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HomeMy WebLinkAboutUNDERGROUND TANK P ROy'~Q..RAW IJ'!.'{- ~ts I CA L ~A Y9-"lJ?L.£A.Çl.(- £þ_.? P A Ç-".y'.ROV IDE D B E ~ OW.- '~:" ALL OF THE FOLLOWING INFORMATION .M.~.§I.....ª.s INCLUDED IN ORDER FOR THE APPLICATION TO JE PROCESSED: ____~_ TANK(S), PIPING DIMENSIONS. & DISPENSER(S), lNCLUDING LENGTHS & .' / '~----7- ------- ,öJt, -t{---- /' ¡:>RºP.()SEDSAMPLINJ3_~_OC~ T},-ºt'-JS .PES I GNA TED...BX __T~J~ SYMBOL '. -- - - "(V" - -- ~--- - .-- NEAREST STREET OR INTERSECTION ANY WATER WELLS OF SURFACE WATERS WITHIN 100' RADIUS OF FACILITY . ~-!) _______ 'NORTH ARROW , ' ..::'.;;;' ; ,~. . ¡ --.. ·':"~·_·':-:~~7-'''~''·'''· .-. ...;;..~-~,;:;;';;;"'~;:-.-==~.-;:;-~~-- _:..u.-:...-- ~~~~.~__o>~-:..:,_~..;:._.,-~"';'~~=;:'-. --:.;:~,.;..;. ,-·-.....;.:;.-..-~..~,_··-;.¡;;::...;,.:...---~~:~;-_-."'O-'::__···_~~·_:;::_-::·_==-..:._h~~-Z~:~--.;;-'~ -~-..;..-::t---==-.....::;:--=....:- -. 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I, , , - - ---_.~------,.._.._.- ----..- --~- ~ - - ."'---- -.-.------.-----.----- -- -. - -.. --- - ---- ---. -- -' 1 ".--..-, .-,- .----.--..,. u,_ ..,.---'. ---. ----,-' ..'u_______,__.____,·_·.. 1 1 --'- '---'~--'--'~<~.--~--~"-~.'.r ,.~.....-----'-,-.-. --,--- , -...'" .,--,-, ~-"O -,-,~..,'-~--~=~... ".,-,.,-~'-.,.--,.,.~-., ! ' - - ~ - - ~ -_. ... - -- - --... .. .~---,..-~-_..---=---_.~-,-....,."-='-=----' .- .---",-~.,---,-.-,",---"",,=--- .... _ n _ _ . II .. ¡:. ¢ ~i~ }' -- e 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 Overall Site with 1 Fac. Unit Page 1 General Information Location: 714 WILLIAMS ST Map:103 Haz:2 Type: 3 City . BAKERSFIELD Grid: 28C F/U: 1 AOV: 0.0 . r--- Contact Name Title - Contact Name Title JOHN LENCIONI / KEN ALTERGOTT / Business Phone: ( 805 ), 327-5934x Business Phone: (805) 327-5934x 24-Hour Phone · ( 805,) 831-2563x 24-Hour Phone · (805) 871-1607x · · Pager Phone · ( ) - x Pager Phone · ( ) - x · · Administrative Data Mail Addrs: 714 WILLIAMS ST D&B Number: 04-167-5257 City: BAKERSFIELD State: CA Zip: 93305- Corom Code: 215-002 BAKERSFIELD STATION 02 SIC Code: 1791 Owner: JOHN LENCIONI Phone: (805) 327-5934 Address: 2030 OSCAR State: CA City: BAKERSFIELD Zip: 93304- Summary I, O/~,,,..{~ Do hereby certify thai I have reviewed th~ at~~u.::hed .~~~rdous materials manage- , CO..OMßO 1.......'. ,:, men,'!, , ",p,lan fql"r".~14 'Williams Stl'ea~ oend that it alan ·th >,," t ~.Iif~JJ g WI any corrections constitute a complete and correct man- agement plan for my facility. qJ~~d~ " I ð-l8-9~' DIIIt 1'~ ~~ 't' -- e I 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 Hazmat Inventory List in MCP Order Page 2 02 - Fixed Containers on Site PIn-Ref Name/Hazards Form Max Qty MCP 600 High FT3 55 Moderate GAL 02-005 ACETYLENE · Fire, Pressure, Irnmed Hlth Gas 02-004 FORM OIL (NAPTHENIC OIL) · Fire, Delay Hlth Liquid --". - --- "- 1 1 0 Mo~e~'te ···---GAL-- Q·2--6iT1- BURKE ~1~1-2-7=WAmE-R=BAS·E=GtJ-RE .~rmltrell Mlt-h...,-.I:)el,a¥~H-J:-t;h OM m 02-006 OXYGEN · Fire, Pressure, Irnmed Hlth L.i.qu-.i:à Gas 1500 Low FT3 02-002 MOTOR OIL · Fire, Delay H1th Liquid 55 Minimal GAL NO L.ONbf;:.-1L uS€"" 02. -uc..)/ ßvtr'2-lLe: It")... ( \).t:v\~a... ~~E.. w~ wE t+f\.IJE; AQOEO 2. AletN þfli}Puc.....n .s~ A-TfAUt-€.O Il\hJêl"1Oæ..i L-I-sT, $u~Sí~'P (ò;.L)::.--A-S.C ~ ~t.,.."'~I+\ \\\JIJ WA---ree.. ~~~ ~ t".V.~\Ñbt Lo""?O\A.~o. .._ .fÏ...:", 1: 09/19/96 e e COLOMBO CONSTRUCTION CO INC 215-000-001098 02 - Fixed Containers on Site Page 3 Hazmat Inventory Detail in MCP Order 02-005 ACETYLENE · Fire, Pressure, Immed Hlth Gas 600 High FT3 CAS #: 74-86-2 Trade Secret: No Form: Gas Days: 365 Use: WELDING SOLDERING Type: Pure Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 600 I 240.00 I 1,200.00 Storage r Press T Temp ~ Location PORT. PRESS. CYLINDER Above Ambient wEST SIDE IN TOOL SHED - Conc l 100.0% Acetylene Components r= MCP -¡Guide High I 17 Liquid 55 Moderate GAL 02-004 FORM OIL (NAPTHENIC OIL) · Fire, Delay Hlth CAS #: 64741-53-3 Trade Secret: No Form: Liquid Days: 365 Use: LUBRICANT Type: Pure Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 55 I '25.00 I 110.00 Storage r Press T Temp ~ Location DRUM/BARREL-NONMETAL Ambient Ambient E SIDE OF TOOL SHED W SIDE OF YA - Conc l 100.0% Naphtha Components r; MCP -¡Guide Moderate 27 e.z 001 ~{ Vfl\. ~~. \ ~~, J.",V Liquid 110 GAL Moderate BURiŒ 1127 WA.IffiR-BAS&-CURE · Immed Hlth, Delay Hlth CAS #: 064742-47-8 Trade Secret: No Form: Liquid Type: Mixture Days: 365 Use: SEALER Daily Max GAL ----r-- Daily Average GAL --r-- Annual Amount GAL -- 110 I 25.00 I 365.00 Storage DRUM/BARREL-METALLIÇ r Press T Temp ~ Location Ambient Ambient E SIDE OF TOOL SHED W SIDE OF YA - Conc -, 5.0% Petroleum Naphtha r; MCP -,-Guide Mod'erate 27 Components '......... .0;:;.'" ,:-; e e 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 02 - Fixed Containers on Site Page 4 Hazmat Inventory Detail in MCP Order 02-006 OXYGEN ~ Fire, Pressure, Immed H1th Gas 1500 Low FT3 CAS #: 7782-44-7 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: WELDING SOLDERING Daily Max FT3 ----r-- Daily Average FT3 --r-- Annual Amount FT3 -- 1,500 I 600.00 I 3,000.00 Storage r Press T Temp -:ì Location PORT. PRESS. CYLINDER Above Ambient WEST SIDE IN TOOL SHED - Conc l 100.0% Oxygen, Compressed Components r=- MCP ---re;uide I Low I 14 02-002 MOTOR OIL ~ Fire, Delay H1th Liquid 55 Minimal GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL ~ Daily Average GAL --r-- Annual Amount GAL -- 55 I 25.00 I 165.00 Storage r Press T Temp ~I Location DRUM/BARREL-METALLIC Ambient AmbientlE SIDE OF TOOL SHED W SIDE OF YA - Conc -I Components 100.0% Motor Oil, Petroleum Based r; MCP ---re;uide Minimal I 27 ~~ ::-;¡... .'. '. e e I 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 00 - Overall Site Page 5 <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation EVACUATE ALL PERSONS IN AREA AND CALL 911. <3> Public Notif./Evacuation IN CASE OF AN EMERGENCY THAT REQUIRES EVACUATION OF SURROUNDING BUSINESSES, A LIST OF THOSE BUSINESSES HAS BEEN MADE AND CAN BE USED. <4> Emergency Medical Plan VALLEY INDUSTRIAL MEDICAL GROUP - DR. CHO - 2501 G ST GREATER BAKERSFIELD MEMORIAL HOSPITAL - 420 34TH ST - 327-1792 "'j -,. .. e e 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 00 - Overall Site Page 6 <E> Mitigation/Prevent/Abatemt <1> Release Prevention sræ.l ~ ~ua;tÎ"'¡:; 4-rJo u.l.~ THE MOTOR OIL, FORM OIL)~KE CURE ALL ARE CONTAINED IN A 55 GALLON DRUM WHICÈr-IS CAREFULLY HANDLED UNTIL PLACED ON THE DISPENSING RACK. THE OXYTEN AND ACETYLENE BOTTLES ARE KEPT IN A STORAGE AREA WITH CHAIN RESTRAINTS TO KEEP THEM FROM FALLING. <2> Release Containment 'STt<...\f' RJ;;-u:;f'rS~ (trJD t.tA~ THE MOTOR OIL, FORM OIL7AND BURKE CURE ALL ARE PLACED ON A DISPENSING RACK FOR REMOVAL OF PRODUCT FROM THE DRUMS. THE DISPENSING RACK HAS A CONCRETE CONTAINMENT AREA DIRECTLY UNDER IT. THE CONCRETE CONTAINMENT AREA IS LOCATED TO THE W SIDE OF THE YARD, E SIDE OF TOOL SHED. TWO (2) DRUMS ARE LOCATED IN THE SAME CONCRETE CONTAINMENT AREA FOR USED MOTOR OIL AND FILTERS. WE HAVE A PRIVATE COMPANY THAT PICKS UP THE USED MOTOR OIL AND FILTERS. IF BY CHANCE THERE IS A SPILL THE MATERIAL IS CONTAINED UNTIL CLEAN UP CAN BE DONE. <3> Clean Up IF A SPILL OCCURS THE MATERIAL CAN BE RECLAIMED FROM THE CONTAINMENT AREA AND USED. KITTY LITTER IS ALSO USED FOR CLEAN-UP IF A SPILL OCCURS. <4> Other Resource Activation n '"1:, /i. e e 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 00 - Overall Site Page 7 <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NORTHEAST CORNER B) ELECTRICAL - STORAGE CLOSET AT NORTHEAST OF FRONT OF BUILDING C) WATER - SOUTHEAST CORNER OF BUILDING D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER IN HALL OF OFFICE AND TOOL SHED. FIRE HYDRANT - ON CORNER OF WILLIAMS ST AND E 19TH ST. <4> Building Occupancy Level ~ ,¡ ~. ;. .\' .. e e 09/19/96 COLOMBO CONSTRUCTION CO INC 215-000-001098 00 - Overall Site Page 8 <G> Training <1> Employee Training WE HAVE 40 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING: IN ACCORDANCE WITH SB 198, EMPLOYEES ARE GIVEN SAFETY AND JOB TRAINING WHICH INCLUDES BUILDING EXITS, HANDLING OF HAZARDOUS MATERIALS AND MSDS SHEETS PLUS USE OF FIRE EXTINGUISHERS. <2> Page 2 <3> Held for Future Use <4> Held for Future Use CIT}T of BAKERSFIELD F,r. IIId Aqricu Itur' L-J St.nd.rd Bus;n,u ~ HAZARDOUS MATER:X: ALS :x: NVENTORY NON-TRADE SECRETS 1 I P'9' __ _ of __u ,\."¡ BUSINESS NAME:èólombo Construction Co. LOCATION:71/ WilU ~m~ St-r¡::>¡::>t- ~~~~É ;~(R~S~¡::>1?;~s~~4 r.;Lq110~ OWNER NAME: .John Lencioni ADDRESS: ?030 O~('9r ~~~~É ;~p(~O~)r8~~ ~~~h1r.~ 93iOú IUll'IlIl ro IlIS'Z'IfUcrIOIIS 1'0" nOPD CODIlS NAME OF Tn1Š ~~JLÅTY: STANDARD IND. CLASS CODE DUN AND BRADSTREET NUMBER .04... -L6. 1- 5. 2..:3_7 I 2 Ir.n, Type Cod. Cod. ] .... Mt . Aver. Mt 5 AnnulI Est , IIHtIll't Unin 1 IIIyI an Sit. t " 11 Cant Cant Un PreI, ,_ Code U llUt 1an ...... StCll'ld In feci Itty 1] 'by lit 1. __ of 11II1tUf'llc-t. SIt IMtructiCIIII Phy1iul IIId "" Ith IIII.rd f r.htck ,II thet ."Iy) ~xi fir' IImrd [:J RHc:tlylty [xi OII.yeII [:J Sudden ..I.... [ill_~I1.t. .... Ith of P,..._ .... It It t.A. S. ........_ side of tg..9.1._..2.h.£1_ SU£§ StrilL. e ~t 1\ .... C.'.S. .... -4 ;:¡lrignr etroleum oil 68476346 1100 ~laterba Lube Oil 64742547 ------------ --- ea.aø.-t 12 .... C.A.S, ....... ~XXFII'I Hemll [:J hec:tlvlty [xx OIl..,. [:J SudtIIn ..1.... [XXI....lat. '....Ith of '"'__ ....lth ~t.2 .... C.'.S. ..... irits 64742478 ~t I] .... c.,.s. ..... -- .---- Phyw Ie. I IIId ....lth Hellt'd (Check .11 thet ,"Iy) C.A.S. ...... ~t 1\ .... C.A.S. ....... r-, ~-., r-, ,.-., r-" L _.J Fir, IIII.rd 1.-..1 AHCtlvlty 1.-..1 OII.yeII 1.-..1 Suddtn ..I.... 1.-..1 1....I.t. "" Ith of Pl'Ø1V1'I ....Itlt ~t 12 .... C.A.S. .... ---"'I..' to.panInt I] .... U.S. .... ---l__L________L__________l__________J____J L__1---1-1 -- Phywiu1 end IIHlth IIlIeN (Check .11 thet .,,1,) C.A.S. ....... ____________~__ eo...-nt 11 .... C.A.S. .... -- ---- r-, ,.-, r-., ,.-., ,.-.., ~ _.J Fir, IIIZ.rd 1.-:-..1 IIHctlvhy 1.-..1 OII.yeII 1.-..1 Sudden ..I.... 1.-..1 1-.dI.t. "" I th of Prllsur. IIH I tit C....t 12 .... C.A.S. ....... ----------------------------------- ------ to.panInt I] .... C.,. S. "'*"" liE RGENCY COIITACTS II IZ II¡¡.¡-~----·------------------------------ TUli----------------------- 'I-A;:-Pliiiñi------- Qii------------------------- T1t1l------------- 21'111'-""""------- Ctrtlliution (Reed IInd sip lifter co.pJp-ting 1111 s~ctlonsJ I c.rtHy undtr "",It, of 1.. thet I hev. Dlrsonel1y ....;n-.l end .. f_lli.r _hh thl infor..tlon subllitttd In this end .11 .tteched *-tl. end thet bls-.l an ., Inquiry of thol. Ind1v1c1ue1s l'Øponslb1. for obt.in!n, the InfOf'tllltlan. I beli.v' thet tilt sublllulcI infOl'Htlan is tMII. .ecur.t., end c~l.t.. A4.. -¡ña-ömmn mnT-¡;;¡¡i;:7õõimõ;:-DII-¡;;¡¡i;:7õD¡;:¡tÕ;:~š_ãütfiõi=mnip;:išiñt mŸi S;qñitüi=i---------------------------------------------------- llitïSlqñiG'----------------------- ~"~SÛ)E STRIP RELEASE e MAT E R I A L S A F E T Y PRODUCT NAME: SURE STRIP RELEASE P~ODUCT CODE: lOlOF e Page: . .!. D A T A S H E E T HMIS CODES: H F R P 1 1 0 ~ '--'" =============== SECTION I MÞ~FACTURER IDENTIFICATION =============== MANUFACTURER'S NAME: EDOCO ADDRESS 22039 SOUTH WESTWARD LONG BEACH, CA 90810-1681 EMERGENCY PHONE INFORMATION PHONE (800) 424-9300 (310) 834-3401 DATE PRINTED NAME OF PREPARER 06/13/95 HONARD tJYENO. ===== SECTION II, - HAZARDOUS INGREDIENTS/SARA III INFORMATION ========= JU:i'OR'rA£LE COMP01."EN'I'S CAS NtMBE1! VAPOR PRESSmu: =- Hg (I 'rEXI' --------------------------------.-.---------------------------------------------------------------------------------------. OSHA FE!..: :5~ Pr:-1, ;'.~G:H TLV: :~o ;:F'~. ST'E!...: SiD PE~RC~~ù'~ ~I~TI~~~!E CI~ 64741-44-:2 .Cl lCi) 68476-34-6 . - ¡~C ATMCS¡HERI: G.~ :!L OSHA PE!.: 1S0 PPJ~, "C',::;I); TL'J: :'SO FFM SARA: *** No tcxic chemical{s) subject to the repcrting ~equirements of sec~ion 313 of Title III and of 40 CFR 372 are present. *** HEALTH WARNING: "'--, D.O.T. SHIPPING INFOR!~TION: NOT REGULATED. ---------- ---------- SECTION III PHYSICAL/CHEMICAL CHARACTERISTICS ------------ ------------ BOILING RANGE: 500 F (260 C). VAPOR DENSITY: HEAVIER THAN AIR. COATING V.O.C.: 1.981b/gl SOLUBILITY IN WATER: INSOLUBLE IN WATER. APPEARANCE AND ODOR: BROWN LIQUID WITH A PETROLEŒ4 ODOR. SPECIFIC GRAVITY (H20=1): 0.90 EVAPORATION RATE: SLOWER THÞ~ ET~ER. ============== SECTION IV FIRE AND EXPLOSION HAZARD DATA ============ FLASH POINT: 249 F (121 C) . FLAMMABLE-LIMITS IN AIR BY VOLUME- LOWER: .6 UPPER: 7 EXTINGUISHING MEDIA: FOAM, C02, DRY CHEMICAL, WATER FOG. SPECIAL FIREFIGHTING PROCEDURES REMOVE kLL IGNIT:ON SOURCES. WEAR SELF COh~AIN£D SRE~:E¡~G APfÞ~~TUS k~ COMPLETE PERSCNkL PAC!£C!:VE EQU:~Y~N! ~HEN ~~~E~:::~ CONn::EO AAEJo.S ¡.,'HERE PO':'EN'!!Al. EXPOSURE TO VAPORS OR i'RC,!:UC"!'S GF COMEUS'I!ON EXISTS. UNUSUAL FIRE AND EXPLOSION HAZARDS , CLOSE:: COIJ7J..INERS MAY RUPTURE DUE TO BUILD UP OF PREssu;;r; WHEN EXPOSEP TO HEAT. ===============a===== SECTION V REACTIVITY DATA ===================== \ '--' STABILITY: STABLE. CONDITIONS TO AVOID HIG); ;"E:AT .:J<E'A ;.,:::;¡ O~E'N FUo."£. , ;~ SU~ STRIP RELEASE e e Page: .... " MATE R I A L SAFETY DATA SH E E T INCOMPATIBILITY (MATERIALS TO AVOID) AVCI~ CONTACT WITH STRONG CXIDIZI~G AG~~TS. XIKE~L ^CIZS.WATER·k~ OTHER ~~TERIALS WITH ACTI~ HYDROGENS. HAZARDOUS DECOMPOSITION OR BYPRODUCTS C1-.R.êvN LiIOX¡~E J.J-'D CA.1<.J::ON lo\ONOXIÞE. HAZARDOUS POLYMERIZATION: WILL NOT OCCUR. ================= SECTION VI HEALTH HAZARD DATA ===================== INHALATION HEALTH RISKS AND SYMPTOMS OF EXPOSURE ïAPORS CR MISTS MAY IRRITATE THE THROAT. NOSE k~ ~t~¡GS ;.!~ Ck~ CAUSE SIGNS OF CENTRAL NERVOUS SYSTEM DEFkESS!~N. SKIN AND EYE CONTACT HEALTH RISKS AND SYMPTOMS OF EXPOSURE SKI~: :RR:'!'A: !:>N . SE1\S!T: ZAT!ON M"D ~ER!'~7I'I'IS. EYE: ?.EDI\ESS. TEhRING. I R.1<.ITATI ON . SKIN ABSORPTION HEALTH RISKS AND SYMPTOMS OF EXPOSURE YXf C.t.t.'SE r¡;'R:'!'hT!C:~ OR ~H !N SE¡':SITIVE INDIVIDU;',LS. INGESTION HEALTH RISKS AND SYMPTOMS OF EXPOSURE ~AY '~.USE VOMIr¡N3 ~'D/OR IRRITATION of THE MOv.ri ~'D ~-~O~T. HEALTH HAZARDS (ACUTE AND CHRONIC) ACU:'E: THIS PRODUCT CO~~AINS ~IST:~TES SIMILÞ~ TO THOSE KNOWN TO CAUSE SXIN TUMoRS IN LhBOATORY ANIMALS. AVCI~ EXCESS OR ?ROLON~ED Sr.:N :O¡<TACT. CHRCNI:: PERSOKS ~I:H C~~cNIC ?.ESPIRhTORY DISEASES SHOU"~D AVOID EXPOSURE TO THIS PRODUCT, CARCINOGENICITY: NTP CARCINOGEN: NO. '-" CARCINOGENICITY: IARC MONOGRAPHS: NO. CARCINOGENICITY: OSHA REGULATED: NO. NON~ OF THE :NGREC:ENTS ~~E LISTED BY :~~C. l~P OR OSf~ ;.~ CARCINOGENS. MEDICAL CONDITIONS GENERALLY AGGRAVATED BY EXPOSURE CHRONIC RESP!RATORY CO~~ITIO~S AND SKIN ~ISORDERS. EMERGENCY AND FIRST AID PROCEDURES ¡~r~TICN:R£MOVE TO FRESH AIR. EYES: FLUSH WITH WATER. SKIN: FLUSH WITH WhTER. INGES,ION: CALL PHYSIC:~. ======== SECTION VII PRECAUTIONS FOR SAFE HANDLING AND USE ---------- ---------- STEPS TO BE TAKEN IN CASE MATERIAL IS RELEASED OR SPILLED SÞJ.VAGE FREE LIQUID WITH SHOVEL. BROADCAST ABSORBE~ ~TERIAL AND PLACE IN A S~LED CONTA!~ER. WASTE DISPOSAL METHOD DISPOSE OF :N ACCORDANCE WITH LOCAL. STATE ~~ FEDERAL REGL~TIONS. PRECAUTIONS TO BE TAKEN IN HANDLING AND STORING ~o SPECIAL STORAGE NEEDED. OTHER PRECAUTIONS KttP ~~VMS ÇLOSE~ TIGHTLY ~ì) IN ?~ UPRIGHT POSITIO~. KEEP MATERI~L FROM FREEZING - ================== SECTION VIII CONTROL MEASURES ==================== RESPIRATORY PROTECTION USE ~EQUATE VENTILATION ~~£N USING TH!S ~RODVCT. IF T~E EXFOSURE LIMITS IN SEC1!Oll II ARE EXCEEDED A NIOSH hPPROVE~ ~~.SK " " e e .' <~., SURE STRIP RELEASE Page: 3 MAT E R I A L S A F E T Y D A T A SHE E T WITH CR~~'IC C~~TRI~GE MUST EE ~SED. .......... VENTILATION :.oç~.L 1-.!:D !'ECH}.N:ChL EXHAUST IS ¡;EÇO~E:,,!)£D. PROTECTIVE GLOVES ~~CFRENE OR RUEBER. EYE PROTECTION SAFETY GOGGLES WI~H S:DE SHIELDS. OTHER PROTECTIVE CLOTHING OR EQUIPMENT LOnG SLEEVED h.~D LWG LEGGED ÇWTH:NG. WORK/HYGIENIC PRACTICES W~.SH H.tJ~S 1:EFORE EATll'G. DRmKING OR S~OKm:;, ====================== SECTION IX DISCLAIMER ======================== ALL INFORl1ATION APPEARING HEREIN IS BASED UPON DATA OBTAINED FROM TH? MANUFACTURER OF THE MATERIALS IN THIS PRODUCT OR RECOGNIZED TECHNICAL SOURCES. WHILE THE INFORI~TION IS BELIEVED TO BE ACCURATE EDOCO MÞ.KES NO REPRESENTATIONS AS TO ITS ACCURACY OR SUFFICIENCY. THE CONDITIONS OF USE ARE BEYOND EDOCO'S CONTROL AND THEREFORE USERS ARE RESPONSIBLE TO VERIFY THE EXPOSURE AT THE POINT OF USE AND THE USER ASSUMES ALL RISKS OF THE USE, HANDLING AND DISPOSAL OF THIS MATERIAL. THIS INFORMATION RELATES ONLY TO THE PRODUCT DESIGNATED HEREIN AND DOES NOT RELATE TO ITS USE IN '- COMBINATION WITH ANY OTHER MATERIAL OR IN þ~ OTHER PROCESS. ',-" " é ~"~ t1.¿~~~J...:.=,J , e , *** MATERIAL SAFETY DATA SHEET *** e SECTION I Date of preparat i on: ;01,/25/91 3011000 (Page 1: v"'· . ====:=======================================================================================================================~ Manufacturer Address Telephone # Emergency # Product Class Mfg. code I.D. Trade Name W. R. MEADOWS, INC. 1,6W185 Allen Road Hampshire, Illinois 6011,0 - H MIS - IHealth, 1 ¡Flammability 1 IReactivity 0 :Personal Protection (708) 683-4500 1-800-1,21,-9300 Chemtrec (Hazard Rating: 0=Least,1=Slight,2=Hoderate,3=High,4=Extreme,*=Chronic) , DIVISION 3; Catalog #360-R 3011000 SEAlTlGKT 1100 WATER BASE ClEAR OJRUIG CQI)(lJtID SECTION II-A ============================================================================================================================~ HAZARDOUS COMPONENTS No. C~nent CAS# X by Weight LEL (åI 25 C) VAPOR PRESSURE SARA (mm Hg åI 20 C) . . .. .. . .. . .. . .. .. .. .. . .. .. . . . . .. .. .. .. .. .. . . . .. . .. .. . .. .. . .. .. .. . .. . .. .. .. .. .. . . .. .. .. . . .. .. .. . .. . . . .. .. . . .. . . .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. (I .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. . .. .. .. .. .. . 1. Petroleum Lubricating Oil Base Stock 6471,2-54-7 2. Mineral Spirits 64742-47-8 None of the components of this product are recognized as carcinogenic. Under the reportin~ requirements of Section 313 of Title III of the Superfund Amenànents and Reauthorization Act of 19, (SARA)and 1,0 CFR Part 372, chemicals listed on the 313 list (1,0 CFR Part 373.65) are identified under the heading "SARA 313' 2-1, 1-3 <0.01 2.60 0.90 0.75 NO NO SECTION II-B =====================:======================================================================================================~ OCCUPATIOHAl EXPOSURE LIMITS No. PEL/HIA OSHA PEL/CEILING PEL/STEL ACGIH TlV/CEILING TLV/STEl SKIN TlV/TIJA SKì . .. .. .. .. .. .. .. . .. .. .. . .. .. .. .. .. .. .. .. .. .. . .. .. .. .. .. . . .. . .. . . .. . . .. . . . .. .. . . . . . . . . . .. .. . . . . .. ... .. . .. .. . . . .. . . .. .. .. . .. . .. . . . . . . . .. . . . .. . . .. . . . .. .. . . . .. .. . . .. . . .. .. . .. . . .. .. .. .. .. .. .. . 1. 5mg/m3* NIE N/E N/E 5mg/m3* NIE 10 mg/m3* N, 2. 100 PPM 500 PPM N/E N/E 100 PPM NIE 200 PPM N, The dried film of this product may become a dust nuisance when removed by sanding or grinding. OSHA recommends a PEL/TlV of ¡ mg/m3 for total dust and 5 mg/m3 for the total respirable fraction. ACGIH recommends a TlV/TIJA of 10 mg/m3 for total dust. Skin absorption may contribute to the overall exposure to this material. Take appropriate measures to prevent skin contact. N/E: Not established * = Mineral Oil mist in air SECTlOH III ============================================================================================================================~. PHYSICAL DATA Boil iog Point Evaporation Rate Vapor Density pH level 212 degrees F. < 1 (ether = 1) > 1 (air = 1) 8.76 X Volati le by volL8e X Volatile by weight \.lei ght per pllon 80.51 (Theoretical) 79.91 (Theoretical) 8.26 (Theoretical) j SECTION IV =================================================================================================================:=========== HEALTH INFORMATION EYE CONTACT: Based on the presence of c~nent 2 this product is presumed to be moderately irritating to the eyes. Based c the presence of component 2 product vapors and/or mists may also be irritating to the eyes. SKIN CONTACT: Exposure may cause mild skin irritation. Prolonged or repeated contact may cause redness, burning, drying, ar, cracking of the skin. Persons with pre-existing skin disorders may be more suspectable to the effects of this material. BaSE on the presence of component 2 prolonged or repeated contact may result in defatting and drying of the skin which may resul in dermatitis. Based on the presence of c~nent 1 no irritation is likely after brief contact but may be irritating afte prolonged contact. INHALATION: Exposure may produce irritation to the nose, throat, respiratory tract, and other mucous membranes. Based on th presence of component 2 exposure to excess ive vapor concentrat ions may cause signs of trans i ent central nervous systt: depression. (e.g., headache, drowsiness, loss of coordination, and fatigue). INGESTION: May cause irritation of the gastrointestinal tract. Based on the presence of c~nent 2 while this material has low degree of toxicity, ingestion of excessive quantities may cause signs of central nervous sys'tem depression. (e.g., headache fatigue, drowsiness, dizziness, and Loss of coordination). Based on the presence of c~nent 1 ingestion may cause pulmonar injury. SIGNS AND SYMPTOMS: Based on the presence of c~nent 1 repeated excessive exposures may cause irritation of the eyes, nose and skin. BaseQ on the presence of component 2 transient central nervous system depression may be evidenced by headache dizziness, nausea, and symptoms of intoxication. Symptoms of chronic overexposure include loss of memory, loss of intellectua ability and loss of coordination. AGGRAVATED MEDICAl CONDITIONS: Pre-existing skin, eye and respiratory disorders may be ag~ravated by exposure to this pr9duct OTHER HEALTH EFFECTS: None recognized. (. " ';" .. 1::te ~'preparation: OJ./22/91 SEAlTe1100 \JATER BASE CLEAR CURIWG COMPOOWD e 3011000 (Page 2) .=á=====----==~===============~~========:======================================================================================= - SEcn.ON V ,.. EMERGENCY AND FIRST AID PROCEDURES EYE' CONTACT: If irritation or redness develops, move victim away from exposure source and into fresh air. Flush eyes with water for'fifteenAlinutes. If s~toms persist, seek medical attention. sKIM,CÓlnACT: Remove contaminated shoes arid clothing. Cleanse affected area(s) thoroughly by washing with mild soap and water. Iffrritation or redness develops and ~rsistsseelc medical attention. UUlALATION: Ifrespiratorys~toms~velop; move victim away from exposure source and into fresh air. If s~toms persist, seek Àiedical,attention.If victim is not breathing, ilTl!lediately begin artificial respiration. If breathing difficulties develop, oxygen should be aåninisteredby qual Hied persomel. Seek inmediate medical attention. I"GESTU.:Do not indùce vomiting. Vomiting will cause further damage to the throat. Dilute by giving water or milk to drink if th~y victim is conscious. Consult IIphysici~n, hospital, or poison control center and/or transport to an emergency facility immediately. / ' ========:===z================================================================================================================ SECTION VI FIRE AND EXPLOSION HAZARDS FlAMMABILITY CLASSIFICATION- KFPA,: Combustible liquid' Class IIIB - DOT Notregulated fLASH POIIT: Greater than 210 degrees F. EXTIMGUISHIMGMEDIA: Use water fog, f~am, dry chemical, or Carbon Dioxide. SPECIAl fIRE FIGHTING PROCEDURES AND PRECAUTIONS: Clear fire area of unprotected personnel. Do not enter confined fire space without helmet, face shield, bunker 'coat, gloves, rubber boots, and a positive pressure WIOSH approved self-contained breathing apparatus. UWUSUAl fIRE AND EXPLOSION HAZARDS: Containers exposed to intense heat from fires should be cooled with water to prevent vapor pressure buildup which could result in container rupture. Container ,areas exposed to direct flame contact should be cooled with large quantities of water as needed to prevent weakening of container structure. ====:============~=========================================================================================================== , , SECTION VII REACT! V I TY STABILITY: Stable KAZARD<J.JS POLYMERIZATION: \.Iill not occur CONDITIONS AID MATERIAlS TO AVOID: Avoid oxidizing materials, strong acids, and strong alkalies. I\AZARDWS DEaM'OSlTION PROOUCTS: Oxides and co¡rpounds of Nitrogen. 01.ides and c~nds of Sulfur. Combustion may yield Carbon Dioxide, Carbon Monoxide, and/or incomplete combustion products. Do not breathe smoke or fumes. \.Iear appropriate protective equipment. ============================================================================================================================= SECT I ON VI II EMPLOYEE PROTECTION RESPIRATORY PROTECTION: Use ventilatiòn as required to control vapor concentrations' at least 10 air changes per hour are recommended for good general room ventilation. If exposure exceeds the PEL/TlV, use the appropriate NIOSH approved respirator. PROTECTIVE CLOTHUIG: \Jear safety glasses, goggles, or a splash shield to prevent eye contact. Contact lenses should not be worn_ \.Iear appropriate gloves and protective clothing to prevent contact with skin and clothing. ADDITIONAL PROTECTIVE MEASURES: Eye wash fountains and safety showers should be available for use in an emergency. ==============.====~==:========~======?===============================================================:===============:=:==::= SECTlOH IX ENVIROWHEWTAl PROTECTIOW SPILL OR LEAl: PROCEDURES: ,lARGE' SPI llS» Evacuate the hazard area of unprotected personnel. \.Iear appropri ate respi rator and protective clothing. Shut off source of leak only if safe to do so. Dike and'contain. If vapor cloud forms, water fo~ may be used to suppress; contain run-off. Remove wi th vacu\.ll1 trucks or ~ to storage/salvage vessels. Soak up res idue wi th an absorbent such as clay, sand or other suitable material; place in non-leaking containers for proper disposal. Flush area with water to remove trace residue; dispose of flush solutions as above. SHAll SPIllS» Take up with an absorbent material and place in non-leaking containers; seal tightly for proper disposal. ~STE DISPOSAL: Observe all Federal, State and local regulations regarding proper disposal. =====;======================================================:=======:============:===:================:===========::===:===== SECTION X ADDITIONAL PRECAUTIONS Containers can contain hazardous product residues even when empty. ~ash with soap and water before eating, drinking, smoking or using toilet facilities. ========================================================:==================================================================== The information contained herein is based on the data available to us and is bel ieved to be correct. However, we make no warranty, expressed or implied regarding th~ accuracy of this data or the results to be obtained from the use thereof. \Je assume no responsibility for injury from the use of the product described herein. (. ~ :. . ~ ',..' 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NO ...,.._.._......_ INS P E C T ION 0 ATE: ..,,,,,.,.....................................,,,. ,_,:=_'.;~~~~c~~~~~~oS ~!-S~~:2!:J~=:"~c~"- -g~1Lr"'ItLL..,~~c__-o,c~=_R ~~:~~-::E_S:~:~, ON .,.-:.;:.c~':7~~:::;.S~~~~~L N,~ ~~,..~,~~-== , ...--.-..................--..-....-.....-..-----.....---..-.......-- F AC I L I TY N AM E : Ç9l.:-º.~ª.Q....,Ç O~.$ T.B.~ C l..tº-I'LÇQ.:...t,""-t~ç_:"............_"....................,..___....._....."............................".............., : FA C I LIT Y ADD RES S : }..JA._ttL~.bl.~,r1.§._.§.IB..s.s.I__...._..._....._._.,...,._.........".""........_"....,...."..."......,,,,.,.........,,,.........,...................."..."" BAKERSFIELD.CA OW N E R S N AM E··: .Ç.Q.b.Q.r1.ª-º....,Ç..Q~.§.I.8.~.Q.I.IQ.~....ç..Q..:...t...,.l~ C...:.._......._..__"_........."......"..__..._.............._.."..............,,............."."... OPE RA TOR SJJ AM E : .Q.Q1,Q.M B..Q....,ç...Q.~$..I..I3Y..º-Il.9..~....Ç.º-:_t...,...~~.Q..:......_............"...."....._....._........".....,...._.....".........".....,,_..._..... ,COMMENTS ~.., - ...__._..... ........._...._..............., " ' .__~~£~~.n "":~~&.~~~'.~~;~~'~~~:"::'~~~__~~~'_"___"'" . .. . . :, .. ~,- , . _ __ _o.o-..~ _ ...->'- .-- .,,- . -- -~õ.-..:.~..;;----..:.-:-=:;:---=-:~. ~,:...:.;;;_____:-...-~~.....~. ,-- -~-'~::..., ~,-~=~..~~~...:.:'.:---t·:·_·::- ~',=----~ . . . ~ ...._-_..~._&_&_-----------~ ._...-.-__.__....&__._._--_....-.-..&_....&.._......~~....~..~-_....- :-, ,'ITEM .~. VIOLATIONS/OBSERVATIONS " , ,1 r , ' , 1..,PRIMARY CONTAINMENT MONITORING: "-a. Intercepting an directing system b. Stanàard Inventory Control c.. Modified Inventèry Control d.:! In,.tank level Sensing Device .: e_;', Groundwater Monitoring > . 'f., :,;1: Vadose Zone Monitoring '. ' ',';"" 2. SECONDARY CONTAINMENT MONITORING: a. liner b. ,Double-Walled tank c . Vau 1 t 3. PIPING MONITORING: a. Pressurized b. Suction c, . Gravity 4. OVERFIll PROTECTION: 5. TIGHTNESS TESING I 6. NEW CONSTRUCTION/MODIFICATIONS I I I I 7. CLOSURE/ABANDONMENT i 8. UNAUTHORIZED RELEASE I 9. MAINTENANCE. GENERAL SAFETY. AND OPERATING CONDITION OF FACILITY COMMENTS/RECOMMENDATIONS.....I.~......~.....~.......~.......~ ..........__.~......~,...,_....._.._...._..,......,_._,.._......._........__...___~.........._..--._,..,~....~_~..___~~..__~_..____..........__~~~~h...~_~__,....~___,_...._...._.."'~~_,..~......._........_,~~~......~..~~........~._-.......~~~......'...~..~..h........'...~......~....~~....,..............~~~..,....,......~..~~~...~_........~.~.~....~.........~....~...~~.............~..~ '=""_"""'"'-_.,.....~___.....=,,---~..~.~,_--.-:-..,...,~.. _._....__...,.-,---=~--._ .__"'.."=-"CT_.....'~-~-·...,,,·..,--_____~-'"'-"-='""~....- ...-,-~~_......,..,. 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'~h. .~..~... ...~. _"h .~.....~.~._ n... ......,. .~..... ,~. ....... ..~.......,..~ ..h..~~~~ .~~..... ...,~,.., ...,... .....~. n'.... on.... .. .~~... ...... .~. ....nnh..~_n~..~.h~..~~..........~~~........~~n..~'.n~...._~~..~~_n~.~~._.~~..~~n..~....~..~.........~...n.~nn._.~n....~~.....~...~~~.~..n...............~.......~........_,_....~...~...n~..h..~._.~...~~~,~_....~~..........n~.~n.....~~.........~~...~...~h~..n_...........nn.h~..'~.~...~..~~~...h~n..~~n..~~~..~..'nn..... R E! N S P E C T ION S C H ED U LED ?............, yes .............00 ,A. P PRO X I \II! ATE ;~ E ~ N S ? E C T ION 0 A. T E :...................................~. INSPECTOR: REPORT RECEIVED BY: .........~.. ,............._.~un. 'h.~"'''_'''''n''~~' ,. '~''''''~''h''~~~'''''''~'' '..n~...~n"'"'''' ~.... ....., ......~~ . ..n~..~.~~.... .~.......~.........~~...........,......, n.. ..~~..~.~n....~. .~.. .~..~.~~..... - .. ,: , .' ",'..' .'.... '._, '.' '. .' . of> ;:.. ,;;~'-; ~ , '" .' ,-,:' ;«:" "'":þ b) ~o ":,:,,,,-~; :~-::' :'.: ;;',' :i.~~;;:·:~S~Ù: ',.: , - r .', -', ./~d~.i'{!~-~~' :'.- .:;.,~~ ,:.: :::"";:>~.._~-: ;fi: ~~t;!~~;~/~~;:::~~:,:;,'\"'\;; ~JX ;':'.r,:,"_·, .'.'" :-;:;'~:'_;~;;~::,::; " "",,:',">:.:". ~S:~~é::~:j-Ft~¡:t., ~ ~1~~~ . ':, -: ,,:::,:-:"?~f1ower S.treet. '"'.,, " : ,~. ,; ,'¿o;, ""!,KERN CPUNT;:X HEA,~TH,t?çPARTMENT- ", ~< HEALTHom~,: '~~Ï?~.~;/>,,:' . ..' ~ . . .BekersReId, Callrorn!a 93305,. ~: _" . ....,,'. _,! ;" :"',', ,,:.. ..:. .':' '. <, " ',' ." ,', ". ' ~- ',leon,M Hebe~.on'.;.M.I~"\::~,,';~¿' :.', ' '" "'.,' '-",' "".,' ¡, ,i· ';," ~" ".. '....n....ONMEN' -L' ...........DMSIOIN ' " " . ,'.. " ' ,~' 0·' .", . ,".,,: ',,¡, , Telephone (805) 861·3638-,:: ' , ,.;',!,"',''''g','''''''' "":.,' ,?..':t"':'~, ',.. ,".......~, (,""'."", ,ie", ",' ,: ',,' " ,;:". :;,.,.-':~,'. I· .'d<:;:\}r'%1~~ik~~l:\j>,i~é-·: . :;'-> ',;, ,"~;' .\....~~~;.. il:,..;Jf~rÍ1co-µnt1' Perml~#:":<:¡" ' l. ..,. "';'~"": tJ~:.li9t);~/$ , ~;t~L,·" .: .. .." ," 'I' -'~5~;~';~'~'¡'~":~ ~,' ¡~~n~~~~:' ,·~<9;t~b,~ ~= ~~.~.' ,~~,\,,~ .-e; - '" ' : ' . , ' . ._", ,t~:t"t:t~,'¡r:'" '. ;t.. ~ i:t"'J"t~ ..,. " ~ .,' uNDBRGR·6ND"'lA~K:'ÐIS~OSITJON'ÏRAèxÌNå,REriom{. ., ' ";l~~¥:~:'{:: ',' ,." '( . , ,.,." "',"',', ,'," ,. " '. '.-,': ," .;jz;~ì~¿UX-·':. " th!s' form 'ts, ,~$( ;be:jr.êturn~dtq the Kern~u~t,tíe~ltb Depar~etlt"wttbi~14 .~~¿:{::,,:', dllY:8: l~f ~cèe.ptan:C! (J·t tank'(s,) b, :þ.\cUs.lt~a~...or,Ì"e~ycli~g , tac~l.(t.,., The<:::~;i~~::" ~r::~r'~.t,\e'-~tm't~ì,!~ c~r ~d~QV8.?~k,~po~.tb-~kr;,i-Muri~g~R\t~""< .~7 tba~· ,tbís:t:ÐJ:m:!S; éotn~'r~tQd al1d'rft;tû-rn~¢" C ,-,' " ;:,," ~',~<'~'>?;( ¥~·t;:. ", Sè~u~it~:~T:~::~:øutht't~n~ " .~. .~ . · ... ','~}';;:~2î' !~;~;l Mdr~~à, Phone""" ,'~-r---eï-t·,. . " rZ~~ '." ~,4~:a~~\: ::' :·¡f~ ttó~ ~iot 'r.árik." iF ",. ~~,~~ ¡ . '~~. I' ,1' i , . 0, I' \ I. I ,I ( f t , " ø.te1:ao1(8 aem:oved . . .. -',.:;> <~ I I t' r r I -. .' .. .', ,* ,_ .' $' .. ., .. "," ... >Ii" ., .f.. _'. _ ,. . .", it .' . < l' .OJ .. -'i'. 'sê~f!O~~.!:' ,."" .~~",;tt::rìeci:'~~~:ÍÛ!,'eontrã~t~r , Tank' upec'o'nt~fDa,tt~jit:Cò.Ditraeto %L Ä¡¡ìdr.uås ue-;, " , ' '. " ", , ! , r-,"':~~>;' .' ¿, .' 'q . " ,..> '. . . '. -, -\' ''¡-:~.'' '. ~ .: ~ t !'. ¡. I -1.~ .> .' , . ~I ~:. ~, ..,,' -" "/¡,' ~ - '" -~ ...._~~ '.. "~ \ - 'YI ",,' I ... ~, " ~1' I:' , f 'I' j" , .I¡ ~ I ',~' t L .-";1- . ¿::' .,r'l " ¡ ., 'J, \ , ,,~;,", ".. ' . .' .;,: . . '" " ~ < ~,:~~i'·~!I1~l~~~,!¡æ,~·,~,.~~,·,i,~i,;,·~,~,:-.t.l~è,...,~d.~~ñ,·,',:~~,~i,jÎ~f,~r,~.~.f~_:,._\,¡.i,~:,~~,îit~~~,:,;~~!~,:',:.'.":'~f. . . (Form #lIr.I~fP-150)' "''''«\'0-'' !' -.¡ ...', .. ~~"., -',' , .~." '''C ' " , ",,' , "'"" ',..... ,--~, ..,~". "·'---r+.... -,', -,-",op'. .." >" , . - . .' ' > ,',\,'.',..',;,:¡;,~..,.~,~,'.:¡,',:.~.'~.::":,,.~;.~.~_,~,Jib..'~,..,:·,~,·,;,..,':,i.;..,;,':,; " , . :'~i,;'è' .::,,;:Y c , ' ".. "¡¡~ ,:i'~';\'~:~;:'~:::'::':;";":::;(;:~l;;:Y:';:\':~~Ú/?~':':'i"iC:I~~~~~~~;¥~i~~:~s\:~i5~:;~r ::·:I2~'~.:f.>·:~~';Y: -- .~~),:'~o ".' .' .. i , I ~' .o:;J. ="J~ ::>z ="J~ :o~ .oð .....;~~ :oË :t ~. ~'-. ~_......,,-- ~ 10 ... N 10 CD ~: - N i ... N i - cr ~ w ,0 w en z o ~ en w cr ~ -< z o ¡: -< z ~ ~ ~ -< o -Ï ::I ~ ø cr o > o z w o cr w :::Ii w z -< .~ w en -< o ~ State ot Calilomia--+tealth and Wellare AgenCY. 15 cû j L Form Approved OMS No, 2050-0039 (Expirea ) Pleue print or type, (Form designed fot uae on' (12·pilch typewriter). UNIFORM HAZARDOUS 1, Generator's US EPA 10 No. ; WASTE MANIFEST (! 0 3r 3, G~rator's Name and MJirnO 'Address , CJizOf':t¿O ,,-ON a " r¡{~'F;~fjj ð: 9.33ÞS 4. eneralor's Phone ~ _ 8. See Instructions on Back of Page 6 and Front 0 ge 7 Depa~ of Health Services Toxic Suœtancea Control Divlaion Sacramenlo, California .. information In the shaded are.. Ia not required by Federal law, t" ....0 E N E R A T o R c. d. J. Additional Deacrtptiona for Materials Ualed AboN {)-I 00 .% <::~:~;.~.~f:'1: ~. ;~'. ... .. . ~ /Je7: 6/1'-, R Vj c:= ~ð-n;:aTIVE CJv-nd¿:..~¡¿ G-/&::iJ^, 16. Special Handling lnatructiona and Additional Inlormation 18. GENERATOR'S CER1'F1CATION: I hereby declare that tha contenta of thIa conalQnment .,. fIIIIy and accurately deact'ibed above by proper aIIlpplng name and are clasaifled. pecked, marked, and labeled. and .,. In aU reapec:ta iI proper condition far 1ranaport by highway according to applicable international and national government regulations. If I am a large quantity generator. I cartlfy that I he". a program In place to reduce the ""- and toxicity of _ete generated to the degree I have detennlned to ~o eccnomiCAJ!o¡ Fs!:t!ca!l!~ en!! th~t II..,... J!~"" "'" practicable /INIIth!:!d of tnt..-. etorace. or dIapoetol ct!rrllfttly evaiahle to .... M\Ich minlmi.,.s ,"'- present and future tlveat to human health and the environment; OR. If I am a aman quantity generator, I ha". made a good lalth effort to minimize my waete generation endaelec:t tI!e beet wests I'!'.anagemønt,mathod th.\lla evallable 10 me and that i c:an afford. T R Ie N S P o R T E 18. Transporter 2 Acknowledgement 01 Receipt of Materi... Printed/Typed Name 19. Dlacrepancy Indication Space F Ie C I L I T y --, 20. Facility Owner 01' Operator Certlflcation 01 receipt of hazardoua materlala covered by Ihla manifest except aa Printed/Typed Nama JIontItDay Year Do Not Write Below This Une otiS 8022 A (1/88) EPA 8700-22 (Rev. 9-88) Previous editions are obsolete. White: TSDF SENDS THIS COPY TO DOHS WITHIN 30 DAYS To: P.O. Box 3000, Sacramento, CA 95812 · e' ~ILZ COHTE~TS SUMMARY :!.;C:::':'.::'!: C~o mho (!. orJ-s+rGlc+-;òY1 ADt;?ESS : )/'f /V¡/lia:11:3 /?,-j. P ~Rl"l:: :~' ~~:: J ~·1",.-1 ~;2.. '--' ......, ~ -' El~V. 3ENSITI'iITY: /1; £.5 ¿.Lt.C t.i '\l i ~.'i Comments D~·''''o a 1..... # Or Tanks OfpJit!.a././ðJ1 / -S-ð () 3:2. t- (}1Jr:!;c Ql¡é) n I I I? /2 tí¡)-/~ L'G b íe~,~ h ('1) )(?,jf r 3/~ 8'/ ,?b 7///R'(, , I 7o.R/~ó /j / 8-;r;--Cfo g-;¿f-9û 8" -ßð-«O (J(f'fak Op-r~ oJ:&ð1/tdOY1 Q.,bctndcfì J / I / e 'e' RANDALL L. ABBOTT . Agency Director (B05) 861·3502 2700 M Street. Suite 300 Bakersfield. CA 93301 Telephone (805) B61·3636 Telecopier (805) 861·3429 STEVE McCALLEY Director RESOURCE MANAGEMENT AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH SERVICES August 30, 1990 Colombo Construction Company 714 Williams Street Bakersfield, California 93305 CLOSURE OF 1 UNDERGROUND HAZARDOUS SUBSTANCE STORAGE TANK LOCATED AT 714 WILLIAMS STREET IN BAKERSFIELD, CALIFORNIA. PERMIT # A1290-15/150032 This is to advise you that this Department has reviewed the project results for the preliminary assessment associated with the closure of the tank noted above. Based upon the sample results submitted, this Department is satisfied that the assessment is complete. Based on current requirements and policies, no further action is indicated at this time. It is important to note that this letter does not relieve you of further responsibilities mandated under the California Health and Safety Code and California Water Code if additional or previously unidentified contamination at the subject site causes or threatens to cause pollution or nuisance or is found to pose a significant threat to public health. Thank you for your cooperation in this matter. ~Q MIKE DRIGGS. ~AZ~~US MATERIALS SPECIALIST cc: McNabb Construction 7808 Olcott Avenue Bakersfield, CA 93308 -; .. " ENVIRONMENTAL CHEMICAL ANALYSIS PETROLEUM - .' \ LABORATORIES~ INC. J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CApFORNIA 93308 Purgeable Aromatics ( SOIL) Q PHONE 327-4911 McNabb Construction 7808 - Olcott Ave.- ---- Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: Sample Desc: . I Date Sample Collected: 15-Aug-90 Constituent Benzene Toluene Ethyl Benzene p-Xylene m-Xylene o-Xylene Total Petroleum Hydrocarbons (Gasoline) Date of Report: 21-Aug-90 7175-1 Colombo Construction, Gas Tank @ 2' Date S~mple Received @ Lab: 15-Aug-90 Date Analysis Completed: 17-Aug-90 Reporting units Analysis Results Minimum Reporting Level ug/g ug/g ug/g ug/g ug/g ug/g . none detected none detected none detected none detected non~ detected none detected 0.02 0.02 0.02 0.02 0.02 0.02 ug/g none detected 0.8 TEST METHOD:TPH by D.O.H.S. / L.U.F.T. method. Individual constituents by Modified EPA method 5020/8020. As Received Basis Comments: California D.O.H.S. Cert. #1186 By æ i: ¢L~ â1' ~' . E( in . ~ ill JS~ o lIAnalyst r' '. ENVIRONMENTAL CHEMICAL ANALYSIS PETROLEUM ,II e LABORATORIES, INC~ J. J. EGLIN, REG. CHEM. ENGR. 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA 93308 Purgeable Aromatics ( SOIL) PHONE 327-4911 Date of Report: 21-Aug-90 McNabb Construction 7808 Olcott Ave. Bakersfield, CA 93308 Attention: Bryan McNabb Lab No.: Sample Desc: Date Sample Collected: 15-Aug-90 Constituent Benzene Toluene Ethyl Benzene p-Xylene m-Xylene o-Xylene Total Petroleum Hydrocarbons (Gasoline) 7175-2 Colombo Construction, Gas Tank @ 6' Date Sample Received @ Lab: 15-Aug-90 Date Analysis Completed: 17-Aug-90 Reporting Units Analysis Results Minimum Reporting Level ug/g ug/g ug/g ug/g ug/g ug/g none detected none detected none detected none detected none detected none detected 0.02 0.02 0.02 0.02 0.02 0.02 ug/g none detected 0.8 TEST METHOD: TPH by D.O.H.S. / L.U.F.T. method. Individual constituents by Modified EPA method 5020/8020. As Received Basis Comments: California D.O.H.S. Cert. #1186 !........" By /J I'/) f~ . !,,< .1: /( :.r< / (,J. . E¢ln rJ. --b~ ¡Analyst ,.-" tit ( e r '¡O RANDALL L. ABBOTT Agency Director (805) 861-3502 2700 M Street, Suite 300 Bakersfield, CA 93301 Telephone (805) 861-3636 Telecopier (805) 861-3429 ,STEVE Mc CALLEY ...., . ;;.}¡.:,-:;:. - * ;1- -. :- . -. :...; ._.~ "".,.; -' .'"J' ~~;.. -.'" .... ..... , ,. ...~... ....... :r ,......- ..:'.~J. TANK(S) AT ABOVE .;:': :"'.'::f;/'~::} ~",' ,,'> 1J:~PPROVED BY' t:' "ifAPPROV ÃL DATE .' r "">-_~~'."~.:',;;-::.,.: ....:- '.~ :.iff' ..'~"- :r.~,j~:;.~' ':. .~.~. ò_ . ~ -'. "-" ..~ . .. ¡;;T \j;~1~~~;;i;~~iïF~~t{~w~~~f~~~;!l~;~;;T~;~~~;1;~~;'~·;··(~~¡~~~3J~1~K~;i.,'}¡:¡;~j;:i~f·f;tii'~ ,::1.:~;.1I is the responsibility of the Permillee tö'~¡'tain permits 'whiéh'may be required bÝ oth'è~ ¡.èguïatory aiètÎcieš~prior'tö beginning\Yõrk '(i.e:'; City ".:", ¡;'¡;(Fire and Building Departments). '.c..' ';;,~::' .,' i.'~:;---;' ",',::,;,:.,,', -: ," ':</,',' ,,;',j)., ,:",;~'b;";:-~;~ti\;..~ :é::- - T, ~~,¿:,\,",:.. - , ,',2. ~;;,::,;Pecmillee must notify the Hazardous Materials Management Program ,at (805) 861-:.3636 two working days 'prior to tank removal or aba.ndoninent , ':, ,':, ':~J,:, in place to arrange for required inspections(s). -- ':, ',; . :'. ',,, '.: :':'\ -- " '~ ' " " : :(" :':, ~ '-,,:')'::; ':' ii'''''.. "'~, .~",:~"':, ::,';!.." .. <:- , :' , " .. ':" :3. ':'~,\:Tank closure activities must be per Kern County Environmental Health and Fire Depanment approved'methods'as descrfbéd in Han'dbook UT-30. , 4. --,'>11 is the, contraclor's responsibility to know and adhere to all applicable laws regarding the handling, tra~sportation or treatment, of hazardous '. ::.;;: materials. . :.:.:~' ~"" ".<, :, ...: :. :..~'. ~,:', : > : '.: .::- "'-. . ~... ....'. ~". .:'..-.:: '": '," :. ..:~.: ~ "', '<: ,,~", )..... ". . "~.~~. \: ' ~.. ,;. \",'; _f.,, ~ j: õ;:....;...= ",' \'.::{~. :'\ .~ :..::' ". <: ':; .::>" -~. S, ".:"J'he lank removal contraclor must have a qualified company employee on' site supervising the tank removal. rhe employee must have tank removal ":'experience prior to working unsupervised. " , "', .,'~~;:;,:';;»,:,y:;", . ' --.. ,; ,',' , ;' ' 6. ' If any contractors other thm those listed on permit and permit application are to be utilized, prior approval must þe granted by the specialist " , ··'''.listed on the permil. Devialion from thesubmilled application is not allowed. " , ,',," .':~~':, -;,::{~:'l '''ê,,,'''''''' ,<:.;" ~': ;:.' , ' H:_7. 7"SoilSampling: _,,~-¡ ," .~ .:. ..~ ,~c[" .,"t.r ,_,_, . WI:' ::.1:--~, :.~.-t~'.:'~~\..,,,, ~~}~t:.(¡,~\·~~J~},:.:.·t.;..,,\..i·\:~~-4.~·, " . ,,' ':.-~'~' : ,,~'~,:',a. ',,? /,~,Taok size less than or equ~1 to ï,ooO gallons -' a minimum of two såmples mûst be retiieved fro~ bèò~at-h' t,h~ ~ent'~~ dtþe ~~nk at depths "',' ,.~,:~::·t\':':7~~(~' '.~of approximately two feet and six feet. :ö.>'~.,~-,:" ',;,,-:¡. ':' .1''-':' ,', .-,~ ,~'., ',~{~,:,~ "::;'-~"':" .,~\"':~{":"<', ',~:, ,:;~, :',': b.' ',.:~'" ~.;';Tank size greater than 1,000 to 10,000 gallons -:8 minimum of four samples must be retrieved one-third of the way in from the ends of '..';... each tank at depths of approximately two feet and six feet.' ". ',,' ", ',.' '.',:--' :" -.:.,-;': " ; "c. ' Tank size greater than 10,000 gallons - a minimum of six samples must be retrieved one-fourth of the way in from ,the ends of each tank , ,,, '" ;" " .. and beneath Ihecenterofeachtankat d.:pthsofapproximatelytw o feet and six feet. ',' ,.",..>':';': ,,-'_,<:' . ," '8.:-._SQjlS.ampling..(piping.,acea.).: ,~_~~",.:...__~__.._.__,~,~.~__.:.-...~~_ ~_,__,_,..,~_,,,,-:,,,,,~~",~,~__,,,___,_,_-,--_,_ ,~, -- A minimum of two samples must be retrieved at depths of approximately two feel and six feet for every 15 linear feet of pipe run and under the dispenser area. '.,'" .. .." .. :,. '.' I e ( er .,¡ PERMIT FOR PERMANENT CLOSURE PERMIT NUMBER A 1290-15 "U ROUND " .. ADDENDUM .' ... J ' '<:~:~1;:_~;:.':'~~i::~-· '~'~~~BS~~~~S STO~~~~r.;v_,~::,,:·:. .'~;,'.. _.. ,,__ .j,:' ' , . ¡""'l,~,::~j~f.t¡~:Ü·); ~:,b":F';:;'J,.;!·:~,',:,·_",,:,~.,..:':~,',)0',~ ',:,..,"'i.'r,:'.;'~_:,~.'",j."":"".',.,',.,',7,',"':,",:",',' ,::':, '. ,),,:,:: ,:,:;,~ :', .,; '.;:;:;' , , ' -- " ',. ' ,; '9. Soil Sample analysis: '.,,::'.,.:' .' , ".">.:,~,..,, . , ..'L§: a.', . ~ -All soil samples retrieved from beneath gasoline (leaded/unleaded) tanks and appurtenances must be analyzed for benzene, toluene, xylene, :., and total petroleum hydrocarbons (for gasoline). " " .~" b. , .' All soil samples retrieved from beneath diesel tanks and appurtenances ~ust be_~~~ly~e,! for_t~tal petro~c:..u~ hydroéàrbons (for dies~J) ':"'-""::"::="-'-~--c"-"7.':", , and benzene;- ,,- _,' '--';:C:::_"?--==-"__"~'~~-=7~~=-:'==;~_=:7"'=-=-c '.-:-",,- ",;,-=-~ "';:;"~:::--';,'7" '"" ,::,::;-;,;;;;:=:-:- ~:'-, ,.-.-,- ,:;;:~~~ "-'; /',:'!:Y:;:;~:;,c;. ,:' ~.:': ~.,AlI soil samples retrieved from beneath waste oil tanks and appurtenances must be analyzed for total orgà~ic:haïides" lead, oil and 'grease. ·'·;:~¡:"d;' ':":. JAIl soil samples retrieved from beneath crude oil tanks and appurtenances must be analyzed for oil and grease. :' ,:,>;': ,:; ''-'"" ," .. J\""" -- ",..",' , ' . ," '. ~ ". '~~::,e;' ,~7·-,.;:;,'AlI soil samples retrieved from beneath tanks and appurtenancestha,t cOI1.tain,ul1~n~wn, subst~n<:es. must be;:, an,alyzed,for a full~a~ge of 11 s~_~ -:-'~- ~;'__..o:,,' . ,..Çom'plëteperïiíifapplfcatiõïï·suDniittelJ --:s: -: ....:- ,;. ·:.:I,:",,-·¡? ,.,..:,.>. ,;\¡-,f.,,"~:At least}~o weeks pripr t~,closur ~~' ;'. '~~,,;i;f~;·,~'J:¡;';.~;'::. k:'¿~,:~~~: .:~~:~~~t ~azar~~~ ~a,~~f~I,~~::7,:~;.~~~t ,r::gra~ ' ,{,:.~: .>,:'~:~~!":~: ~:. ~~5,~~~[~~-?¡~'~ ":{;~7:::r~::' ::::~'}:~; ~;?;¡;,;:~;Æ2~;~{~j ~:4: ,~~~;:t ,? '\r~:' i':'~, :',: " , ,'" ,:,' :'; ":Notifica'tion'to inspeètor liSted on 'permit of date' ':, . :: ..' ," :~:.; . . Two working days :,', ','" ,:"",' ~{.."-<.:," ",' ." : ',' ' i',(~~:}~i~t~/~,~·:';~:~,:~~~V~~:~~;~~~l~ng " . . ';::;r:~,;,~,:;,:·,'.~;;;':';¡t,::~):~:::: ':h::::~/';," ,;'~~~(;~[~;'~)¿'::f(',.::,·. ,...: ,. .,.,. >, ;"":!:i:~::traiispo¡'taiion and tracking forms sent to'.Hazardous " '""No laier than S working days for trans¡iòÌ'tation and 14 Working " '! Materials Managemen.t Program. All hazardous waste ' - ro' "- days for the tracking form after tank removal ~.~ ~', :_ So *~-~ .'.,~c~~·( .... ,;::~~:;:;;;·~!1kb~ft~,:¿{[~,;h~... '. .,,;'i;;'~t:i£~~,~;t~~0~l~~¡~:Þf1}'..iÇ,>:';~'~:'j,j'i.. " ,:Š'ampie 'ä~'aly~i~ t~'&~rdo~ Materi~I~Maß~gemènt ' "No 1~;~;tbaß;3\~~rkingd;-Ýs¡ttët~1;;~i~ti~ii:ofanãlý~is" '~:;J,~~;:"L c" <l;~~:Z~~~:;L~~~~~:~l72t~~'i'·é . . . J . . ....' ·.ç4~,C~~!;~i~'~~i;~~~!,;'~¡~~~;~7~,tW ,,;' 'a.·' Liquid shall be pumped from tank prior to purging such that less than 8 gallons olliquid remain'i'n 'ta'nk:' (CSH&SC,41700j ',.. ' , . b.' ,"Tank shall be purged through vent pipe discharging at least 10 feet above ground level. (CSH&SC 41700) ,'::., ' ':,',' ';;;, , '"., ,c. .;,::,No emission shall result in odondetectable at or beyond property line. (Rule 419) ,'. > <~::\ ::-:':~':~:(:<'ii:~1¡i::-; . i,.'.<,;;:~::;.\) :,"', ".' .' .~, ,-,.; .'d. .' ".:' '," No emission shall endanger tbe health. safely, comfort or repose of any persoD. (CSH&SC. ~1700) ~ ",~ '~"¥':~~i::'f;' ",':. :_~-:~}\éI::;_....~:;J~~) e.~, ,Vent ,lines shall remain attached to tank until the inspector arrives to authorize removal. ":,::l:,~, ,>':'~;:.::i::~~:' . -. .,_~' .. ..i'·:":;,;~'~ .". ~'-~:~:/~'~.~'..~"~"-:~~-.~~:?'; ....~~.. ...~1",;';.' '_'._~..:~',.-" . ~:"., :..... "'::.. :,REC,~,~E~~~I~N~,/~~J~~n.:æs FOR REMOVAL OF UNDERGROUND STORAGE TANKS ,: ,:'::.r~;>:l~;~,:",~ ~i:~::~~t.;;~,;:;.f:";/ ':L~:: 'I'; ','::'.This depàrtment is respònsible for enforcing the Kern County Ordinance Code, Division 8 and state regulations pertaining to ÚndergroùÏid stô¡'agetaókS. i ~\;:i:;' Representatives from this department respond to job sites during tank removals to ensure that the tanks are safe to remove/close and t'ba't 'tbe overall ~,' . ,~,. job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered tó cla~fy the'interests " "" and expectations Cor, this' department. ' " ," ,_\:":,o,::<,::-'~::, '. :~' ., . . . :l':. =- ;.. --;. ,~. ~ , . _L-_'" . J' - ']" f ' . - ::...... . 'I.t"..j~:· 0' 1. ';::','Job sÙe safetÝ' is one of our primary concerns. Excavations are inherenlly dangerous. It is the contractor's responsibility'iô knoW' and abide by . ' . ,:"', CAL-OSHA regulations. The job foreman is responsible for the crew and any subcontractors on the job. As a general rule, 'workers are not ", ¡ " , ¡';' 'permitted in improperly sloped excavations or when unsafe conditions exist in the hole. Tools and equipment are to be used only for their designed ,': function. For example, backhoe buckets are never substituted for ladders. !,:~h ~.. ':" ,',: '.,...: :1';'i:" , - :" "2. . :,' 'Pr~perly licensed contractors are assumed to understand the requirements of the permit issued. The job foreman is responsible for kn'owing and 'ab~~,icng by the ~~n.dit:ion~, or, the permit. Deviation from the permit conditions may result in a stop-work order. .. . ,"- I I', I ..~"' . -;-",- ,;3. :,'rndividual contractors will be held responsible for their post-removal paperwork, Tracking forms, hazardous waste manifests and 'analyses , ' '¡documentation are necessarý for each site in order to close ,a case file or move it into mitigation. When contractors do not follow through on '. '}:,:;~':~:~ecessary ork, an unmanageable backlog of incomplete cases results. If this continues, processing time for co~pleting new cl~ures ,~ill .. " Increase. ' " 'C-, -, ''> " "'. , . ~;~bbI9Þ- - DATE! .. , . \. ..-:..~ . .' ,-" . ,',,' ;. ..,:": " , .. , . . - .. , ~ . . , , --......-..---=-..........,..-~~~=~-...,... ,': MD:cas I I i " ' -- \a 1290-1S.ptc ITY) APPLICATION FOR PERMIT FOR PERMANENT -, CLOSURE/ ABANIXX'JMENrOF UNDERGROJND -, "'-=-C=-:'-;;-;,,,"='~~C'--O_ n Ï'ÄlAROOJS SUBSTANCE STORAGE FACILITY ' Jt REM)VAL. OR [] ABANI:;(;NMENT IN PLACE CA, LIC. NO, 474331 . .-CONSTRUCTION FUELING SYSTEMS INSTALLATION Y TMENT BRYAN MCNABB OWNER 4400 ASHE ROAD SUITE 213 BAKERSFIELD, CA 93313 805/397·8118 805/397,8193 FAX _.~ _ ,__.4,,~ _._ ____. __ 0- __" _ ___" -- e l _' (. INTERNAL USE ONLYÇ?). fa LJ j//¿;J/' ;- APPL I CAT ION DATE: é'/"£:"!.z{¿_ PT A: {lJ:q_(.,,~~_Q._ tt OF TANKS TO ABANIXX'J: _J_ _ PIPING FT. TO ABANI:;(;N: PTo:¿5~()3b6_ 0-- __. ....--.~ .._.~___. . ---..-. i.·1:'· ..- ' --_.. - -. .--- ~-"'. .'-- ".. ----_. ~~~,-,=~..~---, CITY: ' '(' AmSS: CITY: 8: a:HTR..Cl,(~ INfæoIATI() T~K REM:NAL a:NTRÞtTæ: ~E I: PIUœED START DATE: a:NTPJCTæ RfTRIEVI~: ~I: -~- I(ØER'S ~TI() I: .--- ~TæY THAT HIll NW.YlE S6WLES: .........,1\;.. d c.- , ~E I: ') Y'\ tv'"'\--" ~ . -" c: QOOCÞL INf{MTICN CHEMICAL COMPOSTION OF MATERIALS STORED: T~ # ~~~ (¿jÞi- CCl~\~~~__ --------- ------------- --------------------- TIRt2E (RJRAl LOCATlOO): ----~~£at'~,_~. STATE: A-. ZIP: STATE: ZIP: __~g~EMI~A~~ER:Y STORED ----ro ------ 10------ ------ D: 9NIrmelTAI.. IIfŒM'TICN ~TER TO FJ.CILlTY ProIIŒD BY: NEAREST HATER hID. -GIVE DISTNa IF WITHIN 500 ÆET: BASIS Fœ g)IL TYPE ÞHO OOtIOOTER ŒPTH IHATI() : TOTAl.. M.M!ER a: SÞWI..ES TO BE Niij.YlEQ: E: DIs:œAI. I~TICN ŒCOO'N4IHATI() PmWRE: ŒCOO.b."IIHATI() COOTfOCTæ:¡1 ~E 1:- 3'1 DIs.cœAL. ÆTJm Fa? T~K(S): ·DIs.cœAL. ÆTJm FOO PIPI~: .! . **PLEASE CC»4PlETE THE REVERSE SIDE OF THIS APPLICATIctII BEFORE SUBMlTTING FOR REVIEW** ~~ ,,/ TH IS FORM H~, J~PLETED UN~ER Ps-JAL TY OF PERJURY ANDÚiTH,E BEST OF MY KNo,..¡L~CGE 'IS TRUE AND CO~ÞllL-YblC,~ £1 I L ~ SIGNATURE:_~______~__________~~~~ J::___________ TITLE J11JL~~~-~ DATE ~--- I I -.. - 'C (C e I( '( \. . ,~----+ .. - - --~ - - - -." R-E-C,c. E-I--"P,-" T~-·,_ ' .. ·_____'__u~.____ ____. . ---~---- , . ,. ~~ ,== '-.'-, .,..,c=-. --_o~~C'."c·~PA G E--:=-o:. -. '::1-, =:--:=-- -". .-. -- , -----.---------.----------------'-.------------------.--.-----.-----.---.-.---------- I 07/31/90 Invoice Nbr. 1 37699 I 11:13 am KERN COUNTY PLANNING & DEVELOPMENT I 2700 'M' Street 1\';' Bakersfield, CA 93301 Type of Order W I I (80S) 861-2615 I ,--=-_I~':,~7.::.::~_=_;:~__'-'~-:::::"7-:;-:;:;:.::.::...-:::..:.::::;:.::::::::,=o::-=::::.:==:=:~=:=.::.~;-::.::__-~--:---::=:~=~~~":',~=:30~-:-=~¿-:~~'- I CASH REGISTER. MC NABB CONSTRUCTION ' 'I I 1 I I I I I _____________________________________________________,..:.._______________________ I I Customer P - O. # I Wtn By IOrder Date ,I Shi p Date I Vi a I Terms I IH0731903 I RAR 107/31/90 107/31/90 DD I NT I I _______________, 1________ I ___________ 1___________ I ________________ I ___________, I: Line Descr;ption '-- Quantity Price Unit' Disc --.' Total 1 PERMIT TO CLOSE/ABANDON 1 250.00 E 250.00 170G Order Total 250.00 Amount Due 250.00 Payment Made By Check 250.00 THANK YOU! --"-.. . -- - -=..,..-~.."....,_ .~"-' u__ _'"'"" ,___. ",-~._ .,"._~---o~__~~ _ e ( e (r- u TANK FACILITY ANNUAL REPORT Facility ~D-o GJ- Lo Permit # "SJ:J 3J.,¿. Month/Yr. f q rf 1. I have not done any major modifications to this facility during the last 12 mo_n~~~~ :_~_Signature. _ _ ~_ ~ 11) ý'/\A.\Á:"" .J ,tit~ Note: All major modifications require' a Permit to Construct from the Permitting Authority. ---- - .- -....~-- ---- ~ "-- -.., --- 2. I have done major modifications for which I obtained Permi t (s) to Construct from Permitting Authority , Signature Permit to Construct # Date -'-·-"-~-'-'--=~-'~'~-~-3-.7=- Repair and--Mail~te~an~~s-;~;'ary~~"-'O~~'="~' - -~,-,- ," _~...:._._;;;:._:..;...:::.~.:;=-..:--..;~~~--=--:::r..:.";$:...~~.~'i..:':;';"~--';-~ Attach a summary of :811: -- Routine and requ'ired maintenance done to this facility's tank, piping, and monitoring equipment. Repair of submerged pumps or suction pumps. Replacement of flow-restricting leak detectors with same. Repair/replacement of dispensers, meters, or nozzles. Repair of electronic leak detection components, or replacement with same. Installation of ball float valves. Installation or repair of vapor recovery/vent lines. Include the date of each repair or maintenance activity. NOTE: All repairs or replacements in response to a leak require a Permit to Construct from the Permitting Author! ty as do all other modifications to tanks, piping or monitoring equipment not listed here. 4. Fuel Changes - Allowed for Motor Vehicle Fuel tanks Only. List all fuel storage change~ in tanks, noting: Date(s), tank number(s), new fuel(s) stored. 5. Inventory control monitoring is required for this facility on the Permit listed during to Operate, and I have not exceeded any reportable limits as in' the appropriate inventory control monitoring handbook the last twelve months (if not applicable, disregard). f}/v Á/~~, JJ v~ ! , ..., Signà.ture 6. Trend Analysis Summary Please attach Annual Trend Analysis Summary for the last 12 periods. 7. Meter Calibration Check Form'~--'~n~- ~~'~~., " -" .~ n Please attach current, completed Meter Calibration Check Form . --,....,. -- . e ( e ,- ( i ANNUAL TREND ANALYSIS SUMMARY TANK #-L- TIME PERIOD: f'~ '4~9 to J¡~~ lir 0 if QUARTER 1 TIME PERIOD: tvV\ I Ifrq to "I1tJ.~ 7/ ¡fif (/ vii .. =,~.P'~RIOD .J'-':__..'l'otaLMinuses Th~s Period (Line 3) -.._-- - ~ -. .- -, - , , - Action Number for this Period (Line 4) ')...0 PERIOD 2: Total Mlnuses This Period (Line 3) ~D 'h Action Number for this Period (Line 4) 17 t '1/ PERIOD 3: Total Minuses This Period (Line 3) Action ,Number for this Period (Line 4) 5lf - . -.:-~-~...:...;...-~ -~---:;-.=.;:----- -- ~~-::;. .......:-;::~ . ---~~~~- - -~~ ~-~---~ ~:........~ ---=----~ ~--~~~.-..-::-~-~~-;.~-:;,.;.~---=--= ----:-...;....:..;.-.;...:.:-_~--:.;:-- -- .-~--:=..-~~ QUARTER 2 TIME PERIOD: ~ q/ rqff to ' jjl¡t \ Iii? ;~ PERIOD 4: Total Minuses This Period (Line 3) t... ?- Action Number for this Period (Line 4) br PERIOD 5: Total Minuses This Period (Line 3) 53 Action Number for this Period (Line 4) ere; PERIOD 6: Total Minuses This Period (Line 3) hI.{ Action Number for this Period (Line 4) --1DI QUARTER 3 TIME PERIOD: ~tl1- If$q to OJZc,. '-I " ¡iff , PERIOD 7: Total Minuses This Period (Line 3) 74 Action Number for this Period (Line 4) JI7 PERIOD 8: Total Minuses This Period (Line 3) 17 Action Number for this Period (Line 4) J Lfr PERIOD 9: Total Minuses This Period (Line 3) '?7 Action Number for this Period (Line 4) 133 QUARTER 4 TIME PERIOD: to PERIOD 10: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) PER IOD 11: Total Minuses This Period (Line 3) Action Number for this Period (Li~e 4) PERIOD 12: Total Minuses This Period (Line 3) Action Number for this Period (Line 4) _H ~ '0-"" ~ - --- -' ---",--,,~+- I hereby certify this is a true and åccurate report. Signature JL/~~c~ ,¿,Z!;¿'" Date hD "f .r.+. :1, J ç 0 I D t ITi Hose or Tank II a e' me Pump t Product .',. " i i " , - " ì i , / c ::.:5 c '" , " Note: i 1. All Ifteters ÌDust have calibration checks a minimum of twice .! year, which Clay include checks done by the Department of Weights and Measures. ~. Before starting calibration runs. wet the calibration I' can with product and return product to storage. ~ 3. Run 5 gallons with nozzle wide open into the can. Note gallons and cubic Inches drawn. and return product to storage. I' I 4. Run 5 gallons with the nozzle one-half open into toe can. Note gallons and ~ ' cubic inches drawn. and return product to storage.' ¡i, 5. After all product for one calibration check is returnd'd to storage, remember to record the volurae I'eturned to stoI'age in colump 9 of the Inventory Recording Sheet. :', I 6. If the volume measured In a 5-gallon calibI'ation can' is mOI'e than ..2. cubic Inches above 0,1" below the 5-gallon maI'k. the meteI' I'equlres calibration by a registered devIce I'epairlllan. ' ¡ , "I I' ¡: METER CALIBRATION CHECKtFORM ¡, !I ;¡ . I' I) Où P~rm li i! f_ . Facility: ~ -,-~&e'1J ~yt {~ . -- I Calibration Reauired? Yes No , VIIi- Past Plow 5-Gallon Draft Gals Cu. Inches s- -+/ Slow Flaw 5-Gallon DI'aft Gals Cu. Inches .~ + '2... Vo rume Re turned to StoraQ:e Ga lIons ~'/.C; --< " Owner or Operator Slgnature_ ~~~f~~~~~~\~~J' ,'J . -~-/ Ca 1 i b ra t 0 (" s . 5 i gna t ur e '-:"',~'~"Y": / ¿:,..,-"/..,, . SUBMIT A COpy OP THIS FORM~ITH ANNUAL RÉPO~T. ¡¡ ! ìi ¡ i' ¡: \i ¡; Ii Ii ¡; II t !I 'I Ii" ¡! ,i, . - , rReg,stratlOn 'I: I' 'i ¡i l;lC ~ '». " , r :- - e "--..., Device Repair~an Used far Cal1b~ation .A. _~,x S~c.--~ , /. ~c:-~ Date of Calibrati -"7'.- /¿,.,' . I q ~'i " " ¡ i' I, 1 " i ¡ ! ~ ' ! ii e ~ \ ! i tZ? - vcSc " . ... ¡, METER CALIBRATION CHECK FORM Pacility: _C:.ø I \),'V\bo ¡, I' Ii . P~rmi t !j :' '~ , i Hose or Tank t/ Past Plow Slow Plow Vo ruIWe Returned CalibratIon Devida Repa i [' II an Date of Date/Tillie Pump Product 5-Gallon " Calibratio J Draft 5-Gallon Draft to storae:e Reauired? Used tor r " Gals Cu. Inches Gals Cu. Inches Ga 110ns Ves No Cal'ibration ~ ~-~ \ REG- 5 ~~\ " ~+" ,S' 9 \A. \ Ö S +3 O.D \, i ¡I :i +8-"5+ \'\"'?~ " ]1 c.AA V'o- " , : " Ii d I I' 1: 'i " e I " I I ¡ I, i j ! ," " ! ) I Ii 'I' I ~ I ::! I .!¡ I I: 'I - .; jl I' Slgnatu«· -i!:~~ I', i , '" I I; . Owner Operator ¡ or ..' Cal ibrator ,'s \ Registration ,i ~5 ,00 '30 Signature w- LQ.Q .' c¡4- SUBMIT A COpy OF THIS I ): FORM WITH ANNUAL . REPORT. 'I I, - . I, ¡: 11 !i " ~ ~ Note,: ., II :¡ 1. All DIeters must have calibration checks a minimum of twice .!. year. whic'h Clay Includ~ checks done by the Department of Weights and Meas~res. 1 ~. Before starting calibration runs. wet the, calibration pan with product and return product to storage. I; I 3. Run 5 gallons with nozzle wide open into the can. Note gallons and' cubic Inches drawn. and return product to storage. , ,; 4. Run 5 gallons with the nozzle one-half open into th"è c~n. Note gallons and cubic inches drawn. and return product to storage." ì 5. After all product for one calibration check is returne~" to storage. remember to record the volulWe returned to storage In colu..n~ 9. of the Inventory Recording Sheet. ~ I ' 6. If the volume lIIeasured in a 5-gallon calibration CRn lis mora than 6 'cubic inches above or below the 5-gallon mark. the meter reqlÚres caHbrati~n by a registered device repairman. ' ~ ~ :,1,1 Ii 6"...5+ . 15QD :3?-.:L e --~ 1700 Flower Street Bakersfield, California 93305 Telephone (805) 861-3636 -' " , KERN COUNTY HEALTH DEPARTMÆ' HEALTH OFFICER Leon M Hebertson, M.D. ENVIRONMENTAL HEALTH DIVISION -- , INTERIM PERMIT TO OPERATE: DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard '.- ' PERMIT#:L S0032C'" ...: . \ " ~ "." '''.¡''.:'''.- .j ~,l;: .~.. ~~.1,:; ~ ": ".;; ;~:./ _; -'1'>,:t ;1~:< 'JuLY 1, 19à6 qJULY 1,1989 ISSUED:" EXPIRES: UNDERGROUND HAZARDOUS SUBSTANCES '.' -=='T:='~~~~~"='S'TORAGE~FÄC'IL:TY~~==='= ~~'~o~-0T", "NUMBmroF~'T~N~~=~~,Ú;tt~17~~T;~:,' ---------------------------------------------------------------------- ." '.' . I --- ," OWNER: "".". ,-- <,:;;;':{(Û::':<i:;,~;- ," '. I .. . COLOMBO CONSTRUCTION CO .':~(;INC .:':) I ", 114 WILLIAMS STREET "q';',~ .:'> ,:,' , I , " . ,_. ,f '.-,," . '" .".. .,~ ..~;< :-. ....' :.:~~:\~~:~\~':··::~~,<~~~~t~':~>:~~,{..·,·.\~ NOTE: ALL INTERIM REQUIREMENTS ESTABLISHED BY THE PERMITTING,~/,,~¡~;;~p:,;~:;;~~;r:,t1., " AUTHORITY MUST BE MET DURING THE TERM OF ,THIS PERMIT .:,:;c'\;-~;.:;'·~rji1;';~:,::,).; . < ,',;;, '.- '- ";,', .' ".;:,:,' ... . ,>;-};.(,.'" . ;:'>::,~ '.' "':< ::~ '¿ " ,,'.:,:t~~/;>;<::{~:.:~2Z~~¡J,;i~¿~,~~,~Dr? . NON"':'" TRANSFERABLE :-'*'* * i.POST ~RE.~~:rt3ES~!>,: ··t?1'tj~t~~i~~ FACILITY: ' COLOMBO CONSTRUCTION 114!,WILLIAMS STREET , BAKERSFIELD, : CA CO., INC. , - :::.::,~~:;. ,;',-!.'.;o:¿"'-"-'-': :,,-...i=i,.:-:-- ',-,~~::::-::~·;f~~~~: -.---~.~ ',"_. i ". . --,TANK # -", 'AGE (IN YRS) ,< ':,,~<,' ,1 '" . ::..,:'~ 'UNK .-.-'.... .. -~.. - ~; ':-.. ., , <; ~. .:.. -'---' . -'. ~, '.-,- , . , , - ' , " .. ~,..,- ", . DATE PERMIT MAILED: AUG 2 5 1986 DATE PERMIT CHECK LIST RETURNED: ~, - ,'" -~'"- : . '.:'¡, -- , ...1, .,i- , ' " , , , --, . " -? .~.' ". q-~~--=~:-.~-~-----~ . ! K~r~ çounty Heal th DepartmènA (__, DIVISlon of Environmental H~~b. 1700 Flower Street, Bakersfield, CA 93305 . Pe rl!l i t.''- -f" 0 0.3::2 C Appllcatlon~ ~~ l:5 APPLICATION FOR PERMIT TO OPERATE UNDE~ROOND HAZAADOUS SUBSTANCES S'I'ORAGE !'ACILI'N ~ of Application (check): , DNew Facility Ofwbdification of Facility J8 ExistiD3 Facility OTransfer of o..mership . A. Emergency 24-Hour Contact (name, area code, phone): Days :J;;HtJLefUc/oIIJi go5-3.:27-593", ~_ ._,~.~.~FacilitYdNameu-CO£om "J. /7/LlST" c~ ",_a~~_n~ig=~~'_":No.__Ofh'1'.ap!tS; ~O~-__~.3/- ~~6,~_ Type of Business (check): Gaso ne Station er (describe) (;.eAJ /..- C;'I!)'/.tf I1C 7"0;e Is Tank(s) Located on an Agricultural Farm? Dyes ŒJNo Is Tank(s) Used Primarily for Agricultural PurfOses? DYes 18] No Facility Address 7/-'/ !l)/L L /,4/Y)S S/'. Nearest Cross St. £, 19TH T " R SEC (Rural Locations O'lly) Owner Contact Person J#/lJ J PAl (!J () /IJ ) Mdress "/ -S;;-,IC;zL. z P 0 Telep,one .3';< 7- .59.3 V : '~'7__-,,-=Opera,tor...c ,-- _", -~,e- ______~=.;:'O"'-=:-""'7",,~cc.;=-"'=,=COntact-PerSOlL-_=.:1ð_f/ A1~_"/._¿¡¡)r!.cLO/V...L..;c.-=-- Mdrass / -'-- .à-:- -;Q Z P q'.:;¡3o.s- Telephone .3,;2. 7- 59..5~ . B. Water'to Facility Provided by aLII:, 4¿;:J_e.e .5e-fIl~C ¿ Depth to Groundwater /ÀJXAlnùJA! Soil O'Iñracteristics at Facility f{oCJ(._C('Ï/I.;\Pr-}. _ Basis for Soil Type and Ground'Alater Dep Detenninat ons .' C. Contractor Address Proposed Starti1"W3 Date ". Worker's Compensation Certification I AJIf.t I. CA Contractor's Zip ProfOsed Ucense tÐ. Telephone Canpletion tate Insurer D. If This Permit Is For Modification Of An ÐcistiD3 Facility, Briefly Describe Modifications profOsed /I.) ) IJ , E. Tank (s) Store (check all ~t apply): Tank ! Waste Product Motor Vehicle Unleaded Regular premiUl1 Diesel W3ste Fuel 011- I 0 0 mI 0 B 0 0 8 0 0 0 0 § 0 0 0 0 B B 8 B D 0 0 F. Chemical Ccmposi tion of Mat~dals Stored (not necessary £OL mOtor vehicle fuels) Tank t Chemical Stored (non-cCAümerc1al name) CAS I (if known) Chemical Previously Stored 1tJ!/t (if different) G. Transfer of Ownersh1p / Date of TranSter N /} Previous ().¡ner Previous Facility Name I" hl//l) lel1)(',¡ ()J1 J; ~ccept fully all obligations of Permit !b. issued i;.o ((¡"ì:.fT ,.~_O C(1f1)5i;;ur.>7~¡¡)LP,f;J. W1derstand that the PennittiD3 Authority may review aoo modl y or ter.m nate e transfer of the Permit to Operate this' underground storage . " ~ ~~--.facil.ity upoILr.ecelvi~qthis__campleted form.~-·-----~u_---~-~--~--~-. ._~,H__.~~~~_____._~,_ __ - ---'- , This form t-.as been completed under penal ty of true and correct. ~ Signature U{ l ..: .Ç¿r:.¿Ç-c~/A.-L:"-' t/ perjury and to the best of my knowledge is Ti tIe fl e.S i7/¿.;V 7': Date 3l.Jy/?-ç l:-'dcility Name Colombo l:OJ1~ lOll Cu., 111\... ..,~. ;~r1l\it TANK ~ \. ILL OUT SEPARATE FORM F _\lll .ANK) -FÕR EAæSEcTION, CHECK ALL APP'P.õPROOE-OOXE-Š-- -- No . / ~ ~(J -~-c../ H. 1. Tank is: OVaulted ONon-Vaulted ODJuble-Wa'll ~le-Wall 2. Tank Material ~Mbon Steel 0 Stainless Steel 0 Polyvinyl Ctùoride 0 Fiberglass~lad Steel o Fiberglass-Reinforced Plastic 0 Concrete 0 AllJ11im.ll\ 0 Bronze DUnkoo~n o Other (describe) 3. Primary Containment Date Installed Thic~ess (Inches) Capacity (Gallons) Manufacturer ,- ~=--=O"~7 -'-.--''--- ,---- -- ,",C,- -_~ .n,'o~jf-o~~~'-- 0=- --=__,~--7_Cë-'C"--=_,,-,-,'~.-,--" ,..C' ---.-- _ h ----- --'"--,_~---'-~-' '-'¿)",v-A' ~p iAJ;,.;/· , 4. Tank Secondary Contaiment _ /' D Double-Wall--r:J Synthetic Liner 0 Lined Vaul t (0'None 0 unknown DOther (describe): Manufacturer: DMaterial Thickness (Inches) , Capacity (Gals.) 5. Tank Interior Lining _/'"' . -- -rfRubber 0 Alkyd D~xy OPbenolic OGlass DClay IEflblined OlbknO.-l\ DOther (describe): --·------'·õ;-·-Tarik --Cor rosion-Protect i'on -- -----. , .-..-...--------."---- D~vanized DFiberglass-Clad OPolyetHylene Wrap DVinyl wrappil'¥J . Œrí'ar or Asphalt DlInkoown DNone DOther (describe): Cathodic Protection: ~ne OImpressed CUrrent System DSacriflclal Anode System Describa System " Equipnent: 7. Leak Detection, Monitoring, and Interception . a. Tank: OVisual (vaulted tanks only) DGrourowater Monitorln:j Well (s) DVadose Zone Monitorin:J Well(s) Du-Tube Without Liner D U-Tube with Canpatible Liner Directi~ Flow to Monitorl~ wel1(s) * D Vapor Detector* 0 Liquid Level Sensor 0 Condoctivit~ Sensor* o Pressure Sensor in Annular Space of Double Wall Tank D Liquid Retrieval" Inspection Fran U-Tube, MonitoriBJ Well or Annular Space, o Daily GaLr:}in:j , Inventory Reconciliation 0 Periodic Tightness Testin:1 DNone Dlk\knoW'\ o ather 14--<//< 9/l-v,<?/':'-7 A,vd /(ey/oJ< ~ifi-. ~';»/;UÆ$ b. Piping: Flaw-Restricti~ Leak Detector(s) for pres~urlzed Piping o Moni to rl I'¥;) SLDp wi th RaceWlY 0 Sealed Concrete Raceway _ ./ o Half-cut Canpatible Pipe Raceway D Synthetic Lin~ Raceway It:fNOne o UnknoW1 0 other *Describe Make " Modell 8. Tank Tightness Has 'IbIs Tank Been Tightness Tested? ElYea 0 r«> Dlk\known Date of Last Tightness Test <='~ r:.......:-;;:',,~.,I, ,,'.- Resul ts of Test Test Name fJA/('>,U,MA"¡';" Testing Canpany R.L.w. 6:.¡Q\J.~j_........-I- 9. Tank Repair -/' . . Tãñk Repai red? 0 Yea L!rNo Ol.l1known Date(s) of Repair(s) Describe Repairs 10. OVerfill Protection [Japerator Fills, Controls, , Visually Monitors Level DTape Float Gal.X;¡e DFloat Vent Valves BCapacitance Sensor DSealed Fill Box Other: ÇlA~ Shut- Off Controls l]itqóne Dl.l1known List Make &. Model por Above Devices ll. Piping ...,¿- a. lbderground Piping: I!:JYes DNa Olbkno\oK\Material S,lee.,( Thickness (inches) Dianeter;l " Manufacturer DPressure ~tion __QGravity -Approximate Length of Pipe Ru"\ '~~-~"'u~_ - -uD. ' Undergr'ound Piping Corrosion Protect ion: .,', - _U' ." DGalvanized DFiberglass-Clad OImpressed ~r~nt DSacrific1al Anode Opolyethylene Wrap DElectrical Isolation lB"'1inyl Wrap OTar or As¡:Xlalt DUnknown DNone DOther (describe): /0 in ~L wA4¡tJ, ¡()A/ .p, ~"./9~ c. underground Piping, Secondary Containment: __~ ODouble-Wall OSynthetic Liner Systtml l.!:1None Dunknown [JOther (describe): e e~' PERMIT CHECKLIST Fac il i ty Co ta/YJ .6';ìé~r.J S 7"-- Permit # /SOD 3;).C This checklist is provided to ensure that all necessary packet enclosures were received and that the Permittee has obtained all necessary equipment to implement the first phase of monitoring requirements. Please complete this· form and return to KCHD in the self-addressed envelope provided ,~,'-~'within· 30 ndaysof'-receipt'. _'O"------n_C'_~_-_-'_ " -_-,~~c_"_-_~---:-__ -~~-~~'=;:, Check: Yes No ___.-'_~ ,o---=-:. ~= ~ -- /' C. -t/;- z· / V' E. -- ~- F. x_ Signature --- '.~... -..,. ....::. ì. ~..' 't ;~. :-::.:- ì ~ !t ..-.. ~ Nu':;/ ,'~ -;- "J0~ v '_ u 1::'00 A~ The packet I received contained: '::::õ)i\! ie,' !~:7'. 1) Cover Letter, Permit Checklist, Interim Permit, Phase I Interim Permit ----,--" Monitoring--Requirements-;--~-lnformation- S,heet"---(Agreement· 'Between =Owner-~a.nd Operator), Chapter 15 (KCOC #G-3941), Explanation of Substance Codes, Equipment Lists and Return Envelo~e. 2) Standard Inventory Control Monitoring Handbook #UT-I0. 3) The Following Forms: a) Inventory Recording Sheet b) Inventory Reconciliation Sheet with summary on reverse c) Trend Analysis Worksheet 4) An Action Chart (to post at facility) B. I have examined the information on my. Interim Permit, Phase I Monitoring Requirements, and Information Sheet (Agreement between Owner and Operator), and find owner's name and address, facility name and address, operator's name and address, substance codes, and number of tanks 'to 'be accurately listed (if "no" is checked, note appropriate corrections on the back side of this sheet). I have the following required equipment 1) Acceptable gauging instrument 2) "Striker plate(s)" in tank(s) 3) Water-finding paste (as described on page 6 of Handbook): D. I have read the information on the enclosed "Information Sheet" pertaining to Agreements between Owner and Operator and hereby state that the owner of this facility is the operator (if "no" is checked, attach a copy of agreement between owner and operator). I have enclosed a copy of Calibration Charts for all tanks at this facility (if tanks are identical, one chart will suffice; label chart(s) with corresponding tank numbers listed on permit). As required on page 6 of Handbook #UT-10, all meters at this facility have had calibration checks within the last 30 days and were calibrated by a registered device repairman if out of tolerance (all meter calibrations must be recorded on "Meter Calibration Check Form" found in the Appendix of Handbook). G. Standard Inventory Control Monitoring was started at this facility in accordance with procedures described in Handbook #UT-I0. Date Started /{)-'];-cv/~ :..-.--- ___.'_,.,L_' '__n . ' ,( J r), . of Person Completing Checklist: i /û,,¡"1,"'''''- W 7a.A.a-¿c:;. Title: 'ri.iTbo(' hA-woI - Date: /0· 3 r;) - '( c; _........,.....---- ."'~-""",-"""'~- e' .( Permit Qu.est.ionna.ire Normally, permits are sent to facility Owners "but since lIIany ',- '- ,.."',-,..;0. ':=Owne r. s~~'liveoutside' Ke rn~-' C oun t,y ,'''they'..'lIay'.·c hoo se'-t"o : have" t'he ~ 'perm it·s,"'z:=-- sent to the Operators of the facility where they are to be posted. Please fill in Permit # and check one of the following before returning this form with payment: \ For PERMIT # 150032C - , ..._:,~..,- '.'. --,--=,--"'~~~, ·,',=,··'-.---=·'·-X'--l·;-'--"-Send all- ·information,cto-=,Ownere. at--·the- "address -,__~=__,cc__,=:~, listed on invoice (if Owner is different than Operator, it will be Owner's responsibility to provide Operator with pertinent information) . ··____r---.-.;::;__~ - -, -- -- ="~"--.. 2. Send all information to Owner at the following corrected address: 3. Send all information to Operator: Name: Address: (Operator can make copy of permit for Owner) . -~'t"-"_.._."-,,".=-»--'-~-·_-'-O.~,,-_,,,__~·__~__.-=-,,= '-~~.- ""L_~....~__._ <->..' --~,,--.--~-~=,- ......---.---"" ~-. ---~-- ~~,--=~---- ,......-"".-=--"._,-'-"""..",--, ~ -= .-~._- -~. ---.-,-..- ~- .--~-- -- ~._---- '~-.--