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Home My WebLink AboutUNDERGROUND TANK(UNDERGROUND STORAGE TANKS) FILE # ORANGE BELT r ' / ~; 1n'' 1 11 / 1 ~,,,e r ., ~ ~ ~, ~. ' r? _~ ~ti, ~ ~ ~;.;,, 1 . ~ l ~~ ± +;) ~ g,~' + 1 ~ ~' ~ 1 `~ ,~1 , Iy 3640 SII,LECT AVENUE .~ l~Y _ / ~3~b ,, ~ ~ ~u~,,.~r~^yytt ttt ~• }}}~~~,,,''' i. ~ `,q ' + r` +, .l ~ i~ \\ ' ~~ 0 w ~ ~1 {~ `~~ . ;{ [ v V ,~i ~ °u A `~ ` e \ ~ S I .'\>'~ ,. , , ""----- .c:__ Per It·i·ot·\~.perate' _ t. . .?" Hazardous MaterialslHazardousWaste Unified Permit CONDITIONS'. OF ,PERMIT ON REVERSE SIDE This permit is issued for the following: It! Hazardous Materials Plan . 0 Underground Storage of Hazardous Materials o Risk Management Program o Hazardous Waste On-Site Treatment Permit ID #:: 015-000-000119 ORANGE BELT STAGES LOCATION: 3640 N SILLECT AVE ".'~ ~ I TANK 015-000-000119-0001 ONITORING Issued by: ~', --- . , . . ,I > 0 Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES' 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 4 .~ W ¡. OfficeofEv' Services . June 30, 2003 Issue Date I ,I Approved by: Expiration Date: '.." --... -- ORANGE BELT STAGES Permit #015-021-000119 3640 N Sillect Ave Bakersfield, California 93308 This permit is issued on this 2nd day of November, 1998 to: Instructions to the issuing agency: Use the space below to enter the following information in the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue. Other identifying information may be added as deemed necessary by the local agency. An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (805) 326-3979 - I CA Cert. No. 00708 .. . -~- MONITORING SYSTEM CERTIFICATION For Use ay All Jurrsdictio~2s Within the State of California Authority Crtec$ Chapter 6 7, Health and Scrfery Code; Chapter 16, Division 3, Title 23, Calrfa•nia Code ofRegulations This form must be used to document testing and servicing of monitoring equipment. A s~arate certification or report must be prepare for each monitorin~s~tem control panel by the technician who performs the work. A copy of this form must be provided to the tank systetrt owner/operator. The otivner/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: G~A~C--~~~l~~t-~ bTAL~~ Bldg. No.: SiteAddress: 3~o~d .~~ PLC,,:-T f~/~ City: T~AtG.~~<,~~~L~ Zip: 9~~Z-3 Facility Contact Person: m~ '~ Contact Phone No.: (~_~ Make/Model of A~lonitoring System: ~.J=L~tzc.~ E~ ~ Date of Testing/Servicing: ~ / / ~' / d7 $. Inventot•y of Equipment Tcsted/Cct~tified 1NSPBCTOR ON-STTB: YESK I~C~AME: Check the :,nnrnnriare hnxe,,n indicate specific enuinmenl inspected/serviced: Tank IU: D.1 ESr/ ~ 7nn1< ID,: ~In-Tank Gauging Probe. Model: _~ G ^ In-Tank Gauging Probe. Model: I'n ~--Arnuilar Space or Vault Sensor. Model: /~~ Q Am,ular Space or Vault Sensor. Model: ._ ~ -!'iping Sump /Trench Sensor(s). Model: 01 U X ^ Piping Sump /Trench Sensor(s). Model: (] Fill Su,np Sensor(s). Model: ^ Fill Sump Sensor(s). Model; Mechanical Line Leak Detector. A9ode1: 21rJ F~G~-~T ^ Mechanical Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. A2odel: ~ _T ^ Tank Overfill / High•Level Sensor. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Other (s ecif e ui ment [y e and model in Section G on Pa e 2). D Other (s ecif e~ ui ment ty e and model in Section E on Pa e 2). Tanlc ID: "i'arik tD: D In-Tank.Gauging Probe. Model: ^ In-Tank Gauging Probe. Model: O Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: ^ Piping Su,np /Trench Sensor(s). Model: ^ Piping Sump /Trench Sensor{s). Model: ^ Fill Sump Sensa•(s). Model: ^ Fill Sump Sensor(s). Model: ^ h~techanical Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ Tank Overfill /High-Level Sensor. A1odeL ^ Tanlc Overfill /High-Level Sensor. Model: D Other (specify equipment type and model in Section E on Page 2). ^ Other (specify equipment type and model in Section E on Page 2). Dispenser t0: ~ Dispenser tD; ,~~•-Dispenser Containment Sensar~(s). Model: 001 ^ Dispenser Containment Sensor(s). Model: ,r~Shear Valve(s). _ (] Shear Valve(s). ^ pis eraser Containment Floats and Chain(s~ ^Dis eraser Containrent Floats and Chains , Dispenser ID: Dispenser 1D: © Dispenser Containment Sensors}. Model: _ O Dispenser Containment Sensor(s). Model: D Sham valve(s). 1 ^ Shear Valves}, Q Dispenser Containment Float(s) v~d Chain(s). ^Dis eraser Containment Floats and Chain s). Dispenser ID: Dispenser ID: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model:. ^ Shear Valve(s). O Shear Valve(s). ODispenser Containment Float(s) and Chain(s). ^Dis eraser Containment Floats and Chain(s). Ott the tt~c,lity co,ualns more tanks or dispensers, copy this form. Jnclude information for every tanlt and dispenser at the facility. C. C~rtIflCZClOI7 - !certify that the equipment identified in this document was inspected/serviced.in accar•dance with the manufacturers' guidelines. Attached to this Certificatiort is information (e.g. manufacturers' checklists) necessary to verify that this information Is correct antl a Plot Plan,showfrtg the layout of monitoring equipment For any equipment capable of generating such reports, I have also attached a copy of the report; (check al! / at apply): ~Systent set-up ~~larm history report Technician Name (print): ~_>~'~ ABU ~/},y' ~ Signature: - Certii;cation No.: _ ~~1~?~ License. No.: _ ~ a$~ j .S~b - <) T Testing Company Name: 1Z1CH ENVIItONIvi]/NTAL Phone No.: ~ 661 ~ 392-687/ Site Address: ~ yLj 5=(.-Li~..C,.~ AV ~~~f~jy~~2~F'~EL~ ~ /{ pate of Testing/Servicing: Co l ~g 1C.7~ Page l o f 3 03 i 0I Monitoring System Certitlcation ~c~ ~~~ D. Results of Testing/Servicing Softavare Version Installed: ~.Qj Com fete the followin checklist: Yes ^ o {s the audible alarrn operational? ~ Yes ^ o is the visual alarm o erationa!? ~ Yes ^ o Were all sensors visually inspected, functionally tested, and confin-ned o erational? ~t9-Yus ^ o Were all sensors installed at lowest point of secondary contairunent and positioned so that other equipment will not interfere with their proper operation? ^ Yes ^ o If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modern) ,~ N/A operational? ~ Yes ^ o For pressurized piping systems, does the hrrbine automatically shut down if the piping secondary containment O N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Sump/Trench Sensors; ,Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? f~Yes; ^ No. ^ Yes ^ o For tank systems that utilize the monitoring system as the primary tan!: overfill warning device (i.e. no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ^ l es No Was any monitoring equipment replaced? Jfyes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all re lacement arts in Section B, below. ^ es ,~ No Was liquid found inside any secondary containment systems designed as dry systems? (Check al! that apply) ^ Product; ^ Water. f f yes, describe causes in Section E below. ~. Yes ^ ° Was monitoring s stem set-u ~ reviewed to ensure ro er settin s? Attach set u re orts, if a livable ~. Yes ^ o Is all monitoring equipment operational per manufacturer's specifications? * In Section C below, describe hotiv ;rnd r~~hen these deficiencies were or wit] be corrected. E. Comments: Page 2 of3 03!01 T i. F. 7n-Tank Gauging I STR Equipment ~ [.~ ~~/ Check this box if tank gauging is used only for inventory control. D 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. ..~,,, , O Yes D o Has all input wiring been inspected for proper entry and termination, including testing for ground faults? O Yes ^ o Were alt tank gauging probes visually inspected for damage and residue buildup? Q Yes O ° Was accuracy of system productJevel readings tested? O Yes O o Was accuracy of system ~~-ater level readings tested? O Yes ^ o Were all probes reinstalled properly? O 1'es O o Were all items on the equipment manufacturer's maintenance checkist completed? T to [ne aeenon n, oetow, uescr+oe uuw anu +vueu luCJe UeUC,C11e,CJ rvcrc ~r ruin ue ~~„ cert.,. G. Line Leak Detectors (LLD): O Checl< this box if LLDs are not installed. ('nrnnlrfe fhe fnllntivino rhrrklicr Yes ^ N0k For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ NIA (Check all /hc~t apply) Simulated leak rate: ~; g,p.h„ d d. I g.p.h , ^ d.2 g.p.h. Yes ^ o Were all LLDs confirmed operational and accurate within regulatory requirements? ~ Yes ^ o Was the testing apparatus properly calibrated? fz~Yes ^ o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? D N/A O Yes ^ ' o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ~ N/A ^ Yes ^ o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ~9-N/A or disconnected? O Yes ^ o For electronic LLDs, does the turbine automatically shut off ifany pattion of the monitoring system malfunctions ,~&~?/A or fails a test? O Yes O o For electronic LLDs, have all accessible wiring connections been visually inspected? ,C~.Nf A ,®- Yes O o Were all items on the equipment manufacturer's maintenance checklist completed? -„ .,,c ~ccuun n, ue,ow, uescrrve uuw anu wneu rnese ueucienctes were or wilt ne correctea. H. Comments: Page 3 of 3 t)3101 ! U~ "C Y/ LG 163.1, Enc. II •iVlonltoritig System CertifYcatlon Form: Addendum for Vacuum/Pressure Interstitial Sensors . I. Results of Vacuum/Pressure Nlonitaring Equipment Testing This page should be used to document testing and servicing of vacuum and p3'essure interstilial sensors. A copy of this form must be included with the Monitoring System Ctrtiftcation Form, which must bc~•providcd to the tank system owner/operator. The owner/operator must submit a copy of the Monitoring System Certification Forux to the local agency regulating UST systems within 30 days of test date. . Model: System Type: Pressure; ^ Vacuum Manufacturer; Sensor ID ~ - Component(s) Monitored by this Sensor: Sensor Functionality Test RcsulC ^ Pass; ^ Fail Tntcrsfitial Commmunication Test Result: ^ Pass; ^ Fail Compo>ent(s) Monitored by this Sensor: ' Sensor Functionality Test Result: ^ Pass;' ~ ^ Fai! Interstitial Communication Test Result: ^ Pass; ^ Fart` Component(s)Moniitored by Plus"Sensor: Sensor Functionality Test Result: ^ Pass; ^ Fail Interstitial Communication Test Result: ^ Pass; ^ Fail Components} Monitored by this Sensor: Sensor Functionality Test Result: ^ Pass; ^ Fail Tntersdtial Comrnuuication Test Result: []Pass; ^ Fail ' Component(s) Monitored by this Sensor: ' Sensor Functionality Test Result: ^ Pass; ^ Fail Iniea'StitiRl Communication Test Result: [] Pass; l] Fail ' Component(s) Monitored by thls.Se'nsor: ' Sensor Functionality Test Result: ^ Pass; ^ Fail Interstitial Communication Test Result: ^ Pass; ~] Fail Component(s) Monitored by this Sensor: - ' Sensor Functionality Test Result: ^ Pass; ^ Fail Interstitial Communication Test Result: j] Pass; ^ Fail Component(s) Mo~titored by tb,is Sensor: S cnsor Functionality Test Result: ^ Pass; ^ Fail • Interstitial Couimunieation'TestRasult: ^ Pass; ^ Fail Component(s) Monitored by this Sensor: Sc~sor Functionality Test Result: ^ Pass; ^ Fail Interstitial Communication Test Result: ^ Pass; ~,] Fail Components}Monitored by this Sensor: ~ ' ScnsorFunctionality Test Result: ^ Pass; ^ Fail Interstitial Communication Test Result: ^ Pass; ^ Fail How was Interstitial comintinication verified? ' .^ Leak Introduced-atFar End ofIntersfitial Space;' ^ Gauge; [] Visual Inspection; .^ Other (Describe in Sec. J, below) Vacuum war restored to operating Levels In u.[I interstitial spaces: Q Yes ^ No {;J'no, describe in Sec. J, below) J. Continents: ,N~~__-`_~ ~~~~ rit%S J ~4 L ! ~• ~ ~ /-~ T % ~/~5 ~7-'7'r= ~ Page of r If the SCDSOt successfully detects n simulated. vacuumlpressure teak introduced in We interstitial space tst tho furthest point from the sensor, vacuum/pressure has boon dcmonsn•ated Lo be communicating throughout the interstYCO, ~~~/ Monitoring System Certification UST Monitoring Site Plan Site Address: 3l~`-i D SSLL~EG,T Av ~, _ ~L9.1~C~EF~t.~-e`'~ + ~ ----- Ej'n' - --- --- ------- ----------------•-- -------------- =-------- a --- •-•---------------- Date ntap was dram: ~/~jp~ Ins''-..-, actions If you already have a diagram that shows all required information, you may include it, rather than t}iis page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection}. In the space provided, note the date this Site Plan was prepared. Page ~ of-`~-L ostoo ~cy~Y'~. ~. 5S~k3 Bk2QO~S C",~' E~sk':~E1,D~~.7~.93308 <a~'FZCE (661} 352-887 & 1s'.A~:~ (B62) 39~^Q62Z 2+g~~xz~tJrrA~~~ I7F~~2'OR m~gT w/o#: F'ae:i.li~~r Name : O~t~~ ~ r~~~--i 5~S Fae:l.~.i.~y ,~•c3dx~~s "'>ILLFLi AVE., Pr4c,luG~ ~,a,rxe T~'Zae {pressure, Suct.io>;s, (3xavity) ~°.~E`a.`'~~ P,R(:JDUCx' L.E.AK, ,D~:TEC'TQR TYI?~ T VEST TRx~' PASS s~z~1a~,,.z, zat~z~s~u A~~4W F~~ QR L/p T'i!'PE .,QED J~4c1~1~ P.A~ ~~ z-- , s~.~z.A.L #~1~r+g,~-~~~-- zoo /~ F.A~L L/.A TXF~______,~ YfiS PA33~ 5~~~~L # ~~ Sff0 BATI, L/t~ TY'PF._~____._..._~_~___~._..., 9fES PASS _. x,/,7 ~'XP~___... 3C~S PASS; 5~~.~,~.d., ~.._.._~ ..,_,,. NO F,A.~L'. I ::erti£y t=1~ze abozrF~ rests were conducteri on this dale aaaoxdizag to Red ,;lanket Pumj~s .f.ie.ld t_e,^t dppaxai^us test:izlg px~o.cedure an limitat~.ans. Tki~:r Meckzana.c.al_ Lea): Det'ectar. `.Celt. pass / fa.i]. is detexmined by using a 1a~~r £low th,.resZ~o.1,r~ t.r.ip rate o£ 3 ga.llox~ per hour or zees at 20 PSZ, I .:~eknowledgn_ L~aa.t :a.]-?. data eollected 3s true axed aorxeat. to the b4et of rti•k~ knowledge . SigtL:~ture:~-i'~._r ._.. Date: ~-fig -C~~ h•• l l~ ~~/// SWRCB, January 20f Spill Bucket Testing Report Form . This form is intended for use by contractors performing annual testing of UST spill containment structures. •The completed for~rt an printoutsfrom.tests (if applicable), should be provided to the facility:pvner/operatorfor subnsittal to the local regulatory agency. ~sr:rr.rrvliNn'[~'RMA'YZnTT ~•' ' Facility Name: D2.AN G E ~-T SC ~~ ~'S ~ Date of Testing: to -14 -a Facility Address: ,3la ~-•~ U 5yt~-~~.~' V ~, ~ K-~~5 F.~t/c~0 c 933'8 Facility Contact: ~ -r"f" Phone: .55g - - `1 0 8 Date Local Agency Was Notified of Testing : - - - ' Name ofLocal Agency inspector (ifpresenc during testln~: • NU 2. TESTING CONTRACTOR INFORMATION Company Name: .T-G ~ ENS ~~ m G ~rA~ ~ ~ ~ , Technician Gbnducting Test: ~1zA~ s~v^-~ /Yl /-}Sv ~`-1 Credentialsl: CSLB Contractor SWRCB Tank Tester Other (Sped) License Number(s): sd S ~t9 8~ ~ v~ _ -- 3. SPZI.L BUCKET TESTING INFORMATION Tr_ct.MethndT7srci' ~asYat~ VaCUUIIl OthCr Test Equipment Used: ~.%j V (~ ~- Equipmenj Resolufiion: Identify Spill Bucket (By~Tank• Number, Stored Product, etc. ! ~1-~E ~' ' 2 3 4 Bucket Installation Type: Contained in Sum Direct Bury Contained in Sum Direct Bury. Contained in Sutn Direct Bury Contained in Sum Bucket Diameter: /o? " Bucket Depth: ~(~` ~ Wait time between aPPI Y~8 vacuum/water and start of test: c~U/~1 ~.n! ~ Test Start Time ('I'~: ~i3U M ' Initial Reading(R~; ' . ~' . Test End Time (TF): . ~= 3v PN~ Final Reading {Rp): q '' . Test Aeration (Tp - T~: / rJ 2 • Change in Reading (RF-R~: ~j i PassJFail Threshold or Criteria: p ~ ~ . 1. Comments ' (include information on repairs made prior to testing. and recomme • nder •f~llaw-un for failed tertc) . CERTIFICATION OF TEC2~lICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate; and in full compliance with legal requirements. Technician's Signature:. ~~ .~ ~- ~ Date: G' ~1 ~ U 7 ~ State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements maybe more stringent. - SUF1'WARE kEIJ I S 1 OPJ LFVEI. I t~J-TAJV}; SETUP - - - - - - - - - - - - • VERSIOPJ b.01 SUFTWARE+7 61'i;7bO-005-B T 1:DIE5EL CREATED - 9~1.02.20,i5,19 PRUUUCT COp>; 1 JVO tiUFTWARE MGDULE THERMAL CCiEFF :. 1100450 TAN)': UTAI°1ETER SS.Gi~ 'TANK PROFILE 1 PT rULL 'JOL 11783 FLGAT S I?E : 4 , 0 I tVCHES WATER WARN I IVG 2.0 NIf~H WATER LIhIIT: 3.0 c, ,, ~ STEI°J SET UA - - - - - J°1A;~ OR LABEL VOL : 1 1783 JUfV l y. 2007 2:10 PM OVERFILL L I t°l I T 90% 111604 HIGH PRUUUCT 95% SYSTEM UtV 1 TS LiEL 1 VERY Lit°1 I T 11193 5i U.S. 58':~ ~.iYSTEI°1 LAIVr,UAGE ENt~LIaH LOW PRODUCT 1000 ORANGE BELT STAuES LEA}; hLr"iRM L 1 f°I [ T : SUDDEtV LC,SS L I I°J I T : 99 y9 3b40 fi 1 LLF:c_ T HVE TAiVK TILT 0.00 BAY,ERSFIELD: {^•t MAJV.I FULUED TAIVY,S SHIFT TIh11? 1 DI;=~AII.F.P Tu : fVGfVE SHIFT TIMF. 2 DISABLED PERIODIC TEST TYPE SHIFT T 1 NIE 3 D I SAI3LED STANDARD PEk I UD I C TE57' WAR fV I PJC :S !/ER I GD I C TEST FA 1 L U I SAFiLED ALARt°J D I BAWLED ANJVUAI. TE ~T WARfV I PJGS D I SAI3LEU GkOSS TEST FA I L a'YS1'Et°1 SECUR 1 TY ' ALARM DISABLED CODE OOCt000 PER TEST AVERAGING : UFF '!'A?JK. TEST JVOT i F'l : OFF TNK TS7' SI1>HUJV 13REAK:UFF DELIVERY DELAY 1 MIJV LEAK TEaT I~JETHGD TEST UIV I)fiTE AI.L TAhJk: I°lAR J0. 2006 STAk1' T [ f°lE DISABLED TEST RATE :0.20 GAL: HR DURATION 2 HOURS l ~~~ LIt}UIU SEI'JSOR SETUP - - - _~ - - - - - - - HLARf°1 HIaTOF.'! REPORT L 1:DIESEL STP SUMP TRI-STATE -- SEfVSOR ALARt`9 ----- ~ATEGC>R'1 STP SUhIP L 1:U1E~3EL STA SUMP STP ~Uh1P FUEL ALARf°I L 2 : D I ESEL AIVhIULAR •J+JfV 19 , 2007 12:1 `j F't°i TRI -STATE CATEGOR`~~ ANIVULAk SPACE SETUP DATA WAF,tV i IVG JAIV 1 . 1994 8 : G5 Ah1 ALAF'I°i H I STOk`! RP.PORT • ----- SENSOR ALARf°l _____ C0hihlUfVIOATI0fVS :aETUP L 2:DIEaEL H1VfVULAF. - - - - - - - - - - - - ANIVULAk ^PACE FUEL ALARM JUN 19. 20G'1 1 2 : I G Pf°1 ' PORT ~,'E'TT I IVES SETUP DATA WARfVI fVG NOtVE 1"0Uf'JD JAN 1. 1994 @:05 AM RS-'232 SECURITY CODE OOG000 ~"cS-232 EtVD OF ME:3SAG1r DISASLEU. ALAI?M HISTORY REPORT OUTPUT RELAY SET!!P _ _ _ _ _ ._ - _ _ ._ _ _ ----- SENSOR ALHF.1'1 ----- L 3: OTHER SEfVSr>RS R 1:P0SITIVE SHUTDOWN TYPE: STAIVDHRD fVORt°IALLY CI.O ED LIQUID SENOk ALf°IS I. 1 : FUEL ALHRt°1 L 2:FUEL f~LARt°1 ALARf°1 HISTOR'! REPORT ----- I tV-TA(Vh; ALARf°1 T 1 : D I ESF.L OUERF I LL ALARM APR 16.. 2007 1 :49 Phl LOIJ PRODUCT ALARM! JUL 1. 20G5 1 :35 Ah'1 APR 29., ?OGE :3:55 At°1 APR 3a 200b 10:2@ PNI I NUAL I D FUEL LEI.~Ei. f9AY 1 ., 2066 ~ : 21 Ahl DELIL~ERY idE;r£>EA t9AY I . 2GG6 0 : 1 G ANl .~ •~ ~R CERT: FAILURE REPQRT SITE NAME' ~ ~~ ^~~ f3 E ~~ sr ~ ~E~ DATE: G / % ° v 7 _-- ADDRESS• 31~~c~ ~a~ t_t_~T RAG TECHNICTAN• L3~~N~~J/ /rtA~.v~ Vl1 1 "~ t -' THE FOLLOWING COMPONENTS WERE REPLACED/gEPAIRED TO COMPLETE TESTING. REPAIRS: ^/QN~ LABOR: it/"U ~/ ~= PARTS iNTALLED: NU~I c~..- NAME: TITLE: SIGNATURE: THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR TIIE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIRONMENTAL FOR ANY NEEDED RETESTING. TffiS ALSO RELEASES RICH ENVIRONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPYOF THIS DOCUMENT HAS BEEN LEFT ON-SITE FOR 'YOUR CONVIENENCE. ~'! 7j t-~tivi _ •Il r , 14r~ ~ : ~ ~ `Y'1~` 1 ~ `~{ ~~ ' . SR~~iD~t~'SYSTEM CERT'~FICA1'I41~ FORM . , ~: , , ~ DATE l i1 . ,.~. FA~IY,ITY ' {?~ ^r b F $~-' ~S l-1~sES ,.. ~`~`~' ; Fl1GIL1TY ADb~; ~S2!~.,~i~5 ~'Y"~~,...~~~1 ~ _. r fi ,.,, , e~,f•.=' .. ~9 ~ ~ L~ 1~'~. ' LT~'~ A~tDalu S~ce '~. /J `~ ~" ugh ., : - .a . , a:~~ `'x'as~k ~ . Task x Ta~a~k 3 Tic 4. ~~tti; ,. s,:. , ~rt Tireee . . , . ,... Ih~ti~i Presanre ..,.. . , . . . . .x ~y ~~ '~ f y ~ad~ i~AYC ~ ~ ~ ' '. .. '~ o ~, ;~~, t~11-II ,; f.. iV4 ~' '~ t~0 ~N:s~v:S-w~-~~pQ. V5~ ~faal~ ,~.. ~~~, ~,. ~, ~x' ~1 ~ ~ rwj(+] ~ F ~ ~I ~~. ,~`~ ~~~ ~~ ~ ~ .;;i~ ~ . . ~ _ ~ Line 2 . Line 3- ~,Me 4 :~~~ s+~~ r~ t ~' y 'r ~~ •~ h t'~. ~[ , + 77 '/~~4 ~ \ .~ . ~ , . _ .. . ' 4~ 3 4 "+ l ~R~ ~fM~ ~ ~ ; , N,; ~. ~~~ '~~~:. ~^\. ~ . . ' . ~~~;. ~ Page I of ~ . ~ . . >c,. ,: v ~,~~~ ~ / CS e.. l f~- L.1 V..'.' 4 SECOND'~SYSTEM CERTIFICATION FARM .. '~ ~ . ~'ACII,I'I'Y ID ~ .gL~S 1..w~-S '~ FACY~TTY ADDR~S9 '3 (¢+~~1~5F'.~ c~" ~ . " Bd~k Y, f' i 'I~~inL -SU~S .. y. . :. !T ~. .. ~\ Xr.. ~" ' '' , \: Y • •' $w~tp- ~ Sump 2 Samp ~ Su3np 4 ~tl~rt'Time : ~} ~n~tlwi HNg!t<t df Wahr p 'tune ~ {~ ; (S~ Std' H~~ ~..~pd . ~,,,P . I~ ~ ~ 7l~~ L ~~.~~ f V ' - u ' ~ ~~ Lll~~ ~~ c U c ~; ~ ~M 77 "I i . ; / a., C~rlRI Buckets ' Ov~iUi I;: OvertW 2 Ore+rfiil 3 ~ : pvertill 4 $tut 1Yme : ~ . Iinftia! Height ai Water ,.. •. ~ ~ ~ ! ,~ ,. . Time : os Water He3glet . ~jaQia ~:;..::. Time ~ o ~ aaA~ ~ : . ~~~ ~I(Si n) ~ Page 2 of `~~ .{' ^- w. !~~: ,.~ , ,.,.- . . 1~•=. - lr.. i - y. SECGND~RY SYSTEM C ~'RTi#~7CA'~°ION FORM ~• . ~:~; DA ~ 1 c 0 °1 0 5 ?~.~: FACILi'~Y IDY.,p:;cci,Rl~~ ~ t~-s "";::~: FAG`ILI'I'Y ADDRESS ~~ ~_ y .5~..~..~'~_. rQ, :_~~...~~~ ~'~ . ~ , ~'~' UbC 'I~?Sr'fING ~• N r ". ;;. >>- ~;~ ~' :,: _.`. •, y,. , :S D~.SPENS'~~ ~ ;DIS~•NBER 2 DIS'P'ENSER 3 DLSPEtVSER 4 START TYNIE I~ . . i~'ITAL l~LGBT OF 1iYATQt . . 'f 1~YtE p~: 0 S' ~V~1TER lO~aUA ~'VATER ~EIGAT ~ '~ CERTIFICATION ~SIGNATURL~ P5 D15P"RNSE~~~ ~ ' DISPENSER b DISPENSER 7 DISPENSER 8 . START TIME I11TI'FIAL ~ . I#EIt,~A'T 4F WATER 'faKE ~~~ ~ISIGIIT . 't'II10s WATER HEIGHT I(SiQNATVRB) ~:; :; ~ . ;r; S+ ., t.' ~;~ ~; .~ 4'. ,:1' ~'. _~ . ,, Page 3 of ,~ f ~ La ~.} .T B F/RE ARTM RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Cperations/Training 326-3652 December 1, 2005 Orange Belt 3640 Sillect Avenue Bakersfield, CA 93301 FINAL REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31, 2005 of Underground Storage Tank (s) Located at the Above Stated Address Dear Valued Customer, Deputy Chief Kirk Blair ~ Over the last six months this office has continued to send reminder notices regarding Fire Safety/Prevention Services ~ secondary containment testing. 326-3653 Code requires that all secondary containment systems must be tested 6 months post construction and every 36 months there after. 2101 "H" Street Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Bakersfield, CA 93301 ~ Health & Safety Code) of the new law mandates testing of secondary containment OFFICE: (b61) 326-3941 ~ components upon installation and every 36 months, .thereafter, to insure that the FAX: (661) 852-2170 systems are capable of containing releases from the primary containment until they are detected and removed. Our records indicate that your facility is due prior to December 31, 2005. RALPH E. HLTEY, DIRECTOR i PREVENTION SERVICES Those sites that have not been tested and have not pulled a permit prior to December 31, FIRE SaFE7r SERVICES•EN1rtRONMENTAL SERVICES 2005, will have their permit to operate revoked. 900 Truxtun Avenue, Suite 210 This office does not wish to take such action, which is why we will continue to send monthly Bakersfield, CA 93301 ! reminders. OFFICE: (661) 326-3979 FAX: (661) 852-2171 ~ Contractors are already booked several weeks in advance. I urge you to schedule your ~ testing date as soon as possible to avoid possible revocation of your permit to operate. David Weirather Fire Plans Examiner ~ Should you have any questions, please feel free to call me at (661) 326-3190. 326-3706 ', Sincerely, Howard H. Wines, III i RALP • I-IUEY, Director of Prevention Services Hazardous Materials Specialist 326-3649 ~ Steve Underwood I Fire Prevention Officer SU:db i I UNDERGROUND STORAGE TANKS ~; -„ APPLICATION ~''' TO PERFORM ELD /LINE TESTING ',` SB988 SECONDARY CONTAINMENT TESTING !TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. ~~a~ Prevention Services parr T 900 Truxtun Ave., Ste. 210 .~• Bakersfield, CA 93301 Tel.: (661) 32b-3979 Fax: (661j 852-2171 Page 1 of 1 PERMIT NO. ~~ ~~ ~~-''/ ^ ENHANCED LEAK DETECTION ~^ 'L-INE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ! ~ TO~ERFORM FUEL MONITORING CERTIFICATION SITE INFO RMATI N FACILITY ~ Yl N ME 8~ PHO f NUMBER OF CONTACT PERSON boo - a I~ Ca ~ -~ ADDRESS 3 Co ~ lV ~ _ OWNERS NAME OPERATORS NAME ,(\/~ PERMIT TO OPERATE NO. NUMBER OF TANKS TO $E TESTED lS PIPING GOING TO $E TE TED? YES ^ NO TANK. # VO UM CON NTS i ~ac~o~ ~ TANK TESTING COMPANY NAME OFT STIN COMPANY + 1 NAME 8 PHONE NUM ER OF CONTACT PERSON ~y MAILING ADDRESS ~ ~ f~ r a U MAME 8 PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR - 1~ O CERTIF tCAT ON #: DATE 8 TIME TEST TO BE CONDUCTED - -~~ ICC #: TEST METHOD SIGNATURE OF APPLICANT ~ DATE 2_ ,y_ APPROVED BY DATE ~~ ~ ~S ._ ~ S` ~~ ~ ~ FD 2095 (Rev. 09/05) ,.r UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING YANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIEI,D FIRE DES. B S R S F 1' D prevention Services ~t~~ /1R3`~ ~ 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ 7ANK TIGHTNESS TEST ^ TO PERFORM FUEL MONITORING CERTIFICATION FACILITY I ~ ;{TE:INFO RMAT_ION __ ' NAME & PHONE NUMBER OF CONTACT PERSON n S b~- - r /bV DDRESS 3c~~o lJ3d WNERS NAME PERATORS NAME PERMIT TO OPERATE NO. II,,'' pvUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? YES ^ NO TANK# _ VOLUME CONTENTS -- AM F TESTING COMPANY TANK TESTING COMPANY NAME PHONE NUMBE OF CONTACT PERSON ~.~ - ~t,~- ,3 - ~q9 AILI G ADD ESS ' ~ ~ C/a q 3 3~Z AME & PHONE UMBER OF TESTER OR SP ~ '- AL I S CTOR - l0 7 ERTIFICATION #: b 3.S>a 9 -- as~ d 3~'~ 3 ~- ATE TIME TEST TO BE CONDUCTED R ~~ : boy CC #: ~a ~~ a ~ ~ - u ~- EST METHOD ~~~ IGNATURE OF APpLI T ATE ~ ., _ O PPROVED BY _ _ ~ J _ (DATE ~ ~ ~ Q FD2i06 - ' ~~~~~>~ _ ~ Bakersfte'~, C~ 933c~1 r~ ~~€~~~~R~ ~! ~1 ~~~~ ~ES~t~~ Tel.: (63? ; 3~6-337 !` SB983 S~C04VE3€a~Y ~C3~TAIiV~4~E4~dT TE~TIl~G - °: ~v6 ~ 1 z~a2-2 ~ 7 3 ~T if SS EST T~ ~E;~S=C:Rd~ ;`vEi A~ T 1~; -; Tl~E ? A~ Y ~ // tt ~~ pp pff ~++ ~~{{ g ~ q ~ -} T ~'!~5`i~~[.i~tiYa.7 Vt.~~. S 1~l~.re'~'.~~V°~, { I~G~C j '~I 1 °tRr.111 Ad0_ ` Tom' ~ ~~ i EivHa~iCEC LEAK DETEC?IvN J LINE ? ESTWG ~ SB-989 SECvNDARY GONT;AiN1~4ENT TESTiNG- T?,N'~. T:GHTNESS TEST ~ -.. =c~Fc;R,~., -~ _ '.~;GI`~i'•.~ GR!~iG GE~T!f=tir'.TIG~ _ ~.. ~;;~ NrrJRi., ;!=AC!L4TY ;~A~7v ~ ?-sC ~E i'S3: T~*.C'e SE~'~t €'~ F~';EsE:R OE Gs=rt~ ~ ~~ G iA~uRESS 3t~ ~ v ~~- ~~~.t.~ _ - ~ R.~.3a~ _ 01n~NERS NAME ~ ~Ot~ERAT~"~S wi,?d`~lE iC'ER~§iT TC' :~P.E?:d°E Nc~. ItiUN]BER GF TANKS TO 5t TES7^D _~-_ __f,- P!!'ING GOING TO EE TESTEL? ------`----,--' S ! NO ~?kILiNC Aij3)7ZESS ' '~ ~ fl r ~ ~ 7 .1~a-J ~ E ~ ~~ C/-~ X13 ~~ _ ~?~ititEl& PHONE F'C[~11B~R O?= TESTER OR SP +~AL i{y=t~CTO!?. jCERTIciC.A?iON w: DATE TIPttE s tST TO BE COt~t~JCTEC _ !IGt; , : fTES ~:~ETNO? ` ~ ~ ~ ~.YU ~ ; ~ ~.S ~ , a~ I~I~ ~ ~r~2 cr ~ ~ ~ ~ ---' a `T" ~-~~--~ ;?[U[~ATl+'FfE Oi= APr~L! n, T ;DAT€ t ~ " ~, _ ~ ~ i ~"' _ ''~ ~ILL~NCs ~t PERMlT STATEMENT ~" DATE . Bakersfield Fire Dept. PREVENTION SERVICES Fire Safety Services • Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 93301 Tel: (661) 326-3979 UST/AST PERMIT, TANK,TESTING ~ 82 STATE SURCHARGE 86 TENTS, LPG. FIREWORKS, POWDERlOTHER PERMITS 84 COPIESlREPORTS 89 FOLLOW-UP INSPECTION INSPECTOR: DATE TIME SPENT: CHARGES: ~ ~.~ CHARGES CODE: REASON and DATE ' 3 FOR INSPEC TION: LOCATK)N OF INSPECTION : j{,~ fay ~. [/(^jq~ (~ ,/~ ~~(,.s~~(;$ BUSINESS NAME: _ „~-,.,",,, TELEPHONE NUMBER(S):. `"' .»~ ~~ ~~ BILL TO: PAY~BY: •^"°? `~ ~ ~~_. ~ ~. NOTES: - ^' CUSTOMER SIGNATURE:. INSPECTOR/RECENER SIGNATQRE~~ p"1 s^'-. ( r ORIGINAL NMfTE: FINANCE CUSTOMER: PINK OFFICE: YELLOW F01734 (rev. 12/03) s 1VIONITORZNG SYSTEM CERTI~'ICATZON i (~:3a For I,/se ByAll Jvrisdictlans YVithin the State of California ~-~ 11f1I10)'1F}' Cited.• Chapter 6.7, Health a»dSafery Code; Chapter 16, Division 3, Title 2~°, California Code ofRegu!„rio~s I'l~i turns must be used to document testing and servicing of monitoring equipment. A separate certification or report must be preU:,rr~i ti)r each monitoring system control panzl by the technic{an who performs the work. A copy of this form must be provided to the r~nl. s~~;tem ua•ner/operator. Thz owner/operator rnt>st submit a copy of this form to the local agency regulating UST systems within ~i' ~i.,~s of rzst dare. _~. i~enet•al )cnfolr><nation 1-~acilizl~~ Narne: Qt1 ~G~_ CC~T ~l .g-LL,~S Bldg. Na.: ~;t~ :address: ~Lyo ~,, ~ r t t-£~L. i4•yF city: B.~a~,L~s Fi~Ee,fl zi P~ _~.-._.__.... l"zuiliry Contact Person: Contact Phone No.: (~~ ____ _ ___ i\•i:tl:c: l~~iodei of Monitoring System: 1 C-~ ".3S'~ Date of Testing/Servicing: ~_/_~__. G (p t~. llxrva'.nrory of Equipment Tested/Cet•tii~ed t'hcrG the ,i , ro riate boles ro indicate s ecific a ui meat iris erred/serviced: I' t'a„]c 1D: ~~i Tank ID: _ _ ~r _ tn~ I'anf. liauging Prabe. Ivladel: ^ In-Tank Gauging Prabe. _ A4ode1: ____ - ___.... ', ,'t~' -~nnulur Spact or Vault Sensor. Modtl: ~'Q~~DdC,~~ ^ Annular Space or Vault Sensor. Model _ ^___ __ _._ -.. . l, ~ Piping Sump !'I'ranch Sensor(s). Model: ____ 0 Piping Sump /Trench Sensors}. Madirl: __.__ _. _ ~ U }ill Sump Senior(s). lvtodef: ^ Fill Sump Sensors}. Madtl: C] Itl~.~h:uricarl Lim 1.tak Detector. Model: ^ Mechanical Line Leak Dttecror. Model: _-___..-. ' ^ I-:I~cnuni~ Lint Leak Dertcror. Model; ^ Electronic Line Leak Detector. Ivtodel: _..____. _ _, _ ._ O 1':urk 0~•trtill /High-Level Stnsor. Model: ^ Tank Overfill !High-Level Sensor. Model: _ . __. O Orhtr s coif ~ e vi mint r ~ e and mode! in Section F on Pa e ~ . ^ Other s eei ~ e ui meat a and mode! in Section E on }'a,~ :,1. j':Cauk 1D: __ Tank ID: _ ~ U to-F;urk Gauging Probz. _.. Model: ^ In-Tank Gauging Probe. _ Ivfodel: __ ___.... ,. ' v .-~nntrlaf• Space or Vault Stnsor. Model: ^ Annular Space or Vault Sensor. Ivlodel: _ ' .U }'iping Sump !Trench Sensor(s). Model: ^ Piping Sump i Trench Sensor(s). _ Model: __ _____ ___. __ >=1 bill Stamp Sensor(s). Ivtodtl: ^ Fill Sump Sensor(s). _ A9odeL _____... _ _-._. U t~l,:ch:urical Lint Leak Dttecror. Model: ^ Mechanical Line Leak Detector. Model: _ _ ~.1 la~au•uuic Line Leak Dttecror. Model: ^ Electronic Line Leak Detector. Model: ~__ _...__. _ .. v 1':i,ik U~triilJ !High-Level Stnsar. Model: O Tank Overfill /High-Cruel Sensor. Model: ___ _ . i_U C)ilter is tciti• tr ui meat a and modtl in Section E on Pa e 2 . ^ Other s eei a ui meat iti' a and modtl in Szctian E on Prot .1. - l)isprnser Ill: ~~i ^_ Dispenser ID: ____ __.. lli;ptnser Containment Sensor(s). Modtl; ~~ O Dispenser Containment Sensors). ModeL• i i_... _... _. ,~Slncar\-alvt(s). .. ^ ShearValve(s), ~ _. L.1 ~?tY enser Containment Floats and Chains . ~ 0 Dis enser Containment Float(s) and Chain(s). - - Uisl3enser ID: Dispenser ID: __._._. ~. ~,~ J t)ispenstr Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s), Model: , __. .. .~! i.7 Sh~;.rr \'alvz(s). ^ Shear Valve(s). __._ ~" .. ~' it ~ Dis enszr Con[s<inment Flaat(s) and Chain(s). O Di enser Containment Floats and Chain(s). ~ .Uispeuser Ill: Dispenser ID: _.. ' 1)ispdnsar Containment Sensor(s). r J 5h :u \/.Joe ) ModeL• O Dispenser Containment Sensor(s), ^ S V Model: ~~! ~_. ... I. c; (l . hear alve(s). N ''Dis enszr Cuncainmen[ Float s and Chains . r~ O Dis enser Containment Floats and Chains . ~:_ Jt tb.• fuciJity contains more tanks or d ispensers, copy this form. Includz information for every tank and dspenser a[ the faciliR'. t:. C,et't1f CatlOit - I certify that the equipment identified in this document was inspected/serviced in accordance with the manr,t»cct,+-r+-s' guidrlirres. Attached to this Certit`ication is information (e.g. manufacturers' checklists) necessary to verify that this int'ormariof~ is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, t, hay e ::1s~+ :ucached a copy of the report; {check alt ilrnt nppt}): 1$Sysiem set-up I$' rm history report t'c~lutician Name (print): _ •1~~~ /+/~-f~~V Signatare: __.....___... erritirarion No.: _ yvt~ - I.IS'- 11? g License. No.: 1 / D40 # 8 09 B 50 _____ .__ - „- _ Cesrin~CompartyName: RICH ENVIRONMENTAL PhoneNo.:~661 ~ 392-8687 Site address: 3 f„~y~,v! Sj LLg~~_~~~~~y~F)~~~(/bate of Testis /Servicin : ( f t (: _ g g -. _. - - Q.~D .Page ] of3 "-,.,, !~Ioniruring System Certification i~_ llr5~ixs of 'lCestiuglServicing tioir~~:,r~ Versionlnstalled: ~p,Q-+ h~u;;;~h•r~ the t'i,llnwinsr CheClaist: Il~!'~o '~~ ~'~; ' ^ No* Is the audible alarm o erational? `~' ^ 1 c, 1 l~ No* Ts the visual alarm o erational? ( .__.___ `` F~ 1'~•s ^ No* .~___._ Were all sensors visual)vis ected, fitnctionall tested, and confirmed o erational? I AL 1 ~-s ^ No* _._ _.~1 Were alt sensors installed at lowest point of secondary containment and positioned so that other equipment ~~ i . j' I not interfere with their ro er o oration? !I _ u 1'~, ~ ^ No* If alarms are relayed to a remote monitoruio station, is alt co,nmunications equipment (e.g. rni~d~n~1 ~i ) ~ NlA operational? Old 1 ~s ^ No* For pressurized piping systems, does the turbine automatically shut down if [he piping secondary con~ain,n:~;u~! i ^ N;A monitoring system detects a lea):, fails to operate, or is electrically disconnected? if yes: which sensors ini~;a<< positive shut-down? (Check ctll tlr~zt apply) Jf~'SutnplTrench Sensors; ^ Dispenser Contaitunenr Sensors. I,' _i Did ou confirm ositive shut-down due to leaks sensor failure/disconnection? 15i'Yes; ^ No. _ __ iJ ~'~; i ^ No* _ For tank systems that utilize the monitoring system as the primary tank overfip warning de.vicz i i.~ ~;~~ ,+ ~ ~ ~ NiA mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at der rml: ~~ till oinr(s) and o eratinQ ro erl ? !f so at what ercent of tank ca act does the alarm Ui~t_8r? ` ~~ t. _ __ II U 1'~;* ja' No Was any monitorutg equipment replaced? If yes, identify specific sensors, probes, or other equipment replanti ~~ and list the manufacturer name and model for all re lacement arts in Section E, below. _ J ~ esf ~ No Was liquid found inside any secondary containment systems designed as dry systems? (Check nll rlaar r,r,;~~' ^ 1'roducs; ^ Water. 7f es, describe causes in Section E, below. i _ ~~~ 1'~; ^ Nu* Was monitorin s srena set-u reviewed to ensw'e m er settin s? Attach set a re orts, if a livable ___ '' ~t_ 1'~s ^ No* Is all monitorin a tti meet o erational er manufacturer's s ecifications? _ ~= lr; Section E below, describe how and when these deficieacies were or wilt be corrected. ~,. ~i~icitnents: _ _._ ----T'~L N i U f"olL-~-~',O r-~~ a F o 2.4-rJl~r B~ Li t2.~i~_..S ....- --_ __ _........._ Jam' ~-P~ ~ ~ ~ 1~~- a-~` d ~c~ . _ ~,; ,~; 'Prage 2 oi'3 ~l'. in-'x'.tnk Gauging /SIR Eq,ui.pment: J~ Check this box if tank gauging is used only fa- invenror~• cu~rrl ^ Check this box if no tank gauging or S1R equipment is install:: ci.. "1'hi5 s~ctiun must be completed if in-tank gauging equipment is used to perform leak detection monitoring. i'runatilete the Cullowinv chectQist: ^ ,` ~ s O No* Has all input wiring been inspected for proper entry and termination, including testutg for ground faults? _ __ U 1'rs l7 No* Were all rank gauging probes visually inspected for damage and residue buildup? -Y~s U No* Was accuracy of system product level readings tested? U Yes O No* Was accuracy of system water level readings tested? ~ i.:l 1. cs O No* __. Were alt probes reinstalled properly? ~' U Yes ^ No* Were all hems on the equipmznt manufacturer's maintenance checklist completed? '' iu nc~ Section H, below, describe flow and when these deficiencies were or wilt be corrected. is. 3L.ine Leah Detectors (LLD): 17 Check this box if LLDs are not insta]led. ('uutUlrta the followin>t checklist: ~'zs O No* D NlA For equipment start-up or annual equipment certification, was a teak simulated to verify LLD pertc~rmanc~^ ~~ (Check all that apply) Simulated leak rate: `~3 b.p.h.; ^ 0.1 g.p.h ; ^ 0.2 g.p.h. - Yes ^ No* ~~ Were all LLDs confirmed operational and accurate within regulatory requirements? ---:I `~~ es O No* Was the testing apparatus properly calibrated? _~ a "~ Y ~, O No* ^ NIA For mechanical LLDs, does the LLD restrict product flow if it detects a leak? _ _ ~ l:U 1'cs ^ No* '~I N/A ~~ Far electronic LLDs, dues [he turbine automatically shut off if the LLD detects a leak? ~~ __, _ ^ k zs O No* '~ N/A For electronic LLDs, does tlta turbine automatically shut oft if any portion of the monitoring system is dis•ahie,l or disconnected? ' '..1 Yrs O No* `~ NIA For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system maliimLti+~n:; !; or fails a test? J _.._ l"1 1'es O No* For electronic LLDs, have all accessible wiring connections been visually inspected? __ '~ 1'es ^ No* Were all items on the equipment manufacturer's maintenance checklist completed? ~~ °~ In the Section H. below. describe how and when these deficiencies were or Witt he cnrrected- C-il. t~'c~mments: - ._ Page 3 of 3 ~+~ r' r «3~ ~~lonaroring System Certification 1~ ~ G, /~ UST Monitoring Site Plan tiirc A~9dress: _ Sri-fs~!`.'-~~~~ ~~ ~~'t./~~1 ~~ ~'~ -----....... j ~~. o• •C~ "1 ~13l~&~~. -~. .~1_ i. . t1 1 i ._ i ~~-- :::::::::::::::::::::::;::::::::::;::::::: ~~7-~~~G ~ ~ s ~ Date neap vvas drawn: / l / 1 / CJ~j Instructions if ~~~u already have a diagram that shows all required information, you ma_y include it, rather than this lraue, ~~ it!t ~-.~~.;:~ Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly iucr~?i;~ l~~carions of the following equipment, if installed: monitoring system control panels; sensors monitoring tanl, annuie,r `l>~tce5, sttmps, dispenser pans, spill containers, or other secondary eoiitainment areas; mechanieai or electro;~ic. line !<<~4, detccror~; and in-tank liquid level probes (if used £or leak detection}. In the space provided, note the date this S~~*e. !"a~~ ti~ as prepared. Page ~ of ~ ,~: {,~„ ~s ~ +ii[~G~J1i .1~.'iL~iY~ii~ 5643 BROOKS CT BI1Y.13RSFIELD, CA.93308 OFFICE(6fi1)392-868.7 & 8A8 (6fi1)392-0621 Ms_rr±pnrtTnnT. j~jq~x BTgC'rOR 'i'RST W/0#: Fac i 1 i ty Name : ri ~L9~tJ C~ ~Li _~htG~~ ~ Facility Address:.,~16~11'~ S1«F~~~' (~~1~-~ _ f~9 Product Lille Type {Pressure, Ruction, Gravity) /'/~~Sy~~ PRODUCT LEAK DETECTOR TYPL TEST TRIP PASS SSR=AL NU~688R BRLOW PSI OR L/D TYPE SS S s~RIAL # ~ ~ 3 F L/D TYBB YSS 8A88 SERIAL # NO FAIL L/D TYPS 7fS8 PAS9 SSRTLT. # NO FAIL L/D TYPE YSS PASS SERIAL # NO FAIL I certify the above tests were conducted on this date according to Red Jacket 8umpa field test apparatus testing procedure an limitations. The Mechanical Leak Detector Test pass / fail ,is determined by using a low flow threshold trip rate of 3 gallon per hour or less at 10 PSI. i I acknowledge that all data collected is. true and correct to the best of my knowledge. Tech: ~ ~ ~ Signature : Date : ~"~ `~~[ ~ ~4 } ~:~'}'1't.I;JL ra.:'•.r 1 =;1'_:rJ 1_E't;lL '/.'1= 1'bJri~~'~I! F I ~.'?60- OU6-b ~J}tL:f i'I'i:U ~- '3::i . U:. _'O. 1 5 . 1 y I''1L1 ._~•:~:.j"1'(.Ii=,f••.'! t"1';t11IL~E .i~ ;IV I i .. :'i ~i'ir i i ..., ~ ~..;' I L:1'1 1171 r f 11 I~J~ 3. l; li •:;1•:~;iJ~::1: 1. t:l..:1' :,T;=;.".}:~, 1::"~,, .lI.1,L~::r ~,.:I-: t-;FilE'1. i'If•'it~ 1 1~ISrtif:rLEli :1HiF"I' '1'1I•'rE: 3 D1":::rHLFD F'liF: I t:~l ~ 1 ~~ 'fE`:;1' l„IiRl•J I f•Jij; i-itdl'J1_Ir;L 1'E:=~1' 41;;F:1'•llld~~::i D 1 `a'ri1~1..1:D :S `•'I'LI°r :AEI: LII21 T'. c. ~+GF l _:i4 J~J 1 rv ~Tr~.rJ}: :FTI II- 'I' 1 : L• i t::}1_ l rlr kt'•~F.L c~:pF;F'F' , . ' ' Uri~:la~,r 1 ~;rvK DIHr'If;TER ~~3 tll] . FULL. J(?t. 1 ! r ~•~ Pl~()r-+T f~ I ~'.1_ . 4 . Il I Ph:'Hf: :~ t~.lri I`EF' f.Jf ilcq-ll PJI: '~ p , HI~.;H I,d,'I'}12:Ut°II'C: . 3.i1 1 P'IF;; ~: '~I~ I_i;BEL IICtL : 1 1 glj C;1rF:k:FlLL LItwIT . g- U%.> F L UUC:T' 55`~ I:~I:f.I'~JLt;Y 1 1 t 53 5$9 Lta6d FkCyIiUCT 11~I lU ' L.EWr: HLARPI I.lt^'IIT: _ gy _~ULiL~E!'! LOSS LTi"1I7': yy T~;Nk:.TILT Ll,UO ! t°IF;I'J I FGLDED TANKS T1LY'. I ULa I C TE:;T T;~J''E STAfJDtikD !='ENIUL%I~_" TEST FAfL AI.AIi1~! Ti T SABLF.fi FiLfkNl Li I SAbLED ' ft:}; '!(=L:'T' f=,L~EF'faUIlY1;: r,_ypF. ?'r;i'1K 'I'k:E;'1' I'J~aTI1.4 : rJFF 1'PJJ: 7'ST :3! PHA+1+J 13J?EtiK : UFI' ' I~L'i;I'"fE•r;`.: DEl.t~11' 1 P•IIrJ r • i 1 1:t_'r;k' 'I't:F,T P'1E1'MJD `1'1-:ST~,,h~ LSAT}:' ALt. TAN}; ::3~t':;I~:T' T' I r1F J • GJ PM TE4_;'T' k,4TF ;G.'?0 C;t~L/Hk ~UF'r~'I' I i>{U 6 HOUT~S lC930 I_ I cau I L" SENF,~+Is S)rTUI/ L 1:L'~SL EiUI"IP i TR'1 _~;1'r; I'E i::F~T1,C~fiR.' ;`iTP ::ilrj~lF• L :L15Z. i;hNVtlf.f•~R . I i:'r'tT'Efst.%kY : f,l'lIV1.lI.HF::I'Fi!:f- ~.C~I°It'IUI'JI~"~CI~N•J.~ ~:hTUR pUk'f :SETT 1 tVi ;y PJCIVE FCiUND I C0I7E~ : ii*~E+Eit* I 1 ~I i I i ~, r +' ..~t1'1'k Lff 3?~'1_ri'i t:,E1'~1F' !•' I :1=•;>;1'1'1'~~1: 1,NUiCi,~,f,dhJ f. 1 :l lltl, fil.r'iKl'I i1.., ~',~:{°i N i ; ~ l't>I:''r' 1•;':PC:•I::T ~:.'.:, ;::51:C 11l;:1T',' I,liRrV t !'•ii: .)'rind 1 1 =_'UU6 t 1 : ~._ Ht"I f;L.r1F;f°I H 1;1't:>k:',' h:EF':?RT j r `~' 30 rit.i;l{1•'I Fi lil'C:F?`.'' hLF'':k"t" Ji=it'1 11. '~'rJLI~~ t 1 : ;"j rit°! 10::'4 Ht1 F,LtI?t°I H 1:~1'Ok'i kF:FURT L :1?aL raP•11+lULF1R FUELr;Lf;RNI .YFily 1 t , taoE ! 1 :'~'B w"{ _ .- 1 N •'1'FiP!}: iJLtil'P1 - - ~-- I ~1..,gF:l'9 EI i aTLi}i`i' F:1`:F'~Jk''f '1 1 : li 1 L-":31;1.. 1_',.'i~J r'li.~l+ll+.• I i tLriltr"1 .. p.; ,:r 1 -t;~il'i 5:11:1 F'h•1 ~ ' 1 ' )T H1:lt .t Pd:3C1F.'~ i + 1 .. `` i f. f.. - :31ri'd:~'li ri1.Fi}?Nl •--•-._•- L. ~ : f +:1.. rii'drUl.ll.~~l:' r .ril'dhJltl_r;F: C;f~f~,~_`[: ~' ,Irird 1 1 . c'litla i : 'l; ail°I t i 1. 1 . f: i f: ' 1 ,.. ; I i ii f'U)rL. f~iL.riRl") i / t ( \ s R !/°t36 M4NIT~R CERT. FAILURE REPORT ADD~ss THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE THE MONITOR CERTIE'ICATION TE9TINC3. LIST OE' PARTS REPLACED/REPAIRED: REPAIRS: LABOR: r. PARTS INSTALLED: ~-- v _ ~r~--- SITE NAM$: G~~•cJG~,~' ~,L~' ~(~,~~~iS DA~rE: ! ~/l~-U~ _ _ ~~-~`~~~ ~'..~- +~,e,. Ba'_~e7-sfie~c'3. C~ 93301 ~~ ~E€~~~~n~ ~~~1 E_~~E ~~srt~~ Tel.: (66 E; J2~-3979 `s~sas 5E~fls~s~w~~ cap 3A~~~~~~T TEs7i~~ ~= ~~: (36 ~ 1 852-2? 71_ A~~ T :~~ i ~E~S iE~ s A~4~ TfJ R~~F~R~~ ~-6.1Ei. ~~~~~tT~~i~~ ~ERT~r ~~'e~-c T 6~s`V° . 30E i 0t , i aER~,hIT NC. ENH,~NCEL AK DE T ECTiGN I f ~((`lE i ESTI~i;i ~ SB-98y SECGPv~.~^.RY ::ONTAIi^ib9ENT T ES T I":G TANK T;GHTP~ESS IEJT L~ T~ ?ER`O!`~.Pr9; UEL'.iv!~iT:JR1PJG ~RT!I=1~,-`.T!~!~ FAC!LI T Y -- - !~ts$~9~ ~ S~?-~C P~~ ~i-SEt^. ~;_ ~.'UfyTiyG T ~Ee-'~SGi~ ,/ ( ---~- Q ~Ol"JNERS IvaiviE 'F °~±~EP.AT :NHS i"avt"uYE ---- iF' E;~!;it`1 T U ~s~~ s.~,TE ~df7. n~:BER OE TANKS TO SE V`r3Lll~E --- -- - - ~..~!'-' ~ i Ik~G ~ G ,~~AS~v -- - - YA~:- *- TESTi~G C4[t<lP4NY 1 _ r~EAT_= Q, ~13~1dE ~e'aYv.~'~,~'e C# r"~i`r?"AC T z~Et'~SC3=^q _-_. r S ~ ELM'' VA11!`= & P}?JY^iE 4^Fts?vIB~R CF TESTEF~. ©R SPE~AL 'sP~!SP~CTCR jCERTIFiC,',`T!ON =: DAT'E~ "TiR~/IE TEST TC BE CO~DEJCTED '1CC m: ~' ES- s"JETNQ:.. h-Q/~ ~ ~ ~ r oC.c~ GJ % . ~!~ j~~ ! J`~c2 "~~ c~ ~ ~ ° ~ `T- ; b.~'r'Yt- SEGhATEIRE £3F ARr~L! ~T _ r FDA-E 1l " j _ ~ '-- A~°ROVED B`i IGA t ~ ~ rD^ti;6 ~ t ~ ~--t ~ ~--- ~ECONb-'•Y SYSTEM CERTIFICATION FARM L :. . ~.. DINE l t U~ v ~' ~ _ '~~ FACYLITYADDRp.5~5 ~(¢~,~.I~._ ~~ l~0~-1~ t. - . T . ~: ~ Ttu°bi~ Sump t, '~ $iuup ~ Sump 2 Sump ~ '. ~ti~rt Time ; S`~ i:. ~.. ~n1~t~si Deist ~~, .. df vt-~ b .~. ;..- .. s: ~. ~Va~er Hight l -~06 . ir'~ '~irne ~ 0 ~ I ~ . ~ Luber Heist 1-~ 0~'a ~.r <~':. ~ :~:. r: ~~ ~ ~A~: ,~, y _ • ~ ~~i...~..\ ~' . `a . Overlili Buci~s ;~~ ~~ '~ ~. Sump 4 Q}l ~:. ~ ~. ;: QverQll2 Ovec#fi13 (Ivetiitl 4 fii~ Tim „~ I>aftial Height of Water ... _; ' • ~ ~ j ! ,r ,, Time : pS ~ - Water xe - ~ao~,~ ::.:: T~ io~a~~ ~a~ H~~t _~ ~,,~~:~~~ , ~~~ '~(Sigaatnre, ~ ~.. ~. P. ~:~ . }~:~~_ i'agc 2 of ,_ ~u jb. ~i'. • 1.`,~. f~l t.. ~Ei1 ' ,' SECt}ND~RY gYSTEM CERT'fFiCA'I`Ipl~t FORM ,,,~ IAA FAG~LITX ADUR~.SS 3;i: n .`,~~.,,,,,~ ~,cr~- -" - P f 4~ I ~ ~M - ' rj~J}jti / ~. ~ iJ 11 ~v 'IC~:S 1~`ING 411~•~' ~^~ ~, v I •~~~~ a; ~~ ••. -,:~. ~,, ~,>.... ,. ti~;: r". aU,i: ~j,. ;,., . . ;~: .;i. . ;,.~ t; .,•: .. -` 5' FISP'1~#• ~< :DIS~'ENSER Z DTSP'EIYSER 3 DL~P~ISER 4 5'I'ART TYME d ~ . i~VrTtAI, ~IGH'1' QF VS~ATER . ~vATER ~E 1~~20A WATER n ~ERTlI~CATION t'P`~ ~StGriATVR~ 21;~r~S°1~:~.~.. f71J~CiR ~ DISPENSER ? ~ DTSpEN~ER 8 . 5'~'ART TIME ~ . ~~1I'I"~AL I~EItiH'~ OF WATER . ':MME WATER REI6IIT 'I'IlVIE . WATER REIGHT t~SRTi1tix~ATiOI~i ~~GruTC~ ;~ 3~.._ ! (~ ~-4 '7 . . ,2)'1 bO .5: I ~ec.i ð 14~ e. &1 f- ~~~~. ,~~'^-~ 't" ~~w~á.. - ~-t\-o",","@ ul wAi~ +.-rbl~ l':)...... (...) .ì) bo \".)e..- ~Q... ?\A~ ~ 3) '-~<e.. ~..'^-~ I ~~v-e, d.c':-"'" AJd. R.eSs {:d.. 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(/e.c'l- 7"I14Yt k. 1;..'S'I; v¡qCCUJ(h 0" llY\""(;!.'k~ 15 'ð~\)v-r1 w(\'k,~d.e.~l-. ))- ) hdto~ o~+,qnk ) ~ mo~ì-e,.. 8~5. kl.lb\-e.·~l\.eo\ ~~\ w.l.Qb~~14S.:¡¡' éQA,'¡'}'31 ).~lIR.l f1¡em.q/f'5 ~ u,^,de~ y~c"",{,,,., ~~~oüt /;fe. of ill"'/( : ~ Nt~l<.~ weRe.- ç\,;?~ wi -It... sp¡Qf{.k --Ie. sf T/..e.J we.~&- f(!lÝcJ..et:J fln:! (¡" '1 ¡.( ",ei, ß~~'l\~d. ~I s;A"¿ y~ w~ "to f-ob{ ~4NL ( :S~~ 3Dfì~ ~~ Y\e. A Se. f Oç' pJ4Y'6 ! -h:'1<. my iB~í<,q~7 ~J T e)C~$d... c.ov\Ç.€¡:¡'Y'\~ +0 A...lp~ qb?I.;;t: \) H~L....- wA1-"<-12- -+I"'r~l.c...- ¡(:¡,Y\cL ~Ü~iy ~ k-e e e ~AV\ k c\ovvV\. ')..J L -Ac..~ /:; f\,qI^.5. d. Q ~~ ~ \. ~....~ -So \oo\,.c:..~ , ROÞ\I~h. ) \\tw.¡(\~,oAvJ."I v~~~+ed.. s~4e.1 ''0 o~ +ke.~e., ..L CAI\~\ ""S'D~I'\ -.:iõ"''''"S f\v.Å. --\o\d... \-. \.IJV\ 'i- ~IC\ '"t- v..> e.. {\e.~ .p.,Y\ e V'.~ ~ f\e.I?-e...~ ~€{O~""" 0 f'\ ..f-k . +...."'$ ~.e,:t~~~\ ~~ \.....O\.A..! '\"'-...Q.,'7 ~V'!DV'-' ~Q.5\""'+ o-V (.ÁH~"'hûl -.\.Ä~\.~, , th (S. 3".') .sl.?o\.l~ w~+-l.... ~A-\pk ~'I.. \l>\-wVl-'e-, ~~ v...) ~\A .s-eV\C.<"" vte.ce9:A~ , ~~~IMc..-\ 1.<.0"", , ~ho,^-<¿.l ':S. !00€ ~ c:...O'f\\~ ltilV\ ed "3 J I /<; '1. F" ~i"'~ ì 1\.5 )~i,~...., , ,A YlYI""j¡Q t4... . N\uV\.~-1-o~ IS 'r--oò~Q.cL up to Gd~~ecD E('r'K:. I+ 1':; AI" e.l'e.<-'\-¡~__~(,."\ S~~-\:cl-. \"'oe\d op<2'^ \::.'1 +h~ ,,) (\cuù'M , ~V\~ Îe-vel V\.I.0""~~OK 'c,.~ S'-'-f ,¡\I\$,^~-\c>~ oA-~~ ~6 \.,o~~¿ '-'-? -\0 G~\.kA'¡<:''-'', 9'.30 Am 3, 'JoV'\e~ \'$ '-\:e¡ \V\E:.>Q.+ e~~",?-QoR.. ~ ~~~ 4-0 .sk.o"t- ~A.qd-e.£. f'\v0 C:A;lc., ,(rIt2,:-i- DAve- . -¡;<:kJ p~)NlIfN.I./çy ~/2>O /'I"~"l I ~A~ 3=*/30 µ.tEe." ,ðk. 5ut-nf 0)', (T\~ m~~ +lA7wo,e.:i"-... h'nA( - I~U ...s,lJ..V\'I.p (t,'pl"'~ ·rrc~'T $'t'\..sõ..... J ~(lFjI.A./I<R VfCUC.H"V\.· foss- ~I'I~R...., -Fðwe.e.. losj .sl·",.,;+ d~1I'\ ~ liI\.~bt~ ~+s d.o",",(\. 1,;..,)/ ¡:¡.fAraM, Tw.p"'cfv4Ive.. g"1,. d7.5fr¿M;¡e~, mllT- Ð~"(-\ - ~e.\J.. e'fM1~Q,,^,c.y S""\A.i- --oW ..,I W: " ¡ i ... SENSOR ALAR~'l L 2:DIESEL TANK STP SUMP FUEL ALAR~'1 APR 18. 1994 3:23 PM ORANGE BELT STAGES 34360 SILLECT AVE BAKERSFIELD. CA ~ APR 18. 1994 ~.~J PM SYSTEM STATUS REPORT - - - - - - - - - - - - T 1: LOW PRODUCT ALARf"l T I:INVALID FUEL LEVEL T I:DELIVERY NEEDED L 2:FUEL ALARM INVENTORY REPORT T 1 :DIESEL T 1: I NVALI D FUEL LEVEL VOL INVALID 396 GALS ULLAGE 11387 GALS 90% ULLAGE= 10208 GALS TC VOLUME = 395 GALS HGT INVALID 7.06 INCHES WATER VOL 0 GALS WATER 0.00 INCHES TEMP 65.6 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ -; . ~\, ~~ " . k:',.',~ ORANGE BELT STAGES 34360 SILLECT AVE BAKERSFIELD, CA APR 18, 1994 3:22 PM SYSTEfv1 STATUS REPORT - - - - - - - - - - - - T 1 :LOW PRODUCT ALARM T 1: I N\/AL I D FUEL LEVEL T 1 :DELIVERY NEEDED INVENTORY REPORT T 1 :DIESEL T 1: I N\/ALlI.I VOL INVALID ULLAGE 90% ULLAGE= TC VOLUME = HGT INVALID WATER VOL WATER TEfvlP ;. LlEL LEVEL :396 GALS 11387 GALS 10208 GALS 395 GALS 7.06 INCHES o GALS 0.00 INCHES 65.6 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ · :¡ ,,; ~ i.. . SENSOR ALARf"1 L 1 :DIESEL TANK ANNULAR SPACE FUEL ALARt"1 APR 18. 1994 3:27 PM ORANGE BELT STAGES 34360 SILLECT AVE BAKERSFIELD. CA APR 18. 1994 3:28 PM SYSTEM STATUS REPORT - - - - - - - - - - - - T 1 :LOW PRODUCT ALARM T 1: I NVAL I D FUEL LEVEL T 1 :DELIVERY NEEDED FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3911 FAX (661) 852-2170 SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 852-2170 PREVENTION SERVICES fiRE SAfETY SERVICES· ENVIRONMENTAL SERVICES 900 Truxtun Ave.. Suite 210 Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 852-2171 FIRE INVESTIGATION 1715 Chester Ave.. 3'd Floor Bakersfield, CA 93301 VOICE (661) 326·3951 FAX (661) 852-2172 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 December 10. 2004 Mr, Michael Haworth Orange Belt 3640 Sillect A venue Bakersfield. CA 9330 I REMINDER NOTICE Re: Necessary Compliance Deadlines for UST Owners/Operators Dear Mr. Haworth: The purpose of this letter is to remind you about three compliance deadlines for UST Owners/Operators, These are as follows: I) January 1,2005 deadline for submitting declaration statement designating: (a) Owner/Operator understands and is in compliance with all applicable UST requirements. and (b) Owner identifies the designated UST Operator for each facility owned. (c) Owner/Operator passes and submits proof of International Code Council Test. 2) EVR upgrade requirements on spill buckets are due Aprill. 2005. 3) Secondary Containment Testing on all secondary systems. Code requires re-testing 36 months from date of last test which was in 2002. Should you have questions regarding these compliance deadlines, please feel free to call me at 661 - 326-3190, Sil~ Steve Underwood Fire Prevention Officer SU:db /{~t/tJiïl/1 thp. ý¡i;'I'IINIUNU~1f (jJío:¡t 0l(o'lw- Q%CUI Cç/ Yf~itÚ/.-I"Jf II FIRE CHIEF :?(Ii'1 C:~A¿E: ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 852·2170 SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 852-2170 PREVENTION SERVICES fiRE SAfETY SERVICES' ENVIRONMENTAl SERVICES 900 Truxtun Ave.. Suite 210 Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 852·2171 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326·3951 FAX (661) 852·2172 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399·4697 FAX (661) 399·5763 It e June to, 2004 Orange Belt Stages 3640 N. Sillect Avenue Bakersfield, CA 93308 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Dear Sir: Our records indicate that your annual maintenance certification on your leak detection system will be past due on 05-06-04. 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 to either perform or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services bY:L~ ./ Steve Underwood . Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SB U/db "rfj';"JI.'"Ù,//lh(, Yf';I'IINllwlUlll c;Jí().1' º IloR) n'¿luu, Qr;/Ylf;hllltIß,//" ç~ MONITalNG SYSTEM CERTIF.ATION For USf By A}J Jurisdictions Wirhin the Stale of California ,'lIIrÍlorÙy Cired: Chi/prer 6.7, Health qnd Scifety Code; Chapter 16, Division 3, Title 23, CalijòrnÙ¡ Code ofReguJmions ..f Tllis fUl'ln muse be used to docwnent testing ap.d servicing of monitoring equipment. A separate cerdfication or report must be prepared [or l'::ll:I1 lllonirorine. s)'sfèl11concrol panel by Çhe rechniciap. who performs the worle A copy of this form must be provided to the tank sy,slCm owner/operaror. The owner/operaror~mllS( submit a copy of this form to the local agency regulating UST systems wjrhio 30 lby::; ().f ¡ö[ darè, A. G¡:üerallllformation Llctlj¡)' Name: c:>RA.0ó-£t3 ELI ::5TA (r:E.5 SÍlL' A~idrèss: _3G40 6/LLELT ¡4I..1E, Lìciliry COl1l<\C¡ Person: M"l.;,è: Mudd of Moniwring Sysœm: Bldg. No.: City:, 75/J-Ke:R.SF/EL'þ Zip: __.___'... Contact Phone No.: ( )_u., Date afTesting/Servicing: _:1j~l5!!L &ìlfßA-RLD EVV\L B. inV(~ilto:cy of Equipment Tested4Certified Cllèd~ rlJL: :¡ ) Jrù dare boxe~ co indjcare s eeiJic e wi" /Uellr ills Jcered/serviced: 11!'~':'I;¡Ll;:',_-1) fESt: L' TßßkID: II! eV'jß-L1llk G,wging Prob.:. Model: i /IIf1¡;4!T - lOIn-Tank Gauging Probe. Model: 1'1 ~ ylllular Spacè or Vaul[ Sensor. Modd: i"P¡¿'rzbSvfl¡¿ 0 Annular Space or Vault Sensor. Model: _____,_.,_., II c(Piping Sump i Trench SenSOf(s). Model: gé)~ 0 Piping Sump / Trench Sensor(s). Model: I c¿ FiiJ Sump Sensor(s). Model: 0 Fí1J Sump Sensor(s). Model: o í\kd¡,U11Cal L1I1e Leak Derecwr. Maciel: 0 Mechanical Line Leak Detec!'Or. Model: o LkctJ'01li..; Linè Lèak Derector. Model: 0 Electronic Line Leak Detector. Model: o LUlk Ov(.~rtll1 / High-Level Sensor. Model: 0 Ta.nk Overfill / High-Level Sensor., Model: , o _QrJk'r (S ècifv è uÌ Jmè·ß( r' e and model in Se~ríon E on Pae 2). 0 Other (s eci 'e ui ment t e and model in Section E on Pa ~:n 'l'¡wk lD: J Tank ID: o 11l- 1'<1nl\. G<1ugjng Probe, Model: 0 In-Tank Gauging Probe. Model: o ,'\ll1lular Spac.: or Vaule Sensor. Model: 0 Annular Space or Vault Sensor. Model: o Pipini( SlImp I Trench Sensor(s). Model: 0 Piping Sump / Trench Sensor(s). Model: o Fill Sump Sensorts). Model: 0 Fill Sump Sensor(s). Nlodel: I 0 l\k(;h<lllical Lin.: Leak Deœcwr. Model: 0 Mechanical Line Leak Defector. Model: Cl Ekdrùllic Line Leak Detècror. Model: 0 Elecrronic Line Leak DetectOr. Model: ,I¡ ~LUlk OVtfIll! l Hi~h.Level Sensor. Mod~J: :" 0 Tank OveríìIJ l High-Level Sensor. I"fode!: II, ,g,C.ì¡J¡èr_lSp-èCJt)' è( Ul mtnr ev e and modèJ JD Se;tJOfi E on Pae 2). 0 Other (speedy e ui ment tv e and moLiel in Section E on Pa è 2), I Di~nser iD: \ !. Dispenser ID: II œ'DisptllSèf Comainmenr Sensor(s}. Model: !~~ 0 Dispenser Containment Sensor(s). Modd: ¡ ~hèar V,ÜvelS). 0 Shear Valve(s). i ,ÇJL~lcS~,¡\Sèr Comainmènr Flotìr(s) and Chaín(s), I 0 Dis enser COlltainment Float(s) and Chain(s). : Dis¡Jdlsef lD: Dispenser ID: ii' 0 Di::>pèllSèr COil. minmem Sensorls). Model: 0 Dispenser Containment Sensor(s). Model: : 0 Shè~r V,11\'e(s), 0 Shear Valve(s). 1¡I,9J:JlSlkIlSèr Comainm.:nr Floae(s) and Chain s). 0 Dis enser COCltainmem Float(5 and Chain 5). Dispè!hel'iD: Dispenser ID: ~'II, '? L:lsp"l\~èr ConmÍl1mènt Sènsor(s), Mod¢!: 0 Dispenser Containment Sensor(s). Model: o ~l1L'~U' \, ¡dVèls), 0 Shear Valve(s). ¡gDi,' èl1s.òr CÙl1làinm.:nr Floar S and Chain(s), i 0 Dis eDse!' Containment Float s and Chwn(s). "lÌ rÜe' fa¡;jjity conrajns more tanks or disp.:nsers, cbpy this form. Include information for every tank and dispenser at the faciliry, I C. Certification - 1 certify that tbe equipn{ent identified in this document was inspected/serviced in accordance with tbe manufactlln;:n' guiÜelines. Attached to this Certification: is information (e.g. manufacturers' checklists) necessary to verity that this information is ~ûIT",~r àlld it Plot Plan showing the layout pf monitoring equ~nt. For any equip capable of generating such reports, 1 have ¡~Iso ¡Hraèh~·d a èOPY of the report; (check lliI (illl! IlPP~ I!r'""System set-up . istory report [,¡;dulicÜn Namè (prim): A-AR-Ð-JJ kCOì SignatUf . ~/O I I II i I I I I I II \: II I I I I C\;rtiÙcariùl1 No.: -_.~--,--- Jè:>¡ing COl1lpany~ame: RICH ENVIRQNMENTAL Sirc AdcÎrrss: 3løq\) ÓJl....LfiéÍ ¡ AvE. ðA-~5fIECþ C61/D40- =It 809850 , .. PhoneNo.:(661 ) 392-8687 Date of Testing/Servicing: 2J .2.) ~~ Page 1 of3 03/01 Moniwrlng System Certification f ; D. Kcsuhs of Testing/Servicing e (p.O( e SoÌrI', ;ire V èr:>ion Insmlled: CÚll~)t.:U; eli': 101l0wino- checklist: II r~ö.' I 0 No" Is the a~dible alarm 0 er~tional? \~ I 0 No" Is the vLsual alarm 0 eranonal? , _~ ~'s 0 No:; Were all sensors ~isualj ins eeted, fL~ctionall tested, and c.onfinTled ° era:j~nal? .. . '\ \ ~~ 0 No" Were all sensors ll1staqed at lowest pOLnt ofseeondary contamment and posmoned so that other equIpment Wtlt i I nor inrerfere with their' ro )er 0 eration? Ii 0\ èS 0 þ!.0-* If alarms are relayed; to a remote monitoring station, IS all communications equipment (e.g. modem) II ifN/A operational? I ~ 0 No:; For ~re~surized piping¡ systems, d~e.s the turbine aut~matical!y shut .down if the pip,ing seco~1dary conrainlll~~- I) 0 N/A monnonng system delêcts a leak, tails. to oper~r 15 e1ec..ncally disconnected? 1£ yes: wh¡ h sensors initial": , positive shut-down? (Çheck all that clpply) êrSump/Trench Sensors; q,Díspenser Co IIlmenr Sensors, II Did 'ou confirm ositíve shm-down du.e to leaks and sensor failure/disconnection? Yes; 0 No. Ilr CJ \6 For rank sys[çms tha~ utilize the monitoring system as the primary tank overfill warning device (i.e. no i mèchanical overtìlJ pnyvenrion valve is installed), is tl1e overfill warning alarm visible and audible ar tIle rank [I tìll oím(s) and 0 erathl° )1'0 erly? 11'50, at what ercem of tank ca aci does tlle a]ann rri""er? '!'¡j Ii U\.:s'· Was any monitoril1g equipmem replaced? If yes, identify specific sensors, probes, or orher equipment replacc:J II and list the mamLtàctur,er name and model for aU re lacement arts in Section E, below. I 0 YèS" Was liquid fOlmd insj~e any seco.ndary con~inme~t systems designed as dry systems? (Check all (hat apply) 0 -.L Product; 0 Water. If; es, descnbe causes In SectlOn E, below. ð~ 0 Nù* Was monitor in s seen) ser-u reviewed to ensure ro er settinas? Attach set u jcable ì:'ës 0 No:; Is all monitoring e ui11lenr 0 erational er manufacturer's specifications? " In SêcriOll E below, describe how and when these deficiencies were or will be corrected. .,J £. CVJ11IllèìHS: -.----...---. ___h~ ..____.._ --'-~-'- ._-_.~,.~_._. ..~-- --'--" u___.__".__._ ......----..-----".. ...... .--....--- n. . . __ ..______. -_._-_.._-~ --- ...-----.-... - .-. -----_. .-.---- _._--"---'-'~-" -.--.-.----- --- -.--- .--- '. -"--'-'~'--- .----.--.-.-.. Page 2 of' 3 LUlU I f'. iÜ-'~\'ilk G'ìuging I SIR EqUiPlnt: ~k this box. iftanktLging is used only for inventory comrül. CJ Check this box if no tank gauging or SIR equipment is insralkd, This sècÙon mUSI be cOl1.1.pleted if in-tank gauging equipment is used to perform leak detection monitoring. CQ-"1:!'\è tllt: îùllowiuo cheCKList· 1 \ j \: .~ .. !o \'1..:''':; U No" Has all input wiring be~n inspected for proper entry and termination, including testÌl1g for groLlnd faults? L._.... '., 0 \. ., 0 No" Were all Ianlc gauging probes visually inspected for damage and residue buildup? 1 c.'.) Was accuracy of sysœn1 product level read:ings tes~ed? ---- 0 \'c'S 0 No" "OYd I 0 No'" Was accuracy ofsysren~ warer level readings rested? I O-\~~ u No" Were all probes reinstalled properly? 1 [ 0.,5' cS 0 No'" Were all irems on the equipment manufacturer's maintenance checklist completed? I u.. " ill l!ll' Sècrion H, below, describe how aâd when these deficiencies were or will be corrected. G, Line Le.tk Detectors (LLD): ~thiS box ifLLDs are noC installed. CûH¡¡lkH' rhe fù lowlßg c ec.: 1St: -- o 'y'èS 0 No"" For equipment start-up or annual equipment certifi.cation, was a leak simulated to verify LLD perfonnancc? 0 NJA (Check all thaI apply) Simulated leak rate: 03 g.p.h.; CJ 0.1 g.p.h; CJ 0.2 g.p.h, , 0 'y' ~s 0 No* Were all LLDs confirmed operational and accurare within regulatory requirements? Was me testing apparatus properly calibrated? " 0 Yes 0 No* 0 YèS 0 No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 0 NíA 1° YeS o No* For electronic LLDs. does the turbine automarically shut nffifthe LLD derects . leak? ~1 o N/A -' o YèS o No;; For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabbi ON/A or discormected? 0 '{çs 0 No* For electronic LLDs, does the turbine automatically shut off if any p0l1ion of the monitoring system malt\mctlons 0 NiA or fails a !eST? -' ---- 0 Yc:s 0 No" For electronic LLDs, h~ve all accessible wiring COlUlections been visLlally inspected? 0 NlA j 0 \'èS 0 No* Were all items on the e'quipment manufacturer's maintenance checklist completed? h 11' ,,> in (he Section H, below, describe how and when these deticiencies were or will be corrected. H. CommenTs; ·_·_·".~_·___w -------- . . --,._-~-~- .. ---.-. -,------ . ~.~.- ..-;"---- ----,.".-.--.-- -- ..... "--_.-.. Page 3 of3 03/0 l ,¡ e e Monilùciug Sysrem Certìí1cation Sirë ALidn:ss: 3 L::>4 0 UST lVlonitoring Site Plan :5/LLl2L-T A-uE ßA-kERSFJEL-D ¡ ¡ ¡ ! ¡ ! j ! I j II" t}. -, r- if' ¡~J I ' ¡,~. ¡ , ¡ ¡ , I ¡ ! I I ! t \ I ¡ I \ J..' l : ! : r: I I I I I í I I .~' .. '~1' .. \:,... .~. .~~, .~.., , .~. \. :.:;x . . : . . \\ . . . . c/' , ' , .-.\),. .~., . VI . ~\' . . , ·r· . . t I Î i I I I , , I I f I I i , t , 1 .~. 'RV' " :~ (Y .~ .-=J . ,.... Dare map was drawn: --.J --.J _. Instructions If )UU already have a diagram that shows all required information, you may include it, rather than this page, with your Mùnitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identiJ~' lùcations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular Sp,1CèS, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line kak dèlècrors; and in-rank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan \\<1'; prepared, Page _ef_ ()5/(I() ~ e e MONI~OR CERT. FAILURE REPORT SITE NAME: O~A-~ &-tZ. õ~LT S,;4-WS DATE: r¡-CJ,..¿;« ADDRESS: OG:?4[) jlt..L 1Ze-f /1-VE' TECHNICIAN:;4A-~ r CITY: ~¡¿¡z:.I2.S rl e:Lp trI SIGNAT SITE CONTACT: THE FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE THE MONITOR CERTIFICATION TESTING. LIST OF PARTS REPI.ACED/REPAIRED: . REPAIRS: lVe~ ~ LABOR: ~ PARTS INSTALLED: ~ ----- I N'-T{~NK ALARI"1 ---- T 1 :DIESEL LEAK ALARt'1 APR 6. 2004 5:13 PM JAN 11. 2004 2:30 AM O\/ERF I LL ALARf'1 OCT 16. 2003 8: 41 A/"¡ MAY 20. 2003 4:45 AM NOV 20. 2001 7:15 AM. LOI¡J PRODUCT AU~RM APR 19. 2000 4:42 PM JAN 2. 19% 8 :'40 At'f NOV 12. 1995 4:25 PM SUDDEN LOSS ALARM ,ALARM APR 6. 2004 4:27 PM: JAN 11. 2004 2:05 AMI L 4: HIGH PRODUCT ALAR!"! OTHER SEN80~S OCT 16. 2003 8:41 A,'11 1'1AY ~W. 2003 4: 45 AM i NOV 20.2001 7:15: Ar"1) , ] NVAL! D FUEL LEVEL APR 17. 199.4 8:3~ A!M DEL I VERY NEEDED .'1 ": . .'" , . :NOV 1,3,. 1 '395 11 :3l/AN";i;;;',frlRM HISTORY REPORT ,fWR 17. 1994ß:8I?,"~t,:t'r;j.· " "." '··..·.::',;,;!'"ii,~+;~__ S;SNßOR AI ARI"I .' ::: ,~'; ~lr:'!:;ìY:i~'~R"P~N~O~S . ". "1 , '. :~-¡ t " ~ ,; "'.':;',:.: , :~·~'{~·':;:;-2~ :"::~;,: . ~ ; ., ;.~~~,",',';.",.,~,',t.~-.(.-,. ;fJ"; - -. ;-". - ..', ::'.;::¿.'_.-~ ~.:~ ORf\NGE BELT STAGES 36<\0 ~HLLECT IWE BAKERSFIELD. CA JUL 9. 20(J.,{ 9: 36 A!"t S',:¡,'STEf"l E:~TATUS REPORT -.--.-- ALL FUNCT IONS NORf"lAL I0¡LARn H I STORY' REPORT SVE3TH'1 ¡::¡LARl"t P¡:'Ü:>EF: OUT JAN 29. 2004 2:24 PM PRINTER ERROR JAN 29. 2004 2:25 PM BATTEIÔ' IS OFF JAN 1 ,- 1994 8: 00 Atyl SVS SECUR ITY, WARN I NG MAV 6. 2003! 11:44 AM ALAF~!<'l H I STORY REPORT ¡;;\LAJ<ryl HI S.V REPORT ...,--- ~::;ENSOF: ALARI"l L 1 :D!ESEL WiNK MNUU:¡R SPACE FUEL ALAR!"! JUL 9. 2004 9:32 AM FUEL ALARr"1 1"1(\'};' 6 ,. 2003 1 2 : 02 1"1"1 '. ,_ ALARM HISTORY REPORT L 6: SENSOR ALARM OTHER SENSORS FUEL ALARM "'PR 28. 2003 9: 22 AI"1j ¡ ~L~Rr" I ,- t . :, , ¡ iJ~~iT- , J ':,:, o.r"', ·,','~.',:,'jE.· rJ ,; :,.; :,;,',~,: , 1fT c" '" ~:í" "jl ., f~U'Rr"1 HISTORY' REPORT'! ':,1.~ -----, SENSOR ALARM --1 I"~ , L 2 :DIESEL TANK I:¡, STP SUMP : ¡ ¡, . , FUEL ALAR!"1 \:Al!.f!\~M HISTORY REPORT JUL 9. 2004 q' 30 AM "'Y'if " ,~. '.".., ;:.'.d.';,"'··· SENSOR ALARM . FUEL ALARr"l '! :[L Wi , '. ::~L :~A:~03 12: OOPM¡ !iÞ1ìH,R SENSORS APR 28. 2003 9:09 AMI ' HISTORY REPORT ,e¡LARM , ALARM HISTORV REPORT , ALARf"J HISTOR'l fEPORT, SENSOR A~ARM L 3: ! OTHER SENSORS I -"'P_-r--' SENSOR ALAR~1 ___.__. 9, 1: i 'Jlj':~~~~~r 8~$ORS"-c--~-: . t <\.- j J I I . ~. ,1.'- ,~, ~~ '. -'>Î:' I '1 SVSTEM SETUP I JUL 9. 2004 9:37 AM SYSTEM UNITS U.S. SVSTEI"I LANGUAGE ENGLISH ORANGE BELT STAGES :3640 S 1LLECT' AVE BAKER;3FIELD;.CA , 'i' ì; " I': r, t f ~ [ 1; t:. Þ r ~: I, !t [: t ¡i; f~; ~t : ~~ f;:ê:' SHIFT T HytE1: 6: Db A/"1 SHIFT, TIME; 2,,: DISAßLED SH I F:T:TIME~\'\¡ I? t~A,ßLRP ',,: :'C ,,_ "_: ;,'::~,_ <- :<~".,\ '; ,j PERIOPIC TE$TÜi.weWNJ NG$i DISf:lSI;;EL' "Y"'( '[." ¡ , ANN · ·iTESTi'W.ft!RN ~NGß .. DI '. J?<::-1~' ,:r;l " SVS, rT;.·,;;;', ,,'.;.···.SEC,UR1:rÙi, :1 ' ,'~~~t?' ,,-~t""; ,. ~~.::: " ,:,,! COD.E\),¡!;,d234!;ip,~,,¡ , 'I' r j¡~ft~tiR~,j 1¡¡lii~il " ~~L;k;')ev":~- :¡.- 'I~-î if'(i1j :,H~.;f~~\Út.;)}' :j.,. :-j~r~,! W~lj;1: . ¡"n' 'r~;"1--""'> l ),,\j., \"1 \,J ~·i~)}:.';;ir~fi.'~. :' ,t1f:r~j:f~ ; ¡¡~-¡~~;,~:; t;!~ìil!.¡~¡ ; ·,1-' I.·· L,.. :t· 'I'd 'I'~t" ',,:" "Tii':¡!¡.. IN-TANK SETUP - - - - - - ~.,~ T 1 :DIESEL PRODUCT CODE THERMAL COEFF TANK D I AI'1ETER TANK PROFILE FULL VOL : 1 : .000450 '95.00 1 PT 11 783 FLOAT SIZE: 4.0 INCHES I:: '/. I. i WATER WARNING : 2.0 HIGH WATER LIMIT: 2.0 MAX OR LABEL VOL: 11783 OVERFILL LIMIT: 95~ 111 93 HIGH PRODUCT 95% 111 93 DELIVERY' LIMIT 5% 589 , . LOLJ PRODUCT : LEAK ALARM LI M IT : SUDDEN LOSS.; LIMIT ; TANK;r ILT ¡. . )::' : · I"IÄNIFOLDED TANKS T# : '. NONE '. . PERIODIC TEst TYPE :' ,. . STANDARD PERIODIC TEST FAIL . ALARM DISABLED lOUD 99 , 99 · 0.00 GRQSS TEST FAIL ,. ALARM D I BABLED PERTEST AVERAGING: OFF TANK TEST NOT I FY ; OFF TNK TST SIPHON ~REAK:OFF . ,¡I___ DELIVERY DELAY 1"11 N .. -~, ( '~t " LEAK 'fES'1' '.. _ _ _ _ /"JEI'HOD TEST " r" ,. - -. D.p'J') d ,NUALI Ii ". n~, WEE -.. ~~LL T' START TI~~ 2 SUN ANK TE'-' ..IE" , 131' RATE : - ~:05 PrY! DURATI "N . U. 020 I'...A· L . v . -- .... /HR . b HOURS LIOUI"j '....E .. _.' _,L.J_o r·'¡S"OR. _S!fTUP L 1 :DIESEL IR I ,..STA'T" E TANK. I ATE'" ' J' I.JiORV: ANN !. ULf~R SPACE ,1-->: .j:Li ,.... ,.'i,:.[,~.~.',;j; ··,1·,;;;'· ..J,.,.-:. 'Qf.' , l'ì'1 ':'1" , .J.,,:": ¡, ~' ~ ! ' I :1 I I , , L 2:DIE-' . TRl-S ,.,BEL TANK ('f'~'I'EGOTR':ITE ." V : STP S~HP ----.. , I ,_ .....J -. SOFTWARE REVISION LEVEL VERSION 6.01 SOFTWARE¡t 612760-006-B, CREATED - 94.02.20. 15. 1'3 NO SOFTWARE M9DULE PORT 8ETT ING8: . NONE FOUND RS-2::¡2 SECUH 11"1 CODE : ""'~,,:,;:'" .' ¡ J<S-232 END OF Iv\ESSAGE DISABLED OUTPUT RELA't" SETUP - - - .- .- - R 1 :POSlTIVE SHUTDOWN TYPE: /,-st Ptl'IDARD .' NORI"IALLY CLOSED LIQUID SENSOR ALMS L 2: FUEL ALARM' F/-'" . ' ._,____._,_"'"1i.~~~ ~,-.-.-..-- .- , , --_.-.-' -.' j ,¡ :ì i ¡ 1 'j ? J 1 { I , I ¡ -¡ \ ¡ j I. I ¡ I .. e e Page -L- of-d SWRCB, January 2002 Secondary ContainIUent Testing Report Form This jòrm is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completedform, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. Facility Name: DR. .tV Facility Address: ;]'{., </0 Facility Contact: Date Local Agency Was Notified of Testing : Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: R,ŒCH ENVIRONMENTAL ,. A/I '/ ' J I<.ex> ? Tec]uÜcian Conducting Testv' In, ,..... Credentials: Ia CSLB Licensed Contractor o SWRCB Licensed Tank Tester License Type, C611D40 ' I. License Number: 809850 Mal\p.~a~urer Trainine: Manufacturer Comèonent(s) Date Training; Expires INCON , 8/04 INCON 'r'S-STS Component Pass Fail Not iRep'µrs Component Pass Fail Not Repairs Tested ' Made Tested Made '"Pt£~üt- FI"- S;1'ltL l?¿>)t ~ 0, 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 .0 0 0 0 3. SUMMARY OF TEST RESULTS {[hydrostatic testing was per(Qrmed, describe what was dque with the water after completion of tests: RECYCLE AND REUSED ' , ' CERTIFICATION OF TECHNICIAN RE~PONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, tile acts stated in this documentQre accurate Qnd infull compliQnce wiih legal requirements Date: t/¡-9-c« Technician's Si ,¡., ... SWRCB, January 2002 e e Page d of~ 9. SPILUOVERFILL CO~TAINMENT BOXES Facilit is Not E ui ed With S ill/Overfill Containment Boxes 0 Spill/Overfill Containment Boxes are Present, but were Not Tested 0 Test Method Developed By: 0 Spill Bucket Manutacturer DQ Industry Standard o Other (Specify) Test Method Used: 0 Pressure 0 Vacuwn o Other (Specify) INCON TS-STS o Professional Engineer S Hydrostatic Equipment Resolution: . 000 in. Bucket Diameter: Bucket Depth: .I Wait time between applying pressure/vacuum/water and startin test: Test Start Time: Initial Reading (R¡): Test End Time: Final Reading (RF): Test Duration: Change in Reading (RF-R¡): Pass/Fail Threshold or Criteria: Test Result: ~Spill Box # 7tl'- r;).." ~'( 3c>~,~ q~5o^w !Ll~~ J. ìLÞ:;,.,J I" 7lß ,/ i!~ IO~bDA-"", J /)(pa,J I L '7S7lw ID"t.41I"¡ l:S-~t rJ . wJ t .J ..t?í) 1"111 I.,.) $piH Box # Spill Box # Spill Box # o Fail o Pass 0 Fåil o Pass 0 Fail o Pass 0 Fail Comments - (include information on repairs made prior to testin& and recommendedfollow-up for failed tests) -- e e SB989 TESTING FAILURE REPORT SITE NAME: (:)(l.A-µùf:: E~LT srn~ ~ DATE: ADDRESS, 6LR 4t:> $/(LrzCT >4vEn:CBNICIAN' ~ ~ CITY, '8AK~¡25FI'5c-b ; cA SIGNA~_ ~ -::,. SITE CONTACT: 'rHE FOLLOWING COMPONENTS ~ REPLACED/REPAIRED TO COMPLETE THE SB989 TESTING. LIST OF PARTS REPLACED!REPAIJŒD: REPAIRS: ,~ LABOR: ~ PARTS INSTALLED: ~~ ,u~ 22 2004 11:21 BtlJLD FIRE PREVENTION (6.852-21?2 p. 1 PAGE Ell/81 86/21/2ØB4 15:12 6613928621 *COpy REQUESTBD P~EASE !!'AX(661)392r-0621 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES -epOO 71<J.1)Ç.mn A-t.e. -~~F eE.l)) s c.1! ~X (t9.(oi)-ß.s~,-arï;) . APPUCATION TO PERFORM FUEL MONITORING CERTIÐ'ICATION FACJI.JTY ORA-nt*.. ßf,t;r ~l JF.S ADDRESS. ~LDL\·b ~~ UJ;.çr A·d:E.~ß.eis.EiGf}£LJ\ ~~ OPERATORS NAME OWNERS NAME NAME Of MONlTOR MAN'UFACTUR.ER. DOES PAC1L1TY HA VB DISPENSER PANS? YESX- NO_ TANK' ---L- VOLUME \ ¿;:} 1000 CONTBNTS t)1'EßEJ,. . NAME OP TBSTlN'G COMPANY . RI9H ENVIRONKRNTÄL CON"tkACOORS UCENSE If 90-107 2 NAME&PHONBNUMBBROFCONTACTPE.R.SON JAMES RICH (i61)3'¡-'~87 DATE & TIME TEST IS TO BE CONDUCTEp ·}7j/~,¡ø,t.l, - '"l·:·OQp;t::/:):; , ,l rk4»rV APPROVED BY ~ /J-I-/ó4 , DATE., t(~. A~ c.\ , ßd\t(" NO-\- ·h.&L ho~lt- tkNl5"" 60.'15 . ~lf' Tc5\- ~() at ~wJL. ,c,s J I-\- ~ l.. \ Vl-- e OS/21/2004 15:12 6613920521 e PAGE 01/01 *COpy REQUESTED PLEASE FAX(661)392-0621 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES -qOO TRl..lÃmn fk.e. -~~F Æ.l)) , C.1l ~X (CøLsJQ-g.s~,-d\ì;) APPLICATION TO PERFORM: FUEL MONITORING CERTIFICATION FACn..ITV OaA-YlC-ñ=".. 8t:l.T ð-rAh-F,$ ADDRESS ñloq'().5l LlEL\ A\JE-~8ß'kE~F1EJ_]\ }Cßt OPERATORS NAME OWNERS NAME NAME OF MONITOR MANUFACTURER DOES FACD..ITY HA VB DISPENSER PANS? YES'y' NO_ TANK # ---L- VOLUME \;LDDO CONTENTS l)t'E:.S~-,l. NAME OF TESTING COMPANY ~RICH ENVIRpNME~TAI.. CONTRACTORS IJCENSE 11 90-1072 NAME&PHONENUMBBROFCONTACTPBRSON JAMES R.ICH 1661)32.2-8687 , DATE & TIME TEST IS TO BE CONDUCTEp , ¡¡(?OJ / Dt{ - I·' 60p rn ,Jw (¡;!lwaD APPR.OVED BY V/rÂ1IÓ4 DATE, C(~. ~, ~ ~ ' ¡ f: f' '~:::"':r~ .<.o-....-....-_~.......:.;=--:::.;.--...w:.<...~.....-~~::--~~~;'__~;;..-'-.....,_~~ .-;;~.~. ..~~.. ~........"'-'¥~~~..::.~~< . , ,--~. " ~,~ .- ~ '" - ,/$~ C-tJRRECTION .,TICE 0455l BAKERSFIELD FIRE DEPARTMENT ~ 4-0 Al, 5, J(£;c,r Name DYJ.,NJE;; ~f.r S~3C>.s Location ,~ ,:r: " 'i~. ,/" 11 .. f' r Þ , 'f·. (. 't" " ¡ You are hereby required to make the following corrections at the above location: I. r" Cor. No. !~ " l QJ~[ 50dde:AJ 'b7'7;i~/e- A t.b'¡~ Q()ÞJd; -hð"V 6,11Jir; ~ 0 £.wl e.. ~ y ~ 1E.vV\- ';" ': I~' . " " ¡: ~ " I f ,. ~.'. .: if" ì' !~ f,;- iL ,', '," , r ',~ " f. , I¡<" I:, f f' , '. I' ~ ~t r- Completion Date for Corrections Date 3/3O)Dtf f I~; :~ f" ! f !' FO 1950 or:FH'JGE EELT ~:rr.~',GEf: 3G40 SILLECT AVE BAKEF:SF I ELD ,. U', r"1*D. ~:IJ04 9: 41::, {~~'l - - - - -' S\'STH'1 STATUS J~EPC'RT T 1: LEn}: ;~LAF:r"l - - .- -- - - T 1: SUDDEN UX3S ALHRI"1 INVENTORY REPORT T ¡:[dL;:';FL \/OLU~1E Ul.U,GF:: '3CI% UI, TC VOL.':' HEIGHT LJATER ",I\)L L',JATER :EA ~ ~ ~::45':3 8~E'4 7145 :3444 '.-~; 1 ,:3 1 U 0.00 69. ,\ END '" '" GALf::~ 1.;r-:'1LS GAU::~ G;,L~; I NC HE;'=~ U',LS I NCHE::: DEG F .~ ~( ~ e UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program FACILITY NAME ~N<3 Eß~lt-__'Ó.k3~2_-m-----_,-,-,- 3& 4:í2ÁJ.-:2ill~_~t_ ' Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 INSPECTION DATE INSPECTION TIME . ~?;(;,~~ PHON~~ No. of Employees 2-+- f 144 __,_.L,..__,,___ Business ID Number -~-------~- ADDRESS FACILlTYCONTACT 15-021- Section 1: Businèss Plan and Inventory Program LJ Routine d Joint Agency l] Multi-Agency LJ Complaint LJ Re-inspection C V ( C=Compliance ) V=Violation OPERATION COMMENTS b( LJ ApPROPRIATE PERMIT ON HAND 7--=- '----------:--------'..'----'-------- -,.,..,..,----"....-..,-"-.-..--'---.--- -....-..,..-.---.--...,..-----------..' ~ LJ BUSINESS PLAN CONTACT INFORMATION ACCURATE ------....---.--------.----- -- ----------.--- ----------.--.....--.---------------,,---.-.----..--.....------_..- "'-- .--..-.- Þ(. LJ VISIBLE ADDRESS _______________.___.______.___._____ __.____________...___ __._.____.______.____._________ ._....___.________..n_.____. ____ LJ CORRECT OCCUPANCY --~----_. -----.-- -----_.------_..__._.~~._.. ._-----------_.---~---_.._--_.._---_._--,-_.-----~- -------.------. LJ VERIFICATION OF INVENTORY MATERIALS -.------------.--.-- ._-- ------_..- -,-.------- .----.-----.----.----------------------- --+...--. .---.-.-.----- .. LJ VERIFICATION OF QUANTITIES ---.---------------.-----.--------------.-......-- -----------.-------..-.---------------------.---..-.-.--.--..-----.--------..---.-----..-..----- j( LJ VERIFICATION OF LOCATION , YÆ LJ PROPER SEGREGATION OF MATERIAL ~ LJ VERIFICATION OF MSDS AVAILABll';~;---'--'--"-'--..-_-,_..n---'-'-"-------'----,...'-----,----.,.---'-- - -~~------~-----------_._-----.----_.._- -~-_._--_.._._---------------~._._----------------------.---------.-----.---.-- LJ VERIFICATION OF HA'&MAT TRAINING --.--- ----------.---..-..------ -----.----------.-------.- --. ------------..----------.---.- -~-----_._-------_._---_.__.~._---_._-------------_._----------.---.- ~ LJ )tLJ R{LJ }tf LJ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES --------.--..---- ------------_.._..~---------_._------+-_.._~--+--------._~-------_. EMERGENCY PROCEDURES ADEQUATE ----------------~-------------- -------_.._---_..._.__.+~--------------------'------_._..._---_._._-~_.._----_.__._----- CONTAINERS PROPERLY LABELED -------_._-----~-_.._-------------.-_. -----------.--- --.----.------..-------.--------------....--------------------.-- HOUSEKEEPING .-----------..- --------+-------_._-----_._------_.~._--_._~_._----_. ~~~I~E PROTECTIO~___________._______ LJ SITE DIAGRAM ADEQUATE & ON HAND -~---~----------_._-----_._---_._-_._---~.__.._---- .--....-------- ANY HAZARDOUS WASTE ON SITE?: LJ YES )l.No EXPLAIN: \\J IÞ~ L( )-"'78ð 0 I ( ) NO THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 fJ ~B'd9'N~~-~- 'I- ·/~J::.¡i'Z~u---- White' Environmental Services Yellow . Station Copy Pink, Business Copy e e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave.. 3rd Floor, Bakersfield. CA 93301 FACILITY NAME (Jri>'\!jE.. Bdt $~ INSPECTION DATE :;/3ð/04- Section 2: Underground Storage Tanks Program o Routine ~Combined 0 Joint Agency Type of Tank --.Dlt\) FC~ ~ Type of Monitoring Q L VV\ . o Multi-Agency 0 Complaint Number of Tanks ( Type of Piping ~ ORe-inspection OPERA nON c v COMMENTS Proper tank data on tile ..¡.. Proper owner/operator data on tilc 'f Permit fees current ¥- Certification of Financial Responsibility 'f t...EJ>\t- Å IÞ( W\ ~ ;.~ L!P'.J...... J Monitoring record adequate and current x.. 6 'rl~_r::1 f . ~ Maintenance records adequate and current Failure to correct prior UST violations X Has there been an unauthorized release? Yes No 'f- Section 3: Aboveground Storage Tanks PrQgram{ I , Ie \Á4.~ 1>1111 ) 19ð 9)1 TANK SIZE(sdt.) 320 t ) ZZQ~I (¡ f¡~ÂGGREGA TE CAPACITY Type of Tank -UL l 'L . Number of Tanks ( D ?D~.~l\ -3~Þ ( , OPERA nON Y N COMMENTS SPCC available >( SPCC on tile with OES X , Adequate secondary protection '^ ~C,ld:-¿ 'F(~ Proper tank placarding/labeling ~ Is tank used to dispensc MVF? ~ If yes. Does tank have overtill/overspill protection? C=Compliance V=Violation Y=Yes N=NO ~ if 6/é'/ft'Z4 II Business Site Responsible Party Pink, Ausiness Cory :. 661392.1 e PAGE 02/12 " 06/04/2003 16:19 <: y MON~;2~~H",~r~O~~~" £~!!JK~:;~ nON thrrhority Cited: Ch{/pter 6.7, Health and Sofety Code: Chapter] 6, DIvision 3. Title 23, California Code q( Regulations Th,i9 form must be Ll'~ed to d.ocument testing and ser'vic.ing ofmonlwdng equipmen.t. A geDarate c.ertification or reDort mu~t b.i\\ lWepBl"I!cI 1"01' tach monit!:\"inR system control panetby the technician who performs the worle. A copy of this fonn must be provided to the tank S)'9.tl!l11 o'r\TleJ'/opcrator. The owncr/operatol' must submit a copy of this form to the tocal agency regulating UST systems within 30 da)'~ ~lf test date. A. Generalloformation .Facility Name: .etA-.vwE 4E!-r Sr;f6li.5 Siw Addl"css:Jr,#/O P. -S.ll..t.ec.r A ~J! Fadlity Contact Pel'son: Make/Model of Monltoring System; Ú~l 0 þlV1 c.. B. Inventory of Equipment Tested/Certified Checl¡ Ihe II) ro rlßt~ boxes to Indicate ~ eeifit II \lj ment ins tttcdls4"Yieed: Bldg. No.:__, .___ Ci.ty: ~"£LJu. C) ,_._ Zip; ~,_____, COl\tact Phone No.: ( ) _ __ Date ofTesting/ServÎcing: ,.$:) 1I ,-g,3 TllnkW;_Q'EsS~ TankJD: _. ~ 111-1'0.1\1. Gauging Probe. Modc.l: ~/ [:J tn-Tnnk Gauging Probe. MO(lcl: 'it Annulllr Space or Vault Sensol'. Model: ~,Þ~4FL+ rl4«1f!t1 [:J Annular Space or Vault SC11!l)r. Model: .._ .___.. )C Piping Sump l Trench Sensùr(s). Model: ~dî 0 Piping Sump! 'trench &:n501'(5). Model: ,.,.____ [:J }'ill Sump SCl1sor(s}, Modcl: ==:: [:J Pi!! Sump Sensor(s), Monel:, [:J M¢ch¡)lIh:al Linc Leak Detector. Model: _,., q MechaniclIl Line Leal, Detcctor. Model: . _ [:J El¢cU"onic ,Line Leak Detector. Model: q Electronic Line Leak Detector. Moclèl: __._____.. D Tank Ovcrkill/ H.igb-Level Sensor. Model: ~ a Tank Overfill! High-Level Sensor, Mooe1: ___.___.. o <Jrh¢r ;; è:Ci e ui 'nent t c and model in Section E on h e 2 , Q Other . eci e ui ment t e Md model in SectiOf E On Pa c? . T<lnk lD: Tank ID: ___ [:J In-Tank Gauging Prob~.~ Model: _. _ [:J [n- Tank Gauging Probe. Model.: o AnnuJar Space or VmLlr Sen90r. Model: ~ 0 Annula' Spø.<::e or Vault Sensor. Model: a Piping Sump /Trench Sc:n~('r(s). Model: 1:1 Piping Sump I Trench Sensor(s). MNlel: a Fill Sump Scnsor(s), Model: - [:J Fill Sump Scnsor(s). Model: ~", o Mechanical Line LtakDett:ctor. Model: 0 MecJtanÎcll1 Line L;ak Detector. Model; [:J Elc¡:!t'Ol'ic Linc Leak D~t~to(, Model: ,.._ [:J Electronic Line Leak Detector, Model: tJ Tank Overfill! High-Level Sensor. Model: [:J Tank Ovcr.fill/ High.Level Sen~or, Model; ""._ [:J Orh~' s eci c ui ment t and modcl bl Section E On P e 2), 0 Other S I':ci e, ui ment e IIl1d model in Section Eon PII ~ 2). D¡~pen'er JD: ()~ ~ .. Dispenser W: __ þJ Dis[lel\~r Corltainmcnt Sensor(s), Model: oa;¡ [:J Dispcnser Contllinment Sensor(s). Model: ~_. Shl-dr Valve(s), Q Shear Vlllvt(s). o Dis c.l1~cr ContainnlCIlt Float ~ o.nd Chain 9 . a Dis nscr Containment Float sand Chaín ,~ . Dispenser 1D: Dìspen~er ID: __, o Dispenser ContaJnment Sensor(s), Model: a Dispcnser Containment Sensor(s), Model: _...,.. ..... c:J Shcar Va/vets), 0 Shear Valve(s). lJ Dls t!1\~er Containment Float S Md Chain s . a Dis Cflscr Containment r-Ioat s and Chain s , llispcII5er ID: Dispenser In: _ _._. a Di~pl!l1~er Containment 5en80l1:8). Model: C Dispenser Containment Sensor(s). Model: [:J Shear Valvc(s). Q Shear ValYe(S), . [:J Dis lel'1s.:r Cl'nta.Înment FloaT s and Chain 5 . Q Dis enser ContRinmcnt Floa. s and Chain s , ·r(the: facUity conœir¡,:,I marc t/lJ1ks or dispenscrs, copy this fonn. Include Information for every tBllk ond dispenser at the fucility, C. Certification.. t certify that the equipm8nt identified In this document wa, ¡'upeded/servleed in aeeordHnn with the manufactllrel's' ¡¡uidelillCSo Attached to rhl.$ Certification Is information (e.g. mnnuftu:turera' checklists) necessary to verlry that tllìs information is eorrl!ct Rnd B Plot ¥bln sbowìn¡ the layout of monitQrln~ equipment. "'or any equipment ~pllbe of generating sue" reports! 1 hnveo 111,0 Ilttached II copy ofthe N!e,orq (dlllCk (lIU/lnt appbt): ~ystem set-up ~arm hls~ort Technician. Name (print): ..E:J:f,v M~-<J....._ Signature: ~ -e¡--- '_.,_. Certification No.: ~.t'-:.J$- ¡'~ð Liccnse. No.. C61/D40- ::: 8.99850 Testing Company Nart\l!i: RICH ENVIRONMENTAL _~ Phone No.:{661 .L 392-8687 Site Addrcs:;;: ~ U. .$..1J.bfJ,T AI//! ,__...MJ:E.~S.ElJ5t..£3 l-+- Date of Te5tinglServicing: .Æ'./.~. j~ -.....--.--. Monitoring System Certification Page ) of 3 03/01 " 661392.1 e PAGE 03/12 06/04/2003 16:19 D. l~esuItti of TestinglServieing Softwarè Version ]nsralled: (p. 0/ Com let~ th~ .rullowin c::hecklial: . Yes D No· Is the audible a1.arlll 0 eration.al? !irYe~ D No'" rs the visual alarm 0 erational,? y~s 0 No· Were all sensors vL~ua\l ins eeted, fun(:tÎonaJl teited. aJld <:onfimed 0 era.tíonal? Yes Q No'" Were all sensors ÎIIstálled at lowest POlnt of'secondary containment and pos.itioned so that othel' equipmcnt will not interfere with their ]'0 Cr 0 eration? 1f aJarms are rclayéd to a remale monltoring station, is all communications equipment (e,g. nlodcm) operational? For pressurized piping systems, does tbc turhine automatically shut down if the pipit1g secondary contaÎIut1otnt monitoring system detects n leak, faiLs to operatt, or is electrj<:ally disconnected? If yes: which senso~s initiate positive shut·down? (Check (Ill that apply) :¡m Sump/Tre"ch Sr;nsol's; 1:1 Dispenser Containment Sensors. Did au confjm1 ositiyc sbut·down due to leaks al1d sensor fallure/discortne<:tion? Ye$; 0 No. D No'" For tank ~ystems that utilize the monitoring system as the primary tal1k overt. 11 warnÍltg device (i.e. 110 ,ø N/A mecJumica! oycrüll prevention valve is installed), is the overfill warning alarm visible and audible lilt tht tank fill oim(s) and 0 e~atjn ro erl ? 1fso, at what rce-nt of tank ca aci docs tbe alann tri" cr? ',Yo Was any monitoring equipment replaced? If yes, identifY specific s~nson;, probes. or other equipment repr,a<:a:d and Hst the manufacturer name and mode! for aH re lacement arts in Section E below. Was liquid fOWld inside aoy secondary contalnment systems designed a$ dry systems? (Check all thaI appf).~ 0 Product; 0 Water. If e.s, describe causes in Sectlon E, below. Yes 1:1 No* Was monitorin s tern set·u reviewed to ensure rO er settin 51 Attach $et u .. Yr;:s [J No'" Is aIJ monìtorin e ui mcnt 0 erational er 111anufacturer's s eclflcation.~? It In ScctiOl1 E below, dè~cribe how and when these deticiencies were or will be correeted. DYes CJ No* ~ NiA i:J No. D N/A ~ Y~$ I o YI!'!; C] y ~* '2 No D Yes* CNo F... Comments: --........-.--..- -.--....., ......... ~. ""'-....- .....-...-..- .......... -."...... ---------... -,..,...~--- -- ........ ..-----..-- ..,.......-- -,....- .------...- ---..-. .. ""'_"_0- .----.. --..---.... --........ ----. 03/()( .-.---...-. ·-.0··..-·0' ..__ .....- ........-... P!'tftè 2 of;'l 05/04/2003 15:19 551392.1 e PAGE 04/12 F. 111- Tank Gauging I SIR Equipment: ~ Check tbig box if tank gauging is used onJy tor inventory control. a 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 perfom1. leak detectio11 monitoring. c I ' II h kl om)let~ t Ie 0 owml/: c: ec:' ¡st: o y~s o No· Has all input wiring been inspected f(\1' proper entry and tenllination, including testing for ground faults? Õ--,;;~s a No. Were all tank gauging probc~ vhuBlly inspected for damage and n!:$Îdue buildup? o 'I' c::s o No'" W35 accuracy ofsystetn product lc"el readings tested? CJ Yes I:J No. Was !JC(;uracy of system water level readings tested? a Yes o No* Were all probes reinstalled properly? (J Y¢s o No* Were all items On the equipment m.IIDufact1.lfer'S maintenance checlcHst complct:c:d? * hi rhe Secrion H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): )!It Check this box if LLD~ are nòt instaIJed. c I ~ II h kli t OmPI ete t Ie 0 OWlI1l!!: c: ec s : DYes o No· For equipment start-up or aDnual equipment certification, was a leak simulated to verify LLD performance? D NJA (Check all that apply) Simulated leak rate: a 3 g.p.h.~ D 0.1 g.p,h; a 0.2 g.p.h. DYes o No" Were all LLDs confirmed operational and aCClU'ate within regu,latoJ)' requirements? Q Yes o No· Was the tesring apparatus prQperly calibrated? ~. o Yes CJ No· For Incch8l:1ical LLDs, does the LLD restrict product flow jf it detects a leak? o N/A -- [J Yes o No· For electronic LLDs, does the turbine automatically shut off if the LLD detects Bleak? D N/A I:] Yes (J No· For electronic LLDs, does the turbIne automatically shut off if any portion of the moni,toring s)'stem is disabled o N/A or disconnected? o Yes Q No" For electronic LLDs, does the turbine automatically shut off if any p011ion of the monitoring system malfunctions a N/A or tåî Is iii tcst? o Ye.s o No" For elcctronic LLDs, have ¡¡II accessible wiring connecti.ons been vislIillly inspected? Q N/A U Yes CJ No" Were all items on the equipment manufacturer'$ maintenance checklist completed? '" In th SectioD H, below, describe how Bnd when these deficiencies were or will be corrected. H. Comments: ---,_...,..... .--...,........ --'-'·"'·I·___'_._-~ "'-'~'-''''......_'-,^-- ....~.""..-._- ---,...--.- -..----"... ",... ._~.._- ........---.., -- ",-_.. .,..-....----.-.- ..................... --.... --"...-......-. -.-.--_'.~- Pa2e J of3 03/01 06/04/2003 16:19 661392.1 e PAGE 05/12 Monítoríl1Vo System Certíficatíon Site AddJ'ess: '1& 'ftJ Po UST Monitoring Site Plan .! I L t.. ~G T Âf,I€ PA.i:Eß.5Il:E.~14.", { 4- . , '~~L' . :~: :~~; , ~. ,;r,~, . Š'. ~,~. , .1_. '.b="too- ' CJ ÇI~),..: :ðJ: : .'Jt..,~ 'uiU(:. , . ~ ';:J' ~6 ~:(: . I . . I .. . . . :s J~ P : . ...' J . /t/. :~ j¿ ii:, T: A/Ii: - '--.' Date map was drawn: S / (p / oj. Instructions .~. If you already have a diagram that shows aII required informaLion, you may include it.. rather than this page, with your Monill,')ri"g S)'stcrn Ce.rtificatiO,n. On your site pJ,8J'1, show the gener~J layout of tank.~ and piping. Clearly identify loci\tkms of the following equipment, jf inRtalled: monitorin.g systeoo aontr'ol panels; sensors: monito\'ing tank annular spnce$, sumps, dispenser pans, spill containers, or other secondary contain.ment areas; mechanical or electronic line leak dctcctor~~ and in.tank liquid level probes (if used for leak detection). In the spa.ce provided~ note the date this Site Plan w~s preplwed. Page ~ of l/ 11;';/00 06/04/2003 16:19 661392.1 ----- SENSOR ALARM ----- L 2:DIESEL TANI( STP SUMP FUEL ALARM !-IAY 6. 200:3 12: 00 PM ... ORANGE BELT STAGES a640 SILtECT AVE ÐAKERsF I ELD ,_ CA MAY 6. 2003 12:0J PM _ ~Y~T~ StATLS REPORT ALL FUÑcTIOÑs -NÕRMAL - ----- S~NSOR ALARM ----- L 1 :DIESEL TANK ANNULAR SPACE FUEL. ALARM MAV 6. 200~ 12:02 PM ORANGE BELT STAGES ~640 SrLLECT AVE 8AJ<ERSF I ELD, CA '1AV Co. 2003 12: 03 P~1 /, . _ ~V~TEI" STATUS REPORT --- ---- ALL FUNCTIONS NORl'1AL - SOFTt.JARE REV 1 S ION LEVEL VERSION 6.01 SOFTWARE# 612760-006-~ CREATED - 94.02.20.16.19 NO SOFTWARE MODULE e~STEM SETIJP - - - - - - - - - ~ MAY 6. 2003 11 :42 AM SVSTEM UNITS U.S. SYSTEM J~~IIIGUAGE ENGLISH ORANGS ~ELT STAGES ~640 SILLECT AVE BAKERSFIELD, CA SHIFT TIME 1 : 6:00 AM SHIFT TIME 2 = DISABLED SHIFT TIME 3 : DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TE6T WARNINGS DISABLED S\'STEf'1 SECURiTY CODE : 123456 SYSTEM SETUP _ _ _ _ .rw MAŸ -6: 20Õ3 11:42 AM sysTEM UNITS U.S. SYSTEM L.ANGUAGE ENGLISH ORANGE BELT STAGES 3640 eILLECT AVE BAKERSF I E1..D . CA $~IFT TIME 1 : 6:00 AM SHIFT TIME 2 : DISABL.ED SHIFT TIME 3 : DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS D I SASUD S'iSTEM SI;:CURITY CODE : 123'156 e IN-TANK SETuP - - - - - - - - - T 1 :DIE6EL. PRODUCT CODS THERMAL COEFF TANK DIAMETER TANI< PROFILE FUl.L \lOL FLOAT SIZE: 4.0 WATER WARNtNG : HIGH WAT~R LIMtT: MAX OR LABEL. VOL: OVERFILL LIMIT : HIGH PRODUCT . DELIVERY LIMIT PAGE 0E.112 1 .000450 ~5.ao 1 PT 11783 INCHES 2.0 2.0 11783 95% 11193 95.% 11193 5~ 58'9 1000 99 99 0.00 LOW PRODUCT : LEAK Al.ARM LIMIT: SUDDEN l.OSS LIMIT: TANK TILT MANIFOLDED TANKS T~ : NONE PERIODIC TEST TVPE STANDARD PERIODIC TE9T FAIL ALARM DISAElL.ED OROas T£5T FA ¡ L ALARM DISABL.ED PER TEST AVERAGING: OFF TANK TEST NOT I FV : OFF TNK TST SIPHON BREAJ<::OFF DEL. I VERY DELAll : 1 M I N LEAK TI;:ST METHOD - - - - - - - - - TEST ANNUALLV: ALL TANK JAN WEEK 2 SUN START TIME: 12:00 AM TEST RATE : 0 . 20 GAL"HR DURATION : 6 HOURS 06/04/2003 lG:19 ----- SENSOR ALAR~'I ----- L 2:DIESEL TANK STP SUl'1P FUEL ALAR)., MAV 6. 2003 l~:OO PM .' ORANGE BELT STAGES 3640 SILLEOT AVE BAKERSF'IELD, CA MA~ 6. 2003 12:01 PM SYSTEM STATUS REPORT - - - - - - - - - - - - ALL FUNCTIONS NO~MAL ----- SENSOR ALARM ----- L 1 :DIESEL TANK ANNULAR SPACE J::'UEL ALARM MAV 6. 2003 12:02 PM ORANGE EELT STAGES 364Q SILLECT AVE BAKERSFIELD. OA ~~v E. 2003 12:0~ PM SVSTE1'1 STATUS "'REPORT - - - - - - - - - - - ALL FUNCTIONS NORMAL 5513g211 SOFTWARE REVISION LEVEL VERB ION 6.01 SOFTWARE~ 612760-006-B CREATED - ~4.02.2Q.15.19 NO BOFThIARE MODULE SYSTEM SETUP - - - - - - - - - - - - MAY Ó. 200~ lL:~2 ~1 SYSTEM UNITS U,S. SYSTEM l.ANGUAGE ENGLISH ORANGE :BELT STAGES 3640 SIl.LEeT AVE BPiKERSrIELD. CA SHIFT TIME 1 : 6:00 AM SHIFT TIME 2 : DISABLED SHIFT TIME 3 : DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS D ¡SASLED SYSTE~1 BECUR I TV CODE: 123456 S\'STEM SETUP - - - ~ - - - - - - - - MAY 6. 2003 11:42 AM 6\'STEM UN ITS U.S. a~TEM LANGUAGE ENGL.ISH ORANGE BELT STAGES 3640 SILLECT AVE BAKERSF I ELD. CA SHIFT TIME t: 6:00 AM SHIFT TIME 2 : DISABLED sHIFT TIME 3 : DiSABLED PERIODIC TEST WARNINGS DISABLED ANNUA~ TEST WARNINGS D I SABL.SD sySTEM SECUR I TV CODE i 123456 e PAGE 07/12 IN-TANK SETUP - - - - - - ....- .... - - - T 1 :DIESEL. P~ODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILS FULL VOL. : 1 : .00045Q : 95.DO : 1 PT : 11 78~ FLOAT SIZE: 4.0 WATER WARNING : HIGH WATeR LIMIT: MAX OR LABEL. VOL: OVERFILL LIMIT : HIGH PRODUCT DELIVERV LIMIT INCHES 2.0 2.0 11783 96% 11193 95% 11193 5% 589 100C 99 99 0.00 LOW PRODUCT : LEAK AL.ARM LIMITi SUDDEN LOSS LIMIT: TANK TILT : MANIFOLDED TANKS TIt: NONE PERIODIC TEST TWE STANDARD PE~IODIC TEST PAIL ALARM D 1 BABL.ED GROSS TEST FAIL A1.ARM DISABLED PER TEST AVERAGING: OFF TANK TSST NOTIFY: OFF TN( TST SIPHON BREAK : OFF DELIVERY DSLAV 1 MIN LEAK TEST METHOD - - - - - - - - - - - - TEST ANNUAL.L\': ALL TANK JAN WEEK 2 SUN START TIME : 12:00 AM TEST RATE :0.20 GAL./H~ DURATION : 6 HOURS 05/04/2003 15:19 55139211 ----- SENSOR ALARM ----- L 2:DISSEL TANK STP SlUMP FUEL ALARM ¡"'A",{ 5. :200:3 12; 00 PM " ORANGE BELT STAGES ~640 SILLECT AVE BAKERSFIELD, CA ~1AY 6. ~Q03 12: OJ P~1 Sl'STEM STATUS REPORT - ÀLÏ FUÑCTIOÑS-NÕRMAL - ----- SENSOR AlARM ----- L I:DIESEL. TANK ANNULAR SPACE FUEL ALARM MAY 6. 2003 :2: 02 P~1 ORANGE BELT STAGES ~64C SILLECr AVE BAKERSFIELD. CA MAY ~. 2003 12:03 PM SY'STEM STATUS'"REPORT - ÃLi FUÑCTIOÑS-NORMAL - SOFTWARE REV'ISION LEVEL V£RSION 6.01 SOFTWAR5~ 612760-006-S CREATED - 94.02.2Q.l~.19 NO SOFTWARE MODULE SYSTEM SETUP - - - - - - - - - - - - MAY G. 2003 11 :42 Ai"l SYSTEM UNITe u.s. S'I'STEM LANGUAGE ENGl..1SH OP-ANGE BELT STAGES 3640 SILLECT AVE BAKERSF I aD. CA SHIFT nME 1: IS: [m Al'1 S\o!IFT TIME 2 : DISABLED SHIFT TIME 3 : DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS DISABLED SYSTEM BECUR [TY CODE : 1 2:3456 SYSTEM SETUP - ~ - - - - - - - - - - MAY 6. 2003 11:42 AM SYSTEM UN I TS u.s. avBTE~1 LANGUAGE ENGLISH ORANGE BELT STAGES 3640 SI~LECT AVE aA1ŒRSF I ELD, CA SHIFT TIME 1 : 6:00 AM SHIFT TIME 2 : DISABLED SHIFT TIM6 3 : DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS DISABLED SVSTEM SECURITY CODE; 123456 e PAGE 08/12 IN-TANK SETUP ------ - - - - ... - T 1 :DISSEL PRODUCT CODE THERMAL COEFF TANI< DIAMETSR TANK PROFILE FULL VOL 1 .000450 95.00 1 PT 1178:3 FLOAT SIZE: 4.0 INCHES ~TER WARNING : 2.0 HIGH I~TER LIMIT: 2.0 MAX OR LABEL \lOL: 11 ?8S OVERFILL LIMIT: 95% 111 9:3 HtGH PRODUCT 95% 11193 DELIVERY LIMIT 5% 589 1000 99 99 0.00 LOW PRODUCT : LEAK ALA~M LIMIT: SUDDEN LOBS LIMIT: TANK TILT : MANIFOLDED TANKS Tit: NONE PERIODIC TEST TYPE STANDARD PERIODIC TEST FAIL ALARM DISABLED GROSe TEST fA I L ALARM D ISAaLED PER TEST AVSRAG I NG : OFF TANK TEST NOTIFY: OFF tNK TST SIPHON 8REA~:OFF DELIVERV DELAY 1 MIN LEPIK TEST ~IETHOD - - - - - - - - - - - - TEST ANNUAL.L~: ALL TANK JAN WEEK 2 SUN START TIME: 12:00 AM TEST RATE :0.20 GAL/HR DURATION ; 6 HOURS 06/04/2003 16:19 661392.1 e PAGE 09/12 LIQUID SENSOR SETUP - - - - - - -- ALFlRI'1 I-t [STORV REPORT ---- IN-TANK ALARM T 1 :DIESSL. OVERFILL ALARM NOV 20. 2001 7:15 AM MAY' 6,. 1994 10:2& AM LOW PRODWCT ALARM APR is, 2000 4:42 PM ~'AN ;2,. 1996 8:40 AM NOV 12. 1996 4:25 PM HIGH PRODUCT ALARM NO\! 20,. 2001 7: 15 AM MA~ 6. 1994 10:26 AM INVALID FUEL LEVEL APR 17. 1994 8::3:3 Ar-1 L 1 :DIESEt.. TAI"¡K TRI-STATE CATEGOR':i' : ANI"¡ULAR SPACE L 2:DIESEL TANI~ TRt-STAT"S CATEGORY : STP SUMP C<>I-INUNICATIONS SETUP - -- - - - - - DELIVERY NEEDED NOV 13. 1995 11:37 AM APR 17. 1994 8:38 AM f'(JRT SErf I NGS : NONE FOUND RS-232 SECURITY CODE : !E'U"¡'O~~ A~ARM HISTORY REPORT ----- SENSOR ALARM L 1 :DIESEL TANK ANNLILAR SPACE FUEL ALARM APR 28. 20t:1:3 9; 22 ÄM FUEL ALARM APR 28. 2003 S:OS AM FUEL ALARM i"IAV 7. 2002 12: 24 PI"! R8-2:3~ END OF ~1ESSAGE DISABLED OUTPUT RELAY SETUP ~ - - - - - - - - R l:POSITIVE SHUTDOWN TVPE: STANDARD NORMALLY CLOSED LIQU[D SENSOR ALMS L 2:FLIEI.. ALARM ALAAM HISTORY. REPORT ----- SENSO~ ALA~M ----- t 2:DIESEL TANK SiP SlJJ"IP FUEl. ALARM APR 28 _, 20D:3 '3: Og AM FUEL ALAR~1 APR 28, 2003 9:0~ AM FU£L ALARM ~'IAR 17, 2003 2: 58 PM ALARM HISTORY REPORT ----- 6'\,'STEM ALAR!"I ----- PAPER OUT MAR 15. 200~ G~OO AM PR INTER "SRROR ' MAY ~. ~oos 11:40 AM BATTERY IS OFF JAN 1. 1994 e:oo AM ::!\''S SECUR I TV LJARN I NG APR ~ê. 2002 9:~9 AM .I 05/04/2003 15:19 551392.1 e PAGE 10/12 LIQUID SENSOR SETUP - - - - - - - - - - - - AI.ARM HISTORY REPORT ~--- IN-TANK ALARM T 1 :DIESEL OVERFILL ALARM NOV 20. 2001 7:15 AM MAY 6. 1994 10:26 AM LOW PRODUCT ALARM APR 19. 2000 4:42 PM JAN 2. 1996 S:40 AM NOV 12. 1995 4: 25 P~1 HIGH PRODUCT ALARM NOV 20. 2M 1 7 : I f PI!'1 M~V 6. 1994 10::26 A" I NVAT..ID FUEL LEVEL APR 17. 1994 8:33 AM L 1 :DIESEI.. TANK TF/I-STATE CATEGORV : ANNULAR SPACE I. 2:DIESEL TANK TRI-STATE GATEGQR" : STP SLIMP (, COMMUNICATIONS SETUP - - - - - - - DELIVERV NEEDED NOV 13, 1995 II :37 AM APR 17. 1994 8:38 AM PORT SETTI NOS: NONE FOUND RS-2J2 6ECURIT't' CODE : *~~~þ(* ALA~1 HISTORY REPORT ----- SENSOR ALARM ----- L 1 :DIESEL. TANI<: ANNULAR SPACE F IjEt. ALARM APR 26· 2008 9:22 AM FUEL. AL.ARM APR 28. 2003 9:D8 AM FLIEL. AL.ARM ~~y 7. 2002 12:24 PM RS-232 END OF MESSAGE DlSA~LED OUTPUT RELAY SETUP - - - - - - - - - R 1 :POSITlVE B~lITDOI,o.IN TYPE: STAI'IDARD NORMALLY CLOSED LIQUID SENSOR AtMS L 2:FUEL. ALARM ., , , ALA~1 HISTORV RS~ORT ----- S''s'STEM AL.ARM ----- PAPER OUT MAR 15. 2003 6:00 AM PR I NTER ERROR . MA'l G. 2003 11;40 AI"I BATTERY 16 OFF JAN '1, 1 994 e : 00 A/"! sVS SECURITY WARNING APR 26. 2002 9:~9 AM " , ALARM HISTOR\~ REPORT ----- SENSOR ALAR!"I ----- L 2:DIESEL TANK STP SUMP FUEL ALARM APR 28. 2003 9:09 ~I FUEL ALARM APR 28. 2003 9:09 AM \. FUEL ALARM MAR 17. 2003 2:59 PM 06/04/2003 16:19 661392.1 e PAGE 11/12 LIQUID SENSOR SETUP - - - - - - -- ALARM HISTO~Y REPO~T ---- IN-TANK ALARM T 1 :DI£SEL OVERF I LL ALA~~1 NOV 2D. 2001 7:15 ~1 MAY 6. 1994 10:26 AM LOW PRODUCT ALARM APR 19. 2000 4:42 PM JAN 2. 1996 8:4Q AM NO\J 12" 1995 4: 25 PI"! HIGH PRODUCT ALARM NOV 20. 2001 7:15 AM MAY 6. 1994 10:26 AM INVALID FUEL LEVEL AÞR 17. 1994 e:33 AM L 1 :DIESEL TANK TRI-STATE CATEGORY : ANNULAR SÞACE L 2:DIESEL TANI< TRI-STATE CATEGOR't" : STP BUMP COMMUNICATIONS SETUP - - - - - - - DEL-IVERY NEEL'IED NO\i 13. 1995 11: 37 AM APR 17. 1994 8:38 AM PORT SETT I NGS : NONE FOUND R8-232 SECURITV CODE : )OOOE!lE1'Ii ALARM HISTORY REPORT ----- SE~R ALARM ----- L 1 :DIESEL TANK ANNULAR SPACE FUEL ALARM APR 28. 2003 9:22 ~1 FUEL. ALARM APR ~e. 2003 ~;oa ~1 FUEL ALARM MAY 7. 2002 12:24 PM RS-232 END OF MESSAGE DISABLED OUTPUT RELAV SETUP - - - - - - - - - R 1:POSITIVE SHUTDOWN TYPE: STANDARD NORMAL.L.V CL.OSED LIQUID SENSOR ALMS L 2: FUEL ALARM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 2:DIESEL. TANI< S1"P SlII'1P FUEL ALARM APR 28., 2003 9: 09 AM FUEL ALAR~1 APR 2S. 2003 9:09 AM FUEL ALARM MAR 17. 2003 2:58 PM ALARM HISTORY REPORT ----- S~BTEM ALARM ----- PAPER OUT MAR 15. 200~ 6:00 AM PR I NTBR ERROR ' MAV 6. 2DO~ 11:40 AM BAITER'\' I S OFF JAN 1. 1994 B~OO AM SYS SECU~lTY WARNING APR 26. 2002 9:29 AM I .. " 05/04/2003 14:42 551392.1 PAGE 03/12 e D. Results of Testing/ServiCing I~~·~ Sø1~wn¡,e Vel'Sion Installed: lete the Collowin checklist: Q No" ts the audible alarm 0 erational? Q No'" Is the visual alarm 0 erationul? a No' Were all sensors v\sua.1I û,s ceted, functional! teste and continTled 0 erational? Q No'" Wrcrc £Ill sensors i1\stallcd at towest tx>int of secondary containment and positioned sO tbat other equipment will nor interfere with their ro er 0 ration? If a(aT1)'\$ are relayed to a remote monitoring statiot1, is all comrnUlticatiorls equipment (e.g. madem) operational? For pressurized piping systems, does the turbine f.\utomarical1y shut down if th.e piping secondary containment mcmitoring systcm detects a leak, faits to opcra.J$..-or is elect1'ically disconnected? If yes: which senSOr!! initiute positive shut-down? (Che<:k all that apply) et'""SumplTre.nch Sensors; a Dispenser C,nment Sensors. Did ou COl)firm osltlve shut-down due to Icakg and sensor failure/disconncction? !iY\'e~; Q No. a bf.o* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. nO Gr'N/A mechanical overfill prevention valve i.s installed), is the overfill warning alarm visible and audible at the I'auk fill oint s and 0 eratin rO erl ? rfso, at whaf ercent of tank Ctl tlei does the alarm trig cr? '}'é, Was any monitoring equipment replaced? tt'yes. identity specific sensors, probes, or other equipment replac~d and list the manufacturer name and model for IIU re laccment arts in Section E, below. Was liquid fOlu1d inside any secondary cot1tainment systems designed as dry systems? (Check 01/ thol Clpply) 0 Product: 0 Water, Jf es. describe causes in. Section E, below. 1:1 No· Was mon.itorin s stem sel:·u ]'cviewed to ensure IO er settÎn s? Attach set u y~s [J No'" Is all monitorin e ui ent 0 erational er manufacnlrðr'g s ccifications? * In Section E below, describe how and when these deficiencies were 01' will he corrected. [J Yes Q Y~:;'" DYes'" Q l:IP" Gr""'NI A [J No'" a N/A 'E. Comments:, -.--....' -.......- ..... ... ," ··..···.._u.... ...................".... ----.----... ......, ..... -..-',.,," ..-. ......-..........------. ----- ..... --.--.-.. ..... -_. -_..~._--- .. ,..- ...-.------.... "--"---.. ,.,' .... . "" ".. ,,- ........------. , -......,.. .....-. ," ,.-' -..-- ...--.,--.- -"'"-~'''--' ... - .... -.---.-- --. .....---, ...-.....---- .' --.--...-........- . _w','-- ......-.. ...1...··--·-·· .---.....-.-."" -.. .' ,-- Plalte 1 of 3 031111 05/04/2003 14:42 551392.1 e PAGE 04/12 F. tn-Tank Gauging I SIR Equipment: ~Ck this box. if tank gauging is \Ised only for inventory cClntrol. [J Check this box if no tank gauging or SIR. equipment is installed. This section t\l~t be completed ifin-tank gauging ~quîpmel1t is used to perfOt.,1 .teak detection, monitoring. ¡ , COl1lolete the following: checklist: I o y~s Q No· Has all. input wiring been inspected for proper etltr')' and termination, including tcsting for ground fault!!? o Yes [J No'" Were aU taok gauging probes visually itilspecteð for damage and re"idue buiJdup? , I .~ DYes a No'" Was accuracy of system pr(lduct level readings tested? q Yes o No· Was accuracy of system water Jeve' real:Hngs tested? Q Yes o No· Wert': aU probe~ reinstalled properly? , i [:J Yes CJ No· Were aU items on the equipment manufactlucr'smainten811Cc chec.klist completed? . '" In tbe SectiOtl H, below, des~rlbe how and wben these d~ficiende~ were or will be corrected. G. Line Leak Detectors (LLD): ~1<. thiJ box ifLLDs are not installed, I Çomplete the folJowin!!" checklist: ! "0 Yes 0 No'" For equipment start-up ~r annual equlpme.nt certification, wa~ 0 teak simulated to verify Li.D performanc.e'?'1 o N/A (Check all that tlJ'ply) SImulated leak rlate: t:I 3 g.p.h.; t:I 0.1 g.p,b; t:I 0.2 g.p.h, -2. I . o Yes 0 No· Were all LLDs confirmed oper.ationol and accurate within regulatory requirements? o Yes a No· Was the testing apparat\ls propcrJy caliþrated? Q Y f:!> [J No" For mechanica.l LLDs, does the LLD restrict product flow jf it detects a. Icak? D '"MIA DYes D No· For electronic LJ..JJs, does the tu.rbine Øutorrn¡ticaJry shut off if the LLD detects II Itak? Q N/A I DYes Q No'll For electronic LLDs, docs tIte turbine automatically shut off if any portion of the monitoring system is disabl~d D NlA or discoMected? ¡ D Ycs 0 No· For elec:tro:oic LLDs, dQe.~ the (urbine ~lItomat¡cally shut off if any portion oftlle monitoring system malf\.lnctions [J N/A or fails Ii test? ! ~- o Yes [J No· For electronic Lt.Ds, have all accas.qibfe wiring COnnections been vi.sually inspected? QNM i [J Yes 0 No· Were all items on the eq\lipment manufacturer's maintenance checklist completed? w h1 the SC4.'tion HI below de.Cleribe bow ànd when these deficiencies were or will be cOrrettcd. H. Comments: -..'" __"._~ OM"" _.','-- , _I ¡ ."....--.'.'- .......-_. ._........~...-- 4. I ¡ -----. . ----...... , ---"",I ¡ 1_.. ! , I ~aie 3 ofJ I I -'-- ----'".- OJ/Ill 06/04/2003 14:42 661392.1 e PAGE 05/12 Monitoring System Certification . . . . UST Monitoring Site Plan ~ ë?T.oc,¡.l.þC\-(.£...._~FIe-t-Þ ¿ 9'r3/~ . '5ThvJL' ....-....... .. ~.-.. Site Addtess: __1~ C'?D I :~ T:: :~O~ ~o~ f [J,i : :~O~: . , ~ '1' O· , D' '0' ,t . . . . . , . .. . . . I . :~: tJ ~: i :~ .... r: fb r. ~: ~ O' j 'D' .6.>' t::I:.. :~ ~: :(1) tf¡): œ '.~.~' . \l.VJV\ ~ . s; I . I . . - .. . . . . . . . Date map was drawn: 57 I~ I c::. ~ .-----..-- In5trucUon~ If YO\.l already have a diagram that shows all requited intormation, you may include it> rather. than thís ~ge, with }'\.1l1r Monitoril'g System Certification. On YO~Jr site plan~ show the general layout of tanks and piping. Clearly identitY )ocntiol1s of the following equipment) if il,staJled: monitoring ...ystem control panels; senSOrS moo.i,toring tank Qnn\llar spac.es, slIlnps, dispenser pans, spill containers, Ot other secondary containment areas; mechanical or electroníc line leak det~ct(ll.s; and in~tank liquid level probes (if used for leak detection). In the space provided, note the date this Site: Plan was: pl'epMcd. Page 3... of ~ (I~/UO 06/84/2083 14:42 t'10BIL 1300 1 BTOC~:DA1.E H~" BAK£RSF I EUI C:':-. '''lAY 12, 2003 12: 52 F11 S\.'S1'EI'l S-rf-lTua REPORT - - - - - - _. - - -. ALL FUNCTl ONB N()Rt1AL -- ,-- aENSOR i-\LAR/'1 1. 3: :~7 8TF' SUt1P S1'P suMP FUEL ,.'LARM MA\' 12,· 20D3 1: (11 ft'l -,..,...-- SENSOR AJ...\RI" L I: 87 STP 8U1"1P STP SUMP FUEL A..,\RI"I MAY 12. 2003 1:02 PM .,----- SEI'I::50R Al.ARM - m ...- L 5: DIESEL SrP sur-Ir· alP SU~IP rLJ£L AL¡:.\RM '''lAY t 2. 2008 1: 06 Ýl"1 - .,...-- SENSOR p,LARt'1 L ?:'~ 1 81']) SlJt1~ SiP SUMP F~EL ALARt1 IotA',:' 1 ~ " 20D3 1: 0'1 PI"1 ----'. SENSOR ALARM 1. 8: 91 PiNNIJLot'IR ANNULAR SPACE F Wj;;L ALARt1 I"IAV 1:2, 2003 I: 07 Pt'l 66139211 - - - ~ ~ 131::.1'b'J ~~ !-\j.i-\j.:I"1 L 8; 9 L t-INNlJI_AT< ANNULAR ~3PAGE FUEL ALARI"I I'1AY 12,. 20[13 I: 09 PM ,..,....- SENSOR ALHRJ"1 L 1:1: '511 ANNULAR ANNULAR SPACE FUEL fILAR'''! tiAI{ 12. 200~ 1: l19 Pt1 --.-.-- SENSCoR ALt-IR!'1 L ::1:87 ANNULAP. ANNULAR SPflCE FUEL ALARt'l MAV 12. 2003 I: 11 Pt'l ___.m SENBOR ¡~Lf\RI"I 1. 2:87 ANNULAR ANNULAR SPACE F WEt... ALARt-I ~'lfN 12, :2\:)1')8 1: I 4 PI"I ..,,--- SEN~~()P. ALI-IT<I'1 L 4: 87 ANNULAF: ANNULAR SPACE FUEL PlLARt1 1'1AV 12. 200:3 1: 17 PI"1 BENSOF~ ¡L\LARI'1 L 6:DIESEL ANNULAR ANNULAR SP'Ar.~E FUEl ALARM MAV 12. 200:3 1; 18 P/"I e 110BIL 13QOI STOCKDALE HI.II\-' BAKERSF I El"D (;A MAY 12.2003 1:19 Pt1 BYS'fEM STATU::; REP()~T ... - - - .0 ALL FUNCT IONS NùRI1/U. ALARM HISTORY REPORT ___n S\'STEr1 ALARI'1 .__.n PA~'ER OUT I'1A"i 2. ~D03 :3 : 06 Pt1 PRINTER ERROR MAY 2. 2008 ~:OS PM BATTER\" IS OFF JAN 1. 19':16 8:00 At1 ~ ~ ~ ~ ~ END ~ ~ M * M AU\RI1 H I STORY REPOF~T -..-- It~"TANKALARt1 T 1: 87 SVPf-ŒN TANI~ O~JERF' ILL ALAR/·' FES 23. 200:J 1 :06 H1 HIGH P¡¡~O)UCl ALARI'" APR 17. 2D03 11: 53 At1 FEE 23, 200~ 1 :03 PM rEa I~. 2003 7:45 AM ~ )of * )E )( END :It ~ ~ ~ )E PAGE 06/12 AL.ARM H HnOR~' I~EPOF:T ---- I N-1'ÄNK ALARM T 2: 8'7 REGULAR IJNLF.~~DE[J :dETlIP DATA W¡.<RNl N'~ JAN 9. 2003 1:2: 27 Pt1 O\ÆRF 1 LL AL.A~~1 FEE 2::1. 200:3 I: O~~ P1'1 LOW PRODuCT f'LAR!"l JAI~ -:\.. :200:3 12: 27 1>1'1 HIGH PRODUCT ~LARI'1 HAV :3 " 200J 4 : 1 9 POl"1 FEB 2~:. 2008 1: 04 PM PE8 16. 2ao~ 7:~~ AM * )E ~ ~ ~ END * M * ~ k ALAAt1 HI STOR'i REPORT ---- I N-TÂt~~ ALARM T 3:DIEI3EL M ~ ~ ~ ~ END ~ ~ N ~ ~ 06/04/2003 14:42 ,LAJ-=:11 H 1 ~:,~'''UJ,:'¡ I~EP':'~P.T H__,., IN-TANI,: ALI-IRt'1 ..-.,.. , 4 ~ 91 SUPEH UNLEADIF.D :ETlIf' 0ATA L-.IARN ING . tAN 9. 2003 12:27 PM 1101-1 P?'ÚDUCT ";Lf-IR~1 rAI'~ ~,' 2083 12:2'1 l·'i'I 11-1>< PRODUCT /1l..ARf'1 fAN ':ì. ~a08 1:2; '2'l f'l"l ~ * * ~ ~ END ~ ~ * ~ .. '~U'¡RM H1SrOH'f J~EPOP.1' .. - .. - - SENS(jR ALARt1 L 1: ::I" ST~' SUMP SIP SlR'1P FUEL AI~t1P.M ~~~ 12. 2003 1:02 P~I FUEL AL~RM FEe 24. 2008 S: 1 \ ¡..r-I FUEL ALARI"! FEI3 1'3. 200:~ 6: 12 Pl1 66139211 AtARI1 HI STORV REPOIH -- u.~ SENSOR m.~~RI"¡ L :2:87 ANNULAR ANNULAR SPAGE FUEL ALARM MIW 1 ~ . 2003 1: 1 4 F-I-I FUEL ALAR~1 I'IA'" 12, 2003 1: 11 pr"1 FUEL ALARI"I FEE 24" 200:3 10: 26 ~"1 ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ALAR!'1 HIST01t'..' RElJORT ---~- SEI>J~K'JR ALAR~t L :): 87 6TP SUt1P STP SUI'1P FUEL ALARM MAY 12, 200~~ L :l1\ PI-I e ~iLf;Rt'1 HI ::J'[Ui':,( REPORT ----- SENSOR .qLAR~1 ----- L ::: [ I ESEL STP SUMP STP SUMP' FUEL ALARM MAV12.200:3 I:D6¡:'N M M ~ * . END ~ ~ ~ ~ ~ ALARI"I HISTOF!V REPORT _n_._ BENSÇ)R flLARM I. E,:DIESEL ANNULAR ANNULAR S,'ACE FUEl. ALARI'1 I"!FIY 1:2. 2OfJ:) 1: 1 f3 P~1 SfHo:~!())~ OUT ALAHM JAN 25. 2003 11 :58 AM SETUP DATA WARNING JAN 25. 2003 11 :49 AM ~ ~ ~ ~ ~ END w ~ ~ M ~ ~ ~ M ~ ~ END ~ ~ ~ ~ ~ ALARM HI STOF:V REPORT ---~- SENSOr. ALARM 1.. 4:87 ANNULAR ANNUL.AR SPACE * ¡( !I( ;¡: " END ... ... ~ ¡oj ~ FUEl. ALARM MAY 12. ;200:~ 1: 17 Pt1 ~ ~ ~ ~ * END ~ ~ * ~ ALI-IRt' H J STORV REPORT ----- SENSOR ALARM L 7: 91 STP SIJI'1P STP aUt1P FUEL ALARr'1 MAV 12. 2003 L: 07 PI"I ~ ~ ~ ~ M END ~ * * * ~ PAGE 07/12 rU.ARMH I ST'JR"," REPORT .. ..,- -.. SENSOR I-ILARr'1 L a:91 ANNULAR ANNULAR SPACE fUEL ALARI"1 MAY 12" ¡WOO 1 :09 PM fUEL ALAR,., MAY 12,- 2003 I: 09 PI'1 FUEL ALAR'"' MAY 12" 2003 J: fJ7 PM ~ ~ ~ ~ ~ END ~ ~ M ~ ~ ALARM HI STOFlV REF:'vR1' -~- -- SENSOP. PoL¡:;~11 L 9: '>TI£1': SENSORS¡ * ~ ~ ~ ~ END ~ ~ ~ ~ ~ ALARM HISTORY REPORT ..---- SENSOR ALARI'1 9 1: OTHER SENSORS * * ~ ~ ~ END ~ ~ ~ ~ ~ 06/04/2003 14:42 ALAR,.., YiIBT(:oRV REPORT 8E:NÐOR ALAJ~~1 >! 2: OTHER SENSORS ~ ~ * ~ * END ~ ~ ~ *. Al.i\f:M HISTOJ?I RE¡'üRT SEI<JSOR f.ILAR/"1 9 3: OTHER SENf,K.i~ * ~ * ~ M END ~ M ~ M ALHRt'l HI STOR'!" REPoRT SENSOR AU~Rr1 !II .; OTHER SENSORS ~ ~ ~ ~ ~ ~ND ~ ~ ~ ~ 661392.1 ¡'\J.J%J<'" Hl::¡ Hi/';'¥' ¡.;I:..."()j,; L ---- PRÜDLK:1' r1LARi"1 F 1 :87 SYPHEN TANK ;,¡ :of * ¡o. ~ ENr.1 * ,. ill "" ~L.AR/"I HI STOR't' RE!P<JRT J:'RODLlCT HLARr1 F 2: 8'1 SVPJoiEN 'r~I<JK e SENSOR ALARM t. 1: 87 STP sur1P BTP SUMP FUEL ALARM FES 2<1,. 200:J 8: 11 ¡.~t1 F'IJF1. ALARM FEE ) 9, 200:3 6: 12 J::.1'1 FUEL ALARM FEB 19" 2008 b: 11 PI"! ~ iIE * ~ * END ~ ~ ~ ~ ~ AL~~ HISTORY REPO~T .,--- - SENSOR MLARI"I L :2:197 ANNULAR !Ii !II\ II, lot !IE ENt' ~ '.. ~;o. ANNULAR SPACE FUEL ALAR!'" F£B 24. 2003 10:26 AM ALARM HISTORV REPORT PRODUCT ALAR!"I -. F 3:e7 SVPHEN TANI< ~ " ~ ~ * END ~ ~ ~ ~ f;LAJ~J'1 HI STOR'>' p.E:P{i)~l' ---- PRODUCT ALAI~r1 ,F 4 :8'7 SVP¡.¡EN TANI<: FUEL AJ~ARM FES 24. 2003 10:25 AM FUEL. AL",RM FEE 24" 2003 10: 25 AM * * ~ ~ * END * ~ ~ * ~ f.\LARt1 H.I:~1'úRV P.EPORT -"...... SENS(>R ALARI"! L 3: S7 STP BUI1P ST p SUI"IP ~ ~ M ~ . END ~ * ~ ~ ~ PAGE 08/12 M¡,.t"1~I·1 n!.o;:..1tJJl::L" JIt~l-""JM: I 6£NSOR ALARI'1 L 4:87 ANNULAR ANNULAR SPf\L:E " . ~ ~ * END ~ ~ ~ ~ ~ ALAR!"I HI STORY REPORT ----- SENMR ALARt1 -...."-.. L 5:DIESE~ ST~ S~1P STP SUMP ~ ~ ~ ~ ~ END ~ ~ ~ ~ *, AUiRM H ¡STORY REf'OHT ,..----. SENSOR ALARM 1. 6 :DIESEL "'NNULA~ ANNUL..~R SPACE SENSOR OUT ALARI1 JAN 25,. 2003 1] :58 AM SETUP DA'I'~ WARNING JAN 25. 2003 11 :49 AM SETUP bATA W¡::,RN) NG JAN 25,. 2003 11: 46 ÞJ'I ~ * ~ W ~ Er~D ~ ~ ~ ~ * 06/04/2003 14:42 {~l.ARr'1 HI 8TÜRY REPC>RT ..'.,- -- SENSOR ALARM L 7: ~ 1 S'tF- SIJI"IP S'fP BUMf> M ~ M ~ ~ END . ~ ~ ~ AL.ARM H I STORY REPOJ;;:T -__'-0' SENSOR ALARI1 L 8: 9 \ f';NNUl.A:Fc ANNULAR SMCE ~ ~ * ~ M END ~ ~ ~ * AL/~RM HH:ìTOJ;(y' REF'Ü~1' ··.no__ SENSOR i1LriJ'!I'1 L 9: ' OTHER SENSORB ~ ~ ~ ~ M END ~ ~ * ~ 66139211 (')Lî1l1t1 H r sn)RY REF'úRT ----- SBNSOR 1'~L,1.¡Rr1 LIO: OTf¡ER BENSORB ~ JoE It. iof ¡oE END ;.( ~ ¡., '" ;. ALARM HISTORY REF-ORT SENSOR ¡,LARi1 L11 : c)'l'HER SENSORS ~ ~ * * ~ END * ~ ~ ~ j ALARM H T BT(»'''¡Y REPORT ----- SENSOR ALMRM 112: OTHER SENSORS . ~ ~ ~ * END " ~ ~ ~ ,ALARM oj ¡ STORY ~F.PoRT SENSOR ALARf"1 LtG: OT14ER SENSOR::! e '~1J-\RM H I 8T¡J~V REPORT ---.-- SENSOR ALARM l¡rJ: OTKER BENSOR~:::~ .. ~ X ~ ~ EI'Jf.J ,>( ¡o; )( .!IE * AUlRlol HISTCR"l REPORT --- - - SENSO'1 ALARM L15: OTHER SEIf.30RS ~ * ~ * ~ EtW ~ ~ * ~ ~ ALA?~ HISTORY REPORT -- ..'0... SENSOR ~~LAR"'I L16: ò1'HER SENSORS . . ~ ~ ~ END ~ ~ * ~ ~ PAGE 09/12 ¡:''l~ I ~I·I n~ I LIP I"IAY 1 2 . 2003 1: 23 Pf'1 SVSTEM UI;¡ TS U.S. SVSTEI"I ~.ANGUAGE Et,GLI SH SYõ"fEM DRTS.--r II'1E FOF:r1AT /"1<> N DD y,;,VV HH: "11"1 : Sf:¡ "M 1'10B!L. I :)tJOl S-rOCKDALE HI.\I': BAIŒRSF ¡ ELD CA ~~HIFr TIME 1 SHIFT TII"IE 2 SHJ FT TIM£ :) SHIFT TIME 4 DISABLED DISABLED DISABLED DISRBLED TANK P:ER 1'ST NEEDEr) l'JRN DISABLED TANK ANN TST NE1:."'DED ~.iJ~N tJtSABLED liNE RE-ENABLE METHOD PASS LI ~JE TEST 1.1 NE PER TS'1' NEr:DED \.JRN DISABLED LINE ANN TS'I' NEEDED WRN DISABLED PRINT TC VOLUMES ENABUID TEt1P COMPENSAT ION \.I¡:,LUE <DEI':: F j: 60.0 8T 1 OK HE 1 mn OFFSET DISABLED DAI.i1.IGHT SAVING Tlt1E v IaABLED S'fSTJ:;~'1 SEOUR 1 TV CODE : 000000 CUSTOM I-\LARM LABEI~S DISABLED cm'lMUNICATIONS SETUP - - - - - - - - - ~. }.'I)f(f SETTJ NGS: NOlliE FOUND RS-232 END OF f"læSAGE ., DISABLED 06/04/2003 14:42 'oj-TAN!·: 8EI'W' - ... ... - .." 1 : 8'1 S·~PHF.N ,'AI'IK ~ODlJÇl' ÇODE : 1 -IERI'1AL (~OEFF : . OOfJ'¡' 00 -'\r,IX DIAr1ETER ~t,.OO ~NK PROFILE I p'f PULL VOL 10000 LOAT ~3 [ZE : 4 . 0 IN. 'iTER WARNING : 2.0 IGH \¡,IATER Lll"lIT: 3.0 P¡)< OR LHBEL \IOL: 10000 \/ERF I U. t-11111 95-~ 9600 IGH PRODUCT 907' 9000 ELI \/ER't [. m IT 1 5% 1500 OW P~òDUCT : LOOO EAK ALARM LI!"I!']': 99 UDDEN 1..0SS L I f11 T : 99 ANK TILT 0.00 RoaE OFFSET 0 . 00 1 Pt~ON I"lflN I fOUJEt) TAI~.J2. II: NOI'J:E I NE Mfo'N I FOt-DED TANKS UJ NONE EAK MIN r:'ERIODIC: 011& o EAK MI N ANNUAL O~( o 'ERWDIC TEST TYPE STAN[lARD ,NNUAL TEST F':\I L ALARI" D ISABr.ED 'ERIODIC TEST FAIL A1.;~RI'I D I SAeLED ;ROSS TEST FAIL ALARt1 D I SFlBLED INN TFoST A"jERAG I Nr..... : OJ."F 'ER TEST AVERAG I NO : OFF 'ANK TEßT M,:rf I FY : OFF 'NK TS1' SIF-HON BREt\ICOFF IELHiER'1 DELAV : 5 '11 N 'Ut1P THJ1EßH(.ILD: I (i, no% 661392.1 T 2: 87 REG\JLAP- PRODœr QODE THERMML COEFF T~NK DIAME:TER TANK PROPU.E FULL V':>L 1J1~r...F::~E) . " . ... : .000700 9G . GO 1 PT lOOOO FLOAT SIZE: IAIATER WAT~NI N(.~ : ti l(;H ('IA'rSR L I M IT : !'lAX OR L.ABEL \,jOL: OVERF I LL 1. ¡¡"lIT HIGH ¡:'Ror.UCT DELI VJ::R'{ LII'1IT '1.0 IN. 2.0 ~.CI lOOOu ~5~' 9600 90~~ SlDOO 15% 1500 LOW ~RöUUCT : !ùOO LEAK ALA~t1 LI rlI T : '39 BUDDEN LOSS LIMIT: 99 TANK TI LT I). OQ ~ROEE OFFSET 0.00 SIPHON MANlP<')W!:D TANKS T#: NONE LINE MANIFOLDED TANKS T#: NONS LEAK ~II N PE1~ 10D 1(; : a};; o LEAK r11 N ANNUAL 0% JJ PERIODIC TI:."S'f TYPE í?lTANDAP.D ANNUAL TEST J:A r 1. ALARt1 Ii I SABLED PERIODIC TEST FAIL ALA:n'M DISABLED GROSS TEST FAIL ALMRMflI SAI¡U..ED ANN, TEST AVERAGING: OFF PER TEBT AVERAG I NG : OFF TANK TEST NOT I FV : OFF TNK TST SI¡:'HOI~ BI':J::AK :Of:F DELIVERY DELA'! : 5 MI'" PUI'1P THRESHOLD : 10. OOÞ, e T :] : 1:1 1I::6£L PRODUCT CODE 'rHERr1AL COEFF Tf;NK DIAMETER TANK PROFILE FUl.L VOL. : 3 : . 0l)ú4~O ~}fi . 00 I PT 10iJOO FLOAT srz£: 4. (I IN, WATER WARNING : HIGH WATER Ll~1IT: MAX OR LABEL VOL: OI/ERPll.L LH1JT : IlJOOD 95;"~ ~50f) 90:~'. 9000 15Y. 1500 1000 99 99 0.00 0.00 HIGH PRODUC)T P£LrVJ::R't' LIMIT LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT PROI3E OFFSET SIPHON MANIFOLDED TANKS T#: NONE LINë I"IANIFOLDED TANKS TIt: NONE LEAK MIN PERIODIC: LEAK MIN ANNUAL PERIODIC TEST TYPE ST"~NDARD ANNUAL TE;S1' FA] L ALARI"I D I BAStED PERIODIC TEST FAIL ALARM DISABLED CROSS TEST FAIL AI. ARM DISAEl.ED ANN TEST AVERAGING: OFF ÞER TEST A\JER~(; 1 Nt..~ : OFF TANK TEST NOT I F'i : OFf' TNK TST SIPHON aR£AI<:ÖFF ~ELIV£RY D£LAV : 5 MIN PUMP THRESHOLD : IO.orn, PAGE 10/12 T 4: 91 SUF-ER UNLE~\rlED PROttUC'T CODE THERMAL COEf"P TANK [II AMETEJi? THNK PROFILE FULL VOL : .0007C 96.( 1 F looe FLOAT SIZE: 4.lJ II'- ~,O 3.0 2. 3. ¡',IATlo."H WARNING : ~ICH WATE~ LIMIT; !"IAX OR 1..ABEL VOL.: OVERFILL LIMiT HIGH PROIlUCT DEL I VERI{ LIl-li 'T lODe 95 950 ~CJ 900 15 150 LOW PRODUCT ; 1 00 LEAK ALARM LI~I¡1·~ <;:i SUDDEN LùSB Lll-IIT: 9 TANI\ TILT 0.0 PROBE OFFSET 0.0 SIPHON MANIFOLDED TflNKB 111: NONE LINE MANIFOLDED Tr~NKS 111: NONE o~, o LEAK MIN ~ERIODIC: a 0% o L.EAK t11 N ANNUAL . 0: PERIODIC TEST T\'ÿf; STANrlAR ANNUAL TEST FAJL ALARM D I SABI.E: PEP-I0DIC TEST FAil ALARM D I SABLE} GROSS 1'£81' FA I L FlLAAM D I SHBLEI ANN TEST AVERAG I NG : OFI PER TEST AVERAG I NG : Of¡ TANK TEST NO'!' [ FY : OF! TNI' T6T SIPHON BREHI< :OFJ DEL I \fER\' DELAY' : 5 MIl PUMP THRESHOLD : 10 . O(I~ 06/04/2003 14:42 661392.1 e PAGE 11/12 LEI'\K '1"1;:6T "IETHOD - - - - - - - - - - - .. TEST ON DATE : ALL TAN( JAN L 1 996 6TART TH1E : D[SI~BLED 158T RATE :0.20 GAL/HR DURATION ; 2 HOURS TST E~RLY STOÞ:DtSABLED LþAY. TEST REPORT FORMAT NORMAL OUTPUT RELAV (iETUP --.---... R 1 :87 STP RELA~ TYPE: STANDARD NORMALL,( l':L.OSED L[(jLJH) SEN::;¡OR ALI"IS L 1 :FUEL AlAR~1 L 2: FUEL AI.ARM L J: HIEL HL.ARM L 4:FUEL ALARM R :2: 91 ST~ RELA"t' 1'\'PE : C''r^..,n^nT'\ 'i "/\.v MONIT.ING SYSTEM CERTIFATION <.,......0/ ,For Use By All Jur~sdictions Within the,S:G,te ofC~liforniG, " . , / Aurhoriry Cired: Chopær 6.7, Health and Safety Code; Chapter 16, DIvIsIOn 3, Tille 23, CalijornIa Code of RegulatIOns This l' o I'm must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for èach monitoring system control panel by the technician who performs the work, A copy of this form must be provided to the t<mk SYSlèlll owner/operaror. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test dare. A. Generallnformation Facility Name: OeÆ.v(/¡£ ß,EL r S PfC7S S Sire Address:.1Cé'Q V. SILL£"LT AvE Fac ¡¡ity Comact Person: Makc/lvlodd of Monitoring System: W~¿ 0 è þV'¡ <- B. Inventory of Equipment Tested/Certified (J¡èd; rhe ,,) 1'0 riate boxes to indicate s ccilic c ui ment ins )ectcd/serviccd: City: If.;f¡::£lZSrl,ëJ. D Bldg. No,:_,,___,_____ Zip: ___,_____ Contact Phone No,: ( .1_______..___, Date of Testing/Servicing: ,5.JÝ_/ OJ I Tank 10: __0 1E.~1.. ~ in-Lm1\. Gauging Probè. Model: MdW___ 1ií1 '\.~H1ular Space or Vault Sensor. Model: ~ DutJ.e+ II~~~ ~ Piping Sump / Tænch Sensorls), Model: ?¿:?'í( o Fdl Sump Sensorls), Model: o !\kch,u1ical Line Lëak Dëtector. Model: o Flèctronic Line Lèal Dèlec[or. Model: o Tank Overtìll ( High-Level Sensor. Model: ,.. o O!hè~' (S ecil" Cl ui ment t' e and modë\ in Section E on Pa e 2), Tank ID: o In-Tank Gauging Probe, Model: o ,i\nnular SpaCë or Vault Sensor. Mockl: o Piping Sump ¡ Trënch Sensor(s). Model: o Fill Sump Sensorls), ModeJ: o ,!\kcttdnir.:al Line Leak Detector. Model: o Ekctronic LifJe Leak Dètector. Modè!: o Tank OvertÌ1J i High-Level Sensor. Madej: o Other s ecify ec ui ment ty e and modd in Section Eon Paè 2). Dispenser lD: '0 Õ L. .J}J Dispensa Containment Sensor(s). Model: ~_. Sl1t',lr Valve(s), o Dispènsèl' Conrainmèn[ Float(s) and Chain(s), DispenserID: o Dispenser Containment Sensor(s). Model: o She'lrVabe(s). o Djs~n~èf COl1lainl11ent Floar(s) and Chain(s), Dispenser ID: o Disp.:nser Containment Sènsor(s), Model: o Sl1tar VaJw(s), ~ ,gDiS£.ènser COJm¡jnmenr FJoar(s) and Chain(s), 'lfthè tacdily contains more tanks or dispensèrs, copy this form, Tank ID: o In· Tank Gauging Probe, Model: ._____,____".. , o Annulill' Space or Vault Sensor. Model: -------,_., ,,-, o Piping Sump ¡ Trench Sensor(s). Modd: o Fill Sump Sensor(s). Modè/: o Mechanical Line Leak Detector. Model: o Electronic Line Leak Detector, Model: _,_,____,_,_, o Tank Overfill / High·LeveJ Sensor. Model: __.___,,____ o Other (s ecif' e ui ment t e and mode! in Secrion E on p¡¡~t> :2). Tank ID: o In-Tank Gauging Probe. Model: o Annular Space or Vault Sensor. Model: o Piping Sump ¡ Trench Sensor(s), Model: ______ o Fill Sump Sensor(s), Model: _________.,.__ o Mechanical Line Leak Detector. ¡vlodel: o Electronic LifJe Leak Detector. Mode!: o Tank Overtìll / High-Level Sensor. Model: o Other (s ecify e ui ment tv è and model in Section Eon Pa e 2), _.~_._-~---- ____h__m___, _ ----- Dispenser ID: o Dispenser Containment Sènsor(s), Model: o Shear Valve(s). o Dis eoser Containment Float(s) and Chain(s). Dispenser lD: o Dispenser Containment Sensor(s), Model: ______,_.._..___ o Shear Valve(s). o Dis enser ConlaifJlllent Float(s) and Chain s), Dispenser ID: o Dispenser Containment Sensor(s). Model: ~_c____~,__,__ o Shear Valve(s). o Dis enser Containment FJoat(s) and Chain(s). 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 Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, l hav{' also attached a copy of the re¡:JOrt; (check alllhal apply): orSystem set-up ¡arm histor report T\;clmician Name (print): r¿ t.f't/ M~~ Signature: ~ ~---,'-....- Cenitlcmion No,: 5Í/l r - 7.5 - i-'ðé) C61/D40- #809850 - TesÜngCompallyName: RICH ENVIRONMENTAL PhoneNo.:(661_) 392-8687 Sire Address: 3v'lt) ,,() .5/1 L£tT Avr, fJ4-"E.~Sr/J5l.£1 t~ Date of Testing/Servicing: ., s:ll£.J~, Page 1 of3 OJ/O! MonilOring System Certification f D. Results of Testing/Servicing e Softllart: Version Installed: -fp. 0 / Com pie£<: the folio winO" checklist; r- ø Yes' 0 No* Is the audible alarm 0 erational? f» Ú·5 0 No* Is the visual alarm 0 erational? ~;\;~s 0 No* Were all sensors vlsuall ins ected, functionally tested, and confirmed 0 erational? Yè,S 0 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their 1'0 er 0 eration? No* If alarms are relayed to a remote monitoring station, is all communications equipment (e,g. modem) N/A operational? For pressw'ized piping systems, does the turbine automatically shut down if the piping secondary containmenr monitoring system detects a leak, fails to operate, ot is electTically discormected? If yes: which sensors initiare posiÜve shut-down? (Check all rhm apply) ,!iT Sump/Trench Sensors; 0 Dispenser Containment Sensors, Did 'ou confirm ositive slmt-down due to leaks and sensor failure/disconnection? Yes; 0 No, For tank systems that utilize the monitoring system as the primary tank: overfill warning device (i,e. no mechanical overtill prevention valve is installed), is the overfill warning alarm visible and audible at [he rank tìll oint(s) and 0 eratino JfO erly? If so, at what ercent of tank ca acit does the alarm triu~èr? % Was any monitoring equipment replaced? If yes, identifY specific sensors, probes, or other equipment replact;'d and list the manutàcturer name and model for all re Jacement arts in Section E, below. Was liquid fOlmd inside any secondary contaiIll11ent systems designed as dry systems? (Check all rhm app(1:! 0 Product; 0 Water. If es, describe causes in Section E, below, ~ \;~s 0 No* Was monitorín s stem set-u reviewed to ensme ro er sertinos? Artach set l1 Þ!I \:\'$ 0 No* Is all monitoring e ui ment 0 erational er manufacturer's s eciticatiol1s? " in Srction E below, describe how and when these ddiciencies were or wilJ be corrected. o \: es o ~ o No* o N/A ~ Yes DYes o No* ø N/A _. o Yes* ~No o Yes* ¡g; No E. Comments: .."-.-- ~- ----- -----.----~. ----".-.---.--.. . .._---.._-~~---~ . - -. .----.----- .----.--.--.-----.-..---, .-.---.....-- ..+----- . _ n____.'__ _.______._._____ ..-.,..--.-.-.--.------... e ------.----....---. ----.-_.~_.- ------~---_.- -----.-,--,.. --"----...-----.-" -_.-----.--_._---- .'- -_.~----,--~._._-- _.__u._.__.__. .__. .______n. _. --------,_._---~._-----_.__.._. .__.._m_____.__.__ ---------~_.._~---, .- .--'-,~... . ..-'--.- ---- ----,.-. ..'--_.__..-,-_._-- ...-.------ -.,-..--.----..--. --_._--_.~- ----- . -------.-,.----- ----_.._--_.~-_.-._-- -~----_._--------.- .----...--,..---.--------- P9ge 2 of .3 (13/(1 ( 1 e F. In-Tank Gauging / SIR Equipment: e ~ 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 seclÌon Hlllst be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: . 0 Yes 0 No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? 1-, 10 YèS 0 No* Were aJl tanJe gauging probes visually inspected for damage and residue buildup? ~" 0 No* Was accuracy of system prodLlct level readings tested? o 'res 0 No* Was accuracy of system water level readings tested? o \\, s 0 No* Were all probes reinstalled properly? o YèS 0 No* Were aJl items on the equipment manufacturer's maintenance check]ist completed? * In lhe Section H, below, describe how and when these detïciencies were or will be corrected. G. Line Leak Detectors (LLD): ~ Check this box if LLDs are not installed, c f II I r OllllJlete tIe 0 OWIng C lec ( 1st: DYes 0 No* For equipment start-up or annual equipment certitìcatìon, was a leak simulated to verity LLD performance'~ 0 N/A (Check all that appl}~ Simulated leak rate: o 3 g.p.h.; 00.1 g.p.h ; o 0.2 g.p,h. 0 Yes 0 No* Were all LLDs confinned operational and accurate within regulatory requirements? 0 Yes 0 No* Was tl1e testing apparatLls properly calibrated? 0 Yes 0 No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 0 N/A 0 Y.:s 0 No* For electronic LLD5>, does the turbine automatically shut off if the LLD detects a leak? 0 N/A 0 Yes 0 No* For elecu'onic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled 0 N/A or disconnected? 0 Yes 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions 0 N/A or fails a test? 0 Yes 0 No" For elecrronic LLDs, have all accessible wiring cOlmections been visually inspected? 0 N/A 0 Yes 0 No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and w hen these deficiencies were or will be corrected. H. Comments: ------ ..__.--~-.-- .----.---.-.-....---.-. ---.--.-.------- -- ._______.....u._ -------.- . n__"_'_'_ ---------.---..--. --.-"._-- ._------~----_._._. __. ·__._______.n -------..-- .____._____n__ n_.____._____._._._...___~_._~_ ------".---...... -~,---~- "-"'--"--._-'~-'-'- Page 3 on 03/01 e e IHoilÌlorillg System Certification Sin: Address: _.'1~() ÆJ. UBT lVfonitoring Site Plan i I L L. ~G T Avs Ui<;F /2..~ rIEL. Q (",f -_._~.._.,-- -- . , 'psc : lõ'. ,ci 6- . , , '¥ . , <:0, ,~, ' , ~, .~.B' ,/_. ~~, [:J ~~:L.: . . . . :0]: : , f"J L.. L. : '{bU S: ~O~t . . . . . . . . . ·s Î-j~)n· , . 'þ(fC/' y. , . ....... --- . ,,' f /l./.. :~JLLT:( T: :;4:f/:t: -.-............ , . Date map was drawn: S / ~/.Qj, Instructions If YUlJ already have a diagram that shows a]] required information, you may include it, rather than this page, with YOllr l'v1ünÌlürlng System Certification. On your site plan, show the general layout of tanks and piping, Clearly idel1lify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annu tar spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak deTècrors; and in-rank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page ~ of---'::L (lS/UU _S'~'OFTkIARE RE\/ISION LEVEL iERBION 6,01 SOFTWARErt 612760-006-B CREATED - 94.02.20.15.19 NO BOFTt.,JARE f"10DULE ----- SENSOJ;;' ALAR!"! L 2: DIESEL TA NK ST]::' SUf"lP FUEL ALARf<'1 ¡"lAV 6. 200:::: 12: 00 H'I S\'STH'l SETUP MAV 6. 2003 11:42 AM ORANGE BELT STAGES :3640 S I LLECT AVE BAKERSFIELD. CA SV:::3TEf"1 UN I TS U_S. SVSTEf"1 LANGUAGE ENGLI SH ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA MAY 6. 2003 12:01 PM St"STEI"! STATUS REPORT - - - - - ALL FUNCT IONS NORf<'lAL SHIFT TI[<'lE SHIFT TIt"lE 2 SHIFT TI[<'IE 3 6:00 At"l DISABLED DISABLED ----- SENSOR ALAR!"1 L 1 :DIESEL TANK ANNULAR SPACE FUEL ALARf<'l MAY 6. 2003 12:02 PM PER I OD I C TEST klARN I NGS DISABLED ANNUAL TEST t.,IARN I NGB DISABLED S\lSTH'l SECUR I TV CODE : 123456 ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA Sl"~3TEI"1 SETUP MAl" 6. 2003 11 :42 AM MAY [. 2003 12:03 PM SYt:;TEI"l UN I TS U.S. S'y'STEI"l LANGUAGE ENGLI SH ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA SYt:;TEI"l t:;TATUS REPORT - - - - - - - - - - - - ALL FUNCTI ONS NORf<'lAL SHIFT TIME 6:00 AM SHIFT TIf<'lE 2 DISABLED SH I FT T I 1"1£ 3 DISABLED . PEF:IODIC TEST klARNI NGS DISABLED ANNUAL TEST klARN I NGS DISABLED SVSTH'1 SECURIT'l CODE : 123456 e IN-TANK SETUP - - - - T 1 :DIESEL PRODUCT CODE THER!"1AL COEFF TANK D I At"1£TER TANK PROFILE FULL VOL 1 .000450 95.00 1 PT 11783 FLOAT SIZE: 4.0 INCHES klATER klARN I NG : 2.0 HIGH WATER LIMIT: 2.0 MAX OR LABEL VOL: OVERFILL Llf<'IIT HIGH PRODUCT DELIVERV LIMIT 11783 95~\~ 11193 95% 11193 5~\: 589 LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT MANIFOLDED TANKS Trt: NONE PERIODIC TEST TVPE STANDARD 1000 99 99 0.00 PERIODIC TEST FAIL ALARf<'1 DISABLED GROSS TEST FAIL ALAR["I DISABLED PER TEST AVERAGING: OFF TANK TEST NOTIFV: OFF TNK 1ST SIPHON BREAK:OFF DEL I \/EF':Y DELAY 1 [''II N LEAK TEST ["JET HOD - - - - - - - - - - TEST ANNUALL Il: ALL TANK JAN WEEK 2 SUN START T I ("1£ : 12: 00 Af"J TEST RATE : 0 . 20 GAL·, H;: DURATION : 6 HOURS ----- SENSOR ALARf"1 L 2:DIESEL TANK STP SUf"1P FUEL ALARf"! MAY 6. 2003 12:00 PM ':;:'RANGE BELT STAGES :"~640 SILLECT AVE BAKEJ;¡SF I ELD. CA MAY 6. 2003 12:01 PM S'iSTEr"l STATUE; REPORT - ~ - - ALL F U NCT IONS NO Rt"lAL ----- SENf;OR ALARH L 1 :DIESEL TANK ANNULAR SPACE FUEL ALARr"1 f"lA',l 6. 2003 12: 02 N'I 0BANGE BELT STAGES 3b40 SILLECT AVE BAKERSFIELD. CA f"lAI;,;" (.. 2003 12: 03 ;"1"1 E;''l~3TEt''l STATUS' REPORT - - - - - - - - - - - - ALL FUNCT IONS NORf"lAL _SOFTl"IARE REVISION LEVEL IERSION 6.01 00FTWARE~ 612760-006-B CREATED - 94.02.20.15.19 NO SOFTWARE MODULE SY:3TEr"1 SET UP MAY 6.2003 11:42 AM S'lSTEr"1 UN ITS U.S. SVSTEr") LANGUAGE ENGL I t:H ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA SH I FT T Ii"1E SHIFT Tlr\'lE 2 SHIFT TIME 3 6:00 At"1 DISABLED DISABLED PERIODIC TEST klARNINGS DISABLED ANNUAL TEST WARNINGS DISABLED S'iSTEr"l SECUR ITV CODE : 123456 S'lSTEi"1 SET UP (vIA'y' 6.. 2003 11: 42 A~'1 S'iSTEr"1 UN ITS U.S. S\'STEf"l LANGUAGE ENGLISH ORANGE BELT STAGES 3640 SILLECT AVE, BAKERSF I ELD " CA SHIFT TIME ~3H 1FT T I!"lE 2 SHIFT TH'lE 3 6:00 At"1 DISABLED DISABLED PER I OD I C TEST Lo.lARN I t~GS DISABLED ANNUAL TEST l.JARNI NGS DISABLED S'iSTEr"1 SECURITY CODE : 123456 e IN-TANK fŒTUP - - - - T 1 :DIESEL PRODUCT CODE THERt"1AL COEFF TANK DIAr"JETER TANK PROFILE FULL VOL 1 : . 000450 : 95.00 1 PT 11783 FLOAT SIZE: 4.0 INCHES LJATER LJARN r NG : 2.0 HIGH WATER LIMIT: 2.0 ~lAX OR LABEL VOL: O\/ERF I LL L I ~'1 I T HIGH PRODUCT DELI VERY L I~'11 T 11783 95~'~ 11193 95j~~ 11193 5% 589 LOki PRODUCT : 1 000 LEAK ALARH LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0.00 ~'IAN I FOLDED TANKS H: NONE PERIODIC TEST TYPE STANDARD PERIODIC TEST FAIL ALAR~'l DISABLED GROSS TEST FAIL ALARr"1 DISABLED PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELA'''' 1 t"II N LEAK TEßT ~lETHOD ------ TEST ANNUALL''l: ALL TANK JAN WEEK 2 SUN START T I f"1E : 12: 00 AP'l TÐ3T RATE : O. 20 GAL,"HR DURATION : 6 HOURS -. - - - - - :::;E NSO R ALAR~'l L 2:DIESEL TANK STF' SUt"\F' FUEL ALARr"l MAY 6. 2003 12:00 PM ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA MAY 6. 2003 12:01 PM S'y'STEf"l tHATUE:: .FŒPORT ------ ALL FUNCTIONS NOR~'lAL - - - - - SE NSO R ALARf"l L 1: DIESEL TA NY ANNULAR SPACE . FUEL ALARr"l MAY 6. 2003 12:02 PM qf;ANGE BELT STAGES Jb40 SILLECT AVE BAKERSFIELD. CA MAY (. 2003 12:03 PM SV~3TEf"\ STATUS REPORT ------ ALL F U NCT IONS NO R~'lAL _SOFTkIARE REV I SI ON LE\lEL iERS I Of'j 6. D1 30FTWAREU 612760-006-8 CREATED - 94.02.20.15.19 NO SOFTWARE MODULE S\l~3TEf"1 SETUP 1"Wl 6. 2003 11: 42 At"1 S"iSTEr"' UN ITS U.S. S"iSTEr'" LANGUAGE ENGLISH ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA SHIFT TIME 1 6:00 AM SH I FT T It"l£ 2 DISABLED SHIFT TIME 3 DISABLED PERIODIC TEST l.JF\RNINGS D I \2,ABLED ANNUAL TEST l,~ARt~I NGS DISABLED S"iSTEt"1 SECUR I TV CODE : 123456 SVEHH'I SET UP \"IA\{ 6. 2003 11: 42 A~'l ::;:'¡:"STEM UN I TS U.S. SVSTEI"I LANGUAGE ENGLISH ORANGE BELT STAGES 3640 S I LLECT A\!E BAKERSF I ELD " CA SH I FT T If"1E 6 : 00 At"1 S HI FT Tl ["1£ 2 DISABLED ~3HIFT TH'1E 3 DISABLED I>ER I OD I C TEST ~~ARN I NGS DISABLED - ANNUAL TEST ~~ARN I NG:=ì DISABLED S'iSTE!"1 SECUR I TY CODE : 123456 e IN-TANK SETUP ------ T 1 :DIESEL PRODUCT CODE THER~'lAL COEFF TANK D I Ar"1ETER TANK PROFILE FULL VOL 1 : . 000450 : 95.00 1 PT 11783 FLOAT SIZE: 4.0 INCHES WATER WARNING : 2.0 HIGH WATER LIMIT: 2.0 MAX OR LABEL VOL: Ov'ERF I LL LI 1"1 IT HIGH PRODUCT 117B3 95% 11193 95% 11193 5% 589 DEL I \iER"¡:" L I t"1 I T 1000 99 99 0.00 Lm~ PRODUCT : LEAK ALARf"l L I 1"1 IT: SUDDEN LOSS LI 1"1 IT: TANK TILT ~'lAN I FOLDED TANKS TU: NONE PERIODIC TEST TYPE STANDARD PERIODIC TEST FAIL ALARl"l DISABLED GROSS TEST FAIL ALARI"I DISABLED PER TEST AVERAGING: OFF TANK TEST NOT! F'{ : OFF TNK TST SIPHON BREAK:OFF DEL I \.lERY' DELAY' 1 ~'1 IN LEAK TEST METHOD ------ - - - - TEST ANNUALLY': ALL TANK JAN WEEK 2 SUN START T !t"IE : 1 2 : 00 A~'1 TE3T RATE :0.20 GAL./HR DURATION : 6 HOURS '- e LI OU lD SENSCR SE'- ------ ALARr'l H I ~3TOR\" F:EPORT L 1 :DIESEL TANK TVI-STATE CATEGOF:'y' : ANNULAR SPACE ---- IN-TANK ALARM ----- T 1 :DI ESEL Ol/EF':F I LL ALAF:r"l NOV 20. 2001 7:15 AM MAY 6. 1994 10:26 AM LOki PRODUCT ALARI"1 APR 19. 2000 4:42 PM JAN 2. 1996 8:40 AM r'.J()v 12. 1995 4: 25 PI"! HIGH PRODUCT ALAF:f"1 NOV 20. 2001 7:15 AM MAY 6. 1994 10:26 AM L 2:DIESEL TANK TRI-STATE CATEGOF:Y : STP Ewr"u::' I I'J\.IAL I D FUEL LE\iEL APR 17. 1994 8:33 AM C':)f',1t"\ U N I CAT I (; NE¡ SET UP - - - - - - - - - - DEL I liER\' NEEDED NOV 13,. 1995 11: 37 AI") APR 17. 1994 8:38 AM POJ<T ::ŒTT I NGS : NONE FOUND F:8-2:32 8ECUR I T'i CODE : :;.;:;.;:;.;"'''':;.; ALAJ<f"l H I ~nOF:Y J<EP'ORT F:S-232 END OF ["JE88AGE DISABLED OUTPUT RELAY SETUP ----- SENSOR ALAF:M L 1 :DIESEL TANK ANNULAR SPACE FUEL ALARI"1 APR 28. 2003 9:22 AM ------- FUEL ALAR!"] APR 28. 2003 9:08 AM F: 1: POt;;! TI liE SHUTDOl."IN TYPE: STANDARD ["JORf"lALLV CLOSED FUEL ALARf"l f"lAY 7. 2002 12:24 PM LIQUID SENSOR Alf"lS L 2: FUEL ALARI"l ALARr"l HI STORV REPORT ALARf"l HI STORV, REPORT SVE::TEf"1 ALARr"l PAP£¡;:: OUT MAR 15. 2003 6:00 AM PF:INTER ERROR {"Wi" to.. 200:3 11: 40 AI"! BATTER\:' IS OFF JAN 1. 1994 8:00 AM SVS SECUR ITY I,JARN I NG APR 26. 2002 9:29 AM 8E NSOR ALARr"l L 2:DIESEL TANK i3TP sur"!p FUEL ALAF:r") APR 28. 2003 9:09 AM FUEL ALARf"1 APR 28. 2003 9:09 AM FUEL ALAR~'l MAR 17. 2003 2:58 PM " e LIOUID SEI'~~:K~R SETe ------ ALAJ~I'l H I STOJ~'l REPORT L 1 :DIE:3EL TANK TEl-STATE CATEGOR'/ : ANNULAF: ~~PACE ---- IN-TANK HLHRM ----- T 1: D I E~~EL O\/ERF I LL ALARr"1 NOV 20. 2001 7:15 AM 1"lA'y' 6.. 1994 10: 26 AI"! LOW PRODUCT ALARM APR 19. 2000 4:42 PM JAN 2. 1996 8:40 AM NOV 12. 1995 4:25 PM HIGH F'F:ODUCT ALAF:I"l NOV 20. 2001 7:15 AM MA'l 6. 1994 10:26 AM I 1"J\iAL I D FUEL LE\/EL APR 17. 1994 8:33 AM L 2:DIESEL TAI~K TRI-STATE CATEGORY : ~~TP SLlI"H=' C:OI"lI"lL1N I CAT I ONS SETUP - - - - - - - - - - DEL I VER\l NEEDED NOV 13. 1995 11 :37 AM APR 17. 1994 8:38 AM PORT SETTINGS: NONE FOUND RS-232 SECURIT\" CODE : ""0..:0..:0..:"""" ALARM HISTORY REPORT F:S-232 END OF ~'lE~;SAGE DISABLED OUTPUT RELA'{ SETUP ----- SENSOR ALARr"l L 1 :DIÐ3EL TANK ANr'JULAR SPACE FUEL ALARr"l APR 28. 2003 9:22 AM ------ FUEL ALAR!"! APR 28. 2003 9:08 AM F~ 1: POS I T I \.IE SHUTDOklN TiPE: STANDARD NORr"1ALL V CLOSED FUEL ALARf"! MAY 7. 2002 12:24 PM UOUID ~:ENSOR AU'lS L 2: FUEL ALARr"l ALAF:r"l HI STOR'/ REPC'RT ALARr"l H I ~:TOR\'. REPORT S'i~~TH'l ALARf"l PAPER OUT MAR 15. 2003 6:00 AM PF:I NTER ERROR MAY 6. 2003 11 :40 AM BATTERY IS OFF JAN 1. 1994 8:00 AM S'lS SECUR ITV ~,IARN I NG APR 26. 2002 9:29 AM ----- SENSOR ALARM L 2:DIESEL TANK STP S UI"lP F UEL ALAR~'l APR 28,. 2003 9:0'3 Af"'1 FUEL ALARI") APR 28. 2003 9:09 AM FUEL ALARf"! t"JAR 17.. 2003 2:58 Pt"1 '~ e e LIOUID E;ENSOR SETUP ------ ALAR~'1 HI STORV REPORT L 1 : DIESEL TANK TRI-STATE CATEGORV : ANNULAR SPACE ---- IN-TANK ALARM ----- T 1 :DIEE;EL O\iERF I LL ALAR~' NOV 20. 2001 7:15 AM P'IA'l 6. 1994 10: 26 At"l L 2:DIESEL TANK TRI-STATE CATEGORV : STP ::-:Wr"lP LOki PRODUCT ALARr"l APR 19. 2000 4:42 PM JAN 2. 1996 8:40 AM NOV 12. 1995 4:25 PM HIGH PRODUCT ALARr"l NOV 20. 2001 7:15 AM MAV 6. 1994 10:26 AM I NVALI D FUEL LEVEL APR 17. 1994 8:33 AM COt"Jr''lLIN I GAT I ONS SETUP - - - - - - ~ - - - DELIVERY NEEDED NOV 13. 1995 11 :37 AM APR 17. 1994 8:38 AM :PORT SETTI NGS : NONE FOUND F:S-232 SECURIT'l CODE : '>('.0('.0('.0(,",,", ALARr'l HI STOR'i REPORT RS-232 END OF ~'Ð:;SAGE DISABLED OUTPUT RELA'l SETUP ----- SENSOR ALARr"t L 1 :DIESEL TANK ANNULAR SPACE F UEL ALAR~'l APR 28. 2003 9:22 AM ------ FUEL ALARf"l APR 28. 2003 9:08 AM F: 1 :POSITIVE SHUTDOklN T'iPE : STANDARD NORI"lALL \l CLOSED FUEL ALARr"l MAV 7. 2002 12:24 PM LIQUID SENSOR AU"lS L 2: FUEL ALAR!"l ALARM HISTORY REPORT ALARr,, HI STOR'/ REPORT ----- SENSOR ALARf"j L 2: DIESEL TANK STP SU~'lP FUEL ALAR~'l APR 28. 2003 9:09 AM S'iSTEI"l ALARt"l PAPER OUT MAR 15. 2003 6:00 AM PRINTER ERROR MAY 6.2003 11:40 AM BATTER\l I S OFF JAN 1. 1994 8: 00 Al"l S'iS SECUR IT\i 1"IARN I NG APR 26. 2002 9: 29 At"l F UEL ALAR~'1 APR 28. 2003 9:09 AM FUEL ALARf"l MAR 17. 2003 2:58 PM " . '-.. MAY 06 2003 7: 20 ~SFLD FIRE PREVENTION (_) 852-2172 F. 1 05/82/2083 13:0a 6613926621 MA~ Q2 2003 ?!oe B~SFLD FIRE PREVENTION PAGE 01/01 (6Bl)852-2172 p.;.? ØB/81/~ag 14:~e 661à92Ø¡2~ PAGE 81/e1 *OO~Y RIQU28tDD PLEAS. PU(6Gl )U2-0621 I CrrvOFB~ OFJ'ICE OF ENVIRONMENTAL SERVICES 1115 Chester Aw., Ba1œráWd, CA ("1)32603"'9 taz ('~1)326~o'7ð R'/J-'AJ 5-Ç-03 \ ,( .. / .'-' Ù f'.f.,04 APPLICA110N TO PEIUi'ORM FUEL MONITOIUNG CBB.TD1CA.T1OJ1l l'AOU'l'Y (:) R. Rtl.lln ~ &- ¿..1: tYrnQIa~;.S' _ AJ.)ImU, ~"~,, t5' J"t LFt".-!r '&1£ }/'"..ßA~~t ¡:J#:'LDl C ¡::¡ :S~~ rt~~:;;;Íi~:£€: ~'~ ~r NItJØ OJ! !dON1TOJ'i NANUPJ.Cro.Ua.. t)0»~ACJ.JTYHAvaI>ISPINI.PANS7 ~ - , VIâ.;:: NO_ TANX* I. VOLtDG , )~4 ð<? 0 ~. --2)l~~~ -- . -. - _M~171ob..-.- b... ;--..,. r NAJrrŒOPTBS'l'JN<JOOMPANY 1Hí!H F.li¥np~r.JI!'1T. 00NtI1ACt0U ur.::aNaB~ i.2....1R 7;2 NfJ4A.PHOtœNt~U OPCONTAotP.BR.SON .11'MU UCH ,U2-86qJ ~·nU""WØuaTøTO.aCO,NI)uor.BDß¡{.Ið ~ h 1"øðp.'O., ... ..) . , J¡.. cd4,l:t£) 0fi~/~ 9~ ~ AJlPJiO\'St)BY DAD S%QN.,t.1UŒ or ~ .. ;i \.v, ,~1. , - - SWRCB, JanulIl)' 2002 Pap_of_ Secondary Containment Testing Report Form Thb ¡O,.", /., ¡""ndldfor ,I.re by contractors performing per/odic te.rting of UST lIecontlary co",mnnlfllJl .rylltf!m$, U.rtlthe app1fJpr¡ate pop_' o/thl8form to IYpOrt rr.ftIIU/or al1 COnJponem8 'fll1t(l(/. tñe completedfaml. wr/tten te." prrx:«iures, and prilrto",. from terr.; (1/ appltctJble), III,auld be plTJv¡¿ød 10 tl~ facl/lty o1V1r~rlòpertJtor for ~ubmlfttll to the local rrgulatal")' age/lcy. FACIL TV IN R.l\fA TlON TESTING CONTRACTOR ISFORMA TION ColD'JOMot PI.I f.U NDI Repatn CDlllpCllltDt 'AI. r.u ' Nat Repaln T....led Mlde Teitel Made ~ ,./, ¿f u 11 u u u u u <: i! " -:¡;¡..,../ Jt! u u .ð u u u u u u U U U U U U ~ ,I". ;- ~ .Jt1 u u JJ LJ U U W U U U U U U U U ,",Mi' ~ ~ j¿ U u M U u U U U U U U U U U U U U U U U U U U U U U U U U U U U U U u U U U U U U U LJ U U U U U U L! LJ U U LJ U 3. SUMMARY OF TEST RESULTS ¡(hydrostatic testing WB5 perf'onned, describe what WI' done wid! the water ,fter complction of test.: .JtIIi'!.}J ~ ~./... ~ .;Ii.,.... ~_~.J..... I1V" J '<"'4 I..~ .".. ~Ø;;',I .'4(,.. ,., CERTIFlt::ATlON OF TECHNICIAN RESPONSIBLE FOR CONDUCTING TlDS TESTING To the bat øf"V kHDw1HIl" ,I"t ¡,.cø ¡rtø/,d In this dOClllnl!lft liTe tlŒlIl'tit, IIndl,. /fill CtImplilllfCø wit" IøgtIIIYf/II¡,-.",e"", Tecbniofø.a.'s Signature: ~~~ r Date: J1/q , Z:Ø"cI sss't 't'Þ.L 6SS "3"r"i W~ ~Ø:6Ø ~ØØZ:-6Ø-^~W ., - e SWRCB. ¡anult)' 2002 Plge _ of_ Test Method Developed B)/: U Tanir. MI'Ouf\u!turer )lIDdUltry StaDdard LJ Professiopal EDsïnear U Other (~cify) TcJt Method Uacd: U Pressure ~Vacuum U Hydrostatic U Other (SprdfY) Test Equiøment Used: Equipment ResolutiOft: ,::.:'\ ~:;. r~.t~M:I;;:~!~~::~~~~¿~·~·~/~~;~';.:~.11~~:;.' ~ ~..~:~.:~. ~»(~?,,,.\,.:.. ..', :' ·::~i,r. . ;..- . 1;..', 't ~~'. .. '1':' ,'. .,~.... " . . . ',; ;':~ ,'-t . ,,"" . ..,. ..:..\~ ~·I.··' j"J." .: . ..' ..:': .;,'..,:: ~. .:.~". ~. "~~:,, ~. '..<-:"}', '. . ......., .. : ".,,', """''''''~'''''~' ',....,.·..··"·.."·.1,,..,'·,,..,. '.' .,'.,.. T.ü. / Tankf Tank II Tank , ' '::,~ ·~~oÌ¡.f~...';;\·.~~:~:..:: ,,"¿':þ~;'" ,f.'·/:{':¡,~ .,{;.1 ::;:, :",~',,: . it", II Tank Exempt Pram T05tinS?' ,JttIv cs UNo UVea UNo UVea UNo UVea UNo Tank C~lcity: Tank Material: ,#:'""8-~,þ d'-I Tank Manufacturer: ... 1i'Nt' Prøduc:t Sund: -r:>. ....ft~ l W..U time betweeD applyins pn:ssurt/vacuLlmlwater and awUnR test: Teat Stan iJme: initial ROldlDg (Rr): TCIt End Time: Firlal Rading (R.,): Tat DlØ'aticm: Change in Reading CarRI): PasalFail Threshold or Criteria: I- Tnt ReiUltr ' ¿,... U Fall U PUI U ..11 U P... uPaU ' U .P... UFaÐ Wu 1eI110J' removed for tostfDg7 UYos UNo uNA UYes UNo UNA UYes uNo UNA UYes uNo UNA . w.s sensor properly replaced and WYn UNo UNA UYet UNo UNA UYes UNo UNA UYea UNo UNA verified functional after tcstíng'l 4. TANK ANNULAR TESTING Commtdtl - (incl/ldt! In/amra/loll em repo¡~ mad, prior 10 lelllillg. (lnJ 1'f!CoItlnlend~JollOl"'lJp for f(lileJ Il!$ta) "-¡tllt.. ÁA.S '" t-Uta~ øw ,:j, ¿If All ~";A.l . .. I Sec:onduy concainment S)lstems where tho continuous monitoring automaticall)l monitors both the primary and IltCOttdar)' eoncainment. such as systems that are hydrostatically nmnitored or WIder consWrt vacuum, lITe I!;ltempt 110m periDdlc containment testfn.. (CalifOrnia Code of Rcgulalíons, Title 23, Section 2637(a)(6)} s::e"d asat t'Þ¿ 6SS ·3·r·L W~ S::0:60 S::00~-60-^~W " ..~ e e SWRCB, ¡anuary 2002 P.ge~of_ 5. SECONDARY PIPE TESTING Test M_bod Developed By: U Piping ManufllCturer ...-d'lndUlltry Standard U Professional EngÏncer U Other (S/Mcoc.'J Test Method Used: ~n$sure D Vaçuum o Hydrostatic (] Other (S!'«IlvJ Teat BquI~Cft\ U~: A:,. ~~ h..,I . ('¿.h~~ Eq\IÍpmcnt Re$olutlon: , :\~":':': ~'~',:;,,~1~;:~~;:: t~{)qr:;; , ;.' ;"~ . ... . " " ' . " .;'. .. " ,.,':'. .. ~ ." . , , , ........ ,,',. ~ .. Plp'JI. Run II / Plplnl Rlln H Plpln¡ Run ø Plpl'Dl Rua " PlpinS Material: PJ' ~ .. Piping Mallufacturer: l,~. 11 L pjPÙl' Diameter: :lit Length of Piping Run: 2b'..."n", Product Stored: 1'-a¡',.1 Method and location of ,é.J 2, h mtdnit.run ùolation: Wait time between applying plCSlW'eJvac:uumlwater and ./ ð ~-....:. l1.aninlr lest: Test Start Time: -I" - Initial 1\eadinS (R,): .e:" At' / Tes\ End Time: ~;'.-I ..- Final Reading CRr): _~ M('/ Test Duration: ~ð_,P CbaDge in Reading (R.,..R.I): (þj' PusIF.i1 Thrtsbold or ;f Criteria: Test a_ult: '. ..w1"u. U F.II . U Pa.. U Fall U Patl' U F.II UP... U Fail /, A.l/led ¿At-It. ,A/ '-~. , '.' Þ0-d SSS¡ ¡too!.. 6SS ·3·r·~ W~ £0=60 £00~-60-^~W ,f, e e swacs, Jlnumy 2002 Paae_of_ 6. P1Þ1NG SUMP TESTING Tott Method Developed By: U Sump Manutieturct ~lndUSU'y Standard lJ Prof'cs&l~nal Ensineer U Other (SNCIiY) Tcst Method Used: o PrcsSúI'C CJ Vacuum ,flH)'droataùc o Other (SpedJjl) Tett E t Uaed: 1/14 ~,,·/tfI Equipment Resolution: ::!':J~;~~;~~j~;b ."';:i¿~;l1iú({~ <~;.;::::,:.':~,~ . ,. .. ", . '." ..... ' '.,. ,. I .', ~ , ., . ., ' ." ~..' , . , '. .'. : . ,'. Sump t# ( Sump t# SUaqi " Sump tI Sump Diameter: ~1Jf Sump DtJ'th: ~¿" Sump Ma~al: ~_'I F' Height from Tank TaptD Top of J7'~ HS... PIoIn. Penetration: Heisht &om Tank Top to Lowest IV Electrical Penetration: Ccmdidon of sump prior to testing: ~~,j Porticm of Sump Testedl ~Ia_ ~NJ-.4 Does turbine sbut down when J!fY es UNo UNA &utdp sensor det«tA liquid (both UYas UNo UNA U¥es UNo UNA UVea UNo UNA Droduet and water)?' Turbine lbutdoWft fCSJIonse time IIJ j6t!:. . Is Iyltem prozrarnmed for {aU-safe J.l"Vea UNo UNA lJ¥a UNo UNA UYcs UNo UNA wy.,. uNo !.INA shutdown?" ~ Was fìiJ·safll verified to be -tJYes UNo UNA LJYes UNo UNA wYn UNo UNA UYcs UNo LNA Ot!e1Itiona17" Wait time between applyins pre51urel'vBouumlwatcr and starting / tJ ,......,;,. test: T.t Start Time: /d,'97 ;/__ Initial Reading (R,): V'4 Teat End Time: .J!. '#. f ~:J Á,..... FiDal lleadÚlg (R.): UMI Teat Duration: /¿, .r~~:'" Cbanse ill Reading (RrRI): ,. PlIslFail1breahoJd or Criteria: IN'\. Teat lteI\¡st: A.PuI uraD U PUI UFail U Pui UF.n Ü r..., U Pall WallllDlOt remo"ed for teatins? .... -d'Yes uNo UNA UYa UNo UNA UYea UNo UNA UYes uNo UNA W" RntoOr properly rep1aced and _ Jd'Yes UNo uNA UVea UNo UNA UYea UNo UNA uYcs UNo UNA verified functiona[ aflcr testfnJl? Comments - (Include ¡"formatlan ol1lYpair.f mad, prior to te.,tfng, and recommfmdedfollow-up fot' fal/ed æ.,tir) ~.J ~." ,..",..,t ,h~ .L.A.. .~~ _..~ ..../..,. /4ð. '" /~â ~ (".4~¿ __~ ¿........"" A/J'. t"',.....,..4..... III,.-~ ~ A/L ~e~-Q I If the entire depth of the sump il not tested, specifY how milch was tested. lflbe ønawer to m oftl'te questions btdicated with an I.terløk (*) is "NO" or "NA", the entire SU1'1'1p must be t~ted. (See SWRÇD LO·l6ß) se·d sss't 'tto'¿ 6SS '~-r-~ W~ to'e:60 200~-60-^~W ,', SWR.CB, January 2002 e e Pagc_of_ 7. VND2R..DISPENSERCONTAlNMENT (UDC)TISTJNG TeAt Method Dc~eøped By: :.J \JDC Manufacturer ~nduatry Standard LJ Profcssional Engincer U Otber (sP«I.M Tat Method lTslld: 0 PresIIltO D Vacuum ,.ß"9ydrQstatie [;] Ql.her (Spøclfy) Tcst Equipment Used: ...-;.. ,~ Equipment Re50luüon: . -,', .. .1.' : . . . .' . . .".' ~, " " ....4... '0""' '. . :~i;"-;~Ð;iii:;1:,r,0<tJ;i·(¡~..:i.:ii!:~;;:·.',..·:,;~;:i:;: '·Unc ;,.'.'./'.. " . ,." UDC Manllf'.eturer: UDC M.tlftial: b: Hei¡bt fkam UDC' Bot1òm to Top of Hhmest PiDml! Penetration: Hei¡ht 1tom UDC Bouom 10 Lowest Hlectrie.l Pc:nct.1'8tJon: Cmaditlon orUDC prior to 1C51in1l: Portion of' UDC Tested Doca tu1'biœ shut down when ....., es U No UNA UDC SClftI01' detedll Uquid (botb ¡IQ Y r. ~, &I'Id wlter)?" Turbine shutdown fellOOll5e åmc J. .yatem programmed for fail" safe sbutdown?" Wa. '''U-u~ verified to be overatÏCII\A 17· Wait time betwtten applying presaurelvacuum'water and ltaninlt tat "'t:J _.;, Tellt Stan Time: ? ~ u A.... IDitial ReadfJla CRt): J. ,~ ' Tellt End Time: J~ ..' ~ Fiœl ReadiftK CR..): ~ II A , Tcst Dtll'lticm: Ill. I -."Þ-J. CblDalD Readinll (R...Rr\: . ð PassIFli Tbre"bold or Criteria: /' t.: . Illi~ T..tRaalt: ~ Pus UFaIl W.. Jt:Utor removed for testing?...... :2'1' es D No 0 NA WallllmSOf property replaced and ~e8 UNo UNA veriited functional after teWna'1-- tlDC # VDC fI UDCI U/A _:. ... ~'" /?~ JIJI .Jt,¡ ~L J, ,L ~ Jd. ,JtfYea UNo UNA UVcs uNo UNA '..Nell uNo UNA UYea uNo UNA UYa UNo UNA UVea uNo UNA UYes uNo UNA DYes DSo DNA DYes DNa CJNA DYes DNa DNA ~e. UNo UNA u Pus UFaII DYes DNo DNA U Put . U Fal. DYes ONe DNA U Pus U F.II DYes J:JNo DNA UYn UNø UNA i.J¥es UNo UNA L.lYes !.n~ø UNA Commtau - (¡"cluJ. info,.",atføn on IYpøiYð madø prior to tallml. turd recommrllcler/follow-upfor ¡anal "'13) I lfthc entire depth oftbo UDC fa not tesled. specify how much was tCllled. Ifth~ answer to m ofthe qu~dons Indicated with an ..terilk C·) ¡s"'NO" OJ' "NA", the entire UDC must be tellted. (Sec SWRCS LO·l60) 90"d SSS1= 1='ÞL 6SS ·3·r·~ W~ 'Þ0=60 £00~-60-^~W e e SWRCB. 'anuay 2002 Pap_ot_ I 8. FILL RISER CONTAL~MENT SUMP TESTING PlçiJitv II Not EGuimwt With Fill RJser C4Jn1ainment Sum'ØB '::J¡( FiJI Riser Contaimntnt Sumpa JnI PreMnt. b\rt wøe Not Tested U Tat Method DewJoped By: u Sump MlUluf'acturet U IndllßTy Standard U Prof'elllional Engineer o Other (SlJ«:iJy) TII1 MctlJød Used: U ~sW'e U VaCUUl1I U H~lIItfø U Other (Specify) .,.~.. Equipment Resolution: ~,... ..,...~. ~...,.... ','..' , .."" ,'..,.... ','" 'N' '. . . ',. '. ·,·.....·'.H.' .~ . '. .. . ' ." . ..... .... .'1'''' . ." . ~~;;( :{~~~~;~~~!~~+~r~~·~~\~:~::F J1l1 Sumø " FW &lmD N FW I.IIID' FIll SIImD 1# Diømeter. Sunm D-th: Height 6'om Tank. Top to Top Qt HiRbeat PiDinR PeDdration: Hcisbt ttom Tank Top to Lowest Electrical Penetratiott: Colldition of lump prior to tatilll(: PartioD of Sunm Tested SwnD Motlerial: Weft time betwce!l applying prenure/vacuumlwater end stardna tcst: Test Start Time: Initial Radinll fR,}: Tnt Bnd Time: Filial a.dlnll fR.,,}: Test Duration: Chmn iD Rea . R.t~ PlWFail 'ThteAhoJd or Criteria: Test Rault: : '. U Pia.. UFaJI U Paii.' 'UF'" ' 'u Pai. ' U Fall ÜPan UraD,. , ' . Jj !here a JClllJOr m tb aumø7 UY.. UNo UYes UNo UVes UNo UVes UNo Does tile sensor alarm when UYea UNo UNA l!ither product or water ia U YCII uNo UNA UVea UNo UNA UYeø UNo UNA detected? WI. aenlor removed for ter.ting'l uYcr. UNo UNA UYet UNo UNA uYes UNo uNA UYcs UNo uNA WaslC.DlIOr properly replaced and uYeB UNo UNA UYc=a UNo UNA UYes UNo UNA Uv. UNo UNA verified functional after testing? Comments - (11t~'ude ¡'úòrmatlon on repairs made prlðr to telting, and rtC(Jm~nthd follow-up !by (ailed tests) L0'd SSS,: ,:1>L 6SS ·3'r·~ W~ S0=60 £00~-60-^~W ¡ , e e '. " SWRCB,1anuary 2002 Pasc_of_ PaclUtv II Not EClumDed Wilh Sl'ilVO\/erfill Conwlnmcnt Sox.es U S.,n1lOverftll Comainment Boltes are Prelent. but Wife Not Testec1)l(' Test Method Dewtopod By: U Spill Bucket Manufacturer U Industry 5andard U Profcllional Enper o Other (SP«i..M Test McrlJod UIed: U Preuure U V.culØn U Hydrostatic . U Otber ($pøcim , Test Equipmart Used: Bqulpmcnt Resolution: ", '.. 'f,:;i~~*,;," ,..',,~ ",.. ,.., . ...~~::-...:"'i .:.:.. '\ ¡!J,..~'.~~, :If':':: '. ,"~'.y:..: .,.,,'; "':',f.i::"~ '...:'" ~. ;... . 1 : '. ",' "t~:' '.' ~ \:. ~ '::, ';~',,:~:,: .', .":1';::; '. I'" ~:'1.'. ":k:¡·,,,;,:. '.~;'1 ,.::....¡,.,): "':'" ....~ '.:;~. ..~. . ....,.. '1'~" '.. ~..~ . f··~· ···..·\·\1'·'.. ','" ~\~·~.Î:)~;~:~;~ . '. :'·;J.;j~~\fž~~:~~;:~,,;;::(;.é,J·,: &pm Bas t# SpW 80s II SpW 80s " SpQl 80z fI Buc;ket Diameter: Bucket Deptb: Wait tInM between applying I prellurel\/acuumlw8ter and startina ~\: TIst Stan Time: Initial Reading (Rt): Test End Tim.: Pinal Readmg (R,): Tat Duraticm: Chanp In Reading (R.,.Rt): PlIIIPail Tbreshold or Crlteria: T~.t Rilütt~ . U Fall Ulan .. pa. U P... U ,.., urall U, Pill. U UFaU 9. SPILUOVERFILL CONTAINMENT BOXES Coøunentl - (lnclllde Information on repairs mødfl prior to t/:!ltlllg, and recommf!7ldød follaw.up for foiled fe.WI) 80·d 8S81: 1:t-L 6SS --'._..-:--':":'".~, ... ~,---. ,.-.'-.. ·3·r·~ W~ S0=60 £00~-60-^~W .. . e .' . .., .... ,. ~:Imr L~:1k ied,t~ ~e11Ð0 ; .' r~V't I' \. I :!'I~\n4I'r\r-9 , , f(¡I"t.'!'Ia., ÇA ';\\~' :~~~tlj- ..~~, -~ ---..-.---..-.-..- ----' .-.. ....--.- li>L . :~Jlnr! . ,.P/;Á,(~ .----- ,_.... ..." ..--..-.'~ :.)a;,.:,: lI4/: :8/2003 Îi.,\\\':1 12: '9 ---..-. ~~. ~.I;.t \"'1.::;; (.r:~2 in~¡; 14,e !l\lr'tUWI ,_.--I~--L1tI- 01 :< ': E\:,rl T~~· ~I~ ~ "1 ' 69"d 8S8J Jot>..!.. 6SS " . " , i e ¡I' " . ' ':' ! . SumP lea~ Tester Mode] ~1 I ellrrtu,t.ErtJtneerlm, FCI" ~6~ ~ql" . 1/ Sit.I' -d1~ ~~~--., '"'J!M!tßfiÞ __.__ SIJIlfÞl ~~~__, ---- \ " ,'. o.~" 04/2812893 Tilt': 18:41 R.I,,' Pass Dh:1Þ' <. ee2 inches Eli.pl 16.3 minutes Techl "~___ "'" ", , .. .... ,. I. .,1.' I . , ...__ .._. ._...":'t':--"._.-_.~I,,-,"._'·-I... "~"r"~ W~ S9=69 £9Ø~-6Ø-^~W j<V' Ii. «~ _ 05/02/2003 13:00 GG13~~ 1 HAY 02 2003 7:06 BKSFLD FIRE PREVENTION - (681]B52-2172 85/91/2Ð83 14:28 6613928&21 PAGE 01/01 p.2 PAGE 81/1111 -COpy RIODBS~DÐ PLEAS! rAr(G61)]~2-06Z1 CITY OF BAKEBSFŒLD OFFICE OF £NVmONMENTAL SERVICES 1715 Chester Ave., nabr:sØeld., CA ("1) 32~".9 tax ('~')32&.057e APPLICATION TO PERJi'ORM FUEL MONITORING CBRTlFlCA.TlON l'ACl1J1'Y. QJt<fiJU~fLg &~r t}~eu~·'.S' ~, ~"!-I/') tS'1J, L£~ '&E'1 lßAI:!~rr:(oIr"LDl c.,q OlEIù\TORJ rw.m Q~ fi.,~' .ðe;~ ..YO 1']If)£~ ~ OWNBISNAMB Ml9rT HIfét/JÆr/i - v NA1G OJ! MONl1"Orl MANUlAC"tQtWl ...... . DOSS FAC:tUTY8AVBZ>JS.-æœsaPANS? ~ ... NO_ TANK:. J VOLtlWE J~. 00 " . CONTDNTS ' 7J/~gr'- --Lil . """'f --.- ~ "..4 ~ NJ\MBQPTBSTIN<J COMPANY 'R'I~Jot F."ii-TVQW1\l'U.111'u. CON1'RACtOIUUCBNSB_ 99-1Q72 _.'''__..- NAMBA.PHONENt1I4DDR.OPCONTAO'tF.Sl.SON JAM.lZS R!CH ,W-8Q§1 DAD 1sTI&G TBI'r D TO sa CONJ)t./C'T.8D. .øl. /ð -.q ¿"øð ~m. _ } . , J~c/;ltm) 0fi,-I~,~~ AÞPB.O\'Bt)BY DAD 81QN^1'tDI.13œ~ · 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 mail piece, or on the front if space permits. 1. Article Addressed to: MIKE HAWORTH ORANGE BELT 3640 NORTH SILLECT BAKERSFIELD CA 93301 .,. B(~Received by ( Printed Name) C. Date of Delivery 3- 7--Q3 D. Is delivery address different from item 1? 0 Yes If YES,enter delivery address below: 0 No . ~. 3. ~e Type g ~~rtified Mail 0 Express Mail o Registered 0 Return Receipt for Merchandise o Insured Mail 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 7002 2410 0002 1974 9992 I I PS Form 3811, August 2001 I 102595,02,M-1540 I Domestic Return Receipt I ~ I I \ _First-Class M~~ \ Po ' ~es Pal I ===~ ìJsPS=-=- "",-~. => ===" -PermihNo:G~10----C >~..., I ----=-.;:- ·0 -~.:...-. - -"'=0 I "'-= ,=-=- \ I I I I I I · Sender: Please print Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 \. 'S II ,I II II IIIHII ,1111 II 1111,1,1" ,1,1'111111 11111111,11 1,111111 ... U.S. Postal ServiceTM CEp':r'FIED MAILTM RECEIPT (DomE:. 'Mail Only; No Insurance Coverage Provided) , " , . . .. , . I OFF I ~I A L USE l Postage $ Certified Fee ~.:..ru.:~e~~ePt Fee postmerk (Endo , enulred) Here (~nÐJ%r' MIKE HA. WO lru IT' 'IT' lIT' I Irt I~ ru D o 10 o l"":¡ RTH !~ ORANGE BELT lru Tots 3640 NORTH SILLECT l0"'-o Sent BAKERSFIEL mOO D CA 93301 51_,-. .~ I orPOBox'No.----·-~,- -'-.. I ëi¡ÿ,·šiàië~ziP+4····..·············m...-......--'-- ................... ---~-_~__ß Certified Mail Provides: ~69~·1N·~0·969~0~ · A mailing receipt (SSJSASI:IJ ¡rooa '008& WJQ::I Sd · A unique identifier for your mailplece - · A record of delivery kept by the Postal Service for two years I Im/,-ortant Reminders: I · Certified Mail may ONLY be corvbined with. Flrst·Class MalJœ, or Priority Mail~ I · Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. FOI i valuables, please consider Insured or Registered Mail. ' · For an additional fee, a Return Receipt may be requested to provide proof of I delivery. To obtain Return Receipt service, prease complete and attach a Return , Receipt (PS Form 3811) to the article and add applicable postage to cover the I fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for I a duplicate return receipt, a USPSQI postmark on your Certified Mail receipt is reqUired. · For an additional fee, delivery may be restricted to the addressee 01 addressee's authorized agent. Advise 1he clerk or mark the mailplece with the endorsement oRestricted1Jelivery". · If a postmark on the Certified Mall receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail I receipt Is not needed, detach and affix label with postage and mall. IMPORTANT: Save this receipt and rresent It when making an inquiry. internet access to delivery informa ion is not available on mail addressed to APOs and FPOs. FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'W Street Bakersfield. CA 93301 VOICE (661) 326·3941 FAX (661) 39S·1349 SUPPRESSION SERVICES 2101 'W Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFElY SERVICES· EHVIRONIIEIITAI. SERVICES 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 e e .. iÞ-~;.'! '. March 12, 2003 Mike Haworth Orange Belt 3640 North Sillect Bakersfield, CA 93301 CERTIFIED MAIL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to Perform/Submit Annual Maintenance on Leak Detection at the Above Stated Address. Dear Business Owner: Our records indicate that your annual maintenance certification on your leak detection system will be past due on March 26, 2003. You are currently in violation of Section 2641 (J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days. April 12, 2003 to either perform or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by;i Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~7~ de W~ ~OP .A0P6 ff~ A W~" · 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: ORANGE BELT 3640 N. SILLECT BAKERSFIELD CA 93301 .~ B. Received by ( Printed Name) C. Date of Delivery ]-16-03 D, Is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No 3. I \ I I I I \ I 1 02595,02-M·1540 I Ice Type Certified Mail 0 Express Mail o Registered 0 Return Receipt for Merchandise o Insured Mail 0 C.O.D, 4. Restricted Delivery? (Extra Fee) DYes PS Form 3811, August 2001 7002 2410 0002 1974 9787 Domestic Return Receipt ·~ r\,.6.:.S ....-. "--.. · Sender: Please print y~ur~~m ~1idress, and:ZIP+4 in this box · = i::ÍC,$t·Class Mail PõSt~Fees_Pai«f USPS .' . ,,' Permit No. G-10 .I ì \ ~ UNITED STATES POSTAL SERVICE - ~l . ~\ \ I r: .~' c..' ~ ~.'.~_'" ,.-r_ Bakersfield Fire Department Prevention Services 1715 Chester Avenue, Suite 300 Bakersfield, CA 93301 \. os If 11,11111111", II 1IIIIIII,I,/,ul,11I111I1 U 111111,1,1,111111 U.S. Postal SerVlceTM CP....fIFIED MAILTM RECEIPT (Do.. .&tic Mail Only; No Insurance Coverage Provided) , I"- IcO l"- i["" '.::!:' l"- e- ,..:¡ OFFI^"IAL USE Postage $ ru CJ CJ Return Reclept Fee , CJ (Endorsement Required) , CJ Restricted Delivery Fee ,..:¡ (End I t Required) .::!:' ru Certified Fee Postmark Here Tot ORANGE B g:: Sen 3640 N SIt ELT ~ Š¡¡' BAKER. LECT ~,_ SFIELD CA 93301 ~-=~"-=-=.""- ~~ .- If .==l ~ I Certified Mail Provides: Z~. 'ZO'S6SZ0~ I · A mailing receipt (aSJ9A9/:J) ZOOZ a WJO=, Sd · A unique Identifier for your mailpìece i · A record of delivery kept by the Postal Service for two years Imp'ortant RemInders: " : I · Certified Mail may ONLY be conifjined wiiH'First·Class Mai~ or Priority Mailœ I · Certified Mail is not available for any class of International mail. I · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For I valuables, please consider Insured or Registered Mail. · For an additional fee, a Return Receipt may be requested to provide proof of I delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811l to the article and add applicable postage to cover the' fee. Endorse mailpiece Retum Receipt Requested". To receive a fee waiver for ' a duplicate return receipt, a USPSi!Þ postmark on your Certified Mail receipt is reqUIred, , · For an additional fee, delivery may be restricted to the addressee or I addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "RestrictedVelivery". I · If a postmark on the Certified Mail receipt is desired, please present the arti- i cie at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach an,d affix label with postage and mail. IMPORTANT: Save this receipt and present It when making an Inquiry. Internet access to delivery Information is not available on mail addressed to APOs and FPOs. 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' EHVIRONIlEllTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAX (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 e e i þ . ¡>' March 5, 2003 Orange Belt 3640 N. Sillect Bakersfield CA 93301 CERTIFIED MAIL RE: Recent SB 989 Secondary Containment Testing THIRD REMINDER NOTICE Dear Owner/Operator: Our records indicate that you completed your secondary containment testing on September 27, 2002. Our records further show a failed test. Therefore you are required to have your system repaired and re-tested as soon as possible. This office requests an update with regard to repairs of your system. Please be advised that repairs involving the replacing of components must be under permit from this office. The repairs of your system are a condition of your permit to operate. Failure to repair and re-test will result in the revocation of your permit to operate. Should you have any questions, please feel free to contact me at 661- 326-3190. Sincerel~ , Ii[." ," /ß /' - ~ ~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~.7~ de W?~ ~ ~0P6.r~ A W~" · Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Print your name and,.address-õn the reverse so that we can return the card to you. · Attach this card to the back of the mail piece, or on the front if space permits. 1. Article Addressed to: , ORANGE BELT 3640 N. SILLECT BAKERSFIELD CA 93301 '-___ __--===----=-_ - ~_ _n_----'-=-----.-= 12.' 7002 2410 "'\"I PS Form 3811, August 2001 D. Is delivery address different from item 1? if YES, enter delivery address below: " -------'" 3. Se ce Type Certified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) 0002 ~o~?~;v ..:.~ 7 4 DYes I 2ACPRI-Q3,z,09851 ~ I UNITED STATES POSTAL SERVICE A· ~~~ 11111_ , First-CI,' ,¡ . \ Ii C ,-=='" _ Pö'stãQj...&"Ee Pal f"« -7 .~.~- "tISPS· I!;? PM;\ -~-~-" Permltf(~OI ¡,!LU ¿::;~ ~~',""," '.' ,... - , · Sender: Please print ~~ h~Q: á9.Ee: á.,~aress, anctzIP+4:£thi;-bôx:~-.- ---=-\ ~ -- -1 "~I BAKERSFIELD FIRE DEPARTMENT e';";F~Cf: OF ENViRONMENTAL SERVICES ~ï~5 ChS3~er Avenue, Slliœ 3ûO ;l~~'srsf¡e!d, CA ~m \'5 '/11 IIIL, ,lI ,III, Ill/Ii! / ,I, II 1,/" ,1lI¡!, II ,II! I,I! 1I'!l! I.::::t' ,I"- M a- I '.::::t' I"- a- M ru o o ,0 I. . · OS a erVlceTM CEr.....~FIED MAILM RECEIPT (Dom&_..c Mail Only; No Insurance Coverage Provided) .' . . . " . . . I 0 F F I C I ,ðt L U S E I Postage $ ;I.' ,¡ Certified Fee Postmark Retum Reciept Fee Hera (Endorsement Required) Restricted Delivery Fee (Endorsement Required) /' o 'M .::::t' ru Total Postage ru o Sent To o ,I"- ORANGE BELT 3640 N. Sll..LECT BAKERSFIELD CA 93301 siieëCX¡jfNõ:¡ or PO Box No. ëiiÿ,'šiãië;zip+ ~ Certified Mail Provides: · A mailin9 receipt · A unique identifier for your mailpiece · A record of delivery kept by the Postal Service for two years Important RemInders: I · Certified Mail may ONLY be combined with First-Class Mail® or Priority Mailæ < · Certified Mail is not avail~ble for ~y class of international mail. · NO INSURANCE COV~RAGE ÎŠ" PROVIDED with Certified Mail. FOI valuables, please consider Insured or Registered Mail. · For an additional fee, a Retum Receipt may be requested to provide proof of j delivery. To obtain Return Receipt service, prease complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the I fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USP~ postmark on your Certified Mail receipt is required. · For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the I endorsement "RestrictedDelivery". · If a postmark on the Certified Mail receipt is desired, please present the arti- I cle at the post office for postmarking. If a postmark on the Certified Mail I receipt is not needed, detach and affix label with postage and mail. I IMPORTANT: Save this receipt and present it when making an inquiry. I Internet access to delivery information is not available on mail addressed to APOs and FPOs. .~'V'I'ZD'969Z0~ (9Sl9118/:J) zoo 'OOB£ WJo, Sd I I FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" 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. ENVIROHIIEHTAI. SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBUC EDUCATION 1715 Chester AV9. 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.Q576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ< (661) 399-5763 .' e ~ ,~ ;. ~I . February 13, 2003 Orange Belt 3640 N. SilIect Bakersfield CA 93301 Certified Mail RE: Recent SB 989 Secondary Containment Testing SECOND REMINDER NOTICE Dear Owner/Operator: Our records indicate that you completed your secondary containment testing on September 27,2002. Our records further show a failed test. Therefore you are required to have your system repaired and re-tested as soon as possible. This office requests an update with regard to repairs of your system. Please be advised that repairs involving the replacing of components must be under pennit from this office. The repairs of your system are a condition of your permit to operate. Failure to repair and re-test will result in the revocation of your permit to operate. Should you have any questions, please feel free to contact me at 661- 326-3190. Si~ dkÆJ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc .~y~ de Wtv;vnu~ .%p .A0P6 .r~ .A W~" · e UNIFIED PROGRAM ìPfSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME t ~_ßcl :AQ~O___,__ ADDRESS l + Lu:J__________' INSPECTION DATE INSPECTION TIME ~-_._--------_._------~------'-- ----- ._-_._---~--~. PHONE No, No. of Employees FACILITYCONTACT è1L4 Business 10 Number 15-021- _._--~.._~----_._- -: ' "'" ' ,-. D Routine Section 1 :8usiness Plan and Inventory program ? ' ~Combined tJ Joint Agency D Multi-Agency D Complaint D Re-inspection C V ( c=comPliance) V=Violation ~ D ApPROPRIATE PERMIT ON HAND -~--~---~-----------------------~----- ------------ ItJ/'D BUSINESS PLAN CONTACT INFORMATION ACCURATE 07 D VISIBLE ADDRESS ~ CORRECT OCCUPANCY OPERATION COMMENTS ---.-------------- -.----. ---_...__.__._-_._--_.__.._~-------._-------_.._-- _____..._.____+____.____.~_ __ __·___________n_______________.____· ___________.____________.__.____...._________.___.__.______ --.----------.----------------. -.---. - -.-.----.--------.-.-.-- ---_._-_..---.-._._-~._~-_._--- _._--~_._---_._-_. ._"---~._-- ______________~_.____.__ _____.__._..____.___._.___._...___________.____._____ .____________~_________ _" __._._.__n___... ÇJ/ D VERIFICATION OF INVENTORY MATERIALS i{!./6 VERIFICATION OF QUANTITIES -------------------_..__._---_._----_._~- _._------------------~-.-.-----------------"_.._--_._-..--.---"--------"..-"-.- ~ VERIFICATION OF LOCATION rt:v' D PROPER SEGREGATION OF MATERIAL ltJ,/tJ --------.---.--.-. .___._____.__._._______._ .~.________.____.______.__.__.______.__.___._ ___ n_ -~---------------- -------------_._-._-._-------------_.._--_._---~------.----- ---..----------------.-.-.----- --------"----------.------.--..-..------------------ ---.---------.-.--...--....---- VERIFICATION OF MSDS AVAILABILlTYE -7--'----.------'-.--..-.--......'.....--- __,___...__'..",_,.____....____,_.__.._m_'______,,___,._.,--,----, ID/"D VERIFICATION OF HAT MAT TRAINING -----.-------------.---.--.------ .---------..------.-----.----"------.----.----...--.--.--.- -----.-----.--- IV'D rn/D VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES .----.-----.--.-.--- ------.--.-------.--.--.-....------.-------.--------------------.-- EMERGENCY PROCEDURES ADEQUATE ._---------~~----_._---_._"------ -.----------..--.-.---"---.--..------.------------------- ---------.---.---.--.-..------ ~ CONTAINERS PROPERLY LABELED -------------~-_._--_._-_._-----_._.._-_._"- -.--------.-- ----+------_._-_.__._----_._-_."------_...-_---------~----- D HOUSEKEEPING j ------- . -.----.-------.-.----- --_._-----~--_.__.__._--~------_._--"---_._----- Ø""" D F IRE PROTECTION _~-'_-'_----'-_-_--'-,.---'-'--- _,_________.___m_.______._.,__,.___._"_.______,...."_,.....______ e1 D SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE?: ~ES JJt No EXPLAIN: INSPECTION? PLEASE CALL US AT (661) 326-3979 ,ç Badge No, --,~-~---, Business Site Responsible Party White· Environmental Services Yellow ' Station Copy Pink, Business Copy e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ()rtlffl1L tBc1f Stð.qlS INSPECTION DA TE-.J .. ::{(}.. 0 ~ Section 2: Underground Storage Tanks Program o Routine ~ Combined 0 Joint Agency Type of Tank Du)R:.5 Type of Monitoring è L. Wt o Multi-Agency 0 Complaint Number of Tanks ( Type of Piping IfJWF ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile l....... / Proper owner/operator data on file V /" Pemit fees current t/ '" Certification of Financial Responsibility / Monitoring record adequate and current / Maintenance records adequate and current ./ Failure to correct prior UST violations ./ Has there been an unauthorized release? Yes No~ Section 3: Aboveground Storage Tanks Program AGGREGATE CAPACITY 3-]0 'fal.S Number of Tanks ( TANK SIZE(S) ~ ~~{ Type of Tank VL-l c.(L OPERATION Y N COMMENTS If yes, Does tank have overfill/overspilI protection? SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MYF? C=Compliance N=NO Inspector: Office of Environmental Services (805) 326-3979 White, Env, Svcs. 7fJ ~~ Business Site Responsible Party Pink, Business Copy 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 SAFrn SERVICES. ENVIRONIlEHTAL SERVICES 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. Bakersfleld, CA 93301 VOICE (661) 326-3951 FAJ< (661) 326.0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfleld. CA 93308 VOICE (661) 399-4697 FAJ< (661) 399-5763 . -' January 22, 2003 Orange Belt 3640 SiIlect Bakersfield CA 93301 RE: Upgrade Certificate & Fill Tags Dear Owner/Operator: Effective January 1, 2003 Assembly Bill 2481 went into effect. This Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your window) and the blue fill tag on your fill. You may, if you wish, have them posted or remove them. Fuel vendors have been notified of this change and will not deny fuel delivery for missing tags or certificates. Should you have any questions, please feel free to call me at 661- 326-3190. Si0;l tIdv Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~7~ de W~ ~OP .A0P6 §'~ A W~" · 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. I I 1. Article Addressed to: I I If I I, ORANGE BELT '3640 N. SILLECT I BAKERSFIELD CA 93301 I ~"~~'-~~'~ I I I I PS Form 3811, August 2001 C. Date of Delivery t-{ ,- "3 D. Is delivery address different from item 1? 0 Yes If YES, enter delivery address below: 0 No '\ ,,/ 3. Se ce Type Certified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) 7002 0860 0000 1641 5974 Domestic Return Receipt I I , I 1 I I I I 102595'02,M-08351 DYes UNITED STATES POSTAL SERVICE I I First·Class Mail \ I -' ~Po~~ ees ' 1 .--.~"-~. 'USES--"--'~-- ' ,- , " . Permit NOe G~10' ...." =c>. '-, SS, and ZIP+4'in-thjs~b_óx"'" -,--~-=. I _~~ I I BAKERSFIELD FIRE DEPARTMENT OFFiCE OF ENViRON~hENTAL SERVICES 1715 Che8~er Avenue, Swte 300 Bakersfield, CA 9331:»1 \'S 11,1"" I 1,111 IIII!,!,! 111,11111 ,III! "II I 1,111, 111,111, II! I' I I , =r II"- I IT" U1 'M I~ , a la la ; a U.S. Postal Service CERTIFJED MAIL RECEIPT (Domes' 'fail Only; No Insurance Coverage Provided) I C I A L "', UÎ'S E' -»>~ Postage $ Certified Fee I a Return Receipt Fee I.J] (Endorsement Required) : o:t1 Restricted Be a (Endorsam ru Total Pol I § entTo ORANGE BELT I"- ............ 3640 N. SILLECT I ::';ë:'':: BAKERSFIELD CA 93301 ! ëi;Ÿ,'šiãi-"'~T~ Postmark Here - ~-=---- ---->-.---- J .. !I. " ., ... -. .. .. . ! Certified Mail Provides: · A mailing receipt · A unique identifier for your mailpiece · A signature upon delivery · A record of delivery kept by the Postal Service for two years Important Reminders: · Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. · Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. · For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mail piece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS postmark on your Certified Mail receipt is required. · For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". ," I . If a postmark on the Certified Mail receipt is desired';1;!ease pi'6sent the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is no.ed, detach and affix label with postage and mail. IMPORTANT: this receipt and present it when making an inquiry. PS form 3800, Aprìl2002 (Reverse) 102595·02·M-1132 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'W Street Bakersfield. CA 93301 VOICE (661) 326·3941 FAJ< (661) 395-1349 SUPPRESSION SERVICES 2101 "W Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' EIMRONIlEHTAI. SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX(661)326HD576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAJ< (661) 326HD576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX(661)326~76 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAJ< (661) 399-5763 e . .. January 13, 2003 Orange Belt 3640 N. SiIIect Bakersfield CA 93301 Certified Mail RE: Recent SB 989 Secondary Containment Testing REMINDER NOTICE Dear Owner/Operator: Our records indicate that you completed your secondary containment testing on September 27, 2002. Our records further show a failed test. Therefore you are required to have your system repaired and re-tested as soon as possible. This office requests an update with regard to repairs of your system. Please be advised that repairs involving the replacing of components must be under permit from this office. The repairs of your system are a condition of your permit to operate. Should you have any questions, please feel free to contact me at 661- 326-3190. Sincer~,ncere.,.l? . jJf£ ~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~y~ ~ W~? $T0p.A0P6 .r~ A W~" .~.~ ¡" Còmplete it~ms 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: ORANGE BELT 3640 SILLECT AVE BAKERSFIEL CA 93301 I _0 . . ;" A ....:_1_ fl.1. ,.......h....,. D, Is delivery address different from item 1? If YES, enter delivery address below: 3. Service Type XJ Certified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise o C.O.D. ' o Yes I I I 102595,02.M,08351 ! 4, Restricted Delivery? (Extra Fee) 7002 0860·· DODD 1b4'1 6872 r PS Form 3811, August 2001 uomeSllC nt:::lUIII I \C,,",IO'It-'t ~, :§Ç~:-:,) l,J s~~;~ê~~, 'è~~å¡d '.;1 ~T'"'\~ ,U,Sp.s,;:;___._. ., -.;1 ï·-,~''.: -Permit, No.-G-10 .-'''""1 .',J '¡ t", I , , ~ ,...., I' "" ~"! , _y ~"~ l ' " . . - -;I- ¡ ¡;" '~'I""' "11 \ · Sender: Please print Y~~~'!i!~>áddress, anä-ZIP+4 in thIs box .u_' ---- BAKERSFIELD ARE DEPARTMENT C~F~CE OF ENV!RONMIENTAl SERVICES ~ 7~ 5 Choowr AVOOLH0, Su¡~ 300 Bakersfield, CA 93301 . ... ,'¡ :: //,1""/1,,,1 L 11"lllIn ,/,1,"/,1, ,,1111 '," ,11,1,1,11. Ii I lru .('- cD ...D ñ ::r ...D ñ 10 I§ o o ...D ¡c[) o I ¡ru I§ 1('- I I I u.s. Postal Service CERTIF~O\ MAil RECEIPT (Domesti ,Iii Only; No Insurance Coverage Provided) Postage $ -~ > J Certified Fee Postmark Return Raca1pt Faa Here (Endorsement RequIred) Restricted Delivery Fee (El1dOlSBlllBnt Required) Total Postage & Fees $ Sent To ORANGE BELT siñiBi,"Äp,:·Ñõ:¡···············..·············..··..·..····..·............................... or PO Box No. 3640 SILLECT AVE ëi,ÿ;sišië,·Ž/¡;;;¡..··..······················..·..···..······............................... BAKERSFIELD CA 93301 . II :..!. II Certified Mail Provides: I . A mailing receipt · A unique identifier for your mailpiece · A signature upon delivery · A record of delivery kept by the Postal Service for two years I Important Reminders: , . Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. I . Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. · For an additional fee, a Return Receipt may be requested to provide proof of I delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To rec~vea fee waiver for a duplicate return receipt, a USPS postmark ol'l'}ií:lur 'Certi~ Mail receipt is required. , . For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". · If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not .ed, detach and affix label with postage and mail. IMPORTANT: S is receipt and present it when making an inquiry. PS Form 3800, April 2002 (Reverse) 1n?c;.OI:_n.. .. J~__ 'FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "W 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 FIR£ SAFm SfRVICES . EIIYIROIIIlEHTAL SERVICES 1715 Chester Ave. Bakerslleld, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakerslleld. CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakerslleld. CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 TRAINING DIVISION 5642 VIctor Ave. Bakerslleld. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 . . October 31, 2002 -~ ~ .,J.: Orange Belt 3640 Sillect Ave Bakersfield CA 93301 CERTIFIED MAIL 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 I Operator, If you are receiving this letter, you have!!2! yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). Senate Bill 989 became effective January 1,2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. CUI!ently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last six months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to nerform this test. bv the necessary deadline. December 31. 2002. wiD result in the revocation of your nermit to onerate. 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. Si:a d££J Steve Underwood Fire Inspectorl Environmental Code Enforcement Officer Office of Environmental Services ""7~ de W~.97~.A0P6.r~ A W~" e e ¡. , SWRCB. January 2002 paseLo~ Secondary Containment Testing Report Form Th& form 1,. ¡"',,,ded/or u.rø b.~' CCJIIlractors pelfol'mlng pel'lodle te.fling of UST stlCOntlary eOlllol/nIellt ,f.,'~t",I.', L.~f' tll, øppropriQttl PQgr~ of thi.~ form to r.pot1 ~ul' lot' all COnlpdnellt.~ tt!lltrd. 11re COntpl~~d form, 'wlitt~ te." procedr4/"n, aud prlnløut6from l..flR (if applicabl,), should /xr provided to ,ht! lacility oWI,er/operator for $ubm1ttol 10 Ih. local rrsulmory "gelr,,', 1. FACILITY ~FOR-"A nON Paollit ~ame: Facility Address: FICDity CWJ\aÇt: Date Local A enc Was Notified of Testing : Name otL9cal Agency Inspector (lfpre.,.nr durlll tP TEST1~G CONTRACTOR IXFOR.'\otATIO~ U SWRCB Licensed Tank Tester Uc:eni¢ Number. Compo.at Pan F.U Not RtpaIn ColDpoltll!DI PM. ,.u Not Rlp.1n Tested )ilde Tilted !\t.de ""'T"-/ " IA,~ JJI' u LJ U LJ U U U U !oJ U U U U U U ¿..) <'__JI I. ~i .J!1' ¡J I' U U U U U u ,. U U L! U U U I' U U ~.. ,¿(). ',n.' '- U it u u u u u u , , , U U U U U U U U I ~ "d.-I U l,¿d U U U U U U U U u U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U :J U u U U U U 3. SVM1\1ARY OF TEST RESULTS Ifhydrostatic; teitin¡ was performed, describe .....hat was don. with the water after c;on1pletion of tests: ~'X~I7~~ ;i*i.:i ,ff,";j;' ~ ~~J:; 7Ú lIi.d lú'IØ CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING TIDS TESTING To mil /JIm of ml/rn"wlttlgit, tht! A ltttlt~d ill thJ.. 'HIM'" (IN accltTllte II"" ,,, ftill cø",pllll"ce willi Itgll' nttU,~",t!nIR Technician'. Signature: Date: //-~tJß- ~0·d sss't 't-þoJ.. 6SS '3-r-~ W~ 'tS:'t't ~00~-0't-33a e e , , , r , SWRCB, January 2002 Platt z., Of~ .. TANK ANN'(;LAR TESTlSG Test Me1bod Developed By: U Tank Maøufac:turer U Other (SplciM Test Method \,1scc1: U Pressure U Other (SpecW'~ Test Equipment Used: CO~""''AJt.t()ù,~y . ~dUStry Standard Y'acuum U Professional Engineer U Hydrostatic I RauÌmnent Resolution: . . ,ø. '.,' '... ' ',,' . . . :.' . : :::.:~' ..:., ':'~' ":',' ' f: " ....:.' .~ I' .:" :,~~,;':;~¿\}'~:~;,~~,,:.:;> :;, ',' :~; ~;~:~ ':, ~~i i:,,<\;? Tar-Ie 17=/1 II Tank E~emp\ From TestinS71jð'Vcs UNo Tank Cap.çjty:~,;' -, Tank MalUial: I ~ L '"':' ~ 4.J..e I T$I\k Manut\ac\urer. .ft'JA.c' :R,."H. PmduCl Stored: ~. 6.56/ Wait ûme between applying ~SIØ'e/V8C11umlwatcr and ltartlna test: Test Stilt Time: Ini\ill Reading (RI): Tnt End Time: Final Reo.dinS (RF): Test Duration: QtII.. in Ruding (ll,.R): PllulFail Threshold or Cri~a: Telt Res\llt: " '.. ., .,': " .. '.. f' '. " ". .. ',,' '. ",' W Yel UNo Tank" UYc:s UNo Tank tI U YCI UNo Tank" CfJAh11.1'" :"~d -' .' ¡, J)J.. Was sensor removed for tUting? WasleD$OJ' prDperly replac:ed and verified functional after te5tina'l .4'PIUI U Fall uYcs UNo U~A U PIU' U ,an U Pall U Fall UYes UNo UNA U PUI U FaU UYe5 UNo UNA UYa UNo USA U Yes U No UNA uYes UNo UNA UYes UNo UNA UVes WNo UNA Comments - (illcllKltl ilrjormorion 011 rrpø/I'J ntad~ prior to re.~li"" ami ncønt,,'endeå follo14'-Uefor failed ,..".t) ... Secondary çopainment IYitem$ where the coØtinuouA monilorinSlutomBticølly monhors both the primary and seeondary conl.linment, such .. systems that are hydrostatically monitored or under conitant vaCUUln, arc c~empt iiotn periodic c0111.1imnent IClUng. (C.Ufomia Code of Rcgutations, Title 23, Section 2637(.)(6)) to0"d 8S81 1tooL 6SS "3·r"~ W~ ~S:11 ~00~-01-33a " , " . SWRCB. JanuU')' 2002 Test Method Developed By: Test Method Used: Test Equi1Mlcnt UHd: ,,:. .:.: :~:.,~.~!¡.;;:.,>::.:j,/.~>::;.~,;,:" "::', ., PipitlJ Material: Piping Mln\lf~tllt'er. Piping Di.meter: Length of PipinS Run: Product Stored: Method and location of alWllloNn ÍlotatÎOD: Wait time between applying pnlSlureJVlcuumlwlltOT and ItlrÛrllr lest: T.t Stan Time: Initial Readin¡ (R): Tat End Time: Finel Reading (R,): Test DlnliOl\: Change iD Reediøs (RrRI): Pass/F.iI Threshold or Criteria: Test Result: e e P.¡o'3> 013.::' 5. SECONDARY PIPE TESTING U Piping MMufacturer U 0Iher (S".cfß~ ,nresSUI'C o 0tMr (Sp«(/)~ ,6lndlJStry Standard U Professional Engirleer o Vacuum o Hydrostatic I Equipment Resolution: -, .. , .... . " ., raplnl R.I1." J ~·"'--·J...ðS '-.'_ :1,,: ~~I~ ß.t1L ¡~·--.I PlpIftl RuD 1# Plph&lllun " Plplnl Rø tI ~fè'/J ~ j '; _:.J · I,A,/J~ J Jð~' ~ I ~ ..".. .~d;' ~_.- ',j If ~. ÂUt U Fall U Pall U Fan U PUI U Fan U Pa.. U Fall ~:~I~. ð~(.Ø b'(!~A/ /'k~ , '.' !;;0·d S!;;S1 J'Þo!.. 6!;;!;; -3·r-i W~ ~!;;:JJ ~00~-0J-33a e e . . " SWRCB, 1anuary 2002 Page *- of g:- Test Method DevelOJ'1ed By: U Sumll Manufacturer ~ndusU)' Standard U Professional Engineer U Other (:SNdjj~ Test Method Used: D Pmsu.ro o VaculW ~)'drOJtatic o Other (SfNCif:o'J Test E4uillment u.ed: . YÞJlll1'I'S6 Equipment Relolution: , :~;;i:;~;;¿<::;~,:':\:' ..:..... .. ''',!', ' , , . . "~' ',t, . . :. ,";,,' ~.' .,'.. \.. : " ,.¡. SUJDP " I SumÞ , Suøp " Sump" ..,", '..\'... " ","'7:' . ,. . ",'.,' Sump Diameter: ¿¿;" Sump Dq:¡th: , ::t:.. ... Sump Material: _'1 I, __ Height from Tank TO:! to Top of .., Hiabest Pinina Penetr.tion: I :2JI Height ûorn Tank TOJ) to Lowest ~" EJeeaiOlI Penetr.tion: Condldon ofaump prior to teJting: nl,. Portion of Sump Telted' - ð.. "- AJ..... M - r DoeI turbine shut down wben ,)tfY es U~o i.J~A lump "nior detects liquid (both :.IYC$ uNo UNA U¥cs UNo U~A U¥es UNo UNA produd and water)?" . Turbine sbutdòwn response time ;Z ~S I!t:., II SYltem progralnmed for fail.safe ßes :.J~o U~A L,;'Yes UNo U:-lA UYes UNo UNA UYos l.'No uNA shutdown?" Wa. fail·safe velified to be ¡,¿yes uSo u:SA uYea U:So W~A UYIS UNo UNA UYes UNo UNA OÐerationI1" Wait. time between appl)'Î1'Ig prcsllJI'eI'vacuwnlwater and 5t4ning ISm~~ test Test Start Time: I' ~'^ _..~ initial Reading (It,): ~. Tellt End Time: ~~- Final R.eadinS (R,): ' - . ' .drl\L III, Test Dllfluon: ð. ~~ t Change in Reading (R,-RI): Palt/Fail Threshold or Criteria: Tnt R.elult: U PUI fFaIl U Pas. U FaU U PUI UF.U U ,... UFan W.. sensor removed {or teatmg? l-Jd"Yes U~O UNA UYIS UNo UNA UYea UNo UNA U Yes UNo UNA Was amSDr proþCJ'ly replaced and lA"Yes u~o UNA uYes UNo UNA UYes UNo uNA UYcs UNo UNA verified (unc:lÏonll after testinlt7 6. PIPING SUMP TESTL~G Comments - (Include Imo/"1'llQ1Îon 0» ~pDJ/"S mad. wlor to rfwlllll. ami "'cOlf"~fd.d rollow~llp (or !Qf{ed tellts) ¿uI,-,r,f;,. ~l/táI d',..~ ~rJ f'h¿'e ..A./ l'1"rd¡e' LÇ; -ÂJ ~ ..~. . I If the: c:ntJre deplh of the 5~snp il not teJoted, specify how much Will tested. If the answer to IIri Drth. q~cliio". indicated with an asterisk (*) is "~O" or "NA'" the entire IlImp must be tested, (S.:e SWRCB La·1OO) 9Ø"d SSS': J1>..!.. 6SS ·3"r·~ W~ ~S:JJ ~øØ~-øJ-33a ~ ~ e e , .¡ . SWRC8. January 2002 h.e S of 1:" 7. 1.JXDER-DISPESSER CONTAL'ðtEST LUDC\ TESTU\G Teat Method De"eloped By: lj UDC Manufacturer ' ;'fndusU)' S\IIndard u ProftlssionaJ EnJineer U Q\ber (S)f!t!lJj~ Test Method Used: C Pressure o Vacuum "æ1hdroNtie o Otber (SlWCiM Ta' Eq,,¡)\~n' 1J~: 'Á Aa - ~~ Squipment Itesolution: ,,': \,,} {-.:.~ ~\/:' '~'(,:' I,' ,: :;'. "'" .~: ' ' -', . ' " '.'" , . un "':-# f tIDCN UDC' tIDC" UDC MUu(lctllrer: IE",.), ~Mattrial: ... , ~ DeDth: lit; ~,,- Heigh' ftQm UDC Botl.O\1I1.O Top ~." ofH·i.mest Pininl! Penetration: H,I¡bt ftam UDC Boftom to "p" Lowest ElcctriClI Penetration: Cðndirion o(UDe prior to Jl=ÃJ¿# tcstinJl: Pottion orUDC Tested '_,.ß. ~ Docs turbine shllt down wben l,dY II uNo uNA UDC IeJIsor detects liquid (both uYea ~So :"~A LiY. UNo uNA uYes UNo uNA DrQC!uc:t and watet)?' Turbine shutdown res1'On1' tÌ1ne ~/) _~¿:r, II IYI\efn J'fCIgrammtd for fai\- ~e5 UÑo UNA UYes USo UNA UYIS uNo UNA UYes UNo UNA safe sbutdown?' Wa. fail·"re \'erified to be l>fY es uNo UNA DYes CSo ~SA DYes DSo DNA DVes oNo ONA opeftItional?' Wait time between Bpplying presaure/vaeuwn1wlter and 1..< ~ ,~ ItanuuE test Test Stan Time: J.'Si'J ~N\ Initial ReadínR (R.): ~ Tcst EDd Time: 'L.·Vf FiDat ReadlnlZ (R,,): L_J" - . Tc&t P\Ø'ltion: lc. _ ' ..: ChIDSZC iD RClldulJ1 (Rp·R1): PAillFait Tbre$hold or Criteria: Test Rault: U P..I ~.U U Pu. UVaU U Pal UFaU U Pass UF.n Was sensor remo\'ed fo: teating'? ..ð"YeB OSo :J~A DYes ONa D1A OYa DNo DNA DYes ONo DNA W88 sensClr ptQ)erly replaced and... WYell U ,",0 uSA U¥cs uSo L,,;::'¥A U¥e.s UNo uNA UYea U:'IJo WNA I verified funcûonAI after testing? Comments - (include 11I!ormQ,j{m 011 I'~pairl mad, prior '0 'effing, tl,rd røcOnl",t/1Ided fo/lrrn'.tp fpr [oiled I«.,t,) ¿.h"er /eVrT/ dh¡et ./N-:ÆÞfII ~","tD ./Þ/ ~ /$' ",f~ ' '" I l(tbe entire deplb oftbe UDC is not tested. specifY how ¡t'lucb w.. t"ted. lfche an !lower Co W of the questions indic8t1!d with an asterisk (.) is "NO" or ''NA'', the entire \fDC must be ccsted, (See SWRCB LQ·l60) .!.Ø·d SSSJ J'Þ.!. 6SS ·3'£·~ W~ £S=JJ ~øØ~-øJ-33a c e e " ' SWtlCB. January 2002 pase -k of :3:- 8. ¡"ILL RISER CaNT AL"~r.NT S1.j:\\P Ti.STL~G Fac:itilv i, Not Eauhmed With PilllUl~ CorItainmont Sumps ,¿ fill RiMl' Contaln11lCftt Sumps are Proleme. but were Not Telled U Test Mltbod Developed By: U Sump ManufaC1urer U IndusU')' Standard U Professional Engine. 000« (SpøcIM Test tofccfsod Used: U Prcuure U Vaç\auut U Hydroscaci\: LJ ooer (Specif>.) . Test Equipment UIed: Equipment Resolution: .~. ':: ::. \:~>. .~:. ~. .~'~e;:~:·~· ,: .~~.~:. ::~ ~ ~'f:~ ;~,~:~:::. .';:;: :.~;:;':'.\/ . ,..' " ,. ' . ... '., " ..' .... .,' . ...; ~; .... .', -, " FW Sump #I FlU SUlaD 1/ PID Sumø f# PW Sa..... , Suma Dí'1nIwr: SumD DCÐth: Hel¡ht from Tank. Top to Top of Hiabtit Pitlin2 Penetration: Htight &om Tank Top to Lowest Electtical PenetratiOll: CoDCIition of sump prior to \eltIJli[: ' PoniOf) of Sumø Tested Sumo Maltnal: Wait time between appl)'iDg pmlLlro/v.cuumlwater and staninl test: TC8t Swt Time: Initial Re.lldinll lRr): Test End Time: FÜlal RCldmsr fR.): Test Duration: Chana. in RCldin. (R,..R,): puiIPllln Threshold or Criteria: T..t Result: U Pu. UFaU U Pa.. UFaU W h.. U Fall UP... U FaU Is chere . .sensor in the $IIn]tl? UYea UNo uYrs U~) UY~. L.INo WYèS UNo Docs the sensor alarm when UYes UNo uNA either product Of WIta' il uYea L.:No L.;~A UYea UNo UNA UYes UNo UNA deccctcd7 Wn Nnsor rcnwwcd for testing? UYcs UNo USA UYes USo uNA UYes. UNo uNA UYcs UNo UNA Was SIInSOt properly replaced and UVea UNo UNA ~J''' es u'No \.I~A UYea U }liD UNA UVeA UNo uNA \'erified functional after testina? Commen h - (Inetude /n/orntation on repair., made prlol' '0 fcs,'n,. and reeolt/mended folfow.ulJ Jòr fall~rJ fc"M) '" 8B"d 8S8J JpL 6SS '~'r"~ W~ £S:JJ ~BB~-BJ-~3a , " e - ... \., SWRCB.lanu~ 2002 pase ~ of.1 ., 9. SPILL/OVERFILL CONTAlNJ\lE]IIT BOXES '.dUty i. ~ot EqumÐed With SaiJIlOvril1 ContaiDmtm 80~. J SpUVOvcrfitl Containment Bote5 are PreIleDt, but were Nor TesteetA' Test Method DeYeloped By: U Spi1l Bucker Manufacturer U Industry Standard U Professional En¡incc:r o Otbet (S~cljý) Test MetlIod Used~ U PreUIart U Vacuum U Hydrostatic , U Other (S~cV>~ TCS1 Equipment Uled: I EqWpmcDt Resolution: : .:,:,b;J¡i1;{:~~Z~:i:t::X5:'.::'~i.·;Y;::i:i\"':·· : ...... ,:,." ':,.:. '{~... . ~ , . ....... ... :....~ ',,: "';¡'"'' ......:...; ....,'. .....;,.: ;.' , i~·.. . ~ . . .: .' .::' :,.,~~..,":,' "i.·,:~~,.iY.: ',': ':·'.I"·~'· . ,." 0', " ...i~· ~.;."" ; " .. ": ;.' SpW Box , Spill BoK 1# SpW Bas" spm Bos 1# Bucket Diameter. Buwt Depth: Wait time between applying prc.lurclvacuum!wlter and sLlninll \&It: Test Stan Tiu1c: lultial R.CJdins (Il.): Test End Time: Final Radin. (R,,): Test Duration: Chartge in Reeding (RI"R¡): Pa.lIFaU ThNsbold or Criteria: Teat Resu1t: U PUI U Fall U Pal' U Fall U Pa.. U Fall U PUI UFIU Comments - (inçlude ilJform12tloll 011 repQ¡'" naade prior to tutln$. (Jnd recommended/allow·up /or failed teiiu) 60"d 8~8i iÞ¿ 6~~ ·3·r·~ W~ Þ~:ii ~00~-0i-33a ~ I o Agent I o Addressee I C. Date of Delivery I {Z- -ø2---t1Z-¡ D, Is delivery address different from item 1? 0 Yes I If YES, enter delivery address below: 0 No . 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 mail piece, or on the front if space permits. 1. Article Addressed to: , r ORANGE BELT 3640 SILLECT AVE BAKERSFIELD CA 93301 --- - - -~ -- -- ---~ --~----- _ _=-o~__ _~_~_~ 4. Restricted Delivery? (Extra Fee) 0 Yes 2 ~ '\ 3. Service Type o Certified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise o C,O,D. 7002 0860 DODO 1641 5165 PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M,0835 : b. '~>I ,p~aSS-:Mai1"p¡' .,.,"::->',.. . .,' "">;Y:'t "'&"'F"'<,". "d ,-'. '7'<:; OS age ees 8J , , , USPS '- , . ,,-;:,.~ -Permit No:-G-10,-.., , . . ¡ / \ . i . - ~ , , , ' .." ,^, ~1'~,,",,""P:':.'":~ ~ r~':'~';~ O::2PAí';rììlJ;1ENY ~ ,:' .... ,.:;1, . "=:". ' .' ......, " ""-N7AL S ~'RV'CES , ," -<'. -: r 7: if.:.:¡\1VIL":;'V;\o,'.:c' I, I- ~ . ... WÐ .. ,,",L,,'}ter Avenue Suiw 300 t.,.J ....J~ &",..~ J B¡;;¡~arsfiaki. CA 93301 I I 1·3~'::::::C¡ i ,/:S:2 i G i {I/'III /111,1111/",11,1/,1 /! "I 1// ¡ f III"'I/II! /1,1,11 I ,I IJ" , ..D .-=I IJ" U.S. Postal Service CER1'-"~D MAIL RECEIPT (Dome~~.; Mail Only; No Insurance Coverage Provided) '.-=I ::1"' ...tJ .-=I CJ CJ CJ CJ Postage $ þ ::' Certified Fee c:J Return Receipt Fee ..D (Endorsement Required) I ctI Restricted Delivery Fee CJ (Endorsement Required) ru Tot g Sen, ORANGE BELT I'- ...... 3640 SILLECT AVE Strel or PI BAKERSFIELD CA 93301 ëiiý,' Postmark Here , ..................... -...............-... ~--- :.... ., ." ... .. .. . Certified Mail Provides: · A mailing receipt · A unique identifier for your mail piece · A signature upon delivery I . A record of delivery kept by the Postal Service for two years I Important Reminders: · Certified Mail may ONLY be combined with First-Class Mail or Priority Mall. · Certified Mail is not available for any class of international mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. · For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mail piece "Return ReÇ,f!Jpt Requ~sted". To receive a fee waiver for a duplicate return receipt, a USpspostmark- on your Certified Mail receipt is required. · For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". · If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT_e this receipt and present it when making an inquiry. PS Form 3800. April 2002 (Reverse) 102595·02-M-1132 fiRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'W 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. EIMROHIlENTAl 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 . -¡ 'i.- t f ;; .;""', ,> . December 1, 2002 Orange Belt 3640 SiIlect Ave Bakersfield CA 93301 CERTIFIED MAIL FINAL REMINDER NOTICE JANUARY 1, 2003 DEADLINE Dear Tank Owner/Operator: You will be receiving this letter on or about December 1,2002. One month from today, January 1, 2003, your current underground storage tank(s) will become illegal to operate. Current law would require that your permit be revoked for failure to perform the necessary Secondary Containment testing. In reviewing your file, I see that you have received "Reminder Notices" since April of this year. This is your last chance to comply with code requirements for Secondary Containment testing prior to January 1,2003. Should you have any questions, please feel free to contact me at 661- 326-3190. Sin¡ rtkc Steve Underwood Fire InspectorlEnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~7~ ~ W~ .¥OP vØbOPe .r~ A W~" APR-~Ø-2002 09:35 AM T.J.C. 559 741 1858 P.01 \~0l-,~ . .~ ,'" .,. ToJoCo 3216 'Vest CQDÞpolA Ave., Visaluð, Ca,lifoJr'uid 93277 Phone. (559) 732.7609..Faxl (569) 741.1858 L.i.CE'HSe #728782 April 10, 2002 TO: FROM: Steve Underwood Sandi Jones--- ~ ----.---. ~, " REGARDING: Orange Belt Stages' 3640 Sillect Ave. Bakersfield, California On March 26. 2002 T JC performed the Annual Underground Storage Tank Monitoring System Certification. I made a mistake and called the County Fire Department to schedule this test. They informed T JC they no longer do this testing that the Environmental Health Department does. I called and talked to Ms. Laurel Funk. I was asked to fax the date and time I wanted to perform this test. I did. No inspector showed and we performed the test and filled out the new required forms. (see attached). If you have any questions or need more information please give our office a call at (559) 732-7509. Thank you, ~1r5ì Sandi K. Jones ~ TJC 5i9tJ1'~~ APR-10-2002 09:36 AM ; T.J.C. 559 741 1858 P.02 f e .' e M()NITO]{ING SYSTEM CE:RTIFICA1'I()N , Pur UlfS By A'I J"'Ii,dlclioll' W",,¡,. the SlIlIe .if Califrmll'fJ ,'II,thud!.' C;¡.~.I: ChtllJter 6,7. 11,.,/t. Glut Sqlif1 Cod,.. C"øp'.r',J6. DMrion 3, Title 13, Cali/Q1'nia COile ,?/RC,I:lf/llliIW.f 'I hi, 1i'1Il1 11m H be UlOr(' tlJ dl;lcul1lenl tl:IUn. and llerviçina of monitorin, equipmel1t. A.JmiUIŒ "llU1l=..!I,I2.tuU:.I:SJ2!~I!m\!!i1 ¡!S'. HI ~ H¡1I q~! Illr.(;t\I\JII{'!II.i!q!:iJ\&1'~I1(llLH11\b:Ql.mU11 by the tecbnlc-it" who þeffonns the work. A copy of this fu"" l'f'IIJSI b,: 1)fÌ)\,HJtcl I() III.' 1,1111. "~,I ~II 'I rI til' nl:11upCIAlor. l'h~' QWI)tr/of:ICl'ator must illbnut a cop)' of thl. form to the loc.luSl'ne)' regulating US'\" ¡;)',(~m:; \\ Ithin \11 '¡,IY' 11\'11:: t clule, '" ". 1,"'111'1':11 Inforl11:.Uoo, ~_L.¿" ,.,.../.' I ~,cil¡l> Nllm': .._ _.~'I1d.~..,4._.Þ!!/LZ~¡&[~ , ~;tlC ¡'\lhln'1IS: ._,_.~.,~if:L~..Jt-s:ilt5Ct-' A~. I ;'~:llit>, ("111I<H:t P¡;r/ìort: ..:.ð!t21&j.-. ___ r.I.lb·I~I)llcl of MI)lIiltlri1\a Systom: _..6~__llA\ 14, In n'lI.or)' of Equipment Tested/Certified I ~ Iltl'l. t'I~I~I'lI~~II'~I~.II,J!:·\;:.I&.!:!~:!='AW'.f=~I~me'i1=wte'll e v ca": _____._.'._II_~...' ...._.:R<C".... II"" '" " ,::;'~~ \';::,¡ ;r:,,~,iã ~~UI__-1i,;¡I: ~.. t*< ~'j~.r.;k tr..aiña p....~---i~õd;¡ ==: .. . - ,. /llIll\Ilal SP,iIl'C c.r Vault SenHI)f. V" ~"W: - . a Annular~p.cc: or Vlijh St·nlor. Mudel: _._.....'.._ . P'pillg ~'I.UII' / Tn:nr:l S~nllo\'(.), Mucic\: itL:e.t- 0 Plplllg Sump I'french Se\lsar(s). Model: ..._. __~ . '",. U Fill ~lll\111 S.:n50ru}. Mudc!: _~__~ Q Fill SUn'lf' Sc:nsor(')' Model: l.I ~k,:I\(lnlC:'III.i"e !",:al~ D""c~(or. Mndel: .. Q Mech.qìcII Lll\o Leak Delector. Model: .,,_,.___ ...._ .' ,. , " LI E'I:,:uuflic UIII! L"'ØK }rl~ct"'r.' MI,ciel: ---- a BlectrUnh: )..Ino Leak Detè.:tor. Mo(lel: _.____. '..._ .. .. .. , . '1 ;11')., 01 ernlll }ish-I.evel SC:/'If:Of. Me/dll: '-:¡:;-c:;- ....... 0 "~k Overfill I Hføh·Le"el Scnaor. Model: :..:__,_ ,,,_..._ . _ , . H ~lhp,,~1!~~I)'.5!\.!f.'~!~.un!!.!~=/lín Sectior~ Pa 1S:1. Q Otber a ~cqUi~'nc2!.JW.!~!.2~!!t.!!\~~¡£~!;,!L~~,E~~t;l. .0'" ,'I'aulIP:.,_......,_._.._.._._.__.__.,_....__ ___"'. T.lkll)r__ __.__.__.._~._'_._,_,.........~ _....,.. 1.I III 'I':1I1k (']mll!iIlS PI·oha. M"dc1: ___~ Q In.1'ank (laua1ns Probe. ModI:!: _._,__.., "'-I-' . . .. LJ A\lIII\;U Spacl: or V,,, It Slnll\lr. MI'<Icl: ____~ a Annùlaf $pa~ or Vaith Stl1lor. Mod.:l; _"_..__......_ .... U "\I'II!: ~¡\1I111' / 'l'n'ndl 50:1\501'($). Mudel: ____ a Plpt"l Sump I 'trench Son.ior(a). Modl:l: _._,__._. .. _ _. , LJ Fill Slut:! SII1SUJ(S), Mudcl: 0 fill Sump 5cn$or(')' 'Model: ,.'_ ..... , L, /111";)"11111:811 ,'"C Lt' J~ D.!h:clor. Mn4c¡: --- Q M~hantlCal Line Leak I)el~étor, Model; I L.I !:i<":IIUllic Linc ,"cal: Ocltttur. Model: ---;--~- CI EIIC~lronl': Une t:.eak Dète,~t\lf. Model: -.-- - ...- "". .. , l.I IUllk 0\ èflí!11 High-I..cvcl S(!nlOr. ~114e1; ====_ . Q tank Overfill I Hì",.Lcvel $ellSoi'. Madill; =:=-=:~~. ::': ~::':, ',:~ ., LJ Cm\h(.'1,151'~.II'\'~~c1l,lbJ,n.,',I;,'.n.IIYIKI,"_an.d rno...dc~jn, SeCllo,"..! .011 Pa 02. Q Other I I:ciff eI1t,¡lpmc:nl Iwe anCl ml)dcl irl SlIction t: \lIt p:j~\1' .~\, b .., It.... ... .. IIII!I. ....,.... .. _1....'.._tl_....i.I·._;..,~H.j·:ul, I"'.:.: III ¡1'I'II~.'t· 11):.'-.,.;¡,..d~¿.;¡t!I.I.&,;t. ';.1 h'f---- DI.penl,r 11): _".___....~.~____._._._ ... - _' . L) P,';pl'IIS'r CiJllló1iIlO'Cl1t Senl\1r(ll). MI.del; ____--....:- a Di'¡l8n~ (:Orlt.lnn1tnt SCI\.or(s). Modd:_,_ ._.... ,.._ _,' ." ~, I . SII:?I V.lh'(:IS), 0 Sl\clif Valvc(.). I ~ LJ ~ I ';I~",t~l: ':.(;:\I!~!!Îl!!l~~!~!.ELo.a!l!),.!œ.9aln(a). , -'\ot a Dls !!!!!!~t&lnn"nt ~~1J..!:!!~:!t.!~l!~L.. _,." ..... .. .. . ..' : 111';11"""1'1' II)' " _.._ _, .....__~_...__.__. ___ , Dllp~n..r IU: _,__,_-,,----' _ ..__...... ..... : LI !)1"I\'lu.r Cl.lll\lAillnllillt SeIUt)r(s). M(ldol: _____ C DI~nlCr (:ontllnmetlt Sçr¡lor(II). MI)cM: _,_._"..._ LJ SI ,\' J \Í':'h"1:!¡). a Sheur Val ve(l) , I L [J'!:I!ll~"~ ~~~I,~!!!~1.!!.~~!,~,~~!2au:.ù.!.!!9!3In(I). c DI.p,"1CI (:ollt~lnQ1cn' ft~.l,~!!~l'!!.!!1!: ~,__.. ,,_. _. .., I IIHIIII'5"I'II): .,...._._.... ___00___,___-., þ¡'pe~..rln: ~____.__.__.._.___. ....__,_'... _ .. . II )I' III liSI:r C'.llllaÎlm'C!1I1 SCIIU)r(!l), Medel: " C DI8pcn." C;onlainn'ICftt SCI\/lOI{Ø). Model: __.._......". . , . U S¡ l.' 'I Vnhcp;). ----:--.....- 0 Sbear Valv\.1ø), ~. ~II )l'P':H~~':S:~!!~,I~,~~:~! ,!!~.!!:rl!~il\j.>, ~_ 0 bl. cnSCf Con'alnn'f~f!~~!l.!!!1S~!Í!!1~ L..,_....._ ...., , . ~, · '11\': f:'LiI1Y CI~'tt~hui morc tan I.. or d¡spcn.otl, cop~ thl. lom1. Inol~d. Information for èvel)' 'ank alld dispt~.D6¢t at the radlìt)" ( " ("I't i nC~IUOI1 . I ~r.rtUY Hlat tb, ",lIlpaient Idefttln..- iø tbll "~""lIt """...pect.d/lfn'lccd In nccordaf\ce I' lill the IIIßllllfaçlllfH l' f¡llillelillt's. ¡\Uadlrd hi this C~rtlllcatlon 'S htr,nntUOI) n." Þ1InUr,~t\lt1lh' thtcldbts) lI.us.ar)' to I/crlfy ~lIlt thlK Inlllnlll\liol\ It "'1'/ e,,1 .111111 "Iull'lan .howlnl the lay.....r ftIlJßUoril', aqqtp",ént. For ally .qIlIPÞW!1 clpallle of l:cneraUftl ~udl rClIOI'II, I hal'" ;\1-,(1 ;l1(11\11Id" COil)' orllle rllf~rt, (C~I~~ .11 th4l."lrl1)1 a S)'.t,a. "t-up 0 A~. ory rCJlott 11\;11111(1,11\ N'In\(.! (\UÌlll); ..:i;~~lJ~c."" __ SI¡nal\llo: r-~ ,-,. ~_·':L.._ ,__,_ H' _,., ,.' , J!~ r-. , ('.lldl;.IIÏltl1 Nil.: ;r.a,..k~~t":'___- Lioonso. No.:... _---iØ~~! _..s.~¿ /.t.:'_, . II' il ¡'I,'t (,~CIIIIPIIIl)' Nllmc: ._~:-:17- .;.r: ~~_.___ ___ Pbone N".:C:?~uJ ._.?,~. ~... < .~~.~? sll','\rI,lrc!;s: __l.~~_~.R.__~~Î.I.1&sJ:...~~/"¿(· ___ Dat.: ,fTe.ttI18-/Seo'ìdng; .5....I=:~' /..t~.." " ._______.,.,-~'...._"_. Bkg. J~o.:...d. .. .,.. 'City, ¡~, '"I J. h'j 1.' . ':'1i"j I,' _ '. ' ~'I'ß,....~~.DlJl.__u____. -'I'· _.. J_WI 9. ._ Col1taçt Phone No,: t5!.~1.J ,W,= Æ~'r. ... ____ Date ()fT¡:stingiSer\'kiuc ._, ,4,o~ J'..t I .13 0,\/01 i\hUi')I'¡'); System f'IJrUl1c¡aUolI APR-10-2002 09:37 AM T.J.C, ; " 1;"'<11 Us "fT<:ItÎn &,Ser\'ldn C · :., Iì , IIli \'CI sj,).. 11I!,I;llIc.J: .' _..~~!.:...n.L_ St!!:iJ:.t.~~ ~'2. 7t.o,.OÔ(~ - J 559 741 1858 P,03 , ',II, e ~. '!'·I'!'~,:~:W~',J~!!:~~:I!!I..~:~!!!!_ _ .,._ r -_,____'_~,~_"_......,,.._""""E"" ,.. "" !\I ~ '~.. ,9_'''~~~H !!~!~.!'~1ibl!..!!i\nn ol)C~ion.l? .;r-....-..----.-.'-.-.' ...-. .. . ~ :1 , ~ _. f.!, ~~_., !!Jhc ,~is~!!! ala,!!! ODcr~~.!!!11- ___._ __,_-..-__~'...,_ _..,,,, ." .. , ~ ,_~ I. ~.. .9..,~~~_. ,~:!~.ill!.~~~!j..!i.u~U~ j~'s.Pecled, funçtionally teatcd~ al~~'1!inncd ~~tic~paIL_,_. .._ _.. ,,_. . __ _ ,1<'1 "N C.I No* Were allIPcnsor.¡ lustalled lit lowest polnl of second,IY cont.inmenl and positioned IiO thai olhl:1 1!<I¡j ('In! Iii \'. ~I _ _..___., !ill.Ù!!!g!k!:£!ßI b their 'proJ~er ('perltion? _______. _____,,____, _ ,_._... ... _ _ '.,.. .. ill '\ ,'S 1;..1 No·' Ir alIJI111 aro~l'ela)'ccl 10 . rcn\Cte P'IOnitorln. ¡Iation, Is ,U comll1unlt!luions eqHillilel\1 /e.~(, 111(:<1(1111 I .w N/", ()pl~rl1'iOllQI1 'I~' ':.1 ,:·s ,,' 'lj"'·Ñ;." ':o;j)i;;;rïtcd piping sy;t;;, doe;ïhe turbIne lutomatkllnÿ.hut d()\I,;¡fìh;-l;ii;¡ng·;(:~md'~'~~l;;;',i¡;¡;rl~IL',;1 U N/A morlit:lrinn 5)'st)m detec:ts.leu1c, full. to operate, or II cJectric:aUy disC:Mnec:fe.J" II" ye~:: whid¡ ~l'n,;(~r:; ¡I,Hi,III' I)O!ìiH¥c :¡hut,down? (Ch6r:1c till that 4ppM . S\lrnl~r¡'rel)cb Sensors; Ü ()ìsJ'f:nst~r ,c:onliinnh:1I1 Nells!'ni, __.. ___, 'pil!.~~!!!.~.!!fin'~o8I\1ve 8h\lt"(!9~' due to leak, w18ensor r~dis.£2!.!!1.!£.!!pn'~,_~_~: :~:ì_ 9.1:! !~.:_ ' ...'" _, . , II ",,~ ~ No~' Fur funk systcms that qtlli~o tbe trtnnltorina IY'tøm J,' the tn1nmry tank ovt'lfill '\~m;l1~ I!PVI.:t' (i .. ¡,II i U N/A lIIeclumÌt:al overfill preventiQn \Olive i. inltaned). fa the overfill wamln$ ahmn ,'¡sible iLHd alllllblc:: (II Ih( t,I\I 1_ .... _... ..",__. .. !lH.J?.2.!nl~Ì!Lndope'atip&J!2~~rJy? tho. ,. what þcrçenr uftank CIPåciSt~~~.!.!!~!~!.!~r~ ¡~[.~~~~ I'~. _ ..~Ù.: ._. '~~ : iI( " ,'~ I "N() WOIS flny monih'rin¡ equlpmcnt replacc:d'l J()'u.ld~tlfY specific sensol·s. pmhe!l, I)C olher ~·t)Lljlll1I"III('Plall d :., _ ., _ . _'..,,_.__ ,~!!~L!l?,tÊ!!t..lli!!!I!f!!S!!!Œt!!.~Q)c and n'~9del fQral~plac~lI:nt parts In ~:tlo!!.-ªJ!!::!!?.~. .~.._.__ ...._ "... ,_._ , II " "1; f .e¡ No WitS Ij~1l1ld fOlllH! inside any sccondllr)' çontainmcnt ')'$tems desi¡llcd as dl')' sYl'tem87 ({~/¡tl'! (III I/¡"I I/}JJIIII} 1:1 " .. . _" _.."...._._, yrcp.!!S!i_Ll'y!!lcr. 11~Ar:'Bcribc c'LI.~.ln Section H. t!:~~______._,,____,_,,__.~..,.~. _. ".,'.. . .'~ ,) ':~ .. _, .H.I~o*_. .. ~1!!..!!:~!!!.!~l!!i Irstem 1!!:.!!J'_revlewed to crqure ~rope! .!!ttlu¡lI? Att~!,~U!E~:.e!~!!!.iL!!l?EU~:!1!~'; _"..... _ ,.~ ~, l~,,,, ~,,¡,~~~, .,!~~~~.:.2.2i~~~~uij)nle~!.!~erati~n.l ~er mallutl1ct~~!~~~~:L.._,__"_",.""""",="",,,,_ "'''',.0, · In Sc',:II'11I .': holln", d~lujbl1 how ud w"en Ibesc denclenc'" were or will be torrec:tetJ. . d" . r I F. ('0111 nu:..fs: , _, ~~~~,,"-_.AþJ~a(_...~(,4 r.JA~ f~--t.",-.!~,~¡/J j,.aA~~~,__~_~: ~,¡:., ( .. ,., /;1 ..'~~;'~::.~~,~..~~.!~.~~L~,__ ______~--":- ¡ ________-..__,__.._._..... _,_,___ '.. {\ ~ i ',:, . ............... ~_._...-..__._- ----...._-~ ........----____,~__~_._.._~.__._.. ''''1'- ··,.r' 'I' ¡ , I. ~'A,~',L:,~' ~~;~.::~~=- :a:-~~~~ ..1~ ~ i, =-a;_~~~:~==:~f~'~~f-~~:~:~:~~';t"~; ,,~, A (~(.': ~:. ..._'21~J~_~::...J~,!.~ ~~L1ä........á_Q.. , AI ,......-.LA'~!b__~lr L..-f-li.L....1:' ( .~,!~.." i L - . ./ I ,.~ ,.' ~ cl ~ , ;1,11 ",I~,~~,,"!,~:~,,~, .:!~...~.,ut"~:"'~~-r":"-- -__~,___~____ ___....._.........-..._._ ...._ - e' ".. "'... ... ......,...... ,......__.._.._~_......_- --------~ __..--....____ ---.--..____0 ."._'__-;0- .., .., , " .-.. ... -..-......----..----,.--- -~--- ---...--....---.- ---,_.__.._-.-,-~.. ........ .....' . .~.. '.' .,.. _··~·"'-··..".........._n.__.._....._ ____.___ --.--..,..---.....--- --_.__...._---._~ ....-.-...... ...- .... .. . . - .., .....- ........ -~..-,_...__._- ---- --.------ -+--.-.--."....-,., ,...-..-..- ,. "-' ." ,_" ..... . fi' ... ........."._____,_.__. _~...__-....... ----.-..---- ._~.-...-..-.-_.-.,. ...~.........-.. ".,.- .- .. ..... ,,, .. ___... ,..·.._..._4.__·.___ ~__...........__"""'...-. ........_-_._--~...-_- .---,...-..-.......-. -,.........-...., '.., -' "~I ' .. .,. . , .. .-'........"'.-..-.-....--.---..----... -----------.--..-...--...............-.,.. .-,.. , , ,. .......-... ".-.-..-....--...-. ---------.-- ...............------ -_.__..--~-.." ..-...-...."........ i~ _.._.'fi...·.'·..·.__-'.I__..___. _____ V ____~......__,____.._..__-... """.1_..,.., .. .-,...........--...,.--.--. ----.......-. ----.--.- .---...-...--...., ,......-,.... ., . - ,.. ,...... .1. _.......... _..._.._..__.___.. ~ .___,____......0#"'_...-..,.__.._.".".........._ ._. __.",. "" hfj ) ! III/II APR-10-2002 09:37 AM T.J.C, 559 741 1858 P.04 . ~ e f.. , II' ":IU'~ G....H'ng / Slit ~~qulpment: , )" Check tM, hi)( iftank CIII¡dnß is us.:d a111:r Ii)' in~ll1i1)¡')' 11\1\1,.01 , ,0 Chock thil box ifno lank !!lulling II' mil ':'~l'liplU':lIt i:i 1I':lalkd I,i:, : l.'\:lIOd lIlusL b~: compleled ¡fin-tank gauging equipment is Llsed tt) perrOnI) leak dct!~cti(IIII1l(II¡tnljlli", ~t'~Illr ~,,~'~:'.!~'},~~~~h~,,~~;!~.!.'ì~______-.r' ___..___ .'_"',*"=,''.''_,,,,,,,,,.,,,. .,. '"'''' . ,'tit \'" U No· 1115 un \np\ll wirillg been inspecled tOI' proper enny and tenlûn.1lion. including h:sljJl~ Ihl' II [(IIII\(II;I\III:,? , .;::" 'n' ·t~¿·. -;:v-w;~ïìïJ;kgauï~¡;;~¡;UaUy inspected for dIUTlaaõ'ä;r;;sidue b¡;fuht¡;r--"-'---'" ......."......- ..,. :W ì'I'" ",} r¡~';- I,v~;;·;:~u:;~:-O(;;y$tenl p~~~;d¡nl, tested"---·--- ._~-_.._.._.". .... ...,,,.. .. .", . "...-. ....ø.........._ .....-...-.-:z----~.._..-.-,....,.-........--_--.....~---& J7 ........_____.._._..............._......._._......... ._ \'II I.J No" '.v~III"::Ul'a\:)' Qf~)'sten1\y.ttrl~velreadin¡s ,cIted? . "1'" U1j' ·r~';;..··ï;~~;;;~ïip;(¡;;;·T;iãTI;¡¡;;püiÿ7 ---.--.--,,----...- '---'-'," ,-.... i' \'1" '1; I -t~;;- ·~;v~~~r.;";ïi1t~~;;;; the eq~ipJliëñt mar;¡¡¡'ctlU'er's n;'intcmlnce-;heçkJi.t con1p le¡;;d?"-'-"'" ._--,-"'._. ..., t .::: ":;::¡:: .~~.. 1I''''j'.J_I_I'-_._·.__-'_~ ~...._..,_...............___¡,._,I_I_ltII.:.~ I.t::...-=:....~I= ;:':'.:::::: :~ ; " " III (h~ SN·tilm n, bdtlw, dcs-:t'ibc huw and wben tbelo denclendet werll or 'Wilt bo ~orrect~, 1 )f Ch~ck tbls box if LtDlllre hol init.Ued. C. I ,¡¡Ie L(~nk DeH!ct()l'S (tl..D): I s:11I,~lpl~,I,~,,'~rJ':,~,~I\t~~~~J.~,1~~~_ ~__ _._...._ __.,.._"...""'''=. ,=,::.:",'''.''''..." ", .. ) VI", [J No" Fol' .:qL,ip'\'1~ut st:ut·'lp or aMI,ull eqllipn1Cnt cer1ificatlon, was ø etd~ 8iln\JlaJl~cll(l veril y LI ) lttli), malll t" LJ N I A I C/reck (//1 tlltJ( apply) Simulatc¡J Icnk ,atll: Q 3 ¡.p.h.¡ C 0.1 g.p.h ¡ a (I.~ g ,p,h. , J \ I' .;H( ¡ ¡;J~';. 'ï,Ÿ~~r;;"ãïiîIDïÇë;ñfi'mcd oper'-tTc;;ï;-nd accurate w¡,a;¡ñ-;'~;ãûi~~ rcq~ir;m';¡Ü:?-"--"h .-....-.-...- ,- ..... 'J \(' ,"¡j ~j(;.' ··;,V~;;ih~k~i¡;~ã.1.'parat\ls pr(lperl~iilibrated? ---------- ___'__"_'_'_n .____.n.__...... J '1"', "'(j ¡:~~.~.. ·ï·~';;;~I;;;hi';;i~;¡¡:,J)S, clo;-ihc i:LõPitrict product ~IW if~ï.;tcèfs7i;Llic?--'---..-·_······-·__..- ,_...,..'" .., lJ N.'A IJ ,. c'; ï: f'ï;J(~';- "¡ i(;;:-;;ì';;;~;r;k LLi'$, doclI th.;türbln;;;tomaticaUy ¡¡w.t oJ~¡¡¡hc LLD d(~t;-;;I~ãi¡;¡ -_... '..-~,_.._'- "- ,. ,. ." . .. U N,'^ I J ':('" --ëi ·rj~~·.- -i1¡;~¡;~t;.;¡;kïIi581 d~es' the .~;rbi;iëãutomatic.II)' IIhut olf ¡{;;Ÿ po'ticJn (){íh(~ n:;;;jt;;;:i;;j¡·;y,~ï~I\\¡~·.Ìi;.lt,lt;¡ t:J N' ^ liT di~c')nnec'ed'1 -I ~: (:,;" ""¡j'" -rj~)-; 'ï,;,;;~ie;:t;;;;;~ LLI5'., doe. 'h~ turbluu .utomatlcally ahut ofl1(;lny portion of th(;-;~·;Ji~~¡,~li~~};i~~ïi~ i~¡;;ii',;;;[ t Î! ,¡ I~ I..J N '¡\ (If fail. l &e~t? :J \'I·.·¡J ~j~';-" T~;;~¡;;;;;;¡; LlJ>$, have.1I .,:cessiblc wirina ~olUle,tions bër.:n visUQUy ¡nsp,;:k:d'j;·-·---·-·--·- .,- _..~.., ,'" ... LJ N.'A ¡.J y;;,...'·lr-~¡,iþ~ -i,V~~I·c.ïiitõ;~s;.;¡¡le equiplt·;U¡m;;u¡:¡cturcr', n\llnteñãñë~ëhe(;k1ist c;'~lek;d'l,·~n_uo.~._--,.....~,.- . "... - , ,,.. ':~. r' r .:::.: :-:;. ~T."'~_ .., ,1'.'_1. ".....I-.La:::c...-;. _.-....~_ __......t..-..:~.....__.~__._..ti_I...II:.:...:Zl.:.:.c.;;.:r.:.::;:: .:; .;;::: . :,. .... .:1 ., I I', ." e St',. Ion II, bdon', dcs~rlbe h(IW IInd when flie.e denc:lencl.. wert! or wll1 be cortecfèd. , II. 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'," ·_.._·_.I._-.___.....~------- ._-~.-..._....~-- ...---.-..~'".._._.._. - -. .... .. . PI.13013 (,1'01 ... APR-10-2002 09:38 AM . '''/Jil',ri,'! '\',"S("1I ('rl'/II'knfJnn LI'. .'1' tdl' ~i\'; T.J.C. 559 741 1858 P.05 ¡ :'fi'. .6,!Æi _ ~~~~~,r:lælte p~__,___~___,___ -. . ... ....... .... _.. -...-.... .....~...... 11 ,. , . I ' . ' . '. e ,I ; . . I , ~ . · . , _.___..................tw_..._....·_....·__......_I_.. , . , ~ t... , .1 , i IJ1 'J t . f . I . . I I .. .. . . .. , . , . . . I . . . , i · .. I . ~ . . . I · ~ . ~ ... , ¡ . · , · · · · . · · "" ' { ,) , :'~: , . . :f;&t ),," , I . I . . . , . t,·· , : :, ~ ~{ , , , . .). . , \¡·r. . A'j'\tl, . . . ::::~.::: ~ , . ¡. ..... I . I I' t ¿ . ': : : :~~~:: : · 1 , , . . . i . · 1 ; . · · . 1 · ¡ , · . . . I . · . · . 1 . . · I ¡ . .[~ .. . -'" . . · . · . · . . : :J?'~'~ ~ ~v~r , . . . , . · ~ ~ I . . 4 f . I" . 4 . . · , , · 1 · · t , · · , · ; · · " , · · , · . , · . . . · . ,:, , . .. · . . . j , . . ~ . 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II' " ~ .. ~ _ III'" :!\!r:·dy W'c a diaUl'am ll'at :;hows al1l'equlted infonnatlOh, you muy itlclúdr, it, t·~,thet Ih,mlhÎI1 pæ:gc, with Y\'1l.1r \ ¡,iI1Iiíl\.' i,~ ,Ieln Ccrtif¡catio'l, On Y('IUf site 1)tant show the 8en~rallayout (If tlltlks It.nd pipi,ng. C1ei\lIy idenliry I. I" I 'II' H r 1110:: f..l1mvÎ1lg cq~'ipment. if in~tltltcd: monitoring SY8tem control þanelf1; 5(:n!ìOrs t1lOnitoring I,nnk tlt111111ef ;11 I' ';,':11 'II'S. (i~ípcl1<;cr pnus, f piIJ cont.ai"c~s, ot dfh~r secondnry containment (\feu; rnt~(:haflkltl ()f e!et:lnmic line klk ,1 ., t 'Iii": :'t'd it .1:,1,111<. liqu;d k,,-=' probes (if lIsctl fot leak dc!tecUDn). In the I\,,.ce prtwlr.b:l, note the dnle th;g Site l'lan I' ',', IIIIT:' ,~d, . ¡Me tn4r wat dttMt: ...:.!.J_!'.J _~¡,. Ib.t~,c~tO!\J. I'", _ tit ___ n,'OII 04/10/2002 09:29 661-833-5415 BEST RENTS PAGE 01 ;; .~ e e ... ._...,.,.,..,.._,.....'------_...,....",'".,~',,"......-.--~..__..,_._---".._--"._---,.... --......,-----..---.... ~~~ ====-~=-~~============~ ~~ "À~e iii U,S,\, ::-.~ ._'f~....._.._..,._~__.. ~-..~ -== 6 ,7_ __ .. 8= c WILSON JONI!S COMP,..IIIV 07200 GREEN 7208 BUFF .=1' ~---'" . = 2 3 4 ~.... 5 '- .......- .....-.......... -,_. _.._..'-~.._- ._'....~-_.......~. _. .-,....----.-.. -....-...........-...............- ..-...---...-..-.--.. 3 _.._-_...,.....'~_. -,.....--....,-..-.-., -.........-,--..-- ---'-"-"--"--- .-..-.'-.---......,- --~ - """ - _: - 1- .- ~~ "';1'_ _, ,.. -., .... -' ..'".., I~ ___ ...- '-r' ... .. ..... - .... ,-,.- ----...... ,.'..' - "--" ....1;:-.., ..... ..,., ...,-.. ... -,. 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". ,- "...- ~. ...'.. to- '" (~.. .', ....,.. ...! ~-- ., .,'.,--- : !I ,. .,.. ...- "',...- p -.. ,'~ ,...- ,.,.-.. ~ p ,- .'- . -. 40 1-"- 1- ,. - r- .,.-~ 'II _ ' .. ..-.- -- - - ...., _... ,.-. -... ... '..- - '- -.- . -.-.... .'O.... .... ~-I--._. .-,.-...... .,...~- 2S ... 6 ..-.... ....-. --. ... " ... ~-, r"·"· 1-"., .... .~ ~:~: "..,-t-. =~ :~ ........ ,,~. ...~.. _.. . -....... .,...--.........."'... - -,.. .....< ,,<, ..,...... ...... ~ .. .... ....J. ~---.. 1 1--. ...j : ...., ...,.' ...., ""= ",,: \ .-,..... . ..,~". 28 ..- -... ..... .... ... ......... --... 2ù ....~ ... ..... ...." ....-. ....... ..,....... .. .,,".~"... ..." .... ..- ....... .., .."... -.- J() .n.. \ - .. oJ}:i_ _,~:=:.-.-...~ , 3 ......,- - ,- -- .... -.. -.-...... .-- -f- 32 --.... _.. ... .... ..~,- -..-. - ~: ~-!..-'.':=, .-- ..··1,--..,···- .. --,....... 33 ..-"... ...- ....- ..... ....... .- -.. "..---. .. I·.... _'" ,.._....,,_._... ......-..-. 34 .-.-, . ...... .~.. .... ..,...- ...... ·.1.... ._" __ ...." ....". ......... I. ....". .....,........ .... .".......... ............. ~'..·..r"·- :is j ""!"-j-"'-: ,I, ___ i jIII !O ~ ~ II "t: I i!. _ .., ,.., ~ po ,., ...'.... ,.. ,.. ... .,... ._"..... "r' ...,. . -'..... .~ -. ...., ·'t.. -, f r~ ", '.. '-'" "".. ,.."'" ..:;;¡l- ""C' ..~, - -. ., _... -...., --. -p..."\., ,... ~,.., _._ _.._ _" Iø ."". ..'j"........-....' ........._. ,..... .............. ." ..... .-..-...... ..... ..' .-.. .."~- ....- ..... .." ...- - 1'-' -- 38 3$ ........-... ...... ......".....-. 4Q .. - FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 MHo Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAJ( (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 FAX (661) 326·0576 ENVIRONMENTAL SERVICÈS 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 . . April 12, 2002 ORANGE BELT 3640 SILLECT AVE. BAKERSFIELD, CA 93301 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 arid workplan for enhanced leak detection to the local agency, by July I, 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~submitta1." 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 tree to call me at (661)326-3190. Sincerely, Ralph Huey Director of Prevention Services by}t ~ Steve UndelWood Fire InspectorlEnvironmental Code Enforcement Officer Office of Environmental Services SUIkr Enclosures ""7~ de W~ ~OP.A0P6.r~ A W~" SENDER: COMPLETE THIS SECTION · 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: . MIKE HAWORTH WGE ~ELT STAGES 3640 N SILLECT AVE BAIŒRSFIELD CA 93308 -; : 2, A~ÖðtimT5~efYðððfrrv~tj~~/)3430 I PS Form 3811, Julý 1999 I' . C. Signature Þ6,gent I o Addressee DYes o No x D. Is delivery address different from item 1? If YES, enter delivery address below: 3, Service Type ~ertified Mail o Registered o Insured Mail o Express Mail I o Return Receipt for Merchandise I o C.O,D. I I I I 4, Restricted Delivery? (Extra Fee) DYes Domestic Return Receipt 102595'99,M,1789 ì ~_...._ .......".-=""".:: _ __._ _~ ~~~. ,,<'" ~ ~. -,"".-..".-~-",. -;,. U . ~ 1~' nd ZIP+4 in'this box ., - . 1 . -" . t oú'r name, address, a_ ' '. Send,er~ Please W!~¡\~ ~"." :!Z1JUL-__, _ First-Class Mail = - ostage=&~F ~,_ _",ø==' "USPS, .' '_ to.~. ~Permit NO.,G-=1Q== r;....:;:- <0 I I I 1/ I BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENV'RONMENTAl SERVICES 1715 Che~ter Avenue, Suite 300 Bakersflek1. CA 93301 e \,'S 11.1,".1111.11.1111 111111.1.1. 111.1.. 11111111...11.1.1.111111 · . os a e VIC' , CERTlf?IEP MAIL RECEIPT ,-;; "" ,,1' (Domes, Tail Only; No Insurance Coverage Provided) c m .:r m ..D LJ' .:r ITI ..D C a , c Postage $ .34 Certified Fee 2.10 Postmark Return Receipt Fee 1.50 Here (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $ 3.94 C ITI LJ' Sent To I ,..:¡ MIlŒ HAWORTH c št;ëëi,·Ãpi.·Ñõ:¡õ¡:¡;ö·Šõx·Ñõ:····························.............................. c 3640 N SILLECT AVE c··..····..·····'······..·······..·······················......................................... £'- c/lyiffâfi{síIELD CA 93308 .... : .. May 2000 See Reverse for Instructions I Certified Mail Provides: · A mailing receipt · A unique identifier for your mail piece · A signature upon delivery · A record of delivery kept by the Postal Service for two years Important Reminders: · Certified Mail may ONLY be combined with First·Class Mail or Priority Mail. · Certified Mail is not available for any class of International mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. · For an additional fee, a Retum Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Fonn 3811) to the article and add applicable postage to cover the fee, Endorse mail piece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS postmark on your Certified Mail receipt is required. · For an additional fee, delive~ máy' .ß~ restricted to the addressee or , addressee's authorized agent. Advise the clerk or mark the mail piece with the endorsement "Restricted Delivery". · If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post.office for postmarking. If a postmark on the Certified Mail receipt is no,-ed, detach and affix label with postage and mail. IMPORTANT: ~his receipt and present it Wh~ ~~ki~~g an inquiry. I n~ 1:'........... I)onn ."..... "nnn lO"..,n_n\ 1n?"O~..nn..M.."nn4 FIRE CHIEF RON FRAZE ADMINISTRATIVE 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 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3951 FAJ( (661) 326-0576 r~ ENVIRONMENTAL SERVtCES 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 . Fd. ~ ~' .... c;:,. ... ~ "1:; , ., ~r, .~;.. February 20, 2002 Mike Haworth Orange Belt Stages 3640 N. Sillect Ave Bakersfield, CA 93308 CERTIFIED MAIL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to SubmitlPerform Annuàl Maintenance on Leak Detection System at Orange Belt Stages, 3640 N. Sillect Ave Dear Mr. Haworth: Our records indicate that your annual maintenance certification on your leak detection system is past due. February 13, 2002 You are currently in violation of Section 2641 (J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days, March 22, 2002, to either perform or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: jt ~ 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 .FRAZE ADMINISTRATIVE SERVICES 21 01 oH" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 'W 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 e . February 11, 2002 --- Orange Belt 3640 Sillect Ave Bakersfield CA 93301 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. ShoJlld you have any questions, please feel fÌ"ee to contact me at 661-326- 3190. Sincer~, ....ce. re,.,l., .' A J¿¿J Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services, SBU/dm "¿}?~ de W~ ~.A0P6.r~ A W~" e e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd I¡'loor, Bakersfield, CA 9330.1 .'-..... '--. ..... INSPECTION DATE ~ WO~ PHONE NO. ~Jì - f t lie.( BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES -r;- FACILITY NAME O'1C-~ Sktl~ ADDRESS ~Cn lfo ,'1 FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program o Routine ill Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate peonit on hand t / Business plan contact infoonation accurate / \ Visible address '\.. / Correct occupancy \.I / Verification of inventory materials v I Verification of quantities t.... / Verification of location ,./ I Proper segregation of material I ./ / Verification of MSDS availability ,./ Verification of Haz Mat training ./ Verification of abatement supplies and procedures .,/ Emergency procedures adequate ./ Containers properly labeled / Housekeeping Ir../ Fire Protection V Site Diagram Adequate & On Hand IIV C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ¥NO While - Env, Svcs. Pink· Business Copy Questions regarding this inspection? Please call us at (661) 326-3979 Yellow· Station Copy Inspector: It CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME OraVlfG ß~l+ ~ftt~( ~ INSPECTION DATE~ Section 2: Underground Storage Tanks Program o Routine C1Combined 0 Joint Agency Type of Tank ()wFr!1 Type of Monitoring fOl-W\ o Multi-Agency 0 Complaint Number of Tanks ~ Type of Piping OW F" ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile t li Proper owner/operator data on tile ~ V Penn it fees current L.- V Certification of Financial Responsibility L- 1/ Monitoring record adequate and current v Maintenance records adequate and current v V Failure to correct prior UST violations ¡l/ V Has there been an unauthorized release? Yes No V' Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA TION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? c'COmPI¡anœi:J~V¡OlatiOn YoYe, 1n,pocto'" ~h1l1() Oftïce of Environmental Services (805) 326-3979 White, Env, Sves. N=NO ¿j,A/9X" ~.I Business Site Responsible Party Pink - Business Copy ~~"";: ORANGE BELT STHGE:=:~ 3640 E, J I.LECT PNE BAl:EF:SF ¡ ElD, CA - FEE 4. 2002 10:10 AM ~ :'3V::nEt"1 ::3THTUS F:EPCIRT -- - - - "- - - - - - - - FiLL FUI"JCT I CH~~3 r'K:oRJ"1AL INVENTORY REPORT T 1 :DJESEL VOLUr"1E ULU~GE 9œ-~ UlLAC;E= TC \lOLU~'1E HEIGHT ltJATER \/01.. iAlATER TH1P 3~.98 GALS 8185 GHLS 7006 G(-\L8 3592 GALS :32.74 I r"JCHE8 o (J;,.' 1 c; e 0.00 .... 63.7 D ' F "" '0': :>i "" '0': END ~ ;.; n ;.; ;.; FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 21 01 'H· Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 SI1PPRESSION 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 FAX(661)326~76 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399·5763 e. -. August 3, 2001 Orange Belt 3640 Sillect Ave Bakersfield Ca 93301 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, 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. 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"", ,'I .......,..L,""I-~¡,-:t __~.--.J,~_ , I' , , " " , '·1 ¡': ·~·~~~~f1 , , , , " '" , , , " ,I:. .. :' I' , :,,1 " ',",' , , , " ",' , , , , ' , , " 1'1 " "::"1 :: ¡ 'I I: I " ,I, ",: ,,"':, ':,:::¡I" " ,! .:';;,,' i,,', ' I :' " 'r I' , , I J , ~ I I ': ',II,!':) ,t, I ,I ': :' " FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H" 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 - .. January 22, 2001 Orange Belt 3640 Sillect Ave Bakersfield Ca 93301 RE: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update Dear Underground Storage Tank Owner: You will be receiving updates from this office now, and in the future with regard to the Senate Bill 989, which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will be forced to revoke your permit to operate, effectively shutting down your fueling operation. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning now to retro-fit your facilities. If your facility has upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326-3190. S], dk:J Steve Underwood, Inspector Office of Environmental Services SBU/dm (,(,7~ de W~ ~.A0P6.r~ A W~" ·)F:i-'f'JI,;E E:ELT :::;'1';-:;(,;2::; 3640 SILLECT AVE BF~KEF.'::;F I ELL'. CA .'"N !CL CO'll "'00 ,,,.. I N\iHrj'·: '~:. F'[¡:'C'F:T T 1 :[,[Em:I, \iGLIJfIE: ULI,.i:H~~E '} (:ny',; ULLi-,Gf = TC \IOLI.II"\E HEIGHT l....IATH: \/';)L 1,',JATH~ THIF' 71~'jO !.~;r·1L~~: :.3793 C~¡:·:d_~-:: ~I:o I 'I GMU:; '/j:~'?t: (~t:,l,..:~~ 60, ",1'7 I f"J'::Ht,::::: U GALS U . '-'I Ci I r'¥.: riE:':; 6:3. ':1 PH,; F .* ;:.:: ::.::: ::t£ .':t:, Er'~[' ~. .:.; .~ ~ :.: [~ ORGIN~ (:'b'il',J("f:: BELT :<[',-\1,;, ,;_: ,::~~.~ I~ '..~, I L:1[I:'T ,,1:",11': E'C1U~t<..X 1[',1.[1. '..1-'1 JAN 11. 2001 6:00 AM I N\ŒNTOf.'\' F'£E'()PT~:: T I :DIE:3EL \/0 L LW'1E ULLAGE 90'>,; ULLAGE= TC \/OLUr"JE HEIGHT kIATEF: \iOL t.-JATEF: TEr"lP 7~'jO 37~:3 2614 7976 60.97 o 0.00 6:].9 ':;AL3 GHL~:;; GAU:; GALt~ I NC HE:::; GAL~::~ INCHES DEe;. ~ ~F\ M M ~ . ~ END ~ M ORANGE BELT STAGES 3640 SILLECT AVE Bf-'1KEF::::;F I ELD. ,:::A JAN II. 2001 9:34 AM -~----- S'¡':3TEI"l STATU:'::; REPoRT ------- ALL FUNCT ION:::; NOF:r"IAL I N\/ENTORY F:EPORT T 1: DIESEL VOL U,...JE ULLAGE 90~i ULLAGE; TC \lOLLI~'IE HEIGHT lh.lATER \/OL klA TER TEf'-'lP I 7990 l~;ALS 379:3 GAL~~ 2614 GALS 7976 GAL~: 60.97 INCHES o GALE:; o . 00 I NCHEt; 63.9 DEG F ~ ~ M ~ ~ END M ~ ~ ~ ~ . . /'........ CITY OF BAKERSFIEl.;D FIRE DEPARTMENT OFFICE OF ENVIRONMENT AI... SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Hoor, Bakersfield, CA 93301 FACILITY NAME OrÔ-1I\.9( {kH ~~ ADDRESS .3ÚJt/O H. .5.. (J~d- FACILITY CONTACT_ INSPECTION TIME INSPECTION DATE da/ot PHONE NO. >d)-If lfl/ BUSINESS 10 NO. 15-210- NUMBER OF EMPLOYEES f) Section 1: Business Plan and Inventory Program o Routine æ Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate pennit on hand V" Business plan contact infonnation accurate V Visible address V r ..- Correct occupancy V Veri fication of inventory materials V Verification of quantities ,. V Verification of location V Proper segregation of material ¡,. V Verification of MSDS availability ¡,.. r/ Verification of Haz Mat training V~ Verification of abatement supplies and procedures I..- / Emergency procedures adequate ~ V Containers properly labeled t/ v Housekeeping L. Fire Protection t,.. Site Diagram Adequate & On Hand V C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes c1No Pink - Business Copy Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs, Yellow· Station Copy Inspector: -.I . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME 5rah<'(e... ~+ -5 taft 5 INSPECTION DATE ,/wlof I , Section 2: Underground Storage Tanks Program o Routine ~ Combined 0 Joint Agency Type of Tank ()W\Z5 Type of Monitoring Cl-,,^ o Multi-Agency 0 Complaint Number of Tanks , Type of Piping pwF ORe-inspection OPERA TION C V COMMENTS Proper tank data on tïle J Proper owner/operator data on tile 'V Pennit fees current 1/ Certification of Financial Responsibility J Monitoring record adequate and current V Maintenance records adequate and current V Failure to correct prior UST violations V Has there been an unauthorized release? Yes No \/" - Section 3: Aboveground Storage Tanks Program TANK SIZE(S) 300 9" I· Type ofTankMotør i),( AGGREGATE CAPACITY ?#J It -( Number of Tanks OPERATION Y N COMMENTS SPCC available \I f(fA SPCC on tile with OES ~fA Adequate secondary protection V Proper tank placarding/labeling V Is tank used to dispense MVF? if If yes, Does tank have overfill/overspill protection? NIJ\ C=Compliance V=Violation Y=Yes '",peolo, )Æ, (¡litO Office of Environmental Services (805) 326-3979 White, Env. Svcs, N=NO :xIkAA1,rl~ Business Site Responsible Party Pink - Business Copy T"fPl!! 0" ACTION CJ t. NIW SITI NIMT CJ... ~D PeNMT I C/lecll _ ...... tWr1 Gh. "IHIWAI. PIAMT (~__. WIOaI_ tWrJ BUSINESS ~ (SInIe. 'ACILm' NAMI or DBA . Daint .... All ,'Orange Bel t Stages , lOCATION wrTHIN SITI t'QIIIMeIJ J397512 ( April 15, 1994 AOOITIONAL DUatPnØNtfWIOceI"ody) , ,~·~t '..: I, , ' ".I! , . ~.'jJ _.~._. AN( I I I -CITY OF BAKERSFIELD O.CE OF ENVIRONMENTA"'~RVICES 1715 C .er Ave., Bakerslleld, CA 93J11' (661) 326-3979 UNDERGROUND STORAGI TANKS. TANK PAGE 1 (E C s. ()tAHQI OIIWONMTIOHI PII fII CJ .. T!M'OfWtV SlTII 0.0--' CJ 7. Pl!!RMNoIeNTI. v o.oseo ON SITI CJ .. TANK ADtOYIO (~CIIMfe. wlOaI_ tWr) 3 ,N:JUrY 10. ... L TANK Dl!satPTICJN Mosier Bro o v. Ii No (or..,. ~ 12,000 1 43- ~-"",~~- ----0<--,....,....-_-___....,--.-.-..____.__-=-___ - .. & TA* CGIII8II8 " I TANK we ... I ~ I. MOTOR VI!HICLIII'WL ¡ (11-- ___,...... J)peJ ! 0 z. NON-FUEL fI&TIQIUM i CJ 3. CHÐICAI. fIAOCUCT I CJ 4. HAZAADOUI WAITe (tIcWN I IJMI OI OM. UNCNDWN PlTlQ8MTVPII C to. MCMMWUAœD C z. LfAØ8) C t... """WU!AÐID :£13. DIEI& o to. IIDQIW)I UNLEADED 0 4. GAIOHOI. COIiMIH ~,..,,............. ...,,.,.) o S. JET FUEL EJ .. AVlA110NFUEL 0.. OTHER 44t CAS' t*"",.,.,.,.......... ~,.,.) 44: ¡ , ! TANK AMTERIAL . PÑIIIIY 11'* 0 t. lINE..... ' ¡ (ChKIf - .", OIII) 0 Z. SfAN.IIS..... , TANK AMTERIAL . 8ICIGIIItIIIy 11M 0 t. lINE..... (ChKIf _ AIIm OIII) 0 2. IfANØl.... TYPe OF TANK (Ch«;Ir _.... ody) TANK INTEIUOR LM«J OR COATING (ChKIf _ ,.", OIII) SPILL AND OVEIU'U (ChKIf" l1li1 ...,) C t. .....VIMU. ';.' r, :Dc2. DOC&I VIMU.~" .{. .. TNGC CON8'IRUC1ICJN. '[] So ..... WALL WITH EXT'I!AIOR "tl!PØWII! LN!R 0... .....WALL..AVAULT ,'.~ . o .. 8INGU! WALL WITH NI'I!fIHAL I&ADDI!R SY8TIM 0... UNCNDWN ' 0.. OTHER []s.~ o...~ o .. FRfI C::OWATI8Le wnCIØ MErHAHOL 0.. OTHER 443 ,>, o So F1II!RGLASS I PI.A8TIC 181 4. STEEL CLAD WIFII8RGI.A8S AUEOAœD PI.A8TIC a So FIIEROLASS I PI.A8TIC o ... STEEL CLAD WFIIERGtAII REJNFOAœD PI.A8TIC (FIF) a s. c:::ONCAITI o So IJIOXV..... o ... ""HINOIIC LM«J £:J .. GLA8I LNG ell. UNCNOWN C .. UNJNI!D C.. OTHI!R .... Di'TE INSTALU!D 441 IOceI.. DAm Gn'141!D ";';2 .... o .. FRfI C::OWATIIIU! wnCIØ MErHAHOL o .. FRfI~JACICET o to. COATED STEEL 0... UNCNOWN 0.. OTHER ' 4&5 : C t. ........ C 2. 'AIJM)&MG '0 t. MNU'ACnIRB)CATHOOIC Gl So Flll!RGLAllRINORCIDfI&MTIC ell. UNICNOWH MOTICnDN 0 ... -......0 c:uN.tr 0.. OTHER C 2. MØWlClAl.ANOOI VIfAA INSTALLED 450 TVPII (FfN1ouI_ ody) ~ t. SPILL CONTAIfMNT 1 994 o z. .-.TWI . qL( C So ITNCIIUI&ATI q L/ .... (For""- ody) 4It O\IERFIU. PROTECTION EQUAott!NT: YI!AR IN8TALU!O 452 (SJ: 1. ALARM 1 q q ~ 0 3. FI.L TUBe SHUTOFFVAl.VI! ...ßL. , C 2. BAI.L FLOAT 0 4. I!XÐPr :.;~("_WK ~ . . .~.. .: ~~t~!:·:!::; ':~ '. .', ~r:·:..··;·· ~.:..:y:-:~~. ..-:/)', . .:.:,.:.....:..::..~~. o:!,." . ~WAU. TANK Oil TAMe """ IUDOIII (CheåOlll_od# ..... C t.VISUM. (IINCJ&.I WALL IN VAULT 0tI.Y) C 2. CON'TINUOU8INr!RST1T1AL MONITORINCI o 3. MAMJAL MOHITORlNO 0.. MANUAL TANKQAUGINQ(uro) C.. VMIOII ZOHI! ' C .,. OROUNDWArM i1 .. TANK TUTINO 0.. OTHIR V. TANK CLOIUItIIN'ORIlA1'IGH I ~ CLOIUIIIIN PLAce .... IITIMTID QUNmTY 01 SUllTAHCI NIMINNI .... TANK n.&.IO WITH MItT AMTIIUAI.? I' ... ISTIAMTID OATI LAlTUIID~Y) UPCF (1'"> 411 ..... o v. 0 No S:\cUPAPORMS\SWRCØ-8·WPO CITY OP BAKIRSFIELD .' CWPICIOf' INVIRONMINTAL SIRVlCI~_..... , C..... Aw.. "kenfield, CA 13301 ("1) ~ .. ' un"1't\IIC NOe I VI. ..... CGNI1'ItUCTlOH (CIIeo* II lilt WIr '-11.- 01 -. '. uNOÞQM)UHD PIPING SYSTEM 1"I'Pt! ŒI 1. PAlSSUAI! 0 Z. SUCTION 0 3. 0AA1IfTV 4S8 CONSTRU~~IO~' 0 " SINO&.!! WALL. 0 3. uNI!D TfWICH 0 II. OTHER 4ðO : MANUF4CTURERI6! Z. DOUIU!WALL 0 II. uNI<NOWN i MANUFACTUAI!A 41 i ;0 1. lAM STI!!L a .. FAPCOWATIaI!.....,QK MI!THANOl I ~TI!RIALS ANO 10 Z.' STAKasS ma a '1. GALVANIZI!D STI!!L . CORROSION' ¡ I PROTI!CTION i 0 3. PlASTIC COWATIILI WITH CONTI!NTS a II. tNCNOWN !Cl4. ~ a.. F\.!XJII.! (HDfIE) a II. OTHER I : 0 5. STeEL..... COATINO a 8. CATHODIC PAOTECTION .... 0 5. STEEL WI COATING VI. ~ LI!AK DÐECT10N (CIwctllllltWlr '- - - ."" ,- ~- ,1!ØS~O~ATOMOHtV{t;tltc.t"ew~~~~ ,.~- o 14. CONT1NUOU8 SWP 8I!N8ORmDDŒAUTO PUNP SHU1'OFF +AUDllLeNÐ \IISUAL~ o 15. 4UT'OfMTIC LINE U!AK DETECTOR (3.0 OPH TEST) m:DIB£[ FLOW SHUT OFF OR RESTRICTION o Ie. ANNUAL INT1!GRITY TEST (0.1 GPH) 0 Ie. ANNUAL INT1!GRITY TEST (0.1 GPH) o 11, OAILYVlSUALCHECK 0 11. OAILYVlSUALCHECK .~./:<;;':;; ~~\;( "'.~" ..:-. OISPEHSeRCONTAINMI!NT .I::SQ. IILOATMIOWIIMTHATIHUTI9"IHeARVALV8 [J 4. DA1LYVllUALCHECK DAT! INSTALLIO _ a z. CONTHIOUI OIIPI!NSI!R 1W18I!NIOR. AUDIIILI AND VISUAL ALARMS ~ ~ I. ,TRI!NCH LINER I MOHrfOIUNG =:.3 - '\l{ oJ. CONTHIOUIDIIIPI!NII!IUWUINIORIllDlAUTOSHUTOFPFORDtSPENSER+AUOI8U!ANDVlSUALALAAMS ~.. NONI' ". . .- IX. OWNIIVOP!RATOR SIONA1URI 01"" I - I \JNDEAGAOUNO P1PINO I PRESSURIZED PIPING (CIIecII " lilt ¥PIt: o ,. EL£CTRONIC LINE U!AK OETI!CTOR 3.0 OPH TEST rdIlt AUTO P\MI SHUT' OFF FOR lEAl(. SYSTEM FAILUN!. NÐ SV8'ÆM DI8C(N.ECfION + ~ AND YI8UAL ALARMS o - 2. MONTHLY Ü GPtt TEST (] 3. ANNUAL INÆOAfTY TEST (0.1 QPH) CONVI!NTIONAL SUCTION SYSTBoe ,0 5. OAIL Y VISUAL MONI1'ORIG OIl PUIoFINØ SYSTEM + TR&NAL PFINQ IN'ÆGRITY I TEST (0.1 GPH) SAFe SUCTION SYSTEMS (NO VALVES .. BOW OAOUND PFING): o 1. SELF MONITOAINO GRAVITY FLOW: " o 8. IJI£NPML INTEGRrTY TEST (0. 1 GPff) IICONDARlLY CONrAINI!D ...... PRESSURIZED PFING (CIt«:k""" wM: 10. CONTNJOUS T1JA8IIE SUMP SENSOR mi:u AUOIIÏu! NIÔ VlStMLALARM8NÐ (CIIec:k 0IIII) o .. AUTO PUMP SHUT OFF WHEN A U!AK OCCURS o o. AUTO POaIP SHUT OFF FOR LI!AKS, SYSTEM FAIWRE AND SYSTEM OISCONIETION o Co NO AUTO PUIoP SHUT OFF C5l: 11. AU'TOM'TIC LH! U!AK DETECTOR (3.0 OPH TEST) rdIlt FI.OW SHUT' oFF OR RESTRICTION .' C5l: 12. ANNUALNTEGAfTYTEST(O.1 GPff) SUCTIOtWRAVITY SYITEM; ,~ o 13. CONTNJOUS"'II!NIOA + AUDalNÐVl8UALA&NIMI --'L NAME OF OWNIAlOPlRATOR (pIfntJ Michael, Haworth AIOVI!QAOUNO PIPING 1:1 Z. SUCTION o IS. UNKNOWN o g. OTHER a 3. GRAVITY o " PRESSURe o ,. SINGU! WALL o Z. DOU8U! WALL MAHUFACTUAeR o 1. IlARE STEEL o 2. STAÍNLESs STEEL o 3. Pt.AST1C COMPATIBLE WITH CONTENTS o 4. FIBERGLASS ., - .. ~ o e. FRP COMPATIILI WI Ian. MeTHANcl o 1. QALVANIZI!D STEI!L o .. FLEX8.I! (HOPE) 0 ft. OTHER a 8. CATHOOICPAOTECTION o 911. uNICNOWN 46 -~:~. .:" . '-":'?'f'~:, ABOVEGROUND PIPING PI 46 PRESSURIZED PIPING (CIIecII " ilia, ¥PlY): o 1. a.eCTRONlC LINE LEAK œTECTOR 3.0 OPH TEST ïdItlAUTO PUIoP SHUT OFF FOR LEAK. SYSTEM FALUAE. NÐ SV8'ÆM DISCOfN!CTION + AUDB.E NÐ VISUAL AI.ARMS [J 2,~~,~,GPHTES1' [J J. NNJAL INTEGRnY TaT (0.1 GPff) [J 4. DALY VISUAL CHECK . _. -- -~ 00N\IEN110HAL SUCTION SYSTEMS (Ch«:It""".w,): o 5. DAILY VISUAL MCNITOIWIO OF PFING NG PUMPING S'tSTEM " o .. TR/EHNIAL INTEGAfTY TEST (0.1 GPff) SAFe SUCTION SYSTEMS (NO VALVES .. BELOW GROUND PIPING): o 1. SELF MCHfTOfIING GRAVITY FUJW (Check""" WYJ: .0 .. DAL YVISUAL MONITORING o 8. 8IÐoNAL INTEGAfTY TEST (0.1 GPH) il!CONDAM.. of c:oÑrAØiim ...... PRESSURIZED PIPING (CIt«:k""" ~ 10. COHT1NUOUS TUA8INE sua.P SENSORmItiAUOlll.E AND VISLW. AI.AAMS NÐ (diedI-) o .. AUTO PUMP SHUT OFF WHEN A U!AK OCCURS o o. AIITO PUMP SHUT OFF FOR LI!AKS, SYSTEM FAIWRE NG SYSTEM OISCOI\IECTION o Co NO AUTO PUMP SHUT OFF o 11. 4UT'OfMTIC LEAK DETECTOR o 12. ANNUAL INTEGRITY TEST (0.1 GPff) SUCTIOfUGRAVITY SYSTEM: , o 13. CONTINUOUS'" SENSOR + AUDl8l.EAND VI8UAL~ -_ . --0- ,~7, .r._~G~TDØOffLY.(Q'Irct"flltwM~~· ,- -~~ [J I.. CONT1NUOUS SUMP SENSORElDaAUTO PUMP SHUfOFF. AUDlBLEAHO VISUAL ALARMS o 15. AUTOM4TIC LINE LEAK DETECTOR (3.0 GPH Tl!ST) DATI! Ma 11 2000 411 TITLE OF OWNERIOPERATOR President .10 .12 473 PtnIIII~'I'OrIllOlf"''' 474 I ,....1!IqIrIIIOft DIll (~..... ØIO'J 415 I Pwm4 Hum_ fl'Or" 11M only) UPCF (7199) S:\CUPAFORMS\SWRcø-e·wPD CITY OF BAKERSFIELD "FICE OF ENVIRONMENT. SERVICES 1715 Chester Ave., Bakersfield, CA 9jjOl (661) 326-3979 (9: UNDERGROUND STORAGE TANKS - UST FACILITY TYPE OF ACTION {CfIecIt OM ,IWm ønIy} a ,. HEW SITE PERMIT IX! 3. RENEWAl PERMIT a 4. AMENDED PERMIT a 5. CHANGE OF INFORMATION ($p«ifY eItange . IOUI UN only) a 8. TEMPORARY SITE CLOSURE PIc¡e_d_ a 7, PERMAHENTL Y CLOSED SITE o 8. TANK REMOVED . 400 ! BUSINESS NAME (s.m. . FACILITY NAME or DBA - Doing BulIn-. Aa) I. FACILlTYI SITE INFORMATION 3 FAClUTY ID . Orange Belt Stages NEAREST CROSS STREET Gilmore. 401. FACIUTY O'NNER TYPE n" CORPORATION a 2, INDMDUAL a 3, PARTNeRSHIP a 4. LOCAl AGENCYIDISTRICT" o 5. COUNTY AGENCY" o 8. STATE AGENCY" a 7. FEDERAL AGENCY· 402. ; BUSINESS TYPe a ,. GAS STATION a 2. DISTRIBUTOR Ii TOTAl NUMBER OF TANKS REMAINING AT SITE ,~~L ~. 1_ CJ 3. FARM a 5. COMMERCIAL CJ 4. PROCESSOR 12} 8. OTliER 403. ..Idly on IndIIn R.....øan or "11_ d UST a puÞIIc: agency: name d superv!tOr d trUaIIandI? dMIIon. Iec:IIon or o/IIce whk:II op«aI.1tIe UST. (ThiI ia 1he contact MI'SOII for the tank recarcIa.) 404. CJy_ XJ'No 405. 406. ~ -~ '. n. PROPERTY OWNER INFORMATION . .. PROPERTY OWNER NAME Orange Belt Stages MAJUNG OR STREET ADDRESS 2134 E. Mineral Kin Ave P.O. Box 949 407. PHONE 559-733-4408 406. 409. 410. 412, Visalia PROPERTY OWNER TYPE U1. CORPORATION a 2. INDIVIDUAL a 3. PARTNERSHIP CJ 4. LOCAl AGENCY I DISTRICT CJ 5. COUNtY AGEHCY 93279-0949 a 8. STATE AGENCY a 7. FEDERAL AGENCY 413. . '. OL TANK OWNER INFORMATION'. ''t''.~: ... TANK O\\tER NAME Orange Belt Stages MAIlING OR STREET ADDRESS 2134 E. M±neral Kin PHONE 559-733-4408 415. 418. I I ! I Visalia I TANK O'NNER TYPE Ave P.O. Box 949 417. 419. :Ie 1. CORPORATION a2.1NDMDUAL a 3. PARTNERSHIP CA o 4. LOCAl AGENCY t DISTRICT o 5. COUNTY AGENCY 93279-0942 o 8. STATEAGENCY o 7. FEDERALAGEHCY 420. TV (TK) HQ IV. BOARD OF EQUALIZATION U8T STORAGE FEE ACCOUNT NUMBER Call (916) 322-9669 If questions arise 421. INDICATE METHOO(S) o 1. SELF-INSUAED o 2. GUNWI1'EE . a 3. INSURANCE a 4. SURE1Y BOND a 5. LETTER OF CREDIT a 8. EXEMPTION . . ..... V. PETI'OLEUM U8T FINANCIAL RESPONSIBILITY CJ 7. STATE FUND m 8. STATE FUND & CFO LETTER o 9. STATE FUND & co ....... CJ 10. lOCAL GOV"T MECHANISM o 99. OTHER: 422. , I VI. LEGAL NOTIFICATION AND MAILING ADDRESS I Check one ball to IncIIcaIe whk:II addrwa IIIauId lie UMd tor IegalIIOCIftcaIIaIIa 8IId mailing. 0 1. FACILITY IX! 2. PROPERTY OWNER Legal noIIIIc:aIIona 8IId maiIIngI willie MIlIto 1he '** 0WIIII'1MIIeIa ball , 01 2 II c:IIecUd. 03. TANKOWN£R 423. VII. APPLICANT SIGNATURE y knowledge, NAME OF APPLICANT (piIntJ Michael Haworth;~ DATE May 11 2000 421. TITlE OF APPLICANT President 424. PHONE 425. 559-733-4408 4Z1, ! , STATE U8T FACILITY NUM8ER(ForIOtlat_ody 421. 1_ UPGRADE CERTIFICATE NUMIER (For /oeM /lie only) 429./ UPCF (7199) S:\CUPAFORMS\swrc:b-a.wpd CITY OF BAKERSFIELD O~E OF ENVIRONMENTAL .VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS ·INSTALLA TlON CERTIFICATE OF COMPLIANCE One form per tank Pege _ 01 ---.---..------.. .-.----... ..------- .----- ---- -------.----.--- ...-..... ...------ I. FACILITY IDENTIFICATION ...--.--.....--- - -. .. .-.... .. -.. ... --.....-------- . BUSINESS ÑAME (S8nw " FAëiLiiY NAMe « DBA . DoIng auu-...., : FAClUTVID'lTII1ILLLL[1 ~' J397512 ...------.-. . -. - .. -...---- -----... --'--"'---'-'- ---...--..-.. - ...,-- ---~ ~~-~~- -----=-=--_::--.-~------- - ~--=-- --'--'" '-,-~-~--- -----0-..--- --= II. INSTALLATION Check elIlhat apply 6a The Installer has been certified by the tank and piping manufacturers. o The installation has been inspec:-tAd and certified by a registered professional engineer. . ŒJ The Installation has been inspected and approved by the City of Bakersfield Office of Environmental Services. ŒI All work listed on the manufacturer's Installation checklist has been completed. fXJ 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 .1 I ¡. , III. TANK OWNERlAG~NT SIGNATURE õATË ---- ---.---.-...--.- ..... - . . . - , ..----::¡¡¡¡- '~, '-NAME OF TÅÑKõWÑËNÃÖENT (print) May 11, 2000 485 TñïiõFTAAK'ÕŸiNeRiÃÕËÑT--'-'----' '.. ... .-. ...._-~ Michael Haworth President _. _...._.__.. ....._....._._..____._.___._N . ___ ___..____._..__ __._..__.. __......_ .... ....._ '0IIII C ..., . '. STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM :Ø 1 NEW PERMIT i 2 INTERIM PERMIT D 3 RENEWAL PERMIT D 4 AMENDED PERMIT D 7 PERMANENTLY CLOSED ON SITE D 8 {TANK REMOVED LJ 5 CHANGE OF INFORMATION :i 6 TEMPORARY TANK CLOSURE I. TANK DESCRIPTION COMPLETE ALL ITEMS -- SPECIFY IF UNKNOWN Orange Belt Stages DBA OR FACILITY NAME WHERE TANK IS INSTALLED: A. OWNER'S TANK I. D. # J 3. <; ì S I '}.. C. CAT" INSTALL"ë) (MO/DAYiYEAR) ;q..p~ I \ <:: ¡ c; (1 'i B. MANUFACTURED BY: f/YJ () S T f:':. r1... D. TANK CAPACITY IN GALLONS: 12,000 II. TANK CONTENTS IF A,llS MARKED, COMPLETE ITEM C, 1 MOTOR VEHICLE FUEL 1---' 4 OIL B. : C. ì : la REGULAR IKJ A, .x.. LJ ~ UNLEADED r---", 2 PET;:¡OLEUM l! 80 EMPTY L 1 PRODUCT LJ lb PREMIUM I , UNLEADED D 3 CH"MICAL PRODUCT Ii 95 UNKNOWN 2 WASTE , I 2 LEADED n D. IF (A,l) IS NOT !.',ARKED, ENTER NAME OF SUBSTANCE STORED 3 DIESEL 4 GASAHOL 5 JET FUEL 99 OTHER (DESCRIBE IN ITEM D. D D 6 AVIATIO,\¡ GAS 7 METHANOL BELO'N) A. TYPE OF ~ 1 DOUBLE WALL SYSTEM 2 SINGLE WALL BARE STEEL B. TANK MATERIAL 5 CONCRETE (Primary Tank) 9 BRONZE 1 RUBBER LINED C, INTERIOR 5 GLASS LINING LINING ---, C. A. S. # : III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. 8. AND C, AND ALL THAT APPLIES IN BOX 0 AND E 3 SINGLE WALL WITH EXTERIOR UNER f: :-' ! 99 OTHER I 4 STEEL CLAD WI FIBERGLASS REINFORCED PLAS~;~ I a 100"10 METHANOL COMPATIBLE W/FRP ¡ ! i ! I ---; I I I : 95 UNKNOWN .¡ SECONDARY CONTAINMENT (VAULTED TANK) II r-! 2 STAINLESS STEEL POLYVINYL CHLORIDE 10 GALVANIZED STEEL " L-J 2 ALKYD lIN ING I i 6 UNLINED U 3 VINYL WRAP i! 95 UNKNOWN 00 4 FIBERGLASS REINFORCED PLASTIC [J 99 OTHER S liNING MATERIAL COMPATIBLE WITH 100"10 METHANOL? D. CORROSION PROTECTION E. SPILL AND OVERFILL 1 POLYETHYLENE WRAP 0 2 COATING 5 CATHODIC PROTECTION LJ 91 NONE SPILL CONTAINMENT INSTALLED (YEAR) JC¡ 9 'f CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) /99<; IV. PIPING INFORMATION 3 F!BERGLASS Œ1 LJ ii 99 OTHER 7 ALUMINUM 95 UNKNOWN 3 EPOXY LINING D 4 PHENOLIC LINING 95 UNKNOWN Œj S-ì~£ L 99 OTHER - YES~' NO_ A. SYSTEM TYPE A u 1 SUCTION A ® 2 PRESSURE A U 3 GRAVITY A U 99 OTHE R B. CONSTRUCTION A U 1 SINGLE WALL A ® 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C, MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC) ~~ FIBERGLASS PIPE I CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100"10 METHANOL COMPATIBLE \V,FRP I PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ::xJ 1 AUTOMATIC LINE LEAK DETECTOR 2 LINE TIGHTNESS TESTING ' 3 INTERSTITIAL .. L...! MONrïORING U 99 OTHER I V. TANK LEAK DETECTION VISUAL CCiECK ::xJ 2 INVENTORY RECONCILIATION: : 3 VADOZE MONITORING [XJ .¡ AUTOMATIC TANK GAUGING LJ 5 GROUND WATER MONITORING ex 6 TANK ESTING '--.J 7 INTERSTITIAL MONITORING '---.J 91 NONE I 95 UNKNOWN D 99 OTHER VI. TANK CLOSURE INFORMATION 1 ESTIMATED DATE ,-AST USED (MO/DAYIYR) YES D NO!- , 2, ESTIMATED QUANTITY OF I 3. WAS TANK FILLED WITH I SUBSTANCE REMAINING ___,--.S3ALLONS! INERT MATERIAL? THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPlICA,\¡,SNAME DATE (PRINTED & S·GNATURE) LOCAL AGENCY USE ONLY THE STATE 1.0. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW STATE 1.0,# COUNTY # JURISDICTION # m :I,CBU= -~---------- FOR0r048,R5 PERMIT MJM8ER I PERMIT APPROVED BYIDATE I THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORM 8 (7,91) , FACILITY # ~ /~rf""l f;I-~ LäL60-U...LL.1.':µ TANK # 0IIJZll] i PERMIT EXPIRATION DATE ! '-- ,A ... t'1os i.¡¡or Br ,;:os. . 209+564+3305 P.02 POH OrrlCE Box ~77 -- - - '-- e - T~éPho~l---{209} 564-3304 - 1:.f et HOl,lt$ (209) 564-2502 (109) 564'2021 FAX (209) ~64.3305 MOClr-n BR· I".....~(" '=P. C' v.;) , ~ ~\J~~).. --==--- ......""-'. -- ----- -;:: ::" ="'-""-'- TA1<I<$ ! 1',<\;:"'UF.\G'fU~ING - - -~- -_. -- --- -" WOODLAKE, CAl:fCi<;,::/\ ':'~1¿86,OSn Ji> (¡H,t) J c.rne ~ 0'11~ T ~V1.s+ Flfx 68'6·g? S%O M t\rL~ I I ICf 9 '-J J"¿) ~ Vì , It.s ~ diH_IA»M b¡ tk,"'G I 7¡'~ ~"",I c!éc.¡JI2Tn r~<".,/,,,,.J hD(d dôwl1J for.1'--t. /;(, &D !" II,^: TAhir t5~¡>;:) ih.!>/;d/d at OtaV1,ý-L !3e1f In ~/rerJ Aeld 13 r. ~ ~ CXVÞier CttAd ~ ¡"ñe.€ I"' oIe.~ehd/~ J)i-? $¡'fe- C!:-òwd,'"11ZN-15. tI~0ev-er I The. fL::-r bv-v". /1 11 e-c.oM(Y"I~d f/ÞQ,l¿e.:i fr; r :r"".:> f~ Ie, f I 'l)"v¡ of ()v,d e/ ð ròU. vd L- I g l-A ,';?/ ...5 to ~!) e, ~v ~"" le/,<; -5~'r}.;.,~ c..c-I (./A l~f(})"VI5> W r C{ Ie>; 0ZJl) 9cdlD""? FA? ~h/:" 5(.AbM€f"j~ -Iv PL heJ4 ß~I~ ~r~ a ~' 10f' ~Ý:~! bàGlrh¡J (Âv..d Cf $ II l'eJ'n/Jrce-d .5/146 . %/3 !-¡ii/') ~ 1.1 Ir tt·) e / ð ~'\.s O"n (Î ,-5: ~ I~" ~!. l.....) t.. /'/~ ~ ûÍ:v"d:;)( c¿ tJe< II .:>fee/ f: ... k Y ~ F>-» 1-« II eJ t-J e I) t,~ 18; ÒÕ?:\ f'lRA.d- .s ;',,'î c.. -e... C\ ~ C575D f ð (..4 ~,f tal-A fr , ':5 h e./oI 3-e.c...v. ,øj?'f Cc. , /~ ðæ> fðv-'~ ~ vvir fA),-¡-A f?<- 5c. ~ &er?~k ¡; 7/ ;J'l. .-6,. ~tt u-<... D """7 f (0 /-c.. f /1JY1 f If.) bIt! fr\ 5 . 1)1f~ , Ä z~-··_··_--~·~ -....-. .... ----~. . ,.- ----- - --.---,---"- .-.--......"------ / · STATE OF CALIFORNIA . ST ATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION STREET ~o N. Sillect CITY Bakprc;fip I rl COUNTY Kern II. INSTALLATION (mark all that apply): Xi The installer has been certified by the tank and piping manufacturers. ¡ The installation has been inspected and certified by a registered professional engineer. :x1 The installation has been inspected and approved by the implementing agency. :lsJ All work listed on the manufacturer's installation checklist has been completed. XI The installation Contractor has been certified or licensed by the Contractors State License Board. -.J Another method was used as allowed by the implementing agency. (Please specify,) III. OATH I certify that the information provided is true to the bes~ of m~~el~~f :-øWledg:~_ ~ _C; ( , Tank Owner/Agent Orange Bel t Staçw¡ by-:-1/IA .~Jl--;:J:; . :.pate -'> > , I Print Name Mike Haworth, President Phone (209 733-4408 Address P.O. Box 949 Visalia, CA 93279 LOCAL AGENCY USE ONLY STATE TANK 1.0. # COUNTY # CZTIr JURISDICTION # mz FACILITY # ~¿'\~' , ~ TANK # = FORM C (7;91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOA0035C7 '. . ;f ~ O~ ? March 29,2000 Orange Belt 3640 Sillect Ave Bakersfield, CA 93301 Dear Underground Tank Owner: Your permit to operate the above mentioned fueling facility will expire on June 30, 2000. However, in order for this office to renew your permit, updated forms A, B & C must be filled out and returned prior to the issuance of a new permit. Please make arrangements to have the new forms A, B & C completed and returned to this office by May 15,2000. For your convenience, I am enclosing all three forms which you may make copies of. Remember, forms B & C need to be filled out for each tank at your facility. Should you have any questions, please feel free to contact me at (661) 326-3979. Sincerely, Steve Underwood, Inspector Office of Environmental Services SU/dlm Enclosure ~ ,~"'AR-1ø-øø FRI 6:55 T J C 21397411858 P.ø2 U~RGROUNDSTORAGElINK MONITORING SYSTEM CERTIFICATION Tesl Datè:> - 0- ðO ~-'- FacUlty Name: OrA" ')V ¡f.J J- Owner: Testing Company: iJG Facility Addre.a; ~ é ~o ~.' { ( ~ J ;.J vc...,... Phone: ßa~f¡.e/c/ Phone: S$q '1-3~ 7-50{ Monltorln S stem Make and Model: Tank Content. T enk Ca acit Tank 1 Tank 2 Tlnk 3 Tank" Î)¡t; J. Sum Sensor . Tank Annullilr S ace Sensor Ols enser COn'8infT1ent Sensor . Elec(ronic Overfill/level Electronic In-line Leak Deteclor MechanIcal Une Leak Detector Does the monltorln B stem have audible and visual alarms? DOêS the turbine automatically shut down If the system detects a leak falls to 0 erale or is disconnected? Is the monltorfr'lg syslem Installed to prevent unauthorized , / tam erln 7 . L./ Ie the monltorln s stem.o erable as sr manufaç\urer'S, sea? THIS IS TO CERTIFY THAT THE ABOVE MONITORING SYSTEM HAS BeeN TESTED BV AN AUTHORIZED TECHNICIAN, HAS B N ADJµSTED ANDfOR CAUBRATED AS NECESSARY, AND IS OPERATING ACCORDING MAN FACTURER' pE.e FICATIONS. - , :\.".ooI~ Qualified Technlol,," Slgnalure: Dale; 3~')-òa ..... . '---:-. .J C 212197411858 P.12I2 M~R- 2-121121 THU 11:42 . T.J.C. 3216 West Coppola Ave. Vtsalfa, California 93277 (209) 732-7509 Offrce (209) 741-1858 Fax The Complete Petroleum EquIpment, Construction and Service Company DATE: Ot"~ ~. -/£9/ BILLING INFO MA TION: NAME: ADDRESS: CITY: ZIP:. . . PHONE: LOCATION: NAME:~O¿¿..tI,Qé .Ãell ~)'4h:f~ ADDRESS:.. ?¿'R'..t2 Q.'//Ul Al/L- CITY:~~~~4 /¡f ZIP: PHONE: ----- PROBLEM REPORTED .::r&>:rrer~ Ye..4,..I~ ~~SpéO-b~ '~ ......<:. .' ) } , , i I -, START TRAVEL: 11:1.! START TRAVEL: /' ~ ARRIVAL: /¡¿.' ~¢ ARRIVAL:_ DEPART:_'j~Q ~_Ç?D DEPART: I WORK AUTHORIZED BY: : :1 WORK PREFORMED --r~6t6¿ ,../1 '(L M t-u..Nd-,s JJ _ r:ð(..L/VJ. ~ ~~ ~"~ /;?~ Á~a; ~~~> A.d ~v-,v~L ~í~~1~1~~¿r- :~ ~~~~~':t:t - ~/¿~al:.-5i..¿ I Zð ~ cI 1.)11 OW... - (' ". c? å.(tl.¡l~.f J 'for fJ .sJ I v l' ~ (;;¡O(I-'~1 .- {ll () ( "fl....:L. (> I-:' _ ( l~.(I..ð{ v~c.'..f '-,0'" fA.,." r 0,.... 'ot)f:<' t I' (It'¡ 0 I( . . QIY PART #I DESCRIPtl-ºN lllilT PRICE TOTAL , ..----- -- --- --------.--.------..,.... ,.. ,..-. -' ----,,- --,.,.--- . . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME Ofð..\I\qc.- ß.dt ,sto.qó INSPECTION DATE 3-d. -00 Section 2: Underground Storage Tanks Program o Routine l3YCombined 0 Joint Agency Type of Tank OlùFc.~ Type of Monitoring èf.,..M o Multi-Agency 0 Complaint Number of Tanks I Type of Piping ~ W F ORe-inspection OPERA TION C V V V V COMMENTS Proper tank data on tile Proper owner/operator data on tìle Permit fees current Monitoring record adequate and current Certification of Financial Responsibility 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 OPERATION Y N COMMENTS SPCC available SPCC on tile with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? C"COmph'"L V~V¡o:at¡oo Y~Ye' lo'peeto" . ~ Oftìce of Environmental Services (805) 326-3979 White - F.nv. Sves, N==NO Dv---cJ- Busine s Site Responsible Party Pink - Business Copy -- . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~('a.UI~ ADDRESS Sf, l/. . FACILITY CONTACT INSPECTION TIME ßr~tð:~tlf(~ 5,( ( INSPECTION DATE < ~..;l ~(}O PHONE NO. ~)- 4S"71 BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES It.{ Section 1: Business Plan and Inventory Program o Routine (34"Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS Appropriate permit on hand V Business plan contact information accurate V Visible address V Correct occupancy IV Verification of inventory materials V Verification of quantities IV Veritication of location V Proper segregation of material V Verification of MSDS availability V Verification of Haz Mat training V~ Veritication of abatement supplies and procedures IV Emergency procedures adequate V Containers properly labeled Iv Housekeeping 1\1 Fire Protection Iv Site Diagram Adequate & On Hand IV C=Compliance V=Violation Any hazardous waste on site?: ~Yes 0 No Explain: tUA~.\t 4)" f- CVo,e.k_~~Jl(V''1 Questions regarding this inspection? Please calI us at (805) 326-3979 Busin White - En\'. S\'cs. Yellow - Station Copy Pink - Business Copy Inspector: " FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H. Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAJ( (805) 395-1349 SUPPRESSION SERVICES 2101 -H- 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 E~RONMENTALSERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3979 FAJ( (805) 326-0576 TRAINING DMSION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAJ( (805) 399-5763 . . February 9, 1999 Orange Belt Stages 3640 N Sillect Ave Bakersfield, CA 93308 RE: Compliance Inspection Dear Underground Storage Tank Owner: The city will start compliance inspections on all fueling stations within the city limits. This inspection will include business plans, underground storage tanks and monitoring systems, and hazardous materials inspection. To assist you in preparing for this inspection, this office is enclosing a checklist for your convenience. Please take time to read this list, and verify that your facility has met all the necessary requirements to be in compliance. Should you have any questions, please feel free to contact me at 805-326-3979. Sincerely, t-~ Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure ~~7~ de W~ ~ vØbOPe .r~ A We/UÚ~" Of-:HI"Jl,::E BELT ::.;TA'~;E:3 3640 SILLÐ:T AVE BAKEF:SF [ ELf'. CA e MAR 2. 2000 9:00 AM :3'{:3TEf"1 :::,;,rATU:3 REPOF:T - - -- - - ALL FUNCTIONS NORMAL ORANGE BELT t~TAGEt~ e 3640 SILLECT AVE BA)ŒF:SF [ EUi. '~-::A MAR 2. 2000 9:00 AM :,:;,G"iTEt'-l f)Tf-ìlll;c F:EPORT -.------- ~iLL FUNl"'!' I C'N::~; I'K;'RT"lHL e OF:t:;I',JGE BELT :3TH'Æt; :3640 :'::: I UÐ~'T r-:¡'j£ BAKER:::;F 1 EI,[I. CA MAR 2. 21.100 9:00 AM ;3YSTEr"¡ :=:Tfd IJE: F:EF'ORT - -- - -. -- - -.- ,- - - -- r-:¡LL FUN,Vr! ,:)N::::; NOF:f"IAL I 1',J\/Er"JT()f-:'ï ¡:'.:E1'Of-:T T I; ['II:;':[L, \/01. ur"IE ULLA'::E 9Ci~<, ULlJiGF~ TC \/OLur"lE HEIGHT ¡".IATER VOL I.J!,HER TH'IP 5r-:~~'5 5c-l~;t:: 47'79 ~~~;D~ 4'7.0:3 o 0.00 t,l-). g '::;~·\L::.: (;ALS GALS ?_s GALS IN'::HES [iEG F " '" '0; ,. " Ef',m " " " ,., ,., / , r ~~sr~ T.J. C. ~ March 09, 1998 ,',. . ORANGE BELT STAGES P.O. Box 949 Visalia, California 93279 ATTENTION: Ken Baker JOBSITE: 3640. North Sillect Ave. Bakersfield, California 93308 Ken: " '. I spoke to Mr. Underwood with the Bakersfield Fire Department in regards to the "Hold Open Devices" from the letter you faxed our office on March 03, 1998. Mr. Underwood stated that private agencies are exempt from this or.åer. ' If you have any questions please give me a call at (209) 732-7509. Thank you, ,. John J Jones TJC cc:Steve Underwood 3216 West Coppola Ave. - V;sal;a, CaU(orn;;J 93277 Phone: 209/732-7509 - Fax: 209/741-1858 T JC - License # 728782 RRE CHIEF MICHAEL R. IŒl1.Y ADMlNISTRA1IVE SERVICES 2101 ·w street Bakersfield. CA 93301 (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'W street Bakersfield. CA 9330 1 (805) 326-3941 FAX (805) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 (805) 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakers1leld, CA 93301 (805) 326-3979 FAX (805) 326-0576 TRAINING DIVISION 5642 Victor street Bakersfield. CA 93308 (805) 399-4tR7 FAX (805) 399-5763 I I \ ~ BAKERSFIELD FIRE DEPARTMENT . . -- February 13, 1998 Orange Belt Stages 3640 North Sillect Avenue Bakersfield, CA 93308 RE: "Hold Open Devices" on Fuel Dispensers Dear Underground Storage Tank Owner: The Bakersfield City Fire Department will commence with our annual Underground Storage Tank Inspection Program within the next 2 weeks. The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire Department now requires that "hold open devices" be installed on all fuel dispensers. The new ordinance conforms to the State of California guidelines. The Bakersfield Fire Department apologies for any inconvenience this may cause you. Should you have any questions, please feel free to contact me at 326-3979. Sincerely, fficl&£) Steve Underwood Underground Storage Tank Inspector cc: Ralph Huey 1:7~¿(jg, W~ ~.A0P6 ~ A W~ " \ / - -e O~E BElJ S1ÞGES October 17, 1997 Steve Underwood Inspector Office of Environmental Service 1715 Chester Avenue Bakersfield, CA 93301 Dear Mr. Underwood: Enclosed are the documents we discussed today on the phone relative to our Bakersfield site at 3640 N, Sillect. We are providing a Written Monitoring Procedures, Emergency Response Plan, site map, Certificate of Financial responsibility, a hazardous materials inventory sheet for the toilet chemical and degreaser used in the wash bay, and a signed hazardous materials management plan. The fuel pump has been inspected by John Jones to correct the product material underneath.' Mr. Jones will provide us with an annual certification for maintenance on the monitoring equipment. I will forward that to you upon receipt. Our training records are on site and will be available for your inspection. Thank you very much for your patience with me. As new Safety Director, I have a huge leaning curve for a v lex subject. Anything I still need to provide, please let me know. P.o. BOX 949 · VISALlA. CALIFORNIA 93279 · PHONE (209) 733-4408 · FAX (209) 733-0538 WRITf:! MONITORING PROCEDLs UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be kept at the UST location at all times. The iDfonnation on this monitoring program are conditions of the operating permit The permit holder must notify the Office of Environm.....I..1 Services within 30 days of any changes to the monitoring procedures, unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCR. Facility Name Facility Address Orange Belt Stages 3640 N. Sillect Ave Bakersfield A. Describe the ftequency of performing the monitoring: T~ Gilbarco MDE2690C provides automated daily record of inventory and system status Piping Same B. What methods and equipment, identified by name and model, will be used for perfuming the monitoring: T~ Gilbarco MDE2690C Environmental Manaqement Control Piping Same c. Describe the location(s) where the monitoring will be performed (facility plot plan should be attached): Monitor is located on the East wall of the wash area. Wash area is located in the East portion of the building~ D. List the name(s) and title(s) of the people responsible for performing the monitoring and/or maintaining the equipment: Monitorinq done by Al Garden, Dispatcher Maintenace of equipment by certified inspector. E. Reporting F onnat for monitoring: Tank Tape printout Piping Same F. Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance must be in accordance with the manufacturer's maintenance schedule but not less than every 12 months. Annual inspection provided by certified insDectnr. G. Describe the training necessary for the operation ofUST system, including piping, and the monitoring equipment: Instruction manual provided by manufacturer e e EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be kept at the UST location at all times. The information on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures. unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCR Facility Name Facility Address Oranqe Belt Staqes 3640 N. Sillect Ave Bakersfield. CA 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up fÌ'om the secondary containment within 8 hours, or deteriorate the secondary containment, then the Office of Environmental Services must be notified within 24 hours. Hazardous substances released or spilled are cleaned UD usinq the recommended cleanup procedures specified on the MSDS for that product. 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substance. Dike larqe sDills. Absorb with absorbent materialR. Matprial is then swept up and containerized. Marked containers are removed by a certified Hazardous Materials disposal service. 3. Describe the location and availability of the required cleanup equipment in item 2 above. Absorbant materials are strateqicIy located in areas where hazardous materials are used or stored. 4. Describe the maintenance schedule for the cleanup equipment: All cleanup tools/equipment are maintained accordinq to instructions on the MSDS for that product. 5. List the name( s) and title( s) of the person( s) responsible for authorizing any work necessary under the response plan: Mike Haworth, President Matt Haworth, Maintenance Manaqer ~ 7[;4'- ~ --. 47' I IO'HleH .11£011000 SL4TT£0 CHAIN LINK FENCE I·' . , I . r ! . f¡ I I I f i f " . ~7{C GROUND / . j- . I "-';,;.-:::c ,! " 2,000 GA L. I ' '-', - b' FUEL TANK I ,~. ,''-.:L.. ~ " ON.,.c. '01 ;';;-':'.' -:'/1"" ,,'~. I___~ ~ "i-:~.d~ D' ': N b, ,I III rp:: I ,'- c::_;' ~>.',T~~~ ':'. ':::" I ~ . . Q I ~;~~~/X ¡; . . . L20,¡ . 'tÙ' I~ / 'q '1 'I; I . . . r -:-- I U . .., L -1 I~ . ""ì « .I~ / > 'I~ / ,w / ' I. I :', '. £/ ~, .... I ' .' I : ~ , - '. I ï QL <' '92' . . ,., --- - , . I '''''''''"'''''0 __-':-__ ' ï ", .".. " Z 1:, .. i' -1 (/) (/) o Q: LJ '0 to .374~ 94' '- ¡fIr! ~~S \ft-f. l- e .;;?f o . 0J f)\) ~ ßA \1 , f{J £i:. '- 51 I , , GRADE TO DRAIN 6" CONCRETE He;w F/¡;(E- th·"~r\. C,UA~"P'.$T~I Tr(. - ~ --' 166' ,BLDG. A SHOP.' '. \ vf;.~ {)I:' c \ \... <?O ' 0¡r:;. Tf/A-NÐ 16ô' Fl-\I\D 1 T lOa ~iÌl to \:..J 20' a: -,.. u<. Z 0--. .u \,..04 ~ -'-, J~ <r: - ~ -':-"']- ~ w a: U Æ -.' oJ ... z w ... '" z :; '2 g ;., 2 BLDG. a d ~BUS PARf('rNG~T~ÜCTURE :(ROOF. ÖNLY) b ... '. " r· · è.lcl~TJ'¡c; ·F"~E. . t-/1"PµNT !. ' e 45' 20 20' l.J . ~' 20' e 20' ø ZO' ?' .-, iii --. .... \,..04 w -'-, 0: .. BAKERSFI_D CITY FIRE DEPARa1ENT HAZARDOUS MATERIALS INVENTOJr( Pag e..l... of..2... 3usiness Name Orange Bel t Stages Address 3640 N. Sillect Ave I CHEMICAL DESCRIPTION : 1) INVENTORY STATUS: New [~ Addition [ ) Revision [ I Deletion [ ) Check if chemical is a NON TRADE SECRET fC) TRADE SECRET [ I 2) Common Name: Soapman Heavy Duty Deqreaser 3) DOT # (optional) , ¡ Chemical Name: AHM I J CAS # ì 4) PHYSICAL & HEALTH ! PHYSICAL HEALTH I HAZARD CATEGORIES Fire I ] Reactive I ] Sudden Release of Pressure I] Immediate Health (Acute) [KJ Delayed Health (Chronic) I J I 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE i I 6) PHYSICAL STATE Solid I J Uquid IJ<] Gas I J Pure :fC J Mixture [ ) Waste [ J Radioactive [ I æECI< AU. TUAT APPL r I 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 5 Ibs I J gal I~ ft3 I J a) Container: 10 Average Daily Amount: curies [ J b) Pressure: 1 Annual Amount: 15 qal c) Temperature: 4 Largest Size Container: 5 aal ~J,F,M, # Days On Site 1f)C) Circle Which Months: A, M, J, J, A, S, 0, N, D 9) MIXTURE: Ust COMPONENT CAS # %wr AHM the three most hazardous 1) Glycol Et.her F.R 11] 76 2 2-7 [ J chemical components or Caustic Potash 1310-58-3 2-7 any AHM components 2) [ J 3) Sodium Hydroxide 1110 71 ? 6-11 [ J 1 0) Location Wash bay storage room CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New!xl Addition I ] Revision I J Deletion I J Check if chemical is a NON TRADE SECRET [;:J TRADE SECRET kJ 2) Common Name: POlyJohn 3) DOT # (optional) Chemical Name: Portable Toilet Deordorant AHM I] CAS# 5C)20 , 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire I J Reactive I ] Sudden Release of Pressure [ ) Immediate Health (Acute) [XI Delayed Health (Chronic) [ ) 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODe 6) PHYSICAL STATE Solid I J Uquid I~ Gas I ) Pure þC) Mixture I] Waste I] Radioactive [ ] CHfCI<ALJ.. mAr APPl.Y . 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 55 Ibs I ) gal Ix ft3 [ J a) Container: 07 Average Daily Amount: 110 curies I ) b) Pressure: 1 Annual Amount: c) Temperature: 4 Largest Size Container: ~:> Circle Which Months: ~ J, F, # Days On Site 365 M, A, M, J, J, A. 5, 0, N, D - 9) MIXTURE: Ust COMPONENT CAS # %wr AHM the three most hazardous 1 ) I) chemical components or any AHM components 2) I) 3) - ...... I) 10) Location Wash bay in center:, isle / c...tyund",peneJtyol/aw, """I nave _Ity~'nod and em twller Wlth...,~ on Ãand ~& I belíeve-the s~ ínformtftion ís true, tfCCufBte, and complete. _., / % teNAlé-'hJ- C'~AtC6(L. St·r:r-, r¡)¡iGtC.~1t..- / _Á-"~0( l' 'v- Jo.i/9T PRINT Name & TItle of Authorized Company Representati'fl- Signature Dtfte '--Wl'lCNr3Q' 'SIIiIQ N~V L£PCnNrilDMOFaW BAKEijSFIELD CITY FIRE DEaARTMENT HJlARDOUS MATERIALS INV~TORY PageLof...l Business Name Oranqe Belt Saqes Address 3640 N. S i llect Bakersfield CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ 1 Addition [ 1 Revision [ 1 Deletion [J< Check if chemical is a NON TRADE SECRET pc] TRADE SECRET [ ] 2) Common Name: In c a L i qui d Go 1 d I I 3) DOT # (optionaJ) Chemical Name: AHM ( ] CAS # 4) PHYSICAL & HEALTH HAZARD CATEGORIES PHYSICAL Fire [I Reactive (] Sudden Release of Pressure [·1 HEALTH Immediate Health (Acute) pq Dolayed Health (Chronic) [I ' 5) WASTE CLASSIFICATION (3,digit code from DHS Form 8022) USE CODe 6) PHYSICAL STATE Solid [ ) Liquid (~ Gas [ ) Pure [J<] Mixture [ ) Waste [ ] Radioactive [ ) CH£CI( All fHAT APPlY 7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES Maximum Dally Amount: 55 Ibs [ ) gal [XJ ft3 [ ) a) Container: 07 Average Dally Amount: 55 curies [ ) b) Pressure: 1 Annual Amount: c) Temperature: 4 Largest Size'Contalner: ~~ # Days On Site 365 Circle Which Months: J, F. M. A. M, J. J. A, S, 0, N, D 9) MIXTURE: List the three most h¡u:ardous chemical components or any AHM components COMPONENT 1) 2-Hydroxymethyl-2-n i tro-l ,3-propaned i 01 2) CAS # 126114 %WT ::31:) AHM ( ) [ ) ( ) 10) Location 3) Removed CHEMICAL DESCRIPTION 1) INVENTORY ST~TUS: New { ] Addition ( ) Revision ( ) Deletion { ] Check if chemical is a NON TRADE SECRET (] TRADE SECRET [ ) 2) Common Name: 3) DOT # (optional) Chemical Name: AHM ( ] CAS # 4) PHYSICAL & HEALTH HAZARD CATEGORIES PHYSICAL Fire [I Reactive [) Sudden Release of Pressure [ ) HEALTH Immediate Health (Acute) [] Dolayed Health (Chronic) [ ) 5) WASTE CLASSIFICATION (3-digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [J Liquid [I Gas [ ) Pure [] Mixture [) Waste [] Radioactive [ ] CUfCl( ALL THAT APPtr 7) AMOUNT AND TIME AT FACIUTY Maximum Daily Amount: Average Daily Amount: Annual Amount: Largest Size Container: If Days On Site UNITS OF MEASURE Ibs [ ] gal [) ft3 [ ) curies [ ) 8) STORAGE CODES a) Container: b) Pressure: c) Temperature: Circle Which Months: J. F. M, A, M. J, J, A. S. O. N. D 9) MIXTURE: Ust the three most hazardous chemical components or any AHM components COMPONENT CAS # %WT AHM [ ] [ 1 [ ] 1 ) '2) 3) s...,.,.æ 1S/IU ~ v LEPC lTofINQMØFOUII . . -... - - --- EXHIBIT A State of California State Water Resources Control Board Division of Clean Water Programs P.O. Box 944212 Sacramento, CA 94244-2120 (Instructions on reverse) CERTIFICATION OF FINANCIAL RESPONSIBiliTY FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. I am required to demonstmt~ Financial Responsibility in the required amounts as specified in Section 2807, Chapter 18, Div. 3, Title 23, CCR: D500,OOO dollars per occurrence [X] 1 million dollars annual aggregate or AND or rn 1 million dollars per occurrence D2 million dollars annual aggregate B. Orange Belt stages hereby certifies that it is in compliance with the requirements of Section 2807, (Name o/Tank (M-ner or Opera/or) ,,.,.·.',.0,.·,".·,·,·..0..',·.'.,..·,·.·.11.·.·.·.·.·.·,·.,.e.·..,·,·.·..·,cl,·,··,...'...'.'..ì,.·...V,.·.,·.:.·,..ê.·,.,..·.·. ThlrQêè' . ,·/.L; ,: ·Acl¡óô>Còm state UST Cleanup Fund P.O. Box 944212 Sacramento, CA Continuou Yes Yes Cheif Financial Officer Letter range Belt stages .0. Box 949 isalia, CA 93279-0949 N/A $5,000 Annual Yes Yes Note: If you are using the State Fund as any part of your demonstration of financial responsibility, your execution and submission of this certification also certifies that ou are in com liance with all conditions for artici ation in the Fund. Facility Name Facility Address 2134 E. Mineral King Ave. Visalia F3Cility Address Orange Belt stages Facility Name Facility Name Facility Address facility Name Facility Address o Name and Title ofT;lJ\K Owner or Op!::cator Orange Belt stages ;e:::"0f:ì . . CFR(Rc\!isedO-lftJS) =~ 10 1 97 Date 10/1/97 e (Wi ,al') Bruce Lynn FILE. Original, Local Agency Copies· Facility/Site(s) Page 26 · ,e INSTRUCTIONS CERTIFICATION OF FINANCIAL RESPONSIBILITY Please type or print information clearly. All UST sites owned or operated may be listed on one form, therefore, a separate certification is not required for each site. DOCUMENT INFORMATION A. Coverage Required B. " Name of Tank Owner or Operator Check the appropriate boxes. Full name of either the tank owner or the operator C. Mechanism Type Indicate which approved mechanism(s) are being used to show fmancial responsibility either as contained in the federal regulations, 40 CFR Part 280 Subpart H, Sections 280.93 through 280.107, or Section 2808.1 Chapter 18, Div. 3, Title 23, CCR (see Financial Responsibility Guide for more infonnation). Name of Issuer List all names and address of companies and/or individuals issuing coverage. List identifying number for each mechanism used. 'Example: insurance policy number, Letter of Credit number, etc., etc. Ifusing the State Cleanup Fund, leave blank. . Mechanism Number Coverage Amount Indicate amount of coverage for each listed mechanism. If more than one mechanism is indicated, total must equal 100% offrnancial responsibility for each site. Coverage Period Indicate the effective date(s) of all mechanisms. State Cleanup Fund coverage is continuous as long as you maintain compliance and remain eligible to participate in the Fund. Corrective Action Indicate yes or no. Does the specified fmancial assurance mechanism provide coverage for corrective action? It is a required coverage. If using the State Cleanup Fund, indicate "yes." Third Party Compensation Indicate yes or no. Does the specified fmancial assurance mechanism provide coverage for corrective action? It is a required coverage. If using the State Cleanup Fund, indicate "yes." D. Facility Information provide all facility and or site names and addresses. E. Sig~ature Block Provide signature and date signed by tank owner or operator; printed or typed name and title of tank owner or operator; signature of witness or notary and date signed; and printed or typed name of witness or notary. (If notary signs please attach documentation.) \^,'here to Mail certification: Please send original to your local agency(ies) (agency(ies) that issues the UST penn its]. Keep a copy of the certification at each listed site. Ouestions: If you have questions about financial responsibility requirements or about the Certification of Financial Responsibility form, please contact the State W,lter Resources Control Board, Underground Storage Tank Cleanup Fund at (916) 227-4307. '. Notc: Penalties for Failure to Complv with Financial Responsibility Requirements: Failure to comply may result in: 1) jeopardizing claimant eligibility for the State Cleanup Fund, and 2) liability for civil penalties of up to $10,000 per day, per underground storage tank, for each day of violation as stated in Article 7, Section 25299.76(a) of the California HeaLth and Safety Code. Page 27 - . EXHIBIT B 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 f9r Orange Belt stages (Business name, business address, and correspondence address of owner or operator) 2134 E. Mineral~,King AVe. Visalia, CA 93292; P.O. Box 949 Visalia, C.A Q1?79-0Q4Q This letter is in support of the use of the Underground Storage Tank Cleanup Fund to demonstrate . [mancial responsibility for taking corrective action and/or compensating third parties for bodily injury and property damage caused by an unauthorized release of petroleum in the amount of at least $ 5,000.00 per occurrence and $ 5,000 00 annual aggregate coverage. (Dollar Amount) (Dollar Amount) Underground. storage ~nks at the following facilities are assured by this letter: 2134 E. Mineral Klng Ave. Visalia, CA 93292 (Name and address of each facility for which financial responsibility is being demonstrated.) 1. Amount of annual aggregate coverage being assured by this letter............................................·...······ $ 5,000.00 $ 4,497,323.47 $ 2,593,755.40 2. Total tangible assets............................... ............. 3. Total liabilities. ............................ ............ 0....····· 4. Tangible net worth (subtract line 3 from line 2. Line 4 must be at least 10 times line 1)..................... . $ 1,903,568.07 . 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 perjury that the foregoing is true and correct to the best of my knowledge and belief. Executed at Visalia, CA (Place of Execution) On 10/1/97 (Date) ~~ (Signature) Bruce Lynn (Printed Name) V.P. - Finance (Title) II<."T nl r.D OFVI~r:) ¡jt},,\ Page 29 .~~.--- '-~ ----, ............. -r.' ';'- T 1 :DIESEL INVENTORY INCREASE INCREASE START IÞSEP 15. 1997 8:59 AM VOLUME 2833 GALS WATER 0.00 INCHES TEMP 79.3 DEG F INCREASE END SEP 15. 1997 VOLUME WATER TEMP 9:28 At"1 10282 GALS 0.00 INCHES 86.7 DEG F GROSS INCREASE= 7449 TC NET INCREASE= 7350 I ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA SEP 16. 1997 6:00 AM INVENTORY REPORT T 1 :DIESEL VOLUt"1E ULLAGE 90% ULLAGE= TC VOLU~'1E HEIGHT WATER VOL WATER TEMP 10153 GALS 1630 GALS 451 GALS 10037 GALS 76.38 INCHES o GALS 0.00 INCHES 85.3 DEG F e, "" "" "" END"" "" "" "" "" ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA SEP 17. 1997 6:00 AM INVENTORV REPORT _}ESEL = ULLAGE 90% ULLAGE= TC \/OLU~1E HE I G HT WATER VOL "'lATER TEMP 9975 GALS 1808 GALS 629 GALS 9864 GALS 74.98 INCHES o GALS 0.00 INCHES 84.6 DEG F "" "" "" "" "" END "" "" "" "" "" ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD, CA ~ 13, 1997 6:00 AM INVENTORY REPORT T 1 :DIESEL VOLUME ULLAGE 90% ULLAGE= TC VOLU~'1E HEIGHT WATER VOL WATER TEMP 3129 GALS 8654 GALS 7475 GALS 3101 GALS 29.57 INCHES o GALS 0.00 INCHES 79.2 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD. CA ----- .--- SEP 14, 1997 6:00 AM INVENTORY REPORT T 1 :DIESEL VOLUME ULLAGE 90% ULLAGE= TC VOLUME HEIGHT . WATER VOL ',.,IATER EMP 3053 GALS 8730 GALS 7551 GALS 3026 GALS 29.05 INCHES o GALS 0.00 INCHES 79.2 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ORANGE BELT STAGES 3640 SILLECT AVE BAKERSFIELD, CA SEP 15, 1997 6:00 AM IÞINVENTORY REPORT T 1 :DIESEL VOLUME ULLAGE 90% ULLAGE= TC VOLUME HEIGHT WATER VOL WATER TEMP 2833 GALS 8950 GALS 7771 GALS 2808 GALS 27.53 INCHES o GALS 0.00 INCHES 79.3 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ - - - -- ~RRECTION NO"ijCE BAKERSFIELD FIRE DEPARTMENT N~ 625 ' ß/ Location ()ÎIl",,- ßcH ~~acrr5 Sub Div. 3,;))- LIS) 1 . Blk. . Lot You are hereby required to make the fo}lowing COrI'ectio 07 at the above location: !\-eÞ~ Plø.¡\!t-/ -vl·~· \I . Cor. No (., ¿ (L otJr cø «\r~_ ~()Plt!J (þ..ç. '{(Jvr {( W JVf{:.;' ... fLUJ-ttN~~f(,('a¿ ;) ..tf e{e~tct<.1 Completion Date for Corrections Date q f.., (1'7 Inspector 326-3979 UNDERGROUND STORAGE TJt(jNSPECTION FACILITY NAME OraÞl1t", He.lf .~-\r11,Æ FACILITY ADDRESS 3~qO H· 5tfld k ~. Bakersfield Fire Dept. Office of Environmental Services Bakersfield, CA 93301 BUSINESS I.D. No. 215-000 Iff CITY &krs.wcff ZIP CODE 933t9/ FACILITY PHONE No. ID# ID# ID# r{ 17/17 / INSPECTION DATE Product Product Product TIME IN TIME OUT (JI ("!or I Insl Dal~ t( Insl Date Inst Date INSPECTION TYPE: ,it 'J ROUTINE t/ FOLLOW-UP Size Size Size 1:1. ~ 0 REQUIREMENTS yes no n/a yes no n/a yes no nla 1a. Forms A & B Submitted V 1b. Form C Submitted II' 1c. Operating Fees Paid Ý 1d. State Surcharge Paid V 1e. Statement of Financial Responsibility Submitted ./ 1f. Written Contract Exists between Owner & Operator to Operate UST .¡ 2a. Valid Operating Permit if 2b. Approved Written Routine Monitoring Procedure 1- II 2c. Unauthorized Release Response Plan 1- V 3a, Tank Integrity Test in Last 12 Months V 3b. Pressurized Piping Integrity Test in Last 12 Months if 3c. Suction Piping Tightness Test in Last 3 Years V 3d. Gravity Flow Piping Tightness Test in Last 2 Years v' 3e. Test Results Submitted Within 30 Days ../ 3f. Daily Visual Monitoring of Suction Product Piping V 4a. Manual Inventory Reconciliation Each Month V 4b. Annual Inventory Reconciliation Statement Submitted V 4c. Meters Calibrated Annually V 5. Weekly Manual Tank Gauging Records for Small Tanks V 6. Monthly Statistical Inventory Reconciliation Results V 7. Monthly Automatic Tank Gauging Results V- 8. Ground Water Monitoring V 9. Vapor Monitoring v' 10. Continuous Interstitial Monitoring for Double-Walled Tanks J 11. Mechanical Line Leak Detectors .I 12. Electronic Line Leak Detectors ./" 13. Continuous Piping Monitoring in Sumps -I 14. Automatic Pump Shut-off Capability ,/ 15. Annual Maintenance/Calibration of Leak Detection Equipment /.. V 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series V 17. Written Records Maintained on Site .í 18. Reported Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days if 19. Reported Unauthorized Release Within 24 Hours .J 20. Approved UST System Repairs and Upgrades if 21. Records Showing Cathodic Protection Inspection V 22. Secured Monitoring Wells -' II) ...-- h /' 23. Drop Tube / V Þ ----- / I) RE-INSPECTIONlE ~7It7 RECEIVED B~ } ~~~ C"'"" I~ INSPECTOR: v.. ) OFFICE TELEPHONE N. 9'}{¡,- /??? 'j FD 1669 (rev. 9/95) · . ~ITY of BAKERSFIELD "WE CARE" January 30, 1995 FIRE DEPARTMENT M. R. KELLY FIRE CHIEF WARNING! 1715 CHESTER AVENUE BAKERSFIELD. 93301 326-3911 CERTIFICATION OF FINANCIAL RESPONSIBILITY REQUIRED ;:?t :S'-OtZiø-øøø 1 :l ':} ORANGE BELT STAGES 364tZi N SILLECT AV BAKERSFIELD, CA 93301 Dear Underground Storage Tank Owner: Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office. Please forward either a copy of your existing State approved mechanism to show financial responsibility or else complete the attached Certification of Financial Responsibility form. An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms required to pay for corrective actions resulting from leaking underground fuel tanks. Remember, most tank owners only have to show financial responsibility for at least $10,000 of clean up liability. The Underground Storage Tank Clean Up Fund (USTCF) may be used as the mechanism to cover the remaining accidental release liability. The total amounts of financial responsibility required (check boxes from section A of form) are as follows: If you don't sell product from you tanks, and you pump less than 10,000 gallons per month, check "$500,000 per occurrence". Else, or if you are in the business of selling from your tanks, check "1 million dollars per occurrence". For owners of 101 or more petroleum underground storage tanks, check the "2 million dollar annual aggregate" box. All others need only check the "1 million dollars annual aggregate- box. Please be aware that failure to provide the financial responsibility document to this office within 30 days will result in your Permit to Operate being revoked. (25285.1 (b) California Health & Safety Code). If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact Howard Wines, Hazardous Materials Technician. at 326-3979. REH/dlm Permit to Operate Underground Hazardous Materials Storage Facility ...................,.................. ............................... .................................. ........... . .. . .. ........... S ta tel D No I , cr ,.,:,::::::,.::¡:::}::::r;:::::::::::;;:'::i:::::::::;::::::::;;:::::::::;::';::::;:::;;;:;:::::;;:::::::::::::,;:::::::):::::::::::::::::.:.. P ermi t No \ 19 · ~O~DITIONS:;('E;rR\VJl~'EVER~E SIDE ~~:;!:~: Ic¡l~jl~l~j~~Ù,q~,}~~~; ::~~~'" M~;:~ng , . .. , , , ,,':, :....~..... 1715 Chester Ave., 3rd Floor .......,..,... () r~, l"\éJL ~ 1+ ..Ç,"/I!\,\Q.s. Bakersfield, CA 93301 r?.... (805) 326-3979 ~.:;;,6 c40 .5 I I (ec...+ Tank Numbe,r ( / Issued By: Approved by: I ! , . Ralph E. Huey, Hazardous Materials Coordinator I' 'II 1 c Valid from: ~VJ. I( Cf4 to: Jvt.,. ,7 . Permit to Operate Underground Hazardous Materials Storage Facility · State Tank Number Issued By: ,I ! ¡ I J I I . Approved by: I D No t t ~.,:.:::::)::t?:;?}:::?::;::::::::;~':~::;·;;:::;::'~::;::',:,,;:~::;.:~::.;:;~;:::::::::~::::::>:::\:::::::::::::'" Per m it No it ~ · ~O~DITIONS~~:f;tfMilj~EVER~E SIDE .. ,:(C:::.·::::::::::;::: ',:.::;:::: .\;.:.:::... ;:' .: .{:::::-:::=::;,:.,::,::::;:::::::::::::::::::::¡:;::\::::;:;:::::::::'::::::\:::. C!~~~~i?f "~~~ì~1ì!:j:.~i;~~ M~~~~!¡~~\\~~~~ :~~n~d \:~;~E3::// :' ''':1 :~::?,::::.:::::::::t ":::'::f4:ì$,: CLm '''.::: :'::~F fk<2.SS~e... j,¡ i0""/~i~ŒJ!':¡lt¡;~fiÝ;jtø·,; Ù .. ... . . . . . . ," . ...... :...:.:.......;...;..,;.;.;.. Hazardous Substance Piping Monitoring D~e.se-L -AlJ) <t - ~ æ ~\ ~ A õ-? ~ +-~ c\) , . . . , , . . . .... ......... .. . . . :.:\:: {t····\}···\:::. ......... :::" ":::::.:.' ,.;.::;:::::: "' " ....... .:::.......;:;:;. ;.:.;,". .......: :.'.:. .. '.. ...........{:~::.>:::::: ':::::::::=:';';" .-:.,' . . .::::.:;:::;:.~:..'...:..::::::::::::..::;:..!:;::....::::¡;:::::..::i'::::·;::::'::;::.:i¡::::::::;j:·;::·'··::::::::·:::'·'::·::::Ii';;;::::::';:::.::::':·:!::::..."!::':···/:·:···,..1..::·· ::":~~ued To: ..... ..;;.:>:.;..:;,;........ .:::;:::::.:::;:., ..::::.;.-.....:..:/.;. -:' ) .: ~:./:::;::-' ...><::.....-... .- ,.' ..........:.:.:...::;...::.:....:.....:..,...:.;.;.:..;::...::y...... .:" ;' :' : .:.:::.:::.:." ....:.:::::;::...:......... .' .,/ .... .' ::' :',;' .:' .:" .:....::::.:::.;... . ....:.::.;,.::::.:.:::~;.::(.;:::;;;::::;.:/.::::;::.:(:::{:.;:;,:.::::..::::.:.:::::.:..... .. Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 (805) 326-3979 fh~~ tlt"\WO¡Q..~ ORA~ Q.. ßo..I+ G*~e...5 ~ L.fó ¡V,~ ~ t Ce...c:..T Ave;. g~ o~ Ralph E. Huey, Hazardous Materials Coordinator Valid from: to: ----.......- ~-~_. ·),~.:-"'7'"':".T - &)m··~~'·"'~·'~,··-,···'···:·;~·'· . ~"'~pp;',,:~, ':'¿ , ~ '-,' :.' /" . O~E BElJ sv:GES 1fõ)~(Ç~DW7~~, ~~ FEB 211995 ÐJ/ B ' y~ I ._--..........._-~~~ February 13, 1994 City of Bakersfield Attn: Howard Wines 1715 Chester Ave. Bakersfield, CA 93301 RE: 215-000-000119 3640 N. Sillect Ave. Mr. Wines: As per our conversation, enclosed is a copy of Orange Belt Stages Balance Sheet showing that we have the financial ability to meet the $10,000.00 self-insured requirement for the Underground Storage Tank Clean Up Fund. I certify that the enclosed copy is a true and correct reflection of the financial position of Orange Belt Stages. If you have any questions, please let me know. Sincerely, Bruce Lynn Secretary/Treasurer P.o. BOX 949 · VISALlA, CALIFORNIA 93279 · PHONE (209) 733-4408 · FAX (209) 733-0538 ~"...', ';\ . St¡¡te of California State Water RCIiOUrcca. Board (ro.ndiou.. _.... . , ~~.,ifj~llrfl~;~:···. CERTIFICATION OF FINANCIAL RESPONSIBiliTY FOR UNDERGROUND TORA NlKS C NTAlNING PETROlEUM A. ¡.a ,...uinll (IQ dc.o..ara.. 1"""""'" ~.,...,"Wi~ ia elM ~uired _00lIl" .. ....åØed 10 5edJ_ 2801. cu,.., 11, Dno. J, Till. 2J, CCA: 0'00.000 lloa.n per _rreoee @1_illi- lIoIIert ....I'lIJcp'. . .... AND .... ~ Billioa doD.n pet ooellfT'l!oce 0 % .ilioo doDan 'II1II..1'11"1'" B. 0 ran g e Be It S t a ge s hereby certiftn that it is in compliance with the requirements of Section 2801, (11_. øt7itøJto..., IK 0p0nJDr) Article 3. Chapter IB, Owision 3, r,tfe 23, California Code of Regulations. The m«hanisms usBd to demonstrate financial responsibif as" uirød b g'Í~~M~,~~~~~~;t :;~~i.~~:.}t~:~~î~~~t~~~~m~f~:~,:.·~ç:~.·::{~~:;J·~t.~:·Numbêm!.:·~I~;;~,~~[:~1::;'~o~~:l: Self Insured Orange Belt Stages P.O. Box 949 Visalia, CA 93279 $10,000 ntinuóus Yes Yes State CleanUp USTCF P.O. Box 944212 Sacramento, CA 94224-2120 990,000 Continuous Yes Yes Note; "you 're using the $tate Fund 8$ any part of your demonsttatlon of financial responsibility, your execution and submission of this certification ./so c.rtif;es that rJ are In co IJaflCt with an conditions for rtic lion In the Fund. Ave. 3308 , ......,H_. Orange Belt Stages .1dII.,.~. .IdIIIJJII- '-17 AdIIr_ ·1dII171f....· hiIII)'AoIcIr_ I)'M.. ,..., Doat 1'I_...."...onw.O".CltOponIOr Orange Belt Stages CFJ(cwn) fILf; 0.4.... - Local Af1aCf ÇopI.. - rodlil)l'SllI(l) ';:r- . CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT ~ "fI! .. . No, 5907 State of CALIFORNIA County of TULARE On February 16, 1995 DATE before me, Cheryl Faulkingham, Notary Public NAME, TITLE OF OFFICER, E.G" "JANE DOE, NOTARY PUBLIC" personally appeared Bruce Lynn NAME(S) OF SIGNER(S) IX] personally known to me - OR - D proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/Ii:5& subscribed to the within instrument and ac- knowledged to me that he~~e)t executed the same in his/buuøtk8n authorized capacitY(*faS:), and that by his/:her~~ signature(s) on the instrument the person(s), or the entity upon behalf of which the person(~ acted, executed the instrument. I~ ~ ,~ ~ ~ ~ ~ ~ ...... ~ ~ ~ ~ .... ¡;..' V'~'~' CHERYL ~AULKINGHAM I <: :....,.: )'tJ, COMM. # 1033363 2 ~ (r' . -~ Notary Public - California j; j \ . ',' TULA'" COUNTY ' j . ~ My Comm. Expires JUL 28. 1998 .................-----............---........................--- WITN ESS my hand and official seal. ~Q~~~ OPTIONAL Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent reattachment of this form. CAPACITY CLAIMED BY SIGNER D INDIVIDUAL IX] CORPORATE OFFICER DESCRIPTION OF ATTACHED DOCUMENT Secrêtary CERTIFICATION OF FINANCIAL; RESPONSIBILITY TITLE OR TYPE OF DOCUMENT TITLE(S) D PARTNER(S) D LIMITED D GENERAL -1- NUMBER OF PAGES D ATTORNEY-IN-FACT D TRUSTEE(S) D GUARDIAN/CONSERV A TOR D OTHER: -------- DATE OF DOCUMENT SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) Orange Belt Stages None SIGNER(S) OTHER THAN NAMED ABOVE ----------------- ©1993 NATIONAL NOTARY ASSOCIATION· 8236 Remmet Ave" P.O. Box 7184· Canoga Park, CA 91309-7184 :~ ,¡ . . " .l,"" 02/16/95 ORANGE BELT STAGES PAGE BALANCE SHEET DECEMBER 31, 1994 YEAR-TO-DATE YEAR-TO-DATE GIL ACCT NO, DES C RIP T ION : YEAR LAST YEAR ,- --------------- ------------------------------ --------------- --------------- ASSETS CURRENT ASSETS CASH 468,132,39 12,928.09 PETTY CASH FUNDS 840,00 ,. 840.00 1043 SPECIAL DEPOSITS 76,696,29 76,404,67 1061 SAVINGS-BKS DEPOSITS 5,974,69 20,686,86 1124,11 NOTE REC,-HAWORTH LANDS 673,946.69 708,514.75 ACCOUNTS RECEIVABLE 406,370,66 850,.403,94 1180 MATERIALS AND SUPPLIES 101,563,42 74,063,42 1181 DIESEL FUEL INVENTORY-STATE 20,900,00 18,487.50 TOTAL CURRENT ASSETS 1,754,424.14 1,762,329,23 TANGIBLE PROPERTY OPERATING PROPERTY 10,221,956,08 9,034,963,65 LESS RES, FOR DEP, STMT. Al 6,844,230.00 6,176,100,00 TOTAL TANGIBLE PROPERTY 3,377,726.08 2,858,863.65 INTANGIBLE PROPERTY ORGANIZATION FRANCHISES & PRMT 26,621.11 26,627.11 TOTAL INTANGIBLE PROPERTY 26,627.11 26,627.11 MISC, INVESTMENT 1650 GL 10% SENIOR NOTE 7,000,00 7,000,00 1651 GREYHOUND COMMON STOCK 4,31 4,31 TOTAL MISC, INVESTMENTS 7,004,31 7,004,31 DBFERRED DEBITS PREPAYMENTS 2,669.31 175,645.85 TOTAL DEFERRED DEBITS 2,669,31 175,645.85 TOTAL ASSETS 5,168,450.95 4,830,470,15 LIABILITIES NOTES-PAYABLE ,00 ,00 ACCOUNTS PAYABLE 172,443.26 205,279,55 ACCRUED TAXES 6,486,16 13,594.10 2180,1 PASS, RECLAIM ADJ,-VISALIA 2,501.53 2,408,09 2180,10 PASS. RECLAIM ADJ,-BARSTOW 43.35 43,35 2180,11 PASS, RECLAIM ADJ,-TEHACHAPI 1,898,85 4,640,47 2180.12 PASS. RECLAIM ADJ,-DINUBA 2,810,20 7,087,30 2180.13 PASS, RECLAIM ADJ, - L,A, ,00 25,741. 71 2180,2 PASS, RECLAIM ADJ, VIS-PR 25,966,45 19,398,52 2180.3 PASS, RECLAIM ADJ,-PVILLE 2,440.79 11,191.09 "\ I -- ;. -¡; .- 02/16/95 ORANGE BELT STAGES PAGE BALANCE SHEET DECEKBER 31, 1994 YEAR-TO-DATE YEAR-TO-DATE G/L ACCT NO, DES C RIP T ION YEAR LAST YEAR' '"' ---------~----- ------------------------------ --------------- --------------- 218O,4 PASS, RECLAIK ADJ.-HANFORD 4,062,44 17,286,64 2180,7 PASS. RECLAIM ADJ,-PASO ROBLES 53,322,48 (40,076,64) 218O,8 PASS. RECLAIM ADJ.-BORON 1,931.56 2,093.78 TOTAL PASSENGER RECLAIM ADJ, 94,977.65 49,814,31 2181.11 EXP, RECLAIM ADJ,-TEHACHAPI 2,199.05 2,196.25 2181.12 EXP, RECLAIM ADJ,-DINUBA 1,147,58 (178, 10) 2181. 3 EXP, RECLAIM ADJ,-PORTERVILLE 3,557.69 2,876.86 2181.4 EXP, RECLAIM ADJ,-HANFORD 3,988,04 (1,682,48) 2181.8 EXP, RECLAIM ADJ,-BORON 2,230,43 2,231.23 TOTAL EXPRESS RECLAIM ADJ, 13,122,79 5,443.76 1 YR EQUIP, LOAN OBLIGATIONS 927,193.48 751,252.97 TOTAL CURRENT LIABILITES 1,214,223,34 1,025,384,69 LONG TERM OBLIGATIONS 2367 VISALIA DEPOT PROPERTY NOTE 86,965.85 86,965,85 EQUIPMENT OBLIGATIONS 1,503,464.56 1,569,446,23 LONG-TERK NOTES 590,503,38 335,673. 00 TOTAL LONG TERM OBLIGATIONS 2,180,933.79 11992,085,08 RESERVES OTHER RESERVES FOR PLART ADDITIONS & BETTERMENTS 24,000,00 24,000,00 TOTAL RESERVES 24,000.00 24,000.00 CAPIT AL 2700 CAPITAL STOCK 80,000,00 80,000,00 2900 EARNED SURPLUS 1,554,040,38 1,352,124,72 CURRENT INCOME-EXHIBIT B 115,253,44 356,875,66 TOTAL CAPITAL 1,749,293.82 1,789,000,38 ~fL TOTAL LIABILITIES & CAPITAL 5,168,450,95 4,830,470,15 · . e UST F~ BAKERSFIELD CITY FIRE DEPARTMENT HAZARDOUS MATERIALS DIVISION INSPECTION RECORD POST CARD AT JOBSITE FACILITY OWNER ADDRESS --.J ADDRESS CITY, ZIP CITY, ZIP PHONE NO. PERMIT # INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same number are ready. They will runin consecutiv~ order beginning with number 1. DO NOT cover work for any numbered group until all items in that group' are signed off by the Permitting Authority. Following these ins1ructions will reduce the number of required inspection visi1s and therefore prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION' DATE -IN.S.eECTOR V/ Backfill of Tank(s) V," Spark Test Certification or Manufactures Method fI1 Cathodic Protection of Tank(s) PIPING SYSTEM EJectricallsolation of Piping From Tank(s) Cathodi,c Protection System· Piping ..;/ ý/ // Piping & Raceway w/Collection Sump Corrosion Protection of Piping, Join1s. Fill Pipe SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION Uner Installation· Tank(s) Uner Installation· Piping Vault With Product Compatible Sealer / I Leak Detector(s) for Annular Space-D.W. Tank(s) / / ./ Level Gauges or Sensors. Float Vent Valves Product Compatible Fill Box(es) Product Une Leak Detector(s) Monitoring Well(s)/Sump(s) - H20 Test Leak Detection Device(s) for Vadose/Groundwater Fill Box Lock Monitoring Requiremen1s , ~l ';~j: \.~.., ,\.... ,~,., If"';," " '1',,~ \.:.¥. "..~ \ :j~' ....". :.... o::~'. 7'~~ ~r.:1 ~,~~ 0,:",;.,: :~,~ :""'/..L ~~~. . . ~."'; , ;t:. ~~: " ,;i' I ~~, .. "',\' 4,1. ,; e' .'. ¡ ~í '. ~.,', .f " ' '; 1.'- " {... . :;,t> ~":. . ..!.' .\.." . -! '.. .~. .: ',' '.' i( ,. ., " ~'f \ !."~ I'. )':~ '. MAR- 2-94 WED 7:08 TRIPLE J CONSTRUCT e MAR-01-1994 08:16 FROM RLL ~MERICA TRENCHING 1686566Ø 2096865880 . TO RRT (nulronmental 31563 Au.nuI 9 ' Medere, Cft 93658 February 28. 1994 Trlpl~'J COl1!truction 1232 Plir-view AVe. . Tulare, ell. 93274 AUn: Jobn M: Fuel Tank. Plo*-tout Calculatión~1 Out1sebelt StllKe J,J~eø 3<460 Silled Ave.. Baker.neld, Ca .. Dear John~ As reque'ted, "'8 have studied the potential for high .-at.,. tab1e I1t this sit.e l1~d perrorm.ed the Float.out and Anchot.ge Calculation. 1n aCCOrdance -.r¡th PSI Recom.m.ended Practices 100-86. Aþpendix A and the information you provld~d. .ØUr calculations indicAte th.t you will have jurneient deþlh of . overbúrden arid reinforced conc:r~tè pld to þte~ent the lInk trom rIoliting out UDd,,. thl! situation or an empty. fully submersed t.Mk. Thlt calculated lafet.y r8cto~ I" '2.36, 'llrtth an exce~ or restraining ror~ over buoyant force or . iO~,237.9' Þounds. ' '.' > The dep\h to first water in the project area WQS distu8Iad ""~lh I . geolo¡ist from thê Kern çounty Water A8ency vbo concurred that there i, .. very J11rh' potetttial for "hallo~ groUndwater in this area. t'he Cross VaUey C.aÖt!. ~h'ch is operated by (he KCW A, is I~ted apþft')1:irttalely t i u teet to the 4!l.8t of ýò~~...t~5: toeetion. This unlmed canal earries water from. the State Water ProJètt. (CaUfornia Aqueducl) to the ""ater treatment pl."t lUst north or GoJden State Ayenue, This cana.1 can be expected to bt carrying water 365 days þer yea(',' Appto~im8tely 8,~JOO '~re rett or water per year lire recharged iAto the loea! IquiCer through 8eepage lOSSeS Crom the çana1. .' ", , ~ A significant w'~'r mOl.Jnd should e.lis~ adjacent to t.he unlined 'portions or the cross VaHey Canal, Ind this is the reason you el1countered v.t.tr In the tao.k eltlvation on Februlry 1, 1994. Since the canal was reported·to þ'. baø.k full at thl1t time. that was probable. '"votst ç,,," situ_lion. If you have any qu.e!lti~s or eom.menll reaarding thi9 report, þle4se reel tree to eoatact ~s at (209)661-2011. ' Re$peçt{ully SUbmitLed Gd;;j)~~ Da,....id F. Charter, Geoloai.t UA04113 . Bnclosurn P.02 P.02 ," . .' " '" ., .' ", . .. .... . , " ':.., . . < . . ~ ", ~~~. -..:~ ,,: , ~~)~.' ~I ,':~1~ .¡.:' :1', /., . . ,/. I':" '. '," ~: ::' " ." ". . " . . . . ~,. ,'j ~ '. . " ::'" ,.' ~'~'. .."~ .. ~~,' I~ , , '4/>}::: , " , " ~ .- 5;" " .' " , " ..' ," , , , Ò ;.~ " J , \'''': ~( '. ,- '". ", , , '\ -, ~'/ , to' I:' "" .';-.. . }~ :~~'.~ ," ,. , .~,:/ ;1, ~':.~ k ," ,. ", , ' ;::~:. ':i' /;. . . (/: '" " , ' '" " ~~ . " 'i MAR- 2-94 WED 7:09 TRIPLE J CONSTRUCT e MAR-01-1994 0S:1? FROM ALL AMERICR TRENCHING CI) ncre te !õJ ab , -c ! . BUilding . ~ 'tx ." ,~~r~Ogebel~ :'-' :~460 S11Ject Ave, J~~kersrteld câ I.' "," . " ŒAT Envirøhme"t.' ) " TO 2096865880 . P.03 1686588Ø P.03 t' .";;' ,N ., < ::~'''. -:..;1. . ..... " " ,",'" \ ,I' o , , : ;.... . : . ~ " ,'. , '~. ':::t., ... ~ ' / tank 1ocellon ". ':: 0" .:'; NT:S " ., figure I . . Site ~ayout , .': :¡': , , '\ ; ,: " "i ;, ,", ~. i:~. . "tfz ~~.~ ¿.;.I I~··I . ';-~I' '" "", ~{~- ~t;": :;:~~: ' I~I': J:. ,.... .)",i, ;t·'. , , "~../ ~, '4~¡~ MRR- 2-94 WED 7:09 TRIPLE J CONSTRUCT e MAR-01-1994 08:18 FROM ~L AMERICA TRENCHING 2096865880 e P.04 TO 16865880 P.04 r,' '. ~Ø/lations ,\)" '.j' " " A.2 Wemht of M~fa., Sand or pèa gravel 60.0 PCP Reinforced concrete 81.6 PCP Tank 13,000 Lbs, ' , I Wate(' 7.48 Gal per cubic fool Water 62,4 Lbs per cubJc foot 1\.1. l..rlecL~d tank WA Tank diameter 8.0 Ct 'r-ok lenøth 32.25 ft rank Irea 258 sq tt .' " A.4. . Tank. disDlaœ ment "" ,..;, , ' Cylinderical tatl.k body 1620,24 cu ft M'an~ay (... (t diam by ... It) 50.24 cu r,~ 1670..48 eu rt I)J,P1.C8 mtnt 12495.19 gal 10..23·7.9j Ibs ~. Rt!!Îftf«cecl conCNtle Dad at n.uished an,de .Pact length . 38.S ft Pad widlh 23 ft Pa4 arel 88S.5 sq ft Þ.d volum.e .. 6 in thIckness 412.75 cu ft PI4 weight J8.78.f.9 Lbs Á.6. DeDth of butiat to too ~r tank. dbtanee from bottom of pad to top of tank J.' (t \" " .' 0:;' ~~ , dl~' ,4,1 e',' " ~ ~\t ~';f; , , ..' '~...: '" ~, . J':!:; ,~"" ... " , ~,;" ;: '. ~?~ 't~" .' :~. ". .~. ;~f' I ~;.~.: '>, ::~;; :'i( ¡fl. , " , '" %,, ;..-:' poø- 2 , ,'j. ,.,( ., ... . . .., ì~,~{' .' ,~:.. '~I " :i~·~ ,¡.:~. .~~'" .:f~ ., '.~' "~,I' ,\~¡, f', ','. . ;~ .~\, ; ',):.1 ''''¡:r ~.,~ '!" ~ .\ .~.~ "b~: ¡:.- .' . :,~~ ,~ ," , . ~ ~\ ~ ,~. , " . t\~ ,'~k· !'" . , -1(h/3) 1 (81 482 + IQrl(BIIB2)] . (ev 12)" MJ ' . [(2~.S) z (385.5 4 2'8 + sqrt(2284S9)1-I0670.-f812) ~ 50.2011 - ((2.~) . (US.S ~ 2'8 + 177.97)} -1835.2"1 .. ~O.Z"J .. [203 x 1621."71 ~ (885.0481 - (4053.68 - 88'.-181 .. 3168.19' CY n · 190.091.1 L's 7: 1 0.R I PLE J CONSTRUCT MAR-01-1994 08:19 FROM ALL ~MERICR TRENCHING MAR- 2-94 WED , ~.7. . ' Volu.llJe and w~il'ht or ove¡þurden D. tank di.meter . d · depth 0{ overburden h .. Dn · d B 1 .. atel of pad :82 . reflected area of tank V . tank displacement . M . void in overburden (manvay) Votùme " " yreigbt , " A.S. AdeQuaCY of restraioinR ror~e.A. Total rèJtnjnin¡ Coree, In pounds Weight of overburden Co~lO\t.t. ,&\;\ Tlnk weight iol.t .' , ¡~ Total buoyant (otet, in pounds EzCle" ot feslrait1Jng force ovttr buoyant force 10f2.6G2.'S Lb, :.,~.: "!; ,. 'p '" ~r~ .... ~..." l!jJ'; ~~ : ~;:.:' .J...... >^ ,.,p , ,,;,, )~:' . 6,9. CalcuJaUon of ,sLeW Clç,t.2.t Rest~lI1tllng force I Buoyau\ force 246,840.6 ì 104,231.95. ,I. ~J,~¡:~. ./'..:., " ~': , ^ '.} , .J; :::..1. ~. ~. .. ~~;' ., \'~ ..~\\;-, ~, ,-' ~~'~:~ ':"." 2096865880 e P.05 TO 16855880 P.0S 8Cl 3.' Ct 1.'n. 88S.5 sq rt 258 tq It 1670.48 cu Ct 50,2<t cu f1. ":: 190,091'.7 3&,7 ~&.9 .wtQ.Q. Z'i6.'-fO.6 104,237.95 , , 2.36 ..rety I.ctor, pege 5 '¡., " ,', . . . ..0. MRR- 2-94 WED 7:10 TRIPLE J CONSTRUCT e MAR-01-1994 øa:2Ø FROM AL~ AMERICA TRENCHING , , , ' .~, ,r . , " ~ " f. ~ ~ ' ~ ' , ; ',,'" " , .', .~, " ~~ /, ,I , " ;::':' Tank , " . I ,:" . water êl'lCount!!r!ð \1'1 tarde hOle. 1~ rt depth, 2/1/94 '" .i \\) I,: ' - :- ~ ----- ~ ~~ . . , " 2096865880 P.06 e 16865880 P.06 TO Cross Venty ~' canal'" ' ~~. water rechst'ge mound , " ,~'; , " ot, .' , ;~, ' . 110ft '. , " ~~t, i'~( :~ (,,:~ ~. ':~' b' ::~~,w , ,'~ ,\'I;\"r . I)<~ !? ~~\. .'. '. ' ix . ~ '.;Orangebe 1 t , ' ~\3~4GO S111ect Ave. ~aakersf1eJd Ca ../ " ''!, ': " " 'I , ~,,,, figure 2 (A A. T EnVi,.onmen.~ ,I., ' ") ',*4' Å '" \ ~,~, ';.'~~I,'\I: Cross Sect ton: .' " , " '. ':.'": . " I ,,' (\~; .. .' .:' " , , :~; . .;~¡., I . _ ...·.~·u ". 'io MAR- 2-94 WED 7:11 TRIPLE J CONSTRUCT MAR-01-1994 Ø8:2Ø FR~ ALL AMERICA TRENCHING P.07 2096865880 e TO 1686S88Ø PEl Atc!Cmmend.d PrøçtfGte 100,88. ~ f4~ ~\:I, '.(:.: APPENDIX A r:LOATOUT AND ANCHORAoe CALCULATION W~IJ'.t 60.0 povndtpet eubfc tool 8t6p¡,)lInd~t'éCèllbc /'bot '.000 pound" " . ....'.. ~ . ,~'~ . "/ M8(etlal St\hd and pea ¡rll vel Re!roh:~d concrete TlI.nk .lId mIlftWI)', $vbnltuJÞle pUn¡p !l1,d riseI' 300 POUhds - , ' WICer 7.4~ gat/an! ¡?tt etlbic (t'(Il Waler 6VfpQ\.\ljdapereubit foo¡ , A.3 RenfCtetl T'n~ Area. 1'he «:neèttd tl.¡'~ 11).11$. the surC.c~ on which the o~e~~rdt!;, be =Ira , il:t rlJc e&te. or "..' t)'rlndrlcaJ tank~. this. Is round by multiply'''' tlte klut' tèn~ diarrt~tCl' by its ~nlth, tn (he dJe of.ttl/;)(s ..hfa ~U~· 411 enð~. Ibt falCUlèliOt\ illM~ CO,"Jtl~'tcl. 'TJtI '1',(". _ ~ Ifill'. ~~ ."1 ~"-" ltel) "..u prev ded b)ltn! tAnll mOb ~t\frt..: Arta or Itaþe~ldll18nd elrt\llar' fJld segmenls 9'llndrictll body Tolf11 ,', 1'\ ,';';<" "~'1:. , . ~ ?;. ~~.( ..;1,'\' , .....'1 :"(' . ,¡I< '" ;:I~' 1:,: I' ~' . ... Pl.lrpoJl, 1be p\'lI'JOse of the t!oB\"uf and l\'JdòI'ag~ ('.r~ItJ.tion 1. to . ,ermIne ~. d~pth Ørburtll-lrom th~ lop of the ""k to finished: araðe - necessary to prevent ~tJ \meler- lrou"d tlll~ 'ro", f1olltln¡ whrlJ tl11pty I!Ind ruily subm8~atd, To ðo tM., It It deC:eull:Y. tbat t?le total buoy,"t for« be ttlOle th:v offset by the ~Ombined Wtilht or (!Ie Ovcrb\lrden (back. liD ",.fcdal), ravin, Over the tant lltt welglll or the enlpty ,I'.. I""', """ 1I,.,.flil64 .~,,~t. We here ·,Ih,¡trile the CIIICI!_ ,_Hen ror 11\ "",ty ana rulry 8"t>mersed e 8ht reot (110m In II, dlatuelcr. 10,000 ,alJon (nomln.l) ~a{'3¡;it,., d(l\1ble-wllled, fik'lr.n (elnr~ed pJutk (fltP) t&hJc. . .2 Wea,h. of MttetJ"Is. 1'he 'Ir!lght or malcrlal de- .~: ~~ eretSe5 whell.svbmer,èd, For our PU~"s. we h" ve used the ~~ roUowI". SU~èr8e4 weiaht$ tor ~'ommori ttlélerlals: I... 24.39 $q""te ~et +,207.03 Squltrtfect 23 1.4~ .quare fèel ::..... , J.... L'" "". . . '. b ... t.,,~ df.rnet... l · t.,. 1t"Dlf.t t · tN~M" of rtlnforced CIIDr1èttlt d · d.~". bUIll' 10 om'ot' I ttfnforoH " ~It ~ L ". ~ It' r--"---,-____--.. .~_.-..._. . , '- QQ ~ ~ . . '. '. - , -....- . ......... . -... , ---, ---- . ----- -, ........ . . . , \ -~ .'"\ . .' ¡: . . ::' . "'''ff J.. ".'."'f/.',,,,,, ~ff" tot A.w,iø"" ~kll'dd"'fI. Tilt w(lI,A, e/ Ø\"I'bllrdt¡ (IIIatlcd drt") þN)!'ftltJ _ ¡rIO' drill */111f ~I'f:e ..... '.' ,:', dV(l/,d/, to oß'kl 61Ø)'G/rr1. .J .. " r , .~ 22 .~~~ ~..~ '~:'~ ·f. P.07 , '. ~!.f. . ; ~~ . . .... , , Å¡: .... .. ., " ... l' .. .' ..: '. . " ," -\" ,'~~ "¡;:J ., I'" . "¡. ,.. 7:11 TRIPLE J CONSTRUCT 2096865880 FRO~ALL AMERICA TRENCHING TO ~ 16865880 p.e8 : Aecommendltd Praollces ror InrltaUatlon of VndetgrOU"d lIq\lld Stórago Sy,t,itnt MFlR- 2-94 WED M~-01-1994 08:22 A.4 tank Ðl&pl~e'lI1tnt. tne buo~ant tnttt to be over. come .. 'Che toIa' tIÏ1J¡ d¡spltee~ßt, b'c1udin¡ (he. disl."lIce' "'ellt of the .troc:hut WId 'tltthèd ntnl1wey". The f"rlowi", ..s.III.tlòlli lIIu,t",li t.o htethod! of ealcull'll\g di~pl~c:o. ment. '1116 method prov¡dllt.1I1e luger vallie III rl1Qrt conscr. . VltI.e.-.d .1I0I.I1d bè usetf, Mt'hød II, The. firs' I1\etbod " to nlt-urste the lotal 'pflêe occupied by 'h6 tank rfCm dl\t~ ptovJde:cJ by ihe ",an. "r8cturer. " ' ,,"'bol'l CyntldrlctJ tlnk body Two ~u'yt-d end! t...O mllnw8)'t ÇttJJ£f~(l 1.290.6" 1f3,n .s.QJ , 1.~09,OJ " " ~ 9.6~4 848 _,J8 10,540 , N"".d "'1 The ~or\d ""~I"nd I, \0 !ldd ',he 'I'I<:.~- f:Ul'led tly (he I~.,k Ilrvelure t(l1h. utuaJ ~!lI'II~¡ty of the lal'll(. In(e(.{i~, Àlld mAtlwa)'. Mt(hltd #2 lrí~nahk .IMJctute OÛter 'Ink strocturt Alb. (28) , T otat lank IItt'\JetUI'I Tank ~ap~ç"1 . lnt~rstlí:f CI'lkhy MRnwlIY volume Ç,P.bie r-~J Q¡[J2I.!I JS,J8 114 15.75 118 . -_..2~ --12 40.JS 302 .,: 1,300.80 9173D 82.89 e2D - 5.08 _...n t ,42!U 2 10,690 'the Iltemltr"o teall(, 1,429. U cllbJ~ reet (I 0,690 S'~"S), ....,,111'11 be uSed .'nct it i~ mott «mtCt'VIIU,,@, Tile 1."11 mel1u- f8CIUftrl ¡Mulct provide In'ormatlon on tb~ír ,.nk (timen- r;on~ ¡"If caþKlty. "n tl4uest. A.! Rth,rotttjf toneRie rid it Flni5'lt4 Grl(t,. ·The el,bl-Indl thick r:elnrorced «¡"C:/"tle ~ftd extends two te~¡ k>'~lftd ~àch end br the tank IIn\! e~I~"ct. One faot beyond etcb lid!! ollhe tank. 11te paving wlJl be 10' x 35', 350 'qu.~ ~, 233.'3 cubic tett. (350 sq.,,,,, fèel x 81nchel , .. 231.33 'e\rbie rut.) Utling thè ,ubmer,td wtght 0187.6 pound$ per' cuble root. th.e (o(al wdght (i' 1"* I'lIvÎ"a ¡. JO,44fJ pøtutds. A,l ""tIt of 8url" to toþ 01 rank, l'he depth or the oWtbUtdefi (backfill "'ateria') over t"~ tank eomtilUlc. lhe lreøteJ( (OKœ Cot C\Ou"tèractit18 not!lio", The /,IJrÎ*1 cteplh mUlt 1110 be sumclent to allo\\' þlpln8 to boe sloped to 'he tat!\: at least W p" root. AS$\Jming that a tolal Qurilll 4e,th or 3"" k sum~ll!!nt I'c>r ¡his þlJrþose, we œn "'like a . (ri.1 Cl1eulllion to Ihtermn~ if Otis eornbjnall~n ofþaving tl'ld b.utial depth \IIi" ~~nt lIoatoi.tt , A.' ""oru_ _hit Weicht òt Oft!tltlltclfn, To detet- mine tM dt,.ch or ,he oyerburd.n, 'II i.ø l.Iec'mary (0 dtfuct , , Ihe thickness or the reinrorced concreto pe..1nS r~m Ihe d'þlhorbtUialtofhttopolthel~r¡. ()'6H -- 8".. 2'JO"'!!!! 2,'33 It). We bäye lbøut'l1td that pea '.,'avel and SIIud have 'f1~ U"",*e1a1Jt lubtMtSed, ðO þóUh<!s þoer ç\lQic fool. The tofl,ll1W ot the overbllrdcrI e.AtI k C'alculated II follow&: «h + 3)(81 + SZ ... ÝiJšÏ)J - [(V + 2) -4- MJ Mitt: D .. r.nk eli'meter, I'll W (7.938 feel) P.08 I , ,I d -= J'Jeþth or overhutðe.I!. 2' .'6~ (2.833 ftel) , h ~ (D + 2) of. d ... (7.93& + 2) + 2.83), " == 3.9fi9 + 2.833 = e.80Z rrel B I ~ ^rtll ot the conct~t. .hlb jU Stade, , , ~~O 'qUare fe'tl (See 1A'.$) 82 z: Renec:ted tli"1I .f." " :13 1.42 s~tJaté reel tSo6 '^.3) " - l'11nk dl,ptaœll1l.~'ltí IO,G9ö ¡a!lotl!! " (!~29.12(l{bit (!to'tS« 'A.4, , M ... Void in overbu~f:n.(4' x' d'·mall"':.)')" '. .' 41,85 euttic (te-l Tohd volUBle Ør Clvcrburden ~ ((h + 3)('1 ~ 92 4- ~)J ._ -" (V ~ 2) + Mj - (6.801 .;. 3)(350.00 ~ 231.42 *' 'V 3~Q..OO ~ 2..~"42 J .. ~(I"29.12 ,.... 2},'" 41..8S, .... 2,2~7('tla."'2 -4- ~) - (714.$6'" .1.8$).' , ... 2.261($81.42 + 284,'0) - '56.dl · 2.261 (866 , OJ.} .. 151$.41 .. ~63.27 - 756.4. EO J~Oð,~6 c(bitfcr.t ojovrl'lJul'dC'h To'" \te'e"t orbvubUl'dtll ' ' " - I 2Q6.86 cllb¡dcet X welaht ~r bl\C:~1'i II tnltler/IIJ (60 PO\lnds ptr c"'~1e fool) . 17 71.4J2~Jl.ItJI A,. Àdequ:ity Itr Itedt'.;rt¡". Fþt'n", Th. 'd~qvftC,. orte5lralnlns Forces is delcrmlllt>d:as roUowi: ' Tøhtl tt:dnbJ(rtl rorc:t.!. (ri pound. Wel,bt of overburden , C~ncrele þavln¡ tt ,tMe (See 'A.~) Tank RIId m'nway weighl; ""In "¡ltI\lr~f\lrers Submersible ~um" IInd ,i$er. rrom rn."ur.ctu~r ' ~ Tolát 98,ISt 1'o(al b,,01l1nt torCllo be o~er~tI_I!,Iat,þo\ih.b Toll\l displacement ('A.4, Method '2) 1.429.12 cubic: teet It "~welght of "¡ater (62.4 pound, pe~ el.lbjc l'öòt) E)Cèst or ré~raJ.dtlr torus o\'er buoyant tortu,lft poiiJk1~ .. , ! I u:.,%' .' 20,440 ',000 u.m 1 ! 1 8,9,75 Å,~ C.1c:ulatioit oUiltel1 hdot. ~'~I~ty ~ctoUn'. the e~.1ple Is I.J (98,152 -+ 8'. 77). In àddltlo"~ ftletfoø ractc)~. wblch h.w bot bet" cOIIS'~'td¡ Itclef ~ the ttstntlnl"1 ' tOt('e "",, to Ih~ sarti)' "'!lusin, rr a h¡.tll!r ..~t)' ínáttin is desired. burial depth d" be Ihma~e~ ot ìtlp.l'ltlMht.1 te. stralrtls provIded. A..10 ¡ttK. of AddltiC 9." Fool Ie. the bUrl", Dep(h. Addln, bitt! r()()t of burl., <IeI'lL adds sig~¡fiu"tl1 to the over&utden. Thë Additlolt 011',371. pollnti! (1'.7l'3 _, 72,41¡) Incfu,es the! tòtaJ rt$trainÜ'la 'fOtC:f 10 I '~.~2) , þOunds And th, "ret)' f'ðctor 10 1.3 (.II ',$2$'of' 89..171'.'.11 " follows: 13 , J " TO 21219686588121 e P.12I9 MAR- 2-94 WED 7:12 TRIPLE J CONSTRUCT MAR-01-1994 08:24 FR' ALL AMERICA TRENCHING ,,~, Aeco,"""rrded P,.cUc:es100·88 16865880 P.09 , , ~\.~ Wilt...! d. deptborOYet"urden . 3'10' ~ 3.'~3 feel hIS (D +,2' ... II .. (7.9J8 + 2) + 3.833 .. 3.969 ... i.8'3 - 1.802 rC'Ct All other ractor. rtmaln the IlIme a! A.. 7. 1'ðt.t tòh;",f ot oycrllurd,.. :z (7.802 of. 3)(866.02) - 756.14 ... 2.60' ('&&.02) - 1'6.14 · 2~!l1.51 - 756.14 · t 496.38 cubIc: f'bol 0' o\lerbutð," Tot" -ellht ot iIddllløtt.AI Ovtrt)l,lrden .,. r"9f.3I )( 60 pql,l1\4s per c:ublC' (O()I ... 89.7" '- 72,413(Sœ 1 A,7) - 17.3'&, T"e-_ ....he or,...,.tnln8 '.rftt :r- 98.152 (Se. '^.8) + 11,31& f .. I U ,$2J pðUl'ldf . I ClHItrntnt Adding to burial depth 1110 provld~. room for þltçh- 'Ing pl"J~g 10 rbe IlIIk tl/ad protrctiQIl flOl., ða',)age from IJ'ame. . A.U A,pltcltbUII1. Factors \'~ b, ¡eoltaphlc I~., t'Of!. "'I"n_' 'iII'l'lIe('. and e4uiprt\eJlt ",8"u'utu~r. FActotl ~,,6 clllçuJalkmi ,,~ lit Out ct8n1þ'e are nollnteded 10 t'elft. tent,ood prIc1~ f'(Ir I 'peot'U1c tank lnsftn.U~I. They repre- sent. rr.1tJe of tetertnœ for speellic cal~l\hUion$. Manur,c- lutets' Instruetlorti .$houlcl alwayi ~ foUø*ad. C"nl..d Ih~. te/1~ m.""rllttúter "thy ðoub~~.s(s ., Co wJ,elht't II ~reclnc ~lIst81~"'lô,, retJu1reø lIdditlonaf !",titl depth or supplementtd ~,lrIJ"ls. '~~i;. "ro.,_ , , -,'1 ,~.: f"",i ~~: .~;~\ '~,~ . .~.- c:.... . ~::.\, I:' '.. }i;.}: fI ~i1i. 'P.:...... \;:'~ :..~?.. ~, '(''', :. .'1. ,,' , ~~. : ;.~. .1 ~ ~ ., :. ~. . .~:·,~f ~ '~I ~(:; . , ,; '<-;'..~ :~; ·"tt ~,~ ~.:~, . . APPENDIX B BACKO~OUNO: CATHoDIC ÞROTECTION . 'I 8.1 G",~c CotraslOll. 0., vMie c:om!$io" I, the de~e- (toral1on or i Metal by dlrkl or c1cctr«hemlcal rCllcliQD witb Its thVl~II"'lent. COITO~Jon occUrs wben two cllssltn.ila~ metat o~Jed. W pJdèd hi dltcct Ot clecttk.' ton tact with each ot"er. Four ~I~ts 6fe ft:ql.l¡~d: an tleç-tl"t'lytt. tnoðc. , " e-a.thoð., "nd reM" circUit. rn ""cler,round lIècl tl1nk ¡)stll. I,t/on,. the mollt son .eI'Ve. Is t"~ eleetrol)'~. Anodes and clthodea d'lfetop ðn. die t.l'I~ and pipS"., or belweel'l the lank .ysttl1'lltnd more !to"'. tnèfab. TJïe tetum ~lreUlt is provl~ , b~ the co.ndtldMty 0' "'t meta) SUveture. The dlSJimHar. , Met,,! factot ~\ltð bt. dß'ere~.'n the mel.nutgkal ('f1"fe- 1~lJlfu of I~ ..",. strut:IUf't. or tJs~ presenee or I dirfetent nae1al. Curre,,¡ nO'N$ trom Ihe ttlet., or hither tlt¡;lf~morive a~Yllry (811~', tow.rd tbe þ''.ejar or 1('N~r rlrclfQltlotJve -;.;, 24 -y. ;« '-'::",. ,~1::~ ~ "':' r c! 1 ,. T ~ o - 1 BondlhO w1t9 t--~ ì::! IR ..., I0Il11. \ !~Y,$-.cØ ~ ." =~~ '._1': =::.:-.......... , ..... : 14-10 fL~ ~"." J9.:Cðl1tlMlt~ ''01"&'''''''. A 1.~tt.r. ø/11It '.,Wlø/'O't with rrpp;ø~"'ØI' dl""N,lølt.$ Is .~t/tI' (n dettr1lt,,,r,,, ,ht 1tftÓ6tt' G,I/ 1111 0/ 'dlV\1/fc dII~" d"¿ .111/i111'lI4'í;tt. Icllvhy (cl\l,odf'. l'\'Odllclfl' coltOslon It !be MOd,. 1'11. Iftllter the ðe~ or eleetrQ."lollve totée tIt'weeh tM two' mdal., (tlf more rApid the conwiol'\. . COltosion c:C!1Ig tttil)' be 'ormed wben hJetaJ ~ 1ft CÓJltlct "kith djf(etenl soils. Par bllmple. CIoItOslol\ cad tt.lI1t ,",iii p!.~I"& n1et"IJlc þip¡rtg dil'tctf)' on tlllfly~ toft '''I .fI. bottolt\ or . ~nc;:". 11t1sls dllt 10 d»rertn«s in ~AneJ' ot leil eoac:t". h¡¡t!ON between tf\c undJ$turbt4soJt AnðtJi:e JJe'" hlle~R'I. ComslClß tan .1'0 occur wbè:~ . new fteel tA1l1e 1$ idd~d (0 e);/stlrtj tank~ in the same flltllvìtlon. 'nte dlrref!nee~ in potenUal between the hew Md old strUtlu~$ ~a)i eSijbll$b _ circuit. with the new tank as the .n.(,ðe "¡d lite aid '''ub is !he (.thode. Acœtertted tOn~lon of lhe neVJ tAnk' will result, ' .teterial arid ~Ø8k tMttlJureîc::\1 dtelð8ct It'll¡)' libo , " C:!lUBe CO~O$¡on ~~5. bad.rla may C:IUIf <:11111i8es In the $oil. whkh develop Jmo 51rOllt ecnuslM t~lIs. (;orto$Ob may .r.o ocelli" ""'Îlhln tht mo1ècUIJ(' Slr\!tture 0,( the 1!tè,.,. 8.2 Sh"l)" C"t"tlt COl'to3ion. C~It(si~ f. âttO CIUSed by siray dlreç ctltTtnts ftom weldin¡ ~lictlinf'. þoW(!f Irll.n~rn$sIQ" Ii"... ~~1 ellh()dic.II)'. ptol~t~ plþe lirt~$, utllilie~. $1t\1Ctl~S, èt~trlned r.üJroø,; ftC. C'Qrros~ resu1ts (rom dil'l!çt ~\lrttnls now;na underground. from the t.xlenlt\ roWeuourc.,.long tlte 1'1'" ofle"f' rtalstaltce. ."et ~Ick to tlte po~e¡ tOlirce. \1nck:r&toulI~ .tf\lctUrèA In th. JII'tt! or I~ euntnts tlh u~tilee rèpid dctetlOtidon. "tQ\OttJol'I otten ~quird a 4ctailed corrosIon survey AI1d 1\ 8pk,nc.JI)' dedgl2td cathodIc prbteelion &ystcm. 8.~ Ratt 0; COrtollcHI. 11at "'e of corrosiOd it de~ mined by.'¡at1)' rltlo/'$: lhé Rlellv!! slle i\ncl polêntl8' of the Incdt IIlId c:~lhode, the reslstlvit)' of (~e SoU. tÞe Þítttllcè of ói'&l!Ink chtrt2ltab dlUf ...Itl, st~sse~ rre.cnt itllhè stf\letur'e, and the Qmount or C:UI'tt"I trof1t the IxtettWl1powtr .~. . The SulalIet dlC' Medic arta in "ralion 1\'1 the ê.thode, the tMter " . r , ' , , w:. ~ ( \ "e' . " <~ . , ". , . . . :... . ,'; a, ., .. \', ~ I , ,~ \} 'J . ~ ~\ .- \' , , " · Bakersfield Fire Dept. . ~RDOUS.MATERIALS DIVISIO UNDERGROUND STORAGE TANK PROGRAM ;~~, :".: , PERMIT NO.F.5j:.. CoX PERMIT APPUCATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) . ìf(NEW FACiLITY 0 MODIFiCXT10N OF FAC!llTY, 0 NEW TANK INSTALLA nON AT EXISTING FACIUTY STARTING DATE t - JJ - q 4- . , PROPOSED COMPLETION DATE -.l'''~..'1-~ FACILITY NAME ~ 6~l-T 5rÄ6E-5 . EXISTING FACIllTY PERMIT No. - NoN€. Ai ¡r\\~ srtt:' FACtllTY ADDRESS 341.00 SI LLfc.í A\Jf:. 6A-~It~FIFLI) . ZIP CODE ~3::,oß TYPE OF BUSINESS ßvs- ~"\Le. APN TANK OWNER ~(:rE. ßfLT 5íAéf£S PHONE No. 201 -73~ 4408 ADDRESS r'.o.ßo"" '14'1 CITY YI"::>A-L\Þ. ZIP CODE "3Z-1Q CONTRACTOR ALL AMe/ZJ~ Tt2.J.~WI~b J:N(. CA LICENSE No. 620 ö40 ADDRESS _ ~\Slc:>~ Nt.' O . .. CITY M.4-OU~ ZIP CODE -.13(e;i$ PHONE No. 1.P'1- fpi?(- 20/1 BAKERSFIELD CITY BUSINESS llCENSE No. X '~lðS(o 4= WORKMAN COMP: No. lA~ 4'c4:z."1~ INSURER ~oNí -¡:j...)Q£cMN'';:;; 00. BREiFlY DESCRIBE THE WORK TO BE DONE'"IN~\..-,- \- N~ \'2.000 ~. UNf)f!Z~ ~L.U)IM..I- TMJV- . !J'JCT¡..! \- NWJ t)_CS'n... ~ b\E.~e.L . WATER TO FACfllTY PROVIDED BY, DEPTH TO GROUND WATER No. OF TANKS TO BE INSTALLED C't.\...\Fc(Z.NIA. ~ ~\J\'-£ SOIL TYPE 2<PECTED AT SITE ~ ~ \ ARE THEY FOR MOTOR FÜEL '~YES 0 NO, SECTION FOR MOTOR FUEL TANK No. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIAiION ~ \ '2. 000 Ol~~~ SECTION FOR NON MOTOR FUELSTORAGE TANKS ï ANK No. VOLUME CHEMICAL STORED (no brand name) CAS No. (if known) CHEMICAL PREVIOUSLY SiORED ·!tl!!1t)_'~~'BltJt!~~~!~l'lï:i!~!(!~ltl!{~,p:·~1!1 THE AP?tlCANTHAS RECEiVED. UNDERSTANDS. AND WILL COMPl YWITH THE ATTACHED CONDITIONS CFiHIS P:i(MIT AND ANY on..ii:R SiAn:. LOCAL AND F:DERAl REGULATIONS. THIS FORM HAS 8E:N CO~PlEïEù UNDER PENALTY'OF PERJURY. AND TO THE :lEST OF MY I<NQWlEDGê.IS TRUE AND C::RRECT. THIS APPLICATION BECOMES A PERMIT WHEN APPROVED , , Bakersfield Fire Dept. A eAZARDOUS.MATERIALS DIVIS.., UNDERGROUND STORAGE TANK PROGRAM --.':-",,:.. ¡,"i,:'~' -, "., " PERMJT NO.f5I,. God:). PERMIT APPUCATION TO CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK TYPE OF APPLICATION (CHECK) ~NEW FAClllTY 0 MODIFrCATION OFFAClllTY 0 NEW TANKINSTALLATlON AT EXISTING FACILITY STARTING DATE' + l~J] - q 4- . PROPOSED COMPLETION DATE -.1.-1'1- ~ FACILITY NAME ~'a~T,g¡-Ä6e.~ ' EXISTING FACILITY PERMIT No. - NDNe. AT nH~ 511'£ FACILITY ADDRESS it\oD SILLt:cí A\Jf:. &\4Æ"=>fIFLI> ZIP CODE ~:3~ß TYPE OF BUSINESS ßJS· ~~\L.E. APN TANK OWNER O(2.Méff. ßtLT 5ïAc:,£S PHONE No. 20"1-73~ 44c:8 ADDRESS ~ o. '6D~ Cf4Q CITY YISA-LII>- ZIP CODE <'(32-7&{ CONTRACTOR ALL AMeJZJ~ TQ..ÑWI~b :eN'. . CA LICENSE No. 620 '34D ADDRESS. ~\S\C:?~ AVt. '·4 ' CITY M,A-(.)U~ ZIP CODEer~(p'$ PHONE No. "lØ1- ~þ(- 2.011 BAKERSFIELD CITY BUSINESS LICENSE No. X ~loS<O 4- WORKMAN COMP: No. vJp ~~"I.:. INSURER fcz..l.MoN\" ~r.>~NI~ ('0. BREIFL Y DESCRIBE THE WORK TO BE DONE ~=:~~ \ - Ntw' 1'2000 ~. UNOf/l.~ ~L - vJ A-t. f-. TAAJ~ ,(fJ(T~ \ - Nz,w D CS1n.. .. WI2.. 'D\ E~£L WATER TO FACrllTY PROVIDED BY, DEPTH TO GROUND WATER No. OF TANKS TO àE INSTALLED C'b.\..\;C/'2.NIA ~E- ~\J\c.£ SOIL TYPE EXPECTED AT SITE ~ ~ \ ARE THEY FOR MOTOR FUEL '~YES 0 NO SECTION FOR MOTOR FUEL TANK No. VOLUME UNLEADED REGULAR PREMIUM DIESEL AVIATION \ '2000 ~ 0, ~~L. SECTION FOR NON MOTOR FUELSTORAGE TANKS TANK No. VOLUME CHEMICAL STORED (no brand name) CAS No. (if known) CHEMICAL PREVIOUSLY STORED !Î!~!t!l&~!!~~&~~t~!!I~1It!fl:~l~ltl~~I!I~~,1 THE APPLICANT HAS RECEIVED. UNDERSTANDS. AND WilL COMPl YWITH THE ATTACHED CONDITIONS OFTHIS P!:RMIT AND ANY OTHER STATE. LOCAL AND FEDERAL REGULATIONS. THIS FORM HAS BEEN CO~PlEïED UNDER PENALTY'OF PERJURY. AND TO THE 3EST OF MY KNOWlEDGë.lS TRUE AND CC:mECT. THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ~h~!~;-:·{ ~~, :~~,¡ e - '-i~~ ¡\:(,4, j~ . ,:i¡ ~r INSTALLATION AND MAINTENANCE INSTRUCTIONS FOR MOSIER BROS. VACUUM DOUBLE WALL TANK MONITORING SYSTEMS , . ' I . ;¡ General ~h ., -·.,1 . !, This double wall tank is two layers of steel with vacuum in between, (Usually there is a fiberglass outer coating in addition). The annular space, between the layers, is drawn to a vacuum - a permanent vacuum. As long as this vacuum remains, there is no leak in the inner tank, there is no leak in the outer shell and there is no leak in the gauge. Because of the sensitivity and because all parts of both inner and outer tank are continually under test, annual tank testing is generally not required. To measure the vacuum a gauge is provided at the end of 50 feet of Tygon plastic tube. This gauge ( and switch if any) should be mounted preferably above grade for convenient observation. " Gauge The vacuum gauge is of the liquid filled variety to protect against moisture corrosion and foreign particles which might jam the gears. The scale reads (backwards) in inches of mercury. A perfect vacuum would be about 29 inches. When shipped from the factory, the vacuum level is 15 inches or greater. Excessive vacuum can not hurt the system. The gauge is red lined at 10 inches - a conservative level for start of trouble shooting long before any emergency. The gauge has a vent in the top of the base for some reason related to the liquid filling. Gauge should be mounted so the vent is up. 'The gauge should be check occasionally for freedom of movemént by squeezing by hand between the face and the back of the gauge. .. I:> " Tubing The tank comes with 50 feet of expensive Tygon tubing. Cheap tUbing will not hold vacuum. Clear heavy wall Tygon ~ \óÄ~~~ is meant for vacuum but it qets brittle around gasoline., ~~& o~~+o Yellow Tygon is rated for gasoline but tends to collapse in e.f~,,{.ø\:"e. vacuum. Collapse slows down the re-pumping process. Extra length of Tygon is available. Tubing shou~d be run through conduit to the gauge or switch location. A riser to grade above the tube connection on the tank is recommended. Extra loose tubing inside the riser is a good idea. The best inexpensive hose clamp seems to be a very small electricians tri-band. ; I I Tubing can be bent back against crimped, will stop any airflow. gauge can be removed and tubing ./ We.- Sh"vl~ (p~-\-....~s..S +~; £. itself and when thus Once this is done, the pulled through the conduit. .t-, 'fI " , '; e e With care, the whole job can be done without losing the vacuum that'was pumped at the factory. Vacuum. Switch A vacuum switch is available in an explosion proof model about the size of a fist. This switch is compatible with Veeder Root, Petrometer ana other alarm systems. The MSA sys~em requires extra iOO OHM resisters (~dll the factory for advice on this). The switch setting from the factory is 10 inches vacuum with about 2 inches dead band. Even as sharp as you are, I'll bet you can't disassemble that switch and get it back together right the first time. Wire colors are as follows~ .. Blue - normally open (in regular vacuum condition this is closed) Red - normally closed (in regular vacuum condition this is open) Green - ground Brown - Common Routine Checking ,Every six mqnths the tubing should be visually inspected for kinks. Also the gauge shoulëfl6e. squeezeato check for free motion of the needle. If the local jurisdiction requires comprehensive periodic test, it can be accomplished by squeezing of the tube þetween tank and switch and removing the gauge/alarm switch fixture. If the alarm functions at about 10 inches vacuum, it is working properly. This test will cause a slight leakage of air into the system, but can be done several times before re-pumping is necessary. Valves .'i .. Older vacuum double wall tanks were built with valves installed to provide a place for re-pumping vacuum. Since the need to re-pump has been so infrequent, on current models there is no valve to leak and re-purnping is to be done through the gauge tube. .. I Any installed valve should be kept closed since valve stem packing is a sure source of leakage. These valves with Teflon seats should be tightened only with the thumb and one finger. .~ - " ',II "I , q I ,i ~ : .f! ,:'" " " ) '" e e UNDERGROUND TANK INSTALLATION INSTRUCTIONS AUGUST 11, 1993 free soil into the backfill during the design life of the system. MOSIER BROS. COMPOSITE The excavation shall be from any hard or sharp material that may cause damage to the composite tank. Care shall be taken during installation to be sure that foreign matter is not introduced into the excavation or backfill. Bedding and backfill material shall be clean, homogenous granular material made of either sand, pea gravel or #8 crushed stone, with no particle size greater than 1/2" and shall be free of sharp edges which can damage the FRP laminate. The bottom of the excavation shall be covered to a depth of one foot, suitably graded and leveled. The excavation shall extend a distance of at least one foot around the perimeter of the tank providing sufficient clearance. Where anchoring by means of a concrete slab is required, the tank must not ,be placed directly on the pad. Bedding material at least 6 inches deep must be spread evenly over the dimensions of the pad to separate the tank from the pad. The tank shall not be placed on any other hard or sharp material. If installation area is in a tidal area, the tank "bedding" material should be #8 crushed stone or pea gravel~ Sand backfill may be used only if measures are taken to prevent washout of sand and prevent the infiltration of native For doublewall tanks, inspect vacuum tubing for cuts or abrasions and be sure the vacuum gauge reads ápproxlmately 15 In.Hg. Some codes call for air pressure test of tank at jobsite prior to installation. The Mosier Bros. vacuum double wall tank is continually under test. An air pressure test is unnecessary. Such a test could cause damages and create liability. Air test of the annular space is not recommended. Before placing the tank in the excavations, all dirt clods and similar foreign matter shall be cleaned from the tank. Visually inspect the tank for damage. Areas where laminate has been gouged or abraded will appear beige or off-white against the surface. Mark all areas which appear damaged for repair. , Clean areas to be repaired by removal of surface rust, dirt, contaminants and disbonded laminate. The laminate surrounding all flaw areas and/or exposed steel areas should be surface prepared by using a coarse grit sandpaper or grinder. This process should remove all glossiness from the surface surrounding the repair area. Coat all damaged laminate and/or exposed steel surfaces using touch-up kit. Follow ':'1 '~~ ,;ri. ,. :¡i: "~: ,;';~ ; }:1.~ "~'i -'f ,( ,r' ¡;' ! ',: " ;~ '.. " " , , !_~. ¡ f.~, :,1 ¡' .:1 \:' ¡ , 'I' ,:¡, "I',: _ _ . _,. __.c__ ~. ·~. ¡ e ," manufacturer's instructions for mixing and application of materials. Equipment to lift the tank shall be of adequate size to lift and lower the tank without dragging and dropping to ensure no damage to the tank or laminate. Tank shall be carefully lifted and lowered into the excavation hole by use of cables or chains of adequate length attached to the lifting lugs provided. A spreader bar should be used where necessary. Under no circumstances use chains or wire rope slings around the tank shell. Immediately before installation, the coatin~ itselr shall be tested at 25,000 volts. The testing device should be Tinker and Rasor Model, AP/W or equal. Any coating flaws found in this test shall be repaired as noted below. High water tables or partially flooded excavations sites exert' signifi¿ant buoyant forces on tanks. Buoyant forces are partially resisted by the weight of the tank, the backfill and the pavement atop the tank. Additional buoyancy restraint, when required, should be designed in consultation with the manufacturer. Backfill shall consist of clean sand, pea gravel or #8 crushed stone similar to the bedding material to create a uniform homogenous environment around the entire tank. " ' -' e ~ 'JI' ' ;~, -~ . ~: Special care shall be taken when installing backfill along the bottom sides of the tank to ensure that the tank is fully and evenly supported around the bottom quadrant. , : I ~ , .' Exposed steel at the lift lugs should be covered wlth the ~-iaminate rep-air kit. Also, any other exposed steel surfaces must be repaired with this kit. After application, the installer shall verify that his hand lay-up work has cured (adequate material hardness and solidification) prior to backfill. Normal gel time is 30 minutes. Normal cure time is two hours. ..} ,Tank fittings shall receive a coat of reSln prlor to ,backfill. Normal gel tlme is 30 mlnutes. Normal cure time is two hours. Resin coating shall include the entire plug on unused fittings. Homogenous backfill shall be deposited carefully around the tank up to top of the tank and to a depth of at least one foot over the tank to avoid damage to laminate, especially where tamping is required. (See NFPA 30 and state or local codes for minimum depth of cover required.) ,f. LThe openings are equipped with âïel1flëErlc bushlngs to prevent ~Iectrolysls. There shall be no wires, metal pipes or conduits or other conductors in contact with the tank steel. '~ ~ INSTALLATION DRftWM ORIGINAt" _~ j , {~¡",.,~'\_ ': I , t -- -- , \tq~4i;~-;:'r ~7 ;,tX jJ~ ,87 HEX '\,,,,1. _,;Z~ 'f --T 611G ï'/'l '~""lfAD' 611GE ! 1···· . .~' fXW~W'\'" :5~ ~~1 ¡'?i,'P~~'l'" ~lf.. " I~.,\ .:. ~I - '''55UREPORT ^~y [l' ~t- ~ . -- JJ-t 1/'" NPT l ~// ~~.'V""/CPf 1.-, L87'~ ~~~:~p~~~g~¡T J -.. ~ l,~I: J NOTE: , AP?~OX. 9 02 .. , ¡ ~ I 55GRAI'~ E' Unit con be ~¡,t prior to in~loilcliQr,. 6Ú1fT::'~ ,.' ~~:GE 8 61~\'~~68¡H~X ,_~:.) Insert 1/8" Allen wr"nch " -- SHIPP,NGWT r"-'" 'I:" / into adj"stmen! screw (Ioc.oled in APPROX, 120Z, ,/ pressure port) ond I"", clo.:kwiH' (346 CRAMS) 10 d~cre(se Slitting, Max. Proof Adj. Set,Poinl Range Sys, (Tes!) On Incr, On Deer. Press. Press, Prc;,s, Pre;,s. ..-.f:~ _"~ .__,È___ __~_ 250 500 1.5--12.1 ,75,11.35 500 1000 12,1·30 10,1..28 500 1000 30.170 27.1,67 500 1000 70,1-180 63.1-173 PRESSURE SWITCHES 1/4" ALUMINUM MO 611G · PRESSURE PORT AND . EXPLOSION PROOF DEL E POlYIMIDE DIAPHRAGM 1.5,12.1 ,75·11.35 ,75 12,1-30 10.1-28 2,0 30.1-70 '17,1-67 3,0 70,1-180 63,\-\73 7,0 VACUUM SWITCHES 1/4" ALUMINUM MO E 611 V· · PRESSURE PORT AND D L POL YIMIDE DIAPHRAGM ·-.."·r Ad¡, Set,Poìnt Range Arprox. On Inc.r. On Deer. D¿rJrJ- Vacu\J,n Vacuum bond In. Hg In, Hg In, Hg It JNTERNAL ADJUSTMENT OPERA TING AND ORDERING DA r A: PRESSURE SWITCHES ,/.... ALUMINUM MO EL 611 G · PRESSURE PORT AND D POL YIMIDE DIAPHRAGM Appro., DE:oci bond Ihi 250 500 500 500 500 1000 1000 1000 Max, Sys Press. psi Proof (Test) Press. psi 150 '1S0 1. 5, 26 4 -28,5 150 ELECTRICAL CHARACTERISTICS: Roting of Switch Element AMPERES VOLTS SPOT opor "M" Res, Res, 125 AC·50/60 Hz 11 II 250 AC-50/60 Hz 11 11 30D' 5 5 125DC ,5 ') e LOW RANGE DIAPHRAGM PRE$SUR£ VACUUM ...... ,= - - - Press. .75 to 180 psi Vac. 1.5 to 28.5" Hg. SERIES: 611G 611GE ...1 .",~,_. -I'~ <, :r 1/1!. ' '- I ~ :=:a Standard Features: · NEMA: 4, 13 · Weatherproof · Model 611GE U.L./CSA - See Note Explosion Proof: Div. 1,2 NEMA: 4. 7, 9, 13 611V 611VE AMBIENT TEMP. RANCE -----,----,-..--.--.. . --I - 30° to 1600 f ¡ - 340 to 71 0 C ._..__._._____,___ . ....._...,__,....,.....__L......,..__.......___.. ___.. -.----.-... ,~I'H.:·dl;..1 N:-· 0t¡':~ .....;.:.;ít:,:~ PUrlS -.-.....,---.. r..---- ..- ..~_~..__4_...'_._"-___. .-._._-_.~ -_.~. MODEl 5PDT -$1d MODH OPDT 'fS' vv (~r (.j t1(~ h _.__...~.- ._--------_.._..~ . .._--_.~- .--. 75 ,',(; 3,0 7,0 611G&00\ 61 1 GU003 611G8005 (,IIC8007 6\lcr.~>3C(j1 , 61lGM8Ù03L ¡'."Jii';"L"" 611 GM8()O) 0W.." (J, Ft;.j/" '¡'.' 611 CM~0E. ;~:':~=~~:~~,_S::.:1 j(~) :,~ 611GE8001 611 GE8003 61 I GE800~ 611GE8007 ·-·r--------·- 611 GEr¡\,Ü:)ú: I . 611GH1I8003 . AClfnll\U'T'. bilGE' ..C.-S fo,v,o t'J, F'cJ,ln'"de .I\ö U ',.'. <; I ,-" ,- (, .('\.,1...'(...; Cc"o"""",f·Ic'k,.J..I¡,,,., Ju[J~S "I \, Ir.\.; ~ . ___..._...+.___________ ....-.-..-.----..--.--. ..-------.--..-.-,' 1.....(.,} 6 \ I~,~ ---·'-1-----·" MODEl MOOEl Sf'DT,Sld DPDT'I/\ ond \\I¿·:jt;od r\.Hh ----.------... '/'/i2:lt.sJ POliti ----- -"--'-A~:;~---- ¡LnG tJ, PùlfiIJ;,d... CCl01(,iu'-f", Pcot.:".l Sit:',.' I, :sÜ0 S~i :; .5 6111/ fMW0i) Ó 11 V 800G ----~-,--~.._..- ~--._- -----,--,--, AI'.Jrnir!t)rn 61 !VE,W:C.'Û0 el.r,(J r" f'~I'ii'r,¡d" J ('rJ¡Jïivr1') P:':,t~(? Sfeci: J0Ù :;:> . -.-----.- SCHEMA TIC AND WIRING CODE SPCT-:'tondcfd [¡PDT f;Y MODEl611GE EXPLOSION PROOF NOTE: DJ.. 1 ...p1o.lon.prool and h"rm..tlcallf s.."led elettrlcal "....mbly Pori No. 46-1058 !46·IOÓJ lor "M" model opllo,,), 1I,Ied by bolh Under",rlt,,'. LaboratQrles, IlIc. (File No, U2941) and CSA T..lln9 Labor· olories (Fl!. No. 22921) lor .........#0......_.... I"A_"'_"~ ,.. COLOI< OF LfAD" ! ~ I RED N/C"","...~ &ROWN C· "--í BLUE N 10 -;.., , rOREEN '--11'-1 L'E" model only COLOP Of LfA[)S F I ,-- RED N/CI...¿.· L .... BROWN CI """'í i BLI)E N /Oì8-'-' alACK N.'C2 --<;,-., .1. iéllOW C2 '-iF·I'·" , .. ~ . , j -,' \ . II t . \' , :1 "·;1 /~'..~;\ : j i 'i. , " !' , ' ,~, ,{ 'J :!\ ~i ill f~; '.' i~ It ~f ~ '~i. ' " i~\ . ~. . ;¡i , ~ J t ¡ t a', : ~ ~' ii If it ~ '.' 1- 'l 'r l' >} ¿t. ~~ 1../ ,i ~' ¡ I·>' I r' Ii r\ ,. :.; " ; .~.. ':' " ,; I I &---- ~.oA."5::,;... '", Stqte of California, .. 6r-~ . CONTRACTORS STATE UCENS! BOARD , '. Entity ~: I MC TRt~ I;;· . .' ""ODUCER, ¡ THIS CERnl=lcATE IS ISSUED AsHA MAmRHoF ïNï:ORMAT1ëiNHONLÿH AND""'''''' , . .... , ¡ CONFERS. No ,RIGHTS UPON THE CER1iFlCATE HOLDER. THIS CERnFlcATÈ Johnsey Insurance Agency; Inc. ¡ DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE P . 0 . Box 396 9 L.~,~.µ~~~.~...~~~~~:.....................................................................'.......................................................... Pinedale, CA 93650-3969 i COMPANIES AFFORDING COVERAGE (209) 436 - 0833 :........................................................................... .., ...................................................................................... I....~~~~....~......~~.~~~....~:.~~....~~.~~~:~....:~.~.................................,...... ·ïfšüÄm'······,···,·,·,",· ...,.."."".",.,.,..."......".,.,.. .,.......,...,..,.,.."",."",....."., ··"·····,·I.,..~~~..,~.......~~~~~.,..~~.~.~.~....:~~~....,..........,..,.,.".................., L.~~~....?......~~.~..~,~.....~.....~.~~.~.~:~.............................................' I E~ D NORTHBROOK INS . ~f8ffftnrr?~ (..ë~~ÄNŸ·..E·"'·····················,·····,·"·"·,···""....,..................... , ",..."....."..,...;;..........;.........,..""......':.. ,...., ¡ LETTER ALL AMERICA TRENCHING, INC. 31563 AVENUE 9 MADERA, CA 93638 INDICATED. N01WIT11STANCING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMeNT WITH II' .,. ''''. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJEef-1e-Al:l-1HEHER"'S:-··-~------- EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE 13EEN REDUCED BY pAID ClAIMS. ~"~~;.:~~r~;~l~;~~~~r~==~=¡;~,º~~;º~º : X ¡ COMMERCIAl GENERAl. LIABILITY CCP 121751 : ¡ : PROOUCTS-COMP~ AGC!. is 1, 000, 000 !::::::::r:':::-: ClÞJMS MADE DC OCCUR. : :09/01/93 ¡ 09/ 01/ 9(~~:~::Þ:ö.~::I~;r;:::::::·:¡~:::J'~::(j:º:Q:~::(j:º:º :.........: OvmER'S & CONTRACTOR'S PROT. . : ¡ l.~c:':'..~~~~~.................l~.....~Lº.º,ºLº,º,º ..,...1.-..,.".,.':...'......,...............,..........',.'".'.'.,'...............,...................................................................¡..................................1.................................¡.'.;;:'~;;~~;;;~~i~~lt......,',....,'...'.'.',.,~'$,.;.'.'Ø..ø.'.~ l ~~,MOBn..E UABIUTY: : ¡ j '::OMBINED SINGLE !. 1 0 0 0 0 0 0 D ¡ , ANY AUTO ! CA 0528637 : ¡ : LIMIT ¡ , , . . . I ¡"i"! ~=:::. .01/22/93 I 01/22/ 9 4[~~~.~:.þt~·,'..',·.·,·.·,'·,',·,'·,,",·.·,'·.r~··...·,............'.,'...................,...'.,', U('~ HIRED AUTOS! : j : BODILY INJURY ]. .=l:;~im¡mIJ~~I: ·"·,:,,:l~~~O:BREUA FORM I . I \::?!!;0~¿::::,:::::::,::?:',:::?:::::\~:::::::r?::::;,::::::'T::"'?:r:~: WORKER'. ~~~~¡;~""""'... : ........ ..."..."." '" ,...., .'................."."':"""."".'..'..."'.'.".""·:··"··"'·,·""·""·"····'·'··r.i..,'.f..,~~~!0.~~·,~,~~'...'....'......J...'.:.:;:.:....,'.':...........:...,...,š'......,'.'....ili............... B ¡ ÀND WP 464276 :01/01/93 ¡ 01/ 01/94:~c:':'..A.C.c.'.~.......................i~...,~.d)ººd>.º.º CI~~~I=M~=t2/11/921~2/17/931~o~:~t:l:::::::: DESCRIPTION OF OPERA T1ONSILOCA T1ONŠ/vEKICLÉ8l8Ì'ECrAL ITÐI8 THE COUNTY OF !tERN, ALL OF ITS OFFICERS; ..ÄGEN'Ì'S ANi> ÊMPLOYEES ARE NAMED AS ADDITIONAL INSURED, BUT ONLY WITH RESPECT" TO LIABILITY ARISING OUT OF "YOUR WORK" FOR THAT INSURED BY OR FOR YOU. ::ç,.:::::,:::::.f,:::~u::t::;,;:.:;.::,:::.:.:.:,:::.):\IJitii:ttmttttt::t:::t:t:r:rt:m:mtt:rrrm:::t\'t:::::i:rrt:t¡:¡:¡¡:¡:,(:,:,:,:;,:.::.::,;,:.:,:.:,:,:.:).:;:,:,:,:.:,::)ttt:mt:m:r::m:rrr:¡:m::tt:r::m:t:tmtmmmmttttt:rrr:t:rr::r::t:::mt:rr:tttt:m:r::f::tt:r::m:::m:m:m:ml ¡:::f SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE ili¡¡¡::: exPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO :¡¡¡~ MAIL 30 DAys WRITTEN NOTICE TO THE CERTIFICÁTE HOLDER NAMED TO THE KERN COUNTY ¡t::¡ LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHAll iMPOSE NO OBUGATION OR :::::::-: tf UÁBIU1Y OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 2700 AM" STREET, STE. 500 m¡::AUTMORIZEDREPRESENTATIVE' ..... :: ~ e e STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM A COMPLETE THIS FORM FOR EACH FACILITYISITE MARK ONLY ONE ITEM ~, NEW PERMIT o 2 INTERIM PERMIT o 3 RENEWAL PERMIT D 4 AMENDED PERMIT o 5 CHANGE OF INFORMATION 0 7 PERMANENTLY CLOSED SITE o 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS, (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR CX2l*36f ß€.L.-r s ADDRESS 4<00 ?\L\.-f-c.:- Nt.. CI~AME, ~ ~s HEAl:) ./ BOX TO INDICATE 5ArV\.t. NEAREST CROSS STREET PARCEL # (OPTIONAL) STATE CA SITE PHONE # WITH AREA CODE , GAS STATION 3 FARM D o D lOCAl·AGENCY DISTRICTS O ./ IF INDIAN RESERVATION OR TRUST LANDS D COUNTY·AGENCY D STATE,AGENCY D FEDERAl·AGENCY ~CORPORATION D INDIVIDUAL D PARTNERSHIP TYPE OF BUSINESS D o 2 DISTRIBUTOR 4 PROCESSOR EMERGENCY CONTACT PERSON (PRIMARY) II. PROPERTY OWNER INFORMATION· MUST BE COMPLETED STA-b"f-s CARE OF ADDRESS INFORMATION ./ box to indicate D STATE,AGENCY III. TANK OWNER INFORMATION· (MUST BE COMPLETED) NAME OF OWNER CARE OF ADDRESS INFORMATION ./ box to Indicate D INDIVIDUAL D lOCAl,AGENCY D PARTNERSHIP DE \ ~ \-1 ;z.; toß IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 739·2582 if questions arise. TY(TK) HQ @H]-cr=II=co V. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR lEGAL NOTIFICATIONS AND BILLING: I. 0 II. 0 III. 0 THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANTS NAME (PRINTED & SIGNATURE) APPLICANTS TITLE DATE MONTH/DAYIYEAR LOCAL AGENCY USE ONLY COUN'TY # IT] JURISDICTION # ITIJ FACILITY # cr=II=co LOCATION CODE . OPTIONAL ¡CENSUS TRACT # . OPTIONAL I SUPVISOR . DISTRICT CODE ,OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION· FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FOR0033A,R2 FORM A (9'90) ,) '. . .' STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM A COMPLETE THIS FORM FOR EACH FACILITYISITE MARK ONLY ONE ITEM 1SZ1 1 NEW PERMIT o 2 INTERIM PERMIT o 3 RENEWAL PERMIT D 4 AMENDED PERMIT o 5 CHANGE OF INFORMATION 0 7 PERMANENTLY CLOSED SITE o 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS· (MUST BE COMPLETED) DBA OR F ACILl1Y NAME NAME OF OPERATOR 0\2C--N6E. \3EL.;f.' ST é-f S 5AV'At. ADDRESS NEAREST CROSS STREET 4too SIl\.. Eel Avf:... CIl}~AME -pp. -t..f So. s f I ~ LI) ../ BOX TO INDICATE PARCEL # (OPTIONAL) STATE CA SITE PHONE 1/ WITH AREA CODE ~CORPORATION D INDIVIDUAL D PARTNERSHIP D COUNTY·AGENCY D STATE·AGENCY D FEDERAl,AGENCY 1YPE OF BUSINESS D 1 GAS STATION D 3 FARM D 2 DISTRIBUTOR D 4 PROCESSOR E. P. A. I. D./I (oplional) II. PROPERTY OWNER INFORMATION· MUST BE COMPLETED STAb"f) CARE OF ADDRESS INFORMATION f#-. DB ../ box to indicate o lOCAL,AGENCY 0 STATE,AGENCY o COUNTY,AGENCY 0 FEDERAl,AGENCY PHONE 1/ WITH AREA CODE III. TANK OWNER INFORMATION· (MUST BE COMPLETED) NAME OF OWNER ~ r: MAILIlfj OR STRE~ADDRESS \. O. Vo CI~ NAMj 'lIS LI ~ IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 739·2582 if questions arise. TY(TK) HQ @EJ-CIIIIJ] V. LEGAL NOTIFICATION AND BILLING ADDRESS CARE OF ADDRESS INFORMATION ../ box to indicate D STATE,AGENCY fOE> Legal notification and billing will be sent to the tank owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: 1.0 11.0 111.0 THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANT'S NAME (PRINTED & SIGNATURE) APPLICANT'S TITLE DATE MONTHlDAYIYEAR LOCAL AGENCY USE ONLY COUN7Y # CD JURISDICTION # ITIJ FACILITY # CIIIIJ] LOCATION CODE, OPTIONAL ¡CENSUS TRACT 1/ . OPTIONAL I SUPVISOR - DISTRICT CODE . OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION· FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FO RM A (9,90) FOR0033A,R2 _/ -- ;- -~. , <> " ~ ,,.:. -/' , ....~ t'.~'"",,:. ...- ~, ~.-- .¡ '." :. ~-' ..> COMPLETE THIS FORM FOR EACH FACILITYISITE STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM A MARK ONLY ONE ITEM [S1) 1 NEW PERMIT D 2 INTERIM PERMIT D 3 RENEWAL PERMIT D 4 AMENDED PERMIT D 5 CHANGE OF INFORMATION D 1 PERMANENTLY CLOSED SITE D 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS· (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR '\,/'¡\/" '·.ì~ .." \'l( ADDRESS NEAREST CROSS STREET ¡i,>~·( ~ \ .. PARCEL # (OPTIONAL) CITY NAME '. ,,' \ I! <, f ' { ,.1) .,/ BOX TO INDICATE ~CORPORATlON 0 INDIVIDUAL 0 PARTNERSHIP D 2 DISTRIBUTOR D 4 PROCESSOR STATE CA SITE PHONE # WITH AREA CODE o COUNTY·AGENCY o STATE·AGENCY o FEDERAl·AGENCY TYPE OF BUSINESS D 1 GAS STATION D 3 FARM E. P. A. I. D. II (optional) EMERGENCY CONTACT PERSON (PRIMARY) DAYS: NAME (LAST, FIRST) PHONE II WITH AREA CODE .'1', ; ::' i;, !.~ ,\ '.'J ( "L.'r:J .:(-(/- 7:'};i; - ¿~\ 1+09, NIGHTS: NAME (lAST, FIRST) PHONE II WITH AREA CODE >. \ \ V, ¡:, !,~' j\\·.'r'lf';{}~ '1dì - ~ì 2-~" 440B> ~;_ :.¿;" ~~~~1~ ~,u EMERGENCY CONTACT PERSON (SECONDARY)· optional DAYS: NAME (LAST, FIRST) . ' \ PHONE II WITH AREA CODE r~)f2,\Y i:. L:vN\'· 1m 0 ~¥' ~ ~A NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE ~V'f ld'''' éJrJ 1. ·1:.J'J Q 4~10~ II. PROPERTY OWNER INFORMATION, MUST BE COMPLETED NAME ~..l ' /\.^ '''' r ">:,I'".·l-·'· " '::-\'1} t· t t l ,··þ..~f \- ~~:r5t':.. ,..?l" c _ I·~ ,,;) MAILI.I:'G OR STREET ADDRESS ~,C' . f~'" CITY NAME VI r;; ~ l \ (Ä. . CARE OF ADDRESS INFORMATION 1 tV, ~. :~....,... '\. : .':ï'....J\ \"'" .,/ box to indicate 0 INDIVIDUAL qthCORPORATION 0 PARTNERSHIP STAT~ ZIP CODE f ~;'t ( r~1;.""Ié'= o STATE,AGENCY III. TANK OWNER INFORMATION· (MUST BE COMPLETED) NAME OF OWNER 'ßFL'"ì'"' CARE OF ADDRESS tNFORMATION C~ ¡W"~ç. "'SIt\ (---f. ('~ MAILlr OR STRE'PADDRESS (1 'tCI .,/ box to Indicate o INDIVIDUAL D LOCAl,AGENCV o STATE,AGENCV .c. ?c\<. ~ CORPORATION o PARTNERSHIP o COUNTY,AGENCY o FEDERAl,AGENCY CI~ ' S(''fE I ZIP CODE I PHONE II WITH AREA SODE 4 ¡ «.:.^ l~ll\ '^. tj'/)"L7C¡ 'uv!¡ - 1'1.<;; l' ~ Dr""; IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 739·2582 if questions arise. TY(TK) HQ @E]-[LIT[I] V. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked, CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILliNG: I. D II. D III. D THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANT'S NAME (PRINTED & SIGNATURE) APPliCANT'S TITLE DATE MONTHlDAYIYEAR LOCAL AGENCY USE ONLY COUN7Y # CD JURISDICTION # ITD FACILITY # [LIT[I] LOCATION CODE, OPTIONAL I CENSUS TRACT II ,OPTIONAL I SUPVISOR ' DISTRICT CODE ,OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION· FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FOR0033A,R2 FORM A (9'90) ,. . '- I COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B MARK ONLY ONE ITEM ~ 1 NEW PERMIT o 2 INTERIM PERMIT o 3 RENEWAL PERMIT o 4 AMENDED PERMIT o 5 CHANGE OF INFORMATION o 6 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 C. DATE INSTALLED (MOIDAYIYEAR) D. TANK CAPACITY IN GALLONS: A, OWNER'S TANK I. D, # B, MANUFACTURED BY: II. TANK CONTENTS IF A,11S MARKED, COMPLETE ITEM C. ì&1 MOTOR VEHICLE FUEL 0 4 OIL B. C. 0 1a REGULAR ~ 3 DIESEL 0 6 AVIATION GAS A. UNLEADED 0 ~1 0 4 GASAHOL 0 02 PETROLEUM 80 EMPTY PRODUCT 1b PREMIUM o 5 JET FUEL 7 METHANOL UNLEADED 03 CHEMICAL PRODUCT 0 95 UNKNOWN 02 WASTE 0 2 LEADED o 99 OTHER (DESCRIBE IN ITEM D, BELOW) D. IF (A.1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED C,A, S,#: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF ~1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER o 95 UNKNOWN 0 - 0 4 SECONDARY CONTAINMENT (VAULTED TANK) o 99 OTHER SYSTEM 2 SINGLE WALL 01 BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGLASS ø. 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM o 8 100% METHANOL COMPATIBLE WIFRP (Primary Tank) 09 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER 0 1 RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR o 5 GLASS LINING ~ 6 UNLINED 0 95 UNKNOWN 0 99 OTHER LINING IS LINING MATERIAL COMPATIBL WITH 100% METHANOL? YES - NO - D. CORROSION 01 POLYETHYLENE WRAP 0 2 COATING o 3 VINYL WRAP ~ 4. FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE o 95 UNKNOWN 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEA~)'" q 4- OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) '""14. IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A(V2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C, MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINVL CHLORIDE (PVC) A €)4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100% METHANOL COMPATIBLE WIFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION 1 AUTOMATIC LINE LEAK DETECTOR D 2 LINE TIGHTNESS TESTING 3 ~¿N~~~ING D 99 OTHER V. TANK LEAK DETE TION o 1 VISUAL CHECK 0 o 6 TANK TESTING 2 INVENTORY RECONCILIATION 0 3 VADOZE MONITORING ~ 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 7 INTERSTITIAL MONITORING 0 91 NONE tJ 95 UNKNOWN 0 99 OTHER VI. TANK CLOSURE INFORMATION 1. ESTIMATED DATE LAST USED (MOIDAYIYR) 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH GALLONS INERT MATERIAL? YES 0 NO D THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANT'S NAME DAf.E (PRINTED & SIGNATURE) 'Jõ \ (2 LOCAL AGENCY USE ONLY STATE 1.0.# COUNTY # OJ JURISDICTION # ITIJ UMBERS BELOW FACILITY # ITIIIIJ TANK # ITIIJ[IJ PERMIT NUMBER I PERMIT APPROVED BYIDATE I PERMIT EXPIRATION DATE FORM B (7·91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOR0034B·R5 . . STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM ~ 1 NEW PERMIT L:J 2 INTERIM PERMIT o 3 RENEWAL PERMIT o 4 AMENDED PERMIT o 5 CHANGE OF INFORMATION o 6 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: C. DATE INSTALLED (MO/DAYNEAR) II. TANK CONTENTS IF A,11S MARKED, COMPLETE ITEM C. 181 MOTOR VEHICLE FUEL 0 4 OIL B. C. 0 1a REGULAR ~ 3 DIESEL 0 6 AVIATION GAS A. UNLEADED ~1 4 GASAHOL 0 02 PETROLEUM 0 80 EMPTY PRODUCT 0 1b PREMIUM o 5 JET FUEL 7 METHANOL UNLEADED 03 CHEMICAL PRODUCT 0 95 UNKNOWN 02 WASTE 0 2 LEADED o 99 OTHER (DESCRIBE IN ITEM D. BELOW) 0, IF (A,1) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED J':, p,A,S.# : .., III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A; B, AND C, AND ALL THAT APPLIES IN BOX 0 AND E A. TYPE OF œl1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER o 95 UNKNOWN SYSTEM 0 - 0 4 SECONDARY CONTAINMENT (VAULTED TANK) o 99 OTHER 2 SINGLE WALL 01 BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGLASS ø- 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM o 8 100% METHANOL COMPATIBLE W/FRP (Primary Tank) 0 9 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER o 1 RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR o 5 GLASS LINING ~ 6 UNLINED D 95 UNKNOWN 0 99 OTHER LINING IS LINING MATERIAL COMPATIBL WITH 100% METHANOL? YES - NO - D. CORROSION 0 1 POLYETHYLENE WRAP o 2 COATING D 3 VINYL WRAP ø. 4. FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE D 95 UNKNOWN o 99 OTHER E. SPILL AND OVERFILL SPILL CONTAiNMENT INSTALLED (YEAR) ~ OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) ''14- IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A 2 PRESSURE A U 3 GRAVITY B. CONSTRUCTION A U 1 SINGLE WALL A®2 DOUBLE WALL A U 3 LINED TRENCH A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 A U 5 ALUMINUM A U 6 CONCRETE A U 7 A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 1 AUTOMATIC LINE LEAK DETECTOR D 2 LINE TIGHTNESS TESTING A U 99 OTHER A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION D. LEAK DETECTION 4 FIBERGLASS PIPE 8 100% METHANOL COMPATIBLE W/FRP 99 OTHER D 99 OTHER V. TANK LEAK DETECTION o 1 VISUAL CHECK 0 2 INVENTORY RECONCILIATION 0 3 VADOZE MONITORING ~ 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING o 6 TANK TESTING 7 INTERSTITIAL MONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER VI. TANK CLOSURE INFORMATION 1. ESTIMATED DATE LAST USED (MO/DAYNR) 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH GALLONS INERT MATERIAL? YES 0 NO D THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANTS NAME OAT,§, (PRINTED & SIGNATURE) :::Iõ \ ¡, LOCAL AGENCY USE ONLY STATE I.D.# COUNTY # rn JURISDICTION # [II] UMBERS BELOW FACILITY # ITIIIIJ TANK # ITIIIIJ PERMIT NUMBER I PERMIT APPROVED BY/DATE I PERMIT EXPIRATION DATE FORM B (7,91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOR0034 B-RS ~..r;.~ ~-,,- ~~~"" ~--~..~,.,_._" E-- ---~ . ~. '. .""', .. STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM 8 COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM L&l 1 NEW PERMIT O' 2 INTERIM PERMIT o 3 RENEWAL PERMIT o 4 AMENDED PERMIT o 5 CHANGE OF INFORMATION o 6 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: C. DATE INSTALLED (MO/DAYIYEAR) D, TANK CAPACITY IN GALLONS: II. TANK CONTENTS IF A,1 IS MARKED, COMPLETE ITEM C. Ì2Sl1 MOTOR VEHICLE FUEL 0 4 OIL B. C, 0 1a REGULAR ~ 3 DIESEL o 6 AVIATION GAS A. UNLEADED 0 cg1 0 4 GASAHOL o 7 METHANOL 02 PETROLEUM 80 EMPTY PRODUCT 1b PREMIUM o 5 JET FUEL UNLEADED 03 CHEMICAL PRODUCT 0 95 UNKNOWN 02 WASTE 0 2 LEADED o 99 OTHER (DESCRIBE IN ITEM D, BELOW) D, IF (A,1) IS NOT MARKED. ENTER NAME OF SUBSTANCE STORED t~ C.A,S.# : III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B. AND C. AND ALL THAT APPLIES IN BOX D AND E A. TYPE OF ~ 1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER o 95 UNKNOWN SYSTEM 0 2 SINGLE WALL - 0 4 SECONDARY CONTAINMENT (VAULTED TANK) o 99 OTHER 0 1 BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGLASS ~ 4 STEEL CLAD W/ FIBERGLASS REINFORCED PLASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM o 8 100"10 METHANOL COMPATIBLE W/FRP (Primary Tank) 0 9 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER , , 01 0 2 ALKYD LlN ING 0 3 EPOXY LINING 0 4 PHENOLIC LINING RUBBER LINED C. INTERIOR 0 5 GLASS LINING ~ 6 UNLINED 0 95 UNKNOWN 0 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100"10 METHANOL? YES_ NO_ D. CORROSION 0 1 POLYETHYLENE WRAP 0 2 COATING o 3 VINYL WRAP ø- 4, FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE o 95 UNKNOWN o 99 OTHER E. SPILL AND OVERFILL SPILL CONTAJNMENT INSTALLED (YEAR) t;;f4- OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR) '<... \ (J.... W. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND,BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION 2 PRESSURE A U 3 GRAVITY B. CONSTRUCTION A U 1 SINGLE WALL 2 DOUBLE WALL A U 3 LINED TRENCH A U 1 BARE STEEL A U 2 STAINLESS STEEL A U A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL W/COATING A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 1 AUTOMATIC LINE LEAK DETECTOR 0 2 LINE TIGHTNESS TESTING D. LEAK DETECTION A U 99 OTHER A U 95 UNi<)NOWN A U 99 OTHER C. MATERIAL AND CORROSION PROTECTION 4 FIBERGLASS PIPE 8 100"10 METHANOL COMPATIBLE W/FRP 99 OTHER o 99 OTHER V. TANK LEAK DETECTION ; 0 1 VISUAL CHECK 0 2 INVENTORY RECONCILIATION 0 3 VADOZE MONITORING ø 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING o 6 TANK TESTING 7 INTERSTITIAL MONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER '. VI. TANK CLOSURE INFORMATION 1, ESTIMATED DATE LAST USED (MO/DAYIYR) 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH GALLONS INERT MATERIAL? YES 0 NO D THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT ~œ~s~ ~ (PRINTED & SIGNATURE) 'Jõ~' (Z LOCAL AGENCY USE ONLY STATE I.D.# COUNTY # CD JURISDICTION # ITIJ FACILITY # OIIIIJ TANK # DIIIIJ , PERMIT NUMBER I PERMIT APPROVED BY/DATE I PERMIT EXPIRATION DATE FORM B (7,91) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOR00348,R5 . ,.-. -' Ìì._:-.::.-c-Î - . INSTALLATION AND MAINTENANCE INSTRUCTIONS FOR MOSIER BROS. VACUUM DOUBLE WALL TANK MONITORING SYSTEMS General This double wall tank is two layers of steel with vacuum in between. (Usually there is a fiberglass outer coating in addition). The annular space, between the layers, is drawn to a vacuum - a permanent vacuum. As long as this'vacuum remains, there is no leak in the inner tank, there is no leak in the outer shell and there is no leak in the gauge. Because of the sensitivity and because all parts of both inner and outer tank are continually under test, annual tank testing is generally not required. To measure the vacuum a gauge is provided at the end of 50 feet of Tygon plastic tube. This gauge ( and switch if any) should be mounted preferably above grade for convenient observatiqn. O;j Gauge The vacuum gauge is of the liquid filled variety to protect against moisture corrosion and foreign particles which might jam the gears. The scale reads (backwards) in inches of mercury. A perfect vacuum would be about 29 inches. When shipped from the factory, the vacuum level is 15 inches or greater. Excessive vacuum can not hurt the system. The gauge is red lined at 10 inches - a conservative level for start of trouble shooting long before any emergency. The gauge has a vent in the top of the base for some reason related to the liquid filling. Gauge should be mounted so the vent is up. The gauge should be check occasionally for freedom of movement by squeezing by hand between the face and the back of the gauge. Tubing ~;;. The tank comes with 50 feet of expensive Tygon tubing. Cheap tubing will not hold vacuum. Clear heavy wall Tygon is meant for vacuum but it gets brittle around gasoline. Yellow Tygon is rated for gasoline but tends to collapse in vacuum. Collapse slows down the re-pumping process. Extra length of Tygon is available. Tubing should be run through conduit to the gauge or switch location. A riser to grade above the tube connection on the tank is recommended. Extra loose tubing inside the riser is a good idea. The best inexpensive hose clamp seems to be a very small electricians tri-band. Tubing can be bent back against itself and when thus crimped, will stop any airflow. Once this is done, the gauge can be remôved and tubing pulled through the conduit. ~ ~':: I I ~ - . "nh :Ji , :;,:1 . .; With care, the whole job can be done without losing the vacuum that was pumped at the factory. tt'; Vacuum Switch A vacuum switch is available in an explosion proof model about the size of a fist. This switch is compatible with Veeder Root, Petrometer and other alarm systems, The MSA system requires extra 100 OHM resisters (call the factory for advice on this). The switch setting from the factory is 10 inches vacuum with about 2 inches dead band. Even as sharp as you are, I'll bet you can't disassemble that switch and get it back together right the first time. . ., Wire colors are as follows~ Blue - normally open (in regular vacuum condition this is closed) Red - normally closed (in regular vacuum condition this is open) Green - ground Brown - Common Routine Checking Every six months the tubing should be visually inspected for kinks. Also the gauge should be squeezed to check for free motion of the needle. " j " ;! If the local jurisdiction requires comprehensive periodic test, it can be accomplished by squeezing of the tube between tank and switch and removing the gauge/alarm switch fixture. If the alarm functions at about 10 inches vacuum, it is working properly. This test will cause a slight leakage of air into the system, but can be done several times before re-pumping is necessary. -ii! Valves ; I I Older vacuum double wall tanks were built with valves installed to provide a place for re-pumping vacuum. Since the need to re-pump has been so infrequent, on current models there is no valve to leak and re-pumping is to be done through the_gauge tube. i i : t I ;i Any installed valve should be kept closed since valve stem packing is a sure source of leakage. These valves with Teflon seats should be tightened only with the thumb and one finger. "I' 'I ~ ., .¡ ~;f \ " I , >ii, ; , I MOSIER BROS. COMPOSITE UNDERGROUND TANK INSTALLATION INSTRUCTIONS AUGUST 17, 1993 free soil into the backfill during the design life of the system. - '. ,- -' ' The excavation shall be from any hard or sharp material that may cause damage to the composite tank. Care shall be taken during installation to be sure that foreign matter is not introduced into the excavation or backfill. Bedding and backfill material shall be clean, homogenous granular material made of either sand, pea gravel or #8 crushed stone, with no particle size greater than 1/2" and shall be free of sharp edges which can damage the FRP laminate. The bottom of the excavation shall be covered to a depth of one foot, suitably graded and leveled. The excavation shall extend a distance of at least one foot around the perimeter of the tank providing sufficient clearance. Where anchoring by means of a concrete slab is required, the tank must not be placed directly on the pad. Bedding material at least 6 inches deep must be spread evenly over the dimensions of the pad to separate the tank from the pad. The tank shall not be placed on any other hard or sharp material. If installation area is in a tidal area, the tank "bedding" material should be #8 crushed stone or pea gravel. Sand backfill may be used only if measures are taken to prevent washout of sand and prevent the infiltration of native . .¡~ i~ 'II! ,~ ¡It , :Y: For doublewall tanks, inspect vacuum tubing for cuts or abrasions and be sure the vacuum gauge reads approximately 15 in.Hg. Some codes call for air pressure test of tank at jobsite prior to installation. The Mosier Bros. vacuum double wall tank is continually under test. An air pressure test is unnecessary. Such a test could cause damages and create liability. Air test of the annular space is not recommended. it ':¡i' ¡~ .:{ '~¡:, " ·1; i: ;¡j ":' ',. '':; . fl' i"~. Before placing the tank in the excavations, all dirt clods and similar foreign matter shall be cleaned from the tank. " ¡~ Visually inspect the tank for damage. Areas where laminate has been gouged or abraded will appear beige or off-white against the surface. Mark all areas which appear damaged for repair. ,~,~ Clean areas to be repaired by removal of surface rust, dirt, contaminants and disbonded laminate. The laminate surrounding all flaw areas and/or exposed steel areas should be surface prepared by using a coarse grit sandpaper or grinder. This process should remove all glossiness from the surface surrounding the repair area. ,. '" ~{: .¡: ':v ~i Coat all damaged laminate and/or exposed steel surfaces using touch-up kit. Follow r '"j, ... .. manufacturer's instructions for mixing and application of materials. Equipment to lift the tank shall be of adequate size to lift and lower the tank without dragging and dropping to ensure no damage to the tank or laminate. Tank shall be carefully lifted and lowered into the excavation hole by use of cables or chains of adequate length attached to the lifting lugs provided. A spreader bar should be used where necessary. Under no circumstances use chains or wire rope slings around the tank shell. Immediately before installation, the coating itself shall be tested at 25,000 volts. The testing device should be Tinker and Rasor Model AP/W or equal. Any coating flaws found in this test shall be repaired as noted below. High water tables or partially flooded excavations sites exert' significant buoyant forces on tanks. Buoyant forces are partially resisted by the weight of the tank, the backfill and the pavement atop the tank. Additional buoyancy restraint, when required, should be designed in consultation with the manufacturer. Backfill shall consist of clean sand, pea gravel or #8 crushed stone similar to the bedding material to create a uniform homogenous environment· around the entire tank. : ' . ..~ ¡¡ Special care shall be taken when installing backfill along the bottom sides of the tank to ensure that the tank is fully and evenly supported around the bottom quadrant. ~!'J', " ');,,' . .'. Exposed steel at the lift lugs should be covered with the laminate repair kit. Also, any other exposed steel surfaces must be repaired with this kit. After application, the' installer shall verify that his hand lay-up work has cured (adequate material hardness and solidification) prior to backfill. Normal gel time is 30 minutes. Normal cure time is two hours. " . ~I ',' Tank fittings shall receive a coat of resin prior to backfill. Normal gel time is 30 minutes. Normal cure time is two hours. Resin coating shall include the entire plug on unused fittings. !1 :c Homogenous backfill shall be deposited carefully around the tank up to top of the tank and to a depth of at least one foot over the tank to avoid damage to laminate, especially where tamping is required. (See NFPA 30 and state or local codes for minimum depth of cover required.) ,: I The openings are equipped with dielectric bushings to prevent electrolysis. There shall be no wires, metal pipes or conduits or other conductors in contact with the tank steel. .:: I ." ¡ " , I,' fit INTERNAL ADJUSTMENT ¡¡t .ftD OI,,'MAL INSTALLATION DRAWING vYI' LOW RANGE DIAPHRAGM i:l:~~:, -'. \f< ~:;t~~-;;;~ .87 i't' \,-:,f,,;;{~,J ... '::¡D 'a L/~ . .1 -",-,-, _1''-- <, 5'"" .It!. - - 611GE £ ,__ '&:1 , -1;> I,l':\.: 11<1(.".c '" CG,',t,[(TI0:J .1'51 li¡,~~~,~¡ ÌI<,¡,1 ~¡?T ""4"',,Y 1 I , : c_~,¡ ,~ ~! l ,ltL.l,l, PKI )5JP~F. POi'[ '--l'_~'J-""1 '4·1f! .'PT -1 F NOTE: I E'¡-·· Unil con be $()I prior 10 inslollc\ior" 63 ;::;:':x' '~{0:1 ) Inserl 1/8" Allen wrlÕ'J1ch . /.7- ..¡. / inlo Cldìu$lmer,l screw (Ior.ol..d in >, pressure portì and lum do,kwise 10 d"creus& slIUing, 61¡1~~,...~",'.16,ll ~~"f.:~:~;~:DS CONNECTION I :,~- I 1/2,14 NPT 4.5 I ì MAX -"---J 1! I' ..·ITITr I, PRESSURE PORT '__'" ,..Wt 1/4·18NPT 1 I 6\1G&61i'J ¡...·l.e7-~ SH:PPINGWl $, APPROX.90l. J, .' p5GRAfv\Sì .68 ~;ËXn ,=-~), é 1 ¡ GE & 611 'IE " ---I SHIPPiNG 'NT APPROX, 120Z. (346 GRAMS) 1 ~ OPERATING AND ORDERING DATA: -_._-------_._---~-- PRESSURE SWITCHES 1/.... ALUMINUM MODEL 611G . PRESSURE PORT AND POL YIMIDE DIAPHRAGM -- -.---.-..----.,..,-.,--...,-....-. Mo)/,. Proof Adj. Set,Poinl Range Appre:. , Mcd,,"¡ N':, 0:'1'." .../:...~: It ---,..,-..----....·..-'-"r--· .. ....__.~ 51'S. (Test) On Incr, On Deer. D",ocJ MODEl MODH Press, Press, Prc>s5, Press. bond SI'DT·Sld OPDT ·t.~" poi psi psi P>' poi 250 500 1.5.,12,) ~_._-_.~_._.- . ----- ........_.._~ .75- 11 .35 ,75 611G8001 611GM8Cùl 500 lOOO 12,1·30 10,1..28 2.0 611G80ú3 61¡GM8(¡~ 500 1000 30,1..70 27,1-67 3.0 611G8005 611GM800S ,c; 500 1000 70,1-180 (¡3,1-173 7,0 611G8007 611 GM-BOO! ("~~,.,,, PRESSURE SWITCHES 1/4" ALUMINUM MODEL 611GE . PRESSURE PORT AND . EXPLOSION PROOF POL YIMIDE DIAPHRAGM , --r 250 500 1.5,12,1 ,75-11.35 ,75 611GE8oo1 61 \Ct~"li'J(¡: 500 1000 12,1-30 10.1-28 2,0 611GEbOO3 fJ 11 G E,',\BOOJ [0, 500 1000 30.1-70 27,1-67 30 611 GE800~ 61IG£III8(;)5 500 1000 70.1-180 63.1-173 7.0 61\ GE8007 (,I I (;uIJIC'Ol (o(:rnl'... V ACUUM SWITCHES 1 14" ALUMINUM MODEL 611V . PRESSURE PORT AND POL YIMIDE DIAPHRAGM '-'--r' -...-..-- ..-----,.-----.-..-. Max, Proof Adj, Se1·Point Rangc Appro< . ~.'Ic,¡jel N.:.. onL1 V.J>2:jt- ---'--E 51's, (Test) On I f1'r. On Deer. C\<!od, MODEl : MODEL Press, Press, Vacuum Vacuum bond Sf'DT,Std DPDT "1-1\" psi psi In, Hg II'" Hg 11\, H~ 611 V 8~G -:-:,'Mel: ,'-:'-~~- - 150 250 4 -28,5 1. 5, 26 J,5 CCJC'dnlu "'--- V ACUUM SWITCHES 1/4" ALUMINUM MODEL 611VE . PRESSURE PORT AND . EXPL~N PROOF POL YIMIOE DIAPHRAGM "._¿' h" ___, __, __..,_, 150 250 4 -28.5 1.5,,26 25 611Vf8000 61'¡E'\~ E" ((J,jlf\ld . -- __J ELECTRICAL CHARACTERISTICS: Rating of Switch Element SCHEMA TIC AND WIRING CODE $PDT -::"ondord toPDT tV..- AMPERES VOLTS SPDT Opor"M" Res. Res, 125 AC·50/60 Hl 11 II 250 AC·50/60 Hz 11 II 3CDC 5 5 125DC ,5 5 COWl< OF lEAû.) !.p RED Nt( ~--t ..J BROWN C, ,,-;" BLUE Nil) -~. ~ rOHEN--l J LEn model onlY".. COl(¡P Of tE ADS IF' , ,.J FolD NiCI~.. J BRCh"N CI ,-tr'-~/ ) BWE N 101 ;"..--' ¡ BL.A.CK N/C2 -+.-.. J_ 1'éllQW (2 ,-v ,.;...... , hJRplf N/Oi ,~;. . PRESSURE VACUUM Pr~ss. .75 to 180 psi Vue. 1.5 to 28.5" Hg. SERIES: 611G 611GE 611V 611VE Standard Features: · NEMA: 4, 13 · Weatherproof · Model 611GE U.l./CSA - See Note Explosion Proof: Div. ),2 NEMA: 4. 7, 9, 13 AMBIENT TEMP. RANGE I -300 to 1600 f _1....,= 34 :~:_~,I:,.C ..'~ Po: 1'... -~'-._' ,._._~....-. .......--....-.-...- ''.'IF-!$j f'(j' h .........-..._,._._,--~~-~.~_. .-.- /"',:U! ;lir~L'1T1 \...1'"'1..1 ¡-..¡, F';'!ì-:'¡" dc~ !jL'1 :~io!(·d S·eel. 30t) SS --.----. _._--~-.._._---_._-- AIt",J!r:i)U:í1 J',O f'J, f\:,lyín.¡,:k q. PI$Iô;.:..J ~lf't:~, '~':.~~(J':::) .~.--_._._-~...._--- ----. d ~'(h ------. //e:h";-:] Po(,; Ä~¡';-~;'--"--"- no tJ, PL,I"f1r;,dE- rrì ?iCJI.:E~~:~·(!¡)_~_~._ A~;~-·- no N, P(.,1/0,¡dE~ In Pk)f~( SIc (\ j I 3()fj ~;.~; --.----. MODEl 611GE EXPLOSION PROOf NOTE; 01.. 1 ..ploiton·proof ond herm"1Icolly ...aled el..ctrlcal o..e,nbly Pori No. H·l0S8 (46,/061 for "M" model opllo,,), Ils'ed by bOlh UnCle.-...rI'..,', lCtbo,alorles. Inc. (File No. (32961) ønd CSA T..llng lobo,· olallu :fll. No. 22'21) for hazord"". lac allan.. Cia.. " .,:11 , 'k¡ "',1 , ." I , , ,) , :1 "" ,:;ø¡¡, 'I :, ;1 ',1 " ;1 ',I ;\ ;! :1 Ji ¡ì"'¡¡ ¡."j ". I f-'!': r~~ : ". c¡ , " ¡,~t ~'4 . i¡ . Ii 1< if 1, , J¡ ~ ' t i ~¡ ~1 t ~ , ;~ it ;r' 1, If It ~ '.. "î' * J~' t' ~ if' : ~i ,::¡: I~ [:1 - . 1.0 IRIRODUCIIOR AU America Trenching (AAT) is the prime contractor on this project and as such has the responsibiliW' for ensuring overall safet1r for project workers and the pub1ic.lhe work to be performed will be carried out in a¢¢ordan¢e 'flÌth the California LUET field Manual guide1ine~. U.S. EPA ReguJaHons, ASTM Test Methods, and State and County Health requirements. AAT "I\''Ì11 fol1o'\V Standard Operating Procedures for exca"l7Stions. At the beginning of the project ambient air samples (background) will be taken wi th a Photoionization Detector (P ID) to determine the presence of airborne containinants. Personnel on site wiU take periodic readings with the PID throughout the day to determine if an1T increased airborne contamination is present. The provisions set forth in the plan wil1 applv as minimum guidelines for all employees of All America Trenching and any subcontractors on this project. Subcontractors may not modify these provisions without the witten ¢on¢urren¢e of All Ameri¢a Tren¢hing. 2.0 PROJECT SAfETY AUTHORITY A. On-SHe Project Safety The personnel responsible for project safety are: Mr. Steve Coldren, Project Manager Project Safety Offi¢er (AAT) The proj e¢t safety offi¢er has the authority to ~U8pend 'flOrk anytime he determines the provisions of the plan are ina<lequate to ensure worker safety. The Project Safet1r officer shall also inform the property o'WnerlcHent on individuals whose conduct is not con8Ïstent with the requirements of the plan. In addition, the Project Manager is responsible for the foUo'fring: Safety ~upp1ies and equipment in..¡rentory Medical surveil1ance program/Physical examinations Training progre.mslHa:zerd communication Accident/Incident reporting procedures De¢on te.mination pro¢edures B. AU Am.eri¢a Tren¢hing Safety Offi¢er The ¢ompany Safety Offi¢er report~ to the AU .A.merka Trenching Senior Management and is responsible for overall safety and loss prevention functions. His responsibilities include: Health suryeil1ance of ell A.A.T empl01:oeeS Assuring that safety procedures in effect are in compliance with ell appropriate federal, state and ¢ompany regulations ,. . Main'enance of personnel exposure moni,oring records Assuring appropriate personal protective equipment is adequate tor exi$ting -oondiUons Assuring appropriate hazard areas are identified and marked Assuring a11 personnel en tering hæard area are in appropriate le'?91s of protection '3.0 JOB HAZARD AHAL YSIS The possible major contaminants to be encountered on the project are: Petroleum Hydrocarbons, Volatile Organic CompoW1<1S (VOCs), heavy metals, oil and grease. There is <::urrenUy no 1r.no'Tfn air <::on<::en'raHon data a'lreilab1e for vac emissions in the direct breathing zone of personnel working aroW1d the exposed soits. Inhalation end dermal absorption h83ards are the major areas of concern for VOCs. Benzene This is a common constituent of gasoline and other petroleum products. It is a clear, colorless liquid with a flash point of 12 degrees F. The currently establisheð Thresho1ð Limit Value (TLV) for Benzene is 10 parts per million (ppm) in sir, hO'Vever the American Conference of Governmentallndustria1 Hygienists (ACGIH) has recommended a TLV of 1 ppm be adopted. Toluene This is af1ammable.. colorless liquid with a benzol-like odor. The flash point 13 listed 03 40 degrees 1'. The currently este.b113hed TLV for Toluene 13 100 ppm in elr. EthYl benzene This is a colorless liquid with an aromatic odor. It's flash point is listed as 59 degrees E. and it has an OSHA a hour Transient 'Working A-- (TV A) of 100 ppm. The list.ed STEt is 125 ppm. t.he hazerd dess is f1emma.b1e liquid. K..Y.1.ene This materiel is a clear liquid "!'i'Ìth a flash point of 100 degrees F. The TL V is curren t1 y established at 100 ppm in air, and is curren t1 y W1der study as a pm~db1e carcinogen. Hea'lf"ll Meta1s Depending on the type of metals to be found, there may be a possibility of exposure to employees via inhalation and dermal routes. protection of the 'WOrkers will in<::1ooe provisions for these ROEs. - . Protecti va Measures It is currently not anticipated that the potentia1levels of exposure '\\\111 reach PEL or TL V limits. but this is based on limited available specific information. It is planned that inheiation and dermei contact wi11 be the potential exposure pathways of concern, Protective hand coverings including outer and inner gloves 1i111 be mandatory for all fieM operations personnel. In addition. respiratory protective devices sheil be required to be available to each person in the Exclusion Zone during the soils boring/excavation work tasks. or within ee.sy reach of those persons "\\\"Orking in the Contamination Redu.ction Zone, should irritating odors or irritation of respirator}· tract become detectable. The appropriate air-purifying respiratory protective devices, that are required to be a·.,raila1>1e for a11 personnel working on-site, wi11 be fitted with organic vapor cartridges and dust pre-filters, or with the high efficiency, organic 1,o"aporlHEPA stack t}"Pe cartridge. T}"Picall}·, if the respirator1'· protective devices are worn. the cartridge wi11 need to be changed daily. Physicei Hazards The physical hazards present on most job sites include working around heavy equipment, rotatior.L radius for excavators and backhoes, working near stockpiled soils, and the exea.ve.Hon itself. Personnel may be required to enter the excavation areas, heavy equipment operators wi11 con81det· the ovet"ell work e.s a Confined Space Entry operation. AAT safety procedures for 'WOrking in confined spaces wi11 be strictly enforced. Overhead power tines will be strictly avoided by equipment operators. Equipment opera.tors will maintain ten (10) foot radius clearances from any overhead Hnes. It is not known if an y underground lines, tanks Ot· utili ties sti11 do exist in the vicinity of the excavation project site. Supervisory personnel will determine the presence of underground utilities prior to commencing exea.velion a~tivity . Noise Hazards Due to the operat.ion of heav1" equipment "'Ço'ithin confined spaces, .it is expected that high noise levels may be experienced. A11 personnel 'WOrking within the Exclusion Zone "I'rill "I'¡ear hearing protection when equipment i~ operating. These devices may be of the disposable plug type or of the ear muff type, pro,rided that the equipment has been rated for noise reduction by the man uf'acturer. Heat Stress There is a probability of high, ambient temperatures ( over 80 degrees F. ) in Kern Coun ty, California; Since workers may be required to 'Wear protective clothing, it is anticipated that they may reach high enough fit . temperatures that could lead to heat stress or heat exhaustion s'}~ptoms. AAT will plan on implementing their standard Heat Stress Prevention and Monitoring Program., unless ~he Projec~ Safety Officer de~ermines ~he.~ Hee.~ Stress potentials are not being or will not be experienced by operations personnel. 4.0 RIS.I: ASSESSMEBr SUMMARY The potential of any increased risk of exposure on other 'VOrkers or the surrounding community is minimal. The basic potential exposure source "«1Ou1d probably originate from airborne dusts, during the drilling of the soil borings an<J the excavations, an<J those <JU8ts containing lo,., level concentrations of VOCs in the soils. AAT will have equipment on-site to provide for dU8t control during drilling and excavation activities if it appears that dust control is 'Warranted. Perimeter air monitoring to detect potentially migrating contaminants may be cond~te<J to ensure no hazardoU8 materials are migrating to the surrounding community. 5.0 EIPOSURE MOB IrORIBG PLAB A. General: An air quality monitoring program ,,«fill be implemented to provide baseline and on-going air quality data for site operations. This program. "!'fill include: 1. Å preliminary survey of existing air qua1it'}r conditions, prior to an'}r surface disturbances. If possible this survey 'Will be under anticipated "worst case" "!'reather con<Jitions. The survey will be U8ed to establish baseline le'rels for input into the respiratory protection selection process. Z. An on-going evaluation of on-site atmospheric contaminant concentrations during site activities that involve significant surface disturbances. 3. Perimeter monitoring of downwind air qua1ity conditions during significant surface disturbances. B. Project Monitoring During the drilling and excavation phases of projects, AAT personnel will be responsible to monitor for the presence of contaminants with a direct reading instrument or it' s equivalent. Action le'rels to upgrade to le'rel B respiratory protection ,.fill be at <19.5 ~ oxygen, or Benzene at 10 ppm or greater. - . 6.0 PERSOIAL PROTECTIVE EQUIPIIEIT A. Personal protective equ!pment and safety requ!rements must be appropriate to protect against the potèntie1 ha2ards at the sHe. ProtecU,~ equipment will be selected based on the contaminant type(s), concentraUons (s), and routes of entry. £leM personnel and visitors are required to "Ifrear the following clothing and equipment, as a minimum while on the sHe: Hard Hat SafeW' Glasses Long Sleeved Shirts Ð. Levels of ProtecHon - General Level A: Should be worn when the highest level of respiratory, skin, and eye protection is needed. Leyel Ð: Should be selected "Ifrhen the highest level of respiratory protection is needed, but a lesser level of skin protection is required. Level C: Should be selected when the types of airborne substances are kno~'fl, the concentration is measured, and the crHeria for using air- purifying respirators are met. Level D: Should not be worn on any sUe with respiratory or skin hazards. It is primarily a "IflOrk uniform proYiding minima! protection. C. Required Protection 11 is anticipated that Level D 'WOrk clothing ~';11 be 'WOrn on this project. In addition, the personnel working on the project will be required to wear a hard hat, safety glasses and steel toed boots. ÀS the project involves the drilling of soH borings and excavations, the only anticipated exposures will occur during the drilling and excavation activities. Should the odors encountered durirtg the drilling become irritating or of a nuisance to the workers, the personnel assigned to the project will upgrade their personal protection "Iftith appropriate clothing an<1 respiratory protective equipment. AAT will provide it's employees with required personal protective equipment. If respirators are deemed necessar1r, onl1r NIOSH/MSHA cerUfied respiratory protective equipment will be uti1i2ed. AAT sub-contractors are respondb1e to supply the a.ppropria.te safety equipm.ent for their own employees. - . 7.0 YORE: ZORES ARD SECURITY MEASURES A. General: A site must be con troled to reduce the possi bility of exposure to an,1" contaminants present and their transport b,1" personnel 01" equipment f'rom the sHe. This control system is required to assure that personnel and equipment ~rorking on the hezar-dous ~f8Ste site are subjecte-d to appropriate health and safety surveillance. The possibility of exposure or translocation of contaminants can be reduced 01" eHminated in a number of ~'8y:s', including: 1. Setting up securit")l" of ph1~icalberriers to exclude unnecessar")l" personnel from the general area 2. Minimizing the number of' personnel and equipment on-site consistent ~rith effecti're operations 3. Estab 1i~hing ~rork zones ~ri thin the site '\. Estab1h:hing control points to regulate access to ~rork zones ). Con-d~ting operations in a manner to re-d~e the exposure of personnel and equipment 6. Minimizing the airborne dispersion of contaminants 7. Implementing the appropriate personnel and equipment deconta.mination procedures 8.0 DECORTAMIRATIOR PROCEDURES A. Procedures: 1. AU personnel wiU wash their hands and face when leaving the work zone 2. Personal equipment ~."rn into the Exclusion Area ~lÎl1be decontaminated upon leaving the Contamination Reduction Area. All equipment -decontaminate-d ~rill be air -drie<1. 3. The decont.amina.t.ion of equipment., ma.t.erie1, end personnel ~ed ot' working in the Contamination Reduction Area may be somewhat less complex than that used in the Exclusion Area. 4. The spent solution, brushes, sponges, containers, stands, etc., used in the decontamination process must until shown otherwise, be considered contaminated an-d must be properly disposed. '" . 9.0 &IBIRAL SAIl YORK: PRACT ICIS Å. The proje<::t operations shaH be <::onducted with the following minimum safety requirements employed: 1. Eating, drinking, <::he,,«';'ng gum or to1:>acco, smoking, or an1' practice that in<::reases the probability of hand to mouth transfer and ingestion of materials is prohibited in any area "If/here the possibility of ~ontamination exists. 2. Hands must be thoroughly washed upon leaving a contaminated or suspected con taminated area before eating, drinking, or an l' other acti ,Pi ties transpires. 3. Through washing of the entire body should be ac<::omp1ished whenever decontamination procedures for outer garments are in effect. The washing should o<::<::ur as soon as possible after the final wearing of prote<::tive garments. 4. Legi1>1e and understandable precautionar1' la1:>els shaH be prominently affixed to containers of raw materials, intermediated, products, mixtures, s~rap, "'If/'SSte, debris, end ~ontamina.ted dothing. 5. Contaminated protective dothing sheil not be remo'red from the regulated area until it has been <::leaned or properly pa<::kaged and labeled. 6. Removal of materiels from prote<::tive clothing or equipment by blo"lVing, shaking, or any other means ,,«'hich may disperse materiels into the air is prohibited. 7. Personnel on-sUe must use the "buddy system" when wearing any respiratory protective devices. Communications between members must be maintained at all times. Emergency communi<::ations shall be prearranged in <::ese of encountering ,unexpected situations. Visual cont~t must be maintained between "pairs" on-site, and each team should remain in <::lose proximity to assist ea<::h other if necessar1'. a. Personnel ,,«ri11 inform ea<::h other of sUÞjecth?e symptoms of chemical exposure su<:h as headache, dizziness, nausea. and irritation of the respiratory tr~t. 9. No excessive faciel hair ,,«,hich interferes "IVith a satisfact0f'1' fit of the fa<::epie<::e to fa<::e seei will be allowed on personnel required to wear respiratory protective equipment. 10 AU respirator')' protection selection, use, and maintenance "IioiH meet the requirements of established ÅÅT pro<::edures, re<::ognized <::onsensus standards (AIHA, ANSI, NIOSH), and will comply "Ifrith the requirements set forth in 29 CFR 1910.134. . . 11. Appropria1e work areas for support contamination reduction, and exclusion wil11>e esta1>Hshed. 12. AAT personne1 on-site wi11 to 1>e thorough1y1>riefed on the anticipated hazards, equipment requirements, safety practices, emergency proce<:Jures, an<:J communications metho<:Js. This will be accompHshed initially, at the beginning ora project, and then in de.Uy briefings as the project progresses. 1 '3. Contact with surface and groundwater shal11:>e minimi3ed. 14. Steel toed and Neoprene 1>oots wil11>e 'lOrn on-site at all times. B. In addition, the fol1owing precautions sha111>e implemented for a11 personnel working on the project site: Gross decontamination and removal of all personal protective equipment shell be performed prior to exiting the fad1ity. Contamina.te<:J clothing 'Will be removed and collected in a drum. for disposal. The Project Safety Officer wit! be responsible to take necessary steps to ensUt'e that employees are protected from phVSical hæards, to include: falling o1:>jects such as tools or equipment falls from elevations Tripping over hoses, pipes, tools, or equipment Slipping on wet or oUy surfaces Insufficient Of' fau1ty protective equipment Insufficient or fau1tyoperations, equipment, or tools All personnel shall1:>e required to wash hands and face before eating, drinking, or ~moking. field personnel ,111 be cautioned to inform each other of non-visual effects of the presence of toxics, such as: Headaches Dizziness Nausea Bl urred vision Cramps Irritation of eyes, skin, 01" respiratory tract Changes in complexion or skin discoloration Changes in apparent motor coordination Changes in personality or demeanor Excessive salhration or changes in pupi1lary response Changes in speech ability or pattern '" . 10.0 StABDARD OPERAtIBG PROCEDURES Respiratory Protection Guidelines AAT wiU provide suHable respirators when such equipment is deemed necessar,' to protect the hea1th of emplo,~es. The emplo,~r sha11 1>e responsible for the establishment and maintenance of this respiratory prote~tion program.. The Proie~t Safetv Offi~er will appro"lre the selection, purchase, and inspection of the models and types of respiratory protective de"irices. A medica1 evaluation is required prior to "It'earing any respirator, except where emergency escape respirators ere provided. The contract physician will determine annually if any health or physical conditions exist "f,hkh "f1Ou1d prohibit a worker from being assigned to an area requiring respiratory protection. A record "Itri11 1>e retained in the emplo,~es medica1 fHe, "It'hich "Itri11 be retained at the medica1 clinic or doctor's office. Respirators will not be worn when conditions prevent a facepiece to face seal. Contact lenses "fli.ll not be "flOrn when using a respirator for the safe use of any respirator, U is essential that the user be property instructed in it's operation and maintenance. Both supervisors and employees sha11 1>e so instructed. Employees wiU be instructed and trained in the proper selection and use of respirators and their limitations. The employee shall use the proyided respirator in ac~ordance "flith instructions and training received. AU training wiU be documented with records retained in the emplo,~e's training fHes. The AU America Trenching Respirator Program wi11 meet the 11 points specified in Title 29 CfR 1910.1)4*, and CCR Title B. 11.0 EIIERGEBCY PROCEDURES A. SUe Emergency " arning System: The follo"fli.ng "f¡arning s)"'Stems may be used depending on the work site conditions or emergency involved: 1. Verbal communications 2. "ehicle horns ,. Portable hand-held compressed gas horns Horn signals are used to signify an emergency warning. One long blast is used on-site to signify emergency evacuation of the immediate work erea to a predetermined location upwind, where a head count will be taken and further instructions gi"iren. Repeated short blests are used on -site or from off- site to signify evacuation of all personnel from the site to the hot line where further instructions "fli.ll be given after a head count is taken. - . Ð. Emergency Equipment: The following equipment comprises the basic emergency equipment Ust of ".,hich all or some "'frill be available at the work sUe: 1. Fire exHnguishers - dry chemical 2. First aid kits (including chemica11>urn kit) 1. Combustible gas and oxygen detector analyzers 4, Inorganic "apor detector tubes and air supply pumps (Dreger tubes) 5. Hand held compressed gas horns 6. Appropriate spitl clean-up supplies and equipment C. General Emergency Procedures: In case of an emergenc1" or hazardous situation, the team member who observes the condition will immediately sound the alarm. 1. Actions to 1>e taken ~ritl1>e as dictated 1>1" the emergenc1" condition. 2. Upon hearing the alarm, a11 non-emergenc1" communications ~';11 cease and the member giving the alarm will proceed to give the Project Manager all pertinent information. ). PO"/frer equipment not required for the emergency dtuation "/frill be shut down and operators wilt stand by for instructions. 4. Injured personnel wi!! be transported to the Contamination Reduction Line. 5. ÁÁT Command Centel' 'lriU be notified immediately. 6. In case of a fire, explosion., or hazard alarm, personnel wil1 immediately proceed to assigned prearranged safe locations. Upon arrival at the safe locations, a complete head count "/frill be gi'ren to the Project Manager. Personnel wilt stay at the safe location until the area is secured. D. Personal Injury If an injury occurs due to an accident or exposure to a hazardous su1>stance, the AAT Command Center wil11>e notified. The Safet1' officer ~';l11>e given all appropriate information concerning the nature and cause of the injury so that treatment preparations can be initiated. The injured person "/frill be transported to the Con tami.nation Reduction Line where appropri.ate first aid and treatment can 1>egin. The Project Manager ~';111>e informed and ~';11 in vestigate the cause of the in; ury and make any necessary changes in work procedures. E. Ambient Monitoring Contingencies When do~rn~';nd ambient monitoring indicates significant11" higher than background levels of any contaminants, the Safety Officer and Project - . Manager will immediate1 y determine the cause. They will then make changes to 'WOrk pre.¢tices or proceodures, anod if necessary, make changes in site layout (i.e., change the location of the command Center, decon area. or Exclusion Area), and ~l8f'n unprotected personnel to e,'Scuate or to put on personal protective equipment. In the event of an accident resulting in physical injury, first aid m11 be administered, and the injured '!t'Orker 'Wi11 be transported to the nearest emergency medical center for treatment. EIIERGERCY CORIACY LISIIRG EmergencY.: Teleþ'hone Numbers: Emergency Number A1 ternate Number Firel Ambulance Sheriff Nearest Hospital --- SEE ATTACHED --- Directions: Additional Contingenc)t Telep-hone Numbers AU America Trenching (209) 299-7229 12.0 TRAIBIBG REQUIREMEBTS AU personnel 'WOrking at the project site must have completed the IniHe.1 Training Requirements (40 hours), according to Federal OSHA Standards under CrR 1910.120. Personnel from AAT end subcont.re.ct.ors will a.t.tend a. pt·oject specific training pt·ognim tbt· safety issues and project wot'k task reVieW' before beginning 'WOrk. This meeting w:iU ah:o be attended by the Project Manager and the Project Safety Officer. In addition, fit-testing of respire,"ory prot.ect.i va devices will be conduct.ed as part. of t.he sefetvlot'ien taHon treining. AU AAT site personnel wiU have completed U·aining relative to the project operations plans and the materials to be encountered during the project. This training will be conducted by the AAT Safety Officer and will include classroom and prat:t.ical e.pp1ice.t.ion exercises regarding t.he hazards t.o be expected and the pt'otective equipment to be utilized. -~~--- - . This tbrme1 tra1ning is supplemented by da1ly safety briefings and site specific training as required...4.11 subcontractor personnel wi11 be required to complete the same basic training and to attend a11 appllcable safety briefings. 1 '3.0 liED ICAL SURVEILARCE AAT personnel and subcontractors engaged in project operations "If-i11 be participants in the Medical Surveillance program, and must be cleared by the examining phy!ician (s) to "'frear respiratory protection devices and protecti're clothing for VOl' king with hazardous materials. The applicable requirements under Federa1 OSHA, 29 CFR 1910 wi11 be obser,~d. AU AAT personnel on-site wi11 have successfu11y completed a pre- placement or periodic medical examination in accordance with established AAT policies and procedures and consistent with the provisions of the OSHA carcinogen standards. This examinaUon "\Y111 include a complete medical and occupationa1 history, ph~ica1 examination, and selected biologica1 sampling. Laboratory studies include a complete blood count (CBC), urinalysis, chemistry panel (SMAC), pulmonary function (:rEV a.nd :rVC), chest X-ray, audiometry, and vision screening. 14,0 RECORDI:EEPIBG Á. Genera1- Record Keeping wil1be consistent "If-ith OSHA regulations in all respects. The following permanent records will be maintained in the AAT of'fi¢e&l and a.t the &lite: 1. Safety Inspection Reports 2. Personnel Exposure Monitoring Records (spiral or bound permanent log book wil1 be used) '3. OSHA 200 - Current to within 5 days 4.. Accident reports consistent ".,ith the established AAT procedures B. Medical Records - Perma.nent me<1ica1 recor<1s will be meinteine<1 in confidential fites by the contract physician/medical clinic. The physician wil1 supply AAT with a medical status document certitving that the personnel assigned to the project are physically capable of performing their individual vork tagks. ", . 15.0 SIGB.TURÈS Site ltee1th end Sere!,. Øn Å~~d 1Iÿ: Signature: ./~ ~~J ltame: Mr. Stë're Coldrèh Title: Project Manager/SHë SefétYOfficet AU Americê. Trenching; Inc. Dàte: i.âlJs~ Conträctor end Subcontractor Agreements: 1. Contractor cërtiffe$ that the tot1ot-ing þêr~oht'iè1 to be emploi'ed on the subject project hê.vè tIlé\ thé follo'Mhg rêqu1rêtnèhti ot thë OSHA HS2e.rðoU$ "Mte Operé.tor Stáhdé.t'd (29 efR 1910.120) end other é.þpHcãb1ê OSHA s1an<ferds. 2. Cotltrêdor certifiês that in àd<fitioh to meeting OSHA tequirêtriéh1S, it has recei,rëð ä copy of this Site HeåJth ànd Sãfèty Plan ahd .',«1fU ên~ute that it's employees ere informéd éhd 1'Iill complt 1'Iith both OSHA reqUirements and thé guidelines in thit Pian. , '3. Contractor ftit'ther certifies thê.t it h8J rêê.ð éhd understands êt1ð '\Vi11 comph; vi th ell provisions of thi~ Health tUld SMêtt plèhê.t1ð irll1 not hò1d AU Americà Tretl¢hing rëspondb1ê or Hable for ê.h.Y injury Of hée.1th pro1>iëtn.s the.t mê.Y . erise. Con tractor Personnel Signaturë Date - . KERN COUNTY HOSP ITALS Bakersfield Communit}p' Hosp1ta! P .0. Box 5900 901 OU're Dri're Bakersffetd, CA 93308 805-399-4461 Bakersfie1d Memoria! Hospital P.O. Box 1888 BaJr.er~fieM, CA. 93'301 420 34th Street Bakersfield, CA 93303 805-)27-1792 Kern M.edical Center 18'30 Flo"lf'rer Street Bakersffetd, CA 93305 805-326-2000 Merc}p' Hospi tal P.O. Box 119 2215 Truxton Bakersfield, CA 93302 805-337-3271 San Joaquin Communit')p' Hospital 2615 Eye Street BaJr.er~fiel~, CA. 9'3'30'3 805-327-1711 Delano Regional Medical Center P.O. Box 460 1401 Garces Highway Delano, CA 9'3216-0460 805-725-4660 Kern Valley District HospHal Route 1, Box 152 Lake Isabella.. CA 9)240 619-)79-2681 ~Te~t Si~e Di~tri~t Ho~pite1 110 E. North Street Taft, CA 93268 805-76)-4211 f/f . Tehachapi Valley District Hospital 115 Veg\ "En S\ree\ P.o. Box 648 Tehachap!. CA 93561 805-822-'3241