FTB~.RG
COMMENTS
Vent manifolded:
Vapor recovery manifolded:
Overfill protection: Y~s
Overspill protection: ¥-~s
Installed: ATG
CP installed on: /
Bottom to grade in inches:
Fill pipe length in inches:
Fill pipe diameter in inches:
Stage I vapor recovery:
Stage II vapor recovery:
DUAL
B~LANCE
Pressure Set Point:
Tank water level in inches:
Water table depth in inches:
1 Determined by (method):
lOMMENTS Result:
art (in) End (in) ..........
Dipped Water Level: 0.00 0.00
Dipped Product .Level: 23.00 23.00
Probe Water Level: 0. 000 0. 000
Ingress Detected: Water N Bubble N UllageN
Test time: 21:30-23:30
Inclinometer reading: -0.03
VacuTect Test Type: S±ng-le taz~
VacuTect Probe Entry Point: F±l.t
-1.00
0.00
300.00
Make:
Model:
S/N:
Open time in sec:
Holding psi:
Resiliency cc:
Test leak rate mi/m:
Metering psi:
Calib. leak in gph:
Results:
New/passed
L.D. #1
VEEDERROOT
ELECTRON I C
005847
Failed/replaced New/passed Failed/replaced
L.D. #1 L.D. #2 L.D. #2
NOT
TESTED
PASS
COMMENTS
TESTED AT CATASTROPHIC LEAK.
.......................................................................... ~:~:~:~:~*~:~::
Material: DW FIBERG
NOT NOT NOT
TESTED TESTED TESTED
Impact Valves Operational:
COMMENTS
Diameter (in): 2.0
Length (fi): .tOO. 0
Test psi: 50
Bleedback cc: 80
Test time (min): 30
Start time: 23: 30
End time: 00: 00
Final gph: 0. 000
Result: PASS
Pump type: PRESSURE
Pump make: RE]) JACKET
Printed 12/05/2000 09:14 ~
INDIVID~
INFORMATION AND ~T RESULTS
~ ~,~
TEST DATE:ll/28/O0 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER311AA52
CLIENT:CH~.VRON fl. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:ctIF. VRON 90705
Tank ID: 2 2 Tank manifolded: NO Bottom to top fill in inches: 92.0
Product: PLUS
Capacity in gallons: 11,627
Diameter in inches: 92.00
Length in inches: 409
Material: DW FIBERG
COMMENTS
Vent manifolded: YES
Vapor recovery manifolded: YES
Overfill protection: YEs
Overspill protection: YEs
Installed: ATG
CP installed on: /
Bottom to grade in inches:
Fill pipe length in inches:
Fill pipe diameter in inches:
Stage I vapor recovery:
Stage II vapor recovery:
DUAL
BALANCE
Start (in) End (in)
Dipped Water Level: 0.00 0.00
Dipped Product Level: 22.00 22.00
Probe Water Level: 0. 000 0. 000
Ingress Detected: Water N Bubble N UllageN
Test time: 00:10-02:30
Inclinometer reading: -0.03
VacuTect Test Type: Multiple tanks
VacuTect Probe Entry Point: Fill
Pressure Set Point:
Tank water level in inches:
Water table depth in inches:
Determined by (method):
Result:
2OMMENTS
-1.00
0.00
300.00
MONTRWELL
PASS
New/passed Failed/replaced New/passed Failed/replaced
L.D. #1 L.D. #1 L.D. #2 L.D. #2
Make:
Model:
S/N:
Open time in sec:
Holding psi:
Resiliency cc:
Test leak rate mi/m:
Metering psi:
Calib. leak in gph:
Results:
VEEDERROOT
ELECTRONIC
005867
PASS
NOT
TESTED
COMMENTS
TESTED AT CATASTROPHIC LEA~.
COMMENTS
Material: DW FIBERG
Diameter (in): 2.0
Length (ft): 120.0
Test psi: 50
Bleedback cc: 80
Test time (min): 30
Start time: 22: :LO
End time: 22: 40
Final gph: 0. 000
Result: PAss
Pump type: P~sstm~
Pump make: MD JAC~T
NOT NOT NOT
TESTED TESTED TESTED
Impact Valves Operational: YES
Printed 12/05/2000 09:14
TEST DATE:Il/28/00 8900 SHOAL CREEK, BUILDING 200 WORK ORDER NUMBER3114452
CLIENT:CH~.V~ON U. S .A. AUSTIN, TEXAS 78757 (512) 451-6334 SITE:CH~.VRON 90705
Tank ID: 3
Product:
Capacity in gallons: 11,62"/
Diameter in inches: 92.00
Length in inches: 409
Material: DW FIBF. RG
Tank manifolded: NO
Vent manifolded: ~s
Vapor recovery manifolded: ¥~s
Overfill protection: ¥'~s
Overspill protection: ~s
Installed: AT~
CP installed on: /
Bottom to top fill in inches:
Bottom to grade in inches:
Fill pipe length in inches:
Fill pipe diameter in inches:
Stage I vapor recovery:
Stage II vapor recovery:
92.0
DUAL
BALANCE
COMMENTS
Dipped Water Level: 0.00 0.00
Dipped Product Level: 24.00 24.00
Probe Water Level: 0. 000 0. 000
Ingress Detected: Water N Bubble N UllageN
Test time:
Inclinometer reading:
VacuTect Test Type:
VacuTect Probe Entry Point:
Pressure Set Point:
Tank water level in inches:
Water table depth in inches:
Determined by (method):
Result:
00:10-02:30
-0.03
Multiple tanks
Fill
-1.00
0.00
300.00
MONTRWELL
PASS
COMMENTS
I
New/passed Failed/replaced New/passed Failed/replaced
L.D. #1 L.D. #1 L.D. #2 L.D. #2
Make: VEEDERROOT
Model: ELECTRONIC
S/N: oos~?4
Open time in sec:
Holding psi:
Resiliency cc:
Test leak rate mi/m:
Metering psi:
Calib. leak in gph:
Results: PASS
COMMENTS
TESTED AT CATASTROPHIC LEAK.
' NOT
TESTED
COMMENTS
Material: DW FIBERG
Diameter (in): 2.0
Length (ft): 120.0
T.est psi: 50
Bleedback cc: ?0
Test time (min): 30
Start time: 21:45
End time: 22:15
Final gph: 0. 000
Result: PASS
Pump type: ml~ s suz~.s
Pump make: ~D JAC~T
NOT NOT NOT
TESTED TESTED TESTED
Impact Valves Operational:
Printed 12/05/2000 09:14
SITE DIAGRAM
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
TEST DATE: 11/28/00
CLIENT:C~E.¥"P,O'R' O. S .A.
WORK ORDER NUMBER3114452
SITE: C[-D~V[:tON 90705
N
CHEVRON
9700 ROSEDALE HWY.
BAKERSFIELD, CA.
93312
REG
PLUS
SUP
Printed 12/05/2000 09:14 CCHAPA
TYPE OF' ACTION [] 1. NEW SITE PERMIT
(Check one #em only)
CITY OF BAKERSFIELD
t :FICE OF ENVIRONMENT SERVICES
1715"'Chester Ave., Bakersfield, CA 93301 (661) 326-3979
UNDERGROUND STORAGE TANKS - UST FACILITY
[] 3. RENEWAL PERMIT
~ 4. AMENOED PE,~.,,T
[] 5. CHANGE OF INFORMATION (S~oecS~ change -
eta( ~ one/).
[] 8. TEMPORARY SITE CLOSURE
Page ~ o~
[] 7. PERMANENTLY CLOSED SITE
r-] 8. TANK REMOVED
I. FACILITY I SITE INFORMATION
BUSINESS NAME (Same a~ FACILITY NAME ~ DBA - O~ng 8u~neea Aa) 3
NEAREST CROSS STREET 401.
~US~NESS ~ 1. GAS ST^nON [] 3. ~ ~ ~. ~M~RC~
~PE
~ 2. D~Sm~BUTOR ~ 4. ~S~R ~ ~, OmER ~.
FACILITY ID #
FACILITY OWNER TYPE
'~1. CORPORATION
[] 2. INDIVIDUAL
[] 3. PARTNERSHIP
Ill i
[] 4. LOCAL AGENCY/DISTRIC'T'
[] 5. COUI'W'YAGENCY'
[] 8. STATE AGENCY"
[] 7. FEDERAL AGENCY°
402.
TOTAL NUMBER OF TANKS
REMAINING AT SITE
i PROF~RTY OWNER NAME
I~ f~clllty on In,~n Re~er',~ll~n ~'
*if owner al' UST a public ~ name
¢11~s1¢~. section at off.:e vmict~ c~oemtee ~e UST.
(Thru is the contact person fa' b~e tank records.)
· :' " '" " IL PROPERTY OWNER INFO~TION . - :;'. · "?i
MAILING OR STREET ADORE.SS ,
CITY
PROPERTY OWNER ~
~J~l. CORPORATION
407. [ PHONE
~'JU~ Y 410. STATE 411. ZIPCODE 412.
[] 2. INDIVIDUAL [] 4. LOCALAGENCY/DlSmICT [] 6. STATE AGENCY 413.
[] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY
TANK OWNER NA.ME 414. I PHONE
MAILING OR STREET ADORES~
CITY ' - 417. STATE 418.ZIP CODE
ltcr ,dd dA- I q33t
[] 2. ~NOIVIDUAL [] 4. LOC~LAC.~NCYI mST~CT [] 8. STATE AGENCY
TANK OWNER TYPE ~ 1. COR.OORAT~ON r"l 3. PARTNERSHIP ["] S. COUNTY AGENCY I'"l 7. FEDERAL AGENCY
415.
416.
419.
420.
TY (TK) HQ 4 4 '- - Call (918) _322-966g If questions arise
· : : :' ::::' :' :: :; i ' ', .......:V. PETROLEUM USTFINANClAL RESPONSIBILITY
421.
INDICATE METHOD(S)
[] 10. LOCAL GOV'T MECHANISM
[] g9. OTHER:.
[] 1. SELF-INSURED [] 4. SURETY BOND [] 7. STATE FUND
[] 2. GUARANTEE [] 5. LE'ITER OF CREDIT [] 8. STATE FUND & CFO Lt: ~ ~ ~.R
422.
[] 3. INSURANCE [] 8. EXEMPTION [] g. STATE FUND & CD
VI. LEGAL NOTIFICATION AND MAILING ADDRESS
Chec~ o~e box to Indicate v. edc~ addte~a N'muk:l be uaed for legal nollflcalk:ma anti mailing. J~ 1. FACILIT~ [] 2. PROPERTY OWNER [] 3. TANK OWNER 423.
Legal no6flcatlo~$ a~d mailings will be ~e~t to b~e tank owner unreel box I ~ 2 i~ oheck, e(I.
, WI. APPucX"TSiO"ATU.E ::'" .'. ~:.
DATE 424. PHONE 425.
TITLE OF APPLICANT 427.
:~TATE uST FACILITY NUMBER (Forlo~at uae only)
428. tgg8 UPGRADE CERTIFICATE NUMBER (For local u~e only)
UPCF (7/gg) S :\CU PAFORMS~sv.n'cb-a.wT)d
~EN MONITORING PRd~EDURES
UNDERGROUND STORAGE TANK MONITORING PROGRAM
'f"ni$ momtoring program must b~ keM at th~ UST location at all tinms. Tim in~mnation on this
program am conditions of tim OlX~'-_~ permit. TI~ permit holdn' must notity tl~ Oflto~ ot~
S~l~i{x~ within 30 d~ of~ly e_hnn? tO th~ lllonltorillg p~ ~ ~ to o~in ~
making ~ change. R~luired by Sections 2632(d) :anti 2641(h) CC1L
Facility Name
Facility Address
Describe the fr .equ.ency of performing the monitoring:
Piping
What methods and equipment, identified by name and model, will be used for perfoming
the monitoring:.
Piping
Ce
Describe the location(s) where the monitoring will be performed (facility plotplan should
be attached).:
~adc t,o~ t, tc,tl- .-!-n ~/-kc~
De
Ee
List the name(s) and title(s) of the people responsible for performing the monitoring
and/or maintainm' g the equipm~t:
Reporting Format for monitoring:
Tank
Piping C/,.t~&
Describe the preventive maintenance schedule for the monitoring equipment. Note:
Maintenance must be in accordance with the.manufacturer's maintenance schedule
but not less than every 12 months. ~. .......
Describe the training neces._s~ary for the operatiqn of UST system, including piping, and the
· monitoring equipment: f~'tl ~,t,,C ~o, '~-et'g~t r t~¢,,l- fl~ t~,~r~/a, ¢
EMERGENCY RESPONSE PLAN
UNDERGROUND STORAGE TANK MONITORING PROGRAM
This monitoriag program must be kept at the UST location at all times. The information on this monitoring
program am conditions of the operating permit. The permit holder must notify the Office of Enviwnmental
Services within 30 days of any changes to the monitoring procedures, unless required to obtain approval be. fore
making the change. Required by Sections 2632(d) and 2641(h) CCIL
Facility Name
Facility Address
If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note:
If released hazardous substances reach the environment, increase the fire or explosion
hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate
the secondary containment, ~en the Office ofEnvir, onmental Services must be notified
within24hours, iOcot~d~ t~6,,. '['lq I',/a;'~or~ r- P,./ta~tltn+ gl~ t, Ot(4
Describe the proposed methods and equipment to be used for [emoving and properly
disposing of any hazardous substance. Ut, c a ~ ~q...e, ~,t~r{a ' ,4 II 4-~ r
Describe the location and av. ailability, ofthe required cleanu,~.equipment in item 2 above.
Describe the maintenance schedule for the cleanup equipment:
List the name(s) and title(s) of the person(s) responsible for authorizing any work
necessary under the response plan:
-- CITY OF' BAKERSFIF.,.LD
~FICE OF ENVIRONMENT~SERViCES
1715 Ch~ter Ave., Bakersfield, CA 93301 (661) 326-3979
UNOgnOROUND $TO~Og TANKS, TANK PAGE
L TkNK
4,10
0 4. wAC'UUX:X~ WASTe p,,o~
IL TANK CONTm~
0 ~,, neout.~~
m. TANK COlmTRUCTIO~
441
FI~. omm
TYI~ OF TAM(
EXTEmO~ ~,e, eW~E UNE~ Cl~. ~
~z ~o~t~w~. C] ~. mNOLEwALL~NAVAUI. T
447
o~~o~o,, 0 ~. -.~ u~ o ( ~u~ ~ ~ o.. o~
,. ,,.oL. w..,. r,,,,,c ro~...,.,.,.~ .. ~.....,.,_.... ?L.,~,;,
C~ ~. ~J~. (EXFO~D FOf~ION OM. y) C] & MANUAL TAM( OAUOINO (MTO) 0 s. VI.IUAL (~ WALL W VAULT OM. y}
O z ~J~OM~CT~KOAuM~(A?O) C] & VAOOMzo~
2. CONT~NUOU8 fNTF.~ITn'~. MONn'OmNO
C] J. CONTWUOUO)~TO I-! ?, OI~JNDWAI'E~ 3. MANUAL MONITORiNQ
C~ 4. ~TATI~Y-AJ. I~NTOf~ I~.~NC&L4?iON (~q) e C] & TANK TE~T~JO
emNNW. TAM( TEITiW3 0 ~ oTl~j~ _
~T~MA T~0 0ATI I. AIT ~ ~"~T.- _--~J~..y) MI ~M~T~0 ~A~_~T~ r~, O~ ~Je~TANCl ~ 4~e TANK FIU~O WITH IN~AT MAT/J~A&?
8 ACUPAFOP. MS~SWRCS-O.WP 0
1715 Chiller Avl., Olkerlfleld. CA (33301 (dll"l~ 32~3979
A~OVEGROUNO PIPING
SYSTEM
CONSTRUCTr~N/iLJ~ i. SIN~4.E WALL
' ~'NUFAC1'URER~[~' 2. OOuBLE WALL
MANUFACTURER
MATERIALS AM3
CORROSION
PROTECTION
C:] 2. SUCTION
C] 3. GRAVITY 4~
~ i. I~qESSURE
C:] 2. SUCTION
I-1 3. L,NEO mENc~ C] ea. OTTER
I-I ea. UNXNOWN
~:] t. 8ARE STEEL I"1 S. FFLe COMPATI~,.E W/10016 METHANOL
l-1 2. S?/dNLE~S ~'EEL I'-I ?. GALVANIZED ~FEEL
[] I. SINGLE WALL [] 95. UNKNOWN
[] 2. CX)UBLE WALL [] 9g. OTHE~
MANUFACTURER
[] 3. PLA~;C COMPA'rIBLE ~ CONI--=N~ I'"! ge. UNm~OWN
,ERC, [] O ea. oTTE.
STEEL WI COATING I-'] 9. CATHO0tC PROTECTION 4~4
[] h 8A~E STEEL
[] 2. STAINLE~ STEEL
[] 3. PLASTIC COMPATIBLE WTI'H CONTENTS [] 8. Ft. EX/BLE (HOPE)
[] 4. FfBERCd. ASS [] 9. CATI-IOOlC PROTECTION
[] $. STEEL WI COATING [] 95. UNKNOWN
[] S. FR.= COMPATIBLE W/,00% ~
[] 7. GALVANIZ~O STEEL
flea. o'n.~
VI1. PtI~NO LEAK DETECTION (C..'~
C] 2. A,KsNmI.YO.2QFHTE,~r
[-I 3. A/"INUAL~~(0.1 ~
CONVENTION,Id. SUCTION
/"-] S. DAILYVISUALMONITORJN(SQF~SY~TEMe'~PI:~N~~
TEST (0.
SAFE ,SUCTION SYSTEMS (NO VALV'r,,~ IN _~I___O~V G/~OUND PIPING)~
GRAVITY FLOW:
[-] 9. BIE~,~,,4IALINTECd~W~(0.1GPH)
(Cl, hecX ar, e)
I"] a. AUTO PUMP SHUT OFF WHEN A LEAK OC4~RS
D~SCONNECTION
i"1 C, NOAUTO PUMP SI'e.n' OFF
I~ ,1. AUTOMATlCUNELEAKISLrTE¢~rQR(3.0GFJH~wrrHR,OWSHUTO~COR
RESTRK~TION
~ S2. ANteUAL,~'EGRf~YTEST(0.1QF'H) '"
I-! 13. CONI'ff~UO4~OUI4POENSOR*AUOdBL~N~IOVI~JALALARM8
[] 15. AUTOMATIC LJNE ~ O6TECTOR (3.0 (SFH TEST) WITHOUT ~ ~ OFF OR
RESTRICTION
r-I le. ANNUAL INTEGRITY TEST (0., G4°H)
Il--] 17. OAILYVlSUALCHECK
ABOVEGROUND P1PING
~N~LE WALL PlaIN(3
PRESSURIZED PIPING (C. he~ ,M that
r-] ,. ELECTRONtC UNE LEAK DETECTOR 3.0 C.d~I TEST WITH AUTO PUMP SHUT OFF FOR LEA.
C] Z UOHT~Y0.2~'=HTESr
C] 3. MNUAL ene3anY ~(~ ~
0 4. DA/LY VISUAL CHECK
S)~'E SUC~N SYSTr~4S (NO VALVES IN BELOW GROUND
[] 7. SELFMONrroR~3
I-1 ~. mENN~ INTEC, mTY TEST(OJ C~)
PRE~SURIZED P~NG (Check ~ a~mt apply):
· 10. CONTINUOUS TURBINE SUIZ4= SENSOR WlTH AUD~St.E AND VISUAL ALARMS AND (check one
[] a. AUTO I:~kE~ SHUT OFF WHeN A LEA~ OCCURS
[] b. AUTO PUMP SHUT OFF FOR LEAY~, SYSTEM FAJLURE AND SYSTEM D~~
[] c. NO AUTO PUMP SI.RTr OFF
[] 11. AUTOMATIC LEAK DETECTOR
I--I t2" ANNUALen'EoRrrYTEST(0.S (;~:~)
0 13. CO~SSI~IP~N~OR+AU~IILEANOVISUALALARM8
EIIER~ENCY G ENF. R. ATORI ONLY (~ M' ~ Ip~My)
[] IS. AUTOMAT~ LINE LEAK DETECTOR (3.0 C~°H TEST)
n ,$. ANNU~ ~NTEGRrTY TEST (0.1
O 1Z. DAJLY VISUAL CHECK
[] 4. DAJLYVI~JALCHECK
IX. OWNER/OPERATOR SIGNATURE
UPCF (7/99)
473 I
DATE
z.ool
TrrLE OF OWNER/OPERATOR
470
47~
pMrnii ExMMk~ Dltt fFM, W, ii M Wj~/) 47S J
S:~CUPAFORM$~qWRC~B'WPD
· ~ __ CITY OF BAKERSFIELD
ENVIRONMENT,~ SERVICES
,- -~?~n,, 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979
~ -~~ '~' ONO~ROROONO S~O~O~ TANGS- rANg PAa~ ~
L TANK DESCRIPTION
432 J TANK MANUFACTURER
435 T~ ~ ~ ~o~ I
I~ k.
I/Il
m
NUMBF~ OF COI4~AATMENT~
?ANK US~ 43e
C] z NON~Je.~
I-I 3. OiE,le.
I. TANK C(~I~UGTX]N
[] e. AV~Tm~FOB.
I-I 4. ~I~3L~WAU.~IAVAU~?
~ 3~ FmE~3LASS/~ l-I s. ~
TA~KMAF~U~L.-~-::-:-_~,-Z~k O !. 8ARESTEEL
0 & FR~CO~All~EW~00% ~ I-Igg. OTHER.,
O & ~CO~AT~vm00~
O ~o. COATED
OR CO~Til~
M7
Mg
OVEBFIU. P/K)TECTION EQUIPMENT: YEAR INS'T.,~ ~ Fn 452
V. TANK Ct,(3~Ultg INFOftMA'I'ION I PBRMAN~IT Ct, O~URg IN PLACB
~TIMATEO OATII LAIT ~
tPCF.(7/gg)
TAM( FIt,.LBO wrrH JNe~T MA~?
8:&CUPAPO~M~SWRCB-B.VVPO
OF,IC, OF ENVIRONMENTAL SER~
t715 Chelt~r Av~.. Baker~flel4. CA 93301 (~"1~'32~3g?$
UNOE~GROUNO
I~ 3. LINED TRENCH I-~gg. OTHER 4e0
481
[] t. SINGLE WALL
~] 2. 0OU8LE WALL
MANUFACTURER
AaOVEGROUNO PIING
[] 2. SUCTION
l"1 ;. 8ARE STEEL
[] 2. STAINLES~ STEEL
]""] 3. I~A~TIC COMPATIBLE WITH CONTENTS
I-I 4. F~SERC, LA~
[] $. STEEL W/COATING
C3 .. om~
VIL PlaIN(3 LEAK DETECTION (Chedr M ~ ~J
UNOERG/K)UNO
PRESSURIZED P1PING (C/'m~ M
LEAK SYSTEM FNLUR& AND SYS'i~4 I:)P~'~E~ * ~ AND VISUAL
[] 2. MONTt4.YO.Z(~TEST
[] 3.
ID 5. DA~LYVI~JALMONITORIN(]OFPUI4:~N~SY~rF. MeTR~NNIALPIPIN~~
TEST (0.! GPH)
SAFE SUCTION SYSTEMS (NO VALV'r.~ ~1 ard.O~V ~NO P~NG):
[] 7. SEU: MONn'OmNG
GRAVITY FLOW:
[] 9. BIENNIAL WTECl~r~ ~ (0.1 ~)
10. CONTINUOUS TURBINE ~UMP ~d,4SOR WITH AUDIBLE AND V~UAL ALJU~I~ AM:)
(CheeSe ane)
[] a. XUTO PUMPSI. nJTOFFV, t.~NA LEAK~I~
DISCONNECTION
I-I c NOAUTO PUMP S~a/T OFF
l~J[] ~. AUTOMAT~UNeLEAK0eTECI'OR(3.0~TEST)Wn',FLOWSHVTO~OR
RESTRICTION
UCT1ON/~VITY ~'TEke
FJ~I~ENCY OENB~ATORI OI~,Y
[] 15. AUTOMATIC UNE LEAJ< OETEGTOR (3.0 QPH ~ WITHOUT FLOW SHUT OFF OR
~ESTRICTION
[] ~0. ANNUAL ~NTEGRrrY TEST (0J Cd=H)
~ ! ?. OAJLY VISUAL. CHECK
D,S,a~NSER CONTAINMENT [] 1. FU3AT M~CHANISM THAT ~ O~ ~ VN.V~
OATE IN~TAL~LED
~ k
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW C-dROUND
I-I 7. SEU~MONrroR~3
GRAWTY R. OW (Check al mat appty):
[] 8. DA~.YVISUALMONITORJNG
r'l 0. mE~'~ALU~TE~'~TYTES~(O. IC, PH)
8r:cof~AmLY CONTAINED
10. CONTINUOUS TUI~NE ~JMP SEN~OR w~r~/AUDIBLE AND VISUAL AL/J~,(S AM3 (check (x~
[] a. AUTO PUMP SHUT OFF WHEN A LE)J< OCCURS
[] b. AUTO ~MP SHUT OFF FOR LEAY~ SYSTEM F/~LURE AND SYSTEM D~,ONNECT~.
[] C NO AUTO PUMP Si~I' OFF
~-} 11. AUTOMATIC LE/~ DETECTOR
[] 12. AN~ALI~~(0J
I-I 13.
EME~ENCY (]ENF. RATO~ ONLY (Ch4Gt
[] IS. AUTOMATIC UNE LEAK C)L=rECTOR (3.0 GPH TEST)
[] 16. ANNUAL ~NTEG~rrY TEST (0.1 C.~H)
!-1 17. DAJLYVISUALC~ECY,
Me [] 2. CONTINUOU8OLIPENSEAPANMN~O~*AUO~LEANOV~UALALA~LI
~[ 3. GONTINUOU8 ~ PAN ~ WITH AUTO ~ OFF FO~ OISP~N~R · AUDIBLE AND V~qUA~ ~
[] 4. ONLY V~qUAL CHEC~
[] S. T~NC~U~/~~
IX, OWNER/OPERATOR 81GNATURE
OATE
470
471
TITLE OF OWNER/OPERATOR
474 I
472
pllltl~Ex~ll~ll~l(FOt'tOC~ul~G'~'; 475 I
S:~CUPAFORM$~qWRC~B.WPD
__ CITY OF BAKERSFIF..LD
1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979
UNDERGROUND STORAGE TANKS - TANK PAGE 1
r','PE OF ACI'~ON
I C.~' Om, ,~e~ ~'1
C] ~. ~ OF INFOI~iAT~3N)
r"'l ~. rEMIK)I~d~Y ~TE CLO~ji~
f'l y. P~RMANENTLY Ct. OSCO O~ ~rte
LOCA rK~N wrrHIN ~Ti (~-~_~_-_-~M)
L TANK
TANK :-!'-%"JF~R
TA/~ CM'ACITY IN C--~'d i ON~
~ NU~ OF COMP~TMENT3
0 z NOmq~ PtrmOtaUM
TYP~ OF TAM(
l, TANK ~
0 ~. ~I~ WALL IN A VAULT
447
44g
OVEP~IU. F~OTECTION EQUIPMENT: ~ iNST~J ! I~r~ 4.~2
O 2. e,~Z~.OAT O 4. aXmFT
~'~""':'""~"N~' ~:'"'"" ' "' "V ";'"'~'~"~" *" .... ": "~'
IF OOUI.~ WALL TANK ON ?ANK W~TH 1.4DOIN (C:hM~ one M~ oMI0:~4
I"1 ~. VI~{~iN(~WALLINVAULI'0NLY}.
C] 3. MANUAL MC)Nh'OraNG
¥. TANK W t~ I PIRIMNINT CLOIUIII IN PLAC8
I~TIMA fllO OA~ ~ ~ (YIqiIdOA}A~
IPCF. (7/9g)
TANK FlU.BO wt'rH INIRT
d~q7
S :tCUPAFORMSLtWRCS'8.WPO
CITY OF BAKERSFIELD
O~FICE OF ENVIRONMENTAL
1T15 Che~ter Av~., Bakemfleld, CA 13301 (611q~326-397g
/~ ~, FZMR~ O e. R. EXJm.~(HO~E) I'"I;e. OTHER
', . STEEL WI COATING C] 9. CATHO01C PROTECTION 4~4
~--1 I. SINGLE WALL
[] 2. OOUBLE WALL
MANUFACTURER
[] I, 8ARE STEEL
[] 2. STAINLESS STEEL
[] 3. I:~ASTIC COMPATIBLE WITH CONTENTS
[] 4. FiBERGLaSS
[] $. STEEL WI COATING
[] e. FRP COMPAT~m.E W/m0~ ~
ri ?. GALV~O ~I'EEL
[] e. Ft.~,Sm.E (HDPE) ("199. OT~r~
[] 9. CATHO01C PROTECTION
LEAK D,~CTION (CJM~ M mt 4~y)
ABOVEGROUND PfP~NG
~HGLE WALL FiF~i~G
PRE~SUR~T. ED PIliNG (C. Mc~ d ~t ~).'
[] 1. ELECTRONICUNELEAJ<DETECTOR3`0G/:~ITESTWTrHAUTOPUIdP~HUTOFFFORLF~
SYSTEM FAJLURF-, ANO SYSTEM ~c'rlON + AUO~I.E ANO VISUA~ ALARM~
I,I 3, AM4W. WTEC~tTYTEST(~t C~H)
[] 4. D~.YV~W.C~-(:X
[] 5. I~LY VISUAL MONITORING OF ~ AM) PU&E)ING SYSTEM
SAFE S~JCTXSN SYSTEMS (NO VALVES IN BELOW C.d~UNO Pm~3~
[] 8. DAVY ~ MoNrrO~NG
[] I. mENN~~TEST(O.S GFH)
8ECONG4~LY COKTAJNED ~"fNG
· 10. CONTINUOUS TURBINE SUMp SEN,.K)R WTTHAUDim. E A.NO VISUAL ALARMS AND (chec~ m~
/"] a. AUTO ~JM= SHUT OFF WHEN A LE4X OCCURS
[] ~. AUTO PUK~ SH~r OFF FOR LEAKS. SYSTEM F~LURE AND SYSTEM DLSCONNECT~
I--] c NO AUTO PUl/P S~rr OFF
rl ~2. ANNUAL fNTEO~TY TEST (0.1 C;i~)
EIMRGENGY OENERATOR~ ONLY (Chedc M M Ipl)h/)
[] 15. ALrrOMAT~ UNE LEAK DETECTOR (3.0 GPH TEST)
[] ~e. ANNUAL ~NTEG~rTYTEST(0.~ Cd=H)
[] 17. D)JLY VISUAL C~ECK
[] 4. DAJLYV~RUAL CHECX
r'l s. 'r~.NC~ UNER/MON~romNO
IX. OWNER/OPERATOR SIGNATURE
~ OF OWNERK~PERATOR
/,,//,~ ,,.~
]PCF
471
OATE
/ -- /,P', p ~,"al ·
TITLE OF OWNERA3PERATOR
470
472
S:~CUPAFORMS~WRCI~B.WPO
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME 0a_q
Section 2: Underground Storage Tanks Program
[2[ Routine [~1 Combined [] Joint Agency
Type of Tank
Type of Monitoring t5/--W,
INSPECTION DATE
[] Multi-Agency [] Complaint
Number of Tanks ..~
Type of Piping O{~ ~
OPERATION C V COMMENTS
Proper tank data on file
Proper owner/operator data on file t//
Permit tees current
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current ~'/
Failure to correct prior UST violations c/r
Has there been an unauthorized release? Yes No
[] Re-inspection
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: ~j ~
Office of Environmental Services (805) 326-3979
White - Env. Svcs.
Pink - Business Copy
Business Site Responsible Party
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3ra Floor, Bakersfield, CA 93301
FACILITY NAME
ADDRESS
FACILITY CONTACT
INSPECTION TIME
INSPECTION DATE
PHONENO. 5{~'~qoI'f-
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
[21 Routine I~ Combined [21 Joint Agency [21 Multi-Agency [21 Complaint [2] Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy L/ ·
Verification of inventory materials
Verification of quantities V
Verification of location
Proper segregation of material ~, /
Verification of MSDS availability ~ /
Verification of Haz Mat training L /
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection {.//
Site Diagram Adequate & On Hand
C=Compliance V=Violation
Any hazardous waste on site?:
Explain:
Yes ~ No
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Pink - Business Copy
[iusih~ss S~Responsible Party
Inspector: ~,
Test Date: 01/07/2000
TANKNOLOGY
Work Order #: 3206403
Client: __C, HFf(RO I~LIL~,g~A.
--P.
L_A~HABRA, CA, 90631
Site:
CHEVRON 90705
._9_700 ROSEDALE HWY
BAKERSFIELD CA 93312
Overall System Operation
The pumps; Shut down automatically if tile system detects a leak, fails to operate, or is
electronically disconnected.
The ~stem has functioning audible and ~sual alarms.
The circuit breaker for the system is properly identified.
The system is certified operational per manufacturer's performance standards.
[ X ] Yes [ ]No
i X ] Yes [ ] No
IX ] Yes [ ]No
[ X ] Yes [ ] No
Product Tank Monitoring: [ X ! Double wall [ ] Single wall
Make: VE____~E DER~_-_R_OO T Model: FLOAT
Type -A~il/LAR~~__ How many: 3 Operational:
(Automatic tank gauge, annular space vapor probe, annular space liquid probe, hydroguard system,
vadose zone monitor well, groundwater monitor well)
Comments:
[ X ] Yes [ I No
3 ATG's operational.
Product Piping Monitoring: [ X I Double wall [ ] Single wall
Make:. VEEDE~R-_ROOT Model: PLLD
Type: F-X~CT~RONI~II~LE.. How man),: 3 Operational:
(Piping sump liquid sensor, piping trench liquid sensor, electronic line pressure sensor,
mechanical line leak detector)
Comments:
[ X ] Yes ! ] No
3 Turbine sump sensors operational.
Other Monitoring Systems:
Make: VEEDER-_R_OOT
Type: 3UMP LIO~UID~__~
Comments:
Model: FLOAT
How many: 9 Operational:
[X I Yes [ ] No
3 Fill sump sensors and 6 Dispensor pan sensors.
Technician: ~R. ICHMOND PHILLIPS
Technician Signature:
TYPE OF ACTION
(Check one item only)
~O~RAM CONSOl,ID A~TF~D
TANKS
UNDERGROUND STORAGE TANKS - FACILITY
(one page per site) Page 1 of 1
[] 1. NEW SITE PERMIT [] 3. RENEWAL PERMIT [] 5.CHANGE OF INFORMATION [] 7.PERMANENTLY CLOSED SITE
[] 4. AMENDED PERMIT specify change' local.use only [] 8. TANK REMOVED
[] 6. TEMPORARY SITE CLOSURE 400
L FACILITY / SITE INFORMATION
NEAREST CROSS STREET 401 FAC E C I
Calloway Drive [] I. CORPORATION [] 51 COUNTY AGENCY* I
BUSINESS [] 1. GAS STATION [] 3. FARM [] 5. COMMERCIAL [] 2. INDIVIDUAL [] 6. STATE AGENCY*
TYPE [] 2. DISTRIBUTOR [] 4. PROCESSOR [] 6. OTHER 403 [] 3. PARTNERSHIP [] 7. FEDERAL AGENCY* 402
TOTAL NUMBER OF TANKS I Is facility on Indian Reservation or ' *If owner of UST is a public agency: name of supen4sor of divisio~ section or office which
REMAINING AT SITE ' I trustlands? operates the UST (This is the contact person for the tank records.)
3 [] Yes [] No 405 406
IL PROPERTY OWNER INFORMATION
PROPERTY OWNER NAME
Chevron Products Company, Atto: Permit Desk
MAILING OR STREET ADDRESS
P.O. Box 6004
407
IPHONE
925-842-9002
408
409
412
SanCn'ZRamon 410 I cASTATE 411 [ 94583ZIPCODE
PROPERTY OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY
[] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY 413
Ill. TANK OWNER INFORMATION
TANK OWNER NAME 4'~ [ PHONE 415
1
925-842-9002
Chevron Products Company, Atto: Permit Desk
MAILING OR ~'rREET ADDRESS 416
P.O. Box 6004
CItYsan Ramon 417IcASTATE 4]8 [ ZIP CODE94583 419
TANK OWNER TYPE [] 1. CORPORATION [] 2. INDIVIDUAL [] 4. LOCAL AGENCY / DISTRICT [] 6. STATE AGENCY 420
[] 3. PARTNERSHIP [] 5. COUNTY AGENCY [] 7. FEDERAL AGENCY
IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER
TY (TK) HQ 44- I 0 I 3 I 1 I 9 I 1 I 31 Ca~ (916) 322-9669 if questions arise
V. PETROLEUM UST FINANCIAL RESPONSIBILITY
421
INDICATE METHOD(s) [] 1. SELF-INSURED [] 2. GUARANTEE
[] 3. INSURANCE
[] 4. SURETY BOND [] 7. STATE FUND
[] 5. LETTER OF CREDIT [] S. STATE FUND & CFO LETTER
[] '6. EXEMPTION [] 9. STATE FUND & CD
[] 10. LOCAL GOVT MECHANISM
[] 99. OTHER:
422
VI. LEGAL NOTIFICATION AND MAILING ADDRESS
Check one box to indicate which address should be used for legal notifications and mailing.
Legal notifications and mailings will be sent to the tank owner unless box 1 or 2 is checked. [] 1. FACILITY [] 2. PROPERTY OWNER [] 3. TANK OWNER 423
VIL APPLICANT SIGNATURE
Certification - I certify that the information provided heroin is true and accurate to thc best of my knowledge.
ISIGNATURE OF APPLICANT
INAME OF APPL[CANYT (prin~) --
Chevron Products Company/Hal O'Rear
STATE UST FACILITY NUMBER (For local use only)
426
428
DATE 424 [ PHONE
04/12/00 I 805-986-5527
TITLE OF APPLICANT
Retail ESH Specialist
1998 UPGRADE CERTIFICATE NUMBER (F~ lo~1 u~ only)
425
427
429
T~
UNDERGROUND STORAGE TANKS - TANK PAGE 1
(two pages per tank)
Page5 of 6
TYPE OF ACTION [] 1NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE
(Check one item only) [] 7 PERMANENTLY CLOSED ON SITE
[] 3 RENEWALPERNflT (Speeify reason - for loeal use only) (Specify reason - for loeal use only) [] 8 TANK REMOVED 430
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 1
LOCATION WITHIN SITE (optional) 431
I. TANK DESCRIPTION (A scaled plot plan with the location oftha UST system including buildings and landmarks shall be submitted to the local agency.)
TANK ID ti 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No 434
1 Owens Coming !r~¥~',, complete one pag~ for each compartment.
DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437
05/30/91 12,000 0
ADDmONAL DESCRIPTION flor local use only) 438
II. TANK CONTENTS
TANK USE 439 PETROLEUM TYPE 44o
[] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JET FUEL
(IfmarkedcompletePe'eroleumType) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL
[] 2. NON-FUEL PETROLEUM [] lc. MIl)GRADE UNLEADED [] 4. GASOHOL [] 99. OTHER
[-]3. CHEMICAL PRODUCT COMMONNAME (from Hazardous Mateaialslnveatowpage) 441 CASti (fxom Hazardous Materials Inventory page ) 442
[] 4. HAZARDOUS WASTE
(~c~u~ usea m) PREMIUM UNLEADED 8006619
[] 95. um,:~ow~
III. TANK CONSTRUCTION
TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443
(Cheek one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN
[] 2. DOUBLE WALL [] 4. SINGLE WALL IN VAULT [] 99. OTHER
TANK MATERIAL - priraav] tank [] I. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444
(Cheek oneit~n only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/100% METHANOL [] 99. OTHER
REINFORCED PLASTIC (FRP)
TANK MATERIAL - seeondary tank [] 1. BARE ~'fEEL [] 3. FJEERGLASS / PLASTIC [] 5. CONCRETE [] 95. LrNKNOWN 445
(Cheek one itera only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLAS S [] 8. FRP COMPATIBLE W/100% METHANOL [] 99. OTHER
REINFORCED PLASTIC (FRP) [] I 0. COATED STEEL
[] 5. CONCRETE
TANK IN rI~K[OR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN 446 DATE INSTALLED 447
OR COATING [] 2 ALKYD LI2qING [] 4 PHENOLIC LINTNG [] 6 UNLINED [] 99 OTHER
(Cheek one it~n only) (For local use only)
448 448
OTHER CORROSION [] 1 MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN
PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURI~NT [] 99 OTHER
(Cheek oneitem only) [] 2 SACRIFICIAL ANODE (For localuse only)
SPILL AND OVERFILL YEAR INSTALLED 450 TYPE 0oeal use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452
(¢heek all that apply) [] I SPILL CONTAINMENT 1991 [] I ALARM [] 3 FILL TUBE SHIJr OFF VALVE
[] 2 PRO? TUBE 1998 OPW 61-SO-4 [] 2 EALL mOAT [] 4 EXEMPT
[] 3 STRIKER ?LATE Tank Mf$
IV. TANK LEAK DETECTION (^ d~,~ivtion ofm~ monitomg program shall he subm~d to the locU
IF SINGLE WALL TANK (Cheek aU that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454
(Cheek one item only)
[] I VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] I VISUAL (SINGLE WALL IN VAULT ONLY)
[] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE [] 2 CONTINUOUS INTERSTITIAL MONITORING
[] 3 CONTINUOUS ATG [] 7 GROUNDWATER [-I 3 MANUAL MONITORING
[] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING
(SIR) BIENNIAL TANK TESTING [] 99 OTItZR
IV. TANK CLOSURE INFORMATION / PERMANENT CLOSURE IN PLACE
ESTIMATED DATE LAST USED (YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMARqlNG 456 { TANK FILLED WITH INERT MATERIAL? 457
gallonsI [] Yes [] No
PROGRAM CONSOLIDATED
TANK
UNDERGROUND STORAGE TANKS - TANK PAGE 2
VI. PIPING CONSTRUCTION (Check allthat a~aply) Page 6 of 6
UNDERGROUND PIPING ABOVEGROUND PIPING
SYSTEM TYPE [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 458 [] 1. PRESSURE [] 2. SUCTION [] 3. GRAVITY 459
CONSTRUCTION [] 1. SINGLE WALL [] 3, LINED TRENCH [] 99. OTHER 460 [] 1. SINGLE WALL [] 95. UNKNOWN ,162
MANUFACTURER [] 2. DOUBLE WALL [] 95. UNIQ~OWN [] 2. DOUBLE WALL [] 99. OTHER
MANUFACTURER AO Smith 461 MANUFACTURER 463
[] 1. BARE STEEL
[] 2. STAINLESS STEEL
· [] 3. PLASTIC COMPATIBLE W/CONTENTS
[] 4. FIBERGLASS
[] s. STEEL W/COATING
[] 1. BARE STEEL [] 6. FRP COMPATIBLE w/100% METHANOL
[] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] Unknown
[] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Othex
[] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE)
[] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464
[] 6. FRP COMPATIBLE W/100% METHANOL
[] 7. GALVANIZED STEEL
[] 8. FLEXIBLE (HDPE) [] 99. OTHER
[] 9. CATHODIC PROTECTION
[] 95. UNKNOWN
VII. PIPING LEAK DETECTION (Check all ltmt apply) (A ¢
UNDERGROUND PIPING
SINGLE WALL PIPING ~6
PRESSURIZED PIPING (Check all that apply):
[] I. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT
OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +
AUDIBLE AND VISUAL ALARMS.
[] 2. MONTHLY 0.2 GPH TEST
[] 3. ANNUAL INTEGRITY TEST (0.1GPH)
CONVENTIONAL SUCTION SYSTEMS
[] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIBNNIAL PIPING
INTEGRITY TEST (0.1 GPH)
of the monitomg program shall be submitted to the local
ABOVEGROUND PIPING
SINGLE WALL PIPING ~7
PRESSURIZED PIPING (Check all that apply):
[] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP
SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +
AUDIBLE AND VISUAL ALARMS.
[] 2. MONTHLY 0.2 GPH TEST
[] 3. ANNUAL INTEGRITY TEST (0.1GPH)
[] 4. DAILY VISUAL CHECK
CONVENTIONAL SUCTION SYSTEMS (Check all that apply)
[] 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM
SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUND PIPING):
[] 7. SELF MONITORING
GRAVITY FLOW
[] 9. BmNNIAL IlXrfEGRITY TEST (0.1 GPt0
SECONDARILY CONTAINED PLYING
PRESSURIZED PIPING (Check all that apply):
10. CONT/NUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL
ALARMS AND (Check one)
[] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
[] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH)
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):
[] 7. SELF MONITORING
GRAVITY FLOW (Check all that apply):
[] 8. DAILY VISUAL MONITORING
[] 9. BIENNIAL INTEGRITY TEST (0.1 GPH)
SECONDARILY CONTAINED PLYING
PRESSURIZED PIPING (Check all that apply):
10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL
ALARMS AND (Check one)
[] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
[] b. AUTO pLrMp SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM
DISCONNECTION
[]c. NO AUTO PUMP SHUT OFF
[] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT
OFF OR RESTRICTION
[] 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUCTION/GRAVITY SYSTEM
[] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Check all that apply)
[] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *
AUDIBLE AND VISUAL ALARMS
[] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW
SHUT OFF OR RESTRICTION
[] 16. ANNUAL INTEGRITY TEST (0.1 GPH)
[] 17. DAILY VISUAL CHECK
[] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM
DISCONNECTION
[]c NO AUTO PUMP SHUT OFF
[] ll. AUTOMATIC LEAK DETECTOR
[] 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUCTION/GRAVITY SYSTEM
[] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Check all that apply)
[] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *
AUDIBLE AND VISUAL ALARMS
[] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)
[] 16. ANNUAL INTEGRITY TEST (0.1 GPH)
[] 17. DAILY VISUAL CHECK
VIII. DISPENSER CONTAINMENT
DISPENSER CONTAINMENT
DATE INSTALLED
03/06/98
[] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] & DAILY VISUAL CHECK
[] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINER / MONITORING
[] 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR
DISPENSER + AUDIBLE AND VISUAL ALARMS [] 6. NONE 469
IX. OWNER/OPERATOR SIGNATURE
I ce~ify that the infonuafion provi&d herein is true and accurate to fire best of my knowledge.
SIGNATURE J)F]OWNER/OPERAT, OR I DATE
'~/'/~'~/g~~ I 04/12/00
NAME O'F OWNER/OI:~ERATOR (p"rint) ~ TITLE OF OWNER/OPERATOR
Chevron Products Company'/Hal O'Rear Retail ESH Speciali~
Permit Number (For local use only) 473 Pennlt Approved (For local use only) Permit Expiration Date (For local use only)
47O
472
475
PROGRANI CON~OI,IDATED
UNDERGROUND STORAGE TANKS --ENSTALLATION
CERTIfiCATE OF COMPLIANCE
TANKS
(one page per tank)
Page 2 of 2
L FACILITY IDENTIFICATION
BUSINESS NAME (same as FACILITY NAME or DBA- Do~g Business As) 3
Chevron Station # 90705
ADDRESS (For local use only) 476
9700 Rosedale Highway, Bakersfield, Ca., 93312
FACILITY ID#
1115 ],!i!ii 0 2 1 i'il°° 11 [532
TANK ID # 1 477
Supreme Unleaded
IL INSTALLATION
(Check all that apply)
478
[] The installer has been trained and certified by the tank and piping manufacturers.
[] The installation has been inspected and certified by a registered professional engineer having education and experience 4?9
with underground storage tank installations.
480
[] The installation has been inspected and approved by the Unified Program Agency.
481
[] All work listed on the manufacturer's installation checklist has been completed.
482
[] The installer has been certified or licensed by the Contractors' State License Board.
[] The underground storage tank, any primary piping, and secondary containment was installed according to applicable 483
voluntary consensus standards and written manufacturer's installation procedures.
Description of work being certified:
IH. TANK OWNER/AGENT SIGNATURE
I certify that the information provided herein is hue and accurate to the best of my knowledge.
SIGNATUR~ OF TANK OW24ER/AGENT DATE 484
E~ _~7 ~ ~~.A~ 04/12/00
NAM OF TAN~ OWNER/AGENT (pfim~'-
Chevron Products Company/Hal O'Rear
485 TITLE OF TANK OWNER/AGENT
Retail ESH Speciali~
UPCF (1/99 revised) 178 Formerly SWRCB Form C
TANKS
UNDERGROUND STORAGE TANKS - TANK PAGE 1
(two pages per tank)
TYPE OF ACTION l"l 1NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE Page3of6
(Checkon~ite~nonly) [] 7 PERMANENTLY CLOSED ON SITE
[] 3 RENEWAL PERMIT (Sp~ify reason - for local use only) (Specifymason-forlo~aluseonly) [] 8 TANK REMOVED 430
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 1
Chevron Station #90705 131FACIL1TY ID: I 115 I, ,'10 12 [11 ,,[0 l0 I 1 15 13 12
LOCATION WITHIN SITE (optional)
431
I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including building.q and landmarks shall be subinllled to the local agency.)
TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [-I Yes [] No
2 Owens Coming if -¥,s,,, comp~t~ o~e p~ fo~,~d~
DATE INSTAI.I J:.D (YEA1UMO) 435 TANK CAPACITY IN GALLONS 4~ NUMBER OF COMPARTMENTS 43?
05/30/91 12,000 0
ADDITIONAL DESCRIPTION (For lo~a~ use only)
438
IL TANK CONTENTS
TANK USE 439 PETROLEUM TYPE
[] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. IETFUEL
(If marked ¢omplet~ Petrolemn Type) [] lb. PREIvI1-GM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL
[] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE UNLEADED [] 4. GASOHOL [] 99. OTHER
[] 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials lnveato~- page) 441 CAS# (from Hazardous Materials Inventory page) 442
[] 4. HAZARDOUS WASTE
(~d~ u~a oa) MID-GRADE UNLEADED 8006619
III. TANK CONSTRUCTION
TYPE OF TANK [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH IN ~'~:KNAL BLADDER SYSTEM 443
Check one item only) EXTERIOR MEMBRANE LINER [] 95. UNKNOWN
[] 2. DOUBLE WALL [] 4. SINGLE WALL IN VAULT [] 99. OTHER
TANKMATERIAL-tnima~ytank I-I1. BARE~I/~I2;L [~3. FIBERGLASS/PLASTIC []5. CONCRETE []95. UNKNOWN 444
(Ch~k one item only) 1-12. STAINLESS STEEL 1-14. STEEL CLAD W/FIBERGLASS []8. FRPCOMPATIBLEW/100%METHANOL []99. OTHER
REINFORCED PLASTIC (FRP)
TANK MATERIAL - se¢ondaty tank [] 1. BARE~t~j~L [] 3. FIBERGLASS/PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 445
(Cheek one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FRP COMPATIBLE W/100% IvI~THANOL [] 99. OTHER
REINFORCED PLASTIC (FRP) [] 10. COATED STEEL
[] 5. CONCRETE
TANK IN'I'/~Iq/OR LINING [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNowN 446 DATE INSTALLED 447
OR COATING [] 2 ALKYD LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER
Check one item only)
(For lo~al use only)
OTHI~R CORROSION ["l 1 MANUFACTLrRED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN 448 448
PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTI-I~R
(Check one item only) [] 2 SACRIFICIAL ANODE
(For local use only)
SPILL AND OVERFILL YEAR INSTAl J.RD 450 TYPE 0omi use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452
(Check all that apply) [] 1 SPILL CONTAINMENT 1991 [] 1 ALARM [] 3 FILL TUBE SHUT OFF VALVE
[] 2 DROP TUBE 1998 OPW 61-SO-4 [] 2 ~ALL F[OA? [] 4 EX~MP~
[] 3 STRIKER PLATE Tank Mfg
IV. TANK LEAK DETECTION (^ d~smp~ion ofth~ monitoring program shall be su,~,,~,;;;~4 to the local agency.)
IF SINGI .E WALL TANK (Che~k all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER 454
(Ch~k one item only)
[] I VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL (SINGLE WALL IN VAULT ONLY)
[] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE gONE [] 2 CONTINUOUS INTERSTITIAL MONITORING
[] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING
[] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING
(SIR) BIENNIAL TANK TESTING [] 99 OTHER
IV. TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE
ESTIMATED DATE LAST USED (yRflvIO/DAY) 455 I ESTIMATED QUANTiT ¥ OF SUBSTANCE REMAiNiNG 456 i TANK FILLED WiTH iNERT MATERIAL? 457
. gallons [] Yes [] No
VI, PIPING CONSTRUCTION (che~k aU hhat apply)
UNDERGROUND PIP'i~-'~-'--- ~
SYSTEM TYPE [] 1 PRESS~ ~ ~ ABOVEGROUND PIPING
~ ~. .......... u.~.ou~;ll~3~ I 13. GRAVITY 458 I ["]I. PRESSLrRE [-[2~-----''~-T--
-- ~ -- -- ........... :~ I_/3. GRAVITY
ACTUP,.ER I~ 2. DOUBLE WALL [] 95. UNKNOWN I [] 2. DOUBI '
MANUF _ ,,.-,, .... I I_J 2. DOUBLE WALL [] 99. OTHER
ACTUREK /-~_%9 ~)ml[ll 461 I MANUFACTURER
Page 4 of 6
459
462
463
[] 1. BARE STEEL [] 6. FRP COMPATIBLE w/100% METHANOL [] I. BARE STEEL [] 6. FPP COMPATIBLE W/100% METHANOL
[] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] Unknown [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL
[] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [-[ 3. PLASTIC COMPATIBLE W/CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER
[] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9. CATHODIC PROTECTION
[] 5. STEEL W/COATiNG [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATiNG [] 95. UNKNOWN
VII. PIPING LEAK DETECTION ~ 465
UNDERGROUND PIPiNG
SINGLE WALL PIPING 466
PRESSLrRIZED PIPiNG (Check aU that apply):
[] 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST _ .W1TH AUTO PUMP SHUT
OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +
AUDIBLE AND VISUAL ALARMS.
[] 2. MONTHLY 0.2 GPH TEST
[] 3. ANNUAL INTEGRITY TEST (0.1GPH)
CONVENTIONAL SUCTION SYSTEMS
[] 5. DAILY VISUAL MONITORING OF PUMPiNG SYSTEM + TRIENNIAL PIPiNG
INTEGRITy TEST (0.1 GPH)
SAFE SUCTION SYSTEMS (NO VALUES iN BELOW GROUND PIPiNG):
[] 7. SELF MONITORING
GRAVITY FLOW
[] 9. BIENNIAL INTEGRITY TEST (0.1 GPH)
SECONDARILY CONTAINED PIPING
PRESSURIZED PIPiNG (Check aU lhat apply):
10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL
ALARMS AND (Check one)
[] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
[] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM
DISCONNECTION
l-lc. NO AUTO PUM~ SHUT OFF
[] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT
OFF OR RESTRICTION
[] 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUCTION/GRAVITY SYSTEM
[] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Check aU that apply)
[] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF *
AUDIBLE AND VISUAL ALARMS
[] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ...WITHOUT FLOW
SHUT OFF OR RESTRICTION ~
[] 16. ANNUAL INTEGRITY TEST (0.1 GPH)
[] 17. DAILY VISUAL CHECK
~ - tionof~shaubesubmittedtothelocal_~.~Q_
ABOVEGROUND PIPiNG
SINGLE WALL PIPING 467
PRESSURIZED PIPiNG (Check aU that apply):
[] I. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WiTH AUTO PUMP
SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +
AUDIBLE AND VISUAL ALARMs.
[] 2. MONTHLY 0.2 GPH TEST
[] 3. ANNUAL IN'rEGRITY TEST (0.1GPH)
[] 4. DAILY VISUAL CHECK
CONWENTIONAL SUCTION SYSTEMS (Check aU that apply)
[] 5. DAILY VISUAL MONITORING OF PIPiNG AND PUMPiNG SYSTEM
[] 6. TRIENNIAL INTEGRITY TEST (0.1 GPH)
SAFE SUCTION SYSTEMS (NO VALVES iN BELOW GROUND PIPING):
[] 7. SELF MONITORING
GRAVITY FLOW (Ch~k aU that apply):
[] 8. DAILY VISUAL MONITORING
[] 9. BIENNIAL INTEGRITY TEST (0.1 GPH)
SECONDARILY CONTAIINED PIPING
PRESSURIZED PIPING (Check aU that apply):
10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL
ALARMS AND (Check one)
[] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
[] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM
DISCONNECTION
[]c NO AUTO PUMP SHUT OFF
[] 11~ AUTOMATIC LEAK DETECTOR
[] 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUCTION/GRAVITY SYSTEM
[] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Check all that apply)
[] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO pLrMp SHUT OFF *
AUDIBLE AND VISUAL ALARMS
[] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)
[-[ 16. ANNUAL INTEGRITy TEST (0.1 GPH)
[] 17. DAILY VISUAL CHECK
VIII. DISPENSER CONTAINMENT
DISPENSER CONTAINlviENT [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE
DATE iNSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARA/iS
03/06/98 [] 3. CONTINTJOUS DISPENSER PAN SENSOR .WITH AUTO SHUT OFF FOR
DISPENSER + AUDIBLE AND VISUAL ALARMs
IX. OWNER/OPERATOR SIGNATURE
I certify that the/nfonnafion provi&d herein is frae and accurate to the best of my knowledge.
UmS~OPERATOR (p~int) 04/12/00
Chevron Products Company/Hal O'Rcar TrrUE OF OWrm~/OPERATOR
Retail ESH Spcciali~
Permit Number (For local use only) 473 Permit Approved (For local use only)
[] 4. DAILY VISUAL CHECK
[] 5. TRENCH LINER / MONITORING
[] 6. NONE
Permit Expiration Date (For local use only)
469
470
472
475
TANKS
UNIFIED PROGRAM CONgOI,IDATED
UNDERGROUND STORAGE TANKS -INSTALLATION
CERTIFICATE OF COMPLIANCE (on~ page p~r t~)
Page 2 of 2
L FACILITY H)ENTIFICATION
BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As)
Chevron Station # 90705 3
ADDRESS (For lo~al us~ only)
9700 Rosedale Highway, Bakersfield, Ca., 93312 476
1 5? 0 2 1 0 0 1 5 3 2 477
TANK ID # 2
Midgrade Unleaded
H. INSTALLATION
(Check all that apply)
[] The installer has been trained and certified by the tank and piping manufacturers.
[] The instalhtion has been inspected and certified by a registered professional engineer having education and experience
with underground storage tank installations.
[] The installation has been inspected and approved by the Unified Program Agency. 4~0
[] Ail work listed on the manufacturer's installation checklist has been completed.
[] The installer has been certified or licensed by the Contractors' State License Board.
[] The underground storage tank, any primary piping, and secondary containmem was installed according to applicable 483
voluntary consensus standards and written manufacturer's installation procedures.
Description of work being certified:
HI. TANK OWNER/AGENT SIGNATURE
I certify that the information provided herein is true and accurate to the best of my knowledge.
SIGNATL~R, E.O~ TANK OWNER/AGENT
04/12/00
NAME OF TANK OWNER/~_GENT (pi/ut) -- 4~5
'HTLE OF TANK OWNER/AGENT
Chevron Products Company/Hal O'Rear Retail ESH Speciali~
486
UPCF (7/99 revised) 178 Formerly SWRCB Form C
TANKS
UNDERGROUND STORAGE TANKS - TANK PAGE 1
(two pages per tank)
Page I of 6
TYPE OF ACTION [] 1 NEW SITE PERMIT [] 4 AMENDED PERMIT [] 5 CHANGE OF INFORMATION [] 6 TEMPORARY SITE CLOSURE
(Check one it~nn only) [] 7 PERiVIANENTLY CLOSED ON SITE
[] 3 RENEWAL PERMIT (Spocifyreason-forlo~dus~only) (Sp~ify reason - for local use only) [] 8 TANK REMOVED 430
LOCATION WITHIN SITE (optiona~
I. TANK DESCRIPTION (A scaled plot plan with the location of the UST system including buildings and landmarks shall be submitted to the local agency.)
TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK [] Yes [] No
3 Owens Coming If"Yes", complete one page for each eomparon~nt.
DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 43~ NUMBER OF COMPARTMENTS 437
05/30/91 12,000 0
ADDITIONAL DESCRIPTION (For local use only) 438
II. TANK CONTENTS
TANK USE 439 PETROLEUM TYPE
[] 1. MOTOR VEHICLE FUEL [] la. REGULAR UNLEADED [] 2. LEADED [] 5. JETFUEL
(lfmarkedcompletePelxoleumType) [] lb. PREMIUM UNLEADED [] 3. DIESEL [] 6. AVIATION FUEL
[] 2. NON-FUEL PETROLEUM [] lc. MIDGRADE UNLEADED [] 4. GASOHOL [] 99. OTHER
[] 3. CHEiV[ICAL PRODUCT COMMON NAME (from Hazardous Materials Inventoxy page) 441 CAS# (from Hazardous Materials Inventow page) 442
[] 4. m~z.,xRi:)ous WASTE
(i~e~u~ us~i oa) REGULAR UNLEADED 8006619
[] 95. u~r~ow~
IH. TANK CONSTRUCTION
TYPE OF TANK [] 1. SINGLE WALL [-[ 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443
(Check one item only) EXTERIOR MEMBRANE LINER. [] 95. UNKNOWN
[] 2. DOUBLE WALL [] 4. SINGLE WALL IN VAULT [] 99. OTHER
TANK MATERIAL -prima~ytank [] 1. BARE STEEL [] 3. FIBERGLASS / PLASTIC [] 5. CONCRETE [] 95. UNKNOWN 444
(Check one item only) [] 2. STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [] 8. FPP COMPATIBLE W/100% METHANOL [] 99. OTHER
REINFORCED PLASTIC (FRP)
TAme M~TEa~,L-~on~yt~ [] ~. BAaS STEEL [] 3. ~BEROLASS / PLASTIC [] S. CONC~TE [] 95. UNKNOWN
(Check one item only) []2. STAINLESS STEEL []4. STEEL CLAD W/FIBERGLASS []8. FRPCOMPATIBLEW/100%METHANOL []99. OTHER
REInfORCED PLASTIC fr~) [] 10. COATED STEEL
[] 5. CONCRETE
T,~K ncrsRIOR LrmNO [] ;. RUBBER Ln'~D [] 3. EPOXY Ln, nNO [] 5. OLASS LININO [] 95. rmKNOWN ~ DATE INSTALLEr) 447
OR COATING [] 2 ALKYr) LINING [] 4 PHENOLIC LINING [] 6 UNLINED [] 99 OTHER
(Check one item only) (For local use only)
448 448
OTHER CORROSION [] 1 MANUFACTURED CATHODIC [] 3 FIBERGLASS REINFORCED PLASTIC [] 95 UNKNOWN
PROTECTION IF APPLICABLE PROTECTION [] 4 IMPRESSED CURRENT [] 99 OTHER
(Ch~ck one item only) [] 2 SACRIFICIAL ANODE (For localuse only)
SPILL AND OVERFILL YEAR INSTALLED 45O TYPE (local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452
(c~ut~t~wv/) [] ~ SPILLCONT~UN~vmNT 1991 [] ~ AL~aUVt []3mLTUBESmrro~vALVE
[] 2 DROP TUBE 1998 OPW 61-SO-4 [] ~ BALL fLOAT [] 4 EYmMPT
[] 3 STRIKER PLATE Tank Mfg
IV. TANK LEAK DETECTION (A desorivtion of~e moratonng Vrogam sl~ ~ subraltted to ~e local agenoy.)
IF SINGLE WALL TANK (Ch~ck all that apply) 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER
(Check one itean only)
[] 1 VISUAL (EXPOSED PORTION ONLY) [] 5 MANUAL TANK GAUGING (MTG) [] 1 VISUAL (SINGLE WALL INVAULT ONLY)
[] 2 AUTOMATIC TANK GAUGING (ATG) [] 6 VADOSE ZONE ' [] 2 CONTINUOUS INTERSTITIAL MONITORING
[] 3 CONTINUOUS ATG [] 7 GROUNDWATER [] 3 MANUAL MONITORING
[] 4 STATISTICAL INVENTORY RECONCILIATION [] 8 TANK TESTING
(SIR) BIENNIAL TANK TESTING [] 99 OTHER
IV. TANK CLOSURE INFORMATION ! PERMANENT CLOSURE IN PLACE
ESTIMATED DATE LAST USED (YR/MO/DAY) 455 I ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457
gallons [] Yes [] No
~,D PROGRAM CONSOLIDATED
UNDERGROUND STORAGE TANKS - TANK PAGE 2
TANK
VI. PIPING CONSTRU~IO~ Pa~ 2 of
UNDERGROUND PIPING ~ -- .~ ABOV:EGROUND PIPING
SYSTEM TYPE [] I. PRESSURE [] 2. SUCTION [] 3. GRAVITY ~ _[ [] 1. PRESSURE [] 2. SUCTION ------~--~--GRAVITY 459
CONSTRUCTION []
MANUFACTURER [] 2. DOUBLE WALL [] 95. UNKNOWN I [] 2. DOUBLE WALL [] 99. OTHER 462
MA/~U~ACTURER AG Smith 461 I MANUFACTURER 463
[] 1. BARE ~I'EEL [] 6. FRP COM/:~ATIBLE w/loo% METHANOL [] 1. BARE SiEEL [] 6. FRP COMPATIBLE W/100% METHANOL
[] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL [] Unknown [] 2. STAINLESS STEEL [] 7. GALVANIZED STEEL
[] 3. PLASTIC COMPATIBLE W/CONTENTS [] 99. Other [] 3. PLASTIC COMPATIBLE W/CONTENTS [] 8. FLEXIBLE (HDPE) [] 99. OTHER
[] 4. FIBERGLASS [] 8. FLEXIBLE (HDPE) [] 4. FIBERGLASS [] 9, CATHODIC PROTECTION
[] 5. STEEL W/COATING [] 9. CATHODIC PROTECTION 464 [] 5. STEEL W/COATING [] 95. UNKNOWN 465
VII, PIPING LEAK DETECTION~ ~s~tionof~emonit · p st~lJbcsubn~dtothelocala/~,L~-
UNDERGROUND PIPING ABOVEOROUND PIPING
SINGLE WALL PIPING ,~ SINGLE WALL PIPING 4~7
PRESSURIZED PIPING (Check all tlmt apply): PRESSURIZED PIPING (Check all that apply):
[] l' ELECTRONIC LKNE LEAK DETECTOR 3,0 GpH TEST VClT~H~ AUTO PUMP SHUT [] 1.
OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP
AUDIBLE AND VISUAL ALARMS. SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +
AUDIBLE AND VISUAL ALARMS.
[] 2. MONTHLY 0.2 GPH TEST [] 2. MONTHLY 0.2 GPH TEST
[] 3. ANNUAL INTEGRITY TEST (0.1GPH) [] 3. ANNUAL INTEGRITY TEST (0.1GPH)
[] 4. DAILY VISUAL CHECK
CONVENTIONAL SUCTION SYSTEMS CONVENTIONAL SUCTION SYSTEMS (Check all that apply)
[] 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING
INTEGRITy TEST (0.1 GPH) [] 5. DA/LY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM
SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUND PIPING): [] 6. TRIENNIAL I]~rEGRITY TEST (0. l GPH)
[] 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):
GRAVITY FLOW [] 7. SELF MONITORING
[] 9. BlENNIAL INTEGRITy TEST (0.1 GPH) GRAVITY FLOW (Check allttmt apply):
[] 8. DAILY VISUAL MONITORING
[] 9. BIENNIAL INTEGR/Ty TEST (0.1 GPH)
SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING
PRES SU'R~7~ED P]~I~G (Check all l~t apply): PRESSURI~ PIPING (Check all that apply):
10. CONTfNUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL
ALARMs AND (Check one)
ALARMS AND (Che~k one)
[] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS [] a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
[] b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM [] b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM
DISCONNECTION
DISCONNECTION
[]c. NO AUTO PUMP SHUT OFF []c NO AUTO PUMP SHUT OFF
[] 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITCH FLOW SHUT
OFF OR RESTRICTION [] 11. AUTOMATIC LEAK DETECTOR
[] 12. ANNUAL INTEGRITY TEST (0.! GPH) [] 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUCTION/GRAVITY SYSTEM SUCTION/GRAVITY SYSTEM
[] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS [] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATOI~ ONLY (Check all tl~t apply) EMERGENCY GENERATORS ONLY (ch~k all tl~t silly)
[] 14. CONTINUOUS SUMP SENSOR WITHOLr~ AUTO PUMP SHUT OFF
AUDIBLE AND VISUAL ALARMS .
[] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WlTHOLr~_ FLOW AUDIBLE AND VISUAL ALARMS
SHUT OFF OR RESTRICTION [] 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)
[] 16. ANNUAL INTEGRITY TEST (0. l GPH) [] 16. ANNUAL INTEGRITY TEST (0.1 GPH)
[] 17. DAILY VISUAL CHECK [] 17. DAILY VISUAL CHECK
VIIL DISPENSER CONTAINMENT
DISPENSER CONTAINMENT [] 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE
DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS
03/06/98 [] 3.DCONTIlxYUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR
ISPENSER + AUDIBLE AND VISUAL ALARMS
IX. OWNER/OPERATOR SIGNATURE
I certify fltat lhe information provided herein/s ~ and accurate to the best of my knowledge.
SiGN^ o DATE
~g'~/c:Z//~~ 04/12/00
NAME OF OWIqER/OPERATOR ~,i~0
Chevron Products TrrLE OF OW~IVOPERATOR
Retail ESH
Pemdt N',tmh~ (For local use only) 473 Pea-mit Aptnv.ed (For local use only) Peamit Expimlion Date (Fo~ 11:~1 use only)
[] 4. DAILY VISUAL CHECK
[] ~. ~NC~ L~R/MONrroR~G
[] ~. NONE
469
47O
472
475
TANKS
~D PROGRAM CONSOLIDATED
UNDERGROUND STORAGE TANKS - INSTALLATION
CERTIFICATE OF COMPLIANCE (one page per tank)
Pag~ 1 of 2
L FACILITY IDENTIFICATION
BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As)
Chevron Station # 90705 3
ADDRESS (l:or local us~ only)
9700 Rosedale Highway, Bakersfield, Ca., 93312 476
I 5, 0 2 ~1 i 0 0 1 5 3 2 47?
TANK ID # 3
Regular Unleaded
H. INSTALLATION
(Check all that apply)
[] The installer has been trained and certified by the tank and piping manufacturers. 47s
[] The installation has been inspected and certified by a registered professional engineer having education and experience 4?9
with underground storage tank installations.
[] The installation has been inspected and approved by the Unified Program Agency. 480
[] All work listed on the manufa ,ctyrer's installation checklist has been completed. 48~
[] The installer has been certified or licensed by the Contractors' State License Board. 4~
[] The underground storage tank, any primary piping and secondary containment was installed according to applicable 483
vol ,untary consensus standards and written manufacturer's installation procedures.
Description of work being certified:
HI. TANK OWNER/AGENT SIGNATURE
484
I certify that the information provided herein is tree and accurate to the best of my knowledge.
SIGNATURE O~: TANK OWNER/AGENT
04/12/00
NAME OF TANK OWNER/AGENT (print) 485 'I'ITLE OF TANK OWNER/AGENT
Chevron Products Company/Hal O'Rear Retail ESH Specialint
UPCF (7/99 revised) 177 Formerly SWRCB Form C
April 30, 2000
RE: CERTIFICATE
UNDERGROUND TANKS
OF FINANCIAL
RESPONSIB..___~ILITY FOR
To Whom It May Concern:
Chevron Corporation hereby certifies that it is in compliance with the requirements of
Underground Storage Tank financial responsibility'regulations. This certificate covers all
tanks in the States of California, Alaska, Arizona, Florida, Georgia, Hawaii, Louisiana,
Nevada, New Mexico, Oregon, Texas, Utah and Washington owned by Chevron
Corporation.
The financial assurance mechanism used to demonstrate financial responsibility required
under State and Federal regulations is as follows:
Corporate guarantee of Chevron is the amount of $1 million per occurrence,
$2 million annual aggregate. Said guarantee covers taking corrective action
And compensating third parties for bodily injury and property damage caused
By either sudden accidental releases and non sudden accidental releases or
Accidental releases.
This guarantee is renewed annually (within the first 120 days of the year). Copies of the
renewed certificate and a complete list of the facilities are sent to the governing agencies
yearly.
Sincerely,
By: ~-a-,'d-4-~L~
C. P. Garci'a, gn~ronmental Compliance, Permit
Notarized by: Q~..~tfl.~, ~ ~
Susan R. Weber, Notary
8900 Shoal Creek BlYd, Building 200
Austin, Texas 78757
Phone: (512) 451-6334
Fax: (512) 459-1459
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
INSPECTOR STEVE UNDERWOOD
1715 CHESTER AVE., 3RD FLOOR
BAKERSFIELD, CA. 93301
Test Date: 11/29/1999
Order Number: 3206273
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
CHEVRON 90705
9700 ROSEDALE HWY
BAKERSFIELD, CA. 93312
Testing performed:
Stage II blockage tests
Stage II pressure decay tests
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
CERTIFICATE OF STAGE II VAPOR RECOVERY TESTING
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
TEST DATE: 11/29/99
CLIENT: CHEVRON U.S.A.
P. O. BOZ 2833
LA HABRA, CA 90631-2833
ATTN: JUDY BOWE
WORK ORDER NUMBER3206273
SITE: CHEVRON 90705
9700 ROSEDALE HWY
BAKERSFIELD, CA 93312
CONTACT: MANAGER
SUPREME 1
PLUS i 0.14 0.32
UNLEADED 1 0.13 0.30
SUPRE/4E 2 0.13 0.30
PLUS 2 0.15 0.31
~ED 2 0.14 0.32
SUPREME 3 0.11 0.27
PLUS 3 0.14 0.30
~ED 3 0.13 0.32
SUPREME 4 0.11 0.32
PLUS 4 0.14 0.31
UNLEADED 4 0.15 0.32
SUPREME 5 0.14 0.33
PLUS 5 0.11 0.29
UNLEADED 5 0.12 0.25
SUPREHE 6 0.12 0.29
0.08 0.23
0.51
0.47
0.48
0.52
0.50
0.42
0.58
0.57
0.57
0.58
0.59
0.60
0.56
0.34
0.50
0.40
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
12k 1
PRESSURE DECAY TEST
Witness test.
Tanknology appreciates the opportunity to serve you, and looks foward to working with you in the future. Please call any time, day or night
when you need us. ,
Tanknology representative: Test conducted by:
TODD PARKER
RICHMOND PHILLIPS
Reviewed:
Technician Certification Number: 91-1o71
CERTIFICATE OF STAGE II VAPOR RECOVERY TESTING
TEST DATE:Il/29/99
CLIENT: CHEVRON U.S.A.
P, O, BOX 2833
LA HABRA, CA 90631-2833
A'UrN: JUDY BOWE
· Tan
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
WORK ORDER NUMBER3206273
SITE: CHEVRON 90705
9700 ROSEDALE HWY
BAKERSFIELD, CA 93312
CONTACT: MANAGER
PLUS 6 0.09 0.21
UNLEADED 6 0.10 0.22
SUPREME 7 0.13 0.22
PLUS 7 0.11 0.25
UNLEADED 7 0.13 0.32
SUPREM][ 8 0.12 0.30
PLUS 8 0.13 0.31
D-NLEADED 8 0.12 0.30
SUPREME 9 0.12 0.30
PLUS 9 0.13 0.31
UNLEADED 9 0.13 0.32
SUPREME 10 0.13 0.31
PLUS 10 0.13 0.32
UNLEADED 10 0.13 0.32
SUPREME 11 0.11 0.31
PLUS 11 0.13 0.32
0.43
0.41
0.52
0.42
0.50
0.52
0.33
0.48
0.54
0.50
0.59
0.58
0.61
0.60
0.54
0.59
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PASS
PRESSURE DECAY TEST
Tanknology appreciates the opportunity to serve you, and looks foward to working with you in the fi~ture. Please call any time, day or night,
when you need us.
Tanknology representative: Test conducted by:
TODD PARKER RICtSqOND PHILLIPS
Reviewed:
Technician Certification Number:91-1o71
CERTIFICATE OF STAGE II VAPOR RECOVERY TESTING
TEST DATE: 11/29/99
CLIENT: CHEVRON U. S,A.
P. O. BOX 2833
~ H~BRA, CA 90631-2833
ATTN: JUDY BOWE
a · Tank~'~:~ogy'
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
WORK ORDER NUMBER3206273
SITE: C[-D~VRON 90705
9700 ROSEDALE HWY
BAKERSFIELD, CA 93312
CONTACT: MANAGER
UNLEADED 11 0 . 14 0 . 31 0 . 45 PASS
SUPREME 12 0.14 0.31 0.51 PASS
PLUS 12 0.12 0.31 0.58 PASS
UNLEADED 12 0.13 0.30 0.60 PASS
PRESSURE DECAY TEST
Tanknology appreciates the opportunity to serve you, and looks foward to working with you in the future. Please call any time, day or night,
when you need us.
Tanknology representative: Test conducted by:
TODD PARKER RICHMOND PHILLIPS
Reviewed: Technician Certification Number: 91-1071
TEST DATE:Ill29/99
CLIENT:CHEVRON U. S
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
COMMENTS
WORK ORDER NUMBER3206273
SITE:CHEVRON 90705
Witness test after repairs. 3 Pb_~l tite drains replace, 2 PV vent caps, 3 dry breaks, 3 drop
tube 0 rings and 3 fill adapter gaskets. And 3.5 hours of labor.
PARTS REPLACED
2
3
3
3
3
2" PRESSUrE/VACUUM VENT CAP (THREADED) #OPW 523-1100
VAPOR RECOVERY DRY BREAK
DROP TUBE O-RING
FILL ADAPTOR GASKET - OPW-HO415
' Phil Tite replacement drain.
HELIUM PINPOINT TEST RESULTS (IF APPLICABLE)
Printed 12/06/1999 08:15 CWH ITE
SITE DIAGRAM
8900 SHOAL CREEK, BUILDING 200
AUSTIN, TEXAS 78757
(512) 451-6334
FAX (512) 459-1459
TEST DATE: 11/29/99
CLIENT:CI.~.O~ O'. ~ .~,
WORK ORDER NUMBER3206273
SITE: C~]3V'I~.ON 90705
LU
CAR WASH
VENTS
Printed 12/06/1999 08:15 CWHITE
Form 1
Source Test Tesults
Static Leak Test
Date: 11/29/1999
GDF Name and address:
Stage II system (check one):
Stage I type (check one):
Time: 07:00
90705 9700 ROSEDALE HWY
Vapor Balance
Vacuum Assist
Twopoint [X ]
Coaxial [ ]
Application No.
[ X ] Single Hose M.P.D.
[ ] Type:
Manifolded? Yes [ × ]
No [ ]
[ ]
Tank # 1 2 3
'Product grade 92 89 87
Actual tank capacity (gallons) 11627 11627 11627 34881
Gasoline volume (gallons) 2603 4100 7310 14013
Ullage (gallons) 9024 7527 4317 20868
Initial pressure of UST, inches H20 2 2
Number of nozzles served by tank 12 12 12 36
Test location: (A) Stage I vapor
coupler of (B) Stage II riser b b b b
Inifi,al Pressure, inches H20 (2.0) .~ 2.13
Pressure after 1 min. (inches H20) 2.14
Pressure after 2 min. (inches H20) 2.15
Pressure after 3 min. (inches H20) 2.14
Pressure after 4 min. (inches H20) 2.13
Final Pressure after 5 min. (inches
H20)
2.12
Allowable Final Pressure: Table lA,
Table lB, Equations 9.1, 9.2 1.94
Test Status [Pass or Fail] Pass
Tests Conducted By: RPHILLlPS
Test Company: TANKNOLOGY
Tests Witnessed By:
Date of Tests: 11/29/1999
Form 2
Summary_ of Test Results,
Dynamic Pressure Performance
Date: 11/29/1999 Time: 07:00 Application No:
GDF Name and address: 90705 9700 ROSEDALE HWY
Quantity 15 (gallons) of gasoline introduced into Stage II riser.
Stage II system type: (Manufacturer and Executive Order number)
Riser 40CFH 60CFH 80 CFH ~ Riser 40CFH 60CFH 80CFH PASS
No. .16" .35" .62" or No. .16" .35" .62" or
MAX MAX MAX FAIL MAX MAX MAX FAIL
92 14 .32 51 PASS 87 11 .32 ..59 PASS
89 .13 30 .'47. PASS 92 .14 .31 .58 PASS
87 .13 .30 .48 PASS 89 .15 32 59 PASS
92 .15 .31 .52 PASS 87 .14 ~33 .60 PASS
89 .14 .32 .50 PASS 92 .11 .29 .56 PASS
87 .11 .21 .42 PASS 89 .12 .25 .34 PASS
92 .14 .30 .58 PASS 87 .12 .29 .50 PASS
89 13 .32 .57 PASS 92 .08 1.23 .40 PASS'
Did gauge needle pulsate or peg at any flow rate during test?
No IX ]
Yes [ ]
Indicate location of storage tank(s), condensate pot(s), and location where gasoline
was introduced into the vapor return system on reverse side of this page:
Tests Conducted By: RPHILLIPS
Test Company: TANKNOLOGY
Tests Witnessed By:
Date of Tests: 11/29/1999
TO BE ENACTED
APPENDIX C
Facility Name:
90705
Address:
STAGE H POST TEST INSPECTION FORM
Application #
County:
9700 ROSEDALE HWY
city, ~tate, ZAp
BAKERSFIELD, CA 93312
DISPENSER AREA INSPECTION
[ ] All Vapor pipes under the dispenser are capped, plugged, or re-attached.
[ ] No leaks are present under dispenser, nor from hoses or nozzles.
[ ] All impact valves are open on all product lines.
[ ] All dispenser panels are correctly re-installed.
[ ] All lock-outs or "Out of Service" bags are removed from dispenser nozzles.
[ ] All tools, testing equipment, cones, and caution tape removed from dispenser area.
TANK AREA INSPECTION
[ ] Isolation plugs are removed from vapor risers (if applicable).
[ ] All tank top components (plugs, caps, etc...) are reinstalled and secure.
[ ] "Drop out tank" free of product and functioning properly (with all caps replaced).
[ ] Submersible pit(s) free from leaks.
[ ] All tools, testing equipment, cones, and caution tape removed from tank area.
[ ] All lids and covers are properly replaced.
Site Mgr. NAME: Site Mgr. Signature: Date:
Tester NAME: Testers Signature: Date:
RICHMOND PHILLIPS 11/29/199
Testing Company and Address:
TANKNOLOGY, 8900 SHOAL CREEK, SUITE 200, AUSTIN, TX 78757
Date: 11/29/1999
GDF Name and address:
Notes:
90705
Reverse Side of Page
Work Order #: 3206273
9700 ROSEDALE HWY