HomeMy WebLinkAboutUNDERGROUND TANK
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Hazardous ·MaterialslHaiã.i~dôus,'W:å;st({-Unified':·Permit
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Permit 10 #:: 015-000-000046
MEMORIAL CENTER FOR BE
LOCATION: 5201 WHITE LN
TANK
Issued by: '
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Bakersfield Fire Department ,: . .'.
OFFICE' OF ENVlRONMENTALSER VICES.' , ... ., .
1715 'Chester Ave., 3rd Floo~'" è;'>;"~;' , ;:'Àpprove4by:';
Bakersfield, CA 93301
Voice (661) 326-3979
FAX (661) 326-0576 v ',Expiration Date:'
. .
,.
..
. Issue Date
, 'June 30, 2003
,/Per...it",,·,"rfi:;:t:70per il.te
Hazardous Materials/Hazardous Waste Unified Permit-
CONDITIONS OF PERMIT ON REVERSE SIDE
LOCATION '5201
This permit is issued for the following:
@~rdous Materials Plan
"a!:[~round Storage of Hazardous, Materials
." " agement Program
Waste
/~
PERMIT ill # 015-021-000046
MEMORIAL CENTER
000 I Diesel Fuel #2
PIPING PIPING PIPING'
TYPE METIlOD MONITOR
CLM SUCTION ALD
TANK HAZARDOUS SUBSTANCE
Issued by:
Expiration Date:
~~
'~~ .
ph Huey.
ffice of ental Servi es '
June 30, 2000
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield, CA 93301
Voice (80S) 326-3979
FAX (80S) 326-0576
Approved by:
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.
CA,Cert. No.
I
00703
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City'of Bakersfield
Office of Environmental Services
1715 Chester Ave., Suite 300
Bakersfield, California 93301
(805) 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 infonnation inthe 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 Fonn A); name of issuing agency; and date of issue. Other identifYing
infonnation may be added as deemed necessary by the local agency.
This permit is issued on this 2nd day of November, 1998 to:
MEMORIAL CENTER FOR BEHAVIORAL
Permit #015-021-000046
5201 White Ln
Bakersfield, California 93309
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FACILITY NAME~yvì oy,~L.Qp~v
CITY OF BAKERSFIELD FIRE HEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chestcr Ave.~ 3rd Floor~ ßakcrsneld~CA 93301
INSPECTION DATE
9/7/04-
Section 2:
Underground Storage Tanks Program
o Routine ø Combined 0 Joint Agency
TypeofTank~ Fe.-~
Type of Monitoring C-L-VV1
o Multi-Agency
Number of Tanks
Type of Piping
o Complaint
1 '
DWF
ORe-inspection
OPERA nON C v COMMENTS
Proper tank data on tile K
Proper owner/operator data on tile X
Penn it fees current I>Z
Certification of Financial Responsibility )(
Monitoring record adequate and current ¡'
Maintenance records adequate and current IX
Failure to correct prior UST violations 'i
\ V
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/laheling
Is tank used to dispense MVF?
If yes, Does tank have overtill/overspil1 protection?
C=Compliance
V=Violation
Y=Yes
N=NO
Inspector:
Office of
Pink - Rusiness Copy
UNIFIED PROGRAM INIECTION CHECKLIST
SECTIO·N 1 Business Plan and Inventory Program
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield. CA 93301
Tel: (661)326-3979
~:Il.ITY_~~.~yY}ar: \j~1.____.Q~±~C_.____....._..___...__._._.._._.....___.__~...__._
ADDRESS 62D I 1tVY\ '. k __!-0J._____
FACILlTYCONTACT
~:PEI%~ATE INSPECTION TIME
. -.- j~?iöe:r.--·-ÑÕ-OfEm¡;¡õ-yeeSn-
_____________________________ 7£ÆifJ';l.?- _ÆJ_-'.¥!2_
Business ID Number
15-021-
Section 1: Business Plan and Inventory Program
o Routine
Combined
o Joint Agency
o Multi-Agency
o Complaint
D'Re-inspection
c V
( C=Compliance )
V=Violation
OPERATION
COMMENTS
)( 0 ApPROPRIATE PERMIT ON HAND
--R-. n_.___··____·________n_._.___ .--~--_..--. ________n__._._.._._..._._.___ - .. ......- --.--.---.-. . u___···.._._._..__.. -. .....----... _.·_u·_· . --...-.-.....-....-- - .__n..._...·_··.. ..... ..... .. _.__.n_
CJ BUSINESS PLAN CONTACT INFORMATION ACCURATE
---- ---_._-----~---------------_.__._._- - --~---.__. ,. --_..,_._---_._._..~.- .-._-. -....- --..-.---.-- ---- ..... .-----....-. ---." --'+-"
~ 0 VISIBLE ADDRESS
_~____:_~__,.___._______.___..,_____~_.__________.._ _....__._._____. ___._m..___'" n_.. u _..._____.___. _.._n._ __om ______ _.__u _____ _____ _._ ___._._._ ___._.___... ____. ,.
o CORRECT OCCUPANCY
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~ 0 VERIFICATION OF QUANTITIES
~--r1-···-~ERIF;~A~N· OF -:~~~,~~---..-.---........._--.----..-......--..- ----.-----...------ --.-...-.-........~..~-~~~=_~_:~~_~~:.~._-.._::~ -.-- ..-_~:_ .. .....__..
t_~~~~~~~EG~~~~~_~_O~~~TE~~~__._________....___n__ _.__h__.__..._._. ._._.__ __.. ... _________...____._n_______ _.._.....
~ (] VERIFICATION OF MSOS AVAILABILlìî'E
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~ 0 VERIFICATION OF HAT MAT TRAINING
b(--OVE~IFICATI~N OF -~~~TE~;NT S~~-;;:;~~-~~D- ;~~~~~~~~~-.---------- -- _______d_._ .. - ----------
iJi--o- E~~RGENC~ PR~CE~~;~uADEQ~~TE...--- ____________.hm____._____.___._____..._______.... .-. --. ----.----.--.....------
;¡aC;;~~~~~~; ';'~;;;L;~;;';~~------_· t-.. . - ..-... .. ... - ....
~---r;---H~US~~-~~;~~------ -------------- ----- _...__.m_ - - - ---- - ----- --- - -- --... - - - ... ...____________m__..________ .
~ --~--Fr~~_pR;~~~;I~~-----·---m-------- _·_______h --- ____.__________.._____..__________m________. -. ------ .-.
~--r:J-SI~;D--;-~~;AM A~~~~~~--&--O~-H~~~------ ___......m_..~__ -------------- ---.-------------. m .__m__ .-......--...-..-.. . -----.-.
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ANY HAZARDOUS WASTE ON SITE?:
(] YES
~ No 1J~ \csiL~(iká to U~T
EXPLAIN:
( )~{(ð
-;18-- I~DV ~~t -t7D - F,r6- .4lÁV\V--
ING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
f-.-.-~~ÕpoÖ';"" """ ---
Yellow .. Station Copy
Pink .. Business Copy
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r'lEI1C'F: ¡ HI. C'ENTEP
5201 L·jH ITE LANE
Bm:D;~::;f 1 ELD Cf~
805<39t: - 1800
SEP 7. 2004 10:38 AM
SYSTH1 f3TATUS REPOf~T
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ALL FUNCTIONS NOHI"1AL
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[N\IENTOR'l REPORT
T [:DIESEL 2
\iOLU!"'iE
,ULLAGE
'3 ü:',; 'ULLAGE ='
TC \IOLUHE
HEIGHT
IJJATER \lOL
I WA TER
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650
550
:346
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GALS
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MON~ORING SYSTEM CERTI~ATION
, For Use By All Jurisdictions Within the State of California ."
Authority Cited: Chapter 6.7, Health and Sàfety 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 report must be prepared
for each monitoring system control panel by the technician who perfonns the work. A copy of this fonn must be provided to the tank
system owner/operator. The owner/operator must submit a copy of this fonn to the local agency regulating UST systems within 30
days oftest date.
A.' General Informatiop. .
Facility Name: ~y~\( \t\... r\e\fY'c.:)n.c:~\ '~C--v'"
Site Address: 520\ . \¡~~i::..,. ~ ~\vJ".
Facility ContactPerson:-:s:( x-vv. t\",.o~
. .
MakeIModel of Monitoring System: ~ú¡}...¿..v - Roo\
~i:h?',.\.-~\. Bldg. No.:
City:. \S~~ \, tÀc\... Zip: q $::>\
Contact Phone No.: ( \J \D \.) Y\ ~ - l ~0V 1- Z-\3
. \L.-S- 3)0 c- Date of Testing/Servicing: 4- -.At¡ j,y;
B. Inventory of Equipment Tested/Certified
Check the a ro riate boxes to indicate s ecific e ui ment ins ected/serviced:
Tank ID: .1)\(~ (~OK'JI.MA-~__
t3 In-Tank Gauging Probe., '. Model:. 'r\~b - \
S An;ular Spaée õr-VììúltSênsôr. - Model:·· ÀZ.6
~ Piping Sump / Trench Sensor(s). Model: 2.d'6
o Fill Sump Sensor(s). Model:
o Mechanical Line Leak Detector, Model:
o Electronic Line Leak Detector. Model:
o Tank OverfilJ / High-Level Sensor. Model:
o Other s ecif e ui ment t e and model in Section E onPa e 2 .
Tank ID:
o In-Tank Gauging Probe. Model:
o Annular Space or Vault Sens9r. Model:
o Piping Sump / Trench Sensor(s), Model:
o Fì1l Sump Se~sor(s). Model:
o Mechanical Line Leak Detector. Model:
o Electronic Line Leak Detector. Model:
o Tank Overfill/High-Level Sensor. Model:
o Other s ecife ui ment.t e and model in Section E on Pa e 2).
Tank ID:
o In-Tank Gauging Probe. Model:
',0 AnnularSpace'or Vault Sensor.' ModeJ:." c
o Piping Sump / Trench Sensor(s). Model:
O' Fìl1 Sump Sensor(s). Model:
o Mechanical Line Leak Detector. Model:
o Electronic ~ine Leak Detector. Model:
o TankOverfill / High-Level Sensor. Model:
o Other s ecif e ui ment t e and model in Section E on Pa e 2 . '
Tank ID:
o IncTank Gauging Probe. Model:
o Annular Space or Vault Sensor. Model:
o Piping Sump / Trench Sensor(s). Model:
o FiB Sump Sensor(s). . Model:
o Mechanical Line Leak Detector. Model:
o Electronic Line Leak Detector... Model:
o T¡mk Overfill / High-Level Sensor. Model: .
o Other s ecif e uiment t e and model in Section E on Pa e 2 .
Dispenser ID: DispenserID:
o Dispenser Containment Sensor(s). Model: 0 Dispenser Containment Sensor(s). Model:
o Shear Valve(s). 0 ShearValve(s).
o Dis enser Containment Float s and Chain s . 0 Dis enser Containment Float(s) and Chain(s). .
Dispenser ID: Dispenser ID:
o Dispenser Containment Sensor(s). Model: o Dispenser Containment Sensor(s). Model:
o Shear Valve(s). 0 Shear Valve(s).
o Di . enserContainment Float(s and Chain s . 0 Dis eDser Containment Float sand Chain s .
Dispenser ID: Dispenser ID:
Q' Dispenser Containment Sensor(s). Model: ~.--~-.. "--- ~ 0 Disp.éñsêr Coritaiñmênt-Sensor(s): -" ModeJ: . . .~. .
o Shear Valve(s). . 0 Shear Valve(s).
ODis enser Containment Float s and Chain s . 0 Dis enser Containment Float s and Chairt s .
*Ifthe facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility.
C; Certification - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers'
guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is
correct and a Plot Plan showi,ng the layout of monitoring equipment. For any equipment capable of generating such reports, I have also
at~a~hed a copy o~ the report; (check all that apply): 0 System set-up 0 ar 'story repor:t
Technician Name (pnnt): Ah+-rY\\ ~ lxm'Ùn..jL:II:./2- . Signature:
--
Certification No.:
License. No.:
q;¡-/511
Phon~ No.{q z>~,) "22.2..- lD 553
Date ofTesting/S~rvl~ing: 4- /,~ 'i..o:~_:
Testing Company Name: CoY\.-\-rI'A ('.\- FJ'\v\ 'rcY'l~V\.+o..l ~vi CL
Site Address: 1-'1 ìSq M(1.À.r-. .s+.. hí\+~ C¡2.3,'?:J.,..
/
Monitoring System Certification
Page 1 of 3
03/01
,;¡t~·· . '1
"..:
D. Results of Testing/Servicine
-
/ ,~.;~
" 'I
Software Version Installed:
\ S .-0 \
Com lete the followin checklist:
i): Yes ,ONo· Is the audible alann 0 erational?
~ Yes 0 No· Is the visual alann 0 ·eratiDnal?
~ Yes 0 No· Were aU sensors visuall ins ected, functionall tested, andcontinned 0 erational?
BYes. 0 No· '?' ere.:.aU, ,sensors installed at lowest pointof seconda,ry containment and positioned so thatotherequi.pment wiU
.. not'interferewiththeir ro er Ò eratioÌ1? . "
If alanns are relayed to a remote mónitoring station, is all communications equipment (e~g. modem)
operational?
For pressurized piping systems, does the turbine aùtomatically 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 Sump/TrenchSensors; 0 Dispenser Containment Sensors.
Did ou confiim ositive shut-down due tò leaks and sensor failure/disconnection?D Yes; 0 No.
o No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no
o NI A mechanical overfill prevention valve is instål1ed), is the overfiU warning alann visible and audible at the tank
fiU oint sand 0 eratin ro erl ? If so, at what ercent of tank ca aci does the alann tri er? C'1 %
~.=,-~ '~=Yes*- -E)-N 0--= ~Was"any-monitoring··equipment~replacedil~lf~yes,identif.y~specific=sensors,~probt:s;"oLoJher,.e_quipmem.J'.ep!-ªç,~ß__~",=
and list the manufacturer name and model for aU re lacement arts in Section E, below.
Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) 0
Product; 0 Water. If es, describe causes in Section E,' below.
:ßI Yes 0 No· Was monitorin s stem set-u reviewed to ensure 1'0 er settin s? Attach set u
;8J Yes 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.
'0 Yes
o No·
~ N/A.
o No*
~ N/A
DYes
þ;j Yes
o Yes*
~'No
E. Comment.s: (t.~~",-,"t-() "(~
Po ~J.o',,-Y1 L i ~hÞ<; ~fö\''';\J1.. ..J-Æ-t.~
. .
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Page 20f 3
03/01
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41
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~onitoring System Certification
Site Address: . 5:t-o\
UST Monitoring Site Plan
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=---=-:- ~!"'-- ='--ç-....:....,.-._~:-=-_.~ -~'-=--..:-._-~..~.,...:.=-;;....._~,..'=-..:.~~;-"--=-.--!-::--~~,.-:~-:.., ~---=--- -'~-~-~
. . . . . . ., ........
--.... ~-~~--_.- ..;;:...- -~~~~--......,:....,..~-...:-~¡-:-~--:---=--.---~
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . .
. . . . . . . . . . . . . . . . .
Date map was drawn: A-/:\' / tJ1.\ .
Instructions
If you already have a diagram that shows all required infonnation, you may include it, rather than this page, with your
Monitoring System Certification. On YO\lr site plan, show the general layout of tanks and piping. Clearly identify
locations of the following ~quipment, if installed: monitoring system control panels; sensors monitoring tankannulac
spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak
detectors; and in-tankhquid level probes (if used for leak detection), In the space provided, note the date this Site Plan
was prepared.
Page ~ of--Ì
05/00
¡"
t. --\
f ~
-
-
F. In-Tank Gauging ¡SIR Equipment:
o Check this box if tank gauging is used only for inventory control.
o Check this box if no tank gauging or SIR equipment is installed.
__ rhis ·¿ec.Üon ~ust be cõmpleted if. i~-tank ga~ging equipment i~ .~se~ to pe~fonn le~ detec~iön ~.~;~t~ring, I:
-'1' -h··t 11' ,..." h'~kI',~~ '1 . . '" ... ., ., . .':
, . > Compl ete t e· 0 .owml!: c ec ..IS : . . -.- ,- .- ~ . .-.- . . .. .- .. .~ ". ~ .' . , ....,,'\. ..
. . "
.-èSI. Yes o No· HaS all input wiring been inspected for proper eqtCy imd terrriination, including tes.ting ~or ground faults?
:a Yes o No· Were all tahk gauging probes visually mspeè'ted fordamage:~nd residue buil~IlP? .. ..¥. .. ~ " .""-- ,..
;:B Yes IJ No· Was accuracy of system product level readings tested? .
;a Yes o No· Was accuracy of system water level readings tested? . ' . . '
;aJ Yes 0 No· Were all probes reinstalled properly?
.~ Yes o No· Were all items on the equipment manufacturer's maintenance checklist completed?
* In thé Section H, below, describe how and when these deficiencies were or will be corrected.
G. Line LeakDetectors (LLD):
.La Check this box if LLDs are not installed.
.~...~... ·4,!,":"<"._ <.
'-r'¡';'.~~,...__. :;:....
. .
>':.- - .'
:. -;< .: ~.
- ,
- '. - . ~ .-~ .',
---'-'.- .
.....-
.: i +.
c
h ~ 11
h kl'
omplete t e 0 owml!: c ec 1st: . ' ' "
o Yes CJ No· For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance?
o N/A (Check all that apply) Simulated leak rate: 03 g.p.h.; 0 0.1 g.p.h; 0 0.2 g.p.h.
o Yes o No· Were all LLDs confinned operational and accurate within regulatory requirements? .
o Yes '0 No· Was the testing apparatus properly calibrated?
tJ Yes o No· For mechanical LLDs, does the LLD restrict product flow if it detects a leak?
o N/A .
o Yes o No· For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak?
o N/A . .
I:] Yes o No· For electronic LLDs, does the turbineautcimatically shut off if any portion' of the monitoring system is disabled.
o N/A or disconnected? , .."
o Yes o No· For electronic LLDs, does the turbine automatically shut offifany portion oftbe monitoring system malfunctions
q N/A or fails a test?
o Yes o No'" For electronic LLDs, have all accessible wiring connections been visually inspected?
o N/A
I:] Yes I:] No'" Were all items on the equipment manufacturer's maintenance checklist completed?
* In the Section H, below, describe how and when thesedeficiencíes were or W!U be corrected.
H. Comments:
..;~ If", .;,.'1';:, . ,~, _ '
_.:::: . ~ - f. i'
__'J., _-:>.
'---...
Page 3 of 3
03/01
04/13/2004 08:40 FAX 808 822~4
Cont ract Enlli ronme'ntal 'tI
g~C 17 2003 8:42
BKSFLD FIRE PREVENTION
(661)852-2172
~ 002/002
p. 1
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
APPLICATION TO PERFORM
FùEL MONITORING CERTIFICATION
FAClUTY ~'\v~ nr ~.~ Cvvá-~ ~~;.~
ADDRESS 51-0\ \...\'v,,';..:~'L.- ~ ~vÀ. ) ~c~\.\('~\t-.. q ~~\
OPERATORS NAME ~
OWNERS NAME ~.
NAME OF MONITOR MANUFACTURER \J GLM..-.- '"'RoC")+_
DOBS FAcn..rry HAVE DISPENSER PANS? YES_ Noi
'-
TANK ##
\
VOLUME
CONTENTS
t::>\c. ~ c.. ~o(K\.L~"")
NAMEOF'I'BSTlNG COMPANY Gá·vcl,.\;.\· E.."',^V\:>·î ~\ S.......-v..t.o......,.:út\(.,.
CONTRACTORS UCENSE 41 ().ø\ - ùL\ <::I
NAMB&PHONBNUMBEROFCONrACTPBRSONA~~ \:xJ~ ~~tf) '2..~llZ.
DATE & TIME TEST IS TO DB CONDUCTED 1. \ ll\ \ ~:; eo '0 ~ ~ ,
- I
\
~(~~~
APPR.OVED BY
~,?,\~
DATE
¿j
'-D-
SIGNATURE OF APPLICANT
DEC 17 2003 ::1142
BKSFLD FIRE PREVENTION
. .~
Contract Environmental S '"
{ ~
( s ~í') a 5 2 - 2 1 72
~002/002
p. 1
.... " 2Î 17 12 0 0 3 1 1 : 1 9 FAX 908 8 22 6e
, CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661)326-3979
APPLICATION TO PERFORM
nmLMOMTO~GCERTInCATION
FAClllTY ~\\Ü~· \'"'\r~.n:..c.~ r-'-~LAC': \#V'>\~L
ADDRESS 5'2-0\ \...\~-\~ ~ ~\vÀ. )~r~\.\c\c\... q~~\
OPERATORS NAME- ~
OWNERS NAME ~
NAME OF MONITOR MANUFA~U,,~~ - \Z<;:>c,-\-,
DOES FAcnJTY HAVE DISPENSER PANS? YES_ NoL
(
TANK #
\
VOLUME
CONTENTS
"b\(~ c..~'NU~"")
NAME OF TESTING COMPANY G·~.....,,-I..\- E.A..v..",,~,,\ '(V\L.AI,..\r......\ ~ ,..Áü... I :DAL.. '
CONTRACTORS UC'.ENSE 41 ~\ - ùL\ 0
NAME &PHONB NUMBER OF CONTACTPBRSON Av-.1~~ D.).~~)~ \:,\<:1/1") 2~lï z..
DATE" TIME TEST IS TO BE CONDUCTED 1'2... \ z.~ \ Sil~ e "1 : ~ p yV\.
/
Kit~
t
APPROVED BY
I 2-\ l1 \ t:I'~
:DATE
·"-D
¿j
SIGNATURE OF APPLICANT
~
. 6ermJt No. ß. L - 0 3l{- 2-
ITV OF BAKERSFIELD c
OFFICE F ENVIRONMENTAL SERVICES
1715 Cheste Ave., Bakersfield, CA (80S) 326-3979
,.J
,
PERMIT APPLICATION TO CONSTR CTIMODIFY UNDERGROUND STORAGE TANK
lYPE OF APPLrCA TION (CHECK)
{ ¡NEW FACILITY r ]MODIFICA110N OF FAC f)lJNEw TANKINSTALLA'OON AT EXISTING FACILITY
PROPOSED COMPLET1ON DATE
EXISTING FACIUI'Y PBRMrr NO.
~ cm ~..,.t:""'..tc() ZIP CODE 93_~ð9
AFNI
PHONBNO. ..:;?93~ 7~
cm ~~d) ZIPCODB ~~nt:i'
CAUCENSENO.~
CIrY ·ÆA--;C;.t1O . ZIP.CODE 9...;¡<~
BAJŒRSFIELD ClTYB~ UCENSE NO.hY ~G"
TANK NO.
/
,0
-~
VOLUME .
'L~~
/~/YY)
/.-?~
TANK NO.
VOLUME
YES NO
YES NO
UNLEADED
~
PREMIUM
X'
D.Œ8EL
AV1AlION
REOOLAR
X"
TOR FUEL STORAGE T~
CAS NO. CHEMICAL PREVIOUSLY STORED
(IF KNO\VN)
1¡~m~~p,~i!;1¡¡?~;mm:!!;!;!!¡¡m¡¡~'. .
...........,.........,f.....,¡..1/..........,.."..v..:,....¡,.,,¡..,!}!,,¡U/
::::: :::: :~. :,:: ~:::,.. ,:::: ~J/:·:·: ~~~:.;::::::: :,Ut::,:~:::;' v.:.. ='. ~J~l('''''
.
WILL COMPL.YWIm nm AITACHED CONDmONS OF
FEDERAL REGULATIONS.
TYOFPl!RJURy.AND~ MYKNOWLI!OOB,IS
AmJOOff~
TIDS APPLICATION BE
A PERMIT WHEN APPROVED
. CITY OF BAKERSFIELoe
OFJ'ÍCE OF ENVIRON~IENTAL SERVICES
1715 Chester Ave., Bakersfield,CA 93301 (661) 326-3979
~
UNDERGROUND STORAGE TANKS - UST FACILITY
¿NeE OF INFORMATION ISpactly c~nge .
local use On/y)
a 6. TEMPORARY SITE CLOSURE
rYPE OF 4CTION
, C,~ecl< one ,Iem only)
o 1. NEW SITE PERMIT
a J. RENEWAL PERMIT
a 4. AMENDED PERMIT
Page _ 01
a T PERMANENTLY CLOSED SITE
a 6. TANK REMOVED
400.
BUSINESS NAME (Sam. as FACILfN NAME ar DBA - Ooing BuSIness 1.$)
I. FACILITY / SITE INFORMATION
3 FACILITY 10 .
:76:::)
-
401.
I·
FACILITY OWNER TYPE
o ,. CORPORATION
jil "2.'INDIVIDUAL
a 3. PARTNERSHIP
o 4. LOCAL AGENCYIDISTRICT'
a 5. COUNTY AGENCY"
o 6. STATE AGENCY"
a 7. FEDERAL AGENCY"
402.
,
~S STATION
a 2. DISTRIBUTOR
TOTAL NUMBER OF TANKS
REMAINING AT SITE
\.~L
o 3. FARM 0 5. COMMERCIAL
a 4. PROCESSOR a 6. OTHER 403.
Is facilily on indian Resetwtion ar " owner 01 UST 3 public: ~ name 01 suøerllisor 01
1tusIIands? division. section ar oIIIœ _ QØ«3les the UST.
(This is lI1e (X ntaCI petSOn far !lie lank recoràs.)
404.
ayes ~ 405.
II. PROPERTY OWNER INFORMATION
406.
o ,. CORPORATION
o 2. INDIVIDUAl
~TNERSHIP
407.~NE
V)~-ð;Z//
408.
409.
410.
412.
o 4. LOCAl AGENCY / DiSTRICT
o 5. COUNTY AGENCY
a 8. STATE AGENCY
o 7. FEDERAl AGENCY
413.
III. TANK OWNER INFORMATION
TANKOWNE~ Æ'//
'- \ .ß") .':ø (1~;
. jr:~~·~RE_¿~~;~~~~~;;íY'~ .
o 1. CORPORATION
a 2. INDIVIDUAl
~TNERSHIP
414'flJ~3~?azJ
415.
416. .
419.
a 4. LOCAl AGENCY) DISTRICT
o 5. COUNTY AGENCY
o 6. STATE AGENCY
o 7. FEOERAlAGENCY
420.
I TY (TK) HQ
rv. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT ~UMBER
Call (916) 322-9669 if quesöons arise
V. PETROLEUM UST FINANCIAL RESPONSIBILITY; .
421.
INDICATE METHOD(S)
œ-rsELF-INSURED
o 2. GUARANTEE
o 3. INSURANCE
o 4. SURETY BONO
o 5. LETTER OF CREDIT
o 6. EXEMPTION.
o 7. STATE FUND
~ 8. STATE FUND & CFO LETTER
a 9. STATEFUND&CO
o 10. LOCAL GOvT MECHANISM
a 99. OTHER:
422.
Chad< one box to in<1lc:ale which address should be used for legal notiftcallons 3nd mailing.
Legal nolincalions and mallngs will be senllo 1/1. lank owner unless box 1 ar 2 ~ checked.
VI. LEGAL NOTIFICATION AND MAILING ADDRESS
o 1. FACILITY
o 2. PROPERTY OWNER
~KOWNER 423.
VII. APPLICANT SIGNATURE
CMinc<lllon: I C8I1ily 1l>all/1e information prOVided herein is tnJe 3/1d õlCCUrale 10 l/1e best 01 my knowtedge.
SIGNATURE OF APPUc.mr 0,0. TE
NAME OF APPliCANT (. I)
( or ~ use only)
UPCF (7/99)
426.
427.
425.
3- ?<9d()
428. 1998 U
( or local usa only)
429.
S:\CUPAFORMS\swr~b-a.wpd
,~.t!~t.
A.'.
""'"- --oIL
-. -- .-.
CITY OF BAKERSFIELD
OFFI_ OF ENVIRONMENTALSe"'ICES
1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979
UNDERGROUND STORAGE TANKS· TANK PAGE 1
~
,.~
01
,....ø<!;F .crl()H CJ I. ,..", 3fT!! ~T. a t. ~o P!""'T è<=1G. C~ ~ '....OAM.HIOH
';.''';' ,,,.- ~ T -
CJ ). "'~"'- ~
I~-''''-''''~J I~~''''-''''~J
ili$INESS ~ Is-... ~4CII..ITV ~ 01 Q&t.. ~ __ "-I
a s. f!~AAAV SIT!! o.O~
a 1 PEA~HT1. v o.OUO Ott SITe
a S. T AHI< RfMOVEO
ct s+ct \ p -f( ð & &t-ovQ
~O<=^ rroH WfnIIH SIT'I (QNMeIJ
W ~ " {e... La V\~ I
(
. ~N (' .
JA. ,
. ADOfTIOfW.
I
I
,
It,s (,,, (? -
L TAHK O!SCRIPT1ON
-
COMPAAnEHTAUZEO TAH< 0 v..
/I 'Y.... comøItCe one øeve (ot MdI ~
,
TANe USI at
'&' ,. MOTOR VMCU flUB.
1i:"Md. ~ ~ 7)tIeJ
o 2. NQH.ÇVÐ.~
o J. OfEMlCA&. PAOOUCT
o t. HAZAAOOUS ~ (tIdUdN
U_ 01)
o 95. uN<HO'tWf
TYPE 01 TN«
ICNdl- AIm Otty
.. TANK CONTIIn'I
NTIQ!UW T'tPI!
"r.:.- MQlAMUfUH)ID 0 1. ~
0,.. ,...... \MÆAOEO 0 3. OIESI!L
o Ie. r.eoRADIlH.!ACED 0 4. 0AS0H0t.
CIOUo«)H 1WII hm HuMb.e ~ ~f»geJ
~,. ......WM.1.
o 2. OOUIUI WALL
r AI« W. T'E.'IW. ~ pM\Ify ** . 0 t. IIAAf STEEL
ICNdl- - Otty 0 2. STAH.!SS ST!EI.
TAl« W. T'E.'IW. . -*'Y ** (¡J t. IIAAf STœ.
ICNdl- .... Otty 0 2. ITANØS ST!I!L
r AH< INT!AJOR L.....o
OA COATIHO
{CMdt_IMI~
OTHER COMOSIOH
õ>ROTECTIOH IF ~
(C/'IKk OM _ ødy
3P!ll ANO OV!Rf'U
. C/!.c. d ftl41 apølyl
o t. fUIIII!R L»S
o 2. AUM) LIINQ
o 3. 'F18EROC.ASS I P\ASTIC
~... STEEl. CUD w.f'~
REINFORŒO P\ASTIC (FRPJ
o 3. F18EROC.ASS I P\ASTIC
o 4. STEEl. CUD 'NFIIIERGC.ASS
RI!JNFOACED P\ASTIC (FRP)
. 0 S. 00HCRm!
o 3. ePOXY t.M«J [J So 0LAI8 L.-.o 0 115. IJN<HO'Mf
o 4. PH!NOUC lNNO ~.. Ut&H!D CJ It. cmø
o 3. I"IIIEAOLASI A!HOftCI!D P\ASTIC 0 lIS. UN<NOWN 441
CJ ... M'ÆS8ED CI.JARfN1' 0 lit. OnER
.. TANK CONIT1IUCTION
'3.~~LM!R
o 4. SINOU!'~ IN A VÞlJ(.T
o t. .wurAC1'UN!D CAnaIIC
PAOTICT1ON
o 2. SACItJII'ICIAL AHOOe
Y!M INSTAW!D 450 TYPE (~~ .... odrJ
~yu.COHrAMEHr I ~
[¡t'( OAOP TU8I!
~~P\ATII
o So ~ TNIl< QAUGINO (MfO)
o .. VNXJ8e ZOfE
o 7. QAOUN)WA11!R
o .. TN« TUTINO
0... OnteA
V. TANK CLOIUQ lH'OftMA TIOH I ,."IIANIHT C&.OIURIIH PlAC8
UTlMTIO QUAH'Tm'.~ StJIITANCt ~ 4H TAAI< 'IUIO WITH INIRT /AATPIAL.?
IISTI/AA Tro OATI LAtT utIO ~Y)
...
.....
..
o So JET F1JB.
EJ .. AV1ATIOH F1JB.
o fe. one
..., CAS' (!tom ~ A.IINIriMI ~f»geJ ...
$a:xQ - @/-?
o s. SMJU! WALL wmt ~ kACOI!R SVS'TÐoI
o lIS. 'IJNCHOWN
o lit. 0THEIt
o S. CONC:ÆTI! 0 lIS. ~
o .. FRS' COfoI>A~ 'N100% IoETMAHOl 0.. O'nER
44:
.......
o .. FRS' COM'ATI8U! 'N100% IoETMAHOl
o .. FRS' NOH<:OAAOOII!L2 .JACI<ET
[J 10. c::o.r.TEØ STEEl.
o lIS. IJNIO«:)WN
o lit. 01}ER
44.5
.... ~TI! 1NSTAUa)
441
{Fw oe.I_ 0tW1
~TE INSTALLED
449
(Foroe.lUN odrJ
461 O'ÆRFIU. PAOncTION EQUIPW:NT: YEAR iNSTAU.fO·
o I. AlAAM . ~3. FILL TUBE SHVT Of'FVAlvE _
02. 8AU.FI.OAT 04. exaf7T
4.52
.:.' ~'-~.~.... ", ...... ..', :"""""ij!" '.' :.. '·"t:'Þ.'Ji-..
.,' ~'{Yi""". '. y,""·".f . .'. . "\.¿J-.,'"' '.' ''''. . ,.... . :~,-.
... -~ ..*"f, 0; ~.~:".' .; '1"" ..::......;... ';., '. ...... .¡.&4
4ð3 " OOUIIUI WALl. TAHIC 0.. T AHIC MT'H IUDOU (CMcIt OM ,.", Ødf1:
o 1. VISUAL (SINOl4 WAlL IN vAUlT ON. Y)
o 2. CONTINUOUS INT!RSTIT1AL MONn'OAINO
o J. a.w«.JAi. MOMTOAINO
--¡¡1
a v.. aMo
'3CF (7m)
S;\CUPAPORMS\SWRcø-8·wPO
C,"
.. ....'
CITY 0' !lAKERSflELO
a o.rlllCI M INVIROHMeHT At. SERVices· a
W'C,,"* A¥e., Battersfteld, CA t3J01 (M1) 3~t
-
~
un . T~ 'At
-
--!-
w. ,... CCNITItUC'T1ON (CIwd II lie,"
UNDI~ND PfIIIHO
1vS rEM rv~ I I>RESSUAI! a 2. SUCTION 01. ~V1T'1 .a5a 0 I I>RESSURE
CONsTRucr'o~' 9-' ,1HCt,1! WAU. ~ J. uNl!D TRl!NOt a It. On.eR 4ðO, 0 I. SINCl.e 'N"lL
~NUF...crlJREAIO 2. oouet./! WAll. 0 N. UNfOID¥M 0 2. OOUBlE 'N"lL
. w.N\J'AoCTIJRI!R 41 Ml<NtJF"CTlJRER
o ,. 8AAJ! 3THL 0 .. FRI" COW4Ta1 WlI~ MI'nWIOL 0 I. IWI! STeEL
M.\ TERII<I.;S "NO 0 2. STÀINU!SS STI!!L 0 7. QAlVAMZ!D ma 0 2. ST"INlESS S~!L
CORROSION
1>R0TECTtON 0 1, PI.AST1C COW4T18U! WITH CONT!N1'S 0 tit. tJNCN()IM 0 3. PlASTIC COWAoT18L.E WITH CONT'EHTS
:0 .. FI~ 0 .. 'FU!XIILI(1Cft) 0 It. OTHER 0 .. FIBERGlASS
srea WI COA nHQ 0 I. CA T)O)IC PAOTECTION ... 0 5. STEEL WI COA TIHG
VI. fIllING LeAK DeTECTION (a.:t II '* WlfJ
IJNOeAGAOUHO PIPING
: PRESSURIZED P1P1NG (CMcIr "1tteI1I/IIIY):
i
("j¡ I. ELECTROHIC UNI! L£AK oeT!CTOA 10 QPff TEST mDf AUTO P\,MI SHUT OFF FOR
T ~ SYSTEM FAa-UN!. AHO SYS1"ÐofOllÞOC r INECTIOH · AU)8JI NID VI8UAL
ALMus
I
~ 2. ~YIUQflHTUT
,~ 3. ~ IHT'E<W'N TUT (Q.' QPtf)
I CON\l£HT1O'.w, SUCTION SYSTÐ.IS:
; 0 5. DAJI. 'r V\SI.W. WOHITORINO 0fZ PUIoIPING SVST'EItI. TRI8NAL IIfIWG M'EOAITV
TeST; (0. I GPH)
Sl<FE socnON SYSTEMS (NO VAL YES IN IIELOW GROUND Pf'IG):
! 0 7. ~l.FiMOWORJNG
GRAVITY FlOW:
ag. ~ IHTEGRfTY TEST (0.' QPtf)
, II!CONDARIL'I CONTAINID ....-a
PRfSSU~ PIPN1 (CMt:* ., ..., IPtJIy :
'o. ~ TVR8INE! SUWP SEHSORmIt1AUD111U!AN)~ALAAMSNÐ
(QIec ¡ ~
a ~ :AUTO PO.... SHUT OFF 'MEN A Il!NC 0CCtJRS
a Þ.IAUTO PO.... SHUT OFF FOR LEN<S. SYST1!M FAUJRI! AN) S'fS1'EtoI
OISCONECT1ON
, a eo :NO AUTO PUMP SHUT OFF .
; 0 11. .wrOMATIC \.INI! \.EAK DET£CTOR C).o QPff TEST) ïdIt1 FLOW ØJT OFJ: OR
; Rl:STRICT1OH
i a I:' ~ iNTEGRITY TI!ST (0.' OPH)
I '
, SUCTIONlGAAvrTY SYSTE10t
I
o 13. co~ SUoP SENSOR· AUÐeUI AHO WlUALM./t1'M8
, , " !llt.RGÐCY QÐllMTOM OfL'I(CIIIc*......,
",$ ,
!.~,'ft~,~. ~S SUMP SENSOR WITHOUT AUTO fItMI SttITOR.AtJOeLE NÐ
I '/ ':-VlSUÞJ:, ALAAMS
'I .
¡ 0 t 5. AUTOMATIC LINE LEAK O€TECTOR C).O GPH TEST) ~ R.ÞN SHVr OFF OR
; RESTRtCTlOH
,''5 ì ð. ANNUAl. INTEGRITY reST (0. I GPH)
o 17, OÞoJL V '1SUAL. CHECK
A8Q\lECAOUND PIPING
--
o 1. ORAmy --
a 2. SUCTION
o 95. uNI<HO-
o 99. OTHER
o e. FAI'COW4T18U!""'oo,.~
o 7. Q.\I.VAHIZ£I) STE£L
o e. Ft.ÐCJa! (HOP£) 0 it. 0'nteR
o g. CATHOOICPROTECTIOH
095. UNKNOWN
. "j:¡;..~:.
A80VEGROUND PIPING
W.
PRESSURIZED PIPING (CMcIr ., 1tIoI'1I/IIIY):
o 1. ElÆCTAOHIC LINE U!N< DETECTOR 3.0.GAt TEST mDf AUTO PUUI SHUT OI'F FOR LEA
SYSTaot F4A.UAI!. AHO SYSTEM OISCONECT1ON . AUDØ.! NÐ VtSUAL AiAAatIS
o Z. MOHTM.Y U 0fIH TeST ~
o 3. NHJAL HT!GRfTY TUT (0.' QfIH)
o .. Q,\L y VISUAL OEQ(
<::ofoNÐ(T1OfW. SUCTION S't'STÐoIS (OIec* .... ."ç¡iy):
o S.Q,\L Y VISUAL MONITORING 0fZ PIPING AHO PUWING SYSTEM
o .. TRI£NML iHTEGRnY TEST (0.' GPH)
SAFE SOCT1ON SYSTEMS (NO VALVU IN BElOW GROUNO PIPING):
o 7. SELF MOHITOAINO .
GRA VTTY FlOW (C1t«k ., "., II/IIIY):
o .. Q,\L Y VISUAL r.tONrTOAING
o II. IIIEfHAL INTEGRfTY TEST (0.' GPH)
IECONDAAILY CONTAINED PFINO
PRESSURIZED PIPING (CMdc" "., 1/PPI1):
10. COfI11M)()US nJR8INE sur..- SENSOR MIl:! AUOI8U: AN) VISUAL ALAAMS NÐ (dtedt en<!
o .. AUTO PUMP SHUT OFF 'MEN A Il!NCOCCURS
o Þ. AUTO PUMP SHUT OFF FOR U:AKs. SYSTEM FAIlIJRf AN) SYSTEM DISCONNECTIOf'
a eo NO AUTO PUIM' SHUT OFF
o 11. At11'OM'TIC LEAl( DETECTOR
o 1 Z. NHJAL IHTEGRnY TI!ST (0.1 GPH)
SUCT1()HC RAvrTY SYSTÐt
o 13. COHTNJOUS SUoP SENSOR . AUDIBLE AHO VISUAL AlAMIS
I!II!RGI!HCY QINI!RATOU 0... Y (CItect.. M ~
o 14. COHTNJOUS SUM" SENSOR wmtOUT AUTO PU.... StM' OFF. AUDI8LS NIO VISUAL
AlAAMS
o 15. AlJTOfAA T1C LINE LEAK DETECTOR C).O GPH TeST)
""::~'!;'
o ,. F\..OA T Ml!CHAHIIM THAT SHUTS OR 5II!AR VALVI!
o Z. COHTNJOUt DISf'!N8I!R PAH seNIOR · AUOI8U! AHO VISUAL AlAAMS
o 3. COHTINUOUI ~ PAH seNIOR mni.wTO Sffl/T OFF FOR DISPENSER . AUDI8U! AHO V1SUAL AlAAMS
, DC. OWNI!RJOPI!RA TOR SIGNA ruRI!
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o 3. MANUAL MOMTOAINQ
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IX. OWN!RJOPI!RA TOR SIGNA T\JR!
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SIGNA TUft I! OF OWNEIWPeAA TOR
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;·0 S. DAJl Y 'I1SUAI. AoIONTOfUNO OF JIt.U'ING S't"S'TÐf. T'RII!NW......o INTEGAfTY
TEST (0.' GPH) .
SAFE SliCTJON $YS'TEMS (NO VALV1!S IN ee.ow QACUND ~
o 7. SELF MONrTOAJNG
GRAvITY FlOW:
o 9. 8IÐHAL.1HTtGRITY TEST (0.' QfIff)
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o Co NO AUTO PUMP SHUT OFf' .
o 11. AUTOW. TIC LN! LENC DETECTOR (3.0 QPH TEST) wmt FlOW SHUT OFF OR
~~ .
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WCTIONlGAAVITY SYSTEM:
:J 13. CONTNJOUS su..p SEHaOR . AUCeU! NÐ VlM.W.AI.IoMe
bIØG!NC'Y OINlJltATOa OHL Y fC1**"'" WItI
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] 17, O¡'¡L Y VISUAl CHECK
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095. U~
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PRe~RJZE.D PIPING (CMdIII IÑ' ¥/lIlY):
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SYSTEM FALIJRI!. NÐ S"t'S'TÐI OISCONECTION . ALC)Ø.! AM) VISUAl. ALAAMS
o 2. WCH1M. Y U QfIH TI!ST
o '1 NHJN. M'!<R1'Y TaT (0. t OPH) .
o .-.. OM.V VISUAL QEQC
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o .. "T'RJÐHAL, INT£GRnY TëST (0.1 Gf'tf)
SAFE SUCTION $YS'TEMS (NO VAL. lIES IN BELOW GROlINO PIPING):
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GAAV1TY FlOW (CNdI1I ",.,..,): .
o .. DA&. Y VISUIoL AOoITOftIHQ
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o 1'. AI.ITOMA TIC UW< OETECTOR
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SUCT1Of..aAAVI'TY SVS'TÐt
o '1 CONTHJOUS su..p SÐISOR . AUDI8U! NÐ VISUAL AlARMS
IMØO!HCY OI!HØATØftS OHL Y {CIIeCt ".,., 'PPt)1
o 14. COHT1NUOUS SUW SENSOR ~AUTO PU.... StM' OFF. AUDIBl.E NÐ VISUAL
AI.AAMS
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; 0 4. ,.~ 0 L A.!XIIU (~ (j.. OTHER . 0 4. FltIERGI.ASS
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w,....-..a LIAK oeT!CT1OH (Ch«/l" MI«II1J
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'.þ~
CON\l1:NT1ONAL SIJCTtOH SYSTÐ.IS:
o 5. OAJI.. y VISUA4. r.tOHITORINO OF PUU'tNQ SYST'EW . TAII!NIAl ~ ItT'EGAfTY
TEST (0.1 GPH)
~E SU<:T1ON SYSTEMS (NO vAL-YES IN aa.ow QAOUNO PftIG):
o 7. S¡;LF MOhfTORING
~SSURJZEO P1I'tHG (CII«It ., ÑlI«ll1J:
o 1. ELfC'mOHlC LM ~ OET!CTOA J.O GPH TESTmntAUTO ~ SMIT OFF FOR LEA.
SYSTEMFALUAf!. AM) SYSTEM OISCONECTION. ALCØ.£ AHD ~ A&.AAMS
o Z. woHTM. y U 0fIH TeST
o 1 Nftw.1NTtOAI1'V TaT (0.' QfIH)
o .. o.u. y 'o'$W. CHECK
COtNÐmONAI. SI.IC'OON SYS1'ÐCS (QIeœ ., flat ~J:
o 5. o.u. Y VISUAL MON1"ORINQ OF PI'INCJ AHO PUtoIPIHO SYS1'EJ.I
o ~ TRJÐHAL. INTEGAm' TEST (0.' GPH)
SAÆ stJC'T1ON $'tSTEMS pc VAtVES IN BElOW GROUND PIPING):
'0 7.sar~
GRAvnY FI.OW iCh«It.. Nt ¥tilt}:
o II. IWLY~~.
o II. SlElHALIHTEGMY TEST (0.1 GPH)
8I!CoNDARI( Y CONTAINED I'I'INO
~SSURIZfO Pf'INO {CIt«It II 11ft WIY}: .
\0. COHTNJO(JS ~ SUW SENSORmIliAucœt.e NÐ VlSUALALAAMS. NÐ(dIå\1t'oO!
o L AUTO PUMP SMJT OFF WHEN A LEAK 0CCtJRS
o I). AUTO PUMP SfM OFF FOR LÈMS. SYSTEM FA.\.UR£ NÐSYST'EM ~
O· c. NO AUTo PUI.P SHUT 0Fr
o , 1. ~TIC L£AI( O€TECTOR
o ,2. NHJAL IHTEGAtTY TEST (0.' GPH)
SOCTIC)HIIGAAVTTY SYSTSt
o '1 COHTNJOUS SUN" SENSOR. AUDI8u: AHO VlSUALAUIWS.
I!MØGEHCY O!NIRATÒItS OM. Y (CMct"/IIM wo)1
.0 14. COHTJM.IOlIS SUf# SENSOA ~AUTO PUr.4P StM' OFF. AUOIBLE NÐ VISUAL
AI.AAM:S
o 15. AUTOMA T1C LINE LEAl< OETECTOR(3.0 GPH TeST)
GRAvITY FlOW:
o 9. lSIENNW..tmGMY TEST (0.' QPH)
secoNDMLY CONrAINID N'INQ' . .
'PRESSURIZED PIPHJ (Chet:If ., lltetltlPly : .
'0. COHTN.()US T1JA8N! SUWP SENSOR mnt AUOeU! AHD '<'ISW. AlARMS NÐ
(O\ectIene)
o a. AUTO PUr.4P SMJT OFF WIiI!H A LEAK OCCURS
o Ct. AUTO PUr.4P SKIT OFF FOR L.EAI<.S. SYS'T'ÐI FAIlLIN! NÐ S't'ST'EM
OISCONECTIOH .
o c. ND AUTO PUMP »tUT OFF .
o 1 \. AUTO"'" TIC LM LE.AK DETECTOR p.O 0fIH TEST) mD1 FtJ:NI SMIT 0f'F OR
RESTRICnOH '
:J 12. ANNUAL IHTEGfIITY TEST (0.' QfIff)
WCTIOHlGAAVO'Y SYST'EM:
::J 13. COHTNJOUS SUN" SEHIOA . AOOaII NG VllUAl.AoI.AM8
I!IWtGEHCY OINlJllATOfW 0fIL Y (CItM¡t.,....""
. ., '4. COHTlfU)US SUW SENSOR wrTHOUT AUTO fIUMt StCJT ~ ..AUDa.I! NÐ
, VISUAL AI.AAMS
J 15. AUTOMATIC LINE LEAl< DETECTOR (3.0 OAf TUT) mntQ!.II A.t:IN SMIT' OFF OR
RESTRICTiOfI
, 'ð. ' ANNUAlINTëGRrTY T1õSr (0.1 GPH)
] 17. QþJl V Ii1SUAI. CHECK
"7X-'t~i"
o 4. CWLY'JISUAL Clil!CI<
~ TJWOt LINER I WOf«TORJNG 4Ø
O~NOHI!. . ._
. ...:-";~'!~
"SPENSER CONT AINfoEHT 0 1. Fl.ÒAT a.ECHANISM TW.T SHIlTS 0fII steAR VALve
OA re INsr AU.£O ." 0 Z. COHTNJOUI 0ISfI!HSI!It pNf SINIOR . AUOI8U! NÐ VISUAl ~
o 3. COHTINJOUI 0I8PÐISÐt PNf SI!NIOR m:D1 AlJfOSHUT OfF FOR OISP€NSEA . AUOI8l.E AND \/\SUA¡, IUJW,S
. DC. OWN!RIOPI!RA TOR SIGNA TURI!
oeruty 1/1" ~ Mlrmallon )to'oIIded /let.." Ie INe *'II 8CICIInIe 10 fie MIl rI my ~.
SIGNATURe OF OWNERIOPEAArOR
471
-
CATe
410
472
.1
I ,1 r if L..{' v,?,"
"'1- ~ .... /1«'" '" ..,;":
"S:\êUPAFÒR~áJ·s!wPC
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.'
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-. -- .-.
CfT'" OF BAKERSFIELD _ _
OFFI{ìiOF ENVIRONMENTALSiIIV'ICES- -
. 1-715 ChesrPAve., Bakersfield, CA93JOl ~61) 326-3919
. UNDERGROUND.STORAGE TANKS.. TANK PAGE'1
.
If.
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o 3. Oi~ PAOOUCT
o 4. HAZ..WX)US WAST!! {tIcIWu .
UIM 011
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(] Ia. M<UNt1.lUAOB) 0 2. ~
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o S. JET FtJEL
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o 98. otHER·
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~ INU! WAU. W1'H
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a i STAN.DS STœ.
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o 1. IUIII!R LND
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(] . s.. SINOL! WAU.'MTH HTERNAL ÌIt.ADOeR S'fSTÐI
085. UNCNOWN
D.. 0T1iER
05.~ (]ts.~
o .. FRP COWATI8lE 'M100% AMmWIOl 0 It. onø
44-'
o So FeEAOlASS 1 P\AST1C
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REN'OACS) PlAST1C (RV»
o 1 ~/PlAST1C.
04..STœ.cw)~
AI!HOAŒD PlMTIC (FRP)
. 0 S. CiONCMTI!
(] J,. Ð'QXY LNHO 0 s.. QI.A8I L..M«:J a N. UN<NO'Mf
o 4. PfetCUC LM«3 ~ L UN.N!D 0... OTHER
o J,. f"eEAŒASa A!H'OAaO P\AST1C 0 N. UNCNOWN 441
o 4. IMPR£SSEO CUARéHr 0.. OTHER
- .....
o L FRS' ca.tPAT18U! W100% AMmWIOl
o L FRS'~JACKET
o 10. COATED STEEL
o..~
o It. O'T}ER
~
~TI! MTALL£D, 447
..
{For JoÆI_ atM· 449
~TE MT,tU,fO·
o 1. MAlU'ACTUN!D CA-n.oc.c
PAOTICnOH .
(] J.' SACIIft:W. AHOOe
- . . _ YI!AA INSTALLfD 4.50 TYÆ (Fot IOcW UN ~)
~.)I'U COHTAMEHT . J q~
~ DAOP T1JM
ca< ITAItCM P\,AT.
" SIHOLt w.w. TANK (CItItoI/Ilft« wtn:
J I. V\SUAI.' (IXJIOIID P'OfmOH OM. Y)
j[ 2. AUTOMATIC TÞH< QAUQINQ (ATQ)
~ }. COHTlHVOUt A TO
] t. STATISTICAL f#ffNT0tfY AlCOHCIIJA TIOH (SIA) .
lI,eHNW. TAH< TUTINO
o s. ~ TANK QAUQINO (MfOI
0.. VADOse ZONE
07. OAOUN)WAT!A
o .. TA*: TUTIHO
a... one
V.TAM< a.OIUUIHI'Ö«MATIOH I ,IIUIAHIHT Ct.OIURIIH PLACI
~T1O QUAHTTrY 01' sueeTAHCIIUM4HNO 4M TAN< 'IUIO'MTH Hlln'M'T!AW.1
, "
IT/MATro OArt LAIT utIO ~Y)
"'
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CSI OWRFIU. PROTECTION EQUIPMENT: ~ iNSTAU£O
o I, ALMM ~3. FlU. TUBE SHVTOFFVAlV'E~'
o 2. IIAU. Flo... T . 0 .. E!XaFT
4$2
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o I. ~(SHJldWAU.INVAUt.TON.Y)
o 2.. CONTINUOUS INWlSTITIAI.MONtTOAIf¡(]
o 3. IMNUAl r.coMTOA'No
~
. .46T
..."...
o v.. 0 No
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. cs-a.Vð'C
S:\CUPAPORM~. .'
, cm 0' IA,(I!ASFIELO
6: o.rl'1CI ~ IHVIROHM. EHT AL seR.VICU~
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I'
ÍMTERLALS ANO 0 Z. STAH.!SS STIle&. 07. cw.VNCZI!OsTm
OO~~ I
~OTECTION Ó 1. F't..Á.!T1C coWAT18U!'It'I'1')4 CONTEHT'S . a N. ~
'0 ,. FI~' 0 .. ~(tO'!) 0.. OTHI!R ..
. I
STEEL 'oW COATING a I:CA~ PAOTtcnON 4&4 0 5. STEEL"'" COATING
I YI. ftIItNG L2AK DeT!C11OH (Chd iii fWlltIdy)
UNCÐIGAOUNO PIPING ¡
- : PRESSURILEO PlPlNO (C/I«Jt iii ".., 1ItItII1J: I
51 . ELECTJIOHIC I.H! LrNC oeT!CTOA 3.0 OPH Ti!ST'mDf AUTO JI\.UI SMJT OFF FOR
T L£M SYSTEtoI FAA.UAe. AM) SVSTDIDllCor...CTICH . AUDaI NflJ VI8UAL
~
qg 2. MOHn«. y 0..2 0fIH TUT
. ~ 1..vNJAL NTECWN TUT (Q.' QfIH)
! CO~~HA¡, Sucr10H SYSTÐCS: . . I
'0 S. OAU VlSlJAl.IoIOHrTORINO OF PUYttNQ SYSTÐI. T'AIfNIAL.....o INT'EGAn'Y
TEST (0.1 GPH)' ,I.' '
SN'E SU<::TION SYSTEMS (NO VALVES IN·IIB.OW GAOUND Pf'ING):
o 7. St:LF MONrTOAIHG
E·
:. ... . ..
ù . '-'
I·
~~.
~
un 'TAIIc 'Ac
-
ot
-
VL ,... CCNIT1WC'noN (ClwdlIiI ..., IIIfIIY1
01. ~\nT'Y ~'O , PRESSURE
·0 9t. O~ ~; 0 I.SIPlQ.E WAU.
I
II 0 Z. OOU8I.. E 'NAL~·: .
~FACl1JRER
a f. &ARE mEL
o 2. ST "KESS STEEL
o 3. PlASTIC COMPA T18I.E ·Wmi CONTENTS
o 4. FIIWIGLASS
McOHDML y coNTAINID......
PRESSURIZED PI'N) {Ch«It1il "'1ItItII11:. ·1. '
10. COHTJN.(XJS nJA8INI! StJUt SEHSOR mI!f~ NG II1SlW. ALARMS NÐ
(Chedt one) . I .
o a. AUTO PU.... SMJT OFF wtEH A LEAl< OCCURS I" . .
o I).. AUTO PU.... SHUT OFF FOR'LÆNCS, SYSTEM FAILIJN! N«)SYSTEM
OISCOfMCT1OH . I
o c. NO AUTO PUtoM' SHUT OFF .
o 1,. AUTOMATIC 10M L£\I( DETECTOR (3.0 Qf'H TEST):tdD1 FLOW ørr OFF OR
ReSTRICTION . I,..
:J t 2. ANNUAL. INTEGAITY TEST (0.' QfIH) . I·
SUCTJONlGAAVI'TY ~
:J 11. COHTNJOUS SYY" SENaOR . AUe*JI JIG \I1IUAL1UIIet8
I
owtOOIC'Y OeNlJllATOa ONLY (ca.dI~"'"
., 14. ~S SUt.F SENSOR WfTHOUT AUTO PUW StM~.AUOeU! NÐ
í VISUAL AI.AAMS . . I .
] 15. AUTOIM TIC LINE LEAl< OETECTOR (3.0 QPH TEST) ~ AJ1N Sftt11'. OFF Oft
. RESTRICTION
1 ð. ANNUAlIHiEGRITY TEST (0.1 GPI-i)
] 11, OAlL'f VISUAl. CHECK
...:~·i':
I/SPENSER CONTANENT a,. FLOAT r.l!QWØM THAT sKnsOfJr SEAR VALVe
I
4ð8 a 2. CONTINUOUS 0ISf'!HIM ~Nf SI!NIOR. AUOCIIU! AHO VISUAl. Al.AAMS
a 1. COH1N.IOUI 0I8PINRR ftNf SI!NIOR mns AUrO St1UT OFF FOR OISPEHS£R . AUOC8le AND VIsuAL ALAAMS
I IX. OWN!RJOP!RA TOR SIGNA T1JRI!
C*Ut)o 111M IN "'-'alien ~ /let.... It INe ...., 1ClCUt8lll1OiN! Met II my~.
"GNA TURE OF OWNEAJOPERA TOR I
··1
L~ ~:".
r II'
I
>Y')~~''''~P!:
, PAUSUAI!
. ,:CNsr<1ucr'CN/,t;(.' slNCÌ.e wAll .
WN,WF4CrUAER10 Z. ooveu WA¿,L
~F"'CTlJRI!"
o 1. 8AAi! STUL. '
GAAVITY FlOW,
o II. 8IÐHAI. HTEGRITY TEST (0.' QfIH)
. ·.·~·~::r~:r,~l'" ~. .:- ~'.~''';.';J .' .:.
.. ~~~..-.~ .. --' . .:...-....-....,..
OA TE INST ALlEO
471
I') ./" . ..,
/~ '" ¿" l.....L; f"?
."".. 1M
r
, 'CF(7/99) - I
,
-
.r.ðO\lEGAOUNO PIPING
-.
o Z. SUCTION
o 95. VNI(.-.cJ~
o !I!I. on.,ER
a 1. ON.'Vrrt - .
o S. FJUÞ COtoØ'ATIIU! WlI~ ~
o 1. GALvNIZEO STEEL
o .. Fl£XIIU (HOP() 0.. OT)Q
01. CAniOOICPAOTECTIOH
o 115. UN<HOWN
.. ç¡,.~:
ASOVEGROUND PIPING
W.
PRESSURIZED. PIPING (CMdI iii ".., 1PØIy):
o t. aiCTROHlC I.H! LEAl< 0ET!Cr0A .1.0 GPH TE$T m:n1 AUTO JIUYI SHUT OFF.FOR lEA
SYSTEM FAl.UAI!. NC) SYSTEM DI3CONECTION . A&.CØJ! NC) VI:SUA&. ALAAMS
o Z. UC)HT)f. y 0.2 0fIH TEST
o 1 ÞHlJN.INT'!<JArTY Tisr (0.' QPH)
o 4. OAI. y VISUAl. QEOC
COHVEHTJOHAl SUCTIOH ~ ta.. 1iI".,.,pIy):
o 5. OAI. 'f VISUAL a.tOMTORINCJ OF PFING NÐ PUWtNO SYSTEM
o .. ~ INTEGMY TEST (0.' GPH)
SAFE SUC'T1OH SVSTaCS (NO VALVES IN &a.OWGROONOPIPING):
o 7. saF MONfTOfUHQ .
GAAym' FIJ:)W ~ " Nt 1ppIy):
o .. OAI. y VlSUALI.IONTOAING
o .. 8EhMAI.1NTEGAfTY TEST (0.' GPH)
1~.JItLY CONTAINED PItIHQ
PRESSURIZED Pf>ING (Ch«:Ic iii NI.,pIy):
10; CCW1'1fo\)()(JS ruA8H! su.. SENSOR ~ AIJOt8lE NG VISUAL AL.AAMS NC) (dIIœ on<!
o L. AUTO PlJJ.fI SHUT OFF ~ A lEAK OCCURS
,0 II. AUTO PUf,IP SHtJT OFF ~ LEAI<S, SYSTaC FALURI: ÞKJ SYS'1"EW ~
o Co NO AUTOPI.JU» SHUT OFF'
o , 1. AIJTOM'TIC LEAl< DETECTOR
o ,2. NHJAI. HTeGIuTY TEST (0.' GPH)
suc;T1OHIGAAvnY SYS'TÐt
o '1 CONTN.IOUS SUW SENSOR. AUDtÌJLe AHO WlUALÞUlWS
IllØGENCY OI!NlRATOftS ON&. Y {Chect "....,.."
o 1.4. COHTINUOUS SUI.f> SENSOR WITHOUT AUTO PU.... SHUT OFF . A/JDIBLE AKJ VIsUAL
A/..AAIoIS .
o 15. AUTOIM TIC LINE LEAl< OETECTOft (3.0 GPH TEST)
o 1 ð. ANNUAl INTEGRITY TEST (0. t GPI-i)
o 17. QM.'fvtSUALCHECK
Í'1"IUTAINI&!N'T' {':>. ;tii;';~.~
~~.:!. ... &. ,':t",; "'~...'"7.~ ~
"",'4"
...
-
DATe
470
472
till
S:\CÙPAFORMS\SWRCS-S'wPC
. " if
BUILDING DEPARTMENT'~ CITY OF BAKERSFIELD
DIV. . ,1 2 3. 4 5 '
_ DEMOLISH REPAIR"':":""
D BUILDING
, '-
OCC. G ROUP A E H B R M
FOR NEW ALTERATION ADDITION
BUILDING . /'. t. ;} 0 j-
ADDRESS{£7 .Jft)/ f:{/ III ii' hl1)J,~
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t=) æ
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Subdivision (j) ~ C) ry c; ,
Blk.
.Lot No.
,p¡¡~
."h:~~..
C,.J3 à I
II v£/I¡ 0 {?
a:
w
'Z
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o
Nam
City
13if;¿
Eng.-Arch.
City
Lic. No.
Contractor
Contractor
Lic. No.
z
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Permission is hereby. granted to' do the work. described herein, provided such
work conforms to the terms'of 'applications arid plans and specifications 0';',
file in 'this office. Receipt of money for total fee shown hereon. is hereby
acknoviiledged. BUILDING DIRECTOR'
(j
Description.
,
'.
D
ELECTRICAL
'~
Descriptiön
Description
D MECHANICAL
. Description
D SIGN
Description
D MOBIL.EHOM~
Installation
Awning
State Fee
Recordin
Fee
D SCHOOL.DISTRICT FEE
D SEWER FEE·
D SPECIAL BONDS'
B
B lJGO
30J.JO,=b ~ l'8¡;Ü~
WHITE:-Applicant. .
I . " .,' ,.'
YELLOW',-BuilrJi,;g Department
PERMIT NO. L(2-S3
MOVE
-·~f
TH1!lIS YOUR RECEIPT WHEN IT IS PROPERLY VALIDATED
Valuation $
J~~,
Valuation $
Vàluation $
Valuation $
PINK-Countý
BUILDING FEE
..
Plan Check $
Perm'it $
Total Fee $
Plim Check $'
Permit $
Total Fee $
Plan Check $
Perm'it $
Total, Fee $
Plan Check $
Permit $
Total Fee $
Plan Check $
. Perm.it $.
Total Fee $
Permit ,$
. Permit $
Permit $
Permit $
Total Fee $
Permit $
Permit $
Permit $
Total. Fee $
TOTAL FEE
,...-----
$
~ó
GOLDENROD-Auditor
Ø-á)
ei-
--------
-,
lv/IllY')
1) 'of,
~
aN COUNTY HEALTH DEP ARTM. .. ,.
~ 'PERMIT TO CONSTRUCT ~
UNDERGROUND STORAGE FACILITY
PERMIT.#310Q~~
fAClhIT!~!ME-!~Q-!QDR~~~¿
·º-WN!ß.~.L~!t!~.-!ND-21!IhINº-2.QQRE~~..:..
Handi Major
6401 White Lane
Bakersfield, CA
Jaco Oil Company
P.O.' Box 1 8 0 7
.Bakersfield, CA 93303
-------.-----------------------
~!:
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APPROVAL DATE ~~£!~~~er 11L-l985 .
/),. 7r-
.APPROVED BY ~'Ll~ '/;'¡¡/VL .
·7ã~~ëa'fi~J..:~----------
.,
PERMIT ON PREMISES'
NEW. BUSINESS
CHANGE OWNERSH IF
RENEWAL
MOD IF ICA T ION
OTHER
PER ~1 IT E XP IRE S ~~~!!!!? e r -11.L-l~~~___
--------------------------------
POST THIS
CONDITIONS AS FOLLOWS:
1. All perti~ent equi~ment and materials used in. this construction are
subject to identification and approval by the permitting Authority p~ior
to const~uction. This permit is issued contingent upon guaranteed
compl~ance with the guidelines as determined by the Permitting, Authority.
2. All construçtion to be as per facility plans approved by this
department.and verified by inspection by Permittirtg Authority.
3. Permittee must contact Permitting Authority for on-site inspection(s) with
48 hours advance notice.
4. All underground 'metal product piping, fittings and ~onriections must be ,
wrapped t6 a minimum 20-mil thickness with corrosion-preventive,
gasoline-resistant tape or otherwise protected from corrosiort.
5. Construction inspection record is included with permit given to Permittee.
This card must be 'posted at job~ite prior to initial inspection.
Permittee must cont~ct Permitting Authority, and arrange for each group of
re qui redinspe c t ions numbered as 'per instructions on card . Generally,
inspections will be made of:
a. Tanks and backfill
b. Pipihg 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 iristallation of
tank(S). Test(s) must be certified by the manufac~urer, and a copy of
test certifications supplied to the Permitting Authority.
7. All equipment and m~terials in this con~truction must be inst~lled 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
back fill i ng .
9. No product shall be stored in tank(s) until approval is granted by
Permitting Authority.
10. Monitoring requirem~nts for this facility will be described on firial
"Per~it to Opera~e".
(:/", .~ J-:tL¿f,£.~·- .
__~__~i~~~_~~_______~________~_~_____
~/ . .'
ACCEPTED BY
'DATE
---------
'CX>NTRACroR5~o{J:' ( . ' .'
CONTACT '.~'~ .:5ðLU.· \~.J./S.,
.
LICmsEt
mt
'~.
. /j;(U/1., ,
1700 FLaiER.
BAIŒRSE'IEID, CA"
æONE (805) 861..;~,
'. KERN· COUNTY HFALTH DEPARlMF'~
". ,.",mvïROmENTAL HEALTH DIVIS I"".
HAZ~TIDPUS StJBSTAlCES sæTION
n.srŒT ION KJ!lX)1CD
POS'r CUD M' JœSrrB ,.
FN:ILITY
ADDRESS' (¡;
CITY
PHONE ·NO.
Ce
CJolNER
ADDRFSS
CITY
·PHONE NO.
INSTRUCTIONS: Please call for an inspector only when each group of inspections with t :
nunber are ready. 'rhey will run in consecutive order beginning with number 1. ,. DO NOT';;i;
work for any numberm group. until all i tens i.n that group are signm off by the Pend
Authority. FOllowing these instructions willrmuce the number of requirm inspection,,"
am therefore prevent assessnent of additional fees~ .
I NSPEX:TI ON
Backfill of Tank(s)
Spark Test Certl lcatlon
Cathodlc Protectlon of Tank(s)
NSPF.X:TOR
ION -
I Liner
;2
ce-D.W. Tank(s)
- FINAL -
3 MonltonngWells, Ca s & Locks
,3 Fill Box Lock
Monitoring R lrements
,.'
, .t,',.ll'·~~~fN;·t~;~;,j:S:t'Kt~U~'T·1 0'· 'N" " 'R':<':'E"~'\;:'i<}7 "R:·;c:~ft';D!'~\5h<' ' 1~/fjrr
, ,:'" '.' ';~...¡", !. .'. ' " ' "'.'i,
øì'~\~:Bbll1Ø'ì I\IGDEP4läiM'E'Nt
;';5~~\]~!~;i:;;'&;II~.I(~ ~SF I ELD, C A L I F oíl'I\I;'Ä:~~:':';15i~~;Wi;<~gF,';;;';r':" . ",
POSilri<i';~ii"j;;i~IJOü;;'PI~cè at the Job Site 'fo~:JD~~~tiè)~'~~fWork.
':':'~:"- ;':>:','{:~::',':,'::"-;':':.;..:\<;:~::,~-~;~~~~;::~~~.~~;:.;;:.?;,,:~':I-'_·':-:;'·;·.P'.-. .". - ,,> ." ':'.-' !:"":"':'~'_"::::'/<'_?~;~'~':::<"(,:':<:~:- ,._ ,,', . ,_
[)O NO"[ ,I'.m,ôvethis Càrd until Final Building Insp~tiô~'hàs Been Sign~d.,
D9l\ÎOT co~er up any work until inspected and si;ri;åby Inspector~ '
Phone 326-3720
BD-641207
=,j",'.I ~ .;;,.
INSPECTION
Inspector
&
Date
INSPECTION.
Inspector
&
Date
STRUCTURAL
'PLUMBING
7""';. ' .'
p .Þl;L
/2-1 ¡~~
"
MECHANICAL
ELECTRICAL
12 -I -'?3.)
FINAL PLUMBING
FINAL MECHANICAL
FINAL ELECTRIC
'~.., -,' .
FINAL BUILDING & SITE WORK
"'. Building Address ___f;;_~_q_l___&iJ'___,,-ff~___ _____ftr!~_'____n
dhc8 ..".. '/J#
:ct JLê77j~;Zt------------BIO~-~---n------------- Lot __V~.~__~_
t'1>..::.::~~----n---:'(7J~Arçh.- Eng. -.----- ----.---- ______.uu_.-_ -------:-
KERN BUSINESS FORMS 7411-"
. Bldg. permi~ ,~O'.-::i.'-,_----n--.----.-nm-----,. :
Elect. Permit No. u__:mn____:_~-~--u-~,--:---: :
Plumb. Permit No. _n________n_:_:n__________':'___h___'
.. .' - . .... .
Î. . jì'
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TRACER TIGHT® TEST RESULTS
PJI( ~
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Shirley Eniironmental LLC
1928 Tyler'Avenue, Suite K
I
South El Monte,-CA 91733
\ "
1/10/2003 .
Job No: 860152
Jaco #360 .
'.-.'. '~-'_._._'---'-_.'>
(§401 WhiteJdme ¡
--_.~ -.......-.-- -- /.
Bakersfield, CA 93309
SYSTEM STATUS
SYSTEM#
, PRODUCT
SIZE
TRACER
TRACER DETEÇTED?
Tank I
Tank 2
Tank 3
Tank 4
Unleaded
Plus
Diesel
Super
12,000
12,000
12,000
12,000
W
G
R
W
NO,
NO
NO
NO
Soil permeability is greater than 4.4 darcys.
GROUND WATER AND PRODUCT INFO
AT INOCULATION AT SAMPLING
12/20/03 12/27/03
. DE¡>TH FROM GRADE
WATER TANK TANK
TABLE BOTTOM TOP
SYSTEM# H2O PROD H2O PROD
" (in) (in) (in) (in)
Tank I 0.00 44.00 0.00 64.00
Tank 2 0.88 44.00 0.00 70.00
Tank 3 0.94 49.00 0.77 .37.00
Tank 4 0.81 60.00 0.84 52.00
~. (in) (in) (in)
>120 139 43
>120 139 43
>120 '. 43
".139
>120 139 43
SITE COMMENTS
Backfill in tank pit consists of \4 to Y2 inch pea gravel.
Ground cover over tanks and piping trench is concrete and asphalt.
TEST EVENTS
INSTALLATION
12/20/03
.' .
INOCULATION
12/20/03
. SAMPLING
12/27/03
ANAL YS.IS
01/06/03
FILL RISER - SPILL BUCKET TEST
T ANK#
Tank 1
Tank 2
Tank 3
Tank 4
P ASSIF AIL
Pass
Pass
Pass
Pass
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 kno ~ ge.
InstalVlnoculate tJ 1-/3f'?.. CALico No: Signature-
Sampler '1'52- Ib3S CA Lie. No: Signature
TRC Analyst 'f 3 - I 5' 0CA Lie. No: Signatuié
Date
. bate ,jz ~.5;
Date ,¡; '/03 .
'.
-'
î-
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.,'
Test Comments
_ General _
Tanks 1 through 4 are single walled fiberglass. Product distribution lines are single walled fiberglass. Ven!
and vapor recovery lines are single walled fiberglass. . .
Tank 1
No Tracer Detected
Tank 2
No Tracer Detected
Tank 3
No Tracer Detected
Tank 4
No Tracer Detected
L~
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{, ,
- Tracer Research Job No. 860152 . Page 3.of 5 .
Sample Date: 01/06/03 CONDENSED DATA
Location . Compound· Concentration
001 ''0 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 O.QOOOO
006 w O.OOÖOO
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 in milligramsl1iter (mg/L).
Tracer A, R, and W values reported in milligrams/liter (mg/L). .
Tracer E. G, H, and I yaluesreported in microgr3mslliter: (µg/L). .
0.00000 ~Not Detected -999999.99999 = No sample
',:. :,'
....""" ,
. '5"' .¡
e ..0> -.
- Tracer Research Job No. 860152 Page 4 of S'
Sample I)atè: 01/06/03 -- CONDENSED DATA
Location Compound' Concentration
009 R 0.00000 -
009 W 0.00000
009 TVHC- 0.21900
010 G 0.0000
010 R. 0.00000
010 -w 0.00000
010 TVHC 0.15700
011 G 0.0000' -
OIl R - 0.00000
011 W 0:00000
- 011 TVHC 0.34600
012 G 0.0000
012 R 0.00000
012 W 0.00000 -
012 TVHC .0.00000
013 G 0.0000
013 R 0.00000
013 W 0.00000
013 TVHC 0.05700
014 G 0.0000
014 R 0.00000 .
014 W 0.00000
014 TVHC . '0.09700 .
015 G 0.0000
015 R , 0.00000 .
015 W ·~O.OOOOO
015 TVHC 0.00000
016 . G 0.0000 -
016 R 0.00000
016. . W 0.00000
016 TVHC 0.36700 -
017 -G 0.0000 .
017 R 0.00000 -
TVHC (Total Volatile Hydrocarbons) values reported in milligramslliter (mgIL).
TracerA, R,and W values reported in milligr¡¡.rns/liter(mgIL).
-Tracer a, G, H, and I values reporte<;l in microgramslliter (µg!L). .
0.00000.=:= Not Detected-999999:99999 = No sample
,::.......
~i: "" ... ".
e
. Tracer Research Job No. 860152
Sample Date: 01/06/03 .
Location
017
017
018
018
018
018
019
019
019
019
.. .'
,.,.
CONDENSED DATA
Compound
W
TVHC
G
R
W
TVHC
G
R
W
TVHC
TVHC (Total Vol~tile Hydrocarbons) values reported in miÙigramslliter (mgIL).
Tracer A, R. and Wvalues reported in milligrainslliter (mgi'L).
. Tracer E, G, H, and.1 values reported in microgramslliter (µgIL).
O~OOOOO = Not Defected -999999.99999 = No sample
Page 5 of 5
Concentration
0.00000
0.00000
0.0000 .
0.00000
O~OOOOO
0.20500
. 0.0000
0.00000
0.00000
0.00000
.,
. ..
.'
B u i 1 din 9
,Sidewalk
Filel860152
Arc:."860152
Siz.IA
Dat.., 01-15-03
19 18
-:
Vent. .____;.:._
0000
Tank 2
12,000 gal
Plus
Tracer [G]
II
U
J
a
M
Po
I
1.-
I
I
I
I
I
1'17
I
L
¡ ij: lij
I ~ ,. 12 13 .I~
1.16 1 I
I I I
II
I i I
: I'll 14.:
I : I
1'15 O!' '! 0
' 1 MW I
L_ 1:+-____ 2
o 000
]-
o
o
o
o
9
000
6
000
7
000
10
-.
-:>,
lIS
:I
't
lIS
o
II:
Tank 1
12,000 gal
Unleaded-
Tracer [W]
Tank 3
12,000 gal
Diesel
Tracer [R]
.------
+MW
~,!1'rlCer Re,BeHCb Co ipo.r.U 011
EX P LAN AT ION'
'1
Samplin~probe Locat16n
Approximate pipeline Location
Monitoring Well Location
-
~ ..,.
m
-
¡
~ I
~ ,':'
k _ "!""
..
.
.~
N
n 0 8 c: ð 1 e e
S H I R LEY
E N V I ,R 0 N MEN TAL
J a C 0 # 3 6 0
6 4 0 1 W HIT B LAN B
B A K B R ,S FIB L DCA L 1_ P O,R N I A
I s AMP L IN, G L 0 CAT ION S I
F i 'g u r e
1
---1
Tank 4
12,000 gal . -,
Super '
Tracer [w)
860152
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a
/.
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave.~ 3rd Floor~ Bakersfield. CA 93301
FACILITY NAME Mt1/,\()('IU I
¿ I L\. -kv-
I~SPECTION DATE~!lt/()3
Section 2:
Underground Storage Tanks Program
o Routine I:s;réombined 0 Joint Agency
Type of Tank fu)R~
Type of Monitoring ¿LM
o Multi-Agency 0 Complaint'
Number of Tanks I
Type of Piping nWF
ORe-inspection'
OPERA nON C v COMMENTS
Proper tank data on tile /"
V
. .. /
Proper owner/operator data on tile V
Penn it fees current V
"
Certification of Financial Responsibility t...-
Monitoring record adequate and current t.,...
Maintenance records adequate ~nd current .~
Failure to correct prior UST violations /
Has there been an unauthorized release? Yes No V
Section 3:
Aboveground Storage Tanks Program
TANK SIZE(S)
Type of Tank
AGGREGATE CAPACITY
Number of Tanks
OPERA nON Y N COMMENTS
SPCC available
SPCC on tile with OES
Adequate secondary protection.
Proper tank placarding/labeling
Is tank used to dispensc MVF?
If yes, Does tank have overtìll/overspill protection?
C=Compliance
Y=Yes
N=NO
Inspector:
Office of Environmental Services (661) 326-3979
Whitc - Fnv. Svcs.
Business Site Responsible Party
Pink - RlIsincss Cory
r'1_IAL CENTER
5. ~,JHITE LANE
BAKERSFIELD CA
805-398-1800
DEC 15. 2003 10:15 AM
L 1: FUEL ALARI'"
S'lSTEr"1 STATUS REPORT
- - - - - - - - - - - -
I N\JENTOR'l REPORT
T 1 :DIESEL 2
VOLUr"1E
ULLAGE
90:'/. ULLAGE'"
Tl.:;. \/OLUI"Œ
H IT
Wi" ~ VOL
WA.b~
TEf"lP
487 GALS
512 GALS
412 GALS
488 GALS
:30.90 INCHES
2 GALS
0.89 INCHES
55 . '3 DEG F
M M M M MEND M M M M M
'''''''",'
.-" -',")i" --. "',:'¡, ~,.--,--.-.-,-,-~-,~ '~-+~!"'::--- -.."":'tr'",...,¡... ;¡J~""'''''~-':::'
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RF. SERVICES -
C 'license # 767952. '.~ ,...'
.' ~:;..--:.....
1199 N. Ukiah Way · Upland, CA 91786 · (909) 949-9141 · Toll Free: (877) 710-2189 · FAX: (909) 920-6453
.<", Job Location: r?dkCr'S,h<? /) )1('lûrrCl / (eÞi Ie.,.- dý'7/.kl Date: //- t'?;J- O~
G) Address: 5.1a' wt... /<. ftr"'< ((0 if" f/6~ d. ,"<4
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Phone No: (C¿/ )19'Ý- /f¿/d· )( :1-1:>
P.O. N~ed~d DYes D No . P.O. No: I
SERVICE ORDER
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Authorized By: [";T~ /
Job Completed: ß'Yes D No
Bill To: Equipmet
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I !'. Type:
Billing Address: I Make: v;.. ..:>rt-r- /:/t(:,1-J /
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Model: Y7Ò
I Serial#: ;rÛ i {j ;2.,.-:; -:;¡ / t/Ó Ý Ce-,>
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TECHNICIAN: START FINISH TRAVEL TOTAL
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CUSTOMER'S SIGNATURE: iJ .'
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This is to certify that all work was -I'
iãtisfactorily completed.
~ "
\. .I' r ,,--,4 MILEAGE: START FINISH TOTAL
'-.J....! '':'''':\.1"\.--'1 i' r'f\ ~"-'i--( r
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".,,,...._~.,.~.~'-.,...,. SECONÐ~'f~SY8TEM CERTLFICA TION FORM
b~~~::'~'~~:~ ~ 6~¡'1~?: \~ri~::1~ ~;:::.rr . ..' '<'-"~,,~~, h - '. ",--,....,,' '. " .
FAClLlTVlD . ""'lX[1JftJ...' ',.:",' .. :':
FACILITY ADDRESS' 11 \~ hi1f-:"..U\I·:· ~f\I¿t1Ç.·b(;'.l6.Ct¿:.: '-'
_.~.~--,-~-
. T.- 4
UST AUDn~r Spate
Tank ~ "
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SCU1T1me
IDitiaJ Pnaure
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Cerdfkado.n ,.,:::, ~~ I' \. \, ¡'. '
(S'pturé) i " " ¡;;;¿. ,., ,
VI
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~- ._. -,¡-:..- ---
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'- '-- --.... -----. - - .
CertifacatJon
(Sipaiure)
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P~gç 1 of :.;.>
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SECONDi;R¥ SYSTEM CERTIfICATION roRM
DATE Jj - -H .·6 ~' ' I ' . , .
FAClLITV ro íXJ~e.IA (~, -C.EX\ít-rZ.. ' ". "
fACILITY ADORESS S-,~~ \ \AJWT1::' l Ü. 8~EttLD,(ft
- , . ...,
'1'3'3 cP\
Turbine Sumps .>
-
Swap 1 b~L I Sump 2 SUulp 3 Slnap 4
Stsrt·Time . -. . /1}··LjOk,-J.. --. .. - --~-
. - .. - - --- . - . ~ ~~-
JIt1Cùal Height J. ð )d;Þ
or Water
Time Jt'..S'1J~ '
Water Hef.¡bt /. 8721;..;
'Time 0 ~ .....!
Ufl '.r I
Water Height ") ;' Rl~;J
Tb:ne 11.'jt~~
WIII~r He1gbt I ' 8'þ~
CutilkatiDu ' .PA~
,1)._ fA ~ I·
(Stpatu.re) IIf'7IT c¿.r . ..c.:...
7/ 'r
OvertW Buckea
OWrlUIl I Overnu2 OvedU13 OVerftll4
- Staat TIDw :. " . .' - -'- - ! -- - ,---- -. .-
. " - '- . - ---
laWaJ KeJgln ' I
of Water n:..... rH~ rt\ P..
Pa?f\: I "
Time .,llNI~ tm-F
W.tcs.. Height , ,
TIDw I
Wa~ Hei¡ht I
CertJt1catlon f
(Sigxuawrt)
~
'p~ 2 of'-:5. ..
. " - _.-. - ---- ~
;~ - ~~}~
e
-
SECONDARY SYSTEM CERTIFJCA TION FORM
DATE ,Lj·~4 -03
FACILITY ID.1fJ£rroR1~t-, ~ . '
F AClLI'1'Y ADDRESS_ ~ 2 () l WIi1~ 1_ n;ß ~ E: t1>, Cfl
, " C¡33cJ?
uoc TESTING
Q(SPENS&ttl . DISPENSER 2 DlSPENSER 3 DISPENSER 4
START TIME . - . . --. - - -
- ' --. ----- '-"'---' --- -.-. -
INITIAL
HEIGHT OF k-
WATER I ~\ìt-~n on A
TIME . ~ÐitO\5 TMn -',
WA'f£R
KFJGBT
TlM£
"
WATER
HEIGHT
cEaTIFJCÄ nON '.
(SIGNA'1'UU)
r I DIsPENSER 8
DISPENSa,S DISPENSER 6 I DISPENSER 7
S1'AItTTIME
OOI'IAL. -
IiEIGHT OF - ------ ~-'- -. ~- ~ --. ---
-.-- ----- ~ ~
--
WATER
TIME
WotTER
HEIGHT
TlM£
WATER
HEIGHT
CEønFlCA. TION
(SlGNA TURE)
Page 3 o(J
,- - -"..:- - - ----- -
- .-,. - ~. ._---
------
-- - "" --- .- - -,---------'-- -~--
UNITED STATES POSTAL SERVICE
-III
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First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
. .
· Sender: Please print your name, address, and ZIP+4 in this box ·
:. :-J
::;¡¡,
Bakersfield Fire Department
Prevention Services
1715 Chester Avenue, Suite 300
Bakersfield, CA 93301
/ '
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,/
\ os U ,III If II !II f"" II 1111 n ,I,t /111,1 fII"" 11111111 ,1,1,11 fII (
. ¡,----:--
· 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:
~M0RIAL CENTER
15201 WHITE LANE
BAKERSFmLD CA 93309
~
3. Service Type
o Certified Mail 0 Express Mail .~.
o Registered 0 Return Receipt for MerchandisíT',
o Insured MaÍl 0 C.O.D.
4. Restricted Delivery? (Extra Fee)
D. Is delivery address different from item 1
if YES, enter delivery address below:
--.,
1
j
PS Form 3811. August 2001
7fJ02 31500004 9985 3219
1
~
, .
,0 Yes
\
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Domestic RetumReceípt
2ACPRI-Q3.CZ-0985
IT
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U.S. Postal ServiceTM
Cr~)llFIED MAILM RECEIPT
(DÓ.....;stic Mail Only; No Insurance Coverage Provided)
Lr
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IT"
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Postage $
-~ ~
;:r
CJ
CJ Retum Reclept Fee
CJ (Endorsement Required)
CJ ;w. Restricted Delivery Fee
Lr (Endorser' .
,..:¡ I
m TOtali MEMORIAL CENTER
g:: ITa 5201 WHITE LANE
~ ~fñië¡;{ BAKERSFIELD CA 93309
orPO! "-
ëii·SIò.....~ '.
CértJf/ed Fee
Postmark
Here
I
I
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. . :.. . It
Certified Mail Provides:
· A mailing receipt
· A unique Identifier for your mailpiece
· A record of delivery kept by the Postal Service for two years
ImfJortant RemInders:
· Certified Mail may ONLY be combined with First-Class Mail@ or Priority Mail@.
· Certified Mail is not available for~any class of International mail.
· NO INSURANCE COVERAG'Ë IS'RaQ.VIDED with Certified Mail. For
valuables, please consider Insured or Flëgistered Mail.
· For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Retum Receipt service, please complete and attach a Retum
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS$ postmark on your Certified Mail receipJ is
required. .> -=0
· For an additional fee, delivery may be restricted to the addressee or
addressee's authorized a~ent. Advise the clerk or mark the mailpiece with the
endorsement "RestrictedDeJivery".
· If a postmark on the Certified Mail receipt Is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on mail
addressed to APOs and FPOs.
(SSJSAS/:J) ë:OOë: sues WJ0:l Sd
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
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
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April 11, 2003
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Memorial Center
5201 White Lane
Bakersfield CA 93309
CERTIFIED MAIL
RE: Recent SB 989 Secondary Containment Testing
FOURTH REMINDER NOTICE
Dear Owner/Operator:
Our records indicate that you completed your secondary containment
testing on November 14, 2002. Our records further show a failed test.
Therefore you are required to have your system repaired and re-tested
as soon as possible.
This office requests an update with regard to repairs of your system.
Please be advised that repairs involving the replacing of components
must be under permit from this office. The repairs of your system are
a condition of your permit to operate. Failure to repair and re-test will
result in the revocation of your permit to operate.
Should you have any questions, please feel free to contact me at 661-
326-3190.
Sincere!J',ere,I,: "
)Jf£~
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
""7~~ ~~ ~.AOR? ~ A. ~~"
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Bakersfield Fire Department
Prevention Services
1715 Chester Avenue, Suite 300
Bakersfield, CA 93301
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1. Article Addressed to:
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MEMORIAL CENTER
5201 WHITE LANE
BAKERSFIELD CA 93309
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· A unique identifier tor your mailpiece
· A record of delivery kept by the Postal Service for two years
Iml'Ortant Reminders: f'
· Certified Mail may ONLY be. combl~:, ~with First-Class Mai~ or Priority Mail@.
· Certified Mail Is notavailabllfor anf"cTàss of international mail.
· NO INSURANCE COVERAGE IS' PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
· For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, prease complete and attach a Retum
Receipt (PS Form 3811), to the article and add applicable postage to cover the
fee. Endorse mailplece 'Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPSq¡, postmark on your Certified Mail receipt is
reqUIred.
· For an additional fee, delivery may be restricted to the addressee or
addressee's authorized allent. Advise the clerk or mark the mailpiece with the
endorsement uRestrictedTJelíveryu. .
· If a postmark on the Certified Mail receipt is desired. please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed. detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present it when making an inquiry.
Internet access to delivery information is not available on màil
addressed to APOs and FPOs.
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) 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) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield. CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
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March 5, 2003
Memorial Center
5201 White Lane
Bakersfield CA 93309
CERTIFŒD MAll..
RE: Recent SB 989 Secondary Containment Testing
TIDRD REMINDER NOTICE
Dear Owner/Operator:
Our records indicate that you completed your secondary containment
testing on November 14, 2002. Our records further show a failed test.
Therefore you are required to have your system repaired and re-tested
as soon as possible.
This office requests an update with regard to repairs of your system.
Please be'advised that repairs involving the replacing of components
must be under pennit from this office. The repairs of your system are
a condition of your permit to operate. Failure to repair and re-test will
result in the revocation of your pennit to operate.
Should you have any questions, please feel free to contact me at 661-
326-3190.
since,re4t.
)ll~
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
"7~ ~ Won~ 370P vØ6OPß.r~ A W~"
UNITED STATES POSTAL SERVICE
.
First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
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· Sender: Please print your name, address, and ZIP+4 in this box ·
BAKERSFIELD FIRE DEPARTI\AENT
OFFICE OF ENVIRQNMENTAL SERVICES
1715 Chester Avenue, Suite 300
Bakersfield, CA '93301
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· 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 fro lit if space permits.
1. Article Addressed to:
MEA10RIAL CENTER
5201 WHITE LANE
BAKERSFIELD CA 9330~
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4. Restricted Delivery? (Extra Fee) 0 Yes
7002 2410 0002 1974 9275
2ACPRI-OO-Z-0985
PS Form 3811, August 2001
Domestic Return Receipt
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a _______! 5201 WHITE LANE
I'- ~:~~'I BAKERSFIELD CA 93309
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Certified Mail Provides:
· A mailing receipt
· A unique identifier for your mall piece
· A record of delivery kept by the Postal Service for two years
Important RemInders:
· Certified Mall may ONLY be combined with First-Class Maile or Priority Mallœ
· Certified Mall is not available for any class of intemational mail.
· NO INSURANCE COVERAGE ~PROVIDED with Certified Mail. For
valuables, please considEtlnsured or Registered Mail.
· For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt servIce, pfease complete and attach a Return
Receipt (PS Form 3811), to the article and add applicable postage to cover the
fee. Endorse mailpiece 'Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USP~ postmark on your Certified Mail receipt is
reqUired.
· For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery".
· If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present It when making an Inquiry.
Internet access to delivery information is not available on mall
addressed to APOs and FPOs. .
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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 SAFm SERVICES' ENVIRONIlENTAl SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 32e.QS76
PUBLIC EDUCATION
1715 Chester AvÌ!.
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 32eH)576
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) 399-5763
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February 13,2003
Memorial Center
5201 White Lane
Bakersfield CA 93309
Certified Mail
RE: Recent SB 989 Secondary Containment Testing
SECOND REMINDER NOTICE
Dear Owner/Operator:
Our records indicate that you completed your secondary containment
testing on November 14, 2002. Our records further show a failed test.
Therefore you are required to have your system repaired and re-tested
as soon as possible.
This office requests an update with regard to repairs of your system.
Please be advised that repairs involving the replacing of components
must be under pennit from this office. ~he repairs of your system are
a condition of your pennit to operate. Failure to repair and re-test will
result in the revocation of your pennit to operate.
, '
Should you have any questions, please feel free to contact me at 661-
326-3190.
Sin-;¡cerel~ ',.'
. II/' /'
~,
Steve UndeIWood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
""Y~ ~ ~~.¥OP ~0P6 ~~ A ~~"
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FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield. CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101 "W Strèet
Bakersfield. CA 93301
VOICE (661) 326·3941
FAX (661) 395·1349
PREVENTION SERVICES
FIRE SAfETY SERVICES' ENVIRONIlEHTAI. SERVICES
1715 Chester Ave.
Bakersfield. CA 93301
VOICE (661) 326-3979
FAX (661) 326-0576
PUBLIC EDUCATION
1715 ChesterAvè.
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
-.
January 22, 2003
Memorial Center
5201 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 certificatè 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.
Si1z
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
SBU/dc
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UNITED STATES POSTAL SERVICE
-
First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
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· Sender: Please print your name, ;ddress, and ZIP+4 in this box ·
BAKERSFIELD FIRE DEPARTIJlENT
OFFICE OF ENVIRONt;¡ŒNTAL SERVICES
1715 Chester Avenue, Suite 300
Ba~\ersfieki. CA 93301
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· 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 if space permits.
1. Article Addressed to:
'>
. Is delivery address different from item 1?
If YES, enter delivery address below:
MEMORIAL CENTER
'15201 WHITE LANE
'BA~RSFIELD CA 93309
~--- ----- -----~ - ----- ----- - ------ ------ -/
3. Service Type
o Certified Mail 0 Express Mail
o Registered 0 Return Receipt for Merchandise
O'lnsured Mail 0 C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes
t n ^:-'-' ... 7002-0860 0000 1641 5868 t\
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PS Form 3811, August 2001
Domestic Return Receipt
102595-02-M·0835
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· A mailing receipt
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· A signature upon delivery
· A record of delivery kept by the Postal Service for two years
Important Reminders:
· Certified Mail'may ONLY be co,:"bined with First-Class Mail or Priority Mail.
· Certified Mail is not available for any class of international mail.
· NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
· For an additional fee. a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service. please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mail piece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt. a USPS postmark on your Certified Mail receipt is
required.
· For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with thè
endorsement "Restricted Delivery", "
.. If a postmark on the Certified Mail receipt is'lciesired. please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not n..d. detach and affix label with postage and mail.
IMPORTANT: Sa s receipt and present it when making an inquiry.
PS Form 3800, April 2002 (Reverse)
102595-02·M·1132
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "W Street
Bakersfield, CA 93301
VOICE (661) 326-3941
FAX (661) 395-1349
SUPPRESSION SERVICES
. . ·2101"W Street
Bakèrsfield, CA 93301
VOICE (661)326-3941
FAX (661) 395:1349
PREVENTION SERVICES
FIRE SAfETY SERVICES. EHVIROHIlEllTAL SElMCES
1715 Chester Ave.
Bakersfield. CA 93301
VOICE (661) 326-3979
FAX(661)326H0576
PUBLIC EDUCATION
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3696
FAX (661) 326H0576
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) 3994697
FAX (661) 399-5763
-
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January 13; 2003
Memorial Center
5201 White Lane
Bakersfield CA 93309
Certified Mail
RE:Recent SB989 Secondary Containment Testing
REMINDER NOTICE
Dear Owner/Operator:
Our records indicate that you completed your secondary containment
testing on November 14, 2002. Our records further show a failed test.
Therefore you are required to have your system repaired and re-tested
as soon as possible.
This office requests an update with regard to repairs of your system.
Please be advised that repairs involving the replacing of components
must be under pennit from this office. The repairs of your system are
a conditiOn of your pennit to operate.
Should you have any questions, please feel free to contact me at 661-
326-3190.
Si1dav
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
Office of Environmental Services
SBU/dc .
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SECONDi\1tY.SYSTEM CERTIFlCA TION FORM .
DATE 11-/L/-Cr7 '.' :. , .
FAClLlTYID Ø1JâYl/Jt,'P,LC£N~ ,
FACILITY ADDREss ~ddJ1JbltÇLl.N~ fJßkx12.S:ilwdJ· _
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---- --- í;;~ASO-;and ~;;:Ë- ---
'II FOR INSPECTION __ __. " _ _.._._ .___..' .__ _ .__ ._____ _. _________
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TELEPHONE NUMB (5):
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City of Bakersfield
III CUSTOØER RECEIPT III . 1
n......: VDAVIS Type:OC Draver.
~: 11/06/92 01 Receipt no: 49228
Desc . t· Oty hount
82 n~l~RAGE TAIfK 1 $64.00
REDWIIfE TESTING SERVICES IMC
5201 WHITE LII
Tender detail
CK CHECK
Total tendered
T ota 1 pay.ent
Trans date: 11/06/02
&372
$64. 00
$64.00
$64.00
Tile: 10:34:05
BUSINESS NAME:
~TEMENT
I Bakersfield Fire Dept.
PRE~TION SERVICES
Fire Wety Service.. Environmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661 )326-3979
82 STATE SURCHARGE
86
_._- ---~--
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89
.- -.--. -.--
84 COPIES/REPORTS
_L__.._... ._... _ _..._ ..._
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CUSTOMER SIGNATURE:
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ORIGINAL WHITE: FINANCE
CUSTOMER PINK OFFICE' YELLOW
FD1734
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TANK TESTING COMPANY Redwine Testinq Services, Inc.,I.Rich Environmental
MAILING ADDRESS P.O. Box 1567, Bakersfield, CA 93302-1567
NAME & 'PHONE NUMBER OF CONTACT PERSON _ _ Duqan-'Pumer
TEST METHOD Tnrnn,
NAME OF TESTER OR SPECIAL INSPECTOR James J. Rich
CERTIFICA TION # 90-1072 Contractors License 532878 A HAZ
DA TE & TIME TEST IS TO BE CONDUCTED Thursd¡;¡y, NOvember 14, 2002 8: 00 AM
661-834-699-3
APPROVED BY
Ij-6-2002
~~~.
SIGNATURE OF APPUCANT
DATE
f"lEt'10R I AL CENTER
5201 l,JH ITE LANE
BAKERSFIELD C~
801=: '::198-1800
DE~3. 2002 10:52 AM
L 1: FUEL ALARr"l
S\"STH'1 ~3TATUS REPORT
- - - - - - - - - - - -
INVENTOR\" REPORT
T 1 :DIESEL 2
\/OLUr1E
ULLAGE
90% ULLAGE=
TC \lOLUf'1E
HEIGHT
[,vATER VOL
WATER
TE.
679 GALS
:320 GALS
220 GALS
678 GALS
40.49 I NCHEE:~
2 GALS
0.89 INCHES
61 . 1 DEG F
~ ~ ~ ~ ~ END ~ ~ * ~ ~
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CITY OF BAKERSFIEl..D FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rcl I~loor, Bakersfield, CA 93301
FACILITY NAME!C-',tt~t'li ~~IA.(..cr
ADDRESS 5"JO (~ L
FACILITY CONTACT
INSPECTION TIME
INSPECTION DA TE-J;;} . 3 - G L./
PHONE NO. 3q~'" IßOÙ
BUSINESS ID NO. t 5-210-
NUMBER OF EMPLOYEES-100
Section I:
Business Plan and Inventory Program
o Routine
IJ}-éombined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Appropriate pennit on hand l /
Business plan contact infonnation accurate L /
, /
Visible address v
Correct occupancy t /
Veri fication of inventory materials - ,/
Verification of quantities L ./
Verification of location - ./
Proper segregation of material L V
Verification of MSDS availability .. V
Verification of Haz Mat training - ,/
Verification of abatement supplies and procedures L ,/
Emergency procedures adequate ... ./
Containers properly labeled L /
Housekeeping ~ ",
Fire Protection ./ ,/
Site Diagram Adequate & On Hand /
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
o Yes ~No
Questions regarding this inspection? Please call us at (661) 326-3979
While - Env. Svcs.
Yellow· Station Copy
Pink - Business Copy
Inspector:
-
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME M e.lM.Dn it (
~f(lckr
INSPECTION DATE ( l. ~ 3 - () '1
-
Section 2:
Underground Storage Tanks Program
o Routine ~ombined 0 Joint Agency
Type of Tank DuJF<'~
Type of Monitoring è tAt\.
o Multi-Agency 0 Complaint
Number of Tanks -1
Type of Piping po.» F
ORe-inspection
OPERA nON c v COMMENTS
Proper tank data on file \ V
Proper owner/operator data on file L.. /
,/
Permit fees current /
....."
Certification of Financial Responsibility L /
Monitoring record adequate and current ""'" /
¡
Maintenance records adequate and current ../ ./
Failure to correct prior UST violations ,/
,
Has there been an unauthorized release? Yes No J
Section 3:
Aboveground Storage Tanks Program
AGGREGATE 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 overfilI/overspill protection?
:~~,:~:'Ji""'J¡V~~
Oftice of Environmental Services (805) 326-3979
White - Env. Svcs.
N=NO
~~
Business Site Responsible Party
Pink - Business Copy
,
Nov 18 02 01:39p
P.F. Services
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(909) 920-6453
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MONITOR CERTIFICATION
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SAFETY: INTRINSIC
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THIS IS TO CERTIFY THAT THE ABOVE MONITOR HAS BEEN TESTED BY AN AUTHORIZED
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If you already have a diagram that shows all required infonnation. YOIA may include it. rather than lhia P'SC. with )'OW'
MonitOring System Certification. On your site pIan. show the general layout of tanks and pipinS. CJear1y identity
locations of the following equipment. if installed: monitorin¡ system control panels; 5eDSOL'S fIlonitoring tank annular
spaces, sumps. dispenser pans. spill container&. or other secondary containment areas; mcc:ha.nicaJ or eJecaronic line JeaJc
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NOV 04 2002 12:22 BKSFLD FIRE PREVENTION
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CITY OF BþlCRqp'JRI.D
OFnCE OF ENVDtONMBNTAL SBKVlCES
1715 Oesaer Aft., Bakersfield, CA <"I) 326-39'79
APPLICATION TO PBBJ'ORM
PUBLMONlTORING CERTD"JCATlON
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APPaOVIIDBY DATB
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CITY OF BAKERSFIELD
OFFICE'OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3979
APPLICATION TO PERFORM A TANK TIGHTNESS TEST/
SECONDARY CONTAINMENT TESTING
FACll..ITY
ADDRESS
Memorial Center
5201 White Lane, BaKersfield, CA
PERMIT TO OPERATE # 46
OPERATORS NAME Jerry Moore
OWNERS NAME Bakersfield Memorial Hospital
NUMBER OF TANKS TO BE TESTED 1 IS PIPING GOING TO BE TESTED Yes'
TANK #
1
VOLUME
CONTENTS
1 , 000 Gallon
Diesel
t\·:
TANK TESTING COMPANY Redwine Testinq Services, Inc.iRich Environmental
MAILING ADDRESS P.o. Box 1567, Bakersfield, CA 93302-1567
NAME & PHONE NUMBER OF CONTACT PERSON Duqan Turner
TEST METHOD Tn("()n
-"",'''''1'''''' h'··"f"'.'·"'·
661-834-6993
NAME OF TESTER OR SPECIAL INSPECTOR James J. Rich
CERTIFICA TION # . 90-1072 Contractors License 532878 A HAZ
DAi~TOBECONDU1:0:=Sd'Y';;~O ~
APPROVED BY DATE SIGNATURE OF APPUCANT
. .
UNITED STATES POSTAL SERVICE
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First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
· Sender: Please print your name, address, and ZIP+4 in this box ·
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. '''''!¡
BAKERSFIELD AAE OEPARTIAENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Avenue, Suite 300
Bakersfletd, CA 93301
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· 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:
MEMORIAL CENTER
5201 WHITE LANE
BAKERSFIELD CA 93309
3. Service Type
!J Certified Mail
D Registered
D Insured Mail
D, Express Mail
D . Return Receipt for Merchandise
DC.O.D.
4. Restricted Delivery? (Extra Fee)
DYes
2. ¡
7002 0860 OOOIT 1141 6780
PS Form 3811, August 2001
Domestic Return Receipt
102595-02-M-0835
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or PO Box No. 5201 WHITE LANE
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BAKERSFIELD CA 93309
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Certified Mail Provides:
.,A mailing receipt
· A unique identifier for your mailpièce
· A signature upon delivery
· A record of delivery kept by the Postal Service for two years
Important Reminders:
· Certified Mail'may ONLY be combined with First-Class Mail or Priority Mail.
· Certified Mail is not available for any class of international mail.
· NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
· For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
,Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
· For an additional fee, delivery mãy be resfricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery". 7 b
· If a postmark on the Certified Mail receipt is desired, please presentthe arti-
cle at the post office for postmarkinN a poSÌÍT1ark on the Certified Mail
receipt is not needed, detach and,affix lãbel with postage and mail.
IMPORTANwe this receipt and present it when making an inquiry.
PS Form 3800, April 2002 (Reverse) 102595-02-M-1132
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
FilE SAFffi SERVICES' ENV1AOHIlEHTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX(661)32~576
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) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4691
FAX (661) 399-5763
-
C)
.-.
.-.. . 'Íi'
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!.«:,'7 15,
October 31, 2002
Q
Memorial Center
5201 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 / Operator,
If you are receiving this letter, you have!!Q! 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 oerform
this test. bv the necessary deadline. December 31. 2002. will result in the
revocation of your oermit 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.
s7l~
Steve Underwood
Fire Inspector/ Environmental Code Enforcement Officer
Office of Environmental Services
~~7~ /Á!e W~ ~OP ~on? !T~ .A W~"
~'1
BKSFLD FIRE PREVENTION
.
(909) 920-6453
tGGlI852-21?2
p.2
p.2
-
Nov ~4 02 10:2?a
NOV 04 2002 10:11
P.F. Services
.-
CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Ave., Bakersfield, CA (661) 326-3'79
APPLICATION TO PERFORM
FUEL MONITORING CERTIFICATION
FACUnY Bgk[s~e%f/k;;ntJ.( ~cJCM/qP
ADDRESS ;;'0/ 'hi ~ ,~ ~/ .6 -Kersh'eld) C ¿r
OFERAroRSNAME ~y~ .
OWNERSN~ rd-~ .. elJ1.onò.i.. £tl'ff<r
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DOES FACILD'YHA VB DISPENSER PANS? . YEs_ No1
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APPROVED BY
UNITED STATES POSTAL SERVICE
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First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
· Sender: Please print your name, address, and ZIP+4 in this box ·
Œ.
.~
BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Avenue, Suite 300
Bakersfield, CA 93301
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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.
ece.,iV~~( Printed Nam.eJ
- f--.t:J,-c.I·¡¡f-,
D. Is delivery address different from item 1
If YES, enter delivery address below:
1. Article Addressed to:
....
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MEMORIAL CENTER
5201 WITE LANE
BAKERSFIELD CA 93309
3. Service Type
:tJ Certified Mail
o Registered
o Insured Mail
o Express Mail
o Return Receipt for Merchandise
o C.O.D.
4. Restricted Delivery? (Extra Fee)
DYes
2
I
70020860 DODD 1641 7299
PS Form 3811, August 2001
Domestic Return Receipt
102S9S-02-M-0835
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I'- MEMORIAL CENTER
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Postmark
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PS Form 3800, April 2002 _ See Rev
:)J(.."f:Jl' (II ,.,.L"'¡. ....rd. '--' -~_.
Certified Mail Provides:
· A mailing receipt
· A unique identifier for your mail piece
· A signature upon delivery
· A recorti of delivery kept by the Postal SeNice for two years
Important Reminders:
· Certified Mail may ONLY be combined with First-Class Mail or Priority Mail.
· Certified Mail is not available for any class of international mail.
· NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
· For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt seNice, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS postmark"on ~ur Certified Mail receipt is
required. . -
· For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mail piece with the
endorsement "Restricted Delivery".
· If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
· receipt is not_ed, detach and affix label with postage and mail.
IMPORTANT: S ~ is receipt and present it when making an inquiry.
PS Form 3800, April 2002 (Reverse)
102595·02·M·1132
FIRE CHIEF
RON FRAZE
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' EHVtROHIlEHTAL 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-ø576
TRAINING DIVISION
5642 VIctor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697
FAX (661) 399-5763
-
-
.. ~'-'
"" ^
~-
...":p..,...Jo ,~..
October 21, 2002
Memorial Center
5201 White Lane
Bakersfield, CA 93309
CERTIFIED MAIL
I
I
I
I
I
NOTICE OF VIOLA TION¡ & SCHEDULE FOR COMPLIANCE
:
RE: Failure to Submit/Perfonn ~nnual Maintenance on Leak Detection System
I
:
I
I
I
Dear Underground Storage Tank Owner:
I
Our records indicate that your annu~l maintenance certification on your leak detection
system was past due on September 20, 2002.
I
You are currently in violation of Settion 2641 (J) of the California Code of
. I
Regulations. i
I
"Equipment and devices used to mJnitor 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." ¡
I
You are hereby notified that you have thirty (30) days, November 21,2002, to either
perfonn or submit your annual certification to this office. Failure to comply will result
in revocation of your pennit to operltte your underground storage system.
I
I
Should you have any questions, pleÁse feel free to contact me at 661-326-3190.
I
I
Sincerely,
Ralph Huey
Director of Prevention Services
bY:J rt£æ
Steve Underwood
Fire InspectorÆnvironmental Code pnforcement Officer
Office of Environmental Services I
!
cc: Walter H. Porr Jr., Assistant City Attorney
i
¡
""7~ de W~ ~OP AOh?.r~ .A W~"
FIRE CHIEF
RO~I 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)32~576
PUBLIC EDUCATION
1715 Chester Avè.
Bakersfield. CA 93301
VOICE (661) 326·3696
FAX (661) 32~576
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) 399-5763
.
e
September 30, 2002
Memorial Center
5201 White Lane
Bakersfield CA 93309
!
I
REMINDER NOTICE
,
I
!
RE: Necessary secondary containmenti testing requirements by December 31, 2002 of
I
underground storage tank (s) located at: the above stated address.
Dear Tank Owner / Operator,
If you are receiving this letter, you have!!2! yet completed the necessary secondary
containment testing required for all secþndary containment components for your underground
storage tank (s). '
Senate Bill 989 became effective Janu~ 1,2002, section 25284.1 (California Health & Safety
Code) of the new law mandates testing lof 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.
I
Of great concern is the current failure I1;lte 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
. h b' I
m t e tur me sump area. !
For the last five months, this office has tontinued to send you monthly reminders of this
necessary testing. This is a very specialized test and very few contractors are licensed to
I '
perfonn this test. Contractors conducting this test are scheduling approximately 6-7 weeks out.
I
I
The purpose of this letter is to advise ydu 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.
I
This office does not want to be forced t6 take such action, which is why we continue to send
monthly reminders. !
I
Should you have any questions, please feel free to call me at (661) 326-3190.
I
I
I
I
!
~
St ve Underwood I
Fire Inspector/ Environmental Code Enforcement Officer
Office of Environmental Services \
I
i
""7~~ ~~ STop vØt~.r~ A ~~'I'I
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 oW 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
--
.~.
. ,
D August 30, 2002
Memorial Center
5201 White Lane
Bakersfield, CA 93309
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.
Sin::¡erel"
'~"
, '
" .... /
Steve Underwood
Fire Inspector/ Environmental Code Enforcement Officer
Office of Environmental Services
~~--%-~ de W~ §,op ~(}Pß .r~ LÆ W~"
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
21 01 "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· ENVIRONIŒNTAL SERVICES
1715 Chester Ave.
Bakersfield, CA 93301
VOICE (661) 326-3979
FAX (661) 326HJ576
PUBLIC EDUCATION
1715 Chester Ave.
Bakersfield. CA 93301
VOICE (661) 326-3696
FAX (661) 326HJ576
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
-.
-
July 30, 2002
Memorial Center
5201 White Lane
Bakersfield CA 93309
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 perform 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 perform
this test, by the necessary deadline, December 31, 2002, will result in the
revocation of your permit 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:t~
Steve Underwood
Fire Inspector Environmental Code Enforcement Officer
~~~~ de W~ ~.A0Pe .r~ .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
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
-' -."..,...-:>.;~'" .
.'......
1IÞ
--
June 30, 2002
Memorial Center
5201 White Lane
Bakersfield, CA 93309
REMINDER NOTICE
RE: Necessary Secondary Containment Testing Requirement by December 31,
2002 of Underground Storage Tank located at 5201 White Lane.
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 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 will be tested
upon installation, six months after installation, and every 36 months thereafter.
Secondary containment systems installed prior to January 1,2001 will 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.
Si2~
Steve Underwood
Fire Inspectorl Environmental-Code Enforcement Officer
Environmental Services
.,../>i'''f- -..
~." - ,.,-
SUIkr
"Y~ de W~ ~ ~0P6 ff~ 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
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
.
.
Memorial Center
5201 White Lane
Bakersfield, CA,93309
RE: Necessary Secondary Containment Testing Requirement by December 31,
2002 of Underground Storage Tank located at 5201 White Lane
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 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 trom 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.
Sin~ere ," '
,. . // / /',
.~'
Steve Underwood
Fire Inspector/ Environmental Code Enforcement Officer
SBU/kr
. enclosures
""9~de W~ ~ ~0Pe,'.r~ 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 "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'9330B
VOICE (661) 399-4697
FAX (661) 399-5763
-e
«
April 17, 2002
Memorial Center
5201 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
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.
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~Jt ~
Steve Underwood
Fire InspectorÆnvironmental Code Enforcement Officer
SBUldm
enclosures
~~y~ ~ W~ ~ ~tJPe y~ .A W~"
t"lH'10HIAL CENTEH
521] 1 l¡,JH] TE LANE
BAKERSF I ELI) CA
81]5-398-1800
-,
DEC 17. 21]1]1 11]:45 AM
SYSTEM STATUS REPORT
------
ALL FUNCT lONE:; f"JORf"lAL
] NVENTORV FŒPORT
T 1 :DIESEL 2
\!OLUt"1E
ULLAGE
90% ULLAGE=
TC \,JOLUr"lE
HE I (;HT
l,IATER \,JOL
WATER
TH'lP
85:3
146
46
85:3
51] .17
o
0.00
59.9
GALS
GALS
GALS
GALS
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INdiES
DEG F
~ ~ ~ ~ ~ END ~ ~ ~ ~ ~
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITYNAME_i!\CliAKlfl',f ( fLk.-fcr
INSPECTION DATE {:LIt '[Iv I'
I
Section 2:
Underground Storage TanksProgram
o Routine 0 Combined 0 Joint Agency
Type of Tank IIJw Fe <;
Type of Monitoring ( L "'^
o Multi-Agency
Number of Tanks
Type of Piping
o Complaint
r
(J wi=-
ORe-inspection
OPERA TION C V COMMENTS
Proper tank data on tile V
IV
Proper owner/operator data on file /
V
Pennit fees current V /
/
Certification of Financial Responsibility /
V .'
Monitoring record adequate and current V V/
Maintenance records adequate and current V /
Failure to correct prior UST violations V ,/'
/
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
OPERATION Y N COMMENTS
SPCC available
SPCC on tile with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
[[yes, Does tank have overfill/overspiIl protection?
C=Compliance
N=NO
Inspector:
Office of Environmental Services (805) 326-3979
White - Env. Svcs,
Pink - Business Copy
,','
e
.
CITY OF BAKERSFIEIJD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd f'loor, Bakersfield, CA 93301
~~~~~~~ NA~101'~~ l t~{r C
FACILITY CONTACT_
INSPECTION TIME
INSPECTION DATE {~I, 'l(Of
PHONE NO. '31f '( VØO
BUSINESS 10 NO. 15-210-
NUMBER OF EMPLOYEES fO ()
Section 1:
Business Plan and Inventory Program
o Routine
129 Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERATION C V COMMENTS
Appropriate peonit on hand t l/
Business plan contact infoonation accurate L- V
Visible address L V
Correct occupancy Iv /
Verification of inventory materials IL- /
Verification of quantities " /
Verification of location L ./
Proper segregation of material V //
Verification of MSDS availability ,\, /
Verification of Haz Mat training L l/
Verification of abatement supplies and procedures V
./
Emergency procedures adequate V
Iv
Containers properly labeled Iv V
Housekeeping IV" ~
Fire Protection Iv
Site Diagram Adequate & On Hand l V
(\
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
DYes ~NO
Pink - Business Copy
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Inspector:
09/20/2001 04:39 FAX 661 S37 0755
---~ -
~.
MEMORIAL CENTER
,
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CONTRACT ENVIRONMENTAL SERVICE
14759:, MAINE STREET
FONTANA,' CA 92336
. (909). 822-6553
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MONITOR CERTIFICATION
.. . ~i
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CUSTOMER:
LOCATION:
BAKERSFIELD MEMORIAL CENTER
5201 WHITE LANE BLVD.
DATE
BAKERSFIELD, CA
93301
MANUFACTURER VEEDER-ROOT MODEL No. TLS-300C
SERIAL No. 80247071408001 No. OF TANKS 1
ALARMS: VISUAL OK AUDIBLE OK
PRINTER OK MODEM NONE
PROBES: I TANK 1 TANK :'. TANK 3 TANK 4
TYPE OF PRODUCT DIESEL
IN TANK (LIQUID LEVEL) PASS
IN TANK·S,ENSING
ANNULAR SPACE SENSOR PASS ,
SUM~ SENSOR PASS
,"
MONITORING WELL
POSITIVE SHUT OFF Y./N N/A
SAFETY:
INTRINSIC
OK
OK
ELECTRICAL
OTHER
OK
PROBE CONNECTIONS
REMARKS:
"
......-..
,.
THIS IS TO CERTIFY THAT THE ABOVE MONITOR HAS BEEN TESTED BY AN
AUTHORIZED REPRESENTATIVE OF CONTRACT ENVIRONMENTAL SERVICE, HAS
BEEN ADJUSTED AND/OR CALIBRATED AS NECESSARY, AND IS OPERATING
ACCORDING TO MANUFACTURER'S SPECIFICATIONS..
TECHNICIAN; ~
b
ANTONIO DOM~
DATE:
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UNITED STATES POSTAL SERVICE
First-Class Mail .
postage & Fee_Wd
USPS
Permit NO.G-1
d d ZIP+4 in this box ·
·"Sender: Please print your name, ad ress, an .
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BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 Chester Avenue, Suite 300
Bakersfield, CA 93301
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~Iete items 1, 2, and :f5·":·:.~0 complete
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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:
K¡TTY r,INGER
MEMORdr. HOSPITAL
POBOX 119
BAKERSirELD CA 93302
RE:
MEMORIAL CENTER
5201 WHITE LANE
3. Service Type
:t:J Certified Mail
o Registered
o Insured Maií
o Express Mail
o Return Receipt for Merchandise
o C.O.D.
4. Restricted Delivery? (Extra Fee)
DYes
2. Article Number (Copy from service label)
- 000 0520 0021 9625 4982
3811 , July 1999 Domestic Return Receipt
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::2 CI'YiliöiifsIIELD CA 93302 ~,
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Postage $ .34
Certified Fee 2.10
~Postmark'
Return Receipt Fee 1.50 Here'
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees $ 3.94
PS Form 3800, February 2000 See Reverse f.
...I.¡..."'I..,.-.....·..-..~_r_. _
Certified Mail Provides:
, , . A mailing receipt
. .. A unique identifier for your mailpiece
. IÍ A signature upon delivery .
,. A record of delivery kept by the Postal Service for two years
Important Reminders: ' '. " . -
'!II Certified Mail may ONLY be combined with First-Class Man or Priority Mail.
., ÍI Certified Mail is not available for any clàss of international mail.
ÌI NO INSURANCE COVERAGE IS PROVIDED with Certified Mall. For
" valuables, please consider Insured or Registered Mail.
. Ii For an additional fee. a Retum Receipt may b'e requested to provide proof of
delivery. To obtain Return Receipt service. piease complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
, fee. Endorse mailpieèe "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt. a USPS postmark on your Certified Mail receipt is
required.
. For· an additional fee, delivery, may be restricted to the addressee or
. addressee's authorized agent. Advise the clerk or mark the mailpiece with the
, endorsement "Restricted Delivery".
, . If a postmark on the Certified Mail~ipt Is 'ë1esired. please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is n.,eded, detac,h and affi~ label with postage and mail.,
IMPORTANT . this receipt and present it when making an inqúlry.
.-. ".,-...:- "'. . .',
PSForm 3800. Februàrv 2000 (Reverse) . 102595·00·M·1489
, FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 "H" Street
Bakersfield, CA'93301
VOICE (661) 321)-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, CA93301
VOICE (661) 326-3979
FAX (661) 326-0576
TRAINING DIVISION
5642 Victor Ave.
Bakersfield, CA 93308
VOICE (661) 399-4697'
FAX (661) 399-5763
.
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September 6, 2001
Kitty Ringer
, .Memorial Hòspital
POBox 119
Bakersfield Ca·· 93302
CERTIFIED MAIL
NOTICE OF VIOLATION &' SCHEDULE FOR COM·PLIANCE
RE: Failure to Submit/Perform Annual Maintenance on Leak Detection
System at Memorial Center, 5201 White Lane.
Dear Ms. Ringer
Our records indicate that your annual maintenance certification on your leak
,detection system is past due. March 15,2001..
You are Cufrently 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, September 26,2001, to
either perform 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
b~ c£kc
Steve Underwood
Fire Inspector/Environmental Code Enforcement Officer,
Office of Environmental Services
cc: Walt Porr,Assistant City Attorney
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C .J.~g.tY._.BJ1!K~Œ....._. . '
C Street, Apt. No.; or PO Box No.
C 5201 White' Lane ,.'
~ ë~~idPil;ïdcA "93"309 -~
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Postage $ .34
Certified Fee 2.10
Return Receipt Fee 1.50 Postmark
(Endo(Sðment Required) Here
Restrtcted Delivery Fee
(Endo(SðmenfRequlred)
Total Pos1age & Fees $ 3.94
:..
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10259,5-00-M·14811
PS Form 3800, February 2000 (Reverse)
~
. Certified Mail Provides:
'. '. A mailing.réc.¡¡ipt
· A unique identifier for your mailpiece
· A signature upon delivery ,
, .. A record of delivery kept by the Postal Service for two years
Important Reminders: '" '.
., Certified Mail may ONLY be combined with First-Class Mail or Priority Mail,
, . Certified Mail is not available for åíiy class of International mail.
· NO INSuRANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables. please ,consider Insured or Registered Mail.
· For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
· Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Retum Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS postmark on your Certified Mail receipt is
required.
· Foran additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery·~. ..' ~
. . If a postmark on the Certified Ma~"rèceipt f~ desired, please present the arti-
cle at the .post, office for postmarking. If a postmark on the Certified Mail
receipt isweeded. detach and affix labèl with postage and mail.
IMPORTAN . e this receipt and p~esent it when making an inquiry.
FIRE CHIEF
RON FRAZE
ADMINISTRATIVE SERVICES
2101 MHM Street
Bakersfield, CA 93301
VOICE (661) 326·3941
FAX (661) 395-1349
SUPPRESSION SERVICES
2101MH" 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
-
.
~'ft!J,~ ~ ~~.
August 27, 2001
Kitty Ringer
Memorial Center
5201 White Lane
Bakersfield Ca 93309
CERTIFIED MAIL
NOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE
RE: Failure to Submit/Perfonn Annual Maintenance on Leak Detection
System
Dear Ms. Ringer
Our records indicate that your annual maintenance certification on your leak
detection system is past due. (March 15,2001.)
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, September 26,2001, to
either perfonn or submit your annual certification to this office. Failure to comply
will result in revocation of your pennit to operate yòur underground storage
system.
Should you have any questions, please féel free to contact me at 661-326-3190.
Sincerely,
Ralph Huey
Director of Prevention Services
bY:/L ~.
Steve Underwood
Fire InspectorlErivironmental Code Enforcement Officer
Office of Environmental Services
cc: Walt Porr, Assistant City Attorney'·
--y~ ~ CC~' §,op ./160Pe y~ A.~~"
Kitty Ringer
Memorial Center
5201 White Lane
Bakersfield Ca 93309
FIRE CHIEF _hNOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE
RON FRAZE
RE: Failure to Submit/Perforrn Annual Maintenance on Leak Detection
~ADMINISTRATIVE·SERVICES- - - -- - =-""'Svstêm ~ ~ <'~- .-
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 27,2001
CERTIFIED MAIL
Dear Ms. Ringer
Our records indicate that your annual maintenance certification on your leak
detection system is past due. (March 15, 2001.)
You are currently in violation of Section 2641 (J) of the California Code of
.R:egülatiòns;/') ;,:~,''::;: ,.::'~;: ,:: ¡:'. ·.i':.>
L: !..:~':;
'"'....'. ~:~" .;: -}. :='i;:
J:::;'\~'~~:- :S]';:~:.;-:¡ (~.
'·.'Equipmerit··árid 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, September 26,2001, to
either perform or submit your annual certification to this office. Failure to comply
will result in revocation of yoUr permit to operate your underground' storage
system.
_. .8l.!ould you have any questions, please feel free to contact me at 661-326-3190.
...... ___ .' __'_ _" _.__ ~ _ __ '.. ~ ___.......,..__ 4 ____.__--__ ---... ..... ..___-.__ _
---.........-- t .~ -- -"-
Sincerely,
Ralph Huey
Director of Prevention Services
. ,.,'
by: ~. - d£i;C-- -. ." . -'.
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Sté\ie:UiiderWoóö:·/.:::.:,~:; 'j'iC, ~:' "/;,";;., '.""; .'.. :;:_~_~;;::~~ ¡';::J::~
Fire Inspector/Environmental Code Enforcement Officer
bffice öf Environmental Services
:-:'.:
..:..
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cc: Walt Porr, Assistant City Attorney
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"= "_ _ _:~-, '~..:-~='¿~.::,...~.._c.:: ~_;"<"""'_'",,,,~~=-~_ ~~":.",,¿-,_r.~
· 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 ifspace permits.
1. Article Addressed to:
Kitty Ringer
Memorial Center
5201 White Lane
Bakersfield CA 93309
C. Signature
o Agent' " I:
o Addressee [
o Yes I
o No '
x
D. Is delivery address different from item 1?
If YES, enter delivery address below:
3. Service Type
~ertified Mail
o Registered
o Insured Mail
o Express Mail
o Return Receipt for Merchandise
o C.O.D.
4. Restricted Delivery? (Extra Fee)
DYes
2. Article Number (Copy from service label)
7000 0520 0021 9610 7844
PS Form 3811, July 1999 Domestic Return Receipt
. :,',1'-
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.'-- .._-._-~_...~..~.
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102595-99-M,1789
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CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
;:o<¡;~~~ N~~Efc~ ~~r
FACILITY CONTACT
INSPECTION TIME
INSPECTION DATE (J (J () 0
PHONE NO. ?J 1 ~ ,,' too
BUSINESS ID NO. 15-210-
NUMBER OF EMPLOYEES I (JO
Section 1:
Business Plan and Inventory Program
o Routine 'W Combined
o Joint Agency
o Multi-Agency
o Complaint
ORe-inspection
OPERA TION C V COMMENTS
Appropriate penn it on hand \".. ,r
r
Business plan contact infonnation accurate V
Visible address L..- ,
Correct occupancy V
Verification of inventory materials (". /
Verification of quantities t... /
V ,¡I'
Verification of location
Proper segregation of material V "..-
Verification of MSDS availability V ,.r
Verification of Haz Mat training V /'
Verification of abatement supplies and procedures v ,/
Emergency procedures adequate r
V
Containers properly labeled r
V
Housekeeping v' -
Fire Protection ./
v ,
Site Diagram Adequate & On Hand
C=Compliance
V=Violation
Any hazardous waste on site?:
Explain:
DYes DNo
\
Pink - Business Copy
Questions regarding this inspection? Please call us at (661) 326-3979
White - Env. Svcs.
Yellow - Station Copy
Insp~ctor:
- ~---------.------
¡" Ef"¡':)R I AL GENTEF.'
5201 klH ITE LANE
BAKERf3F I ELD CA
805-:398-1 tlOO
DEC 1. 2000 8:49 AM
:3YSTEtv1 f3TATUE; REPORT
------
ALL FUNCT [ONE; NORr" AL
INVENTORY REPORT
T 1 :DIEE:EL 2
VOLUf"IE
ULLAGE
9ü:i. ULLf-1GE"
TC \/0 L Ut"lE
HEIGHT
I¡,JATER \/OL
[dATER
TEf"IP
717
282
182
71:3
42.52
o
0.00
57.7
GALS
GALS
GALS
GALS
I NCHH:;
GALS
INCHES
DEG F
- ~ ~ ~ ~ ~ END ~ M M M M
e
CITY OF BAKERSFIELD FIRE DEPARTMENT
OFFICE OF ENVIRONMENTAL SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301
FACILITY NAME(\\(lo1h~Lll( ~c('t~r -tt) r &~lIlOt"'loJ INSPECTION DA TEI:2 {i ((J 0
t-ka.(-t....
Section 2:
Underground Storage Tanks Program
o Routine tíJ Combined 0 Joint Agency
Type of Tank J)c.ùFcS
Type of Monitoring I'LM
o Multi-Agency 0 Complaint
Number of Tanks (
Type of Piping I\uJ t=-
ORe-inspection
OPERA TION C V COMMENTS
Proper tank data on tile /
V
/'
Proper owner/operator data on file V
Permit fees current /
V
Certification of Financial Responsibility V /
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 1/
Section 3:
Aboveground Storage Tanks Program
AGGREGATE CAPACITY
Number of Tanks
TANK SIZE(S)
Type of Tank
OPERA TION 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?
C=Compliance V=Violation Y=Yes
lo,pecto, _Æ.; (ittMfù
N=NO
Oftìce of Environmental Services (805) 326-3979
White - Fnv. Svcs.
~
ite Responsible Party
Pink - Business Copy
-iP
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_.n__·'_______,._,__,___.. -M,"
STATEOFCAUFORNIA .
STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLlCA nON· FORM A
COMPLETE THIS FORM FOR EACH FACILJTYlSrrE
MARK ONLY ~ 1 NEW PERMIT
ONE ITEM tJ 2 INTERIM PERMIT
o 3 RENEWAl PERMIT
o 4 AMENDED PERMIT
o 5 CHANGE OF INFORMATION 0 7 PERMANENTLY CLOSED SITE
D 6 TEMPORARY SITE CLOSURE
FACILITY/SITE INFORMATION & ADDRESS· (MUST BE COMPLETED)
DB NAME OF OPERATOR
~j1b
PARCEL # (OPTIONAl)
D INDIVIDUAL
D PARTNERSHIP, 0 lOCAl·AGENCY
DISTRICTS
O .,/ IF INDIAN # OF TANKS AT SITE E. P. A.
RESERVATION
~5'OTHER"" ~~'OR'TRl:JSn:ANDS- . .k~/·~~·~" == .~- --.
D COUfiTY-AGENCY
D STATE·AGENCY
o FEDERAl·AGENCY
l D. # (optional)
--:.'~-
..__.-. _ _~~'5-¡
EMERGENCY CONTACT PERSON (SECONDARY). optional
. DAYS: NAME (LAST, FIRS'!) PHONE # WITH AREA CODE
NIGHTS: NAME (lAST, FIRS'!)
PHONE # WITH AREA CODE
CARE OF ADDRESS INFORMATION
.,/ box Ie Indicate D INDIVIDUAL 0 LOCAL.AGENCY
~ORPORAT10N D PARTNERSHIP
I STATE.A- ZIP CODE .
Cn ~33& {
CARE OF ADDRESS INFORMATION
D INDIVIDUAL
D PARTNERSHIP
o LOCAL·AGENCY 0 STATE·AGENCY
D COUmY·AGENCY D FEDERAL·AGENCY
PHONE # WITH AREA CODE
. :2 7'/79~
Legal notification and billing will be senllo the tank owner unless box I or II is checked.
CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING: II. 0 III. D
THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT
COUN7Y #
CD
, JURISDICTION #
ITIJ
FACILITY #
CITIIIJ
LOCA TlON CODE . OPTIONAL
CENSUS TRACT #, . OPTIONAL
SUPVISOR· DISTRICT CODE . OPTIONAL
THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION· FORM 8, UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY.
FORM A (9.90) FOROOO3A
-
MARK ONLY
ONE ITEM
STATE OF CALIFORNIA
STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B
.-- -- --=-
----
-
COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM.
~1 NEW PERMIT
o 2 INTERIM PERMIT
o 3 RENEWAL PERMIT
o 4 AMENDED PERMIT
-
- -
"""""'"
~
~~
~-"""
~~-.
....
--
-
-
..
Li;:\
I. TANK DESCRIPTION
COMPlETE ALL ITEMS - SPECIFY IF UNKNOWN
o 5 CHANGE OF INFORMATION
o 6 TEMPORARY TANK CLOSURE
~ ð { (! ~J1 P
o 7 PERMANENTLY CLOSED ON
o 8 TANK REMOVED
A. OWNER'S TANK I. D.'
C. DATE INSTALLED (MOIOAYiYEAR) ,,_ i í' - B 7
B. MANUFACTURED BY: ;:¡- Q 0 B..
D. TANK CAPACITY IN GALLONS: / & () 0
II. TANK CONTENTS
IFA·1ISMARIŒD,COMPLETEITEMC.
A. 0 1 MOTOR VEHICLE FUEL 0 4 OIL
:g¡. 2 PEiROLEUM 0 80 EMPTY
o 3 CHEMICAL PRODUCT D 95 UNKNOWN
. - -0: ~ìF (A.1î IS Nor MÃÃKED-:ENTEÀ NAMÈ ÒF SUBSTANèESTORED'
B.
~
o
1 PRODUCT
2 WASTE
C 0, 1a REGULAR -a 3 DIESEL 0 6 AVIATION G
. UNLEADED '
o 1b PREMIUM 4 GASAHOL 0 7 METHANOL
UNLEADED 0 5 JET FUEL
o 2 LEADED 0 99 OTHER (DESCRIBE I~ ITEM 0_ BEL
~ ::¿~-- -', -- -ê.-Á.S:~: 62476:".34-b·--
A. TYPE OF
SYSTEM
III. TANK CONSTRUCTION
'Ø 1 DOUBLE WALL
o 2 SINGLE WALL
3 SINGLE WALL WITH EXTERIOR LINER
4 SECONDARY CONTAINMt'i:ä{T~
B. TANK
MATERIAL
(Primary Tank)
C. INTERIOR
LINING
D. CORROSION
PROTECTION
MARK ONE ITEM ONLY IN BOXES A, B, AND C, AND ALL THAT APPLIES IN BOX D AND E
18::'1 BARE STEEL (/JIlt'/. 02 STAINLESS STEEL
o 5 CONCRETE 0 6 POLYVINYL CHLORIDE
o 9 BRONZE 0 10 GALVANIZED ,STEEL
o 1 RUBBER LINED 0 2 ALKYD LINING
'M 5 GLASS LINING 0 6 UNLINED
~ ~ING MATERIAL COMPATIBLE WITH 100% METHANOL? YES _ NO_
o 1 POLYETHYLENE WRAP 0 2 COATING
o 5 CATHODIC PROTECTION 0 91 NONE
E. SPILL AND OVERFILL
SPILL CONTAINMENT INSTALLED (YEAR)
IV. PIPING INFORMATION
A. SYSTEM TYPE
B. CONSTRUCTION
0 3 FIBERGlASS
0 7 ALUMINUM,
0 95 UNKNOWN
0 3 EPOXY LINING
0 95 UNKNOWN
o 3 VINYL WRAP
o 95 UNKNOWN
o
o
95 UNKNOWN
99 OTHER
4 STEEL CLAD WI FIBERGLASS REINFORCED PLAS
o a 100% METHANOL COMPATIBLE WIFRP
o 99 OTHER
o 4 PHENOLIC LINING
o 99 OTHER
~, FIBERGLASS REINFORCED PLASTIC
Ó ~9 OTHER
OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR)
A U 3 GRAVITY
A Ù 3 LINED TRENCH
CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE
VI. TANK CLOSURE INFORMATION
A U 2 PRESSURE
A U 2 DOUBLE WALL
2. ESTIMATED QUANTITY OF
SUBSTANCE REMAINING
1. ESTIMATED DATE LAST USED (MO/DAYiYR)
STATE I.D.#
COUNTY #
IT]
JURISDICTION #
[II]
A U 99 OTHER
A U 95 UNKNOWN
A U 99 OTHER
C. MATERIAL AND 1 BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC) U 4 FIBERGlASS .PIPE
CORROSION 5 ALUMINUM A U 6 CONCRETE A ø 7 STEEL WI COATING A U a 1000/. METHANOL COMPATIBLE WIF~
PROTECTION 9 GALVA-NIZED STEEL A U 10 CATHODIC PROTEÇTION A U 95 UNKNOWN A U 99 OTHER
'.. -.-^. ~-~------ ,-
D. LEAK DETECTION 1 AUTOMATIC LINE LEAK DETECTOR o 2 LINE TIGHTNESS TESTING o 3 INTERSTITIAL o 99 OTHER
MONITORING
V. TANK LEAK DETECTION
o 1 VISUAL CHECK 0 2 INVENTORY RECONCILIATION 0 3 VAOOZE MONITORING ~ AUTOMATIC TANK GAUGING 0 5 GROUND WATER MONITOR I:
o 6 TANK TESTING gj 7 INTERSTITIAL MONITORING 0 91 NONE 0 95 UNKNOWN 0 99 OTHER
3. WAS TANK FILLED WITH
GALLONS INERT MATERIAL?
YES 0 NO C
THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORREC
APPLICANTS NAME
(PRINTED & SIGNATURE) ¡¡;¡ / I /
LOCAL AGENCY USE ONLY THE STATE J.D. NUMBER IS COMPOSED OFTHE FOUR NUMBERS BELOW
FACILITY # '
CIIIIIJ
TANK #
DIIIIJ
PERMIT NUMBER
PERMIT EXPIRATION DATE
PERMIT APPROVED BYIDATE
FORM B (7-91)
THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED.
FOR0034 '
-'
"
~/
..
.
lf~ -
, .~¡
I/PR--' Þ€1J
'l3y. Î' ?OOO'
.~
II
CONTRACT ENVIRONMENTAL SERVICE
14759 MAINE STREET
FONTANA, CA 92336
(909) 822-6553
II
MONITOR CERTIFICATION
CUSTOMER:
LOCATION:
BAKERSFIELD MEMORIAL CENTER
5201 WHITE LANE BLVD.
DATE
3-30-00
BAKERSFIELD, CA
93301
MANUFACTURER
VEEDER-ROOT
MODEL No.
TLS-300C
-~-:----'--
____ "____- ~.o..____ _,
~----- ~,..--...,_...",."'¡;'- --=~- ~ .----. .-- --
: - _-,,__' ,,~. - ._ ..-_ ,-""_0-"':.,
--- ~...... ..:--'
SERIAL No.
ALARMS:
VISUAL
PRINTER
OK
OK
No. OF TANKS
AUDIBLE
MODEM
1
OK
NONE
80247071408001
PROBES: I TANK 1 TANK 2 TANK 3 TANK 4
TYPE OF PRODUCT DIESEL
". ..- "' . - '"
IN TANK (LIQUID LEVEL) PASS ,.
-
IN TANK SENSING
'. r' " ,-. -,"
-. ....-,. -
ANNULAR SPACE SENSOR ,.- ~, . - PASS . , -, - _r" ", ) ,
. , . .
SUMP SENSOR PASS ,
MONITORING WELL
POSITIVE SHUT OFF Y/N N/A
SAFETY:
INTRINSIC
OK
OK
ELECTRICAL
"OTHER
OK
PROBE CÖNÑECTIÔÑS
REMARKS:
THIS IS TO CERTIFY THAT THE ABOVE MONITOR HAS BEEN TESTED BY AN
AUTHORIZED REPRESENTATIVE OF CONTRACT ENVIRONMENTAL SERVICE, HAS
BEEN· ADJUSTED. AND/OR CALIBRATED AS NECESSARY, 'AND"- IS ' OPERATING
Ac:CORDING TO. MANUFACTURE~'.S SPECIFICAT.IONS.
TECHNICIAN:
110
ANTONIO D~UEZ
_... ,.- - "
- . -- .
DATE:
-"
, 3-30-00
·
["IEf"10R I AL CEI'-JTER
5201 l¡JH I TE LAI'. [
BA)ŒF!~::~F I ELD CA
805-::398-1800
DEe 20. 1999 1: 10 pr"J
SYSTEr"l ~::;TATUS REPORT
-+-_._---
ALL FUNCI ION:::; NO¡;::t"lAL
e
["lH'10R I AL CENTEF:
'--5 2o.L .LJ H LT-E-Lèl'lE
BAIŒF:SF r ELD Cf1
805-398-1E:00
DEe 20> 1 '3':i9 1: 10 e
SVSTEJ" :3TATU:::; REPOF:T
--~--~--
ALL FUNCT I o I ', f, [" OHI"1AL
I N\iEr~TOR"" F:EF'OF:T
T 1: D I E~3EL 2
VOLUJ'1E
ULLAGE
9œ~ ULU~GE=
Te VOLUr"1E
HE WHT
~JATER VOL
~JA TER
TEr"lP
858
141
41
859
50.48
o
[1.00
55. '3
GALB
GALS
l~~ALS
GALS
I NC HH3
GAL~3
INCHES
DEG F
....I..~....Jf..
M M ~ M ~ END . ~ ~
-,,-
...,,,M·.'·'· ¡,.- ,
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 \1\lWIOtl(\.( Ii~kt- {'or- ~(h'llJIl!rø(
INSPECTION DATE 1J.""dO -19
Section 2:
Underground Storage Tanks Program
o Routine 0 Combined urloint Agency
Type of Tank J)1.ùR:5
Type of Monitoring CL-.M
o Multi-Agency 0 Complaint
Number of Tanks I
Type of Piping .f\W¡:::'
ORe-inspection
OPERA nON C v COMMENTS
Proper tank data on tile J
Proper owner/operator data on tile V
Pennit fees current v'
Certification of Financial Responsibility V
Monitoring record adequate and current 1,'\/
Maintenance records adequate and current V
Failure to correct prior UST violations LI
Has there been an unauthorized release? Yes No 1/
Section 3:
Aboveground Storage Tanks Program
AGGREGATE CAPACITY
Number of Tanks
TANK SIZE(S)
Type of Tank
OPERA nON Y N COMMENTS
SPCC available
SPCC on tile with OES
Adequate secondary protection
Proper tank placarding/labeling
Is tank used to dispense MVF?
[fyes, Does tank have overfill/overspill protection?
c~comPJi'~ V~Violation V~Y"
Inspector: 'u d~
Oftìce of Environmental Services (805) 326-3979
White - Env, Svcs.
N=NO
-flJ.AAtf ~
Bu iness Si e Responsible Party
Pink - Business Copy
\..
FRESNO
LAS VEGAS
LAUGHLIN
LOS ANGELES
PALM SPRINGS
PHOENIX
SACRAMENTO
SAN DIEGO
SAN FRANCISCO
Haney Affiliates, Inc.
dba
DOCTOR DIESEL
Mailing Address
PO Box 36216
Los Angeles. California 90036
4221 WILSHIRE BOULEY ARD
SUITE 170-5
LOS ANGELES, CALIFORNIA 90010
Telephone 323.934.3755
Facsimile 323.934.3786
February 19, 1999
Memorial Center Hospital
5201 White Lane Boulevard
Bakersfield, California 93309
Attention: Jerry Moore
Re: Monitor Certification Certificate
Gentlemen:
Enclosed for your files is the Monitor Certification Certificate.
Thank you for letting us be of service to you.
Sincerely,
DOCTOR DIESEL
Carole Haney
/ch
Enclosure
e
.--....
.-
tit
e
CONTRACT ENVIRONMENTAL SERVICE
2058 N. MILLS AVE., STE. 107
CLAREMONT, CA 91711
(909) 445-1266
II
MONITOR CERTIFICATION
II
CUSTOMER:
LOCATION:
BAKERSFIELD MEMORIAL CENTER
5201 WHITE LANE BLVD.
DATE
2-9-99
BAKERSFIELD, CA
93301
~IMiUFACTURER VEEDER-ROOT MODEL No. TLS-300C
SERIAL No. 80247071408001 No. OF TANKS 1
ALARMS: VISUAL OK AUDIBLE OK
PRINTER OK MODEM NONE
PROBES: I TANK 1 TANK 2 TANK 3 TANK 4
TYPE OF PRODUCT DIESEL
IN TANK (LIQUID LEVEL) CK'D
IN TANK SENSING
~
ANNULAR SPACE SENSOR CK'D
SUMP SENSOR CK'D
MONITORING WELL
POSITIVE SHUT OFF Y/N N/A
SAFETY;
INTRINSIC
OK
PROBE CONNECTIONS
OK
ELECTRICAL
ÖTHER
OK
REMARKS: REPLACED POWER LAMP
THIS IS TO CERTIFY THAT THE ABOVE MONITOR HAS BEEN
AUTHORIZED REPRESENTATIVE OF CONTRACT ENVIRONMEN~AL
BEEN ADJUSTED AND/OR CALIBRATED AS NECESSARY, AND
ACCORDING TO MANUFACTURER'S SPECIFICATIONS.
b
TECHNICIAN: ANTONIO DOMI~
TESTED BY AN
SERVICE, HAS
IS OPERATING
DATE:
2-9-99
.-
FIRE CHIEF
RON FRAZE
ADMINISTRA1lVE SERVICES
2101 ·W Street
Bakersfield, CA 93301
VOICE (805) 326-3941
FAX (805) 395-1349
SUPPRESSION SERVICES
2101 ·W Street
Bakersfield, CA 93301
VOICE (805) 326-3941
FAX (805) 395-1349
PREVENTION SERVICES
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 DMSION
5642 Victor Ave.
Bakersfield. CA 93308
VOICE (805) 399-4697
FAX (805) 399-5763
--
.-
F ebruàry 9, 1999
Memorial Center for Behavioral
5201 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¡~
Steve Underwood
Underground Storage Tank Inspector
Office of Environmental Services
SBU/dm
enclosure
""7~ ófe, W~ ~ ~o'e .9'"'~ A W~?"
f''lEf''lCR I AL CENTEF:
5201 I""IH I TE UH,¡E
BAKERfT I ELÜ C~i
805'-:]98-1800
APR 13. 1998 9:00 AM
SYSTEr1 STATU:':; F:EPORT
------
ALL FUNCT Iott':: NORt"IAL
e
. ,
------¡-o-_-'. ~~___.-.:.:.::._. _~ -.:.-_____~
r"lEf"j,;~:.R 1 AL CENTER
5201 bJH I TE LANE
BAKEF::3F lEU' '::A
805- :]9B-1 BOO
Ai13. 1998
'3 : 00 P.1·1
~r'!STH'1 ~':;THTUf.; f:EP(ŒT
--------.
0.- __ _ _, ". _~
ALL FUNCT IONf3 I"J(:'F:I"IAL.
I N'v'ENTORV REF\:·frr
T I: DIESEL 2
V(iLUfvIE
ULLAGE
90% ULLAGE=
Te VOLUf"IE
HEIGHT
l¡,JATER \/OL
WATER
TEfv!P
602 GAL:3
:3'3 7 GAL~3
2137 GALE·;
6 (f~! GAL:3
:~:6 . 60 ] NCHES
[¡ GAL£:~
o . 00 ] I\JCHE:':~
5'1.'1 DEG F
~.¥
,.
¥ ;.! END
~.~¥¥~
~ .......
1_
'. .~
" .'
-
.
I
RICH ENVIRONMENTAL
5643 BROOKS CT BAKERSFIELD,CA.93308
OFFICE(805)392-8687 & FAX(805)392-0621
ALERT 1000 UNDERFILL AND ALERT 1050 ULLAGE SYSTEM
Precision Underground Storage Tank System Leak Test
TEST RESULTS
Test Date:02-25-98
BILLING:E.L.G. ENVIR.CONSTR.
4409 ADIDAS
BAKERSFIELD, CA
SITE:MEMORIAL CENTER
5201 WHITE LANE
BAKERSFIELD, CA
PRODUCT
%FULL
WATER IN
TANK
NON-WETTED
PORTION
PRODUCT
LINE
WETTED
PORTION
LEAK
DETECTOR
VOLUME
( GAL )
DIESEL
1000
67% +0.026
0"
NO TEST ELEC.MONITOR
PASS
WATER BALANCE
Measurements showed that water in the backfill area at the time
of testing was below tank bottom, and therefore not a facter in test
determination. A monitoring well or a well point was driven in the
backfill area to determine that there is no water in the backfill at
tank bottom.
A precision test was performed on tanks at the above location using the
Alert 1000 underfill system and the Alert 1050 ullage system. I have
reviewed the data produced in conjunction with this test for purpose of
verifying the results and certifying the tank systems. The testing was
performed in acorrdance with Alert protocol, and therefore satisfies all
requirements for such testing as set .forth by NFPA 329-92 and USEPA 40
CFR part 280.
The results of testing are shown on the following page, and indicate
whether the wetted and non-wetted portion passed or failed. Included
with the report are reproduction of data compiled during the test which
formed the basis for these conclusion. This information is stored in a
permanent file if future verification of test results is needed.
AL\NC 040
Test Certified By:
i!:7 ¿(k/
State cert#99-1072
;.: .,,-,
~ \.,.',':~;; ¡:.
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.......
nIESEL
1.026
750+
¡ ALERT TECHNOLOGIES
I
PLOT OF ULLAGE TEST DA TA
MEMORIAL CENTER
5201 WHITE LANE.
BAKERSFIELD. CA
1000 GALLON DIESEL TANK
12KHz AMPLITUDE RATIO 25KHz AMPLITUDE RATIO
0.7 1.5 750+ 1.5
M M
I I
N N
U U
T 3 T 3
E E
S S
5 5
12KHz DETECTION RATIO = 1. 00 25KHz DETECTION RATIO = 1.00
TEST RESULT = PASS
DATE AND TIME OF TEST 2/25/98 8: 22PM
BEGINNING BOTTLE PRESSURE = 2BOO ENDING BOTTLE PRESSURE = 2600
BEGINNING TANK PRESSURE 1.5 PSIG ENDING TANK PRESSURE 1.5 PSIG
(.
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CITY OF BAKERSFIELD '
OFFICE OF ENVIRONMENTAL SERVICES
UNDERGROUND STORAGE TANK PROGRAM
1715 Chester Ave., Bakersfield, CA (805) 326-397~,_
APPLICATION TO PERFORM A TANK TIGHTNESS TEST
FACILITY !1Je/Jz;,e£1t/ d~'£
ADDRESS 1S:;¿o I ¿¿¡// ffÞJvG"
PERMIT TO OPERATE #
OPERATORS NAME
OWNERS NAME
NUMBER OF TANKS TO BE TESTED /
TANK # VOLUME
/ /¿)Od
,
IS PIPING GOING TO BE TESTED ,;4 cJ
. CONTENTS
J.("~ 6 è
TANK TESTING COMPANY . ,¿;è/T ~-;;;v/~Còne~T~(' '
MAILING ADDRESS £<::13 µ<XJ~s(?~_ ~A?d"¿k 933d8
NAME & PHONE NUMBER OF CONTACT PERSON .~ <::55;.;J -8~c9?
TEST METHOD /4~;¿//¿)CJ() OtV.(JêRr/¿¿ â~;:;-A/ /ò'ffò ¿'jI Úf,¢
NAME OF TESTER ~~~ ~#
CERTIFICATION # %- //J 7 2_
.
DATE & TIME TEST IS TO BE CONDUCTED
;Z - if-C( r·
DATE
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1-UIIZ..JM1 CQORDINATOQ
(SOS) 326-391"
, ' . ,
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U805 326 0_
BFD HAZ MAT DIV
.
CITY of BAKERS FlEW FIRE DEPARTMENT
FIR£ SAFEn'SERf/leES & OFFICE OF E.¥Y/RGY.VEiVTdl. ~i£RV/CES
1715 CHeSTE~ AVE. . BAKERSAELD, CA · 93301
IUt. 108IA$.
FIRE MARSHAl
CI!C5) 326-J9S1
TANK INTEGRnY TESTING INSPECTION FORM
---
THIS FORM MUST 'ijE COMPLETED AT TIME OF 'INTEGRITY TEST BY THE
TECHNICIAN ON ~ AND SL'"BMITrED WITH THE TAN!( INTEGRITY TE£T
Facility Permit to Operate Number
Facility Permit to Tjgbmes.s Test Number
Facility Name /V1 ¡Ç M 0 {( ¡ III L C>r;;: ÁIT'F fl
Facility Address -:')zø 7 Lv 1-117F LAA~
facility Telephone NUIr..:Jer
Have you complied with the following saiety requirements
YES/NO
V'b',)
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/
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The area within 25 (eet aÎ ilnY underground storage tank opening is free of
smoking. open flames. and any other source of ignition.
Legible signs with th~ worås ..~O SMOKING" are posted in conspicuous
locations around the testing area- .
The general public is restricted. trom the testing a.~a by rape. flags., cones. and
"if dark" a fluorescent bamer.
Fire protection in the form of a 1. ~ !OBC fire extinguisher is located within the
restricted area.
Vehicles utilized during the testing period. or within 25 feet of the underground
5tOrage tank opening. have adequate ventilation. and the tester has equipment
which can be utilized to monitor the concentration Ot flammable vapors within
the vehicle.
Personal protective equipm~nt. an eye wash and g1oves, and a site safety plan
are within the testing area.
Equipment/materials is available to absorb and contain any smaJI release of
testing liquid which is discharged as a result' of the teSt. (Exa1!1ples include
DOT-acceptable containers for storage of the absorbent and an adequate
supply of absorbent).
If the answer to any of the above quotions is NO. Stop the testing procedure IMMEDIATEI_Y
until compliance is obtained.
1£5
~lf7
COMPLETE REVERSE SIDE
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JOB ORDER FORM
DA'Æ 0fIm£R!D . '. DAT! TESTING Rl!QU!S1!D ~ -~~-9~. /Vlð /.J
CO.ANY: BILL' I'JG AJ>ÞRêsS SITE:
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PHON! :
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. OOME. AND R£'NRtŒD ~ FAX OR MAIl.
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COMMÐfTS ("*".W...."... .....Ibofe) :
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONMENTAL SERVICES
UNDERGROUND STORAGE TANK PROGRAM
1715 Chester Ave., Bakersfield, CA (805) 326-3979
APPLICATION TO PERFORM A TANK TIGHTNESS TEST
FA~ILITY l1JeÆ:JR#t / d~'Æ:
ADDRESS' ~.;¿ol' b)1/~~{;
PERMIT TO OPERATE #
OPERATORS NAl\1E
OWNERS NAl\1E
NUMBER OF TANKS TO BE TESTED / IS PIPING GOING TO BE TESTED ,.t.( cJ
TANK # VOLUME
/ /¿JOd
.
. CONTENTS
ð~~¿?f C
TANK TESTING COMPANY . -Z jWPO>;17:iJ:¿,(· ..
MAILING ADDRESS "£cf3 ~t:E~,--G~_ ~¿q;¿k 9JßÒ8
NAME & PHONE NUMBER OF CONTACT PERSON .~ ~..;J -8~/l?
TEST METHOD ~,4~¿//¿)ÓO o.y~/¿¿ ~h /offò bÚf-¢
NAME OF TESTER ~~~ ~# .
CERTIFICATION # % - /t1 7 2
r
DATE & TIME TEST IS TO BE CONDUCTED
;2...- if-C? r·
DATE
Sent by: MEMORIAL CENTER
805 8370755;
12/30/97 16:57; JeHã% #681;Page 1/3
_.
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.
CMR
far Behaviorr:zl. ¡.r£Lilih
5201 White Lane
Bakersfield, CA 93309
Y A C S I K ~ L E
TRANSHIT'rAL
'1'0:
)'rr: V€ rjl{ Ð elL 'IIrpf)
FROH:
/)/)(/6 MOOR-e
/;/z,/q)
DATE:
NO. OF PAGES: 9-
(inc~ Cover Page)
If there are any problems with th~ transmission of this telecopy~
please call (80S) 398-1800, ext. ~/~
COHK2N'1'S:
~acsimile N~er is: (80S) 637-07SS~
**CONFIDEN'rIALITY NOTICE..
The document.s accompanying this telecopy transmission con:t.ail1
CONFZDENT~ INFORKA~ION belonging to the sender that is legally
privi~eged. The info~ation is inten4ed only for the Use of the
individual or entity listed above. If you are nQt the ~ntended
recipient, you are hereÞy notified that any disc1osure, copying,
äist.ribution, use, or taking of any aetion en reliance on the
contents of this telecopied CONFIDENTIAL INFORMATION 15 strictlY
prob.ibited. If you have received this telec:opy in errorr plea.se
notify us be telephone ~ediately to ~rranqe for re~urn Qf the
oriqinal te~ecopy transmission.
FAX. SET
~............... ...... ".
~. . . - ..., .. ----- .---. ---- ~ ----
Sent by: MEMORIAL CENTER
11/12/97 12:51
805 8370755; 12/30/97 16:58; JetIãx #681 jPage 3/3
U80tt26 057e BFD HAZ ¥AT DI'e @002
EMERGENCY RESPONSE PLAN
UNDERGROUND STORAGE TANK MONITORING PROGRAM
11W: .aaoa;toriq pIVp'aID IIUØII:Ie kqn ill the UST lQC:1åac all aU åJDcs. ~ ÙICOrmauoa oa WI moJIÍlariø¡
pn::tøram ..-a Cl:lØdiåoas ottllc operari.Qø p:rmi1. T1Ic pc:nniI balder IDUS\ CIOIÜ)r me 0Øicc of E~taI
ScrWzs wWaìA 30 ~ of øy C!~ 10 _ aumiCOriD, proc::aiures. uaJcsiI required 10 abIaiI! apprøYal before
_1ri~1_ dIaDIC- ' ~ by Secùas 2632(d) aad 21W1(1a) CCIl.
Facìüty Name 11~[1I.Ai.. ŒNfe-11-
Facility Add.raa '2"201 {µflrr~ ¿"Aw6'
1. If &D uaauthorUed release occurs, how will the hazardous substance be cleaned up? Note:
If released haZardous substances reach the environmenl\ increase the fire or explo$Íon
bazard.. are not cl_JlnM up tram the secondary c:ont4ÍM:lent within 8 haurs.. or dctciorare
the secandlry containø1ent. then the Office of EnviromneDtal Services must be aotified
wit.biD. 24 houn. ¡'4/LtJt, f'1"ð - ,plAt. 911 'j1 .It./.- Ýfll'-.5 CP,....-fÁ~ w/fJJ
fpll-L- ~/1 t.-ðC.A"~ /11/ ¡VJSc, II/, CAt- â'h... 'I'/~ J&.tf .:7,., - n 'JJ
. 2. I)e¡gibe the proposed mothods and equip-ment to be used for removing and properly
disposins of any baz.ardous substance. $L.!- ¡qr Q:,LF ~IAIt() . .70 'A/fS
W(?C/U' Ge 'CUJ ,~A/ W¿ýø~/1~ ~~ ~~ Mt/'1IÑ!Jt.,
4t7.>AT/TL., Fð"- Rð'(){.Il- ~ ~4Z-- #Ai!~/J.¿)t)l/.J ~fijr..¿ h~II/ßUJI-eÞ-Î ,
r'~~
, 3. Desc:ribe the location and availability of the roquiled ç10anup eqwpmcm in item 2 .:bove.
~/t.i.._ /<L/r L./.ICAr¿; QV ?Ir~ /p Ø1.U~{/I¡VICft~- ¿cpu//~ ~()""
CW 1ft r/..<)~
4. Describe ,the maintenance schedule for the cleanup equipment: ~/5Uftl- IIV">' ¿e.-fltV
AM//t/AUý ~ CCNþAlIN~tll;4/ ,
5. List the name(s) and tide(s) of the I'erson(s) resp~nsible for authorizing any work
necessary under the response plan:
,a1t6 ;otOð/ZL. ~-~/f/r hfiN'Át:4- ¡{t1tÝ;401 od-ll't- C¿-N~
/1-1/~ WDO' r-/~c./I.-/"e.? A;fP/t/A~ gfÞIrJIL//1(,' N05//'T..ðL-
Sent by: MEMORIAL CENTER
11/12/97 12:52
E.
F.
G.
805 8370755; 12/30/97 16:57; . J~ #681 ¡Page 2/3
e8~26 0576 BFD HAZ MAT DI. 141 003
WRI1TEN MONITORING PROCEDURES
UNDERGROUND STORAGE TANK MONITORING PROGJIAM
Tbis moø~ pIOØI1IID IIIUII be 1rcpI8I tbe UST I P'SMQ at all__ Tbe ~ all dIU dMIÙ-i4
propua aø c:aadiDØIII of tile gpaaIiq penaiL T1I& pamiI ba1drIr IIWIt DÆIff die amCII af!!mUn..-w-.1
ScMca witbia JO da)'I at aay ,........._ die _tlGria. ,..--,.. ~ 1IIþIÎ1'Cd 10 abIIàa. .......v4Il1cfan:
---.. rbc dIaap. Rataind ¡,y Scaio.. Z632(d) _ 2641(la) CC1l
Fad.ücy Name M¿ foil 0/2..111 '- CéÑ1Etl-
FaQIity Addn:u ::f:uJ1 WIIJ1e LANE f!/Vµ~p lew , C-A
.
~,
A Describe the freqUCllcy of perfQrmiD¡ the monitori.ng:
TaDk ]?¡41t.., S"71(.,Jt- RfApJ,.I&5 -¿ð? t,L)~ rØt; ¡!II tlS1 ßd()/- /11/ 1'~lÝí
/If¡lN ~ tJ¡t.:rir:J,."
Piping (K5'/¿:c.7~ .é~0# WIPE/'- p(.//Z/~6- GVN~ b/L- 7tDr
B. What metbods aDd equi~ id.ectitied by nlØl8lDd modci, wiD be uted. fbr "~·~:..ø
the m01ÙtOrj.ag:
Taak . c;(lA/)v/l r<I!.<J wOtJJle- 9f(L;:-
Piping f//.5't/A'-. /1V.J'fel.:{I()..)
c.
Desc:ribe the loçatìon(s) where the monitoring will be p;aformed (1àciIity plot pIIII"'l~
be attached); .'
r/t-t.- j/At..yt Or- Uþ'~~~.$ÍMKJ; f)J'ý","
F'?//ù6- A¿lbt/e-~ 1"t) &b./6nAr~ .f)/Iy rA1I1'-
D.
List the namc(s) aad Utle(s) of the people respoDSible for p.-farmiDø the moaitoriJaa
and/or nWatllÎDÎDl the equi cat:
L/ðV6 /f//oa J' Nt" ~~¡I ~ ~{)A.../-o,-
M//k... W(k}J1r"c,¡ZIT/~J P//2¿(:.fP/,-, ¡fI~(}I'ùIÏl(, /./os.
Reportiug Foruw for monitoring;
Tank /I/p".ØWI41'Tav ~CKJ.. ,L.JÚ1r.~ /vI/5'f· b,L - /U4 A1fi~JðfflG- .
Piping ¡(/A;vIpP//WTr.ã- ~tr ""'A./ 6e,vC;s..,rg,...., ß,pøl'- /¿".I\Q' ~1"/A/Ý/I~ OP':'¡::/CL
Deacribe the preventive maintenance schedule for the moaitoriDg cquipmcøt. Note:
MaiDIeJlaDCC mat be ia accordaaee with ~e ....ulutllnr'IIIIaÙIIt·""..ce Riled."
butaotlaatbaaevery 1,Z lDoad.L ¡//$VAL /.tI.$'¡r;~¿ptW ÞòA.. J)fJl,KJA-
DoKribe the rrainiDs necessary for tbe operation ofUST system. iDdudiua piPÎD& azul ~' '_ ì
morútorins equipment; ¿d6'7/~ CF- ~ .?.JIS",r.~s /lft'lA// "-' J) w57¡~/C.j
'f/f)7/f/().... y-v'~ /ÏN/ ~.J20f, '. oC/' í>'tl../,~ -i/i-oCL- úl\/~
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
TRAINING DIVISION
5642 Victor Street
Bakersfield. CA 93308
(805) 399-4697
FAX (805) 399-5763
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BAKERSFIELD
FIRE DEPARTMENT
November 13, 1997
Doug Moore
Memorial Center
5201 White Lane
Bakersfield, CA 93309
Dear Mr. Moore:
During ajoint inspection on November 12,1997, it was discovered that
your leak detection system is not functioning. Section 2632 (a) of Article 4; Title
23, Division 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.
You must therefore, either repair and bring your leak detection system on-
line or make arrangements for a tank and piping precision test. To avoid
revocation of your permit to operate, you must hav~ the above mentioned
correction made within thirty (30) days, (December 13, 1997).
Sincerely,
Ralph E. Huey
Hazardous Materials Coordinator
by:
Ac~
Steve Underwood
Underground Storage Tank Inspector
SBU/dm
'Y~de~~~~~~A~~" .
'--""
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,.~ -:..'<~
'UNDERGROUND STORAGE TAN~SPECTION
. Bakersfield Fire Dept. ,
. Office of Environmental Services
i
Bakersfield, CA 93301 '
FACILITY NAME thrøVl\otta,/
FACILITY ADDRESS S.:Jo f
~~t\-k.,... ,(0" ß".t..a\Jlnrd{ fÌifL.~USINESS I.D. No. 215-000 .:.fro
tùh~t.(., {.,dl1l' _ CITY ZIP CODE
FACILITY PHONE No. '31~ -lS0'Ú 101 101 101 ,
, I
INSPECTION DATE II -( 2. - If? Producl / Product Product . i
TIME IN TIME OUT OCt,se.--
Insl Dale Insl Dale Insl Dale i
INSPECTION TYPE: 1187 I
ROUTINE ./ FOLLOW-UP Size Size Size ¡
r. Ct) e ¡
REQUIREMENTS yes no nIa yes no nIa yes ' no nIal
1a. Forms A & B Submitted ì/ i
I
1b. Form C Submitted V 1
I
tI ,
1c. Operating Fees Paid ,
State Surcharge Paid r/ ,
1d. I
1e. Statement of Financial Responsibility Submitted V
1f. Written Contract Exists between Owner & Operator to Operate UST v': I
,
2a. Valid Operating Permit Iv :
2b. Approved Written Routine Monitoring Procedure " I
2c. Unauthorized Release Response Plan if
3a. Tank Integrity Tesl in Last 12 Months -vi I
I
3b. Pressurized Piping Integrity Test in Last 12 Months V ,
I
3c. Suction Piping Tightness Test in Last 3 Years if , ,
,
3d. Gravity Flow Piping Tightness Test in Last 2 Years J
3e. Test Results Submitted Within 30 Days V I
3f. Daily Visual Monitoring of Suction Product Piping , Ý I
I
4a. Manual Inventory Reconciliation Each Month V !
4b. Annual Inventory Reconciliation Statement Submitted ~ i
4c. Meters Calibrated Annually II i
i
5. Weekly Manual Tank Gauging Records for Small Tanks V I
6. Monthly Statistical Inventory Reconciliation Results V- I
V ,
7. Monthly Automatic Tank Gauging Results ¡
8. Ground Water Monitoring V ,
I
9. Vapor Monitoring 1\/ ,
i
10. Continuous Interstitial Monitoring for Double-Walled Tanks Iv' :
,
11. Mechanical Line Leak Detectors \/ ,
I
12. Electronic Line Leak Detectors 1/ ,
¡
13. Continuous Piping Monitoring in Sumps a/
14. Automatic PumpShut-off Capability V J
15. Annual Maintenance/Calibration of Leak Detection Equipment Nøl- ..c...,.-c.h...1.1Ìof V- I
¡
16. Leak Detection Equipment and Test Methods Listed in LG-113 Series V !
17. Written Records Maintained on Site t/ I
18. Reported Changes in Usage/Conditions to Operating/Monitoring i
Procedures of UST System Within 30 Days cI I
19. Reported Unauthorized Release Within 24 Hours J I
20. Approved UST System Repairs and Upgrades l/ I
21. Records Showing Cathodic Protection Inspection V I
22. Secured Monitoring Wells V I
I
23. Drop Tube , \/ I
0·., ~'AdA i
RE-INSPECTION DATE RECEIVED BY: '/'~ /" v v - -
r I
INSPECTOR:
OFFICE TELEPHONE No.
FD 1669 (rev. '9/95)
- ~-
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....-.
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RECORD OF TELEPHONE CONVERSATION
Location: S:zo I W 4 ,k L""
Business Name: 1'1~,J MeoJ, C~-h.v-
Contact Name: Po L.rL RoJrlC;v(¿<- ~épc.( (
'-<
Business Phone: c¡ 0'1 I (,'2 -z. - .q \'02-
InspeCtor's Name: ~
Time of Call: Date: <6! '7 (S 1
fD#
I
I
I '
I
FAX:
Time: c¡; ¡)
# Min:
(C)
Type of Call: Incoming [ ]
Outgoing ~]
Returned- ~
Content orCaI/: McM( '~"') sy":>+~ (So .-fo ~~ fè-f)~c~cJ
~ OJif t ( I F<-4, ~ .,fE:i'" '.,kf/ -1,. t' {~" U s.e....:=-- SJ"-¡? < I'
0(d YkCM..'~ tS o/.::;'5P(ek.' S<.JJ'V¡f5 were...- (iA.s-&'l!J ,""corr¿f;..
<-1 c)(òW f~ ~ á '-<-kk -fa ,~( !-ifc-+e .
Actions Required: Y ~J v· sJ .-fLc.4- ~ 0 p.svr... (f Wc.Jv (J IcJ <- fe.r 'cI
~ -ft..t-+- fL14...cf' C/( /'v, V':. f- 5> u-..cI us. cop Ie S ò~ ~ WdY'L
C>l'jv- or I "tUC}'c.-€.S li-1.ci(cc'+y~) ..e.Xc.cf-(V ---tle- óe¡x.(r5' (<1.vd/-€oI,
Time Required to Complete Activity # Min: ) ~
I
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.. CITY of BAKERSFIELD··
.""'-",
"WE CARE"
January 30, 1995
FIRE DEPARTMENT
M. R. KELLY
FIRE CHIEF
WARNING!
1715 CHESTER AVENUE
BAKERSFIELD. 93301
326-3911
CERTIFICATION OF FINANCIAL RESPONSIBILITY REQUIRED
I
J
;~: 1 :5-tZiØØ-Ø00Ø4E. .
MEMORIAL CENTER FOR BEHAVIORIAL
~3c.:Ø 1 (,.,IH I TE LN
BAKERSFIELD, CA 93309
Dear Underground Storage Tank Owner:
Our records indicate that your business does not have a Certification of Financial Responsibility on file with this office.
Please forward either a copy of your existing State approved mechanism to show finaocialresponsibility or else
complete the attached Certification of Financial Responsibility form.
An attached letter from the State Water Resources Control Board lists the approved financial responsibility mechanisms
required to pay for corrective actions resulting from leaking underground fuel tanks.
Remember, most tank owners only have to show financial. responsibility for at least $10,000 of clean up liability. The
Underground Storage Tank Clean Up Fund (USTCF) may be used as the mechanism to cover the remaining accidental release
liability.
The total amounts of financial responsibility required (check boxes from section A of form) are as follows:
If you don't sell product from you tanks, and you pump less than 10,000 gallons per month,
check "$500,000 per occurrence". Else, or if you are in the business of selling from your
tanks, check "1 million dollars per occurrence".
For owners of 101 or more petroleum underground storage tanks, check the ·2 million dollar
annual aggregate" box. All others need only check the "1 million dollars annual aggregate"
box.
Please be aware that failure to provide the financial responsibility document to this office within 30 days will result in
your Permit to Operate being revoked. (25285.1 (b) California Health & Safety Code). '
If you have any questions, or would like help in completing the Certification of Financial Responsibility, please contact
Howard Wines, Hazardous Materials Technician, at 326-3979.
Ralph E. Huey
Hazardous Materials Coordinator
REH/dlm
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15'1 ;
I
. . Permit to Operate
Underground Hazardous Materials' Storage Facility
LJIJ
- S tate I D No -3 160 0 'L. ...::::.::):?:;:::}::2:.:..·.;:.:.·,':::;:::;::::::;;:;:;::::;;':.::;;:::./::.;:.:.::.:?:.?:::::.::::::::):::::::::::::" Permit No ~
cl~~·ç!lì: . Iris1iiìì~$'J¡lrype MoHì~~~.~ª\\:\ Type Method
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~:!Þr¿)} \ ..... .:" ".}':::: .' . . . ~t\ lb.. ... ~ uC-f,ÖI\
:·........·.:::·::::::;:.:::::\:::·:;:;¡i!!!;.::,..::;:.::;;::::·i::¡:::::::::;:::\::£::::.·::::::: 'i.::·· ..
Tank
Number
-
Issued By:
Approved by:
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Hazardous
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Piping'
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1715 Chester Ave., 3rd Floor f'v1~c.v,('j /'_".-.....t.f..-....... C,~ (,)..-? J I /( //1
Bakersfield, CA 93301 C/·. L~ _,. C)"",,\<;'.J lOr ,,,. . +1 <1>..:. !-t")
(805) 326-3979 S-:2..ð ( (.J~,-rc t...",
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Ralph E. Huey, Hazardous Materials Còordinator
Valid from: ~J,.·\C,.· ('1<[ to: ~" I). I c~9
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(IDsrnU:ÚODS OD reverse)
.
CERTIFICATION OF FINANCIAL RESPONSIBiliTY
FOR UNDERGROUND STORAGE TANKS CONTAINING PETROlEUM
A. I am required to demoutrate F'UIaDCiaI Respouibility iø the required amOUllllu specified iø SectÏoll2807, Chapter III. DiY, 3"Tide 23, CCR:
0500,000 dollan per occurrellce 0 1 miBioll dollars auual aures.te
M ~D M
~ 1 miBioll doUars per occurrence D 2 minion donars auual auresate
B.~\ J?.''£ j. J.JL L E..e, . p/#NI' /J/ÚAI.4dt:: hereby certffies that it is in compliance with the requirements of Section 2807,
(NameofTdOwaercrOptnIDC) ../ , " .
Article 3, Chapter 18, Division 3, Title 23, California Code of Regulations.
The mechanisms used to demonstrate financial responsibility as required by Section 2807 are as follows:
:iilli!·!····:;~:¥~1;i¡:¡¡!¡i:¡·ii;l¡ii·¡i¡¡II;::W;:·:~~:~:f::j:j:~::i:!:!:~f0:;:r;·i·!··::::::·!¡¡i.!¡·¡¡·!.!·!:¡i:¡:¡.~~~g~iT::;;:::·:·.::·;·:t·.~61~:;!!¡¡:!··:mþ~t~·Î·;!:iÂ~~~~·!~~@tI{ª~
~ í~ :L~CNr~ 4Z005YO - o'3t:f 500,000' '1. 2.1·'~ Y\.C yes
~r\~~4~ ,+'00 wils""tre. ~
' U;¡s A-Nf-l..tó, CA '100/0 ~&.i(..,1d..
---.. . - ~ ;j:~~·r.-~J_c.·3005t _""__01 M_o. - T5'Cl>-OOb -:1~~; - no..-L y es -.
13 ,os t) &J '
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Note: If you are using the State Fund as any part of your demonstlBtion of financial responsibility, your execution and submission
of this certification also ce/tifies that 'aU are in com 1iance with al1 conditions for /tiel tion in the Fund.
. ~ ..·t'aQii1JNZllDCI~
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Faå1i1y Name
Faå1i1J Addr_
Faå1ityName
Faå1i1J Addr_
1'aå1i1J NIome
Feålíty Addrea
Date "
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INSTRUCTIONS
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~IFICA%IOH OF FIHAHCIAL RBSPOHSIBILI~ FORM
Please type or print clearly all information on Certification of Financial Responsibility fònm. ' All UST
facilities,and/or sites owned or operated may be listed on one fonm; therefore a separate certificate is not
required for each site.
DOCUMENT INFORMATION
A. MaInt R~i red -
Check the appropriate boxes.
B. la.e of Tank OWner - Full name of either the tank owner or the operator.
or Operator
C. ltec:Iø1isa Type -
la.e of Issuer -
ltec:Iø1isa IUIIber -
Coverage Mou'It -
Coverage Peri od -
Corrective Action -
Third Party -
COIIpensati on
D. Facility-
I nfo....t ion
E. Signature Block -
Indicate which State approved mechanism(s) are being used to show financial
responsibility either as contained in the federal regulations, 40 CFR, Part 280,
Subpart H, Sections 280.90 'through 280.103 (See Financial ,Rponsibi l ity Guide, for
more information), or Section 2802.1, Chapter 18, Division' 3, Title 23,·CCR.
indi~iduals issuing coverage.
List all names and addresses of ,companies and/or
',' .' ','" ,',: -. - " -~ -,
List identify;Jng nuri>er for each mechanism used.
or fi le nuri>er as indicated on bond or docuœnt.
(State Fund) leave blank.)
Indicate amount of coverage for each type of·mechànism(s). If more than one
mechanism is indicated, total must equal 100% of financial responsibility for each
facility. '
__ ;.~. /;~__.._ - ""',~ . '0-- .-__
Exëi~le:insurance policy nuri>er
Of using .St,ate .CleanuP Fund
Indicate the effective date(s) of all financial mechanism(s).(State Fund coverage
would be continuous as long as you maintain compliance and remain eligible to
continue participation in the Fund.)
Indicate yes or no. Does the specified financial mechanism provide coverage for
corrective action? Of using State FI.I'1d, indicate "yes".) ,
Indicate yes or no. Does the specified financial mechanism provide coverage for
third party cGq)enSation? Of using State Fund, indicate "yes".)
Provide all facH ity and/or site names and addresses.
Provide signature and date signed by tank owner or operator; printed or typed name
and title of tank owner or operator; signature of witness or notary and date
signed; and printed or typed name of witness or notary (if notary signs as witness,
please place notary seal next to notary's signature).
Where to Mail Certification:
_ , _c_J~leasp. .sentLor.igi.N!l.,to.your. JocaLagenc.y=(agenc:y ,who iss~s__y~r J!~T",,~r.mits)-,,-=-K,_ep=a_c-ºRY~o.t, the~ ,'_~~~~~~>=__~~
certification at each facil ity or site listed on the form. .,'" -
4 ""'.
Cluesti ens:
If you have questions on financial responsibility requirements or on the Certification of Financial
Responsibil ity Form, please contact the State UST Cleanup FI.I'1d at (916) 739-2475.
Note: Penal ties for Failure to CcIIJI)ly with Financial Resøonsibil itv Reœire.ents:
Failure to comply may result in: (1) jeopardizing claimant eligibility for the State UST Cleanup Fund, and
(2) liability for civil penalties of up to $10,000 dollars per day, per underground storage tank, for each
day of violation as stated in Article 7, Section 25299.76(a) of the California Health and Safety Code.
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. ~GORREC.ON NOTICE
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BAKERSFIELD FIRE DEPARTMENT N~
n 0020'
Locatiol1 1ll()/1IttJ~./'qJ C~~ ~ ~~ ~~IIÌë>~Ff1 ik4f1~
Sub Div. S:;J.() I t-...¡ L:<-k ~I\-~lk. . Lot
You are hereby required to make the following corrections
at the above location:
Cor. No
Date IIILS/?l.[
Inspector
326-3979
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ROUTING REQUEST
Post-It "routing request ped 7664
8AA/ljO
Please
DREAD
o HANDLE
o APPROVE
and
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o RETURN
o KEEP OR DISCARD
o REVIEW WITH ME
Date
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MEMORIAL
~ENTER, ,
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. Bill Pliler
Plant Manager
5201 White Lane
Bakersfield, CA 93309
Telephone: (805) 398-1800
Fax: (805) 837-0755
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ÔNbeRGROUND ST.GE TANK INSPECTION
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'- è\..~ersfield Fire Dept. .
~rdous Materials Division
Date ComPletedl~~ A Lf
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Operating Permit: ?~:+ f> Q~Å r I...,~ '^"~
Business Name: fJ'þrY\/')!2\ Pr \ C9..Y\i-~ ~ P-Plr-.av,'f)RA-~ ~H·l.
Location:
,"5?--OI Wkd-p, LA,
Business Identification No. ,215-000
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(Top of Busin~ss PI. an)
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Number of Tanks.
Type:
Containment: ~'·I.vn\\"t'~ I hV~ \\
CONTACT INFORMATION
Owner: (1 ßm H
Lines: \St;'':t~D'l'.·) r\b\-l.<J....1 k>.cl /
,'recÁ ~~ I CMv't~8~\
A.....d ~be~l~(' /
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Emergency Contacts:
~~\\ ~h \e,R
I be.~¿~ ~~\e6k~ .. mAr~'\-~ J'3~m
Adequate Inadequate
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Monitoring Program
c..\A..,,"o~Q.-tæ... \....^p_ \'e...o.\i-. Ar>~Q
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RECORDS
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Maintenance
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Testing
fJw~~Or 1:l.:)G ~'ÄentOry;ReCOnCiliation
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RESPONSE PLAN
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Emergency Plan
Violations: ?b~ p~N1I".ð'- 1..,7R.H--eVl pI?D"'OJ'Ok..~tC)_ ..[;"k=> lI1/) lI"",Q./~
d; 1.e/JfJ. AëJ~r'f¡~Y) "'(j . ~ ~ P<r;' t"It4....~ t:J-f~ ¿JlcO£)L;p PR{hJtb
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Business Ownerl .
All Items O.K.
Correction Needed
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WMe - Haz Mat Div
Pink - Business Copy ,
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Bill Pliler
Plant Manager
5201 White lane
Bakersfield, CÂ 93309 ..
. Telephone: (805)3~8-1800 -
Fax: (805) 837'{)755 -
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PouOLERT®
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FLUIP DETECTION SYSTEM, FD102
RECEIVED
ff8 1 1 '994, SECTION 1
HAZ. MAT. OrVSystem Description
1.1 GENERAL DESCRIPTION
The purpose of this Polluler1® fluid detection system manu-
al is to instruct the installer and user with the procedures
to properly. implement an installation. The information
presented herin is intended for use by qualified installers
and operators at the user's facility.
The Pollulert fluid detection system is a continuous monitor-
ing system comprised of several probe configurations for
monitoring hydrocarbon storage sites for leaks or spills.
When installed as instructed herein, the Pollulert equipment
is designed to detect hydrocarbons in a hazardous area.
Deviation from these instructions or modification of the
equipment in any way could result in the development of
dangerous energy levels in the hazardous area and could
void the warranty. Safety is the responsibility of the people
who install and operate the equipment.
1.2 INTRODUCTION
The Pollulert fluid detection system detects liquid
hydrocarbons ilf a variety of applications and environ-
ments. The Pollulert sales bulletin presents a good over-
view of the Pollulert equipment available and should be
consulted to determine the best system for each applica-
tion. If additional information Is needed concerning equip-
ment selection, system planning, Installation, operation, or
maintenance, please contact Pollulert Systems, P.O. Box
706, Indianapolis, Indiana 46206; telephone (317) 261-1442.
I
1.3 SYSTEM PLANNING
The Pollulert control center may be located up to 4,000 feet
from the probes, depending on the number of probes that
are attached to the control center. The probe wires are
color-coded and wired in parallel to the sensor input termi-
nals of the control center. Routing and termination of the
instrumentation cabling between the probe installation and
the control center is at the discretion of the installing con-
tractor. As the control centers are Factory Mutual (FM) and
Underwriters Laboratories (UL) approved for operation in
Class I, Division 1, Group D locations, enclosure of the ca-
bling in explosion-proof hardware is normally not required.
However, the local electrical inspector should be consult-
ed, as interpretation and enforcement of the National Elec-
trical Code (NEC) varies with geographical location.
The Pollulert family of probes has been designed for many
areas of monitoring; groundwater, surface water, oil sepa-
rators (settling tanks), weirs, retention ponds, double-wall
tanks, sumps, and for pipe monitoring. Once a basic un-
derstanding of each probe function is grasped, many other
applications can be developed. While the following discus-
I
sions are on standard probes, special order probes can be
supplíed with variations to suit a particular application.
A probe should be located as close as possible to the
storage site to be monitored in order to detect leaks early.
All probes, when properly connected to the electronic con-
,trol, may be located in a Class 1, Division 1, Group D
hazardous location. .._~_.
NOTE: THE CONTROL CENTER MUST BE LOCA T-
ED IN A NON-HAZARDOUS AREA.
Hydrocarbon detection is signalled by audible and visual
indicators. Therefore, optimum location of the control would
be within hearing distance of the personnel to be alerted.
Periodically, personnel should observe the visual indicators
to assure that no system fault is indicated.
Notification of a hydrocarbon detection may be tr,ans-
mitted any distance from the control by connecting ;data
transmission ~quipment to the relay contacts on the
control center. Status may also be monitored remotely via
a data output connector which provides serial/parallel
data output. Each probe contains adjustable probe sen-
sors. These can be set to detect a desired thickness of
accumulated hydrocarbons between 1/8 to 2 inches (most
probes-see individual probe specifications). Each probe
can monitor up to 10 probes wired in parallel.
In the standard configuration, any combination of ground-
water, surface water, tank or special application probe
may be connected to one control as long as the number
of probes total 10 or less. The maximum number of probes
that can be used is a function of distance from the control
center and type of probe used. A FD210, FD210V or FD221V
can be replaced by four (4) standard probes, as far as total
probe count is concerned. Use the following table as a
guide: '
,
STANDARD PROBES
FD21 O/FD21 OV IFD221 V
No. of Distance to No. of Distance of
Probes Farthest Probe Probes Farthest Probe
1 4000 Ft.
2 4000 Ft. 4 1 000 Ft.
3 3000 Ft.
4 3000 Ft. 5 500 Ft.
,5 2000 Ft.
6 2000 Ft. 6 1 00 Ft.
7 1 000 Ft.
8 1 000 Ft.
9 1 000 Ft.
10 1 000 Ft.
t
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POUULERT®
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-FLUID DETECTION SYSTJM, FD102
.,
Before starting Installation, the following planning must be
completed:
· Read and understand manual.
· Prepare all site layouts and wiring drawings.
· Obtain necessary building permits.
· Specify installation to conform to all local codes
and practices.
SECTION 2
\
It is recommended that the uaer should read and under-
stand ANSI/ISA RP126, "Installation of Intrinsically Safe
Instrument Systems in Class I Hazardous Locations."
NOTE: IF CABLE OTHER THAN POLLULERT USED,
WARRANTY IS NULL AND VOID.
Control Unit - FD102
2.1 GENERAL DESCRIPTION
The Polluler1® fluid detection control center is an electronic
monitoring system that works on the principle of conduc-
tion (liquids) and adsorption (vapors). Typical water (exclud-
ing de-ionized water) is a conductive, or polar, fluid.
--Hydrocarbons are non-condüctive, or non-polar substances.
The probe circuitry can differentiate between polar or non-
polar fluids and provide the appropriate alarms and con-
tact closures at the control center when a non-polar fluid
is detected.
-
For vapor detection, an adsorption sensitive resistor with
extremely low power requirements (cold sensor) is utilized.
As with the liquid hyd~ocarbon detection probes, the vapor
:~Jf.",
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2~2 FEATURES
VISUAL INDICATORS
INDICATE STATUS OF
PROBES:
YELLOW = WATER
RED = HYDROCARBON
GREEN = DRY
POWER INDICATOR
VERIFIES SYSTEM
IS OPERATIONAL
-
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probes can also differentiate between dry and water, and
send the proper dry, water or hydrocarbon (vapor) signals
back to the control center.
i
The probe system uses the fact that hydrocarbons float on
water. The probe sensors monitor the fluid conductivity at
the air-water interface for a specific probe location. Any
hydrocarbon present will displace the water at the air'-
water interface, causing the probe sensors to be immersed
in the hydrocarbon. The lack of conductivity in the non·
polar hydrocarbon will cause the detector to alarm accord· .
ingly.
¿
NEMA 4 ENCLOSURE
FOR FIXED, PERMANENT
INSTALLATION
DATA OUTPUT CONNECTOR
"i/ (SPLASH PROOF) ,
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AUDIBLE ALARM DISABLE SWITCH
(PUSH-ON I PUSH'OFF)
AUDIBLE ALARM
SOUNDS WHEN
HYDROCARBONS
ARE DETECTED
2
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FLUID DETECTION SYSTEM, FD102
OUTPUT CONNECTIONS
FOR RELAY CONTACTS TO START
PUMPS, ACTUATE ALARMS,
PHONE DIALERS, TELEMETRY,
ETC.
PROGRAMMABLE RELAY
CONTACT CLOSURE' -
INPUT POWER
CONNECTIONS
FOR 120 VAC
SUPPLY VOLTAGE
I
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I
2.3 SPECIFICATIONS
ENCLOSURE - NEMA 4, 10"H X 8"W X 4"D, with external
mounting flange. .
SENSOR UNPUTS - One to ten probes wired in parallel.
(See Table, page 1).
CABLE LENTH - Up to 4,000 feet, depending on number
& type of probes used.
VISUAL INDICATORS - Three visual indicators (LEDs) to
indicate dry (green), water (yellow) or hydrocarbon (red).
AUDIO SIGNAL - To indicate hydrocarbon at any probe.
Loudness approximately 75db at two feet. 2900 Hz audio
frequency. External push-on, push-off switch allows disa-
bling of audible signal.
RELA y CONTACTS - One relay with contacts which
change state when any probe detects desired medium
selected with DIP switch. Factory set for hydrocarbon (6
Amp 120 VAC max.)
TRANSIENT REJECTION CONTROL - User selectable. Al-
lows 0 - 5 second delay from time of detection until relay
contact closure.
MANUAL TRIP - Internal slide switch allows manual oper-
ation of relay closure.
LATCH SELECTION - Internal slide switch allows manual
selection' of latching feature and also acts as reset switch.
DATA OUTPUT CONNECTOR - Nine pin connector plug
(mating s'ocket and cable optional) to allow access to seri-
al and parallel data signals. To mate data cable to plug,
order 4 ft. cable and connector socket, part number FD301.
(180K oh,m output impedance).
I
SERIAL DATA TRANSMISSION
RATE SWITCH
MANUAL TRIP -."
SWITCH ALLOWS MANUAL
OPERATION OF RELAY
CLOSURE
LATCH SWITCH
}~ TO ENABLE LATCH
}\ AND ALSO RESET
~DATA OUTPUT CONN.
,..·.1....... (SERIAL & PARALLEL)
11j
TRANSIENT REJECTION
CONTROL
HOLES FOR CONDUIT
CONNECTIONS
SENSOR INPUT
CONNECTION FOR UP TO
10 PROBES (PARALLELEQ)....
(15 WITH PROPER ACCES.§.ORIES)
oi·'"
PROGRAMMABLE DIP SWITCH· Allows programming of
relay contact closure on any combination of AIR, HYDRO-
CARBON or WATER. Also used to select TRANSMISSION
rate of serial data output.
SERIAL DATA OUTPUT - 1.0 VDC ± 1 0% (WATER); 2.0
VDC ± 10% (HYDROCARBON); 3.0 VDC ± 10% (DRY);
5.0 VDC ± 10% (POWER).
TRANSMISSION RATE - Slow: 15 minute period per out-
put, total cycle of 1 hour. Fast: 1.5 second period per out-
put, total cycle of 6 seconds.
PARALLEL DATA OUTPUT - 12.0 VDC ± 10% for
WATER, HYDROCARBON, DRY and POWER indications.
POWER REQUIRED - 120 VAC ± 10%,60 Hz., 8 Watts.
OPERATING TEMPERATURE LIMITS - -400C to +SooC.
RESPONSE TIME - Immediately upon immersion of probe
sensors (with TRANSIENT REJECTION CONTROL set at
minimum, O-S second range). Factory preset for a 2.S se-
cond delay.
tl
2.4 INSTAllATION
2.4.1 MECHANICAL INSTALLATION
The NEMA 4 enclosure that houses the FD102 control is
intended for use indoors or outdoors and will protect the
enclosed circuitry against splashing water, seepage of
water, falling of hose-directed water, and severe external
condensation. The enclosure is sleet-resistant. Mounting
flanges allow permanent fastening to walls, panels, posts,
etc.
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. FLUID DETECTION SYST~M, FD102
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5118 CIA. (4) HOI.£9
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MOUNTING DIMENSIONS
Location of the control should be in an area where per-
sonnel responsible for operating the system are located.
120VAC power must be made available and the necessary
conduit for wiring installed. Although the probes are ap-
proved for operation in Class I, Division 1, Group D hazar-
dous areas, the actual control must be located in a non-
hazardous area. Consult your local electrical codes.
2.4.2 ELECTRICAL CONNECTIONS
Read completely and plan wiring runs before making any
connections.
--------'----
i .ri;;WARNING: DO NOT CONNECT 120VAC UNTIL
.; ,/~OTHER CONNECTIONS HAVE BEEN MADE, ALL
EQUIPMENT IS IN PLACE, AND FINAL INSPEC·
TION HAS BEEN COMPLETED.
Refer to Figure 2.1 for instructions on removing the pro-
tective cover plate prior to wiring.
REMOVAL OF PROTECTIVE COVER
CAUTIDN: DHNEIIGIZE
UNIT PRIOR TO 6ERV1C»G.
WARNING: REI'UŒ
BARRIER COYER IIEFOIIE
OPERATING S\'9TEII.
Figure 2.1
t(t
TO REMOVE PROTECTIVE COVER, TURN PLASTIC LEVER ON
COVER 1/4 TURN TO RIGHT OR LEFT. LIFT COVER UP AND OFF. TO
REPLACE INSERT COVER IN POSITION MAKING SURE LOCKING
KEY SETS INTO MATCHING HOLE ON PARTITION. TURN PLASTIC
LEVER '/4 TURN TO RIGHT OR LEFT TO LQCK INTO PLACE.
.1
i
2.4.3 INPUT CONNECTIONS ¡
I
Input connections to the remote probes are made by con-
necting the Instrumentation cable between the electronic
control and the probes. Cable may be placed in conduit,
directly buried In the ground, or suspended overhead
from poles depending upon standard pract(ce at the in-
stallation site and local electrical codes. I
NOTE: IF CABLE IS PLACED IN CONDUIT, OTHER
VOLTAGE OR CURRENT CARRYING CONDUCTORS
MAY NOT BE IN THE SAME CONDUIT UNLESS A
METAL BARRIER IS PROVIDED.
Only one cable is connected to the terminals marked
SENSOR INPUT'located on the printed circuit board in-
side the NEMA 4 enclosure. Entrance Is via the 1fa Inch
hole directly underneath the terminal block. The cable
may be routed to the hole via V2" metal conduit or openly,
with the cable entering the enclosure through a box con-
nector with clamp.
The cable wires are color-coded and the proper lead color
should be attached to the appropriately marked terminal
(RED, BLK, etc.) The shield or drain wire of the cable
should be attached to the terminal marked SHLD. (Figure
2.2 Use spade terminals provided.) .
Additional probe cables can be spliced to the cable ex-
iting from the control center (paralleled) by use of junction
boxes as shown in Figure 2.2. It is important that good
electrical connections are made at thé splices. Butt termi-
nals may be crimped on the wires or the splices soldered
directly. The splices should be taped with electrical tape
if they are soldered. The use of wire nuts is not recommend-
ed on probe cable splices. It is important that splices (via
junction box) be made at locations where water or moisture
cannot penetrate the splices. Leave 2 to 3 feet of cable in
manholes for splicing.
2.4.4 RELAY CONTACTS
The control center provides a set of relay qontacts that
can be programmed to change state on any ,combination
of AIR, HYDROCARBON or WATER detections. A DIP
switch, located internally to the control unit, has Individ-
ual levers identified 1 through 4. Moving the respective
DIP switch lever to the ON position enables that function
to control the relay switch closure, as follows:
1 = DRY
2 = WATER
3 = HYDROCARBON
Refer to the illustration of the Internal controls In section
2.2 for the location of this switch. Additional information on
the use of this switch is given in section 8.2.8.
Access to the relay contacts Is through terminals marked
RELAY on the printed circuit board inside the NEMA 4 en-
closure. Entrance Is via the center 7/8 inch hole located
directly beneath the terminal block. Refer tt! Figure 2.2.
Again the cable may be routed to the hole using metal
conduit with the cable entering the enclosure directly
through a box connector. Consult your local electrical
4
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V'
. FLUID DETECTION SYSTEM, FD102
'POUÜlERT4Þ
codes. When wiring is completed, the protective cover
plate must be replaced. Refer to Figure 2.1 for instruc-
tions. Refer to Section 7 for Data Output connections.
.
CAUTION: THE RELAY TERMINALS MUST NOT BE
USED IN CIRCUITS THAT EXCEED 6 AMP 120 VAC
MAX. :
!
The standard settings of the FD102 control center as
shipped from. the factory are as follows:
CONTROL i SETTING
MANUALT'RIP OFF
LATCH i OFF
PROGRAMMABLE RELAY HYDROCARBON
I ALARM
.SERIAL DATA SLOW
. TRANSIENT REJECTION MIDRANGE
, (Approx 2.5 sec)
MOOE~ NO FD10R
CONTROl UNIT M'.UA'IOft.....1AIN(; DlIlGAAAI
Mrø TO INSTAlLATK* ~
ft".".-ocm·OQIooo ,,"02
CAUTION'
ØI.·~II UJØT "'lOR TO Sl:1MCINI1
WAANINClI
SUIISTITUTIOM OF COIØ>OM:NTI
.....'1 IMMIfI "'RnaK: IAf(TY.
REFER TO MANUAL.
WARMNGI
~,\~~..~1U0M
REFERENCE
Section 8.2.2
Section 8.2.2
Section 8.2.3
--"'7< -- --.-,.
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_"UllOA'" IIAllAllflOA'"
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Section 8.2.4
Section. 2.3
--
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In the majority of installations, none of the above controls
will need to be changed. If necessary to change the con-
trol settings, be sure to refer to the proper section in this
manual for details.
i
Figure 2.2
{í";~
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SECTION 3
/
/
Pollulert~ Fluid Detecti~~-'system surface water probes Pollulert system probe he~tèrs are also used to lower the
are used to detect hydrocarbons and many other hazard- viscosity of heavy petr91éum products to aid in control-
, ous liquids which may collect on theJJround, on water or ling recovery pumps.jiéater consists of a resistance wire
in drainage areas. Typical monitoring sites include element housed In .rigid aluminum conduit termlnatèd in
storage tanks, dike impoundment areas, 'holding ponds, an eXPlosion-p~6f junction box. Approved for Class I,
oil/water separators, sewer lift stations, wet'sumps and Division 1, G~uP D hazardous locations.
docks. Monitoring surface may be dry. Surfacê'Probes /
c?nsist of a section of four, inch diameter PVC Sl~~~ 32 SPECIFICATIONS
pipe attached to a mounting flange. The sensor IS ~. /
mounted on a float within the pipe. Rart Number FD241S
¡ '" MÌììlrium Detect Thickness '
Standard wobes are 30 inches high an9 will mo~'tor sur- ~f/HYdr carbons with Water
face water level changes of two feet. Special order I S S 25 i (F t t)
models are available in lengths up to 20 feet. n ump A· d' n't bal c fory se1/8
' JUs a e rom to
Each probe cap features a push-to-test button and three 1 in.
LED's to indicate probe status at the well. Yellow - Water, Minimum Detect Thic~ss
Red - Hydrocarbon and Green - Dry. of Hydrocarbons with Dr~
Sump . 0.62 in.
j Maximum Water Elevation
I Change' 2 t~
WARNING: FOR AREAS WHERE LOW TEMPÉRA- Number of Sensors 2 (1 palQ
TURES MAY BE A PROBLEM, THE SURFACE WATER Maximum Probes per "-,
PROBE MUST BE KEPT FREE OF ICE AND SNOW. A Control 10 (See Tàble, Page 1)
PROBE HEATER IS AVAILABLE. THE HEATER WILL *Operating Temperature
KEEP THE WATER AROUND THE PROBE LIQUID Range -400C to + 5qoC
DOWN TO - 40°C. TO ORDER A SURFACE WATER
PROBE WITH A HEATER, ADD AN "H'~ SUFFIX TO *To prevent freezing water from fouling probe, specify
THE PROBE PART NUMBER. / heater accessory when ordering by adding the suffix "H"
to the part number.
~
Surface Water Probes-FD241S
t~
I
3.1 GENERAL DESCRIPTION
ti-
5
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POUULERT®
.-'".'
SECTION 5
. FLUID DETECTION SYSTEM, FD102
.'.:
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..-----...
// \
DOUBLE WALLr.:~~~~~PROBES
FD22~J'\&£Qg:tO)
5.1 GENERAL DESCRIPTION
i
Pollulert@ Fluid Detection system tank probes are used to
detect hydrocarbons which leak into the annular space of
double wall tanks. Models are available for several types
of double wall tank construction. In one application the
annular space of the tank drains Into an external sump
which. is monitored by a probe. A smaller probe is also
available for insertion directly into the annular space of a
tank. Riser pipe must be 4" or 6" diameter.
Tank probes contain a .pair of sensors located on a float
or at a fixed, predetermined location In the annular wall
space. The probes are designed to detect a minimum of
1/8 Inch thick layer of hydrocarbons (sump model) or a
predetermined amount determined by location in the
annular space (direct insertion model). The amount will
quickly accumulate in the annular wall space or attached
sump when a leak occurs. The probes will ignore small
residual layers which may be present, but which do not
indicate a leak.
All probe model: will visually signal if the sensor is in
water or hydrocarbon. Each probe cap features a push-to-~,
test button and three LEDs to indicate probe status.
"Yellow· Water, Red· Hydrocarbon and Green - Dry. .
I
5.2 SPEÇIFICATIONS
Part Number FD221T FD210
Minimum Detect
Thickness iof Hydrocar-
bons with Water Present 0.25 In. (Factory Function of
I Set) Adjustable Location In
I from 1/8 to 2 In. Annular Space
Minimum Detect
Thickness of Hydrocar-
bons with Dry Condition 2 in. Function of
I Location in
i Annular Space
Standard Probe Depth 16 It. 12 It. Tank
, Dla. (Max.)
Number of Sensors 2 (1 pair) 2 (1 pair)
Operating Temperature
Range - 40·C to - 40·C to
+ 50·C + 50·C
5.3 INSTAllATION
5.3.1 MECHANICAL INSTALLATION
Remove probe assembly from the packing carton and
check contents against the packing list on the installa-
tion drawing nos. 500-0038-00DOOO (FD221 T) and 500-
0070-00DOOO (FD21 0). Refer to the same respective draw-
ings for proper installation procedures. (See Appendix).
CAUTION: PROBE SENSORS AND FLEXIBLE
CABLE ARE FRAGILE ELECTRONIC COMPONENTS.
CRUSHING THE FLEXIBLE FOLD CABLE OR INTER·
CONNECTING CABLE WILL IRREPARABLY DAM·
AGE THE PROBE AND VOID WARRANTY. -- ----
5.3.2 SENSOR ADJUSTMENT
The sensors on the float of the FD221T probe are preset
at the factory to 1/4 inch sensing depth. They may be field
adjusted to a minimum depth of 1/8 inch or a maximum
depth of 2 inches. (Refer to Figure 3.1).
· Loosen hex nuts at bottom of float at sensors.
· Thread sensors to desired depth.
. Tighten hex nuts (finger tight) back in place:
ir~~t
'.'~
IMPORTANT: BOTH SENSORS MUST BE AT THE
SAME DEPTH SETTING TO OBTAIN THE DESIRED
DETECTION THICKNESS.
6,.:.
~,
The probe sensors on the FD210 are not adjustable. The
thickness of hydrocarbon detection is purely a function
of the location of the probe in the annular space of the
double wall tank.
To prepare the instrumentation cable leads for termina-
tion, strip approximately one inch of the PVC insulation
jacket from the ends of the cables to be spliced. Now
strip approximately 1/4 inch of insulation from each of the
remaining wires. Match the corresponding colored wires
from the probe and the interconnecting cable and place
into the provided splice connector; then crimp.
,'r.."..·..· *"
CAUTION: TO INSURE PROPER PERFORMANCE
SPLICE CONNECTION SHOULD NOT BE EXPOSED
TO ANY MOISTURE.
5.3.3 ELECTRICAL CONNECTIONS
Refer to drawing 500-0038-00DOOO when wiring the
FD221T and drawing 500-0070-00DOOO when wiring the
FD210. Both can be found packed with their respective
probe. (See Appendix).
The five feet of connecting èable on the probe PVC cap
should be routed to a junction box leaving enough slack
to allow easy removal of the PVC cap for probe sensor in·
spection and cleaning. Entrance into the junction box
should be through a water-tight box connecfor. Allow one
foot of cable for splicing inside the junction box.
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POLLULERr~
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. . FLUID DETECTION SYSTfEM, FD102
The probe connecting cable should be carefully spliced to
the instrumentation cable inside the junction box. Splice
color to color using AMP Butt Splice Crimp Connectors
(#34067) Pollulert PIN 535-0042-00AOOO supplied with
probe or equivalent. Use AMP Crimping Tool (Super Champ
. #12540) or equivalent. . .."_._~~.."_..- .~._~."...,..¡..."_..-'
Where the possibility exists of the junction box being sub-
mersed in water, use an explosion-proof or water-proof en-
closure, andlor the epoxy pouch supplied with the probe.
Refer to the wiring instructions 500-0038-00DOOO (FD221T)
and 500-0070-00DOOO (FD210). See Appendix.
..þ
.--"''' -.........
A~~
;~~;:~
,.
. I
. NOTE:. FAILURE TO. FOLLOW THESE PROCEDURES
~. COULD IMPAIR THE PERFORMANCE OF THE PROBE
·.c ....AND VOID THE EQUIPMENT WARRANTy.t-·^' \
~...,.. ,'~ .._..._,__ _,.....'.___................".......~....¡......~.:",.."......~......-.........~_..._~ '1
In any case, it is very important that water does not enter
the butt splice crimp connectors or cause leakage paths
between the splices.
AT THE CONTROL UNIT
Refer to Section 2.4.3
This completes the probe wiring instructions,
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POUÐLERTÐ
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'. FLUID DETECTION SYS~EM, FD102
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Figure 6.1
POLLULERTe
ELECTRICAL/ELECTRONIC GROUP
IMHART
INDIANAPOLIS, INDIANA 46208
MADE IN U.S.A.
o
PROBE 1/
To set the probe for a specific threshold (detection) value,
proceed as follows:
i
I
threshold point. If the threshold where th~ alarm turns
off cannot be reached, there is tod much :residual con-
tamination to ulitize a vapor probe. If the threshold is
reached and the alarm turns off, rotate the'screw adjust-
ment one turn CW to decrease the sensitivity. Calibra-
tion is now complete. i
I
:
&1iA. Before placing the probe into the monitoring well, pow-
-\,?> er up the probe and rotate the adjustment screw in the
probe cap until the probe goes into alarm (CCW to in-
crease sensitivity and CW to decrease sensitivity). Next
rotate the adjustment screw one turn CW to decrease
the sensitivity.
NOTE: 25 TURN POTENTIOMETER HAS NO END
STOPS. IF ADJUSTMENT IS MORE THAN 25
TURNS IN A GIVEN DIRECTION, ASSUME THE END
LIMIT HAS BEEN REACHED.
B. Place the probe in the well and wait 5 minutes.
C. If the probe goes into alarm, the well is contaminated.
Proceed to step E.
This completes the adjustment of the vapor probe.
D. If the probe does not go into alarm, slowly rotate the ad-
. just~ent screw CCW to locate the threshold (alarm) point
again. Next rotate the screw adjustment one turn CW
to decrease the sensitivity. Calibration is now complete.
E. Rotate the adjustment screw clockwise to locate the
CAUTION: THE VAPOR PROBE SENSOR HOUSING
SHOULD ONLY BE CLEANED WITH WATER. THE
USE OF ANY OTHER TYPE OF CHEMICAL SOLU-
TIONS MAY PERMANENTLY DAMAGE THE SENSI-
TIVE VAPOR SENSOR AND VOID THE PROBE
WARRANTY.
14
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SECTION 8
-FLUID DETECTION SYST~M, FD102
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To check the functionality of the system, carèfully place
each probe into the above conditions and check for the
proper indication at the Push-To-Test button on top of the
probe cap. Likewise, ascertain the indication at the con-
trol panel. Checks can be conducted with the probe out of
its respective well in the following manner: i
DRY Indication· with the probe float assembly resting on
the probe weight assembly, a DRY reading will be dis-
played.
HYDROCARBON indication - with the probe float assem-
bly raised at least 2" above the probe weight assembly,
a HYDROCARBON reading will be displayed. This is be-
cause air, like hydrocarbons, is non-polar or non-'
conductive. To test a vapor probe, follow the prooedure in
section 6.3.3 for introducing product vapors to a probe.
WATER indication· with the probe float assembly raised
at least 2" above the probe weight assembly, and a clip
lead hooked across the probe sensors,,¡a WATER reading
will be displayed. An alternative to the clip lead would be
to moisten the thumb and forefinger and place them
across the probe sensors. -
START-UP & OPERATION
PROCEDURES
8.1 SYSTEM CHECK AND START-UP
At this point you are ready to check out the system, pro-
vided all electrical wiring has been completed and
checked.
Be sure that the 120 VAC INPUT has the black and white
power leads going to the respective BLK and WHT ter-
minals. Failure to follow this color code could cause the
fuse protection to be ineffective.
CAUTION: THE TERMINAL MARKED "GND" MUST
BE PROPERLY GROUNDED PER NEC CODE TO
MAINTAIN THE SAFETY OF THE SYSTEM.
(?t
8.1.1 POWER
Turn on power to unit. The red Light Emitting Diode (LED)
at the lower left side of the front panel, marked POWER,
will illuminate, indicating that the power is on. (Figure
8.1)
8.2 CONTROL OPERATION
-----~-
CAUTION: BEFORE OPERATING THE POLLULERT
~fLUID DETECTION SYs:FeM;.ALL INSTALLATION
Þ,'AND SYSTEM CHECK INSTRUCTIONS MUST BE
·'·FOLLOWED.
(t
· Protective barrier cover should be replaced and power
applied.
· AUDIBLE ALARM and LATCH switches should be set
according to requirements.
8.2.1 CONTROL STATUS INDICATORS (Figure 8.1)
DRY - If any or all probes attached to the control center
are in a dry condition, the green LED at the upper right side
of the front panel will illuminate.
WATER· If any or all probes attached to the control
center are in a water condition, the yellow LED at the
upper left side of the front panel will illuminate.
HYDROCARBON - Likewise if any or all probes attached
to the control center are in a hydrocarbon, the red LED at
the upper center of the front panel will illuminate, and the
relay will change state. The vapor probe sensors should
never be allowed to contact liquid hydrocarbons. While im-
pervious to water and vapors, the sensor will be destroyed
by liquid hydrocarbons.
NOTE: ONE OR MORE OF THE ABOVE CONDI-
TIONS MAY EXIST AT THE SAME TIME DEPEND·
ING ON THE STATE OF EACH PROBE.
NOTE: THE FD210 PROBE IS A SEALED UNIT,
MAKING ACCESS TO THE PROBE SENSORS 1M·
PRACTICAL. THE USE OF WATER AND KEROSENE
TO CHECK THE PROBE FUNCTIONALITY WOULD
BE MORE DESIRABLE FOR THIS CASE.
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8.2.2 AUDIBLE ALARM, LATCH AND MANUAL
TRIP SWITCHES i
As a final check, push the AUDIBLE ALARM disable switch
(Figure 8.1) to the ON position and the LATCH slide switch
in the ON position. Sliding the MANUAL TRIP switch to the
ON position will then enable an alarm condition (Le., the
red LED will illuminate, the Sonalert alarm will sound, and'
the relay will change state). However, when the MANUAL
TRIP switch is returned to the OFF position, the alarm states
will not clear. To clear the alarm state (reset), move the
LATCH slide switch to the OFF position (Figure 8.2).
Selection can now be made of the proper positions of the
AUDIBLE ALARM and LATCH switches. Changing the
AUDIBLE ALARM switch to ON will cause the Sonalert to
sound when an alarm is signaled. In the OFF position, the
Sonalert is disabled. Moving the LATCH slide switch to
the ON position gives the system a useful latching
feature. If the alarm is tripped the system will ~'Iock" into
I
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16
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POUULERT®
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FLUID DETECTION SYSTEM, FD102'
the alarm state. The system will continue to alarm, even
after the fault condition is removed. To disable or "reset"
the latch, move the LATCH switch to the OFF position.
In the majority of installations, the MANUAL TRIP and
LATCH switches will both be set to the OFF position.
This completes the system check and start-up proce-
dures. If any of these tests do not perform as described,
recheck the system wiring. If symptoms persist, replace
I '
the control unit and repeat the above tests. The probe(s)
can now be replaced and rechecked likewise.
I
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The FD102 control center cover can now be closed and
the fastener screw/clamps tightened with a screwdriver.
NOTE: THE AUDIBLE ALARM AND LATCH RE·
SPONSE TIME WILL VARY DEPENDING ON THE
SETTING OF THE TRANSIENT REJECTION CON·
TROl. DELAY IS FACTORY SET FOR 2.5 SEC. AND
SHOULD NOT HAVE TO BE CHANGED.
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17
POUULERT4Ð
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~/
-FLUID DETECTION SYST~M FD102
.~
VISUAL INDICATORS
INDICATE STATUS OF
PROBES:
YELLOW = WATER
RED =' HYDROCARBON
GREEN = DRY
POWER INDICATOR
VERIFIES SYSTEM
IS OPERATIONAL
NEMA 4 ENCLOSURE ,
FOR FIXED, PERMANENT
INSTALLATION; INDOORS
OR OUTDOORS
i
DATA OUTPUT CONNECTOR
(SPLASH PROOF)
.." ..
,;4-- OR
~,
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AUDIBLE ALARM DISABLE SWITCH
(PUSH·ON/PUSH·OFF) i
i
.....ula a.T.C:"'OIlil .V.T.M
"
AUDIBLE ALARM
SOUNDS WHEN
HYDROCARBONS
ARE DETECTED
~ft
Figure 8.1
.i
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INPUT POWER
CONNECTIONS
FOR 120 VAC
. SUPPLY VOLTAGE
MANUAL TRIP
SWITCH ALLOWS MANUAL
OPERATION OF RELAY
CLOSURE SERIAL DATA TRANSMISSION
RATE SWITCH
), OUTPUT CONNECTIONS
"j.,
;'J:¡ FOR RELAY CONTACTS TO START
-Ii PUMPS, ACTUATE ALARMS,
PHONE DIALERS, TELEMETRY,
ETC.
~---- -.-
LATCH SWITCH
TO ENABLE LATCH
AND ALSO RESET
DATA OUTPUT
CONNECTOR
(SERIAL & PARALLEL)
TRANSIENT REJECTION
CONTROL
HOLES FOR CONDUIT
CONNECTIONS
i
SENSOR INPUT
CONNECTION FOR UP TO
10 PROBES (PARALLELED)
(15 WITH PROPER
ACCESSORIES)
Figure 8.2
18
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POLLULERT®
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FLUID DETECTION SYSTEM, FD102
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1
8.2;3 PROGRAMMABLE DIP SWITCH
The DIP ¡switch has its individual levers identified 1
through 4. Moving the respective DIP switch lever to the
"On" position enables that function to control the relay
switch closure, as follows:
1 = Dry
2 = Water
3 = Hydrocarbon
The relay can be controlled to close on any combination
of probe states, depending only on which levers are set to
"ON".
8.2.4 TRANSMISSION RATE SELECTION
DIP switch lever 4 controls the data output TRANSMIS-
SION rate. When moved to the "Off" or down position, the
slow rate (15 minute period) is selected. Moved up to the
"On" position, the fast rate (1.5 second period) is
selected.
8.2.5 DATA OUTPUT CONNECTOR
The splash resistant connector has its output pins identi-
fied by numbers 1 through 9. Available signal voltages at
each pin are defined as follows:
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PIN OPTIONAL OUTPUT
IDENTIFICATION CABLE CODE SIGNAL
5¡ Black Parallel Data-
I 'J' WATER
6 Red Parallel Data-
POWER
7 Green Parallel Data-
DRY
Yellow Serial Data
Output
2 Shield Ground
4 Brown Parallel Data-
HYDROCARBON
The data output connector cap should be secured in
place whenever the connector is not in use.
"
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8.2.6 USING STRIP CHART RECORDER OUTPUT
(Serial Data) -......--...---__, / //
180,000 ohm isolation resist9rs' are required on the data
output socket for safety. /Because of the resulting high
output impedance of thé data output voltage sources,
we recomme76t strip chart recorders or recording·
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voltmeters with an input impedance of 10 megohms or
higher. If degradation of the signal amplitude is not critical
to operation, a strip chart recorder with 1 megohm im-
pedance may be used.
Serial data output to the strip chart recorder is taken from
the data output connector. Pin 2 is ground and pin 1 is the
serial data output. DIP switch lever 4 should be moved to
the down position for the slow (15 minute period) TRANS-
MISSION rate.
In operation the serial data output sequences on a 15
minute cycle rate. The data sequence is DRY, WATER,
HYDROCARBON and POWER, with respective voltage
levels of 3.0, 1.0, 2.0 and 5.0 VDC. If a hydrocarbon is de-
tected, the output goes Immediately to the 2.0 VDC level
and stays there until the hydrocarbon detect is removed.
If one of the states is not present (Le., DRY), during its
respective 15 minute interval, the serial output will be 0,
rather than 3.0 VDC.
If the serial data output is to be interfaced to a computer
for polling of numerous systems at various geographic
locations, the TRANSMISSION switch (4) should be ~.EI~, to
the fast (1.5 second period) rate. One cycle of serial:'dáta
'\.-.'"
will then be outputted in approximately 6 seconds. :c·
8.2.7 USING PARALLEL DATA OUTPUT
Pins 5, 4, 7 and 6 will provide 12 VDC output levels in the A
presence of WATER, HYDROCARBON,DRY and POWER ",~:
respectively. All outputs are measured with respect to
ground (Pin 2). This output can be processed in any way
required by the customer.
8.2.8 USING THE PROGRAMMABLE RELAY CLOSURE
The internal DIP switch (levers 1,2 and 3) allows more ver-
satile operation of the relay contact closures. Any com-
bination of DRY, HYDROCARBON and WATER can be
programmed to enable the relay contacts.
For example, if a relay closure were required for both
WATER and HYDROCARBON, levers 2 and 3 would be
moved to the "up" (On) position. ___
The Sonalert audible alarm also tracks the programmable
switch settings. For example, if the system were pro-
grammed to give a relay contact closure on water (lever 2
enabled), when water was detected the relay contacts
would close and the Sonalert would give its audible
alarm.
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19
1·
.
POUULERTG
.LUID DETECTION SYST~M, FD102
f~
Figure 8.3
rt
8.3 PROBE OPERATION
Up to 10 standard probes can be used with the FD102 con-
trÖI center, with the Light Emitting Diode (LED) status indi-
åators (Figure 8.1) giving the proper DRY, WATER or
HYDROCARBON displays. One or more of these displays
may be lit, depending on the number of probes being used
and the status of the wells or sumps in which the respec-
tive probes are located. To substantiate the status of the
wells or sumps in which the respective probes are located,
the PUSH TO TEST switch on the probe caps may be
depressed to obtain a readout of the condition of that par-
ticular probe. A WATER (yellow LED), HYDROCARBON
(red LED) or DRY (green LED) indication will be given as
long as the switch is depressed. This is a very desirable
feature as the individual probes do not have to be removed
to sample the liquid in the well or sump (Figure 8.3)
During normal operation of the Fluid Detection System, one
or more of the three status indicators at the control center
should be illuminated. It ever the WATER, HYDROCAR-
BON, and DRY LED status indicators are all off simultane-
ously, (and the POWER LED is lit), there is a good chance
that the cabling from the control center to the probes has
been severed. If such is not the case, then the control center
---may be at fault and should be returned for repairs.
(1
8.3.1 PROBE LED STATUS ¡
The following table will be useful in the interpretation of the
LED status indicators on the control center, i
I
:
I
LED STATUS
REO YELLOW GREEN
X
X
X
X X
X X
X X
X
X
!
INTERPRETATION i ACTION
I
Probe or probes Normal situation
are all In dry en-
vironment (no li-
quids present).
Probe or probes Normal situation
are all In water or
other polar (con-
ductive) liquid.
One or more
probes have
detected hydro-
carbons or
other non-polar
(non-conductive)
liquids.
One or more
probes are seeing
hydrocarbons. Re-
mainder in water.
One or more
probes are seeing
hydrocarbons. Re-
mainder are dry.
I
Depress switch
on Individual
probe caps to
find alarming
probe.
,¿
Depress switch
on individual
probe caps to
tind alarming
probe or probes.
!
Dep'ress switch
on individual
probe caps to
find alarming
probe or probes.
Probe or probes Normal situation
are in water or dry.
One or more Depress switch
probes are seeing on individual
hydrocarbons. Re- probe caps to
malnder are dry or find alarming
in water. probe or probes.
X
System Failure
Refer to
"Trouble-
shooting", Sec. 10
i
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POLLULERT®'
'11"""""'"
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/
.
FLUID DETECTION SYSTEM, FD102
SECTION 9
9.1 INTRODUCTION
PROBE MAINTENANCE
~;
When installing or servicing the Pollulert® Fluid Detec-
tion system probes, it must be kept in mind that the
probes are sensitive, delicate devices. Although they can
withstand some abuse, the probe caps, their associated
flotation components, and the flex-fold cable should be
handled with care. This consideration should be given to
any delicate instrument.
9.2 FREQÛENCY OF MAINTENANCE (GlAtH-{¡..1 ~ )
The time between maintenance periods is a variable that
will depend on the environment in which the probe is
operating. In actual field tests, units whose probe sen-
sors were subjected to algae buildup in the water will not
have their performance inhibited. It is recommended that
the installation be checked every 60 to 90 days visually for
severed oi damaged wiring. Of more importance is check-
ing the probe site for debris accumulation that may affect
the mech~nical operation of the flotation system. Sump
wells and other containment areas utilizing a probe
should be routinely inspected for debris. Accumulations
should be removed at that time. The Push-to-Test switch
should be depressed on each probe to ascertain the
probes performance. One of the 3 LEOs should be il-
luminated when push to test switch is depressed. If none
of the LED's Is lit, the system should be checked.
~
9.3 CLEANING
Gasoline or diesel fuel, both readily available solvents,
can be used to clean accumulations of less viscous
hydrocarbon products on the probe sensors and related
flotation parts. A small brush would be helpful in applying
, the cleaner, and brushing away any residue.
CAUTION: THESE SOLVENTS ARE EXTREMELY
FLAMMABLE. DO NOT USE NEAR HEAT, SPARKS
OR OPEN FLAME. USE ONLY IN A WELL VENTILAT-
ED AREA AND AVOID REPEATED OR PROLONGED
CONTACT WITH SKIN OR BREATHING OF VAPORS.
FOLLOW INSTRUCTIONS PRINTED ON THE LABELS
FOR ALL SOLVENTS.
@heprecedingcleaningmethOdS.donoapPIYtotheva3
¿obes. At no time whatsoever should the vapor probe sén-
sorsoe exposed to liquid hydrocarbons.
CAUTION: THE VAPOR PROBE SENSOR AND HOUS-
ING SHOULD ONLY BE CLEANED WITH WATER.
THE USE OF ANY OTHER TYPE OF CHEMICAL
SOLUTIONS MAY PERMANENTLY DAMAGE THE
SENSITIVE VAPOR SENSOR AND VOID THE PRO~E
WARRANTY.*:};
'0:':'
9.4 REPLACING PROBES
When returning probes to their respective inspection \V~~fMi)
or sump wells, please follow installation instructions in Sec- ·
tions 3 through 7. DO NOT lower the wire rope and weight
down into a well and then allow the flotation assembly and
probes to slide down the cable until they strike the water
or lower guide plate. Instead, rest the flotation assembly
on the weight and simultaneously lower both into the well.
SECTION 10
TROUBLESHOOTING
10.1 GENERAL
While all Pollulert@ Fluid Detection systems are 100%
factory inspected, problems will sometimes occur. The
troubleshooting instructions contained in this section
are intended for use by personnel who have a basic
understanding of electrical circuits. Instructions have
been written to assist in isolating the system fault to the
control cènter, instrumentation wiring, or probe. Repairs
internal to the control center should be left to the factory
authorized service.
WARNING: ANY ATTEMPTS TO SUBSTITUTE COM-
PONENTS OR IN ANY WAY REPAIR CIRCUITS IN-
TERNAL TO THE CONTROL CENTER MAY IMPAIR
THE SAFETY OF THE SYSTEM AND VOID PRO-
DUCT WARRANTIES.
1 0.2 FALSE ALARMS
Care must be taken in the initial Pollulert installation and
in providing periodic inspection and cleaning of the probe
assemblies (refer to Section 9), to avoid the possibility of
the control center displaying a false alarm.
The following paragraphs will review and give an Insight
into how such situations can occur. These situations
should be studied carefully as they can give possible
clues to service personnel on how to proceed, if the con-
trol center and probes all check out okay electrically.
SITUATION A: CONTROL CENTER STATUS LEDs SHOW
HYDROCARBON CONDITION, INSPECTION OF ALARM-
ING PROBE SHOWS WATER IN SUMP OR WELL, BUT NO
HYDROCARBONS.
If probes are not installed properly in their respective
sump well or inspection well, hinderance of the mechani- ~l'
cal travel of the flotation assemblies can cause the probe
sensors to exit the air/water interface. As air, like hydro-
carbons, is a non-polar (non-conductive) medium, it will
21
POUULERT®
e
v
'.FlUID DETECTION SYSTEM, FD102
.i~
~-~cause a hydrocarbon alarm. Improperly installed well-
screen (sections not properly aligned when coupled) may
cause the floatation assembly to hang up on the sides of
the well screen in a receding water situation. This would
cause an alarm.
i
)
SITUATION B: CONTROL CENTER STATUS LEOs SHOW
HYDROCARBON CONDITION. INSPECTION OF ALARM-
ING PROBE SHOWS WEll OR SUMP IS DRY, WITH NO
HYDROCARBONS.
A proprietary electro-mechanical system in the probe
flotation assembly prevents alarming of a probe in a "dry"
environment (Remember-air is a non-polar medium like
a hydrocarbon). For this mechanism to function, the
probe flotation system must be allowed to travel freely to
its lowest point of travel, where the electro-mechanical
system performs its function. If a silt buildup, debris or
other foreign matter is introduced to prevent this free
movement of end of travel, the probe will give a hydro-
carbon alarm.
;fft
NOTE: ENOUGH EMPHASIS CANNOT BE PLACED
ON THE NEED FOR PERIODIC MAINTENANCE ON
THIS OR ANY OTHER FIELD INSTAllATION OF AN
ELECTRONIC MONITORING SYSTEM. ATTENTION
TO SUCH DETAIL.S WILL RESULT IN AN EFFEC·
TIVE, RELIABLE OPERATING SYSTEM.
10.3 PROBES
Tb~ Pollulert@ Fluid Detection system probes are active,
~.ot passive, units. The detection circuitry and associated
logic are encapsulated inside the probe well cap. Connec-
tions to the probe circuitry are made via color coded, in-
sulated wires exiting from the top of the well cap.
Although the probe circuitry is protected from improper
wiring, care should be taken in the probe installation.
Never connect or disconnect a probe without first remov-
ing the power to the FD102 control center. Care should
also be exercised in the probe wiring. Color codes should
be adhered to according to the instructions for a specific
probe.
\
¡
10.4 PROBE FUNCTIONALITY CHECK
The PUSH TO TEST switch on the probe well cap should
be depressed every 60 to 90 days to ascertain the fact that
rt
the probe is functioning properly. One of the three LEOs
should be illuminated, when the button is pressed, at all
times. Failure to get a lit LED will indicate the probe is not
functioning properly and the system performance should
be checked. Further checks can be made, if necessary, by
removing the probe from the ground well or sump well and
actually exposing the probe sensors to water, air or
hydrocarbon. The PUSH TO TEST switch, should be
depressed under each condition to check for proper LED
illumination. The red LED should illuminate for hydrocar-
bon, the yellow LED for water and the green LED for (air)
dry. A useful tool for checking the probes is the FD400 Field
,
Test Set (Sectior'l 10.8). !
,
,
10.5 PROBE ELECTRICAL CHECK'
I
A handy instrument, available in most electronic stores,
is a volt-ohmmeter. It is commonly referred to as a VOM.
A VOM that can accurately measure resistances and
voltages is recommended. The Heathkit VOM, model
IM-5217, is used by the factory service group and will be
referenced in the tests to be described. The voltage read-
ings will be made at the splices (junctions) where the
probe cable has been connected to the instrumentation
cable (refer to Electrical Installation, Seçtions 3 through 7.)
All measurements will be made with thEf'VOM ground input
lead (black with an alligator clip) attached to the cable
shield or drain lead (Figure 10.1). The rotary selector
switch should be set to a range of 15 volts, DC, or higher.
As done in paragraph 10.4 above, expose the probe sen-
sors to water, air or hydrocarbon. The respective readings
at the various cable lead junctions should cOnform to the
readings shown in Figure 10.2. Under all monitoring con-
ditions, a voltage of 8 to 15VDC should be present at the
red lead as shown in Figure 10.2. If no voltage is present
at the red lead, the instrument cable may be severed or
the control center is not operating properlY. In such a
case, proceed to the troubleshooting section's for instru-
mentation cabling and control center, which follow. If the
proper voltages appear at the red lead, but not at the
black, brown, or green leads, the probe is not ;functioning
properly and should be replaced with anoth'er probe to
ascertain its failure.
22
I".~· ,-'-.", '-;;q;-';ír,-¡':;-"; ".
,.".....,"''''',.¡,..4I..,.,-.,'
7
:"'--:í"-- ,
'.'
POLLULERr~·
FD210
FD210V ,
f2:"ì FLEXIBLE CONDUIT
~ OPTIONAL (NOT SUPPLIED)
¡$j. (§j
ceo
PROBE CONNECTING CABLE @
BUTT SPLICE CRIMP CONNECTORS r:;'\
~
, .
.. :!
INSTRUMENATION CABLE
FROM PROBE INTERROGATOR.
~ §! 0
J'
TANK ANNULUS WIRING INSTRUCTIONS
1. a. Carefully insert the probe assembly into the tank annulus as shown
in installation No. 500-0055-00DOOO. '
b. Slide the 2" PVC cap down snugly over the end of the 4" or 6" adaptor.
c. Pull guide cable taut and slide cap cable stop down cable to cap and
fasten with alien wrench.
2. a. The 5' connecting cable on the PVC cap should be routed to a junc-
tion box. (Leave enough slack to allow easy removal of the PVC cap
for sensor inspection and cleaning.)
b. Entrance into the junction box should be through a watertight box
connector.
c. Allow l' of cable for splicing inside the junction box.
3. a. The probe connecting cable should be carefully spliced to the in-
strumentation cable inside the junction box.
b. Splice color to color using AMP butt splice crimp connectors (#34067),
supplied with probe, or equivalent.
c. Use AMP crimping tool Super Champ #12540 or equivalent.
I PROBE CABLE INSTRUMENTATION CABLE
! Red Red
! Green Green
, Black Black
Brown Brown
Shield Shield
I
I
4. a. This completes the probe wiring instructions.
b. Neatly coil the excess guide cable and instrumentation cable, lacing
with tie wraps supplied.
5. a. Continue installation per the probe interrogator manual.
6. a. During operation, the probe status can be indicated by depressing the
"push to test" button on well cap.
RECOMMENDED INSTRUMENTATION CABLE
FOR CONNECTION TO THE "CONTROL CENTER"
PROBE MODELS CONDUIT INSTRUMENTATION DIRECT BURIAL INSTRUM.
, , CABLE
PO.L 304
'POL 314 (SEE NOTE)
37
.
FLUID DETECTION SYSTEM, FD102
'12 N.P.T. NIPPLE
(FOR CONDUCT CONNECTION) f'1?\
GUIDE CABLE \..:.:::;J
RTV (AFTER INSTALLATION)
CAP CABLE STOP @
P.V.C. CAP r.-~
'ð
~
SENSOR @
---
. Nema 4 Rainproof (or better rating) Junction Box for above
ground installations. For below grade installations Waterproof
Junction Boxes must be used to insure no leakage of wàtèÍ'.
If necessary fill the enclosure with hot paraffin (wax) and åUOw
time to cure.
I
~I
@
TOP VIEW OF WELL CAP.
·NOTE: Underwriters Laboratories (UL) requires that the POL
314 Direct Burial Cable be terminated in a junction
box outside the building housing the control center.
In the case of a control center located outdoors, again
the direct burial cable (POL 314) must be terminated
in a junction box. Conduit Instrumentation Cable (POL
304) is the only cable allowed to enter the control
center from the external junction box. or directly from
the probe location.
. (Crouse Hinds Model No. GU·I·II & 0 Ring Gasket Pt. No. 6 \, ..
GASK458 or Equiv.) .,
DRAWING. NO. 500-0070-00DOOO (Sheet 1 of 4)
POUÐLERTGP
.
~
'LUID DETECTION SYSTE~, FD102
·a
-Vi'
NOTE: Wiring and installation, is the same on the 2 in. probe
cap and 4 in. probe cap.
--~-
\.-- --
'it
~i'.;,
......'1
?(~~
,>;'~r >
4 IN PROBE CAP
USED ON FD210
During operation the probe status can be determined as follows:
a.) Remove plug ill from probe cap housing. (Wipe off moisture
or condensate from surface of housing prior to removal of
plug).
WARNING: UNDER NO CIRCUMSTANCES SHOULD
PLUG BE REMOVED WHILE PROBE CAP IS IM-
MERSED UNDER WATER.
b.) Referring to the diagram ® on the probe cap overlay,
depress the push to test button inside the plug opening. The
respective OIL (0), AIR (A) or WET (W) LED will illuminate
to give the probe status.
t
c.) Replace the plug in the probe cap. Be sure the seal is in place
before threading the plug into the cap. Be sure the plug is
completely seated against the seal to insure a waterproof
condition.
EPOXY PFJOCEDURE FOR SEALING CONNECTIONS
1 Strip instrumentation cable.
.~
~,m~
7/8 TYP.
2 Cut Butt Splices in half.
(1) Half butt splices per conductor.)
.. [! CUT
- D -- LïNê --.i:
BUTT SPLICE
i
3 Connect instrumentation cables by wire color' with
cut butt splices.
y;
.
I
4 Bunch butt splices together, remove epoxy pouch
from wrappr, remove plastic separator, and mix the
epoxy thoroughly.
Push all expoxy to
one end of pouch
and cut 23,4 off
of the other end.
"'~I'
23/.0
CUT
L - - - 5'/2 REF
LINE ~ .
EPOXY POUCH
5 Push connections into the pouch containing the
epoxy making sure that all the wires are covered
by the epoxy. Let cure for 24 hours.
n,lI, n,I1, PI n, p, fI, r~
111'1'1'1.1"11"1'
~~~~~4J
I I I I
I I I I
I I I I
I II I
i
!
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I
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I
CUT END
~
38
DRAWING NO. 500-0070-00DOOQ (Sheet 2 of 4)
PouOLERTe
....,."..,..,w+
!""';7'"-
~--
.
FLUID DETECTION SYSTEM, FD102
Prior to installation of the probe, an optional Field Test set, Model
FD401, can be attached to the probe cable to check operation (refer
to instruction booklet supplied with the Field Test set).
Proceed to sheet 2 and install probe into tank as shown.
When probe installation is complete, refer to wiring instructions,
drawing 500-o07D-OODOOO (FD210), 50D-0056-00DOOO (FD210 RA)
INSTALLATION OF
DOUBLE-WAL FI ERGLAS TANK PROBE
i
i/
./
i
FD210 RA
TO PLACE PROBE ON THE
BOTTOM OF THE TANK ANNULUS
1. Hold the cap & SS. lead loop together in your
hands.
2. Pull upward to take up slack.
3. Mark the signal cable at the top of the stand pipe.
4. Wrap up excess signal cable as shown in Fig. 2.
5. Unscrew cable stop from loop & feed up through
cap center hole.
6. Screw cap onto stand pipe.
7. Pull SS lead tight & fasten cable stop. Cover hole
& cable stop W/RTV.
y
o I PROBE I
<>0
, '
i
CONDUIT
MARK
CABLE STOP
~\
../
Figure 2
USE TIE WRAP TO
FASTEN SIGNAL CABLE
TO CENTER POST OF
CAP AT MARK.
SIGNAL CABLE
t ,'
~¿;
!1.~~ 6 IN. TO 2 IN. THREADED OR
4 IN. TO 2 IN. THREADED FEMALE
4 IN. OR 6 IN. SOLID RISER
PIPE MUST BE USED. (NOT SUPPLIED)
MANHOLE UNIVERSAL #60 W
OR EQUIV.
TAMPED BACKFILL
4 IN. OR 6 IN. R. SER PIPE INSTALLATION
2"-4"
ASPHALT OR
CONCRETE APRON
AN HOLE
~ ......
TYPICAL TANK PROBE
MANHOLE INSTALLATION
(Aprons Are Suggested As Standard
Installation Practice)
2 IN. SOLID RISER
PIPE WITH 2 IN. FEMALE
N.P.T. ADAPTOR
(NOT SUPPLIED)
TAMPED BACKFILL ~)
TYP. 2 IN. FEMALE N.P.T.
"NST ALLA TION
39
DRAWING NO. 500-o070-00DOOO (Sheet 3 of 4)
I ,.'~ ;'5 POLLUtERTfI
¡
'-
v"
.'~ I
è ,UID DETECTION SYSTEM, FD102
5T ANDARD INST ALLA TION
'. ,
I
1. INSTALL FISH
INTO TANK
~
2. RUN FISH AROUND F
T~AL T\
--'-
(HOOK
F 3. HOOK FISH &
PULL UP STAND
ì~
4. ATTACH PROBE F
LEAD TO FISH END
,ATTACH HERE
\, PROBE
r P5. PULL FISH OUT F
Ý i OF TANK WHILE
FEEDING PROBE
LEAD INTO TANK
r PRO~E CAP
F
.,
6. DISCONNECT PROBE
. LEAD FROM FISH
END. PULL THROUGH
CENTER HOLE OF
PROBE CAP. SLIDE
CABLE TIE OVER WIRE,
PULL UP SLACK &
FASTEN TIE IN PLACE
WITH HEX WRENCH
SUPPLIED.
(FIGURE 2
SHEET 1.)
ATTACH HERE
.~PROBE CAP
. L CABLE TIE
t
FISH
,END
PROBE LEAD
40
DRAWING NO. 500-0070-00DOOO (Sheet 4 of 4)
I
!
. I
,
02. 07. ,84.
1 1 : 2 2 Ae :>t< F A elL I TIE S
,
MNG.
POl
'Mercy Hospital
+
FACSIMILE COVER SHEET
TO;
FRO~:
DATE:
Øð~ Tvf¿K
'l<.eA) S Tt!7NeC(~HeÆ
ø2-1-7'y
# of Pages.2 '
(Including' Cover Sheet)
I
I
,
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!
COMMENTS :L Ad! S £!.,J-DltJ6 '/t!J{J A &¡P V
c;F /He..PPe.v4AJTlIle.. fI1AJA}re,JANcL
f!..(Jt'/)HJA~AJ})ßr/IJNs ON Tff~ ~cUe¡Js.. ¿"OL/'JINd=-
f..~/o' ~ -ell) <ð~ .
II/IL-L 15e.. AJ.;})€f) To ðO~ t!ul!.~;p¡t/r
SY~T~A'1 Fo~ rife StJtJTK µ)Ë-'5T
, . I
!I&J5,/J/T/f1 ;f' .,(;t:)/Ù ~ ' ('J ¡J /I tpoA-L T€¿f lY
151rt~ <; e. 5 i
lj/)
1,/11,
PaC:Wties Management
2115 Truxtun Avenue
P.O. Box 119
R~kl!!':~fil!!':ld. CA Q~:l¡02
'/{
02. 07. 84
1 1
22Att *FACILITIES
MNG.-,
, '"
F02
P ACKI NG ¡'lßUJ.~.fk~1'.lU;.trLlhB.~L~ OPH l
I
PREVENTIVE KAINTENANCE
OkJelJ 5
CðI.NIIJt: ¡¿ S" 10 SefJStf'J I{
The OPW 1 is desivned to require a minimum of maintainanoe. rot best performance,
ho~ever. be sure to follo~ these steps:
1. Inspect and ~lean the interior of the spill ~ontainer on a regular b~sis to
remove any dirt or grit.
2. %nspect the container on a ragularbasis for oracks or cuts. The container
must remain tight to do its job properly.
3. ~ake sure that all seals and clamps are tight and in their proper position.
7
---~---- - -
FIRE DEPARTMENT
S. D. JOHNSON
, FIRE CHIEF
,
\ ,I CI~~ gf BAKERSFIELD
'\ ~ 'WE CARE"
~~ t ~ \/~~I -=-..--
~\ (~\ ~ ~
\ ~ ~~~
~\ I
.
Dear Business Owner:
fa'
\0 ß U . 1· .
~ I dì,~ 0
" ~ f v' ~ '3 '
\:\tJ (;) 7 ;:f
~I V ï-'1
Memorial Center for Behaviorial Health L " l 3
'-~-"5'20T Wftitel:::ãnê--~==~~~---'-~ -=~~ -. :. '-~:/7F' ~~-~~~--=- Å._.o~ "-.
Bakersfield, CA 93309 q I,~~.
\ / (lP'/
This notice is meant to act as a reminder that the California Health and Safety
Code, Chapter 6.7 Section 25284 (C), requires that any person assuming ownership of
an underground storage tank used for the storage of hazardous substances for which
a valid operating permit has been issued shall have 30 days after the date of assumption
of ownership to apply for any operating permit pursuant to Section 25286.
_ ':This means that as-ã new~owner'you mLJst submifciñ Underground Storage Tank,
: applic'ation form, Forms A, Band C completed for each tank .ªt this J~cili~ (forr:ns
include?) ¿rid:àståte surcharge of $5~.~0_for .~~ch tank. j
.- .---- -~ + - - .
You have 30 days from the date of this letter to complete and return these forms
along with the state surcharge to 2130 "G" Street, Bakersfield, Ca. 93301. If you have
any questions or "if We· can 15éfê5f 'anYdfcrrth-erassistance-please-don'-t-hesitateto call
326-3979.
4~~
1 ~alph E.<":"'Huey
Hazardous Materials Coordinator
RECE\VED
JUN 3 0 1993.
H,A?, ~.JIAT. OIV.
--
. ST~;~-~~~~~~~~~~~ö~~~~~~.~
CERTIFICATION OF COMPLIANCE
FOR UNDERGROUND STORAGE TANK INSTALLATION
FORM C
,_-=-:_H~:, '1_
~~A4'(-:l~~~
~'¡ ..
- ij.
COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM
-
--
I. SITE LOCATION
STREET S C:<O( t<)A/~ ¿ /? _
CITY ,J?ðbrfh'-t!(~
COUNTY ,~ 1-'17
-
~=,-~
----".- --~- ~
~---=---~---~-==-~~~~-
---
-
II. INSTALLATION (mark all that apply):
--
--
-
~he installer has been certified by the tank and piping manufacturers.
Q}- The installation has been inspected and certified by a registered professional engineer.
~The installation has been inspected and approved by the implementing agency.
~ All work listed on the manufacturer's installation checklist has been completed.
æ(' The installation Contractor has been certified or licensed by the Contractors State license Board.
C Another method was used as allowed by the implementing agency. (Please.specify.)
-
----
-
-
-
~_...- -
, ~. - ......~_.- .
---~-"
-~--~_.
- ~-- --....., -------.-c~ --<-- ~
--
----
---=
-
III. OATH I certify thattheinformation provided is true to the best of my belief and knowledge.
L2\
Tank owne~y\ k'R.l-'n
Print Name B / "/1
Address I c-vl/ '[J
Date '/7/93
Phone ( ~ ðS1 .3 '.?- / Þð (J
r33ð 9
--
-
-
--
LOCAL AGENCY USE ONLY
--
STATE
TANK 1.0. #
COUNTY #
CD
JURISDICTION #
[IT]
FACILITY #
=-
TANK #
ITIIIIJ
--=~
--
--
FORM C (7191)
THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY
FOAOO:
-
if
,'- l,
~,;....
r' '-"'\
I' - ......
=,,~-, -,-. BAKERSFI,ELD MEMORIAL H
'_. " 420-34lh 51.
, Bakersfield. CA 93301
. .
,)aie: 06/25/93
SPITAL,
55-1368
441.
Check No. 098104
098104
Vendor No. 00296
I' ,
~*****$2490.20 i
MOUNT STERWJG OFFICE,
BANK-ONE. CCVJMSUS. NA
100 EAST BROAD STREET
COlUMBUS, OH 43215
'J the
p~ TWO THOUSAND FOUR HUNDRED NINETY 2b/l00 DOLLARS
BAKERSAELD MEIoIORIAL HOSPITAL
:jrder
of
CITY OF BAKERSFIELD
POBox 2057 ..
Bakersfield, CA
,
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93303-2057
IN COOPERATION WITH
BANK OF AMERICA
1110 qa ~O 1.,111 1:0 I., I., ~ ~ 1 \;8 ~I: 0 ?II'O 50 ~ qUI
INVOICE NO. DATE
1M 785501 92-9306/01/93
'ERMIT 06/23/63
~R-03505 05/31/93
DESCRIPTION/REFERENCE
GROSS AMOUNT
99.00
~
2335.20
CheCK Date: 06/2:5/93
CheCK No:: 098 10,4
DISCOUNT
0.00
0.00
0.00
NET PAY
99..00
56.00
2335.2:0
\/endor No.:
00296
UNDERGROUND TANK
II'
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g- \ - ,:l..<,U s' .
D 11- ~~08D rø;J
ERSFfELD MEMORIAL HOSPITAL
'¡20-34th St
Bakersfield, CA 93301
TOTALS
2490.20
0.00
2490.20
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B019~020
561:00 Ot~!29 /:i3
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sf ATE OF CALIFORNIA
STATE WATER RESOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK PERMIT APPLICATION· FORM B
COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM.
MARK ONLY ~1 NEW PERMIT
ONE ITEM ' 02 INTERIM PERMIT
o 3 RENEWAL PERMIT
o 4 AMENDED PERMIT
o 5 CHANGE OF INFORMATION
o 6 TEMPORARY TANK CLOSURE
D 7 PERMANENTLY CLOSED ON SITE
o 8 TANK REMOVED
DB~R FACILITY NAME WHERE TANK IS INST ALLED:
.t
<!ei1 P
I. TANK DESCRIPTION
COMPLETE ALL ITEMS - SPECIFY IF UNKNOWN
A. OWNER'S TANK I. D. # B. MANUFACTURED BY: ;;roof{
C. DATE INSTALLED (MO/DAYIYEAR) ,,'_/~...B7 D. TANK CAPACITY IN GALLONS: /&00
II. TANK CONTENTS IF A·1IS MARKED, COMPLETE ITEM C.
o 1 MOTOR VEHICLE FÙEL 0 4 OIL B. C. D 1a REGULAR f:[ 3 DIESEL 0 6 AVIATION GAS,
A. UNLEADED
~ 2 PETROLEUM 080 EMPTY ~1 PRODUCT D 1b PREMIUM 4 GASAHOL 0 7 METHANOL
UNLEADED D 5 JET FUEL
D ,3 CHEMICAL PRODUCT D 95 UNKNOWN D 2 WASTE D 2 LEADED D 99 OTHER (DESCRIBE IN ITEM D. BELOW)
D. IF (A.1) IS'NOT MARKED. ENTER NAME OF SUBSTANCE STORED .-#~ C.A.S.#: 62'1-76'34-6
III. TANK CONSTRUCTION MARK ONE ITEM ONLY IN BOXES A, B. AND C, AND ALL THAT APPLIES IN BOX Ò AND E
~ 1 DOUBLE WALL D 3 SINGLE WALL WITH EXTERIOR LINER D 95 UNKNOWN
A. ~~~~~ D 2 SINGLE WALL 4 'SECONDARY CONTAINMC¡~{~'éT~) D 99 OTHER
~1 BARE STEEL (M//.2 STAINLESS STEEL D 3 FIBERGLASS 4 STEEL CLAD W/FIBERGLASSREINFORCEDPLASTIC
B. TANK ~
MATERIAL 0 5 CONCRETE 6 POLYVINYL CHLORIDE D 7 ALUMINUM D 8 100% METHANOL COMPATIBLE W/FRP
(Primary Tank) D 9 BRONZE 10 GALVANIZED STEEL D 95 UNKNOWN D 99 OTHER
D 1 RUBBER LINED 2 ALKYÇJ LINING D 3 EPOXY LINING D 4 PHENOLIC LINING
1;Zj 5 GLASS LINING D 6 UNLINED D 95 UNKNOWN D 99 OTHER
~ ~ING MATERIAL COMPATIBLE WITH 100% METHANOL? YES _ NO~
C. INTERIOR
LINING
D. CORROSION
PROTECTION
D 1 POLYETHYLENE WRAP 0 2 COATING
o 5 CATHODIC PROTECTION 0 91 NONE
o 3 VINYL WRAP
D 95 UNKNOWN
~, FIBERGLASS REINFORCED PLASTIC
tJ ~9 OTHER
E. SPILL AND OVERFILL
SPILL CONTAINMENT INSTALLED (YEAR)
OVERFILL PREVENTION EaUIPMENT INSTALLED (YEAR)
IV. PIPING INFORMATION CIRCLE A IF ABOVE GROUND OR U IF UNDERGROUND. BOTH IF APPLICABLE
A. SYSTEM TYPE CTION A U 2 PRESSURE A U 3 GRAVITY A U 99 OTHER
B. CONSTRUCTION A U 2 DOUBLE WALL A Ù) 3 LINED TRENCH A U 95 UNKNOWN A U 99 OTHE R
C. MATERIAL AND BARE STEEL A U 2 STAINLESS STEEL A U 3 POLYVINYL CHLORIDE (PVC) U 4 FIBERGLASS PIPE
CORROSION ALUMINUM A U 6 CONCRETE A ø 7 STEEL W/ COATING A U 8 100% METHANOL COMPATIBLE W/FRP
PROTECTION 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 D31N IAL o 99 OTHER
¡ MONITORING
V. TANK LEAK DETECTION
D 1 VISUAL CHECK D 2 INVENTORY RECONCILIATION D 3 VAOOZE MONITORING ~ AUTOMATIC TANK GAUGING D 5 GROUND WATER MONITORING
D 6 TANK TESTING ~ 7 INTERSTITIAL MONITORING 0 91 NONE D 95 UNKNOWN D 99 OTHER
VI. TANK CLOSURE INFORMATION
1. ESTIMATED DATE LAST USED (MO/DAYIYR)
2. ESTIMATED QUANTITY OF
SUBSTANCE REMAINING
3. WAS TANK FILLED WITH
'GALLONS INERT MATERIAL?
,YES 0 NO 0
THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY. AND TO THE BEST OF MY KNOWLEDGE..IS TRUE AND CORRECT
APPLICANT'S NAME DA TE
IPRINTED & SIGNATURE) B/I/ {;J i 7.3
LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER IS COMPOSED OF THE FOUR NUMBERS BELOW
STATE 1.0.#'
COUNTY #
[lJ5j
JURISDICTION #
mJJ
FACILITY #
~
TANK #
[IJLIIQlLJ
I PERMIT EXPIRATION DATE ,
PERMIT NUMBER
I PERMIT APPROVED BY/DATE
FORM B (7-91)
THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION· FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED.
FOR0034 ß.R5 "
~þ ,~
. STATE OF CALIFORNIA e·
STATE WATER RÈSOURCES CONTROL BOARD
UNDERGROUND STORAGE TANK 'PERMit APPLICATION· FORM A
COMPLETE THIS FORM FOR EACH FACILlTYISITE
MARK ONLY ~ 1 NEW PERMIT
ONE ITEM 0 2 INTERIM PERMIT
o 3 RENEWAL PERMIT
D 4 AMENDED PERMIT
o 5 CHANGE OF INFORMATION 0 7 PERMANENTLY CLOSED SITE
o 6 TEMPORARY SITE CLOSURE
DB
FACILITY/SITE INFORMATION & ADDRESS· (MUST BE COMPLETED)
NAME OF OPERATOR
(J. ,l1b
PARCEL' (OPTIONAL)
D
D
D 2 DISTRIBUTOR
o 4 PROCESSOR
D LOCAL·AGENCY D COUNTY-AGENCY D STATE-AGENCY D FEDERAL·AGENCY
DISTRICTS
O ../ IF INDIAN It OF TANKS AT SITE E. P. A. I. D.It (oplional)
, RESERVATION
OR TRUST LANDS I
o INDIVIDUAL 0 PARTNERSHIP
EMERGENCY CONTACT PERSON (SECONDARY)· optional
DAYS: NAME (LAST. FIRST) PHONE It WITH AREA CODE
NIGHTS: NAME (LAST, FIRST)
PHONE It WITH AREA CODE
CARE OF ADDRESS INFORMA nON
../ box Ie Indicate 0 INDIVIDUAL D LOCAL.AGENCY
..øtcORPORATION D PARTNERSHIP
SrJð ZIP 9°3 3 t;J (
CARE OF ADDRESS INFORMATION
D INDIVIDUAL
o PARTNERSHIP
o LOCAL·AGENCY
D COUNTY-AGENCY
o STATE-AGENCY
D FEDERAL·AGENCY
Legal notification and billing_will be sent to the tank owner unless box I or II is checked.
CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING:
11.0 111.0
THIS FORM HAS BEEN COMPLETED UNDER PENAL TY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE. IS TRUE AND CORRECT
COUt-..'7Y #
[ill
JURISDICTION #
~
FACILITY #
~
LOCATION CODE· OPTIONAL
¡CENSUS TRACT It . OPTIONAL
I SUPVISOR· DISTRICT CODE . OPTIONAL
THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATION· FORM B, UNLESSTHIS IS A CHANGE OF SITE INFORMATION ONLY,'
. FOROO33A-R2
FORM A (9-90)
.~ -- ~~
.
.
stATE OF CALIfORNIA
STATE WATER RESOURCES CONTROL BOARD
CERTJFIGATION OF COMPLIANCE
FOR UtJl"f:nGROUND STORAGE TANK INSTALLATION
FORM C
t· _:-~_ _~,._..
COMPLETE A SEPARATE FORM FOR EACHTANK SYSTEM
I. SITE LOCATION
STREET S ,;<o( úJh,:.k ¿ /7
CITY )?,,"3/¿rJ"h'-i!iv(
COUNTY
Jr1.f'11
II. INSTALLATION (mark all that apply):
~he installer has been certified by the tank and piping manufacturers.
[lJ- The installation has been inspected and certified by a registered professional engineer.
~he installation has been inspected and approved by the implementing agency.
u;:::r- All work listed on the manufacturer'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 implementing agency. (Please specify.)
III. OATH I certify that the information provided is true to the best of my belief and knowledge.
Tank Owner/Agent ~¡:;n
Print Name
Address
Date ~/7/93
Phone (?ð~Î 39J'-/ÞcrJ
9'33& 9
LOCAL AGENCY USE ONLY
STATE
TANK 1.0. #
COUNTY #
[lßJ
JURISDICTION #
mIJ
FACILITY #
~
TANK #
=
FORM C (7/91)
THIS FORM MUST BE ACCOMPANIED BY PERMIT APPLICATION FORMS A & B UNLESS THEY HAVE BEEN FILED PREVIOUSLY
FOR0035C7
-'
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!: ;'2i, ,j' ~,~ 8AKERSF¡ELD,;~EM0!1 Al HOSPIT.~L·· ~~ºª-
I! .",~, .P"'" "¡"O·:¡'"h :,i,
I· I ' ~ ... k .0." ild CA "'''~(''
, ¡: - '_'.~.'"",../' c::.\ er ~dO, .,~.....) .I ¡ MOUN -; ¡7ì'1::RUHO Of-i-1i,';¡:f¡
... _ .B.At'~K Ol'!;:. COLUMQI)$. NA
I . 100 I:'>'·~T ~¡:;C,\D :'I, ¡:¡E~ I
l' ' COLUMr:I;!;. ;,~H ,'!215'
i,' ça¡~: 06/25/93
p, 02 '
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-.....-..-.....-..-
Check No. 0981 04
098104'
VGnrJorl'Jj. 00296
CWHZ:
L_____
-~ TWO THOUSAND FOUR HUN~RED NINETY 20/100 DOLLARS
CAJ<ERSF1EL.~ ~t:M~JIIAL ¡.:
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CITY OF BAKERSFIELD
P 0 13¢:< 2067 "
Baker~field, CA 93303-2057
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IN.ClJaPEFJATION WITH
13ANK. Of'! AMeRICA
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IF
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lI'OI1B .01,111 1:01.,1.,. .:ì~B .': O?IIIOSO .C1u'
, ~
INVOICE [\10, DATE
HM 785501 92-9306/01/93
pËRMyr 06/23/63
5R-03505 06/31/93
DESC fir PTIO N/R I::F ER ENCE:
GROSS ~\MOUNT
99.00
6'£·.00
2.335.20
Chock D<1le: 06/26/ '';>3
Chec;k No,: 098104
DISCOUNf NET F,
0.00
0.00
0.00 23:
002:96
I/::ndor No.:
'. '
UNDERGROUND TANK
.:.\,:(.:::.~Si;12\..D ìVli:iIiIORLAL :-10SPIT~L
"20-:34th SI.
8r:l"crsiiold, CA 93,']01
ïOTAlS
2490.20
0.00
Z4'~
RECEIVED
.JUN 3 0 1993'
- ~ "J
HAZ. MAT. OIV.
Q
~o\.:c~
oo,':)~
-~~,_':è'~
CMEMORIALR
ENTE
Bill Pliler
Plant Manager
't
j
.
~
5201 White Lane ¡
Bakersfield, CA 93309
Telephone: (805) 398-1~ '
Fax,: (805) 837-o75~
· .
"
CITY of BAKERSFIELD
"WE CARE"
FIRE DEPARTMENT
S D, JOHNSON
FIRE CHIEF
May 27, 1993
2101 H STREET
BAKERSFIELD, 93301
326-3911
'Memorial Center for Behaviorial Health
5201 White Lane
Bakersfield, CA 93309
Dear Business Owner:
This notice' is meant to act as a reminder that the California Health and Safety
Code, Chapter 6.7 Section 25284 (C), requires that any person assuming ownership of
an underground storage tank used for the storage of hazardous substances for which,
a valid operating permit has been issued shall have 30 days after the date of assumption
of ownership to apply for any operating permit pursuant to Section 25286. .
This means that as a new owner you must submit an Underground Storage Tank
application form, Forms A, Band C completed for each tank at this facility (forms
included) and a state surcharge of $56.00 for each tank.
You have 30 days from the date of this letter to complete and return these forms
along with the state surcharge to 2130 fiG' Street, 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,
4', ~;/Cp)~-(l
I Ralph E. Huey -~
Hazardous Materials Coordinator