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HomeMy WebLinkAboutUST-C-10/25/91 e CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT T I ME CHARGED S D, JOHNSON FIRE CHIEF BUSINESS NAME,5(.w~ ~~. Ck12 ADDRESS: 6) I ~ S(/}Vð~ P//\t? .Þ, PROJECT DESCRIPTION:j(h~ v;f' 5'~ 1/ TIME CHGD: T- If.-- "\.' It MATERIALS DATE: NAME: I?-!~ . JH... Ù\J"'W~U- <5/23/12 '{ /( 3/2 "3 J?~ Ii ~( J"n l, ù ~z5 3/], 3/¡Z /]~/j,~- 2 . z5Av~ ~/ÞV ~ //0/.. ~/(5' . 2101 H STREET BAKERSFIELD, 93301 326-3911 COMMENTS: ¡)J"rk1Jt~ Pe,Vl~LÙ V / 'i<e 1/1.e?U FÞ'~_- ~A?>n--A- , f/ 15'5'~ /f./. Þ:.4, /~&,þ- '" . ... Y -i"I -----~~------._--- - - e - UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (L,EAK) I CONTAMINATION SITE REPORT,:;'; EMERGENCY ~r DYES ..lZrNO REPORT DATE HAS STATE OFFICE OF EMERGENCY SERVICES REPORT BEEN FILED? r-;/ DYES LLI NO CASE II >- m o w I- a: o Q. w a: ( lJNw()O iJf.r \ OWNERIOPE OTHER c ---.-'... ..-- o TOR ¿) ~ ¡;,/.!/ / <"j' ':;::> ;;;¡¡-¡ f ~,.., ...?;::) Ii '1 ~ STREET W ...J m ëñ~ Za: 0« ¡);Q. W a: 21 ?-O NAME ¡.,·lk_ <"/ tor ZIP PHONE (S(-'.;) ,Y;J ¿:ff/ ~ '>r/ ADDRESS /'¡ n / Ii'" t''-' ,I<. ! ) :.,; (/ / ~rn/LV FACILITY NAME (IF APPLICABLE) ð <'è; /\h/ ~ Co (.0; ~'/ ¡:: « o 9 w I- ëñ ,..' / ¿~/ k~ /1 ,/ CIW/;I/7 L I' .:s / ZIP' /;'=" '0 r; , -............ / C /",.0 Ati~ "'-,~ ,19 'V'::> 1_ ( , .... .-\ ",/;,"Þ'"';' v;, {r "" Æ': " ' (, ,...( /~ k ~ "'!"~;:> .~ ~ CITY L ' -" 1<:.-/ /...." (." ~ A;.,þ 'COUNTYe-r.· ¡Y/ V ZIP 1"_." V7 ADDRESS ,<' '2 f )':\ c;;. . CROSS STREET ,.... ..,....,/0 . (./ ..'t" r ¡(STREer .,¿ 'n .-..",,~ -1'/ ~''''' G LOCAL AGENCY AGENCY NAME Z'" I i' ( ¡¿ /h I ¡:: f?. L., ..,/,' ,.. ,~)I a:¡ \3 þ[ ~,/.r;- ;j 'I'" eo ' . /"'''r /' ..f" ;/ . . Fi?" . ~ a:¡ REGIONAL BOARD ~~ "J C ~ ¡I/'¡E 'j /û;) ...:;;:> '" (1) ~ ~ ~8 /' " ~ ~ l...;:7 pJ <:"-eP':J // / ....¡;¡ 1-0 '" > (2) ~~ C/) /..tí' ¿"" ¿~-t'V CONTACT PERSe¡, ..4#. Je,e-!/v/!/WCO r{,¡ JO/Vr.. &/V o ,.~,~ - PHONE (70'.;:) ?2 G '" ,.:;;'-; ,;>' PHONE t~, r) t;/;:J r _ _" _ ..~, ;) W!"" I 7'.-;1 ..? ;;. --' " QUANTITY LOST (GALLONS) ~KNOWN NAME o UNKNOWN I- DATE DISCOVERED z w ;:;; W ~ m ~ ffi M M D D Y 15 HAS DISCHARGE BEEN STOPPED? o 6 .ø YES 0 NO IFYES,DATE ÙI w SOURCE OF DISCHARGE ~ 3 0 TANK LEAK J« goo PIPING LEAK HOW DISCOVERED D TANK TEST D INVENTORY CONTROL D SUBSURFACE MONITORING 0 NUISANCE CONDITIONS ..Ja"""TANK REMOVAL D OTHER METHOD USED TO STOP DISCHARGE (CHECK ALL THAT APPLY) D REMOVE CONTENTS ,.ø"hOSE TANK & REMOVE D REPAIR PIPING D REPAIR TANK 0 CLOSE TANK & FILL IN PLACE 0 CHANGE PROCEDURE D REPLACE TANK 0 OTHER Y Y CAUSE(S) )MI '7MI I DI DI ' DATE DISCHARGE BEGAN J2t"'"T1'ÑKNOWN ø UNKNOWN o OTHER D D o RUPTURE/FAILURE o SPILL I ~ OTHER t//4,.. .;...:!:I N/".¡/ OVERFILL D CORROSION UNKNOWN w w CHECK ONE ONLY "'Q. 0« >- 0 f- UNDETERMINED CHECK ONE ONLY J2j"" SOIL ONLY D GROUNDWATER D DRINKING WATER . (CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED) 1-", a:¡~ ~~ a'" o NO ACTION TAKEN o LEAK BEING CONFIRMED o REMEDIATION PLAN CHECK APPROPRIATE ACTION(S) (SEE BACK FOR DETALS) o PRELIMINARY SITE ASSESSMENT WORKPLAN SUBMITTED D . POLLUTION CHARACTERIZATION o PRELIMINARY SITE ASSESSMENT UNDERWAY D POST CLEANUP MONITORING IN PROGRESS ~ASE CLOSED (CLEANUP COMPLETED OR UNNECESSARY) 0, CLEANUP UNDERWAY o EXCAVATE & DISPOSE (ED) D REMOVE FREE PRODUCT (FP) D ENHANCED BIO DEGRADATION (IT) ~XCAVATE & TREAT (ET) 0 PUMP & TREAT GROUNDWATER (GT) 0 REPLACE SUPPLY (RS) o NO ACTION REQUIRED (NA) D TREATMENT AT HOOKUP (HU) 0 VENT SOIL (VS) D OTHER (OT) ...J ~z 00 ~§ Wet a: o D o CAP SITE (CD) CONTAINMENT BARRIER (CB) VACUUM EXTRACT (VE) -. C/) f- Z w ;:;; ;:;; o o ',~ ~ . HSC os (&'90) '..-. ... ,~ ~ ~ ~ ~, & ~ PEBBlE tv 680 Bl?4e¡.¡ J¡>'O¡> " '-____ DR IV/;: /.it ,< ~iJ;::-'·~.--~... ~ ^-J ~ <2 /.....' o / .lï--O~ ' t s ç'S~ GREEN BELT AREA - ~ L...."T-- ------- -, .J9¡> -,qq' 55. ï>'è'... '-~..... - ----..... '., c' , Õ' ~, ~~ \ i I ------ ~-,- .~~,~~- N79°S/'S3"W " ~ 0.00' ---....., \ --~ N VI UJ N UJ ~ <J1 ( 282 ft > .,~/' r' ( ( I I ' GREEN BELT AREA GREEN BELT AREA I , ! I i ¡ I I , !1 ¡i \~ lt~}f] /l? q¡ .. .. W § -- z -- I, 1 I ''''"'' I SUNDALE COUNTRY LCX¿~[;~O~No;TAVERN RESTAURAN #1 #2 MA I NTENANCE au I LD I NG + -11~ . J: +- +-. " t ~ -== - KERN CITY . RES'DENCE-STREET~AP - ~'iŒ ~KERN CITY CIVIC ASSOCIATION , I I I t\o i:: ~ : ! ( ~ ~ ... -.... . ...0 ~^,..a ", 'I,'," ;' :1~. .~._~ ~~"~~ i.~~:~~~__ - 'j. (", ocr<-' : -\ '? --z ....... ~ "'.; ,. .' ~ .. ... .- . . . .",""."="".=="c~~,~,¡~~.,;.",",~,=,,.,~..~c,.,. ..".......~.."'.'é."'~_~_>_.....~.,.. ~"-_.,~-' -- I~,,,,: :...- ":,,,1· , 2 : .... .- ~_. ~- .-~ . :"., - - . -,;.;....:.. - - ~ :.:..or. ?I ~;:.. - :~:~ :"1 .,"',: L, -'I· ',' -,' ~.= - - ~ - - - --- -_. -- - - ' Above -Ground Tank D .. Sample Depths S-I: ' 3' 6" ., S-:-2: 8'0" S"'-3: 11' 0" ~I ~_I ~~I C"-_.. J; [I ~ - ~I 1- ~;I f-Iu . . ..,:: - ; :~I-I'~ :. '~I -. - -~. - - - -- -."- - -'- . . , , Scalé 1"=10' '. Confirmation Sam.p le NOTE:' Excavation dèpth apprèJx, 12 ft , >~I AQuaGeosc i ences, ' Inc. 170 t"Westwind Drive Suite 103· Bakersfield, Ca1ifornia 93301. ~~. - Telephone: (805)",328-0962. . . tax' 328-1129, --- '--._--- -- - -~ - -~ --- _...~ --- Cinderblock Wall Tank Fill · BASE · ~ Excavation l1mits Maintenance Yard I Driveway Title Sunda 1 e - Country Club Bakersfield; 'California - --,. - - -- . - . .~. - ."--.,.-- -. ~- ~'-~--'- .'- 51 TEuì-1AP - · ~ -- ~ -- -----' ..::...... N Exrlibit 2 - C-,: I .' ;.~ . I -'-t ~ : j l) . ¡ I ì " ~() . ,.¿¡ I j 4, _ , +9 ì I ~ t·· -;.' + I ? ~ I I .. , I, " ( -- :z: .- :v 'i 1 I I I : p ~ ~ ~ ~ . ¡;:: ."'.0 o .».~..a; ;' \;'1: I~'¡ ': l:L ~ ~_ ._...L. - _.. . I. -===:= ''''¡' {\ ( , ! --z ....... KERN CITY . RES'OENCE-STREET~AP i[ "KERN CITY CIVIC ASSOCIATION .' .1;..\ ,¡, ~ _ITE/FACILITY FOR:vI 5 D a G R,A.¿"'! ()~ J?, S:OItJ(J4Æ ~ -# II q7 I JftJÇ£) I ~ORTH SC~LE: BUSI~ESS N~.'IE: I FLOOR: OF SUNDALE COUNTRY CLUB AND TAVERN BY THE GREEN DATE: I / FACILITY ~A.'!E: L"X IT .. RF -. ,/ . ¡/ (CHECK ONE) SITE DIAGRA.'t FACILITY DIAGR~~ Gf!1f-55 /TP..!;3H 1 >-... \) ~ I'<') G¡:U::fSS RaE,=! , 'I" Gr2R55 HP..EIf .. , " :o,~".\'- . actR' ,,' , '\!..!.:::I .~~:-. . ,C(>.~ r ! I "l" DE~K ~'~r ¡ -, .' "_ OVER ~E!RE$~EI.".I" ~¡ . ,~' .~, C"'~J·.' ("../ ,..~j ": I, . .. ~,f'ACILIJ ;y'..;~\:, -- ,-." '_<~!;~~~:.~:~)o:_: . " "-~,:"~",. - ~':,'.~..' :. . "-." ,,:.._'c· ~ L . ,,'" ~; ;:< ,- i ~ :.~ 'II Mf1 Jf'J or-Flct:. 1\ I I ( ~ ~( ~~¡ , ~ ori ~ >:JP. ~1 \;1i'i ." 'I" -:~. -W ........,. . . .(it . , - ~ <. ~', . , " , @" ~ WJ:¡T¡¡'¡q, ¡N ,ouT ~-J.:::--- ~- '. .5 -' 7í.,:" ,Þ' . -S'UN (7¡Ù_t:" fiVE' .~- -~- ..,,- , . ~._- -:"';'..-- - J-> .Jr I ð- J;' >-> ')2 G) G 1?t1S 5 j:( ¡:;Z£ ¡;¡ .", (Inspector's Comments): -OFFICIAL GSE O~LY- - 5A - ... ... ~ ; "". ':" ~ORTH ~: SC~LE; DATE: ! LITE/FACILITY F.O R:vI 5 x:eA G RA...."'I: {; ;2 ¡ f ,.;; C{-;N-e:l4 Lr? 1::t-1 /"Q/7 Jru NA.'lE : 'û FACILITY ~A..'!E; (CHECK ONE) SITE DIAGRA.\Y FACILITY DIAGR~~ (;IZ/j.S 5 It/<. e:r t V;J ~ Ç) ~ GI¿F?5S RaE/=¡ 11 I I f ~ ~1 ~~, I ~~ ~, ~ '1 -»y , 'l:.s..- ~>-' ')5 Û) JV ~t¡ï .'> 'f-o-.= ",. .,> ..' .."':;; I <, " . ,. ,:-: ,.....IN _: I:, " ' CUJ(; RcxYr EI£CT-r;'K, /lÀffiR kID G~S SHJT r:Èf'. " ',I¢!A'MP()OWN ':i!V '.. , - ,.' - "'{"-" ", ,.'.. ,0 OUT~ i<':'~', ~ALSO EN!R~ES!<fJD EXITS. ~". ~,~. ~ #. ',' .- ~ þ . ;". .... .... ..' I., _·fnTA.!', ').,J,JW.' 'IN::; HA,$, ·t>~ERHEAD nR£ 'SPRINKLERS' .,' '-,' 'DECK,-"-", ,! _. - ..,r " "'¡;~~ . '14' ~, ,. ~':.: .i"-~'-'" :".;:;;.·.S· ",.'.' ..~.. OVER QEP~~ssJ¡ , . _~ " ;--.i: - - cÃ~T-·.;-·:~: ¡ :..;...~::.~:, ';~ ~ :F ACILliÿ",i).-:,:· __ . ''D "'" .<;:~':<!),:.::', ",'./" . <:(¡ø ....Y" ~~' " ~ ,.-: ..-wz1[" , ,0' j . . : . . ..~. . '..~; ({.( . . ,.,~ ~ . . D Mrr IN Or-Ft , '. @ GRR5S l1/{EI1 ~ .;tr. -W ,. . :'. ;. ~. ,. RECEIVING , :""(¡Jff)':::":~' .: ,,- ...' i " 0': :;,¡..:' - .. .. i ~ .... -'1.....:. '::..". ..., .' ,< ..' , ..', , , ,~.. '- 7l,: ,. 1" . .s'i-'N'7ff-I.~ 17\1£' .~--,.-...,.- -.. - . -y- _ . L___~' _ -~ . 7. ~t <r ~ ~ ~! I ..¡:~ '''; . ~", (;\ r" ... -~. ~ >- ~-'i.~ ~=- GR Ff 5 S ;11?¿g (Inspector's Comments): -OFFICIAL CSE O~tv- - 5A - I ¡ I J I , ¡ I I I (k ~'" .. [t~~ j ~. ..'" i ~ -- :z: -- .. '1 ¡~ t --;;;;..-. ..-;;..* 4'" ¡ J ~ " :\ --z .-. KERN CITY TREET MAP . RE.SIDENCE-S ... ~'¡Œ -KERN CITY CIVIC ASSOCIATION .' -- I .1 ~ I I e ~I 'I ./ ~I Above Ground Tan/( D Tan/( fill Sample Depths S-1: 3' 6" S-2: 8' 0" 3- 3: 11' 0" ~I } l) -~I .1 I .1 -J .1 i.1 I~ " Sca1e 1"=10' ! I {'~JE: Ex~Ÿstion depth approx. 10ft AauaGeosci ences. Inc. 1701 'vt'estwind Drive Suite 103 Baker$f~ ld, Ca lifornia ~330 1 Teo1ep~: (805) 328-0962 Fax 328-1129 e Ci nderblock Wall S-1 Excayation li mits Maintenance Yard D ri Ye\v'8y Title Sunde1 e CountnJ C1 ub Balcersf1eld, C811fornla SITE MAP- EXCAVATION LIMITS N I ¡ ,Xi ,it ¡ , I . J Ex hi bit 2 ~ I~ I e e -- I \ I í N I i i I Á ¡ I I I Ci nderblock Wall I \ I I Above Ground Tank 5-2 'I I I D 5-3 V- i a¡(' ...-- 5 1 m- ¡..-. Tank Fm I~ Sample Depths S-1 : 3'6" I S-2: 8'0" 4-\ I 3-3: 11' 0" Excavation limits Mal ntenance Yard Drive'w'sy " I Scale 1" = 1 0' I ,I NOT E: Exc:avati 0 n I depth approx. 10ft ~ I -I ~I I) ~ '1 --I ~1 1 I 1- I~I . Aqua Geosciences. Inc. 1701 'vI~st\Ifind Drive Suit~ 103 Bakersfi~ ld, California 93301 Tl'll'phone: (805) 328-0962 F.~x 328-11 29 Title Sundale CountnJ Club Balœrsf1elå, Cal1forn1a Ex hi bit -') L. SITE MAP- E;<CAVATION LIMITS · .._~:~~Hr,T¡Jf~¡¡¡;jci:ti];m1£;;~'rZ::¿i~i;;Z~:¡:¡;~~r~'t~f;;t';ê¿)1,~~i¡",ifï8rÊ;:^":"" '. ., III I ! ¡ N ! j f J ¡ I I ¡ I Cinderblock Wall I ~ I , i I Above Ground Tank ! ì D II s'" I I @-+-"-,,, I ~ S-3 \. ! Tank Fi1T ~- " S-l i Sample Depths I , S-1 : 3'6" I ¡ c:_ ". 8' 0" i v ..:.... \ 5-3: 11' 0" ! I I ¡ I ! 1"1aintenance Yard I Driveway I I I ¡ i j I I I , I ! I I I I I ! I I I Sea 1 e 1 u= 1 O' I I I I I ¡ , :I AauaGeosciences. Inc, Title Exhibit Sundale Country Club 1701 Weslwind Drive Suile 103 Bakersfield, california Bak.ersfield, California 93301 Telephone: (605) 328-0962 SITE MAP Fax 328-1129 I ! e - CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF October 25, 1991 2101 H STREET BAKERSFIELD,93301 326·3911 Ben Nolan Sundale Country Club 6218 Sundale Avenue Bakersfield, CA 93309 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANKS LOCATED AT 6218 SUNDALE AVE., IN BAKERSFIELD, CALIFORNIA. PERMIT # BR0002 Dear Mr. Nolan, This is to inform you that this department has reviewed the results for the preliminary assessment associated with the closure of the tanks located at the above stated address. Based upon laboratory data submitted, this office is satisfied with the assessment performed and requires no further action at this time. This letter does not relieve you of any liability for past, present, or future operations. In addition, any future changes in site use may require further assessment or mitigation. It is the property owners responsibility to notify this department of any changes in site usage. If you have any questions regarding this matter, please contact me at (805)-326-3797. h· IÁj/Jjl~ -~ Joe A.~ Hazardous Ma 'al Specialist Underground Tank Program -~-_.'.- q _ r1 ..-//'>Oi~ ("! ¡ '- n .rr £'" I J}? C '."-.':;: ""-"...... "-" ",-,-", '*-' ~ -*" l .......,.,.'} ...... sa """-o;,undwater Scientists · Environmental Consultants e August 19, 1991 crisp Construction P.O. Box 1066 Visa Ii a, California 93270 RECEIVED AilS 29 1991 Aosil. ...........; ATTN: Richard Warren RE: Sundale Country Club Tank Removal - Analytical Results At the request of Crisp Construction, AquaGeosciences, Inc. collected three (3) soil samples in conjunction with the removal of an underground storage tank at Sundale Country Club in Bakersfield, California. On July 29, 1991, Crisp Construction removed one (1) 450 gallon gasoline underground storage tank. Mr. Joe Dunwoody of the City of Bakersfield Fire Department Hazardous Materials Division was present to observe the tank removal and sample collections. AquaGeosciences, Inc. collected soil samples in accordance with City of Bakersfield guidelines after a tank rem6val.The £irst sample (S-l) was collected from the south wall of the excavation at approximately 3'6" below ground surface. The second and third (S- 2, S-3) samples were collected from beneath the center of the tank, S-2 at 8' and S-3 at 11' below ground surface. The sample locations are shown on Exhibit 1. The soil samples were collected from the backhoe bucket immediately after soil excavation. The samples were stored in 2" brass tubes sealed with teflon tape and plastic end caps. The brass tubes were labelled and promptly placed in a ice chest at 40 centigrade. A Chain-of-Custody record was initiated which accompanied the sample to the analytical laboratory. The soil samples were submitted to Mobile Labs, Inc. a California state Certified Laboratory. Soil samples were analyzed' for Total Petroleum Hydrocarbons (TPH) as gasoline and volatile aromatics (BTEX) using DHS LUFT Method, EPA Method 8015 modified and EPA Method 8020, respectively. The results are summarized in Table 1. jq\ B:\REPORT\SUHDALE.RPT 1701 Westwind Drive, Suite 101 · Bakersfield, California 93301 (805) 328-0962 · FAX (805) 328-1129 .... .'" =-- e e TABLE 1 RESULTS OF CHEMICAL ANALYSIS AUGUST 1991 DESCRIPTION DEPTH TPHg -ª ~ E- X 1. South Wall 3'6" 6400 43.970 160.470 14.410 291.035 2. Center 8' 160 1. 550 5.650 .510 10.265 3. Center 11' 20 ND ND ND ND Results in Parts Per Million (ppm) TPHg = Total Petroleum Hydrocarbons as gasoline B = Benzene¡ T = Toluene¡ E = Ethylbenzene¡ X = Total Xylenes ND = Not Detected Copies of the laboratory report and Chain-of-custody document are attached. The laboratory reported that concentration levels are high, yet they do fall rapidly with depth. It is AquaGeo5ciences, Inc opinion that based on the laboratory. analysis, additional work related to subsurface contamination is warranted. We recommend that you forward a copy of this report to Mr. Joe Dunwoody of the City of Bakersfield Fire Department Hazardous Materials Division. Alternatively, if you would like we could submit a copy to the City on your behalf. Please do not hesitate to call if you have any questions. Sincerely, ~ f~' . lLl~? (t-/íq,~¡ dJ~L~ \.)..;- - v -".7 (., ~ Phili , Goalwin, RG, #4779 Princi al Hydrogeologist Registration Expires 6/30/92 /-;'~:ê~ . ~,.."" :~:" (~:j::;;~.~ ,¿::::~,': .:'~ (3Q~¿5~~~]~'. ,i \ I~ I' \ No. 4779 j: '. J }.I -'"\ ., ',' . . :_~~ I" '-'.:/ ··.;OfjL;{;j!j}1 jg\ B:\REPORT\SUHDALE.RPT ~ " I i I i i I ; i , I , I i I ! ¡ i I i i I i i i i I I ! I I I \ I I ! I I ' , I ¡ ! ! ! , t I I I ¡ ! ! I ! . -........-.- - *_. - - .~--. ~_........:..__........ S8mD1e DeDths S-í: 3' 6" 5-2: 8"0" :;-3: 11' 0" ScaJe 1"= 1 O' '.. ...._._....._--~_....-. . ....-" - .....- .------~........-.. ~:.-.."....-:...-~-...-..:--.-.. ~-.....-;..-....¡~..c..~'·~':.~':':~':"";·:_...,r.:...._.._. ",-; - ~-:~-. -.~. ,-, e e Cir.œrblock Wan Above Grcund Tank ¡ank Fi1ì r-l , I S,.., I I~ ¡ ....-~ I ~~ . - ; c- j i ,r.) ¡ ~ ! ---~ .-, " , ~, , :)- I i"1aintenance Yard I I I I ¡ Driveway I I I I I I I I I AauaGeosciences. Inc. 1701 Westwind Droive Suite 103 ôaker~field, Caiifm-ni2J 93301 Telephone: (805) 326-0962 Fax 328-1129 Title Sundaìe Country C1ub Bakersfield, california SITE MAP I N , ~ ~ Exhibit "- e e Nevada M~ ßnk. JI£C. Arizona 5327 Wingfoot Drive Bakersfield. CA 93306 , (805) 872-4750 Laboratory Results For 5undale Country Club Date Received : 7/29/91 DateAn~lyzed : 8/1/91 Analyst: J.5. Johnson Lab No. 910103 Sample Matrix Soils Benz,ene mg/kg Toluene mg/kg Ethylbenzene mg/kg Xylenes mg/kg Tot Pet Hyds mg/kg 5 - 1 43.970 160.470 14.410 291.035 6400 5 - 2 1.550 5.650 .510 10.265 160 5 - 3 ND ND ND ND 20 All Results Reported in Milligrams per Kilogram ND = Non Detectable; EPA 8020 (.005 mg/kg) EPA 8015 Modified for Gasoline (5 mg/kg) Analysis of Volatil~ Aromatics ; EPA 8020 *Analysis of Total Petroleum Hydrocarbons; EPA 8015 Modified for Gasoline *The TPH Method for Gasoline is the Calif DOH5 R~ecommended Procedure Certificate Number E739 Jj¡[ji #~w- Jðtf1fOhns~ Chemist Certified Full Service On-Site Analytical Laboratories - . :-c.;"'::'''-':'~:'', ~"; F4 ~ . , '. - -- I df ua§E:01.clé:ncE:1., [/nc.~ q G'...·UnJ....dll" $'II'IIII.U . 1:"....IfI:mml'nl.1 C.,ntullault ... PROJ. NO. PROJECT NAME 0 SunOaJ ~ Coyn-f,.. u ~-' u I:. - NO, Sample l.P. NO. SAMLI9n:;:;1 OF Type PO NO} Soil - , CON· (51 TAIN· Wale' DATE SAMPl¡{¡D, I SAMPLE 1.0, ERS (WI REMARKS TIME Sludge MM¡DD/YY HH:MM:SS (59) J- 1. 1-'/ 10;10 s-( J~/~// .'¿t. {I t .s >( s 0>c.....-rJ.. t:" 8 0 F _,,_.... ø A ~.J/ð'N ItJ:'ID ~-2 J '6'1 I ~ )( (!e""..¡" /' ð F '/141'1 "-- ~' X'I ~J ¡ð:t¡::J ,$"" j d- II' I 5 '( ¿?p,..'1Þ , of 'iÄ" J, ¿) /11 l' .. -- . 1: '.. 't;I , - .., , ~ . :J t..;¡ -- ~ " -- - ) , Reli~ddj Dale/Time Re~eived by: ¡Signatural Remarks Send Results T:'þ".." /{/f/l:1/.J 7-27'~~.I.· Yo Allenllon of . , AQUAGEOSCIENCES .. ReUI\quislled bf ¡Sign'IuIII Received by: (Signa lura, 1701 WeSlw,nd Dr. SUllo 10\ ..... -..- DelTime Bakers',old, CalilorOla 93301 icj Relinquished by: ISignalure' DelTime ~~:~:f;J l.....:~:' J ' I PI )~ .IrA ) \'VnLle Sampler (I (/ f/t-U CanalY AølLlln Copy To Sh"JIH!1 PII"\~ I ëttJ Cc,t-, ... -'" - ,ij '. ~I', {\~l "I~ i.I'~·~~V\'I,' t': - 'Î e S.M C Laboratory Client Name: Aquageosciences Inc. Address 1701 Westwind Dr. Suite 101 Bakersfield, Calif 93301 Attention Mr. Phil Goalwin Date samples. received 12-26-91 Date analysis completed: 12-31-91 Date of report 12-31-91 Project Name: Sundale RESULTS OF ANALYSIS: #4585 ID: N Sidewall Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene ug/g 0.0075 ND ND ND ND ND ND TPH (Gasoline) ND e Analytical Chemistry MDL,ug/g 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 1.0 Method of Analysis for BTX/TPH (Gasoline): 8020 (FID) MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ug/g = micrograms per gram (ppm) ND = None Detected {¿M l W/û/uh.., Robert J. Mlchels Analytical Chemist 3155 Pegasus Drive . Bakersfield. CA 93308 p,o. Box 80835 . Bakersfield. CA 93380 · . (805) 393·3597 FAX (805) 393·3623 e e RESULTS OF ANALYSIS: #4586 ID: S Sidewall Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene ug/g ND ND ND ND ND ND ND MDL,ug/g 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 TPH (Gasoline) ND 1.0 #4587 ID: E Sidewall Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene ug/g ND ND ND ND ND ND ND MDL,ug/g 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 TPH (Gasoline) ND 1.0 #4588 ID: W Sidewall Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene ug/g ND ND ND ND ND ND ND MDL,ug/g 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 TPH (Gasoline) ND 1.0 tc6J ¡ 1fI~ Robert IJ. Michels Analytical Chemist e RESULTS OF ANALYSIS: :11:4589 ID: Base Benzene Toluene, ... Ethylbenzene þ-Xylene ; m ;'O-~XY-]:'erié Isopropylbenzene TPH (Gasoline) ¡J(µf 11J!~ Robert ~. Michels Analytical Chemist e ug/g ND 0.0085 0.010 0.077 0.14 0.014 MDL,ug/g 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 6.0 1.0 \, (;r~'U!h \\"I!"! 5",.'!\I,~t~ . Fln'lr"l1l1h'I1\.11 (~"n~ult'ln:< PROJ, NO, PROJECT NAME 5Uh dQ/G '-4115 NO, Sample LP. NO. S¡n;J;P~~:::- OF Tvpe #- -::J.l(?- (PO NO) Soil CON· (S) TAIN· Water " --II o SAMPLE 1.0, ERS (W) REMARKS DATE SAMPLE 1,0, TIME Sludge MM/DO/YY HH:MMSS (Sgl 1/)./;1/ /ql I:;'" '3, .)-< N S"-d~wo II 5 V 4S"Bs 1)./.;,;;; q I l.;t·d~ cO .s .. I 'J~~lIll .5 V 4se c::~ ;;,1:; if ~l :;t.,,^~. l'b ...- .r/'~'",~I/ I S V 4.s-B7 t; 1» ;J.l!q / J. :)i ,/j') tJ 5, 'j~ " ." JJ 5 -;;; 4.s-EJ8 _ ~ IJ.. :3b. IS Blf5d j V -'1.s:-ð 7 ~ ~ ' ~.h / ~ ~ ............... "'- ........ r---.... 10... ¡-........ r---.... .... .......... .......... .... .......... .......... .... .......... ............ . ~ ~ ~ ~ Relinquished by: (Sign.ture) Dalerme Re.:eived by: (Sign.ture) Remar~s ~ Ð Send Results To ?Á · i ' 6¡~/1.u1 :.., ;;þI;~ - Attentoon of · $&2 _ 'f{., IV,.", a r(}l.l..... J AQUAGEOSCIENCES Relinquished by: ,Sign.lurel Dale7ime Received by: 'Sign.'ure) i~ 1701 WeSlwind Dr. Suile 101 pI t!rfJ e. ,-; a;C ,4.ír1 p NS:> Bakers',eld. California 93301 1 r'\ 50!'/ 3?- :1 - oe"(6:J. ( I"À~...~ ,~~: (Signlture). tiJ J:tTme Received lor laboralor04 ¿~~ a/d/~4T~ ~oJ/ '3J[;/-/I:2 q ':.)6 S:f9&- (Sign.lur8~""" é, ( ¡:;1'J}c) . rr '1 .;s::;.I"-?C ¿" ð~¿ì' ,_.-.L WhIte Sampler C Canary Relurn Copy To ShIpper PInk Lab Coe-yo ~ if} GJ cffqua<:::1 E 01.CiE.J2CE1., !oo) nc. .1 ·1 CHAIN OF CUSTODY e 5 .Me Laboratory Client Name: Aquageosciences Inc. Address 1701 Westwind Dr. #101 Bakersfield, Calif. 93301 Attention Mr. Phil Goalwin Date samples received 01-06-92 Date analysis completed: 01-06-92 Date of report 01-07-92 Project Name: Sundale Country Club RESULTS OF ANALYSIS: #128 ID: Profile Benzene Toluene Ethylbenzene p-Xylene m-Xylene o-Xylene Isopropylbenzene ug/g ND ND ND ND ND ND ND TPH (Gasoline) ND e Analytical Chemistry MDL,ug/g 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 0.0050 1.0 Method of Analysis for BTX/TPH (Gasoline): 8020 FID MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ug/g = micrograms per gram (ppm) ND = None Detected !lr;t,..J i '!!l~ Robert . Michels Analytical Chemist 3155 Pegasus Drive · Bakersfield, CA 93308 P,o. Box 80835 . Bakersfield, CA 93380 · . (805) 393-3597 FAX (805) 393·3623 PROJ, NO, PROJECT NAME Srnc- Lø.- bs. , _')LLf'd.ó\e Cov-n~ C.lu..b NO, Sample l.P. NO, SAMPLERS: (S'g"allJrelNumberl J OF Type (PO NO) ~n\~~G~ç; n Soil CON, (51 TAIN· Water DATE SAMPLE ID, SAMPLE 1.0, ER5 (WI .. TIME Sludge MM/OO/YY HHMMSS (5gl \/~ lQ2. \ 0 " 40 ftm Ç/ rò ç:¡ \e Sè-~ple... I S j J ~ , . /11~nqUi.s~d bZ~ n Dale/Time Re;eived by: (Signa lure, Remarks Send Results To i¡J"p, ¿to, ·tØ~ ~u. (""r"'\'2.rð\A"¿ Attention of 4-~ µ.Q. . AQUAGEOSCIENCES '/Relinq~ed by: (Sig~aIUre) . ·"Tm. Received by: (Signalure) 1701 West wind Dr.. Suite 101 , Bakersfield. California 93301 Relinquished by: (Signature' DalelTime Received for Labora~ by: . j~"'f~~:IÒ 'S"fature) -'~, , /eel t[ , LA.p~. (f/ WhIle Sampler "= (/ I I ,.7Caflðry Return COP)' To ShIpper Ptrtk Lab COD)' d-I ua<=:; E.Ù:1CLEIlCE:1, .u IlC. q (;1,-1111,1",11,'1 5'-I":ltl<t~ . FI\\'ltt't1!IIt'TII.,1 CC'11~1I!t1ll't< ,. CHAIN OF CUSTODY . h~ . ~ . ~~."._....... ~_.~.._ ".4 .. - ---~.- . ÍI' .. '- .. e e 5 M C Laboratory Analytical Chemistry Client Name: Aqua GeoSciences, Inc Address 1701 Westwind Drive. Ste 101 Bakersfield, Ca. 93301 Date samples received :1-14-92 Date analysis completed:1-16-92 Date of report :1-16-92 Project Name: Sundale Country Club RESULTS OF ANALYSIS: #190 ID:Base ugm/gm MDL,ugm/gm Benzene ND 0.005 Toluene 0.0052 0.005 Ethylbenzene ND 0.005 p-Xylene ND 0.005 m-Xylene ND 0.005 o-Xylene ND 0.005 Isopropylbenzene ND 0.005 TPH (Gasoline) ND 1.0 Method of Analysis for BTX/TPH (Gasoline): 5030/8020 (PID) MDL = Minimum Detection Level TPH = Total Petroleum Hydrocarbons ugm/gm= micrograms per gram ND = Not Detected ~,~ ~øo. ' Kevin Lagan ~ Analytical Chemist 3155 Pegasus Drive . Bakersfield. CA 93308 P.o. Box 80835 . Bakersfield. CA 93380 . . (805) 393·3597 FAX (805) 393·3623 . '-~;' '" PROJ, NO, '"""" "AM' cI1qua § Eo~dEnCE~, [f nc. 0_.. _ þ flQ ~" CON- (5) ~(,j S SAMPLE ./"/ / SAMPLE 10 --,;7 rAIN- Waler ~~ 11 TIME . bD' ERS (W) ~::t HHMMSS 51udge 'L~ REMARKS B.A ~_ ISgl lit.... C- I' I, ¡Þ -ft· I .. ¿Z.ð IU 1-H'1.f:' J ._:) ; [,., I... ( / /4U l.P, NO, (PO NO) DATE MMIDO/YY '/14/cIL . --." - .- , elinquished by: (Sign~ur,%) D I IT' , l A ..#. ~a/h n. IJltf/~r;~52. Rmlved by: (Signalure) I7Relinquish6' by: (Signllure, ¿::J OalelT,-me 'M Received by: (Signllure) Remarks - I tV ee.L -lu.t:-I7/Ji?-ð1.L vi) Send Results To Attention of AQUAGEOSCIENCES 1701 WeSlwlI1d Dr.. SUlle 101 Bakersfield, Callfornra 93301 I Relinquished by: (Signllure) oart.lelTime, .~Rec ' ed lor L8bOj,jbry by: f, /,1 -if ). 'j}. .( g Ilur".iL - 'lJ ..u1../'fl/ 'î , ..... Lv'- t ·/L-Tf/ '. , While Sampler Canary Return COpy To Shlppef PInk LaD COtJ1 i ('Tl ,\ J1\T OJ{' ('{TQT()nV ____c________ ~__ WEIGHMASTER CERTIFICATE . , THIS IS TOJJERTì~that the following des.r¡ ed commodity was weighed. measured, or coun,ted by a W.master. whose signature is on this certificate, who is a reèßgnized'"ãuthòrity of accuracy. as presc by Chapter'7 (commencing with Section 12700) of Di 5 of the California Business and Professions Code. '1i':~ administered by the Division of Measuremen ards of the California Department of Food and Agricultur ' RE C E' VE D * * * * I N T A K E * * * * SfP 0 5 199' HAl. M~T. OrV.TICKET GOLDEN STATE METALS, INC. 2ØØØ E. BRUNDAGE LANE BAKERSFIELD, CA 93307 ,CRIØ3 CRISP CONSTRUCTION 3L~932 Commodity Weight Pt~i ce Amount Weights TANKS 10Ø1- . 13 .01 . Ø0 Gt~O S S 358Ø PDUNDS - --"'''..........;:-- T ¿:n0' e 3330 POUNDS Net ¡=:5Ø POUNDS Deduction, ø POUNDS _- ..4- Adj. Net 250 POUNDS --------- TOTAL DUE >}}> . Øø Ei/L NO. Cat~t~ i et~ License: : : Dt~ivet-· 1. C. # RelTl¿wks :CRISP CONSTRUCTION :lZ22566 Date: Time: 08/29/91 23837 Gt~oss Tare 8.45 ~.m. GOLDEN STATE METALS, INC. Weigh!11astet~ Gross:LINDA HAMMOØND Tare:LINDA HAMM00ND 8.38 a. m. PAID CASH }}}}} RECEIVED BY }}}}} ..----.. ----------.---.- ~~/ A.) I::::> A /...J£" ~¿/A.J~9' ¿?þß ~!;,' ~1 " . .-'··f~;-~f." . :;:~..:' :-:'-~.. --:. ,::~~; .f~~' . " .. ':.. "~':; '<~-:(',::~:::..'; ~:;..:~,t~ .- '" '. -'. "'r~ ;:_:i .~.' :" '. '.- ":~-'~~_..."':'-"":'---':":':"'-'....,;-;..._:..::.;..__....._-_":"-~'-':--"""""~'~',~..;;.~~' "':::~')....';.:/: '" . .~~.~~' , e e August 21, 1991 Richard Warren Crisp Construction P.O. Box 1066 Visalia, California 93270 RE: Tank removal at Sundale Country Club, Bakersfield, CA. Bakersfield Permit # BR0002. Dear Mr. Warren The following information is required to be submitted to this office per conditions and stipulations of the removal permit. 1. A copy of the hazardous waste permit sign-by the Facility operator. p.j) 2. A tank disposal receipt from the scraping facility. If you have any questions Please contact me at (805) - 326 - 3797. Sincerely, Joe A. Dunwoody Hazardous Material Specialist Underground Tank Program Q ~ 17"¡.. ~ ~ Q FACILITY/SITE _Bakersfield Fire De. HAZARDOUS MATERIALS ðl'tISION 2130 G Street, Bakersfield, CA 93301 (805) 326·3970 UNDERGROUND TANK QUESTIONNAIRE RECEIVED JUl 1 5 1991 No. OF TANKS HAZ. MAT. NAME OF OPERATOR Sundale COlmtry Club, Inc. PARCel No.(OPTlONAL) NEAREST CROSS STREET New Stine STATE ZIP CODE CA 93309 TYPE OF BUSINESS .t BOX TO INDICATE Q9 CORPORATION Q INDIVIDUAL a PARTNERSHIP a LOCAL AGENCY DISTIIICTS a COUNTY AGENCY a STATE AGENCY a FEDERAL AGENCY .... DBA OR FACILITY NAME Sundale Country Club, Inc. ADDRESS 6218 Sundale Avenue CITY NAME Bakersfield, CA 93309 a 1 GAS STATION a 3 FARM Q 2 DISTRIBUTOR kERN COUNTY PERMIT Q4PROCESSÒR Q9 5 OTHER TO OPERATE No. 280038C-91 EMERGENCY CONTACT PERSON (PRIMARy) EMERGENCY CONTACT PERSON (SECONDARy) octloncl DAYS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE DAYS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE ! Nolan, Ben 805-831-4200 Newman, David 805-831-4170 NIGHTS: NAME (LAST. FIRST) PHONE No. WITH AREA CODE NIGHTS: NAME (LAST. RRST) PHONE No. WITH AREA CODE Kiger, James 805-834-5829 Klose, Kenneth 805-665-8229 NAME II. PROPERTY OWNER INFORMATION (MUST BE COMPLETED) CARE OF ADDRESS INFORMATION Sundale CountrClub, Inc. MAILING OR STREET ADDRESS 6218 Sundale Ave CITY NAME Bakersfield, .t BOX a INDIVIDUAL a lOCAL AGENCY a STA TE AGENCY TO INDICATE a PARTNERSHIP a COUNTY AGENCY STATE ZIP CODE CA 93309 PHONE No. WITH AREA CODE 805-831-4200 III. TANKOWNER INFORMATION (MUST BE COMPLETED) NAME CARE OF ADDRESS INFORMATION Sundale Country Club, Inc. MAILING OR STREET ADDRESS .t BOX (J INDIVIDUAL (J LOCAL AGENCY (J STA TE AGENCY I 6218 Sundale Ave TO INDICATE a PARTNERSHIP a COUNTY AGENCY- ~5PERAl AGENCY. CITY NAME STATE ZIP CODE PHONE No, WITH AREA CODE Bakersfield, CA 93309 805-831-4200 OWNER'S TANK No. 1 DATE INSTAllED ? VOLUME PRODUCT STORED Gasoli e 550 Gallon$:3 ~ DO YOU HAVE FINANCIAL RESPONSIBILITY? V/N TYPE \ IN SERVICE ~N V/N V/N V/N V/N V/N """,< " ,; ,/~ Fill one segrnenjilut for each tank, unless all tanks and piping are 4 constructed of ~ same materials, style a~ype, then only fill one segment out. please identify tanks by ~ner ID t. I. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # II/If B, MANUFAC1URED BY: ? C. DATE INSTALLED (MOIDAYIVEAR) ? D. TANK CAPACITY IN GAlLONS: .55"0 un. ___._ III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B. AND C. AND ALL THAT APPliES IN BOX D A. TYPE OF 0' DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER 0 95 UNKNOWN SYSTEM ~2 SINGLE WALL 0 4 SECONDARY CONTAINMENT (VAULTED TANK) 0 99 OTHER ~ 1 BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGlASS 0 4 STEEL CLAD W, FIBERGLASS REINFORCED PlASTIC B. TANK MATERIAL o 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM 0 8 100% METHANOL COMPATIBLE WIFRP (Primary Tank) 0 9 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER 0' RUBBER LINED o 2 AlKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C.INTERIOR 0 5 GlASS LINING 2g 8 UNLINED 0 95 UNKNOWN 0 99 OTHER UNING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_ 00_ D. CORROSION 0 1 POLYETHYLENE WRAP 0 2 COATING o 3 VINYL WRAP 0 4 FIBERGlASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION ~ 91 NONE...... o 95 UNKNOWN 0 99 OTHER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND O,R U IF UNDERGROUND. BOTH IF APPLICABlE A. SYSTEM TYPE A@1 SUCTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A@1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND A ~ 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (Pvq A U 4 FIBERGlASS PIPE CORROSION A U 5 AlUMINUM A U 6 CONCRETE A U 7 STEEL WI COA T1NG A U 8 100% METHANOL COMPATIBLE WIFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION D 1 AUTOMATIClINELEAKDETECTOR ~ 2 LINE TIGHTNESS TESTING o 3 INTERSmlAL D 99 OTHER MONITORING V. TANK LEAK DETECTION o 1 VISUAL CHECK 0 ~ 6 TANK TESTING 0 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORING 0 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 7 INTERSTIT1ALMONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER J. TANK DESCRIPTION COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. # B. MANUFAC1URED BY: C. DATE INSTALLED (MO/DAYIVEAR) 0, TANK CAPACITY IN GAlLONS: ----.- ~ 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 0 95 UNKNOWN SYSTEM 0 2 SINGLE WALL 0 4 SECONDARY CONTAINMENT (VAULTED TANK) 0 99 OTHER 0 1 BARE STEEL 0 2 STAINLESS STEEL 0 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 WIFRP (Primary Tank) 0 9 BRONZE 0 10 GAlVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER 0' RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING 0 6 UNLINED 0 95 UNKNOWN 0 99 OTHER UNING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_ 00_ D. CORROSION 0 1 POLYETHYLENE WRAP 0 2 COATING o 3 VINYL WRAP 0 4 FIBERGLASS REINFORCED PLASTIC PROTECTION D 5 CATHODIC PROTECTION 0 91 NONE o 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 U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL AU 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 U 4 FIBERGlASS PIPE CORROSION A U 5 AlUMINUM A U 6 CONCRETE A U 7 STEELW'COATING A U 8 100% METHANOL COMPATIBLE WIFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK -DETECTION D 1 AUTOMATIC LINE LEAK DETECTOR D 2 LINE TIGHTNESS TESTING o 3 INTERSTITIAL o 99 OTHER MONITORING V. TANK LEAK DETECTION r-, 0 , ~~; 1 VISUAL CHECK -1 6 TANK TESTING 0 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORING D 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 7 INTERSTITIAL MONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER / "'~~~~--\~- - ~ -- -~ -' ~-' --HAZA-Â6òus MATERIALS DIVIS¡ON .,. B ;<. (!;)OO~ ' I ~'~H',~:~.: 11 ~, '~ U.RGROUNO STORAGE TANK P.RAM ~,~.... ..... " ~?~SC'J.ç, 4 '.n PERMIT APPLICATION FOR REMOVAL OF AN UNDE~GROUND STORAGE TANK SITE !NFO~MA 11CN SliE :=:-u. Ñ~Lr: c.c>->.~,,2,,\ Cl,UrßADûRESS wu B ~\.I.a~ ~ ZIP CCOE ,S 3?r::F1 A.PN 1-05~'~ FAC:Ur( NAME ~l--li~~<L CCM\.i('r~(~~ROSS STI<E::T ~B&o ~~ c:e... - iANK OWNER/OPERATOR JIIIJIJIp~~ CrlJ..\l~~ß. PHONE NO. f:o!:; - 6=-\ _~ MAILING ADDRESS 1cZJ82'__~ _~_ CITY ~~ZJP cooe q ~~ CCNTRACiOB INFORMATION COMPANY CQ\<:R ~\. CD ) ~é...._ PHONE No. 1P'-ì3-1'-\c~L LICENSe No. Slc14~ ADDRE~S Çb ~x \ c.\.:J\,o CITY \J~'S"AI....A~ ~ ZIP CODE Ci'32..¡q INSURANCE CARRiER l1..ll~()(s... 1.~~-lCQ WOr<KMENS COMP No. e.~ 90~~""Z.ïC?$' PReUMANÅ~Y ASS~MENT INFORMATlON COMPANY ~ù~ l.r\EO~~ PHONE No. AODrtESS ll~ ~.~', vh.~O ~'--(~ \0\ INSURANCE CARRIEif c.:..,~ po, { ~\À(2~ %...s-~-ze-<A.êCENSE No. u¡-n~ ~ ~~I~' City ~~~csv.=> Z1P CODE ~ 3.:3b ~ WORKMeNS COMP No. o~ rz.o ï(ql .. !:4NK C!EANING IN¡:OrlMATION COMPANY Mt' ,! W J Çj¿<2J\~.Q ~HCNe NO. 'B::1S-3i.3 \\S\ ADDRESS r.ìP'! - ,:>~ C:TY ~~~IP CODe 93~ ' WASTE mANS?ORTER !CENT¡F~C~jìCN NUMBER '~ 7 ..::;~ NAME OF RINSIATE DISPOSAL FACILITY ~~ r?~ ' ADDRESS c;s..o ~ ~ mG2uA.4....... ÇQ CITY ~t?S-Çì@.çZJP CODE ~ B:i:iaS FACiLITY!NOENTIFICATION NUMBER (;..F-\-OC\ €:C~e ~ \ ïî . , , TANK TT?A NSPORCEJ? INFORMA T10N , COMPANY J:~ sF Lo~..ç- Co ?HONE No. 2..cß\-T?"-,",,,,~\ L1cENse No. 5c..~,- A:)DRESS ~ ~ \~ ' c:rt \ II ~ ~ a P:r Z1P COOE ~ ¡'1 ~ iANKDESTrNATlON ~~'~_ .~ \ ú..9~'~~ ~ .. \ ' TANK INFORMATION TANK ~~o. AGe VOLUME CHEMICAL STORED OAiES STO~ED h-\\ ~ . \ 1.0 ~(, SSe::> ;u"'~ ~/ð-M~ //:,~õ ?~/¡) s-L"': hØ£) ð¿Jè/s ~ 0'$.;--Y;:: ø ./ " :~'~~,2:~~~'~~:' '7.~:'·~'¡'·~~~~~~~r~¡Þ~"'·NO;OF" TA~Ki:;:I''';e~~~O.Ô>~ (-~~\. ~~ 1~E AI'PLlCANf ~AS ReCEIVED. UNOéi(Si~NOS, ANO WILL COMP'.Y WITH THE ,;:ïAC~eO CONCITIONS OFTIoIIS P£RMlfANO ANV OTHeR STA TE. LOCAL AND FEDERAL ~EG\)~A T1CNS, ¡HIS ¡:O:'ìM HAS ee=N CCMP~ETEO UNOE~ ¡:eNALTY OF PE:1JU~Y, ).NO TO ¡HE 3EST c~ MY KNC'N~æoGE. IS mu~ AND conne.c~. ~¿d- (~PLJCANT NAME (PRINT) 1<i~ \J~ APPLICANT 5¡GNATU~E THIS APPLICATION BECOMES A PERMIT WHEN APPROVED ¡ft.) ¡ 'i';" i e , PLOT PLAN e Plot plan must show the following: 1. roads and alleys; 2. buildings~ 3.location of tanks, piping and dispensers; 4. utilities; 5. SCALE; 6. water wells (if on site); 7. any other relevant information. . NI .:v .J I j , I I I ~ 1~ ~ -S u t\>"\)AI-c.... \.41 '~ ~ \J ...... ~ ~ ~~!,~\CCJ /;:~~ '-~..,,< .~ íÏi -.- ==~~ :ifJ '::"= -:~ =~;::o ~~ ..;;~== ;.- ~: ~ ~\ -. ~~ '!~, (.i? ~'- 4,............... .," / ~&""_,, ,-\\1.,<-,' r//¡Iljjjjj¡t'" 0 - :> 0.. Õ W 0.. ~ ...- ¡..:: w '-0, <1:: 0 - :!: w -I N I a: :;:) "'") «: , J: !' ! . I I - ~~ PERJ.'1IT ;i: . e BAKERFIELD CI~'~'~~E DEP.MENT ß.~ O"9olf:r HAZARDOUS MATERIAL DIVISION 131) /f"'IO 0 'J UNDERGROUND STROAGE TANK PROGRAM . f\ V '~ PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE' TANK Site Infromation " Si te Address 'ìICf Y¡;:f)h)~ ÒeA-(Þ.. mJZip Code fØ"309 ÀPN Facilil ty Name .s, 111\,'¡-IAl~ rO\Jv'\ w~ (I \.u~ Cross Street :;5(YIJ"DItI.e Tank Owner/Operator .s~N'\-t" Phone 83/-Clz.-ð6 Mailing Address <5 Dr-TYl~ City ì)t:.S.fII"J Zip Code Cðntractor Information Company (111 1Áf' ~£ Phone t >!a::ßj'f,,}-/Ll}LicensefF Address -;"1..'33 11\1. ¡}..J.r:., VY'O . ' Ci ty "tJ/¡j Pr I} 4 Zip Code Insurance Carrier fJ11^ ,. f 11 ' Workmans Comp -# 9~;)..ID rYl~ Assement Information Phone City prelimanarv Company Address Insurance Carrier License# Zip Code Workmans Comp :if: Tank Cleaninq Information Company ~+ ~ ,\J¡!-(.,uu W\ . Phone Address r) JcL City Wate Transporter Identification, Number :::: Name Of Rinsate Di~osal Facility ~ -b. Address {)rA #. City Facility Identification Number Zip Code +/:¥I ~1~~ Zip Code ~ I f Tank Transuorter Information Company ~.. '\) ~ _ Addres s ~ Ill. oodJ Ci ty Tank Destination -:i ~() } å' TANK INFORMATION Chemical Dates Stored Sto~ ONI Phone I~ ~~()-~s-?-::;~ 7 l1,si:r/¡r., Zip Code 9)2-11 Tank :if: Volume Chemical Previously Stored. age r l sS""o ~L. ------ For Official Use only Application Date 7/17/1/ Facility :if:)/ 8 /5 :if: , of TanksL Fee$ 550, The applican~ has recieved, unders~ands, and will comply with ~he a~tached conditions of this pe~t and any other State, Local and Federal regulations. This form has been completed under penalty of perjury, and to 'the best of my knowledge, is true and correc~. (y\ c)DÚ<' Name(print) APPLICATION BECOMES A PERMIT WHEN APPROVED 7" I o It) It) ,... c\¡ It) CX) ò o <9 - ~ Ø')3 ~ ~ ~ CD3 ~ , I CO!:: ;0: C\ o CX) CX) -t C\ ., ò o <9 " a: W .... Z . 'W U W rn z 0 c.. rn W a: ..J < Z 0 ~ < z W ~ ..J ..J < U ..j ..J ëï: rn a: 0 >- u z W C) a: W ~ T W Z R A < N U- S 0 P W 0 rn R < T U E ~ R F A C I L I T Y i .-~ . Department of Health Services Toxic Substances Control Division Sacramento, California - UNIFORM HAZARDOUS WASTE MANIFEST 0 0 8 ~ I 3. Generator's Name and Mailing AddresÐeI A.J l)ÇJ (-( <0u~:n'1 c ~ /"718 S,I1vJAlt tRJ~ . Bl'}ÓJt{rFuIJ'r;¡ ~33'Ò7 4. Generator's Phone f!;o)i 0 5. Transporter 1 Company Name 6, US EPA ID Number HP E~;VlkO;\.';:NTAL S¡'RVICES, H:C. 7. Transporter 2 Company Name 2, Page 1 of Information in the shaded areas is not required by Federal law, A. State Manileã D§uSe3 N43r 9 0 B. State Generator's ID C, State Transporter's ID D, Transporter's Phon~O- E. State Transporter's ID F, Transporter's Phone G. State Facility's ID 9. Designated Facility Name and Site Address GlhSON OI~ & REFINING END OF CO?::ERCIA:J DR. BAKERSFIELD, CA. 93308 11. US DOT Description (Including Proper Shipping Name, Hazard Class, and ID Number) I. Waste No. a. State 221 G E N E R A T o R NON RCF.A HA¿-L~)'JUS WASTE LIQUID EE~F1t:fiT b. State EPA/OIher c. State EPA/OIher d. State EPA/OIher J. Additional Descriptions for Materials Listed Above A) DIESEL/GASOLINE RINSATE OILY WATER c. d. 15, Special Handling Instructions and Additional Inlormation G:,ov~~" GOGGLES, AND PROTECTIVE OUTER GAR'·fF.YTS. RE:"EASE#8Qil:-:!i_ 16. GENERATOR'S CERTIFICATION: I hereby declare that Ihe contents 01 this consignment are 'fully and acof¡rately described above by proper shipping name and are classilied,.packed, marked, and labeled, and are in all respects in proper condition lor transport by highway according to applicable international and national government regulations. III am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method 01 treatment, storage, or disposal currenlly available to me which minimizes the present and future threat to human health and the environment; OR, ill am a small quantity generator, 1 have made a good faith effort to minimize my waste generation and select the best waste management method that is available to me and that I can afford. /} - b CJ( t:-,' Rm~ 17. Transporter 1 Acknowledgement 01 Receipt of Materials ~/Tw¡ed Name . K..J. {}J 15 18. Transporter Acknowledgement 01 Receipt of Materials Printed/Typed Name 19, Discrepancy Indication Space 20, Facility Owner or Operator Certitication of receipt of hazardous materials covered by this manilest except as noted in Item 19, Printed 1 Typed Name Signature Month Day Year DHS 8022 A (1/88) EPA 8700-22 (Rev. 9·88) Previous editions are obsolete. Do Not Write Below This line YEllOW: GENERA TOR RETAINS """. '. e e 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 o 1 NEW PERMIT o 2 INTERIM PERMIT o 3 RENEWAL PERMIT o 4 AMENDED PERMIT , o 5 CHANGE OF INFORMATION o 6 TEMPORARY SITE CLOSURE 7 PERMANENTLY CLOSED SITE I. FACILITY/SITE INFORMATION & ADDRESS· (MUST BE COMPLETED) E k NAME OF OPERATOR ~ PARCEL # (OPTIONAL) 0/ BOX TO INDICATE o CORPORATION o INDIVIDUAL o PARTNERSHIP D COUNTY-AGENCY o STATE-AGENCY D FEDERAL·AGENCY o LOCAL·AGENCY DISTRICTS TYPE OF BUSINESS D 1 GAS STATION D 2 DISTRIBUTOR 0, 0/ IF INDIAN # OF TANKS AT SITE E. P. A. L D. # (optional) ~ RESERVATION o 3 FARM 0 4 PROCESSOR ~ 5 OTHER OR TRUST LANDS EMERGENCY CONTACT PERSON (PRIMARY) DAYS: NAME (LAST, FIRST) PHONE # WITH AREA CODE EMERGENCY CONTACT PERSON (SECONDARY)· optional DAYS: NAME (LAST. FIRST) 't , ' . ..è'..,.~ NIGHTS: NAME (LAST. FIRST) PHONE # WITH AREA CODE NIGHTS: NAME (LAST, FIRST) II. PROPERTY OWNER INFORMATION· MUST BE COMPLETED NAME :?ð' MAILING OR STREET ADDRESS CARE OF ADDRESS INFORMATION CITY NAME 0/ box k> indicate 0 INDIVIDUAL o CORPORATION 0 PARTNERSHIP STATE ZIP CODE D LOCAL·AGENCY 0 STATE-AGENCY D COUNTY-AGENCY D FEDERAL·AGENCY PHONE # WITH AREA CODE III. TANK OWNER INFORMATION· (MUST BE COMPLETED) NAME OF OWNER CARE OF ADDRESS INFORMATION MAILING OR STREE 0/ bou) indicate 0 INDIVIDUAL o CORPORATION 0 PARTNERSHIP STATE ZIP CODE D LOCAL·AGENCY 0 STATE·AGENCY D COUNTY·AGENCY D FEDERAL·AGENCY PHONE # WITH AREA CODE CITY NAME IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 323·9555 if questions arise. TY(TK) HQ @E]-o=rIJTI V. PETROLEUM UST FINANCIAL RESPONSIBILITY· (MUST BE COMPLETED) -IDENTIFY THE METHOD(S) USED 0/ box k> indicate o 1 SELF-INSURED o 5 LETTER OF CREDIT o 2 GUARANTEE D 6 EXEMPTION D 3 INSURANCE OTHER o 4 SURETY BOND VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notification and billing will be sent to the tank owner unless box I or II is checked. CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: 1.0 I~·O THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, /S TRUE AND CORRECT JURISDICTION # LQJZIZJ FACILITY # ~. LOCATION CODE· OPT/ONAL ¡CENSUS TRACT # . OPTIONAL SUPVISOR - DISTRICT CODE· OPT/ONAL 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) FOROO3JA-S e e CRISP 1ANt( '¡EST~ P. O. BOX 30481 STOCKTON, CA 952: (20') '31-1121 LICENSE 1#;:-2 . ~ LEON' ~ ~4d AI< ~~r:~CRIsp . --- '.=-:> ~-.:: ~ P. q. aoX' 3ìJ4ã7·..... ",~TO(K~O,':. ~ 95213 , (20") 931.1823 ¡;r J.:.j ~);. >1. C~o:.. ,-,c.-..ì,'::-~ , .^ TEST n I~PORT ONNF.'. 0" S ITE ~k tJ.,1 H\~----.fJu.b ADDRF.Ssl:dl<3 :3.t U'\rlûlLJ}(If.nllE CI'I'y&:J.-u,sF,,¿lcl, ~A, ZIPC¡t~.3DC¡ . OWNER QF TT\N {(s>5L\nd.cJf. C.bUf\fr~ ('ILt") ^DDP.ESS~)~ Stu'\J(d¿ It:llE.lIULCI'l'yfuJ¿ff<f,'Ek1, CA I 'lIrq,:2JCf1. .OPERA'POR AT "()C^"·\ON~1J.0dJé t.'..=~ ~lu.b ADDRESSba1'R :S,tndG\(r~· Av~ Cl'l'Yl S Ed CALIF. ZIpQ3309_.' NANE OF COUNTY Kt..~(\ - - TANI{:fI:Lì^-.)~ON PLO, , PLT\N. T\GE OF 'I'ANIC..;ìt:(' YRS. CAPACITY ,")Of) GALLONS. DIESEL , PHENrml UNLEADED UNLET\DED REGULARY, KEROSENE , O'l'IIEH - '. t-ŒTALXFIBERGL1\SS_. VAPOR RECOVERY SYSTEM:. YES~NOX·, TYPE OF SYSTEr1: SUC'l'll1N1, SUm1ERSlnLE_, OTHER HET\SURED T\P I SPEC T FH~ nRT\ V ITY roD PRODUCT TEHPERATURE 7õ API SPECIFIC GRT\VITY 0IfiO' F..t::;7.,5'". COEFFICIENT OF EXPANSJON ,DOO~l,:5~,S" TT\NI{ FI'LLED - ]1T\'!'E ~~~-~. ' 'HIE 'l'Mm TESTED - DT\'I''( ~ -i'- ILl' START JD;)' 4- LENGTH OF TEST d. tJ l L ~ , FINISH ),;)/g '] -/1 TANK \10TTOf.1 TO GHMH; .::, . TT\NK TOP '1'0 GHT\DE ~'f{ II. DIANE1'ER if711. TEST LEVEL T\\10VE GRT\ )E <g{ìJI. \-/T\TER IN TANK ø'. DEPTH FOR TT\I<lNG SM1PLE 5J,5~' 1'ENP. rROBE DEPTH 3D" . TEST LEVEL TO TANK BO'fTOM JS5/~ GROUNm-/ATER T\BOVETT\NKL. PRODUCT PRESSURE per 1" IIF. I GU1' , D;:>¿,PSl. 4.03 **RESULTS OF TEST*~ CERTIFIED TIGHT: YESANO_. LET\!{ RATE PE~ HOUR: +, om O~ S IGNATUR E OF OI'ER T\' 'OR " t~ "^'lEhöMrul r:~~~. I -. .' . "'.. .:,:-~'.~:~; :.';i.:, ':~.~~:~:~-..;: [?@@ill @æIT®O~&~ LI¿ÈN~E...~.2,~~j'6,~,- LEÓ~~?_·t~".:~~~!ij· .'';'',. '7¡.i0"1!~~lf '~~~1"?'*~~t~ ...,.... ".:..: . . -' .'~ . " . . ',.')" . ---.:;:~:;?.,;-~'~-:':.' . _ .:û.·__4.....;..::...-_.~.::--.~ ~,~~..,...~., < "t· I' ;, ,t'- ,.,~, 'i~~ J~ , '~ \ :\' \ t .;. 'It, ~~ ,. .... .' " ,~'f t' ~~ . ~. ~ ~, ..' f . ,I ." ~ij@~ ©rQ~F~· [P@@!;1 ®œO®O~&[b [f}~iD~ @~~@OW8[L '" ~', ~, ; ~. ; e FILE CONTE~ITS SUMMAR' '. FACILITY: ~(lnrlo)eJ CnUYl+fcl C,\ \ ! b ADDRESS ': 7() YehhJe. :heúC'n -:Dr. PERMIT #: ¿) S?'()(),~ X' ENV. SENSITIVITY: Activity Date # Of Tanks Comments ÚPp)¡ŒO+ìOn t//()/qõ I ntXrak { I I I I I . I >.: ~~":"~".;~ ,'- ~ \~:':. '. ;~JI:Y'. ~....\-...;..:.\.L!.;.';L...j.~"'''''''' .1.:...-..·..:....1;1. .\.\....'.~,.... l)l~r:Jlt .\0. -, ~-;-, ." L.. :: Î 0 0 " 1-1" S '1' R E E T , ~ . ~ÑKERSfIELD, CA STE. JOO 9Je _PI iCI1 liull Dale oj'" APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY Type Of Application (check): ONewFacility DModification Of Facility G Existing Facility DTransfer Of Ownership 831-5224 A. Emergency 24-Hour Contact lname, area code, phone): Days (805) 83l-4liO-83l-4200 Nights 397-8727-834-5829-397-0406 Faci 11 ty Name Sundale Country Club No. Of Tanks 1 Type Of Business (check): OGasoline Station G}Other (describe) Golf Course Is Tank(s) Located On An Agricultural Farm? DYes Œ No C01..lrse Is Tank(s) Used Primarily For Agricultural Purposes? ~Yes []NoEquip to maintaln gol Facility Address 701 Pebble Beach Dr. Nearest Cross St. Burke Way T R SEC (Rural Locations Only) Tank .Owner SlIndale C:otlntry Club Contact Person Superintendent Address 6218 Sundale Ave. Ci.ty / Sta te Bakersfield, CA Telephone 831-4200 Operator Sundale Country Club Contact Person Gen Manager Address 6218 Sllndal e Ave, Bakersfield Zip 93309 Telephone 831-4200 J B. Water To Facility Provided By Own Well Soil Characteristics At Facility San¿¡y-rlAY Basis For Soil Type and Groundwater Depth Determinations Depth to Groundwater 200 ft lll1known License No. Telephone Completion Date Insurer CA Contractorls Zip Proposed C. Contractor Address Proposed Starting Date Workerls Compensation Certification No. D. If This Permit Is For Modification Of An Existing Facility, Briefly Descri Modifications Proposed E. Tank(s) store (check all that apply): Tank t Waste Product Motor Vehicle Unlended Reg:ular Premium Diesel Waste Fuel Oil 1 0 0 0 œ' 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 F. Chemical Composition Of Materials Stored (not nece.ssary for motor vehicle fuels) Tank , Chemical Stored (non-commercial name) CAS I (if known) Chemical Pr~viously Stored (if different) G. Transfer Of Ownership Date Of Transfer Previous Owner Previous Facility Name I. accept fully all obligations of Permit No. issued I understand that the Permitting Authority may review a- , modify or terminate the transfer of the Permit to Operate this underground stora facility upon receiving this completed form. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - This form has been completed under penillty of and correct. perjury and to t~s~ of my ~now)edge is tru ~//7~ ~¿ Titlp General Manager n~tp 1-10-90 (~1 rrn~tllrp- ~ i '. ;; H. :[0 .', ..i..L \t':~L \.)01 2)l':'l<·\!~...\lt.. :"01\.1\11 t·\ ..::.J\Li-"1 i4-\;.'\i\..i " ..L 1. 2. .OR EACH SECTION. CHECK AIL APPROPRIATE BOXES Tank is: .. ) Vaulted ( ) Non-Vaulted () DO_Wall () Single-Wall Tank Material () Carbon Steel () Stainless Steel () Polyvinyl Chloride () Fiberglass-Clad Steel () Fiberglass-Reinforced Plastic () Concrete () Aluminum () Bronze (29 Unknown () Other (describe) Primary Containment Dàte Installed Estimated 1964 Tank Secondary Containment () Double-Wall () Synthetic Liner () Other (describe): () Material Tank Interior LininS!' () Rubber () Alkyd () Other (describe): Tank Corrosion Protection () Galvanized () Fiberglass-Clad () Polyethylene Wrap () Vinyl Wrapping () Tar or Asphalt (X) Unknown () None () Other (describe): Cathodic Protection: () None () Impressed Current System () Sacrificial Anode System Describe System and Equipment: Leak Detection. Monitoring-. and Interception a. Tank: () Visual (vaulted tanks only) () Groundwater Monitoring Welles) () Vadose Zone Monitoring Welles) () U-Tube Without Liner () U-Tube with Compatible Liner Directing Flow to Monitoring Well(s)'" () Vapor Detector'" () Liquid Level Sensor* () Conductivity Sensor* () Pressure Sensor in Annular Space of Double Wall Tank* () Liquid Retrieval & Inspection From U-Tube, Monitoring Well or Annular Space () Daily Gauging & Inventory Reconciliation () Periodic Tighmess Testing () None (x) Unknown () Other Piping: () Flow-Restricting Leak Detector(s) for Pressurized Piping* () Monitoring' Sump witþ Raceway () Sealed Concrete Raceway () Half-Cur Compatible Pipe Raceway () Synthetic Liner Raceway () None () Unknown () Other *Describe Make & Model: Tank TÍI~hmess Has This Tank Been Tighmess Tested? () Yes Date of Last Tightness Test Test Name Tank Repair Tank Repaired? () Yes Date(s) of Repair(s) Describe Repairs Overfill Protection Cx1 Operator Fills, Controls, & Visually Monitors Level () Tape Float Gauge () Float Vent Valves () Capacitance Sensor () Sealed Fill Box () Other: 3. Thickness (Inches) Capacity (Gallons) 500 MarlUfacrurer 4. () Lined Vault Manufacturer: Thickness (Inches) () None (~ Unknown Capacity (Gallons) 5. () Epoxy () Phenolic () Glass () Clay ( ) Unlined Cx) Unknown 6. 7. b. 8. 9. () No Results of Test Testing Company (29 Unknown () No Cx) Unknown 10. () Auto Shut-Off Controls () None ( ) Unknown List Make & Model for Above Devices 11. Piping- a. Underground Piping: () Yes () No Thickness (inches) Diameter ( ) 'Pressure () Suction ( ) Gravity Underground Piping Corrosion Protection: () Galvanized () Fiberglass-Clad () Impressed Current () Sacrificial Anode () Polyethylene Wrap () Elecnical Isolation () Vinyl Wrap () Tar or Asphalt () Unknown () None ( ) Other (describe): Underground Piping, Secondary Containment: () Double-Wall () Synthetic Liner System () Other (describe): /~----J ~ Þ /// J I{ 'ì .' #~7/'/ /)t)/{¿t-L- ,Øt/¿þàl;/ ---ø/1//r (29 Unknown Material Manufacturer Approximate Length of Pipe Run b. c. () None (i9 Unknown