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Home My WebLink AboutUNDERGROUND TANK FILE #2 ~. TANK REMOVAL INSPECTION FORM Page 1 of 1 Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661 )326-3979 þ -\, OtJ OWNER I(") V \.¡ o^-J CONTACT PERSON ~"'Ice~ IA)c. LABORATORY ~I TEST METHODOlOGY c.Je~ce: B",E:)( I \Pl-r-3 VVli13S PRELIMINARY ASSESSMENT CO. I Q. -- L-A.f.,lV i t¿ tV C-£ht.JVtllU7-..J co, RECIEPT LEL% ðIJ z.-,~ I ~ 'f- S:Jð (IoS 0- -f /1) CONTACT PERSON I.r::¡ . Q~ /' "'--DI'$~~? ~ - ~\"'fl.e.~ \ '?.(.\VVfIG ~.~ ,,) (3') t6 ,. PLOT PLAN ~~~.1- 'c ÚN\'f..~ E"d <:4þ~ z- ~ÞIMI?I-e~ z.,-,~ü I~ (z(~ 5 'Ve/.w"t1Yw~ f '7? L\ '-z, ~ + ~Jw ~""7 CONDITION OF TANKS j)IAJF CONDITION OF PIPING CONDITION OF SOIL COMMENTS DATE ø w. 04'- fd2082 JUL 22 2004 11:07 BKSFLD FIRE PREVENTION e ltitil Jt:I::>£:-£:l re:. 1"".<.. Ipermlt No: PERMIT APPUCATlON (UST) FOR REMOVAL OF AN UNDERGROUND STORAGE TANK Baker.fleld FIre Dept. Bmtromnenta1 Services 900 1ì"uxtun Ave.. Ste.210 Bakersfield, CA 93301 Tel: (661)326-3979 P.O. Box 760 INSURANCECAARIER TANK NO. 1 ACE VOLUMe Unkno n 10,000 G CHEMICAL. STORED Gasoline DATES STORED CHEMICAL PREVIOUSlY STORED None ; ~ "f:. . .' ,: /;l. I': ~. ::"'~~'h'l ~:~~;{~i,l~~.'· ·!(~!I~:ì::~~(~t.. tt~·:~r;" ~~ .',1.. ~.: '- \~. ;.(~-s:; ,~\J!:i~~'1\~}'{F';;'ì,f;~'I:~:~1W}t~~1:~~/n~' ¡r.·:1~1.'~ "':1'~t;fi,' ;~~kh~,,~({t:Wi "titJ,,::~ ";:~'J;~i~!~~~¡j~I~}j¡t,t\~'iU~ ;:\,::,~:,~;';;,;:; ;V;f~:'¥:t~f~!~~¡J:t:::J:~~~i;t,~li~~]:g~~"{;~t;~'~;r~;~~:;~~~~2t;~~~'r,it&~~~~~~~\\~~$!¡:F1t.i~'~~1~~~t~;'~r~f¡:1t~;f~},i,~ri!~;:liv~:~~¡{{I1~;r¡~~~J~~*i~~t For OffIcI.. UH Only THEi4PP/JCNVT'M48 ÆCElI4!D, I/NOERSTMIDS. AND WIlL COMPL YlØm THE ATTACHED CONDIT1DNSOF 7NIS PMMIT ANDANY OTHEIJ S1" 1E. LOCAl. AND FEDERAL REOI.4J4nOHS, THt$FORM HASÐEENCOW'tETED UNDERI'elAL TYOI' PEAJum'." m 'fHE 8fiST OF NY KNOWl.EDGE /8 1'RI.IE AND CORRECT. ~ DEC, 25. 2003 9:58AM." .157218 ~ NO, 735 p, 1 Facilities Service Offíce iJ1i ~Sâ'tii& December 24, 2003 AI/\\()I{\ ""- ·~U{b4,..k~ ~g{) ,. lb ,S-'" ì 2. 3.3 Mr. Steve Underwood Environmental Code Enforcement Officer Bakersfield Fire Department 1715 Chester Avenue Bakersfield CA. 93301 Re: Underground Storage Tanks at USPS - Stockdale Station, 5601 Stockdale Highway, Bakersfield Ca 93309 Dear Mr. UndelWood: In a recent telephone conversation with Jeane Martin, Environmental . Specialist, you discussed granting the Stockdale Station an extension on the December 18, 2003 Final Notice of Violation until June 1, 2004. The purpose of this letter is to request the extension. The tank at Stockdale Station Is part of a Postal Service initiative to remove tanks at 57 facilities In California. We have an architecVengineer on contract and all plans and specifications have been completed. We expect to have the appropriate approvals and contractors in place in time to begin tank removals In the spring. A response at your earliest convenience will be greatly appreciated. If you have any questions, please call Jeane Martin at 650-615~7212 Sincerely, ~ .... Kayode Kadara Manager 300 OyGlêr Point Blvd., Suite 22S South San Francisco CA 940/10·0300 850-815-7212 Fax 660-61 $-T21 G FIRE CHIEF f~ON FR.L\ZE ADMINISTRATIVE SERVICES 2101 °H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H' Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES. ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326'3696 FAX (661) 326'0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 -- " December 18, 2003 Ms. Leonor Menchaci, Post Office Mgr. U.S. Post Office 5601 Stockdale Hwy. Bakersfield, CA 93309 RE: Illegally Abandoned Underground Storage Tank FINAL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Dear Ms. Menchaci: I would like to thank you up front for your help in quickly resolving this situation. On August 11, 2003 I received a call from Mr. Mike Bettes, Post Office Manager for the Stockdale Facility. He informed me that the tank was taken out of service, as of August 11, 2003, and scheduled for removal within 60 days. I informed Mr. Bettes that according to California Fire Code (2001 Edition) Section 7902.1.7.2.2 he had 90 days to either remove the tank or put the tank back into service. Section 7902.1.7.2.2 reads as follows: "Underground tanks not used for a period of 90 days shall be safeguarded or removed." Tanks planning for upgrade may have a temporary closure for up to a year. However, since your system has been upgraded already, the temporary closure does not apply. On October 16, 2003 I was again contacted by Mr. Mike Bettes who informed me that the UST (Underground Storage Tank) was being put back into service. I then faxed Mr. Bettes the requirements for resuming operation. I never heard back from him. On December 15, 2003, a follow-up inspection was performed to determine the status of your tank system. It is very apparent that the tank system was not put back into service, nor were start-up requirements completed. ~~ 7~ de W~~ .¥"OP .AoPe .r~ A WedaPp" i. "i 4"'1" 'I Æ" í Letter t. Mr. Taylor Noland Re: Propane Exchange Program Dated: December 4, 2003 Page 2 of2 . Which brings us up ,to the present. You have an UST system that is now considered illegally abandoned. Your 90 days period expired on November 11, 2003. Therefore, prior to February 15, 2004, you shall have the tank removed from the ground and restored in an approved manner. Failure to comply will result in further enforcement action. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, Ralph E. Huey, Director of Prevention Services By: * rMu£J Steve Underwood Fire InspectorlPetroleuml Environmental Code Enforcement Officer cc: Robert Sherfy, Assistant City Attorney <Q CJ ..D m Lt') <Q IT" IT" , " , , , , " , , . r OFFICIAL USE I f $ Postage . Cell!fied Fee '¡ Postmark Retum Reclept Fee Here (Endorsement RequIred) RestrIcted Dellvel)' Fee (Endorsement Required) Total Postage & Fees $ .::r CJ CJ CJ CJ Lt') ,..:¡ /Tl ru CJ CJ I"- , , , I Certified Mail Provides: · A mailing receipt (8SJ8A6/:J) ê:OOê: eunr 'oow WJO,j Sd · A unIque identifier for your mailpiece · A record of delivery kept by the Postal Service for two years Important Reminders: · Certified Mail may ONLY be combined with First·Class MailQ) or Priority MailQ). · Certified Maills not available for any class of internationa\mail. · NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ~ · For an additional feel a Return Receipt may be requested tÇ¡ provide proof of delivery. To obtain RelUm Receipt servIce, please complete al1'd attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USP5QI> 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". · 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: Save this receipt and rresent it when making an inquiry. Internet access to delivery inlorma ion is not available on mail addressed to APOs and FPOs. FIRE CHIEF RQN :=RAZE ADMINISTRATIVE SERVICES 2101 oW 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. ENVIRONMENTAl SERVICES 1715 Chester Ave. Bakersfield, f4A 93301 VOICE (661) 326·3979 FAX(661~326-o576 rj PUBLIC EDUCATION 1715 Chester AV8. Bakersfield, CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-oS76 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 .} . August 11, 2003 CERTIFIED MAIL Barbara Bell U.S. Post Office 5601 Stockdale Hwy. Bakersfield, CA 93309 NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Dear Ms. Bell: Our records indicate that your annual maintenance certification on your leak detection system was past due. 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 ruñning condition." You are hereby notified that you have thirty (30) days, September 8, 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 yours, Ralph E. Huey Director of Prevention Services By:J:;~ Steve Underwood Fire InspectorlEnvironmental Code Enforcement Officer Office of Environmental Services SBU/db ~~ y~ de ~Nn./~u./~ .%p ,./~OPe .o/~ A ~~y'" · Complete items 1, 2, and 3. Also complete Item 4 if Restricted Delivery is desired. X · 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: í US POST OFFICE 5601 STOCKDALE HWY BAKERSFIELD CA 93309 , I I '-.. t .... .. 7002 2410 OOO~ 1974 9817 , 'T~ 3, Service Type I:] Certified Mail I:] Express Mail I:] Registered I:] Return Receipt for Merchandise o Insured Mall 0 C,Q.D. 4. Restricted Delivery? (Extra Fee) 0 Yes ~~- PS Form 3811, August 2001 Domestic Return Receipt 1 02595-02·M· 1 54( UNITED STATES POSTAL SERV, IC~~~' '''À'' LV !'::' ,JM ....\\\ .~ ;\).1 \ I: MAR", ¡ '._--- ".,-' '_ ," '''' · Sender: Please prín~, adQre5s~:~~:Zte+tirf:!.~!:~2.x. ~~,_ ~ I ~---~- _Eirs.t__ClassoMai,',~_ - , -, Postage & Fees,Palâ -- . USPS " ~ ~.. ' Permit No. G-10 ,"~ Bakersfield Fire Ðepartm 1715 6~eventjon Services ent ester Avenue S . Bakersfield, CA 933~~e 300 ';:¡:;::;:: i i + i '3:::4 Aê",~~~ H,r'Il,fJ", tr'l" HilI HlllfH, r 1111 rr" rll HI f'- ,...:¡ c:(J rr Postage $ ..> ~.. =r f'- rr ,...:¡ ru t::J t::J t::J Return Reciept Fee (Endorsement Required) t::J Restricted Delivery Fee ,...:¡ (Endorsement Required) =r ru Certified Fee .' Postmark Here Total' ru ' US POST OFFICE g Semrc 5601 STOCKDALE HWY f'- šiiëët BAKERSFIELD CA 93309 orPOE ëitŸ;šh ~------~-------- -------------- - _4 ~¡:¡IJ_. , II " -. . . . Certified Mail Provides: ;:69~·II\I·ëm·g6g;:0~ ¡¡¡ A mailing receipt (9SJ9119/:J) ;:00;: 9unA£ WJ0:l Sd Iii A unique Identifier for your mall piece .. · A record of delivery kept by the Postal Service for two years ImfJort8nt Reminders: · Certified Mail may ONLY be combined with First·Class MailQj) or Priority Maila¡ · Certified Mail is not available for any class of international mail. III NO INSURANCE COVERAqE, IS F?.BQVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. 81 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 mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPSQj) postmark on your Certified Mail receipt is required. I:! 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: 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 'W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' ENVIRONMENTAl SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 328·3979 FAJ( (661) 326-0576 PUBLIC EDUCATION 1715 Chester AvÈl. Bakersfield. CA 93301 VOICE (661) 326-3696 F AJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326.0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 . . .. ~..... . ..~ '~ March 5, 2003 us Post Office 5601 Stockdale Hwy Bakersfield CA 93309 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 October 16, 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 pennit to operate. Failure to repair and re-test will result in the revocation of your pennit to operate. Should you have any questions, please feel free to contact me at 661- 326-3190. Sinl/zce,reIY,,/' f I I .' Steve Underwood Fire InspectorlEnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~"sP~ de Wewl/.n//~ .97'"0P .AOP6 .r~ A W~?'" '='";õ - - Page_of_ ,- Secondary Containment Testing Report Form This form is intended for use by càntractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility USPO Stockdale Station I Date of Testing 10/15/02 Facility 5601 Stockdale Hwy, Bakersfield, CA 93309 Facility Contact: I Phone 661-834-4158 Date Local Agency Was Notified of Testing 10/10/02 Name of Local Agency Inspector Present: Bakersfield Fire Marshall 2. TESTING CONTRACTOR INFORMATION Company Name: Montijo Tank Tech Technician Conducting Test: Tim Montijo, Richard Cummings Credentials: CSLB Licensed Contractor X SWRCB Licensed Tank Tester 90-1090 License Type and #: Training by Manufacturer Manufacturer Component(s) Date Training Expires INCON STS 10/05 3. SUMMARY OF TEST RESULTS Number of Tanks Tested: 0 Number of Piping Runs Tested: 2 Number of Submersible Pump Sumps Tested: 1 Number of UDC Boxes Tested: 2 Number of Fill Sumps Tested: 0 Number of spill boxes Tested: Component Pass Fail Comments T 1 UNL Annular NO TEST WET ANNULAR L1 UNL North Containment Line x L2 UNL S. Containment Line X Tl UNL Line Sump X UDC UNL North X UDC UNL South X Technician's Signature cf7im ~ Date: 10/15/02 SWRCB December 2001 ~ - e Page_of_ " 4. SECONDARY PIPE TESTING Test Method Developed By: Piping Manufacturer X Industry Standard Professional Engineer Other (Specify) Test Method Uses: X Pressure Vacuum Hydrostatic Other (Specify) Measuring Equipment Used for Testing: Dwyer Mark III ';,iii:'i,",,;f¡i§ .i".., i,i·'i , Piping Run #1 UNLN Piping Run #2 UNL S , 'i, .... .'.i'·.·· Piping Material: FIBERGLASS FIBERGLASS Piping Manufacturer: Smith Smith Piping Diameter: 3" 3" Length of Piping Run: 50" 50" Product Stored: UNL UNL Method and location of 3X2 BOOTS 3X2 BOOTS piping-run isolation: Wait time between applying pressure/vacuum/water and lOMIN lOMIN starting test: Test Start Time: 235 235 Initial Reading (R): 5.00 PSI 5.00 PSI Test End Time: 335 335 Final Reading (Rp): 5.00 PSI 5.00 PSI Test Duration: IHR IHR Change in Reading (Rp-R(): 0 0 PasslFail Threshold: 0 0 Test Result: PASS PASS Comments - (include information on repairs made prior to testing) SWRCB December 2001 "' .,-., - e Page_of_ .~ 5. SUBMERSIBLE PUMP CONTAINMENT SUMP TESTING Test Method Developed By: Sump Manufacturer X Industry Standard Professional Engineer Other (Specify) Test Method Uses: Pressure Vacuum X Hydrostatic Other (Specify) Measuring Equipment Used for Testing: INCON STS " ';"':, :,i : : 'i " Sump #1 RU Sump Diameter: 44" Sump Depth: 36" Sump Material: FIBERGLASS Height from Tank Top to Highest 20" Piping Penetration: Height from Tank Top to Lowest 22" Electrical Penetration: Condition of sump prior to testing: Fair Portion of Sump Testedl 2" ABOVE HIGH PIPE Does turbine shut down when sump sensor detects either product YES or water? Turbine shutdown response time2 @5SEC. Is system programmed for fail-safe YES shutdown? Was fail-safe verified to be NO operational? Wait time between applying 30 MIN pressure/vacuum/water and starting test: Test Start Time: 312/327 Initial Reading (R¡): .8406/.8414 Test End Time: 327/342 Final Reading (Rp): .8414/.8417 Test Duration: 15MIN X 2 .. Change in Reading (Rp-R¡): +.0008/+.0003 Pass/Fail Threshold: .002"/15MIN Test Result: PASS Was sensor removed for testing? YES Was sensor properly replaced after YES testing? Comments - (include information on repairs made prior to testing) I If the testing method does not test the entire depth of the sump, specify how much of the sump was tested. Methods not testing the entire sump should only be used if the monitoring system provides fail-safe turbine shutdown. 2 With the submersible pump running, place the sensor in product (discriminating sensors should also be placed in water). The time between placing the sensor in product and the turbine shutting down is the response time. This should be done if the secondary containment testing method used does not test the entire volume of the sump. SWRCB December 2001 ~ e e Page_of_ / '" Test Method Developed By: UDC Manufacturer X Industry Standard Professional Engineer Other (Specify) Test Method Uses: Pressure Vacuum X Hydrostatic Other (Specify) Measuring Equipment Used for Testing: INCON STS "i':"~~' ,..' .' .,.' ,'. . UDC #IUUNL UDC#2 DSL UDC Manufacturer: Total Containment Total Containment UDC Material: Plastic Plastic UDC Depth: 22" 22" Height from UDC Bottom to 7" 7" Highest Piping Penetration: Height from UDC Bottom to 12" 12'" Lowest Electrical Penetration: Condition of UDC prior to GOOD GOOD testing: Portion ofUDC Tested' ENTIRE BOX ENTIRE BOX Does turbine shut down when NA NA UDC sensor detects either product or water? Turbine shutdown response NA NA timé Is system programmed for fail- NA NA safe shutdown? Was fail-safe verified to be NO NO operational? Wait time between applying 30 MIN 30 MIN pressure/vacuum/water and starting test: Test Start Time: 160211641 160211641 Initial Reading (R(): .9409/.8526 .9581/.9341 Test End Time: 1617/1656 1617/1656 Final Reading (Rp): .9392/.8522 .9580/.9340 Test Duration: 15 MIN X 2 15 MIN X 2 Change in Reading (Rp-R(): -.0017/-.0004 -.0001/-.0001 PassIFail Threshold: .002/15 MIN X 2 .002/15 MIN X 2 Test Result: PASS PASS Was sensor removed for YES YES testing? Was sensor properly replaced YES YES after testing? 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Comments - (include information on repairs made prior to testing) REPLACED DOORS ON UDC AFTER FIRST TEST DUE TO INCREASED WIND. WAITED @ 10 MINUITES AFTER REPLACING DOORS TO START SECOND TEST ( If the testing method does not test the entire depth of the UDC, specify how much of the UDC was tested. Methods not testing the entire UDC should only be used if the monitoring system provides fail-safe turbine shutdown. 2 With the submersible pump running, place the sensor in product (discriminating sensors should also be placed in water). The time between placing the sensor in product and the turbine shutting down is the response time. This should be done if the secondary containment testing method used does not test the entire volume of the UDC SWRCB December 200 1 :1:f ~ 11]:f :.tleJI~I:l.~ ¡::at: It....'"l~.. ¡leU · 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 Addréssed to: US POST OFFICE 5601 STOCKDALE HWY BAKERSFIELD CA 93309 I \.~- p.JI~/:JIf~I::al:Il...."t::t"IW~..NE'}!!!!~A1J;:I~~· o Agent X '0 Addressee B. BecXi~ed bv+frinted N.ame) C. ~a¡e of ~elivery ". fVlÐÌ5t1'r7,; èJ1 (ð f<r ~ D. Is delivery address differentfrom item 11 0 Yes If YES, enter delivery address below: 0 No -j 3. Service Type o Certified 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 2. Article Number 9 411 7002 2410 0002 1974 , ugust 2001 Domestic Return Receipt 2ACPRI-D3-Z-D985 . - dress and ZIP+4 in this box · · Sender: Please print your name, ad , UNITED STATES POSTAL SERVICE II II First-Class Mail . Postage & Fees Paid USPS Permit No. G-10 BAKERSF~ElD FIRE DEPARTMENT OFFiCE: OF ENVfRO~.JMENTAl SERVICES 1715 Chester Avenue, SUZ~ 3!Jû D~~0rn¥i81d, CA £0Zû1 J ru CJ CJ Return Reclept Fee CJ (Endorsement Required) CJ Restricted Delivery Fee ,..:¡ (Endorse, ::T' i ru Total F ,..:¡ ,..:¡ ::T' IT' ::T' I"'- IT" ,..:¡ ru Sent To, o I o I"'- sfñiëï.; or PO I ëiiÿ,·ši..._, ' "0 F'F i C't J\,l Postage $ Certified Fee Postmark Here US POST OFFICE 5601 STOCKDALE HWy BAKERSFIELD CA 93309 :n . " Certified Mail Provides: (8SJ8"8I:i)_'~~~~:~~0;;,~~¡:~~ II A mailing receipt iii A unique identifier for your mail piece II A record of delivery kept by the Postal Service for two years Iml'ortant Reminders: Q Certified Mail may ONLY be co.roJ;¡ined with First·Class Mail", or Priority MailQJ iii Certified Mail is not available for any class of international mail. 13 NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. iii For an additional fee, a Return Receipt may be requested to provide proof of delivery, To obtain Return Receipt service, prea5e 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 receive a fee waiver for a duplicate return receipt, a USP8® postmark on your Certified Mail receipt is reqUired. 9 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 "Restricted7Jelivery". g 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: Save this receipt and present it when making an inquiry. Inlernel access to delivery information is not available on mall 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. ENVIROHMENTAJ. SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 32€H0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAJ( (661) 32€H0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 32&3951 FAX(661)326~76 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 . e .. t ' . ~~ -.. February 13,2003 us Post Office 5601 Stockdale Hwy Bakersfield CA 93309 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 October 16, 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 pennit to operate. Failure to repair and re-test will result in the revocation of your pennit to operate. Should you have any questions, please feel free to contact me at 661- 326-3190. sin;LcerelY. .I' riilÆJ' I - .- , .- . , " I Steve UndeIWood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/dc ~~ 7~ de W~ .¥'tye .AOPe .r~ .A W~~" 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' ENVIAOIIIlEHTAL 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 Chesler 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 -- M January 22, 2003 uS Post Office 5601 Stockdale Hwy Bakersfield CA 93309 RE: Upgrade Certificate & Fill Tags Dear Owner/Operator: Effective January 1,2003 Assembly Bill 2481 went into effect. This Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your window) and the blue fill tag on your fill. You may, if you wish, have them posted or remove them. Fuel vendors have been notified of this change and will not deny fuel delivery for missing tags or certificates. Should you have any questions, please feel free to call me at 661- 326-3190. SBU/dc ~~7~ de W~ 37OP.A0P6 .r~ A W~" Dmplete items 1, 2, and 3. Also complete km 4 if Restricted Delivery is desired. :... ~Þrjnt your name and address on the reverse '" so that we can return the card to you. /J Attach this card to the back of the mailpiece, or on {he front if space permits. 1. Article Addressed to: ( US POST OFFICE ¡ 5601 STOCKDALE HWY ! BAKERSFIELD CA 93309 .Si~nt' ~ ". . --&gent X 0 Addressee B·ftäì;:;~inß~m~ C, B t of Ôlìve~ D, Is delivery address different from item 0 Yes If YES, enter delivery address below: 0 No "'\ I 3. Service Type o Certified 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 ~ Artit"'.IA t\lIlmhor 7002 0860 0000 1641 6018 PS Form 3811, August 2001 Domestic Return Receipt 102595,02,M,0835 ,e I '. ' p First-Class Mail , Postage & Fees Paid USPS Permit No. G-10 UNITED STATES POSTAL SERVICE dd d ZIP+4 in this box · · Sender: Please print your name, a ress, an_ í @ß.&{Ef1~F~ElD FIRE D/EPAR11ìIìfENT ( :'i":'¡(;Ë OF ENVIRONMENTAL SERVICES ~n!5 Ùhaster Avenue, S. 300 Bakersfield, CA 93301 1':'; ILl lillI/wI 1111" ,11,1 I ,I ,I "I/III"IIII'I! ,III I,' ,I," 11,1 c[J r-'I c:J ..D r-'I .::t' ..D r-'I c:J c:J c:J c:J A L Postage $ Certified Fee c:J Return Receipt Fee ..D (Endorsement Required) c[J Restricted Delivery Fee c:J (Endo ru Total I c:J c:J Sentl US POST OFFICE I"- š;;ëëi,' 5601 STOCKDALE HWY or PO BAKERSFIELD CA 93309 CIty, SL",---- 1=J.....~f:f.T._.~5J.IIT..¡¡. u s Postmark Here =l......,..... ..--..--.... ~ ~·~"-a.......,.r""'-"'....r..:>.ra""."- Certified Mail Provides: .. A mailing receipt III A unique identifier for your mailpiece II A signature' upon delivery .. A record of delivery kept by the Postal Service for two years Important Reminders: II Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. .. Certified Mail is not available for any class of international mail. II NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. III 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 mailpiece "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". .. 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 nJlfl, detach and affix label with ~ge and.mail. IMPORTANT: S.is receipt and present it when making an inquiry. PS Form 3800, April 2002 (Reverse) 102595·02-M·1132 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 21 01 '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' EIMROHIIEIITAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX(661)32~576 PUBLIC EDUCATION 1715 Chester Avè. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 32~576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAJ( (661) 326"()576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399·5763 - . -> .} fiÞ- ..,. j\;' January 13,2003 us Post Office 5601 Stockdale Hwy Bakersfield CA 93309 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 October 16, 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. Sincerl. ~~ Steve Underwood Fire InspectorÆnvironmentaI Code Enforcement Officer Office of Environmental Services SBU/dc ~"Y~ de cp~ 370P ~0P6 .r~ A W~" ------- U,S.POSTAL SERVICE 560.1 STOCKDALE HWY BAKERSFIELD CA.93309 661-834-8343 DEC 1 O. 2002 4: 08 Pf"¡ - - - - - - - - - - - - SYSTEf"¡ STATUS REPORT ALL FUNCTIONS NORMAL INVENTORY REPORT T 1: UNLEADED l, VOLUME '" 2250 .' i ULLAGE '" 9377",' _' 90.% ULLAGE", 8214 '('ÃL ' TC VOLUf"¡E '" 2247 G HEIGHT 23.43 INCHES WATER 0.00 INCHES TEMP 77.6 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ U.S. POSTAL SERVICE 5601 STOCKDALE HLvY BAKERSFIELD CA.93309 661-834-8343 DEC 10.. 20.0.2 4:08~ - - - - - - - - - - - - SyBTEM STATUS REPORT ALL FUNCT I ONS NOR~1AL INVENTORY REPORT T 1: UNLEADED VOLUME ULLAGE 90?i ULLAGE", TC VOLUf"¡E HEIGHT WATER TEMP I. 2250 GALS 9377 GALS 8214 GALS 2247 GALS 23.43 INCHES 0.00 INCHES 77.6 DEG F ~ ~ ~ ~ ~ END ~ ~' ~ ~ ~ e . FACILITY NAME ADDRESS 5(n() ( ,7t()cJialL FACILITY CONTACT INSPECTION TIME CITY OF BAKERSFIEl..D FIRE DEPARTMENT OFFICE OF ENVIRONMENT AI.. SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Hoor, Bakersfield, CA 93301 C INSPECTION DATE-lJ -LO- Ð7- PHONE NO. ~34" ~c:rne;- BUSINESS 10 NO. 15-210- NUMBER OF EMPLOYEES c:¿s Section I: Business Plan and Inventory Program o Routine [1J1::ombined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS ~ " Appropriate peonit on hand / Business plan contact ¡nfoonation accurate l V , L l/ Visible address Correct occupancy l V Verification of in veri tory materials \ lJ . Verification of quantities \ / Verification of location 'v / Proper segregation of material L.. / Verification of MSDS availability l // Verification of Haz Mat training - V Verification of abatement supplies and procedures f. V Emergency procedures adequate 1/ Containers properly labeled I........ Housekeeping 1/ Fire Protection V Site Diagram Adequate & On Hand 1/ Pink - Business Copy C=Compliance V=Violation Any hazardous waste on site?: Explain: o Yes If! No Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs. Yellow· Station Copy Inspector: - CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 F ACIUTY NAME~{)(~Ut _ POðt C.ç..Ç[<:'L INSPECTION DATE-IJ. -(0 ~ 0 è Section 2: Underground Storage Tanks Program o Routine ~Combined 0 Joint Agency Type of Tank l{)uH;; Type of Monitoring ('/~fiI\ o Multi-Agency 0 Complaint Number of Tanks I Type of Piping lJùJ F ORe-inspection OPERA nON C v COMMENTS Proper tank data on tile L- V Proper owner/operator data on tile L.- V Pennit fees current l V Certification of Financial Responsibility ~ V Monitoring record adequate and current t..- ~ Maintenance records adequate and current / / Failure to correct prior UST violations ./ Has there been an unauthorized release? Yes No Å / - Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGA TE CAPACITY Number of Tanks OPERA TION 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=Compliance V=Violation Y=Yes N=NO ¡n'redO' ,/I;, (at1HM-O Oftice of Environmental Services (805) 326-3979 White - Env, Svcs, Pink - Business Copy ---------- ~:;;;4/2002 16:19 76075J11t9 TANK TECH 1VRT4IIt ~ OCT 1. 2002 1.;58 BKBFLD FIRE PREVENTION (881}852~2172 PAGE 01 p.l i\íl^J,' ~r~~ LJ µ ~~W()ð à ~-OLo;;( CITY.OFBAKERSFlELD þ~~^-~. OFFICE OF ENVIRONMENTAL SERVICES . 1715 Cbester Ave., Bakersfteld, CA (661) 3Ui-397t, APPLICATION TO PERFORM A TANK TIGHrNBSS TESTI SECONDARY CONTAINMENT TESTING FACIUI'Y l) 7 r:~o So T ð f' (I LC ADDRSSS ~~o, ~"fl'C.~~~~'1 PBRMITTO OPBIATB, OPBRATOUNAMB '-' ~ PUS T 0 fÇ-' cr~ OWNBRSNAMB U? Po? 'r~k 4~ ~-c:... NUMBD OP TANJCS TO BE Tæ'I1Ð IS PIPING OOJNG 1'0 BE TBSTBD--"':" TANK 41 VOUIMB CONI'BNTS ~ L 6t~ TANX TESTING COMPANY"'" 0 t---J"\ ':rD "Y-A-", '" :I t; L '" MAILINO ADDRBSS-.e..ð \?;t) Y- 406 n ~ MM I () ~ (,-1 NAMB" PHONBNtJMBSt OP CONTACT PERSON -r\ tI\ MO ~ "'\ J"' Ù & ( ~ 1~' 1~ 1 "Z. T.BST MBJ1IOD ~ ~ LO ~ S'T ~ ... NAMB œTBSTBR OR SPBCJAI..INSPBCTOR ""}\ M.. M ê) fI.J 1:' I ~.-,) C8RTlPlCATION t. Dr, 'ò ... \ Ù <)ù DilTS l TDŒ TEST IS TO BB CONDUCTBD-1.Q.:; l5· 2 ~ M . .Jt:l/JdllrlD fo",,,n?.. ~4--- APPROVBDBY DATB A11J'1æOP ANT \ \ · 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 maìlpiec~, or on the front if space permits. 1') 1. Article Addressed to: US POST OFFICE 5601 STOCKDALE HWY BAKERSFIELD CA 93309 2. I ^....:.....I..... 1\1.........1-........ , x B. . i .Ii.'_.t~_..._~ .-... D. Is delivery address different from item 1? If YES, enter delivery address below: 3. Service Type 1tI Certified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise OC,O.D, 4, Restricted Delivery? (Extra Fee) 7002 0860 0000 1641 7190 PS Form 3811, August 2001 Domestic Return Receipt DYes 102595-02,M,0835 UNITED STATES POSTAL SERVICE e First-Class Mail Postage & Fees Paid USPS Permit No. G-10 dd" and ZIP+4 in this box · · Sender: Please print your name, a ress, ~.' BAKERSFIELD FIRE DEPARTh!J!ENT OFFICE OF ENVIRONMENTAL SERVICES ~1~5 Chea~øi" AVMU3, Suite 3DO B&t\em~~:e~ CA 003û~ 11111111111111111\1111111\ 111111 t:J Ir ,..:¡ I'- I A-~ ~ t:J t:J t:J t:J Postage $ Certified Fee Retum Receipt Fee ~ (Endorsement Required) <:() RestrIcted Delivery Fee t:J (Endorsement Required) Total Postage 8. Fees $ Postmark Here ru t:J t:J Sent To I'- US POST OFFICE ši;;,ë¡;Äi;i:Ñõ:r·...····5··6··o··1··š·Tõ~~ÄLË···iiWŸ··....................... or PO Box No. ëi,ÿ,·šiãië,ž¡¡;;:¡-·····iiÄiËišFÏËiñ..ëÃ···93·3Ö9"·····........·..···· 1:¡;'"tI;rnr.;wc~".lIn1' ~:1.q,'.!~..."1;,!!m!!!~mR~!:.."!=-~ Cer\itied Man Provides: \11 A mailing receipt \11 A unique identiiier for your mailpiece II A signature upon delivery \11 A record of delivery kept by the postal Service for two years Important Reminders: \11 Certified Mail may ONLY be combined with First·Class Mail or Priority Mail. ø certified Mail is not available for any class of international mail. III NO INSURANCE COVERAGE IS PROVIDED with certified Mail. For valuables, please consider Insured or Registered Mail. Ii 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 lPS 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. 1\ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent. Advise the clerk 9r mari'othe mailpiece with the endorsement "Restricted Delivery". --- \11 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. IMPORlAM.e this ""ipl and p....nl . ""en making an in,oll'. PS Form 3800, April 2002 lReverse) 102595-02-M-1132 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 FIRE SAFETY SERVICES' ENYIRONIlENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 PUBUC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-D576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 . . , ~ -~, ,¡;:o October 21, 2002 us Post Office 5601 Stockdale Hwy Bakersfield, CA 93309 CERTIFIED MAIL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to SubmitlPerfonn Annual Maintenance on Leak Detection System Dear Underground Storage Tank Owner: Our records indicate that your annual maintenance certification on your leak detection system is past due on October 25, 2002. You are currently in violation of Section 2641 (J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days, November 25, 2002, to either perfonn or submit your annual certification to this office. Failure to comply will result in revocation of your pennit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services bY~ dIkü Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services cc: Walter H. Pore Jr., Assistant City Attorney ~"7~ de W~ ~.A0P6.r~ .A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oH· Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' ENVIRONIŒHTAL 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 711 -\' September 30, 2002 US Post Office 5601 Stockdale Hwy Bakersfield CA 93309 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31,2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). Senate Bill 989 became effective January 1,2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last five months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perfonn 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 perfonn this test, by the necessary deadline, December 31, 2002, will result in the revocation of your pennit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. sinYidkv Steve Underwood Fire Inspector/ Environmental Code Enforcement Officer Office of Environmental Services ~"7~ de W~ ~OP .A0P6 ff~ .Æ W~" 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 FIRE SMm SEIMCES. ENYIIIONIlENTAI. SEIMCES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 326H0576 PUBLIC EDUCATION 1715 Chester Avè. Bakersfield, CA 93301 VOICE (661) 326·3696 FAJ( (661) 326H0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 - .~~ D August 30, 2002 us Post Office 5601 Stockdale Hwy Bakersfield, CA 93309 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31,2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perfonn 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 perfonn this test, by the necessary deadline, December 31, 2002, will result in the revocation of your pennit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Si71-cJkv Steve Underwood Fire Inspector/ Environmental Code Enforcement Officer Office of Environmental Services ""7~de W~ ~.A0n3.r~ A W~'., FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES. ENVIRONMENTAL SERVICES 1715 Chesler Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3696 FAJ( (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 1Þ -\ July 30, 2002 us Post Office 5601 Stockdale Hwy Bakersfield CA 93309 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31,2002 of Underground Storage Tank (s) Located at the Above Stated Address. Dear Tank Owner I Operator: If you are receiving this letter, you have not vet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). Senate Bill 989 became effective January 1,2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perform this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perform this test, by the necessary deadline, December 31, 2002, will result in the revocation of your permit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. sin;t~ Steve Underwood Fire Inspector Environmental Code Enforcement Officer "-7' Y ""7~ de W~.¥OP.A0P6 .¥~ ..Æ W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAJ( (661) 395-1349 PREVENTfON 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 ;It e\ June 30, 2002 United States Post Office 5601 Stockdale Hwy Bakersfield, CA 93309 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 5601 Stockdale Hwy. Dear Tank Owner / Operator: The purpose of this letter is to infonn you about the new provisions in California Law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1,2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary . containment until they are detected and removed. Secondary containment systems installed on or after January 1,2001 will be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1,2001 will be tested by January 1,2003 and every 36 months thereafter. RE:MEMBER! Any component that is "double-wall" in your tank system must be tested. Secondary containment testing shall require a pennit issued thru this office and shall be perfonned by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perfonn this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at (661)326-3190. Si~t14v Steve Underwood Fire Inspector/ Environmental Code Enforcement Officer Environmental Services SUIkr ~~7~ de W~ ~l?P ~0P6 .r~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 21 01 'H" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661)395·1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAJ( (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ( (661) 399-5763 e .~ May 30, 2002 United States Post Office 5601 Stockdale Hwy Bakersfield, CA 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 on Underground Storage Tank(s) located at 5601 Stockdale Hwy., Bakersfield. Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1,2000. This bill requires dispenser pans under fuel pump dispensers. On December 31,2003, which is the deadline for compliance, this office will be forced to revoke your Pennit to Operate, for failure to comply with the regulations. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at (661)326- 3190. Sin1t~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SBU/kr ~~7~ de ~~ çtye.A0P6 .r~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 MHo Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 MHo Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326·3951 FAJ( (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 'e' .~ April 12,2002 US POST OFFICE 5601 STOCKDALE HWY BAKERSFIELD, CA 93309 Re: Enhanced Leak Detection Requirements REMINDER NOTICE Dear Owner/ Operator, The purpose of this letter is to remind you about the new provision in California law requiring periodic testing of the secondary containment of underground storage tanks. Your facility has been identified as not having secondary containment on at least one of your underground storage tank components and as such falls under section 2637.(1) of the California Code of Regulations, Title 23, Division 3, Chapter 16; As an alternative, the owner or operator may submit a proposal and workplan for enhanced leak detection to the local agency, by July 1, 2002; complete the program of enhanced leak detection by December 31, 2002; and replace the secondary containment system with a system that can be tested in accordance with this section by July 1, 2005. The local agency shall review the proposed program of enhanced leak detection within 45 days of submittal or re-submittal." Please be advised that there are only a few qualified testers available to perfonn "Enhanced Leak Testing". All testing must be under-pennit through this office. For your convenience, I am enclosing a copy of the code as a reference. Should you have any additional questions or concerns, please feel free to call me at (661)326-3190. Sincerely, Ralph Huey Director of Prevention Services bY:Jk rt4J Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SU/kr Enclosures ~"7~ de W~ 370/".A~ .r~ A W~" FIRE CHIEF RON FRAZE_, ADMINISTRATIVE SERVICES 2101 MHo 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,.§.ERVICES 1715 Chester Ave. 'Bakersfield, CA 93301 VOICE (661) 326-3979 FAJ( (661) 326-0576 TRAINING DfVISfON 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661)399-4697 FAX (661) 399-5763 .. a,~ ....,..\ h_ ,~______ _._. February 1 t~ 2002 , --- us Post Office 5601 Stockdale Hwy Bakersfield CA 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 . -, . .. . .. . REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1,2000. 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 Pèimi(to operáte', for failure to comply with thë' -, , 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 toretro-fit your facilities'h hh -- If your facility has been upgraded already, please disregard tI;1Ìs notice. Should you have any questions, please feel free to contact me at 661-326- 3190. Sincerely, A·'-~l . , . ' . . - " '.- .- ..- / . ~ . Steve Underwood Fire Inspector/Environmental Code Enforcement Officer , Office of Environmental Services SBU/dm ""7~ de W~ ~.A0P6.r~ A W~" U . S . POSTAL SER\/ I C. 5601 STOCKDALE HklY BAKERSFIELD CA.93309 661-834-8343 DEC 21. 2001 8:53 AM SYSTEM STATUS REPORT ------ ALL FUNCTIONS NORMAL INVENTORY REPORT T 1: UNLEADED \/OLUI"1E ULLAGE 90% ULLAGE= TC VO L U~1E HEIGHT l.,IATER TEl"lP 4728 6899 5736 4722 39.45 0.00 76.4 GALS GALS GALS GALS IalES I_ES [,t:.l~ 'F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ .' CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITYNAME~Cc..k. £.s.+ l}Úlct INSPECTION DATE~ Section 2: Underground Storage Tanks Program o Routine tØ Combined 0 Joint Agency Type of Tank .f):.J.JF Type of Monitoring ël-lJ.-\.. o Multi-Agency 0 Complaint Number of Tanks ( Type of Piping (JiJF ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile L/ ~ Proper owner/operator data on tile 1/ v Penll it fees current ",- V Certification of Financial Responsibility V ./ 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) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA nON Y N COMMENTS SPCC available SPCC on tile with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispcnse MVF? If yes, Does tank have overfill/overspill protection? C=Compliance Y=Yes N=NO . Business Site Responsible Party Inspector: Office of Environmental Services (805) 326-3979 White - Env, Svcs, Pink, Business Copy -- . CITY OF BAKERSFIEI..D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd f'loor, Bakersfield, CA 93301 INSPECTION DATE 1'J.!91!lJl PHONE NO. ~jC¡'" 6>QO'S BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES <60 FACILITY NAME~~~kL.L ¡(l${- () f-6.: ADDRESS Çb 0 I ~f ltdt tlu--'r FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program o Routine ~ Combined D Joint Agency D Multi-Agency o Complaint D Re-inspection OPERA TION C V COMMENTS Appropriate permit on hand / ~ Business plan contact information accurate V Visible address / '- Correct occupancy l I Verification of inventory materials V / Verification of quantities G I Verification of location ( / Proper segregation of material t / Verification of MSDS availability L / Verification of Haz Mat training ,C / Verification of abatement supplies and procedures L / Emergency procedures adequate \ /. Containers properly labeled L / Housekeeping \.. / Fire Protection I\.... ) Site Diagram Adequate & On Hand l,.. I C=Compliance V=Violation Pink - Business Copy ( Any hazardous waste on site?: Explain: DYes ~o Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs. Yellow· Station Copy Inspector: ..#' ."- . . ~. . ~au I, - ~~v ~,~ ~!"""'- .. BSSR, Inc. . 6630. Rosedale Hwy., # ~akersfield, CA 9330.8 Phone (661) 588- 7 Fax (661) 588-2786 MONITORING SYSTEM CERTIFICATION, This form must be used to document testing and servicing of monitoring equipment., A separate certification or reJ>ort ,must be,. prepared for each monitoring system control panel by the tecbnician who performs the work. A copy, of this fOrIn111ust be provided to, the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems wi~30 day~, of test date. A. General Information Facility Name: 0....'5, PÔ~M:'-' .sCtt.\hc.,€ Site Address: 51øot Sn:>c...k.D4l'z tlwJ Facility,Contact Person: £./AlD;f COp'", MakeIModel of Monitoring System: Va=1JEA.0c í ' 'Tt.s .3SÞ B. Inventory ofEquipinent 1?èstedlCertified '; Cbeck,the a ro riate boxes to Indicate 5 eclfic e ul ment Ins ectediserviced: Bldg; No.: City: ßAt:.Q.l''<''-A.~ Zip: q 350C¡ Contact Phone Nç.: ((obI,) fl.3t": ¡~Y3 -F'bfi¡7,to -o~2. Date ofTestinwServicing: !..!:-! 2"51 ðJ . Tank lD:\ '1:- VAlLePtlH!!D Tank ID: ÍlQ In-Tank GaugingProbe. ,~Model: 1/Yf290 -(;>07 Q In-Tank Gauging Probe. Model: 00 Annular Space or Vault Sensor. C~op~I:/i:1,O;:::' Q Annular Space or Vault Sensor. Model: IJJ Piping Sump I Trench Sensor(s). VA. Model: () 7q Y. 3fo ~'2.o 'S' Q Piping Sump I Trench Sensor( s). Model: o Fill Sump Sensor(s). Mode]: !!J Fill Sump Sensor(s). Modèl: o Mechanical Line Leak Detector. Model: Q Mechanical LineLeak Detector. Model: Q Electronic Line Leak Detector. Model:Q'Electronic Line Leak Detector. Model: Ò Tank Overfill I High-Level Sensor. Model: Q Tank Overfill I High-!-evel Sensor. Model: Other s ecifeiilÏnente and mode] in Section:Ebn Pa e 2. 0 Other, s eci e' ui ment e and model inSectionE on Pa e 2 , Tank ID: Tank ID: o In-Tank Gauging Probe. Model: Q In-Tank Gauging Probe. Model: Q Annular Sp!lceor~Y'au1t Sensor, Model: ,Q Annular Space <;>1' Vault Sensor. Model: o P~ping r~~l1?p. tTr~nch ~ensor(s). Model: Q Pipipg Sump I Trench Sensor(s). Morlel: Q PIli Spmp'Sensor(s),' \ Model: Q FjllSump Sensor(s). Mode]: o Mechanical Line Leak Detector. Model: Q"Mechanical Line Leak Detector. Model: o Electronic Line Leak Detector. Model: . (, ; Q ';ßlec:tronic LineLeak Detector. "Model: o Tank Overfill/ High-Level Sensor. Model: Q Tank Overfill/ High-Level Sensor. Model: Q Other s ècif ui ment e and model in Section Eon Pa e 2 . Q Other s cjf1 ui ment and model in Section E on P e 2 . Dispenser ID: ? I \)øJl Dispenser ID: Q Dispenser Containment Sensor(s). Model: a Dispenser Containment Sensor(s). Model: ¡¡¡ Shear Valve(s). ÞL:'SJ.u,~:>e.R. 'At-''' a Shear Valve(s). o Dis enser Containment Float s and Chain s . 0 Dis enser Containment Float s and Chain s . Dispenser lD: -1l'.2. UIoJL. Dispenser ID; o Dispenser Containment Sensor(s). Model: Q Dispenser Containment Sensor(s). Model: Gif Shear Valve(s).Þl.bf4.,s:sgQ. p".AJ Q Shear Valve(s). Q Di enser Containment Float s and Chain s . a Dis enser Containment Float s and Chain s . Dispenser ID: Dispenser ID: a Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model: o Shear Valve(s). Q Shear Valve(s). ODis enser Containment Float s and Chain 5 . Q Dis enser Containment Float s and Chain s . ·Ifthe facility contains more tanks or dispensers, copy this fonn. Inclùde infonnation 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' guidennes. Attached to this Certifica~on is information (e.g. manufacturers' checklists) necessary to verity that this Infotmation is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such .. re~~rts. I have al~o attå~ed a copx of tbe ~port; (check all thm apply!: '(;;it S~ .¥t-qp !SIr AlarJq.lýs~ry report TechnIcian Name (pnnt): bðf,ll:a «, .' \ () " SIgnature: ~V CCt1.L!Å.l...() certificationNo.:~a~' ,',' ,License. No.: l.P12~'2... Testing Company Name: ", . ," Phone No.:{ tole ( ) 5~~-2..'l(+ Site Address:let ().' '.' I O~ fJ'1 Date of Testing/Servicing: 1..Qj ~'5/-º-l- Page I od /1 Monitorbìg System Certißcation l C:bPL{ 4v Thsp~d-ov UM(Wocd, 03/01 3'1211 ~ ........ D; Results ofTestinglServicing . . Software Version Installed: tÞ/~ 1"0 .-ooJ-() Con¡ Jete the (ollowin checklist: j1 YêSONo* Istheaudiblealárm 0 erational? iii Yes o No· ls"the visual alarm 0 erational? Yes Q No· Were all sensors visuall ins ected 'functionall tested and confnmed 0 erational? ail Yes 0 No· Were al1 sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ro er eration? If alarms are relayed to a remote monitoring station, is all communicatio~s equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatical1yshut dOVl'n,ifthepiping secondary containment monitoring'system detects' a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all tho/apply) a Sump/Treµch Sensors; a Dispenser Containment Sel1sors. Did ou confnm ositive shut-down due to leaks and sensor failure/disconnection? a Yes' CJ No. Q es ~ No· For tank systems that utilize the monitoring system asthê primary tank overfill warri:ing device (i.e. no 0' N/A mechaIÙcal overfil1 prevention valve is installed), is the oveñlllwarri:ingiå1arm vislble, and audible at the tank fill in s and 0 eratin ro rl 1 If so at what rcentof tank ca aci does the alarm tri er?' '6 % Q Yes· tSr No Was any.monitoring equipment replaced? If yes, iaentify speCific ,sensors, proþes, or other equipment replaced and list the manufacturer name and model for all,r lacement, artkin Section E 'below. Was liquid found inside any secondary conÞùnmentsystems designed asdry systems? (Check all that apply)" a Product; 0 Water. If es desçn"be causes in Section E below. Q( Yes 0 No· Was monitorins stemset-u reviewed tò ensure ro er settin s1 Attach set u Jir Yes a No· lull monitorlh e ui mento eiationål er manufacturer's secifications? * In Section Ebelow, describe bow arid when these deficiencies were or will be corrected. . r. o Yes a No· IiJ NI A DYes. a No· . "IÌI 'NlA a Yes * ~ No 1ìcable . E. Comments: S~6r~ , is,. o Vet" 17 t.{.. ,q{A¡Qp, /.s /9-r :5í Ië ÐoeE:. ~ve. ¡1ft . :5cJGf"IOÞ.J ;ll>o,Jc:r (...,~eS' Wl'~ (2.) nl.lMP.$· r f /J? rVI/,r(),g.'~9 s'Is.réA< /IIIS I.~ i¥' ()¡.:::p¡{.Æ - 10." ovV'ttt<. IJN...l''? ~o.J JA-lùe A'T ¡::'·L.LJ f . A4A.J.o.y Page 2 ofll y 03/0 I :Y1Zí] ""Ii:. ~ffl.- ~an~ Gauging / SIR EqUiP.nt: ail Check this box iftank.ging is used only for inventory control. D Check this box if no tank gauging or SIR equipment is installed. ~is secÎionmust be completed if in-tank gauging equipment is used to perform leak detection monitoring. , \, ,..:-.. ':." Comolete the followin2 checklist: \ - \ lit Yes ' ONo* . Has all input wiring been inspected for proper entry and termination, including testing for ground faults? 01 Yes o Nq,· Were all tànk gauging probes visually inspected for d~age and residue buiidup?\ . ~ Yes o No:" Was accuracy of system product level readings tested? ~ Yes a Nò· Was accuracy of system water level readings tested? J œJ Yes o No· Were all probes reinstalled.propërly? >.~ :tÞ-i II Yes o No· Were an items on the equipment manufacturer's maintenance checklist completed? .. -" ". ¡ * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): \if Check this box if LLDs are not installed. Comolete the fonowiDl~ checklist: o Yes C:J No· For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfonnance? (J N/A (Check all that apply) Simulated leak rate: 03 g.p.h.; (J 0.1 g.p.h; (J 0.2 g.p.h. DYes (J No· D.Yes· D No· a Yes D No* D N/A a Yes a No· D N/A DYes D No· D N/A DYes D No· D N/A a Yes a No· a N/A a Yes a No· Were all LLDs confirmed operational and accurate within regulatory requirements? WI1S the testing apparatµs properly cah"brated? For mechanical LLDs, does the LLD restrict product flow if it detects a leak? For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? , For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ' ',: For elec1ronic LLDs,does the turbine automatically shut off if any..p'Ortion off the monitoring system malfunctions or fails a test? ; -, ,e,;,' ..' , .,_:' . '.' !;,\ ; For electronic LLDs, have all accessible wiring conne~tions been visually~spectèd¡? Were all items. on the equipment manufacturer's maÙ1.tenance cheCklist completed? '" In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: " , . } .; Page 3 of~ Lf 03/01 ~1~11 -'" .:: !i\-~.. . . Monitoring System Certification Site Address: . . . . :T&¢í .....,. Xo. ., . :"i :! .: .. .;;',.. .. ;.'. . ~~ .. v·~· . , . ;;.. '0 . . . . . ~lC.~ I. .\- .\ . ~ .1'- 05 fJÔ:>¡~'S6~cA UST Monitoring Site Plan :S"'bOI 51tH..1<. d"'~ Mdt ß.4.ltu:u~5W . CA- 93<30] : Ji.~I)~.;,,: .,:. . .t; , '~.!;.. . " 7t>' \: '\ . \ ·l . .\ . . \. -I.. . . . .. --:- ". '- . .......: '. ~ 'v~p'" .. .. . . 7' '.... . 4 . .".. . :tJ : /, '. . ' .. " .! . .' ."" . :. If you already have a diagram that. shows aU required infonnation. you may include it. rather than this page, with your Monitoring Systel11 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 (ifused for leak detection). In the space provided, note the date this Site Plan was prepared. . " '. L.._ ...~,.....~ -. .~. . it, _ .-,w· Q"'" w 0', . . 0··'·· . ""0· " . . -, : ! ... .: . ;, -' ~ . . .. .... ....... .. -FIU.·' . . f'«'1Jt¡. . ~I .P/ff"'i . , . .-. .. '" , ~ 'j '. ,. . " . '. " . ... . , . " . , ....: . " . ,: :Œl :~*"'P~ \J~ . O' :~:: Date map was drawn:lO /ZS" / ~I . Instructions Page 4-.r-#- 05100 1ÞJZ,I · J~...,ete 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: x D. Is delivery address diff from item 1? If YES, enter delivery address below: 11 Agent ;:I''Addressee DYes ONo Barbara Bell US PoŠt Office 5601 ßtockdale Hwy '^ ,.11 Bakersfield CA 93309 3. Service Type ~ertified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) DYes 2. Artie e Number (C9PÕ from service labell , 00 15jl 0006 3456 3058 PS Form 3811, July 1999 Domestic Return Receipt 102595-00,M,0952 -- ~AKJE~SF¡ELD F~RE œPAA1M~N'f OFFICE OF ENVIRONMENTAL SERVICeS 1115 Chester Avenue, Suite 300 Bakersfietd. CA 93301 s ~ is Iht\-\'\lltl-,~U\H!H"'" Itllll HI t,l...nUltH\H,lht,l,Il", .. co LI1 Q ITI ..J] LI1 .:r- ITI Certified Fee 2.10 1.50 Postmark Here ..J] Return Receipt Fee t:I (Endorsement Required) t:I Restricted Delivery Fee t:I (Endorsement Required) t:I Total Postage & Fees $ 3 . 94 ITI LI1 Sent To M Barbara Bell t:lši;ëëi;¡¡pi.'¡õ:¡õ¡;¡;ôsõx7¡õ:····························.............................. t:I 5601 Stockdale Hwy t:I ... ...... ......... ............................................................................... ~ ~~B~~é~~field CA 93309 PS Form 3800, May 2000 See Rev' . (IJ .llh~ ~ ~ ~~~ ~ ~~~-~ Certified Mail Provides: £J A mailing receipt !J A unique identifier for your mail piece ¡¡¡ A signature upon delivery E:iI A record of delivery kept by the Postal Service for two years Important Reminders: c 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". iii 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 1aeded, detach and affix label with postage and mail. IMPORTAN~e Ihis receipt and present it when making an inquiry. PS Form 3800, May 20Ô! (Reverse) 102595·00·M·2004 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395-1349 SUPPRESSION SERVICES 2101 'H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661)395-1349 PREVENTION SERVICES 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 FAX (661) 399:5763 '. . .,-...... .' Li ~~f¡¡'..~. October 19,2001 Barbara Bell US Post Office 5601 Stockdale Hwy Bakersfield Ca 93309 CERTIFIED MAIL NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to Submit/Perfonn Annual Maintenance on Leak Detection System Dear Ms. Bell: Our records indicate that your annual maintenance certification on your leak detection system is past due. October 11, 2001. 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, November 19,2001, to either perform or submit yóur annual certification to this office. Failure to comply will result in revocation of your pennit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: ¡£~ Steve UndeIWood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services cc: Walt Porr, Assistant City Attorney ~"7~ de W~ YOP .AOPe.r~ A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 °Ho 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 August 3, 2001 us Post Office 5601 Stockdale Hwy Bakersfield Ca 93309 RE: Deadline for Dispenser Pan Requirement December 31, 2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to Senate Bill 989 which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will be forced to revoke your Permit to Operate, for failure to comply with the regulations. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning to retro-fit your facilities. If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326- 3190. Sincerely, jt~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dm ~"'%"(-'Ú1JI" & ?;~Wl/;lN/U/{/ .,%/~ ._46o......e ..:ør;,/l/ . /'6 Z;;/l.bW,r"" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 SUPPRESSION SERVICES 2101 oH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAJ( (661) 395·1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-D576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAJ«661)399·5763 . "e January 22,2001 us Post Office 5601 Stockdale Hwy Bakersfield Ca 93309 RE: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update Dear Underground Storage Tank Owner: You will be receiving updates from this office now, and in the future with regard to the Senate Bill 989, which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31, 2003, which is the deadline for compliance, this office will be forced to revoke your permit to operate, effectively shutting down your fueling operation. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning now to retro-fit your facilities. If your facility has upgraded already, please disregard this notice. Should you have any questions, please feel tree to contact me at 661-326-3190. sinl d4J Steve Underwood, Inspector Office of Environmental Services SBU/dm "7~ ¿{jg, W~ ~ uØ6on; .r~ A W~" U.S.POSTAL SERVICE 4IJ 5601 STOCKDALE HWY BAKERSFIELD CA.93309 661-834-8343 NOV 29, 2000 2:44 PM SYSTH'1 STATUS REPORT ------ ALL FUNCT I ONS NOR~1AL I N\/ENTOR\{ REPORT T 1: UNLEADED \/OLUl"lE ULLAGE 90% ULLAGE= TC VOLUME HEIGHT WATER TEl"lP 3024 GALS 8603 GALS 7440 GALS 3019 GALS 28.73 I~S 0.00 I S 79.9 DE F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ U.S. POSTAL SERVICE 4IÞ 5601 STOCKDALE HWY BAKERSFIELD CA.93309 661-834-8343 NOV 29, 2000 2:44 PM ------ SYSTEM STATUS REPORT ------ ALL FUNCTIONS NORMAL INVENTORY REPORT T 1: UNLEADED \lOLUt'\E ULLAGE 90% ULLAGE= TC VOLUME HEIGHT l..JATER TEMP 3024 GALS 8603 GALS 7440 GALS 3019 GALS 28.72 INCHEf' 0.00 INCHR 79.9 DEG F ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ ~.. -- e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITYNAME~~l ~ DfW¡ ADDRESS '5(oo~L ___ FACILITY CONTACT INSPECTION TIME INSPECTION DATE t(Þ'l~() PHONE NO. g3lJ'd q es- BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES '10 Section 1: Business Plan and Inventory Program o Routine tá Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate permit on hand V Business plan contact information accurate V Visible address V Correct occupancy V Verification of inventory materials \..,/ V / Verification of quantities Verification of location V Proper segregation of material V / Verification of MSDS availability /' V / Verification ofHaz Mat training Iv Verification of abatement supplies and procedures Iv v / Emergency procedures adequate - Containers properly labeled V Housekeeping v Fire Protection Iv 1/ Site Diagram Adequate & On Hand / C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ~No White - Env. Svcs. Yellow - Station Copy Pink - Business Copy Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 >-.. !~:..~> . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~~.lL p~ D+'lC..~ INSPECTION DATE 1f~{{JO Section 2: Underground Storage Tanks Program o Routine 1!J Combined Type of Tank ,O~ Type of Monitoring o Joint Agency 0 Multi-Agency 0 Complaint Number of Tanks I èt-M Type of Piping JJ{1I F ORe-inspection OPERA nON c v COMMENTS Proper tank data on tile \I Proper owner/operator data on tile J Permit fees current t./ Certification of Financial Responsibility ~ Monitoring record adequate and current V Maintenance records adequate and current J r.lJt(l -Ç.arw£uJ ~ (1"\1 Failure to correct prior UST violations V ' , Has there been an unauthorized release? Yes No J Section 3: Aboveground Storage Tanks Program AGGREGA TE CAPACITY Number of Tanks TANK SIZE(S) Type of Tank OPERATION Y N COMMENTS SPCC available SPCC on tife with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MYF? If yes, Does tank have overfill/overspill protection? C=Compliance V=Violation Y=Yes In'p,,'n, .1:; (/£WÜ Office of Environmental Services (805) 326-3979 White, Env. Svcs. N=NO Pink - Business Copy :~ . ...,. . - --. '-- -- "- a CITY OF BAKERSFIELII Oft"ICE OF ENVIRONMENTAC!ERVICES 1 '71~ Chesrer Ave., Bakenlle.d, CA 93301 (661) 316-3979 s UNDI!RGROUND ITOA,AOI TANKS - UST FACILITY no"'o# ACTIOt ¡o.:a_ ......, c . ...1ITI1IiIJIIWT C J..............,. C ........D IIUMIT o s. QWQI 0' INIOAIMTIOIoI (.....jtIo ..... . .. _ O'II) c .. 1"IJ,ØII01II¡ìA'I' SlTI a.oau_ ~-"'- C 7.~.,c.øSID!IT! C .. T..... MACMlD et L 'ACILI'rY I ...... INPOIUIATION , IIJ . ,. ... r I)¡C/=,(£ f fiN/A c ,. CIAoI ""'11ON 0 ~,..... C I. COIIM!-=aA&. 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AU1Q.......-srOFF...........occua .. ~ «.... '.'. .... ~ "'" o a. MIlO "*'" ØIf"" fIat.........".,,,u,. Mm"""'..".( r .~J1O'" C"JCÞAUtO.........,..OW ..,...,~ ,.¡,...'...~ .' ".....' '1.':~.' " ~.~~~.. ".0 .:$ .. o n. ~......c)&._,~ ~ C,a.~...~~ftØ~~ : ." ~I~~~ C t~ cø.m1Ø.~....·--..---.~ '~ lI!IIIiiØIII'-:-i"Q~"'ONL~af-"" .~ C t'" CiDI'ß'IdIUI'" ...-JlDllllIMltDNIP.....OIIf' ..-.,.--, --- ' C t.. AUTOAM11CLØlUWt~lU"'1IST) , ' '''. . ....,C!DIØ'......" C t. NMT AC" .J..1MØ""'-'!Ø"~ .TI...... . C.. ODNMØ.....4.Mr,...--·---MD.....~ N'ID~~ o a.;;;,aø--..ilI;-;:...-------.- = _ : == ~ ..___~ ..~~~"'1UM ;....:...-¿ -...-;-...-....... _,,,' . ~~ _ , "..d. 'J....~ e; . ~'?7-t: t:f¿;f ~ {!) ~ C'f C l4lrfC ~ (111) c .. ...,......~ o ...~.....,...J.....- ....... '.. : S:\CUPÞI~YlPC . CITY OF BAKERSFIELD .. OFFæE OF ENVIRONMENTAL SEJInIICES 1715 Ch,.ter Ave.. aak.rsfleld, CA 83301 (811) 328-3979 \ - ., '." . .~'. .. ... . p .. ' . . \~.--;" -:~ .«.':../~:~_. '-~~ ': ' UNDIRGIlOUND lTOM_ TANteS ·INITAIJ.,AT10N CERTIFICATE OF COMPLIANCE One form r tank -~A&a&U -... - ", .._-_._~~-- -~'.._""IIiirJ"rII:¡r~~~ J. FACILITY IDI!NTIFICA TlON STOCKDAI.£ IIRANCH 1UaI........... ,.....-~;;¡.... -0.. ~.,--- -----~-~"ØIOt_sroc1CDAl.E HW'f" '..... ....- --.-- IlAIŒRSFlELD.. CA. "."". I TANCí6. /) ll5=i,Þ(f) --...--.- ...,.., ----_. '~IÕ' CIlIIIJJJ.lD --..--.--- ...- ...~..._......_-_...._.. -.--..--.-.... ----.... n.INITALLA11ON : . ø.at..,.",... . . The In...... haI been certified by the tank and piping manufactunn. » The Inetallailon hila be", In8prAd and cer1lfted by . reglster8d prof8ssloNlI engineer. " The Ins.'f8t1on .. been fnapøcIed and approved by the City of Bakersfield 0fIIc0 of environmental Servtcea. ã( All WOI'k lie.. on tile manuf.œøw'.lnatalløØon checldJat has been completed. rj The lnatddon oonnc:tar ... been cartIfIed or Øceneed by the Contractors State UC8nee Board. C Another method ... used '8 ~ by 1he City of 8alcar8fleld 0fI'Ice of Environmental SeMces. Idanttfv ,.,_thad: ,. p'.' M' ID. TANK OWNER/AOeNT SIGNATURE Î I ..,. ...1IIe............. .......... __ II _ & __. .. ....,..,........ JA'NiI·õH_·õwf¡¡N~-·-·- ... .-- --- TI ~~¿~ .t:#T"OIjJ_~ ,..., .fJf...!:.~.~r:-1.rhé(!'. SÓ{J(~L.U ~ 0 .___¿/.~y~ /"/(,"Jh~1/ c/l ,9'!f»f-Yfl/ _-..._____._.._~._,...... ...._ _t .- .-.- ~ .. lñŒliiif-~P -.---. -- .-- _. ,. ...- -: +--.--.. .-. '. - ... . .-- - ,..c ~ .~.~/-' . . .~ " 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 o 1 NEW PERMIT o 2 INTERIM PERMIT o 3 RENEWAL PERMIT o 4 AMENDED PERMIT 5 CHANGE OF INFORMATION 0 7 ÆRMANENTLY ClOSED SITE o 6 TEMPORARY SITE CLOSURE I. FACILITY/SITE INFORMATION & ADDRESS· (MUST BE COMPLETED) DBA OR FACILITY NAME NAME OF OPERATOR u. S. Post Office Stockdale Station Lee Guerra ADDRESS NEAREST CROSS STREET PARCEL # (OPTIONAL) 5601 Stockdale Highway New Stine Road CITY NAME STATE I ZIP CODE SITE PHONE # WITH AREA CODE Bakersfield CA 93309 805/834-4948 ../ BOX o CORPORATION o INDIVIDUAL o PARTNERSHIP o LOCAL·AGENCY o COUNTY-AGENCY o STATE·AGENCY ~ FEDERAL,AGENCY TO INDICATE DISTRICTS TYPE OF BUSINESS o 1 GAS STATION D 2 DISTRIBUTOR D ../ IF INDIAN rOF TANKS AT SITE E.P.A. I. D. , (optional) RESERVATION o 3 FARM D 4 PROCESSOR ~ 5 OTHER OR TRUST LANDS CAL 180090242 EMERGENCY CONTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY). optional DAYSkNAME (LAST, FIRST) PHO¡ # WITH AREA CODE DAYS: NAME (LAST, FIRST) PHONE # WITH AREA CODE loc ette, Jerry 805 222-6222 NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST, FIRST) PHONE # WITH AREA CODE Guerra, Lee 805/834-8343 f II. PROPERTY OWNER INFORMATION· (MUST BE COMPLETED) NAME CARE OF ADDRESS INFORMATION u. S. Postal Service MAILING OR STREET ADDRESS ../ box to Indicale o INDIVIDUAL D LOCAL,AGENCY D STATE·AGENCY 850 (",m"1 TV o CORPORATION o PARTNERSHIP D COUNTY,AGENCY ex FEDERAL,AGENCY CITY NAME STATE I ¡ZIP CODE I PHONE # WITH AREA CODE San Bruno CA 94099 415/742-4526 III. TANK OWNER INFORMATION· (MUST BE COMPLETED) NAME OF OWNER CARE OF ADDRESS INFORMATION same as II MAILING OR STREET ADDRESS ../ box ID indicate D INDIVIDUAL D LOCAL·AGENCY D STATE·AGENCY D CORPORATION D PARTNERSHIP D COUNTY·AGENCY D FEDERAL,AGENCY CITY NAME STATE I ZIP CODE .. I PHONE # WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 739-2582 if questions arise, TY(TK) HQ @E]-~ V. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. 1.0 II.¡!] 111.0 APPLICANT'S TITLE DATE MONTH/DAYIYEAR President 1-16-92 COUNTY # 03J JURISDICTION # mIIJ FACilITY # ~ LOCA TION CODE· OPTIONAL r CENSUS TRACT # . OPTtONAL I SUPVISOR . DISTRICT COQE . 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) FOR&033A,R2 . ,INSTRUCnONS FOR COMI'LEnNG FORM "A" . ~' ':';'1 ......<i., GENERAl, mSTRUCI10NS: 1. Onc FORM "A" shall be compJctcd for all NEW PERMITS, PERMfr CHANGR') or any FACUJTY!Sn'E INFORMA110N CHANGES. 2. SUBMIT ONLY ONE (1) FORM "A" for a Facility/Site, rcgardJess of the number of tanh located at the site. 3, This form should be completed by either the 'gERMrr APPUCANr or the LOCAL AGENCY UNDERGROUND TANK INSPECTOR 4, PJease type or print clearly aU requested information. 5. Use a hard point writing instrument, you are making 3 copies. '1'01' 011 FORM: "MARK ONLY ONE HFM" 1. Mark an (X) in the box next to the item that best deSi.'ribes the reason the form is being completed, I. FACIUI'Y ¡SiTE INFORMA'110N & ADDRPs'<:; (MUST BE COMPLETED) 1. Record name and address (physícaJ location) of the underground tank(s). NOll:: Address MUST have a valid physicaJ location including city, state, and zip code. P.O. BOX NUMUER ARE NOT ACCEPTAUUl Includc nearcst cross street and name of the operator. 2, Phone number must have an area code. If ¡he night number is the same, write "SAME" in proper location. 3, Check the appropriate box for TYPE OF BUSINESS OWNERSHIP (ex. CORPORATION, INDIVIDUAL, etc.) 4. Cheek thc appropriate box for TYPE OF BUSINESS. 5. If Faeility/Site is located on land within an indian reservation or other indian trust lands, check the box marked "YES". 6, Indicate the NUMBER of TANKS at this SITE. 7, Reeord the E,P.A, ID # or write "NONE" in the space provided. n. PROPERTY OWNER INFORMA'nON & ADDRE,')S (MUST rm COMPI£ŒD) 1. Complete all items in this scction, unless aJl items are the same as SECflON 1; if the same, write "SAME AS Srn¡" across this section. Be sure to check PROPERTY OWNERSHIP TYPE box. m. TANK OWNER INFORMAllON & ADDRESS (Musr BE COMPLETED) 1. CompJctc all items in this section, unless all itcms arc the same as SECnON 1; If ¡he same, write "SAME AS sn'U" aeross this section. Be sure to check 'Iì\NK OWNERSHIP Tn'Ii box, IV BOARD OF F!Æ)UAUZA110N usr SrORAGB FlU.! ACCOUNT NUMBER (MUSr BE COMI',Xí!1!D) E111er your Board of EquaJìza1ion (HOE) UST swrage fee account number which is required before your permit appJication can be proccssed. Registration with the BOE wilt ensure that you wìB reccive a quarterly slOrage fee return in reporting thc $0,006 (6 mills) per gallon fce duc on the number of gal10ns placed in your USTs, Thc BOE wiJl code persons exempt from paying the storage fee so returns ",-ill not be sent. If you do not have an account number wilh the 13013 or if you have any questions regarding the fee or exemplions, please call the BOE at 916..739·2582 or write to the BOE at ¡he following address: Board of Equalization, EnvironmentaJ Fees Unit, P.O. Box 942879, Sacramento, CA 94279-0001. V. UiGAL NO'I1PiCA'110N AND mU_ING ADD RES,"; 1. Cheek ONE nox for the address that ~-i¡¡ be used for 80TH UiGAL AND 8filJNG NOTIFICATIONS. AI'PUCANT MUSI' SIGN AND DA'm THE FORM AS mmCAllID. INSTRUCTION IIOR THJH IDCAL AGENCmS The county and jurisdiction numbers are predetermined and can be obtained by caning the State Board (916)739,2421. The facìJity number may be assigned by the local agc'1cy; however, Ihis number must be numerical and cannot contain an alphabet. If the JoeaJ agency prefers the State Board to assi¡';' the facility number, please leave it blank. rr IS 'niB RJESPONSIUlLffY OF '11m WC.!\ ,AGENCY TIJAT INSPBCI'S THE FAQLny TO VERIFY '11m ACCURAC1( OF nm INFORMA'ITON. THIS APPUCA'ITON CANNOT BE PROCE,'>SED IF THE BOE ACCOUNf NUMBER ns Nur I'1Uj~D IN. 'nm LOCAL AGENCY IS RE..'>PONSlBLE FOR 'nIE COMPLE'l]ON OF·nm "IDCAL AGENCY USE ONLY" INFORMATION BOX AND FOR ,FORWARDING ONE FORM "N AND ASSOCIA·Il.!D FORM "n"(s) TO nm FOUDWING ADDRESS. STA1]~ OF CALIFORNIA STA'rE WA'ŒR RI.ìSOURCE..,) CONfROI. BOARD C/O S.W.RIlP.S. DA'!'A PROCESSING CEN1'UR P.O. BOX 527 PARAMOUNf. CA 9û723 ..... "1''-'' ,.,."" '~ ~.... , '\:"!i:;~ ;~~'7"f'ì ---.~~-i",:..:'~.--\'" .J,.... ~. '\~ .'>""'" I.:' 0';" ,~~ .'. '~'. ,. ·:~.7.· ~' )' , . . S1'An: 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 o 1 NEW PERMIT o 2 INTERIM PERMIT o o 3 RENEWAL PERMIT 0 5 CHANGE OF INFORMATION 0 7 PERMANENTLY CLOSED ON SITE 4 AMENDED PERMIT 0 6 TEMPORARY TANK CLOSURE ~ TANK REMOVED U. S. Post Office DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION COMPLETE ALL ITEMS·, SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. ~000005026 7001 B. MANUFACTURED BY: Centurv C. DATE INSTALLED (MO/DAYIYEAR) 1975 D. TANK CAPACITY IN GALLONS: 10,000 II. TANK CONTENTS IFA·1ISMARKED.COMPLETEITEMC. lXJ 1 MOTOR VEHICLE FUEL 0 4 OIL B. C. [X] 1a REGULAR 03 DIESEL o 6 AVIATION GAS A. UNLEADED 0'4 02 0 001 PRODUCT 0 1b PREMIUM GASAHOL o 7 METHANOL PETROLEUM 80 EMPTY o 5 JET FUEL UNLEADED 0 3 CHEMICAL PRODUCT 0 95 UNKNOWN 0 2 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 A. TYPE OF 0 1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER [X] 95 UNKNOWN SYSTEM 0 2 SINGLE WALL 0 4 SECONDARY CONTAINMENT (VAULTED TANK) 0 99 OTHER 01 BARE STEEL 0 2 STAINLESS STEEL [X] 3 FIBERGLASS 0 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM 0 8 100% METHANOL COMPATIBLE W/FRP (PrimaryTank) 0 9 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER 01 RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING lXJ 6 UNLINED 0 95 UNKNOWN 0 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES _ NO_ D. CORROSION 0 1 POLYETHYLENE WRAP 0 2 COATING o 3 VINYL WRAP 0 4 FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE IXJ 95 UNKNOWN 0 99 OTHER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A W 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH .t(]) 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC) A U 4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 6 100% METHANOL COMPATIBLE W/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A@95 UNKNOWN A U 99 OTHER D. LEAK DETECTION o 1 AUTOMATIC LINE LEAK DETECTOR o 2 LINE TIGHTNESS TESTING IX] 3 INTERSTITIAL o 99 OTHER MONITORING V. TANK LEAK DETECTION o 1 VISUAL CHECK KJ o 6 TANK TESTING 0 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORING 0 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 7 INTERSTITIAL MONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER VI. TANK CLOSURE INFORMATION 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH INERT MATERIAL? YES 0 PENAL TV OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT DATE Robert S. Eagan 1-16-92 THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW STATE I.D.# COUNTY # [ill] JURISDICTION # ~ FACILITY # = TANK # ITTIJrill] PERMIT NUMBER I PERMIT APPROVED BY/DATE I PERMIT EXPIRATION DATE FORM B (9·90) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOR0034B·R4 ,-<-_ ~~e::~_""'!:'-~-~~::.:...:~,....-;.:-_;~.,,-"~':-:_-~': ;-_I,_-~:F .;: " J.r '.- :_':.;~'-~ -=:~;~~-~.~:;f~._ - - :---;;:'7 ';:" ';. ~-7' 7~"'" ,- ~ ': ,. . .":.:.-....~" .,,( -'"-·-"T·~¡·?'?":'<';' - ~:':'~'. :: -. .. .' ... -.-"t! ",_ /;1 --~--~~:. '~r;~~, . .' .. . . ~, KNsrRucnONS FOR COM[>Un1NG FORM "8" GENl!11RAJI. HNSI1RIUCTIONS: 1. One FORM "B" shall be completed for each tank for all NIEW JP'ERMJl"][s, PEIRMfI' CJHANGES, REMOVAL'> and/or any other 'JI.'ANK JINFORMATION CJ!JlANGITl 2. 'This fOJ;m should be completed by either the IP'ERMU APPUCANIf or the U)CAJL AGJHNCY UNDERGROUND TANK HNS!P'ECl'OR 3. Please type or print dearly all requested information. 4. Use a hard point writing instrument, you are making 3 copies. TOP OF ['ORM: "MAJRJK. ONLY ONE JiTEM" 1. Mark an (X) in the box next to the item that best describes the rcason the form is being completed. 2. Indicate the DBA or Facility name where the tank is installed. Jio "JI'ANK [)1f'I.~RllJP'Tj!:ON - COMPURTJE AILI. JrrJEMS ~ !fI!? UNKNiOWN - SO SJP'JECJŒ'Y A. Indicate owners tank ID II - If there is a tank number that is used by the owner to identify the tank (ex. AB70789). 13, Indicate the name of the company that manufaclured the tank (ex. ACME TANK MFG,). C. Indicate the year the tank was installed (ex. 1(87). D. Indicate the tank capacity in gallons (ex. 25,000 or lO,OOü etc.). n. TANK CONTENTS A. I. If MOTOR VEHICLE FUEL, check box 1 and complete items B & c. 2. If not MOTOR VEHICLE FUEL, check the appropriate box Ín section A and complete items 13 & D. B. Check the appropriate box. C. Check the type of MOTOR VEHICLE FUEL (if box 1 is checked in A). D. Print the chemical name of the hazardous substance stored in the tank and the c.A.S.#. (Chemica! Abstract Scrvice number), if box 1 is NOT checked in A. m. TANK CONSTRUernON - MAJRK ONE [['EM ONR,YIIN BOX A, n. C .& [) 1. Check only one item in TYPE OF SYS11iM, TANK MATERIAL, IN112RIOR LINING and CORROSION PROTECrrON. 2, If OTHER, print in the sp<Jcc provided. IV. rRPING nNR'ORMATnON 1. Circle Po. if above ground; circle U if underground; and circle both if applicablc. 2, If UNKNOWN, circle; or if 01HER, print in space provided. 3. Indicate the LEhK DETECrJON system(s) used to comply with the monitoring rcquirement for the piping. V. TANK U!I\K ll)JFtm,cTiION I. Indicate the LEAK DETECrrON systel11(s) used to Ç()mply with the moni1o~'ing requirements for the tank. Vn. JiNK10RMJATJliON ON TANK JI'ER.J\lJANBNR1LY c.,"JLOSED TIN PITACE 1. E~ïIMATED DATE [AST USED - M0N11I/YEAR (January, 1988 or 01/88). 2. ESTIMATED QUAN'ITIY of HAZARDOUS SUBSTANCE remaining in tlte tank (in Gallons). 3. WAS TbNK FiLLED WITH INERT MATERIAL'? Check 'Yes' or 'NO'. N>:?UC'-A.l'Jll' i\/J'Us:n: SRGN A1\'D DA'm THE n:~ÜIRM A'; RNmCATEID. KNSfRl[JCRlION [liOR Tim RJ()CAL AGENCRJE.<) 'I11C state underground stoïdge lank idcntification number is composed of the two digit county number, the three digit jurisdiction number, the six digit facility number and the six digit tank number. 111e county and jurisdiction numbers are predetermined and can be obtained by calling the State Board (916)739-2421. The facility number mllst be the same as shown in form "A", 'l11e tank number may be assi¡">11ed by the local agency; however, this number must be numerical and (~annol contain an alphabet. If Ihe local agency prefel~. the State Board to assign [he tank number, please leave it blank. .' '. !if TIS ·Jr1InJE R!f:!..,;rONSRU3IDI.1iT1f 01[1 TRŒ LOCAL AGENCY THAT RNSJP'R.!CI'S 'RUE Jf1ACJury TOVE1IUU1'\( 11IHI! AC<CUJ!!./ì.CY OlF "¡'jm! KN!f:'ORMA'Jf1ION. T'HJE U)CAIL AGn,!NC'Y IS JRJEsroNsmu~ lflOR nm COM'i'JLE'I10N O!f:l11Œ °IT..o!~1L Am~C1f lOSE ONLY" RNKIORMA110N BOX AND JiIOR !FORWARDING ONE t"ORM oN AND A~<;OCIAll!D il70lR1VJ "n~"(s) TO Tii[E [IOU..OWING ADDIRES..~ ..,. srAofE on' CAU1l10iRNIA STA'fn WATIER '!Œ..';;OURŒS CONR1ROIL BOARD C/O s.w.E.E.r.s. DATA JPIROCJESSKNG CEN'mR P.O. BOX 527 J?AAAMOUJ\rn', CA 9û?23 ,...... . rf ,¡f" --i'-- . . STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION D FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM o 1 NEW PERMIT o 2 INTERIM PERMIT o 3 RENEWAL PERMIT ..ø 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. # 0 C. DATE INSTALLED (MO/DAYIYEAR) 2 B, MANUFACTURED BY: Owe D. TANK CAPACITY IN GALLONS: II. TANK CONTENTS IFA-1ISMARKED.COMPLETEITEMC. ~ MOTOR VEHICLE FUEL 0 4 OIL B. ~ REGULAR 03 DIESEL o 6 AVIATION GAS A. C. UNLEADED l2JÍ PRODUCT 04 GASAHOL o 2 PETROLEUM 0 80 EMPTY o 1b PREMIUM o 5 JET FUEL o 7 METHANOL UNLEADED o 3 CHEMICAL PRODUCT 0 95 UNKNOWN o 2 WASTE o 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 A. TYPE OF ....f2r1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER 0 95 UNKNOWN SYSTEM 0 2 SINGLE WALL 0 4 SECONDARY CONTAINMENT (VAULTED TANK) 0 99 OTHER 01 BARE STEEL 0 2 STAINLESS STEEL ..J;2r3' FIBERGLASS 0 4 STEEL CLAD WI FiBERGLASS REINFORCED PLASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM 0 8 100"10 METHANOL COMPATIBLE W/FRP (Primary Tank) 0 9 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER 01 RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING ~ 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 ~4 FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE o 95 UNKNOWN o 99 OTHER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL U DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC)A@4 FIBERGLASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100"10 METHANOL COMPATIBLE W/FRP 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 ~~6~~~~~~A~ D 99 OTHER V. TANK LEAK DETECTION o 1 VISUAL CHECK 0 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORINGJ2j"4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING o 6 TANK TESTING ø 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 0 THIS FORM HAS BEEN COMPLETED UNDER PENAL TV OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPLICANT'S NAME DATE (PRINTED & SIGNATURE STATE 1.0.# JURISDICTION # lQJillJ FACILITY # ~ TANK # ~ PERMIT NUMBER PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE FORM B (9'90) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FOR0034B-R4 -, - . . ~~. ~: ~''''' INSTRucnONS ffl()R COMPœnNG UI()RlVl ".lB" GENEIRAL INSfJRUCnONS: 1. One FORM "B" shall be completed for each tank for all NEW PEJRWfS, PERMrI' CHANGES, REMOVAI..s andjor any other TANK INFOJRMAnON CHANGE. 2. This form should be completed by either the JPERMIT APJPUCANf or the LOCAL AGENCY UNDERGROUND TANK JINSfECTOJR. . , 3. Please type or print clearly al! requested information, 4. Use a hard point writing instrument, you are making 3 copies. Tor OF U'OJRM: "MAJRK ONLY ONJE ITF.M" '.1.' Mark a11 (X) in' the. box next to the item that best describes the reason the form is being completed. 2. Indicate the DBA or Fadlity name where the tank is installed. I. TANK DESCIRJIJPTIION - COMI>K.EJl'E A1LL jj']11MS - W UNKNOWN - SO SI?J&.1FY A. Indicate owners tank ID # - If there is a tank number that is used by the owner to identify the tank (ex. AB7(789). B. Indicate the name of the company that manufactured the tank (ex. ACME ]ì\NK M1IO,). C. Indicate the year the tank was insta1led (ex. 1987). D. Indicate the tank capacity in gal!ons (ex. 25,000 or 10,000 etc.). It TANK C..QNI'EN'J'¡'S A. 1. If MOTOR VEHiCLE FUEL, cheek box 1 and complete items B & c. 2. If not MOTOR VEHICLE FUEL, check the appropriate box in section A and complete items 13 & D. B. Check the appropriate box. e. Check the type of MOTOR VEHICLE FUEL (if box 1 is checked in A). D. J>rint the chemica! name of the hazardous substance stored in the tank and the C.A.S.#, (Chemical Abstraçt Serv;ee number), if box 1 is NOT checked in A. m. TANK c.."ONSTJRUCTìlON - MAlRK ONE U1EM ONR,Y !IN BOX A, 1ß, C &. D 1. Chetk only one item in TYPE OF SYSTEM, TANK MA'ŒRIAL, INIERIOR, .LINING and CORROSION PROTECTION. 2. If OTHER, print in the space provided. IV. ['ll>]ING ìlNìll()RMAT!\ON , , 1. Circle A if above ground; circle [] if u¡¡:':erground; and circle both if applicable. 2. If UN!(¡'\iOWN, cirde; or 'if OTHER, print in spaœ provided. 3, Indicate the LEAK DETECnON system(s) used to comply ",ith the monitoring requirement for the piping. V. TANK ìl.JEAK JDHTìP'c':H1ION 1. Indicate the LEAK DEI1'.CTION system(s) used to comply with the monitoring requirements for the tank. VI ìlND'ORMATIlON ON TANK rEJRlVJANENJl'ILY CJLo,,<)ED JIN J?HACE 1. ESTIMATED DA'Œ LAST USED., MONTHjYEAR (January, 1988 or 01j88). 2. E..<;I1MATED QUAN1TIY of HAZARDOUS SUm!I'ANCE remaining in the tank (in Gallons). 3. WAS TANK FILLED WITH INERT MATERIAL'! Check 'Yes' or 'NO'. Alf'rUCANT MUSJl' SìlGN AND DATE TJlŒ ìll{)JRJ\.1 AS INDICATED. JINsnrUJC][]ON TIi'()R '11m n..oCAJI.. AGENCW£ The state underground stDrage tank identification number is composed of the two digit county number, the three digit jurisdiction number, the six digit facility number and the six digit t!lnk number. The county and jurisdiction numbers arc predetermined and can be obtained by calling the State Board (916)739-2421. The facility number must be the same as shown in form "A". The tank number may be assigned by the local agency; however, this number must be numerical and cannot contain an alphabet. If the ]oea] agency prefers the State Board to assign the tank number, please leave it blank. n ns TI!TIE JRJESPONSlmUiTY OF 'nm WCAIL AGENCY TiHAT ìlNSJP'ECJ!'S TiHE U'ACIL1ITY TO VEIlUJF"Y lIì1IlE AŒ..'UJRACY OIl TUrn ENI10RMA'nON. 1I]~ U.J;:CAL AGENCY US RIJ.<;¡'ONSmìl,E FOR TiHE COMPUmrON (W 'nm "IO:CAJL AGENCY USE ONJL1(" J!NFORMAl1rON !BOX AND ìl'OR ¡FORWARDING ONE 1!i'()1RM "N AND As,,<;OCJ!A'IìED Pi'()RM °ß"(s) ro TIm 1!i'()unW!lNG ADD]rU3..~. SfATJE OIF CAJ!J[IFOIRNJ!A SrATJE WATER JJŒSOURCìl!..<} CONTROL BOARD C/O S.W.JEUUP.S. DATA JPIROCJ11.&<;ING CJENJl1EIR P.O. OOX 527 I?ARAMOUNJr; CA 9ffl23 ..¡.-:- ,;#;. .,:¿:' I . . STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM A COMPLETE THIS FORM FOR EACH FACILITY/SITE MARK ONLY ONE ITEM D 1 NEW PERMIT D 2 INTERIM PERMIT D 3 RENEWAL PERMIT 0-4 AMENDED ~ERMIT D 5 CHANGE OF INFORMATION D 7 PERMANENTLY CLOSED SITE D 6 TEMPORARY SITE CLOSURE ra- PARCEL # (OPTIONAL) STATE CA D CORPORATION D INDIVIDUAL D PARTNERSHIP TYPE OF BUSINESS D 1 GAS STATION D 2 DISTRIBUTOR D 3 FARM D 4 PROCESSOR ...8-5 OTHER EMERGENCY CONTACT PERSON (SECONDARY)· optional DAYS: NAME (LAST, FIRST) NIGHTS: NAME (LAST, FIRST) -e..e.- II. PROPERTY OWNER INFORMATION· MUST BE COMPLETED CARE OF ADDRESS INFORMATION ./ box to indicate D lOCAl,AGENCY III. TANK OWNER INFORMATION - (MUST BE COMPLETED) NAME OF OWNER CARE OF ADDRESS INFORMATION CITY NAME ./ box to indicate D INDIViDUAL D CORPORATION D PARTNERSHIP STATE ZIP CODE D lOCAl·AGENCY D STATE·AGENCY D COUNTY·AGENCY 0 FEDERAl,AGENCY PHONE # WITH AREA CODE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 323·9555 if questions arise. TY(TK) HQ @H]-DIITIJ V. PETROLEUM UST FINANCIAL RESPONSIBILITY· (MUST BE COMPLETED) -IDENTIFY THE METHOD(S) USED ./ box to indicate ):2ì1' SElF,iNSURED 0 2 GUARANTEE 0 3 INSURANCE D 5 lEITER OF CREDIT D 6 EXEMPTiON D 99 OTHER D 4 SURETY BOND VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or" is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: I. D II~ III. D THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT DATE MONTH/DAYIYEAR JURISDICTION # [Q[3IIJ FACILITY # 0?l0\8\'2.47\ LOCATiON CODE ,OPTIONAL CENSUS TRACT # ,OPTIONAL SUPVISOR· DiSTRICT CODE . OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION· FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FORM A (5'91) FOR0033A,5 . '". ~h n..-..........:o.,·. . .' . .....~¡o--....,_.-'"' ,-" '~c "I;- '... 1IN5Tl::UCZ¿:OiNS i"DR. CONiPLEHNG FŒ\.lV,i "A" tGEj\.lJH~{AL RNS':ff.'RUCllIONS: 1. One FOR1\1 "A" shall be completed for all NJIIW J?EIRMfl'S, PERMff CJlJIANtGTI'.S or any FM:JLfI'Y /SITE ITN[10mVIAUON CiFM.NGfli'\). 2. SUlßMJiT ONLY ONE (1) FORM "AP for 3 Faeí1ìty/Sitc, regardless of the number of tanks hX'atcd at the sile. 3, This form should be completed by either the PERMfr APJ?LJlCANf or t!¡C LOCAL AGENCY UNDFR(iROUND TA,NIX:JiNS?[',CrrUR. 4. Please type or print dearly aU requested information, 5, Use a hard point V\'Titing instrum"nt, you are making 3 copies. TOP OJF W<L))L'{l'v!J: "MARK ONLY ONE 11'11\1" . " Mark an (X) in the box next to the item that best describes the reason the form is being completed, Ji. TI?ACnLiiTY/SJfllJE JINIFOmVJi¥TI10f'IJ &. ADDR]ES..~ {M\Us'T BE COM~'L:fJrD) I., Récord name and address (physical location) of the underground !ank(s), NOTE: Address MUST have a valid physical location incJudíng city, state, and zip code. 1!'.O. BOX NUMIIU<.]RS AI~JB NO~:' A('jCiI:ill"1l'AIBJL.IF_ Include nearest cross street afie; ¡lane of the operator, 2, Phone number must have an area ('ode, ïf the night number is the same, write "SAME" in proper location, 3. Chêck the 'Ppropriate box for TYPE OF BUSINESS OWNERSHIP (ex. CORPORATION, INDIVIDUAL. etc.) 4. C':heck the appropriate box.for TYPE OF BUSINESS. 5. If Facility/Site is located within an Indian resetvation or other Indian trust lands, check the box. marked "YES", 6. Indicate the NUMBER of TANKS at this SITE. 7. Record the E.P.A. ID # or write "NONE" in the space provided. , ill!. 1!'ROJ1>1ElR.']IY O\VNJEIR lINJF'üR¡~4i¥JllION .& ADDm'1.<;S (MJUSJI' BE COMJP'IL!l~,,]["]EjI) Complete aU items in this section, unless aU items are the same as SECnON 1; if the same, write "SAME A.';' srn,to across this section. Be sure to check PROPERTY OWNERSIIIP TYPE box, m. TANJ::£ OV1NJEJR. IIN1FORMKII10N & ADDRiF,SS (MUST B1E COM1!'TIJETiED) Complete all items in this section, unless all items are the same as SECnON 1; If the same, write "SAME AS SITE" across this section. Be sure to check TANK O'f:iW1El?..sJ!l!IIJ? 'JI"'¡lP1E box, IIV. OOARD OJF 1EQDAUZATION US'l' S1!'OJP-AG1E Jl1EiE ACCOUNf NUMRiE:R (l'>ßusr HE tL'Oí\,JJP'li.!E'J["]]illJ¡) , Enter your Board of Equalization (BOE) US!' storage fee accouot number which is required before your j)crmit ,)ppjicatiot; can be processed. Registration with the BOE wi!! ensure that you wiJl reœive a quarterly storage fee return in rt:porting the $0.006 (6 mills) per gallon fee due on the number of gallons placed in your USTs, The BOE will eode persons exempt from paying the storage fee so returns will not be sent. If you do not have an account nuniher I\-ith the BOE or if you have any questions regarding the fee or exemptions, please call the BOE at 916-323-9555 or write to the BOE at the fcillowing addJ'css: Board of Equalization, Environmental Fees Unit, P.O. Box 942879, Sacramento, CA 94279,0001. V. PETROLEUM USlI' JFii.NANC1IAK. RK<;JPONs:r¡P¡lliLRTY (MUSJI' ]ß;]E corvJJPUrUIE.D) Identify the methodes) used by the owner and/or operator in meeting the Federal and State financial responsibility requirements, USTs owned by any Federal or State agency arc exempt from this requirement. VJI. li,.!EGAŒ" NO'li'í!1'7ù{:A{]['KOl\! AND lEJULIT.1lNH Aj1)D['?.j}ìS§ Check ONE BOX for the address that \\oil! be used for BOTH U!GAL Af\ID IDvJU1.JINH Ncr1l1IJFTICAT1!ONS. hJJ>TI"LJICANJr MUS][' STI<GN AND DK[,iE 1l'II1IE II'DR\VI J'ili 11'JmC/\1IIE.D, HNS':iJ"JR.UC'JI'10N FOR 'J1'ITlli H~CATI, AGJEt'!Cill'dS The couoty and jurisdiction numbers are predetermined and can be obtained by calling the State Board (916)739-242:1. The f¡¡dUty number may be assigned by the toea! agency; however, this number must be numerical and cannot contain any alphabetical. If the loca! agency prefers the Slate Board to assign the facility number, please leave it blank. Iii.' llS 'Tilm R~:Ûi!'\!;§TIlB!iJUj]1f OJF 'TI'¡}¡;:g LOCAl., AG!E'J>l:::-"í! THAT llNSJl>JF£ll'S TIm FACJLt!l1f TO VJE!RIIiJ1l[ 'li1IDI! ACCURACY ([W THB B\lJF(JI],~,ìVlATION. TllEISi All}l'UCA110N CANNOT BE PROCESSED KiF TiHIJE iJM))JE ACCOUNT NlUlìlrnn~R llS NOT FHLED JlN. THE U1:CA.1L AGENC\f TIS ml~lPONSlinmE FOR 11'TIIIJE COMJ:>unl0N Olll'li1IIJE "WfYü, AGENCY mæ ONJLY" lINJFC)R.1";;:IÞ{lJ.'iiON ]BOA /ì.1".1[j) FOR FORWARDTING ONE FORM "N AND ASSOC1AT!HD lFŒ{lVJ "B"(s) T011Œ FOiTI1JDWJNG ADDJRJE1^';.'i. STA'J11E. OJ[? C!~U1FOJR.N"AA Sli'A1ilE WA·ŒR Rr~OURClE..() CiDiNmGTI. J]~:QAmJ) C/O $. W,JIffilP .§. DA:Jl'A lP'R00ESSTING ŒN][IE.!R !P.O. BOX 527 ]¡>AL'{AMOUNJl~ CA 90723 ) ~ ç'/ . _¥~7f .'. STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD CERTIFICATION OF COMPLIANCE FOR UNDERGROUND STORAGE TANK INSTALLATION FORM C COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM I. SITE LOCATION , BAKERSFIELD STOCKDALE STATION - ¡J~ S ( ?ob-I Se..-r f.) I c...e....- STREET 5601 STOCKDALE HIGHWAY CITY BAKERSFIELD, CA COUNTY KERN II. INSTALLATION (mark all that apply): P D ,k5 ~ The installer has been certified by the tank and piping manufacturers. The installation has been inspected and certified by a registered professional engineer. The installation has been inspected and approved by the implementing agency. All work listed on the manufacturer's installation checklist has been completed. The installation Contractor has been certified or licensed by the Contractors State License Board. D Another method was used as allowed by the implementing agency. (Please specify.) III. OATH I certify that the information provided is true to the best of my belief and knowledge. Tank Owner/Agent R. S. EAGAN & Company Print Name ROBERT S. EAGAN Date June 26, 1992 Phone ~10 _) 732-7300 Address 1992 National Ave., Hayward, CA 94545-1710 LOCAL AGENCY USE ONLY STATE TANK LD. # COUNTY # [ill] JURISDICTION # [QID FACILITY # ~ TANK # = FORM C (7/91) THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY FOR0035C7 ....,......_:~- . . <\, ., v~.. \ " INSTRUCTIONS FOR COMPLETING FORM "C": TANK INSTALLATION CERTIFICATION ~ GENERAL INSTRUCTIONS 1. Each tank sysiem must be in compliance with the federal and sta1e technical standards, contained in law and regulations, for tank and piping installa1ion. 2. This certification shall be completed by either the UST owner or representative. , . 3. One certi1ication is required for each tank system. This form shall be used to make the required certification. 4. Please type or prin1 clearly all requested information (for printing, please use a hard poini writing instrument). ... 5. Submit )he completed C,ertification_to the ('iJppropriate ,local Implementing Agency. I. INSTALLATION: MARK All OF THE ITEMS THAT APPLY TO INDICATE THAT THE INSTALLATION REQUIREMENTS ARE MET. Q , . II. OATH: THE TANK OWNEIRl OR AGENT SHAll CERTIFY, BY SIGNING THE CERTIFICATION, THAT THE INFORMATION PROVIDED IS TRUE AND CORRECT. THE PERSON'S NAME SHOULD BE PRINTED UNDER THE SIGNATURE. , . ! ,. . <. . (Ç;, .. (Q)~þ March 29,2000 us Post Office 5601 Stockdale Hwy Bakersfield, CA 93309 Dear Underground Tank Owner: Your pennit to operate the above mentioned fueling facility will expire on June 30, 2000. However, in order for this office to renew your pennit, updated fonns A, B & C must be filled out and returned prior to the issuance of a new pennit. Please make arrangements to have the new fonns A, B & C completed and returned to this office by May 15,2000. For your convenience, I am enclosing all three fonns which you may make copies of. Remember, fonns 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