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HomeMy WebLinkAboutMITIGATION - - 720 WILLIAMS STREET SITE CHARACTERIZATION WORK PLAN For HARRY E. PHOENIX TRUST ERNIE PHOENIX Bakersfield, California 93307 Presented By Lutrel Services, Inc. 2212 South Union Avenue Bakerstìeld, California 93307 (805) 834-5986 August 24, 1995 e e 720 WILLIAMS STREET SITE CHARACfERIZATION WORK PLAN Table of Contents 1 . 0 INTR 0 Due TI 0 N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . 1 1.1 SffE HISTORy............... . . ...... .... ............ . . .. . ..... .... .. .. ........ . 1 1.2 CONSULTANTS AND CONTRACfORS...................................2 1.3 'fIME FRAME....................................................................2 2.0 SOIL SAMPLING........................................................ 2 2.1 INTRODUCfION ...............................................................2 2.2 SAMPLING PROCEDURES.. ..... .... ..... ...... ........ ....................3 2.3 SOIL BORINGS RATIONALE........ .................. .............. ........3 2.4 LOCATIONS OF SOIL BORINGS ...........................................4 2.5 DEPfH OF SOIL BORINGS ..................................................4 2.6 MONITORING WELLS.... ............ ...... ............... ............ .......4 3.0 QUALITY ASSURANCE/QUALITY CONTROL PROCEDURES..... 5 3.1 PURPOSE........................................................................5 3.2 BORINGS........................................................................ 5 3.3 SAMPLES. ..... ... ...... .. ... .. ....... " .. .. ........ .......... . ....... .... . .. . . ..6 3.4 SPOILS DISPOSAL AND BORING DESTRUCTION ....................6 3.5 MONITOR WELLS......................... ...... .............. ......... ........ 7 4. 0 HEAL TH AND SAFETY PLAN ....................................... 8 4.1 PURPOSE........... ........... ..... ..................... ........................8 4.2 SffE HISTORY.. . . .. . . . .. . . .. . . . .. . .. .. . ... . . .. . . . .. .. .. . . . .. .. .. .. .. .. .. .. . ... . 8 4.3 EMERGEN'CY CONTACfS................ .... ....... ................. .......9 4.4 PERSONNEL.. . . .. . . . .. . . .. .. ... . .. .. . .. . . . .. . . . . . . . . .. .. .. .. . .. . .. .. . . .. .. ... 10 4. 5 WASTES. . . . .. . . . ... . .. . . . .. .. .... . .. .. .. . .. .. .. . .. .. .. .. .... .. .. .... . ... .. . . . .. 10 4.6 JOB HAZARDS................................................................ 11 4.7 RISK ASSESSMENT......................................................... 11 4.8 EXPOSURE MONITORING....................... ......................... 11 4.9 PERSONNEL PROTECTIVE EQUIPMENT .............................. 15 4.10 WORK ZONES.... .............. .................. ............ ................ 18 4.11 DECONTAMINATION....................................................... 18 4.12 GENERAL SAFETY MEASURES.......................................... 19 4.13 PLAN ACCEJYfANCE............................... ........ ...... ...... .....20 Lutrel SelVices, Inc. page 1 e e 5.0 CONTRACTOR QUALIFICATIONS................................... .21 5.1 LUTREL SERVICES, INC........ ...... .... .............. ......... ..........21 5.2 ornER SUBCONTRACTORS.............................................. 21 6.0 CLOS'ING................................................................. 22 Figures Figure 1 Figure 2 Area Map of Site Williams Street Plot Plan Luteel Services, Inc. page n e e 1.0 INTRODUCTION 1.1 SITE HISTORY This site characterization work plan proposes a methodology to determine the vertical and horizontal extent of soil contamination related to the dry well located in the center of the property, Bakersfield, California (Figure 1). Records indicate that historical use of the subject property was for property drainage of rainwater. The surface manifestations of this Dry Well consists of a grate and a clarifier. Due to these past activities on the property, Mr. Phoenix and Karpe Real Estate contracted Lutrel Services, Inc., (LSI) in July, 1995, to remove the Dry Well from the property. During subsequent soil investigation, it was determined that the fluid remaining in the Dry Well had analytical results to be above the action level allowed by the State of California and the County of Kern (see attached analytical). On August 22, 1995, Mr. Phoenix was informed of our findings. During further conversations with Mr Phoenix and Karpe Real Estate, it was suggested that more information regarding the contaminated area was necessary. The use of a drilling rig with a hollow-stem auger was presented and agreed to by the responsible parties. Williams Street Site Char. Work Plan Lutrel Services. Inc. August, 1995 Page 1 e e 1.2 CONSULTANTS AND CONTRACTORS On August 22, 1995 Mr. Phoenix agreed to a modification to the original contract to allow LSI to provide for borehole drilling, sampling, and testing at the subject site at 720 Williams Street, Bakersfield, California. 1.3 TIME FRAME Work will commence on the site characterization within ten (10) working days of approval of this work plan, providing contractor availability, weather, etc. A Site Characterization Report including findings and options for remedial action will be submitted to the County of Kern for approval within three (3) weeks of receiving the soil sampling results. 2.0 SOIL SAMPLING 2.1 INTRODUCTION The following methodology for a soil sampling program has been designed to satisfy the requirement to characterize the vertical and horizontal extent of the following products in the soil. BTEX TPH-D (Benzene, Toluene, Ethyl Benzene, Xylene) (Total Petroleum Hydrocarbons of Diesel) This program consists of enough borings to determine lateral and vertical contamination, all to a depth of approximately twenty-five (25) feet The depth of each boring will be determined in the field If it is deemed necessary that more soil borings are needed, the LSI Project Manager will consult with the Kern County representative to determine whether to increase the number of borings based on new information gained in the field. Williams Street Site Char. Work Plan Lutre1 Services, Inc. August, 1995 Page 2 e e 2.2 SAMPLING PROCEDURES Borings will be advanced using a truck mounted, hollow stem flight auger, with a California split- spoon sampler capable of retaining a 2-1/2-inch in diameter by 6-inch long brass sampling tube which can obtain undisturbed soil samples. The augers will be decontaminated at the beginning of work and between each soil boring. Soil samples will be taken at five (5) foot intervals, beginning at depths of five (5) feet below surface grade at the subject site. Each soil sample will be field analyzed by a Photo Ionization Detector (PID) HNU Model HW-101 to record Volatile Organic Compounds (VOCs) in parts per million (ppm). PID readings will be used to establish the the total depths of the borings if the 25 foot maximum has not been reached. Two (2) consecutive Non-Detect (ND) readings will be needed before the hole is complete. All soil samples will be sent to a state certified laboratory to be analyzed for the following products using Environmental Protection Agency methods. · BTEX · TPH-D using EP A Method 8020 using EPA Modified Method 8015 2.3 SOIL BORINGS RATIONALE An historical review of the site uses revealed that the parking lot drained into the center of the property where the Dry Well is located. The locations of the borings illustrated in this work plan are positioned to detennine the lateral and vertical extent of any plumes emanating from the known areas of concern. Additional borings may be required to determine the extent of any plume encountered. The Kern County Health Department will be consulted prior to commencement of any boring not already contained in this work plan. Williams Street Site Char. Work Plan Lutre1 Services. Inc. August, 1995 Page 3 e e 2.4 LOCA TIONS OF SOIL BORINGS 2.4. 1 720 Williams Street All petroleum related facilities refeITed to in this section were removed in March of 1995 by Lutrel Services, Inc. located in Bakersfield, California. All LSI proposed soil borings at the subject site will be designated on Figure 1, with the letters "Phoenix" followed by a number and depth, e.g.. "Phoenix 1-5". See Figure 1, Plot Plan, for all soil boring locations. Soil Borings #1, #2, #3 and #4 (Phoenix I,Phoenix 2, Phoenix 3 and Phoenix 4) will be located ten (10) feet North, East, South and West of the subject site. These borings will determine the vertical extent of any contamination from the Dry Well. An additional two soil borings (Phoenix 5 and Phoenix 6) will be advanced to determine the lateral extent of the plume or plumes investigated by soil borings Phoenix 1 through Phoenix 4. Soil borings Phoenix 5 and Phoenix 6 will be located about the Dry Well site as shown in Figure 2. 2.5 DEPTH OF SOIL BORINGS The depth of each boring will be detennined in the field by the LSI Project Manager. Bore holes have been slated to be advanced to a point where two consecutive PID readings are Non-Detect. Auguring for all borings will cease at that point Groundwater is not expected to be encountered in any of the borings. If perched groundwater is encountered, drilling will stop, the Kern County Environmental Health Services Department (KCEHSD) will be advised immediately. 2.6 MONITORING WELLS If contamination is found on groundwater at the site, samples will be, taken at the direction of the County Environmental Health Services representative. Upon analyses of these samples, the need for a Monitoring well will be discussed with the County. Williams Street Site Char. Work Plan Lutrel Services. Inc. August, 1995 Page 4 e e 3.0 OUALITY ASSURANCE/OUALITY CONTROL PROCEDURES 3.1 PURPOSE This study has been undertaken to characterize the soil at the 720 Williams Street Site. (Figures 2 & 3). Procedures used in the field will follow guidelines contained in the State Department of Water Resources guidance document entitled "L.U.F.T. Field Manual" dated October, 1989. The field activities will meet or exceed the requirements of the Kern County Environmental Health Services Department's requirements as outlined in its handbook, "Closure of Shallow Disposal Wells (SWD-lOO)". 3.2 BORINGS Exploration will consist of advancing six (6) vertical borings, attempting a depth of twenty-five (25) feet, and to achieve two consecutive five-foot soil samples at or above twenty-five feet showing zero PID reading (above background). The depth of each boring will be determined in the field by the LSI Project Manager. If perched ground water is encountered before the above criterion is met, boring will cease eight feet below the depth ground water is first encountered. The approximate locations of the drill holes (Figures 2 & 3) will be determined by measurement from known facilities, and elevations will be estimated from a topographic map. The locations and elevations of the drill holes should be considered accurate only to the degree implied by the method used. Six borings will be advanced using a truck mounted, hollow stem flight auger, with a California split-spoon sampler capable of retaining a 2 1/2-inch diameter by 6-inch long brass sampling tube which can obtain undisturbed soil samples. All drill bits and auger stems will be cleaned prior to the drilling of each hole to prevent cross- contamination. Each boring's drill cuttings will be monitored by an LSI Project Manager with an Pill to ionize organic vapor concentrations. The Pill will be calibrated with calibration gas prior to the start of each day's work. Williams Street Site Char. Work Plan Lutrel Services, Inc. August, 1995 Page 5 e e I, 3.3 SAMPLES Prior to the collection of each sample, sampling equipment will be washed with a non phosphate detergent solution, triple rinsed with distilled water, and air dried Soil samples for potential analyses will be retrieved at five foot intervals beginning at five feet below grade and at any change in lithology. Immediately after sampling, sample sleeves will be sealed with Teflon sheets and air-tight caps, taped, labeled, and placed in a cooler containing artificial ice and kept at or below 4°C. Chain-of-Custody forms will be completed when the sample is collected and maintained with each transfer of the sample. If groundwater is encountered, a water sample will be retrieved using a disposable bailer. The fluid sample will be sealed in a labeled, glass sample jar and stored in an ice chest and kept at or below 4°C. Chain-of-Custody forms will be completed when the sample is collected and maintained with each transfer of the sample. At the end of the drilling, all samples will be transported to a California state Certified Laboratory. Soil samples will be analyzed for BTEX using EPA method 8020, TPH-Diesel using EPA modified method 8015, and any fluid samples will be tested using EPA 601-602 for water. 3.4 SPOILS DISPOSAL AND BORING DESTRUCTION All soil not preserved for laboratory analysis will be placed in 55-gallon drums which will be sealed, labeled, and temporarily stored at the site. When the drum is full a representative sample will be retrieved using a soil sampling device. The sample weighing at least two pounds will be placed in a glass sample jar, leaving no head space. A Teflon® sheet will be placed over the mouth of the jar, the lid will be firmly secured and sealed with tape. The sample will be sent to a state certified Laboratory for analysis. A copy of the analysis will be included in the fmal site characterization report. Upon completion of laboratory analysis, the drum will be transported by a state registered waste hauler to a state approved hazardous waste disposal site or emptied on site if the analytical results warrant. All rinsate will be placed into a separate drum and disposed of in a manner similar to the soil samples. Borings advanced using the truck mounted auger will be abandoned by backfilling with clean fill sand or Bentonite Clay pellets. Williams Street Site Char. Work Plan Lutre1 Services. Inc. August, 1995 Page 6 e e' 3.5 MONITOR WELLS If contamination is found on groundwater at the site, samples will be taken at the direction of the County Environmental Health Services representative. Upon analyses of these samples, the need for a Monitoring well will be discussed with the County. Williams Street Site Char. Work Plan Lutrel Services. Inc. August, 1995 Page 7 e e 4.0 HEALTH AND SAFETY PLAN 4.1 PURPOSE The purpose of this plan is to provide for worker and environmental Health and Safety during the site characterization at the Williams Street site, Bakersfield, California. This project will be conducted by Lutrel Services, Inc. (LSI). 4.2 SITE HISTORY LSI is submitting this Health and Safety Plan to guard worker safety at the site. Soil contamination was documented during UST tank excavation performed by LSI. The maximum TPH contamination level encountered during LSl's work was 1,000,000 parts per million (ppm) Total Petroleum Hydrocarbons at a depth of two feet below the surface. The Site Characterization Work Plan to which this Health and Safety Plan applies calls for six soil borings for the purpose of obtaining undisturbed samples for laboratory analysis. The planned list of work is summarized in the following tasks: Task 1: Task 2: Task 3: Task 4: Preparation of a Site Characterization Work Plan and this Health and Safety Plan. Advance six soil borings to depths sufficient to characterize any contamination plume at the subject site. Undisturbed soil samples will be collected at 5-foot intervals. Each boring will be monitored for hydrocarbon vapors with a portable photoionization detector (PID). Soil borings will be destroyed by backfilling with clean fill and bentonite clay, if needed. All drilling spoils and rinsate will be sealed in 55-gallon drums and transported to a certified hazardous waste disposal facility, if deemed necessary. The soil samples will be submitted to a California state certified Laboratory for chemical analysis for Diesel and BTEX. Prepare and submit a technical report summanzmg of the results of the site characterization including, but not limited to, results and interpretations of data, discussion of methodologies, boring descriptions and remedial action options including a recommended option and risk appraisal. August 1995 Page 8 Williams Street Health & Safety Plan Lutrel Services, Inc. e e 4.3 EMERGENCY CONTACTS In the event of an emergency occurring during the characterization program, the following emergency facilities are available: Police Call 911 Fire 911 Ambulance 911 Hospital Mercy Hospital, Bakersfield 2215 Truxtun Ave 632-5000 (Edison to Truxtun) A cellular telephone will be located in an LSI vehicle. In case an emergency occurs, the following procedures should be implemented: Minor Cuts or Abrasions. Wash affected area with soap and water and bandage. A first aid kit with eye wash solution must be located on site. The site safety officer is basic first aid trained. Serious Physical Injury. In the event of serious physical injury: a. Call immediately for ambulance or medical assistance. b. Follow protocols established in the Medical Emergency Reference Manual #1 (Emergency Medical Planning, Inc.) until assistance arrives. The site safety officer is basic first aid trained c. If an ambulance is not available, transport victim to nearest hospital (Memorial Hospital). The following infonnation must be recorded by the project engineer or site safety officer for any emergency situation as soon as possible: Williams Street Health & Safety Plan Lutre1 Services, Inc. August 1995 Page 9 e e"" a. Notifier's name. b. Date, time, and location of the incident. c. Nature of emergency (describe what happened). d. Type and amount of materials involved. e. Extent of injuries, if any. f. Agencies and/or organizations notified, names of people notified. g. Actions taken. 4.4 PERSONNEL The following LSI personnel are expected to be at the site during the site characterization project: LSI AlE Environmental Drilling Operator Bill Rosica and/or Ed Dykes Mr. Harold Sugden unknown Messrs. Rosica or Dikes will be designated as site safety officer and will be responsible for ensuring compliance with this plan at all times. Messrs. Rosica and Dykes have completed the 8- hour Health & Safety Supervisors Training course. Drilling and Geological personnel will also have the necessary Health & Safety training. Personnel access to the work zone will be limited if Level D personnel protective equipment are required. Only personnel properly equipped with Level D equipment [see Section 4.9 below] will be allowed to enter the contaminated zone. LSI will provide Level D equipment for only LSI. 4.5 WASTES The contaminant to be encountered at the site is diesel. The specific hazardous substances that are likely to be encountered are shown in Appendix A. Applicable exposure data for these substances are presented in Table 3 - Hazardous Substances Data. Symptoms of exposure and first aid treatments for each chemical are presented in Table 4 - Exposure Symptoms and First Aid Treatment. As can be seen in Table 3, the lowest pennissible short-tenn exposure limit (STEL) concentration is 5 ppm (for benzene). This concentration will be used to establish the requirement to don Level C personnel protective equipment [see Section 4.9]. Williams Street Health & Safety Plan Lutre1 Services, Inc. August 1995 Page 1 0 e e' Contaminated boring spoils and rinsate will be sealed in 55-gallon drums. A licensed contaminated waste hauler will be contacted for removal, if deemed necessary. 4.6 JOB HAZARDS Chemical hazards could be encountered from direct skin contact with the contaminated soils or breathing volatilized chemicals in the air. Level D equipment includes standard work clothing and gloves which would reduce direct skin contact with cheµrical encountered [see Section 4.9]. A photo ionization detector (PID) will be in continuous use in the breathing zone and if organic vapor concentrations of 5 ppm above background are detected, Level C equipment will be donned by all personnel in the contaminated zone. The respirator should protect workers from inhaled contaminants. Weather conditions have the potential to disrupt the project in that if it is raining, drilling and sampling should be postponed. It is unlikely that temperature conditions would preclude completion of the project Temperature ranges expected to be encountered are 85°F to 95°F. 4. 7 RISK ASSESSMENT The potential for adverse health or safety risks to the on-site workers or the immediate surrounding area is low. Since the site is located outdoors, the atmospheric dispersion of contaminants will be significant No unauthorized personnel may be permitted to stand near the boring location during site characterization. If nonessential personnel enter the work site, they will be informed that health and safety procedures have been established to protect both the workers and the public. If they refuse to leave, proper authorities will be contacted 4.8 EXPOSURE MONITORING A PID will be in continuous use during drilling operations. The Pill is a portable instrument used to detect and measure the concentration of a variety of hydrocarbon gases in various atmospheres. The detection is a result of the ionization of the organic vapors in an ultraviolet atmosphere. Photoionization occurs when an atom or molecule absorbs light of sufficient energy to cause an electron to leave and create a positive ion. This occurs when the ionization potential of the molecule is less than the energy of the photon. The ionization potential of a molecule is that energy in electron volts (eV) required to free an electron. In the HW 101 being used on this project, the source of the photons is an ultraviolet lamp with an energy of 11.7 eV. Williams Street Health & Safety Plan Lutrel ~ervices, Inc. August 1995 Page 11 e e The sample gas enters through the filter adapter into an ion chamber. The ultraviolet lamp generates photons with an energy of 11.7 eV and these enter the ion chamber. Ionization occurs for these molecules having ionization potentials less than 11.7 eV. A positive biased electrode causes these positive ions to travel to a collector in the chamber. Ions create a current proportional to their concentration at the collector. The current is then amplified and the signal displayed on the meter. The amount of ionization occurring, and thus the input signal to the amplifier, is proportional to the amount of trace gas present in the ion chamber and to the ionization sensitivity of that gas. Typical gases that are ionized with the 11.7 e V lamp and their potentials are listed on Table 1. Gases having ionization potentials higher than 11.7 eV are not ionized by this analyzer. These gases and their potentials are found on Table 2. As can be seen from Table 2, the ionization potential of the major components of air, (Le., oxygen, nitrogen, carbon dioxide, methane, and FREONS) range from about 12,0 eV to about 15.6 eV, and are not ionized by photons from the 11.7 eV lamp. In the survey mode, the Pill continuously samples the ambient air at .25 liters per minute responding on a total organic concentration basis. This allows one to survey a site for high concentration areas. The PID can detect total organic concentrations from 0.1 parts per million (ppm) to 2,000 ppm. During the site characterization the Pill will be in the survey mode. Williams Street Health & Safety Plan Lutre1 Services. Inc. August 1995 Page 12 e e Table 1 Molecules eV Molecules eV Si 8.149 12 9.28 C 11.264 HBr 11.62 HI to.38 S 10.357 COS 11.18 CS2 to.08 I to.48 NÜ2 9.78 H2S to.46 H2Se 9.88 NO 9.25 H2Te 9.14 CH 11.1 NH3 to.15 C12 11.48 CH3 9.84 BI"2 10.55 Ethane 11. 65 Propane 11.07 n-butane to.63 i-butane 10.57 n-pentane 10.35 i-pentane 10.32 2,2-dimethylpropane to.35 n-hexane to.18 2-methylpentane 10.12 3-methylpentane 10.08 2,2-Climethylbutane to.06 2,3-Climethylbutane to. 02 n-heptane 10.08 2,2,4-trimethylpentane 9.86 cyclopropane to.06 cyclopentane to.53 cyclohexane 9.88 methylcyclohexane 9.85 NH3 ethyl amine i-propyl amine i-butyl amine t -butyl amine diethyl amine di-i-propyl amine trimethyl amine tri-n-propylarrrine aceamide to.15 8.86 8.72 8.70 8.64 8.01 7.73 7.82 7.23 9.77 methyl amine n-propyl amine n-butyl arrrine s-butyl arrrine dimethyl amine Cli-n-propyl amine di-n-butyl amine triethyl amine formamide N-methyl acetamide 8.97 8.78 8.71 8.70 8.24 7.84 7.69 7.50 10.25 8.90 Williams Street Health & Safety Plan Lutrel Services. Inc. August 1995 Page 13 -.. e e Table 1 (continued) Molecules eV Molecules eV N,N-dimethyl formamide 9.12 N,N-dimethyl acetamide 8.81 N,N-diethyl formamide 8.89 N,N-diethyl acetamide 8.60 nitromethane 11.08 nitroethane 10.88 l-nitropropane 10.81 2-nitropropane 10.71 n -butylrolnitrile 11.67 acrylontrile 10.91 3-butene-nitrile 10.39 ethyl nitrate 11.22 methyl thiocynanate 10.065 ethyl isothiocynanate 9.89 methyl isothiocynanate 9.25 phenyl isocynanate 8.77 formaldehyde 10.87 acetaldehyde 10.21 propionaldehyde 9.98 n-butyraIdehyde 9.86 isobutyraIdehyde 9.74 n-valeraldehyde 9.82 isovaleraldehyde 9.71 acrolein 10.10 crotonaldehyde 9.73 benzaldehyde 9.53 acetone 9.69 methyl ethyl ketone 9.53 methyl n-propyl ketone 9.39 methyl i-propyl ketone 9.32 diethyl ketone 9.32 methyl n-butyl ketone 9.34 3,3-dimethyl butanone 9.17 2-heptanone 9.33 cyclopentanone 9.26 cyclohexanone 9.14 2, butanedione 9.23 2, 4-pentanedione 8.87 benzene 9.245 toluene 8.82 ethyl benzene 8.76 n-propyl benzene 8.72 i-propyl benzene 8.69 n-butyl benzene 8.69 s-butyl benzene 8.68 t-butyl benzene 8.68 o-xylene 8.56 m-xylene 8.56 p-xylene 8.445 mesitylene 8.40 durene 8.025 styrene 8.47 a-methyl styrene 8.35 ethynylbenzene 8.815 napthalene 8.12 l-methylnapthalene 7.69 2-methylnapthalene 7.995 biphenyl 8.27 phenol 8.50 ani sol 8.22 phenetole 8.13 benzaldehyde 9.53 acetophenone 9.27 benzenethiol 8.33 Williams Street Health & Safety Plan Lutrel Services. Inc. August 1995 Page 14 e e Table 2 Molecules eV Molecules eV H 13.595 C 11.264 N 14.54 0 13.614 F 17.42 Cl 13.01 Br 11. 84 H2 15.426 N2 15.580 02 12.075 CO 14.01 CN 15.13 OH 13.18 F2 15.7 HF 15.77 HCI 12.74 S02 12.34 CO2 13.79 Ü3 12.8 H2O 12.59 HCN 13.91 C2N2 13.8 CH4 12.98 methane 12.98 4.9 PERSONNEL PROTECTIVE EQUIPMENT Level D equipment will be required at all times that the PID measured concentrations are below 5 ppm above background. Level D equipment includes: · hard hats · safety boots · eye protection (safety glasses or goggles) · neoprene gloves (while handling samples) If organic vapor concentrations equal or exceed five ppm above background, all personnel in the contamination zone will don Level C equipment and remain in Level C equipment until organic vapor concentrations are reduced to below five ppm above background. Level C equipment includes Level D equipment plus: · half-face respirator equipped with combination organic vapor/dust cartridges · Tyvek® suits Williams Street Health & Safety Plan Lutrel Services, Inc. August 1995 Page 15 e e LSI will provide Level C personnel protective equipment for its own representatives. If Level C equipment is required, only personnel equipped with Level C equipment will be allowed to enter the contaminated zone, which includes the immediate working area. Anyone other than the LSI representatives and the drillers who desires entry into the exclusion zone under Level C conditions will be required to provide his/her own Level C personnel protective equipment and demonstrate applicable qualifications. The site safety officer or the designated assistant will ensure that no one without proper personnel protective equipment enters the exclusion zone TABLE 3 HAZARDOUS SUBSTANCES DATA (all in ppm) Substance Benzene Ethyl benzene Toluene Total Xylene PELa 1 100 100 100 STELb 5 125 150 150 IDLHc Carcinogen 2,000 2,000 1,000 Odor Thresholdd 1.4 2.0 2.1 NEe LEUUELf (in%) 1.3/7.1 1.0/6.7 1.2/7.0 1.1/7.0 Max. Levels at site 2.2 24 37 178 a - Permissible exposure limit in air for 8-hour day as established by ACGrn (1987 update) b - Short-term exposure limit in air for IS-minute period as established by ACGrn (1987 update) c - Immediately dangerous to life or health from NIOSH Pocket Guide to Hazardous Substances (1985) d - As adapted for ArnA Journal (1987) e - Not Established f - Lower Explosive LimitJUpper Explosive Limit from NIOSH Pocket Guide to Hazardous Substances (1985) Williams Street Health & Safety Plan August 1995 Lutrel Services~ Inc. Page 16 e Chemical e TABLE 4 EXPOSURE SYMPfOMS AND FIRST AID TREATMENT Inhalation, Inges- tion, Contact Ethyl benzene Inhalation Ingestion Route( s) of Entry Inhalation, Skin Absorption, Inges- tion, Contact Inhalation, Skin Absorption, Inges- tion, Contact Benzene General Symptoms First Aid Treatment Toluene Xylenes Odor - Aromatic Upper respiratory and GI tract irritation, muscle spasms, slow pulse, extrasystoles, hypokalemia irri- tated eyes, skin burns EYES - Irrigate im- mediately for 15 minutes SKIN - Water flush immediately BREATHING - Art- ificial respiration and move to fresh air. INGESTION - Medical attention immediately Odor - Aromatic Irritated eyes and mucous membranes headaches,denmatitis narCOSIS, coma. Same as benzene Odor - Aromatic Same as benzene Fatigue, weakness, confusion, euphoria, dizziness, headache, dilated pupils, lacrima- tion, nervousness, muscle , fatigue, insomnia, paresthesia dermatitis, photopia Odor - Aromatic Same as benzene Dizziness, excitement drowsiness, incoordina- tion, staggering gait, irritated eyes nose or throat, corneal vacuolization, anorexia, nausea, vomiting, abdominal pain, dermatitis August 1995 Page 1 7 Williams Street Health & Safety Plan Lutre1 Services, Inc. e e 4.10 WORK ZONES Two basic work zones will be established for this project: a restricted zone (exclusion zone) encompassing the drilling area and a clean zone. Only the exclusion zone may be formally delineated by a tape barrier. The decontamination zone and clean zone will be separated by function only. Final zone boundaries will not be delineated. 4.11 DECONTAMINATION All personnel who have been working in the contamination zone as defined in Section 4.10 above shall undergo personal decontamination: · when leaving the exclusion zone for coffee or lunch breaks; · at the end of the work day. The decontamination station shall include the steps listed in Table 3 - Personnel Decontamination. Steps pertaining to equipment that is not in use (e.g., respirators) may be elinúnated. TABLE 4 PERSONNEL DECONTAMINATION Decontamination Equipment 1. Outer glove and 1 boot removal plastic drop cloth. Set equipment on plastic, wash in soap solution, rinse and dry. 2. Air purifying respirator 1 plastic drop cloth. Lay equip- ment down, wash in soap solution, rinse and dry. 3. Hand wash I 3- to 5-gallon bucket Liquid hand soap. 3- to 5-gallon bucket. Paper towels. 4. Hand rinse and dry 1 Williams Street Health & Safety Plan Lutrel Services, Inc. August 1995 Page 18 e e TABLE 4 EQUIPMENT DECONTAMINATION Decontamination Steps Equipment 1. High pressure steam rinse Steam generator 2. Inspect visually nla 3. High pressure steam rinse as necessary Steam generator 4.12 GENERAL SAFETY MEASURES The following general safety procedures shall be followed by all persons entering and/or working in the designated work zones: · No employee or subcontractor may be allowed on-site without the prior knowledge and consent of the site safety officer. All personnel at the site shall be advised of the site safety requirements as discussed in this plan. · All contractor or subcontractor personnel shall bring to the attention of the site safety officer or resident project representative any unsafe condition or practice associated with the work activities that they are unable to correct themselves. · There will be no smoking, eating, chewing gum, or drinking the contamination zone. · Hands shall be thoroughly cleaned prior to smoking, eating, or other activities outside the contamination zone. · Team members must avoid unnecessary contamination (i.e., walking through known or suspected "hot" zones or contaminated puddles, kneeling or sitting on the ground, leaning against potentially contaminated barrels or equipment, etc.) · Respiratory devices may not be worn with beards, long sideburns, or under other condition that prevent a proper seal. Williams Street Health & Safety Plan Lutre1 Services, Inc. August 1995 Page 1 9 e e 4.13 PLAN ACCEPTANCE All personnel involved with this project are required to read this Health and Safety Plan and sign in the space below that they have read this plan and understand its requirements. Prior to beginning work on the first day of the project, the site safety officer shall conduct a site safety meeting to explain the requirements of this plan and unsure that all personnel are familiar with it Site safety meetings shall be held at the beginning of each work day of the project. Name Affiliation Date Name Affiliation Date Name Affiliation Date Name Affiliation Date Affiliation Name Date Name Affiliation Date Name Affiliation Date Williams Street Health & Safety Plan Lutrel Services, Inc. August 1995 Page 2 0 tit e 5.0 CONTRACTOR QUALIFICATIONS 5.1 LUTREL SERVICES, INC. Lutrel Services, Inc. (LSI) is comprised of experienced Project Managers and Scientists and is based in Bakersfield, California. Our list of current clients includes the Lockheed Environmental Systems and Technology, Chemical Waste Management, Inc., Shell Oil Company, Texaco Marketing and Refining, and several smaller clients. Over the last two years LSI has been involved as principal investigator in several site assessments and site characterizations that have been accepted by the Kern County Environmental Health Services Department and the Bureau of Land Management. 5.2 OTHER SUBCONTRACTORS LSI utilizes two State-Certified Labs out of Bakersfield, BC Labs and Zalco Labs. LSI's sister company Lutrel Trucking, Inc. is a State licensed waste hauler. The drilling company is based out of Bakersfield, California and is licensed by the State of California to do business in this state. AJ Environmental, Inc. will supply the Registered Geologist on this project. WiIliams Street Health & Safety Plan Lutrel Services. Inc. August 1995 Page 2 1 e e 6.0 CLOSING This site characterization work plan is intended for the exclusive use of Harry E Phoenix Trust. Lutrel Services, Inc. assumes no responsibility nor liability for the reliance herein or use hereof by anyone other than the above named client. In addition, all of the site assessment work cited in this report was prepared by Lutrel Services, Inc. of Bakersfield, California, who is solely responsible for the contents and conclusions of the site assessment. Bill Rosica Registered Environmental Assessor #875 General Manager Lutre1 Services, Inc. Williams Street Health & Safety Plan Lutre1 Services, Inc. August 1995 Page 2 2 e oa~~~ fSTdÖG:J r~-'~ VIM II" :1 ¡~"'~I =. i -~-~~~ a ,11 ; ~~-\.4.~' J¡ I~ TALI"""; r ã ~ ~ : IAv i ~ '>f HOkE i noAA /:' ., ~ A q L.~õW ~--..!'S«~£I [â"ø 'Noea.E i z¡ !5 .I. ~~: i ~ I :;; t;¡ ~ t¡i ti -r" ~¡~~á~~~E1t \1 ~~ S1 ~ § S ~ ~ ! filIi.! ~ ~ JL =::G ; ~ ~, !~fORD. 5T: v"JU il 300 3 1'c\ ~ COUJMlUS . ~ - ::; WAnR ! : ST Iii WA t;¡ 5T lIT ¡ ~ ,~ ~ !~ t;¡¡ ¡~JEFFRE~ 5T ~ i ~ VIEW ~ I ~~ >- I ---¡-;¡2!+- t;¡ fHEIGH" t;¡ >- ~ ¡¡i ~ ~EAST HILLS MALL/ """ :;; '?1 ~, i i ~ 5T:; ~oo; I i!!llll- !~~,:\ ,/ MALI. L -' 1 ~ i ' ' ~~~ f2 ~ ,I i3! Oft, ~.... l ~N ¡ ! ! :5T .~ .j~!.... = i~~ ~ ~ ,ST V "~~_.~~--f0-,. '-~Î_!~ ~~~.J~~:~~ __ ~ ~ /PVr.),~ ~ r i " ri_~~! ! 5T I V-~~/ - ~=J~CUNHA~~''f¡~!§~ .:.~,:¡ BERNA~ _PlCO--.J I~¡"- AVE þ~~- -"iœ~r¡;r~ll"Uf~ EVIEWOII ìãi! IZ·,·, t.. ~~'( .:i'; ~.Å'.c.i J ~ . Þ-ÞL -ì~--: : JEFF ---r'~~' ~,' ~'!~!I ~rJ<'''''' am~~~,~HIs8ùTA~ ~ i~1- ~I" ~ ¡ t' ~Y ~ ,,~~~ ; UNii't. N ... ~TO, . ' ~AV~~MaK' iii" '^ ,S .. Q 7''''. "'I ~r/~ - ~' : ,sr 4'~ AVE J'...... 15 ;; &~ ~~ ... ! F,'" '-Þ- j '''~I ~ S,.;: ~ ~ > GAlE AV I ,RlNe ..~?> ~ ~ ~ ! ...'t.! r ~.,. -'JEIIE. '!-"'¿L7.""'~ ~RIDGE, VETfR £fAHœ.J.WY . PljZ ét/iíi- ¡,;;¡ r ,~_ lit; IIf!!Y I: t;/ -F'""~.~ ~ .. . ' ~ ~ r~" )j ~~ / ---, !-!-,~}..itl~IfNIU ~ ~ ~sr ¡¿ p":.! --'¡:'--Li t;;/~! fo.I . "J sr . t;¡ HALL '~~/o:; ~ j- ~ -t ~ ~~7.e"ífU)PL.; I . ti/ I ~ t;¢; ~')/ ~ KEItH CO '!IN ~ CORTe I):: ~ ~ .U8. ~ ~/,~i~~,r~,- :'--L ~PRoa.DEPtI ~~ ~ ,1C! !/'~:~~~ _. .! / Y.-<; 1C _ _ ---I,: "(1 Sr KERN MEDICAL ;. '. S3 3.../"'~ / ~f~" '? ¡: .9OC\ j At i ~ ~ I~I s . CENTER EAST "rl' ~ ~ ~ t&, c,,, .....~ "11,., "~ r f!!1 9é '1---0-.., BAKERSFIELD,' rp) ~!Io ! &' ~. Nt ~ ~' '" , _~ ~ ' HI.SCHg:' Oil 1 ~~ I~OR ... $T ~~:'(:Q -' ,( "" Sr' ! --k ~,J../ ~,.u: C> ~,~ :-ri' riil~ .. ~ I ~ : fI- :.Q(j~ ~ ~~ / ,71.... ~ "- <'I("f' - ,~ J.-.:. S ~ - I~' §!~Æ-:"-::"~- _ --~"::' Ö _ ~ €T--. ~~ ~ ¿ i'1 . , -- J....::. ~E. ,I ~. ¡ Cliìè" oa '/..... ~ "cF. IE ,~ / sr J¡ ~ '. }èò"-::.t.~ ~ ;;-i': ~ .. 1 ~ ~ * P.O,· c?O FIRE ~ ~~~~Jc ~~~~ Sr ~ ~ MONnRfY :;;~.,<: t;¡ t;¡ ~ I Iii JOOC I ~I 2151/, ~ ~emJct.1 -~ ... , I ...'1 ~~S ~ ~ ~ LAKE .. "'7 r " '-' ";.ç , TltUXT"'N:- . '- 5r :r;"o ,Z KENTUCXY, _ . ;:!i ~tfJJ'~~~œ'!!l# rfjl;; >~~; tt T~ .....~.õìic5;__.\~L Ig= CENnR S I š! t/A;s VIS[~ ~ lUll ~ ~ sr ! II ~~ ~ ~ I~ ~ ~ECURITYg' AVE ~ ~ "i' !, ~~ ~ ~,~ COTTOfIZ HAAOlD L!!~ 1~~~~~U5T :I AVE!: H~:rr~wc¡ ! ~ ~~ -,¡ Sr';I ·sr § .: ~8~ ~! ST~ t;¡AV~'::':'" PROSptþ ~ Sr LI )RN~J ~~~ ~ ~ '" ~ ~ ~ AVE~~~ ~ A IARTlHWTf ~ 11TH i= = 5T Il( ~ ' HAlU'£R ~., !~... I:;; lAA~t HENLEY! ~ ST ~' ~~ ~ ... IIC/NG lit ¡¡¡¡.. I rTLI! ~ ~ AVI '" LARC US 3 ~ AVI ~ I LN u~.. ê A,V~ ,CITRUS ,........... -........;; -I....... -'" ... Q..j EN IOto ST ~M :;; ¡f'~ n¡ ~ ',.. ~ t ... --- ð 9TH, ST Ii;.. Õ LUCK AVe ~ !õ:;; ¡ LUCKY... Ave :iM. "': III -" u'~ ;... POTOMAC AVE POTOMAC ' Jc() Q f AVE ~ u Ii!:: .,' ... ......... ... ~... HC GOIUtI.l ST ~__ .._. ' ' c... ~ ~ ~ . 4( ~ '1 '" >- VICTORIA ~:Ii '" poro." 'ìûè t ... Dt ftVI. E 5T ~!:;; I~~ ~.;p ¡ aunmP" ,n DR RAlST 1N 5T fJ5 ~. HOllY AVE ~ ~ I j I-' HOI SER ¡T COlE z. r ,-- :Ii'" S a I (~U~~RY MUROÖCX 5T J J ... ST :z;¡ ¡VIRGINIA AVf ;: ~ PAULA '" ~..m"II' I ~ n ~ ~ t£Q(¡NTY P (.: . J ~ ~ ;¡: f ll~ "~'i ~ 1 ~ .: : '5 ~ ¡-~ - "'1 "" i 3Rt ;ORE 5TA . I '" ~ ! V,"..Nt< , f AJJD«A' , I, no ,,_,.,.,_,__ _ ~ I II ij I r:- z ~ g ~ i,_,_ I ~LH r Map # 1 General Vicinity Map LUTREL SERVICES. INC. 720 Wil1iams Street Underground Storage Tank Removal March, 1995 + North I e PHOENIX #1 . ·PHOENIX #5 PHOENIX #4 · ...-----:: Clarifier and Dry Well . . D PHOENIX #2 PHOENIX #6· · PHOENIX #3 Fill Cap 1,000 Gallon ~ ,', UST .~~~ VentLme ~'~ ' t-..." ..... ~ Fuel Pump Fence V Warehouse/Office Ramp Loading Dock Williams Street Figure # 2 General Plot Plan LUTREL SERVICES, fNC. 720 Williams Street Underground Storage Tank Removal Fence ~ August, 1995 '08-18-1995 02:47PM FROM BC LABORATOR I ES , I NC. . e TO e 8345018 P.02 ¡ ! Total Pet~oleum Hyd~ocarbons L1JTRBL SERVICES: 2212 S UNION AVE. ' BAKERSFIBLD, CA i 93307 Attn: BILL)MAQ:, 834-5986 I ¡ Sample Description:' Sample MBtrix: : Constituents Total Petroleum' Hydrocarbons (gas) Surrogate % Recovery Date Reported: 09/16/95 Date Received: 08/10/95 Laboratory No.: 95-09743-1 PROJECT NAME PHOBNIX: OILY WATER Water Date Collected: Date ~xtracted·8015M(g) : Date Analyzed-S015M(g>: Analysis Results None Detected 103. Reporting JJ.ni ts µg/L tr 08/10/95 @ 08/14/95 08/14/95 , I i ¡ Prac~ica~i ¡ QuantJ.tatlon .. ~ L1m1t : I 50. : i 70-130 I : i : ¡ ! : 1 j i i ! ! i : : ! TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method - Modified EPA 8015 . California D.C.H.S. Cert. #1186 I Stuart G. Buttram Department Supervisor " " .~, ' '·':;;,~7~¡ :U.~:;: ;' '~;)<I:. ~ f.~~, ',(. :~~::; ~~T, , ¡:·¡:~p'f¡l!n:::: , ' .. ';:[;;!t!P&~~;;: , ,,' ! ' i ; : page I 1 I ! I ¡ I I ' ! I ! I I I ! I , I P9 : 35»1 ' I ! I ¡ I "'.'1 " ; ~H'. ""","'1" 1[' I :1':;~;!fn'f¡'}l: /:(1 , ''''\'.\' ""'\' ';.,' ':¡¡~~;ft¡'!¡;!~ !;j '~' ~. ~ ~: ¡ , :., ! , i , . <,:'~ :f:~,:t ':.,;...~' 'j'::" t "",t..", : '. "I . \'1~ ~~:~;:',i :;} Zr;~ ":;;1 ;::~I ',,! , -," ! ~ .; . ¡ .'" . ;': I '\"¡'''fd~¡~~:; , 1::Ji::: -11::l-1 '::!'::I::> I::J¿: 4' r'l-"f'1 t- ~UIYI J::jl, LHtjUt-<:H I U~ 1 ~;:, 1 f'11,. . e IU e i::: ~4~i<:Jli::: 1-".1::J.j Total Petroleum Hydrocarbons I..UTREL SBRV1:CES i 2212 S UNION AVE BAKERSFIBLD I CA' At1:n: BILL MARK 93307 834-5986 Sample Description: , Page ! 1 Date Reported: 08/16/95 Date Received: 08/10/95 Laboratory No.: 95-09743-1 Sample Matrix: water PROJECT NAME PHOENIX: OILY WATER Const:ituents Total Petroleum Hydrocarbons (diesel) Surrogate % Recovery Date Collected: Date Extracted-801SM(d) : Date Analyzed-a01SM(d): Analysis Results Reporting JJnits ! i I j @ :o~ :35AM, : I i , ¡ Î Practical I Quant.itatioh Limit, I I I 100000. i 57 -137 ¡ I 08/10/95 08/14/95 08/14/95 , i , : ,I TEST METHOD: TPH by D.O.H.S. / L.U.F.T. Manual Method Modified EPA S015 1000000. Not Reportable mg/L % .! .,~ ".; !:' "" '1 i 'J" , .~-:: ,:'! . '. ; ~ i " ~ i , , ! i j ; :'1 ',' ~ '"I ');]1 "', " . t ..,.~n: .-::, r. ,'; ';. ,,',',·'·1' '~ ' . . : :~ ':":":: ·r~.'; , I r.':;f~~: I . ~ }'" ",\ ! , ¡ ! i , I i I """ , ;,j tri:! :,P¡ ":<~\;:~:;,:;;,: PQL 1 S were raised due to high c::onc::ent:rat:ion":¿;'f!¡!;target aiiifi;Ytes sample dilution. 'i,¡::'. Surrogate not reportable due to sample dilution. Approximately 25% of sample is oil. Oil phase was analyzed. , ';:..; ':'~:'~':'~,~,~ <:1 ~,' r: 1 ":;,i":',"":" ";,,,! ;..'.. .,' "'I - -''<110 ! ¡ I I Note: I I California D.O.H.S. Cert. il186 I I B~\~"" Stuart G. Buttram, \;'¡";'';', ',' ","' Department Supervisor ",. , .. 'i" " , , f: ," I" " : , ':;; \1;; '! i j ;, -'; : ¡' ~I ; i i , 08-18-199502:48PM FROM BC LRBORRTORIE~, INC.. e IU e 834501Cj -'.~4 LtlTREL SERVICES, 2212 S UNION AVE BAKERSFIELD, CA 93307 A1:1:n: BILL MARX 834-5986 Total Petroleum Hydrocarbons Date Reported: 08/16/95 Date Received: 08/10/95 Laboratory No.: 95-09743-1, Sample Description: PROJBCT NAME PHOENIX: OILY WAttR Sampling Date/Time: 08/10/95 @ 09:35AM Constituen~s Oil and Grease S~le Results 9600. Units mg/L Method P.O.L. 10.0 Note: PQL's were raised due co high concentration of target analytes requiring sample dilution. California D.O.H.S.: Cert. ~1186 e..b~~,~" StUa.rt G. 8uttram -; l) c;, ",,1 . < ' Department Supervisor ,', ¡ '; ~ ,-.¡,-'.-; ',' ("i , , ' ,or '.,' ~" -,' " " ~!' , ' ..~ ()~t;, ;';:~I.: ì Þage ! 1 i r , Methþd , I BPA-413.1 I '¡'t ,:'~ " j ,,; j ':'! ¡ ;, ::::,; i .. " j ',' I , ',~ , ',·'1 I I ¡ : I ! , , '. " .. " . .... '" ":¡ :,', '''",'' . ~ . '" ,. ' . : 1 ~ ,: ~.- ' ,', ..~, . , , ;: '~~', " ~--' L~iP;rt-Jo:~:-:-"",--~-",-=~~,:~ __uu'_·.· . -,----=--=~,~---:--,~-=~~=~_== -&~-=:~~-,-._.._.--,--=Änåly$i$.RéqoèStecL~-=---~~-- "....,~., O Name: LUTfZ..t,J SE:il.\he~ Project: 'DhDeµ i )é ~ -c- ",',' ':§ ê >. r--' ..-- L {/) (1) .::::: """ .a t;) ~ddress:Z,:2.-12.. So.L)~.J:~ Project#: ._..._._.___,......____ ijfõ ~ ~ i ~ ;;;" ..CitY:'~d~(~...(..~,t:Q-n----' 'Sarnpl~f1·'~ðm,'ë:'-..·..--'-'---.." ~:-..Q \] '.,--- .n· ".. mn. .,"'.' ,-_. ..-,,-- ó ,I ',~i=. o __,b?J~... ,~!. ..' ---,- , .æ CD U) Z oØ 11. State: C!A Zip: Q;ß07 Other: :g~ ~ ~ ~ 'S ~ o -- q Ch :t...... CI2 0 ::;0 Z Attn: ß¡ 11 f-., YYlJ~-k_ _ _, t --s q..=ït r ~ ~[ ! ¿ ~ ~ æ Ci Phone:,:z~l(_s~-g~_,. ('-\-1 La.. (J) Õ 4~~ Sample Descripl~n Dale & Time Sampled ::;; 1-1: ~., ~'(_ _lùa,.T~ae... ~ - . 1ft W +..¡. f ~ § ,____ __....., " ....h_._______. ¡j-=1f2. 9S' -t:t 35 A: ~ <~ o ~ _."- Jiií) ( )O ~~ ê¡)x . -a~ ca. . 1::..... Õ a; ----,.., -., o~ en" -,' ~~ ~- ,,' aU) a~ ....- ~ ..'~ n. _. '. Q) "Og; fó~ .....' '-- ( )CI) .0 .5 E QJ ::J- Z§ o IAbrvvtll) -r~ ,----,-f-. . , ,~-_._,. ---- ..--.---.-- _.---- ._-- --._- - "'--'-- ----------_. --- -f-- -".-. - U.' r'~_~ ..- ---- .....- ur #.. ~.._--....." ..' .---.. --. -" ---, ., .'--,- ---.-. y'-'- --,-~, -.--". -- -'- (j Z -------,--- .--.- --f-- . .--.-.....,.. ------------.-- ,--~-_. .- - --, ---- , -.- ...---,- --- -. -, -'" -.. -------- ,------ ,-- -- -- -- -- --, -,- -,-' ,--- -,-- e- - rñ w [f -,.. ,--, o Comment: ~ [I o m ~ _I 0 :0 Ð~POS~; .. 500 ..- , , I ' n A~(l ro to ~!i Ant .~.._-_... -----.. - - - -::;? ,-.- - -- -'- Relinquishe... nature) --- -_:.--...:!;~ .. ,..,', . c,." __'..... ~~ ,'..... '....,__ 4.$,--Abtvb- Relinquished by: (Signature) ..... ,~~~~ru~~ '..ßeoeived by:l~ignature) Date: 1m Billing Info: --- ,----, ~------ Nämé: ,. ,"" " ------~fDçrr1(¿ Address- '" "" "', , - City ---,- / State-"- ---- ~ ( .. Relinquished by: (Signature) Received by: (Signature) Date: Tim AUention: - Aelinquished by: (Signature) Received by: (Signature) Date: Tim Time: Miles: P.O. # Relinquished by: (Signature) Received by: (Signature) Date: Timl ......- -.. ... . - ;-' ;;... 1J'1' - Aeceiy( d by, (Sig.,alu,~) - .'_ u. _ '~._ _,___. _ OélltJI. Timl