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Home My WebLink AboutUNDERGROUND TANK FILE #2 ~ ------ -- -- . e p1010018.jpg (1280x960x24b jpeg) 'f'l t{~·1 ö.. ~ ~ eM WaGl T OJt\ l ~J...(~t) ù CL ( 1 { Ð , s-\ l\'\L f2J - p1 01 0017.jpg (1280x960x24b jpeg) - ~ .;. .' \', «iIII t ,¥ ~~ \,:~' \",8- r~o · - ....;y e p1010016.jpg (1280x960x24b jpeg) '~ .> '$!!i' ... ~"'1 ~'-è~ - -. - -.--- -- ~ - BADRSFIELD FlU DUAATDH'l' __ ENVIROIGIIIfl'AL SDVI4 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-3979 TANK RDOVAL INSPECTION PORM ~=~!I~~Z:: w.J'ADD~~IT TO OP~TE' COlfl'RAC'l'OR~ P. <:1\ __(1 __~._ _ CONTACT PERSON - LABORATORY t OF SAMPLES TEST METHODOLOGY . PRELIMANARY ASSESSMENT CO.¡'::J.-C- CONTACT PERSON ¡l({ Mhl$l1N CO2 RECIEPT föfJ, (f1. (3rtr~_ LEL' -A- 02' ( t 2 PLOT PLAN 11 l' - f- I.. '- I. .... ~u~(. ~ ~ ~ 5 -. .... ~ ~ c- ... '" c-. ~'^~r Q ~ c5. --, c '.. ..! ... .......c ~ - - ,-I '-l f::¥ ,~ I I ~ \: Ij-r I ",I i ..(; .~ r - I- ':) IcE """J; ~ I I~ I r't!: I r~ I...J r r I~I I ~ r f~ I I L_ - -, - - OJG.J ~hQ~ CONDITION OF TANKsJJ~irl ~\,~Jf CONDITION OF PIPING I1l1~Ù~~(d CONDITION OF, SOIL ({m\"bil"/ßn~t< Vtt-1 t lJtt-~ S~\'Ot\f COMMENTS Orl~ 1" 3/~s/(J 3 DATE ...i-\-c ÙL () vJ. faJflf:'~/ INlPrCTOU NAIE Ji:; cØ4>f£J .u.A11III (~~ FEB 11 2003 12:20 ".../ ,BKSFLD FIRE PREVENTION (661)852-2172~~ p.2 - e PermJtNO·~()Ó() I CITY OF BAKERSFIELD ~ I OFFICE OF ENVIRONMENTAL SERVICES CG~ 1715 Chester Ave., Bakersfield, CA (661) 326-3979 PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK S~INFO : uI. ~AD RES I~l ~I'. R4 ZIP CODE rr;1()~APN FACILITYNAME ~~~~ CROSSSTIŒEr i'~ ~~ TANKOWNERlOPERATOR C· . . PHO NO. ~~ (f3:;-73LJ~ MAll..ING ADDRESS 7'D) /.Uk, '-e LH CITY /~ 'C.#.r . -e.1 ZIP 1'j'().r¡. CONTRACTOR INFOR:\1ATlON ~:"i~~:~\J=~~PHONEOO·c~. - ~ I~ENE~O ~I:~':,e INSURANCE CARRIER _ _lJt\~""(_ _ WORK.J.\ŒNS COM NO. W C· -3~~"2- PRELIMIN~~~EN ~1ATION ':"LG COMPA1'IY _,;.,... ._ _ _ PHS>NE'j9- g3'~Kc~o~-\t 4'"f.I.J ADDRESS --'-._____1:2~ -Þ-ID,,'"} CITY ~ ZIP ~'3'3 INSURANCE CARRIERSí~ U)v-. P WORKMENS COMP NO. - OL 08 ~ TANK TRANSPORTER INFORMA TIO~ COMPANY ~~ /JA ADDRESS TANK DESTINATION PHONE NO. CITY C::x.oLptaV 5íA-,~ YWCi?1AU - LICENSE NO. ZIP T AJ'liK INFORMATION TANK NO. l ~ AGE CHEMICAL DATES VOLUME STORED i€jTO ~~ððð_ ,~ I~~ - .~ 1"1., þ(!JC) Q. -" ð~ 1t.¡OODo - () t? CHEMICAL PREVIOUSLY STORED NðAJe NoAJe A}ðN.e- THE APPLICANT HAS RECEIVED, UNDERST ANDS, A.~D WILL COMPLY WITH THE A IT ACHED CONDIT IONS OF THIS PERMIT A. 'iD ANY OTHER ST ATE, LOCAL AND FEDERAL REGULATIONS, RY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE £;; C--WC t¿ 1Þ1 JI- - Úw50JJ THIS FO HAS BEEN COMP LETED UNDER PENALTY OF PE AND CO,t , CT. APPUCANTSIGNATL1Œ THIS APPLICATION WILL BECOME A PER:\1IT WHEN APPROVED FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSfON SERVICES 2101 oH· Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' ENVIIIOHMEHTAI. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAX (661) 326H0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326H0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-D576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 ;a . WI- February 3, 2003 Niagara Car Wash 1701 Stine Rd Bakersfield CA 93309 REMINDER NOTICE RE: Deadline for Dispenser Pan Requirements December 31,2003 Dear Underground Storage Tank Owner: / A Review of our files indicate that you have been receiving quarterly reminder notices since April of 2002. Effective January 2003, you can expect them monthly. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31, 2003. You will not be allowed to remain open after December 31, 2003 unless you have completed the upgrade requirement. Contractors are already scheduling work 6-8 weeks out. I urge you to start planning to retrofit your facility as soon as possible. Sincerely, A~ / ,I . / .' !! ,; Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~"Y~ de W~~ ~.A0Pe .r~ A W~p'" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395·1349 PREVENTION SERVICES FIRE SAFETY SERVICES. ENVIRONMENTAl. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 32e-D576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399·5763 - -- January 22, 2003 Niagara Car Wash 1701 StineRd Bakersfield CA 93309 RE: Upgrade Certificate & Fill Tags Dear Owner/Operator: Effective January 1,2003 Assembly Bill 2481 went into effect. This Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your window) and the blue fill tag on your fill. You may, if you wish, have them posted or remove them. Fuel vendors have been notified of this change and will not deny fuel deli very for missing tags or certificates. Should you have any questions, please feel free to call me at 661- 326-3190. Si2~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~"Y~de W~ ~ vØb0P6.r~ A W~'I'I FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "W 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· ENYIRONIlEHTAI. SElMCES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 PUBLIC EDUCATION 1715 Chester Avè. Bakersfield. CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 '- .~ January 13, 2003 Niagara Car Wash 1701 Stine Rd Bakersfield CA 93309 RE: Deadline for Dispenser Pan Requirements December 31. 2003 REMINDER NOTICE Dear Underground Storage TanIr Owner: A review of our files indicates that you have been receiving quarterly reminder notices since April of 2002. The purpose of this letter is to remind you of the necessary retrofit of your fueling system. Current code requires that you install dispenser pans prior to December 31,2003. I urge you to start planning to retrofit your facility as soon as possible. Should you have any questions, please feel free to contact me at 661- 326-3190. Sincer:l.,~ yifu~ Steve Underwood Fire InspectorlEnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~7~ de W~ ~ JØ60P6.r~ A W~" .'~ e e 8056870883 p.8 -" . f,~~C \/ 13 02 Q8:34a CCTT MONrrORJNG SYsrEM CERTIFICATION Før lbe By AU ./url8dIctioIu 1YìI1ún IN: SlIIIr: oI'Cøliføl"øIO .4U1bnrity Cited: C1ulptt!, ð.7. Health ond .~ty CðdJt: C"øplt:r J6, Dfp;sion}. Tide 2J. Cøl¡Jòmiø Code of ReglJoJi(1lJ$ 'Ibis form DUISC be used m documem tatia& 8Dd scrvic:inc øf IIIODitorin& equipmem. A --.e certj~.... or npxt musr: be J'I'IPiII'I!d Iòr each _if~ S)'Btem canDOJ Panel by rbe leCbøicìaa wba perfunns the work. A copy of this tbrm ~ be prÐvided to the 1UIk S)'SÞIm owacrlopcndor'. The owucr/øperator InU$I submk a copy ofrhis fiJnnl.o Ihc localagaK:y n:guJating US'J' sysÞ:aIS widún 30 days ottest ~. A. GeDerallJaformatioD Facility Name: to,) , At: &\&. A c~t. b.lAS.-ri Site Address: nOt ~wc.. 2',!) Facility Cant.:t Perwn: MakeIModeJ of Mani10riq System; b.1 '-II £.CL~ C- B. IDv_tory of EqDipRleat Tested1C.erdfied Oedcdlc_ te ......ID~. BidS. 'No.:._ _ City; "gClllc-. sÇl[.kI Zip: ~:\ '1 0 ~ CODtact Phone No.: ( L...., Ltnl..::,~ ,~_ Date ofT~ing: ...12./-!.LI~ . ' '"---=---¡."",;-" ._-"- .._"- Tau ID: ßI C ZD-TanJt ~ I'I'oœ. Q Aaaul.- SJIIICC or Vault Sensor. C Pip¡-. ~ ITn:øcb Sc:usIII(s). C FiU Sump SaaIor(s). Q Mecll8ø1cal Liœ Leak D&:reCror_ ~ Elearoa1c lJDe I.eIIk. Ddccror. ModeJ: T.ak ID: p.. ~ C 1ft. T*Ik (iauaiIIa Probe;. [J .AßnQI.. Space or V_It SaIsor. a Piping Sump I ,...;¡¡' ScmoI(s). Q FlU SUlllp Saaør(s). -.- e Mc:dJDicaÍ'1Jnc: t.çak DcœeøIr. Iiiil"""EI~c Liøe LCIIk òëiiiëtor. Modd; Model: Model: Model; Model: Model: Model: Model:~"'~C\'Ð - OÙ Model: Modc:J; Model: S~q-.fqø-oO D Tank OYClfiJlI Hidt-Levcl Sensor. Nodel: a Tl!'Jk ()wçrfiJ1/1fiSb-LcYd ~. Model: Q 0dIrz t t ... IDDCIeI in Sccaioft 6 OR T_1r ID: ~ \ a ID-TImk Gauàms Pn:Ibc. Model:' Q AnøuIør Spaœ at' Vault SåISor. Model: D Pi¡:Ii.. Sump I Tn:ac:h Seosor(s). M(1dcI: D Fill SaIDp Sasm(s). Nodel: D MecUniAll Liør I.aIIt Dèêector. Model: 5J'"E1ec:bniG Line Lc:ak DåKrør, Model: 84 ~~ C\o~ 00 [J Taak OVØfiR I Hiab-LPd Scnscw. Model: ...s model "' ScdiGn E CJD ,.. 2. Mock1: Q ÅaDuIar $pIçc« V..... Scasor. Model: o Pipill& sum; f T~ SaIsoI(s). WolIJol; Q FiJi Sump Sl:II$UI(s). Model: D Meéïiaøic:aJ I.me Lc:ak DcICCUlr. Modcl; D 0Ihcr 8IId IIIIIdd 'D SIICfÎca £ OD a E~ LiIIe Lc:M. Dcœcror. Model: [] TunIt Overfill I H".p..LeYd S_. Modcf: o ()cÌ¡er and..ad ÏII SQ;tjCJD £ ... Dispeuer 11): 2....- o Dispenser CcMUIIÏImIc:Itt SeasøI('). Model: Disp """wr I'D: 1 o DÌIo-pcnscr ~ Seasøo(s). I7"SJxar VaIw('). D - C'QSCI' CGDt:IÌIIIIICBt 1-1 s ¡wi DiII'-H'P JD: 3 __. a Di5peDSØ' CødaInmcaI Seftsor(S). Gl"šlaár Vlllve(S). D' CÐaraim:øc:Dt P10 Modd: Model: Model: Modd; ,~ e e i' Dee 13 a2 08:35a CCTT 8056870883 p.9 \..:. ' Certifïcatioa -I e.a1ify CUt eM eqllipnlellt ideatißed iD dII& ctecu.ctat _ i~'" ~ acmr.s- wö .... __lIfKhren* pldeliDes. .......... ...... CefI'~ iI ild'anMtiM (eo.. .............. cIIedrJIIu) MC f~" wrif7....... ¡nI....... II cwrect ..... PIoc.... *-iaz. "3'01It oI~ et:5df"P. ~ -.-w. .f.--tñr,s.... npII'Is. .'-" AIM ~ ,m.,. aJdac n¡tyt; (.eI.d ..... .....): ...up Q AlanD bIstoIy report TecJmic:iøn Nmae (priat): ..t C c..ho- (PJ.. ^ de.. SÏJpJIItIn:. _ CerûfiClldon No.: SS'~'t ~:J.ðd-f Liœnse. No.: q 1- \ \ ~~ TESting Company Name: "'l>"'~ 0.,'..1 Eo \:.~-\. PbQne No.;( AC ) SiIe AddJm:s: Dam ofTCSIÏDgIServìcing: . -¡,.. I ~ ..!!!!:-- MOIÛIOriII. System Cel"ti&ation f'acc 1 ....J GHI D. Results of TesdDglServi~ÌJlg Software Vasion 1DstaI1cd: ...¡ ,~~_.._ - Uac 1'aIIøw'-- d--'~ . EI Yes a No· ts Che audible af8rm~aaaJ? a Yes ŒNo· Is die visøaI alum eyes C No* w~ all SCDSOJ'S . . and Cóutbauo;d oDtDltiooal? CJ Yes C No* WCR aU SCIISOfS iDsraUed 81: lowest pojat of secoadaa-r conlainmcot: I11III poIIitivrIod so daat odacr eqaipcøeat wìlf not iaterfeœ widl their - oDl!nltima? CI Vas C No- II aJmDs are ~ fD a remote IIIOIIÎforiDg sation, is an COIJDIIUIIjcatïoøs equipment (e-s. modcaI) a NlA o.pc:nIIioœJ'1 eyes C No· For pressurized pipiø. systems, does Ihc a.tIiDe autmnaôcaJJy sImt down if the piping seeGIMIary CØl'lClÚIIINIIC 1:1 N/A mønilDring sysœm deœcIs a ... fi1iIs fØ øprnde. or is clcclriœr1y cIïsamneacd'l .ryes: whkb SCUIIOI'5 ÛÙIi* po$Ïtiw shuI-dØ'D7 (CJœ&k a// IhøI tI1Ñy) D SwbpITnnch SeDsms¡ D Dispeøser CoIu8iøment Sensurs. Did ~ COnIina positive sbut-down due to ladcsJD.d SCDSor fåilureld¡:SI"'CIn~' a Yes; a No. aves D No· For taDk s,yaœms drat utiIi2c the moui1øriag 8)'SIMIl a$ tho FrimuY tIDt overfill warning deYice (i.Co DO D NIA III~~=~ owafiII pnrweatÏoa ~ is iDaCaDed). Ì$1be overfill W8rDÏng =alarm visible and aadibJe . cbc caøIt fi]J . s aød" If so. at what nerœut oflaak . does 1het Blann tri..-? " OYC:S- DNa Wu ¡my IDOJÚbIiriIIJ eqwpmeat RpIaced7 Jtya. idIIntifY specific ~ pobes. or øabcr equipment rcpr.:ed and list Che JIIIDUfàauR:r øame ønd model for at! . ----'in Scàiøa Ii. below. DY~ aND Was ~uid fiNmd ias.ide 8IQ' sa:ondIry QIIIbti- S)'BbIms dcsipcd as dry £Y*ms? (Omc.t aJI tIIØI ttppIy) D 0 Wata'. Jf~ deScribe cmses ÍA Sectioli It. below. a Yes aN~ Was . . sct--:Uø'rewiI=wed 10 emøn: . . AIIacb scr if . DYes CJ No- .Is aD rnønitorile . . .....~·s ..........fic:aIioas? · Ja Secdaa E beIDtr. 4feserlk"'''' and ..... tIacsc ddldellCiel ~ or will be CÐI'~ I!'. Co.mag; &....,-~"'-~ bJ lb _ðA...t.. '-J"~O~ :J bc..\b~ -.- ......-.- --- ___M -- .... 2 aU GVI Ii e e '" Dee 13 02 08:35a CCTT 8056870883 p.10 ... œ . d "ltI.10.1 F. In-Tank Gaugieg I SIR Equipmeat: C Check Ibm box iflank &8ugÙ)g is used only Coe inventory cun1roT. a Chec:k tIW; hox ifno:Qnk GlU3ing or ~IR eQU;pß1~t if¡ instalJed. This set."tÌan must be completed if in-tank gauging equipment is used to perform leak detection m"nitoring. Com .. _ roDowla cIrcckJìsI IDI Ig, ; Q Yes I:J No. Has aD iaput wiring beea inspected Cor proper enIIy and œnnlna1Ï011. including œstiQg Cor II'UUrId faub? I;;J Yes [] No· Weæ all Cant £ólU8in.c prob,,'S visually inspected fOl' damage and ncsidqe buildup? o Ye.o¡ Q No· Was iICQU1Icy of s.ymm pmduct level read. tcsIed? C Yes C No· Was tll:c::W'IICy of s,ys1erD water leve' ~p t.c:staI? a Yes [J No- Were aU probes ~Jr:d properly? C Yes c:J No· Were: aU ÏfIJm!I ()I' the equipmcm manu&dura-'s maiMcDance chcckJi!ot complesed? . . . it ID rile Sectio.. H, below. describe bow ...et w~. t._ cleðdeDClCS wcn: or ..0 be .correQed. G. Line Leak Detectors (LLD): I:] Cha:k thiR box ifLJ.Ds arc no! installod. c be 0JI0 heddist: 'OIDØIcte t Ii Iriøz ~ . Q Yes (J No· I:or cqUÎpmmt start-up or atUlUaJ equipmcm œni8catioa, W".c; a leak llÏmilfated to vail). . J.o perfonaem;ç? [J NIA (Check. tJ( IhoJ apply) Simulated leak ratt. I:] 3 g.p....; U 0.1 g.p.h; Q 0.2 ~p.h. a Yes C No- Wert; aD l.LDs cooffnnod opcr.ticmal and 8CC4IraIe within n:gulatory requin:mcnts? IJ Yes CJ No· Was the restiug IIppIIndUs pvperIy eaJibratcd1 [] y~ IJ No· For mcc:banicaJ LLDs. docs the (.I J) resuic:1 pocb:t flow if il detc:cts a IeaJc? C NlA [J Ve.<r UNo· For dectronic I J~Ds. does Ihe lcarbine autnmatfc:ally shut olf ifrhe LLv dctccls a leak? (] NlA (J Yes o No· For clearouic 1J.Ds. docs the IUrbine iIIIIOmDlicaUy sInn nff ifazay portion of'the munitariDs I'yste,m i$ disabled. e N/A or discoonCd.c:d? t:J Yos ¡;;¡~ For electrOnic LLDs, docs &he turb~ atltOOlldafy shut off if any portion o( dJe IJlouiluriag sysœœ U N/A ~Ifunctions or fail$ a tesI'/ U Yes Q Nu· For erec:rronic LLDIt, l1ave aU accessible wiring connecdons bçcn vi511idly inspc:ctcd? U N/A o Yes a 'No" Wen: all iœrus Oft die equipmelrt manufac:curcr'a mainIIertance cbCI:ldist ~ed? . . . . . . '" In 'be SectIOll .... llelow. describe !low and -bat tbae deliaeftaes wen: os- will be COf"ru:tcd. ff. Comments: .---. - .----..- - .- --"-- .---. ---"--"-- .- '- -...- -.. -. --- - ..-..--""'"-" .... '--..-. 'o. "'- .-.-. --'---- --....-.. ',þ..- -.----." .-..-----.-. ---. . --. ---.- '--"'--'-- .. .-.--. -.... "--"..- ..---- . "0_.- "__ __ --"- -_. --"'-'---.. ..-.- -..--. .. .---.. '-',.-..---...- ---.- --.. .. --. --". -. --.-..-. .'-.-. ~3ðf3 Cl.JlÐJ ... ... . a.. (I) (X (X o e~ If) o (X e~ u u ~J?~1,W :1~'O~~i~ :J~~~. r:! :i;~~: i~~f;;:t..~'J:i;r-¡'.':;i'~r~ f~í;!f\!: f.~~: f~;,: f~;." f'~\·~'.f.ú: fYf~ 0:: Jl,YWi!·!t': \ ~y . . ", ....... '.. . .. , (":'~ ::,': V S'::' ~ .~: . . ,'.:. :-...'; .... III co (I) .. (X o (IJ o (I) :~ ". . ... .. .. , VEEDER-ROOT Certificate of Completion Hector Galindo lias compfetd tIie Level 4 course of i1k5troction in tIie i1k5taffation of o/eeáer- 9Wot USf[ MÐnitoring Systems !Date September 28. 2001 Patrick W. Schoen Field Serviel Marul8" P~W..~ :. ------ . . u Q c:I R( n: ~ I? C\J .... . Q.. (I' CXI CXI o e~ \I) o CXI e:: u u Q CD (I' .. CXI 0 C\J eJ (I) .... U Q ~ .. .~ .. 0.0&..... ý'y '., Dee 13 02 12:34p CCTT U~~ !~ ~uu~ ~:~~ ø~~rLU r!~t ~K~Vtnl!Un ~' ~~~ 8056870883 ltJlþl I U;)C:;-C:; 1 (Co p.3 p.Co . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO PERFORM FUEL MONITORJNG CERTIFICATION FACIUTY N \Q~ ADDRESS l Î 0 ~l~E Q r~ , ~{J. ~{¡À...c,.-f1:.pjd . OPEllATORS NAME ~ LÙ \ ö OWNERS NAME StLW\ NAME OF MONITOR. MANUFACTURER~ eF.~ ~ DOES FAClIJTY HA VB DISPENSea PANS? YEs_ NO_ ( TANK. t 2 ~ VOLUME CONTENTS ~~ ~ ~ ~~ -3-\ 1f1ß;. Central Coast Tank Testing Post Office Box 2155 Santa Barbara. CA 93120 NAME OF TESTING COMPANY \"¡ l 'Õ . o-f- ~~ CONTRACTORS UCENSE #---9.l.::llIol1 NAME & PHONE NUMBER OF CONTACT PERSON. \\, ~v (')[j.\ tvvl D I R.. ~ DATE &: TIME TEST IS TO BE CONDUCTED~ 0"4- .ft~ I _Ju ddr;{) ( APPROVED BY ~J, / IJ'z DATE ££~ANT Dee 11 02 01:44p CCTT - t.. \ I'\~ -r.e.~t. - q B f.v-c; . í~U/ '<'/ -- N ð617 --- --.-.- ..- ;'Á- 8056870883 - p.3 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave.. Bakersfield, CA (661) 326-3979 ( APPUCATION TO PERFORM A TANK TIGHTNESS TEST FACIUIY--.-h\ \ A-('JA12 A r.J8:iè- vJ \Ö6tt- ~ 3 ADDRESS....lJ 0 \ ~ \ N F Rx). PBRMrr TO OPERATE # t ()#-- 333 OPERATORS NAME OWl'l"BRS NAME NUMBER OFTANJ(S TO BE TESTED :3 TANK # VOLUME I "2- ~ IS PIPING GOING TO BE T.ES11ID~ CONTENTs <;<1 <Bj Dt\ TANK. TBST1NGCOMPANY t, E.t\.\l'"RJofrt._r t)~T~~~T) tJ (..., MAILING ADDRESS Po ~Y... 2\~5 ~ ~J?rC'M 3~\'Z..o NAME &:PHO~"'B NUMBER OF CONTACT PERSON ~L)~ ~KHM.<)^~ ~'Io g1· fold-tö TEST METHOD YS""f: '¿OO~ 1- V€..;T,t5f,~ NAME OFTBSTER~Q:r~ÑKç ÑM~ CER.TlFlCATtON# lAST =- -:sf. .9 I - I I (oct 4-- P'r -=- Ó .t::16ïGf L , "2. "2.,"2.... DATE & TIME TEST IS TOBECONDUCTlID \1)Q.Dt,~ DeL q-tt\ ) biJtvflfY} . 'R¡~ 1'2./r3 4- ~ l"J;/!) . J ~_ ~ CDI't-hWeod- CV\ prCÓJ)c\- dL-lì lÆ1.Jo ~ ~ ~ tv/{{ /a-z- S(J? â~ /+-. 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'" "'.ii· .' . e .' , . .' l e e Nov 27 02 02:24p Anthon~ Hazelwood 510-758-7172 p.7 RECTIFIER BI-MONTHLY OBSERVATION REPORT RECTIFIER SER. NO.: 98008 RECTlRER LOCATION: ON EAST WALL IN EQUIPMENT ROOM HOURIo1ETeRCIF REQUIRED READING DAtE VOLTAGE CURRENT lAMPS) APPlJCABLEI INITIAL COMMENTS 1112312002 46.8 2.01 34962/1 TORY Hazelwood C()IIPLJANCe INSPeCTION P£RFORMEO 112312003 3/23/2003 512312003 7/2312003 912312003 1112312003 ANNUAL INSPEC110N DUE 1/2312004 312312004 5123/2004 712312004 9/2312004 11/2312004 ANNUAL INSPECTION DUE 112312005 3123/2005 5/23/2005 7/2312005 912312005 11/2312005 3~YEAR INSPECTION DUE -RECTIFIER TO REMAIN ON AT ALL 11MES -- DO NOT TURN RECTIFIER OFF AT NIGHT-- -THIS FORM TO REMAIN IN THE RECTIFIER DOOR PANEL- --FOR SYSTEM REPAIR OR MAINTENANCE, CALL CORROSION SPECIALISTS AT (510)867-4108 · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1, Article Addressed to: JULIO SICAL NIAGARA CAR WASH #3 1701 STINE ROAD BAKERSFIELD CA 93309 _.' C, Date:?ery D, Is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No '\ I I I I I I I I I I 102595'02'M'0835 3. Service Type o Certified Mail q Registered O· Insured Mail o Express Mail o Return. Receip.t fó( Mèrchandise '0 C.O,D. ,p , ~-=-~ .----'-~-- ----='-- .~.'~ .-----.-/ o Yes n A.....:....I.... "'111......"hor ! 7002 08bO PS Form 3811, August 2001 4, Restricted Delivery? (Extra Fee) 0000 1b41.519b uomesu(.; nt;llUll1 ne\.l'C';';! UNITED STATES POSTAL SERVICE First·Class Mail , Postage & Fees Paid USPS Permit No. G-10 e '-- sand ZIP+4 in this box · · Sender~Please print your name, add res , \,,} BAKERSFIELD ARE DEPARTMENT OFFICE OF ENViRONMENTAL SERVICES 1715 Chester Avenue, Same 3ûO BfeJ/te:-~1ietd, CA 93301 :1 \.'$ II I II II 11111111"11111,,1111111111111111111'1'11'1111 1 till III 1 o , 0 . 0 o '0 : ...c , o:Q ,0 Postage $ Certified Fee Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endonlement Required) Total Postmark Here :ru '0 , 0 Sent To , f'- š;;ëëi,"Ä or PO 81 CIty. Bfal JULIO SICAL NIAGARA CAR WASH #3 1701 STINE ROAD BAKERSFIELD CA 93309 :.. .. 'I ~ . FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES· ENVIRONMENTAl. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAJ( (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326·3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 e .~ .. '';'''-~ ,,~ ;~, ~ ' '.' December 2, 2002 Julio Sical Niagara Car Wash #3 1701 Stine Road Bakersfield, CA 93309 CERTIFIED MAIL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to SubmitlPerfonn Annual Maintenance on Leak Detection System Dear Underground Storage Tank Owner: Our records indicate that your annual maintenance certification on your leak detection system was past due on September 14, 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, January 3, 2003 to either perfonn or submit your annual certification to this office. Failure to comply will result in revocation of your pennit 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 bY~~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Porr Jr., Assistant City Attorney ~"7~ de W~ ~ ~0P6.r~ A W~" 7 ( ( ( -- -/.-i{L{(P ~J Jit- o l 00 ({J 1'--1 IjCj e CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICATION TO INSTALL AND/OR REMOVE ABOVE GROUND STORAGE TANK(S) In conformity with provisions of pertinent ordinances, codes and/or regulations, permission is hereby granted to: A~I1'~aR A LAIL~S\4 \ìöl SïE-'L.l£' K~. Name of Company Address to display, store, install, use, operate, sell or handle materials or process involving or creating conditions deemed hazardous to life or property as follows: ·l~~Tt=\L,;L (I) l-(9<ï <:qPc-t.-L..Ot..J. A-i~k)\) ~ ~(U)(.)uo PI2Þ~IT.A...'e. \A\.I.t~ -FoCL D~peu~\ L..l~ .fûE..L-. subject to the provisions and/or limitations as provided. Violation of pertinent ordinances, codes and/or regulations shall void this permit. /iO Perm~ 0rç() L- Date ~rlßuno Approved by: U" V4. mE- SLL Applicant Name (print) e THIS APPLICATION BECOMES A PERMIT WHEN APPROVED · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1, Article Addressed to: NIAGARA CAR WASH 1701 STINE RD BAKERSFIELD CA 93309 t) ^....i,...I'" 11............"''''.. D, Is delivery address different from item 1? ¡SO ."" d,';,." "Jd_, ""~ 3. Service Type ¡JCertified Mail o Registered o Insured Mail o Agent o Addressee C. Date of Delivery /OZZ DYes o No o Express Mail o Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) 7002 0860 0000 1641 7251 Domestic Return Receipt PS Form 3811, August 2001 I I I I 102595'02'M'08351 I DYes UNITED STATES POSTAL SERVICE . First-Class Mail Postage & Fees Paid USPS Permit No. G-10 · Sender: Please print your nam-è, address, and ZIP+4 in this box · BAKERSFIELD ARE DEPARTMENT Of-F~CE OF ENVIRONMENTAL SERVICES 17~5 Ch~s~er Avenue, Suite 300 B~ksrsfleld., CA 93301 ----------~,- --- ...=I U.s. Postal Service U" CERTJMFD MAIL RECEIPT ~ (Dom. Mail Only; No Insurance Coverage Provided) '...=I , ::r ,..[ ,...=I o '0 ,0 :0 :0 , ..[ jet:) ;0 '- Postage $ --... Certified Fee Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Poatage & Feea $ Postmar1< Here , ru '0 ,0 SentTo I"- NIAGARA CAR WASH ši;ëë;;Äjji.ïiõ:¡-....···..········..·..······...···..······..·..···.......................... or PO Box No. 1701 STINE RD ëiiÿ;s;šië,·žiÏ>;;;·························....···········................................... BAKERSFIELD CA 93309 PS Form 3800, April 2002 See Reverse for Instructions ._~ FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 'W Street Bakersfield. CA 93301 VOICE (661) 326·3941 FAX (661) 395·1349 PREVENTION SERVICES FIRE SMID SER'I1CES . ENVIAOIIMENTAL SER'I1CES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX(661)32G.0576 PUBLIC EDUCATION 1715 Chester Avè. Bakersfield. CA 93301 VOICE (661) 326-3696 FAJ( (661) 32G.0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAJ( (661) 32G.0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 . . '~ ... .-. ...,.., October 21, 2002 Niagara Car Wash 1701 Stine Road Bakersfield, CA 93309 CERTIFIED MAn. NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to SubmitlPerfonn Annual Maintenance on Leak Detection System Dear Underground Storage Tank Owner: Our records indicate that your annual maintenance certification on your leak detection system was past due on September 14, 2002. You are currently in violation of Section 2641(1) 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, November 21,2002, to either perfonn 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 by: J_ I'IIl /"\ ~~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Porr Jr., Assistant City Attorney ""7~ de W~ ~.A0P6.r~ .A W~.,' FIRE CHIEF RON ¡::RAZE ADMINISTRATIVE SERVICES 2101 'W Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFElY SERVICES· ENYIROHIlElrTAI. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326H)576 PUBLIC EDUCATION 1715 Chester Avè. Bakersfield, CA 93301 VOICE (661) 326·3696 FAJ( (661) 326H)576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-<>576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 ~. . September 30, 2002 Niagara Car Wash 1701 Stine Road Bakersfield CA 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1,2002. This bill requires dispenser pans under fuel pump dispensers. On December 31,2003 which is the deadline for compliance, this office will be forced to revoke your Permit to Operate, for failure to comply with the regulations. It is the hope of this office that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326- 3190. Sincerel-- ~ Ste~rwood Fire Inspector/ Environmental Code Enforcement Officer Office of Environmental Services SBU/dc ~"7~ de W~ STop .A0P6 .rbt- A W~" e - CITY OF BAKERSFIEIJD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd .loor, Bakersfield, CA 93301 FACILITY NAME Nt~~:: i£ (JJo..J..... ADDRESS (, () t 5 FACILITY CONTACT INSPECTION TIME INSPECTION DATE 119 ~ J ~O 1..- PHONE NO.~'" ìqc¡g BUSINESS 10 NO. 15-210- NUMBER OF EMPLOYEES 50 Section I: Business Plan and Inventory Program o Routine IS£1 Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate peonit on hand \... / Business plan contact infoonation accurate \... / Visible address \.... / Correct occupancy v V Veri fication of inventory materials L.. V Verification of quantities L V Verification of location Iv V Proper segregation of material L V Verification of MSDS availability V V Verification of Haz Mat training L- V Veri fication of abatement supplies and procedures 1\ V Emergency procedures adequate :L V Containers properly labeled L V .. . Housekeeping I\) Ii t<.O f Jt r4-c! Fire Protection L V Site Diagram Adequate & On Hand 1/ C=Compliance V=Violation White - Env, Svcs. . Pink· Business Copy Any ~azarJloJls waste qn site?: r 19 ~s 0 No Explam:--.b~lAL ÛJo. ~jL 04: ð.. () \ l Questions regarding this inspection? Please call us at (661) 326-3979 Yellow· Station Copy Inspector: - CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME Nld.qClf'tì\.... ~(b II' W()..~ INSPECTION DATE 10 ~r:J~()L Section 2: Underground Storage Tanks Program o Routine cl Combined 0 Joint Agency Type of Tank ,'1l1JL (é., e') Type of Monitoring f\Tb o Multi-Agency 0 Complaint Number of Tanks 3 Type of Piping 6W.5 C c. p ) ORe-inspection OPERA nON c v COMMENTS Proper tank data on tile I V Proper owner/operator data on tile t y Pennit fees current L ,/' Certification of Financial Responsibility l / Monitoring record adequate and current l- / Maintenance records adequate and current \ / Failure to correct prior UST violations '- /' Has there been an unauthorized release? Yes No l.-/ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA nON Y N COMMENTS SPCC available SPCC on fiJe with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfiJl/overspiIl protection? Pink - Business Copy C"COmPIi'~ V~V;o],t;oo y~y" ]05p"tO"" ~ Office of Environmental Services (805) 326-3979 White - Env, Sves. N=NO FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 ·W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 "H. Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERYlCES· EIMAOHIIEIfrAL SERYICD 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 PUBUC EDUCATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAJ( (661) ~76 TRAINING DIVISION 5642 VIctor Ave. Bakersfleld, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 . - August 1, 2002 Sam Siam Niagara Car Wash 12424 Wilshire Blvd Los Angeles. CA 90025 CERTIFIED MAIL Re: Failure to Perform or Submit Three Year Cathodic Protection Certification NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Dear Customer: According to our records, your three year Cathodic Protection Certification is due on August 7, 2002. Failure to comply is a violation of section 2635 2(a) Failure to Perform/Submit Cathodic Protection Testing results. Section 2635 2(a) is as follows: "Field-installed cathodic protection systems shall be designed and certified as adequate by a corrosion specialist. The cathodic protection systems shall be tested by a cathodic protection tester within six months of installation and at least every ~ ~ thereafter." The cathodic protection is part of your leak detection system and is a condition of your Permit to Operate. Therefore, prior to August 30, 2002, you shall either perform or submit evidence of cathodic protection testing. Failure to comply will result in revocation of your Permit to Operate. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph E. Huey Director of Prevention Services B~ rf££ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services ""7~~ W~ ~.A~.r~ A W~" . e r. ",4""' , SUO!}:>OJ}SUI JOI aSJa^al::l aas ~00ë:: ÁJenuer '008& WJO~ Sd ÇZ006 V~ Sl['líI~NV S<}1.dIZ 'Bas 'Æt:J ..,J .......... ......... ...m ......................... ............. ........... .............. ........ g «A'UI IDIIHS'IIð t¡Zt¡Zl~":.~:'~~J:; t:-' m..·..···....·.....·...··..·············...··....····....mŠ·..wv:Š··..·....·.....m c:J 0.lluas UJ a- t¡ 6 . t $ saa:! 'B a6¡qsod IBI0.L c:J (pa.I!nba!: luaweSJopu3) c:J aad ÁJa^!lao pal:>\JI""1:! c:J (pa.I!nba!: luew9SJopu3) c:J aad Id!e:>e!: wn¡e!: ru ae:! pall!Ja::> eJeH IµSWISOd 0Ç"1 U1 ru .¡: .¡: ..,J c:J t:-' CÞ -----~-~------- -------" ENDER: COMPLETE THIS SECTION · 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. · Attach this card to the back of the mailpiece. or on the front if space permits. 1. Article Addressed to: A. Received by (please Print Cfearly) tt;7 A D. Is de/Iv address different from Item 1? If YES, enter delivery address below: o Agent o Addressee DYes DNa x SAtiSIAK NIA~: CAR WASH 12424 WILSHIRE BLVD 1.( flGELES CA 90025 ~i: , "I,. ':":. ~ 3. Service Type Bcertified Mail 0 Express Mall o Registered 0 Retum Receipt for Merchandise o Insured Mail 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 7001 0360 0002 5244 7018 '8 Form 3811. July 1999 Domestic Return Receipt 102595·00·M·0952 ~, ~ J. ':, CITY OF BAKERSFIEr..a~ "" FICE OF ENVIRONl\'IENTAmERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 e UNDERGROUND STORAGE TANKS - UST FACILITY rYPE OF ACTION I C~8ck on" ,I"m only} o I NEW SITE PERMIT o J. RENEWAL PERMIT o 4. AMENDED PERMIT o S. CHANGE OF INFORMATION (Speedy Cf>8nge' local uS" only) o 6, TEMPORARY SITE CLOSURE I. FACILITY I SITE INFORMATION 3 FACILITY 10 II 401. FACILITY OWNER TYPE IiJ-"í.' CORPORATION o 2. INDIVIDUAL o 3. PARTNERSHIP 1. GAS ST A T10N o 2. DISTRIBUTOR TOTAL NUMBER OF TANKS REMAINING AT SITE o 3. FARM 0 5. COMMERCIAL o 4. PROCESSOR 0 6. OTHER 403. " r8Ci1ity on indian Reeetvation or " owner dUST a public agency: name d SUpeMsor d 1NIdands? division. section or oIIIœ which oøerates tile UST. (This is the c:onlaCl pet10ll ror!he lank recordS.) 404. o Yes ~ 405. II. PROPERTY OWNER INFORMATION 410. o 2. INDIVIDUAL o 3. PARTNERSHIP o 4. LoèAL AGENCY I DISTRICT o 5. COUNTY AGENCY 414. ~;o-4tl- 2~' III. TANK OWNER INFORMATION 411, ST~ ~RPORATION o 2. INDIVIDUAL o 3. PARTNERSHIP o 4. LOCAL AGENCY I DISTRICT o 5. COUNTY AGENCY TV (TK) HQ rv. BOARD OF EQUALlZATlONUST STORAGE FEE ACCOUN1"~UMBER Call (916) 322-9669 if questions arise V. PETROLEUM UST FINANCIAL RESPONSIBILITY , I ¡INDICATE METHOO(S) o 1. SELF-INSURED o 2. GUARANTEE o 3. INSURANCE o 4. SURETY BOND o 5. LETTER OF CREDIT o 6. EXEMPTION o 7. STATE FUND ~ STATE FUND & CFO LETTER 09. STATE FUND&CO I: Page _ of o 7 PERMANENTLY CLOSED SITE o 8. rANK REMOVED 400. o 4. LOCAL AGENCYIDISTRICT' o S, COUNTY AGENCY" o 6. STATE AGENCY" o 7. FEDERAL AGENCY" 402. 406. 407. PHONE 408. 3\.D-44L- \2~ 409. ZIP CODE Ü\OD2~ 412. o 6. STATE AGENCY o 7. FEDERAL AGENCY 413. 416. 418. ZIP CODE C1lD2.-s 419. o 6. STATE AGENCY o 7. FEDERALAGENCY 420. 421. o 10. LOCAL GOVT MECHANISM o 99, OTHER: , I I VI. LEGAL NOTIFICATION AND MAILING ADDRESS 422. Cheel< on" box 10 indlc:at" which address s/IoUId be usecI !or leg81 notiIIcations and mailing. Legal notiftcations and mailings wiD be sent to !he tank ONnfJI unless box 1 or 2 is checked. o ,. FACILITY o 3. TANK OWNER 423. '$ 2. PROPERTY OWNER VII. APPLICANT SIGNATURE DATE "1 \ 2~\DL TITLE ~APPI... ICANT vBO 426. 424. PHONE , Ù \D- 44-'1- \ L:: 425. 427. 429'1 428. I 1998 UPGRADE CERTIFICATE NUMBER (For local usa only) I STATE UST FACILITY NUMBER (For toQ/ usa only) UPCF (7/99) S:\CUPAFORMS\swrcb-a.wpd ~(.¡.~- . .' '". , !..'~ '-- .-. --- CITY OF BAKERSFIELD O.CE OF ENVIRONMENTA.RVICES 1115 Chester Ave., Bakersfield, CA 93301 (661) 326-3919 UNDERGROUND STORAGE TANKS· TANK PAGE 1 i o S. CHAHOe 01' IHFOAMA TION) ". o S. TEMPORARY "T! CLOSORt! Or. PEIUoWENTI. Y CLOSED ON SITe OS. TANKRt!MOVEO t1I rv",!: OF .CTIOH , C.,..,. J'" ,_ (JIfIy o I. H&t SIT! ~T 0 .. AM!NCIO PEAMlT o J. Rt!NlWAI. PeIUMT (Sø«q CNI9I . fIN IOcM .... (JIfIy) (Sø«q,.." . fIN IOcM "H ~ AOOOIO~ I I LTANKDI!SCRIPT1OH CO~AAnENTAl.IZED TANI< 0 Y.. 8-No " "Y.... com.. one øaoe for NCtI ~oartment. NU I (jti) 4;: .. TANK CONT!IfIW NTAOU!UM TYPe ~ IWGU.MUN.!AOEO D 2. WDED CJ 111. ......... UN.JW)EO D 3. 0ESa. CJ 1Co ..xJfWIE tNEAOED D c. GASOHOl COIAIOH HAM!! jIIIIm ~ .....,. *-IDty f»Øe) TANK use ¡g..(" MOTOR vecu AIel. ! (If _"*- ..... PItaIIum 7P) I 0 2. NOH-I'\IEL ÆTROl.EUM : 0 3. CHEMICA&. PAOOUCT ! 0 .. HAZNtCOUS WASTe (1IIcIIIdu , U.-d 01) i 0 95. uNCNOWN ¡ T'V1"E Of' TANK I (CINeJl_'" oNy , T ANI( W. TI!I'IIAL . IftII8Iy link , (CINeJl_." ody) .. 4- D s. .lET FUa (J .. AVIATION FUEl. o ft. OTHER CAS"(fIvm~~~f»Øe) ... 441 G(A1ò~ G1':' IINCU WALL o 2. 00U8U! WALL o 1. BAAl! STEEL o 2. STMUSS ST!Ð. : T ANI( W. TERIAI. . -*Y link [jJ'( BAAl! srea I (CINeJl_... oNy . 0 z. STMUSS ST&L. o 1. awurACTURI!D CATHOOIC PAOT!CTION o 2. SACIW1CW. AHOOe YEAR INSTAU.£O 450 TYPE (F<¡, IOUIIM odyJ o 1. SPILL CONTAMENT o 2. DROP ruee o 3. STRIIœft Pl.ATI ::r:>;~". ~iiM: ~~:,~,r· '.': ':··:G~i':::~:./~,~}r\,,· . ::.IVi:"~ LIAIC IF SIHOLI WAU. TANK (CItedt II "*1IJt1I1J: o I. VISUAL(IXPOIIDPOfmONON.'I') 8-{ AUTOMATIC TANK QAUQINQ (ATO) o J. COHTINUOU'ATO 0.. ST"TtSTICALItNWHTORYAlCOHCIUATION(SIR). III!HNIAI. T AHIC T'IITINO TAN< INTEAIOR IJNNJ OA COATINO (Ch.cJc _1ettI oNy SPILL ANO oveRFill. (Check ~II1YII{JþIyJ r-' D s. MAHUAI. TANI< OAUGINO (MfO) D .. VADOse ZONe o 7. GROUNDWATeR a.. TAN< TUTINO a II. OTHI!A Y. TANK CLOIUIU IN'ORMA TIOH I PIJUlAHIHT C&.OIURIIN PLACII U1WATIO QUNfflTV 01 SUIITAHCI fW,4A1NØa 4M TANI< FIlLIO WITH INIRT MATIAIAU a 1. AUIII!R UNI!D o Z. AUC'tD L...cI aSTIMA Tro OA TI LAIT utIO (YfWotOIDA'I') UPCF (7m) - ~00l0 - GlV-q .. TANK CONSTRUCTION o 3. SNJLS WALL Wf1'H EXTERIOR ~ L.IÐt o ... SINOU! WALL .. A VAUlT o 3. FI8EROLASS t PlASTIC o 4. STI!EL ClAD VWI8EJtGtASS ROFORœD PlASTIC fFRPI D 3. FI8EAOlASS t PlASTIC D ... STEEL ClAD WIt'1IERGI.A8S AElNFOAŒO PlASTIC (FRP) D s. CiONCÆTE o J. EPOXY IJNNJ o 4. PH!NOUC LN«3 o s. SINGlE WALL WITH IHrEfIHAL IIt.ADOI!R S't'STBt o IllS. UNKNOWN o ft. <mER Os.~ O~~ o .. FRP COfoIPAT18le W10cn6 t.ETHANOt. 0 SII. OTHER .... 4CJ D .. FRP COfoIPAT18U! W10cn6 t.ETHANOt. o .. FRP NQN.QORROOIIIU! JACKET o 10. COATED STEEL a IllS. UNI<NOWN o QII. <mER 445 .... MT! INSTAU.ED 447 a 50 QLAI8 LINNJ e--a:-'~ o ~ UNKNOWN 011. 0'ntER beM_ DATE IHSTAU.ED 449 D 3. FIIÐtGlASS R!NOACeD PI.AITIC 0 IllS. UNKNOWN o 4. M'Af!SSEO CUM£NT CJ II. OTHER .... (For beMlIM odyJ 451 OVERFill. PROTECTION EQUIPMENT: YEAR INSTAU.ED 452 o 1. ALARM 03. FILL TUBe SHUT OFF VAL'Æ _ o 2. BAU. Ft.OA T 0 4. I!XS4PT 467 ....... Dv.. DNo S;\CUPAPORMs\sWRcs.e·wPO t . '(¿ ,~ Œf1 " t , i CITY OF BAKERSFIELD . OfIII1CI OfIINVIRONMEHTAl SERVIC___ .115 Chnter Aft., "k.nfleld, CA '3301 (ee1)~19 UIT . TANIc ~AGI! ,. - d VI. PIPIIO CONI'TRUCTICIN (CMcII " filii' ~ -- UNOI!AOAOuNO PlPINO ¡ SYSTEM I"fPE ,...,~ a 0 I 0 lid'" I '""USURI! Zo SUCTION Jo OAAVITY 454 ,. PRESSURE CONSTRUCTION!' aJ.< 51NCL.! WAll. a J. uHEO TRffiICH 0 et. OTHER 480 0 1. SINGLE WAL~ ,IoIANUFACTI;RER10 Z. OOUIII.I! WALL a M. uNKNOWN 0 2. OOUBLE WAL~ I MANUFACTURER 481 MAHtJFACTURER ,0 " 8AR2 STeEL a I. FRP COW'ATa.!.... 100110 Ioot!n4ANOL 0 t. BARE STEEL :MATERIALSANO'O Z. STAINU!SSST1!EL 070 (W.VAHlZEDSTEB. 0 Z. STAIHlESSSTEEL i CORROSION . , ,""OTECTIONO J. ~c COMPA11IU! WITH CONTENTS 0 M. UNICHOWN 0 J. PlASTIC COMPATIBU; WITH CONTENTS : E(.o FJ8ERGL4SS a .. FL2XI1IL! (HOPE) a ft. O'n4ER 0 .0 FIBERGlASS o S. STEEL WI COA TlNO a 9. CATHOOIC PROTECT1OH .... 0 S. STEEL WI COATING VI. PIlING L!AIC DeTECT10N (Chedt" """ WlYJ -,' '..::;~'~; a 1. FLOAT AECHANISM THAT SHUTS OFf' stEAR VALve a 2. CONTINUOU8 0ISPEHSeR PAN SINIOR . AUDI8U! AHO VISUAL AI..AAMS o 3. CONTINUOUS 0IIÆNSeR PAN SINIIOR mntAUTO SHUT OFF FOR DISPENSER · AUDIBU; ANa VISUAL AlARMS IX. OWNIRIOPERA TOR SIONA 1URI! 8IIOn ØftMCIed ......... 18 true ~ 10 IN NIt III my 1IncMIede. O'NNEAJOPeRATO UÞÐERGROUHO PIPING I PRESSURIZED PlPlNO (CMdc " Iftet ¥PlY): ~o ELECTROHIC UN! LEAK DETECTOR 3.0 OPH TEST mD1AUTO IUoP SHUT OFF FOR LEAl<. SYSTEM FAILURe. AN) SYSTEM DIIIaIIN:CTIOH. AUDBJ! AN) VISUAL ALAAMS o 2. MONTK. Y CI.2 GfIH TEST o Jo ANNUAL INT'EGRrTY TEST (0.1 OPH) CONVENTIONAL SUCTION SYSTEMS: I 0 S. DAILY VISUAL MOHtTORINO OF PUIiIPING SYSTEM . TRIEfNAL PFINØ N1"EOAITY TEST (0. I GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GAOtJN) PIPING): o 7. SELF MONITORING GRAVITY FLOW: o 90 BIÐNAL INTEGRITY TEST (0.1 OPH) I secotGUILY CONfAINID I'I'IHG PRESSURIZED PIPING (Chedt " /Nt I/IIIIIy): I 10. CONTINUOUS TUR8INE sua. SENSOR mD1 AUOIØLE AN) VIS1.W. AlARMS AN) (Chec:II one) o a. AUTO Pur,p SHUT OFF WHEN A LEAK OCCURS o D. AUTO Pur,p SHUT OFF FOR IJ!AK.S, SYSTEM FAILUÆ AN) SYSTEM DISCONNECTION I 0 c. NO AUTO Pur,p SHUT OFF I 0 11. AUTOMATIC LINI! LEAK DETECTOR (3.0 OPH TEST) mD1 FLOW SHUT OFF OR RESTRICTION o 1 Z. ANNUAL INTEGRITY TEST (0.1 GPH) suCTlOl'WRAvrTY SYSTEM: o 13. CONTNJOUS SUM" SENSOR +AUDeU!NÐVlSUALA&NIIe !II!RO!HCY OI!NlMTOM ONLY (CItect.....,.., o 14. CONT1NUOUS SUMP SENSOR WITHOUT AUTO PUW SHUTOFF . AUOIIIU! IIHD VISUAL AI.AAMS 10 IS. AUTOMATlCLINELEAKDETECTOR(3.0GPHTEST)~FLOWSHVTOFFOR . I RESTRICTION ¡ 0 f!. ANNUAL INTEGRITY TEST (0.1 GPH) I: 0 17. DAlLYV1SUALCHECK I I I .¡' DISPENSER COHTAlMoEHT DATE INSTALLED .... ¡ ì . ·..~·~!:r~~r<"· 'r' . .:~ 11~·"'.' J I ¡ :.. .. ..:...--~.._;;:;:;;;.;.~ '\:.. " .:......_'...),_~.. 1.1 NAME A80VEGAOUNO PIPING o J. ORAVI'T'Y .' o Z. SUCTION a 95. UNl<NOWN o 990 OTHER ., ." a 10 FRP COMPATlBU; WI 100110 ~ a 7. GALVANIZED STEEL a 80 Fl.EXJ8LE (HOPE) a.. OntER o 90 CATHODIC PROTECTION a 95. UNKNOWN 4Ek .....;;;~. 4ðI ABOVEGROUND PIPING WALL PIPING 46: PReSSURIZED PIPING (CMdc " ilia, ¥PlY): o 1. aeCTROHIC UN! LEAK DETECTOR 3.0 GPH TeST mD1 AUTO PUU" SHVT OFF FOR L£AK. SYSTEM FAILURE. AN) SYSTEM OISCOfMCT1ON . AUDI8LE AN) VISUAL ALARMS o 2. MONTHLY 0.2 OAf TEST o 3. NHJAL IHI'EGRITY TEST (0.1 OPH) o 4. DAILY VISUAL CHEQ( CONIIEHTIONAL SUCTION SYSTEMS {Ch«:Ir " tile, ."""J: o 50 0AIl Y VISUAL MONITOAING OF PIPING AHO PUMPING SYSTEM o I. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GRouND PIPING): o 7. SElF MOHITORINO QRAvrTY FLOW (Chedt .. /IIat ¥PlY): o .. DAILY VISUAL MONITOAINQ o 8. BIENNIAL INTEGRITY TEST (0.1 GPH) SI!CONDARIL Y COfn'AlNED PIPING PRESSURIZED PIPING (CMcIt" Iftet ¥PlY): 10. CONTINUOUS TUR8INE SUMP SENSOR mw AUDIBlE AN) VISUAL AI.AAMS IIHD (dIedt_) o .. AUTO pur,p SHUT OFF WHEN A LEAK OCCURS o Þo AUTO PUMP SHUT OFF FOR IJ!AK.S, SYSTEM FAILURe AN) SYSTEM O\SCONNECTION o c. NO AUTO PUU" SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. NHJAL INTEGRITY TEST (0.1 GPH) SUC'TIOK'GRAvrTY SYSTEM: o 13. CONTINUOUS St.Ut SENSOR . AUOIIII.e IIHD VISUAL ALARMS III!RG!HCY OI!Nl!RATORS ONLY (Chedt.. /Nt fAI/)1 a 14. CONTINUOUS SUM" SENSOR WITHOUT AUTO Pur,p SHUT OFF. AUOI8LE AN) VISUAL AI.AAMS o 15. AUTOMATIC ~INE LEAK DETECTOR (300 GPH TEST) o II. ANNUAL INTEGRITY TEST (0.1 GPH) a 17. OAILYV1SUAL CHECK ÍYiiIT...,..U......'{),:;¡t;;~~~~' ~/*'.: ~~.:~~t...:..:~:C..~...".f,; ~ 471 PwmIlI!lqllr8llan 0lIl {For IOt:M ... onlY} 47J 410 412 I Pf/llfltI Nun1_ (FOIIOul UN only) 473 I PwIIII AIrcMd {I"otAllclt_OIII'yJ ..74 JPCF (1/99) S:\CUPAFORMS\SWRC8-B.WPD . . ,~ ~ ,¡ I' \, " -' . CITY OF BAKERSFIELD OeCE OF ENVIRONMENTA.RVICES 111S Chester Ave., Bakersfield, CA 93JOt (661) 326-3919 UNDERGROUND STORAGE TANKS· TANK PAGE 1 E a " CHAHGI! all INFORMA noN) PIQe o 8, TeMPORARY SITE CI.OStlRI! o 7. PERMAHENTI. Y Cl.OSlO ON SITe o 8. T AHI< IU!MOvEO d ry~ OF _CTION , C.'.c.)'" ,_ onItJ o ,. H/ÞI SITE PI!MIT 0 t. AAII!NCfO PERMIT o 1. IU!NEWA&. PENotfT (sø.u)f __ . IrN IOcM .... """'J 1 -~C\ì AU. ( ? /q f~ iF« IOf»I UN OÑ¥) ¡ AOOITIONAI. DE I L TANK DI!SCAIPT1OH l2000 COMPARntEHTA&.IŒD TANK 0 Y.. Œ1-Ho " "Y.... CIQftIlele _ ~ lor UCII ClQftlpermenc. 4: .. TANK ~ , TNIC use ... , tta< MOTOR VI!HICU! AJEL ! (If _'*«I. ~,....".... 7)pe) ~ 0 2. NON-I'1JEL Æ'TfIOl£\JN ; 0 J. CHEMICAL PAOOUCT ! 0 t. HAZARCOUS WAS11! (1rIdudN UM OIJ i 0 95. uN<NOWN : M'EOFTNIC I (Check - ...., ady i ! T ANI( MATERIAl.· pmwy ** ! (Check_ilemOÑ¥) NT'AOI.IUM TVPI! a 1.. A!OULNt UfUAOEO 0 2. U!AOED aliI. ........IJN..EAOEO 0 3. DIESEL I91C: ..xwœ UM.EADeD 0 4. QASOHOt. COIM)H NAMe (IIœt HIø/IfDut....." ~ ¡»ge) 6l~ .. TANK CONSTRUC1ION o 3. SINOU! WALL WItH I!XTEAIOR M!MBIWE t.»ER o 4. SINOU! WALL .. A VAlA.T e--f.' IN3LI WALL o 2. 00UILe WALL ¡;:t1. IARI! STEEL o 2. STAM.US STEEL ! T ANI( MATERIAl.· -*'Y ** 0 1. IARI! STœ. (Check _ ...., ady 0 2. STAM.US ST!!L TANK INTERIOR L...cJ OR COATINO (C/I.cJf _ ,.", OÑ¥) SPILL AND oveRFIlL (Chec_ ~, Nt I/IIIIY) o t.~UNID o Z. AUCYO UNNQ ... 441 o s. JEr FUEL EJ .. AVIATION F\.EL 0.. 0-nER CAS . {IrDtn HuMIoua ~ Ø\owIby ¡»ge} %fJ[5L.Q -w __0\ 44 o 3. FI8EAOlASS J fUSTJC o 4. STæ.CLADWI'~ ReINFORCED fUSTJC (FAP) o 3. FØ!ROtASS I PI.ASTIC o .. STEEL CLAD WIFIIERGtA8S REINFORCED fUSTJC (FRP) o s. CCIHCA£T1! o 3. EPOXY UNNQ a 4. PHI!:NOUC I..INNG o So SINGLE WALL wmc INT1!RNAL IUDOER S'tSTÐot OM. UNI<HOWN o It. 0T1ER a s. CONC:ÆTE 0 Is. UtoICHOYM o .. FRs> COt.tPATIBU! 'M100% r.ETHANO\. 0 ft. OTHER ..... 443 o .. FRs> COt.tPATI8U! W1100% r.ETHANO\. a .. FRs> NOH-CORROOIIIU! JACI<ET a 10. C04TED STæ. OM. UNCNOWN 0.. <mER 445 441 MTe NJTALLED 447 o .. CKA8I UNWO m-.:- UfUØ) o Is. UN<NOWN o It. OTHER 1IaI_ MTE INSTALLED 449 o 3. FI8EROlASS RÞ*OAa!D P\AITIC 0 M. UNCNOWN o 4. IIoIPAI!SSED CUM£NT 0.. OTHER o 1. MNU'ACTUN!D CATHODIC PAOT!CTIOH o 2. SACRI"ICIAL AHOOe 'tEAR INSTAU.ED o 1. SPIll. CONTAMteNT o 2. DROP T1J1I! o 3. STRIIŒft IUTI 448 (FfN /oQI",.. OÑ¥) 451 OVERFill PROTECTION EQUIPMENT: 'tEAR INSTAI.I.fO 452 o 1. AlARM 03. FILL T1J8ESliUTOFFVAl.vE_ o 2. BALLF1.0AT 0 4. I!XBtPT 4SO TYPE (FfN bcM UN OÑ¥) 't~~: ~~::.~:.~..~~::"~'":~' ":. '. . >.:-.""'. . :~tf.:~~..:-!:.:~'" ..; 7 .:.:,:.....:--~.:~~(;~~ " OOU8U1 WALL TAMe OR TANK NTH euoou (CMt:II_ ,.., ØttJt: 454 o 1. VlSUAI.(SINOLIWALLINVAULTON.Y) o 2. CONTINUOUS INTeRSTITIAl. MONITORING o ~. MANUAl. MONITORING ,: t:-··;~i, ; ~!~'\~: ¡"" .~,~: ',;:: 'H~':::~ :.~:;~::V}': ~~ ,::.I\(S:::y'~ LIAK " SIHOLI WA&.&. TAMe (CIIeo/I".... WIYJ: o 1y"JÍSUAI. (lJCPOao POfmOH 0... Y) I3"Î AUTOMATIC TANe OAUOINQ IATO) o J. CONTINU0U8ATO ¡ 0 t. srATISTICoALINIIIHTORYAlCOHCIUATIOH(SIR). I IIII!NHIAI. TANK TllTIHO !- ..- esTIMATIO OATI ~ UNO ~Y) UPCF (1198) 411 [J So MANUAl. TANK OAUOINQ(MrOI [J .. VADOse ZONI! 07. OAOUNDWATeR [J .. TNIC TUTIHO [J It. OTHeR Y. TANK CLQIUQ INfORMATION I PlRIlANINT Q.OIURIIN PLACII UTlMT10 QUNmTV 0' SUI8TAHCI RIW..-.G .... TANe FILLID wmc INIRT MATUtIAI.' 417 ....,. o v.. ONo S;\cUPAPORMs\sWRc&-8·wPO [,~ ,( I .' CITY OF BAKERSFIELD a 0fIP1C1 CW INVIRONMENT AL SERVICE_ .715 Chet.... AW.,lak.",fleld, CA .3301 ("1)'-79 un . 'rANI( ~AGI! PIee _ 01 VI. IIIPIICI CCNITItUCTlOH (CMcIr " fWI, cPIr1 uNOeAOAOUNO PlPINO ¡ SYSTEM rYP!; t:"1 ---= 0 0 , 0 ~ PRESSURe 2. SUCTION J. OAAVIT'I'.sa I. PRESSURE ~---- , CONSTRUCTION!' I.:::r I SINCI.! WALL 0 J. UN!O TRfHOf 0.. OTHER 4Q' 0 I SINGLE WAL~ .\oIANUFACTURER10 2. OOUIII.E WALL 0 M. UH!<NOWN 0 2. OOUBle WAL~ ~FACTURI!R 481 ~UFACTtJRER ,0 t. BAAl! S11!EL 0 e. FAP CO....ATa.! .... IOO1UÆTHAHOL 0 I, SARE STEEL : MATERIALS ANO '0 2. STAIHU!SS STEEL 0 7. QALVAHIZED ma 0 2. STAINLeSS STEEL : CORROSION : 0 0 0 : PROTECTION , J. PlASTIC CQMPATIIU! WITH CONT!HTS M. UNICNOWN J. Pl.4STIC COMPATIBLE WITH CONTENTS : 8'4. FIBERGLASS 0 .. FUOOBL! (HCÆ) 0 II. OntER 0 4. FIBERGlASS o 5. STEEL VtVCOATlNQ 0 i. CATHOOICPAOTECTIOH 4ð4 0 5. STEEL WI COATING w.1IIPIICI LeAK Dl!TECTION (Chedc""'" WIY) I!MØGÐ«:Y OI!NØATOM ONLy (CItect.,....".", o 14. CONTIHUOUS SUMP SENSOR wmtOUT AUTO PUW Stl./TOFF.AUDIBLE AKJ VISUAL ALAAMS I 0 15. AUTOMl'TIC LINE LEAK DETECTOR (3.0 GPH TEST) mDQ!4F\.OWSHUT OFF OR I RESTRICTION ! 0 18. ANNUAL INTEGRITY TEST (0.1 GPH) : 0 17. OAlL Y VISUAL CHECK ¡ .'~ ·····.:·....;.·~·.~!r i OlSPeNSERCOHTAlHNiENT 0,. FlOATMECHAMSMTHATSHUTSOFF8Hl!ARVALVE I OA TE INSTALLEO 4et 0 Z. COHI'INUOUI 0ISPEHSeR PNf SÐØ)R . AUDIIIU! NÐ VISUAL ALAAMS 0 3. CONTINUOUS 0IIÆNSeR PNf SÐØ)R mIttAUrO SHUT OFF FOR DISPeNSER. AUDIBLE AND VISUAL AI.AAMS I DC. OWNI!RIOPI!RA TOR SIGNA TURI! .... 80CIIdfe ro l1li NIt tI my bIowIedge. , UNDERGAOUHO PIPING I PRESSURIZED PIPING (ChKIc ., ,.., w/y): ~ELECTAOHIC UNE LEAK DETECTOR 3.0 GPH T'EST'ÏII1D1AUTO PUW SHUT OFF FOft LEN<. SYSTEM FAIlURe. AKJ SYSTEM DISCONNEC11OH · AUDaE AHO VI8UAI. ALARMS o Z. MONTHLY 0.2 GPH TEST o 3. ANNUAL INT£GAITY TEST (0.1 QPH) CONVENTIONAl. SUCTION SYSTEMS: I 0 5. DAILY VISUAL MOHITORI'fO OF ptAtPINQ SYSTEM . TRIEtMAL PIPING IHI"EGAfTY TEST (0. I GPHI SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUNO PIPIG): o 7. SELF MOHrTORING GRAVITY flOW: o 9. 8I£NNIAL INTEGRITY TEST (0.1 QPH) SI!CONDMILY CONrAINID PIPING PRESSURIZED PIPING {C/Iet:It;.. ,.., WIYJ: 10. CONTINUOUS T\JR8INI! sua.tP SENSOR mItt AUOI8L£ AND VISUM. AlARMS NÐ (C/IedI_1 o a. AUTO PUW SHUT OFF WHeN A LEAK OCCURS o I). AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAIlUAE AND SYSTEM DISCONNECTION lOCo NO AUTO PUMP SHUT OFF . j 0 ,. AUTOIoMTIC LN! LEAK DETECTOR (3.0 GPH TEST) ÏII1D1 F\.OW SHUT OFF OR RESTRICTION o 12. ANNUAL INTEGRITY TEST (0.1 QPH) SUCTlONlGAAVITY SYSTEM: o '3. CONT1HUOUS SUa.tP SENSOR . AUDB.II AKJ WlUALA1.AM8 , ....~~~r~ ~r<"'. ~. ':-'i f~' ;.' :.J . I :. '. ~1Ia:~.._.~:" ~_.. ..:__....._~.. '.0 -- ASOVEQROUNO PIPING o 2. SUCTION o 95, UNKNOWN o 99. OTHER o 3. ORA"",, .. .. - « o 8. FRI' CO....ATIBLE WII~ ~ o 7. GALVANIZED STEel o 8. FlEXI8lE (HOPE) 0 98. OT)ER o i. CA THOOIC PROTECTION o 115. UNKNOWN 46, ..",;µ~. A80VEGROUND PIPING NG W. PIPING 46: PReSSURIZED PIPING (ChKIr ., IN, w/y): a 1. ELECTROHIC UNE LEAK DETECTOR 3.0 GPH TEST mIt1 AUTO PUtoF SHUT OFF FOR L£4K. SYSTEM FAIlURE. AHO SYSTEM OISCONECTION . AUOI8U! AHO VISUAL ALARMS o Z. MOHntL Y 0.2 OPH TEST o 3. NNJALINTEGRn'Y TEST (0.1 QPH) o ... DAII. y IIISt.W. CHECK COHVENTIOHAL SUCTION SYSTEMS (Chedc ...., ."ply): o 5. !WI. Y VISUAL MONITORING OF PIPING AHO PUMPING SYSTEM o .. TRlEHNIAL INTEGRITY TEST (0.' GAt) SAFE SUCTION SYSTEMS (NO VALVES IN 8ELOW GROUND PIPING): o 7. SELF MONrTORINO GRAVITY FlOW (CII«Ic""" w/y): o .. DALY IIISt.W. MONrTOAING o 8. ØIEHNIAL INT£GAITY TEST (0.1 GAt) SECONDARILY CONTAINED PIPING PRESSUAIZED PIPING (C/Iet:It; .. /Nt w/y): 10. COHTIMJOUS TUR8INE SUMP SENSOR mnt AUOI8lE NÐ VISUN.. ALARMS NÐ CdNIdI: one) o .. AUTO PU.... SHUT OFF 'NHEN A LEAK OCCURS o I). AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAIUJRE AND SYSTEM 01SCONNECTlON o Co NO AUTO PUr.tP SHUT OFF o 11. AUTOMATIC LEN< DETECTOR o ,z. AlNJALINTEGRrTYTEST(O.1 GPH) SUCT'IOK'GAAvrTY SYSTEM: o 11 CONTHJOUS SUa.tP SENSOR . AUOI8U! AKJ VISUAL AlARMS DI!ROÐ«:Y OI!Nl!RATORS ONLY (Chect.,..., WI)1 o 14. CONTINUOUS SUMP seNSOR wmtOUT AUTO PUMP SHUT OFF. AUOIIIU! AHO VISUAL ALAAMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) a 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. OAILYVlSUALCHECK NWTAI"unfti'Ç,),\~:~~~:: ,!~ ~",:~~...._.':~ "-~..'"7;'* . :~~,j'~~:' ~. ~... o 4. DAll.Y'IISUAL CHECI< Ds.~u~/~~ o .. NONe 4Ø 471 T 474 PtmIIt E¡qIrIIIan 0lIl (For Iøc:IIII'U'~) 47J DATe 410 412 I P.",.oI ~1Ier fFot IOUI UN only) 473 I PwInIIAcIØnMd{"'''''''ØIIfJI JPCF (1/99) S:\CUPAFORMS\SWRCS-S.wPO . . ~ \ \ x~· 7 CITY OF BAKERSFIELD O_CE OF ENVIRONMENTA.RVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS· TANK PAGE 1 (! o " CHAHGI! OF INFOAMA noN) "-oe o S. I'!MPOAAAY SITe CLO~Ae o 7. I'EAMoVEHT1. Y CLOUD ON 3rTe o S. T ANI( ReMOVED flI Np!; OF ~CTION , C,'",.)", ,_ ady a I. HEW SITe I"!MIT 0 t. AMl!NOI!D I"'I!"MlT a 3. AfNfWA4. I"!IU«T (StI«#I- . IrN /OeM .a. ~ (SÞed'f ~ . IrN /OeM.... ~ 3 "N(I L TANK OESCRIPT1ON 'V\A-~ql ( Y 1C/?3 (FoI Jot»IIIIf ody 0" I I ~IONAL I I COMPAAnEHT'A4.IZ£D TANI< a Y.. 9-No ,,"Y.... comølele one øege lor uctI com~ Nt} \0 ODD ~ I. TANK CONTINTI I ~ /' TN« use 431 'j (3',. MOTORVI!HICU IIUEL , (If ma,**,- ~ ,.......... T)peJ ~ 0 2. NQN.ÇUE1. PETRCUUM : 0 3. CHEMICAL PAOOUCT ! 0 t. HAZAAOOUS WAST1! (1ItdtIdN U.-d 011 ¡ 095,U~ I ; TYPE Of' TN« I (C/IecJr OM .., ody , i , TANK MATERIAL· øm-y ** : (C/IecJr OM ...., (ldyJ ~TVPI! O'L RHIANt UtUAŒD ~ PAlMlUMutUADEO o Ie:. ..xJfW)E t.HÆAOED COIM)H HAM! /111m HIønbø....,. *-'Þy~ G~~ g-( IINOLI WALL o 2. DCX&I! WALL /" £3'1. loW! STŒ. o 2. STAKESS STEB. i TANK MATERIAL· -*Y ** 0 t. loW! STŒ. I (C/lecJrOM"'odyJ 0 2. STAH.QSSTœ. (CMcJr OM ...., ody SPILL NIl) OVERFILL ¡ (Check ~. flYI I/IØIY) I ¡_. o t. fUIII!R LMD CJ 2. ALJM) LHNCI 4- D 2. U!ADED D J. DIESEl D 4. GASOHOl D 5. JET FUEL EJ .. AlItA T10H FtÆ1. D.. OnEA CAS' /111m Hua/IIØI4 """" ~~ 2;Dèt£rW .--~ .... 441 .. TANK CCIIIS1'RUC'OON o 3. INJU! WALL \\nH EXTERIOR WÐefWE LINER o ... SINOU! WALL If A VALA. T (] 3. FI8EROI.ASS I PLASTIC o 4. STEEL CtAD 't'W18ERGLASS AeJNFOAœD PLASTIC IFRP) o 3. FIØERGlASS t PLASTIC o ... STEEL CtAD WIFIIIERGI.ASS REINFOACEO PLAST1C (FRP) o So COHC:RETE o 3. 8'OXY LHNCI o ... PHINOUC LJNNO o So UIGlE WALL WITH INTERNAL 8lADOER SYSTEM o IS. UNI<NOWN (] II. OTHER o 5. CONCÆTe 0 IS. UNICNCIYM o .. FRPCOWATl8U!WI100'U.m~NOI. Oil. OTHER w 443 OM. UN<NOWN o lilt. OTHER o .. FRP COWATI8U! WI1OO1' METHAHOC.. o .. FRP~JACI<ET o to. COATED STEEL 445 ..... D4T1! INSTAU.£D 447 o So GtAI8 UNNJ []..CUN.N!D o II. UNCNOYttf o II. OTHER /oeM1IIf D4TE INSTAU.£D 449 o 3. FeEROlASI RfINFOfICED fItAITIC 0 M. UN<NOWN o 4. IMPReSSED CUARENT 0 lilt. OTHER o t. AWIUI'ACTUN!D CATHOOIC PAOTI!CT1OH o 2. ~AHOOe YEAR INSTAU.£D o t. SPIlL CONTAHENT o 2. OAOP TUIII! o J. STAIICI!'U'I.A TI! ..... (FfK /oeM_ (Idy) 45t OVEAFILL PROTECTION EQUA.EHT: YI!AR IHSTAU.EO 452 o t. ALARM D 3. FILL TUBE SHUT OFF VA4.vE _ o 2. BAlL FlOAT D 4. exEWT 4$0 TYPE (FfK IOCM 1M (Idy) , I' .-- ISTIMAreO OArt LAIT UIID (VMotOIQAY) UPCF (1190) D So MANUAL TANI< OAUGINO (MI'Q) a .. VAOOII! ZONE D 7. OROUNDWAT!A a.. TANK TI!STIHO D.. OTHI!R V. TANK CLOIUU IN'ORMATIOH , PlRIlAHIHT C&.OIUU IN PlACII 411 UTlMTIO QUAHTITV OIl SUIITANCIIWWNNa .... TANK n.&.aO WITH INIAT MATI!RIAL? "7 tIIIIonI Dv.. ONo S;\CUPAFORMs\sWRCS-S'wPO [ CIT"f OF BAKERSFIELD . OfIfI1CB OP INVIRONMENT AL SERVICE_ W7'S CNttel' Ave., Bak.,.".,d. CA 13301 (811) ""79 uaT . TANK ~AQI! ". - fII VI. ,... CON8TltUCTlON (a.. " ,.., WIYJ UfC)(AQA()UNO PlPlHO i SYSTEM rvpt; m. - 0 (J i 0 ~~ESSUAI! ~. SUCTION ). 0AAIIfT'I' ~ I. ~ESSURE CONSTRUCTION!' c¡¡...,-sINOLI! WALL 0 ), LINED TRfHCH (J II. OTHER 4ðO 0 ,. SINGLE WALL \NI.NUFAcrURERIO ~. OOUBLE WALL 0 M. uNlCNOYttl 0 2. OOUBlE WALL , MANUFACTURI!R 481 MAHlIFACTUAEA .0 " BAAl! ST!EL 0 e. FRs» CO"'A~ WI 1em. M!nW«JL 0 t, BARE STEEL : MA TERIAl.S ANO '(J 2. STAINLESS STEEL 0 7. GALVANIZED STEa 0 2. STAINt.ESS STEEL , CORROSION . PROTECTION '(J). PlASTIC COWA TI8U! WITH CONT'EHTS 0 M. UNICNOI/\/N 0). PlASTIC COMPATIBLE WITH CONTeNTS ; 0 4. FIBERGlASS 0 e. FU!XlBL! (HOPE) 0 II. OTHER 0 4. FIBERGI.ASS o S. STEEL WI COA TINa 0 t. CAT)t()()IC PAOTECTtOH 484 0 S. STEEL WI COATING VLIIIItNQ L2AK DeTECT10H (Ch«:t",..,..) UHDEAGAOUHD PtPtHO PRE~RIZED PlPlHO (CMdt " /11M 1/I1I1Ir): E] 1. ELECTRONIC LINE LEAK OETECTOA 3.0 OPH TEST mDS AUfO ,..... SHUT' OFF FOR LEAl<. SYSTEM FAlLURI!. AHD SYSTEM DISC()N.£I'IOH. AUOaI NG VI8UAL AI.AAMS o 2. MONM.Y CU GPH TEST o ). ANNUAL INTeGRfTY TEST (0.1 OPH) I CON\l£NTIOHAl SUCTION SYSTÐ.IS: I 'Ds. DAILY VISUAL IotONITORJNO OF PUIo4PING SYSTEM . TRII!tHAL Pf'ING INrEGAfTY TEST (0. I GPH) ; SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GAOUNO PIPING): I 0 7, SELF MOHfTOAING I GRAVITY FlOW: o I. 8I£NNIAI..INTEGRITY TEST (0.1 OPH) S!CONDARILY CONrAINID PIlING PRESSURIZED PtPINO (CMdt" """ I/IIIIIy): 10. CONT1NUOUS TUR8ItE SUY' SENSOR rm:tI AUDIBlE AMJ VlSLW.ALAAMS NIO (Check one) o a. AUTO PU"," SHUT OFF WHeN A LEAK OCCURS o Þ. AUTO PU"," SHUT OFF FOR LEAKS. SYSTEM FALIJAE AMJ SYSTEM DISCONNECTION I 0 c. NO AUTO PUMP SHUT OFF i 0 I ,. AUTOMATIC LINE! LEAK DETECTOR (3.0 OPH TEST) mDS FLOW SHUT OFF OR I RESTRICTION o 12. ANNUAL INTEGRITY TEST (0.1 OPH) SUCTIO~vt1Y SYSTEM: o 13. CONTINUOUS SUMP seNSOR . AUDBJ! AHD VlSUALA1..AM8 I!MUG!NCY OI!NlltATOM OILY (Chect"........, o 14. CONT1MJOUS SUW SENSOR wmtOlIT' AUTO PUMP SHtII'OIF. AUOeU! NÐ VISUAL ALAAMS o I 5. AUTOMATIC LINE LEN< DETECTOR (3.0 GPH T!ST) mItQ!JI FLOW SHUT OFF OR RESTRICTION o 18. ANNUAL INTEGRITY TEST (0. I GPH) o 17. DAILY VISUAL CHECK . ·..<~:;r~~r<"··'·· :-1f~' ',' ~. j :' .. ~~~.._~~: ,\ 1.4 r.. ~r'....._.......~... I.. ··:·....;..:;.~·!T -- A80\lEOROUND PIPING o 2. SUCTION o 95, UNKNOWN o 99. OTkER o J. GAAvnv 4, 4, o 8. FRPCO"'ATI8U!WI1em.~ 41: o 7. GALVANIZED STEEL o 8. FlEXJ8L£ (HOPE) 0.. one o t. CA THOOIC PROTECTION 095. UHKHOWN 46.- ,~:µ:;. 46: PRESSURIZED PIPING (CMcIt" /Nt 1/I1I1Ir): (J 1. EU:C'TROHIC LINE LEAK OETECTOA 3.0 GPtt TEST mDSAUTO PUW SHUT OFF FOR LEAK. SYSTeM FAlLUÆ. AHD SYSTEM DISCONECTtON . AUDIIl£ AWJ VISUAL ALARMS o 2. MON'T}tLY U OAt TEST o 3. NN.IAL M'EORfTY TEST (0.1 OPH) o .. DAILY VISUAL CHEOC CONVENTIONAL SUCTION SYSTaotS (CIteQ .. ""t .wy): (J 5. OAIL Y VISUAL MONITOAINO OF PIPING AHO PUMPING SYSTEM o 8. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFe SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): (J 7. SElF MONITORIHO GRAvt1Y FLOW (Ch«:Ic " "'" 1/I1I1Ir): o e. DAILY VISUAL MONrTOAINCJ o 8. 8IEtHAL INTEGRITY TEST (0.1 GPH) II!CONDARILY CONTAINED JIIIING PRESSURIZED PIPING (CMdt.. "'" .",q): 10. CONTINUOUS TURBINE SUW SENSOR rm:tI AUOI8LE AMJ VISUAL ALARMS NlD (dIeck_) o .. AUTO PU"," SHUT OFF WHEN A LEAK OCCURS (J II. AUTO PU'" SHUT OFF FOR U!AI<S. SYSTEM FALURe AMJ SYSTEM 0tSC0NNECT10N (J c. NO AUTO PUIoIP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. AIMJAlINTEGRITYTEST(0.1 GPH) SUC'TIONIGRAvt1Y SYSTEM: o 11 COHTINUOUS.... 8EHSOR .. AUDt8LE AHD \IISUAI. AtNIMS IM!RGENCY GÐERATORS ONLY (Chect"""'~ o 14. CONTINUOUS SU'" SENSOR WITHOUT AUTO PU'" SHUT OFF. AUOI8l£ AHtJ VISUAL ALAAMS o 15. AUTO"" TIC LINE LEAK DETECTOR (3.0 GPH TEST) o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. OAILYV1SUALCHECK Mwr.&IIIII.vr'ç~:i¡ì.;'~:~:: ~;7i.".: ~T~~""..':<' o\':.",,~ ....., o 1. FlOAT MECHANISM THAT SHUTS OFf' StEAR VALve 4ðI 0 2. CONrNJOUS 0ISÆHSeR PM S!NIIOft . AUDeU! NlD VISUAL ALARMS o 3. COHTtNUOUS 0ISPEN8ER PAN SI!NSOR mItt AUTO SHUT OFF FOR DISPENSER · AUOI8U! AHO VISUAL ALAAMS DC. OWN!RIOPI!RATOR SIGNA TURI! to....1IeIt d "" 1a1CMleclge. ¡ OISPENSER CONTAINMENT i ! DATE INSTALLED I CIt1Ify III.. IN SIGNA fURE OF M 471 474 I Pwmlt EIcøIrIIIan OIIe(Fof__"'ødYJ 41J DATE 470 412 4" I PwmII AH/OVId (1Ot..,... CMf)I I Penno( ~1Iet (For IOøIIIM only) ;PCF (7/99) S;\CUPAFORMS\SWRC8-8·wPC e - .' ' '¡ x#' ~ SIMa WI. a,...,u.rc. ~ Sow i .. (1... I . I. _ ......) CEATIFICA TION OF FINANCIAL RESPONSIBILITY ~~rAflJCSCONTAI~~P~" \.. I........... ..1T. ~H_ T" . .. J II - -1 ........... __....... ia s..a. ~ Q.,wll. ow. J. 11rIe Do a:a, 0--....,..· ..- (;3-1.w...................1. _ A14D « C~::ti ...................... 0 % .ilioa 4oUan.............. -,. . ".",by cettilla thIIt it ¡, in complltlnt:tl with thtI ffItfJ/twtnwØ of s.ction 2807. - ..,·;Mec ", ···~~\.;1:~. .y.... '-:-: (:uytinCCtK Dr UCtlJ¡1lhlj \ Y1i IAXCU\e.t "ItS DY\\e~ f\Y\{UìGl'GU Dtf1C{ý l:e:tteý '-ItS \f cs is: If yoU /lie umø thII-.. Fund.. MIJ' ptIItølyour dtHllOMtÆtitJn øll1Mt1t*/respønsiblllly, JIOUTe1fIIaikJn MId ~ 01 this certJllt::alJDn .., CtlttIfIø th1It U .",In com knee with all condllJoM for n/n thtI Fund. PedII.,AddnM .;;130\ "\'\-'. s,,1Tect Çf\clCl Gf\ ~~ ï \ \1'-( l.h ~Bý£}¡e\C\ V\ \~'b~t1Vî'C, ~ f1tlc\ '¥\ ~ .....,...... ~I *If-/[ -W-'ò I I :.,~ ",,- \.åJt\ Due Î 12 -=ö aL .. rJ) IUr Off~ - &.-I t\f11Mf c:..,.. - "''''11(') ~ . . ,. ~,<G Jul-Z5-0Z 11:10A WI ER CENTER INSURANCE 31Wag 3630 P.04 ACORQ". PROOUœR WILSHIRE CENTER INSURANCE 800 S.ROBERTSON BLVD #10 LOS ANGELES CA 90035 CERTIFICATE OF LIABILITY INSURANCE DATI! (MMiPCIYYJ 07 25 02 THIS CERTIFICATE IS ISSUED 5 A' ißATTER OF INFORMATION ONLY AND CONFERS NO ~I HTS UPON THE CERTIFICATE HOLDER. THIS CERTIFJCATE 5 ,I.OT AMEND, EXTEND OR AlTER THE COVERAGE AFFO DED :!IV THE POLICIES eeww. INSURERS AFFO~DrNQ ::OVERAGE ,-- INSURED NIAGARA CAR WASH 1701 STINE RD :aAKERSPIELD CA .-., -- II\IJ>URERA. MARJŒL I~UR.UIC!: C~~~!! .~: INSIJR"~ c: IN~~\): INSURER (, ,- 93301 .-.. --. '--' .- "-' -. ---. COVERAGES , THF 1'()LlCI£:S OF INSlJ"^NCI: LISTEr> IiFI ow I lAVE BEEN IS~LJ~I) 10 THE NSLJrr~l> NAMED ABOVF ~(JH me POLICY I'l.Itll)O Itl:JICJ\TF), NOTWlTHSTANmN(ò AN( REQUIAEMFN!. 'rEAM OR CClN!)!tIQN OF 1oJoN {:C,IMIRACT OR OTHt:H DOCUMENT WI1lI RESPECT TO WInCH TI-IIS (';~, IllICATE MAY RF. ISSUED OR MAy f'lRTAlN, THF IN5UHANCf AFFOIIOl.D UY THE PO! IaES l1(SCRIBED HFHLIN IS SUBJECT ro ALL THE TFflM8, LX('JtUSlotl~ ^NU CONDITlaN~ ()I'SUCH POUCIES. A(¡(òHI:GATE LIt.lrrS $IIOWN MAY H^VF Ht:,t.N REDUCED BV J'^ID CLAIMS. 'NSRI '-m;;,,-INSURANCE '---;;:;~~HUM8fA pæ~Ÿ~1i P81'f'vEXPIRATIDN u;.~' A ,~I!"'AAL.LIABIUTY -'-iCAB706831 05/17/02 05/17/03 ,¡:ÁI':l-IpC.(;JJ~~:N~.. , X : COMMERt".tAt./JE1/EML ~!I1111 y , ~ ClAIMS MAD!: l jf~ <¡n;¡.I7-I Ii ..-. --, $ ~IR~ D~~~I:,,~n,",nr.) $ ME!)_qc~ JAny~,,,, _") $ PFR:;<.jNAL&~:V!.N.:!!!!.y $ c;!:NI:FlAl AC(J iFGA't'1: S , . -.. -- f'fIODl!C:~ ~ :Mt"K>I' ~G $ 10000.00 100000 1000 10Ò1')090 1000000 AUTOM081LE UABIUTY , J NoIV AJ.JTO . AU. OWNED AUTOS SCHEDUl EIJ AUTOS ~IRF.o AU 105 NON·OWNED AUTOS coQm ~: II: liMIT (t~ accident) . , Ol.lll ~ I~JUR" ¡P~I IH'Ir.on) s DOOIl ~ IN.IIJWY (P..'act,IlI....'> $ .--.. PRIIPHHYDAI,\GE (P.r ~W~nI) s GARAGE UAD/LlTY ANY AVTO AUTO ~I::!: ~,A(;C;WENT 1$ LA ACe 1$ OTHt-W: THAN AU10 ~Y A EXC!SS UAeIUTY ~ X i OGCUf'l ! l CLAIMS M^:>r 4602RS240938-0 05/17/02 05/17/03 -, I:A('..H t~ ~.:1."''! ,I\ICJ: A/JQ 1$ $ $ .S S ill __, 5000000, . "rjç"~^.-r:F ,0 DE:DUCTlRI " RETFt.lT1ON $ WORIŒM CQMPENSAT'O~ AHD EMPLOYERS' LIASI LlTY - --' A OTHER ;š"rm: L' 10TH- ..VIJM§i'.. En ~I. ""'~,I'AC~:~I:!!, S 1:,1.. [1~.!.J~' ..MPLOYI:C $ e.l, DIfF.A.~~ ' f tJl.lCY UMrr $ ...--. ARAGEKEEPERS i CAB70683 ,05/17/02 05/17/03 $50,000 BUILDING CAB70683 05/17 02 05/~ 7 03 40~., ºl:) DESCRIPTION OF OPERATIONS/LOCATtO'NŠ;VEIIICLI:S/EXCI USIONS ADcro EN IoNOORSEMENTjSPEtlAl PROVISIONS CERTIFICATE HOLDER I ADDITIONAL IN$UFllitl; INSURER LETTER, '. CANCELLATION SHOI,IUlAHVOFTHEAflQVe: DESCRIBED POU~lfS 81!C ;IINCElLEQ BtifORE1HI! EXPIR4TIgN ÞATeTtlEREOF, TH!ISSV1NCJ INSURER WILL !lNDEAvt·~TO IIAI.. ~ DA'YSWRl'TTiH toir:rnCE TO THE CERTIFICATe HOLDER NAMeD TO THI HT, 1!L1T FAlLURE'TO DO 110 5HAU. IMPOSE NO oaUDATION OR UABIUTY OF Alii KIND 1IltOH THe INSURER. ITa MENTS QR ./ RePRESENTATIVES. ATWOfIIZED REPAES¡NTATlve J11IJr QAlAI;'--: ACORb 2S-S (7/ff'I) e . The Chief Financial Officer or the owner or operator must sign, under penalty ofpeIjury, a letter worded EXACTLY as follows or you may complete this letter by filling in the blanks with appropriate infonnation. LETTER FROM CHIEF FINANCIAL OFFICER I am the Chief Financial Officer Cheaper, Inc. 12424 Wilshire Blvd" Los Angeles, CA 90025. This letter is in support of the use of the Underground Storage Tank Cleanup Fund to demonstrate fmancial 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 $ 10,000 per occurrence and $ 10,000 annual aggregate coverage. (Dollar Amount) (Dollar Amount) Underground storage tanks at the following facilities are assured by this letter: Niagara Car Wash #1. 2301 "H" Street Bakersfield, CA 93301 Niagara Car Wash #2,7991 White Lane. Bakersfield, CA 93309 Niagara Car Wash #3. 1701 Stine Road. Bakersfield, CA 93309 1. Amount of annual aggregate coverage being assured by this letter... ... ... ... ... ... .., ... ... ... ... ... ...... ... ... ... ...... .... $ 10.000.00 2. Total tangible assets... ... ........................ ............... ....... $ 19,000,000.00 3, Total Liabilities ... ... ... ... ... ......... ......... ......... ... ... ......... $ 11.000,000.00 4. Tangible net worth (subtract line 3 from line 2. line 4 must be at least 10 times line I) .............................. $ 8.000,000.00 I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808.1(d)(I), Chapter 18, Division 3, Title 23 of the California Code of Regulations. I declare under penalty of peIjury that the foregoing is true and correct to the best of my knowledge and belief. Executed at Bakersfield, California 93309 (place of Execution) On Julv 24, 2002 ~'IW\ 'S, \~'«\ (Signature) Sam Siam (Print Name) Owner/CEO (Title) ( ¿ -~'"<'i . . Cheaper, Inc. DBA "Niagara Car Wash" Emergency Response Plan Underground Storage Tank Monitoring Program For Store # 3 ./ , I .t _<,_,; ~~.. ~---,¡ . J. . e I.Clean-up procedures for unauthorized release or a hazardous substance For a Major Gas Spill 1. Turn off the gasoline emergency shutoff switch at the check stand. 2. Survey facility for injuries. 3. Make sure no one is smoking or car engines are operating around the area of the gas spill. 4. Contain the spill with absorbent material to keep spill from spreading (Kitty Litter). Shore up or dam any drains or sewers that the spill may impact. 5. Call the local fire department. 911 6. Ca,ll Cheaper, Inc.'s main office. 310.447.1234 7. Call the Office of Emergency Services. 800.852.7550 8. Notify by personal visit any neighboring residence, business, or schools that could be affected by a product spill. For a Minor Gas Spill 1. Contain the spill with absorbent material (Kitty Litter). 2. Dispose of the material in accordance with state and federal laws at proper disposal sites. 2. Proposed method and eQuipment for disposal of hazardous material Safety equipment and absorbent materials to remove hazardous material shall be used and placed in a proper container. Safety Equipment 1. Safety Goggles 2. Rubber Gloves 3. Face Mask 4. Rubber Boots Absorbent Material 1. Kitty Litter 2. Other Environmental Absorbent Material 3. Location of cleanup eQuipment Safety material and cleanup material to be kept in the outside storage room. 4. Maintenance schedule for cleanup eQuipment Cleanup equipment and containers are to be inspected by site manager and assistant manager on a daily basis. 5. Authorization Contact List for Response Plan Sam Siam Julio Sical Jair Flores Luis Flores Company CEO District Manager Site Manager Assistant Manager 310.447.1234 661.343.1706 Cellular 661.363.5707 661.397-8453 ~~ """ . --.... . e Cheaper, Inc. DBA "Niagara Car Wash" Written Monitoring Procedures Underground Storage Tank Monitoring Program For Store # 3 #.)---'-'~'-~ . e 1.FreQuencv of performine monitorine. Tank inventory. Daily printouts from Gilbarco E.M.C, and Daily Stick Readings to reconcile gasoline 2. Monitorine Equipment Gilbarco Environmental Control System 3. Location of monitorine equipment Auto printout monitor located in outside storage room and manual stick to be done at the opening of the tank. 4. Persons responsible for performance monitorine and/or maintenance of equipment Jair Flores Luis Flores Store Manager Assistant Manager 5. Report format for monitorine Tank Fuel reconciliation and individual tank reports are done daily. 6. Preventative maintenance schedule for the monitorine equipment Yearly inspections of monitoring equipment and maintenance performed by RL W Equipment 7. Emplovee Trainine for operations ofUST svstem Department supervisors are shown how to operate the monitoring device and trained to check the pumps and equipment for leaks, 8. Department Supervisors Jair Flores Luis Flores Rafael Astorga Site Manager Assistant Manager Vacuum Supervisor FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3951 FAJ( (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 It . August 30, 2002 Niagara Car Wash 1701 Stine Road Bakersfield, CA 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates from this offices with regard to Senate Bill 989 which went into effect January 1, 2002. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003 which is the deadline for compliance, this office will be forced to revoke your Permit to Operate, for failure to comply with the regulations. It is the hope of this office that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661- 326-3190. sin2 ~ Steve Underwood Fire Inspector/ Environmental Code Enforcement Officer Office of Environmental Services SBUIkr ~~9~ de W~nn~ ~ .AoPe .r~ ...Æ W~'" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES· ENVIIIOHIlEHTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326H0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 fAJ( (661) 326-0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4691 FAJ( (661) 399-5763 It - July 31, 2002 Niagara Car Wash 1701 Stine Road Bakersfield CA 93309 RE: Deadline for Dispenser Pan Requirement December 31,2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1,2002. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will be forced to revoke your Permit to Operate, for failure to comply with the regulations. It is the hope of this office that we do not have to purse such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661- 326-3190. Siß::¡ ~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~"sP~~R~.O~L~~P~N~~" FIRE CHIEF RON FRAZE ADMINISTRATIVÉ SERVICES 2101 'H· Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 "H. Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES· ENYIAOIÌIIEIITAI. SERVICES 1715 Chester Ave. Bakersßeld. CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersßeld. CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersßeld. CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0578 TRAINING DIVISION 5842 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 ,tt . August I. 2002 Sam Siam Niagara Car Wash 12424 Wilshire Blvd Los Angeles. CA 90025 CERTIFIED MAIL Re: Failure to Perform or Submit Three Year Cathodic Protection Certification NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Dear Customer: According to our records. your three year Cathodic Protection Certification is due on August 7. 2002. Failure to comply is a violation of section 2635 2(a) Failure to Perform/Submit Cathodic Protection Testing results. Section 2635 2(a) is as follows: "Field-installed cathodic protection systems shall be designed and certified as adequate by a corrosion specialist. The cathodic protection systems shall be tested by a cathodic protection tester within six months of installation and at least every ~ years thereafter." ' The cathodié protection is part of your leak detection system and is a condition of your Permit to Operate. Therefore, prior to August 30, 2002, you shall either perform or submit evidence of cathodic protection testing. Failure to comply will result in revocation of your Permit to Operate. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph E. Huey Director of Prevention Services B~ rik Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services ~"7~ de W~ çtJP ~~.o/"'~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395·1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' ENVIRONMENTal SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-<>576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 ~- - July 30, 2002 Niagara Car Wash 1701 Stine Road Bakersfield CA 93309 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 thè 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. Sin;jtct£v Steve Underwood Fire Inspector Environmental Code Enforcement Officer ~~7~ de W~ Y"eve .A0P6 .rkt- A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (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 FAJ( (661) 399-5763 - .: June 30, 2002 Niagara Car Wash 1701 Stine Road Bakersfield, CA 93309 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 1701 Stine Road. Dear Tank Owner / Operator: The purpose of this letter is to infonn 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 eQsure 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 perfonned 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 perfonn 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. tv St ve Underwood , ." Fire Inspector/ Environmental Code Enforcement Officer Environmental Services SUIkr ~~7~ de W~ ~.A0Pe.r~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661)395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAJ( (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3951 FAJ( (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 FAJ( (661) 399-5763 . e July 1,2002 Niagara Car Wash 1701 Stine Road Bakersfield, CA, 93309 RE: Deadline for Dispenser Pan Requirement December 31,2003 for Site Location at 1701 Stine Road, Bakersfield. REMINDER NOTICE Dear Underground Storage Tank Owner, You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will be forced to revoke your Permit to Operate, for failure to comply with the regulations. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at (661)326- 3190. Sincere~~ St~rwoOd . Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services (,(,7~ de W~ ~OP.A0P6.r~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395·1349 SUPPRESSION SERVICES 21 01 oH" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAJ( (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 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399·5763 . . May 30,2002 Niagara Car Wash 1701 Stine Road Bakersfield, CA 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 on Underground Storage Tank(s) located at 1701 Stine Road, Bakersfield. Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31,2003, which is the deadline for compliance, this office will be forced to revoke your Permit to Operate, for failure to comply with the regulations. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at (661)326- 3190. Sincer~ ,,/ /' I Jl!tL (JJ1fdli/ðiO Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/kr ~(,7~de W~ ~.A~.r~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (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 FAJ( (661) 399-5763 e 41. April 12,2002 NIAGARA CAR WASH 170 I STINE ROAD BAKERSFIELD, CA 93309 Re: Enhanced Leak Detection Requirements REMINDER NOTICE Dear Owner/ Operator, The purpose of this letter is to remind you about the new provision in California law requiring periodic testing of the secondary containment of underground storage tanks. Your facility has been identified as not having secondary containment on at least one of your underground storage tank components and as such falls under section 2637.(1) of the California Code of Regulations, Title 23, Division 3, Chapter 16; As an alternative, the owner or operator may submit a proposal and workplan for enhanced leak detection to the local agency, by July 1, 2002; complete the program of enhanced leak detection by December 31, 2002; and replace the secondary containment system with a system that can be tested in accordance with this section by July 1, 2005. The local agency shall review the proposed program of enhanced leak detection within 45 days of submittal or re-submittal." Please be advised that there are only a few qualified testers available to perfonn "Enhanced Leak Testing". All testing must be under-pennit through this office. For your convenience, I am enclosing a copy of the code as a reference. Should you have any additional questions or concerns, please feel free to call me at (661)326-3190. Sincerely, Ralph Huey Director of Prevention Services byjt ~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SUIkr Enclosures ~~y~ ~ W~ ~.A0Pe.rkt, A W~''I FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (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 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 .. ". e February 11, 2002 - Niagara Car Wash 1701 Stine Rd Bakersfield CA 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates fÌ"om this office with regard to Senate Bill 989 which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31,2003, which is the deadline for compliance, this office will be forced to revoke yourPennit to Operate, for failure to comply wIth the regulations. -, " , ' It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard 'this notice. Sho.uld you have any questions, please feel fÌ"ee to contact me at 661-326- 3190. sml~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dm ""7~ de W~ S7eve .A0P6 .9'"'~ A W~" . " . CITY OF BAKERSFIEI./D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd 1~'loor, Bakersfield, CA 93301 FACILITY NAME~ldtfJ'lL CAr uJv.~" ADDRESS nO r ,.;\t,,·c Q.J FACILITY CONTACT_ INSPECTION TIME INSPECTION DATE 10{3/ /0/ PHONE NO. ?Jf" ìtjqq BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES çç Section 1: Business Plan and Inventory Program o Routine tå Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate pennit on hand L /' / Business plan contact infonnation accurate V Visible address V I Correct occupancy \ Verification of inventory materials G / ~ / Verification of quantities L- ./ Verification of location Proper segregation of material L- V Verification of MSDS availability iV 1/ Verification of Haz Mat training l l/ Verification of abatement supplies and procedures lL... 1/ Emergency procedures adequate IL- V Containers properly labeled It 1/ Housekeeping LY Fire Protection L- V Site Diagram Adequate & On Hand Iv C=Compliance V = Violation White· Env, Svcs. Yellow· Station Copy Pink· Business Copy Any ~azardou~ waste on si~e?7 f a:. Yes 0 No Explam: {A Ja 9i: C b I. (~ ftJ,U.~..~:::þrH "l. ( Questions regarding this inspection? Please caU us at (661) 326-3979 · CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME f{lð...f6..f!'c.... &ctr (JJã...,>"- INSPECTION DATE Section 2: Underground Storage Tanks Program o Routine CiCombined 0 ~Oi}t Agency Type of Tank 'sWc; Ck(fACt1.. Type of Monitoring v4T" o Multi-Agency 0 Complaint Number of Tanks 3 Type of Piping 5w~s (c. P ) ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile V Proper owner/operator data on file / V Penn it fees current V Certification of Financial Responsibility V / Monitoring record adequate and current V Maintenance records adequate and current L.' Failure to correct prior UST violations r Has there been an unauthorized release? Yes No 1 / -- Section 3: Aboveground Storage Tanks Program AGGREGATE CAPACITY Number of Tanks TANK SIZE(S) Type of Tank 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 overfilJ/overspill protection? C=Compliance V=Violation Y=Yes N=NO In,peoto, _~ rilf,Jtf) Office of Environmental Services (805) 326-3979 White - Env, Svcs. Pink, Business Copy 0/" - KERN CTY - ENVIROMENTAL HEALTH 2700 M STREET SUITE 300 BAKERSFIELD, CA. 93301 Test Date: 09/14/2001 Order Number: 3118637 8900 Shoal Creek Blvd, Building 200 Austin, Texas 78757 Phone: (512) 451-6334 Fax: (512) 459-1459 J ¡';,t::.: -" /.!'" ,1jl' '. S! }/ ¡ fØC¡.... I ~ <O~, /, "" .' Date Printed and Mailed: 09/25/2001 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: NIAGRA CARWASH 1701 STINE ROAD BAKERSFIELD, CA. 93309 Testing performed: Leak detector tests Sincerely, ""J)~ k'~ Dawn Kohlmeyer Manager, Field Reporting CERTIFICATE OF UNDERGROUND STORAGE TANK SYSTEM TESTING ~'~¡f.L 4iI ~ Dlnlmology 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT TEST TYPE: TLD-1 PURPOSE: COMPLIANCE TEST DATE: 09/14/01 CUSTOMER PO: WORK ORDER NUMBER: 3118637 CLIENT: TOWER ENERGY GROUP 111 WEST OCEAN BLVD. SUITE 1650 LONG BEACH, CA 90802 MARK VASEY (562)435-4225 SITE: NIAGRA CARWASH 1701 STINE ROAD BAKERSFIELD, CA 93309 MANAGER (661)555-1212 The following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations Line and Leak Detector Tests 1 PLUS 2 UNLEADED 3 SUPER Y Y Y P P P Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future, Please call any time, day or night, when you need us. Tanknology representative: KEN MINTON Services conducted by: RICHMOND PHILLIPS /¿ 11 ~~ Reviewed: Technician Certification Number: 91-1071 Printed 09/25/2001 08:06 CCHAPA INDIVIDU TEST DATE:09/14/01 CLlENT:TOWER ENERGY GROUP TANK INFORMATION AND ,!I!fii 1r- ~ ~ »mknoIogy 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 ST RESULTS WORK ORDER NUMBER3118637 SITE:NIAGRA CARWASH TanklD: 1 Product: PLUS Capacity in gallons: 12,000 Diameter in inches: 95.00 Length in inches: 396 Material: STEEL COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: NO Overfill protection: YES Overspill protection: YES Installed: ATG and CP 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" vapor recovery: 140.0 145.0 45.0 4.0 COAX BALANCE Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water 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: COMMENTS New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Bubble Make: Model: SIN: Open time in sec: Holding psi: Resiliency cc: Test leak rate ml/m: Metering psi: Calib, leak in gph: Results: VEEDERROOT WPLLD 0J.0260 189.0 NOT TESTED, Ullage NOT TESTED COMMENTS 3.00 PASS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: COMMENTS FIBERGLASS 2.0 125.0 NOT TESTED NOT TESTED PRESSURE RED JACKET NOT TESTED NOT TESTED Impact Valves Operational: UNKNOWN Printed 09/25/2001 08:06 INDIVIDU TEST DATE:09/14/01 CLIENT: TOWER ENERGY GROUP TANK INFORMATION AND ,.~ ..,~' ~~ »mknoIogy 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 ST RESULTS WORK ORDER NUMBER3118637 SITE:NIAGRA CARWASH TanklD: 2 Product: UNLEADED Capacity in gallons: 12 I 000 Diameter in inches: 95.00 Length in inches: 396 Material: STEEL COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: NO Overfill protection: YES Overspill protection: YES Installed: ATG and CP 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: 140.0 146.0 45.0 4.0 COAX BALANCE ··TAN·· . K· HTSST·R.e·S··UC'¡rsH ······t .. ... ....... ....... .. .. ,.'. .". ....... ...... ".". .'....... ...... .. ....... ......... . ... . ..... ... . . H ." .... . {{.,':."",.,.,',.,.""",:';:;".,',.,:.:.,.,.,.,':"{{.':'.'.'.'.{"'.""':""":':';"":"".}',:.}~iL Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water 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: COMMENTS New/passed Failed/replaced L.D. #1 L.D. #1 Bubble Make: Model: SIN: Open time in sec: Holding psi: Resiliency cc: Test leak rate ml/m: Metering psi: Calib. leak in gph: Results: VEEDERROOT WPLLD 010258 189.0 NOT TESTED Ullage NOT TESTED COMMENTS 3.00 PASS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: COMMENTS FIBERGLASS 2.0 125.0 NOT TESTED NOT TESTED PRESSURE RED JACKET NOT TESTED NOT TESTED Impact Valves Operational: UNKNOWN Printed 09/25/2001 08:06 ,¡ INDIVIDU TEST DATE:09/14/01 CLlENT:TOWER ENERGY GROUP TANK INFORMATION AND ¡,«I!) ¡]jil"': Jt ~ DJnknoIogy 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 ST RESULTS WORK ORDER NUMBER3118637 SITE:NIAGRA CARWASH Tank 10: 3 Product: SUPER Capacity in gallons: 12,000 Diameter in inches: 95.00 Length in inches: 396 Material: STEEL COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: NO Overfill protection: YES Overspill protection: YES Installed: ATG and CP 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: 140.0 145.0 45.0 4.0 COAX BALANCE Dipped Water Level: Dipped Product Level: Probe Water Level: Ingress Detected: Water 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: COMMENTS Newlpassed Failedlreplaced L.D. #1 L.D. #1 Bubble Make: Model: SIN: Open time in sec: Holding psi: Resiliency cc: Test leak rate ml/m: Metering psi: Calib. leak in gph: Results: VEEDERROOT WPLLD 010262 189.0 NOT TESTED Ullage NOT TESTED COMMENTS 3.00 PASS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: COMMENTS FIBERGLASS 2.0 125.0 NOT TESTED NOT TESTED PRESSURE RED JACKET NOT TESTED NOT TESTED Impact Valves Op~rational: UNKNOWN Printed 09/25/2001 08:06 e SITE DIAGRAM e "l¥':: .! ~ DInknoIogy 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 09/14/01 CLIENT: TOWER ENERGY GROUP WORK ORDER NUMBER3118637 SITE: NIAGRA CARWASH stine CAR WASH + <[J> <[J> <[J> ISTP PLUS 0 ® <[J> <[J> 12K STP UL 0 ® 12K <[J> STP SUP 0 ® 12K Printed 09/25/2001 08:06 CCHAPA ccp.1'ÞnknoIogy MONITORING SYSTEM CERTIFICATION 4 Ar Use By All Jurisdictions Within the State of Calif~ , Authority Cited: Chapter 6, "'alth and Safety Code; Chapter 16, Division 3 Tit/e ~alifomia Code of Regu/ations .. THis form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate cårtification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date, A. General Information Facility Name: NIAGRA CARWASH Site Address: 1701 STINE ROAD City: BAKERSFIELD Contact Phone NO:555.1212 CA Zip: 93309 Date of Testing/Service: 09/14/2001 Facility Contact Person: MANAGER Make/Model of Monitoring System: GILBARCO EMC B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced Work Order Number: 3118637 Tank ID: 1 Tank ID: 2 X- In-Tank Gauging Probe, Model: MAG-1 fXl In-Tank Gauging Probe, Model: MAG-1 = Annular Space or Vauit Sensor. Model: Annular Space orVauit Sensor. Model: = Piping SumplTrench Sensor(s), Model: I Piping 5umpITrench Sensor(s). Model: = Fill Sump Sensor(s). Model: =:J Fill Sump Sensor(s), Model: = Mechanical Line Leak Detector. Model: I Mechanical Line Leak Detector. Model: ; Electronic Line Leak Detector. Model: WPLLD X Electronic Line Leak Detector. Model: WPLLD Tank OverfilVHigh,Level Sensor. Model: MAG-1 ~ X Tank OverfilVHigh,Level Sensor. Model: PLLD = Other (specify equipment type and model in Section E on page 2), Other (specify equipment type and model in Section E on page 2), - lanKIU: J lanK IU: ø In-Tank Gauging Probe. Model: MAG-1 - In-Tank Gauging Probe. Model: - Annular Space or VauU Sensor. Model: Annular Space or VauU Sensor. Model: = Piping SumplTrench Sensor(s). Model: Piping SumplTrench Sensor(s), Model: = Fill Sump Sensor(s), Model: Fill Sump Sensor(s), Model: = Mechanical Line Leak Detector. Model: - Model: - Mechanical Line Leak Detector. X- Electronic Line Leak Detector. Model: WPLLD - Electronic Line Leak Detector. Model: ~ Tank OverfilVHigh·Level Sensor. Model: MAG-1 = Tank OverfilVHi9h-Level Sensor. Model: ] Other (specify equipment type and model in Section E on page 2), 0 Other (specify equipment type and model in Section E on page 2), ILJ, ulspenser IU: o Dispenser Containment Sensor(s) Model: NO SUMPS n Dispenser Containment Sensor(s) Model: o Shear Valve(s), o ShearValve(s) o Dispenser Containment Float(s) and Chain(s). n Dispenser Containment Float(s) and Chain(s), ulspenser IU: , ulspenser IU: D Dispenser Containment Sensor(s) Model: n Dispenser Containment Sensor(s). Model: D ShearValve(s). o ShearValve(s), 10 Dispenser Containment Float(s) and Chain(s). o Dispenser Containment Float(s) and Chain(s). Dispenser ID: Dispenser 10: D Dispenser Containment Sensor(s) Model: n Dispenser Containment Sensor(s), Model: 0 Shear Valve(s), Õ ShearValve(s). D Dispenser Containment Float(s) and Chain(s), o 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 information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): System set-up report; 129 Alarm history report D PRINTED NAME:RICHMOND PHILLIPS COMPANY: Tanknology SIGNATURE: PHONE NO: page 1 of 3 (800) 800-4633 Based on CA form dated 03/01 ·onitoring System Certification _ '. Site Address: 1701 STINE ROAD Date of Testing/Service: 09/14/2001 D. Results of Testing/Servicing Software Version Installed: unknown Complete the following checklist: c:J Yes DNo' Is the audible alarm operational? c:J Yes DNo' Is the visual alarm operational? [::J Yes DNo' Were all sensors visually inspected, functionally tested, and confirmed operational? DYes DNo' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? DYes DNo' nN/A If alarms are relayed to a remote monitoring station, is all communications equipment (e,g, modem) operational? DYes DNo' E]N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) D Sump/Trench Sensors; D Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? DYes D No DYes DNo' DN/A 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 points(5) and operating properly? If so, at what percent of tank capacity does the alarm trigger? % DYes' []No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below, DYes' E]No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) D Product; o Water. If yes, describe causes in Section E, below, [] Yes DNo' Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. [] Yes DNo' Is all monitoring equipment operational per manufacturers' specifications? . In Section E below, describe how and when these deficiences were or will be corrected, E. Comments: page 2 of3 , , :.~, r. emitoring System Certification e . . Site Address: 1701 STINE ROAD Date of Testing/Service: 09/14/2001 F. In-Tank Gauging I SIR Equipment D Check this box if tank gauging is used only for inventory control. o Check this box if no tank gauging or SIR equipment is installed, This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: DYeS DNo* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ~Yes DNo* Were all tank gauging probes visually inspected for damage and residue buildup? DYes ~No* Was accuracy of system product level readings tested? DYes ~No* Was accuracy of system water level readings tested? ~Yes DNo* Were all probes reinstalled properly? ~Yes DNo* Were all items on the equipment manufacturers' maintenance checklist completed? . In the Section H, below, describe how and when these deficiencies were or will be corrected, G. Line Leak Detectors (LLD) : o Check this box if LLDs are not installed, Complete the following checklist: ~YeS DNo* DN/A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? (Check all that apply) Simulated leak rate: ~ 3 g.p.h 0 0,1 g,p,h 00,2 g,p,h [::J Yes DNo' Were all LLDs confirmed operational and accurate within regulatory requirements? ¡::] Yes DNo* Was the testing apparatus properly calibrated? [::J Yes DNo' ~N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? [::J Yes DNo' DN/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? DYes DNo' ~N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? [::J Yes DNo' DN/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ¡::] Yes DNo* DN/A For electronic LLDs, have all accessible wiring connections been visually inspected? ~Yes DNo* Were all items on the equipment manufacturers' maintenance checklist completed? . In the Section H, below, describe how and when these deficiencies were or will be corrected, H. Comments: page 3 of 3 ç~~ .~"Ø l' - ....t.~ e - · ~~~..~"~h~M~~._~~__~.'.~__~______.' .._..'........-~~..~___.. ---- -- ---. ---.,. --...--.....--.-----., $~P~21-2001 16:Ø9 TOI¡JER Et"JERI3Y GROUP S62 435'· 0015 P.Ø2/Ø4 ,.é~ 1~ MONltOHING SYSTEM CERTIFICATION · "H'1 ~ ' ., FQ( Use By AJI JlJrl$d·~b·D(.S WIthin t/'¡e $(lJt", of CIf"ornl,. AI./thøðr¡ (;írvd: C,h/fpler 6, r. H$dNh alld $/Jrttty Cads; Ch¡¡þto, 16. DMsi(JrJ :¡ TMu 23, C~lìrornì! 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F¡¡(;:allir.:¢/ìt~c:l. P(\'~on: MANAGE R · . i' ___.____.._........ø__..._....__......--..-. --....",_'........ ~¡¡,\..~M ,)ôC 1,)( Mor¡ìlQrlng $y~em: GILeAR CO ~MC WQfk Ordef N\,/rngor 3' 11;36:$1 , ,~. ~~i~~~o~ ~, equlp~nt Teste;,c;rtjr;;'-·---·--'·_-~~-' ----,-..-..--......-......- , :/"~! ,,·ì... ~r ~ .' ;" c;h~k the 3ppn;þrlate b(l)'.c!;:¡ to IndlçDlll 3pœlrn;; equipment jMpf.l(.leCl/~trvlc~ n......~<¥~,.~O:O-\._-___..._A,.-""""',..__...._,.."'....,_;T". - ._.._._"'......... .....-.~.. ."_~.....,_., -,.....~,.....-..'.-....I...,.._........---.,..,.. "WI~:t!t. .,1.. ..w..,......__...._. _ _.. Tank ID:..~. .~':::-:;:;:iÇ, .._,_........_....._.,.,.."_._._ ~j¡'."fa'~k-G~,~·g~~ Pr;~;--·-·---;;~ol; ~~C., ---.-.-"-..~ ~ In· Tank Gauging Probø. Mud!!l: ~.£:!..__._._.__. .] Ant)lJrllr S~co at V1JIJ!t SðnflDf. Marlol: A1nul~r $pa(;Q ar Vgl¡l! $4)~:;"I. MQQ!'Ir; ,_.._.."_.".,__._.._,_.,,....~_._.'_. ; '}h~ti1Q;~\lmpfTrcncÞ $,,1\;0(,::». Modl1l: --.-_._.. Piping S\lI¡pI1rOIC/1 S(:¡~~r('). M<.4i>1: _...,_____.__..._..._,____ "3' fJI';$utl'l) Søn:sor(Ii) Mo(ttl~ Fill Sump Slz.or(1\¡ Modol' _,_._'-._----__ :..-·,J~l,,#,~?'ic;¡ll!no l."óI~ Onløc!DT, Medel: Mllcll:;lßlc.i linD l.eHk [)tltt'lclor. MDd4Jl: ..____.__.___.._,,__--._._ ~.. ~·:......-H '1 . WPLLO ';', ~J,.,~~I~:\~~)'!Jt: Llrtll ,-,;o( 0111C.10" ~C:!lI: _~___......_.,__,__ Ele.-:\r(!r\lelll'llll.n!ò1! ClAI)(:Qr N!IXS(lI: ~~P___.,___,__" '. '. ',~ :,Ti~'~~~r1i~V)o('Ii"·L.ø~QI SorlcOr. Model!, ~~~1.___~... hntOv~;flLl'HIQtH..DYC'l $(¡n¡¡Of, M\)\.I~ fL.LD ___....___._ ,'\~,;Æ;I\!~t~4K;,fy ,~qìFlmll"llyP!I ~I\d ,"Qde~,11' $~hQn E ~;E~_~:__._.".,__~. 'fãñ~bf~ 8Quiprnent ¡ypo ¡¡,~~~~I~ ~1þ(:tJC¡~!~ ~~c.~~:.._..____"_.. J :&..k.C.::....-____....,...,~ --.-._. ___ _.,.........____~. ............---.....,.~ifI"""":~ :·'O::I~:~~l'Ik(bùgillli Pr~b4. M~.t; MAQ..1 In.T;¡nk GQII~¡ni Prob\!. Modtll: _..._..._..,.___,_._,.._ ;'J .A,~~I~r $þiI~11 Q(Vl;Jwlt t"nsót, Modol: .,__, AnnlJl~r Spat!: òrV;luh SCI1~['Ir M¡¡Ool' _.~"". ,._ .., _.___ ;J.P:I!I\~¡ SùmplTlMc:h SM"Qr(~), Modol: Plp)llg S\;rn~rl1nGh Son:lor(a! MOOOI: ___,_._....._____ ~] -r;.~l ~u~p SIII1U1f(IC), f,IIt.uitl; --_._._-,.__.~- FlU Sump Sìlr.~Qr($¡, Mo,j~1: ~~__"~_"_'.~'_''-- t]:f;1~i~~rlt;i¡;¡ll..i/q ~o~k ÞÒloclor. Modol; Mo(;t"r\I~'1:I1 Lir\4) L~k rM<Jclol'. /..1(¡~!1I: __...._"'__.._~_~__ .' 7~}: ",~,\~~Irt¡,nlt line L\I~~ ¡:¡ðl.¡;lor, MI)('iJI: WPlLD ..~_,._"., _'."" ElliclrOfk; Uno Lf!~k O.lu~tlIr. Mo".I~ _..___.____,__~_ .X· ."'I'~i)¡ CiI,J'l1íliHlg~·r..~ð! 5011'0', Mo,)d9J: MAG·, nlfl~ O~~IfiUIt1IQI1.I.¡'lol Se"~o( Mo<leJ; ~__'_._.__. _~ ~ ,'~J ~'a:~1' (~poclfy oo,\li)mÐn' 1VJ:'" -1l\d rNII!I.¡ In $oo::UOf'I e ø~ )s:lgo ;¡;---..-.'-. O1h..r (apoo::lty ..qulp,.,.,n! tY'PtI Q1d mM(I In S(I(;',on E Gr1 P:~!! 2), , '~;~~~itð:qin!1:-=:--- _ ,-,-,.~'----..--..----". ÕisÞ-¡;n:Jor-I1F~:=~.····' .:::::::=.'"-,...._-,.._'-.._--"-~'_._'-- '. . '·~;\.;'.~¡)~~!¡ft C(/"I~lnl'/'ll!ln SU~I.OI(G) MDdøJ: .~,g.ê.~Me!.-___· Olspol1'l¡or Conblr¡rl'1clI'11 SI.11\~Clr(") MJ:1d.,!: ~_._.._,.._~,~.._._.~_.__ ¡~.J q>r:~r Y:¡,I'~a(Ii). Sh~r VQI\(~(.) ~;r~~:;\:~:=~~~~~~!L~_~:!,'!:~:- _~.. O~p~i~:~;ö,r.~~n!.lnm~n~~rJ~'(5)~~~,~~2.:.-_,_____..__ · ,P""I' ,., _''''_-W''_~'_.__ ____' .._~.. ,:"':~ R,;.~~"n~.r Cootollnrmlnt :ì)fI!òor(s) MO<io/: C¡'PClII/¡Of COl1hllnmðl\! Sen..ar(di}, Mó1JuL ,~~_~__._._...,_.____ : J$h~~f Va"'.($), Sl'l~r V¡¡lvCI(:i ,t.:1,~!~ftl~!¡I!~.£I!~~!~~~~tC~) ~rId ~~L-_.__...~.....,.._.. OI.r!Þ~~or c;pn~rrl,~~'(~,).~~!..:~~~L._..,____._ :'i~)¡'¡;¥~k.:~i' \0 Dlr.ponocr IC: tJ,'·#;';r;~¡n~ßrc::~::n~;~:::;) M0<161: _. , ____ OI~pllnll\ll~;~,~:::I~O·~~~;(~¡, ~~"I: _.--------..-._.,.._.__..,__ ~J,;~:'~t!IJ Vwll"(/(~). ShnQr Val""'{i1). tl~i~5~O~I~~~~~~~~ .Flo!"") ""4 C~_._._,_________,....."~~"lIr c:QJl1á'nmø~~~~..~).~.:~.~!.I:(:~:,__,___.._.._._____,. " .. "," ,t. . "th- (acHlt)- oonÞ.Ìitls more ~/'I~or dI3Þe"$rJr$. oøþy thl:¡ form, Jnclud8lMormatlo{] for every tilnlC :and dlspf!I'Ir.l!r 1)\ U'\ð fOIr::ililY, ¢.:,C:~~¡~r~~¡I;I," . '! . :!d~riiìl¡h~t the eq",jprnent Identlflr.'¿ in this documtnt waS.IM~r.:I(>dls,rv¡ctld in acc:o,dantc '<'11th !ne mðftlJfIKtufcI".S' gulde1Im.¡s, ;Ai!~~f;~~' t~ttI¡~ ~erUfic:atlol'J i5 Infr,¡rrnal;o" (e.g mêJn\rut;i\J~Qrs' o~ðCkns!à} r\ðCO&~i.lry to vcrify that this Inrorn,aUcn ¡'Ii tWéc:t ~~dl~jio :PI;s¡¡ :.J¡owit'ig the 1\I~oLlt gr mo"Uorl'r~ ~ql!fpmcl1l. FQr any eqtJlpm~1 c,1pablc or genl:lulinra ~ucn reporls, , have \I1~ù "t1i1cllcd , .' .~~, ~~ .." .. - - - ',~, I:~PY or the (Chec;k..1f tMt .1pply): ,~"I " . r-- ,? '..'~ S~tClm sc:t-I.Iþ r'eþo/t; ~ Alarm hltt.:¡ry "'"-POlt L.J .,e.·" ,;.': .~... ,,1'- ,;·;.':"tÞw11.d. :~"""'.I" ,iI ,.'t't<'~"." :,í~(~Tf,Þ' NÁMe~~MOND PHILI,.',!;~_,_.....____........._,_____ $IGNATURE' ," ~ .~." '. . 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'"' .. .. ... - 9EF'-21··2GiZl1 16: 10 TOWER ENERGY GROUP 562 435 Øf115 P. 1213,''214 MOl'iltoring Systèm Certification Si.(~f,d~t~~:Z: 1 701 SJ1~,.Ro..AO ...... -----.----..- Ogla Crrtt~t1"g/SlJrvjœ, 09/14/2001 -.......-.........-....,......,.-"'----..-.................-.......... ··_-_..,.__~I"'_· '~~~;R?~~;lt$ of r$sting/Sê>Nic;:ing , $.~~~ro VOI~ion In:¡t.;Jód: unknpw('¡ . -_......_-~_._._--,..._--- '~~?~~!9~f\tiØ .f~"owlnCil r;:h~tral; Is tne aUdlbjo 2:l1¡jrm òpúrJtiøl'\o)l? _...........~,........"............\,.p-,....- -- _..._. --.- ...'.-...-...-.-.-,.---- Is t/'I~ vj~unl ;llam'l operational? ---....-- --..-,........,,' '., -_...~......' ...-.-........--...--.--.---.......--.---.................---- W~re aU sensor:; vlsuaHy Inspected, functlcm;!Jly !esied. ilnd àr'lfìrt'l"ltld 1.>f1nr:¡tJOnal? .---- 'w~r;aïìšõnSQ~ Insljiled ir~rporr1t õfšiiêõr)~~ry coñijjñmôfitãñd- p'öi¡i1~d'so tMtôïher e~·ü¡p¡ŸièñrWiì~"-- . ¡,,\erlere with th~ir pl'Qpor Qpera~on? ~'t'.,......~,... .._'' ........,-..... ....I....,.¡ -.....--. -.-... ---,_._._.~..._~". .. ...,. . .._. ... . ..,._..._,,_,..._. _..'P'.._._~,_.,...._._..._..,.... " , . ¡:' ¡tit ill) Na ·O~~~. .~~~\<I~rI1S ''lre r6Iay~~~~~~ monitorin~ ~l¡:¡Uon, ~_~~~~lIOIt'.:\UO~$,(quip~.!~,~~ (~~~~Mdl)lT\) ()p(r:¡tl~~~17 __.__.- .,~:(~ ':i: r '[: " Fe! prtJssIJrl:<:ed piping $Y$tørn~, doos 1/111 tvrbiM 1Jutom;¡1Îc.¡¡lIy $"'" dow" if!hD øl)h)Q :;cc:or'\dary é:"lItail1m~J1l ,Q Y~,,', :;0 No' EJ NlA mCM¡torll18 t~(;torn d~to<:l:¡ 8 'oak, ,,,¡II$ to opor.Jte. ot it) olcc\(icollly dl~r.anoeçted? If ~os.: lN~rch SensOrs InIH3tA PÓ!ÛtJv[t '.' 31\I.It·Oown'( (checlc ~U that apply) 0 Sl.Impftrem::h SUllsOrs: 0 ()isþtJoser ContOllomenl S(!n.~or$, ___",.,"'~ ~"__ _'._ _,?:i~~;~.~Ofirrt1p(l,j¡I~ve shut.~~ 0\10 to le:lKS ~ ~OT\:;o~.~~~~~~~Q~~:~.~,,? 0 '(IJS,._a.~___,_,_~____ :: '(~.y ::'~:O:N . '0 N;A For t3l'\k sY$tAr~ that I,Ilil¡~ !/'Ia mo!\itonnSl ,~y1tel'T1 "~l,hD p~m:1rY ~,,~ QlJorfill v.:nm¡ng aovice (Le.~ no mcctl~nìcaT . I .' ',,:; ~;¡¡~.~¡;, Q cverlif prO\f()ntio" 1/<llve, rs In:$mlled), 1$ the O\fÐrl1tl wartlu\g alarm vttl.blc and ¿¡u(jlbI0 ~t!TIt! tank ~II polnts(::;) ;¡r\¡;j Qper.ltong "to"erfy'i' If s~. at wh<Jt percent of tank cap~dt)' ciOOs Ih", aI311T1lriygt:r? % .__.-:.......-..:....~-"'----.....-- --·.-'..""'7.........'" .. "'-', ,~:..;:.."'-,.^...."-"-.:::;::;:..:;:!"--.......-........_......-...- n V~· 6M No w;¡S any monltor¡l'Igcqulpmtnt rop"~(:f,ld? If yes, Idonlify spoc.:ttíc s(Jl1~Or~. probc~, or other equlpmcnt replaced and list the y , ~ man,fa(,jturoi namo~"d modol f¢r (¡II roplaccrl1Q,(1! part:lln $eçUon ~, b~IQw. : tf~;.:;~ ~Ð-;;~"'" -..... W::u;uqúltl tOUI'I(~j'rt1¡(C ;;any ~~iÿ=ñfâ1ññi«ìr;y~lõr¡;:ï döcJinUd7idry ~y,tõ~~1""~fíø~inh~f appïýf'-[jProducl;- : ::;., '!'::; , 0 Waler'. 11 ~é~, ,dtlSt:I'rbe causes In Sa(;1lQn e:. 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FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chesler Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 ".-- 7, '... .~c "" August 3, 2001 Niagara Car Wash 1701 Stine Road Bakersfield Ca 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates fÌ"om this office with regard to Senate Bill 989 which went into effect January 1,2000. This bill requires dispenser pans under fuel pump dispensers. On December 31,2003, which is the deadline for compliance, this office will be forced to revoke your Pennit to Operate, for failure to comply with the regulations. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel fÌ"ee to contact me at 661-326- 3190. Sin¡ ~ Steve Unperwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dm ~~ ~ . d cX' __."/. (),L; jj ú/Þl d (/;> .,., e.Puu~? . '1£'. (;)r.Y/l/nu/~?' ..fl7P ... ,C(JOPC ,J /UUb úCJ (:je/l/N~r' '\ /.7 // ;¡. '.'y' .. a ----- -- "'¥'--- Winston H, Hickox Secretary for Environmental Protection ~ . 1f:0·. .. California Regional Water Quality Control Board Central Valley Region Robert Schneider, Chair Fresno Branch Office Internet Address: http://www.swrcb.ca.gov/rwqcb5 3614 East AshlanAvenue, Fresno, California 93726 Phone (559) 445-5116 . FAX (559) 445-5910 Gray Davis Governor 27 February 2001 Regional Board Case No. 5T15000808 Mr. Mark Vasey Tower Energy Group III West Ocean Boulevard Suite 1650 Long Beach, California 90802 UNDERGROUND TANK RELEASE, NIAGRA CAR WASH, 1701 STINE ROAD, BAKERSFIELD, KERN COUNTY You submitted Workplan Supplemental Subsurface Site Assessment Fuel Impacts in Soil (work plan) dated February 2001, transmitted on 7 February 2001, and prepared by your consultant California Environmental (CE). The work plan was submitted in response to our requests dated 7 February 2000 and 29 August 2000. The work plan was to propose investigations necessary to determine if SVE is an appropriate remediation method for the site, propose installation of a "sentinel" monitoring well between the site and California Water Service (CWS) well 158-01, and propose additional investigation of , impacted soils in the area of the fuel dispensers. In addition, a well search within 2,000 feet of the site was to have been conducted and all wells within 1,000 feet of the site were to be sampled. The groundwater samples were to be analyzed for benzene, toluene, ethylbenzene, xylenes and methyl tertiary butyl ether (BTEX and MTBE), and total petroleum hydrocarbons as gasoline and diesel (TPH-g, and TPH-d). We conditionally approve the work plan. A summary of the work plan and our comments follow. Background By our letter dated 7 February 2000, we requested that the previous site owner, Carwash of America, submit a work plan to investigate the extent of soil and groundwater impacts caused by an unauthorized release of petroleum range hydrocarbons from the underground storage tank (UST). The due date for the work plan was 15 April 2000. On 24 April 2000, Regional Board staff met with Mr. Charles Buckley of CE to discuss our concerns. The site is near a canal and saturated soil containing gasoline range compounds and MTBE has been found above the regional groundwater table. Possible impacts to the regional groundwater are unexplored. The site is also within 500 feet of municipal water supply well (CWS well 158-01). Mr. Buckley confirmed that he had been retained by you to prepare the work plan in a telephone conversation with Board staff on 3 November 2001. He also proposed postponing the sampling <of water supply wells located within 1,000 feet of the site required in our 29 August 2000 letter until a "sentinel" Ç) California Environmental Protection Agency a Recycled Paper t, The energy challenge facing California is reaL Every Californian needs to take immediate action to reduce energy consumption. For a list of simple ways you can reduce demand and cut your energy costs, see our Web-site at http://www.swrcb.ca.gov/rwqcb5 --- -=' .." . e -2- e 27 February 2001 . ' ') ~r. Jark Vasey monitoring well had been installed and sampled. Board staff indicated that our priorities are to det~rmine whether groundwater and well 158-01 have been impacted by petroleum hydrocarbons, specifically MTBE, and to implement soil remediation. Board' staff also discussed the need for additional investigation to determine the extent of impacted soils in the dispenser area and the vertical extent of MTBE in the vicinity of boring B4. Summary of Work Plan CE proposes one direct-push soil boring in the area of the dispènsers to a depth of 40 feet. Soil samples would be collected at 5:"foot intervals. Three soil borings would be drilled using a drill rig equipped with an 8-inch hollow stem augers and be completed as soil vapor extraction test wells designated VES A, B, and C. VES A and B would be constructed as dual completion wells with two casings placed in the same boring. A shallow slotted interval extending from approximately 25 to 70 feet and a deep interval extending from 90 to 110 feet would be employed in VES A and B. Slotted intervals would be constructed from 2-inch diameter slotted Schedule 40 polyvinyl chloride (PVC) with a slot size of 0.020-0.050 inch. A filter pack of coarse aquarium gravel would surround the slotted intervals. A low permeability seal would be placed between the slotted intervals. A bentonite seal and an overlying grout seal would be placed below the flush-mounted well cover: Soil samples would be collected from borings VES A and Bat 25-foot intervals since these wells would be placed in areas previously assessed. Boring VES C would be sampled at 5-foot intervals to a maximum depth of 100 feet. A plan for pilot testing would be submitted to Board staff following VES well installation. CE proposes installation of one groundwater monitoring well in a location south of the area of impacted soils and north of CWS well 158-01. Monitoring well construction details will be provided by CE following examination of groundwater level, perforation and production rate data for CWS 158-01. Soil samples would be collected from the monitoring well boring at 25-foot intervals to a depth of 150 feet, followed by a 5-foot sample collection interval. Water samples would be collected from the monitoring well using a disposable bailer following a minimum 72-hour stabilization period after development. Development and purge water would be transported offsite for disposal. CE proposes to collect a water sample from CWS 158-01 using a bailer or by a low-flow -purge device or from a wellhead sample port. A mobile laboratory certified in the State of California would provide onsite analysis of soil samples from the proposed soil boring in the dispenser area and YES C. Soil samples collected from VES A and B would be analyzed in the monitoring well boring would be analyzed in an offsite laboratory certified in the State of California. Soil and groundwater samples would be analyzed for TPH-g by EPA Method 8015M, and BTEX, 1,2- dichloroethane (1,2-DCA), ethylene dibromide (EDB), MTBE, tertiary amyl methyl ether ('tAME), di- isopropyl ether (DIPE), ethyl tertiary butyl ether (ETBE) and tertiary butyl alcohol (TBA) by EP A Method 8260. Groundwater samples collected from the monitoring well and CWS 158-01 would also be_ analyzed for general minerals, nitrate by EP A Method 300, total Kjeldahl nitrogen by EP A Method 351.4, and turbidity. "! .~ ....... i e - 3 - e ...., ~ ~Mr.-i!ark Vasey 27 February 2001 A site-specific Health and Safety Plan would be prepared and submitted by the consultant prior to the work. Comments Previous investigation by AJ Environmental (AJE), Bakersfield, during January 1997 has demonstrated the presence of gasoline and diesel range petroleum hydrocarbons beneath several fuel dispensers (soil samples NCWS #9 through #17). The vertical extent of impacted soils beneath the dispensers is undefined. Soil boring B4, drilled and sampled by CE during September 1999, was just south of the fuel dispensers and near product piping. MTBE was detected by EP A Method 8260 in soil samples collected from 75 to 90 feet, the maximum depth of the boring, but was not detected above 75 feet. MTBE concentrations ranging from 0.16 to 3.2 mglkg were reported. The MTBE detected in B4 may have resulted from lateral migration from the UST area or may indicate.a separate plume beneath the dispensers. We approve the installation and sampling of the proposed soil boring.in the dispenser area. We request that 1 additional boring be completed to determine vertical extent of impacted soils in the area of the dispensers. Both borings should define the maximum depth of impacted soils based on mobile laboratory analysis of 2 consecutive samples collected at 5-foot intervals below the contamination. TPH-d analysis by EP A Method 8015M should be included. TPH-d analysis will probably need to be conducted at an offsite laboratory. Please provide the location of the additional proposed boring. We approve the installation of the three VES wells. Pilot test procedures were not provided in the work plan. Please provide this information. We require that all water wells within 2,500 feet of the site be identified through a drive-by reconnaissance and examination of available records available from the State of California Department of Water Resources, California Water Service and other water purveyors in the area. The proposed monitoring well does not appear to be located between the USTs and CWS 158-01. Please provide a map depicting the revised monitoring well location and the location of the Stine Canal and CWS 158-01. CE indicates that the construction details of the proposed monitoring well will be provided following examination of groundwater level, perforation and production rate data for CWS 158-01. Please provide the construction specifications for the proposed monitoring well. Final well construction can be altered based on field conditions. Analysis for TPH-d by EPA Method 8015M should be included for all groundwater samples. A site-specific Health and Safety Plan should be prepared and submitted to this office. We approve the scope of work proposed in the work plan provided you follow the recommendations in . the above comments and incorporate the requested items into a signed final work plan submitted to this office by 10 April 2001. Please contact this office at least 72 hours prior to any fieldwork. You are to submit a report describing the results of the investigation and installations by 10 June 2001. -:? ., e -4- . 27 February 2001 1 êc }vli. 1ifark Vasey Should you have any questions regarding this matter, please contact me at (559) 445-5504. ~ b: áJ~ JOHN D. WHITING Associate Engineering Geologist RG No. 5951 cc: Mr. Ralph Huey, City of Bakersfield Fire Department, Bakersiiè1c:i-J Ms. Sandy Gill, SWRCB, UST Cleanup Fund,Sacramento Mr. Charles 1. Buckley, California Environmental, West Lake Village r U:UG1ìjdw\drafts\Carwash of Amer WP 2-01.Doc FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326·0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 .-,. , . ' ¿ . .'... .~. . " '" January 22,2001 Niagara Car Wash 1701 Stine Rd Bakersfield Ca 93309 RE: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update Dear Underground Storage Tank Owner: You will be receiving updates from this office now, and in the future with regard to the Senate Bill 989, which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On . December 31,2003, which is the deadline for compliance, this office will be forced to revoke your permit to operate, effectively shutting down your fueling operation. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning now to retro-fit your facilities. If your facility has upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Jt~ Steve UndeIWood, Inspector Office of Environmental Services SBU/dm ""7~ de W~ ~OP.A0P6 ffkt. .A W~" , CITY OF BAKERSFIELD , OF.E OF ENVIRONMENTAL S.VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 e UNDERGROUND STORAGE TANKS - UST FACILITY TYPE OF ACTION '0 I. HI!W SITE PERMIT (Check one Item only) o 3. Rl!NEWAl PERMIT o 4. AMENDED PERMIT o 5. CHANGE OF INFORMATION (~cn.ng.. 101* .,. only) o e. TEMPOAARY SITE CLOSURl! P8ge _ of _ o 7. PERMAHENTL Y CLOSED SITE o e. TANK REMOVED 400. I. FACILITY I SITE INFORMATION 3 FACIlITY ID. I BUSINESS I TYPE I. GAS STATION o 2. DISTRIBUTOR TOTAl NUtoeER OF TANKS REMAINING AT SITE 3- o 3. FARM 0 5. COMMERCIAl o 4. PROCESSOR 0 e. OTHER 403. II tecIIIty on Ind8n ~ ot 'If _ of UST . pubic agency: name of IUpeMsor of 1ruaIIanda? cNIIon, MCIIon ot oIIIc:e whk:II ~ !he UST. (1hII1I!he ~ ~ far !lie lank rec:otdI.) FACilITY OWNER TYPE 'I5t I. CORPORATION o 2. INDIVIDUAl o 3. PARTNERSHIP o 4. LOCAl AGENCYIDISTRICT" o 5. COUNTY AGENCY" o e. STATE AGENCY" o 7. FEDeRAl AGENCY" 402. ¡ I 0404. Ov. 405. <106. o 2. INDIVIDUAl o 3. PARnERSHIP ZIP DE ¿¡o3o;) o 8. STATE AGENCY 07. FEDERAlAqENCY 412. I CITY I I o 4. lOCAl AœNCY I DISTRICT o 5. COUNTY AGENCY 413. ' I MAILING OR STREET ADDRESS I ~+ I CITY : etl J, OW-l( é~tfc tJ{,tlJII\ Blvd 418. ZIP CODE qOiD) 4111. , o 2. JNDMDUAl' 04. lOCAl AGENCY I DISTRICT 0 e. STATEAœNCY 420. '6(1. CORPORATION 03. PARnERSHIP 05. CQUNTYAGENCY 07. FEDERAl AGENCY :·,;~;~,rt~~~~;~~'~q~~'~~~w.~P.!Ii'~j:QI#!~~~;:~ÇÇ§Mt9:~~'~~~'~:$::::::': . '~,..,. Call (916) 322-9669 If questions arlse 42i. ¡ PETROLi:UM 'uSr FlNANCIALRESP~NSïB".~ >,:,;","' ."" . . o 1. SElF-INSURED o 2. GUARANTEE o 3. INSURANCE o 4. SURETY BOND o 5. LETTER OF CREDIT o 8. EXEtJPTION o 7. STATE FUND 08. STATE FUND & CFO LETTER II. STATEFUND&CO o 10. lOCAL GOVT MECHANISM o 99. OTHER: 422. : , I Check one ÞaIc 10 IndIc8te whIctI addr-. IhouIcI be UMd rot legal noIIIIcaIIonI and mailing. Legal noIIIIcaIIona and malllngl will be MIll 10 !lie lank owner un!-. ÞaIc 1 ot 21a c:hec:kecl o 1. FACIlITY 423. i i .. ,~".. .. ,,-:/.. '~J~ 'LEGAL·~ånFi.CA~ON AND MAJuNG'AoDREsS" .,'. . ,,", .,..'...... ..,:;~"£,.:::.:.".,.,. ,. ",...',...'..' '. '.' . . ·'ViI;'ÂPPtI.' CANT.'''' SIGNATURË ""n;,., ,..". . ..¡ '" .. CetlJftcallon: I œrdf'f thellhe InbmaIIon pnMdlcllIerIIn IlIIUe II1d 8CCInIe 10 !lie belt of my knoWledge. SiGNATURe OF APPUCAN1' ~ ~/'- NAME OF APPliCANT (pt/fIt) 428. ttl'K /I "s' DATE I L/¡ 01 424. PHONE )~i9-J 't"J{'~Y;;z.r 425. i I 4Z1. ! i TITlE OF APPliCANT f /'-1~4, \ \,~""or FACUTY....... """'" - ".J .. F (7/99) 428, 1'_ UPGRADe CERTIFICATE NUMBeR (Fot IouJ IIA only) 421'1 S:\CUPAFORMS\swrc:b-a.wpd . . -~ Complete the UST· Facility page for all newpermíts. permit changes or any facility informatIon changes. This page must'be submitted within 30 days of permit or facility information changes, unless approval is required before making any changes. Submit one UST - Facility page per facility. regardless of the number of tanks located at the site. This form is completed by either the permit applicant or the local agency underground tank Inspector. As part of the application, the tank owner must submit a scaled facility plot plan to the local agency showing the location of the USTs with respect to buildings and landmarks [23 CCR )2711 (a)(8)]. a description of the tank and piping leak detection monitoring program (23 CCR )2711 (a)(9)]. and, (or tanks containing petroleum. documentation showing compliance with state financial responsibility requirements [23 CCR )2711 (a)(11 )]. Refer to 23 CCR )2711 for state UST information and permit application requirements. (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages. These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR. Appendix C. the Business Section of the Unífled Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated. 1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number which identifies 'I your facility. 3. BUS/NESS NAME - Enter the full legal name of the business. ' 400. TYPE OF ACTION - Check the reason the page is being completed. CHECK ONE ITEM ONLY. 401. NEAREST CROSS STREET - Enter the name of the cross street nearest to the site of the tank. 402. FACILITY OWNER TYPE - Check the type of business ownership. 403. BUSINESS TYPE - Check the type of business. 404. TOTAL NUMBER OF TANKS REMAINING AT SITE - Indicate the number of tanks remaining on the site after the requested action. 405. INDIAN OR TRUST LAND - Check whether or not the facility is located on an Indian reservation or other trust lands. 406. PUBLIC AGENCY SUPERVISOR NAME - If the facility owner is a public agency. enter the name of the supervisor for the division, section or office which operates the UST. This person must have access to the tank records. 407. PROPERTY OWNER NAME - Complete items 407- 412 for the property owner, unless all items are 408. PROPERTY OWNER PHONE the same as the Owner Infonnation (items 111-116) on the BusinesS 409. PROPERTY OWNER MAILING OR STREET ADDRESS Owner/Operator Identification page (OES Form 2730). If the same, 410. PROPERTY OWNER CITY write -SAME AS SITE- in this section. 411. PROPERTY OWNER STATE 412. PROPERTY OWNER ZIP CODE 413. PROPERTY OWNER TYPE - Check the type of property ownership. 414. TANK OWNER NAME - Complete items 414-419 for the tank owner" unless all items 8Ie the 415. TANK OWNER PHONE same as the Owner Information (items 111-116)on the Business 416. TANK OWNER MAILING OR STREET ADDRESS Owner/Operator Identification page (ÒES Fonn 2730). If the same, 417 . TANK OWNER CITY write -SAME AS SITE- in this section. 418. TANK OWNER STATE 419. TANK OWNER ZIP CODE 420. TANK OWNER TYPE - Check the type of tank ownership. 421. BOE NUMBER - Enter your Board of Equalization (BOE) UST storage fee account number. This fee applies to regulated USTs storing petroleum products. This is required before your permit application can be processed. If you do not have an account number with the BOE or if you have any questions regarding the fee or exemptions, please call the BOE at (916) 322-9669 or write to the BOE at Board of Equalization, Fuel Taxes Division. P.O. Box 942879, Sacramento, CA 94279-0030. 422. PETROLEUM UST FINANCIAL RESPONSIBILITY CODE - Check the methodes) used by the owner and/or operator in meeting the Federal and State financial responsibiJlty requirements. CHECK ALL THAT APPLY. If the method is not listed, check Aotheræ and enter the methodes). USTs owned by any Federal or State agency and non-petroleum USTs are exempt from this requirement 423. LEGAL NOTIFICATION AND MAILING ADDRESS -Indicate the address to which legal notifications and mailings should be sent The legal notifications and mailings will be sent to the tank owner unless the facility (box 1) or the property owner (box 2) is checked. SIGNATURE OF APPLICANT - The business owner/operator of the tank fadlity. or officially designated representative of the , owner/operator, shall sign in the space provided. This signature certifies that the signer believes that all the infonnation submitted is accurate and complete. 424. DATE CERTIFIED - Enter the date that the page was signed. 425. APPLICANT PHONE - Enter the phone number of the applicant (person certifying). 426. APPLICANT NAME - Enter the full printed name of the person signing the page. 427. APPLICANT TITLE - Enter the title of the person signing the page. 428. STATE UST FACILITY NUMBER - Leave this blank. This number is assigned by the CUPA as follows: the number Is composed of the two digit county number. the three digit jurisdiction number, and a six digit facility number. The facility number must be the same as shown in item 1. 429. 1998 UPGRADE CERTIFICATE NUMBER - Leave this blank. This number is assigned by the CUPA. . >.,:" ::..... CITY OF BAKERSFIELD OF. OF ENVIRONMENTAL SEaICES 1715 Chester Ave., CA 93301 (661) 326-3979 BUSINESS OWNER I OPERATOR IDENTIFICATION FACILITY INFORMA rlON , FACILITY JD # CITY Page - Of 100 101 3 102 ~ 103 I 104 I CA ZIP 105 106 SIC CODE 5 )'11 107 (4 Digit #) 108 I : DUN& i BRADSTREET j OWNER MAILING i ADDRESS I 113 117 CONTACT PHONE (t0J J 1f'3S" "YJJ.S' i CONTACT MAILING If I : ADDRESS , J' ~ f-- L-Ol\ {heM. Deep/( 13/1'4 S"~. 119 .II ItfJsO 125 TITLE 130 BUSINESS PHONE 126 BUSINESS PHONE. 131 : 24·HOUR~ 127 24·HOUR PHONE 132 ~ i PAGER # 126 PAGER # 133 I I I Certification: Based on my Inquiry of those Individuals responsible for obtaIning the Infonnatlon. I certify under penalty of law that J have personally examined L and am familiar with the Infonnatlon submitted In thIs Inventory and believe the Infonnatlon Is true, accurate, and complete. SIGNATURE OF OWNER/OPERATOR DATE J. ,/ 134 NAME OF DOCUMENT PREPARER 135 fA.---- Y; '¡LfIOf ¡t1~r/( 1/41~y NAMES OF OWNER/OPERATOR (print 138 TITLE OF OWNER/OPERATOR ' 137 /VLø-K ~$ UPCF (7/99) S:\CUPAFORMS\OES2730.TV4.wpd . CITY OF BAKERSFIELD. OFFirE OF ENVIRONMENTAL SEInrICES 1715 Chester Ave., CA 93301 (661) 326-3979 HAZARDOUS MATERIALS INVENTORY CHEMICAL DESCRIPTION 200 CHEMICAL LOCATION f ~ fr.,1 eu"" G¿t!o/l'rf (.. <¡ oO(ì¡(.f I tt FIRE CODE HAZARD ClASSES (Complete if requested by local fire cI1Ief) COMMON NAME CAS II (one form per malerial per building or area) Page m o Yes 0 No 202 204 TYPE opPURE m MIXTURE o s SOUD IiL LIQUID 1/..1 FIRE 02REAC11VE 210 o w WASTE 211 RADIOACTIVE DYes ~ 212 CURIES 213 OgGAS 214 LARGEST CONTAINER /), 000 215 PHYSICAL STATE , I FED HAZARD CATEGORIES I (Check all that apply) ! ANNUAL WASTE I AMOUNT 03 PRESSURE RElEASE ~ ACUTE HEALTH 217 I MAXINLIM /'''1 218 I AVERAGE DAilY AA«)UNT dTDO(;;) DAILY AM)UNT UNITS· ~ GAl 0 rJ CU FT 0 Ib lBS 0 In TONS . If EHS. amount must be In Ibs. 05 CHRONIC HEALTH 218 219 STATE WASTE CODE 220 ¡ 221 DAYS ON SITE 222 : STORAGE CONTAINER (Check aU /hal apply) 223 De PlASTlCtNONMETALLIC DRUM Of CAN o g CARBOY o h SilO o a ABOVEGROUND TANK ~UNDERGROUNDTANK DC TANK INSIDE BUILDING o d STEEL DRUM o I FIBER DRUM OJ BAG Ok BOX o I CYLINDER o m GlASS BOTTlE o n PlASTIC BOTTlE 00 TOTE BIN o P TANK WAGON STORAGE PRESSURE ¢..a AMBIENT o ba BELOW AMBIENT o as ABOVE AMBIENT o Q RAIL CAR o r OTHER i 224 I ¡ç 230 231 o Yes iiZl No 232 233 : I~ 234 235 oYes~No "238 237 , I 5 238 239 o Yea ~ No 240 241 ~ 242 243 245 ¡'U1ff ¡f( V cf.! e y ~~ UPCF (7/99) S:\CUPAFORMS\OES2731.TV4.wpd " .' , CITY OF BAKERSFIELD OFF. OF ENVIRONMENTAL S.ICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUNDSTORAGETANKS-TANKPAGE1 (Ð o 5. CHANGE OF INFORMATION) Page rI o 8, TEMPORARV SITE CLOSURE o 7, PERMANENTl V ClOSED ON SITE o 8, TANK REMOVED 43 TYPE OF ACTION (Ch.ck one ,tem onty) (J " NEW SITE PERMIT (J 4. AMENDED PERMIT (J], RENEWAL PERMIT (Sp-"y _$OIl . for IOI:M u.. only) BUSINESS NAME (SIm.. FACILITY NAME 01 DBA· Doing IIuIineu Aa) 43' I TYPE OF TANK I (Check one item ody) I ! TANK MATERIAL· Iritrwy... 'Of. BARE STEEl. I (ChecIc one item only) ff2. STAINLESS STEEL I . TANK MATERIAL· -*Y'" 0 1. BARE STEeL (Checlcone itemody) 0 2. STAINU!SS STEEL TANK USE ß.1. MOTOR VEHICLe FUEL (If marlced, compIele FeIl'oo1llMn T,.pe) o 2. NON-FtJEL PETROLEUM o 3. CHEMICAl. PRODUCT o 4. HAZARDOUS WASTE (1ncIudN Uød 01) 095. UNKNOWN TANK INTERIOR LINING OR COATING (C/Ieck one item onM OTHER CORROSION PROTECTION IF APPI.ICA8I.E (Check one item only) SPILL AND OVERFILL I (Check aU /hat apply) ,gt. SINGLE WALL o 2. 00U8LE WALL 8tt::r ) q!> 438 I. TANK DESCRIPT10N 433 COMPARTMENTALIZED TANK 0 Ves No If "Yes". complete one øage (01 IllICIt compaltmenL NUMBER MPAR S 434 435 438 437 " -'- n. TANK CONTENTS 43t PETROLEUM TYPE ~1L REGUlAR UNlEADED o 111. PReMIUM UNlEADED o 1c. MlDGRADE UNLEADED o 2. LEADED o 3. DIESEL o 4. GASOHOL o 5. JET FUEL EJ 8. AVIATION FUEL 099. OTHER CAS II (from Huardoul Ma/IeItm tnvent:Jty page) 442 440 COMMON NAME (frum HuaIÓOUS IMterlM InvenfrHy pege) 441 ~ So/,'/t?--<, II. TANK CONSTRUCTION o 3. SINGLE WALl Vt'ITH EXTERIOR MEt.eRANE LINER 04. SINGLE WALl IN A VAULT ¡ ()Ofc -~/"'1 o 1. RU88ER LINED CJ 2. AUM) UNNG o 3. FIBERGlASS t PLASTIC o 4. STEEL ClAD WIFIBERGlASS REINFORCED PLASTIC (FRPI o 3. FIBERGlASS t PLASTIC o 4. STEEL ClAD WIFIBERGlASS REINFORCED PLASTIC (FRP) o 5. CONCRETE ,.er 3. EPOXY LINING o 4. PHENOI.IC LINING o 5. SINGLE WALl \MTH INTERNAL BI.AOOER SYSTEM 095. UNKNOWN 099. OTHER o 5. CONCRETE 095. UNKNOWN o 8. FRP COMPATIBLE W/100% METHANOL 099. OTHER 444 443 o 8. FRP COMPATIBLE W/100% METHANOl o 9. FRP NON-CORRODIBLE JACKET 010. COATED STEEL o 95. UNKNOWN 099. OTHER 44S o 5. GlASS UNING o 8. UNLINED DATE INSTAU.EO / qq f IFfw /oeM UH onM DATE INSTAU.EO 449 095. UNKNOWN 099. OTHER 448 447 o 115. UNKNOWN 099. OTHER o 1. MANUFACTURED CATHODIC 0 3. FIBERGlASS REINFORCED PLASTIC O PROTECTIOH ~ 4. IMPRESSED CURRENT 2. SACRIFICIAL ANODE ¡- YEARINSTALLED 450 TYPE(FtNlouJuøonly) 451 o ,. SPILL CONTAINMENT o 2. DROP TUBE o 3. STRIKER PlATE 448 > ¡:" -. I (For /oeM uø ody) OVERFILL PROTECTION EQUIPMENT: VEAR INSTALlED 452 .)(,. AlARM 03. FILL TUBE SHUT OFF VALVE _ o 2. 8AU. FLOAT 0 4. EXEMPT ,::F>-iij:,·' ::!.w~/~;tf'(r·:;::'~£t:\~:~:¿:'::!;9":::~~~;,'''~1( WI( ~:Ûi$':f<Äi;~:i:ir~;::¡~;:\:;'" . ,,': '>;''r~:;:~;>;, . .:~:. t .<.':'iNÞ··· J IF SlNGLI WALL TANK (a..c...",., ~ . ." 453 " DOUBLE WALL TANK OR TANK VVITH BI..ADDeR (CMck one Ittm only): 450' VISUAL (EXPOSED PORTION ONLY) 0 5. MANUAL TANK GAUGING (MTG) 0 1. VISUAL (SINGLE WALL IN VAULT ONLY) AUTOMATIC TANK GAUGING (ATG) 0 8. VADOSE ZONE 0 2. CONTINUOUS INTERSTITIAL MONITORING CONTINUOUS ATO (J 7. GROUNDWATER 0 3. MANUAL MONITORING STATISTICAL INVeNTORY RECONCIUATION (SIR) + (J 8. TANK TESTING BIENNIAL TANK TESTING 088. OTHER Y. TANK CLOSURe INFORMATION I PIRMANINT CLOSURE IN PLACE 4U I!STlMATED QUANmY OF SUBSTANCE REMAINING 4ðð TANK FILLED WITH INERT MATERIAL? 0,. 1(2. 03. 04, 457 ESTIMATED DATI! LAST USI!O (YRIMOIOAY) UPCF (7(99) a8IIGIII OV. ONo S:\CUPAFORMS\SWRCB-B.WPO 1\--- - CITY OF BAKERSFIELD ."' OFFICE OF ENVIRONMENTAL SERVICES 1.Chelter Ave., Bakersfield, CA 93301 (881) 328·3 . -~," Page U8T. TANK PAGE 2 r:I UNDERGROUND PIPING ABOVEGROUND PIPING vL PIPING CONSTRUCTION (ChecII " /Nt apply) i SYSTEM TYPE ! 1, PRESSURE 0 2. SUCTION 0 3. GRAVITY 458 0 " PRESSURE ¡ CONSTRUCTlON/!þ(I. SINGLE WALL 0 3, LINED TRENCH 0 99. OTHER 460 0 1, SINGLE WALL : MANUFACTURERIO 2. DOUBLE WALL 0 95, UNKNOWN 0 2. DOU8LE WALL ! MANUFACTURER 461 MANUFACTURER o 1, BARE STEEL 0 8. FRP COMPATIBLE Wt 100% METHANOL 0 1. BARE STEEL MATERIALS AND 10 2. STAINLESS STEEL 0 7. GALVANIZED STEEL 0 2. STAINLESS STEEL CORROSION PROTECTION 10 3, PlASTIC COMPATIBLE WITH CONTENTS 095. UNKNOWN 0 3. PlASTIC COMPATIBlE WITH CONTENTS IJ!!' 4, FIBERGLASS 0 8. FLEXIBLE (HOPE) 0 99. OTHER 0 4. FIBERGLASS 105. STEELW/COATING 09. CATHODICPROTECT1ON 4&4 0.5. STEELW/COATING VIL P""'<'¡LEAK DETECTION (Check III fhat apply) I I I I SINGU! WALL PIPING 466 ~E55URIZED PIPING (Check .U lIIat apply): 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST m!!:1 AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBlE AND VISUAL ALARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAL INTEGRITY TEST (0.1 GPH) UNDERGROUND PIPING CONVENTIONAL SUCTION SYSTEMS: o 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAl PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9. BIENNIAl INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chack a" fhat apply): 10. CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBLE AND VISUAL ALARMS AND (Check one) o a. AUTO PUMP SHUT OFF WHEN A LEAl< OCCURS o þ, AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ïl!!!:! flOW SHUT OFF OR RESTRICTION o 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check" fhat apply) o 14. CONTINUOUS SUMP SENSOR ïßII:IQIl[ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~ flOW SHUT OFF OR RESTRICTION o 16. ANNUAL INTEGRITY TEST (0.1 GPH) o 17, DAILY VISUAL CHECK ..':. ~:~,:.... . . o 2, SUCTION 095, UNKNOWN o 99. OTHER o 3, GRAVITY 459 462 463 o 6. FRP COMPATIBLE W/loo% METÍiANoL o 7. GALVANIZED STEEL o 8. FLEXIBLE (HDPE) 0 99. OTHER o 9. CATHODIC PROTECTION o 95. UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING PRESSURIZED PIPING (Check a" lIIat apply): o 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 o 2. MONTHLY 02 GPH TEST o 3. ANNUAL INTEGRITY TEST (0.1 GPH) o 4. CAlLY VISUAL CHECK 467 CONVENTIONAL SUCTION SYSTEMS (ChecJc aJt that apply): o 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAl INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7. SELF MONITORING GRAVITY flOW (Check atI fhat apply): o 8. DAILY VISUAL MONITORING o 9. 81ENNIAl INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check a'lIIat apply): 10. CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBLE AND VISUAL ALARMS AND (check ane) o a. AUTO PUMP SHUT OFF WHEN A LEAl< OCCURS o þ, AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check 1111 fhat apply) o 14. CONTINUOUS SUMP SENSOR ï4I!:I2.W: AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. DAILY VISUAL CHECK ,\'~':w:!P~~~~,~~t~l,;;~~Wi~;~;iJft;ctW: ~~~r: ;~,?""1J"~';"~-¡¿~'~'tib.~,: :>;~,.;.:~...:~,,.~:O~~'g'~'-" .., "..,,, '='.""",." .",,,"~.. , " i~/>,. r~~~¡('~~·:;~..':.r~ "~:,-\. o 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS o 3, CONTINUOUS DISPENSER PAN SENSOR ïiIIt1 AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS IX. OWNER/OPERATOR SIGNATURE DISPENSER CONTAINMENT DATE INSTALLED 468 I certify Ihat IlIe inlormatlon provided lIerein i. true 8IId ac:curate 10 tile best 01 my knowtedge. SIGNATURE OF OWNER/OPERATOR UPCF (7/99) o 4. DAILY VISUAL CHECK o 5. TRENCH LINER / MONITORING o 8. NONE 469 DATE 470 / L{ 01 471 TITLE OF OWNERIOPERATOR 472 S:\CUPAFORMS\SWRCB-B.WPD TYPE OF ACTION rChec_ one ¡Ie'" only} CITY OF BAKERSFIELD OFFIe OF ENVIRONMENTAL SEe-ICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 U~eRGROUNDSTORAGeTANKS-TANKPAGE1 (S F'age ~ o " NEW SITE PERMIT 0 4. AMENDED PERMIT o J. RENEWAL PERMIT o 5. CHANGE OF INFORMATION) o 8, TEMPORARY SITE CLOSURE o 7. F'ERMANENTL Y ClOseD ON SITE o 8. TANK REMOVED 4' (Sp«/I'y c/lenge . for /oeM use only) (Specify re..", . for /oeM U$e only) BUSINESS NAME (s.m. _ FACILITY NAME 01 DBA· Doing au--. 1.8) 43 , TANK ID 1/ 433 COMPARTMENTAlIZED TANK 0 Yes rjlI No 434 If "Yes-. complete one page (01 eacn compartment. S ~ì I. TANK DESCRIPTION L{ 8'1=}- i DATE I SAlLE; q gj ADDITIONAl. DESCRIPTION (FtN bcM UM only) 438 4J6 II. TANK CON1ENTS TANK use 439 :s..1. MOTOR VEHICU: FUEL (If marked. complete ~".." Type) o 2. NON-FUEL F'ETROlEUM o J. CHEMICAl. F'ROOUCT I 0 4, HAZARDOUS WASTE (Include. I U~ 01) 095.U~ PETROlEUM TYPE 01" REGlJt.AA UNLEAOED o 1þ. PREMIUM UNlEADED ~c:. MIOGRADE UNLEADED 440 o 2. LEAOEO o J. DIESEl o 4. GASOHOl o 5. JET FUEL o 8. AVIATION FUB. o 99, OTI-iER 441 CAS /I (!tom fMarrJtJla ~ Invettloty".ge) ....2 COY«)N NAME (ftom fMaflJt:Jue Ueterlab IflVellkHy".ge) 6dtJO(, /r <. Soo"... (P,--q ! TYPE OF TANK I (Check one' item only) ! ! TANK MATERIAl. . prirMry!llnk 'IJK BARE STEEL I (CheCI< one ite", only) /(j=i STAINlESS STEEL ¡ TANK MATERIAl. . seooncIery rank 0 1. BARE STEEL (Check one item only) 0 2. STAINlESS STEEL T ANI( INTERIOR UNING OR COATING I (Check one Item onIYJ OTI-iER CORROSION PROTECTION IF APPUCA8lE (Check one item only) SPILL AND OVERFILL I (Check all tII.! .pp/y) ~. SIHGl£ WALL o 2. DOUBlE WAlL 01. RUB8ERUNED o 2. AlKYD I.Jt....o ill TANK CONSTRUCTION o 3. SINGLE WAlL 'MTH EXTERIOR MEMBRANE UNER 04. SINGlEWAU.INAVAULT o 3. FIBERGLASS I F'LAST1C o 4. STEEL ClAD WIFIBERGLASS REINFORCED PLASTIC IFRP'I o 3. FIBERGLASS t PLASTIC o 4. STEEL ClAD WIFIBERGLASS REINFORCED F'LAST1C (FRP) o 5. CONCRETE ....z 3. EPOXY UNING o 4. PHENOLIC UNING o 5. SINGLE WAlL WITH INTERNAl. BLAOOER SYSTEM 095. UNKNOWN 099. OTHER o 5. CONCRETE 095. UNKNOWN o 8. FRP COMPATIBLE W/100% METHANOL 099. OTHER 444 443 o 95. UNKNOWN 099. OTHER o 8. FRP COMPATIBLE W/100% METHANOL o 9. FRP NON-CORRODIBLE JACKET 0,0. COATED STEEL 44S DATE INSTAlLED /qq7 441 o 5. GLASS UNING 08.UHUNED 095. UNKNOWN o 98. OTI-iER 44ð (FtN local UN onJvl DATE INSTAlLED 4-49 095. UNKNOWN 098. OTHER o ,. r.wIJFACTUREO CATHOOIC 0 3. FIBERGLASS REINFORCED PlASTIC PROTECTION "'£J 4. IMPRESSED CURRENT o 2. SACI'UFICIAI. ANOOE ?' 448 0,. 02. 03. YEAR INST AI.l.ED 450 TYPE (FrN /øCII uH only) SPILL CONTAINMENT 0" I (For /oeM use only) 451 OVERFILL PROTECTION EOUIPMENT: YEAR INSTALLED 452 ~1. AlAAM 0 J. FILL TUBE SHUT OFF VAlVE _ o 2. BALL FLOAT 0 4. EXEMPT DROP ruBE STRD<ER Pl.*. TE 2i::'~"'j':;~;:Jí~;;;:f~ry';::<;;!G~:\<~;;~~<f;~;':;;~M/'~( U!AK ~:Æ4îf;if¡\:~;S:;¡~\:\:~" ·\f?:;~';j1f?;'- .,~: :':".::'!}~:~#' J IF SlNGLI WALL TANK (Check ~ /Nt IPtJIY): 453 " DOUIIU! WALL TANK OR TANK WITH 8t.ADOeR (Check one iIWm onIy): 4504 VISUAl (EXPOSED PORTION ONLY) 05. MANUAL TANK GAUGING (MTO) 01. V1SUAl(SINGLEWAlLINVAULTONt.y) AUTOMATIC TANK GAUGING (ATO) 0 8. v~se ZONE 0 2. CONTINUOUS INTERSTITIAL MONITORING CONTINUOUS A TO 0 7. GROUNOWA TER 0 3. MANUAl MONITORING 51 A TISTlCAi. IIWeHTORY RECONClUATION (SIR) . 0 8. T ANI( TESTING BIENNIAl. TANK TESTING 098. OTI-iER V. TANK CLOSURE INFORMATION I peRMANeNT CLOSURE IN PLACE 415 I!STlMATED OUANTITY OF SUBSTANCe R£MAINING 48ð TANK FILLED WITH INERT MATERIAL? 0" )(2. OJ. 04. 451 ESTIMATED DATI! LAST useo (YI'ttMOJOAY) UPCF (7199) G8IIcnI Oy. ONa S:\CUPAFORMS\SWRC8-a.WPD · ;:. / CITY OF BAKERSFIELD . OFFICE OF ENVIRONMENTAL SERVICES . 1 . . Cheater Ave., Bakersfield, CA 93301 (681) 328-3 .. VI. PIPING CONSTRUCTION (CMck "lNt apply) ABOVEGROUND PIPING ;ili!;;~ UNDERGROUND PIPING ,n¡VòYSTEM TYPE L PRESSURE 0 2. SUCTION 0 3. GRAVITY 458 0 L PRESSURE .II ' ./ CONSTRUCTlONl/J)(,· SINGLE WALL 0 3. LINED TRENCH 099, OTHER 460 0 1. SINGLE WALL ; MANUFACTURER! 0 2. DOUBLE WALL 0 95. UNKNOWN 0 2. DOUBLE WALL ¡ I MANUFACTURER 461 MANUFACTURER o 1. BARE STEEL 0 8. FRP COMPATIBLE WI 100% METHANOL 0 L BARE STEEL MATERIALS AND 10 2. STAINLESS STEEL 0 7. GALVANIZED STEEL 0 2. STAINLESS STEEL CORROSION , PROTECTION i 0 3. PlASTIC COMPATIBLE WITH CONTENTS 0 95. UNKNOWN 0 3. PlASTIC COMPATIBLE WITH CONTENTS ~ 4, FIBERGLASS 0 8. FLEXIBLE (HOPE) 0 99. OTHER 0 4, FIBERGlASS ~ 0 5, STEEL WI COATING 0 9, CATHODIC PROTECTION 464 0 5. STEEL WI COATING VII. PIPING LEAK DETECTION (Check a' that apply) UNDERGROUND PIPING i SINGLE WALL PIPING . 466 ,:2ESSURIZED PIPING (ChecJc all that apply): 'f! 1, ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST ~ AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAl ALARMS o 2. MONTHLY 0,2 GPH TEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) I CONVENTIONAL SUCTION SYSTEMS: ,0 5, DAILY VISUAl MONITORING OF PUMPING SYSTEM + TRIENNIAl PIPING INTEGRITY TEST (0,1 GPH) I SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9. BIENNIAl INTEGRITY TEST (0.1 GPH) SECONDARILY CONT AlHED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAl AlARMS AND (Ched< one) - o a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~ FlOW SHUT OFF OR RESTRICTION o 12. ANNUALlNTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBlE AND VISUAl ALARMS EMERGENCY GENERATORS ONLY (Check "lNt apply) o 14. CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~ FlOW SHUT OFF OR RESTRICTION o 18. ANNUAL INTEGRITY TEST (0,1 GPH) o 17 . DAILY VISUAL CHECK Page UST. TANI( PAGE 2 of -, o 2, SUCTION o 95. UNKNOWN o 99. OTHER o 3. GRAVITY 459 462 ~ o 6. FRP COMPATIBLE WI 1 00% METHANot. o 7, GALVANIZED STEEL o 8. FLEXIBLE (HOPE) 0 99, OTHER o 9. CATHODIC PROTECTION o 95, UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check aU that apply): o 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 o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) o 4. DAILY VISUAl CHECK CONVENTIONAl SUCTION SYSTEMS (Check aJt /llltt apply): o 5. CAlLY VISUAl MONITORING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAl INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): o 7. SELF MONITORING GRAVITY FlOW (Check a.lhat apply): o 8. DAILY VISUAl MONITORING o 9. BIENNIAl INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check a' that apply): 10. CONTINUOUS TURBINE SUMP SENSOR J!Y!I!:! AUDIBLE AND VISUAl AlARMS AND (check 008) o a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAl INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBlE AND VISUAl AlARMS EMERGENCY GENERATORS OHL Y,(ChecJt aI tllat apply) o 14. CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL AlARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 18, ANNUAL INTEGRITY TEST (0.1 GPH) o 17. DAILY VISUAl CHECK "'. . '.. .>,i.~~:'.. :,~;¡tj;t~t~\~it::~,.."'·~",,:.p.'-~~~~,,~~;>;,::!~~%H:~0t~ï?' o 1. FlOAT MECHANISM THAT SHUTS OFF SHEAR VAlVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAl AlARMS o 3, CONTINUOUS DISPENSER PAN SENSOR ïaI!:1 AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAl ALARMS IX. OWNER/OPERA TOR SIGNATURE DISPENSER CONTAINMENT DATE INSTALLED 4e8 I certify that the information provided herein ¡a we and accurate to the best of my knowtedge. SIGNATURE OF OWNER/OPERATOR -?'P? ^ NAME OF OWNER/OPERATOR (print) IoclII use only) lOcal use only) UPCF (7/99) '~t",P.&i$~~~ri'iBM:A~' _~ o 4. CAlLY VISUAl CHECK o 5. TRENCH LINER I MONITORING o 8. NONE 469 471 47'2 DATE ..70 t lOcal use only) ..75 S:\CUPAFORMS\SWRCS-B.WPD '. " TYPE OF ACTION (Ch.ck one Item only) r.- CITY OF BAKERSFIELD OFF. OF ENVIRONMENTAL SAICES 1715 Chester ~ve., Bakersfield, CA 93301 (661) 326-3979 U~ERGROUNDSTORAGETANKS-TANKPAGE1 s o " NEW SITE PERMIT 0 4. AMENDED PERMIT P8\8 d o ð, TEMPORARY SITE CLOSURe o T, PERMANENTLY CLOSED ON SITE o 8, TANK REMOVED 43 o 5. CHANGE OF INFORMATION) o 3, RENEWAL PERMIT (Sp«tIy,...", . lor JocM ¡as only) (SpectIy CNfH}e . lor !QuI use only) BUSINESS NAME (Sam... FACILITY NAME 01 08A. Doing I!uair..a....) 43 TANKIO. 4~ I. TANK DeSCRIPTION I DATE INST i ICt ADOITIONAl OESCRJPTION (For local &.- only) Zti =r ) :3 438 COMPARTMENTALIZED TANK 0 Y... rjá No II ·Y...·. complele one page (01 each compartment. 43J S 43ì 436 NU n. TANK CONTEHTS TAN!( USE 4311 PETROlEUM TYPE 440 :8-.1. MOTOR VEHICLE FUeL o 1.. REGULAR UNLEADED o 2. LEADED o 5. JET FUEL (If marlled, ~/II fOe".." Type) tb. PREMIUM UNt.EAOED o 3. DIESEL o ð. AVIATION FUEl o 2. NON-FUEl PETROlEUM o 4. GASOHOL o 99. OTHER o 3. CHEMICAl PRODUCT 1c. MlDGRADE UNlEAOEO o 4, HAZAROOUS WASTE (1ncIudN COIoNON NAME (from Hu»rdo<Js MIII8MJ$ InvenlDty ".ge) 441 CAS " (from Hantdous MllterieJs ItIWIItory".ge) 442 Uød 01) bt/tS 0 //n f. ¡tJot ~(P1r-1 o 95. UNKNO~ III. TANK CONSTRUCT1ON I TYPE OF TANI( I (Check one itamonly) I ¡ TANK MA TERW. . primary ** ~. SINCU WAU. o 2. DOUBlE WAll o 3. SINGlE WAll WrTH EXT'ERJOR MEMBRANE UNER o 4. SINGlE WAll IN A VAULT o 5. SINGLE WAll WITH INTERNAl8l..ADOER SYSTEM o 95. UNKNOWN o 99. OTHER o 5. CONCRETE 095. UNKNOWN o 8. FRP COM'>ATlBlE W/I00% METHANOL 099. OTHER 443 'Qf.BARESTEEL ff2. STAINlESS STEEl o 3. FIBERGlASS I PlASTIC o 4. STEEl ClAD WiFlBERGlASS REINFORCED PlASTIC IFRPI o 3. FIBERGlASS I PlASTIC o ... STEEL ClAD WiFlBERGlASS REINFORCED PlASTIC (FRP) o 5. CONCRETE ß 3. EPOXY UNING o 4. PHENOUC lINING 444 I (Check OM itam only) I TANK MATERIAl· sec:ondety tank 0 1. BARE STEEl (Check one itam only) 0 2. STAINlESS STEEl o 1. SPIll CONTAINMENT o 2. DROP TUBE o 3. STRIIŒR PlATE .-..:::;:::,;·"j:,':tt.9$::f~,r'·:;:,:~~f;~i::::':ri{~0<~:~:r:::~M:-i'K L!AK D~¢:T~ffM'<ijÍij;li\.~;~'¡;;;:~::·~ .', '. ' :::. .,. :;~:t;:·-:,·:~?·' <: : .-.'.':'}i\#;·· J IFSlNOUlWAU.TAHK(ÒIec:k",,';.,~' '" .."..., '... . ,. .,~ .,~ -IFcO~~W~'TAHI<ORTAN(WrTHlllADOI!It(CheckoneitMlonly: 454 VISUAl (EXPOSED PORTION ONLY) 05. MANUAl TANK GAUGING (MTG) 0 1. V1SUAl(SINGLeWAlLINVAULTONly) AUTOMATIC TANK GAUGING (ATG) 0 ð. VADOSE ZONE 0 2. CONTINUOUS INTERSTITIAL MONITORING CONTINUOUS ATO 0 7. GROUNOWATER g 3. MANUAl MONITORING ST 11 TlSTICAlIN\II!NTORY RECONCIlIATION (SIR) + 0 8. TANK TESTING BIENNIAl TANI( TESTING 0911. OTHER V. TANK CLOSURe INFORMATION I PI!RMAN!HT CLOSURE IN PLAce 4ð5 I!STlMATED QUANTITY OF SUBSTANCe REMAINING 4ð8 TANI( F1U.fD WITH INERT MATERIAl? T ANI( INTERIOR lINING OR COATING (Check one itam onIy OTHER CORROSION PROTECTION IF APPlJCA8lE (C/!«k OM itam only) SPILL AND OVERFILL I (C/I«Jr MI INt .ppIy) 01. )(2. 03. D 4. o 95. UNKNOWN 099. OTHER o 8. FRPCOM'>ATIBlEW/100%~l o 9. FRP NON-<:ORROOIBU! JACI<ET o 10. COATED STEEL 445 D4TE INSTAll.EO / qq 'i (For local use ollM D4TE INSTAll.EO 449 o g5. UNKNOWN o 911. OTHER 44ð 441 o 1. RlJB8ER lINED o 2. AIJM) lM«3 o 5. GlASS UNING D5.UNlIHED o 1. MANUFACTURED CATHOOIC 0 3. FIBERGUISS R.EINFORCEO PLASTIC O PROTECTIOH -..a 4. IMPRESSED CURRENT 2. SACRIFICIAl ANODE T"' . o g5. UNKNO_ o 911. OTHER 448 YEAR INSTAllED 450 TYPE (ForlocMuu only) . I (For /oQ/ use only) 451 0VÐ'IF1lL PROTECTION EQUIPMENT: YEAR IHSTAll.EO 452 ~1. AlARM _ 03. FilL TUBE SHUT OFF VAlVE _ D 2. 8AlJ.. FlOAT _ 0 4. EXEMPT 467 ESTIMATED OATI! LAST uaeo (YRIMOJDAY) UPCF (7199) Ukn Oy.. DNo S:\CUPAFORMS\SWRCS-S.WPO : , : ~"~~~': f~;:if¡~t ~~~~:;'.;.>~ ~)·~.h:~-.~V:f ,- CITY OF BAKERSFIELD .A OFFICE OF ENVIRONMENTAL SERVICES . .Cheater Av... Bak....fI.ld. CA 93301 (861) 328-3 .. VI. PIPING CONSTRUCTION (Chedt " /1II/t IppJy) ABOVEGROUND PIPING Page UST. TANK PAGE 2 01 :¡ . ~~STEM TYPE 'if 1. PRESSUREUNDERGR~N:' :::~ON 0 3. GRAVITY 458 0 1. PRESSURE ,/ CONSTRUCTlON/!þi(1. SINGLE WALL 0 3, LINED TRENCH 0 99. OTHER 460 0 1, SINGLE WALL : MANUFACTURER! 0 2. DOUBLE WALL 0 95. UNKNOWN 0 2. DOUBLE WALL I ¡MANUFACTURER 461 MANUFACTURER 10 1, BARE STEEL 0 8. FRP COMPATIBLE WI100% IÆTHANOL 0 1. BARE STEEL MATERIALS AND 1110 2. STAINLESS STEEL 0 7. GALVANIZED STEEL 0 2. STAINLESS STEEL CORROSION PROTECTION ¡ 0 3, PlASTIC COMPA TI8LE WITH CONTENTS 0 95. UNKNOWN 0 3. PlASTIC COMPATIBLE WITH CONTENTS ~ 4, FIBERGLASS 0 8. FLEXIBLE (HOPE) 0 99. OTHER 0 4. FIBERGLASS :05, STEEL WI COATING 09, CATHODICPROTECT1ON 464 05. STEEL WI COATING VlL PIPING LEAK DETECTION (CMcJc a' fJlat apply) o 16. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. DAILY VISUAl CHECK ; .~;"'\:;.$ ,:~::ft:;1g\';~;\%¡'ë':' '~,,:.. '··",:.,·P.,gØ1~~!JNM~$\.:7h.;;g~1;;£:~J\~~· '::;¿J¡;-¡&~~4%f~~~~:[T;;¡;þ'¡:;:;:?gm~' o 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VAlVE 0 4. DAILY VISUAl CHECK o 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAl ALARMS 0 5. TRENCH LINER I MONITORING o 3. CONTINUOUS DISPENSER PAN SENSOR mI!:1 AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAl AlARMS 0 8. NONE 469 IX. OWNER/OPERATOR SIGNATURE UNDERGROUND PIPING i SINGLE WALL. PIPING . 466 ,~ESSURIZED PIPING (Check all fJlat apply): F 1, ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST ïl!!!:! AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBlE AND VISUAl AlARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: o 5. DAILY VISUAl MONITORING OF PUMPING SYSTEM + TRIENNIAl PIPING INTEGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BElOW GROUND PIPING); o 7, SELF MONITORING GRAVITY FLOW: o 9. BIENNIAl INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check a/1 fllat apply): 10, CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAl ALARMS AND (Check one) - o a. AUTO PUMP SHUT OFF WHEN A LEAl< OCCURS o b. AUTO PUMP SHUT OFF FOR LEAI<S. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) W111-i FLOW SHUT OFF OR RESTRICTION - o 12. ANNUALlNTEGRITYTEST(0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBlE NfJ VISUAl A1ÄRMS EMERGENCY GENERATORS OHl. Y (Check" /1II/t apply) o 14. CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL AlARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~ FLOW SHUT OFF OR RESTRICTION o 16. ANNUAL INTEGRITY TEST (0.1 GPH) o 17, DAILY VISUAL CHECK .. DISPENSER CONTAINMENT DATE INSTALLED 488 I cettity lI1at the information prollidecl herein ¡a llUe and accurate to the best 01 my knowtedge. SIGNATURE OF OWNER/OPERATOR ~~ NAME OF OWNER/OPERATOR (Print)/:, /V1Af'r( /oeM uø only) lOcal uø only} 4 UPCF (7/99) o 2, SUCTION o 95, UNKNOWN o 99, OTHER o 3. GRAVITY 459 462 463 o 6, FRP COMPATIBLE WI 100% METHANoL o 7, GALVANIZED STEEL o 8. FLEXIBLE (HOPE) 0 99. OTHER o 9, CATHODIC PROTECTION o 95, UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check a/1 fJlat apply): o 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST Wtl AUTO PUMP SHUT OFF FOR LEAl<. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAl ALARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) o 4. DAILY VISUAl CHECK CONVENTIONAL SUCTION SYSTEMS (Chedt. all that apply): o 5. DAILY VISUAl MONITORING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW (CMcJc al fllat apply): o 8. DAILY VISUAl MONITORING o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check a' fJlat apply): 10. CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBLE AND VISUAl AlARMS AND (ched< one) o a. AUTO PUMP SHUT OFF WHEN A LEAl< OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAl INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBlE.AND VISUAl AlARMS EMERGENCY GENERATORS ONLY (Check all that apply) o 14. CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPHTEST) DATE 470 , '-I 01 471 TITLEOFOWNE~PERATOR -472 local use otlly) -415 S:\CUPAFORMS\SWRCEJøB.WPD State of California _ State Water Rc:.sourc.es Coo~oard . CERTIFICATION OF FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. ¡ am nquired lO demonstr.LG Financial Responsibility in lbe required amounL< as specified in s.:cÙon 2807, CbapLGr 18, Div. 3. TitJe 23. CCR: D 500,000 dollars per occurrence EJ 1 minion dollars annual auregale or ru 1 million dollars per occurrence f\.¡'D or 02 million dollars .o.n\1.&1 auregate 8, Tower Energy Group hereby certifi€s tbat it is in compliance with the requirements of Section 2807, (Nun. orTanJ: 0...".... or 0p0n1Ot') Article 3, Chapter 18, Division 3, Trtle 23, California Code of Regulations. The mechanisms used to demonstrate financial responsibility as required by Section 2807 are as follows: C. .~fihanismNarryeaooAddressoUs.suerp~~~~'TJ '.'..,~:~/ Cþ~~~ $995,000 Per Occurence and Annual Aggregate State UST Fund Chief Financial Officer Letter . . " Corrective Third Party .·,·.Action Com . State UST Oean-Up Fund P.O. Box 944212 Sacramento, CA. 94244-2120 State UST Clean-Up Fund Continous YES N/ A For UST Clean-Up Fund YES Tower Energy Group 111 \-V. Ocean Blvd., Suite 1650 Long Beach, CA. 90802 $10,000 Per Occurence and Annual Aggregate, Annual ;\I/A For This lVlechanism YES YES Note: If you are using the State Fund as any part of your demonstration of financial responsibiNty, your execution and submission of this certfficalion also certifies that au are in com liance with all conditions for rtici lion in the Fund. , F.ó.liry l'I"",. "" 4ft\. F.ó.liryl'l . F.ó.liry l'I"",. E, Si""'Nr. o(~ CFR{ (4192) F.ó.liry Addr"" C4r tvds4 11 315' !Nt:rsÄ -# 'P16 t'ø. r Wtf! 4 f- P'11- Faciliry Addr"" [)at<: 1'1"",. ",d ìi~. orTon!: Owuel' or Open",r .J.T. Rogers - President [)at<: Name oCWimc:s.sOC"Not3.f')' Mark Vasey FU..E: OripnaJ - LocaJ Ap:ncy Copies - F.ó.lilJ'l'5i«(.) · - '. The Chief Financial Officer or the owner or operator must sign, under penalty of perjury, a letter worded EXACTLY as follows or you may complete this letter by filling in the blanks with appropriate information. .. LETTER FROM CHIEF FINANCIAL OFFICER I am the Chief Financial Officer 1JJ wolf {7Ufðj, x: (;t()Uf!.. (Business Name, Business AddÍlss, and Correspondence Address of owner or operator.) III W Ocean Blvd., Suite 1650, Long Beach, CA. 90802 This letter is in support if 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 $ 10,000 per occurrence and $ 10,000 annual aggregate coverage. (Dollar Amount) (Dollar Amount) Underground storage tanks at the following facilities are assured by this letter: ïtJ¿' -II- ¡4 r l::(t:;( Sf¡'.1~ (Name and address of each facil for which financial responsibility is being demonstrated,) Q33vr 1. Amount of annual aggregate coverage being assured By this letter.. . . .. . .. .. . . . . . . . . . . .. . . .. . .. . . . . . . .. . . . . . .. .. . $ 10,000.00 2. Total tangible assets... ......... ...... ..................... $ 155,828,000.00 3. Total Liabilities......... ... ...... ...... ......... ...... ..... $ 141 ,676,000.00 4. Tangible net worth (subtract line 3 from line 2. Line 4 must be at least 10 times line 1)................ $ 14,152,000.00 I hereby certify that the wording of this letter is identical to the wording specified in subsection 2808.l(d)(l), Chapter 18, Division 3, Title 23 of the California Code if Regulations. I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. Long Beach, California 90802 (place of Execution) Twanna Rogers (Print Name) E.V.P. (Title) C:\My Documents\FinancialOfficerLtr.doc ~, ~.,;~ ,. CERTIFICA T ., ;> F UNDERGROUND STORAGE TANK SYSTEM TESTING ,,d ~., Tånlcnology 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST RESULT SITE SUMMARY REPORT PURPOSE: COMPLIANCE WORK ORDER NUMBER: 3113465 SITE: NIAGRA CARWASH 1701 STINE ROAD BAKERSFIELD, CA 93309 TEST TYPE: VacuTect TEST DATE: 09/06/00 CUSTOMER PO: CLIENT: TOWER ENERGY GROUP 111 WEST OCEAN BLVD. SUITE 1650 LONG BEACH, CA 90802 MARK VASEY (562)435-4225 MANAGER (661)555-1212 The following test(s) were conducted at the site above in accordance with all applicable portions of Federal, NFPA and local regulations Tank Tests 1 PLUS 2 UNLEADED 3 SUPER 12,000 12,000 12,000 95.00 95.00 95.00 0.000 0.000 0.000 PASS PASS PASS PASS PASS PASS Line and leak Detector Tests 1 PLUS 2 UNLEADED 3 SUPER 0.000 0.000 0.000 P P P Y Y Y P P P Y Y Y Tanknology appreciates the opportunity to serve you, and looks forward to working with you in the future. Please call any time, day or night, when you need us. Tanknology representative: KEN MINTON Test conducted by: DAVID TOHIR /¿ -11 ~ J4:7~ Reviewed: Technician Certification Number: 1315 Printed 09/18/200018:10 KOHLMEYER INDIVID AL TANK INFORMATION AN .oed T" 'DJnknology 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 ~.;" .... ,.. TEST DATE:09/06/00 CLIENT: TOWER ENERGY GROUP TEST RESULTS WORK ORDER NUMBER3113465 SITE:NIAGRA CARWASH TanklD: 1 Product: PLUS Capacity in gallons: 12 I 000 Diameter in inches: 95.00 length in inches: 396 Material: STEEL COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: NO Overfill protection: YES Overspill protection: YES Installed: ATG and CP CP installed on: / / -1.00 0.00 PASS COMMENTS GROUND WATER @ 45' PER KERN COUNTY WATER DISTRICT ¡iT ð~~;J:Ë§;'5{ßE:~P~]$]lfi~~r~~r~Qgj~iiì:~i',~c~ tart In n Dipped Water level: 0.00 0.00 Dipped Product level: 74.00 74.00 Probe Water Level: 0.000 0.000 Ingress Detected: Water N Bubble N Ullage N Test time: 08: 18-09: 38 Inclinometer reading: -0.30 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: 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: 140.0 145.0 45.0 4.0 COAX BALANCE New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 NOT TESTED Impact Valves Operational: YES NOT TESTED PASS FIBERGLASS 2.0 125.0 50 o 30 08:26 08:56 0.000 PASS PRESSURE RED JACKET Make: Model: SIN: Open time in see: Holding psi: Resiliency cc: Test leak rate mllm: Metering psi: Calib. leak in gph: Results: VEEDERROOT ELECTRONIC Material: Diameter (in): Length (ft): Test psi: B/eedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: COMMENTS COMMENTS NOT TESTED NOT TESTED Printed 09/18/2000 18: 1 0 -4 '.. . p. INDIVID " ::> TEST DATE:09/06/00 CLIENT: TOWER ENERGY GROUP L TANK INFORMATION A -" Tånknology 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 TEST RESULTS WORK ORDER NUMBER3113465 SITE:NIAGRA CARWASH ;:r:~,~,~i!,~§¡r~ßš~r!;l,~;¡~¡iJi~,~~;M!1f:19è1,\~~ffiT~ç~i;ljjfuttllllUt¡ tart In n In Dipped Water Level: 0 . 00 0 . 00 Dipped Product Level: 73.50 73.50 Probe Water Level: 0.000 0.000 Ingress Detected: Water N Bubble N UllageN Test time: 08: 18-09: 38 Inclinometer reading: -0.40 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: TanklD: 2 Product: UNLEADED Capacity in gallons: 12,000 Diameter in inches: 95.00 Length in inches: 396 Material: STEEL COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: NO Overfill protection: YES Overspill protection: YES Installed: ATG and CP 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: 140.0 146.0 45.0 4.0 COAX BALANCE Newlpassed Failedlreplaced L.D. #1 L.D. #1 Newlpa5sed Failedlreplaced L.D. #2 L.D. #2 -1. 00 0.00 Make: VEEDERROOT Model: ELECTRONIC SIN: Open time in sec: Holding psi: Resiliency cc: Test leak rate mllm: Metering psi: Calib. leak in gph: Results: PASS NOT TESTED PASS COMMENTS COMMENTS GROUND WATER @ 45' PER !<ERN COUNTY WATER DISTRICT Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: COMMENTS FIBERGLASS 2.0 125.0 50 o 30 09:02 09:32 0.000 PASS PRESSURE RED JACKET NOT TESTED NOT TESTED NOT TESTED Impact Valves Operational: YES Printed 09/18/2000 18:10 INDIVID AL TANK INFORMATION A ,,~ r~ 7ånknology 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 (512) 451-6334 /.. r. :!Þ TEST DATE:09/06/00 CLIENT: TOWER ENERGY GROUP ~orðt!!~15~~j'!J,~~H~or~J¡¡~~!!,MiVJgg~,¥.1g¡¡,#;ç,Þ¡¡iI.¡'iI'i\¡¡,i. tart In Dipped Water Level: 0.00 0.00 Dipped Product Level: 72.50 72.50 Probe Water Level: 0.000 0.000 Ingress Detected: Water N Bubble N UllageN Test time: 09: 56-11: 11 Inclinometer reading: -0.40 VacuTect Test Type: Single tank VacuTect Probe Entry Point: Fill Pressure Set Point: Tank water level in inches: Water table depth in inches: Determined by (method): Result: TanklD: 3 Product: SUPER Capacity in gallons: 12,000 Diameter in inches: 95.00 Length in inches: 396 Material: STEEL COMMENTS Tank manifolded: NO Vent manifolded: NO Vapor recovery manifolded: NO Overfill protection: YES Overspill protection: YES Installed: ATG and CP CP installed on: / / TEST RESULTS WORK ORDER NUMBER31134 65 SITE:NIAGRA CARWASH 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: 140.0 145.0 45.0 4.0 COAX BALANCE New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 -1. 00 0.00 Make: Model: SIN: Open time in sec: Holding psi: Resiliency cc: Test leak rate mllm: Metering psi: Calìb. leak in gph: Results: VEEDERROOT ELECTRONIC PASS COMMENTS COMMENTS GROUND WATER @ 45' PER KERN COUNTY WATER DISTRICT NOT TESTED PASS Material: Diameter (in): Length (ft): Test psi: Bleedback cc: Test time (min): Start time: End time: Final gph: Result: Pump type: Pump make: COMMENTS FIBERGLASS 2.0 125.0 50 o 30 10:01 10:31 0.000 PASS PRESSURE RED JACKET NOT TESTED Impact Valves Operational: YES NOT TESTED NOT TESTED Printed 09/18/2000 18:10 ~ c , ~ONITOR SYSTEM CERTIFiA TION ... TANKNOLOGY r.-._< r. :!f9 Test Date: 09/06/2000 Work Order #: 3113465 Client: TOWER ENERGY GROUP Site: NIAGRA CARW ASH 111 WEST OCEAN BL YD. 1701 STINE ROAD LONG BEACH. CA. 90802 BAKERSFIELD. CA. 93309 Overall System Operation The pumps; Shut down automatically if the system detects a leak, fails to operate, or is electronically disconnected. [X ] Yes [ ] No The system has functioning audible and visual alarms. [X ] Yes [ ] No The circuit breaker for the system is properly identified. [X ] Yes [ ] No The system is certified operational per manufacturer's performance standards. [X ] Yes [ ] No Product Tank Monitoring: [ ] Double wall [X ] Single wall Make: GILBARCO Model: EMC Type: AUTOMATIC TANK GAUGE How many: 3 Operational: [X ] Yes [ ] No (Automatic tank gauge, annular space vapor probe, annular space liquid probe, hydroguard system, vadose zone monitor well, groundwater monitor well) I Comments I Product Piping Monitoring: [ ] Double wall [X ] Single wall Make: VEEDER-ROOT Model: WPLLD Type: ELECTRONIC LINE How many: 3 Operational: [X ] Yes [ ] No (Piping sump liquid sensor, piping trench liquid sensor, electronic line pressure sensor, mechanical line leak detector) I Comments I Other Monitoring Systems: Make: Model: Type: How many: Operational: [ ] Yes [ ] No I Comments: I Technician: DAVID TOHIR Technician Signature: J:pxY 'i:; e ~' r. .v SITE DIAGRAM. fiI- . .. ~ Dlnknology 8900 SHOAL CREEK, BUILDING 200 AUSTJN, TEXAS 78757 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 09/06/00 CLIENT: TOWER ENERGY GROUP WORK ORDER NUMBER3113465 SITE: NIAGRA CARWASH stine CAR WASH + <[]> <[]> <[]> STP PLUS 0 0 <[]> <[]> 12K STP UL 0 0 12K <[]> STP SUP 0 0 12K Printed 09/18/2000 18: 1 0 KOHLMEYER ,Y -~ ~ORRECTlON Nq¡ICE BAKERSFIELD FIRE DEPARTMENT N~ 1029 LocatioI1 ~l'Lr uJa.~J, of. A(1W' II'l(~ Sub Div. I {() { Ó-tthZ Di. Blk. . Lot You are hereby required to make the following corrections at the above location: Cor. No 3 Ha. ù..f,d ~~ JUtûúÞttClt..f.toÀ ",dul~ e"" Ie.? -I-tculAk..1 ~ S I ..f-i ~etion Date fo, Date I( ~() Inspector 326-3979 ·' ,c. ~ \ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 : FACILITY NAME è.ax ~~l (á A~ n(~ ADDRESS 110 ( 6 \ d F ACILITY CONTACT INSPECTION TIME INSPECTION DA TE~ 2. -¿I () 0 PHONE NO. ~\- ìq f ~ BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES trJO Section 1: Business Plan and Inventory Program o Routine ~ Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate pennit on hand it! Business plan contact infonnation accurate \/ Visible address V Correct occupancy V Verification of inventory materials V Verification of quantities V Verification of location V Proper segregation of material V Verification ofMSDS availability vi Verification of Haz Mat training V No~ /)t\t"f~ Verification of abatement supplies and procedures V Not- It'II\.s,k Emergency procedures adequate V 0.... " Containers properly labeled Iv Housekeeping II Fire Protection .; II1IDlJ(... ~.Jt ~~ t./I,S Lc. V" / () ,.../.. . t 1'4" wI v . " Site Diagram Adequate & On Hand l,.. I $1 fI-Ú C=Compliance V=Violation White· Env. Svcs. Yellow· Station Copy Pink - Business Copy Inspector: Any hazardou~ wasttj on site?:I, Clì'Ýes o 'No Explain: Wtl6k., (Jd +- W&6 t(.. AV\{ .-Crcr 'r Questions regarding this inspection? Please call us at (661) 326-3979 · CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME {}¡ g- Wtt6~ ~ ~tlc.a... INSPECTION DATE-&?'Z!OO Section 2: Underground Storage Tanks Program o Routine 5!1 Combined 0 Joint Agency Type of Tank .sWI- Type of Monitoring /~TG o Multi-Agency 0 Complaint Number of Tanks 3 Type of Piping ,<;ll J S (é. P ) ORe-inspection OPERA TION C V COMMENTS Proper tank data on tïle ./ Proper owner/operator data on tïle V Permit fees current V Certification of Financial Responsibility V Monitoring record adequate and current V Maintenance records adequate and current 1/ Failure to correct prior UST violations V Has there been an unauthorized release? Yes No (/ Section 3: Aboveground Storage Tanks Program AGGREGATE CAPACITY Number of Tanks TANK SIZE(S) Type of Tank OPERA nON Y N COMMENTS SPCC available SPCC on tïle with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? c~comp];'nJ V~V¡ol,¡;on Y~Ye" In'r"to, , ctir:2ttO Oftìce of Environmental Services (805) 326-3979 White· Env, Svcs. N=NO ~ Pink, Business Copy :a CITY OF BAKERSFIE~ '\ O~CE OF ENVIRONMENTAL ~VICES 1715 Chester Ave., CA 93301 (661) 326-3979 --- UNDERGROUND STORAGE TANK FACILITY o 1 NEW SITE o 3 RENEWAL PERMIT '1D 5 CHANGE OF INFORMATION (State type 0' chenge) o 4 AMENDED PERMIT o 8 TEMPORARY SITE CLOSURE o 7 PERMANENTLY CLOSED SITE o 8 TANK REMOVED 400 TYPE OF ACTION (ChecJc one item only) PERMIT I. FACILITY I SITE INFORMATION 401 FACILITY OWNER TYPE 1 CORPORATION o 2 INDIVIDUAL o 3 PARTNERSHIP o 4 LOCAL AGENCY/DISTRICT" o 5 COUNTY AGENCY' o 8 ST~TEAGENCY' o 7 FEDERAL AGENCY' 402 3 FACILITY 10 II BUSINESS ~ 1 GAS STATION TYPE o 2 DISTRIBUTOR TOTAL NUMBER OF TANKS REMAINING A 1: SITE o 3 FARM 04 PROCESSOR o 5 OTHER 403 o 8 COMMERCIAL 404 DYes "'sJ No 'If owner of UST a public agency: name 0' supervisor 0' division, section or office which operates the UST. (This Is the contact person for the tank records.) -- Is facility on Indian Reservation or lrustlands? 405 406 II. PROPERTY OWNER INFORMATION 408 409 410 zlPqœo 412 o 2 INDIVIDUAL o 3 PARTNERSHIP o 4 LOCAL AGENCY I O;:;TRICT 05 COUNTY AGENCY 08 STATE AGENCY o 7 FEDERAL AGENCY 413 III. TANK OWNER INFORMATION 414 TANK OWNER TYPE ""-s 1 CORPORATION o 2 INDIVIDUAL o 3 PARTNERSHIP 417 S~ o 4 LOCAL AGENCY I DISTRICT o 5 COUNTY AGENCY 418 I ZJq3:?ü( 419 06 STATE AGENCY o 7 FEDERAL AGENCY 420 IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY (TK) HQ Call (916) 322-9669 if questions arise 421 V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(S) 0 1 SELF-INSURED ,,~ 2 GUARANTEE EJ 3 INSURANCE o 4 SURETY BOND o 5 LETTER OF CREDIT o 8 EXEMPTION o 7 STATE FUND o 8 STATE FUND & CFO LETTER 09 STATE FUND & CD o 10 LOCAL GOV'T MECHANISM o 99 OTHER: 422 VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to Indicate which address should be used for legal notifications and mailing, Legal notification and mailing will be sent to the tank owner unless box 1 or 2 Is checked. o 1 FACILITY o 2 PROPERTY OWNER 3 TA!JK OWNER 423 VII. APpLIcANT SIGNATURE IIy that the In'ormatlon provided herein Is true & accurate to the best of my knowledge PLICAN 428 <?Ll~ 425 427 STA TE UST FACILITY NUMBER (For local use only) FormA ~, \ ,., It CITY OF BAKERSFIE. (Ð OFFICE OF ENVIRONMENTAL SERVICES . ~. 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 , UST Tank - 1 TYPE OF ACTION Check one item only o 1 NEW SITE PERMIT o 3 RENEWAL PERMIT ~ 5 CHANGE OF INFORMATION (State type of change) Page of o 7 PERMANENTLY CLOSED ON SITE o 4 AMENDED PERMIT t I fÝJ a oQ.C1. TANK 10 # 430 433 o 6 TEMPORARY SITE CLOSURE 3 08 TANK REMOVED 429 I. TANK DESCRIPTION TANKMAgte1/ZR ~DS TANK CAPACI1 T '''' ""....UN:; 431 COMPARTMENTALIZED TANK 0 Ves No If "Yes', complele one form for each compartment. 432 NUMBER OF COMPARTMENTS I 434 435 436 TANK USE 437 ts;J 1 MOTOR VEHICLE FUEL (If mar1<ed, complete Vehide Fuel Type) o 2 USED OIL o 3 CHEMICAL PP:::"JCT. o 4 HAZARDOUS WASTE o 95 UNKNOWN II. TANK CONTENTS VEHICLE FUEL TYPE !Sl1a REGULAR UNLEADED o 1b PREMIUM UNLEADED o 1c MIDGRADE UNLEADED 438 o 5 JET FUEL o 6 AVIATION FUEL o 99 OTHER o 2 LEADED o 3 DIESEL o 4 GASOHOL COMMON NAME (from Hazardous Malerials Inventory page) . ~ WDll'~ o 1 SINGLE WAlL o 2 DOUBLE WAlL 15:1. 1 BARE STEEL 02 STAINLESS STEEL o 1 BARE STEEL o 2 STAINLESS STEEL o 1 RUBBER LINED o 2 AlKYD LINING o 1 MANUFACTURED CP o 2 SACRIFICIAl ANODE DROP TUBE STRIKER PLATE IF SINGLE WALL TANK (Check all that apply): o 1 VISUAL (EXPOSED PORTION ONL V) 1Sl2 AUTOMATlCTANKGAUGING(ATG) o 3 CONTINUOUS ATG IS! 4 STATISTICAL INVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING 439 :;;'S # (from Hazardous Materials Inventory page) .._ ~CC'i.P-LQ,- q 440 III. TANK CONSTRUCTION TYPE OF TANK 441 Check one item only TANK MATERIAL (primary tank) Check one item only ! TANK MATERIAL (~econdary tank) Check one item only INTERIOR LINING OR COATING Check one item only OTHER CORROSION PROTECTION IF APPLICABLE Check one Item only o 4 STEEL CLAD WI FRP o 3 FIBERGLASS o 4 STEEL CLAD WI FRP o 3 FIBERGLASS 05 CONCRETE '6;l3 EPOXY LINING o 4 PHENOLIC LINING "1SI5 INTERNAL BLADDER SVSTEM 095 UNKNOWN o 99 OTHER o 5 CONCRETE 08 FRP COMPATIBLE W/100% METHANOL o 3 SINGLE WALL WITH EXTERIOR MEMBRANE LINER o 4 SINGLE WALL IN A VAULT o 95 UNKNOWN o 99 OTHER 442 08 FRP COMPATIBLE W/100% METHANOL o 9 FRP NON-cORRODIBLE JACKET o 10 COATED STEEL o 95 UNKNOWN o 99 OTHER 443 o 5 GLASS LINING o 6 UNLINED o 95 UNKNOWN o 99 OTHER 444 o 3 FIBERGLASS REINFORCED PLASTIC lSl4 IMPRESSED CURRENT o 95 UNKNOWN o 99 OTHER 445 SPILL AND OVERFILL 447 SPILL CONTAINMENT INSTALLED (VEAR) Check all that apply ¡----------- I ESTIMATED DATE LAST USED (VRlMO/DA V) ! OVERFILL PROTECTION EQUIPMENT INSTALLED (VEAR) . OVes OVes 446 448 449 o 1 ALARM o 2 BALL FLOAT o 3 FILL TUBE SHUT OFF VALVE DNa DNa IV. TANK LEÀK DETEèl''J'ON IF DOUBLE WALL TANK (Check one item only): 450 o 8 VISUAL (SINGLE WALL IN VAULT ONLY) o 9 CONTINUOUS INTERSTITIAL MONITORING IS! 5 MANUAL TANK GAUGING (MTG) o 6 VADOSE ZONE 07 GROUNDWATER o 99 OTHER 451 v. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE 453 ' ESTIMATED QUANTITY OF SUBSTANCE REMAINING 452 GAS TANK FILLED WITH INERT MATERIAL? aal DYes 0 No Form B " .. CITY OF BAKERSFIELD .= ., OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield. CA 93301 (805) 326· 9 " UST. TANI( PAGE 2 Page Of ._.------- !PRESSURE " \ GRAVITY ,----...,.....--- ----"------ CONSTRUCTION! 11 SINGLE WALL 0 95 UNKNOWN f----L ' 1 DOUBLE WALL 0 99 OTHER 450 ¡ ~~~~~I~NAND ¡ 0 1 BARE STEEL 06 FRP COMPATIBLE Wt 100% METHANOL 1:11 PROTECTION I 0 2 STAINLESS STEEL 0 7 GALVANIZED STEEL 03 PVC COMPATIBLE WITH CONTENTS 095 UNKNOWN . FIBERGLASS 0 8 FLEXIBLE 0 99 OTHER i ¡ 0 5 STEEL WI COATING i CATHODIC PROTECTION 454 heçk all that ap:!ly) UNDERGROUND PIPING INFORMATION o 1 SUCTION ~2 PRESSURE 03 GRAVITY 1 SINGLE WALL 0 3 LINED TRENCH 0 99 OTHER ì . I 2 DOUBLE WALL 0 95 UNKNOWN 01 BARE STEEL 06 FRP COMPATIBLE WI 100% METHANOL 02 STAINLESS STEEL 07 GALVANIZED STEEL 03 PVC COMPATIBLE WITH CONTENTS "4 FIBERGLASS 0 8 FLEXIBLE 05 STEEL WI COATING 'rsJ 9 CATHODIC PROTECTION 456 455 454 o 95 UNKNOWN o 99 OTHER 455 VII. PIPING LÈAK'DÈTECTION ABOVEGROUND PIPING INFORMATION SINGLE WAll PIPING 457 PRESSURI7EI' P:PING (Check all thaI, apply): o 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST rm!:! AUTO PUMP SHUT OFF FOR LEAK. SY$'."" I FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS o 2 MONTHLY 0,2 GPH TEST o 3 ANNUAL INTEGRITY TEST (0.1 GPH) o 4 DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check all that apply): o 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM ! 0 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTI'::; $YSTEMS: o 7 SELF MONITORING GRAVITY FLv;; (Check all that apply): o 8 DAILY VISUAL MONITORING o 9 BIENNIAL INTEGRITY TEST (0,1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): o 10 CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (check one) o " AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o t: AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAilURE AND SYSTEM DISCONNECTION o c NO AUTO PUMP SHUT OFF o 11 AUTOMATIC LEAK DETECTOR o 12 ANNUALlNTEGRITYTEST(0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13 COtf:":",OUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check an that apply) o 14 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS . o 15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 16 ANNUli' 'NTEGRITYTEST(0.1 GPH) o 17 DAILY VISUAL CHECK Check all that a UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 456 PRESSURIZED PIPING (Check all that apply): o 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST J!Y!!!:! AUTO PUMP SHUT OFF FOR LEAK, SYSTEM F .._'JRE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS IJ 2 MONTHLY 0.2 GPH TEST ~... : ANNUAL INTEGRITY T~ST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: o 4 DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: o 5 SELF MONITORING GRAVITY FLOW: o 6 BIENNIAL INTEGRITY TEST (0,1 GPH) SE' :'J;~DARIL Y CONTAINED PIPING PRESSURIZED PIPING (Check a;; :~~t apply): o 7 CONTINUOUS TURBINE SUMP SENSOR J!Y!!!:! AUDIBLE AND VISUAL ALARMS AND (Check one) o a AUTO PUMP SHlrr OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION o c NO AUTO PUMP SHUT OFF ÌSI 8 AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o 9 ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Check all that apply) o 10 CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 11 AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o 12 ANNUAL INTEGRITY TEST (0,1 GPH) o 13 DAILY VISUAL CHECK DISPENSER CONTAINMENT DYes 0 No , VIII~DISPENSER CONTAINMENT o 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 0 3 CONTINUOUS DISPENSER PAN SENSOR ~ AUTO SHUT OFF FOR DISPENSER o 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS o 4 DAILY VISUAL CHECK IX. OWNER/OPERATOR SIGNATURE I ëiiÏtlfy (hat (he in(ormaUon provided herein is true & accurate to the best o( my knowledge. "-ŠIGNATURE NERlOP RATO {ÍL' Permit Approved Permit Number (For local use only) Form B 483 462 464 e CITY OF BAKERSFIEr.4t (Ð OFFICE OF ENVIRONMENTAL SERVICES . ~, .- 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UST Tank -1 Page of o 7 PERMANENTLY CLOSED ON SITE TYPE OF ACTION Check one ilem only o 1 NEW SITE PERMIT 0 3 RENEWAL PERMIT ~ CHANGE OF INFORMATION (Stale type of change) 08 TANK REMOVED o 4 AMENDED PERMIT o 8 TEMPORARY SITE CLOSURE 3 429 BU~~hCILlTY Lr-70i~St I M TANÖCü ~ 439 DATE INSTAlLED (YEAR/MO) 433 I fJ3 ~ Iqq<¿ ADDmONAL DESCRIPTION (For local use only) I. TANK DESCRIPTION 431 COMPARTMENTALIZED TANK 0 Yes No If "Yes", complete one (orm (or each compartment 432 NUMBER OF COMPARTMENTS I 434 435 436 TANK USE 437 .~ 1 MOTOR VEHICLE FUEL (If marl<ed. complete Vehide Fuel Type) o 2 USED OIL o 3 CHEMICAL PRODUCT. 04 HAZARDOUS WASTE 095 UNKNOWN TYPE OF TANK Check one item only TANK MATERIAL (primary tank) Check one ~em only TANK MATERIAL (secondary tank) Check one ~em only INTERIOR LINING OR COATING Check one ~em only OTHER CORROSION PROTECTION IF APPLICABLE Check one Item only II. TANK CONTENTS VEHICLE FUEL TYPE o 1a REGULAR UNLEADED ÌSl1b PREMIUM UNLEADED o 1c MIDGRADE UNLEADED 438 o 5 JET FUEL o 6 AVIATION FUEL o 99 OTHER o 2 LEADED o 3 DIESEL 04 GASOHOL 439 I ~ # (from Hazardous Materials Inventory page) LìiöOLe-LPf- ~ C~rdO~teriaISI~ l a ^-p III. TANK CONSTRUCTION o 1 SINGLE WAil o 2 DOUBLE WALL '~ BARE STEEL o 2 STAINLESS STEEL " BARE STEEL o 2 STAiNlESS STEEL o 1 RUBBER LINED o 2 AlKYD LINING o 1 MANUFAC11JRED CP o 2 SACRIFICIAL ANODE 440 o 3 SINGLE WAil WITH EXTERIOR MEMBRANE LINER o 4 SINGLE WAlL IN A VAULT o 4 STEEL CLAD WI FRP o 3 FIBERGLASS o 4 STEEL CLAD WI FRP o 3 FIBERGLASS 05 CONCRETE 5 INTERNAL BLADDER SYSTEM 095 UNKNOWN o 99 OTHER o 5 CONCRETE 08 FRP COMPATIBLE W/100% METHANOL 442 441 o 95 UNKNOWN o 99 OTHER 095 UNKNOWN o 99 OTHER 08 FRP ~MPATlBLE W/100% METHANOL o 9 FRP NON-CORRODIBLE JACKET o 10 COATED STEEL 443 3 EPOXY LINING o 4 PHENOlIC LINING o 5 GLASS LINING o 6 UNliNED 095 UNKNOWN o 99 OTHER 444 o 3 FIBERGLASS REINFoRCED PLASTIC 0 95 UNKNOWN ~4 IMPRESSED CURRENT 0 99 OTHER OVERFILL PROTECTION EQUIPMENT INSTALLED (VEAR) 445 SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEARL 447 Check al/ thaI apply DROP TUBE STRIKER PLATE OVes OVes ONo ONo 446 448 449 o 1 ALARM 02 BALL FLOAT o 3 FILL TUBE SHUT OFF VALVE .... .. .,'..-. IF SINGLE WALL TANK (Check aU thaI apply): ! 0 1 VISUAl (EXPOSED PORTION ONly) : hl..2 AUTOMATIC TANK GAUGING (A TG) o 3 CONTINUOUSATG ¡ ~ STATISTICAl INVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING . "w. "TANK LEÁK DETÈCTION·· ~ '~5 MANUAl TANK GAUGING (MTG) o 6 VADOSE ZONE 07 GROUNDWATER 099 OTHER IF DOUBLE WALL TANK (Check one item only): 450 o 8 VISUAL (SINGLE WAlL IN VAULT ONL V) o 9 CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YR/MOIOAY) 452 GAS TANK FILLED WITH INERT MATERIAL? 453 ¡ 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING oal OVes ONo Farm B .. . CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES , 5 Cheater Ave., Bakersfleld, CA 93301 (805) 326. ... UST· TANK PAGE 2 Page Of VI. PIPING C N TR ABOVEGROUND PIPING INFORMATION ŠYSTEi..(fYP~-Õ--;- SUCTlON-'-'- 02 PRESSURE 03 GRAVITY .------ CONSTRUCTION o 1 SINGLE WALL 0 95 UNKNOWN o 2 DOUBLE WALL 0 99 OTHER 450 o 1 BARE STEEL 06 FRP COMPATIBLE WI 100% METHANOL 02 STAINLESS STEEL 0 7 GALVANIZED STEEL o 3 PVC COMPATIBLE WITH CONTENTS 0 95 UNKNOWN o 4 FIBERGLASS 0 8 FLEXIBLE 0 99 OTHER 05 STEEL WICQATlNG 0 9CATHOOIC PROTECTION 455 '-MATERIALS AND ' : CORROSION I . PROTECTION I I I I 454 Cheçk ail that app'M UNDERGROUND PIPING INFORMATION o 1 SUCTION ~ PRESSURE 0 3 GRAVITY ~ SINGLE WALL 0 3 LINED TRENCH 0 99 OTHER o 2 DOUBLE WALL 0 95 UNKNOWN o 1 BARE STEEL 06 FRP COMPATIBLE WI 100% METHANOL 02 STAINLESS STEEL 07 GALVANIZED STEEL 03 PVC COMPATIBLE WITH CONTENTS 1sl.4 FIBERGLASS 0 8 FLEXIBLE o 5 STEEL WI COATING ~ CATHODIC PROTECTION 456 455 454 o 95 UNKNOWN 099 OTHER VII. PIPING LEAK DETECTION ABOVEGROUND PIPING INFORMATION SINGLE WALL PIPING 457 PRESSURIZED PIPING (Check an that ap)ly): o 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST ~ AUTO PUMP SHUT OFF FOR LEAK. SYS.'EM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL AlARMS o 2 MONTHLY 0.2 GPH TEST i 0 3 ANNUAL INTEGRITY TEST (0.1 GPH) o 4 DAILYVlSUALCHECK CONVENTIONAL SUCTION SYSTEMS (Check an that apply): o 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM o 6 TRIENNIAL INTEGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS: o 7 SELF MONITORING i GRAVITY FLOW (Check an thai apply): o 8 DAILY VISUAL MONITORING o 9 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check an that apply): o 10 CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBLE AND VISUAL ALARMS AND (check one) o a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c NO AUTO PUMP SHUT OFF o 11 AUTOMATIC LEAK DETECTOR o 12 ANNUALlNTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13 C0N71NUOU5 SUMP SENSOR + AUDIBLE AND VISUAl AlARMS EMERGENCY GENERATORS ONLY (Check aD that apply) o 14 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 16 ANNUAL INTEGRITY TEST (0.1 GPH) o 17 DAILY VISUAL CHECK Check all that a UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 456 PRESSURIZED PIPING (Check all that apply): o 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK. SYSTEM F!;IL'JRE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAl AlARMS o 2 MONTHLY 0.2 GPH TEST '\, ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: o 4 DAILY VISUAl MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: o 5 SELF MONITORING GRAVITY FLOW: o 6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): o 7 CONTINUOUS TURBINE SUMP SENSOR Y!l!I!:! AUDIBLE AND VISUAL ALARMS AND (Check one) o a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISctlNNECTlON o c NO AUTO PUMP SHUT OFF ~ 6 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 9 ANNUAl INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Check all thaI apply) o 10 CONTINUOUS SUMP SENSOR Y!£!I!:!Q!il AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL AlARMS o 11 AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o 12 ANNUAL INTEGRITY TEST (0.1 GPH) o 13 DAILY VISUAL CHECK DISPENSER I CONTAINMENT ¡DYes 0 No I I . VIII. DISPENSER CONTAINMENT o 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 0 3 CONTINUOUS DISPENSER PAN SENSOR Y!l!I!:! AUTO SHUT OFF FOR DISPENSER o 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL AlARMS + AUDIBLE AND VISUAL ALARMS o 4 DAILY VISUAl CHECK IX. OWNER/OPERATOR SIGNATURE truã&'accurate to the best of my knowtedge. Permit ApptOIIfId PennJt NumIIfIt (For lOCal use only) Fonn B 463 462 464 .... e CITY OF BAKERSFIErtþ (9 OFFICE OF ENVIRONMENTAL SERVICES . ~. . 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UST Tank· 1 TYPE OF ACTION Check one item only o 1 NEW SITE PERMIT 03 RENEWAL PERMIT ~5 CHANGE OF INFORMATION (State type 0' change) o 4 AMENDED PERMIT 0 6 TEMPORARY SITE CLOSURE Page 0' o 7 PERMANENTLY CLOSED ON SITE 08 TANK REMOVED 429 TANK ID 1# I. TANK DESCRIPTION LCfl 431 COMPARTMENTALIZED TANK 0 Yes No If "Yes', complete one 'orm 'or each compartment 432 434 NUMBER OF COMPARTMENTS ( 435 436 TANK USE 437 ~ 1 MOTOR VEHICLE FUEL , (l'mar1<ed, complete Vehicfe Fuel Type) o 2 USED OIL o 3 CHEMICAL PRÒDIJCT o 4 HAZARDOUS WASTE 095 UNKNOWN II. TANK CONTENTS VEHICLE FUEL TYPE o 1a REGut.AR UNLEADED o 1b PREMIUM UNlEADED ~c MIDGRADE UNlEADED o 2 lEADED o 3 DIESEL o 4 GASOHOL TYPE OF TANK Check one item only TANK MATERIAl (primary tank) Check one item only TANK MATERIAL (secondary tank) Check one i1em only INTERIOR LINING OR COATING i Check one item only I I OTHER CORROSION I ¡ PROTECTION IF APPLICABLE ¡ Check one Rem only ,INGLE WAlL o £ DOUBLE WAlL 1 BARE STEEL 02 STAINLESS STEEL o 1 BARE STEEL o 2 STAINLESS STEel o 1 RUBBER LINED o 2 AlKYD LINING o 1 MANUFACTURED CP o 2 SACRIFICIAl ANODE 438 o 5 JET FUel 06 AVIATION FUEL o 99 OTHER 439 ~ (from HazanJous Materials Invqry page) , èC1Q - (Q { - 440 III. TANK CONSTRUCTION o 3 SINGLE WAll WITH EXTERIOR MEMBRANE LINER o 4 SINGLE WALL IN A VAULT o 4 STEEL ClAD WI FRP o 3 FIBERGLASS o 4 STEEL ClAD WI FRP o 3 FIBERGLASS 05 CONCRETE 3 EPOXY LINING o 4 PHENOliC LINING INTERNAL BLADDER SYSTEM 095 UNKNOWN o 99 OTHER 441 o 5 CONCRETE 08 FRP COMPATIBLE W/100% METHANOL o 95 UNKNOWN o 99 OTHER 095 UNKNOWN o 99 OTHER 443 442 08 FRP COMPATIBLE W/100% METHANOL \- . o 9 FRP NON-CORRODIBLE JACKET 010 COATED STEEL o 5 GLASS LINING o 6 UNLINED o 95 UNKNOWN o 99 OTHER 095 UNKNOWN o 99 OTHER 445 444 o 3 FIBERGLASS REINFORCED PLASTIC 4 IMPRESSED CURRENT SPILL AND OVERFILL SPILL CONTAINMENT INSTAlLED (YEAR) Check all that apply ¡ ! DROP TUBE STRIKER PLATE DYes DYes oNo oNo OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) 448 448 449 447 o 1 ALARM 02 BALL FlOAT o 3 FILL TUBE SHUT OFF VALVE I' .... , IF SINGLE WALL TANK (Check aU that apply): ! 0 1 VISUAL (EXPOSED PORTION ONLY) : ~ 2 AUTOMATIC TANK GAUGING (ATG) I 0 3 CONTINUOUSATG ~4 STATISTICAL INVENTORY RECONCILIATION (SIR) + BIENNIAl TANK TESTING : . , . IV. TANK LEAK DETECTION .., . . ~ 5 MANUAL TANK GAUGING (MTG) o 6 VADOSE ZONE 07 GROUNDWATER 099 OTHER IF DOUBLE WALL TANK (Check one i1em only): 450 o 8 VISUAL (SINGLE WAlL IN VAULT ONLY) o 9 CONTINUOUS INTERSTITiAL MONITORING ,----- V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE : ESTIMATED DATE LAST USED (YRlMOIOAY) 452 GAS TANK FILLED WITH INERT MATERIAL? 453 , 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 081 DYes ONe Form B .. . CITY OF BAKERSFIELD - . _ OFFICE OF ENVIRONMENTAL SERVICES . 1, .5 Che.ter Ave., Bakersfield, CA 93301 (805) 326 9 ... UST. TANK PAGE 2 -.--------. Page Of ŠYSfEMfŸPr-:-Õ~ SUCTION' o 3 GRAVITY CONSTRUCTION o 1 SINGLE WALL 095 UNKNOWN o 2 DOUBLE WALL 0 99 OTHER 450 o 1 BARE STEEL 0 8 FRP COMPATiBlE Wt 100"" METHANOL 02 STAINLESS STEEL 0 7 GALVANIZED STEEL o 3 PVC COMPATIBlE WITH CONTENTS 0 95 UNKNOWN o 4 FI8ERGLAS5 0 8 FLEXIBLE 0 99 OTHER 05 STEEL WI COATING 09 CATHODIC PROTECTION 455 : -MATERIALS AND' : CORROSION ! PROTECTION VII. PIPING LEAK DETECTION ABOVEGROUND PIPING INFORMATION SINGLE WALL PIPING 457 PRESSURIZED PIPING (Check an that apply): o 1 ELECTRONIC UNE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK. SYS1FM FAILURE, AND SYSTEM DISCONNECTION + AUDIBlE AND VISUAL AlARMS o 2 MONTHLY 0.2 GPH TEST o 3 ANNUAL INTEGRITY TEST (0.1 GPH) o 4 DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check an that apply): o 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM o 6 TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: o 7 SELF MONITORING , GRAVITY FLOW (Check an that apply): o 8 CAlLY VISUAL MONITORING ! 0 9 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check an that apply): o 10 CONTINUOUS TURBINE SUMP SENSOR ïm!:! AUDIBLE AND VISUAL ALARMS AND (check one) o a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION o c NO AUTO PUMP SHUT OFF o 11 AUTOMATIC LEAK DETECTOR o 12 ANNUAl INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13 CON71NUDUS SUMP SENSOR + AUDiBlE AND VISUAL AlARMS EMERGENCY GENERA TORS ONLY (Check aa that apply) o 14 CONTINUOUS SUMP SENSOR mI!:!QY! AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 16 ANNUAL INTEGRITY TEST (0.1 GPH) o 17 DAILY VISUAL CHECK 454 Check all that apply) . UNDERGROUND PIPING INFORMATION o 1 SUCTION "~ PRESSURE 0 3 GRAVITY 1 SINGLE WALL 0 3 LINED TRENCH 0 99 OTHER o 2 DOUBLE WALL 0 95 UNKNOWN o 1 BARE STEEL 08 FRP COMPATIBlE WI 100% METHANOL 02 STAINLESS STEEL 0 7 GALVANIZED STEEL 03 PVC COMPATIBLE WITH CONTENTS o 4 FIBERGLASS 0 8 FLEXIBLE o 5 STEEL WI COATING ~ 9 CATHODIC PROTECTION 456 455 454 o 95 UNKNOWN o 99 OTHER Check all that a UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 456 PRESSURIZED PIPING (Check all that apply): o 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST ~ AUTO PUMP SHUT OFF FOR LEAK. SYSTEM F."ILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL AlARMS fJ 2 MONTHLY 0.2 GPH TEST . "I ANNUAL INTEGRITY TEST (0.1 GPH) CO,..../ENTlONAL SUCTION SYSTEMS: o 4 CAlLY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: o 5 SELF MONITORING GRAVITY FLOW: o 6 BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check alllhat apply): o 7 CONTINUOUS TURBINE SUMP SENSOR ïm!:! AUDIBLE AND VISUAL ALARMS AND (Check one) o a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DIS~NNECTION o c NO AUTO PUMP SHUT OFF ~" 8 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 9 ANNUAL INTEGRITY TEST (0.1 GPH) EMERGENCY GENERATORS ONLY (Check an that apply) o 10 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL AlARMS o 11 AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o 12 ANNUAL INTEGRITY TEST (0.1 GPH) o 13 DAILY VISUAL CHECK I DISPENSER , ¡ CONTAINMENT ! 0 Yes 0 No I I I . . VIIi. DisPENSER CONTAINMENT o 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 03 CONTINUOUS DISPENSER PAN SENSOR ïm!:! AUTO SHUT OFF FOR DISPENSER o 2 CONTINUOUS ELECTRONIC SENSOR + AUDiBlE AND VISUAL AlARMS + AUDIBLE AND VISUAL AlARMS , 0 4 DAILY VISUAL CHECK IX.OWNE OPERATOR SIGNATURE , is true & accurate to the best of my knowledge. i '-- Permit Number (For local use only) Form B 462 484 . - CITY OF BAKERSFIELD OFF. OF ENVIRONMENTAL SE_ICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 ~ UNDERGROUND STORAGE TANKS -INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank Page _ of -~-_.- - -..------- -------. ..-------- -- .---------.---- ---------------- .-------.-.----------------- I. FACILITY IDENTIFICATION , BUSINESS NAME (Same as FACilìTŸ NAMEóiõÈÎA . Doing sUSinešš-Ãš)-------'- _______._______n____ __ _ _ _ ___~.. _. . . _ .. ... . _·_0_.._."____._.____. - FACllrrvIO'~õi~~þ loB ß S ~-OSr) 13 ..--.------. ....--..- ---......------ --.-----___ -_.--- - --- --- - ..-----.---..-..______----.i II. INSTALLATION Check all that apply . '\ The installer has been certified by the tank and piping manufacturers. The installation has been inspected and cêrtified by a registered professional engineer. The installation has been inspe~ted and approved by the City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. ~ lsJ, ~ ~ 0- The installation contractor has been certified or licensed by the Contractors State License Board. Another method. was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: \ III. TANK OWNER/AGENT SIGNATURE -.-.---.'--- 464 .. -, .om - '--46i!" .~ --- .,..-,.-------..--. -- ,.. -. . ....----------- Fonn C ... e CITY OF BAKERSFIEre (Ð OFFICE OF ENVIRONMENTAL SERVICES . ~. 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UST Tank - 1 Page of o 7 PERMANENTlY CLOSED ON SITE TYPE OF ACTION Check one item only o 1 NEW SITE PERMIT 03 RENEWAL PERMIT ~CHANGE OF INFORMATION (State type of change) o 4 AMENDED PERMIT 0 6 TEMPORARY SITE CLOSURE 3 o 6 TANK REMOVED 429 TANK ID f Cû~~ OATEINSTALLED(Y~O) O¡I ADDITIONAL DESCRIPTION (For local use only) I. TANK DESCRIPTION 439 TANK MANUFACTURER 431 COMPARTMENTALIZED TANK 0 Yes 1sJ No If "Yes', complete one ronn for each compa~l 432 433 TANK CAPACITY IN GAllONS 434 NUMBE OF COMPARTMENTS 435 436 TANK USE 437 o 1 MOTOR VEHICLE FUEL , (Ir marked, complete Vehicle Fuel Type) ~2 USED OIL 03 CHEMICAL PROOIJCT. o 4 HAZARDOUS WASTE 095 UNKNOWN II. TANK CONTENTS VEHICLE FUEL TYPE o 1a REGUlAR UNLEADED o 1b PREMIUM UNLEADED o 1c MIOGRADE UNLEADED 438 o 5 JET FUEL o 6 AVIATION FUEL 099 OTHER o 2 LEADED o 3 DIESEL o 4 GASOHOL o 1 SINGLE WALL '~DOUBlE WAlL o 1 BARE STEEL o 2 STAINLESS STEEL o 1 BARE STEEL o 2 STAINLESS STEEL o 1 RUBBER LINED o 2 AlKYD LINING o 1 MANUFACTURED CP o 2 SACRIFiCIAl ANODE DROP TUBE STRIKER PLATE IF SINGLE WALL TANK (Check aU lllat apply): o 1 VISUAL (EXPOSED PORTION ONLY) 02 AUTOMATlCTANKGAUGING(ATG) o 3 CONTINUOUS A TG o 4 STA TlSTlCAlINVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING 439 440 III. TANK CONSTRUCTION TYPE OF TANK 441 Check one item only TANK MATERIAL (primary tank) Check one item only TANK MATERIAL (S4COndary tank) Check one «em only INTERIOR LINING OR COATING Check one «em only OTHER CORROSION PROTECTION IF APPLICABLE Check one Item only o 4 STEEL CLAD WI FRP o 3 ABERGLASS o 4 STEEL CLAD WI FRP o 3 FIBERGLASS 05 CONCRETE o 3 EPOXY LINING 04 PHENOlIC LINING o 5 INTERNAL BLADDER SYSTEM o 95 UNKNOWN o 99 OTHER o 5 CONCRETE 08 FRP COMPATIBLE W/100% METHANOL o 3 SINGLE WAll WITH EXTERIOR MEMBRANE LINER 04 SINGLE WAlL IN A VAULT 095 UNKNOWN o 99 OTHER 095 UNKNOWN o 99 OTHER 442 08 FRP C~PA1JBLE Wt100% METHANOL o 9 FRP NON-CORRODIBLE JACKET o 10 COATED STEEL 443 o 5 GLASS LINING 06 UNUNED o 9S UNKNOWN 099 OTHER 095 UNKNOWN o 99 OTHER 444 o 3 FIBERGLASS REINFORCED PlASTIC o 4 IMPRESSED CURRENT 445 SPILL AND OVERFILL 447 SPILL CONTAINMENT INSTAlLED (YEAR) Check aU lllat apply ¡ OVERFILL PROTECTION EQUIPMENT INSTALLED (YEAR) DYes DYes 446 448 449 o 1 ALARM 02 BALL FLOAT o 3 ALL TUBE SHUT OFF VALVE ,...,.... ... ., IV. TANK LEAK DETECTION . ONo DNa 05 MANUAL TANK GAUGING (MTG) o 6 VADOSE ZONE 07 GROUNDWATER 099 OTHER . IF DOUBLE WALL TANK (Check one Item only): 450 o 8 VISUAL (SINGLE WAlliN VAULT ONlY) o 9 CONTINUOUS INTERSTITIAL MONITORING V. TANK CLOSURE INFORMATION I PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YRfMOIOAY) 452 GAS TANK FILLED WITH INERT MATERIAL? 453 , 451 ESTIMATED QUANTITY OF SUBSTANCE REMAINING aal DNa DYes Fonn B - '- _ CITY OF BAKERSFIELD '. OFFIWE OF ENVIRONMENTAL SE.CES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS -INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank -~------._,----- -----_..-- Page _ ot ..---------.-- ----------.--- --------------_._- _.._~----'~_._-------------~ I. FACILITY IDENTIFICATION -------_..~---_._-- -.---.. . _ .-.,_...." -.---.-------.-.-.--. .---.-.-.-..-. ... - - ..-'"____.. __u.._____.o ------------.....--.- ---. .--- ..--.--,..-..----- II. INSTALLATION Check all that apply . The installer has been certified by the tank and piping manufacturers. ~ The installation has been inspected and certified by a registered professional engineer. ~ The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. C\ All work listed on the manufacturer's installation checklist has been completed. ~ The installation contractor has been certified or licensed by the Contractors State License Board. o . Another method. was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: \- III. TANK OWNERlAG~NT SIGNATURE , , .. , "--"'-464 .. ' -'''- - --"400 Form C . CITY OF BAKERSFIELD OFF. OF ENVIRONMENTAL SE.CES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS . INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank ..-------.- ----- Page _ of "---- ----,---------._--. ..------ -_._-----~------- -~-----.._,----------~-- I. FACILITY IDENTIFICATION ---------------- BUSINESS -----_._._-----.----~- + - - - .--." . - .. -.. --...._----- .---..--..-----.--.--. E[tüXrrhE3r~~ 16 Ò~IOq ~~~I F~ò3 ..__._----_. - .-.- - ..-.._-... ------.------. .-------.....--- --. --- ..----...--------- II. INSTALLATION IS! 1sJ ISI t9. o· Check all that apply . The installer has been certified by the tank and piping manufacturers. The installation has be/inspected and certified by a registered professional engineer. The installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. All work listed on the manufacturer's installation checklist has been completed. The installation contractor has been certified or licensed by the Contractors State License Board. Another method. was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: \- III. TANK OWNERlAG~NT SIGNATURE information provided herein is true & accurate to the best of my knowledge - T_õiiiii~ -.--------------- -- mTfiÃi<-¡n----------- ------- ----- - ----- - - ------... _l~L____ --1-- -4 ~jqCt________m...__ _ ~;;¿(¡;:~r1L'----"' ,y;;;~~<L-----------m-- Form C . CITY OF BAKERSFIELD .. OFF~E OF ENVIRONMENTAL S~ICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS . INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank Page _ of ~--_._-_.'--'----- ...---".-,. .._-------._._- .-----------.-.--- ----..-----..----.-. _.._--_._---------_._------~ I. FACILITY IDENTIFICATION i:~~i~'5i'--- ~~~-~=~~=~......~~....... no ... .._.._.. ...___.__ "'._.__. ....._,_.-. ------.---".--. ..--.---....-,.------- II. INSTALLATION Check a/l that apply . The installer has been certified by the tank and piping manufacturers. lSI The installation has been inspected and cerl.:4ed by a registered professional engineer. fQ The installation has been inspected and anproved by the City of Bakersfield Office of Environmental Services. ) All work listed on the manufacturer's installation checklist has been completed. rs;¡ The installation contractor has been certified or licensed by the Contractors State License Board. o Another method was used as allowed by the City of Bakersfield Office of Environmental Services. Identify method: I i I L- III. TANK OWNERlAGE:NT SIGNATURE -----------..-.---.- , I certify that the information provided herein Is true & accurate to the best of my knowledge i-::~fr:'=~~==~~f:~j,~J~~=~~-~-~n - . ,-J-X-4·~JiL~._-n~-_._n.. .. . ,_ _"'__"'_M__~ .. "..",.. ---468' --- ---.-. -------.--- _.--+ ---.-.-.------ Form C 0/ -. . . ~ \to CITY OF BAKERSFIELD ~vO~~~ OFFICE OF ENVIRONMENTAL SERVICES ?J {,jt~'5{~ , 1715 Chester A vc., Bakersfield, CA (805) 326-3979 1 APPLICATION TO PEH.FORl\1 A TANK TÌGI'ITNESS TEST FACILITY tV l~jtZr /,- C~c-vé LJas ~. ADDRESS I ')D I ~)'-I-T tt~ ~. &JIL~S~~).J cA c¡ :J3t>j PERMIT TO OPERATE It OPERATORS NAME I rJ I ~Ü Cvft:L- (~~ Wo..--J" ~'-- OWNERS NAME---=r-Ó tAl ~., NUMBER OF TANKS TO BE TESTED TANK # VOLUME / rZ-{é 2- t Z,/C ..3 I ~k- __ IS PIPING GOING TO BE TESTED CONTENTS ~~~L 51A~~ TANK TESTING COMPANY ~TA /II<: "j) / Dj ~ - rJ:f) E- . l _ lS¡"I\+e.- i OL1j I MAILING ADDRESS !2 7)"7f¡ CD t'^- ~¡,?-rL e., "t'e..,,-i'--t'¥--r ,Dc) ~IY"\.-e(,w ~) C1+ q2~1D NAME & PHONE NUMBER OF CONTACT PERSON ¡¿f1.,.(\ (Yì{yJ()(t Q-,/)1-30Ç-, 2..IÙ TEST METHOD V aL V1'T~¿:~ NAME OF TESTER J)av \ d Tb k I ( CERTIFICATION # /31 ~ DATE & TIME TEST IS TO BE CONDUCTED q-& -1) ò . éb A'yV\ ~5 'APPROVED r ~,,'31-cfcJ DATE SIGNATURE' OF APPLICANT ~H·W. ",.. California R'gional Water Quality'ontrol Board Central Valley Region Steven T. Butler, Chair ~ ~ Winston H. Hickox Secretary for Environmental Protection Fresno Branch Office Internet Address: http://www.swrcb.ca.gov/-rwqcb5 3614 East Ashlan Avenue, Fresno, California 93726 Phone (559) 445-5116' FAX (559) 445-5910 29 August 2000 FiI:CI:IV~O 4UC Mr. Steve White. } 0 20fJ Carwash of America ENVIRON '0 20280 S. Vermont Avenue, Suite 100 . S~¡:¡'IIC~ Torrance, California 90502 çS Regional Board Case No. 5T15000808 . Gray Davis Governor OVERDUE WORK PLAN TO INVESTIGATE UNDERGROUND TANK RELEASE, NIAGRA CAR WASH, 1701 STINE ROAD, BAKERSFIEW, KERN COUNTY By our letter dated 7 February 2000, we requested you submit a work plan to investigate the extent of soil and groundwater impacts caused by an unauthorized release of petroleum range hydrocarbons at your site. The due date for the work plan, established by our 7 February letter was 15 April 2000. On 24 April 2000, Regional Board stàff met with your consultant, Mr. Charles Buckley, with California Environmental, to discuss our concerns. Briefly stated, the site is near a canal and saturated soil containing gasoline range compounds and methyl tertiary butyl ether (MTBE) has been found above the regional groundwater table. Possible impacts to the regional groundwater are unexplored. The site is also within 500 feet of a municipal water supply well (California Water Service (CWS) well 158-01). During the 24 April meeting, Regional Board staff understood that Mr. Buckley would discuss our concerns with you. Staff notes of that meeting indicate Mr. Buckley thought remediation by SVE might be applicable. A guard well between the site and CWS well 158-01 was also discussed. By 29 September 2000, please submit the work plan. The work plan should include investigations necessary to determine if SVE is an appropriate remediation method for the site, and procedures to install a guard well between the site and CWS well 158-01. In addition, you must conduct a well search within 2,000 feet of the site, and sample all wells within 1,000 feet of the site. The samples must be analyzed for benzene, toluene, ethylbenzene, xylenes (BTEX), MTBE, and total petroleum hydrocarbons as gasoline and diesel (TPH-g, and TPH-d). Should you have any questions, Mr. David Sholes, the engineering geologist assigned to this matter, may be reached at (559) 445-6279. f)!~~ ~ . OHN M. NOONAN Senior Engineer RCE No. C035206 cc: Mr. Ralph Huey, City of Bakersfield Fire Department, BakerS~ Ms. Sandy Gill, SWRCB, UST Cleanup Fund, Sacramento Mr. Charles I. Buckley, California Environmental, West Lake Village California Environmental Protection Agency #r> ~~ Recycled Paper A~~' p..eN~ /ea.vv~ ~ ~._" ~Yð~ ~_ e, ~ California Regional Water Quality Control Board ~ Central Valley Region Steven T. Butler, Chair Winston H. Hickox Secretary for . Environmental Protection Fresno Branch Office Internet Address: http://www.swrcb.ca.gov/-rwqcb5 3614 EastAshlan Avenue, Fresno, California 93726 Phone (559) 445-5116 . FAX (559) 445-5910 Gray Davis Governor 29 August 2000 FlI:Cl:II/~/) AUti Mr. Steve White } 0 20a Carwash of America ENVIRON '0 20280 S. Vermont Avenue, Suite 100 " '~I:¡:¡V/C~ Torrance, California 90502 11;;8 Regional Board Case No. 5T15000808 OVERDUE WORK PLAN TO INVESTIGATE UNDERGROUND TANK RELEASE, NIAGRA CAR ' WASH, 1701 STINE ROAD, BAKERSFIELD, KERN COUNTY By our letter dated 7 February 2000, we requested you submit a work plan to investigate the extent of soil and groundwater impacts caused by an unauthorized release of petroleum range hydrocarbons at your site. The due date for the work plan, established by our 7 February letter was 15 April 2000. On 24 April 2000, Regional Board staff met with your consultant, Mr. Charles Buckley, with California Environmental, to discuss our concerns. Briefly stated, the site is near a canal and saturated soil containing gasoline range compounds and methyl tertiary butyl ether (MTBE) has been found above the regional groundwater table. Possible impacts to the regional groundwater are unexplored. The site is also within 500 feet of a municipal water supply well (California Water Service (CWS) well 158-01). During the 24 April meeting, Regional Board staff understood that Mr. Buckley would discuss our concerns with you. Staff notes of that meeting indicate Mr. Buckley thought remediation by SVE might be applicable. A guard well between the site and CWS well 158-01 was also discussed. By 29 September 2000, please submit the work plan. The work plan should include investigations necessary to determine if SVE is an appropriate remediation method for the site, and procedures to install a guard well between the site and CWS well 158-01. In addition, you must conduct a well search within 2,000 feet of the site, and sample all wells within 1,000 feet of the site. The samples must be analyzed for benzene, toluene, ethylbenzene, xylenes (BTEX), MTBE, and total petr~leum hydrocarb~ns as gasoline and diesel (TPH-g, arid TPH-d). Should you have any questions, Mr. David Sholes, the engineering geologist assigned to this matter, may be reached at (559) 445-6279. f)!~~ . OHN M. NOONAN Senior Engineer RCE No. C035206 cc: Mr. Ralph Huey, City of Bakersfield Fire Department, BakerS~ Ms. Sandy Gill, SWRCB, UST Cleanup Fund, Sacramento Mr. Charles 1. Buckley, California Environmental, West Lake Village California Environmental Protection Agency fro ~'" Recycled Paper - ~' . .r RECORD OF TELEPHONE CONVERSATION Location: lìcJ . I 5 P-rE ID# Busin... Name: Contact Name: Cß<- ~H I,~-::'/('IC~ , JOt-kJ N'uc.J,..fArJ Business Phone: Inspeètor's Name: FAX: tfW Time of Call: Date: <:,£¡t-.}{! 0cJ Type of Call: Incoming [£1' Time: # Mln: Outgoing [ ] Retumed [q-- Content of Call: Ckl-LC-o '7è) S.A-V 17-JA-- T r;¿..t.J~c..ß, W ¡ LL. '> n l..L. , , (~u=. AS L-c.--o.D. ~ f>+A-'( '(A--<;;rE II K-t-L 'íl~J" f'4-E ~~<;.'/ '2{ íl.{A-'r ~c>t..f-t-..J I-\-ÂS ,As'S(G-rVC.-D ÍÃ-VIO S<:qcJt.GS ot:=-- ifls r:)F-Þ,<:..E- '--rv I {A--f P éE . Actions Required: J ð t+N édf\f~(2.f1/1G() 11-0.--, ~E' M(Çé--nvJG- (2.c.J:::c.re..f2'6-0 m- 11\1 N~I'- t)( 0 (2C"-QUtfl.£, c.N?- w/J.s.11 <íO /P\I<;: ,4LL. Â-I (.E4S T &RòJ'rJû~~ W'C--1-L ~~TI.JC==C-..v TH-b SIn=: ~ 11f£ ¡v£AtiÔ'l fV1J¡J 1<:1(::>.1.\-<...,. ~ W"6'-L / ,~ A-D(J ITT6V" '"flJ VAPcJY2.... ~-n...ACT7CJrl. r¡<.vJ&(I~ WILL E-f\JRJQc.6 (Hc,e o(LDC"¡¿ I (r-: Nf?Le-~~f..(· -Jd t-\-N WIMvTC-() 'N Fò ôrJ (".Ir:-r--.J òvJ rJ'C..íJ..$. , -rõo. Time Required to Complete Activity II Min: . ~ BAKERSFIELD FIRE DEPARTMENT EmnRONMENTALSER~CES 1715 Chester Ave. · Bakersfield, CA 93301 BUSiness Phone (661) 326-3979 · FAX (661) 326-0576 FAX Transmittal . - - TO: joo-{,J;J~ COMPANY:., :-¡t.l.Jcl.ctS: FRÒM:'~' . W,Nr:-S FAX No. S-S'1..A4S'. 5''7fù COMMENTS: '3 ~AG-b, ""Tð ~u:x.;j -- -.-.. ". .. ., ._~ -'" --- ~" ,. - wE- H4() ~-Fc.~ ~\ç """fù Dt2¡JC€Si3<=~LW~àF (!\JDfCIJ.-TUW'!> .. h___." " , öÇ /,,¡ç-u.."f'QÞr"¡iÓr-) <F=i2ð"", AbjlJ.C6f1ff CA¡J't.+ê.- W,..f¡c.4 is Co,\/c¡V;rc . Q,.JfJ\,", vI'fDC/L 1"1-I-E fMPC!ZT'Y 4 UNUI\/C-I) Sc:>úlH (ù()WY\/6-/t40(c-w0, <""j1+C..aE W'ð.-$f'I "T SA-TcJM-ït:'-o oR.. p~-I) ~<s.1' JuST LG',...;S ar.::- '''f\1..ð i $ r: ·-SA';'.J1)~" '. ~'t' : W\A-S 6v"dU:U';' .. :.-ro . "- I<'c.-'< (r uP Tð --¡-4c:- íSo~(). ßa..Jc£ S'~0) <{'t) ~ 17-+4./ IAI~it... T(2A··íI<J.,J 's c>CCoRJZ.,.N(ÿ -t þ{z"hNG- ""'('l.h;; Jvt nsé 'þ()WN W/'TU IT, e.Au~fl/IA tSVJ,<t/l..IVW/C..,vrA<... ðE.)f:c.:rc---Ö -tZ> ~ wA'It""- tS~vG '4-. '.I'M -r«.y,NG- <7ð Cð.vF.R.r\/1 W(-4A.T ¿JÄ-S ~-A("'-Y A:5RGc-o 'TO A: I î'1-f E ~c.é .µc...,t¥2.i rJr;... ~ I r= 'rb0 I 0 L. I KG uS ¡5ACI<: ðN ---n+G <"A-S'G' "{õ ¿:JV~S~ VAP(Jt{. G<TfZAc:nèòYJ oPn ØN. Yt..6.a.se; ~V(s.6.. '{7-I-.A-lVKS I ~ J (It ~I RICORDO' TeLEPHONE CONVERSATION Location: ( 7 0 ( S 17 '\/'E ~ ID# BU8in_ Name: CALIH:.xl...¡VIA E:¡ýJ\l?.c>VrtAGV-rA <.... Contact Name: ê /J/Yt,LE"s. Z Ue..-I< u:v Business Phone: <)( leg, "9 '7 I f' I S 4 '2.. FAX: Inspeètor's Name: -kkJ TIme of Call: Date: ~ /I(Õ / ocl Time: ð <7 ðò # Mln: .. Type of C8I':· 'ncomlng (~ .. Outgoing [ 1 Retumed [ ] Content of Call: -¡Z~Ñ(;. M So' eA-"- it; S1'4-rv! ~ CIn-~ ~awCA Ct:¥U2Gc..pL/~ Ae,17cW. 8,.UC/<LlE¥ JlAc-r-w/ {?WQCIš ~ú/3~c-rf- ;d 26 JVtz-IL ~ INV/'T'A71cJN f R.c.Jd2C;B (,I¡:?2~Y ~-ED (1.f.Ar k,T'Vt:- . " VAP()ý('" 6~ 'tb-~Dvcr: ¿t2Vc?LS ,,,, -SÙ/L- ¿,JrJvl..O ßG ~d~G ALrm~A-T1vé'" 70 ~(2.1"4C4. ~N~~ ~fTCf2.iNG ~ I'\JS"Í~L4rtd~ Actions Required: CM- W'JÞ&Ú'/ AM.Ø-,CA <;;ria. ~-o5> ',-0 Aù~~ ßt..t.,K.l(T¡/· <7D SUíJM I -,- ~(.AN ~ ~C() fë>(2... V'AP(ff2.. e)t..-rrz.AC(l d'N I/\.J 1-' tELl e>F Gf1ðú'~-rt8L A.aN /1TJfl.t' Jó-- i.JC-z..<..,. INS r4(.CA-lT úN ~ .1:F (2 wQC íS (5 6ot~ <"{ð /Y'P(ZQJé \/A?t:1<l- G)<èíRJ3c"(TclrV <t A...t.Jr (?¿QUiIlé ~NI(~/.,.JGr vvL"'7..c..S / ¿;:I rý or: ßc..KC..zS"cf6...0 Sft)v¿.C> RtE ,ASSvJlo1ëS l..f:A:() "A6&-k:-V srf1.Tüs" Time Required to Complete Activity # Mln: ~ California ~'ional Water Qualit[Pontrol Board ~ Central Valley Region Steven T. Butler, Chair ~ . Winston H. Hickox S~cr~tary for EnvironfMntal Prot~cticJn Fresno Branch Office Internet Address: http://www.swrcb.ca.gov/-rwqcb5 3614 East Ashlan Avenue. Fresno. California 93726 Phone (559) 445-5116' FAX (559) 445·5910 Gray Davis Gov~rn(r 26 April 2000 RWQCB Case No. 5T15000808 -9~c '#4r ~".~O ~~J?-9a 0 -? ~ ~ $8"~ J?Cçø PETITION OF RWQCB REQUEST FOR FURTHER INVESTIGATION UNDERGROUND TANK RELEASE, NIAGARA CAR WASH, 1701 STINE ROAD, . B~KERS.!lEW, ~~RN ÇOYN'!X_,- . '____' ,_ 'u'h'.. __ ,,_ __ ,_ _, _, '.."......._,__., Mr. Steve White Carwash of America 20280 S. Vermont Ave., St~. 100 Torrance, CA 90502 -..-- -'---.. We received a 10 April 2000 letter from yoUr consultant, Mr. Charles Buckley of California Environmental, regarding your wish to petition our office's 7 February 2000 request for further soil and groundwater assessment at the subject site. Mr. Buckley requested that we provide the necessary forms and information Deeded to file the petition. We have provided a copy of guidelines prepared by State Board staff for the petition procedure as an enclosure, but see petition as premature. ... Petitioning requests ànd decisions of office staff without first attempting to meet and come to some resolution regarding this mattër cannot be in the best interest óf any party. We wouldbe happy to meet with you or your consultantto discuss the environmental conëems at this site arid give ýou an opportunity to explain the technical merits of your position, as you will have to explain in any petition. It is our desire to resolve this environmental problem in a reasonable fashion and avoid possibly time consuming and expensive petition proceedings. - If you still choose to petition our request for further site investigation, you should contact the State Board for specific information on that process. We are not in the position to answer further questions regarding the procedures. You may wish to contact your legal counsel for help. - - -'- - - -- If you have any questions regarding tIDS matter, please contact Mr. Bruce Myers of this offièe at (559) 445-5504 ~ ~5-5550. , Ç:'f\L//f. T/~«--- ' ~~. NOOi-fAN Senior WRC Engineer RCE No. C035206 JMN:bem cc wI enclosure: Mr. Charles Buckley, California Environmental, 31119 Via Colinas, Ste. 501, Westlake Village, CA 91362 Mr. Ralph Huey, City of Bakersfield Fire Department, Bakers~ Ms. Sandy Gill, SWRCB, UST Cleanup Fund, Sacramento cc wlo enclosure: California Environmental Protection Agency - 0 R~cYcled Paper - e Sf ATI 01 CAUFOfl1A STATE WATER RESOURŒS CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM CJ o I NEW ~ERMIT 2 INTERIM ~ERMIT ß~ RENEWAL PERMIT AMENDED PERMIT o o 5 CHANGE OF INFORMATION S TEMPORARY TANK CLOSURE o o 7 PERMANENTLY CLOSED ON SITE 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION COMPlETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. 0.' 8. MANUFACTURED BY: D. TANK CAPACITY IN GAlLONS:l'2.-D--vD Q.. II. TANK CONTENTS IFA.IISMARIŒO,COMPLETEITEMC. A. .~ 1 MOTOR VEHICLE FUEL 0 4 OIL o 2 PETROLEUM 0 80 EMPTY. o 3 CHEMICAL PRODUCT 0 05 UNKNOWN D, IF (A. I) IS NOT MARKED. ENTER NAME 01' SUBSTANCE STORED I PRODUCT :2 WASTE c·D o o ,. REGULAR UNLEADED Ib PREMIUM UNLEADED :2 LEADED 3 DIESEL 0 8 AVIATION GAS 4 GASAHOL 0 7 METHANOL o 5 JET FUEL ~. l1li O~ER cœSCRlBE IN ITëY D. BELOW) C.A.S.': B. III. TANK CONSTRUCTION MARl< ONE ITEM ONlY IN BOXES A. B. AND C. AND ALL THAT APPliES IN BOX D A. TYPE OF 0 1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER DasUN~. l( ~ Ù1 i' .rB SYSTEM o 2 SINGLE WALL 0 4 seCONDARY CONTAINMENT (VAULTED TANK) l1li O~E . L \A..'C{ . .~ BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGLASS 0 4 STEEL CLAD WI FIBEFIGLASS REINFORCED PLASTIC B. TANK MATERIAL o CONCRETE 0 8 POLYVINYL CHLORIDE 0 7 ALUMINUM 0 8 100% METHANOL COMPATIBLEWIFRP :Primary Tank) o II BRONZE 0 10 GALVANIZED STEEL 0 115 UNKNOWN 0 l1li O~ER 0 1 RUBBER LINED 0 2 ALKYD LNNG 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING 0 . UNLINED 0 UNKNOWN 0 l1li O~IiR UNING D. CORROSION PROTECTION IS LINING MATERIAL COIoIPATIBLE WITH 100% ME11-IANOl? o 1 POLYETHYlENE WRAP 0 2 COATING o 5 CATHOOIC PROTECTION 0 III NONE YES_ NO_ o 3 VINYl WRAP o 115 UNKNOWN o 4 FIBERGLASS REINFORCED PLASTIC tSI l1li D~ER \ '('(\\)'(Vbr:e.d ClL.~ + C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION IV. PIPING INFORMATION CIRCLE A IFA80VEGROUNOOR U IFUNDERGROUND.BO~IFAPPLICABLE A. SYSTEM TYPE A U 1 SUCTION A U PRESSURE A U 3 GRAVITY A U l1li O~ER B. CONSTRUCTION A U SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U as UNKNOWN _ A U l1li O~ER A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHlORIDE (PVC~ U FIBERGLASS PIPE A U 5 ALUMINUM A 8 CONCRETE A U 7 STEEL WI COATING A 8 100% ME'THANOL COMPATIBLE WIFRP A U II GAlVANIZED STEEL A U 0 ATHOOIC PROTECTION A U 05 UNKNOWN A U l1li O~ER 1 AUTOMATIC LINE LEAK DEre 2 LINE TIGHTNESS TESTING 0 IIOHITORJiG 0 l1li O~ER V. TANK LEAK DETECTION o 1 VISUAL CHECK o S TANK TESTING 0 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORING 7 INTERSTITIAL MONITORING 0 111 NONE 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 115 UNKNOWN 0 l1li O~ER VI. TANK CLOSURE INFORMATION I. ESTIMATED DATE LAST USED (t.IOiOAYIVR) 2. ESTIMATED OUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WI~ INERT MATERIAL? YES 0 NOD EST OF MY KNOWLEDGE, IS TRUE AND CORRECT D STA TE 1.0.# COUNTY . IT] JURISDICTION. o:JJ FACILITY . = TANK. OJIIIJ ~ERMIT NUMBER PERMIT APPROVED BVIOATE PERMIT EXPIRA TION OA TE FORM 9 (11-IlOl THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATlON· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOIIOO3'U4 e e IT AT! 01 CAUfOlNA STAT1: WAT1:R RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYST1:M. MARK ONLY ONE ITEM o 1 NEW PERMIT o 2 INTERIM PERMIT D 7 PERMANENTLY CLOSED ON SITE D 8 TANK REMOVED ~ J RENEWAl PERMIT ~ AMENDED PERMIT D 5 CHANGE OF INFORMATION o II TEMPORARY TANK CLOSURE I. TANK DESCRIPTION OBA OR FACILITY NAME WHERE TANK IS INSTALLED: COMPlETE ALL ITEMS - SPECIFY IF UNKNOWN A, OWNER"S TANK I. D.' D C, DATE INSTALLED (MOiOAYIYEAR) B. MANUFACT\JREO BY O. TANK CAPACITY IN GAlLONS=l II. TANK CONTENTS IF A· 1 IS MARKEO, COMPLETE ITEM C. s. ~1 1oI0TOR VEHICLE FUEL 0 4 OIL B. C D ,. REGULAR B 3 DIESEL D II AVIATION GAS ~ PROOUCT . UNLEADED 02 PETROLEUM 0 80 Et.IPTY. ~PREMIUM 4 GASAHOL D 7 METHANOL .UNlEADEO B 5 JET FUEL 03 CHEMICAL PROOUCT 0 g& UNKNOWN o 2 WASTE D 2 LEADEO DQ O~ER (DESCRIBE IN ITEM O. BELOW) D, IF (A. I) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C.A.S.': III. TANK CONSTRUCTION o 1 OOUBLE WAlL D 2 SINGLE WAlL MARK ONE ITEM ONLY IN BOXES A. B. ANO C. ANO AlL THAT APPliES IN BOX 0 A. TYPE OF SYSTEM 1 BARE STEEL B. TANK MATERIAL. 5 CONCRETE :Prirrwy Tlnk) 0 8 BRONZE 0 1 RUBBER LINED C. INTERIOR 0 II GlASS LINING UNING o D o o D o o 3 SINGLE WAlL. WITH EXTERIOR LINER 4 SECONDARY CONTAINMENT (VAUl TEO TANK) o 8 POLYVINYL CHLORIDE 0 10 GAlVANIZEO STEel 0 2 STAINLESS STEel 3 FIBERGlASS 7 AlUMINUM 85 UNKNOWN 2 AlKYO LINING e UNlINEO 3 EPOXY LINING UNIOIOWN YES_ NO_ D 3 VINYl WRAP D 85 UNKNOWN IS LINING MATERIAl CONPATI8lE WITH 100"lIo ..ETHANOl? O. CORROSION PROTECTION D 1 F'OLV'ETJ.m.ENE WRAP D 2 COATING D 5 CATHODIC PROTECTION 0 81 NONE IV. PIPING INFORMATION A. SYSTEM TYPE B. CONSTRUCTION CIRCLE A IF ABa 1 SUCTION 1 SINGLE WAlL C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION A U 1 BARE STEEL A U 5 AlUMINUM U 9 GAlVANIZEO STEel V. TANK LEAK DETECTION o 1 VISUAL CHECK o II TANK TESTING NO OR U IF UNDERGROUND. BOTH IF APPLICABlE PRESSURE A U 3 GRAVITY A U 2 DOUBLE WAlL A U 3 LINED TRENCH D 95 UNKNOWN .. go OTHERSt~~lM1IlI-Ò( \ n+ , bkt D 4 STEEL CLAD WI FIBERGlA.SS REINFORCED PlASTIC D 8 100% METHANOL COMPATIBLE WIFRP D go OTHER D 4 PHENOLIC LINING o DQ OTHER D 4 FIBERGlASS REINFORCED PlASTIC -l go OTHER I (Y\-S)f ~a W (VtNl: I A U go O~ER AU 115 _ A U go OTHER A U 2 STAINLESS STEEL A U 3 POLYVINYL CHlORIOE (PVC)A U e CONCRETE A U 7 STEEL WI COATING A ~IC PROTECTION A U 115 UNKNOWN A U 2 LINE TIGHTNESS TESTING D IotONITORING FIBERGlASS PIPE 8 100% "ETHANOL COMPATIBLEWiFRP DQ O~ER D DQ O~ER 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORING AUTOMATIC TANK GAUGING D 5 GROUNO WATER MONITORING INTERSTITIAL MONITORING D 91 NONE 0 85 UNKNOWN D go OTHER VI. TANK CLOSURE INFORMATION I. ESTIMATED DATE LAST USEO (IooIOIOAYIYR) 2. ESTlMA TEO OUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLEO WI~ GALLONS INERT MATERIAl? YES 0 NO 0 STA TE 1.0.# PERMIT NUIoIBER T OF MY KNOWLEDGE. IS TRI.IE AND CORRECT o COUNTY II IT] JURISDICTION II FACILITY II [IT] '.. = TANK II LITIID PERMIT APPROVEO BV/OATE PERMIT EXPIRA TICN CATE THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATlON . FORM Ii., UNLESS A CURRENT FORM A HAS BEEN FILED. FOROa:MI-IW FORM B (11-901 e . Sf ATI OF CAUFOANA STATE WATER RESOURŒS CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM LJ 1 NEW PERMIT o 2 INTERIM PERMIT ª 3 RENEWAl PERMIT o · AMENDED PERMIT o 5 CHANGE OF INFORMATION o II TEMPORARY TANK CLOSURE o 7 PERMANENTLY CloseD ON SITE o 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTAllED: I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. . B. MANUFACTURED BY: <:. -º- IF A· 1 IS MARKED. COMPLETE ITEM C. o o 1. REGULAR UNLEADED b PREMIUM UNlEADED 2 LEADED B 3 DIESEL . GASAHOL 5 JET FUEL 011 OTHER (DESCRIBE IN rre... D. BELOW) o II AVIATION GAS D 7 METHANOL A, 1 '-IOTOR VEHICLE FUEL o 2 PETROLEUM o 3 CHEMICAL PRODUCT D. OIL o 80 EMPTY. o 06 UNKNOWN ~ ~ 1 PROOUCT o 2 WASTE C. D, IF (A.I) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C.A.S.': III. TANK CONSTRUCTION MARK ONE ITEM ONlY IN BOXES A. B, AND C, AND ALl THAT APPLIES IN 80X D A. TYPE OF 0 1 DOUBLE WAlL 0 3 SINGLE WALl WITH EXTERIOR LINER D \15 UNKNOWN SYSTEM D 2 SINGLE WALL 0 . SECONDARY CONTAINMENT (VAULTED TANK) 'Q 011 OTHER -~ BARE STEEL 0 2 STAINLESS STEEL D 3 FIBERGlASS 0 4 STEEL CLAD WI FIBERGLASS REINFORœD PLASTIC B. TANK MATERiAl o 5 CONCRETE D 8 POLYVINYL CHLORIDE D 7 AlUMINUM D 8 100%0 METHANOL COMPATIBLE WIFRP (PrinwyTw) o \I BRON2E D 10 GAlVANIZED STEEL 0 06 UNKNOWN D 011 OTHE R 0 1 RUBBER LINED D 2' AU<YD Lt/t/G 3 EPOXY LINING D 4 PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING D 8 UNLINED D' UNKNOWN 0 011 OTHER UNING IS LINING MATERIAL COWPATIBLE WITH 100%0 METHANOl? YES_ NO_ D. CORROSION D 1 POL \'ETHYLENE WRAP 0 2 COATING D 3 VINYL WRAP D · FIBERGlASS REINFORœD PlASTIC PROTECTION 0 5 CATHOOIC PROTECTION 0 11 NONE o 06 UNKNOWN &. 011 OTHER\ m~-\! C \J---iY-(.V)t IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVI1Y A U 011 OTHER B. CONSTRUCTION AU SINGLE WAlL A U 2 DOUBLE WAlL A U 3 LINED TRENCH A U 06 UNKNOWN _ A U 011 OTHER C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION A 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHlORIDE (PVC) A U A U 5 AlUMINUM A U 8 CONCRETE A U 7 STEEL WI COATING A A U \I GAlVANIZED STEEL A U 10 CATHODIC PROTECTION A U \15 UNKNOWN A U 1 AUTOMATIC LINE LEAK DETECTOR 2 LINE TIGHTNESS TESTING 0 3 IoIONITORING FIBERGlASS PIPE 8 100%0 METHANOL COMPAT1BLEWIFRP 011 OTHER o 011 OTHER V. TANK LEAK DETECTION o I VISUAL CHECK o II TANK TESTING 0 2 INVENTORY RECONCILIATION D 3 VAPOR MONITORING 7 INTERSTITIAL MONITORING 0 \11 NONE 0 4 AUTOIAATIC TANK GAUGING 0 5 GROUND WATER MONITORING UNKNOWN 0 011 OTHER VI. TANK CLOSURE INFORMATION 1. ESTIMATED DATE LAST USED (IoAOIOAYIYR) THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJUR . APPLICANT'S NAME ' ) A ¡PRONT!O' SlGNAT\JRE ,.. ~t IC.. 2. ESTIMATED OUANTI1Y OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH INERT MATERIAL ? YES D NOD F MY KNOWLEDGE, IS TRUE AND CORRECT o LOCAL AGENCY USE ONLY STA TE 1.0.# COUNTY II CD JURISDICTION II ern FACILITY II = TANK. ITITllJ PERMIT NUMBER PERlA IT APPROVED BYIOATE PERMIT EXPIRATION DATE FORM B (g.gQ THIS FORM MUST BE ACCOMPANIED BY A PERMrT APPUCATlON . FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOfIGQ:)C~ .. . . i.' . . 51 ATI 01 CAUfOfNA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONL y ONE ITEM o I NEW PERMIT o 2 INTERIM PERMIT J RENEWAl PERMIT AMENDED PERMIT o 5 CHANGE DF INFDRMATlON o IS TEMI'ORARY TANK CLOSURE o 7 PERMANENTLY CLOSED ON SITE o 8 TANK REMOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I, TANK DESCRIPTION CDMF'lETE ALL ITEMS - SPECIFY IF UNKNOWN A, OWNER'S TANK I. D.' B. MANUFACT\JRED BY: C. 01. TE INSTALLED (MO/OAYIVEAR) D. TANK CAPACITY IN GAlLONS: II. TANK CONTENTS IF A·' ISMARKEO,COf,\PLETE ITEM C. [] 1 IoIOTOR VEHICLE FUEL . OIL A, o 2 PETROLEUM o J CHEMICALPROOUCT o 80 EMPTY. o GS UNKNOWN 1 PROOUCT 2 WASTE c·D o o I. REGULAR UNLEADED Ib PREMIUM UNlEADED 2 LEADED 8 J DIESEL . GASAHOL 5 JET FUEL 110 O~ER (DESCRIBE IN rreM D. BELOW) o IS AVIATION GAS o 7 METHANOL B. 0, IF (A, t) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED C.A.S.': III. TANK MARl( ONE ITEM ONLY IN BOXES A. B. AND C, AND All THAT APPliES IN BOX D A. TYPE OF 1 OOUBLE WAlL 0 3 SINGLE WAll WITH EXTERIOR LINER 0 115 UNKNOWN SYSTEM 0 2 SINGLE WAlL 0 . SECONDARY CONTAINMENT (VAULTED TANK) 0 110 O~ER 1 BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGLASS 0 . STEEL CLAD Wt FIBERGI.ASS REINFORCED PlASTIC B, TANK MATERIAL 0 5 CONCRETE 0 8 I'OL YVINYL CHLORIDE 0 7 AlUMINUM 0 8 100'lIo METHANOL COMPATIBLE WiFRP : Primary Tank) 0 II BRONZE 0 10 GAlVANIZED STEEL 0 115 UNKNOWN 0 110 OTHER 01 RUBBER LINED o 2 AU<YD LtltlG 0 3 EPOXY LINING 0 . PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING ~ UNLINEO D 115 UNKNOWN 0 110 O~&R UNING IS lINING MATERIAL COIoIPATIBlE WITH 100% ..ETHANOl ? YES _ NO IV, PIPING INFORMATION A. SYSTEM TYPE B. CONSTRUCTION SINGlE WAlL . FIBERGLASS REINFORCED PlASTIC D lIS! OTHER D. CORROSION D 1 I'OLYETHYlENE WRAP D 2 COATING PROTECTION D 5 CATHOOIC PROTECTION D 111 NONE NO OR U IF UNDERGROUND. BOTH IF APPLICABlE PRESSURE A U 3 GRAVITY 2 OOUBLE WAll A U 3 LINED TRENCH A U 110 OTHER _ A U 110 O~ER C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION BARE STEEL A U 2 STAINLESS STEEL A U 3 I'OLYVINYL CHlORIDE FIBERGLASS PIPE 5 AlUMINUM A U II CONCRETE A U 7 STEELW/COATINQ 8 100'lIo ME1HANOL COMPATIBLEWiFRP A U II GALVANIZED STEEL A U 10 CATHOOIC PROTECTION A U lIS UNKNOWN A U lIS! OTHER o 1 AUTOMATIC LINE LEAK DETECTOR 2 LINE TIGHTNESS TESTING 0 IoIONrrORING' 0 110 O~ER V. TANK LEAK DETECTION 1 VISUAL CHECK D 2 INVENTORY RECONCILIATION D 3 VAPOR MONITORING o IS TANK TESTING D 7 'INTERSTITIAL MONITORING D 111 NONE . AUTOaAATIC TANK GAUGING D 5 GROUND WATER MONITORING lIS UNKNOWN D lIS! OTHER VI. TANK CLOSURE INFORMATION 1. ES TlIoI A rED DA TE LAST USED (IoAOiOAYIYR) 2. ESTlaAATED OUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FillED WI~ GALLONS INERT MATERIAL ? YES 0 NOD EST OF MY KNOWLEDGE, IS TRUE AND CORRECT DA STA TEI.D.# COUNTY II OJ JURISDICTION II ITIJ FACILITY II = TANK II ITIJJ[]] i>ERIoIIT NUMBER PERMIT APPROVED BYIOATE PERaAlT EXPIRATION DATE FORIoI B (Sl-g( THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATlON . FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. ~~ ¢ /..~ CITY OF BAKERSFIELD "-, : ' OFFICE OF ENVIRONMENTAL SERVICES ."" . Chester Ave., Bakersfteld, CA 93301 (805) 326.9 ,.. UST. TANK PAGE 2 Page Of VI. PIPING CONSTRUCTION (Cheçk all that aDDIy) ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SÝSfE~ï'YPÊ_~--OIS~=~~--'- 02PRESSURE 03GRAVITY 454 O,SUCTION 02PRESSURE ~3GRAVI:rv CONSTRUCTION ' 0 1 SINGLE WALL 0 95 UNKNOWN .-..e 1 SINGLE WALL 0 3 LINED TRENCH 0 99 OTHER , LQ 2 DOUBLE WALL 099 OTHER 450 ~ OOUBLE WALL 0 95 UNKNOWN : MATERIALS AND' 0 1 BARE STEEL 06 FRP COMPATIBLE Wt 100% METHANOL 0 1 BARE STEEL 06 FRP COMPATIBLE WI 100% METHANOL ; CORROSION i PROTECTION 0 2 STAINLESS STEEL 0 7 GALVANIZED STEEL 0 2 STAINLESS STEEL 0 7 GALVANIZED STEEL 03 PVC COMPATIBLE WITH CONTENTS 095 UNKNOWN 03 PVC COMPATIBLE WITH CONTENTS o 4 FIBERGLASS 0 6 FLEXIBLE 0 99 OTHER 0 4 FIBERGLASS 0 6 FLEXIBLE 05 STEEL WI COATING 09 CATHODIC PROTECTION 455 05 STEEL WI COATING 09 CATHODIC PROTECTION .--..------- 455 454 095 UNKNOWN 099 OTHER 456 VII. PIPING LEAK DETECTION (Check all that aDDIy) , ABOVEGROUND PIPING INFORMATION UNDERGROUND PIPING INFORMATION SINGLE WALL PIPING 457 SINGLE WALL PIPING 456 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): o 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH teST ïmH AUTO PUMP SHUT OFF FOR LEAK. 0 1 ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST ïmH AUTO PUMP SHUT OFF SYS1'FM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS FOR lEAK. SYSTEM F.<'ILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND o 2 MONTHLY 0.2 GPH TEST VISUAL ALARMS . I 0 0 2 MONTHLY 0.2 GPH TEST 3 ANNUAL INTEGRITY TEST (0.1 GPH) o 4 DAILY VISUAL CHECK 0 3 ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS (Check an that apply): o 5 DAILY VISUAL MONITORING OF PUMPING SYSTEM o 6 TRIENNIAL INTEGRITY TEST (0,1 GPH) CONVENTIONAl SUCTION SYSTEMS: o 4 DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS: o 7 SELF MONITORING SAFE SUCTION SYSTEMS: o 5 SELF MONITORING GRAviTY FLOW (Check all that apply): o 8 DAILY VISUAL MONITORING ! 0 9 BIENNIAl INTEGRITY TEST (0.1 GPH) GRAVITY FLOW: o 6 BIENNIAL INTEGRITY TEST (0,1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): '0 10 CONTINUOUS TURBINE SUMP SENSOR ïmH AUDIBLE AND VISUAL ALARMS AND (check one) o " AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c NO AUTO PUMP SHUT OFF o 11 AUTOMATIC LEAK DETECTOR o 12 ANNUAL INTEGRITY TEST (0.1 GPH) SECONDARilY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): o 7 CONTINUOUS TURBINE SUMP SENSOR ïill11 AUDIBLE AND VISUAL ALARMS AND (Check one) o a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAILURE AND SYSTEM DIS~NNECTION o c NO AUTO PUMP SHUT OFF o 8 AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 9 ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13 CON71NUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check an that apply) o 14 CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15 AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o 16 ANNUAL INTEGRITY TEST (0.1 GPH) o 17 DAILY VISUAL CHECK EMERGENCY GENERATORS ONLY (Check all that apply) o 10 CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL AlARMS o 11 AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o 12 ANNUALlNTEGRITYTEST(O,1 GPH) o 13 DAILY VISUAL CHECK IX. OWNER/OPERATOR SIGNATURE -, ëërtlty that the informatfon provided herein is true & ~te to the best 01 my knowledge. ---ŠïGNA TURE OF OWNER/OPERATOR DATE 462 . NAME OF OWNERIOPERA TOR (print) 463 TItlE OF OWNER/OPERATOR 464 . VIII. DISPENSER CONTAINMENT o 1 FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 0 3 CONTINUOUS DISPENSER PAN SENSOR ïl!!!:! AUTO SHUT OFF FOR DISPENSER o 2 CONTINUOUS ELECTRONIC SENSOR + AUDIBLE AND VISUAL ALARMS + AUDIBLE AND VISUAL ALARMS o 4 DAILY VISUAL CHECK ; DISPENSER ¡ CONTAINMENT ! 0 Yes 0 No Pennlt Number (For local use only) Pemút Approved Permit Expiration D8te Form B a California 'egional Water Qualit~ontrol Board Central Valley Region' Steven T. Butler, Chair Winston H. Hickox Secretary for Enyironmental Protection Fresno Branch Office Internet Address: http://www.swrcb.ca:gov(-rwqcbS 3614 East Ashlan Avenue, Fresno, California 93726 Phone (559) 445-5116· FAX (559) 445·5910 Gray Davis Governor 26 April 2000 RWQCB Case No. 5T15000808 .,~c '#4;- ~,~~ ~ttl?Þ 0 -? <æ ' 'TO,ft . ~O . $~..~ 7Cq¿. PETITION OF RWQCB REQUEST FOR FURTHER INVESTIGATION _UNDERGROUND TANK RELEASE, NIAGARA CAR WASH, 17.01, STINE ROAD, BAKERSFIEW, KERN COUNTY , - Mr. Steve White Carwash of America 20280 S. Vermont Ave., St~. 100 Torrance, CA 90502 We received a 10 April 2000 letter from your consultant, Mr. Charles Buckley of California Environmental, regarding your wish to petition our office's 7 February 2000 request for further soil and groundwater assessment at the subject site. Mr. Buckley requested that we provide the necessary forms and information needed to file the petition. We have provided a copy of guidelines prepared by State Board staff for the petition procedure as an enclosure, but see petition as premature. Petitioning requests and decisions of office staff without first attempting to meet and come to some resolution regarding this matter cannot be in the best interest of any party. We would be happy to meet with you or your consultant to discuss the environmental concerns at this site and give you an opportunity to explain the technical merits of your position, as you will have to explain in any petition. It is our desire to resolve this environmental problem in a reasonable fashion and avoid possibly time consuming and expensive petition proceedings. . If you still choose to petition our request for further site investigation, you should contact the State Board for specific information on that process. Weare not in the position to answer further questions regarding the procedures. You may wish to contact your legal counsel for help. If you have any questions regarding this matter, please contact Mr. Bruce Myers of this office at (559) ã~:,=-- ' ~~. NOONAN Senior WRC Engineer RCE No. C035206 JMN:bem cc wI enclosure: cc w/o enclosure: Mr. Charles Buckley, California Environmental; 31119 Via Colinas, Ste. 501, Westlake Village, CA 91362 Mr. Ralph Huey; City of Bakersfield Fire Department, Bakers~ Ms. Sandy Gill, SWRCB, UST Cleanup Fund, Sacramento California Environmental Protection Agency #f> ~J Recycled Paper ."" a California ~ional Water Quality fJantrotBoard Central Valley Region Steven T. Butler, Chair Winston H. Hickox Secrerary for Environmental Protection Fresno Branch Office Internet Address: http://www.swrcb.ca.gov/-rwqcb5 3614 East Ashlan Avenue. Fresno. California 93726 Phone (559) 445,5116· FAX (559) 445-5910 Gray Davis Governor 7 February 2000 RWQCB Case No. 5T15000808 ~~r) f:'('lJ 'e,~ I b.t... 9 ¡¡ 1j 20280 S. Vennon! Ave., Ste. 100 . .~ VQQ Torrance, CA 90502 ~ "" , ~ ~ UNDERGROUND-TANK RELEASE, l\/IAGARA CAR WASH, 1701 STINE ROAD, BAKERSFIELD, KERN COUNTY Mr. Steve White Carwash of America In a letter dated 22 November 1999, the City of Bakersfield Fire Department (CBFD) referred the subject case to our agency for regulatory oversight. It also provided us with information that indicates gasoline leaked at the subject facility and degraded soil and possibly groundwater. It will be necessary for you to determine the extent of soil and groundwater contamination caused by the leak and remediate its effects. Back2round Information The CBFD provided copies of two reports of subsurface investigation at the site - a February 1997 Site Characterization Report by AJ Environmental, Inc. of Bakersfield, and an October 1999 Supplemental Subsurface Site Assessment, Fuel Impacts in Soil by California Environmental of Westlake Village, California. California Environmental provided a copy of a February 1997 Car Wash Partners, Inc. - Phase II Site Assessment prepared by AJ Environmental. The site contains three 12;000-gallon gasoline underground storage tanks (USTs), a 2,000-gallon waste oil UST, nine dispenser islands, a convenience store/car wash building, an automobile lubrication service business, and an auto detailing center. The USTs were installed in 1983; they were lined and a cathodic protection system was installed in April 1998. One or more of the fuel USTs previously held diesel fuel. The Stine Canal runs along the site's eastern boundary; the canal is an unlined open channel approaching the southern site boundary and a buried concrete pipe (culvert) as it passes beneath eastern margin of the subject site. Review of the Kern County Water Agency maps Depth to Water in Wells and Elevation of Water in Wells, September 1998 shows a groundwater depth of 170 feet below the site with a south to east flow direction. Review of the above reports shows that the initial subsurface investigation was part of a Phase IT Environmental Site Assessment. Seventeen hand auger borings were advanced in January 1997 at the USTs and dispenser islands. A maximum concentration of 5,700 milligrams per kilogram (mglkg or ppm) total petroleum hydrocarbons as gasoline (TPH-g) was detected at a depth of 18 feet near the north end of the westernmost gasoline UST. Petroleum hydrocarbons as diesel (TPH-d) and TPH-g were California Environmental Protection Agency '" '<oJ Recycled Paper Mr. Steve White - - 2 - . 7 February 2000 detected at a depth of two feet beneath all dispensers and exceeded 100 mglkg at a depth of six feet beneath two of the dispens~rs. Diesel and gasoline were detected at 1900 mglkg at six feet beneath another dispenser. In February 1997, AJ Environmental advanced four soil borings to a maximum depth of 106 feet to the north and west of the gasoline USTs. Based on data from the borings, the soil profile beneath the site is represented by sands and gravels to approximately 50 to 60 feet below ground surface (bgs). Alternating sands and silty sands are present below this interval to the maximum depth explored. Maximum benzene, methyl tertiary butyl ether (MTBE) and TPH-g concentrations of 52,80 and 12,000 mglkg, respectively, were detected at a depth of 70 feet. Toluene, xylenes and MTBE were detected at concentrations of 0.1 mglkg or less at a depth of 105 feet in one boring; MTBE only was detected at sub- ppm concentrations at depths of 100 to 105 feet in the other three borings. AJ Environmental encountered a water-saturated sandy clay in the 1OO-foot dèep sample from Borehole NCWS #21. Pursuant to a letter request for continued subsurface investigation by the CBFD, nine soil borings were advanced by California Environmental (CE) in September 1999 to a maximum depth of 140 feetbgs to further delineate the soil plume at the site. CE noted the' site to be underlain by silty sand, poorly sorted sand, gravelly sand, and silt to a depth of 140 feet with thin, discontinuous silt lenses present in the 65. to 90 and 105 to 120 feet bgs intervals. CE noted sand lenses were saturated in some borings when bound between silt layers but thafno continuous saturated zone was encountered. They attributed these probable semi-perched zones to percolation of water from the unlined portion of the Stine Canal. Seventy-five of eighty-six soil samples collected in September 1999 were analyzed at an on-site mobile laboratory. The maxim'um hydrocarbon concentrations detected during this investigation were 2.9 mglkg benzene and 290 mglkg TPH(g) in boring B-3 (south end of UST cluster) at a depth of 75 feet. The maximum MTBE concentration (con finned by EPA Method 8260B at a fixed-base lab) was 3.2 mglkg in boring B-4 at a depth of 80 feet. This borehole location is approximately 80 feet north of the UST ~luster at the southern edge of the dispenser islands. . Based ~:m the nondetect results for step-out borings, CE concluded in their October 1999 report that the soil plume was confined to the subject site. They concluded that the low hydrocarbon concentrations' detected in 1999, compared to the 1997 investigation, suggest an ongoing leak was not present. CE noted that high MTBE concentrations were associated with saturated samples in several borings, and that the saturated conditions were promoted by infiltration of water from the unlined portion of the Stine Canal. However, they also concluded the saturation representedsemi-perchèd groundwater conditions, as standing water was not observed in any boring after reaching maximum depth. They also stated, "The migration of this water through the vadose zone beneath the property appears to have assisted in the dispersion and attenuation of fuel hydrocarbons and MTBE. " Comments Based on review of the above-summarized reports, we have the following comments: . Nondetect results for samples from borings B-5, B-6 and B-7 at the west, south, and north property boundaries, respectively, appear to define the lateral limits of the soil plume in these directions. The eastern limit of the soil plume is not known. U:\UG1\BEM_files\Kern Co\Carwash of America 1st Ltr,doc Mr. Steve White ;- - 3 - . 7 February 2000 · Hydrocarbon scan/fuel characterization analyses suggest a classification of the TPH fraction as gasoline is correct for soil samples from boreholes B-1 and B-2 near the UST cluster. Review of EPA Method 8015M analytical results for TPH-g and TPH-d from the same samples are unambiguous and would elicit the same classification. However, data from samples at the dispenser islands clearly indicate a TPH-d predominant fraction in some samples; therefore, diesel is considered a constituent of concern u!ltil proven otherwise. · MTBE was detected at a depth of 90 feet immediately west of the dispenser islands, over 80 feet from the USTs. CE presumes this represents lateral spread with depth of a release source at the USTs. The presence of MTBE at this location may also represent a source at the dispensers. We have no information of the further delineation of hydrocarbons in soil detected at a depth of six feet beneath three of the dispensers in 1997. · The 1999 report mentions that a leak was found and repaired in December 1997. We have no further info!"mation regarding the location, cause, magnitude or source of this release. · Based on the depth of detection of MTBE (140 feet), the anticipated depth to groundwater (170 feet), and the self-declared probability that infiltration of water from the Stine Canal has promoted the further downward migration of MTBE, it is likely that this constituent has entered groundwater beneath the site. Work Plan Request Prior to 15 April 2000, please provide a work plan to assess petroleum hydrocarbon impacts to soil and groundwater beneath the site. The work plan, in general, should comply with the enclosed Tri-Regional Board Staff Recommendations for Preliminary Evaluation and Investigation of Underground Storage Tank Sites and Appendix A-Reports Tri-Regional Board Staff Recommendations for Preliminary Evaluation and Investigation of Underground Storage Tank Sites. The work plan shall also include a sampling and analysis plan for both soil and groundwater. The sampling and analysis plan is to include, at a minimum, rational for sampling and analysis frequency, sample preservation methods, laboratory quality assurance/quality control procedures, proposed detection limits, analytical methods and a list of analytes for those methods. The initial analysis of soil and groundwater will be used to establish constituents of concern (COCs) for the site. All potential COCs will be included in the initial analysis. The potential COCs for soil are to initially include, at a minimum, total petroleum hydrocarbons as gasoline (TPH-g) and as diesel (TPH-d), benzene, toluene, ethyl benzene, and xylenes (BTEX), 1,2- dichloroethane (1,2-DCA), ~thylene dibromide (EDB), total lead, methyl tertiary butyl ether (MTBE), tertiary amyl methyl ether (TAME), di-isopropyl ether (DIPE), ethyl tertiary butyl ether (ETBE), and tertiary butyl alcohol (TBA). The potential COCs for groundwater are to initially include, at a minimum, TPH-g, TPH-d, BTEX, 1,2-"DCA,EDB, total lead, MTBE, TAME, DIPE, ETBE, and TBA. The sampling frequency does not necessarily need to include analysis of all samples for all COCs. However, the sampling and analysis frequency must be adequate to define the vertical and lateral extent of the COCs beneath the site such that remedial options can be assessed. In addition, the sampling plan may propose that future analyses for the COCs be performed by different methods than the initial analyses, once the presence or absence of potential COCs have been confirmed. The initial sampling is to include analytical methods that clearly demonstrate the presence or absence of potential COCs. U:\UG1ìBEM_files\Kem Co\Carwash of America 1st Ur,doc Mr. Steve White . - 4 - . 7 February 2000 In addition to the COCs, we require that you sample groundwater for general minerals, nitrate, and total Kjeldahl nitrogen (TKN) during two nonconsecutive quarterly sampling events (minimum of six months between sampling events). It is not necessary to sample all monitoring wells for these constituents during these sampling events; a minimum of three wells, including at least one upgradient well, should be sufficient. The work plan should include a time schedule to implement the plan and submit reports. All submittals should contain the signature and seal of a California registered engineer, certified engineering geologist, or registered geologist who is responsible for the content of the submittal. Identification of Other Responsible Party Notification If you have evidence to support identification of other potentially responsible parties for degradation at this site, we request that you identify them now by providing such evidence so they may be notified of the potential responsibility. Evidence should include the beginning and ending dates and type of involvement, the names and current addresses of all potentially responsible parties, and copies of any documents that would verify the terms and conditions of involvement. Cleanup Fund Notice You should be aware of legislation to assist owners and operators of underground tanks. Senator Keene's Senate Bill 2004 (CleailUp Fund Program) offers several forms of assistance for investigation and cleanup of underground tank discharges. You may want to contact the State Water Resources Control Board at (800) 813-3863 about the Cleanup Fund Program. An application for and information on the Cleanup Fund Program is enclosed. If you have not already applied for the Cleanup Fund Program, we strongly urge that you do. In addition, I have enclosed a copy of the Petroleum Underground Storage Tank Cleanup Fund's Successful Corrective Action, A Tank Owner's Guide. The guide contains information on choosing a consultant and obtaining a good bid (three bids are required to be eligible for reimbursement under the Cleanup Fund Program). Also, staff administering the Cleanup Fund Program have indicated that all costs for corrective action must meet the requirements of Article 11, Chapter 16, Underground Storage Tank Regulations (Article 11). For your convenience, a copy of Article 11 is enclosed. Landowner Notification Our records indicate that you are the "primary or active" responsible party for the subject site. Under the new "landowner notification" of Health and Safety Code, Section 25299.37.2 (copy enclosed), all current record owners of fee title to the site are req'uired to be notified of your proposed actions relating to investigation! cleanup, and closure of this site. Prior to (15 March 2000), please provide us with a complete mailing list of all record fee title owners. Y ouare to certify in writing that the list is complete and contains the names and address of all record fee title owners. If you are the only record fee title owner, please so state in your certified list of record fee title owners. You shall copy all future correspondence to us regarding this site to the record fee title owners and they shall be encouraged to comment on your proposed actiòns to cleanup and close this site. Also, if ownership of fee title to the site changes prior to closure, you shall within 30 days of recording a change in ownership provide us with a complete mailing list of all new record fee title owners and certify that it is complete. U:\VG1ìBEM_filesIKem ColCarwash of America 1st Ltr.doc Mr. Steve White . - 5 - . 7 February 2000 If you have any questions regarding this matter, please contact me at (559) 445-5504. ßw u L 'hi f"=' Bruce E. Myers Assoc. Engineering Geologist CEG No. 2102 Enclosures: Tri-Regional Board Staff Recommendations for Preliminary Evaluation and Investigation of Underground Storage Tank Sites Appendix A-Reports Successful Corrective Action, A Tank Owners Guide Cleanup Fund Application Article 11, Health and Safety Code cc w/o enclosures: Mr. Ralph Huey, City 9f Bakersfield Fire Department, Ba~ Ms. Sandy Gill, SWRCB, UST Cleanup Fund, Sacramento Mr. Michael Tiffany, California Environmental, 31119 Via Colinas, Ste. 501, Westlake Village, CA 91362 U:\UGT\BEM_files\Kem Co\Carwash of America 1st Ltr.doc FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H. Streel Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 -- ~ --_.-- -. ~- SUPPRESSION SERVICES 2101 "H· Slreet Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395·1349 PREVENTION SERVICES, ' 1715 Chesler Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 328-0578 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 328-3979, FAJ( (661) 326-0576 TRAINING DMSlON 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5783 o' -. . Mr. Bruce Myers, CEG Central Valley RWQCB 3614 E. AsbIan Avenue Fresno, CA 93726 .,.. -'- .-'-' e.. November 22, 1999 . .- --. ----.- . -- - - - . - ------- - -- - RE: Car Wash of America, fka Niagara Car Wash, 1701 Stine Road in Bakersfield Dear Mr. Myers: Enclosed, please' find the file correspondence relating to the Unauthorized release that allegedly went unreportedbÿ'llië' above' referenced facility. This constitutes a referral of the case to the RWQCB for corrective action. Our office will continue the enforcement efforts regarding the alleged non-reported unauthorized release. If you have any questions regarding this case, please- f.~el tree to call me at (661) 326-3979. enclosure . -, Sincerely, Ralph E. Huey, Director Office of Environmental Services 1t1t7~ ~ g:'~ ~ ~~ §"~ ~ g::'~" ... 4 ,,~~ ~ - ' . . -- RECORD OF TELEPHONE CONVERSATION Location: (7 0 ( S n I'\/E ~':) ID# Business Name: &-L I RxL"J-'A êNJ\ a.c>-JVf-A.GV'íA L Contact Name: C/~L~ ~ Ue,.I< (£-~ Business Phone: <ll '8 ., <9 '7 I t' I S 4'2.. FAX: InspeCtor's Name: -kKJ Time of Call: Date: <?/16/~ Time: ð1ðò # Min: Type of Cell: Incoming [~ Outgoing [ ] Returned [ ] Content of Call: í2~.J'~ MY Ot«- ¡? €' '>17->rrv $ dF 6','<-'-"'3 0/ ~C4 ~l''/C Ae:nc>rJ. 'TS.¡JCA<'Lé=ý flAC-;-- vJl (?WCfCß <;;.J,3~C-J'/ ïð 2 ~ J¥t<-IL '2.cW f Af1l't -rl). -nðW ~ R.. wd¿ CD II (?2~ Y ~G£O '-r1.f.A r k -,-, VE- vAPoR.- é-¡c:.TfZACTlr!'N 1L> ~r:;{)vc¡ç ¿W'rE-L.S IN -'sù'¿" ¿,JòVLO 136 XcQcTðJS(.G ÂL'Tt!fZ.NÞ-TtVC -ro ~(2.-n+c4. ~^'~~ ~f(DfZ.JNG ~ ''\JS..4(''L4-71d~ Actions Required: CI.XZ..- WAS *'1 AM.é2--lcA <; ·dt..L tJ7¿C-o~' 1"0 "Aù17-(øt?-/z£ ELt..K.LGv- ~ 5t.Jí.!~,-'- ~(AAi <íÙ ~C(3 fVtL. ý'APo'f2.. ~-rI2..(JrC(lcrN ,I\J ¿,lEU c>FG(2ðú'~~ AO"-1ITIJf1-r,J"G- v..JT::-u..... INST'4-<-<A-TtIÍ,...j~ 5=F (2wQC~ is Go,,..JG ~ .~(WJ£ VAPò<L G~'AAc'f'c)r...J <t M:.>'( «£QUlIl6 fk4)N/c(Jfè,vJ& vuL"1-l..S / Cf 1'( ot= ßA¡<C~S,:"/éLO SfÐUl.D ~E ,A SSv"""E LEAO .AtS~V SíA-iUs" Time Required to Complete Activity # Mln: '! ~ \;,;; California ~'gional Water Qualit~ontrol Board Central Valley Region Steven T. Butler, Chair e· '-'. . . . .. .... ~- Winston H. HJckol Secretary for EnvironfMntal Proleclion Fresno Branch Office Internet Address: hnp:l/www.swrcb.ca.gov/-rwqcb5 3614 East Ashlan Avenue, Fresno, Califomia 93726 Phone (559) 445·5116· FAX (559) 445·5910 Gray Davis Governor 26 April 2000 RWQCB Case No. 5T15000808 ~~c .t4r ~V~D ~.tJ?-9Q O.? <Þoo ~8~ . ~l?Q i"ø PETITION OF RWQCB REQUEST FOR FURTHER INVESTIGATION UNDERGROUND TANK RELEASE, NIAGARA CAR WASH, 1701 STINE ROAD, BAKERSFIEW, KERN COUNTY Mr. Steve White Carwash of America 20280 S. Vennont Ave., St~. 100 Torrance, CA 90502 We received a 10 April 2000 letter from your consultant, Mr. Charles Buckley of California Environmental, regarding your wish to petition our office's 7 February 2000 request for further soil and groundwater assessment at the subject site. Mr. Buckley requested that we provide the necessary fonns and infonnation needed to file the petition. We have provided a copy of guidelines prepared by State Board staff for the petition procedure as an enclosure, but see petition as premature. Petitioning requests and decisions of office staff without first attempting to meet and come to some resolution regarding this matter cannot be in the best interest ()f any party. We would be happy to meet with you or your consultant to discuss the environmental concerns at this site arid give YOil an opportunity to explain the techñicalmerits of your position, as you will have to explain in any petition. It is our desire to resolve this environmental problem in a reasonable fashion and avoid possibly time consuming and expensive petition proceedings. ' -'" If you still choose to petition our request for further site investigation, you should çontact the State Board for specific infonnation on that process. We are not in the position to answer further questions regarding the procedures. You may wish to contact your legal counsel for help. If you have any questions regarding thìs matter, please contact Mr. Bruce Myers of this office at (559) ãQ~::~ ' ~~. No'Of{AN Senior WRC Engineer RCE No. C035206 JMN:bem cc w/ enclosure: Mr. Charles Buckley, California Environmental, 31119 Via Colinas, SteM 50 I, Westlake Village, CA 91362 Mr. Ralph Huey, City of Bakersfield Fire Department, Bakers~ Ms. Sandy Gill, SWRCB, UST Cleanup Fund, Sacramento cc w/o enclosure: California Environmental Protection Agency o Recycled Paper :1 ð . - ~ P 024 368 548 , . ,IV-- ~?'8eceiPt for Certified Mail 'M NollÍ!lurarn::,~~Coverage Provided ¡;¡¡ Do not use for International Mail ISee Reverse) Sent to CAR WASH OF AMERICA Street and No, 170LSTINE RD P.O.. State and ZIP Code BAKERSFIELD CA Certified Fee Special Delivery Fee Restricted Delivery Fee ... Return Receipt Showing ~ to Whom & Date Delivered ... Return Receipt Showing to Whom, Date, and Addrassee's Address Q) c:: ::I .., TOTAL Postage Ò & Fees I Postmark or Date E 4-2-99 .. o LL $ Ie \ ~<I- 1 ~ ~Rece!pt for '. \ Certified Mail __ No Insurance Coverage Provided- ~.ø:s - Do not use for International Mail (See Reverse) Sent tOJAMES C. COXETER Street~nð~'ào S VERMONT ST #100 P,O., tð~ndÄ~GrtES , ./ _~. ';:r , ,'::u 024 P <.e(" 368 547: 90502 Restricted Delivery Fee ... Return Receipt Showing ~ to Whom & Date Delivered ... Q) Return Receipt Showing to Whom, § Date, and Addressee's Address .., TOTAL Postage Ò & Fees I Postmark or Date E .. o LL $ Ie 1-/ ~ ;). - 99 Official Business PENALTY FOR PRIVATE USE TO AVOID PAYMENT OF POSTAGE, $300 ~ I j I j I ¡ UNITED STATES POSTAL SERVICE - i ~ Print your name, address and ZIP Code here . . BAKERSFIELD FIRE 'DEPARTMENT OFFICE OF ENViRONMENTAL SERVICEE? 1715 Chester Avenue, Suite 300 , ~}, Bakersfield. CA 93301 -.~. I¡ SENDER: .¡¡¡ . Complete items 1 andlor 2 for additional services. Q) . Complete items 3, and 4a & b. ~ . Print your name and address on the reverse of this form so that we can Q) return this card to you. ¡¡; . Attach this form to the front of the mailpiece. or on the back if space ~ does not permit. I.r:. . Write "Return Receipt Requested" on the mail piece below the article number. I... . The Return Receipt will show to whom the article was delivered and the date 5 delivered. Consult postmaster for fee~ 't:I 3. Article Addressed to: 4a. Article Number ¡ P 024 368 547 Ië. IE ,8 I~ IW I~ I~ Jz I ~ 5. Signature (Addressee) I ~ 6. Signature (Age t) I ~ PS Form 3 1$ CAR WA5H OF AMERICA ATTN: JAMES C. COXETER 20280 5 VERMONT 5T, STE 100 LOS ANGELES CA 90502 I also wish to receive the following services (for an extra 8 fee): .. .~ 1. D Addressee's AddreP Æ 2. 0 Restricted Delivery ... Co .¡¡ U Q) a: c: ... :::I ... Q) a: 4b. Service Type D Registered QQ Certified Express Mail D Insured D COD IX] Return Receipt for Merchandise,' Date of ~':Ji.very /-S--1 5 ò--- > 8. Addressee's Address (Only if requested ~ and fee is paid) ." !ij ..c: .~"::' 'i. . £" CI c: ïii :::I ... o ... 1... . ' DOMESTIC RETURN RECEIPT FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 ·H· Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAJ( (805) 395-1349 SUPPRESSION SERVICES 2101 oH' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAJ( (805) 395·1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3951 FAJ( (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (805) 326-3979 FAJ( (805) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAJ( (805) 399-5763 ....', ~ . . ~ ',- ~\...-,..(~ April 2, 1999 Car Wash of America dba Niagara Car Wash 170 I Stine Road Bakersfield, CA 93309 , .~' Attn: Francisco Morales Certified Mail RE: Revoking your Permit to operate a Underground Storage Tank Dear Mr. Morales: It has recently come to our attention that an underground fuel tank system located on your facility at 1701 Stine Road is leaking. This conclusion is drawn from a site assessment completed on that property in 1997, but only recently provided to us. Our records do not show any repairs made to that tank system since that date, even though a tank lining was completed in 1998. You are therefore ordered to shut down that tank system until this tank system can be satisfactorily repaired or replaced. The tank in question is the west tank, the 12,000 gallon fuel tank closest to Hasti Acres Drive. Through this letter, we are revoking your permit to operate that tank, effective Tuesday, 4-6-99, until such time as the leak source has been identified and the leak abated. Please contact this office to make arrangements for the necessary leak assessment and corrective action. ~ alph E. uey Director, Office of Environmental Services cc: Jose Vargas James C. Coxeter Walt H. Porr, Jr., Assistant City Attorney Kirk Blair, Assistant Chief Bakersfield Fire Dept Steve Underwood, Inspector Bakersfield Fire Dept ""7~ de W~ S7OP.A0P6.r~ A W~?" ~/-'2~--- '~ ------,:::- .' '. " .' NOTE TO FILE CAR WASH OF AMERICA 1701 STINE ROAD RE: April 2, 1999 Tele-conference with Ms. Lisa Webb Tele-conference with Ms. Lisa Webb of California Environmental, concerned with why we were revoking the permit to operate the underground storage tank at Car Wash of America. I explained the site assessment report we received and she stated that it come from her office. Ms Webb also stated that she had received it from Car Wash of America, she thought it was February 1998. When asked why she did not make the report available at that time, she stated that she could not remember for sure, but that she thought she had talked to someone in this office who said we had the report. She did not remember his/her name, but after I mentioned Howard Wines, she said she thought it was him. I discussed this with Howard. He did not recall any conversation with Ms. Webb, with anyone from California Environmental or anyone else concerning the (Niagara Car Wash) Car Wash of America site. Once I explained our concern, Ms. Webb appeared to be very anxious to end the conversation. Ralph Huey, Director Office of Environmental Services ·~ CORRECT,~N NOTICE ;¡ ..., tt- , , ,j.'! BAKERSFIELD FIRE DEPARTMENT N~ 657 LocatioJ1 ~(J..'\ Wð.Ak~,ç AU'I.<.tldt Sub Div. no I -S+\~{. ¡f)j . Blk. . Lot You are hereby required to make the following corrections at the above location: Cor. No Iy Completion Date for Corrections Date L(" (3" r 1 Inspector 326·3979 ,___ ~7"__ _-;-;-__-~ _~-___.__,____.-~_~._~__ ------- ~_ ________~~______...... ..,~...._.- u -'\ , I tf Haz Mat Emerg .\ Spill Report .. .' .., 4, .~. · _ !!_~~K E.R 5 F ( E L D . " ~ .; Complaint ?!' Environmental Services D D B--- Haz Mat Incident / Spill Report / Complaint Follow Up -I Date 4- J:<' - 9C, Reporting Party ~W ðe~þry)ul:C{ Address , .' 'Ii ';t - It tJru r) taL R. e oS. Telephone No. ~.., ~ - 06 7<::> Location of the incident -:::]I (-f Y Á.uÀ Q, - (i? Time I / II- tv( . Environmental Services Contact -<:;f£!ld-ueq . (~.) 1701 $17- -PJ. (Nt~fiII;;,. (1~t?) Description of the incident ( Chemical name and Quantity) " Wh41-O-~ (Í""4ß ~ ~ ~ ~ ! -ttdé5Th ~ ~ ! Responding to Incident V N .. ~~ S: tlAI~ -i- ~ ~ LU) I.NU..h / Nii7.d.ø ~ ~ &...MAf).'~ø&.Ø-r- ObservatIons - ,. -.....,- - -/I 't) --~.-r-""" · "'Tn;'c..\ùke.t d(o..~~\ f~,^V1I~' IV\.\-ö ~-\-f'Ce...f (l-I~~+,~ A~vCJ) ...(!tol1\. tOI,fuj(J~. ..f.(J\lfA.¡ \~~tJ\.Je.. t\~f,.ot, 3(){) 4-t Ih t'tJHcr-. Special Conditions and / or health risks t()V\cc",\rCl.{L ~o..v~l.~ ~CU(!('c- sb", 'T ~"tc... \t('o.{(Ol'\ . UfJI.(lWf.£' \t v \.\- t\ \-l Olft. Haz Mat Team Dispatched (1;\a y ~ð v~ c... rr~ p I fa !o"V OES Number Required V0 v€J Van Cellular No. 332-7865 Number Poss Exposure Victims N()IJ~ Medical Attention Required or Obtained IVt:!) Probable Hazardous Waste Clean Up V N -- 110:/ J- -tL.. --I-'VIttA - ~ ~ (;4þ w.a:l ~. o¡f ~.. I Discussio' and Disposition J W('~\-e.. ~ONU_+(O""" ;N()+-u,~ t- /'{(J-/.-c-t ,~d 11Af1fA(J~/lA.N.f UJ~o tl/1tkdto.tdy ~f.q(f~ é((d."'I.1~J. ~OJW((sL- 191- A~~(c:t\.. wa~ +Ðld {o ~,^Cl'^'tL tJftftt.{..(ctJ\.. ~o .¡tv,....¡ rÙI/\'c!).ç..{- wdl NÐt ~lA~(po.. l~·<\A-vct. W\(( ~(JI(ow"C/p t!J1t\. t.(-{l{'1Q 1-0 V!t\tt(rSIlrc.. ,nrðlfv~.{. UJCI.~ ~(c:atMJ Udl. Fo({t)t~·tUJ 0"'- t..I"ll(-f1 A&~p(1H!,-\.() Referral "1 r r" r r be. C('Cc.eHð up wlcl «<()I'\~tI'\Jc... -+t:> Ø'\ðf1\{òr, M.ERIAL SAFETY D.T A SHEET ZEP MANUFACTURING COMPANY 'ST IN MAINTENANCE PRODUCTS AND SAFE HANDLING AND DISPŒAL INFORMATION ISSUE DATE: 10/22/93 ZEP CTA CLEANER SUPERSEDES: PRODUCT NUMBER: PAGE :3 OF 3 0572 GUIII..t:II~1 ~Lt:d WIIt.n:l W~'.:Ih ßECTrON VIr - REA C T I V r T Y D A T A :n!~E ILITY CNCCMPATIEILITY(AVOID> :\OL \{r1ER I ZA TION I 11AZARDOU.s DECOt1POS IT ION: Stable Strang acids and a~idizing agents. Will not occur. Carbon dio~ide, carbon monoKide, and ather unidentifi~d organic c.ompounds. -------------------------------------------------------------------------------- ;ECT tOhl VI r I - S P ILL AND D I S P 0 S ALP ROC E D U RES I ~TEPS TO EE TAI"EN IN CASE t1ATERIAL IS RELEASED OR SP ILLED: Jb'5EQ've safety precautions in sections 4 ~ 9 during clean-l.Jp. Absorb ·spill ,::In m inert absorbent material (e. g. Zep-O-Zorb)j pick l.Jp and place in a .:lean D. O. - spe>:ifi':ati'Jn container for dispo·sal. Wash area thoro'.Jghly with a detergent \clution and then rinse well with water. IASTf.:: DISPOSAL ME1-HOD: .iquids cannot be sent to landfills unless solidified. Unusable product and ;orne collected, spent use-dilutions ma~ require disposal as a hazardous waste at I permitted treatment/storage/disposal facility. In most states hazardous wastes In t~tal amounts of 220 lbs. or less per month may be disposed of in a chemical r industrial waste landfill. If company effluent is ultimately treated by a ublicl~ owned treatment works. neutralization of spent tank-solutions with sub- ie':{LII.=nf: di·;.¡cha'f'ge to the sewer may be possible. C'Jn-sult I'Jcal, st. at,? .:tn,j -fe.j-' ! 11 agencies for proper disposal method in your area. leRA HAZ, WASTE NOS.: D002 -----,-~._----------------------------------------------------------------------- ECTION IX - S P E C I A L PRE C AUT ION S R£:C(,UTIONS TO BE TAII,EN ~"HEN HANDLING AND STORING: t>:Jr"~ tightly ,:losed container in .:a dr'.J area at temp':;. betl.:Jeen 40-i20 degree,; F, tor@ away from strong acids and oKidizing compounds. eap product away from skin and eyes. Q nat breathe spray mists or vapors. lathing or shoes ~hich become contaminated with substance should be removed Dmptly and not reworn until thoroughly cleaned. ~~p aut of the reach of children. -------~---------------------------------_._---------------------.--------..----- -CTION X - T RAN S P 0 R TAT r 0 N D A T A T PROPER SHIP NAME Cases «66 Ibs) of gallons or smaller may be shipped ORM-D NDt.ÆTH IAL CLEANERS N. O. 1. , LIGUII:W~EEP FROM FREEZING ¡ HAZARD CLASS: NA T I. D, NUMBER : DOT LABEL/PLACARD: A TSCA CHEMICAL INVENTORY - ALL INGREDIENTS ARE LISTED 'A CWA 4GCFR PART 117 SUBSTANCE(RG IN A SINGLE CONTAINER): SODIUM '~C\{LEENZENE SULFONATE, 1000#E MA.ERIAL SAFETY DAtA SHEET '0 MANUFACTURING COMPANY iT IN MAINTENANCE PRODUCTS I >: T [m~ rr r - H E A L T H I AND SAFE HANDLI NG AND DISPŒALlNFORMATION P AGi"î :d o¡:- 2, ISSUE DATE: 10/22/93 ZEP CTA CLEANER SUPERSEDES: PRODUCT NUMBER: 0572 C...",-,_.,t". g~_d WI,ç;;o;;l W¡;;¡¡¡..t. H A Z A R D D A T A (CONTINUED) ,RONIC EFFECTS OF OVEREXPOSURE: peated or prolonged skin contact may produce chronic inflammation or dermatjt- , ,:h,3r,;:¡cterized by redness, ':¡caling, or it':hing. Repeated eye eq¡O'::;ure m·:1~ oduce chronic inflammation of the eye or corneal damage. ne of the halardous ingredients are listed as carcinogens bV IARC, NTP, & OSHA T'D PEL/TLV: Not established PRIt1ARY ROUTES OF ENTRY: N/A --------,-------------------------------------------------------------------þ.'-- [S CODES: HEALTH 3iFLAM. QiREACT. O¡PERS. PROTECT, B ¡CHRONIC HAZ. NO --------------------------------------------------------------------------~-_._- RST AID PROCEDURES: iN Immediately flush contaminated skin with plenty of wate~ for at least 15 minutes. Get med ic,;:¡l attention if irri tati'Jn devel'Jp·;¡¡. ES Immediatel~ flush e~es with plent~ o~ wate~ fo~ at least 15 minutesi C~- casionally lifting upper and lower lids. Get medical attention at once. HALE: Move exposed person to fresh air. If irritation pe~sists, get medical attention promptly. i~EST: If swallowed, do not induce vomiting. If vomiting o.:curs, keep head below hip level. Get eme-r'gency medical attention immediately. --.--------------------------------------------------------------------------,-- crION IV - S P E C I A L PRO T E C T ION I N FOR MAT ION JTECTIVE CLOTHING Wea~ neoprene, nit~ile, or natural rubber gloves or gloves with p~oven resistance to the ingredients listed. ~ PROTECTION Wear splash-proof safety goggles especiallv if contact lenses are worn. 3PIRATORY PROTECTION: Keep face away from spray mist and do not b~eathe vap o~s. ~TrLATrON Ventilation should be equivalent to outdoo~s. Use eK- haust fans and open windows in enclosed spaces. --~--_..._--------------------------------------------------------------------- :TION V - P H Y SIC A L D A T A LING POINT (F~ 'OR PRESSURE (Mt1HG) : OR DENSITY(AIR=1): _UBILITY IN WATER 220 N/D N/D COMPLETE SPECIFIC GRAVITY i. 10 vac CONTENT (CONCENTRATE> EVAPORATION RATEn.JATER =1): 1. () PH(CONCENTRATE) 13.0-13.3 PH(USE DILUTION OF 1% SOLUTION ): 11.2-11.5 YELLOW-GREEN LIGUID WITH A PLEASANT FRAGRANCE 'EARANCE AND ODOR : THIN, CLEAR -.---------------------------------------------------------------------------- TION VI - FIR E AND E X P LOS ION D A T A ,SH POINT(F) 01ETHOD USED): None (TCC Mt1ABLE LIt1ITS LEL N/A IJEL N/A INGUISHING MEDIA Noncombustible. CIAL FIRE FIGHTING: None SUAL FIRE HAZARDS: May decompose to form to~ic¡corrosive gases. M'-ERIAL SAFETY DtlT A SHEET 11/04l(=?e PAGE 1 OF 3 AND SAFE HANDLING AND DISPŒAL INFORMATION ISSUE DATE: 10/22/93 ZEP CTA CLEANER SUPERSEDES: PRODUCT NUMBER: 0572 ZEP MANUFACTURING COMPANY ST IN MAINTENANCE PRODUCTS .:urn_,=u ;,,1 C2lt:d W!,cr::l Wc:a-:tlr 'ECT ION r -- E t1 ERG E N C Y CON T ACT S :EP MANUFACTURING COMPANY \. O. EO):: 2015 \TLANTA. GEORGIA 30301 'F!:f,NSPORT~\TION EMERGENCY: 770)922-0923 o~ TELEPHONE: (404~352-1680 BETWEEN 8:00 AM-5:00 PM (EST~ NON-OFFICE HOURS, WEEKENDS, AND HOLIDAYS: AREA CODE 770 439-4200,424-2048,455-8160,552-8836. 432-2873,424-47H9 LOCAL POISON CONTROL CENTER ...... , . ' . . . .. . ' . . . . . ' , . , CHEMTREC: TOLL FREE 1-800-424-9300 ALL CALLS RECORDED DISTRICT OF COLUf1BIA (202i483-7616 ALL CALLS RECORDED .--.-------.----------------------------------------------------------.----------.-- ECTION II - H A Z A R D 0 U S I N G RED I E N T S . DESIGNATIONS ** SODrUM METASILICATE ** silicic acid (H2-Si-03) di- sQdium salt; wate~ glass; CAS# 6834-92-0; RTECS# VV9275000; OSHA Dust Limit-2mg/m3 (fo~ powders only). ** ETHYLENE GLYCOL MONOBUTYL ETHER ** 2-butox~eth.n- cl; uU1;I.Jl cellosolve; CAS# 111-76-2; RTECSff ¡":.,J8,o5T50()O¡ OSHA PEL (SKIN)- 25 ppm ~* SODIUM DODECYLBENZENE SULFONATE ** linea~ alkyl a~yl ~odium sulfonate; CAS# 25155-30-0; RTECS# DB6825000i OSHA PEL N/D TLV EFFECTS :.~ HJ (PPt1) (SEE RE1./ERSE) PROD, N/D COR 5 .!J·t . - :L',.,\ 25 TOX IRR CEl 5-1'5 N/D IRR .- 5 .' '- ID8~TIFIES CHEMICALS lISTED UNDER SARA-SECTION 313 FOR RELEASF REPORTING. ECTrON IIr - H E A l T H H A Z A R D D A T A PECIAL NOTE: MSDS data pe~tains to the product as dispensed f~om the containe~. dvers@ health effects would not be expected unde~ recommended conditions If use (diluted) so long as p~escribed safety precaution~ are practiced. CUTE EFFECTS OF OVEREXPOSURE: raduct in concent~ated fo~m is a severe eye i~~itant. OvereKposure may lead t~ ye tissue damage which can be permanent. Skin contact may p~oduce i~ritatian, ,nhalation may p~oduce upper respirato~y i~~itation cha~acte~ized by so~e throat r difficulty in b~eathing. T'@dient·; in this product may aggrav.:¡te existing skin, elJer or respirator!; ~'... 0;' d @1~ ':;. '~-_/ ,-,.. SPECIMEN LABEL· ::::; 1'-'.... PROD.1039t BEFORE USING THIS PRODUCT. PlEASE READTHIS ENTIRE LABEL. 1190A DAN G ER ! ·Spl~ Containl aodium metasilicate. ethylene glycol monobUtyl ether. and sodium cIodecyIbenzene sulfonate. I;; .C" . CAUSES EYE BURNS . .. III ~'" ,:lJ.lI~A' CAUSES IRRITATION ,',,' \1 .. '~" ., LAB '1111;;" ~ cause severe IkIn!llldeye irritalionor, inllammalion,; Jnhalalion of Ipray;m.lsllorvapora may cause .~: ....,-.~ .¿i: .::'.' .'. . .' r8spilatoryJr8Ct~. DO NQT bleathe v8pcn or spray mlsl DO NOTswallOW1hIs )fOåICl Repeated ";!Xiéf; "'. ,.~: .'.'. E~ e~urecan.....h~,vec:um.ulative,$ffectI".Exposure~y~ggravateexisting,~",;eye.orrespiratorydso~~. '''''''~I.:''¡>' ,r·Åj ;~'~'~;?'Jf " . .. :.a~:==:~,~ffeCtI of~rexpolUr8lS ~uded on the Material Safety Data Sheet. which IS CONS .;, "Ba¡-, ED·· ZeP ~Iits limiling êxpolure to all chemical producta. 'Wear light-tiitin$!. ìplash-proof safely goggles ~.r". "(' ..,~_. ". . dû!ingp~duS8.e~~COI:'tact.enswearerl. wea.. rnaturalrùbber;nitrile.neoprene.oro~erresistanl .' . '. '.. ;.'. " gløil$l. U" product Jn~P wntila~ areal only; ope" windowsldoorsand ,:,se eJ!haust fans In endosed .p,~, , '. t., ., '., .: area.. Remove contamlnal8d clothing promptly and '00 NOT rewear until thorqughly deaned. After Ø~AI' In·G hancliilg wash hands thoroughly with soap and water. .., .... .," '.' ,'~~:"":,r~. ' : j~,:,:. ~1:~~~~~~~~~~~;~~foratleast 15minutes:~sion:~lylifling ~eupper~nd UI:··' " ..11' '.;, ··I~~!~'·~'I' ,.., ·~I"""·~·.' .. . A·" J,.,.. HTM. SK. ..'~.:~mmecial8IyIlUsh. co..,.ntamlnated.SkinWlth plenlyolwaterloratleast'5 minutes. Getmed icalattenllOn ,.... if in1taÞon dEivelopa.· , } I"··c..,~ . .. INHALATION: Move expöaed perso~ to fresh air. If irritation persists, get medical attenlion immediately. .. ¡;' ,,- ';' INGESTION:.lfthis pr~i,lSw~lIowed. 0.0 .NOTincfuœ vomiting. If vomiling occurs k~p he~ below hip '<.>~;',i r.~.?~'¡ fii:..<.~ ~'~ .... ..,'. " ~to~t=;U.;'.J=~::::,~ntothelungs. ItaftectedpersonlsconSCIousglveplenlyof FOAMING' WJi~'I, ;EV}{A. n.L~.,-. '.. EL CLEANER ;: INCA. ~~OF.ALARGES, PILL: Absorb~~onan~ertabsorbentmateriaJ,suchasZEP-O-Z<?RB,and ..¡ ,"~\"," ;i.~:""'»'>'" .. '~:l .,;. '." ., . ,:. deposit In a dean. sealable. D.O.T.apeaficatiOn contaIner for disposal as a hazardous wasle. Rinse area ZEP CONCE~TRATED FOAMf,t{~~t:Et~~~fts á'Piè.mium grat!.. high foaming whitew.all W!" wi~ water. .,' . . cleaner especially designed fortt)e~ ~l~lrt.£I~~EP CONCEN~TED FOA!'AI,~G Store Þghllyclosed container In d~ area at temperatures between 400 and 120° F. DO NOT store at WHEEL WASH is non-caustic ~..,. . :J'~fe 0E: :. , .\~~anâ'a.IIJ.. . .iøum. (NO. '~. ;: limit contad t,'....m. ,to te~peralure~ below 3~F.Keep.. thIS product away from food and food producta. 3minutesorless.DONOTallO~ce EN' ,: ;¡toAMINGWI:IEELWASHtod,l'Y,~n ';.. KEEP OUT OF REACH OF CHILDREN paint or aluminum.) i.£"',;:"",,,; '¡ ., .,:~ '~"'~.' ,..... ';;'. :.::, : ,,: FO. R INDUSTRIAL AND INS11TUl1ONAL USE ONLY ~":..'!i$;.;: DfR5:0NS:o\¥-"''1~; <., , , '.':~ . NOT FOR HOUSEHOLD USE OR RESALE P'RE;MlX: Add one 7-gallon pail t~~.~t"lor :', filll~~ter. Mix ~u..Use this premixfOr'the, , .,: " .. PRECAUClOH dlluÞons below. ~':$. ,\I-~.. ~, ,. ~...~ ',_." ,.-.: :.":'.' .; ,.,ALUSARIO,:SIUS!8dI1OIee.Jnglél,I1OUIe, esteproduc:tohastaquelaeliqu.talehayasidoexpUcadaampUamente. FULLSERVEANDEXTERIOR~'ª', RW,. I' : t , .' " ,¡..,. ..' ':.', :ITOTHEUSER: IIYOUC8MO. ,lreadEIIgJiah.doI1OIUlelhiaprodUdurltiIJheIa.belhas,been....IuUy.xplainedIOYOU.) AUTOMATlCAPPUCATlON-D~, partZEPCONC :.JED~~~NGWHEELWASHp~ix· , ':p-' ,,' . ,: . with up to 5 pans water. Allow 10 pm' contact _~ agitation by,brushea.:.' ;," >. , Z ., ""*lean.... IllUdlybf: ..:.' '>, , PRE.TREATMENT - To enhan~',ÍÞ!I, ,aning ability of WhiieWaJI cleaners'~ for brake dusl rëmovSl. . <- ;" Eæ~~~~p~NY::, ,: .~"". apply. premix unáluted. Apply using 8Ikàllhe resistant pumþ-up sprayer to drY~'and wheels just prio~ to, ;':::.¡ -',; ATLANTA, GEORGIA 303Ó1>,.,':;. :-: entemg the IUnneJ.·.. .':' ~ .': ~,: ..~:. ~: ' '"ÇLENi ACROSS NoIERICA NID rHRouGHour:1HE wpRlD",' SELF SERVICE CAR WASHES:' , ...~ ~., ;: '1:; Tl!Is produd ¡¡desIgned txcru.iveIy for IIèiUaNl and inIIi1ull.ónafuse bYJi.ainèd¡Pi'of..~ maintenance personnel. DilUte premix with up to 3 parts wal8r (use a gray tip with Zep Model 80 Proporflorier) for applicalion1Ø ~!9' LaþØI direclioll,' and pr~. '0lIl, I11III\ be 1oUowed exaaly. ?ep Ma~raclllri11g COínP!'"Y1U1 not ~ respon~bIe for any and for engine cleaning through spray wand. "" -; ,j'; Injuty . lost, or.damage,II ~d II uMd i!:1any manner not In ~Iiance WlIh label dlrecjíOns. or. II precaullO/1S are not The introduction of compressed air (40 ID 60 psi) wiD increase the amount ~ ~ilily of the fO~::, ~~. o~." !(~, '.: >;. ::: ~.. ." ~. A .. . ~ ' .:......w. - ''';'''' '. "¿.' ~ "0: ,; .~ , ~:: \,.:.';' ¡ ;. - fr ... -. ,~ q . Per it to Operate Hazardous Materials/Hazardous Waste Unified Permit " CONDITIONS OF PERMIT ON REVERSE SIDE PIPING PIPING PIPING TYPE METHOD MONITOR SWF PRESSURE ALD SWF PRESSURE ALD SWF PRESSURE ALD - - - . ~ - '£ -- ~ - ~ - nel Sen June 30 2000 This ermit is issued for the followin tI@~ardous Materials Plan · ""·'r$lround Storage of Hazardous Materials '~Q,~gement Program " Waste PERMIT ill # 015-021-000333 CAR WASH OF AMERJ;~ [~~;~::::":::J J~'\..:"",>~¡ ~~~"" ..,,"!j 2;', ·····Y mS'EINE ~'¡. ~".. ':;j ~ CAp: 12,000 1701 HAZARDOUS SUBSTANCE Unleaded Gasoline Supreme Unleaded Gasoline Chevron Plus Unleaded LOCATION TANK 0002 0003 0017 ~. t~ ~4 Approved by: Expiration Date: Bakersfield Fire Department OffiCE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rdFloor Bakersfield, CA 93301 Voice (805) 326-3919 FAX (805) 326-0576 Issued by: i''''---- TYPE OF ACTION (CheeJr _ ".", only} CITY OF BAKERSFIELD ' .FFICE OF ENVIRONMENT_ SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 I UNDERGROUND STORAGE TANKS - UST FACILITY o 1,...w SIT! PERMIT~ ), RENEWAL PeRMIT Û S. CHANGE OF INFORMATION (SÞ«tfy ClNnge . o .. AMENOED PERMIT /oUIuø only} o e. TEMPOAAAY SITE ClOSURE (9 PIge _ at _ o 7, PEAMANENT\.Y ClOSED SITE o e. TANI< REMOVED ~ I. FACILITY I SITE INFORMATION 3 FACILITY ID . o .. LOCAL AGeNCYIDtSTRlCT" o 5. COUNTY AGENCY" o e. STATE AGeNCY" o T. FEOEIW. AGENCY" 402. 1. GAS STATION o 2. DISTRIBUTOR ¡TOTAL NUMBEA OF TANKS i R6WNING AT SITE I 404. o 3. FARM 0 5. COMMERCIAL o 4. PAOCeSSOR 0 e. OTHER 4O:J. II,.., an iridin ~ 01 .. _ dUST. pubic 8geIICy. _ at IUPeMIor at ~, dVIIIon. MCIIan 01 oIIIc8 whIc:ft apneIlN UST. "- (Thll1I lie canI8à /*IGI'I fCIr IN IIM-*.) o v. 'BJ No 401. .. PROPER1Y OWNER'.r.FORIIATION 4011. «11. PHONE (} ~Z-?J, 4011. 409. 410'1:~ 411./ ŒClbYJ2 412. o 2. INDMDUAL o 3. PNmERSHIP o 4. LOCAL AŒHCY t DISTRICT o 5. COUKTY AŒHCY o e. STATE AGEHICV o 7. ÆDEJW. AGEHICV . 413, '" .. TANK OWNER INFORMATION·. ~ .... ..,..> 415. 4111. {)2- 419, o 2. INOMDUAL o 3. PARTNI!RSHP o 4. LOCAL AŒHCY I DISTRICT o 5. COUKTY AGEHICV o e. STATE AGeHCY o 7. ÆDEJW. NJEHCr 420. TY (TK) HQ ri. BOARD OF EQUAL.ŒATION U8T 8TORAGE FEE ACCOUNT NUMBER C8II (918) 322-9869" quesllona.rIse 421. '~ . ". '.. v. PETROLEUM U8T FINANCIAL RE8P0N8IB1UTV INDICATE METHOO(S) o 4. SUÆTY 80ND o S. \.ETTER OF CREDIT o e. !XaPTIOH 7. STATE FOND o a. STATE FUND & CFO lE'TTER o t. STATE FUND & co o 10; LOCAL OOVT MECHANISM o 98. OTHER: 422. , .,! r VI. LEGAL NOTIFICATION AND MAlUNG ADDRESS ChedI_ belli 10 IIICIaI8 wfIIcfI.--1fICUd lie UNCI fCIr IegII noIIIIo:rooIIoill 8IId III8IkIa. -....... F.,.. .... 0 --...... OWNER IAgII noIIfIctoIIoIlI 8IId 1MIIngI"1Ie MIlt... IN -* _ unIII8 belli 1 012 II c:I'Iá8d. U 1. ........" 2. ..........~" 03. TANK OWNER 423. VlL APPUCANT 8IGNATURE ?J¿ .'VJ 428. 4X1. I STA 11 UST FACILITY NUMBM (ForIDc8l_ cWy 42L I 1l1li UPGfW)II CEATIFICA TII NUMBeR (For IøUI 11M only} .aI, UPCF (7199) S:\CUPAFORMS\SwrdHI·wpd STATE OF CAUfOANA a STATE WATER RESOURCES CONTROL BOARD.' ., CERT1FICATION OF COMPLlANC FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET J=zQJ ~-LUÌ1.Q CITY ~& Qoorf C~~OtdDd) COUNTY Kern II. INSTALLATION (mark all that apply): o The installer has been certified by the tank and piping manufacturers. ;z: The installation has been inspected and certified by a registered professional engineer. ~ The installation has been inspected and approved by the implementing agency. Y' All work listed on the manufacturer's installation checklist has been completed. '0 ~ The installation Contractor has been certified or licensed by the Contractors State License Board. < ; [] Another method was used as allowed by the implementing agency. (Please specify.) . vided is true to the best of my belief and knowledge. . Date 5úJ (J¡) )'6~2..'l~4.L ' LOCAL AGENCY USE ONLY STATE TANK I.D, # COUNTY # CD JURISDICTION # ITD FACILITY # ITIIIIJ TANK # = FOAM C (7191) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOAOO35C7 STATE OF CAUFORNA _ ST ATE WATER RESOURCES CONTROl BOAR_ ., CERTIFICATION OF COMPLlANC~ FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET \1)t Sh\~f CITY ~~.ç~ld ~ Lro\d~ClL [L~) COUNTY ~ j{ VI II. INSTALLATION (mark all that apply): o The installer has been certified by the tank and piping manufacturers. Z The installation has been inspected and certified by a registered professional engineer. -c:J The installation has been inspected and approved by the implementing agency. ,Ø J2 All work listed on the manufacturer's installation checklist has been completed. The installation Contractor has been certified or licensed by the Contractors State License Board. ':> o Another method was used as allowed by the implementing agency. (Please specify.) Print Name Address iC d is true to the best of my belief and knowledge. . Date 5l) t l ðÙ ~ \) ~~1~~~ LOCAL AGENCY USE ONLY STATE TANK 1.0. # COUNTY # OJ JURISDICT.ION # FACILITY # ITIJ ' ITIIITJ TANK # = FORIA C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOA0035C7 STATE OF CAUFORNlA a STATE WATER RESOURCES CONTROL BOARD" ,., CERTIFICATION OF COMPLlANC~ FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET 'tc CITY ~Á\¿\c\ nuadQ /î) II. INSTALLATION (mark all that apply): [J The installer has been certified by the tank and piping manufacturers. Y The installation has been inspected and certified by a registered professional engineer. ß The installation has been inspected and approved by the implementing agency. I ~ All work listed on the manufacturer's installation checklist has been completed. ." ? The installation Contractor has been certified or licensed by the Contractors State Licens~ Board. U Another method was used as allowed by the implementing agency. (Please specify.) . 'ded is true to the best of my belief and knowledge, Date r \t Print Name Address l. LOCAL AGENCY USE ONLY 5T ATE TANK I.D. # COUNTY # IT] JURISDICTION # [[JJ FACILITY # ~ TANK # = FORM C (7191) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOAOO3~7 Sf ATE OF CAUFORtlA _ STATE WATER RESOÙRCES CONTROL BOAR. ., CERTIFICATION OF COMPLIANC!!I" FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET \ lO l SÜvU2 2(m CITY 'PiLW~\I~\~\ ClûQJtE'_ êiJ COUNTY }./em II. INSTALLATION (mark all that apply): [J The installer has been certified by the tank and piping manufacturers. Ø'The installation has been inspected and certified by a registered professional engineer. ~ The installation has been inspected and approved by the implementing agency. ~ y U All work listed on the manufacturer's installation checklist has been completed. The installation Contractor has been certified or licensed by the Contractors State License Board. .. Another method was used as allowed by the implementing agency. (Please specify.) ed is true to the best of my belief and knowledge. Print Name Address LOCAL AGENCY USE ONLY STATE TANK 1.0. # COUNTY # IT] JURISDICTION # ITIJ FACILITY # ITIIIJJ TANK # = FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOAOO35C7