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Home My WebLink AboutFUEL MONITORING CERT lx'1 MONI&NG SYSTEIVI CERTIFlaTIÖN " For Use By All Jurisdictions Withiñ'the StaiT! of California Authority Cited: Cþapter 6,7, Health and Safety Code; Chapter J 6, Division 3, Title 23, California Code of Regulations . \. This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator IJ?ust submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: PACIFIC BELL GEO PAR # SA-532 CLLC Code: BKFDCA19 'f Site Address: 11101 WHITE LANE City: BAKERSFIELD Zip: Facility Contact Person: HARRY DYCK Contact Phone No,: 559-959-3003 MakeIModel of Monitoring System: VEEDER ROOT TLS-350 Date of Testing/Service: 4/17/03 B. Inventory of Equipment Tested/Certified C h . d' ïì d d heck t e appropnate boxes to m Icate spec I IC eqUIpment ins eete /service : Tank ID: 990 - , - TankJD: IZIln-Tank Gauging Probe: Model: 846391-602 DIn-Tank Gauging Probe: Model: 0Annular Space or Vault Sensor: Model: 794380-340 DAnnular Space or Vault Sensor Model: DPiping Sump/Trench Sensor (s): Model: DPiping Sump/Trench Sensor (s): Model: DFill Sump Sensor (s): Model: DFill Sump Sensor (s): Model: DMechanical Line Leak Detector. Model: DMechanical Line Leak Detector. Model: DElectronic Line Leak Detector Model: DElectronic Line Leak Detector Model: 0Tank Overfill/High-level Sensor: Model: 790091-001 DTank Overfill/High-level Sensor: Model: DOther, Specify equip. type and model in Section E on Page 2 DOther, Specify equip. type and model in Section E on Page 2 Tank ID: Tank ID: DIn-Tank Gauging Probe: Model: DIn-Tank Gauging Probe: Model: DAlll1ular Space or Vault Sensor: Model: DAnnular Space or Vault Sensor Model: DPiping Sump/Trench Sensor (s): Model: DPiping Sump/Trench Sensor (s): Model: DFill Sump Sensor (s): Model: OF ill Sump Sensor (s): Model: DMechanical Line Leak Detector. Model: DMechanical Line Leak Detector. Model: DElectronic Line Leak Detector Model: DElectronic Line Leak Detector Model: I DTank Overfill/High-Ievel Sensor: Model: DTank Overfill/High-level Sensor: Model: DOther, Specify equip. type and model in Section E on Page 2 DOther, Specify equip. type and model in Section E on Page 2 Dispenser ID: Dispenser ID: DDispenser Containment Sensor(s): Model: DDispenser Containment Sensor( s ): Model: D Shear Valve(s). o Shear Valve(s), DDispenser Containment Float( s) and Chain( s ) DDisDenser Containment Float(s) and Chain(s) Dispenser ID: Dispenser ID: - TIDlspenseiTOri.tanillienf Seiisor(s): - -- 'Model: ----: ...__. .n. -_.-- -E:]DispenserContainmentSensor(s) :-- ------Model: -~-- '" -. ..--.-- . .,----..-.-.. D Shear Valve(s). D Shear Valve(s). DDispenser Containment Float(s) and Chain(s) DDisDenser Containment Float(s) and Chain(s) Dispenser ID: Dispenser ID: DDispenser Containment Sensor( s): Model: DDispenser Containment Sensor(s): Model: o Shear Valve(s). D Shear Valve(s), DDispenser Containment Float(s) and Chain(s) DDispenser Containment Float(s) and Chain(s) *If the facility contains more tanks or dispensers, copy this form, Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report; (check all that apply): IZI System set-up IZI Alarm hjsto~eport~~ Technician Name (Print): DON S, THOMPSON Signature: ~ ~ V . Certification No,: 3354 License No,: ~ ' ...... t> - Testing Company Name: TAIT ENVIRONMENTAL SYSTEMS Phone No,: (714) 560-8222 Page 1 of 3 03/01 e e Monitoring System Certification l' Site Addr~s: ,~ ., 11101 WHITE LANE, BAKERSFIELD Date of Testing/Servicing: 4/17/03 D. Results of Testing/Servicing Software Version Installed: 119,05 Com lete the followin checklist: 1:81 Yes 0 No* Is the audible alann 0 rational? 1:81 Yes ,0 No* Is the visual alarm 0 rational? 1:81 Yes 0 No* Were all sensors visuall ins cted, functionall tested, and confirmed 0 rational? 1:81 Yes 0 No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere With their ro r 0 ration? If alarms are relayed to a remote monitoring station, is all communications equipment (e,g, modem) operational? For pressurized piping systems, does the turbine automati,cally shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors in,itiate positive shut-down? (Check all that apply) 0 Sumprrrench Sensors; 0 Dispenser Containment Sensors, Did you confirm positive shut-down due to leaks and sensor failure/disconnection? 0 Yes; 0 No, o No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no o N/ A mechanical overfill prevention valve is installed), is the overfill warning alann visible and audible at the tank fill int(s) and 0 ratin ro rly? If so, at what rcent of tank ca acitv does the alann tri er? 95% Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment re laced and list the manufacturer name and model for all re lacement arts in Section E, below, Was liquid found inside any secondary containment systems designed as dry systems? (Check all that app~y) o Product; 0 Water, If es, describe causes in Section E, below, 1:81 Yes 0 No* Was monitorin stem set-u reviewed to ensure ro r settin s? 1:81 Yes 0 No* Is all monitorin ui ment 0 rational r manufacturer's s ifications? * In Section E below, describe how and when these deficiencies were or will be corrected. 1:81 Yes o No* o N/A o No* ~ N/A o Yes ~ Yes o Yes* ~ No o Yes* ~ No E. Comments: n._ ___ __...__....._ _ _~ _ .... --"" -. ,.--. __.____..__ ._... n.._.._ _,_. - - ,-.-- --.--. ,- --'.-' ~ Page 2 of3 03/01 e e r':'. 'SIte Address: '; III ° 1 WHITE LANE, BAKERSFIELD Date of Testing/Servicing: 4/17/03 F. In-Tank Gauging / SIR Equipment: ~ Check this box if tank gauging is used only for inventory control. o Check this box if no tank gauging or SIR equipment is installed, This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring, C h t II h kI" omOlete t e 0 OWlDl! C ec 1St: ~ Yes 0 No* Has all input wiring been inspected for proper entry and tennination, including testing for ground faults? ~ Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? ~ Yes 0 No* Was accuracy of system product level readings tested? ~ Yes 0 No* Was accuracy of system water level readings tested? ~ Yes 0 No* Were all probes reinstalled properly? ~ Yes o No* Were all items on the equipment manufacturer's maintenance checklist completed? it In the Section H, below, describe how and when these deficiencies were or will be con"ected. G. Line Leak Detectors (LLD): 181 Check this box if LLDs are not installed, Complete the followio!! checklist: DYes o No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? o N/A (Check all that apply) Simulated leak rate: 03 g.p,h,l; 00,1 g,p,h,2; 00,2 g.p.h,2 Notes: 1, Required for equipment start-up certification and annual certification. 2, Unless mandated by local agency, certification required only for electronic LLD start-up, DYes 0 No* Were all LLDs confirmed operational and accurate within regulatory requirements? DYes 0 No* Was the testing apparatus properly calibrated? DYes 0 No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 0 N/A DYes o No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? o N/A DYes o No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled o N/A or disconnected? DYes o No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system o N/A malfunctions or fails a test? DYes o No* For electronic LLDs, have all accessible wiring connections been visually inspected? o N/A DYes o No* Were all items on the equipment manufacturer's maintenance checklist completed? it In the Section H, below, describe how and when these deficiencies were or will be corrected. ------ --~~- - - ----~ -------~-- -- ------ --- - .. - -- -------.-----...--.----. .-----.--- ._---- --."-- ---- --------. - -_._._---~.,-_.- ~. -------- ---.- -.- .._----. ---' ... ----,."-- -.-- H. Comments: Page 3 of3 03/01 e e Date of Testing/Servicing: APR 1 7 2003 ~ Site Add¡;ess: 11101 WHITE LANE, BAKERSFIELD Monitoring System Certification UST Monitoring Site Plan . . . . . . . . . . . . . . . . "'~.~. ð\.~.c~F' ~t: ú.~"I-4. 8 ko,V'w\ . . . . . ,6Ll-<a't ~1'P, . . . . . . . . 'ff,S- -5 ~c' : pJ~ \ic: . . . . . , /\.Acxl"H' : f3 ~ ',: ( d:: ~1 ~ : ,,",' ,J' . . . . . .. . :çZ ~~.~ \;~ : 'r;)' . , . , . , '.' "-,' , . I ~("k'~ ""~ hoT:" · \ Date map was drawn: APR' 1 7 20G3 --- Instructions If you already have a diagram that shows all required infonnation, you may include it, rather than this page, with your Monitoring System Certification, On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). ill the space provided, note the date this Site Plan was prepared. Page _of_ 05/00 ... ..-. --.-.--._- --- - 0; '" -'f;j' .. . . ..---.' .----. --- ----- -::..; ~ ~I. :.._", ': c¡ :-~;:" I~,:~:,' 1 j 1 (i : '_"~:-~ i .;:.: L,-', j~:-- BAKESF I ELD. . CA 661 665-2381 APR 17. 2003 10:10 AM , . SVSTEI'1 STATUS REPORT - - - - - - - - - - - - ALL FUNCTIONS NORMAL , . 1 NVENTORV REPORT, I :~, ··f 1 :DIESEL 990 ~ ,: VOLUME 1 71 8 GALS ,ULLAGE . 282 GALS 90% ULLAGE- 82 GALS 0' ,TC VOLUME'" 1714 GALS ~~~HEIGHT = 40.37 INCHES ~t~p - 64.3 DEG F C· ,.~" ,.~"'"*~'- * END ;J( ~ * ~ ¡.¡; ,', SYSTEM SETUP -' - APR 17. 2003 10:[0 AM SYSTEM UNITS U.S. SYSTEM LANGUAGE ENGLISH . SYSTEM DATE/TIME FORMAT MON DD YYYY HH:MM:SS xM SBC- BKFDCAI9 SA~532 11101 WHITE LANE: BAKESF I ELD. CA ; ;~ 661 665-2381 ~ ·-'SHI-F'f-T-IME- ·1- -: - SHIFT TIME 2 : SHIFT TIME 8 : SHIFT TIME 4 7': aOAI"! . DISABLED DISABLED DISABLED I ~ TANK PER TST NEEDED WRN DISABLED TANK ANN TST NEEDED WRN DISABLED LINE RE-ENABLE METHOD PASS LINE TEST . LINE PER TST NEEDED WRN DISABLED : LINE ANN TST NEEDED WRN DISABLED PP. J NT T(' \/I,u !MpC; EfJi\! :dJ' _. .. ,. Of':·'··"· ·,,'·1 ':;:- ,-:: .,-:·o:f: : 0.'''- --..- -- i.. ,r . ~.r.!- ~.~t.:Jr-I~.i.'.JI·'~ . ~./l)LI !~ ~. [1£\; 1.' .'!: Ci"j ~ II ,:",., .'·'r ¡'jI='T(··fiT .. :,.,..."-....,,. DÎSÃÉLED" ·r . ,.'.' H-PROTOCOL DATþ' FORMAT HEIGHT DAVLIGHT SAVIN TIME ENABLED ' START DATE . APR WEEK SUN START TIME 2:00 AM END DATE OCT WEEK 6 SUN END TIME 2:00 AM RE-DIRECT LOCA PRINTOUT DISABLED EURO PROTOCOL PREFIX S I f : t· r I COI"U"IUNICATIONS SETUP ------ ------ , PORT SETTINGS: COMM BOARD 1 (FXMOD) BAUD RATE 1200 PARITY ODD STOP BIT : 11 STOP DATA LENGTH: ~ DATA DIAL TYPE TONE ANSWER ON Ii RING RECEIVER SETup:1 J~!r~~11 F1~lLE PORT NO: 1 ¡ RETRV NO: 99 I RETRY DELAV: 10~ CONFIRMATION RE ORT: ON D 2:ALARM MONIT RŒNG CO 171q5608237 :. RCVR TVPE: FACßIMILE PORT NO: 1 I RETRY NO: 99 ' RETRY DELAY: 10' ¡ CONFIRMATION REÞORT: ON e 8KFt)CA I 9 " ----- ..-------- r::·.l.rr~:· .0: I ;l.. : t r·-¡E ::'r:'1'! J~ ~ D 1 :EMCC DIAL ON DATE JAN 28. 2002 DIAL TIME : DISABLED RECEIVER REPORTS: SYSTI::r~1 STATUS IN-TANK STATUS LEAK DETECT D 2:ALARM MONITORING CO DIAL ON DATE JAN 28. 2002 DIAL TIME : DISABLED RECEIVER REPORTS: RS-232 SECURITY CODE : *..10<",** RS-232 END OF MESSAGE DISABLED AUTO DIAL ALARM SETUP ------ ------ D 1 :EMCC RECEIVER ALARMS SERVICE REPORT WARN D 2:ALARI"I I"IONITORING CO - NO ALAR!"I ASSIGNMENTS - I,N-TANK SETUP ------ T 1 :DIESEL 990 PRODUCT CODE THERMAL COEFF TANK DIAMETER T;~···JJ;·~ PROF r 1.1: Fl.l~.,), i(;i : . 1 : .000450 : 47.00 T.I NEAR -::1~;t:JÚ -------- .. "t- ~ '" If '. f ..", . '.::, ì ; ~ ¡.j - (!;"" "~I; ;,,'.úi·:. :.:(iL vv~Rf1LL LIMIT HIGH PRODUCT DE~IVERV LIMIT i LOW PRODUCT : LEAK ALARM LI I'll T : SUDDEN LOSS LIMIT: TANK TILT MANIFOLDED TANKS T,* : NONE DELIVERV DELAV LEAK TEST METHOD: ------ TEST ON DATE : AILL TANK SEP 11. 2001 ; START TIME: 3:52 PM TEST RATE :O,20¡GAL/HR DURATION : 2 ~OURS , ; LEAK TEST REPORT!FORMAT NORMAL 2 WIRE CL SENSOR!SETUP - - - - - - - -¡- ---. . ..-.--- '.1. '! ; :n' :1 ~u~t.: 90% 1800 .. 95% 1900 70% 1400 500 99 99 3.65 ~; :: 5 MIN C'r:ANNULAR'-' "j" ULTRA 2 CATEGORV : ANNULAR SPACE I ì I OUTPUT RELAV SETUP - - - - - - - -¡ - R 1: OVERF I LL ALARI"! ...~ ..../ ~., ~= : :~~-I~'i:I1'!L:'r Ü::ft ¡J(:T:¡"\r"'¡l ~ "j: ::.....j~~...~. . ~"----. -'-',<:",/.;~,,;;~p":-' ',).. ...1.... ..r .1 ,I,~, ,._, ,I·, i·\!.l :¡'I~'"~'i í 1, .~:;.;. ï ·:"'Ii.f-;;.-i··; t';L~_ ~ ;·1~'~·).' C'F...~,!.d.l,": r:,L.:·;f]"ì· RECONCILIATION BE UP - - - - - - -- ..f-\.uTOr1AT Ie DA I L V C~OS I NG TIME: 2:00 AM PER I OD I C RECONC I L' AT ION MODE: IONTHLV TEMP COMPENSATION STANDARD ' - - - - - - -- BUS SLOT FUEL MET R TANK TANK MAP EMPT\" SOFTWARE REVISION; LEVEL VERSION 119.05 ¡ SOFTWARE,* 3461.19-~'1 0.0., -F CREATED - 00.02.2 .12,15 S-MODULE,* 330160- 02-A SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS CBLD I ALARM HISTORV RE ORT ----- SYSTEM ALA PAPER OUT AUG 2. 2002 PRINTER ERROR AUG 2. 2002 1: BATTERY IS OFF JAN 1. 1996 8: ,; . ~ ." . :-::1'1]) '! ;r. :.. ! ~ " e gKf!\CA- l7 f2- -. - .- :' / J 'I~'\!'~ ':-. J ::. I ",.1<'_: J"':l~·!···.)i,: t' ---- IN-TANK ALARM T l:DIESEL '390 OVERF J LL ALAR"! JAN 28. 2002 2:58 PM LOW PRODUCT ALARI"1 JAN 29. 2002 2:57 PM JAN 29. 2002 2:56 PM JAN 28. 2002 3:11 PM HIGH PRODUCT ALARM APR 17. 2008 9:84 AM JAN 29; 2002 2:57 PM INVALID FUEL LEVEL JAN 29. 2002 2:57 PM JAN 28. 2002 3:11 PM JAN 28. 2002 2:41 PM PROBE OUT APR 17. 2003 9:32' AM JAN 29. 2002 2:57 PM JAN 29~ 2002 2:55 PM DELIVERV NEEDED APR 17. 2008 9:32 AM JUN 18. 2002 2:06 PM JAN 29. 2002 2:57 PM ..- -.- I"IAX PRODUCT ALARM APR 17. 2003 9:84 AM JAN 29. 2002 2:57 PM LOW TEMP WARNING JAN 28. 2002 2:54 PM * * *-* ~ END ~ ~ ~ ~ * ,. -. e gK.f))CA- I 7' e . . " " I'; fJ , "';} - ......-' -. -- . .- - : -- - -. "'l,.;;J:11 :54 PI"1 ----- SENSOR A G 1: ANNULAR ANNULAR SPACE -nEt' ALARM APR 17. 2003 FUEL ALARM JAN 29. 2002 FUEL ALARI"! JAN 29. 2002 1 :35 AM ¡.¡ ,.,.-;- ;.; EÑD J ( "" ~ it ALARM HISTORY EPORT ----- SENSOR A RM C 2: ,OTHER SENSORS - I -,_... - -' .- . u._ . _. _ _ .n ~ ~ ~ 'IE * END ~ ( ( ~ ~ 1 ..:- -- -~ COMBUSTIBLE NO SMOKING r I ~ K 1Pi1~ ..~.'-';; ,';;. r( -, . , _.- "''' - .. ï,::--- ..y I '.' ¡--- t~ ! ". I ,'''. .. ~ f¥'- I I- I. I A CONTAINMENT ~ SOLUTIONS 1·877·CSI. TANK ; ,;¡. ( ./ .~,~""..'. :.:1 ~~%r,'." '<~'~.i", ~"-'~"'.?? ' ...,' 'j;' ,,,'. I .. ""(' ¿j'J , I " ,';¡.oj::'" I' ~" .~ -/ ... -ff~-'-'-'·-··~··'--=,~ . "'-'j' ~ -<.. ...\ , .' .. .-.¡ l ~ --, . , "'~.. .. '.'! '''. , . ,,-< ~/; I.., '>-_ ~ \ ~ ,. '-.,,,--~ ~.~-o: '.'."\:. . OJ '" ~ "~~~. -'~I --- ...- :;f-~..~- \ \ -----. ~::;ENE;OR ALARr"I,An C 1: ANNULAR ,., ¡::iNNULAR SPACE FUEL ALARt···! JAN 29. 2002 2:54 ~1 ---- IN-TANK ALARM T I :DIE;::ŒL 990 PROBE GUT JAN 29. 2002 2:55 PM -- ---- IN-TANK ALARM T ¡: [J I ESEL '3'30 [IEL l'v'ERY NEEDED JAN 29. 2002 2:56 PM . ...;. -- -~ -..---..;....... o.--=----~~ ---- IN-TANK ALARM T ¡:DIE:::;EL 990 LGli.1 PRODUCT ALARr"1 JAN 29. 2002 2:56 F. ---- IN-TANK ALARM T I :[IIE:::;EL 990 MAX PRODUCT ALARM JAN 29. 2002 2:57 PM ---- IN-TANK ALARM T ¡ :DIE:3EL 990 HIGH PRODUCT ALARM JAN 29. 2002 2:57 F~ ---e ._-~~---~ ---- IN-TANK ALARM T I :DIESEL 990 DEL I "ÆF:',/ NEEDED JAN 29. 2002 2:57 PM e ---- IN-TANK ALARM T 1 :DIEEŒL 990 LO[...I PRODUCT ALAR~' JAN 29. 2002 2:57 PM ---- IN-TANK ALARM T 1 :DIESEL 990 INVALID FUEL LEVEL JAN 29. 2002 2:57 e Fl'l IN-TANK ALARf"1 T 1 :DIESEL 990 PROBE OUT JAN 29. 2002 2:57 PM e T 1 :DI EE;EL 990 I NI./ENTORY INCREASE INCREASE START JAN 29. 2002 2:56 PM VO L Ur'1E HEIGHT TEt"lP 49 GALS 1 . 16 INCHES 40.4 DEG F INCREASE END Jf~N 29. 2002 ~' : 59 Pf'1 \/OLUr"lE HEIGHT TEf"lP 543 GALS 12.76 INCHES 40.4 DEG F GROSS I NCF:EAE;E= TC NET INCREASE= 4_ 498 e CITY OF BA~FIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 Facility INSPECTION RECORD POST CARD AT JOB SITE Owner Address Address City,Zip City,Zip Phone No, Pennit # INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same number are ready, They will run in consecutive order beginning with number (, DO NOT cover work for any numbered group until all items in that group are signed off by the Pennitting Authority. Following these instructions will reduce the number of required inspection visits and therefore prevent assessment of additional fees. TANKS AND BACKFILL INSPECTION DATE INSPECTOR ",I ~ Backfill ofTank(s) 11.1' l\ Spark Test Certification or Manufactures Method ~ .'1/\ MIlA Cathodic Protection ofTank(s) Piping & Raceway w/Collection Sump tltl nUu (L I COlTOsion Protection of Piping, Joints, Fill Pipe PIPING SYSTEM I. ~ b,¡;- tfI/1 I . /'ò-3'0 "2- 11 llA ~ A ¡jt¡;;' IP' /I. fJ) 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 A Level Gauges or Sensors, Float Vent Valves I-.lli-O L .J1A¡ Product Compatible Fill Box(es) Product Line Leak Detector{s) Leak Detector(s) for Annual Space-D,W. Tank(s) Monitoring Well(s)/Sump(s) - H20 Test Leak Detection Device(s) for Vadose/Groundwater Spill Prevention Boxes -J..q....O 2...... J!¡J SECONDARY CONTAINMENT, OVERFILL PROTECfION, LEAK DETECfION FINAL Monitoring Requirements Type f TL-S-1S'Q Monitoring Wells, Caps & Locks Fill Box Lock Authorization for Fuel Drop CONTRACTOR~l~ {> L..\t.() l cll"'-- LICENSE# '3ICosì5' Ald- CONTACT_ß, \\ bo.l é.-~ PHONE # 4O'r..· ~ (1"2.- ~ 8 ~ ....\ I 05/04/01 ì1 1---- -- '-- is I ! -q '- \;:--- 13:50 ~~_~tì~_~_~5_~6______~ ____._ _B.:__HA"Z ~IAT DIVe. ., . - ----------¡- /"). _ 'f 1 ßQ'- 141 003 .~_/ CITY OF BAKERSFIELD OFFICE OF'ENVIRONI\1ENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 -4 r'!' APPLICATION TO INSTALL AND/OR REMOVE ABOVE GROUND STORAGE TANK(S) In confonnity with provisions of pertinent ordinances, codes and/or regulations, permission is hereby granted to; I " _'PAc..-tF" \ c... ~.e:.u- "Z-~oo ~'I\JO- B-AfI'U:¡t-I¡~ f2+tJtlðiVf..-'1 è/t({0¡3EðOO) Name of Company Addiess ~lJc:.APD~~: '"01 WHITE-I-ANE.¡ BIftt.F--I!.-l!!>fr/ž.L9 to display, store, install, use, operate, sell or handle materials or process involvíng or creating conditions deemed hazardous to life or property as follows: --1.tJ ~TA-L-L ~, 000 ~A-LLÐ,..( Aßo\¡F ~R/){-J¡...JD DtlZ-~IZ-L-~To¡<"l¥'=lE- TJ4.I.J..1£... W J ïH ~D \IE. t':tl<i>u,.J 0 P I pH..J(~ ' subject to the provisions and/or limitations as provided. Violation of pertinent ordinances, codes and/or regulations shaH void this permit. C.J~~llPd- ~ Permit Denied 6" 2'Y;O( Date ~~ (<HL Dí~1 ~,j 6f«.Ovp ttJ¿.. t.~¡;µT fVlz-P~IFL~B~) 5c.orrTf\+4J~1..L ~ I~ Applicant Name (print) Applicant Signature THIS APPLICATION BECOMES A PERMIT WHEN APPROVED .'--. I ~