HomeMy WebLinkAboutUNDERGROUND TANK-C-09/14/94
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CITY of BAKERSFIELD
UWE CARE"
FIRE DEPARTMENT
M. R. I<:ELL Y
FIRE CHIEF
September 14, 1994
1715 CHESTER AVENUE
BAKERSFIELD. 93301
326·3911
Mr. Gerald Wiemer
832 Vineland Road
Bakersfield, CA 93306
CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED
AT 1401 E. TRUXTUN AVE, BAKERSFIELD, CA.
PERMIT # BR-0098
Deê!r Mr. Wiemer:
This is to inform you that this department has reviewed the
re2;ul ts for the preliminary assessment associated with the closure
of the tanks located at the above stated address.
Based upon laboratory data submitted, this office is satisfied
wi 1~h the assessment performed and requires no further action at
this time.
If you have any questions regarding this matter, please
contact me at (805)-326-3979.
Sincerely,
~ dtLJ~ ~-
Howard H. Wines, III
Hazardous Materials Technician
HHW/ed
cc: Pat Mullhofer, CALPI
Jason Castillo, RWQCB
R. Huey
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P.O. BOX 6278 · BAKERSFIELD, CALIFORNIA 93386 · (805) 589-5648
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e 1eld City Fire Dep
ATTENTION: Howard Wines
1715 Chester Avenue
Bakersfield, CA 93301
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September 6, 1994
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SUBJECT: PERMIT #BR-Q098
Dear Mr. , Wines,
On August 23, 1994, CALPI, Inc. removed one (1) - 500 gallon
underground gasoline tank from Bookout Properties at'
1401 E. Truxtun Avenue, Bakersfield, California 93305.
..
The tank was decontaminated on site
cleaner and inerted wi th dry ice.
Gibson'Environmental in Bakersfield,
waste manifest #93196442. The tank
Metals. '
using a high pressure steam
Rinsate was disposed of at
California under hazardous
was removed to Golden state
Soil was sampled under the direction of the Bakersfield City Fire
Department. The sampl es were analyzed at B. C. Laboratories of
Bakersfield for TVH gas and BTX&E. A complete chemical analysis is
enclosed.
In addition to the lab results, copies of the manifest, chain of
~custody- -and- the tank o~dispos4-tion tr-ack-ing record are enclosed"
Please contact our main office at (805) 589-5648 if you have any
questions or require further information.
Sincerely,
~~~
Pat Mullhofer
Supervisor
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cc: Gerald Wiemer
832 Vineland Road
Bakersfield, CA 93306
Santa Maria, California 93454 (805) 925-2231
.
Bakersfield, California FAX (805) 589-5312
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LABORATORIES
Purgeable Aromatics
and
Total Petroleum Hydrocarbons
hAi'é
~tll
CALPI
POBOX 6278
BAKERSFIELD, CA 93386
At tn .: J. P. MOLLHOFER
Date of
Report:
Lab #:
08/26/94
94-09062-1
589-5648
Sample Description: JOB #6313 BOOKOUT TRUST: SAMPLE #1, SO. END @ 2' (SOIL) 08-23-94 @
1045 HRS SAMPLED BY J.P. MOLLHOFER
TEST I~THOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015
Individual constituents by EPA Method 5030/8020.
Sampll3 Matrix: Soil
Constituents
Date Sample Date Analysis
Received @ Lab: Completed:
08/23/94 08/25/94
Practical
Analysis Reporting Quantitation
Results Units Limit
None Detected mg/kg 0.005
None Detected mg/kg 0.005
None Detected mg/kg 0.005
None Detected mg/kg 0.01
None Detected mg/kg 1.
Date Sample
Collected:
08/23/94
Benzene
Toluene
Ethyl Benzene
Total Xylenes
Total Petroleum
Hydrocarbons (gas)
California D.O.H.S. Cert. #1186
~/¿
Department Supervisor
All results listed in this report are for the exclusive use of the submitting party. Be Laboratories, Inc, assumes no responsibility for report alteration, separation, detachmentorthird party interpretation.
4100 Atlas Ct. . Bakersfield, CA 93308 . (BCJ5) 3274911 . FAX (805) 327-1 91 B
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LABORATORIES
Purgeable Aromatics
and
Total Petroleum Hydrocarbons
CALPI
POBOX 6278
BAKERSFIELD, CA 93386
At tn.: J. P. MULLHOFER
Date of
Report:
Lab #:
08/26/94
94-09062-2
589-5648
Sampl1e Description: JOB #6313 BOOKOm TRUST: SAMPLE #2, SO. END @ 6' (SOIL) 08-23-94 @
1050 HRS SAMPLED BY J.P. MULLHOFER
TEST ]~THOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015
Individual constituents by EPA Method 5030/8020.
Sampl1e Matrix: Soil
Date ;Sample
Collected:
08/23/94
Constituents
Date Sample Date Analysis
Received @ Lab: Completed:
08/23/94 08/25/94
Practical
Analysis Reporting Quantitation
Results Units Limit
None Detected mg/kg 0.005
None Detected mg/kg 0.005
None Detected mg/kg 0.005
None Detected mg/kg 0.01
None Detected mg/kg 1.
Benzene
Toluene
Ethyl Benzene
Total Xylenes
Total Petroleum
Hydrocarbons (gas)
California D.O.H.S. Cert. #1186
~/¿
Depart:ment Supervisor
All results listed in this report are lor the exclusive use 01 the submitting party. Be Laboratories, Inc. assumo¡s no responsibility lor report alteration, separation. detachment or third party interpretation.
41 CXJ Atlas Ct, . Bakersfield. CA 93308 . (805) 327-4911 . FAX (805) 327-1 91 B
~ Ch . of Custody Record
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ADDRESS ' CALPI. Inc. PARAMETERS OTHER
POBOX 6278
BAKERSFIELD CA 93:386 ffi
(805) 589-5648 ~ ,
PROJECT -2?'~O¿¿'~ ~~~-r 2~ ; ~
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sAMP~gnOlure: : ... m~ \1 ~ i 8 OBSERVATIONS'
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RELINQUISHED 8Y ;;¡;ç. REC:EIVED BY DATE RELlNOUISHED BY DATE RECEIVED BY DATE I TOTAL NUMBER
Ø~/Å ; -4{V!", . OF CONTAINERS
If í..t METHOD OF SHIPMENT
A~dYlh Slgnalure Slgoalure Slgnalure
TIME TIME TIME TIME
~;;/i tZ'2~ Prlnled Name Prlnled Name Printed Name SPECIAl. SHIPMENTIHANDUNG
OR STORAGE REOUIREMENTS
company l' Compaoy Company Company
REUNOUISHED BY OATE RECEIVEO BY DATE RELINQUISHED BY DATE AECEI'lEO BY (laboratory) DATE'
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:!Ignalur. SIgnature Signature ( ~alure - ~ '?' 'Jig-
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P:'"l\led Name Prlnled Name Prlnled Name Printed N an)4t . ~ <rp'"
·'Company Company Company 13clcd:>orcfc;r it" Ç' l'}'
Company
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Form Approved OMB No. 2050-0039 (Expire. 9·30-94)
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See Instructions on back of page 6.
Deportment of Toxic Substances Contr.
Sacramento, California
Information in the shaded areas
is not required by Federal law.
UNIFORM HAZARDOUS
WASTE MANIFEST
nt No.
00 0
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G!nerotor's Name and Mailing Address
G,nerator's Phone ~
Tr"nsporter 1 Company Nameðc1if/
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6. US EPA ID Number
7. T "'nsporter 2 Company Name
~~ignated F~ility Name and Si~ Address
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16. GENERA TOR'S CERTIFICATION: I hereby declare that the contents of the consignment are fully and accurately described above by proper shipping name and are classified,
packed, marked, and labeled, and are in all respeels in proper condition for transport by highway according to applicable federal, state and international laws.
If I am a large quantity generator, I certify that I have a program in place to reduce the volume and toxicity of waste generated to the degree I have determined to be
ecc'nomically procticable and that I have selected the practicoble method of treatment, storage, or disposal currently availoble to me which minimizes the present and future
thro!at to human health and the environment; OR. if I am a small quantity generotor. I have made a good faith effort to .:ninimize my waste gener tion and select the best
. wa:5te managt:ment method that is available to me and that I can affo:d. Q..c 1'__
Prlntedl ped Name Signature
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19. Discrepancy Indication Space
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erator Certification of recei
this manifest exce t as noted in Item 19,
DO NOT WRITE BELOW THIS LINE.
White:
To:
TSDF SENDS THIS COpy TO DTSC WITHIN 30 DAYS.
P.O. Box 3000, Sacramento, CA 95812
Drsc 8022A (7192)
EPA 8700--22
._----_.,------------_._-_.---_._.-.-~- - - ---
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GOLDEN STATE METALS, INC.
P. O. Box 70158 . 2000 E. Brundage Lane
Bakersfield, California 93387
Phone (805) 327-3559 . Fax (805) 327-5749
Scrap Metals, Processing & Recycling
Date
Contractor's
License No.
Contractor's
Phone No.
JOB SITE:
ADDRESS: (
DESTINATION:
G. S. M. . 2000 E. BRUNDAGE LANE . BAKERSFIELD, CA 93387
HAULER:
LICENSE NO'
TANKS RECEIVED
QTV
GALLONS
SERIAL NO. NET TONS
TOTAL
T~~ECTION
B1:::LEAN & DRY (ACCEPT), OR
.00 BESIDUALS PRESENT (REJECT)
LR READING
250
::::::;::millJ}~;;;~;~;:;;;;;;;;;;:::~~::::~:::::::::::::::::::èI:::¡::::::::;\:'"""
550
;:;;~:;:;;::::::::::::\)::::::::::::::/::::¡~¡~¡~¡~¡~¡~¡:::::::~:::~m~i.~:iâ~:¡ti¡::::::;;::::::'·:~:::U::U::M~})~
1000·6 ft
:::::::::}))))))):/::~~:~:;;::~::::::;:::::~:d:$.iM:;}:::::;:d):::::~@i:?
2000
.14
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.24
.61
3000
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5000
.
1.32
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2.42
DISPOSAL FEE
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7500
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9000
:::¡::::::::/:r:/;;;:::::;::::::::;:::¡::::::::¡:::::::: :U¡~jl@:::~:::::::::~::::::::::::H::@ ""'" """', .<):4)33::::
3.28
:@1M:'
3.82
OXYGEN CONTENT
SGRAP VALUE
12000
4.93
OTHER
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TOTAL CHARGES $
TOTAL
All fees inc:urred are per load unless specified. Terms are
net 30 days from receipt of tank. Contractor's signature
represents; acceptance oHerms for payment, and confirms
that tank rli!moval complies with State laws.
CONTRACTOR'S SIGNATURE
. YELLOW - Rle Copy . PINK - Permanent Copy
1'>
~RSFIELD FIRE DEPARTME~
~ZARDOUS MATERIAL DIVISI~
2130 G Street,
Bakersfield, CA 93301
(80S) 326-3979
TANK REMOVAL INSPECTION FORM
FACILITY ''3:úl<.ðUT (1l.u<;;.-r-
OWNER M ~ ~ ?;.boK.CfU'I
CO~~RACTOR ~~P1
LABORATORY
TEST METHODOLOGY
PRE:LIMANARY ASSESSMENT CO.
CO RECIEPT '30-# 'BI2J.Wco
2
ADDRESS 140 I IS -¡(Z..(.)XTuN
PERMIT TO OPERATE#
CONTACT PERSOp fAt fVl.Ùc..~
# OF SAMPLES 2.. - @ z. t G I ßé(.d.J ~ E:f\Jf)
C~J:? , CONTACT PERSON tJ. M\.)t.(.~oÇ'EJL...
LEL% L S ð ~ ð
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PLOT PLAN
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CONDITION OF TANKS
GCX>D
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()IJð V' 5' ßL£ -S1b">$. ct= C~Itö>'Ò,.J
CONDITION OF PIPING ~DO - 51.JC.-'Th>1\Ì <ÙI(?CCTLY A~lfE rAI'JIL
CONDITION OF SOIL ¡Jo Vf,SIß\£ S-rf.l,,J,,JG- ~ ~.,t\ND I SILïfro/ SAh'O
COMÞ1ENTS ~PLC~ "'TA~&7J
Locj).\(C).J ~ 'D'~ fe-NC;6R...
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DATE
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INSPEC'l'ORS NAME SIGNATURE
<J... 2"3 --'14
, Bakersfield Fire Dept. '
_HAZARDOUS MATERIALS DIVI~N
UNDERGROUND STORAGE TANK PROGRAM
PERMIT No.
~a:Aß
SITE INFORMATION
SITE BOOKOUT PROPERTY TRUSTADDRESS 1401, E. TRUXTUNZIP CODE 93305 APN
FACILITY-NAME :ocx:>KOUI' PROPERTY TRUST CROSS sTREET WILLIAM..S
TANK OWNE~/OPERATOR MARGAREI' ID)KOUI' PHONE No. 363-0534
MAllINGÀDÖRE~S .,.~32 VINELAND ROAD CITY BAKERSFTF.T.n ZIP CODE 9:n06
CON1'RACTOR INFORMATION
COMPANY CALF!, INC.
ADDRESS P. O. OOX 6278
INSURANCE, Cf\RRfen'~ STATE FUND
1 j C:' ~ '
PHONE No. 589-5648 LICENSE No. "A"506025
CITY BAKERSFTF.T.n ZIP CODE 93386
WORKMENS COMP No. 1011809
PRElIMANARY ASSEMENT INFORMATION
COMPANY" CALFI, INC.
ADDr.!ESS P~' a.'Pox 6278
INSUR'ANCE. CARRIER STATE FUND
. ::"~:U;~,Î
PHONE No. 589-5648 LICENSE No. "A"506025
CITY BAKERSFIELD ZIP CODE 93386
WORKMENS COMP No. 1 011809
TANK CLEANING INFORMATION
COMPANY _ CALFI, INC.
ADDr.!ESS P:JO.BOX 6278
WASTE TRANSPORTER IDENTlFICA TlON NUMBER 438674
NAME OF RINSTATE DISPOSAL FACILITY GIBSON RF:FINF.RY
ADDr.!ESS END OF CDMMERCIAL DRIVE CITY RAKRR!=:FTF.T.n
FACIUTY INDENTlFICATlON NUMBER CAD980883177
PHONE No. 589-5648
CITY BAKERSFIELD ZIP CODE 93386
ZIP CODE 931na
TANK TRANSPORTER INFORMATION
COMPANY, CALFI, INC.
ADDr.!ESS P;' O'~"PoX 6278
TANK DESTlNA TION "GoLDEN STATE METALS
PHONE No. S89-SM8 LICENSE No. "~"5060?5
CITY BAKERSFIF.T.n ZIP CODE 91386
TANK INFORMATION
TANK No. AGE VOLUME
CHEMICAL
STORED
DATES CHEMICAL
STORED PREVIOUSLY STORED
T~1
--1i1_ UNKNOWN 500r,~T.T ON
C,ASOT .TNR
--
--
--
--
II_Jl'II!fl!~r_.!"
THE APPLICANT HAS RECEIVED. UNDERST ANDS. A NO WIll COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER
STATE. LOCAL ANDFEDERAl REGULATIONS.
THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT.
~? ~
t ' é ~----- ~~ ~I/~t?k
A PR~Y. / . APPLICANT NAME (PRINT)
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED
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CITY of BAKERSFIELD
"WE CARE"
RRE DEPAFmAENT
M. R. KE:LLY
ARE C.-liEF
BAKERSFIELD FIRE DEPARTMENT
HAZARDOUS MATERIALS DIVISION
UNDERGROUND STORAGE TANK DIVISION
1715 CHESTER AVENUE
BAKERSFIELD. 93301 '
326-3911
CONDI110NS FOR ABANDONMENT OF UNDERGROUND STORAGE TANKS
** Contractors must have the following information on file in order to obtain a permit:
1. Copy ()f Contractors license
2. General liability policy
3. Workmans compensation policy
4. Site safety plan
** Site assessment/sample collection contractor must have a soil sampling and quality control/quality
assurance protocol on file.
GENERAL
1. A p~ermit application for an UST abandonment shall be filed and applicable fees paid 5 working
days prior to the commencement of work. This permit shall remain on-site during the entire
removal process.
A. Permit is valid for 90 days.
2. Forty-eight hour advance notice shall be given to the Bakersfield City Fire Department
Hazardous Materials Specialist to arrange an inspection appointment.
3. It is the responsibility of the Permittee to obtain any permit required by other regulatory
agencies (i.e. Building department and Department of Public Works).
4. Tank Closure activities must follow the Uniform Fire Code and all Federal and CaI-Osha
regulations.
5. It is the Contractors responsibility to know and adhere to all applicable laws and regulations
regarding the handling, transportation or treatment of hazardous materials.
6. If any contractors other than those listed on permit and permit application are to be utilized,
prior approvaJ must be granted by the Bakersfield City Fire Department Hazardous Materials
Specialist. Deviation from the submitted application is not allowed.
----- -
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TANK EXCAVATION. REMOVAL AND DISPOSAL
1. Abandonment of tanks in place will only be allowed if removal would pose undue risk to an
existing structure. Proof of risk and a work plan/proposal shall be submitted to the Bakersfield
Ci~V Fire Department Hazardous Materials Division for review and approval prior to the
commencement of any work activity.
2. Ex(=avation of enough material to expose the top of the tank, removal of contents, high pressure
rinsing, and inerting may be done prior to the arrival of the inspector. TANKS MAY NOT BE :
REMOVED WITHOUT AN INSPECTOR PRESENT. '
3. Job site safety and assuring all CAL-OSHA regulations are followed is the contractors
responsibility.
4. Exc:avations, holes, pits, trenches etc. shall be back filled immediately. Any excavations not
bac~k filled shall be properly secured as to ensure public safety (i.e. fenced off).
5. Any excavatèd material from the tank pit, piping runs, etc. not used as back fill will be property
disposed of, or if left on location will be either containerized or covered with suitable material
to prevent the emission of hazardous, noxious or unpleasant vapors and/or odors. In addition
the material will be properly secured as to ensure public safety (i.e. fenced off).
6. Tar1ks shall be either decontaminated or transported as hazardous waste.
7. A Hazardous Waste manifest will accompany either the rinsate or the tank and shall be present
on site and presentable upon request.
8. ThE~ interior of tanks being transported not as hazardous waste (decontaminated) shall have a
lower explosive limit (LEL) of no greater than 5% immediately following cleaning and crior to
the introduction of CO2
A. The contractor shall certify on the inspection form that the cleaning process was
properly conducted and the LEL results did not ex~eed 5%.
9. ThEt decontaminated tank shall be inerted with the introduction of CO2, in the form of dry ice
or from canisters.
A. A rate of 20 pounds of dry ice to 1000 gallons of tanks capacity, or the
corresponding weight of Carbon Dioxide (COJ.
B. If canisters are used they shall be bonded to the tank(s).
C. A receipt for the CO2 shall remain on site and presentable upon request.
10. Priclr to the removal of a decontaminated tank the LEL level will be no greater than 5% and the
oXY~:Jen level will be no greater than 12%.
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SOIL SAMPLINGIPRELIMINARY SITE ASSESSMEN1:
1. Soill samples shall be obtained under the direction of a professional engineer; geologist, or
authorized representative, of a state-approved laboratory.
2. Samples shall be collected, at a minimum, from depths of 2 and 6 feet below the tank bottom,
dispensers, and produd lines and from the following locations:
A. Tanks less than 1000 gallons - from the center of the tank.
B. Tanks 1000 - 10,000 gallons - 1/3 of the way in from each end.
C. Tanks greater than 10,000 gallons - from the center and 1/4 of the way in the end
of the tank.
D. Below all dispensers.
E. Piping - every 15 feet and/or at connedions, joints, bends, etc.
3. Any area of obvious contamination or likely areas of contamination may be required to be
sampled.
4. All !;amples shall be analyzed by a state certified laboratory.
5. Soil samples shall be analyzed for all known and suspected substances to have been stored
in the tank.
6. All samples will be accompanied by a Chain-Of-Custody sheet.
7. A soil sample report/preliminary assessment shall be submitted to the Hazardous Materials
Division with five days after results have been received and shall contain at a minimum the
follc)wing information.
A. Name and location of where the tanks were disposed of.
B. Name and location ot where the rinsate was disposed of.
C. A signed copy of the Hazardous Waste Manifest.
D. A tank disposal receipt from the scraping facility.
E. Copies of all lab data sheets and Chain-at-Custody documentation.
F. A plot plan showing the locations of the buildings, tanks, piping runs, dispensers,
and ALL SAMPLE LOCATIONS WITH CORRESPONDING I.D. NUMBERS AND
DEPTHS.
-------~-----~
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REPLY
J ~ JUN 291994
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CITY of BAKERSFIELD
"WE CARE"
June 14, 1994
FIRE DEPARTMENT
M. R. KELLY
FIRE CHIEF
1715 CHESTER AVENUE '
BAKERSFIELD. 93301
326·3911
Ms,. Margaret Bookout
53'14 Prospect St.
Vis,alia, CA 93291
CERTIFIED MAIL
P 390194796
NOTICE OF VIOLATION AND SCHEDULE FOR COMPLIANCE
Dear Ms. Bookout:
It has come to our attention that you currently own property located at 1401 E. Truxtun Ave.
(APN017-080-01), in Bakersfield which contains at least one underground storage tank(s). The
tank(s) have not been properly permitted and have been out of service, therefore you are in
violation of the following sections of the Uniform Fire Code as adopted by the Bakersfield
MLlnicipal Code, Chapter 15.64, Ordinance No. 3502:
Section 79.115 (a,b,& 1) Uniform Fire Code, (1991 edition)
(a) Failure to remove or safeguard an out of service tank(s).
(b) Failure to obtain a permit to remove or temporarily close an underground storage
tank.
(1) Failure to remove an underground tank out of service for one (1) year.
In 'Drder to avoid regulatory action, you must either properly permit and bring the tank(s) up to
code, or else apply for a proper abandonment and removal of the tank(s) within 14 days of this
notice.
If you have any questions regarding this notice, please call 326-3979.
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Sincerely,
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Howard H. Wines, III
Hazardous Materials Technician
cc; Alan Daniel, Assistant City Attorney
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UNfT£D STATES
POSTAl seRYK:£
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Receipt for
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No Insurance Coverage Provided
Do not use for International Mail
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Sent to
Me::: u" I Kill( 1111
Street and No,
5314 PROSPECT ST.
P,O" State and ZIP Code
VIS ALIA. CA 93291
Postage $
Ce!tified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
to Whom & Date Delivered
Return Receipt Showing to Whom,
Date, and Addressee's Address
TOTAL Postage $
& Fees
Postmark or Date
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5. Enter lees lor the services requested in the appropnate spacas on the front of this receipt. If
return receipt is requested. check the applicable blocks in item 1 01 Form 3811. ;... ~ ~
6. Save this raceipt and present it il you make inquiry. 105603·92-B·O!!?t) Ill.
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STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE.
CERTIFIED MAil FEE. AND CHARGES FOR ANY SElECTED OPTIONAL SERVICES (see front'.
,. If you want this receipt postmarked. stick the gummed stub to the right 01 the return address
leaving the receipt attached and present the article at a post ollice service window or hand it to
your rural carrier Ino extra charge).
2. If you do not want this receipt postmarked. stick the gummed stub to the right of the return
address of the article. date. detach and retain the receipt. and mail the article.
3. If you want a return receipt. write tha certified mail number and your name and address on a
raturn receipt card. Form 38 t ,. and attach it to the front of the article by means of the gummed
ends ~ space permits. Otherwise. affix to back of article. Endorsa front of article RETURN RECEIPT
REQUESTED adjacent to the number.
4. If you want delivery restricted to the addressee. or to an authorized agent of tha addressea.
endorse RESTRICTED DELIVERY on the front of the article.
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"¡¡¡ . Complete .items 1 and/or 2 for additional services.
CD . Complete items 3. and 4a & b_
CI) . Print your heme and address on the reverse of this form so that we can
Gi return this card to you.
~ . Attach this form to the front of the mail piece. or on the back if space
.. does not permit.
.! . Write "Return Receipt Requested" on the mailpiece below the article number.
... . The Return Receipt will show to whom the article was delivered and the date
g delivered.
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3. Article Addressed to:
4a.
2. 0 Restricted Delivery
Consult postmaster for fee.
Article Number
P 390 194 796
MS. MARGARET BOOKOUT
5314 PROSPECT ST.
VISALIA, CA 93291
4b. Service Type
o Registered
~ Certified
o Express Mail
o Insured
o COD
o Return Receipt for
Merchandise
7. Date of Delivery
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> PS Form 3811, December 1991
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5...:Signí'lt~~e (Addressee)
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. - Signature (Agent)
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8. Addressee's Address (Only if requeste
and fee is paid) e
"'u.s. GPO: 1992-323-402
DOMESTIC RETURN RECEIP1,
UNITED STATES POSTAL SER~~~\~~D C'
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PENAL TYFOR -PRIVATE
USE to AVOID P.AY.MENT
'-'''OF POSTAGE, $3ÖÖ·~"
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Print your name, address and ZIP Code here
( ì ·
I City of Bakersfield Fire Dept.
I 1715 Chester Ave:, Ste~ #300
I Bakersfield, CA 93301
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