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HomeMy WebLinkAboutUNDERGROUND TANK (2) PROVIDE: DRlMING or ~ LX;C~T Cf ¡:-.~CI:'IIT :_'Sl!,~ SP^ctfROVIDED B£LC~·J. ALL OF THE FOLLCWING INFORHATICN MUST 8E INCLUDe: ::! ORDER FOR APPLICAT.lCN ro SE Q PRCCESSED: ) .j .¡ TANK(S), PIPING & DISPENSER(S), INCLUDE!\~ LENGTHS AND DIMENSIONS PROPOSED SAMPLING LCCATIONS DESIG~ATED BY THIS SYMBOL II ® II NEAREST STREET OR INTERSECTION JJD.\.f':;ANi WATER WELLS CR Si1RF.n.CE tvATERS WITHIN 100 I RADIUS Of FACILITY .¡ NORTH ARRCM 7EZl(1u~ ~. ~~ ~"~lLDJi t 1/ -.. / I 0 0 k .,/ ;(~5b/~(; Ç~LE~¡\(Ù .-> \ ¥, ~ If ^. . ~ ~t.:".~ E. Á.j:e ~+t Ov,,- /,»~I\ (p/,,¿}~ (~ ''''---\ )( / I) ceo 9At. LQt::>~ O;L 1í&JK--, . ~ \f) '< 'ìZ >< y.:. \(' . . K If k. K K f-l~ L~ct~ --¡£Ãcts k: x:. )<... ~ ...J.(..... .~ ! - I _ r - ~ '" -, ~ -: ,.,.~1t-. ' .; ,jf_- ': ";:,, .- . . '.. ~r:-;.{~'-./, . . '. :;<~¡' -: :"': ;':c~.. . . ,,·:,:...:<¡:>';ii'·"rl?û'XTOi/ ~.i~J:~t~~~!.·~; '. '. ---- ' " ,~ .', , " ~. '.~ :} :',!. ,,' ~. ......"! '.: . ~ ~. 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Ce"''t__~ ~Ç>.~~e.. ,/'" ~-O() ~ 0; I 11)/ 0"0:> d~se.l 'eS ....... ¡ D, 000,5 8,(,)"o~ d~«.sc{ 300~ o~ l \ 'J-, \ S í~V\l'to~ \ ooo~ &\~\ +e..~eð./p4~d \G../Dq,/<îZ- ;2- ID¡oW.:> tAt\-""~ \"",ve. bee.... ~vY-O\Jec( tÑ'-v..-'f.,IA. ~ oo".!¡ ~I'r^k. 1^""'!AIi"C£ ~ J --~ --.. ~ V) ~ ~\' Q:' '" ~J ~'-< . . l'ke.cled '. -~-~--.-- ;).o ooo~ G.~1)I~V\E.... ~+e5't leAk G~~~e 01\. ~OIDCO~ ~PI.sol,'r'\.Q.. +-AV\~ ~ li.¡t~-í:ev'J<.1on If/;>.h ?~,qD'J,.. (r:..ì D1090 ~ ¡>,.V\-Ä. ~o ooo..5 1-¡o.",,\-I.Æ, , ,1).1\ 5" ~ (\€.~ ~\,L., ~~\-.-\-V'e5S +-~~ ),) ut'~~'\e- ~,/f\....* ì'^\I~ *o~ ìµ.v~.!¡c"" L/+ i I r {. 'r' PI "I" t' ~~( -~~, I "0 E. (8 '-..., ~ II~o ~ ~\Q,::.Q,\ \~ 15' /B.\J,,-IOY'. ßl~ :S\)..~t'c..Q..- I') "'~ "1-"",,'\'1'- ~'\-~ t~t -~ ~ - lO) Dot;) 3 ~~I}...e., ~30 r",,/,, I - '3 Doo~ d.~~ \ }~ I, -¡:'S OY\E?. {'i-\V\,K.. CL; 't oC:: s€~"ke ~ ìr $0)1'-1- M(,<$f -be. f"Opert..'J d,,~d ~. I ~,,~ +~~'" QVe.~y 3y~ 01'\ ~te.~QÀ +AV\\< "3, -tAV\.\I..!:. I'\~ '-h~l..'\ V'~ 4SE.'\-~ ~ 4f-/Acked --~-"-~~~-----~' - '-"---'~ ~-'--' .;-~-- ~--:".._~_....- "I j -:;,;:::..-,."-,, ~ -:'-~- ·~~Pri'~1!f~":.-_ -.r --_"",,_¡,;¡,=~, ,_"'''OC'"C-- --- 'U ~;-.,.,' -.., ~,-~. -.-.. . I STEVEN G. LADD Director Eme,,,ency Servlc.. FacUItI.. M.n.gem.nt FI..t M.n.gement Property M.n."emenl Purch..lng COUNTY OF KERN .NERAL SERVICES DEPART.T Olllee Addre.. . 1600 Norrl. Ao.d Baker,fleld. CA MeUlng Add,...· 1415 Truxtun Av.nue B.ker.neld, CA 93301 Telephone - (805) 861·2491 10 April 1990 James E. Petersen, CPM Real Estate Marketing/Management 901 W. Civic Center Dr., Su~te 340 Santa Ana, CA 92703 o~V\e-~ 0~-+-A V\.!L @.. /)...30 -:ç~ SUBJECT: Y-lb - HUMAN SERVICES - O.C. Sills Building - 100 E. California Ave., Supervisorial District '5 Dear Jim: Here is another original and two copies of the Agreement to Monitor Underground Storage Facility per your phone call. Please have the owner sign all three documents and return them to me. A fully-executed copy will be'sent to you upon execution by the Board. Thank you. Sincerely, SGL:JM Steven G. Ladd, Director ;k' - 7 IÍ' )//7ê ~¿'3<-/ /~;:.¿ cC t {..I Janice A. McClain L/ Real Property Agent General Services Department , cc: Supervisor Shell '~,,[¡aN~yi?l'J Ohn'i'c'8.n~Dlvlt8"1rOí:i"""'Chl e f '!t;"Gti~!ig~.; <K~. r~ ~'\-yi€k. <:S<IG.5 - . . .~ , ,~ . -- ---~ I I I ! ---- ~ .;o.,^., . . . < .,¡ " ~ ~ f I!J ~ ~ ! 2 *''-~ '~ . . I DIESELI3.0794 INYO STREET TANK # 3· JULY 1994 VARIATION 20. , , · . . . . , . , · . . . . · . . . . · . . . . · , , · . . . . i~__ ~__ _15~ ~"~~' l.. ~":.: ", ~'.~:"," :.:.:.' ~,' ~~ ".'. L~'" ":.,,,,,,, ~""" ":,..,," ':".,,'" ","" ,~.,,'"'' "",,, '"'''' '" · .. .. --. . - ~. --.--~- . - --.- . - . , ' , . . . . . . . · . . . . . . 1 0 ' .: ::,:::: : : .......:........:....... ........ ~. . . . . . . . ~ . . . . . . . ':' . . . . ':' . . . . . . . ~ . . . . . . . .~. . . . . . . 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V. -t'2.2.-S /( - 2-( -ff' D .V. +-.J.-ð 1 1/ - 2... ( - f.?> O.\J -¿b ì (~~ - . \" . ()",' :<IKE;SFIELD CITY , '- ~~"I ~ ~ARTMENT ~. ~~.411 ..L~-4 ". MARK TURK ~) ~ ';; -", INSPE~CTOR _ HAZ MAT ~~ r ·~~t,J~'\1 ~'~,.P\&\ ~ (805) 326-3979 HAZARDOUS MATERIAL DIV, FAX (805) 326-0576 '715 CHESTER AVE, BAKERSFIELD, CA 93301 " i' \I; ~ Iii ¡ , .' .' II - . ,.~ · ~-S-)7 Iii ~ ~~d~d,',~,~/,,"Z4/. lI7Þ~ ~t;/;#Z z;.,b·F/ l'I-d/jtÚL~~&~ 4jð,t{/;F1~ ; ~ ¡¿Úá ~Ø1- .1,~. -4#1 Þu- ¡~ k ~,- r~ðflú/~I-: ./. S~:/h~,K::F a 2._~~_ ¿f kJ;' ~~. fwtJ aðVj/+ úU£ ~'~ II fd¡¡.J; -4 -MJ~ü,¿ ~'/~kúM~. ># 'i ~. " ðed~-~~£.ul;.~r~~ '1 !i j4ð-r ttv.ue. ;lit./<i!f M#4Z'T:..¿.?_ Lé Ûh~ 7-- ~4~. I, ¿: I II Ii! , 11:£ ' , 1_._ 'd/A ~ $7 -1-_ / {--IS: 87 I: d~~)/ ¡;-t-t¥é:/~JkI. I/æ .L I~/¿ r~ð- ¿Z!-t- !i ðutJwJLIe, ,-- q( 3~3 t7h /:~ 9 /1 ,4~, t/ M'- I¡[~I' #1 /~o/. '¡I -4 d¿ ~7·1r~~;¡',k~ 1~ /?:¿2~,6;d¡;;£; /1Wv'~¿/62ØJ ' II ,_J¡ , L - . '/ - -, ~ /}, , Ii! 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I' ¡.,- , ' ; i , . i i ¡ ! : , , "- l__ C P 390 214 2ë8 --, ~ Rec~ipt for ~' CertÎ1íêd Mail " __ No Insurance C~verage Provi~ed ~~ Do not use for International Mail (See Reversel Sent to ~ Special Delivery Fee Restricted Delivery Fee õ) Return Receipt Showing (J) to Whom & Date Delivered G> Return Receipt Showing to Wh § Date, and Addressee's Addressom, "") TOTAL Postage ,ò&Fees $ g Postmark òr Date (W) E (; u.. C/) a. f<, .g Se.NDE~ 'Iii . (;omplet,,',Thms 1 and/or 2 for additional,~ervices, 'Q) . Complete items 3, and 4a & b. , I!! . Print your name and address on the reverse of this form .\....,tat we can II) return this card to you, ~ ". Attach this form to the front of the mailpiece, or on the back if space ... does not permit. l! . Write "Return Receipt Requested" on the mailpiece below the article number. '.. . The Return Receipt will show to whom e article was delivered and the date g delivered, '.' -g 3, Article Addressed to: ~ KAREN GEYE, GENERAL ã. E o u ~ 1415 TRUXTUN AVE. w ~ BAKERSFIELD, CA 93301 c c:( ~ 5, Signature (Addressee) :::::I I- ~ 6. .. ::s o > PS F .!! '- .-/ r'" I also wish to receive the following services (for an extra fee): 1, 0 Addressee's Address II) u 'S; ãi CI) KERN COUNTY INYO STREET FUEL FAC SERVICES MAN GER 4b, Service Type I[Ij~gistered UYCertified o Express Mail 2, .. Co '¡¡; U II) a: õb>ß~ ¡ .. II) a: o Insured o COD o Return Receipt for Merchandise 7, Date, of Delivery ,'0'; ~ 10, 9 g'1 ._ r III . ::s .. o - 8. S I > Only if requested .10: c œ .s:. I- 1tU,S, GPO: 1992-.0323-402 D() VI.E~'TIÇ.~~TU,t:t·~,REPEIPT., ¡ , ," ;A"< '. ,,¡;..~ ,";1'" ...,,;;:¡;~\ j~;;: i <J...:iJ (- v. . . CITY of BAKERSFIELD ~ ~ "\ ~c-_.... ¡J ~ \' ;:~~, ' .. . ., -. )".¡:-.- "WE CARE" August 5, 1994 FIRE DEPARTMENT M, R. KEllY FIRE CHIEF 1715 CHESTER AVENUE BAKERSFIELD. 93301 326-3911 Karen Geye, General Services Manager Kern County Inyo Street Fuel Facility 1415 Truxtun Ave. Bakersfield, CA 93301 Dear Ms. Geye: NOTICE OF VIOLATION - SCHEDULE FOR COMPLIANCE WARNING! THE PERMIT TO OPERATE YOUR UNDERGROUND STORAGE TANK(S) HAS EXPIRED AND WILL NOT BE REISSUED UNTIL YOUR STORAGE TANK(S) ARE BROUGHT INTO COMPLIANCE. Our records indicate that you have not performed an annual underground tank system tightness test in the last year. This annual tightness test was a condition of your previous permit to operate which has now expired as of June 30, 1994. In addition, there appears to be an illegally abandoned tank on the property. There have been no monitoring records submitted to this office for the tank since it's apparent abandonment. Herein, you are granted a conditional authorization to continue to operate your underground storage tank(s) for the next 30 days. During this interim, you must submit proof to this office that you have arranged for the tank system tightness test. A valid permit issued within the next 30 days by this office, to perform a tightness test at your underground tank site will satisfy the interim condition. The abandoned tank must either be brought into compliance with current requirements for repair or upgrading of existing underground tanks, or else comply with permanent closure requirements, commencing within 30 days of this notice. If you do not respond to this notice within 30 days either by providing proof of an annual tightness test performed within the last year, or obtaining a permit for testing the tank(s) and/or upgrading or closure of the abandoned tank, you will be required to cease Ünderground tank operations until compliance is achieved. ''', ~ ~.~ ., . . . Page 2 If you have any questions regarding this notice, please call the Hazardous Materials Division immediately at 326-3979. REH/ed - - --------------- p 390 21¡4 231 ", J ~ - UNITED S1O'" POSVolSEJMŒ !:' Receipt for ~ Certif~ed Mail No Insurance Coverage Provided Do not use for International Mail (See Reversel ~ ~ Ø) Ø) Sent to KERN COUNTY GENERAL SERVH E Street and No, KARIN JUSTICE BLDG.. ATTN: P,O" State and ZIP Code 1415 TRUXTUN AVE. Postage ì $;3301 BAKERSFIELD! CA Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom & Date Delivered Return Receipt Showing 10 Whom, Date, and Addressee's Address TOTAL Postage $ & Fees Postmark or Date - - ' _ _ ___~_._ _ __._ _ _ _~___w________ S CD c: ~ ""') Ò o 00 (W) E Õ u. C/) Q.. "¡,, - ,'- -~ ~ ~--- "", CD '1:1 ïii CD III - 'CD > Q) ,- CD .s::. - SENDER: · Complete it'ems 1 and/or 2 for additional services. r' ·st;omp'let~items 3, and 4a & b, , · Print your.name and address on the reverse of this form Ut we can return this èard,to you, . · Attach this forr;, to the front of the mailpiece, or on the back if space does not permit, · Write ':Return Receipt Requested" on the mailpiece below the article number, · The Return Receipt will show to whom the article was delivered and the date delivered, I also wish to receive the following services (for an extra fee): 1. 0 Addressee's Address CD U 'S; - CD ' en Õ. 'i6 u C ) a: c - :I - C ) a: tÐ C 'w :I c ,0 I 't:I 3. Article Addressed to: CD , - ;CD 'is. E o t) CIJ CIJ w a: C C <C 2 a: ::) to- ~ 6, ... :I o > PS ,.!!!. 4a. 2, D Restricted Delivery Consult postmaster for fee, Article Number KERN COUNTY GENE¿:rÐ'SERVICES 4b, Se~vice Type o '3ßglstered JUSTICE BLDG., ATTN: KAREN GEYE Ø"Certified 1415 TRUXTUN AVE. 0 Express Mail BAKERSFIELD, CA 5, Signature (Addressee) 93301 o Insured DCOD o Return Receipt for Merchandise 7, Date of Delivery 8-/0-9 ... o .... :I o > 8, Addressee's Address (Only if requested..ll: : and fee is paid) ¡ .s::. to- tt :,' ',1,,; ',:'" ' DOMESTIC RETURN RECEIPT '-'.-;' ',,-- .J.-'._.... , ' .>~, , -~"'-' ,- :: ". -- ¡--- "WE CARE" ~ ~, It "t J. , t) " . . . CITY of BAKERSFIELD -' >1(' August 5, 1994 FIRE DEPARTMENT M. R KELLY FIRE CHIEF 1715 CHESTER AVENUE BAKERSFIELD. 93301 326-3911 Kern County General Services Justice Bldg. Attn: Karen Geye 1415 Truxtun Ave. Bakersfield, CA 93301 Dear Ms. Geye: NOTICE OF VIOLATION - SCHEDULE FOR COMPLIANCE WARNING! THE PERMIT TO OPERATE YOUR UNDERGROUND STORAGE TANK(S) HAS EXPIRED AND WILL NOT BE REISSUED UNTIL YOUR STORAGE TANK(S) ARE BROUGHT INTO COMPLIANCE. Our records indicate that you have not performed an annual underground tank system tightness test in the last year. This annual tightness test was a condition of your previous permit to operate which has now expired as of June 30, 1994. Herein, you are granted a conditional authorization to continue to operate your underground storage tank(s) for the next 30 days. During this interim, you must submit proof to this office that you have arranged for the tank system tightness test. A valid permit issued within the next 30 days by this office, to perform a tightness test at your underground tank site will satisfy the interim condition. If you do not respond to this notice within 30 days either by providing proof of an annual tightness test performed within the last year, or obtaining a permit now to do so, you will be required to cease underground tank operations until compliance is achieved. If you have any questions regarding this notice, please call the Hazardous Materials Division immediately at 326-3979. Sincerely yours, 4~~y.- Ralph E. Huey Hazardous Materials Coordinator REH/ed · . CITY of BAKERSFIELD "WE CARE" August 5, 1994 \ 'i FIRE DEPARTMENT M, R. KELLY FIRE CHIEF 1715 CHESTER AVENUE BAKERSFIELD. 93301 326·3911 Kern County General Services Garage Services, Attn: Karen Geye 1415 Truxtun Ave. Bakersfield, CA 93301 Dear Ms. Geye: NOTICE OF VIOLATiÐN - SCHEDULE FOR COMPLIANCE WARNING! THE PERMIT TO OPERATE YOUR UNDERGROUND STORAGE TANK(S) HAS EXPIRED AND WILL NOT BE REISSUED UNTIL YOUR STORAGE TANK(S) ARE BROUGHT INTO COMPLIANCE. Our records indicate that you have not performed an annual underground tank system tightness test in the last year. This annual tightness test was a condition of your previous permit to operate which has now expired as of June 30, 1994., Herein, you are granted a conditional authorization to continue to operate your underground storage tank(s) for the next 30 days. During this interim, you must submit proof to this office that you have arranged for the tank system tightness test. A valid permit issued within the next 30 days by this office, to perform a tightness test at your underground tank site will satisfy the interim condition. If you do not respond to this notice within 30 days either by providing proof of an annual tightness test performed within the last year, or obtaining a permit now to do so, you will be required to cease underground tank operations until compliance is achieved. If you have any questions regarding this notice, please call the Hazardous Materials Division immediately at 326-3979. Sincerely yours, 4+J~ - Ralph E. Huey Hazardous Materials Coordinator REH/ed . '. r.p..... ~ ---- --- -- -------- P 390 214 224 , ~ Receipt for " "-- Certified Mail TM No Insurance Coverage Provided ~ Do not use for International Mail POSTALSE"""'" (See Reverse) Sent to Special Delivery Fee Restricted Delivery Fee .... Return Receipt Showing ~ to Whom & Date Delivered ê ~~~~:na~~C:~dr;:s~:!~gA~d;.':Som. ;, ., TOTAL Postage o & Fees g Postmark or Date (\') E o u.. en a. $ --- -. --- -- - - ----- -------- ------- I ~'" SENDER: , '} ::2,,,,.' Complete items 1 and/or 2 for additional services, t~' ,~" 'C:ompletef'.tems 3. and 4a & b. '--../ , :.," Print your name and address on the reverse of this form so that we can ¡¡ return this card to you, I ¡;" Attach this form to the front of the mailpiece. or on the back if space . .. does not permit. ~: " ~~:~::U~~U~::e~~:~~I~::;S::~'h~~~~e':~i~::c;::~~::;e:~~~ t~~~::~' C delivered, ~ 3. Article Addressed to: CD J \) } KERN éOUNTY GENERAL o : GARAG~ SERVICES, ATTN: CI) , I ~ 1415 TRUXTUN AVE. ~ BAKERSFIELD, CA 93301 2 cr: 5. Signature (Addressee) :;) It; !6. ~ 0, ' ;;~l~t~ '...'~ I also wish to receive the following services (for an extra fee): 1. 0 Addressee's Address CD U ';; .. CD CI) ~¡ SERVICES 4a. 2. 0 Restricted Delivery Consult postmaster for fee. Ar ' Ie Number KAREN GEY 4b. Service ype o ~ístered 0 Insured Q"(;ertified . 0 COD o Express M¡f¡t 0 Return Receipt for '': Merchandise 7. Date of Dèlivery -10 -9 CÐ C '¡¡¡ ~ .. o ... ~ o > 8. Addressee's Address (Only if requested .¥ and fee is paid I :ä .s::. ... .--;- * u.s.G,P,Q,: 1992-307-530 ~ ,,~ :&>OMESTIC RETY~,~REC'ErR'f . ANNUAL TREND ANALYSIS . SUMMARY ~K # !2? c,") I QUARTER 1 ~ ~ PERIOD 1: ! PERIOD 2: . <,--1 PERIOD 3: QUARTER 2 PERIOD 4: PERIOD 5: PERIOD 6: '1 4 /10/7 (J to t.( /1../ l:; / TIME PERIOD: ¿¡ J¡!)j 9 0 to *7 /: /~ ,I) Total Minuses Thïs Pe~iod (Line 3) Action Number fo~ this Pe~iod (Line 4) Total Minuses This Pe~iod (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) ø Nf+ Nj+ QUARTER 3 TIME PERIOD: /0 / ~ /'1 b to / /1.//1/ PERIOD 7: Total Minuses This Period (Line 3) Action NUllber tor this Period (Line 4) PERIOD 8: Total Minuses This Pe~iod (Line 3) Action Nu.ber tor this Period (Line 4) PERIOD 9: Total Minuses This Period '(Line 3) ¿4 Action Number tor this Period (Line 4) d QUARTER 4 TIME PERIOD: ¡/g/i/ to t.j J¡ /y I I PERIOD 10: Total Minuses This Period (Line 3) Action Nuaber tor this Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 12: Total Minuses This Period (Line 3) J14- Action Nuaber to~ this Period (Line 4) J TIME PERIOD: 1 ! loi?/tp/.) TIME PERIOD: 7/~/tfo to~ Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number tor this Period (Line 4) Total Minuses This Period (Line 3) Action NUllbe~ for this Period (Line 4) ø true and accurate report. Date ~ /5/1/ , ANNUAL TREND ANALYSIS TANK : J QUARTER 1 PERIOD 1: PERIOD 2: PERIOD 3: QUARTER 2 PERIOD 4: PERIOD 5: PERIOD 6: QUARTER 3 PERIOD 7: PERIOD 8: PERIOD 9: QUARTER 4 TIME PERIOD: '-1/;0110 TIME PERIOD: '-/ ) I 0 / f 0 to Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: 7/B/90 to Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: ¡!JIB/50 to Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: I/~/'f( to PERIOD 10: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 12: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) report. I hereby certify this 1s a Signatur~ . (~ ~... euMMARY "7'// t.( / 7 I to J~ - ,. I .I ~/¡ 7' 0 , c) 101J)70 ø 1/ '1/,/ ø '-I /..¡ I 7' / (þ Date L./ )S /7 ~ AI),..- J/A-. ;{/~- I ...J/A- ..... (...!UAf<TEf<LY MUVl.Fl.ED INVENTORY CONTROL SHEET >Ie >Ie FACILITY T V;- PERMIT #_ /' 20, {JOO --º.UARTER/YEAR, TANK# ~ ÇAPACITY SUBSTANCE STORED '?E" / SE¿ , - 11 - I 1 1 1 I 91 10 1 COL. COL 2 6 COL. COL. COL. 11 I I COL. 3 COL. 4,COL_ 5,COL_ 7, COL_ S,COL. I I - TEST I WEEKLY 1 WATER 2ND _ 1ST = INCH 2ND _ 1ST =VOLUME+ TOTAL= CUMULATIVE WEEK ¡SHUT-DOWN I LEVEL GAUGE GAUGE CHANGE VOLUME VOLUME CHANGE SUB _ CHANGE , ¡ TIME PERIOD I INCHES INCHES INCHES INCHES GALLONS I GALLONS GALLONS L GALLONS L GALLONS 1 IDA TE/HR L¡-/ 0 11.l,;2 '( ()!JI' 1 I 0 I I I TO ~. ø /9Jð2 I I I I DATE/HR if' /2/,;f/ I fA/! 1/3'12 1/ {','/. .f!L / '1502 ø ø j¿ .- I - .... <2- L . 2 I DATE/HR '{uJ lllt~.t;~ /If¡1 I 1 I I I TO I /1' I 113~ 113 /2. ø I J a ,- .r, "] I I t:; r --: 7' A!:::r I ø I ø- I - DATE/HR 1- .loll'sf) I f/f/' I I .I /~, v..:- I / j' (./ ~ L k I 3 I DA TE/IIR .:.¡ -;..7 r; /2,1 51 f¡V1 I I I I I I I TO I ø ~ II]7/; / / 3 /2. 1/,-/ 1/91:"23 ' /7S¿;2 ¿/ I ø I L/ I - :DATE/HR t¡ -211?-,0;, f/lll I J I L k I 4 ! DATE/IIR 5 - 2 /1 :10 I I'M ' I ø I , I I I I TO _ /..,.1 ¡p I //~ I I 'f 11157'31/9SLf3 1 I 2/ 1 .2/ - i DATE/HR 5 t.¡ - ~ t/'l' , L k 5 I DATE/IIR 5 -1 / // Pi.'t , I I I ! TO ~~ ¡¿r / / 3 /z.. 113 ~ ø '195()2 I I f 5~Z- ø:r I 21 I 2/ - . DATE/HR 5 -I) 6: ~ fl JI1 L k 6 ¡DATE/DRY"/? /2.:>; C 113Yr /IJ11 ø- I ø: I I I TO I' /95"23: /'1523 I 2 I I 2/ - DATE/DR r;-11{/ P) I · 1 k 7 'DATE/IIR S -./ ¡, l/:II I ."" I 0~ I I DAT~~HR 5 -27/1 I(,ffl IlL-( / I Lf ' , ' , / fÇ"ý 3' I / 1 S ~_f I 2/ I 2- I ('. ...y. . " .~- 1 k - . ..-r I S 'DATE/IIR - ;tJ I~NI' II '-I i)¡ I II 'I 12- I I I TO - 5' 0 111~ -li- / '1 Çb / ~ I ~ S ¿fO -11 I ,2./ I 2- - DATE/HR 1 k 9 DATE/IIR - 7; I />t,.n I 0 I I DAT~~HR ~ -6 19:10 I~" ,ø 11L('l¿ (It( 12- i!2 ¡qjtft>l/frf?J 1 2 I 2 L k - --¡ DATE/HR l -II /." ./ :1/)/<11 I I I 10 DAT~~HR (, /j//(/(lf¡Y1 ¡;r " I 'I ~/ /1 if )/;~/I ~ 19s! ç I ! 9,;-;7ç;- ør I 2- I 2 (/1.(+, - DATE/HR /,. /f./,'«/'; 11JP7 ' . I 1 - L L 11 I 11 / (/6/ ? I I TO " I ç / ' '. ~'/ / /S' I /95'11 -If I 2- I - It DATE/HR ( ,'1/ _:' ': ¡r~" .y/ ¡ ¡ ! : " I ' L 1 - - 12 DATE/HR ¡; -;?Ç/ ~·I (J ..¡ I tf I TO t ?7/-'" f~ ø' I /C¡t:/t; ø /6 I J ,,' liS, liS /f't/6 -/1 DATE/HR ,-..., !,/" L 1 \.;/ - DATE/DR 7-2/2:'(''1'' ø - - 13 J / S lr /Ij I 1/ l( /fj6J2- /fÇ/t /6 /(, I ø DAT~~HR 7-5" /;/:5f AI!') I I -.- , , .-:..._--' UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE CHECK ONE ONLY I TANK MONITORED S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A MOTOR VEHICLE FUEL TANK I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF: I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF -- - - I -- - - A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE I A. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 I OF r/- 25 GALLONS OR MORE R. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE I B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COL 9 I OF +/- 35 GALLONS OR MORE I C. TANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 O. I +/- 50 GALLONS OR MORE I D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS I OR MORE OVER THE QUARTER TIME FRAME REPRESENTED ON REVERSE. I SUMMARY I SUMMARY I TANK # PERMIT # I TANK # 5" PERMIT # :I 6 ó,YC-' ~ MONITORING BETWEEN DATES OF AND I MONITORING BETWEEN DATES OF V~O/7 0 AND 7 /:::/ ~j u (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSÉ RESULTED IN: I _ ) 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF L GALS 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF I 2. A CU,MULA~VE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF GALLONS I GALLONS I I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND . ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCIUBED IN A AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "D" ABOVE. I Ii, I ¡,: I I ___-)' / i SlONE!) _ TITLE I S JGNED á '-'It &/4~I'¡"(,- c . ---./ TITLE ; ",' ,:' J ,,<:- I ( ,/ -/ I / / /_ DATE I / DATE </ ! / 'r I I - / * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT ~ ~ RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS J. ¥ J. LÞ J.J.1. .1." .1. J::. J.J .1. J..~ v ~J..~'l.'UK)( CUNTHUL SHh'c'J." - - -..¿ '-' ~~ -'- J::. .IJ:',...L.o ~ FACILITY '¿ /J NT PERMI T :#= - be;, TANK# ~ CAPACITY 20,000 SUBSTANCE STORED Or (sr: L-- --º-UARTER/YEAR, - - - - / - - - - 11 - - - I I I I I 1 gl 10 I COL. COL. 2 COL. COL. COL. 11 1 3.COL. 4o,COL. 5, COL. 6,COL. 7 I COL. SICOL. I , - TEST I ~TI 2ND 1ST INCH I 2ND 1ST VOLUME aT CUMULATIVE WEEK 1 EVI 'AUGE -GAUGE = CHANGEIVOLUME-VOLUME =CHANGE~SUBT AL= CHANGE # 1 [NCHE INCHES I INCHES I INCHES 1 GALLONS I GALLONS GALLONS 1 GALLONS GALLONS 1 I I I I I I 0 I ø liS I /IS I -ß- I I ~Ç161 /r5/? ~ I ø 1 I 1 1 .2 I I I I I I tI I / S ~2- II s1J2- I ø I I q (p 4~ I'l ~ Lf o¡ ø I ø cØ - 1 - - 1 1 3 I I I I ø I Cf I / 5 3¡L{ //5% -Æ- 1 '1' fo 5 I L I (þ' - 1 - I If bb 5 1 4 I I I I I Icþ 1/6 JIb ø 1/9f,Sf I 1168/ ø I L rØ - 1 - - 1 5 I I I ø I ø II ~ (if /1' 1/,¡ ~ I 19 " ~ ~ /9 (, '1:5 ø I ø I - 1 - 1 1 6 I I I I Q lIt 1/1./ 1/6 f/ú ø I )7b75 19 t. ? S ø I ç1 ø - 1 - - 1 1 7 I I I ~ I (/ //61(7- //t.Iz-- -Ø- I ¡C¡7oq 19 ?o~ ø I cp - 1 - 1 I 1 8 I I I I r¡; I ~ / fro (l- Ilt Ý2- ø I I if 70'1 I 1'77tf1 9 I ø 1 1 1 - - - 9 I éÞ II' Vz.. I I I ,ø I lIt ~ cÞ 1 If ì 01 I 1t:¡7D( I ø - - - 1 - 10 tÞ 1ft 'i'l.- l/ {. ~z:- I ø I ø ø I /7 7D'7 I T '707 I ¢ - - - 1 1 - - 11 d 1/10 1/z..- 1/ tfz... ¿þ I I ø I 1'1'701 / If 70 i ø I ~ - - - 1 - - - 12 ø lIt 1?- I ø //',12- {p I 1970~ /'1 70 I cp if I / I - - - - - - 13 ØJ / /~ Ýý If ø )Lj- I J Ibl;¿, I?, 7ð 9 /9'95- 11 I , UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE CHECK ONE ONLY I TANK MONITOR1;:D S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A MOTOR VEHICLE FUEL TANK I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF: I REPORT TO .I!lli PERMITTING AUTHORITY WITHIN 24 HOURS .!! I A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE I A. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 ·:';r. I OF +/- 25 GALLONS OR MORE . B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE I B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COL 9 I OF +/- 35 GALLONS OR MORE I C. TANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 OF I +/- 50 GALLONS OR MORE I D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS .I OR MORE OVER THE QUARTER TIME FRAME REPRESENTED ON ~EVERSE. . I SUMMARY I SUMMARY I .5 !GOOð'C- TANK # PERMIT # I TANK # PERMIT # MONITORING BETWEEN DATES OF AND I MONITORING BETWEEN DATES OF 7 /2:> (éf 0 AND 10 ! 3. / 'l 0 (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: ·~.if· I A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF /1 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. 1. GALS 2. A CUMULATIVE VOLUME CHANGE (COL. II, BOTTOM LINE) OF I 2. A CUMUL~IVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF GALLONS I I GALLONS . I I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCHIBED IN A AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "0" ABOVE. I I I I SIGNED TITLE I \-- TITLE I ,/<1 ~t:.Jf;&F", .~ - I ' - / DATE I DATE / ,I - * * SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT * * RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS '-lUA.t<Th.t<L~ MUU.l.F.l.hU .l.NVENTORY CONTROL SHEET * * I FACILITY ¡/!.. 4rv' FERMI T # - ) óc~é - ,.- STORED~ )/~ TANK#" ~ ç:AFACITY ;Lú 000 _SUBSTANCE ---º-UARTER/YEAR - ( - - 11 I I I I 10 I - COL. COL 2 I I I I COL- COL. 11 I I COL. 3ICOL. 4,COL. 5, COL. 6,COL. 7,COL. aICOL. 9, I - TEST I WEEKLY I WATER 2ND _ 1ST = INCH I 2ND _ 1ST =VOLUME+ TOTAL= CUMULATIVE I _WEEK ¡SHUT-DOWN I LEVEL IGAUGE GAUGE CHANGE VOLUME VOLUME CHANGE_SUB _ CHANGE -1 # TIME PER OD INCHES 1 INCHES INCHES INCHES GALLONS GALLONS GALLONS L GALLONS L GALLONS -1 - - 1 IDATE/HR /0 2.c/ I çJ I I 0 I I I TO <"I I / /{; (/';1 1/(. ~~/ ø Ic;t:,'1S If b 9' S cj I I d I DATE/HR 19 fI 1-..> 1 L 1 .J - - - 2 I DATE/HR (& (- 2-{/~ I I I ø I I I- I TO, ,,' 11 I /I~ II~ I/V - Yt/ 19tß) 11b?:S /1 I I -(Lf I IDATE/HR /o!7! ;:¡ ft,1 1 L l ..J - 3 DATE/HR If)!:-,../t,~ Q I I I -1'1 I I I TO ~ V I ø I Jib /J' ø /7t8 ( / P b g¡ ø I I Il/ I - - IDATE/HR/O tt /101 1 - - L 1 ..J 4 DATE/HR /~/-&íZ-JD I '¢ I I I -IL) I I TO /;/01 I /J 5 }I,¡ J/S'3j..¡ (!J Ie¡ 0b S /7bbS (jJ I -/LJ I I I DATE/HR 103111-40 1 L 1 .J - - - - 5 IDATE/HR II I 2.;5 I I /1(0 J1 ø I -/Y I -/1 I I TO /1 t/ I cj I IIS~i. / I ~ ~/2 ø J 1 c-"' ~ 1 I I I - - IDATE/HR /f/?' ? 5 1 1 - - 1 1 ..J 6 DATE/HR 11/ ¡3¡tv''¡o I I I _It.( I I I TO 3tn'1 rp 1 ¡/~'ItJ ... // ,/ t.j (9 b 3~ 19(..'1, -11 I - ~J I DATE/HR II 15- I /I~ 'z..-. ! 1 ..J - - - - 7 DATE/HR ,!¡ I / .::;- I II rs-(t/ I I I I I TO 'hi ,<I ÇD I I IS lIt.¡ ø /fbJJ- t /9 b 3;2... ø I -þ ( I -3/ 1 IDATE/HR II ~ /- ~ I 1 ! 1 ..J - - - - . a I DATE/HR ,,/ 7-...¡5 I cI I rP I 1 I I I TO ~ 1 I II~ 115 I? ~/t I 19 b / t, (Þ I - 3-/ I -~,/ I DATE/HR II tß I ;;- SD 1 1 1 1 ..J - 9 DATE/HR o ,<F-t?Þ/'J I I I 1 I I TO ;/;/¡ ø 1 /1~1ý- - - I 9 5" I I - - I - .3 I I -3/ I - DATE/HR /:¡~~ZO) - - 1 ..J 10 DATE/HR I /t( 11./.0 I I I TO ¡þ I lit! ~/r./ - /7578 - I -3/ -3/ I DATE/HR;Jo R~b")h- - 1 ..J - DATE/HR I z./! e,/ I ¿ Zc> - - 11 I I TO ~ ø JiLl 11r; / J t.lJ~ rL / tjSb( / f 5·' ( t/ 1 - 31 --":;, / I DATE/HR ( rj'/Z-t!3 1 -- ..J -- - 12 DATE/HR I ¿ 'LI../? z,S ø /J7!j", If~ 1915'6 I - t.f!v I TO J (I JJ'] Iy /9747 - I I -~ I DATE/HR I z8 J'z'~-'I I. I - - - - 13 DATE/HR l- I z.58 I ~ 'f ø -t/?--- r'~ I TO /. I /17 ¡q73t;. /173' ø I DATE/HR / ~ I" S~ , 1/7 UARTERLV SUMMARV FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE ,(CHECK ONE ONLY TANK MONITORED [S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK TANK MONITORED IS A MOTOR VEHICLE FUEL TANK -- - - - REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS If: REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE A. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 OF r/- 25 GALLONS OR MORE .' B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COL 9 OF +/- 35 GALLONS OR MORE C. TANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL, 9 OF + / - 50 GALLONS OR MORE 'I D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS I OR MORE OVER THE QUARTER'TIME FRAME REPRESENTED ON REVERSE. I " SUMMARY ,I SUMMARY I ~ I TANK # PERMIT # I TANK # .;;; PERMIT # / b O;,;:~:.- c.. c:.. t , MONITORING BETWEEN DATES OF AND I MONITORING BETWEEN DATES' OF ID /3/9' 0 AND tlLli'l ) (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: " I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF - /,¡ GALS, 2. A CUMULATIVE VOLUME CHANGE (COL. 11, BOTTOM LINE) OF I 2. A CUMULATIVE VOLUME CHANGE (COL. II, BOTTOM LINE) OF GALLONS I ' - t..{ ;L.. GALLONS . : \ I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I HEREBY CERTIFY THAT THE ABOv'E-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCHIBED IN "A" AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "D" ABOVE. I I I \ I ____- ') _ . SIGNED _ TITLE I SI9NED / <..../ TITLE / ¿(:. el þ:t,!~)/;-6~"i_ I ¡." ,( J I DATE I DATE _ '¿/S ,'I / '* '* SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT * * RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS I "'" VUAH~~KLY MUULFLEU INVENTORY CONTROL SHEET :>Ie :>Ie FACI LI TV tÄ' "'0-¡- PERMIT :#: b 6 (:)2 6C - - - ..- TANK:#: -2 _CAPACI TV ~/é)OO _SUBSTANCE STORED :V/6S~ --º.UARTER/VEAR - - , = - COL. 1 1 - I I I I I 91 I - COL. 2 I COL. 11 COL. 3,COL. 4,COL. 5, COL. a I COL. 7, COL. aICOL. I COL. 10 , TEST I WATER I 2ND 1ST INCH I 2ND 1ST VOLUME TA _ CUMULATIVE WEER 1 LEVEL IGAUGE -GAUGE = CHANGE VOLUME-VOLUME =CHANt3E+SUBTO L: CHANGE # 1 INCHES 1 INCHES INCHES INCHES GALLONS GALLONS I GALLONS I GALLONS 1 GALLONS 1 I (J I I I 0 I d I I 1 //6' 3/y // {, 3/4' ø 1?7~2.. ' I~ ? 2...'-.: çt,! I I I - 1 - I ~ I 2 I I I 1 I I I I ~ I J 153/<-1 /15 12 ly /9fc,~S 19fo<-/9 ~/ro ¢ I -I-Ib - 1 1 1 3 I I ø ø'r +Ib I I Ó I liS //~ 115' /2-- 17bLJt ¿1b'i~ I +/ ~ 1 1 1 - - - 4 I I 1/5"fz., I I J. I 1/£1/2" ø I q0 41 I 9'''¡~ /',: +J b I -I-/~ 1 1 - - 5 I I , I -i 1 / Ii /{ // 112- ~ I q 5: E3ó I? 56 0 {}'I ~/, ~Jb - 1 a I I I (j; 111¥ yY I II t/ !It.! ø 1/1St/ /f5~1 øl +Ib f-lfo - 1 - 7 I I Ilv I ,'6 +-â-~ I ø 1 ! / 1- //4 III I I Y 5(, J / r St)3 -I-J~ 1 1 . - - a I rj I I .....~'-\ I I / / 'i //t/1'-1 :& I /1S~3 /9 $b I - 15 +/rø - 1 - 1 1 9 I I I I rþ I /J s 3/~ n "3 s/Lj (/J I If ~)-3 176;J- Q ø +/b +-110 1 1 - - 10 I I P I J/ '3 113 V~ '1,-/ I I c¡c(~, /e¡ c¡ g~ -;U -rJ& --5 - - I 11 I I ¡ ---5 ø I I / 2- 3/t.j 1/3 I í ~ 31 I~ "¡~I I \ -;)..7 Jj -~~ - 1 , I I --L 1 12 1> I J /;L '.Iv. I JJ I ¢: I -;¿ 7 I ) 1)- '/£..,I J9cj/7 I) L/I] t I - :ì---( - - 1 I - l I / r;, 'Iv yl d I i I 13 ø I / /1 zJ. /Î4'7 / I ~'7 I cI I -2 7 -;2 7 - -~ ; CHECK ONE ONLY SUMMARV FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE I UARTERLV ! ¡ TANK OF 1000 GALLONS OR LESS CAPACITY HAS OF +/- 25 GALLONS OR MqRE TANK OF 1001 TO 5000 GALLONS CAPACITY HAS OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLONS CAPACITY HAS +/- 50 GALLONS OR MOREl ANY TANK HAS A CUMULAT~VE VOLUME OR MORE OVER THE QUARTER TIME TANK A MOTOR VEHICLE FUEL REPORT TO THE PERMITTING AUTHORITY IS TANK MON !TOR ED HOURS IF WITHIN 24 9 OF GALLONS .-. TANK # ~ ~PERMIT MONITORING BETWEEN DATES OF L (INCLUDE YEAR) NOTED ON REVERSE I t MAXIMUM WEEKLY VOLUME CHANGE r CUMULATIVE VOLUME CHANGE (COL -~ GALLONS I I J ,r), ", / ,Q (:;) (/O~;:;¡'- AND SUMMARY GALS IN 9) OF -2 4:: BOTTOM LINE OF , , I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A THROUGH "D"'ABOVE L TITLE DATE 9 COL COL 11) OF +/- 250 ON REVERSE RESULTED COL 11 ¡ --,,' -c; .- S IYNED ~ '----~ ' 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 I I I I I S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK TANK MONITORED REPORT TO THE ,PERMITTING AUTHORITY WI~HIN 24 ,HOURS 1!: 9 A VOLUME CHANGE A VOLUME CHANGE COl. A VOLUME CHANGE CHANGE (COL. FRAME REPRESENTED A D B C 10 GALLONS OR MORE 100 GALLONS OR MORE IS +/- 11 IS +/- COL 9 CUMULATIVE VOLUME CHANGE COL VOLUME CHANGE A B .) AND SUMMARY PERMIT BETWEEN DATES OF _ YEAR) NOTED ON REVERSE # TANK # MONITORING (INCLUDE A A 1 2 GALS OF IN 9) OF BOTTOM LINE RESULTED COL 11 A MAXIMUM WEEKLY VOLUME CHANGE A CUMULATIVE VOLUME CHANGE (COL GALLONS 1 2 I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCIUBED IN "A AND "B" ABOVE . TITLE DATE SIGNED * * YEARS I ) I OF THREE / SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM * * _,,>U,,' "'!""':r:'.--,----;--',c> :';;;¡""'-"7Y"--:~-'","<'7'¡f',,~'" !;>~)F ;;":~~'~¡;:1'" . 2080 SO, UNION AVE, .' BAKERSFIELD, CA 93307 (805) 834-1100 1450 W, McCOY, SUITE A SANTA MARIA, CA 93455 (805) 928-1135 ~~"'" ", \ '-", III E III II E R ~P£!j SERVICE INVOICE AUTOMOTIVE-INDUSTRIAL PETROLEUM EQUIPMENT INSTAllATION-MAINTENANCE "LEA.. NOTa AI.1.INQUIR... AND CORRa· SPOJltiUaNCa SHOULD Ra...aR TO THIS CALIF. CONTRACTORS LIC. NO. 294074 ~uv:~~: ~ro s . . 1267 INVOICE NO. DATE REQUESTED BY PHONE NO. ORDER NO, BY Æ 0 CHARGE CASH ,q\ I "'" H. '3\ r ~ L o C A T I o N MAIL. INVOICE TO J00~¡Y u~ KERN 1#1 Gener-a 1 Sel'"v.i cas 141'-; Tl'"uxtun Ave Lg ~A0€" ...J :b a.kel'"~riald r~A a ~ ~ ", PC ~Ù'i p", fY\ 0 ('\~ 1 t 11 )ct- '-PI( .{-è () fY\ ~V' -" 17 V lANK- WORK TO BE PÄ~'R0 MED: ;rt:.. )9 ~ . t O~ (~«- .. FOR 171') ÙI~cß~; OFFICE J/uM.a X1 // of ~~ ~ ç~/ £ (!)I + USE WORK PERFORMED: 1:)(.,04-1' ..:z a oo¡) ONLY , fA. e..1 . ÍÁ,., If ".- M., 01 / ~)7?¡¢ ~Á . ~"/ , '¡'-17~ .;<1(/ (')/""j I.,j4 -ny, 5' -I-1~P' S 4-.L {OIA_J /I/o "v 4 ft"'r, TECHNICAL r w, SERVICE " O¡,r.,L h'-1ø 7""Hey /;,j{'~ .s 7: c. K, ;"''Y //,1..,.1(' HOURS . (J~ -r~ f' w / rl, tJlÁ. r .s Ir,'Kpl" ~ //1 72 MILEAGE I 1'1 or ..' I!/ ~ -rk-r / i ¡Jr~ 7Zt hi' ¿ The N ~ ;( 7" 7ó -r/¡ ¡tJ -/ Sub Contract (1 Þ'J P jp O/'¿ h41ve. A /Jro.ð -;7¿.,b~ AMd Rentals 5ír:KpYt 7;'s7þ.,t' b () -rA t!/tA, ~kð- Sf' '/ f'r-I -r; ',..... ~ ~ ,¡1.,t:.! 4tA -d No v,/ ,,4 Tf r, ! I I I i MAKE MODEl. NO, SERIAL NO. I I ! I QTy·1 i SI PART NO. DESCRIPTION ; 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 1 I I I - I I ! I i I I I I I I I i Supplies I I Date Completed }-lrJ~ 911 - Tech~ici~S)~ "7Z"..-,:-:¡ )<?- Sales Tax I I I , /_hr! /U i V I I L- /J4;--z. ~-rl TOTAL I Received & Accepted By I i '7' / PLEASE PAY FROM THIS/1NVOICE. TERMS: Net due upon ReceiPt , Finance Charge oí 2% per Month after 30 da ys. PLEASE REMIT TO R LW EQUIPMENT P,O, BOX 640 BAKERSFIELD, CA 93302 .J . . FILE CONTE3TS SUMMARY FACILITy,.k.cn ~,OI1ni-~ (;..QCOjE:. ADDRESS: ~ J6 ) íU x+U Vì HUP. PERMIT #: } (ç()OJ... 0 ENV. SENSITIVITY: N I:: 3 Activity Date # Of Tanks Comments Opp)¡ (',cJ,'(J() . iJ/,;{) RS S- ()perok / /0()1J;;~G 4/1 JP? - c.oerak ,~ / ' I o'p;d/f £;. -I- /û )'7 ,,-1/ ~/R1 ) (júeí.a-!-e. I nppi ¡(',a ~iOYì ~/ /S¡J!P r::¿ Oh()VJM n A f?()R-/~ !aId (pI Jl f ,~ ~ /0;; I< c" crfn'J7rh ¡¡çJ' I I ClfrJ i~ n +/'é) V\ ?fÞ Lf:/ f'9 I aha YlJ~ Y7 /-fbú YI d 10.* í I (So~/-}P (e~H'3 ~/d~1 3 f (3J< }e -/Þ r / //iíoJ R' 7 0; rJ/~ a+/r'J F) - C ßn-l-\ yj I ( e.. IY\ J ¡pa '* SHEET PERMI T # '* MUU~F~hU ~NVENTURY CONTROL SUBSTANCE STORED l,¿UAK'J.__h.KL Y I ..... _,,"--; ';Ooè"-~-"'c""',,'" ~'/..j¿¡~~' "'''~;;>-- ~:~,_~,4 ~:'~F" UARTER/YEAR ¡?L /J /1 CAPACITY 'It /17' / FACILITY TANK# 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 COL. 11 CUMULATIVE CHANGE GALLONS 2ý 8 ¡COL 9 _VOLUME -CHANGE+SUBTOTAL= GALLONS GALLONS o 10 COL. 2p I 1 I I -2Y I I 1 I I -27 ,ø- 2R- - .;' r' -7Ç -27 -2cY -2ý I I 1 I I -2r -2y" -5h I I 1 I I -J- ø , ð' I I I L I I 1 i I i ~ I , 1 I 1 I I COL. 6¡COL. COL INCH I 2ND _ 1ST CHANGEIVOLUME VOLUME INCHES GALLONS GALLONS Yì' / f /, 7?fS 7rC/ 79'39 '15 7'1&7 7 I I 1 I I 1 I I 1 I I 1 I I 1 I I 5 C2D <4 ¡ COL. 1ST GAUGE INCHES P?7 I I 1 I 1 ø 71 A 71 -, ,./ 7139 ;1 trS 7~¿;7 7rJ7 I I 1 I I -2fY -2r I I 7~6? -:. 2 7- 7 ç;, ( - çc. 2Y I I 7f¡"7 7'1 Jr 7t!#'7 7'1 jr¡ 7fb7 - 21/ () I I 1 I I I I 1 I I I I 1 I I 1 I I 1 I I ø ø F -- ø 1r ~ I I 1 I I ,-- ): '/ /' g 7Ç/~ /7 7?t /' I I 1 I I I (/,- I -20 ---1 I I _J ;; I ,- I I L_ //;r ~..// I I I -;- ,<, ;.; --:/ /'/ '7' .L ,7 t?,~{ c; ; 71 7~fý I I 1 I I 1 I I ! I I 1 I I I I 1 I 1. COL. TEST WEEK # 1 2 ø I I 1 I I ¡'P ../1:; I I 1 I I I 7¿:? -; c? -' .,' I 7 I - 17 t? 7 9' ,.._ ,__ J ,_, 7q ff ff ð I /7{J ï; i I /: ,":/: I / (i /1' 1 ?/ I "'/0 /, Ç/ I / . ---'-- I I 1 I I 1 I I 1 I I 1 I I 1 I I 7ó# ':/7' 3 7/ /¡y 71 <4 5 7/ 7tJ ~ 6 I I 1 I I 7 71 7/ 70 Jý -- ! ./ I I 1 I I 1 I I 1 I I 71 7ð~ 8 9 . 7/ II I I 1 I I 10 l~~ 11 I I I 7ú Y4 7v~ I I 1 I I 12 13 COL 2 COL. 3¡COL. WEEKLY IWATER 2ND SHUT-DOWN I LEVEL !GAUGE TIME PERIOD I INCHES INCHES DATE/HR 't-/C'/12.'/ Çl"~ - TO . ~ ,?) DATE/HR 4/./2/.2.10 }f' /-" 7L DATE/HR ¥-If. I /():'I.ç lIP" TO ." I DATE/HR '-.lcll:'I() Iftfl ,. 71 DATE/HR f-} S/2.(/Olf~ TO 'I .11'1 DATE/HR -} 5" DATE/HR c:, - 1:00 If"'" TO I I ¡ /'7J DATE/HR 5 - 'f 2:'f5,11I' V DATE/HR p - q/ / .'l¡ 51 r Nt TO I DATE/HR -/1 G:]2 pili DATE/HR < - / 1 /];1{ Jj TO ¡: . I DATE/HR ~ - / 9 /J:OO DATE/HR - 'S I' I I TO j ~ DATE/HR - :77 1Cf.'t¡ P DATE/HR - &J 7,'tJp I A "" TO _ / f5'''' r I "II rØ'f DATE/HRC " ,/ ,'" }!:/ DATE/HR 0-1/ / 7:JtJ 1,..,vI TO I I "" a- DATE/HR . 0 K/ DATE/HR (; / y:(;J( 111"''' ,~ TO "., /:;r\IJlI' a DATE/HR (- -/, / ",. , )J DATE/HR'!I 1?!/1 DAT~~HR ~- J Ú/~'" i/~# f} DATE/HR (.,)' § / '1.~!') V11Y1 , TO " ~a? <1 1 ., ,,"..' / DATE/HR (-/ //1'" ~" ~/ DATE/DR / -, Cj I IN" ~\#,.=- DAT~~HR 7-7¡ð"7';;i~ (c UARTERLV SUMMARV FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE CHECK ONE ONLY I TANK MONITORED S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A.MOTOR VEHICLE FUEL TANK .' I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF: I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS if I A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE I A. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 I OF ~/- 25 GALLONS OR MORE B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE I B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COL 9 . I OF +/- 35 GALLONS OR MORE I C. TANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 OF I +/- 50 GALLONS OR MORE I D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS I OR MORE OVER THE QUARTER TIME FRAME REPRESENTED ON REVERSE. I SUMMARY I SUMMARY TANK # PERMIT # : TANK # ~ PERMIT # I b ~...J':: ,:;;..:...., 'I MONITORING BETWEEN DATES OF AND I MONITORING BETWEEN DATES OF ýll 0/ '(0 AND 7/7/ 'f0 (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I c 1, A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. I 1. A MAXIMUM: WEEKLY VOLUME CHANGE (COL. 9) OF -~ß GALS. 2. A CUMULATIVE VOLUME CHANGE (COL. II, BOTTOM LINE) OF I 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF GALLONS I -:2- ~ GALLONS I I . I HEIŒBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCHIBED IN "A" AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "0" ABOVE. I I , J ' I I ," " ( \ I' T I __'-- , ¡ :', -.. <:! IGNW TITLE I S~G-NED - ¡·¿/711c1:., AL -<-' -/' TITLE ,L-¿ l; j. T j.>:¡ ;(: i3£¿ oJ _ I ' // :', - -- DATE I (/ DATE _ II :/;f * * SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT * * RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS ---- ---- ~U.A.rti.t::.. -'(L~ lvlUU.1. .1:" .1. ~U .1. N V EN '.l'UH.)( CUNTHUL SHEET - - FACILITY ...vr- PERMI T :#: - c..-. TANK# ~ CAPACITY /() .000 SUBSTANCE STORED 7 £ / 5" ~L QUARTER/YEAR, - - - , - 1T - - = I I I I I I 91 1 - COL. COL. 2 COL. 11 1 COL. 3ICOL. 4,COL. 5, COL. SICOL. 7, COL. a ,COL. I COL. 10 I TEST I ~T ~ I 2ND _ 1ST = INCH I 2ND _ 1ST =VOLUME+ TOTAL= CUMULATIVE WEEK 1 =:v ~ IGAUGE GAUGE _ CHANGE VOLUME VOLUME CHANGE_SUB _ CHANGE # 1 NCH -L INCHES I INCHES i INCHES GALLONS , GALLONS ,. GALLONS L GALLONS L GALLONS 1 I I I I I I , 0 I ø I I ø I 71 I 7/ I ff 71?7 ~ 7/b7f' Æ I I f 1 -L , i L k I - - 2 I I I I I I I I I I I ø I 71 I 7) I ~ 7'1br : 7'1b7 I ø I ø I d I I-;- 1 -L I i I L k I - I I I I I I I I I I I I d I 7) I Î) I ø I 79(,7 I 7'b7 I ,j I 0 I cÞ I 1 - -L I 1 I I I L k I 4, I I I I I 1 I I 4> I I I I {þ I ;1 I /1 I (þ I /767 I í9'7 I Ç1J I I ø I 1 - -L I 1 - I l , L k 5 I I I I I I I I I I c¡ I 7 / í~ 7 ¡ /1<./ I ø I 7q9~ l 7'79$ I. ([) I ø I ¿) 1 - -L . / 1 - I , L k S I I I I I I I 1 I !L I 7 I '11 I (!þ I 1r,fo7 l 71'7 ø I Cþ I ø 1 --L L I L L - 7 I I I I I I f I I ø' I ¢ I Î I (~ Î\ fly I P- I ~ 11 5 l ífî5 ø I I 1 --L L I l L - .~ I IJ I I I I I I I I I 7/''-J 1 1/ I II t 7C(fÞí I 719S --'~ I 6 I -2..t. 1 --L 1 - L - l ~ 9 I ø I I I I I 7967:1 I I I I I í' I ,I I ø I 7'107 I if I - .)-~ I -2-ß - - --L ! 1 - 1 L I L ~ 10 (þ I I I (þ I I ,I çi I I I ìl I II I I 7'167 I 77071 I -2--~ I -~ - - --L 1 1 - L L ' 1 - L l 11 if I I I [j I I I I I I 7 J I 71 I I 71' 7 I 7 967 t I --B I --L 1 1 L L L .-' ¿,.. r. ~ -¿S - - - - 12 ø I I I I I I ø I I I '7 l I 7) I ø I 79t7 I 19'7 I - ¿. ~ I -~8 - - -L i 1 - 1 i 1 - 1 ~ 13 tÞ I íJ 17/ I 1/!/Ä I CÓ I I I cp I - 2-a I - ;2. e~ I I I 6ð~5 I @o~ I I I _L , I , I I , , ____.__---1 UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE CHECK ONE ONLY I TANK MONITORED S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A MOTOR VEHICLE FUEL TANK I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS .ll.: I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF I A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE I A. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 I OF +/- 25 GALLONS OR MORE B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE I B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COL 9 . I OF +/- 35 GALLONS OR MORE I C. TANK OF OVER .5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 OF I +/- 50 GALLONS OR MORE I D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS I OR MORE OVER THE QUARTER TIME FRAME REPRESENTED ON REVERSE. I SUMMARY I SUMMARY I TANK , ~ .. PERMIT , I f b OJ;' ~ c..... r TANK # PERMIT # I MONITORING BETWEEN DATES OF AND I MONITORING E.TWEEN DATES OF 1 It::> Cfa AND /0/ i/7O (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I I " -..2 8 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF I 2. A CUMULATIVE VOLUME CHANGE (COL. II, BOTTOM LINE) OF GALLONS I -;;¡ ~ GALLONS ¡ . I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPbRT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCHIBED IN "A AND B" ABOVE. I DESCRIBED IN "A" THROUGH "0" ABOVE. I I I I f / SIGNED TITLE I SIGNED ,-' TITLE F L lêJ, --;- /Æ',,1-t-)i;~~<- - !~/ - " . I DATE I DATE - I , * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT '* '* RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS I I I I I I I I I I I J I I J I I I I I I I I COL. 11 CUMULATIVE CHANGE_ ___GALLONS _ I ø I J I I / ~_OO:¿~ C- ð d IS <1 ø ø ø d ø ð / /'~ '"..,./ UARTER/YEAR aiCOL. 9 10 =VOLUME SUBTOTAL= CHANGE+ GALLONS GALLONS éÞ 0 I I 1 I I 1 I I 1 I I 1 I I L I I 1 I I "'" Ç/ ø ß p ~ C/' P {/J ø ¢ cÞ ø PERMIT # ø COL ~Ul'l, i .KUL :::>HJ:.J:.i I I 1 I I I I 1 I I 1]5 - o -0 {)'.,,' q (j ¢ cÞ o ø ß I I I I I 1 I I 1 I I 1 I I 1 I I 1 I I 7@8-s ¡ I 785:.6 II -J....O~ /~'.> 1770 ?~ S""S ! COL. 6¡COL., 7 COL INCH I 2ND _ 1ST CHANGEIVOLUME VOLUM~ INCHES GALLONS GALLONS I 1 s55 7~7;Y 7fþ&3 /&33 -;; 57if ßo(), 5 ðo~S - ):;:>/. .L J.. ~ \I J:.1." .L U.t'<. J( SUBSTANCE STORED ~o~~ 1£933 l3 0;) .5 7 8 ::;~ 782~ -(g~3 7tf]=:{"5: 777D 782-3- Î770 "7 S7tj 7S?L) --- I I ø ø ø d a f j,...\JJ.J.L.t:' .L c..LJ cÞ tI 6 I I 1 I I I I I 1 I I COL 2 COL. 3¡COL. 4¡COL. :> WEEKLY WATER I 2ND 1ST SHUT-DOWN _LEVEL IGAUGE -GAUGE TIME PER~OP INCHES INCHES INCHES DATE/HR /0/ /2.:30 ,- - TO ~ 'I,¡f. 7[/1 'f DATE/HR 1%/ ~ I 'f/ (2.- 7Ð z.... DATE/HR ,/D LS/2?D I TO (I I DATE/HR 10 (7. ;ì-3 ( DATE/HR J '¥"L ((10 I TO ';1 DATE/HR/D/~I (~o I DATE/HR /C1/'tfl, :,< I TO J//.._,I DATE/HR /¿V~H ".' t/~I DATE/HR 1//51 'J-.t b I ; TO / / .( I DATE/HR II 11 ,')-"'Î/-' I DATE/HR 1//1.7/ n z..o I TO I DATE/HR ,511--'-/¡) DATE/HR II / I >~ I TO / i I DATE/HR l'l7A I vJ .5 I DATE/HR ¡~/~øI /. 30 I TO ~ ~.d DATE/HR If I t.~;;" I DATE/HR No f¿¡;:.A~~,I\)?I TO 1 ISo I DATE/HR /2 - -I I DATE/HR Iz:/ll/q 7;5 I TO D I / ~<> ~ ,€JI,:;:;".}f:-- DATE HR DATE/HR TO DATE/HR DATE/HR TO DATE/HR DATE/HR TO DATE/HR b 7//2- b 7 '/2 ÎO Y'-I 7r) 'ILl b7~ Illj I . 7Ð f 7-- 'lL! --;0 7D -;0 , ÎD 70 ~ I I 1 I I -....¿ U~,C'I,..L C.."L I 1 1 I 7D 12- I Ie í '/2- f, Î '!z- b c¡ 12- 7D I It.! it) lIt-! 70 &, If 1/2- 7D~4 II t./ 70 10 CAPACITY I I 1 I I rt5 (þ (þ rI p ø rf 6 ! ø ¢ ø c) FACILITY I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 TANK# COL. TEST WEER # 1 10 13 12 11 :3 4 5 8 9 6 7 2 . - UARTERLY SUMMARY ¡ FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED; ON REVERSE CHECK ONE ONLY I , I ' TANK MONITORED S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF: RBPORT TO THB PERMI'M'ING 'AUTHORITY WITHIN 24 HOURS IF A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE A. TANK OF 1000',. GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 OF ~/- 25 GALLONS OR MORE ß. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE B. TANK OF 1001\ TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COI, 9 . OF +/- 35 GALLONS OR MORE C. TANK OF OVER, 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 OF +/- 50 GALLONS OR MORE D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLON~ OR MORE OVER'THE QUARTER TIME FRAME REPRESENTED ON REVERSE. SUMMARY :, SUMMARY I TANK # ~ PERMIT # I r O:.:>~.:.. TANK # PERMIT # I MONITORING BETWEEN DATES OF AND I MONITORING B~TWEEN DATES OF I D/3/? 0 AND /IY/c¡r (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I ! q 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF I 2. A CUMULA,T E VOLUME CHANGE (COL. II, BOTTOM LINE) OF GALLONS I I GALLONS I 'J . I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I I HEREBY CERTIFY T~AT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "D" ABOVE. I I r ,I " I ( " I ,- '....,. '/ SIGNED TITLE I SIGNED -(~U-~ c~_~..__.J TITLE ¡":'L t; F _, M.\ 4- *E".L. - l_~,,,' - I /':/9 DATE I I DATE - !. i ) *' *' SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT *' *' RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS - , / 6 ð 0,;)-6 * * INVENTORY CONTROL SHEET - - ~UAHTEHLY MUDIFIED f~-' PERMIT # F AC I L I TY U T( LA TANK# I I I I I J I I I I I I I I COL. 11 CUMULATIVE CHANGE GALLONS a ø d UARTER/YEAR ø ø ðð I I I I I I I I <l5 $ ø r$ I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I ~ I I ø COL I I 1 I I I Ì)J ¡ _ I - i COL. alCOL 7 COL 8;¡COL. 9 10 INCH I 2ND _ 1ST i_VOLUME+ _ CHANGEIVOLUME VOLUME ¡-CHANGE SUBTOTAL- INCHES GALLONS GALLONS 11 GALLONS GALLONS d ' /I 0 Y' 7S7~ 7 St..J+1 (lJ - (I ~ i I rf 75('-/1 q ø 'is!'! 9 " ï5/6( Î 7 ~t/~¡ I 7St/6 ,I' \ 7 5ý~ ~ 'I 75~&' ø (jJ tþ c;I I I 1 I I 1 I I STORED 757'-/ 'iSf' 7:; t-/b I I I I I SUBSTANCE 7~/B I I 1 I I rÞ ø Ç1; ¢ ø ¢ 4 7s-lb 7Srb 75"t/6 "..( ,.J ø ø () cp 754b 1 .,c: t./ 6 (j t) cÞ / cþ 5 I I 1 I I I I I I I 1 I I 1 I I 1 I I ~ 7 J¡z., b 7 72- 4¡COL. 1ST GAUGE INCHES b7Y¿ I 0 ~ 00 0 I I I I I COL 3¡COL. WATER I 2ND LEVEL IGAUGE INCHES INCHES cÞ '71/¿ CAPACITY 2 COL t:. 7>/ý ~ 7 \/-1 b 7 it.! '7 '/ t-f t, 7 '/d- I( --I ¢ t/ 1 I I 1 I I 1 I I 1 I I 1 I I 1 I I I I I COL. TEST WEEK f 1 2 {,1 I I 1 I I (,1l!,¡ '/1 67 (ç7 I I 1 I I 3 4 5 ~ Î ~ , ' 'c.f 67ft.! (þ tÞ a 7 8 9 I I (þ ¢ I I - -------I -..Lfó I I I ø ø tJ) (5 I I I I I I I I 75t/~ 75'-/10 (j) I I I I I ~I b 7 f{¡ I !~--! '(4 b 7 ~¡) {g1 10 /J 11 I I , -~~ I I I I I ¡, I "'7' é }/ ...:;;,'-ib 7~t/6 ¢ ø '" I to b'1 (/) ø 12 ~ ,~'-I1o ïS I I , ')->/ B ß 7,)) I I , ~i I I I {,7 þ7/)y I I , teí 107 I I --' ~---- 13 I j ,( UARTERLY SUMMARY I FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTEOION REVERSE CHECK ONE ONLY II TANK MONITORED S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A MOTOR VEHICLE FUEL TANK __ - I - , , REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS Xl: REPORT TO THE PERMiTTING AUTHORITY WITHIN 24 HOURS IF I A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE A. TANK OF 1000¡GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 OF +/- 25 GALLONS OR MORE R. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE B. TANK OF 10011TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COr. 9 . OF +/- 35 GALLONS OR MORE C. TANK OF OVERI5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 OF +/- 50 GALLONS OR MORE I D. ANY TANK HASjA CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS OR MORE OVER!THE QUARTER TIME FRAME REPRESENTED ON REVERSE. ¡ SUMMARY' SUMMARY 'rANK . PERMIT . : TANK' g I PERMIT" / Þ iPo 2 r., c- , , MONITORING BETWEEN DATES OF AND I MONITORIN BÈTWEEN DATES OF / / 'ñ 19( AND 4'/</ ¡ T / I , , (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: I I ¡ 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF GALS. I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF -~Ó GALS 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF I 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF GALLONS I - "2 'B> GALLONS I I .1 HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I HEREBY CERTIFY T!'IAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE ANU ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS OESCnIBEO IN "A" AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "0" ABOVE. , I /--, I c-' , SIGNED _ TITLE I TITLE _r-ll::'CC ÞVi-\-\'J;] ',-G-'- I DATE I DATE _ ¡ , * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUA~ REPORT * * RETAIN THESE RECORDS AT TilE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS . . 24. HOUR /~~r¡;: ....\ \ ,~J -'.' <~~>y~ '-~., ,'.:' ...~t:)~ì ¡ \~ ~"" , REP=~~~A~~~ATION/LOS~' ~\~ ., ...,,\:\,~;' .. i'\.\ \ \, ìi\\.\ \~ ~" .. ' ..- , , _'-¥; , '-/ .:...~ , ';/ TO: ':~-:-~;:..~. /; -,,,,,,~. Kern County Environmental Health Department 2700 "M" Street, SUIte 300 DakcrstIcld, Calltornla 93301 Attn: Underground Tank SectIon REGARDING: faCILIty: KERN COUNTY GARAGE - UTILITY Permit '* 160026C FdCLllty Address: 1415 TRUXTUN AV. BAKERSFIELD, CA 93301 Nd:::e üt per:.:on flllnq t{eport: LARRY JOHNICAN, FLEET MANAGER Oil WEEK ENDING 2/17/90 , the above tacIlity had an t cia t e ::wd t i:rrc ) Inventory variatIon/loss that excèeded reportable lImits as described below: Amount ot Amount ot Amount ot Total MInuses l' .) n t: If l)')lly Weekly Monthly LIne 3 ot ;r VariatIon/loss Variation/Loss VarIation/Loss Trend AnalysIs 4 N/A N/A N/A N/A 5 N/A N/A N/A N/A 1 have/have-not stopped dispensing product and begun investIgation procedurE requIred by the Permitting Authority. This notitication is in addition to the phone callI previously placed NICAN, FLEET MANAGER SERVICES GARAGE DIVISION . . KERN COUNTY £NVIROMPIENrAL HEALTH DEPARTftENT VARIATION/LOSS INVESTIGATION REPORT Facility: KERN COUNTY GARAGE ~ UTILITY Permit 1} 160026C facility Addrc~s: 1415 TRUXTUN AV. BAKERSFIELD, CA. 93301 Tank(s) ~lth Discrepancy: # Date/Time ot Dlscovery: Na~e ot Per~on Filing Report: Larry Johnican. Fleet Manaqer De~cription Ot Discrepancy:A SECOND STICK READING WAS INADVERTENTLY MISSED DURING THE WEEK. CONTROL HAS BEEN ESTABLISHED. INVE~TIC^TION ~UMMARY 1'he tollowlnq procedures must be pertormed within the specltied tlmes startlng dt the time a repoltable loss is discovered or should have been discovered: 1'1 L U11 Cl: 6 Hours Owner/operator or other qualItied person is to Date I Tlme reView record~ tor errors betorc determining 12/20/90 I 0900 tt1CLC' l~ a rcport.J.bLc varlatIon/loss.' ,-S;è; Pertormed By : LARRY JOHNICAN~ 24 Hour~ 11) owner/Operator ~ust verbally report I Date I Time 1 discovery to KCEHD and tOllo'.v-up 'tilth \vTl tf:n~~ I 0818 I notltlcatlon on tor~ provlded. ~~'- 1 Pertormed By : HAROLD H. LAWLER 12) Visual tacllity checK to be pertorrr:ed uSlng I Date 1 Tlme I checKlist on the bacK ot this torm I I I Pertormed By : 13) All product dlspensers are to be checked tor Date Tlme I callbration and adJusted It out ot tolerance I Pertormed By 48 Hours Piping to be leak tested using approved methodl Date I Time Contractor"s Name Llcense # Test pertormers Name Descrlption ot test pertormed ~ ~ ATTACH COpy Of TEST RESULTS. ,~ . 72 Hours Tightness Testing ot Tank(s) to be performed Date using approved tester and method. I Contractor's Name: Llcense # Test Pertormer's Name De~cription ot test pertormed Time ~. ATTACH COpy OF TEST HESULTS. '.~ ~ NOTE: THIS REPORT MUST 8E SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAY Of COMPLETION OF INVESTIGATION PROCEDURES. ~.l . . 2. VISUAL INSPECTION CHECKLIST A. Dl:.>pensecs M/A ¡'\11 di spenser- s and the I r- end door-s vi sually checked tor- leaks. M/A All hos~s and nozzles visually checked tor- leaks. ~ All totalIzer seals checked tor tamperIng. Results: M/A ^ll dispenser-s appear tight signatur-e/date Ulspenser{s) not tlght as listed below signature/date l!)l~PEN~EH I I I I #I~~EIUAL 1 :: I C01'1f'1E NT::;: I I I I I B. Tank Area N/A All turbIne boxes inspected. M/A All tIlls and vapor- reanholes Inspected. Results: Tank ar-ea appear-s tight wIth no product or liquId present signature/date Tank acea does not appear tIght because ot the problems/conditions lIsted be 10','.': slgnatur-e/date #IPRODUCT#ICOMMENTS/RESULTS: ¡TANK I I I I c. Piping 'rype: 11 Pressure 11 Suction Pressur-ized piping leak detecto~ls) tested tor proper tunctIonlng a detection of leakage. Suction pipIng tested tor indicatIon ot leakage. Results: Piping tight based on test{s) above~ signatur-c/datc Piping not tight based on testls) above, with pr-oblems/condltions 1 i s t eej be low. sIgnature/date DescrIption . . FUELG1.0789 GARAGE Jðto/ 19¿9(SOUTH) VARIATION 120 ' , . . , , " "", · . . . . . .. ..... · . . . . . ., ...... · . . . . . .. ..... 1 00 : ".....~....,," ~ " .. . . , ~, . .. " ,,~.. " " , . ~ .. .. .. . ~.. . . " "~..,, ... ,...,., ~" , " " ,~ " " " , ~ .. .. , . , ~. .. . .. ..~.. , .. '" ,.,.... "" · . . . . . .. ..... · . . . . .. ..... · . . . . . .. ..... 8 0 ~ ,...,.,~:....... ~ " " , " ,~, .. , . " ,~" " " .. ~ .. .. . , ..~. .. " , . ,~.., .. , ..,,,...>.,,"'~"" '" ~ ' " . .. ..~.. . .. .. ,> .. .... .."... "" · . . . . '. .. ..... · . . . . .. ..... · ...... ..... 60 ; ..,... "..,.,;.."." >,.....> .., ~.."... >..,...> ,... ....... ,>"" <..' , .. ~"......>......>...., ""'" .." · . . . . . ., ..... · . . . . . . . . . . ., . 40 : """'~''''''''~.......~".."..~'''' "~""..,~...,.,,'~,,.,,"~, ."..~'" ,,':" "".~'''''''~"".."~,,..,,' "....,~'" .. ........... . .. ........... . .. ... ....... . 20 : ....' .~. ,.... ~, '''' ~ ,,,....~, ..,"'~'" ''', .,.....~, ...":,,. ...~." , ..~ .,.,......... ~....... :"..... ,,,.., ~" , · . . . . . . . . . . .. . · . . . . . . . . . .. . · . . . . . . . . . . . .. . 0, ' , , . , , , , . , , ,. , · .... .. :" ..... ~ . . . . . . . ':' ...... ..... . ~ .. .... ';' . . . . . . ':" ..... ~ . . .. .. ':" ... . :' . . . . . . . : . .. ... ':' . . . . . . ';' ...... ..... ..:.... .. .......... · . . . .. ... .... · . . . . . . . .. ..... - 20 : ' , ...~,. ,.. ,~""" ,,:.., , <....,. ~, ""..;, ",,,.;, ......;...., ":' .""""....,:".... <. .. .. " ,~" .., ': ,... <"" · . . . . . . . " . . . . . . . · . . . . . . . . . . . . . . - 40 : """,:". , ..:""" ":" " " ":,, ' " .. ~ .....,,~ " '"'' ~, "."':"",, .;"."..,:"""" ~ " " .. . ~.. , .. , ) '" ". ~ " .. ",:.." · . . .. .......... · .. . ..... .... · .. . .., ," . . ~ . . . . - 60 : ",," ,:.", "':"""'~"'''' ,,:,""",:,,""'~'" .".:"""':",,,,': """'~.".,,':"""'~.,,"" ,:".",,:... ". .:"" · , . . . . . .. .....,. · . . . . , , .. ,...,. · . . . . . . " ...... 80 ' ' . , , ' , " """ - . ..'....:........ ~ . . . . . . . ':' . . . . . . ':' . . . . . . . ~ . . . . . . . ':' . . ., .. ....... ~ . . . . . , . ':' . . . . . . ':' . . . . . . . ~ . . . , . . . ':' . . . . . . ':' . . . . . . . ~ . . . . . . . ': · . . . . .. ........ · . , , ., ...,.... · . . . ., ....,... -100 J-,::,\ é:C\ ,6 8 '. : 0 12, ,1~li'~ 18 20 22 ,24 26" 28 30 "'\'1····.· (.\., \ l.'.i;c;:~q ~ \r"u~;_'\:-è:.l·Y. \\~~~~d ,,/(,~-~~-+/(... '.-,,'----:'--........ ( il' " \,.~f\,;/~\ ,)~:~~ ~ '\').' . , ,I !'\ /\ - ',\", '\/ /~\ " / -,' ',,---,) . ',-" ,\" \ \ T·~ L,,(\ ._~ , J ( \ '- -(\)<¡D<\. ð. is'- 3 1 0 o 1 1 0 O__L_ o 1 1 0 1 0 6 3 1 _L \ I 1 ! \ 10.000 UIUADID -- ---; -.vnu 6 7 8 . 10 11 12 13 \ 16 15 16 17 18 lt \ CLOSDC-Illftll-DULY,IIIftII-- __ -_DIll GWGDIII'---QAUCWII --'IW.IVUBO.-___-DIVBIIIOU--toDL_IIIftUD-AIIDUII! _ _PDaII! DGU1YK-l'OsnvE _DIll _DIll JlBftUD ADJU!mII ØlI'OU AI'fta DI9III!OU QAl C DIII uoucno. _lIT ovaa OR S VMIATIOII COUIIr COUIIr SM.U IW.IVIIIY DBLIVDY ..! GALLOIII GALLOIIII GALLOIIS GALLOIIII I»CBIS GALLOIIII I»CBIS QALLOIIII GALLOIIII _,~!' QALtQE GALLOIII GALLOIII . o 0 0 I 105 75-30 -~- : : I ~ 55}--=~:'- 633' 70-3/6 8308 3t7.: 567 883 36 ~ ~ ~ 0:, m ~~ 3: o 0 0 ( 135 107 -38 ..~:.....n .n~~.n.-;;n.4J1-\ _ .)~:: 36:_: o ,0 ".\, _ _ 516 887 73 o 0 637 571-M _,0-____ __0--- Q , J6£ 7'L__U _, 62N 70-1/3 8377 3te3 61t 687 38 o , 516 663 -73 o 0 0 : 330 136-K DIDØXÌ 3612 16oo36C --~----- 07/8t . PØllIT PRODUCT Cl-1/6 75 U o 883 617 560 107 C»JlCIn DBP AII!IIEII'f 116816 1167Cl ___117364-__116816- 117368 117368 11,.51 117368 118568 117t51 1UU8 118M8 11U35 11.128 IŒIIII COUlftY JlllALTH rullLS IIIVDI'OU UCOIIDDIII SIIØT ~- --- -.------ __ BIlK . 5 3 3 6- ------DAIII:....· ·,·D- OPaIIIa-,OPDDIII, ,CLOSDIII o CWlGI_ IJIVDm)U IJIVDm)ay . DU/JIOUII IJICIIU QALLOIIII QALLOIIII 01/638M 7 67-116 5166 5061 -_03/603M ---1-"-1/3---__5061_65711 03/700M 3 63 <15711 61105 N/608M 3 62-1/3 61105 ,.37 05/608M 6 67-3/6 ,.37 7333 N/61OM 5 63 7333 6788 07l638M 6 5. 6788 6653 I'JlCILI!T 1 - OÞ O. " 587 571 '9L 687 663 136 oK.....·..···· _It 1 YOTALS 6551 11U36 11Un 6037 11tt31 llU36 M10 1206.3 11..31 _""__-_UU83_ '3o-aU__ 7_ UU70 121283 "56 123612 121.,0 732<6 133566 133613 6n3 n51 6037 ,_MlO. "" ,.68 "M 08/638M 7 88 ot/608M 1 57-1/6 10/63OM 3 53-1/3 1l/1I08M,__--3-6.,___ 13/618M 6 n-l/3 13/613M 5 68 1t/UOM 6 " 1 1 1 o 1 ,0 1 5 o o o 1 o 1 o 05. -3. 1 ,__0 1 1 1 o o '-' o 1 3 o o o o o 1 o 1 1 o 6.n. 1.5n 3311 -101 -------- --. o 0 1eM1 1eM1 o 0- 810 863 53 o 735 70 36 o ' 836 763-" ___L. I :t____;~; ..__-~~ o I 100 183 83 \ DUD IIIIXDU' 6165 l o ¡ 131 ___,3t6L-., 70L___, o 0 )' 730 g 1 ::: 6101 ' 570 o \ 116 '-iìÖlxDD/--- -373t o \ 17. o ' 707 --- --'1---.- . I, ... 61 o o o o o 0- o o o o o o __~,,____o o 1eM1 863 70 763 tlO .187 183 ............. 1331166 133656 133517 136366- 1311038 ,_ U5U8. 136735 IIUIt 3 70TALS 1336116 1331117 136366- 135018 135ua ,-136735 126_ 7336 "16 568t 6853 3t88 --31,. 30,. 7 63-1/6 7336 1 63-1/6 7336 3 56-1/6 "16 3 51 568. 6 65 6853 ,,,..5---38-3/6-_3t88 6 33-3/6 317. 15/600M 1""8M 171603M l'/6NA11 It/61OM --,30/600M 31/"8M 6363 317 168 17 ..'- 701 ..____0 757 37 66-5 3t 880 15 530 -60 116 0 37., 88 110 -n 768 61 583 -3 o "-u o o o "a3 o o o o _____3657 57-3/6_ o o o 3581 65 3/6 o o o tID1{ 3 YOTALS ............. 3H8 1370M 13'_ 168 no. . 127757 ._ ___137056- ..__701, _______38-3/6-, 116,. 128516 137757 757 6853 13.17. 138516 "-5 3t88 13005. l:lt1,. 880 751. 13058. 13005. 530 35 3/' "03 130705 130589 116 IIUIt 6 YOTALS ..__.....IIk. 110 "8 130705 13eM1lS 13081 !5 131583 7236 6517 33/"OM 7 33 30,. U160lJllt 1 31 ' ..3Na 36/6NA11 3 56-3/6 not 35/608M 3 "-1/3 116" 26/61 !5AII 6611 6853 37/600M 5 38- 3/6 3t88 381618M 6 " 1/3 75U - 3""8M 7633/6 7603 30/6_ 1 U 1/3 7336 o 1661 -10 -0.68' '----i 111635 1"- 1.eMI. 13 17 00 ! 581 \ ØIIXJXD 'j---147i , IIIIXDU ;¡ 1535. --r-- -1-'-'------ I ¡-. \ ! I -1 o o 6517 5U3 1331" 131583 583 IIUIt 5 !OTALS ......U,A ( ~ YOTALS ........... 3 57 311607M . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: Kern County Health Department 1700 Flowe~ Street Bake~sfield, California 93305 Attn:Underground Tank Section REGARDING : Facility: k~q.; C~~ ~~ Fac il i ty Address: I '-1-( 5 ïïZv...~'V Permi t # / ~ t!)Ø~ G t4-v, Æ.4-k.E/1.8. ;:t~Q CA- 'l S 5 ()J . J"ð/"f+.J (~. F'-££:T"I11ArJ~ . - Name Of Person Filing Report: '-~ 1/3-1h? / 9/cg M I On , the above facility had an (date and time) inventory variation/loss that exceeded repo~table limits as described below: Amount of Monthly Variation/Loss /~~t/ Total Minuses Line 3 of Trend Analysis Tank # Amount of Daily Variation/Loss, Amount of Weekly Variation/Loss :2... ~ I have ^stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. i f\ :\(' ,(, , "V\" ; _ "\ \ \' I -C;'\ \ (~ ' ( \ \ ..___ "0 +-" ,\ < \¡ (~L RRY JOHNICAN, Fleet Manager ',I,",-,,--Î ( \.z:.~ _ eneraJ Services. Garage Division, C1 / -:-¡ (.'\ l/ - -lJ - \ /\1\;r- j \. ¡~\~\J \ ' \ d., ',¿r;;=,\.{~ (~' " Si ature " '\' '\ " ", ~:\ f' \ \'" "- \ n \~~C/.,' \ , 1,-'-' ~~><.........~~<_\ ',-._~"~'-__~~'" ~/ j" ~\ . -.! " \ "" ::~~, ~, \, i' , _' ....j...._.' '. ..~.... / ""ls~' ~_.\,-./r ·1 I 1\., '.\ ":~~f~, _:~~~:::J.;~." . . KERN COUNTY HEALTH DEPARTMENT VARIATION/LOSS INVESTIGATION REPORT Permit , It (!)O~G Facility: k~ CJQ-A.J'( &-~ Pacili ty Address: 41 S TR u.."f- ¡J 4-V, Tank(s) with Discrepancy:' ex Name of Person Filing Report: ~ Description Of Discrepancy: ß1fh1-nf{.f /?m t2~+- ( 1- & 'I o.¡o ') INVESTIGATION SUMMARY " Date/Time of Discovery: '- ").;. 1-1, <V ( c.~, ,...c: LÞ=~~T f r6,¿ u.v¡ r£--kÆ.Æ:pl~ #f"¡"µ· ~L tK~)~Uz.. The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I I I I I 11) I I I 12) I I 13) I I I I I I I I I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES" 8 Hours 24 Bours 48 Bours 72 Bours NOTE: Owner/Operator or other qualified person is to Date ~~/~ q . I Time 118 ¡f1v1 review records for errors before determining there is a reportable variation/loss. ~' Performed BY~ ~ ~ (~ ./ Owner/Operator must verbally report Date I Time discovery to KCHD . and follow-up with wri tten ~I-zI~'( I C¡'tg A1.v¡ notification on form provided. /~,~, tJ ' Performed By: ~J"~ Visual facility check to be performed using I Da~teTìme checklist on the back of this fora. _ ,Å. I n I!(, h~30 4c<-\ Performed By: ..:::t::§~~ All product dispensers are to be checked for Date !Time calibration and adjusted if out of tolerance. I Performed By: Piping to be leak tested using approved method. Date Time Contractor's Name License , Test Performer's Name Description ot test performed * * ATTACH COPY Q! TEST RESULTS. * * Tightness Testing of tank(s) to be pertor.ed using approved tester and method. Date Time Contractor's Name License , . Test Performer's Name Description of test performed * * ATTACH COPY Qf TEST RESULTS. * * PERMITTING AUTHORITY WITHIN .§. DAYS OF . . 2. VISUAL INSPECTION CHECKLIST A~ispens~rs . , ~ll dispensers and their end doors visually checked for leaks. ~ll hoses and nozzles visually checked for leaks. All totalizer seals checked for tampering. ~:·~~i·~1spen.er. appear tight ~;f:~"-,, r.IJ7 signature/date Dispenser(s) not tight as listed below signature/date !DISPENSER #ISERIAL #1 COMMENTS: I I I I I I I I I I I I B~ank Area ~' turbine boxes inspected. __ All fills and vapor manholes inspected Results: Tank area present.. . appears tight wi th no product or liquid ~'rj,~ ~A---/ cf.!-v4( . signature/da~e, Tank area does not appear tight; because of the problems/ conditions listed below. signature/date I TANK I I I #1 PRODUCT I COMMENTS/RESULTS: I I I I I I I I C. Piping Type: 0 Pressure 0 Suction Pressur ized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems/ conditions listed below. signature/date Description . . FUELG2.0789 GARAGE JðfJ 1#9§g(NORTH) . VARIATION 180 ' , , " , "'" · . . " . ..... · . .. . . ..... 160 ; "'''''~.""'''!'''...,.>''''''>.'''' """. ". '<""'''' ",,,-- ,.""<."....,!"""<..".,..~.."".. .""'''>'' · . .. . ..... 140 ' , , .' , "'" · .......:'....... ~ . . . . . . . ':' . . . . . . ':' . . . . . .. ....... .... ...:'....... ....... ........:'.......:....... ':' . . . . . . ':' . . . . . " ....... ':' . · . " . ..... 120 : ,.,""~.,"'" ~"""'~..,"" ,~...,.," "...., " , .,'~"",.. .",'.. .,"""~""'" ~..,..,'~"',....~",.," ".,,'. ,~.," · . . .. . ..... · . .. . ..... 1 00 ; ".""~"...,..!.....,.,~...,..,.~...'''.. .,..... "..".. > .. '" ..,.." ,,,,,.., > .. . , " ~ . " " , "> ' " .. .:.. .. "" "......~.." · . .. . ..... 80 ' , , " , '.'" : .......:'....... ~ . . . . . . . ':' . . . . . . ':' . . . . . .. ....... . ... ..:'....... ,....... ........:'....... ~ . . . . . . . ':' . . . . . . ':' . . . . . " ....... ':' . . . · . .. . ..... 60 : ".".,~"..",:.,,,...'...,,,,,:........ ,,,..,, .." .,~.., "",.,.. .""..,~"....,:".""~..,,..,.~:...... .."..,~.." · . . .. . ..... . · . . . . ..... 40' , , , , ,.,.. · ....... :. . . . . . ., ...... .: ...... :- ...... ....... .. . . . . .:. .. '" . . . . . .. ........ :. . . . . . . . ~ . . . . . . . .:. . . . . . . .:. . . . . . " .........:.... .. . . .. . ..... · . .. . ..... 20' , , " , ,,',' : ....... :' . . . .. . ~ .... ": . .... ':'" .... .. .... ...... ':'" .... . ...,.. ..'......:........ ~ . .. ....:... ., .:..,..... ......'.:.... · , " . ..' . o : "''''': "..,,~"" .,~.. "":",.,,, ....", ".." ,~, ..", ". .., '"'".,~''' ,: "--,,~,, ".,.~, '''''--..."'~,,. · . . ... . . . . · . . " . ..... - 20 ; "", <' . , . " , . ~ ... ,. "> ' , <' " " '" ,."", """ <" "'" ""." , ,..' '>'''''' ,.", ":: ,.,. < " . .. . , ~ " " " . -> " · , ., . ..,.. 40' , , ., , ,",' - : ...... .:........ ~....,.. .:....... .:........ ....... ....... :' ...... ....... ..."... .:',..,... .......: ...... .:........ ~....... .:"... · . .. . . .., - 60 : ",." ':""',.,:"""'~"',.,"~,.,"" """. ""'" ~ """ ,.,.", "',.,"~""'" ".,"'~""',.,~"""':,.,.". ':',., · . .'. . ., . . . , . . . . ., . . . - 8 0 ; .",..':'''''''' ~ " " " "> " " <" " , ". ""'" ",,"" ,."", "."" """" > .. ", ",.." ':' " " . <" " , .. . ! . . " " ":. . " · . . . .. . . . -100 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 . 160026<: POIlU I 1 f 1 L (\ I \ KIIIDI COUIIft IIJW.TB DBP_ rtlILS III9ØI'OU RICOIDØQ søn .~_.~--_._--- .~ ------ rAl:ILIft _ ftK . - i 2 10.000 \ 1IOiirîVUM- 01/"- 2 3 4 5 6 7 8 , 10 11 12 13) 14 15 16 11 18 1 1 --~IIAft---- )- ~,. or__ c:toSør: c:toSIJIIJ IIftIa-..IlAIU,IIIIfta--'J'O!\\t..,-IIADIIIIJ- ~ _~__Da.IVUlD_.fta_---DIVIIII!IIII------..~aJLNIDUII!, ._PDCIIIr ,...'lIVILl'OSU'II ° GAUOør: IIIftIIrORf III9!JftOU 1lADør: IlUDIJIIJ lIIftaD _ Blroa APftR IJI'IBIn'ORr GAl/GIJIGI a.ooc:nOll _ 0VIIt OR S w.aunOll _ COUll! . SALIS DlLIVIU DltIVllr _" 'I DAr~ DICIIIS QAU.OIIS QAJ.J.OIIS GALJ.OIIS GAUOa QAU.OIIII QAU.OIIII IJI:IIIIS GAI.LOIIS IXIIIS QAU.OIIII GU.LOIIS DICIIIS GAUOa QAU.OIIII QN.LOIIS & 01/USM 7 43-3/4 "7' _ 137202 137126" 0 0 0 -- ~ 70 "6 --_02/_,----.1-43-1/4-"09, __60S7 _------U7756____137202- ___,SM- 0 O. 0-__ \ 5Sa._ 554_.1.___, :~= ~ ~:-1/4 ~= = g::~ m~~ m 311-3/4 3.~ 65 7~ 4oo~ \ m ~;~ ¡: OS/60SM 6 61-3/6 7158 6517 131308 138692 616 0 0 00) "1 61'-n 06/610M 5 57 6517 5861 160027 139308 719 0 0 0 \ 65& 719 U 07/63SM 6 52-1/4 5861 561!1 160238 160021 all 0 0 0 262 211-31 ___ 1 -U -----;;;;;;no.. no...........n'" n..nn..nn..n..nn..........~:::.. IIIØJŒD _3 3112 ¡¡- 160238 121 0 0 0 ,- \ 70 121 16035' 776 0 0 0 '" Tl6 141133 601 0 0 0 0 ¡ 602 691 f:~:: -.--'-.:~: ---iii:;1/4---1ì1~'6ì~--"70~ -~..~--- \ ~:. m 163196 720 0 545 720 163914 186 0 0 O:¡ 270 186 US DDXDD 3'69 _ I -0--- '\- Ü¡--'-'--'-iÒ3 o ° '" 801 o 1072 1070 o 808 7t6 . -~ t-,--·--~:~ ----,~~~ o '¡ 3'S 600 zn ~ 5136 5186 o ,~ 417 610 6039- \ . ___972. '95 00 \ 918 866 o '00 932 o \ 689 70a 3959 704 696 o 301 301 XJIUJIXU 6101 4902 o í, 110 US o I '63 972 1 I o 1 o 1 1 0 o 1 1 0 o 1 1 0 3--.--------- - -_. -- ~. PIlODUC1' UIILUIIIJ) -------. -- CAPAl:Ift o 1 o 1 1 0 ,___0__1_ o 1 o 1 1 0 6. ," 2 5 ~---- ...- ~- ~ -. o 1 o 1 1 0 1 0 1 0 ._,_1_ ~.___O o 1 6 1 1 0 o 1 1 0 o 1 o 1 1 0 o 0 3 1 o 1 o 1 ----" 1.5" 51 8 -1 __.so 23 115 -n 160359 141133 161824 ------16UU 163194 143916 1_ _2 554P 6783 4091 ___3&&6 6720 6175 Nt¡ 5619 554P 6783 .,_6091. 3&&6 6720 6175 08/U8M 7 50-1/2 09/608M 1 50 10/UOM 2 44-1/2 _-----U/605M, ._ 3_39-1/2, 12/61SM 6 :H-3/4 13/613M 5 N-lI2 l"UOM , 56-1/2 191 65 35 -1 -12 -35 ,-~, 5 ---- o o o o o o o ------- o o o o o o o .,.......... -_. ~---~_.._----~--- 144098 203 166301 801 165102 1070 166111 796 166968 1013 147981 901 148881 600 WYWYW~ 96& o. 50 -7 23 -u 32 13 -8 o o 4U6 o o o 4399 o 39-316 o 87 o o o 640 o ,-2-3/6, 610 ---995, 866 932 702 696 301 169282 14"92 150687 151553 151685 153187 153883 0.02& 1 15 , o o 316 41 o o 1/6 8 125 972 ~~"......II: 154186 154309 !'CWALS 166301 14S102 146112 146968 167981 1_2 16U82 lIEn 3 !'CWJW 169692 1506&7 151551 152485 153187 153983 154186 !'CWJW 154309 155281 1lU1li6 5758 4992 39ao 3112 2066 1157 763 54196 51N 6992 3920 3112 a066 1157 52-1/2 51-1/2 46 38-1/6 32-1/6 24 16 7 1 2 3 6 ,5, 6 15/500M 16/"'5M 171602M 18160U11 U1610M --. 20/_ 2l/"'SM 365 3612 a6N 1596 905 4160 3859 162 -..365, 3612 26114 1594 105 4160 712 1 7 2 36-1/' 3 27-1/2 6 ao 5 13-1/2 , 60 a2l"'OM - 231601M 26/60U11 25/6011M 26/615M 211600M 28161SM 3760 2186 3859 3749 "6 737 1 37 191"'SM 3O/608M 2054 22 1.0n 1'116 313 1. "'. 13 17 -~-- A o -2 059 \ I --ÒO '(--------i61 I I œ---žØxxnu t--- :J: øznuu \ I -- ,¡- ! - \ I I - -r ,I ¡ 2036 1_1 o o 31/607M a 29 "4 2186 1825 156160 155241 959 IIØIC 5 !'CWJW ...............4 _ !'CWALS W'II'III...k.. . , (..." ' ('S Lt--' f'\V , ./"'\rO~ V\,U . FU ELG 1 0889 GARAGE TANK # 1 I;;OUTH) AUGUST 1989 VARIATION 100 80 :-, 60 :, 40 : 20 0: , '-20 ' -40 ~"" -60 :- -80 2 , , . .......... " , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . . . . . , , , , ........... -.. .. ".... .... ...... ..... . .......................... .... .... . . - . . . , , . ... " , .. ....... -.. ....... -... '............ ......... .. '. . . . . . ......'. . .. ......... -. .-..... .. , ' , ... " ................... '.' ... .. ,'.... . . . . . . . . . . . .. .."., ....... ..... ... .... .....'.... . .......... .. .......... ............. , ..-.... -, .............'. '. 8 10 12 14 16 18 20 22 24 26 28 3D I I , , I I I I I I I I I I I 2 4 6 í', '-::\,~-,- I, '--:ì ,,-\" I L' L ~ l ,~,-- \{~Ú P-'\: " ! í . f' \,\'\ -t ~., t i,\ \ \:~'-) 0' <...., i\ (,/,-~\.. .:-'" "f'" '\í'(\'~'~,/'\!) ~-~~"___ '-., .-, ~"-" ,-.. ~>L) '< I ~'--' ,- ~¡, ~\ ~\ \), ~-\\ \..X-../ '''--' ......' "\ t' {\ I , \"" " ' ~. ',./ ',\ , (" :; \', ':'_ Î' , ~~ _\,_ ! /'f'. .[...., ¡r,/·..·\r'_~'" \' \ i . /' ~ \ \. \ ...::-----' ',.-': i:'\-'~\j,_y{~'v ('~"--'> .', ;, \ /1' ' \ ;' "--- / . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION ", TO: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDING : Facility: j¿ l/Z/i/ r" Ot//1/77~ ?/9/?.4C':¿': Permit # Facilit~ Ad~ress: ILl /5 r /tv YT V/V /9Y~ Name Of Person FilinŒ Report: /6' 002Çc On 1- S - pr I {J :J ¿? A/Vì , the above facility had an (date and time) inventorY~ss that exceeded reportable limits as described below: I I Amount of ~ ri . /Loss I , 590 Total Minuses· Line 3 of Trend Analysis 62 /~/7S Tank # Amount of Daily Variation/Loss Amount of Weekly Variation/Loss CJ'f I haver/stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. s~ LARRY JOHNICAN, Fleet Ma~ager Gener::ll Sorvicss ~ Garage Division . . KERN COUNTY HEALTK DEPARTMENT VAR:IAT:ION/LOSS :INVEST:IGAT:ION REPORT· Facility: ¡¿ f/Z/i/ CÕt/N-r-/ r;;/J.4/J¿;e Perllit # /? 002bC . Facili ty Address: It.¡. / ~ Î /1 (/ Jt T (/.IV /l ¡/ ~ ,ïJ /J K f-/?.J //¡It'E ð ,....... Tan1.«s) with Discrepancy: # / Date/Time of Disc~ery: Cj-S"- /?9 IO,f3ú,4,v; Name of Person Filing Report: o Description Of Discrepancy: IN t= >'CÉ!:S OF INVESTIGATION SUMMARY The following procedures must be performed wi thin the spec!f ied times starting at the time a reportable loss is discovered or should have been discovered: Within: 6 Hours 24 Hours 48 Hours 72 Hours NOTE: M /JNT/7'~7 F£~ if /J / N /,N'. I Nyl /V'TC/? /' i r þ,/ /"J S- I, s 9' ~ 1 I I I I 11) I I I 12) Visual facility check to be performed I checklist on the back of this form. I 13) I I I I I I I I I I I I I, Description of test performed I I THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 0,\ YS OF COMPLETION OF INVESTIGATION PROCEDURES., Owner/Operator or other qualified person is to I Date Time review records for errors before determining I t'f- S--57 /t/,'354A-1 there is a reportable variation/loss. Performed By: a~~~-z- Owner/Operator !lust verbally report - r ~Date I Time discovery to KCHD.and follow-up with written I q-.J -5'"1, I C,' ~ S -9",,,( notification on form provided. Performed By: ~/U?~V7- 7 using I Date I Time I t4_ -ý Performed By: All product dispensers are to be checked for calibration and adjusted if out of tolerance. Performed By: Piping to be leak tested using approved method. Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS. * * Tightness Testing of tank(s) to be perfor.ed Date Time using approved tester and method. Contractor's Name License # Test Performer's Name * * ATTACH COPY OF ~ RESULTS. * * . 2. VISUAL INSPECTION CHECKLIST . A. Dispensers " ~ll dispensers and their end doors visually checked for leaks. ~~l hoses and nozzles visually checked for leaks. ~All totalizer seals checked for tampering. " Results: -- All dispensers appear tight " 'J - .5 --5/ -- Dlspenser(s) not tight as listed below (ý signature/date !DISPENSER #ISERIAL #ICOMMENTS: I I I I I I I ¡ I I I I B. Tank Area ~ll turbine boxes inspected. ~ll fills and vapor manholes inspected Results: Tank area present.. . tight wi ~h /' no 'product or t:l~/r/ /ld,¡ ffi~ ~ signature/da~e Tank area does not appear tight because of the problems/ conditions listed below. appears 11 qui d 9-5'-;;1 signature/date ¡TANK #1 PRODUCT I COMMENTS/RESULTS: I I I I I I I I I I I I C. Piping Type: 0 Pressure 0 Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication at leakage. Results: --Piping tight based on testes) above. signature/date Piping not tight based on testes) above. with problems/ conditions listed below. signature/date Description 1\ ) \ ~ , f PERlUT t 160026C DEPAIITftEIrr COIIII'rY HEALTH IŒRII RECORDIIIG SHEET INVENTOR! FUELS ¡ -' if " . " , o 1 1 0 ï ö' o 1 1 0 1 0 o 1 4573 Ü '4 '3 650;U 0 1 443 -U 1 0 566 86 0 1 _108__-----"51__'____1___0___~,_ 44 U 0 1 588 -3 1 0 654 -24 1 0 3053 32 4 2 3 4 6 7 8 II 10 U 12 13 14 15 16 17 18 19 DATI! D OPI!tIIIIG OPENIIIG CLOSI1ICI CLOSIøa /liTER DAIL! /liTER TOTAl." READIIIQ CAlltõIIIQ CAllGIIIQ DELIVERED urn INVENTOIIY TOTAl. /llTllllED NIOUII! PtRcm IlEtõATIVt POSTIVE -O-CAUGIIIG -INVEIITORY-IIIVEIITOIIY READIIII:I '-- READIIII:I '-IŒTIRED---¡ ADJUSTftEII -BUORE '--'AfTER -IIIVIIITORY-CAUÖIIIC-REDUCTION-THIIOUtõIIÞ\IT'-OVER' OR-S'VIIRIATIOII-COI/IIT-COI/IIT' II SALES DELIVERY DELIVERY DAI/IIOUR - IIICHES CALLOIIS CALLOIIS QALLOIIS CAl.I.OIIS QALLOIIS \ CALLOIIS IIICIŒS CALLOIIS IIICHES CALLOIIS CALLOIIS 11ICHES CALLOIIS CALLOIIS CALLOIIS " 1_. 5932 5271 132910 132166 744 0 0 0 661 ,5a7L_4365 __~133754 _,132910 844 0 _0 ,0 906 4365 7058 135107 133754 135~ 33 1/2 3278 63 1/4 7355 4077 IT"' 7058 6913 135290 135107 183 0 0 0 135 6923 6788 135422 135290 13i 0 0 0 135 6788 6209 135995 13!IU2 573 0 0 0 0 579 6209 5479 136739 135995 744 0 0 0 730 __ __________ _ _.._ ----1--_,______________,___,________,____._____ _ lIEU 1 TOTALS XXJCaXXXXX \ XXXXXIXXXXXXXXXXXXX IIXIXXIXXI XUXXIXXX 4530 137389 136739 nIl 626 137B32 137389 443 454 138398 137832 56'6 41 480 ___138506 _--U8398 ____108 J.59. 138550 138506 Ü 33 139138 138550 5. 591 139792 139138 65Ì 678 nix 2 TOTALS XXXXXXXXXX I XIXXXIXXXXIIXXXXXIX 3021 140317 139792 525 140767 140317 450 141255 140767 4ds 141393 141255 1~8 141475 141393 82 142102 141475 6i7 142690 142102 588 --- --,- ---- j WEX 3 TOTALS XXXXXXlXXX XXXXXXXXXXXXXXXXXXl 1989' 744 83 844 -62 n53~Ji 183 48 132 -3 573 -6 744 14 PRODUCT'-UIIJ.E1.¡¡ED , CAPACUY-'10.000- I \I TAlQ(.----TCsOUTH rÃéÏLITY--WME 3 52 3/4 _....8__ 5 41 1/2 6 61 760 1 59 2 54 3/4 1/607A/! _2I615A/! 3/620A/! 4/635A11 5I635A11 6/613A/! 71614A11 , 0.9n o 0 o 0 8216 3912 ___0__0_ o 0 o 0 o 0 70 o o UII4 ,Q o o o 4853 4399 7841 7682 7649 7058 6380 112 54 79 4853 3/4 43911 _,_____7841 3/4 7682 1/2 7649 7058 81620N! 3 U "600N! 4 45 10/610Nl 5 41 _ll/610Nl __6_67 121640N1 7 65 13/61lNl 1 n U/612N1 2 61 o 1 o o 1 1 1 ---0 o 1 o o o o '1 on 1. 6 -1 o 69 12 4 -26 64 525 450 488 138 82 627 ---,~--- 588 2898 ~-- --519-- 451 488 69 70 623 ·'--614 2834 XXXXlXXIXXXXXXXJIJIJIXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX o o o o o o o '0 o o o o o o o o o o o o o -0 5861 5410 4922 4853 4783 4160 3546 6380 5861 5410 4922 4853 4783 4160 56 52 114 49 45-112 45 44-1/2 40 3 4 5 6 7 1 2 1S/606A11 16/614A/! 171605AII 18/638A11 19/636A11 20/603A11 a/610AII 1 1 o 1 o 1 1 5 2 o o 1 o 1 o o 2U 2. 30 26 -5 7 -15 25 41 109 397 644 553 67 103 369 504 'i637 367 618 -558 60 U8 344 463 ---r52S---'-- XXXXXXXXX xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx o o o o o o 3974 o o o o o o 5236 o o o o o o 1262 47-3/4 . o 1 4.13" -13 41 509 UO 522 379 17 XXXXXXXXXXXXXXXXXXX xxxxxxxxxxxxxxxxxxxxxxxxXXXXXXXXXXXXXXXl' - xxxxiixxx o o o o o o -46 364 -410 o o o 1 16 13 -1.3n 1.5n ( -18 UO 1293 14454 1311 14224 xxxxxixxx JlXXXXlXXX xxxxxxxxxxxxxxxxxxx XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX IXXlXXXXXXXXXXXXXXX 397 644 553 67 103 .169 T 509 4~0 ,\ J I 3,64 ¡ I , I 142690 143087 143731 1.40a84 144351 144454 1«823 143087 143731 144284 144351 144454 1448.3 145327 3179 :1561 2003 1943 IS25 1481 4V9. 3546 3179 2561 2003 1943 1825 1481 3 35-1/2 4 32- 3/4 5 28 6 .3-1/2 7 23 1 22 219 22/605A11 23/610AII '4/615A11 25/6<15A11 26/640AII 271608A11 28/603A11 xxxxxxxxxx 1453:17 145836 TOTALS 145836 146256 !lEEX 4470 4091 4992 4470 46 42-114 29/608M 30/610M 146156 146620 3681 4091 39-1/2 31/610M XXXXXlXXXX XXXXXXXXXX TOTALS noHTH TOTALS !lEEK ! ,. /~.--....,) Î \ I,' ( {, '., / I ¡--'¡ "\"'-'~ ~\.-,-' . . . " - C\c"--' / ,n0 vi l~ V \L/ " FUELG200889 " GARAGE TANK # 2 (NORTH) AUGUST 1 989 VARIATION 300 ' 250 .' ... '" ','''''''''','''''' 2 0 0 ~. " . " , : , .' , " " "" , "":".",,, . '"'''' : 150 " 100:- ",,'., 50 o / -50 -100 - 1 50 : ,,'" ,. , , ., "-,, " ","" -- " , " " ,," ""'".,' - 2 0 0, ..'". ',. .' . ..", " .... "'" ," '" ""'" ," " '" "".""''', .....'...' , -250 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 . . . . . . . . . . - , . ' ....... ",......"....... ",..... ....... -.. ...... . . . . , . . .. .... . , ' .... ...... '" .. .......... , ' . . . .. . .. .... , , . . . . . . . . .... . ',. ....... ... .. ... ,',. .... ,". ,_.... . ... ....... , " . .., ", .. ......... . .... ,,_... ......... . , ' , ..................... . , , , , , .. ...........- .... ....,. . . .......... ,",.... . . . . . . . . . , . . . Q \¡ c""k (~\ \ ' ..~ -j\ '--' I , f'c" ¡'VI. \ ;. \ ¡ (" \\-..--~_.\[, \\. \ \, \ "-..J \'" \~3' '-~~) , ~-" "- -j r\ " \j ~^. ': ' ~ '\, ~ . ~¡- (\ tL r\ Î ~\ '.~~,/' '. ~~,_ '\['''--2 \. -.'Zl'\¡ \~'U,__\L'-lê). , ~/fì: è ,. n. ' [1) ~, ,~" \' ' , l.,/\ v I'F . \, ,,' I' .\.<:{,\ (; , ' - J: i~\J\'\...~/:) '{ xJYV '-"-' \1-,-,- C~ IQVU . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION , TO: Kern County Health Department 1700 Flower Street Bakersfi~ld, California 93305 Attn: Underground Tank Section REGARDING : Facility: k f7t N' C-(7t/'/1/r7 ~/l/1/7r:;L Permit # / COO 2 ç C Facility Address: It! If T/l t/)~ Tv/V /9 t:/r Name Of Person Filin~ Report: On r - < - ßO-~ . ---~ -- - I ~ /3 ó , the above facility had an (date and time) inventory variation/loss that exceeded reportable limit~ as described below: 2- Amount of Daily C;/9/~/ Variat1on~ 2 f 7' 0-/1 C- Amount of Weekly Variation/Loss Amount of Monthly Variation/Loss Total Minuses Line 3 of Trend Analysis t'g-- /' ffl § Tank # r have ~2t~ped dispensing the Permitting Authority. product and begun investigation procedures required by This notification is in addition to the phone call I previously placed. JOHNICAN, Fleet Manager rei Sarl,'iG·s.~~ G:::rJ.ç:;e O;vision · .' KERN COUNTY HEALTK DEPARTMENT VARIATION/LOSS INVESTIGATION REPORT Facility: J! ¡::æ /V - I'" ¿7 ¿//f/7Y ¡Ç/J4A'? E- Perllit # Paci 11 ty Address: I ¿¡: (,5" '/ /Z ¿./ Y Tt/'/Í/ fi ~ Tank(s) witn Discrepancy: # ~ Date/Time of Discovery: Name of Person Piling Report: Description Of Discrepancy: 1+ IN (/1 N T/'?/l Ý Ç- h 1'/\/ INVESTIGATION SUMMARY / /"t7t/2hC '-. &:J- ç-~ ,- / ¿/"y (j /J /V' t/ IV \ j"- 7ð -rf9 1/\/ E;errrS' CI¡- rANK- ~/ ~/I¿ .s-l¡t~ C7 ?¥ ~ /? // ' &1./Á ç- 2 5 'r'e=;I'j<- 20cJ The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I I I I I 11 ) I I I 12) I I 13) All product I calibration I I I I I I I I I I I 'License # I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES., 8 Hours 24 Hours 48 Hours 72 Bours NOTE: Owner/Operator or other qualified person is to Date Time /1/,')' ç /'In??' 9-.5-59 Performed By: ~~ ;://4A~4-v . Owner/Operator must verbally report --~ Date I Time· discovery to KCHD.and follow-up with written I 1-S-ð'1 I /ð,.~J /9/1/1 review records for errors before determining there is a reportable variation/loss. notification on form provided. Performed By: '~ ~~ Visual facility check to be performed using r Date I Time checklist on the back of this form. I q - S .,ý LJ_II' C7 ¿; Perfor.ed By: ap "'" ~ '" dispensers are to be checked for I Date 'I Time and adjusted if out of tolerance. I I Performed By: Piping to be leak tested using approved method. I Date Time .1 Contractor's Name License # Test Performer's Name Description of test pertorlled * * ATTACH £Qf! OF ~ RESULTS. * * Tightness Testing of tank(s) to be perfor.ed Date Time using approved tester and method. C~ntractor's Name Test Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS. * * PERMITTING AUTHORITY WITHIN 5 0,\ YS OF 2. VISUAL INSPECTION CHECKL. . . A. Jr.Lspensers ' ~}ll dispenser~ and their end doors visually checked ~)ll hoses and nozzles visually checked for leaks. ~All totalizer seals checked for tampering. for leaks. Results: -- All dispensers appear tight '-- " ~J=-ð/- -- Dispenser(s) not tight as listed below signature/date !DISPENSER # SERIAL # COMMENTS: I I I I I I I I \ I I I B. Tank Area ~~l turbine boxes inspected. ~ll fills and vapor manholes inspected RelSults: Tank area present.. . appears tight wi th no product ~/j,A~ ,I signature/date or liquid 1- 5' - ,çr- Tank area does not appear tight because of the problems/ conditions listed below. signature/date ¡TANK #IPRODUCT\COMMENTS/RESULTS: C. Piping Type: OPressure o Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems/ conditions listed below. signature/date Description . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION '-... TO: Kern County Health Department 1700 Flowe~ Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDING : Facility: I< f IZ /1/ C {/ tV ,AIry þ/J/1/J¿-;E Permit # / ;;0 cJ 26" C Faclli ty Address: / f.{ 15 T /l t/ X TV />./' fi t/ ~ Name Of Person Filing Report: On c¡- s-gr /tJ/Jo ~ . the above facility had an (date and time) inventory variation/loss that exceeded reportable limit~ as described below: Total Minuses· Line 3 of Trend Analysis b% /'r.~ E' 2. Amount of Daily /4 Variatio~ 2Lf3e-rJ<:.. Amount of Weekly Variation/Loss Amount of Monthly Variation/Loss Tank t· li01 " I haver~~topped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. '/'-/1 Signatu~ LARRY JOHNICAN, Fleet M9:n~ger Genera! Sor\'!c<~sê G::raÇ!e OIV191on . . KERN COUNTY HEALTH DEPARTMENT VARIATION/LOSS INVESTIGATION REPORT' /bO()2~,C- Facility: j( f/l~1 /"é/{/,Á!T,Y' ?/1/1.IJCE Permit , Facility Address: I" I( r//vYr(/).,/ A (/1- 1 I, Tank(s) with Discrepancy:' ~ Date/Time of Discovery: Name of Person Filing Report: Description Of Discrepancy: CiA' It IN/lN/¿~?t/ t r)~ ( //& INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: I I I I I 11) , I I 12) I ¡ 13) I I I I I I I I I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES., Within-: 8 Hours 24 Hours 48 Bours 72 Hours 'NOTE: ß A // ;&/7 SF/' r,. ,.;::7 q- S - ;?C) é¿J --'30 4", r- ~ c¡ ~ g? 77"4 N ~ 2- ~ h' c"7,/ø'-z;7 H' é r s:.r C/ r 2 CJ t/ C~Á' t.. 1"/ V¡/.4 ç :z ¥JVA Owner/Operator or other qualified person is to review records for errors before determining Date c:¡ - ;-ý'f I Time I I~,' Jf./l~ there is a reportable variation/loss. ¿?~~ 4x/1Þ~ Pí Date I ¿¡ - ;-Ý?- Performed By: Owner/Operator ~ust verbally report discovery to KCHD.and follow-up with written I Time I I ?/./tff ,4/WJ notification on form provided. Performed By: ~~i:-<-- Visual facility check to be performed using I Date I Time checklist on the back of this form. I c¡ - t; -t"f I I' / tJO A~ d'~?- Þt-~ ¡/ I I Performed By: All product dispensers are to be checked for calibration and adjusted it out ot tolerance. Date Time Performed By: Piping to be leak tested uSing approved method. ' Date Time Contractor's Name License . Test Performer's Name Description of test performed * * ATTACH £QfY Q! TEST RESULTS. * * Tightness Testing of tank(s) to be performed Date , Time using approved tester and method. Cantractor's Name License . Test Performer's Name Description of test performed * * ATTACH COPY Of TEST RESULTS. * * PERMITTING AUTHORITY WITHIN 5 DAYS OF 2. VISUAL INSPECTION CHECKL~ .' "'- A. þispensers ~ll dispensers and their end doors visually checked for leaks. ~ ~ll hoses and-nozzles visually checked for leaks. ~AIl totalizer seals checked for tampering. "- "- Results: -- All dispensers appear tight 1- S"-£7' -- Dispenser(s) not tight as listed below signature/date !DISPENSER *ISERIAL I I I I I I I I B. Tank Area ~ll turbine boxes inspected. ~ fills and vapor manholes Results: Tank area present.. . #1 COMMENTS: I I I I inspected appears tight o pro,;; or" liquid YlívU4t--' t:J - .5-lj signature/da~e Tank area does not appear tight because of the problems/ conditions listed below. signature/date ¡TANK #IPRODUCT\COMMENTS/RESULTS: C. Piping Type: OPressure o Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems/ conditions listed below. signature/date Description - li\ 12 , , I i 31 ,j 6 i a q c' - c '- ,- I, -, , \ KZIUI COUIITY IŒALTH DEPARTllEIIT I PEMIr . 160026C PUELS IHVI!H'I'ORY RlCORDIJIQ SIIEEY ------_._~---~----_._-- -- ---"- j PACILI1'Y QARAC:E rAIIK . a (JIOImII CAPACI1'Y 10.000 PRoouer UHLEADED \' IIOIITH/YPR AUCllSr 1989 1 a 3 4 5 6 7 8 9 10 11 U 13 14 ( 15 16 17 18 U -DML,__D,._OPDUJIQ" OPEIIDIQ, '" ct.OSIlIQ , .CLOSIJIQ, IŒnJL_IlAILY_JlErEII.-..-,fOTAI.__UADIlIQ ""iII:IlIQ_ QAUQIJIQ _,-'-----.DELIVERED _JfAntI_~RY-LJorAL_1Œ1'EJIEL,VIOUIIT__PERCEJIT _1IBt:ArIVE_p,OSrIV1!: o QAUQIIII; I1IV£H'I'ORY IIIV1!:H'I'ORY READIJIQ READIJIQ IŒnRED ADJUSTIIEH BEFORE unR llIVElITORY t:AUOIIIQ REDucrION I THROOOIIPUY OVER OR S VAIIIArIOII COUIIT COUIIT II SALES DELIVERY DELIVERY , DAY/HOUR IIICHES QAtLOHS QAtLOIIS QAtLOHS CALLOIIS QALLOIIS QALLOIIS IIICHES QALLOIIS INCHES QALLOIIS QALLOIIS IIICIIIS QAtLOIIS , QAtLOIIS QAtLOIIS It -- .. 1/607A11 3U IUS 1004 157114 156240 874 0 0 0 811 874 53 0 1 _U615AIL__"-14_,1/4,--1004..,_76,_158006 ___157114 __892 ,0____0__0 921\ 892 -36 1 0 3/620AII 5 2 1/2 76 3817 158338 158006 332 2 1/2 76 40 4160 4084 343 332 -11 1 0' 4/6351111 6 37 1/2 3817 3546 158635 158338 297 0 ° 0 a7i 297 26 0 1 5/635A11 7 35 Ita 3546 33Ia 158854 158635 219 0 0 0 au al9 -15 1 0 .; 6/613A11 1 33 3/4 33U 2625 159567 158854 713 0 0 0 0 687, 713 26 0 1 7/614AII 2 28 1/2 a625 1943 160259 159567 692 0 0 0 682 692 10 0 1 IlEEK 1 rorALS ~ ~VyyyyYYYXD nyyyvyyyyyyyy:xxxXJXYYYYYYYYYYYYYYYYYYYY XXXXXlXXX 3966, 4019 53 1.32* 3 4 8/620AII 3 23 1943 1157 161007 160259 748 0 0 0 ,- 786' 748 -38 1 0 9/6001111 4 16 1157 521 161662 161007 "5 0 0 0 n _~ 6361 655 19 0 1 10/6l0AII 5 9 1/4 521 3988 162240 161662 578 9 500 42 1/4 4505 4005 538/ 578 40 0 1 _11/610A11 ,_6_38 3/4 __3988 ____.3647 _____162516 __,_,162240 ,,,__. _276 0______ __.____0. 0 341 276 -65 1 0 12/640AII 7 36 114 3647 34-46 162713 162516 197 0 0 0 201' 197---4 ---·--------1-'0-- 1316111111 1 34 3/4 3446 2753 163451 162713 138 0 0 0 0 693' 738 45 0 1 14/6l2AII 2 29 112 2753 uu 164258 163451 807 0 0 0 8101 807 -3 1 0 IlEEK 2 fOYALS XXXXJl1ClJlXX XXXXXXX1YYYVYYYY1YV YX'YYrvYYYYYYJ~X~VYYnYYYYnYU XJCCCIDXX 4005. 3999 -6 -O.lU 4 3 ,- ------.. --.-- ---- --- .--- -164258 "-'---580-------¡01ïa- '---ï651ài------------g640 ~9ä9 slÎó -·i1---'-- ---ò- .-------¡:---------------. 151606A11 3 23 1943 9424 164838 508' 16/614A11 4 80 3/4 9414 8694 165533 164838 695 0 0 0 730 695 -35 1 0 17/605A11 5 74 8694 7999 166209 165533 676 0 0 0 695 676 -19 1 0 18/638A11 6 68-1/4 7999 7746 166483 166209 274 0 0 0 0 ~53 "4 ~1 0 1 19/6361111 7 66-1/4 7746 7552 166693 166483 HO 0 0 0 194 110 16 0 1 ~0/6031111 1 64-3/4 7551 6619 167610 166693 917 .h__.._ 0 0 0 - 933 927 -6 1 0 11/610A/! l 57-3/4 6619 5793 168483 1676~0 863 0 Q 0 -826 -'--'----863 . 37 0 ---1'-- IlEEK 3 fOYALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXJIXXXX XJlXXXXXJ(X 4139 4U5 86 2. 04 It 3 4 22/605M 3 51-3/4 5793 5026 169239 168483 756 0 0 0 _ ___.¡:r I 756 -11 1 0 23/610A/! 4 46-1/4 5026 4365 169900 169239 661 -~.-~ --- --,-- 0 0 0 .- 661 0 0 0 24/615A11 5 41-1/1 4365 3419 170779 169900 879 0 0 0 886 879 -, 1 0 25/645A11 6 35 3479 3312 170981 170779 ~02 0 0 0 167 20~ 35 0 1 36/6401111 7 33-)/4 3312 3179 171124 170981 143 0 0 0 0 133 " 143 10 0 1 27/608AII 1 )a- 314 3179 2465 171839 171134 715 0 0 0 714 ~ 715 1 0 1 28/603A11 ¡ 27-1/4 2465 5733 172572 171839 733 ~5-1/4 2116 54-3/4 6209 3993 735 733 -2 1 0 IlEEK 4 fOYALS XXXXXXXXXX XXXXJ[XXXXXXXXJ(XXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX unmxx --4063 +'''' 4089 26 0,64S 3 3 29/608AII 3 51-1/4 5733 4748 173304 172572 733 0 0 0 975\ 732 -243 1 0 - 30/610A/! 4 44-1/4 4748 4294 174012 173304 708 0 Q 0 0 4541. 708 254 0 1 I .------ .._-- ._----~---- -.----- - - -.--- - --- -----1-' ~ 31/6l0"" 5 41 4294 3581 174769 174012 757 0 0 0 ,- '-'--113- ,I 757 " 0 -1- , IlEEIt 5 TOTALS XXXXXXXXXX XXXXXXXXXXXXXXX)(XXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXxxXUXX -,--:1142\1 H97 55 2.501t 1 2' ,I IIOIITH rorALS X)(XXltXXX](X XXXXXXXXXXXXXXXXXXX XXXJCXXJCXXXXXXXXXXXXXXX)(XXXXXXXXXXXXXXXXX X)(X)(XDXX 18315 18539 314 1.15S 14 16 , \ 1 \ .' ,--', . - ,,- ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDING : Facility: K f¡{N' C ÓC/A/T7 ¿f,A/Z/lC:E Permit # I h 0 0 26" C Facility Address: / tf IS T/lC/XTC/V /Jt/~ ðr9/Lr/7çr/~¿ /:? Name Of Person Filing Report: inventory 7- 3- ð1 / / or/ ç /1/1/7 I (date and time) ~~oss that exceeded reportable limits as described below: . the above facility had an On / Amount of Mont~ ¡V8ri ati 0 Loss J 12 ((¡; 1-] J IcAt. Total Minuses Line 3 of Trend Analysis J"'¡ /¡C,/7/(/.(73 Tank # Amount of Daily Variation/Loss Amount of Weekly Variation/Loss 0'( I have ~stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. Signature RRYJOHNICAN, Fleet Manager eneral Services. Garage 0 ¡vision KERN .UNTY VARIATION/LOSS HEALTH DEAlRTMENT INVESTIGATION REPORT /¡{Ó02Cc- Facility: 1< f/1A/ éC/C/A/T7 C:11/'t/lc;¡; Permit # Pacili ty Address: (t( 15 r II (/ ,k' Tv.IV A v~ Tank(s) with Discrepancy: # / Date/Time of Discovery: Name of Person Piling Report: lflt=- IT Description Of Discrepancy: E'1CCf-Ss- Of" I, s'0 INVESTIGATION SUMMARY /I/! t7 N' T t'I L .7 // A- ,.f I/'J r 10,(/ vv /9 ( vv195 :2 ,26 (p t 3J I C;-/r¿ /A/ The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: 6 Hours 24 Hours 48 Hours 72 Hours NOTE: Owner/Operator or other qualified person isOto I I 11 ) I I there is a reportable variation/loss. Performed By: Owner/Operator must verbally report 1 7-:5 -?1, /o//?' /J~ ~/!k~kc~ I Date I Time I "7- J -~1 I ((/',:20 fi/WT Date Time review records for errors before determining discovery to KCHD,and follow-up with written /-~,çr;.AE. notification on form provided. Performed By, ¿?~ Þ1/Í ~~~ Visual facility check to be performed using Date I Time checklist on the back of this form. I 7 - 3 -S:-c¡ I (I ~. C CJ ~ M,~~ All product dispensers are to be checked for I Date Time calibration and adjusted if out of tolerance. I I 12) I I 13) I I I \ 1 I I I ! I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES. Performed By: Performed By: Piping to be leak tested using approved method. I Date Time Contractor's Name License # Test Performer's Name Description of test perfor~ed * * ATTACH COPY OP TEST RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS. * * PERMITTING AUTHORITY WITHIN 5 \,'') OF 2. VISUAL INSPECTION CHECKL~ ,a ,-- A. J)1spensers ~~dispensers and their end doors visually checked ~~hoses and nozzles visually checked for leaks. ~All totalizer seals checked for tampering. for leaks. Results: -- All dispensers appear tight - 7- 7-ffY Dispenser(s) not tight as listed below signature/date ¡DISPENSER #ISERIAL #ICOMMENTS:. I I I I I I I I I I I I ~nk Area ~ ~l turbine boxes inspected. ~All fills and vapor manholes inspected Results: Tank area present.. . appears tight with no product or liquid ~Þ/ÝlCd&<- 7 - :? -6/ í' signature/date Tank area does not appear tight because of the problems/ conditions listed below. signature/date I TANK 1 I I I #1 PRODUCT I COMMENTS/RESULTS: I I I I I I I I C. Piping Type: 0 Pressure 0 Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. 's ignature/ date Piping not tight based on testes) above. with problems/ conditions listed below. signat,ure/date Description . ,It" '- .. ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: ,Underground Tank Section REGARDING : Facility: K E J? /t/ t: OV/V T /' C/l/f/7C E Permit # I ÇO () 2 b C Facility Address: /t¡/( í/lvx ri/,Æ/ Af/(- ß/JIC¡Ç/lSr/¡t"{¿:7 Name Of Person Filing Report: On f-Jú-8"9 /0/00 A~ . the above facility had an (date and time) loss that exceeded reportable limits as described below: Amount of Weekly Variation/Loss 7, /2 t:, Amount of Monthly Variation/Loss Total Minuses Line 3 of Trend Analysis J'f ,PMIC/o3 Tank # Amount of Daily Variation/Loss, .L o{ I have ~ stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. Signature KERN .NTY VARIATION/LOSS HEALTH DEP"T~=N::--. INVESTIGATION REPORT Facility: k ¿C'1l Á/ C CJ ¿,;Æ/,/ /' r;:.)1/l,4{; é Faci 1 ity Address: / 'I /S 111 (/ )r 1'" (/ ....v fi VI ~ Tank(s) with Discrepancy: # ~ Permit # /b 011)2 C C ß /J ~ r/1.f" ¡:: Ir ¿þ {-JO- ~ Date/Time of Discovery: 1(/. '00 .4#1 Name of Person Filing Report: Description Of Discrepancy: í fir / T W/95 Wf"t-KtY ilA/lI/Jrlt'/V FXCí#r-C7 sic 7,12t, INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I 12) I I 13) 1 I I I I I I I I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES. 6 Hours 24 Hours 48 Hours 72 Hours NOTE: Owner/Operator or other qualified person is to review records for errors before determining Date I 6- J'ó -FC/ I Time I I 11 ) I I there is a reportable variation/loss. Performed By: Owner/Operator must verbally report IC/, 'I Ó /'/¥1 ~4r~ I Date· I Time I C -.1v-fr I It}: 15 /1H'7 discovery to KCHD.and follow-up with written notification on form provided. Performed By: Visual facility check to be performed using I Date I Time checklist on the back of this form. I ø - J't1- g'! I / () " 2 Ú /Jh?I Performed By: ~#- P"tt<¿,~~ All product dispensers are to be checked ~ Date Time calibration and adjusted if out of tolerance. Performed By: Piping to be leak tested using approved method. I Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTAC~ fQfY OF TEST RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS. * * PERMITTING AUTHORITY WITHIN J , ,') OF . 2. VISUAL INSPECTION CHECKLIST . A. Dispensers ~ll dispensers ~ll hoses and /All totalizer - and their end doors visually checked for leaks. nozzles visually checked for leaks. seals checked for tampering. Results: All dispensers appear tight ~~ ';·0.7C08";, ignature/date -- Dispenser(s) not tight as listed below signature/date !DISPENSER #ISERIAL #1 COMMENTS: I , I I I I I I I I I I B. tank Area ~~turbi,ne boxes inspected. ~ll fills and vapor manholes inspected Results: Tank area present.. . appears tight with no product az/~ .::t(~~ /' signature/date or liquid ç- j'C-S9 Tank area does not appear tight because of the problems/ conditions listed below. signature/date ¡TANK #1 PRODUCT I COMMENTS/RESULTS: ! I I I C. Piping Type: 0 Pressure 0 Suction Pressur ized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested far indication of leakage. .~ I Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems/ conditions listed below. signature/date Description I' \' J ,I ( 1600a6C t PBRllIT OEPAR'I'IIIDIT SHEET --- COUNTY HEALTH RECORDI1IG JŒD FllELS IJIVEJITORI' ~ ,---,---- -ì 1~ POSTIVE COUNT 06/8~ 17 18 PI!RCEIft IIIc;ATIW VAllIATIOH COUNT i" UHl.EADID 1 6 6 7 8 10 11 12 13 DAft D OP_ OPENINQ CLOSINQ CLOSINQ IIIftII DAILY IIIftR TOTAL RlADI Ç c;A\KII1IG CAUGI Ç DELIVERED 1IA'fEII o CAUGINQ IIIVEIIfORY IIIVEIIfORY RlADI Ç RlADINQ IIBftRED AllJUS!!IEN BEFORE ArftR IllVEIIfORY c;AUGIIIQ DÃiiHÔÜ:¡-1IIilcHEs--¡¡w;õøs---w.i'oïiS- aALLOIIS cwJ:ôiiš---~:s --GÀÍ.Loïîs--¡¡Cíiis-DIL~mliS~~:Ll.~LO ¡¡¡-aALLOJlS----T.ïëiIÜ PRODUCT 10000 CAPACITY SOUTH t TANK FACILITY " ì :j -; ç o 1 o 1 o 0 o 1 1---0--------'--- 1 0 o 1 4 " , 1 Õ 1 1 0 o 1 1 0 o 1 1 0 'C-O--- 6 3 o 1 o 1 O-í o 1 1 0 1 0 1 0 --3 o --To-' o 0 o 0 ---- ,7454_39,75-,_ o 0 o 0 o 0 o o o 367~_64, o o o __35__ 102618 102100 518 102654 102618 36 102720 102654 66 _--l.03235_~2720____515 103995 103235 760 1047" 103~~' 762 10U19 1047" 762 au 1 TO'rALS In 1i...u.&I. A 01/60''''' , 3~-1/4 40'7 3681 02/636"" 6 36-1/2 3681 3647 03/637"" 7 36-1/4 3647 3'81 04/60"'" .--L35~3LL__---358L____7058 05/60~"" 2 61 7058 6276 06/606"" 3 "-1/4 6276 547~ 07/600"" 4 4~-1/2 547~ 68U 7.021 IXIXXXXD o o 0'0--- o 0---- 406~ 'I) _____, -----r--- t í, I, ,11IOtITII/YEAR I 14 i 15 16 , IIIVIIIfORY ',TOTAL IIIftRED MOUNT BEDUCTION i THROUGHPUT OVER OR :¡ GALLolrÍŠ; aALLONS aALLO¡¡S- , , ... 376( 518 141 ::1 :: ~ _498'1,__'15,_17._ 7821 760 -22 7~7 762 -35 626: 762 136 31791 3419 240 727 754 27 103' 52 -'1 -- -,- 69, ,--- " 86 " 17 676~ 667-9 68':1 740 55 __620 ,61~ ---=1_ 6U 688-5 3573) 3606 33 6~6' 717 21 6~~ 78_9. 105' 110 , 653) 656 3 771 679 -92 711'1 578 -133 761, 755-6 ',,---, '376.' ---- "---3573 ..-'--193 , 3481 516 168 1051 88 -17 105 149 44 ---'-:~~í '----:~~ -if 676 711 35 62f 641 21 _____ _ _~31\ , 3371 240 5911 600 9 70\ 72 2 I ì I -----r-----.-,.--.~. ¡ -,--, l-- I 1 JClZXXXXJC[ 661 672 11 - -,-----+-.._--- - ,--- XXXXXXXXXXXXXXXXXXXXXXXIXXXXXXXXXXXXXXXl XXXXXXXXX 16310\ 14641 331 ,\ 754 0 0 , 52 0 __, __ 0 86 0 0 667 0 0 740 0 0 619,_____,______,___0 _______0 688 20 1594 50 3.4 "54 10'519 106273 106315 106411 107078 __,_107818 108437 4126 106273 4023 106315 3954 106411 3278 107078 2593 107818 ,_-11173-____108437 5340 109125 68U 4126 4023 1/2 3954 1/2 3278 1/6__~593 1/4 1~73 5 45 6 3~ 3/4 7 3~ 1 38 2 33 __3,18 4 23 08/60"'" 09/630"" 10/643A11 11/606"" 12/607"" ____.13/607"" 16/60"'" 0' . 0.92* IDXXXXXX 00 o o 4045 o 00 o J o o 7124 o o o 0_ o o 3079 61-1/2 o o 717 _78, 110 656 679 578 7U XDXXXXXXl 11111[ 2 TOTALS 6644 10~842 109125 __.6575 _109nO__J09842 4470 110030 109910 3817 110686 110030 7091 111365 110686 6380 111943 111365 5619 111698 111943 llllIC 3 TOTALS 5 48 1/2 5340 ,_6_43-lL2 4644 7 43 6575 1 41-1/4 4470 2 37-1/2 3817 3 61-1/4 7001 6 56 6380 15/605"" 16/635"" 17/635"" 18/605"" 10/606"" 20/604"" 21/600"" 32 1 o 1 o --0 1 1 o 1 o o 1 o o -5:60* XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXIXXXXXXXXXXXXXXlXXXXXXXX----xixxxXXXX o o o ----Q-- 3339 o 00 XXXXXXXXX o o o ___ 0 7101 o o o o o _ 0 3852 o o XXXXXXXXXl 516 88 149 _ _662 603 711 642 112698 113214 113302 _,___113451 116113 116716 115427 113214 113302 113451 ,__114113 116716 115417 116069 111111: 4 5271 5166 5061 6399 7126 6448 5827 5619 5271 5166 ___5061 4399 7124 6448 5 50 1/2 6 48 7 47-1/4 L 46-1/2 2 41-3/6 3 61-1/2 4 56-1/2 22/60"'" 23/62"'" 24/630"" ,_15/607"" 26/604"" 27/605"" 28/600"" 62 37-3/4 - -- 6 -C 1 2 o o o 7,121 1.6" XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX ._--- o 0 0, o 0 0 XXXXXXXXXXXXXXXXXXX XXXXXXXXXXDXXXXXXX 600 72 XXXXXXXXXX xxxxxxxxxx XXXXXXXXJC[ 116069 116660 TOTALS 116660 116741 TOTALS 111111: , 5236 5166 5827 5236 , 52 6 47- 3/4 20/60"," 30/634"" - . Jì' ::::' 17 11 2.26* ,___--1-___, I I .\ XXXXXXXXXXXXXXXXXXX I!ONTII TOTALS 'I J-,- ) ,I 11 .\ . FUELG1.0689 GARAGE TAN K :/J 1 (SOUTH) JUNE 1'989 VARIATION 180 ' , , . ' 160 : "",,,;,.,,,,":,.,,,,, "..,":,.""" ."",....",.":,..,,,,,':",,.,,,:,,..,,,,':.,,,,,,, .""":".'.'" '.'."...,..,. . .' . 1 40 : ,., ",;"",. ,,:. , . , . , ., "'" <' " , "" ,.""";".",, ':" " " " ':" , " " '~ " " " ":--- ' " "~ ",,,":",,.,,. "'."":"'" '. 120 :' ':" :,:"" ."',.,:'''''':.,'';'''''~''''''':,.,,., : "",,,:,.,..,, """:'"",,,.. " ...... . 100 ' " ' .,."" " : . .. ..:........ :. . . . . . .. ..... ..:'....... ........:........ :' . . . . . . . ': . . . . . . . . ~ . . . . . . . ':' . . . . . . . ~. ......:'....... ........ ~ . . . . . . . ': . . . .. ... .. 80 :. ,,,;,,,,'.,.,, ",., ':""" ,."'"'~".''''':'''''''''..''''''.~'''''''.:...''' .~, ,,,":",,,,,, ""''''~'''''',.: 6 0 : ..,."" ,..' '.. " . " : " , . , . ":' " " . " ;" " . , , : , , " , ":,, " , , . : , " " ,. " " ". ".,.,:""",.. 40 ' ., ".."", .,. : ...... ~"""":"""" . ..... :.........:....... ~ ....... :' . . . . . . . ':' . . , . . . . :' . . . . . . . ':' . . .. .. ~ .. .....:....... ........ ~ . . . . . . . ': . . .. 20 : ",:, . o ,":' -20:" .. -40 :', -60 : .,:. : -80 : -100 :' ' -120 ", ''''"""""."" '.,,,,,, ""'"''.''''' ,. , ,,,,,,,;...,:.,,,,.,,,,,,,,,,:,,,,,,, ......... -.................. , , , , , ,.. .... ..........,' .. . ... ................................. . " , . .".,..... , , """" 0'·· -,.. "....... ......,. "',,_. ........ . ... ......, ..... ... ..,.' . . . .. . .. . ........... . .. .................. .. . . . . . . .. .' , , ..................... . , , , . . . . . . . . . . " .... ......... . --140 L.L.,,~_J__L-L-I I I I I I I I I I I I ') ') 4 6 8 10 1214 16 18 20 22 24 2() 28 3C PDlUT . 1600aGC \ 06/89 - -- 16 17 18 I I I II I f '-- - " ~ ICED COI/IITT flUL1'II DEPAllTIIIIBr V Fll!LS UIV!JITORf RECORDIIIQ SRI!!T " FACILIT!' I:AllAGI TAIIIt 1 (II:IUII 10 11 n 13 14 QAUQIIIQ QAUQIIIQ DELIVERED !lATER 'IIIVtIftOR! BEFORE AFTER IIIVEIITORY QAUGlliG ,REDUCTION DEUVER.r..._D£LIVF.RY ____ GALLOHS ll1CHES c:.\LLOHS GALLO/llS IIICHES <:AU.ONS o 0 0 0 647 o a 0,,__... . 169 o 0 0 .98 28413 5g....J...(.t 4490 .007....--_ II;":IQ o 0 0 759 o 0 0 'f 731 o 0 0 U9 xnxxxxxxxxxxxxxxxx XXJlXXXXXJIXXXXXXXXXXUJlXXXXX](J(XXXXXXXXXXX UXXXXXXX \ 397. a 0 0 \ 7C8 o 0 0,..., 'I 135 Q 0 0 0 \ 234 10 0 0 L. 619 o 0 0 I 719 13 e5~¡6 3/( 509~ mf ~~g XXXXXXXXXXXXXXXXXXX XXXXXXXXXXJIXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX i 1683 ,--- ____on' ----,-.~ -----~,----~- -,,-1-~~~- ~ ~ ~ ·1 ~:; .7-1/1 .U( 57-V2 6585 (091 'I 80. (¡ 0 0 'I' 6.. o 0 0 0 663 XXXXXXXXXXXXXXX¡ÌXxX 'JCtXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXxxxXx XXXXXXXXX --¡---' -')ii5i--~835----:¡¡ 7 o 0 0 ,6.7 o 0 0 138 o 0 0 I 170 o 0 _ __ ----.JL.'__ '..-r----·.. _ 679 30 l818 159-11Z 6720 3902 \ 71q o 0 0, I 5<18 o {) 0 0 ) 691 XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX) 3588 o 0 .----0-- -T- -.51 o 0 0 'I 108 ~ 19 HllQATIV! POSTIVE COUIIT COUIIT 1 o 1 ~ o 1 o ( o 1 o Q 1 o 1 3 PERCEIIT VARIATION , IIOIITI!/YIAII 15 TOTAL 1lEn:1IEII AIIOUH'r THROIJC:/IPUT OVER OR S -- CAU.OIIS CALLOIIS 671 756 596 86 -13 3 -87 .5 -33 733 356 301 UlØ.!ADBD PRDDUCT I!lCKES 733 356 101 <Ô41 30-, 671 756 596 10000 3 " 5 6 7 8 DA'fE D OPEIIIIIQ OPENING CLOSIIIQ CLOSIIIQ IlE'fER DAILY IlE'fER 1'01'AI. R£A )IJ ( o c:.\U<:ING IlIV!lI1'Oar IIIV!H'f()RY READIJIQ READIIIQ /I!ttR£D ADJUSntEN __, 11_________,._..___,___ ______ -- _______SAl.&S______ DAY/HOUR I1iCHES CIILLON$ c:.\LLONS GALLONS GALLOIIS GALLONS GALLONS Ol/605J\ll 5 U C.9" 36(7 lU839 111106 O'/636AK 6 36-1/( 3647 3178 U'195 Ul830 03/637M , 13-1;. 3178 1980 Ul(96 111195 __~605_l_31-l_/.._.9a<>______..._~II,7--1..(!16 a5/600M . 56-V. 6((8 5689 123789 U311 7 06/606M 3 51 5689 U58 U(5(5 U1789 07/600M C (5-3/( US8 Cl19 125Ul 114545 IlEEK 1 1'OYALS XXXXXXXXXX CAPACIT!' . 5n o 1 o 1 1 0 1 0 1 0 _~____0__,,____1_ .______, o 1 .0. 3 ( 1. (035 U - - 78( 16 195 60 189 -(S 616 -1 738 -1 &.2.1 5_ ____ 6U 31 3766 83 lS81 115915 1151(1 78( IC(6 U6HO 165015 US 1111 U6300 1161.0 189 159) 116915 11630~ 616 1854 127671 116915 718 .--,-1136, _1~~4-·__U767J. 613 es8' 128917 118196 611 IlEEK 1 T01'ALS XXßXXXXXX 081605M 5 C)-V( Cl19 09/610M 6 15 3/( 1581 lO/6"AM 7 J<I 3/4 .1..6 111606AK 1 33 3.U ¡ ;:,607M . 28 J/C .503 -~"'~7M----~U,lH-- --1854 lC/605J\ll ( 16 3/( 1216 1. o 1 _ __,____1_____0 1 0 o 1 1 0 o 1 o 1 ) 4 611 28 181------=.0 US -12 866 .4 7U -160 638 16 670 7 611 .183, 115 866 711 638 670 1.8917 U9518 129711 U~8'6 130711 131444 13.081 119538 U9711 D~8(6 13071;: 131444 IJJ.08J. 13l,'5¡ (¡94 4091 395. 31U 6.11l 568~ 502.6 '1887 _ _ 4.Ø4 4.091 195( 111. 60)11 15689 5 45 1/. Ó ,61 7 )9-1/2 1 18-1n 1 11-1/( 3 155-1/~ . 51 15/605AH J.6..r6.j5Att 17/63fhK 18i60!5AH 1 ~i606AM lO/604M JL'buOM 1 1 1 .1 1 1 1 7 1 o o o o ___0 o o o o o 1 05. l,6n ,3 635 8 lCO Il 178 8 ."._ _ _-.-701,_11 761 JJ 550 ¡ 7U 15 3687 ~9 '--.g5'-'1 191 -16 635 H' 178 ,701 161 550 711 XXXXXXXXXX 195 191 XXXXXXXXXX 131751 133367 133536 1337lC 134415 135177 135717 TOTALS 131187 133516 133714 13(415 135177 1357:17 136(39 TOYAL::¡ 13693( 1371.6 . WlEK IlEEK 43QQ ("'61 '0~1 3(H 6585 6037 53(0 5016 4.199 ..&;£61 ,o91 341.:1. 6585 6.0).'1 5 4' 1/.2 6 41-.3/.t 7 40- 3/4 1 39-1n. :l. 34-1/2 1 57-In " 53-Ill 5 "8-1/2 6 tS-l/t ¡,;:....605M .d... Þ~5A1t ,it....6J(J!I.H J&i5ú4AH ,¿'1¡6ù'lAK "SJ' 6ùOAH H/605M !Ol631.M . 3.78. 0.9n 10 10 16 1M 687 16010 ---i-- I ----t,.. ,- XXXXXXXXX ¡ 661 15856 I ,-I I ,\ XXXXXXXXX XXJlXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxn xxxxxxxxxxxxxxxxxxx -----.-~_.~-- XXXXXXXXXXX](J(XXXXXX XXXXXXXXXX XXXXXXXXXX 136(39 136~34 WEEK 5 TOYI\LS IIOtmI TOTALS C687 4679 53CO (887 . . r--lJ f-~~ l C'~ 2 CJ c.-' 8 9 . ___',,] 0 l) C;ARA(~E 'TAN~ # 2 (NORTH) ~J LJ N E l' S) 8 9 , --- VAr~IATION 1 00 ' ----~_.---'--- ~----- 80 ~ 60 . -, 40 : 20 -' . 0- ·'20- , ·'40 ~- ,,60 ' RO ~, -,100 :. -·170 - 1 40 - . -160 2 2 . . . . . ... . .. . ... .... ... .............. ...... '....... .,... , , ... .."... , , .... ............. , ' . ....... , ' ......... . , , ........ . , , , ' , , " .. ,"..... ...:. ...... ,",...... ......... ........ ............. ....... ......... , , , , ............. . . .......................... ~. . , , , , . ......... '...." ....... .... .'. . . . . . ~ . '" ,"... ...... .. . . " . . . . . . .. ............ ....... ...... ... ... , , ... . . ..... .. .. "..... ," . ...... . .... '. . . . . . . . ~. .. . . . .. . . .,.. .. ... .......... .......... '" ............ ......",.. ......."... 4 6 8 10 12 14 16 18 20 22 24 26 28 3C PERIIIT . 150011C /IO!ft'II/YEAa I 14: 15 16 IJIVE!m)RY J TO'lJU. IlETERED AIIOUII'!' REDUCrION t' TIIIIOUCHPUT OVER OR S aALLOIIS f¡ aALLOIIS aALLÔiiS 10'. 36 -13 o 19 19 ~8 14 U 31 U_--=-7, '0 45 45 ¡ f¡ " ll;~ 138 15 34 11 61 11 59 o 10 8,0 38 " I ~... 202 5 31 ___57 36, ¡, 11 -5 5 3" 09 ¡ XXXXXXXXXXXXxxXXXXX xxxxxxxxxxxxxxxxxxxxxxxxxxxXXxxxxxxxXiD:- xXXXXXXXX ----'''--I:i'5 ,- -- '-----138 ,/ o 0 0 51 o 0 84 11 o 0 '0 19 o 0, ._____,_ __-6 39 o 0 60 16 \ I \ \ í t I DEPARtIIEIIT COUIIrY HEALTII allB FUELS llIVElIfORY RECORDIIIQ SHEn ...~ L 5 CLOSIIIQ CLOSIIICI IlETER llIVEIITORY READIIICI _._--~-- ----- aALLONS QALLOJlS 1/630P" 5 155 17Ul 17312 3018 29n 2/600P" 6 154 17312 17312 3037 3018 5/600P" 2 154 17312 17340 3051 3037 6'530P"_.1-1~,U4----J.73'0-V309- )0'5- 'OU 7/600P" . 154 17309 17309 3120 3015 19 POSTlVE COUll'!' 1989 17 18 PEIIC1Ift NEGATIVE VARIATION COUll'!' . JU\II 13 !lATER GAUGI11Q IIICHES U DELIVERED IIIVEI/fORY aALLOIIS UllL£ADID 10 11 GAUCIIIQ GAUGIIIQ BEPORE APTER ,DEUVEII1-____DEUVER: nrcllES aALLOIIS IIICIlES aALLONS PRODUCT ¡O.OOO 7 8 DAILY IlETER TO'lJU. READI11Q READI11Q KlTERED AllJUSTIIIN __SALIS-. QALLONS aALLOIIS aALLOIIS CAPACITY 6 TAIIIt ST. 1 . DATE D OPItIIIIQ OPEHIIICI o GAUGING IIIVEIWORY --,-11---------- .- DAY/HOUR IIICIIES aALLONS mo FACILITY ;" o 1 1 Q, 1 1 o o 1. o o o o o o o 36 19 l' U 45 . 3 o o 1 1 o 2 1 1 o o 1 18.84& 26 -U -16 48 10 -U IIDXXXXXX o 0_.., 00 0.._ o o o o o o o o o o o XXXJIXJ'~"""XI - - 3. 61 59 10 38 yyyyyyyyyy ---_.- 3120 3154 3215 U74 3284 lIEU 1 TOTALS 3154 U15 3¡70 U84 3322 17233 11156 11105 17145 17065 17309 Inn 17156 17145 17145 1/4 In 1/¡ In 5 154 6 153 2 152 3 152 . IS¡ U/555P" 3 2 o 1 ____,_,__L_,O, 1 0 o 1 o 1 ,,. -20. -02 32 ._~21 -18 10 10 XXXXXJCIXX1CI1CtXXXXXXUXXXXUXXXXXXXXXXXXX xxxxxxxxx o ,-~- 00 0, o o Q,. o o o xxxxxxxxxnxxxxxxxx 37 34 11 5 09 xxxxxxxxxx 3322 -,3359, 3395 3406 3411 TOTALS 3359 --, -, 3395, 3406 3411 3460 IiEEIt 17060 17003 16974 16979 169.0 17065 17060 17003 16970 16919 3/0 3/0 11. 5 151 6-151 ¡ 151 3 151 o 151 --------- 2 3 o 1 1 0 o 1 o __1 1 0 9.4n 13 51 -73 19 45 -'0 o o 00 ___,--'L-_, o o o o 51 11 19 -,39 16 xxxxxxxxxx 3460 3511 3522 3541 3580 TOTALS 3511 3522 3541 3580 3596 liEn 16900 16856 16856 16862 1680¡ 16940 16900 16856 16856 16862 5 150 3/4 6 150 3/0 2 150 3 ISO o 150 3 1 o 2 o 1 -1. on -¡ 59 -00 136 59 106 138 xxxxxxxxxxxxxxxxxxx xxxxxxxxnxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxx ----- --.-~--- ..-- .-. - --- o 0 0 o 0 0 xxxxxxxxxx TOTALS 3655 3761 III!EK U/600P" ¡7/600P" ¡8/600P" . 15,C¡ I i .1_______,___ ¡ ) ~, I 59 106 3596 3655 16802 1665¡ 16802 16802 149 1/2 149 In 12 10 9.091 1.281 15 10 :, i 150 165 -~-------- ,,'p '719 I I ~ I ___,___,_L_ J XXXXXxxxx - '- xxxxxxxxx ,nnnnnnnn,n1(UXXXXX XXXXXXIXXXXXXX7U1CXXX: --_.~- _._--~--- XXXXXXXXXXX'l'""nnX xxxxxxxxxxxxxxxxxxxxx' XX'(YYY"""" --~- -~_._- VYYYVY'l:xxx TOTALS ItOIITII TMALS lIEU o . . FUELI/I.0689 INYO STREET TANKS # 1 AND 2 JUNE 1989' VARIATION 60 . . . . . , , I . , - 20 : " , , . . . . 0, . ' , , 4 : " ":" - ':-- ' " " ;, : .... .... .,... . , , ! _ i . ........ .. . ... ..' . ··1 I I I I i ¡ o ," ,,:, , . , ..... ............. ,_. .. .......... . , , , ,-40 : : .... ,',.... ,',... .... .. ,',.... :.,.. ./. .' ..... -60 .' . .. ... ... ........ ~ . . . . . . . . . . . . .. . ... . ........,... . ..' ...."..... -80 2 1 2 5 6 7 8 9 12 13 14 15 16 19 20 21 22 23 26 27 28 29 3C , I ! \ \ I i 150011C PIRIII'f ! I, IIOII'fIVYIAa 15 ~ .' t o 1 1 0 o 1 -'-----0.__________ o 1 -7 i 0 7 58 U-6 43 53 9 4~_U____~:¿..__"_ 85,( 87 3 13 -;; 13 DILIVERED S IIA'fIR IIIVIII'fORI iGAuaIIIG aALLOIIS DICIIIS o 0___ 1730 0 -_0--.--_ o DIPAR1'IIBJI'f IIIVIII'fOJII RECORDIIIG SKEI'f COUII'fY IllALrH KBJIII l'UELS .7" -. L ì' 2 ]¡ U POSTIVI CQUII'f JIIIII U89 18 lIICA'fIVI CO\lll'r 17 PIRCIJIf S VARIA'fIOII . 16 ~ /II'1'IRED AIIOIIII'r 'fllJl0UQ pU'f OYIR OR (aALLOIIS aALLOIIS 14 DIVEII'fOR1' REDUC'fIOII aM.LOIIS DIESEL 10 11 ~IIIQ ~IIIQ BEFORE AF'1'IR ,Da.IVEU--DIILIV&I1Y, IIICHIS aALLOIIS I!lCKES aALLOIIS PRODUC'f 000 RlADIJ113 ADJUS'fIIJ1I aALLOlIS 3. CAPACI'f! 1 4 6 7 8 DA'1'I D OPIIIIIIQ OPIIIIIIQ CLOSIJ113 CLOSIJ113 _ DAILr /II'1'IR 'fO'fA!. o QAUGIIIQ IIIVIII'fOJII IIIVIII'fORY RlADIIIQ RlADIJ113 /II'fIJIID _,___11___-----,- -- -,,--SALB~ DAYIHOU1t DICIIIS aALLOlIS aM.LOIIS aALLOIIS aALLOIIS aM.LOIIS . 'fAlllt S'f. IIIIO 3 rACILI'f! ;~ - . o o 1914 0_ o o 0, 184 68 0-_ o 11 278 285 2969 2969 0 285 227 3021 2969 52 227 1914 3073 3021 52 ,191~1865-----3098 3073,----25 1865 1780 3185 3098 87 1/630PII 5 14 3/4 2/600PII 6 15 5/600PII 3 13 3/4 6/530'11-- --),68--- 4 65 3/4 c: 3 1 o o o o 2 o 1 o 1 1 -5. ". -13 6 -13 o -1 -3 216 o 75 o 34 71 .: 3 1 1 0 ____0___1.,_ 1 0 o 1 o 0 -5.5n -10 -3 __6 -6 1 o 180 59 __37 36 89 o DDXXXXX 228 0- -:¡ h-- -- 8~ l 0,__, , 35 o 74 I --,- -------r' ---, IX DXUXXXX 190 /, o 61 I' ___--4---__ ,___--11.______ 00 33 ' 0.. 88 o 0 I o o o o o o o o o o 'fO'fA!.S XJftl!""""" _.._----~-- 3185 3185 0 3360 3185 75 3260 3360 0 3294 3360 3-& 3365 3394 71 XXXUXXXXX o 0, o o o o 0_ o o o xxxx 59 ___37 ___ 36 89 o 3365 __3-&24 3461 3487 3576 'fO'fA!.S 3-&24 ___3-&61. 3487 3576 3576 1II81t 1786 1699 1699 1664 1590 øllt 1529 ,1498, 1466 1378 1378 1780 1786 1699 1699 1664 1590 ,__un 1498 1466 1378 5 62 1/4 6 63 1/2 3 59 1/4 3 59 1/4 4 58 5 58 1/2 _ 6-- 53 1/2 3 52 1/3 3 51 1/3 4 48 3/4 ~ '" 3 o o 1 _____0____________ o 2 o o o ,_0 o -0.471 -1 o o 5 ____ 0 o 211 o o 13 __66 o ) 313 o o 8 __66 o xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx XXXXUXXX o o 00 _--Ø----- o o o o ,_0, o o o o ,____0 o o o 13 66___________ o XXXXXXXXXX 3576 3576 3576 ,3589 3655 'fO'fA!.S 3876 3576 3589 ,_3655 3655 øllt 1378 1378 1370 _1304 1304 1378 1378 1378 1370 1304 5 48 3/4 6 48 3/4 2 48 3/4 3_48. l./2 4 46 1/2 22/600PII 33/600PII 36/600PII . 1 --0 1 o 1 o 6.331 5 -8 5 79 o 46 74 '8 41 XXXXXXXXXXXXXXXUXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX -- XXXXXXXXX o 0 "--0-' o 0 0 XXXXXXXXXX 'I'O'fALS 3655 3701 ølK 4 2~' ,- ./ ':(1 ~ o 46 3655 3655 1296 U55 1304 U96 5 66 1/2 6 46 1/4 I - -,---- \ I, 1 8 -6. 52. -2.87. -3 -31 46 733 49 --¡- 753 \1 I øuXXJIXX --- .- X7YYDYYYYYYXXX¥XXX YYYYYYYYY'WYYXXxxxxxxxxxnxxxxXXxxxxxxxø. XDXXXXXX XXIXXXXDX xxxxxxxxxx 'fO'fA!.S øllt IIOH'fII 'fO'fA!.S 5 ¡ ~, ¡ , U0007C PEBllIT - ~ 11 2 ¡ .; 18 LP IlllCATXW POSTXW COUNT COUIIT 1989 IS 16 1'1 TOTAL /lllftUD NIOUIIT P£RCm THIIOUGIII'UT OVER OR S VARIATIOH CALLOYS CALLOiis--, JUIIII ì I J ¡ \ I 1 , I i , .J ¡ I ,KDlmVYIWI ~ --'- ~ " DEPARTIII!HT KBRJI COUJITY IIDLTH UCORDIIIC SHEET FUELS llIVElrfORY ~. , 14 IJIYEIrfORY UDUCTIOH CALLOYS 13 !lATER CAUCIIIC IHeRES 11 DELIVERED' IWEIrfORY CALLORS IIIILUJIED 11 CAUCIIIC lonER DELLVEIII__ I!lCRES CALLORS PRODUCT 1 4 5 6 7 8 9 10 DATI D OPEIIIJIQ OPEJlIIIC CLOSIIIC CLOSIIIC /lllftR DAILY IlETER ?OTAL RllADIIIC CAUCIIIC o CAUCIIIC DIVEHTORY IIIVEHTORY Rl!ADIIIC Rl!ADIIIC IlETERED ADJIISTIII!H BEYOBE __.__ __11_______ ________SALES rl!II: DAYIHOUR I!lCRES CALI.ORS CALLORS CALLORS CALLORS CALLORS CALLORS IHCRES CALLOIIS 10.000 CAPACITY 8 . TAIIJ: ~. JESSIE FACILITY i, . 5 6 7 , g¡ -3 90 28 189 -34 _,92__27. 142 -53 94 ,62 223 _65 In o o o JI o g¡ 90 leg -U 142 1/645P" 5 ¡g 80U "n 372472 372381 2/630P" 6 68 1/4 7n9 7U7 372562 372472 5/630P" 2 67 3/4 7U7 7714 372751 3'12562 6/63QP"_~6L-,_'l7a_76ü --11284> >~.751 7/620P" 4 65 1/2 7649 7U4 37U85 3'12843 e: û: ri L, , 2 1 o 1 o o 3 o 1 o 1 1 -5.7U -35 60 -28 20 -Zl -3 604 159- 70 1¡g 147 64 2 o ______1 o o o 3 1 _0, 1 1 1 5.0U 28 -7 _15 -17 -4 -7 559 OS 81 153 64 164 1 1 o 1 1 o 4 o 1 o o 1 -3.59& -20 29 -25 1 18 -42 557 133 144 142 89 130 639 \ 09 98 99 168 67 1 53l( 102 I!, 1;~1' 68 ! 171 ì, XxxXicaXxXXnxXxXXxxXxxXxxxxxXxxxxXXxXzxrïXxxxxXJI---~- --577 t- o 0 0 104 o 0 0 169 ,¡ o 0 0 0 141 ,\ o 0 _..JL_ _.71 'I: o 0 0 172 IDXXXXXJI o 0" 00 0.. o o o o o o o o o o o XXXD~J""Y1m<uxxn 159 70 119 147 64 IXXXXXXJIU 3'12985 373144 373Zl4 373333 373480 IIUIt 1 ?OTALS --------- 7355 373144 7257 373214 7158 373333 6990 373480 6913 373544 7454 7355 7257 7158 6nO 5 64 6 63 1/4 2 51 1/2 3 61 3/4 4 60 1/2 XXXD IXXXXXXXX o .-JL ,_ 00 o o o o o o o xnxxxxxxxxx: o o o o o 95 81 153 64 164 xxxxuxxxx 373544 373&3St 373120 373873 373937 ?OTALS 373639 373'120 373873 373937 374101 lIEU 68U 6755 6585 6517 6346 6913 6821 6755 6585 6517 560 6 59 1/4 2 58 3/4 3 57 1/2 4 57 ~ ~-"- XXXXXXXXXX XXXXXXXXXXXXXXXXXXX 133 144 142 89 130 374101 374234 374378 374520 374609 TOtALS 374234 374378 374520 374609 374739 IlEEK 62U 6073 5U2 5861 5689 6346 6242 6073 5932 5861 5 55 3/4 6 55 2 53 3/4 3 52 3/4 4 52 1/4 } 2 3 -1- ----Ö----------------- o 1 13 - 2. 98& -2.94& -2.04& -,9 -::¡g 12 -7 53 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXJIXXXJIJIXX XXXXXXXXX 657 638 ----- 0 ---'0 ----------0-- . -------ï:èò'¡-------12l o 0 0 105 1 117 I I 238 2596 I I 245 2649 XXXXXXXXXXXXXXXXXXX -~_.-. XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXUXX J"""""""""""""""XXXXXXXXXXXXXXXXXXXXXXlX UXXXXXXX xxxxxxxxxxxxxxx =XXXX XXlXXXXXXX --121 117 xxxxxxxxxx XXXXJIXXXXX 374739 374860 ?OTAtS 374860 374977 TOtALS IIOHTII TOTALS IlEEK 4 IlEEK 5549 5444 "'5689 5549 5 51 6 50 . "io""'___ . . FUELJ800689 JESSIE STREET TANK # 8 . JUNE 1989 VARIATION 60 ' , . ., . , ' , · . .. ". . ..... 50 : ,."':'",.;".";,,,,, ,,,":",,': ",":,.", ".";",,. ""';""';""":'"'':'''''':''''' '"'' "". '"'' "'" '''' ,,,.' · . .. ... . ..... · . . . . . · . .. ..... 40 >"':'".,:.,,,;,,,,,':"": "":".,, ,.,,':",.. "",'" ":""":""":.,,,:,,,, ,.", ,,,"" "'" ,.,,': · . . " . · " ..... . 30 : ,.",:.",:,,,,,;,,,, ""':". ,:.",,,:,,,,. .",.,:"", "",;,.".:,...":.".,,:,...,,:,.,,, "". '''', ",":---'" "" ",,,. .. . ... . .. . .' .' . 20 :". ":,,, ': ,.":,,, ;",,,:,,,,':" ",:,,,,. ,.,..:"" ,,,.:,,,,.:.,,,,:,,,,, ':" , ":. ." : '''',,' "",:", "" "'" ': .. ., . . - . . . 10 :' ':' . : .' :. ,: "~:. ':' , , o :' ":,,, ,,: '.' ';'"::.,,.,:," ,,:, ., , " ,":",. " ,,: ,.:,.":,,, "> ' ': ' , .:' ,,;,..., "..:""" "" '" ..: · .... . . . '. ... . . 10 ' ,.,." ' - :.....:......:... .:.... ;.....:-. ...:.... .:. --20 :. -30 :,,:, " · . . . -40 : """",;"";,,,, ,,,,,,,,,,,,,.,,,,,, '" .,.":.,,, ;,,,, ,.":""",.".,,, ";,,,., ,,,,", 50' . . ,. ., ."... , . ' - :....-:......:.....:.....:..... .....;-....-:..... ..... ..... .....;.....:......:-....-:.....-:......:.....:..... ......:.....-:... ..:-....-: · . . . . . . . . .. '" , .' . . . . -60 2 1 2 5 6 7 8 9 12 13 14 45 16 19 20 21 22 23 26 27 28 29 3C . . . . . . . . . . . .. ... ~ . . . . ..' . . '.. . . . . .... .. ~ . . . . . . . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION (:'--~ " !Q.: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDING : c;..~ T~ ~+U.ù Name Of Person Filing Report: l~ g:~ ,~ Facility: _{(~ ('roeµ.J'-] Facill ty Address: I 4 I ~ Permit * t b óC) ~b c. -w. ~4-k~~ e.4 <1'350] .Jo t4"'.H~, ç..L~::r- MA-1V~ / On ~ ~lei . the above facility had an (date and time) inventoryvariatlon/loss that exceeded reportable limits as described below: Amount of Monthly 7ariation/Loss Total Minuses' Line 3 of Trend Analysis Tank # Amount of Daily Variation/Loss, / ~~ I have -'\stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. Sl ~~©~~W~[D , JUN , 6 1989 ENV11-10NMENTAL HEM.TH -~- " KERN ~UNTY VARIATION/LOSS HEALTH DE4tÀRTMENT INVESTIGATION REPORT ~ ~"k~ I Name of Person Filing Report: L~. Description Of Discrepancy: ~~kL~ Permit # I' 00.2' t!... I'k... . ~ #éA:.ß.~.Q CA r~ .? ð-.7 Date/Time of Discovery: (,/-z,?/S9 g3()~. . -701fIJlC:~, ¡C-~ M~~ tJA-~ LA- -kl);'; IS..,1.C-Iã~~ ~ ~ .Ç&;7o Facility: k~ ~ Facili ty Address: I 4 15 Tank(s) with Discrepancy: # M A-rLk. INVESTIGATION SUMMARY The following procedures must be performed within the specified'times starting at the time a reportable loss is discovered or should have been discovered: Within: 6 Hours 2~ Bours 48 Bours 72 Hours NOTE: I ! , ! I I 11) I I I 12) Visual facility check to I I 13) All product dispensers are to be checked for I I I I I I I I I I I I I I 1 THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN - COMPLETION OF INVESTIGATION PROCEDURES" Owner/Operator or other qualified person is to I . ~te Time review records for errors before determining 1"(2) (e7 ~ 50 ~ there is a reportable variation/loss. _ IÅ _ ~ A ' Performed BY:~~ Owner/Operator must verbally report I Date I Time discovery to KCHD.and fallaw-up with written I '/23/SC; ! To; ~ notification an form pl'ovided. . (J _ ~\\.." A --P , Perfol'med BY:~~~~ be performed using Date Time checklist on the back of this form. Performed By: Date Time calibration and adjusted if aut of tolerance. Performed By: Piping to be leak tested using approved method. Date Time Contractor's Name License # Test Performer's Name Description at test perfol'lIed * * ATTACH COPY Qf TEST RESULTS. * * Tightness Testing of tank(s) to be performed Date Time using approved tester and method. Contractor's Name, License # Test Performer's Name -- Description of test performed * * ATTACH £Qf! Qf ~ RESULTS. * * OF 2. VISUAL INSPECTION CHECKLIS~ . A~ plspensers . ~~ll dispensers and their end doors visually checked /'All hoses and nozzles visually checked for leaks. ~All totalizer seals checked for tampering. for leaks. Results: -- All dispensers appear tight cIJ~~ to(z3/'IJ<) signature/date -- Dlspenser(s) not tight as listed below signature/date !DISPENSER #ISERIAL #ICOMMENTS: I I I I I I I I I I I I B. '}ánk Area ~A~ turbine boxes inspected. __~ll fills and vapor manholes inspected Results: Tank area present. . . appears tight with no cl~ ~~ , . signature/date liquid L " (2.-3 ß( Tank area does not appear tight because of the problems/ conditions listed below. signature/date I TANK #,1 PRODUCT I COMMENTS/RESULTS: I I I I I I I I I I I I C. Piping Type: DPressure DSuction Pressurized piping leak detector(s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --P1ping'tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems/ conditions listed below. signature/date Description ~ HOUR . . REPORTABLE VARIATION/LOSS NOTIFICATION Kern County Health Department 1700 Flower Street Bakersfield. California 9330~ Attn: Underground Tank Section ldao ~I"H ~non IIa)I '^fa WISH Il¡u&WUQJIAlJ3 ~Þl" , ~ f) ~vn @ãJ~om~mP£ TO: REGARDING : Facility: .k("¡{/v Ct;iV/'l177 6=/1/'?/Jú,E: Permit * / 600 2~ c Facility Address: /~ 1ST /1 V yr vA/ /J ¡/¿&. ð.ÞJ¡t'(c.r1JF/E~p7 ·Name Of Person Filing Report: On 3 - I - .ð 7 / 1,';2 0 /1 N1 . the above facility had an (date and time) inventory ~ati'~ss that exceeded reportable limits as described below: Tank # AmouI1;t of Daily Variation/Loss Amount of Weekly Variation/Loss 2- Amount of Monthly Variation/Loss ~7!~ Total Minuses Line 3 of Trend Analysis /2 5 j7t=/l/l:'~// r/Í r have # stopped dispensing product and begun investigation procedures required by the Permitting Authority, This notification is in addition to the phone call I previously placed. S1gnat LA Y JOHNICAN, Fleet Manager General Services. Garage Division KERN C~NTY VARIAT"ION/LOSS Facility: HEALTH DEP~TMENT INVESTIGATION REPORT l<étlN r: // v N?' Y (Ç A 4/l r; ~ 1'1 IS T¡!t/)'TV,.v /'9 v~ Permi t # I ç t? ~ 2- (; C LJ /'l/~ r--/? J F / E I ø "- Facility Address: Date/Time of Discovery: 9. '2 ?' .4 h"J 3-1-87 Tank(s) with Discrepancy: # ~ Name of Person Filing Report: j,.qN'k IVv¡VIJ! ~4.2 )-f~O /I Vfi¡(llJrlP~ ¡rvv¡l115 /,,9'f~ T.2S6~A¿' Description Of Discrepancy: IN {.~' { (- 5' .5 (/ F /, S 1, r~'1f ., ¡I-/;r "'AP;YT INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I 12) I 1 13 ) I I I I I I I I I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES, 6 Hours 24 Bours 48 Bours 72 Bours NOTE: I I \1 ) I I Owner/Operator or other qualified person is to review records for errors before determining there is a reportable variation/loss. 3-/- $1 Date Time CT,' 2.J /'J /In Performed By: Owner/Operator must verbally report discovery to KCHD,and follow-up with written ~/Z/{~ I 'Date I Time I J - I - tf f 1 1 q ¡? ,4 --~ notification on form provided. ..,:r/- 1'/1 ¡c 5'$', ~~ /lA'f-£~l--Z- Visual facility check to be performed using I Date I Time checklist on the back of this form. I J- / - 8- 'I I 9;¥5,¡:J/If"I a~ /V(, ~~¿t:-¡:"t- Performed By: ~ All product dispensers are to be checked for I Date Time Performed By: calibration and adjusted if out of tolerance. Performed By: Piping to be leak tested using approved method. I Date Time Contractor's Name License , Test Performer's Name Description of test performed * * ATTACH COPY Q! TEST RESULTS. * * Tightness Testing of tank(s) to be'perforaed Date Time using approved tester and method. Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COpy OP TEST RESULTS. * * PERMITTING AUTHORITY WITHIN v - ¡JF .. \', " . 2. VISUAL INSPECTION CHECKLIST . A.J!;ispensers ~~l dispensers and their end doors visually checked for ~l hoses and nozzles visually checked for leaks. __ All totalizer seals checked for tampering. leaks. Results: -- All dispensers appear tight ß~~t>IÝt7á- ]-/-Sf signature/date -- Dispenser(s) not tight as listed below signature/date !DISPENSER #ISERIAL #1 COMMENTS: I I I I I I I I I I I I B. Tank Area ~All turbine boxes inspected. ~ll fills and vapor manholes inspected Results: Tank area present.. . appears tight with no product or liquid ~.;;2./ZAvC/h<.- J:"/ - ð 7 , signature/date Tank area does not appear tight because of the problems/ conditions listed below. signature/date ¡TANK 1 I I 1 #1 PRODUCT \ COMMENTS/RESULTS: I I I I I I I I C. Piping Type: [JPressure []Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) a'bove , with problems/ conditions listed below. signature/date Description i . . \ I I , I FU ELG 1 1 1 88\ GARAGE TANK J/:1 (SOUTH) NOVEMBE~' 1988 VARIATION 250 ' , . , , , , , . , . , , , , , " , · . . . . . . . . . . . . . . . . . . .' . · . . . . . . . . . . . . . . . . . . .. . · . . . . . . . . . . . . . . . . . " 200 : "':",,;,,":",,;,,":",,;,, ";,, " ; " ":" " ~ " , ~" ,,~ ," "":",,;,,":",,;,,, ':" " ; " ":" " ; '" "":"";,,,, '" '" ':"" "..: . .. .. .... . ..... ... . . · . . . .. .. ., . . . . . . .. . . · ..' ...... .. .. ..... . . 150' , ' . , ' . . , ' , " "","."" . , : ...:'... ': . . . ':' . . . ~ . . . ':' . . . : . . . ':' . . . ~ . . . ':' . . . :: . . . .":. . . ':' . .. ....;'... '; . . . ';' .. . : . . . ':' . . . ~ . . . ';' . . . :: .. '; ...;'... ';' . . ': . " ....;'... ....: .. .. . .. .. ............ . . · . . . . . . . . . .. ............ . . · . . . . . . . . . . " ............ . . 100' , , , . ' , , , . . " ",..""." ' , : ...:-....:....:.... ~ . . . . > . . . : . . . .:. . . . : . . . -:. . . . : . . . -:. . . . :. . .. ....:.....:.... > . . . : . . . <. . . . : . . . -:. . . . :. ..:. ..:.....:....:. " ........ ....: · . . . . . . . .. .. ............ . · . . . . . . .. .............. . · ...... .,. ............ . . · . . . . . . . . . . .. ............ . . 50 :'~"': .:..";,, ':",:" ":'''','''';'' :" ,:.. ":". ''':'":,, ":",,;,,, ,:"..:" ":,,..: ,,;. ":..,: '..:. " '" ;, " "..: · . .. . .... . ...... ..... . . · " ..... . . . . . . . . " . · . . . .. .... .... . o : ",;".: ,,,;, ",;..,,:.. ,;",,: ".:' ..:, ";,,. :,,,:, , "":,,,.:,,..;.,,.:,,,,: "'~" ~" ': "'~" ,~'" "..:"" " ':" ' "..: · . , , . . . . . . . . . .. .. . . , · .....,.." ...........'. · . .. ., .. ....... .... . . 50' . , ' " """ ".""",., . . - . ...:....:.... ':' . .. :.' . . ':' .. . ~ . . . ':' . .. .1' .. ......... ':' . ":' . .. ... '.' .. . ~. .. ':' .. . ~.. . ':" .:... ':" ..:.... ':" ':'" ':'" ':" . .. ':'" "': . . . . . . .... . . . .' .... 100' . . , . . " ,.', .,.,. .,."". , - :...:.....:....:....-:....:-...:....:....:....:....:.....:.,..:.... ....:-....:....:-...:....:....:.........:.....:...:.. ..:....:....:.. ..:....:...-: · . . . . . . . . . . .. ................ .. .. . " . . ., ..... . . .. . . .. . . . . . .. .. · . . . . . . . . . . .. ................ -- 1 50 : ,.,:,..,;..,:',..;", ,. . , , : ' , .:' , . , : . . . ':' , , , : , , , ': " , :' '" ":'",;"";"":,'..:.,,':....;,,,,:.,,;,,,,:.,':',,':', ;" .:, , ' , : , , ": . .. . . ......... ...... · . ... .. ... ..... .... . · . .. .. ... . . - 200 : .,.;", ~ . . , .; , . . ; . , , ':' . . , : . . . .:' ' . , : ' . , .;. , , , ; , , , ;, , . , ; . ,. ".,:.":"":,,.,:,,, ,:. . , , ; . , , ,;, ' . . ; , , , ;, , , , ; , . . :, , , .: , , ,~ ,.,:'",:." ,; · . .. . . ... . . .. .... . .... ... . . . . . .. . · ....... ................ - 250 : "':" ,. .:'" ':'",;,.. ':',.,;". ':',. .~.., ':""~'" ,;,., ':" ,. .', ';'" ,~.,' ':"";"":.,' ,;, ".:' ,.,~, ,. ':" ";,,, ":. "':"" '" ':'" ,;" ,.; · . . . . . . . .. ...... . . . . . . . . . . . . .. ........ . . . . . . . .. ................ -300 2 1 2 3 4 5 6 7 891011121314151617182021222324252627282930 lJlj&~&nw&[Ò) Dte a 7 1988 t:NV/RONMENTAL HEALTh / .í 1600UC: . 1BIIIŒ7 I I -----------' --r-----------------' ---, CAPAC:Ift 10.000 PRODUC'I' UIILBADID JtOIftH/DAR __ 1988 I 8 9 10 11 13 13 14 11 16 17 18 l' ---'TO!'AL '--IIZADIJIg --,_1l1li -- ----_1l1li -DBLIVBIIED,---lIIIftR -'~1' -!O'IAL 1IBftUD- MOUIII' ,,---PIIIC:BIII' _7IV11--POftIft. ,- J!I7BREI) AII.J1ISTftD BBroRB AnD IJIYZIIIOI\r _IJIg 1IZIJUC'lI0II TIIIIOUGIIPII7 OVZII OR S VllRIAnOll COUll!' COUll!' SALES DBLIVIIR1' DBLIVIIR1' -, ÇAL1.OIIS ÇAL1.OIIS DIc:IIBS ÇAL1.OIIS DIc:IIBS ÇAL1.OIIS GALLOIIS DIc:IIBS QALLOIIII QALLOIIII GALLOIIS . o 0 0 0 In 611 l' -- -----0' -,--- -- --------0--- ·----0- -'---'----640.. -----619 --1' U 4436 71 3/4 8429 39U _ 122 18 o 0 0 446 419" o 0 0 61" o 0 0:1 131 90 o 0 0' 0 167 116 -- --- --- .-- --.----- - --.. ........... DDIJD ID ~ 2NI 29N o 0 0,' 179 631 o 0- , 0' 971 Ul o 0 0 118 6<17 41011 11 1/2 1718--- 1313 487 473 o 0 0 139 111 o 0 0 31 19 o 0 0 0. 626 637 XIDXDD 3391 3477 f, ì' " 7 ) o 1 1-_ o 1 o 1 o 1 1 0 1 0 -_. .---- 34 -41 -11 611 ------'6"' In 419 " " 116 . _..-- - ---- 11:........... rAC:ILIft 1 2 7 -OAft-It-OPBIIIJØ' OPBIIIJØ'- -CLOSI.' - CLOSIIIIt'IIIftIt-- IlAILS" IIBTIII'" o QAUClI. 1_1' IJI9ZII'fOIIr RUDIJIG IlZADIIIII . DUIBOVII DIc:IIBS ÇAL1.OIIS QALLOIIII ~ QAl.I.OE 1/628A11 3 11 3/4 1793 1201 8721 8110 1ItlOM' -4-47-1;/2---1201--41141 -9_ '-"21 3/60SAII I U 3/4 4161 8030 9902 9380 4/6_ 6 68 1/2 8030 ,_ 10361 9902 1/636A/1 7 n 7_ 7119 10660 10361 6/63SA11 1 6<1 1/2 711' 1388 10110 10660. 116_ 2 63 112 1388 6821 11106 10110 --~ _ _ "-"------ -------- au 1 !01'A1.S ~ ( Jœ1III COUJn'1' Hu.l.711 DEPAImIBJI1' DIVBII1'OR1' IIICOIIDI. SIIU7 ~ J -- 7~' 'T~~~) 4 I 6 lUlLS ~_. ~.¡;~~.......~.~ --- \ . o , e, " 4 1 o 1 ---,-----0-'--.--------,- o 1 1 3 o 1 o ---1-. 1 o 0. 1. on 112 U 10 631 911 611 -- 473 111 19 631 11106 11141 13612 -- 13S09 13182 13891 13916 11741 13612 13309 13782 13891 13916 14193 6243 1271 6713 1679 1340 130.1 6679 8I61LV1 3 " 1/4 6821 9/.- 4 II 62062 10/60SM I 48 1271 -----11/6_ -6- 44 -----4713 12163SM 7 49 1/2 1t79 13/640M 1 48 112 1340 14/601M 2 48 114 1301 " 4 1 1 1 1 o 1 I o 1 o o 1 o 1 3 o 1 17 3 o o o o 1 o 2.36. 28 13 41 3 11' 616 661 I" 691 6<13 6206 196 139 101 3400 o o o 6"' o o o o o "32 0'- o o o o 2121 77 o o 1/2 36 119 616 661 I" 41 114 .."'.........11( 14193 11313 11968 16633 11232 11213 _ 2 1'01'ALS 1un 11968 16633 11232 3988 3341 2721 9032 88n 8186 4679 3988 3341 3121 9031 8893 +---- lS/60ü11 3 43 3/4 16/630M 4 38 314 11/610M I 34 18/61SM 6 29 114 191 110 RUDIJIg --20/6_ 1 77 21/6G1M 2 71 3/4 -98 41 34 41 114 3434 TAICEII 1 1 o 1 0. o 1 o 0,". -29 nl -181 o 201 -267 106 13 -98 38 671 '20 81 o o 36 683 1'91 134 691 100 291 268 o -201 303 179 1944 832 661 o IDDDXX i XXXUD o o o o o o o o 0- o o o o o o o o o o o o 671 120 81 o o 36 683 .,...........,.I"L 3 1 o 11 2.61. -4.90. 0.98. -10 130 1439 13333 14" 13203 o ~ ¡) ! i i I IDIDID I XUID XUIDID , 3221 o 8631 o 1410 13 112 49 134 691 ....."'.....11: JIj·Ii'"'..)!;........ XJCDCCDCXD 18027 18698 19118 19301 19301 1930.1 19341 20036 20118 1127! 18021 au 3 1'01'ALS 18698 19218 1UOI 1UOI 1UOI 1U41 200206 _ 4 1'01'ALS 30718 21413 _ 5 1'01'ALS 1!0111'11 1'OTALS 1486 1191 6933 6n! 7136 68U 6362 8186 1486 7191 6n! 6n3 7136 68U 3/4 1/4 369 464 '63 6 60 160 1 61 219 221610N1 23/609M 36/6S8Aft 2I/700M 26/630M 21/630M 28/618A11 ~. 1410 1968 6362 1410 113 1/4 35!i 449 29/611M 30/630M PERM IT # L00ú2b I ~ MONTH/YEAR ,I K~ ;~N COUNTY HEALTH DEPARTMENT ) INVENTORY RECORDI~G SHEET / O~(} , /7 L? r: ,¿;1 TANK # CAPACITY , PRODUCT I I f I< E f(N C (JV/./T?, tr/7/l FACILITY 12 l~ DELIVERED WATER INVENTORY GAUGING ---- GALLONS INCHES ~- -- ; ./' ·1 .::f ,- - ]) -- + - --- --- ---- -- /" ". ~, ':J .._-- -----..-- .--- ~-=--~ t ---- -- (.907 --.---- ~_.- ---.-- ----- -.-- [---~ '7-,_ fL-' ___ --- lj;2 ~z. YS OS 15) /.z. - - - - - - .2'1~1 21.2S 72 .2 9 10 11 READING GAUGING GAUGING ADJUSTMENT BEFORE AFTER DELIVERY DELIVERY - GALLONS INCHES I GALS INCHES GALS - "7:f2. /¿ v l' 71.!ð fs Lt.2 ,/ 7.:2JZ il_ ~J~ ~f~ /8'ç'lf? 520 IH.//Ç 9'7 If(}Ç(; t1 /qJtJ5 ~ r-, .., I ¡q?f/::> ': /Ú}l-l! ~( , ;?(ú.) if ~ 5 .., '¿Cl7t:9' 9< ../ - JC) 8 TOTAL ' METERED SALES 'I GALLONS! &/1 ~S'f ,i 5 ~ 2 : 45'9' Jl ~ *~ -W- I; )'7 T Y7:J : J) C) 7 5"'~ - - 7 - 63 L N i 6 t; f} ; ('?? I - EOt,!ATION ;!. 1 7_ DAILY METER READING 6 CLOSING METER READING 5 CLOSING INVENTORY i OPENING INVENTORY 3 OPENING GAUGING 2 1 DATE ; : GALLONS YI¡O i' 7:2 / QJ90 9'10:2 ! {,/ ]{rl " v ""U I tJ ,r J (/ 111//6 ) /7'1/ / J... G52 JJJ()Cf I] 7?z- /5'K'" 7 IJlf5b / '-/ ç ¿¡ ..3 /5.31 ¿ /5}~:?' ¡Ç- J J GALLONS ,\', I Q3£o r~ (i 2- ! ú 3t.¡ I¡)'-IGO / t550 JJ /t/b 1!7~1 /26 S:2- / 'j 'j> t> ,'/ fj7r.2- f/3- 7 J3'l. C. J Lf 51 "3 /57/7- / 5~ 0 ,? 16 33 17232 /7 27~ / B"(};2 7 / ß b1 c¡ 19:21Y /CfJú5 11Jt/S /1:;0.5 / 13 ~/ .2002'1 ..J.07ÇY 2 / If 53 .. GALLONS .. S;;a) 'I5~ / ð (/Jú /' .5 é-/-i/ /5/1 l jyf þ/ ;'.! ;;. S27/ '-t 7 /3 5'17Cf' 5710 S -,.~~ é> ..5 ,/h1j j'1~'i/ 5J£{S TH INCHES GALLONS 5/7/:.; 1)71;' , 1 Ii J S;), u? I ~ 23/-1 /.¡ )"1/ 4 ý. '/1.. (f () ] 0 v J '-;- ,.- !.: .~ (:' '-/ '/2. 7 r~ J -/ 'T t _ j. ~... -1Vl - _,: 0'; - r;~t (~ - G:/ p -C,I( ¡. 11 NO ( \'!.2 0- ? :], It 2/· ,:ol~ 1:.2- ~ltJìI': J.- '5- r ~¡)? H 2'f - ~~5 f..A il q I .25 - 7'V c-tf 12 3 zt;" (;.Jú ~ L> t'/ ;; 3 ;;J' ~,?Ú . 71 .2 '-I :l f' .r¡1 Ý i/'L /; &.,).. J 11-{"¡!!I (:2 '-/2- J 0 - I- '? (4 5 '1 í () ----__1= --,-- =r=----- ~ 4l-e: ~----- 73 1:2-- J /'(::.::.. DATE { r; ./ ? ".- I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT Env, Health 5804113 1018 (6/86) PERMIT # C:002£¡-~ - MONTH/YEAR //- ~, ( I KEß COUNTY HEALTH DEPARTMENT \ INVENTORY RECONCILIATION SHEET TANK # I CAPACITY / 0 0 () 0 PRODUCT - EQUATION 2 1 2 I 12 I 5 =r DATE DELIVERED CLOSING + - = - - INVENTORY INVENTORY DAY/HOUR GALLONS GALLONS 1=6/1/l >J...~ ).. - h; I !!...Æ 4J5~/ . J-~'O)4 ON) , '1- ?'c-(; ,[~ g~ Þ'" '7 I . . ~-!.:.... ..' A 7~: WEEK 1 TOTALS (-(',/1 A I q ~ 'I/" ¡4 !II-:..1-fL21 J II-(~'r:-::l, /Z -~·}¿d_. 1..Lf.r ( 1 & 6.'C- A \. 8;':t7-; ;rl?,; WEEK 3 TOTALS 74 S 6 71q¡ r;,1.¡j ,:~ ".2 J , (;./ .' t% '1 .2 '-/ ~ f.[- ;. t:: y¿Lf WEEK 4 TOTALS ~~ ~J~l.- I fJ2 \ .5'-110 7 'I G ý' J{¡-f:: l.fi II _ 4 (0 MONTHLY TOTALS Env. Health 5804113 1017 (6/861 (Front EQUATION 4 15 T- 14 C 16 TOTAL METERED _ INVENTORY = AMOUNT THROUGHPUT REDÚCTION OVER OR SHORT GALLONS GALLONS +GALS. -GALS. / I ..¡ 19 -/ -4/. --~- - '! _-60 -/jI -..2 'I //////1/////////11//////////// 7/" ? ç '?/ -t-2 2'" ~5C.; G0/3 ~/ 3 //( ffi ~41 G:7 (;;> --' þ Stf9' 'l~ + ? I J 1 -,' b -?¿?' -:XJ -It" ..- ~.. ;' -7ý r .,() r,20/ t 10 L/ 5~ r ..::t...Z. 14 1.22 " ~ 15 TOTAL METERED THROUGHPUT GALLONS (PI! ?5~ s;z z L/sq 99 .tj' ,{j #Þ- q// 6~ 7 '-r7Y f/5 ~ }r! (, £j f1 I 0 " ~ Ú \ ~ ~3 ; ~ / / / / / / / / / / /I / / / / / / / / / / / L/ / L/ / L/ / / I rc¡ 7 7J"f- : 7J¥ Gq~ 6~5 EQUATION '3 - I 9 ~ _ READING" = ADJUSTMENT_ GALLONS \ ¿ 1/ . L , i I i , I /////////////////I////L////111-1// -2L.Cf J -Gf"t 6 ç ~ i LJ 'iCì ~ , 14 INVENTORY REDUCTION GALLONS ~ ~ I '] I 1) ~ <' J r,z: ~ .., fj£ ~ f ? 'I r ffi 6 7 Ll 59~ l.2:L Zfzko 700 tH= (') - 201 ~Íl3 570/ 19lfV g- J 2- (Ó C 7 £/1 ~ ç COt/NT/' I< E /lIV FACILITY 127 / / 1/ / / / / / / / / Il / / / /1// I / // / / / / / If 13 0 333') f I U 11L/I/ / IILU 11/ / II / /1 / / / / /; / / / 1 lV) I ~ I > INVENTORY RECONCILIATION SUMMARY ~11 I ,I ~ . Percent Variation Amount Over/Short (Col 16 +-J Gals. · Total Metered Throughput (Col. 15) 2 q 9 c; Gals. x 100 / ()j % Variation -;- I - I. Reporting: I I 1. Does the Amount Over or Short exceed 350 Gals? DrNo - Continue routine aonitoring I DVES Report within 24 hours of discovery 2. Does the Variation exceed 5~? l8No - Continue routine aonitoring DVES - Report ~o Peraitting Authority within 24 hours of discovery. IRRK 21 J ~ . ~ Variation: I f~2- I 2, -; 5 Ä t Over/Short (Col. 16) Gala. T Total Metered Throughput (Col. 15) 7'177 Gals. x 100 = % Variation I. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? ~NO - Continue routine aonitoring DVES - Report within 24 hours of discovery I 8No DVES ) 2. Does the Variation exceed 5%? - Continue routine aonitoring - Report to Peraitting Authority within 24 hours of discovery. lEEK 31 ,1 J't.3 ~ ~ . Percent Variation: Aaount Over/Short (Col. 16) f 31" Gala. Total Metered Throughput (Col. 15) Gals. x 100 = , 90/ % Variation , I. Reporting: i 1. Does the Amount Over or Short exceed 350 Gals? gNO - Continue routine aonitoring ! DVES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? ~O - Continue routine aonitoring DVES - Report to Peraitting Authority within 24 hours of discovery. lEg 41 I ~ . ~ Variation: í ..J- 5 3 Gala. · Total Metered Throughput (Col. 15) /'191 Gala. x 100 = 2,¿;5 % Variation Amount Over/Short (Col. 16) · I. Reporting: \ \ 1. Does the Amount Over or Short exceed 350 Gals? ~O - Continue routine monitoring I DVES - Report within 24 hours of discovery " Continue routine aonitorin DVE§.... I 2. Does the Variation exceed 5~? 0 - Report to Permitting Authority within 24 hours of discover ÐRTIII I I"] j' JJ L. Percent Variation: Amount Over/Short (Col. 16) +- / 3 u Gals. · Total Metered Throughput Col 15 Gala. x 100 - ,97 % Variation Reporting: I ØNO Continue routine monitorin I Authority with~24 hours of discover Does the Variation exceed 1.5%? - eport to Peraittin . T I r fR I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT SIGNATURE DATE ýY Env. Health 58041131017 (6/86) (Back) it . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION I!l: " U J : ¡'")..;'I 1-\2 ;,.~-, ::=.; [.~ C 1'~7 [~ f ~ . . . : I k' ( :"-j Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section -,.I .; 0 1988 f-=\IV¡pnN^,~r.:;T""': '-it:, L..... -.. II .. ¡'ao" I '. .¡~'-\.\ ~ ......-~t- i j ,-.1,.\ 1 H REGARDllIG : Facility: J< fllA¡ CC/I//tIT 7' G/J/11'J t:é Permi t. I b (í (J 2 6 c Facility Address: /1.//5 TI1 vXTpN' /J v~ tJ ~KN'f /H, t7 Name Of Person Filing Report: On 11- 2 3 I / J - 2 G .rJ- / / - 2 7 - J 9 f'i' , , the above facility had an (date and time) "" inventory variation/loss that exceeded reportable limits as described below: /1·13 .". / /1-1' :#/ //-27 .Ç . / Total Minuses Line 3 of Trend Analysis 8"C I'~ 121017 8' Tank * Amount of Daily Variation/Loss 1-225 f.1()/ . - 2 '7 Amount of Weekly Variation/Loss Amount of Monthly Variation/Loss of I have tJ stopped dispensing product and begun investigation procedures required by the Peraitting Authority. This notification is in addition to the phone call I previously placed. RY J HNICAN, Fleet Manager n~ra! Scrv¡cesoGarage Division. .... it . KERN COUNTY VARIATION/LOSS HEALTH DEPARTMENT XNVESTIGATION REPORT Facil ity: 1< Ell N C tI t/ ,(/T 7' C ¿i:j /! /'J ~ & Facili ty Address: I '1 I S Tit v y TON /9 (/ t' Tank(s) with Discrepancy:' ~ Date/Time of Name of Person Filing Report: Perm! t, / t 0 I) 2. , C ß"1~Fd5r/~ld Discovery: 11-). g-- ~g" /.·Oó¡ø~ Description Of Discrepancy: rlJ M/~ F' / 3 [},q 15 fh'r-11. 7Hf 1I".IP.I1-r 1'1-/11(1(1 INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: 6 Hours 24 Hoars 48 Hours 72 Dours ..... NOTE: E., éEt7fl/, .2 ~(J tr/H OI'I'f'r7f#C~ ClN //-).3 t.l2561J' 1/-.2'f-.201"A' //-27-.JC,"7?4.... I I I I I 11) I I I 12) I I 13) I I I I I 1 I 1 I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES. Owner/Operator or other qualified person is to I Date I review records for errors before determining I 1/- 2 $'- ffl Time ;,'/5 ~~ there is a reportable variation/loss. Performed By: ~~~~ Owner/Operator aust verbally report ~- ~ Date I Time discovery to RCHD and follow-up with written I 11-) 9- ð r I 8'í'2 5 ~.- notification on form provided. Performed By: ~ ~ ~ Visual facility check to be performed USin~-- - ~ Date I 'rime checklist on the back of this form. I //-29-ðg-- I 1:30 A1'V7 ~/U~ All product dispensers are to be checked for I Date I Time calibration and adjusted if out of tolerance. I I Performed By: Performed By: Piping to be leak tested using approved method. Date Time Contractor " s Nue License , Test Performer's Name Description of test performed * * ATTACH COPV OF TEST RESULTS. * * Tightness Testin¡ of tank(s) to be perfor.ed Date Time usin¡ approved tester and method. Contractor's Name License , Test Performer's Name Description of, test performed * * ATTACH COpy OF TEST RESULTS. * * PERMITTING AUTHORITY WITHIN .§. DAVS OF it . 2. VISUAL INSPECTION CHECKLIST A. ..,.Dbpen..rs ~~ll dispensers and their end doors visually checked ~~l hoses and nozzles visually checked for leaks. ~AlI totalizer seals checked tor tampering. tor leaks. Results: -- All dispensers appear tight ~A,-(~l /1-.2,,-S-~ (~ - jf~a~~re/date ' Dlspenser(s) not tight as listed below signature/date IDISPENSER "SERIAL .¡COMMENTS: I I I I I I I I I I I I B. Jank Area ~AJl'turbine boxes inspected. ~ll fills and vapor manholes inspected Results: Tank area present. appt:ars tight with no product ¿;;:?~/~ ~ ~ signature/date or liquid //-.29-$"r Tank area does not appear tight because of the proble.s/ conditions listed below. signature/date I TANK I I I I '1 PRODUCT I COMMENTS/RESULTS: I I I I I I I I c. P1piD& Type: OPressure OSuction Pressurized piping 'leak detector(s) tested for proper functionfng and for detection of leakage. Suction pipiDg tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date ..... Piping not tight based on test(s) above. with proble.a/ conditions listed below. signature/date Description ~ PERMIT CHECKLIST paci 11 ty k¡;¡¿,J ~ ~ . r.:;W ic.. 3 ("" 0 3 :'or.1 t . I (, ""0 ,;.6c... , . C6~TAM ¡tJ~ /fs.T£ 6@.fJ..(¡7fJ1GAJT ~bs This checklist is provided to e~~u~ that all necessary packet enclosures were received and that the Permittee has obtained all necessary equipment to implement: the first phase of monitoring requirements. . . Please complete this form and return to KCHD in the self-addressed envelope provided within 30 days of receipt. Check: Yes No / j~- /- ./ / -~ 7= L _ L E. ,~_ F. ~. Signature .- tØø1ttl4- ()/¿ J!dte¿' -¡;-- ~ f:. ij~. A. The packet I received contained: 1) Cover Letter, Permit Checklist, Interim Permit, Monitoring Requirements, Information Sheet (Agree Operator), Chapter 15 (KCOC #G-3941), Explanati Equipment Lists and Return Envelope. 2) Standard Inventory Control Monitoring Handbook #UT-IO. with the following forms: a) "Inventory Recording Sheet" b) "Inventory Reconciliation Sheet with summary on reverse" c) "Trend Analysis Worksheet" 3) Modified Inventory Control Monitoring Handbook #UT-15 with form: "Quarterly Modified Inventory Control Sheet" with Summary on reverse" 4) An Action Chart for each inventory method (to post at facility) ¡ r ! "Quarterly B. I have examined the information on my Interim Permit, Phase I Monitoring Requirements, and Information Sheet (Agreement between Owner and Operator), and > find owner I s name and address, faci 1 i ty name and address, operator's name and address, substance codes, and number of tanks to be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). C. I have the following required equipment (as described in Handbooks under "Before Starting") 1) Acceptable gauging instrument 2) "Striker plate(s)" in tank(s) 3) Water-finding paste D. I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). I have enclosed a copy of Calibration Charts for all tanks at this facility (if tanks are identical, one chart will suffice: label chart(s) with corresponding tank numbers listed on permit). 5¿-¿ I~~") (,~- As required on page 6 of Handbook #UT-IO, all meters at this facility have had calibration checks within the last 30 days and were calibrated by a registered device repairman 1f out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found 'in the Appendix of Handbook). Standard Inventory Control Monitoring (Handbook #UT-10) and Modified Inventory Control Monitoring (Handbook #UT-15) were started at this facility in accordance with requirements described o~ interim per conditions. Date Started ~ ¡qc.../t£:. ~ Ti tle: Date: Mailing Address - 1415 Truxtun Avenue Bakerstleld. CA 93301 Olf/ce Address - 1400 "H" Street Telephone - Area Code 805 General Services Emergency Services Communications Garage Purchasing Property Management Data Processing GEARY TAYLOR Director, General Services Director Emergency Services County Purchasing Agent Jerald A. Cotton Assistant Director . COUNTY OF KERN . GENERAL SERVICES DEPARTMENT 10 August 1987, Kern County Health Department Environmental Health Division 1700 Flower St. Bakersfield, CA 93305 Dear Mr. Scheide: This letter is submitted to request a waiver for the Garage waste oil holding tank on permit number 160026C, with regards to the monitoring requirements as outlined in the "Modified Inventory Control Honitoring Handbook", number UT-15. The waiver is respectfully requested because our waste oil holding tank is not underground, nor is it covered. However, it is below natural ground level bolted to the concrete floor of the garage basement in plain sight. The tank drain overflow system is connected to an audible alarm to indicate when the tank is full. Leaks can be detected from our daily inspections and by our employees working in the general area. Since the primary purpose for the requirements outlined in Handbook #UT-15 is to establish monitoring that will provide for the detection of leaks in underground fuel tanks, we feel that our present method of monitoring is sufficient for an uncovered tank. Your approval lS anticipated. Lar y J nican Fle_t Manager General Services Department LJ:cb 861-2491 861-2491 861-2300 861-2611 861 ·2301 861-2186 861-2441 2-22-88' ~~'..4 . ,. 4ni~ ~~- ('~ÙL,'-1Y7Ø~-, YZð/f/ 1f::j(/r/ ~ 3J~..&., 32GJ' J4. /+1: 9.7~ tm1. /~f.(K~Z, f- /79 JdJ./ 3/30 ;æ4. .¡-~I- 5:7~. ow¿. ;Ç ~ i-IXe<~ 2-2./-38'. 4~ ð~ 7ð 4¿...ø!#/.L Ik ~ £.¿~ t~, ¿U(¿i' k ~~ /4. tm-1. ~Ip ~ð7; //54/ /2-22. +f ~'Õ~~ ~'-6Þ D~ ()~ 0/0 ./~~ ~ :l." S-~ -fJ IYI.U. 2.s~ + 3 4,-; 2- 9 - 4 -JJ M . LJ, C I . if7 Cku. ) + 22. L¡ I ~ - C; -¿>ð W1.V· 2,/ 7 +337 1 ll-t-P;> M,V .2.00 + 2.?J "2- II-(-PP M .V. I. ì~ + 2-' b 2- /2..-6 -& fY1 . u. (/'47~ + 2/5 11-2-3 -# D. u. -r2.2.S /( -2...( ~ D .v. +-~ 1 1/-2.."7 -~ D.v -;¿ ~ "7 -- . e· . FU ELG 1 11 88\ GARAGE TANK 1J 1 (SOUTH) NOVEMBE~ 1988 VARIATION 250. .., . , ' " .,.... · . . . . . . .. ..,..... . · ..' ............ '. · . . ., ..... ...... . . 200 : ...:....~....:....~,...:....>..:....;..<....:...~....:.... ....:....~....:....~....:....:....:....:... ...:...~....... ....;.... ... · ........,.. . ......... . · . . . . . . . . . . . . . . . . . . . · , . . . . . .. .,. . '" ..... 150' ' , . . . , , . , . ., ,.....,.." , , 1 00 . .. LT,... .... r.,.r.,. L. L LT.. ... ....... ..L T.. L' .... ...... ..... .... ..r... ..! : : : . : : : : :. :: '::::::::::: ,! · , . . . . ., ... ......... " . .¡ 50 : ...:...;...:....:....;....;,...:....:....:.., ;..,;....;.... ...:....~....;....;....:....;...,:....; ..;. ,.:,; ...: .. ...:' .. '" : . : :. ::::::: '::::.::';:: · ....... ... ....... . o : ...~.,,: ...:....:....;.. .;,...: ...:. ..:. ..;... :....;. . ....;....:....;....:....: ...~.. ~.. .: ...~.. .~... ....:.... .. .;.. , ...' .. ...... .. ........... · . .. .... ........... · . . . " .. ....... .... . 50' , . , " ".", ......".... - , ...:'... ':' . . ':' . . . ':' . . ':' . . . :. . . ':" . . ~ . .. .. ':' . .. ':' . . ':' . .. ...:'... ':.' .. ':'" . ~. . . ':" . ~ .. ':'...:'. " ':" ':'" ':'...: · .. .. . . . . ...... · . .. . .. .. ., . . . . - 1 00 : ...:.... -:- ...:.. .. : .. ..:' . .. : .. .. >- ' ~ .. <.. --:- . .. -:-- ..;.. .. .....:"..;.. <. . .. ~ " ..;.. ": .. --:. . --:- .. ..;... :-- ..:....:...:,.:,.." · .. ..... ., . . . . . . . . . . . . . · . . . . ... ... . . . . . .. . · . . . . . . . . . .... ............... -150 ; .' -:.,., ;'" ':.",;". ':..'.:'.' ';..,.:'., ':.,.,~." .;, ..;..., "':' c.':., .,;.,., :....:... ':' ...:" ..:., ,;.. ,.-.. :" -:" :" .':..,':'., · ... .............. . . · . .................. - 200 : ,..:..,;..., ~ ' ' . : ' . . .;. ' . . ~ ' . ' .:. . , , : . ' . ,:. . , . : , . . ~. . , . ~ ' " .", ~ . . ' : . . . .:. . . . : , , . .;. . . . ; . ' , ,;. . , . : . . . ;. . . . : . , , :, . , ,~ , . ,: ",:.,..:,.. · . . . . . . . . . . . . . .. . · ,.. . . . . . . . . . . . .. ....................... - 250 : ...:.,.,:,.,.:',..;.".:,..,;.,.,:..,. ~ . . . .:. . . , ~ . . . .:. , , . :' . " ....:".,;..,.;.... ~ . . . .;. . . . ~ . . . .:. . . . ~ . . . .;. , . , :. . . , ,; , , , ,;. . " ."':...,:,, . . .. ..... ....,. · .. ....... ............... · . . . . . . . . . . .. .............. -300 2 1 2 3 4 5 6 7 8 91011121314151617182021222324252627282~ lÆ &©&oWIE [Q) DEC 0 7 1988 ENVIRONMENTAL HEALTh ~~':::I ~ HOUR ~PORTABLE VARIA~N/LOSS NOT:t:F:tCÁT:tON .' 'rr - \ . . IQ.: , . . , Kern County Health Department 1700 Plower Street Bakersfield, California 93305 Attn: Underground Tank Section RBGARDIlIG : Facility: k e/l/l/ C" aPNr7 CA///9po!=- Per.it. / C vtJ 2. C" c Pacility Address: / &of /5 7" /1 C/ XTv/V Avr-· /J -4 Kr-d{"r/~~~ !!!! Q! Person Piling Reoort: On 9- / -?r . the above facility had an (date and time) inventory~oss that exceeded reportable limits as described below: / Amount of . Mont~ (Variatio Loss 2.. I 7 ~ +-'J.J'~;#1' Total Minuses Line 3 at Trend Analysis 5' ø' - ¡7fn I' I/.f Tank . Mount of Daily Variation/Loss Amount of Weekly Variation/Loss ',to' ~ I 'have' stopped dispensing product and begun investigation procedures required by ·t~e Perai tting Author! ty. This notification is in addition to the phone call I previously placed. -t· , '.:?, .. ~ :~J :~! ~ARRY JOHN!CAN, Fleet Ms:n~~er Generat Services. Garage DIvIsIon . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: ,: ~ ._'../ 'j'0. ~. ,", ,."" ['" n í'P r:~ Ct21::'U '0J LS rr~ ',' i ¡ '; 1-"''' ...- :.-.-" F:3 0 9 í9ê) Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Onder ground Tank Section L:>~\ilR,r:;\\.-1t-¡1E:-.1T)",~- t~~~',~L T~' REGARDING : Facility: J< E ¡t /if C t-'v/1/T7' c;:."e}¡tl9c.C Facility Address: /'1 /5 rl1 t/ YTv/l/ A rf- ~ame Of Person Filing Report: Permit # I ç Ø'i 2 G C /!/9 //,-ß!'r/hd c p- On .2. - r- g-1 / '1,'30 4/1/1 . the above facility had an (date and time) inventory ~i~lOSS that exceeded reportable limits as described below: Tank * Amount of Daily Variation/Loss Amount of we~ @riati nos,s - , ' 051, -/ ÝN,4t Amount of Monthly Variation/Loss Total Minuses Line 3 of Trend Analvsis /3.2 ,t?f/?/P/.7 10 / c..-í I have tJ stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. Signature ~*X~ ~ ~RRY JOHNICAN, Ffeet Manager 1 \",or General Servicese Garage Division KERN C'UNTY VARIATION/LOSS Tank(s) with Discrepancy: # Name of Person Filing Report: Description Of Discrepancy: OF 5'0 / T 1/v¡e¡5 INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the Facility: Facility Address: HEALTH DEPtkTMENT INVESTIGATION REPORT K f Illt/ C Vt/¡'.I7/ Permi t # I b .ø ø 2 6 c c ,4 /1 "., C ¡;. 1'1/5 AV~ ß~.Kr-dfr/~~o TI1VJl'Tt?/I/' ("~ 1. .2 - f"-g-1 9 .J 0 AlA-'? Date/Time of Discovery: 7 H f \IV F f K if J/,q ,¡( / arC! /¥ vv,IJ~ IN FXCt:f5 - (,Ó5t.P time a reportable loss is discovered or should have been discovered: Within: 6 Hours 24 Bours 11 ) I J I 12 ) I 13) I I 48 Bours I I I I I 72 Bours Owner/Operator or other qualified person is to review records for errors before determining there is a reportable variation/loss. Performed By: ~ /?1 ~ Owner/Operator must verbally report I Date I Time discovery to KCHD.and follow-up with written I} - ~-~9 I 1,'~ 5' ,4/¥17 Date Time .2 - ;- - þ-''.-1 9 ; ~ C ,,;.-.-, notification on form provided. d-rv-f? ~ ~/¿¿~ ..f'. Date , Performed By: Visual facility check to be performed using I Time checklist on the back of this form. 12 - ýtf-1 !C'.'Cú/l,-v? Performed By: ~~ All product dispensers are to be checked for ! Date i Time calibration and adjusted if out of tolerance. Performed By: Piping to be leak tested using approved method. ! Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COpy OF TEST RESULTS. '" * Tightness Testing of tank(s) to be performed using approved tester and method. Contractor's Name Date Time License # Test Performer's Name Description of test performed * * ATTACH COpy OF TEST RESULTS. '" '" NOTE: I THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHT~ COMPLETION OF INVESTIGATION PRCCE8URES. OF . 2. VISUAL INSPECTION CHECKLIST . A. Dispensers ~ÁII dispensers and their end doors visually checked for leaks. ~~ hoses and nozzles visually checked fo~ leaks. -2'AII totalizer seals checked for tampering. Results: -- All dispensers appear tight ß:v/a~~ 2-f--f~ si4TIatu~e¡date -- Dispenser(s) not tight as listed below signature/date ¡DISPENSER *ISERIAL #1 COMMENTS: I I I I I I I I I I B. Tank Area ~åJI turbine boxes inspected. ~All fills and vapor manholes inspected Results: Tank area present.. . appears tight with no product or liquid t¥/L,Æ~~ .2-ý-rr signature/date Tank area does not appear tight because of the problems! conditions listed below. signature/date ¡TANK #1 PRODUCT I COMMENTS/RESULTS: I I I I C. Piping Type: OPressure OSuction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems! conditions listed below. signature/date Description . . ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDING : Facility: J< r /IN Facility Address: CVI/NT7' C-~/l"qc;!f 1"11.5 T/1vXTV/ý Permi t # / bOO 2. ~ C /lvf- Bt/9/<' r-d .f'r/EU:? C A ~ ~ame Of Person Filing Report: On .2 - l- ~r ,I 10,' CO /1/1/> , the above facility had an (date and time) inventory variation~that exceeded reportable limits as described below: 1. Amount of DailY'j~ Variatio~ - 2. OS Amount of Weekly Variation/Loss Amount of Monthly Variation/Loss Total Minuses Line 3 of Trend Analysis /32 ¡7~4'N7 / t? Tank # of I have ~ stopped dispensing product and begun investi~ation procedures required by the Permitting Au~hority. This notification is in addition to the phone call I previously placed. Signature LARRY JOHWCAN, Fleet M3:n~~er Genera! Servicese Garage DIVIsion KERN AUNTY VARIAT'ION/LOSS HEALTH DEAlRTMENT INVESTIGATION REPORT Facility: I< (/1 N C 1/t//lIT7- (;4/1/'76 ~ Permit * / ç p"ø'2 ~ C Facility Address: I if /.5 T /1 (/ yr f//V /J t/{- 13" /¿' ¡;'/1 f' /t~ ~ /7 é/'9 Tank(s) with Discrepancy: # I Date/Time of Discovery: --2 -{-,Fe¡ / IC-'CO /J/VI Name of Person Filing Report: ítlfl/1 wAS A Or -;2 oS t//1¿. Description Of Discrepancy: ¡; (JIZ 1 fI (- O~)I". ff w [- INVESTIGATION SUMMARV I Nt'; IV rp/l Y t PSS 1l€c::,(/f.ç1 C~S 7.H~ 5-.A/VI~ 17fi1')J The follöwing procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I I I I THIS REPORT MUST BE SUBMITTED TO TiiF. COMPLETION OF INVESTIGATION PRCC~8~r-:S. 6 Hours 24 Bours 48 Bours 72 Bours NOTE: Owner/Operator or other qualified person is to review records for errors before determining Date I Time ~ - 6- f'C/, /~-'/f ~-' I I 11 ) I I I 12) I I 13) I I I 1 I I I I I there is a reportable variation/loss. Performed By: Owner/Operator must verbally report discovery to KCHD.and follow-up with written notification on form provided. ~/M~ I /' Date I Time I )..-'-8"1, /O.'3C /-IN! C¡!l¿lt'9/JIIl >H/dry ¡.IF ..,q~ sv¡?~,J If f fvAN />/> J' r ¡tI< .. Performed By: ~ ¿::z/{,..~~ Visual facility check to be performed using I Date , Time checklist on the back of this form. I 2 - ç. ff 1, / ?',' ¿,,) /9"...., Performed By: ~~ /lA d~-e-z..... / All product dispensers are to be cþecked for I Date Time calibration and adjusted if out of tolerance. I Performed By: Piping to be leak tested uSing approved method. I Date Time Contractor's Name License # Test Performer's Name' Description of test performed * * ATTACH COPY OF TEST RESUL~. * *, Tightness Testing of tank(s) to be performed using approved tester and method. Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS * * PERMITTING AUTHORITY WITHI:- 2. VrSUAL rNSPECTION CHECKL~ . A. Dispensers ~All dispensers and their end doors visually checked for leaks. ~ll hoses and nozzles visually checked for leaks. ~AII totalizer seals checked for tamperIng. Results: -- All dispensers appear tight ~//Ír/¿;h ./ -C-E1 s1'gnature/date '" -- Dispenser(s) not tight as listed below signature/date . ¡DISPENSER #1 SERIAL #1 COMMENTS: ! I I ! I I I 1 I I B. Tank Area ~ll turbine boxes inspected. __ All fills and vapor manholes inspected Results: Tank area present.. . with no product ai~//¿-t~ / signature/date Tank area does not appear tight because of the problems! conditions listed below. appears tight or liquid 2 - C 'F1 signature/date ~ ¡TANK #1 PRODUCT I COMMENTS/RESULTS: I I I I C. Piping Type: 0 Pressure 0 Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problems/ conditions listed below. signature/date Description - . . ) 24 HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDING : Facil i ty: /< ~ 11 Iv' C C/vNr;' c:,,/ll9c- G Permit # /'-1/5 T/ft/YTv/Í/ /J vr /~ /¡/Z G C- 1'.1/9 ¥f71JF/~t"d Facility Address: Name Of Person Filing Report: On 1- / - ~ '1 / ~'J c; /l ~ . the above facility had an (date and time) inventory ~a~i~losS that exceeded reportable limits as described below: J- Amount of Mon~ (Variatio Loss -r I ,'8""2 r.J 7'thu.. Total Minuses Line 3 of Trend Analysis 1/ 5 ~~A"&4/(. Tank # Amount of Daily Variation/Loss Amount of Weekly Variation/Loss "'{ I have r'stopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call I previously placed. Signature ARRY JOHNICAN, Fleet M9:n~ger GQneralServic:es. Garage D'''lslon KERN AUNTY VARIATION/LOSS HEALTH DEJlkTMENT INVESTIGATION REPORT Facility: Ké/1Ñ CC'I/Nrr C,,4/1h6E Facility Address: I e..¡ If' ¡/lVyrv,v Tank(s) with Discrepancy: # Name of Person Filing Report: Description Of Discrepancy: MI7,Ml'H'ì' V41?14T/~,,/ I I c-- ~ /'/ , r /,tv /-1 .5 t ().2 (¿? f ¡. 71{ tr"q t Permit # J~Ot7 2C C "'",If- 2. . f'uI/,¥d /'Al9r# /,'Of) /",. ffl1/1#1tZ -95/1; ¡1,Huvt· ,(""p,c Date/Time of Discovery: ..1 - ? - 8''f t ~ c ~/?é-/? /'.5 (, INVESTIGATION SUMMARV The following procedures must be performed wi thin the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I I I I i THIS REPORT MUST BE SUBM'ITTED TO THE COMPLETION OF INVESTIGATION PROr.r:íìiiR¡;;S 6 Hours 24 Bours 48 Bours 72 Bours NOTE: Owner/Operator or other qualified person is to Date I Time review records for errors before determining 2 - 7 - ¡;er I /,'J 0 ¡7/V1 there is a reportable variation/loss. Performed By: i1) Owner/Operator must verbally report ~À~ I Date I Time I 2. - 7 - g 1 I / I ~ 5" tf7 A/I I I I 12) I 13) I I I I I I I I I discovery to KCHD.and follow-up with written notification on form provided. ~/1A~ Visual facility check to be performed using I Date I Time checklist on the back of this form. I 7- - 7 - ~ 1 I .2,' C ~ /,<,t Performed By: a~Æ{~ÞL I All product dispensers are to be checked for I Date I Time calibration and adjusted if out of tolerance. Performed By: Performed By: Piping to be leak tested using approved method. I Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COPY OF TEST RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Date Time Contractor's Name License # Test Performer's Name -.- - Description of test performed * * ATTACH COPY OF TEST RESULTS. ,. ,. PERMITTING AUTHORITY WITHI.N -:' - 0F I 2 J 41 5 é 7 a i 9 0 ;! , . '0 14 15 I r 20 ~') .. -' ., -" :ì . , " .. , , - 18 1!1 r.TJ1IB--POST: COUIIf COUIIf ...._> ____.___u__ -- .. 1 0 o J. 1 0 o 1 1 0 o 1 1 0 4 1 1 0 o 1 o 1 _L_CI o 1 o 1 1 0 1 4 PBIIIDT . I_Me ~fl l" ¡ _~_m r~ I f\lBLS I1IW1IIOI\'l u<:oIIDX1III SHIft I í _ I DMK . _ & . I""'": 10.000 PRODUCT UIILIADZD ( IIOIIIII/'lIM 1 1 ,! 4 5' 8!1 10 11 U\ 11 14' 11 16 17 I __IICI-_IICI-ctOS~ III ,'1"": ~ -RIWIIIICI _Iøo- _DIll DBLI9ÐBD---WM'! BIITOII'l-'IO't1oIr-IIBftIIBl>-MOOI IICI o ~1111 IIIVEIIfORf III'IZIftOR'l RE JIG RlADDII: /IBTZRBD ADJ\JS1'J\EJI BZFORE ArnR DIYØrORf QAUOJ1III RBIIUCTIOII TIIIIOIJQHP\rl OVIIII oa S VARUfIOII .- --'', -------" ----- ------ SALES ----- ---. DBLIVP'l ..----,Ðl:LXVP'l "-'-'---..-- ·1- -----...- ..-.. .....---- ---.., -..--" DICIIIS GAI.LOIIII GAI.LOIIII GII III GALLOIIS t:ALLOIIS t:ALLOIIS DICIIIS <::ALLOIIS DICIIIS GALLOIIS GALLOIIS IJICBB GAI.LOIIII GAI.LOIIII GALLOIIS C lln 7018 14 ' 14245 0 0 0 0 111 - -10M---'109,'--.... -"3414~---M- 0 -41 1/4 70!ll 6384 14101 101 0 711 6380 ,"' 1_ U7 0 414 "66 '", 3nn 4'1 0 Ul 1/4 1444 488' 14024 5n 0 ''"' 1/4 4881 48' 145" 11 0 14 ........,lk o -111 ,_,1- 101 -8 '37 111 4Pl -11 ,n 18 11 -31 1.11C 3147 3 1 90 -~ 101 106 641 48 6!15-_-U- 606 51 44!1 100 ., -U5 1118 UO 591 "6 --14~ 551 14P 174 o IDDDD 11 15 1314 79 --- - -- l' 71 18 0 1 ---..- 616 "1 11 0 1 715 611 -106 1 0 110 613 -131 1 0 511 689 168 0 1 __0-____531_______,500-__-11__________ 1 CI -1' 11 68 0 1 IDDDD 1189 1303 11 0.4n 1 6 69 5 -" 1 0 ,68' _ 611. _._'U, 1 0 661 644 -17 1 0 661 !580 -81 1 0 141 "1 U6 0 1 655 486 31 0 1 99 111 18 0 1 3171 3308 11 4 1 111 73 -60 1 0 165 793 67 0 1 3.44C O.91C o IDDDD o ~ o I 0 o \ 0 o 0 o 0 ~ ~ :x: ax - .j o \ 0 1906 1468 o I 0 --0-- --L-o o \ 0 o 0 o I 0 ¡ J:IDDX OOIJI , ----0- Tõ o \ 0 9005 6118 : r\ g o ·0 o 0 ---- "'~''''~=f~ o \ 0 o , 0 8419 3646 g ! g ._.n _ ,_._.. ¡ x o o - CAPAÇIT'l _røl;:l FACILITY IIM_ 1/610M 1 61 '3/601Wt--~'''1- 3/60IM 1 61 4/60IM 4 ,. 5/800M 5 53 6/800M 6 4!1 11610M 1 6' ¡ 1 ; '.' I ' I I n LJ A ¡ f 14m 90 0 14103 103 41 4416 61 111 37605"3 0 -_'----69..------.0-'-- 18141 606 0 39148 «9 0 19191 4P 0 1 4!1 6853 6711 16'703 3 64 6711 1584 31405 1 " '7584 "90 38067 -- 6-60_,l/1---H9C)----+143·,-38'763- , " 6243 5689 39368 6 51 5689 5340 1919'7 '7 48 1/3 '360 '166 19..6 81'700M 9/6_ 10/61IM -'---1l/65SM 11/'lOM 1l/'lIM 16/631M o .--.. . ---~--- -- --- .- .-.-. -- . --------.-- 149' -39 -3.6n 3 1 13!101 113 O.NC 16 l' () ---------- --------- 611 -16 1 r, ('\ I ----.-- o 65'7 153' 13394 .--.--.-- IIØXDD IIØXDD I \ 0 I 0 I ¡ 0 \ XJ I r \ r J I o o 60 116 6331 16 3/6 o o ._------------~, o 3/6 o o o o 6783 11 o o o o 64 113 .........1It _.- 39Mt '71 39919 "1 40561 631 41193 633 61816 689 ---,43115 ..---.- . -- 500- 43015 33 .........If 43068 , ·-4305) , ''7l- 63126 "4 64310 !580 649~ 693 65643 686 U119 111 .--- 1rO.......:1[ '7l 1 13 663116 66339 _ 3 TOI'ALS ---- 1I/611M 1 6'7 1/6 5166 5131 3!1919 16/60IM 34'7 5131 6505 401163 11/60IM 3 41 1/3 4505 8148 41193 18/60SM 6 13 3/6 8568 TI'78 41816 19/61IM 5 66 111 11'78 '735'7 41'15 ------10/610A11 - 6-61· 111 ---'731'7-----6130..-- ·--6!G1S 31/63IM '7 58 3/4 6120 6755 63068 _ 1 TOI'ALS U/630M 1 58 1/4 6755 6686 63051 ·--31/_ 3-,18 116- ----6686- _1 ,-- -,63'716, 24/606M 1 n 1/6 6001 5360 64310 n/601M 4 68 1/1 5360 4'U «!I!SO 16/60IM , 63 3/4 6679 1'7'78 65663 31/61~ 6 66 1/1 11'78 1133 66119 18/64IM 761 '7333 7114 46156 -- -. -------- ----- ..---'-- _ 4 TOI'ALS .\ 19/63~ 1 63 1/4 '7324 1091 66119 , " 30/60tM 3 61 1/6 '7091 6346 61111 o o -- ------ ..' ---- 31/60IM 3 5' 1/4 614' 5689 67n3 6'7Ul 631 -- .- _ , TOI'ALS .................If IIOII!II TOTALS ~~ \ . 6' FUELG 1.0189 GAF~AGE TANK # 1 (SOU-r~-1) JANUARY 1989 VARIATION 180 ' 1 60 ; .", · , .", "" '.,..,... .;....,:..". ,...,...".,.. """. ,," 140 ..... .... ...... . ... ..... .............~..........................: ... : ., : . : , " , . .., '............:........,"... ...... .,...., .... . ..... . 1 20 : ......:,.,...,:..... . ~.. . .. . ..:.. .. .. .. : . . .. . . : .. .. ..: . .. .. .. : . . . .... .., ...,:.......:....... ~.. .. ... : ...... ..',.. . .. .. .... 1 00 : ",..,':........,.,.... ,;.. ' , . ..;.. ., ,.:.,....:..,....:--.......;"..., ..... ..:,.......;........:.,... :. ............ ,... 80 : ".'" ,'.. ,.."..,.",..", ,..;.. ..... .."..,.... 60 : '...., ;... ,;.., ", ..,., ,.:'....,_..... .:' ." ......, .... 40 : ...' ;. ...,:, 20 : .. 0' -20· -40: ., -60 ',.,.., -80 : ' , ' '" --100 :" ,'".. -.120..··..·..·" "..,... -140 ' 2 2 4 6 8 1 0 12 14 16 18 20 22 24 26 28 30 . . ...... . . . . . . . ~ . . . . . ......... ., '" .... ..... ......... ,..... ... . .' ..... . ........ " . . . . . .. ....... ~. . . . . . . . " . . . . . . . . . . , --,- ! - 160026C PEMIT DEPARmENr C(lUNrY HEALTH ""RH Rf:CORDIJIÇ SHEET III\I!II'fORY FUELS L 1I01I'TH/Y!AII -------'O<:TOBtR-1966----- 19 POSTIVE -COUJIT 18 IŒGATIVE COUJIT 16 11 1I/IOUJIT PERCENT OVER OR S VARIATION IVoLLOIIS . 15 TOTAL IlETtRED THROOOHPUT 14 I!fVENTORY REDUCTION 13 VATtR GAUGING INCHES 12 I DELIVERED III\I!II'fORY , IVoLLOIIS UllLEADiD 11 ___~ING AFTER DELIVERY IIICHES GALLOIIS ---------,---- PRODUCT 10 GAUGING - -- -- BEFORE DELIVERY IIICIŒS IVoLLONS READING ADJUSTllEN IVoLLOIIS TAllJl:t----¡-TIIORTHf--------CAPACITY ---1"õ;öoo 8 TOTAL MTtRED SALES IVoLLONS 7 .DAILY MTtR READIIIIõ GALLONS 6 CLOSING CLOSING MTtR I!fVENTORY READING GALLONS GALLOIIS OPENING III\I!NTORY GAiÏÃê:E _ OPENING GAUGING IIICHES FACILITY ___.__DATE ..__,_D o V ~ 1 o --'-1' 1 1 1 1 o 1 ·-------0 o o o o 20 -37 ----n 17 14 41 7 GALLONS 329 207 ---6U 819 521 601 603 ---3710 GALLONS 309 244 ·592 802 513 560 596 3616 ---0 o o o o (I 3681 67 (I 329 207 ----6U 819 527 621 603 4 333 ----- 540 1164 1983 2510 3131 333 ___540 1164 1983 2510 3131 3734 6037 u__ 5793 5201 4399 3886 "86 6890 GALLONS 6346 ____,__6037 5793 5201 4399 3666 7486 3/4 1/2 3/4 1/2 3/4 1/4 7 55 ___1.53 2 51 347 4 41 5 ~6 6 64 DAY/IIOIIR 1/701A1! 21'700Al! 3/605M 4/605M 5/630M 6/600M 7/640M 36 1/2 20 ¡ -- 1 o 1 1 J 1 o 1 o o o o o 2.53$ 94 29 -93 5 20 43 9 12 25 Z33 145 626 646 635 664 595 3~44 2~ 2~ 6U 6U ~2 6~ 93 "19 o xxxxxxxxxxxxxxxxxxx 233 145 616 646 635 664 595 xxxxxxxxxx 3734 3967 4112 4738 538-< ~o19 6663 TOTALS 3967 4112 4116 5384 6019 6663 7279 II!EX 6686 6448 5"27 _ 5201 4609 3954 e062 6890 6686 6"46 _____5627 5201 4609 3954 7 59 3/4 1 58 1/4 2 56 1/2 ,__.3 52 _ 4 47 113 5 43 1/4 6 38 1/2 8/6330M 9/630Al! 10/605M 1l/602A/I 12/605M 13/610M 14/605M (I J o 1 o J 1 4 1 1 (I J 1 1 1 6 1 1 o 1 o 1 o o 0.71" -152 116 -3 28 -16 42 7 132 310 658 709 642 495 425 3)'7 284 194 661 681 658 453 418 xxxxxxxxx o o :0 o 0 ---'0 -------·'0 o 0 o ;0 7841 4160 o :,)0 xxxxxxxxxxxxxxxxxiixxxxxxxxxxxxxxxxJCJCXXit xxxxxxxxx i o -- 0 10 o 0 \0 o --- 0 0 o 0 0 o - 0 0 o 0 '0 :'886 73 09577 .4t)~1 xxxxXXXXXXJ!XXXXXXXlXXXXXXXxxxxxxxxxxxxxx o o o o o o o o o o o o o o o o o (I (1 o o 38 xxxxxxxxxxxxxxxxxxx In 310 6!1e 709 642 .95 425 xxxxxxxxxx 721a "10 7720 €I37*=, 9087 9129 J0224 TOTALS 7410 7720 8378 90S? 9729 10224 10649 II!U 7779 7584 fo923 6242 5584 5131 4713 8062 7778 7584 6923 6~42 S564 5131 3/4 1/2 , 68 1 66 2. 65 3 60 4 55 5 50 6 47 15/630M 16/635A1! 17/6081\11 18/609!\/! 19'609!\/! 20/610Al! 2l/610M 3 o o 1 o o o o O. (.5.. 22 11 38 -7 3 16 25 75 191 160 787 570 £-29 718 493 3548 3~49 180 In 794 567 613 693 418 387 xxxxxxxxx o xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx , '-'3 n 1/2 ~.." 3805 \1 0 0 o - 0 ,\0 ~ ~ 0 !o 10 ',0 xxxxx xxxxXXXXXlJCX>:Y.XX XXXXXXXXXXX ~.. o o o '" ~ o o xxxxxxxxxxxxxxxxxxx 44 191 160 78' ~'70 &29 718 493 xxxxxxxxxx 10649 10840 11000 117ft1 12.3.~7 12986 13104 TOTALS 10840 II 000 11 787 123157 12 986 13704 14191 TOTALS wt:EX 6338 6216 742.2 6855 &242 5~"9 5131 4713 8338 6216 1422 68515 6242 5549 1/4 7 '4 1 71 2 70 3 63 3/4 .. 159 1/1 ~ 55 6 50 22/630M 23/635!\/! Z4/60SM 25/606!\/! 26/606M 27/615A1t 281105M o o 4.5n 16 -40 -16 169 221 209 243 xxxxxxxxx "0 :'('1 I o o xxxxxxxxxxxxxxxxxxx 169 227 xxxxxxxxxx 14191 14366 14 366 14593 wt:EX 4922 4679 ~131 4922. 47 45 1/2 29/'700AK 301100Alt n o -3_~n 1. 75t. 20 36 266 608 1004 15171 588 1040 1491 o xxxxxxxxx xxxxxxxxx o xxxxxxxxxxxxXXJlXJlXlllxxxxxxxxxxxxxxxxxxxx I , xxxxxxxxxxxxxxxxxxxxx;:xxxxxxxxxxxxxxxxxx ! \ o xxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxxx 608 xxxxxxxxxx xxxxxxxxxx 4593 15201 TOTALS TOTALS II!EX tIONTH 4091 4679 43 3/4 31/610M I HEREBY CERTIFY THAT THIS IS A TRUE Env. Health 5804113 1018 (6/86) DAY/HOUR 1- 7.'01 ,1 2 - 7.(Jó A J- ~..oS A '-1- ','05 ~ 5'- {p 3t ~ (, - t.:úv It 7 - '.1 () A e . t':J/ -1 q. (.,)/ A It)- 6.Ðf A 11- ~p2 A r }-b:eS I ~ - 6.'1 (¡ A I - þ:CljA J f - ¡.'JI A IV· ','If A I)' fv' ~ It- 'Ct' A 1?-6;vtA ;20 --(p , 0 Pr .-' A- , -:Q.ß. - . ~ - ; . - ) l. - r'(¡ (,~ ¡:r (P\IS" ~ : ' - 1,'OS J1-7'(,-tJ 1 jO~l¡;b .1..J -, .'1 0 ~ .5 'So ¥7 4.r~ 437'11 ~ .íü 5,Jj/ ¥ '122 '1 ~ ?'I AND ACCURATE REPORT GALLONS (:,037 5í'lf3 ;-1 $1 'rJ ~ JR'g'~ 7""¡::-~ Cý9ð ~ ~ fj"b ; ~ '7~ S B"'.7 7 ~t2~ 79.5'1 ~7;: 758"'; '''/J..J 6#$~Tt ) ~~'"í~ C;Sif'1 5" J JJ '-'922 LtC?¿/) I.f. rJ ~ GALLONS 3..3 3 r; 'f0 /lh~ I ~n 251tJ "]) iI 37J"r ,'f¿7 i-¡I/;z.. ~ ~ ft: H IfJ "22 ~ lobi '1 \ð~q~ \ 100 : ~] 5~ì f ~, t?G. \~ 'ìtJ'I /'¥/ :: 11.{3 J If S"I/f 3 15;20/ DATE 1 2 -ª OPENING GAUGING ~ OPENING INVENTORY .Q CLOSING INVENTORY ~QATION 1 § _1 7 --1 !! CLOSING METER DAILY METER TOTAL READING - READING ~ METERED SALES GALLONS f 2 c¡ 207 62~ ¥'I 52 ::æ . ) - - GALLONS 10000 7' ~'?J S:'t- 0 J I~'~ 41 It¡ ýJ .215/0 ~'/71 "J 7J~ 1~¿? '-/11/2- t.! 7Jý S~t''-I I?ó/Cf 6~h 7.2 73" 7~/o ? 7.2 () ~1~ I p~;l-,/ :~~~ l \ OOð II 1,'7 1.2)1.57 I ø.-q f'(, "';, I)~O'" J I.fJ? 7 I .., 3Þ~ I Lf5f 3 ~IGN~ I I I " I, Il~r ....... }JJiJ 2 10 11 12 13 READING GAUGING GAUGING DELIVERED WATER ADJUSTMENT BEFORE AFTER INVENTORY GAUGING DELIVERY DELIVERY - GALLONS INCHES GALS INCHES GALS GALLONS INCHES - - tñ - , - .::L.a .li...:b 'IIC/') - - - - - - --Ø- --- - - W '3 ? ý,- 71 4IE¿¡/ - - - rJ - 0 - - J.¡.~ L¡ 7/3 72 '12- If- 1; /lr :3 xo.r; ø --- - -_. - '..;'-: '~.f DATE FACILITY ;I <' ' , ': Cvv/vrY /.?-ßA-G'EANK , \ \ 1 .ERN COUNXV HEALTH DEPARTMEN·.... ,; INVENTO~V RECORDING SHEET .2- CAPACITY 0 006 PRODUCT 1//1/ ~ E,tH/. MONTH/YEAR PERMIT , '2C C Env. He.lth 5804113 21- ?U ~ ~ ~-,b;3" -b~J ( ?-.4- í:O¡ 9-~- :01 2' - ':0' ~ 'ì ~ fI.( 5 ~...R. - 'J (> í 1 DATE LIJU Wf!i1 /~-¡~'I/ 19-b~ D1f. ;JD- ""oA 21-~.1(J4 ø-tjl 4 '7.,,, 4 / (r~/J 4 /I-/:n '" I,:)' -.h :05.. 1?-(;.l¡)f7 14 - b tJ.5 A DAY/HOUR ) - ÃO I A 2· 7.t?( Á J-~'(;f" ¡J l..¡-t'f/,fil1 ~, ~1,,"), j t:: '(j( 2~.rv 2 IlUftTBLY TOTALS 1017 (61861 (Front) >/J/ ¡¡¡¡n If Þ 71 EQUATION 2 1 12 ~ = DELIVERED CLOSING INVENTORY INVENTORY GALLONS GALLONS ~0.77 .5 79.3 52&11 1m '71.1- r6 ( f"1/~ IfBBl{ 3 TOTALS ~'\\3 ~ ~O5" ~1?~ ì4~ 6 ~~J & ':l4<1J. S S.!i9.. WEEK 4 TOTALS Lff:;-¿ !!.f.L1 w.(/Cf) ~ ~ Ý.J~ ~~4'l. £2yg 51 '1 ~~y~ "'1lfF SY2? ~ 7778" 75 R''I- 1m ~ 1 14 INVENTORY REDUCTION GALLONS 3//f 2'-19 Sq2.. 3'0 :¿,. ilo M= .2 '? 9" m H± j ~ 1fu ~ f&.fs (o't~ ;{~7 ffi: srv I 'fH I - - I ¡,. '- Cf XI}f Z¿?- /5"172 15 TOTAL METERED THROUGHPUT GALLONS 32? 0; 5'.77 bOI 603 37,0 ~?~3 ;2(; .15 ,ç~ .5f.5 ljJ~ ii~ -'0&1 ~ ~ , f_ EQUATION 15 =:I 14 I: 16 TOTAL METERED _ INVENTORY _ AMOUNT THROUGHPUT REDUCTION - OVER OR SHORT GALLONS GALLONS +GALS.I-GALS. '32 f :J (7 ~ + 2 0 -- 207 2~Lf- -ll... t.;;:2 ¥ .)''12 +- 3.2. 9' / , ;;-~ "2... or / ""7 ~27 ) ~ 1-17<- hú r;¿"17 -I 4/ ,"j; ~ ý? A- "'7 //!////////////I.'// / 'II/II/II 9¥ .2 ~ 7 . (/'0/ 2 q I v5? ? Þ2Ç- 6'" 1"" ç L u ¿ /'::. _¿:. +~(') ?'7 S J 72- ~ ., 7 ¿.¿~ ~SS ~ .- . .5 ~ §,"3 -r 1 Ill/I///////////.' ////.' //////// .2 ~ :12 ;2 ';- t,I ~/() I~'~ "fP , 5Y ~,ç) ï (') , 6 R. -I-J.-f( to (. 2. ~.5"~ 4 ~.. J.,~_ +'f2... ~:;. 5 <I" / t¡( -+- 7 //11/ '//////////://J//I/////// ..22 JkO -rJI , ~ rJ \ ~ +"1 ~ -- <7Î - qU 7 &J t¿ '7 or 1 '" Á. Cj ." / ? + II" If? (I tf +-.2.S- ~",.... '1'1 -+ 7S /////////1////// '1//////////// .;-/£ J J ~ ~ 20' , 2. '2. ? 2 'f:1 Þ C;; ó 5 rr -1 2 () //////////////////111/ //1/ /.L1L .2 b ~ - 'ftJ -Lf¿ -Lf.2 . I --L /& -~.:3 -~ , i , I ¡ i ,*i ..ì FACILITY ,. fA N (ClVA-Ií.l" I K: tN COUNTr HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET TANK tt 2.. CAPACItl'Y () 0tJ (J PRODUCT / # L rn l?L/.? PERM IT tt MONTH/YEAR 4 ,C c /c; -r I I INVENTORY RBCONCILI!A.TION SUMMARY __11 ~ A. Percent yariation ,'~\I·~~'.'J';'r" ' Total Metered Throughput (coJ. 15) J 7 I Ó A.ount Over/Short (Col 16) ~ c¡ If Gals. 0 Gals. x 100 2.5 % Variation B. Reporting: ¡ 1. Does the ~ount OVer or Short exceed 350 Gals? ~O - Continue routine aonitoring DYES Report within 24 hours of discovery I 2. Ooes the Variation exceed 5%? 0 - Continue routine .onitorin DYES - Re ort to Peraittin Aut rity within 24 hours of discovery. WBBIt 21 A. Percent Variation: ¡ +2S I J5lf'7' , 70 Aaount OVer/Short (Col. 16) Gals. T Total Metered Throughput (Col. 15) Gals. x 100 - % Variation I B. Reporting: ( g}NO I DYES 1. Does the Aaount OVer or Short exceed 350 Gals? - Continue routine aDnitoring - Report within 24 hours of discovery I 2. Does the Variation exceed 5%1 ~o - Continue routine .0nitoriDK (]YBS - Report to Peraitting Authority within 24 hours of discovery. WBBIt 31 ( A. Percent Variation: i ~ount Over/Short (Col. 16) +22 Gals. Total Metered Throughput (Col. 15) 3771 Gals. x 100 - , ?!J % Variation \ , B. Reporting: 1. Does the Aaount OVer or Short exceed 350 Gals? BÞNo \ DYES Report within 24 hours of discovery - Continue routine aonitoring - I 2. Does the Variation exceed 5%1 &0 - Continue routine aonltoriDK DYBS - Report to Per.itting Authority within 24 hours of discovery. -- 41 \ A. Percent Variation: A.ount Over/Short (Col. 16) t/r;r Gals. . Total Metered Throughput (cJI. 15) J S'f$' Gals. x 100 ... '1,sj % VE!ation \ I B. Reporting: I , 1. Does the Aaount Over or Short exceed 350 Ga181 t'ßjNo - Continue routine .onitoring DYES Report within 24 hours of discovery 2. Does the Variation exceed 5%1 ,6NO - Continue routine .onitoring [j]YES - Report to Per.it tin within 24 hours of discover ""'1 I I A. Percent Variation: I Amount Over/Short (Col. 16) .,.. 2 ,ç Gals. i 15) /5/77 . Total Metered Throughput (Col Gals. : ion I B. Reporting: Does the Variation exceed 1.5%1 DNO - Continue routine ort to Peraittin discover " I HEREBY CERTIPY THAT THIS IS A TRUB AND ACCURATE REPORT Env. Health 5804113 1017 (6/86) (Back) )H CAN, Fleet Manager ervicesa Garaae Division I , I I r I ~ñ TMK t ,~: ,_ml) , CAPACIn - 10.00ò PaODUC1' UJILBAI)ID r - 118. f 1 a 3 . I 6 7 8 ) 10 11 1:1 I 1<1 16 17 18 11 -____IIICI-_IIICI-(;LO I__CLOllIIICI-IIIft.-DA1L~I!BftIt___!'II'_Il IICI _tIICI DIILt\IB~1 ~ g _----.naçarr_JlSGMIft-_ o QAUC;IIICI I_I IJIVEIItOIIt RZADIIICI RZADIIICI IŒTBIIBD ADJ1IImIEII IIIB AnZII IJIVD'IORI GMII:IIICI UDUCTIOII ( .. S VAllIAtIOII COUJn' COUJn' . ,>..- ".....- ..,. -.- . -'-SALES ......... '''.''''-'--' 01 ,·-,·--ÐlLIVIIRI,-·,·-----,----·..,· ~_______.____ .. 'h___._._.._.._..___·__·___..,·, IlUIIIOUII 1JICIŒS __LOllS t;ALLOIIS ~ GAWIIIS t;ALLOIIS GAWIIIS IIICIIBS ~_.._~.... ~___.~ \~..__.._~__._ IIIS_. .__.._....__ -- _ __'::.__ 1/nOM 1 67 11. 787:1 "83 ..8n 6<l6N 30. 0 0 ° \ 0 1 )0 11 0 1 1/6oeM-·-·:a-n-',./. 7682"----"1111:1 ..ne-- «861 ~ 0 8 0 I HO- 15 1 0 .'. '\ 7 3/6011011 3 6<1 3/. nla 6811 .1703 ..1)78 735 0 0 ° I , 61)7 a8 0 1 , ' " ./60!5M. I ) 1/3 6811 61U .6<I:H n703 731 0 0 0 \ 71. 17 0 1 " I; 1/800M I N 11. 61U N10 .71:17 ....:H 61)3 0 0 0 I 731 38 1 0 6/8OOM 6 . ) NI0 .60!1 .7 )71 .71:17'" 0 0 0' ,'", eo1 .3 0 1 7/nOM 7 63 1/. ..O ) 63U .8n6 .7 )71 3n 0 0, 0 I ',' 380 11 1 0 MID 1 T01'ALS .......... .........-....&..~........................ 1111ZDXD 3M3 39 1.09. 3 .. .-..,-.. ,--... 1"-'''' -,-.., :7.:: ~ ~~ ~~ m: m~ ~:~~ ~:;~~: 39~ 68 1/a eo:· ,'h_ m~ ( ..--.~ ~~ ;~ ~ ~ --·l~~=-..-~~~-~~ ~~-:--~~ ~~~~-:=~ =- ~ ~ ~) ~__ ~~ ~ ~ 13/610M I 16 1/3 6<1.8 15896 108U IOn6 601 0 0 0 I n3 13 0 1 U/615M 6 sa 113 58 )6 5301 11368 SON 1 137 0 0 ° 6 )1 68 1 0 1.1637M 7 67 1/3 5301 5301 51.... IU6. 176 0 0 0 0 0 76 0 1 _ a JODLS .......... "''';''''''''''''''''''';'''''''''''oilllZDXD 3:: 3:;~: a.m : : o 0 0, .-- 516 573 16 0 1 4339 '70 1/2 8a.,7 )9481 617 607 10 1 0 o 0 0' 517 579 6:1 0 1 ~ ~ _~¡ 0 ~~ _____~~~ ~~. __h. L_~ n...:................h.:...........o/IUDDU 3: 3::: 1.70. : : o 0 01 173 154 18 1 0 -0----,----.-0------ 0-----....·--558 ..5N- 36- _._ _.. __..__ O. 1- o 0 01. 556 577 31 0 1 o 0 ° h" 68 ) 686 -3 1 0 3783 68 7"8 4185' 519 573 53 ° 1 o 0 0' 0 5n 559 33 0 1 ..._~._ ° 0)__ ..___ __~5_ __._3~7 .8 __.___ 1 _ 0 __ Xi ]I; xx ' IIUDXD 3336 3389 63 1. 86. 3 -. --, o 0 0 67 )I;¡e 0 1 o 0 ° 687 706 1P 0 1 ¡ _.____h.__... J -. { .---.- ° 556 i I \ ¡ -----. --- -.-- , XUDJI]IXX 1310 I ØIXDXJIX It705 .... . , C' r.....; " 2 ., S 6 ¡ ¡ 4 5 Ó ,,,,-' ! i ---I J ~-_. PENlU . liOO:l6C IIOIItIV1'BIIII 11 1/. 1/4 38 u QAII COIJJrtt IllALm ÐIP_ F\JELS III9EII!ORI IIBCORDIIICI _ j~,¡ n01 109'7 516<11 11.... 97 S097 4M1 I33U 516.1 573 4~ 1 7871 Sa8aO 5a313 60'7 787a 7315 13n9 53830 5n 7355 6751 MOn 53399 633 ·---6n_6001 _11----- N03~n----6&7--· 6001 5861 Nee9 54689 300 _ 3 JODLS 1 47 1/3 3 .6 3/. 3 43 3/4 . 67 11. 5 63 1/4 -·-6, 58--3/.' 7 13 114 161605M 1'7/6015M 18/605M 19/615M '---·---3CW61OM· , J ; r, - ¡ n t - 26 " 1/4 37 ...II:........1<.t'/I. Stee ) 1 M '..55043-- .--_ nn7 577 5n04 686 56890 573 5746:1 519 leo31 317 ----- ~ ~ ...............11: l58a78 58373 )I 706 51043 "-lln7- 1630t 56890 17U3 58031 58378 . JODLS 58373 5!1079 - 5689 --SUI· 4'75 3886 7153 7035 6720 6653 n66 5861 ..--·-5689, 5U1 075 3886 7553 70al 67ao 6n3 53 51 3 .7 .43 I 38 6 6<1 3/4 7 60 3/. 114 1/3 58 58 1 3 :Iot/606M 15/607M 36/605M 37/615M 38/64 5M 3 )/n5M 3O/605A1\ ;. " ,~ .. .:;... '~b o 3 18 /'"\ 1 1 13 ---- 3.3n 1.8n -a n 37. 1M 1311 lU7 ) o ---- o 1M 1 )079 .-. --- --~ ....nu.. >nraft""'Ol 5.U3 _ 5 JODLS _ TOtALS --'- 5610 1 )66 53 31/601A11 ,"''''1... . e· . . . FUELG2 0 89 GARAGE TANK--n 2 NORTH) JAN UARÝ' '1 9 9 VARIATION 200 . · , . · . . . . · .. . , , 150 ; ,.,.,',:,...,.,.:",.,.,;",....,:,....... ',...,";..,""': .,.",,;....,., "."", ,...... .".....;...,"";,.,""':.".".,"" . . · . . . . . , , 1 0 0 ; ...,..:......,;,......;,......;........ ........;....., ;.......,;....... ....:... "'''' ........; . '.. .. .. .;.. , .. . . ; .. . . . ..; .. . 50 :" . , . . . . . , . -50 :. . ..... ...... ,". . .. . .... .. . . . . . . . . . . . . . . . . . . . . . . . . . . '. .... . . .... ............ ......... ,........... . ..... ...... .-.,' ,.. ....., .0..... .....,. ..............,.. ....,.....,.....:.,.. . , , ' ... . ........... -100 : . . . . . . . . . . . . . . . . . . . .............. .. .. . . . . . .. . . .. '" . . . . . . . .. . . . . . . . ........... ........ -150 ,:" ",. " . .... . . '....... .... .............. . . . . . . .. ... '. .. .. \ . . , . -200 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 . . 24 HOUR REPORTABLE VARIATION/LOSS NOTJ:P1:CATJ:ON '..... ....';. '.,""\ TO: ~ ":.: Kern 'County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section RBGARDIBG: Pacility: k(Ç/Ì/l1' , COC//Vr7 ?/'J/!/9p..p. Permit* /bt/Ó2C'C Fac ili ty Addres s : I &of / 5" .,. /1 C/ .K r v N' ¡tJ ¡/ ~ ; ß ~ K 141 ç ¡C/ E E /7 Name Of Person Piling Report: 9"""1-g-g- . the above facility had an On (date and time) inventorY~oss that exceeded reportable limits as described below: Tank . Amount of Daily Variation/Loss Amount of Weekly Variation/Loss / Amount of ' Mont~ 0ariatio Loss 2" 170 -T-J'J'7vR' Total Minuses Line 3 of Trend Analysis 5" 8"- ¡7IH/~//5 -.~; - I have' stopped dispensing product and begun investigation procedures required by ·t~e Per.i tUng Authority. This notification is in addition to the phone call I previously placed. '.' ¿ARRY JOHN!CAN, Fleet MEl:n~~er General Servicese Garage DIVIsion '.::: . : ~' ;:. .. , .r . . , KERN COUNTY HEALTH DEPARTMENT VARXATXON/LOSS XNVESTXGATXON REPORT Facility: /< E/?/'-/ CC/f/MT7 C-,q/1/-96-B Permit' /6 ¡tJø ;;.GC Pacili ty Address: / J.f 15 i /? v Y T t/ /1/ /9 t/ ~ J ß,4 It:' (- /?.f F/ ~ { /7 " Tank(s) with Discrepancy: # 1 Date/Time of Discovery: ~-I-g-r /O;OtJ "1M Name of Person Filing Report: Description Of Discrepancy: IÁ/ t= XCESJ' d'r INVESTIGATION SUMMARV The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: 6 Hours 24 Hours 48 Hours '12 Hours NOTE: 'T /7 ~ 1/1 I/V ~s IJ5~ IrwnS ¡7t/lC~47 (/l'9fil,l1r/é'/A/ + .777~A¿ A A .2;/7 I I 1 I I 11) I I I 12) I I 13) 1 1 I I I I , 1 I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES. OWner/Operator or other qualified person is to Date I 9- 1- c:f"y¡ Time / ð', "/ Cl /!A-o? review records for errors before determining there is a reportable variation/loss. Performed By: ~~/1~~ Owner/Operator must verbally report ~ _ Date I Time discovery to KCHD and follow-up with written I '1-1 -?~ I 1/:5tJ notification on form provided. 4.10'1 Performed By: ß~/ ~~--z- Visual facility check to be pet'fot'med using .( Date I 'rime checklist on the back of this form. I 'f - /- fff I /,'0 tJ ¡7An Pet'formed BY:'-~~ "':-0 ~ --/ /., 4 All product dispensers are to be checked for 1 Date 1 Time calibration, and adjusted if out of tolerance. I I Performed By: Piping to be leak tested using approv~d method. I Date Time Contractor's Name License , Test Performer's Name Description of test performed * * ATTACH £QfY OF TEST RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Date Time Contractor's Name License , Test Performer's Name Description of test performed * * ATTACH COPY OF m:r. RESULTS. * * PERMITTING AUTHORITY WITHIN .Q. DAYS OF . . 2. VISUAL INSPECTION CHECKLIST A. J)1speneera ~~ll dispensers and their end doors visually checked ~~l hoses and nozzles visually checked for leaks. ~ All totalizer seals checked for tampering. tor leaks. Results: -- All dispensers appear tight signature/date -- Dlspenser(s) not tight as listed below ~1:~~~' , ignature/date /1'-1- err r ¡DISPENSER *,SERIAL #ICOMMENTS: I ÂfJ I IV-'J!plllJC'(r¡ r/tI9Cll.'u:J - Plf¡l~NJI/1 ¡.n:Krl7 I I I I I I I I I B. J'ank Area L~ turbine boxes inspected. ~AIl fills and vapor manholes inspected Results: Tank area present. tight with no product 0/ 4'~~~d~t. Tank area does not appear tight because of the problems/ conditions listed below. , . appears or liquid 9' - (-,57 r signature/date I TANK I I I I *1 PRODUCT! COMMENTS/RESULTS: I I I I I I I I C. Piping Type: OPressure OSuction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test (s) above.. with problems/ conditions listed below. signature/date Description '"r', ~ HOUR tLpORTABLE VARIA~ON/LOSS NOTIFICAT:ION TO: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDIlIIG : Facility: I\€A0 éifJc::..,.;t-¡ ~L.t~~~L Permit * I 6 oo~ Fac 11 i ty Address: )c.f S T~~'tU;ù A-v. 84--h::'£.~-s.;:/GL..Q Name Of Person Filin~ Report: L~ 3';(JI-/-,¡..hC..-4N / I~ rJ¡ M~-€./2.. On c¿) 9/;;e, , /'310 . the above faci~ity had an (date and time) inventory variation/loss that exceeded reportable limits as described below: ~ Amount of Weekly Variation/Loss -;.. 185 Amount of Monthly Variation/Loss Total Minuses Line 3 of Trend Analysis "'¡'S Tank # Amount of Daily Variation/Loss , ~"\ I have" stopped dispensing product and begun investigation procedures required by the Per~itting Authority. This notification is in addition to the phone call I previously placed. \ KERN CaNTY VARIATION/LOSS HEALTH DEPJtTMENT INVESTIGATION REPORT Facility: ~~ C~{)\y &~.-£_ Facility Address: ItJ/5 ~~ Tank(s) with Discrepancy: # ;t Name of Person Piling Report: ,L~ Description Of Discrepancy: uJ I'£€k.lf Permit # I 6ØC¡F2-(c C- ~~ Æ.~~¡:.,UF-ú.Q f!:4 ~ '1 'J:?o -r Date/Time of Discovery: 6/tlltf( ~f(.4..)¡LhlJl ~~ J ;L+~k~.Æ.... ) At2.J."..}-lð f.j r~ ~.;Ðr.J€_ ~" .~U£. INVESTIGATION SUMMARV The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: 6 Hours 24 Bours 48 Rours 72 Bours I I I I I 11) I I I 12) I I 13) I I I ç, Owner/Operator or other qualified person is to review records for errors before determining D~ cJ/9 . . I Time 1/3/1 there is a reportable variation/loss. ~ ' Performed By~tI..~\~QJ-"'-- Owner/Operator must verbally report I Date I Time discovery to KCHD and follow-up with written I ~(t7 key I I 31 :) notification on form provided., . ~O ') Performed By: Cf::ßlP~.~b-~ Visual facility check to be performed using checklist on the back of this form. Performed By: All product dispensers are to be checked for calibration and adjusted if out of tolerance. Performed By: Piping to be leak tested using approved method. I Date 'rime 09 leb ¡3/'; Date Time Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COpy OF TEST RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Contractor's Name Date Time License # Test Performer's Name Description of test performed * * ATTACH COPY QE 1§§I RESULTS. * * NOTE: THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN .§. DAYS OF COMPLETION OF INVESTIGATION PROCEDURES. . 2. VISUAL INSPECTION CHECKLIST . A. ~pen.el'. ~~~ dispensers and their end doors visually checked for leaks. ~~~l hoses and nozzles visually checked for leaks. __ All totalizer seals checked for tampering. if-" ' .j cIÞ/(lr~,' '~~~ signat~re/date Results: -- AU dispensers appear tight Yhþß . -- Dlspenser(s) not tight as listed below signature/date !DISPENSER ~ISERIAL #1 COMMENTS: I I I I I I I I I I / I \ B~~ Area ~~l turbine b~xesinspected. __ All fills and vapor manholes inspected Results: Tank area present. appears tight w~ Ä liquid ~/u~ v' , ~(c;·/9fj - signature/date Tank area does not appear tight because of the problems/ conditions listed below. signature/date ITANK #1 PRODUCT I COMMENTS/RESULTS: I ! I I C. Piping Type: 0 Pressure . 0 Suction Pressur ized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above, with problems/ conditions listed below. signature/date Description . _ ._::.J . . FUELG2.1088 ) GARAGO~~tö~~~ t9~80RTH) VARIATION 1 20 --- 100 80 :-. """" "" ,,',' ".'""" , , 6 0 :' "',' , , , " '" .... -.. ,. , . .. .. " , , , ,- ",' -, "...." . ~. " .. .. . ~ ' . . , . " : . . . -" , .. ~ .... , :'.... ..:. .. , . . 40 ' 20- " 0, - 20 ' , , , , " "'" ,. ,., , , ... ",., ,,' " .." " -40 :., ""..""", "",.", ',',...,"",., ."", -- 60 : ,. '" .,,'.,. "., ",,'..,... .. ,.....:...,..~.... , "... . . - 8 0 " '" , . . , ' , , , , , ..... .. '. .".....:.....,..:......",.".....,.".. ", ., 100 ' , , " '" - .' .....:........;........:........:........ ....... ........:....... ........:........:..... . ..... ...........:....... ............. . . . .. ... . .. .. --120 : "..:,...:.,.,:........~....... ....... ....,.,~.. ... ........~........~....... ......,:.."...~..,.".....:.... . . . " .. . 140 : : : :: :::::: - . ...... .:........ ~....... .:....... .:........ ....... ....... ':'... ... ....... .:....... .~........ ....... .:....... ,",....... ....... .:.. -. . '. ... . . " ... . --160 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 . .........,. " I . . " ~ HOUR REPORTABLE VARIATION/LOSS NOTIFICATION TO: Kern County Health Department 1700 Flower Street Bakersfield, California 93305 Attn: Underground Tank Section ItEGARDIWG : Permit. I ~(J():z b C Facility: KERN COV¡(lry ,(;Al!fi6-é Facility Address: 1'-1/5 T/lC/ ¥ 7t7Y A v? Name Of Person Filing Report: A ,t:) k ,e /? J",e" /E /d ("' -"J. On ~ I//?.Y?' / / (J/J ð A#7 ,the above facUity had an (date and time) inventory ~i~OSS that exceeded reportable liaits as described below: Tank . Mount of Daily Variation/Loss Amount of . Month~ ¿c¡ariation oss 2, 00 ~ T 2 8'8'(;.A /, 7 5 ~ r .;., ',yl' Amount of Weekly Variation/Loss t ,2- Total Minuses Line 3 of Trend Analysis o Ir " . 7 (/ -/'1'/1/;/7 "7 " " 75 -¡;/e/~1/ 7 I-' '-have~~pped dispensing product and begun investigation procedures required by the Peraitting Authority. This notification is in addition to the phone call I previously placed. LA RY JOHNICAN, Fleet Manager General Services. Garage Division - .' . . KERN COUNTY VARJ:ATJ:ON/LOSS HEALTH DEPARTMENT J:NVESTJ:GATJ:ON REPORT Facility: Ie E 1tN' C C/VNt-)' 6"-fi/l/9c-E Facili ty Address: / J¡ I S T 11 V X r~rV "'" 1/6 Tank(s) with Discrepancy: . I d-"L Date/Time of Name of Person Filing Report: Peril! t. / h 0 0 :2 b C A,qK~ /?.sF/E LO C~, Discovery: / . I - lrX' /o,Jð 11 ::¡;. Description Of Discrepancy: íI7M/¿ ¡:Z._J rl-2 - EXCE-~ IVr (I N T III Y , V ,q It / rJ '/ I P /)/" 7 f-I t '1 INVESTIGATION SUMMARV Î/-IE /,slP :1:1/_ 2,PC'b The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: I 6 Hours I I I I 24 Bours 11 ) I I I 12) I I 13) I I 48 Boars I I I I -License. I I 72 Bours I I I I 1 I I NOTE: THIS REPORT MUST BE SUBMITTED TO THE - COMPLETION OF INVESTIGATION PROCEDURES. Within: Owner/Operator or other qualified person is to I Date I I .II - / - tf~ I Time / (l,'35 11 review records for errors before determining there is a reportable variation/loss. Performed By, ~ A4~ Owner/Operator must verbally report I Date I Time discovery- to KCHD and follow-up with written I / / -- / -t'r I / /,' '15 A notification on fora provided. ~ Performed By: a ~ ~ Visual facility check to be performed using Date I Time checklist on the back of this form. \ I - / - ff. Performed By: All product dispensers are to be checked calibration and adjusted if out of tolerance. Date Time Performed By: Piping to be leak tested using approved method. I Date Time Contractor's Naae Test Performer's Naae Description of test perforlled · · ATTACH COPV OF TEST RESULTS. . . Tightness Testing of tank(s) to be performed using approved tester and method. Date TilDe Contractor's Name License . Test Performer's Name Description of test performed · · ATTACH COPV OF TEST RESULTS. * * PERMITTING AUTHORITY WITHIN .§. DAYS OF . . 2. VISUAL INSPECTION CHECKLIST A.~l.penser. ~/~ dispensers and the1rend doors visually checked -!~~~ hoses and nozzles visually checked for leaks. ~ All totalizer seals checked for tamperin~. for leaks. Results: -- All dispensers appear tight ~ ~d'....-~ / /-I-ff , s, ature/date -- Dispenser(s) not tight as listed below signature/date ¡DISPENSER *ISERIAL #ICOMMENTS: I I \ I I I I I I I I I B. /'ink Area ~~l turbine boxes inspected. ~ll fills and vapor manholes inspected Results: Tank area present. appears tight with no product or liquid ¿;:?¥-~ 11-(-íJ~ signature/daté Tank area does not appear tight because of the probleas/ conditions listed below. signature/date !TANK *IPRODUCTICOMMENTS/RESULTS: C. Plplnc Type: [JPressure [JSuction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. , signature/date -- Piping not tight based on testes) above, with probleas/ conditions listed below. signature/date Description /' . . r-U E-LG 1#01)88 C;ARAC;t~TANK 1 SOUTH) , GClOBEf 1 9 8 VARIATION 160 ' 140 ~ 120 : 100- " 80 '., 60 ' ". 40 ,. , 20 ~, o -20 . --40 "". ,. . "." ","'." ", - 6 o· "" , ," '."'"'' ,,"'. , ' " . . ,. ",."." ','''' " " . " . . " - 80 : " '. ",' ,. '''.:'''''' :" " ., ..,.". ...,..:...".., "" "...,.......,... . . , 100 ' '" ' . ", - : ...... ':".......: -...... ':'...... .:... .... ....... ....... .~........ ....... ....... .~........ ....... ':'...... ':'...... '.:" . . " ' 120 ' , . '. . ' .., .- " ...... .~. . . ... . . ~. . .. . . . ':" ...... ':'.... ... ....... ....... ':'... .... ....... ....... ':'... ... .. ....... ':'..... . ":' . . .. .. ':' . . .. . . .. , .. '·--140 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 . . . . . . . . . . . . . . . . - .... .. ... ...... .... . .. . . . -" . . . . . . .. . . .. ., . . . . . .. .. ~ . . . . . . . .................. . .. '.............. .... . . -' " '.,. .. .. . -.-. . . .. .... .........', .......... . . . ... . . , . . . . . ..... .. .......... "- J I Î t ( \ i I ) 160016C PEMIT DEP ARTllEIIT INVENTORY RECORDII«: SHEET KERN COUIITY HEALTH FUELS --- - I , J 6 i ---~-~._-.--.-'--------- OCTOBER 1988 ~ 0 1 -69 1 0 -·-:;15------1-0 ~ 0 1 -5 1 0 ~ 0 1 -30 1 0 --111----j~n~--·4--'3--- ¡15 16 17 18 19 _TOTAL IlETERED _AIIOUJIT _ _PERCEIn'_ _IŒÇATIVE_P.OSTIVE_ TIIIIOuç¡¡pUT OVER OR S VARIATION COUJIT COUNT ¡ ÇALLONS GALLONS ~ U , 97 --699 .- 765 691 685 594 '-348Z --·----'-1.--3594 __,__________4-'_ _ IIONTHlYEAR -33 ____,___166 714 717 697 587 U4 11 13 14 _____DELIVE1lED_____IlATE1l, ,__IIIVEHTORY, INVENTORY ÇAUÇIH<ò REDUCTION ÇALLONS IIICHES GALLONS ) 0 )___0____,_, ) 0 0 o 0 o 0 8751 4038 o 0 UllLEADED 1 4 5 6 7 8 9 10 11 OIIoTE_I)-OPI!JIIJIOO¡__,OPEIII_CLOSIJlÇ-ÇLOSIIICò_I1ETER_IIMLY_IlETEII_TOTAL_,_READIJIÇ_ ------ ÇAUÇIHÇ- -.-- _QMlÇIJIÇ o ÇAUÇINÇ INVENTORY IIIVEIITORY READIH<ò READII«: JV:TERED ADJUSTllEN BEFORE AFTER II ZAL£S DELIVERY DELIVERY DAY/HOUR I!lCHES <;ALLONS GALLONS GALLONS <;ALLONS GALLONS ÇALLOHS IIICHES CõALLOHS IIICHES <;ALLOHS 1/701M 7 61 3/4 7158 7191 93813 93751 U 0 ¡r!OOM--1-6.1-_---2.l11l----'1015 93910 93813_ ,___._97--__,_________0_ -_ -,-- 3/605M 2 60 3/4 7025 6311 94609 93910 699 0 4/605M 3 55 1/2 6311 5584 95374 94609 765 0 5/630M 4 50 1/4 5584 4887 96066 95374 691 0 6/600M 5 45 1/4 4887 8338 96781 96066 715 30 44 4713 74 1/2 7/640M 6 71 8338 7714 97375 96781 594 0 -- RElclTorM:S-' --xxxXXXxxxi--xXXxxxXXXXXXXXXXXXX XXXxxXXXXXXXXXxXUxXXXXX: ~xxxxxxxxxxx --XXXXXXXXX PRODUCT 10.000 -.--- CAPACI1'Y SOUTH TAHK ÇAMÇE FACILITY \ . .þ.~ ¡ I: i:: o o 1 1 ---r o 1 4 -0 o o 1 1 o I 1 o 1 o " 1 o 3 o o 1 1 o o -0 1 o 3 1 1 1 o o 1 o 4 o 1 o 1 1 o 1 -9 -131 57 54 '17 -45 131 74 186 65 660 701 680 721 4U 3475 195 196 603 647 -- 663 766 331 3401 o o o o o o o 3933 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX o o o o o o 8577 o o o o o o 4644 73 186 65 660 701 680 721 462 97375 97561 97626 ___98186 9696'7 99667 100388 97561 97626 98186 ___98987 99667 100388 100850 IlEEK 7519 7323 6710 __6073 5,UO 4644 8:146 7714 7519 7323 ___,6710 6073 5410 4644 7 66 1 64 1/2 2 63 __3_ 58 1/2 4 53 3/4 5 49 6 43 1/2 8/6330M 91630M 10/605M 1l/602A11 12/605M 13/61 OM 14/605Al1 2.13~ -28 -9 -6 56 19 -42 68 58 64 22 762 691 666 621 451 3178 91 31 768 63S 647 663 384 ~220 xxxxxxxxx o o o o o o o o o o o o o o o o v o iJ o o o 43 1/2 XXXXXXXXXXXXXXXXXXX 64 762 691 666 621 451 xxxxxxxxxx --1008')0 100914 100936 101698 102389 103055 103676 TOTALS 100914 100936 101698 ¡(j1389 1030513 103676 104U8 -----8Î54 812) 7355 6710 6073 5410 5016 8146 815'" 8113 7355 6710 6073 5410 '7 70 1/4 1 69 1/2 ~ 69 1/4 3 63 1/4 4 58 1/2 5 53 3/4 6 49 ----15/630AII 16/635M 17/608A11 16/609M 19/609A11 _________ZO/610M 21/610AII L 77. 65 -19 26 -49 -31 160 -I 51 87 73 503 693 6.1 616- 636 ),229 n 92 4" 7<4Z 6S~ 456 637 3076 XXXXXXXXX o XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 4705 o o o o o o 9731 o o o o o o XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 64 5026 o o o o o o XXXXXXXXXXXXXXXXXXX 46 1/4 87 73 503 693 611 616 636 XXXXXXXXXX 104128 10H15 104¡e;8 104791 10154f1.4 1061 05 106721 TOTALS 104215 104288 1041'91 1054a. 106105 106721 107357 TOTALS IlEEK 9709 9617 9140 639E' 7746 7190 6653 5026 9709 9617 9140 8398 7746 7190 1/4 3/4 3/4 7 46 1 83 2 81 3 76 . 71 5 66 6 62 2Z/630M .3/635A11 Z4I605A11 25/606M Z6/606A11 27/615A11 Z8/705A11 .) 11. 114 3/4 4.68. -91 o 78 o 170 o xxxxxxxxx o o o o o o XXXXXXXXXXXXXXXXXXX 78 o XXXXXXXXXX 107357 107435 107435 10'435 IlEEK 6483 6483 6653 6463 3/4 58 56 29/700"" )O/700M o -15 675 690 o o o 675 107435 108110 5793 6483 3/4 56 31/610M 13 17 2n 2.0n -14 107 288 753 1"329 660 14041 XXXXXXXXX XXXXXXXXX xxxxxxxxxxxxXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXxXXXXXXXXXXXXXXXXXXXXXXXXXXXX xxxxxxxxxxxxxxxxxxx XXXXXXXXXXXXXXXXXXX XXXXXXXXXX XXXXXXXXXX TOTALS /1OHTH TOTALS WEEK gOUATIO~ 1 ------, - I 2--1 !! r"n DAILy METER TOTAL - READING = METERED ¿AL~ ~ .ß2 _ I ß I - ..1. ~ -:; :7 7- JO NICAN. FleetM,8A8ger I SeeviceseGarage Division PERMIT 11_/ b t? t? .2 C C --~UL.NG sap~T C t:J PRODUCT ' ,.y c. ~ ""'d ~ .P I . _ ... ......n,u.;f TY - '"I(1tJ;-:.. 11-1 G-~~ §. CLOSING INVENTORY ! OPENING INVENTORY ;! OPE1-'· -'G GAUt,. _ -.G ~ DATE . g WATER GAUG I NG - --- ~ - --:-J::-t- ø- II.ÆLa.B· - INCHES -,--- ~._- -- -- --- -- -- ø-- ¡. ! ø -- -- ~ --T-~- -i_____ 12 - DELIVERED INVENTORY GALLONS 'j 03 8' 75 ;;;2LY9 J 3 - 4- 7þ. t;" MONTH/YEAR !l GAUGING APTER !lli&lVE.RY. INCHES GALS 7~2l.L ?7SJ - 97J/ DATE ?1 -- );~ !Q GAUGING BE PORE QELIVE.RY. INCHES GALS t.f]/J '~ J7~.,.'I 'f£7?i1JD 26 'io/- !! READI'NG ADJUSTMENT I - ~ - GALLONS , ! I , , , ¡ Ji5 ~ CLOSING ME....." READING ~ ~ 3 J :/0 ~ ðJ.. .!i ~ '7 7~ JÞd¿;&:. -96 ;¡'o--L: .!2 7 77£. ::! /.S"¡Ç ~ r 7t:2 "9 ¥".2 í"? ~\,~~~ - .J K-.k ,F'.5"t? = ~/~~ J'~¡~ J,~1: ø ~~ 1~Œ .2 72- ~ -L '" li f?//O GALLONS ? /9/- ?(/2$ .h ] / ?:.. .£5 ;:-~ ~ ..27/~ .2 ~/1:. u ..2.I. ~7;o I 0 3: s y / f!:... ~ t 'f ð-2~~ ~/S¥ -= ~I ¿;] - ./.?S5 ~laQ . i~3{ -E-1£ pß '.:!D 7.13 IS A TRUE AND ACCURATE REPORT - ~TIPY THAT THIS '\. /6/86) \ /~7~/HOUR ~ .1.. - r; 'or ~- ;';'v}d ~A - ~ 'Jð -'-- - C~ -f- ~t/ðA -.::- (,71 - L- '1'" L1. !. I? ; " .d.. /()-£~ ~ ~ ß -0 L:t - 6.ï 0 -4 '1- (úS - '! ~ C'N )¡ ~ ~ ~ fi;:fj-i-tL tt-tJf1 .. 4 2.£.-- :0 ~" ~. '() (p 2~ 2' ,~'o) . \;éL f .~~ .\ ¡ Kl.. _~N COUNTY HEALTH DEPARTMENT' ¡ INVENTORY RECONCILIATION SHEET I I TANK * I CAPACITY OOtJ PRODUCT r/Nf II PERMIT * I b ffý 2 6 C MONTH/YEAR , (' Qf/NT)' /< F7l N ¡ í I i t 1 ! ¡ 1 ! ¡ ~ 16 AMOUNT OVER OR SHORT +GALS -GALS. +9..5 -- - -~9 -:::¡:j I \ ~ ..,.J. -~ ~ "3'0 .... ¿¡ t; =~ ~ :::...1- -¡,7/ - " EQUATIO I 15 =:J 14 ¡ TOTAL METERED _ INVENTORY THROUGHPUT REDUCTION GALLONS GALLONS 2 -jJ 6 or ::::.L -:î.2. ~ tS-7 tr:z: .J.... L.:lL 74 2 ð'~ N 4 L .J-?r r?? 1/2- +1/;:,6 ,~ , +f'J 1 15 TOTAL METERED THROUGHPUT GALLONS 6~ 1l 59 c;rt /;2 ¿¡ 6S ~ 72/ J.f ~ Z- 7 ~ 75 #£ ¿¿£- Z..:z. ¥ 7 ª- 5UATI ~N TOTAL METERED READING SALES ADJUSTMENT OMS GALLONS 111111111 L/I /I /I / 1/ /1//1 / / III/ILl I ..,. J ]..1 :3 I 14 INVENTORY REDUCTION GALLONS -1.3 ~ /.77 617 5"8'"7 H:L M %§:: ~ æ 1 7 -+2- t h90 Ilfo"fl /l "?!.- 7.5 19 J1;.3 1720 bOì} ~~~ r' 'I- 1::~ ¡; 7 ., ~ EQUATION 2 I 12 ~ = DELIVERED CLOSING + - INVENTORY INVENTORY GALLONS GALLONS 7/ Ifl 7Q¿.5 63// sSý~ ~)j'8 7 3-.J 7:;;- 77/'1" I '} " 'If) '~53 ft ¡.; Y!? .!!m!IßL Y TOTALS Env. Health 5804113 1017 (6/16) (Front 2 FACILITY DAY/HOUR ~77i 2. -1:~ 0 I"f J-~nA 't- ~:V 5/f 5 - ~:3~A- L ~'v6 .~ 7- 'Yð A ~, ~ (fI- ~ti )"t)_ 11- ~"]A f 7-- b:05 Ij-~" ~ ILf - ':fI J a&.~ ~3- :.3.c: ~~ J~ lft,·,:~r, ,,')~ /";IS' J '{ ~/&5 2 I J 7.'(/' J - }"f/6 1/- ,:t(j 15þ3M ,(,. ~ ¡fA 17-~ur,4 ~'fl1A ICf-G:oCJ t .20-b/OA JI·C'loA ! DATE ./ .\ ¡ ¡ ¡ INVENTORY REC;QNCILIATION S~y ... 11 A. Percent Variation ( ....u\lt~~.' ", ¡..:-'I,·, rl/2... . S 9' ¥ I Gals. x 100 = 3 II A.ount Over/Short (Col 16) Gals. · Total Metered Throughput (Col. 15) % Variation -""" ¡ B. Reporting: I 1. Does the ~ount OVer or Short exceed 350 Gals? ~MO - Continue routine .onitoring ¡ DYES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? ßJNO - Continue routine .onitor1ng DYES - Report to per.itting Authority within 24 hours of discovery. 1IIŒIt 21 \ A. Percent Variation: ¡ A.ount Over/Short (Col. 16) +7'f Gala. · Total Metered Throughput (Col. 15) J 'f ? 5 ¡ Gals. x 100 .. 2 I J 2- % Variation T B. Reporting: ¡ 1. Does the Aaount OVer or Short exceed 350 Gals? ,3B0 - Continue routine aonitoring I DYES - Report within 24 hours of discovery ~o DYES \ 2. Does the Variation exceed 5%? - Continue routine .onitori02 - Report to Per.itting Authority within 24 hours of discovery. IIIŒK 31 ¡ A. Percent Variation: Aaount Over/Short (Col. 16) t 51' Gals. · Total Metered Throughput (Col. 15) J ¿ ? ?' I' Gals. x 100 .. /, 7 ~ % Variation B. Reporting: ) )0 NO I 1. Does the Aaount OVer or Short exceed 350 Gals? - Continue routine .onitoring , DYES - Report within 24 hours of discovery I 2. Does the Variation-exceed 5%? ~O Continue routine aonitoriDK OVES \ - - Report to P~r.ittinK Authority within 24 hours of discovery. -- 41 I A. Percent Variation: \ A.ount Over/Short (Col. 16) 1"'/ ç I Gals. · Total Metered Throughput (Col. 15) 322 r \ Gals. x 100 = 4,67 % Variation · ) B. Reporting: I 1. Does the Aaount Over or Short exceed 350 Gals? ~NO Continue routine aonitoring I DYES Report within 24 hours of discovery - I 2. Does the Variation exceed 5%? ~NO - Continue routine .onitoring DYEL Report to Per.ittin rity within 24 hours of discover , ..ul I - A. Percent Variation: I ,,-- - -'~'-- ~ion f 2 1ft ¡ ---- ,. " 00 Amount Over/Short (Col. 16) Gals. · Total Metered Throughput (Col 15 It.¡ 32 Gals ,,"' ,.2 B. Reporting: --- Does the Variation exceed 1.5%? DNO - Continue routine aonitorin: ¡ r.it rity of I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT . OATB ~ - Env. Health 5804113 1017 (6/86) (Back) ,,-;;:.r .~ \ I, . '. 7 ;\. \ . . F U t~_l__ G 2 0 0 9 8 8 GARA(~E: 'TANK#' 2 (NOR-rl--I) S I-~- fJT [~MÐJ=R 1 (18 r) '-_ ._ r L_. LJ L_ '-_ () VAr\IATION 1 OC) '---'---'. .-.-.--:-......-. ,-....-- -,-- ___u,_. --,._-:- .-----. ......-..'..."...----:--'--.-:--..--- -' -.-,..-- _____.'_d__.. 60 ~' QQ , u-" ' . ....... . . .. ... . . . .. . ... .... , , . .. .... .... ....... "~I: . . . . ,... I" I 40 . 20 ~, " o ... ,. -20 :.. --- 40 : .. ..,.... , , ...,.... .. -.. . ........, -.. ,',.. -.. .,. .. ,.... ... '".. .... ... ,". . ....... ..-. ,', .. . --60 :- , . .. . ..... . .... ...... ............ . .. ...... . ....... . ... .... ....... , . . . , ..- 80 : .....:......-:" . . . . . . . . . . . . . . ~ . . . . . . . ,". . . . . . . . . . . . . . . . ", . . . . . . . . . . .. ." ~ . . . . . . . .'. . . . . . . . . . . . . . . . . . .. ....... ~ . . . . . . , . '. ' . .. . ... -100 _..1.--1 I 1--1.----1-, 1 , I I I I I' I I I I , I I I , I I I I ._L_.L- 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 "' ',- ...; '¡'. - { / 6."Ø':2 b G " PERMIT # . MONTH/YEAR .' , ( , " kERN COUNTY HEALTH DEPARTMENT INVENTORY RECORDING SHEET 2. CAPACITY /OJ 000 PRODUCT VNI- {".t?~1C7 ( ( k e IVtl -- 11., ... . ; . 9 12 13 READING DELIVERED WATER ADJUSTMENT INVENTORY GAUGING - GALLONS INCHES - - - - - - - - -- ø- - - -- ~~~S 7b7~ ~ t:lvS --.--- '11 ~2 ~~':'/é) -,..-- - JlJ , ...... : /' ,:1 /;hIG2)_JI ~,/ ,:.- , ,'. 'i,'-:- , . ~1.; Z . ~ :":'" :.- . . ø ~74 37/' 66 77/'f J 9r - - z¡O' ~ 'fzC / 59S/; t r !! TOTAL METERED SALES GALLONS fh'l I.ÿ r (/ .z.Z~ I ?'O ~7r 70 ..3flf' =ill: 2(:10 ~ ~ 5"~S /9ð .2.3 r lli= ~ ~o ~~" 9" t/ <T 701 ~~ 1.2- EQUATION 1 §. I 7.-l. CLOSING METER DAILY METER - ... _ READING READING GALLONS ¡; ý("? 2,4f ;:. r 7,'T ¡.r::{f12. 5-tll2. ¥ 6 2 9'i' 9'6'1r-9-" e755b /?'~'7lK-r 8'"8" 995 ý"!/1f5 '?"1;l 73 r'l f?'31 &ft7~3.2... &f J :;..~ 7 q ¡ tf2 7 ~.7~~ 2v ~ 2 'fC;/J if 15/'1 q I.f 11 '-t ~ ~ ~ 7 J 7J q !'(i7 '1 ?' r;.3 :z. '7 ~ 272 JaOOð¥ TANK , §. CLOSING INVENTORY t1.I1/1vé COVNr7 ! OPENING I NVENTORV ª OPENING GAUGING 2 FACILITY 1 GALLONS F~~.rS 1'"522 ¥ 1r'S71Jor Ý 5'13;¡ íf' ~" 2- f'~2srr 8'"Þ iT 5?' 3'7sSe. ~? 2 tf-9" 8-~"45 f:9/ ¿¡S " 277 ?9G;y¡ 9()6.72. q /;¡ r7 '11.,27, q 2 ¥72. 9Z¡;¿2. q 2 ,,/l1J ~"1 r"J 7 ,,""it / / 9' ~tr7b'Y 5JJ' ~ ~ 9~o73' 9 r~ :/.2- q 42 72.. GALLONS 8'-J?r )rt;J: ? 'f- rG 712 -., hGÇ'J (;,017 ç' ~Q 5" if ý~ 'r~'I1 4365 g-ttSCf [7/Y 9 '10 ~~/~ 51"~C, 5 ~ 8'9 ç" ¥¥ "'7$J 't227 ~ ~ ~~~ y t1 fJ12. '12. G/ N~l '¿f 'f INCHES '11 7/ ~ 6J 59' S'? 1/2- LI l' '1-1 'I "II/..¡. 4 2 3/'1 't J '/L. ' 72- v¡ f, 0 /~ DATE DATE SIGNATURE ~~ '~LARRY JOHNICAN. Fleet Manager ~ tY V" General Services. Garage Division I - / I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT Env. Hulth 5804113 1018 (6/86) PERMIT # / 6 ..- "ø _ ~ c , MONTH/YEAR KE__N COUNTY HEALTH DEPARTME.....T INVENTORY RECONCILIATION SHEET TANK # 2 CAPACITY 0 CI 0 PRODUCT ,- " : ~,¡ :¡ 'I -, ,;I , -.:j ,_,o .___....~ EOUATION 2 EQUATION 3EQUATION 4 1 2 4 12 5 14 8 I 9 I 15 15 I 14 I 16 DATE OPENING + DELIVERED _ CLOSING = INVENTORY TOTAL METERED _ READING = TOTAL METERED 1 TOTAL METERED _ INVENTORY = AMOUNT INVENTORY INVENTORY INVENTORY REDUCTION SALES ADJUSTMENT THROUGHPUT THROUGHPUT REDUCTION OVER OR SHORT DAY /HOUR GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS +GALS. -GALS. 7--c,'}CJ4 ~¿'1fL ~~L.S g-y..J8' 5B"/ '-<S'G'-" S'b''? St:'" ,55-/ -/2 2.. - b,'1 'fA %JJ:B 7 q 3 7 l/ I'J L ,--'" '-I %-1) 't 8"0 .., 01 ~7 '1 3-& 'J ð A ? 93 ? "7 7/ ..¡ 2:2 ,... :2 2 -y 22 K 2 :2 r ';)-,),3 or >5 t.¡-¡','?rJ I 77/~ 7LfC"'- z.2.~~ ~O I XI.. } &,P :2.2Y -~¥" .!.Jø; A 7 'I ,,"" "73 ;L ] / Á ~ 7 c., I" 7 G / ~:1 -+- L"3 £-61> 1 7J.2:; ¿¡S3 t70 /,,70 6 7'1/ ~ TCJ "670 -I-t?J 7-~.2(U1 ¡'~5.3 COJ7 t/6 (c¡y 5 'jR' SC¡K e:,/~ -Ig' WEEK 1 TOTALS 7 ~ 1('2-- 1/ '//////1//1////1/1//////////1/ / G tl / '/////////////////////////////1 J 'I { - b.1I A '0 J 7 ! 3 c> 5 732 7:J 2-.. 7 2-. I 7 -.J 2.. . 7 J L ~C; , -r - ~J / A 1} ? n '7 1 If Y 5' r 7 h '>7 ~ .5 / C, 7 ç 5 7 J 0 () 1{)~t.JIA ¥,?¥;:-- 45'1/ '(;17 2tl~ 2P~ 1201' Zl/7 -7 //-(tIIA q5'!/ 'r.?Þ3 J7G 12Y /2ý /21{' 17(, -'Y 12~~:/J~ I.IJ'"' t-fC £tv v1f5~ < ~h 5j{j S",rR ççlJ ~4b .,L/J.. /3 - 6J 1 A r~ .5 1 ? 7 / ~ 7 9..5 C7 17/ ~ t? I g--t7 / '7 ¥ S -r 5 ~ l'-t ·tlJ1 A 7 7 / .." 'l 1 {¡ n 7 7 I (.1 ~ 5.s b. ,S ? ~ 0' -:7 2 '¿' - 6 1 WEEK 2 TOTALS (, r 1 // '11/1/111/111/1, '//////1///1/111 17 ? / / //1/1 /1 /I 1/1 1111 1///////1///1 ~ I.J Is- l.!' ~ 9 t? CI ç '-II ¿¡ 7 . ~'? 4f 0 b ~ CJ t ~ IJ -' 7 ~ +-- fÍ' ~ -&.)0 hCf/~ I)ef~~ ~~",I""'" '¥'i )'-/..5 5'~.5 ¿,¡;tr -I-~7 ~y.... 7.~() 'I '?"1, ç ~ rq ..? / '? a I itf () / ~ () ~ 7'7 - r 7 1!f- ~'PII -¿ ¿ ~ .,. c; y.., y , '1'.) 2 7J.", J "'t v" 2 j 9" :;. ~..s - 7 'I - -,1· ¥.~ 'f 7 f':J I.. t' -¡ ç / ' ~ T7 6/ '7 £ ~ I - ~ LJ ./ (;- ~ .' v " .... t..r:2 .2 7 S.5 (d S ìJ ... ( 7 5" f 7 r;-.5 ð ..J- 'i J ~ .}- lYJ ~ Lf72. - ] 9 9 f(' 7 S / 0/ 7 ? (¿) , S S " ,.. t? f S '7 0 {~ - f'1 WEEK 3 TOTALS 3 'f" 'f I' / ¡ 1///1/////// '//1/1////////// '] LI ~'2- ////////1/ 1/// / / / / / / lIlt I / I //1 +1 '1 );;~ç,.'2r4 7)/~ b9r() '124 1J¡¿,7 ..>67, 52~ -t3K ' 11-{/1//1 ¡;ffl fo?Þ.JI 'Þ"7,) ~ I~ 7/1 7J7 (p,/'1 + tfO J\.j -Î~AI1 t'o ~ £9bb 3t/._ ( __",0 ~o ~ 0 3~ - ess 2< -Io3fllM .5'9(,6 515e ~of: ;¿$&. #l.~L/.. £1./ :J...rJPJ + % :Jl. _~Au... ;Ç"¡ ( ~ ¥~" 2. 76(. ZrCl i'""" ~ ?" oB' /. ~// '8 7 ~ g '../-4- 2 - ? 7. C.I ~ A /.f 4 q Z- JI ¿ ç 1 7 :> / . 7 7 IJ I 7C1 .¡ 7 :? / -.:- 3 Q 2g--'I05A 42'1 ¿c-¡~s 771<-1 ¡;ú2- ~ 7C ~Slf5J,¥ ço2- ~("? WEEK 4 TOTALS 7c'() III, /. /////////////////////////// -< X-l ,~ ///1/,'//////////////11//////// /1 (J '1 J q. ¡/f r A 771 'I 7' v r I ,.2 7 & 'I' CI , ¥ c/ ,q ~ ¥ Ú r, 2J I +- I 7 ?1)-£,t¡rA 7,Jo/I ~ ?y(; ¥-( 7 72- 7 '? 7'7 2- 7¥.5 -/J I JlONTHLV TOTALS ,I tj] & 6 /1////11/1////////////1////////// / 5 j If") //////////1///1//////1//////// -1-/ H'3 E C (¡ vNr Front [fll.l 1017 (6/86) FACILITY Env. Health 5804113 . . - INVENTORY RECONCILIATION SUMMARY DItK 11 I A. Percent Variation 0~ Amount Over/Short (Col 16 -+- I c¡ Gals. . Total Metered Througbput (Col. 15) 2 c¡ 0 I Gals.' x 100 = % Variation .L - -;- I B. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? ES-NO - Contiuue routine aonitoring OVES - Report within 24 hours of discovery 2. Does the Variation exceed 5~? ~NO - Continue routine aonitoring DYES - Report to Per.itting Authority within 24 hours of discovery. ~I Percent Variation: ,L{ I( Amount Over/Short (Col. 16) --J--- Gals. .... '-"7 "' I I /7 % Variation . Total Metered Throughput (Col. 15) : / ;;J Gals. x 100 '" I ' B. Reporting: 1. Does the ~ount Over or Short exceed 350 Gals? ri!J.NO - Continue routine aonitoring OVES - - Report within 24 hours of discovery 2. Does the Variation exceed 5%? I!JNO - Continue routine aonitoring DYES - Report to Per.itting Authority within 24 hours of discovery. 1ŒEK 31 I , A. Percent Variation: Amount Over/Short (Col. 16) A") '7 Gals. Total Metered Throughput (Col. 15) -.; 4t ?__/ Gals. x 100 = ,37 % Variation B. Reporting: 1. Does the Aaount Over or Short exceed 350 Gals? flfNO - Continue routine aonitoring DVES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? ffiNo - Continue routine aonitoring OVES - Report to Peraitting Authority within 24 hours of discovery. ~I 'i (Percent Variation: Amount Over/Short (Col. 16) ,,¡- IcJ3 Gals. . Total Metered Throughput (Col. 15) 3 yc. '3 Gala. x 100 = .;.r;c; % Variation B. Reporting: 1. Does the Aaount Over or Short exceed 350 Gals? cBNO - Continue routine aonitoring DVES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? I!I NO - Continue routine aonitoring DYES Report to--Peraitting Authority within 24 hours of discover JDmII A. Percent Variation: Amount Over/Short (Col. 16) T /53 Gals. . Total Metered Throughput (Col. 15 f Gala x 100 '" I ~ / 1 ~ Variation B. Reporting: Does the Variation exce~d 1.5%? mNO - Continue routine monitorin DVES Authority within 24 hours of discover I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT SIGNATURE DATE Env. Health 58041131017 (6iBf,) CR., " i ï6tJtØ2~;'1 ¡ ,,..;,~. .....,PERIIIT JUNTY HEALTH DEPARTIIENT l KH. ":NEET FUEL:> INVEl/TORY RECORDIlIG -- Z 3 4 5 .$. 7 $ 16 11 D OPENIlIG OPENIlIG CLOSING CL03H1G METER DAILY METER TOTAL READING GAUGING GAlJeINC (tGAUGItIC---nIVEtITC'RY-INVENTCRY---READHlG' ----READING- --HETERED--ADJU3TMEII--¡;EFORE-- -lIFTER- 4 SALES DELIVERY DELIVERY INCHES CAlLONS CALLONS GAlLONS GAlLONS CAlLONS GALLONS INCHES GAlLONS INCHES-' GALLON$ 39 3/4 4126 74 l!Z -.-- o --..--------" o o I! I! J ....-- "L-.~,.,,~R_'El------ ~ 16 17 IS 1 ~ TOrAl.. METERED AIIOl'NT PERCENT NEGATIVE POSTIVE '--THRO\)Ç pUj- --OVER- OR->-'lARIATION- CCUNT-(:OU!IT--- I CALLCNS GALLONS % .. IIONTH/YEAR' 14 INVENTORY --REDl'c:TION ---PRODUC'-UNLEADED 12 13 DELIVERED WATER '--rnVENTC¡¡r----CAl'GIIIG GAlLONS INCHES II! , ø"l! TANI<¡¡- ,;;;3:l~'n };-------------CAPACITY niCII:I ..-< \ , 3 I! 1 '-----1- I! 1 I! I! XJOOCxxx~xXJu\....~~.xxxxxxxxxx--xxxxxxxxx- .832 ~-1-r------ ;:_6'%---~$ 1 I! eO. 1 o I! I -lZ 79 ~-,'- -4S n o -IS ~1·7 4$0 Z2S I$I! 176 670 ~\'$ CAl..LONS ~$1 401 ZZ3 223 Ilo3 671! 616 ø 4'(~25 ø " o ø I! o 8~1 o -'-It ø ø I! ø ~I,7 4:30 223 181! 176 6711 ~~8 DATE DAY ¡HOUR '5 41 4294 $338 35224 $4655 (-. 71 ~¡t3.8 7?37 3~ï~4 $522~ -7--67-374-7937-7714 ---85932----85704 1 66 7714 74$6 86112 8~?32 2 64 1/4 7481, 7323 86288 86112 3 63 7323 66~3 ;3ó?58 $62'$$ 4 ~8 6653 lo037 37~~6 86'158 UEEKliOTAl3" 1/1·30A11 2/61~AI1 316~ØAH-' 41 ¿~ØAII ~I7ØØAM 6/64~AII 7163ØAII ! . C' ø 1 " .' I- I ø 3 ø ø I I l' o 1 " 10Ø -7 -.4S -\.2 ~b -b7 7~2 ·~,57 2t'Ø 12~ 5~8 301 ¿':S5 313 7~Z S~7 207 In ~46 745 724 3637 o o ø ø tI 4(040 o o o o ø ø '--?tI0, o I! I! ø " o ---436~ 7/. ~I o o 7~2 0~7 2ØØ 1~~ ~~$ ~01 b~~ 37'5'56 :';~28~ 8894.5 ~?1 ~5 ~--- --$?'Z7?' $'ì~~1 1"0(,,32 ~82$3 ({3?4'5 ~~!4~ B-?17~ ------~~~31 ?Ø~:<2 712$7 ~30~ .$74:'3 4541 4.3-!-5 --34'57 7714 (,\'~ø g/¿l1AH 5 53 1/2 ~.Ø37 ?lbl1AH {~ 48 1/4 5~0~ 10/(,30AM 7 44 114 474« 1l/¢3ØAI1 1 42 ~/4 .i54) 12/(.15AII----:<-41 rJ2---'4,¿'5- 13/~l1AA 3: 72 :3:45? 14/0Ø2A11 4 01, 77\4 - .. , 18t ------- __---1------ o 1 1 ø I ø l ;3 ~ 1 I 0 44 ----M- - ?7 -~7 -44 "1 -~1 1:3 040- 545 1?0 2~~ "'7 517 ~:5~ 3432 --~7~ 44« 277 ~4~ /.1...1 :.% 700 xxxxxxxxx --0" ø .. ø ..' " 3?9$ xxxxxxxxxxxxxxx:, )(Xxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxx¥ ~xxxxxxxxxxxxxxxxxxxxxxx --0----- o a ~ o J 7714 12 xxxxxxxxxxxxxxxxxxx --------IJ'-- ø o o ø ø 3716 M 41 xxxxxxxxxx ----7tZ~·--- --~(.~ø ?1?27 545 ';>2.472 l?O -:.::~.{.<: :::'~'f. ì2,'ØØ 1.1 ~ '-/:<~17 :,'}7 94114 6'5'5 xxxxxxxxxx 4EEK 2 TOT AL$ --(,414 - ---, h, -71\'27 ~1~,~, ?2472 ~(,«9 ~. 2l.,,:.,2 '.5-4.44 ')2?0~ 4 78';( 77.~17 4227 74114 7'519 ?47é-? "EEK 3 TOTALS 12------(.7911 14 ~.414 ')'?(.(. :'':·37 /4 ~444 12 -'7$3 12 4227 --I'5n03A11-S-U- 1~/~30M \.~ 5\.~ 17/70ØAH 7 '53 l$I7~{'>Ai1 1 51 l'ìI(.'3~AM :: 41 2Q'¡.I·~·Øß¡1¡M :< 4.$ 21 I (·09AM 4 40 c :< I 1 ø 1 I tI ¡ '5 1 o 4 o ø I o ø 1 Ø.:-<7t ~3 40 -$~ 'Co 4-:= -:-{~ n 10~ %7 717 2!·Ø 2~.\ ~e(~ 7~1 ~~4 ·:'3~::< ~4{"7 52? 07? :34~ 203 7(,(, 731 '5Ø2 :~7·~ø xxxxx~xxx Ø ~ {í o o o t' ;'~5 o ø o ø o o ;:!'zH· Ø o ø ø o ø 42(·1 ?l~ 8/4 xxxxxxxxxxx~xxx~xxx ~1.,7 717 21,0 2~4 ;-.¡ø~ ìØt $54. 9471...<t ì53:'~~ "Ì~05~ ?~·81~ '?/:.$¿·9 ?7 ~77 ';'8073" ?~3.~b "1.S05~ 'f'~.?15 ?.t-.~,$7 ~7~77 1"<-<078: '"/8~·~2 Tc>TALS 1,770 .:.~311 5'ì1-t. 57~:3 49'9'';:! 42,\1 7714 7519 ~·~j?0 ¿811 5?/,'::- '575(-< 4')')2 4261 12 12 12 12 2-/4 S /,4 {, ¿ø 7 ~~ 1 5~ :! 51 ;,,~ 4(~ 4 40 22/l.25AH ~~/611An 24170ØAn 2'5/631AI1 2.~.! ¿·0l·AH 27nl'5~tí 2C< n0~AM . , . o 1 .t>17.. 17 -13 ó4Ø 732 623 74~ ~~~ux~xx ø 70 xxxxxxxxxxxxx~x~ ~xxxxxxxxxxxxxxx~x¥x X x~~ o ø .. o o o o 4-ø 2./4 xxxxxxxxxxxxxxxxxxx (040 7:32 xxxxxx~xxx ?${.32 '."19272 7n72 ! ØØØ04 ~EEK 7091 (..~4":~ 7714- 7071 4 b6 bl 5 ,'" ~7Il.3.BAt1 '30U~15A.11 " -' fJ.Z9't "' ~<{ .....,.., ~?4"1 :?:t.$' 5 ~xxx~xxxx :~:xn''XX.xxx xxxxxxxxxXXX~X"'~xxxxxxxxxxxxxxx ~ ~~¥x~~~ ·':XXXXXXXXXX.J:·;((:X X'i \: ~ XX'X.xx ~xxxxxxxxxxx:, xxxxxxxxxxxxxxxxxxx x x_~):x.xxxxxxxxxxxxx ~xxxxxxxx~ '';X:~XXXXX)::X ~EEK 5 TC>TALS T(JTÄL:"; MONTH I I ----1 ,I PËRtlIT'" 16Ø26C CCUNTY HEALTH DEPARTMENT FlIEL~ HIVEIHORY RECORDING FACIl::!T~~~) rANKT wl~=~~:': -----CAPACITY----- ~HEET KERr - -----·--lKIrUHIYEArr-----' _;o!~!~" -PROoocr-tINLEADEJ) 10 '11 12 GAUGINC GAllÇING DELIVERED -ItEFOR£,- 'AFTER-III\IENTCR'f-' DELIVERY DElIVERY INCHES C.ALLONS H ÇHES' CALLONS CALLONS 1/2 10';000 23 4 ~ b 7 8 DATE D OPE!!It4C OPE!!INC CLOSINC ClOSINC IIETER DAILY IIETER TOTAL READINC ---O-CAUGINC-INVEIITORV-mVENTORY---- READING-----READINC·- --HETERED--ADJUSTJ1EN- !of SALES DAY IHOUR IN<:HE$ CALLONS CALLONS C.ALLONS C-ALLONS C-ALLONS CALLONS ? ,~ j -5'1 1" 124 ø 1 --~~---I"-tl- -32 1 ø -~~ 1 0 ~2 "1 21 "1 --2771O~I\r--0';(,n- 84~S Z:?$~ o " ,,---,,-- o II o 0 o 0 o " '4505 72 112----- I' ¡r---- I' 8 8 8 42 /,84 ..~\? 175' 68 o 71'7 747 79405 78901 81'074 7741'5 "-30'21·9-31'1.174- 80337 $62,$1 $8337 81J337 31"44 88337 317?! 81144 ~EEifT-TOTAL$ 1//,30411 5 43 314 4~79 7999 2J614AH ~\ 63 1/4 7??? 7454 3-"'30AN-,6'4 7454"-'19C 4 I 630AN 1 62 71'11 7ß?1 5n0øAII 2 [,1 1/4 71'91 71'25 6'615AN 3 61' 3/4 71'25 6330 7 ¡¿2øAN 4 56 63$0' 5654 . 1 ø ø 1 ø 1 1 ø ------,.------ø-------..------------ ø 1 I' 1 4 ¡-, ø ø 1 {4 ø -~ 42 11 -40 -23 3b 3 --ø- J , ø I I to- 4 1'.55% o 144 -2~ ..< !.;.:C -1~Ø -12 W~ 7'/a 61'1 145 77 '722 347 5'10 ;:13£10 A?"2 .4')4 l~c; ~8. ~~., 7?~.. 101_ :{2{-<3 301 551 134 137 '~ø- 311 537 ø II " ø ø 3913 " o ø ø ø ø 1/4 -737Z-·---~-- ø I' XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 0' 0' I' I' 395'-67' I' 0' 7';'$ (,0'1 145 77 "7~2 $41 590 3171:/1 ~<2~$1' $:<190 :3~~35 ----~~32 ~41~4 35001 3253'1 B-3l?" ::<::-t~3:5 ~!-t432 --~4154 (-<5001 $5~91 4353 421'4 41(,0' 40Z3 ---7171 ~~~~ø ~7n 5654 4353 42')4 'Ii,(\ --- -41'23 7171 i.33ø '3/4 U[.11AM 551' ?/611AN 6 45 l0'I/,?-ßAK 7 41 ll//:-~ØAH 1 40 YZ/615AM --~2-·39 13n,l1AH 3: ô2 14/60'2I0Il 4 5lo 12 '38 3777 ~3'" 52Z 1~7 ?':. 63? 30$ ~ :?~Ø9 XXXXXXXXX ~ ~ '.\ 0' ¡¡ ø (.3 ~ (4. 4~'3:? XXXXXXXXXXXXXXX~XXXXXXXX,~XXXXXX~XXXXXXXX .- ~ ø ø ø ø ~ 7422 ~XXXXXXXXXXXXXXXXXX ----e· 0' ß ~ e (\ "-2883 {.;:t~ .1""/.1 \ '~~5 r,:-<. 7'Î,~~ /,14 XXXXXXXXXX ----~B'55'11 8·~,22:< -::::/..,71"; ,;,,":·5;: 8~)'ØS ;'¡;74,~,4 3$21,O ~EE" 2 TOTALS ----5::tØS-- - ----(-«(,223 4 7::<-« :'~~,717 4.(.4.-'\. B(.~t;2 . .~~Ø? 8(-,'/35 :jS>2'ß ~-t7~"':,4 :.(112 8::-t2~·Ø 7323 $8$74 TOTAL~, -579,'" 53Ø~ "'1~~ ..1..$4J. 4(,09 ~?2~ --"-3112 ?¡4 1 (4- iJ"¿ .1 /2 1/4 1 ¡~ 1/4 --1:5nß3-~K--Ç51- It-/.$8ØAt1 (, 4:'< 17n~~A.~ 7 44 1{-tt7;,~'JA;; 1 -4;:: 1)' I {.:-:foAii "2 4~:< 2(".~,Ø?~,¡; :< :.:;< --~----:a¡{'CBAH 4. :?:~ " ~ o ~ t I 4 I' 1 1 ø ~ \ ~ o 3 1 0' (-t. ~5't 274 -43 r/~{ -110 4-' -17 76 ion; 57,~, 171 1':,:-« /,~~ .~..-" , ~-{~~3 ì~!"-t ..$77 231 1"4 ;\(.~ :.? 1 /.~? 3'~.12 :~x~xxxxxx ~ 0' " ~ 7ï t..(.77 XXX)()(J(XXXXXX~X'XXXXXJCXXXXXXXXX~ xxxxxxx xx (\ " ø .' ~ ......11~: ø J 0' ø o ~ ~4:~{. ?:0 1/21 ~xxx~XXXXX~XXXXXXXX ¿~.'~ 57,:, 171 1 ~;:.( <'.4~ ·:"~7 (,'"','1 '.('(xxxxxxxx ::-«(o({-<;-1. .?:'i~.).) <'ØI<5 -:'~::-Cl( ~'\';41:~ ':'11P ;'1771 :::-:')'~69 ',)~1~~ 9~31¿ ?('i"~,? <'1114 r'1771 ~:~/.;: ~EEK 3 ¿~$~ ôhW ~327 ~728 50.t.l " '470 ~4-;38 7~-t2~ ...:.5(-15 ¿lC8 5:327 57::~ 5Ø61 C.47\"1 /2 1 1< 1n u:,. 13 14 15 16 17 13 1'1 I WA1ER INVEIHORY I T01AL HETERED A"OUNT PERCENT ~E(,-ATIVE P()$TIVE GI\t'GIN<;--RE\)lICTIOrr-r-TNROtlGHPl.IT---CllEJ< CR-g-'VARI AT I CN---COOtn-COOItT .. I NCHE$ GALLONS I CALLON$ CALL(IIj$ :t 663 61'4 0' ~45 66'1 --- --2/,3-------195- 11''' 6::< 66 " 64~ 707 726 747 -""XXXXXXXXXX---'''XXXXXXXXXXXXXXXXXXX-X)(XXXXXXXXX)()(XXXXXXXXXXXXXXXXXXXX)()(J()()()(X-~XXXXXXXX----?3ß8 5 1~,3 .::. ~7 7 54 1 ~:;: 2 51 :~ ~.~, c. t,.:: 2'2/ .~2'5A" '2"2</·~,11)'M 24¡7~CArI 2~/":,;<1Äf'I ZL./(,Ø(,A~ ~7/:~·i5.1M ~~/f..:,}~,;"~ 1., \" / 12Y. '. -7~ ~4 (-.1;.7 ·~22 742 ~3.C-< XX~XXXXxX ø Ø ø 0' ø < 0' ø .-, X~XXXXXXXXXXXXXXXXX <,(,7 ~,:;:2 ::o:xxxx-xxxx r,'24(.;Z ?-:<t2r, TOT ;LS ';':";127 ?'37S1 ~EE!( 774./j 715.« (-<4(-<$ 77~~ 1/4 1/4 77 ('b 5 2'7 I ~.~<-tAM 3:&1/-.:H'5AM .' .' 1$% 2.Ø:'-~ -~ -4 ~12 ZS? 4?5-ß ¡ ¡ 3:<0 4(\3~ XXXXXXXX~ ~xu~xxxx ~XXXXXXXXXXXXXX'XXXXXXXXXXXXXXXXXXX~xxxx ':XXXXXXXXXXXXX ~XXX ~,~XXXXX XXHXXXXXXX, XXXXXXXXXXXXXXXXXXX i,XX:XXJcX):X,X:S:XXXX;:XXX ~x~"'XXX~X nxx,x,','X i TOTALS TOTAL:..; µEE¡: MONTH . '. / " FUELG201188 GARAGE TANK fJ 2 (NORTH) NOVEMBER 1988 ". VARIATION 100 . ' . ., ..", ,.', . . · . . . . . . . . 80 : ...:....;...,:....;,.,:,.;..,:....;...:....;...;,.:..,.:....:....;,.,:...~....:....:....:... .., '...:....;.... ...... .. · .... . . . . . . .. . .. . .. . .... . .. · . . .' . .. ... . . 60' " "......,., ... ' ,.. : ...:.....:....:...~....:....:....:....:....:....:.....:....;.....;....:..... ...:....:....;....: ...:.... ....: ...:.....:.... ...... ,.. ....: " . .... ....... ." ." ., ................. 40 : ..,..,':.. .:..--: ..'..:;....:.........:....;....:....:....;....:...;, ..:... ;....;...; ...:... ..,:, ..:.....;......... · . . . . . . . .' . . . . ... . 20 : ...:;, .:..:....: ...:....:....:..,:....:,..;....:...;....:.. .;.. .:. ..: ...:....;. ";"',;' .:...... ...... .. :..,' · . . . . . . . . . .. .... · . . . . . . . .. ... . · . . . . .. . . ... ..' . o : ,.;..,: ...;....:..,;, ..:.. .;....:.. ~... ;...~....; ..:....;. ..:...: ...;....;.. .;.. .;.. .;..,;...;. .: ... ..:.. ..; ...: · .. . . - 2 0 :' '". ',........" · .,. .. . -40 : ..,;.........:,.....;....; ':....;....:,..~....:....~.. ,;.... ...;....>-'~'<. ..;...' ...~....:...;.....:.. ';,.<.......:..< · . . . , , - 60 : ,.....",' ..,...,'.........'''''' d .. .. , ,.. ' -80 . ,...--......,.....,....... "..,..........,.... .............. ........."..............' ..,..........,.. · . . . -100 : .""".,..' "',,' ".,.".".".,..,.:',.,; ",.,':',......,.:',.. ....:..,,;...: ',.;......,"',....:....."...."..,...,"',.,", . . . . . . . . . . . . -120 2 1 2 3 4 5 6 7 8 9 1011121314151617182021222324252627282930 I l.í=ß ¡¡¡ © ¡H 'W I'ô m} Ii ('.~ 0 i \988 ENVIRONMENTAL HEALTh GARY J. WICKS Agency Director (805) 861-3502 . . 2700 M Street. Suite 300 Bakersfield. CA 93301 Telephone (805) 861-3636 Telecopier (805) 861-3429 STEVE Mc CALLEY Director RESOURCE MANAGEMENT AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH SERVICES , " November·30, 1989 County of Kern Attn: Andrew Richter 1415 Truxtun Avenue Bakersfield, California 93301 CLOSURE OF 2 UNDERGROUND HAZARDOUS AT 1415 TRUXTUN AVENUE IN BAKERS PERMIT #A808- /16002 TANKS LOCATED This letter confirms of site investigation and remedial action at the above site. With the provision that the information provided to this agency was accurate and representative of existing conditions, it is the position of this office that no further action is required at this time. Please be advised that this letter does not relieve you of any liability under the California Health and Safety Code or Water Code for past, present, or future operations at < the site. Nor does it relieve you of the responsibility to clean up existing, additional or previously unidentified conditions at the site which cause or threaten to cause pollution or nuisance or otherwise pose a threat to water quality or public health. Additionally, be advised that changes in the present or proposed' use of the si te may require further site characterization and mitigation activity. It is the property owner's responsibility to notify this agency of any changes in report content, future contamination~findings, or site usage. If you have any questions regarding this matter, please contact T~ Crumpler at ) 861-3636. Amy E. Gre~RÇfs. ' Program Ma~~er Environmental Health Services Department ~\~\GCev~( · ql6(l\~: \i\Q..ùc.b~ r~VY\ove.ð. ~D\t Oe.\ow d\~~ ~ dQ.,~ ¡: at ID' ðG.{Y\~ ~ 01: ID' \at GM-Ó1 \5' :! dJ.ü~\cf~ .~ óo:J.. wc...o 'Y\~ ~J. 16', KQ.fl, ~ðf McÆJabIJ tCJY1d. d~ -b4d tk dtðe/~tÝ órXf ,'cL.'J n6f ~Cv\It. ~ OOo-L, ~. e, kb Óð ~~ ,,!.L/ ð'LMA ALl/"'\ '!i'~ _H_~ .., " II I I!! . . ( ~ ." . . qf¿¿ \ct,q. ~4 LÙ[ ~"': mc)(\Qbb ?R^ \Q\o\'&t ~ ~ \\ +---t- \10o\V\1' . \~ ~~ ~'ÇìfYY' \<C)f-\ ~w \ Q~YY\ . fu J\,Qp(y\o\f ÇLÒ ~ '+o~ \'2 I ~ ~zÓ -+O~~ ~ ~~cQ ~. &oomd6~ ~ ~~J ~ WL\l \o.Q J\QJ('(1DV¡¿cß ~\\LQ.D&~ ql 'Ue \L:6q. · Y\~ ~ ~k'v~ ~\..Ùr \VU0::C. ~~~ - (PHONE CALL) D~~ () . FOR '- 'i:(./"Urz¿'lc:¿ DATE /1'1 TIME '/.'10 : : 11.'7 i0 ) , -~ Ii ¿¿. PHONED I // /'/¿) /l RETURNED - ,-J '-T - / J U YOURCALL '" ~ M OF PHONE , EXTENSION PLEASE CALL WJLWCALL AGAIN ," ,Ct\fØErrO ., "SEE';'~(}¡j TS;1:0 SÈEYOU , :~ !'L~q,q I 'c.~c {.-eV\'\---t K · ~~~ ~~ ~fu y\V'cu.) ~ -~~Q ~ \4lO)~ , C c.\'.1~c.. 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Ld' ¡. .,'.....,. .'\'!~~J~,;\.:~~(~~;o"~:j '¡~J"\ ,Iij - '. , ".'; '. . ;'.," ..,: .;¡'", f; ,;" ~. '1~~"" d' """"-a. ,', NON-HAZARDOUS WASTE DATA FORM "'-.. ._-, . .,-<"",.-. ", " ..,:ß..'i..;' a: o ... 'ct a: w z w ~ > m Q w I- W :..J Q. ~ o o w m "0 I- NAME !~!.'1t iq ð/, /á, '1 '11/ , 'ADDRESS I ,.,. - I \f-. U 111J14f- A.-..A: I t - '{ ~~ CUy, ..'TIC ". '-i? (), iLl r/b!~ Ût CONTAINERS: No. .' ~:-~~,.~ ' . : EPAI I.D, .NO, I ;~ , á1)~ . . ".~. - If? In I '"' I PHONE NO, ( VOLUME WEIGHT -:,.:;,,~ç, "'" ':1, TANK ~MP 0 0 TYPE:' " 0 TRUCK lid" THUCK 0 DRUMS CARTONS· OTHER " " ' ,'~, "I ~ASTE DE~C~I~TION 1/~tjÇl~ '1' tift' p. ill ir GENERATING':PROCESS·~ft~:f)1.J' ~ COMPONENTS OF WASTE I PPM ' % , COMPONENT~'ð1=W,{m' ""'ì '"" PPM .>:.: ",'·,~~~lt( 'S"f" ~M;', " : ': .. '"0 ,¥ ~,." '., ",.,J'. ~ ·~;"~~~;~\¡~'1"· .~ ,'''' . '1.~,. ..~/- ': .. ." .~ . . . i\~'i::,ff;~~~~~J,~'" - ';:5. . "'.' ..:..... .0\,,- 2. ./ 6. ,-,-, 3, 7, . '" ::'::·'~;<K~:~I:·:~;~,~;j~~:?;tJ,tL·~';;'i. . 8. 4. .....;::~,j:~::~~~j.:t :'~>j~~~,': . ~ ... , " . . ~.- .! pH _ ~SOLID o LIQUID o SLUDGE 0 SLURRY 0 OTHER PROPERTIES: HANDUNG INSTUCTIONS: .......-.' , THE GENERATOR CERTIFIES THAT THE WASTE AS DESCRIBED IS 100% NON·HAZARDOUS. I )\,.".,-.. , : , r I ~ 1 . I " . " , I EPA'I I.D, NO, a: NAME W I- a: ADDRESS 0 a. rn CITY, STATE. ZIP Z ct a: PHONE NO, ( l- " TRUCK. UNIT, !.D. NO. SERVICE ORDER NO, PICK UP DATE '¡¡. ~. '!~~ ',i TYPED Of' PRINTED FULL NAME & SIGNATURE DATE > I- ::i o c( u. Q rn I- . i t'" /./ - "h . / ' NAME r.,L,l1','; .l{' / /.{J".,i/¿/ / ~ " .-,' , ',r:- '~t.~ ADDRESS ·~>t'<jl ' i1. . Ì¥J ~1, ,', li1 J '- /' ¿ t ~ I CITY, STATE. ZIP ;::;;-'. ("'. '."t ('. ,~,....t'. I 2j' , PHONE NO. ~ O..~) ? 61. -? Ie 7 ,.!î h j ð q f () .¡ ~lt is ~ I DISPOSAL METHOD ,': ' IêI LANDFILL 0 OTHER l'(}¡;¡'V' ~'!~ ,", " " , ¡ ",.I TYPED OR PRINTED FULL NAME & SIGNATURE DATE GEN OLD/NEW L S RT/CD TRANS A B TONS cIa (e (.,_ <~~-rLtj¡~:,.. -' , ' . '/--.....¡"'r , ~ - . 101089-i:~~> :if ':;~" NON-HAZARDOUS WASTE DATÀfF,~ïV.:;: ...~ , '. -( -,,,i; " ,~~: -v:.,. 'J i", rr:..i 2- NAME r.:OUNTY 0F KERN ADDRESS 1.415 TPIIXTF'M, 4VF. -\e\, J'..,,1.¡'iV r-! l......1 .....:1.' /¡-"/ ' EPA I ':":l, , /". <, I 10 , ... .., ~ ¡I NO, I I I r- I·I"-i-·I'~·.Þ/ I I -.'----'. CITY,STATE,ZIP ~A\{¡:'Q<)FT¡:" n. C/\ 9~~01 PHONE NO ( a: o ~ c( a: III Z III o > CD Q III ~ III -' a. :æ o (J III CD o ~ CONTAINERS: No, VOLUME WEIGHT .- ': nt DUMP ILl THUCK TANK o TRUCK o DRUMS 0 CARTONS 0 OTHER TYPE: . ~ UNDER GROUND STORAGE GENERATING PROCESS TANI< ROOVAl COMPONENTS OF WASTE PPM WASTE DESCRIPTION l~SS THAN :3,000 P. P. g. COMPONENTS OF WASTE PPM "" .. 1, SOIL UST 2. 3, 4, PROPERTIES: pH_ /[] SOLID 5 6 7 8, o LIOUID o SLUDGE 0 SLURRY 0 OTHER .-,> HANDLING INSTUCTI0NS: I THE GENERATOR CERTIFIES THAT I THE WASTE AS DESCRIBED IS 100% NON·HAZARDOUS, 1\ ¡ ~/ I \ i ~;-' '(';- ,! ..y, r-'¡ ,.'1 ¡ i' ¡!, r ..... '" ,"';I~' ',t, TYPED OR PRINTED FULL NAME & SIGNATURE I tePA I '~~ -~~r4111 ! ,,·It J~' ~ ' .'--/) ~ I ' It<; -'," ç-] l -'.J -. '''¡ DATE - "118 ¡1 ~ a: III ~ a: o a. (/J z c( a: ~ S1..u.&gëðn-&-Sb1l , J4.sx NAME Iut. " '"" ) '1 ADDREss-3.5.1-~enu.e SERVICE ORDER NO ,. CITY, STATE. ZIP Bake;l:-s.f.ie-ldy-4;a.J,.Hor-nid . ~ 3"3'0'8""" PICK UP DATE .~._ l',_Ç?q PHONE NO, (805 ....1.22::AAOB <".';: .--~ .,' ,,/,"? _.)",1_ \.;q ," - .~. ..- . ~_.~. .;.....-.. .. " -::.. .' ........." .- ,'- ;..,'.~.' !."''':. ' " .' .."j. ,~ ,~',-: to;: , -, , ,. TRUCK, UNIT, 1.0, NO. :' .I,..::" .. ,-,< ,,; ,-, "........, TYPED OP PRINTED FULL NAME & SIGNATURE DATE NAME LIQUID HASTE MANAGE~ENT ~~;~ leA D 9 8 I] S 3 6 A I NO" I I I I I I I I c: I 3 I .. DISPOSAL METHOD o LANDFILL 0 OTHER ~ ::; - (J c( I&. Q en ~ STAR ROUTE 4 ADDRESS CITY, STATE, ZIP MCKITTRICK. CA 93251 ~ PHONE NO, (80~ 762-76C7 TYPED OR PRINTED FULL NAME & SIGNATURE DATE GEN OLD/NEW L A TONS TRANS S B cIa ATICD HWDF NONE DISCREPANCY ,~ " '~f" ,;.¡ , ~... . ., c,: . . t /0 81-171:,F... ,'. NON-HAZARDOUS WASTE DATA FORM 'f~r' .' ~. , . NAME C; 0 (( 1'.1 0/ . t' -f /! FE. R 11/ 1 ADDRESS-14/~ 7P.. f./x. jlHtI 4//£ CITY. STATE, ZIP e f)~ ¡;~A) J" I ~ J-ß : û J4. ? ~ ? (J I EPA I LO. NO, III PHONE NO I a: o l- e( a: w Z w ~ > CD C W ... W ..J ~ ~ o (J W ID o ... CONTAINERS: No. VOLUME WEIGHT O TANK ~ .J1J(]MP 0 0 TRUCK ~THUCK DRUMS CARTONS TYPE: ~J o OTHER ,L /1l /) £-è 6 ¡'t'/,/ IV Ð r¡ F} IV I( GENERATING PROCESS fIE h1 t' 1/ JIJ J..." COMPONENTS OF WASTE PPM ." WAST~ DESCRI~T'ON~fiJS 7' f./I4JlJ ~J &IJ{/ Pþ i3 COMPONENTS OF WASTE PPM IJ& 1. ::~ () I L/'!:<U 5"'- 5. , " :. . . .. 6. 2. ", 3. 7, I'.''"'". 4, 8. PH_~ o LIQUID 0 SLUDGE 0 SLURRY 0 OTHER PROPERTIES: HANDUNG INSTUCTIONS: THE GENERATOR CERTIFIES THAT THE WASTE AS DESCRIBED IS 100% NON-HAZARDOUS. a: w I- a: o Q. en z e( a: ... (, ..;.' i .\- ( l' -~·r ''':.' J . EPA I I.D. NO, I I --,.. .1'./''', .I / j !' , ¡V'/!¡ '/Y"-' NAME I::.~ 2¡Y'/ ti, \, 7-~ !-! At/ ,,' '1 G/' ADDRESS SERVICE ORDER NO, íf1 - /(. -¡; '[ i.:; . 2 ( ? PICK UP DATE CITY. STATE. ZIP ,...-, UJ/ ,) f A,,- i I,' v' .,." J - l¡Þ( "'-,/( 7 / /", ,...,' "...-" PHONE NO. (~' ') , '." . !, (, 10- /ð/~ ¡r? TRUCK. UNIT, I.D. NO. TYPED OR PRINTED FULL NAME & SIGNATURE DATE > ... ::; - (J c( II. C en I- NAME /.-.-. I fJ Ii 1 D «) ~.:... r F. /Y1 Ii Ji;)f F l! tvl is ¡U I ADDRESS ,5 íl1 ~ ,E:í +- "'^C KJ rr ô A~ ""',,, &1,'1 A,,:::>: 1.. I"'" I CITY, STATE. ZIP /'1 .. JC.' V;\. (-, t:!. '2.. _~_ 1 PHONE NO. ~ûS) 7 ¡.). - /7 ¡" I' 7 EPA I'" I ~%. C I¥J l.b, 41 1 I.(JIf. d It 1(3' I:?II DISPOSAL METHOD ~ LANDFILL 0 OTHER TYPED OR PRINTED FULL NAME & SIGNATURE OATE Ii> GEN' TRANS cIa L S RT/CD OLD/NEW A TONS 8 HWDF NONE DISCREPANCY IE: o t- ea: IE: w Z w CJ > CD o w t- w' ..J a. :! o o w en o t- ~.- . -;;0.... --- (. J tJ ~ f -:: lîj~:{(~;~1:tì -'J C',..llt.. ~('!~'J ,.. '~I"'" ,1 \,~i " "" i: Q NON-HAZARDOUS WASTE DATAFO~¡Ìf~Jf '9f§} ,;f j. ·-..,¡~.¡.1.0 '<')>"'_ ' è' ~:~~'7 ", ~~., .''-,,,-:-;~·:,~~.-l\~·~~~i~.· " ' "--~" I I I I I I I I " 'I "0:;'"' . 'Of NAME !/fJ'Ü1!.'-;'; .1/ ~, 1./ , ' VV ~. ADDRESS /1-f/'...~ 1),,~!u4~ Ilut/ I' J CITY. STATE, ZIP \...f9 aJl14í~ tþ. '1~:S tJ ! EPA I /.0, NO, , " . . PHONE NO, I CONTAINERS: No, VOLUME WEIGHT " lYPE: 't:" 0 i~~~K ~~;K 0 DRUMS 0 CARTONS 0 OTHER . . ..J"~ ' ~ ~.. . . W.¡gt~, '),.¿ WAS~~ DESCRIPTION ~' ?~ 3;1 Of)() P P ~ GENERATING PROCESS ' ~ _' ' COMPONENTS OF WASTE ~PM % COMPONENTS OF WASTE PPM ." . '\ J t./ 1..~ t(~T 5. '.' ,; .. .. ." .. .. 2. 6. . .. "¥." 3. 7, 4. 8. PROPERTIES: pH_ ~ID o SLUDGE 0 SLURRY 0 OTHER o LlaUID HANDLING INSTUCTIONS: , J' 1 / ,~ '," J¿ ( /?l¿t JÇj{ DATE I I I I 1 I I I THE GENERATOR CERTIFIES THAT, I THE WASTE AS DESCRIBED IS 100% NON·HAZARDOUS. I f::::c OR pRINTED FULL NAME & SIGNATURE -.':,..... <, .~/ ~,~t I NO, I I I I .. a: w ~ IE: o a. en z c( IE: t- NAME :'" ',' ,.,/).. ,'" .' ¡ ... .. / ~ -:7 ,;''''-''! ..-'1 -í' ADDRESS ,"....' ,f., ,.- I .' , <L SERVICE ORDER NO, 7"'-:'- ',...-. -..] -' (../ CITY. STATE. ZIP ,.' : ;! '.. /'. ~ /' " .......'.... -.... ..··1""· '.-'.-' . PICK UP DATE ." /.'-'.-, .-'./-" i~>;:",r .''- <",I" ..'.;., ',. .....,:.....,_. .....,' 0 ..~-...><+"'7···.. .~...... f-! . t- ,.,..,. ~~-"', If ....-~~..:;:::.- J TYPED OF> PRINTED FULL NAME & SIGNATURE - .._, ,..~-" PHONE NO. .t:"í:",) y :.; <: ';/"~7 ,.-, /;""'f - ,,.~/'~~~?~~~'.~, TRUCK. UNIT. 1.0. "'0. ·r..:::. r.~_ .-' .~:;.-;:~ DATE > t- :¡ o ea: II. o en t- ,/ ' · ./7 !' I -J... NAME ~;ilr.u:-!j IÁ/Cl,.u:bT(Jt;n'u¿!.i~.M( ADDRESS ,itr¿¡/v, --ftJ.flf./¿'t¿. 4- '.... CITY. STATE, ZIP Jy) Q.> K:ttt.;,6o' /~/. 'B ¡,s I PHONENO,r§'{$) 71 ¡..- 7t.tJ'7 EPA I ' I ~~, t!.~~ #1, D (/,8 ,0 ,tLJ ,J:. I~ I~ J/ DISPOSAL METHOD ŒJ LANDFILL 0 OTHER TYPED OR PRINTED FULL NAME & SIGNATURE DATE GEN TRANS L S RT/CD A B TONS OLD/NEW HWDF NONE DISCREPANCY cIa · ,'........; , 1''-' j 0 8' t? -I'?J-,¡-;-;'-~':"',~:/ _ " _ '..,' -~...:>.J...j- '. .' - ,/ ../.". :,/-y , " '~>\'-' n ~,;.I "(" \, ~11 ~·:t . , . Cd/.~· 'I, " 'r', \: , ,,~ ., '." , ,rf\\ NON-HAZARDOUS WASTE DATA FOR,Mkiy '~f y'.;/ :';.~. ")! '6 . i~?:~, ,- .'-' ':;'''.: " NAME èOUA/1j ðF k£ þfl/ ADDRESS / '+ IS- íÞt.IJt.Tð/U 11//£. CITY, STATE, ZIP . 8 fl-kE, P...5 .ç I ¡; '-' Ú I ('/J 1J~~:5 0 I a: o ... c( a: w z w CJ > ED .0 ,W '... W ... Q. :E o o w m o ... CONTAINERS: No, VOLUME -~P L.!"'"THUCK TANK o TRUCK o DRUMS 0 CARTONS EPA I I.D. NO. ·~~.~·À. . ""'\ ' PHONE NO, I WEIGHT ..;;W o OTHER ': UIV )e.J? tiJ{OU/LI.j)..j Tt7J? 146£ GENERATING PROCESS ',7 J4 tfJJ( ~ EJv} LJ /J,J:J. µ' COMPONENTS OF WASTE PPM .. ...... ,.; ~ ¡ /c' . ~ {H ---i-> , I) ¡ ~~'~,J~'~ !~. ÞTYPED OR PRINT'ED FULL NAME & SIGNATURE TYPE: WAS~EDESCRIPTIONt.. C".5j rll¡: (II ~()(JtJ PþK - . COMPONENTS OF WASTE PPM '!b 1,-·:;5 (), L 'U~f 5. <, 2. 6. 3. 7, 4. 8. PROPERTIES: pH _ ~SOLlD' o LlOUID 0 SLUDGE 0 SLURRY 0 OTHER HANDUNG INSTUCTIONS: THE GENERATOR CERTIFIES THAT THE WASTE AS DESCRIBED IS 100% NON·HAZARDOUS. a:: w ... a:: o Q. UJ Z c( a: ... /¡: " '1' NAME : 1-1,' r¡ , , ' , .,,",.:..-"1 '/ ...:-;:-,-:;,J., 1._' ,'" '.:' c· -.~ ,.-" 1-:"" ..-,? ADDRESS I ..:;;,,_ ! C.' ,r..t, <./ I::; .-,.- ..~... ;-1 -' .-' -- CITY, STATE. ZIP PHONE NO, C<'::' _:~.) -"/ ,.- , ¿.' ;' ,; l fl./ '../ _/ I ,'j ,", - /" TYPED OR PRINTED FULL NAME & SIGNATURE TRUCK, UNIT, 1.0. NO. ~ :::::¡ o c( u. Q tJ ... NAME L I Ç} tI" () /J.,; J4.~ TOE. Y'r1 t1./lJ;q h i n1 E nfr ADDRESS 5 rfJ f ~-r k CITY, STATE, ZIP.ì'n':: J\ I Tí Id I r:: k' r1.1 Ii. 43 'Äf I ,r-) 'j PHONE N6:fi0.5 ?I J.. - ? ¿ lJ7 TYPED OR PRINTED FULL NAME & SIGNATURE GEN L S RT/CD DISCREPANCY TRANS A B TONS OLD/NEW HWDF NONE C/O :' ".~ "",1 , . -1<. . . ,"'~: :..;¡" "~~~~jø~~]~{; "~_;,~i~~ >~.. ~.'_:. " ;';:):\:-¡:",::¿;'r~ \[,' ,';- ~ ~ .~'... ~ . ,;" : .' \.'.'-'j . ~3·4\ .,.-.¡ ,. ,:,;~~fÑj:f~':- I ò~ ./89 DATE ¡ ri. I I,' I j If I :/ I ' :' II I' I -I 'Ie' SERVICE ORDER NO, PICK UP DATE i'~ ' ¡ ./ , , .. i . ~.;,.. '--:1' ,/ (f " _.~r' . ~..C~./';J .' , I.....·;: . J' 'r /... DATE ~A G, ,11, hI91(f,o 161.~ ,I.: 8 J~ 1/ I DISPOSAL METHOD IZJ LANDFILL 0 OTHER '\... DATE . '. " .;;' . / 0 if¡ '1- I?.}." "~:,u<0.·6 : ')001 ". ,., , ' ., q;;¡ {J ,\'....., NO·N-HAZARDOUS WASTE DATA FÒRM~l, ~~l NAME (~ell JV7 7 "'1" kG.~ JtI c.,.. ADDRESS 'If/~- ifPUXT0f/.-) ¡tf/£. CITY,STATE.ZIP ~tJKE RS F'I bL ~ J 64· 9~.)tJ I ..~~~.' '>~ . ):. ':" ,~~ "-! i:' ~ ""''''#/ I...Ä:-/, I .~-- --~.--' .';~' ,~ '/ . ~._~ ; ,..("' \ 'I-~I· -ì-··f· '1 EPA I I.D. NO. I I PHONE NO, ( , a: o ~ a: W z W CJ > CD Q W to- W ~ ~ ~ o o W a1 o to- , CONTAINERS: No, VOLUME WEIGHT ,.""t 0 TANK - ~P 0 TYPE: .,,.' , mUCK Il:rTHÜCK DRUMS 0 CARTONS WA;;:DESCRIPTION Lf;5'5 ¡¡..IßJtv !./il'l: AÞ. ~ COMPONENTS OF WASTE· ptM' q¡, 1. .5CILl ClSr o OTHER t.<".liJC~ fil2clI/tV 1'11/1/1( RE"(JlI¡J~ GENERATING PROCESS COMPONENTS OF WASTE " PPM ;.,',"'Q¡, 5, ." , - ~ >~\.' .,' -~ ....'~':~.. .':: .~~.~;,~~:~~~':"-_..., 6. 2. 3. 7, 4, 8. pH_ ~~ o LlOUID 0 SLUDGE 0 SLURRY 0 OTHER PROPERTIES: ." . HANDLING INSTUCTIONS: Jv~R~ ,/~,t,/~ DATE THE GENERATOR CERTIFIES THAT THE WASTE AS DESCRIBED IS 100% NON-HAZARDOUS, TYReD OR PRINTED FULL NAME & SIGNATURE a: W to- a: o Q. tn Z <t a: to- Cu to ¡n-' nrJr J ff1nSf})rf T I ADDRESS 137 rr ¡Ai 11 ~+ CITY, STATE. ZIP -rAf {. ¡ (h . SERVICE ORDER NO. EPA I I,D. NO. I I I NAME PHONE NO. 13ó~) 7(PQ· S? I ,ç ,': PICK UP DATE 10 ,/1 ~ eq } ..~ -rhOTrìA r ß. ¡If'.. H 1/::¡éJ1YVU) ß /' /o·¡1-8Q TYPED OR PRINTED FULL NAME & SIGNATURE DATE TRUCK. UNIT, 1.0, NO. > to- =:¡ - o <t II. Q ø to- NAME L I (J U t D ADDRESS .<f)1·p , . d\~ '~ k.. f'1~: re- p.r: 4- EPA ~ ~~. C 14 I~ q r3 10 16 I-? 16 Iff ~ r/ DISPOSAL METHOD ~ LANDFILL 0 OTHER m fJ/I/ A f~ ¡¿,11 Glt) r CITY. STATE. ZIP Jÿ1 (' K I IT p.. {~k : r.... If. 'q,,:;> "].cj-/ PHONE NJS::I13) '11"} -- ? Ie? - , TYPED OR PRINTED FULL NAME & SIGNATURE DATE GEN TRANS cia OLD/NEW L S RT/CD DISCREPANCY A TONS B HWDF NONE r' r.:.(~ / 0 f}>fP"'7¿fj~~/þ/ .' , ..... '«~\ ".':''/88e[!} ,. ~ , ,h,. " VOH ;t~ NON-HAZARDOUS WASTE DATA FO~~ ,t} '. 91",· "~y..)~, ' /~ -. .' t"'~~~.' , ~A I I I I I ,lr:~:i~~;j I I I ,. . (e " NAME 60(jIVTj of fEE- R- fl.! ADDRESS I 4- IS"" -r"f1l/ Xí LI A) t) 1/ ¡;.. CITY,STATE,ZIP ß a,<,f5,~ .S/I&LJJ I (~.J1. ? 5.1£;/ PHONE NO, ( II: o ~ c( II: W Z W CJ > m Q w ,~ w -' Q. :E o (,) W a1 o ~ CONTAINERS: No, VOLUME WEIGHT ., TYPE~"l 0 ~~~K ~¿K 0 DRUMS 0 CARTONS 0 OTHER 9 :-,," P , . UJlt j)ce & RtJ¿lIt¡'~ 7 f}¡I..:!( k. f-Iljcpl'lJ..., WASTE DESCRIPTION" £5_<i ítlJ V~. L'bTJ It ¡: e , GENERATING PROCESS . , COMPONENTS OF WASTE ~M % COMPONENTS OF WASTE PPM ... 1. .ð()J~ U!I 5. "", - .. J 6. .\""..., ", 2. .. ., 3, 7, 4. 8, , pH _ OSOLID o LIQUID o SLUDGE 0 SLURRY 0 OTHER PROPERTIES: HANDl.ING INSTUCTIONS: (ì :9 .' ~. 17.. _ J c#~J~ Cft/ IP~,)g9 DATE l 'ITHE GENERATOR CERTIFIES THAT I THE WASTE AS DESCRIBED IS 100% NON-HAZARDOÙS. . TYPED OR PRINTED FULL NAME & SIGNATURE ,~ EPA I ; 1.0. I NO, I I I I I I I I I II: W ~ II: o a. en z c( II: ~ .::r........... !.._ .:;~ " k1 /;1 ./, Æ¡ .(;- ,;::7 .I '" i/ £:.' 1)<~;/<,c-)(7 NAME . \. ......., ADDRESS !''';;' -:-- ). :=- //'J'r / .'h ..,' //1/ .-r / SERVICE ORDER NO, /" ~,.,""I PICK UP DATE ,; ;'} ~ /' / _. y,C;;' ,'~t..~ ," /" I" CITY. STATE. ZIP -/ ... - ,-"-/" ) /,ç,,,"?') 1 b ........- PHONE NO. ( ..-/' -,....' - <.,? '~'1 (_'7#yt).':'t:',t'¿:i~5 .~/'~,:".t" TYPED Of' PRINTED FULL NAME & SIGNATURE :/ .,~ ~-~ .-Y"' _ ~ ~ ...:-:1:. {./"_. .~,. '" TRUCK. UNIT, I.D. 1110. i / ¡../ DATE > ~ ::¡ - o c( II.. Q tn ~ NAME Iv I tp tit [) k,,' t1- S -rC m A IV 4 b f ¡ru; }1/1 ADDRESS ..5 í JJ fè f2 () II r L -t- CITY, STATE. ZIP ro f}. X' J rr ,Q lî,U C· IJ t 1 "3 ~ / 1\-¡ PHONEN{5 O~) '7 {.]. - 7 t[7? ri.~.: ~1/~f1I(f It¡{'I':?I'£ 61~ III DISPOSAL METHOD ~ LANDFILL 0 OTHER TYPED OR PRINTED FULL NAME & SIGNATURE DATE GEN OLD/NEW L S RT/CD A TONS B TRANS HWDF NONE DISCREPANCY CIQ I'" .. <:J - ~ .e8£[ e II NON-HAZA~DOUS WASTE DAt~ 'E~. NAME (', f:'", J1)ì"v r.f ¡,.., 1=,.. P1U\<~ " µ. T fir EPA ADDRESS I Jf L~ II~ 1/1.., f./ {\1 f1V t:. ~~, CITY,ST~TE,ZIP l?1J~ 6PSt I Þf..I 1:1 I d¡J.·/f-?3C J >;.i.~ ,', . .. . a: o ~ <C a: w Z w CJ > m Q w ~ W ..J a. :! o (J w en o ~ CONTAINERS: No. ·;-·-:--l....... TYPE: ":'f O TANK TRUCK ~ at\'GP IB"TH'ÜëK . PHONE NO. ( VOLUME WEIGHT o DRUMS 0 CARTONS WASTEDESCRIPTION ~E...~.f .-rHAIV .:? CPO P~iJ COMPONENTS OF WASTE PP';;/ '!b o OTHER u/v Þt~ (; 1?Otf J1Jð í¡f!tik ~8I"Cf/ÞlL1 GENERATING PROCESS" " COMPONENTS OF WASTE PPM .. ti ) J4 !: T r;. /'11 H It'Í~ c £ ~ d:.11)" ¡O£(T~ ~ CITY. STATE. ZIP {Y't c. K ' 1T 12. I ('/J( i C lJ I C¡;;].-)',I PHONE NO. (1; [S ) ? I J.. - 'l t,/) 7 1. $(!i~'·;'l.{ ~'r-- .,';: 2. ~!. . 3. 4, PROPERTIES: PH_~ HANDLING INSTUCTIONS: THE GENERATOR CERTIFIES THAT THE WASTE AS DESCRIBED IS 100% NON·HAZARDOUS. a: w ~ a: o a. rn z <C a: ~ 8-- U.ti·! .A·I ! M -7) " J3;) /(.1 A//I!!..' ÇT (" A. NAME 7141-/ ') ADDRESS CITY. STATE, ZIP TA FT PHONE NO. I (ftX{ ç 1. f? . '-/:2 F / TRUCK, UNIT. 1.0. 1110. NAME 1,. 1~~fAID 5íÞ? > ~ ::; - (J <C II. Q UJ ~ ADDRESS GEN L S RT/CD OLD/NEW TRANS c/o " 5. " ?' ....'. . ,. '" -,. ~, .;..... 6. 7. 8. o LlaUID 0 SLUDGE 0 SLURRY 0 OTHER 1 . ,í . ,---··..1, Q i" . . fI~ ,,''¡ -J" h ('I 1'-'14·...' ; :~ I ;"1 ~ ¡;.. .. ........_. TYPED OR PAINTED FULL NAME & SIG'1<tATÛRE !: ~f I NO" I , I I { t-ci f"¡ DATE I I rN~ / SERVICE ORDER NO. 9]')6P' PICK UP DATE ;Iì c·d (2 ~,. A Nd ~ /' ~;- ð /IJW ~/~J'--<-- 6!,,;/'Þ__, . / ¿;-O/; -ey TYPED OFVPRINTED FULL NAME & SIGNATURE ~ - DATE riA 1c.-,t1 ¡J)f7 18 ,0 1¡'1?1¡"-I!1I~ d I . - , DISPOSAL METHOD ' lID LANDFILL 0 OTHER TYPED OR PRINTED FULL NAME & SIGNATURE DATE A TONS B HWDF NONE DISCREPANCY · COUNTY OF KERN. Environmental Health Services Department 2700 "M" Street" Suite 300 Bakersfield, CA 93301 (805) 861-3636 (805) 861-3429 Fox Number PERMIT FOR PERMANENT CLOSURE OF UNDERGROUND HAZARDOUS ----- SUBSTANCES STORAGE FAOUIY FAOUIY NAME! ADDRESS: PERMIT NUMBER AB08-16 OWNER(S) NAMF/ ADDRESS: CONTRACfOR: Kern County Civic Center 1415 Truxtun Ave. Bakersfield, CA 93301 Kern County Attn: Andrew Richter . 1415 Truxtun Ave. Bakersfield, CA 93301 McNabb Construction 7808 Olcott Ave. Bakersfield, CA 93308 Phone: (805)-861-2481 License #474331 Phone: (805)-399-4742 PERMIT FOR CLOSURE OF ,r'1"" 'i: TÃÑK(.S) AT ABOVE , LOCATION .............................................................................. CONDmONS AS FOIl.OWS: 1. It is the responsibility of thp P"'--ùttee to 01 to bpo-i....-:- -f' 2. Pen fo () h c-." }'VJ-- - )US Mater to té ~ 1 filling) t 3. TPeankm L,/:- ~J Departme 4. W/~ I ,Kern COt descn \ \ 5. Soil S ' Any dt __.A>I and nun in Hai, _ _.. .... .l-.jU must receive prior appr a. (Tank size from 1,000 to 10,000 gallons' in from the ends of each tank at depths 6. If any contractors or disposal facilities other prior approval must be granted by the spec PERMIT EXPIRES September 26. 1989 APPROVAL DATE June 26. 1989 -~~~H>N~J\Ø: Turonda R. Crumpler, R.E.H.S. Hazarònnc l\Ir-~ .. :pecialist APPROVED BY I 'I'"roullng requesl pad 7664 Pos .\ -' ............. ROUT\NG - REQUEST -¡¡-;¡('(':(Ý-JO _ . - cles prior Ët~(Jk~ ifCì .~ 'Y' ~ ~ tlOds a~ \ \ Please DREAD o HANDLE o APPROVE and o FORWARD o RETURN o KEEP OR DISCARD - ~ 0/J;~;~ ~R~7·"E ,.om_ /}1 sr Dale L. =- ...../ Dwana -= \e way .-. ""rlN o KEEP OR DISCARD o REVIEW WITH ME Date . ) / ~\.;:?f).:t9 utilized. From ~ ~ . . PERMIT FOR PERMANENT CLOSURE OF UNDERGROUND HAZARDOUS SUBSfANCES SfORAGE FACILITY 'PERMIT NUMBER AB08-86 ADDENDUM 7. Soil Sampling (piping area) a minimum of two samples must be retrieved at depths of approximately two feet and six feet for every 15 linear feet of pipe run and also near the dispenser area(s). 8. Sample analysis a. All (leaded/unleaded) gasoline samples must be analyzed for benzene, toluene, xylene, and total petroleum hydrocarbons for gasoline. Copies of transportation manifests must be submitted to the Environmental Health Services Department withir. five days of waste disposal. 10. All applicable state laws for hazardous waste disposal, transportàtion, or treatment must be adhered to. The Kerr: County Environmental Health Services Department must be notified before moving and/or disposing of an: contaminated soil. 11. Permittee is responsible for making sure that "tank disposition tracking record" issued with this permit is properly filled out and returned within 14 days of tank removal. 12. Advise this office of the time and date of the proposed sampling with 48 hours advance notice. 13. Results must be submitted to this office within three days of analysis completion._ ' \~, :xi.V'f\IQ\¿Cl'{ti\,\~ ~ fDf ~~OçL- f\\-=O ~Uf'('Q\è ~~{ \yTl ~~ ~~b~ \ .-t L1\~(L~¿ '~ ' ACCEPTED BY:t~~~ I ~ " 9. ~/. DATE / / ,-0 ,( , TRC:cd crurnpler\808-16.pta 6-23-4 · COUNTY OF KE. Environmental Hcaltb Services Department 2700 "M" S,lree!, Sulle 300 BokersOeld, CA 93301 (805) 861-3636 (805) 861-3429 Fox Number PERMIT NUMBER ABOE PERMIT FOR PERMANENT CLOSURE OF UNDERGROUND HAZARDOUS SUBSfANCES STORAGE FACIIJ1Y FACIU1Y NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACfOR: Kern County Civic Center 1415 Truxtun Ave. Bakersfield, CA 93301 Kern County Attn: Andrew Richte; 1415 Truxtun Ave. Bakersfield, CA 93301 McNabb Construction 7808 Olcott Ave. Bakersfield, CA 93308 Phone: (805)-861-2481 License #474331 Phone: (805)-399-4742 PERMIT FOR CLOSURE OF PERMIT EXPIRES September 26. 1989 LOCATION APPROVED BY June 26. 1989 \~~t~,~At}~! Turonda R. Crumpler, R.E.H. Hazardous Materials Speciali ~ TANK(S) AT ABOVE APPROVAL DATE ............. .................. ............... .................. ..................... posr ON PREMISES.... .......... .......................... .... .............. ......... .... ' CONDmONS AS FOu..OWS: 1. It is the responsibility of the Pennittee to obtain pennits which may be required by other regulatory agencies P' to beginning work. 2. Pennittee must !!Q!jfy the Hazardous Materials Management Program at (805) 861-3636 two working days IL to tank (removal) or (inerting and filling) to arra.nge for required inspections(s). 3. Pennittee must obtain a City Fire Department pennit prior to initiating closure action. 4. Tank closure activities must be per Kern County Environmental Health and Fire Department approved method: described in Handbook UT-30. 5. Soil Sampling Any deviation from sample locations and numbers or constituents to be sampled for which are described below ~, in Handbook UT-30 must receive prior approval by the Environmental Health Department. a. (Tank size from 1,000 to 10,000 gallons) -a minimum of f~ur samples must be retrieved one-third of the v in from the ends of each tank at depths of approximately two feet and six feet. , 6. If any contractors or disposal facilities other than those listed on pennit and pennit application are to be utiliz prior approval must be granted by the sp' coialist listed on the permit. , . . . PERMIT FOR PERMANENT CLOSURE OF UNDERGROUND HAZARDOUS SUBSfANCES SfORAGE FACILI1Y PERMIT NUMBER AB08- ADDENDUM ,.: 7. Soil Sampling (piping area) a minimum of two samples must be retrieved at depths of approximately two feet and six feet for every 15 lin£ feet of pipe run and also near the dispenser area(s). B. Sample analysis a. All (leaded/unleaded) gasoline samples must be analyzed for benzene, toluene, xylene, and total petrolet hydrocarbons for gasoline. ð, 9. Copies of transportation manifests must be submitted to the Environmental Health Services Department wid- five days of waste disposal. 10. All applicable state laws for hazardous waste disposal, transportation, or treatment must be adhered to. The Kc: County Environmental Health Services Department must be notified before moving and/or disposing of a contaminated soil. 11. Pernúttee is responsible for making sure that "tank disposition tracking record" issued with tlús pernút is prope filled out and returned within 14 days of tank removal. 12. Advise tlús office of the time and date of the proposed sampling with 48 hours advance notice. 13. Results must be submitted to tlús office within three days' of analysis completion. ~ ' , C, ;J ACCEPTED BYCL la,--~ ¡Jaê{ij DATE rJ('~1 / ~ TRC:cd crumpler\B08-16.pta 6-23-4 "l . INTEk~AL USE ONL~ ---- ENVIRONMENTAL HEALTH DEPARTMENT 2700 "M" STREET, SilITE 300 BA~ERSFIELD, CA ·93301 PTO PTA APPtlCATI0H DATE 9- /-1 tJ , 01' TANkS TO BE ABANDON!D 1805) 881-3838 LEHGTII 01' PTPTNO TO ABAHDON APPLICATrON FOR PERMIT FOR PERMANENT CLOSURE/ABANDONMENT OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY TillS A,PPLICATlON IS POR ~~EHOVAL. OR 0 ABANDOIlHEHT IN PUCE (PILL OUT ~ APPLICATION peR PACILr~ z I PHONE' OJ --t' _~' \ ¡RURAL LDCATIDNS ONLY) ". 0 C'~ DAYS- c...'V . : ;: , f\ PlIGHTS- 8lo1 -:J-, CD ::;¡ PACI ITY NAHh () . n ADDRESS : ~ . E£.J C:eu~,-q CHJì'e C&...."tc£- li.JI5'I1àtL:.ftuJ ßk5. .. - OWNER \E£0 CöU.V'T\ AD7:¡'~ 77lai:lu,J Æv~ ~, IP~ONE (&S}80I-~ì f NEAREST CROSS STREET Æ~ z :0 ~ - ¡..¡.. ~ .. ~:: ;:õ "''''' ;:) ;: ...- ADDRESS 18Lf3 CL· PHONE 09 <8:15>39(1 -c/?tØ- ::i !.ADORA T/:JR TIIA T '¡ I LL AHAt.'iZE SAMPLES 1;(1 (.~fD ADD&£SS (j' D'-' l{!'C[; 'rlEJæé ;L[). \~t~ c1 z o ..I _ ..¡- '-' .. - E Ex "'0 ="- '-'Z TANK , ...L ~ VOLUHE '"\ / (. , ¡HZ '/rl;' OJ) OATES STORED 1~61 TO Flf3C1 I ';:::;'7 TO 1í.ft2:9 TO TO u z o ..1- ..¡- '" .. o :Ii: ::.CZ: "'0 - "" Q: --..J WATER TO PAC:LITY/PRovrDZD BY DEPTH TO GROUNDWATER &::;.1 :.....;C ..I "z ...0 ~;: ~;i Ocz: xo - "- :> z z_ .. ::i D ,DISPOSAL CDIIP~IES I: , j ¡ t:f;¡.i'ffJ J;¡j , vL IJìcU6L l ... .Ll...,!) , () J iJn' i 12" I i ~.,..,(1 /! l1uf;:.., M.- ) YLrm:à) OJ .U'VC / ~1t:f- . itj}~1 . ~~:(Lw 'TrtE. bd_iU(' ,. ¡ v . . ~'i':: ~~ :!!!!!!!!!!!!!lli lli~!! ON !!~ ~!!)~ m~ !!!!~ !1!!~[! J!..gf!!!!~ 1!!!!!H.!!!l!!! APP!.ICATT!!!! f!l!! !!~Y!~ . . TlfIS POR" "...~~.~tÌ) ,,)!4PLETI!D UNDER PENALTY 01' peRJURY AND TO TilE BEST 01' !<IY KNOWLEDGE I S TRUE AND CORRECT, '~l' ¡ Jill.' 1]/,,('": 1\. /f-- ,,/:Ä "lr/,.¡,rrl/C' .1 ¡. -' '1_1r...·~:\i... ,.' _' TfTLE f f,.',(.. 1-/".. I,,~L DATE .; l.¿' !.../, r,! . :'-.' ,--.. ,r . ¿/ <- SIGNATURE '_..~- PROVIDE DRA~'¡ING OF PHYSIC ~ OF c.:\.CILlTY US1:i SPACL ~ BEID'l. - ALL OF THE FOLLCWING INFOPJvIATICN 1-IUST BE INCLUDED : ¡ ORDER F~ APPLIC\TION TC 3E -- PROCESSED: ,/ \¡ TANK(S), PIPING & DISPENSER(S), INCLUDI;: ~ LENGTHS AND DIMENSIONS I V PROPOSED SAMPLING LCCATIONS DESIGNATED BY THIS SYMBOL" @" V' NEAREST STREET OR INTERSECTION .A)~ANY WATER WELlS ORSt:RF.1'~CE ~'¡ATERS ~'¡ITHIN 100 I RADIUS OF FACILITY v' NORTH ARRCW ' ~/~'.\,U~ -' , s{' '\' \ LP ìétl'l-/-tt,J fhl'E bU;(.D'1 (cd ~l >< ',-<- x ~ J- -'/OJGrrJ) qAL, 7f(:--l- - U~,. 6't;W~ ~¿^ .' . ~\Q(E,- 0:J:..~(:Y\S ~\~tc\.1~¿)/MK..:) c4 bt¥Œ-E£S ><.)' K '< \.( j( , / :: . " , , I , - 1'. - ><..... x...... k/ I " ·Trc ..r '; f\ I \, .' ~A-l.,~èf\\) i 1!f- ¡Q " I~® ~. ~ YMt¡JJf (Dr "f /' \/ .. ~- 1¿Š "(' \ v / "'- 1 h-Òv¿~ò\,· m~ m ~ \-p" ... L I "\ .. rt. A\ rv-Ì 0\ L\-'(\ ~~ f\ù \-onE ~m-eJl-\-o l'{\U\JWti1 1l1!!!~~ £U ONLY: . PTC \loŒ/)-L0 . PT. ~ffi-lCp APPlICJ.TION DATE .q, l '2\1: \ q q . KERN COUNTY ENVIRONMENTAL HEALTH SERVICES DEPARTMENT 2700 0"0 STREET. SUITE 300 BAKERSFIELD. CA 93301 (805) 861-3636 , 01' TANKS TO BE ABANDONED LENGTH 0' PtPtHO TO A84HDON THIS APPLICATION IS paR APPLICATION FOR PERMIT FOR PERMANENT CLOSURE/ABANDONMENT OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE PACILITY ~R[KOVAL. OR c:J ABANOONN£HT IN PLACE' (PILL our ~ APPLICATION PER PACILI~I c .,{Ctt-tE~, C¡\JI'eCEN~ ¡SEC/TlR ¡RURAL LOCATIONS ONLYI rfAR/. CRO~EET ¡PHONE (8~)61c( - ~ t ( z ~~ /PHONE I c8-ð5) =n+-<t1<?:>-- ¡ I I ..e ~ = =õ 5~ ...- UDOR.1'OR¥ TIIA T It I LL ..NAL VI£ SAMPLES D.e ~ (~..wo:) n tD Cbs. IPIION£ ' <fj);;):tJ1-</-.t( If IPHONE ( ¡PIIONE CEd3Yl-'{9f( :I - 0'7 CIIEJ4lC.\L COMPOSlTIOII 01' NATERl.\~ STORED ~! ~ -0 ="-- '-'Z u-F VOLUME 1/ D....7' , CIIDUCA1. neue (NON-COMMERCIAL NAME 1 (;>k-k ,'L ,c, ", -- (.' _ OAns ST!)RED ¡951-ro LINK.· CIIEMtCJ.L J1R£VtOUSLY STORED Þv; Ò'ìlE -ro -ro TO ... cz ~c s:: '" c =z ::J = ::0 ~ ... :>z z- ;eo itA TER DEPTH ro CRfUHDIIIATER ISO~E AT FACLLITY ~a ^ Löt~ - 5.~L Iè;¡: CUri-iQ¿ llLï~ Q \DESCRIBE IIQW RESIDU~I~. T.\HKISI AHO PIPtJ!.~ ,IS TO ~BE RENOV'W ¡AHD DISp,0SED a~IINCl.UO£ ~lfSPORTATIOH .u¡O.D~OSAL, CQ)(p~tES,I.: ' .. ~ f7íþiJ( -, -- -I~tl) =-'Ñ\) ~C~, "fh\u.(8) '. 6 )y~\-,- (t$~Gl . 0ÿ- 'iff(-> VI'0-\.\.lt~ ~; ESCRIBE BOT)I TnE CISPOSAl. NETtIOD "HD DISPOSAL LOCATIOI! FOR: - %: ' '~~ ~L --/b L"£ ... \~ lYfC_ iHIS !'OR" ~.: ~ :"I'nRMATTnN 1!!!2!.!!m2 m! !~ ~!!!~ !!! !1.!!~ ~!!!;~ ll!!!!!! ~!.!!!!!!! ~P,,!.ICAT!nN !!2! !!~~ . · ,,~~ a~1~PL~~D !1IlD~R ;E,~~r.r:. 01' P!:I!JURY AHa TO nIt BEST OP7KV KNOWL!On! IS ~UE AND CORRECT. " ~Lt·',eí..'--:'O \,1 <- ,,\.,'J,c.,t:- , <:l:'" J~-, \1'{;'<) C ¡'^:.L... Ice '_ __ '- '!'IT1.%: \ ; \_r- f--. \\ ,L.I-- DATE <- _ .I J c.' I - - ___.,._'''. KEP.:; CUUNTY HEALTH DEPAR!MENT PTA It '6UfJ -/& \1--P'"Y ~ L.jD ~ DIVISION OF ENVIRONMENTAL HEALTH . PTO APPLICATION DATE. 1 C) - , OP TANKS TO BE ABANDONED 1700 FLOWER STREET. BAKERSPIELD. CA 93305 (805) 861-3836 LEIIGTU OP PIPING TO ABANDON APPLICATION FOR PERMIT FOR PERMANENT ~LOSURE/ABANDONMENT OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY THIS APPLICATION IS POR [] REMOVAL. OR 0 ABANDONMENT IN PLACE (PILL OUT Q!ä APPLICATION PER PACILITY) Z ~~ ...... ~i <0 ...... ~ PROJECT CONTACT rHO~:y=_ 861-2481/ ISEC/T/R (RURAL LOCATIONS ONLY) Andrew Richter NIGHTS- 861-2500 PACILITY NAME ADDRESS NEAREST CROSS STREET Kern County Civic Center 1415 Truxtun Avenue "L" Street OWNER ADDRESS PHONE Kern County 1415 Truxtun Avenue ( 805)861 - 2611 < COMPENSATION , PHONE ( ) Z 0110 ~i: ~~ "'0 ZI>o OZ U... . _ T K REMOVAL CONTRACTOR be determined INSURER PHONE ( ) PHONE ( ) PHONE ( ) PRELIMINARY SITE ASSESSMENT CONTRACTOR To be determined by bidding WORKER'S COMPENSATION' ý~ \ L- a:i LABORATORY THAT WILL ANALYZE SAMPLES ,1V'1,t'J, "V0\...J ~"._, ADDRESS CHEMICAL COMPOSITION OP HATERIALS STORED z TANK , VOLUME CHEMICAL STORED (NON-COMMERCIAL NAME) DATES STORED CHEMICAL PREVIOUSLY STORED 0 ...... 1 10 ,000 G Unleaded Regular 1972 1988 Premium Leaded <... TO ::~ -Ž- 10,000 G Unleaded Regular 1972 1988 Regular Leaded i5¡§ TO =... 1 10,000 1957 1972 '"'3 G Premium Leaded TO None 2 10,000 G Regular Leaded 1957 TO 1972 None U WATER TO PACILITY PROVIDED BY California Water Service Company NEAREST WATER WELL - GIVE DISTANCE AND DESCRIBE TYPE IP WITHIN 500 PEET 200' to Domestic Well with 14" Rf C;¡sing BASIS POR SOIL TYPE AND GROUNDWATER DEPTH DETERMINATION Soils Investigation OTAL NUMBER OF SAMPLES TO BE ANALYZED SAMPLES WILL 8E ANALYZED POR: 7 I Benzene. Toluene, Xylene, Total Volatile Hydrocarbons I DEPTH TO GROIIHDWATER 50' ISOIL TYPE AT PACILITY I Sandy Loam , ... <21 "'0 Z... ...... ~~ 0011 "'0 -... >z z_ ... ci pESCRIBE HOW RESIDUE IN TANK(S) AND PIPING IS TO BE" REMOVED AND DISPOSED OP (INCLUDE TRANSPORTATION AND DISPOSAL COMPANIES): ~ ,To be determined by Contractor, in conformance with County Ordinances. ..J .... ~ ~ ~ESCRI8E BOTII THE DISPOSAL METIIOO AND DISPOSAL LOCJ\1'JON FOR: ~ ~ TANK(S) ~ ~,'"See above. QZ ... PIPING cai . See above. · · ~ ~ INFORMATION REQUESTED ON :rEVERSE ~ Qf TillS ~ ~ SUBMITTING APPLICATION ~ ~ · · THIS FORM'HAS BEEN COMPLETED UNDER PENALTY OF PERJURY AND T~ TilE BEST OF MY KNOWLEDGE IS ,TRUE AND CORRECT. SIGNATURE ::... ~~ ~ ¿b~~l..-- TITLE Design Engineer DATE /0-//- y~ (Fora 'HMMP-140J . MICHAEL R. RECTOR, INC. Water Resources. Consultant Toxic Chemical, Monitoring Geology and Hydrology Agricultural Drainage Water Use Evaluation Groundwater Quality Water Supply . 1415 18th Street. Suite 708 Bakersfield, CA 93301 805/322-8206 September 20, 1989 Daphne Washington Kern County Environmental Health Department .2400 N Street, Suite 300 Bakersfield, CA 93301 RE: County Garage, Civic Center Gasoline Tank Pit Soil Description Dear Daphne: I visited the construction site and observed McNabb Construction Co. employees excavate two holès to a depth of 24 feet below ground level. The approximate location of those holes, relative to the larger pit which originally held the 2 gasoline tanks, is shown on EXHIBIT-A. The holes, located aout 12' apart, are deeper extensions of those that were initially drilled to recover soil samples from the 2' and 6' depths beneath each tank. At Hole #1, about 3 feet of soil overlies approximately 9 feet of grayish brown (dark gray when wet) silt-silty sand, poorly sorted. Some fill channels, near pipes was observed. At about tank bottom depth of 12-13 feet, a light brown fine grained sand with coarse grained sand lenses was penetrated. This loose, friable sand extended to 24' total depth as a massive body. Soil samples collected at 22 feet and 24 feet were described as medium to coarse grained sand with pebbles. These light brown samples appeared to be quite moist and yielded a gasoline odor. No clay beds were observed below the former tank bottom (12') and slumping prevented detailed description of upper 8 feet. A soil description at check point B appeared to be natural and was thought to correlate with that of Hole #1. Hole #2 was cut through re-worked soil to a depth of about 12 feet approximately 12 feet north of Hole #1. Light brown, fine grained-coarse grained sand with a few pebbles was found in the 13'-15' interval. It was underlain by a black silty clay lense (about 6' in length exposed) within the 15'-17' zone, directly above a brown silty clay bed at the 17'-18.5' depth. From 18.5 to 24 feet a light brown, moist, fine to coarse grained sand with a slight gasoline odor was recorded. A bottom hole sample was saved for ready reference as it appears similar to the 22' and 24' soil samples collected for lab analyses from both holes. Page 2 County Garage . . The 22' and 24' hole samples from Hole #2.had a gasoline odor but possibly less concentrated than the Hole #1 samples. Within the new tank pit, no contamination was reported in a pit at check póint A, about 20'-30' east of Hole #1. Near check point C, evidence of pipeline fill and man-made asphalt layers were observed to a depth of nearly 8 feet. Final gravel fill prevented a deeper look. The Civic Center water well log (160' NE of gas tank pit) shows that the hole passed through about 9 feet of sandy soil and surface rubble before penetrating: 9 ' - 61 ' - Sand and rock 61 ' - 67' - Clay anq rock 67' - 69' - Sand and rock 69' - 92' - Clay and rock 92' - 94' - Sand 94' - 112 ' - Sandy clay and rock, some gravel The static water level, in 1969(?), was about 100' below ground surface in the 14" casing which was perforated from 132', to 300', total depth. If you have any questions concerning this short summary of my observations, please call me. I will prepare a more detailed stratigraphic section if it is needed, but it is my opinion that the stratigraphy is quite changeable within short distances; but mainly on the sandy side as river bottoms usually are. Yours truly, .-¡ -;> .0 ^ ,/7¿;.¿:/uuj}. /t /LL<.L'<;:,- Michael R. Rector Registered Geologist California Certificate No. 78 MRR:eaa E, III#"' Wa i<f,v ¿Jul / ~() ( IV'~ ~c. Aid IW 7fV VI /l(. . . PI c'£ I , COUNTY G.l1I2 ¡.I -_._._~ bASð¿lll/£ ClfLa'V1 \J/A r5 . / A"'1Vk ..J",b,L () 6s (" /z I P T/Q,v L. )- -I..v C L Oé/f- r/() " æ It'Ecfð..e 1'1';., 0" fI f' -1-. 7..- 0 I 13 Y ./Þl (<::J-I A 6 ¿ , ' ' w' ~ /ô) {)()U 7a{ )('2.. __~.n:. cJ¡f,Atfi - X· V 10) 0 () D ? It I ~ ~ 2. 4-' "111' - oIl ~" ,{k ~J p/:r ,J¿(r.-¿ (: 4-'1::. s I (ÇJ tP~k.) , E ,{ tl ( rJ / I "--.J ~ ----- --- -- · . Office Memorandum KERN COUNTY August 23, 1989 ,~ ,-,1 (-. 'e-::-' lr::::· ~ ~ ¡n r-::J:---.. ;-'\ \ .:;:] I \. J.-.~.:J ~! '\\/ ; 1:"_. ¡ rN",-., \ ¡ '_.J I to.- I] I ,¡ \.. J r-' , \ I' . ......1 ~.,' :::::. 'J ,-, c::.;1!j¿J1 I,·, , I I LJ (I I _J" ~, AUG, 3 1989 TO: Turonda R. Crumpler, Environmental Health Specialist Kern County Health Department Division of Environmental Health êN\ìiRÓNMENTAL HEALTH FROM: A. E. Richter, C.E. IV Public Works Department Capital Projects Construction ¡tc~ TELEPHONE: 861-2481 x265 SUBJECT: Administration Bldg New Fuel Tank Project The recent discovery of a metallic storage tank on this site prompts this correspondence. The Public Works Department proposes to accomplish the following with regard to this tank; 1. Perform site assessment a. Contractor to obtain all necessary permits required to remove and dispose of the tank. b. Contractor will remove tank and determine it's contents (if any). Should the tank be found to contain any substance it shall be disposed of according to Health Department requirements. Should \\ the ta~k be empty it shall be rinsed and the rinsate disposed of r}~' ,) /-!~ .\ accord1ngly. ~. ~ '"-\'''t:.-~''-'<- ~0r~' Contra~tor shal: sample the soil, beneath the tank in the "'l, \~\ \.\'('<~'- ~,'-:' p~escr1bed, fash10n ( approx. 2' 1n from each end and in the t:.:-..,.- -~ \\\->S m1ddle) uS1ng B. C. Labs locally to perform tests. ~£.\ ~___{\-0-01\;ea,:~-2¡ ~ G l ~~~\- ~ased upon the results of these tests, a single course of action will be taken , (from a possibility of two, courses of action) to mitigate the problem. Should the soil tests indicate no contamination exists, the following will take place: 1. Remove the tank to the contractors storage facility for disposal at a later date at an approved disposal facility. 2. Backfill and compact with suitable material the excavated (and vacated) space. Should the soils tests indicate the presence of contamination the following will take place: 1. Determine the extent of contamination using an approved method--most likely thru the use of soils tests obtained by boring in strategic locations. 2. Remove contaminated material and dispose of at an approved disposal 'facility. . . Should the soils tests indicate the presence of contamination and a plan of action become necessary which details where borings are to be taken, then such a plan will be submitted for your approval. It should be noted that this contracto.r (RLW Inc.) will be accomplishing all the work associated with this tank and site removal/mitigation under the terms of the original contract. Pulic Works appreciates your cooperation and assistance in this matter. Should you have further comments or recommendations please, do not hesitate to contact me at this office. o . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR, 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Arorrøtics ( SOl L ) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 22-Sep-89 Lab No. : Sample Desc: 7433-1 Truxtun & "L" Sts 11' Under Island DATE SAMPLE RECEIVED @ LAB: 21-Sep-89 i DATE A~ COMPLETED: 22-Sep-89 \\!-)\A h~00 J \ 1 I DATE SAMPLE COLLECTED: 21-Sep-89 ¿ Constituent Reporting Units Analysis Results Minirrrun Repxting Level Benzene Toluene Ethy 1 Benzene p-Xylene m-Xylene a-Xylene ug/g ug/g ug/g ugjg ug/g ug/g 9.97 82.77 162.37 266.52 608.75 378.72 0.02 0.02 0.02 0.02 0.02 0.02 Total Petroleum Hydrocaroons ugjg 17345.76 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method, Individual constituent.s by EPA method 8020. Dr:\.' Matter B3,sis Comrr.ents : California D.O.H.::., Cert. -¡tl02 ~; [ J l~iJ __~~fuc-__-c___ '...../ /·,rJ.~~~..".r_'-! By...__u____ .. -. - ...- --- -~-- "- .~_._.._.-... -- ---- . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Pu.rgeable Aromatics (:30IL) McNabb Construction 7808 Olcott Ave B~ersfield, CA 93308 Attention: BIyar¡ McNabb Date 'of Rep()~-t: 22-:3ep-89 Lab No. : Sarnr:>le Desc: 7433-2 Tn.1xtun ¡$: "L" :3ts 1.3' Under Islarld DATE SAMPLE COLLECTED: 21-:3ep-89 DATE SAMPLE RECEIVED @ LAB: 21-Sep-89 DATE ANALYSIS COMPLETED: 22-Sep-89 Constituent Rep:·rting Units Analysis Results Minimum Rep::>rting Level Total Petroleum Hydrocarr..üns ug/ g none detected 0.02 0.09 0.02 \u.07 0.02 0.13 0.02 0.28 0.02 0.21 0.02 19.E16 fl.OO Benzene ug/g Toluene ug/g Ethy 1 Benzene ug/ g p-Xylene ug/g m-Xylene ug/g a-Xylene ug/g TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Individual constituents rJy EPA method 8020. Dry Matter B3..'3is Comments: California D.O.H.S. Cert, ~102 ~~:?~] j ; J u_}~-1AJ~_~~)Új k_o__ I" t /'J;:.: ~.~:. ',"! - By ____no_no n__ . _____ _~ _____________m_____.__.___. ENVIRONMENTAL . . LABORATORIES, INC. " CHEMICAL ANALYSIS PETROLEUM J. J, EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable P..rorrBtics (SOIL) McNabb Constn~ction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Repc.'i.:-t: 22-Sep-89 Lab No. : Sample Desc: 7433-3 TnJxtun <'Y. "L" Sts 1t:) - Onder Island DATE SAMPLE COLLECTED: 21-Sep-89 DATE SAMPLE RECEIVED @ LAB: 21-Sep-89 DATE ANALYSI2, COMPLETED : 22-Sep-89 Constituent RepJrting Units Analysis Results Minimum Re¡:orting Level Benzene Toluene Etby 1 Benzene p-Xylene rn-Xylene a-Xylene ug/g ug/g ug/g ug/g ug/g ug/g none detected none detected none detected none detected none detected none detected 0.02 0.02 0.02 0.02 0.02 0.02 Total Petroleum H,vdrocarb-.ms ug/g 9.98 5.00 TEST METIIOD: TPH for gasoline rJy D, O. H . S, L. U . F . T. TfJE=thod . Individual cc~stiDJents by EPA rr~thod 8020. Dry i-latter Basis Corrn~nts : California D,O.H.S. Cert. #102 F~[~Jjfi ~fQ"r:A:;L o.L~_ By ---- -- --- --- ----- . . ENVIRONMENTAL LABORATORIES5 INC. J. J. EGLIN, REG. CHEM. ENGR, 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 CHEMICAL ANALYSIS PETROLEUM BTX/TPH GASOLINE Quali ty Control Data McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryarl McNabb Spike ID: 7378-5 Analysis Date: 22-Sep-89 Sample Matrix: Soil Uni ts: ug/g Quali ty Control for Lab Nos: 7433-1, 7433-2, 7433-3 One sample in twenty is selected as a representative matrix which is spiked. The percentage recovery (?Io Rec) of the spike is a relative measure of the accuracy of the analysis, The comparison of trJe spike wi th a duplicate spike is a msasure of the relative precision of t,he arialysis . Constituent t' Cone. Cone. Dup in Spike Added V..J Spike Spike Spil...e S:unple Spike % Ree % Pee RPD -------------------------------------------------------------------- Benzene 0.00 ~\. 01 87.02 91.50 5.02 Toluene 0.00 :S.03 99.57 102,87 3:26 Eth.v 1 Benzene 0.00 5.09 88.29 91.12 3.15 p-Xylene 0.00 ['.02 90.21 92.53 2.[\4 m-Xylene 0.00 5.11 94.22 96.91 2.81 a-Xylene 0.00 5,03 92.18 95.88 3.93 TPH Gas 0.00 301.06 97.1'1 99.34 2.27 QC Corrrnents : ;3piked s':UTJple Concentration - ~3arTJple Concentration ~'{ Recovery = --- ----------------- ---------------- ---- --- ---- ~ ---- X 100 (Concentration of SpikE::) BPI) (Relat:iv~ Percent DifferF:1Jc(;) -- ,··:d ?.~~n!.'J.:·' .r .... ,,: }.~.:.r1 T'rt IT:1 ; .,-·:·:¡t ~-. ~:--,::'~rnL\l .~, 1"1l . . - - -. ._- "l J (.\; , ( PJ.VeJ....:.-:I.F(t-_~ ." ' 1: . ,.J" :;J.\iJ:t::'.(~ ';i ENVIRONMENTAL CHEMICAL ANALYSIS PETROLEUM . . LABORATORIES, INC. J, J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) Date of Report: 20-Sep-89 McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: Sample Desc: 7388-1 County Garage - Truxtun & "L" Sts South Tank ,East End 22' DATE SAMPLE COLLECTED : 20-Sep-89 Constituent Benzene Toluene Ethyl Benzene p-Xy lene rn-Xylene o-Xylene Total Petroleum Hydrocarbons DATE SAMPLE RECEIVED @ LAB: 20-Sep-89 DATE ANALYSIS ca1PLETED : 20-Sep-89 frtt.iJ: ~~~ ~t~ MinÌID.lm Reporting Level 0.02 0.02 0.02 0.02 0.02 0.02 5.00 Reporting Units Analysis Results ugfg ug/g ug/g ugjg ugfg ugfg none detected 0.11 0.10 0.23 0.48 0.49 ugfg 36.63 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F .T. method. Individual constituents by EPA method 8020. Dry Matter Basis Corements : Califo:rnia D.O. H. S. Cert. #102 By s~~ ^"~& .J. J. Eglin f~ J, C{jJQ , ' lyst . . ENVIRONMENTAL ' LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG, CHEM. ENGR, 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 20-Sep-89 Lab No. : Sample Desc: 7388-2 County Garage - Truxtun & UL" Sts South Tank East End 24' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED : RECEIVED @ LAB: ca1PLETED : 20-Sep-89 20-Sep-89 20-Sep-89 Minirruro Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g none detected 0.02 Toluene ugjg none detected 0.02 Ethyl Benzene ug/g none detected 0.02 p- Xylene ug/g 0.06 0.02 m-Xylene ugjg 0.12 0.02 o-Xylene ug/g 0.15 0.02 Total Petroleum Hydrocarbons ug/g 30.48 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Individual constituents by EPA method 8020. Dry Matter Basis CortlfJ::nts : California D.O.H.S. Cert. #102 J. J. Eglin -d2J,~(l :b ctLk _'A.né:llyst . By . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN. REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327·4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb DatE: of Report: 20-Sep-89 Lab No.: Saxnple Desc: 7388-3 County Garage - Truxtun & "L" Sts North Tank East End 22' DATE SAMPLE COLLECTED : 20-Sep-89 DATE SAMPLE RECEIVED @ LAB: 20-Sep-89 DATE ANALYSIS CCt1PLETED : 20-Sep-89 Constituent Rep::>rting Units Analysis . Results MinirWIU Rep::>rting Level Benzene Toluene Ethyl Benzene p- Xylene m-Xylene o-Xylene ug/g ug/g ug/g ug/g ug/g ug/g none detected 0.22 0.18 0.32 0.67 0.52 0.02 0.02 0.02 0.02 0.02 0.02 Total Petroleum Hydrocarbons ug/g 24.86 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Individual constituents by EPA tæthod 8020. Dry Matter Basis Corements: California D.O.H.S. Gert. #102 .J. J, Eglin ~J ~ cUJ- \, Analyst By . . ENVIRONMENTAL LABORATORIES, INC. J. J. EGLIN, REG. CHEM. ENGR, 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327·4911 CHEMICAL ANALYSIS PETROLEUM Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 20-Sep-89 Lab No.: Sample Desc: 7388-4 County Garage - Truxtun & "L" Sts North Tank East End 24' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: cc:t1PLETED : 20-Sep-89 20-Sep-89 20-Sep-89 MiniIII..U£1 Reporting Analysis Reporting Consti tuent Units Results Level Benzene ug/g none detected 0.02 Toluene ug/g none detected 0.02 Ethy 1 Benzene ug/g none detected 0.02 p-Xylene ug/g none detected 0.02 m-Xy lene ug/g none detected 0.02 o-Xylene ug/g none detected 0.02 Total Petroleum Hydrocarbons ugjg none detected 5.00 TEST METHOD: '!'PH for gasoline by D.O. H. S. L. U. F . T. method. Individual constituents by EPA method 8020. Dry Matter Basis Coranents : California D.O.H.S. Gert. #102 ,J. .J. Eglin . -h~l;s~dJL By . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327·4911 BTXiI'PH GASOLINE Q.tali ty Control Data McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Spike ID: 7226-2 Analysis Date: 20-Sep-89 Sample Matrix: Soil Units: ug/g Q.1ality Control for Lab Nos:, 7388-1, 7388-2, 7388-3, 7388-4 One sample in twenty is selected as a representative matrix which is, spiked. The percentage recovery (% Bee) of the spike is a relative measure of the accuracy of the analysis. The comparison of the spike with a duplicate spike is a measure of the relative precision of the analysis. Cone. Cone. D.lp in Spike Added to Spike Spike Spike Constituent Sample . Spike % Rec %Rec RPD --------------------------------------------------------------------" Benzene 0.00 5.01 92.55 94.01 1.57 Toluene 0.00 5.03 100.42 97.48 2.97 Ethy 1 Benzene 0.00 5.09 83.32 88.93 6.51 p-Xy lene 0.00 5.02 88.21 91.79 3.98 m-Xy lene 0.00 5.11 91.18 93.78 2.81 o-Xylene 0.00 5.03 89.05 94.10 5.51 TPH Gas 0.00 301.06 93.53 95.84 2.44 OC Corrments: Spiked Sample Concentration - Sample Concentration % Recovery = -------------------------------------------------- X 100 (Concentration of Spike) RPD (Relative Percent Difference) = Spiked Sample Cone. - Spiked fuplicate Sample Cone. ----------------------------------------------------- X 100 (Average Cone. of Spikes) , '?u,\(}, '\ '\ . \\ \vl '\.) ('I .' . .- I J QISJ,<ì '3 ~,,~ J ~U:5='I'ü[ \> ~ '~\ ':1> I L, ; \ \ ~ "\'Vt\ n 00 / ~ ~Ol1u(~/v,d \~ \ '\vt-\ \C\ v\r.:A \J \ Ö I --\~-t \ {\ ,\ \;> fXY N ~ \()~ CV\~ð- V~ W0--~! ~ \ '~~r£-d J)\GL)~ :\,ry-;:5\J \. \/\ C\ J .0,....., 4'_ ~0! 6h~ð0~ \~ ENVIRONMENTAL . . LABORATORIES, INC. CHEMICAL ANALYSIS 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 13-Sep-89 Lab No.: Sample Desc: 7180-1 Truxtun & "L" Sts North Tank East End 2' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: ca1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 Minirr.urn Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g 0.14 0.02 Toluene ug/g 0.48 0.02 Ethy 1 Benzene ug/g 0.81 0.02 p-Xylene ug/g 1.61 0.02 m-Xylene ug/g 3.55 0.02 o-Xylene ug/g 2.96 \,0.02 Total Petroleum Hydrocarbons ug/g 136.46 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Individual constituents by EPA rrethod 8020. Dry Matter Basis CC.'ITlfJents : Califonlia D.O. H . S. Cert. #102· By-- ~ J>aJ.L- - 'Ar ,ly-:t-----:-:- -------- .]. .J. Eglin 1 PHON; ? E- r-' ~ ~ . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics ( SOIL') McNabb Con.sUuction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNab~ Date of Report: 13-$ep-89 Lab No.: Sample Desc: 7180-2 Truxtun & "L" Sts North Tank East End 6' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: ca1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 Minim..un Reporting Analysis Reporting Con.stituent Units Results Level Benzene ug/g 0.08 0.02 Toluene ug/g 0.23 0.02 Ethyl Benzene ug/g 0.32 0.02 p-Xylene ug/g 0.56 0.02 m-Xylene ug/g 1.11 0.02 o-Xylene ug/g 0.96 0.02 Total Petroleum Hydrocarbons ug/g ,50.43 5.00 TEST METHOD: TPH for gasoline by D.O. H . S. L. U . F . T. method. lndi vidual constituents by EPA method 8020. Dry Matter Basis Corrrænts : Califor.nia D.O.H.S. Cert. #102 By -__n_________._. ,J. ..1, Eg} j lJ . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Arorratics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: ' 13-Sep-89 Lab No,: Sample Desc: 7180-3 Truxt.un & "L" Sts North Tank West End 2' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: ca1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 . Minim.un ReJX)rting Analysis Reporting Constituent Units Results Level Benzene ug/g ,none detected 0.02 Toluene ug/g none detected 0.02 Etlw 1 Benzene ug/g none detected 0.02 p-Xylene ug/g none detected 0.02 m-Xylene ug/g none detected 0.02 o-Xylene ug/g none detected 0.02 Total Petroleum Hydrocaroons ug/g none detected 5.00 TEST METHOD: TPH for gasoline by D.O. H. S. L. U . F . T. method . Individual constituents by EPA method 8020. Dry Matter Basis Corrrœnts : California D.O.H.S. Cert. #102 ,J. ,J. EglitJ By ENVIRONMENTAL . . LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM, ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 B~geable Arorratics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 13-Sep-89 Lab No. : Sample Deisc: 7180-4 Truxtun & "L" Sts North Tank West End 6' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: CXX1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 Minirwm Reporting Analysis Reporting CorlSti went Units Results Level Benzene ugjg none detected p.02 Toluene ug/g none detected 0.02 Ethyl Benzene ugjg none detec-œd 0.02 p-Xylene ugjg none detected 0.02 m-Xylene ug/g none detected 0.02 o-Xylene ugjg none detected ' 0.02 Total Petroleum Hydrocaroons ugjg none detected 5.00 TEST METHOD: !PH for gasoline by D.O.H.S. L.U.F.T. rœthod.. Individual consti wents by EPA method 8020. Dry Matter Basis CoITITIE:nts : California D.O.H.S. Cert. #102 .J. ,J. Eglin f~ ~<t!k naly s1.. . ' By. ENVIRONMENTAL . . LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN. REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 3: J ~lrgeable Arorratics (SOIL) ~ ) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 13-Sep-89 Lab No. : 7180-5 Sample Desc: Tzuxtun & "L" Sts South Tank East End 2' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLEcrED : RECEIVED @ LAB: COMPLETED : 12-Sep-89 12-Sep-89 13-Sep-89 MiniTlLlß) Reporting Analysis Reporting Constituent Uni ts Results Level Benzene ug/g 12.98 0.02 Toluene ug/g 133.74 0.02 Ethy 1 Benzene ug/g 65.32 0.02 p-Xylene ug/g 144.32 0.02 m-Xylene ug/g 338.28 0.02 o-Xylene ug/g 237.27 0.02 Total Petroleum Hydrocarbons ug/g 4170.28 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Individual corLSti tuents by EPA method 8020. Dry Matter Basis Cí..lrrmemts : California D.O.H.S. Cert. #102 By. ------- -H:l~cill,,· ...1. .J. Eglin . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J, EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable AroITatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 13-Sep-89 Lab No. : Sample Desc: 7180-6 Truxtun & "L" Sts South Tank East End 6' DATE SAMPLE COLLECTED: 12":'Sep-89 DATE SAMPLE RECEIVED @ LAB: 12-Sep-89 DATE ANALYSIS COMPLETED : 13-Sep-89 Constituent Reporting Units Analysis Results l1inirwITJ Re¡x:>rting Level Benzene Toluene Ethy 1 Benzene p-Xylene m-Xylene o-Xylene' ugjg ugjg ug/g ug/g ugjg ug/g 2.65 15.17 8.33 14.'55 33.23 24.44 0.02 0.02 0.02 0.02 0.02 0.02 Total Petroleum Hydrocarbons ugjg . 629.17 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. rrethod. Individual constituents by EPA method 8020. Dry Matter Basis Corrments : California D.O.H.S. Cert. #102 By ~L~aJh ,J. .J. Eglin . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield) CA 93308 Attention: Bryan McNabb Date of Report: ,13-Sep-89 Lab No.: Sample Desc: 7180-7 Truxtun & "L" Sts South Tank West End 2' DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECI'ED : RECEIVED @ LAB: Cct1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 Minirwm Reporting Analysis Reporting Constituent Uni ts Results Level Benzene ug/g none detected 0.02 Toluene ug/g none detected 0.02 Ethy 1 Benzene ug/g none detected 0.02 p-Xylene ugjg none detected 0.02 m-Xylene ug/g none detected 0.02 o-Xylene ugjg none detected 0.02 Total Petroleum Hydrocarbons ug/g none detected 5.00 TEST METHOD: TPH for gasoline by D.O. H. S. L. U . F . T. rrethod. Individual cor~tituents by EPA n~thod 8020. Dry Matter Basis Corrlnents : California D.O.H.S. Cert. #102 .J, .J. EgliI1 ~':'l~t«1J.,- By . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG, CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb ConstI1lction . 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: ' 13-Sep-89 Lab No.: Sample Desc: 7180-8 Truxtun & "L" Sts 'South Tank West End 6' DATE SAMPLE' DATE SAMPLE DATE ANALYSIS COLLECTED : RECEIVED @ LAB: CCt1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 Minirwm Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g none detected 0.02 Toluene ugjg none detected 0.02 Ethyl Benzene ug/g none detected 0.02 p-Xylene ug/g none detected 0.02 m-Xylene ugjg none detected 0.02 o-Xylene ug/g none detected 0.02 Total Petroleum Hydrocaroons ug/g none detected 5.00 TEST METHOD: TPH for gasoline by D.O.R.S. L.U.F.T. method. lndi vidual corlSti tuents by EPA method 8020. Dry Matter B?sis Corrments : California D.O.R.S. Cert. #102 .J. ,J. Eglin By . . ENVIRONMENTAL LABORATORIESs INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. pC) , ,.-J <I (\), J'I 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE PurgeableAromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 13-Se~89 Lab No.: Sample Desc: 7180-9 Truxtun & "L" Sts Side of spoil pile ~6t> r;1"""~ ~~ DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED : RECEIVED @ LAB: CCt1PLETED : 12-Sep-89 12-Sep-89 13-Sep-89 Minirwm Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g 0.57 0.02 Toluene ug/g 3.34 0.02 Ethyl Benzene ug/g 3.35 0.02 ~Xylene ug/g 6.70 0.02 m-Xylene ug/g 5.04 0.02 a-Xylene ug/g 13.90 0.02 Total Petroleum Hydrocarbons ug/g 395.69 5.00 TEST METHOD: '!'PH for gasoline by D.O.H.S. L.U.F.T. method. Individual cor~tituents by EPA method 8020. Dry Matter Basis Corrrœnts : California D.O.H.S. Gert. #102 a, By--------------------- ..1. ..1, Eglin I~J~ufu- ENVIRONMENTAL CHEMICAL ANALYSIS PETROLEUM . . LABORATORIES, INC. J. J, EGLIN, REG. CHEM, ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Arorüatics (SOIL) Date of Report: ,13-Sep-89 McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Lab No. : Sample Desc: DATE SAMPLE COLLECTED : 12-Sep-89 Constituent Benzene Toluene Ethy 1 Benzene p-Xylene m-Xylene o-Xylene Total Petroleum Hydrocarbons (j('5( (þ) cF- 1'"~ ;;:~ & "L" Sts ../' ~ M--Æ 'f ~~ ') Top of spoil pile \2 ~ DATE SAMPLE DATE ANALYSIS RECEIVED @ LAB: CCt1PLETED : 12-Sep-89 13-Sep-89 Minirwm Reporting Analysis Reporting Units Results Level ug/g 3.68 0.02 ug/g 40.94 0.02 ug/g 33.83 0.02 ug/g 70.87 0.02 ug/g 160.86 0.02 ug/g 92.86 0.02 ug/g 2951.30 5.00 TEST METHOD: '!'PH for gasoline by D.O.H.S. L.U.F.T. rœthoo. Individual COI1Sti tuents by EPA Irp-thod 8020. Dry Matter Basis Corrroents : California D.O.H.S. Gert. #102 BYn .J. .J, Eglin 1rY1nJlll~ i:>~_ ~k~lYsi., , . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN. REG. CHEM, ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 BI'X/I'PH GASOLINE Q.¡ali ty Control Data McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNa.bb Spike ID: 71~)2-2 Arlalysis Date: 13-Sep-89 Sample Matrix: Soil Units: ug/g Q.¡ali ty Control for Lab Nos: 7180-1, 7180-2, 7180-3, 7180-4, 7180-5 7180-6, 7180-7, 7180-8, 7180-9, 7180-10 One sample in twenty is selected as a representative matrix which is spiked. The percentage recovery (% Bec) of the spike is a relative measure of the accuracy of the analysis. The comparison of the spike wi th a duplicate spike is a IfBasure of the relative precision of the analysis. Cone. Cone. fup in Spike Added to Spike Spike Spike CorLSti tuent Sample Spike ~~ Roc % Bee RPD -------------------------------------------------------------------- Benzene 0.00 5.01 94.60 93~81 0.84 Toluene 0.00 5.03 101. 78 101.86 0.08 Ethy 1 Benzene 0.00 5.09 92.33 93.52 1.28 p-Xylene 0.00 5.02 94.97 95.69 0.76 m-Xylene 0.00 5.11 97.91 98.06 0.1:\ o-Xylene 0.00 5.03 98.71 97.76 0.97 TPH Gas 0.00 301.06 95.80 106.58 lO.6~¡ Q:; Coraœnts: Spiked Sample Concentration - S.::1If1ple Concentration % Recovery = -------------------------------------------------- X 100 (Concentration of Spike) RPD (Relative Percent Difference) = , Spj kêd 2>élJlJplE: GAIC. - Spik""ò DuplicatE: SamplE: Cc·nc. ---------------------------.---------------------.----- X 1 no (AveragE: Cone. of Spikes) . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN. REG. CHEM. ENGR, 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 01-Sep-89 Lab No.: Sample Desc: 6755-1 ' Civic Center Pump M3 10' Below Pipe DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED: RECEIVED @ LAB: COMPLETED : 31-Aug-89 31-Aug-89 31-Aug-89 Minirrum Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g 0.79 0.02 Toluene ug/g 0.94 0.02 Etby 1 Benzene ug/g 2.11 0.02 p-Xylene ug/g 3.53 0.02 m-Xylene ug/g 7.17 0.02 o-Xylene ug/g 2.46 0.02 Total Petroleum Hydrocarbons ug/g 168.50 5.00 TEST METHOD: '!'PH for gasoline by D.O.H.S. L.U.F.T. method. Individual constituents by EPA method 8020. Dry Matter Basis Corrrœnts: California D.O.H.S. Gert. #102 .J, .J. Eglin l--'1~f-,L ~ QQ, b í1- ^~,:-.l,y,,:t ......,' tuL......'1......J By . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J, EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Const:ruction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 01-Sep-89 Lab No.: Sample Desc: 6755-2 Civic Center Pump AB 12' Below Pipe DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECfED : RECEIVED @ LAB: CCMPLETED : 31-Aug-89 31-Aug-89 31-Aug-89 Minirrum Reporting Analysis Reporting Constituent Uni ts Results Level Benzene ug/g 0.11 0.02 Toluene ug/g 0.14 0.02 Ethyl Benzene ug/g 0.80 0.02 .p-Xylene ug/g 1.43 0.02 m-Xylene ug/g 3.10 0.02 o-Xylene ug/g 0.80 0.02 Total Petroleum Hydrocarbons ugjg 104.75 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. ræthod. Individual corLSti tuents by EPA method 8020. Dry Matter Basis Corrments : California D.O.B.S. Cert. ~102 .J. .]. Eglin ~(yµ lJ;'~~__ rj- ~ . A ::¡lys't By ENVIRONMENTAL CHEMICAL ANALYSIS PETROLEUM . . LABORATORIES, INC. McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: Sample Desc: J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics . (SOIL) Date of Report : 6650-1 County of Kern' Yard - Truxtun & "L" Sts. 2 ft under pump AB DATE SAMPLE COLLECTED: 25-Aug-89 Constituent Benzene Toluene Ethyl Benzene p- Xylene m-Xylene o-Xylene Total Petroleum Hydrocarbons Reporting Units ugJg ug/g ug/g ugJg ug/g ug/g ugJg DATE SAMPLE RECEIVED @ LAB: 29-Aug-89 DATE ANALYSIS cn1PLETED : 29-Aug-89 29-Aug-89 v ~ ~ qj J\ Analysis Results 29.90 67.75 55.19 91.12 191.07 132.11 - 4557.~ 44 . . Ç.,....... "-"-. Mininurn Reporting Level 0.02 0.02 0.02 0.02 0.02 0.02 5.00 TEST METHOD: '!'PH for gasoline by D.O.H.S. L.U.F.T. method. Indi vidual cor1Sti tuents by EPA rœth,od 8020. Dry Matter Basis Cooments : California D.O.H.S. Gert. #102 By .J. ,J. Eglin H1YS~~· . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG, CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 29-Aug-89 Lab No.: Sample Desc: 6650-2 County of Kern Yard - Trux:b.m & "L" Sts. 6 .ft under pJmp AB DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED : RECEIVED @ LAB: CCliPLETED : 25-Aug-89 29-Aug-89 29-Aug-89 MiniIwm Reporting Analysis Reporting Constituent Units Results Level Benzene ugfg 5.26 0.02 Toluene ugfg 8.33 0.02 Ethyl Benzene ugfg 30.97 0.02 p- Xylene ugfg 49.71 0.02 In- Xylene ugfg 107.07 0.02 o-Xylene ugfg 23.54 0.02 ... Total Petroleum Hydrocarbons ugfg , 2003.64 5.00 TEST METHOD: TPH for gasoline by D.O. H. S. L. U . F . T. method. Individual constituents by EPA method 8020. Dry Matter Basis Corrments: California D.O.H.S. Gert. #102 J. J. Eglin J2- L ,J,eLQk ~!alyst By ENVIRONMENTAL . . LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN. REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield. CA 93308 Attention: Bryan McNabb Date of Report: 29-Aug-89 Lab No.: Sample Desc: 6650-3 County of Kem Yard - Truxtun & "L" Sts. 2 ft under pJIUp AE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED : BECEIVED @ LAB: cœpLETED: 25-Aug-89 29-Aug-89 29-Aug-89 Min:iIJJ.un Reporting Analysis Reporting Constituent Units Results Level Benzene ugjg none detected, 0.02 Toluene ug/g none detected 0.02 Ethyl Benzene ug/g none detected 0.02 p-Xylene ug/g none detected 0.02 m-Xylene ug/g none detected 0.02 o-Xylene ug/g none detected 0.02 Total Petroleum Hydrocaroons ugjg none detected 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. Iœthod. Individual constituents by EPA method 8020. Dry Matter Basis Corrments : California D.O.H.S. Cart. #102 By 1?~ .1)a1k () ~ lyst J. J, Eglin ENVIRONMENTAL . . LABORATORIES, INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 29-Aug-89 Lab No.: SamPle Desc: 6650-4 County of Kern Yard - T:ruxtun & "L" Sts. 6 ft under PJJDP AE DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECTED : RECEIVED @ LAB: CCtiPLETED : 25-Iwg-89 29-Aug-89 29-Aug-89 Minim.Jm Reporting Analysis Reporting Constituent Uni ts Results Level Benzene ugjg ,none detected 0.02 Toluene ug/g none detected 0.02 Ethy 1 Benzene ug/g none detected 0.02 p-Xylene ug/g none detected 0.02 m- Xylene ug/g none detected 0.02 o-Xylene ug/g none detected 0.02 Total Petroleum Hydrocarbons ug/g none detected 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Individual constituents by EPA method 8020. Dry Matter Basis Corrments : California D.O.H.S. Cert. #102 J. .J. Eglin ~1'~. --1<U.k- AT yst By . . ENVIRONMENTAL LABORATORIES, INC. CHEMICAL ANALYStS PETROLEUM J. J. EGLIN. REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 BTXíI'PH GASOLINE Quali ty Control Data McNabb Const:ruction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Spike ID: 6706-23 Analysis Date: 31-Aug-89 . Sample Matrix: Soil Units: ug/g Quality Control for Lab Nos: 6755-1, 6755-2 . One sample in twenty is selected as a representative matrix which is spiked. The percentage recovery (% Rec) of the spike is a relative measure of the, accuracy of the analysis. The comparison of the spike with a duplicate spike is a measure of the relative precision of the analysis. Cone. Cone. lli¡:1 in Spike Added to Spike Spike Spike Constituent Sample Spike % Rec % Rec RPD -------------------------------------------------------------------- Benzene 0.00 5.01 85 . 2:7 83.97 1.54 Toluene 0.00 5.03 106.20 111.05 4.46 Ethyl Benzene 0.00 5.09 83.48 88.86 6.24 p- Xylene 0.00 5.02 84.90 90.04 5.88 m-Xylene 0.00 5.11 88.22 93.44 5.75 a-Xylene 0.00 5.03 88.15 93.83 6.24 TPH Gas 0.00 301.06 83.42 83.10 0.38 OC Conments: Spiked Sr..lIf1Ple Concentration - Sample Concentration % Recovery = -------------------------------------------------- X 100 (Concentration of Spike) RPD (Relative Percent Difference) - Spiked Sample Cone _ - 2,piked Duplicate s...~ple 0::mc. ----------------------------------------------------- X 100 (Average Cone. of Spike~) ENVIRONMENTAL . . LABORATORIES! INC. J. J. EGLIN. REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 CHEMICAL ANALYSIS PETROLEUM BTX/l'PH GASOLINE Quality Control Data McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bzyan McNabb Spike ID: 6596-1 Analysis Date: 29-Aug-89 Sample Matrix: Soil Units: ug/g Q..1a1ity Control for Lab Nos: 6650-1, 6650-2, 6650-3, 6650-4 One sample in twenty is selected as a representative matrix which is spiked. The percentage recovery (% Bee)' of the spike is a relative measure of the accuracy of the analysis. The comparison of the spike with a duplicate spike is a rœasure of the relative precision of the analysis. Cone. Cone. fup in Spike Added to Spike Spike Spike Constituent Sample Spike %Ree %Rec RPD -------------------------------------------------------------------- Benzene 0.00 5.01 93.37 98.14 4.98 Toluene 0.00 5.03 100.47 103.05 2.54 , Ethyl Bènzene 0.00 5.09 92.24 95.84 3.83 p-Xylene 0.00 5.02 95.52 99.54 4.12 m-Xylene 0.00 5.11 95.72 101.45 5.81 o-Xylene 0.00 5.03 96.72 102.19 5.50 TPH Gas 0.00 301.06 98.02 89.45 9.14 OC Conroents: Spiked Sample Concentration - Sample Concentration % Recovery = -------------------------------------------------- X 100 (Concentration of Spike) RPD (Relati ve ~ercent Difference) = Spiked Sample Cone.- Spiked fuplicate Sample Cone. ----------------------------------------------------- X 100 (Average Cone. of Spikes) 08,<::4/89 14:. Z 80S 327 1918 BC La.t.o," i eo, 01 I ~ M C ~ ..,¡ AÇfllCIII Trlfll LABORATORIES. inC. J. J. £GlIN, UG. CWfM. U4Gt. 4100 PIERCE RD., BAKERSFIElD. CMIFORNI^ 93308 PHONE ~ CHt MICAt ANAl t'S/$ ,.tT~ðUUU f^CSIMILE rnMtSHI5SION COVEn SItEET D~te of Trrmsmission: 3-' ~)q.,,~Ct TO: ^TTENTI ON: ·-Yl~/IJl..Ld.l1,,· COl1\p~ny ; ll..:....Jj {}j_l.~1--11~f·:t. F^X Number ~{:J .- :3 L:l;:;¿ q -.............-..----.-------..-.-.---- COHHENTS: . e f ~ /Yì~.:D'lbÞ GnuiÝ.-, 'ÁJJ.;/'IY~' ~}li'7(1. CL~("":Ç/ Ît. -t--, I \, ?,,~_, 1\ ~ r1--¡-;' I. I! U./rlJ....Q,hl v-~~C!.- l.).J-\! _L!J.:n.~ ' .- ' .-------... ......-....--- .-.--.........-..---.----.--...--þ----- ^NY PROBLEMS WITH TR^NSMISSION, I"LF.^SE C^LI.: l-ß05-3'7-/I~n1 Ext'n: .2/,';) TrOh<mitted by: ~ ~Robfu,."",tQ..d Number of rñge!: (tncludinQ cover !;hr.r.l): _¡).______ n c l^80R^TORIES. INC. "':::,24 :::9 14:2r::. Z 805 327 1918 BC LabOt~·ator'ies ~:1 2 . . AGltlClI1 Wilt LABORATORIES. Inc. J. J, EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSfiELD, CALIFORNIA 93308 PHONE 327~4911 CHlMICAI ANAlYSIS ,., TROI.lUM MCNABB CONSTRUCTION CO 7806 OLCOTT AVE BAKERSFIELD, CA 9330a Attn.: BRYAN MCNABB 399-4742 Date Reported: 08/24/69 Pate Received: 08/23/89 Laboratory NO.: 6544-2 Page 1 sample Description: CIVIC CENTER WASTE OIL TANK 61 SAMPLED BY DAVID RITTENHOUSE OF B.C LABS TOTAL CONTAMINANTS (Title 22, Article II, California A~mini8trative Code) Method Constituents Sample ReBultø P.O.L. Ynlli Method Ref. Lead "",..r..,e-te~ 2.5 mg/kg 6010 ~ TOX 'It01'I~ 20. mg/kg 9020 1 Oil Ó< Grease ~~~8.0t_ 20. mg/kg 413. . 2 (See Last Page for comments, Definitions, Requlatory Criteria, and References) Constituents Regulatorv Criteria STLC, maIL TTLC, mg/kg Lead 5.0 1000. comment; All constituents reported above are in mg/kg (unless otherwise stated) on an as received (wet) sample basis. Results reported represent totals (TTLC) as sample subjected to appropriate techniques to determine total levels. Practical Quantitation Limit (refers to the least amount of ana1yte detectable Þaseà on sample size used and analytical technique employed. None Detected (Constituent, if present, would be leee than the method P.Q.L.). Inaufficient, Sample P.Q.L. ~ N.D. '" I.S. .. STLC TTLC .. Soluble Threshold Limit Concentration '" Total Threshold Limit Concentration REFERENCES~ (1) "Test Methods for Evaluating Solid Wastes", SW 846, July, 1982. (2) "Methods for Chemical Analysis of Water and Wastes", EPA-600t 14-79-020. BY CHEMICAL ANALYSIS . . LABORATORIES, INC. J. J. EGLIN. REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 '-------:EN VIRONM EN TAL PETROLEUM Purgeable AroITøtics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 24-Aug-89 0, Lab No. : Sample Desc: 6544-1 Civic Center Waste Oil Tank 2' Permit #A808-i6 DATE SAMPLE DATE SAMPLE DATE ANALYSIS COLLECI'ED ; RECEIVED @ LAB: cct1PLETED : 23-Aug-89 23-Aug-89 24-Aug-89 MiniITJJ1T} Reporting Analysis Reporting Constituent Units Results Level Benzene ug/g none detected 0.02 Toluene ug/g none detected 0.02 Ethy 1 Benzene ug/g none detected 0.02 p-Xylene ug/g none detected 0.02 m-Xylene ug/g none detected 0.02 o-Xylene ug/g none detected 0.02 Total Petroleum Hyd.J:'lxarbons ug/g none detected 5.00 TEST METHOD: '!'PH for gasoline by D.O.H.S. L.U.F.T. rœthod. Indi vidua~ consti tuent.s by EPA rrethod 8020. Dry Matter Basis Corrments : California D.O.H.S. Cert. #102 By --------------------------'--'- .J. , ,], Egl in _.1:o~J-L~~u G Änéily:::t_ ENVIRONMENTAL . .. LABORATORIES) INC. CHEMICAL ANALYSIS PETROLEUM J. J. EGLIN. REG. CHEM. ENGR. 4,100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 . . Purgeable Aromatics (SOIL) McNabb Construction 7808 Olcott Ave Bakersfield, CA 93308 Attention: Bryan McNabb Date of Report: 24-Aug-89 Lab No. : Sample Desc: 6544-2 Civic Center Waste Oil Tank 6 . Permit tiA808-16 " DATE SAMPLE COLLECI'ED : 23-Aug-89 DATE SAMPLE RECEIVED @ LAB: 23-Aug-89 DATE ANALYSIS COMPLETED : 24-Aug-89 Constituent Reporting Units Analysis Results Minirwm Reporting Level Benzene Toluene Ethy 1 Benzene p-Xylene m-Xylene o-Xylene ug/g ug/g ugjg ug/g ug/g ug/g none detected none 'detected none detected none detected none detected none detected 0.02 0.02 0.02 0.02 0.02 0.02 Total Petroleum Hydrocaroons ug/g none detected 5.00 TEST METHOD: TPH for gasoline by D.O.H.S. L.U.F.T. method. Indi vidual constituents by EPA ræthod 8020. Dry Matter Basis Corrrnents : California D.O.H.S. Cert. #102 P:y~______._u__. '. .1, .J Errjjr¡ --.;12-~ ~ . 1. ~~_. ".'~ AGRICUL TURE , (. LABORATORIES. Inc. J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 PHONE 327-4911 CHEMICAL ANAL YSIS PETROLEUM MCNABB CONSTRUCTION CO 7808 OLCOTT AVE BAKERSFIELD, CA 93308 Attn.: BRYAN MCNABB 399-4742 Date Reported: 08/24/89 Date Received: 08/23/89 Laboratory No.: 6544-1 Page 1 Sample Description: CIVIC CENTER WASTE OIL TANK 2' SAMPLED BY DAVID RITTENHOUSE OF B.C.LABS TOTAL CONTAMINANTS (Title 22, Article II, California Administrative Code) Lead , Method Sample Results P.O.L. Units None Detected 2.5 mg/kg None Detected 20. mg/kg None Detected 20. mg/kg Method Ref. Constituents 6010 1 TOX Oil & Grease 9020 413.1 1 2 (See Last Page for Comments, Definitions, Regulatory Criteria, and References) Constituents Requlatorv Criteria STLC, mq/L TTLC, mq/kq Lead 5.0 1000. Comment: All constituents reported above are in mg/kg (unless otherwise stated) on an as received (wet) sample basis. Results reported represent totals (TTLC) as sample subjected to appropriate techniques to determine total levels. P.Q.L. Practical Quantitation Limit (refers to the least amount of analyte detectable based on sample size used and analytical technique employed. N.D. = None Detected (Constituent, if present, would be less than the method P.Q.L.). I.S. Insufficient Sample STLC = Soluble Threshold Limit Concentration TTLC = Total Threshold Limit Concentration REFERENCES: (1) "Test Methods for Evaluating So~id wastes", SW 846, July, 1982. (2) "Methods~;,c~~mical Analysis of Water and Wastes", EPA-600, 14-79-020. BY ß-4- £~ V· J(/ Egl!# Cailtorma--riealtt1 ana Welfare Agenc'ý .:;¡erl "oved OMS No. 2050-0039 (Expires 9'30'9". PleBsp. ,,,int or type, (Form designed 'or use on elite' h 'typewriter), UNIFORM HAZARDOUS 1,~/.erator's us EPA 10 No, WASTE MANIFEST .0 (.iC I ~O 3. Ge,nera or~'s N e and Mailing¡dr~ss ) ~-4.^, D(./,vr-1," JVlc. Û-V~ I S ~!( £', 'ki;t..S¡::'Ic::_~ C . 4. Generator's Phone (~ ) g¡ 1-.2"<11 ~ 5, Transportar 1 Com~a" Name ~ V A¿.¡ V4a!v; :g 7. Transporter 2 ompany Name 8 "9 ..J ...J < _u :):!; z -tgj ~!!:: f')~ u Jz O~ O~ ~ ,,¡. N ... :3 "9 a: w ~ z w U w rJ) z 0 ~ en w a: ...J < Z 0 ¡:: < Z w ¡: ...J ...J < u ..i ...J a: rJ) u: 1 c >- u z w C!I a: w ~ T w Z R A < N u- S 0 P w 0 (/J R < T U E ¡; F A C I L I T y G E ~~ E R A T o R 11. US DOT Deacription (Including Proper Shipping Name, Hazard Class. and 10 Number) a. 'At-I ~~.fi¡A .<;v(,4-7éXJ 1vlÞ6~ Oli~ b. EPAlOther c. State EPA/ Other d. State EPA/Other J. Additional Oeacriptiona lor Materials Listed Above 0-10/0 GA-S o -lOt!) % NA7Ef.... ~ ....,",.... c. d. , . " . .. ~....' ... 15. Special Handling Instructions and Additionsllnlormation '¿3~3~-~¡ I i Wa:M... ;::J¿ o-rlFC,-rlv¿ Ovn:e.- tJ~ G Ô;;OAi 16. GENERATOR'S CERTIFICATION: I hereby declare that the contents 01 this consignment are lully and accurately described above by proper shipping name and are classilied, packed. marked, and labeled, and are in all respects in proper condition for transport by highway according to applicable international and national government regulations. III am a large quantity genarator, 1 certify that I have a program in placa to reduce the volume and toxicity 01 waste generated to the degree I have determined to be economicaUy practicabfe and tnst I nave seiected ¡he µiã...;tÎCau'ð iTldtho": c! ~ro::.tm~:'!t. gt~r30e. or tji!'pO~A r.:urrently available to me whích minimizes the present and future threat to human health and the environment; OR, if I am a small quantity generator, I have made a good faith e"ort to minimize my waste generation and select fhe best waste management method fhat is available to me and that I can a"ord. Printed/Typed Name /)N¿JY VV/9L '-,;9cE-- Month Da)' 17. Transporter 1 Acknowledgement 01 Receipt of Materials 18. Printed/Typed Name Month Da)' Year 19. Discrepancy Indication Spsce ~ 6c..JL QQ 0. 1 (04þ5 DHS 80 (1/68) EPA 8700-22 (Rev. 9-68) Previous editions are obsolete. White: TSDF SENDS THIS COpy TO DOHS WITHIN 30 DA Y~ To: P,O. Box 3000, Sacramento, CA 95812 0 II) It) ... N It) <0 g '9 ..J ..J O->('§ <..0:$ Mæ L.í}~ cY')ët u 'nZ G CO~ E :O~ N E N R ~ A <0 T .., 0 N R .., 8 '9 a: w I- Z W U w en z 0 Il. en w a: ..J 4( Z 0 ¡:: < z w ¡: ..J ..J < U ~ ....J ii: en a: 0 >- u z W f!J .. a: w ~ T w Z R A < N U- S 0 P w 0 en R < T U E ~ F A C I L. I T y State Manifest Do~m§t~u3~ 16 9 3. 7£ïJS.¡' ~~~.~n~ê~~~: ./-oL ~(I S TI]..I) X. TVN h', ¿, I 'lTKé-12.5,t:i C,Il---:- 4, enerator s Phone ( )" -.",. .ð?/ 9~igl1jlted Facility Name and SiY?'ddresf , . /' 10, (0/ ¿,.5 O'Ý a..L.. "- ~E h/lj 1I'V0 L'ß.t ".z;f'C . £¡y.D 01= CCMMd'<::A-L~ LIK.. BI'1á:.~éz .' 13, Total Quantity 14, Unit Wt/Vol g I. Waate No. State ~I EPA/Other State EP A' Other State EPA,Other State EPAIOther d. GENERATOR'S CERTIFICATION: I hereby declare that the content a ot this consignment are fully and accurately described above by proper shipping name and are classified. packed. marked. and labeled. and are in all respects in proper condition for transpon by highwåy according to applicable international and national ~overnment regulations, If I 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 selecled the practicable method 01 treatment. storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment; OR. ill am a small quantify ~enerator, I have made a good laith effort to minimize my waste generation and select the best waste management method that is available to me and that I can aHord, DHS 8022 A (1/88) EPA 8700-22 (Rev. 9·88) Previous editions are obsolete. ", US DOT Description (Including Proper Shipping Name, Hazard Class. and 10 Number) a. {'4ú¿ OI2.N/".4 WUL.,4ïW a7 b. c. d. J. Additional Descriplions for Materials listed Above 0- / 90 t;Y".<..- f)-I DO % á/4n:.---rL.. 'lQSh-Z- c. Month Day Day Year g¡<J Month Day Year -~ 15, Special Handling Instructions and Additional Information ¡d-!;¡¿ ~ftC/I;Æ ~-~ 18. Printed/Typed Name #Oy W/1£¿~¿E 17, Transporter I Acknowled~ement of Receipt of Materials ;J£5 18, Printed/Typed Name 19, Discrepancy Indication Space /4 gLf 15 (0 ACTUAL GALLONS RECE!VED White: TSDF SENDS THIS COpy TO DOHS WITHIN 30 DAYS To: P.O. Box 3000, Sacramento, CA 95812 .. ~ --------- ._------.......---------...-_-...... ---~-........--...--------------.~ 1ìOO Flower Street Bakersfield, California 93305 Telephone (805) 861·3636 fé/fil!#:y ALTH PEPARTME. L HEALTH DIVISION 0: ~JOJ HEALTH OFFI¿'E~' Leon M Hebertson, M,D. )L& - . DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard Kern County Permit # * * UNDERGROUND TANK DISPOSITION TRACKING RECORD * * This form is to be returned to the Kern County Health Department within 11 days of acceptance of tank(s) by disposal or recycling facility. The holder of the permit with number noted above is responsible for insuring that this form is completed and returned. .. . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. t .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Section ~ - To be filled out ~ tank removal cqntractor: , Tank Remnval Contractor< /11e~ G.""~3f::í\lc..{,~ a,· , ':. . Address 1f3A5 o~*Avb. ' Phone ,0~399-¥7t../9- Ç)AV-gé:H~iJ:J CA. Zip 935D8 Date Tanks Removed 9-Q- ;19 No. of Tanks ~ .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Section ~ - To be filled out ~ contractor Address rC¿ Phone t 39.d~7 70 Zip 9Jdo? Tank Authorized representative of contractor certifies by signing below that tank( s) have been decontaminated in accordance with Kern County Health Department requirements. 6M ~~}'.l/) nature {}¡ Æ)-Y1J.)J T1 tIe .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. " .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. Section 3 - To .be filled out and signed .Qy an authorized representative treatment, s~, JU: dis~osal facilit~ accenting tank(s): Facility Name ~ R Address ¿ 2. 0 2 S. ,r>-?,,'/;{~C4 O//}- of the Date Tanks Signature Phone # (7/</) 9'~ è·o::Pcs~"ò Zip //~b/ No. of Tanks 2- ,r-?~...¿:",.A. f!' é',.....-. V' Ti tie (Authorized Representative) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * * MAILING INSTRUCTIONS: Fold in half and staple. (Form #IIMMP-150) DISTRICT OFFICES Delano ,Lama,,' '1ke Isah'1l1a , Mojave . RIc1gecrp.~t . Shaner . Taft 1~' 1700 Flower Street Bakersl/e/d, Call1orllla 93305 Telephone (B05) B61-3636 I<.EnN COUNTY ,·V\//, ,- Lfi 'to 0L'- .. -. .<0 ' "ð IlEALI11 DE?AnTM' l" HEAL1H OFFICER Leon M Hebertson, M.D. . -. ENVIRONMEI~ I^L HEAL111 DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relcherd AddL'ess # * '" UNUERGHOUNU TANK Ul SPUSITION TRACIUNG IŒCORU * * This form is to be retlll'lIed .to,,' ~he I{ern County Ileal th Uepartment $'i thin 1.1 .øa~ of acceptAllce of I:nlllq s J.t.~y disposal or recycling facility. The holder of the permit with uumb(Ù' nolBd above is l'espol1sible for insuring that this form is comple ted allù ret:urlwd. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section .! Addl'CSS Phone Zip No. of Tanks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Section 2 - To ue f111ed out .h.ï cOlltr~ctol" "dcc'mtarninatlng tallk(s): /} / i / '/', . Tanlt "Uecontamination" GOllt1"aclo1' !5 1£.)...., Ú;drUf/M S¡;::RV/C¿ Address t, 9fl~ ,\~·/tI/ß:.Fl2,--,'í;-, Phone #g93~ ") 770 ~ . ~ ~ 15f1¡¿'£x5FIf=L 0 . (~ . Zip ~~:?30cP- " Authorized l'epl'eselltaUv ~ of GOlllraclol' certifies by signlllg below that tank (s ) bave !Jeell dncolI tnmi 11/1 lcd ill élcconlélllcc ¡\'l tl¡ l~cl'lJ COUll ty Heal Lh ~t~ent requirement:>. ~~C(7 ,'ìr7Á/Prt:/ Ct ,1 J, ) , 'r-rgllu tUl'e '--" . . . . . . . . . . . . . . . . . . . . . . . . o V.J'y¡../!./G '1'1 tie . . . . . . . . . . . . . . . .. Section 3 - To ue flUe.!! ,Y..to!.~ .!III!! ~J.&!!..~IJ. .!!X. UII ~ulhorlzed representative of the Ll'catmcIIL, storage, .QI .~LL~jiJosal [tl(.:lllLy Qcceptin~ tallle(s): Facility Name -:~e;;e/c-~ 0'~- A?e-C/C¿~ 4Æ./é r Addresf1?;h:J2 S /.1?/~C¿/éce~ ~e , Phone # 1/$/ 7'dJ> -.}'o<:/o é/~7/?;d/~ 0· Zip 0;?b/ ~ - ¿;)- -- cI No. 0/ Tanks / 4~-( Va Le Tanlcs 'fltle k~~, / SIgllature H(~pJ'(' !H!nl n t1 vc) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . * * * NAILING INSTHUCTLUNS: FoJ (ì .III l1a,l [ and staple. (Form #IINÞlP-150) Orl"no . L;¡nll'''' DISlmcr on'ICES 'k" 1"'1",11" , Mn :1Ve . nldgec'I!st . Shaller . Toll 1700 Flower Street Bakersfield, California 93305 ' Telephone (805) 861-3636 tRN COUNTY HEALTH DEPARTMe;. ENVIRONMENTAL HEALTH DIVISION HEALTH OFFICER Leon M Hebertson, M.D. INTERIM PERMIT TO OPERATE: UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard PERMIT#160026C I S SUE D : APRIL 1, 198- E XP I RE S APRIL 1, 1991 NUMBER OF TANKS= 5 ---------------------------------------------------------------------- FACILITV: KERN COUNTV GARAGE 1415 TRUXTUN AVENUE BAKERSFIELD, CA OWNER: COUNTV OF KERN 1415 TRUXTUN AVENUE BAKERSFIELD, CA 93301 ---------------------------------------------------------------------- !!.!lS._! 1,2,4 3 5 !.ggl!!_XB..§.l 26 26 3 §'!H!§'!!.!£.!i_£J!º-!i MVF 3 WO 3 MVF 3 fB.g'§''§'QB.!!gº-_f!fl~gl NO NO NO NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PERMITTING AUTHORITV MUST BE MET DURING THE TERM OF THIS PERMIT NON-TRANSFERABLE *** DATE PERMIT MAILED; MAR 3 11981 DATE PEroHT CHECK LIST RETURNED: ' ; " POST ON PREMISES : . 1700 Flower Street Bakersfield. California 93305·419.8 Telephone (80S} 86,1'3621 ~ERN COUNTY HEALTH DEPAR.H AIR POLLUTION CONTROL DISTRICT LEON M HEBERTSON. M.D. Director 01 Public Health Air Pollution Control Officer o December 15, 1987 Larry Johnicall General Services Garage Division County of Ket'n 1415 Truxtun Avenue Bakersfield, CA 93301 RE: Reportable Variat.i.ol\s/Loss. Tank #1 - Perniit #160026C Dear Mr. Johnican: This is to inform you that unleaded tank #1. at the above facility is pe't'iodically exceeding the repol'table limits as described in Handbuok #I1T-10. "Standard Inventory Control Monitoring." Dut'ing October and November of this year. the notification reports indicate this tank exceeded the weekly variation limits twice and the monthly limit once. Under the monitoring requirements for this facility's operating pel'mit. you' al'e required to conduct a complete variation/loss investigation. Although your department did submit investigatioll t'eports. these illvestigations were not completed wit h c 1 ear 0 I' sat i s f act 0 I' Y e x pIa n a t ion s for the v a ria t ions. per page 16 of U.T. 10. You must complete the investigation and submit the completed report by December 30, 1987. Should you have any questions regat'ding this matter. please call me immediately at (805) 861-3636. Sincerely, D¿& ~kt.- B.i.ll Scheide Environmental Health Specialist Hazardous Materials Management Program 8 S / g'b 01'115:0n ot Envl[;)nm~nc.dl Healuì ApplicaClOn D,::;te~-~//~j'?,S- 1 ;00 ¡;'lo....."e[ Street, BakerSfie. ~A 91305 ", . APPLI~.ÁTlf)N FOR PERMIT TO OPERATE u&RaJND HAZ.AROOUS SUBSTANCES STORAGE FACILITY ~ of l>.ppl ication (check): o New Facili ty 0 r-bdification --= A. of Facility ~E:xistiN3 Facility DTransfer of Q,mershiF ' J '. «0 ')-- ~{¡'>f - :J. 4.' ¡, Ðnergency 24-Hour Contact (name, area code, P1one): Days A-tire.I~~~Jot, yÌ ',C .4-v'1 Nights $~,.;' Facility Name No. of Tanks *.t) Type of Busine s (check): so lne S tlon Other (describe). Is Tank(s) Located on an Agricultural Farm? Dyes ~ ' Is ~a~k(s) Used Pdmari:x for l>qricultural ,Pur, r? Dyes I1J-fb ,,,) 'f'.--..J Faclllty Address, ,/..(.' (. 1 4K~ .', Nearest Cross St. 1-- ~ ;;"'er 8~ (Rura Locat~~~~~2~rson Address ~ ,", ~-, .~' f!..M<f!.1 <'~: - , Zip 9,-)-:Y)( Telephone ~{, J& I . Operator _ _£~_ _.___ _ , Contact Person I... A-rU<. 'Ý Jc)/1V1/C~ Address _ Zlp Telephone 'Y'(bl - '"J 6 II B. Water to Facility provided by U1/1. ¡(VI t7!A) It) Depth to Groumwater LLvtkncu; II..) Soil Characteristics at Facility Basis for Soil Type and Groundwater Depth Detenninations C. Contractor Address Proposed Starting Date Worker's Compensation Certification t .;V;/ ¡¡ CA Contractor's License No. Zip Telephone Proposed Completion Date . Insurer D. If This Permit I s For Modification Of An ÐdstiN3 Facility, Briefly tescribe Modifications Proposed E. c £t:; 11 ++,4.(; f'e I Tank(s) Store (check all that apply): ~ ~ ~ ~ Tank t Waste Product Motor Vehicle Unleaded Regular Premium ' Diesel Waste - - Fuel Oil I 0 0 g rn/ 0 0 0 0 ~_ 0 0, m- ~ 0 0 0 ~ ~,L-D 0 0 0 B B ~ tj _t.-.D 0 0 0 ð (;nE~llcàt ~PJSitioPOf Materialsqtored (not ~cessary f~ IOOtor '~icle fue'!:;' Tank t Chemical Stored (non-coarnercial name) CAS t (if known) Chemical Previously Stored (if different) F. G. Transfer of ewñership Q3 t~'àf ~nsfer Previous Facility Name I, NIIl prev ious Owner accept fully all obligations of Permit N:>. issued to I understand that the Pennittirg Authority may review anà modify or terminate the transfer of the Pennit to Operate this underground storage facility upon rec~iving this completed form. under penalty of perjury aoo to the best of my knowledge is Title þœf M<Þ1't5~Date ~V/llf)- ".:J<.......... ... '- i ,~Qll"" ! \ ,"-,ýV V ¡~;~ i-<..-(.'L- ?' '~ fff'L ¡,'t:J G- 1:-''= rm 1 t NO. TANK! 1 (FILL OUT SEPARATE FORM Foa.œ TANK) FOR EA-cH SECTION, œECK ALL APPROPRïAPãõxES H. 1. Tank is: DVaulted ~n-Vaulted DDouble-Wall ~ngle-wall 2. Tank Material [];tCârbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-<lad Steel B Fiberglass-Reinforced Plastic 0 Concrete 0 AllEimm 0 Bronze Dunkoo~ Other (describe) 3. primary Containment Date Installed Thickness (Inches) 1 ~ ~....~ 'ú fA k '41A"'"U... /\ 4. Tank Se onda ry Conta 1l"lnent ' o Double-Wall--o Synthetic Liner OOther (describe): o Material 5. Tank Interior Lining --c:rRubber 0 Alkyd DEpoxy DPhenolic OGlass DOther (describe): 6. Tank Corrosion Protection DGaJ.vanized DFiberglass-Clad DF\:)lyethylene Wrap DVinyl Wrappi~ ~r or Asphalt DUnknown ONone OOther (describe): . Cathodic Protection: ONane DImpressed Olrrent System [:J Sacrificial Mode System Descrite System , Equipnent: ' 7. Leak Detection, Monitori~, and Interception ~Tank: DVisual (vau ted tanks only) (TGroumwater MonitorirJ)' WIllI (s) , D Vadose Zone Mani toriB;) Well (s) D u-Tube Wi thout Liner OU-Tube with Campatible Liner Directi~ Flow to MonitorirJ) welles)· D Vapor Detector· D Liquid Level Sensor 0 Conductivit~ Sensor· o Pressure Sensor in Annular Space of Double Wall Tank g Lj,çluid Retrieval , Inspection Fram U-Tlbe, Meni tori~ well or Annular Space ~ily Gaugir~ , Inventory Reconciliation DPeriodic Tightness '1'est1~ o None 0 t.k\known 0 Other 'b. Pipirq: Flow-Restrictirq Leak Detector(s) for Pressurized Pipi~· OMonitorirq Stnp with Race,.y DSealed Concrete Raçeway D ~l f-cut Canpatible Pipe Raceway 0 Synthetic Liner Raceway 0 None [B'tJnknown D other *Describe Make , Model: - 8. Tank Tightness Has 'lhls Tank Been Tightness Tested? DYes Date of Last Tightness Test Test Name 9. Tank Repair ~~ Tank Repaired? DYes IIdNo Dl1'1known Date(s) of Repair(s) Describe Repairs /9 7~- - \/~o;.) I¿o~c:..~ ~ VAÉ¿ . I ~"1 J.AlluI lO. ov~ Protection ,-... ( rator Fills, Controls, , Visually Monitors Level DTape Float Gauge DFloat Vent Valves 0 Auto Shut- Off Controls BcapaCitance Sensor DSealed Fill Box DNane Dl1'1knoW'1 Other: List Make , Model roc Above Devices Thickness (Inches) Capaci ty (Gallons) Manufacturer /D/ òðD :j t:tL 4d /~I{í-t? ft... fl,'lJ4.V1r· o Lined Vaul t D None ~knOW'1 Manufacturer: Capacity (Gals.) __ o Clay Dl1'1lined ~oW'1 DNa ~own Results of Test Testirq Campany 11. Piping __~ a. lk1derground PipiB;): !BYes DNa Dl1'\known Material Thickness (inchesl. ~iameter Manufacturer I ~~ OPressure IItSùctlC;>n . Gravi ty . Approximate Le~th 0 pe RIm k-¿f b. Underground Pipirq Corrosion Protect ion : {j DGalvanized DFiberglass-Clad DImpressed CUrrent DSacrificial Anode bJPglyethylene Wrap DElectrical Isolation DVinyl Wrap DTar or AsP1alt ~nknown DNone OOther (describe): c. Underground Pipirg, Secondary Conta irment: .. /' DDouble-Wall 0 Synthetic Liner System [Iffione Dunknown DOther (describe): H. - I ' 0 TANK' ! A _ (FILL OUT SEPARATE FORM F~ ::H TANK) FOR EACH SECTION, CHECK ALL APPROPRÏÄW'80XES 1. Tank is: DVaulted ~n-vaulted ODJuble-Wall ~~le-Wall 2. Tank Materia 1 [R'C~rbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-Clad Steel B Fiberglass-Reinforced Plastic 0 Concrete 0 Alunim.ll1 0 Bronze DUnkoown Other (describe) . Primary Contai~nt Date Installed Thickness (Inches) 1 C¡ S-- ~ lA/A k.~'..-'"\ 4. Tank Se onda ry Conta lrl'Rent o Double-Wall U Synthetic Liner DOther (describe): o Material Thickness (Inches) 5. Tank Interior Lining , uRubber DAlkyd OE'Çoxy o Phenolic o Glass o Other (describe): 6. Tank Corrosion Protection -crGalvanized DFiberglass-Clad OPol~thylene Wrap OVinyl WrappiD;¡ ~ or Asphalt Dlh'\known ONone OOther (describe): . Cathodic Protection: o None DImpressed CUrrent System [J Sacrificial Mode System Describe System' Equipnent: 7. Leak Detection, Monitoring, and Interception ~Tank: DVisual (vaulted tanks only) LfGrotJrdwater Monitorirg" well (s) o Vadose Zone Mon! toriD;¡ Well( s) 0 (}-Tube Wi thout tiner DU-TUbe with Compatible Liner Directi~ Flow to Monitorirg welles)· D Vapor Detector· 0 Liquid Level Sensor 0 Cqndœtivitï Sensor· o Pressure Sensor in Annular Space of Double Wall Tank g L..!,Quid Retrieval & Inspection Fran U-Ttbe, Moni torirç Well or Annular Space UJ,;!1àily Ga~iD;¡ & Inventory Reconciliation 0 Periodic Tightness Testing o None 0 unknOW1 0 Other . b. Piping:' Flow-Rest=icting Leak Detector(s) for pressurized Pipirç- D Moni tor ing SlIDp wi th Racewsy 0 Sealed Concrete Raçeway D I)¡t-lf-CUt Canpat!ble Pipe Raceway D Synthetic Liner Raceway D None [B"Ünknown 0 Other *Describe Make & Model: 8. Tank Tightness Has nus Tank Been Tightness Tested? Date of Last Tightness Test Test Name 9. Tank Repair _/" Tank Repai red? 0 Yes ~ OUnknown Date(s) of Repair(s) Describe Repairs J'17~-... \/cyl-vj i¿v.;:r~ ~ vA/á:. . I ::t;., J#/Itd Ov~ Protection ~ ( rator Fills, Controls, , Visually Monitors Level DTape Float Gau;)e DFloat Vent Valves 0 Auto Shut- Off Controls DCapacitance Sensor OSealed Fill Box o None Dlbknown [JOther: List ~ke , Model For Above Devices 3. Capacity (Gallons} Manufacturer ,/~, òðD 3!±L . ¡Jd¡¡¡k'Ifi..¿ 7k. fil4J17ðM: D Lined Vaul t 0 None ~known Manufacturer: Capacity (Gals.) __ DClay Olblined ~oW1 o Yes [] No ~l)1known Resul ts of Test Testing Canpany lO. 11. Piping __~ a. Underground Piping: [BYes DNa Ounknown Material Thickness, (inches],. ~lameter . Manufacturer (14 ~~¡ DPressure £ltSÚctlon Gravi ty Approximate LeJ'X}th 0 P pe RLn k,:¿r b. Underground Piping Corrosion Protection : U DGalvanized OFiberglass-Clad DImpt'essed CUrrent OSacrificial Anode QPgJ.yethylene Wrap OElectrical Isolation DVinyl Wrap DTar or As~lt ~nknown [JNone DOther (describe): c. Underground Piping, Secondary Containment: ~ DDouble-Wall OSynthetic Liner System ~ne OUnknown [JOther (describe): ~--. 'j'G"C . \C'~'~~:L~~~~:~T SEPARATE FORM FO.P:::~ ~. FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES -- H. 1. Tank is: 01laulted ~n-Vaulted OIbuble-Wall ~ngle-Wall 2. Tank fo1p.terial ~arbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass~lad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 AlLmim.ll1 0 Bronze DUnknown o Other (describe) 3. primary Containment Date Installed Thickness (Inches) I S ~'-C¡ 4. Tank Secondary Containment DDouble-WallUSynthetic Liner OLined Vault . 0 Other (descr ibe): DMaterial 5. Tank Interior Lining -rfRubber DAlkyd DEpoxy OPhenolic DGlass DClay Dt11l1ned ~own' DOther (describe): 6. Tank Corrosion Protection -UGalvanized DFiberglass-Clad DPolyethylene Wrap DVinyl WrappiJ'X) , OTar or Asphalt DUnknown DNone DOther (describe): ·f Åtì~'"i-~ Cathodic Protection: o None OImpressed Clrrent System C sacr c a System Descrite System & Equipnent: 7. Leak Detection, Monitoring, and Interception -¡:--Tank: DVisual (vaul tad tanks only) LrGroumwater Monitorin;i well (s) o Vadose Zone Mon! toring Well (s) D tJ-'l'ube Without Liner DU-Tube with Compatible Liner Direct!~ Flow to Monitoring well(s)* D Vapor Detector* D Liquid Level Sensor 0 Conductivit¥ Sensor* o Pressure Sensor in Annular Space of Double Wall Tank o Liquid Retrieval & Inspection Fran U-Tt.be, Monitoring Well or Annular Space o Daily GalXJing , I!!yej)tory ReROnciliat.ion D Periodic Tightness Testing ~, 0 None 0 ~known [Q-Other V SuA f b. Piping: Flow-Restricting Leak Detector (s) for Pressurized PipiJ'X)1II' o Moni toring SlDp wi th Raceway 0 Sealed Concrete Race1liØY . o Hal f-CUt Canpatible Pipe Race~y 0 Synthetic Liner RaceW:5Y 0 None OUnknoW1 DOther ~41. ¿'{I ±1~' . *Descr ihe Make , Model: I 8. Tank Tightness Bas TIns Tank Been Tightness Tested? Date of Last Tightness Test Test Name 9. Tank Repair _ /" Tãñk Repaired? DYes ytNO' DlbknoW1 Date (s) of Repair (s) Describe Repairs 10. OVerfill protection ~ator Fills, Controls, , Visually Monitors Level ~a Float GalXJe DFloat Vent valves 0 Auto Shut- Off Controls pacitance Sensor OSealed Fill Box DNone, Olk'lknoW1 Other: List Make & Model Por Above Devices Thickness (Inches) Capaci ty (Gallons) ððO ~ne 0 lbknown Manufacturer: Capacity Manufacturer Iß-¿ 1 )( '''HC!t.-cYl (Gals.) .._ DYes DtÐ ~oW1 Results of Test TestiJ'X) Canpany 11. Piping ~~ a. lbderground Pi piJ'X) : 0 Yes W'No Dll1knoW1 Mater ial Thickness (inches) ~D~ter Manufacturer , OPressure OSuction Ia'Cravity . Approximate Len:;Jth of Pipe RLn} ~ d b. Underground Pipin; Corrosion Protection : ð .- OGalvanized OFiberglass-Clad OImpr-essed current OSacrificial 1v1ode Opolyethyl~~rap DElectrical Isolation DVinyl Wrap DTar or Asphalt DUnknoW1 Wtfone OOther (describe): c. Undergroum Piping, Secondary Contairment: ~ /" DDouble-wall OSynthetic Liner System Wf«:>ne OlbknoW1 OOther (describe): 10. ~"-';1.-¡." -"-'--"í"'-/'rl-"í- -- rt::LI1I1L. NU. T",,7{ . J (F;LL OUT SEPARATE FoRM ~O~ T""K) . ~ ~ECTION I CHECK ALL APPROPRIAT BOXES 1. Tank is: o Vaulted ONon-Vaulted Or::ouble-Wall ~le-Wall' 2. Tank ~terial ~arbon Steel 0 Stainless S~eel 0 Polyvinyl Chlo~ide 0 Fiberglass-<:lad Steel o Fiberglass-Reinforced Plastlc 0 Concrete 0 All.mln\m\ 0 Bronze DUnknown o Other (describe) primary Containment Date Installed Thickness (Inches) 4. !a~ ~~Ondary Contairment ODouble-Wall---r:J Synthetic Liner []Other (describe): o Material 5. Tank Interior Lining DRubber 0 Alkyd DE+oxy OPhenolic OGlass DOther (describe): Tank Corrosion Protection (]qplvanlzed [JFlberglaSS-Clad DPolyethylene wrap [JVinyl wrapping lQ1'ar or Asphalt DUnknown []None []Other (describe): . Cathodic Protection: o None DImpressed CUrrent System OSacrlflclal Mode System Describe System &' Equipnent: Leak Detection, Monitoring, and Interception ~Tank: OVisual (vaulted tanks only) ITGroumwater Monitorin;i Well (s) o Vadose Zone Mani toriD;) Well (s) [J lJ-'1'ube Without Liner o U-Tube with Canpatible Liner Directin¡ Flow to Monitorirq Well(s)· o Vapor Detector* D Liquid Level Sensor 0 CondlX:tivit~ Sensor* D Pressure Sensor in Annular Space of Double Wall Tank o Liquid Retrieval , Inspection Fran U-T1i:>e, Moni toriB) Well or Annular Space o Daily Ga~iD;) , I~tory Reconciliation [J Periodic Tightness Testing o None 0 lb'1knoW'1 f.J~er //ì<; r,-<é""'¡¿ b. PipiD;): Flow-Restricting Leak Detector(s) for Pressurized PipiD;)w o Mon! toriD;) SlmIp wi th Raceway 0 Sealed Concrete Race'llSY D~f-CUt Canpatible Pipe Raceway DSynthetic Liner Raceway [JNone fti(JnknoW'\ 0 Other *Describe Make " Model: - Tank Tightness _./ . Has 'l'hlS Tank Been Tightness Tested? Dyes DNa I[pD'lKnOW'\ Date of Last Tightness Test Resul ts of Test Test Name Testi~ Canpany 9. Tank Repair _/ Tãñk Repai red? 0 'Les IliNo Olmknown Date(s) of Repair (s) Describe Repairs ~ Protection ---~:rator Fills, Controls, , Visually Monitors Level DTape Float Gau:Je DFloat Vent Valves 0 Auto Shut- Off Controls BCapacitance Sensor [JSealed Fill Box ONone DU'1known- Other: List Make " Model For Above Devices . ~..; j H. 3. Thickness (Inches) :,paci ty (Ga~, 0 ) , O,ð()V o Lined Vaul t 0 None 0 lbknoW'\ 'Manufacturer: Capaci ty (Gals.) [JClay Olblined ~oW'\ Manufacturer U..AA¡/V1~ 6. 7. 8. 11. Piping a. lbderground Pipi~: es DNo Olbkno\¥n Material ~~ Thickness (inches)' ~ Dianeter ~v(j Manufacturer t4,(..1i~ ~ DPressure GJSuctlon OGravity"Approximate Length of Pipe RLn i,{)~ b. Underground Piping Corrosion Protection : OGalvanized DFiberglass-Clad OImpl"essed CUrrent DSacrificial Mode [JPo..lYethylene Wrap DElectrical Isolation OVinyl W,rap DTar or As¡:nalt ~o\¥n DNone DOther (describe): c. Underground Piping, Secondary Contairrnent: ~ ' DDouble-wall DSynthetic Liner System ~ne Olk1kno\l«1 DOther (describe): 4. Name /l ~~JU ';;'7 !,i ~~~ ruT SEPARATE FORM . _.:H P:::~ "'. FOR EAOl SECTION, OlECK M..L ~OPRIATE BOXES 1. Tank is: DvauÙ.ed DNon-Vaulted OD:>uble-Wall ~le-Wall 2. Tank MaterÏal o C~n Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-Clad Steel [R-f'îberglass-Reinforced Plastic 0 Concrete 0 AlLmim.m 0 Bronze DlJnkoown o Other (describe) Primary Containment Date Installed Thickness (Inches) J~~~ Tarik Secondary Containment DDouble-Wall-y:] Synthetic Liner DOther (describe): o Material 5. Tank Interior Lining D"Rubber 0 Alkyd OEpJxy OPhenolic OGlass OOther (describe): 6. Tank Corrosion Protection -:-UGalvanlzed [JFiberq!'a5S-Clad OPolyethylene wrap DVinyl WIappiD3 OTar or Asphalt [Jd1known ONone OOther (describe): . Cathodic Protection: o None OImpressed current System D Sacrificial 1node System Describe System & Equipnent: Leak Detection, Monitoring, and Interception ¡:--Tank: DVisual (vaultedtãnks only) LfGrourowater Monitorirg' well (s) o Vadose Zone Moni torirJ;) Well (s) D lJ-Tube Without Liner D U-Tube with Canpatible Liner Directi~ Flow to Monitorirg Well(s)· D Vapor Detector* 0 Liquid Level Sensor 0 Conductivit¥ Sensor· o Pressure Sensor in Annular Space of Double Wall Tank º ~uid Retrieval & Inspection Fran U-T\be, Moni tori~ Well or Annular Space ij}'úaily Ga\X]ing & I!!:'.'-Atory Reconcil~tion 0 Periodic Tightness Testing o None 0 UnknoW1 t..¡l'Other ~ ~ ()-. ~ b. Piping: Flow-Restricting Leak Detector(s) for pressurized Piping- D Moni toring Sunp wi th Raceway 0 Sealed Concrete Race...ay o ~f-CUt Canpatible Pipe Raceway 0 Synthetic Liner Raceway D None IlD"nknoW'1 0 Other *Describe Make , Model: - 8. Tank Tightness _ ./ Has 'nus Tank Been Tightness Tested? DYes ONe W1)ùmOW'1 Date of Last Tightness Test Resul ts of Test Test Name TestiBJCanpany 9. Tank Repair ~ ' Tãñk Repaired? DYes ~ Dl)\known Date(s) of Repair(s) Describe Repairs ' OV~l Protection Operator Fills, Controls, , Visually Monitors Level OTape Float Ga\X]e OFloat Vent Valves 0 Auto Shut- Off Controls BCapacitance Sensor DSealedF,ill Box ONone Ot)1known Other: List Make , Model ror Atxwe Devices r al.:;'.J.. 1 cy H. 3. Thickness (Inches) Capaci ty (Gallons)¡I (~{) Ò¿.î¿í C¡A , ¿:J OLined Vault. ~ Otbknown Manufacturer: Capacity (Gals.) o Clay Dl11lined ~knOW1 Manufacturer [41..-jl~~/ 7. 10. 11. Piping _ / ',_ ð. tbJerground Plplrv:¡. ~es - ON<> Olklknoloin Material ~"'"'<~../ Thickness (inc~~ f ,t...,(þ,í( Diameter ~f../"r Manufacturer ~ ~ , OPressure IJd'5UCt.Tõñ'-,:]Gravi ty Approximate Lel'J3th 0 pe RLn b. Underground Piping Corrosion Protection : OGalvanized DFiberglass-Clad DIm¡ressed CUrrent DSacrificial Anode OiØÍyethylene Wrap OElectrical Isolation OVinyl Wrap OTar or As¡:bal t œGrumown o None OOther (describe): c. Underground Piping, Secondary Containment: ~~ OD:>uble-Wall OSynthetic Liner System ~ne OlktknOW'l DOther (describe): Kern County lIealth Departme. Division of Environmental H , . 1700 Flower street, Bakersfi~d, CA (805) 861-3636 93305 A. Perrai t. No. / Ó a.').;:L6 C- ttion Date .5/¡9-j@ 7 fI , ~'\.; , . .;:~~ .~ ,] j.... .. .-/\ Type Of []New APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY Application (check): ~ Facility []Modification Of Facility Existing Facility []Transfer s,:~ '> , " ,', "¡:" """-"- ·~~',c, , Of owrærship ..... A. 'Emergency 24-Hour Contact (name, area code, phone): Days A!;/-,;!.61! Nights 3f1 -li'l"7(q No. Of Tanks II- r; (n.¡)D J Other (describe~~ ,clkd..t!:f Is Tank(s) Located On An Agricultural Farm? []Ves ~o Is Tank(s) Used Primarily For Agricultural Purposes? []Ves ~ Facility Address ,1.//5" ~~ 4<J·ÆÆk~w ~4. Nearest Cross St. L .s'Tl'e££r . T R SEC (Rural Locations Only) Owner ~T4 0 ~ k~.-.( Contact Person LMU..¡ .ft}¡.l.N Ié-~ Address It! I:; T~~ /!.u.J IJU· þ"~~ a..Á- Zip 9.-~~,.., I Telephone U, d-6 i! Operator !..~£ ~ ~........¿ Contact Person Address Zip Telephone B. Water To Facility Provided By SeLf £I c....+, Soil Characteristics At Facili ty t..I-.vk:./oJ~¡j Basis For Soil Type and Groundwater Depth Determinations Depth to Groundwater u.uh::. ~. C. Contractor CA Contractor's License No. Address Zip Telephone Proposed Starting Date Proposed Completion Date Workerls Compensation Certification No. Insurer D. If This Permit Is For MOdifica1j¡: Of An Existing Facility, Briefly Descrit Modifications Proposed E. Tank(s) Store (check all that apply): Tank # Waste Product Motor Vehicle Unleaded Regular Premium Diesel Waste ~ Fuel Oil 0 ø/l'\~·q,. 0 0 0 0 0 0 0 o Òl.... 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 necessary for motor vehicle fuels) Tank # Chemical Stored (non~commercial name) CAS # (if known) Chemical Previously Stored (if different) +1,10 rno'~ YélJ. ~ OIL dl.o Ið~O G. Transfer Of Ownership Date Of Transfer Previous Owner Previous Facility Name I, accept fully all obligations of Permit No. issued T I understand that the Permitting Authority may reviewal modify or terminate the transfer of the Permit to Operate this underground stora¡;o facility upon receiving this completed form. - - - - - - - - - - - - - - - ------ - - - - - - - - - - - - - - ~ted under penalty of perjury and to the best of my knowledge is tru, ) Tit 1 e ¡:::Us::,- IYJMV~ Date 5/~/8 7 '''~~I':~~~: ., . ~-~--""'- I F 1 LL OOT "CPARA TE FOR" EACH TANKI . FOH EACH SECTION, CHECK ALL APPR~E BOXES - - - --:--- 1. Tank li: 0 Vaulted 0 Non-Vaul ted 0 Double-Wall ~ingle-Wall 2. TrJ!< Material Carbon Steel 0 StainJ ess Steel 0 Polyvinyl Chloride [] Fiberglass-Clad Steel [] Fiberglass-Reinforced Plastic 0 Concrete D Aluminum D Bronze D Unknown [] Other (describe): 3. Primar~ Containment Date Installed Thickness (Inches) ~ 11(;:2, I/C!b 4. Tank Secondary COlltaillment [] Double-Wall [] Synthetic [] Uther (descrIbe): Material 5. 'Tank Interior Linin£ DRubber [] Alkyd [] Epoxy 0 Phenolic [] Glass 0 Clay 0 Unlined [] Unknown o Other (describe): 6. Tank Corrosion Protection [] Galvanized [] Fiberglass-Clad 0 Polyethylene Wrap 0 Vinyl Wrapping [] Tar or Asphalt [] Unknown 0 None 0 Other (describe): Cathodic Protection: [] None 0 Impressed Current System 0 Sacrificial Anode System o Describe System & Equipment: 7. Leak Detection.. Monitoring:, and Interception a. Tank: ]('Visual (vaulted tanks only) 0 Groundwater Monitoring Well(s) [] Vadose Zone MonHoring Well (s) [] U-Tube Without Liner [] U-Tube with Compatible Liner Directing Flow To Monitoring Well(s)* [] ValJor Detector * [] l,iquid Level Sensor * 0 Conductivity Sensor* * o PreSRure Sensor In Annular Space Of Double Wall Tank o Liquid Retrieval & Inspection From U-Tube. Monitoring Well Or Annulac Space [] Daily Gauging & Inventory Reconciliation [] Periodic Tightness Testing o None [] Unknown 0 Other Piping: [] Flow-Restricting Leak Detector(s) For Pressurized Piping* o Monitoring Sump With Raceway [] Sealed Concrete Raceway o Half-cut Cómpatible Pipe Raceway 0 Synthetic Liner Raceway [] None o Unknown [j Other II .. S IooI..A L. *Oescribe Make & Model:, 8. Tank Tightness Has This Tank Been Tightness Tested? [] Yes Date Of Last Tightness Test Test Name 9. Tank Repair Tank Repaired? [] Yes Date(s) Of Repair(s) Oescribe RepairR 10. Over. ill Protection Operator Fills, Controls, & Visually Monitors Tape Float Gauge 0 Float Vent Valves 0 Capacitance Sensor [] Sealed Fill Box D Uther: 11. Pipin£ ' _~ a. Underground Piping: [] Yes Œr No [] Unknown Material Thickness (inches) Diameter Manufacturer [] Pressure 0 Suction [] Gravity Approximate Length Of Pipe Run b. Underground Piping Corrosion Protection: , 0 Galvanized 0 Fiberglass-Clad [] Impressed Current 0 Sacrificial Anode o Polyethylene Wrap [] Electrical Isolation [] Vinyl Wrap [] Tar or Asphalt [] Unknown 0 None [] Other (describe): c. Underground Piping, Secondary Containment: [] Double-Wall [] Synthetic Liner System [] None[] Unknown [] Other (describe): . <.J. 1....L l..,) H. Capacity (Gallons) 3'i;o Manufacturer f(i3Í~iJ...hllc.. SkeL 4.kj~.&iE. Liner D Lined Vaul t 0 None [] Unknown Manufacturer: Capacity (Gals.) Thickness (Inches) b. E1' No 0 Unknown Results Of Test Testing Company ~NO ŒJ Unknown o [] [] Level Auto Shut-Off Controls None 0 Unknown List Make & Model For Above Devices --,!"".-;:'O",;,-,It7..--"I(...,~.- "....'.-~ .-.--,-_....,..., ~ -~ ....~.__. --- \ \ ~\t/ . . TANK FACXLXTY ANNUAL REPORT l~~ ~vr PacUlty LL.:\\L\.~ ~ 1. I have not done any .ajor last 12 .onths. Signature Note: All lIajor aod1f icati the Peraitting Autho Per.1 t t l~ðo:;"bG Month/Vr. < this ,/92-- facility during the t..~ HiNDMAk Supv Mach ji ~9rar S9t"'\'lcese Garage Divisior. a Perai t to Construct froa 2. I have done aaJor lIodit1cations for which I obtained Perait(s) to Construct froa Peraitting Authority Sipature Perait to Construct t 3. Repair and Maintenance Suaaary Date Attach a suaaary of all: -- Routine and required maintenance done to this fac! 11 ty t stank, pipinc. and aonitorlng equipaent. Repair of subaerged puaps or suction pumps. -- Replacellent of flow-restricting leak detectors with same. -- Repair/replaceaent of dispensers, meters, or nozzles. -- Repair of electronic leak detection. components. or replaceaent with 8ue. -- Installation of ball float valves. -- Installation or repair of vapor recovery/vent lines. Include the date of each repair or lIaintenance activity. NOTE: All repairs or replacements in response to a leak require a Perait to Construct froll the Perllittii1g Authority as do all other aodificat1ons to tanks. piping or monitoring equip.ent not listed here. 4. Puel Changes - Allowed for Motor Vehicle Puel tanks OnlY. List all fuel storage changes in tanks. noting: Date(s). tank nuaber(s), new fuel(s) stored. S. Inventory control aonitoring is required for this facility on the Perait to Operate, and I have not exceeded any reportable liaits as listed in the appropriate inventory control aonitorlng handbook during the laat twelve aonths (it not applicable, disregard). Signature 6. Trend Analysis Suaaary Please attach Annual Trend AnalyslsSuaaary for the last 12 periods. 7. Meter Calibration Check Para Please attach current, coapleted Meter Calibration Check Pora i!! . --'11:. / ...., . . ANNUAL TREND ANALYSIS SUMMARY to 6 1M',/, ?_ 9 /2,6/'1 I í TANK , tj QUARTER 1 PERIOD 1: PERIOD 2: PERIOD 3: QUARTER 2 PERIOD 4: PERIOD 5: PERIOD 6: QUARTER 3 PERIOD 7: PERIOD 8: PERIOD 9: QUARTER 4. PERIOD 10: PERIOD 11: PERIOD 12: I Sipature TIME PERIOD: /O~ /? { to / ?-/Z'/9( . . Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: ,I;söh / t() ~)7 ,J - Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) 7 /~/ 7/ . TIME PERIOD: 7 !-z,/9l to Total Minuses Thfs Period (Line 3) Action Number for this Period (Line Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: TIME PERIOD: ~llc; 2.. to' /4<] ?...... Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) ~ is a true and accurate report. '/ JIM HINDMAN, Supv, Mf!~h II ~n.r.' ServIces- Garagt Oi¥ttfø: . , ......:. Date ~ 4-9 /92- . II -- * * QUARTÉRLY MODIFIED 1NVENTORY CONTROL SHEET * * FACILITY ~ PLr4""'- FERMI T :11= - TANK# - ~ _CAPACITY /C>¡ C)OO SUBSTANCE STORED.:I:>,£S£L --2UARTER/YEAR = = C I I I I , I I COL. 1 COL. 2 I COL. 11 OL. 3 COL. .4ICOL. 5, COL. 6 COL. 7,COL. B1COL. 9, COL. 10 I - TEST WATER I 2ND _ 1ST _ INCH I 2ND _ 1ST =VOLUME+ . L= CUMULATIVE WEEK LEVEL jGAUGE GAUGE - CHANGEIVOLUME VOLUME CHANGE_SUBTOTA _ CHANGE - . INCHES j INCHES I INCHES , INCHES GALLONS I GALLONS I GALLONS L GALLONS L GALLONS - 1 (þ I I I I 75/B I ~ I 0 I ¢ I I {g1 I (P1 I ? 7~/6 I I I I - j I I I L k .-J 2 I I I I I ø I ø I tj I ~7 I b7 I ø 7~/S 7S/~ I cp I J I . - j I I L k .J I &(3/1 I \),µ I I I J f 3 ~711 ~ J 75'-/10 7190 I ~ I f2J I 50 I j I L k .J - , I I I I I I .4 L it I &1 61 I 7~/8 75/ B L r ~/p I .s--0.oo f 1 I t 1 k .-J 5 I ' I . . ~ - ~. . "oo ." I .. I I bt¡¡.3/t./ ' Jj "~l q I ~fo ýz. 7'i9v' 1~~~ ' ÃB>-' I - . , I, '·8'1+ I - 1 - L k .J 6 I bl, I/-¿, - , I I --" 1 'rp J ~, '/z" cb "1 y,'-i " .7"Y62.;. (,1>, I 8e.¡' t . ,,;-'.. . 8 'I I - 1 - L .J I --- . I I I 7 tþ tþ Î 'f~ ~ 7 t{ ~~ (J I to ~ 1'-11 6 (Plly I 8vl. I 8e{ I I 1, ' ' L L k .J - - - .8 I I - 7~o{6 I I I I ~ I lob I ¿'b ø 7t1D€::. I é,$ J (fItf I 6'9'-' I I 1 L 1 k .J - - 9 I I (j 7 t/ 0' ?t!o, I I 1 1 . ' .. !t J bb I b' I q I By I ~r.¡ I ,. '- L 1 ~ .J ...,...., -.., ..ø- ." ~ .~.-... - - 10 () !.¡b Iø b' I I I I ~ 7/J06 7 LjO~- I ç I e3 cf' I 6'9 I - - L 1 ~ .J 11 /; ~II¿ 6~ lz., ¢ 7350 -' I tp I 1 I {I 7350 J I e'j I Br/ I 1 1 L .J - - - - - - 12 rf 6S 1J I J J J b$ 7~ r-tj 7~7t/ I ø I 8'-1 f riLJ I (. l l L , - - - - - 13 ø fo~ ø I ¢ I I I - h5 J?-94 7..:2-':}LJ I I 8<-; 1 ~c( 1 1" - SUMMARY .. - TO THE TANK NOTED ON REVERSE UARTERLY , , FILL OUT THE FOLLOWING REPORTING SÙMMARY APPLICABLE CHECK ONE ONLY) , ' 'PERMITTING 'AUTHORIT'{WI!HIN' 24 'HOURS IF: -- - ...~. _.....-<-~ - CAPACITY HAS IS A MOTOR VEHICLE FUEL TANK TANK' MONITORED REPORT ·TO THE TANK OF 1000 GALLONS OR LESS OF +/- 25 GALLONS OR MORE ·TANK·OF 1001 -TO 5000 GALLONS OF + / - 35 GAr.LONS OR MORE " ._. ¡ANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHAliGE (COL + / -50,GALLONS.. OR·MORE ' .' - '-. ...___....._..,-c::_c.::,.:':::-.':;:~:-;:,::,::~ic;~~.,..~' ~ ANY TANK HAS' A CUMULATIVE VOLUME CHANGE·;(-COL~· 11 )~cOIr +/!..' 250 GALLONS ..J . OR MORE OVER, THE QUARTE~ TIME FRAME REPRESENTED ON.ItE.YEKSE j' ~ ....._-'..~...-...... ..-...,~... ~ '. ' ;.~...~_.. .--..... ._~#. ._",. .~~ ..- .-..- .- ..._._~., "- ---. . '..~""'._#. ..~---, .-.... SUMMARV "; ;:"1, >.7: 9 COL , , k VOLUME .C}fANGE A 9 OF .;1-¿"'" ... -~, .- -.~' ;~'!--- fi' ",.' , ,~",., GALS ~~~El: O~ 'n "~.:; -;.. ;.- i':. ....... . .. ..g)-OF BOTTOM COIn' 11, .- .-" MAXIMUM WEEKLV VOLUME CHANGE CUMULAT.IVE VOLUME CHANGE (COL .. GALLONS A A .1 2 I.. HEREBY CERT I FV ~HAT. THE ABOVE-NOTED ,RESULTS REPRESENT A ,j,'RUtAND ACCURATE REPORT AND THAT THEV DO NOT EXCEED THE .REPORTAB4~ LIMITS DESCRIBED IN A THROUGH "0 ABOVE ' ¡, \ \"":n ! Oivis.iof, JiM H:r'¡Of..,'iAt{ Sup\' M ..,ériOral $e(V:ices~; Garage . ' . COL 9) ..,----... RESULTED IN: 00'''_''--''''''''--' _ -.."" oo---.~. _', '... ~.. .. ;rANK -., := ="PERMIT '. , MONITORING BETWEEN DATES OF ~ ;(INCLUDE YE~R) NOTED ON ~REVERSE TITLE SIGNED I I I I I I I I I I I I I I I f I I I I I I I I I ¡ I I I I I I I ( ''',"'- ."..- CAPACITY ':HAS::·ÃVÖLÚ~:::CIfA.NG'E ....t... _~. y._. B C D TANK:MONITORED [S A WASTE-OIL OR NON-:-MOTOR.VEHICLE FUEL. TANK , ". . , _~, ;...._~ "::î_ ~ .. ... ." ~ . ,. -ç REPORT TO THE PERMITTING' AUTHORITY WITHIN:'24 -HOURS 'IF: ' ..~--:".~_:'. _. ·'r___.·..._. "'_ _.. ~_._. _._._..':',;:::'~::''::-:':~'~'=_" '__~"'''' A. VOLUME CHANGE (COL. 9) IS +/-. 10 GALLONS ()R MORE B. CUMULATIVE -VOkpME ..CHANGE· '(COL~--H 'IS' +/-~100 GALLONS OR MORE ..~-r e.. ._:..... ,., -... ~ c .. . AND IN: _GALS OF 9) OF BOTTOM LINE) ~.~ ----. - , . ·---TANK-#:::' PERMIT ., MONITORING BETWEEN DATES OF ~INCLUDE YEAR) NOTED ON REVERSE RESULTED ~.......,_...--- -"-"-.:~" '--'--"..~~~...., .....~- - -" .-- .._,----...~ ~ ...... 1 A MAXUfUM":WEEK"L Y VOLUME <;HANGE (COL 2 A CUMULATIVE VOLUME CHANGE (COL 11 ,.', .: .... ~·_·GALLONS ; , A ; SUMMARY I HEREBY CERTIFY..THAT ·THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND':THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE . TITLE " . ,._~.., SIGNED DATE DATE ,::." * * SUBMIT A COPV OF THIS SUMMARV WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITV FOR A MINIMUM OF THREE YEARS =Ie =Ie . _. (. * * QUARTÉRLY MODIFIED iNVENTORY CONTROL SHEET * * : ~ _ Z;n.J{ PERMIT # _ I ~ 00 TANK# = A TY ¡O.; (JOe:::> SUBSTANCE STORED VJl'E-__~é--L --2UARTER/YEAR_ /ttf"~/ , - . . COL. 1 COL. 2, : :COL. 3ICOL. 4 COL. 51 COL. a:COL. 7: COL. aICOL. 9: COL. 10 : - COL. 11 TEST W WATER I 2ND 1ST INCH I 2ND 1ST VOLUME _ CUMULATIVE WEEK SH1 'N LEVEL IGAUGE -GAUGE = CHANGEIVOLUME-VOLUME =CHANGE+SUBTOTAL: CHANGE _ . TJ INCHES I INCHES I INCHES ' ' 'INCHES 1 GALLONS GALLONS I GALLONS I GALLONS L GALLONS _ 1 ' DATEI I ' I I I I I I TC d. I ~/J3~/1 ~t}5ItJ ø 11:ì-~~ 7~blo I (þ I 0 I LIJ I DATEI -.!!:!. , T '1 I ~ 1 I I L Y .-J 2 DATE I I }J 0 I , NO I I p./o I I I ~ /Ih I iJ:"A?)J~q I, ,JI /I;¡ ~~~fS. . ? 7 J..3 B I ~~:.":'..{& I ø I d I . DATE I Y' I ",r;4~ I 7 ~ 7'(~ 1 I ;/~~ I _ ¡Y .J :3 ,I DATEI ,I I I I I , I IDAT~ (!þ I b~lIi I '4 1/", ft5 1 7d--O¡ 7;;¿07 t¡5 I çJ t if J 4 I DATEI ,; I I·' 'I I I I ~ A I b 4 I) I ~ '-I I J ~ I ' 1- ar I A , I DATE I L z.- -, /2 rµ 1 7;23~ 7~3~ r , -1: ¡ '-f' .J 5 I DATE I I "I I . I I I ~ Á-." ,1 I C l/ A< r I 0 , ì· (b. ø I /d\' ~ I I DATE I c,v ~ .,. I ' .' ~ 1 7" C> ,I ð' ,~ L ' Cµ .J 6 IDATEI , ' ,I _ 'I I ,I I IDAT~ i 6 i 1 ¡; If tp ¡ 7/l1( /I'ð-r '11 6' I f25 J 7 DATEI I I I ,,' , I IDA~ t ~31'yl t.-t/.¡ ø ¡ 71~'S I 7153 ø (¿ ß5 J ." 8 IDATEI , I .) IDAT~~ [(P3'lv "3 '1'2/ () 1 7/P 7/ ~S r(J ~ .(J..' J 9 '~I I I ":~_,,·~,..lnAT~ p 6sJ/i ~slLf'f ø 1 7D71 707C¡ tp' ðJ ¢ : ,", ....,'; .~''',r:'J': "'I - - I - I " _... #_~... ': ., .... ~. , .. 10 ' , '., _ ~~ C! b~lj..¡ ~3~cil cÞ 1 7D~ 7077 c¡ ø 3·~· : 11 ~I I I· .. I _ ~~ ~ ~:J-3N t.~3)'1' I ø t 70Y\ 704( fJ ÇÞ if, : 12 ~/. J I I _ ~~ t ~A~I ';L~/¥I (j ~ 7ov/70'lf ~ 15 ø I 1 3 ~I I ~ ,I I I ~~ tf~).. !/ I 6.;Z/tj l~ I 70/3 '7 ôl..) J - ¡;<f5; ø -~ð I ;;- UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE'ONLY) IS A MOTOR VEHICLE ~ TANK PERMITTING, AUTHORITY.ITKiN 24 HOURS IF: .. ~, . .'~. \ .. . \ - "" -, TANK OF 1000,GALJ;.ONS OR LESS CAPACITY tlAS"A VOLUME CJ.fANGE OF +/-25 GALLONS OR MORE ' ':', ') \ ,,: '. \ "," TANK 'OF-l 00 1.' TO '5000 GALLONS CAPACITY ÍfAS"A .vòtÚM.Ê C!JANGE OF +/- 35 GALLONS OR MORE"'·'~:~::':" ,.....~ ,c- ., ... ~ TANK OF OVER;5000'GALLONS CAPACITV HAS A VOLUME CHANGE (COL -+- / -,50 "GÂLLO~S OR MORE':" . .c... _C', _. :..:~;' \' , ··,:::-;,:·-::a, '~,', :;~: ., ÅNY rANK .HAS A CUMULATIVE. VOLUME CHANGE:(COL;:'i1) :·:o~; +/- 250 GALLONS OR MORE .OYER' THE QUARTER TIME F~E REP~~SE~~~,~~.~p~~REV~R~E ...._. . _ __ . '_n ..... ..~ . .~..~.~_. _ ~ \ ". "'- .<'~~.J SUMMARY '. . ~" '.', ·..TANK--' : PERMIT -# MONITORING BSTWEEN DATES OF ~ (INCLUDE YEAR) NOTED ON REVER: GALS I HEREBY CERTIFY THAT THE ABOVÈ-NOTED RESULTSREPRfsENT ',A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEEDTH~REPÒRTABLE LIMITS DESCRIBED IN nA THROUGH no ABOVE . _,JiM_HiNO~v'¡AN,Supv MGch ¡; ~·Ö~~¡ElI.~~e)"'li.~~_s_...ß.ar:~ge ,QjyJ.Wµ I 9 OF , IN :_. "..', ',':" , .'- -". -". ...' ..-. ;. .. . - ~ ". ~ -'-. ,-," .. :9):~OF Ä~~: ~OTTOM.. L l~E) OF :', ···pr,:..-'.........·, COL" 11 A MAXIMUM WEEKLY VOL~E CHANGE A ClJMQLATIVE VOLUME CHANGE .cCOL .. .:~·J..6· : GALLONS TITLE DATE 9 - ( COL COL 9 SIGNED I I I I I I I I I I I I I I I , I ,I 'I' I :/ I I Î I I I I I I I I I I /,-12 ·~','ø~;..t /.1} .,' .".. -l.ì/:"- ~ .~; ,--' ". ~ .. - ~. . .' :;:~. :' " 'AND' ":" TANK MONITORED REPORT TO TIÍE , A :--'ì ~ B C D TANK MONITORED (S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK .. REPORT 'T~ THE PERMITTING AUTHORITY WITHI.N 24 HOURS IF: . _.' -._ v- _ ..". ,..~ A. VOLUME CHANGE (COL. 9) IS +/~ 10 GALLONS OR MORE \ ' ì., . ,,} '- I . -. ~ ~~ .J ,-·B.· CUMULATIVE ·VOLUME CHANGE (COL-;'--l1) IS +/-100 GALLONS OR MORE _.~"'-,'. . .... , , ..'~ " .' ',- . . ""'" " . _._.. :':X' '>., , <~ -- ¥ -.. -.' slnIMARY . " " (... '. . \.' ,- . ·TANK , ',.1 ..,. , PERMIT # " . ..., . ,.. '", - MONITORING BE~EEN DATES OF , ' AND (INCLUDE VEAR) NOTED ON REVERSE RES,UL TED IN:.' .- ~. ---~..... .. ....,-. .... 1. A MAXIMuM ,:I~EEKi Y VOLUME CHANGE (COL. 9) OF GALS. 2. A CUMULATIVE VOLUME CHANGE (CQL. 11, BOTT9' LINE) OF , . -. ,GALLONS ' '.. -,," .-'~:. \."...... " i . ~ ~ I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND .' ~ ACCURATE REPORT AND ,THAT T!lEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "An AND "B" ABOVE TITLE DATE StONED ~ ~ SUBMIT A COPV OF THIS SUMMARV WITH FACILITY ANNUAL REPORT ~ ~ RETAIN THESE RECORDS AT, THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * tNVENTORY CONTROL SHEET * * _. PERMIT # It êO¿~ ~ ~UBSTANCE STORED. )/~ --2.UARTER/YEAR 19/,V ~ _ 31COL. 4¡COL. 5: COL. stCOL. 7 COL. S COL. 9: COL. 10: COL. 11 ~ ~I I ~NI 1ST _ INCF. I 2ND 1ST _VOLUME + _ CUMULATIVE ~ n 1 ~u-c ~ 4 AUGE - HANe: 1 DLUME :>LUME -CHANGE _SUBTOTAL- . CHANGE _ ~ ª- 1 :NCHE --i INCHES" I INCHES 1 GALLONS ¡ALLONS GALLONS L GALLONS .1. GALLONS _ I I /1 I ~ I I 0 I -1-, I f I~? ~ I ,;... Ý.?--I . /. I /D~ ::, 7 Ð I "3 rp. I I I Z_l_:..i 1 _L~...J I I I 'I ~ I I rt I ~ J I ~ } ø I é? '04Ç ~B4 ç ø I (þ I ø I 1_--L 1 L ¡).. ..J ~ I I, I 1.1 Lfl Ql I hó-o/tJ I 00~~, tfh I /ö.. t1 C?~ 11 /1) I ø I '-II I 1 ' I '1' 1 IOC' .t::- L ~ . ..J "I I, I 1£ ~I I (þ I he> 3)'1 I b 0 Y<? + Y'ò I fo ~~ ,g J 7 / 7' I lp 1 / c; I 1 I ~ 1 _ 1 L. I " ..J I ! I I .. d I ~... ~ I it 1 ~ ó Ilz.- I bD 3/11 - '/'1 I ~ I'B> 9 ~ 811 l ~ I J '1' I. -r 9 J /rL I I J ,1 ' - ,/ I rl I <.p L .IG;ÒJ/z.., H(4 j/fl+- b"7ðcr 1.1· J ·-9 '1 -tj I _ 1 '_ _ 1 .J ..J 1 '... r I (I I Cþ 1 ~o'/2.1- ~D '12- !L ¿, ïS9 ~7~{ L 1 - 7 ~ -i.. J 1 " .. I ", ' ' 1 .J _ -. I (þ 1 6D ¡lb' J 60 IlL; ¡j, ~ 7~ì ~ 7~'7 ø I -?' ,I~r' <::' I ~ _ 1 l _..J I I I (í I I &0 I bO f 673;)- ~73À (ß 1 -'7 I -7 _ J . I ' / I cl I ~ö jlz. I&,o 1(2" tP ~ 7~7 b 769 tp 1 - C¡' "I -~-7 J I ' " , I 1 I lob ,/~ I (¡;;() Vë., ø (p ì 2> ~ ~ Î ~, (/ I -7 I - i 1 _ _ 1 i ..J t I I I wÝca·,.1- ~ ,/tò ø (01 YQ:) b?I../-'ô fD I - i 1 - c¡ I _ _1 _ _ _ _ I /r;D be I tf Þ73;2. tb73 ø - '7 - í I TANK# COL. 1! COL. 2 TEST WEEK L 1 - 2 - 3 - 4 - 5 I J 21 '~:~I I : s 7 .S 9 ~i'ò 11 12 13 UARTERLY SUMMARY - ~. ..." - - FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTEU ON REVERSE (CHECK ONE ONLY _. <, TANK MONITORED RBPOR'l: -TO IS A MOTOR VEHICLE FUEL TANK 'PERMITTIN~ TANK· OF 1000 GALLONS OR LESS CAPACITY OF'+Y-"25' GALLONS ,OR, MORÉ '" " \-, '..' , '" ' ---'TANKOF '1001': TO ',5000 GALLONS -CAPACITY ,HAS A VOLUME,CQANGE . , '\ ; . ~ - .: OF + / - 35 GALLONS OR MORI;: ".. ~..- ::. '.. ' TANK \OF,. OVER ,5000 GALLONS CAPACITV HAS A VOLUME C{lANGE, (COL ) .' - - .-~. -- ~.'. .,' . A ;..,:",::",:,';:._._~....._..-:~ .... ~"', . I- -+ / --50 -GALLONS OR··MORE-- -----...... .----- ---' ".- --...- . ... .,.-.....:. .,~ .. ,;' . -, \ ,'- \\\ " '..~-":'" ,.~~",.;.. '..- . ANY, TANK HAS;A CUMULATIVE VOLUME CHANGE-·(COL·,:H) OF. ,'+/- 250 GALLONS OR MÒRE -OVER' THE 'QÙARTER' TIME FRÀME RE~.RE~E,N!~[)~ ON iÉ~~~~E ..-_. ~. - ......- ~--'-.jo '",' ''t.-"' .:;:¡::.,'''' SUMMARV : ..." ':" ".,. 9 COL !!I!{JN 24 HOURS IF .. .:.. ~ - ---"~ -~ ... -" HAS' A VOLUME CHÅNGE AUTHORITY 'THE A ,\ ......J ) OF .. "- - ... j-~ <þç.:p:~(jt!...': ,:. ':':,-\\::AND' .. .. TANK··' - -. ::.::/ ::.:--PERMIT MONITORING BETWEEN DATES OF (INCLUDE, YEAR) NOTED ON REVERSÉ, I- \ .;.GALS 'pF' r.y. I,N;:::<'.,.. ,:"._ .' \ '. '\ ",>,' '.'}2:.:'b;, 9T -OF:·-..O B~ITOM L,I rtE) ~ ,;. t ~ . ' ' A MAXIMUM WEEKLY VOLUME CHANGE (COt A CUMULATIVE VOLUME CHANGE (COL. 11 - - -GALLONS, :... 1 2 .-...-- - I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT:-~ TRUË AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A THROUGH "0" ABOVE : l \ '.~ JiM HtNR.~,¡iAN,Supv M0Ch ìI .~~~er5.1:Seiv~es.i'-.srege .O¡v,iaiQr. :3 9 COL 9 TITLE DATE B c. o SIGNED \ 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 I I -,,- TANK MONITORED fS TANK A WASTE-OIL OR NON-MOTOR VEHICLE FUEL .' WITHIN ,24 HOURS 'IF 10 GALLONS OR MORE R~~~RT.~O_:_THE ,~E~ITTING AUTHORITY A UME CHANGE +/- \ . (COL. 11) IS'+j- 100 GALLONS-OR 'MORE IS VOL CUMULATIVE 'VÒLUME-CHANGE 9) (COL '- -- --.'- '.. - -, " h " ,". .....--- ,.......--. B .' -- "-...- .. ... .. ~_. GALS. OF- .;1, \ . AND IN: 9) OF _ BOTTOM LINE - \' \ -".: - . . - .. ,--TANK ,# ..:.",' -'.¡- PERMIT' MQNITORING B~TWEEN DATES OF _ (INCLUDE VE~) NOTED ON REVERSE RESULTED _ ~'_4 .' . . . . ~ _ ~ ~ _~. . . _ A MAXIMUM·~;WEEK·J;.Y VOLUME CHANGE (COL A CUMULATIVE VOLUME CHANGE (COL. 11 , GALLONS - '-' Sl!MMAR'( # .--- - , 1._ 2 I HEREBY CERTIFY TH~ THE ABOVE-NOTED RESULTS' REPRESENT A TRUE AND ACCURATE REPORT AND:"THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE . TITLE DATE SIGNED ~ ~ ~ SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT ~ ~ RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS d '* '* QUARTE-RLY MODIFIED INV:ENTORV CONTROL-SHEET FACILITY Uí/LI T' ,.,JT PERMI T :/I: /6 6>0;:).. Ie - 1_ TANK:/I: - / _ CAPACITY 10 OoD SUBSTANCE STORED_ ~ 1'55é.L QUARTER/YEAR /77:L - 01 = - - COL. 1 COL. 2 COL I I I I I I I I COL. 11 . 3.COL. 4,COL. 5, COL. S,COL_ 7 I COL_ B COL_ 9, COL. 10 , TEST WATER 2ND _ 1ST _ INCH I 2ND _ 1ST _VOLUME + U - CUMULATIVE WEEK LEVEL GAUGE GAUGE - CHANGEIVOLUME VOLUME -CHANGE_S BTOTAL~ CHANGE # - INCHES INCHES INCHES INCHES 1 GALLONS J GALLONS GALLONS l GALLONS L GALLONS - 1 ø I I 0 I ~7 3/'1 t'e¡ 3Jt.f ø I b Î ~)\.-\ b 70 '1 ø I I 4> - 1 - l L - 2 fb ¢ I I ø I ø 00 ¿o I ~752- {, 75:l- éD I I .3 - 1 - l 1 - ø .5¡3/t.f if I I ¢ I I ~7~if I ~loLI fÐìO,-\ ø I I ø I 1 1 L .J - - 4- 4 5?1z, I 5? Yz.- I ø I I ø I Jt. I b67fc 10, 710 I ¢J I I 1 L , .J - - 5 I I I I !k 59 )/1- ~~~ JL I fot:, 7 b '£,7b (þ I ¢. I ø I 1 L L .J - 6 Cl I Çt I ø I ø I 571/Z. 5/ '/z... ~ I 0b7b &'(,710 I I I 1 L L .J - - - 7 2- I cf I I I !l 57 ~/ I ~b~ ~ ;J..Ð I ~ I ~ I I 1 1 L .J a ~?;jy 5'71y- ø I j¿ I I ç I ¡. Æ I bú t/f$> bbt/~ J ø J I 1 1 L ..J - - t 9 !l- I I !Z I I l 50¡ á--.¡ -E I (Pb~ hb:ÆJ ~ I I -f5 I r 1 L ..J ¡ "... .,. , . .: ,'"",: ~ ~ .; ~ I J I ~ ~,~;t:;~~9:.j;)s " sg/i- ~.~ ø ¢.- ~ 5"b t..{ í 656L( (j) I ø I ø I - 1 L ..J - - - 11 I ~ I ø I I ø 5'~ '/1- ~g 'I?.... ø 's'Ý I , S'Lf. ø I J ø I - L L ..J - - - 12 ~ 'J'f ~V~ ø t, §3 ~ ø I ø I ¢ I '$'36 I J I - L - L - I 13 I Sf I ø I ~~ ~ I s~ (/~ bSf.o 05~c/ I I ~o Z- ~ UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE CHECK ONE ONLY) I TANK MONITORED CS A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A MOTOR VEHICLE~ TANK ~ I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF: I REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF: I . .. " A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR ~ORE - I A. rAN~ Of 1000 GALLON~OR LESS CAPACITY HAS A YOLUME CHANGE (COL 9 . . .. '.. '''OF -+/- 25 GALLONS OR MORE ' '-' ,. \ .'.'. '. B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR MORE I B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS' A VOLUME CHANGE (COL~ 9 ,. , \ I' OF +/-,35 GALLONS OR MORE \- . . . -.- . 'I C. ·TANK OFOVER5000GALLON~ CAPACITY HAS"À YOtÙME CHANGE (COL. 9) OF I t/- 50 GALLONS OR MORE'. ,""': . '.\ '. .," . ,'\ ~., , D. ANY. TANK HAS A· GuMpLATlVE VOLUME CHANGE ,.(CpL. 11) OF +/- 250 GALLONS , I 9R MORE OVER THE QUARTER TIME FRAME REP~ESEN~~D ON REVERSE. '. I " SUMMARV __ ' ',) . I" ", 1 ,SUMMARV, - TANK # PERMIT # : . ~ANK # 'i' . pkRMI~ # 7/" OO~\.c.:-,' ¡. . 'MONITORING BE'rWEEN DATES OF AND' , ' . I MONITORING BETWEEN DATES OF .3/3/ e; 't- ANDGIi:E¡1 z..... (INCLUDE VE~) NOTED ON REVE~SE RESULTED IN: I{ INCLUDE YEAR) NOTED ON REVERSE RESULTED IN:." . I · 1. A MAXIMUM'WEEKLY VOLUME CHANGE (COL. 9) OF G~LS. ,I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL..9) OFØ GALS. , 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF . I 2. ·A C1JMU~IVE VOLUME CHANGE (COL. 11. BOTTOM LINÉ) OF GALLONS I GALLONS . ; f I .'~ I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND · I I HEREBY CERTIFV THAT THE ABOVE-NOTED RESULTS REPRESENT·A TRUE,AND i ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REpORTABLE LIMITS ! '., ACCURATE REPORT AND THAT THEY DO NOT 'EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "D" ABOVE. I ," , I , ' I . \JIM HINOfviÁN, Supv Mecn ¡; I ~,e~eral ServIces e Garage Oiviaior.. SIGNED _ TITLE I SIGNED TITLE ~ ' , I " DATE I DATE . . '6 '. * * . SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT _ *.. RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS . . ANNUAL TREND ANALYSXS SUMMARY TANK # TIME PERIOD: ""/2/91 to "J~..sJ9L , . TIME PERIOD: 7/2-)9/' to C¡('¿'/9/ Total Minuses Thfs Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) 5· TIME PERIOD: ¡oj¡ /9 J to I Ý2-~J9/ Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number tor this Period (Line 4) TIME PERIOD: I~a) 'lJ to 04"/72- Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) QUARTER 4 TIME PERIOD: ..3 ~ I /92- to" )25/,2- . , . PERIOD 10: Total Minuses This Period (Line 3) Action Nuaber tor this Period (Line 4) PERIOD 11: Total Minusea This Period (Line 3) Action Nuaber tor this Period (Line 4) PERIOD 12: Total Minuses This Period (Line 3) Action Nuaber tor this Period (Line 4) QUARTER 1 PERIOD 1: PERIOD 2: PERIOD 3: QUARTER 2 PERIOD 4: PERIOD 5: PERIOD 6: QUARTER 3 PERIOD 7: PERIOD 8: PERIOD 9: Sipature \ is a true and accurate report. . JIM HINDMAN, Supv Mech ¡¡ ~~neral Services" Garage Divialor. ..'~,' t· I Date bþ; h2- , , ", '..., \ \ \ \ \"" .. * * QUARTERLY MODIFIED 1NVENTORY CONTROL SHEET * * FACILITY b.:rJi,..1I!; .-J 'l-AtJr ',' , PERMIT :# _ ÔO~ G TANK#_ 5" _C A ITY ¡;ll!),él!) ~~UBSTANCE STORED ~,Eß¡:J --2UARTER/YEAR 1?9/ F COL = : = I I I I I I I C . 1 COL. 2 COL. 3.COL. 4ICOL. 5, COL. 6 COL. 7, COL. B,COL. 9, COL. 10 , OLe 11 TEST WATER 2ND 1ST INCH 2ND 1ST' VOLUME CUMULATIVE WEEK LEVEL GAUGE -GAUGE = CHANGE VOLUME-VOLUME =CHANGE+SUBTOTAL= CHANGE t INCHES INCHES I INCHES INCHES GALLONS I GALLONS I GALLONS i GALLONS J GALLON~ = 1 '^, I I I I I I rp 1()8 '14 /o~ 1'1 ø Jf2>q~~ I IBqQ3 I rp I 0 I cß I 2 n; NO ßD :: #0 ,t ~ --1 r ~/~ JDS'I,J I..€AIAJ~ I, ':) I 18983 I~/M~ I (þ I /~ I It- - ~ ï m-k~ I , I ~ 1 ~ Y _ .J 3 ' I I I 1 .1 I ø I 68 J/~ ) Ði 1/~ çt I 18 983 I I gpg 3\ cf 1 ø J. ø _ J 4. '., I I I I .1 I ~ ló~f4 IO~ 1£f1 !/) I 18983 \ le7~31 c?f 1 1 I fØ _ J 5 '. L I I - 1"1- -, . 1 t it /eQJI41IÐ~ Ýc.d ~ r 189~31 la9~3 .-"<¥. ø;"ø _ J 6 ,I I I I, . .1- I q5" , /' 00. I /O~ 1 /5{ I IcB rr5~r/ fi?S5 (15 AJ·I ø I t:.- C) I I 'f" I I ..r."1 _.J 7 1 I I I .J I !t. /tB /02>1 ø llg7S~1 /:39~5 ø P J ~. _ J .8 1- /&~ ; ItJ~ i . f? I /$PS! /S,1SS¢ ø.i ¢ _ J I 9 I I 1 ¡ _ 1 /07S¡~ /ð7~'t'f ø ¡e'r;L5f IBt¡;;-s cP ø _ J ¡-"III 10 é( /075;,/ JD/~<l1 ø ¡g9Þ-s t /g7~ qJ. Çi J 11 I I I _ (þ 1071j-¿ \ 107 V~I fJ / ø ''110 1 Jf8tg,qb ~ f 1 I I,· ' I . 12 /071¿ I /07~1 ð /88?b I IS&j'=¡(, c$' ø _ 13 ó11J~ I07~ -)/2-- II3B/;(;, /'ð?dl, -~ -~ ~ UARTERLY SUMMARY , . .' .' . . ~ . FILL OUT THE FOLLOWING REPORTING sUMMÁRv APPLICABLE TO THE TANK NOTED' ON REVERSE (CHECK ONE ONLy) -, - \ . .', .. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE OF +/- ·25 GA~LONS OR,MORE , \ \' , ,:-f:' " . :TANK OF 1001 TO 5000 GALLONS CAPACITYliÀš '-À'VÖLUME'~CHANGE 'PF +/- 35 GALLONS OR MORE " '"~_\....þ-:_"",_._:;...,,,.;¡, TANK OF OVE~. 500Ò' GÀLLONS CAPAÒTV HÁs A VOLUME CHA~GE_. ('"COL ç+/- 50 GALLONS OR MORE ",-.,.--,,--. ... - ...c·'::--~;~\';""·:·'··:"':;'::':'-~2;::·- ., ANY TANK HAS A CUMULATIVE VOLUME CHANGE .:( COL-;-:'} 1)' 'OF'.):; - 250 GALLONS . . '- .' . :OR . MORE OVER THE 'QUARTE~ TIME FRAME RE~RESENTED ON.·R~'yJ;:~SE .~'::......~ .';..-~.-.....~...-,;-,. . -~~.. ~ ~--~.~'.-~~. ;'.-- ;.~.":':-:--:'":.-~-".-:';-~':.':':',.".':?"; .~~~~:'::,<' [, SUMMARV ;.: ".;, :..,.,~. \.;:.'~':::'.".;:' \ . \;:. - ""~ - £!" \. . " , \'~:"I' /,A. -TANK .# ...;;1. ,.' '.--- .--"PERMIT-#--·l~:·~~ :' MONITORING BET~EEN DATES OF /.oj, Iql'"'''~''\'~:~:AND I (INCLUDE YEAR) .',NOTED ON REVERS~ RESULTED IS A MOTOR YEHICLE,FUEL TANK TANK MONITORED 9 (COL PERMITTING A1ITIIORITYWITHIN 24 'HOURS -IF ~ ~ ~ - 7·.~ ~PORT TO TJ.IE A 9 OF .. GALS ~. .: ;~3.:0 : OF .IN: . ....- -. .-.:-~-",-". . \~. . 9 ) OF':. BOTTOM LINE; ", -- -. . '-~ ~. , , ' cot 11 MAXIMUM WEEKLY VOLUME CHANGE CUMULATIVE VOLUME:CHANGE, (COL -' GALLONS A A 1 2 '.. ' . ., . '. I HERE,BV CERTIFY 'fHAT THE ABOVE-NOTED RESULTS .REPRESENT ~",TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" THROUGH "0" ABOVE \. Ji;~ HiNbMM'¡;:SUfW M~r;¡" if :'-'~e~''9~~' .se.,\.¡t,~~'~ (b1!:'IIQ(>!lhdftt1',,-_ TITLE DATE . . SIGNED 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 I I I I - [S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK TANK MONITORED \ _.__ø ...,) , ' ) 100 GALLONS OR MORE : 10 GALLONS OR MO&E ." , . - ~ ,- WITHIN '24 !lOURS - IF . ;::.':.:."':":-:."" REPORT TO THE PERMITTING AUTHORITY ... ",-._~ 9 +/- IS COL VOLUME CHANGE A A.." TANK" # - "¡" .,,-- PERMIT '# .= MONITORING BETWEEN DATES OF - (INCLUDE YEAR) NOTED ON REVERSE RESULTED "." .- _. ._ ....... _"-"'_"_~_ ._ ~ . _ > .. ~~_ ~-, 01 ~._. 04_ "'f:" . 1 A MAXIMUM~WEEKLY VOLUME èHANGE (COL 2 A CUMULATIVE VOLUME CHANGE (COL 11 , GALLONS COL 9) " B o C - ~ '", '''"' ~ - - AND ;IN: IS +/.:.. -11 St¡MMARY CUMULATIVEVOµUME-CHANGE-(COL .~ --'. -~-, " ;, '. ::'-~"L. ~,~~ I..~'::.' I, ~.:'.;..\' --~, B '. . '.' ", .... GALS OF - 9) OF BOTTOM LINE) - " ' , " I HEREBY CERTIFY TH~T THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND~THAT .THEY DO NOT EXCE~D THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE ','-' . TITLE -- DATE SIGNED * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * '" * * QUARTERLV MODIFIED 1NVENTORV CONTROL SHEET * * FACILITV ~ ~ l[ PERMIT :# _ " TANK#_ S' _Cj A T .tc) ðeo _SUBSTANCE STORED~ ~/~--L ~UA.RTER/VEAR, "" I "- COL. 1 COL. 2 = :COL. :: COL. 41C' L. 51 COL. S:COL. 71 COL. S COL. 9: COL. 10 I COL. 11 TEST WATER 2ND _ 1ST _ INCH I 2ND _ 1ST _VOLUME _ CUMULATIVE WEEK LEVEL GAUGE GAUGE - CHANGEIVOLUME VOLUME -CHANGE~SUBTOTAL=- CHANGE _ , INCHES INCHES I' INCHES I INCHES I GALLONS GALLONS I GALLONS 1 GALLONS L GALLONS _ 1 t I ,I I I I 0 I I /071~ /6131ul - ~f I rCb BCfro l<Ócr ~5 I -:2..9 I I -;t ~ I 71' I 1 ,k: ..J 2 ' ,I I I I I II ø /o? ~ I 107 1/? I /rh I /èf3'Jb /83'1b I ¢' I _?.ct I -.2.C) I ~ _ 'Ii I (,- í I' I l ') k:. ( ..J III' 3 I "I I I I I ø I07fz.-1 I07~ - 'I ~ I ¿ S g 910 I ~ 9 'J-.S I <-;;-c¡ 1 -'<'7 k. -s-~ J 4 ,I I I I I !L /07 )It( I ID7J)c.¡ ø /89;>"s ) ~f 025 I c(5 1 - 58 lL -sf3 J 5 .. ' I ' I I ... I I it ,/ð73/ý[ ~l)7~ ¢ J~~5 ï~1;)'s /r> 1 -5-g' k-S8 J S _, I I I , I 1.-. ,,: , I -2- /070/,-/ /07o/yl ø lá 9~ /a?~ ÇJ 1 -.s'B l' '~SB J 7 . I I I .t. /&> ß _ /o.:;.J/I Y'I J89~~ I Btt~~ )Ð 1- '.' -$ 1 -::?-ß J .s I. I ,;. I . m/o§~c JDS - <f 1&95'".5 1<à9SÇ ø I ·-.~8··. I -38:- I 51::- - _1 J J 9 I I I ;~ .>:': ~ J06 /IJß Jl I 89.Ç$ /@ ,sS ø 1 -3f1, 1 -á-8 J s..........'.; , I I I ._~"..:ï: Ó ' - - , ø /oe; /O~ q /89$5 -/81'.s:.s ?5 I - >tð- I -:58 I - - - ' t J 11 Æ I I _ ~ (DB I~ ø L IB9SS 1~<J55 (j) -~ { -3g I 12 tþ I081~ J I08'/'-{ ø I /81B3 /a7a3 {Ó -~~: - 38 - - - - 13 tf5 /08 ft./ /08 Ñ (/ ¡BrBs J$983 fØ -38 -32> ~ UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE ONLY) I - TANK MONITORED [S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK I TANK MONITORED IS A MOTOR VEHICLE FUEL :TANK .' _, ';0 ." I.".., " , .. ',' " REPORT TO THE PERMITTING AUTHORITV WITHIN 24 HOURS"IF: ." I REPORT TO THE PERMITTING AUTHORITY 'WITHIN 24 HOURS IF: . ..', . ... '... ._, ,,' ...... . .'_ ...._. ,_ "/ .. ,_~.. .... ,_ " . ..... .... .... ':::c'... ,-'-_.. _ .... .. : A. VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE I A. TANK OF 1000 GALLONS OR ~ESS CAPAC~TYHAS A VOLUME CijANGE COL 9 OF +/- 25 GAr.LONS OR MORE , ",,"' ,. , ' . ·..B·¡·"CUMULATIVE,VOLµME·CHANGE (COL.--U)··IS +/-"100'GALLONS OR MOR.E·..·· I B. . TANK OF'1001:TO-5000 GALLONS CAPACITYHAsÄ'··.VoîùMß,~CH.AAG·E··(COI. 9) ~;i I OF +/- 35 GAtLONS OR MORE -'-'; :..2. ".:~: ':. .\. . I C. TANK OF OVER :5000 GALLONS CAPACITY HAS A VOLUME CijAN'G¡:: (COL. 9) OF '" ....., ...,.......--... , :.... '. '. .- ".-... -'" -' - ."-" --..-.." - .. '-... -.' '. .,... ---.........- . . '... .... "...-.-+ / - ,50 GALLONS . OR- 'MORE--: .~. -"'-. '" ." ,':' cc-.;;::.:::::,~::~.:::....!:~;....:~:~è..i:: ' . .~. '~I _. D. ANY TANK HAS!A CUMULATI~ VOLUM~ CHANqE '(COÌ.;'·ll) ,:Òf....+j:·~:i250 GALLONS : I' OR MORE OVER';THE QUARTER TIME FRAME REPRESENTED O~.REVE~SE. ..... ,.-. ...._.:\~,.,_._.q_........ .... ....~ -', .... m. ï ....,:.._.,,-,.........~.,., . ....... ...--,'-....--. '.:-':'-.-::':">: /~:~:~..:~> "'-' .:... SUMMARY I SUMMARV ; ,. :.....~. ." - .:. ,I';; , . !~:::. '.., ;; I, ~:: . _ I / ' . .".. .:,_'::'.., ..:,i":,"'·,,{:.:.; .... ..._, ~:~T~~;;~'-'~~'~~~~-~~~E:E:IT # qn._ ... .-. ~;D' ....... .......-..... ...,-.-... "-. - ~:~T~R~~G ~E~;~;'~~;~=E~;I~l ¿¡ 1; .ð':_:.~ ~~··'·-~l;.z)~ l' ....- ~., (INCLUDE VEAR) NOTED ON REVERSE RESULTED IN: '/ (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: "... :,r ' . .,..-.... ...' ,'- ..._, . -_:~~ .~-,._.... . -.. .-.. --,'. . -. ., ....". " 'f" ". ' ..'" '- .'...._-"..,.. -_.. -'- " .'.. ... ,''''':":'':. ~-::::::;.:~ "':~, ':",:.';.;' , ' , 1. A MAXI~A~EEKtY VOLUME CHANGE (COL. 9) OF' GALS. I 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL";·-9)'-oF·-:~~"'::;GALS.,,;. 2. A CUMULATIVE VOLUME CHANGE (COL. 11, BOTTOM LINE) OF 'I 2. A CUMULATIVE VOLUME ÇHANGE (COL. il, BOTTOM LINE) Q~ .. ',' -ztJÌl ' ..' .." , ......,.; ...::, :'. .::' '-'-' " ' GALLONS....··, ...- ...... . I .. ,-.. ... '6-;;-0" GALLONS <>. ..' ", ; :p', I " ...',.. ,.." :;';'" .:,.; I, '. I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND I I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT ':'ri~TR..UE ,AND" . ACCURATE REPORT AND~THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS I ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE ·REPORTABLE LIMÍTS DESCRIBED IN "A" AND "B" ABOVE. I DESCRIBED IN "A" THROUGH "D" ABOVE. .. .. ,I \. ..- _,.. ' , : .~ SIGNED _ TITLE I SIGNED .._ _ .~ TITLE '.~~';~~~~"~~~~a~~i~~~ ,I J ' DATE- ' I f DATE elf / - - * * SUBMIT A COPV OF THIS SUMMARY WITH FACILITY ANNUAL REPORT * * RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS --~ '" * * QUARTERLY MODIFIED iNVENTORY CONTROL SHEET * * ìl ~ /~. PERMIT:/I: I b ~bG TANK# _ _CAPACITY ~ 0r:(Z:J SUBSTANCE 'STORED~__, ~UA.RTER/YEAR /29A.~ - - COL 1 I COL _2- C I I I I I 'I OL I COL .. . OL. 3ICOL. 4,COL. 5, COL. 6,COL. 7, COL. a,COL. 9, C . 10 I . 11 TEST WATER I 2ND 1ST INCH I 2ND 1ST" VOLUME CUMULATIVE WEEK LEVEL IGAUGE -GAUGE = CHANGE 'VOLUME-VOLUME =CHANGE~SUBTOTAL= CHANGE _ ~ INCHES, I- INCHES I' INCHES INCHES GALLONS I GALLONS GALLONS' 1 _ GALLONS I GALLONS _ 1 d I I I I £ I 0 I . .1/' I -¥- I )07ïf I 107 Ytj L lðr§ro~ ~ / eBlob 5±!.- 1 _ y' , J 2 I I I' I 1 I e-;- . ø ¡ /O"¥~i. IDb}'è L /B7'ð>! }e1~$ ø ¡ - L r 4 ~ -t- 10 53/q 1 , ¡Os$/t( ø , 186~) I 186~J Q 1. L~ ø J 4. "'4, I I' I I , ''If lo,3.l¡ I I Ðb Ý& 11'-1 Iß~oS I J81? ~ r ~ I _ ø ~ ~ J 5 " . .:' "'-';'7 ,..'11' . '," - I '-, 0 I . , ' I :. '-M Itk'li r)bl,/~1 - 3/"" I tfó1~% ",' ftD?7S1 ~'-f7' I~- I··· -'~':",1;7"-';' I -Y- 10 í'b I '1 _ V ..J 1!1::1!. rp f ' ' l )' ". I ~ I I J ~ '. - '. N ~f'-là" 'I'ð ¡) /4. ¡ ,.J ~. _.~/ ~::?~ ·1~",-4- I -I Î r: ~,>::"'-~- J 7· , _ - 1 ~ ..J I 1 1-.-. t '7 J /05 % . /ps% i!- / g(,lo$ ) 8 bh $1 .i- I -77 : -J( J a ' 'i ,', '.' - " .' I I ,-, , . /2 /o5~"; I': /oS~~~ .fif' I~~~S /a 6l,S I /Qi I ;..-J 7 '-/:7 ' ---'- :::L {" ~ ' ~ 1 1 .J 9 , , , , , r;')_~'" ~, 0 s 511 I, /05,3/.¡- -.!L /6 (p~( 1 ~6e) (!¡i 1 ~) Î 1 .... 17 J 'í'd ' . " I, -, ," I I , t. /iJ~ ,,- /P¿ 1/'1 - 11 I ç, '7 ,'5" J '1C81 L,P '-' 3--1 I :-;7 I ':-"tf6 I _ ..;....J _ I ___I .J 11 , 3--" . 1 I I 9 /~ 1'1 / o~ Sf,; Vµ / 87'-1tf I /ß ~81 ~3 I ~"¡B I ~ I _ - - '_ _ J :12 ~ /0 b ..¡,x,(þ /8 7/""$ : 187/3 ép /5 j s i - - - - - - 13 fb los7k lo51'~ tf ß~'t7 /86lft ø )~ I~ --- , ONLY) CHECK ONE ~-,- ~. ~ - ., ~---. -. -' UARTERLY SUMMARY . .- , - ,_ n FILL OUT THE FOLLOWING'REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE .1 ~~RMITTIN~_-AUTBORITY_:,~~~BíN 24 HO~S':~'~: ._:,:.', . _.~'. _ ~_. .......-....... .~_h___.,..____..._...·.....~. _ ~., '4_' < __ __.3t -.._ .....~_. A TANK OF 1000 GALLONS OR LESS CAPACITY HAS' A'-:VÒÙJME' CHANGE OF, '''+/''' 25\GALCONS óR'MORE '. ,_ -. \':-:\"'Á' - '"",' ...' .- .. '~'.'--' _..\~~. ... < r" BTANK-OF-'lOOl 'TO-5000GALLONS CAPACITY 'H~~ A\'(~~U~j;~~GE ,OF +/- 35 GALLONS OR MORE .----..~-._,-,...... ,.,' . " , _ -" " . à' .r CTANK OF·OVE~ 5000 GALLONS CAPACITY HAS A;VOLUME,CUANGE (COL ~ "- . ; + ì:···50 -GALLONS OR ·MORE _. ~:. .-.__...-~.__. -'--" ::~:-·--:··:=t-:~-~~:~~·Z~;. ~.;~'\~ . o ANY TANK HAS A CUMULATIVE VOLUME CHANGEc,..( COD;;-·),.H) ~OF.+/~, 250 GALLONS .- . 'Ii' . .1:f"- . :ORMORE\OVER THE QUARTER TIME FRAME REP.RESENTED QN'REYERSE . "'. . - .. .-~~ __.:.--\':":"~J>o\'~. ·;'~U·\~~·.:·.<...~. ...._ ~. _..._~". _"..___.-,......-~ 0. _ .._...__. ~~'". .__'" __ .' ._'. ,_. _--,__"",_,_,~.~___", __ . "._... _. .__.~..,_._.. ,,_.........-"_. .~___ _....~ .. " ... ..... ,'. . SU~y ~_ -':"~:.';i~::: --·..·-·-TANK ..# .._~ '. .,..--.--.,.- ·-·PERMIT-·#---· -¡-:b e(þ~ç,;~,_____ , . "'":"" :MONITORING BETWEEN DATES OF rz. ·---ANn - ... ;(JNCLUDE YEÁR) NÒTED ONREVER~E ( IS' A MOTOR VEHICLE FUEL'";TANK ~ ~-\.- ,-. TANK MONITOREQ REPORT -TO THE r . ~. -~.~. - ...-'*..... ~. . ~ RESUt TED' IN: .' \. ' ..:::_., '. " ...:: _·:'··:~--\;¡·':·;'-:-~!:.f:;;' . éOL"..·-9)·6p·.'3 ::·"'6/3 GALS 11,-BOTTqM.. LÆ~f:),PJr -:-. ~,. . :~~_:'.: '. ~:.., '~~.;./o.- :--.:." ::~ :.:: -i. ~_ _~ _ -. ~ :.:.:.... _:',~.~:: ·,~·:":~-'1·~~.:.·~· 9 OF .' ,~~_.,..... MAXIMUM WEE~LY VO~UME C~ANGE 'CUMULATIVE VOLUME CHANGE ,( COL - ~~. ,GALLONS ._- A A \ ..-.-~ .. 1 :2 . , \ \ , I -HEREBV CERTIFV·THAT ·THEABOVE-NOTED RESULTS·:-REPRESENT,:ATRltE AND . , '. -.. ," ..' J ,', ACCURATE REPORT AND THAT THEY,DO NOT EXCEED THE REPORTAB~É LIMITS DESCRIBED IN "A" THROUGH "0" ABOVE. ' , , ,. . .. ;JIM--HIND:MÁN,Supv Mach ji f:~.~r.~r ~etVlceS. Ganîgé Oivisior. 9 ) --' TITLE DATE COL (COL 9 f t " . , " SIGNED , 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 I I I TANK T~K MON~T?RED A ·WAST.E:O.~L,:OR NON-MOTOR VEHICLE FUEL R~~?:.~_~.i~:_ TH~. ~~~ITTI~~ ~~THORITY WI·TH.IN ~~_:;~~~RS 'I~F,-:' A VOLUME CHANGE COL..9 . \ [S ~. -, , ,'~ ~... ~ ' ' ..~-- _.- _..*,.... \ AND IN: , ' , ^, , . --100 GALLONS 'OR MORE 10 GA~~ONS OR M~~E .' ,..... '.~ IS-+j- '...... SUMMARY --..' --~. ~.: . .. ·TANK·# =:.PERMIT-#-~ MONITORING BETWEEN DATES OF ' (INCLUDE YEAR) NOTÈD-:ON REVERSE RESULTED 11 ; +/-:- (COL IS B.--· CUMULATIVE V~~UMECHANGE , .. \ -.," 11..- ~-.;~ , . > _GALS OF , ,.- 9) OF BOTTOM LINE , MAXIMUM~WEE~LY VOLUME CHANGE (COL CUMULArIVE VOLUME CHANGE (COL. 11 -.<~GALLONS A A 1 2 ~ ' " " I HEREBY CERTIFY THA,T THE. 'ABOVE-NOTED RESULTS REPRESENT-A TRUE AND ACCURATE REPORT AND~THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B"--ABOVE. ' . ~\ - , .. ,\ TITLE DATE ~ j , SIGNED - '* '* SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITV FOR A MINIMUM OF THREE YEARS ~ '. '* '* ~) * * - QUARTE:RL'Y MODIFIED INVENTORY-CONTROL-S - - FACILITY ~\ PERMIT :/1:_ I' oo;;J.6L... T ANK# 5 _CAPACITY.;t~ OÐÐ _SUBSTANCE STORED 1>/ Æ€.-L QUARTER/YEAR /91::l....> - - = I I I I I I gl I eOL. 1 COL. 2 COL. 3 COL. 4,COL. 5, COL. S,COL. 7 I eOL. s I eOL . I COL. 10 I COL. 11 TEST WATER I 2ND 1ST INCH I 2ND 1ST _VOLUME T _ CUMULATIVE WEEK LEVEL ¡GAUGE -GAUGE = CHANGE VOLUME-VOLUME -CHANGE~SUB OTAL:- CHANGE - . INCHES I INCHES I INCHES INCHES GALLONS I GALLONS I GALLONS 1 GALLONS J GALLONS - 1 I I I I 0 I I ¢ I J()57/~ I ) ()S7/~ .L ¡ ß'17 /8ro9'7 I ¢ I I ø I I 1 ~ -1 2 I I d I I ø 'Ç/J I -2. I lOb 'Iý I /6fo'/~ ( CÐ 7 l/y l!ß ?t./y !L I I I 1 J ..J .3 ø I ([) I I r¡. lOb lob ¢ 1f!D7/3 1~'?/3 I I ø I 1 { ..J - - 4. I 12- ø I ø- /66, '4 / dc. XI £L I~?t.f'i- I 19?t.),+ a I I I 1 J ...J - 5 I I I Ith4 - ø ~ I ($- I (§ I ~ / Ob '/4 18?tfl.{ /e)~ 1 t ..J 6 I I ø /6 ~ 'I'Ll' I D,J/Z- ¢ )f9 77 s: ¡g 77 ~ cp I ø I (Ô I 1 ~ .J - 7 I Db 3/~: I -Æ J I I Cf /0634 lfJ1'ð5 I § 725", Q I 1 I L J I 1 ~ ...J - 8 /; I I()~ Vzt d . I (!). J I .~ J . P lOb I Zl. 1 )8 :ì?5 18)?SI J ø: I J 1 ~ ...J - ' I - - 9 ø ~ I I J I ø I I ø' I Irk I 2- I lot 1~ Þ I / S 775 /~ )?5 I J f2J I I 1 j .J - 10 P- I I I ø I ø I I 5' 'I: ~f .:: l.J :..,,;,, ~-. .. ,,;.. 10 6/~r j06 t!Z4 JÉ /~ ì7~ ¡@ ;75"1 I I Çð I 1 t .J - - 11 I} I I I : J I -2 J ø I I () b 5"/81 106 qal ~ I g $>00 1 IB~ocJl q I I I - - - 1 I - J 12 ø ~I "" I ø I I I I (þ J /0 Iø y! I ô~ t( I J8 Bo~ I ¿~~O~ I c1) I ðþ J I - - - - 1 - J ~ ø I r:f I I I (J ø J 13 ID7 ¡D) I !6~3bl IB~3fp I ø I J - SUMMARY UARTERLY THE FOLLOWING REPORTING SUMMARV APPLICABLE TO THE CHECI< ONE ONLY TANI< NOTED ON REVERSE VEHICLE ~ TANI< TANI< MONITORED A MOTOR .. -.. ,...._- REPORT TO TBEPERMITTING AUTHORITY IS !} OF GALLONS , '- .~ ...,:. ; TANK. á. PERMIT MONIT9RING BETWEE~~pATES OF~ (INCLUDE YEAR) NOTED ON REVERSE COL 11 WEEKLY VOLUME CHANGE IVE VOLUME CHANGE·, (COL GALLONS A' A 1 2 \ I HEREBY CERTIFY THAT THE ABOVE~NOTED RESULTS REPRESENT TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" THROUGH "0" ABOVE ",JIM HINDMAN, Supv Moen i' I.~ooral ServIces e Garage Divisior. 9 (COL COL 9 ., .-" WITHIN 24 ,HOURS IF TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME oF' +/- 25 GALLÒNS OR MORE.." _._~'" '..' .' TANK OF 1001 TO 5000 GALLONS\CAPACITY HAS A VOLUME OF +/:;-,35 GALLONS OR MORE " ,..... .' _ ' TANK OF OVER 5000 GALLONSCAPACITV HAS A VOLUME CHANGE +; - 50 GALLONS OR MORE . . . \ ',' \ ". . ., ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/~ 250 : . -.\, -. - f?R MORE OVER ·THE QUARTER TIME PRAM~-·REPRES~NT.ED· ON REVERSE SUMMARV"'- TITLE \ (COL'. 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 ! I I I ! I FILL OUT TANK FUEL A WASTE-OIL OR NON-MOTOR VEHICLE .." .¡ WITHIN 24 HOURS IF: [S TANK MONITORED CHANGE CHANGE A B C D \ '\þ'" " \ .) \ 10 GALLONS OR MORE 100 GALLONS OR MORE IS +/- ~- 11) REPORT TO THE PERMITTING AUTHORITY IS +/- CUMULATIVE VOLUME CHANGE , <~\, COL 9) COL. VOLUME CHANGE A B þ' AND IN: ~ SUMMARV TANK # PERMIT MONITORING BETWEEN DATES OF _ (INCLUDE YE~)NOTED ON REVER,SE RESULTED . # \ j _GALS OF 9) OF ; BOTTOM LINE , COL 11 . " .. MAxlMUM~WEEKLY VOLUME CHANGE CUMULATIVE VOLUME CHANG,E (COL GALLONS A A 1 2 I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE þ TITLE SIGNED DATE DATE - * * . 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CAPACITY 10 Ooc PRODUCT /V /- ('" /l /.:? t' æ MONTH/YEAR ~, / , þ FACILITY 1< E tZ tV C (/ (/ II/T ,y I EQUATION 1 1 2 3 4 5 6 7 J 8 9 10 11 12 13 OPENING OPENING CLOSING CLOSING METER DAILY METER TOTAL READING GAUGING GAUGING DELIVERED WATER - = DATE GAUGING INVENTORY I~VENTORY READING READING METERED ADJUSTMENT BEFORE AFTER INVENTORY GAUGING : " SALES DELIVERY DELIVERY ,.., ' DAY/HOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS - GALLONS INCHES GALS INCHES GALS GALLONS INCHES 1-~2ý,q J '1 '/.1- 409/ '3 '-:-I-L.- J r; II j <'J / S2 0/ <,' ç 7, R5 1.. - 4 "7 -..-,/" ~ 51-' ~:,8e3 1 ~ J 6~ /.5 7SY ¿'/2 ]-~.()5A JC '/z ;J?¿lJ 0923 I 7 Õ2 ç; 16 ] tfC hhC .L 1 ÿ.¡ 27?b "Jfh 7"122- I,t C3 6 -= t.-t - (" () ~ /1 t./J f;r¡2.-;ç &3f'() / 7'-1() /7.ó~~ r; ç;--' ',/ ç. r..;'!' ..it-' A y/ (" y,) !..c :./ :1_: I /7/'", / 7 ~/o /71 :.Ç (, J 7; /Ì '.J,j (..).7';" .~ ó : ¡ / 7 q 3' / 77 f?/ IS S 7 ~,; u ,) S z '¡" ,~u j 7 ,- J: '~,:; / /X2 7 I 7r ;'c,. ¡j'Cj¡ <t- '"" - /., I I .-I '! 7 '/1-{ r; I {. 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'-, I .~ ,. - / 1\ n ( - -.--. ------ SIGNATURE///--^h~\J. ~ '.- -'--'-- I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT. DATE ~ ~ {\~ , ~ I!Á~RY ðd-fNICAN. Fleet Manaaer 9 I ., j 1 I ,¡ "t i 1" í I " ~ ~ ¡ , k PERMIT # Le! MONTH/YEAR ERN COUNTY HEALTH DEPARTMEN~ INVENTORY RECONCILIATION SHEET TANK # ~ CAPACITY / G7t70 PRODUCT :1 ~ '/ -/J~- .¡ p 16 AMOUNT OVER OR_SHORT +GALS -GALS. -,,~ -I/' .2<: -:.k'- -;2 / -.~ - 'I/. -;2' -)", -"[ - 2/ -5 z.z &t-J..f0 V ¡- , Y2.. 7' 5" +2 ~f -1-19 +-6 c¡ S"T +2 '7 4 1-- {;, t..f .tLfL -t 5 f 20 - {} .~ -I ¥ I ~ EQUATION 15 =:J 14 ( TOTAL METERED INVENTORY - - THROUGHPUT REDUCTION GALLONS GALLONS 2. ~I "", <,01 c:- , v .2 7 /5 - 5UATION 3 !! 9:=I 15 TOTAL METERED _ READING _ TOTAL METERED SALES ADJUSTMENT - THROUGHPUT GALLONS GALLONS GALLONS 5..;7) 53 IL CtJ ?'tf I 7 o ¿;; 261 ¡(wr: .)5 It( I f~4 'i~ I) 2. ~ ---;c:/ ! r:. 5 Gú ') 27'i'/ :-;'...: r; Sr7 - " 05 1IIIIIIIj~/II/I//II1LIII/IIIILII 7:2 :5 S"8; 14 INVENTORY REDUCTION GALLONS ~ 1it- ç-"¡J /38" 2 05 ff7! j 5 ~ I 62S 6ý'1 !J(/7 J 7ft )0/ 2IJO t71 3). 71 ~ ~j 9' f ;/ "t7 If'L 8''1í ¥i1- S'/2- /77 ~ ~ 7'1 W 5"Q ~ ) 7 I EQUATION 2 12 I~ I DELIVERED CLOSING INVENTORY - INVENTORY GALLONS GALLONS '7"J" 2-1 23fjJ' 67) 3 , Jtói fP'; 12 G(¡3'~1 5 / 'l.'! 77.2 2- ð'ú'f ~, 7Çg-'i grJ"~ t ,£J '!i~'2 ! G; 7].; :; I , 60'65 ~ 013 ç go ~c. r;t;J?9 r; jq() ';201 t¡ 5 75 Lf S' 'f /i J9"5.2: 13 -ISi IÚ27J /ú/l} ',./ ·f /;'1 '7/ ". /.l IÇ13 (1 ( /' /.) / /' TOTALS TOTALS TOTALS 7271 Ct7VtVT'y '1 ~ jC; 1 rl v r" ~r;i4l )&-52 ) ; Ii :; 1(,237 /ú () ? ~ '1537 WEEK 2 'f/{;'(- f' 72 2.- f? (/ (Ç .2- 7 r; vi /1/(,.- tYJ<;lrj ý,'J I C, \ WEEK 3 - , ;ry ;.,7 65515 fú 73 '5 f?'i 6 '7 (~,-," '? "J- ¡' <Ie: .,.:' U I [Il/ll 4 OPENING INVENTORY GALLONS '109/ ~~)-"-L WEEK 1 + 2 IS:-- bll ~., 9 -eo" 11 )O-t,·o>~ fl-'2(¡¡.1 I) -- G,'7f A ---=-Trt~-' fl:¡-fc 7 ;17·7-,li¿ ii:6:ð? ~ ~~~f.4 7? . ZfI.f.d. } ?.1J.,¡f 1_ ? 7 ~~{¡A l? ~J~ A Lí:_LZ'i1L If, -v,t/7 LLf:..iLl., l1.;;f ..1iL I (I IV ~ }5=T!J[;) z I 'f. (,,1(: FACILITY -1 DATE DAY/HOUR ¡'::r;::Jf7l' ., .,....~ A -'. ;;?~.J. n:ø.1 t~6A b:~':J1 ~ 7'~ V'¥ 4 h -t.2.2 1'67 3 i? ;~.~ ,14 ç CJ WEEK 4 TOTALS 'iS7f :;,s 80 2. q- C ·l/~ l!!_=Æ}6A 1_ / / / / / // / / / / / /I / / I I / I / I I I /1 II 111-+ ::2 /Çl- 4 S 37 I ll////I///I/I/IIIIII////I//III/II 'i-J22 I ('/0 MONTHLY TOTALS 1017 (6/86) (Front 5( Env. Health 5804113 I I I . ) ¡INVENTORY RECONCILIATION SUMMARY ~11 ,I A. Percent Variation I, ? .- I ](20 I /' (7 Amount Over/Short (Col 16) ~ ~als. · Total Metered Throughput (Col. 15) Gals. x 100 % Variation B. Reporting: \ I 1. Does the Amount Over or Short exceed 3501Gals1 (3 NO - Continue routine .onitoring DYES Report within 24 hours of discovery 2. Does the Variation exceed 5%1 ~NO ~ Continue routine aonitoring DYES - Report to Per.itting Aut ity within 24 hours of discovery. IfRBK 21 A. Percent Variation: --25 I . /" 77 Amount Over/Short (Col. 16) Gals . T Total Metered Throughput (Col. 15) '52 'f- c' Gals. x 100 = ,. % Variation . B. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? ~NO - Continue routine aonitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%1 :8Jà0 ;- Continue routine .onitoring DYES - Report to Per.itting Authority within 24 hours of discovery. I IIBEK 31 j A. Percent Variation: 1-3f" , J57V I, C 6 Amount Over/Short (Col. 16) Gals . Total Metered Throughput (Col. 15) Gals. x 100 = \; Variation B. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? 53:'NO - Continue routine monitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5\;? &0 "- Continue routine .onitoring DYES - Report to Peraitting Authority within 24 hours of discovery. DB 41 I A. Percent Variation: ': 1"33 I Total Metered Throughput (Col. 15) .J 7 f'( /, / y Amount Over/Short (Col. 16) Gals. · Gals. x 100 = \; Variation I . B. Reporting: I I t8I NO Continue routine monitoring DYES Report within 24 hours of discovery 1. Does the Amount Over or Short exceed 350 Gals1 - 2. Does the Variation exceed 5%1 12$N0 ¡- Continue routine .onitoring DYEª-. Report to Per.ittin rity within 24 hours of discover ~I A. Percent Variation: I Amount Over/Short (Col. 16) .:2-15 IGals . · Total Metered Throughput (Col 15 11'537 Gals . I, '17 B. Reporting: I SNo , Does the Variation exceed 1.5%? ,- Continue routine monitorin to Per.ittin rity within 24 hours of discover i ¿ W I HEREBY CERTIFY TIIAT THIS IS A TRUE AND ACCU~TK REPORT DATE Env. Health 5804113 1017 (6/86) (Back) . . FU ELG 1 .0888 GARAGE TANK # 1 (SOUTH) AUG85-1-1988 VARIATION 180 . . . .. . ..,. · ~ ~ .. . .... 160 . . . .. . ,... ~ ......:.:'....... ~ . . . . . . . ':' . . . . . . ':' . . . . . .. ....... ........ :' . . . . . .. ....... ........:'....... ....... ':' . . . . . . ':' . .. ... ........:.... · . " . .... 140 . . . " . .", · .......:......... ~ . . . . . . . .:. . . . . . . .:. . . . . . .. ....... ........:........ ....... ........:........ ........:........:... . .. ........:.... · . . .. . .... 120 : .......~........~.......~........~........ ....... ........~,...... ....... ........~....... .......:,.......:,, '... ........:.... · . " . .... 1 00 . . . ,. . ..'. : .......:'....... ~ . . . . . . . ':' . . . . . . .:. . . . . . .. ....... .......':'....... ....... ........:'....... .......":........:'. .. .. ....'...:.... · . . ...... 80' . . . , .,.' I :-...... ':'.......:....... ':'...... : ....... ....... ....... '"0....... ....... ....... .:........ ....... ':'" '" . ':" .. .. ....... ':' . . . 60 :. .......~........~.......~...... .~........ ....... ....... 7....··· ....... .... ...~....... .......~.......~ ... .. ........~.... · . .. . .... 40' . . " , .". : .......:........ ~ . .. ....: . ......:. ...... ....... ...... . :' ..... . . . . .. ..... ..:........ .........;........ ;' ...... ........;.. . · . .. . .... 20' . . .. . ..,. · .......·........1 .......:... ....:.. .... . ..... ........:.. .... ..... ...... .:........ .. .....:...... ..: ..... . .,. ...... · .. . .... o : ..... ,~... . ..~.......~........~.. ..... ... ... ,.... ..~... . .. . ... . ....... ~....... ...' ..~......... ..... ' ........~.... · . .. . .... 20' . . '. . ,.', .'- ~. .. . .:........;....... .:....... .:... .... ....... ..... .:........ ., .... .............. . ..... . .:.. .... .:........ ., .... .:.... · . . ... ... · . .. . .... 40 . . . " ' .,.. - . . .......:........~........:........:... . .. ....... ........:......... .... .. ........:. ..' .. ...... .:. ......:....... ........:.... · . . " . .... -60 : .......~.......~.......~........~....... ....... ...:....~....... ...... ........~.. ... .......:........~...... . ......:.... · . .. . .... 80' . . .. . .... - : .......:.........~".......:........:........ ....... ........:........ ....... ........:........ ........:........:....... ........:.... · . . .. . .... 1 00 . : : :: : :::: · .......:.... ....:........:........:........ ........ ..... ...:........ .. ..... ........:.. ...... ........:........:.... .... .......:.... · . . .. . .... -120 : ..... ..~...... ..;..... ..~....... .~...,.... ....... ........~.. ...... ....... ........~....... '..... .~....,...~....... ...... .~..,. · . .. . .' .. . ·140 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 '.';'.'." ,.~- ..,;. 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MONTH/YEAR ~""I'? ~ /.7 t (J æNK . C(Jv,/llr Ell^! FACILITY PERMIT # '2..f~ ~ & c ,&} // (-/? MONTH/YEAR %'"- KL~N COUNTY HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET TANK # / CAPACITY L 0/ C CJ tJ PRODUCT I I ('Ovll/if C/1/?/fC,?- , --, \ , i -57 -'3 -=-LZ -33 -60 -~ ..;.2 -)1( - EQUATION 4, 14 C 16 INVENTORY AMOUNT - REDUCTION = OVER OR SHORT GALLONS +GALS. -GALS. 9d :"'J 6 :::-s , / -/t:. -61 -7;- - t; 9" 15 TOTAL METERED THROUGHPUT GALLONS ìØ S'Ý 7/:1 r; ?,1 ':ir:fV , r5 g- ~,... ) ,r;,I :, d-,. 11 Y. .;-q¿ Eif ¡; 7 'Í r;r;~ 77 f' (. '1 / ~ (, 5 ~ 7/ 255 6F2 ¥tÝ2 rft: , 7 7tf )752.3 ;;22 ð~~ f. ~ k 5'1 IC,(, ß 3 LfCfLf 7:36 7'7b 7ftl /~L(ffS :3 I ~~~if,//////IIIII/IIIIIIIIIIIIIII i, I 111/////lll///III//III////I/III/1 EQUATION I 9 READING ADJUSTMENT GALLONS 14 INVENTORY REDUCTION GALLONS ~'?tJ ~ qt:. ila' /. .lJS 'W~ 3.;;G I :3;).., ~1~5 ?S~ "'72- 557 7 Î.5 J{;2.. 07 5774- 27/ ~22- 545 7'1Lj sg--7 I ~ '1 1<1-0 '2..qt7/'3 ~9 / ·7(, 5 ì 0 8--.... (, q 3 c;q'l C5 17.s '5 If '1> () 7/lf 7.1' ??/ I>15( -- EQUATION ,2 12 I 5 i [ DELIVERED CLOSING - ,= INVENTORY INVENTORY GALLONS GALLONS 5793 .5 ~ 9;7 ¿.¡. .J 0/ (¡ 79S~ ~ -r:; I 2. ?:J.::2:J 71 '11 , (,b~~ -..i.il£ J.J...!tJL !..I 78'3 :J 9 ?',( JXJ-'{} '~'; I 7 ¡ J 5" 'fbl 7~tf'f' 7!J 'f " (;.:3 y~, S 1 CfJ : S (, ¡-q : ç,'-I". I 4 q r;~ ~ 6' 'Í If () ~1t¡O . ~ y5S 1,/'1/ J..::!.1..£ _4 /LZq TOTALS TOTALS " '1&5 TOTALS TOTALS TOTALS WEEK 3 ?iC-:, If 72 5 ~BLY 1017 (6/86) (Front 1 2 < fit 1\1 ! ::r OPENING INVENTORY + GALLONS h~fT3 IS 711 j 5ð' 7 /.I59Cf ?9Yý 1>/'2.. 77.J-J WEEK 3 ,'r 17 7 r;et' 7 ~ ~t:; 712'f (¡Jý(; i.Zi2 !?TtT ~{// 410 Env. Health 5804113 2 z 1~(p /)q '10-~ JJ 4 1/- f:ì() 'IA FACILITY I S-!;:'}! If, - 7.~ß,4- /7-?; II A Iff ~:J ð f 1((- C:/I/) .l~-~:J(A 1.1 - t.'Jð A ! DATE t{- ('.!f /I q -~.'ð 11- I Ó-t/ ( /I- II-~tt 4- )2- ~,H A. If-f.'5o t1 I 'f . /:'1/ A . . L, -.--- ! l I NVENTiORV RECONCILIATION SUMMARY - ". IIIŒK 11 ( A. Percent Variation " I J;-36 Amount Over/Short (Col 16) 0 Gals. · Total Metered Throughput (Col. 15) ~t/.t./ Gals. x 100 = % Variation B. Reportin~: I 1. Does the Amount Over or Short exceed 350 Gals? ¡ lðNo - Continue routine aonitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%? ~NO I DYES Report to Peraitting Authority within 24 hOurs of discovery. - Continue ~outine aonitoring - IIEBIt 21 , I "',. A. Percent Variation: Amount Over/Short (Col. 16) -r-f7 Gals. · Total Metered Throughput (Col. 15) ]L.¡ll 'Gals. x 100 '= 2~7q % Variation B. Reporting: I I 1. Does the Amount Over or Short exceed 350 Gals? i ~O - Continue routine aonitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%? ,3ÑÖ I DYES Report to Permitting Authority within 24 hours of discovery. - Continue routine aonitoring - 1IIŒK 3\ J A. Percent Variation: ï t JÒ ¡ 30:2 '3 ,19 , Amount Over/Short (Col. 16) Gals. · To~al Metered Throughput (Col. 15) Gals. x 100 '= % Variation B. Reporting: \ ¡ 1. Does the Amount Over or Short exceed 350 Gals? ~O - Continue routine aonitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%7 ~ I DYES Report to Peraitting Authority within 24 hours of discovery. - Continue ~outine aonltoring - 1IBBK 4\ " I A. Percent Variation: ) , Amount Over/Short (Col. 16) 1/Lf Gals. · ¡ 7¥9 r Gals. x 100 '= , '10 % Variation · To~al Metered Throughput (Col. 15) B. Reporting: J I 1. Does the Aaount Over or Short exceed 350 Gals? ¡ gf'NO - Continue routine aonitoring DYES - Report within 24 hours of discovery. ~~: ØNo DYES ¡. 2. Does the Variation exceed 5%? - Continue t.outine aonitoring - Report to Peraitting Author within 24 hours of discover ", :"::.";': '. !!!!!!!!t I : A. . Percent Variation: ¡ Amount Over/Short (Col. 16) ,,-337 Ga18. /5lf95 Gals. x 100 - .2.,/7 % Variation · Total Metered Throughput (Col. 15) \' .- B. Reporting: Does the Variation exceed 1.5%7 DNO - Continue ~outine of discover i J i I HEREBY CERTIPY THAT THIS IS A TRUE AND ACCURATE REPORT ¡ .1 ¡4,R 'y JOHNICAN, Fleet Manager Env. Health 5804113 1017 (6/86) (Back) I I eneral Services. Garage Division j . . FlJ [-:l__G2 00888 GARAGE TANK # 2 (NORTH) A lJ G tJS-i---~ 9 88 VARIATION 1 20 ,---:-----;-----:-- 100 . ," , " 80 è- """'" 60 . '" 40 ..'" 20 :" o -20 :-,. I -40:.. .....,.,....,,' -60.",,·,· """",,- 80' ' , , - ........:........:........:....... ....... .............. ......... ....... ................. ..........................,...........,. .. . -100 2 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 ___v ' ' . .. ,.. .... . , ' . .. .........." ........ ,',... . . . ".- . . . . . . . .. . ... .. < . -~--. - J ¡ ~ ICERN ';....JIIn IIIW.TII DEPARTllEIft' PEIUII'!' . UOO26C r-ï! L .. , FUELS IIIVEIft'ORY RECORDING SHE!'!' ,tl FACìLi'J'J",,~Mi > -rAIIX -.- ,~,~~!"fBT ---~ACI'J'J ---10-;-oÒO -PRODUC'!' -UNLEADED-- -1IOIft'II/J!AR- ----:-AUWSrIf' , 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DI'.'J'! , D OPEIIING OPEIIING CLOSIIIQ CLOS11lG g'J'!R DAILY MTER 'rO'rAL READ11IG CAUCING CAWIK DELIVERED IIA'J'!R IJIVEIn'ORY 'rO'J'AL MTERED MOUN'J' PERCEH'J' IIEGA'!'IVE POS'J'IVE _ - - ---0 ë:MI<':ING -IIIYEHTORr IIIVEIft'ORY READIIIG -,- READING ---IIETEREDr--ADoJ\JS'I7IEN --- BEFORE ---ArTER '--IIIVEII1'ORY----CAUQIIIQ -REDUC'J'ION -TllROOOIIPU'J' --0VEIt OR-S-vARIA'J'JON-COuwr-COIJNr" '. SALES ' DELIVERr DELMar DAt/llOUR IIICHES CALLONS CALLOIIS CALLOIIS CALLONS CALLONS CALLONS INCHES CALLONS INCHES QALLONS CALLONS INCHES CALLONS CALLONS CALLONS , .- .. j 1/U5A1! 2 59 6788 5932 70283 69426 ,857 0 - 0 0 0 856 857 1 0 1 Z/645A1!__L52 314_5933_5305 _70910 _70283 ___637, 0_ 0 0 627 637 10 0 1 3/nOAl! 4 48 1/4 n05 4713 71555 70920 635 0 '---0 - 0 592 --635-43' 0----,.- , ' 4/U5A1! 5 44 4713 4193 72144 71555 589 0 0 0 520 589 69 0 1 ) , :~::~: ~ ~: ~~~ ;~:i :~~ ;~~:~ ~~~~~ 11:~ 36 1/2 '68~ 71 833: m~ 1~ 1:~ :~~ ~ ~ , 7/645A1! 1 69 1/2 815<1 80U 72"4 72190 204 0 0 0 0 92 204 112 0 1 ------'---.EK I' TorALS ---,..-.- XXXXXXJIXXX - "--xXxxxxxxxxxxxxxxxxx -jcxxxxxxxxxxxxxxxxxiüixxxxxxxxxxxxxxxxxx "XXXXXXXXIC 3383 '568---i85-5:-18'-1-r- 8/U5AI! 2 68 314 eon 7U2 135<16 72994 551 0 0 0 640 552 -88 1 0 9/UOAl! 3 63 1/2 1U2 6788 74131 735<16 ,685 0 0 0 634 685 51 0 1 10/6101111 4 51 6788 6209 14833 7U31 602 0 0 0 0 579 602 23 0 1 - _11/800Al! 5 '>4 314 6209 5619 75367 74833, '534" 0 0 0 590 534 -56 1 0 12/610"" 6 50 1/2 - -- 5619 4922" ---76UO ---·75367 .-. - --,-. 143 -.- -- --'- - --.'- ,- - 0 -- 0 0 ------------697 '-----'43 -46- -- -0 1 13/650Al! 7 45 1/2 4922 4713 76293 76110 '183 0 0 0 209 183 -26 1 0 14/61~ 1 U 4713 4575 76520 76193 , 227 0 0 0 138 227 89 0 1 IIIEIC 2 'rO'J'ALS XXXXXXJIXXX, xxxxxxxxxxxxxxxxxxx XXXXXXXXXXXXXXXJOXXXXJlXXDX1lUXXXX xxxxxxxxx 3<187 3526'9 1.11' 3 4 15/6381111 2 43 4575 U27 76807 76520 ' 287 0 - 0 0 348 287 -61 1 0-' t~~¡~~: ¡ :~ ;~: m~ ¡::~ ~¡~~~ ~~~~i ! ¡:: J7 3/4 385~ 66 3/4 781g 395~ 0 æ ¡:: 3; ~ ~ 18/UOAl! 5 60 1/2 6990 6311 78716 78031 ; 685 0 0 0 679 685 6 0 1 19/611A1! 6 55 112 6311 5793 79253 78716 I 537 0 0 0 518 537 19 0 1 10/630M 7 51 314 5793 5689 79373 79253 120 0 0 0 104 120 16 0 1 21/630Al! 1 51 5689 558<1 79440 79373 67 0 ..- 0 0 0 105 ----67' "'38 ,- '1- ---'0-- IlEEK 3 'rO'J'ALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX JCXXXXXXXXXXXXXXJCXXXUlXXXXXXXXXXXXXXXXXX XXXXXXXXIC 29U 2920 -19 -0.9U 3 4 12/6U1III 2 50 114 558<1 4887 80148 79440 708 0 0 0 697 708 11 0 1 23/615M 3 45 114 4887 U94 80743 80148 595 0 0 0 593 595 1 0 1 24/605A1! 4 41 4294 7616 81239 80743 496 40 III 4217 69 Ú4 - 8123 3896 574 496 -78 1 0 25/608M 5 65 114 7616 7091 818U 81239 : 582 0 0 0 525 581 57 0 1 16/607"" 6 61 1/4 7091 6414 61488 81811 " 667 0 0 0 677 667 -10 1 0 27/647A1! 7 56 1/4 6414 6242 82700 81488 r H2 0 0 0 0 In U2 <0 0 1 18/630Al! 1 55 6242 6108 61837 82700 J 137 0 0 0 134 137 3 0 1 IlEEK < 'rO'J'ALS JCXXXXXJCXXX XXXXXJCXXXXXXJCXXXJCXX xxxxxxxxxxxxxxxxxxxxxnXXXXXXXXXXXXXXXXX XXXJCXJCXXIC 3372 3397 25 0.74' 2 ~- ., 29/611M ~ 5<1 6108 '>479 83472 82837 635 0 0 0 629 635 6 0 1 30/635A1! 3 49 III 5479 4922 8<1018 83472 ) 546 0 0 0 557 546 -11 1 0 , '31ì609A1! 4 45 1/2 4922 4294 8<1655 8<1018 ' 637 0 - 0 0 628 637 9 . 0 . '--1 IlEEK 5 ro'!'ALS XXXXXXXXXX XXXXXXJCXXXXICXXXXICXX XXXXXXXXXXJCXXXxJOCXXXØXXXXXXXXXXXXXXXXXX XXXICXXXXX 18U 1818 4 0.22' 1 2 IION'J'II rorALs XICJCXXXXXXX XXXXXXXXXXXJCXXXXXXX IC: XXXXXXXXXXXXXXXXX XXXXXXXX1t 1 '5005 15U9 2~< 1. '" 11 10 PERMIT # /6(//2ÇC ß C"7? MONTH/YEAR KERN COUNTY HEALTH DEPARTMENT I"NVENTORV RECORDI NG SHEET 2- CAPACITY 0' 0 0 PRODUCT .' ."'". ,./ . . EOUATION 1 1 2 3 4 5 6 " I 7 8 9 10 11 12 13 OPENING OPENING CLOSING CLOSING METER DAILY METER TOTAL READING GAUGING GAUGING DELIVERED WATER DATE GAUGING INVENTORY INVENTORY READING - READING = METERED ADJUSTMENT BEFORE AFTER INVENTORY GAUGING \ SALES DELIVERY DELIVERY DAY/HOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS - GALLONS INCHES GALS INCHES GALS GALLONS INCHES - ',I , 11 S q t 7 9"7' fj Cf J 2... ? (¡:; J?-'? f,; ~ ¿¡' 2. ç, .... 5" 7 ø -t"lf5 A- 52;1/,,'" 12 ç 11'J5 7tJ 9 ,/2.0 ?n 2~3 l 7 "-"'.20A J.¡{(1!¿.¡505 ù'7/? 7/55.5 u7t/'20 ~.~ 4- I ,1> 4 4'f 't - / 1 if / 9 J 7"7 I '-I¿¡. 7/ SS' t; 5' 'c, '1-, .10 A- '-to 'If{ 1-1 I'?"? J 6 'ê I 7 ) r; J:;; '7 ~ / 1/ ~ ..¡ y '1' þ-<;'C¡v,;} lG!I:l.. 7~f;/ r?:'/Sv 7;l71'Cl 72:77 117 7?/h ~.(~ç·1 7/ Ç·37X--<+C.,>? 7 t,Uf ,:/ ' 611/2. 8"/5L/ 9:c-v-Z 72 1f:: 72~"() ,os¡. /J'f (,Ç;/f,4 ~({3¡'¡ Ÿt?{,~ ÎI./.;;.~ Î'?$tJfn 72:7.::.,_1 55~ 9/610~ t-3/h.... -¡1f~iN ¡;, /xÝ '772if '135r.J.('" t.X"'S /¡;/f,/fJA c::'J t7p<;,/ ¡¡PÇ 7~~].J 7f..t-77/ 02 fY" I -¡;()~/! t;L¡.J/.¡ 62o~ r;h/9 7,5-;¡¿,'7 7if?].:J ];t '2 - (. , I û (1 S (j Y'2.... c:; (, / q J-f q.2 2. 7 C II /J 7 f 3 b.7 "7 /¡ 3 ¡"-- -C.'.HI1 Lrl/z '-11;22- '17/1 7b2C¡'? 7/../ltJ eJ ¡ -/':'15-11 LJ'f 47/~ Ji5?J' 7Cr;¿O 7/.?9:; ')2..7! -r;::Jt ~ Å if? l../.57 5' '-f 22 7 /' ~ 8'-C/7 7 C 5" ;U) 2 ;r 7 : 'l-lriJ-4 '-(0'/2... L1227 7~;2?- 77562 7Þ8"¿J? TSS 773/"" '"?Ýs.2 ,,,:/.;;4 7ý/O ""';'51?' Iff '7 -(,?.'/! Ii 6 ::JJllf 7 "f 2 2 ¡; ~ t? 0 7 'l' C) 'J I ? 7 7" b 2.. t./þ 1 v-b}ð;q tv'/-;? 1140 t 1/1 7 g 71 ~ 7YCJ/ ;;'~5 - ~- // I 11 1;' ç 'l~ ¡; '3 J / rJ 7 93 7 Pj 2.,17 7 r 7/ ç ç'] 7 '} ~ç,,:Jo 4')" / J/~ ::¡ 7 &f:3 S &--'1 7 C; 3 73 7 1f' 2- S J I 2...0 ') / ~ C:J~ A 5 I S 6 Y9 , fJ 'f 7 q ~ L( 0 '/ <;'/ :1 ? "3 I/; 7 ø '1-2' MIll 5 (/ '/1/ r; S fJ'i '+ r77 ~ 0 / L/lf" "7 q 4..,.7) "/ fJ IT I . 21-054 '~c:ll<I i..J Vr¡ 4Z'flf R-ð7"73 ~~() /1.1) r;·'i5 -- .2.!:L:J&.i1l ¡,,'}421i1'/ 7?'/r-, RF'2J,·¡'1 ~(I7tr? L/G'£.. I.{O~ lIM---,¡:'971 ~().~ 'J,)?e:¡h ~:iA- i6~'ý(./ 76Jb ïO¡::j I fj r<-.:ll ~/")~'" 5i~~: 1L ~ bo11tw\ {,., (Ift./ 70'1 ) ~ 't I ¥ ? ~ 19~ ç.. I (;?-. I t c.. 7 27- v.'"/7' A S¡ð lie.; ~ Y I 'i r" 1 if L.- Ý 2 7/1f) ý":2 ~ ýV 2 2.. ø :zf'-(,:;J(rA ss; t;;2 '"t2 / ¡oK.... ;;.- 2 ~'37 ~Z 7P~ /17 'lq- (,.'1/-4 s.¡ (:, / () f' § 'I 7 q <::- i '" 7 Z- 9"2 €--.J'7 ¡;, ,'1S ?Ó-{¡JSA l.tql/~ r;'f7C1 'fTf,1 ~'4d/X k'?'f72 S"l~ 'JJ-~.'{j91 .r.; I/,;¡. '1 r'2' 'f) q If ?'If {.. ç S 'Ylf 0 I R" in 1 7 ^ '.~ J I I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT. SI~TtlRE ~^ .~\J!. DATE 9/?/M " ~ ç ,4-11 ;'-Jc; f- TANK , C(JC//vIa < (-íl /1/ FACILITY PERMIT # / ? c (J. ! G C MONTH/YEAR KE N COUNTY HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET /J /-){-'E TANK # 2- CAPACITY C7, æ.cY PRODUCT ~-~ - - '. EOUATION 2\ EOUATION 3 EOUATION 4 1 2 4 ~ 12 5,~ I 14 8 ! 9 I 15 15 14 I 16 DATE OPENING + DELIVERED _ CLOSING '= INVENTORY TOTAL METERED _ READING = TOTAL METERED : TOTAL METERED _ INVENTORY = AMOUNT INVENTORY INVENTORY INVENTORY I REDUCTION SALES ADJUSTMENT THROUGHPUT THROUGHPUT REDUCTION OVER OR SHORT DAY / HOUR GALLONS GALLONS GALLONS.' GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS +GALS. -GALS. -Ç·1S;if - '7 rvS' 9 ~ 2... " X'S 6 ~_~ 7 ñ~ 7 r5 ;7 7' .f & .¡- / '1r~:'f/H q J 2.. J '1 (/5' ~ 2 7 C" ~17 (, J 7 tJ 2. 7 +, 0 ~ - ~ & AlP'> ..,. ., 13 ' ,... 9 2- ~...;¡ .c ?5" ~ ? '5 5" ,. ~ ..,J.4 1 1./' 4./f A If. 71 :1 .'-/- If 3 l 2. () S ý' <l; Y'1 5 ~ S J 0 -I- II< 9 -,. ( -" ,fðA l. I q'J "1 , ;;-1 C' 7 2... U ,f"Ý Lf r'/ IJ r~ 5' I 2.. -2~ it - ~ ¡lfU ~ ;?~ / 4- ¡; 5 7 ~ l S 7' I r 'f / 5 7 I )' 7 I ~ "7 / ~ 't - .,¿ /' 7- ;/If! S; '/5 t.f r(/~:L q Z- )~ Cl 'I ').(/ V ' ] (/ ¡ 'í J--¡ / L WEEK 1 TOTALS ! 7, ., <Ý"":> 111/ II.' 111/1/ / / / / / //////1/1//1//1 "5 5 b <y / / / /1/// / / / 1/1/ / ///1/ / lIlt / /1/ ~ 1 Ý.5 ' y,!JJ t:61(;, 2. i'-l;)"~ fn tto ~. ~ ~..;?-.:> ~ ~ (.t/o - &8 ~ ífn{bÞ.v. í t.f ,,~,,_ b 7 x--~~' c 7l..f- ;; ;-5 ¿, ý" ç b ý- ) 6 j Y r5 I 'Il/f./hf 4 7 jK/ ,.'/ 17 ~ I S" 7 q (, t.. Z ç ~ Z b ~ '2 ç 79 "":2. ~ /-r(1U,tf 6ZtJ9 ~~/q ~ r9t/ ç'" t.,/ S'?,! 53 'I r;1~ -)1- ) 2 - ~,n A 5 C I 9' 4 92 2 \ b '1 7 7 Y 3 7 '-/ J 7 i-f J ~ '! Î '-¡( 6 I"r G5().4 y Ii 2 z. IÞ 1/3 I 2.0 7 / f) ') / f' J l Ý ~J ¡ l} Ct - ,¿ f. I 1.(- ~(JJ f1 u 7 / 3 4 S 7.5 i /;ç Ç/ :2 2 ?' ::; 2 ? 2 2. 7 / "] ;/ 11 9 WEEK 2 TOTALS : :3 £J ~ 7 //11//1/ / 1111//11// / 11//1/ 11////1 '] ç 2 , /1/111/ / 11111111/11/ 1///111//1 ,] q I 1: £l~ '1 .s 7 ~ j.; '2 :; 7 ì 7"f Y 2 ;:-7 % 7 .z r 7 :3 41- % - 6/ Fl.'or <t-J;2.J J 7S~ ? ¿:¡ 22- , 7? 75'1 "7 Ç" t; 7 f :5 7 &'? - t?' I 7- hYI4 ? 'f 22. C q 1 ¿; 'fj, L+I" f {. '" ¿¡ r; CJ '-t .~ T -:3 7 It"- 6YtJ 11 '9 1 () ~ J / / (;; 7 ' £ yÇ" h r,. G :;-5' r; 7 ~ 1- (à ¡((-G:I! 4 ? J) I£;7 ij:; ,$ I ç... s- J 7 ç 7 7 r:; 77 .J / ~ +- I Cf .. , J"., Ot II ') ll/f J q ~ 9" ("1 ' I) 't J 7- d I '2 CI / 2 0 ~ 't .¡ It,. 21'&'J? A f6?C¡ !? rý'f (¡~ t? 7 '~7 ~ 7 I vS -3í5' WEEK 3 TOTALS ' ., ~ '-f q / // / // / // / lIlt / 11///111/ /1///1/// 2 '1 '20 : /111/// / / /II / // / //11/// / / / lIlt - 2 9 22-6gð f.1 c; ç y'f 'l4 ( ~? t. c¡ 7 70 r 7 v Ý 7 (Y Ç/ &:. 9 7 -r / / 2.? .' &J r: /1 4. ,r;- [/ 7 J.f 2 (1 Lf 5 q3 tj tf s S" ? .s ~ 9 .5 S ~ "1 -f .:; 7.t.,!Ú,V)/} l,2C¡i! ~Rq C, ¡61h ~-I../ IJq?, ~ .t:. 4/rh C5 7L/ -79 ~5':b~ðgA 76/b 7ð4/ 5'?..1) 5~~ ~~~ .c;:'~~ <Ç;).!5 -+-5''1." 1:~01~~ ''1t:?'11 ¡;Lt/~ c....,~ ¡'~7 ~ CC? ¡'¿7 b77 -10 7-~/tl+ ~t¡I'Y (/242 /72. 2/2.. 2/2 ;)./2 112 t4-ó '1f{-(p.']olf --¿. 2 'f 2 (, I () r I J 'i 11 7 /' 7 J J 7 1'1'/ ~ WEEK 4 TOTALS 7 ì 7 ).. / /1/ '/1// / / / / I / / / / I / / /1 / 11// / / / / / ':? r 7 / / /11/11 / /1/1 / / / / / / / ¡ / / / / / / I / I -+-2. r:; H' 6'// ¡f ~ I?'';--- ~ 'I 7 r ¡, ~ fj 63 ') ~ J S ¿ -;.5 é .2 tf -r 6' 70-&115"4 5Lf79 l.f1J. 2. .s 7 ,--,7'6 54ft S'f6 5 S' 7 -II -1J-IWfA '-I-?2;} 1.12Qtf 6rlY h?7 6J7 617 ¿,uy ';-'1 MONTHLY TOTALS I 7 {I (;.5 11//////1//111/1/////11////////// 1.5 2 ¡q /////////////////////1/111//// 22 c¡ C (7//,rwT; 1017 (6/86) (Front 1< fn ¡./ Env. Health 5804113 FACILITY i .. 1 1 1 1 i 1 :¡. 1 t ì } t, f "~ -, , I NVENTORY RECONCILIATION SUMMARY -¡ ~ 1 i I S:/9 3S"6& 8:5 Variation ,IIIŒK 11 A Percent % Variation Report within 24 hours of discovery 100 DYES to Per.Htin x Gals 15 (Col Metered Throughput Total Gals exceed DNa t Amount Over or Short Variation exceed 5%1 16) Col Amount Over/Short Reporting 1 Does the B within 24 hours of discover Report Does the 2. '-.: . i .~ I, 2C .rJi Variation 1ŒBIt ....il A. Percent % Variation o 100 = x Ga1s 15 (Col Metered Throughput Total 16) (Col Amount Over/Short Reporting: 1 Does the B. Report within 24 hours of discovery DYES Report to Per.ittin Continue routine .onitoring DYES or Short AIIount Over within 24 hours of discover .onitorin the Variation exceed 5%? Does 2 % Variation f 2920 -29 Variation !JEK....! I A. Percent 100 x Gals 15 Col Metered Throughput Total Gals 16 (Col Amount Over/Short Reporting: 1 Does the B Report within 24 hours of discovery DYES to Per.Htin Continue routine monitoring DYES '~fNo routine or Short exceed 350 Gals? C3Ñ0 Coritinue i Amount Over within 24 hours of discover .onitorin 73 Repol't s the Variation exceed 5%? Variation Does !!B-!I A. Percent 2 . % Variation Report within 24 hours of discovery within 24 hours of discover ¥ % Variation 100 DYES to Perai ttin /7 ì 350 Gals?! ~o Continue routine monitoring I Continue routine .onitorin YES Gals. T I I exceed 350 Gals?j 1lrNO I ~O Continue routine ¡- i (~ I . ¡ Over or Short exceed 350 Gals? ! &0 Co~tinue r x Gals 15 Continue routine monitoring DYES (Col Metered Throughput 0-NO routine Total Gals 16 (Col Reporting 1 Does the 2 Does ~he Variation Amount Over/Short AIIount B .onitorin exceed 5%? , ort Re Variation .u.rø/ A. Percent of discover I 100 x ort to Peraittin Gals 15 (Col Metered Throughput Continue routine ACCURATE REPORT , ì ¡ Total . Gals NO :22t..f AND IS A TRUE 5%1 16) 1 Reporting Does the Variation exceed HEREBY CERTIFY THAT THIS Col (6/86) (Back) Amount Over/Short Env. Health 5804113 1017 I B . . FUELG2.0788 . GARAGE TANK 2 (NORTH) VARIATION 180 ..-. . ,..... . " . ...... . 160 .. . ...... . .......;........;....'... ........:........ ... ...;........;..".....;........;.......';.........;....,... '....,.. ........;........ .. . ...... . 140 .. . """ . ...... .;....... .:.....'.. .. ..... .:........ ... ...:....... .:........:.... ....:'...... .:........ .:........ ...,.,.. ,..,... ':.,.. .., .. . ...... 120 ..... ..~........~........ .... ..<........ .. ..... ~...... ..:........ ~........ >..... .~....... ..~........ "...... ...... ..'... ... 1 00 :: : : .::: : ."'...:..'.....;........ ........:........ ..,.. ..;...'...: ........:........;'.......:........':........ "...... ...""'.'.. ,... .. . ...... 80 " . ..... . .'.....:........:........ ... ....:........ . ......;...'..' :........:........;........:........:........ ........ ......":'. ., .. .. . ...... . 60 .. . ...... , .......:........:........ .. . ...;........ ...... .:...... ':' .......:........:........:.........:........ ........ ... ....:.. .. .. 40 - ......>.. ...~... ........ .~........ .......~....... .~.. ......> ......~...... ..;...... ...:........ ...,.,., .. .:......, 20 .. . .. .~.. . - . . .. ;. ...... ..... ..¡........ ....... ~..... ..:........;........:., . .. .:. . .. .. .. ~.. .. . ... ........ . ..... ~. .... . O' ., 20 . . .. . - .. ....:........:........;...... .:........ ........ .... ...:.... ...:....... :...... .:.. ......:........ ... ...., ...... .:...... . · . .. ....... -40 .,.. -60 -80 -100 -120 . -140 -160 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 · . .. ...... ., · . .. . -0- . . . . . . ..., . . . . . . . _ . . . . . . . . . . . . .. ................................................................ ........_................ : :: :::::: I : : · . .. ...... .' · . . .. .:- ...... ~ . . . . . . . . :- . . . . . . . .:- . . . . . .. ........:-........:-........: . . . .. ..:........;.........:........ ........:........ -:. . . . . . . . · . .. ...... ., · . .. ...... .. · . .. ...... ., ...... .......,........,................. ..........................,.... ............................... ........................... . .. ...... .. . .. ...... ., · . .. ...... ., · . . . . . .:. . . . . . . . ~ . . . . . . . .: . . . . . . . .:. . . . . . .. ........:....... .;. . . . . . . . :. . .. ...:....... .;. . . . . . . . :. . . . . . .. ........:-.......:........ · . .. ...... ., "'Þ' ., .. .... . .,.... ! 16H26C '4 ,..!ERIIIT . COUNTY HEALTH DEPARTHENT Y.t:.r.... FUELS INVENTORY RECORDING SHEET r- --- -IioHTHlYEAR--- ,:,,JULy>,Uee 13 14 15 16 17 18 19 ,_ HATER __INVENTORY--1OTAL, HETEREIL AHOUNT_ _PERCENT _-,!EGATIVE,_1-0STI'Iç GAUGING REDUCTION THROUGHPUT OVER OR S VARIATION COUNT COUNT INCHES C-ALLONS GAlLONS GAlLONS % ++ UNLEADED 11 12 __,__GAUGING__DELIVERED AFTER INVENTORY DELIVERY INCHES GALLONS GAlLONS PRODUCT 10 __GAUGING BEFORE DELIVERY GAlLONS 10.000 7 ___ READING ADJUSTHEN GALLONS H ~ ~. CAPACITY 7 8 DAILY HETER___nTOTAL READING HETERED SALES GALLONS GAlLONS --~~. "--~-~--~-----.,._- -,--' . FACILITYi~, J TANK '~J.~H) 6 CLOSING HETER READING GALLCffS 5 CLOSING INVENTORY 3 4 nATE-__1L- OPENING _,OPENING o GAUGING INVENTORY II INCHES GALLONS 2 1 o " o 1 1 1 o 1 r 1 o o o INCHES 590 113 311 -27 -----147"---=128 194 -58 788 5 723 45 o 562 9 XXXXXXXXXX-XXXXXXXXXXXXXXXXXXX-XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX-XXXXXXXXX----3356 ..1' 477 33a -- -- '---275' 252 783 678 553 o o --'---4889 ø o o o ø o 8368 o o o o o o 3479 71-174- o o o o 35 590 311 147 174 7Et8 723 562 53193 53783 54094 54241 54435 55223 55946 53783 54074 <--- 54241 S443' 55223 55946 56588 GALLONS 3817 3477 --8Ø93 7841 7059 63a0 5827 4294 12_,3917 3479 s"n 7941 7058 6380 DAY IHOUR 1/6Ø7AH 6 41 _2I605A11_7_37 31701A1i 1 35 4/620AII 2 69 5/650A1i 3 67 6/600AII 4 61 7/605AII 5 56 4 o 1 1 0 ø 1 o 1 -r-l- 1 0 1 0 83 -92 16 15 -176- -29 -43 120 7Ø9 2~6 196 534 -767 737 625 3818 626 348 174 517 597-- 766 668 o 3 o 3 4591 " o o o 3 3 8751 o 3 " " o 3 4160 74 o o 709 256 190 534 767 737 625 56508 57217 57473 57663 58197 58964 59701 ----wEEK--CTOTALS- 57217 57473 57663 58197 58964 59701 i.ø326 5201 4853 4679 4160 8154 7388 6728 5827 5281 4853 4679 4160 8154 7388 1/2 3/4 652 747 1 45 '2 43 --3 48 4 69 563 8/6Ø8A11 9I630AH 10/640A1i 11/613AH -12/605AH 13/610AII 14 I 685Ai'1 01 I, 3 4 II 1 1 ø 1 ø 1 0 o 0 o 1 --'1- ---ø----- 2 1 1 o 1 o o I t 4 o o II o 1 1 o 2 1 o 3.I4X 3698 ----47!r-----~ -n 276 253 -26 277 225 -':52 775 6::<2 -143 $:53 ~3 0 70'S 732 27 861 (¡ II - - -611- 4225 40a2 -143 11- XXXXXXXXX II " o o ",,·0 , , o lTr XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX '-'-0 -,- '---¡,.--'-------- o 0 o 0 .. . ?2 10304 M' ø " o xxxxx (xxxxxxxxxxxxxxxxxxxxxxxxxxx .._4_ " " o 40 XXXXXXXXXXXXXXXXXXX 49 14 589 250 225 632 853 732 381 XXXXXXXXXX 60326 60915 61165 61370 6.2022 62315 63607 WEEK 2 TOTALS , 6Ø915 61165 61390 62022 6237~ .\3.;07 ~4408 -- 6242 5966 5689 9774 8921 8216 7355 -6720 6242 5966 5689 9774 8921 3216 1/2 1/2 1/2 12 ---6 58 7 55 1 53 .2 51 3 84 4 76 5 70 ---151616AH 161630AII 17/930AH 18/700AH 19/620M 2Ø/~15AI1 211610A11 -3.50X 10 1 II 4 -23 -2.2 66 36 679 170 296 757 682 753 690 ,,"7 669 169 .20b 753 705 775 624 3?01 XXXXXXXXX o o o 4260 II o II o o o 10192 o 3 II o ø II 5932 70 3 o 3 xxxxxxxxxxxxxxxxxxx 212 52 3/4 679 173 .286 969 682 753 é,93 XXX xxx xxx X 64408 65087 65257 65463 66432 67114 67867 3 TOr AL$ 65037 65257 65463 66432 67114 67367 63557 , TOTALS IIEEK 6686 6517 6311 7313 9113 8338 7714 7355 6686 6517 6311 9813 7113 8338 14 14 12 3/4 6 63 7 58 1 57 2' 55 3 85 477 5 66 221613AH 23/635AM - 24/645AH 25/645AH 26/610At't 271633AII 23/610AH ".91X -73 151 450 213 523 67 xxxxxxxxx ø 3 XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 3 ø o 3 xxxxxxxxxxxxxxxxxxx 450 218 XXXXXXXXXX 63557 67307 69007 61225 \ , WEEK 7191 712-4 7714 7191 666 7 62 29/610A" 301645AM -----'-1------8-- -135 2Øl 336 II ø o 20 Ó 9225 69426 6788 7124 1/2 i-0 31/653AH 15 ~, 14 -6.56%' -0.53X -57 -85 369 1602 926 16106 XXXXXXXXX XXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXX XXXXXXXXXX WEEK 5 TOTALS HONTH TOTAL> ¿Ç; C/ , PERMIT #-L MONTH/YEAR KERN COUNTY HEALTH DEPARTMENT INVENTORY RECORD I ~ CAPACITY 0, 00 PRODUCT TANK # íl..r 11 12 13 GAUGING DELIVERED WATER AFTER INVENTORY GAUGING DELIVERY INCHES GALS GALLONS INCHES -- 711/'1 ¡rj C; '/ "f ~ g-- 9 f --- Rf . --- -- -- 7U i, ..--- ---ç-- ~: "j;:.; ';"':.::. , ~--- 92 ,I ¡j ":") i -.: ,~o :::;J .-ß-- --~.- -- t --- -,- 7-- ~. ," r' :/ lC/ ~. .:~ .,'; J':':) , ./ -- --- --- --- - ----- - - 10 GAUGING BEFORE DELIVERY INCHES GALS 2 READING ADJUSTMENT §. CLOSING INVENTORY - EQUATION 1 §. I 7 r !! CLOSING METER _ DAILY METER _ TOTAL READING READING - METERED SALES GALLONS ''10 7 I / ''-17 'q/.-f ......;--5 ?2J .- r- ..... ", . ,; ~ .) t.! ..." :. r:- .:::- .:;. ~:-. ./ 5' .....,1 ,.:) / fi1772(.-, C. ;j o:..;!./ t:-: ¡ i /' :> j .(/ '2 -;! :.-:. "7 r~ / "1- C- -~ ~;;: c.-- 7 (~ /. ."10 "/ __ J ./ :: REPORT. "", /1.0 E í.J ( " ¡.' ,) -I ,<) 1'/ /r / / i ,.. ,,1\ I' í ;. /1 .11 .- ( S! I (" /<1' II ( /1 r,/ I /,.' '- ~,> '/",; 12 C/J f <.7.2-0_____ U 1- OPENING INVENTORY \ FACILITY (¿ - - - h/l\¡^ ,-", - - -1- 2 3 OPENING DATE GAUGING J .-- ®/;~lÞS .- DATE - .- Vv t' ".)::, ." .'! , . ,.- /.-' ,ç /1.( I';) Irr :,,',", ./' ,~,' ftr r)/ ('/1/(/1 ; /1 ( / (: 5 ~ q ¿.5 3 'f If ·f'l -, ~ '- I.: C '" 41 :..-: ~ [, T5 "! 1/;', :~/..J '10 J../ 52 GALLONS ; Í2 12 " ¡ i , , ./' . /'1 (i~ ? :~'.,.: ! /'- -" ./ (j." 7 "( ,-c , ) , ::: Y 'i·1 (. (; :: C:7 ¡ r; 1 HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE j ~ oJ V 51 An f) ¡-r I.V /' J ,~," VI-If!! VV[ C&~II) út· I ~ ,!~ ( , .'Í .., II C '..: G 1 cr;,) GALLONS J ff/ 7 J'770/ ;;. ,~~!' j" 7f'i-f/ :; ¿? r; ,-;/ f, ? 7,' rJ .:: V...Z 7 I)}o) :;/ ),,~ 7 ;.J ::c.:.~:',-4 , ' _! "r '6cl2.! X-~:' I;; 7/ :>'!,;- ::. /": :: ;/ (j~(1 Ÿ Cj//l.¡ ;¡- ? '{ ~V" 77/'1 7/1J 7 I ;> t..I G 7~fI G GALLONS 1../:;....9¥ J g/ 7 ? 4 79- Yor.l 7 ff"i/ 7(' t;;:' b J X'O 5/5.2"7 f))O/ 'I if!;? ¿JC:79 ;.: ,.. l :"1' 7~ (; 7.2 0 /_ :;) ~J~' !,' i.f INCHES if! J 7 '/2- ~ ç 69' k7 ?- / Sb 'i2- 47 '1.2- ~,: j.' :/~¡ -f~ (, '1 'j:' : ---7. .- f , /..., Š 9- '} ,;;. !" 'f 5"3 5/ g- 4¿.? .....,/ ..L.:.:!- Zt2 (6/86) 1018 DAY/HOUR 1- 6;01 f1 .b - (".'0 r I) 3 - 7:0 I 11 /.f~ f,:2 0 4 5- 65 Ó A (ç - (,'ot ...1 7- ~..() ;/1 ý- ~/"A í _~I ') ; /J 1/ - (. ,~. " {-'I ",~ /1 - f:. F' ¡? 12 - ",- I ,,- /" ,: /tI-&,:H,a , . I ..; /. 5" - :' 7 I,' ,. , I G - {'t(, ~, /-;- . 4'; ~ .J l.L.l{"LJ IQ-(,?c.1. )..6 -.t:f~ A "I· (,ï¿j! _ 1:;./'<· :~+_.- ?t-/. ". .._ f") .... .: J" 1& -b'/ð A 27-C-'v,{ 4 2 ~." fl'",~· //~;. J - . ~'J" . 2Q-(,:/()!1 ? Ii -~ ,'-f( fly/·1/:50 Health 5804113 I Env. ("" çJ ~' c;; 7 / I)' PERMIT # d COUNTY HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET TANK # 2-- CAPACITY 0 0::.) C PRODUCT " KERN f. , (-. û\ t . !..~ AMOUNT OVER OR SHORT +GALS. -GALS. rOil -:-.2. "7 -/ ;J:;-- --5T / -17 -,.,¿ ~1 _L.IJ -t:o -'1/.7 -2::J -2.2.. -1'35 -?'S 5.2- tf3° MONTH/YEAR / 15 TOTAL METERED THROUGHPUT GALLONS 590 .'.~ / ,/ - h 7) /L r:. .-) -) ;:.- - 77fS- 7 p_ :.. ) ., '-' 0/ q~ ~.: ¡:/ 76'"7 777 ¡,;'- _7f< I Ç'/ .~?.:j ;.' (") "J ; :- c-; 2 ¿s" ?.l.z.. ,,-. :/ / - - ~ ") -' - . 3 UATION 9 READING ADJUSTMENT GALLONS ~ ERED ,. }"'i UATION 2 ~ --2_ DELIVERED CLOSING INVENTORY INVENTORY GALLONS GALLONS J 6'/7 31119 ~·t::'q3 7 ~1 / ,/(> ,.r; .> ¡". -. ¡' ,,- r .' /'....; .~."'.2 '/ WEEK sy;;:; >.?Cl.. 4 ý-'~: "j (jo' ?Y Ç)()/ '1/'/.;; t.I G 70/ :-/,: /-: ;'.': :'/:;í 7 _; X'v ~ 720 ~.. ,." ~j :/' r.- :) ,:.: (: r If- ,Ý, ·í '~777 K"'1). ! 8"2¡r;:. J ? ~_ /,~ ).) ..."1 I '7/ WEEK 2 TOTALS '2 () <./2 ~ -..,- c- .'/ 't f?? 1;- u-¡ :> / , . WEEK 3 TOTALS >v 7 4?(;O fI' :3 :/ WEEK 4 TOTALS ,j I 1:../ MONTHLY TOTALS Env. Healtl1 5804113 1017 (6/86) (Front) TOTALS ,~ .. (- 2 ,. ) I 1 , + 1- OPENING INVENTORY GALLONS Cf!-i FACILITY -L- DATE t . INVENTORY RECONCILIATION SUMMARY ~11¡ A. Percent Variation WI ..... ,- /27 Amount Over/Short (Col 16 ~ Gal;s.. Total Metered Throughput (Col. 15) 1) / _" Gals. x 100 --2 % Variation B. Reporting: /' 1. Does the Amount Over or Short exceed 350 Gals? ø NO - Continue routine Jlonitoring D YES Report wi thin 24 hours of discovery 2. Does the Variation exceed 5%? gJNO - ,Continue ro~tine Monitoring DVES - Report to Permitting Aut rity within 24 hours of discovery. IfRRK 21\ A. Percent Variation: ) Amount Over/Short (Col. 16) ~ 11 0 Gal,s.. Total Metered Throughput (Col. 15) .? ;r / 2/ Gals. x 100 <= J ' /:¡ % Variation B. Reporting; 1. Does the Amount Over or Short exceed 350 G~ls? ~NO - Continue routine aonitoring DYES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? ~O - <Continue routine aonitoring []VES - Report to Per~itting Authority within 24 hours of discovery. /' WRRK 31 i A. Percent Variation: I " /) ¡ -...; ) II/i--¡ 5 ("0 Amount Over/Short (Col. 16) - - Gals. Total Metered Throughput (Col. 15) ....,. {/ .,..- Gals. x 100 = I .J % Variation 1 B. Reporting: \ 1. Does the Amount Over or Short exceed 350 Gáls7 ~NO - Continue routine monitoring DYES - Report within 24 hours of discovery 2. Does the Variation exceed 5%1 ~o - :Continue routine aonitoring []VES - Report to Peraitting Authority within 24 hours of discovery. WEEK 41 ' A. Percent Variation: ¡ Amount Over/Short (Col. 16) +- L¡..5 Gaia. . Total Metered Throughput (Co!. 15) J 9 '7' G Gals. x 100 <= / I / Lj % Variation I B. Reporting: I, 1. Does the Amount Over or Short exceed 350 Gals? cgNo - Continue routine lIonitorlng []YES - Report within 24 hours of dlscovery 2. Does the Variation exceed 5%1 ~O - Continue routine aonitorln2 []VES - Report to Permitting Author within 24 hours of discover Imrrru I ; A. Percent Variation: Amount Over/Short (Co!. 16) -~S Gals. . Total Metered Throughput (Col 15) / b (j 2 I Gals x 100 _ % Variation B. Reporting: Does the Variation exceed 1.5%7 ~o - Continue routine monitorin S - Report to Permltt hours of discover I HEREBY CERTIFY THAT THIS IS A TRUB ARD ACCURATE REPORT "I GRATO ~ ,/ Env. Health 58041131017 (6/86) (Back' '2 . :HCAN, Fleet Manager .."'-~N~~~::;: a (~;)P·""l~n ¡')¡HlC· ;r-n . . Permit t Environmen1:al/ SenS'! tiv1~~' ¡~/ r:::;' UNDERGROUND HAZARDOUS SUBSTANCE STORAGE - //¿, /7,,: FACILITY , " ',F Facil1 ty Name No, of Tanks Type of Inspectioñ: -- Date Inspectton Time ... INSPECTION REPORT ... Address . I / --~--, Yes' ' - ,- -,... ·:7 ,l í ~ ! /~v,~ :r ·_7/,\1 '..J) ,.'."fJ Permit PostJrd? Yes _ . No 7' Reinspection '! Is i~for..atioÔ on e.'1J"~mAPpl1cat1on Correct? Routine ' . Complaint /....." ~: - /\,. No 1':'/, Y ,,' , , .: ¿l.~'~'! e.. ITEM -/ 1 II 1-' /-, I . '..... ,-. I I I I 1 I I .1 1 1 f. Vadose Zone Monitoring 1 ______________________________________________1 _________________________________________________________________________________________ I I 1 1 I I I c. Vault 1 ----------------------------------------------1----------------------------------------------------------------------------------------- 1 1 1 1 I I ¡.c:. Gravity I --~:_-----------------------------------______I______-__________________________________________________________________________________ I 1 I I ----------------------------------------------1----------------------------------------------------------------------------------------- 1 I I ----------------------------------------------1----------------------------------------------------------------------------------------- 1 1 ----------------------------------------______1______-__________________________________________________________________________________ I I , I '----------------------------------------------1----------------------------------------------------------------------------------------- 1 ----------------------------------------______1______-_________________________________________________________________________________. I 1 1 I ,----------------~---------------~-------______I_____-__________________________________________________________________________________. e, Primary Conta1n~ent Monitoring: a. Intercepting and Directing System û' ",r.. '-./ d. Standard Inventory Control Monitoring Modified Inventory Control Monitoring In-Tank Level Sensing Device e. Groundwater Monitoring 2. Secondary Containment Monitoring: a. Liner b. Double-Walled Tank /~. Piping Monitoring a. Pressurized ,F.b. Suction ..-4.. Overfill Protection ., 5. Tightness Testing 6. New Construction/Modification 7. Closure/Abandonment 8, Unauthorized Release ,g.. Maintenance, General Safety and Operating Condition of Facility ...... Comments/Recommendations: ~þ('.,.' .... ! ':'('''./' "- '~ 1',;." :~--:.:./I;, ,.- "Jrr Y'i,",~~ , .~ ¡ fÝ .I~II ~-' ;'" r. ,'~ ¡ I ", " f: 'j I ! j I r,'-" ,. (, 'f (::::.. ,.'l,r ,·'1.!-. , ' t-"~ I :-' :' (' Relnspectlon scheduled? Yes +- No INSPECTOR: -.,' I / '" I:. (~..~ /' '. '".'- -:'("', . , {·f L~ 1..,iJ,,-"" (Form 'HMMP-170) ~ I' r! i I d þ, {I/'/ 1 ;>'(t.{.1¡r /for ¡;r.5feda:s YA1Y-v'¡ t"e . I ~ I (' j._ f /I~ . , ;- ,_" .- r ",(' I J .. .- j"'-",.. , ,. r t-"f ._~ --. '. I ._J' , / ; ,'.',.' /'.-" .' ¡.f:;:: r,-'(- '7'!'ic:;... I;; ,',.Ii """'.' i.-.\;'/.. ..'[..j..- vt I. .r , f) ~1/\ J \ t ~-( i "'(/ I , ~ t'.... 1/ .:! .:: j." ~,.. ~--- I ,.,. -- ,~~ \..l\ -,¡ ,:_f1> '/~: : :..,.. --r- ~" -<- JioI 'i, :! ..Il I if I \.'1._ ;'if Approximate,Reinspectlon Date fì I' , " " /ì REPORT RECEIVED BY: i'~./ ......-...,- '-' . ( ì ----L- ~ - ( i , -- KERN COUNTY HEALTH DEPARTNENT , PERIItT . 16"26<: ~ I, '" r¡ .... FUELS INVENTORY RECORDHlG SHEET -'-. !!. \ ¡~Jf- FACILITY .<CAIIAGE TAIIK . <i.1i~~) ---cl\PACITY 18;"88 PRODUCT UHitADEn- l1õifTH7Y~AR" ,,~C~..' ¡ " i/ I; 1 2 3 4 ~ 6 7 8 9 18 11 12 13 14 1~ 16 17 18 11 J I DATE 0 OPENING OPENING CLOSING CLOSING IlETER DAILY NETER TOTAl READING GAUGING GAUGING DELIVERED IIATER INVENTORY TOTAL METERED AllOUNT PERCENT NECATIVE POSTIVE ,¡ - - - 0 CAllGING -INVENTORY INVENTORY READING READING '--NETERED --ADJUSTNEN--FEFORE ' AFTER ----- INVENTORY-CAl/CINC-REDUCTION-THROU9HPUT' -OVER OR-"'VARIAnON----CC\JNT--CO\JIIT- II SAlES DElIVERY DELIVERY I DAY/HOUR INCHES GAlLONS GALLONS GAlLONS GALLONS CALLONS CALLONS INCHES GALLONS INCHES CALLONS GALLONS INCHES GALLONS CALLONS C-Al.LONS % -- H , 1I687A11 6 4~ 1/4 4837 436~ 4941~ 48842 ~73 _h_ --- ø 8 ø ~22 \ ~73 ~1 " 1 )' 2/68AN 7 41 1/2 436~ 4261 49~48 4141~ 133 ø ø 8 11!4 133 29 " 1 -3í628A11-C48 '3/4'-4261 -8123 ---49616 --49!;48 -- 68 41n'}2 4227'78-3/4--- 8388~881 "1.,-------\-w------=~1 i ø 41781A11 2 61 1/4 8123 7?9'1 49782 4?61~ 86 ø 8 8 124 I 86 -3$ 1 I! I' ~/68~AII 3 68 1/4 79'19 7218 ~83: 4 49782 652 . I! 8 71!9 ,. 6~2 -~7 1 8 6/60ØAII 4 62 3/4 72?Ø 67~~ ~Ø982 ~83~4 628 J 8 8 ~3~ , 628 n ø 1 .. 7I68~AII ~ ~8 3/4 67~~ 6881 ~1736 ~8982 7~4 ø 8 8 ø 7~4 7~4 II 111 8 I '. ---- IIEEI(--1 TOTAlS h____ '-XXXXXXXXXX-XXXXXXXXXXXXXXXXXXX-XXXXXXXXXJCXXXXXXXXXXXXXxxxxxxxxxxxxxxxxx--xXXXXXXXX----2?6T" ---- ,--"-- 2894- ·-";;TI-·~2;~zr-"·_~----~--~--- I 8161!8AN 6 53 1/4 61!1IIl 5418 ~2348 ~1736 612 8 ø 8 ~91 ( 612 21 ø I ?/63MN 7 4? ~41111 ~271 ~2471 ~2348 123 ø ø 8 13'1 123 -1~ 1 111 lØ1640AN 1 4$ ~271 5131 52638 ~24 71 167 ø 8 8 141! I 167 2:T ø 1 11/61BAN 2 47 ~131 457~ 53182 ~2638 544 8 ø 8 ~~6 ~44 -12 1 I! -- -12/68~AII----3-43 ----4575 ----7746 -- --~3949 ~31$2 -~---767 ----43-1/2---41;44 '72'3/4 -- 8548 -'-'3984'---¡r---733-------,-76r--34----~r_____- - 13/610AN 4 66 1/4 7746 7191 ~4566 ~3141 617 II ø II ~~~ ¡ 617 62 111 1 14/61!1A11 '62 7191 6653 5~103 ~4566 ~37 . 8 8 ~38 ,\ 537 -1 I 8 IIEEK 2 TOTAlS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXJCXXJCXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX 3252 I 3367 115 3.42:t 3 4 1~161bAM 658 (.653 6837 5~b94 55183 591 II ø ø (,ll, t 511 -:;" I 8 16/ó30AH 7 ~~ 112 .~Ø31 6~"1 55805 55674- 111 ø ø 0 :<1, 111 ï5 ø \ I7ln8AN 1 53 1/4 6001 5723 55968 55C'0~ 163 0 ø 0 8 27$ 163 -115 1 0 181700AN :2 51 114- 5723 ?1M 56612 55?68 64' 4? 5410 $0 1/2 nt?$ 3188 545 ¿,44 ?? 0 1 1 ?162M" 3 73 1/4 91M 8363 57361 ~b612 749 ø \\ " 798 749 -49 1 0 20/615M1 4 71 114 8368 7714 53018 57361 657 I! 0 0 654 657 " 0 1 21/61ØAN 5' 66 7714 6923 58828 ~3013 810 ---------ø- -- 0 0- 791 31ft 1-'- .' 0- -I-- WEEK 3 TOTALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXi<,X X XXXXXXXXXXXXX XXXXXXXXX 3718 3725 7 0.1n 3 4 22/610A11 6 /·0 ó923 6209 ~?494 53823 M6 ø 0 0 714 ) (,66 -4B 1 0 23 ¡¿1!5AN 7 54 3/4 620'1 6108 5?643 5?4?4 154 I! ø II 101 154 53 ø 1 24/645A" 1 54 6108 61J73 596?'5 59643 n 0 0 0 0 3'5 <7 12 0 1 25/61~AH 2 53 3/4 6073 ?473 (,ß24!3 5'i'.~r,.5 ~!o3 51 5639 3' ':'731 -$042 642 ) '55~ -B7 1 ø 26/610AN 3 $1 1/4 9473 $809 bÐ92'S .0243 677 0 ø 0 66~ 677 13 0 1 27 !bØ3AN 4 75 330? 3216 61475 bØ?2~ 550 0 ø ø 5'):3 55Ø -4:3" 1 0 23/¿Ø1A" ~ 70 3216 7486 (,21n 6147~ 721 0 ø 0 730 721 -9 1 ø - IIEEK 4 TOTALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXX 347? 3368 -111 -3.36X - 4- -3- 29/610AN 6 64 1/4 7436 66~3 63040 62196 344 ø ø 0 333 344 11 8 1 30/645AN 7 58 ~6~3 6~17 6313~ ó3040 145 " 0 I! 131, 145 ? 8 1 31/650AN 1 57 6517 6433 63306 6«185 121 0 0 8 34 I 121 37 0 1 --, - ~ - -, -- IIEEK 5 TOTALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX XXXXXXXXX 1003 1110 137 '1.64% ø 3 ----- - "ONTH TOTALS XXXXXXXXXX XXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXXXXXXXXXX XXXXXXXXXXXXXXXX XXXXXXXXX 4417 14464 45 0.31% 1~..( 17 . . FUELG1.0788 GARAGE TANK 1 (SOUTH) VARIATION 100 80 ..... ..:........~... ...,...... .:'....... ........:......' .:........ ... ...:....... .:........ .:....'.'. .,...... .,..... ........ .. . .. ... .. . .. ... 60 .......>.....>..... ........>...... ........:-....<... ....... <........>....<........ ........ .....:. ........ .. . .. ., .. . .. ., 40 .. . .. ... .. . .. .:. .. .. .. . ~.. ... . ....... .:. .. .. ... .... ... ~ ...... .:.. .. .. .. .. .. ~ .. .. . .. .:.. .. .. .. :. ...... ........ ....... ..... .. .. . .. .,. .. . " ... .. . .. '" 20 o ---20 -40 , -60 -80 -100 : -120 140 '" ......... - ...... ... .., .:.... ..'.:........:.. ...... .,... ...:...... '.:.... ....:.. ..... .:.. ..... .~.......:........:.'......: ...... ..:..... ... · .. ......... · .. ......... -160 1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 .... ....... ..." ......................... .......................... . ...... .......................... ...... ................. · .. .. " . · ,". .. .. .. · .. .. .. .. · .. .. " .. · .. .. '" . .... ...... -............................... ......................... .................................. .......................... · . .. " ." ., · . .. " '" . · . .. .. ... . · . .. .. ... .. · . .. .. ... .. ..... .... ...............:................. ........:................. .......:........................... ........................... · . .. .. ... .. · . .. .. .,. ., · . .. .. ... ., · . .. .. ...... ..... -;...".... .:.........:....... -:......". ........:....... -:........ ."......:....... .:.........:-.......:....... .:.........:-....... · . .. .. ...... · . .. .. ....,.. · " .. .. ...... · . .. .. ...... . . . . .... .""... ~ . . . . . . . . .. . . . . . . . ... . . . . . " ........"....... '" . . . . . . . - . . . . . . . . " . . . . . . . '" . . . . . . . ... . . . . . . . . . . . . . . . ... . . . . . . . ... . . . . . . . · . .. ......... · . .. ......... · . .. ......... · .. ......... " . ',",', , . . . ., . , " . , . . -.... .... ... .. .... '.., ,. ":-....:. . :' '," .-:.' :".: :::: :: .' :,:.; -': ~ ",: : , :';:-,' . , .. . ',',',,"., " .- PERMIT # t~ MONTH/YEAR . q~ - - - - 11 - ~ L~ GAUGING DELIVERED WATER AFTER INVENTORY GAUGING DELIVERY INCHES GALS GALLONS INCHES - 70 -~..¡ r )¿.;¿ :.¡ c ,~ ! I' I KERN COUNTY HEALTH DEPARTMEN~ 1 INVENTORY RECORDING SHEET ' CAPACITY 'I) 00 ð PRODUCT' .:,.(~-<--... \ 1 TANK # ::.lQ GAµGING B¥FORE DELIVERY INCHES GALS I f f,.J "'\ ì "., .'.,J._ .' - EQUATION 1 §. =1 7 =r ª CLOSING METER DAILY METER TOTAL READING - READING = METERED SALES GALLONS 1)7J ~ -' - 3 ~ ¥c t:¡ /,ç.-- ..; SIGNATURE 9 READING ADJUSTMENT 5 CLOSING INVENTORY ,^l , ,., . tJ-'<- 1 OPENING INVENTORY ,~ ;! OPENING GAUGING (7:1_ 2 FACILITY ! DATE - --- ~ -- -- .. ., I :.. , , .. 8' 'j " ,/ ' ',1 -'-ff'-- - ..- - - --- - - -------- - - -- - - ð __ J ð-? ~ '1 Pi? ~ qX-L - --_.- ----- ----- __.1_ 7- .r;;-- LI 07~ ¡.; ?~/2 -- - - -f-- - --- - -'- - -- - - -- - DATE ~J¡oJ€1~ t; t. /if¡ & j tll If /; i , k.J- ,J q , ) ... .- -' GALLONS GALLONS Lj 't. 'Y./ s ;.; '1 ,;)~9' 'i II? /6 '-I ~ ltJL .5'ú75f'é l) 0 '/,ç'.:2 5" I 7,. c,; r23t¡F '52y7/ 5 2 (; 3V l; t /., ..:: r: ~;., .:./~.,' c;~ :.¡ 3-"-'- ~'... S" ~ J I] --" r-"'¡;:f/ ~~ "'r.· -;~ (;1' ~," r; c; 7";;, ¡( r; 61:: /2 5-7.f0'/ ¡< :,/ ';"" ~w:.. .,/ >:_ / ;0-2'-1- if ~(j q 2 S 1/ ~r 71 ,lIClr,. ?Jú'tt C 7/ fY t 330C ~ GALLONS LI 3?5 'f2Ç/ ý/..?3 7 q .::1"1 729'0 r.; 7 r.;- !: ¿ Ú~ 1 <) 4/0 £:2..2.1 ~ / ~ I L.J !- -,' ~ . -. -, , - 7/0 /. :: ; ? é;':0 ? 7 i~ ,";- /J / , -7:;;~" r, -j q I C:6 g ] ('7 77/'-1 /- ,;/;.; ..": (;lCC, j / /" (.- ::,' ,.- ."/' '.:: 'lL¡ 7} /}YO q <.21(. 74f'(, 1fff- G '-I tr :J GALLONS '-f~77 Lf'3&5 4;261 5r'/23 7'if'í ffff ,-; 0(; I f·... "-.1 l /~ ')771 [' ) -;} LJ , "7"- INCHES l:f512¡ '1/ '/).. 4 (j 7/.¡ C. q '/'1 c: / '/'1 /.;? "5/;"- r; .~. );I~I ,- J '/¥ 41 . I-IY :..J7 Z { '/'1 7 7 oJ' {. C-2- 7/1; S\ &[,5"5 ... -, '/ / " -, /' ~ f"( j 5 ;' '/::I'~ {~:;.., () / r,' ' /~o' c; -; ;! -3 '7 ç ;/'-/ /" ? ,/' ;'- 6t 7 7 I '-I ,< :}.:J '5 ( :..... ~,. -/ C 2 C (} ,.::/ > ';;:,;' " . . : :, ... .-... 57 5 f, //'1 CERTIFY THAT THIS IS DAY/HOUR [- .'~ - -... --:" ^ ~~ (,,: I ..f 2 - ¡;.5 C> £) ~ . &.20 t1 4- - 7.01 r1 ç. {or; ~ {- - c'úú A 7- ;;"(.r;;1 5/- [,:o¿ A- Ø/-Ç3(; fI /t/~t''tú 4 /1- b'/J A /,~ (, '.. (': iJ- {,::J /-! /L! - { ',i 1~1 I , - (/ t4 Jr. - :;'71 A ) ,I . ~?,.:;" .~/ J':-. ;<;~ i1 ¡C/-ii"å/j- _ -»T ;2 1- G~!JJì _ ~) ~) -- /~ .. )..>' -,- j '$ _:.': ç r'1 :-, . 1" l :.. ~' c,. ",of) t::..... :~::-r;ï'..J 2~-f(Ú~ 'j 7- ,,:i/~ I ') 9,:- b. (;7 A 2 'j-(;.ï6 A lú-(¡:'1J 3' - f/:5 V . .' . REPORT AND ACCURATE A TRUE HEREBY Env. Health 58041131018 (6/86) I ('/):¡, \/''-''J 0 f -K'" ~ "'- . (:Î '.. ...... -'" ~ : ( #Ow '\ r f" / EQUATION 2 12 I 5_ DELIVERED CLOSING INVENTORY INVENTORY GALLONS GALLONS 'IJ~J ~). C:/ :;ð'/ f"/;.J3 :7qþq 77 ft Ú <: 7,.s r; f?¿/ WEEK 1 TOTALS ; _7_-~i: !? PERMIT # MONTHIYEAR j, ,1 '., -.oC..r /f.~ ~RN COUNTY HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET TANK # 1-. CAPACITY 1..1/), Il/')Q PRODUCT /Ip?./.,¿~ e e: 4, - 16 AMOUNT OVER OR SHORT +GALS. -GALS. + / ·of- '" -* -57 J-C?5" - / ff"- -73 .?J- ::-/b .77 -12 -/ + ~~SI_2~ -f'.;;.> -:1!..2. .:L:L'i - 1(0/ ,¡ - .J " CJ -1 ---¿,. -L¡'c -"Pi -<-¡3 :/f, - EQUATION 15 =1 14 [ TOTAL METERED INVENTORY THROUGHPUT - REDUCTION = GALLONS GALLONS _>" 7. 7 r 2 '2 í 1.? I Ý '7' tý ?1'1' 8'6 / 2 '-I I'- .-: ~~ 7 C/ "'j ?::/ ~--- (" 7 r: 7;;'-/ -7t;V , 1///////////////////////////// (;/2 .> Cj/ ' /77 / jC! ;1:7 /'-11) r: u ~. f' ç- :.,'- '7 ¡:: )' "7'7 :' .;- ? i/ f ; 7 r::: 'i ; ,-J- r:; 2 c ';' -... ::-..' ...- - ~-'/ 7 -' . /- .:'.-7 Pi",:-: 1/ ///j/~//ILl///////////~////LLI :: ¡, :'~ /,/ Y ,. 2..:::.:' I -I2. / -;:=---:7 ') . ---.:... /7 TIT ill +Lf6 " t:; ..../ /2 -r./3 .J. -I f I 15 TOTAL METERED THROUGHPUT GALLONS 5;73 1 ? 7 ....1 _I (; ;."Ý ý¿;' ~)2 6./ ç' ;; ::;-.:..¿: 2:....£'1 f ..kL2 17']' / (; 7 .:.... o¿' 7 4 ë ç r' ~ --.::..2. /.7-:0' ',: :.. j /21 13(X ý~~ / tff I;' , J44G. 7?7 ( í ï ~ "t -~/' ? 7 (; 5 ~/ I ! I t / "7 , ," , ~ij'i/ 7 ';' r:;- , ,- ...:.. (.' / f;/? Of OJ 2- .,.: i.~' I"'~ 3 I = 8 TOTAL METERED SALES GALLONS r; 7, i ..~ J t.ff' ý? &17 ...~, /" ~-_~1 3 ,~-7 7 r EQUATION I 9 READING ADJUSTMENT GALLONS 1. 14 _ INVENTORY - REDUCTION GALLONS r; ;:2 2- / t/ '-f .2/'1 121./ 7¿-'1 rJr; 7 c:- 'I /q ) :":/ /' _/ 177/ I:?Cf IY(... í, .:: 7·?_..)~ ;"".- { t;]y 1 .., ,..-.. ) . ~....:-- ~/; f C'" 2 7Ç~ ( ..¡ /-- 7qir 6 ~.µ 77/ 17/7 -/ i J I ( I "< r (,,';,1 :.- ?? -I ') ''r 3 7 Jo '3 ~ 7 q _f~t -;./ ï if '741ó c. :;- ~7 ;' Ç} ? 1 w· I: 7 !I- ? 7"' (~ 7/qi (.çC~ f: (.' ~- /.... I'''' .~. , 57.?:! ql/-(· ~' ,~I /. ,'7 -~ '7 , ./ .. '. ' ('íV3 i 7: " " " /7 ,:/ -/ -;0 '" . ' I . Yf:;' t·-q ;';. .~ " (-'7 7 fJ y (- / (- i; ? !Ic.· Of TOTALS MONTHLY TOTALS En.. Health 5804113 1017 (6/86) (F/onl TOTALS F/ ,"; .t-- WEEK 4 TOTALS 71ft&- - TiTJ TJIJ ç: '-/ 9 Lt(/ .'- '.:; ._'.:' r:: 1,< (; 1;)1.:/ j7/·~i WEEK 3 ".1 -...-) -'.~ '; , ..... ['I " f;O{)! ;;.., / V ';..17./ ,;- J ~. / - t' /, :/ r 2...Z.:f.:. -, ! :';'.'r Î ac., 7':, ~J < 'J ' !~. 7 ~ 2 >; - (;/ t·fA 1 . if;' ., !:.I' ;:l!i /! ! l /..J'~ ,/. ; ;?-o :;; ï-~ ~-=;- ! '-/-!~(// )'1',:'f),. 717;im ~rJfi FACILITY 1 DATE DAY/HOUR ¡-::-rZò'7µ ;;, t5r ?- ¡;:.? C '1- 7,tJ1 'i' ~t'f 1_- -, ~i""_' 7-(;¡/j !5-l, ZÆ, / í ' .~ 'j'i )1 / ,7.' ;' ; ,p /!'( Ii /?ï-Y;¡;¡ L (. ,~ ·f _ r 7/ (. ./ ,- , . -~ ' ~~~¡0 ':" ',' / ;¡~ " -- . :t-'· ì (, - ç~¡v ().: J :7 - ~:.!-;I1 , . .', 1 INVENTORY RECONCILIATION SUMMARY IŒEK 11 I A. Percent Variation < Amount Over/Short (Col 16) -7] Gals. Total Metered Throughput (Col. 15) - 0--'1/ Gals. x 100 -2 52 % Variation . .L t1 ':: ' - B. Reporting: I 1. Does the Amount OVer or Short exceed,' 350 Gals? gJ"NO - Continue routine monitoring DYES Report within 24 hours of discovery 2. Does the Variation exceed 5%? ;e1NO - Continue routine .onitoring DYES - Report to Permitting Aut ity within 24 hours of discovery. WEEK 21 A. Percent Variation: /I 5 f - Amount Over/Short (Col. 16) ..¡--- Gals. Total Metered Throughput (Col. 15) 3J(7 Gals. x 100 = J, '-II % Variation . B. Reporting: I I 1. Does the Amount OVer or Short exceed¡350 Gals? ~O - Continue routine .onitoring DYES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? 0NO - Continue routine .onitoring DYES - Report to Permitting Authority within 24 hours of discovery. IŒEK 31 A. Percent Variation: Amount Over/Short (Col. 16) -1 I Gals. Total Metered Throughput (Col. 15) '] 7 ") c... Gals. x 100 = ;2/ % Variation \ ..' .... ....-' I , B. Reporting: I , 1. Does the Amount Over or Short exceed,350 Gals? BNo - Continue routine monitoring DYES - Report within 24 hours of discovery 2. Does the Variation exceed 5%? ßNo - Continue routine aonitoring DYES - Report to Per.itting Authority within 24 hours of discovery. DB 41 ! A. Percent Variation: i Amount Over/Short (Col. 16) II! I ?"?{C/ 3.2.1 % Variation Gals. . Total Metered Throughput (Col. 15) ) .t/ /,} Gals. x 100 = , B. Reporting: '\ I I [2t:No Continue routine monitoring DYES Report within 24 hours of discovery 1. Does the Amount Over or Short exceed) 350 Gals? - - 2. Does the Variation exceed 5%? t'aNo - Continue routine aonitoring DYE~ Report to Permitting Authority within 24 hours of discover JK)flITH 1 A. Percent Variation: ¡ 0, J! Amount Over/Short (Col. 16) T 'i 6: Gals. Total Metered Throughput Col 15 I~ r Gals. x 100 = % Variation . - I B. Reporting: I Does the Variation exceed 1.5%7 ~O - Continue routine Perlli ttin rity within 24 hours of discover ; I I DATE I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT Env. Health S80 4113 1017 (6/86) (B.ck) I 4IIÞ PERMIT CHECKLIST Facility kr:¡¿,j c.or.uJ~ ~ r:4/J~ J ~¡;;t . Permi t, I~ ø'ø .2..6 c... This checklist is provided to ensure that all necessary packet enclosures wer-e received and that the Permittee has obtained all necessary equipment to implement the first phase of monitoring requirements. Please complete this form and return to KCHD in the self-addressed envelope provided within 30 days of receipt. Check: Yes No / A. / j 1- I J T J The packet I received contained: 1) Cover Letter, Permit Checklist, Interim Permit, Phase I Interim Permit Monitoring Requirements, Information Sheet (Agreement Between Owner and Operator), Chapter 15 (KCOC 'G-3941), Explanation of Substance Codes, Equipment Lists and Return Envelope. 2) Standard Inventory Control Monitoring Handbook 'UT-10. with the following forms: a) "Inventory Rec~rding Sheet" b) "Inventory Reconciliation Sheet with summary on reverse" c) "Trend Analysis Worksheet" 3) Modified Inventory Control Monitoring Handbook 'UT-15 ,wi th form: "Quarterly Modified Inventory Control Sheet" with "Quarterly Summary on reverse" 4) An Action Chart for each inventory method (to post at facility) B. I have examined the information on my Interim Permit, Phase I Monitoring Requirements, and Information Sheet (Agreement between Owner and Operator), and find owner I s name and address, faci Ii ty name and address, operator's name and address, substance codes, and number of tanks to be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). C. I have the following required equipment (as described in Handbooks under "Before Starting") 1) Acceptable gauging instrument 2) "Striker plate(s)" in tank(s) 3) Water-finding paste D. I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). ' / 7/:;µ I have enclosed a copy of Calibration Charts for ~ tanks at this facility (if tanks are identical, one chart will suffice; label chart(s) with corresponding tank numbers listed on permit). ../ E. ~ F. - - V" - As required on page 6 of Handbook 'UT-lO, all meters at this facility have had calibration checks within the last 30 days and were calibrated by a registered device repairman If out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). G. Standard Inventory Control Monitoring (Handbook 'UT-lO) and Modified Inventory Control Monitoring (Handbook 'UT-15) were started at this facility in accordance with requirements de~~be on interim pe conditions. Date Started Signature of Person . Date: _ ~ / foó.oz(p_c S~VL<:..L ') ~ r mt! !. ,------ 1\1 l:.._.! J.:' t <. c ..' ~_~:._ ~i::-::...':~~:-,-~ Tv"\.A I( f-o t."\. FacilltY:C:~~~ ~~~~-á~ \~hich may ~ ~p.ar, m of twice --- -- --.-...-- 'ind Measur'cs i bra t ion can ß minlmu Weights the, ca and remember Inventory more than 6 cubic cal1brat1~ by a can is requires on ca1Jbratlon mark, the meter AIl meters must have ca 11 bratlon checks include checks done by the Department of Be fore ca 11 brat ion runs we t startIng return product to storage. Run 5 gallons with nozzle wide open into Inches drawn. and return product to storage Run 5 r;allons wi th the nozzle one-hid f cubic inches drawn, and return product After all product for one calibration to record the volume returned to Recording Sheet. If the volume measured in inches above or below the regIstered device repaIrman Note t and cubic gallons to storage 9 of the product and gallons Note with Note n ca lito gee s returned in column can the e tt (j i open to 5 tor check storage " <. 3 4 5 a 5-gall 5-gallon 6 .' --- ----7-- --.,- t-! 2 ð /t 7 ------- __·____u·_ .___'_~.______ ~_ ~._.___ _____._.____~__~_ ______.__.___._____.---------.---- Tank 1/1 Fast Flow Slow Flow ~vorume Returnedlcallbrati~n Device Repairman Date of Product-º:..º-alJon_º_~JJ_ __5-=-.Qa V,on _ºY;:~_U___.J-2___~!~r~J~e. ,_B.~_gU.il~_ºJ Use~ for Cali bra lion _º-~@CU~ I~ChC~ !!~§I"~' ;~~~"' ___/G:}~~'- _Yc' L'!o._¿~y~~;:t~"t~no- .-k ~ f m-¡"q Date/;~::Tïtc;~e -;;-r Pump t If /20 II " ')~:1'-i-- I ,.",.It< V1~ c¡ /Zo!f 7 rv.'f ( '7ð/1o V\ I v o " /0 -) ~ -'/ Ç" U v,1{'..J,~ 2 !.//¿o . L/ /éi.'Îf7 I v1 /Ò,O -0:- ~ -2.. LI "J(¿,..I..A S "3 ¡he £O..Ú ~ ~ -3 s- ~-1/""¿/~/J q /~(! I t.f)~oJ¡ì .2~o"3 0 on , , ! v- H(~eistrat 81 na:~::atV1J~_---~/lL -v- g --.[)?~----J¡~~ 44--- - - TH IS FOP-M ii lTII AHè!UAL HEFt)RT or Operator Calibrator's A COpy OP T Owner Sl1aM ." .. ~'-:;. .___._....:...__~._.~'. ......~_ ,;...J..... ., '" .' 1~~!.~1'!~1~ ~', .¡" ":~'" :,s:.::l.A ~ ~'J'~~~~ . \..0 o COMPUTER C~I\NCE ~l.j~^T10N o WI!/, NOTIfIeD Rl'lCOrrti 01 Com~~r Ct:~n~^~, ~t' ~er C'hsno@, or C~Ub(l!I1t~o~ nMETER CHANGE ttJr,tPANY / ADDRESS I I C;~UßPAT ON "'::>- I '<> CHEC:-;ED ¡ AQ. USTEO TO TOT^LIZER OALL°2:¡-49¿'ì, ) FA9+3 (L0+2.. rAST ~EAOINGS STAAT r~Y -e- IGALL~'fq.1 7 ( :) TOTALIZI:::ALEO 0 I«) r"m~:D IMOMíud,J"'"f u r TOTAL C) ì'~'~""'ïöo:'D''', I ~~~~ ~£,.~~~~' I .........."" ",".LI Ml.>'J~1. . 'EHIAL ",1,,"0<11 , CALl3AA nON L-_[Çf.C _ JZ)o A I ~ y~_i-__ ._--1___CHECKED I î í l"'ONlY ¡G"I L<lN:' ,'''S!, i:>l.CW II"sT I' TùTAlIZEH ¡fINISH ! O'j ! - q \ -:s- I READINGS _u , ¡GALLONS, IO'AU~EH SEALED ¡..tI~1I :!EALEO , STAAT 0 I 'if? D "3.l.f ~ 0100 ì ~ES "lOOUCT ~ # TOTAL _' ALL N~REfUHNW10STOA"G[ I I ~L~:~~... ,-~,~~~~w~~~ P""... ...~.E ANI) ,.OUtl .1~E)\'AL ><\.I....,lll CAL!ßf1í\ lION TD ~-.---:-L"}.59__. ¢r _. _.__._~.?-_ 5.1..-1-.5 _. '--'11-,- ..-9H~~~~_D ¡ "DJ~O It' _ I F!NISH ¡t.tOHCY ¡r.ALLtlNS I A~! ¡....uw ¡fAST (lIIW TOT~LllER ¡ F!NISH ¡.-B- i 3~ ~ ,_~J ' - L . U ! REI\DINGS ¡ START ~ONt.Y -e- l"A3~G, ":> ~ . \ Túr~:l"'LL~ C NO í1'õii5üij(:\- ~ I,PU.[DJJ if TOTAL --e-- i(·"Ü( "sï',u(;'~'i.~'.'d"...r--; - ! 0 \"1 le.lJtd~ ~ ; ~ ~ t..:f~! f~~4,...~~..:,m~~~~~~;œk~~t:..~Z!tY~1~~~~~~~'I'~:~~~~~~~~~!.~"fi.t~~~;1~~:· r'-'·..'T~'l¿·"LL \""L 50 r\ 1""""I.'''''''u", ~ ~ 2 r:::.. I c;..,-:r;-ìr:'Y''')''' ,.-..-----T - . -----~,- _.__1 ___~~~;KfU.__~~:._-_~.:::.;~w 29_ ~ {! (JHE't fl.AlU)N~ 1"fA:;, ,~I..',)W .,I~~T "..(.Iv..,.-\1 \ lUTAUlER ~':~_L.___O ~9_ 311fJ..~~_.L_:,_?__~__: _~__.c__~ ~_ ..~__: AEAOINtj:) I . :...fJNfY IhA¡IUN~ ! nIAlI'l.~¡t.:"l'"t' ~...t~lA.....t.~...(tJ . i STAfn'!.-ê- j '-::J"5 (J.o~5 I 7kl' C "'J i ;a-vf5 0 N,I rv:tÅ~J~~ruq # ¡:urAL C 1C.·'"II"~Ol~IO':~(JëS , ---~- ~~"'~t~.'.~t1'r~~\'~'~~"""·'~.<"'''..mÕòJ'1s;ì£oi!It''''''~i~'' ,~;r~~~}.~¡¡.]~'f;'~-:.:;""""~~.?n\~·w.~.n~¡;,-·ß,.· 'Wi. ' "Ii' ""~~~~.1{~~;.:~,\, !I..j. ~~~~1Jr;:~'~···~~i-~;):L~~~;~t\J.t-..~~ .:.t.' ·~.¿¿¡~.wÙSì!j~~,~~r-'t·~~~'~{r:t~~~~i~,~..· ìõ"Jb.t~·'-'A".': "Nf.) :..iO£;\;i. íSb'~~ t-IUMi;f:,,1 , C'''l!3RA nON '. j CHECxliLJ I· ADJt.:5iED TO ¡l.<OiOU ¡(}AlI.ONS j'A~T 1'".:.. ;fAST ¡'~'0'" ¡ TOTALIZER FINISH \ I i I! ! REI\OINGS iMO",ty IUAI.I.ON:I : rOIALlllR StALED \,"U~R S[.~I.E!J b ST""T I I I [!,,, 0·0 ,0'" 'fIOOUCI ¡Jump #~ TuT AL '¡UA'I.ON:; M.IU'!N>O 10 310"A<1f ! . \ , , I ,I , , . ~m_~~~~~~~~!~;S!11@l.~~: \,."'.... '''~I ~' (¡"U..,ll ~-;:~.- l_ CALI I:\H¡. TI'.)N t- I i CHECKED ! ADJUST,,!) to FINISH "'ON~" ¡GAl.lUNS ¡'...~r \~I.OW I¡FÞo:IT \~IOW TOTAL/Z£A . I' I ¡, I -~ ~ ¡ REAOINGS STAAT l"'OHty r:,AlltlNS ¡1l)!"'~~E:;:"'EU nNO .--~.- , MŒN" k""i.L.. "~.~;.~:;~~..,O,~"~,~,'~~rc:r:l~:t!v~:~;~:~~..;~ /...'.'I.~,,......,,,..,:',~,,·.:¡).'~ :, A no!. MO. I zð!fì ,OI$"MCIi "'0, ! bLOW 0- ADJUST!:n TO ! ~I r)~ I I I o 'to '.£1 E? ~(At(Q I i , , ~e5 nNO - DHO j p.,C(Tf.~ ~fAL~O Oy~ nlOO '-' DATE (805) 834-1100 REQUESTED BY AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INST AUA TION - MAINTENANCE SALES Z080 SO. UNION AVE. BAKERSFIELD, CALIFORNIA 93307 CALIF. CONTRACTORS LIC. NO. 294074 áa,·,·,~,' ~ ' \ .. E "'B,t... , ~ PEI'~ SERVICE \...-.,...., INVOICE P1.IIASI[ NOTE A....L INQUIR... AND CORAl:· SPONDIEHCE SHOUI..D RIEFI[R TO THIS INVOICE NUMall:R s 6665 . ' INVOICE NO. PHONE NO. CUSTOMER ORDER NO. W -'7- ,-¡ "\';rn ...... ~ CHARGE o CASH MAIL INVOICE TO r ' '.' \ ' , "vdd 1; v!' !\..:.r1;~ ##ff: General Services :41':: Truxtun Ave 3akAr~ri~ld. CA 93301 L PC SLìri 1 L o C A T I o N ~~ --'rU-.)( kn ..J AP~./ ',9 C"A LI bco +e û..\\ (\ :"'- rìp'f\ <:;"o'r- WORK TO BE PERF'ORMËb: 1115 C:'kl..pJ~ +~\. \ ~ - . ~h- IuA../ì rFOR I ,QVÛ, " " " A 1-4 --h, L OFFICE WOR7;(ERF'ORMED¡ (£II -, U. _r ~...I ''^'J /1 /1 JL....... ,.-¡l/." ...., ¡f USE ,;:;f-/J-A .JO L_~ .-! J:., -:/; ~ / .., 1'-;;1£. _ ,Lc þ/ í / - ~*P¡PJ/ ~ ONLY ~Q L~dP -'1 j)-t(-,- d ~-~L~ /l f! ~/ G..../k _' ~ J¿ LØ' . / y -; ., TECHNICAL. SERVICE HOURS MILEAGE " Sub Contract I I I ¡ Rentals I -1 j ! I I I ':'7 )(\ -:- ,,--. / J_ (- I '-, - -.r.; -:¡/L ./ ...) <-/~) /-";," ~...- !//,~ MAKE MODEL NO. SERIAL NO. ., ! S QTY. PART NO. DESCR IPTION ! .. /~ '--i ' " <",: J. _ : ,1 1 1.1..,:' / ,~ r., ,,' ,r .i ~~; .,~ ì < Ii-_-..~_,,;r .i~/ ¡ "~lŠ? ,I 'I' ~ !.AJ r-' I . I /{ 1-/... ,r ,/...~ -, -+", - I \ . / -" I - , -/ ;',~ í ,'_ I , , I ( .. ' , .:"............ ,'", ,"':.' -'¡ " ,I,.,.·: >;::; v, ." (' 7/' ~ , , I I i ì i j -, Supplies , 'If- / c/ D ¡,' c:;-; \ , ¡ .--.:- Sales Tax Technician(s) ; \ V \ ./' Date Completed ! ¡ ,\ ... ,-, f!~ 'ì~ h! .J/ fl ,~' - TOTAL Received & Acce ted By'·Æ. ,/1 !/I i /,,<:':' .~, i.. -t d :,+:",,\ __< P PLEASE PAY FROM THIS' INVOICE. TERMS: Net due upon Receipt Finance Charge of 2% per Month after 30 days. PLEASE REMIT TO RLW EQUIPMENT P.O. BOX 640 BAKERSFIELD, CA 93302 .J ~...-_._- -- . - kJ Cé>""''¡'y &-~ /4,v~ ~~ J t ~. ?~ \1" I boo;)kc... } ~ DEFT 2000 5000 60(\0 1(1000 DEPT 20U') 50Ü:) 600G ~ r~¡'ì{;:'" INCHES GALLONS GALLONS GALLONS GALLONS ìNCHES GALLONS 5ALLGNS GALLONS 2ALLQ?,S nIP STiCK rM~k READINGS CAPACITY OF McCARTY UNDERSROUNj rAN!~S ONE QU?ìRTEF INCH CHART Dtn ,2000 5000 6000 ¡(lOOO DEPT 20 (¡':; 5000 . "'r. "I t!iN;:", ~, , bij...,tJ .. ',I v.' '. iNCHES GALLONS GALLONS GALLONS GALLOii5 INCHES ,... to ¡ , :-,~!.-. GALLONS GALLONS GALLCnS OI1L~~l'f~ 5 10 12 ' ~ I f '1! 9 t ,~ Ii ~a 1 '1 I ' ~ l~ 1 1'" 1ü IS 23 ~¡b I \,... 1.3 ;:S ,~ , . ....~ . ...j 't..) ') 15 27 ..., "'.. 2 1/4 i3 40 il: .. ,),) oJ,) '.'':'' ;;,.1 " 112 21 38 46 7b ~ .. '. ,,. 44 - ' 87 <- .)j ~ i..1.! ""'.' 3 27 50 60 98 .. \14 :1 56 63 1" ~ .J ,) 1 '., 34 6:j 76 ,""!:' .. 3/4 ~~ ; l' d:';' ;~,.., ,. I' , ....ì ,"0 4 42 76 92 151 " I iA !~ -23 1('1 165 ~ I. 4 I'" 50 83 101 165 4 "14 54 1'" 1'6 Ii. ,)1. 77 . L 7 .- 58 106 128 210 " 1/4 6' i14 138 ,",,"1 oJ oJ ,- ''':'0 !:' I'" 67 1"" 148 242 .. 3/4 72 i31 ' ... ~ --:"" ,J I~ 1..1.. ,¡ :~ë ...1oò' b 76 139 tóe 275 6 11.1. B1 . ,~ I" "'...... L"t/ J~ ....., ~,~ tin, Bb '1"" 189 'T"'., 6 3i~ Çl 156 :01 .:~-: ~ .. ~ .,¡b ·)1 ') 7 96 lì4 211 .)J.t~ 7 114 101 + ,"'~ ,,..\ 1!J·_' i.i..i.. 1 ,~ 106 Ir... 234 ~n'"' . 3i 4 :12 203 :46 402 ,"- 7.J ,)OL i 8 117 212 ".-" 420 8 íí4 '''' ~-:-; 2b~ 440 \ li L'¡¡ .~- ~..~ 8 .. ,~ 1"· ,""'..." 281 460 8 ~ " 1-· :4: L"'::; 4Bí) ;,/~ ~/ .1..~¡;' ':'·1'+ """-' ,. 138 ""'c 305 500 '1 if4 1H 262 ""4'" r:-, t .; ....J..:. -.H: ,)" q f ,,, 150 .,-r~ 330 <;.¡'.., 9 ;;',/Ï' 156 284 ~.~ ,f 56.3 .1,) u ,< .~,~"! 10 162 294 356 584 10 f ,- 168 305 369 605 l/~ 10 1I? 174 31b 383 627 11) !i4 lEO 3:8 ~,..~ 650 .:: 71 11 186 33'1 410 671 11 1/4 1'12 350 4"'" : .-:~ 1..j 07·) !! I'" 198 361 437 71b 11 ,;,j-'i 204 .) I ,) 4r- 740 ..I ~ 210 384 465 12 1/4 ~'17 3':;'6 ....~ 785 ¡L ItL .. , ~(.. ", 1/2 223 4",Q 4'ì4 809 12 3/4 -,...... 42;) 50~' :"'I-~ ~u ".n: tk,j 1: 236 47-' r~,~ 856 i: 1 i! 444 r~~ 68;) ,)"- ')';'.J ....,... oJ:"/ ,.. il2 249 456 ~C'~ 905 i: 3/4 256 4t.r. '=:t.Q ¡¡...., ¡ ...~ ,.¡" u7 ...)1.' 14 263 481 582 954 14 1/4 I":~": 494 c,..,.., 97'1 ..;7, 14 1 ." 276 S06 613 1004 14 ~,llf ......1"'1... ~I r, ;..,~ 1 r¡':'~ ..I, t..å·) ....'.:. "1 b..:.'1 L .) 29(1 -~..... , " 1D54 15 1/4 /'"<;........ r'!:' 659 ~fj?7' ,¡J.:. o'h ..J~": is 1/2 304 ..rQ /..~.. l\n~ 15 .. , 311 co'" b91 ~13¿ '¡~'w ~t'¡ ov;) .)] ., ..Jl¡ i6 318 584 706 ft'="" 16 1 .. 7"C 7~" . i ."'\- ll,J! ¡4 ..jJ..J :J'1i U. ¡ .." .' 1/2 3...., 610 738 1209 16 3/~ .,...,., 6'24 ~~I:' 1.::.":'0 Ie ,)~ ~,.)1 :,J,¡ 17 346 637 771 \2,;2 17 I . ~ 354 65') 7ôì 1231 ¡/., 17 1/2 361 664 804 1316 17 3/4 ..,.," 670 ~'-1 1:44 ':'0': bL. 18 376 691 837 f"'~· IS I" 384 705 Q~1 1:19 ¡.); ¡ / ~ w,)'.i 1B !"" 391 719 870 fi"":/.. 18 3 '. 399 !~~ B82 !~~.! I':' ¡"fLu /.. 19 407 747 904 1481 19 1/4 4i5 761 92i 15(;9 19 1/2 4"~ ì/5 938 1537 19 3/4 4"" "'''.,-, 956 '~6' "" 171/ {.~ 10 70 436 81)4 9~~ 1594 20 1/4 '444 818 99,) f . 'Î"" I,) ¡o~"' 20 , /" 451 8~..) 1008 1651 20 .3/4 4~~ fF" 1026 'Jr;,', II" _~o ¡COI.l '" 467 862 1043 1708 21 !I' 11·'" e" L 1060 1 ~~., L~ , ~ ./,) Q. '..' .. !.jl 21 1 I" 482 891 1078 1766 21 ~ ! A 410 907 !Ü~'7 1796 1"- .J I ~ . . DEFT 2000 5000 6000 10000 DEFT 20 ¡)(i 500i) 60UO 10~OO INCHES GALLONS GALLONS 6ALLONS GALLONS INCHES GALLONS GALLONS GALLGNB GALLONS 1..i. 498 921 1114 1825 "" 1/4 5i}6 735 1132 1854 ". "I" I'" 514 950 !l50 1884 ?') 3/4 r..-.,.-, 9,S6 1169 1914 ~~ ..! ~ ~~ ..)L~ ~~ 530 '780 a fn., 'n1 ,." 1 .. 0"::- 12;)5 ' .'.,~.. L...' !1ö/ , .OJ .;) lJf ;,j..::;: i',. / .::: 23 ¡/~ 546 1(110 1""" 2003 "., :;4 554 1026 I ..".~... :;:;::34 ....oJ ~...) ':''':'1'':: 2~ 562 1041 1260 20,)4 24 1/4 r.,.", 1056 Ins 2:)14 .J/!.: ..:~ 1/2 578 1072 î297 2125 24 3/4 58ì 1083 1"'7 2156 ~., ~"i 595 1103 133j 218b 25 1/4 603 1118 ''''r":,, 221& Lv ! ,)..¡,; "" . ." 611 1134 1372 2247 25 3/4 6 '" 1150 4 o::';=:' ..........r! ...J 11.. 17 J.,.,-, ~ ..1./1 26 627 1165 1410 2309 26 1/4 ,." 1180 14')0 2340 tJ')b ,~, ')' t ¡I"' o 644 1196 1448 2371 '" 3/4 ¡.,r:~ 1213 1467 2403 ~/: l' , i.Ö , ~ ...~,) ".., 661 1228 1486 2434 ..,~ 1/4 670 1243 1505 2465 .., LI "., 11':' 67S 1259 1525 2494 ?" .3/4 686 frl"T 1545 ·2530 1..1 ~/ .,,¡C "Q 694 1291 1564 2561 28 1/4 702 1307 1583 2593 I..w 28 1i2 710 f"'''~ 1603 2625 28 3í4 719 1340 1¡"':'~ "',1 t;~ J."::~";': w~,) i.C..J/ 29 727 1356 1642 2689 29 1/4 736 1370 1661 2721 29 1/2 744 1384 1681 2153 ~., 3/4 753 1398 1701 278b L7 30 762 1421 1720 2ô18 30 114 no 1437 1740 2850 30 1/2 778 1454 1760 2883 30 3/4 787 1471 1780 2916 31 795 1487 1800 2948 31 1/4 904 1503 1320 2980 ~1 lí2 812 1520 1840 3013 31 3i4 B'" 1537 1860 3047 ,). L1 .,,, 830 1553 1880 3079 ~" 1/4 839 1569 1900 3H: .J¿. ,)L ~:-, 4 :1'\ 847 1586 1~"{\ 3145 .,,, 3/4 ~;jb 1604 1941 3m ,;1.. 1./ ~ ,Lv .jL. 864 1620 1961 ':';! ') 1/4 873 1636 !981 ..,...,.. ~.j .;;.:" ~';'i;j ..~.j 112 881 1653 2001 3278 3;4 690 4 I'" 2i)22 ~"'!"" ,).;. lcl :. ,}...\.t .:. 34 898 1687 2042 3345 34 1/4 '1% 17rli! 2062 ;'v,lo 34 I·M 914 1721 2083 ~.1 f .-, 34 3/4 922 1733 -", , ,-, ~ 3446 l ¡ .J"l.i, ':'.L'...:''t .,- 930 1755 2124 34ì9 -:"r 1/4 94;) .-...,., 214.. 3512 .::OJ ...\~ 11,'1. .,~ f <." 949 1769 2165 ,roil. 35 3/4 "M" 18Ü6 2137 3581 .,}"J 11i. '.,~ 'W 1~ij 3ó 967 1823 2207 3614 36 1" 97', 184(~ 'ij-:-:, 36~7 ':'''.;.' 3é ! ,M 991 1857 2248 3661 36 .jf"+- 1003 1874 "il'\.I,__ ....,. : ../.:.. ~~C1 .2: t ~ C! :"'\Î 1015 1891 2289 3749 37 1/4 102') 1 "::;) 230'1 .}/OJ .1vw 1 --, 1024 l!n": 2330 3817 '7 3/4 i !.,~" I f"'.~ .. ~g52 v' . ,. 1V":: ¡"7 ...~ ........... 38 1034 19b(i 23n 38% 38 !r'4 1043 1';'77 239: 312u 38 1/2 1051 1"'~" 2414 3;;54 38 3/4 lObO ~('1: ¡4~5 ":"'~r-,'" 7'W ,;.go;) :9 106B 202? 24% 4023 39 1/4 f......,ì 2;)46 2477 4:)57 1'.)! i 39 j" 1086 206~ 2498 4(191 -~ . , . 1 (jç~ :,':81 251i p,.....! ./i. ,)7 j,l.\f ~L~¡J 40 1104 2098 2540 4160 40 114 1113 2115 256·:; 41i3 40 1/2 1121 2133 2581 4'7';'7 40 3/4 1130 2151 26(12 4261 ~~, 41 1138 2168 2622 42'14 41 1!4 ~IP 2125 2,)4.3 4 "-,,, ..... ,/ :.'.0-; 41 f !', 1156 2203 2665 4365 41 3/4 i 165 r¡r.,-" f :688 .. ..~..-: ..I:" 1..1...1 "f.:J 1'1 42 1173 2238 2709 4436 42 li4 1181 """':'r' 2730 4470 ~~.J.J 42 1/2 1189 ??~\ 2751 4505 j':' :r/~ ; : l' 2291 i..j!~ 45H ~~/v' .L .~11 't .F 1206 2308 2793 4""" 43 1/4 1')4c; ·¡":,,,-,r 2814 4609 ,j .JI.J aj,. ~';'':'.J 43 1'M 1224 2343 2B35 464'; 43 3/4 11',,,,-: 2361 :-,....'=7 4679 .Ii. . .....~. '.' "O.J, 44 1242 2378 287B 4713 44 1/4 1251 2393 2811 41"0 44 i ,.~ 1259 2413 2020 4783 44 3/4 :268 2431 2~'42 4813 :./1. J": 1276 2448 2963 4853 45 1.1.1t 1··)...·!- 2465 2'7'94 488ì J.~j., 45 i .''-' 1292 2483 301)5 4 ",'-'. ,~ 3/4 1301 2501 3(;27 49:18 111. ,~~ ,;:! 46 1309 2518 3048 4992 41. 1/4 1317 'i~":"!: 3069 5026 ~';_j..J 46 I P' 1325 'ïrC'~ 3090 5061 46 3/4 1333 2571 3112 :!ù97 1 i ~ <. J.J v' 47 1341 2588 3133 5131 47 1/4 1350 2605 3154 5161: '7 li2 1359 ..... ,,~ 3175 5201 47 3/4 13tH 2642 ":"t,,~ !:"''1,:,,: 't, <.ö<.,; .Jl1/ 48 1377 2659 3218 52ìl 48 1/4 1385 .-~ ' ... I 3139 5305 "'0/0 48 1/2 1393 2694 3261 5340 48 3/4 L!lf,~' 271: 328: 5376 .' . DEPT 2000 5i}OO 6000 loono DEPT 2Ci)O 500G 60J~ 1(;000 INCHES SALLOi{S GALLGNS GALLONS GALLONS T~!"'!lr~ GALLONS GALLCNS GALLDNS GALLm¡S ,~l.Htb 4'1 1410 2ì29 3304 rdt(; .~ I" 1418 :'\,~I ' .1....,.. 5444 Jt', ../-'; ..::.:arÖ '·.",/l .J..'.' .............. 49 I'~ 1426 2ì 64 3346 5m 49 . ,. 1434 .......~,.. ::.62 <;r,' ':; ..jl ~. :'Iei. "'.""...... S;.:¡ 1442 2799 3389 1"'1'"...... 5Ci î/4 ¡Wi 1816 341(1 5534 Jj~1 ~',.; I ,; .~. 1458 2834 3431 5619 50 Jí i 1466 :853 -!'-.... ' ' .j~J,) ~c,..'~ 51 1474 2870 3474 5689 51 li4 1483 2387 3493 :;¡~, \01........ =, t ,~ 1491 2904 3516 ·5ì58 51 3/4 1500 2'13.3 .3537 ~ '1.-.... . ~ I.. ji"7.J 52 150B 2939 3558 582ì ~., ii4 I'" , .1n::- I 3577 5861 ¡¡" ..1..."1' :.'f~!J C~ 1/2 1519 2974 3600 3896 52 3/4 1525 29"12 3622 ~Q\~ J.:. C~ 153Q 3009' 3643 5966 "'~ i/4 15~O ~I027 '7' I I~ bOO1 J.J ..I,) JOO., 53 ,~ 1550 3045 3686 6037 ~~ 314 1561 3063 3N9 6iŸ73 .1 (.. J.) 54 1571 3081 3730 61038 54 ii4 1579 30'18 3750 6141 54 I"" 1587 3115 3771 6175 54 3/4 lc,~r 3132 3792 6209 ';7.J ~" 1602 3149 3812 "'4~ 55 f" 16IO ....f I. ~8~~ b27b .J.J a,,¿ .f'l ,) bò ..~ .j.J rr , i·", 1618 3183 3854 6311 35 3/4 1626 32U ~Q~'= 6346 .¡.J ¡/... ~~IJ 56 1633 3218 3B9b 6330 56 1/4 1641 "':'j~r: 311ó b4}.~ ~'~.J.,J 56 1 '" 1648 '7'"C',.., 3931 6448 56 3/4 1656 3270 "'M!::,,\ 6483 I ~ 01 I..! I. "';1..J1 57 1663 3287 3979 6"'1~ 57 1/4 l' ~ t 3304 3'199 6551 ,;. J ~t1IL 57 !I~ 1678 .,...."f 4020 b"'nr "'"' 3/4 Ib85 3339 4042 6~19 ,.:. .J.JI.! .Je.J .JI 58 1612 "''''1:'' 4062 6633 58 il4 170Ü ":'.,..,.,. 4ÜB2 ~J. .JoI.JÖ ,J".\,':J oò_~ 58 1'" 170B 3390 4103 6ì20 58 3/4 1116 34)7 04',",'= ,ç'=t: I:' ~;.,¿..¡ I.J.J 59 1723 3424 4145 6788 "''' If 4 1730 3441 4165 6B21 .f1 59 "."'\ 1737 3458 4186 6a55 59 3/4 1744 3475 4?:':¡¡ 6890 .I.; ~ ~ow 60 1751 3492 4228 6923 60 1i4 1758 3509 4?JQ ,~t56 60 1/2 1764 3526 4269 !·sr;n 60') 3/4 !ì7l :::543 'l'"."','. "':,.-,1: ~~ 1'.: "';.1 61 177ì 3560 , ~ "'j 7058 ¡, 1/4 1786 35ì6 m,o 70'1 i ..)! '.... 'O 61 . .t ~~ 1794 ~rQ~ 4350 7124 61 7'" 18(:: 3611 :1:;'. 7153 ' , ..1..),";; ~I'I '1oJJ';' 62 1910 3627 4391 7·1 ~1 i 62 1/4 1815 .,.. .a: '1 H!1 7224 ,;ò'I.;, 62 j'" 1820 3660 4431 7257 62 :/4 1~:6 :675 IillC:: ~I"'~..- : ~ 1t) , ~ 1831 3694 4472 "":"'1~ 63 I" 1837 4326 5237 "'''''''1''' 'J,J 1·)1.,) .!"f /.;;"J:J 63 1/2 1843 3727 4512 7388 63 3/4 1850 3744 .~ C' ":""', .,.. ~.'" "'-.J.J":' i"t:'L 64 1856 376ú 4552 7454 64 1" 1862 ","".., 4571 7~8b ./~ ;jf Ie 64 112 1868 3793 4591 7" If' 64 3/4 1875 "PHI 4612 75~2 .J , .)",. v 65 1881 3826 4631 7584 65 IJ4 188b 3342 4'-' 7616 öJl 'c 112 la90 3858 4670 7649 65 3/4 1895 :'875 4690 ì662 b.J 66 1900 3891 4710 7714 66 114 19':'7 3707 4729 7776 cö , .1"1 1913 ~Q"" 4749 77""'! 66 3/4 t C''7';-¡ 3939 d-' -, 7810 I' , .),L~ . . 7...' ,/01" 67 1927 3955 4788 7841 67 114 1 ~",~ 397i 43~) 7 ¡2ì2 1'~'k 67 I'" 1937 3987 4826 7904 67 ~n 1943 400.3 4846 7937 IL ...1. 68 1949 4019 4865 7%8 68 l!4 1~~'" 4034 4834 7Y19 .. ,oJ") 68 1í2 1958 4050 4903 8030 6B 3J4 1963 4067 4n.,,, 8062 '~1.. 69 1968 4082 4'942 80'13 69 1/4 1'-'"~ 4097 4960 5123 1.' .j 69 1 ,., lQ77 4113 4979 8154 69 3/4 I~"'~ 4130 4999 8186 II. " , 11:JL 70 1987 4145 5017 8216 70 1 ill 1'792 ,41,~:j !:"'-¡"7r 8246 ..:',.J.J 70 1/2 1996 4176 5054 8277 70 3í4 2001 41 '7'1 ~O74 6308 7! 2005 4206 5092 8338 71 1/4 2009 4221 5110 8:·62 71 lJ2 2012 4236 5128 83"8 71 3i~ :016 4"<=" 5147 E427 'J, 72 2020 4267 5165 a't""' 72 1i4 ';:(\7.:1 4'7"1 5t83 :J~Ij~, 'I,;, ~Q. 72 !í2 2027 4296 5201 8518 ì2 3/4 2030 4312 c·-, I ,., 8542 ·.)L 11 2033 4326 5237 8q· 73 1/4 2i)3b 4340 5255 6606 .' 'J .J, I ... .J 1/2 2038 II":'t'J::' 5273 ~'~C' j.) 3í4 2:J41 4371 5291 8665 .,.J.J.J ...a.hJ 74 2(144' 4385 5309 8694 74 lí4 "",a, 43'11 r·.......,l an: "J~e .J,,:.o 74 \ ," 2048 4414 5344 875\ h ¡o ! .~ 2C50 4421 I:'~.' .-, 3181 II.} ~ "I~ 1.i·_~OL ~c 21j52 4443 5379 8809 75 ' I'~ 205.} 4457 5396 8837 I.J l.'! "10 îí2 1054 44/1 5413 8865 75 }¡ 4 4486 5430 88';'3 IJ . . DEPì 2000 SO,:)!) 6000 10000 DEPT 2000 500(; 6 0 :~F) i0GOO [ItCHES GALLONS GALLONS GAlLm~S GALLONS I"'~"'" GALLONS GALLCiiS GAlLOt-iS GALLO~~G 'i....r.'""~ ~!. 4500 544ì 8921 ìb 1/4 4514 5464 8)46 ! w .:t 1./2 4528 5481 3976 ìI:. ~ 'f. 4542 54'15 ';(:¡15 ,~I ~ 4556 5515 9032 '1~ , t.' 4569 t"t''''f ,"'I ,0, !:'.., JJ 1/0:, J..!....'¡ ì'j,.)1 ~~ 11: 4583 55~a 90£6 ..,.., ~ " ,'r,"~ 5565 .~ 113 II ,)J't '1,J.1 73 4610 5581 9140 ì8 11 j 41.'1, ~~,..~ ,"\:.' wLw ,ww 1, . .~ò 78 1 i"" 4637 5613 9192 is 5i4 .. .c"' 562;' ~'219 u. .,O,Jl 7'7 46ò4 5645 9245 71 114 467b 5660 '9270 79 1'" 46B9 5676 9296 71' 3/4 47C3 '::J..f"'.'1 "'-",;t I,; ,Jw1J 1~;;'.J "^ 4715 5708 9348 80 I" 4727 5723 Q~"'~ t:J'.J I ~ .·:"1·':; 80 1/2 4740 5739 9398 80 3/4 47~4 5755 9424 81 4766 5770 9449 81 1/4 4778 5784 9473 81 11'7 4790 5799 9497 81 3/4 4803 5815 f"\~":1"1 ., L "U.."- 82 4815 5829 9546 82 îi4 48n 5843 9567 82 1/2 4839 5857 ,",C'n'" 82 3/4 4851 S8ì2 ...... f'" 1,J1,) '1tu i 83 4863 5886 9640 83 1/4 .4874 5900 9662 83 I'"' 4886 5914 9685 83 3/4 4898 5928 "'1709 J,;;. 84 4909 5942 9ï31 84 1/4 4920 5955 9752 84 112 4931 59bS qJ74 84 3/4 494Z r/"p'''~ 9797 ,11 1:1 l. 85 4'153 5995 9alB a5 1/4 4963 6007 9839 as 1/2 4974 b020 9860 85 3/4 4985 6034 1aBl 86 4995 6046 9902 86 1/4 5005 6085 9922 B6 1/2 5015 6070 9942 86 3/4 1:'f'~r::' 6083 '1962 ,J.'L.J B7 5035 6095 9982 87 114 5044 610b 10000 87 1 ~ 5054 6118 10019 87 3/4 5064 6130 10039 ./;;. 38 5073 2501 10051 88 1/4 5(;31 6151 1(p)J4 8B 1/2 5090 6162 10092 BS 7;4 5100 61ì4 10110 ""~ : B? 5108 61B4 10127 B9 114 5116 6194 10145 89 I ," ~''''J: 6204 10159 B9 3/4 I:"~~ 6214 1('174 ' ,. ,J1i. , .JJ.-:...; 90 5141 6224 10192 9" 114 5148 6233 10207 ',' 90 , /"j 5156 6242 10222 90 7'4 51ó4 6251 11)237 :J, 91 5171 6260 10252 91 1/4 51n 6268 t···"""'- ~'JLc:: 91 ' I.~ 5184 6276 lü278 91 3/4 5192 6284 I .". ~:"', ~ ~l:. l'JL 71 ~" 5198 67f"1') 10304 ~" 1/4 ::i.1J.j 6293 lQ315 1'; ~7~ H '7L 112 5209 6305 10326 n" 3/4 5215 6313 10338 1:. 93 ~)'Ìr: 6319 1034-9 ,..,., lí4 52~>t ;, ,n 10357 1.,) , ,j ,-, 522~ I,:""n 10366 it: :~: ~ C"'~.~ I~~'" !O:ì5 to.' 1::.. 0"':\", ., 1 ~\ ..I,:,.~ "t C~~~· -;'4 5238 6340 tlJ393 94 llß 52~O .~.... ti,7r~ é·:;",j . J.JÖ: 94 1/2 5242 6346 103'12 i""! ~ 3/4 5245 6~49 10395 1"!- "1:; 5247 ''''C'1'''j 10402 b.J.J;;' 4+[ / . PERMIT CHECKLIST . Facillty l<u)/ CIlwrJb¡. ~ I~k:.. Lj Permit' / b ¡)O~" ~ , ~~I/ f?4IL6t2... ~ ('0ol"Oc» Thie aheakU.th prov1d-ed to enaáre that all necellary packet enalalurel were received and that the Permittee ha. obtained all neoe..ary equipment to impl...nt the tl~.t ph... ot aonitoring requirements. Please complete this form and return to KCHD in the self-addressed envelope provided within ~ days of receipt. Check: ~ No I / ¡ .-L' t/" -- / 27" _ _ D. /- _~fL P. / Signature ;HJ5 is A- ~~.; 6L- "",.~ vGH It-LiZ r().. A. The packet I received contained: -:IJJ ~. S~~~:l; 1) Cover Letter. Permit Checklist. Interim Permit, Phase I Interim Perml~~ Monitoring Requirements, Information Sheet (Agree.ent Between Owner anel'-' Operator). Chapter 15 (KCOC 'G-3941). Explanation of Substance Codes. Equipment Lists and Return Envelope. 2) Standard Inventory Control Monitoring Handbook 'UT-I0. with the fOllowing forms: a) "Inventory Recording Sheet" b) "Inventory Reconciliation Sheet with summary on reverse" c) "Trend Analysis Worksheet" 3)rHodified Inventory Control Monitoring Handbook 'UT-15 with form: "Quarterly Modified Inventory Control Sheet" with "Quarterly Summary on reverse" 4) An Action Chart for each inventory method (to post at facility) B. I have examined the information on my Interim 'Permit. Phase I Monitoring Requirements. and Information Sheet (Agreement between Owner and Operator). and find owner's name and address, facility name and address, operator's name and address. substance codes. and number of tanks to be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). C. [ have the following required equipment (as described in Starting") ~h sJ.,££r 1) Acceptable gauging instrument - se£ ¡;rr. . 2) "Striker plate(s)" in tank(s) - ~E£ JrTrA-L+£J) Si1~' 3) Water-finding paste - $€é. ~I~t) ShEc\- Handbooks under "Before I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). E. I have enclosed a copy of Calibration Charts for all tanks at this facility (if tanks are identical, one chart will suffice; lab~l chart(s) with corresponding tank numbers listed on permit). geE 1}--rr~\tæ:ÞSI €.£:r- As required on page 6 of Handbook 'UT-10. all meters at this facility have had calibration checks within the last 30 days and were calibrated by a registered device repairman 11 out of tolerance (all meter calibrations must be recorded'on "Meter Calibration Check Form" found in the Appendix of Handbook). G. Standard Inventory Control Monitoring (Handbook 'UT-I0) and Modified Inventory Control Monitoring (Handbook 'UT-15) were started at this facility in accordance with requirements described on interim permi onditions. Date Started -~-~ Date: 'I I I, it Ii ,1 '. . " .~ .,_ /P.If:J·~ -.-: ç.19::f-'-'-'^-I_ .'DJ'SÆL T~~_. l~ .,W-~ ¡-o T1I-£, r'L/kJ~' &I{.~ ,^WP~ I'3l2þuJ,.} ~~ 4/L - 5A;ru~~. 71 ~ ~ ~C-ê~(~~/C- ;11lS~tM!:.II~ . --- ,i - ! .--. J t" c .;:;,vsr~ .;' " / TD ?hI£ r4N1( . ¡ e:..<.f ~ ~. __, . û'" fA NI D/2.;. __LI (J. L.l Ii:) _ð 1")14 r9-ft.} ö ok ,,_~_.I~ ~____~~~v,f-LS, T~ 7'Jk. ,.,,£~ /.s 4- ~ /,5 . /1?~é.Ù ~ w ~ NO CA-L(,g~~t;IV ~" i e.J~~r _ hNþ'_~_Æy ~f¿.tJ(~,-~~ UtE._t;>t...cl. j~l.~t7!f?,;'lJfs._. nf€ VJU!....1Ø.Æ.,l~.- -- d.€: _../I"~_.._.~ Ç-. T~ G-l.. £ ,.. __ TJM T ~ tL ~ I X 91XID'. ' C.e.,\!-,~I G-l.#.A.J4-/.roN. _._ LV€.. ._~~ . ;')1/Ù)€ lIr'.Æ ~1~~9-+-J,. <!../~ k.1""1_L.1r.~,vEr- ._r~€ _~~ ,.-:, ~ . , ----.--. .._-._.~ -._,-~- 4 ) .~ \<.~~,~ j>(.~ L.tÞ-~ .ød,,~ ~_t/-2c --fh7. ..__ __ _ _ h ----_..--_._--- --- -. - -."..-"--.. --- --- -_. - - -.----- -- ., -...... , .' :...'..:,.... -.- +_._-- ------ ... .... - . -.. . -- - -. ---- --- - - - ,- - - - - --- 1~ -.·"'~i..~\:I~ ---.-.-..----."----- ._- --.----- . .;'\ ¡: . '---+-- ._---_. --:....---. '. - -- ,"_..- .. .-. - - ._-_.~- --- -- ----.------ .--..-- -- ,~ ' , ~ '. - - --.--- - - --- -------. ----,- -.-....- - . - --- --- ...---- .- --- - -._- - ---- --"- ---' - -.~ --.. ---.----..-... - - -- ---. -- - - .-- ._--------- -.-- --.--- . _" . _. n._ .--- - --- .. . ----.- -- ----_.__.._- ..--- ---- -~-_._-- ---- -- . -. --_..------ -..- ---_.... ...-.-- -..- -.-.-.- - "..- - -- -. -- _ _ _ ___n._ .' .". .-.,--..-.- .- - - - .-.- -. . ,~ . - :-:~---' -------,- - _._. .-- -. ..--- -- _.- __. u,__ n.__. _ _n.__ -0..__'" T~~k .~O~~itv Ch~~ta M~C~~th,. T~~k & St~~1~~_ , ' \ I Custclmer }'"Iame: ,~ COUNTY OF KERN - GARAGE ~ HORI-ZON-TAL-T~NK--<REG-)-108-·IN..-WIDE-*_120, INr--H-IGII, X~'+0 I~eNG '_____.__ _.._____,____ ,.., ' ID' ,,:::'ii'::,i:::'':':,,:::' .-.-. --_.. ----" ._----- ....'...'..:.........;:.....;..:.,.. ":":'::-::"-:-'':".::-::-::'":-'::::: DE·PTH (IN.) ··VOL-liME.'· '(SnL~:' r .... 1-.,.,.000 11-2.2 L ,,": "..,', ' 2.000 224.42 ' 3. 000.336.62 '1.000 '{1'18.83' 5..·000 ,56-1.,..,-04 &....000 6?~5 -7-.-000 -~7 a~..,45 8.000 8~~rb6 .s...00Ø --1·009."&7 10.-000 'l-1-ae.øa 11....000 1234.. 29 lê-r-00Ø ~346-.'t'3 1-3...000--- ----1458....+0- 14...000 - -1570..-9-1 15.-000 , ----~..16a~?:" ' 16.-00.ø 1795.32 " 17.000 190+.-5J,« , 18. øøø 20-19. 74 ' ," ' 19..-000------- -a 13-~ 20...000-,.---------- ---- ---2244...46 21,-000--------..---- ,-----23$.36 22. 000 ----~468..-57 -i.U..-000----------..-.--;--a5a0~ 24....000 --------26'32. 9'3 --------2S0000-------m - ----·--2805. 19 ---..--- e6.-000291-7'õ-40 2-7-.--000 3029;, G L ·28-.-000 -3-1..41 . 8íZ -es.-000-- 3254.03 aø~0ø0 336G.23 31-. 000---..-- --:-·------34180--44 32.000 35'30.65 33..-000 3=702. 86 34.,..000 38-1-So 06 35.-000 39a-7.--a-7" 36-.-000 -----40390-48 37-.· 000--------4·151-. 69 3B.000 4266.'30 J'3. 000 --43+6.-40-- , '.0.000 ---A488-. 31 :------4-1-.·000----··-·--·---· ------ 4600.-52-··-------·-- '12.-.000--------..---- ---4712.-7-3- ----- ·------43. 000---------------·--·--- - 4824.-94~--· ------------------------ {¡ 4. 000 ------------ ---- - 4937..-14 -·----45.000------·--·---··-·--·--·-·5049.·35 ___h_____ 46.000------·..··-- ., ,....- .---. 5161-.56 ,-------41-.. 000---------- ..,.", 5273.7-7-- {IS.-000------------· ,.... ----5385. 97 4'3.000 --------·..--,-----5498.48--..--· 50. 000--..-----...·--·---..- 5610.-39-----.. ---,---51. 000 -···-...---·-·-....·-....,5722. 60---,·--..--·-·---· "------52.000-..-- ,- ,----5834..91--- ----------53.000-------·-- ,·5947.01--·--,-- ---54.000--------- 6059.-aa __"m 55. 000 ' ' 6171.-43··...---.. 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' 73.,,000____ ------.------,----813.1.....J..2- 7A.0fZ1l71 8311113f' 75__00~--.-~_~_~----,.ß4.1,5..;SR",.,,"",.,.',. 76.-000 85~'3 .,", 7-7-.J1J00-- __h_____ ,-,-.--8640. øø 78...000.----- ---- -.8752...a 1 _____7-3. 000________ ---- ---8864.42 80.-000 -- --------.-. --.-8976--62 81...000.--:--. -----.-- ,-----9088-83 8g..-000 ---_920.1 _ 04 8Z....0ØØ ------9313...25 --~-84__000 ·--94a5.-45 , --o..--·85..0Ø0--------'3537-.-€.6 86-000 9649.87 - - ,-, --------.. a:z. øØø --9.762.}Z¡8 , ,,» ., --_.------ 88..-000 9874_~9·· ... ---" -._-~- .--.--- . 8-'3.-000 ----·--9@ßé../t-'i. "._;.<". __._.___n__._.___ 90..-000· -.----A·----1-009a~·:7ø . 'U_ - - - - - ----- 91...ø00--.-.-.--1-0a141 ---- ---.---- '3@,.-0Ø0 -1-0323.12 , - ,-- ,..--------- 93..-000----'-------i-0435~.~2 i/ ,-., -- -' - 94.-000- 1-054 7~53 " 'u"___ ---------.:..gS.-000-----------106W.7 (¡ '36-.-000-------..---10771 ~> 95 .'---- ------13-7. 000--,------ ---------- - "'.-.. -- -- 10884-....16 ".'.','.',. ...',,',', '---·---------~--98..00Ø --.-----'---- -'-10996T36 -----.--..--- 'J9;,-ØØ0------~----"..-- H:-1-0ß.;¡7..".,..""."""., --------- _ 100-;.-000--H-220.78 ----------1-0b-000 -- -11332-.~9-"'~- -------------102.12100----- _ 11445. 1 'J ' --.. ------ ----103. 12100 -- ,. 11§67-.-'~0·,~-"----- ------ 11214.. 01210----- " -11669.-&1 -·--·--·-11215. 000---..-- ,_. 1178h-8a--~·---- , -------106. 01210 ---- 11894.-03-'--- --- ------------107. 01210--- 121211216...23---- .-,... ---' ---- ------11218. 000~-------12118;,-44- ----- - ' ..·-------,..---109. ØØ0-------..~ 12230.65--" -..------..1--10;, Ø0Ø ,-- 12342.86-..------- - -----·---111. øøø ---, 12455.ø6--~-- - --..--.-------",-----..------- ·----112.1210121--,..- 12567.-27·---------- ---- -113. 000 12679.48'--- -- -..---------- ,----114.12100 12791.-69---- . ----....------, -115.000 12903.90 116.000 13Ø16~10 117.0Ø0 l~i~A.~1 ----_.. --.....,..-.. --,. ....__..._-- ---_.-----_..- .... -----..--- '-'-'-"---"'"." ·_P.'· ..-- ." --..---. ..-.- .-- ..._-~---_... _.__ n.......__ ~_u. - -..---.-.----- ~_ ._" ". _n __. ._.--~--.._.._-- --------.- .------- -.- -~_._._---_. ..----..----.-.-.--- ----_.. .- .----- _.-.~-- .'. -_.-._-_._- -----.. -._~_."'-' .---.---- .-_._- --.- --- ._·___h. __,__ . ..-.---"-'" . PERMIT CHECKLIST . . /. FacUlty I«~ CÐ~ ~ r4f0'r=... Ii.. f: Permit I I (Ø ð)o;:¡..6 c.. , GM~"¡ ðCJtLG/2- Ãt-I{) ~~R..~ (¿uoJ ø ~ 0 J Thil cheoklilt il provided to enlure that all neoellary packet enololurel werr received and that the Permittee has obtained all neoe..ery equipment to lapl.a.nt th. first ph... of aonitoring requirements. -.> Please complete this form and return to KCHD in the selt-addressed envelope provide~ ~~thin ~ days of receipt. ..,.-,I.s t S It iJotl ht~J.«L t' ~~, £<. fM£(, 5'¡-~ II~IC. . ~ '~H.J/ ;, j) ALJ,I... .,.mJt( , ø. ~~( :IN p~ - æ~~~rJ,.~' The packet I received contained: J~ 1) Cover Letter, Permit Checklist, Interi~Permit, Phase I Interim Permit Monitoring Requirements, Information Sheet (Agreeaent Between Owner and Operator), Chapter 15 (KCOC '0-3941), Explanation of Substance Codes, Equipment Lists and Return Envelope. 2); Standard Inventory Control Monitoring Handbook 'UT-10. with the following forms: a) "Inventory Recording Sheet" b) "Inventory Reconciliation Sheet with summary on reverse" c) "Trend Analysis Worksheet" 3) Modified Inventory Control Monitoring Handbook 'UT-15 with for..: "Quarterly Modified Inventory Control Sheet" with "Quarterly Summary on reverse" 4) An Action Chart for each inventory method (to post at facility) Check: !!!. No / A. - - / - - /' - / 7= B. C. ..~ . ' - - '/- D. - - /- E. --AIL F. L_ G. Signature I have examined the information on my Interim Permit, Phase I Monitoring Requirements, and Information Sheet (Agreement between Owner and Operator), and find owner's name and address, facility name and address, operator's nallle and address, substance codes, and number of tanks to be accurately listed (it "no" is checked, note appropriate corrections on the back side of this sheet). I have the following required equipment (as described in Handbooks under "Before Starting") . 1) Acceptable gauging instrument ...>é& ~Jf:E:!> S' j -¡;;,I¿T 2) "Striker plate(s)" in tank(s)-~ ~'ì:) SHF-€-T! 3) Water-finding paste _s£e. ~14<..~ :>~T I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is cheeked, attach a copy of agreement between owner and operator). I have enclosed a copy of Calibration Charts for ~ tanks at this facility (if tanks are identical, one chart will suffice: label chart(s) with corresponding tank numbers listed on permit). J>£e H'1"'T~f+,(¿.'b 5I~;: As' required on page 6 of Handbook #UT-10, all meters at this facility have had calibration checks within the last 30 days ~ were calibrated by a registered device repairman l! out of tolerance (all meter calibrations .ust be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). Standard Inventory Control Monitoring (Handbook IUT-10) and Modified Inventory Control Monitoring (Handbook 'UT-15) were started at this facility in accordance with requirements described on interim p~ conditions. Date Started -f:) \ , ~' Date: \[ !; I, Ii I! . . '. ;:lO,. dd1-O c:;...4--£..'-o.u ~4! L r ~ h:. ' S Uo.S£ Ò 70 ~ ~ S ~Ù f5.n.,£iU-e.....N'-'I ~I::~ GU>D.ÐZ. &~~ ~ ! L_~¡O/L'I Sku:!- k..o~, ¿/ 4& ~ ~/c., AfU€&A..Iff!./M &() 'CJ£. ,i;N S~Æ J) ,/ ~¿." ~ ,r~f-r, T7Ié::. h1 ~ "s /'(1 y ~ u...L( C. 5 ¿ AI , 042. "." ()JI£ L ./ ;..hs /LS£ )" ,;p"JlJ 77I-ä. F~ _'.02H4k&b __~, ,H: _;;J..ac ~AJ.s ZJ'¡'~~, 77~ 1'.(' __. ; o._:~ß'4-Lr~I2A-.J..,~__~~T:~J) Æy '~/~l~'-, ~J ß~ ¡ ',' ." . -, "", , , --. ,flIk."..': w.e_~~é;~~€____/,t. 't;.4L' _ ~_'6-V4-t-_.T~1:c. ~.4-T __.______ ~¿_··:"~3,( / y~ " X /ð I ? N d. _We! ~cr;, ~d£l~b _ , _.__n__" L.Lt.).î:.j:,~.....~A-.À-n_ Ato'b€,L. b-3_ ~~ _ Lù~lndl, ~s A-Tr,ok~E~ ~..; : " ._- -- . --- _.- ----- ..- ..----- -- ._-" --.-- Srf')..1. \-:.EI1. Pi~ .-. - --- . -- ----- - -.- ~ ~t:£d.£~ . . -... - - ~ "·.2.4~~7· "- .-- - . - - -- - ----- --- -- ¡ ¡- :i , t'-' -- . - -. -. I --------- ------.." . -- _._--- ---- --.-... - -- ,.- --- '-'---- . --. -, --- --.-- .·-·P--- .:-... ;.!..¡ - -- ...- ".- _. -. .._.- -. . - .-. .-. -. "- -------------- ---- -_. -_.- _.---- - - -.-.. -- + . ~._-. ~.'. . " ,; 1 __. .. ________-~ .,..___._ ___ ___ on_ __ ..--- _.- -~ - ---_._-~. ~,---- --- -- ------.---- -- ~----- - -------- "..- - ,. - - - .' --- - -- - .-- . ..- - ...- ----.--.- -".---.- .--.---- ---- -- - .. ._ .h._ I . - -- -- - - -- _. ------ - - ----- ---. - _._- . ------.----- '. \..../ . K~~~1-j ç.A.-~ T~\-<" ¡j; Model D,,3 Tanks 15,000,20,000* Calibrations For Level Tanks Tank size, ca city Tank size. capacity Tank size, cap Ily Tank size. capacity '- Dipstick 15,000 20.000 Dipstick 15.000 20.000 Dipstick 15.000 20,000 Dipstick 15.000 20,000 '. _.# , '~;'>f«;' , '12" 6' 10 33" 3235 4313 65 V2 " 8487 11188 93- 12701 16732 1 16 ,; 23 33'/2 330B 4409 60' B5/0 11296 93V2 12766 16819 , '12" 28 40 34 3381 4505 ob'/2 ¡30~3 11405 94" 12831 16905 2" 44" 62 34 '/2 " 3455 4602 6ì" 8736 11514 94V2 128% 16990 2'/2 " 61 86 35 3529 4699 67 V2- 8819 11622 95' 12958 17075 3" 31 113 35'/2" 3604 4797 68" 8902 11730 95V2- 13021 1 '715g- 3V2" ,103 " 143 36 3679 4896 68'12 8985 11839 96 13084 17242 4" '. 126, 176 36'12 3754 4995 69 9067 , 11947 96- 1314-5 17324 4 '/2" 152' 210 37" 3830 5094 69 V2 " 9149 12054 97" 13206 174Ò6" 5 ' 1 247 37'12 3906 5194 70 9231 12162 97 V2" 13267 17486 5'/2 " 2 286 38" 3983 5294 70'/2" 9313 12269 98- 13326 17566 ' 6 Z 3~b 38 '12 " 4059 5395 71""- ~395 123/7 98V2" 13385 17"645 6'/2 " 268 ' 369 39- 4137 5496 71 V2- 9477 12484 99" 13443 1 7723 7" 300 413 39'/2 " 4214 5598 72'" 9558 12590 99'/2 " 13501 1 7800 7'/2 " 334, 459 40- 4292 5700 72'/~ 9640 12697 100" 13558 17877- 8" 369 ' 507 40 '/2 " 4370 5802 73" 9721 12803 100'/2" 13614 17952- 8'/2" 406 .. ~. 556 41" 4448 5905 73 V2 " 9802 12909 101 " 13669 18Õ2i5- 9 443 bUr 41'/2 " 4527 6008 74" 9882 13015 1u1 '/2 13723 18 fõo 9'/2 " : <482'" 659 42- 4606 6111 74'/2" 9963 13120 102- 13777 18172- 10" . 522. 113 42V2 " 4685 6215 75" 1 0043 ' 13226 102'/2 13830 18243 10'/2" 563 70B 43- 4764 6319 75'/2" 10123 13330 103 ;, 13882 18314 11" 605 B~4 43 V2 " , 4844 6424 76" 10202 13435 103'/2 13933 18383 11'h" , 648 882 44- 4924 6528 76 V2 - , 1 0282 13539 104- 13984 18451 12" 692 942 44 V2 " 5004 6633 77" 10361 13643 104'/2- 14033 18518 12'h" . 737 1002 45 5085 6739 77'/2- 10440 13747 105 14082 18584 13" 783 1064 45 '/2 " 5166 6844 78" 10518 13850 1 05 '/2 - 14130 18649 13'h" 830 1127 46" 5246 6950 78 '/2- 10597 1 3953 106- 14176 18713 14" 878 1191 46V2" 5328 7056 79" 10675 14056 106'/2- 14222 I 18775 14'12" 927 1256 47" 5409 7163 79 '/2 " 10752 14158 107" ' 14267 18836- 15" 976 1323 4 7'/2 " 5490 7269 80" 10830 14259 107'12 14311 18396 15'h" 1027 1390 48" 5572 7376 80'/2 - 10907 14361 108" ' 14354 13955 16" 1078 1459 48 '/2 " 5654 7483 81" 10984 14462 108'/2" 14~95 19012 16'12 " 1131 1529 49" 5736 7591 81'/2 " 11060 14562 109- ' 14436 ---1.~06~_, 17" 1184 1600 49'/2" 5818 7698 82" 11136 14662 109'/2 " 14476 1912:3 17'h" 1238 1672 50" 5901 7806 82 '/2 " 11212 14762 110" 14514 19176 18" 1292 1744 50 '/2 " 5983 7914 83" 11287 14861 110'/2 " 145~L ~92P_ 18'/2 " 1348 1818 51" 6066 8022 83 '/2 " 11 362 14960 111 " 14587 19277 19" 1404 51'12 " 6148 8130 84 11436 1 50_58 111'12" 1 4.622 . 19326 Hj~j 19'/2 " 1461 1969 52" 6231 8238 84 '/2 " 11510 15156 112" 14656 19373 20' 1519 2045 52 '/2 " 6314 8347 8S--- 11 58.4 15253 112'/2 " 146813 19418 20'/1" 1577 2123 53" 6397 8456 85 '/2 " 11657 1 5350 113" , 14719 ¡C;'l!(j 1 21" 1636 2201 53'/2" 6481 8564 8.6" 11 730 15446 113'/2" 14748 , 19503 ---'-"'---- 21 '/2" 1696 2281 54" 6564 8673 86'/2" 1jß.03 1S542 114" 14776 19~;L 22" 1756 2361 54 '/2 " 6647 8782 87" 11875 15637 114'/2" 14803 19581 22'/2 " 1817 2442 55" 6731 8891 8.7Y2 " 11946 15732 115" . 14828 19§}lC 23" 1879 2524 55'/2" 6814 9000 8B" 12017 15826 115'/1" 14851 19650 23'h" 1942 2607 56" 6898 9110 edV2" 12088 15919 116" 14872 n1i6'är 24" 2005 2690 56 '/2 " 6982 9219 89" 12158 16012 116'/1" 14891 19710 24'h" 2068 ' 2774 57" 7065 9328 89'/2" 12228 16104 117" 14909 19736 25' 1 2B~~ 51'12" 7149 9438 90" _~J-297 16196 117'/1" 14923 19759 25'/2 1 2945 58" 7233 9547 90'12" 12~65 16~~Z-- 118'12 " 149.~5 19.779 26" '2 3032- -Š8V;-'; 7317 9657 91';, 12434 16377 118 V2 =_ ~44 19794 26'h 3 3119 59" 7400 . 9766 91'12 " 1 2501 16467 119" 14947 h1.9804- 27" 2396 320"1 59 V2 " 7484 9876 92" 12568 16556 119'/2" 19807 27'/2 " 2463; 3296 60" 7568 9985 92 V2 " <~12635. 16644 'r·o ~... "; ,..:. , I 28" 2531 3385 60V2 Ib~l 1009~ 28'h" ,2599 . 3475 61" 7735 10204 29- 2668 ' 3566 61'/2 " 7819 10314 . 29'12" 2737 3657 62" 7903 10423 30- 2807 3749 62 Y2 " 7986 1 0532 30 '/2 - 2877' ' 3841 63" 8070 10642 31- 2948·' 3934 63 '/2 " 8153 10751 31'/2 3019 ' 4028 64" 8237 10860 32" 309Cl 4122 64V2" 8320 10970 32V2 " . , l '',¡ 4217 65" ,', ,AA().ð.'.. .. 1107Ç ·Calibratians for D-3 tanks are for measurements taken between center of tank an::! either end ribs. 1700 Flower Street Bakersfield. California 93305·4196 Telephone (805) 861·3621 . . I\ERN COUNTY HEALTH DEPARTI'V,_,-.JT AIR POLLUTION CONTROL DISTRICT LEON M HEBERTSON, M,D. Director of Public Health Air Pollution Control Officer December ;15, 1987 Larry Johnican General Services Garage Division County of Kern 1415 Truxtun Avenue Bakersfield, CA 93301 RE: Reportable Variations/Loss. Tank #1 - Permit #1G0026C Dear Mr. Johnican: This is to inform you that unleaded tank #1. at the above facility is pel'iodic:111y exceeding the reportab.le limits as described in Handbook #IJT-10. "Standard Invento~y Control Monitoring." Dut'ing October and November of this year, the notification reports indicate this tank exceeded the weekly variation limits twice and the monthly limit once. Under the monitoring requirements for this facility's opet'ating permit, you are requit'ed to conduct a complete variation/loss investigation. Although your department did submit investigation reports, these investigations were not completed with clear or satisfactory explanations for the variations, per page 16 of I1.T. 10. You must complete the investigation and submit the completed report by December 30, 1987, Should you have any questions t'egat'ding this matter, please call me immediately <It (805) 861-3636. Sincerely. ð¡& .¿:~ B ill Sell e i'd e Environmental Health Specialist Hazardous Materials Management Program BS/gb Per.i t, l/r;{}ßfft~G, G- . Environ.en #6 UNDERGROUND '. .<e ~ ~ ~ - I nspec n-r¡ - /h.IJr: HAZARDOUS SUBSTANCE STORAGE FACILITY ... /.' I NSPECTI ON REPORT ... PaoiUty Nan -Ætf (;,UÞl~ G1;j,i/;':' , ".,;';:":" Address I+/~ 7i'vx1u~ tJ,v-,: ~ I.{d f7eli :;::::::",,-[ .. ~::,::·;;l.~'X"'~::':~":;¡f::::::""·:-·" - .. .::::.2.~..,,, "'.!.-. .. · vi '~;bb!io~t;1~f~~~7iØ}ËE=~:;ij~~.%;~ ITEM " . .,., ' VIOLATIONS NOTED ' .. I ¡1.1J")c.f;rihly ppYJU¡1- "of ¡05fdas Y1¿)ì~ed. A. Standard Inventory Control Monitorin. I 'v'" :'.... ' V ,I Ó' Modifisd Inventory Control Monitoring ", I d. In-Tank Leval SenBing Device - I I 1 I f. Vadose Zone Monitorinc I __________________________1 , I 2. Secondary Contain.ent Monitorinc: I I I I q I I " c. Vault . I" ,; , . --------------------------------------______I____~_-----______________________________________________________________________________ I ' o Piping Monitoring : ' a. Pre88urized I I <=" Suction I I . --~~-~:::~~~-------------------------____--_I______----__~______________________________________________________---------------------- , I ~. Overfill Protection : ----------------------------------------______1______-__________________________________________________________________________________ . I :I, Tightne88 Testing ,I , , ,----------------------------------------______1_____-___________________________________________________________________________________ I I I .----------------------------------------______1_____-___________________________________________________________________________________ 1 . 7. Closure/Abandon.ent I' " ,----~-~-~~~-----~-~-----------------~--------¡~-~~---~-~-----~~~-------------~~------------------------------------------------ 8, Unauthorized Releaae ,..,'". I ':'_":," . I ._----------------------------------~~-~~____~_I_____-___________________________________________________________________________________ I O Maintenance, General Safety and I ' Operat1n¡r Condition of Pacility I , ' I .----------------------------------------______1_____-_____________________~________~____________________________________________________ a. Intercepting and Direotinc Syste. o Pri.ary Containaent Monitoring: a. Groundwater Monitorinc .{: ", - -------------------- a, Liner b. Double-Walled'Tank 8. New Construction/Modification ............ Reinspection scheduled? -I- No ðili 4~ Yes ~., Approxiaate Reinspection Date ."", "",,,,"',4 % ,p~ fb.,r ;;~: ./ , 'v '-' , INSPECTOR: (Pora IHHMP-170) 1700 Flower Street Bakersfield, California 93305 Telephone (805) 861-3636 _RN COUNTY HEALTH DEPARTM~. HEALTH OFFICER Leon M Hebertson, M.D. ENVIRONMENTAL HEALTH DIVISION INTERIM PERMIT TO OPERATE: DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard PERMIT#160026C <,' ISSUED: EXPIRES: APRIL 1, 1987 APRIL 1, 1990 NUMBER OF TANKS= 5 ---------------------------------------------------------------------- FACILITV: KERN COUNT V GARAGE 1415 TRUXTUN AVENUE BAKERSFIELD, CA OWNER: COUNTV OF KERN 1415 TRUXTUN AVENUE BAKERSFIELD, CA 93301 ---------------------------------------------------------------------- !AriK_! 1,2,4 3 5 !º-!11!!_Xߧ.1 26 26 3 §'!!!!§'IAri£!_£Q.Q! MVF 3 WO 3 MVF 3 fß!§.§.!!Rl¡!Q_flfl!!Ql NO NO NO NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY ~HE PERMITTING AUTHORITV MUST BE MET DURING THE TERM OF THIS PERMIT NON-TRANSFERABLE * * * DATE' PERMIT MAILED': ì>\/l.R 3 1.\987. ,DATE PERUIT CHECK LIST RETURNED: ' ¡ ;.;, POST ON PREMISES K~rn \~O~jilty He.jlCì C~¡,k¡(L:nefìt D1VISion of Environmental Heal'" 1700 ;:'lo....oet Street, Bðkersfie1..-A Appli~ti'~~ ;~te--'5;/~":'~~)~' .' '". ' APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZÞ-ROOUS SUBSTANCES STORPGE FACILITY ~ of Appl ication (check): o New Facil i tyO t-bdification ~ 91305 A. of FadIi ty ~ E:dstirg Facili ty" DTransfer _ of Chmership / ;':~-a I «û')- ~~I- d-.q /I Ðnergency 24-Hour Contact (name, area code, ¡:tlone): ~ys A.,t4-r€.¡e.~"~jóVI V\', CIhr1 Nlghts .s1}W,"~ Facility Name Ve.,¡e.1Ù Cóù-rDit G04Y~( No. of ,Tanks *' h Type of BusineSs' (check) : sol1ne S tlon C]Other (describe) :;< Is Tank(s) Located on an Agricultural Farm? Dyes (B-nö ,', ~Y::,."¡< Is Tank(s) Used primarily for ~ricultural Pur ¡*7;S? DYes ~"',." ,'" I ~',.-..J Facility Address '",5 - u. 4'kr:v ~ t Nearest Cross St. f.- ... '::;Yf T R SEC (Rura Locatlons 011y) ().oJner C,'J..t.UAi... .. ~~ , Contact Person Mdress -/ Ifl f:::.--~i-<r'~ J4-v.Q AJ¢k~1('~Zip 9,i-:YY( TeleI¥1one :21ó1... :l(~ II Operator ÀA-~fL~;()hl"~(A4.v'1 . Contact Person /.... M.~~ ~~~V\~G~ Address ___ ___ Zlp Telephone \Y¡..:. - _ _ It B. Water to Facility Provided by lÁ-V\J(I/1ð4.,ì IÙ Depth to Grourdwater lLvt/,(¡.WUì/Ù Soil Characteristics at Facility . Basis for Soil Type and Groundwater Depth Detenninations , c. Contractor Address proposed Starting Date Worker's Compensation Certification t .,v/A CA Contractor's License No. Zip Telephone proposed Completion Date " Insurer D. If This Permit I s For Modification Of An Existing Facility, Briefly Describe Modifications prop:> sed ' E. Tank (s) Store (check all that apply) : 5~f; A-ff A-é; ~eof Tank I Waste product Motor Vehicle Unleaded Regular Premium Diesel Waste -- Fuel Oil I D 0 7 ~ 0 0 0 0 -:2._ D D m- ~ 0 0 0 0' -~- 0 0 0 0 B 0 ~ ~ -,1:-- 0 0 0 0 0 ~ C1 Cl C Çl t:J t:1 fue rIt; a F. cn lcãl Composition of Materials Stored (not necessary for motor vehicle Tank t Chemical Stored (non-commercial name) CAS t (if known) Chemical previousl y Stored (if different) G. Transfer of awñership Da t~.'òf ~>ansfer Previous Facility Name I, 1//1 Previous Owner accept fully all obligations of Permit NO. issued to I understaoo that the Permitting Authority may review anà moài fy 'or terminate the transfer of the Permit to Operate this œderground storage facility up:>n receiving this completed form. This form has bee~pleted under penalty of true and corr t~ { - s~re-' xØU-tÞf' '~, J '._ ,/~J i perj ury and to the best of my knowledge is Title þeet- Mo4>1''15 ",,_Date <3/ /;1./ ~S- F3Cil i ty Name t\E~;JL' LÞ;Û-vL~ ~4'¿¥:!j e.., PerInlt No. TANK I·. .. (~ILL ~T SEPARATE FŒM F.EACH TANK) ------ -- ---- FOR EACH SECTION, CHECK ALL APPROPRIATE BOXES -- H. 1. Tank is: DVaulted ~n-Vaulted DDouble-Wall rn-si~le-wall 2. Tank ~terial ŒJ'Carbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-flad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 AILIt1inLlt1 0 Bro~z~\ ,º~koown o Other (describe) ,"\,' , 3. Primary Containment \ \ --.., '¡II,;,..' rate Installed 'Ibickness (Inches) Capaci ty (Gallons) \\.)../ Manufacturer 1 ~ S-- ~ LA. I^ k~A~"'Î ) D¡ ò!JeJ 3~ \ IIdv4v/t'.Æ Tk. MJ4.V7r·' 4. Tank Se onda ry Conta ument o Doubl e-Wa 11-0 Synthetic Liner DLined Vault DNone ~known OOther (describe): Manufacturer: DMaterial Thickness (Inches) 5. Tank Interior Lining -- -crRubber 0 lùkyd OEpoxy OPhenolic DGlass OClay OU1lined ~0W1 [JOther (describe): ' 6. Tank Corrosion Protection ~~vanized I:lFiberglass-Clad DPolyethylene Wrap DVinyl Wrappi~ urrar or Asphalt DUnknown DNone DOther (describe): . Cathodic Protection: DNone DImpressed CUrrent System [J Sacrificial Anode System Describe System r. Equipnent: 7. Leak Detection, Monitoring, and Interception . a. Tank: OVisual (vaulted tanks only) Q"Groundwater MonitorirJ} well (s) o Vadose Zone Monitoring Well(s) 0 lJ-'I'ube Without Liner DU-Tube with Compatible Liner Directi~ Flow to MonitorirJ} welles)· D Vapor Detector· 0 Liquid Level Sensor 0 Condoctivitï Sensor· D Pressure Sensor in Armular Space of Double Wall Tank' g Lj,Quid Retrieval r. Inspection Fran U-Tube, Moni toriD:J Well or Annular Space ~ily Ga~iD:J &. IlWentory Reconciliation 0 Periodic Tightness TestiD:J o None 0 unknown 0 Other - b. Pipi~: Flow-RestrictiD:J Leak Detector(s) for pressurized Piping- o Moni toring SlIDp with Raceway D Sealed Concrete Racew:ay o fjt-lf-CUt Canpatible Pipe Raceway 0 Synthetic Liner Raceway 0 None rB'fJnkno\liil1 0 other *Descr ibe Make r. ,Model: - 8. Tank Ti~htness ' Has ThlS Tank Been Tightness Tested? DYes Date of Last Tightness Test Test Name 9. Tank Repair ....../' Tank Repai red? 0 Yes ~ OUnknown Date(s) of Repair(s) Describe Repairs /9 7~-- \/~LvJ i¿o~c.:.-~ ~ vAL) :::t;., ~/(ui 10. ov~ Protection· , , c--...( , ( rator Fills, Controls, r. Visually Monitors Level OTape Float Gauge DFloat Vent Valves 0 Auto Shut- Off Controls DCapacitance Sensor OSealed Fill Box o None Dlk1known OOther: List Make , Model Por Above Devices o No œt""'tWmOW1 Results of Test Testi~ Canpany 11. Piping __~ a. Underground PipiD;): W'Yes ONo Dunknown Material Thickness (inches]" ~iameter . Manufacturer í 14 ~~ [JPressure IIt§Jctl<;m Gravity Approximate t.eB3th 0 P pe RLn/1) -kd b. Underground Pipil'¥1 Corrosion Protection : () , OGalvanized []Fiberglass-Clad DImpr-essed CUrrent DSacrificial Anode gPgJ.yethylene Wrap OElectrical Isolation Dvinyl Wrap OTar or Asphalt ~nknown DNone DOther (describe): ' c. Underground PipifY1, Secondary Containnent: .. /' DDouble-Wall DSynthetic Liner System ~ne DUnknown [JOther (describe): r'acÜlC.Y N~ F\c...UU LÞ;ù-iu~1 \:;;:rfh¿.^j¿· _ Permit. No. I TANK! J- (FILL OUT SEPARATE FORM ~æ TANK) FOR EACH SEC1'ION, CHECK ALL APPROPRIATE BOXES -- H. 1. Tank is: 0 vaul ted ~n-Vaul ted OD::>uble-Wall rns1ngle-wall 2. Tank Material· m-cârbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 FiberglassrClad Steel o Fiberglass-R~dnforced Plastic 0 Concrete 0 AlLmim.ll1 0 Bronze n/UnkJiOwn OOther (descnbe) (, ,_,I 1"",":,\ 3. ~~': ~s~~~~rure~iCkneSS (Inches) Capac! ty (Gallons¡i\ \0.i'r>~Ufacturer I 'i 5:7 4 /Þ k~ "'ì . ¡ D, ò1JD ..':1 !'1Lt' y 1Id,,41f'¿ Tk. /11 rI-"'rild- 4. ~ Secondary Contall'ment ' I o Doub le-Wa 1 1 U Synthetic Liner 0 Lined Vaul t 0 None ~known [JOther (describe): Manufacturer: DM3terial Thickness (Inches) Capacity (Gals.) 5. Tank Interior Lining -- -rfRubber OAlkyd OEµ>xy OPhenolic OGlass DClay OU1lined VJthknOW1 o Other (describe): 6. Tank Corrosion Protection g~vanized DFiberglass-Clad DPolyethylene Wrap DVinyl Wrappi~ l,W1"ar or Asphalt DUnkna-,¡n ONone OOther (describe): - Cathodic Protection: o None OImpressed Current System L] Sacrific.ial Mode System Describ! System & Equipnent: . 7. Leak Detection, Monitoring, and Interception ~Tank: OVisual (vaulted tanks only) ,CfGroundwater Monitori~' welles) o Vadose Zone Mon! toring Well (s) 0 tJ-Tube Wi thout Liner o U-'l'u.be with Canpatible Liner Directi"i Flow to Monitori~ Well (5) · o vapor Detector· 0 Liquid Level Sensor 0 Condoctivi tï Sensor· o Pressure Sensor in Annular Space of Double Wall Tank g LJ.guid Retrieval & Inspection Fran U-Tube, Mani torin; Well or Annular Space ~ily Gaugi03 & Inventory Reconciliation 0 Periodic Tightness Testi03 o None 0 unknOW1 0 Other .. b. Piping: Flow-Rest=icti03 Leak Detector(s) for pressurizedPipi~· o Moni toring Sl.wp wi t,¡., Race\IØY 0 Sealed Concrete Ra~ew!Y o ~lf-CUt Canpatible Pipe Raceway 0 Synthetic Liner Raceway 0 None (B'ÜnknO\ro1l'\ 0 Other *Describe Make & Model: - 8. ~nk 4igh~~ Be s 1S en Tightness Tested? DYes Date of Last Tightness Test Test Name 9. Tank Repair ..../ Tank Repai red? 0 Yes \Id'NO DUnknown Date(s) of Repair(s) Describe Repairs /975-... vcyo.-J i?µÀ..C~ ~ VA..ft~.., ~.., ~11f.d 10. Ov~ Protection . ~ ( rator Fills, Controls, , Visually Monitors Level DTape Float Gauge' DFloat Vent Valves 0 Auto Shut:" aff Controls DCapacitance Sensor DSealed Fill Box ONone Ounknown Dather: List Make & Model For Above Devices ONe ~lJnknoW\ Results of Test Testing Canpany 11. Piping __~ a. Underground Piping: lli'Yes ONe Dunknown Material Thickness (inches)" ~iameter .. Manufacturer I n ~~ DPressure [RSÙctlon Gravity Approximate Leß3th 0 P pe RLI'\ Þ..:¿f b. Underground Piping Corrosion Protection : Ù DGalvanized OFiberglass-Clad OImpressed CUrrent OSacrificial Anode [dpgJ.yethylene Wrap DElectrical Isolation Dvinyl Wrap DTar or' Asphalt ~nknown o None DOther (describe): c. Underground Piping, Secondary Containment: I ~ o Doubl e-Wa 1 1 DSynthetic Liner System ~ne DUnknown Dothec (describe):, F de il i ty Name YI",-,,-,U '-.£"H'. ~!" fi.JZ- . pe emi t ""'. TANK! <""":"J (FILL OUT SEPARATE FORM FO~CH TANK) ~ E:ACH SEcTIõN,CHECK ALL APPRõPRÏÃTE--šõXES- H. 1. Tank is: Dllaulted ~n-vaulted ODouble-Wall ~ngle-wall 2. Tank ~terial [ltéarbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-Clad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 Alllt'lim.ll1 0 Bronze DUnkoown o Other (describe) 3. primary Containment Date Installed 'Ihickness (Inches) I q 6'"7 4. Tank Secondary Containment ODouble-Wall-rJ Synthetic Liner DOther (describe): DMaterial S. Tank Interior Lining D"Rubber DAlkyd OEp:>xy OPhenolic DGlass DOther (describe): 6. Tank Corrosion Protection -rrGalvanized DFiberglass-Clad OPolyethylene wrap OVinyl wrappin;J DTar or Asphalt OUnknown DNone OOther (desc:ibe): 'r ~~ Cathodic Protection: o None DImpressed O1rrent System [J Sacr c a System Descril:e System, Equipnent: 7. Leak Detection, Monitoring, and Interception . a. Tank: OVisual (vaulted tanks only) CTGrourX3water Monitorin:j Well (s) o Vadose Zone Moni toring Well (s) 0 ~ube Without Liner o U-Tube with Canpatible Liner Directin¡ Flow to Monitorin:j welles) * o Vapor Detector* 0 Liquid Level Sensor 0 Condoctivit¥ Sensor* o Pressure Sensor in Annular Space of Double Wall Tank o Liquid Retrieval , Inspection Fran U-Tube, Moni toring Well or Annular Space o Daily Gaugir~ & I!!yeptory Re~onciliat.ion [J Periodic Tightness Testing o None 0 Unknown (ZJ-öther iLl S u.. A ( b. Piping: Flow-Restrictirç Leak Detector (s) for Pressurized Piping'll" o Moni torin;J S\I11p wi th Raceway 0 Sealed Concrete Raceway , o Half-cut Canpatible Pipe Race~y 0 Synthétic Liner Raceway 0 None o Unknown 0 Other G-v4iJJl.{¡ ~iw-.) ! *Descr ibe Make , Model: ' 8. Tank Tightness Has 'nus Tank Been Tightness Date of Last Tightness Test Test Name 9. Tank Repair _/ Tank Repai red? 0 Yes l NO OUnknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection [JOperator Fills, Controls, , Visually Monitors Level gT~ Float Gau;e []Float Vent Valves [] Auto Shut- Off Controls [1}Capacftance Sensor OSealed Fill Box o None DU'1known OOther: List Make & Model For Above Devices Thickness (Inches) Capacity (Gallons) Manufacturer ððO [.L¿,t k"t/IOtA.-¥1 DUned Vault ~ne Olhknown ' Manufacturer: Capacity (Gals.) . DClay OU1lined ~own Tested?, DYes Dt«> ~known Results of Test Testi~ Canpany 11. Piping ..~ ð. tl1derground Pipin:J: DYes WNo Ounknown Material Thickness (inches) _ DJÞmeter ' Manufacturer OPressure o SUction , iJCravity"Approximate Ler¥3th of Pipe Rm I ~;::t; b. Underground Pipirg Corrosion Protection : 0 OGalvanized OFiberglass-Clad OImpressed current Dsacrificial Anode o Pol ye thy, l~ne~rap DElectrical Isolation DVinyl Wrap DTar orAsPKslt OUnknown Wffone OOther (describe): c. Underground pipirg, Secoooary Contairment: ~/ DDoubl e-Wa 1 1 DSynthetic Liner System fßf«:>ne DUnknown [JOther (describe): Facil i ty H. 10. 11. Name /~ .¿¡/ ,U Cnu<-7: r;&<frH&f¡ / , J.-ltrl.1l- permi t No. TAN7) .. (FILL OUT SEPARATE FORM ~~CH TANK) - FOR ~EcTÏÕN, CHECK ALL APPROPRïAPBõxES- 1. Tank is: o Vaulted DNon-Vaulted DDouble-Wall ~le-Wall 2. Tank ~terial ~artx:m Steel 0 Stainless Steel 0 Polyvinyl Clùoride 0 Fiberglass-Clad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 AlllTlimlO 0 Bronze DUnkoown D Other (describe) Primary Containment Date Installed Thickness (Inches) 19~ -rank Se ondary Containment DDouble-Wall U synthetic DOther (describe): DMaterial Tank Interior Lining DRubber OAlkyd OE¡x>xy DPhenolic OGlass DOther (describe): Tank Corrosion Protection []qplvanized []Fibergla5S-Clad OPolyethylene wrap []Vinyl wrapping (Q1'ar or Asphalt Ounknown ONone OOther (describe): . Cathodic Protection: o None OImpressed current System OSacrificial Anode System Descril:e System' Equipnent: 7. Leak Detection, Monitoring, and Interception . a. Tank: OVisual (vaulted tanks only) LfGroumWðter Monitorin:;¡ well (s) o Vadose Zone Moni torin:j Well ( s) 0 u-Tube Wi thout Liner D U-Tube with Canpatible Liner Directin¡ Flow to Monitorin:;¡ Well(s)· D Vapor Detector· D Liquid Level Sensor D Conductivit;t Sensor· D Pressure Sensor in Annular Space of Double Wall Tank o Liquid Retrieval & Inspection Fran U-Tube, Moni toriB] Well or Annular Space o Daily Ga~ing , I~tory Reconc.;il1ation D Periodic Tightness Testing o None 0 unknO'-'1 'F ~er l/ì <; (,< d.J¿ '. b. Piping: Flow-Restricting Leak Detector(s) for pressurized PipingW D Mani to ring SlInp wi th Raceway D Sealed Concrete Raceway D ~.f-CUt Canpatible Pipe Raceway 0 Synthetic Liner Raceway D None ~nkno'-'1 0 Other *Describe Make & Model: - Tank Tightness ~.~ Has ThlS Tank Been Tightness Tested? DYes Dt-b 1[pŒ\Kl10W'l Date of Last Tightness Test . Resul ts of TeSt Test Name Testing Canpany Tank Repair ~/ Tank Repai red? DYes !H'No Dunknown Date(s) of Repair(s) Describe Repairs ov~ Protection rator Fills, Controls, , Visually Monitors Level DTape Float Ga~e OFloat Vent Valves 0 Auto Shut- Off Controls DCapacitance Sensor OSealed Fill Box o None Dtb'known- DOther: List Make , Model For Above Devices 3. Manufacturer U-Mj.(~ 4. Capac!,ty (Ga~J , O.ðOV . Liner OLined Vault DNone []tl'1knO'-'1 -Manufacturer: Capaci ty (Gals.) o Clay Olhlined rtlt6nO'-'1 5. Thickness (Inches) 6. 8. 9. Piping ~~ a. lbderground Piping: fj4Ýes DNa Dunknown Material ~4-1..<.~v-J Thickness (inchesy ~ Diameter .~ Manufacturer t4,vt¿~ ..J . DPressure GJ$uctlon DGravi ty Approximate Length of P1pe RLn <... Z, [) ¿;t;:¿ b. Underground Pipirg Corrosion protection : U OGalvanized OFiberglass-Clad DIm¡xessed current DSacrificial Anode OPo1Yethylene Wrap ,DElectrical Isolation OVinyl Wrap OTar or AsP\alt ~own o None Oather (describe): c. Underground Pipirg, Secondary Conta irment: .// , DDouble-Wall DSynthetic Liner System ~ne DUnknown DOther (describe): - - Facility Name /i'¿rGrU L~"--£.A.tl ./'7<- , i ~ Permit No. TANK! '-.) (FIt.!: OUT SEPARATE FORM FO&.CH TANK) FOR EACH SECTION, CHECK ALL APPROPRIAråOXES -- - H. 1. Tank is: DVaulted DNon-Vaulted ODouble-Wall ~le-Wall 2. Tank Material o C~n Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-Clad Steel I1tfiberglass-Reinforced Plastic 0 Concrete 0 AlLmim.ln 0 Bronze DUnkoown .0 Other (describe) 3. Primary Containment Date Installed Thickness (Inches) Io¡ ~~ 4. Tank Secondary Containment DDouble-Wall--r:J Synthetic Liner [JOther (describe): OMaterial 5. Tank Interior Lining o-Rubber 0 Alkyd OEfoxy DPhenolic OGla~s OOther (describe): 6. Tank Corrosion Protection -rrGalvanized DFibergJ.ass-Clad OPolyethylene Wrap DVinyl WrappiB;) OTar or Asphalt ~known ONone OOther (describe): . Cathodic Protection: o None DImprešsed CUrrent System DSacr1f1clal 1node System Describe System Ii Equipnent: 7. Leak Detection, Monitoring, ~ Interception . a. Tank: OVisual (vaulted tanks only) LfGrourrlwater Monitorin:J Well (5) o Vadose Zone Mani taring Well (s) 0 lJ-Tube Wi thout Liner [] U-Tube with Canpatible Liner Directi~ Flow to Monitorirq well(s) * o Vapor Detector* 0 Liquid Level Sensor 0 Condoctivit;t Sensor* o Pressure Sensor in Annular Space of Double Wall Tank º L~uid ßetrieval Ii Inspection Fran U-Tube, Moni torin;J Well or Annular Space {]¥Daily GalJ;1in:] Ii I!!:'~tory Reconcilj.ftion 0 Periodic Tightness Testiß3 o None 0 unknown LJYOther ~5 v- ~ b. PipiB;): Flow-Restricting Leak Detector(s) for Pressurized Piping~ [] Moni toring SlDp wi th RaceWlY 0 Sealed Concrete Racew:!y [] ~f-cut Canpatlble Pipe Raceway 0 Synthetic Liner Raceway 0 None Id11nknown 0 Other *Descr ibe Make Ii Model: - 8. Tank Tightness Has TIns Tank Been Tightness Tested? nate of Last Tightness Test Test Name 9. Tank Repair ~ Tãñk Repai red? 0 Yes ~ Dunknown Date(s) of Repair (s) Describe Repairs 10. Over~ll Protection irOperator Fills, Controls, Ii Visually Monitors Level DTape Float Gau;¡e OFloat Vent Valves 0 Auto Shut- Off Controls BCapacitance Sensor 05ealed Fill Box o None Dlk1known , Other: List Make Ii Model For Above Devices Thickness (Inches) Capaci ty (GallO~ á(~ Òð¿? -J DLined Vault ~e Dtbknown Manufacturer: Capac1 ty (Gals.) o Clay Olblined ~knO\JA'\ Manufacturer WvP~./ DYes D~ ~own Resul ts of Test Testi~ Canpany 11. Piping _ /" ' - a. tbJergrow>d Pipirr:¡: ~s 0110 o1k\kno"", Materia~ Thickness (inc~~ ¡ ~ Diameter fL..¿(..o1-;' Manufacturer , DPressure IkJ'SUCt.TõñUGravi ty Approximate LeN3th 0 Pipe Rm ,b. Underground Piping Corrosion Protection : DGalvanized OFiberglass-Clad DImpressed current OSacrific1al Anode Oßø1yethylene Wrap OElectrical Isolation DVinyl Wrap DTar or As¡balt Œfirumown o None OOther (describe): c. Underground Piping, Secondary Contairment: ' .4'/ ODouble-Wall OSynthetic Liner System ~ne OUnknown OOther (describe): .'.v J.> Type Of ONew Demit-. Nò. ¡ ~r-~D.,p..6· c.. AP.'atiOn Dat~_ 5ïI9'l~'? _, -', '-¡"7,4" ;7 /Ì'-') . 'í-'/ , .; r' 1/"';; ..:-..~ ,,': \; ~ '-~ ~ ;--, , '/....,' APPLICATION FOR PERMiT TO OPERATE UNDERGROUND ~':''Ìi;' .<9c5?;> c.::;'::::::.-::;> ¡¡,,~ HAZARDOUS SUBSTANCES STORAGE FACILITY --"1~ì'- Application ( check) : ~ /1 ()~ . .0.,. Facility OModification Of, Facility Existing Facility []Transfer Of Ownership 93305 Kern County Health Departme* Division of Environmental H ,\ 1700 Flower Street, Bakersfield, CA (805) 861-3636 A. Emergency 24-Hour Contact (name, area code, phone): Days AIPI- d..~// Nights 3?1 - f¡"¡"7t> Facility Name Gtl~, No. Of Tanks,f$~ (;tl.;)iJJ Type Of Business (check): Other (describe~~ ~~I~~ Is Tank(s) Located On An Agricultural Farm? []Ves ~o Is Tank(s) Used Primarily For Agricultural Purposes? []Ves ~ Facility Address It.f,.{" '(7l.¡..~ /-f<.',¡jJJ}6e!:AEI.J <:!.4. Nearest Cross St .L s ~J T R SEC (Rural Locations Only) , Owner ~i~ 0 So;- kéie'-'{ Contact Person l.AtJA..¡ J'o¡hV I~ Address/L{,5T11!...I..,;Ÿ.TtuJ t1U.¡j¡¡~€J.J a.Á-Zip c¡~~o{ Telephone et:.1 ;;....611 Operator S -h.-tE. ~ ~.-.It:: Contact Person Address Zip Telephone B. Water To Facility Provided By $eL.ç. £I c.~+-y Soil Characteristics At Facili ty ~.,)Ic.AJ(ß>UJJ Basis For Soil Type and Groundwater Depth Determinations Depth to Groundwater lA,u1-c. N./~. CA Contractor's Zip Proposed License No. Telephone Completion Date Insurer C. Contractor Address Proposed Starting Date Worker's Compensation Certification No. D. If This Permit Is For Modifications Proposed Modification b.l ?~ Of An Existing . Facility, Briefly Describe E. Tank(s) Store (check all that apply): Tank # Waste Product Motor Vehicle Unleaded Regular Premium Diesel Waste ~ Fuel Oil 0 o l"Iof-o'~ 0 0 0 0 0 0 0 o Ò 1'-' 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 necessary for motor vehicle fuels) Tank # Chemical Stored (non-commercial name) CAS # (if known) Chemical Previously Stored (if different) tift:> t?'\o~ ¡/¿¡.).Ic4:. OIL c?o ið~O G. Transfer Of Ownership Date Of Transfer Previous Facility Name I, Previous Owner accept fully all obligations of Permit No. issued tc I understand that the Permi tUng Authority may review anI:- modify or terminate the transfer of the Permit to Operate this underground storagf" facility upon receiving this completed form. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - This form has bøéfi c~ and ,corr~. ( ~~ S i g1'Ía t ur~'<~'¿'¿;'/ under penalty of perjury and to the best of my knowledge is true " ) i-¿.. - ~ Ti tle AÆÆ:.T /'I'J/}fVM,·¢l2- Date .{/~/B '7 .1: (1 l -L. L.y 1.'1 c...J.11I1.~ ¡::,::.,¿Al. r.:(C'~~ W (·1J.r:'¿..i)...f~s Ie , TANK!.-L _ (F iLL OUT SEPARATE FORM FOHEACIl SECTION, CHECK A1h APPROPRI --:;- ~ EACH TANK) BOXES H. 1. Tank li: 0 Vaulted 0 Non-Vaulted 0 Double-Wall ~ingle-Wall 2. Tr¿;J.< Material Carbon Steel [] Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass-Clad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 Aluminum 0 Bronze 0 Unknown o Other (describe): / 3. Primar~ Containment Date Installed Thickness (Inches) Capacity (Gallons) Manufacturer l' I? (,;).. / lOb 3 80 1<£f'iJ..h [, c. SÞ-et... 1Jt.r:,f.....4Gif. c 4. Tank Seconùary contaÜ{ment o Double-Wall 0 Synthetic Liner 0 Lined Vault [] None [] Unknown o Other (describe): Manufacturer:' Material Thickness (Inches) Capacity (Gals.) 5. 'Tank Interior Lining: (] Rubber (] Alkyd (] Epoxy (] Phenolic 0 Glass (] Clay 0 Unlined 0 Unknown (] Other (describe): 6. Tank Corrosion Protection o Galvanized 0 Fiberglass-Glad 0 Polyethylene Wrap 0 Vinyl Wrapping o Tar or Asphalt 0 Unknown 0 None 0 Other (describe): Cathoùic Pr(!)tection: 0 None 0 Impressed Current System 0 Sacrificial Anode System o Describe System & Equipment: 7. Leak Detection... MonitorinJ,!, and Interception a. Tank: [B'Visual (vaulted tanks only) 0 Groundwater Monitoring Well(s) o Vadose Zone MonHorin~ Well (s) [] U-Tube Without Liner o U-Tube with Compatible Liner Directing Flow To Monitodng Well{s)* o Vapor Detector * 0 l.i4uid Level Sensor * 0 Conductivity Sensor* o PreSfiure Sensor In Annular. Space Of Double Wall Tank * (] Liquid Retrieval & Inspection From U-Tube, Monitoring Well Or Annula~ Space o Daily Gauging & Inventory Reconciliation 0 Periodic Tightness Testing o None 0 Unknown 0 Other b. Piping: 0 Flow-Restricting Leak Detector(s) For Pressurized Piping* o Monitoring Sump With Raceway 0 Sealed Concrete Raceway (] Half-Cut Compatible Pipe Raceway 0 Synthetic Liner Raceway [] None (] Unknown cr Other i/ .. s\.V~ L- *Describe Make & Model:, 8. Tank Tightness Has This Tank Been Tightness TeSted? 0 Yes B No 0 Unknown Date Of Last Tightness Test Results Of Test Test Name Testing Company 9. Tank Repair Tank Repaired? 0 Yes if No ŒJ Unknown Date(s) Of Repair(s) Describe Repairfi 10. Over ill Protection Operator Fills, Controls, & Visually Monitors Level o Tape Float Gauge 0 Float Vent Valves 0 Auto Shut-Off Controls o Capacitance Sensor 0 Sealed Fill Box 0 None 0 Unknown o other: List Make & Model For Above Devices 11. Piping: , _'/ a. Underground Pipin¡r: 0 Yes Œ' No 0 Unknown Material Thickness (inches) Diameter Manufacturer o Pressure 0 Suction 0 Gravity Approximate Length Of Pipe Run b. Underground Piping Corrosion Protection: o Galvanized 0 Fi berglass-Clad 0 Impressed Current 0 Sacrificial Anode o Polyethylene Wrap 0 Electrical Isolation 0 Vinyl Wrap tJ Tar or Asphalt o Unknown 0 None 0 Other (describe): c. Underground Piping, Secondary Containment: o Double-WallO Synthetic Liner System 0 None 0 Unknown o Other (describe): :;'::~O'~i.~T~<O" ,.' 'j.,..::.,,::',/, . "~~~~~~Š·;~', ,"', '., , ...".-,,'.. "'TRúXTON ~d;~í~~\;~t~~~} 1:,=~~,;" ".; . ' ',¡ ,'O' , '. ".~,L."''; . , .. .O' , ", !'":". '. -. ... ;:. :. . .~. ~: ..~:,-i" ;.~.~ "';::'O''' ""'. . .' ' '.!' -.... ':" '", ":. :-~-; . ;)- "~ '.~ .~~ _,':..,.:r '" ' .;J< "3"-'::~~~~O'~.~;·~"~_~~:~~L :, '~.I~~-e '" l,,:f-~':;)i~~,.: "'~"~,:':":~"~,-'Jt- ~;'O' :~;,:-:~:"O'~;{~:~·r:;O'Y ;.:~!~L:~~~~·~:?'~: ... ,-'..'" ';"" 'X 'dP"'~''''''''>'' 'r~',4" . -, ....'.',', :~';iJ'2':;.f.!C,:G;;¡'r;;Xn ::t:è "', ., ~':. ',è~:,;.: ,~~. '.1';' '.1 ~ ;: .~:;L:;-~;,· ',",; .: ,.:' 11,::, k,:,;;.:I·,:.'~'/~:t·; '.:~<~;.":\~ ¿~:' ~'" 'O' ,'p;e" ¡ ::O':~"~-l ;'V ",O' O:-Qj ¡, '. ... ,Il{¡{ k ' , ;" '. ~ ;- . I. K:..:1¡' ¡ I \i-' ¡ ,U }j "L, " 'I I' , I ! ..-. r' 1: ,'~~~. ,1~, .¡,-. , :~..; ~. ~.-' . . ..-=.:..." .~~: "~i.{:: ~~~: ',' . '. ¡<~~ ....,.. ":'" ';'/.. "~O',l;,~J~,', ..',"~ :~",~ ",..:- "... . ..~.. ¡:;- f~~;'" --..', . ó '~.'-- ';~' ....; " .. -~ ~,. \.', .:..' .. "';" 'O' . t:'"':"·~ .. ..... " . .'J ". . .. I¡ -' '. .,- ~ ~ ':r-· .. ~~."~'~'*~".~ .'t'.. . "~' ~- :,~.:~.. :',..i'.¡.;-. : .:.~. ': ~ . 'L/ß/'ÍfA,~Y'" _ .1-:,;_, .,.... V" ".,;,-.. ';',:-:.. 01' .';,;'-[]- -::. ~ ¡~ , r"--"'--'·'-_·_'__O'__i-- , . '", ,;' !..r~- .. ~. .. 'v '" '''" :\,....:;v " ..' .... ,~ ., f: , .. . , <.--..--.-----. ...... --------~'-~-~._.-_1l ¡ I , t i I' " ,- ---~~ """", , " - ~ - ". ~-:,,,-,, t . -.-.J::::" ~ , ..;T ,...,..,. PL..·;;/V.' O" , I I ¡ DÒ'i-ì' ~ït <:... ....> A T'E,2, ,()~r' ,It, . -.' I 1 '"t- ..; ________J ," , ....5:~.~....,,.\A,, ~.....=:-,:;,; /......·-·........-·+C....· ......: ("-'-ì"~ , rr +- --1 /.h~Îi>ntI~:~ <" f ¡,T: I, /-J-- 1 t ~. - ..1 . ~ -,' ,/.. / ,1 ~ ! ' / , , lVf', ' /,! '{ , / , . .i I r//~ " /j ~-.--'-'- r-, "--. -f--~ '\--\ -, -O'--'" ~3 ð!i.C IÞ #I '*: ;{. ~ \. .1- I .J 4 ¡.':" .;';.. ". # ,-~" (. i i '~ , I --- ~~ -- :;) I I ¡ , / (-;y:" ,~~··¡f.' ~7.."/3.··"::'·"""'- Se.A-L£ I tI = Go ( , /4/ 5' !"1'<-u..KìUj\) ~ A-K~yZ~ Foot ¿ tel N t r"-O'--- h ..--- I ! I ! i I I /' I I 1 '-~ , j' ¡ '---O' ¡ ~-,t-: '. ¡~ :- .~~ '" I ¡ I I I ! ¡.,,' / ¡ I I I , ! I , P.4/' , . \ '-.\ ~' r I , i I f_ . . ~ HOUR REPORTABLE VARIATXON/LOSS NOT:tP:tCAT:tON IQ.: Kern County Health Department 1700 Plower Street Bakersfield, California 93305 Attn: Underground Tank Section REGARDIlIG: Facility: k f æ ..AI Facility Address: r // t/ /1/ T T c: /9 /1 /l t:- t'" Peril! t . /'-1/5 tlll/~Tv/l/ Ay£- /6JfØ"26"C ~ Of Person Pllln2 ReDort: On 5-lC-8'g--- , the above facility had an 0/,'.3 ø A,/I/7, (date and time) inventory variation/loss that exceeded reportable limits as described below: ..... Tank , Amount of Daily Variation/Loss / Amount of Amount of Weekly Monthly Variation~ Variation/~ " oð'b "¡'2~PÇhL Total Minuses Line 3 of Trend Analysis /2- '1 I have ~~topped dispensing product and begun investigation procedures required by' the Per.itting Authority. This notification is in addition to the phone call I previously placed. LARRY JOHNICAN, Fleet Manager General Services. Garage Division - ~J . ~ :. . HEALTH DEPARTMENT XNVESTXGATXON REPORT KERN COUNTY VARXAT:ION/LOSS Fac i 1 i ty : k E tt IV L t? t, tv r l' ç Ij 11 ;9 .r- ë Perlli t, / b /' ø 2 G C Facility Address: 1'1 / 5 .,.. /! V' ,Ç T Þ'í;(/ /J r f- IJ /1 /¿- ,c /7 .5 r / E L 4 Tank(s) with Discrepancy:' / Date/Time of Discovery: 5 -i 6- rf? tt3c /'J"~ Name of Person Filing Report: Description Of Discrepancy: st, 17 w/!.5 ç, ///I;{ l,q r(ç/V -¡:::t'd rl-/f V?' t, 'Î 2 0/.1 r.;:./}¡:. £-7 C E 17197 ,'V E tt= 1<' INVESTIGATION SUMMARY The following procedures must be performed within the specified times starting at the time a reportable loss is discovered or should have been discovered: Within: I I I I I 11) I I I 12) I I 13) All product I I I I I I I I I r using approved tester and method. I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES. 8 Hours 24 Boars 48 Boars 72 Boars NOTE: Owner/Operator or other qualified person is to review records for errors before determining there is a reportable variation/loss. I )-/~"f¡ï Date Time 9,'3 S AN! Performed By: ~tftt~". Owner/Operator must verbally report 'I Date I Time discovery to KCHD' and follow-up with written I J -/ 6 . ð If I ÇI //?Ó AM notification on form provided. Performed By: ~~?tJt-~~ Visual facility check to be performed using ~ Date I Time checklist on the back of this form. I 5-1' -f't 1 I (j ( 'I f Performed By: ~~/'l/[,~--- dispensers are to be checked for ~ Date I Time calibration and adjusted if out of tolerance. I I /1/1'" Performed By: Piping to be leak tested using approved method. \ Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH COPV Q[ TEST RESULTS. * * Tightness Testing of tank(s) to be performed I I Date Time Contractor's Name License # Test Performer's Name l\ Description of test performed * * ATTACH COpy QE TEST RESULTS. * * PERMITTING AUTHORITY WITHIN .2. DAYS OF -:- _..:' :..'.... . ."'. . ... i. 'e 2. VISUAL INSPECTION CHECKLIST I , A. D1apelUlera '~ll dispensers and their end doors visually checked , L~ll hoses and nozzles visually checked for leaks. ~AlI totalizer seals checked for tampering. . for leaks. ResJH:ts : ~AII dispensers appear ti~ht ~/b4~ J;-/Ø"-.çÿ- , ~~~~;/dat~ I -- Dispenser(s) not t1~ht as listed below signature/date ¡DISPENSER _'SERIAL '¡COMMENTS: I I I I I I I I I I I I B. ,..:tank Area ~&ll turbine boxes inspected. ~All fills and vapor manholes inspected Results: Tank' area present. appears tight wi th no product or liquid ~ . S ~/ç-eK' signature/date Tank area does not appear tight because of the problems/ conditions listed below. signature/date ¡TANK '1 PRODUCT I COMMENTS/RESULTS: c. PipiD~ Type: DPressure o Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. __ Suction piping tested for indication of leakage. Results: --Piping tight, based on test(s) above. signature/date Piping not tight based on test(s) above, with problems/ conditions listed below. signature/date , I Description 26C PERMIT . \ I KERN COUNTY HEALTH DEPARTMENT: INVENTORY RECORDI NG SHEET ¡ I CAPACITV 0 tJ 6 PRODUCT / A/ L X/9# ¡('ð ,~ ~ 13 WATER GAUGING 12 DELIVERED INVENTORY MONTH/YEAR 11 GAUGING AFTER DELIVERY INCHES GALS I :10 GAU¡GING BE:FORE DEÙVERY INCHES: GALS 9 READING ADJUSTMENT - GALLONS INCHES - - 3?¥' Ø" ~- --.J------ ..,-- 7:J GALLONS ,'~ ,-r/ ,/ .I ':;.1 / , . -J X'b 1./ ~, .. 741 '..' ./ ~7/3 :~_. J>;" J -'j i \ I i :-l I '-1'1 -30 1 I !! = TOTAL METERED . SALES GALLONS - /03 ..5 (. ~ ¢ ~ ~ ~., (.. .:1 (-:- ,~~"'.5 ç C' I c;75' J"50 /06 ~ '-I~" ? II Þ'IO 74'r :; 2 :; /J.2- Y~3 TANK . - EQUATION ~ ___ 1 7 CLOSING METER DAILY METER READING READING 5 CLOSING INVENTORY 4 OPENING INVENTORY ~/! /V ª OPENING GAUGING 2 FACILITY 1 DATE GALLONS -:':-;' v" ¡.fÙS7 ::,/' ~~ ~ ,:~'.J - - :./ 7 77 .2 2 wq '-/ ;¿.2 C; :z 4' :2 oÞ~ -;/.:ï' .':) ,". ~.. '~'-. J ? 7£"5/ 2'1521 L~ r; /.-::: q, j ,,-) r,r ,,?' --' :; ,;:! ..'~.~ ~.~ }-- ..j ,;.: ..~~ -.; ." -- 2 (. /70 / GALLONS / 4'-/ r/- , ';J ') 0 C)j r; ""7 ..-, -, .; -. ¡,....-. 2 I i7ú :)'; ,-, 2 2 ~"77 ;2.:2 G27' ::2.27.30 ;) ~-~ ';." . '. ":; 2 ., ,ý&'"1 :2 ~ 52/ 25:::2&1 ~:) 1:,- 7 Ii? i?Ç-¡ij ~ .<1 '," -. ~ '....., "'- -' 2 ç; ; 76 GALLONS :..: (/" /' q ~_: ¡"" :,- :/" 7 r: J -'-.) . 7 Ç-"Ç/ . '. . r<<;_,,~/ j ."J t'/ ~; ) ..:¡- ~"f" :.; -{ 7' () ~,.-, .'. -... 0/:/ :/ 7 J58'1 (~ ð'"90 c;:27?- ;~ 7// Í; I 75 r:; Cf?6 INCHES GALLONS " Ii ..; _I., / ? ~,./;I '(, ó :.¡ )' J/~.: :-/ ;. 7.:í ~1/.z. :;--l!"t¡. ;;':';'/7 7f/:j 5 'j -- v >.x- :X-"- s'-l (.I(S;~ 5ó 'I'T ~!) ý~ 5ú'/¥ ;r;y~ ...¡r'/~ r;?'-IO ¿; :~ : .... / t I 75 51?? DAY/HOUR I _ f, '.5 C ,1 2· G.-Ow,d .:? - ~- ,'" ,- ·1 /, "0 ~ ,... .......{./....:, .;,/ !)- 5''-If A 0-6:0, A - 63& ;4- . ,.'J(¡ -4 q. S':52 ..¡ I () -~: (¡ D 11 11- J'.l/J ~ /1- 5.'54 ;5- ßC 11 Lf - ~/Jð . '17' A ì ~ t·) () , > ~(¡ (¡ ¡':, 7-6.')0/1 I " . ~ - .' DATE SIGNATURE IS A TRUE AND ACCURATE REPORT HEREBY CERTIFY THAT THIS ------ Env. Health 58041131018 16/86) I Lb'C KERN COUNTY HEALTH DEPARTMENT PERMIT # ¡Ç INVENTORY RECONCILIATION SHEET , I '. TANK # J CAPACITY CI tJt?ð PRODUCT '/,¡(/LI r:/JL?~ð MONTHIYEAR i GE EOUATION 2 EOUATION 3 I EOUATION 4: 1 2 4 12 I 5 I 14 8 9 I 15 , 15 14 I 16 DATE OPENING DELIVERED CLOSING INVENTORY TOTAL METERED READING TOTAL METERED TOTAL METERED I NVENTORV AMOUNT + - = - = : THROUGHPUT - = INVENTORY INVENTORY INVENTORY REDUCTION SALES ADJUSTMENT THROUGHPUT REDUCTI ON OVER OR SHORT DAYIHOUR GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS +GALS. -GALS. 1- ç.1.~ 4 - '-Ix-I£>' LI{7~ /'3£i 11'1 ~ / (/ , / t/") If' 9 -"'?b" J. /'/:: / 4/.."7'1 ;? 'Í,¿ I ÿ! ;; 1./ .YO ~ 5(,..,3 ("'bY :.; ;:. ~,~ r;úc. .¡-r;7 . ~ ....:... I·- ..:.1 p S:--r:' ,.; 8-1£"9' 7r;/7 t, ?S ~ £' :-: / ¡; -<;" (;: £' ;- ç;?S -f?7J 'i '?-" . 71)/1 67f?g" 7 ?/ Ä~5 b- ¿-j' r'· (.... ~ ..- 7 , 1 -Lf6 - ~.v~ n ¡" /".J t, -- ç.'! _~',":"_; h7~C;;' {. I /:' <,", o ÍJO t:~1 /<. i:: (~ / ¡; ~C) / ,- 71 .... ~'/ ....r- .... .'.( (' ¿) (if: Ÿ S-f ,r; r¡' r:;) 4 5" 23 ç - --) r:- Î 7 ç' 2 Y , - ) .. . ~ . ' ., 7. t)( J 5_S" f: ~ 5S f- </ a- 1']0 /'?(/ ; 'j' () 0 4- I I'D WEEK 1 TOTALS 7 2 IS //1/1//11//1'//11/1/1111/1/1//1/1/ )2 I () /1/1//1///1///1111//111111111/ +- r,ç 7: '··..t r; 5' i."" ~~ S .3 L{ 15 2<-!Y lOr; / (j r ! / ~ (, .)L/'f -/"?){ . r, _; ¡ 'l~:.52 .:', 5 1 ,U I; :.." (; .~ :~" ?fi"2 r;-'fO r; .',- r· ~ 4 ¿:. "," .' --1 -+-/ _r s- '; .... ~ '.~' L..: (t .~ ,'." ~~27 ? '! I £/1 ,& / I '£ /1 77/ -I.ilf . .- 1/ -PI}11 1..f127 "J S ý! ~L¡ç c lit? 6~n !t: 7/0 b¥h -&:. (";50 " _ 15 rl "}?/--:; ?C r:"/'I SO Lf 7LfÇ(' 74Y 7L/¡:;- ,5' ¿: ~ ~y:~ I)'.) ~:... -- i (. r ~"" f·r f-. ¡;'q (.> (.27(- tiLl r:; / C; r; 2 c> 1.5 ') q (;/4' -f?S 1:'/· (,":", f- '? '/ l' ~ - ~:; I ... - .(r¡ JiL- I ¡ ') ! ..' .I 2 -j5 -tJ'-I 7 WEEK 2 TOTALS J () &/? ¡/Til I 171 /TTn II I / I I I / 1/ I I I // I I I I 3 ) ýC- //II/IIIIII/I}IIIII/III//I/III .//'JO I ~.. .. \: ' "';. I' ¡ i ~/ .-. /Jt.. 7{ 77 73 / ?h - /? "V !..2.-.f: .-'v ¿ wþ ,} '/ J': -,' .:.; .' :~ . ~'r ~ __: r-!~~ 5+ C? {~/~ ?/}¿¡ I 9, 7., -50 2:? ~ 2;? '7 /09 tILl , 7- (- 20··:.; c {) /;::. J ,".' ,." j WEEK 3 TOTALS 1////17/1'17//111111/11111111/1111 ¡ 111/111/11/1/111111//111//1111 WEEK 4 TOTALS /li 17/ / ITi¡¡¡il I I / I I / I I / I I / / / I / I / ////1111/111/11/1/////11/1//// MONTBLV TOTALS 1111//1/1111111/1/111/1/111//1//1 111//11/1/1/1/11111//11111111/ Env. Health 5804113 k (-/l1V {(/(/I¡/ì /' Front 1017 (6/86) FACILITY . . :, INVENTORY RECONCILIATION SUMMARY - IRŒK 11 A. Percent Variation Amount Over/Short (Col 16) 1-S5 Gals. Total Metered Throughput (Col. 15) 1270 Gals. :x 100 = / , 'g % Variation · B. Reporting: I: 1. Does the Amount Over or Short exceed 350 Gals? (2 NO - Continue routine aonitoring O,iYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%? l8fNO DYES ( - Continue routine .onltorlng - Report to Permitting Authority within 24 hours of discovery. IŒKIt 21 I A. Percent Variation: ) 00 3;;;;6 Gals. I x 100 = 6 r·, (: . Amount Over/Short (Col. 16) Gals. · Total Metered Throughput (Col. 15) _ r' , L/ Ú % Variation B. Reporting: : 1. Does the Amount Over or Short exceed 350 Gals? ;gNO - Continue routine aonitoring qVES - Report within 24 hours of discovery. 2. Does the Variation exceed 5~? DNO - Continue routine .onitoring ~VES - Report to Permitting Authority wi thin 24 hours of discovery. I IŒKIt 31 I A. Percent Variation: I ¡ Amount Over/Short (Col. 16) Gals. · Total Metered Throughput (Col. 15) Gals.; x 100 = % Variation ( B. Reporting: I t 1. Does the Amount Over or Short exceed 350 Gals? DNO - Continue routine monitoring [jYES - Report within 24 hours of discovery DNO OVES \ 2. Does the Variation exceed 5~? - Continue routine .onitoring - Report to Per.itting Authority within 24 hours of discovery. WEEIt 41 A. Percent Variation: Amount Over/Short (Col. 16) Gals . · Total Metered Throughput (Col. 15) Gals. x 100 = % Variation . · / > "» B. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? DNO - Continue routine monitoring DYES - Report within 24 hours of discovery 2. Does the Variation exceed 5~? ONO - Continue routine .onitoring OVES Report to Permitting Authority within 24 hours of discover' JDmII ; A. Percent Variation: J Amount Over/Short (Col. 16) Gals. · Total Metered Throughput Col. 15 Gala. x 100 ... % Variation B. Reporting: . " Does the Variation exceed 1.5%? DNO - Continue routine monitorin DYES Report to Permi tUn rity within 24 hours of discover I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT. SIGNATURE DATE Env. Health 580 4113 1017 (6/86) (Back) .. .. KERN C~NTY HEALTH D~ARTMENT TREND ANALYSIS WORKSHEET FACILITY KE/fIV TANK # I ' CAPACITY C 1/ C/Æ/T)" /(J,OOO , r;A/l~?E PRODUCT PER M I T # /' 0172 b C; VAIl.. E/1l?rll':7 VEAR/PERIOD I/g-r INS T R U C T I 0 NoS: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysis DAV 1 Lf-;Jf5-J'ç - being conducted (from 1 through DAV 2 t/ .,. ;.1 l. ¿",;/ ..;-. 12 ~). Transfer the date and . ;"'~ DAY 3 tl'" /'2.,. ,,'-," ~( - the sign from columns 1 and 16 of DAY 4 'I. :l :;'. ,;/' - Reconciliation Sheet to columns DAY 5 !/.. '7 ~ ~ /'/ - at left. Use the table below to DAV 6 ~ -?5'S;:r +- determine the action number for DAY 7 /.¡-:?f-/(/f -J- the period being analyzed. DAV 8 <,£-.2 7-5'Y -f- DAV 9 ~-2.f-Rr +- ACTION NUMBER DAV 10 7 - .2'1-gý' +- TABLE DAV 11 if - Jr;- R-fY -- DAV 12 1j-/-8·g- - 30-DAY I ACTION DAY 13 7··,;,' . ¿::-r -r PERIOD ..HUMBER NUMBER DAY 14 ~ - g- ¿: ý' -+- 'l..J./ = 20 DAY 15 r:,-¿.I-,?Y - 2 = 37 DAY 16 S-')"-x R' - 3 = 54 DAY 17 ç. {.. - &S - 4 = 69 DAY 18 Ç"' 7 - ,~ tì + 5 85 = DAY 19 5- ;1' - ó-ý - 6 = 101 DAV 20 t; - '7 - ð' ý"" +- 7 = 117 DAY 21 "3 - I µ.¡;'-S-- - 8 = 133 DAY 22 1j"-II-f"~ - 9 = 149 DAY 23 S-¡2-E?J¡- +- 10 = 165 DAY 24 5 - /3 - ,ft?· ~ 11 = 180 DAY 25 [ - )'1 -- ([v -+- 12 = 196 ) DAV 26 ')' - J 5 ' Kt DAY 27 f:- - J b ç,'" -+- Circle appropriate period and ' ...- DAY 28 action number. A full cycle is DAV 29 made up of periods 1-12, after DAV 30 which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2 . Line 3 . Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A .. .. .. .. .. .. .. .. .. .. .. '. Cumulative minuses from previous periods in this cycle. ø Total minuses (add lines 1 & 2) . . .. .. .. .. .. .. .. Action number for thi. period (from table above) . Is line 3 greater than line 41 []Yes ONo 11 ~, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86) .-~:. . ..r _ i. I. ~ HOUR REPORTABLE VARIATION/LOSS NOT:IPXCATXON J:¡ .1";,, ,¡",. ,', ":1 ' lfj,,¡,,·;t(.', " I' . \. [" . - ,-' \ ." . : ::,;f::',I.g: I ,I,. : ~ ..: : ' ..! Kern County Heal thDepartJlent , 1700 Plower Street Bakersfield. California 93305 Attn: Underground Tank Section . " " " , , '. RBGARDIJm: FaclUty: /<. ill AI ' Facility Address: , , C Cl (/ /t/r,7 c~ /1 ¡éJç I? ¡¥ /5 -rrll VYTC/N Permit. / b clø 2 he , /I 1/6- ð/J I~ r~rP/é/ð ~ Q! Person Filing Report: , On 3-2- s-r . / 0, ' Cl Cl r1 M , the above facility had an (date and time) , inventory variation/~that exceeded reportable limits as described below: Tank , Amount of , Daily Variation/Loss Amount of Weekly Variation/Loss Amount of Mo'nthlY Variation/-Loss- 2,52 ~ 1- J'I-.y~¿' Total Minuses Line 3 of Trend Analysis ,. - ¡?E/t/c/// / .2- , , ~ I 'have~qtopped dispensing product and begun investigation procedures required by' the Peraitting Authority. This notification is in addition to the phone call I previously placed. Si i I " F~cili ty: k. E /? Á/ C (;I (/Nr 7' C;-"IJ/1/1c;. ð Perlli t # / G (/ r7 .2. G c; . ' 'Pacility Address: ¡q /5 r R c/)r rf/N /1 v.{ ¡:g .& k ~/? f ¡P/~¿.c? Tank(s) with Discrepancy: # -2.. Date/Time of Discovery: 10:00 /}N7 S -..J -g;g' Name of Person Piling Report: Description Of Discrepancy: f T W fl ~f"'" ;;., 52 ~ INVESTIGATION SUMMARY - ..... ~ KERN ctUNTY VAR:I'AT:I,.ON/LOSS . HEALTH DEPARTMENT :INVEST:IGATION REPORT II/) 0 ~/ r H t. /' V""" /l I,e¡ T / ¿) A/ + '3 ~ ~ fÇ-"9¿' t. PH (" /,c5"~ 15 xc t;,{7E-d The following procedures must be performed within the specified times starting at the time a reportable loss Is discovered or should have been discovered: Within: , I ! 8 Hours 24 Hours 48 Hours '12 Hours Owner/Operator or other qualified person is to I Date I Time review records for errors before determining I 5-..2 - 8-8'1 I () .'/5 ///1;1 there is a reportable varlation/lo~s. Performed By: ~~ 1) Owner/Operator must verbally report 'Date I Time discovery to KCHD and follow-up with written I S '.2 - g-8'" I / () ,:f 0 /J /II'! notification on form provided. 'L' / ¿;? . Performed By: ßv¡'/ 1/ÍA:,£,c~ -, ~rr /V1rS".r;¡(;'~ t/ 2) Visual facility check to be performed using I Date I 'rime checklist on the back of this form. I 5 - _~~ ~ 2.'06 /A-, Performed By: ~/~_~ 3) All product dispensers are to be checked for I Date I Time calibration and adjusted if out of tolerance. I I Performed By: Piping to be leak tested using approved method. I Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH QQfI Q! TEST RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Contractor's ~ame License # Test Performer's Name Description of test performed * * ATTACH COPV OF TEST RESULTS. * * --- Date Time 'i,.~ NOTE: THIS REPORT MUST BE SUBMITTED TO THE PERMITTING AUTHORITY WITHIN 5 DAYS OF COMPLETION OF INVESTIGATION PROCEDURES. .... ~.. ",. .. I:' , ! 2. VISUAL INSPECTION CHECKLIST ~ i i , . . '; '~~~~~::::a~rs and their end doors vis~allY Che~ked , ll,ho... and ~ozzle. visuallY checked tor leaks. . All t~tallzer ,seals checked tor tampering. for leaks. Results: -- All dispensers appear tight· ~~ - S-.2-1ff" './' ignature/date " Dispenaer(s) not tight as listed below signature/date . .J. .~ t'! i IDISPENSER *'SERIAL *'COMMENTS: I I , I I , I I I I I , B. ..;páñk Area -t:~ turbine boxes inspected. ~All fills and vapor manholes inspected Results: Tank area present. appears tight with no product or liquid signature/date ~ Tank area does not appear conditions listed below. tight because of the ðr~~date problelRs/ 5-.,2-£Y ITANK _IPRODUCTICOMMENTS/RESULTS: ':2-II/J-/Jrf-ll-l /N~Tm fAI ð~T7'NI ~r FlU MAN /./v¡.,ç I I I I I I C. Piping Type: 0 Pressure 0 Suction Pressurized piping leak detector (s) tested for proper functioning and for detection of leakage. __ Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above, with probleas/ conditions listed below. signature/date Description ... . . ~ HOUR REPORTABLE VARXATXON/LOSS NOTJ:P'ICAT:tON IQ.: Kern County Health Department 1700 Flower Street Bakersfield. California 93305 Attn: Underground Tank Section REGARDIRG: Facility: k flliV Facility Address: Cp (//1/7 Y /'( IS 6- ./J ,;Il /J ó- i?- Per.i t. / ¡{ t7 t/ 2 b C rß(/¥;(/N' .AvG L7/J/L't!'/?5~/éL¿7 ~ 2l Person Pilin2 Reoort: On s - / ]- g-g- J/? 0 P 11/1 , the above facility had an (date and time) inventory variation/loss that exceeded reportable liaits as described below: I Amount of Daily Variation/Loss t 2 '-I r 6-/lL Amount of Weekly Variation/Loss Amount of MonthlY Variation/Loss Total Minuses Line 3 of Trend Analysis I 0 I r:r ¡;f#,,.~;;: Tank * ()J I 'have rstopped dispensing product and begun investigation procedures required by the Permitting Authority. This notification is in addition to the phone call 1 previously placed. LA YJOHNICAN, Fleet Manager General Services. Garage Division ! ,\ . ,j: ,- . . . KERN COUNTY HEALTH DEPARTMENT VARIATION/LOSS INVESTIGATION REPORT Facility: /<fltt/ Covl<lTT 6-/-J¡1/1C(3 Permit # / ~ ¡// 2& C Faclli ty Address: / ''¡ / S 'Î /Í~ Þ Y r ". /1/ Tank(s) with Discrepancy: # / Date/Time of Discovery: 5' -I :; - $"r I:..YO ~ Name of Person Filing Report: Description Of Discrepancy: '"Ï /J N g. ¡..¡ A Î/ 1/ A 0/1'7£ 7' vL!ff(/IJr/p/ý t--~5 -¡-.2 4f¥ r;.A£; 1M F>"CE5.5 /:J,t:" 2~1l ¿;:;4L ( INVESTIGATION SUMMARY The following procedures mùst be performed within the specified times starting at the time a recortable loss is discovered or should have been discovered: Within: 8 Hours 24 Bours 48 Bours 72 Bours '- NOTE: I I I I I 11 ) I I I 12) Visual facility check to I I 13) I I I I I I I I I I I I I I I THIS REPORT MUST BE SUBMITTED TO THE COMPLETION OF INVESTIGATION PROCEDURES. Owner/Operator or other qualified person is to I 5-/ J-ff-ÝI Date Time I,) 5 review records for errors before determining there is a reportable variation/loss. ~/1't~~- I Date I Time I 5-IJ-t?ð1 /:C-f, Performed By: Owner/Operator must verbally report discovery to KCHD and follow-up with written notification on form provided. ,f-FT ¡ll1f55A/if Performed By: ~~- ~~~ be performed using I Date I 'rime checklist on the back of this form. I " -I .1-; Ji( ;2 -' J 0 Performed By: ~ -~ ~~~/'- All product dispensers are to be checked for I Date I Time calibration, and adjusted if out of tolerance. I I Performed By: Piping to be leak tested using approved method. Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH £QfY OF ~ RESULTS. * * Tightness Testing of tank(s) to be performed using approved tester and method. Date Time Contractor's Name License # Test Performer's Name Description of test performed * * ATTACH ~ OF TEST RESULTS: * * PERMITTING AUTHORITY WITHIN .§. DAYS OF ., ~ ¡,. '. 2. VISUAL INSPECTION CHECKLIST , A. pispensers ' ~ll dispensers and their end doors visually checked for leaks. ~)dl hoses and nozzles visually checked for leaks. -E:AIl totalizer seals checked for tampering. Results: -- All dispensers appear tight ~~/Ú~ 3-IY·ðff ~;~u;ej/date -- Dispenser(s) not tight as listed below signature/date \ DISPENSER I I I I B. Tank Area vrAll turbine boxes inspected. ://AII fills and vapor manholes inspected *1 SERIAL I I I I * I COMMENTS: I I I I I I I I I Results: Tank area present. appears tight wi th no product or ¥~~~ signature/date, liquid 'S-/J-E¡J- Tank area does not appear tight because of the problells/ conditions listed below. signature/date ITANK *1 PRODUCT I COMMENTS/RESULTS: C. Piping Type: DPressure o Suction Pressurized piping leak detector(s) tested for proper functioning and for detection of leakage. __ Suction piping tested for indication of leakage. Results: --Piping tight based on test(s) above. signature/date Piping not tight based on test(s) above. with problells/ conditions listed below. signature/date Description . . TANK FACILITY ANNUAL REPORT Faclli ty kl!M G:tuM+y ~ Perml t # 16 toUt!.... Month/Vr. 1. I have not done aU 0 this facility last 12 .onths. N~ ~'ð Note: Signat All major lIod1f f ns the Permitting Authority. during the ¡::~ M 'tfV~ Construct from 2. I have done lIajor modifications for which I obtained Perllit(s) to Construct from Permitting Authority Signature Per.it to Construct # Date 3. Repair and Maintenance Summary At~~h a summary of all: 7R~utine and required maintenance done to this facility' stank. ~iplng, and Monitoring equipment. ~Repair of submerged pumps or suction pumps. -~eplacement of flow-restricting leak detectors with same. -- Repair/replacement of dispensers. meters. or nozzles. -- Repair of electronic leak detection components. or replacement with same. -- Installation of ball float valves. -- Installation or repair of vapor recovery/vent lines. Include the date of each repair or maintenance activity. NOTE: All repairs or replacements in response to a leak require a Per.i t to Construct from the Permi tUng Authority as do all other modifications to tanks. piping or monitoring equipment not listed here. 4. Fuel Changes - Allowed for Motor Vehicle Fuel tanks Only. List all fuel storage changes in tanks. noting: Date(s), tank number(s), new fuel(s) stored. .~¿w € .2..?... I f ~ Î - rMNsf~ ~ rAf1}k #1 1'{) 7ibJk. 4.2..J .::tS'i c.~s.. ¿~ PhJK 8-1 wA< ~,,;t::- TO k S~,ð£b' 5. Inventory control monitoring is required for this facility on the Per.it to Operate. and I have not exceeded any reportable limits as listed in the appropriate inventory control monitoring handbook during the last twelve months (if not applicable. disregard). Signature 6. Trend Analysis Summary Please attach Annual Trend Analysis Summary for the last 12 periods. 7. Meter Calibration Check Form Please attach current. completed Meter Calibration Check Form · ¡. ANNUAL TREND ANALYSIS SUMMARY TANK , ~I TIME PERIOD: tf-;).. Co - ß'] QUARTER 3 TIME PERIOD: If!) -J-3 :- ß1 to /-;lo-eB PERIOD 7: Total Minuses This Period (Line 3) C¡þ Action Number for this Period (Line 4) //1 PERIOD 8: Total Minuses This Period (Line 3) If) 1 Action Number for this Period (Line 4) 13-3 PERIOD 9: Total Minuses This Period (Line 3) //9 Action Number for this Period (Line 4) /t/9 QUARTER 4 TIME PERIOD: /-;)..( -~ to '-/---/7- B>b PERIOD 10: Total Minuses This Period (Line 3) /:)..1 Action Number for this Period (Line 4) /,,5 PERIOD 11: Total Minuses This Period (Line 3) /~/f . Action Number for this Period (Line 4) I~o PERIOD 12: Total Minuses This Period (Line 3) /.$ / Action Number for this Period (Line 4) If? QUARTER 1 PERIOD 1: PERIOD 2: PERIOD 3: QUARTER 2 PERIOD 4: PERIOD 5: PERIOD 6: TIME PERIOD: t/ -.;2." - ßî to Total Minuses This Period (Line 3) Action Number for this Period (Line Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: 1 ~.5 -87 to Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) I hereby certify this is a true and accurate report. to ·tj-19-8 ~ 1-;)~ -'87 )J... 4) ~o :27 :J1 31 .5¡J ID -)..d., - ~) 50 u:; 6& r¿,.s 7ß /ð! ?"L6~1 J\I\¡.}t3.~ Date ý ;;Ja . -- KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET F A C I LIT ~ k~{ 4tAIJ+-'f ~4&£.. PERMIT # / , ø ¡J.;J..6 c. J TANK' I (.S:OlArU CAPAC I TV /0, ¿lOO PRODUCT wvLEAb6.?J VEAR/PERIOD I /f) 7 , INS T Rue T I 0 N-S : PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysis DAY 1 '7 ~~ tß'1 + being conducted (fro. 1 througt: DAV 2 '-1-",2 7-,p. 7 --r 12 ~). Transfer the date and DAY 3 4 -"z"ð' ¡;: 7 - the sign from columns 1 and 18 of DAY 4 Y - .1 ~ - ->-' ./ + Reconciliation Sheet to colu.ns DAY 5 1,1 - _i¡; - A·- _7 - at left. Use the table below tc DAY 6 l]-/-Jr7 1- determine the action number for DAY 7 5-2-?'--7 - the period being analyzed. DAY 8 -r; - 7- ð 7 -r DAV 9 IJ-4 - X'7 -I- ACTION NUMBER DAY 10 r:; -~-V'7 - TABLE DAV 11 < -- ~- ð 7 +- DAY 12 .')-7'(7 - 30-DAV I ACTION DAY 13 1 - ~ f-7 - PERIOD NUMBER NUMBER DAV 14 ['_ Ii - /)' .... +- ~ 1 == 20 DAY 15 '> ,': f-/ - 2 .. 37 DAV 16 ~-II-~ 7 - 3 - 54 DAY 17 f-17,..(:7 -+- 4 == 69 DAY 18 -17 _,r- ? +- 5 = 85 DAY 19 - I y-,,7 - 6 .. 101 DAV 20 -/)./17 - 7 == 117 DAY 21 c - 16 ' ,(7 + 8 .. 133 DAV 22 S..; '7- e7 + 9 .. 149 DAY 23 ~-IF-ð7 +- 10 == 165 DAY 24 Š- -I 0. r' .7 + 11 .. 180 DAY 25 5"-2(;-S" "7 - 12 .. 196 DAY 26 S-71-'1'7 + DAY 27 r; -27·/7 + Circle appropriate period and DAY 28 r; -2'7 -,f" :'" -f- action number. A full cycle is DAY 29 ¡O" _of"...I _;,.~- 7 -¡- made up of periods 1-12, after DAV 30 r; "'.,7 C '-,~:-",7 - which a new cycle begins. Use TOTAL MINUSES information to comDlete Part B. PART B: Line 1 . Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . " . . " " " " /2 I~ 20 Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 &: 2 ) . Action number for this period (from table abòve) . Is line 3 greater than line 41 OVes rgfNO .!1. Yes, YQ.!! have a reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 58041131016 (6/86) . . KERN COUNTY HEALTH DEPARTMENT ,TREND ANALYSIS WORKSHEET FACILITY kEIl/!/ TANK # ...L CAPACITV PART A OVERAGE/SHORTAGE DAV DAV 1 DAV 2 DAY 3 DAY 4 DAY 5 DAV 6 DAY 7 DAV 8 DAY 9 DAY 10 DAY 11 DAY 12 DAY 13 DAY 14 DAY 15 DAY 16 DAY 17 DAY 18 DAY 19 DAV 20 DAY 21 DAV 22 DAY 23 DAY 24 DAY 25 DAV 26 DAY 27 DAY 28 DAY 29 DAY 30 TOTAL MINUSES PART B: Line 1. Line 2. Line 3. Line 4. Line 5 . C t?V/II"T /" / C', t??I~ I PERMIT # /~&:2~C-- I/NL. ~""t7~¿? YEAR/PERIOD 1""7-,.2 INS T R U C T 1: 0 N'S : Fill in all information ~t top of form. In the space for year/ period indicate the year and the consecutive period of analysis being conducted (from 1 througt 12 ~). Transfer the date anL the sign from columns 1 and 18 or Reconciliation Sheet to coluans at left. Use the table belowtc determine the action numb&r for the period being analyzed. 6-/9/11'96' é PRODUCT - +- -+-- ACTION NUMBER TABLE 30-DAV I ACTION PERIOD NUMBER NUMBER, 1 = 20 -72 .. 37 3 .. 54 4 .. 69 5 = 85 6 .. 101 7 = 117 8 .. 133 9 .. 149 10 = 165 11 = 180 12 :EO 196 + Circle appropriate period anè action number. A full cycle is made up of periods 1-12, after which a new cycle begins. Use information to com lete Part B. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . IS /2. 27 '1 7 Cumulative minuses from p~evious periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? []Ves 8rNo !1. Yes, Y.QJ! have .!!. reportable loss ,and' must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86) . -- KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET F A C I LIT Y 1< E ¡( 1\( C. 0 (J 1\/ ì 7 TANK' I CAPACITV /Ó,OOO , C-/9/l/1C;l-' PERMIT .# 16Ø¢J'2{· PRODUCT (/Nl r'/'J t/ ~¿;7 VEAR/PERIOD /9 á 7 INSTRUCTION-S: PART A : OVERAGE/SHORTAGE Fill in all information at top c forll. In the space for year 1 16 period indicate the year and th DAY DATE (+/-) consecutive period of analys:l DAY 1 sç - 2>"- ð 7 + being conducted (from 1 throuf DAY 2 k - 2.Ý- ,~ "7 + 12 only) . Transfer the date ar: DAY 3 14- ) 7-...r7 the sign froM coluMns 1 and 16 c DAV 4 ,-/f'.f I + Reconciliation Sheet to coluar. DAY 5 -2 (".J 1 .f- at left. Use the table below + ... DAV 6 ,-]o-ð'7 +- determine the action number fc DAV 7 ,,_tJf-t27 - the period being analyzed. DAV 8 '?- .... . :s- ?' -J-. DAY 9 7 ',.('" r '-::" - ACTXON NUMBER DAY 10 /' (.... ' r'" / - TABLE - " -I- DAY 11 / ..' " DAY 12 )' - ç: ,.t' /" - 30,-DAV ,I ACTION DAY 13 7- / - [ 7 ~ PERIOD NUMBER NUMBER DAV 14 7 -{f-· ,.ç 7 . - 1 .. 20 DAY 15 7-<}>. E? 4- 2 .. 37 DAY 16 7- ,'t; . f.~ ..,. + -7"3 = 54 DAY 17 "- " ?' + 4 = 69 DAY 18 . ~ . ,.. -K-; - 5 = 85 DAY 19 /- /7 -fi7 + 6 .. 101 DAV 20 /-!v --e 7 -l- 7 .. 117 DAY 21 7-/5- ...¡'/' ~ 8 .. 133 DAY 22 7- I c--,f' ;7 - 9 .. 149 DAY 23 7- /7- ). "c- t-- 10 = 165 DAY 24 ? .?," . (~? + 11 = 180 ..... ('" DAV 25 ' . . , ~.. }:- '7 + 12 .. 196 DAV 26 7-:.Jú -6'".7 - DAY 27 .....,-:J\~Jï + Circle appropriate period an DAV 28 7-Z-z--çn 4- action number. A full cycle i DAY 29 7' Z3 "Jí'7 +- made up of periods 1-12, afte DAY 30 7-/ "-.5'"? - which a new cycle begins. Us TOTAL MINUSES information to comDlete Part B PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Pa~t A ... . . ... ... . ... ... . . . ... I CJ 27 37 50 Cumulative minuses frail previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? DVes ~o 11 Yes, ~ have A reportable loss and lIust begin notification and investigation procedures as described in Kern County Health Department HANDBOOK 'UT-10 "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) '. .- KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET F AC I L I TY I< 1'11;1/ C Ot-WT/ c: /J /? /9 ¡/,.' E PERMI T # /Ç~':) ,t;'( TANK , J CAPACITV J () ./? r;J If PRODUCT (//1/ ¿ r-/f // /-' // VEAR/PERIOD it! ,f"7- /' I NSTRUCTI ON'S: PART A : OVERAGE/SHORTAGE Fill in all information at top 0 forll. In the ,space for year 1 16 period indicate the year and th DAV DATE {+/-} consecutive period of analysi DAV 1 7-.25,<.(7 - being conducted (from 1 throug DAV 2 '7-;) (. r. .7 - 12 .Q..!!.!.y) . Transfer the date an DAY 3 7-J 7'£ 1 I- the sign froll columns 1 and 160 DAV 4 7-~ ç. ["7" -I- Reconciliation Sheet to coluan DAY 5 '7. / '?- r; / ..¡- at left. Use the table below t DAV 6 í-30-Y7 - determine the action number fo DAV 7 7- 71-,.(" .7 - the period being analyzed. DAV 8 ')?_ I-,$" "7 - DAY 9 .~ ' ..? -./17 - ACTION NUMBER DAV 10 /}-f-87 + TABLE DAY 11 J'. (/-- ð 7 'ooþ DAV 12 Y·f'· J' / 4- 30-DAV I ACTION DAY 13 k;....~-ð/ PERIOD NUMBER NUMBER DAV 14 £·7-',.( .,. - 1 .. 20 DAY 15 , .~. ,,' + 2 .. 37 DAY 16 .. '·;Jv; ;> +- 3 .. 54 DAY 17 P ,/,; " "r:: "7 - '4 .. 69 DAY 18 1" " , ..J... -75 = 85 DAY 19 . , , , .:? +- 6 101 - DAV 20 1 ,... T 7 117 ' , = DAY 21 : ~ ' " ~ 8 133 .. DAV 22 + 9 .. 149 DAY 23 -t- 10 = 165 DAY 24 .' - 11 = 180 DAY 25 7 / ,f.... :. . - 12 .. 196 DAY 26 .J- DAY 27 8,' -'. -+- Circle appropriate period - ¿~ 0' -. '. .- anc DAY 28 < ./ I . ~ " + action number. A full cycle iE DAY 29 /.,' ( - made up of periods 1-12, after DAY 30 .. , - which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . . . . . Cumulative min~ses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? DYes ~NO If Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK 'UT-10 "STANDARD INVENTORY CONTROL MONITORING". / J 77 SO 61 Env. Health 5804113 1016 (6/86) . - KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET FACILITY Kfl1lV CC'VNT/' TANK # I CAPACITV /~/Ot'1 , ~ rJ /l .#C¡::. PRODUCT PERMIT #l6Ø'/.:l6C C//Vt. ~/I¿;?f";:7 VEAR/PERIOD /~?/-.5 INS T R U C T I 0 N-S : PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysis DAY 1 ç , " " " "7 , -t- being conducted (from t througl: ,) DAV 2 X· 2 ç . ,\j + 12 .2.!!lI.) . Transfer the date anCÌ DAY 3 (' , ,,' 7- the sign from columns 1 and 16 of DAY 4 ð--)7,f' 7 - Reconciliation Sheet to colu.ns DAY 5 ¡;. 7£.. ç ,-:t' - at left. Use the table below to DAV 6 " .''''' ,c;- - determine the action number for DAY 7 .Ç- ¡7t·.(' / + the period being analyzed. DAV 8 cY- ? /",ç /' +-- DAY 9 ,?--I ,(7 - ACTION NUMBER DAY 10 ,-;). 6'7 TABLE DAY 11 ;; - j ..+: ,,7 +- DAY 12 , . /J '. ,r ;7 - 30-DAV I ACTION DAY 13 ~,r,-,I 7 - PERIOD NUMBER NUMBER' DAY 14' 4·,:; f' / 1- 1 .. 20 DAY 15 Q-7-,§7 - 2 .. 37 DAY 16 ç__ ,( -.r"/ +- 3 = 54 DAY 17 q _ '" ,. .r ./ + 4 = 69 DAY 18 1- i¡:: J - -7'5 = 85 DAY 'J , .- .... - 101 19 6 .. DAV 20 . . ; ~, 7 = 117 , DAY 21 '-to; / ~.." ~ ,,5." .-.,. + 8 = 133 DAY 22 , '" ~ - 9 .. 149 DAY 23 ..... 15'';- / ~ 10 = 165 DAY 24 - 11 = 180 '/ ' .. - , - 12 196 DAY 25 , , .. DAV 26 ~_. /., \ , - .. <II'. DAY 27 Î- J./ è" ,- J. Circle appropriate period and DAY 28 ' , .. /' ,.'"/ - action number. A full cycle is DAY 29 "i' ,if' - ,\- 7 - made up of periods 1-12. after DAV 30 which a new cycle begins. Use TOTAL MINUSES information to cOlllclete Part B. PART B: Line 1. Line 2. Line 3 . Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . .. . . . 16 S'O 66 õS Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . .. .. .. . .. .. Action number for this period (from table above) . Is line 3 greater than line 4? DYes ~No If Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86), . . i . KERN COUNTY HEALTH DEPARTMENT .TREND ANALYSIS WORKSHEET k (-/I /1/ C OV,(/T 7' PERMIT # /(~ø.26'C ~ 0 FACILiTY CA,If/?C;: TANK # CAPACITV I /1, t" (1 () PRODUCT (//1/ L ~,¡L}¿7~'# VEAR/PERIOD 7- INSTRUCTION-S: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year! 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysis DAY 1 q. 23 - ð' .7 r being conducted (fro. 1 througt DAV 2 ~,;' ~_.(' ,'"7 1- 12 only) . Transfer the date anc DAV 3 'Í- '/ or ,ç ,/, - the sign fro. columns 1 and 16 ot' DAY 4 ~ -./ ,>' ,.(" .,"" I - Reconciliation Sheet to coluans DAY 5 ,',;. .;:- :", f,7 + at left. Use the table be 10 W tc DAV 6 q.~~_~·1 +- determine the action number for DAY 7 t¡-jt:;., ? -j- the period being analyzed. DAV 8 7- <0 -,,( ;7 - DAY 9 iJ-/-.C/ -r ACTION NUMBER DAY 10 ie;.) ,r ,- - TABLE DAY 11 ,I ¡. . .- - , ' DAY 12 ..... . - + 30-DAV I ACTION .' DAY 13 't· .$'" J- 7 -4..... PERIOD NUMBER NUMBER DAY '14 I CI' '. ~. - . ~ + 1 = 20 DAY 15 IrJ- 7- R7 - 2 = 37 DAY 16 10' .\. --:~ / t- 3 = 54 DAY 17 I/},· q. ,Ç' ;? + 4 = 69 DAY 18 I":., I¡:' ¿;-/ -T 5 = 85 DAY 19 ,." ," ... . , , ,1,',7 - ~6 .. 101 . . DAV 20 } I, I? [7 - 7 .. 117 DAY 21 }(),/:-' " / +- 8 133 , .. DAY 22 1,- /' , ;.í" ? -+- 9 149 ., = DAY 23 I/r/'/f'-,S 7 r 10 = 165 DAY 24 } Tl -II' ,( 7 --. 11 = 180 DAY 25 / C/ - /7 -,(" --;.... - 12 .. 196 DAV 26 r..-1[.¡:7 +- DAY 27 10'/ '~-d >:-. - Circle appropriate period and DAY 28 /Ç "L¡/ (/ +- action number. A full cycle is DAY 29 Iv>'1 (' ? +- made up of periods 1-12, after (, DAY 30 :"/~:,~)/' / -- which a new cycle begins. Use TOTAL MINUSES information to comclete Part B. PART B: ACTION NUMBER CALCULATION Line,l. Line 2. Line 3. Line 4. Line 5. Total minuses this period-Part A . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1, & 2) . . . . . . . . Action nnmber for this period (from table above) . I s 1 i n e 3 g rea t e r t h a n 11 n e 4? OVe s Ø'N 0 If Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-IO "STANDARD INVENTORY CONTROL MONITORING". I 2 bC 7r- 101 Env. Health 5804113 1016 (6/86) FACIL!TY TANK t CAPACITV It?, /?l7tJ PRODUCT t/ .IV L h?.ß& VEAR/PERIOD rf-7 - 7 INS T R U C T ION'S: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysis DAY 1 /I)<l7¿. - being conducted (froll 1 through DAV 2 !,': . ;/ ':' ',i .., 12 ~). Transfer the date anå - DAV 3 .. .' ;- ( :'," ~ the sign from columns 1 and 16 oÎ , DAY 4 lo-2C'Æ? ...¡- Reconciliation Sheet to columns DAY 5 IC-27-K .7 - at left. Use the table below tc DAY 6 /1/'/1_$ ,(7 -I- determine the action number for DAY 7 I {, }--> "/ - the period being analyzed. " , ',j DAV 8 'r -;- '. DAY 9 / / ...+ ACTION NUMBER DAV 10 /I,/-J7 -- TABLE DAY 11 ' ! ¡ , ,í :7' - DAY 12 ' . ~ \ J -+ 30-DAV I ACTION , DAY 13 ¡I. II - (" . ./ - PERIOD NUMBER NUMBER DAV 14 1/' , , " . . . 1- 1 20 = DAY 15 I ( t" ' " - 2 .. 37 DAY 16 (f - "'/ #' / ~/ - 3 = 54 DAY 17 I ; .- rf ' .r / +- 4 '" 69 DAY 18 ! ;'.-- 'j' ,f-/ -I- 5 = 85 DAY 19 1- .,- / .J-. 6 '" 101 DAV 20 ,,1. ' ' -77 117 . ' == DAY 21 . . ; -.. 8 = 133 DAY 22 .' / ' . ' ' " - 9 = 149 . , DAY 23 I,' + 10 == 165 DAY 24 ., ,';; . + 11 = 180 DAV 25 / ./ - / ¡': ::- /' - 12 == 196 DAY 26 J 1- /7 ",-)" DAY 27 Ii, I;. .C.- - Circle appropriate period anà DAY 28 / /" !I:;, " . ........ action number. A full cycle is DAY 29 J 1- ./ ( , ,~ . -t- made of periods 1-12, after up DAV 30 . . - "J . .~ :;p - which cycle begins. Use , a new TOTAL MINUSES information to complete Part B. PART B: Line 1 . Line 2. Line 3. Line 4. Line 5. . - KERN ,COUNTY HEALTH DEPARTMENT ,TREND ANALYSIS WORKSHEET j¿. ~ /f Æ/ C t!f/A/-r 7' C- /I /1/1 (.'ç PERMI T # It ~ø 2 v'c ACTION NUMBER CALCULATION Total minuses this period-Part A Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . Action number for this period (from table above) . Is I in e3 greater than 1 in e 4? 0 Ve s ~ No 11 Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK tUT-10 "STANDARD INVENTORV CONTROL MONITORING". Iff' 7.? 1(; /! 7 Env. Health 5804113 1016 (6/86) FACILiTY . :e KERN COUNTY HEALTH DEPARTMENT .TREND ANALYSIS WORKSHEET /< f /1 /1/ é c'/v /1/)"?' I c:.1'J/1,q¡Ç~ FERMI T :# J h ~~26C TANK # CAPACITV (] /C C/ Ó PRODUCT {/ Nl f/?¡C# VEAR/PERIOD ~7/,f , INS T R U C T I 0 N"S : PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for yearl 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysi~ DAY 1 TI j'" -', ..;- being conducted (from 1 througr . ," ,í " DAV 2 /1.,.,)'/ ',( / +. 12 .2.!:!.il) . Transfer the date anc DAY 3 //'7(/ , ,-, 7 rr- the sign from colullns 1 and 16 or DAV 4 1'- -jl';", ( "/ + Reconciliation Sheet to columns DAY 5 II ~ 7C ~ J 7- at left. Use the table below tc DAV 6 . .",;. " , + determine the action number for " DAV 7 !, . 2'f . .c ,:~ - the period being analyzed. DAV 8 /1' .J t,'. r:? ,- - DAY 9 IJ-'?Í/~'(1 - ACTION NUMBER DAV 10 /:1' )'- ,~-;1 - TABLE DAY 11 I - ".~.. ¿:- ".f ..¡-- " DAY 12 J.2- -y-.F'1 ..;- 30-DAY ,I ACTION DAY 13 ' " PERIOD NUMBER NUMBER DAV 14 ' " , - : ,.J 1 .. 20 DAY 15 , , . + 2 .. 37 DAY 16 ,-' ?-...'" ' - 3 54 '/ = DAY 17 .. J . . ,--/ - 4 .. 69 " DAY 18 l¿- '7·.F;7 +- 5 = 85 DAY 19 /7- /c '.¡? / -I- 6 .. 101 DAY 20 /).. I ,. .r / +- 7 .. 117 DAY 21 ' ! --/;." - ,( .' -- ~8 133 = l~.". .I ~., " .;- 149 DAV 22 9 .. DAY 23 /./ It,. ( ,7 +-. 10 .. 165 DAY 24 .'') . j', - " '. + 11 180 = DAY 25 1/- /þ. ('-;0 - 12 = 196 ',. . DAY 26 I,: ./:# .. '7 7 - DAY 27 ,'._';-. 1/' .' - Circle appropriate period and DAY 28 !,.'/," ,.:' -,7 - action number. A full cycle is DAY 29 /7')(;' /7 ~ made up of periods 1-12, after DAV 30 f -., ~ _' 1- ..sO' ,.- -t- which a new cycle begins. Use TOTAL MINUSES information to comclete Part B. PART B: Line 1. Line 2 . Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? []Yes , ~No 11 Ves, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-I0 "STANDARD INVENTORV CONTROL MONITORING". / I 1G 1?l7 /3 ? Env. Health 5804113 1016 (6/86) ----- . . KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET 1 DATE 16 C+/-} +- T +- C/.}/l~c;.é- PERMIT:# I{~~~C PRODUCT f/ /II L ~# r /./ VEAR/PERIOD ?l9 INS T R U C T I 0 N-S : Fill in all information at top 0 form. In the space for year period indicate the year and th consecutive period of analysi being conducted (from 1 throug 12 only). Transfer the date an the sign from columns 1 and 16 c Reconciliation Sheet to colum~ at left. Use the table below t determine the action number fc the period being analyzed. FACILITY J<EIlN' COt/NT)'" TANK # / CAPACITV 10,000 I PART A : OVERAGE/SHORTAGE DAV DAY 1 DAV 2 DAY 3 DAY 4 DAY 5 I 2 . ? ('~ " "," DAY 6 ,2 ,,7,' ,';.- , DA Y 7 I'" ,,,- / o A V 8 I.)· ;.U'· _,' ,7 DAY 9 I)' Ifr/ê / DAY 10 / ~', -' I-.g 7 DAY 11 DAY 12 DAY 13 DAV 14 DAY 15 DAV 16 DAY 17 DAY 18 DAY 19 DAV 20 DAY 21 DAY 22 DAY 23 DAY 24 DAY 25 I";';' A) DAY 26 DAY 27 DAY 28 1- / ,c: /-..:r,. DAY 29 ,- I'" ('" DAY 30 ,;,.'(-' TOTAL MINUSES PART B: Line 1. Line 2. Line 3. Line 4. Line 5. .' /) // ""'?' U,/J-g" ;7 '12. ' 2- ./ ",' 'J /2 ' ;' r; . ,.:.' ~ - T - +- J- . ACTION NUMBER TABLE - I - I -,}3 :;." !,./'r? I '''-j' .', r: ;::r - - 30-DAV I ACTION PERIOD NUMBER NUMBER 1 = 20 2 = 37 3 = 54 4 = 69 5 = 85 6 = ·101 7 = 117 8 = 133 @ = ~ 10 = 165 11 = 180 12 = 196 - I· l " (-' ,¿-. 1- )" /""/"'-- J ¡-" .c- J. .- -1- 1- .'.... I-F;- E'~ /-9-99 1-/0 - ?iX" /-II-S/9 I-/~- 99 /-/7. -9r::- 1- /!J - ? D' - + + - + -J- -+-- - ,-'- ,- f- -f- -r- Circle appropriate period ant action number. A full cycle i: made up of periods 1-12. afte which a new cycle begins. USf information to comelete Part B ('r" - +- ACTION NUMBER CALCULATION Total minuses this period-Part A /2 107 I I c¡ /'-19 . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? OVes ~o 11 Yes, ~ have ~ reportable loss and must begin . notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-I0 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/861 . -..- KERN COUNTY HEALTH DEPARTMENT . TREND ANALYSIS WORKSHEET F A C I LIT Y /< [' (( /11 TA.NK , / CAPAC I TV Ctl¡;'",,-,,/ J),C< . PER M I T # / ~ (.~ C;'" /: <.' 1/1-/ I /"/,/.}/,"/' VEAR/PERIOD ,&.~.,// /" ., " " p' /1 ,.!,' ¡F, 1'" ,'" .' ¡ll , .' PRODUCT X N S T Rue T X 0 N'S : PART A : OVERAGE/SHORTAGE Fill in all information at top 0: form. In the space for year, 1 16 period indicate the year and th~ DAV DATE (+/-) consecutive period of anal ys i: DAY 1 / - 2 I -g' ¿(' -r being conducted (from 1 throug DAV 2 /-.);' (" ,J..' + 12 only) . Transfer the date anl DAV 3 ,I" ;'J" ~-. . .... ;:" t the sign from columns 1 and 16 0 DAY 4 ./. è'~' - Reconciliation Sheet to column: DAY 5 ) -:J 5"- ;:; í~~' -f- at left. Use the table below t DAY 6 I '-;.? C: '(,- E - determine the action number fo: DAV 7 I -- :2---- _. ?; ¿.>-/ -I- the period being analyzed. DAV 8 -7$?·S'} -1- DAY 9 -7.1<~ t- ACTION NUMBER DAY 10 ' .~ l c;] - TABLE ~_. , DAY 11 I - . ¡., . :: :;-.--/ -I- DAY 12 Ij...:/-A/" -+- 30-DAV I ACTION DAV 13 ./ , . -+-- PERIOD NUMBER NUMBER . . . ¡J-, DAY 14 ' . .. + 1 20 . , == DAY 15 " ! ~ . :.>;'" - 2 == 37 .. DAY 16 ;;-S-p;? 1- 3 == 54 DAY 17 -,7 . r; , .' - 4 == 69 DAY 18 :?- 7 . + 5 = 85 DAY 19 / X' -..-: ". - 6 == 101 DAV 20 ) ,~ .... ,. -+- 7 117 .... , = DAY 21 ,,( :' - 8 == 133 DAY 22 J.. I I· ---,-0 + 9 == 149 . 0 DAY 23 ¿ - 12 : ,~/ +- @ = @P DAY 24 2- /7 . .r;"ç + 11 == 180 DAY 25 ,j,I'{'çi' - 12 == 196 DAV 26 .:;- /5- ;tt' ..J- DAV 27 ;:' I (:. .r ¡f + Circle appropriate period and DAY 28 .'. , "".'.: (."" .+ action number. A full cycle is DAY 29 . + made up of periods 1-12, after - DAV 30 .? I p' to"' f- -r- which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION - ~ ~ I I C/ /.2-/ JÞ5 Total minuses this period-Part A . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? []Ves ~No li Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86) FACILITY I TANK # CAPACITV 1/J (J O() PRODUCT U f,ll I" ,.,.,)/- // VEAR/PERIOD #"7/// / INS T Rue T I 0 N'S : PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAY DATE C+/-) consecutive period ,of analysis DAY 1 ) - L--'C .' ,:; ,~ - being conducted (from 1 througt DAV 2 ? :.' I· ,w;",~ ~ 12 ~). Transfer the date anc DAY 3 2-.:Jz-fS.Y + the sign from columns 1 and 16 of DAY 4 2-27-6'3' - Reconciliation Sheet to columns DAY 5 "'-? ~ <I.... i..., . r(j" ;-' at left. Use the table below tc DAY 6 . '} . --~ ( ,ç ~~. r determine the action number for DAY 7 .J - / (:, F X- --F the period being analyzed. DAV 8 ' .J. ;/'? çc - DAY 9 j /~',;; . ,(" y -f- ACTION NUMBER DAV 10 [5- 2 q.. S( ~ - TABLE DAY 11 h- I - F ~ -+ DAY 12 1'2-:l-~·r. 't 30-DAV I ACTION, DAY 13 - ":. -h"'~ - PERIOD NUMBER NUMBER DAY 14 .~ - if" <:f ç;, T 1 = 20 DAY 15 'f-ç~ Ç' ,.oo - 2 = 37 .: ð 5 r; ,-' -;- 3 54 DAY 16 - -/(- = DAY 17 }, ./ ,\'7 --r- 4 == 69 DAY 18 "l - f' -,~ ¡; -r 5 == 85 J 0/ S!? j- DAY 19 - .' 6 == 101 DAY 20 J-/~-8:? - 7 == 117 DAY 21 ¡. /f' ,"( + 8 =: 133 DAY 22 J. '7· ~(' ;"': +- 9 == 149 DAY 23 .f ! :¡-, /::' ~ == 165 DAY 24 I~- I <,I ~ ç f- == 180 DAY 25 -:>_It:; Jf + 12 == 196 DAV 26 7'/1- f,~ - DAY 27 ?-/7-~r +- Circle appropriate period and DAY 28 :f -/'l.--fT T- action number. A full cycle is DAY 29 No /?(/1£J/~/,/ made up of periods 1-12, after DAV 30 "3 -....! c) _,'w' ¡¿ - which a new cycle begins. Use TOTAL MINUSES information to comnlete Part B. PART B: Line 1. Line 2. Line 3. Line 4. Line 5, . . -0 ______ .______ _ _ ._______" .-- -. .---.--- --- KERN COUNTY HEALTH DEPARTMENT .TREND ANALYSIS WORKSHEET 1/ 1.' ~ ',/ , '- ,. (\ I" '/.,( '7 /..- # " {;.7 ,..' /~. <-- c? (//1/7' ,~ (f- n /1 /J r/ l! PERMIT ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 41 []Yes ~o 11 Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK tUT-10 "STANDARD INVENTORY CONTROL MONITORING". I Ó /.2 7 /J7 /150 Env, Health 5804113 1016 (6/86) . . KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET FAC I L I TV k £Irll/ TANK' / CAPACITY Co V¡Vr/, / () /(/ tI () , C I'J /1/1 ~ ¡: PRODUCT PERMI T # IbOO 26c- (/IV{ hid!'/'? VEAR/PERIOD ;?f/2. I NSTRUCT:I ON"S: Fill in all information at top 0 forll. In the space' for year. periQd indicate the year and th consecutive period of analysi. being conducted (fro II 1 throug 12 only). Transfer the date an, the sign from columns 1 and 16 0 Reconciliation Sheet to colu.n at left. Use the table below t determine the action number fo the period being analyzed. PART A : OVERAGE/SHORTAGE 1 16 DAV DATE (+/-) DAY 1 7~ :l/~¿' I< 1- DAV 2 <-'J."J-;j<4' - DAY 3 ~-À ) -2 'R' or DAV 4 '< -.l..'..I~~8 - DAY 5 <-:;J...5" -~J? +- DAV 6 <;- .L'/..- ~,.¡J + DAY 7 z-"J 7_ ÿY ~ DAY 8 7-:;£,ÇÇ +- DAY 9 . /~ '~:'. r.r E - DA Y ·10 7- ]C- ð'¡:: - 0, DAY 11 ?- "'! -, ç- + , , (: (~ DAY 1 2 q - / -,f ~ - DAY 13 1..(- 2 - [,( -!- DAV 14 t,_1' I" í? - DAY 15 tJ - !.J - /"<? -¡- DAY 16 y- Ç"-ýR" - DAY 17 '-I-~·rtr - DAY 18 '-t- 7- Ii" -J- DAY 19 If- f' - tf'1 -+ DAV 20 H-~-¡-Ý - DAY 21 ~-II-tfý - DAY 22 ~ -11- Fr +- DAY 23 c.¡- J).- S--V - DAY 24 4- n-d"R' +- DAY 25 '7- jt-r óð -f- DAV 26 '-I~/S-fY - DAY 27 L. ./t:--r! .-t- DAV 28 'J . / ~ .' ;. ; -J-. DAY 29 -. .ý - FF ...r- DAY 30 L¡'¡"'-,'rf - TOTAL MINUSES ACTION NUMBER TABLE 30-DAV I ACTION PERIOD NUMBER NUMBER 1 = 20 2 '" 37 3 '" 54 4 '" 69 5 = 85 6 - 101 7 - 117 8 '" 133 9 = 149 10 = 165 ~ = 180 '" 196 -- Circle appropriate period and action number. A full cycle is made up of periods 1-12, after which a new cycle begins. Use information to comclete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A . . Line 2. Cumulative ainuses from previous periods in this cycle. 137 Line 3. Total minuses (add lines 1 & 2) . . . . Line 4. Action number for this period (from table above) /96 Line 5. Is line 3 greater than line 4? OVes ONo 11 Yes, ~ . have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK 'UT-10 "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1018 (6/86) . . ANNUAL TREND ANALYSIS SUMMARY TANK # ~ TIME PERIOD: 0-.:2-6-<87 to L.f-;lý-88 QUARTER 1 TIME PERIOD: if -?.Co - t!Ð "7 to 1-d..~ -Ð? PERIOD 1 : Total Minuses This Period (Line 3) /Lf Action Number for this Period (Line 4) c;J-Ù PERIOD 2: Total Minuses This Period (Line 3) ;)..1 Action Number for this Period (Line 4) ~1 PERIOD 3: Total Minuses This Period (Line 3) '1/ Action Number for this Period (Line 4) ·St./ QUARTER 2 TIME PERIOD: 7-~5-~1 to 10 -2..2 -~'1 PERIOD 4: Total Minuses This Period (Line 3) do? Action Number for this period (Line 4) °1 PERIOD 5: Total Minuses'This Period (Line 3) hß Action Number for this Period (Line 4) ß5 PERIOD 6: Total Minuses This Period (Line 3) 84 Action Number for this Period (Line 4) /G; ( QUARTER 3 TIME PERIOD: 16-:2-3-6Î to I-d-.o -~~ PERIOD 7: Total Minuses This Period (Line 3) 9'8 Action Number for this Period (Line 4) 117 PERIOD 8: Total Minuses This Period (Line 3) I/O Action Number for this Period (Line 4) 13-3 PERIOD 9: Total Minuses This Period (Line 3) I J..J- Action Number for this Period (Line 4) I '-Ij QUARTER 4 TIME PERIOD: 1-;),( ~g,8 to PERIOD 10: Total Minuses This Period (Line 3) /3 r..f Action Number for this Period (Line 4) J 6:5" PERIOD 11: Total Minuses This Period (Line 3) ( 3. d.... Action Number for this Period (Line 4) ¡go PERIOD 12: Total Minuses This Period (Line 3) /'-11 Action Number for this Period (Line 4) (9 to I hereby true and accurate report. Rßðt Date ~¡~ß KERN CjlNTY HEALTH nJlARTMENT TREND ANALYSIS WORKSHEET FA C I x.,. I T Y k¿¡2,,\ CÐIJ..JJ+' G-~~ TANK # .;t (NC)I2.Tft~ CAPAC I TV 10, 0 00 , PERMI T #: /6Øø.;L6 G PRODUCT l.{AJl.E4ð£l) VEAR/PERIOD I/ß1 INSTRUCTION'S: PART A : OVERAGE/SHORTAGE Fill in all inforllation at top of form. In the space for year/ 1 16 period indicate the year and the DAV DATE -{ + / - i consecutive period of analysis DAY 1 t-{ -:2b - fj 7 + being conducted' (from 1 through DAV 2 <-t - .J 7-% ? 1- 12 .!ill.!I.) . Transfer the date and DAV 3 lf~2i'-£ 7 -, the sign from columns 1 and 16 of DAY 4 ~ -:7 "'. Æ" '7 +- Reconciliation Sheet to colu.ns DAY 5 f,oI-]/-"'::":;to - at left. Use the table below tc DAV 6 i:j-I-ð"? +- det,ermine the action number for DAY 7 ç' -..1.. - /i ,7 - the period being analyzed. DAV 8 ¡;-7-p,7 - ~ . ... .... > . ··..........··h .~ DAY 9 r::;-J -~"'" ,~ ACTION NUMBER DAY 10 ~ -s-¡: 7 - TABLE DAY 11 ç-~-r.; -:¡::: DAY 12 r:"- 7-P] - 30-DAV T ACTION DAY 13 r; -E·[ - -r PERIOD NUMBER NUMBER DAY 14 r' i, - ,J<"';, "7 '-::¡~ --31 - 20 DAY 15 J. I:; '{.',7 - 2 .. 37 DAY 16 5'~ 11-.17 ~ 3 .. 54 DAY 17 ~-/;J -¡:. 7 ~ 4 .. 69 DAY 18 -I :1-,$7 - 5 .. 85 DAY 19 I -/""-ð'? - 6 os 101 DAY 20 !./r;-.f",7 "t- 7 .. 117 DAY 21 .- IG- ¡; ,;7 + 8 '" 133 - DAY 22 .5 - / ?- Ç'? + 9 .. 149 DAY 23 5 ~ /;;-, ~. ,? - 10 = 165 DAY 24 ~~, I..!;' - ,C: ::> u~_ 11 = 180 DAY 25 S -"/C;-ð",7 -+- 12 '" 196 DAY 26 5-';,0-'; ? ...+- DAY 27 5-.22 ',5.7 -. Circle appropriate period and DAY 28 S' :7 '1- .s? - action number. A full cycle is DAY 29 s- :? &..... - _~-7' 7- made up of periods 1-12, after DAV 30 S- 2fi" -/: I ¡ which a new cycle begins. Use TOTAL MINUSES information to comnlete Part B. PART B: Line 1. Line 2. Line 3. Line 4 . Line 5 . ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . ILl çp /4 .20 Cumulative minuses from previous periods in, th~scycle. Total minuses (add lines 1 & 2) . . Action number for this period (from Is line 3 greater than line 4? . . ... .... '.-. .......f·.. ..;......~-.,,:.....-.-'., .:.. ,.' . . table above) . DYes gNo If Yes, ~ have ~ 'reportable loss and Must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) . . KERN COWNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET FACILITY f<FItIV C(Jf/IIITY TANK # 2- CAPACITV 1t!,OI/Cl , , 6-/1/1/16-'6" PRODUCT PERMI T # 1((7'4.2Cc 1//1/ ¿ t"'1"1,?,¿¡Ç7 VEAR/PERIOD 19r7 -.2. INS T R U C T I 0 N"S : PART A : OVERAGE/SHORTAGE Fill in all information at top of ð forlR. In the space for year/ 1 16 period indicate the year and the DAV DATE (+/-) consecutive period of analysis DAY 1 "-20.-&7 +- being conducted (fro. 1 through DAY 2 5-.J~~-~7 - 12 only). Transfer the date and DAY 3 )-..2 ,("-'.("7 +- the sign from columns 1 and 16 of DAY 4 S~2 f-f7 ...,- Reconciliation Sheet to coluans DAY 5 t;'7t/-,(? + at left. Use the table below to DAY 6 <; ,- 71 -;,: 7 - determine the action number for DAY 7 G - (-¿-7 -+- the period being analyzed. DAV 8 G -;; -.,5"/ - ¿ DAY 9 ("-]-,5"7 +- ACTION NUMBER DAY 10 G·~" .):(,7 -¡- TABLE DAY 11 ~- 5"-~'7 7- DAV 12 ¡;.- ~ . f 7' - 30-DAV I ACTION DAY 13 I"; - 7- ;;] - PERIOD NUMBER NUMBER DAV 14 h -f? <i7 + 1 == 20 DAY 15 6-9 -cP> - ~2 a 37 DAY 16 ;;'-10-87 -/ 3 == 54 DAY 17 k.-1 J - a 7 .~ 4 '" 69 DAY 18 6-1;).-~7 - 5 .. 85 DAY 19 6-/3-77 + 6 .. 101 DAY 20 6-/'1->::7 - 7 .. 117 DAY 21 6-/5 -S, + 8 .. 133 DAY 22 ð - /h - '1"7 - 9 .. 149 DAY 23 6 -/7 - ð 7 + 10 '" 165 DAY 24 t. -19- 9 7 of- 11 .. 180 DAY 25 b-¡Il·,f7 -I- 12 == 196 DAY 26 /-///-1: 7 .f- DAY 27 J -:?I-Æ? - Circle appropriate period and DAY 28 '-J;?'ff7 + action number. A full cycle is DAY 29 ,-2]-cf7 - made up of periods 1-12, after DAY 30 '7 -¿ ':/' E ,7 + which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A / 7 .-' /7' 27 37 . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? DYes -ØNO 11 Ves, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-I0 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86) - . KERN COUNTY HEALTH DEPARTMENT .TREND ANALYSIS WORKSHEET F A C I LIT Y k' [ ¡? IV" TANK # ~ CAPACITV C Of/IV;/" I c./ 0 eNJ 6/J/7/J6'fÇ PRODUCT PERMIT # /~~d¿bc.. V/V I to ¡1d~¿J VEAR/PERIOD I 9,;;-7- I NSTRUCTI ON'S: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and the DAY DATE ( + j.- ) consecutive period of analysis DAV 1 6 :)'i --;¡:7 +- being conducted (froll 1 through DAÝ 2 r¿, -.2 f' ,) :7 - 12 only) . Transfer the date and DAY 3 (-'-27-,j +-- the sign from columns 1 and 16 of DAY 4 ('".7r ,f/ +- Reconciliation Sheet to coluans DAY 5 {-. - ;;. ~ .. ,¡" ,/ +- at left. Use the tab 1 e. be 10 W to DAV 6 r;. '·.J~-ð"7 .J- determine the action number for DAY 7 r¡ ~ðl- ¡; 7 - the period being analyzed. DAV 8 7-2 -,.( 7 -r DAY 9 7, '7-,<"-:'" -I- ACTION NUMBER DAV 10 /' ,:".- ç: // - TABLE DAY 11 7 - r; .. ç- ;7 -I- DAY 12 ;7 -(.. .. .. 7 - 30-DAY ,I ACTION DAY 13 7- ;7.·.r '7 - PERIOD NUMBER NUMBER DAV 14 ~7_ ,~... ,5' "7 1- 1 ... 20 DAY 15 7- "7. ,f"? - 2 ... 37 DAV 16 7-/['/-? 1- -7-3 ... 54 DAY 17 . .f-' !.: -';'(,..7 - 4 = 69 DAY 18 ' ..~ I / -f 5 = 85 ' . DAY 19 7-/'3-<5".7 - 6 ... 101 DAV 20 7-/V.£.7 -r- 7 = 117 DAY 21 '/-/5-r:F7 - 8 :: 133 DAV 22 7-- / (!:" .roo ;;; - 9 ... 149 DAY 23 / .. l7, r:- f· 10 = 165 DAY 24 ., ~ / .f 11 ... 180 DAY 25 " ." ;'~. ,..t' ./ - 12 :: 196 DAY 26 7-2 (#. -F/ - DAY 27 7-::l/-Ý7 - Circle appropriate period and DAV 28 '7- Z. 'Z.- -8 7 +- action number. A full cycle is DAY 29 7-7<-#7 - made up of periods 1-12, after DAV 30 7-.2 v ~.,) ~ -¡- which a new cycle begins. Use TOTAL MINUSES information to comolete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A . . i 'f Line 2. Cumulative minuses from pre v i 0 us periods in this cycle. 27 Line 3. Total minuses (add lines 1 & 2 ) . . ~ f Line 4. Action number for this period (from table above) Sif Line 5 . Is line 3 greater than line 4? OVes ~o !L Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86) t . . KERN COUNTY ßEALTH DEPARTMENT TREND ANALYSIS WORKSHEET F A C I LIT Y k ¡C.r1 N C V ¿.' /117' ;; (;.: /9 /7 /9 6' ¡:: TANK ~.2. CAPACITY I C1/C7¿:;t;' PRODUCT PER M I T # / 6' t7' 12 t« {/N ¿ tcL?t<£? VEAR/PERIOD /q ,Ç7'~ INSTRUCTION'"S: PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year/ 1 16 period indicate the year and th€ DAV DATE (+/-) consecutive period of analysi~ DAY 1 7-7'>-,R- ,7 - being conducted (froll 1 throug: DAV 2 ' 7-.7C~' ,) .,. - 12 onl y) . Transfer the date anc DAY 3 7- ') 7- ð ;7 ..;- the sign from columns 1 and 16 0:; DAY 4 7-; S·£ 7 - Reconciliation Sheet to coluan:: DAY 5 7' ;?{?-ð'/ -¡- at left. Use the table below te DAY 6 11_ ,.',~ 87 + determine the action number for DAY 7 7-JI-ð'/ - the period 'being analyzed. DAV 8 .8 - J- ð" 7 , t- DAY 9 ,ç. ;';'X '7 +- ACTION NUMBER DAY 10 3'- ?'-8.7 - TABLE DAY 11 ¡ç- c,;- (')/ -¡- DAY 12 ..,r-- 5'., ¿- :;,7 - 30-DAV I ACTION DAY 13 If -t;. ,.ç ? - PERIOD NUMBER NUMBER DAV 14 tff- 7-h 7 -¡- 1 - 20 DAY 15 ,.(. ,c¡-, r'~ .:;-' - 2 37 .. DAY 16 ,". ('Ì", £. 7 '+ 3 .. 54 DAV 17 ,(' k /' . ...,. 4 69 ,\ / -7" .. DAY 18 '"' ,. + 5 85 ~ = I' DAY 19 , ' , + 6 .. 101 , DAV 20 ! I . ..; 7 .. 117 DAY 21 ! ¡ 8 .. 133 DAY 22 - -! 9 149 .. DAY 23 " ' -. 10 = 165 DAY 24 - , , oj.. 11 .. 180 / DAY 25 ,x + I " .. t';" 7 r 12 196 . r. .. DAV 26 i"; . , I (., . / -r DAY 27 (", - _/ Cr / - ?' - Circle appropriate period and , DAY 28 ~ " ~ . ,. -.... t action number. full cycle is ( -. ' ' A DAY 29 - made up of periods 1-ì2, after DAY 30 / -, which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . . . . . /2- 4- / ,~ '1 69 Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2 ) . Action number for this period (from table above) Is line 3 greater than line 47 OVes I)!N 0 .!J. Yes, ~ have J!. reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK _UT-I0 "STANDARD INVENTORY CONTROL MONITORING". Env. Health 5804113 1016 (6/86) . . KERN COUNTY HEALTH DEPARTMENT .TREND ANALYSIS WORKSHEET FA C I LIT Y K ("/t/1/ ét7(/¡1/T/ TANK' 2- CAPACITV frJ,Ot?o - , C¡q/1,-.,c;l!" PRODUCT PERMIT #IGrlrl26C V/'I/L /f"A4(!'", VEAR/PERIOD L9~7-S I NSTRUCTI ON'S: PART A : OVERAGE/SHORTAGE Fill in all inforllation at top of forll. In the space for year/ 1 16 period indicate the yeàr and the DAV DATE (+/-) consecutive period of analysis DAY 1 ð - ") {-t. ç -r- being conducted (froll 1 through DAV 2 6"'''; S-k/ -+- 12 .2l!..!.I. ) . Transfer the date and DAY 3 3 ,../(;-,(' ,/ 1- the sign from columns 1 and 16 of DAY 4 ~·2 7-.(' '-rt' - Reconciliation Sheet to colu.ns DAY 5 ç......' F'(f'~'? - at left. Use the table below to DAV 6 ~~.. ., ~ to .t. .~ ~:? - determine the action number for DAY 7 ,.' . ., '¿,: _. ~.+.. :> 4- the period being analyzed. DAV 8 g-7/-ð" 7 - DAY 9 9' / - (Ç" '7 - ACT:ION NUMBER DAY 10 ~'.J.ç " . 1- TABLE DAY 11 If· ? -,)" ;7 +- DAY 12 ti-Lt.,J" 7' -¡- 30-DAY I ACTION DAY 13 q.- r. -.ç -7 PERIOD NUMBER NUMBER DAV 14 n. C' ~ -?" - 1 .. 20 DAY 15 {f- .:'!'··.,S" - 2 37 .. DAY 16 '7 ",f" ' ,r'/, +- 3 = 54 DAY 17 r¡ - 4r '-,.(-7 - 4 = 69 DAY 18 ...... it? ( ,- 75 85 ,~. I - - = , '. , -!- 101 DAY 19 6 . DAV 20 , ' . .-- 7 117 = DAY 21 " ;/ - 8 = 133 DAY 22 ~ . " 1/. ..('" / -L 9 = 149 DAY 23 '1. /_r:--,/- ~;' - .10 = 165 DAY 24 c:; /::- ,:/ - 11 = 180 I DAY 25 <1-/7,.r7 - 12 = 196 DAV 26 '1· I,r . ,:' '~. ,+ DAY 27 ,. '> .- . ....... - Circle appropriate period and DAY 28 - /" ~, action number. A full cycle is .' DAY 29 '..;- >' ' .t. ,/ ~ made up of periods 1-12, after DAV 30 i~ '..).;>. ;i'/ - which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1 . Line 2. Line 3 . Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A IS }'3· ø~ ~5 . . . . . . . . . . . . Cumulative minuses from previous per'iods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? (]Ves ~NO liYes, ~ have ~ reportable loss and must begin notificatio~ and investigation procedures as described in Kern County Health Department HANDBOOK 'UT-I0 "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) -. --_. "--"'--'. --.---- - ----" . .' KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET FACILITY A61Æ/ TANK # 2- CAPACITV éC7C/Nr7 /tP,O¿:i'o , C/l/l~~r PRODUCT' PERMI T # /6 'rT?f26C I/A/¿ ~/?~p7 VEAR/PERIOD Æ-?- (; INS T Rue T I 0 N"S : PART A : OVERAGE/SHORTAGE Fill in all information at top of form. In the space for year! 1 16 period indicate the year and the DAY DATE l+/-) consecutive period of analysis DAY 1 ",. ;,; 3'.;~ - ,q I) being conducted (from 1 througt DAY 2 tf· ? l.¡ -,,( / T 12 on! y) . Transfer the date and DAY 3 (/J-./ r-,,/ .... the sign from columns 1 and 16 of DAY 4 e,y ?(.'..~,7 1- Reconciliation Sheet to columns DAY 5 r¡. .>' ,..., ,f 7" - at left. Use the table below tc DAY 6 q~7fhð7 -¡- determine the action number for DAY 7 '1-,79-.57 .... the period being analyzed. DAV 8 '1- ?O·C? - DAY 9 fé' ¡'. ,r ') .f.- ACTION NUMBER DAY 10 It· ) - TABLE DAY 11 ' " .. - ". DAY 12 " T 30-DAV ' I ACTION, ' . DAY 13 !r/-.J-S7 i- PERIOD NUMBER NUMBER DAV 14 / " (...../ - 1 = 20 v DAY 15 J()~7- H7 - 2 = 37 DAY 16 / (/- [ , ,5 / ;f- 3 = 54 DAY 17 I (; . ., ' í- .7 .... , 4 = 69 DAV 18 n' Jt (1 5 = 85 DAY 19 I,?·/It] f ~ = 101 DAY 20 .: r: . /¿ ,r / - = 117 DAY 21 ! . " -I 8 ;" 133 DAV 22 J/,~:_ /"_Þ,,,<'-/~ -:t" 9 = 149 DAY 23 10· I 'j' '" 7 - 10 = 165 DAY 24 I;; _ / /,.í· ,? -I , 11 = 180 DAV 25 /0 -,I/' <:? 7- 12 = 196 DAY 26 I ,', I r " . ".. DAY 27 ,:' ,.J. ;os-. ./~' - Circle appropriate period and DAY 28 ,.., .' ... + action number. A full cycle is ' , DAY 29 /:)-;.-' ~. ,í7 - made up of periods 1-12, after DAV 30 , I - which cycle begins. Use ", . " a new TOTAL MINUSES information to complete Part B. PART B: ACTION NUMBER CALCULATION Line 1. Total minuses this period-Part A . Line 2. Cumulative minuses from previous periods Line 3. Total minuses (add lines 1 & 2) . Line 4. Action number for this period (from table Line 5. Is line 3 greater than line 4? . . . . . . 16 6"/5 8"'if 10 ( . . . . . . . . in this cycle. above) ~ OVes 'Ø'NO 11 Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) KERN COATY HEALTH DEARTMEN'T TRE.ND ANALYSI S WORKSHEET E"AC I L I TY ¡¿fA'/I/ rANK,;2 CAPACITV C{/t/NT'/ ¡~I (/¿70 t~/?,I ¡II b ,r- PRODUCT PER M I T # /6 ø ç¡/¿;;~ c: 1/,(,/ L //9///,.;7 YEAR/PERIÓD Ý7-7 INS T Rue T ION'S: )ART A : OVERAGE/SHORTAGE Fill in all information at top of forll. In the space for year/ 1 16 period indicate the year and the DAV DATE (+/-) consecutive p'er i ad of analysis DAY 1 //)-:2.3-g7 r being conducted (froll 1 through DAV 2 It·~~->7 - 12 .2.!!.l.I.) . Transfer the date and DAV 3 I¡'" /J-;7 ...;- the sign from columns 1 and 16 of DAV 4 Il'j -26'J"7 + Reconciliation Sheet to columns DAY 5 /rr27·ý] - at left. Use the table below to DAV 6 /1- . ) £'. .)7 -I- determine the action number for DAY 7 /¡; --;lif-X' ;' 'i- the period being analyzed. DAV 8 /(,-:( ý-,( / 1- DAY 9 '·:,7/·..Ç "7 - ACTION NUMBER DAV 10 I I - I -,If '7 - TABLE DAY 11 1/-2-.rJ -I- DAV 12 iJ- .< - ,( 7 - 30-DAV I ACTION DAY 13 Ii - L/. c<'";7 -r' PERIOD NUMBER NUMBER DAY 14 II - t;" . (" -/ 1 1 = 20 DAY 15 /1 . ~ - . . / ,- 2 = 37 ~ , DAY 16 1/. 7- - , - 3 = 54 DAY 17 If· ç . .' / . 4 = 69 DAY 18 1/- ,I í '/ -+~ 5 = 85 DAY 19 II - /( - (' 7 - 6 = 101 DAV 20 / I - / / . :",1 - '. 117 77 = .". " +- DAY 21 . ¡- '/J - ;. . 8 = 133 DAY 22 I ' 1"1. ' , +- 9 = 149 ' ) - DAY 23 II . , -- " ..; 10 165 = DAY 24 ' ,~ ' " " / - 11 = 180 DAY 25 /) . j ..' . ,- 12 = 196 DAY 26 '- DAY 27 II. .Ii? ( '/ - Circle appropriate period and DAY 28 /1· /:í - :, - ./ -t-- action number. A full cycle is DAY 29 I - ¿ c. - ç '7 + made up of periods 1-12. after DAY 30 /, , ) , .' (' / - which a new cycle begins. Use " . TOTAL MINUSES information to complete Part B, PART B: Line 1. Line 2. Line 3. Line 4 . Line 5 . ACTION NUMBER CALCULATION Total minuses this period-Part A I Lf' ý~ 97' /.1 7 . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? []Yes CQNO 11 Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK tUT-IO "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) . . KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET FAC I LI TV ¡¿[11M é(/{//lt'7/'" TANK # ;2... CAPACITV IIJ ,OC/( , 6-/9/1/7ðl P E RMI T :#: I '¿1ft 26C PRODUCT t/N t ,c",/'?//7 VEAR/PERIOD %7/ F' INS T Rue T I 0 N'S : PART A : OVERAGE/SHORTAGE Fill in all information at top 0 form. In the space for year 1 16 period indicate the year and th DAY DATE (+/-) consecutive period of analysi DAY 1 I J . 7/ .S j ..J- being conducted (froll 1 throug DAV 2 .I j ..> " r-/ I 12 ~). Transfer the date an DAY 3 f.~ ~ :..:.~ !../. t"s~' ~7 - the sign from columns 1 and 16 0 DAY 4 I r - :; (' _. f:. '7 - Reconciliation Sheet to column DAV 5 fl- ?(.. f7 ..¡- at left. Use the table below t DAY 6 I ")7-<::"7 - determine the action number fo DAY 7 '{-JI;../; ;/ +- the period being analyzed. DAV 8 ,,-./1·;7 - DAY 9 /I ' /' - ,:- " ~ ACTION NUMBER DAY 10 17· I-f?} - TABLE DAY 11 /1.-:7 -..P 7 - DAY 12 1:J-7-?7 +- 30-DAV I ACTION DAY 13 -J- PERIOD NUMBER NUMBER DAY 14 -I. 1 .. 20 DAY 15 ~- 2 .. 37 DAY 16 : / 3 = 54 - DAY 17 1./ 2" .('.- ';./ 7- 4 .. 69 DAY 18 -:2 ,7 -- 5 .. 85 DAY 19 /.JL, 10-l7 -t- 6 .. 101 DAV 20 /) . " -- "t- 7 117 .. DAY 21 J.' e -+- 78 .. 133 DAV 22 - - +- 9 .. 149 DAY 23 /:J /'/ r ) - 10 .. 165 DAY 24 //. IS-'cr)' - 11 = 180 DAY 25 II 1/ -ð'/ - 12 .. 196 DAY 26 .I.~ I ;7 - ,1" / f- DAY 27 / " - ,'''; -;'</ -r Circle appropriate period anc DAY 28 ' ~.~ ' " .~ . 1 - action number. A full cycle i~ - < , DAY 29 .. . '/ 1- made of periods 1-12, afte: ',. - " up DAY 30 I' ! -I which a new cycle begins. USE TOTAL MINUSES information to comclete Part B PART B: Line 1. Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A I ) I -- . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 41 DYes DIN 0 11 Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-IO "STANDARD INVENTORY CONTROL MONITORING". c¡ :S" / ' ~ , / () J ~ ) e:nv. Health 5804113 1016 {6/86/ . . . KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET Co (/11/1")' lú/oo() . - PER M IT, # / 6 d'tf 2 be i.//tl L ~//~L? YEAR/PERIOD % 7/ ~ INS T Rue T :r 0 N-S : Fill in all information at top c form. In the space for y~ar period indicate the year and tr consecutive period of analys: being conducted (from l~throu: 12 only). Transfer the date ar the sign from columns 1 and 16 r Reconciliation Sheet to columr at left. Use the table below - determine the action number f· the period being analyzed. FACILITY kERN TANK # ~ CAPACITY 6A/lAtJ.e PRODUCT PART A : OVERAGE/SHORTAGE 1 DAV DATE DAY 1 ,....' ~ , DAV 2 I?-/}/- DAY 3 /7., :-J" " DAY 4 / Z· ;' r; , DAY 5 ;l' .,' DA Y 6'7 ,<' DAY 7 /'" , DAV 8 /'/ ,//:,:/ DAY 9 ,-' <." ,r / DAY 10 17 JI- K7 DAY 11 1- 1- ,~ R' DA Y 12 I ./' \ '. DAY 13 ;-- ¡it' D A V 14 , - IJ ; DAY 1-5 I" ,,,,. DAY 16 I,r-::,F,':' DA Y 17 /, ,,/ '/"- Y· DAY 18 J- fi"- s;- ~ DAY 19 1-9 -/<: ~ DAV 20 /-/0. -¡c7 DAY 21 J-J/-t? ~ DAY 22 I -l'l.-..Ç,$ DA Y 23 í - J .....r :; DAY 2 4 1- I ~/ - Ii" ,;:¡- DAY 2 5 I, J,~ ," DAY 26 ;" ;' DAY 27 (;,/ DAY 28 /. //. ,.Ç' /;- DAY 2 9 / - ',,' " :~- DAV 30 1- ;10- ,<f'r! TOTAL MINUSES PART B: Line 1. Line 2. Line 3. Line 4. Line 5. 16 (+/-) - +. +- ~ - - + ,¡-' - ACTION NUMBER TABLE ... .. of- - 30-DAV I ACTION PERIOD NUMBER NUMBER 1 = 20 2 . 37 3 = 54 4 = 69 5 .. 85 6 .. 101 7 .. 117 8 .. 133 @ .. Q!V 10 .. 165 11 .. 180 12 .. 196 ..L_ I ...J--" ~ - -t- -+ oJ- - - + -I-- -I- - ..J- - Circle appropriate period an action number. A full cycle i made up of periods 1-12, afte which a new cycle begins. Us information to complete Part B +- - -t- ACTION NUMBER CALCULATION Total minuses this period-Part A I) .Þ-- II 0 / ') ,) ..t::-_~. lye¡ . . . . . . . . . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? []Yes ~o !L Ves, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-10 "STANDARD INVENTORV CONTROL MONITORING". Env, Health 5804113 1016 (6/86) I ------------ --.- -_.- .. KERN, COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEET F A C I LIT Y 1< r ¡,> j./ TANK # ~ CAPACITV (" (,' I//'. /.. .>/ I ¿; . 0 c:' 0 ,,:- I.' /:.."/1/': . PER M I T# / ¡; (/ C ] {: . PRODUCT {.JJ,I! /-,111)/'0 VEAR/PERIOD (','//1 INS T Rue T I 0 N-S : PART A : OVERAGE/SHORTAGE Fill in all information at top 0 form. In the space for year 1 16 period indicate the year and th DAV DATE (+/-) consecutive period of analysi DAV 1 J - ;2 .' - ,K ,.;-~-- - being conducted (froll 1 throug DAV 2 1-7?-/Z 1- 12 -º.!!.!.ï.) . Transfer the date an, DAY 3 , .,/ ~,. }~;" f-: -+ the, sign from columns 1 and 16 0 DAY 4 ! - ..¿' <,," ,R' Y - Reconciliation Sheet to column DAY 5 / ,7_ -,(" -t- at left. Use the table below t - ~--;~ ,'\ DAY 6 / / j.:', ,ç <ç ..- determine the action number fo DAY 7 1-27-£/( -, the period being analyzed. DAV 8 ,~7<:,(" +- ,¿ ~ . .' DAY 9 1- )~-, /" " - ACTION NUMBER . \ ....~ DAY 10 I" ·/t·· (J ~ TABLE DAY 11 1 :,' l . r: ; - ,', i DAY 12 ".2. - ! .. 8í? -t- 30-DAV I ACTION DAY 13 .2 '..l·,.rr - PERIOD NUMBER NUMBER DAV 14 .7 " ~ ~. ('- I ' - = 20 DAY 15 - ~-"" f ; 2 = 37 - DAY 16 ,/ ' .- .. -¡ 3 = 54 DAY 17 Y - . .'- 4 = 69 DAV 18 ) , -r 5 ... 85 -' DAY 19 J. -- % - ð"l?" - 6 = 101 DAY 20 2' <1' ~ :7 -f- 7 = 117 DAY 21 /'/,: ,......... ~. 8 = 133 .. DAV 22 2.. - II" JF .( -I- 9 = 149 DAY 23 J - 12" Ii' - @ = Ci§þ 2- , ? - II' - DAY 24 11 = 180 DAY 25 ,;/- 1'-1- ,,, -J. 12 = 196 DAV 26 2, /;--;rr ..} DAY 27 -. I , (- (.... +- . Circle appropriate period anå - DAV 28 - action number. A full cycle is DAY 29 ) ! ( r~ +- made up of periods 1-12, after , (, DAV 30 .2- /t# ',( ,;,.... ¡- which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2. Line 3. Line 4. Line 5. '\ ACTION NUMBER CALCULATION ~ I Total minuses this period-Part A /:0 . . . . Cumulative minuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . Action number for this period (from table above) , J ;; ./ _13~ / ~ ~ '.:l ~, Is line 3 greater than line 41 DYes 1Jþ(0 l! Yes, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-lO "STANDARD INVENTORY CONTROL MONITdRING". Env. Healtn 5804113 1016 (6/86) · e KERN COUNTY HEALTH DEPARTMENT TREND ANALYSXS WORKSHEET FA C I LIT Y /-:'" r /. /I...' (..- {}V,:,,·.,... /..... TANK # .2- CAPACITV lo'CC/ú PERMIT {,.. /VIr>' ,';-,r,:.-vEAR/PERIOD ,;./ .' C /' // /J t~(ç PRODUCT I NSTRUCTI ON'S: PART A : OVERAGE/SHORTAGE Fill in all inforllation at top o ~. form. ' In the space for year, 1 16 period i n d ic ate the year and tho DAV DATE (+/-} consecutive period of anal ys L DAY 1 )I -.2 () " xX' -/- being conducted (froll 1 throug DAV 2 ') ') /. .r; ¡;.' - 12 .!!.!!.!.I.) . Transfer the date an ., DAY 3 2-22-Rã +- the sign from columns 1 and 16 0 DAY 4 ./-;; 7 -if%'" - Reconciliation Sheet to column DAY 5 ;7..7V-fJ +- at left. Use the table below t DAV 6 ,~ ). ..,. c - ,!( r-:. -I- determine the action number fo DAY 7 :;.~. ",/,'-: - (~:--.J~' .--- the period being analyzed. DAV 8 ~- "27- /)f( - DAY 9 ..':)-~~-';1?, +-- ACTION NUMBER DAV 10 0. -~? - O:>? - TABLE DAY 11 1,< - \ - J'9 - DAY 12 - ;;. (~ ---- 30-DAV I ACTION DAV 13 ' " -t- PERIOD NUMBER NUMBER ,.j " DAY 14 ' . ,..,- 1 20 , ::I DAY 15 I· j -- 2 ::I 37 ¡ DAY 16 , ,. .¡- 3 = 54 DAY 17 :J- 7-ð'ð'" - 4 ::I 69 DAV 18 .J - J"., ð'r ~, 5 = 85 DAY 19 ?-e;-g¿- - 6 ::t 101 DAV 20 õ(1-It/-Æ f' + 7 = 117 DAY'21 '1" II - r r -+ 8 '" 133 DAV 22 '1. /2-;'Y ~ 9 '" 149 DAV 23 /. I 7- JJ ¥ - 10 = 165 DAV 24 < II" r ;,- + ðP '" 180 I' f." DAY 25 3-/.::;-$9 -I- 12 '" 196 DAV 26 ~. - ,I,:. í. ~ ~..- +- ( I' DAY 27 1'/7-ð'r- -I- Circle appropriate period an DAV 28 '(- If ,J :; -r action number. A full cycle i DAV 29 A/'c- /,11'"/' /.>"'" '¿;. made up of periods 1-12, afte DAY 30 / - Err + which a new cycle begins. Us TOTAL MINUSES , information to complete Part B PART B: Line 1 . Line 2. Line 3. Line 4. Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A .. .. .. .. .. .. .. .. .. . .. . I Ú I ;2 ;.L I 3 2-. / ~O Cumulative ainuses from previous periods in this cycle. Total minuses (add lines 1 & 2) . . . . . . . . Action number for this period (from table above) . Is line 3 greater than line 4? DVes ~NO 11 Ves, ~ have ~ reportable loss and must begin notification and investigation procedures as described in Kern County Health Department HANDBOOK #UT-l0 "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) ". (e KERN COUNTY HEALTH DEPARTMENT TREND ANALYSIS WORKSHEBT FACILITY ItE1l~ TANK'.2 CAPACITV CUI/Ñ77 10 ,()~(; , 6I1A,e¡6-~ PRODUCT PERMI T # / 60~2hC f/Mt. ~A(/¡:P VBAR/PERIOD 9'7//Z. . " J:NSTRUCTJ:ON"S: PART A : OVERAGE/SHORTAGE Pill in all information at top 0 form. In the space for year, 1 16 period indicate the year and th DAV DATE (+/-) consecutive period of analysi DAV' 1 ?-;?/-'!"ý ,.¡-- being conducted (froll 1 throug DAV 2 ~ -.:1 2- ~ç. - 12 only). Transfer the date an, DAV 3 1. - d. 3, -ff'p' -I- the sign froll columns 1 and 16 0 DAV 4 3--?S/-~ R - Reconciliation Sheet to colu.n' DAV 5 ? -2. 5"' -Jl + at left. Use the table below t DAY 6 ~ - Z c.. ' ó ~' -t determine the action number fo DAY 7 1~-2.7- If- - the period being analyzed. DAV 8 '1-2 g- - 8' f + DAY 9 ~.?1· (~ +- ACTION NUMBER DAV 10 '1-](/-,5'£ - TABLE DAY 11 1· '71 - ~ X - DAV 12 -J/-J-tf".f ~ 30-DAV I ACTION' DAY 13 l~-")' J;Ý. - P,ERIOD NUMBER NUMBER DAV 14 .'4. 3 . x i +- 1 - 20 DAY 15 !.I . . t~··. ,~r y - 2 .. 37 DAV 18 '1 - _f - ð' .... - 3 = 54 DAY 17 4- ,-~ ::--- - 4 .. 89 DAY 18 0/-' /-,1 Ý - 5 = 85 DAY 19 .., - r· ~~ + 6 .. 101 DAV 20 if - i - 'g- r 7 = 117 DAY 21 ~ . I () - YJ?' - 8 .. 133 DAV 22 4-II-fi"" - 9 .. 149 DAY 23 Lf-I.l Ifý +- 10 = 165 DAY 24 ~-/ ?"xR' + ~ = 180 DAY 25 4-!L(·fit6 - .. 196 DAV 26 '" -/)-~-r - - DAY 27 '-I -II "p't + Circle appropriate period and DAV 28 Lt,/7-'&x .:;... action number. A full cycle is DAY 29 L,. Ix- gy +- made up of periods 1-12, after DAV 30 J. .I e;- f% - which a new cycle begins. Use TOTAL MINUSES information to complete Part B. PART B: Line 1. Line 2. Line 3. Line 4 . Line 5. ACTION NUMBER CALCULATION Total minuses this period-Part A . . . . . . . . . . . . Cumulative minuses fro~ previous periods in this cycle. I 32.. Total minuses (add lines 1 & 2) . . Action number for this period (from Is line 3 greater than line 4? . . . . . . table above) . . . . DYes ONo / q6 11 Yes, ZQY have ~reportable loss a~d must begin notification and investigation procedures as described in Kern, County Health Department HANDBOOK 'UT-lO "STANDARD INVENTORV CONTROL MONITORING". Env. Health 5804113 1016 (6/86) 1 . '-'c ... - -#- - I ':~b-~ I.- , I, ",., "~ ,..,,-~,~,,-~~ti¡.4 ~\'J~iiy~1m'~'V:!: 1 ¡ ç}:,; ~ ~,. '::: :h.:":j\~:: ~;..,V··J..2A~;.4;_~ ,',.' ,:"~",. ": ,,,·~t ,~ " ¡"'~"'~,"-' .... '-1'';;; , r~:¡.f,..'\-·t:·· u. .~¡" ·-AP..~'(-~...,*,,·,t'1,' ~t j'i"J$II'"';J''' 'r ' .,~ ' .. :;;~ttf~::~;¡;:g~ : ''','' ," ".,,,'n,, ".,;'À~æ:~,~...' " ?~:'~,:i;~h~i. - if -?-'!". 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I' ,¡:~ ':" ":i~~ .:~. ~> . ,"", ~,......- '.... ...¿-~~,,~ ". , I', :·I-~ 'f'~./r ~ '\, .~rt . I\~~"~~"'~~:' Receh,.. ''<''',. - "~"" l~~·;t:~(l.~· '~: - ¡ ~ , PLEASE þ,... . e ~ ¡;4~ ¡~;: " .~ . -,~' ::g~~~.. ~.·~:'-.I ....:~"* føS8S , ,~3f (,"~ , .,: _ 'a;.':i.4'T1.... ~;i;."~~ '. '. ': .,-,,; ,\ I,,\~>,~~!r¡, 'f, '!':'1f'f } ., ,"", I"' T' .-....:;, ,.', it ;,. '....... } ¡.... .~', .ï;tS!i"...; ·',,;........'1-·..,1 ¡ ~, . I..,:'"..,."....' ",;,.,j,. - . "",,:;- 1ff,1o~1"" ,<, , " ,'1,:,';.-" ,....~",: 'H~ .. ,,''':'~'' tò.tI..,~t~\".,.:~.I".,''I'". -.,:"~'. < .' '" ; ·'OO;:l AUTOMOTIVI.INDUSTIIAL ,,_.. lit ~ lit. f ~ ' , :~~~~~ J Q ~ PEl SERVICE INVOICE INSTALLATION· MAINTIiNANCI \"'~IfJ S 6885 8A L.. aOlo so. UNION AVE. BAKERSFIELD, CALIFORNIA 93307 CALIF. CONTRACTORS LIC. NO. 294074 ....A.iI ,..,.. A.... U..U.",. AIID CO""" --.-. 8MOUUl ...... TO "'N18 ..VOIC_ -... INVOICE N.. DAIJ'I!: (8011) 834·' '00 REQUESTED BY PHONE NO. CUSTOMER ORDER NO. '-l ~ d -g7 :Ji m. I ÞX)"'A~ ~\"Zk," o 0 CHARGE CASH Ò,. . MAIL INVOICE TO ,. 'J . 'I UJt' K~RN 111/# Gal"!~"'a J Sa...vloas llll&; l'ruxtun Ave H~k9r~rteld, CA 9)301 LpO 50'1 APH 9 ::I:j ~~l\... , L o C A T I o N ~ ~m~ .J irt:.b ~ IV Ct/') /l¿:1" ~ ~ WORK TO BE PÍ~í05RME . " . ,." ~ . FOR "" ,. ~ ~.LA JJ_..J ,/;J'~4I;"..~.i~. ,.+ J"'~/)/- J J ~,. _ _ L rl""~"".IV OFFICE WORK PE¡RFORMED: -... / -.,- USE -J.~ -.\4> LV' ) ,. ONLY , .ø (fiJ. &I"tLJIj/tk ~ . , TECHNICAl. .."VlelE .- HOURS MILEAGE " Sub Contract I I , , , , j, . . I . \\ Rentals I ~ ',' , , .~ ~ r I IJSðA-I-P~": r¿Vllll- C þ.;.fl.--rP J:t 2 " , , 'L" " , , I -- . I . MAKE 1(11- MODEL NO. SERIAl:. J:,~II2." IZ" '-5"1/1- ! ....- S QTY PART NO. DESCRIPTIO.r--j¡,_ 12. -.J"" n W R ~J' 0009 ' LA z" _~6JIIJ/~-( ,.' . t V""'. " í ....-. - y , , - : " " " '., ~. Supplies -. Date Completed 'f -~ '. ,j.Jl "'1. ~~;I:Z:I: .fk¡~, ~)} Sales Tax "- Received & Accepted By "i (. ~-1 '-/ ~.Æ---1' ' ~- .i'- 'I' TOTAL '.. '. E Y T I" V ICE. T(.;MSI Net due upon ReceiPt p , '- La.SQ2 EL-S ' PLEAS PA FROM H S IN 0 / ! Finance Charlie of 2% per Month after 30 !!~\'."__ LEASE REMIT TO RLW EQUIPMENT P.O. BOX 840 +" ..-~,'''--~'-.~' - -- .............. . . M'E M 8 E R tPLb AUTOMOTIVE. INDUSTRIAL . PETROLEUM EQUIPMENT INST ALIA TION . MAINTlNANCI 2080 SOUTH UNION BAKI!RSFII!LD. CA. 83307 . PHON!! 834·1100 CALI". CONTRACTORS LIC. fI 284074 MAILING ADDRESS P.O. BOX 840 BAKI!RSFIELD. CA. 833' l, I :. \ . . nN LOA OINO DOC rILL PIP[···-COR t1AT-ER J:AL ;; OTY PART:I: 1. ~7.0094 1. 4040078 1. 240077 1 247067 1 ~4c)046 rAGE 1. > '.. rCOUNTr., OF Kr::RN " 1715 I nr:NE '- SER\JICF.:S 1415 RUXTUN AVr:: DAKE FU:U."I CA 9~30 l - L .J 05/'l1/Ð-::' S 68 39 Garage Jim Hindman .:t . . HAt) TO RETURN-··-OAlJrJF.: STICK :.CTED AND cnECI<ED FOR PROPER r:r.r POWN ,r :1 " ¡: " I ~ I! .' I I ¡ I . . Dr::~CfUPTION 7ß3~' TANK BQTTO~ PROTE '~42 3 '~TANK BOTTOM PROTE 9ß4~' 2 .1···~ANK eOTTOM r~oTt A20 004 ~ ALUM DROP TUDE 41 ¡ 14' FI9EROGAUfJE STICK (CAt PRICE 1. -1 . S 0 ~~:~~ ,1,1.11 ~1.67 , I, ¡; I: ¡ ¡¡ U I o ¡. I , " "0 "';' f' lABOR: ~.oo t1AT£Rt AI..:: SUPPl~ I ES : GALEr. TAX-. TOTAL: ~ if. - I ~.. .:.~ PLEASE PAY FROM THIS INVOICE AS NO STATEMENT WILL BE ISSUED. TERMS: A FINANCE CHARGE OF 2% PER MONTH WHICH IS 2~% PER ANNUM CHARGED AFTER 30 DAYS. ._-~~__-:"'_õi.._~_ ..._ . MEMBER æ£b II I AUTOMOTIVE. INDUSTRIAL . PETROLEUM EQUIPMENT INSTALLATION. MAINTENANCE , í i: r-COUNTY OF KERN GENERAL SERVICES 1415 TRUXTUN AVE LBAKERSrrCI..D . 2080 SOUTH UNION BAKeRSFIeLD. CA. .3307 · PHONe 834-1100 CALIF. CONTRACTORS LIC. , 284074 PAGE 1 I MAILING ADDRESS P.O. 80X 840 BAKeRSFIELD. CA. 83302 05/14/07 S6665 arage--Truxtun A~ I WORK PERFORMED-CALIBRATED ALL PUMPS FOR STATE REQUIREMENTS. IN- STALLEU STRIKER IN TANK. INSTALLEij 4-INCH AnAPTER MA1=ERIAL: ' , ~ GTY PART.' DESCRI~.TION ~\.., PRICE ..,t 2~n079. 9042""'4:', TANK BOTTOM ~.,~ 67.48 O~2690 B1468~ 12., LEAD/WIRE ~' E ..... 1.00 1 2:45508 A9() 001 'ADAPTER (A~"., ,,).,.......~ 5.02 . ~\ ....//~/ "" ." / ~ / ~ ~" to ~¡\ '<;J 1715 CA 93301.-' .J LABOR: 2.50 MATERIAL: ªUPF'LIES: sALES TAX: TOTAL: PLEASE PAY FROM THIS INVOICE AS NO STATEMENT WILL 8E ISSUED. TERMS: A FINANCE CHARGE OF 2% PER MONTH WHICH IS. 2"". PER ANNUM CHARGED AFTER 30 DAYS. 70. 121. .., ,: 200 . . . . _.' ,....... 4~....._··"" "'-'''~-''''''';.''-''~-'~~'''-=1'' ..;.~ '..-....-.-' M E M'B E R ~PEI~ <1fUM EQUIPMENT IN')' AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INST ALLA TION - MAINTENANCE 2080 SOUTH UNION BAKERSFIELD, CA, 93307 · PHONE 834-1100 I CALIF. CONTRACTORS LIC. II 294074 MAILING ADDRESS P.O. BOX 640 BAKERSFIELD. CA. 93302 Ie n :.!i'H Y rJ F :.:: Fr.:: ì·J (ìF¡~CR(,I,. ~::;~(:;:')J:r:CS :1715 I r,,':. /1 i,/ f~~" r· {If·; E 1. ':;722S 14 t5 r :::II)<"TUN ¡;WE r:,w:c ¡;'i; r r :'=1, n L r.t\ ?::~.~ () 1 -. .J ¡,Ai-i'(,Gr \ 11M '):'1 r:;'·,'¡¡:'ì·iCI:t ::c':r~Î~!f:';'r(¡ TOT¡')I.J:'/FR ";:;:\1. ¡'¡NO r,1·:F:CI·',::;·f FOR F'F:(iF'Er< ,r'::,J ~,:",;!¡-J Tn iT¡liF'1 FTr"O'R ï . .:.. T roo ~'.' J ~., L ~ ; I"'; :-..' ;-. , '.','1 ...' " :J. ~;"¡;!~:;~;~.j~ M ~'.' "-" ;:·."i ;.. J5 ,:::·:·~.}:;0tt:~YN?~~:.~}' '~.;" '~, ~,.jÎÎ~:1:'£ia,~:-..,,\...,~.i . .-.i- ~:;;.>~;; .,. '(' - ." . ~ ";.~~; '.).¡;'; ., "i.~..j t· '\" .. i;,t../;>" ,:;.,,¥..," ", ..',......,' , '.' ~.-r..~~'ít..... ...:.:...i-i!i~:..::'.¡..;..r:i$' ......~..- . ~,~,.¡, ;.¡-~~~' L(1ÐÜF' ~ 1. .50 Í'~ n C I:;¡'¡ r. ~ ~,I, T()TAl.~ 4;~!::: ;:),/. I::; .~~: .. ,CI"~ PLEASE PAY fROM THIS INVOICE AS NO STATEMENT WILL BE ISSUED. TERMS: A FINANCE CHA~GE Of 2% PER MONTH WHICH IS U~. PER,ANNUM ÇHARGED AFTER 30 DAYS. .. ;-l;- . 'ok:.... 1 ~ /' . . .. ' --;pMËi~ qfUM EQlJIPMENT INS" AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION· MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834-1100 CALIF. CONTRACTORS LIC. IJ 284074 MAILING ADDRESS P.O. BOX 640 BAKERSFIELD. CA. 93302 r'/'II~f~' 1 C."7 . ~ !~; ....~. ~.~.~. " I r.rH 'NT'( ¡- F~ I,;'r,:"-' ".' . ' .. 1 r:. 1 ï;r. ¡.~ E R,^¡ I. ';", F; ~ ',,' T i": ::.. ,.., 1,7\ 0::; -, INVOICE NO. "'-4 '1 ...... IJ. 141~ THII;<TJ li,1 r, 'll:: n'\ "':' ¡::'~~.... 'e 1'1 ",I L ' t1 \... \'.." " .... J CUSTOMER'S ORDER NO. Ci~ ,?',.: '; ,", J ~ LOCATION ORDERED BY JT~ fnr'" r:..::r;-TI:'~Ì'i::-D ·("'.:ICCI;:'-(, Ci:,,·\:"r~tinn¡·, nr' ~:::.tr: :···!..!i·;:~· ;",ì·Ji) f~ÇI.."",Y Fin;::'. ',.\.:.. ,::,:"r':': r:I,lr~¡.Jr::1) III r ,' r:-S t.NT.1 Dr"rFCT T VF 1":(;1'" tiC T T(l¡:~. CHr:rl<rn Fn R ';: r, ;:. rr' r I;" C ;.~.;". T J II ì·! , « I ";"t::: F' T ¡.~, ~~ : .,;'" F' tJ(f :~: ?: 31, .(~ ':.1 ';, "331·:19/) 17:;;'771.). 't 9 oO"~() (' ::~I , .~ '} 09.'- 79:1 T'lr::'::r: ::~~ r f' T r n¡..' :I ;:, ,·I!. ':<c ì"i:\ t:;¥ ,::- .~,I.ITrL;: 'j t, iT Î\'117.71.F ?,;t,ITr)* I~)_.\;')\·\'~~ 0 :1. () i··:nl·,~~t::-: t,)("t~'r}r~ I..:!. :I~ r'nr:F "(,)0(),:~'~1 H'\ I UH J:1:1 (')';'::'::, ',','J,Y:~/.?/T,\PtiC!TCI¡:;; ~X5~n DrG~nNNrrT FM F' r:::r r r- .:7:. ::; ~1.7~ 4.::'0.0(ì .~0. (}O '~l..I ;' Q..'75 .....; St. .' . \, . \~> , .-oM ',' ^ ~ ... . L, <\.0 . ...., .,;, . ....,,,.__'..~.,J ::L,r., :'. " .. " , .. ...- . I ...'/ ~ '_'. ~.....¡ ¡ ....d" !~;'::,;¡';.~..:...; '. .,," ~. . . . . : '.': I \~... ......,. q -.,. I,t, '(~nR ~ -~ . 00 r1(:,Tr.RT ;'¡I " !";UF'P!., L FS:: r:r.,,!TS T(:.:<:; TOTAL: '.. ., ,.I1ft.....:, t:" ..' ., : i. C::4)_ ., ~ PLEASE PAY FROM THIS INVOICE AS NO STATEMENT WILL BE ISSUED. TERMS: A FINANCE CHARGE OF 2-;. PER MONTH WHICH IS 2..-;. PER ANNUM CHARGED AFTER 30 DAYS. . ...~ ',-=-... ':' "":'" .. ~...,;", ··ic '. '" 1" ~_. q~ ~__ If ; ;6~;~L.~~:':E~:'( s 7480 j" 2080 SO. UNION AVE. j , ;.' I.BAKERSFIELD. CA 93307\, (805) 834-1100 1450 W. McCOY. SUITE A SANTA MARIA, CA 93455 (8015) 928-11315 ......... -.... ALl..I_UI"'. - -.... "'''.MiCa ....ULD ...... TO YM" CAL.I.,. CONT"ACTO"S L.IC. NO. UeGTe :::.v:~~: INVOICE NO. AUTOMOTIVE·INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION·MAINTENANCE DATE REQUESTED BY PHONE NO. CUSTOMER ORDER NO. a- 0 CHARGE CASH ,. ,\ !:J.~ . i vr' IÜ..RN ### G~nA~~l Services :41~ Truxtun Ave Bak~r~rield, CA 93301 L Pc 7û'i WORK TO BE PERAF~~M/HV9 1'115 , L o C A T I o N 00 IJ.) 1\.) G:L\a.~ MAIL INVOICE TO ...J ^~/ Aß a...f\ 0 ... FOR OFFICE USE ONLY . WORK PERFORMED: MILEAGE Sub Contract .. Rentals MODEL NO. SERIAL NO. Date Completed Received & Accepted By PLEASE PAY FROM T IS INVOICE. TK"MSI Net due upon ReceiPt PLEASE "-? / I, , ;' Finan!=! ~l1arg. of 2% øer Month ~ S:MIT Tn <. Supplies Sales Tax RLW EQUIPMENT P.O, BOX S40 TOTAL . . .. . ----.... E M,8 E R i!PEI~ ~fUM EQUIPMENT INS" AUTOMOTIVE· INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION· MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834-1100 CALIF. CONTRACTORS LIC. /I 294074 MAILING ADDRESS P.O. BOX 640 BAKERSFIELD. CA. 93302 :1.715 I 07/22/B/ Pf:~GE 1 r COUNTY OF KFr~i-4 GENERA L. !~(R'v'l CES 1415 TRUXTUN ,~VE ~ L£!(':II,E:HSFIEI..Ü 87480 (: í~' <J ~.~ ~~: () 1. ..- .J "I;!:I': \.- t':r-~I~UF:NFn-·C¡·'¡I~:n~rÜ DPFr;::"1T I DN OF II I f~I::'EN~3F.:R--Cll::r-\Ni:·:D STHi~1 IN!: R ::1,1'1 . :~,(:[n SUB F'UìíF' ¡'~' ".ID CHECI{En FGr< F'r::GPFF: ()F'EFo:ATI()N r;(,!"L¡:~ Itll.. :: 1(1'( h~¡:;:T: : :I. O:!'29:"jf-, 1. 0219132 nEf.1C¡:~ I PT r. ON H5995M GASKFT* UMP75S1 MOTOR 3/4 HP PRICE 3. 9~i 462 . 19 " ""IT. " , '. ',~ .... .. .... PLEASE PAY FROM TH~S INVOICE I...ABOP,: 2.50 "ÎI;TEI~:I AI..: SUPPLIES: TERMSi!1J!.t~{:¡OT 8 ~S íÓ7~L. 7 ~.\ .. 4~, :', .. ,¡ . .~.. ',.; "' "'. L ') . ~_'\.J : '0 A '''ANti CHMGI Of 2% ,. MONbt WMlCH .. U'Y. ..I A.-.. CHAKID A'''. 31 DAYS. IN TH1 IVIHT O' ANY LA-MUff OUt O. THIS RANSACtION fttI ",VAIUNO 'Am ,"AU" IINm'l.m ro UCOV. "ASONAta' A"O....Y"I 'HI. AU MUCHAIirOIII UMAINI rtf. NOf'IaT' Of ftW fQUfI'MIHr tINT.. ~NO ICM .. 'W. A- ...roarlNG otAKI 0' NOT lISI THAN 11% waL II MAGI ON ALL IIIMS RlTUøno .011 CIIIDff .......lIIOI: IS HOt OUIIS. MAn....' 111U1IN1D WILL NOT .. AcàPTao Ami II DAYS. CLAIMS JOlt IHQftAGD MUS1' .. MADII .......-.,. Y UPON aK'P'f 0' GOODS. ,",II ~ ,-,....nv LJ! 2080 SO. UNION AVE. BAKERSFIELD, CA 93307 (805) 834-1100 1450W. McCOY, SUITE A SANTA MARIA, CA 93466 (805) 928·1135 ! pïi i SERVICE INVOIC~ "III UlllllII'" f ~~ AUTOMOTIVE·I USTRIAL PETROLEUM EQUIPMENT INSTALLATION·MAINTENANCE PlAA.. NO.,. ".... ....un.... ANa co.....· SPONoaNce ...auLD 1111.... TOT"" CALIF. CONTRACTORS LIC. NO. ZU074 ::':.:~~~ s 7598 INVOICE NO. PHONE NO. CUSTOMER ORDER NO. DATE REQUESTED BY ¡::) 0 CHARGE CASH .-)- \ L,-'8l '-, \Il L o C A T I o N , ,. vUlJN'l''f OJ!' KERN III General Services 1415 Truxtun Ave Bakersfield, CA 9330d L PO 0'7 ~ORK TO BE PE;fo~~~<9 , ._____ 715 A:/' Go-.("Q... '(j~ MAIL INVOICE TO ..J ·~T£T2.. ON FOR OFFICE USE ONLY . -. --.- _..~._--_._._~."--- . - _..._..... WORK PERFORMED: .----- Gi!_~_-..2 .. _ _ _ _ .)~. Sub Cantrac:t R entail MAKE 7lJ¡¿ SERIAL NO. ?S II G MODEL NO. I DESCRIPTION S QTY. PART NO. Lo Supplies Sales Tax Date Completed Te#ician(s); Received & Accepted By I}J--- PLEASE PAY FROM THIS INVOICE. TRRMS: Net due upon Receipt PLEASE ~ / _ / /:/ ~ F.lnan~ ~harga of 2% per Month I) I: 11111 T Tn TOTAL ~ R LW EQUIPMENT po !:!O)( 114'" . . .' . . . -' . ---------.-..--,. - -A~ =: M B E R ¡;PEI~ qfUM EQ!,IIPMENT INS' R~ AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INST ALLA TION . MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834-1100 CALIF. CONTRACTORS UC. /I 294074 MAILING ADDR~SS P..O. BOX 640 BAKERSFIELD. ~A"93302 , ' I. 1'715 -, 07/3J/D7 PAGE 1 r COUNTY OF KF.F:N GENERAL: ~)[RVICF.S 1. 415 TRUXTJJN AVE h :~ I·' F: R(~ I:" T [,:., "'I L"{'\" ;:> .. ....J. .. S 75'98 Cf; ("1330 t·- .J ,'"", 1-·!.. ·;Flili'jvil=:D--CIIFCI<I::'Ü ÜF'F¡:i:ATIDN OF TJ:CI-::¡;::T PfnNT¡::R ON t..A F'UI"If' I' ,1; lJd..l T:rCI<ET ¡:"I~:INTF¡:~ ?;ND HECHECI\ED For..: F'r~DPER OF'E¡~:;;r TON (;"11 i ;) ¡-j '1 ,:.: ItIL,:: h~Fn :II: ~) 6~~ 3~?O [lESCr~ 1(=,T ION 788800 001ZERO TIP PIUCI:: 165.70 --.; :~...;~j.;.... ~. I..' ~-.... ';: .:fi~.jj· " . .¡ .. .':~:::;:;:~ } ~ .....,.;....'" ~ "'! r, ., 'i ' , ;;¡¡,....'" i.- ..,~'~.:.,..;,._.'... ~.;.!-.. ....;.' ~ ". ....~~'....:~ ~..,'.,.,.~~ (:x' ".Ai~A'"-'..'...., 1 ~, 'i:.L ".' ~ , I,:;', .. ,~ t~ , ,. :..;." \~;, '. '. / ~-.. ¡J ~11~.,¡;J' ·~·r~............. 11;:- . . ~. ) L?,DOF: ~ 2.00 MATlT([ f~lt. : f:ìLJPF'L r E:S: PLEASEPA'! FROM THIS INVOICE TERMS'f~~3pTeAts -T;T,¿J'- A ""ANCI (HAIOI 0fI 2% ,.. MOIfnt WHICH II U,. .... ANNUM CHAIOID Ami,. DAYS. IN THI IVINT Oil A'" LAWSUIT our O. ". T'IAHIACIIOtt fMI ,avAILING 'AITY 1M.... H unmlD TO .ICOVII HAlON...... ..no....n PHI. AU MUCH-. ._ nt. 'IO"ITY O. ILW .__ UNTI. .AID _ .. IW. A HITOCIIIIG OIAIOI Oil HOT lUl THAN "'" WILL .. MADe ON AU. rTIMI aN..... 11011 C-' WMIII 1IlOl II NO' oun. MAflllAL II1UINID WILL NOT . ACCII'fID APTU "DAYI. CLAMM PO« __MUSt II _ _ray \WON ne.'" 01'_. ~~; :> .. ie, :,<. ]. ?~ : 23':') .. FILE COPY MEMBER 3PEI~ qruM EQUIPMENT IrS' AUTOMOTIVE· INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION· MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834·1100 CALIF. CONTRACTORS LIC. /I 2514074 MAILING ADDRESS P.O. BOX 840 . '.' ._!'AKERSFIE&;.D. CA. 51330£ I COUNTY OF ¡'ŒfW GENEI;:I~L. SFi;:I..,'ICF.S 1.400 H STFŒET . 1'71.5 -, 08/17/8'? PAGE 1 S 77 37 "c¡ ~ K'EI-'C: F T r;'( {' L 1::1-1 ,~ ..1:..,...1 CA 9:-)3(H'- -.J GARAGE ,.HM ¡I,J!.'I~ ¡' Fh:FDW·íf.D-fŒPL.ACFD NOZZLE ON AD PlJhP--F'OSß rBLE WARRANTY I' ¡('Ill: F.I: {II.. : (. \1 p¡:::'Fn:ß: DESr::;:JPTION J :.> 32 7'74 A:':l,OO:3 O~. 0 N07.ZLE VAPOr;: ut.* PIUr.E 210.00 ~.~ ' . '. ..;.v~~ir . ~. '.r:.} .' ., :',.i> '~(}. y:. ...... ~..: :':L>,:' tì:,,~':r~'7" ..'~~" ..: 'j _____ :.....~¡.:r..._..,...... .......' \. : ~, . .:~:(.i,;,.. . '.;~ ,>~'~ PLEASE PAY FROM THIS INVOICE LI~lbcm: 1.50 M?ITF h:T I;\' ~ SUPPLIES: ~¡AL.FS TAX: TOH'~L. : TERMS: NET 30 DAYS it ' 21' J' '-, (." 0:.'-' .. '....NCI CMAIOI Of 1% I'D MONTIt WHICH IS 2A% PH ...... CltAIGID Ami . DAn. IN 'HI IVINT O' ANY LAWSUIT OUT Of ~ RAHSACnON 1'HI ...VA&INQ ,urr SHAl.L II INTnUD '0 ItcOV'. nAIOHAIU AnOlNlrl PIlI. AU MllCHAHDtl1 llMAlNS 'HI PlOHltv O. ftW lOU.MIId utrn.. PAID Po. .. RIU. A IUTOCØIG OtAIGI O' NOT \US THAN 11% waL II MADI 0.. AU ITIMS qTUINIO '01 caDIT WHIM IØOI IS NOr Dun. MAnlllAL II1UINID W&L NOT II ACCIPTID AmI . DAYS. a.A.. POll __ MUS' II _ -.-,a, .-..ncWf t» ooom, ' FILE COPY "'.0' ..__. __._ ... --~ ---.' _.-- -.--- .._- -~_. _. -.'- --- -- -.'--. -.... --~_.- If} ¡C.~' ::0 "!T Cï:f:!JIT Ai~C/C.í( i~:::'L'..c.Lf.\r:¡'~T '" WILL (;':'11.'( 13:; :~,:;lC U¡üI~ II L:)¡:CT;::':"~ ;,{,1:; r.PPF:·:;'.I/~L TOTAL - fJ., RLW EQUIPMENT P.Q, BOX 640 ._--- Date Completed Received & Accepted By PLEASE PAY FROM TH.SINVO¡CE;., RMSI Net due upon Recøiøt PLEASE I '/ "';.',,:~';:"1-"'';'§:¿·''Ij.~~,·Finanœ,CI1or9'o 2~;per.Monttl. ' ,., .' / -, ¡,. ~ ',' ,..:;.~' }\:<:..!..~~-.: .........:..r._..-:,," ...:'::.~~ ¿:, ';··:·.¡"::·.(i.-!}~ít:¡ "12.' R'¡:'MI'T\~T('·l·~_~) . Supplies Sales Tax ..J/ el . .tMBER ~.PEI~ All 'huM EQ1JIPMENT IrS' . AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INST ALLA TION . MAINTENANCE 2080 SOUTH UNION BAKERSFIILD. CA. 13307 . PHONE 134-1100 CALIF. CONTRACTORS LIC. II 284074 PAGE 1 r-COUNTY OF KERN GENERAL SERVICES 1400 H 13TREET L BAKERSFIEL.D 1715 I CA 93301.- .J wORK PERFORMED-NOZZI :' f"'~t='nTT Pt=' :;o MôllJllt='Af"'TIIRER MATERIAL: OTY PART. DESCRIPTION PRICE 1 232774 A3003 010 NOZZLE VAPOR UL* 210.00 ':';'1;:'. ':', . .. I . '. q.~ "'-'.. f . r ~ ." .... ,"". . ,i '¡~~~.:}. ~-;\ . "4 ", ",".'.', , '. w.J~'. ", ., ¡ 1.~,"'(:.· ,t., t ; i, ~ t..,. _""._ . . "~'..' "";" " , ' ;::.~'.. ,., . :;òljij':i\"':.t> " . I . f.;/.~ "~ : ..;...v MAILING ADDRESS ~.O. BOX 8.0 BAKERSFIELD. CA. 83302 09/11/87 57737 GARAGE ,,' MATERIAL: SALES TAX: TOTAL: TERMS: NET 30 DAYS -210. -12. ('" - 222 r . PLEASE PAY FROM THIS INVOICE A 'IU.NCI CHAIIOI Of '" .... MONttt WIeCH .. It" P'II ....... CHAIOID Ami" DATI. IN '"I IVIMT O' AN' I.AWlUIT OUT O' TMII TlAHlAcnGN TNt ",VA&..o 'AIT," "'AU .. _ID TO IICOVII _ION.... ..no...." fIlS. ..u _01_ ItMAINS !H' '"""If' 0. ILW IQUIPMINT UMJIL ,..ID _ .. PUU. .. ""'OC._ 01_ 01 NOT LIII1'MAN "'" W&L II MADI OM At.11T1M111TU1H1O 101 caorr WHIM 11101 IS HOT oun. MAnltAL I.NIHII) \ft.L NOT .. ACCIPTID Ami" DAYS. QAMIM POI __ MUST"_ _..,a, UPOfI_ 0' GOOOI. OR1GINAl . AI AUTOMOTIVE·INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION·MAINTENANCE . 2080 SO, UNION AVE, BAKERSFIELD, CA 93307 (805) 834-1100 1450 W. McCOY, SUITE A SANTA MARIA, CA 93455 (805) 928·1135 . ..1..eIR \P£!~ SERVICE S INVC PiA"'.. NOTa ALL.NQUIII... AND CD"".· .....D..C. SMOULD ....... TO.,M.. CALIF. CONTRACTORS LIC. NO. 2..074 ::'uV:~~: 796' INVOICE NO. DATE REQUESTED BY PHONE NO. CUSTOMER ORDER NO. - ~<¡f -81 ~I m o 0 CHARGE CASH WORK PERFORMED: L o C A T I o N '~.. c:al~ cJ.dl.s O~ - A'50 ':íM1 '. k çç- -.. A- -..- ri1~~.-.Ll~ ª-~t-__,., o_'!.'___.. ,~ ,.{(;~:: ~uUNTY OF KERN III General Services 1415 Truxtun Ave Bakersfield, CA 9))OQ -=,..a __ _ ,!PO 501 WOR K TO BE A:~~oi~~ ,_ .... ..œtl,~.\e' 0"t1 "S~m~" ?" ... \ ", ;iö~,> .~ ' , Cvtra9~ MAIL INVOICE TO .J FOR OFFICE USE ONLY .. TECHNICAL SERVICI; HOURS J MILEAGE Sub Contrac:t s:'.CO Rentals MAKE ;7êtL MODEL NO.O .s:"lJ SERIAL NO. <~Y/ 6 S QTY. PART NO. DESCRIPTION Date Completed Received & Accepted B PLEASE PAY FROM THIS INVOICE. TItR;"S, Net due upon_i e«:JI~ PLEASE <,) / r, ,../ /,'P' -T' Fin.nee Charge of 2% per Mon!!- REMIT TO , / '- .'1' / /) /.' . IIftllr 30 days. Supplie. Sales Tax ·....6øW _.,¡MPUTEA CHANGE o CAl.IIA.. Record o' computWIIIIP, Met... Change, or CaUbratlor o METER CHANGE o W/M NOTIfIED COapaDl TOTALIZEA READINGS I0IO..,. STAAT ",oove r TOTAL (L- .../ ( .) () ... .-...,.- Ci'-UÕ"'-:;-'-- . -.- .- TOT AlIZEH READINGS FINISH _11' GAl.LUNI STAAT ",oove r TOTAL IIIUUftNf.O ro 1T00000QI ---.--- . Mó~ÿ-·'-_·· TOT4LIZER FINISH READINGS MO....' START \)ü,;;:¡-- Pump #. TOTAL P\J..... u"lIl AHI' "'t.'\H.'- ,---.---- a,o(,N(Y 1 (J I ALlZER FINISH READINO:) ,..,.. '1·:·'·f~··.T---- P·...."E "NO MOOEL uo.., TOTALIZER FINISH READINGS MONIY STAAT 'AOoucr 1'\)...' \II ~..( "NO MOU( L MONU ll>TAlIlER FINISH READINGS MONl.Y STAAT PfllOI)UC T Pump # TOTAL QÃLL..¡¡r· -.- ..,.-., -- QAt IfINS GALLON:> "I IUIINIIIIO ~;:;¡¡¡¡.f IIf 1:1.... NU..BI A r,",ujj~ - ..-.----..- ..AlI"t",S ---~. GALl UNS AL IUIINF U TO 'ò I ClAAUL IlEAl.... NUMIIEA GALLONS GALLUNI ALLONIRUURNEO TO STORAQI SERIAL NUMIIt II GALLUNS - LUINI ,/ 'AIr CHECKED I&.OW TOT ALIlIII 11....10 o YU 0 NO t'-~' TU'MIUM o \'IS 0..0 CHfCKEU .--. -r-··· ':~'_.__ ~L.~: 101AUII;" lot... Lit DyU ON\) 'AIT CHECKED SLOW rut ALI.!IIIIIALIO DYES ONO ,u, CHECKED SUM IUIAUltM :1111&.10 Oy" ONO ---_._~. ....--- . -, " ..--....."....,...."..- ,u, ADJUSTED TO SLOW MlTllllEALiD o YU oHO CALIBRATION fAit AOJUSTEO TO (M "'Ut.A SEAi.iQ OYU -.--.- OND CALI BRA nON "Ii IoIt Ilà ;¡¡;¡¡tu DYE' -.....---- 0""1 CALIBRATION FAIr ADJUSTED TO SLow MlflllllALID Dnl o~ CALI BRA TION 'AST ADJUSTED TO sa ow METER S£AL.iO OYU DNa ..,..\. . .' . " .. 't .._-~ ME M B E R 3PEI~ ~EUM EQUIPMENT INS" AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INST ALLA TlON .. MAINTENANCE AI 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834-1100 CALIF. CONTRACTORS LIC. /I 284074 MAILING ADDRESS . P.O. BOX 840 BAKERSFIELD. CA. 83302 09/08/H '..,. PAGE :I. r COUNTY OF l<fRN GENERAL SE¡:~VICES 1.1400 H ~TREET BAI\E RS F I G.D L I S ï'9 63 L / 1 ~:j CA <;>:·5?()1.- GAHAGE .J ,.JIM ,; ': ¡::'C'Ü·Uld·WD-UH::CI<.FÜ rJO. t. ~ ÜI!3F·EIJ~)FI::·n_.nF'FPLACFO CDMPUTEI~: f~Sn··- ":i'¡ ¡'\iJJ) NOZZLE TO REPAIR. CH[CI'~[[I ("Cit,LI! FOH PROPER OPEI:;;A,'ION , ,.F::h: ltil.:: :q'Y ,P(tl;:T ;1\: J :230009 1 ~~':2-¡lOl 1. :::~3:ï"?4 DESCR I F'T ION At 0 ~5 00 1. I..;'i !;) F.r~ Bt-.l.l.. ~; W H'E L 745104 100NON COMPUTER (FOR A3003 010 NOlZLE VAPOR Ul* PRICE 15..00 163..B5 210.00 ..~ ~"-"'~'" ,.....,.:~.".. , ; 1, . ;""Yi"':'" . f', ~ . ' (i ;:': :!;~ ,.,1 \-~'·'t·\;~~·,: .., ...,_~...'1.,,::,::' .i<...· :J': "", '\., !.,,,b:;,, \ .: ¡ ~¡., -',... "..- ·t,·#",. Ltd:mF: ~.5 . 00 M~\TEi,I (-11...: SUPPL.IES: ~:¡AL.E (~ T Þ,X : TOTí;L: TERMS: NET 30 DAYS , . .j. ,., '..'......'. . 'I . ' ...'! " 4... ..' II ~:¡O I) . ; . PLEASE PAY FROM THIS INVOICE . A 'eNANCI CHAIOI O' J'" 'I. MONTH WMtCH IS 2.1"'" .... ANNUM CHAIGID Anll )Q DAYS. IN THI IVINY 0' ANY LAWSUIT OUT O' THII nAHIACTION ntl ....VAIUNO PAIn SHAlL II ønmm to ncovlI "AIONAIU AnOINIY" 'III. ALL MUQtANOlll .IMA... ntl 'ROPIItY 0' ILW IQU.MIHY ""'& PAD POI .. PULL. A IIITOCUfG OfMGI 0' NOt LIU tHAN "'" W&L II MAGI ON AU ITlMllltulNm '01 caon WttIN lno. II NOT OUIS. MAnilA" 'ItulNlO waL HOt II ACCDTID Am. II gAYS. CLAIMS fOI IHOn..oa WIlT N _ _..rRY UPON IICI.T Of GOODS, ç ç rr.pv . . MEMBER aPEI~ ~M E(IIIPMENT INS' AUTOMOTIVE . INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION· MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA, 93307 · PHONE 834·1100 CALIF. CONTRACTORS l.IC. 1/ 294074 MAILING ADDRESS P,O, BOX 840 BAKERSPIELO. CA. ~3302 1715 I 1.0/09/87 S8260 'COUNTY OF KERN GENERAL SERVICES 1400 H STREET . L BAKERSFIELD PAGE 1 CA 93301- .J WORK PERFORMED-CALIBRATED FUEL PUMPS AS REQUESTED--NO ADJUST- MENTS NECESSARY. OPERATION OKAY MATERIAL: aTY PART. DESCRIPTION PRICE 2 021073 20698 060 CUP SEAL* 0.50 !':f]f:~~; :f{ft,,~~~ :~~" "." ,)'~ , , PLEASE PAY FROM THIS INVOICE LABOR: 2.50 MATERIAL: SUPPLIES: SALES TAX: TOTAL: TERMS: NET 30 DAYS 70.0C 0.50 0.50 O.Ot 71.06 A flNANCI CHAIIOI OJ t,. HI MOfiI1'M """" .. Iot-" ,.. ANNUM CHA~fD 'Ami. DAn. IN THI tv,,,, 0' ANY I.AWSUff OUT O' ,.... TlAHlAcno.. TMI ,..-vA_rHO 'AITY ....u II DlTITtIO TO ncovø ""10M".' Ana....,..' '111. ALL MftCltANØISIltlMAM THI ~".,.y O' IttW taUtI'M'"' UN'In. 'AID H)' IN 'Ull.. A "'TOe.1IIO CHAIG' 0' HOT Lnt fMAN It,. WIlt U MAØI ON AU rrIMI nTUIINID '011 CIIOrf WHIM Ino' IS HOT O'*'. MATlIlAI. llTUlNlD WM.I. HOT II ACCIPTID A''''I "DAn. CLAIMS '01 SMOn.on MUST II MAOI tMMIIMATRY UPON ate"" OP oooot. .~- "':"- . ii.~~-:~1"·~""T"'rr::'...q... - ~ "~:": ~;~:~é. ~~";ç,,"",:'I\l':~~.~~' ,0 9.':,", ... -"':.ï~_U'~ 2080 SO. UNiON AVE. BAKERSFIELD, CA 93307 (805) 834-1100 14ðO W. McCOY. SUITE A SANTA MARIA. CA 9MS! (805) 928-1135 __. _TtI ALIoI_UI.,. AIID ca_.... --.-. ' MIOULD ..raw , TO "PN_ CALIP'. CONTRACTOR. LIC. NO. 1'''07. =~:: .1f.lllt ..P.I!, SERVICE INVOICE S' 8260 INVOICE NO. DATE PHONE NO. CUSTOMER ORDER NO. £ o CASH ¡()-i-S'1 . . '0 ....... '. ' <:7iiY1 -',' CHARGE ,. ";Vl,,~fry ~é' KtJRN, III General ~.rvloe. ',' 1415 'Tt-uxtun' Ave', aak8r~tløld~CA,:93~Ol L 'PO ,,~,' ' ~ , ,.50/1 AÞ t:!xJ.. /l.Q 9/ð , L o C A T I o N c: .;;)(/)-1''- MAIL. INVOICE TO .J l ~ ;:.k BE PERr,;;r~J~ ',. .'.. A I b~ /1;-L)S WORK TO ":" I :.O;~t·,/i '.:: , FOR , , " , ", '," ""fI;~tih.' ~ OFFICE ~¡µ~~f' r'~ 1 "-.b USE - - ONLY .. ' ~:. I. ' : ~. :.... ", , : - . ¡ , ,.". '.. .' . '. .' ~ ~ ..~: . , I .. :;')..':",:: " _:..,; T.CHNICAL. . .l~·:.· " ..RVIC. '. ~, ;.' !r~'····:~1 . HOURS , ..... .' " . ;':t ';', ~ , .. MILEAGE " ' .- " , , .". Sub Con1rllc:t .. Renul. : ~~ 1'2. $0 1.:5 \ 2..S Tõt. )"L5~ .,:),5 I \I..ø , MAKE MODEL. NO. SERIAL NO. S QTY PART NO. , DESCRIPTION --«.:.>3 ~ ~~ 't:r13 ~,. <s"crq -0<.0 ,.....,·~o \ I~U""' '5:..A'~ , , " , , ... , .. I .... J ',", " " '". " " f" . '., ,. I I " " " " , : . " . '. " : , ': ' 'Ii.:,;._,:-:" . .,; ! .j'" ~..'t. . " '\ : ", :.; Suppll.. ; .... " ',f. D8te Completed 10 - ~- -&-,: T~nlci.n(s); 3 L\ Sa,.. Tex , : - ',~ /~ ':,t/~ ./ /~ Reœived & Accepted By " '- .J.ì TOTAL FROM THIS INVOICE~IItM' . PLEASE PAY Nt1 due upon Receipt PLEASE LWE UIPMENT Flnllnee CharOI of 2% øer Mo"th 0 t::\JlI'T 'Tn R a P.O. BOX 1140 .J . METER CALIBRATION CHECK ,FORM ~~C'.\ 1 of' .\ . .. 2Clt:- Note: I. All .eters aust have calibration checks a .tnt.ulI at twice !. year. ,which include checks done by the Depart.ent of Wel¡hts and Measures. Before startlne calibration runs, wet the. calibration can with product return product to stora¡e. Run :s ¡allon. with nozzle wide open into the' can. Note ¡allons and cubic Inches drawn, and return product to stora¡e. 4 Run :s aallons with the nozzle one-halt open into ttie can. Note lallons and cublc..1Dchea-,drawn. and return product to storaie. . After all product tor one calibration check ia returned to storale. reaeaber to record the volume returned to storale in coluan 9 ot the Inventory Recordin¡ Sheet. If the voluae .essured. In a :S-aallon calibration can ts aore than .!. cubic Inches above or below the 5-¡al1on .ark. the .eter requires calibration by a re¡l.tered device repalr.an. .ay and I' ¿ ~!.! 1. ( 6~t..- '\ ,."rl'\ Facility: 5. 8. .. ... 3. 4. Date/Ti.e Hose or Tank '/ Past Plow Slow Plow Vo ru.e Returned Ca! ibration Device Repalr.an Date ot PWlP' Product 5-0allon Draft 5-Gallon Draft . to Storae:e Reauired? Uae~ tor Calibration Gals Cu. Inches Gals Cu. Inches Gallons Yes No Calibration , u/¡... 5 -2- 5 -\ \0.0 ,~\ X (.,Ii.,J ¡ Ç',--.d S ~~\\o'" )9 <i ì L- UlL 5 6 5 0 ~ö. 0 jlA- \ )( +c.S4- c:..f\ n . d. 3 u.'~J S +2- 5 .}-l lo'O,\'frl ~ . \ \ Y ~ ",l~Qt f~ -3 \0 -""2- 2o,~ ~~ , . \ , . :0 lS - ~03Q Re¡lstraUon . Owner or Operator Calibrator's Signature SUBMIT A COpy OF THIS FORM WITH ANNUAL REPORT. .' ,'';'", ,,' ~t.,,,.7. ....... ~ "It'~~~' ';~-·.d';"!;: b." ", 'rPI f/'~ ,:. /:""'<',f~,~", ,:r,§-,b',<:,Ú;i:",Q.lCALI8R.~T~ ¡ ~ï-T:' '. ,,~:r¡:.\ ?' ~;.I';',~~- "~1r~ ',' . t ., .' ":(J ....,... ~::.!'. ,>:,~rO"""" ..~.. 'RL~ ,L ~ . Record of eo............., Me.. C1Iange, or Callbratlor -' (';" " 'iI' : .I.~. IMr¡ - \O-d"~ ~"2... CALIBRATION S I '1... 5 , OALLONa '1''' - 3ï( it:> -'2. .-:- GAUONa ". 311 'I, t:> ~ aND OND ¡-. OALLONa IllJURNID , 0.0 , I I I I .-- CALIBRATION CHECIC!U fAIl I -. r.. -' -2- -~. , -..---- 101M lie: LU YU 0 190 .---- ONO . CALlBRA TIOH ONO . ; T~T:"IZ;"~ RUDlN_!;,; , t;~~ -, :'to" 0..0 o .Il OftS CALIBRATION ". /~:!; ·r: QAU~ ,... 0190 ONO jr, 2080 SO UNION AVE. BAKERSFIELD, CA 93307 (805) 834·1100 1450 W. McCOY. SUITE A SANTA MARIA, CA 93455 (805) 928·1'35 . MfMBfR i! PEl š SERVICE INVOIC~ ~"IUWI1"'~ AUTOMOTIVE·INDUSTRIAL PETRO LEUM EQUIPMENT INSTALLATION·MAINTENANCE ......A... NOTE ALL '"DUII'.U A"C co.."e· SPOND.Nce attOULD ...P.. TO TH'. CALIF, CONTRA'CTORS LIC"NO. 294074 ::'u":~~: ' s 8858 INVOICE NO. DATE REQUESTED BY PHONE NO. CUSTOMER ORDER NO. I (). -, ~., --=-- 0.--- 0 CHARGE CASH ,. ~UUN'l'Y 014' Kl::HN 11## General Services 1415 Truxtun Ave Bakersfield, CA 93301 LpG 0'1 '. APR ~ j9 WORK TO BE Pio/f5t.1E'D. 1 L o C A T I o N G~_t" l") ~ MAIL INVOICE TO ...J WORK PERFORMED: L '." r2. "-.~ ".' A 8 - 1- :' , :Jill.~y.: O"'Y\ ---- -u,~--- -----. ..,\:~~~~~.l: '",,;,} . l.r ,~.,~ . I _ ' , '--~~._-"~---~F~, '~A' ,.-----.-.. ";) d,/ · "~rM .' >\4~ "f . r, '. I. \¡... ,,, ~ · u' :;¡±-.u..-I ~./I~ ,L L< ,- L' ..l, ' _.__ ._.__. 'fi . ,-I ¿!...t:.. ~/.~ {"./ ¥I t~ (, Mo· huh.. J <~....... U .' ¿~ ...i-^f.-.:I...fl i~~ ¿é4: _....-ß.~____ /7 / ~ J iI, . L.k:.... " .::l.( t-. .L.-.~~£¡.!....I -:2~" d~l.jGL;~~ "'J..'-lA_l.. J- ~'--- (j,{.. ......µ --"--' ---_. .-----.--.-- FOR OFFICE USE ONLY . ._.0_.__._--- TECHNICAL. SERVICE HOURS MILEAGE ------ Sub Contract .____._____4 .-..---------- ----- Rentals .-------- .,---. --------. .-----,. ----- MAKE.1J,Il.... MODEL. NO. /7. oK:. ~SERIAL NO. 2s=LL ----_. ..-- S QTY., PART NO. ,'~rj' fE ~~--j-' --t--· ] b:.G 2 '3'), 7 7 "f DESCRIPTION :ï~I""~ ';' . A 30(,"3 -aiè ü...L (,' / ¿ ~- '7 .~~..J ' ___...,_., P2-(X'.. _.________B_ -', ~_'l.i:.~~:..,~ w JILl (C/~ -I'/l41-, ,ì "~ A~l,,:.·,H'./ .- .--.--------- --...--.... ...-- .. .........-.. .....--...... --....:~ í',X" .,·\i ~. '. ....' : : :, 'i ."".t.~ ~,.. \ -:. iT ~ \.'.' r. nt . :', " ....N .., . \.1... .' ; '/. I' l_:·,F"~!. \' . . I. '. , ; I .L ~I Date Completed Received & Accepted By PLEASE PAY FROM THIS INVOIC .' " ,~/ .r~~' 7" - ,. ,.;.1: ,.. "1._" '....' , 1..-- ' ,., __._.. ...' .._.._ ... _'.. ..' ,..... ": TERMS. Net dUB upon Receipt p' EASE Finance Charga of 2% per Month R ËM I T TO aftBr 30 days. , ~.2 . ," , RLW EQUIPMENT .J P.O. BOX 640 O^VY:OD~I:"I':"'I _ _10 "'....~^~ .' . .. ' MEMBER i!PEh j ~ruM EWlPMENT 1r6' ,I Î .," " AUTOMOTIVE - INDUSTRIAL PETROLEUM EQUIPMENT INST ALLATlON . MAINTENANCE 2080 SOUTH UNION, BAKERSFIELD. CA. 93307 ',.PHONE 834-1100 CALIF. CONTRACTORS L19' " 294074 . I ~ " MAILING ,ADDRESS '. P.O. BOX 640 '\ BAKERSFIELD. CA. ~330 , " . . I. :,:;' / :I :,:' ::)t h\ U ¡:~ I. I !t~:; II i ~)Hf~j::.:H II ' " "" . ',i ," /" '''I L\).JNT I 1.11·· '1\.::",. ßlNU~NL\ ,:)[:1:':',11 C[ ~:; , .... . .1. "~Ü(i: H, :;' j,'¡:ET , j~t,I': E f~¡:; F J ¡: I.. Ü L, . ,,' c: {.; (1' :.~ :- (J:i .- i !.J J L I ¡ II r ¡ ¡ , ..! I:' : ,! II, '1'1, I .; I) ill ;.' I: ,~·:f Uh I'iF 1.1" CHE,:,,';!:: j I ¡··I: I ¡\~TE'!:: ¡:\ND t·tO:?, I.. F I!N ,(,t: 1'1 ;rIP·-.... F<:ff-' ':\I,J~.u ,: 1,.1( T H.,:: E r:\) r L [' lion T" F:I~T·I.()CF l.J f\!n ? I.. ;~!4T'nl ¡,l[(,1 UN IT.; HELl< iH UI"IT~:i fur, 1~'hUI~ï:::r,' UI"i:J~I::,TIUr\! ,'\1', I CHI..;!..:: '! : j "',:) ,.; T it:, .", ;~,;5 3::: (¡ , ):~;I }'74 m<;c¡:~ I PI' J ON ~/\:!;:;~iO':) OOlZEF:U T IF' (I,<r:),)~~ ',.' 1./) dCil/LC \)(:,¡::'C,F¡ ~ II.. ~ ¡-: P¡:;;ICE 1(.0::;..70 "I I:: ç~ ¡"""\ :,/1,"1'1"''''','''1' ,¡ .,' ., '~ ,~¡¡. ~:f .:¡ J ';1 ~:'.(. ~ ';~ ' . .: ,I !"'<': ':', -,~),¡ , . : ,. ",II ',!' t,: ~";. :'-; '-':"",1': ¡ b:;~~j~ ~..tIJ J ! -,~ ...,¡: "~:1 r ¡ , I i I '~ ~ I I ;1 . IMPORi JI,I'H CREDIT AND/OR REPU,CEMENT ro~ WARRANìf MATERIAL WilL ONLY Bl: ISSUED UPON INSPCCTION }'.['tD ¡W?IlOVAL BY T:¡t: ,\'J...: :UFt.crURER. ;~i:l,~~.~¡~:;~L~li'.:l ,¡¡.T·..·"'· > ì , I It. l' O-/,- , ..J C! 1/ .' L' t ..t!' J.,. ·.,,1 ,,:·;~i..i;_;·:-r . :¡ Ii " , ... I.. (, HI: I:;: ~ 1. . :";0 r' (\ í !' \::.\. ~'I L. :: EI..tI:>I:,IF::;~ '::.i\I, ::; T {.",;< :¡ lCI I', ;..:: PLEASE PAY FROM THIS INVOICE TERMS: NET 30 DAYS f¿Z Z 'Z-. A ,IiIAMCI (MaGI Of 2'" ,.. MOfIÎnt WHICH II lot"'" ,.. 4NNUM CHAIGID A"" 10 DAYI. IN THI IVINT O' ANY lAWlUn OUY 01' YHII TIANlACnoH 'HI '''VMING rAI" IMAU II _IT\IO '0 IIICOVII ""SON_I "no"'I'" .... "U MUCH_ lIMA'" '"I ..ormy O. IILW lQu...un UNTIL PAlO fal .. 'ULI. """OC._ 01...01 O. 110' 1111 '''''N "'" Will II _ ON "u. "IMI UN"'ID .01 c...1ItT _N 1IlOl . NOI au.... ....fllIAL U'- _I 110' II "CCIP'IIO Ami M D"". C1A_ fOI __IIIU1111 _ _"I', UPON IICI., 01' QOODI. · . ~.M É M B E R ~PEI~ All <7EUM EQIIIPMENT INS' '- AUTOMOTIVE. INDUSTRIAL PETROLEUM EQUIPMENT INST AllA TlON . MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834·1100 CALIF. CONTRACTORS LIC. # 294074 MAILING ADDRESS P.O. BOX 640 BAKERSFIELD. CA. 93302 I COUNTY OF ~~FI:;;N GENE R(.~I I.. r;Ef;~\JT 1':1::: ~:ì Il15 I O.l./ll/BU 51016 PAGE :I. 1.400 H E;TI~:FFT I:r~I":;E RU F I EL J) L C f~1 Ii> ~..U l) J. ..- KC GARI)GE .J - ,:'.11';(· :';:::r{F(]RI1FD-(~D (ìHn ¡:\E T{\GGED BY f'lf'Cft ¡::ï:m L.FAKJNG SWJIJEU;. ,('I" ¡,, ·'l..t'lCF/:I ~:ìl JJ:\)ELfl o¡,¡ ¡::'¡:WI)UCt ~INn IMI>;)h: HO~:;r:::. ('IE,..·_..I~CPLJICIJ:¡ 'i i:·I[I... D¡~ P¡i:UDUCT HO!:¡[,.CHECI":;FJ) BUTH IÌlHHì F() ~ FlIliTHER LEAKAGE I,i J';¡' ·!I]NF.. flPCD N()ïI FJT:I) (JF IŒP{\II~!:; ì'i(¡ )[ .. 1:(\ TE fU Moo ~ i.!TY PArH :1\: [lE~ïCr<IPTHJN 3 230()O't AJ.03 OO:!. L.(.IH(J~ BAL.L. m.JJ:'JEL PRICE 45..00 '/~þ~;: If:'r·· r-" '., I '., '''. ""i~';;¡jrT~~ rt1":~:,;;,J.' I ~>';'. I~:·~·.;~~~·"L...-:..~·. ~. ,,,' '; ... .,.,¡,£ :·;.~"~I':.:·¡""'·' ".. .. LAÐOF': '1 "50 M~ITF ¡~;): (11.,:: ~~UPPL 1 Ef:ì : SAl..E:~:¡ ·rt:IX:: TOTAL: ' TERMS: NET 30 DAYS ~. ,: , ,- '".I (/ '.'> PLEASE PAY FROM THIS INVOICE A ...AHa CMAIGI 01 t% ,.. MON1H WHICH IS 2A% .... ANNUM (HAIGID A.TI. Jo DAn. IN 'HI IYINT O' AN' LAWSUIT OUT O' THIS nANlACßOM THI ""YAklHG 'An, SNAiL II INm'LID fO 11(0".. IlAIONAaI AnOINIV', "111. ALL MlKHAHDtII '!MAINS 'HI PIO"W1'V 0' IILW IQUIrMlHT UNT& PAID PO. .. PUU. A' .lnOCUifG otAIGI O. NO' Lns iMAN ..,., WI.&. .. MADI ON AU ITIMS .IYUINID FOI (IIDIT W..M ,nol tI NOT OUD, MATlIIAL "YUINIO waL NO' II ACWTlD AlTlt )I DAn. CLAIMS POI IMOII'I ACID ,.,11 II MAGI iMMIDIAf.' WOH IK'" 0' 0000I. . . .,' " MEMBER ~ PEl ~ ~M EIMPMENT I:! AUTOMOTIVE . INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION - MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 83307 · PHON!! 834-1100 CALIF. CONTRACTORS LIC. fI 294074 0~ .. , MAILING ADDRESS P.O. BOX 840 BAKERSFIELD. CA. 93302 1 L713 -, o 1I12/S8 ?AGE 1 I COUNTY OF KERN 7903 L BAKERSFIELD CA 93301- --1 ANDY WALLCE i 1-'31 1400 "S" STREET COPE -h PART :It 255E.02 22UE AL DESCRIPTION PJU C E HOOD ASM AL 34.5ï 1 34.57 .- c-J . . c"":) c:' ('.... ORDER 34.57 2.07 :3E.64 PLEASE PAY FROM THIS INVOICE TERMS: NET 30 DAYS A "'''NCI CHAllOt 0fI I'" N8 MOH1'M WHICH " lot'" .... ANNUM CMAIOID ...mII "DAn. IN THlIYINT O' ANY lAWSUIT our O. tNII ftANlAC110N TMI JÞIIYA...INO 'AITf SMALL .. ","",ID TO IICOYII ""IOHAI'" AnollN'"..... AlL MllCMAHDtII ItIMAINI ,"I no".,., o. ItlW IQUIPMINT UNTIL ''''10 fOl IN M.L. It. "STOCKING CHAIGI O' NOT llSI THAN 1'" WIlL U MADI ON ALL mMS ntVlINID '01 caørf WHIM lnoII.. NOT DUll. ~tnI lnulNID WILL NOT I' A~A . "DAn. ctA_S POI SMOI'TAGn MUST I' MADlIMMIOIATIt Y UPON IICIPf Of' 0000I. ~ A ~ _ ¿7ð¿J ./ ¿ . _...._u..., øér'nav ~~t7//vi . . .. '. .... - - _. -.-.-. ---- _." ._... '~~EMBER 3PEI~ qfUM EQ1IIPMENT INS' AUTOMOTIVE· INDUSTRIAL PETROLEUM EQUIPMENT INST ALLA nON . MAINTENANCE 2080 SOUTH UNION BAKERSFIELD. CA. 93307 · PHONE 834-1100 CALIF. CONTRACTORS WC. II 294074 MAILING ADDRESS P.O. BOX 640 BAKERSFIELD. CA. 93302 r COUNTY OF l'a~i;:N GENE R{-iL SE¡:;:\)I CES 1.400 H STREET BAKERSFIEl.D L 1.715 I () I. / 1 5/ tj H PÞ,GE 1 S 1045 ,Ci'~ <t ':) ':,'i () J. -. .J LOCATION . ,-. ." ~... ". "\ ; , ¡:- i ([ ~'t L hi 0 S . ORDERED BY I , . ,,:)" :', AND OOl~:j3. i'1 ,·ïTI".\: :rAt..: ,,¡T'/' P~IRT oil' ) :2 ::>;.;.~ 77,4 DFS ï~ ;: I t='T T [li,1 ¡':)~~()I.I~'~ \1.1.') lifiL~.i.F 1}'IF·I.Ji-:J,t. PRICE 3'?8.00. " ",,:i., 'f J~ T';~.· ,:;-.... . r":.;/',:¡"· ¡,. . : '01 , '''.,.d. ~.""- '¿"'J"'~ ~iu..~ !~¡,,~. '~"""" :. -': I \~'~~,Cl " .;~~~,;,:~ , ., ';' ," ~j;d~;.J ·.:,"¡~I'~{.ør t I-'..i:i..".... "~ ~.:::~~:'::::.::t! .~::-..,;¡...;;:..;;;.,,/ '¡~~~._¡¡;,. i .. MATEì~~ TAL: ~3AL.F :::) T ,:¡X :: TOTAL: TERMS: NET 30 DAYS .'f? i: . ,.. ~' . ~tÜ \J , PLEASE PAY FROM THIS INVOICE A '''ANet CM,"" Of ,"- PII MOtet" WHICH " U% ". ......... '"AIOID ..". 10 0"". IN 'HI 1'4INt O' AM" ,"..¥dUn out 0. na& 'I"NIAC1'1OM 1H1 .IIV....1ttG '"I''' SHAU II INTm.JD TO llCOvlJ HAIOHAlLI AnO.I"" ,..1. ALL MUOtANOtII llMAlHl nt. 'Iortnv o. ItW IQUI'MliHT UNTR 'NO POI .. PUU. It IIITOCUfO OtMGI O' NOT LUS THAN 11% WILL II MADI ON ALl. ITIMS IrtTUINID '01 CIIDrr WHIM 0101 II NOT QUII. MATlItAL _"'UINID WlU HOT II ACCIPTIO AnI' "o.n. (LA" H)I IIfC)ITAOa MUS' II MADlIMMIDIA'.' UPON IKIPT 0' GOODI. -- ---~ --:- .; ~. . ~ -..... -. ,~=-.~=.:, - - ~ - ,I- "..I!t"~"""'·''''·.'·>\'~"I~~f¡¡J: ~"tl ;1--"4',,...,1 -) ,f·, '.'\ ...,. !fI.1-. , I 2080 SO. UNION AVE. 0 IU It . f It BAKERSFIELD, CA 93307 PEl (805) 834-1100 \ J SERVICE 14150 W. McCOY, SUITE A -""'" BANTA MARIA. CA 83485 ~~:-:.-.. (805) 928>1135_.... =..===- \ ;:0.,'::: ....... I '"VOIC. C LIP'. CONTRACTORS LIC. NO. 1'<1074 _.... '-"'--- - AUTOMOTIVE·INDUSTRIAL PETROLEUM EQUIPMENT INSTALLATION-MAINTENANCE DATE REQUESTED BV PHONE NO. ~ CHARGE ",,- CUSTOMER ORDER NO. :!'1r'Y"' -, MAIL INVOICE TO ,. 'J u.~! t Vf" I\c;R!~ 1#1 General "arvic8S 141') rruxtun Ave LBakprArield. CA tJ( L:, t¡r,¡ ,. - .. L o C A T I -J 2 .'a, \ IC I'S?en ~rS , ~<l. ("G ,'?f- INVOICE s :1828 INVOICE NO. o CASH ¡ 93)01 C'll, qrQ. \-c: .... '... WORK TO BE A:~~o,",,~ 1'115 .l ,0 ..~ i., "J' ",;.. ~ n ~. - ,j;~'\....:\..,.. '\. -- "" I ' , ""~:;'-ï" ,\ .f'... ' l -. ~.. I TI[CÞ1JitICAL ,,' .".' _I. A.- 'IE"VICIE HOURS , s· . ,- MILEAGE - -. WORK PERFORMED: C'.,.~:,.. ~-h.J) ~ A '.± . - - O.~. I , ~~. \ -I f\ß- ~Oaroj)l~ ~~ , .. . t··· Sub Contrllct ~\.J (~~.L ., \ ( ., \ '. r"_ R~ta~ - ~) - Tht. I"2...SC> ,t r· ;'. " I' I' MAKE II MODEL NO. II ....' ,I ! ~. -~.. i .\.~·t& .~. ." . ,. ~S I"1...S .. " , ., i SERIAL NO. ( , S QTV PART NO. DESCRIPTION ~33 \ :3"': \ ~ ~~ ti it.~: \ ~ 30053 3/w- ",\1-' (..IV t'...<o J ~ 1 5L. ~ )...1 '4. '"'3' .... s L INII.D OS Ÿ l.J' 50 ß \ '3 ~~ -h~ft,..Js O~Yuv5 yq C\U.D ' I J It 'Rrc+ ß.....I. A I .. . .., !Ii .. I' : : " " . 4t.dl 'T'. Date Completed W- V - <i? ~ .o;¡.." Tech~~l'~: 'D '3 Y Received & Accepted By /;, f /v1 /IX ,~ã.::¡:---.J.--..... , -- PLEASE PAY FROM THIS INVOICE. TIERM., Net due upon ReceiPt Flnence Cherge of 2% per Month 8fter 3OdsVS. .. Supplies Sales Tax ,.- TOTAL " J "Jr .J PLEASE REMIT TO RLW EQUIPMENT P.O. BOX UO ð""''C''t':!I~....~. - --. .............. " '\ FOR OFFICE USE ONLY. , ... - .-- - I u ö t> "l..(, <- \ PacllIty: ~~ öF' ,¡ '. P~rmli !. Note: I. All .eters aust have calibration checks a minimum of twice ~ year. which may include checks done by the Department of Wel¡hts and Measures. 2. Before startin¡r calibration runs, wet, the, calibration can with product and return product to atorale. . 3. Run 5 gallons with nozzle wide open into the can. Note gallons and cubic inches drawn. and return product to storage. 4. Run 5 gallons with the nozzle one-halt open into tti~ can. Note gallons and cubic tnches drawn. and return product to storage. . 5. After all product for one calibration check is returned to storage. remeaber to record the volume returned to storage In coluan 9 of the Inventory Recordfn¡r Sheet. 8. It the volume .easured In a S-iallon calibration cftn 1s .ore than J. cubic Incbe. above or below the 5-gal10n .ark. the .eter requires calibration by a re¡rfatered device repalr.an. ~ . I ¡ Date of Cal1bration ,q~ Device Repalr.an U.e~ for CallbraUon ~~&d S c¡w-'Io +e..~ '" VP\ wr0- te q voru.e ReturnedlCallbratlon to Storage Required? Gallons Yea J[o \\0..,3 X -t .,- .~ . " ( I( .. )( K X Jb 'j~ 1 () ~~Uø,,~ \5 ~"\\o,,.s Slow Plow S-Gallon Draft Galslcu. Inches 5 1-( Plow Draft Inches o 5 Past 5-Gallon rah'CU<-. 0... S 0 \M:ÞaJ 5 (::) DatelTiaelHose orlTank -, Pup , Product PcA 1\6 '+v C{~ .-.' '1:> ~,,\\o~S I -2- s 5 + I s S I\\) I'cß . --, Owner or Callbrator's ;):5 -CC30 RegIstration _ ,. ANNUAL REPORT PORM WITH Signature SUBMIT A COpy OP THIS . RI.W-- . iJ COUI'UTEA CHANG! o UITlR CHANG, o CA&.I"ATION . 0 WIM NOTI"ID Record of eo......... Change, M..... Chang., or Calibration . , "TION NO. OATI '-t-U'-~~ AQJUSTEP TO 'AaT "'0IIIr k-M- ...... \"1-S0 ~ 'AaT D CHECKED "'¡ \ - -:- TOTALIZER READINGS QAU. TOTM.IUlllIAI. (Stf'U [J NO MI1~~ , B""YU ONO T U,,'~ - «-.L!.L1.3 QI4 , (IMS '3"ír' .s S . "'2. Q I.OftIlHLlURNrDI03hl".'.f. t ~. \ CHECKED ,m'- ..-.. auw +\ STAAT ONO Tar :¡ .IIW - - ALIO &d OHO TOTALIZER READINGS FINISH MOMI" P Y!I1p. # ~P\b TOTAL ""OW ....... "Nil W\.'Ut.L TI~~'~ ICMM._er" ~$;" L. S OAI LI)HIi ï !.Q..3-~-!.1. ,_ flAil 11M. o~5 .9 GALlONS ,"t IURi'ÖTO.:HðCòt¡ CALIBRATION CHEClCEU 'AGI -~uŸ¡ .;... \ - 1- ---. - ..._-- 10IMl/tH...AI LU c:ru ~ "!iT - _1LJi $I."" U ~.. DNa . I.Otta ""UIIMIO TO ITCIIIAGI CALIBRATION GM.I.ONS 'Aa 'AaT ADJUSTED TO II.OW TOTALIZER READINGS .. OttO MlTI" 11101.10 [J 'II [JNO GALw. "".... """,( ANO "(10(1. OlAl,I~ 0"" CALIBRATION 110..., GALU_ 'AaT TOTALIZER READINGS FlNI8H OttO ONO 2"C ð" PERMIT # / b MONTH/YEAR \ 3rC i If)' KERN COUNTY HEALTH DEPARTMENTf INVENTORY RECORDI NG SHEET i! \ J CAPACITY 000 PRODUCT 11ß'" !.;f7 } ì -¡ .,,¿::. L.Þ-- ,.-:; , , r .;, FACILITY ,.... ." EOUATION 1 1 2 3 4 5 6 7 8 9 10 11 12 13 OPENING OPENING CLOSING CLOSING METER _ DAILY METER _ TOTAL READING GAUGING GAUGING DELIVERED WATER DATE GAUGING INVENTORY INVENTORY READING READING - METERED ADJUSTMENT BEFORE AFTER INVENTORY GAUGING SALES DELIVERY DELIVERY DAY/HOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS - GALLONS INCHES GALS INCHES GALS GALLONS INCHES 1-t.¥ÿA 4ý'//2 'j,)Lj() 1171, fl 70 ~l:: :"/../ L:J{; 4t þ;'V (/I'" 4 '14 7 / ? 4 C 1/ tor r; ') 1{.2- ') /"7 0 'l 2- ~:;;..4 1.f?/2... !.fr;¿fLf qo 1"? r:, ',/?'C ~ "(:,'J 12?~ ~J?¡j ~~7t:¡ /i'i':J Q2?O LIS'!! -<4í- :. 7 7 q() '5 2R- :;'¿;:¡ ¿(.~ I 71 '; :.J ~.' ,. 7.? r; ,. - 6 '1 r A 7 (; J/'I R :J t) .K 7..J p,- kf 6 X- 7 I:' / 7 I /' ¿:; v ,2S :, - ~ ~/ A- l. f 7 ~g-- ¥ "7/) 2 t; 7 L/.J 0 -;: Ý 7 I t;" G '7 . D< :2 ç -~!?¡J1f C,(jJII/ 7025 t '(II x-J r¿- ?£t"¥tJ '7 It: ~" ~~ ~ - 6.'fj A 5" 5 'I? ~ 71 I Ç)2 3 f?k 3.2. x / )" ?:: c; 7 b ~ - {(;ð ¿ 5 J 1/1- ç 7 ¿. '5 5 ç Ý 0/ ¡;- &j .5 7 Ç- ý ? 2. / 2 ? ., /1J-.JPb" SfI'/'¡'C)3Ý¥ 5271 Q27'-¿; 8-'757 25r? /, - ':11 A I{ r l ., 7/ 4 (" 7~-9--q 7&7 "7;;'" Ltð ;?J 9 ~ J1...-':!fA 43 .ft;'7r ? ''It! / 67':¡O ~79 P'I/ I -- ..-- fJ-C~'io.l1 -:¡ 7 7¡,¡Q 7777 ) /'-IX'¥ Ir/7.t;/"J b?~ ?}'0 31"15 ~ç/j:z 777Y ~/? ?-;¡ 1(-7¡vlJ'~~-- k?,lh "777)1" -7/7'-1 /.J Ç"? II'I~~ ¡;"¡:'1 I 1'-6'f5~ ;';'/1/.2 /12~ ?5'-vCj 12 ~x7? /")/')3 5JS I d 14 -5:3 0 A ') 71/'2- l.5 5?' 5 C 4 ý3 J ') ý L( 3 ) 2 ~ ý <?' , r 5 /7 -b.Þ~ A ~6 3//.J. t 'I %-.5 &, I µ I / ;;1 2 ) I 1.2 ý~5 ') ç, Ý l'i"- {:~ e A ',- " ~ .f 1/'-1- (/ I ~ I 5 ~ / 9 ' ., ,I .? 7 4' ~. / é' J / / ' ' ç 72- a?Tcfr- A"· r /J t/2. r;' ~ / 9 - 'f~ 5 ð"''--~ J '-I -; '? J ¡ '.? 74''i If. ? /J r¿5Pk 't.f:J/'I '195 ~ J../~qLf JJ. Q5'-1 /"'f.:J.?...:? -8/ / , ~'-"}It' A- 41 l. ~qtJ g-5-r~ ¡'.60.? /'-tJlf5¥ ~ 'T/' 3t:Yz 1t?:/ 77 gÇ7? L/3'7'-;i; )''J'''J!JPA- 72J/~ 1r5I.iJ?'" "/ qíJ ¥ l b toJ /5"6,-; ? 5"K 0 ; , ~ ø 71-(,líl A , 7 'l'~ 79 ()'f 7~ g-z I ~ 7?¥/ r; / f' '3 IS Ii --- 2'1-II'(lll!-------ftJ.~'1'" 7~f(Z 7C',¥9 11,1 ¿iF F~7?'7' (?J - 25-¡;úr;~ t'i '/'.2.. 7 (, '/0// /2.. 'f- . I b. 0/ /7 / b JJ ~ ? ~ ':f .. 7'-56'''''1. ·£/11'7_ /2 '-I C .5R~ I 755.3 Ih977 - 71- ''r?~1Ø¡tf.:.' '>-/'l2.' t, C;k~ I.~~(/I / ð172.. /7.{"r:;? l It:; ~- , 2k-j ,'/0 If-.... 53,'/£/ ¿ '/ó I C'I:,' 5 ý¡;' 71 1.(" I 7:> '-1"/1 -- 2.7- '.Mk4 't~)/6f" I ',' -¡,.¡ t; t:I -:J-. c¡ 2. V Z J Ç"'t 7 "1 .'>2 q 70- 7-ú6,1/·.. I.f" I.f 412- ' t¡' PI % ç¡ 3S ~ / 't:2 ~ 2 15..2- f'5 -oc!.c.___, '_,-,:_', ~ ' " r HEREBY CERTIFY THAT THIS £S A TRUE AND ACCURATE REPORT. SIGNATURE"""- 0~ I ) '.. DATE dt>~8 ---.-- -_..' -~---- ~.. .. _ ._ __ ,__ -, -¿:"::::7 n/ARRk JC HNICAÑ:Fí, ~+. Ma'nager ---- 'Em. Health 58041131018 (6/86) I r;) r '. c, ,-: - -1 en~al Services. Ga, ..Je Division _t~, CJ TANK # ~IJ i/iI/T7' /<f/t/\/ PERMIT #_ 1!f!!.....2bC L (.' r'// /,¡"";' MONTH/YEAR KERN COUNTY HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET ;:r /9 6- t=- TANK # I CAPACITY If) Ú PRODUCT N . ",-*, , ~' FACILITV i< r- t!./V ,C {;: V 11/7" -Jr - 2-'1 -15 r' -"J.} " -1'/ -30 -IS -';t ",. :J I -2-3 - 2... 2.. - If., y. - 7/ -33 -. - - - - . - -::].4 - - ,- _.' - . .¡ -- - EQUATION 4, 15 =:J 14 C 16 TOTAL METERED I NVENTORV AMOUNT THROUGHPUT - REDUCTION = OVER O~J~HORT GALLONS GALLONS +GALS -GALS ?ç 7 --I 2 ,¥ 2 / -I- rY 5UATION :3 ª 9--L TOTAL METERED READING_ SALES - ADJUSTMENT - GALLONS GALLONS .G //////////////////LLLL/L/////L//L U3.. /5.J- 1 14 INVENTORY REDUCTI ON GALLONS 62. 7 6 7 203 7 ') '-I 7.7'1 ç,\¥ 7/ 1(.,2(') Spy lye¡ G~i f'2 C ~OL( Ir;¥ J fr 2-0 5""7 q I C/ 2.. ? L./ 2. ~ ' ,522- .:: (- / ~C:~ ?~ /2- !/-Lf¥ 222- (-3 - r;;/ ~ 1)7. t; r"'¡- '-/' ~,.c;, J.a..:L 7. ll3.. 17'7 - EQUATION 2 1 12 I 5 - DELIVERED CLOSING + - INVENTORY INVENTORY GALLONS GALLONS .t¡ 7/3 4(...,"-1'" ~(/?2 &-??;'{r 7 5 %"71 ?ú2S h? II .5 1..2;1 SS-&'7' 5 27/ If 5' 75 ") 7L1 !-1 'fþy.z 77?Y 7/2 'I (;5%..5 ? t(g-3 c; /.,. / .~t~/~? '-,/751( l-I ;:), q J.( '-t .f' 'I r .K5'1&'" WEEK 3 TOTALS 7Q?Y 7 f Z-Z .7~ 2 7f.,tf 7~.J't¡ ¥2lf 7/7 .¡ _ rk'S /. r; ",S: { (Jv I {. (,(1 I :; > IS WEEK 4 TOTALS I >515 L(qq;¿ 411/2 49/9' 2 1 DATE DAY/HOUR ~ 'If' ~ :2 :~(; 4 5/v V I µ f. .It( (; ,1 r~t..;rA [= 6."1/ ,¿ 7 ~ I" "? [A IS - 6. ò'r'..2d I?' 5'3~ f1 ~7 -f.((,.:1 I ¡r 11f;' ~. /... , -~ " a;~t;¿'à ~I ')f(ì 2Z' ?S?l! .L '{ ·¡;a/l 2 y, /If;t/' ? S' 5'''' A ')... ~ ~ );)11 A- ? 7 ~}:.J(, /I 2J ,PIC A 'L~-M¡(, ß. 3n -71/IA ;i':09JA f¿ -f.~c A fr .J'p() A II-Iii d /2 - ''5,f /1.. -f if¡ It /4 -7.(1;,4 \' 111I1I11I11I1111/111I11LIII' ',b-} lr3 ¡ 14 7;'5 1IIIIIIIIII111111ILLllllllll11ll1 Lf r;, t{ 2 I _MONTBLV TOTALS Env. Health 5804113 1017 (6/85 ont -,~ ... « -- -', " -\ INVENTORY RECONCILIATION SUMMARY '.' - - '~. WIŒIt 11 . .. -,.. A. Percent Variation Amount Over/Short (Col 16 ]3 Gals. · Total Metered Throughput (Col. 15) .....J ~f-7 Gals. x 100 = 1-1 % Variation - · --.--- B. Reporting: 1. Does the Amount OVer or Short exceed 350 Gals? ~NO - Continue routine .onitoring - DYES - 24 hours of discovery. 2. Does the Variation exceed 5%? DYES hours of d18covêr -. -.- NO - Continue routine .onltorin - Re ort to Peraittin IIKKIt 21 -_._.~- - A. Percent Variation: ,- Amount Over/Short (Col. 16) /77 Gala . · Total Metered Throughput (Col. 15) 5197 Gals. x 100 = if, tf 2.. % Variation · .B. Reporting: -,-~ .- ------- .- --.---. "-.. _ _ _~.m 1. Does the Amount Over or Short exceed 350 Gals? 0:N0 - Continue routine .onitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%? NO - Continue routine .onitoring DYES - Report to Permitting Authority within 24 hours of discovery. IIKKIt 31 A. Percent Variation: Amount Over/Short (Col. 16) -22 Gals. Total Metered Throughput (Col. 15) Jl¡-.JO Gals. x 100 = I ¡j- % Variation · B. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? - 0:'NO - Continue routine monitoring DYES - Report within 24 hours of discove~y'~__ 2. Does the Variation exceed 5%? œwo - Continue routine .onitoring DVES - Report to Per.itting Authority within 24 hours of discovery. DEI[ 41 A. Percent Variation: '. Amount Over/Short (Col. 16) + }7 Gals . · Total Metered Throughput (Col. 15) ']070 Gals. x 100 = /. 20 % Variation' · B. ' Reporting: 1. Does the Amount Over or Short exceed 350 Gals? ~O - Continue routine monitoring DYES - Report within 24 hours of discovery. 2. Does the Variation exceed 5%? ~NO - Continue routine .onitoring DYE§.. Report to Permitting Authority within 24 hours of discover - JDmII , A. Percent Variation: Amount Over/Short (Col. 18) ..¡- i t.f ) /12 ó5 ,76 .--- Gals . · Total Metered Throughput (Col 15 Gals x 100 - % Variation I B. Reporting: Does the Variation exceed 1.5%? I8J NO - Continue routine monitorinE_ !.! .j Authority within 24 hourlt-of discover , - . .. I HEREBY CERTIFY THAT THIS. IS A TRUE AND ACCURATE REPORT. - DATE SIGNA' - . - i - Eny. Healt" 5804113 1017 (6/8'" 'O¡ack) 'if ( " ------ - ------.....- -- ( -l~f 3~ 4 6 8 10 11 -----12--13 14 ---15 16 --~I7--1r--ll DATE o OPENING OPENING CLOSING CLOSING METER DAILYH METER TOTAL READING GAUGING GAUG ING DELIVERED IIATER INVENTORY TOTAL METERED A/IOUNT PERCENT NEGATIVE POSTIVE 0- GAUGING INVENTORY INVENTORY READING READING METERED - ADJUSTlŒNT -- BEFORE--- AFTER - INVENTORY -GAUGIm;-~ REDUCTION-TIIROUGHP1JT--OVEROltSHORT-VARIATIO¡r-CO~COUN'l II SALES DELIVERY DELIVERY , DAY/IIOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS niCHES GALLONS -INCHES GALLONS GALLONS INCHES GALLONS GALLONS GALLONS , -- +' ,----'~ ~- KERN COUNTY HEALTH DEPARTIIENT ,_ _ _.__~.n__ --_._---~- --~+ PERIIIT-r----t60026C G--FUELs-INVENTORY RECORDING SHEET - ___H__ -- ---- - -- -~-- -- ---- --.--- ~- -- ~-_. - -- -" - -- ._.------~--- _.._~,_._---_.~-~-_._-- II, , - --~ .....- ~-- ---~ .. --, - .,.-- - ----..._.-- '''1 ,-rACItITy---"GARAGr--------- TANK . T (SOUTH) ----·CAPACIft HI'; 000"" ~- PRODUCT'-\JHLEADED------IIONTH/YEAR- APRIf;-!988 -~--1---¡----3-- -- --- 4 h5 - 6 - -, 7--- -.- ,,' 8- ---9 -10 ------ 11 -------------12------13 - ----14----- - 15 ------I6---17---Ia------19 DATE o OPENING OPENING CLOSING CLOSING IlETER DAILYH METER TOTAL READING GAUGING GAUGING DELIVERED IIATER INVENTORY TOTAL METERED AIIOUIIT PERCENT NEGATIVE POSTIVE --- -- -~ - 0 GAUGING INVENTORY INVENTORY READING READING METERED ADJUSTIIENT BEFORE - AFTER . INVENTORY -GAUGING REDUCTION- THROUGHPUT -OVER-OR-SHORT- VARIATIOIt-COUN'l-COUNT II - SALES DELIVERY DELIVERY DAY/IIOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS INCHES GALLONS INCHES GALLONS GALLONS INCHES GALLONS GALLONS GALLONS , .- - ----- -- - --- -~._- ..---_..-- .--~.- -----_._-~-- - --- - - - 11 2l 31 - - -. - - 41 51 -1/648A11 61 48 1/2 5340 4713 5170 4544 626 0 m 626 -1 ---1- -..O----~-~ 2/600AII 71 44 4713 4644 5262 5170 92 0 69 92 23 0 1 -~- - .--.-. WEEK 1 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 696 718 22 3.06' 1 1 3/500AII 12 43 1/2 4644 9032 5446 5262 184 43 3/4 4679 79 1/4 9270 4591 203 184 -19 1 0 -,' 4/640AII 22 77 9032 8308 6I7l 5446 725 -- 0 724 725 I 0 --1- 5/635A11 32 70 3/4 8308 7584 6871 6I71 700 0 0 724 700 -24 1 0 6/641AII 42 65 7584 7025 7440 6871 569 25 0 559 544 -15 1 0 7/630AII 52 60 3/4 7025 6311 8156 7440 716 - 0 7!4 716 2 0 - 1 8/643A11 62 55 1/2 6311 5723 8832 8156 676 0 588 676 88 0 1 9/600AII 72 51 1/4 5723 5584 8957 8832 125 0 139 125 -14 1 0 -, -- - WEEK 2 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 3651 3670 19 o.m 4 3 -- 10/500A/! 13 50 1/4 5584 5271 9240 8957 283 - 0 313 283 -30 1- 0- lI/mp/! 23 48 5271 4575 9979 9240 739 0 0 696 739 43 0 1 12/635A11 33 43 4575 3149 10790 9979 8Il 0 826 8Il -15 1 0 -B/640A/! 43 37 3749 7778 11484 10790 694 32 1/2 3145 66 1/2 7778 4633 604 694 90 0 1 14/700AII 53 66 I/2 7778 7124 12153 Il484 669 0 654 669 15 0 1 15/645A11 63 61 1/2 7124 6585 12688 12153 535 0 0 m m -4 I 0 ---I6/530AII 73 57 I/2 6585 6483 12843 12688 155 0 102 155 53 0 1 WEEK 3 TOTAlS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX r-JD {XXXXXXXXXXXXXXXXXXX 3734 3886 152 1m 3 17/600AII 14 56 3/4 6483 6141 13211 12843 368 t.f'~:\S 0 342 368 26 0 18/600AII H 54 114 6141 5619 13m 132Il 532 0 522 532 10 0 19/645A11 34 50 I/2 5619 4958 14313 13743 630 ~~~ 0 661 630 ·31 1 J . 20/650AM 44 45 3/4 4958 4294 14954 14373 581 f~' ~i / .~... 0 S54 <Ai _'>1 . . , ¿- ~ 15 16 1-7 18 l-~ 14 1·3 ( - DELIVERED WATER INVENTORY TOTAL METERED MOUNT PERCENT NEGATIVE POSTIVE INVENTORY -GAUGING- REDUCTION---THROUGHPUT-OVER-OR-SHORT-VARIATION--GOUNT---C~ o o + 1 1 t -7- -64 -71 GALLONS GALLONS -649--- 580 151 GALLONS -----642 644 m o INCHES -4896 o o TOTAL READING GAUGING ,;GAUGING HETERED-- ADJUSTlIENT~--BEFORE-- ~TER- SALES DELIVERY --DELIVERY GALLONS GALLONS INCHES GALLONS IHalES GALLONS GALLONS - -649 ----36-1/2--3681'-'13 8577-- 580 151 [2 1-2 10 1----8- 5 6-- 1----2-----3--4- > t , CLOSING METER DAILYH METER -READING - READING 15603 16183 GALLONS GALLONS -----15603--14954 16183 16334 CLOSING INVENTORY GALLONS -8548 7904 7682 OPENING INVENTORY GALLONS -4294 8548 7904 D OPENING (}-GAUGING If DATE DAY/HOUR INCHES -21i710M--54--n 22/730M 64 72 23/600AM 74 67 3/4 112 j ; ó . v< 3 o 1 1 1--- 1 1 o 4 1 o o o o o 1 -5.90t -206 -33 118 37 -35 15 6 -22 3491 o 643 576 619 501 529 152 3697 33 525 539 -584 486 523 174 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX '-- o o o o o o o o 643 576 619 501 529 152 16334 16334 16977 17553 18172 18673 19202 16334 16977 17553 18172 18673 19202 19354 WEEK 4 7649 7124 6585 6001 5515 4992 4818 7682 7649 7124 6585 6001 5515 4992 65 3/4 65 1/2 61 112 57 112 53 114 49 3/4 46 15 25 35 45 55 65 75 -24/tlOOPK 25/645AH 26/559AK -Z7/530AM 28/610AM 29/600AM 30/700AK I. o 5 16 14 5.17t o.m 156 143 3020 14785 2864 14642 WEEK 5 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx -14.0000 43. 0000 -8.2500 6.7500 9.7500 5.0000 -6.2000 5.1500 I-SUNDAY 2-/'IONDAY 3-TUESDAY 4-WEDNESDAY 5-TH'JRSDAY 6-FRIDAY 7-SATURDAY TOTAL AVERAGES -56 172 -33 27 39 25 -31 143 I-SUNDAY 2-KONDAY 3-TUESDAY 4-WEDNESDAY 5-THURSDAY 6-FRIDAY 7-SATURDAY TOTAL MONTH TOTALS TOTALS -19 -30 26 -33 43 10 lI8 -24 -15 -31 12 13 14 -15 22 23 24 25 32 33 34 . . -18------1~- POSTIVE COUNT ---1&- 17------ MOUNT PERCE~ ~GATIVE OVER OR SHORT-VARIATION COUNT 15 TOTAL METERED THROUGHPUT 14 INVENTORY 13 WATER GAUGING 12 DELIVERED INVENTORY 11 GAUGING AFTER DELIVERY INCHES GALLONS 10 GAUGING BEFORE DELIVERY INCHES GALLONS 9 READING ADJUSTMENT 8 TOTAL METERED SALES GALLONS 7 DAILYH METER READING 6 CLOSING METER READING 5 OPENING CLOSING INVENTORY INVENTORY 4 OPENING GAUGING 2 D o W + t GALLONS GALLONS REDUCTION GALLONS INCHES GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS INCHES -14 53 -71 -22 DATE DAY/HOUR 72 73 74 75 . ·.... /6Clt72b"C .:i - , / ';>7 - ' , PERMIT # / 51 ]/.¡ KERN COUNTY HEALTH DEPARTMENT INVENTORY RECORDING SHEET .2- CAPACITY / C?.O 0 PRODUCT GIJ/1/J6é TANK' C Cì (/ I).{ T, ,J .þ" ~. 4';~ MONTH/YEAR FACILITY 12 13 DELIVERED I WATER INVENTORY GAUGING GALLONS INCHES 11 GAUGING AFTER DELIVERY INCHES GALS 10 GAUGING BEFORE DELIVERY INCHES GALS ; i . .L J) , , ¡ i j í - ,- .fZt..._ -- -Ø'-= l..l. cj77 -, q:7 J? , - - ø - - - - - - - - - - - -- 7tll~ 8'<7¥?Ì :3 't5b -IL-=- - - - - - - - - - - - - - - - - - - - - ±~ - - - ----i - DATE ~/Í.oIøÐ - - T I ç 5 4L c;f 8'6' ¿ì I ~/ ;7 , , .:.',;71 ~17L !! TOTAL METERED SALES GALLONS - GALLONS - [I ~ Y (:1" J I " ) ,f ç 7úL Æ77 2 6 bÓO SIb 115 /C/? S:J2.. ? ".~ ç' '7' 7" 4 :r/ , 71 32.3 2?3 1I-7C '/ ~ I c.. '? ( Hj 6~ 60S !rf ';Ç'I f5; , .:;~ìC:\~!t F;c~t ~~a:1aaër a G?i'ag0 Divi:::icn º- READ I NG ADJUSTMENT 1 EO QAT I ON ~ 1 7_ DAILY METER READING §. CLOSING METER READING §. CLOSING INVENTORY 1- OPENING INVENTORY ª OPENING GAUGING 2 1 1)7/' 1-/'; 43'Y~ ~0 lj/ GALLONS 7/;!D ¡'7P.-Y -;} (:- "ç>.'::-) /'797 f ?,< -z.. qç,:';--.-¡.: 97.2.. :2 I v ., 22 l(jgJý'" 1 V 953 I I tl~2 /I 59¥ 1).:Jl,/7 12 9 ¥ I I ? ~/ ~"2 I 1 "J ~ ., Ivllb 1'-159"1 I..J01Ì) ¡s56 C I (. 2.:3 7 let: '7 I!? 17/72- 17 ifl 7 ' J 7 ¥Jf:3 I,f- t7%ÿ JÇ8~~ / Ct I.f f(,¡ 2ún; r :Jl>h07 GALLONS / ,- ,.;--.,.;;- -:7 b y- -2 ? 79 ý" g~X''3 9 ,'J tÝ , '7 :7.:2.z... 0]';2.?- / OP-YF / ¿/ ~5.J' / I ¡JIG 2. 115o/if 1~'11...t7 /:2"1q/ J ..J'Ì.22 / :3 "i J J '-I;JJ b 14- 599 15 07S / ,,:;-66 1(,7..~'7 I~ ~"f / 7/72 !7J-I/¡ I '7~ "3 f I ~oC'g-- Ið: ,q , q 'tJ() 2. G05l :;. :Zo Co 2 20JhL I GALLONS 57 S:?" S" h5~ c:¡ 7.52- 9/ ¡:::/; .;..- L./~q 7 ¡r"f / 727"-1 C. 720 ~t53 Cr;/7 J'9hC .J;) 71 ðS77 f? tJ "3 7519' 7.25"7 ~ ~ 9t> C 5'>7 ¡;~tJ/ n'7?- ;~! &-- 2 1 ~CJ93 f~~ c;¡ 31 '-fC¡'Z2. INCHES c. ..¡ j/"! c:- I .' ..::.. - DATE DAY/HOUR J ·t~I'A 1· (.;,:1# A ./J; ~ 5' - h.> ~ A (¡ - I: :'1/4 SIGNATU ---. I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT. - - ~ _.~ ,7-'1--, -'- Env. Health 5BO 4113 \1;/81;) i .' . .. , --- ..-._~ _.,.- _4_______....---- ..... ." , PERMIT # -Þ MONTH/YEAR 'tJt' KERN COUNTY HEALTH DEPARTMENT INVENTORY RECONCILIATION SHEET TANK # ;2.... CAPACITY tJ PRODUCT , , --- FACILITY )( {-t! /tICe; (//itr¡ -p- -I ~ -j -.5" - I -/7 =-:27 -1'7 -3 -.3 - -5' ; -I? - -~ 7 -2' ,. ..:.:..- -'t&Jf - EQUATION 15 =1 14- ( 16 TOTAL METERED INVENTORY AMOUNT THROUGHPUT - REDUCTION = OVER OR SHORT GALLONS GALLONS +GALS -GALS L.¡ " '-ISI .~- ()y 4: .¡. rt) T ,/ .¡....~7 ..:!:~J.5 -tJL. _ J__. ... 15 TOTAL METERED THROUGHPUT GALLONS L¡ r;. r Cf¥ I 1(' 5' ý'r¡ ?C2 ~/7. 1-00 '3/ r2- J/~ //5 Ip? )J2- lS.3 r .:;...., ---' ' .. Jf<' I )/tJO .5"7/ 32"3 2R5 t-' It/; '1'11 I.r 'ì ( "'¡:.2... 1777 .;.J 7 ") ;J ~g (; ç. t~r:; 711'1 (¡2. / S-~( .L:l.. ç? .L£l I;;~ :3 I !! 5UATI ~N TOTAL METERED READING SALES - ADJUSTMENT GALLONS GALLONS ¿'¡'é'~ 4" -;/ 5 7 (, 2.. I 14 INVENTORY - REDUCTION GALLONS 'tSI lOr.{ 77 ~gþ ?/J 7 ¡,IY 0.17 1/:.,2- .5" V 'I {7 /..16 C; ~ I C1S 5 c¡ :L. µ(/ ~ ,:¡ 0 ~ c¡ .s-7'f ./02- ¿~f 55 cJ (p ;¡. S- ~/I 11:LY - '-f q 2.. -;}1 73/ t. ! y S57 '1..3..:l. 7 'i52.. )(j1 EQUATION 2 12 c=:§: = DELIVERED CLOSING INVENTORY INVENTORY GALLONS GALLONS 57)!) ~ 65¥ q 7~,) C,/hG r.~t;C; 7?"::(./ /';1 :L '-I- '7'j 2 I 9"t2t:J f'/~? þ;¡;J q J ~~íf WEEK 4 5'515'1 ,. I ? I JrLf2-o/ fr/g;-v X 1/' q.3 ffff 'I Lf I 5" fš'f 7>Jq 7 ."7 5 '7 t I'l q() V 1;[./ I (it; / 53"7(, ? 9:21 r; 72 6 Gc..r;J C. 'i17 S'16C ')2 71 P--..J 77 f5/2ý;3 ·r;TJJ t.{q~2- TOTALS TOTALS T75b 3 TOTALS TOTALS .2_r 9 fÇ (; 1 q );r;7 f7r¡r; f5jl lOM , (7, r¡ fc WEEK J7 I 2 1 Ii ! OPENING INVENTORY GALLONS ø¿ 0 "I )7)' Ç7 ,~>f£ 9?Sz.. 'tlv? 8''15 if ?é-"i J WEEK :z22:.!:t ~ f?S"3 ilLZ ~ 5'27/ ¿--527 1 + 2 ! DATE DAY/HOUR I - 6. V{;;.f 2 . 6!/X f) ~ . 5./:/01 Lt . .!'f cA , .¿¿ - G :t.I/1'r z.- c';3C /I f-6:IfJ ,4 rr - {/ct It to - SÞd Å_ /1, l.J2I1 /2·1:354 /J - C. i(M- !'" 7/f1'J /.H.,¥>L 1(-- f:>ð A '! "7 . ¡;.,~,~ /' ! {." ,'" ,: '_f_J:Jf A /(1. /f;t f'~~~:; A 22· 7;J! A ., ? - I~ N 4 -? t/-!!ßf f' ;c. 5'(>1/ ' ./ (- r: [',eM ;t;l-f.',;, A / (. h'f; .J 2'( -ha~ 7fJ-71/{ (3 27~ rllul/I!I//ILL1//I//II/I//II!I!I/lj J r;, 2 2 II I! / I! /I /Ill! I! / LlLJ.L1/1 I! I! I! / I .J 'T~ - ---- - ------ . -...-- ... ------ ---.-.---.---------.- ,.~.''''~'.- -.. JIONTBL Y TOTALS Env. Health 580411 '17 (6/86) ¡;;;.;; ,-- -~~~- ..-". - ~ ;-- INVENTORY RECONCILIATION SUMMARY ~ IIIŒK 11 "'.- A. Percent Variation Amount Over/Short (Col 16 i ~ Cl Gals.. Total Metered Throughput (Col. 15) ~ ;f';? Gals. x 100 .. % Variation B. Reporting: . 1. Does the AIIount OVer or Short exceed 350 Gals? ~ NO - Continue routine aoni toring DYES - Report wi thin 24 hours of discovery. 2. Does the Variat!on exceed 5~? 'rZrNO - Continue routi~e aonito~i~;-----bYES ' ~. Report to Peraitting Author i ty- within 24 hours of discoverÝ~::' IIIŒK 21 " -'-- A. Percent Variation: . Amount Over/Short (Col. 16) r '7 / Gals.. Total Metered Th;~ughPut (Col. 15) ? / ¿? () Gals. x 100.. 2, 2 J % Variation B. Reporting: 1. Does the Amount Over or Short exceed 350 Gals? ŒiNO - Continue routine aonitoring []YES - Report within 24 hours of discovery. 2. Does the Variation exceed 5~? EðNO - Continue routine aonitoring []YES - Report to Permitting Authority within 24 hours of discovery. IIIŒK 31 A. Percent Variation: ____ Amount Over/Short (Col. 16) l' { L( 0/ Gals. Total Metered Throughput (Col. 15) }177 Gals. x 100 .. /¡-, I)i % Variation B. Reporting: ':k'- l-~~oes the Amount Over or Short exceed 350 Gals? ÆžÍNO - Continue routine monitoring 24 hours of discovery. 2~'-Does the Variation exceed 5~? 0 - Continue routine aonitorin DYES - Re ort to hours of discover . WIŒK 41 A. Percent Variation: ." Allount OVer/Short (Col. 16) + /3 Gals.: Total Metered Throughput (Co.l. 15) .3 J s 1 Gals. x 100 .. , if 'I % Variation . Reporting: t 1. Does the Amount Over or Short exceed 350 Gals? ~NO - Continue routine aonitoring DYES - Report within 24 hours of discovery. ; 2. Does the Variation exceed 5~? EìNo - Continue routine .onitoring []YES - Report to Peraitting Authority within 24 hours of discover' ~I A. Percent Variation: Amount Over/Short (Col. 18) .}-:3 'f 'I Gals. . Total Metered Throughput (Col. 15) lJ/ 6Z 2 Gals. x 100 _ 2',52 % Variation B. Reporting: ,,-. Does the Variation exceed 1.5%? ONO - Continue routine Report to Per.ittin rity within 24 hours of discover I HEREBY CERTIFY THAT THIS IS A TRUE AND ACCURATE REPORT ~ - DATE ~¡jo¡'~ Env. Health 58041~~1017 (6/86) (Back) ,. ~~~,:;;G.ger Services. Garage Division - - \ -1-----2 10 -11 ---~12 13 ----14 15- ------16~-17~-1&____19- DATE D OPENING OPENING CLOSING CLOSING IlETER DAILYH IlETER TOTAL READING GAUGING GAUGING DELIVERED WATER INVENTORY TOTAL IlETERED AIIOUNT PERCENT NEGATIVE POSTIVE --------+- o GAUGING INVENTORY INVENTORY READING READING IlETERED ADJUSTIlENT BEFORE - AFTER -INVENTORY GAUGING REDUCTION- THROUGHPUT -- OVER OR- SHORT VARIATION---COUIIT-COUIIT-- W SALES DELIVERY . DELIVERY DAY/HOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS INCHES GALLONS IIICHES GALLONS GALLONS INCHES GALLONS GALLONS GALLONS , -- . ---- KERN COUNTY HEALTH DEPARTIlENT - ----,---~._. -- ---- ---------- ----~---- ---------PERIIIT -'--16OO26C FUELS INVENTORY RECORDING SHEET .m ___ * __ _ _.__ "" - ------- -" --- ____. .___ _____._~___._a__ Q ,I:: - ;,-FACII;Irt--GARAGE----TANX ,-- -t-tNORTH~- --------CAPACITY--10.000-----PRODUCT -IJH ¡EAQED- IIONTH/YEAR APRII.-l988 --1-2--3---4----5- ·----6- -- ---7 --- -- 8 -- 9-------10 ------11 --12--13--14--15 16 17-18--19- DATE D OPENING OPENING CLOSING CLOSING IlETER DAILYH IlETER TOTAL READING GAUGING GAUGING DELIVERED WATER INVENTORY TOTAL IlETERED AIIOUNT PERCENT NEGATIVE POSTIVE ----- 0- GAUGING INVENTORY INVENTORY READING READING IlETERED ADJUSTllENT BEFORE - -- AFTER --- INVENTORY GAUGING REDUCTION-THROUGHPUT---OVER -OR- SHORT VARIATION-COUNT -- COUNT--- W SALES DELIVERY DELIVERY DAY/HOUR INCHES GALLONS GALLONS GALLONS GALLONS GALLONS GALLONS INCHES GALLONS INCHES GALLONS GALLONS INCHES GALLONS GALLONS GALLONS , -- . ~- ---- - - -.. -- --- --. --- - 11 21 31 41 51 -11648A1t---- 61 54 3/4 6209 5758 7588 7120 468 - 0 451 468 17 - -------0------1---- 2I600AII 71 51 112 5758 5654 7682 7588 94 0 104 94 -10 1 0 WEEK 1 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 555 562 7 1.25t- 1 1 --- 3/500AII 12 50 3/4 5654 9752 7798 7682 116 51 1/4 5723 85 1/2 9860 4137 39 116 77 0 1 4/640AII 22 84 114 9752 9166 8383 7798 585 ---- 0 586 585 -1 1 -0----, 5/635A11 32 78 114 9166 8459 9085 8383 702 0 0 707 702 -5 1 0 6/641A11 42 72 8459 7841 9722 9085 637 20 0 618 617 -1 1 0 ---7/630AII 52 67 7841 7224 10322 9722 600 ~ 0 617 600 -17 1 0- 8/643A11 62 62 114 7224 6720 10838 10322 516 0 504 516 12 0 1 9/600AII 72 58 112 6720 6653 10953 10838 115 0 67 115 48 0 1 -..--- - - WEEK 2 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 3138 3251 113 3.m 4 3 - -10/500AII 13 58 6653 6517 11062 10953 109 - 0 136 109 -27 1 -0 l1/mAII 23 57 6517 5966 11594 11062 532 0 0 551 532 -19 1 0 12/635A11 33 53 5966 5271 l2347 11594 753 0 695 753 58 0 1 --13I640AII 43 48 5271 8577 12941 12347 594 43 3/4 4679 73 8577 3898 592 594 2 0 1 14!700AII 53 73 8577 8093 13422 12941 481 0 484 481 -3 1 0 15/645A11 63 69 8093 7519 13993 13m 571 0 0 574 571 -3 1 0 16/530AII 73 64 1/2 7519 7257 14316 13993 323 ,- 0 262 323 61 0 1 WEEK 3 TOTALS XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 3294 3363 69 2.05' 4 3 171600AII 14 62 112 7257 6990 14599 14316 283 0 267 283 16 0 1 18/600AII 24 60 1/2 6990 6551 15075 14599 476 0 439 476 37 0 1 19/645A11 34 57 114 6551 6001 15566 15075 491 0 550 491 ·59 1 0 20/650AII 44 53 114 6001 5376 16237 15566 671 0 625 671 46 0 1 .' . ¡ ----16--11--18-----19~----- --13---14-----15- -,l2 H---- -9--10 8 --1'-- ,1, I DELIVERED ¡¡ATER INVENTORY TOTAL 11ETERED A/lOUNT PERCENT NEGATIVE POSTIVE INVENTORY -GAUGING-REDUCTION--THP.OUGHPUT --OVER-OR' SHORT- VARIATIO~-COUNT'·-COUNT- -(t-------} 1 0 o 1 51 -19 1 GALLONS GALLONS ------461 m 245 GALLONS -411 492 243 INCHES GALLONS ---3956- o o GAUGING GAUGING ---BEFORE- -mER --- DELIVERY ---- -DELIVERY INCHES GALLONS INCHES GALLONS 46-m2--761/4-------8948 READING ADJUST11ENT GALLONS TOTAL 11ETERED SALES GALLONS - , 462 473 245 DAILYH 11ETER READING GALLONS 16237 16699 17m OPENING OPENING CLOSING CLOSING IlETER GAUGING INVENTORY INVENTORY READING GALLONS 16699 17m 17417 GALLONS . 8921 8429 8186 GALLONS .- 5376 8921 8m DAY /HOUR INCHES --1117l0A/l-54-- 48 3/4 12/730A/l 64 76 13/600A/l 74 71 314 o o 11 DATE , o -- XXXXXXXXXX (XXXXXXXXXX 3027 ---3101 74 2. m _.-~ . -~-- - )- - -93 66 27-- 1---0 ) 607 605 -2 1 0 ) 731 781 50 0 1 - )- - -614 -6-1}------7 ~1 ) 557 561 4 0 1 ) m 551 98 0 1 --~-;~-O-- 0----209---160 49 1-0 mmxxxmmxxxxxm xx 3264 - 5 WEEK 4 TOTALS xxxxxxxxxxxxxxxxxxxxxxxxxxm ---17417 "--66 17463 605 16088 781 .---- 18869 - - 621 19490 561 20051 551 20602 160 ----17463 18086 16869 - 19490 20051 10602 20762 -'-8093 7466 6755 -- 6141 5564 5131 4922 c.' ,~ '. -'lt/UOOPII--15--69-3/4--6166 :: 25/545A/1 25 69 6093 , 26/559A/1 35 64 114 7466 ':,-21I530A/l----45 58-3/4----6755 ,., 28/610A/l 55 54 114 6141 29/600A/l 65 50 1/4 5564 -30/700A/l-75 47 5131 . 4 16 14 m 2,m 2. 61 344 3345 13622 13278 TOTALS xxxxxxxxxxxxxxxxxxxxxmxxxxxxxxxxxmxx xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxmmxxxxxxxxxxxxxxxxxxxxxxxx ---- -- l-SUNDAY HONnAY 3-TUESDAY 4-WEONESOAY 5-THURSDAY 6-FRIDAY 7 -SATURDAY 9, 7500 3.7500 11.0000 13. 5000 6.7500 21. 0000 10,4000 _. i-SUNDAY 2-IIONDAY -3-TUESDAY 4-WEDNESDAY 5-THURSDAY - 6-FRIDAY 7-SATURDAY AVERAGES 39 15 44 54 35 105 52 TOTALS TOTALS WEEK IIONTH 11.1643 TOTAL -- 344 TOTAL 77 -27 16 -27 -1 -19 37 -2 -5 58 -59 50 -1 2 46 7 -17 -3 51 4 17 12 -3 -19 98 -10 l2 13 14 " 12 D H H 32 33 ~ ~ ~ u « ß ~ ~ 54 H Ü 62 63 U 65 71 . \ --+14 ¡ 1 WATER INVENTORY TOTAL I1ETERED AIIOUNT PERCENT NEGATIVE POSTIVE - GAUGING - REDUCTION---THROUGHPUT -OVER- OR-SHORT -VARIATION-COUNT-COUNT T I I , I - , . ,.......' ¡ , Ioo....._~ ---18--19-- ---17-- --~16 15 -~12--13 GAUGING DELIVERED AFTER ---INVENTORY- DELIVERY INCHES GALLONS --ll 10 GAUGING --- BEFORE DELIVERY INCHES GALLONS 9 READING ADJUSTMENT 8 CLOSING I1ETER DAILYH METER TOTAL READING --READING ---METERED 7 6 5 OPENING CLOSING -INVENTORY INVENTORY 1-2--)---4- ~\ i D OPENING --o-GAUGING If DATE t GALLONS GALLONS i GALLONS I INCHES GALLONS GALLONS SALES GALLONS GALLONS GALLONS GALLONS GALLONS INCHES 48 61 2 -49 DAY/HOUR n 73 74 75 . I i CONTROL SHEET FERMI T :# UARTER/YEAR * * QUARTERLY MODIFIED 1NVENTORY I CE.\VED * ... SUBST~a:,~W~TORED I FACIL:ITY , T ANK:# COL. 11 - CUMULATIVE CHANGE - GALLONS - ?5 I I -1 I I I I J I I J I I I J I I I a¡COL. 9 COL. 10 =VOLUME+SUBTOTAL= CHANGE GALLONS GALLONS o fK ,....-/r.) ø ct ~ I I 1 I I 1 I I 1 I I ctt~.: 7 COL. INCH 2ND 1ST CHANGE IVOLUME VOLUME INCHES GALLONS GALLONS ¢ ,~-:Z~ /db~~ ICY-&?-c/ j ð'c¿¿~ I(:J ~-::?-c¿ /~ 4 :zs ¡ Ó £6;J<:.j Ii o·~ ~ "ð I lðc¿.?~/Ó~2c¿ I I (0 77~ I /c:)77 "A I / é1 6(6.G) I / t...-') ¿.& 0 'D(~U lð~~C }O t:,6 0 /D ~ <.co I D~ÖÝ 10 to öý ¡00~t{ I(J ~ot./ I(~(,b'f I~o'-f ¡èin'O'f /ObO¥ ---------- t::;4 ø 1 = I I 1 I I 4.¡COL.,5 1ST -GAUGE INCHES' (PIA CIl~ 7 ç ~ 7s q~ 9& Ii 76- CAPACITY I COL. 3,COL. WATER 2ND LEVEL GAUGE INCHES ~. INCHES ¢i~ 'Ýt - . ¢ I I 1 I I I I 1 I I cf 2 COL. 1 I pOL. TEST ~ W~EK I !... 1 10 11 12 13 3 4. 5 6 a 9 7 2 , , I I I I , i , ¡ I: ~ì! p"'. ¡ i;, (, it I , I; I í ì I: < I' I ì. " ¡ t I 1 I , UARTERLY SUMMARY CHECK ONE ONLY SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE IS A MOTOR VEHICLE FUEL TANK TANK MONITORED 9 OF GAL. ~ SUMMARV 9) OF ~,. GALS B0:I:TOM LI E) .OF COL 1¡, A MAXIMUM WEEKLY VOLUME CHANGE A CUMULATIVE VOLUME ,CHANGE (COL , GALLONS 1 2 ,e. , I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A THROUGH "0" ABOVE TITLE DATE 9 COL (COr. 9 TANK' -, ~ PERMIT MONITORING BETWEEN DATES OF ~ (INCLUDE YEAR) NOTED ON REVERSE SIGNE 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 I I I I FOLLOWING REPORTING FILL OUT THE TANK MONI TANK , PERMIT , MONITORING(BETWEEN DATES OF ____ (INCLUDE Y~AR) NOTED ON REVERSE RESULTED REPORT TO THE ,PBRMITTING AUTHORITY WITHIN 24 HOURS IF: TANK OF 1000 GALLONS OR LESS CAPACITY HAS OF +/- 25 GALLONS OR MORE ' TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE OF +/- 35 GALLONS OR MORE " TANK OF OVER 5000 GALLONS CAPACITV HAS A VOLUME CHANGE (COL +. / - 50 GALLONS OR MORE ¡" " " , , ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) oF. +/- ,250 OR MORE OVER THE QµARTER TIME FRAME REPRESENTED. ON REVE~SE I I J ¡ TORED [IS A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK ¡ ---- I '1'0 THE P~RMITTING AUTHORITY WITHIN 24 HOURS IF: 'I VOLUME CHANGE (COL. 9) IS ~ CUMULATIVmVOLUME CHANGE ¡ , CHANGE A VOLUME A B C o GALLONS OR MORE 100 GALLONS OR MORE +/.:. IS 10 11 +/- COL, .. REPQRT A B AND IN: SUMMARY _GALS OF 9) OF BOTTOM LINE COL 11 A MAXIMUMiEEKLY VOLUME CHANGE A CUMULATIVE VOLUME CHANGE (COL ! GALLONS 1 2 '/ I HEREBV CERTIFY ¡THAT THE ÀBOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT ~ND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A ,!AND "B" ABOVE , TITLE DATE \ I ! ¡ I SIGNED , , *' *' SUBMIT A COPV OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR, A MINIMUM OF THREE VEARS ~ *' *' I o 0 '2,¡b <:-.. PERMI T # UARTER/YEAR I ~ --- -- '- ---'-- - ,-.-.....- -- ~ . --- ......---- - --- ----- --- --~ -- - - - -....- - -,- --~-- .~ "~'- ~ CAPACITY FACILITY TANK# '¡ I I I I I I I I I I J I I COL. 11 CUMULATIVE CHANGE G~LONS / SiCOL. 9 COL. 10 L =YOLUME SUBTOTALJ CHANGE+ ; GALLONS GALLONS o SUBSTANCE STORED COL. a¡COL. COL. INCH I 2ND _ 1ST CHANGE IVOLUME VOLUME INCHES GALLONS GALLONS 1 -/7 /1 / 1 o ~ 7 I I 1 I I 1 I I - 1 I I 1 I I 1 I I 1 I /03 I -' I crr'kt 5 4. ¡ COL. 1ST GAUGE INCRES_ ~ I I 1 I I 117S to/£{ 1/ / / "1 .- 5.... . ¡ ;;.. /ß (DI.{ I D -, Yz- D"3 3/ ~ I I I I I I I I I I -I -/e¡- -/ / c, 1 c. /' / cr ) C2._ ?- ) I I 1 I I <1 Ie¡ II -Ie¡ I - -I I I 1 I I cp ~, '-, I I 1 I OL67<Z! &i~ I I) 5':57 I I I ¿ oq~4 " I I Dc¿7c¿ I / I I 0 ~ <¡cd I I I O~~ I! I I ' I 'Û L¿~/( . I ~ / () g c¿... «" I J j~c¡ I I / ó c..¿ '"'rd/Oc/=..-_.1/ I C> I6í I I O~ '7Cl1 ¡ DC¿ ~I I I 2¿:.¡1 /O~ ~~I .c¿'rcJ (oy~ 557 I I \jc ) / d cj ø c¡6 s6 I I 1 I I I I 1 I I I :3:COL. 2 COL.. 1 COL. TEST WEEK !... 1 to S1l- /0 s 1£/ I I 1 I I l I I rf rj ps 0/ C/J }b 2 :3 . 4. 10 13 5 9 11 12 6 7 a I HE~EBV CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPOR-T---AND-THAT THE¥DONOT- EXCEED THE REPORTABLE LIMITS I '- DESCRIBED IN "A" AND "B" ABOVE , I)' , :1 ~ , I t if 1~ t ~~ ) ~ I * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS ... ... SIGNED DATE TITLE , ì ) ,I , 'I ',ì ¡ " MONITORED fS,¡ A WASTE-OIL OR NON-MOTOR VEHICLE I' , REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF .-- l' - - VOLUME CHANGE (COL. 9) IS +/- 10 GALLONS OR MORE r, » CUMULATIVE ~OLUME CHANGE (COL. 11) IS +/~ 100 GALLONS ~ :1 l iI t SUMMARY TANK # - __ J PERMIT # MONITORING BETWEEN DATES OF AND (INCLUDE YE~R) NOTED ON REVERSE RESULTED IN :1 . /. " A MAXIMUM tEEKLY VOLUME CHANGE A CUMUL~'IVE VOLUME CHANGE (COL ;ì GALLONS .----- ¡ - 1 2 COL 11 9) OF BOTTOM LINE _GALS OF B OR MORE A 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 I I I I I I SIGN DATE TI TLE I HEREBY CERTIFY THAT THE ABOVE~NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "-Ai' THROUG}{"J)" ABOVE-- -- '.' 1 2 A MAXIMUM WEEKLY VOLUME CHANGE A CUMULATIVE VOLUME CHANGE (COL GALLONS COL 11 9) OF/9 GALS BOTTOM LINE) OF o C B TANK # PERMIT # MONITORING BETWEEN DATES OF____ (INCLUDE YEAR) NOTED ON REVERSE RESULTED SU~V TANK OF 1000 GALLONS OR LESS OF ~/- 25 GALLONS OR MORE TANK OF 1001 TO 5000 GALLONS CAPACITY HAS OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLONS CAPACITV HAS A VOLUME CHANGE +/- 50 GALLONS OR MORE ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- ,250 GALLONS OR MORE OVER THE QUARTER TIME FRAME K~pRESENTEü ûN REVERSE ~~-,,~ AND IN A VOLUME CHANGE COL 9 cor. 01.; 9 A CAPACITY HAS A VOLUME CHANGE COL 9 REPORT 10 THE PERMITTING AUTHORITY WITHIN 24 HOURS ..!! TANK FUEL TANK TANK MONITORED IS A MOTOR VEHICLE FUEL TANK r ) I FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE UARTERLY SUMMARY CHECK ONE ONLY '- ,~ FACILITY ~ ~t DO 2-bC" PERMI T # L. T ANK# ~ _CAPACITY tV ~UBSTANCE STORED QUARTER/YEk_ 199 1- j - COL. 1 l = = - COL. 3'COL. 4¡COL. 51 COL. 91 COL. 10 I! - COL. 2 6 COL. 7 COL. a¡COL. COL. 11 1 I TEST I ATER 2NI: 1ST INCH 2ND 1ST VOLUME ! CUMULATIVE WEEK 1 EVEL GAUe :: -GAUGE = CHANGE VOLUME-VOLUME =CHANGE+SUBTOTAL: CHANGE _ , 1 INCHES INCHE INCHES INCHES GALLONS GALLONS GALLONS - I GALLONS 1 GALLONS - I . I I I 1 ø 0 f) I 5b~ ~ Sb o/~ ¢ ro 3 ~4 Co ~ SL\ 0 I I I - 1 I ~ -1 2 I çro 1'ð r.o3 D3 I () I / I I -ø S£ '10 tf> ro6~ ø I I 1 0 ! -1 It - · 3 I t ::5 34 tI éf I c$ I I s5o/f 6;;-Ste ~:;)- 5 ~ (!J I I , - 1 i ..J I': I I I , I 4- j; I I 55 5/~ :;5 5/~ ø 19')lo (g;}-'ìO rf cf i 1 I - 1 1 · ..J " I 5 I 1, I I , cp ¢ , I S S;3!t; šS 3/t.f ~ ).~~ ~ ~S-b ø I ø I ;, " , 1 I ..J · ~ - ;l I · 6 rf I I I ø :;s //1- ~S '/2 ~;LJ-~ Co")..:l.<6 q;, "1 ø I ø I " 1 1 .J if· - f ~t I · ,> 7 cþ Io?/s ~ I q I cp I " I S~ 3/~ /.- 3A ø fo éÀ 13 I I I S ~ Ð - 1 1 .J I · a 5$1)2..- 'Iv I ø I I ø 5 $/)"; b~B ro /'1/1 ~q I d-.~ I - 1 1 .J I · 9 I I I (.., L r 5é--Þ ìb~;.J ;::u-~ TOY' ¿>-ff ~,~ 7f"l=8ï?N' I ;Lj ~ I - t I I I 1 .J I · 10 I I I ¡fv.J&, I I I I C.- !LoS ~j) ~AJ FðVL" rð~ oFR ~TI ~( I ~7 LJ I - I I I 1 .J 11 I I I I I I I :- .%~I~A.J ~r? o~l ~~ ~ I ~ì 2 I " ~ : ' - .J ' 12 I I I I I lo53/~ I 105 3/~ tþ l ,/ ~;¡1 I 1/ a ~f( I ~( ."J ? I i, - l I I; 13 ¡05 ~I 10 <5 y~ ø I I I I / / 3 ~0 I { I ~ Gb ~f: ~, .-. I c;...L,11 - I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE _REPORT_AND THAT THEY DO NOT-EXCEEDTHE.REPORTABLE LIMITS DESCRIBED IN "A" AND "B" ABOVE ì '\ 'I ¡ J. , 1" , 'j' :1 I, 'i h ,Iii ~ * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * SIGNED DATE TITLE i CHANGE ¡ CUMULATIVE VOLUME I 'II ,I ¡ .j ,I ,¡ J: TANK # 'Ii PERMIT # MONITORING BETWEEN DATES OF (INCLUDE YEAR) NOTED ON REVERSE RESULTED r I, '.. MAXIMUM ~EEKLY VOLUME CHANGE CUMULA[IVE VOLUME CHANGE (COL I ~ GALLONS ! I' 1 2 A A COL 11 SUMMARY 100 GALLONS OR MORE ""In - n&.'tv IN: 9) OF ' GALS BOTTOM LINE) OF B CHANGE COL 11 IS +/.;. A ,I f [Sl. A WASTE-OIL OR NON-MOTOR VEHICLE 'r[ REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS -- T - TANK MONI VOLUME TURED COL 9 IS +/- 10 GALLONS OR MORE IP I I I ,I I I I I I I I SIGNED DATE TITLE I Jim Hindman G~ragt Services suoervfsor Genera' Services Gar.t~ ~1~\s1~~ A /13 I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY. DO NOT EXCEED THEREPORTABLELIMLTS_ DESCRIBED IN "A" THROUGH "0" ABOVE ..' 1 2 A MAXIMUM WEEKLY VOLUME CHANGE A CUMULATIVE VOLUME CHANGE (COL GALLONS COL 11 9) OF .J- 7 BOTTÒM LINE) OF n ,.. " TANK # MONITORING BETWEEN DATES OF (INCLUDE YEAR) NOTED ON REVERSE Lj TANK OF 1000 GALLONS OR' LESS OF ~/- 25 GALLONS OR MORE TANK OF 1001 TO 5000 GALLONS OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLONS +/- 50 GALLONS OR MORE ANV TANK HAS A CUMULATIVE OR MORE OVER THE VOLUME CHANGE (COL 11) OF +/- ,250 GALLONS QUARTER TIME FRAME REPRESENTED. ON REVERSE PERMIT # / ~ ,I 0/1_ /;;:;- ~-,-,,--, RESULTED SUMMARV CAPACITY HAS A VOLUME CHANGE IN C902bG. AND / ,// / ,7 '3 COL GALS 9 0.' B CAPACiTY HAS A VOLUME CHANGE COl, 9 A TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF CAPACITY HAS A VOLUME CHANGE COL 9 ¡ ,¡' \ :1 I,' , ( FUEL TANK UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE ONLY ---- -- -.- "-. ,- ~ - ... --~..-.-.- - - ---- .................._~-_.._----_.... . ~- - --- ~ , - PERMIT # ! 10 OC;;Lb y' - r ~ ~ _SUBSTANCE STORED :!Sl QUARTER/YEA:R {C;9'¿, COL. 3¡COL. 4¡COL. 51 COL. I - ' I I 6,COL. 7 COL. a ¡COL. 91 COL. 10, COL. 11 I 2ND' _ 1ST _ INCH I 2ND _ 1ST _VOLUME + _~ CUMULATIVE IGAUGE GAUGE - CHANGE VOLUME VOLUME -CHANGE_SUBTOTAL:, CHANGE - I INCHES INCHES I INCHES GALLONS GALLONS GALLONS 1 GALLONS GALLONS - q i- I 0 ¡ I 5"ð ~~ ~<õ Y4 6$~~ ,~ 34 ~ I r d I 1 1 .J S-~ 'ly ~ 'ð 1--+ ø 05Sfo (lJ I rzJ '" I ø &, 53 b I Ii ø I - 1 ¡ .J ,tp 5'8 iLj ~~ :J~ Ji I ~I ø ,I ~53f- ~.53'= -4 I fZ5'1 I 1 ~ .J I ø~~: I tJ $Î I/'ì- ~1 '/o¿, ø (p L-[ ~-:A foy 5À ¢ I cØ I - 1 -1 .J rp , ~7 J/~ 5"7~ Ii I ø I 6 t/ 5"2- ~ l/ S":l.. ¢ I ¢ìl I - 1 - ~ --1 51'1z, $7 IL- I ¢ (p Lf 5"")- I ¢ I .1 I -9- eLf 5ÀI I ~ I ¢5 I - - J :L - --1 ø I ø I ø I -If / 1 :57/z j) 1~Lf52-- (p c..l 5~ I I I ::;;>? -z.. - - J L - --' I I I I Æ- 5; 1z- .511z, (¿ I ~45~ ~ tJ s-~ t¡) I r:J5 I rt3 I 1 J --' - - S-7 ~s I I ~ I tp :;:;'-7 .3 / €> Q I &'1 3~ (, ~ 3~ f!t I ø5 I - 1 J - - .J ø ;;7 ~Î ø 163ft 639b 'qt I ,::;- I I -2 ,{J I c... - - 1 - 1 .J I - 1- 5lS/ù, ~~ sf ~ [;J I ~ ø I I 63b'b 1 b30~ !f I I 1 1 J cj S" 7(1?; ~ b 7/lß Æ I I I I I b.3 ~1 I 03~7 Æ I ø r:p I I '" "'7/ .; h 7&¿ rp bSO? b3~ì f ø I ~, I¡g; I FACILITY TANK# l - - - 1 - COL. '11 COL. 2 TEST I WEEK 1 # L 1 I I J 2 I I I 3 I I , 4 5 6 7 a 9 , . I '" , '-1 i'o" . I - 11 - 12 - 13 -- , " ~ I il ) ~ 'i * :<Ie SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * REPORT. TO THE PERMtITTING AUTHORITY WITHIN 24 HOURS IF VOLUME CHANGr (COL. 9) IS +/- 10 GALLONS OR MORE CUMULATIVE VfLUME CHANGE (COL. 11) IS +/- 100 GALLONS OR I( ,~ '~ SÚMMARY í TANK # t PERMIT # MON!TORItI}(,-Bl:'"rWEEN DATES OF - . AND (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: . :1; A MAXIMUM, WEEKLY VOLUME CHANGE (COL. 9) OF A CUMULATIVE VOLUME CHANGE (COL. 11, BOTTOM LINE) ÖF '1' GALLONS I" I " " CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND REPORT ANd THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS . -----__---4- IN "A" AN:D "B" ABOVÊ -- i ~ \ ~: 1\ SIGNED DATE TITLE I HERÈBY ACCUR.~TE DESCRIBED , B A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK 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 I I SIGNED DATE TITLE 10/ Jim Hindman G~rage Services Supervisor General Sèrvices Girage Div1sion I q l/ 1 2 GALS MORE \ TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IT A. TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 OF ~/- 25 GALLONS OR MORE , B. TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COI, 9 OF +/- 35 GALLONS OR MORE C. TANK OF OVER 5000 GALLO~S CAPACITY HAS A VOLUME CHANGE (COL. 9 OF.~ +/- 50 GALLONS OR MORE D. ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS ;ùR MûRE ûVE~ IHE QÜÂRïER' TIME FRAME RZPRg~ENTEG pN REVERSE. SUMMARY TANK # t./ PERMIT # , I ~ 00:;'- b G I , MON !TOR I NG BETWEEN DA TESOF rq /3.Ð/?'Z-'.' AND I,D / ,( '1 z- ( I NCLUDE YEAR) NOTED ON· REVERSE RESULTED ï N :, 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. 9) OF ,~ GALS ,2. A CUMULATIVE VOLUME CHANGE (COL. 11, BOTTOM LINE) OF 4> GALLONS I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS ~~ DESCRIBED -IN-"A"-THROUGH"D" ABOVE - - TANK MONI l'ORED [8 I' !, " ~ '\ UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE ONLY . . ANNUAL TREND ANALYSIS SUMMARY r TANK # '-/ TIME PERIOD: (p -:;?ð -72 to 7-/-c;...3 TIME PERIOD: LÞ - ~~ -9-~ to 1t..:::>-1-7~ , Total Minuses This Period (Line 3) Action Number ,for this P~riod (Line 4) Total Minuses This Period (L~ne 3) Action Nuaber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) TIME PERIOD: It.:> -¿..- 7.!2 to 1-1- So~ Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 6: Total Minuses This Period (Line 3) Action NWlber for this Period (Line ~) ... , I 1-/- /- QUARTER 3 TIME PERIOD: 1- 7.... c; ~ to 7S PERIOD 7: Total Minuses This Per iod (Line 3) Action Number for this Period (Line 4) . PERIOD 8: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 9: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) QUARTER 1 PERIOD 1: PERIOD 2: PERIOD 3: QUARTER 2 PERIOD 4: PERIOD 5: QUARTER 4 TIME PERIOD: ¥-I..- c;.~ to 7- 1- 503 PERIOD 10: Total Minuses This Period (Line 3) Action NWlber for this Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 12: Total Minuses This Period (Line 3) Action NUllber for this Period (Line 4) I hereby certify this is a true and accurate report. Signature~ ~~ ~ - ¿ -+- Date 7-1- 5-:S +- _..La-....."'~û..~.........- ........... ,...._-Ìl......~.-..o.a- -- '~.~.._~. ._,-._~.' .:-.....~--.<~~ ~. -- -...,.---.......~~.....~-~ TANK FACXLXTV ANNUAL REPORT FacUi ty UTI LIT Y rpL ~I'J î Perllit, /¡bðo;2¿Qlonth/Vr. :::fu Ll 15:r::;' I 1. I have not done any major modifications to this facility during the last 12 .onths. Slgna~ure g ~ ~ ~ ~ fí Note: All lIajor .odificatio require a Permit to Construc fro. the Peraittin~ Author ty. ./ 2. I have done .aJor modifications for which I obtained Per.i t (s) to Construct fro. Per.itting Authority Sipature per.it to Construct , 3. Repair and Maintenance Suaaary Date Attach a suaaary of all: Routine and required maintenance done to this facility's tank. pipinc. and .onitoring equip.ent. Repair of submerged pu.ps or suction pumps. Replacement of flow-restricting leak detectors with salle. Repair/replacement of dispensers, meters, or nozzles. Repair of electronic leak detection _ components, or replace.ent with sue. -- Installation of ball float valves. -- Installation or repair of vapor recovery/vent lines. Include the date of each repair or maintenance activity. NOTE: All repairs or replace~ents in response to a leak require a Penait to Construct from the Permitting Authority as do all other .odifications to tanks. pipinr; or monitoring equip.ent not listed here. 4. Fuel Changes - Allowed tor Motor Vehicle Puel tanks Only. List all fuel storage chanaes in tanks. noting: Date(s), tank nuaber(s), new fuel(s) stored. ~. Inventory control monitoring is required for this facility on the Per.it to Operate, and I have not exceeded any reportable li.its as listed in the appropriate inventory control .onitoring handbook during the laat twelve months (if not applicable, disregard). Signatur~ .---sr- ~- rC 6. Trend Analysis Sua.ary Please attach Annual Trend Analysis Suaaary for the last 12 periods. i.... 7. Meter Calibration Check Por. Please attach current, co.pleted Meter Calibration Check Por. ¡ , ; '. * QUARTERLY MODIFIED 1NVENTORY CO~~~WSHEET * * c. u ,y J;';CS, I .f.Ç 13u I L 0 ]I\j(,.- JUt O~6.1993, PERMI T :/I: _ ÇAP~CI,:rY, ~ 90,0 _SUBSTANCE STORED:{ 14=f~.(P¡k.DIV. QUARTER/YEAR, I I" I I I I I I I --1 COL. 3,COL. 4,COL. 5, COL. SICOL. 7, COL. SICOL. 9, COL. 10 L COL. ~ I ,TER·2ND _ 1ST = INCH I 2ND _ 1ST _VOLUME+.: CUMULATIVE U VEL GAUGE GAUGE CHANGEIVOLUMEVOLUME :CHANGE SUBTOTAL- CHANGE _ -1 rCHES '::'. IHCRBS' " ' , INCRBS·' ' IHCHES GALLONS GALLONS 1 GALLONS·" 1 GALLONS GALLONS_ ~ "I I I 0 I ~ 1> ,.~f;t I ~!offt/, cI .c673 473 1 ~ 1 ~ J ~\=ftJ. " I I I ~ 'f ~ 5/c( s~ ~/o/' /IJ ~73 Lb ~ <, 1 y!- 1 ¢ ¡6 J ill . , ~ I I , d ¢'~b :;;1' 3-(" %/1 q;:. L6 73 c¿ '7 s:. I Æ I £ <;t J ~r.f1 I I I ~ cJ<, 3C.~/y 3i>1y t L/;,C¡3 Lb73 ¡ t:f ¡? ¢ ~ d t., ,,~~3Ä/ 3& ?/Ý/' L ~c¡.s 473 l ~ 1 ~ 2 J 11~ ,. ' I' J d :f ;3"G. ~~ 6G3jy -$ c.¿?S L-b ì~ 1 %- 1 ~ J!!.. J ~ I I I d ~ 3~Y7.- ~~Y2- 1:- Cbb/ 46C¡ 1 ~ 1 ~ .:L J ~ " I I I cl 0L 3S~ 3~!lz-: L ~Š7 ~£;/ 1 ~ 1 ~ ~ J 1m' r--- I I J ~ ~ 3Ç~~:3,S:~ ¢ C6,ç;:'t "LÇ7 ¡ ~ ¡ L ? ~ ~ ~- '\i~y~:'13Ç'Jh ~ ~Ç7 ~Ç7 l ex' ~ ~ ;ð I ~I I I I r=- I ~ 6 ~·¥I.Iß-/ ~ ,£ ~LI! rv'i I 1 ~ I ~ ;6 : ~ : I f- 1+ - I ~ $L l ¢ SLf/ 44/ l ~ ~ ~ I ~ I I ~1tJ ø I op 4tf'( ~~)/ I 4f 4J!i ~ FACILJ:TY TANK#' - - = L COL. - !:~ ~ L 1 - 2 - 3 - 4 - 5 - S 7 9 10 11 12 13 ! ! 1 ¡ , I I I , i , ~; i, .. I ' i i; 1" I ' ,'1 ' , " , ;' j'" .,',',",' ~M e ~,t : ¡ I I 1 , , I i '~ ! ¡, ;; ,\< i,1 , .'~ i " ~: ~~; :,\ ,: i "'"¡1 j j 1 I i ¡'- 1 ¡ t SIGNED ,,, ~ I ì q I¡ *' *' ¡ , ¡ .L , SUBMIT A COPV OF THIS SUMMARY WITH FACILITY ANNUAL REPORT , .\"r . -. RETAI~ THESE RECORDS AT THE PERMITTED FACILITV FO~,A MINIMpM OF 'THR~~ YEARS -. . *' - , ~ ; "jl 1,'-1- !, , DATE TITLE t i I I I ! I i ¡ Î } 11' 11 TANK , 1 PERMIT # MONITORING BETWEEN DATES OF ;1 - - (lNCliUDE -YE~)- 'NOTED-ON REVERSE'RESULTED \1-., 1 MAXIMUM iEEKLY VOLUME CHANGE (COL 2 CUMUL" IVE VOLUME CHANGE (COL. 11 GALLONS A A 9) OF BOTTOM LINE _GALS OF -IN-: AND I, r i I i TANK MONITORED (S l4. WASTE-OIL OR NON-MOTOR VEHICLE ·1-- - 'I REPORT TO THE PERM-ITTING AUTHORITY WITHIN 24 HOURS '--~I - VOLUME CHANGE (COL. 9) IS \1 CUMULATIVE VOLUME CHANGE I , '\ SUMMARV B COL 11 IS +/.:.. 100 GALLONS OR MORE A +/- 10 GALLONS OR MORE IF': J I HEREBY CERTIFY T~AT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS 'I DESCRIBED IN "A" AND "B" ABOVE J-- r 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 DATE , ! TITLE; ,-61 I I ! ! I I HEREBV CERTIFY THAT THE ABUVJ:;-NUTJ:;U Kt;~UL'J.·~ Kt;t'Kt;~t;NT A TKUt;ANU ACCURATE REPORT AND THAT THEY DO NOT EXCEE~ THE REPORTABLE LIMITS DESCRIBED IN "A" THROUGH "0" ABOVE --.-1-- . 1 ·2 A MAXIMUM WEEKLY VO~UME CHANGE A CUMULATIVE VOLUME CHANGE (COL GALLONS COL. 11,. 9) OF -# 'GALS BOTTOM "NE) .OF ' .' -~ 'TANK OF 1000 GALLONS OR.LESS HAS OF +/- 25 GALLONS OR MORE TANK OF 1001 TO 5000 GALLONS CAPACITY HAS 9 OF +/- 35 GALLONS OR MORE TANK,OF QVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL 9) OF of, / - 50 GALLONS OR MORE~·' ",,' '. ANY TANK HAS ,A CUMULATIVE VOLUME CHANGE (COL. 11) OF. +/- ,250 GAt~ 'OR MORE OVER THE QUARTER TIME FRAME R~PR~SENTE[) ,ON ~EVER,~E o SU~ARV <' C B A VOLUME CHANGE COl. ~I ;i!i ;~ A TO THE TANK NOTED ON REVERSE CHECK ONE ONLY TANK MONIT~RED IS A MQ!QR VEHICLE FUEL TANK .' REPORT TO, THE PBRMITTING ~~~RI'fY' ,!!TBIN 24 ~OURS IF CAPACITY A VOLUME CHANGE COL 9 FUEL TANK ¡ I II ! , . FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE UARTERLY SUMMARY o~61 /99 , PERMIT #_ '< ,.-- "- CAPACITY F AC I L I TY Î'(Id2-J. TANK# J I I I I I I I I J I I COL. 11 CUMULATIVE CHANGE GALLONS ----¡ ø if ~ 3- aiCOL. 9 COL. 10, VOLUME '. =CHANGE+SUBTOTAL= GALLONS GALLONS U írT\ 0), I '-r' r I _ 1 I ~ I 3- UARTER/YE,AR ø ~ --;c:: ...-J "3 I I i I I I I I 45 ~ -3 ,3 3 I I 1 I I 1 I I 1 I I 1 I I tf> I I I I I I I I SUBSTANCE STORED COL. SICOL. COL. INCH I 2ND 1ST CHANGE IVOLUME-VOLUME INCHES GALLONS GALLONS 79 q 9 9 ~ ø fBB> 9'1:2- S~~ é.? 7$'-1 ì i .3 :5 S 3' ~S ø I I 1 I I ~ -3 ~ :3 3 3 I I 1 I I I I I I I I I I §i, C:¡~t-, 7~ /3~ L673 9>5' ?~y 7S 75 7 I I I I I I I I I I I I I I I I 1 I I I I 1 I I 1 I I 1 I I t:¡J = 5 4¡COL. 1ST GAUGE INCHES ~;¿ 3/'-1 '-i~ (!)& é) COL. 3¡COL. WATER I 2ND LEVEL IGAUGE INCHES INCHES tf;).3 J'-{ t./~ C¡8B 1~ 5 I I 1 I I ø 9~~ 7$ý 9~1" yt¡ I I 1 I I c.¡ 2. '1'-1 y~ I I I I I '-1:2. I)-¿ ~~ ;;$7 f ~7 sc¡.- Þ7! :Þ{ 37 c:;b tf 73'- 47-~ c,I I I I I I 3 ~'7 ~~~ -=s 3'7 3~ 3C 3t=~ r:þ '3 I I I I I COL. 2 WEEK Y SHUT-D {I\ TIME P D DATE/HR '7 r' TO DATE/HR I 71 DATE/HR 1 13 !>; TO DATE/HR J I~ tf F= DATE/DR ..!J TO DATE/HR ~ IS DATE/DR 1.=. L!J. TO / DATE/HR æ .!j DATE/DR :1¡L: ~ TO DATE/DR ~ :.3 DATE/DR.q; 4 TO DATE/HR ~ ~ DATE/DR ~ ~ I TO I DATE/HR:2/("'7 /~f"1-..1 DATE/DR?/;;:z;;: I c; é/ M I TO ' , I DATE/HR~/.:z~/.3' Ph DATE/DR Y~/~nn1 ro j DATE/HR ~/:7 {'tv"- I DATE/HR V'7:/7~t..-...J TO I DATE/HR~//:7 "">--1 DATE/HR~4/'~fvo-. TO DATE/HR "5//~/ ijF'm; DATE/DR 2 TO - 2: DATE/HR..-,¡ I DATE/DR · I TO ATE!HR 1 COL. TEST WEEK !... 1 2 :3 4- 5 6 7 8 9 10 13 11 12 . I (~ " II i fl , \ > * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * ¡- VO/IUME \1 ,1 11 u \1 II \! ¡J; TANK-#- l- - -- PERMIT #-- MONITORING BETWEEN DATES ûF (INCLUDE YEAR~ NOTED ON REVERSE RESULTED ·i\ 1. A MAXIMUM~EEKLY VOLUME CHANGE (COL. 2. A CUMULATI~ VOLUME CHANGE (COL. II, I .' ' GALLONS ,I 1 t I HEREBY CERTIFY THA~ THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND :\ ACCURATE REPORT AND ¡;I'HAT- THEY DO NOT - E-XCEED-THE-REPORTABLE--L-IMITS I DESCRIBED IN "A AND!i"B" ABOVE ~, I, :~ I~ 1. :~ SIGNED DATE TITLE 9) OF BOTTOM LINE OF IN - ANû GALS SUMMARY B CUMULATIVE CHANGE COL 11 ) IS +/..:. 100 GALLONS OR MORE AtWASTE-OIL REPORT TO THE PERMITTING AUTHORITY .-- \ ~, VOLUME CHANGE ,y, (COL A 9 IS +/- WITHIN 24 HOURS IF 10 GALLONS OR MORE I I 1 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 DATE TITLE I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE -REPORT-- AND THAT-1'HEYDO-- NOT -EXCEED THE REPORTABLE-LIMITS DESCRIBED IN "A" THROUGH "0" ABOVE . 1 2 A MAXIMUM WEEKLY VOLUME CHANGE A CUM~ATIVE VOLUME CHANGE (COL :5:> GALLONS COL 11 9) OFS GALS BOTTOM LINE) OF TANK # ~ PERMIT MONITORING BETWEEN DATES OF _ (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN --- TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME OF +-/- 25 GALLONS OR MORE ' TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLONS CAPACITY HAS +/- 50 GALLONS OR MORE -,~NY TANK !!.~S.~ OR MORE SUMMARV Ct~ULAT!VE VOLt~E CHANGE (COL, 11) OVER THE QUARTER TIME FRAME REPRESENTED ON A VOLUME CHANGE OF +/- 21)0 REVERSE D (;.4!,LONS C B COL , CHANGE 9 COl. OF 9 . A TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF CHANGE COL 9 TANK MONI TORED [S I II ~I 'I Ii I " T ! OR NON-MOTOR VEHICLE UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARV APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE ONLY FUEL TANK ~'-'4""'2r...a.",'&' .a...:.....'IfIIrrr...LA..:. 41r...-.....1L.J..&.. .L. .JL. .a..:...L.I ..L.. ,L.... .., ~.L.~ ~ '-".&"'- ..-. ~"'-'~... ~ u--< ç-( c.6 ,ß~ ~,.v PERMI T # ~, ()O~ _SlaSTANCE STORED-:V,¡;g" I TV ~ ðc '0 QUARTER/VE.þ.R /9F; I o I I I I I a ¡ COL. 9:' COL. 10U COL. 11 C L. 3.COL. 4ICOL. 5, COL. SICOL. 7, COL. WATER 2ND _ 1ST _ INCH I 2ND _ 1ST _VOLUME + !¡_ CUMULATIVE LEVEL GAUGE GAUGE - CHANGE IVOLUME VOLUME -CHANGE SUBTOTA.:£!.: CHANGE - INCHES INCHES INCHES I INCHES I GALLONS I GALLONS GALLONS , GALLONS , 1 GALLONS - cþ 35 Yz- 3 5 ilL I ¢ I I 0 I I e> 5Ö¡ I ~S'7 ø I I ø I - I I · J .J I I I I I Þ- 35 !/tj 351'11 tj, §S~I <B5~ ~ ~ .1 Œ I I .,J 3S Jl8 J-S '~ I ø I I I ø I !L 550 ~5ð q> ¿p I I gl · ) .J f pI*' r ø 13~Y I I I 3 ¿( 7/ß 8~'1 ø qS I cJ5 I · J .J q rp I I cfJ I L 3Y~ $ '-I )!Cb rp 8'-11-/ 9 'f4 I I · ) .J 3 tJ I¡z, 3'1 (¿ ,P I rþ I f5 ß3~ ~sy tp pi I J · J .J 1- "3 4 'IL ~ 4- IlL- ø ¢ c;Þ I (j5 I 'Í5~4 S3Y I I · J .J , t 3 tj "Yt/ 5 V '/'1 1~ L ~ ¡ I <&4-1 B2~ ,-;; 13 I r .J ~<tJ ~ tJ":;'':¡: ~ Î) I I I L-oc:;.&Þ 7b~ ~.,..,~ I /3 ; I /3 I I I I - I j I .J I I I I I I L-bSb{) ~, hY/.2- ITð~ ~ þV'b 1 T€-£ ?7rJ ~ /3 I IS I - I - ~ J .J L(-~ L I I I £ I I I 1s I I jo 5 I / Dc) 0" I I 3 I /~ I 1 - 1 ~ ¡ - .J I 4~ ¢' I /~S q5 'I I I t.f~ I I /~5 13 : I 1.5 I 1 , , - - - - - ~ - ~3 I 43 ø /00 S / C)ë> -.5 ~ 13 ¡' /3 I I I FACILITY TANK# - - - - COL. 1 COL. 2 , TEST - WEEK - L :1 - - 2 .J - :3 - 4 - 5 I I 1 I I t";''': 6 7 8 9 10 11 12 :13 . ". SIGNED 4, ), r 11- ~, ' if "t " :\ ~ ¡ " 1 % \ il * * SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * DATE TITLE TANK MONITORED S Ä WASTE-OIL OR NON-MOTOR VEHICLE ~-- - REPORT TO THE PERMIITTING AUTHORITV WITHIN 24 HOURS IF -- 'I -- ~ A. VOLUME CHANGE;; (COL. 9) IS +/- 10 GALLONS OR MORE ~ B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/~ 100 GALLONS OR MORE i ~, ~ r lit, SUMMARY --~ TANK-' -I- PERM-IT- -, _ _ MONITORING BETWEEN DATES OF ÂND " . (INCLUDE YEAR~ NOTED ON REVERSE RESULTED IN: i 1. A MAXIMUMj~EEKLY VOLUME CHANG~ (COL. 9) OF GALS 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF (I GALLONS It i ~ I HEREBY CERTIFY TH4T THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ÄCCO~ATE REPORT-AND :fTHATTHEY DO NOT-EXCEED THE REPORTABLE -LIMI-TS DESCRIBED IN "A" AND "B" ABOVE ,/ 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 I I I , I , DATE / SIGNED TITLE Jim Hindman Garage Services Supervisor General Services Garage Division ç SUMMARY TANK # PERMIT # It/; Oo;t~ MONITORING BETWEEN DATES 6F u__; ¿>7219'~--'- - AND--- 11(/7" (INCLUDE YEAR) NOTED ON REVERSÈ RESULTED IN: 1. A MAXIMUM WEEKLY VOLUME CHANGE (COL. -9) OF l~ GALS 2. A CUMULATIVE VOLUME CHANGE (COL. 11. BOTTOM LINE) OF I~ GALLONS I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE_R~I'.ORLANJL1'HJ\T _Tf{EY 1)0 NOT ~XCEED_:r_I!~__R.E~O~'l'~BLE LIMITS DESCRIBED IN "A" THROUGH !'D" ABOVE TANK MONITORED IS A MOTOR VEHICLE FUEL TANK RBfOR1: TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF A TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 OF T/- 25 GALLONS OR MORE B TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE Cor. 9 OF +/- 35 GALLONS OR MORE OF(e C TANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL. 9 +/- 50 GALLONS OR MORE 0 ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- ,250 GALLONS OR MORE OVER THE QUARTER TIME FRAME REPRESENTED ON REVERSE . ~ [ ! i I , \ I, 1\ , I: FUEL UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE ONLY TANK PERMI T # il b óo~ I I 1997 CAPACITY ~UBSTANCE STORED Ç.UARTER/YEtR - :;II' \ - COL. 3 CO=L. 4¡COL. 5: COL. a¡COL. 7 COL. g: COL. 10~ COL. 11 - WATER 2ND _ 1ST _ INCH I 2ND _ 1ST _VOLUME+ 1_ CUMULATIVE I LEVEL GAUGE GAUGE - CHANGE1VOLUMEVOLUME -CHANGE SUBTOTAI.1- CHANGE -1 INCHES INCHES INCHES INCHES 1 GALLONS GALLONS GALLONS GALLONS 11 GALLONS -1 3 7 ~~ )i I 0 { : ø I f) ~ -; ì/~ I 9 I l-' Cf ,^ tP I 1 I -1 ...;; ø 37 f</ 37 jL¿ (ZJ I cþ Iw; I I 70~ 103> çb' i () I L ¡ -! R .37 ~ ~7i I cþ ~ dJ' I ø I '703 703 ø ¡ I ) -' ~ · J á 7 1.; ø I -A . :s) III 89Ø g')<ß:> ø fL cf I -' - · 6~ 3b X; ø ~ I I Cj; -Æ eB7 gBI 2- Z I I 1 I -' · ¢ i I ~ 3/LJ ?lYe.! d ~~7 887 g¿ ø cp I ì -' i I Q -;áfo 3V 303/¥ tJ ge7 tØ$? p Q ¡ fð I i -' G ~ --¡¡; I Q; 36 .~"2.- ~fo '/'L. ;¿ B~) B~( e¡J I I i -' - ~ - £ l 3¿ //l 3 t' I~ £ (J) {þ . clJ I 813/ 9S( J I - - -1 ø I 3 t I/z.. 3 (. (/~ ¡) tB~ ( 88c (þ fJJ I I ([) I - l - - - - -' I i I ø 36f~ ø I I 3t0ð ~ / lip 9/~ it , I c¡ - l l -! - ? ø I {if ~70 q5 rp ! I I J-Ie 3? ra7° I - L - - - - I ¢ I éf ø I I 3~ 7/6 3S7/B ;P SG7 r367 ø I FACILITY TANK# Co - - - COL. 1 COL. 2 TEST _WEEK , - 1 - 2 - .) :3 4, 5 6 7 8 9 1"~ ' j<Ot - 11 - 12 - 13 ! A MAXIMUM WEEKLY VOLUME CHANGE A CUMULATVE VOLUME CHANGE (COL ~ GALLONS f " III I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE-REÞÖRT-ANDtTHAT'THEYDO NOT EXCEED-THE-REPORTABLELIMITS DESCRIBED IN "A" ANl "B" ABOVE ~ 1 SIGNED }' '\, 'I } 1 '~ I \ ~ * * SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * DATE TITLE 1 2 COL 11 9) OF BOTTOM LINE OF TANK -# ~ - PERMIT # MONITORING BEfWEEN DATES OF ____ (INCLUDE YEAR9 NOTED ON REVE~SE RESULTED IN AND GALS ¡ I 1 \ I, ¡ 1 TANK MONITORED (S i_WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK \1'-- -- ¡-. REPORT TO THE PERMITTING AUTHORITV WITHIN 24 HOURS .-- ¡ --, VOLUME CHANGE (COL. 9) IS ~ j CUMULATIVE VOLUME CHANGE J · ~' 1 i SUMMARY B COL 11 IS +/- 100 GALLONS OR MORE A +/- 10 GALLONS OR MORE IF 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 ï I I I I ¡ I I I DATE Jim Hindman Garage Services Superviso,r TITLE General Services Garage Oivision I(~/, (q Z/ ( I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT-AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" THROUGH "0" ABOVE .' 1 2 A MAXIMUM WEEKLY VOLUME CHANGE A CUMUL~IVEVOLUME CHANGE (COL (f) GALLONS ----- I COL 11 9) OF ,ø BOTTOM LINE OF ~ TANK #.: _ PERMIT MONITORING BETWEEN DATES OF ~ (INCLUDE YEAR) NOTED ON REVERS IN ~n º_ð d:, ~,~. - - . I' AND l> II / f' Z-- GALS TANK OF 1000 GALLONS OR LESS OF ~/- 25 GALLONS OR MORE TANK OF 1001 TO 5000 GALLONS OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLONS +/- GALLONS OR MORE ÂNY 50 TÂNK HÂS A OR MORE OVER THE Cü'MüLATIVE QUARTER SUMMARV VûLüÏliE TIME / CHANGE (CûL. 11) ûF +j- 25û FRAME REPRESENTED ON REVERSE D GALLûNS C B CAPACITY CAPACITY HAS A VOLUME CHANGE HAS A VOLUME CHANGE COL 9 COl. OF 9 (. A TO THE TANK NOTED ON REVERSE CHECK ONE ONLY TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF CAPACITY HAS A VOLUME CHANGE COL 9 FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE UARTERLY SUMMARY -...-.-.-- . ANNUAL TREND ANALYSIS SUMMARY r TANK # In TIME PERIOD: ~ - 3 ~- 9-~ to 7- 1- 7~ TIME PERIOD: IL, -,30 - 9'% to /C> -1- ~"2 Total Minuses This Period (Line 3) Action Number for this Period (Line 4) , . Total Minuses This Period (L~ne 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) QUARTER 1 PERIOD 1: PERIOD 2: PERIOD 3: QUARTER 2 TIME PERIOD: /0- (. - cz,!'< to /-/- ~~ PERIOD 4: Total Minuses This Period (Line 3) Action NUllber for this Period (L1ne 4) PERIOD 5: Total Minuses This Period (Line 3) Action NUllber for this Period (Line 4) PERIOD 6: Total Minuses This Period (Line 3) Action Nwaber for this Period (Line 4) ..: QUARTER 3 TIME PERIOD: 1-7-93 to ;./-1- 7-< PERIOD 7: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 8: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 9: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) QUARTER 4 TIME PERIOD: L? ~ - 7-'"3- to 7- I - 5 ~ PERIOD 10: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 11: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) PERIOD 12: Total Minuses This Period (Line 3) Action Nuaber for this Period (Line 4) I hereby certify this is a true and accurate report. S¡""y J<r ~~ - '.c Date ~-I- $3 . . TANK FACXLXTV ANNUAL REPORT .:J__+'¿ ~ 'acUity ~.e-("'''r\ t.cJ.....+'-1 -gt.oL. Per.it ./~~o2~~Month/Vr. .Jù ~,. £<70,.:=; , d- 1. I have not done any .ajor .odifications to this facility durinE the last 12 aonths. Si~nature Note: All .ajor .0dif1cat 0 require the Per.itting Aut rity. . 2. I have done .aJor modifications for which I obtained Perait(s) to Construct fro. Peralttlng Authority Sipature Perait to Construct , 3. Repair and Maintenance Suaaary Date Attach a suaaary of all: Routine and required maintenance done to this facUity's tank, plping. and .onitorlng equlp.ent. Repair of sub.erEed pu.pa or suction pumps. Replaceaent of tlow-restricting leak detectors with sa.e. -- Repair/replace.ent of dispensers, meters, or nozzle.. -- Repair of electronic leak detection. coaponents, or replace.ent with s_e. -- Installation of ball tloat valves. -- Installation or repair of vapor recovery/vent lines. Include the date of each repair or aalntenance activity. NOT!: All repairs or replace.ents in response to a leak require a Perait to Construct froa the Peraittiog Authority as do all other .odiflcations to tanks, piping or lIoni toring equip.ent not listed here. 4. Puel Chan... - Allowed for Motor Vehicle Puel tanks Only. List all tuel .torage chanEes in tanks. notinE: Date(s), tank nuaber(s), new fuel(s) stored. 15. Inventory control lIonitoring is required tor this facUity on the Per.it to Operate, and I have ne1 exceeded any reportable li.its as li.ted in the appropriate inventory control .onltorlng handbook during the la.t twelve aonth. (if not applicable, disregard). Signatur~~' ~ ~ ~- Trend Analysis Sua.ary Please attach Annual Trend Analysis Suaaary tor the last 12 periods. 6. 1. Meter Calibration Check Por. Please attach current, co.pleted Meter Calibration Check Pora I I 1 I I ¡ ! i I í I I I I I I >r~c CONTROL SHEET * * ) PERM:J: T # IL a i UARTER/YI1:AR _ --L - --t'" 9 10 I * LIL CAPAC,ITY ,; 11~j~), '. - ;,¡;. fJI: ! .' ,,"1' ,I, i ¡;,'i , 'i., '.",1:,1 þ. AC XL t TY U 1'1 ! I , , \f,' TAN'Er# i ~l ~ --- 'I' I ,I H, ; I ~~"," ¡ pOL... 11 I ',I ::,', :TEST " ~:' ~ WEEKJ , ,i , U I': - - ' ~,.:<,:,,:¡::., 1 ¡ I 11" " n ~ 'I I :~ I , " \ ., ;1 .' !1 "I' ;11 ÎJ,~ ¡,I r,,1. Ll :1' .', j : I' ~:¡;: I Jt" Ll ',',~~: ¡. 1 "~' : ! ,,;:1,' II tr J J ! I :,1 I, ~"" UI ~t, t , 't ' .' ~11 I ;,~:. i ¡ I ¡,I' 11 t: I I,."",',·,','·,"",' I .'1 I :i ~: ~' ,:¡: " ~. :1-' . I I ,\ '1 QUARTERLY MODIFIE~E~~NTORY T m. 0.6 \993 * ,. ~ SUE?~T1f¡{E~.A~RED - I L 5 COL. a.co . I I I I I I I I I J J I I I I I COL. 11 CUMULATIVE CHANGE _GALLONS c;1 ,.. ~ '¢ COL. ~ a ~COL. ¿p COL. 1-7Jé~~' 7 cþ .. o >' . 1ST AUGE INCHES 2 COL. 2 3 4. a 9 10 13 1i 12 5 6 7 TANK # PERMIT # MONITORING BETWËEN DATES OF II" - (INCLUDE YEAR) NOTED ON REVERSE RESULTED , Ii '. il ' 1. A MAXIMUM iEEKL Y VOLUME CHANGE (COL. j/ 2. A CUMULATIVE VOLUME CHANGE (COL. 11. .:\ GALLONS 'If 1\ I HEREBY CERTIFY THAT~THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPORT AND TI~T THEY DO NOT EXCEED THE REPORTABLE LIMITS 1\ DESCRIBED IN "A" AND 'iB" ABOVE ~~- ti 1 ~ r I~ !i II I * * RETAIN .I. SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMuM OF THREE'YEARS " SIGNED DATE TITLE 9) OF BOTTOM LINE _GALS OF A. VOLUME CHANGE ~COL 9 IS +/- 10 GALLONS OR MORE B CUMULATIVE VOLUME CHANGE (COL. 11) IS +/~ 100 GALLONS OR MORE 1 ' ¡~ ,- SUMMARV IN AND l \j A WASTE-OIL OR NON-MOTOR VEHICLE FUEL TANK "! REPQRT TO THE PERMITtING AUTHORITY WITHIN 24 HOURS IF; I I I I I I I I I I I I I I I I I :1 I i I I I ,I 'I I I I I I I I I I I 9Î3 1" '! 1 A MAXIMUM WEEKLY VOLUME CHANGE (COL 9) OF ',- ø ; GALS ~2 A CUMULATIVE' VOLUME (CHANGE, (COL. 11 tl0~TQM L~NE) :011 I , ¢. GALLONS ' , ; ! ~ . , , . I HERÈBV CERTIFV THATTHE'ABÒVE~NOTED RESULTS REPRESENT A TRUE ANU , ..... I ._. ACCURATE REPORT AND THAT THEV DO NOT EXCEED THE REPORTABLE LIMITS ~ DESCRIBED IN "A" THROUGH "D':..180VE . 4"~ S~j- TITLE - DATE - * * - " - o C B TANK OF 1000 GALLONS OR;LESS CAPACITY CHANGE OF +/- 25 GALLONS OR MO~E 'TANK OF 1001 TO 50ÓO GALLONS CAPACiTY HAS 'A VOLUME CHANGE OF +/- 35 G~LLONS OR MORE t " ,¡ , TANK OF OVER 5000 GALLONS CAPACITY HAS A VOLUME CHANGE (COL +/- 50 GALLONS OR MORE ,~," ',: ,'~' .','~, :'¡ ANY TANK HAS'A CUMULATIVE VOLUME CHA~GE' (COL. 11) OF +/~'250 GALLONS OR MORE OVER 'THE QUARTER TIME FRAME REPRESENTED ON REVERSE '. , ! . . ~ ": . - . -. . , .' :. -. SUMMARV 9 cor, OF 9 I A TO THE TANK NOTED ON REVERSE CHECK ONE ONLY TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REPORT TO THE PERJlITI'ING AUTHORITY 1tITJUN 24 HOURS IF HAS A VOLUME COL 9 TANK MONI TORED (S \f ~, FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE UARTERLY SUMMARY oc-:2-6G ; 1 PERMIT:#:) I b ï - UARTER/Y)EAR I F AC I L I TY _ CA.. TI L,T ,oLA4t-J,-. TANK#',S; _CAPACITY ~ 'I i' ! t I I I I I J I I J I I J I I I I I I I J I I J I I COL. 11 - CUMULATIVE CHANGE GALLONS ¿j - '-I - L{ L/ SUBSTANCE STORED y ( ~ ¥ I / 7' _3¡COL. 4¡COL. 5¡ COL. a¡COL. 7 COL. a¡COL. 9 COL. 1;0 :1 I 2NI _ 1ST _ INCH I 2ND _ 1ST _VOLUME+i,_ :1 GAUe ~ GAUGE - CHANGEIVOLUME VOLUME -CHANGE SUBTOT-fL- ; INCRE _ INCHES INCHES l..-§ALLONS GALLONS GALLONS GALLONS ' I 0 _ 1/7- ~ 1t7'/f +- 1/'13 ~ l5- t-/ I _ /17 117 .Þ Li -.!.1 ø Y I _ L.!..J' % 1 116 7/~ J L ~q ~ t) I I I I . ø I /1 I //6 sly I ø I! I cþ Y __ ~ 1 _ 1 L - - I I I I 9> _ I I J 1 ~ 1 ~ 1_ ....! -f _l/ . ~ _ U. I.J. Q.J _l ~ ~- 1 _ II r( 1 J ~ --.!:._ 6_ ¿¡ '1 1. ~ .Q ~_ 1_ ti G J t .4 7_ ~ - ¿ 1 i -1-!i ~ _ /..J. L {c ~ 7. j 2_ (j L 1 ~ j J q!> ij / ¿ 7 \ I COL. 1! COL. 2 TEST WEER . 1 - 2 - :3 - 4 - 5 - a - 7 - a - 9 - 10 - 11 - 12 - 13 I t· SIGNED ß ,¡ ~ ~- I ¡ t \ 1- t * * SUBMIT A COpy OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * DATE TITLE , ~ REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF I ' A. VOLUME CHANGE (10L. 9) IS +/- 10 GALLONS OR M~RE t B. CUMULATIVE VOLUME CHANGE (COL. 11) IS +/~ 100 GALLONS OR MORE ¡ l 1 SUMMARY TANK --,- PERMIT-' MONITORING BETWEËN DATES OF ÄND (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN: . ., ~: ,1. A MAXIMUM ~EEKLY ,VOLUME CHANGE (COL. 9) OF GALS 2. A CUMULATIVE~VOLUME CHANGE (COL. 11. BOTTOM LINE) OF !I ~A L LONS .. !Ú , ~ i II I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE REPoRT--¡\ND'rHtf-tllEY--DO- NOT EXCEED THE REPORTABLE LIMITS I 1 DESCRIBED IN "A" AND "B" ABOVE :~ , " TANK MONITORED f ! ~ I r (S A W1STE-0IL OR NON-MOTOR VEHICLE FUEL TANK 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 I I I I SUMMARY ,.,..-' TANK #;::i PERMIT # MONITORING BETWEEN DATES OF I--~ (INCLUDE YEAR) NOTED ON REVERSE RE ïN , ~ 1. A MAXIMUM WEEKLY VOLUME CHANGE COL 9) OF 'GALS 2. A C~LATIVE VOLUME CHANGE (COL. 11 BOTTOM L NE)OF GALLONS I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE R~PORT AND THAT THEY DO NOT EXCEED THE REPORTABLE LIMITS DESCRIBED IN "A" -THROUGH "D"- ABOVE - -- - TITLE DATE TANK MONITORED IS A MOTOR VEHICLE FUEL TANK REfOR~ TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF A TANK OF 1000 GALLONS OR LESS CAPACITY HAS A VOLUME CHANGE COL 9 OF +/- 25 GALLONS OR MORE B TANK OF 1001 TO 5000 GALLONS CAPACITY HAS A VOLUME CHANGE COl. 9 OF +/- 35 GALLONS OR MORE I C TANK OF OVER ,5000 GALLONS CAPACITV HAS A VOLUME CHANGE (COL. 9 OF +/- 50 GALLONS OR MORE ' 0 ANV TANK RASA CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- ,250 GALLONS OR MORE OVER THE QUARTER tIME FRAME RErRESENT2~ ON REVERSE . UARTERLY SUMMARY FILL OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE TO THE TANK NOTED ON REVERSE (CHECK ONE ONLY ....~-- - J PERMIT # ! I b OO~b<: ¡- UARTER/Y£AR f '1$ 2., ~ -.........'_...... ,&.-....'-'.-.-..... ..... íJ CAPACITY .;2ò /' ""< --"'-'. ¡?L1 l\ FACILITY U-,/ /~ TANK# .=" COL. 11 CUMULATIVE CHANGE GALLQNS çð' ¢. ¢ ø £ ø ¢J ø , , i , ¡ 1 ¡ I i a¡COL. 9 COL. 1~O VOLUME ,"{ =CHANGE+SUBTOT-tL= GALLONS GALLONS ' o ø l3 d ø ¢ ø ÇI ~' ï ~ i (fJ I I 1 I I 1 I I 1 I I ø tJ .....0- r? I 9 ~z:5 17 '32,-5 I I I/f :s?-S I /7 -S¿J$ I I I 1 J952-5 1 /93z.S1 éß I I I ~~~ ofF ~~t ~17, I I I t-ó~/L. þ--ð? ðq~ T£¿-h I - éf I /7 §Jo( /9 ®a( rf 1/ / 17~fD éþ r; cþ I I 1 I I 1 I I I I 1 I I 3;1S 17'~ t,I, C) ì7þ SUBSTANCE STORED COL. a¡COL. 7 COL. INCH I 2ND _ 1ST CHANGE IVOLUME VOLUME INCHES GALLONS GALLONS /9373 /13 cJ 193¥- 9~£:J I c¡ l I I 1 I I 1 I I 1 I I 1 I I 1 I I / c¡ 373 ~c) "3 .;;2.5 , / r 3 £j~ q7?~ 1 í é1 ß ø ¢ (/J I I 1 I I 1 I I 1 I I 1 I I I I 1 I I 1 I I I /lg5) I ~I I 1/ ßo/t>1 I /I '7 7/~ I COL. 3¡COL. 4¡COL. :> WATÈR I 2ND . 1ST LEVEL IGAUGE~GAUGE INCHES INCHES 1 INCHES I ø 1/2, I /I/-. /)/3/4 /113/1 J II 31r¡ fz- Vz- JI / ~ /111/2- I ,/ I I J/II¡~ I lit II¿, I I I L.DS~! D~ ,~. . cILos~~ I _ I I/~ 0/8 /1') 1/~ 1// 1/1 I I 1 I I 1 I I 1 I I 1 I I I I 1 I 3/t.{ / I ) jz. /II 'h- ¡I/ ø ø tÞ COL. 1 TEST WEEK L 1 - 2 t - :3 - 4- - 5 6 - 7 - t a - 9 ~t+ i' <. , \.~ ~\I ;" 10'" 11 - 12 - 13 i \ I ~ ~ ,SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS TANI<# l _ PERMIT # MONITORING BETWEEN DATES. OF II - (INCLUDE YEAR) NOTED ON REVERSE RESULTED , 'î ., ~ 1. A MAXIMUM ~ÐEKLY VOLUME CHANGE (COL. 2. A CUMULATIVE~VOLUME CHANGE (COL. II, . ~ GALLONS f I HEREBY CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND II ACCURATE REPORT- ANDuTHAT-'THEY-DO NOT EXCEED THEREPORTABLE-LIMITS-- r . DESCRIBED IN "A" AND "B" ABOVE I ~ L f 11 '* '* '* '* SIGNED DATE TITLE 9) OF BOTTOM LINE OF IN .....,ft H.nl.l GALS ~ SUMMARY !\ I' I [S A WASTE-OIL OR NON-MOTOR VEHICLE FUEL II REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF .-- I\' -- VOLUME CHANGE (&OL. 9) IS ~, CUMULATIVE VOLU~E CHANGE ~ B COL 11 IS +/.::. 100 GALLONS OR MORE A +/- 10 GALLONS OR MORE I I I I I I I I I I I I I , I I I I :1 I I I I I I I ,I I I .! I I I I I I I I SIGNED DATE Jim H ¡IdOla" 6,rage Services Supervisor TITLE &eneral Services Girage Divisio" 1/( ?3 I HEREBV CERTIFY THAT THE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCURATE. REPORT AND THAT__THEYDO NOT,EXCEED THE._REPORTABLE. LIMITS. DESCRIBED IN "A" THROUGH "0" ABOVE t 1 2 A MAXIMUM WEEKLY VOLUME CHANGE A CUMULA~IVE VOLUME CHANGE (COL , GALLONS COL 11 9) OF cf5 GALS BOTTOM LINE) ,OF ~ TANK # ~, PERMIT MONITORING BETWEEN DATES OF -L ~~ (INCLUDE YEAR) NOTED ON REVERSE RESULTED IN ~ ""Tn l'1.1'tU I -- / ~ (!) ¿ ;J (~ -- TANK OF 1000 GALLONS OR LESS OF ~/- 25 GALLONS OR MORE TANK OF 1001 TO 5000 GALLONS OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLONS CAPACITV HAS +/- 50 GALLONS OR MORE ANV TANK HAS A CUMULATTVF. VOUJMF. CHANGE OR MORE OVER" THE QUARTER T I ME SUMMARV (GOT. J 1) OF +/- ,250 FRAME REPRESENTED ON REVERSE D GAT.toNS C A VOLUME CHANGE COL 9 OF I B CAPACITY HAS A VOLUME CHANGE COr. 9 A CAPACITY HAS A VOLUME CHANGE COL 9 REPORT TO THE PERMITTING IS A MOTOR VEHICLE FUEL TANK AUTHORITY WITHIN 24 HOURS IF TANK MONI TORED , ! ¡ ¡ FILL TANK OUT THE FOLLOWING REPORTING SUMMARY APPLICABLE UARTERLV SUMMARV TANK MONITORED TO THE TANK NOTED ON REVERSE CHECK ONE ONLY I I I I I I I I I I I I J I I I I I I I I I I COL. 11 CUMULATIVE CHANGE GALLONS ø ø d 199 ctJ ¢ {J ø éO ø ø (j) f5 cþ , I i PERMIT # ~ I Q.UARTER/'1EAR a¡COL. 91 COL. io : =VOLUME+SUBTOTh..L= CHANGE ,1_ GALLONS GALLONS r 1 (þ 0 1 : _ -1. 1 \ I ø oj \ 1 {J I I I 1 I I L I I L I I ¡Ø } ~L¡' rf¡, ~I' ¢1 ~ t/J: ~ 4'( d " ¡ I ø I I I I I I I 1 I I I I I I I I I I ¢J ø Çb ~ é) {[J (þ Brae¡ b lcø~1h 18 ebb Ba?le I ~ a CJ6 1,.3-73, /1373 COL. S¡COL INCH I 2ND _ 1ST ÇHANGEIVOLUME VOLUME INCHES ßALLONS GALLONS 1>' ( ~ ~Sb ¡B8'b M~b ) 7373 ) <689/0 !8&J6b 189~þ ) / I I I I I 1 I I 1 I I I I 1 I I I I 1 I I trv (~f1Þ (~89(o (f!J8/6 Có ~~b / ß S7b 18S(o~ /~s 7b ;q 3 7-¿ 8~9b /8 5lofo B:ðfk 860 I I I SUBSTANCE (þ ø (;6 ø dJ ø I I I I I (0/ V¡ D 7 !(-¿, 5 /07 12- /o/'! //:0 /D71z- / Ð7 Ih COL. 3¡COL. 4¡COL. WATER I 2ND 1ST LEVEL IGAUGE-GAUGE INCHES INCHES INCHES ø /07 1°7 )/;(- I I I ()? ,/z,[ I II~ I 107 12- 1°/ Jj~ I071z, / tJ7 14 (97 I; /07 'Il- I ()71/1- JJN CAPACITY I I I I I I I - - c? rþ tf I ø ø N FACILITY TANK:#: .5. - - l' - COL. COL. 2 l TEST I WEEK l !- l 1 I I - L 2 I I t - l :3 I I - L 4 I I - 5 S - 7 I I - --1 a I I - - 9 " """'7'..~ 10 - 11 - 12 - 13 t SIGNED 1_ -I, :¡ II II I III ¡ 'I ~ * * . SUBMIT A COPY OF THIS SUMMARY WITH FACILITY ANNUAL REPORT RETAIN THESE RECORDS AT THE PERMITTED FACILITY FOR A MINIMUM OF THREE YEARS * * DATE TITLE A MAXIMUM WEEKLY VOLUME CHANGE A CUMULAT, IVEIVOLUME CHANG~ (COL GALLONS ' 'L I HEREBY CERTIFY THAT ~HE ABOVE-NOTED RESULTS REPRESENT A TRUE AND ACCU~~rE REPQRT ANDTH~'L.THEY_ DO NOT EXCEF;D TH.E' REP9R'l'~BLE I.J_MITS DESCRfBED IN "A" AND "Il" ABOVE 1 2 COL 11 9) OF BOTTOM LINE OF TANK # - - --- MONITORING (INCLUDE PERMIT # RF.TW~~N nATF.~ OF YEAR) Ñbl",l'EO- õÑ - REVER,SE RESULTED . / IN AND GALS SUMMARY 'II' ,l 1 f ¡\ l I: TANK MONITORED [S A WASTE-OIL OR NON-MOTOR VEHICLE , -r-- --- REPORT TO THE PERMITTING AUTHORITV WITHIN 24 '-- ~ - VOLUME CHANGE (~¡OL. 9) IS CUMULATIVE VOLU~1E CHANGE ~ " B COL 11 IS +/- 100 GALLONS OR MORE A +/- 10 GALLONS HOURS OR MORE IF I I I I I I SIGNED Jim Hindman Garage Services Supervisor ITLE General ServicesGlragt Division I HEREBV CERTIFY THAT THE ABOVE-NOTED RESULTS ACCU~~TE REPORT AND THAT TH~Y DON9T_EXCEED T~E DESCRIBED IN "A" THROUGH "0" ABOVE REPRESENT A TRUEÁND REPORTABLE LIMITS + -~~ ~-~.- -- t 1 2 A A MAXIMUM WEEKLY VOLUME CUMULAT VOLUME CHANGE GALLONS CHANGE (COL COL 11 9) OF .15 " GALS BOTTOM LINE) OF TANK # ~ PERMIT # / to (!>C) Äb~ MONITORING BETWEEN DATES OF c./-3. ð/ ?L . AND /' all/7' ¿ (INCLUDE YEAR) NOTED ON REVERSE RÉSULTED IN ' TANK OF OR LESS CAPACITY HAS OF ~/- MORE TANK OF 1001 GALLONS CAPACITY HAS OF +/- 35 GALLONS OR MORE TANK OF OVER 5000 GALLON~ CAPACITY HAS A VOLUME + / - 50 GALLONS OR MORE . ANY TANK HAS A CUMULATIVE VOLUME CHANGE (COL. 11) OF +/- 250 GALLONS OR MORE OVER THE QUARTER TIME FRAME REPRESENTED ON REVERSE SUMMARV o c CHANGE COL B 1000 GALLONS 25 GALLONS TO OR 5000 A VOLUME CHANGE COL. 9 COl.. 9 9) OF t A TO THE TANK NOTED ON REVERSE CHECK ONE ONLY TANK MONITORED IS A MOTOR VEHICLE FUEL TANK - - REPORT TO THE PERMITTING AUTHORITY WITHIN 24 HOURS IF A VOLUME CHANGE FUEL TANK FILL· OUT THE FOLLOWING REPORTING SUMMARV APPLICABLE UARTERLY SUMMARY Date 7-/- 7~ . '. r= -=~~ S¡¡Daty . I hereby certify this is a true and accurate report. PERIOD 12: PERIOD 11: QUARTER 4 PERIOD 10: PERIOD 9: PERIOD 8: QUARTER 3 PERIOD 7: Action Number for this Period (Line 4) \ PERIOD 5: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PERIOD 6: Total Minuses This Period (Line 3) Action Number tor this Period (Line 4) « TIME PERIOD: '-t- &:. - '9 ~ to 7-1- <7 ~ Total Minuses This Period (Line 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Nu.ber for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (tine 4) TIME PERIOD: 1- 7- '4~ to ~ /- 7:S Total Minuses This Period (tine 3) Action Number for this Period (tine 4) Total Minuses This Period (tine 3) Action Number for this Period (Line 4) Total Minuses This Period (tine 3) Action Number for this Period (Line 4) TIME PERIOD: Ie!) -~ - 72 to 1-1- ~ '=?: Total Minuses This Period (Line 3) TIME PERIOD: ÚJ - ~l~ - <7--2 to /ð-{-9L Total Minuses This Period (Line 3) Action Number for this Period (Line 4) , ' Total Minuses This Period (L~ne 3) Action Number for this Period (Line 4) Total Minuses This Period (Line 3) Action Number for this Period (Line 4) to 7-1-9'3 QUARTER 2 PERIOD 4: PERIOD 3: PERIOD 2: QUARTER 1 PERIOD 1: TIME PERIOD: It:J - $ö - 72 TANK # :;; ANNUAL TREND ANALYSIS SUMMARY t