The URL can be used to link to this page

Home My WebLink AboutUST TESTING 11/19/1993 Operftte 121 Hazardous Materials Plan a Underground Storage of Hazardous Materials a Risk Management Program a Hazardous Waste On-Site Treatment Date Issue Waste Unified Permit , , CONDITIO-NS ,OF PERMIT ON REVERSE SIDE '- ' '. ':!: :~ ' >~: :\~, :':::j;~!;'~~~~,~bt-~;:~~- .. .;." . :~:' ~" ,,"r· : ,: .~ .<. Approved by: i .. Expiràtion Date: A ~~:~~f~ tJ~i;;_~~~~ :~~~,-~. -:", ;::'.,;.;:: t ~':1:: ~ ..; to Materials/Hazardous Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave" 3rd Floor Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661) 326-0576 Ît Hazardous "1 .." I Permit 10 #: 015-000-000623 FARRELLS FASTRIP lOCATION: 6401 WHITE LN 112 Per , ;-. Issued by: - ..') ¡- · .--- -'-- Per...it to Operate Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ~- ( i I ~ PIPIN ONIT This ermit is issued for the followin rdous Materials Plan ~rs.round Storage of Hazardous Materials '" !.agement Program , ,Waste PIPING METHOD ::T"A;NK I PIPING I PIPING &,nOR TYPE TYPE PRESSURE ALD PRESSURE ALD PRESSURE ALD PRESSURE ALD F F F F LPT LPT LPT LPT ¡¡.¡; Lj !,,¡ CAP1pltá :¡:::G~L ..... .... . ... ... .. 'ij, "'~.." 'b r··! .,¡;-- ", .j. ". ... -.. .. . ;¡¡,. '..;¡, ',..', ';f,~·····~· .::Jj¡ "r:\ ~ .. on . 12,odQ~Oó, GAL '., 12,000'190 "GAL, 12,OOO.OO$AU,i' .... ... .... 12 000.00 "GAU'i¡, , .-"'.i'. ........: WHITE HAZARDOUS SUBSTANCE ~ , PERMIT ID# 015-021.000623 FARRELLS FASTRIP 6401 LOCATION PREMIUM UNLEADED GASO UNLEADED PLUS GASOLINE UNLEADED GASOLINE UNLEADED GASOLINE 0001 0002 0003 0004 Approved by: Bakersfield Fire Department OFFICE OF ENVIRONMENTAL SER VICES 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 Voice (805) 326-3979 FAX (805) 326-0576 June_3~2000 Expiration Date: Issued by: · . I CA Cert. No. 00762 I City of Bakersfield Office of Environmental Services 1715 Chester Ave., Suite 300 Bakersfield, California 93301 (661) 326-3979 An upgrade compliance certificate has been Issued In· connection with the operating permit for the facility Indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. Instructions to the issuing agency: Use the space below to enter the following information in the fonnat of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; facility identification number (from Form A); name of issuing agency; and date of issue, Other identifying information may be added as deemed necessary by the local agency, This permit is issued on this 2nd day of November, 1998 to: F ARRELLS F ASTRIP Permit #015-021-000623 6401 White Lane Bakersfield, California 93309 MONITOR·WELLS ':. Well Number' 1 ..: Well Depth "Deoth,to Water .~ Product Detected AMOUNT in inches Standard Symbols for diagram below: . ®FiII, Q V~R. w / Ball Float @ Monitor Well Ö (Outside Tank Bed Area) ,@ Ball Float @ Tank Gauge ;:~.ManWay Œl'ron Cross L9C~t~o~pi~graf11-:-lnçluøe ~he.Vapo~ R~coyery Syst~m~ <.~ ,'. " , , , . ~5.f/p, ~O . ., L a~ ' '. 1if;~f.{J ~~~iJl\ .1f.I.p.~~c..~. ;:; . ~1Þ': . , ®, .~ . ffiJ, (!). ~ ! ÇÐ, ". . - -. - - . ._....~- - ..-- ~~ "'5-0# 3ö7ba.. . ',;, &r: '3 b C) FA-RREll.. . 2 3 6 7 4 5 '~'~ "s~ 'H :~:~~'~ : .~.". . P<f. :~1 . pc. .:.µ~.~.... [t] '--- L, ¡.)~ .¡/} [1j , ---.- L,Jolt? 'J A-' .¡ , , i. . ~ '. :'.~/ .j , , ' I :¡' I ue:t1-P u~3. Q' , o 0,' 0.:' " , FA,e l2¿- C- " " \, ;,'. , - . " , .' . ~ ~ ',,' ?: V~por RecoveÌy System & Vents were tested with which tank? Parts and Labor used 'I- LfJ QbD TAC/C~t- .. ' Site#' 8 9 10 11 ," .!' i\ -- \.." '.-:~) . /\ ,'- , ø Vapor ReCO~!ry;: @ Observation"Well O (Insld.Tank BedAÌ'ea): Vent [!I'TUrbine', , . ) do)::. $'" {J q:l. ðc..-r' fir -, ,( ¡.Ie ~'IJ- '~ @ ®I {Ð' ,~ (",,,,,& , '111 · ~ " , General Comments L () ('\ JI\J -r/ I.. Ñ-r:. .PRÞ.OIJ C, t C, tV ç t-é ff + L{J. R f. jJ ¿A-'C¿;-: rtlf..,,p . N ð I,."J A L( PR e:.f)1I C+ C ,.v t:: j. I ~J!T ¿;\ If? E' - .' ~. . - . .' \ .' , , , , , , t " +. , _. , -to ,(\\ " , r " <. I , · - ".; -. 1.2 "__,, J_ - '" .,Þ,. ¡ -.;.~ , ~! ;~ w.,;. ".:t. ¡ ,..- f:! . - t' .; '.~~ 'j~ , ~ ) ~, ','1 ,U ".." , , , , , I -"~ . ~ \ , When OWNER or,local regulations require immediate reports of system failure-Complete the following: REPORTED NAME DATE TO: . Phone# OWNER or Regulatory Agency Pnnt. Certified Testers Name St8Je-v E, i-tALÙÇ./cVS I CerJified Testers Si~nature L#" ~¿:' ¡¡~ '~ .... / , , ) , , t·~ .... . r . i . , ,;' - Vacu1ec{fM Certmcation Number' #:OO? :3 ; Date Testing Completed ' J / - I ~ -1 J . . i . . . , I , . . · , I ~ _: . - rJ¡1) fÐ ¿P - , . TIME .. FILE NUMBER ... ~ 'i~;: ~ ~-.J . " "" r :.-/ ;; .~. -!If ~~\' ~, Permits , Fac 11 it y - Name 3 Îö 0 "Yt, flAAJ¡)/ P1A.k~ (JAco Olt) 1Ãht Inspector Date "' i_ :'\, ~.....' FINAL INSPECTION CHECKLIST I /,).)OC" (Jw) u!.. '/.:J.ooo--:": /::w5 /{¡:.c I /10:)O~.~;-") I::"'Ç 1'<7> ,r ., v';: a OJ ~"' i.;",\ f';N,!: , -' \. j I ,j't'.!) ../....:1c .;-:';,/ (,,'If¡ 'F [ t \ ,J./A/6< ..¡-,..),;z.LS I I þI.IIU~' !.-r I I I I I I I I I I I I N \::./ " a Ie> t>~ I:.~I> e> v a. II> :-, :".~ ,I j if) ''î " .' q . ~ . U~u i ~ ¡ì . " " ¡ ./ I ';" I::: '-( Ç) .J Plot plan notes Plot Oiagram /.c,'? - ,_~ _ l.., I 1. All new and existing tanks lQcated 0n plot plan? Yes ~o I~(/ i_I ~ I I 1_, ;{ - 1_, I_I 2. Does tank product correspond to pr~duct labels on plot plan? 3. Was there no Modifications .dentified which were not depicted on the plot pl~n~~ If "No" described ~ -._- ---_.- 4. Are monitoring wells secure and tree of water and product in SUMp? 1/ - 1_' 5, Is piping system pressure, suction or gravity? ,/-//dJ:"://'.:f' c¡._ ~ MONITORING SYSTEM CERTD~ICATION For Use By All Jurisdictions Within the State ofCalifomia Authority Cited: Chapter 6.7. Health and Safety Code; Chapter 16, 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 reoort must be preoared for each mooitorine: sYStem control oanel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator, The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Informajion __ I'{ / ~ _ _ r Facility Name: ~ bO f'11-f'/"~.. ~ O"I1i:,1·Lt'l Bldg, No,: Site Address: i¡éJ I 'ú/Iff ~ ~ City: f3r¡cé:4.bhè9. Zip: 93/507 Facility Contact Person: 7641 ¡;:::;;,..,- r().( Contact Phone No,: (66/ ) 377 -0 "'Z. 7/ MakeJModel of Monitoring System: ii/II- 7l,ij 3~"t> Date ofTesting/Serviciog: ~L/.Jcft I . B. Inventory of Equipment Tested/Certified Check the a te bo_ to iDdicate Seniœd: Ta$ID: -n (1,JL. TankID: .~<ifL 1a"Ín- Tank Gauging Probe. Model: ~ Q In-Tank Gauging Probe. Model: a""'bJmularSpace or Vault Sensor. Model: 1.44. ' Q Annular Space or Vault Sensor, Model: ~ljpingSump/TrenchSensor(s). Model: VjIL Q Piping Sump I Trench Sensor(s). Model: ~ill Sump Sensor(s). Model: C/¡Q. Q Fill Sump Sensor(s). Model: Q Mechanical line Leak Detector. Model: . Q Mechanical line Leak Detector. Model: CJ Electronic line Leak Detector. Model: Q Electronic line Leak Detector. Model: Q Tank Overfill I High-Level Sensor. Model: Q Tank Overfill! High-Level Sensor. Model: CJ Other s . ui t and model in Section E on e 2 . CJ Other s ' ui ment t and model in Section E on P e 2). ~~ .~- ~~ ~~ CJ In- Tank Gauging Probe. Model: f CJ In-Tank Gauging Probe. Model: Q Annular Space or Vault Sensor. Model: CJ Annular Space or Vault Sensor. Model: CJ Piping Sump I Trench Sensor(s). Mode]: CJ Piping Sump! Trench Sensor(s), Model: Q Fill Sump Sensor(s). Model: ,14-- CJ Fill Sump Sensor(s). Model: CJ Mechanical line Leak Detector. Model: CJ Mechanical line Leak Detector. Model: a Electronic line Leak DetectoC·-- MõdeJ: .-. e Electronic line Leak Detector. . Model: a Tank Overfill I High-Level Sensor. Model: a Tank Overfill! High-Level Sensor. Model: a Other (s' . t and model in Section E on P e 2). Q Other s . ui t t and model in Section E on P e 2). DågD¡er ID: DispJnser ID: ~Uispenser Containment Sensor(s). Model: t:t1Jispenser Containinent Sensor(s). Model: a"shear Valve(s). ~hear Valve(s). a . nser Containment Float(s) and Cbain(s). 0 . nser Containment FI DlsgmerID: ~ ID: la"þispenser Containment Sensor(s). Model: O' ontainment Sensor(s). Model: Ia"'"Shear Valve(s). a Shear Valve(s . a' Containment Float(s) and Cbain(s). a Di Con . Dfmeøser ID: Dispeøser ID: e::r-- J:}ispenser <:ontai t Sensor(s). Model: ,II).. C Dispenser Containment Sensor(s). ~hear Valve(s). a Shear Valve(s). ODis nser Containment Fl s) and Chain(s . a Dis Containment Float(s and Cbain(s). *H the facility contains more tanks or dispensers, copy this form. Include infonnation for every tank and dispenser at the facility. C. Certification - I cerifty Chat die equipMeut ~ in tills ~... ~ ..iced in aeconIaoœ wfdt tile 1IIIUIUfaduren' guidelines. Attaehed to tills CertIfkation is information (e.g. JIIIDIIfaeturer' eheddists) necessary to verify Chat this information Is cot'n!d and a Plot Plan showing the layout ofmooltoring ~"P"'--' For aoy ~Fot such reports, I have also attaehed a copy of the ~k II1l J!!;!1J apply): cJ.Sy¡féiñ set-up Technician Name (print): - ß-ù JCA>?Æ"~ Signature: Certification No,: q 7'3 £, License. No,: ð' I c3 ~ I ~ .¡(- Testing Company Name: ¡tfc..6=" fJ~ t..øJ~ .s~~fU5S Phone No.:(t;hl ) 387-b52 ""L Site Address: /S-S"~O òTæé:ßÐ'U.. 1J4I'i~eJdt 0\.- Date of Testing/Serviciog: ~ I..ILP-Y. t 7~Jir Page 1 of3 03101 Monitoring System Certifkation D. Results of TestiDgIServidng It Software Version Installed: Q Yes ~* . N/A Yes Q No* Q N/A Q Yes ~* NIA Q Yes* Q Yes* Yes Q No* es Q No* * In Sedion E below, deseribe bow and wbeD these defidencies were or wiD be correded. licable E. Comments: Page2of3 83JfIl F. In-Tank Gauging I SIR Equipment: ~eck this box if tank gauging is used only for inventory control. Q 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 perfonn leak detection monitoring, Complete the foDowin2 checklist: 0 es [J No· Has all input wiring been inspected for proper entry and termination. including testing for ground faults? a es Q No· Were all tank gauging probes visually inspected for damage and residue buildup? a Yes Q No· Was accuracy of system product level readings tested? -CI Yes [J No· Was accuracy of system water level readings tested? '.eI"'"Yes Q No· Were all probes reinstalled properly? 'gyes a No· Were all items on the equipment manufacturer's maintenance checklist completed? · In the Section B, below, desen'be bow and wben these ...~ were or will be corrected. G. Line Leak Detectors (LLD): út' Check this box ifUDs are not installed, Comølete the 10Ho riD2 cbecldist: [J Yes [J No· For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfonnance? [J NIA (Check all that apply) Simnll\kd leak rate: Q 3 g.p,h.; [J 0.1 g.p,h; Q 0,2 g.p.h. [J Yes [J No· Were all UDs confirmed operational and accurate within regulatory requirements? [J Yes [J No· Was the testing apparatus properly calibrated? [J Yes [J No· For mechanicallLDs, does the LLD restrict product flow if it detects a leak? a N/A [J Yes [J No· For electronic UDs, does the turbine automatically shut off if the LLD detects a leak? [J NIA a Yes [J No. For electronic LIDs, does the turbine automatically shut off if any portion of the monitoñng system is disabled a N/A or disconnected? .'-- a Yes [J No· For electronic UDs, does the turbine automatically shut off if any portion of the monitoñng system malfunctions Q N/A or fails a test? a Yes a No. For electronic LLDs, have all accessible wiring connections been visually inspected? [J NIA [J Yes [J No. Were all items on the equipment manufacturer's maintenance checklist completed? · In the Section B, below, desen'be bow and when these defidendes were or will be corrected. H. Comments: Page3of3 03101 Monitoring System Certlfieation Site Address: ~'T'"I'J(".D 'If" I UST Monitoring Site Plan ' ~o/27 / U/#1 k ~ð; ¿h,K...Õr0.6 1re.kL ,. .~: ~\::~,: 8I..~. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. : : ~ ~ ~< : ®: : .: : : tt:. \r.-: .~ , . . . . ./-A(j¿h . ........................ r."..... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .~:-~< .~. :~::~: :@ .. .. .. .. .. .. .. .. .. .. .. .. .. .~... .~... :::::~: :~: .~. :gQ:: . . tt;I'7 :~rn": : . . . . 2' ...... ·7· ..~........ .~ ~.. . . ::.::~:f:Æ}¡: .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. :S~: ~~~~: :@:1Þ~: :3~'Õ : .. .. .. .. .. .. .. .. .. .. .. .. .. .... ............ : : tgJ :~.v:ik,~V: . ,~. . , . . . . , , .. .. .. .. .. .. .. .. .. .. .. Date map was drawn: !lJ J.!J ~'f. Instnactions If you already have a diagram that shows all required information, 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), In the space provided, note the date this Site Plan was prepared. Page ~or'1- 05100 ·--.---- IN-TANK SETUP - -'" - -- ------ ..---. T 1: UNLDADED PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL : 1 : .000700 96.00 1 PT 12000 T 2:PREMIUM PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL : 2 ............000700 :~6,OO 1 PT 12000 SYSTEI'1-SETUP-· ~UG îl~ ;0~4~ PM- SVSTEM UNITS U.S. SYSTEI'1 LANGUAGE ENGLI SH SYSTEM DATE/TIME FORMAT MON DD '1'1'1'1 HH:MM:SS xM FASTRIP 6401 WHITE LN, BAKERSFIELD.CA 93309 FLOAT SIZE: 4,0 IN, 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3,0 MAX OR LABEL VOL: OVERFI LL LI M IT FLOAT SIZE: 4,0 IN. 8496 WATER WARNING : 2,0 HIGH WATER LIMIT: 3,0 MAX OR LABEL VOL: 12000 OVERFILL LIMIT 95% 11400 HIGH PRODUCT 97% 11640 DELIVERY LIMIT 1% 120 7:00 AM DISABLED DISABLED DISABLED PERIODIC TEST WARNINGS DISABLED ., ~ ANNUAL TEST WARNINGS DISABLED PRINT TC VOLUMES ENABLED SHIFT TII"IE 1 SHIFT TIME 2 SHIFT TIME 3 SHIFT TII'1E 4 LOW PRODUCT : 1 000 LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT : 10,00 MANIFOLDED TANKS nt: NONE LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT MANIFOLDED TANKS Tit: NONE 1000 99 99 0,00 LEAK MIN PERI0Dl~: 1% 120 LEAK MIN PERIODIC: 1% 120 LEAK MIN ANNUAL 1% 120 TEMP COMPENSATION VALUE <DEG F ): 60,0 H-PROTOCOL DATA FORMAT HEIGHT RE-DIRECT LOCAL PRINTOUT DISABLED SYSTEM SECURITV CODE : 000000 LEAK MIN ANNUAL 1% 120 - PERIODIC TEST TYPE . STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAG I NG : OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:1FF DELI VERY DELAY : 15 11 N PERIODIC TEST TVPE STANDARD - ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAG I NG : OFF PER TEST AVERAGING: OFF TANK TEST NOT I FY : OFF TNK TST SIPHON BREAK:OFF DELIVERY D~V : 15 MIN ~~::/ "ý~"~ --. "f.~' T 3: D I E.SEL -............ PRODUCT CODE : 3 THERMAL COEFF :,000450 TANK DIAMETER 96,00 TANK PROFILE 1 PT FULL VOL 12000 FLOAT SIZE: 4,0 IN, 8496 WATER WARNING : HIGH WATER LIMIT: MAX OR LABEL VOL: OVERFILL LrMIT : HIGH PRODUCT DELI VERY LI M IT 2,0 3,0 12000 95% 11 400 97% 11640 1% 120 1000 99 99 0.00 LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT : MANIFOLDED TANKS TIS: NONE LEAK MIN PERIODIC: 1% 120 LEAK MIN ANNUAL 1% 120 PERiODiC TEST TYÞE STANDARD ANNUAL TEST FAIL ALARM DrSABLED PERIODIC TEST FAIL ALARt1 0 I SABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAG I NG : OFF TANK TEST NOT I FY : OFF TNK TST SIPHON BREAK:OFF DELiVERY DELAY : 15 MIN LEAK TEST METHOD ------ - - - - TEST ON DATE : ALL TANK JAN 1. 2005 START TIME: 2:00 AM TEST RATE :0.20 GAL/HR DURATION : 2 ~ LEAK TEST REPORT FORMAT fdl'rlto......1' ~ --.--.--.--------.--- ~I~U:D_S~N~OR_S~T~P_ \_ L 1 :UNL STP TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUNP L 2:UNL ANN DUAL FLOAT HYDROSTATIC CATEGORY : ANNULAR SPACE L 3:UNL FILL TRI-STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS L 4:PREM STP TRI-STATE (SINGLE FLOAT) CATEGORY : STP SUMP L 5:PREM FILL TRI-STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS L 6:PREM ANN DUAL FLOAT HYDROSTATIC CATEGORY : ANNULAR SPACE L 7 :D1E STP TRI-STATE {SINGLE FLOAT} CATEGORY: STP SUMP L 8:DIE FILL TRI-STATE (SINGLE FLOAT) CATEGORY : OTHER SENSORS L 9:DIE ANN DUAL FLOAT HYDROSTATIC CATEGORY : ANNULAR SPAC;E L1 0 :DISP 3-4 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN L11 :DISP 1-2 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN Ll2 :DISP 7-8 TRI-STATE (SINGLE FLOAT) CATEGORY : DISPENSER PAN .----- Ll3:DISP 5-6 TRI-STATE {SINGLE.FLOAt> CATEGORY : DISPEN~3R PAN OUTPUT RELAY SE UP ----- - - - - R 2:0 TYP , STANDARD NORMALLY CLOSED IN-TANI< ALARMS T 3: LEAK ALARM LIØUID SENSOR ALMS L 7:FUEL ALARM L 8:FUEL ALARM L 9:FUEL ALARM LIO:FUEL ALARM Ll1:FUEL ALARM L12:FUEL ALARM L13:FUEL ALARM L 7:SENSOR OUT ALARM L 8:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L 1 0: SENSOR OUT ALARM Ll1:SENSOR OUT ALARM L12:SENSOR OUT ALARM L13 : SENSOR OUT ALARM L 7:SHORT ALARM L 8:SHORT ALARM L 9:SHORT ALARM LIO:SHORT ALARM L11 : SHORT ALARM L 12: SHORT ALARM L 13: SHORT ALARM L 9:LOW LIQUID ALARM R 3:UNL-PREM TVPE: STANDARD NORl'1ALL Y CLOSED IN-TANK ALARNS T 1: LEAK ALARM T 2:LEAK ALARM LIQUID SENSOR ALMS L 1 :FUEL ALARM L 2:FUEL ALARM L 3: FUEL ALARM L 4:FUEL ALARM L 5:FUEL ALARM L 6:FUEL ALARM L10:FUEL ALARM L11 :FUEL ALARM L12:FUEL ALARM L13 : FUEL ALARM L 1: SENSOR OUT ALARI'1 L 2:SENSOR OUT ALARM L 3:SENSOR OUT ALARM L 4:SENSOR OUT ALARM L 5:SENSOR OUT ALARM L 6:SENSOR OUT ALARM LIO:SENSOR OUT ALARM Ll1:SENSOR OUT ALARM L12:SENSOR OUT ALARM L13:SENSOR OUT ALARM L 1: SHORT ALARM L 2:SHORT ALARN L 3: SHORT ALARI'1 L 4:SHORT ALARI'1 L 5:SHORT ALARM L 6:SHORT ALARM L1 0: SHORT ALARM , Ll1 :SHORT ALARM L12:SHORT ALARM L1 3 : SHORT ALARM - ¡. ~ ALARM HISTORY RE~ ----- SENS- L I:UNL ST~R ALARM ---- STP SUMP FUEL ALARM AUG 11. 2004 2:36 PM FUEL ALARM MAY 18. 2004 7:00 AM FUEL ALARM MAY 18. 2004 6:34 AM ALARM HISTORY REPORT _____ SENSO~LARM ----- L 4:PREM STP ~ STP SUMP FUEL ALARM AUG 11. 2004 2:35 PM FUEL ALARM MAY 18. 2004 7:02 AM FUEL ALARM MAY 17. 2004 7:10 PM ALARM HISTORY REPORT L-2~ÜN~E~~~R ALARM ----- ANNULAR SPACE ~~gHITIQUID ALARM . 2004 2:29 PM M~~ T~QU~D ALARM . _004 7:01 AM ALARM HISTORY REPORT _____ SENSOR ALARM ----- L 5:PREM FILL OTHER SENSORS FUEL ALARM--- " AUG 11. 2004 2:33 PM FUEL ALARM MAY 18. 2004 7:03 AM FUEL ALARM MAY 17. 2004 7:11 PM ALA~ HISTORY REPORT - - -- =- SElfsOR ,-./""~,><.,,... L 3:UNL FILL ALARM ----- OTHER SENSORS FUEL ALARM AUG 11 2 . 004 2:33 PM FUEL ALARM MAY 18. 2004 7:01 AM FUEL ALARM MAY 17. 2004 7:10 PM ALARM HISTORY REPORT _____ SENSOR ALARM L 6 :PREM ANN ANNULAR SPACE HIGH LIQUID ALARM AUG 11. 2004 2:30 PM LOW LIQUID ALARM MAY 18. 2004 7:03 AM LOW LIQUID ALARM MAY 17. 2004 7:14 PM . - ALARM HISTORY REPORT . L-7~~r~~R ALARM STP SUMP FUEL ALARM AUG 11. 2004 2:35 PM .. ~~9h/~~~u"" ""t {_ u"t Mf'" - FUEL ALARM MAY 17. 2004 7:15 PM ALARM HISTORY REPORT ----- SENSOR L 8 ALARM ----- :DIE FILL OTHER SENSORS FUEL ALARM AUG 11. 2004 2:34 PM FUEL ALARM MAY lB. 2004 7:05 ~1 FUEL ALARM MAY 17. 2004 7:15 PM ALARM HISTORY REPORT L-97DI~E~~~R ALARM ANNULAR SPACE HIGH LIQUID ALARM AUG 11. 2004 2:31 PM LOW LIQUID ALARM MAY 18. 2004 7:05 AM LOW LIQUID ALARM MAY 17. 2004 7:16 PM ~ .;¡-.., ,.. -.-- ALARM HISTORY REPORT ----- SENSOR AL~--- Ll0:DISP 3-4 . DISPENSER PAN FUEL ALARM AUG 11, 2004 2:25 PM FUEL ALARM MAV 18, 2004 7:08 AM FUEL ALARM MAV 17, 2004 7:07 PM ~-------- -. -----~---- ALARM HISTORY REPORT ----- SENSOR ALARM Lll :DISP 1-2 DISPENSER PAN FUEL ALARM AUG 11, 2004 2:26 PM FUEL ALARM MAY 18, 2004 7:09 AM ALARM HIS¡P~REPORT ----- SEN LI3:DISP ~~: ALARM ----_ DISPENSER PAN FUEL ALARM AUG 11. 2004 2:27 PM FUEL ALARM MAY 18. 2004 7 :06 AM ALARM HISTORV REPORT ----- SENSOR ALARM L12:DISP 7-8 DISPENSER PAN FUEL ALARM AUG 11, 2004 2:28 PM FUEL ALARM MAY 23. 2004 12:32 PM FUEL ALARM MAV 23, 2004 12~ '" DKSFLD FIRE PREY~NTION e 661-387-6522 (661)852-2172 p.9 p, 1 Rug 08 04 07;36p OCT 03 2003 12:27 e Ron Rogers . CITY OF BAKERSFlRlJ) OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave.. Bakersfield., CA (661) 326-3979 APPUCA.TlON TO PERFORM FUEL MONITORING CERTIFICATION FACILITY.:30 r¡;;^/,~/ ~ ~i-UV ADDRESS 6~/ t.</¡';k,; /..rr....~ OPERATORS NAME 7Þ~ P.Ñ-r/d( OWNBRSNAMB IÞ41 ~( NAMa OPMONlI'OR MANUFACTURER £4(1.. noS 3S'O DOSS FAcn..rrYHA VB ÐrsPBNSBR. PANS? YEs ,,/ NO_ '- TANK # VOW.M8 CONTBNTS 1 (~ ,;;;IIf> 0 .., , ?"7 ~r "2- t ¡:) C).pO 7/ " :\ IQ ~pp p,~ , NAMEOP~nNOCOMPANY ¡:k,G {Jri'ï/Lo t.£~ftA.. &/U.J, uC~ CONTRACTORS UCENSB" R /3 l:>/h "t" ... NAMB& PHONBNUMBEROPCONTAcrPER~N ~ ~~ ~ 1'-Y72-"-¡Ql;¡/ DA'Œ&TIM2msTISTOBBCONDUcœD [(-/I-o'l .teJo /?n;, il/a¡J,¡£) { APPROVED BY <g '"' 9 r-tJ V PATE ~~APPUCANT I ' I"-~- ~ ~ . ~ þ; -e - I· CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave,. 3rd Floor. Bakersfield. CA 93301 FACILITY NAMEfi".¡ ~\\ \~ INSPECTION DATE 7/30/04- , Section 2: Underground Storage Tanks Program o Routine ~ Combined 0 Joint Agency Type of Tank SiN F~S Type of Monitoring ¡1T~ o Multi-Agency Number of Tanks Type of Piping o Complaint 4- L~T ORe-inspection OPERA TlON C V COMMENTS Proper tank data on tile X Proper owner/operator data on tile X Pennit fees current X Certification of Financial Responsibility X Monitoring record adequate and current K Maintenance records adequate and current X Failure to correct prior UST violations )( Has there been an unauthorized release? Yes No )( Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA TION Y N COMMENTS SPCC available SPCC on tile with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MYF? If yes, Does tank have overtill/overspill protection? C=Compliance V=Violation Y=Yes N=NO ~OOíUlÙ Busmess Ite ResponsIble Party Inspector: Office 0 White - Fnv, Svcs, Pink - Busincss Copy .'~--~::':'.-: :>: e ---.... ----.-'"\ ( ..' . <1 i:-,_. of "'\.....-$ , y' _I' \ FASTRIP 6401 l...IH ITE LN, BAKERSFIELD.CA 93309 . JUL 30. 2004 9:47 AM SYSTEf"l STATU~::; F:EPORT, - - .:..~ - - - - -.- - ALL FUNCTIONS NORMAL I N\lENTORY REPOF:T T 1: UNLDADED \/0 L Ur"'lE ULLAGE 90~, ULLAGE= TC "jOLUr"1E = HEIGHT WATER \/OL = ,- -l...IATER - TEMP T 2: PREI''1I Ut"1 \lOLUME ULLAGE 90% ULLAGE= TC \lOLUI"lE HEIGHT I.JATER \lOL L'JATER TEI'W T 3:DIESEL \/OLUr"1E ULLAGE 90% ULLAGE= TC 'v'OLUr1E HEIGHT WATER 'v'OL L'JATER TEMP 5799 6201 5001 5656 46.74 o TL 00 95.1 GALS GAL:3 GALB GALS INCHES GALS TNC HES - DEG F 4072 GALS 7928 GALS 6728 GALS 3973 GALS :35.75 I NCHE~3 o GALS 0.00 INCHE3 94.6 DEG F 4987 GALB 70 1:3 GALS 5813 GALS 4920 GALB 4 1 . 62 I NC HES o GALS 0,00 iI NCHEB 89.5 DEG F ~ ~ M M M MEND M ~ M M M ""~ ? ~,/' ....,. I / ~~<~;/"",",..... -~~'...-~.... -'-' ···.....·r:-1.V~...'· -. ',........,..~,--.,._~_. e ~-- .c> ...-:.... .'~) U-NIFIED PROGRAM IN'ECTION CHECKLIST ~~::.... n; f~,;,:,!)";~~?.w;¡W__~~~?:1ifl:~~~~'»~'1>¡:;,~~',. SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME C L.)" J e; \ \ S 117r;;;NJdt- INSPECTION TIME --------1-----'-- ----- - -----------------.-----------.----.----------------.----------- ---.- .----.---. --- --------.-.--..-..-.-lc-------r-~-.--u-- -----.--.-..-----.-- =oOO,^~A:Q\ _~bd_Þ .h--Y____ ···-·--·····--F:;"~~I~'::k"-- . Section 1: Business Plan and Inventory Program D Routine J( Combined D Joint Agency D. Multi-Agency D Complaint D Re-inspection C V ( C=Compliance ) V=Violation OPERATION COMMENTS D ApPROPRIATE PERMIT ON HAND -----_._-~----------------,.,---,_.__._-~-- -_._.__._-~--_.-.-- .-----.------,.. ......---.----.---- ..-.--.. -'-- --- ..___.',_ n_ .._.. __,."____._ ___ ..________.________u~._ .~ D BUSINESS PLAN CONTACT INFORMATION ACCURATE ~_._---~----~-------------,-_.__.__._-,--_._-_._..",.--.-.----.--..,---- --- ------- -_.~...._------ _.~ ð!..._~__ VIS~~~~_~.:>RES~___________ ---.------------- -------- -- t - øI D CORRECT OCCUPANCY ~---c---..-----u---------------------------.-----------.--__h._ -------__ _________ --__ __ --------___ _ ______ ~ D' VERIFICATION OF INVENTORY MATERIALS ------~ -O---~ERI~~~~~~-~;-~~:~;I;I~;_--------- - ------- -- - --j----- -- -------- - --- - ----- ~ -----~---- VE~I;;~:;ION---~~~~~~;;~~----- - ----------"---------------------------------- _.___._____..____..._________________ ___...___.____ .n__._.'"__.__._____.__~._____._._ ___.__ _____....__.__...___~ __ __.. _._____._ ~_~___~~~~=~__SEG~__~~~~~~~~_F~~~E~I~~ ...----------------i---- _.. ...... ________ - .______ u_________________ ------- ----------------- ~___~__~~I~~~~ION___~~__~~~__~~~~L~_~IL~~E_.___________------- ----f.---- ...-- ~ D VERIFICATION OF HAT MAT TRAINING ' Å-~,,';'~~()f .;~M..;~~ES~~~~;,.,;~URES t~- ~~- __. -__ u__u=-=_=___ ~ ~___=~_=~~:~~~~~~~_~~~R_:~.~~~~~TE___________.__u_______ __1_______..______.________.__________. -.-- -- -- ..-.--------- ----.. ---.---.----- -.------ ------- ~-~~~~;~~<>PERLy~ELEJ) u____ ____1_____ ... -- ------ ___________.________ ________________u_____·___·___·___ __________ ____________.___._________ __._.¡ _..__ ... __________.___ _ __ ___________ ___ __ . ___._._______ _____________ ~ D FIRE PROTECTION ~--O--S;T~-[}¡~~~~~-A~~-~~T~&--O~ --H~ND------- ----------- ------------ . ----- -- ---------- .... .- .-. .-----.--.-.-.....-.--.---- ----.- . .-.._.... "_._--~------_.-..- -.- __ - ._·_._...u"_._ .... ------.--..-...--..--.-....-----.- .-....--.----.---.-..---.. .-.--.-----...-... -.-...- --.----..-..-.--------.---- . .. ...._ ._on. ____.____. ._._...__..,.______ .-. - -- -- -...-.... -----.-.._-----_..---- -~---_.__._.._-------~---_. .. -- ..- --.--..---.. -..-.--.-.-..-......---.-. ..-.------~_._. ANY HAZARDOUS WASTE ON SITE?: DYES !NO EXPLAIN: l./..1d4-/-- -----'=1; Preveñïiorl1sl-ïfiiShift of site--- -- er 1 White - Environmental Services Yellow - Station Copy Pink - Business Copy THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 " I~~ \/ -- e Praxair Services, IrlC~ Technical Solutions for the Industrial World. CUSTOMER COpy tJCf,sc(')M Tt"ß~~r'~~~_¡-:<:;h Corròr-øn CERTIFICATION OF ELDsM TRACER TIGH.T®-"fESTffì5:S:Ul TS ~b # 37302NC '~~, Prepaired. For: Shi(ley Environmental 1928 Tyler Ave, Suite K South EI Monte, CA Site Info Fastrip Food Stop 6401\Ñhite Lane Bakersfield, CA 05/13104 Date: Test Time Period SYSTEM TRACER STATUS Diesel Tank A PASS 87 Tank A,R PASS 91 Tank A PASS Piping 87 Primary W PASS Piping 91 Primary W PASS Piping Vapor Recovery Primary W PASS Piping Vent Primary A PASS Piping Diese! - Primary W PASS Piping Future Vent Return Primary W PASS Dispenser Sumps W PASS Praxair Services Inc, certifies that the tank and product distribution lines listed in the above table have been tested by means of Enhanced Tracer Tight®, According to EPA standard test procedures for evaluating leak detection methods, the Enhanced Tracer Tight® method is capable of detecting leaks of ~O,005gallons per hour with a Probability of Detection (PD) of 0,95 and Probability of false alarm of <0,05 - --<=~=-~. ::~:t-e-'-ster:~..~.::B9b.:càurrìñíisar"-=-_ -. '". _: -~-=---~G'A-=EïC;#::::-'1'34665 -~- Signature: ;Ú1C: ~ Date: 5/13/2004 I declare under penalty of perjury that I am a licensed tank tester in the State of California and that the information contained in this report is true and correct to the best of my knowledge, The following criteria are used for the classification of leakage based on the presence or absence of tracer, PASS Criteria: No Tracer Detected FAIL Criteria: Tracer Detected ¡' >~~. 1 JNIFJE) PRO(;RAM r:ONSOI,mA TEl) F M TANKS UNDERGROUND STORAGE TANKS - FACILITY (one page per site) Page_of_ TYPE OF ACTION 0 I. NEW SITE PERMIT 0 3. RENEWAL PERMIT (Check one item only) ,r7 A~!E:--;DED PERMIT o 5,CHANGE OF INFORMATION speeity change local use only o b.TEMPORARY SITE CLOSURE o 7,PERMANENTL Y CLOSED SITE o 8, TANK REMOVED 400 I. FACILITY I SITE INFORl'\'IA TION 401 FACILITY OWNER TYPE o l.CORPORATION o 2. [NDIV[DUAL ~PARTNERSHlP 402 . If owner of UST is a public agency: name of supervisor of division, section or office which opemte' the UST (This is the contact person for the tank records.) F AC[LITY [D# . FARM 05, COMMERCIAL 04, PROCESSOR 0 6, OTHER 40, Is facility on Indian Reservation or trustlands? 404 0 Yes ~ 405 406 II. PROPERTY OWNER INFORMATION 407 PHONE 408 409 410 412 o 2, INDIVIDUAL ~PARTNERSHIP 413 Ill. TANK OWNER INFORMATION 414 415 416 417 -d,S/~ 6, STATE AGENCY o 7. FEDERAL AGENCY 419 o 2, INDIVIDUAL Ilr3."'PARTNERSHIP 420 IV, BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER Call 916) 322-9669 if uestions arise V, PETROLEUM UST FINANCIAL RESPONSIBILITY 421 INDICA TE METHOD(s) JrÏ.SELF-INSURED o 2. GUARANTEE o 3. INSURANCE 04, SURETY BOND 07, STATE FUND 05, LETTER OF CREDIT J:jš:"ST A TE HIND & CFO LETTER 06, EXEMPTION 09, STATE FUND & CD o 10, LOCAL GOYT MECHANISM o 99, OTHER: ~,:": 422 VI. LEÇAL NOTIFICATION AND MAILING ADDRESS Check one box to indicate which address should be used for legal notitications and mailing, Legal notifications and mailings will be sent to the tank owner unless box I or 2 is checked, o L FACILITY 02, PROPERTY OWNER ~\lK OWNER 423 VII. APPLICANT SIGNATURE Certification - I certity that the information provided herein is true and accurate to the best of my knowledge. SIGNATURE OF APPLIÇ 424 1998 UPGRADE CERTIFICATE NUMBER tFor locol ose only) 429 UPCF (l/99 revised) 8 Fonnerly SWRCB Fonn A e e " UST - Facility Formerly SWRCB Form A. Complete the UST - Facility page for all new permits, permit changes or any facility information changes, This page must be submitted within 30 days of permit or facility information changes, unless approval is required before making any changes, Submit one UST - Facility page per facility, regardless of the number of tanks localed at the site, This form is completed by either the permit applicant or the local agency underground tank inspector. As part of the application. the tank owner must submit a scaled facility plot plan to the local agency showing the location of the USTs with respect to buildings and landmarks [23 CCR 02711 (a)(8)]. a description of the lank and piping leak detection monitoring program [23 CCR 02711 (a)(9)], and, for tanks containing petroleum, documentation showing compliance with state financial responsibility requirements [23 CCR 02711 (a)(11)], " .-~ -- , . ' ':_-~."s"'>!, " Refer to 23 CCR 02711 for state UST information and permit application requirements, (Note: the numbering of the instructions follows lhe data element numbers that are on the UPCF pages, These data element numbers are usedfor' ;.. , electronic submission and are the same as the numbering used in 27 CCR. Appendix C, the Business Section of the Unified Program 'Data Dictionary!) 'V,<\ á Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated, . 1, FACILITY ID NUMBER - Leave this blank, This number is assigned by the CUPA, This is the unique number which identifie'¡¡,your facility, 3. BUSINESS NAME - Enter the full legal name of the business., ',':, 400, TYPE OF ACTION - Check the reason the page is being completed, CHECK ONE ITEM ONLY, ' . 401, NEAREST CROSS STREET - Enter the name of the cross street nearest to the site of the tank, 402, FACILITY OWNER TYPE - Check the type of business ownership. 403. BUSINESS TYPE - Check the type of business, 404. TOTAL NUMBER OF TANKS REMAINING AT SITE - Indicate the number of tanks remaining on,the.site after the requested action. '..' " 'r",., 405. INDIAN OR TRUST LAND - Check whether or not the facility is located on an Inqjan r.e¡¡ervation or other trust lands. . '--,," '.,.", . ____'~. 406. PUBLIC AGENCY SUPERVISOR NAME - If the facility owner is a public àgency, énter the name of the supervisor for the division, section or pffic~ which operates the UST This person must have access to the tank records, .. .... -', 407, PROPERTY OWNER NAME - Complete items 407- 412 for the property owner, unless all items are 408, PROPERTY OWNER PHONE the same as the Owner Information (items 111-116) on the Business :~~: ~~g~~~~ g~~~~,~~';INGÖR STREET ADDRESS" ~~~~~~~~~a~o~ ~I~~~~ii~a:~~; ~:~~~~ESForrñ ~730). If the sam~", 411. PROPERTY OWNER STATE 412, PROPERTY OWNER ZIP CODE 413. PROPERTY OWNER TYPE - Check the type of property ownership. 414. TANK OWNER NAME - Complete items 414- 419 for the tank owner" unless all items are the , 415, TANK OWNER PHONE same as the Owner Informalion (items 111-116) on the Business 416. TANK OWNE;RMAILI~G OR $J:REET ADDRESS Owner/Operator Identificatie," page (OESForm 2730). If the same,; / 417, TANK OWNER CITY , . write "SAME AS SITE': in'thissection, " , )', .' 41B. TANK OWNER STATE . . 419, TANK OWNER ZIP CODE .... 420. TANK OWNER TYPE - Check the type of tank ownership. " ' ", 421. BOE NUMBER - Enter your Bo;¡¡rd Of Equalization (BOE) UST storage fee account number. This fee applies to regulated USTs storing petroleucJ:j', products: This is· required bèfo,[e yoUr permit application càn be processed, If you do not have an account number with the BqE Or.jf you' :,~', : ¡ have any qUestioni;' regarding the fee or exemptions, please càll the BOE at (916) 322-9669 or write to the BOE at: Bòard of EqùalizaÎion, Fuel Taxes Division, P,O, Box 942879, Sacramento, CA 94279-0030. , 422, PETROLEUM UST FINANCIAL RESPONSIBILITY CODE - Check the method(s) used by the owner and/or operator in meeting the Federal and State financial responsibility requirements. CHECK ALL THAT APPLY. If the method is not listed, check "otherOand enter the method(s), USTs owned by any Federal or Slate agency and non-petroleum USTs are exempt from this requirement 423. LEGAL NOTIFICATION AND MAILING ADDRESS -Indicale the address to which legal notificatio~s,.aJd mailings should be sent. The legal notifications and mailings will be sent to the tank owner unless the facility (box 1) or the propeFtYJowner (box 2)Î~ checked,'~ SIGNATURE OF APPLICANT - The business owner/operator of the tank facility. or officially designated representative of the owner/operator, shall sign in the space provided. This signature certifies that the signer believes that all the information submitted is accurate and complete, 424, DATE CERTIFIED - Enter the date that the page was signed, 425, APPLICANT PHONE - Enter the phone number of the applicant (person certifying), 426. APPLICANT NAME· Enter the full prinled name of the person signing thè page, 427, APPLICANT TITLE - Enter the tille of the person signing the page, . 428. STATE UST FACILITY NUMBER - Leave this blank, This number is assigned by the CUPA as follows: the number is composed of the two digit county number, the three digit jurisdiction number, and a six digit facility number, The facility number must be the same as shown in item 1 , 429. 199B·UPGRADE CERTIFICATE NUMBER - Leave this blank, This number is assigned by the CUPA, '\'" . ,.....~. ."<. t.: .'. -\ ----,_._~_.- --... UPCF (1/99 revised) 9 Fonnerly SWRCB Fonn A . li~IH[D PROGR.\\I CO~SOLlOA TED F , I TA:\KS U~DERGROL~DSTOR~GETA'KS-TA~KPAGEl (two pages p~r tank I o 3 RE~EW\L PER,\I!T ~.\!E\DEJ;'~K.\IIT 0 :C!l-\~GEOf::--'f':>R.\I.\T;('," 06 TE'\IPOR,-\RYSJTECcOSLRE o 7 PER.\I \':E\ TL) LLOSD 0," SITE ISr~;:"~' ~:J>.n - : i :':':J.I .~ oni:--¡ (Sl'!c::;':. r_-1h~n - fœ iOC31 'JS;: ;,nly! 0 8 T A\"K RE~O\'ED P'ilgc _of _ TYPE OF ACTIO:" 0 ! \EW SirE PER.\IIT {CMck one ¡Iem oJnl)'1 ~JO HCILlTY ID: ~JI .a~.\ t f'·VcI". completc one ~gt (or c.2.cn ~omp¡nm(n\ ~j6 NUMBER OF COMPARTMENTS 4J' :-~. .. 4J1 e.. II, T A:'<K CO~TENTS TANK USE ~ MOTOR VEHICLE FUEL (1fnw1ud .amp!... P.troltum Typo) (] 2. NON-FUEL PETROLEUM (]], CHEMICAL PRODUCT CJ 4. HAZARDOUS WASTE Oll<luclc. U..d Oil) CJ 9'.l1NKNOWN 4J9 PETROLEL'M TYPE III"'i7.' REGULAR UNLEADED o Ib, PREMIUM UNLEADED o k MIDGRADE l:NLEADED 440 o 2. LEADED 03. DIESEL o 4, GASOHOL 05. JET FUEL o 6, A VIA TJON FUEL 099, OTHER 441 CASlllfrom HuordGus Moterial, In"ntory pag' ) 442 COMMON NAME (from Ha..rdOllJ MatcrialJlnvemorypage) C: .e.- III. TANK CONSTRUCTION 3, SINGLE WALL WITH 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM EXTERlOR MEMBRANE LINER {J 95, t.JNKNOWÑ 04. SIGI'LE WALL IN VAULT 099, OTHER 3. FIBERGLASS ¡ PLASTIC 5. CONCRETE 04, STEEL CLAD WíFIBERGLASS 0 8. fRP COMPTIBLE WlIOO"4 METHANOL REISFORCED PLASTIC (fRP) 3, FIBERGLASS í PLASTIC o 4. STEEL CLAD W:FIBERGLASS REISFORCED PLASTIC (FRP) o 5, COSCRETE 3, EPOXY LINING Boo(o - w J - or TYPE OF T ANI< I. SINGLE WALL 443 (C1Icck on. item only) ¡¡f2. DOUBLE WALL L BARE STEEL 02. STAINLESS STEEL 95, ü¡.¡KNOWN o 99. OTHER 444 TANK MATERIAL -p,imarylank (CIIcck.... ¡¡em only) TANK MATERIAL - ...ondlry ,.nk (C1Icck one il<m only' I. BARE STEEL 02, STAISLESS STEEL 5, CONCRETE 95. {.¡'NKNOWN o 8. FRP COMPTlBlE W. J 00% METHANOL 0 99, OTHER 010. COATED STEEL .¡.¡, TANK INTERIOR LINING L RL'BBER LINED o 2 ALKYD UNI:-IG 04 PHENOLIC LlNI:-¡G 5, GLASS LINING I!1'6UNLINED 9$, UNKNOWN 0146 DA TEI:"IST ALlED 0147 . OR COATING (Oock.... iIcm GIIIYI o 99 OTHER (For local ~IC onl)') OTHEaCORROSION 0 I MANUFACTVRED CATHODIC PROT£CTION IF APPLICABLE PROTECTION (Oack.... iIcm onlYI 0 ! SACRIFICIAL A:-IODE SPILL AND OVERFILL YEAR INSTALLED (Oock &111M' aw1y) œ(,SPJLL CONTAINMEST O~ f!2DROP n;SE 0 1" æf3STRIKER PLATE éJ.y o 3 FIBERGLASS REINFORCED PLASTIC o 4 IMPRESSED CURRENT 095 UNKNOWN o 99 OTHER 0148 DATE INSTALLED 0149 (For 1..01... only) IF SINGLE WALL TANK ,Check.1I Ih.. .>ply) IF DOUBLE WALL TANK OR TANK WITH BLADDER 44 (Chc,k one item onl)l" o I VISUAL (EXPOSED PORTION ONL YI 05 MA:-:UAL n:-lK GACGI:\G (MTG) 0 I VISt:AL (SINGLE WALL )II V.WL T O!\'L YI 02 AUTOMATIC TANK GALGING IA 1'G) 06 VADOSE lOSE 0 ! COJ',ïJSUOUS INTERSTITIAL MOI'ITORI:-G 03 CONTIN1:0US ATG 07 GROLNDWHER 0 3 MA~UAL MOSITORlSG 04 STATISTlCALI:>IVE;\ôTORY RECO:-;CIUA TION 0 ~ TA:"K TESTING (SIR) BIENNIAL TASK TESm<G 099 OTIIER IV. TA:-;J< CLOSlRE l:'oiFOR:\L-\TI0:-; I PER,\IA:\E.'T CLOSCRE 1:\ PLACE 4'1 OVERfILL PROTECfION EQlJIPME:-¡T:YEAR INSTALLED Øí:ALARM ø..y' 03 FILL TUBE SHUTOFf VALVE Ø2 BALL FLOAT M 0 4 EXEMPT 4% ESTIMATED DATE lAST L'SEDI YR \:(1l)-\)1 J~S E5T~1 A TED QLA.\TITY OF 5LBSTA~CE RE\I.\J:"I:-':G gallons .j ~f'¡ T.-\~K FILLED WITH INER T '!A TERIAV' o Y~s 0 \0 J,~ UPCF (12/99 revised) 10 Formerly SWRCB Fonn B e e UST . Tank Page 1 Formerly SWRCB Form B Complete the UST . Tank pages for each tank for all new permits, permit changes. closures and/or any olher tank information change. This page must be submitted within 3C days of permit or facility information cranges, unless ap¡:roval is required before making any charges, For compartmentalized tanks, each compartment is considered a separate tank and requires completion of separate tank pages, Refer to 23 CCR :::2ì11 for state UST information and permit application requirements. (Note: the numbering of the inslructions follows the data element numbers that are on the UPCF pages. These dala elemenl numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C. the B.siness Section of the Unified Program Data Dictionary.) E t;· ~..:f:~ ~...', ~:'~~' $.-" f:~; ,~. - t>", Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated. 1. FACILITY ID NUMBER - Leave this blank, This number is assigned by the CUPA, This is the unique number which identifies your facility. 3, BUSINESS NAME· Enter the full legal name of the business. 430. TYPE OF ACTION· Check the rea so;' the page is being completed, For amended permits and change of information, include a short statement to direct the inspector to the amendment or changed information. 431, LOCATION WITHIN SITE· Enter the location of the tank within the site. 432. TANK ID NUMBER· Enter the ownerí1 tank ID number. This is a unique number used to identify the tank. It may be assigned by the owner or by the CUPA. . "33. TANK MANUFACTURER· Enter the name of the company that manufactured the tank, 434, COMPARTMENTALIZED TANK - Check whether or not the tank is compartmentalized. Each compartment is considered a separate lank and requires the completion of separate tank pages, 435. DATE TANK INSTALLED - Enter the year and month the tank was installed. 438, TANK CAPACITY - Enter the tank capacity in gallons, 437, NUMBER OF TANK COMPARTMENTS -If the tank is compartmentalized, enter the number of compartments, 438. ADDITIONAL DESCRIPTION - Use this space for additional tank or location description. 4-39, TANK USE - Check the substance stored. If MOTOR VEHICLE FUEL. check box 1 and complete item 440, PETROLEUM TYPE. 440. PETROLEUM TYPE - If box 1 is checked in item 439. check the type of fuel. 441, COMMON NAME· For substances that are not motor vehicle fuels (box 1 is NOT checked in item 439), enter the common name of the substance stored in the tank. 442. CAS # . For substances that are not motor vehicle fuels (box 1 is NOT checked in item 439), enter the CAS (Chemical Abstract Service) , number. This is the same as lhe CAS # in item 209 on the Irtazardous Materials Inventory - Chemical Description page. 443. TYPE OF TANK· Check the type of tank construction, If type of tank is not listed, check [btherO and enter type, 444,·TANK MATERIAL (PRIMARY TANK) - Check the construction material of the tank that comes into immediate contact on its inner. surface with the hazardous substance being contained. If the tank is fined do not reference the lining material in this item. Indicate the type of lining material in item 446. If type of tank material is not listed, check CctherOand enter material. 445, TANK MATERIAL (SECONDARY TANK)· Check the construction material of the tank that provides the level of containment extemallo, and separate from, the primary containment. If type of tank material is not listed, check [bther] and enler material. 446, TANK INTERIOR LINING OR COATING - If applicable, check the construction material of the interior lining or coating oflhe tank. If type of interior lining or coating is not listed, check [bther] and enter type, 447, DATE TANK INTERIOR LINING INSTALLED - If applicable. enter the dale the tank interior fining was installed. This is to assist the CUPA to develop an inspection schedule. 448. OTHER TANK CORROSION PROTECTION - If applicable, check the other tank corrosion protection method used. If other corrosion protection method is not listed, check [bther[! and enter method. 449. DATE TANK CORROSION PROTECTION INSTALLED - If applicable, enter the date the tank corrosion protection method was installed. This is to assist the CUPA to develop an inspection schedule. 450, YEAR SPILL AND OVERFILL INSTALLED· Check the appropriate box and enter the year in which spill containment, drop tube, and/or striker plate was installed. CHECK ALL THAT APPLY. ' 451, TYPE OF SPILL' PROTECTION - Enter the type of spill containment, drop lube, andlor striker plate, FOR CUPA USE ONLY. 452. YEAR OVERFILL PROTECTION EQUIPMENT INSTALLED· Check the appropriate box and enter the year in which overfill protection was installed or whether there is an exemption from overfill protection. CHECK ALL THAT APPLY, unless tank is exempt. 453. TANK LEAK DETECTION (SINGLE WALL) . For single walled tanks, check the leak detection system(s) used to comply with the monitoring requirements for Ihe tank. CHECK ALL THAT APPLY, If leak detection system is not listed, check [blherOand enter system, 454, TANK LEAK DETECTION (DOUBLE WALL) - For double walled tanks or tanks with bladder, check the leak detection system(s) used to comply with the monitoring requiremenls for the tank, CHECK ONE ITEM ONLY. 455, ESTIMATED DATE LAST USED - For closure in place, enter the date the tank was last used. 456. ESTIMATED QUANTITY OF SUBSTANCE REMAINING IN TANK - For closure in place, enter the estimated quantily of hazardous substance remaining in the lank (in gallons). 457, TANK FILLED WITH INERT MATERIAL - For closure in place, check whether or not the tank was filled Wilh an inert material prior 10 closure, f,· ~!~ 01~.". te.,"'''. ~~~~-" ... ~~ .. , ~, . .,. ATTACHMENTS· 1. Provide a scaled plOl plan with the localion of lhe UST system, including buildings and landmarks, 2. Provide a description of Ihe monitoring program, UPCF (12/99 revised) II Fonnerly SWRCB Fonn B .,. i,. -:;'~,,' ." e e U~IFlED PROGR.-\:\I CO~SOLlDA TED FOR:\-I T-\'iKS ll"DERGROU~D STOR;\GE TA:\KS - TANK PAGE 1 VI. PIPI:'\G CO'lóSTRCCTIO'l; ;('Ö JJI'h,,,,,:·." L~DERGROl~D PIPI\G ! SYSTEM TYPE PRESSlRE 0 ~. SlCT!O~ 0 :. GR.; \îiY n CONSTJ\UCTlON 0 L S¡'òGLE WALL 0 j, USED TRE:'>CH 099. OTHER 4<>3 MA.~F^cruRU tI2 DOL'BLE WALL 0 ,S, L~KSOI,\''ò MANUFACTURER ' .8/'J 4~' o L BARE STEEL 0 6, FRP COr-I?" TlBlE Wi IO~', METH.~:-;OL 0 I, BARE STEEL 02, STAINLESS STEEL 07. GAL\'A:\¡ZED STEEL D lnknown 01, STAJ:\LESS STEEL 0], PLASTIC COMPATIULE W COI'TE:-':TS D'I9, Other 0 J. PLASTIC COMPA TIBLE WCO~TE:\'TS S!J'4, FIBERGLASS D 8, FLEXIBLE (HDPE) O~, FIBERGLASS o 5. STEEL W/COA TI:-IG 0 9. CA TIlODIC PROTECTION 4&1 0 5, STEEL W. COA T¡;":G VII. PIPING LEAK DETECTION (Cñ<ck ,11 thaI ,!,Ade"" tionofthemonitorin r L'NDERGROL'ND PIPING StSGLE WALL PIPING PRESSURIZED PIPING (Cheek ,n thai apply): o I, ELECTRONIC LINE LEAK DETECTOR 3,0 GPH TEST ~lli AUTO PUMP SHL'T OFF FOR LEAK, SYSTEM FAILURE, A1'I'D SYSTEM DISCONNECTION .. AUDtBLE AND VISUAL ALARMS, (J 2. MONTHLY 0.2 GPH TEST CJ 3. ANNUAL INTEGRJTY TEST (0, I GPH) CONVENTIONAL SUCTION SYSTEMS 05. DAILY VISUAL MONITORING OF PUMPING SYSTEM" TRJESNIAL PIPISG INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALUES IN BELOW GROUNDPIPING): [J 7, SELF MONITORJNG ORA VITY FLOW [J 9. BIENNIAL INTEGRITY TEST (0, I GPH) SECONDARlL Y CONTAINED PIPING PRESSURJZED PIPING (Check ,II .hlt appl)'): 10. CONTTNUOUS TURBINE SliMP SENSOR ~ AUDIBLE AND VISUAL ALARMS AND (Cñcet OI'e) 1i1J'Í, AUTO PUMP SHUT OFF WHEN A LEAK OCCURS 55'b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AI'D SYSTEM DISCONNECTION Dc. NO AuTo PUMP SHUT OFF a II. AlTTOMA TIC LINE LEAK DETECTOR (3.0 GPH TESn mI!:! FLOW SHUT OFF OR RESTRICTION [J 12, ANNUAL INTEGRITY TEST (0.1 GPH) S1JCTION/ORA VITY SYSTEM ~3. CONTINUOUS SUMP SENSOR" AUDIBLE AND VISI;AL ALARMS EMERGE.~CY GENERA TORS ONLY (Check ,lIllIat .pply) (J 14. CONTINUOUS SL'MP SENSOR WITHOUT AUTO PUMP SHUT OFF' AUDIBLE AND VISU"L ALARMS a 15. AUTOMATIC lll'E LEAK DETECTOR (),O GPH TEST) ~ FLOW SHUT Off OR RESTRICTION 016, ANNUAL INTEGRiTY TEST (0,1 GPH) (J 17, DAILY VISU AL CHECK ABO\'EGROl'?\D P¡P::---IJ 01 PIli'SSLRE O~. SlCTI0~ 0 !. GRA\'11ì' o I. SISGLE WALL 0 ~S. lSKSOWS o Z. DOlBLE WALL 0 ,)9 OTHER ~IANLFACn;RER Pae of J~i 41>: 46) o 6, FRP COIvIPA TlHL£ ...."00·. METH-I-NOI. o 7. GAL V A:>ilZED STEEL o 9. FLEX1BLE If/DPE) 099, OTHER o 9, CATHODIC PROTECTION 095, lJ'IK."OWN oI6~ 0166 m Sh3Jf be submilttd to the loal enc...) ABOVEGROUND PIPING SINGLE WALL PIPING PRESSURJZED PIPING (Cheek all thaI apply): o L ELECTRONIC LIJ'.'E LEAK DETECTOR 3.0 GPH TEST.MI!:f AUTO PUMP SHUT OFF FOR LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION + ACDlBLE A:-iD VISUAL ALARMS, o 2, MO]l,THL Y 0,2 GPH TEST o ), Al':-IUAL INTEGRITY TEST (0, I GPH) o 4, DAilY VISUAL CHECK ~7 CONVENTIONAL SUCTION SYSTEMS (Check .11 that apply) o S, DAILY VISUAL MONITORING OF PIPING ASD PUMPING SYSTEM o 6, TRJESNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO V ALVES IN BELOW GROUND'PIPING): o 7, SELF MONHORlNG GRA VITY FLOW (Cheek ,II .hat apply): o 8. DAILY VISUAL MONITORING o 9. BJESNIAL INTEGRITY TEST (0, I GPH) SECONDARILY COJ'iT AINED PIPING PRESSURJZED PIPING (Check.II that apply): 10. CONTINUOUS TURBINE SUMP SENSOR~ AUDIBLE "'''D VISUAL ALARMS AND (Cheek 011<) o a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS o b AUTO PVMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION Dc NO AUTO PUMP SHUTOFF OIL AUTOMATIC LEAK DETECTOR 012. ASNUAL INTEGRJTY TEST(O,( GPH) SUCTION-GRAVITY SYSTEM o 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS EMERGENCY GENERA TORS ONL Y (Chtek.1I thO! apply) 014. CONTINUOUS Sl:MP SENSOR WITHOUT AUTO PUMP SHUT OFF . AUDIBLE AND V\SlJAL ALARMS o IS, AL'TOMATlC LINE LEAK DETECTOR (3,0 GPH TESn o 16, A!'.~AL INTEGRITY TEST (0 1 GPH) 017. PAlloY VJSUALCHECK , . _ h _~ DISPENSER CONT AINME:-.:T DATE.lNSTALLED 4óI ." - t:fa)-</ VIII. DISPENSER CONTAtNME:"T D , FLOAT MECHA:"ISM THA T SHUTS OFF SHEAR VALVE 01. CONTI:\L'OU5 DISPE:"ISER PAN SE:-iSOR . AlOIBLE AND VISUAL AlAR.\IS r13. COi'oTlNl.'OUS DISPE:>ISER PAN SENSOR.\UTI:! AUTO SHL'T OFF FOR DISPE:-SER . AL:DIBLE A:-;D VISl:AL ALARMS IX. O\V:\ERJOPER.-\TOR SIG~ATl:RE 04. DAIL Y VISL:AL CHECK 05, TRE:-;CH LlNER i MO:-iITORJNG 06. NOt>E ~Q I c:Cftit) t,har the infotTN.tion prC'\.ded hc:reln I' true 3tld ;t.Ct':.,¡ratc to :h: th:~t of m~' kno" Icd;c UPCF (12/99 revised) DATE ~:o 471 ~7:: Ptmtlf hplr.tIlOI'l Dille I FIJr 10e¡I use on!y} 4;5 12 FonncrIy SWRCB Fonn B e e UST - Tank Page 2 Former1y SWRCB Form B (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages, These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C. the Business Section of the Unified Program Data Dictionary,) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and jf any pages are separated. 458. PIPING SYSTEM TYPE (UNDERGROUND) - For items 458 and 459. check the tan)¿S piping system 459. PIPING SYSTEM TYPE (ABOVEGROUND) information. CHECK ALL THAT APPLY. 460, PIPING CONSTRUCTION (UNDERGROUND) . Check the tankCS piping construction information. CHECK ALL THA T APPLY. ' 461. PIPING MANUFACTURER (UNDERGROUND)· Enter the name of the piping manufacturer. 462. PIPING CONSTRUCTION (ABOVEGROUND) - Check the tank!]; piping construction information. CHECK ALL THAT APPLY, 463. PIPING MANUFACTURER (ABOVEGROUND) . Enter the name of the piping manufacturer. 464. PIPING MATERIAL AND CORROSION PROTECTION (UNDERGROUND)· For items 464 and 465, check the 465. PIPING MATERIAL AND CORROSION PROTECTION (ABOVEGROUND) tanka piping material and corrosion protection. 466. PIPING LEAK DETECTION (UNDERGRo.UND) - For items 466 and 467, check the leak detection system(s) used,·· 467. PIPING LEAK DETECTION (ABOVEGROUND) to comply with the monitoring requirements for the piping, . 468. DATE DISPENSER CONTAINMENT INSTALLED· If applicable, enter the date that dispenser containment was installed. 469. DISPENSER CONTAINMENT TYPE - Check the type of dispenser containment monitoring system. SIGNATURE OF OWNER/OPERATOR· The owner or agent of the owner shall sign in the space provided. This signature certifies that the signer believes that all the information submitted is true and accurate, 470. DATE CERTIFIED· Enter the date the page was signed. 471, OWNER! OPERATOR NAME· Print the name of signatory, 472. OWNER! OPERATOR TITLE· Enter the title of the person signing the page. 473. PERMIT NUMBER - Leave this brank, this number is assigned by the CUPA 474, PERMIT APPROVED BY· leave this blank, this is the name of the person approving the permit. 475. PERMIT EXPIRATION DATE - Leave this blank, this is completed by the CUPA. UPCF (12/99 revised) 13 Formerly SWRCB Form B .} '"" .', ~ IFIED PROGR.-\.\I CO:\SOllD:\ TED FO T:\,\1\5 L~DERGROL~DSTOR~GETA\KS-TANKPAGEl i n'PE OF ACT!C:-; I (CMck on" item o.I~·1 C ! \E''\ S:íE PER\!!T C->"\E\CD ~::~\\íT 0 5 CK->.:;CE OF :"F'~R:,'.\ T:U'" II'..." p~ges p.:r tank' 'o~,_.r _ o 6 TE'I?O.~RY Sl,E CéOS~~E o -: PE~.\I \\E:\7~ ~ CL05,~) 8' Sr:-E C j RE\E'.\'I'- PEiÜllT !s..·¡;~:(~- ~;:.H.·· - .,.. ',:..:.).1 .~ ¡,,In:y' (Src:-r·~ fCU"" - for '~''':;¡¡ Ji::: Jnl'~1 0 S T.-\:"i\ ~E.\'OVED F.-'.C¡UTY ID TANK ID /I 360 ~.;¿ DATE INSTALLED (YEAR.:-'IO) ,5- JJ: ~J\ tfWYc.", c.amplctc OM P'¥C ~ot c.~h c:ompil'1m:n\. .)6 NUMBER OF COMPARTMENTS .~,. ; .,. .."'- II. T A~K CONTE~TS TANK USE ~MOTOR VEHICLE FUEL pr-'"d complete Petroleum Type) C 2. NON·FUEL PETROLEUM C 3. CHEMICAL PRODUCT C 4, HAZARDOUS WASTE (1..1u4c, U..d Oil) CJ 95.lJN1{NOWN 439 PETROLEL:M TYPE o la, REGULAR UNLEAOED ¡g'Íb, PREMI1:M UNLEADED Ole. MJDGR.-IDE L'NlEADED o S. JET FUEL 06. AVIATION FUEL 099. OTHER +I¡ CASI/ ((rom H.."dou. Malerial,lnvcnlory p.,. ) o 2. LEADED 0), DIESEL o 4. GASOHOL COMMON NAME ((rom H&UrdoUl MaI..i.l. tnvcntorypa.c) Boo0-CQ I-q Ge~@JJv~ !II. T A~K CONSTRUCTION J. SINGLE WALL WITH 5. SINGLE WALL WITH INTERNAL BLADDER. SYSTEM EXTERJOR'MEMBRANE Llt'ER Ð 95: liNK:-IOw;.¡ 04, SIGSLE WALL IN VAULT 099, OTHER J: fIBERGLASS I PLASTIC S. CONCRETE 95, lJ1"KSOWN 04. STEEL CLAD WIFIBERGlA.SS 08, FRP COMPTIBlE WIlOOo/, METHANOL 099, OTHER 8,E1:'íFORCED PLASTIC (FRPJ L BARE STEEL J. FIBERGLASS f PLASTIC o 2. STAISLESS STEEL 0 4, STEEL CLAD WFIBERGLASS REISFORCED PLASTIC (FRP) o 5, COSCRETE J, EPOXY W<lING TYPE Of TANK (o.:Jt.... i..... only) L SINGLE WALL 443 , i (0.:1<.... 111m only) , , œz. DOUBLE WALL I. BARE STEEL 02. ST AII'LESS STEEL 0144 TANK MATERIAL -primary ..nk TANK MATERIAL - ICcoodaty lank (Oeck _ t1cm onlyl S. CONCRETE 95, liNKSOWN 08. FRP COMPTlBlE W:IOO% METHAl'iOL 0 Y9,OTHr::R o I Q. COATED STEEL 44.\ TANK INTERJOR WIING 01 CO... TlNO (Oock - ÍIIm only) I. RL'BBER LINED 5, GLASS LINISG trr6L'NLINED o 99 OTHER 9S. U:<II(.'<IOWN oU7 oU6 DATE INSTALLED 02 ALKYD Lr.<IlNG 04 PHENOLIC UNING If.. locII...""I,} OTHEI COIlllOSION 0 I MANUF ACTlJRED CA THODIC PttOTECTlON IF APPLIC....BLE PROTECTION (aèt _ iI&m only) 0 ! SACRIFICIAL ANODE SPILL AND OVERFILL YE,'-R INSTALLED (O..,hllw..""ly œfiSPILlCONTAISMEST 0-<; Ø2DROP Tl:BE 0 ..y !f1TšTRIKER PLATE tJ r o 95 l;NKNOWN 099 OTHER ... oU9 DATE INSTALLED OJ FIBERGLASS REINFORCED PLASTIC o 4 IMPRESSED CURRE:<IT If or ,....1_ onlYI 4SI OVERFILL PROTECTION EQUJPMENT:YEAR INST ALl.ED '51 Ø"[ALARM ø'7' 0 J FILL TUBE SHUT Off VAL VE ftlBALLFLOAT M OHXEMPT IF SINGLE WALL TANK ¡C!oc<k.lllh.. .p¡>ly) IF DOl:BLE WALL TAr;K OR TA:'IK WITH BLADDER ~.I ¡QC'ckonC' Irem only) 01 vtSUAL (EXPOSED PORTION ONLY) 0 S MA:--:lJAl H:-JK GAt.:GISG(MTG} 0 I VISL;AL(SINGlE WALL IN VAL'LTOl'OL Y) 02 AIfTOMA TIC n:-';K GAt.:G¡~G (A TG) 06 VADOSE ZO:-.;E 0 ~ CONTI:-';lJOUS INTERSTITIAL MONITORI:'\G 0) CONTTNL'OLiS HG 07 GRO¡;SDW-\TER OJ MA:\'UAL MO:\,¡TORJ;\,G o 4 STATISTICAL I~VE:-;TORY RECO:-;ClLLI TIO:'<l 0 ~ T-\'\''' T£5TI"G (Sill) BIENNIAL T,AN"- TESTI!\G 0 \}9 OTHER IV, r.\:\K ClOSUŒ l~fOR-'L·\ TIO~ f PER\IA\E:-;r ClOSLRE 1\ PLACE ESTIMATED DA TE lAST UEOI YR:'wIO 0-\ \ J '¡j; .15;, TA;\f( FILLED \IITH ¡"ERT "I-\TERL-\L" o y~s 0 \0 J,:-' E5TI~I.-\ TED QL.-\:\TITY üF Sr;SST A;\CE RE~L~\I"G g~lt\Jns UPCF (12/99 revised) 10 Formerly S\VRCB Fonn B ~30 J) .¡J.a 4)1 o. 440 442 .:..,1:, . ~ i_. -I..c.- ....,. e e UST· Tank Page 1 Formerly SWRCB Form a Complete the UST - Tani< pages for each tank for ali new permits, permit changes, closures and/or any other tank information charge, ThIS page must be submJttec...,thn 30 days of per:'1it or ~ac:lity irfor~a:,:::n c~ançes, urless apcr:Jval is re:;Ulrec~ before r.1ak¡~g an, charges. For compartmentalized tanks, each compartment is considered a 5eoara:e tar.k and requires cCr'1pleUcn of separate :ar·k pages, Refer to 23 CCR =2711 fer slate UST information and permit application requjrements, (Note: the numberirg of the instructions follows Ihe data element numbers that are on the UPCF pages, These data element numt:ers are used for electronic submission and are the same as the numbering used in 27 CCR. Appendix C, the Business Section of the Unified Program Data Dictionary,) , Pleaae number all pages of your submittal. This helps your CUPA or local agency identify whether !he submittal is complete and if al'1y pages .re uparated, 1. FACILITY ID NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number which identifies your facility. 3, ' BUSINESS NAME· Enter the full/egal name of the business. 430. lYPE OF ACTION· Check the reason lhe page is being completed. For amended permits and change of information, ¡I'1clude a short statement to direct the inspeclor 10 the amendment or changed information, ( 431, lOCATION WITHIN SITE· Enter the location of !he tank within the site. ~:: 432, TANK ID NUMBER· Enter the ownerí1 tank ID number, This is a unique number used to identify the tank. It may be assigned by Ihe \ . . . owner or by the CUPA. 433. TANK MANUFACTURER - Enler the name of the company Ihat manufactured Ihe tank. ;. 434. COMPARTMENTALIZED TANK - Check whether or not the tank is compartmentalized. Each compartment is considered a separate lank (. , and requires the completion of separate tank pages. : ·435, DATE TANK INSTALLED - Enter Ihe year and month the tank was installed. j.,,431, TANK CAPACITY - Enter the tank capacity in gallons, lX437, NUMBER OF TANK COMPARTMENTS -If the tank is compartmentalized. enter the number of compartments. :¡ 438, ADDITIONAL DESCRIPTION - Use this space for additional tank or location description. 439, TANK USE - Check the substance stored. If MOTOR VEHICLE FUEL, check box 1 and complete item 440, PETROLEUM TYPE. , .. 440. PETROLEUM TYPE· If box 1 is ohecked in item 439. check the type of fuel. 4-41, COMMON NAME - For substances that are not motor vehicle fuels (box 1 is NOT checked in item 439), enter !he common name of !he substance stored in the tank. 442. CAS # . For substances that are not motor vehicle fuels (box 1 is NOT checked in item 439), enter the CAS (Chemical Abstract Service) number, This is !he same as·the CAS # in item 209 on the lriazardous Materials Inventory· Chemical Descriptionpage. 4-43, lYPE OF TANK - Check the type of lank construction. If type of tank is not listed, check [bther!] and enter type. 4«. TANK MATERIAL (PRIMARY TANK) - Check the construction material oUhe tank that comes into immediate contacl on its inner surface with the hazardous substance being conlained. If the tank is lined do not reference the lining material in this item. Indicate . the type of lining material in item 446, If type of tank material is not listed, check IJJtheriJ and enter material. 445, TANK MATERIAL (SECONDARY TANK) . Check the construction material of the tank that provides the level of containment external to. and separate from, the primary containment. If type of tank material is not listed, check IJJtherÐ and enter material. 446. TANK INTERIOR LINING OR COATING· If applicable, check the construction material of the ¡nlerior Jining or coaling of the lank. If type of interior lining or coating is not listed, check [bther] and enter type. 447. DATE TANK INTERIOR LINING INSTALLED -If applicable, enter the date the lank interior lining was installed. This is to assist the CUPA . to develop an inspection schedule. 446. OTHER TANK CORROSION PROTECTION - If applicable, check the other tank corrosion protection method used. Jf other corrosion protection method is not listed, check CbtherlJand enter method. 449. DATE TANK CORROSION PROTECTION fNST ALLED - If applicable, enter the date the tank corrosion protection method was installed. This is 10 assist the CUPA to develop an inspection schedule. 450, YEAR SPILL AND OVERFILL INSTALLED· Check the appropriale box and enter the year in which spill containment, drop tube, andlor striker plate was installed, CHECK ALL THAT APPLY. 451. TYPE OF SPILL PROTECTION - Enter lhe type of spill containment, drop tube, and/or striker plate. FOR CUPA USE ONLY. 452. YEAR OVERFILL PROTECTION EQUIPMENT INSTALLED· Check the appropriate box and enter the year in which overfill protection was installed or whether there is an exemption from overfill protection, CHECK ALL THAT APPLY, unless tank is exempt. 453. TANK LEAK DETECTION (SINGLE WALL)· For single walled tanks, check the leak detection system(s) used to comply with the monitoring requirements for the tank, CHECK ALL THAT APPLY, If leak detection system is not listed, check o,lherC and enter system. 454. TANK LEAK DETECTION (DOUBLE WALL) - For double walled tanks or tanks with bladder, check the leak detection system(s) used 10 comply with the monitoring requirements for the tank. CHECK ONE ITEM ONLY. 455, ESTIMATED DATE LAST USED - For closure in place. enter the date the tank was last used. 456. ESTIMATED QUANTITY OF SUBSTANCE REMAINING IN TANK· For closure in place. enler the estimated Quantity of hazardous substance remaining in the tank (in gallons). 457. TANK FILLED WITH INERT MATERIAL - For closure in place, check whether or not the tank was filled with an inert material prior to closure. ATTACHMENTS - 1, Provide a scaled plot plan with the location of the UST system, including buildings and landmarks. 2. Provide a description of the monitoring program, UPCF (\2/99 revised) II Formerfy SWRCB Form 8 .. .,.... '. -, ';:",":-:":. Cfl; r.·;j~t~,··.·· ··'··"'c,JG,,· . ..\' ~·~':.'~::!t<~: ." .' ":; ....:.-~- .': .. f;fi, . .~.~::-:.-(. ;:c:'i::,':: ;. ':':'~:' '.~ ;Ô" "". . ....- i.'k ~ . , ;-¡ e L~lFlED PROGR-\:\( CO~SOLlDATED FOR" TA'KS L~DERGROC~D STOR-\GE TA,"KS - TA:\K PAGE 2 \'1. PIP\:\C CO'"STR l·CìIO'; .:::",<>I! ''''''C .. L'.; C::RGROL~D ?!PI~G i ¡ SYS~M TYPE PRESSCRS 0 2, SL'C;~O\ 0: GR.". '.:TY 4!\ I 0 i ?R£5S~R:: COi'OSTJU:CT10S 0 I. S¡,GLE II. ~L:' 0 J. Ll'Eù fRE\CH 099. OTHER .6() 0 I. SI:\GLE WALL w.¡.;-:fAcn;UR tr2 DOCBL:: WALL 0 ~S, L,"K\O\\":'; 02, DOl'B:'E W...lL M....-n;F....CTt;RER 3 461 ~t...:-;LFACn;;tER C :. BARE STEEL 06, FRP CaMPA T!BLE w,IW.~ METH.-<:-;OL 0 I. BARE STEEL 01, ST AINLESS STEEL 0 '. GAL VA:-¡IZED STEEL 0 l'nknown b 1, ST Af.';LESS STEEL OJ. PLASTIC Cmtp...TlULE IV CO'TE:"rS O~· Other 0 J. PUSTIC C01-IP,HISLE WCO'TE~TS 12Í4, FIBERGLASS 0 ~. FLE..X1BLE (HDPE) 04, FIBERGLASS OS. STE£L WICOATING 09, CAnmDIC PROTECTION 46-1 05. STEEL W,COATr.-.:G VII, PlPlNG LEAK DETECTION IChtck ,II that L"NDERGROU'ND PIPING SISGLE WALL PIPL~G PRESSURlZED PIPI~G ¡Check all 'hat ""ply): la, CONTINUOUS llJRB1NE SUMP SESSOR ~ AUDIBLE A."ID VISUAL ALARMS AND (Check 011<) o a AUTO P¡;MP SHUT OFF WHES A LEAK OCCURS O!> AUTO PL'MP SHUT OFF FOR lEAKS, SYSTEM fAILURE AND SYSTEM DJ SCONNECTlON Dc NO AUTO Pt:MP SHLrT OFf 011. AUTOMAnCLEAKDETECTOR o 12, ASNVAL INTEGRITY TEST (OJ GPH) SVCT!ON¡GRA VITY SYSTEM o 13. COSTINUOUS SUMP SENSOR + AUDIBLE ASO VISUAL ALARMS t:'>I£RGE:'o1CY CENtRA TORS ONLY ¡Check .n,h.. .pply) o 14, CONTINUOUS SeMI' SENSOR ~ AUTO PUMP SHUT OFF· AL'OIBLE AND VlSt:AL ALARMS o IS, Al:TOMATIC liNE LEAK DETECTOR (J.O GPH TEST) o 16,AJ'.'\'tJAL f:'iTEGRITYTEST(O,1 GPH) o 17, DAlL Y VISUAL CHECK VIII, DISPE:'iSER CONTAIN\1E:'iT o L FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE 01. COI'TJ:--;¡;OUS DJSPE,'liSER PA:>: SENSOR· AUDIBLE AND VISL:AL ALAR.\IS ffj, CO'Tr~L'OL'S DISPE:-ISER PAN Se'¡SOR ~ AUTO SHLT OFF fOR D1SPE:-iSER . A(1)BLE A:--;DVIS\.:AL ALARlIolS IX. O\\lNERJOPER.-HOR SIG~"\Tt:RE PRESSURIZED PIPING (Check all .h.. apply): o I. ELECTRONIC LINE lEAK DETECTOR 3,0 GPIf TEST)flTII ,'UTO PUMP SHUT OFF FOR UAJ{, SYSTEM F AlLURE, AND SYSTEM DlSCOM-'ECTION + AUDIBLE AND VlSUAL ALARMS. C 2. MONTHLY 0,2 GPH TEST C 3, ANNUAL Ifo,TEGRlTY TEST (0, 1 GPH) CONVENTIONAl. SUCTION SYSTEMS C ,. DAILY VISUAL MONITORING OF 'PUMPING SYSTEM + TRlENN1AL PIPING INTEGRITY TEST (0.1 GPH) SAfE SUCTION SYSTEMS (NO VALUES IN BELOW GROUND PIPING): CJ 7. SELF MONITORING GRAYfTYFLOW 09. BIENNIAL INTEGRITY :rEST (0.1 GPH) " i SECONDARlL Y CONTAINED PIPING PIlESSURJZED PIPING (Chcckalllh.. apply): 10, CONTINUOUS TURBINE Sl:MP SENSOR:Ð.II:i AUDIBLE AND VISUAl. AlARMS AND (Check one) 1Ið':'. AUTO PUMP SHUT OfF WHEN A LEAK OCCURS srb. AL1TO PUMP SHUT OFf FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION Ce. NO AuTo PUMP SHUT OFF I:] II, AL1TOMATlC LINE LEAK DETECTOR (3.0 GPH TESn lliIH FLOW SHUT OFF OR RESTRICTION I:] 1%. ANNuALINTEGRlTY TEST (0.1 GPH) SUCTION/OIlA VITY SYST1õM 1fÍ], CONTINUOUS Sl.1'oIP SESSOR + AUDIBLE AND VISUAL ALARMS EM£RGE."ICY CESER.A TORS ONLY (Check ,11 'hal.pply) I:] t.. CONTINUOUS SL1'oIP SE.'SOR WITHOUT AUTO PUMP SHUT OFF· AUDIBLE AND VlSL:AL Al.ARMS o U. AUTOMATIC LINE l.EAK DETECTOR (3.0 GPH TEST) WITHOLT flOW SHUT OFF OR RESTRICnON 016. ANNUAl. INTEGRITY TEST (0,1 GPIf) o 17. DAILY VISUAL CHECK DISPENSER CONT AI:>IME;o.¡T DATE INSTALLED 4óI Q£.-æaw I ,cnify tJ\althc infD~Iø" prt!\ uSed hC~ln IS :n.u: J,nd ..c~.r~:c:o the beSf ~r m~ k.1'O\4Ic:d;;e NAME UPCF (12/99 revised) I':I~. _ of _ ABOVEGR8L:-:D ?I?¡~G SLCTiO." 0: CRA\'In o .; L:"K,'liOW~ [J ~o OTHER u: 06. fRP CO"'IPA TlIJLE 11':100·, \1£TH.ASOL o 7, GAL V,A:-;¡ZED STEEL 03. fLEX:SLE ¡HDPE) 09Q, OTHER o 9. CA THODIC PROTECTION o 9$, li:-lK.'\'OWN Ih:JJI be submitlcd :0 1M loal c:nc ) t66 ABOVEGROUND PIPING SINGLE WALL PIPrNG PRESSURlZED PIPING (C1Icck all lb. apply): o I. . ELECTRONIC LINE LEAK DETECTOR ),0 GPH TEST mH AUTO PL'MP SHUT OFF FOR LEAK, SYSTEM FAIWRE, A."ID SYSTEM DISCONNECTION + AUDIBLE A~D VISUAL ALARMS. o 2. MOr.THL Y 0,2 GPH n;:ST 0), A:'-o'NUAL INTEGRITY TEST (OJGPH) o 4, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (Check.n Ih.. apply) o S, DAlLY VIS¡;AL MONITORING Of PIPING A:'ID PUMPING SYSTEM o 6, TRJENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTlON'SYSTEMS (NO VALVES IN BELOW GROUND:PIPING): o 7, SELF MONITORING GRA VlTY FLOW (Chcck.lllh.. a¡>ply: o 8, DAILY VISUAL MONITORING 09. BIENNIAL INTEGRlTY TEST (a,) GPH) S£CONDARI L Y CONTAINED PIPING o .¡, DAIL Y V1SL',Al. CHECK OS. TRESCH U:'IiER, MONITORI'G 06.:\0I\E 469 DATE ,~o '¡':'I ," Pennu EI!;:)ln:lon D.:uc ¡ F¡)( Iou! U'~ only, '"5 12 Formerly SWRCB Fonn B J;. -Ið: 46J .~ .., :;1-, ... e e UST - Tank Page 2 Formerly SWRC8 Form 8 (Note: the numbering of the instructions follows the data element numbers that are on the UPCFpages, These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C. the Business Section of the Unified Program Data Dictionary,) Please- number all pages of your submittal. This helps your CUP A or lecal agency identify whether the submittal is complete and if any pages are separated, 458. PIPING SYSTEM TYPE (UNDERGROUND) - For items 458 and 459. check the tank=S piping system 459. PIPING SYSTEM TYPE (ABOVEGROUND) information. CHECK All THAT APPLY. 460. PIPING CONSTRUCTION (UNDERGROUND) - Check the tank]; piping construction information, CHECK ALL THAT APPLY. ;,.,~1.PIPING MANUFACTURER (UNDERGROUND) - Enter the name of the piping manufacturer. ~~S::' . J!:t482.· PIPING CONSTRUCTION (ABOVEGROUND) - Check the tank[$ piping construction information. CHECK ALL ~'~ . THAT APPLY. ~ :~:'" ~:'i~ '463, PIPING MANUFACTURER (ABOVEGROUND) - Enter the name of the piping manufacturer. ~:.~~- l",464. PIPING MATERIAL AND CORROSION PROTECTION (UNDERGROUND). For items 464 and 465, check the f¡:,: 465. PIPING MATERIAL AND CORROSION PROTECTION (ABOVEGROUND) tank[S piping material and corrosion ~t'.: protection. , . 466. PIPING LEAK DETECTION (UNDERGROUND) - For items 466 and 467, check the leak .detection system(s). us~d 467. PIPING LEAK DETECTION (ABOVEGROUND) to comply with the monitoring requirements for the piping, 468, DATE DISPENSER CONTAINMENT INSTALLED -If applicable, enter the date that dispenser containment was installed. 469, DISPENSER CONTAINMENT TYPE - Check the type of dispenser containment monitoring system. SIGNATURE OF OWNER/OPERATOR - The owner or agent of the owner shall sign in the space provided, This signature certifies that the signer believes that all the information submitted is true and accurate. 470. DATE CERTIFIED - Enter the date the page was signed. 471, OWNERI OPERATOR NAME - Print'the name of signatory. 472. OWNERI OPERATOR TITLE - Enter the title of the person signing the page. 473, PERMIT NUMBER - Leave this blank, this number is assigned by the CUPA. 474. PERMIT APPROVED BY - Leave this blank, this is the name of the person approving the permit. 475. PERMIT EXPIRATION DATE - Leave this blank, this is completed by the CUPA. UPCF (12/99 revised) 13 Formerly SWRCB Form 8 6:. 40 ~ ! .-.': . .. '·;~'.·.j~'~~~frI '.. ~'. -',."'.' ..-. :..... . .,(·J,'¥í . . \ ~'t:+~~~~Y .:'.'" .. .- ,.- ~~~" ~'t:;~i~~'" ". :·'..·f,·~·~~(ri~·· :- :·:~~:t?~~· "!: i:~:~,~/~~.' I . . " . '., 7-~ ~ ,~ ""'- ~.."~~ >¡,' :;.: .~~<:, '-. ~....'* 'f, ~ <¡ " ,'IFIED PROGR_-\:\l CO:\SOUD,-\ TED FO T-\\KS L'DERGROL'DSTORAGETA'KS-TA~KPAGEl \I'-\"è ?J¡;~S p.:r tank; ! TYPE OF ,.,G¡G'>; [J , 'Ew S:í: F'E~:-'\1T ~\1E'''E'' '-"\111' 0 "'¡\·"C-oç·,-rp,'I\-"'· iIJ 4 .J.... . l.l ...J: ~_."<.., , \.. ....... r. ", r. .... ,.U... /o~, - .;__/. o 6 '':\:?OR.\RY SITE C::'OSè RE o '7 ?:::.~\! \.\E:\7"LY CLOS~D()\ Si7"E (C~d. '"c ~LCTTI 0"1:--1 C ) R:SE'.I'-\'- PF.iÜ!!T ¡S:-~'': '.' 'CJ;\'''' - '.~:' ·,......If .K :.Jf1¡~ I (Src=rf~ r';ljon - for IOCJi '.Ise :'nl~t 0 8 rA~"K RE~IO\'ED Jf-Yn", compjctC' OM pIIjC (Of c~,h .:ompanmcnl Hó I\I.'MBER OF COMPARTMENTS .~I s¡> "'''~J 431 431 4«1 II, T A:-IK CO;'iTE~TS TANK USE4J9 II!f'Î."" MOTOR VEHICLE FUEL (Ileutcd compl..e Pe..okurø Type) C 2. NON·FUEL PETROLEUM C J. CHEMICAL PRODUCT C 4, HAZARDOUS WASTE (IDelude. U..d Oil) a 95.l1NKNOWN PETROLEl1M TYPE o la, REGULAR L~LEADED o Ib, PREMIUM UNLEADED o Ic, MIDGRADE liNLEADED o 2, LEADED IB'3. DIESEL o 4, GASOHOL o 5, JET FUEL o 6. A VIA TION FUEL o 99, OTHER 0141 CAS#(frvm H..a,do", M"<rial.ln"nlory paae) 442 COMMON NAME ((,omHarardous Ma..rill.'nvcnloryp"C'1 ~ /eS,e/ #2.. TYPE OF TANK J. SINGLE WALL III. T ANK CO~STRUCïIO~ J. SINGLE WALL WITH S. S~GLE WALL WITH INTERNAL BLADDER SYSTEM EXTERIOR MEMBRA:'iE ll!\'ER Ð 95: L'NKSOW':'i 04, SIGNLE WALL IN VAULT 099, OTHER 3. FIBERGLASS I PLASTIC 5, CONCRETE 95, li1\KSOWN 04, STEEL CLAD W/FIBERGLASS 08. fRP COMPTlBLE WiIOO% METHASOL 099, OTHER REINFORCED PLASTIC (FRP) ), FIBERGLASS I PLASTIC o 4. STEEL CLAD WFIBERGLASS REINFORCED PLASTIC(FRP) o S. CO;>.;CRETE 3. EPOXY LINING -1-1, ..., (Chock .." ¡,em only) Œf2. DOUBLE WALL I. BARE STEEL o t STAINLESS STEEL 0loi4 TANK MATERIAL -prirølt)'..nk (CIocck oae ilcm only) T ANK MATERIAL - ..condit)' rank (Occk ....Iu:m only) J. BARE STEEL 02, STAI:-ILESS STEEL s. CO!\CRETE <¡S. liNKNOWN o 8. FRP COMPTIBLE W, 100"10 METHANOL 0 99, OTHE II. o lO,COATEDSTEEL TANK INTERIOR LINING OR COA TiNe:; (o-k _ ium onlyl S, GLAS.UI!'-11NG II16úNLINED o 99 OTHER J. RL:BBER LINED 02 ALKYD L~I:-;G .9S.-USK:-IOWN ~-f)ATE·INST..u:r 04 PHENOLIC LJ!\JNG <·¡For '-'alose oolYI OTHElt COIUOSION 0 I MA."IUFACTIJREO CATHODIC PROTECTION IF APPLICABLE PROTECTION (Oeck _ ium only) 02 SACRJFICIAl ANODE SPILL AND OVERFILL YEAR INSTALLED (CIa<cIc 1I......lfII'ly) œrí'SPILl CONT AINMEST O~ £'f2DROP TI.:BE O,.y œf3šTRIKER PLATE t) o J FIBERGLASS REINFORCED PLASTIC o 4 IMPRESSED CURRE:-IT 095 UNKNOWN 099 011(ER -148 .wJ DATE INSTALLED '(For I..al... only) 4S1 OVERFILL PROTECTION EQL:/P,\IENT:YEAR I:-.ISTALlED 412 Ø'CALAR.\1 ø-r 03 FILL TUBE SHL:TOFf VALVE ß2 BALL FLOAT M 04 EXEMPT IF SINGLE WALL TANK rClKckJlllh"opølyl IF DOUBLE WALL TAI"K OR TA;';K WITH BLADDER 4.1 \Chcdc 3nC item only. CJ I V1SlJAL (EXPOSED PORTION ONL Y, Os MA:\UAl TANK GAL:GI:-;G (MTG 0 I V¡SCAlISINGlE W.~lL IN VAL'L T OSL YI 02 AUTOMATIC n:-;K GALGI:-.IG tA TGI 06 VADOSE ZO~E 0 ! CO)TI:\L:OUS I:-.ITERSTlTlAl ~IOSITORISG 03 CONT!N\iOliS ATG 07 GROLNOWATER O} MA:-;t:AL MO:-;ITORJ~G 04 STATISTICAL INVE:'ooTORY RECOSCIUHION 0 ~ H'i¡; TESTISG (SIR) BIENNIAL TA:-':K TEST!I\G Oq90TIIER IV, To'" K CLOSl1ŒJ;\iFOR,'L-\ TlO.' / PER,\/A'E.'n CLOSLRE (' PLACE "STlMATED DA TE LAST UEDr YR.I.10 DA 'r ~}S T .\~K 'ILLED \1 lTH ISER i\l.\ TER:..\L" o y~s 0 \0 ..l~ ';' J~h ESTlILA TED QL ",-TlTY OF SLBST A~CE RE\!.\lSISG gJ 110M JPCF (12/99 revised) 10 Formerly S\V'RCB Form B 4)0 <. , ',~ " , '. .< ~.... <. .' .' >4" ~. e 'e UST - Tank Page 1 .:rly SWRCB Fcrr:1 a ,nplete the UST - Tar:~ pa¡¡es fer each tark icr all new perr;its, permit :ha,1ges, closures and/or any other tark information ei"arçe, This age must be subrì'ltte~ Nlthir: 30 cays cf per~¡t o,r fa::!:r]' irf:;~~a;lcn ct"a."çes, urless acpr"valls requ'rec before rr:a~;ng ary charges. For compartmentalized tarks, each compartment is ccnsidered a separate lark arc requires cOr1pleticr. of se¡Jarate tark ¡;açes, Refer to 23 CCR :::27î 1 for state USï information and permit application requirements, (Note: the numbering of tre instructions follows the data elemer:t numbers that are on the UPCF pages, These data element numbers are used tor electronic submission and are the same as lhe numbering used in 27 CCR, A~pendix C, the Business Section of the Unified Program Data DicUonary,) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separate<!. 1, FACILITY ID NUMBER· Leave this blank, This number is assigned by the CUPA This is the unique number which identifies your facility. 3. BUSINESS NAME· Enter the full/egal name of the business, 430. TYPE OF ACTION· Check the reason the page is being completed, For amended permits and change of information, include a short statement to direct the inspeclor 10 the amendment or changed information. f:· 431, LOCATION WITHIN SITE· Enler the location of the tank within the site. ~'::432, TANK ID NUMBER· Enter the owner) tank ID number. This is a unique number used to identify the tank, It may be assigned by the ;. ." owner or by the CUPA. < 433, TANt< MANUFACTURER - Enter the name of the company that manufactured the tank. f, 4304. COMPARTMENTALIZED TANK - Check whether or not the tank is compartmentalized. Each compartment is considered a separale tank ~.' . and requires the completion of separate tank pages, f.'435. DATE TANK INSTALLED - Enter the year and month the tank was installed, v; 438, TANK CAPACITY - Enter the tank capacity in gallons, ,'{437. ~UMBER OF TANK COMPARTMENTS -If the tank is compartmentalized, enler the number of compartments. ~,,438. ADDITIONAL DESCRIPTION - Use this space for additional tank or location description. ',' 439. TANK USE - Check the substance stored, If MOTOR VEHICLE FUEL, check box 1 and complete ilem 440. PETROLEUM TYPE ·440. PETROLEUM TYPE - If box 1 is checked in ilem 439, check the type of fuel. ".....1. COMMON NAME - For substances that are not motor vehicle fuels (box 1 is NOT checked in item 439), enter the common name of the substance stored in the tank. .....2. CAS" - For substances that are not motor vehicle fuels (box 1 is NOT checked in item 439), enter the CAS (Chemical Abstract Service) numbe'r, This is the same as the CAS # in item 209 on the Irlazardous Materials Inventory - Chemical Description page. 443. TYPE OF TANK - Check the type of tank construction, If type of tank is not listed, check CbtherOand enter type. 444, TANK MATERIAL (PRIMARY TANK) - Check the construction material,of the tank that comes into immediate contact on its inner surface with the hazardous substance being contained. If the tank is lined do not reference the lining malerial in this item. Indicate the type of lining material in item 446. If type of tank material is not listed, check CbtherOand enter material. 445. TANK MATERIAL (SECONDARY TANK) - Check the construction material of the tank that provides Ihe /evel of containment external 10, and separate from, the primary containment. If type of tank material is not listed, check [blher: and enter malerial. 446. TANK INTERIOR LINING OR COATING - If applicable, check the construction malerial of the interior lining or coaling of the tank. If type of interior lining or coating is not listed, check [bther::! and enter type, 447. DATE TANK INTERIOR LINING INSTALLED ·If applicable, enter the dale the tank interior lining was installed, This is to assist the CUPA to develop an inspection schedule. 448, OTHER TANK CORROSION PROTECTION -If applicable, check the other tank corrosion protection method used. If other corrosion protection method is nòt listed, check CbtherO and enter method. " . 449. DATE TANK CORROSION PROTECTION INSTALLED -If applicable, enter the date the tank corrosion protection method was installed. This,is to assist the CUPA to develop an inspection schedule. 450. YEAR SPILL AND OVERFILL INSTALLED - Check the appropriate box and enter the year in which spill containmenl, drop tube, and/or striker plate was installed. CHECK ALL THAT APPLY, 451. TYPE OF SPILL PROTECTION - Enter the type of spill containment. drop tube, and/or striker plate. FOR CUPA USE ONLY. 452. YEAR OVERFILL PROTECTION EQUIPMENT INSTALLED - Check the appropriate box and enter the year in which overfill protection . was installed or whether there is an exemption from overfill protection. CHECK ALL THAT APPLY, unless tank is exempt. 453, TANK LEAK DETECTION (SINGLE WALL) . For single walled tanks, check the leak detection system(s) used to comply with the monitoring requiremenls for the lank, CHECK ALL THAT APPLY. If leak detection system is nOllisted, check :::DtherO and enler syslem. 454. TANK LEAK DETECTION (DOUBLE WALL) - For double walled tanks or tanks with bladder, check the leak detection system(s) used to comply wilh the monitoring requirements for lhe tank. CHECK ONE ITEM ONLY, 455. ESTIMATED DATE LAST USED· For closure in place, enter the date the tank was last used, 456. ESTIMATED QUANTITY OF SUBSTANCE REMAINING IN TANK - For closure in place, enter the estimaled quantity of hazardous substance remaining in the tank (in gallons). 457, TANK FILLED WITH INERT MATERIAL - For closure in place. check whether or nol the lank was filled with an inert material prior to closure, . ATTACHMENTS- 1. Provide a scaled plot plan wilh the location of the UST system, including buildings and landmarks, 2. Provide a description of lhe monitoring program. UPCF (\2/99 revised) 11 Formerly SWRCB Form B ,,~, 't"~'~;~' ,.; tt~~~ . ,...;:_:f~~~~;j;7è. ',.:,;~:f~ ;'; , ''r._'"Q''''' ,,::·t~1~~ :t~~ ',,~::::~p~; :,'1" '~". '''C.~~ i:,''f!; "- .~ " "'-'li , ;,'.......' '. V:\IFIED PROGRUI CONSOLIDATED FOR\I L\:\KS C"DERGROCND STOR'-\GE T.-\:\KS - TA:\K PAGE 2 SYSTEM n'?E I PRESSL R~ o 2 SLCT!C:'-o 0: SR" '<:TY VI. PIPt:\G CO'iSTRlCìIO\' ,:',<" ,I: "" ;:~ L'\~':;RGROl-SD :>!?!\G ! J.:' C ?R~SSLRé ABC',EC:;{OL-:\D ?¡P¡~ 'J 01, SLCTiC' 0: CíC-,,-VIW o .3 ¡;:-;K"Ow," o .9, OTHER CONST1Il:rnON 0 L S¡:--;GL£ W,,,LL MANt:F\C1VIlER trT DOL'BLE WAL,- MANtT.\Cn:RER ~6: o L BARE STEEL 06, FRP CO~!PArrBLE W'¡~', ,\lEíHA\Ol 0 L BARE STEEL 01, STAINLESS STEEl 0'. GALV..\:-.IIZED STEEL 0 \:t1kno.....n 02, STA!};LESS STEEL OJ PLASTIC CO,\JPA TIßLE \\" COSTE.'<TS 0 99. Olher 0 J. PLASTIC CO~IP,.\ TIßLE \1;, CO~TE~TS e'4, FIBERGLASS 0 ~. FLEXIBLE (HDPE) O~, FIBERGLASS 05, STEfL W/COATr:-lG 09, CATHODIC PROTECTION 46-1 05, STEEL W,COATP.'G VII. P[PING LEAK DETECTION (Chttk .,1 :h.. L'NDERGROUND P¡PfNG SI:'íGLE WALL PIPING 099, OTHER 4þ) o ; S¡'ûLE W,.\LL 02, DOl'BLE WALL MASL;FACn:RER 06, FRP CO~IPA THJLE W,IOO" \fETH..\:'IOL o 7, GAL VA:-;12ED STEEL o g, FLEX!BLE(H;:JPE) 099. OTHER o 9, CA mODIC PROTECTION 095, UC'iK."O""N E:\lERGENCY GENERATORS ONLY (0... In .hlt lpØly) o 14, CONTI1'o't.'OL'S S\:MP SENSOR WITHOLT AUTO PUMP SHUT OFF' AUDIBLE ....ND V1St:AL ALARMS o 15, A li'TOM A TIC LINE LEAK DETECTOR (3,0 GPH TEST) o 16, A!\;-.ruAL P.'TEGRlTV TEST (0 ¡ GPH) 017, DAfLY\1SUALCHECK VIII. DISPE'iSER CONTAI:"/:\1E.'<T o L FLOAT MECHA:-i¡SM THAT SHUTS OFF SHE,~R VALVE 02, CO!'óTI:-it:OlJS DISPE:O<SER PA:-Ö SE:->SOR . A\:DIBLE A:->D VISLAL ALAR:'>-IS ffi CO/l.T~¡;OL'S DISPE:-ISER P,.\:>I SE:O<SOR 1tlItl ALTO SHt:T OFF FOR DISPE:-iSER ~ AL'DIBLE A:"D VIStJAl ,"LARo"IS IX, O\V~EROPER.HOR SIG~,,\Tl'RE .Jll.ESSUlUZ£D PIPING (Check all ,h.. "",Iy): . t:J I. ELECTRONtC UNE LEAK DETECTOR 3,0 GPH TEST ~ AUTO PUMP SHLT Off FOR LEAK, SYSTEM FAILURE, AND SYSTEM DlSCONNEcrlON ;- AUDIBLE A/I/O VISUAL ALARMS. C 1. MONTHLY 0,2 GPH TEST P 3, ANNUAL INTEGRlTY TEST (O,IGPH) CONV~ONALSUcnONSYSTEMS C ,. DAILY VISUAL MONITORING OF PUMPING SYSTEM;. TRlE:''NIAl PIPING INTEGRITY TEST (0, I GPH) IAFE SUCTION SYSTEMS (NO V AWES IN BELOW GROUNDPIPING): C 7. SELF MONITORING ORA VJTY FLOW CJ 9. BIENN1AlINTEGRlTY TEST (OJ GPH) SECONDARILY CONTAINED PIPING I'RESSURJZED PIPfNG (Check .11 ,hJlI>ply): , 10. CONTINUOUS TURBINE SUMP SENSOR mH AUDIBLE AND V1Sl:Al ALAItMS AND (Check "",el ør;. AUTO PUMP SHUT Off WHEN A LEAK OCCURS I§!'b. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAIL URE AND SYSTEM .. DISCONNECTION Ce. NO AurO PUMP SHUT OfF CII. AUTOMATIC LfNE LEAK DETECTOR (3.0 OPH TEsn IDItl FLOW SHUT Off OR RESTRIcnON a Ii: ANNUAL INTEGRITY TEST (0.1 GPH) SUCTlON/CiRA VITY SYSTEM flÍ3. CONTINUOUS SL~IP SENSOR" AUDIBLE AND VISUAL ALARMS IMERCE.'l/CY CE:O¡ERATORS ONLY (Check .1I,hll >pply) o 14, CONTINUOUS SL~JP SE.>./SOR WITHOUT AUTO PUMP SHUT OFF' AUDIBLE AND V/StJAL ALARMS C 15. AUTOMATIC LI1'E LEAK DETECTOR (3.0 GPH TEST) WITHOL ï FLOW SHUT Off OR RESTRJCTION 016, ANNUAL fNTEGRlTY TEST /0,1 GPH) o 17. DAILY VISUAL CHECK DISPENSER CONT ArNME:'\T DATE INSTALLED 461 - c:f,óO'Y I CCftity d\aI d\e I8rotm.&tlOI'l prt"\ldcd her'Cln IJ UO,II: J.nd ;¡c;,.nJ,It":o:hc bcs\ ~fmy 'r.no~\cd!te NAME UPCF (12/99 revised) 12 466 , sh.;¡{1 be submitted ~Q \he loa! nc) ABOVEGROUND PIPING SINGLE WALL PIPING PRESSURlZED PIPING (Check all IIIaJ apply): o I, ELECTRONIC WiE LEAK DETECTOR 3.0 GPH TEST ~ AUTO PL'MP SHUT OFF FOR LEAK. SYSTEM FAILURE, A.'D SYSTEM DISCONNECTION 4- AUDIBLE A)ID V1St:AL ALARMS, o 2. MOI'<THL Y 0,2 GPH 1t:ST OJ. A:-'¡"1:ALlNTEGRlTY TEST (O,IGPH) o 4, DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS ("'ect all ,bal apply) 03. DAJl Y VISUAL MONITORING OF PIPING AND PUMPING SYSnM 06, TRIESNIAL INTEGRITY TEST (0.1 GPH) SAFE SUcnON SYSTEMS (NO VALVEs IN BELOW OROUND'PIPfNG): 07. SELF MONITORJ};G GRA VITY FLOW (Check llIllu1l>ply), 08. DAILY V1SUAL MONITORlSG o 9, BJENNIALlNTEGRlTY TEST (0. ¡" GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Ched.II Ih.. 'Pply: 10. CONTINUOUS n:RBINE SL!MP SE:-ISOR ~ AUDIBLE A.'D VISUAL ALAR.\1S AND (Check one! o . AUTO PL:MP SHUT OFf WHEN A LEAK OCCURS Db AUTO PVMP SHUT OFf FOR LEAKS. SYSTEM FAILURE AND SYSTEM DISCONNECTION DC NO ALTO P¡;MP SHu'T OFF o II, AmOM... TIC LEAK DETECTOR o 12. A:-INlJAlINTEGRlTY TEST (0, GPH) SUCTION/GRAVITY SYSTEM o JJ, CONTINUOUS SUMP SENSOR + A UDIBLE AND VISUAL ALARMS . o 4, DAILY V¡Sl:Al CHECK 03, TRE;>;CH LINER, MONITORING 06, NOl"E "¡';'l DA T5_, nnE OF P~mm hplr1tlOn Dille IFLlr 10(',¡':,¡K Dn~) Formerly SWRCB Form 8 !'-ae -..-'''is of J;~ I ~ 016} 4~ .., .$r «Q J~O ,-. ". .~} e e UST - Tank Page 2 Former1y SWRCS Form B (Note: the numbering of the in~tructjons follows the data element numbers that are on the UPCF pages, These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C. the Business Section of the Unified Program Data Dictionary.) . Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated. 458. PIPING SYSTEM TYPE (UNDERGROUND) - For items 458 and 459, check the tank::S piping system 459. PIPING SYSTEM TYPE (ABOVEGROUND) information, CHECK ALL THAT APPLY 460. PIPING CONSTRUCTION (UNDERGROUND) - Check the tank.:$ piping construction information, CHECK ALL THAT APPLY, £~~'.ce1, PIPING MANUFACTURER (UNDERGROUND) . Enter the name of !he piping manufacturer. þ~~. PIPING CONSTRUCTION (ABOVEGROUND) - Check the tankLS piping construction information, CHECKALL ~'¡"2;. . THAT APPLY. ~~~~~. BT41163. PIPING MANUFACTURER (ABOVEGROUND) - Enter the name of the piping manufacturer. ?r:~t , ~:;~484, PIPING MATERIAL AND CORROSION PROTECTION (UNDERGROUND)· For items 464 and 465, check the ~~465. PIPING MATERIAL AND CORROSION PROTECTION (ABOVEGROUND) tankCS piping material and corrosion ~';f . protection, ::. ..~,~;: . "':.'. .,.~ >7466. PIPING LEAK DETECTION (UNDERGROUND) - For items 466 and 467, check the leak detection system(s). used . 461, PIPING LEAK DETECTION (ABOVEGROUND) to comply with the monitoring requirem'ents for the piping. . 468, DATE DISPENSER CONTAINMENT INSTALLED ·If applicable, enter the date that dispenser containment'was installed. 469, DISPENSER CONTAINMENT TYPE - Check the type of dispenser containment monitoring system. SIGNATURE OF OWNER/OPERATOR· The owner or agent of the owner shall sign in the space provided, This signature certifies that the signer believes that all the information submitted is true and accurate, 470. DATE CERTIFIED ~ Enter the date the page was signed, 471. OWNER! OPERATOR NAME· Print the name ofsignatory, 412. OWNER! OPERATOR TITLE - Enter the title of the person signing the page. 473, PERMIT NUMBER - Leave this blank, this number is assigned by the CUPA. 474. PERMIT APPROVED BY - Leave this blank, this is the name of the person approving the permit. 475. PERMIT EXPIRATION DATE· Leave this blank, this is completed by the CUPA. UPCF (\2/99 revised) 13 Formerly SWRCB Form 8 .. , ' . - '~II~I¿ . ...........". ~·J~.;~!Æ\· ,J.,i..11~n~ , ·.f:7i~:·:·~~~'·~~~:··,~·:· f';:'. ~ ".~. '.' "-'cO"~ .,' . '~ l1 '~"': ¡ ~': . ,.-.. , :~·o~f; '* "~' -~-:;\~ '''..'' , .. ~ f ,~~~, ,. '..... L:\"lfIED PRO(;R,UI CO'SOLlDATED fOR TANKS U~D£ RCROC~D STORAGE T.-\:\KS - I~ST.-\LL.-\TlO:\' CERTlFlCHE OF Cû'IPlI.-\.\"CE (conr;:' ~¡¡ge ?C'r ~'H!k ¡ Plge "f J. FACILITY IDE:\TIFIC\ TIO' 9'3 J76 J" II. INST ALLA TIOl\ i. (Check all that appl» ~ The insta1ler has been trained and certified by the tank and piping manufacturers, ø The insta1lation has been inspected and certified by a registered professional engineer having education and experience with undergro1Jnd storage tank instalJations, ØThe installation has been inspected and approved by the Unified Program Agency. ~II work ~iste~ on the manufacturer's instaliation checklist has been completed. ~The insta1ler has been certified or licensed by the Contractors' State License Board. ~The undergro~nd storage tank', any primary piping, and secondary containment was insta1l~d ac~ording to applicable voluntary consensus standards a!\d written manufacturer's installation procedures, . ' Description of work being certified; 478 479 410 481 482 483 . -. ,"" ,- f'" -. ... JII. T ANK OW~ERlAGE'T SIGNATURE : cenify that the infonnalion provided herein is true and accurate to the best of my knowledge. SIGNA TURE OF T A 'K OW~ j NAME Of TANK 5- r // 0 .~; TITLE OF TASK OW!\E!VAGE~T DATE JIOJ 4K6 UPCf (1/99 revised) 14 Formerly SWRCB Form C e ,e UST Installation· Certificate of Compliance Formerly SWRCB Form C Complete this certification upon installation of an UST and piping. One certification is required for each tank system, This page may be completed by either the UST owner or representative. Refer to,23 CCR 2635 fer UST installation and testing requirements, (Note: the numbering of the instructions follows the data element numbers that are on the UPCF pages, These data element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, the Business Section of the Unified Program Data Dictionary.) Please number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is complete and if any pages are separated, 1, FACILITY 10 NUMBER - Leave this blank. This number is assigned by the CUPA. This is the unique number which identifies your facility, . " 3, BUSINESS NAME· Enter the full legal name of the business. 476, ADDRESS - Enter the street address where the tank is located, This is to assist the tank inspector in locating the tank. 477. TANK 10 NUMBER - Enter the tank 10 number assigned by the owner. This is a unique number used to identify the tank. It may be assigned by the owner or by the CUPA. This is the .same as item 432 as found on the UST Tank Page 1. 47a, TRAINED AND CERTIFIED BY TANK AND PIPING MANUFACTURER - Check jf the tank installer provided evidence of being trained and certified by the tank and piping manufacturer, 479. REGISTERED ENGINEER INSPECTION - Check if the installation has been inspected and certified by a registered professional engineer, if necessary, 480. UNIFIED PROGRAM AGENCY APPROVAL - Check if the installation has been inspected and approved by the " Unified Program agency. ' 481. COMPLETION OF MANUFACTURER'S CHECKLIST - Check jf all work listed on the manufactureCs installation checklist was completed. 482, CONTRACTORSOST ATE LICENSE BOARD CERTIFICATION OR LICE NSE - Check if the installer has provided proof of CSLB certification or licensing. 483. INSTALLATION DESCRIPTION - Check if the UST system was installed according to applicable voluntary consensus standards and any manufacturer£S written installation instructions. Describe the installation in the space provided. Clarify the type and the extent of work completed at the facility, such as installation of dispenser containment, replacement of piping, or installation of turbine sumps. SIGNATURE OF TANK OWNER/AGENT· The tank owner or agent of the owner shall sign in the space provided. This signature certifies that the signer believes that all the information submitted is true and accurate. 484, DATE CERTIFIED - Enter the date that the page was signed, '. , 485. TANK OWNER/AGENT NAME - Enter the full printed name of the person signing the page, 486. TANK OWNER/AGENT TITLE - Enter the title of the person signing the page, UPCF (1/99 revised) 1.5 Formerly SWRCB FOI1T\ C .1.... ~ ~~--- -- ~-- -" '...---...... '-- ì"- ,---" . -....-----.-- ~'~ ----- SENSOR ALARM ----- L 1 :UNL STP STP SUf"1P FUEL ALARM r"lAY 18, 2004 6: :34 At'1 ----- SENSOR ALARM --___ L 1: UNL STP STP SUMP FUEL ALARM r"lAY 18, 2004 7: 00 Ar"1 \ , '---" /' , ~--.-, ',-./ l FASTRIP E.401 WHITE LN. BAKERSFIELD,CA 93309 ----- SENSOR ALARM L 3:UNL FILL OTHER SENSORS FUEL ALARM r MAI(- 18, 2004 - 7:-0-1-AM r"lAY 18, 2004 7 : 00 N" , ~ INVENTORY REPORT T 1: UNLDADED VOLUI"IE ULLAGE 90% ULLAGE= TC VOLUME HEIGHT WATER VOL WATER TEMP T 2: PREt"l I Ut'1 VOLUME ULLAGE 90% ULLAGE= TC VOLUME HEIGHT' [,JATER'vbL WATER TEMP T 3:DIESEL VOLUI1E ULLAGE 90% ULLAGE= TC VOLUI1E-= HEIGHT WATER VOL WATER TEr1P 3091 GALS 8909 GALS 7709 GALS 3055 GALS 29.2:3 INCHES o GALS 0.00 INCHES 76,5 DEG F v ----- SENSOR ALAR'"I L 2:UNL ANN ANNULAR SPACE LOW LIQUID ALARM MAY 18, 2004 7:01 AM 1 :392 GALS 10608 GALS 9408 GALS 1375 GALS 16.65 I IIJ(" 'SS o GP, 0.00 IN~S 77.2 DEG F ----- SENSOR L 4: PREr"1 STP STP SUf'1P FUEL ALARI1 MAY 18, 2004 ALARr"1 7:02 A------J 2208 GALS 9792 GALS 8592 GALS 2-1-89 GAbS - - , 22.99 INCHES o GALS 0.00 INCHES 78.8 DEG F \J ----- SENSOR ALAR~'I L 5:PREM FILL 2THER SENSORS 'UEL ALARM f8, 2004 7:03 AM ~ ~ ~ ~ ~ END ~ ~ ~ ~ ~ r, tolAY ¡, ----- SENSOR ALARI"I L 6: PREI'1 ANN ANNULAR SPACE LOW L I QU I D ALARr"1 MAY 18. 2004 7:03 AM ----- SENSOR ALARM L ?:DIE STP ~ STP S Uto1P FUEL ALARr"! MAY 18. 2004 7:04 AM ,. --------- --- --- (\ T 3:DIESEL INVENTORY INCREASE INCREASE START MAY 18. 2004 6:48 AM VOLU~1E WATER TEMP 2156 GALS 0,00 INCHES 78.8 DEG F INCREASE END MAY 18. 2004 7:04 AM VOLUto1E t~ATER TEtolP 2219 GALS 0.00 INCHES 78.8 DEG F GROSS INCREASE'" TC NET INCREASE'" P\ I ~~ '" '-- "--- ----- SENSOR ALARM L 8 :DIE FILL OTHER SENSORS FUEL ALARM MAY 18. 2004 7:05 A~~ --:-- SENSOR ALARM L ':J:DIE ANN ANNULAR SPACE LOW LIQUID ALARM MAY 18. 2004 7:05 AM /----, ----- SENSOR ALARM L13:DISP 5-6 DISPENSER PAN FUEL ALARr1 MAY 18. 2004 7:06 AM ----- -- --- - ("\ ----- SENSOR ALARr"1 L12 :DISP 7-8 DISPENSER PAN FUEL ALARM MAY 18. 2004 7:07 AM __ /,r~:..___.ç"':::~~~_~ -:--. \--.; ,____ SENSOR ALAR!"1 _1\_ Cl0:DISP 3-4 DISPENSER PAN FUEL ALARM MAY 18. 2004 7: 08 AI"1 ------ SENSOR ALARI'1 L11 :DISP 1-2 DISPENSER PAN FUEL ALARM ~ MAY 18. ~004 7:09 A ) FASTRIP 6401 WHITE LN, BAKERSFIELD,CA 93309 MAY 18. 2004 7:11 AM SYSTEM STATUS REPORT - ÃLL FUr~CT I or~s -N¿Rr1~/ _~I _ BADRSrIELD FIRE DUAA'1'KØ'1' .. EHVIROHIIIIfl'AL SDVICZtl 171.5 Che.ter Ave., .~ Bakersfield, CA 93301 (80.5) 326-3979 TANK RBlKJVAL IHlPEC'l'ION PORII ADDRESS (ot/Of {JJ~J( IA PERMIT TO OPERAU....[R - () 3.:2.1 COR'l'ACT PERSON {J..os~ ~£'~frr'T~ t OF SAMPLES ~ (¿, CONTACT PERSON LELt 'T'¡- PLOT PLAN tl) Ltc. /-('1 .' krùtÑ It I stOf(.. ~ , ( ~ ~ cr r- - - -~I I "J. }.I<- v-,c ",. '^ I ~----' '- __ I t- ---, I ~ J. '<- D'J(IJ? " L.:.... ~ _ __I ~ - ý..- --, I I J. \c. íU~. Uc'l.'t Ii- _ _ _-' I I I I tj)cs('c£lsr ::..s{w./ o OJ J)\SþCMU" ¡,s(OtJ ...._----. ~~~)(.o~\!~ CONDITION OF TANKS ~~ed CONDITION OF PIPING /jwc í"ru'rl.. /I\(wr CONDITION OF,SOIL ÇJot.,(,( ('{,~'f ÚL¡ùA CO.oo:NTS çtW~ ~~ 1 ~~y *~ tv~ :trt°r. 1t(~ ~~(:(t:ff~~, ~ ~= . , - r::;;' ~.. l(~« -,." i- ~ !;,. : --of<. ¡L 'wi'L L{. ¡ \ . f) t£L tj It fi~ c( 7-t'Lf U.,J'fh ",,,,,c . -r::>Ji- râtlbfip DATI I . . INlNCTOAI ~ lu.AnIII ¡..~ J«.::i (:-' Address City, lip Phone 'io, _ CITY OF B:-\.SFIELD OFFICE OF EN\'IRO~~[ENTAL SERVICES 1715 Chester Aye" Bakersfield, CA (661) 326-3979 I~Si'FCTi{)N '{¡:C:W,l) ?OST (,\íW\ r JOB 5iíE Owner Address City. Zip Permit" è'/STRl:CTIO:'lS: Ple:1Se c:l1I ror Jn inspector only when ~ch group or' inspections with the ¡ame :lumber:lre ready, They will run ;n ~onsecuti"e order beginning wÌlh :lumber I. DO .'OT cover work tor Jny numbered group unu all icems in thaI group:lre signed orTby the Permitting Authority. Following these instru.:tions will reduce ehe number oJ! ~quired inspeclion v isils :lnd lherelore pn:vent asscssmenl of 3ddiliol\31 fees. T Ai'lKS AND BACKFILL Backlill ofTank(s) Collhodic Prolection of Tank(s) Piping & Raceway w/Collection Sump INSPECTION PIPING SYSTEM ~!b\- COlTOsion Protection of Piping, Joints, Fill Pipe ( Eleclric:allsolation of Piping From Tank(s) Cathodic Protection System-Piping Dispenser Pan '"ü-"-c.. \-c...6+ OiL' ;J ~ -() (f SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTIO Liner Inslall3tion . Tank(s) Liner Installalion . Piping Vault With Product Compatible Sealer Level Gauges or Sensors, Float Vent Valves Product Compatible Fill Box(es) Product Line Leak Delector{s) L~k Deteclor(s) for Annual Space-D,W. T3IIk(s) Monitoring Well(sYSump(s) - H20 Tesc Leak Detection Device(s) for VadoselGroundwaler Spill Prevention Boxes Monicoring Wells, C3pS & Locks Fill Bo.~ Lock Monicoring Requiremenls Ty~ ( ..\uthorization lor Fuel Drop FINAL T \I-~ '3 .Ç1) CONTRACTOR ,~dr\~-t rhc.J\n " I (I} ( ")NT,\CT Q () l, ~ (') r Ifuu..~ PHONE II 1ì $" çoe:r INSPECTOR ~- ~~O q 5""tg "oif ç~ l ( "0 if b~ l ~ "'6 V LICENSE" c)ß15f .., - e PERMIT APPLICATION FOR REMOVAL OF AN UNDERGROUND STORAGE TANK Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 Page 1 of 1 I PermitNo ßR- D 2>~ J- ^"'-"...--",., ~ ,-. -:-." , ~ ~'~':-::~\';i- ' ., "'i:/, q INSURANCE CARRIER COMPANY . ···';;irAÑK.SllliËAN·iÑ.GINFÔRMÄmIÔNŸiY¡ ,_ ,- éê, ~ ,;; ".-. ':"'- .;',' ~,'\ vtt,;;;" \::< i ",:- ',' ,: :',. ~ '-'",,'-', ',',' « :: ::< ':":"" ~ ,'.' "'< ';.; _':': '.'-:. <'.,.-; }': - .--- :-",,': :'---"f--:-~-'" :.:'_' ': ,:- ,,- ,_,e_ :::~ _~ PHON FACILITY IDENTIFICATION NUMBER ''UÁNK'URAÑSRÔ'RfER/I·NFôRMÃmlôN " \~~' '_.<. ;:"~,,,. :'_:~,:;",::',:,:): /\~, -«~,¡!~~~;:::::,~:,< <>. '.,~~:. - ,'_ "__:: ,-.:: - .;.;':' -~-:'-. '<-' '-,.: _:' :'-" >'>. "t' ¡".y.',' <,,:':: :'. .:-. :-_,^,_:(~i:-':::" PHO ... ';;¿~;;;i::j;';'mÃÑKiINJfÔRI\IIAmIÔN 'c';' :. :-, '>:''--,:-r.-:<:.<>-r.-;!.,,' ':' '.':"?c.i'f,,,:\c ;,,--<:..>:;':. ,,,:;,\.t'.~:..:·"'·/;-;;,} }:!',:: ,__./., '., -':"~::'_'~_,::~., TANK No, AGE VOLUME CHEMICAL STORED DATES STORED CHEMICAL PREVIOUSLY STORED For Official Use Only THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS OF THIS PERMIT AND ANY OTHER STATE, LOCAL AND FEDERAL REGULA TlONS, THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS TRUE AND CORRECT, N CD o N :E THIS APPLICATION WILL BECOME A PERMIT WHEN APPROVED AMOUNT 1421 ~ 6-24- 1 220 DOLLARS I CHECK ~ AMOUNT $d~.C(:J ß :::;;;;:i-"'" I Co.I..4o',c....;.. M' EXPLANATION SUNSET CONSTRUCTION 3812 PANORAMA DR. BAKERSFIELD, CA 93306 PH, (661) 871-1788 .. W:' ~ PAY AMOUNT OF DATE WELLS FARGO BANK 11100 ¡ ~ 2 ¡ III I: ¡ 2 2000 2 ~ ? I: e i , _milt No. ~ff --' 0;)-77 ÇITY OF BAKERSFIELD V CL,~ OFFICE <l>F ENVIRONMENTAL SERVICES 1115 Chester Ave., Bakersfield, CA (805) 326..3979 ¡ I, I I I PERMIT APPLICATION TO CONSTRUCTIMODIFY UNDERGROUND STORAGE TANK TYPE OF APPLrCA TION (CHECK) I ( ¡NEW FACIUTY ~ODIFICA110N OF FACILITY []NEW TANKINSTALLATJON AT :EXISTING FACIUTY STAATINGDATE 5-/ -:"0 I PROPOSEDCOMPLETJONDATE __<"-dD -ó~ FACIUrY' ~ 1AGU'\.t:.L.L':) ..,. T ~"O EXIS~ FACILITY PBRMIT NO. FACIL1TYADDRESS '-\0 l.J.,.:)~"..;> CITY "'-\~~~.o ~\ t-~ -. ZIP CODE cr~oq TYPE OF BUSINESS ~ \~ APN I TANKOWNER. PHONBNO. 3c\3-ìcoo ADDRESS " ZIPCODB C\ 'ª'~o~ CONTRACTO CALICENSE NO, ,.,~q 51 ? ADDRESS ~ ~ t,';). >.¡po, ~..~ ') ZlPCODE ~0lØ PHONE NO, d -CXolò' BAIŒR.SFŒLD CITY BUSINESS UCENSE NO..ðkl F..~ WORKMANCOMPNO.6\~~~ -6:ð =f,JN$U1ŒR. 6,-~,\~ ~~Ù ~y DESCRIBE THE WORK TO BE DONE 1\ fiE: -?'F\\R.. -v<.e \~ ~ ·1='"\ü.. ~,'LG-\ I fC1fl. \¡C\, \:>~c.. \) _ _ I ' WATER TOFAcnnyPROVJDEDBY ~ tt'\-, DEP1HTOOROUNDWATER -\r \.ð~ I SOIL T'YPBEXPBCTBDATSITB NO, OF TANKS TO DB INSTALLED ,g. fARE THBYFOR MOTOR FUBL SPILL P1U!VI!N'I1ON CONIROL AND 7 URE8l'LAN OIIFJLB )<J _rn~ª MOTOR FOIL UNLEADED daiJl..AR PR.EMtOM )ð . I\V/.'V,·'· 7 I I ~ TANK NO, ¡ ~ '-~ ,/..1 . VOLUME /~ tWO ø (}{J() B TANK NO, VOLUME -. '---/ NO ...NO DIESEL A VIA110N .)(1 10 >!L CAS NO. CHEMICAL PREVIOUSLY STORED (IF KNOWN) . mE APPUCANT HAS RECmvED, UNDERST~,~ W1LL COMPLY wrm THE AITACHSD CONDmONS OF THIS PERMIT AND\~ OTHER STA'Œ, LOCAL IU'If FEDERAL 1Œ0ULA11ONS, THIS FOJß{ HAS BEEN COMPLETED ' UNDER PEN TV OF PERJURy, AND TO THE X Of KNOWLJIDOE, IS TRUE ~ CO~CJ1 . dr~:f1Û « SIONA11JRB TlDS APPLICATION BEi A PERMIT WHEN APPROVED , I FIRE CHIEF RON FF-:AZE ADMINISTRATIVE SERVICES 2101 "W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' ENVIROHIIENTAl SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 -- -- December 12, 2003 CERTIFIED MAIL Farrells Fastrip 6401 White Lane Bakersfield, CA 93309 RE: Propane Exchange Program Dear Owner/Operator: The purpose of this letter is to advise you of current code requirements for propane exchange systems, such as "Blue Rhino" or "Amerigas," This does not apply to large propane tanks, only propane exchange systems, Over the past two years this office has noted a dramatic increase in the propane exchange system in the city of Bakersfield. It has also been noted, with great concern, that many of these installations are a clear violation of the UFC (Unifonn Fire Code) and represent a danger to public health and safety, Accordingly, procedures for storage of propane cylinders awaiting use, reside or exchange, have been adopted through BMC (Bakersfield Municipal Code) and adoption of the 2001 UFC. The procedures are as follows: Storage outside of building for propane cylinders (1,000 pounds or less) awaiting use, re-sale, or part of a cylinder exchange point shall be located at least 10 feet from any doorways or openings in a building frequented by the public, or property line that can be built upon, and 20 feet from any automotive service station fuel dispenser. (Note distance from doorways increases when cylinders are over 1,000 pounds cumulatively,) Cylinders in storage shall be located in a manner which minimizes exposure to excessive temperature rise, physical damage or tampering (Section 8212, California Fire Code, 2001 Edition). When exposed to probable vehicular damage due to proximity to alleys, driveways or parking areas, protective crash posts will be required as follows (Section 8001.11.3 and 8210, California Fire Code, 2001 Edition): 1) Constructed of steel, not less than 4 inches in diameter, and concrete filled. 2) Spaced not more than 4 feet between posts, on center. .. ,%qN/~? d;, cc;.~It/ItN/I/(?- ,':/N' , I'¿r>~'r . './h//I. . -(; ?St-:/I////r ~~ -- -- Postage $ ;:r '0 , 0 Return Reclept Fee ,0 (Endorsement Required) . 0 Restricted Delivery Fee '..n (Endorsement Required) ru ru Total Po Certified Fee fI1 . c:J Sent To c:J r'- šiñišfÄp or PO Bo) ëñÿ; 'šïãii Po3Imark Here - .:;;- Farrells Fastrip 6401 White Lane Bakersfield, CA 93309 - - -. - - PS Form 3800, June 2002 . See Reverse for Instructions SENDER: COMPLETE THIS SECT/ON : . Complete items 1, 2, and 3. Also complete : item 4 if Restricted Delivery Is desired. . Print your name and address on the reverse so that we can return the card to. you. . Attach this card to the back of the mail piece, or on the front jf space permits. 1. Article Addressed to: Farrells Fastrip 6401 White Lane Bakersfield, CA 93309 2. Article Number (Transfer from service label) PS Form 3811, August 2001 I " . ' . . . B. elved by ( Prlntecj~ame) ~, , L-- Nf /t Ié- < D. Is delfoJ1Iry address different from Item 17 If YES, enter delivery address below: 3. Service Type 'ttCertIfled Mall 0 Expœss Mall o Registered 0 Return ReceIpt for Merchandise o Insured Mail 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 7003 2260 0004 7652 2938 Domestic Return Reçeipt 102595-02-M-1540 ~ ..., ""' ..- ..-- Letter to To: Owner/Operators of Propane Exchange Systems Re: Propane Exchange Program Dated: December 12.2003 Page 20f2 7' 3) Set not less than 3 feet deep in a concrete footing of not less than a 15 inch diameter. 4) Set with the top of the posts not less than 3 feet aboveground, 5) Located not less than 5 feet from the cylinder storage area, Exceptions: Cylinders storage areas located on a sidewalk which is elevated not less than 6 inches above the alley, driveway or parking area, with not less than 10 feet of separation between the curb and the cylinder storage area, "No Smoking" signs shall be posted and clearly visible (Section 8208, California Fire Code, 2001 Edition), Resale and exchange facilities must be under permit to verify compliance, All existing facilities will be checked and when compliance is confirmed, a permit will be issued, All new propane exchange systems must be permitted prior to installation, You will have 90 days (March 4,2004) to comply with the procedures outlined. Once compliance has been confirmed, each exchange system will be issued a permit, which will be placed on the exchange system, Sites not conforming to current code, will be "red tagged" and must be taken out of service immediately, You should contact your Blue Rhino representative, Mr, Taylor Noland, or your local Amerigas representative, They are aware of current code requirements. If you do not have a propane exchange system, please disregard this letter. Should you have any questions, please feel free to contact me at (661) 326-3190. Sincerely, /£ dk~ Steve Underwood Fire InspectorlPetroleuml Environmental Code Enforcement Officer tit ITY OF B~ŒrD i OFFICE F ENVIRONMENTAL SERVICES 1715 Cheste Ave., Bakersfield, CA (805) 326-3979 ~.. . ")'(¿j " PERMIT APPLICATION TO CONSTR CT/MODIFY UNDERGROUND STORAGE TANK mE OF APPUCA nON (CHECK) ( JNEW FACILITY []MODIFICATION OF FAC STARTING DATE FACILITY .NAME F ACILlTY ADDRESS TYPE OF BUSINESS TANKO~ ADDRESS CONTRACTO ADDRESS PHONE NO. WORKMAN COMP NO. Y Dr:.SCRIB [)dNEw TANK INSTALLATION AT EXISTING FACILITY PROPOSED COMPLETION DATE EXISTING FACIIl'IY PERMIT NO. CITY ~~-i..c() ZIP CODE 93_::U:J9 APNI PHONBNO. ~_=?-/~ ZIPCODE ~~~ CAUCENSENO,~ CITYÆ..t-'~.oCI . meODE BAIŒRSFŒLD CITY BUSINESS UCENSE NO.bY' ~ê CITY ~~.D YES NO YES NO TANK NO, / ¡:;; -.3 VOLUME L~ccn /_?/YY) /r? /YY) UNLEADED ~ REGULAR PREMIt1M K' DIESEL AVIATION X" TANK NO. VOLUME TOR FU'EL STORAGE TANICS CAS NO. CHEMICAL PREVIOUSLY STORBD (IF KNOWN) ¡!~;~~~~w1~!;!iWB1mm!m!!:!!r!m¡¡~:·, ,>,:!.,!<,.:: ,,,,..,,, "1'''·'' d,),.....,¡, ,11,·" ,,," (" ,)"." '\"".. ,,¡...>i'J'¡¡~11 :::::;:;::~.:J:::::~.~::~::.o::·:~~:.::::::::::)J:::::-:!:t,,,~~t. ~'. ~ ~ h:,-,1, . TI-Œ APPUCANT HAS RECEIVED, UNDERSTANDS, WILL COMPLY wrm THE AITACHSD eONDmONS OF THIS PERMIT A:.'ID\~ OTEER STATE, LOCAL FBDERAL RE0ULA1!ONS. TV OF PERJURY. AND ~ MY KNOWLI!OOB. IS :.ME (PRINT) AI'I'U~ TillS APPLICATION BEC A PERMIT WHEN APPROVED e - FPDr'l ,::;ut·-~I,=;E~-r ':£::t ~:ht IH [':~:~:::~ '. H ~II-I;~ i i'"J, :..U:. ?L 1-;:':::...' '-·:C.3. IT? ·.~-·F1¡:·1,:-: (J2::·~r·;.'Hr·'l PIE. ,. ~'i.lmJnlìfi" t , ";1.,\)) l"""~..,,,.~¡!lr ,^ ..~iJ' if!;, '\~ L..---., !~::;:-.:.... '\,~~;~. ,~¡t;~lt~~\'~ ,~"i~~~;iil~ "¡~,í,,, II )", "JJ"", ~"~'¡II"¡!¡! t '\ Ii \,nj,-. Jk . ,\ ".:r 1'" . A'" qll" ~'""". !', ,," \ t,.'" ,~.í."1 1", ~ "~" , w, L -J!'fi . M,.r _ ~. ,!:,~;U ;:~ .~ ~~ ':~":~r)J! II.~,; to ~ tr:i ~_ ~ :~ ·Il~,:'l E' ~þ .!;ji:'¡ ;&-11 ¥' r :01Ii~ ' i~ 8I_;il~ ~..~.... :~'~"S " l.~~~" ...:;:.; ..~. J'. T1.Ia w..~,\. ." ~~ ~~~:~,:....1)!, . C¡... '(~.~-~~~t.~~ ,P J'?i(ilj;Fltmm)~~~ cq¡r~iV.l {'µ,¡r;l ·I~I! j~ ~( V"I!jl ,'1 Pi\l~,. U .¡··'1, 'i_ li~. ,fL ~LÞ .R! <,,'~ f:'\ !LL,i;, " 'i. .1, ;t ' fl ill (1..1.' ) r~~,.;,¡,:"\I1, r.'~,~\ r~"'\ 'P1"~"V,"t'i1í',,(,~~,¡Y.1 in¡':\'{,"i'/l1 I, r f"1f~']'¡J'\nr'ilìi"(1 t,J..l' ¡"J 1 t"'~¡ì...1 ~)fl' _:r~.Ll "'1 'itl J:J:í\. tJ.," ·~JLi!.1,í.L \ì IL 1.'1.,\;..! ..).1i:~J . L .ltl~,1"--.!LJ ~l}. ~t]1. ~4; (~.~ ¡[Ii" 1 "~i; i-~t~ it· l~:._'¥ 1~~~. r~~ ~;:~¡.~,~¡e r:5ïfi ~~~.l if; (fp,61 J2tíi..3E1,;V?9 AIÞr"L.1!Cá'T[(}]$ 'IG! P]L~l;tJli'OH\<i 'f-1~' ì t'~l t\ 'j .() 'II> ' 1; r"",' -J'U~ T'II, .¡' ,('1 '--~"'.' 1 "', (T' ',- ._~ ,p.', . '. 1 'T"" l' , ,j j ~ _ j"'·h'~. ! r$¡! Ii ' i 1 a , "' i'(~ f! ~f ~i - i!~ I~;¡ ~!: ~ .¡" iD ~ ',.:.\ ¡;' t l ~ fill '0>' ",' "I.. _, ~ ,... 1. ". ,it ".., C "",c",,:"..ß,.lL, ,¡,,",,'" , '~""~ ,'It F/~(~Jl.l~:··'J- ~....:' __~:r5~t~2.a=:;::¿L...,_... "......_.,,_"'____ __._...._ ....__. ,__..~_.....__..~·u.__·_ ~__~ __..___._..._ ___"' _.....__._____._.~'._ I :- j:....DDlZE:;:;..._.I;:;.:':...::~:::::;'~;¿n' "..:~::t,::,:::' i:;::/,;' ,~: ~ - .... "::: ~¡,. . ". ........, ..,- ,_...._--_.__..._._~. ()J.)}::J;,~ /~,.' {()F~ S l~.~ ¡\ ì\-ll~"_".';;--~~~"~~f~~i~~~·;;,,'~!?.... (~~~:. ;~~~< . ''''. - .,ç!~~.)...' J. ~.- --~..~..... "........."...... ~'.' -"--'-'- /') /,.;¡ GWl'ŒF :S:' f\lVrE,.._,_L~.:.:.,.:~1(:~::::L_, \':._¿:'JrL,,_)I.,..r.2:....~___u-n_' , , ... -. -- . . - -.,"\. '.' 'r -," ~"I,F':::"~ . , . ''':') f' f\ìvJL OF tv 1 U1ì1]' ru R ivIhN1) J A C i, C: 1, u\... ._æ;¡:1,;;~~~:'.:;;~I:¡~~~:'"'..",J::::~;,¿~·í~:~:::..::,,_.__._"_,,,_,~_, __ _,___, .--~-...- -."~"--,,... ....".--...,.......-.-- --. DOES F,,\(-:'ILJTY FL\ \IE DIS,~:r:t,;:::::, ," ;::>"~?IS? \'-.-~~,i)S: t,[ (), ._:::.:,,,, ,. -~',\."'¡l< "1 Vi, !It::'>/E ('; , '.fIT .fiTS ¡' .-,'..-..-... ""IL~~"'''''··'·'''''''' ,.,..!~,,:~.:~'!,,:,';~;~~~-. ...... "'......... .... ._,........ '"',,~ ., ...-.. . '') r:)<,. -, 7'¿'~\ .¿:r::r:,~,.._".u."" "'''- ",L ._u~. I~<~~~: ~:~~~.~, ,~'6.""'-=' '_''-'''.~'''_~"__._.__,.~.. .._....._,._-~._..- ") mC,.:;\______... ~-¿:/ _..nÆ¿""""-~ -"._.._ ,~~~:.,~. (~~?::~J~¿ I" '~_~:~~t~~~:f: . - .-". -- ..--.---- -- , ·"'1...-,-'"","''-' J,' ~,,~. j~.... ~~...t :.' ,__..~ n_~..~___ -....,-..................--.- .~.._----' ~~ .- -....- - . '... ,---,...~.,.~,.......~ .- -.... ....... --_..- .-.. . ._..~... - ...._~ ._--._.~ 01A1v'lE OF r.lT~TI'INC COhlP;'\;'iV ..::::S~~'::¡:~J:E~~: ._,i':~?¿~~()J::~:§~rt;:~:::;'t:,"( --'- .-..,....,..,..-'--O...~. CON';·Rr'¡,!:.'T)RS I..I ::::I::¡",¡'S to: N ..,- .-:~. :. ""-' " ~- .--.-- ._ -~",.-,."..... ..--..___,.·._._._..v ~.' Ni\~l\/ín~ 8: PII()],\~T':: !··.Tf...n\"D3I~I( (.ir· c·~(·:·'tf ..:..c··r P.E~j~~S¡ .:,.t;,/.::~:~.:i(~~~l~;"t~~h,,~:= 1) /\'TI~ ¿;;: 'l'l1vi.F·: '-rI~,S'j" 1$ 'rc) }~:E (~'c::.·~~~j~~ ì._: :~··'··rr·r),,~:~·::.:;;~..,.;:(1.:l~:~~_u.(~~~:.~·:;:\ \:;~)~~:]~: ~~L _ __,_~': ::J'~;:;¿:_;_~ _ ~ (~1~'¿ ð .'L~ç::·~_."....:.)~~. ,~! _n__ ~-~ ~-(ò "Ð ~ , .......~._m .~~-._......~...><~....,..," _ ~ ,-"',:~:;1¿,~~:::;;~~)=,:.::.~~:~.. SJC:j-t'\IJ~l:.."t '·L..rH__':~J (·J.2 /;,J-·-¡~;[.J(~;,AJ...;:rr A.>lr;J~:_"-'·I·'./l~I) 'F.~";j;' D..\TE ....--.----- .. '; "- 1: / S'/STH1 ~~ETUP AUG 13. 2003 9:20 AM SYSTH1 UN I TS U,S. SYSTErvl LANGUAGE ENGL I ~3H 8\'STEtvl DATE/T 1 rv1E FORt"IAT t"10N DD 'Y"'/'ti HH: t"H"l: S~3~J'1 FPlSTR I P :360 6401 WHITE LN. BKFLD,.CA, 93309 bE, 1 - :397 -0271 SHIFT TJ/"1£ 1 SHIFT TIt"1£ 2 SH I FT TI t"lE 3 SHIFT TIME 4 D I ~=;ABLED DISABLED DISABLED DISABLED PER I OD I C TEST I.,,JARI'J I 1',J(;:3 DISABLED ANNUAL TEST IloJARN I N,:;S DISABLED p¡;:: I NT TC \/OLUf"1£:3 ENABLED ' TEMP CO!vlPENSAT I ON VALUE (DEG F): 50.0 H-PROTOCOL DATA FORMAT HEIGHT RE-DIRECT LOCAL PRINTOUT DISABLED SYSTEt1 SECURITY CODE : 000000 .,--.~- '-"""-~. COtvH"IUN I CAT I ONS SETUP ------ PORT SETTINGS: COt"ll"l BOARD BAUD RATE P'AR I TY STOP BIT DATA LENGTH: 1 (RS-232) 9600 NONE 1 STOP 8 DATA AUTO TRANStv1lT SETT I NGS : AUTO LEAK ALARM LIMIT DISABLED AUTO .HIGH WBTER Lll1lT DISABLED AUTO OVERFILL LII'1IT DISABLED AUTO LOW PRODUCT DISABLED AUTO THEFT LIMIT DIßABLED AUTO DELIVERY START DISABLED AUTO DELIVERY END DIÌ3ABLED AUTO EXTERNAL INPUT ON DISABLED AUTO EXTERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED AUTO SENSOR OUT ALARt"1 DISABLED RS-232 SECUR I Tli CODE : 000000 RS-232 END OF MESSAGE DISABLED ,~~ " ~ "'~--~ IN-TANK SETUP ------ T 1: UNL. 1 PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL 1 : .000700 96.00 1 PT 12000 ~ FLOAT SIZE: 2.0 IN. 8495 WATER WARN I NG 2.0 HIGH WATER LIMIT: 3,0 MAX OR LABEL VOL: 12000 OVERFILL LIMIT: 95% 11400 HIGH PRODUCT 97% 11540 DELIVERY LIMIT 22% 2540 ~ LOW PRODUCT LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TA~K TILT : MANIFOLDED TANKS n: NONE 2500 99 99 14,00 LEAK MIN PERIODIQ~_ _ __ 1% . ---,----~ :: 120 LEAK MIN ANNUAL 1% 120 PERIODIC TEST TYPE . STANDARD ANNUAL TEST FAIL ALARt"1 DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALAR!"I DISABLED ANN TEST A\1ERAG I NG: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF INK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 MIN -~ ---..- -. -",,-,~. "-...-, ---- ....~ '.. ........--..... .-----............. ...' ------.-- ~' T 2:PLUS PRODUCT CODE THERt1AL COEFF TANK D I Ar1ETER TANK PROFILE FULL VOL 2 : .000700 95,00 1 PT 12000 FLOAT SIZE: 4.0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12000 OVERFILL LIMIT 95% 11400 HIGH PRODUCT 97% 11640 DELIVERY LIMIT 22% 2640 LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT 2400 99 99 11.00 MANIFOLDED TANKS T~: NONE LEAK MIN PERIODIC: 1% 120 LEAK MIN ANNUAL 1% 120 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARt"l DISABLED ANN TEST AVERAGING: OFF PE~ TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TN)( TST SIPHON BREAK:OFF DELI VERY DELAY : 1 5 t"l1 N T 3:DIESEL PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL 3 : .000450 %.00 1 PT 12000 FLOAT SIZE: 4.0 IN. 84% WATER WARNING : 2,0 HIGH WATER LIt1IT: 3.0 t1AX OR LABEL VOL: 12000 OVERF ILL LI M IT 95% 11400 HIGH PRODUCT 97% .::..) ~ : 11640 DELI VERY LI M IT ., 22% 2640 LOW PRODUCT : 2500 LEAK ALARM LIMIT: 99 SUDDEN LOSS LlI1IT: 99 TANK TILT 11 .70 MANIFOLDED TANKS T~: NONE LEAK MIN PERIODIC: 1··' '. 120 LEAK t"1 I N ANNUAL 1% 120 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARt'l DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TA~K TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DEL I VERY DELAY : 1 5 ("11 N ~ ~-~--""---.-. ~--.. T 4: PREM. UNL, PRODUCT CODE THERt'1AL COEFF TANK DIAMETER TANK PROFILE FULL VOL : 4 : .000700 96.00 1 PT 12000 FLOAT SIZE: 4,0 IN, 8496 WATER WARNING : HIGH WATER LIMIT: MAX OR LABEL VOL: OVERFILL LIMIT : HIGH PRODUCT DEll VERY L I M IT 2.0 3.0 12000 95% 11400 97% 11640 ...,.-,~/ '- ,,/( 2640 LOW PRODUCT : 25~~ LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 13.00 TANK TILT : MANIFOLDED TANKS T~: N9NE / LEA~~IN PERIODIC: /" ~ 1··" /. 120 LEAK MIN ANNUAL 1% 120 PERIODIC TEST TY~~ANDARD ANNUAL TES1LÄ~~(DISABLED PERIODIC T~tlR~Ab\SABLED R" -'S TEST FAIL G Op ALARM DISABLED \ ANN TEST AVERAG 1 NG : OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELAY : 1 5 1"11 N DELIVERY L ~~- '----- --~ ~ '~,~- -. --------- -- -----, --- .. ~""'" . ~-~ l::;EAK--1'EST- METHOD -- 1______ ___ TEST ON DATE : ALL TANK OCT 20. 2002 . START TIME: 12:00 AM TEST RATE : 0.20 GAL·HR DURATION : 2 HOURS ~J 2: PLUS PIPE TYPE: FIBERGLASS LINE LENGTH: 50 FEET T 2 : PLUS DISPENSE MODE: STANDARD LEAK TEST REPORT FORr"lAT NORt"lAL ~ W 3:DIESEL PIPE TYPE: FIBERGLASS LINE LENGTH: 50 FEET T 3:DIESEL DISPENSE t10DE~: STANDARD WPLLD LINE LEAK, SETUP .. ----- WI: UNL. 1 PIPE TYPE: FIBERGLASS LINE LENGTH: 50 FEET T 1: UNL. 1 DISPENSE 110DE: STANDARD W 4: PREI'1. UNL. PIPE TYPE: FIBERGLASS LINE LENGTH: 50 FEET T 4 :PREt"I. UNL. DISPENSE MODE: STANDARD ~----~ I.~ ---_ ..___ 0- _ _ LIGUID SENSOR SETUP ------ -- L 1: LI NER NORr"IALL Y CLOSED CATEGORY : OTHER SENSORS L 2: LI NER NORMALL Y CLOSED CATEGORY : OTHER SENSORS -,.~ --- ~ -,~ WPLLD LINE DISABLE SETUP - - - - - - W 1 :UNL. 1 IN-TANK ALARt"IS T 1: LEAK ALARM T 1 :HIGH WATER ALARM W 2 : PLUS IN-TANK ALARr1S T 2: LEAK ALARr", T 2:HIGH WATER ALARM W 3:DIESEL IN-TANK ALARMS T 3: LEAK ALARt"l T 3:HIGH WATER ALARM W 4 :PREt"I. UNL, IN-TANK ALARMS T 4: LEAK ALARr1 T 4: HIGH WATER ALARt"1 i< .....~-. -'~""--.--> "-......-- -; ~. -- -- SENSOR ALARt'l L I: LI NER OTHER SENSORS FUEL ALARM AUG 13, 2003 '3: 24 At"1 ----- SENSOR ALARt1 L 2: LI NER OTHER SENSORS FUEL ALARI1 AUG 13, 2003 '3:24 AM - - --------..' --- --- --- WPLLD LINE LEAK DIAG AUG 13. 2003 9: 26 AI1 IN I :UNL. I ------ DISPENSING ENABLED TEST COMPLETE PENDING PUMP OFF HANDLE OFF CRC:2783 PARITY:57 3.0 GPH PI :21 ,726 P2:21 .766 PSI 0.20 GPH PI: 0,000 P2: 0.000 PSI ¡1ID TEST PI: 0.000 P2: 0.000 PSI WPLLD LINE LEAK DIAG AUG 13, 2003 9:26 AM l"J 2 :PLUS ------ DISPENSING ENABLED TEST COMPLETE PENDING PUMP OFF HANDLE OFF CRC:653 PARITY:4 3,0 GPH PI:24.730 P2:24.7IB PSI 0.20 GPH PI~ 0.000 P2: 0.000 PSI MID TEST PI:. 0.000 P2: 0.000 PS I ---"--- ------ --- ~-.~.__.. WPLLD LINE LEAK DIAG AUG 13, 2003 9:27 AM . W 3:DIESEL ------ DISPENSING ENABLED TEST COMPLETE PENDING PUMP OFF HANDLE OFF CRC:3275 PARITY:1716 3.0 GPH Pl:21.866 P2:21 ,730 PSI 0,20 GPH PI: 0.000 P2: 0.000 PSI M lD TEST PI: 0.000 P2: 0,000 PSI v.JPLLD LINE LEAK D I AG AUG 13, 2003 9:27AM W 4: PRE!"\, UNL, ------ DISPENSING ENABLED TEST COMPLETE PENDING PUMP OFF HANDLE OFF CRC:391 PARITY:2 3,0 GPH PI :24.656 P2:22,920 PSI 0.20 GPH Pl.: 0,000 P2: 0.000 PSI MID TEST PI: 0.000 P2: 0.000 PSI -''""'''-'-........" ---/,- -'-- .- SOFTWARE REVISION LEVEL VERSION 14.00 SOFTWARE~ 346014-100-A CREATED - 97.02.10.13.33 NO SOFTWARE MODULE SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS IN-TANK DIAGNOSTIC ------ PROBE DIAGNOSTICS T 1: PROBE TYPE MAGI SERIAL NUMBER 206612 ID CHAN = OxCOOO GRADIENT = 351.7000 NUM SAt1PLES 20 COO 1711.9 COl 16751.0 C0216750.9 C0316751.0 C04 16751.0 C05 16750.9 C06 16751.0 C07 16751.0 C08 16750.9 C09 16751.0 CI0 16751,0 Cll 44230,4 C12 9752.0 C13 10656,3 C14 11260.4 C15 12182,5 C16 12674.:3 C17 13191,2 C18 44235,2 SAMPLES READ =108543995 SAMPLES USED =108533569 .~.' '.v.~·,_._,___~ IN-TANK DIAGNO:3TIC - - - - PROBE DIAGNOSTICS T 2: PROBE TYPE MAGI SER!AL NUMBER 574828 ID CHAN = OxCOOo GRADIENT = 348.4500 Nur", SAf"lPLES 20 COO 1310.3 Col 1 :3711.0 CO2 13711.0 C03 13711 ,0 C04 13711.0 C05 13711,0 C06 13711,2 C07 13711. :3 C08 13711.4 C09 13711,6 C10 13711.2 Cll 44165. :3 C12 6329.4 C13 8834,0 (;14 9573.8 C15 10444,1 C16 12305.0 C17 130:39,3 C18 44165.6 SAMPLES READ =107703376 SAMPLES USED =107693165 : IN-.TANK DIAGNOSTIC - - .- - PROBE DIArNAoTIro T 3: PROB~ i~PE'~AGl ~ERIAL NUMBER 163076 ID CHAN = OxCOOO GRAD1 EN!-=-- -35.r~:T(OO-· NUM SAMPLES 20 COO 1400.6 COl 6338.0 C02. 6338.0 C03 6:337.9 C04 6337.7 C05 6338,0 C06 6337.8 C07 6338.0 C08 6337.8 C09 6338.0 CI0 6337.9 Cll 4439:3.0 C12 6493.1 C13 8393.7 C14 8685.8 C15 8957,7 C16 9338.0 C17 11042.8 C18 44394.8 SAMPLES READ =107840506 SAMPLES USED =107830201 IN-TANK DIAGNOSTIC ------ PROBE DIAGNOSTICS T 4: PROBE TYPE MAG1 SERIAL NUMBER 659015 ID CHAN = OxCOOO GRADIENT = 356,6200 NUM SAMPLES 20 COO 1317.2 C01 9965.0 C02 9965.0 C03 9965.0 C04 9965.0 C05 9965.4 C06 9965.0 C07 9965.0 COB 9965.0 C09 9965,0 C10 9965,0 Cl1 45312.9 C12 5573.9 C13 7528.1 C14 8489.0 C15 8985.1 C16 9843.3 C17 11861.2 C1845313,1 SAMPLES READ =106549056 SAMPLES USED =106542512 WPLLD LINE LEAK DIAG AUG 13, 2003 9:30 AM WI: UNL. 1 ------ DISPENSING ENABLED TEST COMPLETE PENDING PUMP OFF HANDLE OFF CRC:2783 PARITY:57 3,0 GPH P1 :21 .726 P2:21 .766 PSI 0.20 GPH PI: 0.000 P2: 0.000 PSI r"lID TEST PI: 0.000 P"" <- . 0.000 PSI .. -. ~. .~ "-~------ "---- '""'-, '" W 2 : PLUS - - - - - - - - - DISPENSING ENABLED TEST CO!vlPLETE PENDING PUMP OFF HANDLE OFF _£Rº~;53___ _ P8ElIY_: 9 "- 3.0 GPH Pl:24.730 P2:24,718 PSI 0.20 GPH PI: 0.000 P2: 0,000 PSI r"lID TEST P1: 0.000 P2: 0,000 PSI W 3:DIESEL ------ DISPENSÌNG ENABLED TEST COMPLETE PENDING PUMP OFF HANDLE OFF CRC:3275 PARITY:1716 3,0 GPH PI :21 .866 P2:21 .730 PSI 0.20 GPH P1: 0.000 P2: 0.000 PSI MID TEST PI: 0.000 P2: 0.000 PSI .~ .......- '- -, ~ -- . ~-~-~- W 4 :PREr'1. UNL, -- --- DISPENSING ENABLED TEST COrvlPLETE PENDING PUMP OFF HANDLE OFF CRC: 391, PARITY: 2 3.0 GPH PI :241,656 0,2/ GPH PlI: 0.000 ~ D TEST IPI: 0,000 P2:22.920 PSI P2: 0,000 PSI P2: 0,000 PSI ) ALARM HISTORY REPORT -~--- SYSTEM ALARM ----- PAPER OUT JUL 8, 2003 9:04 AM PRINTER ERROR JUL 9, 2003 10:19 AM BATTERY IS OFF JAN 1, 1996 8:00 AM , - .-,.. -------......-. . ----~-~.~ _,,r- __.--.____ ~- ALARM HISTORY REPORT ---- IN-TANK ALARM ----- T 1: UNL. 1 LEAK ALARt1 SE~ 20. 2001 3:28 PM HI G H WATER ALAR!'! AUG 29. 2001 10:07 AM I OVERF I LL ALARt"' NOV 2. 2002 12:00 AM NOV 26. 2001 9:56 PM NOV 5. 2001 4:28 AM LOW PRODUCT ALARM AUG 7. 2003 12:51 PM JUL 30. 2003 5:12 PM JUN 20. 2003 11 :54 PM SUDDEN LOSS ALARM MAY 21. 2003 10:03 AM MAY 20. 2003 4:33 PM FEB 25. 2003 3:13 PM HIGH PRODUCT ALARM AUG 29. 2001 10:04 AM INVALID FUEL LEVEL AUG 7. 2003 12:46 PM JUL 30. 2003 5:01 PM JUL 19. 2003 6:57 AM PROBE OUT MAY 21. 2003 10:03 AM MAY 20. 2003 4:33 PM FEB 25. 2003 3:13 PM HIGH WATER WARNING AUG 29. 2001 10:07 AM ..........-- -. ---.- ALARM HISTORY REPORT ----- SENSOR ALARM L 1: LI NER OTHER SENSORS FUEL ALARI1 AUG 13. 2003 9:24 AM FUEL ALARM AUG 6.. 2002 9:50 Arvl FUEL ALARM OCT 14. 2001 8:21 At., ALARM HISTORY REPORT ----- SENSOR ALARM WI: UNL. 1 WPLLD SHUTDOWN ALM JUL 30. 2003 5:33 AM WPLLD COMM ALARM JUL 30. 2003 5:33 AM WPLLD SHUTDOWN ALM JUL 25. 2003 6:47 AM DELIVERY NEEDED AUG 7. 2003 10:27 AM JUL 30. 2003 4:08 PM JUL 19. 2003 3:54 AM MAX PRODUCT ALARM AUG 29. 2001 10:04 AM LOW TEMP WARNING MAY 21. 2003 4:15 PM MAY 20. 2003 4:55 PM o /28/01 07:45 'B~6_26 0576 BFD HAZ :IIAT D_ @002 ~ MONITORING SYSTElVI CERTIFICATION [-'Qr UJe 8v All Juri.l'diC:IIIIII:i Wilhi" I¡'~' Stale or" Cu/ifomia Awhurity Ciled: Chupll!r 6. 7. Heallh ami Sa/i:IY Cude: Chaprer /15, Di~'is¡(m J, Tit/e 23, C<//¡jlmlÍa Code of Regu{QliUl1J if j:; torm must be used to document testing and servicing of monilOring equipment. A SeOllfUte certitication or report mu"t be DreDared 1'0 ~:lch monitoring wstem conlrol P.~1~ by the technici¡¡n who performs the: work. A .:opy of this form must be provided [0 lhe lank $)1 tem owner/operator. The owner/operator must submit n cop)' of this rOnTI to the loe:ll agenc)' regulating UST systems within 30 da s or test date, A . General Infor¡najjpn Fa ilitv Name: . ~ Bldg, No,: Sit, A:jdress: &,~tZ¿_~H/~ ,./~, City: ~~.o. Zip: 9-~~"'9 F:l ilit)' Contact Person: /7?/fk' $~V..,;;..v~ Conrnct Phone N'o,: (//¢ )..393- /,o¿,D M keIModel ofMoniloring System: ~~ ~T _ ~~ Dale of Tc:sting/Servicing: ð- /¿;£/~ Model: r-.-todel: ModeJ: MOOel: ._____ Model: Model:~~ , Tanls.JD: ~ ~-T¡¡nk Gauging Probe. Model: P/AJ6 / q Annular Space or Vaull Sensor, Model: Q Piping Sump / Trench Sensor(s), Model: Q Fill Sump Sen~or(s), Model:, CJ Mechanical Line Leak Detector. Model:' ij;a"'Elecrronic Line LeaY. Detector. Model: A-JP~/) CJ Tank OvertiIJ / High-Lèvel Sensor, Model: CJ·Otr.er (s cif e ui em t e and model in Seclion E on Pa e 2). I Tank ill: 8'1n-Tank Gauging Probe, Model: CJ Annular Space or VAult Sen:ior, Model: o Piping Sump / Trench Sensor(s), Model: Q Fill Sump Sensor(s). ModeJ: Q ~lechanicaJ Line Leak Deteclor, Model: ~EJectronic Line Leak Deteclor, ModeJ: ~.JP"'¿¿tfD Q Tank Overfill / High-Leve! Sensor, Model; Q Olher (:i ecifv e ui ment I e and model in Section Eon Paae 2). Dispenser lD: :J ~penser Containment Sensor(s), Model: :n hear VaJ ve(s), u Dis enser Containment Float(s) and Chain(s), Dispenser ID: ::J Dispenser Containment Sensor(s). Model: , 3""'Shear Valve(s), U Dis enser Containment Float(s) and Chain(s). Dispenser ID: o Dispenser Containment Sensor(s). Model: :.ïr'!rICur Valve(s), o Dis enser CQntainmenl Float(s and Chain(s), Include infomlalion for every lank and dispenser at the facility, Ta kill: -¿) n-Tank Gauging Probe, Model: E~ .,I Þù1nular Space or Vault Sensor. Model: ¡ping Sump I Trench Sensor(s). Model: ___ iIJ Sump Sensor(s). Model: eehanical Line Leak Detector. Model: lecrronic Line Leak Detecwr. Model: Ø?~ ani< Overfill i High·Level Sensor. Model: _,___ e and model in Section E ~Pa e 2), - ----..------ C, Certification· I certify that the ~uipment Identilied in this document was Inspected/serviced in accordance with lhe manufacturers' guidelines, Attached to this Certification Is Infonnation (e.g, manuCacturers' checklists) necessary to yerify that tlùs Infomtation is to"''' ",. Plo. PI" 'bowl', th, I.,out of mOrn""ng .qrnpm"'. Po. ~. "'p,bl. of g,n"""g ",b "p'''o. (b", '('0 attached a copy of the repcw: (che:J>1!1 !}¡al apply): . IrSystem set,up . m h~.~~rt . Te.; n¡cian Name (print): ~ ~A!> Signat <;, ~ -c-J _ Cert t¡cation No,: ~ Licen~e, No.: .s-M~'l 7 Tc:st ng Company Name:~ ~~/"A~..___ Phont: N().;(~J-~-'- Q/~t1 Site ddres>: -9'tb/ "7 ~ ~~:... Date of Testing/Servicing: _5 /"B /C]3 Page 1 or 3 03101 ,\-10 Haring System Certitic:~tiún 9/28/01 07:45 'ð'6t41Þ26 05ï6 BFD HAZ MAT De @002 , MONITORING SYSTEIVI CERTIFICATION For Use Bv All JurisJiC:llll/!ö Wilhlll lilt' Sill/I! II; California AlIIhuri(\' Cill!d: Ch'/pler Ô, 7. Health ami Suf/!/y Cud/!: Ciwf'ler II), Di~Ú¡(m J, TiTle 23, C<lIijlJr/Ú" Codl! of Regulaliulls is form must be used to document testing ano servicing or moniloring equipment. A s~para[e certitiCi11ion or repo" mu,~[ be DreDared (,I c::\ch-II!QJ1ilOring sYstem conlrol P.~1~ by the technician who pedorms the work. A copy of this form must be provided 10 the lank y, [em owner/operator. The owner/operator must submit II copy of [his form [0 the 10'::11 agency regulating UST systems within 30 a s or teSl date, . G~neral I~n :J. ¡Iity Name: ~ il' Address: ¿;"-9aL_~T.c!.- ~ a ìli[)' Contact Person: keIModel of Moniloring Syslem: City:&~, Bldg, No.: zip:9~ Contnc[ Phone No,: ( Dale: ofT.::sting/Servicing: _/_/_ . Tank lD: a In-Tank Gauging Probe. Mode!: a Annular Space or Vaull Sensor, Model: o Piping Sump / Trench Sensor(s), Model: a FW Sump Sensor(s), Mode!:_, a Mechanical Line Leak Detector. Model:' CJ Electronic Line LeaY. Delector, Model: CJ Tank Overtill/ High-Level Sensor. Model: CJ Otl:er (s cif e ui mem t e and model in Seclion E on Pu e 2). Tank ill: CJ In·Tank Gauging Probe. Model: CJ Annular Space or Vault Sensor. Model: o Piping Sump / Trt:nch Sensor(s), Model: CJ Fill Sump Sensor(s). Model: CJ ~lechanicaJ Line Leak Deteclor. ModeJ: CJ EJectfonic Line Leak Deteclor, ModeJ: Q Tank Overfill / High-Leve! Sensor, Model: a Other (5 ecifv e ui mem t e and model in Section Eon Puoe 2), Dispenser 1D: ::¡ Dispenser Containment Sensor(s), Model: u Shear Va]lIe(», Ü Dis enser COlHainmen[ Float(s) and Chain(s), I Dispenser ID: o Dispenser Containment Sensor(s). Model: o Shear Valve(s), Q Djs enser Containmenl Floal(s) and Chain(s), Dispenser lD: _ 1:1 Dispenser C()mainmem Scnsor(s), Model: U Shear Vallle(s), 1:1 Dispenser CC'nlainment Floa[(s and Chain(s), Ol( t e facility contains more lanks or dispensers. copy [his form. Include Infom13[lon for every lank and dispenser a[ [he facility, J Certification· I certify that the ~uipment Identì1ied in trus document was Inspected/serviced in accordance with the manufacturers' guidelines, Attached to thIs Certification Is Information (e,g, manufacturers' checklists) necessary to \'erify that tlUs Infomtation is correct and a Plot Plan showing the layout of monitoring equJpmeßt, For any equipment capable of generating such reports, I hav~ also aUached a copy of the report: (check aU that apply): :J System set,up a Alarm history report T .: nlcian Name lprint): Signatur~: _ C1 '- , " L' N -¡r ItlcatJon ¡,o,: 1,;e!1~e, ~ ().: T¢s ing Company Name: ___,___ ..___ S¡I e Address: a kill: n-Tank Gauging Probe. Model: _ nular Space or Vault Sensor. Model: iping Sump / Trench Sensor(s.). Mod.::l: ___ ;¡¡ Sump Sensor(s). Model: lechanical Line Leak DeleClor. Model: lectJ'onic Line Leak Detector. Model: Bnk Ollerfill i High-Level Sensor. Model: _._-,-L-__ lher (s ecif e ui ment l e and model in Section E on Pa e 2), Model: !o,'todel: ModeJ: Mood: ._____ Model; Model: ,___ --.....----- - ----..----- Phon~ No.:(_J Date of Te8ting/Servicing: __I __/_ Page I of 3 OJ/Ot Mo ¡coring System Certilication '" U~ /:!!!/Ol 07:46 'ð,6.326 0576 BFD HAZ MAT D__ @O I~, Results of Testing/Servicing S }flware V~rsion [nsl:llJed: fi Ol) ( 0 mplete the following checklist: - ç . Ye,s a No" ! [s the audible alarm operational?' , ( Yes ~No" I Is the visual (l(arm operational? I ç Yes 0 No* Were all sensors visuaJly inspecled, functionally tested. and confirmed opcr¡¡tional? i Yes a No* Were ail sensors installed at lowest point of secondary containment and positioned so that other equipment will nOI interfere with their proper operaùon? I: Yes 0 No" [f alarms are relayed to a remote monitoring slation, is 3]( communications equipment (e,g. moáem) ¡¡r N/A operational'? Yes CJ No" For pressurized piping systems. does the turbine aUlomatical!y shut down if the piping secondary containment I Q N/A I monitoring system detects a leak. fails co operale, or is elecr.ricaJly disconnected? If yes: which sensors initiate positive shut-down? (Check all t}¡at apply) ~ Sump1Trench Sensors; 0 Dispenser Containment Sensors. Did you confirm positive ShUl-dQwn due to leaks and sensor failure/disconnection? C1J"Yes: q No. D Yes Q No· Por tank system> that utilize the monitoring system as the primary tank ovc:rtìll warning device (i.e, no ~ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill point(s) and operating properly'~ If so, 01 what percent of tank capacity does the alarm trigger? 9ð % iii Yes· Q No Was any monitoring equipmenl replaced? If yes, identify specific sensors, probes, or olher equipment replaced and list the manufacturer name and model for all replacement Parts in Section E, below. 0 IV es· ~No Was liquid found inside any secondary containment systems de,~igned as dry systems? (Check all that apply) Q Product: Q Water, If yes, describe causes in Section E, below. fi Ves Q No· Was monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable G I" "es Q No'~ Is all monitoring equipment operational per manufacturer's specifications? .,. I Section E below, describe how and when these deficiencies were or will be corrected, E. Comments: ~...~ ~A,1 11 b~N6 ~~. - -' . - ,..... ¡ -----.-".--,--..- .....---_...-....~---_._-~._--_.__.__._---_.__. -~-~..._------_.------------- ---..------......--..-.--.- ...-.-.......------.-. - .----- ...-..-..-.-........ .---.--- ---..~--~ Page 2 of 3 OJ/O! 03 '" C9/28/01 07:47 ~6.326 0576 BFD HAZ ~rAT 11 , 1410 j . In-Tank Gauging / SIR Equipment: u Ch~ck this box if tallk gauging is used only for inventory control. o Chc:ck this box jf no tank gauging or SIR equipment is installed, . 1 his section must be completed if in-tank gnuging equipment is used to perform leak detection monitoring, t omplete the fol1owiß1! checklist: !O Yes Q No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? IS' Yes a No* Were all tank gauging probes visually inspected for damage and residue buildup? ~ Yes 0 No* Was accuracy of syst~m product level readings tested') i: Yes 0 No" Was accuracy of system water level readingstesled'? .a; Yes 0 No'" Were all probes reinstalled properiy? ~ Yes 0 No" Were all items on the equipment manuìaclurer's maintenance checklist completed? ... n the Section H, below, describe how·and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): o Check this box if LLDs are not instaBed. C mplete the foUowln2 checklist: ~ Yes o No* For equipment start·up or annual equipment certification, was a leak simulated to verify LLD performance? 0 N/A (Check all/hat apply) SimuJated leak rate: ~ 3 g.p,h,: Ù 0.1 g.p.h; 00.2 g,p.h, .. )ëJ Yes 0 No" Were all LLDs contimled operational and accurate within regulatory requirements? ¡¡(f Yes 0 No'" Was the lesting apparatus properly calibrated? - . a Yes ,0 No* For mechanical LLDs, does the LLD reslrict product flow if it detects a leak? :2Ø" N/A ø' Yes o No" For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? 0 N/A 51 Yes Q No* For electronic LLDs, does the turbine automaücally shut off if any portion of the monitoring system is disabled (J N/ A or disconnected'? ~ Yes o No" For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring syslem malfunctions o N/A or fails a test? ær Yes Q No* For electronic LLDs, have all ucccssible wiring conneclions been visually inspected? :J N/A ~ Yes 0 No'" Were all items on the equipment mllnufacturer's maintenance checklist completed? '" I the Section H, below, describe how and when these defIciencies were or will be corrected. II, Conunents: - .. , - - ..--.....---. - - .-- "'--.-. '; .. -..--....-..- -' -.-- . -......------- - ---. - -- - - - . rage .3 or 3 03/01 04 " I I r I Monit ring System Certification I I I Site AI ress: ¿, -Y¡J/ I e e '> UST Monitoring Site Plan b.J/I/:r~ ..,¿/.. . .; " " .' " , .' .' '." . :'~. " ' " .. . '. . ,.. " " "- ".. : , '1,' .' .. I i ' , :.ß i 'E.t: :'01. ~ OIl? '04 ¡,aä :3 ' , . '. " , . ..... ,",' .- " ..:.;;" " ., $D&. :-to g, : i~ Jf, : . . . , , . . , . . '.5' ,,' , . . , . , . : (j~-r~~~ : . ~~ )?ebBëS: 0' .' . : Þ.D)~: . ~. . ~ ," ~ I" '. Ie: I " , " '.. 0' ...... ", . .,' '..: .;. . ,. ,";. i ¡ ; . , i . , . , , . l!ìðli¡ iÞR : : ~.,: . ....-..'.. '.' " ,," ",' .. . , '. , . " , . .. ~ , " Date map was drawn: kl.ß..i t:;3, Instructions If yo~, ~ready þ'~Y~,a ,~i~gr~m..$~~.:sho\Vs :a~~ ,~~~~ir.~~)I}fo~a~i9~!J.'<;~:.~t,i,~~!~,ª~.H' ~~h,9I;0)~~~~~~~~~' ;~.tþ y~ur MOnIt nng Sys~em ,ççrtlficati9n~·,.0n your slte. pl~,show th,e,gener!!,l. )~yout ,oft,¡µ\ks aIJ.d ,plplpg. ::C.Ie¡rrlYldentlfy .1 ". ". ..... . ',' .'~:. . 't·,;···-·:···· ", '. .,'-. ·...t.· ," _·~.~..."'ò~.~...:u41.~t'''"'~.::.:. .:..,........:~...~,\.,.".~,....:,...,~...;,~..::'?..._~.,..._.. .~.:.~......;. . . locah() s. of the folloW1ng equIpment, if installed: :!i:'rnonitoring 'system "Çþri~9¡ p;mel~rserišors ïiiolutÖnrig'tank annular i ' . ' '. '",' -' ,. ", ~_\ .,. " ~ '. , . .",.. . ~ .. "., '.. :... .~. ..... - . spaces sumps, disPenser pans, Spill containers,; or Other secondary contairirij~Ì1tãreas;mechai1Ïcal or ''è1ectrönic line 'leak detectl rs; and in-tank liquid level probes (if used for leak detection). . in the Space provided, nòte the date this Site Plan ! . . " ... . ~"....". . ." -.-. .. . -.. "~ . .-" was Pf pared, '. ' ., ,. . ." '. . .... " '-" ..' i . ,~".~".i.. . .... "". 'X"",:?: :i{·.... ...::........ .'.'. .; . :-:..~..~:- ,.~,.:. ..~. P;i~~;' O~¿2[~~~~tii~j~1":;? 05100 . . '~þ e . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave,. 3rd Floor. Bakersfield. CA 93301 FACILITY NAMEJá.~h\p INSPECTION DATE &-/0 ,() 3 Section 2: Underground Storage Tanks Program o Routine a;rtombined 0 Joint Agency Type of Tank ,'1WFt. ~ Type of Monitoring -AT (., o Multi-Agency 0 Complaint Number of Tanks tf Type of Piping ~ Pr ORe-inspection OPERA TION C V COMMENTS . \... V Proper tank data on tìle Proper owner/operator data on tìlc \./ V ~ Penn it fees current V ~ Certification of Financial Responsibility ...... V Monitoring record adequate and current ( Maintenance records adequate and current ~ Failure to correct prior UST violations ~ Has there been an unauthorized release? Yes No / Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA TION Y N COMMENTS SPCC available SPCC on tìle with OES Adequate secondary protection Propcr tank placarding/labeling Is tank used to dispensc MVF? If yes, Does tank have overtìll/overspill protection'? C=Compliance Y=Yes N=NO ~~. Business Site Responsible Party Inspector: Office of Environmental Services (661) 326-3979 Whitc - Fnv, Svcs, Pink - RlIsincss Copy e ,- "'~ - '..."-\ ':,>.,,, ---.~ - ------- FASTRIP 350 e-'~~1 WHITE LN. i .D. ,CA. 93309 6151-397-0271 JUN 16, 2003 9:28 AM SYSTEI"I STATUS REPORT - - - - - - - - - - - - PAPER OUT PRINTER ERROR INVENTORY REPORT T 1: UNL, 1 VOLUlvlE ULLAGE 90% ULLAGE'" TC~UME 1(''1 ' HE~t,~ WA1'E::¡-1 VOL WATER TEMP ¡i_2.:.E:LUS_- VOLUt"1E = ULLAGE '" 90% ULLAGE'" TC VOLUr"IE HEIGHT I¡JAT'"'8. VOL wd / ' TE~ T 3:DIESEL VOLUME ULLAGE 90% ULLAGE'" TC VOLUr'1E HEIGHT WATER VOL WATER TEMP T 4: PREf'" , VOLUI"1E ULLAGE 90% ULLAGE'" TC VOLUr1E HEIGHT (,^TER VOL \. ..¡ER TET"IP 89:35 GALS 3055 GALS 1855 GALS 8816 GALS 55.94 INCHES 48 GALS 1 . 7 2 I NC HES 78,9 DEG F 5142 GALS 6858 GAU3 5658 GALS 5070 ':;ALS 42.60 INCHES ° GALS 0,00 INCHES 80.0 DEG F 4132 GALS 7858 GALS 5668 GALS 4095 GALS 36,14 INCHES 15 GALS 0,79 INCHES 79.:3 DEG F UNL, 4857 GALS 7143 GALS 5943 GALS 4792 GALS 40.79 INCHES ° GALS 0.00 INCHES 78.9 DEG F M M M M MEND M M M M M , . - .'\........ e , '... ----- -, .i;" . ""'V'"',~,. "',_ !'~'_::'~':"~;~'$-';¡':;-~' e e UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: {661}326-3979 FACILlþoNAME INSPECTION DATE INSPECTION TIME ~~h+-~_m ... ... m_____ . .. --- _____._mu_ ..... ...... ..!£~LJ.·9L ""'7''''- ~~~_~-':l () I (,Ù~ ~ t-'-_1_('j_________._________________________.____~________ lCJl:w_7l__ _____ ~ ________ FACILlTYCONTACT Business ID Number 15-021- Section 1: Business Plan and Inventory Program o Routine O"Combined o Joint Agency D Multi-Agency D Complaint D Re-inspection C V ( C=Compliance ) \i=Violation OPERATION COMMENTS LU:/b ApPROPRIATE PERMIT ON HAND --:--_./----------------------------~--------_. ------.-------.----.-,------.- ---.- ----------- .--.----------------.--- --..--..----- _on. ___ iD/ D BUSINESS PLAN CONTACT INFORMATION ACCURATE --~---~SIBLE AD~RESS--------------------n------------------ -------------~ ---------------- ----------. - ----- . f----.-----,-----'---------------------- .------------------- -.--,----- ----.-... --- _ -,-----.---- ------ -, -. ---- - --- --- ----.------- .-----.-- - ,~- - IQ.;1J CORRECT OCCUPANCY ~~- VE~~IC~;IO~-~F-I~~~NTORY ~~TE~IAL:-------------- - - _·____________n__ ------ --- _______·_._nu____ --.--. ---- ------------. ..- ------- __'___~~__.__.~____..__________..~_______.___.___....____.__._ _____ .....______. _ .__ __.,____" _. _______,_'u ... _. ..___.____.__ u _________....._. .__ . __ __ __.-.___ ..._ 0/' D VERIFICATION OF QUANTITIES ~-·-·--7¡:--·-----------------------'------·----- rtY' D VERIFICATION OF LOCATION u__._._________...__.....__ .___ . ___.___.______________ __.·__.___.__.._._..._"__·____..~m.~______.,_.~__·,·__ __._ _ '__.._.n.__ ..n an -------_._-~-------_._------_._----_._---------_._--_.------.------.-..- --- -.------- ._,-_..--~. --.-..- .. .-,-.+....---.-.. ------. --.- ....- .....-....- ~,.~_....__...- C\L/Ó PROPER SEGREGATION OF MATERIAL ---¡..-.-.7-----------------------.------ ---------.----------------.--.-.------ -, ___.__________n_______. .---------- -- - ... __·___________m -------- ------ _..__n________· ...--.- IL/'D VERIFICATION OF MSDS AVAILABILlTYE -~-nV~~-I~I~~TION OFH-~-M~~~~;~~------ _____________·___h ----------------------------------------------- - ------ ..____u__ f----.------------------------------.----------, -------. .-------- ____________.____________.m_____ -, -------..-- .....- ¡]/' D VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES - -~-- E~~RGENC~-;;~CED~;~~u~DEQ~~TE---m-----------------m------------------..----------- - ------ --------.- --------------- ------------J---------------------------------.. --------------.---.-.---------,---------- __m___ --------~--,------------,-.. - .-.-------.-.-..--.- _____m_ ,--- --- ~ CONTAINERS PROPERLY LABELED I ----~------.-.----. _______m____ ______.___ _._______.____ ·_______m____.__ .__ __ -----l-..---- _.__.______ _ _nu_ __.__n___n._ _ _ _.. ______ __ _________m____ ._._____ D HOUSEKEEPING . 1----- ---r----·-·--------------------------------------·-----·----- ,-- __._n____ ---. ----------- -,---------.-----------------.--------.--------. - - ____n___ --- g 0 FIRE PROTECTION --~r:J--- SI~~D-;--;~~~MA~~~~~~~--&-O~---H~~~----- _____un____ ------------- --- ------.------------- .. -----.-..-.-.-. ----.--....-..---.---- ."._ .._. _ u.__._____._... ANY HAZARDOUS WASTE ON SITE?: DYES ~ EXPLAIN: QUEZTIONS GARDING./ __ (I -- ----._- --. . Inspector L( _ ~'___u usiness Site Responsible Party S I ¡PECTION? PLEASE CALL US AT (661) 326-3979 - ._n._ __.._._______._____~___~__. Badge No,_ White . Environmental Services Yellow . Station Copy Pink . Business Copy ~ -.::.J - e e Xl TRACER TIGHT® TEST RESULTS tor C{)\1~ Reg\l\~ Shirley Enviromnental LLC 1928 Tyler Avenue, Suite K South El Monte, CA 91733 1/10/2003 Job No: 860152 Jaco #360 6401 White Lane Bakersfield, CA 93309 SYSTEM STATUS SYSTEM# PRODUCT SIZE TRACER TRACER DETECTED? Tank 1 Tank 2 Tank 3 Tank 4 Unleaded Plus Diesel Supcr 12,000 12,000 12,000 12,000 W G R W NO NO NO NO Soil penneability is greater than 4.4 darey!, GROUND WATER AND PRODUCT INFO AT INOCULATION AT SAMPLING 12/20/03 12/27/03 DEPTH FROM GRADE WATER TANK TANK TABLE BOTTOM TOP Tank 1 Tank 2 Tank 3 Tank 4 H20 (in) 0.00 0,88 0.94 0.81 PROD (in) 44.00 44.00 49.00 60.00 H20 (in) 0,00 0.00 0.77 0.84 PROD (in) 64.00 70.00 37.00 52.00 (in) (in) (in) >120 139 43 >120 139 43 >120 139 43 >120 139 43 SYSTEM# SITE COMMENTS Backfill in tank pit consists of v.. to \Ii inch pea graveL Ground cover over tanks and piping trench is concrete; IIId asphalt. TEST EVENTS INST ALLA TION 12/20/03 INOC JLA TION 1~/20/03 SAMPLING 12/27/03 ANALYSIS 01/06/03 FILL RISER - SPILL BUCKET TEST TANK# Tank I Tank 2 Tank 3 Tank 4 P ASSIF AIL Pass Pass Pass Pass I declare under penalty of perjury tt. at I am a licensed tank tester in the State of California and tllat the information contained in tbis reF ort is true and correct to the best of my kno ~e ge. Install/Inoculate " 1-/3 '17-... CA Lie. ?Co: Signature ' SampJer 62~ /63S' CA Lie, 1'10: Signature TRC Anal~ CJ 3 - ~ , 0 CA Lic, .,. fo: Signature Date Date , µ~.5 Date t/J ,fa 3 2'd LI0L-vvv-929 e20:tt EO v2 ~d~ " e --. e Test Comments General Tanks 1 through 4 are single walled fib~rglass, Product distribution lines are single walled fiberglass. Vent and vapor recovery lines are single wal led fiberglass. Tank 1 No Tracer Detected Tank 2 No Tracer Detected Tank 3 No Tracer Detected Tank 4 No Tracer Detected .. E'd l..!Ol..-vvv-S~S ~~o:!t EO v~ .Jdl::J -; e e Tracer Research Job No, 860152 Page 3 of 5 Sample Date: 01106/03 CONDENSED DATA Location Compound Concentration 001 G 0.0000 001 R 0.00000 001 W 0.00000 001 TVHC 0.49300 002 G 0,0000 002 R 0.00000 002 W 0.00000 002 TVHC 0.30900 003 G 0,0000 003 R 0.00000 003 W 0.00000 003 TVHC 1.53200 004 G 0,0000 004 R 0.00000 004 W 0.00000 004 TVHC 1.64400 005 G 0.0000 005 R 0.00000 005 W 0.00000 005 TVHC 0.27000 006 G 0.0000 006 R 0.00000 006 W 0.00000 006 TVHC 0.27800 007 G 0.0000 007 R 0,00000 007 W 0.00000 007 TVHC 1.47200 008 G 0.0000 008 R 0,00000 008 W 0.00000 008 TVHC 0.31900 009 G 0_0000 TVHC (Total Volatile Hydrocarbons) values reported n milligramslliter (mgIL). Tracer A, R. and W values reported in milligramslliter (mg/L). Tracer E, G, H, and I values reported in microgramslti' er (µgIL). 0.00000 ~ Not Dctected -999999.99999 = No samplf þ'd ¿!O¿-Þt>t>-9Z9 ezO:!! EO ÞZ ~d~ e Tracer Research Job No. 860152 Sample Date: Olf06f03 Location 009 009 009 010 010 010 010 011 011 011 011 012 012 012 012 013 013 013 013 014 014 014 014 015 015 015 015 016 016 016 016 ---e Page 4 of5 CONDENSED DATA Compound Concentration R 0.00000 W 0.00000 TVHC 0.21900 G 0.0000 R 0.00000 W 0.00000 TVHC 0.15700 G 0.0000 R 0.00000 W 0.00000 TVHC 0.34600 G 0.0000 R 0.00000 W 0.00000 TVHC 0.00000 G 0.0000 R 0.00000 W 0.00000 TVHC 0.05700 G 0.0000 R 0.00000 W 0.00000 TVHC 0.09700 G 0.0000 R 0.00000 W ' 0.00000 TVHC 0.00000 G 0.0000 R 0,00000 W 0.00000 TVHC 0.36700 G 0.0000 R 0.00000 017 017 TVHC (Total Volatile Hydrocarbons) values reported in J nilligramslliter (mgIL). Tracer A, R, and W values reported in milligramslIiter (rr glL). Tracer E, G, H, and I values reported in micrograms/1iter (µg/L), 0,00000 =' Not Detected -999999,99999 = No sample S'd ¿YO¿-vvv-sas aEO:YY ED va ~d~ e Tracer Research Job No. 860152 Sample Date: 01/06/03 CONDENSED DATA Location Compound 017 017 W TVHC 018 018 018 018 G R W TVHC 019 019 019 019 G R W TVHC TVHC (Total Volatile Hydrocarbons) valucs reported in milligramsllite1'(mgIL). Tracer A, R. and W values reported in milligrnms/liter (1' IgIL). Tracer E, G, H, and I values reported in micrograms/1iteJ (µgIL). 0,00000 = Not Detected -999999.99999 = No sample Sod LIOL-ioo'ioo'ioo'-929 e- Page 5 of 5 Concentratiolll 0.00000 0.00000 0.0000 0.00000 0.00000 0.20500 0.0000 0.00000 0,00000 0,00000 eeO:I1 eo ioo'2 ~d~ " ,e e " Truer Research Corpora 00 m EXPLANAT 1: 0 N S~linq Probe Location --- Approximace Pipeline Loc~tion .MW Monitoring Well Location >. IU :I '" iii 0 II: Tank 1 12,000 gal ~ Unleaded Tracer (W] N Tank 3 n 0 8 c: ale 12,000 gal Diesel Tracer [R 860152 rs H IRLEY E N V I RONMENTAL J a c 0 # :3 6 0 6 4 0 1 W H :r l' " L "01 B BAK8RSPIBt.D C:"LXPOkNXl\ SAMPLING LOCATIONS - Fig u r e 1 rrï1 rñl ¡Uf' ilUI D :.12 13,ICJ I I I I I I I I I'll 14': I I' l: . 1[01 I 1 11 MW 1 1:+--=.--- 0 ~ I 0 oeo 4 3 , - ' ~ 0 oeo S 6 , : . ~ 0 oeo 8 7 , , ~ 0 000 , , ~ 10 19 18 v.nt. . _ _ _ _ ~ _ 0000 _ I I I I ~ 1 ., I 5 I ~ I 1'17 I I I 1 I I I 1'16 t I I 1 I I I 1 I' ~ I L_ B u i 1 d i n 9 Sidowalk p11.,860152 ala.IA Arc::.8501~:Z oa~.1 01-1.~-O3 Tank 2 12,000 gal Plus Tracer [G Tank 4 12,000 gal Super Tracer IN r-- , ~ r-- .... o r-- 1 '<t '<t '<t 1 CD C\J CD /1 C") o .. .... .... C") o '<t C\J to, ~ cr FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "W SIreet Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "W Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395-1349 PREVENTION SERVICES FIRE SAFETY SERVICES' ENVIRONIlENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBLIC EDUCATION 1715 Chester Avè. Bakersfield, CA 93301 VOICE (661) 326·3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX(661)326-Q576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 , VOICE (661) 399-4697 FAX (661) 399-5763 -- -e. January 22, 2003 FarrelIs Fastrip 6401 White Lane Bakersfield CA 93309 RE: Upgrade Certificate & Fill Tags Dear Owner/Operator: Effective January 1,2003 Assembly Bill 2481 went into effect. This Bill deletes the requirement for an upgrade certificate of compliance (the blue sticker in your window) and the blue fill tag on your fill, You may, if you wish, have them posted or remove them, Fuel vendors have been notified of this change and will not deny fuel delivery for missing tags or certificates, Should you have any questions, please feel free to call me at 661- 326-3190. SinCe¡, jfkdLo Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dc --y~ de W~,g7Oft uØ60RÞ y~ A W~" 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 FIRE SAFETY SERVICES' EIMRONIIEIITAl SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX(661)32EH0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 32EH0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326.()576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX(661)3~5763 It ,·e ¡<- ~~ :.~ "¡ October 31, 2002 Farrells Fastrip 6401 White Lane Bakersfield CA 93309 CERTIFIED MAIL REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31, 2002 of underground storage tank (s) located at the above stated address. Dear Tank Owner I Operator, If you are receiving this letter, you have !!2! yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). Senate Bill 989 became effective January 1,2002, section 25284,1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%, These have been due to the penetration boots leaking in the turbine sump area. For the last six months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perfonn this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to Derform this test. bv the necessary deadline. December 31. 2002. will result in the revocation of vour Dermit to oDe rate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders, Should you have any questions, please feel free to call me at (661) 326-3190, Sincerez[ j ¡J /J ~ ~bt() Steve Underwood Fire Inspectorl Environmental Code Enforcement Officer Office of Environmental Services -"Y~ de W~ .¥OP vØ6~ ..r~ A W~" /\ --/ -tit rr~ 4-~ :it> ~ "''' U.S. p.ostal Service 'Lr1 CERTIj6iD MAIL RECEIPT . : ~ (DOme~ail Only; No Insurance Coverage ProvIded) ..n - '.-'I ,~ ,..n .-'I , c::J , c::J c::J 'c::J c::J ..n cO c::J Xl:.. L p( USE Postage $ Certified Fee Postmatk Return Receipt Fee Here (Endorsement Requited) Restricted Delivery Fee (Endorsement Required) Total postage & Fees $ , ru , c::J c::J Sent To ['- F ARRELLS F AS~!!'m.m......""'''''''......' Si;eëi;ii¡;;:;¡õ:;m.....m........................~ or PO Box No. 6401 WHITE· ................,.............. ëiiÿ,"siåië.·ŽI¡;+4··m·BÄiËRSFÏËiñ·~···ëi· 93309 :1' " ,t .. . - . . . · Complete items 1, 2, and 3. Also complete , item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1, Article Addressed to: , 1 8, ,R1\eived by .( Printed N /Y~;4"L/l./ D, Is delivery address different from item 1? If YES. enter delivery address below: SEND-ER: COMPLETE THIS SECTION o ~ FARRELLS FASTRIP 6401 WHITE LANE BAKERSFIELD CA 93309 3, Service Type XI Certified Mail D Registered D Insured Mail D Express Mail D Return Receipt for Merchandise DC,OD. 4, Restricted Delivery? (Extra Fee) DYes 7002 0860 0000 1641 6605 PS Form 3811, August 2001 Domestic Return Receipt 102595·02·M·0835 <.Y" 'O!',"'01 ()ï:45 \ 'B'661_6 05ï6 BFD HAZ :II.-\.T DI\e @002 ? MONITORING SYSTE~I CERTIFICATION For Use Bv All JurisJi(.'(/()I!J W/IIIlII l/rt' Swre (if C((¡¡{omÙ; Awhurirv Cired: C/wP!1!r <5.? Heal/h w¡d Safn.'>; Code: Clwf'11.'r 16, Divisirm J. Title 23, C"liJ(JTIlill Code of Regulariuns This form must be u~ed to document testing and servicing of monitoring equipment. A separate cerlitìcation or report must be prepared f()U~3ch.....!I}ºÐitori¡¡!!: sYstem control p<1!1el by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this t'orm to the local agency regulating UST systems within 30 days of teSI dale A, General Information Facility Name: -þ~í?'-¡k ~e3<dc> Site Address: ~_~fpl £<lfhrr:: /..4-iU[,: F:lciJj¡y Contact Person: 'Tcþ¡ /::;~i"j/r:..t/ Bldg, No:: City. ----Ba.KG-f:, r:;¡;¡- ~ Zip: q-:r"Jo'i _____ COlHflcr Phone N'o,: ( t:,cP I ) (')c)7 ,/02- -¡;/ Date of T~Sting/Servicing:' LLI ð¿ Make/\1odel of Monitoring System: 'rL5 -3..5...0 ~ li,~ II Ii ~ ~ " i! " 1 ¡ " Tank ill: " Tank ID: ~ 0 In-Tank Gauging Probe. Model: ~~ 0 In-Tank Gaugj¡¡g Probe. Model: :11 ':J ."'J1nular Space or Vault Sensor. 'v!odel: I 0 Annular Space or Vaull Sensor. Model: 'I 0 Piping Sump / Trench Sensor(s..L Mode!: ___,..__ I 0 Piping Sump / Trench Sensor(s), Model: '! 0 Fin Sump Sensor(s), Model: 0 Fill Sump Sensor(s). Model: _. :1 :::1 \'Iechanical Line 'LeiÙ< Detector. Model: . 0 Mechanical Line Leak Detector. Mode!;' . ::J Electronic Line Leak DeteclOr. Model: 0 Electronic Line Leak Detector. Modej: CJ Tank Overfill ¡ High-Level Sensor. Model: ' 0 Tank Overt1U / High-Level Sensor, Model: I. 0 Olher (s ecif e ui ment r e and model in Section E on Page 2), ......~r.er (specify equipment type and model in Section E on Page 2), Tank ID: i Tank ID: o In-Tank Gauging Probe, Model: ¡ CJ In-Ta,nk Gauging Probe, Madej: C) Allnul<lf Space or Vault Sensor, ,1,1odel: " 0 Annular Space or Vaull Sensor, Model: o Piping Sump / Trench Sensor(s), Mode]:, 0 Piping Sump / Trench 80n50r(s), Model: I 0 Fill Sump Sensor(s), Mooel: ,_______ 0 Fill Sump Sensl,r(s), Madej; o 1v!echanical Line Leak Detector, Mode; ~ 0 ~lechanical Line Leak Detector. Model: , 0 Eleçrronic Line Leak Detecror, Mode!: --- , I CJ EJectronÍC Line Leak Detector, Madej; II CJ TaDk OverfjIJ.I Hlgh-Level Sensor. Mode!:---- 0 Tank Overtil1 / High·Leve1 Sensor. Model: : 0 Olher (s cifve ui ment I e and model in Se~¡ion E on PaRe n 0 Other (5 ecifye ui ment I e and model in Section E on Pace 2), , . /;lÙ4 :: DIspenser ID: _~~__._..__.__________ ;: 0 J)ispenser Containment Swsor(s), Model: ~Shear YaJ\'e(s), CJ Dis enser Containment Float(s) and Chajn(s). Dispenser ID: /. I" o Dispenser Containment Sensor(s), Model: Q(')hear Valve(s), o Dis ensa Containment Floae s) and Chain(s), Dispenser ID: . __________ a Dispenser Contuinrr.ent Se sor(s), Model: ____ CJ Shear Val\'e(s). :J:)is enser Contaj:lmenl Floal(s) and Chaines), "If the faciliry conlains more tanks or dispensers, copy this form, j Dis'penser ID: :J Dispenser Containment Sensor(s), Model: , CJ Shear VaJveCs), , U Ois enser Containment Floal(s) and Chain(s). I Dispenser ID: o Dispenser Containment Sens:x(s). Mode!: ¡ 0 Shear Valve(s) o Db enser Containment Fj at(s) and Chain(s). Dispenser lD: I 0 Dispenser Containment Sensor(s). Model: CJ Shear Valve(s), , 0 Dispenser Containment Float(s) and Chain(s), lnclude infomJallon for every lank and dispenser at the faci]j(y: I -;; :1 C. Certification· I certify that the f{}uipment identìlied in this document was inspected/serviced in accordance Wilh the manufacturers' gnjdelines. Attached to this Certification is inforTlU1tion (e.g. manufacturers' checklists) necessary to verify that this infomlation is correct and a Plot Plan showing the layout of monHoring equJpjPenl. For any equipment capable of generating such reports, I have also attached a copy ofth,e r,epo'7:)CheCk aU/ha/ appLy): GrSýstem set-up ï:rA'~st~o report Technician Name (print): /. C...y ...J..<J::>.5j.Ct'-S, Signilrur¡;:: _ '~ , ___ 9 f CertitkatIon 0:0,: 7 ~3 \D Liceo~e, No,; ç~S71 Testing Company Name: __:=7;.~5·êrÎ /Yl6c.¡;f __.____ Phof]¡: Nü.:(6Ce/ J 322. -C¡'f>î7 Site Address: ¿:¡ & /) / /5í~b4" /fvt;. Date of Te8ting/SerYicing: _Ç7 / _~/ ~ z.:. f¥; 14::/{~ !"ivÙI Page of 3 03/01 :\-loniloring System Certiticatiun _ 09/28/01 .' 07:46 'ð'661_6 0576 BFD HAZ MAT DI_ @003 ;' Software Version [nstaIJeJ: 0, Results of Testing/Servicing /Lj¡ 00 I I:] Yes'" Co Jete the following checklist: Yes I:] NO'k I Is the audible alarm 0 eratiollal" D No" Is the visual alarm operationaï? o No'" Were all sensors visually inspected, functionall~sted. and confirmed operational? o No'¡' Were ail sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere \vith their ro cr operation? D No¥ If alarms are relayed to a remote monitoring station. is al! communications equipment (e,g, modem) rz" Nt.'" operational'1 CJ No'" For pressurized piping systems. does the turbine automaticaJIy ShUl down if the piping secondary containment __ N/ A monitoring system detects a leak. fails to operate, or is eJect.rically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) Ø"SumpíTrench Sensors; 0 Dispenser Containment Sensors, Did ou_ confirm positive shut-down due to leaks ~ sensor failure/disconnection? ¡¡{Yes: 0 No. D fio" For lank system~ that utilize the monitoring syslem as the primary ~nk overfill warning device (i.e, no ¡;¡¡( N/A mechanical overfil1 prevention valve is insralled), is the overfiJl warning aJarm visible and audible at the tank fill oint(s) and~ating properly': If so. at what percent of ~ank ea acitv does the alarm tri er? 1Bt % Was any monitoring equipment replaced? [f yes. identify specific sensors, probes, or other equipment replaced and list the manufacturer name and mode! for all re lacement arts in Section E, below. Was liquid found inside any secondary containment systems de,~igned as dry systems? (Check all ¡hat apply) 0 Product; 0 Water. If 'es, describe causes in Section E, below. Yes 0 No* Was monilOring s 'stem sel-U reviewed to ensure ro er settin s? Atlach set u Yes 0 No" Is all monitorin . e ui ment 0 c:r¡,¡tional er manufacturer's s ecifications? * In Section E below, describe how and when these deficiencies were or will be corrected. DYes o Yes* licable E. Comments: -~---_._--,.-_._..-.,_. --'-"-' -.- -_.,...._-----~....._-_.~--...__._....._--'-_...__._------.---. ~__.___h.___.____.____.________.___... --_._-----------_......._-_...._~--,-----------_.......-...-.----.--.---...... .-----.,¿.---- ----.-.--- .'.'-"-"-'-"'-'. -_._--_._~------_._... ~--'-' Page 2 (¡f 3 03/01 09/28/01 07,4ï ~66_6 0576 BFD H.E ~IAT DI_ @004 1 F. In-Tank Gauging / SIR Equipment: z( Check this box if tank gauging is used only for inventory control. o Ch~ck this box if no cank gauging or SIR equipment is installeu, This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring, c h f II h kl' OJl1Plete t e 0 OWJnI!C ec . 151: r::fyes 0 No" H¡¡s ¡¡II inpul wiring been inspeC't~d tar proper entry and termination, including testing for ground faults? Ø' Yes 0 No" Were all lanX: gauging probes visually inspected for damage (\Od residue buildup? í2f Yes Q No" I Was accuracy of system product level readings tested') . , ø Yes 0 No* I Was accuracy of system water level readings tested') ¡Zf., Y es 0 No* Were all probes reinstalled properly') ø Yes 0 No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): o Check this box it' LLDs are not insta!led, c h t u h kJ' t ompJete t e 0 owmg c ec IS : -. cr'Yes 0 No'" For equipment stan·up orimnual equipment certification, was a leak simulated to verify LLD perfomance? 0 N/A (Check ail that apply) Simulated leak rate: l:a"'3 g.p,h,; a 0,1 g,p,h : o O,2g.p,h, ./ ---- Ø' J Yes 0 No* Were all LLDs contìm1ed operational and accurate wÏlrun regulatory requirements? ø Yes 0 No* Was the testing apparatus properly calibrated'? DYes . ~\¡O* For mechanical LLDs, does lhe LLD rcslrict product flow if it de,teets a leak? /' ' N/A 0' Yes 0 No* For electronic LLDs, does the turbine automaticaJly shut off if the LLD detects a leak? A 0 NIA 2f Yes 0 No* For electronic LLDs, does the turbineaulomaticaJJy shut off if any portion of the monitoring system is disabled ./ 0 N/A or disconnected? E) Yes 0 No* For electronic LLDs, does the turbineautomaticaJJy shut off if any portion of the monitoring system malfunctions ./ 0 N/A or faiJs a tes¡'i Ø' Yes 0 - - No* For e]ectronic LLDs, have all acccssible wiring connections been visuaJIy inspected? ~ :1 N/A :J No* Were all items on the equipment manufacturer's maintenance checklist completed? . - --.- >I< In the Section H, below, describe how and when these deficiencies were or will be corrected. II, Conmlcnts: -----_._--,.-.- ~._----_. --- --_._--~-_.. ...----- ----------,-. .--.....------------ ..-. ---- Page .3 of 3 03/0 I T 2 :PLUS '2 PRODUCT CODE THERMAL COEFF : ,000700 TANK DIAMETER 96.00 TANK PROFILE 1 PT FULL VOL 12000 FLOAT SIZE: 4,0 1 N. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12000 OVERF I LL Ll M IT : 95% 1 1 400 H lGH PRODUCT 97% 11640 DEll VERY Ll M IT 22% 2640 LOW PRODUCT : 2500 LEAK ALAR!'" L I M IT: 99 SUDDEN LOSS Llt"l1T: 99 TANK TILT : 11 .00 MANIFOLDED TANKS n: NONE LEAK MIN PERIODI~: 1·/ '. 120 LEAK MIN ANNUAL 1% 120 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALRRM DISABLED GROSS TEST FAIL ED ALARM DISABL ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 MIN e IN-TANK SETUP ------ - T 1: UNL. 1 PRODUCT CODE THERr1AL COEFF TANK DIAMETER TANK PROFILE FULL VOL 1 : .000700 96.00 1 PT 12000 FLOAT SIZE: 2.0 IN. 8495 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOL: 12000 OVERFILL LIMIT 95% 11400 HIGH PRODUCT 97% 11640 DELIVERY LIMIT 22% 2540 LOW PRODUCT : LEAK ALARM LIMIT: SUDDEN LOSS LIMIT: TANK TILT ¡·¡AN I FOLDED TANKS Tit: NONE LEAK MIN PERIODIC: LEAK MIN ANNUAL 2500 99 99 14.00 1% 120 1% 120 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED ~,. --".-..- GROSS TEST FA It: ..' ALARr·l '[;'ABLED v~"_·...........~ ANN TEST AVERAG,¡ NG' :""" ,)FF PER TEST AVERAG I NG: "\'JFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DEL I VERY DELAY : 1 5 t"1I N ~T~M_S~T~P _ _ _ _ _ _ ~ 6. 2002 11:14 AM SYSTEM UNITS O.S. SYSTEM LANGUAGE ENGLlSH SYSTEM DATE/TIME FORMAT tvl0N DD YYYY HH: MI"1: SS xr'1 FASTRIP 360 6401 WHITE LN. BKFLD. ,CA. 93309 661-397-0271 SHIFT tItv1E 1 SHIFT TIME 2 SHIFT TIME 3 SHIFT TIME 4 DIBABLED DISABLED DISABLED DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS DISABLED PRINT TC VOLUMES ENABLED TEt"lP COt"lPENSAT I ON VALUE (DEG F): 60.0 SYSTEM SECURITY CODE : 000000 COMMUNICATIONS SETUP ------ - PORT SETTINGS: NONE FOUND RS-232 SECURITY CQDE : 000000 RS-232 END OF r"1ESSAGE DISABLED Õ' ~ :E~K _ T~S: ~ET~O~ _ _ _ _ e TEST ON DATE : ALL TANK OCT 20, 2002 START TIME: 12:00 AM TEST RATE :0.20 GAL/HR DURATION : 2 HOURS LEAK TEST REPORT FORMAT NORMAL WPLLD LINE LEAK SETUP ------ ------ W 1 :UNL. 1 PIPE TVPE: FIBERGLASS LINE LENGTH: 50 FEET T 1 :UNL. 1 DISPENSE MODE: STANDARD W 2:PLUS PIPE TVPE: FIBERGLASS LINE LENGTH: 50 FEET T 2:PLUS DISPENSE r10DE: STANDARD T 4 :PREf"I. UNL. PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL : 4 : ,000700 96.00 1 PT 12000 FLOAT SIZE: 4.0 IN. 8496 WATER WARN I NG , . HIGH WATER LIMIT: MAX OR LABEL VOL: OVERFILL LIMIT : HIGH PRODUCT DELI VERY LI M I T 2.0 3,0 12000 95% 11400 97% 11640 22% 2640 LOW PRODUCT : 2500 L~AK ALARM LIMIT: 99 SUDDEN LOBS LIMIT: 99 TANK TILT 11.00 MANIFOLDED TANKS T;t: NONE LEAK MIN PERIODIC: 1% 120 LEAK MIN ANNUAL 1% 120 PERIODIC TEST TVPE STANDARD ANNUAL TEST FAIL ALARf"1 DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF P~R TEST AVERAGING: OFF TÀNK TEST NOTIFV: OFF ~NK TST SIPHON BREAK:OFF DELIVERY DELAY : 15 MIN e T 3:DIESEL PRODUCT CODE THERMAL COEFF TANK DIAMETER TANK PROFILE FULL VOL , 3 ; ,000450 96.00 1 PT 12000 FLOAT SIZE: 4,0 IN. 8496 WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 t"IAX OR LABEL VOL: 12~g~ OVERFILL LIMIT ~ 11400 HIGH PRODUCT 97% 1 1640 DEL I VERY L I I'll T _ .-: 2~~~ LOW PRODUCT - ,-. : LEAK AtARt1 L I t1 1 T : SUDDEN LOSS LIMI~: TANK TILT . MANIFOLDED TANKS TIt: NONE 2500 99 99 11 .70 LEAK MIN PERIODI?: 1% 120 LEAK MIN ANNUAL ~ 1% 120 PERIODIC TEST TV~~ANDARD ANNUAL TES~LÄ~~LDISABLED PERIODIC T~~¡R~AbTsABLED GROSS TESTAr~k~ DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF DÈLIVERY DELAY : 15 MIN .. e :- I N-TANK DIAGNOSTIC ------ - - - PROBE DIAGNOSTICS T 1: PROBE TYPE MAGI SERIAL NUMBER 206612 ID CHAN = OxCOOO GRADIENT = 351.7000 NUM SA!"lPLES = 20 COO 1311,0 COl 3802.7 CO2 3802,7 C03 3802.8 C04 3802.8 COS 3802.8 CÇJG 3810,5 C07 3810.5 C08 3810.6 C09 3810,6 cio 3810.8 Cll 44236.9 C12 7911.5 C13 8636.2 C14 8902.2 C15 9213.9 C16 9561.4 C17 10030 . 1 CI8 44238. I SAMPLES READ =81800004 SA!"1PLES USED =81792030 I N-TANK DIAGNOSTIC - - - - - - - - - PROBE DIAGNOSTICS T 2: PROBE TYPE t"lAG 1 SERIAL NUMBER 574828 ID CHAN = OxCOOO GRADIENT = 348.4500 NUM SAMPLES = 20 COO 1412,0 COl 7518.1 CO2 7518.0 C03 7518.0 C·04 7518.0 C05 7518.3 CCl6 7518.7 C07 7518.8 C08 7518.8 C09 7518.6 CIO 7518.4 Cl1 44166.9 C12 5392.6 C13 7385.5 C14 7925.0 CI5 8251.4 CIG 8866.4 C17 10156.2 C18 44167.9 SAMPLES READ =80979086 SAMPLES USED =80970299 WPLLD LINE DISABLE SETUP ----- ------ WI: UNL. 1 IN-TANK ALARMS T 1: LEAK ALARM T 1 :HIGH WATER ALARM W 2 : PLUS IN-TANK ALARMS T 2:LEAK·ALARM T 2:HIGH WATER ALARM W 3:DIESEL IN-TANK ALARMS T 3:LEAK ALARM T 3:HIGH WATER ALARM W 4 :PREI"1. UNL. IN-TANK ALARMS T 4:LEAK ALARM T 4:HIGH WATER ALARM SOFTWARE REVISION LEVEL VERSION 14.00 ~OFTWARE" 346014-100-A CREATED - 97.02.10.13,33 NO SOFTWARE MODULE SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL IN-TANK TESTS w o,.).LJ1CacJ... ~PIPE TYPE: FIBERGLASS ~LINE LENGTH: 50 FEET T 3:DIESEL DISPENSE l"lODE: STANDARD W 4: PREM. UNL. PIPE TYPE: FIBERGLASS LINE LENGTH: 50 FEET T 4: PRE!"1. UNL. DISPENSE MODE: STANDARD LIGUID SENSOR SETUP - - - - - - -- L 1: LI NER NORMALLY CLOSED CATEGORY : OTHER SENSORS L 2: LI NER NORMALLY CLOSED CATEGORY: OTHER SENSORS ALARM HISTORY REPORT ----- SENSOR ALARM _____ W 2:PLUS WPLLD SHUTDOWN ALM AUG 6. 2002 10:54 AM WPLLD COMM ALARM AUG 6. 2002 10:54 AM WPLLD SHUTDOWN ALM FEB 8. 2002 5:36 PM ALARM HISTORY REPORT -----SENSOR ALARM _____ W 3:DIESEL WPLLD SHUTDOWN AU"I AUG 6. ~002 l¡ :11 AM WPLLD COMM ALARM AUG 6. 2002 11: 11 At"! WPLLD SHUTDOWN AL!"! DEC 15. 2001 10:18 AM ALARM HISTORY REPORT ~---- SENSOR ALARM -____ W,4:PREM. UNL. WPLLD SHUTDOWN ALM AUG 6. 2002 11:00 AM WPLLD COMM ALARM AUG 6. 2002 11 :00 AM WPLLD SHUTDOWN ALM APR 8. 2002 3:16 PM e ALARM HISTORY REPORT ----- SENSOR ALARM L 1: LINER OTHER SENSORS FUEL ALARM AUG 6. 2002 9:50 AM FUEL ALARM OCT 1 4. 2001 é : 21 Al"l FUEL ALARM NOV 15. 1999 8:19 AM ALARM HISTORY REPORT ----- SENSOR ALARM L 2: LI NER OTHER SENSORS FUEL ALARM AVG 6. 2002 10: 01 A!"! FUEL ALARM OCT 14. 2001 8:17 AM FUEL ALARM NOV 15. 1999 8:24 AM ALARM HISTORY REPORT ----- SENSOR ALARr"! _____ WI: UNL, 1 WPLLD SHUTDOWN ALM AUG 6. 2002 11 :11 AM WPLLD COMM ALARM AlIG 6. 2002 11: 11 A!"1 WPLLD SHUTDOWN ALM MAY 20. 2002 3:35 PM 4t ALAR!"! HISTORY REPORT IN-TANK ALARM T 3:DIESEL HIGH WATER ALAR!"! PM JAN 1. 2001 2:22 LOW PRODUCT, ALA~M52 pr1 AUG 2. 2002 3, JUN 17. .2002 ): 48 pr1 r"1AY 4,·2002 5.25 AM SUDDEN LOSS ALA9~~9 AM AUG 6. 2002 . ~ AUG 29. 2001 10:0~ AM JAN 2. 2001 1 :10 PM INVALID FUEL LE~E~ PM DEC 28. 2000 10,13 PROBE OUT AUG 29. 2001 10:06 AM JAN 2. 2001 1:10 PM HIGH WATER WARN~~9 JAN 1. 2001 2,22 PM DELIVERY NEEDED AUG 2. 2002 11:52 AM JUN 17. 2002 7:41 AM JUN 5. 2002 9:25 AM ALARM HISTORY REPORT IN-TANK ALARM T 4:PREM. UNL, LOW PRODUCT ALARM JUN 20. 2002 9:31 AM DEC 22. 2001 3:59 PM APR 14. 2001 12:19 PM INVALID FUEL LEVEL APR 2. 2001 4:50 PM AUG 5. 2000 1 :30 PM JUL 9, 2000 5:58 PM DELIVERY NEEDED JUN 19. 2002 1 10 PM JUN 5. 2002 3 45 PM MAR 24, 2002 2 03 PM - e- CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 APPLICA TION TO PERFORM FUEL MONITORING CERTIFICATION FACILITY ADDRESS la~~ell~ la~t~ip #360 64-01 White Lane (Site ID #623) OPERATORS NAME OWNERS NAME Jaco Oil Company Jaco-fLill NAME OF MONITOR MANUFACTURER Veede~-Root DOES FACILITY HA VB DISPENSER PANS? YES~ NO_ TANK # VOLUME CONTENTS 1 12000 fYIVl 2 12000 ;fYI V 1 3 12000 fYIVl 4- 12000 fYIVl NAME OF TESTING COMPANY SUNSé7 fYIéCfLANICAL CONTRACTORS UCENSE # CA 5895 1 7 NAME & PHONE NUMBER OF CONTACT PERSON fYIa~k Blackgu~n 322-0660 DATE & TIME TEST IS TO BE CONDUCTED 08/06/02 9: 15AfYI-1 0: 4- 5AfYI Jo~ rg---("-Oè APPROVED BY DATE SIGNA TURE OF APPLICANT 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 PREVENTlONSER~CES FIRE SAFm SERYlCES' ~AL SElMCES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 PUBUC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3696 FAX (661) 326-0576 FIRE INVESTIGATION 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 TRAINING DI~SION 5642 VIcIor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 - e July 31. 2002 David Palmer Jaeo Oil Co. P.O. Box 1807 Bakersfield, CA 93380 CERTIFIED MAIL RE: Annual Maintenance on Leak Monitoring Systems REMINDER Dear Mr. Palmer: This letter is to advise you that the following Jaco Oil sites are coming due for annual maintenance on their leak monitoring systems. They are as follows: Howards Mini Mart Mt. Vernon Fastrip Fastrip #622 Fastrip #641 Chris' Liquors Fastrip #6 Ming & Real Fastrip Fastrip #19 Fastrip #640 Wholesale Fuels Fastrip #621 Fastrip #26 Harris Market Howards #6 Farrells Fastrip Howard's #4 Fastrip #633 3300 Planz Road 3501 Mt. Vernon 4013 S, "If'St 1200 Coffee Rd 2732 Brundage Ln 1640 S. Chester 3701 Ming Ave 4901 S. Union 800 1 White Lane 2200 E. Brundage 805 34111 Street 2698 Oswell 1701 Union Ave 4201 Belle Terrace 6401 White Ln #112 '-- 3200 Panama I:n 6401 S. H Street Due 08-17-02 Due 09-04-02 Due 09-06-02 Due 09-07-02 Due 09-07-02 Due 09-07-02 Due 09-07-02 Due -0-07-02 Due 09-19-02 Due 09-27-02 Due 10-01-02 Due 10-01-02 Due 10-01-02 Due 10-15-02 Due 10-15-02 Due 10-15-02 Due 11-01-02 As a courtesy, this reminder has been sent to you. No further reminders will be sent, and formal "Notices of Violation" will be sent 10 days after the due date, unless documentation of testing has been received, Should you have any questions, please feel free to call me at 661-326-3190. S¡.~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer Office of Environmental Services SB VIde 101o7~ de W~ .¥Q;I' ~ONÞ .r~ ../6 W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "W 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 FIRE SAFETY SERVICES' ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 32S-0576 PUBLIC EDUCATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3696 FAX (661) 32S-0576 FIRE INVESTIGATION 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX(661)326-D576 TRAINING DIVISION 5642 VIctor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 e - July 30, 2002 Farrells Fastrip 6401 White Lane Bakersfield CA 93306 REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31,2002 of Underground Storage Tank (s) Located at the Above Stated Address. -' Dear Tank Owner / Operator: If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank (s). Senate Bill 989 became effective January 1,2002, section 25284,1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perfonn this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perfonn this test, by the necessary deadline, December 31, 2002, will result in the revocation of your pennit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Si:¡ ~ Steve Underwood Fire Inspector Environmental Code Enforcement Officer ""Y~ ~ W~!7CP.A0P6 .o/~ ./6 ~~" e e CITY OF BAKERSFlEl.,D FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave" 3rd Hoor, Bakersfield, CA 93301 FACILITY NAME ¡:;;~f~{t EL~~ ADDRESS fJJ'tO ( l & l.N . L FACILITY CONTACT INSPECTION TIME INSPECTION DATE ì - JÇ'-o è PHONE NO, ~17 "'02 ..,1 BUSINESS ID NO. 15-210- t1Ý NUMBER OF EMPLOYEES "1) Section I: Business Plan and Inventory Program o Routine rp Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate permit on hand L- / Business plan contact information accurate v / / Visible address V Correct occupancy l V Veri fication of inventory materials / ./ Verification of quantities / Verification of location v ~ Proper segregation of material 1/ 1/ Verification of MSDS availability 1/ ./ Verification of Haz Mat training 1./ /' Verification of abatement supplies and procedures ~ Emergency procedures adequate / v /' Containers properly labeled r / Housekeeping !/ ".. Fire Protection !/ / Site Diagram Adequate & On Hand ./ C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes ~o Pink - Business Copy Questions regarding this inspection? Please call us at (661) 326-3979 White - Env, Svcs, Yellow - Station Copy Inspector: · CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester A ve,~ 3rd Floor~ Bakersfield~ CA 93301 ./ ' FACILITY NAME -1-/1 II'(T't Its - (0.. ,~if' ~D INSPECTION DATE I rdÇ~CL Section 2: Underground Storage Tanks Program o Routine ~mbined 0 Joint Agency Type of Tank juJ FcoJ!3 Type of Monitoring -J}T~ o Multi-Agency 0 Complaint Number of Tanks if Type of Piping AfT ORe-inspection OPERA nON C v COMMENTS Proper tank data on tile v J ",-' ,/ Proper owner/operator data on tile V Permit fees current /' Certification of Financial Responsibility "/ V / Monitoring record adequate and current I~~ Maintenance records adequate and current ( V Failure to correct prior UST violations II'" / Has there been an unauthorized release? Yes No~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION 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 overtill/overspill protection? c~comPI:¿V~ N" Inspector: j ~ Oftìce of Environmental Services (805) 326-3979 White - Env, Svcs, N=NO Pink - Business Copy FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 oW Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 oW 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 Chesler 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 . . Farrells Fastrip 6401 White Lane Bakersfield, CA,93309 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 6401 White Lane REMINDER NOTICE Dear Tank Ownerl Operator: . The purpose of this letter is to inform you about the new provisions in California Law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1,2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1, 2001 shall be tested upon installation, six months after installation, and every 36 months thereafter, Secondary containment systems installed prior to January 1, 2001 shall be tested by January 1,2003 and every 36 months thereafter, REMEMBER!! Any component that is "double-wall" in your tank system must be tested. Secondary containment testing shall require a permit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office, Should you have any questions, please feel free to contact me at (661) 326-3190. Si"J¿ (~ Steve Underwood Fire Inspectorl Environmental Code Enforcement Officer SBU/kr enclosures 4t4t7~~ W~ ~ ~0Pe.r~ A W~" - "- ~--~--~- --~- -- F~:,;3'J ~': [ ' '.,U 64 [J 1 L.!H I J'E LN, '--.J BITU, , ,Ci~. ,:':11-) 61:.1-:]':'17 -O~' ¡ .j liL :2::" :;:'OU.:' ',4: 2::: nl''! 8'\,';3T£I"1 :::;TATU:::; ¡;;'Er.'OJ~T ----.-- ALL FUI"':;T 1 e""lf; f\jOF:I"I~~L I I'J\/ENTC'R\' F:EPOF:T T 1 :Uf\JL. I \/CLUf"lE ULLAGE '3œ-; ULLAGE= TC \/()LUf"lE HE l'~~HT ¡',I¡'iTER \/C'L I..iíHEP. TEr"lP T 2:¡:'LU:::: \/OlUi:'IE . , ULLAGE 90~:' ULLAIÆ= TC \iOLUI"IE HEIGHT LJATER \/\)L I,.,JATER THW T 3: D I E3EL \/OLur"!E ULLAGE 90"-; ULLAGE= TC \iOLUI'-lE HEIGHT ¡'"JATER \/OL v.JATER TEr-"1!:> 73::3'7 G¡0;LB 466:J GAL:3 ::"1 E, :~: GI11.::':; 7:J2Ü GAL:::; 56. '-1'-1 I NÇHEE; I] GP: 0,00 I f"~:~; 'j:? . E, D[I,; r :j 81· '/, i;:,'1L:-;--. Et 1 :::¡:] (~AL:-3 ¿S8::; GAL:3 :::808 G{iL:3 :3'1,0'3 I f'JCHL:-~ ] 8 GPo' I] . 89 I r'~:::; 9[1.0 DEe: F :3804 GAU3 81136 GAL~3 6996 GALt~ :]798 Gf"\L8 ;::i4 . DO I/'JCHES ::-:0 GALS 0.97 I NCHE:3 90.8 DEG F T 4: PREt'I, Uf"JL. VOLUME 53:J2 GALS ULLAGE t,6E,8 ':;¡'\LS 90% ULLAGE= 5468 GALS TC \/OLUt'lE 5:31 '3 GALS HEIGHT 43.79 INCHES t'JATER \/OL 15 (: ; t'JATER o. f':: 1 iUES TEI'-lP 91.7 DEG F '" :.: '* ,<i ,'" f",W. '" '" '" '" '" - FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Streel 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 - - April 17. 2002 Farrells Fastrip 6401 White Lane Bakersfield CA 93309 RE: Necessary Secondary Containment Testing Required by December 31,2002 REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bil1989 became effective January 1. 2002, Section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed, Secondary containment systems installed on or after January 1,2001 shall be tested upon instaIlation, six months after installation, and every 36 months thereafter. Secondary containment systems instaIled prior to January 1,2001 shall be tested by January 1,2003 and every 36 months thereafter. Secondary containment testing shall require a permit issued thru this office, and shaIl be performed by either a licensed tank tester or licensed tank instaJler, Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing, For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. SinjlcerelYi . -" rI£¿;/.. .. . . I Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer SBU/dm enclosures ~~7~ de W~ ~ vØ60P6 ..o/~ ..A W~" 1<7.~ J!CO OIL COMP!NY /1' '7 \ I) "~"~I /./ /", <~) -,) ~ wlONITORING SYSTE~I CERTIFICATION, For Use By All Jurisdictions Within the Stete ofCa!ifomia Chapter 6,7, Hec1!/r and Safety Code: Chaptu ! 6, Division 3, Tit!e 23, Ca!ifornia Code of Regu!ations Av./Ror;ty Cited This Corm mL;st be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared tor each nioniroring svstem control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The O\"l1er.'operator must submit a copy of this form to the local agency regulating UST systems v.;thin 30 days of test d:lte. .-\. General Information Faciliry~ame: rARí2~LL;"S FAS'íRtP Site Address: L'le \ (},}¡-II í F Lt-J, Facility Contact Person: 'P~\jLE" F Make/},{odel of Monitoring System: TL S-1 ~~O / ù8'-1 7 oq 0- (j ),;). B, Inventory of Equipment Tested/Certified Check the a ro ri:ate boxes to indicate s ecific e ui ment ins ectedlserviced: Bldg. No.: '360 City: ~;¿FQ"":~"F\FU~ Zip: c¡ ~ "1C'C¡ Contact Phone No.: ( ~ (. \ ) Y11' 6;) 71 Date ofTestinglServicing: ! 0 J..J.Sj ü\ Tank 10: ()Nlt:Aì"I¡:::\ ~I CYÍn-Tank Gauging Probe. Model: 8i(1~q6 - 16 -:¡ o Annular Space or Vault Sensor. Model: o Piping Sump I Trench Sensor(s). Model: o Fill Sump Scnsor(s). Model: o Mechanical Line Leak Detector. Model: ~Iectronic Line Leak Deteclor. Model:8i'1'-i qC· 00 o Tank Overfill / High-Level Sensor. Model: o Other (s ecif e ui menl e and model in Section E on Page 2), Tank 10: i:)1 E'::,.~L CYÍn-Tank Gauging Probe. Model: A"'-1J<1 (;;- 10-1 o Annular Space or Vault Sensor. Model: o PIping Sump / Trench Sensor(s), Model: G Fill Sump Sensor(s), Model: o Mechanical Line Leak DeteclOr. Model: ;:sn:lectronic Line leak Detector. Mode\: 8'-1949 ()- 00 . o Tank Overfill / High-Level Sensor. Model: o Other (s ecifve ui menl type and model in Section E on Page 2). Dispenser 10: ì ~~).. I Gl r~L - RC - íuJ . APC o Dispenser Containment Sensor(s), Model: CYShear V::!he(s), o Dis enser Containment Float(s) and Chain(s), Dispenser 10: S '- G (L) fL - QC - -í W- f} P(' o Dispenser Containment Sensor(s), Model: C3"'Shear Valve(s). o Dis enser Containment Floal s) and Chain(s). Dispenser 10: '1 - 10 I L:2l - QC - TW~ (-\ PC o Dispenser Containment Sensor(s), Model: ~Shear Valv'e(s), , o Dis enser Conlainment Float(s) and Chain s). °1 f the facililY conlains more lanks or dispensers, copy lhis form. Tank ID: p l '-' <; CY-rn-Tank Gauging Probe. Model: t'lr )q 0 - \(>""1 o Annular Space or Vault Sensor. Model: o Piping Sump / Trench SC!1sor(s). Model: o Fill Sump Sensor(s). Model: o Mechanical Line Leak Detector, Model:. ~ectronic Line Leak Detector. Model: Ý 'C\I.¡q (è- <>0 i o Tank OvertiIl I High-1.evel Sensor. Model: o Other (s ecif e ui ment e and model in Section E on Page 2). Tank ID: r í2 E rf\' \,Ì ,,', G-til- Tank Gauging Probe. Model:' ?'47j c¡ (; - l 0 f o Annular Space or Vault Sensor. Model: o Piping Sump I Trench Sensor(s). Model: o Fill Sump Sensor(s): Model: o Mechanical Line Leak Detector. Model: úYElectronic Line leak Delector. Model: t'>í q (, q c - 60 ; o Tank OverfiIl I High-Level Sensor. Model: o Olher (s ecifve ui ment t e and model in Seclion E on Page 2), Dispenser 10: "3 'i I(,~ fL - R C - "li.0 o Dispenser Conlainmenl Sensor(s). Model: Q..-Shear Valve(s). o Dis enser Containment Float(s) and Chain(s), DispenserlD: 1'~ í6:1f"L - RC- -T¡,J o Dispenser Containment Sensor(s). Model: (}-"Shear Valve(s). ' o Dis enser Containment Float s) and Chain s). Dispenser ID: i - \:f.- ")'2 Fl - R C -- It, j o Dispenser Containmenl Sensor(s). Model: CYShear Valve(s). o Dis enser Containment Float s) and Chain s), Include information for every tank and dispenser at the facility. C. Certification - I certify tl!at 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 genersting such reports, I have also al~a~hed a copy o~ the rep0:,t; (c':!ck all that ~I!ply): __, Q-$ystem ~et-up 0 ~arlI1 bistq¡ry ~ort_, A Technician Name (pnnt): r ¡Dc L C A1(QiLU:; SIgnature: ':~O\ }¡,/\ <..... c"y., '!-. o\.Á ,\ ,t Certification No.: bJ. '5- iO- /,:, 11 License. No,: G i.) Ë-lr d- Testing Company Name: ßc-~-S R \ .N C__ Phone No,:( C L i ) 5 t'}ð -;:2 f ii Site Address: GG 3(.: K Co SC Ù ALE d(~'1 -It ~:J Date of TestinglServicing: I G 1\ j / Q ~ Page 1 of 3 03101 ~., . "j 11'-1~ 'e 0, Results of Testing/Servicing - ,).~ ' ¡q..c(j Software Version Installed: ,Com lete the followino checklist: Q....:ves 0 No· Is the audible alarm 0 erational? Q--Yes CJ No· Is the visual alarm 0 erational? ~'Yes CJ No· Were all sensors visual! ins ected, functionall tested, and confIrmed 0 erational? Gr Yes CJ No· Were all sensors installed at lowest point of secondary containment and positioned so that other equipment \.ill not interfere ""ith their ro er 0 eration? If alarms are· relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) 0 Sumprrrench Sensors; CJ Dispenser Contaimnent Sensors. Did ou confirm ositive shut-down due to leaks and sensor failure/disconnection? ~es; 0 No. o No· For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ON/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill oint(s) and 0 eratin ro erl ? If so, at what ercent of tank ca aci does the alann tri er? '" % W as any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced 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 systerrís? (Check all that apply) CJ Product; 0 Water, If es, describe causes in Section E, below. ~Yes 0 No· Was monitorin s stem set-u reviewed to ensure ro er settin s? Attach set u ~es 0 No· Is all monitorin e ui ment 0 erational er manufacturer's s ecifications? * In Section E below, describe how and when these deficiencies were or will be corrected, DYes o No· CJ N/ A o No· ON/A ¡¡;r'Yes GYVes ¡;YVes· o No DYes· ¡¡a No E. Comments: .' \ "'}.. R E. Pi. f:'\ CF "I AN K.. i'Y10N'¡ \' () i< (I\. if) ¡ CA Tnì? l A rÝ1 D <; Page 2 of 3 03/01 ¥-' ~ e F, In-Tank Gauging / SIR Equ:pment: e . .5111/~ o Check this box if tank gauging is used only for inventory contr~ 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 perfonn leak deteétion monitoring. C h kJ omplete the followmg c ec ist: Gr'Yes o No* Has all input wiring been inspected for proper entry and tennination, including testing for ground faults? 13'" Yes 0 No* Were all tank gauging probes visually inspected for damage and residue buildup? cY"Yes 0 No* Was accuracy of system product level readings tested? 13' Yes 0 No* Was accuracy of system water level readings tested? [¥'Yes 0 No* Were all probes reinstalled properly? I::3"'Yes 0 No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected, G, Line Leak De~ectors (LLD): o Check this box if LLDs are not installed, c h f II h kJ' omplete t e 0 owmg c ec 1st: ~Yes o No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD perfonnance? o N/A (Check all that apply) Simulated leak rate: Et3 g.p.h.; 0 0.1 g.p.h; 0 0.2 g.p.h, ~Yes 0 No* Were all LLDs confinned operational and accurate within regulatory requirements? Id'Yes 0 No* Was the testing apparatus properly calibrated? DYes o No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ca N/A ~Yes o No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? . o N/A GYY es 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? Q.-"l es 0 No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions 0 N/A or fails a test? ~es o No* For electronic LLDs, have all accessible wiring connections been visually inspected? o N/A urYes o No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected, H. Comments: Page 3 of 3 03/01 ,~J r~l / :1 í) Monitoring Systë::.2ertification Site Address: (; ~ 0 I - . ,J.~ ,-,: ,-1 I" F UST Monitoring Site Plan \-N _ . . r-\'o lIIT 0 , u,;·,? 't'i n.. . '! L5 ,:;;:~ I~('-"'l_ ï : : :'ÇJ ¡ ...:--~....P~~~~ ~) cc';,~'¡cå-' 1 r-c~-~~--=~ r . . , . \ .) ~_.__~,_._.._.o.,.~_. _..'.'. " ~. ',) , i :\¡ / t:-'-'v~' / \: '. 'N' ,-..', . . J,,!"._-_~,j . . .1lll , . J . 1':1.· 1-~.i . . t t · J-î . , . o lïr:TJ . , . · ,-wi" . · Lr3;"I.. ';Jt' " ..... , - \ i')\i~-..:~t · --.' ~... . oj .1 ": . .', .: . . .. . . . .' . . . . . . :ð:}:: · . ~.~ ~CI "t. ~,.. . l' ' \ ; ,,' \.,. . . ). . i:'.í -----J <',.1 . . ~illt . . ¡ . I ~). \ \: i--r--i ~.,~ . Ii ð ö,1 . . Jot: · :'-'-~' · (- :; '~-' ~ · \. ~-rp. j. · . -----_/ . · '{(t¿¡¡'" r" . . U. . o DC" ... .-<' .." . .., . '¡> 'r . ..~, . . · . . . · .. .. . .. · /-.'~ f .:' " \ · . '-:,'. .j \ Pr:.. I · ~./. · . . .. . · '.";;;'/<' cr: , 00: '- ..... ,"'? ' '" . .;\> r · . . .. · . .. . o :-..~. . . /... . ; ?1E".>F~... l. .j. .~"".'. · . .. . .. · ('"7'~ . " .0_j.1 , \ .~. . . /. '\. ,/ · ~-'~ . · . . .. :)0' :O~: : 0.: TE'i .. ·Cr n r,; \..:) .\- ( . 4'. -<' <.. or' ~, .?'"1-~ ;;Or .. '1. .~. Or" or . .. ..t? .. . . . . ~(:- O'~ <1,1"', , " .. .. . .. . Date map was drawn: \ 0 / I 5/ 0 \. Instructions If you, already havea diagram ,that shows all required information, you may include it, rather than,tþis page, with your Monitoring System Certification:' On your site plan, show the general layout of tanks and pipi1'lg: ' Cleàrly identify locations of the following equipment, if installed: monitoring system control panets;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). In thè space provided; note the date this Site Plan was prepared, Page _of_ 05100 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "W Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "HM Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 I I PREVENTION SERVICES 1715 Chesler 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 '. e +-. ,) ::::;. ~(I.t¡.'" .,. September 27,2001 John Kerley J aco Oil POBox 82515 Bakersfield Ca 93380 Certified Mail NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE RE: Failure to SubmitJPerfonn Annual Maintenance on Leak Detection System at Farrells Fastrip, 6401 White Lane #112, Bakersfield Dear Mr. Kerley Our records indicate that your annual maintenance certification on your leak detection system is past due. September 4,2001, You are currently in violation of Section 2641(J) of the California Code of Regulations. "Equipment and devices used to monitor underground storage tanks shall be installed, calibrated, operated and maintained in accordance with manufacturer's instructions, including routine maintenance and service checks at least once per calendar year for operability and running condition." You are hereby notified that you have thirty (30) days, October 27,2001, to either perfonn or submit your annual certification to this office. Failure to comply will result in revocation of your permit to operate your underground storage system. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerely, Ralph Huey Director of Prevention Services by: / JL dfwø£J Steve Underwood Fire Inspector/Envirorunental Code Enforcement Officer Office of Envirorunental Services cc: Walt Porr, Assistant City Attorney "" C/' 1/7 CL7 (J7 /2-/ ú'77J /~ <L" ~~ ._7èPUÚ~? Út£!; 6t:JnlhU~/lð~ .~O/~ ._/ÞOOPß .%Q/t- ../(:J o'é.nÚ'/r- e ¡ ..1>, ;,.... ~ . .t; .-% ...,'-.¡¡" I"'- " .-:I ,.-:I co , 0 " r-"I ..D 0- .-:I " ru , 0 :0 : 0 ru L/'1 o "0 : 0 ,t:] I"'- Postage $ ,34 Certified Fee 2,10 Return Receipt Fee 1.50 Postmark' (Endorsement Required) Here Restricted Delivery Fee (Endorsement Required) Total PostIIge & Fees $ 3,94 ReCIRle"t's Name (Please Print Clearly) (To be Completed by mailer) John Kerley. .' . .. šiiëii~Ä~·Ñi~~pï~ï·rr···'········"······'-"7··_·_····_···,......,.,... ëiiY.·!~¡~~~4f·i~ïd···ë~··9·33·8Õ··_·············_·.._-_·.--. PS Form 3800, February 2000 See Reverse for Instruchons OJete-items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired, . Print your name and address on the reverse so that we can return the card to you, . Attach this card to the back of the mailpiece, or on the front if space permits. 1, Articl~l:Ödressed to: John K~rley Jaco 01.1 POBox 82515 Bakersfield CA 93380 3, Service Type rxCertified Mail o Registered o Insured Mail o Express Mail o Return Receipt for Merchandise . o C,O,D, RE: Farre11s Fastrip " 6401 White Lane 11112 2, Art!c~ Number (Copy from service Jabel) \ ;00 0520 0021 9610 8117 .~ PS Form 3811, July 1999 Domestic Return Receipt 4, Restricted Delivery? (Extra Fee) DYes 102595-99-M-1789 ;:;~------ - - - ~- ------------- '. - - - __ ,__ __ __.__ ____ - - - . u_ _ _ __ ___ _ _ __ _ _ - ----------------- ~----~-- FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "W 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 '" . . ~ i;!;,..,r. ¡þ?~~ September 10, 2001 John Kerley Jaco Oil Company P.O. Box 1807 Bakersfield, Ca 93380 CERTIFIED MAIL NOTICE OF EXPIRATION ON MONITORING CERTIFICATION Dear Mr, Kerley: The following Jaco sites are currently due/past due on annual monitoring certification. These sites are as follows: Site Address Due Date 1. 2. 3, 4. 5, 6. 7. 8, 9. 10, 11. 12. 13. 14. 15. 16. Farrells Fastrip, 6401 White Lane Chris Liquors, 2732 Brundage Lane Fastrip #640,8001 White Lane Wholesale Fuels, 2200, Brundage Fastrip #19, 4901 S, Union Fastrip #621,805 34th Fastrip #6, 1640 S. Chester Fastrip, #26, 2698 Oswell Street Howards #4, 3200 Panama Lane Fastrip #622, 4013 "H" Street Ming & Real Fastrip, 3701 Ming Ave Fastrip #641, 1200 Coffee Road Howard's #6, 4201 Belle Terrace Howard's, 3300 Planz Road Harris Market, 1701 Union Ave Mt. Vernon Fastrip, 3501 Mt. Vernon 9-04-01 9-05-01 9-05-01 9-12-01 9-12-01 9-20-01 9-22-01 9-22-01 9-23-01 9-27-01 9-27-01 9-28-01 9-28-01 9-28-01 9-30-01 10-2-01 Failure to perfonn or submit monitoring certification within 30 days of due date will result in revocation of your Pennit to Operate. Should you have any questions, please feel free to contact me at 661-326-3190. S2'~ Steve Underwood Fire Inspector/Environmental Code Enforcement Office Office of Environmental Services SBU/dm ~~ Y/'OÚl;? d~ C¡S;";lHU'~~ ,-~p ./~0Pe ff~ ./6 g--~~~"" . ~ '.," . 7-"-"';:'¡' r-:t Lt) , IT" :::r Lt) ru , ..J] , IT" ,..:¡ ru o o ,0 'ru , Lt) . 0 ~ 0 o o ('- U.S. Postal Service CE~ED MAIL RECEIPT (Do Mail Only; No Insurance, Coverage pro, videdJ, I ~- ~ I Postage $ ,,34 Certified Fee 2,10 Postmark Retum Receipt Fee 1.50 Here (Endorsement Require() Restricted Delivery Fee, ' , (Endorsement Require() "':'... ".. Total Postélge & Fees $ 3,94 Recipient's Name (Please Print Clearly) (To be completed by mailer) __..:!.?!!-.~..!~E,!~'y'.........~___.,____"____,..._..._...._______~......___ Street, Apt. No.; or PO Box No. ' , - POBox 1807 ëit~i1iëéfi~;ti-;ïd--ë;-----~3j8Õ--'-'-'----'--'-"-'--'-'- PS Form 3800, February 2000 See Reverse for Instructions J John Kerley J aco .on '. ' POBox 1807 Bakersfield CA 93380 . SENDER: COMPLETE THIS SECTION · Cr - 'Iete items 1, 2, and 3. Also complete it~ ~ if Restricted Delivery is desired. · Prim your name and address on the reverse so that we can return the card to you, · Attach this card to the back of the mailpiece, or on the front if space permits. 1, Article Addressed to: RE: 6401 White Ln & Various Other Jaco Sites, 3, Service Type xz: Certified Mail o Registered o Insured Mail D Express Mail o Return Receipt for Merchandise DC.OD. 4. Restricted Delivery? (Extra Fee) DYes 2. Article Number (Copy from service label) 7000 0520 0021 9625 4951 _1-"'" PS ~'3811, July 1999 Domestic Return Receipt 102595-99-M-1789 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 93308 VOICE (661) 399·4697 FAX (661) 399-5763 - - August 3, 2001 Farrells Fastrip 6401 White Lane Bakersfield Ca 93309 RE: Deadline for Dispenser Pan Requirement December 31,2003 REMINDER NOTICE Dear Underground Storage Tank Owner: You will be receiving updates from this office with regard to 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, for failure to comply with the regulations. 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 to retro-fit your facilities, If your facility has been upgraded already, please disregard this notice. Should you have any questions, please feel free to contact me at 661-326- 3190. Sincerely, }L~ Steve Underwood Fire Inspector/Environmental Code Enforcement Officer Office of Environmental Services SBU/dm ~(, ex) , -If! (/:' ,(j7 /h/ (Jnl ä (/> ~, .7e.PUU~?, UI.-e U~;'I/;uuu)'?, ..'TOP ../P'00pe JAOA Jø 6e/lb'~? e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave" 3rd Floor, Bakersfield, CA 93301 FACILITY NAME (i(f e.{ ~ F(; ,r,-\t\~ INSPECTION DATE ,-1-[0' O( Section 2: Underground Storage Tanks Program o Routine 0 Combined 0 Joint Agency Type of Tank 51.ùF<:...~ Type of Monitoring ftT(O o Multi-Agency Number of Tanks Type of Piping o Complaint L/ API ORe-inspection OPERA TION C V COMMENTS Proper tank data on file V V Proper owner/operator data on tile II V Pemit fees current !V v Certification of Financial Responsibility .\/ Monitoring record adequate and current / V Maintenance records adequate and current V /' Failure to correct prior UST violations V Has there been an unauthorized release? Yes No V Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGA TE CAPACITY Number of Tanks OPERA TION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MYF? If yes, Does tank have overfill/overspill protection? :~~:,~:1i':i-(¡4~' Office of Environmental Services (805) 326-3979 White - Fnv, Svcs, N=NO Ãø/L Business Site Responsible Party Pink - Business Copy e '--""~~-~----- ,~ FA~:HR I P ;.360 6401 LlIH ITE UL BKFLD..CA, 93309 MAY 9, 2001 8:15 AM "-.-J f3'/STH'1 :3TATU;3 F:EPORT ----.-- ALL FLINCT I C'NE; NCH'lAL I NVENTOR''l F:EPORT T 1 :UNL. 1 \/OLUI'1E ULLAGE 90% ULLAGE: TC \iOLUI"IE HEII::;HT l-,JATER \iOL l-JATER TEI"lP 7091 GAL:3 49[1'3 (;¡.ìU3 37[19 GALt~ 7018 GALS 54, t:8 INCHES ° GALS [1,00 INCHES 74,6 DEG t:' '---I T 2:PLUE; VOLUME 4256 GALS ULLAGE ~ __. 7J.,:L4-, GfiI:.:;::. , 9[1\;ULLA(;E~ 6544 GALE; TC VOLUr"lE 4217 l::;fiU:; HEIGHT 36.95 INCHeS WATER \JOL [I GAL t..JATER [I. (j[l I Nc.~ TEI"1!) 73, 1 DEG F T :3: D I E3EL \JO L UHE ULLAGE 9m'. ULLAGE~ TC \/0 L ur"IE HEIGHT l-,JATER VOL l-JATER TEI"IP / 51 4 [I GAL.:3 6860 GAL:::; 5660 GAL:':; 508:3 GALE:~ 42.59 I NCHE:':; o I::;ALE: o . 00 I NCHÐ3 75.9 DEG F T 4: PREf"I. UNL. \!OLUI"1E :35:J 1 GALS ULLAGE 84E.9 GALS 9œ-ó ULLAGE~ 7269 GALS TC VOLUME 3495 GALS HE I GHT 32,2[1 INCHES , WATER \lOL 14 GALS I,JA TER [I , 78 I NC HES'-' TEMP 74,7 DEG F ,- -_. ,.~- -- --~--~, -- --- . M M M M MEND M M M M M '-" e e e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave" 3rd Floor, Bakersfield, CA 93301 FACILITY NAME F/1.ffe..(¿ htS{~ ADDRESS føt.lD { lAitJ( "fit . If ~ FACILITY CONTACT INSPECTION TIME INSPECTION DATE t; -l Ð ~O { PHONE NO, '3 17 ~o 2. ì( BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES / Section 1: Business Plan and Inventory Program o Routine ~ Combined o Joint Agency o Multi-Agency o Complaint D Re-inspection OPERA TION C V COMMENTS Appropriate peonit on hand t.... / Business plan contact infoonation accurate / V Visible address \.,.. V Correct occupancy l- V Verification of inventory materials t V Verification of quantities L- V Iv V Verification of location l/ V Proper segregation of material ..- Verification of MSDS availability ~ Verification of Haz Mat training It/V Verification of abatement supplies and procedures V Iv Emergency procedures adequate [V ~ Containers properly labeled / Housekeeping ,/ Fire Protection L., ~ Site Diagram Adequate & On Hand / C=Compliance V=Violation Any hazardous waste on site?: Explain: DYes DNo /'F' / -taw/! Business Site While - Env, Svcs, Yellow - Station Copy Pink - Business Copy Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "Hn Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "Hn 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 -.--' . . January 22,2001 Ferrells Fastrip 6401 White Lane Bakersfield Ca 93309 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 pennit 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. Sincerely, )t~ Steve Underwood, Inspector Office of Environmental Services SBU/dm ~~.9'~ de W~ ~ vØbOPe.r~ A W~" ..--- .~-. -'."~'j ! -'''-'-~'''''''''''1--' .u N S' T - Construction (661) 871-1788 & MECHANICAL Continuous Monitoring Device Certification TEST DATE 7. - f7 ( - 00 FACILITY NUMBER FACILITY NAME~ ~'T'r J./? CONTACT PERSOÑ·(~),,^v-....\ /', ¡¿ ADDRESS (!,//O {J/h 'r/- LA/' TELEPHONE ,-.~'2-?. ' ¿JOe "..-" .-"')--'" ..,- CITY //~A- liP CODE ~~¿ "-" MAKE AND MODEL OF MONITORING SYSTEM (.,¿l;l/(rJt';J r _350 TANK 1 TANK 2 TANK 3 TANK 4 Contents of Tank J/tt/;C', .;.... ~ Capacity of Tank &? ¿jOt) - ..... : .--- ---;!? Type of Product Line (Gravity, Suction, Pressure) .~ (!.- \¡~ ~5'5 lJ K. (-- ~ INDICATE LOCATION OF THE MONITORING SENSORS TESTED BY PLACING A YES OR No IN THE APPLICABLE BOX: Annular Space Sensor lAÁO - - - Sump Sensor WO - - ---, Dispenser Containment Sensor we Electronic Overfill / Level ço';0 ff!5 -5!iJt1' Electronic In-Line Leak Detector f¿¿5 - - Mechanical Line Leak Detector ~O ~ /fš: -- In-Tank Gauging Device INDICATE THE FOLLOWING BY PLACING A YES OR No IN APPLICABLE BOX: Does the Monitoring System have audible and visual alarms? Does the turbine automatically shut down if the system detects a leak, fails to operate or is electronically disconnected? Is the monitoring system installed to prevent unauthorized tampering? Is the monitoring system operable as per the manufacturer's specifications? '5: ~ ¡:J , Which continuous monitoring devices Initiate positive shut down of the turbine? . f (? \ CXAl \ IC CERTIFIED TESTER'S tD# z,?~~)' -'1 Ñ. " S,GNATURE OF CERTIFIED TEc'HNICIAN PRINTED NAME OF CERTIFIED TECHNICIAN , TESTING COMPANY NAME & TELEPHONE CERTIFICATION DATA -', , ---;-~- ;J CORRECTliN NOTICE - '~ 'ì I , ¡ \y/ ?'~ ,.. BAKERSFIELD FIRE DEPARTMENT ~ ¡ , LocatioI1 rfi t,hc'') , Sub Div, fr, :~!(; { (f i\ \ i <~, l ,f~ fBlk. . Lot You are hereby required to make the following corrections at the above location: ! '} 'I I ~/( ((1; I, , ~( : .\L . (/r f( d (, ~ \ (rIï(¡lltl( . .1 ¡fI! ¿: ~ !I ¡'{',: ltl ,7l1 L. I Cor. No :'C /1 ¡ ,,1 /\( '.'.'.. ¡ -r -(') (~ \., r'.A(·ll , , þ" /' t(: \,'t kt -fr.ç.{y I f- '.(li V u:'/J. rfr/ 1) -~1( '1') ", ~ ?' Û, 1 I v1c..~! J C C_ f<::' / !llolrte/ ¡f\~, ("/1 ~/;(I¡Ct"r i 0/JlfJbMf: {I 'TÙ; tt (";~( t ((' if) 'f (if); ~ ) ~ ,j Ij(~,.. rf ,. f ( . ~ I:t! (.J( 5, 1/.,/1 L; I . ¡, {( I,+n "'¡(I 'I' . I , ðÆ \- lV,... ()r[' i'- '" '"\ :..4 7' ci f . '_JII( h!í "f : f\l(fr~( {'(\i.J( ,( /! ¿t0U( f ' t'i¡;: ,-( l+lf' 1.1 ~ , ( :'UV, I't. · ! +\: ):¡, . f . , ... \J >\0 1,"" I " if J ('''(0/ ~ I I Completion Date for Corrections i ; ~ I j' .' / t, / ..--.. , ,i' 'if --'"") / I I y . ~ ! Date (,/~í,/l,'(,t; ~'/liC /'/If-.:ft:'it./ .-' Inspector 326·3979 , e f ~ ¡. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave" 3rd Floor, Bakersfield, CA 93301 FACILITY NAME f7,{5ft¡f INSPECTION DATE f/c:l t{ nn Section 2: Underground Storage Tanks Program o Routine CY"6ombined 0 Joint Agency Type of Tank 5qp.Jfe.ß Type of Monitoring 1fT&, o Multi-Agency 0 Complaint Number of Tanks t-{ Type of Piping i..tflí ORe-inspection ~ ~-~-- -- OPERA TION C V COMMENTS Proper tank data on tile No'\.-/' Proper owner/operator data on tile Pemit fees current Certification of Financia] Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION y N COMMENTS SPCC available SPCC on tile with OES Adequate secondary protection Proper tank placarding/labeling ¡---' Is tank used to dispense MVF? If yes, Does tank have overfiJl/overspill protection? C=Comp]iance V=Violation Y=Yes N=NO 'mp,"o, ~ (lkkfE) Office of Environmental Services (805) 326-3979 White - Env, Sves, ¡:fJ Business Site Responsible Party I Pink - Business Copy ê'.~:'.':;" '-~--I i . e e r f .. CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 .' INSPECTION DATE ~/.J(kO PHONE NO. BUSINESS ID NO, 15-210- NUMBER OF EMPLOYEES '1 0 - f FACILITY NAME ht(, 1:If . ADDRESS "tin I {/~l.~( LH FACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program "'\ -./ ,. - -'-~8 -Routine- {J Combined- -- 0 Joint-Agency. ~O_Multi..Agency __ D Çomp1ain.L D J~:__~:.!nspection OPERATION C V COMMENTS Appropriate penn it on hand r V Business plan contact infonnation accurate V Visible address ¡/ Correct occupancy if Verification of inventory materials V Verification of quantities V Verification of location / Proper segregation of material /' Verification of MSDS availability ../ Verification of Haz Mat training ./ Verification of abatement supplies and procedures / . -- .' - I 'T -- ¿L~.f Emergency procedures adequate #..ir, ç; ..I. f. "I' n~I.,!"'hc." ".. --- -- - '1 f -~ '<PJ _0 Containers properly labeled / Housekeeping V ~fj~A7 Fire Protection \./ V\ Site Diagram Adequate & On Hand ../ C=Compliance V=Violation i'" White - Env, Svcs, Yellow - Station Copy Pink - Business Copy æ 7-~((- . Busmess SIte/RespOnSIble Party Inspector:};( ft¿;c Any hazardous waste on site?: Explain: DYes DNo Questions regarding this inspection? Please call us at (661) 326-3979 _.-._-~------------ -~---~-- C<èRRECTION NOT~E BAKERSFIELD FIRE DEPARTMENT N~ 968 r' { . Locatiofl rðA rt,p Sub Div, ~ l{ () f (1J~ Jë: t£yBlk. . Lot You are hereby required to make the following corrections at the above location: Cor. No r L-f.r,,~ Completion Date for Corrections Date tg(J.t!~(J I J Inspector 326-3979 e . CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 INSPECTION DATE f.kl(oo PHONE No.~l- O.} BUSINESS ID NO. 15-210- NUMBER OF EMPLOYEES-llo "-.rl ="- ~' ~~~~~N~~~I ~AJr,~ hatu F ACILITY CONTACT INSPECTION TIME Section 1: Business Plan and Inventory Program o Routine o Combined o Joint Agency o Multi-Agency o Complaint ORe-inspection OPERATION C V COMMENTS Appropriate peon it on hand ~¡, Business plan contact infoonation accurate Iv' Visible address Iv Correct occupancy Iv Verification of inventory materials IV Verification of quantities IV Verification of location V Proper segregation of material V Verification of MSDS availability it./ Verification of Haz Mat training ~ Verification of abatement supplies and procedures / Emergency procedures adequate J Nn ";/Altc, 111\ ()tbt}cn.c;o- 1',411 ",( . , Containers properly labeled ./ Housekeeping iV Fire Protection ~ Site Diagram Adequate & On Hand V C=Compliance V=Violation Pink· Business Copy Any hazardous waste on site?: Explain: DYes ONo Questions regarding this inspection? Please call us at (661) 326-3979 White - Env. Svcs, Yellow - Station Copy Inspector: o,_,v, .__'\_" r~_ ,--......~-..._I-.......'-".__. "" ~_...../,_"",~""",~-,_ ~,y ..._~ ."._'_ _.....'.,,-~---~,-- . '.' " _ " -...... ~ -. ~ FASTRIP 360 640 I klH I TE LN, BKFLD, ,CA. 93309 ! À'trr! 20. 2000 l~': 12 PI"l ~3\"STÐ'1 ~3TATUS F:EPORT ------ I NVENTOR'i REP(:,RT ALL FUNCTIONS NORMAL T I: UNL. I \/OLUI"1E ULLAGE '30?" ULLAGE= TC VOLUr"1E HEIGHT ~JATER VOL ~\JATER TEt"lP 'J , T :¿:PLUS "j.;) lJ-itlI; -1~ILLrl"t 9l}'o IJLu,,;¡-> TC LUI"1ì:: HE~T li,IATEF: \/OL I,..IATER TEI"lP T :3: UNL, 2 \/C'LUI"ìE ULLAGE '30% ULLHCE-~ TC \iOLUI'1E HEIGHT I"IATER \/01.. l"JATER TÐ'lP 1 0 1 08 GAU3 1 892 (:;AU:~ 592 GALE:~ '3888 GALS 75,37 I NCHE~::; o GALS o . CJO I NCHE~; 91 .0 DEG F - - .~4· ~~}~i---'(~r '~+ I-~ r \-1' : ~i-;J. .~-_: ïJt~1 Ie): : l~i1L::: l_~¡'-1LS Jill 'j - "~~~J. 'j(' ¡ 1',h_'HF~: fJ GHL;-.J o . 00 1 !'K'HE:::: 90, ,\ [JEG l' 424:3 GAU3 7657 GHL~; 6457 GAL~::~ L:t 247 Gr:'tL:; 37. :50 ¡ l'jCHr::':.: [I Ge,LE:~ [I. DO ] NCHf:::: 91,:3 DEG F T 4: PRH'l. U\"jL. VOLUME 3545 ULLAGE S"¡55 90% WLLAGE= 7~55 THIE-=:l. ~,. '-rUI"'lE :346¡=! ~ :.i2.::~9 WATER VOL 14 WATER 0.78 TEMP 90.5 l~~r:::; L.~::; GALS GHL.~3 GAL~~; 11',!CHF:,: GAL~3 11'JCHE::; ¡ÆCF '" '" '"' '" ,', ENL' >, ...: :."':". :-:' 'e _ _r_",..-." .<ço_....r-'\. e e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave" 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~'~'P INSPECTION DATE f/~t( on Section 2: Underground Storage Tanks Program o Routine C9'fombined 0 Joint Agency Type of Tank ,slÙFt...5 Type of Monitoring AT(Õ o Multi-Agency 0 Complaint Number of Tanks tf Type of Piping /...ff ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile Proper owner/operator data on tile Penn it fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No~ Section 3: Aboveground Storage Tanks Program AGGREGA TE CAPACITY Number of Tanks TANK SIZE(S) Type of Tank 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? ::~~:¡¡a:lv~;;;æ~" Oftice of Environmental Services (805) 326-3979 While - Env, Svcs, N=NO ff 7 ~Æ/~ Business Site Responsible Party Pink - Business Copy CITY OF BAKERSFIELD .. g¡FICE OF ENVIRON~IENTAWERVICES . 171SWtester Ave., Bakersfield, CA9~1 (661) 326-3979 ,,<,,~NDE~G~OUNp STORAGE TANKS ~,LJ,SrfAçIL!1Y. "(9'" . . .' . 'Ie . ~ . " T"YÆ OF ACT!ON (Cl,ec)( ~n~ ¡(am only) o 1 NEW SITE PERMIT }(3 ;¡ENE'NAL PERMIT o . A~ENOEO PERMIT o $, CHANGE OF INFORMATION (~ec1fy c/1e~ . local use only) o 6, TEMPORARY SIT" CLOSURE ~".>';~ . ."¡;,,- '. t ",,,"r<~ -,':"~"'-_t,(':'r>ð::f...j,..~_u.."'~·:",¥ '.. .. .. "'p~:'I:)~'" o 7. PERMANENTLY CLOSED SITE o a. TANK RE,~1(::),¡EO 4()(J I. FACILITY / SliE INFORMATION FACILITY ID . I 401. 3foo FACILITY OwNéR TYPe D 1. CORPORATION œ-1"INDNlDUAL D 3. PARTNERSHIP o 4. lOCAl. AGENCYIOISTRICT' o 5, COUNTY AGENCY' o 6, STATE AGENCY' o 7, FEDERAL AGENCY' 402, 1. GAS STATION o 2. DISTRIBUTOR TO TAL NUMBER OF TANKS REMAINING AT ITE o 3, FARM 0 5. COMMERCIAL o 4. PROCESSOR 0 8, OTHER 403. Is faciUty on Indan ~bon ~ \ru$I!ands ? 40-4, Dyes ~ 'f own... of UST a public agency. name of super.isor of dlo;ision, sectIcn Of offl<:e whic!l O(>etales tile UST, (This is lI1e CQntad p«son f~!he ~ records,) 405. 406, II, PROPERTY OWNER INFORMATION 407. PHONE C? fó/- 3 22-$" ~ 2. 406. ";ìTY Ld c:::¡ 330 409. 410. TATE CA- 411. 412. D ,. CORPORATION 2. INOMDUAL D 3. PARTNERSHIP D 4. lOCAl AGENCY I DISTRICT D 5, COUNi'f AGENCY D 8. STATE AGENCY o 7. FEDERAl. AGENCY 413, III. TANK OWNER INFORMATION D 1, CORPORA TICN D 2. INDMDUAL js:J, PARTNERSHIP 414, PHONE 415. 0ror- 37'.3-7000 416, 417, STATE 418, 419, CA 2-,r-I'J""" D 4, LOCAL AGENCY I DISTRICT o 6, STATE AGENCY 420, D 5, COUNTY AGENCY o 7, FEDERAl. AGENCY ¡.//[ L "Y (TK) HQ IV. BOARQ.OF EaUAlIZATION UST STORAGE FEE ACCOUNT NUMBER Call (916) 322-9669 if Questfons arise 421. . "V. PETROLEUM UST FINANCIAL RESPONSIBILITY iNDICATE METHOO(S) ~ -SELF.INSURED D 2, GUARANTEE D 3. INSURANCE o 4, SURETY BONO D S, lETTER OF CREDIT o 5, EXEMPTION D 7, STATE FUND o 8, STATE FUNO & CFO lETTER. D 9, STATE FUNO & CO o 10, LOCAL GOVT MECHANISM o 99, OTHER: 422. VI. LEGAL NOTIFICATION AND MAILING ADDRESS .hoc>< one 00Jt fO ,~OICaleNt1ten addteu would 04 uS6d r~ I~ nOllIlQW.s and m...lI~g, ..òQ-"I n()(nulions MId m,,In~ w\I 04 Sðnt 10 1110 tM1k own« unleu :x:u< 1 C1: 2 IS d1ec1<ed, D 1, FACILITY o 2. PROPERTY OWNER 3, TANK OWNER 42:3. VII. APPLICANT SIGNATURE 425. -?93- 7¿t)ð 4Z7. ( Of IOC.I use oNy) 419, "'CF (7/99) S:\CUP AFORMS\swrcb-a.wpd ~A t~ '::ki; _.~,_. .~,~....¡,.. CITY OF BAKERSFIELD 0ICE OF ENVIRONMENTALâf:RVICES 1715 Ch ter Ave., Bakersfield, CA 93JðIf'(661) 326-3979 UNDERGROUND STORAGe TANKS· TANK PAGE 1 ....~ 'I....,.. ",·":·v:·'..~ ..:~..- .,_.'¿ _.'::-', \.:--,. . , ,. ',.. , L'···'f¿~·tf o ð, rEMPOAAAY SiTE ~O~RI! o 1. PERMAAeNT1. Y ~O~O ON SITE o ð, TANK ~MOV'EO t~ . ~ ,:- . ..""' "~ OF 4CT>ON :;:.''''> J'" ,.", oNyl o " '*-W SlTII ~ 0 .. AW!.'CJ4!O ~RMrT .~ Rl!NEWAI. PVUKT o s. owa '" HOfUAA T1ON) ¡ $þ«.fy.~ ' .w 'OeM u-H oNyJ 3L. SINéSJ.~ I~" FAClU7'f ~ <:r C'6A. 0c0t'<9 e.-- Ñ cß éJ;~W ',,<I( I . ¡~ ~ . lOr >rxM u-H :>r'yJ /btt-~de-(cP. L TANK DI!SCQIT1ON CO,*AAn.ENTAUZEO TANK 0 v. II "y.'. c:ornplele one ~ ror MCfI ~ -Ø- '-' .. TAHK COfiIT!JfTI iT /IH( U8I! 431 I, a.«)TOR VÐ«:UI fIUI9. ",.Ibd, ~ ~~} ~ 2, "-ON-F\.El PET'ROt.E\JW :J J. ~ PROOOCT :J 4, HAl.AADOUS ~ (~ UMd OIJ :J".~ , ~TYPt! *.. NOIAAA IH..!N)EO ,It. ~ IH.J!AœO Ie;. ~ l.N.£ADEO 4- o t. w.œo o ). oes. o .. QASOtIOl o s. ,£T FUEl. EJ e. "VIA T10H FUEl. o 98. O~ 441 CAS' (!I'cm HuIrtbcI:I ~ ~~) 4-0 c:ot.a«)H NMII! ~ HuM10cø ~ ~~} ~ 'YPe Of T AH( .,..!. SINOU! WALL. o 2. 00tJIIU WALL. ;.--" 0tI8 ..... Ot'trl '.'« w. TERIAI. . pRNty ** -..c.t on. <Nm oNy) o 1. IIAAf! STœ. o t. ST AINl!SS STEa. ....1< .\M. TERW. . NCOI'dry ** 0 " IIAAf! STœ. -.. on. ..... Ot'trl 0 2. ST A.M.!-SS ST!B. II( :HTfAJC)A LNNQ COA TJo4O .. TAHK CCIH8TItUCT1ON o 1 SINOU! WALl v.mt EXTt!RIOR tA!NMANI! LHR o 4. SINGU! WALl .. A VAU. T o 5. SNJU! WAlL 'MTH ~ IIUoOOER SYSTÐ.I o IllS. lINI<NOWN o 98. OTHER o 5. CONCÆTI! 0 IllS. ~ o a. FRP COW>ATl8U: W1100'J1. ~ 098. OTIER o 3. ~1PtAST1C þ(.. STEEl. ClAD W'F~ RaI=ORC£D PlASTIC (FRP) o 3. ~I PtAST1C o .. STEEl ClAD Wf'1IIERGlASS REH=OACm PtAST1C (FRP) o s. COHCÆT!! o 1 EPOXY lNoIO 0 S. ou.ss l.M'«) 0 IllS. ~ o 4. PH!HOUC lJoØ) 0 .. lH.ND 098. OTHt!R )( 1 FI8EROLUS ftfHOAC!O PlASTIC 0 IllS. lINI<NOWN 441 o .. &4PR£SS8) ~ 0 88. ~ "" o IllS. lINI<NOWN o go, OTHER o a. FRP COW>ATI8U! WIIOO'J1. ~ o 8. FRP NOH-CORROOI8lE JACKET o 10. COATED STEEl. 44:: 44ð ~ TI! IHSTAU.£D ~¡ (1'« bœI_ Ot'trl ~T! INSTALLS) ~.. (F« bœI UN odyJ :>Ø 0tI8 .... oNr1 "Ð{ CORAO$IOf )TECT1ON F AI'P\JCA8U! o 1. ~L.eD o 2. AU('Y1) LM«J o t. ..wurACT\NO CATMOOIC PAOTtCnON o 2. ~AHOOI! o S. '-WIUAI. T AH< OAUOINO (""0) o 4. v JolXJSllCNf! o 1, O#!OIJNOWA TeR '. 'TArln1C.Al. ~ !qCONC!UATION (SIR). 0.. TAl« Tf$TINO !I~NNW. TAn< ran...o o. O~ V. TANK Ct.otu~ 1HI'000MAnoH I PlltMAHIHT Ct.OIUq IN PlACI! 4U IIT'MA.TtC QUANTITY ~ Sù8ðT~ ~ 4ðð TAH< 'ILUIO 'MTH JNeA1' IMTVUAI.? ,clúci~ aeIcr4 .xk ~ .... or-i'y) LL AM:! O~IU '...:Jr ~ NIIWfY} . to'o'" : I, ,w.rIOQAT'I..'ST+MO~'I1 C oYl. ,,,-(,Ú() ~5 ; (7t90) 1. SPU. COHT M4M!HT 2. OAOP T\M TYPe ¡For IOuI ""' Ot'trl 4$1 ~IU. ~TECT1ON EaUI~: YeAR INSTALlED 4$2 . AlARM V3. FlU. ruBE SHVT OFF VAl.'Æ _ 2. BAU. FlaA T b '.. exEWT ,.~,T~K t.!AK ~~A;_1.ii...~·~~.:·~·>· '. ,:-.-". ·;·~f~>·:·:..~~:· ,,: _. .:,~.".:··..f_11·¿" F 00U8UI WALL TAM< Olil T AHK v.tTM II.ADOeIt 1Ch«Jc Me ..." ody'}: 4&4 o 1, ~(SINOU!WAU.INVAUlT~'I1 o 2. CONTINUOUS ~TlTIAL a.«)NlTORlNO o ], MANUAl. a.«)N!TORINQ 443 441 OYM 01'«3 S;\CUPAFORM~CB-8·'M'O - CITY OF 8AKERSFIELD .. 0fI'1C8 OfIIHVIRONMI!HTA1. SERVICES a .Chø~' Ave,.lSðk....".ld, CA t3J01 (M1) 32~ YL .....0 CONI'TJItUCT1OH ~ II "-t I«JI11 uNC~NC "'PlNQ I svsrEM rYPe 0 0 I 0 ' PRESSURE Z. SUCTlOH 3. GlV.VITY.54 I. PRESSl;AE CCNsrRUcnCNI' '3¡NelI! ""AU. 3. L)NU) 1'Rf.~ 091. OTHER ~ ¡ 0 I. SINGlE 'HAl.:. I .'#NUFACTI.;AER:O 2, OOUBlI! w....:.. 1(-0 ¡6, (;~."".. L : 0 2. OCUBlE ""AU. . ~FACTUAVI _~/~ )I'f..,'k.Jf .e1! IoW-o\; FACTU REA I .0 1. lSAAe STEEL 0 8. FlU> ~AT:8L!"'" 100'BETHANCL 0 1. I!I<AE 3TEEL : ~TERIAlSANO:O 2. STM.U!SSSTE!L 07. GA1.VNCZEDST!fL 02. STÞ-iNUSSSTEEL , CO~SION , : PRO'rECTIQN :0 3. ~co.M'AT18l!WI"n1~ D9S. UNI<NOINN 03, PU.ST1CCOMPATTBLeWITHCOI'ITENTS . FleERGlASS 0 .. FUXIIIl!~) 0 M. OTHER 0 ., Flee~ $, STEEL WI CCA T1NO 0 t. CA THOOIC PROTECTION 4&4 0 $, STEEL WI COATING W. PPINO L2AK OETECTIOH (CI»Ø II 11M ~) . ~. .Y ''Þ ~. o " F\.OAT ~ TMAT SHJT'S 011' SH2AA VAL-lit! o 2. COHTNJOUS 0ISP0ISVI1W4 SÐðOR . AUOI8U! NÐ Vl8U-'L ÞUIU.tS o 3, COHTNJOUS ~ PAN SÐ$)R ïdn1 AUTO SHUT OFF FOR OI$PENS£R . AUOI8LE ANI) VISUAL ALAAMS IX. OWN !RJOP !RA TOR SIGNA T\JR! ~PIPING SIHOLe WAU. ,.~ .eð i~SSURIZEO PIPING (CIt«JllIlNt~): 1, ElEcmoHIC UI'E LEAK œTeCTOA 3.0 OPH TEST ïdn1 AUTO fIII.UI SHUT OFF FOR LEAX. SYSTEU F.....URf!. ÞHJ SY3TSf 0ISC0f.£CTQ . AI.()IIU! ÞHJ \IISUAL ALAIUoCS o 2. MOHTK Y 0-2 GPH T!ST o 3. AAH.JAl HTEGRrTY TEST co. 1 0fIIi) CON'ÆNT1ONAL SUCT1Ofo SYSTEMS: I 0 $. 0A4. Y VIStJAL. 1oIOHIT0fUH0 OF ~ SYSTEM . TRÐN.IL ÞIPMJ HTeGRtTY TeST (0.1 GPH) ~E SUCTION sY'5TaCS (NO VAL YES IN sa.ow OAO\JNO ~ ¡ 0 7, SELF MONITORING I ~:"'.= __"<T,.. ,., ..... I ; UCOtÐARlL Y CONT AIHeD f'U'INQ I ~SSURIZEO PFNJ fO*Ic II ".., I/t1ÇI/yJ: 10, CO~ T\JR8ItoE SU"*' S£HSOR ~ AUOt9lE ÞKJ VISUAL AlARMS,AHJ (o..d< ON) o ~ AUTO ~ $}fIJT OFF ~ A LEN< OCCURS o 0, AUTO PU.... ~UT OFF FOR l.fN(S. SYSTEM FA.f.l.F!:E IoICJ SYSTEM OISCOI*oECTION o Co ~ AUTO PIJtoM' SHUT OFF I 0 11, ~~ lJE LEAl< O€TECTOA (31) GPH TE3T1 ÏIID1 FlOYt St«JT OFF OR i 0 12, ANNUAlINTEGRfTY TEST (0,1 GPH) SUCT)()W(;AAVITY ~ '0 1 J. COHrH..IO\JS SIAM> SENSOR . AUOIIIU! ÞHJ WIUAL ~ ÐIVtO!HCY OeH!AATOttI OM. Y (C1t«* II ,.., ~ o 14, CONTlNJOUS S\JIM> SENSOR :t4nI2!.lI AUTO P\JYI SKIT OFF . AL()ØJ! NÐ VISUAl ALAAM:S ! 0 1 $, AUTOIoM TIC UNE LEÞJ< O€TECTOA (3.0 0Pti TE3T1 ~ FlOYt St1IJT OFF OR RE~TRICTION . 0 15, ANNUAl INTEGRITY TEST (0, 1 GPH) o 11 OAIL 1 '''SUA!. CHECK OISPeN~ER CONT AI~ 4ðI Ind ~ 10,.. ~ oJ",.., 1u1owIedge. I p."", ~O« (Fot ouJ .... onI'y I 471 PermíI ~ íMl bcitI_ oriyJ UPCF (7199) ''r: - ~;~..:- .... ". , ,"" ,. UST'f~~AQI - 01 ---= AðO'I1!GIIOuNC PtPlHO o 2. SUCT10N o 9$. u~ o 91, OTHER -' o " GRAVITY o II. FRPCO....AT1kEW/1~~ o 7. GAl.,vAHIZEO STEEL o .. FlEXJ8t.E (HOPE) 0 M. OTHER o 9. CAntOOIC PROTECTION o 95. UNICNOINN ?="-" A80VE~ND PIPING saHGLa W~ PlPtHC PRfSS1J RIZEO PIPING (CMck II rn./ aþØIy): o 1. ElECffiOMC LJIoE lEAl< DETECTOR 3.0 GPH TEST Mn1 AUTO PVM' SHUT OFF FOR LEÞJ. SYSTEM F.....URJ:, AHO SYSTEM OCSCONECTIOH. ALÐI8LE AHO \I1SUAl AURMS o 2. UOHTK. Y 0.2 GPH TEST o 3. NHJÞL M"EGRITY TEST (0.1 QPH) o 4. OM. Y VISUAL 0iE0< CONVÐmONAl SUCTION SYSTBIS (CMdl.. .., 611P1rJ: o $, OM. Y VISUAL MONrTORING Of' PIf'N) NlD PUMPING S'I'STÐot o ð, TRJENNIAlIHTEGMY TEST (0.1 GPH) SAFE SOCTIOH SYSTEMS (NO VALVES IN BELOW GROUND PIPING): o 7, sa.F MONITORING GRAVITY FlOW (a..ct ., /Nt~): o 8. OAL y VISUAL IoOofTORING o 9. 6IÐHAlINTEGRtTY TEST (0.1 GPH) SECONDARILY COHTAINEÐ PIPING PfU:SSURIZED PIPING (Ch«Ir II !tWIt aþØIy): 10, CONT1MJOOS T1JR8INE SlIJM' SENSORmn1AU018l.EAHO VlSUALALAAMS AHO (~OI'< o a. AUTO PUI.F SHUT OFF 'MEN A L£\( OCCURS o Þ. AUTO PUI.F SHUT OFF FOR LEAKS. SYSTEM FAJlURf ÞHJ SYSTEM OISCONNECTICt o Co NO AUTO PUI.F SHUT OFF o 1,. AUTOW. TIC LEAl< DETECTOR o 12. ANNl.W. INTEGRITY TEST (0, 1 GPH) SUCTJQWGRAVITY SYSTEM: o 13. CONTNJOUS ~ SeNSOR . ALIOC8U: NlD VISlW. ÞUF:US ~EHCY O!HØATO«:t ONLY (Chec*" fYf ~ o 14. COHT1NUOlJS SU.... SENSOR wrTHOUT AUTO PU.... St«JT OFF. AI.JOC8U: NK) \IISUAL ALAAM:S o 1$, AUTOW.TIC UN!: LEAK O€TECTOR (3.0 0Pti TEST) o I II, ANNUAl INTEGRITY TEST (0,1 GPH) o 17, QAJlYVIS\JAlOiECK -:. ,~c;qHTAlHwnn:;~,,, :·~\·;;·:.-;~i:; . $ffi~\.~~i-V'~~.-W:~:~ 4:;'; . o 4. OALYVIStJAL o.eo< o So TRfNO LINER I MOHfTORJHO o .. NON! 4ðe OAre 470 ..72 474 I P......~OIIIIForOc*~orìyJ 47S S;ICUPAFORMS\sWRC8-8.'M'C I -~ ';(ßiit' _.~,_. CITY OF BAKERSFIELD OF-ICE OF ENVIRONMENTALMRVICES E' 1715 Ch er Ave., Bakersfield, CA 933ð1r(661) 326-3979 . ~ UNDERGROUND STORAGE TANKS· TANK PAGE 1 " '.'! ','C',:',' ",.'.,,", "" P8Qe ":,"'-~ d"i' o ,. DWGI ~ JNFORMA 11ON) 0 5, JëMPO~Y SITe o.o~~ o " PERMA.NEHT1. Y o.o~o ON 3rTe o 5, TANI< R£MOYt:O , ' .....,.~C:..\CT)()N C,'",. J~ ,.". ~J o 1. ~ ~Te PfJtWT 0 4, AMf~O ~AMfT þ¡(l ~NEWAI. PVUMT J (~ -..,., , ~ Joc6I ... Qn/'y) 30.; SIN€ 33 .'iAMI! (~ .. /I AClUT'f NAMe Of De.4 . ~ e....w- AI) cI éJ;~W ~NK I . 3(óo b~de.rØc CÆ ?3:?dT I. T AH DESCRIPTION 1--10 'ðEfLJJ J- ~ . CO~ARTMENTAUZEO TANK 0 Y.. If "Y..., c:cmplele on. ~ /Of' MdI ~ 4: L TAM< CON'TÐfT8 "i TN« use 43t , I, L«:)~ VÐ«:U I'\a " ~tUd. ~ ~ J'kIe} 'J 2. NOH-FlJEI. PE1"AOl!\M " ._3,~~ , :J 4, KAZAROOCJS ~ (tIc:A.dN UMd 01] '~.~ , ~TYÆ *-- MOI..tAA tM.OOEO ,.. ~ I..NJ!AOEO 'c:. YDOAAœ IN.EN>ED 4- o 2. L!ACED o ). DIESEL o 4. GASOHOl o 5. JET FUEL EJ ð. ^IMT1OH FUEL 098. On-æR "", CAS'(!\'om~~~~} ... COI.M:)H JoWoI! (1Ioøo HiU:et'doua ~ ~~) . '!>E OF TAl« 44: ......,. ~ WALl. [J 2. OO\JIU! WALl. ..'«k one _ ørIyJ -oJ« 1M TERW. . pM\a'y '** o ,. BAAl! STœ. o 2. STMUSS STEa. '_~ one iNn! orI'y} I :,1( 1M TERW. . MCiOI'drt '** [J 1. ,t,Rf! STI!B. ~ one - ørIyJ [J 2. Sf A.MZ.SS STœ. '~'II( IHT'EAœ ~ "COA~ o 1. ~lMD o 2. AU<'tO l.MI«) ~ one .... ørIyJ -HER~ ,Ort:CT1OH" ~ .. TAHK COHST1tOCT1ON o ). SINOU! WAU. 'MTH EXT'!RJOft I.88We t..fER o 4. SINGt.£ WAU. .. ^ VIoU. T o 5. SINOU! W/.U. 'MTH ~ IUOOER SYSTEM O~. lJNt<NOWN o go. OTHER o 5, CONCRETe 0 M. UN<NOWN o a. FRP COtM>ATI8U: """'00'41.ETHN«X 0 te. OTHER o 3. ~I FV.STIC 'þ( 4. ~ <:LAO Wr'F18ERGlAS3 R£NORCE!) Pt.ASTIC (F'RP) o 3. ~/FV.STIC o 4. STEB.. <:LAO ~ ~ P\AST!C (FRP) o S. CONCRfT! o ). EPOXY LN'(J 0 5. 0lA8S L.N.o O~. ~ o .. PH!HOUC L.t.Ø) 0 I. I..M.tED 0 98. OrnER )(). ~~PiASTIC O~. UN<HOWN .... o 4. ~ CtJAA!H1' 088, OTHER U< o a. FRS> COtM>A T18U! W/1 00'4 I.ETHN«X o .. FRP ~RROOI8U: JAO<ET o to. COA TB) STEfl. o ge. UN<NOWN o ee. onER ~ I Do\ TE HSTAlLED 447 4:4ð (FfN bceI UN ody1 Do\ TI! NST AUB) 44i ....,.- ~ 8ß orI'y} "ll AHO OV1!Mt.L o t. toWUACT\.MD CArnoc.c PAOT!CTION o 2. ~NCOf!. Y!!AA tðT...u.eO 450 1. SP1U. CONT~ / c¡ r r I (For tocM .,. orI'y) 451 ~1lL PROTECT1ON eaUIPMENT: YEAR INST-'U.ED 452 . AlNW V3. Fill T\JB€ SHVTOFFVAI.'Æ_ 2. ßAU. FlOAT b '., !!X64PT o s. w.NUAL. TAH< QA\J()N( (MfO) o .. vÞoOOSl ZONe o 7, ~ATeR 'TArl'T!CAL.~ORY~CONCJuATION(5IA)' 0.. TANK~INO 8JI!NtMl TAH< TUTIHO O. OTH2R v, TAM< Ct.OIUIU! 1HI'0000MA ~ I P'''MAHIHT ClotUIU IN PlAce '" ItnMtIC QU.AHTTTY ~ SU8ðTAHCt ~ 4H TAH< /luao 'MTH IN(RT w.nRW.? ¡::-lúCf~\ ~ '·o<:k.1 NI accIYJ ,~r-'~ '" -' , 2, " ,; 4, . '1M rlO OI<TI WT}IM" ~Y) C .(Jj'1-r'''h.()Jl) ~5 2. OAOP T1Jee TYP!! (Ffx kxM 1M orI'y) ,.~,T,t.N( lIAK '=~~;_?~.,~'~~::.~':~~' . ':-.' '. .;~~~:"~:....!,t/.. ';,' .:,:.'".:··..t.:1·¿· If' 0008UI WAU. TAM< 0" TAM< ~ ~ (Ch«Jc OM ,.", ødtJ: 464 o f, ~(~WAI.1.IHVAlJt.TOM.Y) o 2. CONTINUOUS ~TTTIAL L«:)NfTORJHO o 3. w.MJAI. L«:)NITORINQ 463 46T 0'1'.. DNa 'F (7iW) S:'CUPAFORM~C8-8,'M'O ~ ~-,.~ CITY OF BAKERSFIELD _ OfIFICI 0. eNVIRONMENTAL SERVICES A _ C*te, A....., e.k.,.".'d. CA 13301 (5e1) 32s:w'i _L- ,. UIT"~~AQI - 1/1 --= SYSTEM rYp€ 1 pqeSSUAt! o 2, SUCroN o 3. OAAVTTI' o it. On-tER ~ IÞW'tNG CONITRUCT1OH fO** " ,., WIY I .~ r 0 I. pqeSSURe 4ðO I 0 I. SiNGlE 'HAll, o 2, XUSU: 'N.\U. IMNUFACTUFtER CCNSTR\JCT;cNl' - sINGle WAll. .'.I.ANUF ~CT1.iReR: 0 ¿. oc\Jßla WAll. IfO",~~~/ ___ L)-\,.'k.eõ" IoMM.iFACT1JRI!R _r --T. "'r -'" ~ .0 L SAAE STEEL C] a. FRP COf,fIATI8U \W 1~ I.ETHANOL 0 L !.APE STEEL : MATERIAlS ANO : 0 2. STAJHU!SS STEEL C] 7. GALVNCZ!D S1U1. 0 2. STAJNLESS STEEL : CORROSION . '~TECTiON :0 3. PLAST1C ~AT1al.E 'MT}i COHTEHn 0 M. UNl<NO~ 0 3. PI.ASTJC COMPATl8lf 'MTH CONTëHTS , FIBERGlASS C] .. F\.ÐCJ8l! (HCPE 0.. On-tER 0 4, FI8éRGLASS 5. STEEL WI COA T1NO C] 9, CA ~ PROTECTION 4&4 0 5, STEEL WI COATING VI. PPINO L2AK Df!TECT1OH (CMdI""'",) UNO~NO PIPING 3, Llk!D 1'RfN01 UNOERGAOUNJ PIPING , ~ '1SSURIZEO PIPING (CIt«k ~ INt-øpiy): I. ELECTRONIC lJPoE L.EAI< œTECTOA 3,0 GPti TEST mD:1 ÞUTO PIAIP $1U1' OFF FOR LEAK. SYSTEU FAA.URe. AKJ SYSTEM DISCOtrc:CT1CH . AUOeU! AKJ VISUAL ALMU3 o 2. MOHTa. Y 0.2 GPti TEST o 3. ~ HTEGAtTY TEST 10. I 0fItf) COPM:NT1OfW. SUCTIOH SYSTEMS: o 5. OAJI. y V1SUA.L WONrTORINO OF PIJY'INQ SYSTEM . ~ PFN3 HTEGRtTY TEST (O, 1 GPti) SAFE SUCTION SYSTEMS (NO VAlva .. IIElOW 0A0UtÐ PI'toIG: o 7, SElJ MONlTOI'UHG GRAVTTI' FlOW: o II. BIÐHAL. iNTEGRITY TEST (0,1 0fItf) II UCOtCWaL Y COHT AIlE) P'II'INQ PfUõSSlJRIZEO PFN3 (a-Ic ~ /Nt ~ 10. COHTNJOUS TVRSH: sow sa4SOA ~ AUOt8l.E NÐ VISUAL AlARMS NÐ (o-x~) . o a. AUTO PIAl> SHUT OFF WHEH A UW< OCCURS o O. AUTO PUM' SHUT OFF FOR l£AAS. SYSTEM F~ I<HJ SYSTEM OISCOM'ECT1OH o Co NO AUTO PI.JtM> SHUT OFF I 0 1 1. A~ T1C IJE L.EAI< DETECTOR (3.D GPti TEST) mD:1 FV:Nt 9VT OFF OR . RESTRlCT10N i 0 12. ~ INTEGRITY TEST (0.1 GPH) SUCTIONlGRAVITY SYSTÐot o 13. c.oHTN.)()IJS St..U' SENSOR . AOOIIU! NÐ V18UÞL /oUJVS ÐIPQ!NCY OÐetATOftS OHL Y {Ot«t " ..., It1IJIY1 o 14, COfffiNJOUS suw> SENSOA ïzmQI.lI AUTO P\.M' SKIT OfF· AUOI8U! AKJ IllSUAl AlARMS : 0 '5, AUTOMA T1C LINE L.EAI< OETfCTOA (3,0 OPH TEST) ïxmQ.lI FL(1N SHUT OFF OR RESTRICTION ; 0 I a, ANNUAl INTEG,qfTY TEST (0.' GPti) o 17 OAIL Y '''SUA!. CHECK A80Vt!CROUNO PlPINO -' o 2. SUCTION o 95. UNI<NQ'M o it, OTHEf~ ' 03,G,qAVTTI' -'ð1 o S, FRP CO"..ATI8lS WI 100"4 ~ C] 7. QALV.AMZEO ST!a. C] .. FlÐCJ8LE (HOPE) 0 90. OTHal C] 9. CATHOOIC PROTECTION C]~. UNICHO~ ~''': A80VEGAOUNO PIPING WALL PIPING PRESSURIZEO PlP1NG (Ch«k II tNllþØIy): o 1. ELECTROHIC UfE LEN< DETECTOR 3.0 GPH TEST :äm1 AUTO PUY' SHUT OFF FOR lEA)o SYSTEM FAl.U~ I<HJ SYSTBI ocsc:oNEC'TIOH . AL08LE AN) VISUAL ALARMS o 2. MOHn«. y 0.2 GPH TEST C] 3. ÞoINJAl M!GMY T!ST (0. I QPH) o 4, OAJI..YIIISUAlCHEO< CONVamONAI. SUCTIOH sYSTaIS (CMt:Ir .. .., ~): o 5, CAllY IIISUAl MONTORIHG OF PIPING NÐ PVt.IPtNG SYSTÐI o a. TRJe.MAJ. IH1CGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (~ VAl ~S IN BElOW GROUNO PIPING): o T. S£LF MONTORING G,qA VTTY FlOW (CMek II/Nt-øpiy): o .. OAI..VIIISUAl ~ o 9. 8IÐHAL HTEGR1TY TEST (0. GPH) SECONDA.RIL Y CONTAINED PII'INO PRESSURIZED PIPING ca- " tNt 1þØIy): 10. CONTINUOUS T1JRBaE stJJ.P SENSOR XdIl:1 AU048LE NÐ '-"SUAl ALARMS J¡JÐ (c:hedt on< o a. AUTO PU".. SHUT OFF WHeN A UW< 0<:ClJRS o Þ. AUTO PU"" SlilJT OFF FOR l£ÞJ<S. SYSTEM FAl.UR£ AN) SYSTEM OISCONNECTIOt o Co NO AUTO PU".. SHUT OFF o 1'. AUTO",,", T1C LEAK DETECTOR o 12. 1J-HJAL. IHTEGRfTY TEST (O.I GPti) SUCT1O....aRAVTTY SYSTBt o 13. CONT"H.JOOS SUt.P SÐmA . AUOIIIU! NÐ WIUAl AI.Niws ÐIVtOI!HCY O!NØATOftS OHL Y {Ot«t III 11M ~ o '4. COHTNJOUS 50".. SENSOR wmiOUT At1TO PU".. 9VT OFF . AUDIBLE AND VISUAL AlARMS o 15, AUTOMATIC UNE LEAK OETECTOA (3.0 OPH TEST) o ,a. ANNUAl INTEGRITY reST (a, 1 GPH) o 17, OAJL Y VISUAL CHECK .. .~~~IŒNt:~,.\ ·'f~·;;·:--:~i~;· $-;~~~;;'-.\V'~~,~<~4:.';;.: . ,OISPt!NSfRCONTAJNt.ENT 0 I. FU)AT~THAT~Of1'SH2AAVAl\1! 4ðI 0 2. COHTNJOUS OISPÐ«R ~ SÐðOA . AUOIIU! I<HJ IllSUAL AI.AAMS o 3, COHTN.ÞOUS ~ PNI SÐ«)R ïdl11 AUTO SHUT OFF FOR OISPENSER . AUOI8lE ANO 1llSUAL. ALAAMS IX. OWNI!RJOPI!RATOA SIGNATURE rod Ka.nIe 10.... MIl 0I",.,~. IIwm. No,n. I)« (H¡, IOUI .... onf)') 473 PenN! Aøøro.ed (Fot bœI_ aNy} UPCF (7199) o 4. OAI.. V VISUAl OifCl< o So TRfNCH LINER I MONrTORN) o &. NON! 4ð( OATE 470 472 474 I PwrnHçinòan 0. (1'0( ~ 1M Ø/Y)'} .7~ S:\CUP AFORMS\SWRC&-8, ',WC , ~~.. ':(~l~ir _.~._. CITY OF BAKERSFIELD OFICE OF ENVIRONMENTAL~RYICES 1715 Ch er Aye., Bakersfield, CA 933ð1P(661) 326·3979 UNDERGROUND STORAGE TANKS· TANK PAGE 1 ....~ OF 4C1'I()N c..,~" "'". tem orIy} o t, ~ SIT! ~ 0 t. AJ.«.'CfO ~AMrT þ¡G, ~N(W~ PVUMT o s. ~ ~ iH'ORMAT1ON I .,.. ~ ot Y- o If, TEMPORÀAY 3lT!! Q,O~RI: o 7. PER~'" Q,oseo ON SIT!! o II, TANK Rf~O (~~ ' Jr:" ItXAI UM Gdy) 3L5'~33,~ (s-.... '''OUT''r NM4I! 01 06A. Ooo/'og 8I.--~) cI tJ;~w (~ r;/YNJe . Jr:" ItXAI .... Gdy) "AG:AJT"r 10 , 3(òo ibfrMsj¡'dcg Ot '7' j .?o/' L TAH OI!SCRJPT1OH µo~EfLIJ d- ,,>(1 '3 CO".,ARTMENTAUZEO TANK 0 v_ II...,..'. c:ampleCe one øage rot MdI ~ 4d- 4: .. TAHK CONT'ÐfTW ~ TN« use 431 .. I, a.C) TOR V!HCl.I I\JB. , tNMd. ~ ~"".) o 2. NON-ruEL fI£T'AOt.E\JN o ], CHÐ.IC,f.l ~ ::J t, HAZAROOVS WASTe (1ncWN UMd 01) CJ~,~ ~TYPe !L MOU.AA \HDŒO 0 Z. LfACED '" PN!fo«t, I.H.!AOEO 0 :s. OIESS. ~e. ~ ~ 0 4. GASOHOt. coe.&IOH NoAMI! toøI ~ ~ ~~} o S. JET FtJEL EJ ð. A'N.TIOH FtJEL 090. OnæR CAS' (II'Om HazM10us ~ ~~) 4-' 4. 441 4-<, o S. J.IM'UAL TANK Q.WOINO tWO) o .. VÞOOSf ZONe o 7, GrIOUHOWA TER J 4. STAnST1CAI.~~CONCJuATION(SIR). 0.. TANI<~3TINO IIII!NNW.TAHK~ o. O~ V, TAM< ClOlUIt! IHJIOftMA11OH I PI'UIAHIHT ClOlUIU IN PU.CI! 4U I~TtO QUAHTTTY ~ SU83TANCt ~ .u TANK "uao 'MT1i INVfT IMTUW.? ¡::-Iücf~ ØIW4 :'Pf OF T.v« ..." SINOU! WALL o 2. OOOIU! WAU. ,-..c;k OM ..... ody1 '.'<K 1M TERW. . pM\afy ** o 1, BAAl! ST!!L o Z. STAMLSS STEEl ',-..c;k OM 8m orIyJ ,"<K 1M TERW. . NOCndIry ** 0 I. IIAAI! STU1. -.<:Jr OM ....... orIyJ 0 2. ST~ STm. 1 -.9( INTVIJOR l..fNJ , COA T'H3 o 1. ~LN!O o 2. AO<'r'O L.fN) o 1. t.wU'~ CAntOOIC PAOT!CT1ON o Z. ~AHOOe .: -..c;k OM .... ody1 'HER~ ,'OT1:CT1ON" AI'PlICAIIU! .oQ OM ft<ft orIy .l Þ.NOO~U c~ II NIIU>Ir I. SPILl CONT~ 2. OAOP ruee ,:r'·"" /2 \- .~ ). ~ f'IMTIO OATI ~+MO ~Y) C <JY1 ,~túlJ t\,5 .. TANK CONST1tUCT1ON o 3. SINOU! WALl wmt EXT'!RIOA ~ lH!R o .. SINOU! WAll IN A VAULT o S. SINOl.I! WAU., v.mi INTERNAl eu.ooeR S'YSTEM o 9ð. UN<HOWH o 90. 0TJiER o S, CONCÆT1! 0 M. ~ o a. FRP COY'ATI8lé V111~ MEnW«)l. O~, OTIER o J, ~/PlA.!T1C þ( 4. STUI.~WIF~ REN=ORœD F>tAST1C (FRP) o J. FEEROlASS I PlA.!T1C o 4. STEEl. ~ Wf'IIEROlA8S REH=OACa) P\ASTIC (FRP) o S. COHCÆT!! o 3. ff'OXY UNING 0 S. 0lMS LJfe«) 0 1115. UM<NOWN o 4. PH!HOUC UNING 0 .. I.H-tEO 0 eo, OnER )( 3. ~ ftfHORC8) P\AmC D9ð. UN<HOWH .... 04.~~ Ooe,cmER ..' o M. UN<NOWN o oe. ()T}ER o a. FRP COY'AT18U! V111 ~ MEnW«)l. o a. FRP ~AAOOC8U! JACIŒT o 10. COATED STEEl. 4-<-:. 44ð ~ TE INST AU.ED 4047 (F« bøI UN oNy ~ re INST AL.LfO 44~ (~IOCM UN orIy TYPt! (For IOuI .... ody1 451 ~1lL PROTECTION eQUIPMENT: Y1:AR INSTAU.£O 45ë . AlAAM 'tst']. Fill TU8é SHlJTOFFV~V1:_ 2. BALL FlOAT b '., ex£MPT ..r\I¡,T.4HK LIAJ( ~~Á;_fi...~·~~.:·~· ~~: . . ".:-.'.. ';~f~'" '.::..'~~' .;: "':':...: ··..t.n-¿:.. rI 00U8UI WALt. T AHK 0" T AHI( 'Mn4 ILADOeA (CMdr OM ..", Øf'Iy1: ~ o I. VIaUAL (SINOl! WAU. IN VAUt. T ON. Y) o 2. COHTI~ IHT!RSTITIAl a.C)NfTORJHG o ], MAMJ~ MONITORING 447 0'1''' OliO s:\CUP AFORMS\SV'IRC8-8, 'M'C :F (7iW) ----- -. CITY OF BAKERSFIELD ... 0fI'1C1 OfIIÞNIROHMeNTAL SERVICes ... .Chestor A.,.., S.k....".,d, CA 13301 (N1) 32~ ~ .-...0 CONITIUJCTJOH 10*« II ""1Wr1 UNCPOAO\JNO PIPING , SY'ITEM r'fP€ 0 0 I 0 ' PAESSURt! 2, SUCTlOH 3. ORAI/TTV 4S8 , PAESSURE CCNSTRUCTiCNI' SINCl! WAU. J, W~ ~ 098. OTMER 4ðO 0,. SiNGlE WALL MANUF"'CTURER: G 2. OOU81" 'II.. , 0.... U·_·....~ ,. 0 2 OOU81" ,~.., 'M.>o¡JFAcrv:eR--- If~~ U~''''-7 441 . ~;:CT1.JRER ,0 1 SAAf Sleft CJ e. FRP COW'AT18l! WlI~ a.ETHANOL 0 L BARE STEEL : MA leRIALS ANO : 0 2. ST AJNU!SS STUl CJ 7. G.A1. VNCZED STUL 0 2. ST AJNl.ESS STEEL : CORROSION '0 . PR()TECT!ON : J. PlAST1C COMPAT18U! wmt COHTENTS CJ~. UNI<NC!WN 0 3. Pl.-'STJC COMPAT18lE wrrH CONTENTS . F18ERGlAS3 CJ .. F\.!XI8l! (K>PE) CJ.. OTMfR 0 4. FIBE~ $, STEEL WI COA T!NQ CJ t. CA THOOIC PROTECT1ON 4&01 0 $, SleEl WI COATING VI. PPING L!.AK DETECT10H (CMdr II ,.., ~) ~PIPINO , 4U 1SSURIZfD PIPING (Ch«.t II fÑt~): 1, ELECTRONIC UHf lEAK œT"ECTOR 3,0 OPH TEST :tzm1.AUTO PI.U" SHUT OFF FOR LEN<. SYSTEM FAA,UR!!. /oHJ SYST1:M DCSCOI.«:CT1OH . AUOeU! /oHJ WIUAI.. Al.ARUS o 2. ~'(O.2OAiTUT o 3. AHMJ,IoL HTEGAfTY leST (0.1 OPH) CON\lVlT1ONAL SOCT1ON SYSTa.cs: o 5. O.AA. '( VISUAL 1oIONIT0fUN0 OF P\AFHJ SYSTEM . TRIEPoNAl Pf'ING NTEGR1TY TEST (0.1 GPH) : s..o.FE SUCTIOH ~ (NO VÞL va ., sa.ow GACXJN) PF9oIG: ¡ 0 1, SElF IoIONITMING I GRAVITY FlOW: o t. BÐNAL HTEGAfTY TEST (0.1 GPH) I I I' secotCWtL Y COHT AN!D I'\PINQ PRESSURIZED ~ (C1wdt II /IIfi ItÇItIIyJ: . , 0. CONTlNJOUS T\IR8INE SUJ,M> seHSOR :tIID1 AtJOIBLE NÐ 'nSUN. ~ ÞH:) (CNdr ON) . o .. AUTO ~ SHUT OFF 'MEN A lÆN< OCCURS o /), AurO........... ~UT OFF FOR lE.AXS. SYSTEM F~,v.Ð SYSTEM OISCOHtECT1ON o c. NO AUTO PIJW> SHuT OFF I 0 1,. ~?~ LH: LEM OETECTOA (3.0 ~ TEST):i1ID1 FV:1N SWT OFF OR o 12. ANMJAl iHT1:GRITY leST (0.1 GPti) SUCTIOWGAAV11Y ~ o 13. COHTN.IOI.JS su.f> ~ . AUOIIIU! NÐ WlUALJ.UIIMS UIVtO!NCY OÐ«AATOItI OM. Y (CIt«* 1I,.,1tfIIt1 o 14. COHT1N.J01JS SUM> 3EHSOA wmnrr AUTO PI.JM' SKIT OfF . AUOIIIl2 /oHJ VISUAL AlARMS o '$, AUTOMA nc UfoE LEM ~CTOR (3,0 0Ai TEST) ~ FlC1N SHUT OFF OR RESTRICTION ; 0 I ð, ANNUAL INrEGRITY le3T (0,1 GPti) o 11. DAILY '11SUAL. Ct<ECJ< - " ,. un . TAaec ~AQ I - 41 --= AðOVeGAOUNO PIPING o 2, SUCTION o i5. UNI<NOVwN o 98, OTHER o 3, GAAVITY o S, FRP CO,*AT!8lf WI ,~ I.ET1iAHOL CJ 7. a.-lVAHIZa) STEfL CJ .. FlêXI8LE (HOPe) CJ~. OT}£R CJ t. CA THOOIC PROTECTION O~. UHI<HOWN ~'-" A80veGROtJNO PIPING WAU. PIPING ~ PRESSURIZED P1PfNG (Ch«;Jr II fÑl ~): o 1. ElE~ LINE LfA( œTECTOR 3.0 GPti TEST XImf AUTO P'UJM' SMUT OFF FOR lEA'- SYSTEM FAa.UR!:. /oHJ SYSTaI OISCONIECTIOH . AOOI8U: /oHJ VISUAL ALAAMS o 2. WOH7a '( ().2 OPH TeT o 3. »HJIoL M!GRtTY TUT to. 1 GPH) o 4, OM. '( VISUAL QiEQ( CONVEHT1OHAI. SUCT10H SYSTaCS (CII«Ir II..' ~J: o 5. 0AIt. '( VISUAL. IoIOHrTOAING Of' PIPING NÐ PVY'tNG SYSTEM o ð, TRJe.tML.1HTEGfUTY TEST (0.1 Gf'H) SAFE SUCT10H SYSTEMS (NO VÞL\II:S IN BElOW GROuh() PIPING): o 7, SéLF MONITORING GAAI/TTV FlOW (CMcIc II tNt ."ç¡Iy): o a. OM.YVISUAL ~ o t. BeHAL INTEGRITY TEST (0.1 Gf'H) SECONDAItL Y COHTAINED PII'IHO PRESSURIZED P1PING (Ch«k II fÑt .ppIyJ: 10. COHT1MJOtJS T\JR8IIE SU,* SENSOR mw AIJ()I8U¡ /oHJ VISUAL AI.AAMS AHO (CIIId on< o a. AUTO P\J,* SH\JT OFF WHfH A \..EM OCQJRS o /). AUTO P\J,* StiUT OFF FOR LfAKS, SYSTEM FAJlURE ÞH:) SYSTEM OISCONNECTJO' o c:. NO AUTO P\J.... SHUT OFF o ". AUTOIoM T1C LEAl< DETECTOR o ,2. ~ IHTEGRITY TEST (0. I GPH) SUCT10WGRAVTTY SYSTEM: o 13. COHT"HJOUS SUY> SENSOR . AUCC8LE NÐ VISUÞ.l ~ b6!ItO!HCY OÐ«AATORS OK. Y ~ II,.., ~ o 14. COHT1foM:)US SU.... SENSOR wmnrr AUTO PU".. s..sT OFF . AIJOI8U: AHO VISUAL ALARMS o , 5. AUTOMA T1C UNE lEAl< O€1CCTOR (3.0 <JPH leST) o 1 ð. mNUAL INrEGRJTY TEST (0.1 GPti) o 17, DAJl Y VISUAL CHECK -~# . ~~!JHW!HT~'~.;\ . rf~·;;·:.-;~t~; ~~~~~,,\t'~~:~:,~~;;;¥.';;.: . o 4. o.u. y VISlIAl ClifCl< o So TR!NCIi UNER I MOHrTOftØ) o .. NOt.e 40Q . OSPfN3ERCONT~ 0 1. FU).f.T~T!iATSHIT3~~VÞLV!! 4ðI 0 2. COHTN.IOUS OISP!HS!II rw. SÐ«)R . AUOI8U! /oHJ VISUAl AI.IJ'U,&S o 3. COHrH..I04JS ~ p~ SÐ«>f\ JMn1 AUTO 5HVT OFF FOR DI3PENSER . AUDIBLE ANO VlSUAt. AI..AAMS IX. OWNI!RJOPI!RA TOA SIGNA T\JRI! r.d ~ 10 fie Me! cllII'f~, OATe 470 472 473 PwmJI ~ {Fod_l_ 0IIIy} 47. I p.",.. ~ 0. lFoI' 1øøI_ only} 415 L"'~-'F«OUI--oNyj , UPCF (7199) S:\CUP AFORMS\S'hRC8-8. WP[ ,~.. ^(1~i~t -,~._. CITY OF BAKERSFIELD OF-ICE OF ENVIRONMENTALMRVICES 1715 Ch er Ave., Bakersfield, CA 93JiJIr(661) 326-3979 UNOERGROUND STORAGE TANKS· TANK PAGE 1 ""<>E OF ACTIOH ';,'.c. ~". .,- crI'y) o I, ~ SIT!! PVtMIT 0 4, AM!I<OeO P1!,q1oCT ~ ~AL~ o s. ow.Ga ~ IH'ORMA T1ON) I ~ ~dt o 4, ~MPOAAAY ~e C1.0SIJRe o 7. PERMoV4!NT1. y C1.0~O ON me o 4, T ANt( A£~O I~·_ ' "" 1tXM .... only} 3t..S¡NéS3.o;AMI! ¡s..-r.... ""OUT'!'.'oIM4I! Of Oð.4. 0cIt"9 ~...¡ ¿þ tJ ;~ 0J COMPARTJ.ENTAUZEO TANK 0 v. 11,,(.', QCtllpleCe one ~ I« Men ~ 4 -Q- 4: .. TANK CCINT!NTI i TN¥. use 431 I, MOTOR 'iÐOCU I'UI!I. 1Ntbd. ~ ~ J)peJ :.J 2, H()N.ÇUEL ~ ::J ), ~PAOOUCT ,.J 4, ~WAST1!(~ UMd OIJ :J~,~ ~T'I'Pt! ,a. MQUtNt I.HJ!AOED 0 Z. ~ ~.. ..,..,..,.. tHbCED 0 ). OIESS. Ie:. YOOAAœ t.MÐDEO 0 4. GASOHOl CO&.U:)H JWiI!~ ~ ~ "-'Þy~) o 5, JET F1JE1. o a. AVlAT10H RJEL o SI9, O~ 441 CAS' (JIom HaZMious ~ ~ ¡»ge) 44 4- 44: ':;>E Of TN¥. ...." SINOU! WAU. o 2. 00tJel.! WAU. ,d OM _ oNy (j( 1M TëRW. . pnnaty IIII'é :.'<Oct ~ ... crI'y) o 1. BAAl! STœ.. o Z. STAtUSS STEa _";11 .IM. TëRW. . --.dIIty IIII'é 0 1. BAAl! STœ.. '«J< ~ .... oNy 0 2. aT AIN.!$S STUl. I ::;.x tHTVUOR LN«J I ." COA THJ :~ ~ .... oNy ';'H€R~ ;~On:CT1OH. ~ 01.~L.ND o 2. ALJ<'t'O lNNQ .. TAHK CON8T1tuCT1ON o 3. SINOU! 'N.'U. v.mt ÐCT!:RIOR I.8otMAH! lH!R o 4. SINOU! 'N.'U. IN A VN.A. T o 5. SINOU! WÞU. v.mt ~!IlAOOER SYSTÐoI o CIð. UNCHO'Mf o SI9. OTHER o 5. COHCÆT! 0 SII5. lJNI<NO'M4 o a. FRP COt*ATI8lE Wl100"4 /oETIWoIOI. 0 ie. OTHeR o 3. ~/PlASTIC 'þ(... STf£l. ~ Wo1'IefR()U.SS R£N=ORCED PlASTIC (mP) o 3. ~I PlASTIC o ... STEB. ~ WFeEROlA8S REN=ORCm PlASTIC (mP) 05.CONCÆT1! o 3. EPOXY &....0 0 5. 0lASS L...o 0 CIð. ~ o ... PH!HOUC lNNO 0 ... \"M.IHED 0 SI9. OnER )( 3. FeEROLUS AOf'OAaO PlASTIC 0 CIð. UNCHO'Mf .... o ... ~ CI.JAAfHT 0 III. 0TIi£R .... o .. FRP COt*AT18U! Wl100"4 /oETIWoIOI. o .. FRS> NOH-roAAOOC&.E JACIŒT o 10. COATED STEEl OSll5.~ o III. OTHER ~ ~TE INSTAllED 447 44ð (F« #tx* UN orty1 ~ T! INST AU.!O 440 .';0--" ~ .... Ot'i'yJ ~tL ~OVV!FU o 1. 1WU'ACT1.JN!D CAntOOIC PAOT!CT1OH o 2. SAOW1CW. AHOOt! 't1!AA MT AU.EO ~ L SPUCONT~ / C¡rr I (FtN ItxaI 11M Ot'iyJ 45 1 ~IU. PROTECTION EOUIPt.EHT: vt:I.R INST AU.ED 452 . At.AAM , VJ. FlU. T\J8é SHVTOFFVALV1:_ 2. ðAU.. FLOAT b ",:, E!XfMPT o S. I.IANlJAL TAN< GAUOINO (UTO) o .. VÞoOO~ ZONe o 7, OIIOONOWA TeR 4. STArl$T1CAI.~~TIO+4(~). 0 l TANK~INO ðll!NNW. rANt< TI6TIHG o. OTHeR V. TAM< Cl.otU~ 1H10000MA 110H I P.~MAHIHT Ct.0IU g IN PlACt! 4U UnMrtD QUAHTTTY ~ SUeaTAHCf ~ 46ð TAN< I'U!O WlTHINVfT ~TfI{JI.L? f:!úci~ 0Ib4 , 'ù ~ :Nt fCP/Y) 2. OAOP ruee ':rIIMrIO OAr.lAß'+MD~Y) C.(J}'1 0\lÚD t4.5 TYPe (FQ, touI 11M oNy ,.~,T~K LKAK t'~~;_?._~.~~,,:.~.:~: "" ':-: ". '¡~f:!:' .~::..~:... .; I' . .:..:.".: ....t.:1:~.. " oooeu WALL T AHK OR T AHI( \'ofni ~ (CMdt ~ """ Øf'/# 464 o 1. ~(SINGl!WAU.1NVAUt.TON.Y) o 2. CONTINUOUS IHT!IlSTlTIA1. MONfTORJNO o 3. MANUA!. IoAONITOAING 4&3 487 0.,... ONe! S;\CUPAFORM~CB-8·'tWC ''':;F(7m) --<h- CITY OF 8ÅKERS,~ELD . OfI'lCi CW INVIRONMENTAL. URVICes A ChqNr Ave., ISak,,.ft4Id, CA '3301 (M1) 32~t YL IÞIttNO CONITRUCT1ON ra-r III '* .." UI'<C~~ ""PlNQ I S'rsrEM r'r~ 0 0 I ' PRESSURt! 2, SUC~ 3. 0AAV1TY .54 0 I, PRESSURE CC..STRUCT:CNl' - 'JHClI! WAl!. J. uNm 1'R!.'<:M O~, OniER ~ I 0 I, SINGtE 'HAl!. ,wNu""crURE,R: G 2. OCU811! WAW. 0 ¡¡s, u~ I, 0 2, OCU8LE 'HAl!. IM.M.JF"CTlJR~ --6-"....,/~ \.A.'YI.''^1~, ~F"CTURER o ',~ne!l 0 s. FRPCOW'AT18L!Wlt~~l 0 " a,..qe3TEEL : MA TERIAlS A/'<O '0 2. STAJHU!SS STE!1. 0 7. QAt.VNCZ!D S1UL 0 2. STAINlESS STEEL : CORROSION , 'PROTECTION :0 J. PlAST1CCOW:>AT18U!......-niCONTÐlTS O¡¡s. UNI<NO'M4 0 J. PlAST1COJIo4PAT!8U;WlTHCONTëHTS . FIBERGlASS 0 .. Fl!XII!IL! (M)Pt!) 0 tt, OTHER 0 4. FI8éRGlASS 5, SiEELWlCOATINO 0 t. CATHOOICPAOTECT1OH ~ 05. STEEl'NlCOATlNG YI.. PPtNO L.2.AK DETECT10H (Chet:Ir III ~ ~J I lJHOERGAOUNO PIPING , SIHOU! WAU. ~f'IHO .eð ~SSURIZEO ""PlNO (Ch«JI ., ItIe,~): I. EtECTROMC LH LEAK œTl<:TOR 3.0 GPH TEST :ðm1 ÞUTO PIJIP SHUT OFF FOR lEM. S"I'STaI FAl.UAI!. NCI SYSTEM OISCONECT'(» . AUOØ.I! NCI VISUAL AI.).AAIS 2. IoIOHTa. Y 0.2 GPH nsT o o 3. mHJAJ. INT"EGftITY T!!ST (0.1 OPH) CON\l1:HT1OfW. SUCTION SYSTEA.O: o 5, 0AJl Y V\SUAL 1oIONfT0RINQ (y PUY"M) S'\'STÐ.I . TReHAI. PPN3 INTEOArTY TEST (0, t GPH) SAFE stJCTJON SY$TEMS (NO VAlVES ~ saow GAOVN:I Pf'Hj); o 1. SElF Io4ONlTOfUNG GRAIiTTY flOW: o t. ~ INT"EGftITY TEST to.1 OPH) i I' SlCONDAM. Y COHTAINeÐ I'\PINQ PRESSURIZEO PF...o ra..ør IIIItIel ~ . 10. COI'ffiNUOUS T\JR8INE SU1oM' SEHSOA :ttm1 AUOI8LE NÐ vtSUAL AlARMS AKJ (0*'< Qr'4) o &. AVTO PIJY> SHIJT OFF 'MEH A t.eN( 0CCUR3 o f~, AlITO PUW" ~VT OFF FOR lEAKS. SYSTEM "AA.1Æ IoIÐ SYSTEM OtSCON'ECT1ON o c. NO AUTO P\Jt.M' SHUT OFF I 0 1" ~~ ~ LEAK OElCCTOR (3.0 GPH TDT1 ~ NM SWT OFF OR ¡ 0 12, ~ IHTEGRtTY TEST (0,1 GPH) SUCTIOI'4'GRA VITY 3YSTEJ,t o 13. ~ SUM> ~ . AUOIM.! NÐ VISUAlN.J./IIMS ÐlØGfHCY OBiEM TOftI OM. Y {CIIeck III lilt WIrl o 1.. CO~S S\.M> SENSOR ~ AUTO fIUI,fI SKIT on:. A&JOIBL! NCI V1SUAl AlARMS ! 0 t 5, "uTOMil TIC UI'E LfA( OET!CTOR (3,0 GPH TEST) ~ FlUN SHUT OFF OR Rf,TRICTIQN ,0 HI, ANNUAlIHrEGRITY TEST (0.1 GPH) o 1 T OAll f V'SUAL C}<ECK - " PI98 I.IIT '1'~ 'Act - fill ---= ~CAOU~ ""PlNQ ~ o 2. SUCTION 0". LJNI<NO'M/ o 91, OTHER o J, 0AAV1TY o S. FRPOJMPATI8lÆW/I~~ o 7. QAt.VAH!ZED STœ. o .. Fl£XJ8l.E (HOPE) 0 91. O-nER o 9, CAntOOIC PROT!!CTIOH o ¡¡So UNKNQ'M4 ~..:.. ABOVEGROUND PIPING SlHQU WAl.L PlPINO PfU:SSlIRIZEO ""PING (Ch«JI" ItIe,.wy): o I. ~ UNE LEAK OElCCTOR 10 GPH TEST mntAUTO PIAIP SMUT OFF FOR ~ SYSTEM FAl.UÆ. NCI ~ OCSCONECTIOH . AUOt8L! NCI VISUAl ALARMS o 2. MeHTa. Y Q.2 OPH TEST o ], NHJN. M"EGI'ItTY T!.ST (0.1 GPH) o .. CAJt. y WIUAL. aEO< CONllENTlOHAl SUCTION SYSTEMS (CMdr" IIte,~): o 5. DAJl Y WIUAL. ~ (y PFtNO AKJ PU1.IPtNO SYSTÐt o S. TRJENNIAlIHT!!GMY TEST (0.1 GPH) SAFE SUCT10H SYSTEMS (NO VAlWS IN Ba.OW GRQUN) PIPING): o 7. Sél.F MOHTORING GRAVfTY FlOW (a..ck" 1tIel~): o e. CAJt.YWIUAL. ~ o II. BIENNW. NTEORrTY TEST (0.1 GPH) sa:oNDA.... Y COHTAIN!D PII'INQ PfU:SSURIZED PIPING (CMdt III ItIe,.wy): 10. COHTtHUOUS T\JR8ItoE SUMP SEHSOR mw AIJOI8le NCI VISUAl ALAAMS AKJ (c:hedI: or>< I o a. AUTO PUMP SHUT OFF 'MiEN A t.eN( OCCURS o Þ. AlITO PUMP SHVT OFF FOR LEAKS. SYSTEM FAl.URe I>HJ SYSTEM OISCONNeCTlOI o c. NO AUTO ~ SHuT OFF o 11. AUTO"" T1C LEAK OETECTOR o 12. ANMJAlIHTEGRITY TEST (0,1 GPH) SUCT10NlGAAVITY SYSTEM: o 13. COHTH..lOUS suw> SENSOR . AU04IIle NÐ VISUAl AI.AAMS Ð6f1t(JfHCY OÐÆltA~ OM. Y (QIect., twt ~ o 14, CONTlNUOUS SUMP SENSOR WfTHOUT AUTO PUMP !HIT OFF. AIJDI8lE AHO VISUAL AL.ARMS o 15, AUTOMilT1C UNE LEAK OETECTOR (3,0 OPH T!!ST) o I ð, ANNUAlINTEGAITY TEST (0,' GPH) o 17, OAlL Y 111$UÞ.l CHECK -:. ,~~AlNW!Ht:~,,,'f'>;;:-!;'l:; $ffi~~~~\V'~~~~:~~~~~:. . o .. CAJt. y VISUAl. OiecK o S. TRfNQ LINER I MONrTOftlNO o .. NOM! 4ðQ OISPENSER OJNTAlHU!HT 0 1. FlOAT ~ THAT SHlTSOfI' SHI!AI't VAlV!! ~ 0 2. ~ 0ISP!NSeR ~ SENSOR . AUOIIIle NCI V1SUAL AURMS I o 3. ~a ~ PAN SÐðOR ~ AUTO SHUT OFF FOR Ol~ . AUOI8LE ANO V1SUAL. ALARMS IX. OWH!RJOfI!RA T~ SIONA ruRI! ~ ~ 10 lie *' 01 my 1UIcMIedge. L~ ~- (~OUI .... only) ~1] ~~{Fotbcel_onìyJ UPCF' (7199) OArE 410 472 4 H Pwmc !J::¡inòon 0. (~1oøI1IM only) 47 ~ S:\CUPAFORMS\SWRC8-Ø. 'M'( J I ~ ~ 1 '> CITY OF BAKERSFIELD O~E OF ENVIRONMENTAL _VICES 171! Chester Ave., Bakersfield, ~A 93301 (661) 326·3979 UNDERGROUND STORAGE TANKS . INSTALLATION CERTIFICATE OF COMPLIANCE .-...--..-..-.--. .-.---.. ..-- --.-- ---- One form per tank , Pege L 01 U __.._ _.____.....______....____ '_"__"__ L I. FACILITY IDENTIFICATION US'NEAš7Z:ëiŒiYtWÆOI;;;OobJ ~~!LG- " c/Ol ~-Z;; -ik!{,;s/'o-fjl- CÞr----~)~ AC<ßY'O·mf~ ~. I ._:==~=_~~'=~h_-.._' II. INST ALLA TtON Check all that apply . 'P- The Installer has been certffled by the tank and piping manufacturers, o The installatIon>has been inspec-+Ad and certified by a registered professional engineer, 'f- The Installation has been InsPflCted and approved by the City of Bakersfield Office of Environmental Services, 'f- All work listed on the manufacturer's Installation checkJist has been completed, . o The installation contractor has been certlfled or licensed by the Contractors State License Board, o Another method was used as allowed by the City of Bakersfield Office of Environmental Services, Identify method: III, TANK OWNER/AGENT SIGNATURE inJonnallon ~ "-WI & acQXÛ 10 !he ÞftI 01,." ~ õ¡: -ë5wÑÊÃiA -- --------------- - ---TõAiE ----- ----,---- - --..- --- - - - -, ----~ 'AA;ia.;¡.~ÃG""~-.- ---.J=[.;:~"'~------n .. u -- ---..... --.-~.J--.17----_.--I.- J il.q:-'/ e_FJ~.~·_u hU. .__ '01"1 C e e 1 !" - ( 1 -..---.... ~-"'.~,~;:;., CITY OF BAKERSFIELD o.e OF ENVIRONMENTAL .VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS . INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank .._______.____ ____ _.____________..____~ ._____~_ ;;J::. of ~ I, FACILITY IDENTIFICATION ",~EF~ß;;P-Š;;~ _ "<1'01 d;k-Z;¡-i~~!"(;_it-ëit--_·~ ~OL1TY'D'JjJIIIIJJlIr ~'~ ___________ ____=~.------- .-..--..-.-....-. .-----.. II. INSTALLATION Check all that apply . 'P- The Installer has been certffled by the tank and piping manufacturers, o The installatJon has been inspøcfAd and certified by a registered professional engineer, 1- The Installation has been Inspocted and approved by the City of Bakersfield Office of Environmental Services, 'f- All work listed on the manufacturer's Installation checklist has been completed, . o The installation contractor has been certified or licensed by the Contractors State License Board. o Another method was used as allowed by the City of Bakersfield Office of Environmental Services, Identify method: III, TANK OWNERlAGt;NT SIGNATURE / õnIonnItIon ~ '**".. & KanIa '" IN bat 01 ""I knooo4edge õ" ·'öWÑÉÀlA -- ----.---.------ - ---TõAii: "j~~ïL,/~-- =1~~7:~j~i- _q-o_ _-."0--- - ,-, ----------7--------- ---- ---,,-----,- ..-.-.--- --,-. --.---------..--- .._.._~-... - - - , -------:¡¡¡- ------4ðð" ,_c CITY OF BAKERSFIELD OFe:e OF ENVIRONMENTAl.VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3919 UNDERGROUND STORAGE TANKS . INSTALLATION CERTIFICATE OF COMPLIANCE --...--..- .-..--. .-.---.. ..---.--.--- One form per tank PIIge Ð of a. ____ _______.._____.......___ .____.._. L I, FACILITY IDENTIFICATION USNEM:?rZën.TiYÑÃiAeOl;;¡~ew.-~~ " c/Ol ~--(;)--lk4;f/,O·(j'·~---~. A~'D'~ - ~'3 ._.~.~=.=_~~~=-----' II. INSTALLATION Check all filet epply . 'f- The Installer has been certffled by the tank and piping manufacturers. o The installation has been inspøcfAd and certified by a registered professional engineer, '1- The Installation has been Inspected and approved by the City of Bakersfield Office of Environmental Services, 'f- All work listed on the manufacturer's installation checklist has been completed, . o The installation contractor has been certified or licensed by the Contractors State License Board, o Allother method was used as allowed by the City of Bakersfield Office of Environmental Services, Identify method: III. TANK OWNER/AGENT SIGNATURE inbmatlon ~ '**" & aoc:u:wca 10 IN besI cI "'" ~ ·õ" - UöWÑÊÀlA -- ----.---.------ - ---TõAiE ----- ----,---- - ....- -.. - . ... -.-----:¡¡¡- .. TÅÑi(ÒWÑèRÌÄGiÑT~ì'. . =1 rm[;:}-~~~ENT----'--_·_-- -.... -- .-----~ ~ ~(~ V,(.£ l/e~l'j~{. --...-.--.... .-..------/-.------. ----,---..-.---,-..-.-.---.-,..,.....----- ,_c I I r CITY OF BAKERSFIELD ore=e OF ENVIRONMENTAL .VICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326·3979 ' --:;" UNDERGROUND STORAGE TANKS -INSTALLATION CERTIFICATE OF COMPLIANCE One form per tank , p. ':t. 01 ~ ....- ---.. --...- ------. -- ---- ._- ----- .-.. --..- -----' .-.---.. ..---....- .--- I. FACILITY IDENTIFICATION "'"'~~Z~~ " <lol-{;£k-C;;°4i±if!{r:;¿Jir----~· 'CU1Y'''~' ~. £. --- . ! L I __._____.___ _____. II. INSTALLATION : ~ o ! i- 'f:- o o . Check all that apply The Installer has been certffled by the tank and piping manufacturers, The installation has been inspec-t~ and certified by a registered professional engineer, The installation has been InspPCted and approved by the City of Bakersfield OffIce of Environmental Services, All work listed on the manufacture(s installation checklist has been completed, The installation contractor has been certified or licensed by the Contractors State LIcense Board, Another method was used as allowed by the City of Bakersfield Office of Environmental Services, Identify method: III, TANK OWNERlAGf;NT SIGNATURE õnJormallon ~ '*-' & ec:a.nc. b !he bet! 01 "'f ~ ÕF - "öWÑÉÃJA -- ----'---·----------TõAie I =1 ~-L-~ : ' "~oo~(~ - ~ J;;;¡;:wj~i- OH_O - -' .-..,...- - ... --.-------7-.------- ____'__.h_.___,__..,_.___ ----, --..-- --.-..-----.----"- --..----.. . . - . .._-=--:;¿¡- ._----~ 'Otfft C f ì' r ., / FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRE~NSERVICE8 2101 'H" Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 PREVEKnONSER~CES 1715 Chester Ave, Bakersfl8ld, CA 93301 VOICE (805) 326-3951 FAX (805) 326-0576 E~RONMENTALSE~CES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (805) 326-3979 FAX (805) 326-0576 TRAINING DMSlON 5642 VIctor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX (805) 399-5763 . , April 4, 2000 J aco Oil Mr. John Kerley POBox 1807 Bakersfield CA 93303 1807 Dear Mr, Kerley: You have been identified as the compliance coordinator for the facility/facilities referenced in the attachment. The permits to operate this facility/facilities will expire on June 30, 2000, However, in order for this office to renew your pennit, updated forms A, B, & C must be filled out and returned prior to the issuance of a new permit. Please make sure that you are sending the updated fonns which are indicated by the date 7/99 in the lower left hand comer, Please complete and return to this office by May 15,2000, Failure to comply, will result in a delay of issuance of your new permit to operate, Should you have any questions, please feel tree to call me at 661-326-3979, Sincerely, sÆ-~ Steve Underwood, Inspector Office of Environmental Services SU/dam attachment ~~7~de ~~ ~ ~rH¥Þ.r~ ~ ~~" , ~,.,,,,. "",,, j'~-: r;¡¡:- - . Facility Address Farrells Fastrip ~r~lÜteIãnb, Bakersfield, Ca 93309 F astrip 8001 White Lane, Bakersfield, Ca 93309 Fastrip 1200 Coffee Road, Bakersfield, Ca 93308 Fastrip 4901 S, Union Ave" Bakersfield, Ca 93307 Fastrip 2698 Oswell Street, Bakersfield, Ca 93306 Fastrip 1640 S, Chester Ave" Bakersfield, Ca 93304 Fastrip 805 34th Street, Bakersfield, Ca 93301 Fastrip 12851 Rosedale Hwy, Bakersfield, Ca 93312 Fastrip 4013 S, "H" Street, Bakersfield, Ca 93304 F astrip 6401 S. "H" Street, Bakersfield, Ca 93304 Wholesale Fuels 2200 E. Bruridage Ln" Bakersfield, Ca 93307 Chris Liquors 2732 Brundage Ln" Bakersfield, Ca 93304 Howards 3200 Panama Lane, Bakersfield, Ca 93312 Howards 4201 Belle Terrace, Bakersfield, Ca 93309 Howards 3300 Planz Rd" Bakersfield, Ca 93309 COMPLETE THIS FORM FOR EACH FACIUTYISITE ~. ~; $' A õ:' L 7E CF CALIFORNIA . STATE WATER F.¡:SOURCES CONTROL BOARD .- UNDERGROUND STORAGE TANK PERMIT APPLlC ION· FORM A MARK ONLY ONE ITEM [] 1 NEW PERMIT c:::J 2 INTI:RIM PERMIT o 3,RENEWAl PERMIT ~ AMENDED PERMIT o 5 CHANGE OF INFORMATION 0 6 TI:MPORARY SITI: CLOSURE 7 PERMANEHTl Y CLOSED SrTE ~ '---' I. FACILITY/SITE INFORMATION & ADDRESS -(MUST BE COMPLETED) PAACEl, (OPTK)NAl) STATE CA SITI: PHONE , wm~ AREA CODE Ô? = CORPORAT1ON ~OIVIDUAL C PAATNERSHIP = LOCAL· AGENCY DISTRICTS , ,/ IF INDIAN U RESERVATION OR TRUST lANDS = COUNTY-AGENCY o STATE-AGEHCY o FEDERAl-AGENCY :YPE OF BUSINESS --.J r---; 1 GAS STATION I 2 DISTRIBUTOR 3 FARM r- 4 PROCESSOR 5 07"ER - EMERGENCY COtlTACT PERSON (PRIMARY) EMERGENCY CONTACT PERSON (SECONDARY), optional DAYS: NAME (lAST. FIRST) PHONE. WITH AREA COOE II. PROPERTY OWNER INFORMATION· MUST BE COMPLETED) ,/ b,a ID Indlcw : ~RAnON ~ PARTNERSHIP " ¿::¡ ¡ ZIP CODE o LOCAl·AGEHCY 0 STATE·AGENCY o COUNTY..\GENCY 0 FEDERAl-AGENCY PHONE. WIn! AREA CODE ~-~~3"~ III. TANK OWNER INFORMATION· (MUST BE COMPLETED) o lOCAl.-AGEHCY 0 STATE·AGENCY o COUNTY..\GENCY 0 FElJERAL-AGENCY PHONE. WIn! AREA CODE ¡ I ~~RPORAT1ON , S~ I' Z¡P COOE ~:=<'L), ' 93 IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER· Call (916) 739-2582 if questions arise. TY (TK) HQ ¡4l4l-~ V. LEGAL NOTIFICATION AND BILLING ADDRESS ~E?a r,::,~;cation and billing will be sent to the tank owner unless box I or" is checked. Ci-<¡;CK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE US¡;íJ ¡:OR L=:;~_ ,'OTlFlèATlONS AND BIllI'<G: I. 0 II, ~ III. ~ -..>~o THIS FORM HAS BEEN OMPLETED UNDER PENAL TY OF PERJ¡;¡;Y. AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT I ~=;>lICANrs TITLE LOCAL AGENCY USE ONLY I J cour-.;'7Y /I ~ ~ LeCA nON COOE - OP TIONAL JURISDlcr:ON /I FACILITY /I ~ = CENSUS TRACT. . OPTIONAL SUPVISOR· DISTRICT CODE - OPTIONAL THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION. FORM B, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY, FOROOJ3A-A2 =ORM A (9-90) ~ i:OO " e e STAll OF CAUIORIU STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM D 1 NEW PERMIT D 2 INTeRIM PERMIT ~: RENEWAL PERMIT AMENDED PeRMIT o 5 CHAHQE OF INFORMATION o a TeMPORARY TANK ClOSURE o o 1 PERMAHÐm. Y ClOSS) ON SITE a TANI( REMoVED A. OWNER'S TANK I. D. , B. MANUFACt\JAED BY: D, TANK CAPACITY IN GALLONS: DBA OR FACIUTY NAME WHERE TANK IS INSTALLED: I, TANK DESCRIPTION C. DATe INSTALLED (MOIOAYIVEAR) II, TANK CONTENTS IF A.IISMARKED,COUP~ITEM C. D. IF (A. 1 ) IS NOT MARKED. ENTeR NAIÆ OF SUBSTANCE STORED D I. REGUlAR C. UNLEADED o Ib PREMIUM UNlEADED o 2 LEADED 3 DIESEL 0 a AVIATlCNOAS · GASAHOl 0 1 METHANOl. o 5 JET FUEl ~ OtHER (DESCAIIE IN ITEM D. Ba.OW) C.A.8.,: A. 1 MOTOR VEHICLE FUEL CJ 2 PETROLEUM n :I CHEMICAL PROOUCT D. OIL o 80, EMPTY C 95 UNKNOWN B. ~PRODUCT D 2 WASTe III, TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B. AND C, AND ALL THAT APPliES IN BOX D A. TYPE OF CJ 1 DOUBLE WAll [Q/3 SINGLE WAll WITH EXTERIOR LINER o 95 UNKNOWN SYSTEM CJ 2 SINGLE WAll 0 4 SECONDARY CONTAlNIo!ENT (VAUlTEOTANK) o 9Q OTHER 0 ' BARE STEEL 0 2 STAINLESS STEel o 3 FIBERGlASS ~ STEa. ClAD WI FI8ERGlASS REINFORCED PlASTIC B, TANK MATERiAl CJ 5 CONCRETE 0 6 POLYVINYL CHLORIDE o 7 ALUMINUM o 8 I~ METHANOL COUPAT18LE WIFRP :PrimllY Tn fl g BRONZE 0 10 GALVANIZED STEa D 95 UNJ<NOWN o 9Q OTHER '---' CJI RUBseR LINeD o 2 AlKYD LINNG o 3 EPOXY LINING 0 . PHENaLC LINING C, INTERIOR ~ 5 GlASS LINING rJ:::V$ UNLINeD D~ 0 l1li OnER UNING ; I ---J IS LINING MATERIAl CQUPATI8lE WITH I~ METHANOL ? YES_ NO_ -' --, POL ¥ETHYLENE WRAP Ii 2 COATING ¡-: 3 VINYL WRAP [];¥'4 FIBERGLASS REINFORCED PLASTIC 0, CORROSION I , - ---' - PQOTECTlON 5 CATHODIC PROTECTION ,- 91 NONE - 95 UNKNOWN o 9Q OTHER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND,BOTHIFAPPlICASLE A. SYSTEM TYPE A U 1 SUCTION A (U)2 PRESSURE A U 3 GRAVITY A U l1li OTHER B, CONSTRUCTION A U I SINGLE WALL A U 2 OOUBLE WALL A(u) 3 LINED TRENCH A U ;5 UNKNOWN AU gg OTHER C, MATERIAL AND A U I BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHlORIDE (PVCI A U . FIBERGlASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A ói)7 STEEL WI COATING A U 8 100% UE1HANOL COMPATlBLEWIFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U ¡$ UNKNOWN A U 9Q OTHER 0. LEAK DETECTION [J I AUTOMATIC liNE LEAK DETECTOR ;-;2 LINE TIGHTNESS TESTING ~ MONITOR/NQ o 9Q OTHER - V. TANK LEAK DETECTION 1 VISUAL CHECK 2 iNVENTORY RECONCILIATION ~ 3 'APOR MONITORING cç¿ AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING ;; TANK TESTING L- i INTERSTITIAL MONITORING ' 91 NONE 0 95 UNKNOWN 0 gg OTHER VI. TANK CLOSURE INFORMATION 1, ESTlMA TíoD DA TE LAST USED ¡MClOAYIVR) 2. ESTIMATED QUANTITY OF SUBSTANCE REMAINING I 3. WAS TANK FILLED WITH GALlONS' INERT MATERIAl ? YES 0 NOD F PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT APPlICANrs NAME DATE . PAINTeD' SIGNA TUR LOCAL AGENCY USE ONLY THE STATE 1.0, NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW STATE 1.0.# COUNTY , I] JURISDICTION" ,=0:= . , , . FACILITY , = TANK' = PERMIT NUMBER I PERMIT APPROVED 8YiOATE I I PERMIT EXPIRATION CATE FORM 8 (gogo¡ THIS FORM MUST BE ACCOr.flANIED BY A PERMIT APPUCATlON, FORM A. UNLESS A CURRENT FORM A HAS BEEN FlL£D, FCAIIaMa.- 'i, e e STATI OF CALJR)IIIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPlETE A SEPARATE FORIlFOR EACH TANK SYSTEM. MARK ONLY ONE ITEM o 1 NEW PERMIT o 2 INTERIM PERMIT 0/3 RENEWAl PERMIT o .. AMENDED PERMIT o 5 CHANGE OF INFORMATION o IS TEMPORARY TANK CLOSURE o 7 PERlIANENTI. V a.oseo ON SITE o 8 TANC REMOVED DBA OR FACIUTY NAIE WHERE TANK IS INSTALLED: I. TANK DESCRIPTION COMPlETE All. ITEMS - SPECIFY IF UNKNOWN A. OWNER'S TANK I. D. . B. MANUFACT\JRED BY: '..// ;\f I C, DATE INSTALLED (MOIDAYIVEAR) D. TANK CN>ACfTY IN OAllONS: II. TANK CONTENTS IF A·IIS MARKED. COMPLETë ITEM C. A.' 1 MOTOR VEHICLE FUEL [] 2 PETROLEUM c:J 3 CHEMCALPROOUCT 0" OIL o 80, EMPTY C 95 UNKNOWN B. . ~ PRODUCT o 2 WASTE O ,. REGUlAR C. UNlEADED I::EJ'1b PREMIUM O UNlEAOED 2 LEADED 3 DIESEL 0 IS AVIATIONßAS .. ßASAHOl D 7 METHANOl. o 5 JET FUEl o 98 OTHER (Da1CA1BE W ITEM D. 8QOW C.A.9..: D, IF (A. 11 IS NOT MARKED. ENTER NAMe OF SU8STANCE STORED III, TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B,ANDC, AND ALL THAT APPlIES IN BOX D A, TYPE OF 0 1 DOUBLE WAll. [9/3 SINGLE WAll. WITH EXTERIOR LINER o ¡s UNKNOWN SYSTEM CJ 2 SINGLE WAll. o .. SECONOAAV CONTAlN~ENT (VAUlTEDTANIQ o 98 OTHER c::J 1 BARE STEEL 0 2 STAINLESS STEel D 3 FIBERGlASS ~ STEEl ClAD WI FIBEAGL'9S REINFORCED PlASTIC B, TANK MATERIAL CJ 5 CONCRETE D 8 POLYVINYL CHLORIDE 0 7 AlUMINUM D 8 100'!1. METHANOl. COUPA,T18lE WIFRP : Primary T wI 11 9 BRONZE 0 10 GAlVANIZED STEel 0 95 UNKNOWN 0 9(1 OTHER --' CJI RUBBER LINED D 2 ALKYD LINNG o 3 EPOXY LINING 0 .. PHENaLC LINING C. INTERIOR ~ 5 GlASS LINING ~ UNLINED o 95 UNKNOWN D 98 OTHER UN1NG ~ YES~NO_ IS LINING UATERIAl COUPATI8lE WITH 100'!1. UETHANOl? ~ POL YETI-rflENE WRAP n 2 COA TlNG ¡: 3 VINYL WAN> .. FIBERGlASS REINFOACE1) PlASTIC O. CORROSION I 1 - --' - PQOTECTlON 5 CATHODIC PROTECTION 1- 91 NONE ---: 95 UNKNOWN D 9(1 OTl-lER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND,BOTl-l IF APPLICABLe A, SYSTEM TYPE A U 1 SUCTION A{Jj) 2 PRESSURE A U 3 GRAVITY A U 9(1 OTHER B. CONSTRUCTION A U 1 SINGLE WAll A U 2 DOUBLE WALL A@3 LINED TRENCH A U QS UNKNOWN A U 9(1 OTl-lER C, MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYViNYl CHlORIDE (PVC)A U .. FIBERGlASS PIPE CORROSION A U 5 Al,UMINUM A U 8 CONCRETE A ~7 STEEL WI COA TlNG A U 8 100'!1. METHNiIOl COMPATIBLE WIFRP PROTECTION A U 9 GALVANIZED STEel A U 10 CATHODIC PROTECTIO A U 95 UNKNOWN A U 9(1 OTHER D. LEAK DETECTION o 1 AUTOMATIC liNE lEAK DETECTOR ~2 LINE TIGHTNESS TESTlNG ~ IotOHITOAIfG 09(1 OTHER_ - V, TANK LEAK DETECTION 1 VISUAL CHECK 2 :NVENTORY õlECONCllIATION ~ J 'JAPOR MONITORING ~ 4 AUTOMATIC TANK GAUGING D 5 GROUNDWATER MONITORING 6 TANK TESTING L- 7 INTERSTITIAL MONITORING ' 91 NONE 0 95 UNKNOWN 0 9(1 OTHER VI. TANK CLOSURE INFORMATION I 3. WAS TANK FILlED WITH GAlLONS I INERT MATERIAl ? YES D NOD 1, ESTlMATé:D DATE LAST USED (MO,DAYIYR) 2, eSTIMATED QUANTITY OF SUBSTANCE REMAINING LOCAL AGENCY USE ONLY THE STATE I.D, NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW STA TE 1.0.# COUNTY II =rJ JURISDICTION II :=0= FACILITY II TANK' = ITIIIIJ I PERMIT EXPIRATION DATE PERMIT NUMBER I PERMIT APPROVED BYiOATE I FORM 9 (9-901 THIS FORM MUST BE ACCOWANIED BY A PERMIT APPUCATlON ' FORM A. UNLESS A CURRENT FORM A HAS BEEN FILED, FOIIDCIM..... .:'I .:"1 &i "I.. e - STATI OF CALIIQIU STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPlETE A SEPARATE FORM FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM D 1 NEW PERMIT o 2 INTERIM PERMIT D 3 RENEWAl PERMIT IL?' 4 AMENOED PERMIT o 5 CHNŒ OF INFORMATION o IS TEMPORARY TANK ClOSURE o 7 PEJIMANENTI. Y ClOSED ON SITE o 8 TAMe AEUOVED A, OWNER'S TANK I. D. . B. MANUFACT\JRED BY: DBA OR FACILITY NAIE WHERE TANK IS INSTAllED: I. TANK DESCRIPTION C. DATE INSTALLED (MOIOAYIVEAR D. TANK CAPACITY IN GAllONS: II. TANK CONTENTS IF A.IIS MAAJ<ED, COMPLETE ITEM C. A. 1 MOTOR VEHICLE FUEL o 2 PETROLEUM C 3 CHEMICAL PRODUCT o 4 OIL D 80, EMP1Y [J !IS UNKNOWN B. ~ PROOUCT o 2 WASTE C, I. REGULAR UNlEADED o Ib PREMIUM UNlEADED o 2 LEAOED 3 DIESEL 0 IS AVIATlDNOAS 4 GASAHOl 0 7 METHANOl D 5 JET FUEl D ill OTHER (DESCRIIE IN ITEM D. 8ELOW) C.A.s.,: D. IF (A. I ) IS NOT MARKED. ENTER NAME OF SU8STANCE STORED III, TANK CONSTRUCT10N MARK ONE ITEM ONLY IN BOXES A. B, AND C. AND ALL THAT APPLIES IN BOX D A. TYPE OF 0 I OOUBLE WAlL ~. SINGLE WALL WI1H EXTERIOR LINER D gs UNKNOWN SYSTEM CJ 2 SINGLE WALL 0 4 SECONDARY CONTAlN~ENT (VAUlTEDTANK) D ill OTHER 0 I BARE STEEL 0 2 STAINLESS STEEL 0 3 FIBERGlASS ~ STEEl ClAD WI FIBERGLASS REINFORCED PlASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORlOE 0 7 AlUMINUIoI D 8 100'A. M£1HANOL COMPATIBlE WIFRP (Primary T wI ïl g BRONZE 0 10 GALVANIZED STEEL 0 gsUNI<HOWN D go OTHER '--' D 1 RUBBER LINED o 2 AlKYD LINIIIG D 3 EPOXY lINING D 4 PHENOLC LINING C, INTERIOR ---. 5 GlASS lINING c:Q--( UNLINED o gs UNKNOWN D lie OTHER UNING ~ YES ~_ IS liNING MATERIAl COMPATIBLE WITH 100% METHANOl ? / ---. POL VETHYlENE WRAP 11 2 COA T1NG ~ 3 VINYL WRAP ~ 4 FIBERGLASS REINFORCED PlASTIC D. CORROSION I 1 - ---' PQOTECTlON 5 CATHODIC PROTECTION 1- 91 NONE - gS UNKNOWN D go OTHER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IFUNDERGROUND.BO~IFAPPI.1CA8lE A. SYSTEM TYPE A U 1 SUCTION A @) 2 PRESSURE A U 3 GRAVI1Y A U lie OTHER B. CONSTRUCTION A U 1 SINGLE WAll A U 2 DOUBLE WAll A ~J 3 LINED TRENCH A U gS UNKNOWN A U gg OTHER C, MATERIAL AND A U I BARE STEEL A U 2 STAINLESS STEEL A@ 3 POLYVINYL CHlORIDE (PVCA U 4 FIBERGlASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COA TINa A U 8 100% METHANOl COMPATlBLEWIFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHOOIC PROTECTION A U gs UNKNOWN A U gg OTHER O. LEAK DETECTION o I AUTOMATIC liNE LEAK DETECTOR :--' 2 LINE TIGHTNESS TEST1NG lJJ"" MONffORINO o gg OnER V, TANK LEAK DETECTION t VISUAL CHECK :1 INVENTORY RECONCILIATION L...... J '¡APOR MONITORING I 4 AUTOMATIC TANK GAUGING D 5 GROUNO WATER MONITORING I) TANK TESTING L- 7 INTERSTITIAL MONITORING ~ 91 NONE [J 95 UNKNOWN D go O~ER VI. TANK CLOSURE INFORMAT10N t, ESTlMATë:D DATE LAST USED (MO¡DAYIVR) 2. ESTIMATEO aUANTI1Y OF SUBSTANCE REMAINING I 3. WAS TANK FILLED WITH GALlONS I INERT MATERIAl ? YES D NOD :;:.V LOCAL AGENCY USE ONLY THE STATE 1.0. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW STATE 1.0.# COUNTY , =c JURISDICTION" :=cL FACILITY , ITIIITJ TANK. ITITITJ PERMIT NUMBER I PERMIT APPROVED BYtOATE I I PERMIT EXPIRATION DATE FORM 8 (\}.90 THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCAT10N ' FORM A. UNLESS A CURRENT FORM A HAS BEEN FILED, FCADaMI-IM -~ - I ~ .¡ ,¡; '... e e ) '----' STAn OF CAUIOIIIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B COMPlETE A SEPARATE FORII FOR EACH TANK SYSTEM. MARK ONLY ONE ITEM D I NEW PERMIT D 2 IN11:RIM PERMIT ~ RENEWAL PERMIT AMENDED PERMIT D D 5 CHANGE OF INFORMATION 8 11:MPORARY TANK CLOSURE D o 7 I'EAMANENTLY CLOSED ON SITE 8 TANK REIotOVED A. OWNER'S TANK I. D. . B. MANUFACTURED BY: 0, TANK CAPACrtY IN GAlLONS: DBA OR FACILITY NAME WHERE TANK IS INSTALLED: I. TANK DESCRIPTION C, DATE INSTALLED (MOIOAYIVEAR\ 1/, TANK CONTENTS IFA.IISMARKED.COMPlETEITEMC. A. G 1 MOTOR VEHICLE FUEL 0 4 OIL o 2 PETROLEUM 0 80, EMPTY o 3 CHEMICAL PRODUCT C 95 UNKNOWN D, IF (A.I) IS NOT MARKED, ENTER NAME OF SUBSTANCE STORED B. ,-4-, /' LY" PRODUCT D 2 WASTE C. ,. REGULAR UNlEADED o Ib PREMIUM UNlEADED o 2 LEADED 3 DIESel 0 8 AVIATIONGAS 4 GASAHOI. 0 7 METHANOl B 5 JET FUel 9Q O-n£R (ŒSCRIBE IN rTEU D. BELOW) C.A.S..: 1/1, TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B, AND C. AND ALL THAT APPliES IN BOX 0 A. TYPE OF 0 1 DOUBLE WALL ø 3 SINGLE WAlL WITH EXTERIOR LINER o 95 UNKNOWN SYSTEM [J 2 SINGLE WAlL 0 4 SECONDARY CONTAINI.!ENT (VAUL 11:0 TANK) o 9Q OTHER 0 I BARE STEEL 0 2 STAINLESS STEel D 3 FIBERGlASS ~ STEEL CLAD WI FI8EAGI.ASS REINFORCED PlASTIC B, TANK MATERiAl 0 S CONCRETE 0 6 POLYVINYL CHLORIDE D 7 ALUMIMJM o 8 100.. METHANOL COMPAT18LE WIFRP ~Primary Tank) !l 9 BRONZE D 10 GAlVANIZED STEel 0 SlSUNKNOWN o 99 OTHER '---' CJI RUBBER LINED o 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR --, 5 GlASS LINING [Ç(6 UNLINED o SI5 UNKNOWN D l1li OTHER UNING U IS LINING MATERIAl COMPATIBLE WITH 100.. METHANOl? YES~NO_ 0, CORROSION I 1 POL YE"THYLENE WRAP n 2 COATING [J 3 VINYL WRAP c::r-4 FIBERGlASS REINFORCED PlASTIC - PQOTECTlON , 5 CATHODIC PROTECTION 1- 91 NONE - 9S UNKNOWN D 9; OTHER ""I IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A, SYSTEM TYPE A U 1 SUCTION A @j2 PRESSURE A U 3 GRAVITY A U 99 OTHER B. CONSTRUCTION A U I SINGLE WALL A U 2 DOUBLE WALL A@3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C, MATERIAL AND A U I BARE STEEL A U 2 STAINLESS STEEL ~ 3 POL ¥VINYL CHLORIDE (PVC A U 4 FIBERGlASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE 7 STEEL WI COATING A U 8 100.. MElHANOL COMPATIBLE WIFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOW," A U 99 OTHER 0, LEAK DETECTION o 1 AUTOMATIC LINE LEAK DETECTOR ~2 LINE TIGHTNESS TESTING ¡gr 3 MONITORING o 99 OTHER ~ V. TANK LEAK DETECTION 1 VISUAL CHECK 6 TANK TESTING ,- 2 INVENTORY RECONCILIATION L......; J VAPOR MONITORING ~ 4 AUTOMATIC TANK GAUGING 0 S GROUNDWATER MONITORING 7 INTERSTITIAL MONITORING . ! 91 NONE 0 95 UNKNOWN 0 99 OTHER L- VI. TANK CLOSURE INFORMATION L ESTIMA TED DATE LAST USED (MOIDAYIYR) 2, ESTIMATED QUANTITY OF SUBSTANCE REMAINING 3. WAS TANK FILLED WITH GALlONS I INERT MATERiAl ? YES 0 NOD LOCAL AGENCY USE ONLY STATE 1.0.# COUNTY " =0 JURISDICTION" CIIJ FACILITY # ITIIIIJ TANK. DIIJ[JJ PERMIT NUMBER I PERMIT APPROVED BYiDATE I I PERMIT EXPIRATION CATE FORM B (9-901 THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPUCATlON, FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED, FOAaaMII-M -- SUNSET MECHANICAL -- ·3812 PANORAMA DR. BAKERSFIELD CA:-W'" (8œ] 322-06EK) Continuous Monitoring Devicè Certification CrN FACILITY NUMSI!R MAKE AND MODEL OF MONITORING SYSTEM - ---. S ',,-0 ~ / .~. " .J~ ~ Contents of Tank Capacity of Tank Type of Product line: (Gravity, Suction, Pressure). INDICATE LOCATION OF THr; MONITORING SENSORS TESTED BY PLACING A YES OR No IN APPLICABLE BOX: ~ 1iamtl8:J~..J~~S~ %s -:::. .. ~ . " Sump Sensor f¿;ø - ..... Dispenser Contal,nment Sensor ""-'0 -p Electronic O'lerfill J Level ~S% U. ~ ---. ,"6!s - -- Electronic In-line le¡tk Detector "'þ - - -- , Mechanical LIne leak Detector Yb - , In Tank Gauging Device ~ 1'$ - - INDICATE THE fOLLOWING BV PLACING A YES OR NO IN APPLICABLE BOX: poes the monitoring system have audible and visual alarms? ß Does the turbine automatically shut-down if the system detects a teak, fail5 to operate or is electronically disconnected? ~ Is the monitoring system Installed to prevent unauthorized tampering? ~ Is lhe monitoring system operable as per the manuracture~s specifications? SIGNATUR: OF CERTIFIED rEC"I~IICIA'N ~ DATE~;JO¿U Which continuous monitoring devIces Initla:~ positive shut-down o~ the turbIne? CERTIFIED TESTER'S ID# P RI:·¡-r:o r·i.~,~.~= C~ c:: ~,¡-,~~~:) -f ::;::H'~: :.:}..~: - , 2~.~':; c-:>~.P;.:f( t'.~.:.~: e·, ";¿LE:=':-t)~.=:;';: __"__.'.._._ FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 'H'Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 'H' Street Bakersfield, CA 93301 VOICE (805) 326-3941 FAX (805) 395-1349 PREVSKnONSERVlCES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (805) 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield. CA 93301 VOICE (805) 326-3979 FAX (805) 326-0576 TRAINING DIVIStON 5642 Victor Ave. Bakersfield, CA 93308 VOICE (805) 399-4697 FAX(805)3~5763 . - February 9, 1999 Farrells Fastrip 6401 White Lane Bakersfield, CA 93309 RE: Compliance Inspection Dear Underground Storage Tank Owner: The city will start compliance inspections on all fueling stations within the city limits, This inspection will include business plans, underground storage tanks and monitoring systems, and hazardous materials inspection. To assist you in preparing for this inspection, this office is enclosing a checklist for your convenience. Please take time to read this list, and verify that your facility has met all the necessary requirements to be in compliance, Should you have any questions, please feel free to contact me at 805-326-3979, S)'d4J Steve Underwood Underground Storage Tank Inspector Office of Environmental Services SBU/dm enclosure ~'9~ de W~ .¥OP ~~ §""~ A W~p" ARE CHIEF MICHAEL R. KEllY ADMlNISTRAJIVE SERVICES 2101 'W Street Bakersfield, CA 93301 (805) 326-3941 FÞII. (805) 395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 PREVENOON SERVICES 1715 Chester Ave, Bakersfield. CA 93301 (805) 326-3951 FÞII. (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 (805) 326-3979 FÞII. (805) 326-0576 TRAINING DIVISION 5642 VIctor Street Bakersfield. CA 93308 (805) 3~7 FÞII. (805) 399-5763 ~ BAKERSFIELD FIRE DEPARTMENT Farrells Fastrip 6401 White Lane 112 Bakersfield, CA 93309 . -- - February 13, 1998 RE: "Hold Open Devices" on Fuel Dispensers Dear Underground Storage Tank Owner: The Bakersfield City Fire Department will commence with our annual Underground Storage Tank Inspection Program within the next 2 weeks. The Bakersfield City Fire Department recently changed its City Ordinance concerning "hold open devices" on fuel dispensers. The Bakersfield City Fire Department now requires that "hold open devices" be installed on all fuel dispensers. The new ordinance conforms to the State of California guidelines. The Bakersfield Fire Department apologies for any inconvenience this may cause you. Should you have any questions, please feel free to contact me at 326-3979. cc: Ralph Huey Sincerely, ~(/~ Steve Underwood Underground Storage Tank Inspector IY~~ W~ ~..A0Pe ~.A W~ II FROM TANKNOLOGY-SO.CAL TO 915124591712 - BAKERSFIELD FIRE DEPARTME. . HAZARDOUS MATERIAL DIVISION 1715 CHESTER AVE.. BAKERSFIELD, CA 93304 (805) 326-3979 f3T- m 36 APPLICATION TO PERFORM A TIGHTNESS ~EST I ' I FACILITY P4rrø//< PERMIT TO OPERATE # OPERA1'ORS NAME OWNERS NAME ~j , · mER OF TANKS TO BE TESTED-1!- IS PIPING GOING TO BE TES'ŒD,/t:S.. ADDRESS ~P-l t,)J,¡k L¡" . TANK# J 2 J V - VQLmŒ /Z4c }2.-1l. I Zit:- J¿K, CONTENTS ~ÚW flW rlló S¡"n/ J s"lk .:;¿ 7r7tø Co,wllterte" (~ ADDRESS T~et:.úk:~ ~ 9ZS"<fÒ TANX TESTING COMPANY 74....J""4r- IÝPE .' . TEST 'METHOD IL. 0 / NAME or TESTER C!A1'13 El1c 1n45 CERTIFICATION f: :J2s-' STATE REGISTRATION # /r J?'f DATE & TIME TEST IS 'l'O BE CONDUCTED s-j, . @ ~~ ~í¡þ3 PR . ' DATE \, ---- - . -. - ..- CCWRECTION NOTI~ BAKERSFIELD FIRE DEPARTMENT N~ 585 '" If' .... £I.r . Loca tiOI1 171. r~ r I j f71 lP Sub Div, & C/O I {{}hrkh.N 397~O 7.. 1111 Blk. . Lot You are hereby required to make the following C.<>frections.-, - ~ l at the above location: ð r J.cl ~ r f.., IDOl.{, t Cor. No ¿Os (){'~ t 11 e kð.g (... t2.c Completion Date for correct~ "'L Date '5'/11<1) . Inspector 326-3979 '\ UNDERGROUND STORAGE TAN~SPECTION ". .:,. Bakersfield Fire Dept. Office of Environmental Services Bakersfield, CA 93301 /J ~ J FACILITY NAME 1-11 rldJ ('hurr.Úc, FACILITY ADDRESS ~ C{(J I I1JkJG Å.N BUSINESS I.D, No. 215-000 CITY B(lft'rv;.ft~ ZIP CODE (pzj 9?l(j 1 FACILITY PHONE No. 397-m"7l ID# ID# ID# !;/I f tj" /II n~ ð3-+-¡()C/ INSPECTION DATE P~uct Product Product TIME IN TIME OUT ~t1rI. ( lL 1"' I(/¡. RL'9' Insl Dale Insl Dale Insl Dale INSPECTION TYPE: 119(,. 19Uo 1 '1 C(o ROUTINE ¡/ FOLLOW-UP Size Size Size I.J. t1{Jð I.J OtJO ..0 Y 121~()t) REQUIREMENTS yes no n/a yes no nla yes no nla 1a. Forms A & B Submitted V 1b. Form C Submitted V 1c. Operating Fees Paid ~ 1d, State Surcharge Paid 1/ 1e, Statement of Financial Responsibility Submitted \/ 1f. Written Contract Exists between Owner & Operator to Operate UST ~ 2a, Valid Operating Permit 1/ 2b. Approved Written Routine Monitoring Procedure V 2c, Unauthorized Release Response Plan ../ 3a, Tank Integrity Test in Last 12 Months /\lIhnlll'l'1-kCi\ nu.;....."'i ''1/ 't7 / 3b. Pressurized Piping Integrity Test in Last 12 'Months I~ 30, Suction Piping Tightness Test in Last 3 Years V 3d, Gravity Flow Piping Tightness Test in Last 2 Years V '- ..... 3e. Test Results Submitted Within 30 Days .:/ ~ ':f: 3f. Daily Visual Monitoring of Suction Product Piping V V \f) 4a. Manual Inventory Reconciliation Each Month vi ...... ..... 4b. Annual Inventory Reconciliation Statement Submitted ~ ~ J 4c. Meters Calibrated Annually ,/ .~ ~ 5. Weekly Manual Tank Gauging Records for Small Tanks V - ~ 6. Monthly Statistical Inventory Reconciliation Results .if 7. Monthly Automatic Tank Gauging Results V- 8, Ground Water Monitoring / 9, Vapor Monitoring v' 10, Continuous Interstitial Monitoring for Double-Walled Tanks .¿ 11. Mechanical Line Leak Detectors .../ 12, Electronic Line Leak Detectors . 1\/ 13. Continuous Piping Monitoring in Sumps V 14. Automatic Pump Shut-off Capability 1./ 15, Annual Maintenance/Calibration of Leak Detection Equipment J 16, Leak Detection Equipment and Test Methods Listed in LG-113 Series ,/ 17. Written Records Maintained on Site JelC-O , vi 18. Reported Changes in Usage/Conditions to Operating/Monitoring Procedures of UST System Within 30 Days ./ 19, Reported Unauthorized Release Within 24 Hours V 20, Approved UST System Repairs and Upgrades v' 21. Records Showing Cathodic Protection Inspection 1/ 22, Secured Monitoring Wells I y 23, Drop Tube V' 't '> !J. ~/ .A"- RE-INSPECTION D E RECEIVED BY: INSPECTOR: ",'::tJ--I ~-a//Ht() OFFICE TELEPHONE No. g~(a" 39 7 l' FD 1669 (rev. 9/95) '--._'-"" e e -----...............~--- -~.,,~,~,. .-~---~- -'--~ -- FA::::;'fR 1 p' :JI:,O t,·1\] 1 LJH ITE U,¡ ·';..:,V :-. :Jo::.~r' 1.J:'1 LL 1~·.h E:iU~':; -!. L¡:"-~;? I 1"I!~i i. 1 '::¡,'n 1: :7,3 JI'I --._-- ~::;Ert:::OR i'iLAF:n L 2:TRE~~H LINER 2 F' I P J NG ::::U["1!:' FUEL ALARI'" MAY 1, 1997 1 :58 pn ~=::'i::n'D'l ETi-iTI.(:: F:EF-':)F:T -------- '- ..- -- -- L 1 ,: FUEL ALi~F:I'J L 2: FUEL iiL¡èiRl'I , ~ -- .._-- - ----- EENSOR ALARn L 1 :TRE~:H LiNER 1 PIP I r'J(; :=::Uf"lP' FuEL ALAF:!'1 1"1iÚ' 1. 19'j7 \: 5:::: PI"1 .. Fi-i::nF.' j ¡:, Jt,Ci ~,491.IJf~ 1 '1:[ _ L"I~J.. 1:3i'ihU::~:f' 11:.1.1.' 1,:1'1 E:05- ~,j'j'?·_-Ü~~? I v , l"1,c,'{ \" 1 '=<'j':' I: 59' PI"¡ :i-- - ,. " 1-' r I I, _-1--, "'I":Of~'T' . - - .- - FA:=:~TR 1 P :360 (AO 1 I,JH ITE u.¡ E:AI:£F:::::F 1 ELI' C:i; t~D5-:]lj7·-D:;:·~71 L ,1 :¡;UEL ¡"!.i",r'I' L j'.. :FUEL i'>L,hF:I"¡ f- 1"1A\' I. 1997 I : ':, :=: r'I:';-' V ::::y:-=:nTr"'] :::3'[",TU:-:: F:EPC,F:'1' (-1' --.----- ----..--- L 1 :FUEL ¡;LAF:r"! L 2;FUEL AUiF:r, , r-..\ ,,,,yr' c. ¡" 1:' "r I . F r-,._, ", ~, _I _ È,401 .,IHlTE UJ ì.~KEF::=:;F 1 EUI CA '8-11/5 <:97 -0271 l'lA\' 1. loj'37 1: 5'j Ft'! -~ SYSTEM STATUS REPORT - - - - .- - - - - - - -. '- L 1 :FUEL ALARf"1 L 2:FUEL ALARr"! -~-- HAZARDOUS MATERIALS INSPE.N Alkersfield Fire Dept. OFFI1!!l' OF ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 Date Completed 5/' /17 '" ' f"" I Business Name: rð.tít({s t-a51tljf) Location: (q «(0 I lJ Ie.. I k /..N Business Identification No, 215-000 ÚJ:J3 (Top of Business Plan) Inspector steve... d(¡lrk'W()')r~l Station No, Shift Arrival Time: Departure Time: Inspection Time: Adequate Inadequate Ade~te Inad6uate Address Visable riI C] Emergency Procedures Posted Correct Occupancy cg/ C] Containers Property Labled 3Y C] Verification of Inventory Materials ~ C] Comments: Verification of Quantities ~ C] g' Verification of Location C] Verification of Facility Diagram C] Proper Segregation of Material ~ C] Housekeeping IÝ C] Fire Protection rri C] Comments: Electrical á C] ~ Comments: Verification of MSDS Availablity C] Number of Employees: Ie UST Monitoring Program C] rrI Verification of Haz Mat Training ~ C] Comments: Ner.J ~IA\ +c,ft~1 ff\'l(rd.,H-L Pennits C] C] Comments: Spill Control C] C] Hold Open Device C] W Verification of ~ Hazardous Waste EPA No, Abbatement Supplies and Procedures C] Proper Waste Disposal rot C] Comments: Secondary Containment ~ C] Security C] Special Hazards Associated with this Facility: Violations: 5~c.. !torftc..+c{Jf'\ Ote{~ ~ ~Li£].£- Business Owner/Manager PRINT NAME f"0 I .7nK-.k4Ø SIGNATURE (Õ !2! ~ All Items Q,K Correction Needed C] ¡Ý :> Q) e; f?j <0 ~ White-Haz Mat Div. Yellow·Station Copy Pink·Business Copy CI u. FIRE CHIEF MICHAEL R, KELLY ADMINISTRAßVE SERVICES 2101 oW street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 SUPPRESSION SERVICES 2101 oW Street Bakersfield, CA 93301 (805) 326-3941 FAX (805) 395-1349 PREVENnON SERVICES 1715 Chester Ave, Bakersfield. CA 93301 (805) 326-3951 FAX (805) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 (805) 326-3979 FAX (805) 326-0576 I I TRAINING DIVISION 5642 Victor Street Bakersfield. CA 93308 (805) 399-4697 FAX (805) 399-5763 .~ - . - BAKERSFIELD FIRE DEPARTMENT December 10, 1996 Thomas & Victoria Farrell Farrells Fastrip 6401 White Lane # 112 Bakersfield, CA 93309 RE: Underground Storage Tanks located at Farrells Fastrip, 6401 White Lane. Dear Thomas & Victoria Farrell: As I am sure you are aware, all existing single walled steel tanks that do not meet the current code requirements must be removed, replaced or upgraded to meet the code by December 22, 1998 . Your tanks do not currently meet the new code requirements and therefore fall into the remove, replace or upgrade category. Your current operating pennit expires on or before that date and of course will not be renewed until appropriate upgrade of your tank system is accomplished. In order to assist you and this office in meeting this fast approaching deadline, I have attached a brief questionnaire addressing your plans to upgrade these tanks. Please complete this questionnaire and return it to this office by Friday, December 27, 1996. If you have any questions concerning your tanks or if we can be of any assistance, please do not hesitate to contact this office. Sincerely, V~~ Ralph E. Huey Hazardous Materials Coordinator Office of Environmental Services REH/dlm attachment 'YO~~W~~~~~AW~" ,4t -~. USTMAN SIR SYSTEM Yearly Statistical Inventory Reconciliation (SIR) Report 1995 STATION NAME: FASTRIP FOOD STORE STATION #: 3360 COMPANY NAME: JACO OI,L ADDRESS: 6401 WHITE LN, UNIT A CITY: BAKERSFIELD STATE: CA COUNTY: KERN ZIP: 93309 PHONE: DATE OF REPORT: 02/09/96 MONITORING THRESHOLD: 0,05 GPH LEGEND --> T - TIGHT/PASS *I* - INVESTIGATE/FAIL IP - IN PROCESS/INCONCLUSIVE ND - NO DATA SUBMITTED TANKID CAP JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 33601 12K T T T T T T T T T T T T 33602 12K T T T T T T T T T T T T 336 OM 12K T T T T T T T T T T T T 3360P 12K T T T T T T T T T T T T SIR PROVIDER: USTMAN INDUSTRIES, INC. 12265 W, BAYAUD AVE, SUITE 110 LAKEWOOD, CO 80228 PH: 303/986-8011 FAX: 303/986-8227 SIR VERSION: 91,1 I certify under are as calculat of perju that all SIR results listed above YC~ / )..-;¡7.9te, Signature Date .' ,£': \ - BAKERSFIELD FIRE DEPARTME v ~ .~ 2130 G Street, Bakersfield, (805) 326-3979 151- o=ss APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY FAIZ.e.E~ PERMIT TO OPERATE # ADDRESS &;,4.01 ¿V..f(n; LN. Sl:\c:.o 0 I L OWNERS NAME :3'1\<"0 bt L I IS PIPING GOING TO BE TESTED~ OPERATORS NAME NUMBER OF TANKS TO BE TESTED TANK # I Z ± VOLUME t ;)Do?) l';)r'>n() / ~ "'Y'> 0 (! :J t>l'>?'\ CONTENTS 2vN '.'" b ~ON Rút-...J Lloß~ tooNrV Cr2. ADDRESS .,.£ME~OlA, ~ ~Zs-tf TANK TESTING COMPANY -rANKNOLO'='V TEST METHOD 1I A-c..UTt(. T NAME OF TESTER STE.UE COLBy CERTIFICATION # ;;;)7'c::, STATE REGISTRATION # 15~? DATE & TIME TEST IS TO BE CONDUCTED--11ßfCH ~c¡ ,I"c\l, <;Z~[¡fr-(f c2 '//p -1 (p DATE 6" SIGNATURE OF APPLICANT R,E, HUEY HAZ·MAT COORDINATOR (805) 32ó·3970 .. e CIT1'of BAKERSFIELD FIRE DEPARTAfENT FIRE SAFETY SERVICES [. OFFICE OF ENFlRONMENTAL SERVICES 1715 CHESTER AVE. . BAKERSFIELD, CA · 93301 i~ R,B_ TOBIAS. FIRE MARSHAL (805) J2ó-3951 TANK INTEGRITY TESTING INSPECTION FORM THIS FORM MUST BE. COMPLETED AT TIME OF INTEGRITY TEST BY THE TECHNICIA.N ON SITE AND SCBMITIED WITH THE TANK INTEGRITY TEST Facility Pennit to Operate Number Facility Pennit to Tightness Test Number Facility Name FA RREU ~"" ::#:3(,..0 Facility Address ~ ~ 0 I WI-{ In:; LN . Facility Telephone Nurr.ùer "fšo~ - -::<'17- ð ~ 7 I Have you complied with the following s,Üery requirements YES/NO Vt===-5 Fire protection in the form of a 2N20BC fire extinguisher is located within the restricted area, Vehicles utilized during the testing period, or within 25 feet of the underground storage tank opening, have adequate ventilation, and the tester has equipment which can be utilized to monitor the concentration of flammable vapors within the vehicle, Personal protective equipmènt, an eye wash and gloves, and a site safety plan are within the testing area. . V~5 . . EquipÌDeÌnJrnaterials is available t6 a:bs'òrb and contain àny sm'aIl release of testing liquid which is discharged as a result of the test, (Examples include DOT-acceptable containers for storage of the absorbent and an adequate súpply of absorbent), If the answer to any of the above questions is NO, stop the testing procedure IMMEDIA TEL 'X' until compliance is obtained, ves y~ y~ veç ~~ The area within 25 feet of any underground storage tank opening is free of smoking, open flames, and any other source of ignition. Legible signs with the words "NO SMOKING" are posted in conspicuous locations around the testing area. The general public is restricted from the testing area by rope, flags, cones, and "if dark" a fluorescent barrier. COMPLETE REVERSE SIDE e e .' " T~K INTEGRITY TESTING INSPEC110N FORM continued Is the following data consistent with the information submitted on the application for Permit To Perform Integrity Testing (PIT)? YES/NO y~ y~ Y'€< YES' 'rES Vç:;s The number of tanks being tested Testing company Test method used , . - . State Licensed Technician on site State Licensed Technician's # Is the site layout consistent with the application plot plan? State exceptions for any NO answers to the above questions: I CERTIFY THAT THE AFOREMENTIONED FACTS ARE TRUE AND CORRECT UNDER PENAL TV OF PERJURY. (Not valid If not signed and dated.) Signed this ;;)9 Tf(. day of ¡<-fA Rc.H date month , 19ZG, at RA~~'F=:rJ;:.f '[:'J ~ ê~('"' city and ltale: ~ STE-~,..j I? Cð Li3Y (PRINn . S13Ie: uccnsed Techmcian on Site: ) 160391 03/29}96 <800>1253-8054 VacuTect™ TEST REPORT S.O.# TECHNOLOGY FOIl TANKS AND THEIR ENVIRONMENT Date Phone 360 Site # JACO OIL COMPANY Owner BRUCE.McDUFFY Attn 80228 CO LAKEWOOD #110 BAYAND AVE W 12265 INC INDUSTRIES USTMAN nvoice Name/Address 93309 CA BAKERSFIELD WHITE LANE 6401 FARRELL'S JACO OIL COMPANY Site Name/Address i , i TANKS and LINES Tested to CFR-40 Parts 280-2811& NFPA 329 Spec's. I \ I ¡ , Other: Leak Det NEW LD(s) Tested & PASS Exist LINE LD(s) . Pass/ Tight Fail! or or Fail NONE Finàl Leak Rate . LINE TEST . END TIME LINES LINE TEST . START TIME Line Delivery Sysl. Type . Line Material . ST/ -FRP TANK . Tight or Fail Ullage Air Ingress Delected . Bubble Ingress Detected . Yes/No Water Ingress Detected . Yes/No Probe Water Level . START END TANKS Dipped Product Level . START END Dipped Water Level . START END Tank Dia, & Materia' ST/ FRP-L Lined See Diag, For Loc, . 1 ~ ST ~ -mäñieter lameter Start Time: S ~~~ K lameter atena Start Time: S T _ EŒ! Tim~: ~ GPH PS/SS/GS Line # Yes/No -Tank CapacilY Tank Product XLD XLD ExislLDSN/MDLlMFG 31284 - 9084 i . New/2nd LO:SN/MDLlMFG: 50.00 V 30291-2883 50,00 V LINE TEST PSI Dispenser Shear Valves Operate (yes/no) Exist LD SN/MOL/MFG: LINE TEST PSI Dispenser Shear Valves Operate (yes/no) p P OOO-IT T 0,000 , o 41 25 : : 9 55110 11 : : 9 9 PS s,!, -711'.s, 1AI'ST 'I' N N N 000 000 . IQQ 95100 I\/faterial Namete 12000 12000 REG UNL REG UNL 2 1.È;li2 12 PS ST XLD Ex;s! LD SN/MDUMFG 3 1 2 8 4 - 9 0 8 5 New/2nd LD SN/MDLlMFG: P QOÖ,IT .. o .46 : : ·1 12000 SUPR UNL 3 50,00 y. Ex;s' LD SN/MDL/MFG 41 ° 9 3 - 6 6 61 New/2nd LD SN/MDLlMFG LINE TEST PSI Dispenser Shear Valves Operate (yes/no) RED JACKET Inclinometer N / 7\ DeQr~ M.. N T XLD 50,00 V LINE TEST PSI Dispenser Shear Valves Operate (yes/no) P Ç)Q'O'IT - - .' o , 35. : 051Ì3 : 13 'I.. pS ,. .~AIST: RED JACKET Inclinometer " 0 0 Degrees: - ,.., t 12000 NO LEAD PLUS 4 -- Exist LO SN/Mpl/MFG: New/2nd LD ~N/MDL/MFG Dispenser Shear Valves Operate (yes/no) Exist LD SN/MDLlMFG: ncllnometer D~$; ump Mf!F TPr06e I Enlr'l: ~ ,5¡d Time:. -t Materia - - t ump Mfg,: t 'ercen! of FilIai Time of Test: ~ Test PSI l)ìamete 1Ÿ1ãtena nternationa Dispenser Shea~ Valves Operate eves/no' Tanknology çorporation 5225 Hollister St. (800) 888-8563 · TlnCTlnometer I Dearees: TProbe I EDl",: Start Time: Eo_d Tì m!!; TX 77040 3) 690-2255 ~ Houston FAX (71 I I I CA State: State Lie. # 15 67 file. Con.trol Department and maintained on 015 # Unit NOTE: Original VacuTect Data recordings are reviewed by Tanknology's Audit TAK-01 WESTERN REGION TANKNOLOGY Region 50# /4ò3<1/ MONITOR WELLS Well Number 1 Well De th ' De h to Water Product Detected AMOUNT in inches Standard Symbols for diagram below:' ®FiII @ V,R, w / Ball Float ® Monitor Well ® @ (Outside Tank Bed Area) B Ball Float G Tank Gauge ~ Manway [JJ Iron Cross Location Dia ram-:-ln~luç:le ~he.Vapo~ R~coyery oeer: fA~5 e Site# ~"6 . '. 2 3 4 5 6 7 8 9 10 11 12 o Vapor Recovery ® Observation Well O (Inside Tank Bed Area) Vent [!] Turbine . J.!.1. \J e^-,~ . .. '... . FA F? RE:.L.LS ~ æ ð r' .~ ,. .~ . " ~ ~ . ~ . 'QÐ: :S: :T~~0 !ED ~(jJ :~4ŒJ 0@~ R E:tto'n::. f: .,.. ~A<êtE.·.1.. (ôR' .7I\':1K ~3. W/-tI:TE:. LN, Vapor Recovery System & Vents were tested with which tank? l::>E:.D:r:s:;ATE:£J ~R\.f:I:'C€. Parts and Labor used '-r- -- ~ -When 'OWNERCirlocal'regulation's require immediate- reports of system failure-Complete the following: REPORTED NAME DATE TIME TO: Phone# OWNER or Regulatory'Agency FILE NUMBER R: Pnnt Certi Testers Name ré: e . BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326-3979 APPLICATION TO PERFORM A TIGHTNESS TEST FACILITY FA£2EL.L-S PERMIT TO OPERATE # ADDRESS eø4,OI WI-ltfT LN. SÄc..o 0. L OWNERS NAME .:J1\<.o (:>1 L IS PIPING GOING TO BE TESTED~ OPERATORS NAME NUMBER OF TANKS TO BE TESTED . TANK # I Z ± VOLUME CONTENTS 2u^, ""f) .sON ðle Ll08~ CwNrV Cre. ADDRESS "T£IW\£eUU\. ~ 1Z,",,' TANK TESTING COMPANY -rAI\lKNOlO"Y TEST METHOD VAK:U~ NAME OF TESTER PA-f/!ICK Pr::~t;, CERTIFICATION # STATE REGISTRATION # /~O DATE & TIME TEST IS TO BE CONDUCTED~ :¡<1 / J'J' , I ,,,(, <iZ~Wëf c2 '1ft, .'J(P DATE cû SIGNATURE OF APPLICANT · - 3 ¡ oo1~ USTMAN SIR SYSTEM Monthly Statistical Inventory Reconciliation (SIR) Report STATION NAME: FASTRIP FOOD STORE STATION #: 360 COMPANY NAME: JACO OIL ADDRESS: 6401 WHITE LN, UNIT A CITY: ZIP: STATE: CA PHONE: PERIOD ANALYZED: MAY, 1995 DATE OF REPORT: 06/14/95 PART A: Data Tank ID: Tank and Lines Status: Product: Quality: -Dels: Sales: 02 TIGHT 02-UNL #1 FAIR 30841 31979 03 TIGHT 03-UNL #2 GOOD 9830 10031 05 TIGHT 05-FS MID POOR 16863 17566 00 TIGHT OO-FS PRE POOR 13796 13977 USTMAN INDUSTRIES INC, is a certified Statistical Inventory Reconciliation (SIR) release detection vendor, Tank status results for monthly monitoring are based on parameters specified by the EPA protocol for SIR methods, PART B: O/S listed below represent removals, additions or delivery discrepancies which were accounted for as part of the SIR analysis, Tank ID: Comments and Recommendations: 03 {5/8/1995:DEL 148} {5/25/1995: 2608} {5/26/1995: -64S3} {S/29/199S:DEL 401S} {S/28/199S: -4289} {S/29/199S:DEL 4349} 02 05 No comments, 00 No comments, e . USTMAN SIR SYSTEM Monthly Statistical Inventory Reconciliation (SIR) Report STATION NAME: FASTRIP FOOD STORE STATION #: 360 COMPANY NAME: JACO OIL ADDRESS: 6401 WHITE LN, UNIT A CITY: ZIP: STATE: CA \ PHONE: PERIOD ANALYZED: APRIL, 1995 DATE OF REPORT: 05/15/95 PART A: Data Tank ID: Tank and Lines Status: Product: Quality: Dels: Sales: 00 TIGHT OO-FS PRE FAIR 12611 16518 02 TIGHT 02-UNL #1 POOR 19808 20978 03 TIGHT 03-UNL #2 GOOD 19053 14651 05 TIGHT 05-FS MID FAIR 12951 17741 USTMAN INDUSTRIES INC, is a certified Statistical Inventory Reconciliation (SIR) release detection vendor, Tank status results for monthly monitoring are based on parameters specified by the EPA protocol for SIR methods, PART B: O/S listed below represent removals, additions or delivery discrepancies which were accounted for as part of the SIR analysis, Tank ID: Comments and Recommendations: 00 {4/2/1995: 113} {4/16/1995:DEL 133} {4/23/1995:DEL 2989} {4/27/1995: 107} ¡4/2/1995:DEL -156} {4/3/1995: 236} {4/19/1995:DEL 168} 4/20/1995: -124} {4/23/1995:DEL 4074} {4/26/1995: -183} 4/30/1995:DEL -5619} 02 03 Loss due to dispenser meter mis-calibration (120 gallons) - check meters {4/3/1995: 116} {4/16/1995:DEL -127} {4/16/1995:DEL -1496} {4/2/1995: 156} {4/13/1995: 1419} {4/23/1995:DEL 1882} {4/30/1995: 219} 05 For regulatory compliance in California, a p~p~ng integrity test every 12 months and a tank integrity test every 24 months are required in association with SIR monthly monitoring, e e ) USTMAN SIR SYSTEM Monthly Statistical Inventory Reconciliation (SIR) Report STATION NAME: FASTRIP FOOD STORE STATION #: 360 COMPANY NAME: JACO OIL ADDRESS: 6401 WHITE LN, UNIT A CITY: STATE: CA ZIP: PHONE: PERIOD ANALYZED: MARCH, 1995 DATE OF REPORT: 04/17/95 PART A: Tank ID: Tank and Lines Status: Product: 00 TIGHT OO-FS PRE 02 TIGHT 02-UNL #1 03 TIGHT 03-UNL #2 05 TIGHT 05-FS MID Data Quality: Dels: Sales: GOOD 18166 16769 FAIR 23937 17501 GOOD 13995 16745 FAIR 20944 20563 USTMAN INDUSTRIES INC, is a certified Statistical Inventory Reconciliation (SIR) release detection vendor, Tank status results for monthly monitoring are based on parameters specified by the EPA protocol for SIR methods, PART B: O/S listed below represent removals, additions or delivery discrepancies which were accounted for as part of the SIR analysis, Tank ID: Comments and Recommendations: 00 {3/2/1995: 126} {3/31/1995: -115} 02 P/2/1995 : 166} {3/13/1995: -149} {3/27/1995:DEL -235} 3/31/1995: 133} 03 Data adjusted for tilted tank {3/5/1995: 101} 05 {3/5/1995: 145} {3/31/1995: -114} For regulatory compliance in California, a plplng integrity test every 12 months and a tank integrity test every 24 months are required in association with SIR monthly monitoring, no .... ~.~._.......~..._.", '__'_"-""__~__ ~: ~~ .. JJ;.>f..< '''-:~" :.t~ >'~:~ "."",-: /, ''':,.,,>,,~~.(',''' , _"'<""~ ! ~" ~ \".,_",::.., - ,,-. HZ-~; ...... \~.:~:...,:: ,~.- ~:.,. \_":.;:~,'.,__:..._:'::!!~.:._ \~~"·"'..t;;,.~.--,:1'.·~~::_'~:·,<::=-.,;.il.~'~?',~,"":~;~"~\'¡'~~'~.'..:::',~,'..~..., .__ [~-.._V\~.:,J",.,-,.~1!;,-.~,;;;;,,~."~ÒI.r.J'''''' .:"4., ,;{';. ,i';.~A N"', '~~':~/¡' ",..,.;'-....,'.~~:.~::",' ·,\\;¡t:;·:·'..,·... ......:;..; '.- -"'_'-'. ;.>.. ,.~--...;.-_-..._._ __~~. -.'".".---" ..... -..:',-_.. At _-L r;.~~ !t'~"J' TANKNOLOGY CORPORATION INTERNATIONAL I;;,·, ''fj !é~3. I'] !,,$q !rIJ:rj , ..""~ ' .':;.~;~. ii\~'~ I'~ :,.' '';} U~':~~ . ti'...·. '." " . :"';c»!l ¡ "_X'-: ,? .:~'.;>.'.';..'.~.Á ; '-1: .":;~~ ¡ ::::·~'.f? ···.ï'.~·····~.:~.i :..'>f~ ,.J ;:~, l~~:' I"," {~ .,~-..';;j... .. :.:,,:~ :~ t:~;j~ :"~- ~;... í'" ;~ .¡ ~¡ ~!'~~~ 1'/' "1 r Gi.. .'Ì ~1.JI ".~ ~.'..;.'¡: ~,. ., lit,;, ~, ~I ?¿:. {!':¡I !!to ..,....' I ~;~:\ ~JI ~ ~~:~I ï~,.:... I~::; ~.:.;?' ','- ···1 ~;;~j I'····· ~:'.:.:}' ~,::' ~"V) ····,·11 .)\.'~ ". ~iI"':--\ . ~ ~~t~:,:. .::~ ~~~/' '....~ '::'-.'. ~:} .> ~k~11 ~"l ~::'I ~.~.1 "I ~1i '\ , \ \ \ ~ l/ I 11,\·,j i '" \: cP~?ORATlCJI;: :": . ,~:;o. ,"0..,.. . ,/ ~, (,)- .,.'.. ", . ,,, / ..:: fl·- 'f'ip., ~':;.;' - ~ .... '#.. 0;-- O.RA~ij", .... :::$! ;' c . '~I-:£: =;5 i ~. :..,( ~ ~~~r~': - ,*. ~'l.> r la:í,-.-. ~ \. dL~~:t ,.~ ."". Ð.. ~ ~ ..... 0"- ~.. "/ r() '.,....." '., ~~ /// l:LAWp.,ç¡; ". I/!/prq\\ . ,,,, ~¡;;, . .d1 ,......">."~... :..!.": f~::;; -.'.....>......j "'\",-: ,--.:.<~ ...... ,.N ~> ., "J' (¡,:f ¡ ~:5'1 ~ 'i' 5225 Hollister, Houston, Texas 77040-6294 Phone (800) 888-8563 FAX (713) 690-2255 v Certificate of Tightness ,'-"" .~ ~., '~I.&.~-~ Service Order #: 142145 04/21/95· Test Date: Underground storage tank system(s) tested and found tight for: Tank Owner: Test Site No.: Test Site Address: Tank(s) only, JACO OIL COMPANY 360 JACO OIL COMPANY FARREL'S BAKERSFIELD, CA 93309 4Line(s) only, 4Leak Detector(s) only. Tank sizes & products tested: lines Tested: 1A REG, 2A PLU, 3A REG, 4A SUP Leak Detectors Tested: 30291-2583 DLD 21384-9034 DLD 41093-6661 XLD 31284-9084 DLD Valid only with Corporate Seal Unit Mgr, Certificate Number & Name 231 TODD L, PARKER 04/96 1487 TODD L. PARKER 10/96 u.s. Patent #4462249, Canadian Patent # 1185693. European Patent App!. #169283 TANKNOLOGY & VacuTe<:t are trademarks of TANKNOLOGY CORPORATION INTERNATIONAL Note: See VacuTect Report for tank identification & site location drawing. I I I I 142145 \ 04/21195 <800> i, 253-8054 I BRUCE II McDUFFY VacuTect™ TEST REPORT 'KNOLOÕ ~.}t J_ r -- .......... S.O,# II Ctit"Ûl OG, fO~ TA.N..S /I.~O· lib" £tÚ'~~Otd'H,T Date Phone 360 Site # OIL COMPANY JACO )wner 80228 #110 )Voice Name/Address Attn CO LAKEWOOD BAYAND AVE W 12265 INC INDUSTRIES USTMAN 93309 CA BAKERSFIELD WHITE LANE 6401 FARREL'S JACO OIL COMPANY ~~ite Name/Address i TANKS knd LINES Tested to CFR-40 Parts 280-281 &NFPA 329 Spec's, I I I Other: Leak Oet NEW LD(s) Tested & PASS Exist LINE lD(s) . Passl Tighl Faill or or Fail NONE Final Leak Rale . LINE TEST . END TIME LINES LINE TEST . START TIME Line Delivery Syst. Type . Line Material . STI FRP TANK . Tight or Fail Ullage Air Ingress Detected . Bubble Ingress Detected . Water Ingress Detected . Probe Water Level . START END TANKS Dipped Product Level . START END Dipped Water Level . START END Tank Dia, & Malerial STI FRPI lined Sua ),af FOI loco GPH PS/SS/GS Line" Yes/No Yes/No Yes/No Tank Cap"city Tank Product 'Ial' q DLD E"sl Lo S';/MoLlMFG 30 2 91 - 2 5 8 3 I Ne.....l2nd LO SN/MOL/MFG: P T 000 o 45 : 9 15 : 9 PS ST 1A Nameter kEG UNL 1 XLD 50,00 y hisl LD SN/MUL¡MFG 41 0 93 - 6 6 61 f New/2nd LD SN/MDL/MFG I LINE TES' PSI LiNE lESl PSI I Dispenser Shear Valve Operate Iytfs/no) P o . 000 IT 30 : 10 00 : o PS ST 2A f Jnclinomete Deoree~: f>ump Mfg,: "'("J5(õbe I Ef;i",: at t l'ëicent oTFmãi Time of Test: ~ Tesl PSI l'ëicel\t ami Time 01 Test: ~ Tesl PSI t ~: End Time: Material Oíameter PLUS UNL '2 50,00 y OISptmSef Shear Valve Operate (yès/no) 11 t Indoometer Degrees: Vump Mlg.: TPf6be I Enlry: ~: End Time: atena DLD bisl Lo SN/MoLlMFG: 31 2 8 4 - 90 8 4 I Newl2nd 1:-0 sr:/MDL/MFG; P T 000 o 10 : 40 : LO PS ST 3A t at t Diameter REG UNL 3 LINE 'TEST pSI DIspenser Sheaf Valve Operate !ycMno) E,isl Lo SIVMoL/MFG: 2 1 3 8 4 - 90 3 4 Newl2nd LD SN/MDL/MFG 50,00 V nClínometer pean;!e~: ump Mfg.: TPröOe I Entry: -Percent 01 Time of Test ~ Tesl PSI ~: End Time: 1J"aleriãr DLD LINE TEsrpsI 50 , 00 Dispenser Shear Valve OpefalelY~ V I Ex.ist LD SNlMOUMFG: I Nllwl2nd ~o SN/MDL/MFG LINE TEST PSI P T 000 o 45 : 11 15 : Ll PS ST 4A f 1 ai í 'creent 0' Time of Tesl ~ ~IPSI t Oíamete lTaleriãr '1 SU P R UNL .' I t nCllnometer Oeore:e~: ump MI~¡.: TPrObe I Entr": t 'ercent 01 Fill ai Time of Test: ~ Tesll'SI t ~: End Time: Diamete, Valves DJ:,;p~llscr She;u Opernlt! ¡yes/no' nchnometer DcC)ret~~;: ump Mfg.: I Probe Entry: ~ Eod Time: 1;fateria EJllblLD ~1~/MDl!MFG: I New/2nd ~D'SN/MDL/MFG; t ~mp Mfg.: t 15Crcent örrnãf lime of Test: ~ res' PSI t Nameter Matenal on mternationa LINE TESI PSI Dispenser Shear Valve Operate (yes/no) \ . Tanknology Corporat 5225 Hol St. T1ñëI1ñomete I b-eqrees: I ~~~~v~ ~: €cnd Time: 1· TX 77040 FAX (713)690-2255 Houston . ster (800) 888-8563 I I I CA Slale State Lic. # 1 487 O~ginal VacuTect Data recordings are reviewed by Tanknology's Audit Control Department and maintained on file, 089 # I Un WESTERN REGION ^NKNOLOGY Region E () SO# ;' LI ~I c. /.::::- . (...-, ' J MONITOR WELLS Well Number 1 Well Depth '1,1 Depth to Water t{/!+ Product Detected ;' , AMOUNT in inches Standard Symbols for diagram below: ®FiII Q V,R, w I Ball Float @ Monitor Well v:.:5 (Outside Tank Bed Area) ® Ball Float @ Tank Gauge ~ Manway QJ Iron Cross LÇ>c.at~o~ pi~grarn-:-ln~lu~e ~he.Vapo~ R~coyery Syst~m~ w(-Hí0" ~NI O· r: '~-! " 'L:>/ Vi )'+(/ ~í Site# ~?0Z./ ",'. ì~ ¡¿ //¿,.. / / , ,.' (I. f, ( ..... ì 2 3 4 5 6 7 8 9 10 11 12 r í ì ø Vapor Recovery ® Observation Well O (Inside Tank Bed Area) Vent [!] Turbine . . . ---- - r. .]1 I~ .~ ~ . \ŒJ. .11 .\ ¡ . \(i; ~' ^J ~ 1J I~ W~I' tf\ ' :~. \ ~I ~\ Irq' , 9,: , ',i1~' l' ,~: loj <,~1\¿.\0\~ 1 /r/: ")1\ ! II I I ! J I' ' . . . J . . 01, . . , 01.. ,.,. I ' . Vapor ReCOVery'S'ystem & Vents were tested ith which tank? 1 [J: J . 1 \1]: , I Wi , I --.~.... Parts and Labor used , General Comments ---..----.... When OWNER or local regulations require immediate reports of system failure-Complet,e the following: REPORTED NAME DATE TO: Phone# OWNER or Regulatory Agency TI"E FILE NUMBER pnnt Certified Testers Name Certified Testers Signature «~~-' , -- v 8C\,\~ CertmcatK>n Number 2~/ Date -:rting Completed 7'l;2¡!r5 lO2)þ , /jt2/áP¡7 Fonn-TanlatU>e~ " - . CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT M. R. KELLY FIRE CHIEF October 20, 1994 1715 CHESTER AVENUE BAKERSFIELD, 93301 326-3911 AM PM MINI MARKET #5175 19q5D Wht-fe- LK1 P.O. BOX 6225 ARTESIA, CA 90702 t~fr Dear Business Owner: This notice serves as a reminder that owners of underground storage tanks must be registered with the State of California Water Resources Control Board and renew that registration every five years. Our records indicate five years have passed since your last State registration pursuant to Section 25287 of the California ~ealth and Safety Code. This means that for state registration renewal you must submit an Underground Storage Tank renewal application form, Forms A. Band C completed for each tank at this facility (forms included) and a state surcharg~ of $56.00 for each tank. Please make your check payable to the City of Bakersfield. You have 30 days from the date of this letter to complete and return these forms along with the state surcharge to 1715 Chester Ave" Bakersfield, Ca. 93301. If you have any questions or if we can be of any further assistance please don't hesitate to call 326-3979. Sincerely Yours, Ralph E. Huey Hazardous Materials Coordinator REH/ed Ope Materials Storage Facility rate to . . PermIt Underground Hazardous .:,"/':/). '/ " .,.. P · t "....,." , . .. ,. erml .... . ... . ... .. ...,. .. ... .. . .... ...... .... . .... . .. .... .. .. ..... . . .. .... . . . . .. . . . . .,. ... .... ..... . . . . . . . . . . . . . .. ...... . ..0. . _. .. .........'... ....... ..... ......... .... ........ .... ... . . . . . . . .. , . - - . . . . . .. . . . . . . . . . . . . . . . . . ". :.:. :.:....::.. '.:: ..:.......:-......-.. ..':':':'. ........ . ..............:..... ", ......... ....... ...... .... ....... '.,'. ...... ......... . ............. ......... ,........ ...' . . .." .... . ........... ,...... .. .. ... ..... . .." .... '.. ..- ... ,-. . .... ..... ...... .... ... CON DIYI ONS:),",:ØF::··:"F :,,:·,;!IM::,:,:REV ER S E SIDE .-,... ..... .... .. .. ... ,.. ...- . ... ... ",. -. . .. ... ... .... d. o . . . . . ..' . ...... .... ".. . ..' ...... ...... ... ... ... .. . ..... . -..... .., ... . .., . ... .. . . . . .. . .. . . . . . . . . ... ... '., ....... .. ... ..... .... ... .... ...... ... . .. ... ... .......... .. - . . .... ... ..... . . . . . . .. . , . .,. .. . . . . .. . . . ..' ..' .. . ,. .... ... .... .. ,.. . . . . . . . . ,. . . .. ......" . . ........ .. ,. . ... ........ ... .. .. ...... .... . G "·,'1" . ,. ................ Y ...:". .. " T' k . ·r '·'''''··k' '. ,..,.... a" 0, ·0·· ,............. a'··,·······,·'·· , ., .. ·a··n·· . ..'. ... . . .... :",... e. .' /:}{ " i·i an·' '. ..' . ,,:\,\.. ......: 1:1~~~'lr ~:;~~, ~t;;~>, . :~:~~I"I ·12000,· ,1966,· FCS .' . ... SIRITTT·· . f·::) ::::j . .,.:'" /:"'\., . . , . . ". :;',., :-: ", :: "-12000,'1986 FCSSIRITTT ' ::j2;.POO \."19Sê·: ':ËêŠ/:)!"~JHrtTT' ... . . . ... 623 310046 D. No. I. State No. Piping Monitoring Piping Method Piping Type Hazardous Substance . ... .. . ... .. .. . . . . . . . . . . . . . . . . . \~òq~~~~~?8' to chan\J~jl ALD ALD ALD ALD PRESSURE PRESSURE PRESSURE PRESSURE LPT LPT LPT LPT PREMIUM UNLEADED PLUS UNLEADED UNLEADED Tank Number 01 02 03 04 , . . . . . ... . · . . · . .. · ... · . · .' ',' .. .. ... ... .. .. . .. .. ~~Ulati~S,,\ , Issued THOMAS & VICTORIA FARRELL FASTRIP FOOD STORE #112 6401 WHITE LANE BAKERSFIELD, CA 93309 To: , Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION 1715 Chester Ave" 3rd Floor Bakersfield, CA 93301 (805) 326-3979 Issued By: 12-22-98 to: 12-22-93 from: Valid Coordinator Ralph E. Huey, Approved by: --~-~- ------ -- - - - -- - -- ¡'or. ~- ~ CORRECTiPN NOTICE \- " e B'A'KERSFIELD FIRE DEPARTMENT N~ 0499 ,- 1// - ~( Locatiol1 ~R...e.Jl5 I-,qs p Sub Div. ~(){ ul.)4-"-L,,. Blk. #-~o . Lot You are hereby required to make the following corrections at the above location: Cor. No ,-J Completion Date for corr""tio~ Date ,Y~o/'-Š- ~ ¿;;;:¡ Inspector 326·3979 - ... UNDERGROUND STORAGE -eK INSPECTION .J v FACILl1Y NAME 1i4s1Rl~ (F~fš) FACILITY ADDRESS ,4, I OJ....~ LI'\ Bakersfield Fire Dept. Hazardous Materials Division Bakersfield, CA 93301 BUSINESS I.D. No. 215-000 ,~ CITY ß~~ ZIP CODE ~~ FACILITY PHONE No. /3'77- ()~ 7/ II» II» II» ðl ('t)~ Ð"<..t:)t.¡. INSPECTION DATE <2'ýR.C¡ ¿'(is. ~~ Product Product . /11 (.IL + I JL /" I. TIME IN TIME OUT INSPECTION TYPE: Po II \A.-I €.P- +-- Ins! ;q~/n Ins! ~e cQ/-. Insl ~~./-. ..,~ , Size Size Size ROUTINE V' FOLLOW-UP I? Mn 1 19.0!1 "\ .:J.. . 2JPt'J REQUIREMENTS ..cft(l~ ... L ñ. , nIa nIa nIa yes no yes no yes no 1a. Forms A & B Submitted V / ,/' 1b. Form C Submitted ~ ,/ ,/' 1c. Operating Fees Paid V v ".. 1d. IL L I I ..rlJ ..=jiIi .. ~ 1e. Statement of Financial Responsibility Submitted V r/'" 1/ 1f. Written Contract Exists between OWner & Operator to Operate UST V fI"" V- 2a, Valid Operating Permit t/ ./ ,/' 2b. Approved Written Routine Monitoring Procedure r/ v' V"" 2c. Unauthorized Release Response Plan II'" ~ .,,;' 3a. Tank Integrity Test in Last 12 Months ...i-. .¡.. <::\'JL I.. nPoL *" ., 3b. Pressurized Piping Integrity Test in Last 12 Months l'utl.-1 -h v Y" "...-- 3c, Suction Piping Tightness Test in Last 3 Years v ,/ ,,/ 3d. Gravity Flow Piping Tightness Test in Last 2 Years "... tI" ,,/ 3e. Test Results Submitted Within 30 Days "r .......... ,/ 3f, Daily Visual Monitoring of Suction Product Piping II" r ....- 48, Manual Inventory Reconciliation Each Month ~ ,/ V ....-..-. 4b. Annual Inventory Reconciliation Statement Submitted i<. ./ ,,/" '--'" 4c, Meters Calibrated Annually ~ /. v" , k-- . 5. Weekly Manual Tank Gauging Records for Small Tanks Ý "..- ,/' 6. Monthly Statistical Inventory Reconciliation Results "{',8 7. Monthly Automatic Tank Gauging Results '1 .r ,,,/ -' , 8. Ground Water Monitoring ......... Ý ",.- 9. Vapor Monitoring " ,/' ,.....- 10. Continuous Interstitial Monitoring for Double-Walled Tanks ~ /' ......- --' 11, Mechanical Line Leak Detectors -'l. 1"""- V .' ,/ 12. Electronic Line Leak Detectors JJ- ¡/ V ...... 13, Continuous Piping Monitoring in Sumps I V V ".., 14. Automatic Pump Shut-off Capability ~ v" ..........- 15. Annual Maintenance/Calibration of Leak Detection Equipment '* v V L-- 16. Leak Detection Equipment and Test Methods Listed in LG-113 Series ~ ,/ v: ...-- 17. Written Records Maintained on Site .:\' ACO ~ ý" 10"" ---' 18. Reported Changes in Usage/Conditions to OperatinglMonitoring Procedures of UST System Within 30 Days V Ý ,./ 19. Reported Unauthorized Release Within 24 Hours V Ý ¡;;/ 20. Approved UST System Repairs and Upgrades ......... y ,/' 21, Records Showing Cathodic Protection Inspection ¡/ V ......-- 22. Secured Monitoring Wells !' "'A' ¿,,,-:,f \AÁ)ll< \-'" D~ I ~A éJ"" v" V /'V 23. Drop Tube \ - V ,/ V I / RE-INSPECTION DATL4 RECEIVED BY: l.h~ ~ ~ OFFICE TELEPH~E No, tI(?. ~¿: - ::<q7 <:;> INSPECTOR: -m-:, ~ ;5~- FD 1669 ~ ~ MONITORING PRocItURES UNDERGROUND STORAGE TANK MONITORING PROGRAM 1biI ~.. ..... .. be kept It Ibe UST location at aU IÌIMI. Tbe .........Ibis ""'" '-r J». ............ . eœ rlitio... of Ibe oper'" permit. The penait holder mUll aadIy fthe IDeal .-, .......30.,. of aay .... to Ibe IDØDÏlarÎIII prucedura. unJca required to obtaiII approval beIDa 1IIÜiaI......... , Requind by Sections 2632(d) and 2641(h) CCR, ,< Facility Name Facility Address A. Describe the frequency of performinq the monitorinq: Tank Pipinq B. What methods anã equipment, identified by name and model, will be used for performing the monitorinq: Tank Piping c. Describe the location(s) where the monitoring will be performed (facility plot plan should be attached): D. List the name(s) and title(s) of the people responsible for performing the monitoring and/or maintaining the equipment E. Reporting Format for monitoring: Tank Piping F. Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance must be in accordance with the manufacturers' maintenance scbedule but not less than every 12 months. G. Describe the training necessary for the operation of UST system, including piping, and the monitoring equipment: "", ,,~ EARGENCY RESPONSE P. < UNPERGROUND STORAGE TANK MONITORING PROGRAM TbiI ~ propIIII .... be kept at the UST Ioc:ation at .u timeI, TIle ÌDfDrmIIiaa oa Ibia 1IIOIIÌIOa4...."...... <!OIIdÌliOlll of die opeøIÌDI permit. Tho permit holder must noIify fthe Iøcd aøncv)widIÏIa;30'.,.of any c:banaa fa tbe moaiIoring proeedura, unJcu required fa obcaia approval before maIdaa...,......... Required by Sections 2632(d) and 2641(b) CCR, Facility Name Facility Address 1. If an unauthorized release occurs, how will the hazardous substance be cleaned up? Note: If r.l....d haz.rdous substances reach the environment, incr.... the fir. or explosion hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate the secondary containment, then (the local aaencv) must be notified within 24 hours. 2. Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substances. 3. Describe the location and availability of the required cleanup equipment in item 2 above. 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: ,',1 .: ~ ~ ..'¡ ,~- ~~.c: ~~~ \ .- . ".' ". "~~~i~3~~~~~~~,- ' , . 11 DESIGNATION OF PREMISES , . . IT IS AGREED between the parties hereto as foLLows: Reta.ÍLer is hereby granted the right and privilege to sell gasoline through Company's remote control gasoline dispensing equipment upon the premises of Retailer at the following Location: 6401 White Lane, Uhit A, Bakersfield, Ca. 93309 Retailer hereby warrants and represents that he is the owner or Lessee of said premises and has the right to enter into this Agreement, 111 EQUIPMENT AND OPERATION Such remote control gasoline dispensing equipment, including ;the neces sary control units, pumps, tanks and connections, lighting and signs shall be installed and maintained by Company at no expense to Retailer, except maintenance occasioned by the negligence or wilfuL misconduct of Retailer or his employees, Retailer agrees to exercise reasonable care to protect Company's equipme£lt a£ld i£lve£ltory from loss or damage, Retailer shall at his expense, fur£lish the £lecessary personnel to operate said equiprne£lt, a£ld coLLect the price of gasolirle dispensed, a£ld to perform such other functio£ls as may be necessary to effect the sale of said gasoline, Retailer shall have £10 authority to incur, a£ld s~aLL £lot i£lcur, any expense on behalf of Company or otherwise obligate Compa£lY i£l any manner, a£ld Compa'ny shall £lot be required to provide or pay for a£lY services or materials except as expressly set forth herein. --, IV COMMISSIONS.. .. Compa£lY shall pay to Retailer the foLLowi£lg mO£lthLy commissio£l onHalL sales of gasoline furnished or desig£lated by Company hereunder, to be paid not lat~_:}~a£l the twe£lty-fifth (25) day of each month foLLowing the month of sale: ';':.i'o-.,--:_,4';~';;;;~~ª~~~;n All commis SiO£lS are based O£l the gro~ s profits from 'the"~a'i~ of g~~~liri~:-;:~'The gross profits shall be defi£led as the differe£lce betwee£l the cleliveá:~.:'çoS~:;óLsaid gasoli£le products deposited i£l the tanks UpO£l the premises and thèpr(c:~"~åld gas- oLi£le is sold for by the Retailer at retaiL. Retailer a£ld.CoÏripäríyjl.gr,~:~:J<?ßiyide the gros s profits one third (1 I 3) for the Retailer and;.~~òt.hÙg~~h£Wi~j;¡,ff.8:5:;~he .. . '"' . -. - ._.,-. -.....i.. _.' ...,---f.",~><;:"...~,~.;:-_y; -. '-'. -,..~~;,~~"..,-".:... :Zë'-:--r-'" Compa£lY,' but i£l £10 <ev~nt isRetaiLerJ;o..:r~ceJ 'f.,e' ,~e_~§.,thª-n.(),rie7:'::""t;¡,- .,. .- ,...,- OIJ. :g~£l_: . tota l. gaLL? ci~.of.. g~ SÒL{~~~~.f~~ péris 'eëi ':~'~tf§-~~IE;0~r~~~~Jltl~0~~~L _ ,{þ~~'~ik' ~i~;:t:~ent of? price "ch~rigec~~':;i1;~')~~\::~~~"$l~ifp~\3s+~'f~'t¡1~6Cè . . '. -'.- --'-:--:~.~.,-- ·-'''''·_,~·>;:';''·;.Z:'"~·7--''''-· -":"" ':"~\~'{~:Y!~:;~f~;š~~~:~t:: ~:':":~S~1:~e~~~1;;~~;~[~~f;~~~i~~~~T!t:~ . ~ - ".,'.":_..::.'-:'::'t-~ ,"~--:::: ~."-·:'.·:-7~ :-;+....;..:.~ ".-'::-þ-";:;::,,,~'~:..-_,~';'~:':.--_-,~,,:-..."::;.,':¿;.;;;.L...~,:::,:<+'- --. ~'. -';"~.~:-::_=:~::;:~~~~~~~~~~: :=~.- ~:.~~~-~:~~;~~:-~~~·~:-:E~~~~~~~~~3~-,~2·=E~~~~:~:~~-i-= _. 'H . ;. ~-.. ..< -'. ~. . ....." u_........ -". ..~_'" '" . . .' þ .' . --c ~H_ .._ _ .._~__.._ . ~. ", - _. . - -.- - '. ~ -" .. '_.~"__~'_'____r_______ ~~_._ P'.. j I ì I I j I )~!~~~îf,t~çt~t-~~~?;' . - . . : , -~,;":~ ~ - '.. ....' .......... ~ · "~;~'~~,;Sf;ê.tfti~~i~E~iipi~:~':,,:i!~~#"~'~f: ,),; ',,' ,) ,'" ,." u . ,Tot~Lñìor;thly_gasoJil~i.iatë~šh~lIbe .co~puted by c:ompôny,after verificå'ti:d6~tji\d.;;:'_:. córrè~tiôn;"irn~~èss(Çry":'7~(Rê"tãiì~~'~- R~'p' o~t òf sàlé;'~ :......~ ":~~:·~:'è,,·· .", , , '".. ·'~~~:2:'.~'-S~t~:~:i.':;/F¡-:":'-· '... "-' <~~ í'L~E " INITIAL ..- ~ I' I I ~ -' ~."'>' .----.--..,>- - - . V BOOKS AND RECORDS fNSPECTION Retailer shall maintain and 'sCbmit to Company complete records of all inventory and sales of gasoline, on such forms and in accordance with such written instructions furnished from time to time by Company, Retai ler and Company shall have the right to inspect and audit each others books, records, receipts, sales tapes and otherwise, as pertaining to their particular operations and business relationship at any reasonable time, It is understood and agreed that this right to audit and inspect is limited to Retai ler's and the Company's gasoline operations covered in this agreement only. VI PROCEEDS FROM SALES Retailer shall make all sales for cash only, and at prices designated by Company, and Retai ler agrees to collect in cash at the time of sale, the proper charges for all gasoline sold, Retai ler shall not change any prices without the prior consent of Company, Receipts from all sales shall be and remain the sole pwperty pf Company, without deduction or offset of any kind, Retai ler agrees that at leastltNIXV~ tPrrles a week to remit directly to the Company, or to deposi tin a bank agreed on mutua Ily by the Reta i I er and Company, to the account of the Company all sums collected by Retai ler for gasoline sold, without commingling such deposits with Retailer's own funds, Retai ler shall be responsible for all inventory, and for receipts of all sales of gasoline as evidenced by meter readings on the pump totalizers, Retailer hereby authorizes Company to deduct from any commissions earned by Retai ler any amounts owing to Company, VII SALES MERCHANDISING Retai ler hereby agrees to use his best efforts to sell the gasoline furnished or de.signated by Company hereunder, It is understood and agreed, however, that Retailer is an,iñdepend- ent contractor, with full power and authority, except as otherwise specifically provided herein, to select the personnel and the means, method and manner of performing Retailer's work hereunder, . . ., ~ -. '-~. ." Retai ler shall at all times keep the pumps clean, and the premises clean andJree of debris, and shall at all times provide access to the gasoline dispensing pumps,' Re'tãiler'shall notify Company immediately in the event of any damage or malfunction to any of the equip- ment of Company, . .. " .' - ..:-' :... .:. -' ,.-....- .- _ _ _:.~'" -:;,-:";'::;':~.:~~."~R."";r,. .:,;", ~,->.-,'., VIII COMPANY PERFORMANCE " q;r:iÈ5Ë¡':'j~Ù1:.~·;~::, . . , '''.'. ,,'.c_. " ~_, ',.. _ f;¿~fZ~~~~~;r;f~~:" Company shall be excused from performance hereúnder sö'long bs ~nd fo=tKe-:':é)(t!~f}~õf performance by,.it, shall be prevented by any act of God,ä~tof a public E!n~~Y i:~ª(;~f:;-~tr!ke; . war, insurrec-tion~ labo~ distu~b~n:ce,; firê,':flooa,éorthéiual{eÎ~wash~òùt ;:exptó.si§r\~/~~_<?rt~ge' _.. of)abor or -s~pp lies, or f~i lure 'of C~rrÍpany' s sùpp-' i eÌ'sto f~i-ni shi t with ade~licít~:~lí§.~li.ti.~~.~f . '. .- ~ ~-"" ~ -, - .,:... . ,"..' ..' ., ~-, ".c-:_;';~á~~~~f~12f~:~~~.~-f;~:7~~·' .-; .,-.. ... .. -...... - .'-> .,:,..' . :.:.~: ·¿~~3=~~:~::7~f;~s:,~~~~~~~/if~~&~~~~~":-;:_~ --. -",.---- ..~ ~ ~ -..- "..-. . _.. '_0__.. ---* -. .. t < I :'. g1:isôltne:, oc,ena . g '. ., ;su'ÞÞWJhe ¡ m,. . overn.a ~I ". -.' ~ ".' _i. ..... ~ -~ ~.£;;,i;'" ... -- ::-.,:iç:::.":f:';~--'~~~ ,-r;.~~.., "~i1ê;t?+~Jf.<~;:.~~"~"~ :;: t .-. , '. ." /.-:':"-"-\..4~;-'_ ~;;t,!:';,(·;1<;;{.,,:::ji~':~;~~j:'-1~3t~:.t ~~~' . -~ +"~z";'':;:' ;,':~':!~;i~-f'i_('tjt;~"'::*~~{{~J,§' 'C~~:.::~<:.<;.~~Þrdh "~kind;~oC"'(),r~;ª~C:f:~e;:~or b . 'an' 'other~¢èJÛse'b~yond}hê~èon.t:fò .;7õf'th'è::,; . I :'!f~"'!f;~~'f~gY?~!~þIt~t?r.ã",~!,,~~~~~è~i:rt~f;~~1~~~~~~~~ff;:~ê~~'3RJ~V~S;'·.. : 'shall not be' liablèJöfånY::lósš;'~âáíñ~ge/ôr delay occasioned thêreby..:: " .' .':::':r'!:":~.~:;::::':· . :~- _ . ~ '-,¥'~ :·~~'~~~~'~~~:;~~~~?·;;:'~-~':::<'~·'~,~'.:f~>~:I~:',_ . _ . -.' _.., . _ -7.-:-..~:~f.::::<~;.~:.~'~.:." . , During thê faJ lur'~ ~rC~~p~~-Y't:b'furnish said premises with its requirements'òf 9a~line, such requirements of gasoline over and above any furnished or designated by the Company may be obtained by Retai ler from any other source or sources of supply, but without recourse to Company for any loss or damage incurred by reason thereof. Any gasoline so obtained elsewhere shall not be sold or distributed under the Company's name, brand, trade name or trade mark, or distributed or sold in or from any vehicle upon which Company's name, brand, trade mark or trade name appears without written consent of Company being first obtained, Thereafter, upon written notice by Company that the Company is able to resume performance, in whole or in part, the total requirements of gasoline for said premises shall be the gasoline furnished or designated by Company to the extent that Company is able to supply the same, Company hereby reserves the right to apportion, at any time, its avai lab Ie supplies of gasoline among its other customers and, in the sole discretion of Company, to supply the total requirements of any of its other customers before making delivery of any gasoline to said premises at any time when Company's avai lab Ie supply of such gasoline is not sufficient to meet the requirements of all its customers. Company further reserves the right to change the name, designation, trade name, or brand of any of the grades or classifications of products furnished hereunder at any time or from time to time as Company may so elect, IX DELIVERIES .., All deliveries shall be made in bu Ik by tank wagon or truck and trai ler, at the option of Company, and no delivery of gasoline shall be less than a truck and trailer lot per single delivery, except by consent of the Company, All gasoline shall be hauled and delivered in vehicles owned or contracted for by Company, X LITIGATION , , ";1 ~, ;,~ '1 In the event of legal action to enforce the terms of this agreement by either party, the fa i ling or losi ng party sha II pay a II expenses, costs and attorn~y ~ees()f the ot~;r<:~:_:~;;.~;, ., Retailer waives any claim against Company as to price, quantity or quality'o({]liypro~, duct delivered hereunder, as well as any claim for damag'es resulting'frömañÿ-breÓ'ch"or'-'" asserted breach of contract on the part of Company un less claim therefor ismadeþy'Retailer to Company, in writing, specifying the facts out of which,such<claimcC?r<:>~e;;~:~t~Ey-~r"~è:I ,..: to Company within thirty>(30) ,days ,after. receipt' of the .'product,å~~:tÓ>,~hiçh:tç"ðfr[:~I(s:~:"-:~:~7:::: .. ~';~~~":r;;at~ê~~~r~~ft:¡~:~;~f~,r:tJð)b~(~Êffc~;tt~~il~;~i~~~~rfÆ[~~jî~~~~~~~~~~~, . < .~~:_~:~:~~~' . h.____ suchc la i mand ¡'érjieë:li';fhêþreach6fcontrac t ,re l,iedup~r1J?Y.~,~t9I~Ì',;LêIf\~~IQ22ªš.ti9JijE~;::'.i;:', .. '. '. ~~y ~obe/ i !;1st ¡ t~!~~ :,9.f:,::!,:,?:i ~[9J~~d_ ~ÿ.,~e!~iJ ~~,: ~y:<,\:~s~,~;-;~,t¡~~:èh~'£~~~~,~ :i"~~~;~,~r;~ -tª'~"" 'ó'~:;::<~~&h~:~: , ,'::' SOl ~,~_t~.I::l~}:O>,.- ,º.o!,/,p:r~~~, ~..' ':_'/:>~.' -~: :-'.. "'-':'::' -- ~:P>5:~~~:,~2:~;!~~"1:,~~:':/;f,~~,!'::'" ';:::~Æ~~!~E~:~f~~~=Z:;;~;r~tf.~t~.~;~~~;¡~~c~: {Ž1:;,,!:¿:x~;;f~:~"~)~~{i,;~'~S~t~~:~~:~~~:· ;.'~~,~~~~='c.~~,~~>~=:~î6:~~~~~~!:~~~±'~~~~~Ë:;;~<~;:~'¡:~i.:::tZ;~7 "~ ~--~-,.-:: - '.' "... ".. ." "", 7 ' . -",,' - - ~ .' '-'~-~:~~fø;;'~';;;;'-> -..,-,..J1,....;:-~':':~--~~~.:...;-.. , :'~~~::.~i¿~~::;~~~=i7':.~j~~{";~<::7,:~=~··?;'~~:~~4i~¿~:L.',,:~,·':t":?~~~;':~:~~~'~f~~...·~~.~~~:~jtg~~~t.~::~Ì~};f~~ii-I-¥zËZI-f;~-:~:~~·.:~=~;';;~~ ._~-.'_.....--_._--_""-,.. .....","-...~ .J ,_""....~.,_.,,'.. _. _ c. . ._~_ _ ._">_u _ ~.. _ . ._",,,,,~,,,~""'..-,,,,,,-~............... '-'" _____h·_~__·'" .. ......_ _> _~-___ -'_~, _~~_~ ·_·r_____._______ _ . .._ _u _... __ _ _.._ ~ _ . ~ ",.n'" . _'. .... ~------,.-----_._-~_..~-- ...- .--........ ..~~"'. ~.'- -,- -._.~:"'~-'. ,~~~~::?=i.:~~~~~~:~ ~:.~·:-~v . ~~'-'_T- ..-;-.:;-,:,;-~.~~~.~.;.?;/:.:.-~"..'~~;-::-~_~~~~,~ -.. .~--~~._-_.--.~.. --..'-- -', ~ - . " '-' -'. ,. -~-"--:;..=.=.!:-~---=-..'.. - --- . -.-- ""--- - --- . _==..:.~~:õ............~__. .~ .' "'-- " '-:... - .- -.:'--', - ~:. . . -. ,. . . . _. ~.......___. _ ..," -:.............W.. - ._h..,_'....''''''".;:;;--.. _~'I,",,' - ,,_~,q.~-<="'" ....."".~--' ~ ~.>_""-<..__~"..___ ....,.7........,....,~ . ,,' ,:~~~~0'f!;}~;r~~~;t-::=:.èf];;]TIci;:~~;t~i~ljÙ;_.'~::c.:~:.~~;- ..C",. :.,:',L,'.-.:_.~'";.-_ ~. '__"' . -' ..-..- ,'.- -,. ..... " . RETAILER:' ',' .. ti~S?~J22g~i~;~(;;~,;." :-,' d" ,."~ " . ".". - - , . .....,:.:. ~-. :::..... .::_-' -::-"": .::;' .- . ,:-CO'~P.~J~'J.Ac;O"'HI~L"CO., a. Partnership BY: Jacõ'OIi ,'·A'Corp. , General partner . - ...::~ / ~A-:fLA- /~/ BY~~~ . ... ,,_.:. J ...:J'. !11:.~~S9~, President STATE OF CALIFORNIA COUNTY OF J{.,¿ ({ 11/ }s , ACKNOWLEOGMENT -GeneraJ-;-Wolcotts Form 233CA-Rev 5;82' . ©1982 WOLCOTTS. INC,." :' ....~" ,,~,' .. ' , in the year 19~ aJe, personally appeared ~ -;J No- J-.. I ~; ~LL ~ (or Pdt, , personally known to me -cl: ~~ me on the ~as's ot satistactory evidence) to be the person~whose nameX sUbscrrbed to the within instrument, and aCknowledged to me that -r..he!d"., executed it. -Lf (r WITNESS my hand and official seal. ~1:;~bl~~¿~tat. . ,- - . -". "':; f: ".".. <;-.:: .... ,:"."!;:o. ~ __ , .,,~, _. ~', " œ On this d- I à day ot Ð ~ 1" b 'L-fL bet r me, the undersigned, Notary Public in and tor said ~LL - . . þ..~ :.."'. ; -,0;: ~~, :.\- - (-"; :c'. ... KnriiV'1 t <> ~t1ic t:&e ·';'c :.:;' _~.~ ----.:: _ th~t executed the within instrument 0-:- _ of ,JACO Oi( Company, h .-------,., b k '4 '4 behalf f . t e Corporation elng nOWQ to me to be One of th 0 said corporation said ·'I,¡_:~rtners.~iP th~t .~~e~,uted th.~ With~:_;::~;:::~t ~ ~Lt;, 7l, ~/ / &rpOratio'n' , ~~he__ 'I i ~ ..,. * .. . - .....,.;..~- --' r·.'""'--.'................. STATE OF CALIFORNIA _.. ..,.. COUNTY OF }s J- On this J I - day ot () tttJ b ~ f2- ,'in the year,1~' ~.:'.j' betor~ me, t~eu~dersígned. a No~~ry!1b~C i¡ and lor said. State, persona"y·ap'~é~~ed '."'ii;'!;,~;i~~;"'¿'è";-ë~("'~c',,¡it{~~~~~;;;~:A;;L7 . ..... ..... ....~;~~:~~~~~~-.: .. A1AXINElaVINO - .. . . --( ór proved to me on" thè,Þ~s.i(~t satisfactorY evicienèe) to be tlÍe person '!Ý~o ,~x.e:è,ÌJtè(Uhe ,: ' .. NOTMŸ:iiiSÜc:Ó\ÙfOØGA . , . ',:::,. .,. withiñ·¡ñ·stñiiiï~~t ·onbehalf ot. the~-:'---;:;C:';-'-' Partnership :nâmed thérein ;,àrÏd, 'åcknów-"." :.:-;" ':'~-;:;~é~~,~:?:': ';:::~: . J( Z-f fJ). ~,,__.·~~"~:~,:,:.~:~~~~;=!~:~:~~~:=:~:~~~::§J~::t:~~~:~~'Ä~e':'=~~~~:~'k~·"f~è~C:: ;.-;-:;.;~- ;-~_~_.r ~ ~ ::'-7=" '_,;,:_ .i'" ->G':"_"~......." : ~,:;:~~~~~~,:~:~.~?;, ~:::; ---~.'. ::: ... -- ~_. -r .,- , , .. ~ ·1 " ~ ,. :... ... ¡¡:.- ::/~.~ ":..' ...-, . ~ ".. ,; " ;0;" . '- d " , " ,. ! :1 " . j i ::¡ :',1 '. ~ ¡ .' ADDENDUM In addition to Article IV, Commissions, retailer shall receive the sum of $500.00 per month as a monthly accounting and cleanup allowance due to Kern County restrictions on the installation and maintenance of underground storage tanks. - Japuag MaqnßW 9 . - .. . -~, -.-.., . - . . ~ ,- _...;.._ ~"'-"""",____u < ~ . ~", - --- -' - . - ~ - ~ - - <'~.' . ~ "... - .."'- ~ ""--~ .---~ .--. ._>..-.' .. JACO HILL CO., A PARTNERSHIP BY: Jaco Oil, A Corp. General pt B~t BY: \Vlih~~~tner .- , . '.- -.--.- _ n" _. - - -, . --"'-..,-- .- .'..-i-"e> #;~':~" tf . .. ~~"'! I' . ¡ ;.a "I , " 'I ../ :¡ ,., Iî ,~,( . ,., ., , ' J't ~;'~ t~J .. .., ,. . ADDENDA TORET ÄILER'S COMMISSION AND OPERATING AGREEMENT· ALL terms and conditions of this Retailer's Commission and Operating Agreement shall apply to diesel fuel. INITI.Aor: ,. ,.. " ..-.~: ".._>;~ ,,~_._., u.. .~_. "-'.. ---;;,.:.-~'" :..,""'...~-~~~,,,, ,-~",. -,~ ,. ___ _ _._. h . .~~. -., . -.P· -- - - -' -- ,."".- ......-.."- .. .. ~ « - -- ".' . ,-...~ -' -. ."'-. .. . ,.. - ~ "..- . ." .-.--- .-.._- -. -. _. -'''- .-._.- -'-, q . .~,_u _.., . _.- r;~"'\~ : \d!;r.~ ' {t , I!&: :'::!\1, ' , ~ t:":~' .;:, I,' I ';J. :.~, ~: j' ! STATION NAME ADDRESS' PHONE' EMERGENCY RESPONSE PROCEDURES .. 9.) "'alntena.née)". "; ,: .:<1':1. Ct~ler w,U,J/ .," " "dl;¡rk File Neces~arY,;¡¡:' , i.';;' I,:"~ \I~¡ ~~~~~J:t~~¡!:~;¡¡¡:~(¡'I~':¡i;;¡;:;:¡¡;I' Agericles;~¡f~:g"'F: !;.~ ~1':\ :;~/~ ;;.' ~t'", ' '.C:· , ; ~ !'~ 8.) CONTACT - CðI) Your Territory Manager. It . Complete & Forward Required Reporls. 7.) CONTACT .. STORE MNGR. . If Not At Facility: Home It aliter It Standby WIlh FIre Extinguishers. Try To ConlaJn Inclden lal Spills Wllh Absorbe:nl Socks Or Olher Absorbent Materials. Do Nar Flush Any Spills Wllh Water Inlo The Em1ronmenl. Call and report to Exxon Maintenance Cenler. 11-800·443·5739 OBSERVABLE LEAK .. FffiE . Exllngutsh Only If Il Can Be Done Safely! SPIlL 4. 5.) .. OR ~.. ~Qß .. :ã oS I: .. III .a 9 () ,.. õl - ë. tn tb ,.. õl .. .. ï;.. '<I' "'Qß >. u r: u t>O .. u a f¡J u Q t:i u 0. tn o ~ 't:I .. .. u o ~ I A' ;.i; ~~,\,,:;-~~:-\'. ,., .Jl,;.t. Try To Isolate; ConlaJn And Clean-Up. If II can be: done safely. Call and report 10 Exxon Maintenance Cenler. ~ 1·800·443·5739 6. TURN OFF .. 2.) IF THREAT OF .. 3.) CALL FOR HELP PUMPS IMMEDIATE IF NECESSARY , Use The DANGER - Dial 911 Or Emergency _ Announce - Fire Dept. Shut·Orr ' Emergency To Swllch and All Pernons It . CIrculi On.Slle. . Breaker - Eliminate Swtlches, ' Sources of - Slore Mngr. IgnlUon. 100 or Employee Nol Slarl Cars: In charge Extinguish AJI must assess Smoking possible hazzards Malenals.) to human or - Have All environ, lhat Persons Exit may resull. Premises On If assessmenl rool. , delennlnes a . Give AssIstance hazard. he/she To Those Injured musl nollry And To Persons appropriale Needing Help CMC. To Leave The Premises. . Block orr Driveway Entra.nces/Exlls To Facility, IBe Able To AJlow Emergency Response Vehicles To Enler.) Ambulance Tell Dlspalcher: + ,Type of Emergency Exxon Slallon Name. Address Phone .:(see heading). Police + It It It 1.) .. INCIDENT Fire. :,:Splll. ]': Ot i + Advise If Medica] AllenUon Is Required. + Slay On The Phone To Ans\Io"erA11y AddlUonal Questions. Provide Info. & Assls 10 ArrlvIng Emergency Response Personnel I[Your Phone Service]s Dlsrupled. Try To Use: + ^ Near·by Working Phone Or + Car Phone Or + CB Or + Ham RadIo , ):J,~;i,':: Posl ori,employee bullelln bÒartl 'òr;bi conspicuous area :nêa't!telephones. í::~~:¡:*;:~ '"J, ;J I ~:., . ".' J. StorêMlinagèr' or Employee in':;, : charge ,/1 Observable Leak' " ,. I' I' n ~I .. ( i ; l·,· ~ '.' ' ,.. 1 , ., f . ;i :1 .' --'·'~·Aëcù~rãte '" al1.,~~g~ì~1~t~~if:r~~;~1I,e<i.rn~t~".z~~~~t~_!t ' , '. .".',èh-'~: <"Co:. element of . fuel inventory cOl1troL:..~ln·~~Stýpl¢t;ìI:Jank,..":'·,,,;~{~'~~)~.:;;.,j.:"',: ~: L Ln6:~··:;::::brt: i~Ò~~eth:h~~f~~~·'~~fk~~~~~~l~1~;~~t~ .:)~'/,"¡~~'~{)~"\..' . MISTAKE· OF . ONE INCH CAN 'THROW : YOUR . '.. INVENTORY OFF BY AS MUCH AS 160 GALLONS! ,~ The following procedures should be used to make sure you have an accurate reading: 1. Use a good tank stick. Do not use a warped or bowed stick. The stick must be marked off in 1/8 inch marks, and all marks and numbers must be readable. The stick m~y need to have a plastic tip or bumper on the bottom -- if it's not there your stick will be off by 1/4 inch. Also, be sure to use the same stick every day until it needs replacement. ,4. . .' ~ti , .' .. I :': ¡ ¡ '/0/':- ¡ \ \ ",~ 'T.~ ~-1) ;;,:¡ '-':;'-:9 d i:""j "~:¡ i;~J ~i~ .".1 .. _. ,f. - - -- - -.. -.- - '--',~ - - _._ ____ - _~ d'.' ~_ _ _.. _ _. .. . 2. YOU SHOULD USE WATER FINDING PASTE (USUALLY TAN/YELLOW). FUEL FINDING PASTE (USUALLY PINK) IS USED FOR GASOLINE. Any other substitutions may contaminate your fuel. Using fuel finding ,paste is the only way to read t01 /8 inch accurately. Gauge your tanks at the same time every day, Tank. gauging to determine the daily inventory should not be made during the first hour after a delivery, It is·· extremely important that yoU' gauge the tanks at the" same time you are determining withdrawals from the -, tank -- remember that the physical tank inventÓryis being compared to withdrawals from thetank.·' 3. .--.-. - -.... ' Gauge from the same opening oOhe .t.ankevery~§iX,:~~.o-;c.. - . - .._. . ..~. _,......,... n..- _ -.. - - ,-,'. . . 5, Before heading out to the tank field, use .yeste~day's:" ,. books to estimate which tank will havè -the lowest "" level, next lowest level, etc., of pro~,~91JrlJh~~>1?D,~~.. .....,._.,~_:,.~:;:.,',."_.,', . Tan k g aug i ng is rnl,l,ch, eª~*ª r..aI}Q,""Q1-º r.~.~ªçpuJ~~~.;.'Lt:::;'o;~:::::;é~~~~~~t~:;;~;;: .'c you gauge the tank with .to~~:Jº~(~_$t¿~~ij-ªKI~.ª:qJ.n'-]irš -C:ß;;;:~ ~~;:;O:':'~~~;:::'~C:"J~7~"q .,. ,··,the Ii theJãñk·with·tIìÊf;nt~fHÒWê'st~$liçß~~ã-ai so on. .", ·"J:;·f:+-~~';1t~f;~Zi:iJ!~wø~'~:;1j;"f,.". .-. .- .., .-~ ,. -----.- ,~",.'.', '-. ........_~..........~. ~ .-.,:,.:::.. .~'. .d· ..-~-;::;: :.:~.~~::~~.~:~._~~~:.: .._;:~ ~...:...., ',u" _#~ ~ :"'-"-;. :.:,;~. :-_.:......;.. . . .... . _' ,<-:<--?:.~_....~.,;.~.;,,~" ~ ;.: ;:.' . c.~·:. ___ ~;::-_ ~~_.._;::-..~.~; ~:'~_:" ~~~;f~;:: . -.. - :....,.---.~ .::.;'~.---,-.-'-. ..;:..._~ -., ·::.~!¡-:J:~~~_,~~.~;P7·. ~),'~; \':':1-.~:::"~''!':::___'"'' ;t~Ò :~:?:'''''':''''''l~~::ff-;;r':i¿--;:'7', ~I;:~:':?~ .. . .'- . . , , . r-_ . '., :':~:~f:;;~ 'i¿t,~!~i¿t:~r::;-:ifë;.:.;.~:¡.,: ~~.:.~.~~:,?~~;,~,:,·~,.~.I.~.\,t. i.·.:,<~:,~" ~,., ~.:.. ,..:.::.,. '--'~~':"'J.- ." ,,'~ «-._ .- .,,"_"'_ "'¡-' -J, ~~~~O-~'::_'_~'~~:~" ~'-_-~'." .-'_':. !-.' __'·~;"~-.:~~~:;:~~~~'~~~~:;~3. --;" - ,,~ ."-," .. -.'" . . - " ."., ,. ,~, ...~~.... . - - -O:_:-~.'~"?_.'" ;::.! :;:",~:;~~~(;;~,¥i: ",;é"+At.iK~2·;:~cAÚGIN 'ROCEDURES é:' on '. -' '.?~,~ -. .-: .=. ·;,,-"~~~~>:~>;~~:'~;:~~(~¿:}{~-~~';~~iff:';;~~ __:'.¡' ".'~ ~:-'~.; _ :-- -: ~~.;>;=- .~,:~~rt~:i}.::·~,t;c;õ>·:~"_ .,:":,.~~'~'<'-.~ -. :~:". 6; :'~7¿~j'Aþply~wátéOinding' paste to thebó~onïJ9ÜtJhþtïes ()f :': '. , 'the gaÜgestick, Apply fuel findingpasté;'áneast eight:,' '.'" inches, ab'ové and below where youestimafe,the fuel' levelwilrbe in the tank with the: least~'amourit' of , product. Apply a"light, even film of thepåstes Òri one side of the stick -- do not cover the numbers or marks, 7. Gently lower the gauge stick into the tank -- do not use force and do not let the stick bounce, To avoid splashing or creating waves, do not turn the stick in the tank. Hold the stick as nearly vertical as possible and the moment the stick touches bottom, quickly remove the stick. Do not let the stick stay in the tank -- if it does, product will "creep" up the stick and give a false reading, Record the stick reading for both water and fuel levels. The reading is the line (or "cut") dividing the pink from the tan with water finding paste, and the line (or "cut") dividing the darker pink from the lighter pink with fuel finding paste, Wipe the stick dry, place some more fuel paste/water paste on the stick, and re-gauge the tank. If the readings are not the same, but are within 1/4 inch of each other, average the two readings to get the true reading. If the readings are apart by more than 1/4 inch, re-stick the tank until you get two readings that are less than 1/4 inch apart. Enter your stick readings by grade on the "Tank Gauging Worksheet" or other suitable form, , --' [,/--} ,- ,( , ' . "'_~"O~ "-ii,:; -·r ." .. :.::,:, ,I !~ . ¡ ,.> i ¡ , ; ~. :',.m4 " l.·".'.'..·.';" \t:'~.:..;-'=.-. :.~£;7 ..> .".'- -- ---. , , _.~ . __n._ ~~. . .--... 8. 9. If water is detected in the tank, an adjustment to the tank inventory must be made, YOU CA N NOT SIMPLY SUBTRACT THE INCHES OF WATER FROM THE INCHES OF FUEL AND THEN READ THE TANK CHART. This will result in the wrong" physical inventory. , . . . n '. .. .. -.." ....... . --...,--, .- ~~ . . ,,, " e>.' '. . . t~·'~'~.,~ "a: :r . :~j J7~ ~~1' ~.~f : 1 -¡ ',~ -j ~ .-- -. '. .~- ~..;.. -. ..,.,..~:. ."",,'} ..'. : ',; "->-" . .."-.,~,-~-,-.--,.,,,-,,,--,,-",,.,.... ,', ~-. - ,- , .,..... - . ~. 'if ~ :~. ...,;~ , ' . (CO I1tin,lieCt),<;,' + .'~., "" ';., " ' ~. J' . ......;c-~f~I~~~1is:.:.:_.~Jj~~r@~}~i~:ft~';~fJ·~;i:J):\ff¡f(;t~1~+!~·;···. :;> -:~ . .. -_-·:~7=~,~-·:~_~~l:¥~;;2~~~¡g~¿~;¿· ~ .-\~'-- .:,~ .,~--"~ . > ',' - " . , .~ .: ~-",:::':F., :-"'-'-' '-',~~~p'::. ~ '">_~ ;.:~ ~'7~'~-¿':Ä}i:~ ~ - ',' ~::··-~~~:~;:j~:;Š~!~2;:::~!"::::-,.··,::·;./-: .~"._: ,: '.-: ',', T A¡\il<;;G;ÀÜG'I~Úi"~:p~àCEDURES . -..- , '".'. ':;.-./ " Here. is the "correct procedure-- ,use ,the appropriate tank chart to convert.. the water . inches to gallons, then use" the same chart to convert the product inches to gallons. Finally, subtract the water gallons from the product gallons to obtain the fuel inventory gallons, EXAM'PLE: Tank size = 12,000 Water inches = 1/2, 'Convert to gallons = 7 gallons Product inches = 44, Convert to gallons = 5476 gallons Motor fuel inventory = 5476-7 = 5469 Çlallons NOTE: Wrona way is to look up 43 1/2 inches = 5392 gallons 10. Follow these procedures for each tank. \.- . 1;·:1 ,·'·'t .,. ,,:~~:'1 J ~¡,('~\:~i-.:, . ;:'~'.'! ~tl ·~~t f~ jr;:~. ~- " ',""-, , . -- ~ -- -, - PART A: FAST RIP FOOD -,:STORà> ,- WHITE cL~_::r~~~_:_,A'~~;:-':::, ... Station Name: -'Address: 6401 "'''''~-' ':..-". - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Data Tank ID: Tank and Lines Status: Product: Quality: Dels: Sales: 00 TIGHT OO-FS PRE GOOD 18982 16548 02 TIGHT 02-UNL #1 POOR 39747 38243 03 TIGHT 03-UNL #2 FAIR 10199 10128 05 TIGHT 05-FS MID GOOD 20766 19524 USTMAN INDUSTRIES INC, is a certified Statistical Inventory Reconciliation (SIR) release detection vendor, Tank status results for monthly monitoring are based on parameters specified by the EPA protocol for SIR methods, PART B: Comments and Recommendations . , ; O/S listed below represent removals, additions or delivery discrepancies which were accounted for as part of the SIR analysis, 00 02 ",j :0.J 03 I 05 {12/4/1994: 5121} {12/6/1994:DEL 131} {12/4/1994: 9545} {12/5/1994:DEL 135} {12/26/1994:DEL 167} {12/31/1994: -208} {12/4/1994: 5628} {12/7/1994: 157} {12/27/1994: 101} {12/26/1994:DEL_:}~i} -- -~. {12/5/1994:_ -120} {12/6/1994:DEL -314} {12/21/1994:- --,139}{ 12/31/19 94 ::3:L~ F--~"--"- .C.._...__ '. 0" __,___ --.-.- ._,---~,-.~--- ."-. i 1- I I For regulatory compliance in California, 'a pipingintegrl.ty--yestP every 12 months and a tank integrity test every 24 months:--à.re required in association with.SIR,mo:?thly monitoring. - ,. ~.. - , ,..... '. USTMAN SIR SYSTEM Monthly Monitoring Report SEPTEMBER, 1993 Report Date: 10/07/93 . Company name :JACO OIL Station Name: FASTRIP FOOD STORE Address: 6401 WHITE LN, UNIT A Station # 360 State: CA City: PART A: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Data Tank ID: System Status: Product: Quality: Dels: Sales: 00 TIGHT OO-FS PRE GOOD 5811 5944 02 TIGHT 02-UNL #1 POOR 28511 32399 03 TIGHT -03 - UNL -#2 - - - ~- - ---FAIR 7222 7413 05 TIGHT 05-FS MID FAIR 11715 13350 USTMAN INDUSTRIES INC, is a certified Statistical Inventory Reconciliation (SIR) release detection vendor, Tank status results for monthly monitoring are based on parameters specified by the EPA protocol for SIR methods, PART B: Comments and Recommendations O/S listed below represent removals, additions or delivery discrepancies which were accounted for as part of the SIR analysis, 00 {9/7/1993: -95} {9/12/1993: 226} {9/13/1993: -100} 02 {9/7/1993: 357} {9/12/1993: 282} {9/21/1993:DEL -269} 03 t9/12/1993: -257l t9/15/1993: -85} {9/21/1993:DEL 175} 9/26/1993: 1134 9/27/1993: -209} 05 ~9/7/1993: -133} ~9/9/1993:DEL 228} ~9/14/1993: 111} 9/15/1993: -275} 9/19/1993: -135 9/21/1993:DEL 218} For regulatory compliance in California, a piping integrity test every 12 months and a tank integrity test every 24 months are required in association with SIR monthly monitoring, -,- ~ - -.-.- .......---:'-.~ - C iR'R E CT ION NO T ~ E BAKERSFIELD FIRE DEPARTMENT "Jr~ '-J_ .. .'1 ., 9 " . (.> "') € ' ..; .' , 'I 'J i Locatiol1hlKl<f? If:; h1S1,2¡'::J I Sub Div, <:;;/fOI UÁ:..f....-; ~, Blk. . Lot I ",:1 i You are hereby required to make the following corrections at the abòve location: Cor, No ''\ ' I) /:! I 1.-;"": ',-' ..j I ... 1\. ' ,. _,t 3 ,«,] (. '(~·Pl.r ("\ (,,,/. f)U~ (.<-,f!.; f)(;'t 1( '{~ 1I'~')1-Fj J ' .0t'! JI.-t.-t'€f JJ (', 'I, ,; !!.? ./ ¡:..- t ..4' ,~,' I Ie! ./ " <_' (.()(? -;u n{:¡~f'I\"f..L- tJs;7, I v{l\--e C/. /~s o~(ì,' " .' 6,..· J)\f::.-.e /~ ,':k J¿;~ ~/QI~: L )~'\!-¡(:'¡., " -J, :-'(;0 '.. .le ; ./ -, ¡~, , \\ - \ / :-.' ^ ('\ ...., I . ,J . ,\(.....$.\1. ,()(.(,. (''''''', f 1£ ,~(-; ....1.\..;,~'- ~ h f,ì"""Cy.),£ ~ ,t",<,..'!:.D¡'~ If¡/! I 1. . /t),0: e,\ t )~-I~/(j{:;i2¡7''''-'~\ ..; ~ 1 ~'~ Completion Date for Corrections dJAi /'7'r ,-I ~,'" " ~ " ...",.... _~ ..../.' ("'/.-(:,4 t ,.- Date Y~/,.s 77~¿!.-.,It/ki1.1. '. {l¡-..(:~' Inspector ~.I ;:1 -: ~i 326·3979 ,I, . ~ , ~ ~' ·f~ "i ~...;.-'--~---- - r'''''V'~' , --:c:-e;'\(;''',è>''~'i<.::-.;fM~~'::;:': '> -, -~.-:::" '-;.' <' ,: :. :: , A'=::' ' "~~<~~::: ~ --, ~ UNDERGROOND1TORAGE TAN.PECTION '-'-'._-'--~. _:__ -~-", _~__-~_'" ~., .... ._',_~_ '", ___',J ',~._....~.~. -' <-"'___~ _ _,~____._. .'\ ~ . \ - , . '" ."- ,:-:""1 e ' 'Bakersfield Fire Dept. Hazardous Materials Division Bakersfield, CA 93301 FACILITY NAME lii.-.1R& (IÝ1Rgel/5) FACILITY ADDRESS ,i..¡, I oJ..~4e. 1", " BUSINESS I.D. No. 215-000 '93 CITY g~~.Jd ZIP CODE 93~? --- FACILITY PHONE No, ,5<97- O~ 71 II» II» II» 61 (') :J.. O~ .64- INSPECTION DATE ~f;).c., /7,~ P.roduct Product Product TIME IN TIME OUT ~MI""lr'Ia (JL of- UL-(;AÚ\/.'.. .It. Ins! Da~¢?~ Ins! ÃeAb In&t~e".,£ INSPECTION TYPE: ,",CI l\ \A- , e.,," .y Ie; ,...,~ v" Size Size Size ROUTINE FOLLOW-UP I f)tf r\ /' 000 :;1.- , L a:.o REQUIREMENTS t'ì\I_~r, Ü "'''~ "I,~'\~ ){/<, yes no nla yes no nla . yes no nla 1a. Forms A & B Submitted V' ,/ ".,..,- 1b. Form C Submitted "" ,/ ,,/ 1c, Operating Fees Paid V V' ,/ 1d, .<Std~tIa~8IdIV ,::¡¡i<'i ~ :~ 1e. Statement of Financial Responsibility Submitted V- I/' V""" 1f. Written Contract Exists between Owner & Operator to Operate UST V v V' 28. Valid Operating Permit V ./ V 2b. Approved Written Routine Monitoring Procedure Ý v ......... 2c. Unauthorized Release Response Plan ý' V ..,.... 38. Tank Integrity Test In Last 12 Months _\ .1. ' J: ~- Cu,., . ...",,,, 3b, Pressurized Piping Integrity Test in Last 12 Months I.' Y\ e c1 1 a.-t t\C.l.. v ý' V" 3c. Suction Piping Tightness Test in Last 3 Years V V v 3d, Gravity Flow Piping Tightness Test in Last 2 Years ".... "" .........- 3e. Test Results Submitted Within 30 Days ,r t/ ,/' 3f, Dallý Visual Monitoring of Suction Product Piping V ,r r;- 48. Manual Inventory Reconciliation Each Month *' ./ v ...-- 4b, Annual Inventory Reconciliation Statement Submitted ~ ./ v" '-'" 4c. Meters Calibrated Annually -4" /' ,/ I ~ ~t'-, ( 5. Weekly Manual Tank Gauging Records for Small Tanks Y' V v' 6. Monthly Statistical Inventory Reconciliation Results 1\g 7, Monthly Automatic Tank Gauging Results I 1 ý' V --- 8, Ground Water Monitoring ",...- Ý ..- 9. Vapor Monitoring II"" ¡/ ",,- 10, Continuous Interstitial Monitoring for Double-Walled Tanks ~ "..... .".. - ", Mechanical Line Leak Detectors -'" ;F' V ¥ 12. Electronic Line Leak Detectors .ok- V- I/' .........' 13. Continuous Piping Monitoring in Sumps ¡/ V ...... 14. Automatic Pump Shut-off Capability v' V , ,,/" 15, Annual Maintenance/Calibration of Leak Detection Equipment ·f v' V" '-' 16, Leak Detection Equipment and Test Methods Listed in LG-113 Series 4' - V- I/' '-'" 17, Wrltten'Records Maintained on Site :rACO .:t' ¡/ ø/'" -.... 18. Reported Changes in Usage/Conditions to OperatingJMonitoring Procedures of UST System Within 30 Days ¡/ V ¡,/ 19. Reported Unauthorized Release Within 24 Hours V Y' V 20. Approved UST System Repairs and Upgrades v y ./ 21. Records Showing Cathodic Protection Inspection V V ...- 22, Secured Monitoring Wells ~}{II\I ,,-(\...1 \.v(~tl< \,\ r,o.~4 f} . r"J:. V' V I 'J.r 23, Drop Tube \ '- V V V /~ I ~ /V""I £¡..A It-~ ~ 'f'/ RE-INSPECTION DAT~ RECEIVED BY: 7 OFFICE TELEPH~E No. #,7..::J..h - 'AS'? 9 INSPECTOR: --'7n" ~ ~..-- ¡ I ¡ ¡ ¡ , I I, . ¡ ¡ ¡ ¡ ¡ i I i. ,. FD 1669 Operate Materials Storage Facility to Permit Underground Hazardous ......... ............. ............ .......... .. .......". ..... . .. ........... . .. ..... ......... . .. '. ........ ........ ,",.,..,' ,',..·N,','.... P . . ... . . . . . . . . . . ......". . . . .. '" ....... ..... .. . . ... " ..... .'. . . . . ... ... "........ . .. .. . . . . .. .. .. . .... . . .. ... .... ''''.'',........,.".,..'''.. .,....,.,',.",'.'.. erm ....... ,";.: ':.' ,',' .........:..............:..... . .,' .... .......:.:.. ..-,' .,'.',,'. ................ ................... ,'- ,.'.. ... .... ... . ..... .... ...... "' .. ... .. .",.. ..... -" -,-. .. - .. . ...... ... ....... .... . ,".. . . ..... . . ". ....... . . . . . . . . .. . . . . . . . . . . . . ..... .. .... ....... ..... ... .... .:..{··~:::r··~i i). .:::;::;~;;{:;;:.. . :~~t~:~~!!~iit .../:;;}~i~¡~:. }r~~~~{':'" .;~;~~;:;::::..:;:;:... ;;t;;;.::·:··;·:·:·:····:;::::::}:::::;;;.:.. CONDI rlo ":$~}:\:Î:~!!!:¡::f!:Ë!RMI'!:::::·::::;!M;N:::¡::!i;8EV E R SE SID E :~::~::: ~~,;~;>;"~I~::t~t;r,':"'£:~!i:!,!;!\:;! UNLEADED PLUS "1·2, 000 '" ",.... ··1·9Sb"".". ... '" FCS' , ,.... SIRIT'T"T·"" " . "LPT t:, :; ::)" ::,:' ":':' ~::::\}(, . . .. .: , ' ::): d l:· «:::? UNLEADED ..1·2 000 . ,. 1986' . .. "" 'fiCS . .. SJRITTT "" LPT r··::j .",,",:::::. .(::: .'''. .,.:,.: :)\)( :::",::::::":':,,:,,.'.,:(:{.:"'::(:::.:,:,..', ,. ,:': ':=,. < ".}: ...... .... ...:...... .'. '. ............ ............. .'. ......................................................... .' '.' .... .... '. .'. U LE ....1.· ... 00'·,'··'···, ,",..........,.. 8'·a···'··" ··'··""·"'·'··""8"6""·8·"·"'·""'·'·············'··.-.."·"·8f" 'T· '.... ....., . . .... . ....... .... ... .... ............ . .. . .. N ADED ... 2·'0· . .'. ','".. 19· ..........,','....'..,..... ,'. ,.., ,',,',.,....." .,.. .'. ·R/T· T .,:... .-.. LPT ::¡;:,'::::, \:;:::-:::::: :.. .::{:(} .,:: ':'. .... ,:::::::::::.::::. .:::::/ :: :}:}.,::}( .::::....... "'::; .:..... ". :.:./ ::::. ". ···..r· .. . . . . . .. . .. ... . ... .... ... ..' . . . . . . . .. . . . . . .. . . . .. '. .. ... .. .... · . . .. . . . . . . .. . . · . . . .. . . .. . .... . . . ... · . . . . .. . . .. \~~t~!,tJ¡¡Rrì1¿Z¥ì~;~~72~o: ... . .. .., .... Bakersfield Fire Dept.:·::.-::::::--·· :.,:... ./.:<:::.-:":-;..)::{ //,::} HAZARDOUS MATERIALS DIVISION " :::,,' 1715 Chester Ave., 3rd Floor Bakersfield, CA 93301 (805) 326-3979 623 310046 D. No. I. State Piping Monitoring THOMAS & VICTORIA FARRELL FASTRIP FOOD STORE #112 6401 WHITE LANE BAKERSFIELD, CA 93309 ALD ALD ALD ALD Piping Method PRESSURE PRESSURE PRESSURE PRESSURE No. t . I Tank Number Issued By: 01 02 03 04 12-22-98 to: 12-22-93 from: Valid Coordinator Ralph E. Huey, Approved by: . . Jaco Oil Company 3101 State Road Bakersfield. California 93308 - P 0, Box 1807 Bakersfield, California 93303-1807 . Phone: 805 393-7000 . Fax: 805 393-8738 :~~~¡:~~~~~~~*1~~~ill i~ili~~1~f~~lt~1*f~ . ............................. .............................................. ~1jj~jI~~~!~¡¡¡~~~¡IjjjjjjjjII~j jjjjjjjjj1jjjjjjjjjjjjjjj~jjjjjjjjjjjjjjjjj~ ...................... ...................... .......................,.,.,................. ...,.............................,........... ............................................. ............................................. ....................... ...................... August 1, 1994 LETTER FROM CHIEF FINANCIAL OFFICER I am the chief financial officer for Jaco Oil Company, general partner of Jaco Hill Co" This letter is in support of the Underground Storage Tank Cleanup Fund to demonstrate financial responsibility for taking corrective action and/or compensating third parties for bodily injury and property damage caused by an unauthorized release of petroleum in the amount of at least $10,000 per occurrence, and $10,000 annual aggregate coverage. Underground storage tanks at the following facilities are assured by this letter. Farrell's F.T., 6401 White Lane, Bakersfield, CA 93309 1, Amount of annual aggregate coverage being assured by this letter: $10,000 2. Total tangible assets: $5,869,372 $1,737,100 $4,132,272 3. Total liabilities: 4, Tangible net worth I hereby certify that the wording of this letter is identical to the wording specified by subsection 2801.1 (d)(1), Chapter 18, Division 3, Title 23 of the California Code of Regulations, I declare under penalty of perjury that ttile foregoing is true and correct to the best of my knowledge and belief. Executed at Bake~Sfie~ Signature ~ - on Date AUG 0 11994 Name: Brian Busacca Title: Chief Financial Officer BB:jlc ·~ _ e Jaco-Hill Company . 310 1 State Road Bakersfield, California 93308 Telephone (805) 393-7000 Post Office Box 1807 Bakersfield, California 93303-1807 Q.Â ~ '~uary 12, 1994 Mr. Ralph Huey CITY OF BAKERSFIELD UNDERGROUND TANK PROGRAM 2101 "H" STREET BAKERSFIELD, CA 93301 REceiVED JAN 2 4 1994 HAZ, MAT, OlV, Subject: F ARRELLS F AS TRIP 6401 WHITE LANE BAKERSFIELD, CA Dear Mr,Huey: In accordance with the state and local regulations requiring annual testing of product lines and line leak detectors at secondarily contained facilities, tests were performed at the above referenced location. Attached for your review are copies of the results of the line and leak detector tests which were performed November 19, 1993, by Tanknology Corporation International. Review of the results indicate the product lines are tight and the leak detectors are functioning properly. Jaco-Hill Company strives to maintain compliance with all state and local regulations at our facilities. Should you have any questions or require additional information, do not hesitate to contact me at (805) 393-7000. Re¡~~~) ~hn Kerley Operations Manager JKljk attachments TANKNOLOGY CORPORATION INTERNATIONAL 5225 Hollister. Houston. Texas 77040-6294 Phone (800) 888-8563 FAX (713) 690-2255 Certificate of Tightness ServlceOrder# 030702 Underground storage tank system(s) tested and found tight for: TANK OWNER: Test Date 11/19/93 I ¡.. I I"" t'<tt~ , ".,~-:.. I "'}i"". "., I I II TEST SITE ADDRESS: Ii I I I JACO OIL COMPANY INC. [ ] TANK(S) ONLY TANK SIZES & PRODUCTS TESTED 1 3 JACO OIL COMPANY INC. FARRELL #360 6401 WHITE LANE BAKERSFIELD, CA [ 4] LINE(S) ONLY, [3] LEAK DETECTOR(S) ONLY, REG UNL PLUS UNL 2 4 REG UNL SUPR UNL LINES TESTED lA, 2A, 3A, 4A LEAK DETECTORS TESTED , , Unit Mgr, Certificate Number & Name 083 STEVEN E. HAWKINS 06/94 Valid only with Corporate Seal U,S, Palenl #4462249. Canadian Palenl # 11 65693. European Palenl Appt #169263 TANKNOlOGY & VacuTecl are Irademarks of TANKNOlOGY CORPORATION INTERNATIONAL _._-.'-'~ --- ~~- ---- -- - ----. ---. - . , .. , ' "--. " . ',"-'. '~_::T~·;i:· y:..,,;~.'.... ." .." . -..~ " >:"-,,. ". .:.:..';, =~.:,n: J',- .. ~, 030702 11/19/93 <800> 253-8054 BRUCE McDUFFY i S.O.# Date Phone .. VacuTectTM TEST REPORT J TEcHNOL~V FOR TANKS AHD rHÐR ENVmONMENT . Owner JACO OIL COMPANY INC Site # Invoice Name/Address USTMAN INDUSTRIES INC, 12265 W BAYAND AVE, #110 LAKEWOOD/ CO 80228 Site Name/Address JACO OIL COMPANY INC FARRELL #360 6401 WHITE LANE BAKERSFIELD CA AUn TANKS LINES Leak Det See Ullage TANKS and LINES Tested to CFR-40 Parts Dìag, Tank Dipped Dipped Probe Water Bubble Air Line Final Exist 280-281 & NFPA 329 Spec's. For Dia, & Water Product Water ingress Ingress Ingress TANK Line Del ivery LINE LINE Leak LINE LD(s) NEW Loc. Material Level Level Level Detected Detected Detected . Material Syst. Type TEST TEST Rate . Pass/ LD(s) ST/ . . . . . . Tight . . . . . Tight Fail! Tested Other: ank Tank Tank FRP/ START START START or ST/ START END or or & # Product Capacity Lined END END END Yes/No Yes/No Yes/No Fail Line # FRP PS/SS/GS TIME TIME GPH Fail NONE PASS 1 REG Ulameler 1A S'Ì' PS 5:35 6:25 0,000 T P N ExisllD SN/MOL/MFG" UNL New/2nd LD SN/MDLlMFG: Malerial Start Time: Itr~~H)es'i~" at M~:rP LINE TEST PSI 50,00 I End Time: If:"Jpsl: I~~~~ - ~~~,~.,'~!'ter g~~~~:~~;s~~~; Valves y 2 REG lameter I 2A ST P$ 6:35 7:05 0,000 T P N Exist LO SNIMOL/MFG: UNL New/2nd LD SN/MDLlMFG: Malenal Start Time: I tr~~If.:s'ï~" at ;;,~:rP LINE "ES1 PSI 50,00 End Time: If:~rPSI· g,~~ ~;~~.?e~~ter g~~:::~;s~~~) Valves y 3 PLUS lameter I' .i, I 3A ST PS 7:15 7:55 0,000 T F Y ExisllD SN/MOllMFG UNL P New/2nd LD SN/MDLlMFG: Malenal Start Time: I ~=:¥~s'i~" at M~:rP LINE TEST PSI 50.00 I C~.. TI~ð· 1+:~rPSI: I ~~~~e ~~~,~'..'~~ter g~~~7:~~;s~~~; Valves y 4 SUPR Dlameler t"- I,', 4A ST PS a:io 8:40 0.000 T P N Exist LO SN/MDLlMFG' ..~-- UNL I New/2nd LD SN/MDLlMFG: Malenal Start Time: I ~~e~l¥~~~" at M~~P LINE TEST PSI 50,00 I "no! Ti.....: I+:~r~" I~~~~,': ~;~~~~~ter g~~:~~;s~~~ Valves y Diameter ' 'I I Exist to SNtMDlIMFG I I NewJ2nd LD SN/MDUMFG: Matenal Start Time: I~~~l¥.:sr;~"at M~:rP LINE TEST PSI: 1+:~rPSI: I~~~~ ~~~.?e~~ter '- g¡~~~7:~~;~~~r Valves uiameler I -,' I I ExisllD SN/MOL/MFG I I I New/2nd LO SN/MDLlMFG: Malenal Start Time: I tr~';,e~l¥~s'i~ at r!!mp LINE TEST PSI- Mfg.: I ~:~rps, I~~~~ I ~;~~.?e~~ter ' - gí~~~7:~~;S~~~1 Valves "no! TimA: I: I Tanknology Corporation International 5225 Hollister St., Houston, TX 77040 (800) 888-8563 · FAX (713) 690-2255 CA State: State Lie. # Control Department and maintained on file. 416 # Unit recordings are reviewed by Tanknology's Audit WESTERN REGION TANKNOLOGY Region t NOTE: Original VacuTect Data , TAK-Qi, . . CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT S. D. JOHNSON FIRE CHIEF July 2, 1993 2101 H STREET BAKERSFIELD, 93301 326-3911 l. FASTRIP FOOD STORE *112 6401 WHITE LN" A BAKERSFIELD, CA 93309 RE: Monitoring requirements for underground storage tanks, Dear Business Owner: >: Our records reveal that no precision tank testing has been performed on the four underground storage tanks located at 6401 White Lane, Section 2643 2(A) of Article 4; Title 23, Div, 3, Chapter 16, CCR" requires that all underground tanks that do not utilize automated leak detection shall have a precision tank test annually, Additionally, pressurized piping shall be tested annually and non- pressurized piping shall be tested every three years, Pipeline leak detectoisand automated leak detection systems also have to be certified to be in working order on an annual basis. Please make arrangements to bring the tanks into compliance with state law, .. - If you haveLany questions, please call me at (805) 326-3979, h ..., -.:r . Sincerely,':-¡J _ ~ßdW$U-.:f- - ~. Huey Hazardous Materials Coordinator Underground Tank Program ~ e . BAKERSFIELD FIRE DEPARTMENT HAZARDOUS MATERIAL DIVISION f -;.\' 1- PERMIT TO OPERATE UNDERGROUND HAZARDOUS STORAGE FACILITY Pèrmit No.: 310046 State ID No.: 310046 Issued to: FASTRIP FOOD STORE #112 Location: 6401 'VHITE LANE - UNIT 112 BAKERSFIELD, CA 93309 r Owner: JACO HILL P. O. BOX 1807 BAKERSFIELD, CA 93302 Operator: JACO HILL P. O. BOX 1807 BAKERSFIELD, CA 93302 Facility Profile: Year Is Piping Tank No, Substance Capacity Installed ~ 1 GASOLINE 12,000 GAL 1986 YES 2 GASOLINE 12,000 GAL 1986 YES 3 GASOLINE 12,000 GAL 1986 YES 4 GASOLINE 12,000 GAL 1986 YES , This permit is granted subject to the conditions listed on the attached summary of conditions and may be revoked for failure to adhere to the stated conditioDB and/or violations of any other State or Federal regulations, i I Issued by: Ralph E, Huey Title: Hazardous Material Coordinator Issue Date: JULY 1, 1991 Expiration Date: JULY 1, 1994 POST ON PREMISES NONTRANSFERABLE t. , ¿ ~' ~\ 1 e Bakersfield Fire Dep. HAZARDOUS MATERIALS DIVISION 2130 G Street, Bakersfield, CA 93301 (805) 326·3970 IRE 1, l¡ÒPto l /\ . o<-tlo l I, FACILITY/SITE' ~ UNDERGROUND TANK QUEST lqv- ~ \q \, No, OF TANKS 4 DBA OR FACIliTY NAME NAME Of OPERATOR E PARCEL No.(OPTIONAL) ADDRESS 6401 Hhite Lane CITY NAME Hakersfield STATE Ca ./ BOX TO INDICATE I:) CORPORATION ~INDIVIDUAL I:)PARTNERSHIP (J LOCAL AGENCY DISTRICTS (JCOUNTY AGENCY (JSTATE AGENCY (JFEDERAL AGENCY TYPE OF BUSINESS ßJ 1 GAS STATION 1:)3 FARM 02 DISTRIBUTOR 04 PROCESSOR I:) 5 OTHER KERN COUNTY PERMIT () f ¡-f.-, TO OPERATE No. '3 l 0 Ï' v Tom Farrel (805) 397-0271 John Kerley (805) 393-7000 NIGHTS: NAME (LAST, FIRST) PHONE No, WITH AREA CODE NIGHTS: NAME (LAST, FIRST) Tom Farrell (805) 397-0271 PHONE No, WITH AREA CODE II, PROPERTY OWNER INFORMATION (MUST BE COMPLETED) NAME CARE OF ADDRESS INFORMATION I Colbek Investments MAILING OR STREET ADDRESS ./ BOX o INDIVIDUA L o LOCAL AGENCY o STATE AGENCY I P,O, Box 10419 TO INDICATE o PARTNERSHIP o COUNTY AGENCY o FEDERAL AGENCY I CITY NAME STATE I ZIP CODE I PHONE No, WITH AREA CODE i Bakersfield Ca 93389 I III, TANKOWNER INFORMATION (MUST BE COMPLETED) NAME / CARE OF ADDRESS INFORMATION JACO HILL MA IlING OR STREET ADDRESS ,/ BOX o INDIVIDUAL o lOCAL AGENCY o STATE AGEN~Y P,O, Box 1807 TO INDICATE ~ PARTNERSHIP o COUNTY AGENCY o FEDERAL AGENCY CITY NAME STA TE ZIP CODE PHONE No. WITH AREA CODE Bakersfield Ca 03302 (805) 393-7000 OWNER'S DATE VOLUME PRODUCT IN TANK No. INSTALLED STORED SERVICE 1986 12000 gasoline 0)N 1986 12000 gasoline @/N 1986 12000 gasoline @/N 1986 12000 gasoline Q)N Y/N Y/N DO YOU HAVE FINANCIAL RESPONSIBILITY? Y/N TYPE ........ ,;. Fill one segmen~t for each tank, unless a~tanks and piping are constructed of III samè materials, style an~ype, then only fill 1\ one segment out. please identify tanks by owner ID #. f -I. TANK DESCRIPTION COMPLETE ALL ITEMS·- SPECIFY IF UNKNOWN A, OWNER'S TANK L D, # B. MANUFACTURED BY: Ì'1odern lveldi n p- .' C, DATE INSTALLED (MO/DAYIYEAR) 1986 D. TANK CAPACI1Y ,IN GALLONS: 12000 ¿: ---- .---- -, ._---_.--~------- III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPLIES IN BOX D A. TYPE OF D 1 DOUBLE WALL D 3 SINGLE WAll WITH EXTERIOR LINER D 95 UNKNOWN SYSTEM B 2 SINGLE WALL 0 4 SECONDARY CONTAINMENT (VAULTED TANK) 0 99 OTHER D 1 BARE STEel 0 2 STAINLESS STEEL 0 3 FIBERGlASS ~ 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC B, TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM 0 8 100% METHANOL COMPATIBlEWiFRP (Primary Tank) D 9 BRONZE 0 10 GALVANIZED STEEL D 95 UNKNOWN 0 99 OTHER 01 RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C. INTERIOR 0 5 GLASS LINING 0 6 UNLINED 0 95 UNKNOWN 0:99 OTHER Trpnrh T.inf>r LINING I IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_ NO_ D, CORROSION 01 POLYETHYLENE WRAP 0 2 COATING .' 0 3 VINYL WRAP [X] 4 FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE o 95 UNKNOWN -0 99 OTHER IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE A. SYSTEM TYPE A U 1 SUCTION A@ 2 PRESSURE A U 3 GRAVI1Y A U 99 OTHER B, CONSTRUCTION A U 1 SINGLE WAll A U 2 DOUBLE WALL ACŸ)3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER C, MATERIAL AND A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC) A@ 4 FIBERGlASS PIPE CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100% METHANOL COMPATIBLEWiFRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION ~ 1 AUTOMATIC LINE LEAK DETECTOR o 2 LINE TIGHTNESS TESTING o 3 INTERSmlAl o 99 OTHER MONITORING V, TANK LEAK DETECTION o 1 VISUAL CHECK [i] [X] 6 TANK TESTING 0 2 INVENTORY RECONCILIATION 0 3 VAPOR MONITORING 0 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 7 INTERSTITIAL MONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER I. TANK DESCRIPTION COMPLETE ALL ITEMS.. SPECIFY IF UNKNOWN A, OWNER'S TANK L D, # B, MANUFACTURED BY: C, DATE INSTALLED (MO/DAYIYEAR) D. TANK CAPACI1Y IN GALLONS: III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A. B,AND C, AND All THAT APPLIES IN BOX D A. TYPE OF 0 1 DOUBLE WALL 0 3 SINGLE WALL WITH EXTERIOR LINER 0 95 UNKNOWN SYSTEM D 2 SINGLE WALL 0 4 SECONDARY CONTAINMENT (VAULTED TANK) 0 99 OTHER 0 0 0 I 0 1 BARE STEEL 2, STAINLESS STEEL 3 FIBERGLASS 4 STEEL CLAD WI FIBERGLASS REINFORCED PLASTIC B. TANK MATERIAL 0 5 CONCRETE 0 6 POLYVINYL CHLORIDE 0 7 ALUMINUM 0 8 1000/0 METHANOL COMPATIBlEWiFRP (Primary Tank) 0 9 BRONZE 0 10 GALVANIZED STEEL 0 95 UNKNOWN 0 99 OTHER 0' RUBBER LINED 0 2 ALKYD LINING 0 3 EPOXY LINING 0 4 PHENOLIC LINING C, INTERIOR 0 5 GLASS LINING 0 6 UNLINED 0 95 UNKNOWN 0 99 OTHER LINING IS LINING MATERIAL COMPATIBLE WITH 100% METHANOL? YES_ NO_ \ D. CORROSION 0 1 POLYETHYLENE WRAP 0 2 COATING o 3 VINYL WRAP 0 4 FIBERGLASS REINFORCED PLASTIC PROTECTION 0 5 CATHODIC PROTECTION 0 91 NONE o 95 UNKNO,WN 0 99 OTHER .. IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND, BOTH IF APPLICABLE ~- A. SYSTEM TYPE A U 1 SUCTION A U 2 PRESSURE A U 3 GRAVI1Y A U 99 OTHER \. B. CONSTRUCTION A U 1 SINGLE WALL A U 2 DOUBLE WALL A U 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHER \ A U 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POL YVINYL CHLO~!DE (PVC) A U 4 FIBERGlASS PIPE "'- C. MATERIAL AND CORROSION A U 5 ALUMINUM A U 6 CONCRETE A U 7 STEEL WI COATING A U 8 100"10 METHANOL COMPATIBLEW/FRP PROTECTION A U 9 GALVANIZED STEEL A U 10 CATHODIC PROTECTION A U 95 UNKNOWN A U 99 OTHER D. LEAK DETECTION o 1 AUTOMATIC LINE LEAK DETECTOR o 2 LINE TIGHTNESS TESTING o 3 INTERSTITIAL o 99 OTHER MONITORING --. V. TANK LEAK DETECTION o o ¡-.J 1 VISUAL CHECK r '] 6 TANK TESTING 2 INVENTORY RECONCILIATION D 3 VAPOR MONITORING 0 4 AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITORING 7 INTERSTITIAL MONITORING 0 91 NONE D 95 UNKNOWN D 99 OTHER '/ ."'¡' ~ , ~. ~NCOU "'1" RESOURCE M AGEMENT ¿NV r RONM'-AL HEALTH SERVICES DEPARTI I::NT 2700 :M" STREET, SUITE 300, BAKERSFIELD. CA.93301 (805)86'¡-3636 AG2Nf":. UNDERGROUND HAZARDOUS SUBSTANCE STORAGE FACILITY * INSPECTION REPORT * ':>E~UTT'~G'y . "," 4 ., .~ :, ,; 'J ,_ r: '.. ::) ~ ~~M : T ~';_-:: ~ '::: ~ ! TYPE OF I~jS?ECT!ON: A T I ;1/! ¿ : ;\¡ ~.,~.Ç~~i~f' '[ :'!! E '.J u:- ~,,,"'..~...,...~.,,.._. ."~ U ~1!8 E ~f 'J:= -; Þ.;\j \-{:.3: ""On _. _..':: "..._."... '( E S """a'~H' I\¡ C b"""'''HHm r N S PEe T I 0 i\j D /~, T E: :H"iI:,,'2:~10""""H H''',"' :~ C U ï INS """,,,K,_.m" ¡~ E I i'J :3 PEe T r 0 N """''''''''''''Hm" CO I't'I P :_ A I i'J T ",,,,,'""-"'''''''''''', ./ . ,...._,.~....-....-......~..............................-......,.......................... :=).\C I l_ r TY ;>"A¡M:=.iA!H-tT::' ; ,.\.i\'F CA<;-¡c:""',,;,"LtJ : "I . '- . .!.! ...~~..... :..~.....::"::. .~:..~..7':.....~...·..~.~"::':....u:.'::-::..... ~.:. ~.h:...'~'nh.'~.._.h..h.~U .~..." ......, .,. .~... n........,"' ...,,, .... ...."" ..."......,. ...........~.,..... .,.~.~. .,... .....',.. ...",. '~"h;" ."...,,,_..... ~., r- A C I L r T,( .A 0 0 RES 5 : §A:gJ...J~.t!,II,s....J~A,0.!.s.m'..'..............-..,...._.."."".,...,...,.,,......".....,...,.,.,...._...,.,.,,,.,........,..".,'....m.,.,...,..'...,...,.......',,...,.......,,,,,,.,......,,,. 3A;.;2RSF I ë:LD, C,,~ OWNERS N.AME:JACO OIL COMP,A.NY;;360, ' . . . . .._....,,_..,,~.......,............. ...._............ ...._..........~...h.....~..,..................~.....~~~......'.H_..:....".....,................,..................,......................................................................................................._....... OPE RAT 0 R S N A ME: .F...ðB.8,s.,h.b..!._..,I,Ç~~....".....m........m.,..'''....'''.._.m..._..''.."...............:....."..'...m..'..'....,........,..'''.,'''.m....'..........,........'.......,m_........m......"m... COMMENTS: ' .......................-.............-..................,......................,...........................-....................................,........................-................-.....-......................._...._........_....._......-........_..-.~-........._...._..........-...............-......-.--.............-........... ..,__.........................._._._............_."................................_...............__...,~.._,_.............................................._.....................n..........._................_............................_._...~...................~~.._............._.........._............._..h.~__...........~....___......~~.._...........h............ ~ :. . ........---... ......--....................-.... ............................................--.."'..............._.................._....~............................ ...........~........,......._.......~......._.........__..........-........,'-,...............~.............."........................~....~........~..~... ................~............~....., ........ r::'ì '~ ~o:~~~gci I~vsn:c~y ~a~:~G~ VIOLATIONS/OBSERVATIONS ~tJl.tJ~ JüC~ '(V'-.~.[J ~' (j ~ ~GC-Ù \J ITEM 1. PRiMARY CONTAINMENT MONITORING: a. InterceDting an directi~g system 3t3nd~rd rnven~:ry Ccnt~~ì d. =. in-cank Level Sensing Javic9 Grcwnci~ater ~cnitcri~g Vadose Zone ~onitoring , f. , . .~ 3ECC·NOAR'( C0NT AIN~!EN¡ ~c~~ I ¡:JRI NG: ,3. Liner r;;r--., , " ,.1'" , ~.. "OUD ,e-"a I jeo canK :, Vault._ 77 c. Grav~ ty : /', ,1 ~ ~U .orG- 1::.. ck t.o ~-I-:-. : LN C:. "0LO'L ðtrL (?~y:X(Q. "-~ .. '!?I~~ ~C~!TO~I~G: ~~) O~~~'~"~;~~~ c;....,. . J ..;w...¡"':, oW""'-'" J. Suc:ic!'1 1\ . . J ().LQ ,()Vé '- ~' -b::JX<..[) þLJ '1 p}¡cy4..c ¡ û! cW.:+- f!.l Ci CL ~ ëJUf . , v ¡ U-.'"t..l.~ ~"-- J. QVERF:L~ ;~¡)T2CTIGN: ., T¡G~TNES3 ~~S¡NG ... NE:Ñ ,:ON:37~:..:I:TION/¡,'OGiF:CJTI0NS ;{(J>1.J¿ '. ;:·_'~::UKË/A2,,~~C:2N~,ËNT ,:!?Ë~ATI~G ~:~r401Tlf~N :JF ~,~CIL!T{ 11 C¡..---L i ~h 01-L-'Y1 oJ ¿~ c", eJDc,l u u ~. ~NA~THOR¡:~: RELEASE '3. !,t~I~JTE~;\NCE. G€NE~AL SAFETY, AND C~~1MENTS,/~EC()M~!END!~rr~~N3 ....,."....~"...."'. .'".."'''',....,,. .·.·.h...···....... .,~..,............"...... ....... .' ,. p' .....-""... ~..'.' '-" "".-- ,,~....._...",......, ,. . ........... .....', ... "" ......__.."'...,. ,.............."...... '''. .'" .,... ".............". .."..".... '''''''., , . "'....~,. .n'.. .",... ..........,...., ....... """'" .......... ......" ...... .............,..,..... .. __. ....,.. .,,,, _. .. ..,. ..............."....... ...".."........_.. ,.,·"H' He'....."',,··..... ......... ... .............. ............... ,..---..."".......'".........,..~..... ................ ....., ............................--....... -- ..................-......................................................-.- .~,"--."",...."",.,,.....~.,. ..... .... ..... ... -- .........~......., ..., ?~i~-~.~~,~i~,~~,c~_~;;~!~~.~-~:=...~·~·;~~.~~;;;.~~~i.~~~~~:~~~/·~-~_~~4X- / .. . .~.~ ~ a -.. - "_..~_. "-- .- i ~ KERN COUNTY AIR POLLUTION CONTROL DISTRICT . ' / --- .., ~'. -. . 2700 "M" Street, Suite 275 , Bakersfield, CA. 933()1 (80S) 861-3682 PHASE I VAPOR RECOVERY INSPECTION FORM , ' . , Station Name--~~, /:J Location ÚJ</O / I~J,;fe Lf1 Company Mailing Address , 7;() ð,qy 1<¡~1 "'3 Q'1- ();). 7¡ Date 1/- 7- 7 Ò Phone Inspect", þ(tJlJ/ i--* . --"' ~ 'Notice Hec'd By .---- - ~.._-_.-- -~~--- - -.- .~-----, -----._- :~·~·~,:<~t~;>. .. 1. _ PRODUCT (UL, PUL,P, or R) , 2. TANK LOCATION REFERENCE 3. BROKEN OR MISSING VAPOR CAP 4. BROKEN OR MISSING FILL CAP 5. BROKEN CAM LOCK ON VAPOR CAP 6. FILL CAPS NOT PROPERLY SEATED 7. VAPOR CAPS NOT PROPERLY SEATED 8. GASKET MISSING FROM FILL CAP .. " . 9. GASKET MISSING FROM VAPOR ÇAP -10. FILL ADAPTOR NOT TIGHT 11- VAPOR ADAPTOR NOT TIGHT - 12. GASKET BETWEEN ADAPTOR & FILL TUBE MISSING / IMPROPERLY SEATED 13. DRY BREAK GASKETS DETERIORATED 14. EXCESSIVE VERTICAL PLAY IN \ COAXIAL FILL TUBE 15. COAXIAL FILL TUBE SPRING MECHANISM DEFECTIVE 16. TANK DEPTH MEASUREMENT 17. TUBE LENGTH MEASUREMENT 18. DIFFERENCE (SHOULD BE 6" OR LESS) TANK # 1 {;ð WI- '-~.J TANK #2 '-PlU- f4d ',' TANK #3 '-TANK #4 ' R _Vt- '-- :,/t1jj/t ~5tri~,.,<> ',/ ~~~ ~~ ./ I \ " .rf2'\ /'1 I 1;z ~ )3LJ/' GÐ ---5411 19. OTHER fÍt\ u\ 20. COMMENTSlJ:;L 1'Y'0 lY Q f I 0 _// ry , '" () ,"l ., ,- ,'v {.II', ~ -" ð v , I , 1/ I+~ :--( t3 Ii It> :".-..- \/ It I i-Lo Jt\'1 , ,u I It LP I \~~ Y1ìO(\511('0 J J ¡J -/_ LI", ..I- /{'(:-' ~_ 'YlrJ\ U { Q-.'\ t- ~ .~ * WARNING: SYSTEMS MARKED WITH A CHECK ABOVE ARE IN VIOLATION OF KERN COUNTY AIR POLLUTION CONTROL DISTRICT RULE(S) 209, 412 AND/OR 412.1, THE CALIFORNIA HEALTH & SAFETY CODE SPECIFIES PENALTIES OF UP TO $1,000.00 PER DAY FOR EACH VIOLATION. TELEPHONE (805) 861-3682 CONCERNING FINAL RESOLU- -t,. Ù:~ .:~ TION OF THE VIOLATION(S) "Cr-(-¡ ù:": .;;" -:--;{¡-t¡ ~?-(:;:''''::'1·7·,^;.-tr frÙ:~ ¡~¡ ",^rtr1{ Ù '.'7>-^r~~t.. trtrtr-t.·-t{1¡¿ --:,?¿¿ ¿ ¿ ¿¿-.::r -:-r -::¡.¿ ~ {':¡ 1:r.¿ .. '~r \:~ . , KE.COUNTY AIR POLLUTION CON'" DISTRICT 2700 "M" Street, Suite 275 Bakersfield, CA. 93301 (805) 861-3682 PHÀSE II VAPOR RECOVERY INSPECTION FORM . .";: NOZZLE # GAS GRADE NOZZLE TYPE w\A-~ Lr\ P/O # ?()q~ 51- I ~Ò City --py.i:er.sç~e IJ Zip q~,Cl ~ System Type: ' ~ HI HE GHHA Notice Rec'd BYl/" ~ Station Location l.ùh l \ 0 L 1'1 r;; ~~(; p ( 0 ~ [) \ Cçmpany Address ,F 0 ?: r:;/ ! ? ñ 7 Contact ;¡¿5Yi~ Phone 3C;7-_(J~'7/ Inspector _ _-0. _ _ __ ' Date /17 7D ~ 1< I I ~pfJ '¿{P ?> ~ Ì)r:J:jJ 7JjjJ!fJo , ,b ~ 1. CERT. NOZZLE .,'- - , 2. CHECK VALVE ,'- ,. ". - ". 'N 0 3. FACE SEAL ' " Z Z 4. RING, RIVET #\ L E 5. BELLOWS 6. SWIVEL(S) ~ . 7. FLOW LIMITER (EW) ., , , , 1. HOSE CONDITION , ; V ~ A 2. LENGTH , P 0 3, C0NFIGURATION R 4. SWIVEL H ~ 0 5. OVERHEAD RETRACTOR , S E 6. ' POWER/PILOT ON < 7. SIGNS POSTED Key to system types: "Key to deficiencies: NC= not certified, B= broken BA=Balance HE =Healey M= missing, TO= torn, F= flat, TN= tangled RJ =Red Jacket GH=Gulf Hasselmann AD= needs adjustment, L = long, LO= loose, " HI =Hirt HA =Hasstech S= short MA= misaligned, K= kinked, F¡;¡= frayed. , I; I; I ** INSPECTION RESULTS ** Key to inspection results: Blank= OK, ,7=Repair within seven days, T= Tagged (nozzle tagged out-at-order until repaired) U= Taggable violation but left in use. COMMENTS: VIOLATIONS: SYSTEMS MARKED WITH A "T OR U" CODE IN INSPECTION RESULTS,' ARE IN VIOLATION OF KERN COUNTY AIR POLLUTION CONTROL DISTRICT RULE(S) 412 AND/OR 412.1. THE CALIFORNIA HEALTH & SAFETY CODE SPECIFIES PENALTIES OF UP TO $1,000.00 PER DAY FO~EACH DAY OF VIOLATION. TELEPHONE (805) 861-3682 CONCERNING FINAL RESOLUTION OF THE VIOLATION. NOTE: CALIFORNIA HEALTH & SAFETY CODE SECTION 41960.2, REQUIRES THAT THE ABOVe: LISTED 7-DAY DEFICIENCIES - BE CORRECTED WITHIN 7 DAYS. FAILURE TO COMPLY MAY RESULT IN LEGAL ACTION 4j,F)-!01;:, APC!) FJ!.E . . -,¡ PERMIT NUMBER '~ \COL\lo( TYPE OF INSTALLATION ( ) 1, In-Tank Level Sensor (~2, Leak Detector Fill Box (v) 3, FACILITY NAME Fn. rrllll,,~ FCl\'*:t:i0 0 FACILITY ADDRESS LoL\O\ \ 1 )~~!b - lh I 11) ~-hr,lr\} G¡ ,lrnÎl ¥\f'(lt'J , q~3n9 CONTACT PERSON 1. IN TANK LEVEL SENSORS Number of Tanks List By Tank ID Name of System Manufacturer & Model Number Contractor/Installer , - 2. LEAK DETECTORS Number of Tanks ~ J i t ¡ List By Tank ID ~~ Name of System ' ; Manufactur~r & Model' mber /I~ Contractor/Installer I 3, FILL BOXES Number of Tanks y List By Tank ID Name of system~()ÎeC() Manufacturer & Model Number Contractor/Installer Iff ^/I ~-+- , , OW~TOR ~ /--;/~ 91 DATE -, .. Jaco Oil Company .3 / t10~~ " - , ., ,. 3101 State Road Bakersfield, California 93308 Telephone: (80S) 393-7000 Facsimile: (80S) 393-8738 Post Office Box 1807 Bakersfield, California 93303-1807 '" - - ---:-~ j~?::~:" Å "-,-, ':t" '/~\ -'/, JUN 28 7QI10 '.';2\ J"j ,_, RECEIVED if) /( v~/ '.> "-_c:-~)/ .,,-- June 27, 1990 Kern County Environmental Health Department 2700 "M" Street, Suite 300 Bakersfield, Ca. 93301 Ms. Amy Green: Please be advised that the attached forms are those forms that we have requested that all of our operators in Kern County utilize in completing underground tank monitoring. ~ Please advise us if you have any problem with these forms. 1- .(f .( , FILE CONTENTS INVENTORY Fa c i 1 i t Y ~ a. '(\~M (1"\ () r' DPermit to Operate # ..J GaConstruction Permit t 3foo~ DPermit to abandon~ No. of Tanks OAmended Permit Conditions DPerl'[lit Application Form, DAppl ication to Abando,n DAnnual Report Forms Date Date Date Tank Sheets, Flow Chart tanks (s) Date DCopy of Written Contract Between Owner & Operator [JInspection Reports []Correspondence - Received Date Date Date [JCorrespondence - Mailed Date Date Date [JUnauthorized Release Reports [JAbandonment/Closure Reports [] Sampl ing/Lab Reports o MVF CompI lance Check (New Construct ion DSTD Compliance Check (New Construction []MVF __Plan Check (New Construction) ~D Plan Check (New Construction) [JMVF Plan Check (Existing Facility) OSTD Plan Check (Existing Facility) O"Incomplete Application" Form ~ermit Application Checklist [Jpermit Instructions [JDiscarded [JTightness Test Resul ts , Checklist) Checklist) Date Date Date OMonitoring Well Construction Data/Permits ----------------------------------------------------------------- DEnvironmental Sensitivity Data: OGroundwater Drilling, Boring Logs DLocation of Water Wells DStatement of Underground Conduits IS?JPlot Plan Featuring All Environmentally Sensitive Data [JPhotos DConstruction Drawings Location: -=aJe..C; []Half sheet showing date ,received and tal)y of, inTfaectlon tjme" etc ffiÞtiscellaneous Ifl6PtJJftOlí Æ!ef!ord, {)rOJè{!>"t" S fuð ,sheer , I . , , e /'( '- 1~¡'!1":;'·;1' i) .\ (- KJu(N COUNTY . PERMIT UNDERGROUND . (- HEALTH DEPARTMENî TO CONSTRUCT STORAGE FACILITY PERMIT //310046B fACILITY NAME AND ADDRESS: OWNER(S) NAME AND MAILING ADDRESS: Handi Major 6401 White Lane Bakersfield, CA Jaco Oil Company P,O, Box 1807 Bakersfield, CA 93303 :XX I I ,- I I -I I I I I I 1 I 1 I I I I I NEW BUSINESS CHANGE OWNERSHIP RENEWAL MODIFICATION OTHER PERMIT EXPIRES September 1~986 APPROVAL DATE 1~985 APPROVED BY POST THIS PERMIT ON PREMISE~ CONDITIONS AS FOLLOWS: 1, All pertinent equipment and materials used in this constFuction are subject to identification and approval by the Permitting Authority prior to construction, This permit is issued contin~ént upon,guaranteed compliance with the guidelines as determined by the Permitting Authority, 2, All construction to be as per facility plans approve~ by this' de part.ment and veri fi ed b'y ins pec t ion by P e rmi t ting Au thori ty, 3, Permittee must contact Permitting Authority for on-site inspection(s) with 48 hours advance notice, 4, All underground metal product piping, fittings and connections must be wrapped to a minimum 20-mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion, 5, Construction inspection record is included with permit given to Permittee, This card must be posted at jobsite prior to initial inspection, Permittee must contact Permitting Authority and arrange for each group of required inspections numbered as per instructions on card, Generally, inspections will be made of: a, Tanks and backfill b, Piping system with secondary containment c, Overfill protection and leak detection/monitoring d, Any other inspection deemed necessary by Permitting Authority -6, Spark testing (35,000 volts) required at site prior to installation of tank(s), Test(s) must be certified by the manufacturer, and a copy of test certifications supplied to the Permitting Authority, 7, All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications, 8, Liner shall be installed by a trained experienced liner contractor and installation at site approved by Permitting Authority prior to backfilling, 9, No product shall be stored in tank(s) until approval is granted by Permitting Authority, 10, Monitoring requirements for this facility will be described on final "Permit to Operate", ACCEPTED BY __~1:~_~jl_~~~~~________________ DATE Kern County Health Oepartme~_ Division of Environmental H_ 1~00 Flower Street, Bakersfiela,' CA 93305 ÅPPLICATION FOR PERMIT TO OPERATE' UNDERGROOND, HAZARDOUS SUBSTANCES STO~E fACILITY !YEl! of Application (check): . ~NëW Facility Dt'odification of Faci1ityDExisti~ Facility DTransfer of <>.mersh!p A. Ðnergency 24-Hour Contact (name, area code, ¡:hone): Days <V00-3Q3-70é)O Nights ~t'S--3 Cr 3,- FCC () Facil i ty Name -It 0."" d,. f'vl 0. i ,ð V . . ~. of Tanks ..., Type of Business (check): ~GaSO lne Statlon OOther (aescnbe) . Is Tank(s) Located on an Agricultural Farm'? Dyes ¡;iNo Is Tank(s) Used primar~ly for 1qricultural Pury;:>ses'? DYes f3.No 5-t? ~c Facility Address L( ~ I IJ/)., ,'t-~ Jo".e. (~/¡:rJ k)f·~_Nearest Cross St. ()!; h~ SEC- T R SEC (Rura.l Locations Chly) Owner .:¡- 2> C-(~ &~ C('> Contact Person fÎ()y ~c(r. ¡/Ic1\d Y"'.s Address ~ r' 7 Zip C(?,3 cJ-' Tele¡i1one gtJ_r-~~:3-7()ðO Operator ïL)/11/1 ~ V" oQ. , , Contact Person TON\. Address p, () " 9 ~ ~ .. Zip TeleP'lone ~(")c:--?,CI 5-1(') ('., C 8. Water to Facility pr~vided by L ('..\, IA/á: te r Depth to' Groundwater fA Ifl,/r Soil O1aracteristics at Pacility .!::J ~ '"' Basis for Soil Type ðIld GrolJl"rlwater Depth Determinations c., ;-e... - C. Contracto.r S ~ , f- CA Contractor's License No. Address Zip Telephone Proposed Starting Date --.9 i IS- fc ~ s;- propo~ed Canpletion rete '1/ 15-/ ? ~ Worker's Canpen.sation certI icat on I ~ V' F, , -e Insurer ' . Fermi.. Applicatio . \ ~ D. If This Permit s For Modification Of An EXisting Facility, Brie~ly Describe Modifications Proposed .e E. Tank(s) Store (check all that apply): ~! -- Waste Product Motor Vehicle Unleaded Regular premium Diesel Waste Fuel Oil I 0 In .~ 13 ~ 0 0 8 L- 0 IZJ 0 j D '3--/ 0 m ~ B B 8 B 0 ÿ1 F. Chenical Canp:>s~ tion of Mater ials Stored (not necessary for IOOtor vehicle fuels) Tank' Chemical Stored (non-comnercial name) CAS t (if known) Chemical Previously Stored (if different) G. Transfer of Ownershi2 Date of Transfer Previous Owner Previous Facility Name I, accept fully all obligations of Permit NJ. issued to 1 understand that the Permitting Authority may review and modify or te~inate the transfer of the Permit to Operate this underground storage facility upon receivi~ this completed form. This form has been canpleted under penal ty of per jury and to the best of my knowledge. 1s ::::ecor~;...?-. LI~ Title (".-f' VI ",.,1 , ¡!,~", I»te ...,/27jg:J t.' Facility Name Jta V"d I' .,tl-j CJ r- .- Permit No. TANK! I (FILL OUT SEPARATE FORM FOR EACH TANK) FOR EACH SECTION, CHEC¡( ALL APPQOPRIATE BOXES -- H. 1. Tank is: DVaulted DNcm-Vaulted DIbuble-Wall ~ingl,e-wall 2. Tank Material -, __ Carbon Steel 0 Stainless Steel 0 Pol yvinyl .. Chloride 12fi'iberglass-Clad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 Alt.minum t1 Bronze DUnkoown o Other (describe) 3. Primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Y L-/ J 2J () c) 0 4. Tank Secondary Containment . DDouble-Wal1~thetic Liner DLined Vault DOther (descnbe): I-Ibp£ !mMate(ial Q f) ~. Thickness (Inches) 5. Tank Interior LinIng ~Rub~r Dlùkyd DEpoxy DPhenolic DGlass DClay Dtrllined Dtrlkno\1l1 (Sather (descriœ): ...þ V L ¡I. ý\..Q... ~ 6. Tank Corrosion Protectlon _ ---r:J"Galvanized ~Fiberglass-Clad O~lyethylene wrap DVinyl wrappi~ OTar or Asphalt DlJnknown ONone OOther (describe): . - . .. . Cathodic protection:JSitNone OImpressed OJrrent System [J Sacrificial Anode System Describe System' Equipnent: 7 . ~ Detection, Monitoring, and Interception , . a. Tank: DVisual (vaulted tanks only) r:rGroun.1water Monitorin:j Well (s) o Vadose Zone Moni toriD3 Well (s) 0 U-Tube Without Liner []U-Tuþe with Compatible Liner Directi~ Flow to Monitorin:j well(s)* o Vapor Detector* DJLiquid Level Sensor 0 Conductivit~ Sensor* o Pressure Sensor in Annular Space of Double Wall Tank ' o Liquid Retrieval' Inspection Fran U-Tlbe, Monitoring:Well or Annular Space o Daily Gau:Jir~ , Inventory Reconciliation 0 Periodic : Tightness Testing . 0 None 0 tmknown 0 Other .$ ..Q..ç P I (J ~ <; F fA , ) ,:' "" ..Q 10- b. ~Jping: BFlOW-Restricti~ Leak Detector(s) fór pressurized Piping" o Moni toring SlInp wi th Race~y 0 Sealed Concrete Raceway DHalf-cut Canpatlble Pip! Raceway ,SSyn~tic ~iner Raceway DNone DUnknoW'1 OOther K>eA :5?-c-b~ ).pr, I:. /"-~:+:Jr III, -!)1~ *Describe Make , Model: 8. Tank Tightness Has '!'tus Tank Been Tightness Tested? Date of Last Tightness Test Test Name 9. Tank Repair .1 Tank Repaired? DYes ~ OUnknown Date(s) of Repair(s) Describe Repairs 10. OVerfill Protection ~ator Fills, Controls, , Visually Monitors Level DTape Float Gau:Je DFloat Vent Valves D Auto Shut- Off Controls BCapacitance Sensor GaSealed Fill Box o None OtmknOW'l Other: List Make , Model For Above Devices Manufacturer ---Ai' n 1':) .e y" V\ o None 0 unknOW'1 . Manufacturer: Q u..,...J 0 <2.. Capacity (Gals.) __ DYes ~ Dl11knoW'1 Results of Test ~sti~ Company 11. Piping a. tkldergrolU1d Pi ping : ~Yes ONo Ounknown Mater ial )< ¡yo (,4 e (0 f- e Thickness (inches) ,e:, ~ j, \lcDiameter '2) I Manufacturer ~essure DSuction (]Gravity ~prõXimate Length of Pipe RU'\ b. Underground Piping Corrosion Protection : I9Galvanized OFiberglass-Clad OImpressed CUrrent OSacrificlal Anode SPolyethylene Wrap ØElectrical Isolation [2fvinyl Wrap OTar or A$p\iIlt DUnknown o None DOther (describe): . c. UndergrolU1d Piping, Secondary Conta irment: ODouble-wall Yfsynthetic L?,ner Syst<~,· ONone Dunknown DOther (describe): Facility Name J+-O rd I' ~t) () r- ~- pennit No. ~ ! A._ (FILL OUT SEPARATE FORM FOR EACH TANK) FOR EACH SECTION, CHECK ALL APPQõPROOE--šõXEŠ-- -- 10. 1. Tank is: DVaulted ONon-Vaulted O[):)uble-Wall ~ingl.~-Wall 2. Tank Material -:!Ill Carbon Steel 0 Stainless Steel 0 Pol yvinyl Chloride l2fi'iberglass-<lad Steel· . B Fiberglass-Reinforced Plastic 0 Concrete 0 Ahmim.m tJ Bronze DUnknown Other (describe) . primary Containment Date Installed Thickness (Inches) Capacity (Gallons) Y L-/ J 2J () éJ 0 4. Tank Secondary Containment . - [] Double-Wall ~thetic Liner 0 Lined Vaul t o Other (descr (¡;) ; BMaterial 8 t) MïL Thickness (Inches) 5. !ank Interior Lin ng . LfRubber' [J Alkyd o Epoxy DPhenolic OGlass 18·0ther (describe): .) 1/ L ," ý'\..q,. ,- 6. Tank Corrosion Protectlon . -LfGalvanlzed """'œF1bergÍass-Clad DPol}'ethylene wrap [JVinyl WrappiR} [JTar or Asphalt DUnknown DNone Cather (describe): . - , . £athodic Protection: ·6INone DImpressed O1rrent System []Sacr1f1clal "Anode Syst_ Descr ibe System , Equipnent: 7. Leak Detection, Monitoring, and Interception ã:--Tank: OVisual (vaulted tanks oiùy) CfGrouOOwater Monitorirg' Well (8) [] Vadose Zone Moni tori~ Well (s) 0 UJl'ube Wi thout Liner . []U-~ with Compatible Liner Directi~ Flow to Monitoring WBll(s)* o Vapor Detector* [¡Liquid Level Sensor q Condœtivit¥ ~r* 8 Pressure Sensor in Annular Space of Double Wall Tank . . Liquid Retrieval , Inspection Fran U-Tlbe, Mani toril'¥J . Well or Annular Space o Daily Ga~lÞJ , Inventory Reconciliation 0 Periodic Tightness TeatlR} . ... " DNone Dt)1kno'l\ DOther 5...Q-Q Plo~<; FrAIl ,,""'~I- . b. Pipi~1 rJ,rlOW-ReatrictiR} Leak Detector(s) fór Pressurized PlplR}'II' [] Moni toriÞJ SLap wi th RaceWlY 0 Sealed Concrete Raceway DHalf-CUt Canpatible Pipe Raceway ,S'Synthetic Liner Raceway DNone D Unknown Oather *Describe Make , Model: 8. Tank Tightness ~aa 'lbl. Tank seen Tightness Tested? Date of Last Tightnus Teat 'f..at Name 9. T:ank Repai r t 1iñK Repaired? DYes ~ Oll'1known Date (s) of Repair (a) , Describe Repairs Overfill Protection -~ator Filla, Controls, , Visually Monitors Level DTape Float Ga~8 OFloat Vent Valves 0 Auto Shut- Off Controls BCapacitance Sensor ~Sealed Fill Box ONone DU'1kno'l\ , Other: List Make , Model For Above Devices 3. H. Manufacturer ---A;1 (") r..) ~ Y'" V\ o None 0 t11known Manufacturer: Capaci,ty (Gals.) .....' - DClay OU'\lined DU1knoW'\ DYes ~ Olt1known Resul ts of Test ---.¡têstil¥J Canpany 11. !iping a. U'1derground Pipil¥J: 'Ji-Yes ONo Otktknown Material )< rY'~ e (0 t- f: Thickness (inches) ~ c.}l ~VDiameter ¿ \ I Manufacturer ['SJeressure D5uctlon DGravityApprnimate Le~th of Pipe RLI'1 b.. Und'erground Pipirg Corrosion Protect ion : . !9Galvanized DFiberglass-Clad OImpr-essed CUrrent OSacrificlal Anode 1aPolyethylene Wrap SEl~ctrical Isolation I3'Vinyl Wrap DTar or ~lt DUnknown DNone Oather (describe): . c.. Underground Pipi~, Secondary ContailTnent: 'DDouble-Wall ~thetic Liner Syst·:~· DNone DUnknown OOther (d~scr 1 re\ ~ ----- ,~ \ Facility Name t-¡-O y,d.1 11itl ;nr- e--- Permit No. - TANK i ~_ (FILL OUT SEPARATE FORM FOR EACH TANK) FOR EACH SECTION, CHECK ALL APPQOPRIATE BOXES -- - li. 1. Tank is: OVaulted ONon-vaulted O[X)uble-Wall ~il'¥]l_~-Wall 2. Tank Material - .. Carbon Steel 0 Stainless Steel 0 Polyvinyl C1ùo~ide l2fi'íberglass-Clad Steel B Fiberglass-Reinforced Plastic 0 Concrete 0 Allltllnlll\ tJ Bronze OlJnkoown Other (describe) 3. Primary Containment Date Installed 'n1ickness (Inches) Capaci ty (Gallons) Y '-I ) 2; tJ é) 0 4. Tank Secondary Containment - . ODouble-Wall~thetic Liner OLined vault D Other (descr &) ~ imMaterial - ~ t) ~ Thickness (Inches) 5. Tank Interior Lin ng --crRubber OAlkyd OEp>xy OPhenollc DGlass Delay Olbl1ned DlbknoW'\. 180ther (describe): ) 1/ L ,.. v'\ ~ ,,- 6. Tank Corrosion Protectlon , _ -crGalvanlzed ÌZ!Fiberglass-Clad DPo!J'ethylene Wrap DVlnyl Wrappirq []Tar or Asphalt ounkncM\ ONone DOther (describe): - -, Cathodic protectlon:6lNone IJImpressed CUrrent System C Sacrificial Anode Syst_ Describe System, Equlpnent: . 7. Leak Detection, MonitoriÏt, and Interception - - ¡:-Tank:Ovisual (vau teð"tãnks oiù.y) LfGroW'dwater MonitoriR]' Well (s) OVadose Zone MonitoriB3 Well(s) Ou-Tube Without Liner o U-'I'uþt with Canpatible Liner Directi~ Flow to MonitoriR] Well (s) * o Vapor Detector* [JLiquid Level Sensor 0 Condœtivit¥ Sensor* _ 8 Pressure Sensor in Annular Space of DoubJ..e Wall Tank ' Liquid Retrieval , Inspection Fran U-TLi>e, Moni toril'¥J well or Annular Space o Daily Gat.¥}irq , Inventory Reconciliation [J Periodic Tightne. TestiR,¡ .' IJ None IJ ~ 0 Other 5 ....Q.ç P I (J "'" <;. F eA. J) ),' ~ ~ ...- . b. Pipil'¥J: 1:i-l'1ow-RestrictlRj Leak Detector(s) fór Pressurized PipiB)'- o Moni tor in¡ StDp wi th RaceWllY 0 Sealed Concrete RaceWllY []Half-CUt CQDplltible Pipe Raceway ,fa'Synthetic Liner Raceway DNone o Unknown 0 Other - *Describe Make , Model: 8. Tank Tightness HaS thIs Tank Been Tightness Tested? Date of Last Tightneas Test Test Name Tank Repair Tãñk Repal red? 0 Yes ~ Dl11kno~ Date(s) of Repalr(s) Describe Repairs 10. OVerfill Protection ~ator rills, Controls, , Visually Monitors Level OTape rloat GaU}e DFloat Vent Valves D Auto Shut- Off Controls BCapacitance Sensor e;lSealed Fill Box o None Dl)1knoW'1 Other: List Make , Model ror Above Devices Manufacturer -J\I7 (") (') .e 1" V'\ D Nane 0 tk1knOW'l Manufacturer: Capaci ty (Gals.) --- Dyes ~ OU1known Resul ts of Test ---;¡¡slil'¥J canpany 9. t , 11. Pipi~ a. tbierground PipiR;): fi-Yes DNa Oll'1kno~ Material >< /)"(,,4 e (0 f- e Thickness (inches) co <. }'I \(}Dlameter '2) Manufacturer ~essure OSUct!on L]Gravi ty . Approximate LeR;)th of Pipe Am b. Underground Piping Corrosion Protection : . J9Galvanized DFiberglass-Clad DImpcessed CUrrent Osacrificial 1v1ode figPolyethylene Wrap 6!ElectricalIsolation ~vinyl Wrap DTar or Asphalt DUnkno~ o None OOther (describe): c. Underground Piping, Secondary Containment: DDouble-Wall ~thetic Liner Syst,::~· o None Dunknown [JOther (descrtbe)' . Facil i ty Name 11. Pi~ing . a. O'1derground Pipirv:J; ~Yes ONo Ol)\known Material;:>< Ti"l-4 e (0 f-e Thickness (inches) <. < }, 'lvDiameter :¿ \ Manufacturer ~essure OSuct1on DGravity . Approximate I.ef¥jth of Pipe Qœ b. Underground Piping Corrosion Protection : J9<;alvanized OFiberglass-Clad OImpcessed CUrrent OSacrificial Mode BPolyethylene Wrap SElectrical Isolation l'B'Vinyl Wrap DTar or As¡:ftalt DUnknown o None OOther (describe): c. Underground Piping, Secondary Gonta irment -;--- ODoub1e-Wa11 ~e1~t!.C Li ~er ~"yst~,· o Norl(: Ounkn-.)WJ1 [JOther (describe): . H. .' 6. 10. f - . -/ ¡ ". ,.,"\~. , ¡-T- (( V~ú' I I (~, i~\ \ ( r f e--H Permit TANK 1 ~_::.5:t_ (FILL OUT SEPARATE FORM FOR EACH TANK) ~ EACH SECTION, CHECK ALL APPQOPRIATE BOXES No. 1. Tank. is: OVaulted ONon-Vaulted OD:>uble-Woall ~ingl.~-Wall 2. Tank Material "C~rbon Steel .0 Stainlesss7. eel 0 Polyvinyl Chlo~ide 12fi'iberglass~lad S.teel B Flberglass-Relnforced Plastic 0 Concrete 0 AlLltUnLmt 'tJ Bronze OlJnknown , Other (describe), 1. Primary Containment Date Installed, 'l11ickness (Inches) Capacity (Gallons) 4 k d . Y'-/. /2.} tJ () 0 . Tan Sacon ary ContaInment DDouble-wall~thetic Liner OLined Vault D Other (descr {bë) ~ ISlMaterial . ~ f) Mil..:.... Thickness (Inches) S. Tank Interior Lln ng ~Rubber OAlkyd OEpoxy OPhenolic OGlass DClay D\11lined DU1knoW'1 180ther (descrlbe): Þ V L ,'- ý\ -4- ,- .Tank Corrosion Protect~on --crGalvanlzed '18Fiberglass-Clad OPol}lethylene Wrap - DVinyl Wrappirq . , CTar or Asphalt DUnknown DHone o Other (descr1be) : - . . .. Cathodic protection: ·5INone Otmpressed Olrrent System [::JSacrillclal Anode Syat.. .. . ...... Describe System, Equipnent: . .. 7. ~ Detection, Monitori~, ~ Interception . a. Tank: QVisual (vaulted tanks omy) CfGrourrlwater Monitoril'l1 Well (8) D Vadose Zone Moni toriD3 Well (s) 0 u-Tube Wi thout Liner . o U-~ with Canpatible Liner Directi~ Flow to Monitoring Well(s) * D Vapor Detector* [J.Uquid Level Sensor [J Condœtivit¥ Serµ¡or* .... . 8 Pressure Sensor in Annular Space of Double Wall Tank . Liquid Ratrleval , Inspection Fran U-TtÐe, Mont tor1Bj *11 or AMular Space o Daily GatqlRJ , Inventory Reconciliation [J Periodic T1qhtne. Testi~i':' L... [] None [] la'\knoW'1 [j Other .$ ~ ~ P J 0 .., e" F fA J) },' '" ~ ....- . " b. Pipirq: rJl'law-RestrictiBj Leak Detector(s) for Pressurized PipiB) [J Moni torirr:J &lip wi th Racftlly D Sealed Concrete Raceway DHalf-CUt Cœpltible Pipe Raceway ¡fSynthetic Liner Raceway ONone o Unknown [J Other *Describe Make , Model: 8. Tank Tightness BaS 'l111a Tank Been Tightness Tested? Date· of Last Tightness Test Test Name 9. Tank Repair t Tãñ1ë Repaired? DYes ~. Olk\known . Date(s) of Repair(s) DeScribe Repairs OVerfill Protection ..~ ~ator Filla, Controls, , Visually Monitors Level .DTape Float Gatqe OFloat Vent Va}ves 0 Auto Shut- Off Controls BeaP8Citance Sensor SlSealed Fill Box o None Dtk1knoW'1 . Other: List Make , Model ror Above Devices Manufacturer ~ n /,:1 ~ ý'" Y"'\ o None 0 lk1known Manufacturer: . Capacity (Gals.) -.- ,. o Yes ~ Dtk1knoW'l Resul ts of Test ~Sli~ Canpany i( .' . {. . 6, Are Red Jacket subpu~ps and all line leak detector accessible?' Type of line leak detector if any /"JOI.j¡'··~d ....10(..£-:, 7. Overfill containment box as specified on application? If "No", what type and !lodel number: Yes No I~ 1_, I~ 1_' a) Is fill box tightly sealed around fill tube? I~ 1_' b) Is access over water tight? I~ I_I c) Is product present in fill box? I I ~ 8, Identify type of monitoring: A¿L.~~r ~J~ a) Are aanual monitoring instruments, product and water finding paste on premises? b) Is the fluid level in Owens-Corning liquid level .onitoring reservoir and alar. panel in proper operating condition? c) Does the annular space or secondary containment,! liner leak detection system have self diagnostic capabi 1 i ties? If "Ves", is it functional If "No", how is it tested for proper operating condition? 9. Notes on any abnormal conditions: I I !:\? ~ I_I I_I pi/A I~ i I 1/ i I I e . Standard Compliance Check -:' Facility: .µ~ tj({ ~ á-r , - CT 2} Eq~}pment to be installed: ^I Tank (5) , ft. of Dsuction Œ!pressur i zed piping R:>' d Approved :r(!., 9·-).J~primary Containment DFiberglass (FRP) ßaFiberglass-clad 'Duncoa téd stee 1 OOther: Co~ment: steel Make Make Make Make & Model & Model & Model & Model M".J~;/'r1., [¿,Ii' t~;~ Additional: ~ , £.!1þ.le~ Secondary Containment of Tank(s) ODouble-walled tankrs) Make & Model œSynthetic liner Make &ModellJ1á..L~Ac:. DLined concrete vault(s) Sealer used ~ OOthe'r Type Make & Model' commen~t: . \,' ht... ~.L"'L-II~J h~ ¡~().H/o, ()-fJr;- ~_~':!'L( + _ ..1_ Addltlona : . Pntö~~ ~ \ 1 ì I"-..LK" .:. .-:> -' / ,/ ;s¿ q/,)¡E I Secondary containment volume at leÇist 100% of primary tank vol ume (s) Comment: Additional: Secondary containment volume for more than one tank contains 150% of volume of largest primary containemnt 0 10% of aggregate primary volume, whichever is greater Comment: Additional: Secondary containment open to rainfall must accomodate 24 hour rainfall Total Volume Comment: / Additional: ~e 9~~15secondary containment is I Product {},ð.t:ifrl\~- Comment: _?E Additional: product-compatible J)ocumentation 1 , v' ~~9)~~ Manufacturer-Approved Backfill for Ta~ks & Piping Type Comment :.' " J1! /' --....... _.-~...- / v L J V' e- ( Annular space liquid Product . Comment: :'_...I.:.. 9/12)/35 Addi-tional: e. (' is comp,~tible wi.th pr,oduct A"laF>·~~~!~:~S~:;.';·'>:~ ...·;~~.c.. ,.~.~ ::~·::-~>~~i·~:.~f~:;~:~~ T~ primary Containment of Piping DFiberglass piping ~Coated steel piping OUncoated steel piping DOther Comment: Additional: 9)2~econdary Containment of Piping . 'DDouble-walled pipe (XSynthetic liner in trench DOthe r Comment: Size & Make Size & Make Size, )(- Tv-u-{l~,+~ Size & Make Size & Make :B-l,)P\=. .Additional: ~~ ~~corroSion Protect!:..~n j ~Tank (s) r, L Clift:.' t,,oA C II':" ' caPiping & fitti-RgS ~'- l~,::-t~, ~Electri ca 1 isolat ion ')¡'E'" i '. . . Comment: R.,/Ju·"1J.h~.",,-J.6 wj Additional: I '-:3'~ t:tltZ!B5 Additional: Tank(s) Located No Closer Than 10 Feet to Building(s) Comments: Additional: :-st'.9/065 Complete Monitoring System Monitoring device within secondary containment: DL iquid level ind icator (s) OLiquid used æfThermal conductivity sensor(s) DPressure sensor(s) Dvacuum gauge 6lSump (s) DGas or vapor detector(s) OManual inspection & sampling DVisual inspection Other Comments: ~D I(H ;W~ c;. .Ltj~.:k -)( ~ /Y\()·v'\.t~ S;l~"')' ? I. ;_ ,._;;~,~~~?::' :,,'~."j~. C"~!'" "~~.V'_H"'''''~ a 17{/) < .... ". .·,~~.·~_,,~~1'-:""-- 1/ k II ~ / v ~--øi;5. e' ( Additional: e (-' Other Monitoring periodic tightness testing Method Pressure-reducing line leak detector(s) Other Comment: Additional: Overfill Protection DTape float gauge (s) OFloat vent valve (s) DCapacitance sensor(s) DHigh level alarm(s) DAutomatic shut-off control(s) ~Fill box(es) with 1 ft.3 volume &/J Jt7lq .. [»perator control s wi th visual level mont tor ing . Other Comment: Additional: Monitoring Requirements ; Additional Comments J /f Inspector !, ¿J (-''b-1,~_1 // 1/ Date 9-/;::) - ~.~ 3 e - .31 Facility Name J-/w~ Permit Application Checklist t'1-a:i D~ ÜJ ~A--b i á-s-i _L Facility Address Application Category: ~Standard Design (Secondary Containment) Motor Vehicle Fuel Exemption Design (Non-Secondary Containment) Approved Permit Application Form properly Completed Deficiencies: :30" :s-c.- 3 Copies of ~ Plan Depicting: property llnes Area encompassed by minimum 100 foot radius around tank(s) and piping All tank(s) identified by a number and product to be stored .:\ c.. -::sC-- "$ c,~ -(' ~ -' , Adequate scale (minimum 1"=111'0" in detail)" fll-=. 3b' North arrow ,1 All structures within 50 foot radius of tánk(s) and piping :!e- Location and labeling of all product piping and dispenser islands Environmental sensitivity data including: *Depth to first groundwater at site *Any domestic or agricultural water well within 100 feet of tank (s) and pi ping *Any surface water in unlined conveyance within 100 feet of tank(s) and piping *AIl utility lines within 25 feet of tank(s) and piping (telephone, electrical, water, sewage, gas, leach lines, seepage pits, drainage systems) *Asterisked items: appropri~te documentation if permittee seeks a motor vehicle fuel exemption from secondary containment Comments: .N"____ ,.---.-. . . , Approved 5Œ 3 Copie~· of Constru~tion Drawings Depicting: Side View of Tank Installation with Backfill, Raceway(s), Secondary Containment and/or Leak Monitoring System in Place. -C'l ~. Top View af Tank Installation with Raceway(s), Secondary Containment and/or Leak Monitoring System in place ~ J( .:!"C_ A Materials List (indicating those used in the construction): Backfill ~ ~~~~~~~ PiPin; ~~ -) ;JÞf~::'J,"l 5.-~1, l.Jall Raceway(s) Sealer ( s) Secondary Containment Lì~DA' ~D~ .:::> (' , :\"C- :-s- ('/ Leak Detector(s) ¡¿oJ. ::rarW 1I/..-DI7 Ove r fill pr otec t i on E>M..c <.::> fl.) k~.LL~t.R^,4Î' '1 Gas or Vapor Detector(s) Sump( s) ^I T~ -le;__...1 f\~j{~LHJ:rr-l-iCV\ ¡a-w/:J . IA -If.pÅAr~ :!'c Monitoring Wel1(s) Additional: , i Documentation of Product Performance Additional Comments P J;¡/IA/) 0A.e. hvfYl- II ~ù? t€-~/k II Rev i ewed By Date SITE INSPECTION: -COmments: Approved Disapproved Inspector Date . . -' .', . p This Memorandum Is an acknowledgment thaI' . copy 'or duplic4te, COV. . ill of lading has been iuued and is not ,he Origiu' liII of l" :,. property nolmed herein .nd is inTended lolely for filinq o. ~. no, "d. Shipper's No. 11288 ~-IODERN ~tELDING CONP,\NY. (Name of Carrier) REÇE,IVEO, subj.ct to the classifications and tariffs in .ff.ct on the date of the issue of this Bill of ladinq, INC. Carrier's No at FRESNO, CALIFORNIA 93711{)ct"hPT ., , 19 ~t:¡ From MODERN WELDING COMPANY, INC. the property der.erlbt..>d oolow, In apparent. good ord.r. except as noted (contents and comHUon of contents of Ila~'kage8 unknuwn). marked. const¡:,nt."CI. and desUned as Indicated below, which S&IQ c:arrlvr (the \Vord cnrrfer being unllerst.ood througtlOut. thl!i contT8t"t all meanlnc any per!'lon or corporation In po!'l~es.lon· of the property under th~ cuntract) AC1'ees to carry to ,its usual place or lie· Ih'ery at ,said destl~..tlon.. It on It!> route, otherwrse to dellv@f to another catTier on the route to aald df'stlnutlon. Jt Is mutu.aUy a«reed. all to C!ach c:Iorr1er of "II or any øl said property over aU or an)" portion or said route to destination. and as to each party at any time Interested 1ft .11 or any of gld pro~rty, lhat ever)' service to be performed hereunder .ball be subject to all the term. nnd con,jltlons of the Uniform Dome!'otlc Stralcht 0111 of Ladlnc .aet lort~ (1) In Official, Southt"rn, Western Dnd IUlnol. I"relcht C1.s.lflcatl~ In dIed on \be dato benot. It this I. . rail or . rail· water øhlpment, or (2) In the applicable motor carrier cl8slôlnntlon or tariff If this Is . motor _'arTier shipment. ahlpP4!'t: ".reb)' artifin that "II" I. f...War with all tIt. term. and conditions of the said bill ., lading, Ineludlag th-. Oft the back thereof, Nt fwlll i. .... claMlllcaUoe .r tariff which gove:rn. the tr....portatlon of tlli. shipment, and tbe Mid wrm. ...ct condition. are he""" ..need to III)' the .hlpper aM accepte4 for hlm..lf ..... 111. ...1.... Consigned to Jaco 0 i 1 Destination Bake-rsflftld Route State r.,\ (Mail or- street address of consiqn_For purposes of notification only.) County . Delivery Address * Wb it eo laD t- & Ash (* To be filled in only when shipper desires and gcwerning tariffs proyide for delivery thereat.) Delivering Carrier No, Packages Car or Vehicle Initial~ No Kind of -Package, Description of Articles. Special Marks, and Exception. -WEIGHT (Subject to Correction) Class or Rete Check Column SUbJect: to SectIOl'1 ., of CondltlonR of applicable but 01 ladlftll'. II this øhtpmpnt I. to ~ dellvered to the contllpee with. out J"eCOCII"M on Ute con.tpor. the con· .~ sbaU alp the followlDC st.tement, TINt can1er ..It nœ mall. deU..ery 01 We ahlplDell.& ""'thout PAynMDt 01 helKb' _&11_"__ ., '"' UL MOOWEtnco (stcuture ot Conalpor) 1) - nr: 2 ("1 ," I I It r:...... .... to tw pnpa¡ld. WI1t.e w damp ~ UTo be Prepaid." P.O. 15683 .,- / .,',' PPD <,..., ~ ReeeIYM . to .pply 10 prepayment of the cbarC". 00 \be propen¡;r deacrtÞed benG'D. AaeD& or (·.abler r{ 0 1 i d;] V T est .3 5 D {) 0 Vol t::; 1:/ i t pes elf the ahlpment movea between two ports by . can1er by ....ater. the law require. that; the bill 01 lading shall state whether Ie .. camel". or .hlpper·. we11{hL NO'rr--Where the nt. I. dependeont on value, shippers are required to øtate specifically In wrttlna the acrød of declared ftl.. 01 the property. The .....-cI or dec:larecll value of tile ,rapenr- I. henÞ¡o spocHlcall)' .ta.... b. tIM ahipper to be not eJCaeCIlnv .... (nil' stcnatun hero ac.k.Dowled&'et. only the am.ouat prepaid.) CbarK.. Advanced' . Ie' fShlpper'. bnprtat tn lieu of 8tamp; not a part of BUI ot Ladlnc approved bJ' the In&en&ate OoIDmen:e. Commlaalone 1The rlh1'e box.. UfO"" for thl. shtþn..œ confonn to. the speclflcatloRe set tortb In tbe bos makn'. c:ertUI,..te thereoa. &Del all oIher requlnmenu of the Con"oUdat(l'd FrplR"ht ("laull.catlon,. ,'; ; f Shipper, Pèh /~''- ,? .. FRESNO, CALIFORNIA 93711 MODERN WELDING COMPANY. INC, r ."l Agent, Per ~ Permanent post-offiœ address of shiPPel, , tt.. :; (\ .,., Thi!. Shipping Order mutt be leqibty fill" Of in CcHbon I (n Ink in 1nde.libte PefKH :tdined'by the .Aqent. ( Shipper's No. 11287 MODERN 1iELI1TNr. rOMPA1'JY, p.rC. (Name of Carrier) RECEIVED, subject to the cl.assifications and tariffs in effect on the date of the issue of this Bill of Ladin9, Carrier's No at fRESNO, CALIFORNIA 937110ctober 2 19 85 From MODERN WELDING COMPANY, INC. th~ property debcrlbed below, In npparent g~Jer. except as noted (contents 3nd cor.dltlon of cnntents of 11:","kagea unknuwn). rn:'lrked, consi~ned. and destined a. Indicated below. whl~h saQ ~arr¡er (the word carrier I,)elng ulHJcrlnOOd throughou, th1~ contr3t"t aIJ meaning any p4!r!'lon, or courporatlon In po!'l!tesslon of the propt!r1y undt'r th~ contract) agrees to carry to Its usual place of de- Ih'ery at lòðld desUnaUon. " on Itt> route. otherwise to deUver \0 anotb£'r can\e-r on \be route to said d¡':.HnuHon. 1t. is mutuaUy ngreed. :l~ \0 (>1\r.b cnTl'\.r of ,," or any pf snid property over aU' or ;lny pnrtlon or aald route to deßt1naUon. and as to \!ach party at any time Intere!'ited In all or any of uld pr0p'·rt)', lhat ever)" service to bo performed hereunder eball be &ùbject to all the termø :md cond.lttans of the Untlorm Dome!oUc Straight Dill ot Lading set fort~ ~ I) In Official. Soulh£,rn, We.tern and IlIlnot. Frell'ht Cl...ltlcaUon. In .Clect oø the date bereof. it this I.. a 'ran or a J'.all~ .·.ter fthlpment, or (2) In the applicable mocor carrier cJasslllC!aUon or tarler If this IS . motor ,·.rrler shlpment._ . ."Ipþet' ".t'eb~ unifl" tt\at tte ,.. f.millar with ....U the tel'''''' .nd conditions of the u:'!I bUt of IU¡A'II, inchldh.g tho.. 01\ the back tt,.C'eOf. Nt fCM'tb h, tbe c......"lcatloft or, tuiff wtddt. ~r". th. ~.naportatl.n Of .thi_. ahi,u"ent. and the said term. .nd condition. are hereby agtee4 t~ by the ahlpper and accepMtl '01' him...' and bla ...Ig.... " Consigned to laco 0;] Destination . . Rakerc:;.fielò State CA (Mail or street dddress of consi9ne_For purposes of notification only.1 County Delivery Address * \'¡þ i t ~ J, ~ n e & A <> 11 (* To be filled in only ",hen shipper desires and 90verning tariffs provide for delivery thereat. I Route Delivering Carrier No. Packages Car or Vehicle Initial<¡ NQ Kind of Package, Description of Articles, Special Marks, and Exceptions ·WEIGHT (SUbJerl to CorN!ct.'Qn) Class or Rate Check Column SubJed to Seetlon If of Condition,. of .'Ppllcable bill of tadln¡r. II this øhlprrwn' ~. \0 be deUvered \0 \be C'OIM'1fIMe ~\th. out I'eCOUI'M on the conalcnor, ebe c:on~ -tenor sbaU ,.ap tlM foUowlftC, atatemen&.' Tbe eanj.,. abaJi not mall. deJlyery' øI thla abi¡mwn, W1\boOt J)ayft\eftt GI ~'.bt .... all _ lewtal ......- MOD\iELDCO 7 (Sl.....ture 01 c.o.u'por) " ,; , , If ehaJ'Wq .... to be pnPBtd. wrtte _ at.amp beIwi, "To be Prepa1d~" PPD ! R-.1'Md . to applY .a prepayment of the cbaI1Je. OD t.be pJ'OPØI"CF ,de8Cl1bed hereon. Aaent or (".abJe. P.. (The 5tl'MtUnt here acknowled&'ea only tM al'DØQnt prepaid.) e" the IIhlpment .hlpper·. weUrht. ~OTE-Wh.", the flit. Is depe~nt on value, ahtppera ue required to IItate &~lneal1y. In wrtUnc the -peed _ declared vatu 01 t.be property. "... agr'MCI or clec.lared val... of Ut. "roperty I. he""" specificallY a,u," It,. the ahipper to·... not ~I". Cbarl'e. Advanc.edl . Permanent post-offiœ address of shippeI, ... tThe tlbre boxeo. u,.e-d tor this shlpmeù conlonn to of th. «"on"olh1ntNl Frt'IKht ClaJIIlllncaUon.. the boJC make-ria certitlc:ate thereon. and .U other requ1ntmeøÞ tShlpp@r'. imprint tn Ueu of stamp; no' . part of Bill of Ladln« øpproved by the Jntenta~ Commerce Commlulon~ MODERN WELDING COMPANY, INC, __ Agent must detach and retain,this Shipping P Order and must s,qn the O<iginaJ Bill of ladi,,"