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DATE
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INITIALS
TIME
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HAZARDOUS MATE.RI ALS MANAGEMENT
PE...., I TTI NG AND 'IAS-PECTIONS
AWTIVITY SHEET.
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FILE CONTE~TS SUMMARY
FAC¡LITY:~rð.pield We. <L M.a.cb)e.
ADDRESS: I&;~~ E.TrLl~~vt À1>t.
PER!'1IT #: /6ZìZ)/óZ ENV. SENSITIVITY: AJ;=.s
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Activ~ty
Date,
# Of Tanks
Comments
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rrP)j~cthb y} ¥~,ps-
.. '.C /57JtJ/tt2. ê;" ~' ,C OC,.~.. ,', ?J/-1'~'
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0IJfI/~o'¡'/ð rJ 7/ ~/90
JJ./2b8 -15 7/11/90
LAß ~trl ~~~J.-c¡ 0
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RANDALL l. ABBOTT
Agency Director
(B051861-3502
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2700 M Street. Suite 300
Bakersfield, CA 93301
T~ephone(8051861'3636
Telecopier (8051861-3429
STEVE McCALLEY
Director
RESOURCE
MANAGEMENT
AGENCY
DEPARTMENT OF ENVIRONMENTAL
HEALTH SERVICES
-. -. - ~- -. -.->
,
August 22, ~990
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H. E. Aaron
P. O. Box 3187
Bakersfield, California 93308
CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED
AT 1626 E. TRUXTUN AVENUE, BAKERSFIELD, CALIFORNIA.
PERMIT # A1268-15/150012
This is to advise you that this Department has reviewed the project
results for the preliminary assessment associated with the closure
of the tank noted above.
Based upon the
satisfied that
requirements and
time.
sample results submitted, this Department is
the assessment is complete. Based on current
policies, no further action is indicated at this
It is important to note that this letter does not relieve you of
further responsibilities mandated under the California Health and
Safety Code and California Water Code if additional or previously
unidentified contamination at the subject site causes or threatens
to cause pollution or nuisance or is found to pose a significant
threat to public health.
Thank you for your cooperation in this matter.
'\Jt~ D '
MIKE DRIGGS, ~US MATERIALS SPECIALIST
cc:R.L.W. Equipment
2080 So. Union Avenue
'Bakersfield, cA 93307
!: '::'riR:";.~';ÞiTV1.t
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LABORA1~ORiES,
J, j EGLIN, Rr,c., CH~M, iNQn.
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INC.
RECf::,i vEÇ
AUG 1 7 19YO
C:H[lJ!(~¡ _ ,NAlrS/5
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ì>ETIi;!¡ EU~
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";~Q!J PiERCE RD., BAKERSFIELD, CALIFORNiA 9330S PHONE 321.4911
rl:.~ t' ~~ç~ f)] E: Aroma t. i (':~:~
(SO! L)
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P. Ü. Box 6A lJ
Ba~er5fielð, CA 93302
Attention: Bud McNabb
Lab N,).:
3am}'Jlé t)esc;
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oat9 Sample
Coll-ected~
08-·Aw;-90
CQi1stítl.Jent
Bê.T1Zene
Toluerï9
Ethyl. E\f.:nzene
p-j~~,;l.s'~e
m-XyleJì8
Ow. Xy 1 è!nE!
Totðl Pet.:CGle.\1l':'¡
1 i~ld.~-Lic:a !:bo!1.s
(:;e:;.s~'l i~i~~)
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Da t e 0 f
Report: 09~Aug-90
63B9-}
B~ket'sfiE:lÖ Til8 "'Ind ¡'1arble Cn., Gas Tank @ 21
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!)at.t; Sample
Reçeived ~ Lab:
08-Aug-90
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a e nna' ys-ls-----·-·'·--==.c-,""','-'-'='-'-',
COl¡,¡pleted :.
08-Aug-90
Repc::rt i ¡~{.4
t]~1i t.5
. Analysis
Results
Minitnum
Reporting
Level
ug/q
utj/g
uq/9
_.1y,/q
~1q/g
uY/tj
none detected 0.02
none detacted 0.02
none detected 0.02
none detecteà 0.02
none detecteà 0.02
none dete(~teù 0.02
2.9 0.8
UÇi......g
.~_,_ ·_u· .__.._ .._......__ ._..,._.____ .._.. .._.. ~__'. .-._.. '-_."_.__
'Yf:S·"I' !·f21'I1C~=:::; TP~{ t.~{ Cf. () .·11. S ~ / L. U. f.. 'T.. lP,ethcH3..
Indiv}.dui3;;" c(:j{)s:it.uents by Ì1odìfi~d EPA method 5020/9020.
As Rec8i':ed Basis
CC'!ffil:i€':T1 t..s ~
Calif0r~ia D.O.H.S. Cert. #1186
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"CilWUUI.J ,I. J H'l!t.;, FI~G, CHi:..., EN.1R
4100 PIERCE: RD., ßAKER:;,FIELO. CALIFORNIA 93~(tJ.} PHONE 327·4911
~:rt¿},UC'(L Jt.tJ4!.rs.i.S
Pu ¡'9'?:f~!') 1 €: Ar0111i3 t lei;
( SOIL)
ELF L:;'Jip!~H~nt
Dat.e of
Þ.Ct Sax 64(t Report:
09-Aug-90
Rakersfjel~j, C^ 93307
... _._-.-:-_._n-7:~t1:el1t~i-ùi'·;-;-· Btlti t1c:r··)ar.:b
'---:..:. ":--'-::':,.-~~:-_=. -:....:..:..:;-"7:.;::~---"';:;:::-~.:;-::;;;-¥.
Lab f'~·~),~ ~
6389-2
Bakersfield Tile and Marb1e CD., Gas Tank @ 6'
Sa~p12. [>9::::;'C;
Dtlte San;ple,
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Ø3- Þ~tlg - s~ (1
Date sample Date Analysis
,,-,' "'---~-R":~ei·\I·êd- -@-:.1...¿,þ,:--- _~..,,-,__._Completed~,,,=-'-~"~'_'.o: "..--.-,
OS-Aug-90 08-Aug-90 '
cGr:stituent
J~ep(>rt.iny
unit,s
Arial~lsj,~
Results
Minimum
Reporting
Level
Benzene
Toluene:
Ethyl Benzen¡.l
p·-Xl' lena
m-Xyl~r¡e
c -- X}t l-en e:
\~g/g
U9/g
ug/g
ug/g
·~9/9
U9/g
nor !~: detecteà
norH~ dE<tected
none detected
Done. de:tected
nOI1~ dF-:~ected
nODe dlË;t~çted
0.02
0.02
0.02
0.02
0.02
0.02
Tot,a 1 P·~trGJ t~üE,
t1.'<;{d r(')C.~a rl;·c:~s
(C:;Gso} ir1e)
ug/g
4.1
0.$
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_.........-------
TEST METHOD: 1tpH by D"{)4H.S~ / L~U.F.T. methf}d~
Indi..'id.uiÜ GcnE,tituent.s by ~"adified EPl~ method 5020/8020.
As Recei~~d. Basis
C::Jrn::ne nt.~.; ¡
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-----:~-nð lyst '
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1700 Flower Streel
!. Bakersfield, California 93305
Telephone (605) 661-3636
. (Erf,'-~ ':;OUNTY HEALTH DEPARTaT (
"
l ,ENVIRONMENTAL HEALTH DlVISIO['J
HEALTH OFFICER
Leon M Hebertson. M.D.
Facillty Name
ßak:eesþeJd íTÎe ~Màl2bJ¿
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, Address 1621(, E. lÆuJt/ÙN
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i'c:.---c. '. a.1œtz:s teld; CA
~Kern.County ,Permit #
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* * UNDERGROUND TANK DISPOSITION TRACKING RECORD * * ./,fL2 ",',.,.'
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DIRECTOR OF ENVIRONMENTAL HEALTH
Vernon S. Reichard
This form is to be returned to the Kern County Health Department within 1.! ...,'
"days of acceptance of tank(s) by disposal or recycli,ngfacility. The",'>'
. .. ' ". _._,-=-,'-'."_~,__.J\old,er._~,L.the.,,p_e['lIIi t .with ,number _..noted abov~Js-,- re9pon91bl~L-,,-f..Qr...cin~_udng~L'L.':;::..~,
,-,-- ,- that this forlll is---ëom-plefe'd-ãÎ1d'~reTÙrñed':-'--~" , .. -:-,"'~~-~:~-
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· . . . . . . " " " " " " " " " . " " " " , " " . " " .. " " " , " " . " "
Section ~ - To be filled out ~ t~~k removal £ontractor:
Tank Removal Contractor: 121.. t<J IZr.
Address ~ ýì'ð ...10. c/,J IY iff.if 11-.J to
.15'":z-j¿;:7~~L:7 ..... ~
Date Tanks Removed 7- ¿ð '-';::::0
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Phone # Pt:7~~4.., .I/<!} 0
Zip 7.~ ~o7
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, No.: of Tanks:.:t¡;I "..
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SectIon Z - To be tilled .2.!:!1 ~ contractnr "decontar:tlnatlng tank(s): ~l...~..._.
~'-, .. ;' Tank "uecontamination;" c~nt;';ctor 3-L U.CJUA/{ ~Vlc..¿- , ,:~,:, '..:
,.-' Addr~;'s 7¿OI LuC/~ 4£. Phone # ~S~393-S 77D'
8A-K:t::ßÞII::L(J ("4· Zi p 9.3-3 ¿) y-
,
Authorized representative' of contractor certifies by signing below that
tank(s) have been decontaminated in accordance with Kern County Health
Department requirements.
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Title
· . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . .
Section.ª- - To 1!~ filled out and si~ned ~ -ª.!l authorized r2presentative of ~
treatment. stora~e. or disposal facility acceDtir.~ t~nk(s): .
Faclllty NaDe ,Æ,ner/cat:1 ød.J £.o:¡(f/,~ . '.:
Address c:Jd)o~ 5, /Vl1/,1..t!4/¡ ÂtI¿nu e. hone # P/'¢J?!'J1-R'CJOD'
,Ont'ar: Cy f¥A Zip ØJ/ 7 to!
ived - 9 Ö No. of Tanks '/
_Title ~ ~~"",
Representative)
Date Tanks
Signature
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MA II. ING INSTRUCTIONS: Fold in half and staple. Postage and mailing
label have already been affixed to outside for your convenience.
(Form #HMMP-150)
DISTnlCT OFFICES
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Fonn Apprcwed OMS No. 2050-0039 (Expir.s &-30-91)
PI.... print or typ.. (Fonn d.aigned lor use (I2-pitch .
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See instructions on Back at Page 6
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Departmanl ot Health ServIce,
TOllic Subatanc.a Contrm Divisiol1
Sacramento, California
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GENERATOR'S CERT1FICAT1ON: I h.reby decl.r. lhat!tle content. oIlhi. conaignment ar. fully .nd accur.leIy d.acribed above liy proper shipping nama
.nd ar. classified. packed. m.rked. and labeled. and ar. in .11 r.spects in proper condition for Iransport by highway acc:ording to applicable international and
n.lional govammant regul.liona.
If .m . I.rg. quanlity gen.ralor. I certify Ih.1 , have a program in plac. to reduce Ih. volum. and 10llicity of W.... generated 10 the degr.. I have d.lermined
to be economically pracliCabl. and lhall h.v. ..Iected lhe practicable m.thod of trealmant. .torag.. Of disposal currantly available to me which minimiz.. lhe
pre.ent anG lulure threal to human ""slth and m. .n'1.'Cr.m..~; OR. 11 , em a amall quanlity oen.ralor. I h.v" mad. a IIooci raith elfort to minimize Ir.Y wast.
gen.ration and ..I.ct th. beat .a... management melhod Ihat ia av.ilable lò me and Ih.t I can alford.
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19. Oiscrapancy Indicalion Space
~20._,Facility__Ownar,or Oper~tor Certification of receipl of huardouam,a_lerial. ccwered by ~his manif~slaxc.pl.._ n~t!d,in Item 19.
Name
Monlh
Day
Year
DHS 8022 A (1/88)
EPA 8700-22
(R.v. 9-88) Previoua editlona ar. obsol.I..
White: TSDF SENDS THIS COPY TO DOHS WITHIN 30 DAY:
To: P.O. Box 3000, Sacramento, CA 95812
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.RE~URl:¡;:: MANAGEMENT AG'ÉNC"-
RANDALL L. A~BOTT
Director
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Envlnuu,wnt411 Ht""hh S..~r\'ln's 1)'-I'_nll1"'l1t
STEVE McCALLEY. REHS. DIRECTOR
':;£Ì'¿J:t'1~:~P:rs;@i!'
PI~'nnln4& [)"V"I¡)lmU"~1 S'·rvli~,·~ (>.·.M,II1Wut
TED JAMf.S. AICP. OIRR'"OR
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" :' PERMIT FOR PERMANENT CLOSURE
, ,'OF UNDERGROUND HAZARDOUS ,
":L,;~,~,/:SUBSTA.NCES STORAGE ,FACILITY:',,'
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ACILITY NAMEI ADDRESS: ,:,.,:::;:;'::;.::cCOWNER(S) NAME I ADDRESS: ,~:,':~S'CONTRAC
¿'t~~~Til;'!1'~:;~!~:;~¡~~~~j~~~.E.'~~:~Y?~~:¡~ "":,.:;;£f "~~w J!q.ip~~,
,1626 E. Truxtun Ave. ,:,,}:,~., '<"1.>:" ',"~':' P,O. Box 3187 " ";,'!:r~~"';:<\';",~.",:.,:2080 So.Unl(~n:'i ye
Bakersfield, CA 93305 ,,',"" ;",''';Bakersfield, CA 93308 '·"'}5"?':;"·",."""Bakersfield,'CA'933
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ENVIRONMENTAL HFALlH SERVICES DEPARTMENT
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, " ,"APPROVAL DATE
1. T ANK(S) AT ABOVE
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LOCATION
APPROVED BY
Michael Driggs ,
Hazardous Materials Spec
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'........... .................................................................... PO S TON PRE MI S ES.................. ................ ... ................;......;.. .;;........;.....
1.
CONDITIONS AS FOLLOWS:
It is the responsibility of the Permittee to obtain permits which may be required by other regulatory agencies prior t~ beginning work '(i.e., City
Fire and Building Departments). ""'''''-t..'~, ' _,' "
Permittee must notify the Hazardous Materials Management Program at (80S) 861-3636 two working days prior to tant'Í'emoval or abandonment
in place to arrange for required inspections(s)., 'j'??'-~1-;,':i!!;-!{~~'~~;~.¡.~,:g~~~';;:
Tank closure activities must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT-30.
It is the contractor's responsibility to know and adhere to all applicable laws regarding the handling, transportation òr treatment d. hazardous
materials. ...''', .' ~'.., _,'
The tank removal contractor must have a qualified company employee on site supervising the tank removal. The employee must have tank removal
experience prior to working unsupervised. ".':',:;,;~;:~i:&;i:;iit;~¿;:i-,z-;.., , ,
If any contractors other than those listed on permit and permit application are to be utilized, prior approval must" be 'gráíìiëd 'by"ï'héãpecialist
.. , listed on the permit. Deviation from the submitted application is not allowed. ' ",' , -', '.." -"
Soil Sampling: .~'..'
a. Tank size less than or equal to 1,000 gallons - a minimum of two samples must be retrieved from beneath the ccnterof the tank at depths
of approximately two feet and six feet.
Tank size greater than 1,000 to 10,000 gallons - a minimum of four samples must be retrieved one-third of the way in from the ends of
each tank at depths of approximately two feet and six feet. ,/i;-.,'::-:<":,,: ,:~';.'>:,'
, c. ,'Tank size greater than 10,000 gallons - a minimum of six samples must be retrieved one-fourth of the way in from the ends d. each tank
-~"~~and, benea tlJ...t,he,cenler- of"each"lank a t~deplhs' of-a pproximately,t'WO-feet ,and.six,feet.~~_~.._...,_~_,~...._~,..,~~ ,.,:...'.~~~_~_..:"~..~_"
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 ànd under the
dispenser area. .."
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2700 "M" STREET, SUITE 300
BAKERSFIELD, CALIFORNIA 93301
RECYCLED PAPER
(H05) 861,3636
FAX: (805) 861,3429
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PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A 1268-15 " .
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a. ,All soil samples retrieved [rom beneath gasoline (leaded/unleaded) tanks and appurtenances must be an'a'lÝzèci [or benzene;foluenê; xylene,
and total petroleum hydrocarbons ([or gasoline). ,', " .' ',:' "':, ' .
All soil samples retrieved [rom beneath diesel tanks and appurtenances must be analyzed [or total petroleum hydrocarbons (for diesel)
·'.~-,:--:'and benzene~-'"-:~~'",:.=:.=.:_a;.~...- -= -:;=~-:::.::-- ~-.-=-:::::.~~~~""'-;_:;:;:~~-:-;;- .-"._-- _.~~. <-.~:'-.___;.~~.- '"~:':"_7_- _-:-_ - - _ ._-_~ .~''';...,"--:; ~--'-:7-.~:.~,::~;;::~i{~...._~~~~~~~~-;~~~-'.::S:;~;:;:-~
All soil samples retrievea [rom beneath waste oil tanks· and appurienanœs must' be analyzed [or total organiC' b~lidëS:'ìead~~li á;ci'ieàse.
' All soil samples retrieved [rom beneath crude oil tanks and appurtenances must be analyzed [or oil and grease.."~~i;¥~!j;*~1J~~f,~!;;.,:'
, All soil samples retrieved [rom beneath tanks and appurtenances that contain unknown substances must be analyzéd (or'~ 'fùll range of
' ,substances that may have been stored within the tank. . --, '
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. .The following timetable lists pre- and post-tank removal requirements:
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nÍplet'&p;;mrriippiicá¡iOíf~íitfníiÚ~d~·'. ,_, ~:~~-::':Ai leást-twö-,w, s'
,:0;~~:rd~,~;,,~~!~;.I~·~~~"~~,g~7~~~,::;!%0;;,;¿~f~t~f~,:;,;b0:Z~;'~~';:;C,'.;:;,,:d~~i(':.,,;¡~~~~r;" ":.r~l/::'i~.
otification to inspector listed on permit, of date >"(;;~ :;\~;,"::',t..: ':¡,,?<,;:';;';':;::'Two wórking day
,.!ij,~ pm~,'~ò~;~~~:,~,n~t~il;;~:Í>li~g,·');;}~~¥;~fÚ~~j'~;~~l~ë;("};~F.:~~~~;;""~t~.¡~~~:." ,', " """,' ',.',".,",'."
/Transporta'tion ~nd ti'aèking forms sent to HaZardou¿ "; ::,' "''':f"~No I~t~ than S\Wrki~g'days 'for trailsportatlOn and',14'.wor
J~" "Materials Management Program. All hazardous waste ''', days for the tracking form after tank, removal !.\,,¡þ;,.i;;',.:,.,,'~:l':, , " "
"i,manifests must be signed by the receiver of the ,. ,,:" . ',,'" " ' ",~.'(,~:,
"";:"~;;'~2r~~~':07~:: ;;.;tif~tL:~jþ~,~~:' '.'~iÙ\}?J:t};;~~à~~~;:~t;+'~J:~)li)~ift;~9(~;"
,,:SaÍDple analysis' t~ HaUr~o~ j,{aterià~,¥anagemen " .,J:lo ~at~lhàD 3 working~ays
~.~'::~~·:P~gram : ~ ," ,:~::(j,(~,~~~,t~f.~\{t:<:,~ ~,' _--"';j"{:'~:'.;:,' )7í,' ~?,~~,~ >!~:~:~¡'rf.1t~ ':t~ .. ", h ~ f' {- ,~,.~ ,,~ .'
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11. Purging/Inerting Conditions: " " ,,':'-. ,';," ,.". _
a. Uquid shall be pumped from tank prior to purging such that less than 8 gallons of liquid remain in tank. (CSH&SC 41700),
, b. Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) ",/,\", , ,
c. -,- No emission shall result in odors detectable at or beyond property line. (Rule 419)'~;"" <~,<::p;'
d; , No emission shall endanger the health, safety, comfort or repose of any person. (CSH&SC 41700)-",
e. Vent lines shall remain attached to tank until the inspector arrives to authorize removal. J' '"
f. All soil samples retrieved from beneath tanks and appurtenances that contained furfuryl alcohol resin must be analyzed for phenols,
formaldehyde and furfuryl alcohol. ~""_',' ".'".;t~";:j.i;;:/:':t;ö,:,,,:
RECOMMENDATIONS/GUIDELINES FOR REMOVAL OF UNDERGROUND STORAGE TANKS ,', ",!:~j;J~~ik';i;P~;:"·.t
This department is responsible for enforcing the Kern County Ordinance Code, Division 8 and state regulations pertaining to undergroùnd storage tanks.
, Representatives from this department respond to job sites during tank removals to ensure that the tanks are safe to remove/close and that the overall
job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify ~he interests
and expectations for this depanment. , ' ,;';~~:.,:;::Þ};:;¡~~S~::~,~i;~t~~:;~:
",; 1. Job site safety is one of our primary concerns. Excavations are inherently dangerous. It is the contractor's responsibility to bow ·and'abide by
CAL-OSHA regulations. The job foreman is responsible for the crew and any subcontractors on the job. As a general rule, wor1ters are nOl
permit ted in improperly sloped excavations or when unsafe conditions exist in tbe hole. Tools and equipment are to be.used only for their designed
function. For example, backhoe buckets are never substituted for ladders. ,;~,:~.:ò':¡;~,~';}f?.z:JÇ\:~c:?:c;~~r,.';
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Properly licensed contractors are assumed to understand the requirements of the permit issued. The job foreman is ~ponsible fO! knowing anG
abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order.. 'i,':"W "
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Individual contractorS will be held responsible for their post-removal paperwork. Tracking forms, hazardous waste manifests, and analys~
documentation are necessary for each site in order to close a case file or move it into mitigation. When contractors do not follow through on
necessary paperwork, an unmanageable backlog of incomplete cases results. If this continues, processing time for completing new closures wi!:
increase.
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~NERORAGENT ,..-
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driggs \ 1268-1S.pta
DATE
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KERN caJNTY RESŒJRCE MANAGEMENT ACENCY
ENVIRCt--IMENTAL HEALTH SERVICES DEPARTMENT
2700 10M" STREET. SUITE 300
BAKERSFIELDÅ'CA 93301
(605)861-36.:16
(FILL OUT ONE APPLICATION PER FACILITY)
uAPPLICATICN FOR PERMIT FOR PERMANENT
, CLOSURE/ABANDONMENT OF UNDERGROUND
HAZAROOJS SUBSTANCE STORAGE FACILITY
IS FOR ~ R8'fOVAL, OR [] ABANDONMENT IN PLACE
INTERNAL USE ONLY:
APPLICATIQ\J DATE: -¡--f=-'O_ PTA: fl¡J~-1s.._
# OF TANKS TO ABANro-I: -1_ '
PIPING FT. TO ABANOON:_O PTO:¿
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B: COORAC'I'œ lNmM'TIíW
T~K RfM)\IA!.. COOR.ACTOO: 12 L (J.J G 9' '
PlœE #: 'ð '5-
PImJXD START DATE: ,4
Tæ RETRIEVIt«3 SN4US:
PlœE #: " 5'-
I()RI(ER'S C(WfNSA TI~ #:
TæY 1HAT WIll .AHAlYlE s.wt.ES: .L? b
PlœE #: F" 7'-
c: OIMlCAI. INRWATlCN
CHEMICAL COMPOSTION OF MATERIALS STORED:
TANK # VOLUME CHEMICAL STORED
-1_ _5P.!?-____ -&./L-ß~---
DATES STORED
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10
10
CHEMICAL FORMERLY STORED
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D: BNIIm6TAI.. I~TI(J4
*TER TO FACILITY PIDJlœD BY:
NEAREST WATER WELL ~IVE OISTNa IF WIlHIN 500 FEET:
BASIS FOR SOIL TYPE NolO Gro..t400TER DEPlH D£l'mIIINATI~:
TOTA!.. tfJIotiER OF 5ÞK'lES TO 8E ANALYlEO:
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E: DISPœAl INRA'ATIíW
œcooNl\INATI~ PROCEWRE:
~T~INATI(} CCNTR4.CTOR:
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OISPœAl ~ FOR TNoIK(S):
-- DISPœAL EHOD FOR PIPI,.,;
**PLEASE ca.1PLETE THE REVERSE SIDE OF THIS APPLICATION BEFORE SUBMITTING FOR REVIEW**
TH IS FORM HAS BEEN COMPLETED UNDER PENAL TV OF PERJURY AND TO THE BEST OF MY KN~LEOOE IS
TRUE AND CORRE2?" '
SIGNATURE: _~__~~~~__________ TITL~Jx1ý.;C;..:..____ DATE_k:.J..?~
PROVIDE DRAWING O~.' "tØCAL LAYOUT OF FACILI~. U.'-- SPACE PROVIDED BELOW.
ALL OF TH E FOllOW ING I NFORMA T I ON !11JS.I..J~É I NClUDED I N ORDER FOR THE
APPLICATION TO BE PROCESSED:
___¿ TANK(S), PIPING
DIMENSIONS.
& DISPENSER(S), INCLUDING lENGTHS &
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PROPOSED SAMPLING LOCATIONS DESIGNATED EiY ,THIS,SYMBO~"II@II
NEAREST STREET OR INTERSECTION
ANY WATER WEllS OF SURFACE WATERS WITHIN 100' RADIUS OF
FACILITY
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" I 3: 10 pm, ' "KERN COUNTY PLANN ING - & DEVELOPMENT ",,_, '/
" I 2700 'M' Street, ,"
" , ,'::,':::t, 8akersfield., CA 93301 Type of Order "WI
.... ... ~¡c-;ë:¿-=;::c:è.:.è;o.:==::;7-'-:--'";~;:~~-;~·:~:~;~:.~~~7.:~~~:c-:-::~~~-:::"#1f~F~:~~..::;i£1:fJ.
: I. GASH 'REGIStER' ",' :, ,RLWEQUIPMENT,ltl/C" ',' , >:::""_":',1
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I Customer P.O..# I Wtn, By lOr-del'" Date I Shi p Date I Vi a ,-I Terms ' ~, ,I
IH07.06903, " ,I RAR ,;, 07/06/90 07/~6/90 ,I ' "_ '" ,J.;!:'JT, :__" ,I
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'Line'Descr;ption, ", ."" ,;,-..Quantity ':,', ;:,P"'ice ,Unit Oisc;';::,;'TC)~al,
1 PERMIT TO CLOSE/A8ANDON 1 "'250.00 E """ 250.00
170G
Order T cta-1 250.0,0
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Amount Due 250.00
Payment Made By Check 250.00
THANK YOU!
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1700 Flower Street
Bakersfield, California 93305
Telephone (805) 861-3636
.'RN 6~UNTY HEALTH DEPARTME.
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HEALTH OFFICER
Leon M Hebertson, M.D.
ENVIRONMENTAL HEALTH DIVISION
:J:NTER.:J:M PER.M:J:T
TO OPERATE:
DIRECTOR OF ENVIRONMENTAL HEALTH
Vernon S. Reichard
PERM:J:T#:L500:L2C
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ISSUED:
EXPJ:RES:
JULY 1, 1986
JULY 1, 1989
UNDERGROUND HAZARDOUS SUBSTANCES
---- ~ - ~::-~-s'ToRAGTE FACILITY
--:: '-',-:--'-NUMBER ' OF-TANKS='~l
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. FACILITY: "I OWNER:
'BAKERSFIELD TILE & MARBLE I AARON, H.E.
"",1620~26 E. TRUXTUN AVENUE I P.O. BOX 3456 :,"
..,..'.,.: _<.~,;,BAKERSFIELD, CA " ' ,I ',' - BAKERSFIELD, CA', 93385 ..~·<\'::\,;f/.'/', "
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~')"",\::TANK "# :~:~~~'<:AGE (IN YRS)
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, :'NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PERMITTING :-i:::,~:;;.';,¡!:,;?::':~..
,...:~ AUTHORITY MUST BE MET DURING THE TERM OF THIS PERMIT ,::.;-:"'Ît~~:~:i'¡;'~)~'::
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NON-TRANSFERABLE*** POST 'ON~PREMJ:S~S ¿
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DATE PERMIT MAILED:
JUL 1 6 1986
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,'DATE PERMIT CHECK LIST RETURNED:
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Permit
Questionnaire
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Normarry-;permlts~"~are sent to facility Owners but since many-~-~,"
Owners live outside Kern County, they may choose to have the permits
sent to the Operators of th~ facility where they are to be posted.
Please fill in Permit # and check one of the following before
returning this form with payment:
For PERMIT * ~
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-A 1. Send all inform'ation to Owner at t'.1e address
listed on invoice (if Owner is different than
Operator, it will be Owner's responsibility
to provide Operator with pertinent
information).
2. Send all information to Owner at the
following corrected address:
3. Send all information to Operator:
Name:
;fif··
,{f:
Address:
(Operé1l0: can make copy of permIt Îor
Owner)
~~--.---.-~~--~.
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Kern County Health Oepartme~
Division of Environmental H
1700 Flower Street, Bakersfi a, CA 93305
Permi ~ /.,"::- () 0 I;J..C-
Applicatiorw 3- ~-l R-R~
¡ ~-
, '-"
, "APPLlCATION FOR PERMIT TO OPERATE UNDERGROUND
HAZARDOUS SUBSTANCES STQRP£;E F~CILITY
~ of Application (check): ,
ONew Facility O~ification of Facility DExistin; Facility DTransfer of CMnership
A. Emergency 24-Hour Contact (name, area code, phone): Days
Nights
_~__,_Faci1ity Name BAKERSFIELD TILE & MARBLE No. of Tank 3 I ", '
------Type of Business (check): [JGasoline Station ~Other (describe) TILE & 'MARBLE CONTR.
Is Tank(s) Located on an Agricultural Farm? Dyes !]No
Is Tank(s) Used Primarily for Agricultural Purposes? DYes 2] No
Facility Address 1620-26 E. TRUXTUN AVE. Nearest Cross St. 'WASHINGTON
T ' R SEC (Rural Locations Q1ly)
Owner 'H. E. AARON Contact Person 'H. E. AARON
Mdress p:. O. BOX 3456 Zip 93385 Telephone (805) 324-9824
, n __ Operator(LESSEE) BAKERSFIELD TILE & MARBLE ' _,ÇOr1~c:~,_Person UNKNOWN
....·'----Address '-1620 E. TRUXTUN AVE. Zip 93305 Telephone (805) 324-0043
8. Water to Facility Provided by CALIF. \~ATER SERVICE CO. Depth to' GroW1dwater 'UNKNOWN
Soil Characteristics' at Facility
Basis for Soil Type and Groundwater Depth Detenninations
CA Contractor's License No.
Zip Telephone
proposed Completion Date
Insurer
C. Contractor
Address
Proposed Starting Date
Wbrker's Compensation ~ertification t
D. If This Permit Is For Modification Of An Existil'XJ Facility, Briefly Describe Modifications
Proposed
E. Tank(s) Store (check all that appl y) : OUT OF USE MANY YEARS
~! Waste Product Motor Vehicle Unleaded Regular premh. Diesel Waste
Fuel Oil
1 0 I1J EJ 0 B § 8 8
0 0 0 0
0 0 0 8 B ·8 8
0 0 0
F. Chemical Canposi tion of Materials Stored (not necessary for motor vehicle fuels)
Tank t Chemical Stored (non-coamercial name) CAS t (if known) Chemical Previously Stored
(if c11fferent)
G~ Transfer of Ownership
Date of Transfer
previous Facility Name
I,
Previous Owner
accept fully all obligations of Permit NJ. issued to
. I understand that the Permitt11'XJ Authority may review and
modify or te~inate the transfer of the Permit to Operate this underground storage
facility upon receiving this canpleted form. , _ _ .,~_.,._~~
_._ ___' _ r,- ..., "-' ___·~·__--ol ,.~_. '-.~ -"-- -'--"-=='---"""-"'--....."..,-,." ~...--.------......_-._~ . - -----.-----~.------,' ----~~ ,_. -'--""'=-'---' --'---
I"
,
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'Ibis form has been canpleted under penalty of perjury and to the best of my knowledge is
"true and correct.
'Signaturt!::.. / C--?~
H. E. AARON
Title
PRF<:;rnFNT
Date 3-1R-R~
Fac il í ty Name
3AKERSFIELD T~ - MARP' ~- I', rormit l'b./~()é)/.;LC
TANK ~ ~ (FILL OUT SEPARATE FORM F R EAæ TANK)
-FOR EACH sEcTIõÑ,œECK ALL APPRõPRU\TE-šõ'XE-Š--
I '
H. 1. Tank is: DVaulted IDNon-Vaulted ODouble-Wall OSingle-Wall
2. Tank Material
OCarbon Steel 0 Stainless Steel 0 Polyvinyl Chloride 0 Fiberglass~lad Steel
o Fiberglass-Reinforced Plastic 0 Concrete 0 Allninlm\ 0 Bronze ~unknown
o Other (describe)
3. Primary Containment .
Date Installed Thickness (Inches)
UNKNOWN UNKNOW~
4. Tank Secondary Containment
o Double-Wall U Synthetic Liner
DOther (describe):
o Material
5. Tank'Interior Lining
WRubber 0 Alkyd OEp:>xy OPhenolic o Glass , OClay OU1lined ijllbknown
OOther (describe):
- '---'6; '~-'Tank 'Cói'rosion Protection
-rTGalvanized DFlberglass-Clad OPolyethylene Wrap OVinyl Wrappirg
OTar or Asphalt [ZJunknown DNone OOther (describe):
, Cathodic Protection: DNone OImpressed CUrrent System DSacrificial Anode System
Describe System , Equipnent:
7. Leak Detection, Monitoring, and Interception
~Tank: OVisual (vaulted tanks only) DGrouOOwater Monitorin}' Well (s)
o Vadose Zone Moni toring Well (s) 0 U-Tube Wi thout Liner
OU-TUbe with Compatible Liner Directi~ Flow to Monitoring WBll{s)*
D Vapor Detector· D Liquid Level Sensor 0 Conductivi t¥ Sensor* ,
o Pressure Sensor in Amular Space of Double Wall Tank
o Liquid Retrieval , Inspection Fran U-Tube, Moni toring Well or Annular Space
o Daily Gauging' Inventory Reconciliation 0 Periodic Tightness Testirg
o None [) unknown g Other OUT OF USE MANY YEARS
b. Piping: Flow-Restricting Leak Detector(s) for Pressurized Piping-
o Moni toring Slmtp wi th Racew:.y D Sealed Concrete Racew:sy
o Half-cut Canpatible Pipe Raceway 0 Synthetic Liner Raceway üI None
o Unknown 0 Other
*Describe Make , Model:
8. Tank Tightness
Has TI11S Tank Been Tightness
Date of Last Tightness Test
Test Name
9. Tank Repair
Tank Repaired? DYes ONo K1unknown
Date(s) of Repair(s)
Describe Repairs
10. OVerfill Protection
~ator Fills, Controls, & Visually Monitors Level
DTape Float Ga~e OFloat Vent Valves 0 Auto Shut- Off Controls
BCapacitance Sensor DSealed Fill Box o None lXIunknown
Other: List Make & Model For Above Devices
Capaci ty, (Gallons)
UNKNOWN
" Manufacturer
IINk'NQI·/N
o Lined Vaul t IX) None 0 unknown
Manufacturer:
Capacity (Gals.)
Thickness (Inches)
--
Tested? DYes i]No Ounknown
Results of Test
Testing Canpany
11.
_.....,.-.____. r- .
Piping
a. underground Piping: DYes DNo filUnknown Material
Thickness (inches) Diameter Manufacturer
DPressure DSuction DGravi ty Approximate Lel'¥3th of Pipe RLß
,b. Underground Pipil'¥3 Corrosion-Protection : ,~,-,----,.,-----,.~. -,~' .. ->' ..
DGalvanized OFiberglass-Clad DImpressed CUrrent DSacrificial Anode
Dpolyethylene Wrap OElectrical Isolation OVinyl Wrap OTar or Asphalt
DUnknown DNone DOther (describe):
c. Underground Piping, Secondary Containment:
o Do ubI e-Wal 1 DSynthetic Liner System DNone Ounknown
Dather (describe):
,/
\,
.
.
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