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Home My WebLink AboutUNDERGROUND TANK FILE #2 e ............_~-_.<-"--'--,-----_._------ ~-- ._----.- --..-...--. ---- --- -.------.--- Bakersfield Fire Dept. Prevention Services 900 Truxtun Ave #201 Bakersfield, CA 93301 Tel: (661 )326-3979 JOB CARD .-.--~-- ~---~-'-----~-----'-'"-'-----'--'-~'-"-----' --'-'~-+-'.-~----- -_._------_._--_._.~.."~-----~ POST CARD A TJOB SITE FACILITY NAME \(..( ~Vp(t. t{ ADDRESS QS-5D. CITY BAKERSFIELD ~(~ LhHON A'^-. ZIP OWNER 5 «.IkL ADDRESS 7{L~ ,~o. ClJAfON CITY V3't.(J PHONE No. L INSTRUCTIONS: PLEASE CALL FOR AN INSPECTOR ONLY WHEN EACH GROUP OF INSPECTIONS WITH THE SAME NUMBER ARE READY. THEY WILL RUN IN CONSECUTIVE ORDER BEGINNING WITH NUMBER ONE. DO NOT COVER WORK FOR ANY NUMBERED GROUP UNTIL ALL ITEMS IN THAT GROUP ARE SIGNED OFF BY THE PERMITTING AUTHORITY. FOLLOWING THESE INSTRUCTIONS WILL REDUCE THE NUMBER OF REQUIRED INSPECTION VISITS AND THEREFORE PREVENT ASSESSMENT OF ADDITIONAL FEES, INSPECTION DATE INSPECTOR TANKS AND BACKFILL BACKFILL OF TANK(S) SPARK TEST CERTIFICATION OR MANUFACTURES METHOD CATHODIC PROTECTION OF TANK(S) PIPING SYSTEM PRIMARY PIPING SECONDARY PIPING TYPE OF PIPING o FLEX o FIBERGLASS --- --- ------ ~- -- - ------ -~--~---- - ------~--- ----- --~--- --- -- --~---- CATHODIC PROTECTION SYSTEM-PIPING DISPENSER PAN SECONDARY CONTAINMENT, OVERFILL PROTECTION, LEAK DETECTION CONTINUOUS VAPOR MONITORING ENHANCHED LEAK DETECTOR TEST iiL LEVEL GAUGES OR SENSORS, FLOAT VENT VALVES o{~JjJLL ~~¿ ~-o If FILL TIGHT FILL BOX(ES) PRODUCT LINE LEAK DETECTOR(S) LEAK DETECTOR(S) FOR ANNUAL SPACE-OW, TANK(S) MONITORING WELL(S)/SUMP(S) - H2o TEST SPILL PREVENTION BOXES FINAL .MONITORING WELLS, CAPS & LOCKS FILL BOX LOCK MONITORING REQUIREMENTS TYPE --------- AUTHORIZATION FOR FUEL DROP CONTRACTOR _____c:aJ:_U1t¡[cy___ê</JJ--1p__________________________________________ LICENSE No. :J_ß~LL7{l___A_j-l4 L CONTACT ____~ltt'_~_~_("_____t1tvLt-:_____________________________________________~_____ PH ON E No. _3.r12_=-(jJY_2___ fd1743 ,V' ~ 2-11-2Ø0d 10:2BAM FR.CALVALLEY EQUIP 16613252529 - P.2 MONITOIUNG SYSTEM CERTIFICATION For U$C B)/ All Jurisdictio/1S Within lhe Stale olCalifornia , Allthority Cited: Chapter 6.7, Health and Stilet)! Code; ChopÚJ1' J 6, DMslon J, Title 23. California COth of ReguJaliolt.' This fonn thust be used to document testing and servicing of monitoring equipment. A sel?arate certiflC.8tlon or report must be ~repared før eacb monitorinlt system control Þsnel by the technician who pl:!rfonns the: work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regula(ing UST .ysterns within 30 days of test date; A. Generall..roruaation Facility Name: t't.VI1 Cnql.1TY SUßý'¡'nuì;fR'ehr "'-! S'ci.IlbJ.r Site Addre$$: '7°" s, L/~w"', City: ..ß€!-klJ~".r~/lld Fac¡'¡ity Contact Person: Cont4lct Phone No.: ( ) MakeIModel ,of Monitorins System; TI1 COVl TS ·-lbfJJ EFr Date of Testin¡/Sctvicln¡: .:2...J~.4- B. loventoJ")" of Eqùipment Tested/Certified SIll- ~z.'r~( (:h~ek Ibe II rlllltt bUn 10 I"dle.le s celfte equipméJlI iMpt(led/*~rvlccd: Tank lD: ( Tank 10; Q¡f In-Tank OQua;ng Probe. Model: í.!:d'-/4,1.. [J In-Tank GQ~ging PtQbe. Model: IJI Annular SP81:e or Vault Sensor. Model: t.ll,·S [J Annular Space or V.I."! Sensor. Model: I( Piping SU"IP" Trench Scnsor(s). Model: _ i '--" ~. 0 Piping Suml' I Trench Scnsor(s). Model: o piIJ Sump Sensor(s). 'Model: [] Fm Sump Sensor(s). Model: [J MlChanlc~1I LÍlle Leak Detector. Model: [J Mechanh:8I Llno Leak Deleclor. Model: ,0 ElectIonlc Line Leal( Detector, Model: C Elcctronic Line Leak Detector. Model: o Tank Overfill I Hlgh-Levef Sensor, Model; C T$nk Overfill I High-L~cI Sensor. Model: I;J Other I i lDent ty e æ'ld mooel in Section B on Page 2). [J Other (specify equi ment II and model in Sccllon E 011 Page 2 . Tank IDI .2 1'lIInk AD: I'II'ln.TankGlIlIgingPtobe. Model; T.<:f-l'-Z [J In.TankOauglngProbe. Model: ' fa. Annular Spaço or Va"lt Sensor. Model: U""Z-s.. Q Annular Space or Vault Sensor. Mollel: fØ Piping SutnpI Tralch SelJ$(lr($). Model: --1,¿LK 0 PipinS SLlm) I Trench Scnsor(s). Model: o PilI Sump Sensor(5). Model: a Fill Sump Sensor(s). Model: [J MecJl8llieal Line Leak Dolectur. Model: C Mechanlclll Line Leak Detector. Model; C ElcçÚonlc LidO J.,eok Deiec:tor. Model: CJ I!leclronlc Line Leak Detcc:\or. Model: IJ Tank Ovcl:filll Hi¡h.Lcvel Se.nsor. Mo4et: tJ Tank Ovcrmll Higtt·Level Sensor. Model:, [] Other cify equipment type 4Itd model in Section ß on Page 2 . 0 Olhor (specify eql1ipmenllype and model in Section E on e 2 . Dispenser ID: I ~ 2. Dispen;erlD: 7-J{" [J Dispenser Containment Scnsor(s). Model: /1/ gf <.-:--- !J Dispenser Containment Sensor(s). Model: ~4~7 ~ A'SllCII'vltlve(s). ]il' Shear Vlllyc:(~). tJ D ser Containment float s).and Chain(s). tJ Dispenser C(!ntaiume\t Float(s) and Chain(s). Dllpenaer 10.: . ;3-i' D.1'peb,er IP; o Dispenser Containment Sensor(s). Model: V/2kf;( 1:1 )ispcns~ Containment Scnsor(s). Model; ~ Shear Valve(!I). [J Shear Valvc(s). o Pis nser Containment Flo oS and Chaill(s . [J Dis Dser Containment Floa s) and Cbain s . Dlspenaer ,ID: ~ Dllpenser 10: _ '[J Dispenser Containment Sensor(s). Model: A/ðn ( C Di~nser Containm.ent Sensor(s). MQlJel: Gr Shear Val~($). C Sh~r Vlilyc(,). CDI set Containment Float s ànd Chain s). D Dis enscr Containment Float s) and Chain s . -If tho f'aèlllty contains mare tanks or dlspclIMrs, eopy this R>rm. Include IDR>rnwion COt evet}' tllrlk IlJld dispc:n,ct' e1 the '~ilit)'. C. Certißtation - 1 a;rtiry th.t the 8quipQl~t identfntcl In thts document was In'spec:ted/servleeð In IIcc~rda~ee, w'th the IDlriur.ttUl'1IIn' guidelines. Attached to this CerUncØtlOIl II Information (e.l. maDufftcttll'en' checklist,) nKeSIAr)" to verify thlt thl~ lI.rot"mAtloo I, carre!:t and, II PInt. rlan.showing tile I.yout of lIIo.dtoJ"lng equipment. For Any equIpment é:apab" 0' g....ratlng luch repot"ta, I bave 11110 attacbed a copy of tbe reporl¡ (chl!t:k all that flI1PIy): 0 System sel-up [J Alarm histOry report Tecbnicløn Name (print): -7'frf..4L" )h 'yt.f/~, Signature: ~"'.w_"¿" l.h';"~'~ ' , ' Certi6Cóltion No.: 'OI/222JD,II, /2' License. No.: 71'dl11 A IIIIZ. TeslingCQlnpanyNalDe: é:.A.I-Lt'.AI#,,· Ev:<¡pJnIJÞt't- PhoneNo.:(6¿;/ ):7~7-9J~ Site Address: '7ðS' <: (.A. ,'tJlq ÂV~- Oâ K-t Y.f',¡:,·-e/~ rA _ Date of Testing/Servicin¡: ..2...I...6../.e$: Bldg. No.:: ZIp: '13307 -~~ Page I of3 OJAlt Monitoring System CertißcaUon 'f' 5- 2-11-200410:29AM FR. CAL VALLEY EQUIP 16613252529 e P.3 .}. ~ D, Results ofTeatiDglSen'ic:iDg' software Vc;rsion Installed: Complete the following cheeklist~ lit Yes Q No'" Is the audible alarm operational? It Yes [] No· Is the'visual a.larm operational? IJ Y c. a No· Were all sensors visually inspected, functionally tfJStcd, end con finned operationa'? Q. Yes ' C No· Were tll sensors installed at lowe.,~t point of secondary contaihmcnt and positioned so that other equipment will not Interfere with their proper operation? DYes o No· If alarms are relayed to a remote mOnitoring station, is all communications equipment (e.g. modem) dB N/A operational? I» Yes a No· For pressuriud pipíoa systcms, does the turbine automatically shut down if the pipIng secondary containment Q N/A monitoring system detects à leak, rails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut~own7 (Check aU that apply) !'if Sump/Trench Sensors; 0 Dispenser Containment sensors. Did you confirm positive shut-down due to leaks and sen$Or failure/disconnection? ill Yes; a No. a Yes a No· For tank systems that utilize the monitoring system as the primary tank over fin warning device (I.e. no iii N/A mech'anicat overfill prevention valve Is hl,talled), is the overfill warning alann visible and audible at the tank fill point(s) and Qperating properly? If so, at what percent of tank caDacity does the alann trigger? ' 0/. eYes· !;It No Was any monitoring equ!pmcnt replaced? If yes, identify specific sensors, probes, or other equipment replaçed and list the manufacturer name and model for all replacement parts in Section E, below. eYes· ~ No Wu liquid tbund Inside allY secondary containment systems designed 81 dry systems? (Check alllMI apply) [J Product; [J Water. If yes, describe causes in Section E, below, -. Yes o No· Was monitoring system set-up reviewed to ensure proper settings? Attach set up feports, if applicable ìJB Yes C No· Is aU monitoring equipment operational per IlIanufactuter's specifications? . In Section e below, d..cribe bow .nd wben thc5e deßclencies were or will be corrected. E. Comments: . .' Pa£tZ orJ 03/01 ~ 2-11-2004 10:29AM F~ CALVALLEY EQUIP 16613252529 e P.4 '. . F. In-Tank Gauging I SIR Equipment: ~ ~ . .. Check this bo" iftank gauging Is used only for Inventory çontrol. o Check this box ¡fno tank gauging or SIR equiPment is imta~h:d. This section must be completed if in-tank. gauging equipment is used to perform leak detection monitoring. , Complete the following checklist: o Yes o No'" Has aU input wiring been Inspectcd for proper entl')' and tenniøatlon. Including t&Sting (or ground faulls? . a Yes CJ No. . Were aU tank gauging probes visually inspected for damage and'residue buildup? ,. Q Yes a No· Was accuracy of !lY!lte1n product level readings tested? C Yell Q No· Was accuracy of system water level readIngs tested? Q Yes Q No· 'Were all probes reinstalled propcrly? [J 'Yé& o No· Were all items on che equipment manufaçturer's maintenance checklist ~pletcd7 ft In the Section II, below, describe how and when these deßc1encJe¡ were or will be correeted. G. Une Leak Detectors (LLD): þ( Cheçk this box ifLLDs are not Installed. c I t h Ii h k oll1þJe e t e ollowlna t ec: list: [J YC8 [J No· For equìpment start-up or annual equipment certIfication, was a leak sImulated to verify LLD perf~rmance? o N/A (Check. olllhot apply) Simulated leak rale: a 3 g.p.h.; a 0.1 g.p.h; Q 0.2 g.p.h. OY" C No. We(e all LLDs confirmed operational and accurate within regulatory requirements? o Yes C No· Was tho testins apparatus properly calibra(ed? o Yes r:J No· For medl8n1cal LLDs, does the LLD l'CSttict product flow if it detects a leak? o N/A Q YeS C No· ' For electronic LLDs, does the turbine automatically shut off if the LI,..D det«ts a leak ? o NIA eyes C No· For electronic L.L.Ds, does the turbine automatioally shut off if any portion ofthe monitoring $)'Stem is disabled (J .NI A or disconnected? o Yes t:J No· For eJectrònic I..I..DII, does the turbine automatically shut otTlf any ponlon of the monltorin, system C N/A, malfuncdons or (ails a test? CJ Yes I:] No· For electrOnic LLDs, have all accessible wiring connections been ViSUtaJly inspected? , , Q. N/A o Yet o No'" Were all items on d1e equlpmol1t manufacturer's Jnaintenance checklist completed? ·In tbe See lion H, below, describe how Bnd when these deßelem:ies were or will be corrected. H.. Com.m.ents: , " P.ge 3 or 3 03101 ... .;.1::' . 2-"-2Ø04 10:30AM F~ CAL VALLEY EQUIP 16613252529 e P.5 Monitoring System CertlOcatJon .) .. UST Monitoring Site Plan Site Addre$s: 7ðÇ' ~. V",'DLt Ave. ßa:.Ki!.r"If"~j~ Ca.· -·L····' - . . . . . . .. ... .f- . . ....... . .' , ./ ' , . '3' · AI' · ~'I'" · 1.'/' ./v: . " .' , r5 ~~ . ,.-,', ¡; .. 0 Ç1 s , , rfrplii,.'r . : ,::6 -::- :-~:~-~-: ::-: ~- :-~-~~ _ . . , . . . .......;..,... ..:"~ '4JhI~~M.. : ,.:::~~?:: . '. fi.L.Ql~.: :S~lQ' . , . ~,-' .. .. . .. I . . , .. . . .. . .. . . . ,-~-:-:-~~-:--:--a--·I··-r-.....-.-_.. . .. . . . ' Date map Was drawn; .1:..J 6 I.Q!L. Instructions IC you aJreådy have a diagram that shows all required infonnation. you may include it. rather tban this page. with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly Identify locations of thc fOllowii1g equipment, it: installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps. dispenser pins. spill oontainers, or other secondary containment areas; mechanical or electronic tine leak delectOß; and in-tank liqui~ level probes (if used for leak detection). In the space provided. note the date this Site Plan waS 'prepared. , .' . , ' Page ~or~ OMlO 1-21-2004 8:55AM FRtt CAL VALLEY EQUIP 16613252529 e P.2 - CITY OF BAKERSFIELD OFl~ICE OF ENVIRONMENTAL SERVICES! 1715 Chester A ve.~ ßakersfield~ CA (661) 326-391~ AP,PLICATION TO PERFORM FUEL MONITOIUNG CERTIFICATION FACILITY ~y¡., (Jl/Hty SU/NY/J,;T:e';"',WkJr q..l'Scitð"k ADDRESS 70S So Vh/PIr1 11-1/.... '$~_,<f'i'rJ-I/~M( Ca.-- OPERATORS NAME Sal'YJ.¿ OWNERS NAME S,:;l..WHl NAME OF MONITOR MANUFACTURER ~kJ Co'" DOES FACILrry HAVE DISPENSER PANS? YES.....f;:::: NO_ TANK 1# I z. VOLUME CONTENTS gZVL ,Pies e/ , I i I ; I I ' .~/-"~~ , I ' I . ',:' 'I' I "1 . . NAME OF TESTING COMPANY_Cø.,./- 0.t.iI~· E~(/¡'Ph1eJ-7'r CONTRACroRSUCENSB# 7Z"/70 A ft...~ NAME & PHONE NUMBER OF CONTACT PERSON ß~:;~ ~'~dii'P , DATE & TIME TEST IS TO BE CONDUCTED . .,... h-O?' ;:. () , ( '. ~ . , 'I SiONAtURE dÞ APÞUcANt ,; ":., .: ,I¡'k';'::,; . ,;¡..! f . . ··if'"". ,¡ ,:;¡i!¡j1: ' . ", !III' I;, I, \ I , ;1 ¡itill, ¡ , ¡ ;] . ,.J '.f ". '.,. .t,' ..11'(1'1'·..· " , F ¡i¡f~¡ ¡'I I:! L dlJl¡a() APPROVED BY L- 2/-rJf/ DATE - CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Avc.~ 3rd :Floor~ Bakersfield~ CA 93301 FACILITY NAME ~,c ~t.JJk" 01 5r~()nI ~ INSPECTION DATE~ Section 2: Underground Storage Tanks Program o Routine ~ombined 0 Joint Agency Type of Tank IJUJt=~ Type of Monitoring ð...£...Ut\ o Multi-Agency 0 Complaint Number of Tanks 2. Type of Piping 19uJF ORe-inspection OPERA nON c v COMMENTS Proper tank data on tile ,1,.- / Proper owner/operator data on tile v ,/ V / Pennit fees current / Cel1itication of Financial Responsibility V / Monitoring record adequate and current t./ / Û / Maintenance records adequate and current ,/ Failure to correct prior UST violations v I Has there been an unauthorized release? Yes No 1/ Section 3: Aboveground Storage Tanks Program TANK SIZE(sís) ~c;o e,f RGtCl(f (1)S<!04,J ú..ro.~k OIIAGGREGA TE CAPACITY Type of Tank Number of Tanks OPERA nON Y N COMMENTS spec available V 1/ spec on tile with OES L.- V . Adequate secondary protection \........ Proper tank placarding/labeling L.- v Is tank used to dispense MVF? V / If yes, Does tank have overtill/overspill protection'? :~:::;'nJi~v~ Office of Environmental Services (661) 326-3979 N=NO 23A~l1 7èc:tAÁ.{}ØL/ Business Site Responsible Party White - Fnv. Svcs. Pink - Business Cory /'1.{ ~}Jf~- ~~''>. , \ !C 2-06-2003 12:38PM FRtCALVALLEY 16613252529 . P.2 EQUIP 7 MONITORI,NG SYSTEM CERTlJ3'1CATION Fur U$t! By All Jllrisdictions Within thc Stalè (ifCalifQl'lIia ' Authority Cilltd: Chaptc/' 6. 7. Health alfd Safety CocJe.; Chapter /6. Di.,,~Í(m J, Titre 23, California Code of Regulations This form must be used to úuÇ\lment testing unci servicing of monitoring equipment. A separate certification or report must be prepared for each nlOnitorinA system conll'Ol panel by the technician who performs the work. A copy of this fo"!, must be provided to Ihe lank system owner/operator. 'Ole owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days oftest date. A. General Information Facility Name: t~J;¡ C"Uh 1"j' .[p...lZf.r/t17:e;'JÇ('r"l/ t..ç'J:...Jè/;/~/.$' ..-- Site Address: 7"S-' $.. f.l11Ù£iJ. A,¡/~. _....._ City: ~1/:LJ.'I;·e/a" Fncility Contact Pet5on: Contact Phone No.: ( ) MakelModel of Monitoring System: :j:ll (.i'J1 T:t~ JiJll1l IE a,-'2.:p. Date of Tc:uing/Scrviçjng: ZJ L! ,0 'J B. Inventory of Equipment Tested/Certified Cltuk Ibe I roprl.le boxc! to indltllte spedßc equl mcntlll~lCctcdfsen'iced: Tank JD: _I-- ,.... Tllnk ID: ~ In.Tonk Gauging Probe. Model: T<;: P:'iL;.T Q In-Tpnk QlllIgillg Pl'tlbe. Model: œ Annù!øt Splice or Vault Sensor, Módel:L! L~ [J ^nnular Space or Vault Sçqsor. Model: I:s¡ Piping Sump / 'french Scn;)I'(s). Model: T:7LY~'-- 0 !>iping Sump I Trench Scnsor(s). Model: a F'íJI Sutnp Sensor(s). Model: ___.__._ [J Fill Sump ScIlSOr(S). Model: [J McchallicDl Lim:: Lellk Detector. Model: Q Mççlumicslll.inc Leak Detector, Model: C Electronic; Line Leak I)çtççnr. Moocl: U Elcclronie Line Lct\k De(eçtur. Model: CJ Tank Overfill I JJf¡h.I..cvcl Scnwr, Model:.. '_~__~' [J Tllnk Overfill / Iligh'Lcv~1 Sensor. Model: o Othçr . ceif ulpmcnl type and model in Sectiun ~ 011 I>nge 2). 0 Olhcr (specify c: IIi Incnl ly e and model in Section E on Page¡ 2). Tank 10: I, ~ Tank ID: ,_~_, Q In-Tank (iauging .>robe. Modë['~'íi::zrT Q In-Tonk (jauging l>robe, Model: i1'AnlJular Space or Vault Sensor, Model: 12 ß I:J Annular SJ'II:e or Voult 5ensol'. Model: ~ Piping Sump I Trcu:h Sensor(s), Model: JLidS__ Q I>iping Sump I Trçnch Sensor(s). Model: IJ Fill Sump Scnsor(s), Model: 0 Fill Sump Sensor(s). Model: a Mechanical Line Leak Detector. Model: Q Mechanical Line Leak Detector. Model: o Electronic Lin(: Leak DClc¡;lor. Model: Q ~It..clronic Line Leak l>ctector, ModeJ: tJ Tank Overfill/ J IiSh.Levcl Sensor. Model: Q Tank Overfill/IUgh.Level Sensor. Model: a Olher s eçlr c "Ipmenl type and model in Sectil)l BI)ll p¡¡gc: 2). CJ Other (~ccry c;quiPITI'='11 type IInd mo"'el In 8«11on' E on 1'lIge: 2). Dupenaer 10: Dispenser 10: 7-ff [J DispenserConlainmcnt Scnsor(s). Model: 0 Dispenser ConlaiOlncnl ScnSDr(S). Model: œ Shear Valve(s). a 1;hear Val\'e(!}, IJ Dill ISor ContalnlllOflt 1:loot(s and CI¡ain(s). Q Jis nser Containlnl)lIl Float(n IInd Chllin II : Dispenser ID: DiJlcnst:r 10: C l)isPQll$et Containment SensDr(s). Model: __--.:......-__,_ a Dispcnser Cont.·lÍnmcnt Sensor(s}, M(I~': ~ ShÇ¡r Valvc(s). tJ SlullIr V¡¡lvc($). o Di onsor Cùll\.Qinmcnt 1'1011 $) III1d Chain s), Q Dis cnscr Containrnenl flollt s ond Chaih $ . Dispenser ID: ~ Dispenser IÞ: a Dispenser Containmcnt Sensor(s). Model: [J Dislenscr Containment Scnsor(s). Modol: ,IJI Shear vatvc(s). C Shear Vall/c(s). CDis cnscr Conløíomcnt 1'10111 s and <".nin s). Q Dispenser Containment FIOtI $ IU1d Chain s. . ·Iflhe realU')' "oalD;ns more tanks Of di$pcnS"eB, coPy this (oml. Jnçlude information fur Cl/cry 'III¡ and dispenser al the faclllt)'. C. Cc:rtific:ation - I certify that (he cqlJip';'cn, identified in this dOC!Un'lCllt was infpeçWdlserviced in a~or~anee with the tJlanufaçturllrs' guid.nn... AUl\ehcd to this Certif_ejon is informl\tion (e.!:_ laBnuracture"" checklists) nt«15l1ry to .verlCy tblte tMs . Information is correct Imd ft Plot PIAn showing the Inyout of monÎlorllla equilllJll:nl. For any equipment capable 01 eeneratlne such rcporb, J bave also aC(a.:brld II Cqpy of the report; (check oJllhot Dppl,y): [J System set.up D A'arm bis'ory report Technician Name (print): l3 rU Ce I/'/if t¡/.!!:/::- Signature: ::Z:l:2.c--~" ''ÃJ~r . Cel1.ifica(Îon No.: 11221.1:2,' 'I,. J4_.r Licenso. No.: '7g '-1/7'( 1111/12 Testing Coinp¡IIIY Name: CA/- V,,/ /</1 l?,.tdRl:.t7e¡,T ~ Phone NU.:( ~I ) 32 7- 'ÝJ~/ Site AdcJress: 71)5 ~. lI.ViÌJH, Ave.· ¡J4.ter.s-H·e~ C~. Dl1tcofTl;sling/Servicing::ZJ.£.JiJ Bldg. No.:' Zip:__ '>age I or 3 O3lU1 Monitoring System Certification 2-Ø6-20Ø3 12:39PM FR'CALVALLEY EQUIP 16613252529 . P.3 ~. D. ltesults of Testing/Servicing Software Version Installed; c 'olnplete the following checklIst: ~ Yes o No· I, the audible alønn operotiolial'l a Yes !;J No· Is the visual alann operational? 1J Yes o Nu· Were all senSOrs visually inspected, functionally tested, and continned uperationsl? OJ Yes .CJ No" Were aU sensors installed at lowest point o(secondnry containment and positIoned SO that oOler equipment will not interfere with their proper operation? a Y~ tJ NQ* If alarms are relayed to a remote mQnitoring station. is 411/ communicntÎons equipment (e.g. modem) III NI A operational? iii Yes o No· For pressuri:ted piping systems, does the turbine automatically shut down if the piping secondary containment [J NlA monitoring system detects a leak, fails to opelllle, or is eJectric&lIy diseonnccted? If yes: which seoso,", initiate positive shut-down? (Check all/ha/ app/JI) IS.Sumprrrench Sensors; 0 Dispenser Containment Sensors. Did you confirrn positive shut·down due 10 leakll and sensor failure/disconnection7 ø Yes; [J No. o Ycs o No'" For t~nk sySlems that utUjte the monitoring system as the pthnary tank overfill wamin¡ device (i.e. no m N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank till l'Oint(s) and operating properly'! If so, at what percent of tank capacity does the aamI trigger? % IJ Yes· fit No Was any monitoring equipment replaced? Jfyes, identify specific sensors, probes, or other equi,pment ~eplBced nnd list the manufaelurer name and model for all replacement parts in Section E, below. o Yes· '121 No Was liquid round inside any secondary ~onta¡nmcnt systems designed as dry systems? (CI,eck all that app/JI) o Product; Q Water. Iryes, describe causes in Section E, below. OJ Yes Q No· Wu monitoring system seN.r1) rcvtewed to ensure propcr settings? Attach set up reports, if applicable ~ Yes o No· Is all monitoring equipment operational per manufacturer's specifications? · In Section E below, describe bow "lid when these deficiencies were or will be corrected. E. Comments: ~-- ~ -.... . PAge 2 or J OJIÐI 2-06-2003 12:39PM e FROM CALVALLEY EQUIP - 16613252529 P.4. " -, > F. In-Tank Gauging I SIR EquiplUcnt: PI Check this box ¡ftook gauging is used only for inventory control. a Check this box if no tank gauging or SIR equipment is installed. This section must be completed jf in-tank gauging equipment is used to perform leak detection monitoring. c h (¡ II h kl' omplcte t C 0 oWing c ec: 1St: C YeI t1 No· Has all input wiring been inspected for propel' entry and termination, including testing for ground faults,? o Yes tJ No" Were all tank gauging probes visually inspected for damage and residue buildup" o Yes o No· Was accuracy of system pl'Oduct level readings tested? [J Yes o No. Was acc:unlcy of system water level read ings tc:stcd? o 'Yes CJ No· Were aU probes reinstalled prupcrly? o Y~ 1:1 No· Were all items on the equipment manufacturer's maintenance çhecklist completed? · III the Section H. bclow, describe flow and when these deOc:lenc:1e8 wen: OJ" will be corrected. G. Line Leak Detedors (LLD): ~ Check this box if LLDs are not installed. Complete the following rhecklist: 1;1 Yes C No' For equipment start· up or annual equipment certification, was a leak simuJated to verify LLD pcrfonnanco1' o N/A (Check all that apply) Simulated leak ntle: Q 3 g.p.h.; 0 0.1 g.p_h; 0 0.2 g.p.h. IJ YOI 1:1 No. Were all LLl>s confimlod operøtionaland ac:curate within rc¡ulatory requirements? a Yes [:J No' Wøs the testing apparatus properly calibrated? .. ,0 Yes o No' For mechanical LLDs, does tbe LLD restrict product flow if It detects ft leak? CJ NI A o Yes o No' For electronic Ll.Ds. does the turbine automatically sbut off if the Ll.D detects a leak? (J Nt A a Yes CJ No' For electronic I...LDs, does the turbine automatically shut off if any portion of the monitoring system is dIsabled 0, N/A or disconnected? . . , o 'Yea C No' For electronic LLDs, docs the turbine automatically shut off if any portion of the monitoring system C N/A malfunctions or fails 8 (CSl? eYes C No· For electronic LLDs, have all accessible wiring connections been visually inspccted? 1:1 NIA 1:1 Yes C No· Were all items on the equipment manufacturer's maintenance checklist completed'! . . In tbe Section H, below, describe how and wh,n tbese denclencles Were or will be. corrected, H. COIDments: Page 3 of3 OJlfH 2-Ø6-20Ø3 12:4ØPM e FROM CALVALLEY EQUIP - 16613252529 - P.5 ,. 1 , MOldtoring System Ccrti1ïclltion UST Monitoring Site Plan Sj1eAddre~: 70s.s; tlh,·I.~.i.1 J4ve, &k-e(";"~¡'e.I..d. Ca:.. · , 1 [k(:~;~yj~ -1 IV, .. .. · , · , . · · · · vkl6~ · . ~ . Av¿ · . ,. , . · . . ~ .. " I ·~ø"t,'1&r, CI CJ .ctj~. , · . . . · · 0 " [J · . . :.5 hèJP · ~~'; ~'qli:7~~ . . · '. . J · · .~.. . · . . DSÍ-: . . . . · . ~)}Å(' : . . . . 1~¡'b/~ £ .' . · , · . . .RJI. bt· ~v~Jtf' · · · · · · · . . . . . . · . · · · . · · · · . . . . . . . · · · . · . . · · '. '. · . · . . . Date map was drawn: '2 / (; /0..3. Instructions If YOU already have a diagram that shows all 'required infonuation. you may include it, rather than this Page, with your Monitoring System Certification. 011 your site plan, show the general layout of tanks and piping. Clearly identify loCations of the foHowing equipment. jf installed: monitoring system control panels; sensors inonitoring tank annular spaces, sumps, dispenser pal1S, spill containers. or other secondary containment areas; mechanical or electronic line teak detectors; and in-tank liquid level probes (if used for leak detection). In the space ptovidedt note the date this Site Plan ~~~ ' Page ~of_ O!ilflO ' ~µ/ <:.~ ,~Ø3-2ØØ3 4,4GPM FR.CALVALLEY EQUIP 16613252529 - P.2 ¡', .... . ,:x'r~H.fW~~rf,n,;! , :- I : :'::;:":,,:, :', .;.. ," . ,,'..,. , CITY OF BAKERSFIELD '. ..,':",:",' . OFFICE OF ENVIRONMENTAL SitRVICES ';:. ,',' "",: ..'. 1715 Chester Ave., Bakersñeld, CA (661) 326.397P.'·· ':, , . I', .. , ' : !.; , ", 1,1. . ,~ : '. )':. " .' ApPLICATION TO PERFORM FUEL MONITORING CERTIFICATION . . , ' FACILITY /{-n-l-1 ûuuttr sufJe¡l'/i..'f'-tHd~t tp'¡' Sc.t?Dbß ADDRESS 70S S. Uvu't1h :J4v~, ðAK"'~Yr·-ft·elAj ç¿.' OPERATORS NAME Sa.tz..: , OWNERS NAME Sa.m"C NAME OF MONITOR MANUFACTURER I'M C()t(j DOES FACll.JTY HA VB DISPENSER PANS? YES....f:::- i . , i : ' 'I , I . I ',.' ' .. ! i I . j " ,I NO_ TANK # I Z. VOLUME CONTENTS g'7 Vt.- /J1·~/.¿>1 " " , . . '. .. ". ~ . ~ ,,: ;:' , ',' , .. I ;: ,,' "~:..'.:" ( : ': . ., . :;..;:'>,:'>:, : .,'" ," " . , .;'",:(2:1(1 NAME OF 1ESTING COMPANY C~/-UI/t'1/- q.v/Pþ1evd- <, " ' " , :' .j '~(; j !:j¡ft~;I' Þ-r , .' "" I ,~.~:.' ~.~f~.'t'~f. ...~ ,).. C<;)NTRAcrORS UCENS~ # 7'd'1f/711 If /-1HZ, , ; , , :,' ':, :, L ::~,' ~ j'::~~';:~\;~ 'i~:::l~ ,NAME & PHONE NUMB~ o~ CoNTACT P~SON ßY~e I//HSI4jl' ~¥.'~ .1~,?~#*.;.. ,~[~tH~: ~: : ;; ~~-, ~ DATE&11MBTESTISTOBECONDUC'fED ''2~ '-:-PJ .:" :'1,:' .:<; ,,'<;,<:~I' ~Ji.,. ' : ;r:: : ' " j'i ';. :;',:' :':: ~I' .,~:' ,r ".~!(~, . ' .! .' '" 'I . ..: " . ~ t . ..' :...',.. ". , ", . , ' ~ ,,~. 4.' ~l ;J¡, .. " ~ ~ i ' '\ ¡ . '::' <. ':'.' : .¡:. '~r ~T.·t; . . 'I' ..! ',.\ .t. ~.~.;.: ;,' , 1(;!ti~ ''''':' 'Ï ~" .~ .. . ,:!.' .~ ~.~;.~ 4't ¿.- -../ 0 ~, ~. ' , , ; :-'. J 'II \' '1(": ,'··...1' _ . .,: . ." . ,¡, ~, ):.4 .' DATE '. StONA'tUJtS ÖÞ:'AÞÞUdAiJt:~:,:.~~~~~N~ ¡ ':¡, .,~~::. (:":":' :::;~::':'iL::: '~~JL, ¿ifF. , .. ", '.., 'I" I 'f .~ f ¡ : . . . ¡' ',':fìti~~'~¡1~tJ : " ;,.,.. '.' . ! '. . ~ . ..... , , .. '. :,' ' i' " :., ! . .' . ~J,d~ '. ~.: ¡.;':;'. .: \. .,.,,' . .': '. ~ ...: .. .. .,"; ~ .:.: APPROVED BY ¡; I . ., .. , " .. ", . .. ). "'. . ~ . i . .', ~'. ~ . .... . , (~v/ .- , x/' ~ e . 5596881467 p.2 Jan 14 03 08:50a Franzen Hill SWRCB, January 2002 Page L of -2- Secondary Containment Testing Report Form This.form is intended for use by contractors performing periodic testing ofUST secondary containment systems. Use the appropriate pages of this form to report resu/tsfor all components tested. The completedform, written test procedures. and printouts from tests (if applicable). should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACn..ITYINFORMATION Facility Name: Kern County Superintendent of Schools - Maint. I Date of Testing: o 1/03/03 Facility Address: 705 South Union Bakersfield WO 111171 8:30 am ~ 'ra'ciiíty Contact:' ....·:·Scott Bohannen I Phone: 661-852-5812 Date Local Agency Was Notified of Testing : 12/24/02 Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Franzen-Hill Corp 1100 North J Street Tulare, CA 93274 Technician Conducting Test: Felix Mendes Credentials: x CSLB Licensed Contractor o SWRCB Licensed Tank Tester License Type: A,B,C-611D40 HAZ I License Number: 304147 ,...... , .-. .... """ ...., '" ' , ., Manufadurer Trainine: Manu facturer Component{s) Date Training Expires Environ Pipin~ and Testin~ 10/03 Total Containment Piping and Testing 10/03 fneon Testing 09/04 Cadwell Testing 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Repairs Component Pass Fail Not Repa irs Tested Made Tested Made An VIlA' PI Ý 4J:./ '& 0 0 0 :J 0 0 0 f'i4 ':ll, ..' I ....~""'., ~ 0 ,; ¥" . 0 0 C :J 0 0 ~ of v()"1 ;; "ý'v #>1 0 0 0 C ::J 0 0" 0 ~-t tAJV1 dW: #-z.. '$. 0 0 0 0 0 :J 0 f.....n rJ / # 'al ] ] 0 [j 0 ] 0 5" !.1 Th '.0 .:Jt:2- It ] ] 0 C 0 ] 0 UPG' -Z- 0 ] ] 0 C 0 0 0 U p(.. 'J...l¡ 0 ] 0 0 C 0 0 ] VDl/ 5 -, 0 0 0 0 C 0 0 ::J VDc. 7-5 0 0 C 0 0 0 C 0 0 C C 0 0 IJ C 0 0 c:: c:: 0 0 ] 0 C Ifhydrostatic testing was perfoffi1ed, describe what was done with the water after completion oftests: W~Hv ~ P I/UhP-l J CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To tile best of my knowledge, thefac:ts .ftated in this document are accurate and in full compliance with legal requirements '1/1 .. ..,...,." ,.... þ. ...... T'··"-hn···· "S" ~--'~---~~~ Date.' {-J-c;/7. ec ICléIß S Ignature: r~':,.r- ./ --.--.----....- 4. TANK ANNULAR TESTING o Tank Mantlfacturer Industry Standard o Other (Specify) D Pressure ~Vacutlm o Other (Specify) , . e Jan 14 03 08:50a Franzen Hill SWRCB, January 2002 .-'trPest Méthod be~elóped ~y:......~.. .. Test Method Used: Test Equipment Used: e 5596881467 p.3 Page Ÿof1 o Professional Engineer D Hydrostatic Equipment Resolution: .,f! 11 H!! ~ ~~In:!! Tank # ¡ Tank# Tank # DYes . No eYes No DYes DNo ;] Yes DNo [s Tank Exempt From Testing?· Tank Capacity: Tank Material: Tank Manufacturer: Product Stored: Wait time between applying pressure/vacuum/water and startin test: Test Start Time: [nitial Reading (Rr): Test End Time: Jnal ij,eadins (Rr):. .,¡,.,... ò" N' .-. Test Duration: Change in Reading (RrR): PasslFait Threshold or Criteria: Test Result: Was sensor removed for testing? Was sensor properly replaced and verified functional after testin ? /ó Y'-11y" :00 -11f ¥ Pass D Fail Yes JNo DNA 'tf-Yes :J No 0 NA ,'n D Pass 0 Fail DYes ONo DNA DYes DNo DNA D PasS 0 Fail eyes DNo DNA eyes DNo DNA Pass 0 Fail Yes DNo DNA rves DNo DNA Comments - (include information on repairs made prior to testing, and recommendedfollow-upfor failed test.v) ~w·,··· .....:. .~ ... ... .~... , . I Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 2637(a)(6)} , , , Jan 14 03 08:51a SWRCB, January 2002 Test Method Developed By: Test Method Used: Piping Material: Piping Manufacturer: Piping Diameter: Length of Piping Run: loduçtSto~d: .. .. '\Ï(o,"". Method and location of i in -run isolation: Wait time between applying pressure/vacuum/water and startin test: Test Start Time: Initial Reading (R1): Test End Time: Final Reading (Rr): Test Duration: Change in Reading (RF-R,): Pass/Fail Threshold or Criteria: Test Result: e e 5596881467 p.4 Franzen Hill page~of1 5. SECONDARY PIPE TESTING J Piping Manufacturer 1)tlndustry Standard J Other (Specify) ~Pressure 0 Vacuum o Other (Specify) o Professional Engineer o Hydrostatic Equipment Resolution: Piping Run #I Piping Run # Ie) ,..... ¡'.... or: IS S cr:ttf s (,¡' "3 ....,,\.., o Pass 0 Fail '. Pass 0 Fåll o Pass 0 Fail o Pass IJ Fail Comments - (include in/ormation on repairs made prior to testinf{. and recommended/allow-up/or /ailed tests) ~~, ., .J' '''orJ-._':'~'' tit· -'. (t'4..- , , -, . .....- ,..------ ...-_.-.----_.. ~...... ;"'!..JIi....... '_OM ·\ Jan 14 03 08:51a SWRCB, January 2002 e Franzen Hill e 5596881467 6. PIPING SUMP TESTING .eäMeothodJ)eveJoped Iiy:" ;'.' ".- 0 Sump Manufacturer ¡(Industry Standard o Other (Specify) Test Method Used: D Pressure C Vacuum Sump Diameter; Sump Depth: Sump Material: Height úom Tank Top to Top of Hi hest Pi in Penetration: Height trom Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: Portion of Sump Testedl Does turbine shut down when sump sensor detects liquid (both roduct and water ? Turbine shutdown response time ~ ..~yst~rn p.n~~rarnwed f~fail-f¡,\fe... shutdown? Was fail-safe verified to be o erational?· Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading (R(): Test End Time: Final Reading (RF): Test Duration: Change in Reading (RF-R): Pass/Fail Threshold or Criteria: Test Result: Was sensor removed for testing? Was sensor properly replaced and verified functional after testin ? ~Yes DNo DNA 5' S'=t ~Yes DNo DNA '(J.Yes DNo DNA ¡ð ~.^ I 0 : CiV ~l Ú ~ '3l1 00\ () o1-1.h . v()').. Pass [J Fail Yes :JNo DNA ¥ Yes ONo DNA " II 25" c/~~ '" F", It !4Yes DNo DNA J fec. ~Yes DNa DNA ~Yes DNa DNA .00'], Pass 0 Fail ,Yes DNo DNA f{..Yes ONe CNA p.5 Page iL of 7 o Professional Engineer ')1 Hydrostatic Equipment Resolution: " Sump # DYes DNa DNA DYes DNo DNA DYes DNo DNA o Pass :J Fail DYes DNa CNA DYes DNa DNA 1\J1~ .::;~ .IB' f! Sump # e Yes DNa :JNA eyes DNa DNA eyes DNo DNA o Pass iJ Fail DYes DNo DNA :JYes DNa DNA fM_~ ~..... .""!:"" Comments - (include information on repairs made prior to testing, and recommendedfo/low-up for failed tests) , ..- I Jfthe entire depth of the sump is not tested, specify how much was tested. If the answer to m1X of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) -'~.."- - -.--.-..... --....-.... .\ e Jan 14 03 08:51a Franzen Hill .. ....,..-.. ~''C.. ~ ,."...... .' ~ .. .. ...,..... e 5596881467 p.6 SWRCB, January 2002 Page Í- of-2 7. Test Method Developed By: UNDERMDISPENSER CONTAINMENT UDC TESTING o UDC Manufacturer ~lßdustry Standard 0 Professional Engineer :J Other (SpecifY) :J Pressure 0 Vacuum Hydrostatic .J Other (SpecifY) Test Method Used: UDC Manufacturer: UDC Material: UDC De th: Height fTom UDC Bottom to Top of Hi hest Pi in Penetration: Height from UDC Bottom to Lowest Electrical Penetration: Condition ofUDC prior to testin <>: Portion of UDC Tested óeš rurbine'Shút" down wen UDC sensor detects liquid (both roduct and water)?' Turbine shutdown res onse time Is system progr~mmed for fail- safe shutdown? Was fail·safe verified to be o erational?' Wait time between applying pressure/vacuum/water and startin test Test Start Time: Initial Readin (R): Test End Time: Final Readin Rf): Test Duration: Chan e in Readin (RF-R¡): Pass/Fail Threshold or Criteria: Test Result: Was sensor removed for testing? Was sensor properly replaced and verified functional after testin ? 1þtóiìuiíents':"" (i~clude 1';¡~r';'~;i~~-(m repairs made prior to tes/ing, and recommended fallow-up for failed tests) Equipment Resolution: 7-§- II ~/I II ~ " if" } II eYes ONo ~NA DYes ONo 'f/NA DYes ONo ~NA DYes ONo }õNA eYes oNo ~NA ~NA DYes ONo ¥NA ¥NA CYes CNo NA CJYes oNo NA DYes CNo NA DYes DNo NA eYes 0 No DYes ONo o Pass 0 Fail DYes oNo A DYes 0 No r)'NA OPass D Fail DYes oNo A DYes DNo ~NA o Pass 0 Fail iJYes ONo ,0 Pass C Fail DYes oNo NA DYes oNo jt!NA [Yes oNo JlNA I If the entire depth of the UDC is not tested, specify how much was tested, If the answer to mrx: of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG~160) ..-.....-..- ..----- ;'\ " e e Jan 14 03 08:52a Franzen Hill 559688146? p.? SWRCB, January 2002 page~of1 8. FILL RISER CONTAINMENT SUMP TESTING Facility if> Not Equipped With Fill Riser Containment Sumps 0 Fill Riser Containment Sumps are Present, but were Not Tested 0 Test Method Developed By: o Sump Manufacturer o Industry Standard o Professional Engineer o Other (Specify) Test Method Used: o Pressure o Vacuum o Hydrostatic o Other (Specify) Test Equipment Used: Equipment Resolution: ·..:1 II "" . ,....., ... , , :.¡t'~"'J:' :!~ .... Fill Sump # Fill Sump # Fill Sump # Fill Sump # Sump Diameter: tM SumR Depth: .... ......... ;"f n< "-"C . < ' . Height from Tank Top to Top of Highest Piping Penetration: Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testin,g; Portion of Sump Tested Sump Material: Wait time between applying pressure/vacuum/water and starting test: Test Start Time: Initial Reading (Rr): Test End Time: Final Readjn~ (RF): . Test Duration: Change in Readin.!l; (RF-R): Pass/Fail Threshold or Criteria: Test Result: D Pass OFaU o Pass o Fail C Pass o Fail o Pass C Fail Is there a sensor in the sump? eVes DNo DYes ::JNo DYes DNa eVes ONo Does the sensor alann when either product or water is DVes ONo DNA DYes DNo DNA ::JYes DNo DNA DYes DNa DNA M ' detected? # . ..'.. ....,... , ; "':~ I' ., . Was sensor removed for testing? DYes DNa DNA :J Yes DNo :JNA :J Ves DNo DNA DYes DNa DNA Was sensor properly replaced and DYes ONo DNA JYes DNo 0NA :J Yes DNo DNA DYes oNo DNA verified functjonal after testin,g? Comments - (include information on repairs made prior to testing, and recommended/allow-up for failed tests) ~t4."~ " .~" ."'t."'". ..,,- .---.... ."--.. . l '- e - 5596881467 p.8 Jan 14 03 08:52a Franzen Hill SWRCB, January 2002 Page 1- Of-2 9. SPILUOVERFILL CONTAINMENT BOXES Facility is Not E ui ped With S ilUOverfilL Containment Boxes 0 Spill/Overfill Containment Boxes are Present, but were Not Tested 0 Test Method Developed By: :J Spill Bucket Manufacturer 0 Industry Standard , .", ...-.. ¡'r..'·· -:J Other (Specijÿ) o Pressure 0 Vacuum o Other (Specify) :J Professional Engineer ;:J Hydrostatic Equipment Resolution: ',":Z !:il~ Ì'I 'q'.,,:,:;~::1: .~'~:lUa~~;~! Spill Box # Spill Box #I Spill Box # Spill Box # Bucket Diameter: Bucket Depth: Wait time between applying pressure/vacuum/water and startin test: Test Start Time: lnitia! Reading (R¡): Test End Time: Final Readmg (Rp): Test Duration: Change in Reading (RF-R¡): Pass/Fail Threshold or Criteria: Test Result: r"""r.. o Pass ~'t!!---''''~''-'''-' o Fall o Pass o Fail .. 0 PaSs DFail o Pass o Fail Comments - (include in/ormation on repairs made prior to testing. and recommended/allow-up .lor /ailed tests) . "ta4c ,_. .'" " .. ". ..,.~...,,¡ '"I' '* .... - S;ga...... ar Camp.ay Rep,...ala"ve .~. -- Date: · e CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ~.(. 1Upl \r1h~v.d( J- ·lJ f- Sclo{)lS- INSPECTION DA TE-L(·~ t 3 - Ð':l. Section 2: Underground Storage Tanks Program o Routine []}éombined 0 Joint Agency Type of Tank l'iJJFc..S Type of Monitoring dLLÛ\ o Multi-Agency 0 Complaint Number of Tanks L. Type of Piping ð.vF ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile V Proper owner/operator data on tile V Permit fees current V Certification of Financial Responsibility v/ Monitoring record adequate and current V' Maintenance records adequate and current V Failure to correct prior UST violations V Has there been an unauthorized release? Yes No V Section 3: Aboveground Storage Tanks Program 1150 Y N COMMENTS SPCC available If yes, Does tank have overfill/overspill protection? L J () ~ 5" 11 (J.. ted' + " ~ SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? o vc..v- --C ,ll c~comPI;'n'J.J V~V;nl~t;on Y=Ye, In,pecto, . cd CtJJrl1{) Office of Environmental Services (805) 326-3979 White - Env. Svcs. N=NO 8ruÙtJ 1?n-ll.MA /' Business Site Responsible Party Pink - Business Copy f - . ~--òU4 ( PÁJ;;f/:-2bßô0 CITY OF BAIŒRSFlRT ,D OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA <(61) 326-3979 FACILITY ADDRESS PERMIT TO OPERATE 4# OPERATORS NAME OWNERS NAME NUMBER OF TANKS TO BE TESTED Z. TANK # VOLUME \ z.. APPLICATION TO PERFORM'A TANK TIGHTNESS TESTI SECONDARY CONTAINMENT TESTING ~~O~· ~~)~~hroIS ~ D \- b IS PIPING GOING TO BE TESTED CONTENTS TANK TESTING COMPANY~ Z-eJ/\- \-h \ \ r ðV pvv--a:Ji lW\ MAILING ADDRESSJ 'ntì t--\.:r srv~ð, IµJD.A1 \ fJt. t13:2'1Lf NAME&PHONE~ER.OFCONTAcrP~ ~(lUr lI~¡ ~ 45lJlf TESTMETHOD~C\~D.. ~fìO)"' j:Vl__~WtU NAME OF TESTER OR SPECIAL INSPECTOR~ VV\'VY ! Felt¥:. YV1wtles CERTIFICATION # ()2.. O~~1S / DZcff&~S2 . - DATE J TIME TEST IS TO BE CONDUCfED o-Z DD .rit (fl,Cuv (O-ß^OC APPROVED BY DATE FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield. CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield. CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chesler Ave, Bakersfield. CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield. CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 . - D August 30, 2002 Kern County Superintendent of Schools 1300 17th Street Bakersfield, CA 93301 REMINDER NOTICE RE: Necessary secondary containment testing requirements by December 31,2002 of I underground storage tank: (s) located at 705 S. Union Avenue, Bakersfield. Dear Tank Owner / Operator, If you are receiving this letter, you have not yet completed the necessary secondary containment testing required for all secondary containment components for your underground storage tank: (s). Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Of great concern is the current failure rate of these systems that have been tested to date. Currently the average failure rate is 84%. These have been due to the penetration boots leaking in the turbine sump area. For the last four months, this office has continued to send you monthly reminders of this necessary testing. This is a very specialized test and very few contractors are licensed to perfonn this test. Contractors conducting this test are scheduling approximately 6-7 weeks out. The purpose of this letter is to advise you that under code, failure to perfonn this test, by the necessary deadline, December 31, 2002, will result in the revocation of your pennit to operate. This office does not want to be forced to take such action, which is why we continue to send monthly reminders. Should you have any questions, please feel free to call me at (661) 326-3190. Sinc~ ~ Steve Underwood Fire Inspector/ Environmental Code Enforcement Officer Office of Environmental Services "" 7~ de CPonl//U~ ..¥OP ~0Pe y~ ,A; ??eduPp-" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395·1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326·3941 FAX (661) 395·1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326·3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 - - Kern County Superintendent of Schools 1300 17th Street Bakersfield, CA,9330 1 RE: Necessary Secondary Containment Testing Requirement by December 31, 2002 of Underground Storage Tank located at 705 So. Union Avenue REMINDER NOTICE Dear Tank Owner/ Operator: The purpose of this letter is to infonn you about the new provisions in California Law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bi1l989 became effective January 1, 2002. section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1, 2001 shall be tested upon installation, six months after installation, and every 36 months thereafter, Secondary containment systems installed prior to January 1, 2001 shall be tested by January 1, 2003 and every 36 months thereafter. REMEMBER!! Any component that is "double-wall" in your tank system must be tested. Secondary containment testing shall require a pennit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer, Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a pennit issued by this office. Should you have any questions, please feel free to contact me at (661) 326-3190. Si"7 ~ Steve Underwood Fire Inspector/ Environmental Code Enforcement Officer SBU/kr enclosures ~~y~ ~ ~~ ~ ~~ ybt, A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H' Street Bakersfield. CA 93301 VOICE (661) 326·3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H'Street Bakersfield. CA 93301 VOICE (661) 326·3941 FAX (661) 395·1349 PREVENTION SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield. CA 93301 VOICE (661) 326-3979 FAX(661)326~576 TRAINING DIVISION 5642 Victor Ave, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 e . May 1.2002 K C Superintendent of Schools 1300 17th Street Bakersfield CA 93301 RE: Necessary Secondary Containment Testing Required by December 31. 2002 at 705 South Union Ave REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1.2002. Section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter. to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1. 2001 shall be tested upon installation. six months after installation. and every 36 months thereafter. Secondary containment systems installed prior to January 1.2001 shall be tested by January 1.2003 and every 36 months thereafter. Secondary containment testing shall require a permit issued thru this office. and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience. I am enclosing a copy of the code for you to refer to. Once again. all testing must be done under a permit issued by this office. Should you have any questions. please feel free to contact me at 661-326-3190. Sincere~_ . ~..~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer SBU/dm enclosures ~~y~ de r?~ YOP vØ60Pe ffkz, A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave, Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 e e April 17, 2002 K C Superintendent of Schools 705 S Union Ave Bakersfield CA 93307 ll.x~ ~t t\ '?) 7)' RE: \~co (~'.<\ O~ .~~1-- Necessary Secondary Contain:¿ent Testing Required by December 31, 2002 REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1,2002, Section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed, Secondary containment systems installed on or after January 1,2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1,2001 shall be tested by January 1,2003 and every 36 months thereafter. Secondary containment testing shall require a permit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. s¡n:l~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer SBU/dm enclosures ~~:7~ de W~ ~OP ~0Pe ffbt, A W~" FIRE CHIEF RON FRAZE ADMINISTRATIVE SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395·1349 SUPPRESSION SERVICES 2101 "H" Street Bakersfield, CA 93301 VOICE (661) 326-3941 FAX (661) 395-1349 PREVENTION SERVICES 1715 Chester Ave. Bakersfield, CA 93301 VOICE (661) 326-3951 FAX (661) 326-0576 ENVIRONMENTAL SERVICES 1715 Chester Ave, Bakersfield, CA 93301 VOICE (661) 326-3979 FAX (661) 326-0576 TRAINING DIVISION 5642 Victor Ave. Bakersfield, CA 93308 VOICE (661) 399-4697 FAX (661) 399-5763 e II~ April 17, 2002 K C Superintendent of Schools 705 S Union Ave Bakersfield CA 93307 RE: Necessary Secondary Containment Testing Required by December 31, 2002 REMINDER NOTICE Dear Tank Owner/Operator: The purpose of this letter is to inform you about the new provisions in California law requiring periodic testing of the secondary containment of underground storage tank systems. Senate Bill 989 became effective January 1,2002. Section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and periodically thereafter, to ensure that the systems are capable of containing releases from the primary containment until they are detected and removed. Secondary containment systems installed on or after January 1,2001 shall be tested upon installation, six months after installation, and every 36 months thereafter. Secondary containment systems installed prior to January 1,2001 shall be tested by January 1,2003 and every 36 months thereafter. Secondary containment testing shall require a permit issued thru this office, and shall be performed by either a licensed tank tester or licensed tank installer. Please be advised that there are only a few contractors who specialize and have the proper certifications to perform this necessary testing. For your convenience, I am enclosing a copy of the code for you to refer to. Once again, all testing must be done under a permit issued by this office. Should you have any questions, please feel free to contact me at 661-326-3190. Sincerel~.. ' ~~ Steve Underwood Fire InspectorÆnvironmental Code Enforcement Officer SBUldm enclosures --7~~ W~ ~.A0Pe y~ A W~'I'I /\.cJ/ For U.W By All J'lI'ì.l'dicti()J'~· Within the Slate o/CalijÓntia X 7,t:: AmhoJ·ity Cited: Chapter 6.7, .. ,., lth. and Safety ~O~(~; ChoPtel'./6,. DiVi,ri(~' 3. 1.3, California COd~ of Rcgulatlon.v " Thi~ form n1!1~t hI:' lIsed to docuJ1)en estlng :md ~er...tcng (If monitoring eqlllpmclIL ~epHrale Cel'tlOc3uon or report must be prcpared for each monitoring system control panel by the technician who performs the work. ^ eopy of this form must be provided to the t311k sysrem owner/operator. The owner/operator lTIust submit a eopy of thi:;; form to the local ageney regulating UST systems within 30 days oftest. c!1-1It:, A. General Information Facility Name: j(E(,J-' (ðUJ1ty SuR.e('lJT~;"Le,"Jr bl Site Address: 7ðS $. L!.hiOY¡ Ave ~._ s..cJWJ/.s Bldg. No.: _. Cìty: &,é-rrrf,,¿Ja' .. Zip: "',__ Contact Phone No.: (__) Date of Testing/Servicing: 11-/.2fi!~ FacililY Contact Person: _.. Make/Model of Monitoring Systel11::¡::hCðl4 '..--...... B. Inventory of Equipment Tested/Certified ('hr,1l the Apprö"r;'.te I,Q;US to Indic:nte """"ifk cquílnncnl Înspcctcd/~c. y¡'o;"; " T:'Ink ID: J ~7 Tnnk ID: . 5;f In-Tank (;augiI1g Probe, Model: ISI!-::'~ ......- o fr.-Tank Gaugirlg Prohe, Modèl: " Annubr ~p:let! or V:mtt Sonr.ot, Modcl~ jjfi: 1..- a Annular Space or Vault ~enSl!r. Model; !if !'iring SlJrnr I Trench Sensor(s), Model: _. ..... o Piping Slimp 1 Trench Scnsor(s). Model: o Fill S\lmp Sen~or(s), Mode!: -----,---. o Pill Sump Stmsor(~). Mo(kl; o Mcehnnic!11 Line Lenk Detector, Model: ·'u_. o M,'r.hlmic:l1 Line tcnk Dctoc!()r. 1'.10"<::1; - Q Electronic Line Leak Detector. Model: o Eleetronìe Line I.enk Detector. Model; -., Q Tank Overfill/High.Level Sensor. Mod.;:/: ., _. o Tank Overfill/ High-Level Sensor. Model: o Other (specìfy equipment type and modc:1 in Seelion E on Page 2), o Other (specifv eQuj)l1ent type and model in Section E on Pae~ '), Tank JD: '7 Ot:,¡ , Tßnk fD: ~ In-Tank Gauging Probe. Motfd: TSP-/""l.Z o In· Tank Gauging Probe, Model: }lJ Annular Spaè~ or Vaul! Sei1~or, Modo;!; ..U L f o ^nrmlnr Space (II' Vault Sensor. Model: ~ Piping Sum!,1 Trench Sensu'(:f). M~d(:l; ..LJt-S - U Piping SUInP I Trench Sensor(s), Model: o Fm Sump S<:nsor(s), Model: .. .. o Pill Sump Sensor(s). Model: Q Mechalical Lìne Leak Detector, Model: --... - o Mechanical Line Leak Detector. Model: - ,. o Electtunic Line J.enk Ikkr.IM. Model: --'._-'/._-- o Elccl'(Jlli~ Lillc I.enk Detector. Model: . a Tank Oyerlill I I Iigh.Level Sensor. MQdc:l; .. .- Q Tunk Ovel'JiIl/ Hígh.l.evel Sensor. Model: Q Other (specify equipltlcnllypc and rnodelïn Section E on Page 2), Q Other (specify equipment type nnd model in Section E on Page 2). Dí~'Ien~l'!r In! -1:::2 . I)spenser U); 7-g- o Dispenser Containment Sensor(s), Model: --... o Dispenser Containnu:nl Sensnr(s), Model: IIi2 Shear Valye(s). þiJ Shear Vnlve(s). o Dispenser Conlainment Float(s) and Clmin(s). " Q Di~penscr Containmcnt Plant(:!) and CJlI1íll(~). Dispenser ID: '1-4 Dispenser ID: .,- o Dispenser Cnntninment Sensor(s), Mr.,dc:l: _..'----,- CI Dispenser Containment Sensor(s). Model: 2 SheIlI' Vnlvc(s). o Shear Vlvc(~) o Uispcnscr Cont(!inmcm 1'10111(5) and Clmin(s). o Dispet¡ser ContajlJment 1'10(11(5) and Chain(s). Dispenser ID: !:'- t. ._'. Dispenser ID: _. o lJispènser Containment Sen50r(s), Model: -. ..- o lJisl'lenscr COI1tllinmenl .sen,qor(~) Modal~ Þt SheilI' V!1lve(~). a Shear Valve(s), ODispenser Contailllncnt 1<loat(s) and Chain(s). o Oispenscr Containment P/olIl(5) and Chain(s). . . ·'fthe: facility containsltlorc tanks or dispensers. copy this form. Include information for ever)' tnnk and dispenser at Ihe facilHy. C. Certification - I çertify th1t the equipment identified in thi!; docurncnt Wpg Îllspcctedfservicc(l in aCl;ordanee wHit tile IIInnurllcturet~' guidelines. Attached to this Certification í~ inforlllßtion (e.g. mnnufal':fllrers' c:hecklisb) neces~:!..y to vc"¡fy thßt this infonnntion is correct nlld II Plot Plan showing the Ißyout of monitorhle efJllirm..nr. I~.,,' ..ny equípnlcf çnpn\;lc tlf J,:encratlng 5\)dl reports, I h:¡ve ßlsfI :lttpched :'I copy of the rcwrt; (r:h<!clc all 'lrat tJpply): 0 System set-up LJ Alarnl history rcport Technician Name (print): ~rtL~ ¡J Hi~ '_'_ Signature: '~~~~.___n_ Ccrtifiention No.: .._ _, _ _.._, ,_ License. No.: -'--'-~--"- Testing Company Name: .c.~I/~"J" ~iejJ::Lf:j"IL-,,_. _ Phone No.=( G~~}322-9.fYI,_. Sila Addrcr.r.: ~b- S. ~~. /..~K~'~k;.~ ,_, _ bate of Testing/Servicing: // / 21 /~L Monitoring System Certification Pn~(' I of 3 OJIOI 2"d SI29-22E-199-1 ..Ia~eue., le..laua£l dSS:20 10 ""0 oaQ L'. .,"'~uu~ VI J. \:'l'lIlIl:;/¡;)t:rvn;lng -:" .. tftware Version Installed: ..---'_.. e Complete the following checldist: 1M Yes a No" Is the audible alarm operational'? G Yes a No· Is thë visuål alarm operational? ~ Yes a No· Were all sensors visually inspected, functionally tested. and confirmed operatiol'\al? "9ì' Yes a No" Were ;)11 sensors installed tit lowest f'oínt of ~r.r.nnd;U'y containment and positioned :;0 that other cquipl1lelll will not interfere with their proper operation? (J Yes 0 No'" If alarms are rcfayed to a rcmote monitoring station, is all communications equipment (e.g. modem) a- N/A operational? IS Yes a No'" For pressurizcd pipil'\g systems, does the turbine automatically shut down if the piping secondary containment o N/A monitoring system detects iI leak, làils to opcrate, or is elcctrically disconnected? I f yes: which sensors initiate positive shllt-rfcmrn? (CJwdc r;¡JllhCl( applJ~ IðSump/Trcnch Sensors; 0 Di:spc:nscr Containment SensorN. Did you conlìrm positive shut·down due to leaks and sensor failure/dìsc:onnectìon? -ið'Yes; 0 No. 1:1 Yes 0 No· For lank systems that utílíze (he monitoring system as the primary tank overfill warning device (i.e. no 0 N/A mp.ch;¡ì1icnl overfill prevcntÎ()I1 v<1lve ill in3tnllcd), Î5 the ovcrfill wimling alarm visible and audible at the tank IiII point(s) and operating property? Ifso, at what percent of tank capacity doc$ the alann trigger? % 0 Yes'" ~ No Was any monitoring equipmcnt repJilced? If yes, identify specilÏc sensors, probes, or other equipment replaced ~nd list th~ manufacturer n:II111) ::IIId model for aU rc:pl~cemc:nt part:; in Section E, below. 0 Yes" e.r-. No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) a Product; a Water. If yes, describe causes in SectÎon E, below. 61 Yp.~ a No· W;¡s monitoril'lg system :Jet-up reviewed to Cllioult:: propc:r settings'! Attach set up reports, jf applicable 13- Yes Q No" Is all monitoring equipment operational per manufacturer's specíficatÎ()f\s7 * In Section E below, describe how and when these dcfic:lencie~ were or will be corrected. E. Comments: .--" --,.-... ..-...-.. --.--..----.. -...-" "-.' "-"-"-'-"-'--. ....-.-..-.-.------. -".-"-...,_._._ '-.._',_0 "-".-'-,-.,--- -- '-'.-.--.- - .--.. -"-- .-..--.-"--.. -".-' ._"__. ._0.._ ._" __'".__ ---.-.------ '--- ,"_._ u__~ '--"'-'-"'-'-'-'--'-- Page 2 of3 OJ/OJ E-d SI29-22E-I99-I .Ja'eue\.l Ie.Jaua9 dSS:20 IO va :::Iaa _ ___u. ----b'.."" ~au '~'1-'I".'''''.· VI ,-.11"'-1\ 1111:> COX II mnK gaugIng IS usca only tor inventory control. .. 0 Check this box. ifnWk gauging or SIR equipment is installed. This section must be comPlete!¡n-tank gauging equipment is used lo perform leak detcctìon moniloring. Complete the following checklist: DYes a No· Ha$ all input wiring been inspected for propel' entry and termination, including testing for ground raull~? a Yes a No'" Were all lank gauging probes vis\lêllly inspected for damage and residue buildup'¡ o Ycr. CJ No· Was accuracy ofsystcm producT !c:vc!l",.:ItJi"gs tested? DYes 0 No· Was accuracy of system water level readings tested? DYes tJ No'" Were all probes reinstalled properly? -ïJ Yes CJ No· Were all itel11S on the equipment manufacturer's maintcnance checklist completed? 1/ In the Section H, below, describe how and when these deficiencies were or will be corl"etted. G. Line Lcak Detectors (LLD): f>'l Check this box if LLDs are 110t installed. Complete the rollowine chc:c:klbt: a Yes o No'" ror equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? o N/A (Check all that apply) SÎmulêlted leak rate: q J g.p.h.; a 0.1 g.p.h; Q 0.2 g.p.h, DYes 0 No· Were nil LLDs confirmed operational and accurate within regulatory requirements? DYes 0 No· Was the testing apparatus properly calibrated? Q Yes CJ --. For mechanical LLDs. does the LLD restrict product flow ifit detects a leak? No· o N/A Q Yes I:.J No· For electronic LLDs, does the turbine aulomatìclllly ~hllt off if the I.tD deted/: ::t leak? o N/A 0 Yes 0 No" Fol' electronic LLDs, does the tllrhine êlutomatÎca1ly shut off if any portion of the monitoring system is disabled o N/A or disconnected? DYes o No· ror electronic LlPs, docs the turbine automatically shut off if any portion of the monitoring system o N/A malfunctions or fails a test? o Yc:¡ 1:J rQr c:lc:ctrùoi<: LLD~, have all accessible wiring connections been visually inspected? ,. No· D N/A DYes o No· Were all items on the equipment l11êl11l1facturer's maintenance checklist completed? .. III the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: -' H_.... --, .'-'. ._0' '-".'----".-' ,__,__ .._HH'__"._ -- -- -~._'---"'-'- -'----',- ._0.- ,.._ ___ ._...._.._ _._._._.... -"-. ',.-".-- ..-....-..--.-.--..--. Page 3 of 3 03101 iI'"d SI29-22E-I99-I ..Ia'euelol le..laua~ dSS:20 10 il'0 oaa "Site Address: UST Monitoring Site PIau. 7ðS S. utI/LJLt, ßarfCí-l/"J~ ("4 . '''.1'1: :,1" L}Il.JJl' . vv, Vi tH.e yClI . , . . tA1i~Lr . AII",- ":'~----"-'-......:.........:........:. ~o: :2 r:1.1: T~(J:4',¡< :80i :'Os: ~ . . . 5 hop- A ~!iM: . . , . . . . . þ~ :o.7J1 OJ~,: , .' Date map W3!: drawn: jjj 21/ PL. Instructions If YOll alre<tdy have a diagram that, shows allrcquired information, you may include it, rather than this page, with your Monitoring System Ccrtitìcatíon. On your site 1'1;111, show the general layout of t~nks and pipins. Clenrly identify locations of the following equiplTJent, if installed: monitoring systern control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if IISP.ri fot leak detection). In the space provided, lJuLe the date this Site rlan was prepared. P¡I~C _of_ O!lí/OO S·d S129-22E-199-1 ..Ja~l?ul?. II?..Jaua£¡ dSS:20 10 ..0 oaa .:v: .' For U.vc By All ,h,r¡.vdiclion,r With;,1lhe State (?{Ca!{{m'nia . ,A It,,/(},.i~y Cited: Chap fer 6.7,.'117. and SaJèty Code; CI:aptcr. 16,. [Jivisiun 3, _ 23, California ~od~ of Re~ulations ThloS form must be: lISCÚ tll LI~II,;Ull1cl1l lestmg and servicing. 01 monitoring equIpment. A separate cerl1hcatlon or report must be: prepared for cach monitoring systcm control panel by the technician who performs the work, A coþy of this form must be provided to the tank system owner/operator. The owner/operator Illust submit a copy or this form ro the local agency regulating UST systems within 30 days of tC:st date. A. General Information Facílity Name: t'tyllt CAl/J1't1J..- ~ehe~~1 5ly//¡'a.{ Site Address: 1'I1s- 7r.Jc.X7VJ/t Ave..._ Facility Contact PèrS()n: ll./c,hP¥¿:{ OJ;.P.!!,H Make/Model of MonitQring System: V<M~r-4&1l' ìL.!-1~ B. Inventory of Equipment Tested/Certified OCtll Ine npproþriatt bOles to InlJlute Sptcific tl]ulprnellt in!1cctcd/scrvlwJ: Rlclg. No.: Cjly:~tY'f'¡;'d61' ~ Zip: 1.2LD/ , Contact Phone No.: (_. ) Date of Testing/Servicing: .1LJ2:ZIL Tnnk ID: I T:ml, ID: -_. ~ In-Tank Gouging Probe. M-;;del: æ:lA { ,- o In·lank GAuging Prohe. Model; QØ' ^nnular 5puce or Valllt Sensor, Model: ~r__. o Annular Space or Vault Sensor. Mod.:l; - (j, J>í ping Sutn¡'Þ / Trench Sensor(!:). Model: .s(J~ Stl1.sør __ Q !'iping Sumr I Trench Scm:or(s). Model: Q Fill Sump ~cnsM(s), Mndel; . , .... - o rill Sump ~ensol~:». Model: o Meeh:mical Lin~ L=nk Dctcclor. M(\dc:l; _. ,...,- Q M.:"lmui¡;al Line Leak ))eteclor. Model: o EI~ètroníc Line Leak Detc::elor. Model: -- " o meClronic Line Leak Detector. Model: [J lank Ov~rfïlll High·Level S~n$or, Model: _.---- o Tal\k Ovèrfìlll High.Level Sensor. Model: a Other (specify cquipmcnltYDe nnd model in Seetiòn E on l'al1.c 2). o Other (s('l~cif)' ~'1l1ipll1ent type ::l.I1d ,nodd in Soction E on ()l1gc 2). Tank ID: .--- Trink (0; ~ Q In-Tank Guuging Probe, Model: -.. ',-- o lit-Tank Gauging Probe, Model: o Annular Space or Vault Sensor, Model; o Annular Space or Vault SeMor. Mnd~.': -. U l'iritlg Sump /Trench Sensor(s). M\ldcl; -,. o Piping Sum!" I Trench Scnsor(s). Model; o Fill Sump Scnsor(s), Model: o Fill Slimp Sensor(~). Model: o Mechanical r .ine Lcnk Detector. Model: -" .,~- o Mechanical Line I...eak Dcteclor: Model: --. .. o Elcctronk I,illt: L¡;¡Ik. DClc;:clor, Model: -..... --,-- U Electronic Une Leak Detector. Model: o Tank Ovcrfill/lligh-l...eveJ Sensor. MQdcl: o T3nk Overlïll/lligh-I...evd Sensor. ModeJ: o Other (specify equipment type and modelln Section E on Page 2). o Ûtht:r (specifj' equÎþment type nnd model in Section E on Page 2). DI'p~nsrr rD: .. 1-2- Dispen~er ID: - Q Dispenser Containment Sensor(s). Model; ',h. a Dispenser Containment 8ensOr(5), Model: ~ Shenr V!llve(s). ., o Shenr Valve(s), o r)i~pen$cr COI1I~ihmcnt Flo.:ll(~) nnd Chain(3). Q Dispenser Containment "oat(s) and Chnin(s). D1srl::rlser 11>; 3-~ ., Dispenser ID: o Disl"enser ConlaÎnm~nt Sensor(!:). Model: .- o Dispenser CO'Itainment SCn!1or(s). Model: V Shear Valye(8). Q Sh~¡1r Valve(!i), o Dispenser Cotltninmem Float(s) and Chaill(S). o Dispènser COlltainment Froat(s) nnd Chain(s). Displ::nser ID: . "'--'.- lJispen~l:r ID: o Di~p':l'1ser Containment Sensot(s), Model: _. ',,- o Di!:l'~"s"r Contflihmcnt Scns(lr(~), Modo;;, o She.ar Vnlvc(s). o Shenr Vnlve(s). ODispensc:r Contairunc:nt From(s) Imd Chain(s). o Dispenser Cont.ainmcnt I'lont(s) and Chnin(s). . . Testing Company Name: CLJj-VA../!-7 SIte Address: J....'t.JS Tr...w.;rtuV/ #//C. ·Irthe facIlity contains more tanks or dispensers, copy this form, Include inrorl1latÎolJ for cvr.ry tnnk I1l1d (Ij~r.":-nser:at the f:!cilit)., C. Certification - I certify tll/lt the equipment identified in this document was inspected/serviced in aceordllnte with the manufacturers' guidelinc!. Attached to this Certification iJ information (e.g. nl:!lJlI(actlln;rs' checklists) necessary to verify tbRt this information is corred nnd a Pint Pion ..hnwinl( thl! "YOllt or monitoring "(lIipnu'lIl. For Imy equlpml::ln capable of gener;Uing such reports, r h:'lVe nlso RUg;; a copy of the r~port: (dIce" nil that llppfy): a System s~t.up [J Alarm history report Technician Name (print): ,. C,(,..Ct JIt.'nS/o/ _ _._ Signature: :~._~__ Certification No.: .__.. I.icense. No.: 2:l1l7D A 1iA2......___ Phone No.:C 6'6/ ~) '3?-7-- ~ 1'1 _ Dale of Tescing/Servicing: .1..1../?:.2I.PL .- ._- ß.êA.Kl'¥If'~.~. #)3./0/ Monitoring System Ccrtificatiorr l'l\gç 1 uf 3 03101 S'd SI2S-22E-lSS-l ...Ia~eue. le...laua~ dSS:20 10 ""0 oaa · CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME t..t .Sùp'\-. ~+ 5c.~(S INSPECTION DATE ({/;;,/O( Section 2: Underground Storage Tanks Program o Routine 0 Combined 0 Joint Agency Type of Tank .aU) F(' ~ Type of Monitoring éLII'\. o Multi-Agency 0 Complaint Number of Tanks .;2. Type of Piping ,(JW P ORe-inspection OPERA TrON C V COMMENTS Proper tank data on tile V'" Proper owner/operator data on file V ", Pennit fees current V ,,; Certification of Financial Responsibility V'" Monitoring record adequate and current \/ Maintenance records adequate and current V " Failure to correct prior UST violations V ~ Has there been an unauthorized release? Yes No V Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA TrON Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling [s tank used to dispense MVF? [fyes, Does tank have overfill/overspill protection? C=Compliance V=Violatíon Y=Yes In,p"to, ,J¡, rid"HO Office of Environmental Services (80S) 326-3979 White - Env. Sves. N=NO Pink - Business Copy ·. . CAL VALLEY EQUIPMENT I·" o GILMORE AVENUE B KERSFIElÞ, CA 93308 661-327-9341 FAX # 661-325-2529 CONT. llC. #784170 DATE: 12/1/00 TANK MONITOR INSPECTION -', KERN SUPERINTENDENT OF SC '7tJ5"' SOUT~ UNION AVE BAKERSFIELD, CA 93307 MAKE: INCON MODEL: TS·100012-P CONDITION OF UNIT: UNIT IS IN GOOD WORKING ORDER TANK PROBES: QTY. 2 TYPE MAGI UNE SENSORS: QTY. TYPE 1 SUMP SENSORS: OTY. 2 TYPE LIQUID ANNULAR SENSORS: QTY. 2 TYPE liQUID \ OTHER SENSORS: QTY TYPE PROGRAMMING ACCURACY & COMPLIANCE: (1. READS ACCURATE TO TANK CHART? YES X NO (2) POSITIVE SHUTDOWN? YES X NO 2'd SI29-22E-199-1 d60:10 00 62 oaa ~... ':¡ e e COMMENTS: (3) TANK PROGRAMMING MEET COMPLIANCE? yes x NO PROGRAM INFORMATION: NO T ANI< TESTING PROGRAMMED/SITE MONITORS THE ANNULAR SPACE WITH POSITIVE SHUTDOWN/REMOTE AUDIBLE ALARM IS IN GOOD WORKING_ORDER TANK DATA: MANUFACTURER OF TANKS? MODERN WELDING PRODUCT DIESEL SIZE 12,004- SIZE 12.000 SIZE $IZ£ PRODUCT REGULAR PRODUCT PRODUCT COMMENTS: fNSPECTED BY: /Z~~/~ ., r DATE: 1211100 RAYMnNO BACHAR E'cI S,(29-22E-,(99-,( cl60:,(0 00 62 oaa e CAL VALLEY EQUIPMENT e 3600 GILMORE AVENUE BAKERSFIELD CA 93308 661..327-9341 FAX # 661..325-2529 CONT. LlC. '784170 ~ TANK MONITOR INSPECTION DATE: 12120/00 SITE: MESA MARIN PITSTOP/CHEVRON 11101 HWV 178 BAKERSFIELD. CA 93306 MAKE: GILBARCO SOFTWARE VER. 14.00 346014-100-A MODEL: EMC SN: 6.08397E+13 CONDITION OF UNIT: ALL FUNCTIONS NORMAL TANK PROBES: QTY. 4 TYPE MAGI LINE SENSORS: QTY. II TYPE PPLD SUMP SENSORS: QTY, TYPE ANNULAR SENSORS: QTY. TYPE OTHER SENSORS: QTY TYPE PROGRAMMING ACCURACY & COMPLIANCE: (1) READS ACCURATE TO TANK CHART? YES X NO (2) POSITIVE SHUTDOWN? YES X NO .,-d SI29-22E-199-1 d60:10 00 62 oaa ,- . ~ e e COMMENTS: tESTED POSITIVE SHUTDOWN ON EACH PRODUCT/ALL PRODUCTS SHUT DOWN WHEN TESTED (3) TANK PROGRAMMING MEET COMPLIANCE? yes x NO PROGRAM INFORMATION: TANKS ARE PROGRAMMED FOR WEEKLY .02 TESTING TANK DATA: MANUFACTURER OF TANKS? MODERN STEEL WITH FIBERGLASS LINING PRODUCT R.EGULAR PRODUCT DIESEL PRODUCT SUPER UNLEADED PRODUCT UNLEADED PLUS sIZe 10,000 SIZE 10,000 SIZE 10,000 SIZE 1 0,000 COMMENTS: INSPECTED BY: /~~.&;"~- RAYMOND BACHAR 12/20/00 DATE: S·d SI29-22E-I99-I d60:IO 00 62 oaa r ""- ... e . KERN COUNTY SUPERINTENDENT OF SCHOOLS LARRY E. REIDER, Superintendent January 12,2001 RECEIVED JAN 2 J 2001 ENV1Rf)~, ~t: " RVlCES City of Bakersfield Office of Environmental Services 1715 Chester Avenue, Third Floor Bakersfield, CA 93301 To Whom It May Concern: I am the chief [mancial officer for the Kern County Superintendent of Schools, Bakersfield, California. This letter is in support of the use of the Underground Storage Tank Cleanup Fund to demonstrate [mancial responsibility for taking corrective action and/or compensating third parties for bodiJy injury and property damage caused by an unauthorized release of petroleum in the amount of at least $1,000,000 per occurrence and $1,000,000 annual aggregate coverage. Underground storage tanks at the following facilities are assured by this letter: Kern County Superintendent of Schools, Schools Service Center, 705 South Union A venue, Bakersfield, CaJifornia 93304. 1. Amount of annual aggregate coverage being assured by this letter ..............................$10,000 2. Total tangible assets.............. ........ ........................................ ............................ $115,613 ,293 3. Total liabilities (if any ofthe amount on line 2 is included in total liabilities, you may deduct that amount from this line and add that amount to line (4) ............................... .................................................. $112,703,369 4. Tangible net worth (subtract line 3 from line 2. Line 4 must be at least 10 times line (1) .................................................................................. $2,909,924 I hereby certify that the wording of this letter is identical to the wording specified in Subsection 2808. 1 (d)(1), Chapter 18, Division 3, Title 23 of the California Code of Regulations. I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. Executed at Bakersfield, County ofKem on January 12,2001. Sincerely, Larry E. Reider County Superintendent of Schools C.TB~ Bud Burrow, Chief Business Official .~ Division of Administration and Finance BB:ge c c c (;J@~@ß(;J~Gm íÍ'@[i' ~h8Ødfel1il Printed on recycled paper. ) 300 ) 7th Street - CITY CENTRE, Bakersfield, CA 93301-4533 (66) ) 636-4000 III FAX (66) ) 636-4130 III TOO (66) ) 636-4800 III http://WWW,kern.org lParrineli' . Kell'!/i) CiDl1II!i'IIiy Netwcli'k for Children .. scallloCC¡ü(gruia ,;-.:í. _,;.. Stall W... a.øarca CoA~ Board }...:.' . e / (1......... .. ,..,....., I CERTIFICATION OF FINANCIAL RESPONSIBILITY I FOR UNDERGROUND STORAGE TANKS CONTAINING PETROlEUM A. I..,........ Ie ..., _I 4& A . .... r .I? ~''J fa.... ......................... ia Seeåoa 210'7. QapIw 1.. CW..1. 11de 23. cca: 0--....,., . ;4'" @ 1 .w. cIoIIIIn_........... 01' Al'fD tW I xx 11 .iIJoe doØan per ~_ D 1aaillioa doUan __agreplD .' . . . . . . . ~.. ,.' " ···..·i~b~;~tii_î.. 3, Ke rn County Su pe r in t enden t 0 f Schoo Is hereby cef1i/ia that it is in complltJnce with the fflqtJ/remtInts of &It:tion 2807. ~o(n.to....~ ArticleS, Chapter 16, Division 3, Title 23, CaIHomia Cede of Regulations. The IT1tIChlJnisms ,..¡ to demonstlatrl tlnlJncial respoMibi/,' as required b Section 2807 are as follows: :;.. :M~~:;:,,:;:·: . '~~=%1~~~i\~ ~:I~~1¡:¡)î.~=~}:=;;i:¡;\:::~t:; ;t3}~1~J.t :::!:!::gÞ1=~i:b ~¡:~~ :Jl-'gg:~~ State State Cleanup Fund Not applicable $990,000 State Fund P.O, Box 944212 for State Fund per Fund Sacramento, CA 94244-2120 Occurence Coverage $990,000 Continuou Annual Aggregate $10,000 per Occurence $10,000 . Annual Aggregate yes yes Chief Financia Officer Letter Kern Co. Supt. of Schools 1300 17th Street Bakersfield, CA 93301 Not applicable for State Alternative Mechanism Renewed Annually yes yes I I Vote: If you SI8 tJ$ing thII Ststø Fund as any psrt of your demonstration of finIIncitJl responsibility, your ø.1tØCfJIion MId SlIbmiaion of this certification slso certifitts that you are in compllsnce with all conditions for psrtic/pstJon In thtI Fund. F~~H.u Kern County Superintendent of Schools 'MŒ~~ 1300 17th Street Bakersfield, CA 93301-4533 I Faa1I~H.u 'MŒ~~ F"'¡¡¡fJ~ f'ea1IfJ Addr-. ¡ I ¡ !'ea1IfJH- f'ea1I,,~ ,,~ '1IIiII,,~ ;~ (. " ".. ...11de oITMk QaIMr., ap.r.- Bud Burrow, Chief Business Official .... 01 WI...« How' Monique Tomasello 0IpIeI- ''''''''11(') e . '. ..~ .",<~.., -'\:'>.... , .......¡ - "' .... ¡. '-.. I1ISftUC'.r%OHS aIB%n~OIf or rIDIICIAL USI'OIISUI%.Ift ra_ Pl.... c.,.pe or pr'M cl....ly aU .",...cfon on C.rtfflcat'on of "IWIC'al ......'bfUcy f...... ' AU UIT fecH fc'" ...u.. afc_ ..... or operaUd _y be lilted on one to,..: ch.rafor. a ...reee certlffcate I. not requfred for .ech .fce. .- , DOCI.IEJfT l.fORMA nOlI A. ... a.,.t.... . CIIect the approprllt. box.... 8. .... of Tint OWner - Full ~ of either the tank owner or the operator. or ap.ntor C. ........ 1')pe - Indicate whld! Stlt. approved -.c:hanilll(.) ara being u.ed to allow flnanc'al responelbfllty .Ith.r a. contllned in the federal regulations, 40 CFR, Part 280, SUbpart H, Sectiona 280.90 through 280.103 (See FInancial Rponalbllfcy Guide, for more info,...tion), or Seccion 2802.1, Chapter 18, Division 3, TItle 23, CCR. .... of I..... - List .ll ~ and addresses of c~i.. artdJor fndivlduals issuing cover.,.. MecMnf. ........ LIst ldentlfY'~ ruaber for each llledtanlSID u.ed. EXlllpl.: inaur.x:e poLIcy IUllber or fHe IUlbtr a. Indicated on bond or doc:uDent. (If using St.te Cleanup FIoM (Stat. FIoM) leave blank.) Co¥It... --.m: - I ndl c.t. ......t of coverage for each type of IDeChani III( s). If mre than one MdIani.. is indicated, total IIIJSt equal 100% of financial. responalbfl Icy for eKlt facH Ity. c.ov..... Period - Indicate the effective date(s) of all financial lllechaniSIDCS). (St.te FLnd coverage would be contirAlOUS as long as you lIIIIintain coqJl lance and r....in ell,lble to conti,.. participation in the fLnCl.) Cornet'''' Action - Indicate yea or no. Does the specified financial lI8dIan... provide cow..... for corrective action? (If using State FLnd, Indicate "YesM.) , TIll rd Party - ~_t'on D. FecfL Ity - lmor-t'an E. Sl~ure Iloct - Indicate yes or no. Does the specified financial llleChanl.. provide cover.,. for third party coœpensation? (It using State FLnCI, indicate MyesM.) provide all facHlty and/or site NlllleS and addresses. Provide signature and date signed by tank owner or operator; printed or typed MIle and title of tank owner or operator¡ signature of witnesa or notary and date s I gned¡ and printed or typed name of witness or notary (if notary a f gns .. wf tness, pl.... plac. notary seal next to notary's lignature). ....... to ...1 l certlffèltlön: . . Pl.... aand original to your local qency (Igency who fllws your usr pe,..ft.). Keep. cop)" of the certification at each facilfty or aft. Li.ted on the fOnD. ouestlana; If you have queatf~ on flnanci.l responsibility requirements or on the Certification of financial ResponaibU fty fona, please contact the State UST Cleanup FI.nd at (916) 739-2475. Note: ,-ltf_ for Failure to cc.ly with Finencf.l Itesoonalbll ftv Iteœlf~.; ,.llur. to comply..y result in: (1) Jeopardizing claimant .ligibility for the St.t. UST CI.8nUp Fund, and (2) lIabllfty for civil penalti.. of up to 510,000 dollars pel' day, per \ntargrØU1d stora,. tant, for ..ch day of violltion IS Itlted fn Artlcl. 7, section 25299.76(1) of the Californf. H.alth and Safety Code. . .--..... ~~ /.¡!('/~t . . 1. ".. A.r. --- --. -' -- .-' CITY OF BAKERSFIELQ.. OF~E~OF ENVIRONMENTAL .RVICES 171S Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNOeRGROUNO STORAGe TANKS· TANK PAGE 1 'I ~ 01 r.-Ø!! <J~ _crOON 0 I. "4W SIT! PeIWlT 0 4, AMVC)t!O PeRMIT 'Ø " 0W«Je 0" I/'!FORMA noNI ,C,'". .,,,, '*" 0III't) o ). "'I!NeW~ Pl!l'lMlT U p d ate (~,..... . IItN IOcM u,. OIII'tJ (~ ~ . IItN IOCM .... O#t/'fJ alJ51NE3:1 ~ ¡s-... ""CI\.ITV NAMII at 08A. aa..e ~ AI' o 5 TeMPORARY SITt! ClOStJ~ o , PER~HT\. y ClO~O ON SIT!! o S. TAH( R!MOV1!O Kern Count Superintendent of Schools lOC-' TiCN WITHIN SITI (~) ANI< I . t. TAHK OfSCRIPT1OH I May 1998 I """""",,,"'9COPnOH -.... -... COMPARTMENTAlIZED TANI( 0 Y.. x:!{J No It 'Y..., comøleC. one ø.ge for NCh comøar1m«1t Modern Weldin IH 12,000 Gallons 1 .. TANK CON'T!HTW ; TAM< use 4» ; ~ 1. MOTOR V!JiICU! I'UI!L . ; (If 1fIM/ted. ~.. PWoIIc.wt 7)pe) ~ 0 2. NON-FIJEI. PE1'ROl.E\.IW ¡ 0 ), CHEMICAL PAOOUCT ! 0 4, HAZAAOOUS WASTt! (1ndudN I u..:f 0#) o <)5, lJN<NOYI'f f I TYPe OF TANI< 1 (Ch«Jt.",. ..." odyJ ! ! T ANI( MA TERW. . If1maIy link . ÆJ"IIIOLØJM TYPe , t1,,, ReOtAAR UfUAOEO 0 2. lEADED tJ III. PRÐIUW UN.J!AOED aa 3, 0ESE1. o Ie. ~ UN.EAœD 0 4. GASOHOt. COYCIN ÞWiI! /II'IMt ~ IoIaIMaØ /nvenIoty".ge) o 5. JET F\JEL o S. AVIATION F\Æ1. o gg. OT1iER CAS' (from Haza1Wua.......... ~~) 441 4- o 1. SINQl.I WALl. xtJ Z. DOU8L! WALl. .. TANK COHSTRUCTIOH o 3. SINQU WAU. WITH EXTERIOR MBeRANE lIPER o 4. SINGLE WALl. W A VAUlT ~. o 5. SINOLE WALL WITH IHTERNAI. 8LACœR SYST1:M OM. UN<HOWH o eo. OTHER o 5. CONCÆTe 095. UN<HOWH Os. FRPco.M>ATlBU:WlI00%METHANOL Ogg. OTHER o 1. BARf! STæl o Z. STAN..ESS STEEL o 3. FI8ERGlASS I PtAST1C . ~ 4. STEEl. ClAD W5I8ERGLASS REJNFORœO PtAST1C (FRP) o 3. FeERGLASS I PtAST1C o 4. STEEl. ClAD WJFIIIERGlASS RElNFORœQ PU3T1C (FRP) o s. COHCRETE o 1. EPOXY LNNG 0 5. 0tASI1JNNJ 0 95. ~ C 4. PHeNOlIC L.M«J xE .. UNLINEO 0 It. OTHER ::ð 3. FeeROV.Ss 1tØf'ORœO P\ASTIC 0 M. UN<NOWN 448 o 4. ItoFRfSSED CURA2HT (J.. cmtER 44- ! (Ch«Jt OIN _ only) , I 'TANI(MATERIAL'-*"Y~fJ 1. BARf!ST!S. (Chedt OM AIm odyJ 0 Z. STAINJ!SS STœ, TANI< INTERIOR uo.w«J OR COATING (Chedt OM lint only) I SPILL AND OVERAU. I ! (C/!.,;/(., tNllPPIY) ! o L FRP COMPATI8U! WlI00% P.ETHANOl o e. FRP ~AAOOI8l.E JACI<ET o 10. COATED STœ. (J 95. t.JN(N()'M ON. OTJER ~ a 1. RUIIIR LHD a 2. AUC'tD LIMQ MTE INSTAUS) 447 I 441 IØ(»IIIM MTE INSTAU.EO ~g [J 1. ~ACT\ND CATHODIC PAOT!CTIOH o Z. SACIWICW. AHOOI!! Y!AA INSTAlL!O xEJ I. SPlU.COHTAIfM!NT 9'1 ~ z. OAOP TU8I! 98 xS 3. STRIœAPl.ATI 9$ 450 TYPE (For IOUI UN only) (Ftw IØ(»I .- only) 451 0\IeAF1U. PROTECTION EQUIPW:NT: Y1!AA INSTAUS) 452 o 1. .ALAAM xfXI 3. FIll TUBe SHUT OFF VAL.\IE 9t--- o 2. 8AU. FLOAT 0 4. exEMPT :.~;: ~.~$rë:·. x~i~~:~:::~::' '. . ::.: -,' . ..". ::~~?'!.: ~'?:.;~~' .. ~:' T . :.~,:. '. ~ -: '..~}~'~~~ . ~ WAU. TANK 0" TAM< 'MTH ~ (Ch«Ir _..", ødyJ: 45A o I. VISUAL (SINOL! WAlL IN VAUL T ONLY) ~ 2. CONTINUOUS INTeRSTITIAL MONITORING o 3. MAHUAl MONITORINO ... o So MANUAL TANK QAUGIHG (MT'Q) o .. VADOse ZONe 07. (W)UtONAre.q o L TAN( TESTINO 0.. OTHIR I Y. TANK CLOIUU INI'ORMAT1OH, ""MANIHT CLOIURlIH PU.CI IITIM\TIO QUNm1'V Of' SU84TAHCIIWoWNINCI ... TANK 'IlLIO 'MTH lNafn' IMTllUAL.1 467 I I' ... , 'STIMArIOOllT'l.A8TUtlO~Y) JPCF (1m) \ aeIoM o v.. ONo S;ICUPAPORMS\SWRC8-8.WPO ~ CJ'T'Y OF IIA)(ERSFIEl.O o.r'IC8 0.. !NVIRONMENTAL SERVIces ... c"...... Aw.o BaIl_Aft.ld, CA iJJ01 (IM1) 32....,9 VI. ~ CONIT1ItUC"TlOH (CIt«* .. ~I ..." uNOeAQIIOUNO PlPlN() I ~Y~¡rEM I"'I'PE ß I >qESSURE 0 2, SUCTiON 0 ). GRAVITY 454 I 0 I pflESSURE I CONS fRUC nON!' 0 I ',NQ,e W,o\L~ 0 ), LINED TRENQ1 0 91. OTMER 4ðO I 0 ,. SINGLE W,o\L~ ,IMNUF"CTUREA~O 2. DOUBLe W,o\LL 0 ið, UNtCHOWN 0 2, OOUBLE W,o\L~ I MANUF"CTURER Modern Welding 441 WlNUF,o\CT\JRER : 0 I. SARE STEEL 0 4, FRP COMPATI~ Wl1ocn. ~L 0 t. ß,o\RE STEEL : w. TERIALS ANO : 0 2. STM4.ESS STEEL 0 7, QAl.VANIZI!O STEEL 0 2. STAINLESS STEEL : CORROSION : , PRO TECTION ; 0 ), ~IC COMPA Tl8lf WITH CONTEHT9 0 gs, UNt<NO'M'4 0). Pl.'STIC COMP,o\ TlBLE WITH CONTENTS x¡:¡g 4, FIBERGlASS 0 S. Fl£)(JBLE (HOPE) 0 91. OTHER 0 4. FIBERGLASS I '05. STEELW/COATINO 09. CATHOOICPROTECTION 4&4 Os, STEELWICOATlNO VI. PPtNG U!AK DI!T!CT1ON (Ch«k .. eNl apply) :- <', PRESSURIZED PIPlNO (CI>«k ., eNl.wy): o 1. ELECTRONIC UNE LEN< OETECTOR 3.0 GPH TEST mnt AUTO PlJf.4P :HJT OFF FOA LEAK. SYSTe.t FAIlURe. ÞHO SYST1!M OISCONN£CT1ON. AUOIBl.E AND V1SUAL ALAAMS o 2. MONTMl Y 0.2 GPH TEST o 3. ANNUAL INTEGRrTY TEST (0, I GPH) , , CONVENTION,o\L SUCTION SYSTEMS: I 0 5. CAlLY VISUAL MONITORING OF PUMPING SYSTEM . TRIENNIAl. PIPING INTEGfUTY TEST (0.1 GPH) I SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUNO PIPING: I 0 7. SELF MONITORING i GRAVITY FlOW: , 0 9, BIENNIAl. INTEGAITY TEST (0.1 GPH) SI!CONOARIt. y COHTAIN£O PII'tHQ PRESSURIZED PIPING (CI»ck ., "-t apply): 1 0, CONTINUOUS TURBINE SUMP SENSOR ïiIItt AUDIBLE IlK) ~ ALARMS ÞHO (Chec;lt ooe) JI.ŒI a. AUTO PUMP SHUT OFF 'MiEN A LEAK OCCURS o b, AUTO PUMP SHUT OFF FOR L.EÞ.KS. SYSTEM FAA.URE IlK) SYSTEM DISCONNeCTION o c. NO AUTO PUMP SHUT OFF . nIl, AUTOMATIC LINE LEN< OETECTOA (3,0 GPH TEST) mnt FlÞN SHUT OFF OR ~ RESTRICTION '0 12. ANNUAL INTEGRITY TEST (0,1 GPH) ISUCTJOtoVGRAVITY SYSTEM: fUc 13. COHTlNUOUS SUMP SEHSOR . AUDI8U! NlO VISUAL. AI.AAMS !M!RO!HCY O!NØATORS OM. Y (Chedr ""'I/11III1) o 14, CONTINUOUSSUMPSENSOR~AUTOPUMPSHUTOFF.AUOIBlENlO VISUAL ALAAMS :J 15. AUTOMATIC UNE LEN< DETECTOR (3.0 GPH TEST) ~ FlOW SHUT OFF OR RESTRICTION :J 16, ANNUAL INTEGRITY TEST (0,1 GPH) :J 17. OAILYVISUALCHECK utT. rAMIe ~AO' ,.. - of "80V!CROUNO PIPING o 2. 'UCTION o ~5, UNI<NOWN o 99. OTHER o ), GRAVITY o 4, FRPCOMPATlBLEW/I~~ o 7. GAI.VANIZED STEEL o 8. FlEX/8lf (HOPE) 0 91. OT1-1ER o 9, CA TMOOIC PROTECTION 09$, UNKNO'M'4 <, ..~ - 4M ASOVEGROUNO PIPING SING WALL PIPING PRESSURIZED PIPING (Check ... eNl ~): o 1. ELECTRONIC UNt: lEAl< DETECTOR 3.0 GPH TEST ~ AUTO PUMP SHUT OFF FOR LEAl<. SYSTe.t FAIlURE. IlK) SYSTEM OiSCON'ECTION . AUDI8l.E ÞHO VISUAL AlARMS o 2. MOImIl Y 0.2 GPH TEST o 3. NHJÞL INTEGRITY TEST (0,1 GPH) o 4. OM. Y VISUAl CHECK <E CON\'ENTlONAL. SUCTION SYSTEMS (Check 116 "-I ~): o 5. OAIL Y VISUAL MONrrORJNG OF PIPING AND PUMPING SYSTEM o 4. TRIENNIAl. INTEGRITY TEST (0,1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BelOW GROUND PIPING: o 7. SELF MONITORING GRAVITY FlOW (CMck'" eNt .wy): o 8. OM. Y VISUAL MONfTORJNG o O. BIENNIAL. INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check II6lÑt ~): . 10. CONTINUOUS TURBINE SUMP SENSOR ~ AUDIBlE AND VISUAL A1.ARMS AND (ctIedt one) o a. AUTO PUMP SHUT OFF 'MiEN A LEAK OCCURS o b. AUTO PUMP SHUT OFF FOR lEAJ(S. SYSTEM FAIlURE AND SYSTEM DISCONNECTJON o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC t.EAI< OETECTOR o 12. ANNUAl. INTEGRITY TEST (0. I GPH) SUCTIONlGRAVITY SYSTEM: o 13. COHTlNUOUS SUMP st:NSOR + AUOI8LE AHO VISUAL ALARMS EMeRGENCY OI!N!RATORS OHl Y (ChØ" IhIl ~ o 14, CONTINUOUS SUMP SENSOR wmIOUT AUTO PUMP SHUT OFF. AUDIBlE AND VISUAL ALAAMS o 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) .\ ~~;} ~ )ISPENSERCONTAlNMI!NT 0 1. FlOATMeCHANlSMTHATSHUTSOFFSHEARVALV£ OA TE INSTALLED 4M 0 2. CONTINUOUS DISPENSER PAN SENSOR . AUCI8U! AND VISUAL AlAAMS '1a y 9 8 xta 3. CONTINUOUS DISPENSER PAN seNSOR ïdD:1 AUTO SHUT OFF FOR DISPENSER. AUDIBLE AND VISUAL AI..AAMS IX. OWNIIRIOPIlRATOR SIGNATURe cet1Ily 1/1811/1. ,n/omlallon ønMØecIlIerein ia tnIe anø ec:cur8le 10 IN bell 01 my 1uIowIedge. JICHA TUR! ~RIOPeJV.¡!(R / /~ ¿) ~-c...__ lAMe: OF OWNERiOPEAA TOR (SHWJ Ron Shearer ~t~'::····· ···.;~t~;~tè:it~~ o 4. OM. Y VISUAL CHECK o 5. TRENCH UNER J MONrrORING o 6, NON!! 4ð9 CATl / 11/01 410 41\ TITLf OF OWNERIOPEAATOR Director of Operations 412 ...,0( ute uN CF (7199) S:\CUPAFORMS\SWRCB-a. WF'D ,JP . (~ ./ '" .' 1 ,~ ".. .' ~,~ -. -- .-. CITY OF BAKERSFIELD OF_E OF ENVIRONMENTAL .VICES 1715 CheSter A ve., Bakersfield, CA 93301 (661) 326-3979 UNOERGROUNO STORAGE TANKS· TANK PAGE 1 Œ ,.. 01 f'fPf! OF _CTI()H 0 " NIW SIT! PeAMIT 0 4, AMVaO PeRMIT I C"..,. ~". ,_ 0tIIy JØ " 0WI0e OF INFORMA noN) Update ISIHdy ~ . ftN IOu/ .... 4lIIy J FACILITY 10 . o S. TEMPORARY SITe ClOSURe o 1. PERMANENTL'" Closeo ON SITe o a, r AHf( FU!MO\I1!O o ), ReNeWAL PeIU.IIT I~ __ . ftN.IOCaI w. 0tIIy 8USlNESS "IAMI!. ¡s-.. I'''ClUTY NAMI! 01 oeA . Oøng e.- Aa) Kern Count Superintendent of Schools , ~OCA TICH WITHIN SIT1I (~) ANI< I . I. TANK DESCRIPTION COMPARTMENTALIZEO TANI< 0 v.. x:IiJ No If -v.... corn.. one øege tot e.ec:h compartment. .. I ¡May 1998 I """"""" DESCRPnON - - -- Modern Weldin IN 12,000 Gallons 1 f::. "TANK~ ; TAN< use 431 i 6 " MOTOR VEHIC&Æ flUB. ; (1f/flM1tfld. ~..~ 7)pe) i 0 2. NOH-FUEL PE1"ROI..ÐAI I I 0 ). CHEMICAL PAOOUCT I 0 4, HA.lAAOOUS WASTe (1rw:aIdø , 01) I095.~ I I TYÆ Of TANK I (CMck OM ìIIm ody i I T ANI( WI TEfUAL . prImIIfY" (] ,. IN3U WALl. x:(J 2. DOU8U! WALL PÐROI.BJM T\'Æ xS ,.. Al<UNtUNDOEO a z. ~ a 111. PADIUM UN.I!AOEO 0 J. OIESEI. a 1Co ~ \.H..EADED 0 4. GASOHOt. COfoM:)H PWE (IhIm HIøIdouI AlaterlaØ InvenIøty ¡»ge) 4- o 5. JET FlIEL o S. AVlATIONF\Ja. o 90. OTJiER CAS' (from~""'" ~".) ...., ~ .. TANK CON8TRUCTIOH o 3.. SINGlE WALl. 'MTK EXT'ERIOR MÐ IIfWE UNER 04. SlNGLEWAlLIHAVAUlT o s. SINGlE WAlL'MT1i INTENW. aADOER SVSTEM 085. UNICNOWN 0.. OTHER o 5. CONCR£TE 0 tIS. UNKNOWN o &. FRPCOMPATlBlEWl100%MeTHANO\. 090.0nER 4043 . o 1. BAAl! STEEL o Z. STAH.£SS STæL o 3. F~I Pt.ASTIC 'Ø 4. STEeL a.AD WIFI8ERGLASS RaNFOACEO Pt.ASTIC (FRP) o 3. FBERGlASS I Pt.ASTIC o 4. STEa. a.AD WIFIØERGLAS8 ABHFOAŒD PlASTIC (FRP) D s. COHCRET! D 3.. Ð'OJCY LNNO (] s. GI.A88 LM«J (] tIS. UNKNOWN D 4. PHINOUC LNNO x£J L UNJNEO 0 It. OTJiER JCI: 3.. ~ RØIIQRœD Pt.ASTIC (] 15. UNICNOWN 448 D .. U'AESSEO CUAA£N1' (].. OTHER #4 , J (Ch«J¡ one AMI only) I , T ANI( WI TERIAL . MCOndIry ~f] 1. BAAl! STEEL (CMck one.. ody a 2. STAINLUS STeEl, TAl« INTERIOR ur.w«J OR COATING o S. FRP COMPATI8I.E WI100% METHANOl. o t. FRP NOH-CORAOOIBlE JACKET o 10. COATED STEEL. (] tIS. UNKNOWN o lie. cmER 44S DATe IHSTAU.EO 447 (] 1. NJIIIIR LINED C 2. AI.K"tO UIINCI ..... IOCeI cøe DATE IHSTAU.EO 449 (CMdt one iNm only) , I SPILL AND OV£RF1U. I I (CII/Kk ~. tIIiIl.ppIy) ! a 1. M,VUIACTUR!DCATHODIC PAOTICTION a 2. SACM'1CW. AHOOI! YEAR IHSTAllEO xEJ 1. SPILl. COHTAMII!NT 97> xm 2. CROP TUBE 9' xS 3. STAICIR I't.ATI 9' (FfN IOCeI UN only) 451 O\IERFIU. PROTECTION EQUIPMENT: YEAR INSTAU.EO <152 0,. AlARM xIX! 3. FIll TUBE SliUT OFF VALve 9Jl- o z. 8AU.FLOAT 04. !XEMPT 450 TYPe (Few /oCeI .,. only) :~:.: ~~~;. _Y·';i,t.~::·~:::,·... :...:.......... :;~~.:~..;..~~~. ,.~'"/. .:.:,:.... :"',?/t.(~~ .., . . .·OOWU ~ÅÜ. TANK Oft TANK Mnf ~ (CMcIt_,." onIy1: 464 o 1. VISUAL (SINGl! WALLIH VAULT ONLY) g Z. CONTINUOUS lNTeASTITIAL MONlTORIHG o J. IoWruAl MONITORING 411 (J So MANUAL. TANI< OAUGINO (MfO) (J .. VAOOIe ZOHe CJ 7, <W)tJHDWATER o L TAl« TESTIHO (J... OTHeR Y. TANK CLOIUItIIINPORMATIOH I 'IRIIANINT CLOIUU CN nACI U'TIMot.T1O QUANTJTY 0fI sueaTAHCI fWwWNI'Q .... TANK 'UlO WITH INIRT WoTIfUAI.' <151 tsTIWoT10 GATt lAIT utIO (YMotOIO.t.Y) UPCF (7m) ,.. Dv.. ONo S;\CUPAFORMs\sWRce.s·WPO r ,. CITY OF BAKERSFIELD Ofr,.CI 0' INVIRONMENT AL SERVICES ..A eC........ Aw.. Bak....".,d. CA 93301 (1Se1) 32'99 ,;. ~ utT. rANK ~AQI! i III :1 I - uNOEROItOUNO PlPINO VI. ~ CONI'TRUCTION (CMcII" ilia, WIY1 I ABOVECROUNO PIPING SYSTEM ryPE ß I PRESSURE 0 2, SUCTIOH 03, (]AAVITY 45a 0 r. PRESSURE CONS TRUCT'lON/! 0 I SINGlE WALL 0 3, LINED TRENCH 0 911, OTHER 400 0" SINGLE WALL MANUFACTURER!O 2. OOU81.E WALL 0 M. UNI<NOWN 0 2. OOU8LE WALL i MANUFACTURER Modern Welding 4a1 MANUFACT'1JRER , : 0 t, BAAE STEEL 0 a, FRP CO....ATlIIU! W/I~ MeTHANOL 0 t. BARE STEEL :MATERIALSAHO;O 2. STAIHlESSSTEEL 07, QALVAHlZEDSTEEL 02. STAINLESS STEEL I CORROSION i I PROTECTION 10 3, PlASTIC COMPATIBLE WITH CONTENT'S 0 M. UNKNOWN 0 3. PlASTIC COMPATl8LE WITH CONTENTS 1tJ 4, FIBeRGlASS 0 8. Fl.EXlØU! (HOPE) 098. OTHER 0 4, FI8ERGl.'SS : 0 5, STEEL WI COA TlNO 0 9. CA THOOIC PROTECTION 4&4 0 5. STEEL WI COATING VII. PPINQ L£\K DeTECT10H (CMcII" r..t .ç¡pIy) PRESSURIZED PIPING (ChKJc aI ilia, apply): o " ELECTRONIC UNE lEAK DETECTOR 3.0 GPH TEST mIt1 AUTO PUfoIP SHUT OFF FOR lEAl<. SYSTEM FAIlURE. NÐ SYSTÐt DISCONNECTION . AUOI8LE NÐ VISUAL ALAAMS o 2. MONT'Hl Y 0.2 GPH TEST o 3. ANNUAl. INTEGRITY TeST (0.1 GPH) CONVENTIONAl SUCTION SYSTEMS: I 0 5, DAII. Y VISUAl. MONrTORING OF PUMPING SYSTEM . TRIENNIAL PIPING INTEGRITY I: TEST (0.1 GPH) I SAFE SUCTION SYSTEMS (NO VAlVES IN BElOW GROUND PIPING): o 7. SELF MONITORING GAAVI1Y FlOW: o 9. BIENNIAL INTEGRITY TEST (0,1 GPH) SI!CONOARIL y COHTAINEO PIPtNQ PRESSURIZED PIPING (CMcllaI ilia, apply): 10, COm'INUOUS TURBINE SU.... SENSOR mw AUDIBlE NÐ VISUAL AI..AAMS NÐ (Chedl one) )G a. AUTO PU.... SHUT OFF WHEN A lEAK OCCURS o b. AUTO PU.... SHUT OFF FOR lEAKS. SYSTEM FAIlURe NÐ SYSTEM DISCONNECTION o c. NO AUTO PU.... SHUT OFF . H ", AUTOMATIC LINE lEAK DeTECTOR (3.0 GPH TEST) ~FlOW SHUT OFF OR RESTRICTION o 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIOWGRAVITY SYSTEM: &): 13. COHTlNlJOUS SUIotP SENSOR . AUDt8U! IWO VISUAL. N.NWiS UllRGI!NCY O!N!JIIATORI OM. Y (CIIecIt .. IIIIfIlJlllyJ o 14, COm'INUOUS SU.... SENSOR mII:I2W: AUTO PUW> SHUT OFF. AUOI8l£ NÐ VISUAl AlARMS o 15. AUTOMATIC UNE lEAK DeTECTOR (3,0 GPH TeST) ï4II:I!2w: FlOW SHUT OFF OR RESTRICTION I 0 16. ANNUAlIm'EGRI1Y TEST (0.1 GPH) o 17 , DAILY VISUAl CHECK o 3. GRAVITY o 2, SUCTION o 95. UNKNOWN o 911. OTHER o 8. FRPCOW>ATl81.EW/I~~ o 7, GAlVANIZED STEEL o 8, FlEXJ8l.ê (HOPE) 0 911. O'ßiER o 9, CATHOOIC PROTECTION o 95, UNKNOWN ., i 46 '.~.. :'. 4ð8 ABOVEGROUND PIPING SINO WALL PlPINO 46 PRf:SSURIZED PIPING (Cheçk .. ilia, IPPIY): o 1. ElfCTRONIC UNE lfA( OETECTOR 3.0 GPH TEST mI!1 AUTO PUW> SHUT OFF FOR lEAK. SYSTEM FAIlURE. NÐ SYSTEM DISCONNECTION + AUot8lE NÐ VISUAl AI..AAMS o 2. MONT'Hl Y 0.2 Gf'H TEST o 3. NHJALINTEGRfTY TEST (0.1 GPH) o 4. OM. Y VISUAl. CHECK CONl/ENTlONAl SUCTION SYSTEMS (Check .ø ilia, IPPIYJ: o 5. OAIL Y VISUAl. MONITORING OF PIPING AND PUMPING SYSTEM o a. TRIENNIAL INTEGRI1Y TEST (0.1 GPH) SAFe SUCTION SYSTEMS (NO VAlVES IN BELOW GROUND PIPING): o 1. SELF MOHITORJNG GRAVITY FlOW (Check .. ilia, ~): o 8. OAIL Y VlSUA1. MONITORING o 9. 8IENNIAlINTEGRfTY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRf:SSURIZEO PIPING (Cheçk" ilia, apply): . 1 O. CONTINUOUS TURBINE SUMP seNSOR Ï!!nt AUDIBlE AHO VISUAl. AlARMS AND (chec:k one) o a. AUTO PUMP SHUT OFF WHEN A lEAK OCCURS o b. AUTO PUMP SHUT OFF FOR lEAKS. SYSTEM FAIlURE AND SYSTEM DISCONNECTION o c. NO AUTO PUMP SHUT OFF o 11. AUTOMATIC lfA( OETECTOR o 12. ANNUAl fNTEGRfTY TEST (0.1 GPH) SUCTIONlGRAVITY SYSTEM: o 13. CONTINUOUS SUMP SENSOR . AUDf8lE AHO VISUAl. ALARMS EMeRGENCY OI!NERATOttS OHL Y (C/Iedt.. ilia, ~ o 14. CONTINUOUS SU.... SENSOR 'MTHOUT AUTO PUW> SHUT OFF . AUDI8l.ê AHa VISUAL ALAAMS o 15. AUTOMATIC LINE LEAK DETECTOR (3,0 GPH TEST) o la, ANNUALINTEGRI1Y TEST (0,1 GPH) o 17. DAILY VISUAl CHECK ~. ~"~:~~\)f(~:;~:t~~~:· '" ... .... DISPENSER COm'AlNMeNT 0 1. FlOAT MI!CHAN1SMTHAT SHUTS OFF SHl!ARVALV! DATE INSTAlLED 4ð8 0 2. CONTINUOUS DISPENSER PAN SENSOR . AUOf8U! AND VISUAL Al.ARMS Ma y 98 xlC 3. CONTINUOUS DISPENSER PAN SI!NSOR mIti AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL AlARMS DC. OWN!RIOP!RATOR SIGNATURe I c:.rtJIy I/Ia! 1/\. Inlormallorl to';Idec herein ia InIe ancI ac:cur... 10 IN bell 01 my kncMIeØge. SIGNA TURE OF 0 0 Permtl ~'* (Fot IOcM ~ only) 473 I PetrnIt~{FotIOøl...onIy) JPCF (7199) I o 4. OM. Y VISUAl CHECK o 5. TR£NCH UNEA I MONITORING o 8, NONE .ce9 DATi./11/01 470 471 472 TITU! OF OWNERIOPERATOR Director of Operations .r< ---.......,........ '" I S;\CUPAFORMS\SWRCB-B.WPD CITY OF BAKERSFIELD O.E OF E:'.'V(RON~[ENTALeRVICES 1715 Chester Ave., Bakersfield, CA 93301 (661) 326-3979 UNDERGROUND STORAGE TANKS - UST FACILITY (Ð r'fPE OF ",CTlON I Ch/KÆ on.. 1..m only) o I, NEW SITE PERMIT o J. RENEWAL PERMIT o 4. "'~NDED PERMIT o S. CHANGE OF INFORMA TroN (~Ify Cl'tange . lOcal... Only) o 8. TEMPORARY Sm: CLOSURE Page _ 01 _ o T. PERMANENTLY CLOSED SITE o 8. TANK REMOVED 400 I. FACILITY I SITE INFORMATION J I FACILITY 10. I~ .á I . NEAREST C OSS STR T 401. ~IW;'" ~ ff.-.va.. ü.~ I ~~~NESS 0 1. GAS STATION a J. F Ilr s. COMt.£RCIAl I a 2, DISTRIBUTOR a 4. PROCESSOR a 8, OTHER 403. I TOTAL NUt.l!ER OF TANKS IS raclllty on Ind., R_1Ion or l'lf ownerr:l UST a pullllcagency: name r:I SUpeMsorr:l REMAINING AT SITE lrusUands? ¡ dMsIon, sec:IJon or oIIIce whicl1 operates the UST, I (This IS the oonc.ct penal lot II1e IMIk reccráS.) 1'1:/ /" / ;¿ 404. a Yes or No 405. , ~-./ ~~.(N' FACILITY O'MIIER TYPE a 1. CORPORATION o 2. INDIVIDUAl a J. PARTNERSHIP I a 4. LOCAL AGENCYlOlSTRlcr ~. COUNTY AGENCY' a 8. STATE AGENCY" o 7. FEDERAl-AGENCY' 0102. BUSINESS NAME (Same as FACILITY NAME 0( DBA· Doing Sualn... As) 406, IL PROPERTY OWNER INFORMATION PROPERTY O'MIIER NME /rC~'> MAILING OR STREET ADORESS -r-r / .3cl:7 }7l.!. ~r ß¡¿.. PROPERTY O'MIIER TYPE a 1. CORPORATION <407. PHONE R,r'~ Gër~/ 406. CITY 1~8o/ 409, a 2. INDIVIDUAl a J. PARTNERSHIP 410. I STATE !tÁ a 4, LOCAL AGENCY I DISTRICT B'S. COUNTY AGENCY 411., ZIP'330/ a 8, STATE AGENCY a 7. FEDERAlAGENCY 412. 413. j.,.,~'- ~~., .~!'"..¡¡ ~:"-Ll'~~,gwÑE~'ï~f()RMÀfïò':f~:"'~-'/" . :" , .:-..:: ::~::... ~ "$~;;'d:;...:~_: . . -~." .'.:: !..:j:~..:~':;.i·~:;, 4~ -=:-:::. . ,-. ."~- ..-.- ~ .-:~-". .,.. ,. -.-":...= . "." - - - " TANK O'MIIER NAME 415. MAILING OR STREET ADORESS 416. CITY 417. I STATE 418. ZIP CODE 419, I TANK O'MIIER TYPE o 1. c;oRPOAATION a 2. INDIVIDUAl o 3, PARTNERSHIP / a .>-LOCAL AGENCY I DISTRICT ~ 5. COUNTY AGENCY o 8. STATE AGENCY o 7. FEDERAl. AGENCY 420. . IV. BOARD OF EQUALIZATlONUSTSTORAGE FEE ACCOUNT.NUMBER Call (916) 322-9669 If questions arise 421. V. PETROLEUM UST FINANCIAL RESPONSIBILfTY INDICATE METHOO(S) o 1, SELF-INSURED a 2, GUARANTEE a 3. INSURANCE o 4. SURETY BONO o 5. LETTER OF CREDIT a 8, EXEWTlON o 7, STATE FUND ' a !, STATE FUND & CFO LETTER a 9, STATE FUND &CD o 10. LOCAL GOV'T MECHANISM o 99. OTHER: 422. VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one bOx 10 Indeale wtúch addresa sIIouJ< lie uaed (0( legal noll1lc:adons and mailing. Lðc;JaI notlflcadons and mailings wtn lie sent to the IM1k owner unless bOx 1 0( 2 Is d1ecked. o 1. FACILITY 2. PROPERlY OWNER a 3, TANK OWNER 423. VII. APPLICANT SIGNATURE ¡ C<W1lftcadon: I certify t/IaIlhe In(ormadon prO\'ided herein Is II\HI and acx:urate 10 II1e best r:I my knowtedge, ¡- SiGNATURE OF APPlI 427, . ÑAMe-ÖF APP ICANT (print) 120N' 428. 424. PHONE 4~. S/'e~.;!rev- ~~.I ( ( lOCal UU only) 428, 1t8 U ( ( leXal ua. only) 4211. UPCF (7/99) I S:\CUPAFORMS\swrcb-a,wpd e . CVE- 381 05 OOÌ<H£IM~ TOKHEIM DISTRIBUTOR Cal- Valley Eqyipment 3500 Gilmore Avenue, Bakersfield, CA 93308 Cont. # 750103. Phone (661) 327-9341 . Fax (661) 325-2529 Authorized By: Date: I 'J-¡~/.A1:L Order # Customer: j1e.,v"Vl C.ùk,^-fv ,}LLO. i S("'~lJ(s. ( I Job Location: Arrival Time: If-: ùÖ A.M.lP.M Departure Time: 1. ';{.o A.M.lP.M Notification to W & M Confirmation # City: Job: Make Ý ;)..J; s-I --------------------------- ---------------------------------------------------- Qty. Part number and Description Unit Cost Total Cost Additional Information Listed Below: ~ef7o... ;v<~ ~.'y~ ," ¡þ .n b 1.... "1. '<! I r /", 5 1) Parts d-7 2) Sales Tax 3) Freight 4) Labor Total 5) Mileage Total 6) Equip. Rental 7) Subcontract Total Amount It is understood and agreed that in event this bill becomes overdue and the seller commences legal action for the collection of same, the buyer will pay all costs of collection including attorney's fees. The title to the property described herein shall remain the property ofthe seller, and title shall not pass to purchaser until paid, A service charg of 2%, equal to 24% per year, charged on past due accounts. Servic Cal-Valley Equipment Representative By: Title Date: J ~-1-60 WR.IT4tN ~IONITORING PRocAURES UNDERGROUND STORAGE TANK MONITORL'iG PROGRAM Th.i.s monitori11ó prognm must::C Lqx at me UST !oc:1tioa at Jil tin:Ies.. The iJ:J:formatioa on this ~ program are coadinollJ of the opcrariDg perm1L The permit bolder must aoti1Y the Office of Enviro·\,\~.....1 Services Mthin 30 day1 of any cMnr to the monitoring proo:dures. unless rtqUired to obuin approva.I before making the change. Required by Sectioas 2632(d) and 264 1 (h) CCR. F~ty~3Ine Kern County Superintendent of Schools - Schools Service Center F~ty Address 705 South Union Avenue A Describe the frequency of perfonning the monitoring: Tank Monitoring is done on a continueous basis throu~h an electronic detection system. Piping Same as tank monitorinq B. What methods and equipment, identified by name and model, will be used for pafoming the monitoring: Tank Electronic Monitorinq - Make: Incon-Tank Sentinel Model: TS 1000 Piping Same as tank C. Describe the location(s) where the monitoring will be performed (fàciIity plot plan should be attached): LCD Reader and paper printout located in PG&E room northwest corner of transportation building. Visual Alarm (Strobe Liqht) located inside the vehicle maintenance building. D. List the name(s) and titJe(s) of the people responsible for performing the monitoring and/or maintaining the equipment: Darrell Simons, Fleet Manager Scott Bohannon, Shop Foreman E. Reporting Fonnat for monitoring: Tank LCD Reader, paper orintout Piping Same as tank and strnhp liohr ~l~rm (CLM) continuous line leak monitoring (CLM) F. Describe the preventive maintenance schedule for the monitoring equipment. Note: Maintenance mlUt be in accordance with the manufacturer's maÏDtenaDce schedule but not less than every 12 months. Once each year, an equipment companv is contracted to inspect and calibrate leak detection system. G. Describe the training necessary for the operation ofUST system, including piping, and the monitoring equipment: Minimal traininq required. OperatinÇJ manun1 ~nrl instructions kept in PG&E:room next to the mnnitnring systp.m · e EMERGENCY RESPONSE PLAN UNDERGROUND STORAGE TANK l\IONITORING PROGR-\l\1 This monitoring program must be kept at the UST locaúon at all times. The infonnation on this monitoring program are conditions of the operaúng pennit. The pennit holder must noúfy the Office of Emironmental Services within 30 days of any changes to the monitoring proœdures. unless required to obtain approval before making the change. Required by Sections 2632(d) and 26~ l(h) CCR Facility Name Kern County Superintendent of Schools - Schools Service Genter Facility Address 7~,5 South Union Avenue 1. If an unauthorized release occurs, how \\111 the hazardous substance be cleaned up? Note: If released hazardous substances reach the environment, increase the fire or explosion hazard, are not cleaned up from the secondary containment within 8 hours, or deteriorate the secondary containment, then the Office of ~nvironmental Services must be I!otified within 24 hours. A supply of absorbant is kept close to locations where an accidental spill may occur. Employees are instructed on proper use. The Fire Department will be contacted should a maior spill occur. 2, Describe the proposed methods and equipment to be used for removing and properly disposing of any hazardous substance. All hazardous substance is removed from the premisses by a licensed waste hauler. 3. Describe the location and availability of the required cleanup equipment in item 2 above. Absorbant material is kept in matal trash containers located at the fuel island and in the vehicle maintenance shop. 4. Describe the maintenance schedule for the cleanup equipment: Equipment is inspected weeRly and replentished as needed. 5. List the name( s) and title( s) of the person( s) responsible for authorizing any work necessary under the response plan: Doug Snyder, Director of Transportation Ron Shearer, Director of Maintenance and Darrell Simons. Fleet Manaqer Scott Bohannon. Shop Foreman Don Fowler. Administrator of Maintenance. Doerations & Transportation Sp.r\/ices . . CVE- 381 05 OOKHE'O TOKHEIM DISTRIBUTOR Cal- Valley EqIDpment 3500 Gilmore Avenue, Bakersfield, CA 93308 Cont. # 750103 . Phone (661) 327-9341 . Fax (661) 325-2529 Authorized By: Date: -'-1:d -'-/.11t:L Order # Customer: /1 ~ý" VI. C.Ût..LV\. -+ r S Lt.f· ~ S c..-I-J vis. Job Location: Arrival Time: lf~ ùÒ A.M.lP.M Departure Time:f.'~o A.M.lP.M Notification to W & M Confirmation # City: Job: Make Ý ;;..f; S"' I Qty. Part number and Description Unit Cost Total Cost Additional Information Listed Below: 1f7 /f;ef7o.. :-y-<J. I,/.,n' Y ~ . "" .JI;> /1-ó1-7. ~ I r/", 1) Parts 2) Sales Tax 3) Freight 4) Labor Total 5) Mileage Total 6) Equip. Rental 7) Subcontract Total Amount II is understood and agreed thatlß event this bill becomes overdue and the seller commences legal action for the collection .of same, the buyer will pay all costs of collection including attorney's fees. The title to the property described herein shall remain the property of the seller, and title shall not pass to purchaser until paid. A service charg 0£2%, equal to 24% per year, charged on past due accounts. Servie Ace ed Cal-Valley Equipment Representative By: ,~ Title Date: / ;z..-/-ÓO 16 It \,;AL VALLEY EQUIPMENT . 3500 GILMORE AVENUE . BAKERSFIELD, CA 93308 661-321-9341 FAX # 661-325-2529 CONT. UC.1#184170 ,~' T ANI< MONITOR INSPECTION DATE: 1211/00 SITE: KERN SUPT OF SCHOOLS SOUTH UNION AVE BAKERSFIELD, CA 93307 MAKE; INCON SOFTWARE VER. 050-G027 REV 09910 MODEL: TS-100012-P SN: 42951 CONDITION OF UNIT: UNiT I~ GOOD WORKING CONDtTlon TANK PROSES: QTY. 2 TYPE MAG STYLE LINE SENSORS: QTY. TYPE SUMP SENSORS: QTY. 2 TYPE LIQUID I ANNULAR SENSORS: QTY, 2 TYPE LIQUID OTHER SENSORS: QTY TYPE PROGRAMMING ACCURACY & COMPLIANCE; (1) READS ACCURATE TOTA.Ntt CHART? YES X NO (2) POSITIVE SHUTDOWN? YES X NO 2-d St29-22E-t99-t eSS:LO 00 LO oaa .. -- . " COMMENTS: (3) TANK PROGRAMMING MEET COMPLIANCE? YES x NO PROGRAM INFORMATION: NO TANK TESTING PROGRAMMING IN USEJAN.NULAR IS MONITORED WITH POSITIVE SHUTDOWNIREMOTE AUDIBLE ALARM IS IN USE AND RESPONDS TO ALL ALARMS TANK DATA: MANUFACTURER OF TANKS? MODERN WELDING PRODUCT DIESEL size 12!000 SIZE 12,000 SIZE sIZe PRODUCT UNlEADED PRODUCT PRODUCT COMMENTS: INSPECTED BY: ft:..~~ /J;J~ . DATE: 12/1/00 RAYMOND BACHAR E'd SI29-22E-199-1 ess:loO 00 loO oaa , CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME rc\"V\ ~~tJL'\l7 .5ùptr. Qf. SChðO/ S INSPECTION DATE "(.Jgj{)'() Section 2: Underground Storage Tanks Program o Routine ~Combined 0 Joint Agency Type of Tank ÛwFc-S Type of Monitoring ¿L(¡¡A o Multi-Agency 0 Complaint Number of Tanks 2- Type of Piping ¡xv ,=' ORe-inspection OPERA TION C V COMMENTS Proper tank data on tile t-c..~vt I'\. Proper owner/operator data on tile Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERA TION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspiIl protection? C=Compliance V=Violation Y=Yes N=NO In,p"to" .;;Ii: ~ ./ Oftïce of Environmental Services (805) 326-3979 White - Env, Svcs. 4-4> ~ Busmess Site Responsible Party Pink - Business Copy