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Home My WebLink AboutUNDERGROUND TANK 7.r:'· >Ii e e p1010301,jpg (1280x960x24b jpeg) ? '~\\'1 ~ 50\1I.~ S Hw~ \ 3 00 \ s -to (lJuJ L 'l' '" e e p1010300,jpg (1280x960x24b jpeg) '" .. e e p1010299,jpg (1280x960x24b jpeg) ". .. e e p1010298.jpg (1280x960x24b jpeg) ---~- SENSOR AUiRr"l L 3. STP SU~'lP STP "1P FUEL ALARM MAV 28. 2004 7:24 AM ----- SENSOF: ALARt"l L 1: 8'7 STP SUr"lP STP SUr"IP FUEL ALARf"¡ MAV 28. 2004 '7:24 AM . ----- SENSOR ALARM ----- L 5:DIÐ':;EL STP SU~.¡p STP sur"!p FUEL ALARH MAY 28. 2004 '7:26 AH . ----- SENSOR ALARM L 7: 91 f:;TP 8Ur'tP STP SUr"lP 'FUEL AU~Rr"l t"lA\' 28. 2004 7: 27 At"1 ----,- SEr'-t:XìF: ALARr'l L 7: 91 Bn' BUI"lP STP Bur"1P FUEL ALARI'1 ¡VIAY,. 2004 7: 28 ?\\"\ ".-- :....~ -- ..'': · CITY OF BAKJtWsFIELD , OFFICE OF ENVIRONlVlENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 Facility INSPECTION RECORD POST CARD AT JOB SITE Own.:r AJdress Address City. Zip City, Zip Phone No, Permit 1# INSTRUCTIONS: Please call lor an inspector only when each group of inspections with the same number are ready, They will run in consecutive order beginning with number I, DO NOT cover work tor any numbered group until all items in that group are signed otT by the Permitting Authority. Following these instructions will reduce the number of required inspection visits and there tore prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION DATE INSPECTOR Backtill ofTank(s) Spark Test Certification or Manufactures Method Cathodic Protection of Tank(s) Piping & Raceway wlCollection Sump ( Electrical Isolation of Piping From Tank(s) Cathodic Protection System-Piping Dispenser Pan Liner Installation - Tank(s) Liner Installation - Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Detector(s) L.:ak Detector(s) for Annual Space-D,W. Tank(s) Monitoring Well(s)/Sump(s) - H20 Test LA<£ fGso( òi¿ ~¡1-4 !o4- sJ Leak Detection Device(s) for Vadose/Groundwater Spill Prevention Boxes ç 1-;.'6/ ð4 dJ1, J FINAL vt. Monitoring Wells, Caps & Locks r~.-/'&- C~ð MP''OvvJ ~/Z'ilICJ4 ~ Fill Box Lock Monitoring Requirements Type '} Authorization for Fuel Drop ( CONTRACTOR ~ t &.-\-1 t' ~ fl bt t, CONTACT~~ dIAd ttUJOOJ LICENSE 1# ìl{J ) ~ A..:l:ftz.. . PHONE 1# ~o 3 " 5't~q i':-- _ __ - \;;; PERMIT APPLlCA TIO_O CONSTRUCT/MODIFY UNDERGROUND STORAGE TANK Bakersfield Fire Dept. Environmental Service 1715 Chester Ave Bakersfield, CA 93301 Tel: (661 )326-3979 PERMlTNO. ßJ::¡:.. -63 S"~ I TYPE OF APPLICATION (CHECK) o NEW FACILITY XMODIFICATION OF FACILITY o NEW TANK INSTALLATION AT EXISTING FACILITY -' WATER TO FACILITY PROIl1DED BY STARTING CATE DEPTH TO ? GROUND WATER I NO,OFTANKS O· TO BE INSTAlLED SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE YES 0 NO THIS SECTION IS FOR MOTOR FUEL TANK NO, VOlUME Ill; -ÞJVIfß UNLEADED REGULAR PREMIUM DIESEL AVIATION /1/fe F;(,:)'///</& THIS SECTION IS FOR NON MOTOR FUEL STORAGE TANKS TANK NO, VOLUME CHEMICAL STORED (NO BRAND NAME) CAS NO (IF KNO'M>) CHEMICAl PREII10USL Y STORED FOR OFFICIAL USE ONLY I APPLICATION Do\TE I FAClUTY NO. I NO, OF TANKS I FEES S The applicant has received, understands. and will comply with the aI/ached conditions of the permit and an othe state. local and federal regulations. This form has been completed under penalty of perju ,find t / best of my knowledge. is /rue and COrrect. Æ . . d. LA-ltfJ&,¿ APPLI E (PRINT) APPLICANT SIGNATURE M U') o ('oj :E THIS APPLICATION BECOMES A PERMIT WHEN APPROVED " .' - San Joaquin Valley Air Pollution ('ontroll)istrict - \\ \\,\\" va I kya i r.org I I þ<{ I I ",,1 I Pcrn,it Application For: ,\111/ ( mllY T() ( '( )NSTI{I I( T (AT( ') - Nnv Fmissiolll ¡lIit. ,\ I I'll ( )1{ II Y I ( ) ( '( )NSTR I ¡( T (AT( ') " !\,lodirlGHIOII or h1llssillll I illll \\1(11 Va IJd I' '( )fV JIHI An' 1\ II III( )IUTY T( ) ( '( INSTR lJ( T (AT( ') 'Rt'III'wal or Valid Atllllollty "I Cflll~tIIH,t. I ", I~ r-.I 1'1' 'I( ) (,~I'I ':J<:~DL!!:l~!.L,__~,,,,,,,~,c,,,: !':''.~,~.!'!,I~Lj'I~~:"!21!,~!~','r:~'~ R \ "'q},I,'~~"I,~~:,~~~"::.'!!~~~"!~~"~.~J;;:;3,~~"~,~~,~"", 1'11,1\111 '1\) 1111.\\1 III) 'II I ,~1bc:/( d/1/.:.~ rvJ ,;?/J / !-- __..._/ / F 6:.:_.. ,.~. ._...-.." .~...... ......" ...~_,_. ,.___..__.__..___________. _________ _.____._ .. . . SØck¿-}IfJe II/v,/, S 1MI' (1/;, ;t,~)i~i~i) .. 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III: OI'LRATU) -rç-19 -0 e- S I HII I ('IY \~IIIIIN 1,IIOí) 1'101' A ::il î II I( M YFS I I NO -~-_.-..._-----_.._...._....._----~.__."._,_. -..-... \()WNSIIII' , IC\Nljl SIC ('()),(S)OF r¡\(îlHY , n'____ ,'_____m'_......____ ,_...._.._"_..__..,,__,__, _,_.._..___ "_.... .,'_...._ _~I~~.~~)"!..I~~~.=il.~!.._.??_,__ ,¡ (iFNŒ¡\1 NATIIRI: OF IIIISINLSS, ¿t:Jjt/¡'/. -:7 ¡;;/e-- ~,/;(; ,ç::;v. -'/" ,19' INSTAl f (),\'IE .. _, ....'n..., .__.,____ .....__ _ _.. ___,_....__...._m_..'...__________.._...,£-..fl_,~.._____....._....,..,...___....... ,.._.._..... ..,...., ,.. _...._,_....__..__... ..,..___ ,\ TIII.F V I'!:I{ "'11'1 III )1.1 )LRS ON I Y 1>0 you rcqucst a (:O( 't 1':1' A Review) 111 lor 10 receiving your AT( '" t I \TS I I NO 1·1 \11 III,¡"'¡ _...~- -.--.--. -_.._._---_.~ . ... '¥---.-.'.- -..... .. _._-.---_...~-_._._---_.__.---_.__..---_._------~--_.--_.....".._..__._._"._~.._. ...-_._._".-._~.- ._._._~.,..._~._..._- --~-~ (0 I )I'SC,UI'TION ()I' H)I/Il'i\ILNT OR '" 101>/FICATION FOJ{ WIIICII AI'I'I.ICATION IS MA1>E (indtllk f'<'flllir //''s ,I' known, and usc a,ldll,,,,n.lt sIIl'eh" neees',;IIY) _ IR J) ¡ ," /' 1/# ø;JL:J, ,/J~C:f¿:?//¿::'~.? - & !W" :f'¡.-L5'Î/:J J-./.-- /Vé~ /-,lJ k t r 1111..5 e. J- 1'/1/~/\ If:::::-, / '/,,..:../, , 'J If¡td Re 1"1 e- II; Il5 e ff lA' /Tl? f)cvþ e- v{//fl/ '/i/Jé',f'_ C,,'-/1~" /J I e /J,p'.5/kJ /.~ 11)/- VII/oj( F§4//I/pe/JÎ / S' PÆIY//ÁJC; ""'" .., _._-..__..._-_.-.._...._----_._._....~. ~.--.. ..~___......___...._~. .+ __u_._·____.__ ..__.~.._..__ _ _ ".'. ... .....__._._._.___....______..._.. .- ..-..-. ...... ........~..__..._-_._.....- ......---..-......-. _.. ..-,-....-. - ...-....-......-..---.,...- 'i 1\ TillS 1\ 1'1' I. ( ',YIII.lN SIIIII\II 1'111) AS '1111 ¡{lS\ liT ()' UTIILR 1\ NI),H ï: I) VI\ )AII()N I * A N( lilt T T() ('I )1\11'1,\"/ I YES )4NO IfYI's, NOV/NTC II, Op/ional SediulI 10 \'III\( \\IILIIIII< nil I :\1<1' A I'AI< 111ï'..\N r IN I'IIIII'R 01' 1111 Sl' \ OII.JNlAl( Y "I<()I ¡1(..\~I~ "SI'¡\RI~ TilE AIR" lYe,; I INt) I ISmd IIIIÜ "INSI'ITî ., IYc,; I INn I Selldlllfu I~I\\FJ <:.. ~' ),'AII\ c' (VL- (7 7 11:\ VI: Yot I IV I I< /\1''''"'/1 H )/, AN ATC 01< I' '() IN '1'111 PAST" J><i YES IN<) I t yes, AT( "/1''10/1: I ~'ES I NO S Is '1'1 tiS PR( WI'< IY I( INt'!) I'I{( Jl'1'J<I,Y I,()< TIIII'IWI'OSIJ) I IS I,." -....--..-....-.... -... -... ..-....... .-.-.-.., ..-...-.,,-.......-... . _~·_.M_.._··....____._._... _...._.. ..,_~ ..... _..________.__.__.._._____~.__...._ "--_._'-'.~-'-_.- --.---..-. ~-_.__..__..-._._-.._._-----,--"_._-_....- _.H____~___.___.____._____.__.H..~______,.~._...._ II 1\'1'1 Ol{ I'IUNl NAI\II:1 II: AI'I'I.I11NT ,TITLL OJ AI'I'LI( :,\NT __,&¿hqUJ.)d~¡¿ kilC20...º_......_,..,____,.........._____,_._._'-:fJ :.J L2:J.2!L.- Pj¿!Z?~lJ? ¡¿ ---'?J""-"--'- I: S(iNAIIIRI (II AI'I'II(.;,t\NI IMII /'110'\1,;' ((,/>/) t?,f..?'?-'_)/BL/ ..., jJß¡J, j¿~~~~~ß,~__..___,,~_~~=~.~~===_~-~~~~- . ::~l~~:_,..~:~~_t~_:~~..~.:~~~~-,-_-~ FOR Al'l 'I) I 'SI: \ )NtY "'.. ....."... -.. . -.-..,-.-~._. ...._-. ........~_.. .... ._.:::.._.;-:.~::..::_:::;::.:-_::=::-....::..H-:-.::.::;;:;;::;.==:..==_~=~-::.',_::==;;;:;...;:.:.;.;:;;:.;=:::::.;;::;........=;;..;:=~=-:...:.;.;::.;::.;=;:;:.;;...;.._:..~.;...:.:::;::__:::::;:.::;.H_"';.-.:.~.;..;;_.:;~.:.'.;.~:::..::::....-=".:=:.;:_-:::;:::::..:::;.,:.;,.-==::.~===.===::-: 11:\Tt Sî ""'II' FlI.INC ì I'IY RLCElVEI): S t:11I:CK , .___ _._ .... .u_. IJ:\TE PAID: PROJECT II: .__.._...n_h.. ...__~ FACILITY III ........_--...-.._~_....-"_. .--.. .-_H·...'7.:":-.-::::.:::·~~:,.~..=~__:::=.:;_~::._::=~.=..~-_====_...=;::;::.:.;;~~~:.=·~.=-.=.:::=.-:::.'-7'.-..::;;,-;.;~.=::=:-..::.:.:;;.;:...::.=:-.::..~.:=:_..;:::::~..::.__ NOlthCIII Rq~I"",11 I IlIlle · 4!.,W Klerll;111 Avt'fHle, Suite 130' Modesto,Callfornia ')),\:'ih-'),\21 · (20') ))!,MOO · FAX (209) 557·(,475 ('I'lIlf,III{I'!~ll1nal OITil'1' · 1')')0 Last (ieltyshurg Avcnuc' Fresno. Calif(¡mi:1 ')j72()·0244 · (559) 2\0,5900' FAX (55'») nO-(JO(d S'"llhl'llI Hq',illll:II (Jlflll.' · :' ¡OO 1\1 Stl n'I, SlIite 2"15 · Bakcrsfìcld, C;¡I ilì)(ni;¡ 'J .no 1,:2 ,170 · (h(, I) V(,.(,')()O · ' AX ((,() I) 32(,.(¡9R5 Jll\ IIII)!I":H) 'i; :0 e e Phase I Vapor Recovery System Manufacturer: W So" - ç ;; e ¡;¡ l'e.5 CARB Executive Order Number: ø t/ ~2 Component Manufacturer Model Number Spill ContaInment Bucfcet (Product) Spill Containment Bucket (Vapor) _;- ,/ ~ Debris Bucket (Product) Dust Cap (Product) Oust Cap (Vapor) (.I Debris Buoket (Vapor) Rotatable Adaptor (PrvduGt) Rotat8ble Adaptor (Vapor) Drop Tub. II II PressureNacuum Vent Valve Extractor Fitting Ball Roat Vent Va~e Additional Equipment Not Listed Above Phase II Vapor Recovery System Manufacturer: SyatQm Type: CARB Executive Order Number: Component Noule Coaxial Hose Breakaway F/ltfng . t( f(. Dispenser 6, L.lJ~ç!t2__ Additional Equipment Not L.lsted Above o Balance acuum Assist o Burner M.nufa~ur.er tJ ¡J tV Model Number ,"-'. 3 J ':> tJf e~7 7, e e San Joaquin Valley Unified Air Pollution Control District Supplemental Application Form GASOLINE DISPENSING ¡cation fo, Autho' to Construct .nd Permit to 0 erøte form. Permit to be issued to: \ S/i;J¿j(d/J Je- f}1L?þ/'J Location whore the equipment will bo operated: ð I/n})-Sj e,/l f¿ 8 /1_,._..__ Current Permit to Operate number (if applicable): S'-'p72 Instructions 1 ì Complete a separate form for each tank and dIspensing sysl8m whIch has a different type of Phase I or Phase 1/ vapor recovery system with as much infonnatlon .s po.slbl.. 2 Attach It copy of the site plan showinll underground fue(ä"d vapor lines and location of dl.penser island.. Note: Informlltlon on Vapor Reçovery Executive Orders I. available online at: WVM'.arb.ca.QovlvaDOrlvaDorhtm (oJ ~ ~ I~ ~ ~ ~ '~ ~ Gasoltne Storage Tanks and N,ozzles Quantity of Type of Tanks Capeclty In Gallons Type and Grade Tanka ¡C.'lcJC1I One for ~tI.;i' Tani\J (lrn1JcatØ It SpIll TaiWiJ of Fuel /l ---~ I//J/e-/f;j Jle¿;r JAíUnderground :J AbovegrDund" 10 Pi? 0 ( 2 J(Underground . I, o Aboyeground· , f I( )3 )( Underground o Aboyeground" ( I ,/L --'...,- I ( W~.p? ¿~ ;&'Underground :J Aboveground" I f Þ¡'ëYe,t C_ --- Total Number of GaaollneDlspensers: n - r Total Number of Gasoline Fueling Points: 13 'M,lIimum nL/r.1bt>r of v&hicl96 w/Jich C&i'I be fuÐJOO (, one "mo. .'lCrmø/ly two v8h~l6s 0fN dlSDflII&ert Totall Number of Grleo'inø Dlspenltng ,Nozzles: f6 IDo not incluœ DiMs!,! Total Number of VlpOr Reçovery Instruction Signs: B ,'Sf:uúlà tJ8 clearly rfiaaablB from 9'I9fY fuel.ng PiJin'j *For Ab~v.grbun~ Tan~1 Man"'-c:turer: CARS executive Order Number:, PLEASE CONTINUE ON REVERSE S!DE 7/01 -\ :\ \ ~ \.9 Q:: '-- e - :I:(/}I O(/}I zw WZ1 a::~ 1-0' lL,.::I:1 ol-i iE~1 0.« w+ 0: o .C'\ Z -(/) ~- GRAVEL BACKFILL ~ . TO PAVEMENT \ PAVING VARIES : Z <D- ~ VAPOR RETURN UNE PRODUCT LINE PRODUCT LINE UNDISTURBED SOIL OR COMPACT TO 95% NOTE: ALL PRODUCT PIPING TO SLOPE BACK TO TANKS @ 1/8" PER FOOT MINIMUM GRADIENT. ALL VAPOR RETURN PIPING TO SLOPE TO REGULAR UNLEADED TANK @ 1/4" PER FOOT MINIMUM GRADIENT. TYPJCAL PIPE BURIAL DETAIL PIPE-BURIAl- TYPICAL-SINGLE ) !\l ~ '-.9 ~ - d e e 3" TO 2" F.R.P. CONCENTRIC REDUCER WHERE APPLICABLE (TYP.) 3" FIBERGLASS VAPOR RETURN LINE (TYP.) 3" 90' ELL ----- 3" TEE 2" FIBERGLASS DOUBLI;_WALL VAPOR RETURN LINE ~ CLAM SHELL r:: L - ::1 REDUCER -1'- I I -... 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I I - r---- -4-_ -,,---~, -l-t---, .....l.~-L..J.........L.... : i i ¡ r _.+---:--,-t-- I , .1" _!.=F' '.. -, --1--,-L- ~~" ----- i I ' I ' , . --\---,! f : I ¡ I , T-----¡ -.-~._-+-- , I : i f, , , I - -1'-- ---¡ ----:-- -- ._-- ~- - , +-+--- 1 I I , -+- ~ -'-'- -- 1 1 I I ·1 -, , -, '-S . ~\-S- ~W-", ,-.(. ~ <tI:.~ ~~ ~~ I I 1 i l , 1 \ . " - !- ð ~ , I f'\ ........tk ~"(;;/-I-I-~r,v r¿¡ " I ~ I , , - f _" ''''" - - '''__ " I (!.t7¡u(!1R01è_~Df(L¡?f¡d, € {!lJ¡tj()/(ï·"t~,:¡v~ , t.- ~ I, ....J__ I ' , i -----\------..--,--~----"-~.--- - , + . f'--'" 7 i \ / -.¡.--- -- -- " ' -- -- ' -- ,~ ,m -+ -T ~, - -~--- --+- .;.., < --- d~ 1-- ,. -'-L''''------ - - -~_.- __ -'1----- ! --t-- .__ '03/30/2004 09:55 66139.1 - PAGE 01/01 *COpy REQUESTED PLEAS~ FAX(661)392-0621 C:[T¥:O;F BAKERSFmLD OFF~CEOFENVIRO~NTAL SERVICES 171$ Chester,A;,f~, B,akerstleld, CA (661) 326...3979 ' FAX (.~ 61) i:; 1. -1..} 7 "2. APPLICATION TO PERFORl\lI FUEL MQNITORlNG CERTIFICATION FACILITY (Ý\(\Iß\ l", . ~:. ADDRESS I ~D~ ~~r£.,..~"'I- ß~\-CtJ<S:=ŒJJ) OPERATORS NAME °rO()l(j (' ~ OWNERSNAMB ;11JVÎll'1 . CMf;> I ,: NAME OF MONlTOR MANUF~ DOESFAcn.rrYHAVEDr.sPENSER.P~? YBS~ NO_ TANK', ----L- 2- ~ i.-/ : VOLUME , , [I (), (~)Q ", : 10 (XX':? I I: :(,O.. C)r)Q . I ., : It) 00().. I , :' ; CONTENTS U(JL~ .- f?t1.s,- ¡Ant... ~'J;- W£5T 1J1t5$f L , --»E1Y1..&f I. " .. ~ . NAMEOFTSS~aCQMPANY RI,Çij' I'VTRQNM~þT~~L . , CON1RÂcroRSUCENSB~ 90-1072" ' . ..': . :' l' III NAME & ,PHONE N~ER·OF: CONI' AC'1',fijRSON JAMES RI CH DATB&TIMB.œnISTOBECONDU~¡ . ~/~J}Ò~' '.;' , ,It fhtuJrßQ r~~P687 . APPROVED BY 3!30i6c{ I ,7\ , P"''f£,~~; . ~anUf)mc.L' SId ATDRE OF APPucÀNT " , ~.:. '. ,t./ , wAiEN MONITORING PR.EDURES UNDERGROUND STORAGE TANK MONITORING PROGRAM This moaitol"ÍJlg propam IDUII be kepc at the UST location It aU times. The ÎdmDIIion on thÎllIICJI1i1ariDa program are coadåÙODl of the opcrariD¡ permit. The permit bo1dcr IIWIt aoâtY the 0fIIc:e of EDYironn.........1 Services 'within 30 days of aD)' clut"r to the moaitoring procedures. UD1ca required to obCaiD appronI before nuln", tile dwlgc. RcquUed by SectiODl 2632(d) aud 2641(h) CCR. ~=~ ,¡~~~& ,~¡; ffw~ i!'di. (6,11. ~]51 L A Describe the fi'equency of perfonning the monitoring: Tank ~C\IA lUAlJa:"" , Piping ~(){A...h"ut.I· t1 B. What methods and equipment, identified by name and model, will be used for perfomiøg the monitoring: Tank ~LAA dtti~t-· tllll\t TL~, 3ÇO Piping tL l( C. Describe the location(s) where the monitoring will be performed (tàcility plot plan should be attached): , . At ~ D. List the name(s) and tit1e(s) of the people responsible for performing the monitoring an, dJ,or~' .. gthe equip.~~t: ~~ ~ "()W~== __~ Ou)~___ E. Reporting Fonnat for monitoring: Tank t.LIM. Piping r L tvL F. Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance mUJt be in accordance with tbe manufacturer's maiate...nce sc:bedule but DOli!" th~D every 12 mODtId. !: w,... 'td r I{){ t. !b..(q. (ó,n~ I r G, Describe the training necessary for the operation of. ST system, including piping, and the monitoring equipment: .. It It EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PR,OGRAM This monitoring program must be kept at the UST location at all times. The infonnation on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures, unless required to obtain approval before making the change. , Required by Sections 2632(d) and 2641(h) CCR Facility Name .fuJukJ', ~ ~bj Facility Address ~ ~~, ~'f ß\c(:6. ~..A. q:~.,?{ "') 1. If an unauthorized release occurs, how \\-111 the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up trom the secondary containment within 8 hours, or deteriorate ~:~~;~eifOf~"1~en~ª~~:;rifi~ LU~o(~~}~( 11IlL:!~:}k,r ï~ : k~~~ -= £roA{. ____Ie 2. Describe the proposed methods and equipment to be used for removing and proper! disposing of any hazardous substance. , , t d- . 3. Describe the location and availability of the required cleanup equipment in item 2 above. {HI\. ~t\ rt l;~J(.. ø 1- ('1 ( I -1--( 0.";¡ , ( 4. Describe the maintenance schedule for the cleanup equipment: ~~( J ¡ It1 L'b., , 5. List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: N1 V\.l-\ V\ C ~ ILfA () u/ /It e.r-- t:'e ~ ,0h/.LU 0 LV VI Ø1r . CITY OF BAKERSFIEY.l¡ 'ðFFICE OF ENVIRONMENTA.ERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY TYPE OF ACTION (Check one item only) o 1, NEW SITE PERMIT D 3, RENEWAL PERMIT 'ill 4, AMENDED PERMIT o 5, CHANGE OF INFORMATION (Specify change· loca/ use only) D 6, TEMPORARY SITE CLOSURE Page _ of _ D 7, PERMANENTLY CLOSED SITE o 8, TANK REMOVED 400, BUSINESS NAME (Same as FACILITY NAME or DBA· Doing Business As) I. FACILITY I SITE INFORMATION 3 FACILITY ID # 401. \ d.. FACILITY OWNER TYPE D 1. CORPORATION )!t 2, INDIVIDUAL o 3, PARTNERSHIP D 4. LOCAL AGENCY/DISTRICT" D 5, COUNTY AGENCY" D 6, STATE AGENCY' D 7, FEDERAL AGENCY" 402, 1, GAS STATION D 2. DISTRIBUTOR TOTAL NUMBER OF TANKS REMAINING AT SITE o 3, FARM D 5, COMMERCIAL o 4, PROCESSOR D 6, OTHER, 403, Is fadlity on Indian Reservation or trustlands? 4 404, Dyes ~o "If owner of UST a public agency: name of supervisor of division. section or office which operales the UST, (This is the contact person for Ihe lank records,) 405, 406, II. PROPERTY OWNER INFORMATION , ! PROPERTY OWNER NAME 408, 409, ' 11'- .e... 410, ZIP CODE q3312 412, ø' 2. INDIVIDUAL D 3, PARTNERSHIP o 4, LOCAL AGENCY / DISTRICT D 5, COUNTY AGENCY D 6. STATE AGENCY D 7, FEDERAL AGENCY 413, i.1II~ TANK:OWNËR INFORMÁTION . -'. .. . , I 415, 416, 417, STATE CI4- 418, 419, D 1. CORPORATION 2. INDIVIDUAl D 3, PARTNERSHIP o 4, LOCAL AGENCY / DISTRICT o 5, COUNTY AGENCY D 6, STATE AGENCY D 7, FEDERAL AGENCY 420, INDICATE METHOD(S) 1'3 1, SELF-INSURED o 2. GUARANTEE o 3, INSURANCE IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER Call (916) 322-9669 if questions arise .',', , ,:~:rj'e~. PETROLEÙMUSTFINANtîACRÉS¡:t6NSII311.JrY ., ~. . ..., .,' ' " .' '. ' ',. 421. TY(TK)HQ D 4, SURETY BOND D 5, LETTER OF CREDIT D 6, EXEMPTION ~ 7. STATE FUND , D 8, STATE FUND & CFO LETTER D 9, STATE FUND & CD '. D 10, LOCAL GOV'T MECHANISM D 99, OTHER: 422, VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate which address should be used for legal notifications and mailing, Legal notifications and mailings will be sent to the lank owner unless box 1 or 2 is checked, 1K' 1. FACILITY D 2, PROPERTY OWNER o 3, TANK OWNER 423, VII. APPLICANT SIGNATURE 424. 425. 426, 427, 428, 429, UPCF (7/99) S:\CU PAFORMS\swrcb-a. wpd ,~ "~ ,.~'" ' ,,~. , A.'. ......... ......... '-- -- .-. .. CITY OF BAKERSFIEy! OwrCE OF ENVIRONMENTAL_RVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326..3979 UNDERGROUND STORAGE TANKS· TANK PAGE 1 (S _ ell -, TYPe OF ACTION (Ch.cll 0'" ,,.,,, only) CJ t. NEW SIT! PERMIT ~.. AMENOEO PERMIT o 5. CHANGe OF INFORMATION) p. o S, TEMfIORAAY SITE CLOSURE o 7, PERMANENTl v CLoseo ON SITE o S. TANK REMOVED 4- CJ J. RENeWAL PERMIT J (Sp.uy __ . for IOaI u.. only) (Sþedy ~ . for IOt:M u.t. only) BUSINESS NAME (s.ne.. FACILITY NAME ot D8A . DOIng.... AI) \1ÛÐ ( " TANKID. Mm{b!JL ~, ~Jt- , I. TANK OESCRIPT1ON 43 9J 3 I 2- ! DA IN ALLE I j ADOITIONAL DESCRIPT10N (FoI1Ot:M _ only) i TANK use 43t i'fÍJ.. t. MOTOR \IÐfICU FUeL I (JfnYrlred. __lit PNMc.tn 7)pe) , 0 2. NON-FUEl PETROLaJM I i a J. OIEMICAL PROOUCT I a .. HAZARDOUS WASTE (IndulIN UIed (1) a 95. UNKNOWN ! TYPE OF TANK I (Check - item only) i ! TANK MA TERW. . prtrMIy IIinII 433 COMPARTMENTALIZED TANK av.. 'Ø Na " 'Y.... compleCe one ø. (ot NCh aJ¡Paltmenl NU 437 4~ 438 438 o II. TANK CON'1'ENTI P!'mOL!UM TYPE o t& A£GUtAR UN.!ADEO 0 2. LEADED o 111. PReMIUM UNl£ADED 113. OIESEL a 1c. YDGAADE UNLEADED a 4. GASOHOl COMMON NAME! (/I'om HuMdocø ../ItrleIs ItIWfIIOty ".ge) a 1. SINGLE WAU. .,. 2. DOUBLE WAU. at. BARE STEEL a 2. STAINLESS STEel I (Check one item only) ¡ TANK MATERIAL . ~ IIinII 0 1. BARE STEEL (Check _ i/IttrI only) 0 Z. STAIHU!SS STEEL 0, 1. AU8IER LINED o Z. AIJM) LN«J I' "NOla WALL TANK (CIIet:It.. tile, eppIy): o t. VlSUAL(1XP01fO PORTION ONLY) o 2. AUTOMATIC TANK GAUGINO (ATO) a J. CONTINUOUIATO CJ .. STATISTICAL INllENTOAY Al!CONCIUATION(SIA). 81ENNIAL TANK TUTIHG 440 o 5. JET FUEL EJ 8. AVIATION FUEL a 99. OTMER 441 CAS' (from ~ "/ItrleIs Inventoty".ge) 442 II. TANK CONSTRUCnON a 3. SINGLE WALL WITH EXTERIOR MÐ&WIE UNER a 4. SINGlEWAlLINAVAULT o 5. SINGLE WALL WITH INTERNAL IILAODER SYSTEM a as. UNKNOWN a w. 0'J10tER o 5. CONCRETE 095. UNIOIOWN a 8. FRP COMPATIBlE W/100% METHANOL a w. 0'OiER 443 TANK INTERIOR LINING OR COATING 9" 3. FI8ERGLASS / PWmC a 4. STEEL ClAD W518eRGLASS ReINFORCED PWmC "$ 3. FI8ERGtASS I PlASTIC o 4. STEEL ClAD W/FI8ERGI.ASS REINFORCED PlASTIC (FAP) a 5. CONCRETE o 3. EPOXY UNHG 0 5. C3t.A88 LINING 0 as. UNKNOWN o 4. PHENCUC LINING ~ .. UNLINED 0 W. OTHER ... 3. F18ERGtASS AI!INFORCED PI.ASTIC 0 as. UNIOIOWN 448 CJ 4. IMPRESSED CURRENT 0 W. OTMEA 444 a 8. FRP COMPATIBlE W/100% METMANOl. I:J 8. FRP NQN.CORROOIBlE JACKET a 10. COATED STEEL a 95. UNIOIOWN I:J 88. OTHER 445 448 ~TE INSTAUEO 441 /oQ/ - ~TE INSTAUEO 449 o t. MANUFACTUAI!D CAntODIC PROTECTION o Z. SACRIFICW. ANOOE V1!AA INSTAlLED ¥-t. SPILL CONTAINMENT ,,( 1p- 2. DROP TUBE q C\ t:i 3. STRII<!R PlATE 'Iç (Check _ i/IttrI only) SPILL AND OVERFILL (CIt«II .. INIIPPIY) (For IoI:aIIIM only) 45t OVERFILL PROTECTION EQUIPMENT: V1!AA INSTAUEO 452 o ,. AlARM 'jlJ 3. FILL TUBE SHUT OFF VALVE K- I:J 2. BALI. FLOAT 0 4. EXEMPT 450 TYPE (For 1oI:aI_ only) ....._ ..._ _., "___·0 . :.~( ~r~~..:~:;~:·~~~~;::~~'::.·~:::··' :.-:: :,'. ....: . :~?1'~~,:·'/)~::~:'· ",::: /. .":::..:,~.::'?:~/~~~~~.' I ., oOueLl WAU TANK OR TANK NTH ILADÔÏR (ch.ør 0IIII1IItm ØfIIyJ: 454 a t. VlSUAL(SINOU!WAlLINVAULTONLY) 1:$ 2. CONTINUOUS INTERSTITIAL MONITORING o 3. MANUAL MONITORING o 5. MANUAL TANK GAUGING (MTO) I:J 8. VADOSE ZONE I:J 1. GROUNDWATER a 8. TANK TESTING OW. OTHER .- ·V.TANK CLOIURI! INPORMATION I PIRMANINT CLQIURIIN'PLACI!- 418 IITIMATID au.wmv OF SUBSTANCII RIMAININO 418 TANK FIW!D WITH INERT MATERIAL? fISTIMA TED DATI LAIT U8IO (YR/MOIOAY) UPCF (7199) 451 IIIIIortI ay.. aNa S:\CUPAFORMS\SWRCs-e.WPC /~ ~ ~#" ': ~ : . _ CITY OF BAKERSFIELD . OFFICI OF ENVIRONMENTAL SERVIC. 1715 Chea.... Aw., B.k.,.fI.ld. CA 93301 (H1~79 UST. TANK PAGe 2 ,.. d - - " ' UNDERGAOUND PIPING vL ...... CONSTRUCTION (CIttcII "lIIat WI1J ABOVEGROUND PIPING : SYSTEM TYPE! , PRESSURE 0 2, SUCTION 0 1. GRAVITY 458 0" PRESSURE : CONSTR,UCTlO~ " SINGLE WALL 0 3, LINED TRENCH 0 91. OTHER 4eO 0 1, SiNGlE WALL : MANUFACTURE",! ~ 2. DOUBLE WALL 095. UNKNOWN 0 2. DOUBLE WALL Ii, MANUFACTURER 481 MANUFACTURER : 0 1, BARE STEEL 0 8. FRP COMPATIBLE W/I~ METHANOL 0 1. BARE STEEL I MATERIALS AND !O 2. STAiNlESS STEEL 0 7. GALVAHIZEOSTEEL 0 2. STAINLESS STEEL I CORROSION I , PROTECTION ¡ 0 3. PlASTIC COMPATIBLE WITH CONTENTS 095. UNKNOWN 0 3. PlASTIC COMPATIBLE WITH CONTENTS , !'$= 4. FIBERGlASS ~ 8. FLEXIBLE (HOPE) 0 91. OTHER 0 4. FIBERGLASS ; 0 5. STEEL WI COATING 0 9. CATHODIC PROTECTION 484 0 5. STEEL WI COATING VIL ~ LEAK DETECTION (ChedI ,,1IIat~} UNDERGROUND PIPING U! WALL PIPI 488 PRESSURIZED PIPING (CIt«k " lllat ~J: o 1. ELECTRONIC UNE LEAK DETECTOR 1.0 GAt TEST mII:1 AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM 0ISC0NNECT10N · AUÐIBlE AND VISUAL ALARMS o 2. MONTHLY 0.2 GAt TEST o 3. ANNUAL INTEGRITY TEST (0.1 GAt) CONVENTIONAL SUCTION SYSTEMS: o 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAl PIPING INTEGRITY ¡ TEST (0, I GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, SELF MONITDRING GRAVITY FLOW: o 9. BIENNIAL INTEGRITY TEST (0.1 GAt) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check" that apply): 10, CONTINUOUS TURBINE SUMP SENSOR mnt AUDIBLE AMJ VISUAL ALARMS AND (C/1edc one) o a. AUTO PUMP SHUT OFF V\lHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LeAKS. SYSTEM FAlWRE N4) SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF I ,. ~~~~~INE LEAK DETECTOR (3.0 GAt TEST) ï!1!!1 FLOW SHUT OFF OR o 12. ANNUAL INTEGRITY TEST (0.1 GAt) SUCTIOKlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ON&. Y (Chedr" "" tppIy) ¥ 14. CONTINUOUS SUMP SENSOR ~AUTO PUMP SHUTOFF +AUOI8LE AND VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GAt TEST) mII:Q!l[ FlOW SHUT OFF OR RESTRICTION o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17, DAILY VISUAL CHECK o 2. SUCTION o 95. UNKNOWN o 99. OTHER o 1. GRAVITY 45S 46: 463 o 8. FRP COMPATIBLE W/IOQ% METHANoL o 7, GALVANIZED STEEL o 9. FlEXIBLE (HOPE) 0 99. OTHER o 9. CATHODIC PROTECTION o 95, UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (CIt«k " lllat 8ppJy): o 1. ELECTRONIC UNE LEAK DETECTOR 3.0 GAt TEST mII:1 AUTO PUMP SHUT OFF FOR LEAl<. SYSTEM FAILURE. AND SYSTEM DISCONNECTION. AUDIBLE AND VISUAL ALARMS o 2. MONTHLY 0.2 GAt TEST o 3. ANNUAL INTEGRITY TEST (0.1 GAt) o 4. CAllY VISUAL CHECK CONVENTIONAL SUCTION SYSTeMS (Chedc" that 8ppJy): o 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 9. TRIENNIAL INTEGRITY TEST (0.1 GAt) SAFE SUCTION SYSTEMS (NO VALVES IN BelOW GROUND PIPING): o 7. SELF MONITORING GRAVITY FLOW (Chedt" that 8fIP/y): o 9. DAILY VISUAL MONITORING o 9. BIENNIAL INTEGRITY TEST (0.1 GAt) SECONDARILY COflT'AlNED PIPING PRESSURIZED PIPING (Chedc" lllat apply): 10. CONTINUOUS TURBINE SUMP SENSOR mIl:! AUDIBLE AND VISUAL AlARMS AND (CI1ec:k one) o a. AUTO PUMP SHUT OFF V\lHEN A LEAK OCCURS o Þ. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAL INTEGRITY TEST (0.1 GAt) SUCTIONlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONlY (ChedI" that 8PPIYI o 14. CONTINUOUS SUMP SENSOR ~AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL AlARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GAt TEST) .'::~" ,~. ,:,:<.:,<::Xifärã~ ~ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUOI8LE AND VISUAL ALARMS o 3. COflT'lNUOUS DISPENSER PAN SENSOR mntAUTO SHUT OFF FOR DiSPeNSER + AUDIBLE AND VISUAL AlARMS IX. OWNER/OPERATOR SIGNATURE I certify lIIellne inlonnellon ptOIIIded IIereIn Ie true 8IICI 8CCUt8Ie to die ÞeeI d my knowIecIge. SIGNATU OF OWNERIOPERAT DISPENSER CONTAINMENT DATE INSTALLED 488 ;}oo ( 471 472 DATE 470 e. 474' PetmU&pItItIonOlle(Forløcalu..onty) 4751 I Perrrnl Numb« (folloW UN only) UPCF (7/99) S:\CUPAFORMS\SWRCB-Ø.WPO a CITY OF BAKERSFIELD OJIIPICE OF ENVIRONMENTAraRVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326..3979 UNDERGROUND STORAGE TANKS - TANK PAGE 1 TYPE OF ACTION ¡Cllee. 0'" ,'-'" 011/1} o t, NEW ,ITE PeRMIT ~ .. AMENDED PERMIT o 3. RENEWAl. PeAMIT o 5. CHANGe OF INFORMATION) P-.¡e ~ o S. TEMPORARY SITE CLOSURE . o ], PERMANENT\. v CLOSED ON SITE o S. TANK REMOVED .: s aUSINESS NAME (Sam... FAClUTY NAME at D8A . 0QIng 1IuIIneII.48) 3 (~__ . for IOCM un oNy) \30() ( I TANKID. ~~~lbLJc f/wy I. TANK DESCRIPT10N i TANK USE 43t i~ " MOTOR VÐtIQ.E FUEL ¡ (If",.md. __.."....." r,p.J , 0 2. NON-FlJEl PETROlEUM I I 0 3. CHEMICAL PRODUCT I 0 .. HAV.RDOUS WASTE (1ItcIudN I Used 01) 095, UNtcNOWN" 10 f)()O .. TANK CON1Ðfr'8 PE1'ROlEUfot TYPe '!P-1.. REGULAR UtI.EADED 0 2. LEADED o 1Þ. PAÐoIUM IJNI.EAOED 0 3. DIESEl o 1c. ~ UNLEADED 0 .. GASOHOl COMMON NAME (from ~ """"tMlnlOly".geJ o 1. SINGLe WALL l1i2. DOUBU! WALL .. TANK CONSTRUC11ON o 3. SINGLE WALL wmt EXTERIOR MEMBRANE UNER 0.. S!NGlEWALLINAVAULT ! TYPE OF TANK I (CMcIr - ifIIm ødyJ i ¡ TANK MATERIAL . tIIMry tIN 0 1. è.w: STæL ! (CIHIck_iIMI01I/I 0 2. STAlNLESSSÆEL I I TANK MATERIAL· -*y ** 0 1. BAR! SÆEL (CMcIr_ iIMIødyJ [J 2. STA1NL!S8 STI!I!L (CMdt _ iIMI ødy SPtLL AND OVERFILL fCllee. .. INI ~ þi3. FIBERGLASS I ~ o 4. STEEl CLAD W518ERGlASS R£INFORCED ~ 3. FIBERGlASS I ~ o 4. STEEL CLAD WIFI8ERGlASS REINFORCED ~(FAP) o 5. CONCRETE o 3. EPOXY UNINO CJ 4. PHENOLIC LININO [J 1; AU8IeR LN!D [J 2. ALJM) LJNINØ 3. FIBERGlASS REINFORCED P\ASTIC o 4. IMPRESSED CURRENT 450 TYPe (Fot toc.J ~ ødy [J 1. MANUFACTUREDCATHODIC PROTECTION [J 2. SACRIFICIAL ANODE YEAR INSTALLED ~ 1. SPtLLCONTAINMENT ft 2. DROP TUBE lB 3. STRIKER PlAT! 4J COMPARTMENTAl.IZ£D TANK 0 Vel No 4J.> If -V... complete one pege'at ucn partmenl. 4J~ TANK INTERIOR LINING OR COATING I 438 440 o 5. JET FUel EJ e. AVIATION FUel 099. OTHER 4041 CAS" (ftom HMtIrtlou"'''''''InvMfoIy".ge) ....2 o 5. SINGlE WALL wmt INTERNAL IIlADOER SYSTEM OM. UHI<NO'NN o ft. OTHER o 5. CONCRETE 095. UNI<NOWN o a. FRP COWATIBlE wt100% METHANOL [J ft. OtMER 443 444 o e. FRP COWATlSlE WI100% a.tmtAHOl o 8. FRP NOH-CORROOISlE JACKET o 10. COATED STEEL o 95. UNKNOWN [J ft. OTHER 445 o 5. 0lA88 UNING ~ UNLINED 448 DATE INSTALLED 4047 OM. UNKNOWN [J It. OTHER 'Fotlot* _ DATE INSTALLED ....9 OM. UNI<NOWN o It. OTHER 448 (For 1ocaI_ onIy 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 01. ALARM ~. FILL TUBESHUTOFFVAl.VE ~ (] 2. BALLF1.OAT 0 4. EXEMPT ,::,~(:t~(LIAK " I' SlNGLI WALL TANK (CMcIf" "", 1iIJItIy: o t. \/ISUAl.(IXPOI!OPOfmONONLY) 02. AUTOMATlCTANlCQAUOIHQ(ATG) o 3. COHTIH\JOUIATO o 4. STATISTICAL INVENTORY RECONCILIATION (SIR) · BIeNNIAL rANI( TIlTING -." ,. ~O;'+- ,.,.- .~.,. ~'. -,,,,", . ,,: '~... :~i:' Zf~é'f:~: ~;~··'~1?i:<·~::. ': ,. . :,< :.,. ....:.: :~i7fr~' "< '~~{.' .. ':'.. .:,:,:."..:::!:::}t(~~-; ,. I '- ,,00,*11 wA;¡ rANI( OR TANK vwrH ~ (~_".", only): 4&4 (] 1. \/ISUAI.(SINQU!WALLINVAULTONLY) 'tl:2. CONTINUOUS INTERSTITIAL MONITORING tf 3. MANUAl. MONITORING o 5. MANUAL TANK GAUGING (MTG) (] s. VADOSE ZONe o 7. GROUNDWATER o e. TANK TESTING C ea. OTHeR "Y. TANK CLOIUU INPORMATIOH , PIRllAHINT CLOIURIIN PLACI!" '" ' 4N UTlMATlD QUANTITY OF SU88TANCI RIMA/NING 4N TANIC FIW!D wmt INIRf MATERIAL? eSTIMATeD GATlI.AIT U8IO('tRIMCWAY) UPCF (1199) 457 ,.,. CJy. ONo S;\CUPAFORMS\sWRCS.s.wPO -,", a CITY OF BAKERSFIELD .' OPPIe! OF ENVIRONMENTAL SERVIC. 1715 Chester Ave., Bak.,.".ld. CA 93301 (H1iW3879 "- ,r..,~ , UIT . TANK "MI 2 Pege _d_ UNDERGROUND PlPIND vL ...... CONSTRUCTION (CIItcIt aI INt tll/lllyJ ' ABOVEGROUND PIPING SYSTEM TYPE " PRESSURE 0 2. SUCTION 0 3. GRAVITY 458 0 " PRESSURE , CONSTRUCTIONlIO " SINGLE WALL 0 3. LINED TRENCH 0 911. OTHER 4ðO 0 " SINGLE WALL : MANUFACTURERifjiL 2. DOUBLE WALL 095. UNI<NOWN 0 2. DOUBLE WALL ! I MANUFACTURER 481 MANUFACTURER 10 ,. BARe STEEL 0 8. FRP COMPATIBLE WI 100% METHANOL 0 1. BARE STEEL MATERIALS AND ,0 2. STAINleSS STEEL 0 7. GALVANlZEDSTEEL 0 2. STAINLESS STEEL CORROSION I PROTECTION 10 3. PlASTIC COMPATIBLE WITH CONTENTS 095. UNI<NOWN 0 3. PlASTIC COMPATIBle WITH CONTENTS ~4. FIBERGLASS ~ 8. FLEXIBLE (HoPe) 0 911. OTHER 0 4, FIBERGlASS : 0 5. STEEL WI COATING 0 9. CATHODIC PROTECTION 484 0 5. STEEL WI COATING VIL ....-.0 LI!AK DETECTION (Chedt allINIt ~J ,. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUOIBLE AND IÌlSUAL ALARMS o 3. CONTINUOUS DISPENSER PAN SENSOR mD1 AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL AtAAMS DC. OWNER/OPERATOR SIGNATURE I cet1ily lIIallll. informallon ptOIItded IIareIn I' rrue 8nd acc:uraIe to II1e beat d my 1uIcMIedge. SIGNATURE OF OWNER/OPERATOR UNDERGROUND PIPING NO WALL PIPI ... PRESSURIZED PIPING (Check allNt ."ç¡Iy): o 1. ELECTRONIC UN! LEAl< DETECTOR 3.0 GPH TEST mItt AUTO fII.UI SHUT OFF FOR I.EAI<. SYSTEM FAILURE. AND SYSTEM OCSCONNECTION + AUOIIILS N«J VISUAL ALARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: o 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIEIINAL PIPING INTEGRITY i TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN øaow GROUND PIPING): o 7. SELF MONITORING GRAVITY FLOW: o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check ItIlNt ."ç¡Iy): 10, CONTINUOUS TURBINE SUMP SENSOR mIt1 AUDIBLE AND VISUAL AI..ARMS AHO (CIIeck one) o a. AUTO PUMP SHUT OFF WHEN A LEA/( OCCURS o Þ. AUTO PUMP SHUT OFF FOR L£AKS. SYSTEM FAlWRE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF 11. AUTOMATIC LINE LEA/( DeTECTOR (3.0 GPH TEST) mII:t FLOW SHUT OFF OR RESTRICTION o 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONT/NUOUSSUMPSENSOR+AUOIBLEANOVlSUALALARMS eMERGENCY GEN!RATORS ONLY (Chedt"'" tppIyJ F'JI:.,4, CONTINUOUS SUMP SENSOR MItQL[ AUTO PUMP SHUT OFF + AUOI8lE AND T . VISUAL ALARMS o 15. AUTOMATIC LINE LEA/( DeTECTOR (3.0 GPH TEST) ~ FLOW SHUT OFF OR RESTRICTION o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT DATE INSTALLED ... ~I NAME OF OWNERIOPERA TOR (pm : I Permit NumlMr ¡For lOcal v.. ollly) 473 I P.,-n" Ap-.cI (For '-' 1118 0ftIy) , UPCF (7199) . ' o 2, SUCTION o 95. UNI<NOWN o 99. OTHER o 3. GRAVITY 45S 46: 463 o 8. FRP COMPATIBLE W/IOC)% METÎiANOL o 7, GALVANIZED STEEL o 8. FLEXIBLE (HOPE) 0 99. OTHER o 9. CATHODIC PROTECTION o 95. UNI<NOWN o46S ABOVEGROUND PIPING $NOLE WALL PIPING 467 PRESSURIZED PIPING (Check althat apply): o 1. ELECTRONIC UNE LEAl< DETECTOR 3.0 GPH TEST mItt AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. ÞH'J SYSTEM DISCONNECTION + AUDIBLE AND VISUAL AI..ARMS o 2. MONTHLYO.2GPHTEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) o 4. CAlLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check allNt ",ply): o 5. CAlLY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BElOW GROUND PIPING): o '7. SELF MONITORING GRAVITY FLOW (Check allNt ."ç¡Iy): o 8. CAlLY VISUAl. MONITORING o 9. 8IENN1AL INTEGRITY TEST (0.1 GPH) 8ECONDARlL Y CONTAINED PIPING PRESSURIZED PIPING (Check ItI /hat øppIy): 10. CONTINUOUS TURBINE SUMP SENSOR m:w AUDIBLE AND VISUAL ALARMS AND (cI1eck one) o II. AUTO PUMP SHUT OFF WHEN A LEA/( OCCURS o Þ. AUTO PUMP SHUT OFF FOR L£AKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUOIBlE AND VISUAl ALARMS EMERGENCY GENERATORS ONLY (Chedt allNt øppIy) o 14. CONTINUOUS SUMP SENSOR mItK2IlI AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. CAlLY VISUAL CHECK :,,:'~~~m«l~t.dt¥#~~V DATE / jl/:J. 01 471 TITLE OF OWHERIOPERATOR o 0Y 470 .72 474 P.,-n" ExpIrIUon 0IIe (For lOcal uae only} 4t~ I S:\CUPAFORMS\SWRCB-a.WPD . CITY OF BAIŒRSFIELJ2 OPPlCE OF ENVIRONMENTAL.RVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUNDSTORAGETANKS-TANKPAGE1 <Ð o 5. CHAHOI! OF INFORMATION) p. t1I o 8, TEMPORARY SITE CLOSURE o 7, PERMANENTLY CLOseD ON SITE o 8. TANK REMOVED 4: rvPE OF ACTION ¡Chec. OM ,,.,,, only} o " NEW SITe PeRMIT "fS14. AMENOED PERMIT o 3. ReNEWAL PERMIT (~_. fwlOt:M un only} 8USINESS NAME (s.m.. FAClLlT'I' NAME or 08A . 00in0 1IuIIneu....) ¡ LOCATIO \.1«\(\ I ANKI , I DAT I I' i AOOITIONAL DE {FoI1ocM /lie only} i TANK use 43t i~ 1. MOTOR VEHICU! FUEL ¡ ¡;"tbd.~.. ~ T)pe} ! 0 2, NON-FUEL PETROLEUM I I 0 3. CHEMICAL PRODUCT I 0 4. HAZARDOUS WASTE (1ndIIdN, ! UI*l Of) I 095. UNKNOWN : TYPE OF TANK I (ChecJr OM itIm only) I ¡ [ TANK MATERIAL . WMry ... 3 #w.y a.fJ t'vt I. TANK DESCRIPTION 4J flf{1 L COMPARTMENTALIZED TANK 0 '1'.. ~No 43- It -V.... complete one p. ror eacn compartmenc. 438 NU ( 437 438 .. TANK CONTENTS fIETROLSM TYPE ~1" REGUlAR UN..EADeo 0 2. LEÅŒO 0111. PREMlUMUNlEAOED 0 3. DIESEL o 1e. ~ IN..EADED 0 4. GASOHOl COWCIN NAME /IIDm HaøIIIow AM,.,." IIMnfOty".ge) o 1. SINGle WAlL ~OOUØU!WAlL o ,. BARE STEEL. o 2. STAIH..ESS STEEL ! (ChecJr OM itMI only) ¡ TANK MATERIAL· ~!.-III 0 1. BARE STEEL. (ChecJr OM iIMI only) 0 2. STAINU!SS STEEL TANK INTERIOR LJNIN(J OR COATING o ,. AU8II!R LNO CJ 2. ALJM) LNNQ (C/ledt OM iIMI only) ,SPtLL AND OVERFILL (Ch«k " /IIoI1~) " SINOL8 WAU. TANK (CItecII.. INIIIJIIIY): o '. VISUAL (exPOl!O PORTION ONl. Y) o 2. AUTOMATIC TANK QAUGINO (ATG) o 3. CONTINUOU8ATG o 4. STATISTICAL INWNTOAY RECONCILIATION (SIA) + 81eNNIAL TANK T8ST1NG -. "..',", ..- eSTIMA reo CA TII.A8T U8IO (YAIMOo'OAY) UPCF (7199) 411 +Ie o 5. JEI' FUEL EJ 8. AVIATION FUEL 099. OTHER 441 CAS . (from HaDIfIoua AMIMIlsInvenfOty ".ge) 442 .. TANK CONSTRUCTION o 3. SINGlE WAlL Vt1TH EXTERIOR MEMBRANE LINER 04. SINGlEWALLINAVAUlT o 5. SINGLE WALL Vt1TH INTEANAL BI.AOOER SYSTEM OM. ~ o g. cmtER o 5. CONCRETE 0 95. UNKNOINN o a. FRP COMPATIBLE WI100% METHANOL 099. OTHER 443 "p§ 3. F18ERGLASS I PlASTIC o 4. STEEL CLAD WlFI8ERGLASS REINFORCED PlASTIC ""3. F18ERGLASS I PlASTIC o 4. STEEL CLAD WJFI8ERGLASS REINFORCED PI.ASTIC (FRP) o 5. CONCRETE o 3. EPOXY LINING 0 5. GlASS LINING 0 IS. UNKNOWN o 4. PHENOlIC LINING 'fila. UHI.UED 0 g. OTHeR 3. FI8ERGLASS REINFORCED PLASTIC 0 IS. UNKNOWN 448 o 4. IWRESSEO CURRENT 0 g. OTHER 444 o a. FRP COMPATIBLE WI100% METHANOL o t. FRP NON-CORRODIBLE JACKET o 10. COATED STEEL 095. UNKNOWN o g. OTHER 445 448 DATE INSTALLED 447 'For 1ocM.. CATE INSTALLED 449 450 T't'PE (For 1ot:aI/IIe only) (ForlocMuse only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 o 1. AlARM ~. FILL TUBE SHUTOFF VALVE ..:J£ o 2. BALL FLOAT 0 4. EXEMPT ~ ~1.· ~;f~~';~: ;~··:i~~ :::t.:·!:;: :..:: :.\' :....:... :~¡;~..~: "';. ~~~~. . .<.. :.'. .:;: ::::}t(~~.; .. ! . "cOuaLe wAl...:. TANK OR TANKwmf ~ (ch.c. OM"'" odn: 454 0,. VlSUAL(SlNOLeWALLINVAULTONl.Y) ~ CONTINUOUS INTERSTITIAL MONITORING o 3. MANUAL MONITORING o S. MANUAL TANK GAUGING (MfG) 08. VADOSE ZONe 07. GROUNOWATER o e. TANK TESTING o g. OTHeR V. TANK CLOSURe INPORMATION 1P11UlAN1NT CLOIURIIN PLAce d'" - ',- ,- -" UTlMATID QUNmTV OF SU88TANCI RIÀoWNING 411 TANK FlWo WITH INERT MATERIAL? 457 .. 0'1'. CJNo S:\CUPAFORMS\SWRC8-8.wPO rr- q'-~~ ,~ _. CITY OF BAKERSFIeLD . OFFICE OF ENVIRONMENTAL SERVICA 1715 Chute' Av.., Bak."fI.ld, CA 93301 (H1)W-3979 " UST. TANIC PAGI! 2 . ' "-ge d - -= va; ...... CONITItUCTlON (CMcIt " IIa, eppIyJ UNDeRGROUND PIPING SYSTEM TYPE ¡~1, PReSSURe 0 2. SOCTION 0 J. GRAVITY 458 0" PReSSURE CON5TRUCTIONlIO I, SJNGU! WALL 0 J, LINED TRENCH 0 98. OTHER 480 0 " SINGLE WALL MANUFACTURER~ 2. DOUBLE WALL 095, UNKNOWN 0 2. DOUBLE WALL i MANUFACTUReR 481 MANUFACTURER ! 0 " BARE STEEL ,0 e. FRP COMPATIBLe WI 10011. METHANOL 0 1. BARE STeEL MATERIALS AND ,0 2. STAIHlESS STEel 0 7. GAlVANIZED STEEL 0 2. STAJNLESSSTEEl CORROSION .¡,.¡ , PROTECTION f"" J. PlASTIC COMPATIBLe WITH CONTENTS 095. UNKNOWN 0 J. PlASTIC COMPATIBLE WITH CONTENTS 10 4. FIBERGlASS ~ e. FlEXIBLe (NOPE) 0 ge. OTHER 0 4. FIBERGlASS : 0 5. STEEL WI COATING 0 9. CATHODIC PROTECTION 484 0 5. STEEL WI COATING VII. p~ U!AK Dl!TECTION (CMt:k 1II1Mt.ç¡ply) 1. FlOAT MECHANISM THAT SHUTS OFF SHEAR VAlVE o 2. CONTINUOUS DISPENSeR PAN SENSOR . AUDIBlE AND VISUAl AlARMS o 3. CONTINUOUS DISPENSER PAN SENSOR mItiAUTO SHUT OFF FOR DISPENSER + AUDiBLe AND VISUAl ALARMS IX. OWNERIOPERATOR SIGNATURE I cer1Jfy Ihallhe intonnatlOn pnMded herein la true IIId accurate to !lie ball d my kncMIedga. SIGNATURE OF OWNERIOPERATOR UNDERGROUND PIPING NO WALL PIPI 488 PRESSURIZED PIPING (Chedc " IIa, .ç¡pIy): o 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST mIti AUTO PUMP SHUT OFF FOR lEAl<. SYSTEM FAILURe. AND SYSTEM DtSCOHNECTIOH . AUOI8I.E NÐ VISUAl AlARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) CONVENTIONAl. SUCTION SYSTEMS: o 5. DAILY VISUAl MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY i TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BElOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9. BIENNIAL INTEGRITY TEST (0.1 GAt) SECONOARlL Y CONTAINED PIPING PRESSURIZED PIPING (Chedc " ilia, eppJy): 10. CONTINUOUS TURBINE SOMP SENSOR mIti AUDIBLe AND VISUAl AI.AAMS AND " (Check one) o a. AUTO PUMP SHUT OFF 'MiEN A lEAK OCCURS o Þ. AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAIlURe AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF , 11, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) mD1 FlOW SHUT OFF OR RESTRICTION o 12. ANNlJAlINTEGRITY TEST (0.1 GPH) 5UCTIOWGRAV11Y SYSTEM: o 13. CONTINUOUS SOMP SENSOR + AUDIBLE AND VISUAL AlARMS eMERGENCY GENERATORS ONLY (ChecIf III /lilt tppIy) t::{.14. CONTINUOUS SUMP SENSOR mJ:tg4 AUTO PUMP SHUT OFF + AUOI8l.E AND VISUAl AlARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) mIJ:QJ,[[ FlOW SHUT OFF OR RESTRICTION o 18. ANNUAl INTEGRITY TEST (0.1 GPH) o 11. DAILY VISUAl CHECK DISPENSER CONTAINMENT DATe INSTAlLED 488 ~() r I Parmll Numb.. (For /oQJ 11ft only) NAME OF OWNERIOPERATOR (p ABOVEGROUND PIPING o 2. SUCTION o 95. UNKNOWN o 99. OTHeR o J. GRAVITY 459 46~ ' 463 o 8. FRP COMPATIBLE WI 100% METHANol o 7. GAlVANIZED STEel o 8. FlEXIBLE (HOPE) 0 99. OTHER o 9. CATHODIC PROTECTION 095. UNKNOWN ABOVEGROUND PIPING SINO E WALL PIPING 487 PRESSURIZED PIPING (Chedc " tha, apply): o 1. eLECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST:t4D:1 AUTO PUMP SHUT OFF FOR lEAK. SYSTEM FAllURE.1HJ SYSTEM DISCONNECTION + AUDIBLe AND VISUAl AI.AAMS o 2. MONTH\. Y 0.2 GPH TEST o 3. ANNUAlINTEGNTY TEST (0.1 GPH) o 4. CAlLY VISUAl. CHECK CONVENTIONAl. SUCTION SYSTEMS (Check llllllat apply): o 5. DAILY VISUAl MONITORING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): o 7. SElF MONITORING GRAV11Y FlOW (Chedc dlMt apply): o 8. CAlL YVlSOAl MONITORING o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SecONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check .. Ills' apply): 10. CONTINUOUS TURBINE SUMP SENSOR:t4D:1AUDIBlE AND VISUAL AlARMS AND (c:tIec:k one) o a. AUTO PUMP SHUT OFF 'MiEN A lEAK OCCURS o Þ. AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAILURe AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC lEAK DETECTOR o 12. ANNIJAL INTEGRITY TEST (0.1 GPH) SUCTIONlGRAV11Y SYSTEM: o 13. CONTINUOUS SOMP SENSOR + AUDIBLE AND VlSOAl AlARMS EMERGENCY GENERATORS ONLY (Chedc" 1M' fPpiy) o 14. CONTINUOUS SUMP SENSOR Y!1It!Q!lI AUTO PUMP SHUT OFF . AUDIBlE AND VISUAl AlARMS o 15. AUTOMATIC LINE LEAK OETECTOR (3.0 GPH TEST) o 18, ANNUAl INTEGRITY TEST (0.1 GPH) o 17. DAllYVISUAlCHECK , '~""""'~;;;~,;.é;;':;;~~~ ~;':tê, ....,_. ~~~.~~-i;.....~.,,~,~~.:~ ,~" 411 472 410 473 474 Parmlt ExIIrIIIon DIll (For IøcaIIIft only) 475 I UPCF (7/99) S:\CUPAFORMS\SWRCB-B.WPO ?fflr ,.- . ' ./ ,,'> ".. : A.'. ~ .......... -- .-. .. CITY OF BAKERSFIE1J2 OPl'lCE OF ENVIRONMENTALaRVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS· TANK PAGE 1 ~ rYPE OF ACTION (C/t.c_ 0... ,_ 0lI/)l) a " NEW SITI! P!At.tIT '¥i .. AMENOED PERt.tIT a " CHANGe OF INFORMATION) P-ve 01 a S, TEMPORARY SITE CLOSURE a 7, PERMANEHTL v CLOSED ON sITe o S. TANK REMOVED .: a 3. RENEWAL PERMIT 13tì Cì I ANK 10 . (Spedy _ . frN lOcal u.. 0lI/)l) 3 ..s{({\(,(t ¿CLl 4J tfw-~ ßkÆt(. (b J\- I. TANK DESCRIPT10N 93:ltL COMPARTMENTALIZED TANK ' a v.. pitNo If -v.... c:cmplele one P8ge for ucII c:cmpaltment. L{ ) I 11 0 ADOfTIONAL OESCRJPI'ICIN (FfN JocM _ 0IIIy) ¡ TN« use 43t I' 'rß 1. MOTOR VÐfICU! FUEL I (If ".,tbd. ~ ,..".,..,.., ~) I 0 2. NON-FUEL PE'TROLÐJr.t a 3. CHEMICAL PAOOUCT I 0 .. HAZAROOUS WASTt! (1ndudN I V* 01} 095. UNKNOWN : TYPE OF TN« I (CNcIt one iIIIm 0IIIy) ¡ i TANK MATERIAL· II1Nry ** a 1. BARE STEEL I (CIIeck one iIIIm 0IIIy) 0 2. STAINlESS STEEL ¡ TANK MATERIAL . MCOndery ** 0 1. BARE STEEL (CMck one iIIIm 0IIIy) 0 2. STAINLESS STEEL TANK INTERIOR UNING OR COATING (CltICk one iIIIm 0IIIy) SPILL AND OVERFIU. (CItec_ .. /N/ .ppIy) o 1. RU8IER LINED o 2. ALK'tD LJtINJ .~ 438 NU l 437 (() C() 438 .. TANK CON1IN'I'8 ÆTACX.I!Uftt TYPe o 1L RE<JUtAR UNLEAOEO ~II. PREMIUM tH.EAOED b Ie. MIOGRACE UNLEADED 440 o 2. LEAOEO o 3. DIESEl o ... GASOHOl o 5. ÆT'FUB. EJ e. AVIATION FUB. o 99. OTH~ 441 CAS' (!tom ~trIou$lM__1twenIøty P9) 442 COW«)H HAM! (IIvm~ ~ 'tMltllOfy~) o 1. SINGLE WALL f1.2. 00U8LE WALL .. TANK CONSTRUCnON o 3. SINGL.E WALL 'MTH EXTE1UOR MEMBfWIE UNER 04. SlNGLEWALLINAVAUlT 443 o 5. SINGlE WALL WITH INTERNALIILADOER SYSTEM OM. UNKNOWN o ft. OTHER o 5. CONCRETE 095. UNKNOWN o 8. FRP COMPATIBLE WlI00% METHANOL 099. OTHER 'f¡1: 3. FIBeRGlASS, PlASTIC o 4. STeEL Q.AO WJFfBeRGI.ASS ReINFORCED PlASTIC 3. FIBERGlASS I PlASTIC o 4. STeEL Q.AO wlF18ERGLASS REINFORCED PlASTIC (FRP) o 5. CONCRETE o 3. EPOXY LINING o 4. PHENOLIC UNINO 444 o e. FRP COMPATIBLE W/100% METHANOL o .. FRP NON-CORROOIBLE JACKET o 10. COATED STEEL o 95. UNKNOWN 099. OTHER 445 44ð DATE INSTAI.LEO 447 o 5. 0I.AS8 UNING ¢'.. UNLINED ON. UNKNOWN 099. OTHER Iot* UIII DATE INSTALLED 449 ~. FI8ERGLAS8 REINFORCED PLASTIC 0 115. UNKNOWN b 4. IMPRESSED CURRENT 0 ft. OTHER o 1. MNU"ACTUMD CATHODIC PROTECTION o 2. SACRIFICIAL ANOOe VI!AR INSTALLED "1. SPILL CONTAINMENT r¡ç Cf2. DROP roBE q ("' l'lh. STAIICI!R PLAT! qç- 44ð (For ~ 11M only) 451 OVERFILl.. PROTECTION EQUIP1.ENT: VI!AR INSTAUED 452 o 1. ALARM Œ13. FILL roBESHlITOFFVALVE-.!l£- o 2. BALLFLOAT 0 4. EXEMPT 4.SO TYPE (For /øQ/ uH only) ,:;;w.i:!f~( LUIC ' :.~t,· ~~~~~~:,;~:,~~·~~;::t:~'~::: :::: :.,. .... .': ;~tþI~.~··(.:~~.· .. :::' ·'\":"..:;:!:::/t(~~,·' ., oOueLe WAL&. TANK OR TANK WITH eUÓÔÏR (~one /111ft ~ 464 o 1. VISUAL. (SINGt.S WALL IN VAULT aNt. Y) 'tÓ 2. CONTINUOUS INTERSTITIAL MONITORING o 3. MANUAL MONITORING 4S8 o 5. MANUAL TAHKGAUGING(MT'OI o 8. VADOSE ZONE o 7. GROUNDWATER o 8. TANK TESTJNO 0.. OTHER Y. TANK CLOIUIU! INPORMATION I PIRIlANIHT CLOIURIIN PLACI eSTIMATeD QUNmTY OF SUBSTANCe IWoWNINO 4S8 TANK FILLED WITH INI!AT aMTERIAL? 467 ::X"~':"j:" " SlNOLa WALL TANK (ChecIt" "", ¥PlY}: o '. VISUAL (1!Xf'01«O PORTION OHl. Y) o 2. AUTOMATIC TANK OAUGINO (ATOI o J. CONTINUOUS A TO o .. STATISTICAL IH\IIHTORV Rl!CONCIUATION(SlAI+ BIeNNIAL TANK TlSTlNO ESTlaMT!D OATI WT UIIO(YRIMCWAY) UPCF (7/99) IIIIIonI o v. 0 No S;\CUPAFORMS\SWRCS.S.wPD :¡ _ CITY OF BAKERSFIELD . OFFICI! OF ENVIRONMENTAL SERVICeA 1715 Cheat.r Av.., B.k....fI.ld. CA 93301 (H1iW3879 ./ i PIge U8T . TANI( 'AGe 2 _ d _ UNDERGROUND PIPING va; !tIlING CONSTRUCTION {CItedI " IN, WIYJ I ABOVEGROUND PIPING ,. ' SYSTEM TYPE :)9 " PRESSURE 0 2. SUCTION 0 3. GRAVITY 458 0 I. PRESSURE , CONSTRUCTIONl! 0 " SINGLE WALL 0 3. LINED TRENCH 0 98. OTHER 480 0 " SINGLE WALL : MANUFACTURER~. DOUBLE WALL 095. UNKNOWN 0 2. DOUBLE WALL ! I MANUFACTURER 481 MANUFACTURER I i 0 ,. BARE STEEL 0 8. FRP COMPATIBLE W/IOQ% METHANOL 0 " BARE STEEL I MATERIALS AND ,0 2. STAINLESS STEEL 0 7. GALVANIZED STEEL 0 2. STAINLESS STEEL I CORROSION I , PROTECTION ¡O 3. PlASTIC COMPATIBLE WITH CONTENTS 095. UNKNOWN 0 3. PlASTIC COMPATIBLE WITH CONTENTS ~4. FIBERGlASS ~ 8. FLEXIBLE (HOPE) 098. OTHER 0 4. FIBERGlASS : 0 5, STEEL WI COATING Ò 9. CATHODIC PROTECTION 484 0 S. STEEL WI COATING W. PIF'IN9 LEAK DETECTION (ChecIt" tNt ØPØIy) 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS o 3. CONTINUOUS DISPENSER PAN SENSOR mIH AUTO SHUT OFF FOR DISPENSER · AUDIBLE AND VISUAL ALARMS IX. OWNI!RIOPERA TOR SIONA TURE I cet1ify 1h8l111e informallon IfO\Iided lleteln la !rUe ancIllCCUtlle to 1M bell d my knowIecIge. SIGNATURE OF OWNERIOPERATOR UNDERGROUND PIPING WALL PIPING PRESSURIZED PIPING (CIIecJr 81 tN, 1/IIIIy): o 1. ELECTRONIC UNE LEAK DETECTOR 3.0 GPH TEST mIH AUTO PtJa.p SHUT OFF FOR LEAl<. SYSTEM FAILURE. AND SYSTEM OISCONNECTIOH + AUOIIILE NlO VISUAL ALARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAl. INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: o S. DAILY VISUAl. MONITORING OF PUMPING SYSTEM . TRIENNIAL PIPING INTEGRlTY ¡ TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BElOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chedc .. tha, 1/IIIIy): 10, CONTINUOUS TURBINE SUMP SENSOR n1It1 AUDIBLE NÐ VISUAL AlARMS AND (Chedc one) o a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAILURE NÐ SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF 1" AUTOMATIC LINE LEAl< DETECTOR (3.0 GPH TEST) m!t1 FLOW SHUT OFF OR RESTRICTION o 12. ANNUAl. INTEGRITY TEST (0.1 GPH) SUCTIONlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE! NlO VISUAL ALARMS EMERGENCY GENERATORS ON&. Y (ChecIt II lilt.".) 'tí 14. CONTINUOUS SUMP SENSOR mI!:I.QJ,lI AUTO PUMP SHUTOFF +AUDI8lEAND ï VISUAl. ALARMS o 15, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~ FLOW SHUT OFF OR RESTRICTION o 18, ANNUAL INTEGRITY TEST (0.1 GPH) o 17. DAILY VISUAl. CHECK , ~:.. '.< ....,. ... DISPENSER CONTAINMENT DATE INSTALLED 488 ~\ NAME OF OWNERIOPERATOR (pm - , UPCF (7/99) o 2. SUCTION o 95. UNKNOWN o 99. OTHER o 3. GRAVITY 45S 46: 463 o 8. FRP COMPATIBLE W/IOQ% METHANol 07. GALVANIZED STEEL o 8. FLEXIBLE (HOPE) o 99..0THER o 9. CATHODIC PROTECTION o 95. UNKNOWN 465 ',>~f,ft; 488 ABOVEGROUND PIPING ~NO WALL PIPING 467 PRESSURIZED PIPING (Check 81th.' ~): o 1. ElECTRONIC UNE LEAl< DETECTOR 3.0 GPH TEST mrt1 AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAIlURE. AND SYSTEM DISCONNECTION. AUDIBLE NÐ VISUAL AlARMS o 2. MONniL Y 0.2 GPH TEST o 3. ANNUAl. INTEGRITY TEST (0.1 GPH) o 4. CAlLY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (CIMcIr ..that 1IfJP/y): o 5. OAIL Y VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BElOW GROUND PIPING): o 7. SELF MONITORING GRAVITY FLOW (ChecIt .. tN, 1/IIIIy): o 8. OAIL Y VISUAL MONITORING o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SecONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check .. tN, 1IPfJ/y): 10. CONTINUOUS TURBINE SUMP SENSOR mItt AUDIBLE AND VISUAL AlARMS AND (cf1edt one) o a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECT1ON o C. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAl. INTEGRITY TEST (0.1 GPH) SUCTIONlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EIIEROENCY GENERATORS ONLY {Check IItha' ~ o 14. CONTINUOUS SUMP SENSOR mII:ImlI AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) o 16. ANNUALlNTEGRITY TEST (0.1 GPH) o 17. OAILYVISUALCHECK ',' '~~~~~~¿(~~~,'~j} , 471 - 470 472 4 S;\CUPAFORMS\sWRC8-S. WPD _~s::w~._ I' ~ (I.......... _ ........\ CERTIFICATION OF FINANCIAL RESPONSIBILITY . , , , " FOR UNDeF\qAqyNQ 81't)AACE TANKS CONTAINING PE'YROlEUM 4._ (...~....... 1t. ~._ -. rUt 1t1t., T ItIUIII fa... ................... 'P.1iJIe4 ia SMâGa ZIO'7. a.,w LI. ow. J. 11da 23. cc:a, 0-.. ......,.---- CiJ 1 .ii* ......-........... . A14D _ o 1 ..... 4011u1,.r 0CIIIIIrN1IOe 0 Z àailioa doUan...... ......... htlftlby certifle6 that it is in complltlnt:e with the ~ of StIt:tion 2807. f;ct+ ThOM( t) .1-"'50 aU\tL ~. ( ".\(dl('~ ~ () t(:f,K.u.v !.. 'E-l;. 4333 H, WCbt. Avt. yeS ,,- q?J '](9 Ç" r~ ~'^() .eVt çh,k ~tak ttttl\d· UST· ~-: d)(b èo urlcM \.. t.; I.~·ß~" fl/c.( '1.. ( L 'es \{C~ ~V\d . ~ '-tfa \Nu. -lea , c.1f} I~te: /I you M8 using the State Fund lIS .ny p1JIt of your demonstration of f/nIJnciarresponsibUity, your «øcutJon MJd 6UbmJaion of this CtJrtIfIt2t1rJn _0 CtJft/fltg fhllt you 11M in compllsfICtJ with III/ conditio". for P/lrticipstJon In thtI Fund. dJ"H_ FMiII" .Addt.- -iU",~ FMiII,,~ I ~~~ H... FIåII.,~ I :-::~~ ..... , ., Addr-. ~' . fILII 0It.., .. 1..-1 AfIIWI 'e e . .r~ "'~....... nr8ftU~%O.S ~,,""~GIf or rDlAllcu:. "'POJrsøu.zn PO'" Pi.... c". 01" prfM cteerty eU ffttONltfan an Cartfffcetfan 0' "",,'et ......b'tfty ,.,;.. , AU UIT fecft'tl. "'011' .'t. ... or ""Ired _., be tlsted on one tOMl: Ch.refor. e ....r.c. corcff'cet. f. not requfred 'or .acft .ftt. DOCtIRT IIIPCIIMATlCII A. .............- .- CIIec:k the epproprf.t. bon... 8. ... of Tn 0IINr - full n-. of either the tank owner or ChI operator. or Clpencor c. ......... 1')pe - ... of I..... . ......... ....... - Col..... ~ - Indfceta ....fdl Stata approwd -.ell.",..) ara befng wed to MOIl ffNÌlc'el roaponafbfl Icy .lch.r a. cont.fned in the federal regutatfana, 40 Q" '.rt 280, SU:1parc H, Sections 280.90 through 280.103 (S.. FlnMC..1 RponafbH fey Gufda, for ~r. fnfonletion), or Section 2802.1, Chapter 18, Dfvf.fan 3, Tftl. 23, CCR. List .ll ~ and addres... of c~iea and/or fndfvfcials fuufng cowrag.. LIlt fdentlt;tni nuaber for aaell -.cIIanf. used. ÞMpI.: f".urance pat fey IUllber or fH. IUIber a. fndlcated on bond or ~t. (If usfng Stat. Cl....., Fn (Stata Find) I.a~ blank.) Indfcat. ..u\t of coverage for each type of MCh."f..). If.... th." one MChani.. fs indicated, total IIUIt equal 100x of flNnCial. reaponsfbft fey for ndI faclt fey. ' Indicate the effective dete(s) of aLL financiaL mech."flll(s). (State Fund coverage would be contilUlUS as long a. you _intaln cOlllPl fanee and r_in el fgfbte to conti.... participation In the Find.) corncc'w Act'an - Indlcat. yes or no. Does the .pecffled fInancIal ..chen'. prov'de cover... for corrective action7 (If using ,Stace Find, fndlcaee 1Iyn-.) CcMInI8e Per.od - í 111. rd hrty - c..p._c'an D. 'ecllfey- InfonIatfan E. SI_cure .toct . Indfcate yes or no. Does the specIfied financial lMtdI."f. provide covera,. for thIrd party ~ation7 Of using State Fwd, fndlcate"IIyes-.) Provide all facH it 'I and/or site "... and addr...... Provide "gnatur. and date sfgned by tank owner or operator¡ printed or typed ,.. and title of tank OW1er or opernor¡ sfINcure of wfenna or notary and date sfgned; and prfnced or typed name of wftness or notary (if notary 11_ .. witness, pl.... plac. notlry seal next to notary" "gnatur.). IIIere to ..It Clrliflc:atfan: ' Pl.... land o.rfgfniL to. your toeal agency (agency ....0 ta.un your UST perllltl). ' Keep a copy o.f tII. c.rtlflcation at each facll It)' or Ifte tr.ted on che fona. QuestfON: If you haw ~tfona on ffMnCial reaponafbit fty requirements or on che Certlffcatfon o.f Flnancfal ResporwfbUfty Fo"., pLease contact che State UST Cleanup FU'Id at (916) 739-247'5. Note: ,..1 tt.. for 'eft.... to ec.lv with Flnencial Resaonalbft itv Recalfr _htl: '.Ilur. to c~ly.-y r..ult fn: (1) topIrdlzlng clai..nt eligibilIty for the Stat. UST Claanup Fund, and (2) lfabft ley fo.r civil penaLef.. ot up cO S10,OOO dollars per day, per ",*rgrCM.l1d .tor... tank, tor .ach day of Yfolatfon al .tated fn Artlcl. 7, Sectfon 25299.76(1) of the CaLlfornfa H.alth and Saf.ty COde. . .-..... '- ~, SUMMARy.QF.'.IN$IJQÅNCI:.... .....-.'..;....:...-'.......:..-........:..;.'-:,..;:.'~,..,.,.-.-..'..,;.::....>-:-: ..., Fö;? Stockdale Mobil Munn & Feng Chau 13001 Stockdale Hwy Bakersfield, CA 93312 661-832-4672 .- -. . .. - ,. >~~~~~~~i.?ì~ºl~~ Thomco In ance Assoc. Inc. 0791289 4333 N. West Avenue Fresno, CA 93705 559-226-1000 P ""'2....'" ......'Q!.,.,./)" Coverage, ... f\tlìöuiit ,','.' Glass and Sign Westport Insurance Company SST105027 07/30/01 07130/02 Glass Coverage: Deductible · See Attached Glass Schedule · See Attached Sign Schedule 100 Garage and Dealers Westport Insurance Company SST105027 07130/01 07130/02 Liab Auto Only Ea Acc Liab Other Than Auto Only Ea Acc Liab Other Than Auto Only Aggr Hired Autos Only Non-Owned Autos Used In Garage Bus Medical Payments Non-Owned Autos Used In Garage Bus Premises & Operations Garage Keepers Collision Autos Left For Serv/Repair/Storage Location Limit Per Location Deductible Per Auto · See Attached Vehicle Schedule 1,000,000 1,000,000 2,000,000 5,000 30,000 500 Crime Westport Insurance Company SST105027 07130/01 07/30/02 Robbery & Safe Burglary Inside: Robbery of Custodians Deductible Safe Burglary Outside Premises Deductible Schedule 5,000 500 INCL 5,000 500 --~~---- Cj)RRECI\ON NO~CE BAKERSfiELD fiRE DEPARTMENT N~ 1049 LoCatio . I ~ 1.1. (, ~,' 'I, ~~' SubDIV~ Blk.-· L<>~ You are herebY required to make the following corrections at the above location: ~ -- Cor. No \ ~ - Completion Date for Correctio Date~/tJ I Inspector 326-3979 ~ L e CITY OF BAKERSFIEI..D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd .loor, Bakersfield, CA 93301 FACILITY NAME ,"~i-o c.k..Jd(, fk"(¿H t ADDRESS \300 I ~ r k!l,{(. 1J¡,J.}' F ACILITY CONTACT INSPECTION TIME INSPECTION DATE 7 -{ {j... n I PHONE NO. Sg~~d {?b I BUSINESS 10 NO. 15-210- NUMBER OF EMPLOYEES CO Section 1: Business Plan and Inventory Program o Routine !;ïð Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERA TION C V COMMENTS , V ./ Appropriate pennit on hand Business plan contact infonnation accurate \) \.... / Visible address Correct occupancy V Verification of inventory materials V , \I Verification of quantities Verification of location V Proper segregation of material V Verification of MSDS availability V Verification of Haz Mat training \' N(q 0- ,........) (. ..(.". \_1 nff\<...iè Verification of abatement supplies and procedures V¡,... Emergency procedures adequate ""v Containers properly labeled V Housekeeping ð V ~x:,,{.. ~.tf1f1 t. /oJ,.. t A ~ "(,, i#...AI-\..f Fire Protection \Y Ç(~ ,.., _I _I ý f.JI"J c.. "I.. .....,.,,;', T . . Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes DNo Pink - Business Copy Questions regarding this inspection? Please call us at (661) 326-3979 While - Env. Svcs. Yellow - Station Copy Inspector: ........ /' e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 , FACILITY NAME ,5+OrJ/alr ~ fuDhJ INSPECTION DATE ì - tj· 0 I Section 2: Underground Storage Tanks Program o Routine ~ Combined 0 Joint Agency Type of Tank OwF Type of Monitoring C L (11\ o Multi-Agency 0 Complaint Number of Tanks 4 Type of Piping Oû.) ORe-inspection OPERA nON C v COMMENTS Proper tank data on file V Proper owner/operator data on tile V Permit fees current V Certification of Financial Responsibility V Monitoring record adequate and current v/ Maintenance records adequate and current vi Failure to correct prior UST violations V Has there been an unauthorized release? Yes No L../ Section 3: Aboveground Storage Tanks Program OPERA nON Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection? AGGREGATE CAPACITY Number of Tanks TANK SIZE(S) Type of Tank C=Compliance V=Violation Y=Yes In'poeM: _J., ~ Oftice of Environmental Services (805) 326-3979 Whitc - Env, Svcs, N=NO (' (J()./¿ ~ Business Site Responsible arty Pink - Busincss Copy II,!': I 1 :::Cill J ~;'j ()'~ï::L'HLE t 11"./,/ . Elf';}' 1 }-:;.,,;F I FLLI 1-·'f1. 1_~:::;jO t,,:, I ' JuL Jt.. :'IICiI ;~::4:J HI"! - - - - U',~, rEi"1 ;~;Tf-iTU:,: J.;'EJ":)f(T ,-iLL, Fu[,¡,'j' I C'lt::1 r'·JOF:f'1i-1L 1I'·J\iEI ¡ ¡",:'k,' kr-:¡ ": :,L:T T 1 III',J h,¡ ,n) 'OI.I,II"IE !.ILl,!-" :E ':J[r', u; ,1.,-"".1> TC \...·"U.lI"IE HE ¡ 1 ;rI'f IIHTt:k \/c·l. - 1.11'; 1 t,,; TEI1f- T _ Ui-JU:I;['Ef' \/C'L !.Ii' 11, ULLi-iI:';£ 91];::,. ULLAGE = IC: \/OLLJI"lE HEI':;/ff 1.,IFilLh' \u:'I, ("lriTEk '¡'[,I'll' 'j :.:::¡'IL:-..:U" .,,":iU.lI'IL ULl hl::L ':'0:, ULL"ì';1::- TI:',"A I !f"IE HE JI,,}ft ("Iii [LP. "J 1 , 1,,1,:; l'LP. 'lUll T .J :;-11 I¡:I~J; "/ULIII'Il'; ULLr1I,;t ',11,):';, UU.i'HÆ.~ '[I' "/OIUI"If-: HC ¡'"IH 1,',If-iT fl,,' ""\)1 1"Ii-iTEh' 'rJ-J'¡F --l f:~~, E, '¡î:~i~'t; :~i E: ~) Ij 1..~r··11~~3 ':;fìL.:::I t=·;F1LE¡ (~AL;3 II'JCHE:-:; ,,-' c, L ,~, 'i, '~(;Hp;;; jlDV ,¡t:'¡:~: ,1'¡ 57 Ci u CIII :i ~:I . i ~ 1:1 :l5 C~f1L~3 4'749 GAL:3 3'78 Ci Gf~L::,; 4'32 1 ':;~L.:3 4:, 12 I NCHEE; ::;:15 C~HLS 1 Ci::~ I NC'HES ':':" '7 [1[(; F ";I'-I¡-:,5 t. t, 1 'j r.) t. ~~ U 3010 " ,,:¡ J .7"1 11:, ~ ,~'''~1 C' J ~_'1-1 t::.....::;V CAL~3 (~ALE; (;AL:3 Ci. 7~, I NCHE:3 CAU='l I NC ¡'1E:3 [iEG F j 1111. U :J~5t,..¡ '~~;·~L:3 t. I ~~ I] (;ML~3 ~'l t.,1 '.;HL:::: '::~~ts...¡ ,'~HL~-=: ;:,. ,)::: II'JCHE:'3 ~:.:] Gr-:1LS iJ. -:'J8 I NCHEE; ':It: . 7 [lEG F '. ;., ;. '" '" EI,j) .. ;.;, '" e - HOBIL .0 I ::no,"J:[J¡.;LE Hi".J',¡,' ..EF:::::P ¡ ELD Cf~. ~:3:3Ci - - j - ¡"1AR 1'3. 20[1 I 7: 2:3 1\1"1 SYSTEM STATUS REPURT --'-.--- ALL FUNCTIONS NORMAL I N\/ENT,:)f(y' PH'ORT T 1: UNLE¡..;ÜEÜ \,/OLUf"lE ULLAf3E 9fß;:: ULLi-iGE= E; ·,jOLLlI"lE HEIGHT I,JATER \/01.. ~- T 2: UI"JLEALJED 2 \/OLUt'IE ULLAGE 9Ci~\; ULLAGE= TC \/OLUI"1E HEIGHT l..,JATER \/OL ~JATER TEI'1P T :3 :DIESEL \/OLUI"lE ULLAGE 90% ULLAGE= TC VOL UI'1E HEIGHT WATER \/OL l,.JATER TEMP T .":';UPER VO UL 3E 90% ULLAGE= TC \/OLUI'lE HEIGHT LJATER VOL I,.JA TER TEI'lP ,,>:,,-,<= .... -'';;':.~ 515':1 4190 .:¡521 'I:::: . ::;. t- O O.OD 71 I 5257 G,:::¡LE C¡::;U=:: Cr1L~3 Cf\U3 II',JCHE:::; CAL~::; Ir'JCHEf:; DEG F GALS / 4427 (~ALS :3458 GALS' GAL~3 ~ - '- 47.42 I NCHE:=:: If., GALS 0.76 I NCHE:3 74.4 DEG F GALS GALË~ GAL~3 GMLS ¡ r',CHEE; GI~LS I NCHG3 IÆ(; F GHLS Gr;LS GHL~::~ GALS I ',JCHES GALS I NCHE:=:; DEi=-: F ;.: ;": ;.: ," '" E Nfl ,""t :..: .., 5252 3620 6064 5095 359í;:, '-t¡:: 1-1'1 ':"'I..~J. 00 o 0.00 74.5 1 ';d33 8UOl 70::::2 1681 20. <.f~/ (.I 0.00 r"1'-1 ,...-. i':":'. ¡ .c:---,rr_;7-'C:: -~ -~e- SENSOR í-\Lri¡'::!~'1 L'4:IJNL-2 :3TP OTHER SENSORS FUEL ALARI"1 1"lAR 1 9 " 2001 7: 25 hr'l ._- _.--~-- ----- E~EN::::;OR ALARr"] L b:DIESEL STP OTHER ::::ŒI',¡:='::ORE3 FUEL ALARI"1 MAR 19, 2001 7:26 AM - :3Er'¡SC'F: ALAR!'1 I, :3: PREf"l ¡ Ut'1 STF' OTHER SEN:::;OF:;3 FUEL I-\LARI'1 MAR 19, 2001 7:37 Hf"l e ~--- ~'"- -~ ---~~--.:--;:' ----- SENSOR ALARM L 6:DIÐ3EL STP OTHER SEI',JE;,:)Rf:; FUEL AU~Rlvl MAR 19. 2001 7:38 AM ----- SEN~::~OF: ALAR!"! L 5:DIESEL ANNULAR OTHŒ EiEN~30RS FUEL ALA¡~1"1 f"1_19. 200 I 7: .3'3 AI"1 ----- ~3EI',J~=;OR ALARI"! L 3:UNL-2 ANNUL~R ANI',¡ULAR ~3Pf;CE FUEL ALAFJ"I 1"IAR 1 9. 20D 1 7: 42 hl"1 e SE['¡:=::.:)R ALi-1F:I"l ----- L 7: H~H'11 Uf'1 i-1NNULA~ (:,nIER SENS(.'F~S FUEL i-1LAR!'l MAR 19. 20D! 7:44 HM 7 ------- BAKERSFIELD CITY FIRE DEPARTMENT I dlhCEOF~MENT~CES / I - POST CARD AT JOBSITE - ~N:a.IrY OWNER J ~.. AODMa .....·0 crrv.ZIP crrv.ZIP Pt«)N1 NO. ,... II ...... 011.. 8ft &. r a.]>' _........ group at ~ 1 ..w. wilt .. __ ......,...... n.,.. run n "" T ..... order ~ ..;... WII'I ,...,.., t. DO NOT CIIJWI' __...., ........ group &II'1II""" In lUll group.. ..... CIIfI.".. ft....-..~. ,"nla l,,- ~... ,.... .. numbIr 01 ....... ¡'-"J. ...."""... end ._.....,...... I II ._11 01 ~.. .... , 1.... ...-:11..·...,;. . TA*8 AND BACKFILL r' ..... IICJ10II DAU II If _u'" I B-*II 01 T-*CS) I I I SpMc T_ c-....... or ~ a.teIhod I CaIhodIC P,..~. of T~) " , ' PIPING SYSTEM ,PIping" ~ wlCc*dion SYmø rIùM.c{t-V d ¡Nt) ,iLL. '3 ~;Ol eom.ion p,,*,*,,. of ~ Jointa. FII PIpe ~w IIadon of PIPn9 From Tank(I' CathodIC PI"""'" SyåII.Þ-Ptøi Ig , ? " " .. SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECT10N "~ Uner ..-~ ~ "" . T""I' Un« If'~M. ~.-. . PIc*1g Vault WIll ProducI ~ Sealer I ; : L.eV.f Gaugee or s..or.. FIoIIt Vent VùMe I, I Product CompIdIbte FII Box(.., ! : "l,-(~"'nf ßL1 I , Product un. LNk 0ItId0r11) ! Laale o.tK1Iof(l) Jot Annular s~.w. Tank(l) MonIÞ1ng Wel(1)/8Wnø(I)· ~O Teat Laale ~ o.va(I' Jot V~"OUh.~.. FINAL Mon/IDmQ W..... eaø. & l..ocIœ F'rI Box l.Ddr MonIlDfing Aeqwremema CONTRACTOR f2>, t;~ R ,-n...TArT ß\c-f/- O~ Jo '((C. uc::ø.. . PHONIi . t;t,g rdìì) , - .. , " ~ ,,< . -'.' ,·t.. ,', ,i,-'... . -'l . ,'r ~ ~.';;:',.- , ::- ,¡~1::' , _, " -r~~T APPLI~TION TO CONSTRUCTIMODIFY UNDERGROUND STORAGE TANK :.- '¿::} .+',' , :, . <_,;F\·i;.'~_.~~" :~:'>:":::~ ' +'~ ~ ,>~}:'~:~ .'. '..' TYPE 'OF APPLICA110N(CHECK) , ,'( '<:,' ":'~'~{~rJ1J)'Y' OOMODIFICATION OF FACIUIY [}NEW TANK. INSTALLA110NAT EXISTING FACIL1TY'~:,;~\-;,},t ' "'== ,)- ~~ ~ ~~~~ ~~¡~i~~~: '. . ::~'~fACJµlX ADDRESS Cnx ~~~-'Q f Í[{ ZIP CODE q ~.:3i 2 . ,"';}f', ((O'PEOF,BUS., S ' ' APNf# 'IP\, D\O 4~ D~~~' ':<rANKOWNER, . ' PHONHNO. (Pil\' 3;q-1,,32:ri'.,:, ',~:,:,' , 'ADDRESS "\ ' ZIP COD:E ~ "'~¡~' ',~" "cONmÀCT NO l£l~~ "",.r,-::,. "".:' .,:'ADDRESS , CITY' l mcoDs ~ ~?ð1,-~'..:;f .' PHONE NO ' ' BAIŒR.SFIE1D CITY BUsINESS UCENSE }l!O.':,¡i:;:". ,:WORKMAN COMP NO. .. Z; INSUIŒR, ~ : ~ii.! £::¡ 4- ^-s..c.rf JíJÆ-~ .:~.:::~¡..' ", ' , :~;!:~ES~.T1Œ WORK ~OBE D()NE ':¡-~D, àf)ptr~ ¡r pel 4~/L ,',,:,i~~< ~~=:~~&!~f"ÛV\'k}t~~~f~' ~*<ÆAUnn. ..... j~.~ '";:~~:n~~~~~RFtŒL ' ~:.~i';.. I i I '., .... ~ '"' T~~Q(:. ", VOLUM]! , """" ~O~ '; J:' ..'. ,- .. ~;._.' . jj':):' \ C> \?, , ¡, . , . ',:, ,~ '. . .j" u,"""'"u.,'~ . }:~ij~\~!~~~,< . ,T~.,No.!:i:;':_ "',> VOLUME :;~:;Jt::?!f;t~;;:~:~~t':~f/;" ' . ';:. .-. ';d ·;,~~/·;~~:,~"E.; ..'~"~~~. ',' . ~'. .' , "-". ,. " . ';·.'i::-{>:·;~~~"l :~~~}~\¿:~;.t: .::~: '. .. e ',~ InmtN~~~ , CITY OF BAKERSFIELD 'Pd V-ibÇûr¡ctl,D OFFICE OF ENVIRONMENTAL SERVICES<f';',!J, ,'_,' 1715 Chester Ave., Bakersfield, CA (805) 326-39'79 ;ß~ , . . " ~ m,: _',.r,' , "J ~;;; 1ff.' ncnoN FOR MOTOR FUEL ~iîf REGULAR PREMIUM ~ . <" . ,;~:r.>.· " .. t .'. "";'~l', . 'jJj'- A VIA nON",,:, ;n1' "',',",:::J~1L DIESEL X- Y-... / ./ , 'X , ,~<?;,:', , SECTION FOR N9N MOTOR FOEL STORAGE TANKS CHEMICAL STORED (NO BRAND NAME) " ¡:<;t~ . CHEMICAL PREVIOUSLY STORED '~~~:: , "~'~P~r~t> 't~~~~¡: , ";:.,' I, -' ,.::r'; CAS NO. (Œ' KNOWN) FOR OFFICIAL USE ONLY CITY OF BAKERSFIELD .FICE OF ENVIRONMENT~SERVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY TYPE OF ACTION (Check one/tem only) œ( 1. NEW SITE PERMIT D 5, CHANGE OF INFORMATION (Specify change- local use only) D 6. TEMPORARY SITE CLOSURE D 3, RENEWAL PERMIT D 4, AMENDED PERMIT BUSINESS NAME (Same as FACiliTY NAME or DBA . Doing Business As) I. FACILITY I SITE INFORMATION 3 FACILITY ID II .$~"7:)Al-£ NEAREST CROSS STREET A4clS 401, FA9llTY OWNER TYPE Œf 1, CORPORATION D 2. INDIVIDUAL D 3. PARTNERSHIP . .::J BUSINESS ~,GAS STATION TYPE D 2. DISTRIBUTOR TOTAL NUMBER OF TANKS REMAINING AT SITE D 3. FARM D 5. COMMERCIAL D 4. PROCESSOR D 6. OTHER 403. Is facility on Indian Reservation or 'If owner of UST a public agency: name of supervisor of trusUands? diviSIon. section or office which operates the UST, (This is the oontact person for the tank records.) -'- 404. ~ 405. II; PROPERTY:O~lfR INFORMATION' Dyes Page _ of _ D 7, PERMANENTLY CLOSED SITE D a, TANK REMOVED 400, D 4, lOCAL AGENCY/DISTRICT' D 5. COUNTY AGENCY' D 6, STATE AGENCY' D 7, FEDERAL AGENCY' 402. 406, PROPERTY OWNER NAME 406, ., ~ \ ---,," '. . // ~. 4- rJ-l CITY 410. STATE .8,4.1:: e.Æ?:.s J::¡I!3¿...l:::> , PROPERTY OWNER TYPE ~ CORPORATION QA D 2. INDIVIDUAL D 3, PARTNERSHIP D 4. lOCAL AGENCY I DISTRICT D 5. COUNTY AGENCY III, T~K'ÕÝlÌNËR.INFORMATiON ' , TANK OWNER NAME ..:f' -r¿p~æT:5 "'Pe 7~UECJM MAILING OR STREET ADDRESS // é.. 4. TI-/ A CZ,¡.d tÇ' -3 ~07 411. ,STATE 418. C14- CITY 72J,4~J?/E.¿..b TANK OWNER TYPE D 2. INDIVIDUAl D 3. PARTNERSHIP D 4, lOCAL AGENCY I DISTRICT D 5, COUNTY AGENCY ~ CORPORATION IV. BOARD OF EQUALIZATION US! STORAGE FEE ACCOUNT NUMBER .. . . . '.' d, . '. "" ." '. Call (916) 322-9669 If questions arise P~OLE'ÛMUŠTfìNÂN61AL RESPONSIBILITY INDICATE METHOD(S) ~STATE FUND D 8. STATE FUND & CFO LETTER D g. STATEFUND&CD D 1. SELF-INSURED D 2. GUARANTEE D 3. INSURANCE D 4. SURETY BOND D 5, LETTER OF CREDIT D 6. EXEMPTION VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one box 10 Indlcete which address should be used for legal notifications and mailing. Legal notifications and maJllngs will be sent to the tank owner unless box 1 or 2 is checked. D 1. FACiliTY 2. PROPERTY OWNER D 3. TANK OWNER 423, VII. APPLICANT SIGNATURE P ded herein is true and accurale to the best of my knowtedge. DATE / - 3.0 - ð / NAME OF APPLICANT (print) ~qp~ ~~t-/ 426. TITLE OF APPLICANT 4 . UPCF (7/99) o 409, 411. ZIP CODE 9 :J 307 D 6. STATE AGENCY D 7, FEDERAL AGENCY 412. 413. PHONE 415. ~61- ;3':J5· ~ 3'7-0 416. ZIP CODe 419, '7.3307 D 6, STATE AGENCY 420, , D 7. FEDERAL AGENCY 421. D 10. LOCAL GOVï MECHANISM D 99. OTHER: 422, 424. PHONE ð.:<' b- 6:52: (!::> 425, 427, ( or local U'II only) 429. S:\CUPAFORMS\swrcb-a.wpd . CITY OF BAKERSFIEL.g. OFrlCE OF ENVIRONMENTAL ~VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - TANK PAGE 1 TYPE OF ACTION (Check one Item only) ~; NEW SITE PERMIT 0 4, AMENDED PERMIT o 3. RENEWAL PERMIT (Ð o 5. CHANGE OF INFORMATION) Page 01 o 8, TEMPORARY SITE CLOSURE o 7, PERMANENTLY CLOSED ON SITE o 8, TANK REMOVED 430 BUSINESS NAME (5<lme as FACILITY NAME or DBA· Doing Business As) 3 :s 70Ckt..:Z:>¿;)t..£ LOCATION WITHIN SITE (OptkJnal) .;$~c:.K:2:>.a. TANK ID # -ø./ DA TE INSTALLED (YEARIMO) MO.(1/L- (Specify change .. (o,local use only) (Specify leason .. (o,lOcal use only) ti ,4.¿L.ÆjJ R.P· I. TANK DESCRIPTION 432 TANK MANU ACTURER X".e'A?Æs 435 TANK CAPACITY IN GALLONS /O,OÐt!':) /99e; ADDITIONAL DESCRIPTION (For local use only) --./ TANK USE 00 1. MOTOR VEHIClE FUEL !" marked. comp/effl Petroleum Type) o 2, NON-FUEL PETROLEUM o 3, CHEMiCAl PRODUCT o 4, HAZARDOUS WASTE (Includes Used 01) o 95, UNKNOWN TYPE OF TANK (Check one item only) TANK MA TER~ - primary tank '~ (Check one item only) D. TANK CONTENTS ./ PETROLEUM TYPE f¡Z£ 1a. REGULAR UNLEADED o 1b. PREMIUM UNlEADED o 1 c. MIDGRADE UNLEADED 439 o 2. LEADED o 3. DIESEL o 4, GASOHOL COMMON NAME (from Hazardous MafflriaJs InvenlDry page) o 1 SINGlE WALL Gt; DOUBLE W~ o 1. BARE STEEL o 2. STAINLESS STEEL TANK MATERIAL.. secondary lank 0 1. BARE STEEL (Check one item only) 0 2. STAINLESS STEEL TANK INTERIOR LINING OR COATING (Check one item only) SPILL AND OVERFILL (Check al/ Ihat apply) . ,-.. o 1. RUBBER LINED o 2. ALKYD LINING ID, TANK CONSTRUCTION o 3, SINGlE WALL WITH EXTERIOR MEMBRANE LINER o 4. SINGlE WALL IN A VAULT 3. FIBERGLASS I PlASTIC o 4. STEEL ClAD WIFIBERGLASS REINFORCED PlASTIC FRP œ-3. FIBERGlASS I PLASTIC o 4. STEEL CLAD WIFIBERGIASS REINFORCED PLASTIC (FRP) o 5, CONCRETE o 3. EPOXY LINING o 4. PHENOLIC LINING o 1. MANUFACTURED CATHODIC PROTECTION o 2. SACRIFICIAL ANODE YEAR INSTALLED œ11. [!2( 2. r;r 3. SPILL CONTAINMENT DROP TUBE STRIKER PLATE 3. FIBERGlASS REINFORCED PLASTIC o 4. IMPRESSED CURRENT 450 TYPE (For lOcal use only) 1'1'l'5 199$ / 94 6" 431 433 COMPARTMENTALIZED TANK 0 Yes No 434 If 'Yes', rompJele one page lor each rompartmenl. NUMBER OF COMPARTMENTS 437 436 / 438 440 o 5. JET FUEL o 8, AVIATION FUEL o 99. OTHER 441 CAS # (from Hazardous Materials InvenlDry page) 442 o 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 095. UNKNOWN 099. OTHER o 5. CONCRETE 0 95. UNKNOWN o 8. FRP COMPATIBLE W/100% METHANOL 099. OTHER 443 444 o 8. FRP COMPATIBLE WI100% METHANOL o 9. FRP NON-CORRODIBLE JACKET ' o 10. COATED STEEL 095. UNKNOWN 099. OTHER 445 o 5. GLASS LINING o 8. UNlINEO DATE INSTALLED 447 095. UNKNOWN 099. OTHER 448 Far local use on DATE INSTALLED 449 095. UNKNOWN o 99. OTHER 448 (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 o 1. AlARM ~. FILL TUBE SHUTOFF VALVE Œ!Zr o 2. BALL FLOAT 0 4. EXEMPT ~:·J~,~t~1:[:jj~~~:?~~,:::,~[~;~~~~t]~~.)~t~fJ:?,~~T~~~~~:,~~~~~'111l~;~~~~t¡~~~u:f~:rt~f~~Jt¡~~;j;~;i:~~;~:.:f~;,;,(;~i;;:~~h~~:~:~r.~{~J¡g~~¡{~;:~~~~;~t%~~i¡~;¡~1;;:t~;::~?;r:?)~~\;~~.:¡:?~:::· 453 01. rif'2, 03. 04, IF SINGLE WALL TANK (Check all that apply): VISUAL (EXPOSED PORTION ONLY) AUTOMATIC TANK GAUGING (ATG) CONTINUOUS ATG STATISTICAL INVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING o 5. MANUAL TANK GAUGING (MfG) o 6. VADOSE ZONE o 7. GROUNDWATER o 8. TANK TESTING o 99. OTHER V. TANK CLOSURE INFORMATION' PERMANENT CLOSURE IN PLACE ESTIMATED QUANTITY OF SUBSTANCE REMAINING 458 TANK FILLED WITH INERT MATERIAL? ESTIMATED DATE lAST USED (YRIMOIDAY) UPCF (7/99) 455 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one Item only): 454 o 1. VISUAL(SINGLEWALLlNVAULTONLY) p}. CONTINUOUS INTERSTITIAL MONITORING 3. MANUAL MONITORING 457 glllons DYes ONo S:\CUPAFORMS\SWRCB-B.WPD' · , ~-", CITY OF BAKERSFIELD _ OFFICE OF ENVIRONMENTAL SERVICE_ 1115 Che.ter Ave., Bakersfield, CA 93301 (661) .919 . Page UST. TANK PAGE 2 of UNDERGROUND PIPING vL'~ CONSTRUCTION (Check" /hit 1PfJIY) ABOVEGROUND PIPING SYSTEM TYPE 1, PRESSURE 0 2, SUCTION 0 3. GRAVITY 458 0 1, PRESSURE CONSTRUCTION/ r::J/ SINGLE WALL 0 3, LINED TRENCH 099. OTHER 460 0 1, SINGLE WALL MANUFACTURER ~ 2, DOUBLE WALL 0 95, UNKNOWN 0 2, DOUBLE WALL MANUFACTURER 481 MANUFACTURER o 1. BARE STEEL 0 8. FRP COMPATIBLE WI 100% METHANOL 0 1. BARE STEEL o 2. STAINLESS STEEL 0 7. GALVÅNIZED STEEL 0 2, STAINLESS STEEL o 3. PlASTIC COMPATIBLE WITH CONTEm'S 095, UNKNOWN 0 3, PlASTIC COMPATIBLE WITH CONTENTS 5t'4. FIBERGLASS 0 8, FLEXIBLE (HDPE) 0 99. OTHER IØ" 4, FIBERGlASS 05, STEEL WI COATING 09. CATHODIC PROTECTION 484 05, STEEL WI COATING , . ';¡¡li~1p!NG LEAK þtrECTlON (Check aJI/hIt apply) MATERIALS AND I CORROSION PROTECTION UNDERGROUND PIPING SINGLE WAlL PIPING 468 PRESSURIZED PIPING (Check all that apply): o 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST l4lli AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAl INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS:, o 5. DAILY VISUAl MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTËGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9, BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Chack all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAl ALARMS AND (Check one) - o a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c. NO AUTO PUMP SHUT OFF [fJ 11. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) JCi!I!1 FLOW SHUT OFF OR RESTRICTION o 12. ANNUAl INTEGRITY TEST (0.1 'GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAl AlARMS EMERGENCY GENERATORS ONLY (Check as IhBt apply) ~ 14. COm'INUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION o 16, ANNUAL Im'EGRITY TEST (0,1 GPH) o 17. DAILY VISUAL CHECK , , o 2. SUCTION o 95. UNKNOWN o 99, OTHER o 3. GRAVITY 459 462 463 o 6, FRP COMPATIBLE WI 100% METHANOL o 7, GALVANIZED STEEL o 8, FLEXIBLE (HOPE) 0 99, OTHER o 9, CATHODIC PROTECTION o 95. UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): o 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS o 2. MONTHLY 0.2 GPH TEST o 3. ANNUAL INTEGRITY TEST (0.1 GPH) o 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check all that apply): o 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 6. TRIENNIAL Im'EGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7. SELF MONITORING . GRAVITY FLOW (Check all that apply): o 8. DAILY VISUAL MONITORING o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR ï1!I!:! AUDIBLE AND VISUAl ALARMS AND (check one) o a, AUTO puMp,SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c. NO AUTO PUMP SHUT OFF æf 1,. AUTOMATIC LEAK DETECTOR o 12. ANNUAl INTEGRITY TEST (0.1 GPH) SUCTlON/GRAVI1Y SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAl ALARMS EMERGENCY GENERATORS ONLY (Check aII/hIt apply) æ(,4. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ~-g~!~:;ç,Qijt~~~~~~~?1~1~i¥~~lg?~iß~i~t~,~ti:~1~;šf~~~t:~:t;~·~t,}:;:.·:~~~:~~~~1:~:ì~~~~4~~~~~:¥I~WßtIi~1J"~~::· o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT DATE INSTALLEO 468 ~ o 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS o 3, CONTINUOUS DISPENSER PAN SENSOR ïiIJJ1 AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS IX. OWNER/OPERATOR SIGNATURE ttue and accurate 10 the besl of my knowledge. o 4. DAILY VISUAL CHECK o 5. TRENCH LINER I MONrTORING o 6. NONE 469 DATE 470 /- Bo _0/ 471 TITLE OF OWNERIOPERATOR 472 4 474 Permil Expiration Dale ( or local use only) 475 UPCF (7/99) S:\CUPAFORMS\SWRCB-B. WPD CITY OF BAkE~LD . O~E OF ENVIRONMÊ ,!~'.VICES 1715 Chester Ave., Bakersnéld~~.' "I)t (661) 326-3979 UNDERGROUND STORÀGE''t: :~TANK PAGE 1 \,'f~'~ -!' ' TYPE OF ACTION (Check one ,rem only) ~, NEW SITE PERMIT 0 4, AAENDED PERMIT o 3, RENEWAL PERMIT (Ð Page d (Spectly .....on . for local un only) MOðlL- ! BUSINESS NAAE (Same as FACILITY NAME or DBA . Doing Buliness As) I TANK I · '~1- :s 7OCK-Õ,¿}L.E LOCATION WITHIN SITE (Optional) I ! ~7'i/::JCK2:>P. $/ 4~ R.?>' L TANK DESCRIP110N 43 / <¡9ð ADDITIONAL DESCRIPTION (Fo'1ocIII use only) TANK USE 439 Ii',. MOTOR VEHICLE FUEL (If matftMJ. compte. PeIlÐleum Type) o 2, NON-FUEL PETROLEUM o 3, CHEMICAl PRODUCT o 4, HAZARDOUS WASTE (InducIu UsMJ 01) o 95, UNKNOWN TYPE OF T ANI< (Check Ontl item only) TANK MATERIAl· primary tank (Check Ontl item only) /0 OC>CJ I. TANK CONTENTI / PEmOLEUM TYPe e;(,.. REGULAR UNLEADED o lb. PRaIUM UNlEAOED o Ie. MlDGRADE UNlEAOED o 2. LEADED o 3. DIESEL o 4. GASOHOL COMMON NAAE (Itom Hazardous MaMrlIJØ InYenloty page) o 1 SINGlE WAll ~ DOUBLE WALL o 1. BARE STEEL o 2. STAINLESS STEEL TANK MATERIAL· secondary tank 0 I. BARE STEEL (Check anti item only) 0 2, STAINLESS STEEL TANK INTERIOR LINING OR COATING (Check Ontl item only) SPILL AND OVERFILL (Check ,ø "", 'PØ!Y) o 1. RUBBER LINED o 2. AlKYD LINING II. TANK CONSTRUCTION o 3, SINGlE WALL WITH EXTERIOR MEMBRANE LINER o 4, SINGlE WALL IN A VAULT [it 3, FIBERGlASS I PlASTIC o 4. STEEL CLAD WIFIBERGLASS ,REINFORCED PlASTIC F IR''3, FIBERGlASS I PLASTIC o 4, STEEL Q.AD WIFIBERGLASS REINFORCED PLASTIC (FRP) o 5, CONCRETE o 3, EPOXY LINING o 4, PHENOlIC LINING o 1. MANUFACTURED CATHODIC PROTECTION o 2. SA~IFICIAl ANODE Y£ARINSTALLED !!1 1. Ø'2. r;a 3. SPILL CONTAINMENT DROP TUBE STRIKER PLATE 01. 05. MANUAlTANKGAUGING(MTG) ¡gl2, 0 8, VADOSE ZONE o 3, CONTINUOUS ATG 0 7. GROUNDWATER o 4, STATlSTICAllNIIEHTORY RECONCILIATION (SIR) . 0 8, TANK TESTING BIENNIAL TANK TESTING 099. OTHER 1----" V, TAÑÎ< ClOSURE INFORMATION I PERtMNENTCLOSUi'W iN PLACE I F.STlMA TED 01. TE 1ft!!: USED (YRl1\«:tIOAY) -455 ES riMA TED QUANTITY OF SUBSTANCE REMAININO 45d TANK FILLED WITH INERT MATERIAL? 1_, ,__. ,_ ---=,-:-:===-'=:::::, ",__,_,,____.__ ___ __:~__..=====:-_.Ð!IoIo" \ ;pr~r .-.; ¡T. 3. FIBERGlASS REINFORCED PLAST1C o 4, IMPRESSED CURReNT 450 TYPE (Fo, IocII u,. only) /q<?5 19'15 /946' ,~~~ o 8, TEMPORARY SITE CLOSURE o 7 , PERMANENTLY CLOSED ON SITE o 8, TANK REMOVED 430 431 COMPARTMENTALIZED TANK 0 Yes IB'Ño 434 If 'Yes". complete one page rcw each compartment. 437 / 438 440 o 5. JET FUEL EJ e. AVIATION FUEL o 99. OTHER 44 I CAS II (from H,zardous Materlllls IlMIntory page) 442 a e. SINGlE WALL wrrn INTERNAl BlADDER SYSTEM d III. UNKNOWN d 110. OTHER o 5. CONCReTE 095, UNKNOWN a e. FRP COMPATIBLE W/I00'" METHANOL 0 Q9. OTHER 443 444 o e. FRP COMPATIBLE WI1 00% METHANOL a I. FRP NC)N.(X)RRODIBLE JACKET ' 010. COATED STEEL 095, UNKNOWN 099. OTHER 445 a 5. 0LAS8 LINING a 8. UNUNEo DATE INSTALLED 447 095, UNKNOWN 099, OTHER 448 449 a III. UNKNOWN a 01. OTHER 448 (For ~I use only) 451 OVi!RF1LL PROTECTION EQUIPMENT: YEAR INSTALLED 452 a 1. ALARM œ(;. FILL TUBE SHUT OFF VALVE t.!l.!lr o 2. BALI. flOAT 0 4, exEMPT 4S3 , ;·~~ài~;·}~0,:::; ::.:?/~..:~~\.::.:r· :.; , WALL TANK OR TANK WITH BLADDER (Cheek one item only): 454 YI8UAL (SINGLE WALliN VAULT ONLY) CONTINUOUS INTERSTITIAL MONITORING MANUAL MONITORING 457 ayes ONO S:\CUP AFORMS\SWRCB-B .WPO CITY OF BAKERSFIEL l~t" OFFICE OF ENVIRONMENTÂL ' , 'ICES e,15 Chester A"., Bakersfteld, CÀ 's.~;:o~ .'. ~1) 3_79 ~ , . . >;:^~~,: UST. TANK PAOI! 2 I PIge _ cI UNDERGROUND PIPING VI. PIlING CONI11tUC11ON (Old...', ., ABOVEGROUND PIPING i SYSTEM TYPE I, PRESSURE 0 2, SUCTION 0 3. GRAVITY 458 0 I. PRESSURS I '0 0 0 0 ¡ CONSTRUCTION/' I. SiNGlE WAll 3, LINED TRENCH 99. OTHER 480 I. SINGLE WALL : MANUFACTURER~, DOUBLE WAll 0 95. UNKNOWN 0 2. DOUBLE WAlL I MANUFACTURER 481 MANUFACTURER o 1, BARE STEEL 0 8. fRP COMPATIBlE WI 100% MET1iANOl 0 1, BARE STEEL MATERIALS AND 0 2. STAiNlESS STEEL 0 7. GALVANIZED STEEL 0 2, STAiNlESS STeEL I CORROSION ' I PROTECTION 0 3, PlASTIC COMPATIBlE WITH CONTENTS 095, UNKNOWN 0 3, PlASTIC COMPATIBLE WITH CONTENTS : (2(4, FIBERGLASS 0 8. FLEXIBLE (HOPE) 0 90, OTHER ir 4, FIBERGlASS 05, STEEL WI COATING 09, CATHODIC PROTECTION 484 05, STEELWlCOATINQ VII. PIPING LeAK DETECTION (CMdt " flit fPPIY) UNDERGROUND PIPING L WALL PlPI 468 PRESSURIZED PIPING (Cllec_ al III.' .ptJIy,: o 1. ELECTRONIC LINE lEAK DETECTOR 3,0 GPH TEST mII1 AUTO PUMP SHUT OFF FOR lEAK. SYSTEM fAILURE. ANt> SYSTEM DISCONNECTION. AUDIBlE ANI) VISUAl AlARMS o 2. MONTHl.YO,2GPHTEST o 3, ANNUAl INTEGRITY TEST (0.1 GPH) CONVENTIONAl SUCTION SYSTEMS: . o 5. DAILY VISUAL MONITORING OF PU~NG SYSTEM. TRIENNIAl. PIPING INTEOfUTY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9, BIENNIAl. INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all I1ItIaptJly): 10, CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBlE AND VISUAL AlARMS ANt> (Check one) o a, AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b, AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c. NO AUTO PUMP SHUT OFF IE ". AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) Ï!'!!I:1 FlOW SHUT OFF OR RESTRICTION o 12, ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIONlGRAVTTY SYSTEM: o 13. CONTINUOUS SUMP SENSOR. AUDIBlE AND VISUAl AlARMS EMERGENCY GENERATORS ONt Y (CMdr" I1Itt apøIy) ~ 14. CONTINUOUS SUMP SENSOR WIIt:IQYI AUTO PUMP SHUT OFF. AUDIBlE ANO VISUAL ALARMS o 15. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) ~ FlOW SHUT OFF OR RESTRICTION o 18, ANNUAL INTEGRITY TEST (0,1 GPH) o 17, DAILY VISUAl CHECK o 2. SUCTION o 95, UNKNOWN o 99, OTHER o 3. GRAVITY 459 46: 463 o 8, FRP COMPATIBLE WI 100% METHANOL o 7, GALVANIZED STEEL o 8, FLEXIBLE (HOPE) 0 99, OTHER o 9, CATHODIC PROTECTION o 95, UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PlPIHa fCIteck al I1Itt apply': o 1. ELECTRONIC liNe LEAK DETECTOR 3,0 GPH TEST ~ AUTO PUMP SHUT OFF FOR LEAK. SYSTEM F~ AND SYSTEM DISCONNECTION. AUDIBLE AND VISUAL AIJ\RMS o 2. MONTHl. Y OJ öPH TEST o 3. ANNUAL INTEGRITY TEST (0.1 GPH) o .. OAII. Y VISUAL at!CK CONVENT1ONAL SUC1'ION SYSTEMS (Chech aØ lIIat apply): o 5. CAllY VISUAL MoNnoRING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAL INTEGRITY TEST (0.1 G"H) SAFE SUCTION SYSTEMs (NO VALves IN BELOW GROUND PIPING): o 7. SELF MONITOI'VHG . GRAVITY FlOW (CIt«:II;I IMt apply): o a. OAII.YVISUAL~ING "!j!f'_n o 9. BIENNIAL \H1"SORftY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPINO (CMck all1Itt ~): 10. CONTINUOUS TùR81NE SUMP SENSOR mI!f AUDIBLE AND VISUAl AlARMS AND (check one) o a, AUTO PUMP SHUT OFF 'NHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION o C. NO AUTO PüMP SHUT OFF œ< ,. AUTOMATIC U!AK œreCTOR 012. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIONlGRAVITY SYSTeM: o 13. CONTINUOUS ~ 8ÐI8OR. AUOIBLE AND VISUAl AlARMS . IMØaÞICY GENERATORS ONLY (Check" INI epp/y) Œf'4, CONTINUOUS SUMP 8ÐISOR ~ AUTO PUMP SHUT OFF. AUDIBLe AND VISUAl AlARMS o 15. AUTOMATIC LINI! U!AK DETECTOR (3,0 GPH TEST) ~'" :'·.:·,:~,;'·;.~\:~,~:·'i~:~· ~~..~. ".~::~~-;:'.~:~, ... . ., lf~~:;1};t{>,~ ?: ,~\ ",. :,;,;~}~,~:¡~~t~Ú;Atltfi~~" o .. DAILY VISUAL CHECK o 5. TRENCH LINER I MONITORING o 8, NONE 469 DISPENSER CONTAINMENT DATE INSTALLED 468 ~I o 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR + AUDI8U! AND VISUAl AlARMS o 3, CONTINUOUS DISPENSER PAN SENSOR mD1 AUTO SHUT OFF FOR DISPENSER. AUD18U! AND VISUAL AlARMS IX. OWNERIOPERA TOR SIONA TURI I CfJt1lfy thøllha in' 4 armll upcr: mqq\ DATE 470 /- ae _0/ 471 TiTlE OF OWNERIOPERATOR 472 S:\CUPAFORMS\SWRCB-B.WPO CITY OF BAKER$";~iD OAE OF ENVIRONMENTAL &VICES 1715 Chester Ave., Bakersfietd, CÁ93301 (661) 326-3979 UNDERGROUND STORAGE TAÑk~f. TANK PAGE 1 " '..'..... ¢9 TYPE OF ACTION (Check one ,rem only) ~, NEW SITE PERMIT 0 4, AMENDED PERMIT o 5. CHANGe OF INFq~MATION) Page of o 8, TEMPORARY SITE CLOSURE o 7, PERMANENTLY CLOSED ON SITE o 8. TANK REMOVED 430 o 3. RENEWAL PERMIT 431 (Specify reason· for IOc.' u.s. only) BUSINESS NAME (Same as FACILITY NAME or DBA· [)(no Business As) ~ 70G¡¿---l:>a~ LOCATION WITHIN SITE (Optional) I i .$7ò~P. TANK 10" *3 MOð¡~ ~I ;Q.~ ~þ. 432 435 ) / f/9'CJ ADDITIONAL DESCRIPTION (For bc4J use only) TANK USE 439 ¡x( 1. MOTOR VEHIClE FUEL (ff mamed. ccmpleM Petroleum Type) o 2. NON-FUEL PETROLEUM o 3, CHEMiCAl PRODUCT o 4, HAZARDOUS WASTE (Indude$ Used Oi) o 95, UNKNOWN TYPE OF TANK (Check one iMm only) TANK MATERIAl· primary tank (Check one iMm only) I. TANK DESCRIPTION TANK MANU A TU R 433 COMPARTMENTALIZED TANK 0 Yes IB"Ño If "Yes". complete one page lOt' each compartment. 434 437 10 OCJC / 438 U. TANK CONTENTS / PETROLEUM TYPE flI1.. REGULAR UNlEADED D 1b, PREMIUM UNlEADED D 1c. MIDGRADE UNlEADED 440 D 2. LEADED D 3. DIESEL D 4, GASOHOL D 5. JET FUEL D 8. AVIATION FUEL D 99, OTHER COMMON NAME (from Hazardous Materials Inventory page) o 1 SINGlE WAll ~ DOUBLE WAlL o 1. BARE STEEL o 2. STAINLESS STEEL TANK MATERIAL· secondary tank 0 1. BARE STEEL (Check one if&m only) 0 2. STAINlESS STEEL TANK INTERIOR LINING OR COATING (Check one iMm only) SPILL AND OVERFILL (Check an thaI apply) 0,. Gi'2. 03, 04, o 1. RUBBER LINED o 2. AlKYD LINING 441 CAS " (from Hazardous Malerials Inventory page) 442 m. TANK CONSTRUCTION o 3, SINGlE WAlL WITH EXTERIOR MEMBRANE LINER D 4, SINGlE WAlLIN A VAULT 3, FIBERGlASS / PlASTIC D 4. STEEL ClAD WIFIBERGlASS REINFORCED PlASTIC FRP æ-J. FIBERGlASS / PlASTIC o 4. STEEL ClAD WIFIBERGlASS REINFORCED PlASTIC (FRP) o 5. CONCRETE o 3, EPOXY LINING o 4. PHENOLIC LINING D 5. SINGLE WAlL WITH INTERNAl BlADDER SVSTEM o 95. UNKNOWN 099. OTHER o 5. CONCRETE D 95. UNKNOWN o 8. FRP COMPATIBLE W/100% METHANOL D 99, OTHER 444 œ:( 1. Ø'2. r;a 3. SPILL CONTAINMENT DROP TUBE STRIKER PlATE 443 L ESTIMATED DATE LAST USED (VR1MOIDAY) D 8. FRP COMPATIBLE W/100% METHANOL o 9. FRP NON-CORROOIBLE JACKET o 10. COATED STEEL 095. UNKNOWN o 99. OTHER 445 DATE INSTAlLED 447 o 5. GlASS lINING o 8. UNLINED 095, UNKNOWN 099. OTHER 448 o 1. MANUFACTURED CATHODIC PROTECTION o 2. SACRIFICIAL ANODE YEAR INSTALLED 3, FIBERGlASS REINFORCED PlASTIC o 4. IMPRESSED CURRENT 095. UNKNOWN 099. OTHER Forlocsl use 0 DATE INSTALLED 449 448 450 TYPE (For local uSe only) (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTAlLED 452 01. AlARM ~. FILL TUBE SHUT OFF VALVE ~ o 2. BALL FLOAT 0 4, EXEMPT ¡Q'?5 (995 / 946' o 5, MANUAL TANK GAUGING (MTG) o 8. VADOSE ZONE o 7. GROUNDWATER MANUAl MONITORING o 8, TANK TESTING o 99, OrneR V. TANK ClOSURE INFORMATION' PERMANENT CLOSURE IN PLACE 458 TANK FILLED WITH INERT MATERIAL? 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING ga110nl Dves ONO 457 UPCF <7IfJ9) S:\CUPAFORMS\SWRCB-B.WPD ¡Jr-:i l , ' . . CITY OF BAKERSFIELQ'. ' a OFFICE OF ENVIRONMENTAL SERVICE~ "715 Ch.ster A.,.., Bakersfield, CA 93301 (881) ~79 UST. TANK PAGe 2 . Page - r UNDERGROUND PIPING VI; PIPING CONSTRUCTION (Ch«k " 1M' tppIy) ABOVEGROUND PIPING " i SYSTEM TYPE 1, PRESSURE 0 2, SUCTION 0 3. GRAVITY 458 0" PRESSURE : CONSTRUCTION¡'~' SINGLE WALL 0 3, LINED TRENCH 0 99. OTHER 460 0 1, SINGLE WALL ~ MANUFACTURER ~ 2, DOUBLE WALL 0 95, UNKNOWN 0 2. DOUBLE WALL MANUFACTURER 481 MANUFACTURER o I,BARESTEEL 08. FRPCOMPATIBLEWI 100% METHANOL 01, BARE STEEL MATERIALS AND 0 2, STAINLESS STEEL 0 7. GALVANIZED STEEL 0 2, STAINLESS STEEL I CORROSION I PROTECTION 0 3, PLASTIC COMPATIBLE WITH CONTENTS 095, UNKNOWN 0 3, PLASTIC COMPATIBLE WITH CONTENTS I 1Ø"4, FIBERGLASS 0 8. FLEXIBLE (HOPE) 0 99, OTHER rø' 4, FIBERGLASS 05, STEEL WI COATING 09. CATHODIC PROTECTION 464 05, STEEL WI COATING , VII. PIF'ING LEAK DETECTION (Ch«k "IMI apply) UNDERGROUND PIPING SINGLE WALL PIPING 486 PRESSURIZED PIPING (Check al/ thaI apply): o 1. ELECTRONIC LINE LEAK DETECTOR 3,0 GPH TEST ït!I!:! AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. ANO SYSTEM DISCONNECTION. AUDIBLE AND VISUAL ALARMS o 2, MONTHLY 0,2 GPH TEST o 3. ANNUAL INTEGRI1Y TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: o 5, DAILY VISUAL MONITORING OF PUMPING SYSTEM. TRIENNIAl PIPING INTÈGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, SELF MONITORING GRAVITY FLOW: o 9. BIENNIAL INTEGRI1Y TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all thlJI apply): 10, CONTINUOUS TURBINE SUMP SENSOR ïl!I!:I AUDIBLE AND VISUAL ALARMS AND (Check one) o a, AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b, AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c, NO AUTO PUMP SHUT OFF œ 11, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) Ï!ID1 FLOW SHUT OFF OR RESTRICTION o 12, ANNUAl INTEGRITY TEST (O,1GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR. AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check" thlJI apply) ~ 14. CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF. AUDIBLE AND VISUAL ALARMS o 15, AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) ~ FLOW SHUT OFF OR RESTRICTION o 16, ANNUAL INTEGRITY TEST (0.1 GPH) o 17 , DAILY VISUAL CHECK o 2, SUCTION o 95, UNKNOWN o 99, OTHER o 3. GRAVITY 459 462 463 o 6, FRP COMPATIBLE WI 100% METHANoL o 7. GALVANIZED STEEL o 6, FLEXIBLE (HOPE) 0 99, OTHER o 9, CATHODIC PROTECTION o 95, UNKNOWN 465 ABOVEGROUND PIPING SINGLE WALL PIPING PRESSURIZED PIPING (CheCk aU tlJal apply): o 1. ELECTRONIC UNE LEAK DETECTOR 3.0 GPH TEST Ïl!lli AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAILURE. AND SYSTEM DISCONNECTION. AUDIBLE AND VISUAL AlARMS 2. MONTHLY 0.2 GPH TEST 467 o o 3. ANNUAL INTEGRITY TEST (0.1 GPH) o 4, DAILY VISUAl CHECK CONVENTIONAL SUCTION SYSTEMS (Check aU thaI apply): o 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 6. TRIENNIAL INTEGRI1Y TEST (0.1 Gp¡.¡) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, SELF MONITOftING . GRAVITY FLOW (CIHIck" l/1li1 apply): o 8. CAlLY VISUAl MOt<!JTORING o 9. BIENNIAl INTEGRiTY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (CIHIck all Ills' apply): 10, CONTINUOUS TURBINE SUMP SENSOR ïl!I!:I AUDIBLE AND VISUAL ALARMS AND (check one) o a, AUTO PUMP, SHUT OFF WHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c. NO AUTO PUMP SHUT OFF ŒJ 11. AUTOMATIC LEAK DETECTOR o 12. ANNUAlINTEGRI1Y TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR. AUDIBLE AND VISUAL ALARMS EMERGeNCY GENERATORS ONLY (Check" thlJI apply) æ14. CONTINUOUS SUMP SENSOR mIl:!2W:AUTO PUMP SHUT OFF. AUDIBLE AND VISUAL ALARMS o IS. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) .~ ::~;:.i~/ ~,~:::,t ~:;}~~;~~'£:~l ~l~~~~;1~f(.f./:~·\:·;:):~~:.·.;:··~:~tn~~s~/\~~~~~ W:~;Jtttfi~~j~·~:·· DATE INSTALLED ~I 'l:. o 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE o 2. CONTINUOUS DISPENSER PAN SENSOR. AUDIBLE AND VISUAL AlARMS o 3. CONTINUOUS DISPENSER PAN SENSOR mII:1 AUTO SHUT OFF FOR DISPENSER. AUDIBLE AND VISUAL ALARMS IX. OWNER/OPERATOR SIGNATURE o 4. DAILY VISUAL CHECK o 5. TRENCH LINER I MONITORING o 6, NONE 469 DISPENSER CONTAINMENT 468 UPCF (7/99) DATE 470 /- 30 _0/ 471 TITLE OF OWNERJOPERATOR 472 S:\CUPAFORMS\SWRCB-B. WPD a CITY OF BAÍŒaSFttLQ. OFPrCE OF ENVIRONMENtAL ~VICES 1715 Chester Ave., Bakersfietd, CA~~301 (661) 326-3979 UNDERGROUND STORAGE TANI<.. TANK PAGE 1 (Ð TYPE OF ACTION (Check one II.m only) ~, NEW SITE PERMIT 0 4, AMENDED PERMIT o 5, CHANGE OF INFORMATION) Page of o 8. TEMPORARY SITE CLOSURE o 7, PERMANENTLY CLOSED ON SITE o 8, TANK REMOVED 430 o 3. RENEWAL PERMIT BUSINESS NAME (Same as FACILITY NAME Q( DBA . DoIng Buliness AI) :¡ 70CK:..__~,a~ M Oðl.l.- LOCA nON WITHIN SITE (Opllonal) ~7,þc:.K--L>p. TANK ID ø *4-- (Specily teason . to, lOcal use only) (Sp.Cify Change· ff¡r /lxal us. only) 3 431 s/ ,4~ R.,p. 432 ) /99t:;; ADDITIONAl DESCRIPTION (For IocaJ us. only) TANK USE 439 ¡¡( 1. MOTOR VEHIClE FUEL (If marlced, complete PIIl1DIeum Type) o 2, NON-FUEL PETROLEUM o ), CHEMiCAl PRODUCT o 4, HAZARDOUS WASTE (1nc1ude8 Used OI) 095, UNKNOWN TYPE OF TANK (Check one itum only) TANK MATERIAl· primary tank (Check on. item only) 435 I. TANK DESCRIPTION 4 COMPARTMENTALIZED TANK 0 Yes IB"Ño If "Yes", complele one page 101' each compartment 434 )('I!!REs TANK ACITY IN 438 NU 437 10 Ooc I 438 ø. TANK CONTENTS / PETROlEUM TYPE fir 1.. REGULAA UNlEADED o 1b, PREMlUMUNlEAOED o 1 c. MIDGRAOE UNlEADED 440 o 2. LEADED o 3. DIESEL o 4. GASOHOL o 5. JET FUEL o 8. AVIATION FUEL o 99, OTHER COMMON NAME (from Hazardous MøtørlaJs Inventory page) o 1 SINGlE WALl. ~ DOUBLE WAll o 1. BARE STEEL o 2. STAINLESS STEEL TANK MATERIAL.. secondary tank 0 1. BARE STEEL (Check one item only) 0 2. STAINLESS STEEL 441 CAS # (from Hazardous Malerials Inventory page) 442 m. TANK CONSTRUCTION o 3. SINGlE WAlL WITH EXTERIOR MEMBRANE LINER o 4. SINGlE WAlL IN A VAULT 3. FIBERGlASS I PlASTIC o 4. STEEL ClAD WIFIBERGlASS REINFORCED PlASTIC FRP œ-3. FIBERGlASS I PlASTIC o 4. STEEL ClAD WIFIBERGlASS REINFORCED PlASTIC (FRP) o 5. CONCRETE o 3. EPOXY LINING o 4. PHENOlIC LINING D 5. SINGLE WAlL WITH INTERNAl BlADDER SYSTEM d 95. UNKNOWN d 99. OTHER D 5. CONCRETE D 95, UNKNOWN 08. FRPCOMPATIBLEWI100%METHANOL 099. OTHER 444 TANK INTERIOR LINING OR COATING (Check one item only) SPILL AND OVERFILL (Check all /1Ial apply) o 1. RUBBER LINED o 2. A1..KYO LINING 443 SPILL CONTAINMENT DROP TUBE IF SINGLI! WALL TANK (Check an /halapply): o I, VISUAL (EXPOSED PORTION ONLY) g-'2, AUTOMATIC TANK GAUGING (ATG) o ), CONTINUOUSATG 04, STATlSTlCAlINVENTORY RECONCILIATION (SIR) + BIENNIAL TANK TESTING D 8. FRP COMPATIBLE WI100% METHANOL D 9, FRP NON-CORRODIBLE JACKET 010. COATeD STEEL o 95. UNKNOWN 099. OTHER 445 . ESTIMATED DATE LAST USED (YRIMOIOAY) UPCF (7/99} o 5. GlASS LINING D 8. UNLINED 095. UNKNOWN 099. OTHER 448 DATE INSTAlLED 447 I For local use 0 DATE INSTALLED 449 I o 1. MANUFACTUREDCATHOD1C PROTECTION o 2. SACRIFICIAl ANODE YEAR INSTAlLED 3. FIBERGlASS REINFORCED PlASTIC o 4. IMPRESSED CURRENT D 95. UNKNOWN o 99. OTHER 448 450 TYPE (Fo, local us. only) (For IOcIJI use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTAlLED 452 o 1. AlARM ~. FILL TUBE SHUT OFF VALVE t!l!lr D 2. BALLFLOAT 0 4. EXEMPT Iq~5 19~.s 19<16" o 5. MANUAL TANK GAUGING (MfG) o 8, VADOSE ZONE 07, GROUNDWATER o 8. TANK TESTING o 99. OTHER V. TANK CLOSURE INFORMATION' PERMANENT CLOSURE IN PLACe MANUAL MONITORING 455 ESTIMATED QUANTITY OF SUBSTANce REMAINING ONo 45ð TANK FILLED WITH INERT MATERIAL? 457 gallons Dyes S:\CUPAFORMS\SWRCe"e.WPD i CITY OF BAKERSFIEL;O;(,;:r a OFFICE OF ENVIRONMENTALURV1ces.A 9115 Cheat.r Ave., Bakersfield, CA 933þn~81) 3W979 . . ,.;1 ,,' .;.. ,- Page UST· TANK PAOE 2 01 - --, VL PIPING CONSTRUCTION (Chtdt. /lilt jppIy) , UNDERGROUND PIPING ,-,. ABOVEGROUND PIPING ¡ SYSTEM TYPE ! 5f 1, PRESSURE o 2, SuCTION o 3. GRAVITY 458 o 1. PRESSURE o 2, SUCTION o 3. GRAVITY 459 i . 10 o 3, LINED TRENCH 099. OTHER o 1. SINGLE WAµ' o 95, UNKNOWN I CONSTRUCTlONl ~. SINGLE WALL 460 462 ! MANUFACTURER 2. DOUBLE WALL 095, UNKNOWN o 2. DOUBLE WA~~ o 99, OTHER MANUFACTURER 481 w.NÜf~CTURER 463 o 1. BARE STEEL o 8. FRP COMPATIBLE WI 100% METHANOL o " BARE STEEL o 8, FRP COMPATIBLE WI 100" METHANOL MATERIALS AND o 2. STAINLESS STEEL o 7. GALVANIZED STEEL o 2. STAINLESS STEEL o 7, GALVANIZED STEEL 1 CORROSION o 3, PlASTIC COMPATIBLE WITH CONTENTS o 95. UNKNOWN o 3, PlASTIC COMPATIBLE WITH CONTENTS o 8, FLEXIBLE (HOPE) o 99. OTHER ¡ PROTECTION [!2(4, FIBERGLASS o 8, FLEXIBLE (HOPE) 099. OTHER jQ' 4, FIBERGLASS o 9. CATHODIC PROTECTION 05. STEELWICOATING 09. CATHODIC PROTECTION 484 o 5, STEEL WI COATING o 95, UNKNOWN 465 I , VII. p~ LEAK DETECTION (Check ..that~) UNDERGROUND PIPING SINGLE WALL PIPING PRESSURIZED PIPING (Ch&Ck al/lNt apply): o 1. ELECTRONIC LINE LEAK DETECTOR 3,0 GPH TEST mI!:1 AUTO PUMP SHUT OfF FOR LEAK. SYSTEM FAILURE, AND SYSTEM DISCONNECTION + AUDIBLE AND VISUAL ALARMS 2. MONTHLY 0,2 GPH TEST o o 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: " o 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING ImEGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7. SELF MONITORING GRAVITY FLOW: o 9, BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Ch&ck an that .ppIy): 10, CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBLE AND VISUAL AL..ARMS AND (Clleck one) o II. AUTO PUMP SHUT OFF INHEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c, NO AUTO PUMP SHUT OFF IE 11. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) mIl:! FlOW SHUT OFF OR RESTRICTION o 12, ANNUAL INTEGRITY TEST (0.1GPH) SUCTIONlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONt Y (Ch&CJcø'1II81~) 1!1,4. CONTINUOUS SUMP SENSOR ~ AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15, AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) mlliQJil FLOW SHUT OFF OR RESTRICTION o 18, ANNUAlINTEGRITYTEST(O,1 GPH) o 17, DAILY VISUAL CHECK , , 486 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Ch&ck al/ /hat .ppIy): o " ELECTRONIC ÍJNE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK. SYSTEM FAlì.u.~ AND SYSTEM DISCONNECTION ;¡¡jõIBLE AND VISUAL AL..ARMS o 2. MONniL Y 0.2 oPH TEST o 3. ANNUAL INTEGRITY TEST (0.1 GPH) o 4. DAILY VISUAL CHECK CONVENTIONAl SUCTION SYSTEMS (Check a/l fhalapply): o 5. CAlLY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM o 8. TRIENNIAL INTEGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, SELF MONITORING . GRAVITY FlOW (Check 8II/hal apply): o 8. DAILY VISUAL MONITORING o 9. BIENNIAL INTEGRITY TEST (0.1 GPH) 8ECONDARlL Y CONTAINED PIPING PRESSURIZED PIPING (Check 811 that apply): 10, CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (check one) o II, AUTO PUMP, SHUT OFF WHEN A LEAK OCCURS o Þ. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION / 0 c. NO AUTO PUMP SHUT OFF [Ø ". AUTOMATIC LEAK DETECTOR o 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIONlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Chsck d/hat apply) œ",4. CONTINUOUS SUMP SENSOR ~AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL ALARMS o 15. AUTOMATIC LINE lEAK DETECTOR (3.0 GPH TEST) o 18. ANNUAL INTEGRITY TEST (0.1 GPH) o 17 . DAILY VISUAL CHECK )J.~.Ç9Nt~"~~'1~m\~~" o ~~{~~i~~M~1~~t~.';t~~:~:. ~~it: ·::··~::·~:.:+~~?t\~f4~~~~ W~~;J.fÞ jfi*.~t~:·: ';::,\;',.:{:};';:~r'it~· ~(:,;~ ': ~~r~h!f\t~~:' DISPENSER CONTAINMENT 0 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE DA TE INSTALLED 488 0 2. COI'ITINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS -z.c>e¡ I 0 3. COI'ITINUOUS DISPENSER PAN SENSOR WIII:1 AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS IX. OWNER/OPERATOR SIGNATURE o 4. DAILY VISUAL CHECK o 5. TRENCH LINER I MONITORING o 8, NONE 469 DATE 470 /- So _0/ 471 TITLE OF OWNERIOPERATOR 472 Ð m ermil pltaUon Date ( ,1oc.1 UH only) 475 UPCF(7/99) S:\CUPAFORMS\5WRCB-8. WPD WRthEN MONITORING PRdtEDURES UNDERGROUND STORAGE TANK MONITORING PROGRAM This moaitoring program IDUI& be Iœpc at the UST locaâoa at an times. The imbnaaôoa on thia IIIOIIÏtDriD¡ program are c:oDdìåoDl otthe opcraâ.D¡ permit 1'be permit boJdcr IIWII DOC:i1ÿ the OfDœ afEøYironn......',.! Services withia 30 days of any çhAlt.. to tho moairoring procedures, uaJca required to obWa appnM1 be:fon: "'--Iring the cbaDge. Required by Sectioas 2632(d) aud 2641(h) CCR. Facilhy Name Facility Address .;S 7'nr V''''7''1 AL.F' ~tt:9L"'1'/"-- /.3ð / S"T"DrN!....~,¡QL-.F: .c.(y' /Bf,¡QV,¿a¿¡?~/2!L"!I\ (7.Å A Descri~e the trequency of performing the monitoring: Tank \. ;:> DA;¿'~ - G/~3A-<' ~ M~/7'/)LP./A. 9 S'Y.5'7'.s'~ Piping B. What methods and equipment, identified by name and model, will be used for perfomiDg the monitoring: Tank > G/.~f'.., !:-foVI1ÐðliLJ&.. ~"'.s""",^"" Piping C. Describe the location(s) where the monitoring will be performed (facility plot plan should be attached): .::TEé' 'PLOr P.u4N D. List the name(s) and title(s) of the people responsible for performing the monitoring and/or maintaining the equipIn~t: J,o¿JAI A. SruAA!'7"- PLÇ~. E. Reporting Fonnat for monitoring: ¡i~~~s /$ -:..,~?::';¡' ::::~ ::::::. 4ð:> F. Describe the preventive maintenance schédule for the monitoring equipment. Note: Maintenance must be in accordance with the manufacturer's maiaþp.nce schedule but not less than every 12 months. 'sS:sL ~.Ç) 7.1,tC'c..rS &v.e .A4~'7ll::M?~ 4A1Aiul)"-y G. Describe the training necessary for the operation of UST system, including piping, and the monitoring equipment: .R1V~ I 4:/N~;<" ME A4/JA.'" roL /05., K.A..&::If...r 1 ¿u~,p_ ~ .4D'7VI'fIA71C. ~"5í:.fo '7" ~r ./.5 ( e e EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be kept at the UST location at all times. The information on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures. unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCR Facility Name Facility Address J'»':::V .P"2::>~LL N~ / L- /~~/ ,s-n;'YÞ-7:>,at' ~ .tI7-' . 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate the secondary containment, then the Office of Environmental Services must be notified within 24 hours. Nh?'7ç;"/ :'5P/.U $ .. :S'.c?,û¿PLJr.e ¿u/ru /<1rr'1' ,t-rr,eoe.- / .JS/-uE.t:&> vP ~2) PPk:i!!. /AJ ';P¿'~.s77c... ~ ~ -me- ~.,. r-fA'7"-?ð,eZU':Jð...!: .iA../As:.-r# -p",..___.p4 ALL- MI/Wt!)é:.. f]p;LJ-,S, er:,~ '"'?'HE ~~_P<,t:'/~'::h .&:'ltP¡;:: ~tf!!!!Pr. W/ã... .wILL.- ~7»c;r A (lee:Y/t1!!/J!E}) ~ -r4.4c..:rl.Qe. . 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substance. ~/?? "))I/s..,- p~ __ , 3. Describe the location and availability of the required cleanup equipment in item 2 above. /H ~Æ..._ 4. Describe the maintenance schedule for the cleanup equipment: 5. List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: ...k~ A S7Z...P;t2.;7: - P/2e6 @ ~&a. oCCaIifDnIja . . Iscua w..... a..aurc- CoacraJ Soard . ~ .. .~. - . . k: CERTIFICATION OF FINANCIAL RESPONSIBiliTY ~ UNDe8~ STORACE TANKS CONTAINING PE1ROlEUM 0\. (.. ....__.. ... 1"" . .. J' I It II, ...................... ...m1e4 iaSMlioaZ801. o.,w 11. OW.J.11aIIIZ3.cx:aa 0-0lIO ....,...-..... 01 .w. .................... Of AND or ø 1 aiIIoa 40Uan per~... 0 Z aaili.. doUan...... ......... (1.......... Nft,. \ I - " -'.,q: ':: ~,~;~ :;::',<~,..;~,;,:;~ '.: ,~.¡~i:;i(':~~:.'¡~:> ::;':~q ;':' .' '...' "'..,<.. ~ ,,,,,, ''''.."... .'.,~.,..,.,'~ "~",,q " _,.;r,\,,::,;.L.;·:~~:~¿~:~~~~\~¡]!;~il:·:' ' ~~tA~~~Y.. htlrebycertJffe6 that it is in compliance with the ~ of &Iction 2807, .:Jmre :$7";47'£ ?(.$7:' ;::v~ 'P. é'. &>< . ?~ U~ d""".qQ<Z.fJm4óiÚ 7'b d-o J __ /K.. (j!)eJ 6'8-/7 99 S; tfJt!je/ _ ;Þ,¡!3Æ. ~"µdt95 Yeë ~.t.a :!i;~('!) ;Þ~ ~<?( ~.u«. a,~N~ ýé,s Y£.-f> Clsr rO~ (!IIIU '~NJ1,fJ(11At- t:;,q:: t'c.E:.<2.... l.é.rnø12 .;1"7V/l1l1"6 Pe7&Jl..IlWµ /1 e. 4:- 'r# S'~ '78AK€R-5ql!!í(2) ~ ' . ,; 9::1307 Yé$ REceiVED ;EB 0 7 200\ E ,,\f.tf.'M ~ " '~te: /I you MIl using the State Fund lIS IUIY patt of your demonsttalion of fiMncilfl/'tesponsibiJity, your e.TtØCU/Jon MId 6lIbtnØsiøn of this certJflClJtJon also ce1tll1es that you Ste in comp/Isnce with sll conditions for partJc/pstJon In the Fund. -..1::;11... .;) 7o.c:..KZ>¿:JLE Mð8/¿.. ICI1IIJ'H_ ~~ 'Z4co Mð-ð..lL... oj -~~~ ",... I Mo~ ~ I'1óØ/'7- ~'!~~H... ./ /9 "7'.i/ ~ /.?- fi' .;¡, 3-<:? "7 :=-'Y~""" v"~ ;r;H .$'T; Due OÞð,(,-O/ ;¡::>¡{!£,s - .~WI Due :~ t:Jz. -CJ~ / PILla Ort-..a -1..-1,...., CGpIeI- '''ItI.III(I) , . .... . · ... ~.., e nr8'l'IutC'!IOIlS ~d'lc::&Z%oar or PDlUfCUL ..8POJr8IJ1ZLZft PO_ Pl... rn- or prfnt cl....ly aU fÌt1...cfon on C.rtfffcatfon of 'f".,.,fal ........b.Uty fori.. ' AU UIT fecfLltl.. ..".. ate.. ..... or oper.c" _., be listed on one fo,..: Ch.r,'ora a ...raca cercfffCltce I. noc requfred for .ech .'ta. DOCIIeEIfT I.PGlMATlCII A. __........... '-.. -0' CJseck tha lWopI'flt. box.... 8. ... of Tri CIMMr - full ".. of eith.r the tank owner or the oper.tor. or ~cor IndfCltc. ....fell Stat. 8ppI'owd MCIIenfUl(I) are being wed to sit... flnancfat reapanalbfl Icy .f ch.r al contafned in the fedenl regutaclone, 40 CPR, 'ert 280, ~rc H, Sections 280.90 through 280.103 (S.. Flnanclat RponalblUcy GuIde, for .or. fnfor.-tion), or Section 2802.1, Chapter 18, ,DfYI.lon 3, !ltl.,23, CCR. List all ~ and addresses of c~ies ardIor IndiylduaLs Inulng cowrq.~ Lilt ldentlfY'ni tuIIÞer for eadllleChanl. used. ExMpLe: Insurance poLIcy IUlber : or ffL. IUIber u Indicated on bond or doc\IWIt. (If using Scace ct....... 'WId CState FWId) I..ve bLenk.) , Indicate .x.nt of cover.ge for .ach type of lIecfIenl..). If.... then one lIIIChani. fI indicated, totaL IIIUIt equaL 100x of finanelaL. responalbfl Icy for .8dI facfL Icy.. ' Indlcat. the effective date(s) of aU financiaL MChanISll(s). CState FWId coverage wouLd be contll'UlUS as Long al you JIIIintaln c~L lanc. ~ r_in .L lalbL. to conci,.. participation in the Fwd.) Cornett. Act'on - Indlcat. yes or no. Does the specified financial MChanl. provIde cove..... for correctIve action7 cr f using ,State FCIId, Indlcat. 1Iyn-.) C. .......f. 1)pe - ... of ....... . .......,. ...... . CøwI... Ma&nt - C4M1t... ......od . Th.rd hrCy - ~...tton D. Fecfl fcy - 'Irrtor.ctan E. Sf.-ture Itoct . Indlcat. yes or no. Does the specifIed fInancial 1DIdI.,,1.. provide covera,. for third parcy c~uion7 (If using State FU'Xt, Indicate 1Iyn-.) Provide aU fac:ìUcy ertJ/or sit. names and address... Provide slgnatur. and date signed by tank owner or operator; printed or typed ".. and title of tank owner or operator; sipture of "imeaa or notary and date signed; and printed or typed name of witness or notary (If noearY signa .. witness, pl.... plac. notary seat next to notary's IfgNtU,..). lINIn to "'U IildtffCltfon: ' PL.... send orljlnat to your tocat apncy Cagency who fasues your UST pe...fts). Keep a copy of th. certlffClttlon at eacb facftfty or sit. lilted on the fone. 9'JeICIGN: If you have cptetlona on financial r..ponaibit ity requirements or on the Cerefffcatfon of Ffnanciat ResponaibUfey Fona~ pl.ase contace the State UST Cle.nup F\Id at (916) 739-2415. Note: pfttc'''for FaILure to,ea.lv with Ffnenciat Resoorwlbfllty .ecad~.: 'allure to c..,ly -.y' ,...ule In: (1) ¡..rdfzi", cla'lI8I1e .UgfbfL fty for the State UST ct...., F\nf, and (2) lflbfLlcy for clYIL penalties of up co 110,000 doLLa,., per day, per ....rground stor.,a en, for .ach day of violation as seated In 'Article 7, Section 25299.76(a) of the Californ'a H..hh and S.'ety Code. .-..... " ~" ~ tþ . l</Æ:1rCN~TeA!:: Moø/~ .3 ;z.oo r: ,;sr. ßA'~..eú,i:"'~ò c::l.4 ?~ ~CJ I r.4~T~~ M~ ~?~ J,.Jl-llrE. .LN. ;aF1~¡::-I'ELD, <24 9iJ3~ "" FEE .", """,Eff ,::' ~,' ~, : ~. '" ¡ W~,,:::~~ii ¡ ~1 .' tt E.S.S.R INC. BSSR, Inc. a 6630 Rosedale l.'f!ffy., # B Bakersfield, CA 93308 Phone # 661-588-2177 Fax # 661-588-2786 1211 THU 1 :3 :.6 FROM · · · " .,j :';,: :.~, :: ~\'jjr;TO: ,'..' ;~~;.r :': ,: ': f,~ ~ . \' , ''',''. " ,......'.. }'~i:.. '''1 ,', ,,:.,; '. , " ~':. ':~;. \ , . :^,~" i ':1: 01 , ... 'hfjir:;:;'['-~f'::' ," , l' .., , ,,! 0"" 'H .: :':":',~. ,. ':, I:, '::, . ~ ;~;',:; )).J>:,',;',,' ).~,: . ," ,:,' !t '" .. "', 1., . ,~: '. " '.: '.,:~ : ~:;: .' " :.; " ;l:':'~:i:': " " ,'1 i¡;::';;~:::" ' of . I ,:~:"'.':,,,',' ,,':!,!:',':', ~:,,:::,'::,:"";"~:.::.',' ,::,::,,~:,.¡~::.;::',"","',';','~:',,'.',' "::" ::tjt~r¡ :' i'-!}Ui;,~!;:i';'.· ,\ ;' ...,{: A;':"· f~ '. " ;;~,:,; ~ ';' ,,~ I. >,1:.,:" , ~ ;'; \<·"~':'·'·'·':":':·:::··I'~~,: '.,' , I ',:,.1:""I! ':,;,,' . i', .t:;¡, ' ," ... \ '. >,~~ ~ q h.,':' '.¡. ~ . . ::,'" . .. , ::: :;'; .:.:,':' :;~! ,:' :j::':, ::~i .,;;i'),,~,:,::, .~(~: " "'" . ::¡:i¡f(:r;:/ . , ~':'i '. /t i;·;;;:~t; '; " '"," ."', . ¡ ..:-; . ~.;~. ," ". .. ,:.~ ~,~>':,:,':;: ¡!)~:.I,~ i1.\~ ~¡"": "\: :.::~~ ~ ~({'~( ':K: ..f;}Hr~~··~,'", ,'~ ' . !Z~~l'~ '" ""."'.r'"!I."(,,,,,,,¡ ·U~1 1ÎiIDe~ltranSïmLW" " ..., SJ-l Vi /j f/fiLf u;PJIi· Fax: F~: ~4Cl1â("jJ1fY ,R~:<~ddw mob'j lrß¡jlJ ! sroddCJJ¿ Date: Pages: ',':" <~';'.~' .::~. ::.':~ '0 Urgent' , \ '. o For Rø¥1ew C PI.. CcIn1ment . . . . P . 121 1 "',M '~~~¡~~;îT: ~' "~r ";I,~¡::~~i~t;;~~~~f¡'1~¡:::~~:~';tr:.::~!.itt;:~i.:~i!;;J!/,:!{\.,;:;;"\!~!'" fk ! . " .,' ,¡.::~ :;':" "","(;,r,;~,:":r"!': ":I;~;':' ..': ):};<:';" I .' ,,~,~,\,;,.,,:,: ¡<,,'::; ;,':::,:"",':':~,;:',;."~;:::',.,..,:'::'i.,:' - . :,if::;'::': :··::i};;:·:I, . 3Z(P~ Of;'~7l{; c2JB/~ðt>2 ;:¿. Hwlj , ~:!~;' ',.. «t<r>. 1;'3;~X, .. . ,; ,.'~ ;,..~: ,. ~. I. .', \. 'J,'; ,;(,;; :-:':;.':,:~:,;::~, :.' .:. ~.: : :":(:'" o Please Reply (J ~,D_'" '., '~J~" . : '~, ' ','j .,~,,;I : ': . . , ::,:,::;. :~~j:';''':,. · .,,;:~ ...;.~;~···~;,:>:.r:, "";.:. ~.~: ,.:.,.:~~:.:(. . am \/~r :yd7c~ I ( '--d I,,", f)sþ/ ouý , " ;" " ~fjnJ; ""~ !;" ~; ~ I ~, .'.'(':::?', .>~::.l'~ · '. , H~, I ,:' ,",::"": ::.: ,.'::~: ::':;::~:'/~}5:, ;""::")?:j~';r;: , ,','" \~ .~'!.' 7,:0 : ~\.:: ','). '\" ..;, .,;': .," . .' : . . . N.....· "J' ':~\:."':'\ .: IJ ¡l)ttú!Iv ( "",' "I' i ' " ,', ,I' " ' -, . .,',,' I,,' ';. . ',":,' .,'. '~ : ,:. :':' ;":','1 ;.', : . . :.. ':;;; . :.: " ,'. ,:," t', '1,", " \': · },¡", ::i/;,;:::;:. :~:; , · ::¡;:?~,i¡'~}:; ,i:··.· ",' ::~:~:.{~".\'. ';':#1' ,: ;' ,,'. " · :0:;, '" ::.:..~,¡::,:,,: ~ : ¡,",:,',.~.[t-," ;,f; ~ I :I.::~: ,:. . . , , :::·.'~~i:,:;~¡[t·,:,,{ :,; :)', '.J '.. I ,', ;~,~:\:;, "',: ·'1 ';" ,:·,~t.~~·~:·~ 1-, , "" ':~, ':'::;;,..,'. ,:(,.r,f.¡';,:,'\'< .,' '.. ...,:' ¡:§':Y , i~'~~:itUf :'" ':'8i<t~ :'~1í ""''i'-~¡'''' , ! !'" ¡,i, ;;:'~,:i:;~ ':1 .:~ "I:~ ~~'~II ,...~ '. ':f{~~j'~, ';::.;.,':.: 1.1::' .,,,. .fl_ . '. ~·r." . f,', " ",: ~ .: ··Io'.. . :,.'::,·r. ,I':" ., ':.;;'.," .','. " " (,..~. .:~1}~·.~: :. it, ....'" , ~...... . . . ..,,~ .;'" 5.f'~.;:·:;. ., ""I '<j(!:' ~;!f:.: ;,:":,:'::{' j : :ii;> ", .).. ·1..... ":. .~~:~~ . . ".:,' .:, .:. .:.' ·.:~.~~t;··: ~"~,. '.. ..,' '" I FEB- 8-01 THU 13:tþ' FROM B.S.S.R. INC. P_02 ..~ ;¡ e ."1, Ine. Bakersfield Service Station Repair 6630 Rosedale Hwy., # B Bakersfield. CA 93308 Phone #661-58a~BSSR(2777) February 8, 2001 Bakersfield City Fire Dcpal1rncnt Inspector Steve Underwood 1715 Chcstt.T Avenue Bakersfield, CA 93301 RE: Stockdale Mobil, 13001 Stockdale Hwy. Dear Mr. Underwood, Per our c:onversation regarding the above facility, the d,ispcnscr pans that will be installed arc l'Oade by Total Containment, Model # DF4221. And the tank monitoring system ill a V ceder Root TLS 350. I appr(,Xiate your assistance in advance and please call TtlC at 661-588-2777, if you should nced further information. cc: File FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES ·_~;---'2101-·H" Street~'- Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 9330B VOICE (661) 399-4697 FAX (661) 399-5763 ,--- e -- Januar'j 22,2001 Stockdale Mobil 13001 Stockdale Hwy Bakersfield Ca 93312 .-::---~~-~-----;;;- --- ---~- RE: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update Dear Underground Storage Tank Owner: You will be receiving updates tÌ'om this office now, and in the future with regard to the Senate Bi11989, which went into effect January 1, 2000. c'~:':~ 'L \{~ ~}.f This bill requires dispenser pans under fuel pump dispensers. On December 31,2003, which is the deadline for compliance, this office will b~ fqre~d to revoke your pennit. to operate, effectively shutting down your fueling operatiQn.. " It is the hope of this office, that we do not have to pursue such action, which is why this office plàns to update you. I urge you to start planning now to retro-fit your facilities. If your facility has upgraded already, please disregard this notice. Should you have any questions,J)lea~è feel tree to contact me at 661-326-3190. sin1~·· , . Stev~ 'Und~~oo,d, Inspector Office of Environmental Services, ' ,'" I'" ",', '. '.", . ".' " " . '~ "~~_.',.'~' -, ......_~,..- .'~~ -_..!. c.-._...;....:.+ v..... ~,-<,.,,-~~_.-!:-, ~...;~...~..,.... ~--'¡.... ~~.;)..~i:-,'.If...(. ·'I'.).:....'..~: .~. ;--, l.\,:-·t~("'1~.:-}.~".~i. -;1.1 ~ :,(~(~,7:' ,Ji\I;~Ç[T ~:î ~;.<:; ~}~f.;~·_;F:~'Jt~ {G', ;·:0;.:..I):-;~:~;~;~·.: ~,F:-' G~J.!:'''; ~ i.f\':1! -§k'{T;d~ L!,6;,!:::~' ··I~~'7J';;lfc',~;. b'_~':¿ ï:p¡r:,i?:'C'¡ LiL<J!: q!¿:I:;;;".;;,:;- i ~j: r<·~.~· :;'~wt! ¡-r) ~:;;~~:';::-Jr~;' ()':;J ~~~~'..:~>~ :·\r·:·,.....':J >".!..f.:t~.;~ :'~~:\.; ·"{:.,''',~r '·t':Jj~;f.~:~·!~ï. ~~ >:.'.(¡:j , _. . ~...'".. \-.'.. f' /'- . : .; :" : ~ ,~".~~'''.. i::-~:;: :.;;.... f. _ . . ..' " ., . ~ ..: > t i~·_::: ,"/ '. . > "," ""Y~ de 't5~ Mop vØ6OPe' §"'~ .ß _~~" I I \ '~ :1 .i \ j ". , , I ~ . "~ ;:,'C,$' f ÍI o " '='í .t r, .' ?" """ U(U >' J;. 7' ~7- c; =, ~ ~~~-'''''~ -1\:./ ;:_ ....;-;, f ~ H; 0(.') /~ Wen {f,_'?' t~/", I:: <': fq- ¢."''\ ôd '~Qj' t/\ ({)_ ,/\1 ,,;'JI23'J1 G I wU)./ '\ -, n: c.:( ~ .....~ '\ ' ,.,.....i".... ~'. If '~(' ~,~ETUPN SERViCE:. R:=(JUCST~D t"LÌ- Þ.,MER!CAN CITY) ~-~/.d(ER3;:-ïcL:J& C~~~ .._, CITY OF BAKERSFIELD FIRE DEPARTMENT CE OF ENVIRONMENTAL SERVICES 1715 CHESTER AVENUE BAKERSFIELD, CALIFORNIA 93301 OFF e '. 1. "'I \', \\~ ,,' G\ tJ; , \ f\ C) l/ f'\ ~ $ ~ =j / " ./ / //- ~ï,k~~' -~~ I 1 I I I I I In \llil\\ 1111\11\1111111 \.\ \\ AUii_'_.H.3.1 ~__ . _ ~::t.::...:::_rl.~"" :".:.:¿ l"iJ I,~ ¥ FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 UH" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAX (661) 326-0576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (661) 399·4697 FAX (661) 399-5763 - - January 22,2001 Stockdale Mobil 13001 Stockdale Hwy Bakersfield Ca 93312 RE: Dispenser Pan Requirement December 31, 2003 Underground Storage Tank Dispenser Pan Update Dear Underground Storage Tank Owner: You will be receiving updates from this office now, and in the future with regard to the Senate Bill 989, which went into effect January 1, 2000. This bill requires dispenser pans under fuel pump dispensers. On December 31,2003, which is the deadline for compliance, this office will be forced to revoke your permit to operate, effectively shutting down your fueling operation. It is the hope of this office, that we do not have to pursue such action, which is why this office plans to update you. I urge you to start planning now to retro-fit your facilities. If your facility has upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326-3190. SiD] ~ Steve Underwood, Inspector Office of Environmental Services SBU/dm ~~y~ de W~.¥OP.A~ .r~ ./6 W~" ANDREINI&CO, FAX NO, 029478541 ~ p, E~~!~!!:,~~~~~~~t;~~;~~ PROPUCM , THIS CERTIFICATE IS ISSUED AS A M~TTER OF INFORMATION ONLY AND , CONFERS NO RIQHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE ; DOES NOT ~MI:ND; EXTEND OR AL 'J1:R THE COVERAGE AFFORDED BY THE ; ,~,~~IÇ'~,~, ,~~~~~'.... ",., "., .',.' ,.. , '" ' '" , . ".., "," , ...', " "" ,.." , .. ' Andreini & Co License 0208825 220 West 20th Ave. San Mateo, CA 94403 (650)573-1111 Fax(650)378-4361 COMPANIES AFFORDING COVERAGE .. ..... ...... ..., .... .... ...... ... ..... ..,. ....... .... ... ., ".,. ... ..... .... .... E~~Y A COMMERCE &: INPUSTRY INS. :.. ....,...,.. '.. . ....... ...... .........,... ...... ....... ... ... ..... .... ......... .". ...... ... '" .....,..,... .... IJSUR~ ......""".,......: ~~Y B .................'.""........,..............,.""...........····..···....··'·/1·,......·....·..-· LLO GAS, INC. 23805 STUART RANCH, #220 MALIBU, CA 90265 , , . ... \' . ... . COMPANY C lETTER COMPANY D LETTER , , ,.. COMPANY E LETTER .... .. . ............ ... . ."". \ .. .... . ..... ......."... . ..,. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEE;N ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WrrnstANDING ANY ~EQUIREMENT, TE;RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED 01'1 MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI!IO~~ OF SUC~ f>OLl~IE~" ,lI~I!S SHO~N ':-I~~H~V~,BE~~..R,~I?~C~D8Y P~.D ~,lJ\',~,S: ' : POLICY !mCTlVEPOUCT DPIII.A.T1O/II ; 0& TE (MMIPD/Y'f) ÞA TE (MM/OD/'fY) co! LTR; TYPE Of INSUAANCE POLICY NUIIBEI\ LJMITS . . ..... .. . . .... ......... i (;ENEA,U UAÞIUTY : GEONEAAl AOGAEGAlE " '....:: 1 COM~EACIAL GEÞŒFIAL llASltlTT' , , ..··,,,·,.1..................·....··....·'.."""11. i PRODUCT~COMP/OP A.GO. '5 ............. . ; ........ ..."... .. .... ..... :'UTOMOBIU UABIUT'Y : ANY AUTO i ALL OWNED AUTOS ; i SCHEDULED Auras ¡' .... : :.....) HIRED AUTO$ ; NON.OWNED AUTOS ".'.; ¡ GAAA.GE LIABILITT' . .. .. ... ¡ . ....,'....' ".".... ...... ..,., .... .".,.... ~. .... ... .. : PE'R$O/IIAI. & AOY, INJUFn" ;$ :...........,.,.."""...........................¡:....,.,.''''''.....,.................... : EA?H..~~~R~~~E ,,' ,...... ..$,.,..", .. ,.., : f~:~~.A,~E, ,(~y. ,~~,~, ~~~?....,..:~..",....,.....,.., '" ,," ,.. ,......' , ,¡ ~~~:~E~.S~,(M.y,~ .~r~>:~.. ,.. ...,.... ,.. ..' ; COMBINED SINGLE ; LIMIT ,$ , , CLAIMS WlOE : OCCUR. : ;"..... .~i. ...... : :' .. ¡ OWNER'S & CONtRACTOR'S PROT. :" " , . . .. .............. .. ... ... ",...... . .............. ~ .,..... .... .... . ...... ; DO Oil Y INJURy : (Pet perllOn) ,$ ...."...."... ...... . . . . . . . . . . . .,.,. .. , , I : 800lL Y INJJi'it' : (Psr accldenl) '5 : ".'" ...". .......... ..:.... ." . . ..... .."..... ... : ~ : PROPEFI'TY DAMAGE s , ' ,',' !n~EŠï'W;Blu:r; '. .. ' , , .... ' " .. ,.. , ", '" ,..,....' , .. "",.."" 'T,~~~,',0~~~~~~...',','..',',',',',',s,'..'...,.."..,,',........, ! UMBRELlA FORM ¡~GC>RE~A1ë,.," , ' , .. .. ' ",,}, " ","" ,..' , ,......;,.... ,..,,:, ?:r~~~ ,~~, ~~B,R~~~,A, ,~~~~, """" ..:"......... ,......,.. ,......, '" ,'" ,............ ......,........,.. ,:,,, ...... '" ,.. "..,..,..... ,.... ..'".........,........ ,', ,"" " ....',.. ......".............,..,"..'" '..,,,,,'.. ,..,'..,....,.. . . .. ... .. . . .. , .. "". , , , 1 , ":~ ; WOAkel'S COIIIPQISATION ii' 'e;ëJ ~~;:i'~ L~~I~. .. ',:,.".........:..,.....,.,"';:.. AND :..,..,..""....,......,'"""",......,....,..",..,..,.........,..,..."""'........,.. ENPlOYI!.IIS' UA81LITf L~',~~E :,~?,-I~~ ~IM,I,T...."" .. .:~" ""'..'"",, "..' ",.. ......, "',""" .......,.... ...." '..." "..., '" "..... ..,:,..... ....,',.....,', ,,",..', ,. ..",..... ..,.. "" ,'"',,,.., ..,..,.. ..,..,.. ..,., '..' ..,.. ", ..,',,, ,,"" ,.., ,¡,~,I~~~.~,'~~,~"~~:.~,O'~~,.. ....: ~,.. ..,.. ",.. ......., , '" ,',... ...., : OTM£A Ai POLLUTION : LIABILITY 75'466 :05/23/00 , ' : OS/23/01: ..,.............,.....'.1'..............."..........,.,...'.."...........:..,....,.............."""........................."......,.,."i."",............................... .........."....,.., ...................,.",,,.,,, ".,................. ...................".............. OESCRIP11ON OF OPQlATIONSlLOCal1OIIS/VQUCLQ/9P£C\ÁL ITEMS WHICH IS 10 DAYS INSURED'S COpy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE. CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIl. --1Q DAYS WAJTTEN NOTICE TO THE CERTIFICAT¡: HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHA.LL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE C AGENTS OR REPRESENTATIVES, -....-.......,....'. ..........-..............-,..... . ..........-.... wdhEN MONITORING PRcADURES UNDERGROUND STORAGE TANK MONITORING PROGRAM TbiI monitoring program IIIUSI be kept at the UST location at aU times. The infonnaûon on thillDOIIÏIariD¡ program ate coodiåoDl of the operating permit. The permit bolder IDUII DOå1ÿ tbc 0fBc:e of EJMronn_.UI Services within 30 days of any CMQFC to the monitoring proc:edwa, WÚCSI required to obtain approyal bc:fore maJå.oB rbe c.baDøe. Rcquiftd by Sections 2632(d) aDd 2641(h) CCR. Facility Name --nzÓ~¿ 0/ab~dt9'-A- FacilityAddress ? 50ð/ 67õ¿Â(vX4:-þ- A Describe the frequency of perfonning the monitoring: Tank Vq.;7~Y 'ðT/~ '74-/7 ß.:s - ~....t.~ÆD M,.u,-naa.J'~ Ý ~S/I~ Piping H/)IlPú4-z- -;/ e.~~ ,4PT~47'íc.. L&d~ n.,..-'7".ç(?~ . B. What methods and equipment, identified by name and model, will be used for perfomiDg the monitoring: T.~ :ì ~,....-~ M>.. IJ~'" ÑV "A~""" Plpmg __ C. Describe the location(s) where the monitoring will be performed (fàciIity plot plm should be attached): ~~Iiá A~L.Il.ßCh ?../L)'7" ;Z:>""'A¢ D. List the name(s) and title(s) of the people responsible for performing the monitoring and/or maintaining the equipment: ~.e7.....AJA- /S/D.!!r/ f - Mo..v,A~.dI""~ J/?? ....ø~/~ E. Reporting Fonnat for monitoring: Tank ,-:ðA~n. - .é'ð~ r rß!!J1'-T /J1t!JAJI-n:!JIIfL-. ~~AI.Ç' ~~ , ,/, Piping ~ ~.t::... Vðþ./J~~ F. Describe the preventive maintenance schedule for the monitoring equipment. Note: MaiDteDaDce mutt be iD accordaDce with tbe manufacturer's maintenance schedule but Dot less than every 12 months. :Bss~ A;/I"a.... ~/7if1E/2. if /~.s..7- ~ .4;() A-A/L111A~ ~.;v~-- G. Describe the training necessary for the operation ofUST system, including piping, and the monitoring equipment: ~o.u.J ~¿ç ~ ~??c... ~r .6&"..z:" /6 . ~ ,'~ " ", ' . ,... ,.. "'I' , . ,q,{) /.0 1~5- .S-- ..-:::=----' 3~cJ ',. ." " ' - . ., ,.' . ~ . .. ' '"'" - . ~. . I ' ~~ ... }' " , ,'~ . , . " ~' , 1 ". . ' e e EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK MONITORING PROGRAM This monitoring program must be kept at the UST location at all times. The infonnation on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures. unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCR Facility Name Facility Address -S '7'l:Z;)c:.K;:::>RLE-. /VI' ð4J ~ /3e:;ø I d'7~~F ~/. 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up £rom the secondary containment within 8 hours, or deteriorate the secondary containment, then the Office of Environmental Services must be notified within 24 hours. ~~ð/ ~ N.ð7 :?,J!ÇL- ..I..#I',¿)V"c<::.. ð¿Z ..'5P/¿,¿ AhC; #~ÐÆ- / / ' /....,;-~ ~L~ ~ ~~p~~r-~ AA..Jn ~L"ð4Y~ ~ (?..:.o.2,;' .c-~¿:2::> (7 ~/'Y> ,;¡;:;oAA....... '/ 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substance. C;A."I' S~"'¿..¿.., - ~A-r~~rø: ú..N?¿./ 4'1~ ~/rre/2... - s~£p AH..J7> ~,;'N ~7'4''--.L'.B'.'-2- -z::- ~ Prt""'..i".8» e;/;;P ~ ~~CX-lS k./.tÞ-5.;=- 3. Describe the location and availability of the required cleanup equipment in item 2 above. ",..Ai .:5"~e:- 4. Describe the maintenance schedule for the cleanup equipment: AI / /J. , 5. List the name(s) and title(s) of the person(s) responsible for authorizing any work necessary under the response plan: ~¿7/,A.J.A /s~~.L.L- - /'-/4-/.2... /¿/~s..q.N Voço:C¡/M - ~~/~ UlL. þ¿:¡p - , . CITY OF BAKERSFIELD ~ICE OF EN'VIRO~ME~TALeRVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 ," UNDERGROUND STORAGE TANKS . INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank ... _ 01 -.--.---------., -- ..------ --- -------.......--- -..--- I. FACIlITY IDENTIFICATION , BUSINESS NAME (Seme .. FACÜfŸ fWE or D8A . 00InCI1kIIiMR Aa h h t:' - G fi S/ ,.:¡-;.,. c FAClUTYÐ. [IIl.l-'!l~MiJ ~. --------.----.-.--... ... ...-...... -......--.--.. ..--.--- ..... .... ..-.-. -----. . -.--.--.-.- -----... u. INSTALLATION : Chedc ell thet apply . o The Installer has been certified by the tank and piping manufacturers. o The Installation has been lnspertAd and certified by a registered professional engineer. ~ The Installation has been Inspected and approved by the City of Bakersfield Offiœ of Environmental Services. o All work listed on the manufacturer's installation checklist has been completed. o The Installation contractor has been certified or ncensed by the Contractors State Ucense Board. o Another method was used as allowed by the City of Bakersfield Office of Environmental Services. , Identify method: ' III. TANK OWNERlAG~NT SIGNATURE r '*"'r" lhelnbmatlon prowIded ...., II We & __II) lhelMltol my ~ slGÑA--···· fANfõWÑiRIAGËÑT-' DATE --.-..---...-.. ..- -. , . ... ..----:¡¡¡- /tP//jo 0 TANK oWÑËÑÃÖiÑT (ptfnC) --.- -\];,hJ7 eFJ~ !c?/(¡'pCC i * 'iiii:ë'õF TANK OWNERIAGENT ..---, - ..... .-.. 4ðII. ?r/' ;) .. ..--.-..- -.. ......-.- --.. .-----.. -..-..-. ..-...-.... -..- '-c .~- ".. ' A.r. ........ ---- .-- ~ .-. CITY OF BAKERSFIELD " .t)FFICE OF ENVIRONMENaL SERVICES 17"Chester Ave., Bakérsfield, CA~301 (661) 326-3979 "S, , " . .~. UNDERGROUND STORAGE TANKS - UST FACILITY rYPE OF ACTIOH ' (Chedt _ IIIIm 0tIty o I. H&t SITE PEfUT o 3. A£HEWAL PEfUT o c. AMEHOEO PERYT æ:s. CHANGE OF INFORMATION {~c:IIeIIe. ItIUJ 11M only} o .. TEMPORARY SITE ClOSURE Page_fII_ o 7. PEfUoWEHT\. Y ClOSEO SITE o .. TNoIK R£MOVEO 4()( : IUSlNESS NAME (Seme. FACIUTY NAME ar DBA· Doing ~ Ac) ¡ L FACILITY I SITE INFORMATION 3 FACIUTY 10 . 4~ ð> -(pITS I ~I'7C g ::zðG r o 4. LOCAl. AGENCY/OISTRICT" o S. COUNTY NJEHCY" o .. STATE NJEHCY" o 7. ÆOERAL AGEHCY" 402 . NEAAEST CROSS STREET e h ('Po <$ T~ /'" ø.. I. GAS STATION o 2. 0IST'RIIU1'0R ; TOTAL NUMBER OF TANKS t REMAINING AT SITE ~ ; BUSINESS TYPE C01. FACIlITY 0WtER TYPE ...ß-t:. COAPORATIOH o 2. INDMOUAL o 3. FARM 0 5. ~RCIAL 0 3. PARTNERSHIP o 4. fIAOŒSSOR 0 e. OTHER 403. II ,.., on IndI8n ~ ar " __ 01 UST . puIIIk: IIIInCy. _ 0I1UMMIor 01 hIIIndI1 ..-.on. MCIIon ar oIIIcI wNcII CII**a the UST. en- II the concecr ~ far the I8nk '*ØdI.) OVa ~ 405. , . .06 404. , , .. PROPERTY CM'NER INFORIIATIOH :~ < .·'1 ..... PROPERTY OWNER tWoE ¡ ht..o- GH<;; " MAIlING OR STÆET AOORESS Q"3€CS" «17. PHONE I ð \..{ s:- 6:- ð" t.¡ po 408, 409, 41. 412, o 2. INOMOUAL o 3. PARnERSHIP C-/þ o 4. lOCAL AGENCY I DISTRICT o S. COUNTY AGENCY ?O;;?(;Ç- o .. STATE AGENCY o 7. ÆDERAL AGENCY 413, ..' II. TAÑKåWNeRlHf:oRIIATIOH, '/,,;, " " .... . ....... ~~~. TANK 0WtER tw.E 414. PHONe 3/e; L[::>G 8 Y ~ 415, - G >.. In MAIUNG OR STREET AOORESS ¡ em' ~;¡, .2>Tv/f'r1/ Æ:Hñct, I ____ ~() I TANK OWN£A TYPE ;!L.... COAPORATION ;{>c£ 416, o 2. INOMOUAL o 3. PARTHERSHIP C11./ ST~ß' 411./ ZIP ~ ð :z G" .s- 04. lOCALAGENCY/DISTRICT 0 I. $TATEAGENCY OS. COUNTYAGENCY 07. ÆDERALAGENCY 419, 420, IV. BOARD OF EQUALIZATION U8T STORAGE FEE ACCOUNT NUMBER TV (TK) HQ CaD (916) 322-9669 If questions ItIse , ."::, :;-;c:~';:::.; ''v Br9B~ ~~ U8T.....,;....~....RESP0N8I81UTY'· , ,'.. '. . ..':": ..,~.. .' . r"'I~~"'_ ,,"'""""'''-''''- INOICATEMETHOO(S) [] t. 8EI.F-INSUREO 0... SUÆTY8OHO [] 7. STATEFUNO [] z. 0UNWfTE£ . 0 5. LETTER OF CREOfT ~ STATE FUND & CFO I.ETTER [] 3. INSURANCE 0 .. EXEIoIPT1OH [] t. STATE FUND & co 421. o to. LOCAl. GOVT MECHANISM o II. OTHER: 422, VI. LEGAL NOTIFICATION AND MAlUNG ADDRESS ; CIMdt _ IIoIIIa ..... 0IIfIIåI ***-1IIouId tie UMd far '-gII naaøc.øor. end maIIng. [] ......_ , ~ ..clllll,:lIIlanl end 1MIIngI" tie Mlltla...... __ ""'-lioii , ar Z II cMcMd. 1. FACILITY ~ PAOPER'IY OWNER [] 3. TANK OWNeR 423, VII. Al'PUCAHT SIGNATURE ~; I~'" the 1nIarmIIIGn~"" II /rue IIId __Ia the /lei( 01 my 1cnawIedge. SIGNA DATE c / tP '/~ t? (J' 421. TITU! OF APf>UCANT pf$ 424. PHONE 425, p(tP c{ ~G g r'iY 427, r STAn! UST FACIUTY NUMBER (FtNloceIlIModyJ UPCF (1199) C2I.,oeeUPGAADECERTlFICATENUMIIER(FtN*""lIHodrJ 429,/ S:\CUPAFORMS\sWrcb-a.wpd¡ f·¡t ,,/ . "., - A." .-... ...-. -. ~ .-. ---~ - CITY OF BAKERSFIELD , ' Q(FICE OF ENVIRONMENTÞáSERVICES 1715 ~ter Ave., Bakenßeld, CA 9S1 (661) 326-3979 UHO!RGROUHOSTORAG!TANKS·TANKPAGE1 <t ,.. - " a.. ~sm!~ a t. ~YCLOSfOON arT( a.. TN«~ I"VPI! 0' ACT10H a t. NIW ItTI NMCT a .. NeCICO ~ (CIIecIr _ _ 0I'III'1 a s. CHAHOI 0' INP'ONMTION) 01. MNIWA&. ~ ~_'WIOcel_OI'III'I euSIHESS HoWl IS- . 'ACIUTY fWIII fII OM . 0aInt ..... AeJ , "q(1§~ 4h(!)-~hSI;y;,<:.. . lOCATION wm.t sn"I ~ ~/oo 6:9/¡¡:!ð";?/'-p /9~(Ii' Ør,(;4rs- ~(? /01' (:>1"9 L TANK D!SCU'TION 93;:J°7 , TANK 10' H/ qz 4;p OOWNmENTAUZED TN« a Y. p:...No XtfI fo~ S r.....·.~_fgerarlKfl~ /rf1lF 4a -431 ! / ðC>ðÐ, ADOtT1OtW. oe:~TIOH(I'w___OIIIñ " . .. TAMe 00N1D1'W ~ , I ~ TANCU. _ JiG NtROUUM'M'II . I I. MOTOR VIHICU PUB. 1& MQl.AM4JUADI!D o Z. &.rAœD o S. JET fUEl. ¡ --- ---,....... J)pt 0"" ......UNWøm a I. 0IE8B. EJ .. AW.11ON fUEl. ! 0 Z. NOtU\Ø.~ o 10. IImQIW)I c.tUADED a..GAIOHCX. a.. OTHER ¡ 0 1. CHÐoICAA. MOCIUCY' CCIIAION NoW! thttHllMbu8..... .....".". 441 CAS.... HIzMbuI........ *-'Dy".". 4A I a 4. HAlAAOOUI WAITe (IIaWN I u-Io# .. a IS. IJNOQWf .. TNIIC COII811IUC11ON .. , , . " TYPE: OF TN« I (CMdt_....... i I TN« aMTERW.·IIInIIIy" O,.......MU. ;';', .2. oouaIMU.., ".', " o S. .......a.L wnH EX11!RIOR ·.-NlEUN!R a.. IN3lEWALLlfAVAULT o .. IN3U! WALL WITH INn!fIfW. aAÐOER I'tITI!M 0.. UNICNOMf a.. OTHER' [] S. COHC::Af!T1! c.. uiNIcNowN [] .. FAPCOIiPA'TIIIl£W'lOO1UtE11WIOL C.. OTHER 44J ....,.~:..'.., .. ,"" - I (CMdr. _ ........ I I' TANK aMTERIAL· -*'Y 11M C t. IMe srm. , ' (CMdr. - ......... C Z. ITAINU!a 8T&L ì C 1. IMe srm. C Z. ITANØS srm. ¡t:s. FIIIEROt.ASSI PI.AS11C [] 4. STœ. am WFI8!ROLASS ReNFOACED PlAST1C (FAP) ø... FIIIEROt.ASS I PLASTIC [] .. ITEEL CUD WFIIÐQ.ASI ReNFOACED fUS1'IC (FN'J [] .. c::oNCAÐ'E C S. If'œYI.INIG C .. GI.AIII.INIG ell. UNCNCMtI C 4. ...IOC ICI.INIG .... UIUI!D c.. cmøt Jif'"s. AII!ACJI.AII ~ PUITIC ell. UNIOIOWN ... [] 4. M'ÆSIID cuMø.r c.. OTHER 44-< a .. FAP COIof>ATIIIU! W'l0K r.EnW«)l. .,0.. IHCNOWN C .. "'~JIOfEr 'C.. OTHER C 10. COA1rD STEEL ~ , TN« INTfIUOR LI'ØI Oft COATING (CMdt- "'O/IM OnER COAAOSIOH PAOTKTION. NIfUCAIl8 (CIIKIt _ .... oMy SPlU.NÐ~ C 1. N.-..... C 2. 'HJM)...... ..... ~TI MTAW!D 447 1F«1tøI_~ Do\TI! INIT~ 448 (C/I«Jt. .. Nt I/tIIIIy (For tot»I_ oMy 481 CMJtfU PROTECTIOH EQUIPIotENT: YeAR INITAUm /? 9 5'" 482, C 1. ALW.I 'ø( I. FIJ. TUðE SWfOFFVN.'Æ ¿19'S- , CJ z. IN.L ~T a 4. !XGIPT 'STIM4Jm OAfI LAIr '*Ø ft'I'iIDCM\1 C.. WAHUAL TN«~(IIf'O) a .. V~ ZIOHI C,. CMOuNDWAmt o .. TN« TUT1HQ C. ona V. TANK CLOIUIU! 1Nf'00MATIOH I NIUiIANIHT CLOIUU IN PLAC8 .... II1WMJm QUNm1'Y ~ soeITNØ ....wNIfCI .... TN« I'1U.IO wmt IØT aMTINoL? : ""~~ .: 4~. '~,' ::', ' :""',;, ~ '. "iIi... . '~ ~.. h.~Y. " . .;~. ..... w..;"'·':~: ~~ " ., ":' ;\Y""....';,..,ç;.. ":..:' ......'......,:-~.; ~~ ~ . DOWUWAU. T~ Oft TAM( WITH a.AOOa lCI**-" ot'i# 464 C t. WUN.(IINOUIWAU.lfVAULTOHL\1' , , 1fÍ2. COHnNUOUIIHTrRS111W.IoIOHITOfUNQ C I. IoW«IN.IotOHITOfUNQ 4S7 ..... a v. C No 'CF (1/OC1) S;\cUPAPORMS\SWRc;ø.8·'M'O .Cf1'Y OfIIlAlŒRSflELD 0fIfIIC. 0# MVlRQHMeHTAL '~S 1111 a..w ~~ ~fWd. ~ mo1 (....71 ~<~q.. -- '-Ie un ~ '.. PAG " w..... CGNITRUCT10H (o.t ,,_~ ~fIW'IHQ SYST1!M1"'fÆ X. PMSSUM 0 2. IUCT10H 0 i OMvrT'f" _ If{ I. PRESSURE CONSTRUCTIONI'O 1. SINOl.!WAU. 03. LIN!OntrHCH 0.. OTHU' _ 0 I. SlN<iU!WAU. :' MAHUF~T\JR£R!18[' 2. 00U8I.Æ WALL 0 IS. UN<NOMC 0 2. DOU8l! WALl. " r I ~~ 4t1 a.w«JFACt\JR£A ¡ ;OI.aAAesm.. 0.. "'COWAT&e1lW100. MmW«X. 0 I. IAAESTE£L I '-"T1!R1AlS AHO '0 2. STAIHl!SS STœ.. 0 7. OALVAHlZ!DSTUL (] 2. STAINU!SS STEEl. COAAOSIOH ¡ I PROTECTIOH ¡O 3. P\.AST1C c:oa..ATa.! 'MTH OOHTEHI'I 0.. UNICNOWN 0 3. PtASTIC COMPATI8L£ WITH CONTENTS ~ 4. ~ 0 .. F\.I!JœU! (HDf'!J 0.. OTHIR ø 4. FIØERGlASS ;0 5. STEEL W COA TINQ 0 t. CATHOOIC PAO'ÆCnON 4t4 0 5. STEEl. loW CO-' TN] w.....,.. U!M DETECTION {CIId"" ~ UN[)ER(W)UNO fIW'IHQ PRESSURIZED PIPING (CMc* "..., IJIIIIIt: o ,. e..£CTRONC IJfE lEAK 0EÆC'r0R s.o QPM ŒST mDilU10 fIUYIlHISfOff' fOR LEAK. SYSTEM FAILUN!. NÐ ~ DISCO! flECTION +~NÐ VIaW. ~ . o Z. Ø)HM.YG.2 QfIH mT o So ~ IN11!GftIT'r TESr (0.1 OPHJ CXINVÐITIC)NAL SUCTION SYS1"EMI: . 0 5. OAI- Y VISUAL MOHITOAINO 01' PUIot"INQ SYSTEM + TItIENNW. fIllING IIfÆGRITY I TEST (0.1 GPH) I SAFE SUCTIOH SYSTEMS (NO VALVES .. eaow OAOUND PIPING): o 7. SElF IoOIrTOAINQ GRAVITY FlOW: o t. 8lENNW.1NreGRßYTEST(O.1 GPH) ··"T ", .... :I II!CONDAALY CONfMI!D PIPINQ PRESSUftIZED PIPING {Ch«:Ic" ..., IJIIIIIt: 10. OONTNJOUS T\JR8H! SUMP SENSOR rdnt AUi:Iíit.E Nfi'JISÛM.NNWs NÐ (0)<<* _) (] .. AUTO PUMP SHUT OFF WHEN A LEN< OCCURS "~' o Þ. AUTO PUMP SHUT OFF FOR LEAKS. SYSTeM FAlLlJRENO 8Y8TEfoot OISCONNECT'ION (] c. NO AUTO PUMP SHUT OFF " 11. AtITO'-"T1C UlElbK DETEC1'OR (1..0 QPM 1Dr) mD1 AJ:1If lHÙToiF OR R£STRICT1OH " b( 12. ~~~JEST(O.1 OPHJ '" :. SUC'1'1OftGAÁVITY S'1'I'TEM; o 13. OONTNIOUSSUMPSENIOR+AUDaI!NGVl8UAl.N.Nwa q IllØGINCY 0ØI!M1OM OILY (Q'INt ........., 4. OONTNIOUS SUMP 8EHSORfI1]]:QSlIAU'IO f1UY18HUfOR +AIJDeU! NÐ VISUAL MAAMS a 1S. AtJTOM4T1C UIE LEN< 0ET1!CT0R (J.O QPM TaT) mnarI AJ:1tN IHISf OFF OR ReSTRlCTlOH J;.18. AHHJÞL INTEGRtTY TEST (0.1 GPH) o 17. Do\Il.YVlSUALCHEO< A8Q\1!0A0UN0 P1PIHO o 2. SUCTION al5.~ 0... OTHER o " 0RAvn"( a .. fRPCOWATa!1oW 1~ ~ a 7. ON.VNtIZ1//) STœ. o .. F'I.EXaI! (HDP£J 0 ft. OTIER a .. CATHOOIC PROTECTIOH o IS. UN<NOWf . ....~ . .. :-~... A8O\IEGROUND PIPING PRESSURIZ£O P1PWG {CII«It" tIIat ~ a 1. ELECTIOIC UIE IS( 0E1'ECt0R s.o Qf'H 'ÆSf mIJ1 AUtO fIUYISHUT OFF FOR I.£A¡ SYSTEM FAIL.URe. NG SYS1"EM,DISCONECT1ON + ~ NG VI8UAI. AiAAMS a 2. MONTHI. Y G.2 OPH TEST a So NH»L INTEQAfIY TØT (0.1 GPH) a .. DAIlY VISUAl QEQ( CiON'ÆN1'1OHAl SUCTION IYItÐotS (CMc:fI...., fIPPIY: a 5. DAIlY VISUAL MONr1'ORNJ 01' PIPING NG PUM'1NG SVST&I ' a .. TRIÐNAL M'EGAITY ŒST (0.1 GPH) , ' " SAFE SUCTION SYSTEMS (NO VALVES .. øa.ow GROUND PIPWG): a 7. seLF MONITORING .!",J GRAVITY Ft.OW {CIId" II«-*J: a .. DAIlY VISUAl MONr1'ORNJ a .. IIENNW. M'EGAITY TEST (0.1 GPH) , ..- . .....,: ... "\";.I~ II!iCONDIIIaLY coNTMim'....-a PRESSURIZED P1PWG fCI** ,,111« IJIIIIIt: 10. CXIH11NUOUS TUR8&'E SUMP SENSORmnt AUOIIILE NG VlSUALAI.ARMS NÐ(di.dI one o .. AUTO PUMP SHUT OFF WHEN A LEN< OCCURS (] II. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILIJRe NÐ SVST&I OISOOI.ET1Ot-. ;.. (] c. NO AUTO PUMP SHUT OFF f2( 11. AUTOIoMT1C LEAK 0ETECr0R '. t!irt2. NØJþL M'EGAITY TEST (0.1 GPH) ..r...~.i.' .. SUC1'IOHIGAAvnY SYSTBot o 13. 00HT1NU0US SUMP SENSOR + AUDIIU! AHlJ vøW. MAAMS IlEtGINCY Gt!NIMTOa OILY {CIteot .."..,~ 4t 14. CXIH11NUOUS SI.U' SENSORmnaa;AU'IO PUMP SHUT OFF + AUOIBU! NÐ VISUM. N.AAMS a 1S. AUTOIoMTIC LIfE L.EAK DETECTOR (J.O OPH TEST) }¡( 18. ANHUAlINTEGRITY TEST (0.1 GPH) (] 17. OAA.YVlSUALCHEO< ~::;~;. . - . "'.. ..... ". ..~ .,. :.:'"~:..:-; .' .~":¡·f /.'04.;~1J:l. .....~~ ~-r..".... ": . ..lÖ....·..~·i.. ' .~~.... :~~.,~~:~-:~..¿ :( ..', '. ~. ~. ~'.. _.t:....~~. CJ 1. fI\.Oo\T~1HATIHUTIOf'PIfeMVA&.W o Z. COHrNIOUI 0IIfJII*" PM ___. AUOIIÌ.I NG VISUAL N.AAMS o So COHrNIOUI 0IINHI!ft IWf IINIOIt mIHAU'IO SHUT OFF FOR DISPENSER · AUOC8U! NÐ VISUAL AUIWS DC. OWMUIOPUATO« ItGMATUR! ,~:,. o 4. DAIlYVI8UAI. QtEQ( o .. ,TN!NCH UNER/Io1ONR'OfUNCJ It.. NON! - ~ COHTAINM!NT DATI! WSTAUfO _ DATe 470 /o;'l/oo 471 Tm.eOF~TOR pi' ¡j 472 I .... ~ (For /oeM 11M only) 47:1 I ,*",,~{ForAlc:lll_onIy) 474 PwmII~OIIIe(IrorØOll-odY1 41J UPCF (7199) S:\CUPAFORMS\SWRC8-8·wPD . ,'.' ' .. .' ...~:...'~¡ '., ,.. .' €:. ' ' ." . ".. - A.'. ........ ---- -- -- .-' , ' CITY O'F BAKERsFIEJ..D ' , , .ICE OF ENVIRONMENTA.ERVICES 1715 Chester Ave.. BakenGeld, CA 93301 (661) 326-3979 UNDERGROUNO STORAGe TANKS· TANK PAGE 1 I: hie o .. ~ SITa 0.0-.- o 7. ~va.osmOtc srrt CJ .. TAN< AÐoIOVIO rtPe 0# ACT10H 0 I. fCW SITI NMIT 0 to AWIHOIO ~ 11.. CHAHQI 0' ~nOtc) /C/IecIt _ _ ...", fII c So RIHIWAL NMIT ~-,"--OItIyJ euSINESS ~ (S-. "AQUTV 1WotI« OM· OIlIng -...-..., 3 , 4hC9..GffSI..z-~ . LOCATION wrn.I snw ~ , TANI< 10. Ø;Z q¡r ~ COMPNmEHTAUZED TAN< Ov. rlÑI" ,,<pr~ "~.·.~one,. rore.ctl~ I DATE - - -, ! /r9' ( I~ AOOmOtCAL ~rllONltW",.,_.., I 4' .. TANK QON'I8I1W " TANt \III 411 ~rmr 4- 112U. MOTORVlHCUIIIUIL Jtt.. MCUMUM.IAœD a ~ L£G!D o .. JET AJB. ¡ f' -*"4 ---"""1'PJ c ,'- ......tKIAom o s. DIÐJa. £J .. A\MTIOH AJB. ! 0 2. NOtUUB. NTROLBAI 0,& YDtMADIUtUAŒD 04.CJAIOHO&. 0.. OTHER ¡ 0 s. CHEYCAL fIROOUCT COIMJN fMMI! <'-............. .--..".geJ 44' CAS' jIIOøII".,.......... .....,.,.J 4-< ¡ 0 c. HAZAADOUI *S11! (IåIM I u-t OIJ .. o IS. UN<NOWN .. TANK CONI1'RUC1'ION .. , , C t. ~LMD C I. 'MJM).... C t. ~CA11tOOIC M01'ICnOH C 2. IAaW1CW.ANOOI WM INSTAU.ED 450 TYPt! ~1t1u/ _ onIrl l[,. ...... COHTANt!NT /'9 9.G" .Q.2. ~TUM /9"~r !h: ,TNCIIUUq I cr 9 S- "~~·'~~...,i4.¥}r<,.. ,,,J~;?:f~t.MIC' 0.. MN«.W. TN«~cano) o .. VAOOU ZIOHI 0,. OIOJHDWAmt C .. TNIC TUTIHQ ell. 01'HIR V. TANK a OIUM WOIWATIOH I ~ a.oIUU IN PlACB UTlMTIO QUAHn1Y 0' SOI8TNa NIoWHt«J - TN« f1I.UO WITH ICm' "'TMW.1 I rtÆ OF TANK I (C1t«:II_ ....., I , Ct.......WNL ;:', jU...z. DOCaIWNL., ,.', " .~ !" I TANK "'nRW.,.,...,... C t. IMeSTI!B. ' ! (eMeIt. - ... onIrl C ~ STAM.ØS STI!B. I ¡ TAN<~TERW.·-*Y...C ,. IMeSTI!B. I (CNcIc - ..... onIrl C ~ STAKes..".. I TANK INTÐtIOR LINNI Of' CG\TINQ {CIt«:k _ .... MM OnER CORAOSION PAOTECT1OH . N'fUCAIlI (CNcIc _ .....~ SPIU. NÐ OVÐV'U (CNcIc" tN' I/PIIIY1 ~f··;.. . ...0&.1..... TANIC(OIIaIfI.....~ o I. VISUAL (ÞPOIID 'OfmOH ON.\') a 2. AUT'OM\TIC TANt GNJaNJ CATQ) a I. COHT1NUOUt ATG ;a-.. ITATII11CAL IH\/INfOfW MCOHCIUATIOH (uq · a&ÐHA&. 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SYSTÐot FAIl1Ø. NCJ SVST'ÐtI DIICOIKCTIOH . ~ IHD VI8UAL ÞUIOAS ' a !.. IOm4lV0,2 QPH TeST a '- NHJIL fIÆGMY TEST (0. t 0PtC) 00N\IÐfTI0fW. SUCTION SYSTÐ.CS: . 0 s. DAIlY VISUAL r.ÐHITORINO OF fIUUPINQ IYSTEM + TRIEMML PI'INQ INÆGRm' I TEST (0.' QPH) I SAfE SUCT10H SYSTEMS (NO VALVES IN eaow OAOUND PI'ING): o 7. SELF t.tONITORINO GRAVITY flOW; o .. IIENNIAL INTEGAITY TEST (0. t GPH) " ,.,'}.' ", .. / :I ØCONDARlLY CONTAIN!D""';¡ PÆSSURIZ£O PIPINQ (Chet:A.. ftM ~ 10. 00NT1NU0US T1JMN: SUMP SEH9ORmwAUOilii.E NGVISÙM.~ NCJ (0IecIt _I o L AUTO PI.IMP SHUT OFF WHEN A LEN< OCCURS o 0. NJfO PUIIP SHUT OFF FOR LEAI<S, S't'8TÐoC FAIWRf NÐ SY8T&C 0IS00NIECT10N a Co NO AUTO PUMP SHUT OFF ' " " ' á..-". AUTOMAT1C LINE LeN< OET£CTOR (U OPH TØT) mIll AtMlHÙ'l'on OR R£STRJCTIOH NHJN..1NÆ0ArTY TEST (0. t 0PtC) SUCTIOM'GAAVITY mTEM: o 11 COH1'NIOUS SUWIENlOR. AUDeL!NGWICW.,u",. t\ IIIIMINCY O&!NI!MTOItI ONLY 10**........, J!1..t.4. 00NT1NJ0US SWP 8EH8OR r..mtaUIAUTO PUMP IHUrOW +AUDa! NCJ VISUAL ALARMS .é-ts. AIJ'I'O'MT1C UNE LEN< 0E115CT0R (10 OPH TIlT) mIII:ISlI AtM SHUT ~ OR ÆSTRICTIOH o It. NHJN..INÆOArTYTEST (0.' oPH) o 17. 0AIl Y VISUAl CHECK AeOVeOAOUNO PIPING a 2. SUCTION a IS. UNKHO¥t'N a... OTHER - o '- OAAvnv - a .. FRS> COWATa! WI 10011. ~ a 7. cw.VN«lBJ STUI. a .. F\ÐCa!(HDPE 0 ft. Ob£p o .. CATHODIC fIAOTECnOH at5.~ "~.~ . .. .'~-. A8OV£GROUND PIPING PRESSIJRIZEO PIPING (CMdc""'" ~ o 1. B..ECTAONIC LINE LEN< OETECTOR 10 OPH TEST mnt AUTO PUMP 8t«JT OFF FOR lEA SYSTaI FAI..UR£. NÐ SYST1:M,OCSCONECnON + AUOØJ! NÐ WICW. ALARMS o 2. UOHTK.Y 0.2 0Ptf TEST a I. NHJN. ttm1IfIN TEST (0.1 0PtC) a 4. DAIlY WIUAL CHECK CON\ÆNTIOfIAL SUCT10H SVSTÐoe 10**" ftMlfIPI1I: o 5. DAILY WIUAL MONITORINQ OF PIPING NCJ PUM'IN(J SYSTEM ' a .. TRIENNIAL INTEGAITY TEST (0.1 GPH) SAfE SUCTION SYSTEMS (NO VAlVES IN øa.ow OAOUND PIPING): o 7. SELF M':)NITORNQ .!",¡ GRAVITY FlOW lO**" II« apply: o .. DAIlY \/ISI.W. tØIRORING o .. IIENP&U. MEGRfTY TEST (0.' GPtq .., ,. . 'v l .'J-:t ., ' RCOIIIMRlLY c:oÑrÄiN!o'.....-a PRESSURIZED PIPING (Ct»dc.. flirt ~ 10. COHTINUOUS T\.IR8INE SlUt SENSORmD1AU01ØlE NÐ VlSUAl.AI.MMS NCJ (di.ct (tIe o L NJfO PUMP SHUT OFF WHEN A LEN<QCCURS o 0. AUTO f'I.N> SHUT OFF FOR LEAKS. SYST'EM FAa.URe NÐ SVSTBt 0CSC0fH:CT10f', o Co NO AUTO PUt.P SHUT OFF ¡ .. 2Ñ1. AtJ"I'C)W.T1CLEAKOETECTOft '. ~ AIHJIL MEGRfTY TEST (0.1 oPH) SUC1'IC)tWRAVITY SYSTBot . a 11 00H1'1NU0US'" SENSOR. AUOIIC.E NCJ VlSUALIUIWS -lor....... j.. . IIIBGIMCYOBBATOItI OHLY lCI**1611«WM ~. COHTNJOUS'" SENSORmDDlIAUTO PUMP SHUTOFw: +AUOIBt.ENCJ VISUAL ALARMS a 15. AtJ"I'C)W.T1C LINE LEAK DETEC1'OR (10 GPH TEST) P-1t. AINJAlINTEGMY TEST (0.1 GPHI o 17. DAlLYVlSUALCHECI< ~~~;. .~.."~;.>~:.~; ",!'C.~., ),'~;i'~' ..~. ;r·'''''· ", . '·~~''-·-·i·' ' ·-!....u~.. ~;~.,,~.~~~.:.~,.....~ ::..:~.. ""~" ~'.. ::t~.~.~~. o 1.I'\.OAT~THAT.."..O...H!MV~VII o 2. COHTINUOUI O.....U.M MH""". AUOaII NÐ \II8UAl ALAIUoAS o 3. OOHTNJOUI 0IIfIINIeft IWf ~ mDiAUTO SHUT' 0,.,. 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