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Home My WebLink AboutUST-REPORT 4/6/2007 r .~ d ~F- ~~ m~~ ~NI N{ O ~ F" I ~ `__ ~_, __ ~- ---_- ~IJNDE~RGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. '~ 3 '' '-; CC-- BAKERSFIELD FIRE DEPT. B .`.! B k ~ P 7F£~'',~L ~~R~ Prevention Services a RTC T 900 Truxtun Ave. , Ste. 210 ~~'~'`~` Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ,ES ENHANCED LEAK DETECTION ,@S LINE TESTING .@S TANKTIGHTNESSTEST ®TO PERFORM FUEL MONITORING CERTIFICATION SITF7NFC~RMATI(~N ,ES SB-989 SECONDARY CONTAINMENT TESTING FACILITY / vrt NAME & PHONE NUMBER OF CONTACT PERSON o~ L U ~r' -~ Cpl- 3~S- 6°5` 7.? ADDRESS _ l5 G a ~`~ S7" OWNERS NAME 7 OPERATORS NAM E PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? es YES es NO TANK# VOLUME CONTENTS ~" P a G ~ !e s~~. __- _ NAME OF T TI~COMPANY l/ v! /~c~t/%-,~i~/J`7~•~ TANK TESTING COMPANY NAME & PHONE NUMBER OF CONTACT PERSON ~'~ s7~ri7 r ,~ ~/Za~s2c-r/ MAILING ADDRESS NAME & PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR CERTIFICATION #: DATE & TIME T ST TO BE CONDUCTED ~/~il 0 7 0; a~ i9 ~n ICC #: TEST METHOD SIGNATURE OF APPLIC T DATE 4!. G ~ 7 ~'l (~ ~ , APPROVED BY ~, ~~~ DATE (~ q FD 2095 (Rev. 09/05) ,.- ~---- . ~~. ~ ~. __ _ _ - °a~ viror~rtaer~~al e~°vie . ~.}~?" ~fC377S~Tfl{;f?t7f~ f~.~.f'E'aSiy(i {i.tctlt3Cf3rIcx77Cf' ~.;.:?fl7Dfti:3?1i.£: April 6, 2007 FED EX - 8601 3902 6044 Bakersfield Fire Department 900 Truxtun Avenue, Room 200 Bakersfield, CA 93301 RE: AT&T 1520 20th Street Bakersfield To Inspector Steve Underwood: Enclosed is the permit application to conduct the annual Monitor Certification for the above reference location. Feel free to ca11 if you have any questions. Very Truly Yours, TAIT ENVIRONMENTAL SYSTEMS BRI N HARMON Compliance Manager ~~i tvic #58~(}9~ ~ tWic #Q959~4 ~dV Lic #i3C3~S666 1t~=i3 '~crth '~e~=ilir ~t~ret C)r~r~c~e, ~`~3if~~r~a ~2i~~i5 7'~.56~.~2?~' 7t~.~fa.OGGG F=ax "~2~i? 7~a~e ~,~~ter C}ri°e f~anuhc tiord~v~, ~aliFcrE~ia ~5~1~2 • ~"6.&5S.`~%s~?t~ ~1~~:.a5~.1~i1 fax x~rs~r.tait.cam BILLING & PERMIT STATEMENT BaxERSFiELn FIRE DEPT. B H R S P I D prevention Services ~„ FIRB 1600 Truxtun Avenue, Suite 401 A 1ft 1M f PERMIT NO: TT--0534 .Bakersfield, CA 93301 Tel.: (661) 326-3979 • Fax: (661) 852-217] •- LOCATION OF PROJECT 1 520 20TM~ 5T ~ • PROPERTY OWNER ~M C>/~2T 04~11/O j 20~M A / STARTING DATE D'Q'~11/ D~" COMPLETION DATE NAME J O Fi t~I/tC~~I/t,Fi PROJECT NAME ~4T~T ADDRESS PHONE NO. 32.J~ D~j 2 PROJECT ADDRESS 1520 20TH 5T cRY STATE ZIP CODE • •' CONTRACTOR NAME gR.l~ N I-fi~RN10 N CA LICENSE NO. •' • TYPE OF LICENSE. EXPIRATION DATE PHONE NO. CONTRACTOR COMPANY NAME Ti41 T E N V I RO N M E N T~k l_ .S`(ST~MS Fax No ADDRESS 1803 N N EV I l_l_E 5T cITY OT2~ N Cj E ZIP CODE~2g65 All permits must be reviewed, stamped, and approved PRIOR TO BEGINNING WORK ON THAT PROJECT. ~ iI • • ~ e) $262 50 ^ ^ Alarms -New & Modifications - (Minimum Char • • ~ ~ g . ^ 98 Over 20 000 Sq Ft Ft x 013125 =Permit fee Sq 8 ^ , . . . . ~ ^ Sprinklers -New & Modifications - (Minimum Charge) $210 00 ^ ~ . ^ 98 ^ Over 5 000 Sq Ft FL x 042 =Permit fee Sq ^ ~ . , . . . ^ 98 ^ Minor Sprinkler Modifications (< 70 heads) $ 93 00 [Inspection Only) ' ~ . ^ 98 ^ Commercial Hoods -New & Modifications 26 $ 398 ' ~ . ~ 98 ^ Additional Hoods $ 36 00 ^ ~ • . ^ 98 ^ Spray Booths -New & Modifications $458 00 ^ ~ . D . ^ 98 ^ Aboveground Storage Tanks (Installation/lnsp.-1 ~ Time) $165.00 ^ 82 ^ Additional Tanks $ 26.00 ^ 82 ^ Aboveground Storage Tanks (Removal/Inspection) $109.00 ~ 82 ^ Underground Storage Tanks (Installation./Inspection) $878.00 (per tank) ; 82 ^ Underground Storage Tanks (Modfication) $878.00 (per site) ; 82 ^ Underground Storage Tanks (Minor Modification) $155.00 ^ 82 ^ Underground Storage Tanks (Removaq $675.00 (per tank) ~ ^ 84 ^ Oilwell (Installation) $ 72.00 ^ 84 O Mandated Leak Detection (Testing) /Fuel MonB.Cert/SB989. Note: $81.00 for each type of test /per site (even if scheduled at the same time) $ 81.00 (persite) (~ ~ P ~ C (b ~ ~ ~~ ~ ^ ^ 82 ^ ents $ 93.00 (per tent) ^ 84 ^ After hours inspection fee $122.00 ^ 84 ^ "Pyrotechnic - (Per event, Plus Insp. Fee @ $90 per hour} $ 62.00 + (5 hrs. min. stand -by fee /Inspection)=$527.00 ~ 84 ^ RE-INSPECTION(S) /FOLLOW-UP INSPECTION(S) $ 93.00 (per hour) ; 84 ^ Portable LPG (Propane): NO.OF CAGES? $ 66.00 . 84 ^ Explosive Storage $249.00 ^ 84 ^ Copying & File Research (File Research Fee $34.00 per hr) 25¢ per page ^ 84 ^ Miscellaneous 84 "(Stand-by Fa for Arena & Tents is $40 an hour) FD 2021 (Rev. 11/06) - - 1 -ORIGINAL WHITE (to Treasury} 1-YELLOW (to File) 1-PINK (to Customer) ~~~g~~ F ?,TkT M)SILITY-S?,KERSFIEL) 1 c SiteI): •15-•21-•11274 Manager DEBRA OKANO Location: 1520 20TH ST City BAKERSFIELD BusPhone: (425) 580-4902 Map 103 CommHaz High Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA Ol EPA Numb: SIC Code:4812 DunnBrad:10-202-6754 Emergency Contact / Title Emergency Contact / Title DEBRA OKANO / NETWORK MANAGER WIRELESS NETWORK / CONTROL CENTER Business Phone: (562) 468-6495xsa~~s Business Phone: (800) 832-6662x 24-Hour Phone - 24-Hour Phone (800) 832-6662x Pager Phone (qq q ) 33 S - g439x Pager Phone ( ~~A ) - x Hazmat Hazards: Fire React ImmHlth Contact DEBRA OKANO Phone: (562) 468-6495x MailAddr: 12900 PARK PLACE DR 3RD FLR State: CA City CERRITOS Zip 90703 Owner NEW CINGULAR WIRELESS PCS LLC dball}T~'j Phone: (425) 580-4902x Address PO BOX 97061 Mobitl~ State: WA City REDMOND Zip 98073 -9761 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ~ d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT .~~~.~ >~-- ~~ ENY'D ~ ~1 ~ ~ ~ ~0~~ Based on my inquiry of those individuals btaining the information, I certify f or o responsible under penalty of law that I have personally examined and am 'ramiliar wish the information submitted and believe the information is true, acc~ .. te, and c mplete. g1-30~ ~ Oate Signatur. ., -1- 06/29/2007 FAT&T MOBILITY-BAKERSFIELD 1 SiteID: STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: AT&T MOBILITY-BAKERSFIELD 1 Cross Street Business Type: Org Type: -Total Tanks QS X IndnRes/Trust: No PA Contact: ob~~~t-y Dsg Own/Oper NEW CINGULAR WIRELESS PCS LLC dbd ~t'CT1~- ICC Nbr PROPERTY OWNER INFORMATION Name WIRELESS NETWORK Phone: (800) Address: City State: Zip: Type 015-021-001274 ~ 832-6662x TANK OWNER INFORMATION SS NETWORK Phone: (800) 8 Address: City State: Type BOE UST Fee# Financ'1 Resp: Legal Notif Date: Phone: ( ) - x Name• Ttl: S e UST # 1998 Upg Cert#: ~eanni' Tease contac-~ -~h~ p~rs~r,Cs) Vise-~c1 1~e~low re~ardlin.~ Owner JOp~e~~-}-or } dt~er,fifi ~a-t-i o~n for ~-h e TanxCS) 1 o c,~t-eca ~ X520 ZO+h street-., ~3a~Kersfi~lc~~G~. X330 1. New C4nc.~v~lar 1nlireteSS PC. S ~ LLC not the c~orrre G ~' ~ w1neY J o per~fia Y mer~~-i a~~~ ~e~v~~ p m~~fi. ~'hariK v~~! ~a.~o~ We11er '~1a~na~er- ~ ~ ~ S f~~' ~ ~f' s ~ vv i c.e S 3n$ S . AKar~ Si~re~et.,~2.aam 11oD 1pollaS, "~'X. X5202- 53~!°~ ~'el : (2 ~ 4~ 41~~ ' 3131 d-b~ ~~T• ~ ~" nr-~ a b i lA• ~ t s for ~-h.e, ab~~ -2- 06/29/2007 ,? ~'- F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP T1T mm~ TT r. C~T/lT1TiR 1~K-~~,L~d.RGlf~ F IH S 59904.00 LBS Low El~ec-t-r'o-yte R IH L 2016.00 GAL Low -3- 06/29/2007 u ? ~`~ -4- 06/29/2007 i ,~ F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 ~ F= Inventory Item 0011 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME Days On Site l..edGF' ptG1C~ '~3d-~~Yl e s 365 Location within this Facility Unit Map: Grid: IN CELL SITE CAS# S C G co wtp o n e.n1'S b el aw STATE T TYPE ~~ PRESSURE TEMPERATURE ~~ CONTAINER TYPE ~ Solid I Mixture I Ambient ~ Ambient I OTHER - SPECIFY/h„ ~ ~.,,,, e~, AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 416.00 LBS 59904.00 LBS 59904.00 LBS b5 21- . . - -, , ., . -... nr~atu~L r~a a~aarlalvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / ~ cJ L~. Low Inventory Item 0009 Facility Unit: Fixed Containers Site ~ OMMON NAME / CHEMICAL NAME DIE ays On Site 365 Locatio ithin this Facility Unit Map: Gri . CAS# STATE TYPE PRESSURE TEMPE URE CONTAINER TYPE Liquid Mixture Amb' nt A 'ent UNDER GROUND TANK AMO AT THIS LOCATION Largest Container 'ly Maximum Daily Average 8000.00 GAL 000.00 GAL 8000.00 GAL ruac,ruu~v~a ~.vi•irvtvr~ly t J °sWt. RS CAS# 100.00 Fuel No. 1 No 70892103 ruyc~rucL r~ a~aoi•1~1v 1 D TSecr RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No/ Curies / / / Low HAZARDOUS COMPONENTS °sWt. RS CAS# ~q'/•~-@~ Sulfuric Acid (EPA) No 7664939 p~-~'0 Lead No 7439921 -5- 06/29/2007 F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME E~~'P~OA TLr.-.CT~~E BA~"~'ER3~ Days On Site ~ ~ ~C~'O ~~ ~"~i 365 Location within this Facility Unit Map: Grid: CAS# In ~n~d4e bar~~rt~e S '1(0 ~4 -~ 3 - ~ Liquid TMixtur~mbient~E ~ AmbientTURE CONTAINER TY E OTHER - SPECIFY~nS i dI~C ~ AMOUNTS AT THIS LOCATION eXle Largest Container Daily Maximum Daily Average _- 14.00 GAL 2016.00 GAL 2016.00 GAL S ril-~GEjtCLVU.7 1.V1~lYV1VL' 1V 1.7 °sWt. RS CAS# ~ j-5-A--0~0 Sulfuric Acid (EPA) No 7664939 -5.6--6'0 Water No ~J )~A- i1HGtiKL HA .7r,.7.71~1~1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Low Inventory Item 0010 Facility Unit: Fixed Containers on S'-t'e ~ = OMMON NAME / CHEMICAL NAME DIES Day n Site 365 Location 't` this Facility Unit Map: Grid: CAS# STATE TYPE _ Liquid TMixture SURE Largest Container D 400.00 GAL CONTAINER TYPE ABOVE GROUND TANK Daily Average 400.00 GAL c,rucLVV.~ ~.vrirvlVr~lvtJ °~Wt• RS CAS# 100.00 Fuel Oi o. 1 ~ 70892103 Y1tiL~tilSL tiw 7 iJ L' J.71"1L'1V 1.7 TSec RS BioHaz Radioactive/Amount EPA Hazards NFPA USDO MCP o No No No/ Curies / / / ow TEMPERAT = Ambien HIS LOCATION y ximum 400. _ GAL -6- 06/29/2007 J' '.~ F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 06/01/2006 ~ AT&T DOES NOT HAVE EMERGENCY RESPONSE TEAMS. THE TECHNICIANS RESPONSIBLE FOR THE MAINTENANCE OF THIS SITE ARE TRAINED TO CONTAIN AND CLEAN UP INCIDENTAL SPILLS WITH THE WORK ENVIRONMENT BY FOLLOWING THE INSTRUCTIONS ON THE MSDS AND AT&T PRACTICE 157-601-701 (STORAGE BATTERIES LEAD ACID TYPE REQUIREMENTS AND PROCEDURES). AT&T WILL USE THE SERVICES OF AN APPROVED CONTRACTED COMPANY TO INITIATE FULL CLEAN-UP AND DISPOSAL OPERATIONS. AT&T INDIVIDUALS WILL CALL THE HAZARDOUS WASTE GROUP WITHIN AT&T 800-8WASTE9 WHO WILL HANDLE THE WA5TE REMOVAL FOR ALL LOCATIONS. Employee Notif./Evacuation 06/01/2006 VERBAL ALARM - INDIVIDUAL WILL CALL OUT FIRE, ETC. INDIVIDUAL ENSURES THE BUILDING IS EVACUATED (USUALLY ONE PERSON AT SITE AT A TIME AS SITE IS UNMANNED). EMERGENCY EXITS POSTED - EMPLOYEES ARE AWARE OF THE NEAREST EXIT LOCATION AND THE LOCATION OF ALTERNATE EXITS. MEETING POINTS/RALLY POINTS HAVE BEEN ESTABLISHED OUTSIDE AND CLEAR OF THE BUILDING IN THE EVENT OF AN EMERGENCY. Public Notif./Evacuation 06/01/2006 THE FOLLOWING ALARM SIGNAL WILL BE USED TO BEGIN EVACUATION OF THE FACILITY: HORNS/SIRENS AND VERBAL. EVACUATION MAP IS PROMINENTLY DISPLAYED THROUGHOUT THE FACILITY. Emergency Medical Plan 06/01/2006 POISON CONTROL CENTER 800-876-4766. NEAREST HOSPITAL: BAKERSFIELD MEMORIAL HOSPITAL, 420 34TH ST, 327-4647. -7- 06/29/2007 „~ ~'~ F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 06/01/2006 BATTERIES: BATTERIES ARE VISUALLY INSPECTED FOR DEFECT/DAMAGE UPON ENTRY TO THE BATTERY LOCATION. ENSURE THE BATTERIES ARE SECURELY MOUNTED. INSPECT BATTERY CABLES FOR CRACKS, FRAYING, ETC. RACKS THAT CONTAIN AND SUPPORT WET CELL BATTERIES HAVE BEEN DESIGNED BY AT&T BELL LABORATORIES, AND ARE DESIGNED TO PRECLUDE TIPPING AND FALLING OF CELLS. FUEL TANKS: SHUT-OFF VALVES ARE VISUALLY INSPECTED AND TESTED. THE EXPOSED LINES LEADING TO AND FROM THE SHUT-OFF VALVES ARE VISUALLY INSPECTED FOR LEAKS. THE FUEL TANKS ARE OF DOUBLE-WALL CONSTRUCTION, THEY ALSO HAVE ELECTRONIC METER DEVICES FOR AMOUNT OF FUEL. THE TANKS ARE ALSO DIP TESTED TO ENSURE THE CORRECT LEVELS OF FUEL. Release Containment 06/01/2006 FREQUENT INSPECTION OF CONTAINERS, SAFETY MATERIAL AND SAFETY EQUIPMENT, BASED ON (CMP) CONTROL MAINTENANCE PLAN. Clean Up 06/01/2006 PERSONNEL NOT REQUIRED FOR SPILL CONTAINMENT OR CLEAN UP ARE KEPT OUT OF THE AREA. INDIVIDUALS THAT WORK WITH THE HAZARDOUS MATERIALS HAVE BEEN TRAINED TO STABLIIZE/CONTAIN RELEASED MATERIALS. PROVIDE CLEAN-UP OF INCIDENTAL SPILLS WITHIN THEIR WORK ENVIRONMENT USING THE APPROPRIATE MATERIALS ON SITE AND IN ACCORDANCE WITH MSDS GUIDELINES. -8- 06/29/2007 ~s .r~ l F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Other Resource Activation -9- 06/29/2007 d,, •s'' ,: F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ o~C~:ial nc~c.aiu~ Utility Shut-Offs 04/13/2007 ELECTRICAL - MAIN COMM POWER SHUT-OFF AT AC DISTR PANEL WATER - ALLEY NE CRNR OF BLDG SPECIAL - DUE TO EMER ENGINE AUTO START IT MAY BE NECESSARY TO SET ENGINE CONTROL TO MANUAL OR OFF LOCK BOX - YES S SIDE MAIN ENTR 15FT R OF FRONT DOOR AND 15FT ABOVE SIDEWALK IN RED BOX Fire Protec./Avail. Water 12/21/2006 PRIVATE FIRE PROTECTION - PYROLARM DETECTION SYSTEM, 4 ABC EXTINGUISHERS, DRY STANDPIPE SYSTEM, AND WET STANDPIPE SYSTEM. FIRE HYDRANT - W ON 20TH ST AT ALLEY; S ON EYE ST AT ALLEY; E IN ALLEY AT CHESTER AVE; AND N CRNR EYE & 21ST ST. Building Occupancy Level 03/22/2006 UNMANNED SITE -10- 06/29/2007 S , ~'f, a [~ F AT&T MOBILITY-BAKERSFIELD 1 SitelD: 015-021-001274 Fast Format ~ Training Overall Site ~ Employee Training 12/22/2006 BRIEF SUMMARY OF TRAINING PROGRAM: PROCEDURES FOR HANDLING HAZARDOUS MATERIALS: EMPLOYEES ANNUALLY REVIEW THE MSDS AND SAFETY PROCEDURES FOR MATERIALS HANDLED. PROCEDURES FOR COORDINATION WITH EMERGENCY RESPONSE AGENCIES: EMPLOYEES ANNUALLY REVIEW THE EMERGENCY RESPONSE PLAN AND EMERGENCY NOTIFICATION PROCEDURES TO ENSURE COORDNDATION WITH THE LOCAL FIRE DEPARTMENT, PARAMEDICS, AND CLEAN-UP CONTRACTOR. AND IN CHARGE PERSONNEL WILL MEET THE FIRST RESPONDERS. USE OF EMERGENCY RESPONSE EQUIPMENT AND MATERIALS UNDER THE BUSINESS CONTROL: PERIODICALLY INSPECT AND MAINTIAN SAFETY EQUIPMENT (FIRE EXTINGUISHERS, EYE WASH STATIONS), AND REVIEW OF PROCEDURES FOR PROPER USE OF SAFETY AND SPILL CONTROL EQUIPMENT. HAZARDOUS MATERIALS BUSINESS PLAN IMPLEMENTATION: REVIEW THE PLAN, EVACUATION PROCEDURES, AND LOCATION OF EMERGENCY SHUT-OFF SWITCHES AND SPECIFIC RESPONSIBILITIES OF ALL EMPLOYEES. ENSURE ALL EMPLOYEES ARE AWARE OF THE LOCATION OF THE HAZARDOUS MATERIALS BUSINESS PLAN AND MSDS. NEW EMPLOYEE TRAINING: EMPLOYEES NEW TO THE LOCATION ARE PROVIDED WITH THE TRAINING SPECIFIED ABOVE. 9 rayc c. Held for Future Use -11- 06/29/2007 L iE F AT&T MOBILITY-BAKERSFIELD 1 SiteID: 015-021-001274 Fast Format ~ Training Overall Site nciu ivi ru~uic use -12- 06/29/2007 USID°~92203~• UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I. IDENTIFICATION FACILITY ID# ~ BEGINNING DATE too ENDING DATE tot 1274 8/13/2007 8/13/2008 BUSINESS NAME (Same as FACit.iTr NAME or osA- Doing ausiness As) 3 BUSINESS PHONE 102 AT&T Mobility- Bakersfield BSC 01 (33686) 425-580-4902 BUSINESS SITE ADDRESS 103 1520 20th Street - CITY 104 ZIP CODE tos CA Bakersfield 93301 DUN & BRADSTREET 106 SIC CODE (4 digit #) to7 10-202-6754 4812 COUNTY 106 KERN BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE tto AT&T Mobilit 425-580-4902 II. BUSINESS OWNER OWNER NAME 111 OWNER PHONE 112 New Cin ular Wireless PCS, LLC; dba AT&T Mobility 425-580-4902 OWNER MAILING ADDRESS 113 PO Box 97061 CITY 114 STATE 115 ZIP CODE 116 Redmond WA 98073-9761 III. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE ~ 16 Debra Okano 562-468-6495 CONTACT MAILING ADDRESS tts 12900 Park Place Dr. 3rd Floor CITY 120 STATE 121 ZIP CODE 122 Cerritos CA 90703 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123 NAME 126 Debra Okano Wireless Network Control Center TITLE 124 TITLE t29 Network Mana er, Compliance Control Center BUSINESS PHONE 125 BUSINESS PHONE 130 562-468-6495 800-832-6662 24•HOUR PHONE 126 24•HOUR PHONE 101 800-832-6662 800-832-6662 PAGER # 127 PAGER # 132 949-338-8434 N/A ADDITIONAL LOCALLY COLLECTED INFORMATION: 133 Property Owner: New Cingular Wireless PCS, LLC; dba AT&T Mobility Note: Please send to the ATTENTION of EH&S. Please note that all Hazmat related Billing, Permitting and Correspondences need to be mailed to the "Owner Mailing Address" listed above. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF 0 RIOPERATO OR DESIGNATED REPRESENTATIVE DATE t3a NAME OF DOCUMENT PREPARER t3s 8/13/2007 Jackie Schnell NAME OF SIGNER (print) 136 TITLE OF SIGNER 137 Donald Harris Director, EH&S UPCF (1/99) ~ i~~_~ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - cHEMicAI_ DESCRiPTioN one e r material r buildin or area ^ADD ^DELETE ®REVISE zoo I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) 3 AT&T Mobilit -Bakersfield BSC 01 33686 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA zo2 Inside cell site ^ YES ® NO FACILITY ID # 1 MAP# (optional) 203 GRID# (optional) 204 1274 ~`~" `. , II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os Lead Pb a subject to EPCRA, rater to instructions COMMON NAME 20~ 208 EHS' ^Yes ®No Lead-Acid Batteries CAS# 209 *If EHS is "Yes", all amounts below must be in lbs. 7439-92-1 FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 2t0 Health: 3 Fire: 0 Reactive:2 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ®b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^Yes ®No 2f2 CURIES: WA 213 PHYSICAL STATE (Check one item only) ®a. SOLID ^ b. LIOUID ^ c. GAS 2f4 LARGEST CONTAINER: 416 215 FED HAZARD CATEGORIES 215 (Check all that apply) ^ a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ^ d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 2t7 MAXIMUM DAILY AMOUNT zt8 ANNUAL WASTE AMOUNT 215 STATE WASTE CODE zzo 59904 59904 N/A N/A zzt DAYS ON SITE: 222 UNITS' ^ a. GALLONS ^ b. CUBIC FEET ®c. POUNDS ^ d. TONS 365 Check one item onl ' If EHS, amount must be in unds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CANS ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER -Batteries ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ .TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 2za STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 65-70% 2zs Lead (Pb) ~~ ^Yes ®No 22a 7439-92-1 229 2 7-9% 230 Sulfuric Acid (H2SOa) zat ®Yes ^ No 2sz 7664-93-9 z33 s 21-28% zaa Water (H20) 235 ^Yes ®No z3s None zs~ 4 z3a zss ^Yes ^ No 2ao eat 5 za2 zas ^Yes ^ No 244 245 If more hazardous components are present at greater than 1% by weight if nontarcinogenic, or 0.1%by weight if carcinogenic, attach ad ditional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION: zas If EPCRA Please Si n Here ~.. ~ ` UPCF (1/99) ' •=?~ r. -_ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - cHEMicAL oESCRiPTioN one e r material er buildin or area ^ADD ^DELETE ®REVISE 200 I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 AT&T Mobilit -Bakersfield BSC 01 33686 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 Inside Lead-Acid Batteries ^ YES ®NO FACILITY ID # t MAP# (optional) 203 GRID# (optional) 204 1274 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os Electrol a If Subject to EPCRA, refer to instructions COMMON NAME 207 2oa EHS" ^Yes ®No Lead-Acid Batte CAS# 2os "If EHS is "Yes", all amounts below must be in lbs. 7664-93-9 FIRE CODE HAZARD CLASSES (Complete if required by CuPA) 210 N/A HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ®b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES: N/A 213 PHYSICAL STATE (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS 214 LARGEST CONTAINER: 14 215 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ®b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 216 ANNUAL WASTE AMOUNT z19 STATE WASTE CODE 2zo 2016 2016 N/A N/A 221 DAYS ON SITE: 222 UNITS" ®a. GALLONS ^ b. CUBIC FEET ^ c. POUNDS ^ d. TONS " 365 Check one item onl If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTICINONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CANS ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER - Lead-ACid Battery ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ .TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 40-50% 22s Sulfuric Acid 227 ®Yes ^ No 22e 7664-93-9 22s 2 50-60% 230 Water 231 ^Yes ®No 232 None 233 3 234 235 ^Yes ^ NO 236 237 4 23s 23s ^Yes ^ No 2ao z41 g zaz 2a3 ^Yes ^ No 244 245 11 more hazardous components are present at greater than 1% by weight i1von-carcinogenic, or 0.1%by weight it carcinogenic, attach ad ditional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION: zas DOT Hazard Class (rl2soa): 8.0 If EPCRA Please Si n Here UPCF (1/99) s=':~ :; ~4 ~ R , ~~~~-~ t+cCVt50ri/ - 3as-o~~~ 3 3d- q9 ~~ a~y~ yap ., - ~~:~~~ ., `~'` - - -. ~ ~{. '-''+as G5'~~~ UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION ~ ~ ~~ BUSINESS OWNER/OPERATOR IDENTIFICATION Pa e 2 of 2 I. IDENTIFICATION FACILITY ID # 1 BEGINNING DATE 100 ENDING DATE I01 (Agency Use only) - 02/01/2007 02/01/2008 BUSINESS NAME (sa~rx ~ Fncll.trv Nnt~I 3. BUSINESS PHONE 102 AT&T Mobility -BAKERSFIELD 1 (33686) (425) 580-4902 BUSINESS SITE ADDRESS 103 1520 20TH STREET CITY 104 ZIP CODE los. BAKERSFIELD 93301 oo~ 106. DUN & BRADSTREET SIC CODE (4 digit #) 107 ~ 10-202-6754 ~ 4812 couNTY 108 Kern BUSINESS OPERATOR NAME tog. BUSINESS OPERATOR PHONE I1°. AT8~T Mobility 425 580-4902 ext. II. BUSINESS OWNER OWNER NAME 111. OWNER PHONE 112 New Cingular Wireless PCS, LLC 425 580-4902 ext. OWNER MAILING ADDRESS 113. P O Box 97061 CITY 11a. STATE 115 ZIP CODE 1t6. Redmond WA 98073-9761 III. ENVIRONMENTAL CONTACT CONTACT NAME I t7. CONTACT PHONE I Is. Debra Okano 562 468 - 6495 ext. CONTACT MAILING ADDRESS 1t9 12900 Park Place Drive, 3rd Floor CITY 120 STATE Izl. ZIP CODE 1zz. Cerritos CA 90703 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123. NAME 1zs. Debra Okano Wireless Network Control Center TITLE 12a. TITLE 1z9. Network Manager, Compliance Control Center BUSINESS PHONE 12s. BUSINESS PHONE 130. 562 468 - 6495 ext. 800 832-6662 ext. 24-HOUR PHONE* 1z6. 24-HOUR PHONE* 131. 949 338 - 8434 ext. 800 832-6662 ext. PAGER # 127. PAGER # , 1 nA ~ 13z. N/A N/A { Yy,~ ,Y~, ADDITIONAL LOCALLY COLLECTED INFORMATION: t33. Billing Address: P O Box 97061, Redmond, WA 98073-9761 Property Owner: New Cingular Wireless PCS, LLC - DBA: AT8tT Mobility Phone No.: (425) 580-4902 Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATUR F OWNER/ E TOR R SIGNATED REPRESENTATIVE DATE . 134. NAME OF DOCUMENT PREPARER 135. - - ~~ ~ Steven Y Jin E O IGNER (print) 136. TITLE OF SIGNE 137. Sian Wiltshire Environmental Com liance S ecialist UN-020 - 4/17 www.unidocs.org Rev. 07/24/06 ' , F j~ CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 Manager ELIZABETH MARTINEZ BusPhone: (425) 580-7515 Location: 1520 20TH ST Map 103 CommHaz High City BAKERSFIELD Grid: 30A FacUnits: 1 AOV: CommCode: BFD STA O1 EPA Numb: SIC Code:4813 DunnBrad:006980800 Emergency Contact / Titl Emergency Contact / Title CHRISTINA WAGER / WIRELESS NETWORK / CONTROL CENTER Business Phone: (562) 4 -6164x Business Phone: (800) 832-6662x 24-Hour Phone (800) 2-6662x 24-Hour Phone (800) 832-6662x Pager Phone ( - x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth Contact CHRI TI WAGER Phone: (562) 468-6164x MailAddr: PO 97061 State: WA City MO Zip 98073 Owner NEW CINGULAR WIRELESS PCS LLC Phone: (425) 580-7515x Address PO BOX 97061 State: WA City REDMOND Zip 98073 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ' d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT s~ 1 2007 PROG T - ABOVEGROUND STORAGE TANK ~~'j'D APR l PROG U - UST 1 ~O Based on my inquiry of those individuals responsible for obtaining the information, I certify ~, Q~ ~'~`' ~ ~,.p.p C under enalt of law that I h ll ll.'~X~ p y ave persona y examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ~ '~ ~~ ~~ ~ Sig ture Date -1- 01/29/2007 • ~ ~- -ry' F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 ~ --- STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: CINGULAR WIRELESS 33686 NEW Cross Street Business Type: Org Type: Total Tanks 1 IndnRes/Trust: No PA Contact: Dsg Own/Oper NEW CINGULAR WIRELESS PCS LLC ICC Nbr: PROPERTY OWNER INFORMATION Name WIRELESS NETWORK Phone: (800) 832-6662x Address: City State: Zip: Type . Name WIRELESS NETWORK Address: City Type BOE UST Fee# Financ'1 Resp: Legal Notif Date: Name: State UST # TANK OWNER INFORMATION Phone: (800) 832-6662x State: Zip: Phone: ( ) Ttl: 1998 Upg Cert#: x -2- 01/29/2007 .. F CINGUT,AR WIRELESS 33686 NEW SiteID: 015-021-001274 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order .Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP SULFURIC ACID R IH L 5967.36. LBS Mod DIESEL L 8000.00 GAL Low DIESEL L 400.00 GAL Low -3- 01/29/2007 -4- 01/29/2007 F CINGULAR WIRELESS 33686 NEW SitelD: 015-021-001274 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME SULFURIC ACID Days On Site 365 Location within this Facility Unit Map: Grid: BASEMENT 3RD FLR CAS# 7664-93-9 Liquid TMixture ~mbRent~E ~ AmbientT~E ABOVE GROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 369.41 LBS 5967.36 LBS 5643.84 LBS - tlti~rj.lcl~vu~ ~ulnrvlv~lvta °sWt. RS CAS# 28.00 Sulfuric Acid (EPA) No 7664939 riAGH.ttL S~~SliaJ1~1151V1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Mod ~ Inventory Item 0009 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum ~ Daily Average 8000.00 GAL 8000.00 GAL 8000.00 GAL nliGtiRUV U.7 ~.vl~lrvlvl;ly 1 A aWt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 _ riE~GHtt1.J L~.7.7L' .7 ~J1~1L' 1V l TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -5- 01/29/2007 F CINGULAR WIRELESS 33686 NEW SiteID: 015-02,1-001274 ~ ~ Inventory Item 0010 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 400.00 GAL 400.00 GAL 400.00 GAL t~~tirc.LVU~ ~vinrviv.~iv 1 a %Wt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 tll-~GI~KL 1.7.7 L" .7 J1~1L' 1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -6- 01/29/2007 F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 06/01/2006 ~ AT&T DOES NOT HAVE EMERGENCY RESPONSE TEAMS. THE TECHNICIANS RESPONSIBLE FOR THE MAINTENANCE OF THIS SITE ARE TRAINED TO CONTAIN AND CLEAN UP INCIDENTAL SPILLS WITH THE WORK ENVIRONMENT BY FOLLOWING THE INSTRUCTIONS ON THE MSDS AND AT&T PRACTICE 157-601-701 (STORAGE BATTERIES LEAD ACID TYPE REQUIREMENTS AND PROCEDURES). AT&T WILL USE THE SERVICES OF AN APPROVED CONTRACTED COMPANY TO INITIATE FULL CLEAN-UP AND DISPOSAL OPERATIONS. AT&T INDIVIDUALS WILL CALL THE HAZARDOUS WASTE GROUP WITHIN AT&T 800-8WASTE9 WHO WILL HANDLE THE WASTE REMOVAL FOR ALL LOCATIONS. Employee Notif./Evacuation 06/01/2006 VERBAL ALARM - INDIVIDUAL WILL CALL OUT FIRE, ETC. INDIVIDUAL ENSURES THE BUILDING IS EVACUATED (USUALLY ONE PERSON AT SITE AT A TIME AS SITE IS UNMANNED). EMERGENCY EXITS POSTED - EMPLOYEES ARE AWARE OF THE NEAREST EXIT LOCATION AND THE LOCATION OF ALTERNATE EXITS. MEETING POINTS/RALLY POINTS HAVE BEEN ESTABLISHED OUTSIDE AND CLEAR OF THE BUILDING IN THE EVENT OF AN EMERGENCY. Public Notif./Evacuation 06/01/2006 THE FOLLOWING ALARM SIGNAL WILL BE USED TO BEGIN EVACUATION OF THE FACILITY: HORNS/SIRENS AND VERBAL. EVACUATION MAP IS PROMINENTLY DISPLAYED THROUGHOUT THE FACILITY. Emergency Medical Plan POISON CONTROL CENTER 800-876-4766. HOSPITAL, 420 34TH ST, 327-4647. 06/01/2006 NEAREST HOSPITAL: BAKERSFIELD MEMORIAL -7- 01/29/2007 F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 06/01/2006 ~ BATTERIES: BATTERIES ARE VISUALLY INSPECTED FOR DEFECT/DAMAGE UPON ENTRY TO THE BATTERY LOCATION. ENSURE THE BATTERIES ARE SECURELY MOUNTED. INSPECT BATTERY CABLES FOR CRACKS, FRAYING; ETC. RACKS THAT CONTAIN AND SUPPORT WET CELL BATTERIES HAVE BEEN DESIGNED BY AT&T BELL LABORATORIES, AND ARE DESIGNED TO PRECLUDE TIPPING AND FALLING OF CELLS. FUEL TANKS: SHUT-OFF VALVES ARE VISUALLY INSPECTED AND TESTED. THE EXPOSED LINES LEADING TO AND FROM THE SHUT-OFF VALVES ARE VISUALLY INSPECTED FOR LEAKS. THE FUEL TANKS ARE OF DOUBLE-WALL CONSTRUCTION, THEY ALSO HAVE ELECTRONIC METER DEVICES FOR AMOUNT OF FUEL. THE TANKS ARE ALSO DIP TESTED TO ENSURE THE CORRECT LEVELS OF FUEL. Release Containment 06/01/2006 FREQUENT INSPECTION OF CONTAINERS, SAFETY MATERIAL AND SAFETY EQUIPMENT, BASED ON (CMP) CONTROL MAINTENANCE PLAN. Clean Up 06/01/2006 PERSONNEL NOT REQUIRED .FOR SPILL CONTAINMENT OR CLEAN UP ARE KEPT OUT OF THE AREA. INDIVIDUALS THAT WORK WITH THE HAZARDOUS MATERIALS HAVE BEEN TRAINED TO STABLIIZE/CONTAIN RELEASED MATERIALS. PROVIDE CLEAN-UP OF INCIDENTAL SPILLS WITHIN THEIR WORK ENVIRONMENT USING THE APPROPRIATE MATERIALS ON SITE AND IN ACCORDANCE WITH MSDS GUIDELINES. -8- 01/29/2007 F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site V1.11C1 1CC~V Ul LC L'il:L1VCLL1V11 -9- 01/29/2007 n~ F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~~JCC:1d1 ridGdLU~ Utility Shut-Offs 12/22/2006 A) GAS - NONE B) ELECTRICAL - MAIN COMM POWER SHUT-OFF AT AC DISTR PANEL C) WATER - ALLEY NE CRNR OF BLDG D) SPECIAL - DUE TO EMER ENGINE AUTO START IT MAY BE NECESSARY TO SET ENGINE CONTROL TO MANUAL OR OFF E) LOCK BOX - YES S SIDE MAIN ENTR 15FT R OF FRONT DOOR. AND 15FT ABOVE SIDEWALK IN RED BOX Fire Protec./Avail. Water 12/21/2006 PRIVATE FIRE PROTECTION - PYROLARM DETECTION SYSTEM, 4 ABC EXTINGUISHERS, DRY STANDPIPE SYSTEM, AND WET STANDPIPE SYSTEM. FIRE HYDRANT - W ON 20TH ST AT ALLEY; S ON EYE ST AT ALLEY; E IN ALLEY AT CHESTER AVE; AND N CRNR EYE & 21ST ST. Building Occupancy Level 03./22/2006 UNMANNED SITE -10- 01%29/2007 F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 12/22/2006 ~ BRIEF SUMMARY OF TRAINING PROGRAM: PROCEDURES FOR HANDLING HAZARDOUS MATERIALS: EMPLOYEES ANNUALLY REVIEW THE MSDS AND SAFETY PROCEDURES FOR MATERIALS HANDLED. PROCEDURES FOR COORDINATION WITH EMERGENCY RESPONSE AGENCIES: EMPLOYEES ANNUALLY REVIEW THE EMERGENCY RESPONSE PLAN AND EMERGENCY NOTIFICATION PROCEDURES TO ENSURE COORDNDATION WITH THE LOCAL FIRE DEPARTMENT, PARAMEDICS, AND CLEAN-UP CONTRACTOR. AND IN CHARGE PERSONNEL WILL MEET THE FIRST RESPONDERS. USE OF EMERGENCY RESPONSE EQUIPMENT AND MATERIALS UNDER THE BUSINESS CONTROL: PERIODICALLY INSPECT AND MAINTIAN SAFETY EQUIPMENT (FIRE EXTINGUISHERS, EYE WASH STATIONS), AND REVIEW OF PROCEDURES FOR PROPER USE OF SAFETY AND SPILL CONTROL EQUIPMENT. HAZARDOUS MATERIALS BUSINESS PLAN IMPLEMENTATION: REVIEW THE PLAN, EVACUATION PROCEDURES, AND LOCATION OF EMERGENCY SHUT-OFF SWITCHES AND SPECIFIC RESPONSIBILITIES OF ALL EMPLOYEES. ENSURE ALL EMPLOYEES ARE AWARE OF THE LOCATION OF THE HAZARDOUS MATERIALS BUSINESS PLAN AND MSDS. NEW EMPLOYEE TRAINING: EMPLOYEES NEW TO THE LOCATION ARE PROVIDED WITH THE TRAINING SPECIFIED ABOVE. rca1J. c ~ 11G 11.1. 1V1 L'IAVl.L1G VAC -11- 01/29/2007 a ~u F CINGULAR WIRELESS 33686 NEW SiteID: 015-021-001274 Fast Format ~ Training Overall Site ~ Held for Future Use -12- 01/29/2007 ~\ USID: UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Pa elof I. FACILITY IDENTIFICATION FACILITY ID # 1 EPA ID # (Hazardous Waste Only) 2 BUSINESS NAME (Same as Facility Name of DBA-Doing Business As) 3 AT&T Mobilit - BAKERSFIELD MSC (33686) II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does our facilit .. If Yes, lease com lete these a es of the UPCF.... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases ®YES ^ NO 4 HAZARDOUS MATERIALS INVENTORY (include liquids in ASTs and USTs); or the applicable Federal threshold _ CHEMICAL DESCRIPTION (OES 2731) quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emer enc lan is re wired ursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Formerly swltce Form A) 1. Own or operate underground storage tanks? ^ YES ®NO S UST TANK (one page per tank) (Formerly Form 8) 2. Intend to upgrade existing or install new USTs? ^ YES ®NO 6 UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Fore C) 3. Need to report closing a UST? ^ YES ®NO 7 UST TANK (closure portion -0ne page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTsI Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ^ YES ®NO 8 NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? ^ YES ®NO 9 EPA ID NUMBER -provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted RECYCLABLE MATERIALS REPORT (one recyclable materials (per HSC 25143.2)? ^ YES ®NO 10 perrecycler) 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE ^ YES ®NO I 1 TREATMENT -FACILITY (Formerly DTSC Forms 1772) ONSITE HAZARDOUS WASTE TREATMENT -UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for CERTIFICATION OF FINANCIAL Permit by Rule and Conditional Authorization)? ^ YES ®NO 12 ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE /CONSOLIDATION ^ YES ®NO 13 SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1 l96) 6. Need to report the closure/removal of a tank that was classified as ^yES ®NO 14 HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Fore 12x9) E. LOCAL REQUIREMENTS Is (You may also be required to provide additional information by your CUPA or local agency.) UPCF (1/99) UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page _ of _ I. IDENTIFICATION FACILITY ID# 1 BEGINNING DATE 100 ENDING DATE 101 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE Ioz AT&T Mobility- BAKERSFIELD MSC (33686) 425-580-4902 BUSINESS SITE ADDRESS Io3 1520 20TH STREET CITY 104 ZIP CODE los CA BAKERSFIELD 93301 DUN & BRADSTREET lob SIC CODE (4 digit #) log 10-202-6754 4812 COUNTY 108 Monterey BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE Ilo AT&T Mobility 425-580-4902 II. BUSINESS OWNER OWNER NAME 111 OWNER PHONE 11z New Cingular Wireless PCS, LLC 425-580-4902 OWNER MAILING ADDRESS 113 PO Box 97061 CITY 114 STATE 115 ZIP CODE 116 Redmond WA 98073 III. ENVIRONMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE 118 Debra Okano 562-468-6495 CONTACT MAILING ADDRESS I I9 12900 Park Place Dr. 3`d Floor CITY tzo STATE tzl ZIP CODE t2z Cerritos CA 90703 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123 NAME 12s Debra Okano Wireless Network Control Center TITLE 124 TITLE Iz9 Network Manager, Compliance BUSINESS PHONE 125 BUSINESS PHONE 130 562-468-6495 800-832-6662 24-HOUR PHONE 126 24-HOUR PHONE t31 949-338-8434 800-832-6662 PAGER # 127 PAGER # I32 ADDITIONAL LOCALLY COLLECTED INFORMATION: 133 Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiaz with the information submitted and believe the information is true, accurate, and complete. SI bF OWNER/OPERATOR R DESIGNATED REPRESENTATIVE DATE 134 NAME OF DOCUMENT PREPARER 135 Nicholas Oswood NA I E (poor) 136 ITLE F SIGNER l37 Sian Wiltshire Environmental Compliance Specialist UPCF (1/99) UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - cxEMicAL nESCxiPTioN (one a e r material r buildin or area) ^ADD ^DELETE ®REVISE 20o Page _ of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILTI'Y NAME or DBA -Doing Business As) 3 AT&T Mobilit - BAKERSFIELD MSC (33686) CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL EPCRA zo2 In cell site ^ YES ® NO 1 MAP# (optionaq 203 GRID# (optional) 204 FACILITY ID # II. CHEMICAL INFORMATION CHEMICAL NAME zos TRADE SECRET ^ Yes ®No zob Lead (lead-acid batteries) If Subject to EPCRA, refer [o instructions COMMON NAME zoz 2os EHS* ^ Yes ®No Lead Pb CAS# zo9 *If EHS is "Yes", all amounts below must be in lbs. 7439-92-1 FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL TYPE (Check one item only) ®a. PURE ^ b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^ Yes ®No 2t2 CURIES 213 PHYSICAL STATE (Check one item only) ®a. SOLID ^ b. LIQUID ^ c. GAS 214 LARGEST CONTAINER 416 215 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ^ d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT z17 MAXIMUM DAILY AMOUNT zls ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 59904 59904 N/A 221 DAYS ON SITE: 222 UNITS* ^ a. GALLONS ^ b. CUBIC FEET ®c. POUNDS ^ d. TONS 365 (Check one item onl) * If EHS, amount must be in ands. STORAGE CONTAINER ^ a. ABUVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ®r, OTHER -Batteries ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 224 STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 226 227 ^ Yes ^ NO 228 229 2 230 231 ^ YCS ^ NO 232 233 3 234 235 ^ Yes ^ NO 236 237 4 238 239 ^ Yes ^ NO 240 241 5 za2 za3 ^ Yes ^ No zaa zas If more hazardous components are present a[ greater than 1 %a by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION za6 _ (]C~ If EPCRA Please Si n Here UPCF (I/99) UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - cxE1vl><cAL nESCR><PTION (one a e r material r buildin or area) ^ADD ^DELETE ®REVISE 20o Page ~ of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 AT&T Mobilit - BAKERSFIELD MSC (33686) CHEMICAL LOCATION tot CHEMICAL LOCATION CONFIDENTIAL EPCRA zoz Irl Cell Slte ^ YES ® NO t MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # II. CHEMICAL INFORMATION CHEMICAL NAME zos TRADE SECRET ^Yes ®No zo6 Electrol to (lead-acid batteries) If Subject to EPCRA, refer to instructions COMMON NAME 207 2os EHS* ^Yes ®No Electrol to sulfuric acid CAS# zo9 *If EHS is "Yes", all amounts below must be in lbs. 7664-93-9 FIRE CODE HAZARD CLASSES (Complete if required by CtJPA) 210 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ®b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE 214 (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS LARGEST CONTAINER 14 215 FED HAZARD CATEGORIES 216 (Check all [hat apply) ^ a. FIRE ®b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 2016 2016 N/A zzl DAYS ON SITE: z2z UNITS* ®a. GALLONS ^ b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365 (Check one item onl) * If EHS, amount must be in unds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i. FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ®r. OTHER - Batteries ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ 1. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 224 STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 40-50 226 Sulfuric acid 227 ®Yes ^ No zzs 7664-93-9 229 2 50-60 230 Water 231 ^Yes ® NO 232 233 3 234 235 ^Yes ^ NO 236 237 4 23s 239 ^Yes ^ No zao eat 5 zaz za3 ^Yes ^ No zaa zas If more hazardous components are present al greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets or paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 2a6 If EPCRA Please i n Here UPCF (1/99) Emergency Response/Contingency Plan (Hazardous Materials Business Plan Module) Authority Cited: HSC, Section 25504(b); Title 22, Div. 4.5, Ch. 12, Art. 3 CCR All facilities that handle hazardous materials in specified quantities must have a written emergency response plan. In addition, facilities that generate 1,000 kilograms or more of hazardous waste per month, or accumulate more than 6,000 kilograms of hazardous waste on-site at any one time, must prepare a contingency plan. Because the requirements are similar, they have been combined in a single document, provided below, for your convenience. This plan is a required module of the Hazardous Materials Business Plan (HMBP). If you already have a plan that meets these requirements, you should not complete the blank plan, below, but you must include a copy of your existing plan as part of your HMBP. This site-specific Emergency Response/Contingency Plan is the facility's plan for dealing with emergencies and shall be implemented immediately whenever there is a fire, explosion, or release of hazardous materials that could threaten human health andlor the environment. At least one copy of the plan shall be maintained at the facility for use in the event of an emergency and for inspection by the local agency. Within Santa Clara County, hospitals and police agencies have delegated receipt of these plans to the local agencies administering Hazardous Materials Business Plans, so additional copies need not be submitted. However, a copy of the plan and any revisions must be provided to any contractor, hospital, or agency with whom special (i.e. contractual) emergency services arrangements have been made (see section 3, below). 1. Evacuation Plan: a. The following alarm signal(s) will be used to begin evacuation of the facility (check all that apply): ^ Bells; ^ Horns/Sirens; ®Verbal (i. e. shouting); ®Other (specify) b. ^ Evacuation map is prominently displayed throughout the facility. Note: A properly completed HMBP Site Plan satisfies contingency plan map requirements. This drawing (or any other drawing that shows primary and alternate evacuation routes, emergency exits, and primary and alternate staging areas) must be prominently posted throughout the facility in locations where it will be visible to employees and visitors. 2. a. Emergency Contacts*: Fire/Police/Ambulance ................................:........ State Office of Emergency Services ............................. . b. Post-Incident Contacts*: Bakersfield Fire Department California EPA Department of Toxic Substances Control ........... . Cal-OSHA Division of Occupational Safety and Health ............. . Air Quality Management District ....................... . Phone No. 911 Phone No. (800) 852-7550 Phone No. (661) 326-3979 Phone No. (510) 540-3739 Phone No. (408) 452-7288 Phone No. (415) 771-6000 Regional Water Quality Control Board ........................... Phone No. (510) 622-2300 * These telephone numbers are provided as a general aid to emergency notification. Be advised that additional agencies may be required to be notified. c. Emergency Resources: Poison Control Center ....................................... Phone No. (800) 876-4766 Nearest Hospital: Name: MERCY MEDICAL CENTER-SOUTHWEST Phone No.: 661-663-6100 Address: 400 Old River Rd City: BAKERSFIELD 3. Arrangements With Emergency Responders: If you have made special (i.e. contractual) arrangements with any police department, fire department, hospital, contractor, or State or local emergency response team to coordinate emergency services, describe those arrangements below: UPCF (1/99) Eme"rgency Response/Contingency Plan (HMBP Module) 4. Emergency Procedures: Emer„pency Coordinator Responsibilities: a. Whenever there is an imminent or actual emergency situation such as a explosion, fire, or release, the emergency coordinator (or his/her designee when the emergency coordinator is on call) shall: i. Identify the character, exact source, amount, and areal extent of any released hazardous materials. ii. Assess possible hazards to human health or the environment that may result from the explosion, fire, or release. This assessment must consider both direct and indirect effects (e.g. the effects of any toxic, irritating, or asphyxiating gases that are generated, the effects of any hazardous surface water run-off from water or chemical agents used to control fire, etc.). iii. Activate internal facility alarms or communications systems, where applicable, to notify all facility personnel. iv. Notify appropriate local authorities (i. e. call 911). v. Notify the State Office of Emergency Services at 1-800-852-7550. vi. Monitor for leaks, pressure build-up, gas generation, or ruptures in valves, pipes, or other equipment shut down in response to the incident. vii. Take all reasonable measures necessary to ensure that fires, explosions, and releases do not occur, recur, or spread to other hazardous materials at the facility. b. Before facility operations are resumed in areas of the facility affected by the incident, the emergency coordinator shall: i. Provide for proper storage and disposal of recovered waste, contaminated soil or surface water, or any other material that results from a explosion, fire, or release at the facility. ii. Ensure that no material that is incompatible with the released material is transferred, stored, or disposed of in areas of the facility affected by the incident until cleanup procedures are completed. iii. Ensure that all emergency equipment is cleaned, fit for its intended use, and available for use. iv. Notify the California Environmental Protection Agency's Department of Toxic Substances Control, the County of Santa Clara's Hazardous Materials Compliance Division, and the local fire department's hazardous materials program that the facility is in compliance with requirements b-i and b-ii, above. Responsibilities of Other Personnel: On a separate page, list any emergency response functions not covered in the "Emergency Coordinator Responsibilities" section, above. Next to each function, list the job title or name of each person responsible for performing the function. Number the page(s) appropriately. 5. Post-Incident Reporting/Recording: The time, date, and details of any hazardous materials incident that requires implementation of this plan shall be noted in the facility's operating record. Within 15 days of any hazardous materials emergency incident or threatened hazardous materials emergency incident that triggers implementation of this plan, a written Emergency Incident Report, including, but not limited to a description of the incident and the facility's response to the incident, must be submitted to the California Environmental Protection Agency's Department of Toxic Substances Control, the County of Santa Clara's Hazardous Materials Compliance Division, and the local fire department's hazardous materials program. The report shall include: a. Name, address, and telephone number of the facility's owner/operator; b. Name, address, and telephone number of the facility; c. Date, time, and type of incident (e.g. fire, explosion, etc.); d. Name and quantity of material(s) involved; e. The extent of injuries, if any; f. An assessment of actual or potential hazards to human health or the environment, where this is applicable; g. Estimated quantity and disposition of recovered material that resulted from the incident; h. Cause(es) of the incident; i. Actions taken in response to the incident; j. Administrative or engineering controls designed to prevent such incidents in the future. 6. Earthquake Vulnerability: [19 CCR §2731(e)] Identify any areas of the facility and mechanical or other systems that require immediate inspection or isolation because of their vulnerability to earthquake-related ground motion: UPCF (1/99) Emeigency Response/Contingency Plan 7. Emergency Equipment: 22 CCR §66265.52(e) [as referenced by 22 CCR §66262.34(a)(4)] and the Hazardous Materials Storage Ordinance require that emergency equipment at the facility be listed. Completion of the following Emergency Equipment Inventory Table meets this requirement. EMERGENCY EQUIPMENT INVENTORY TABLE 1. Equipment Cate or 2. Equipment T e 3. Locations * 4. Descri tion** Personal ^ Car[rid a Res irators Protective ^ Chemical Monitorin E ui ment (describe) Equipment, ^ Chemical Protective A rons/Coats Safety ^ Chemical Protective Boots Equipment, ®Chemical Protective Gloves and ^ Chemical Protective Suits (describe) First Aid ®Face Shields Equipment ®First Aid Kits/Stations (describe) ^ Hard Hats ^ Plumbed E e Wash Stations ^ Portable E e Wash Kits (i.e. bottle e) ^ Res irator Cartrid es (describe) ® Safet Glasses/S lash Go les ^ Safet Showers ^ Self-Contained Breathin A aratuses (SCBA) ^ Other (describe) Fire ^ Automatic Fire S rinkler S stems Extinguishing ^ Fire Alarm Boxes/Stations Systems ®Fire Extin uisher S stems (describe) ^ Other (describe) Spill ®Absorbents (describe) Control ^ Berms/Dikes (describe) Equipment ^ Decontamination E ui ment (describe) and ^ Emer enc Tanks (describe) Decontamination ^ Exhaust Hoods Equipment ^ Gas C tinder Leak Re air Kits (describe) ^ Neutralizers (describe) ^ Ove ack Drums ^ Sum s (describe) ^ Other (describe) Communications ^ Chemical Alarms (describe) and ^ Intercoms/ PAS stems Alarm ^ Portable Radios Systems ®Tele hones ^ Under round Tank Leak Detection Monitors ^ Other (describe) Additional ^ Equipment ^ (Use Additional ^ Pages if Needed.) ^ * Use the map and grid numbers from the Storage Map prepared earlier for your HMBP. ** Describe the equipment and its capabilities. If applicable, specify any testing/maintenance procedures/intervals. Attach additional pages, numbered appropriately, if needed. UPCF (1/99) Employee Training Plan (Hazardous Materials Business Plan Module) Authority Cited: HSC, Section 25504(c); Title 22, Div. 4.5, Ch. 12, Art. 3 CCR All facilities that handle hazardous materials must have a written employee training plan. This plan is a required module of the Hazardous Materials Business Plan (HMBP). A blank plan has been provided below for you to complete and submit if you do not already have such a plan. If you already have a brief written description of your training program that addresses all subjects covered below, you are not required to complete the blank plan, below, but you must include a copy of your existing document as part of your HMBP. Check all boxes that apply. [Note: Items marked with an asterisk (*) are required.]: 1. Personnel are trained in the following procedures: ® Internal alarm/notification ® Evacuation/re-entr rocedures & assembl oint locations* ® Emer enc incident re ortin ® External emer enc res onse or anization notification ® Location(s) and contents of Emer enc Res onse/Contin enc Plan ® Facility evacuation drills, that are conducted at least (specify) (e.g. "Quarterly", etc.) 2. Chemical Handlers are additionally trained in the following: ® Safe methods for handlin and stora e of hazardous materials ® Location(s) and ro er use of fire ands ill control a ui ment ® Sill rocedures/emer enc rocedures ® Pro er use of ersonal rotective a ui ment ® Specific hazard(s) of each chemical to which they may be exposed, including routes of exposure (i.e. inhalation, ingestion, absor tion) ^ Hazardous Waste Handlers/Managers are trained in all aspects of hazardous waste management specific to their job duties (e.g. container accumulation time requirements, labeling requirements, storage area inspection requirements, manifesting re uirements, etc.) 3. Emergency Response Team Members are capable of and engaged in the following: ® Personnel rescue rocedures ® Shutdown of o erations ® Liaison with res ondin a encies ® Use, maintenance, and re lacement of emer enc res onse a ui ment ® Refresher trainin ,which is rovided at least annual] ® Emergency response drills, which are conducted at least (specify) (e.g. "Quarterly", etc.) UPCF (1/99) a Record Keeping (Hazardous Materials Business Plan Module) All facilities that handle hazardous materials must maintain records associated with their management. A summary of your recordkeeping procedures is a required module of the Hazardous Materials Business Plan (HMBP). A blank summary has been provided below for you to complete and submit if you do not already have such a document. If you already have a brief written description of your hazardous materials recordkeeping systems that addresses all subjects covered below, you are not required to complete this page, but you must include a copy of your existing document as part of your HMBP. Check all boxes that apply. The following records are maintained at the facility. (Note: Items marked with an asterisk (*) are required.]: ® Current'em to ees' trainin records (to be retained until closure o the acili ) ® Former em to ees' trainin records (to be retained at least three ears a er termination o em to ment) ® Trainin Pro ram(s) (i.e. written descri tion o introducto and continuin trainin) ® Current co of this Emer enc Res onse/Contin enc Plan ® Record of recordable/re ortable hazardous material/waste releases ® Record of hazardous material/waste stora a area ins ections ^ Record of hazardous waste tank dail ins ections ® Descri tion and documentation of facilit emer enc res onse drills Note: The above list of records does not necessarily identify every type of record required to be maintained by the facility. A copy of the Inspection Check Sheet(s) or Log(s) used in conjunction with required routine self- inspections of your facility must be submitted with your HMBP. (Exception: Available from your local agency is a Hazardous Materials/Waste Storage Area Inspection Form that you may use if you do not already have your own form. If you use the example provided, you do not need to attach a copy.) Check the appropriate box: ® We will use the Unidocs "Hazardous Materials/Waste Storage Area Inspection Form" to document inspections. ^ We will use our own documents to record inspections. (A blank copy of each document used must be attached to this HMBP) UPCF (1/99) _ Teter, _ -- ~ ~ R~ _~-._ - - - ~ SW'T~N ROeb r ~ t TF::fA RCOFI ~ i i ?t7 r, ~T T~ . . .. ' ,.5, ~ ~ ti _1 . ____ ~ Wr.li{OT RCX1M _. _._._.-i . ~SS ! . __ .. ._. I f ( TO7K SOU6RE f70TAy ""1 l - G i S' c, l.._.__.______.~_._.- , _L~--- { 17;70.1, USfD W eW5 ` ~ 6,131 _J t i Q O O O E F ~ ~ Y ~~ 1 f i ~ ~~~ .~~--., ~~ ~ f ,: ~ ~~ 1 ; R m I~ ~ ~.~ to ~. - ~ ~ ~ .~noua ' . ~ s - --:_._.... _~.:.na~ i - fl_-- _r-..~.--,.__ _ I - ~ 1 FOURTH FIAOR PL1N NE1- 1fORK ~ T~Z 1 ~ 7. r.,.. .i ~' . - - ~E~ _-~ 1 ..._1r.. -..i• ~-_ a!!srr..lr~._L'•~17a_.._.~ -.-..~ 1 _ ..__._ .. q O 1 _._- o ~ - 3 ~! ~~ ... . I, i ^~i - __.___~ _. __.....- _ .- ~ _,-~sc~ _ Li~27`D 3 ?52~ 207E S-REE" rKERSFIEID CA _~33u1 i-C~t jj[. D! m ~:r....++.~~ '-re~F aa+e. ~t ~~ w- f''f' tas7 :,eft cm•o- :;-v-ot - ~- .~.-.~..~ ,~,,,,..K , 1 i t .~_~ y~rT M March 28, 2007 l / F~ ~i~i -e~ Environment; He filth & Safety 30b S. k a.rd ~t eet: I2ootn 1700 Dallas, TX 75202 RE: UPDATE OF DESIGNATED UST OPERATOR INFORMATION FOR AT&T CORP. FACILITIES To Whom it may Concern: We respectfully request you update your records to reflect the following administrative changes to our previously submitted Designated Operator information. We have enclosed an updated submission form for each site within your jurisdiction highlighting the primary Designated Operator for that facility. Additionally, you will find an addendum listing the alternate Designated Operators. This update is required to reflect changes to staffing and to provide ICC Certificate Numbers and expiration dates for our assigned Designated Operators (i.e. Tait Environmental Systems) providing services for AT&T Corp. If you have any questions or require any additional information, please feel free to contact me at (214) 464-3131 or by email at jw1288~att.com . Sincerely, ~,~._~ ~~ Jason D. Weller Manager -Environment, Health & Safety AT&T Services, Inc. Cc: Site-Specific ESM EH&S File Copy ~:4 vy y UNDERGROUND STORAGE TANK SYSTEM OWNER STATEMENTS OF DESIGNATED UST OPERATOR AND UNDERSTANDING OF AND COMPLIANCE WITH UST REQUIREMENTS For use by Unidocs Member Agencies or where approved by your Local Jurisdiction Authority Cited: Title 23, Div. 3, Ch. 16 California Code of Regulations (CCR) FACILITY NAME FACILITY PHONE AT&T Corp. (CAK010) (661) 325-0572 FACILITY SITE ADDRESS CITY 1520 20th St. Bakersfield REASON FOR SUBMITTING THIS FORM (Check One): ®Change of Designated Operator ^ Update of ICC Certification Expiration Date(s) PRIMARY DESIGNATED UST OPERATOR FOR THIS FACILITY DESIGNATED OPERATOR NAME: Phli HOIbrOOk RELATION TO UST FACILITY (Check One) BUSINESS NAME (Ifdi/ferentfromobove): Talt Ef1VlrOnmental SyStemS ^ Owner ^ Operator ^ Employee DESIGNATED OPERATOR PHONE: (714) 920-$236 ext. ^ Service Technician ® Third-Party INTERNATIONAL CODE COUNCIL CERTIFICATION NO.: 5252931 _UC EXPIRATION DATE: 1 O/3O/2OOH ALTERNATE 1 DESIGNATED UST OPERATOR FOR THIS FACILITY(Optional) DESIGNATED OPERATOR NAME: See Attached LISt Of Alternates RELATION TO UST FACILITY (Check One) BUSINESS NAME (/f differentfrom above): Tait Environmental Systems ^ Owner ^ Operator ^ Employee DESIGNATED OPERATOR PHONE: ( )See Attached ext. ^ Service Technician ®Third-Party INTERNATIONAL CODE COUNCIL CERTIFICATION NO.: See Attached EXPIRATION DATE: See Attached ALTERNATE 2 DESIGNATED UST OPERATOR FOR THIS FACILITY (Optional) DESIGNATED OPERATOR NAME: RELATION TO UST FACILITY (Check One) BUSINESS NAME (If different from above): ^ Owner ^ Operator ^ Employee DESIGNATED OPERATOR PHONE: ( ) eXt. ^ Service Technician ^ Third-Party INTERNATIONAL CODE COUNCIL CERTIFICATION NO.: EXPIRATION DATE: ALTERNATE 3 DESIGNATED UST OPERATOR FOR THIS FACILITY (Optional) DESIGNATED OPERATOR NAME: RELATION TO UST FACILITY (Check One) BUSINESS NAME (If different from above): ^ Owner ^ Operator ^ Employee DESIGNATED OPERATOR PHONE: ( ) ext. ^ Service Technician ^ Third-Party INTERNATIONAL CODE COUNCIL CERTIFICATION NO.: EXPIRATION DATE: I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Designated UST Operator(s). The individual(s) will conduct and document monthly facility inspections and annual facility employee training in accordance with California Code of Regulations, Title 23, Section 2715(c) through (f). Furthermore, I understand and am in compliance with the requirements (statutes, regulations, and local ordinances) applicable to underground storage tanks. TANK OWNER NAME: Ja$on Weller TANK OWNER TITLE: Manager, EH&S owNER PxoNE: (214) 464-3131 TANK OWNER SIGNATURE: DATE: O3- ZC~- © ~ INSTRUCTIONS 1. Report the name(s) of the Designated UST Operator(s) as registered with the International Code Council (ICC). ICC certification information is available on-line at: www.iccsafe.org/e/certsearch.html. Search for "California UST System Operators." 2. Submit this completed form to the local agency that regulates this facility's USTs. Unidocs member agency jurisdictions and contact information are listed on-line at: www.unidocs.org/members/whoregulateswhat.html. Contact information for other local agencies within California is available at: www.swrcb.ca.gov/cwphome/ust/contacts/docs/local agency_list.xls. 3. 23 CCR §2715(a) requires that you notify the local agency of any changes to this information within 30 days of the date of change. UN-062 -171 www.unidocs.org 09/22/05 ,.~.: ,= ,: ,- -~ . ~~ - Tait Environmental Systems Licensed Designated Operators Designated Operator Program Director: Andy Salmond - 714.560.8217 Name D.O. License# Exp. Date Phone Aguilar, Adolfo 5238610-UC 08/26/2008 714.560.8200 Butler, Shaun 5245828-UC 11/24/2008 714.920.7818 Dawson, Peter 5280692-UC 03/29/2008 714.920.8238 Durham, Eric 5240929-UC 01/07/2008 714.920.8239 Fowler, Kirk 5243705-UC 09/25/2008 714.920:8201 Graham, Stephen 5240926-UC 08/15/2008 714.560.8200 Holbrook, Phil 5252931-UC 10/30/2008 714.920.8236 Koffel, George 5247982-UC 12/19/2008 714.920.5387 Kostel, Timothy 5248172-UC 08/31/2008 714.920.8214 Meckfessel, Don 5238770-UC 06/22/2008 714.920.8215 Pesic, Dragan 5240928-UC 10/26/2008 714.560.8200 Rogers, Brian 5248762-UC 11/22/2008 714.920.7661 Southwick, Sean 5238654-UC 06!30/2008 714.920.7970 Thurston, Yolanda 5253048-UC 11/21/2008 714.920.7056 Yellish, John 5249179-UC 11/22/2008 714.920.8189 *See Attached RightFax 2/2/2007 12:14 PAGE 002/002 Fax Server 7 ~0 7-~70.~0 7 STATEMENT OF ACCOUNT PAGE 1 ~ ~~~~ fJ~ e ® ~yeOkq ,ta ~ \~- P,r ` ..id c ~~ ~ ~ i~~'O CITY OF BAKERSFIELDL~ ~'~~~~,~ F+~B ~ Ztt~l D 4 ~ ~( P O BOX 2057 D ~~~' ,~'~,~ BAKERSFIELD, CA 93303-2057 _-I,~,~~y.~~'~~o~4i''- (661) 326-3678 7`~ a .~- !/ T~ ~ - ~ DATE: 1/01/07 TO • CrNri7r A72 t~7?'~Er.FCe ~ Z ~st~ rT~.~ • Dn n~~ c~?nc~ ,S' ~OO~ RE: 152Q 20TH~~ ~a~~ Q~10~, ~ 9~Sb'3~09~IS REDMOND, WA 98073 ~N I'D MAR 2 2007 CUSTOMER NO: 3742/3742 TYPE: ES - ENVIRONMENTAL SERVICES - ------- CHARGE --------- DATE ----------------------------------------------------------- DESCRIPTION REF-NUMBER DUE DATE TOTAL AMOUNT 12/01/06 BEGINNING BALANCE .00 HMO10 1/01/07 HAZ MAT FEE GROUP 10 414.00 HM017 1/01/07 HAZ MAT ANNUAL INSPECTION 93.00 SS001 1/01/07 CA STATE SURCHARGE 24.00 SS002 1/01/0? UST STATE SURCHARGE 15.00 THIS FEE IS A STATE SURCHARGE OF $15.00 FOR EACH UNDERGROUND STORAGE TANK. UT001 1/01/07 UNDERGROUND TANK ANNUAL 93.00 OPERATING PERMIT FEE --~ FOR QUESTIONS OR CHANGES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT -------------- -------------- -------------- -------------- CURRENT OVER 30 OVER 60 OVER 90 -------------- -------------- -------------- -------------- ~ 639.00 - - -- -- -- - - yrr~._ ~...- _ /31/07 ,~ MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited.• Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepazed for each monitoring system control panel by the technician who perfom~s the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. Generallnformation Facility Name: AT&T LEGACY T SITE Site Address: 1520 20TH STREET Facility Contact Person: RICHARD HANSON GEO PAR # CAKO10 CLLC Code: BKFDCA01 City: BAKERSFIELD Zip: Contact Phone No.: (661) 332-9901 Make/Model of Monitoring System: VEEDER ROOT TLS 350 B. Inventory of Equipment Tested/Certfied Check the appropriate boxes to indicate specific equipment inspected/serviced: Date of Testing/Service 93301 4/11/07 Tank ID: DIESEL Tank ID: DAY TANK : ~.; ®In-Tank Gauging Probe: Model: 847390-109 ®In-Tank Gauging Probe: Model: 847390-301 ®Annular Space or Vault Sensor: Model: 794380-420 ®Annular Space or Vault Sensor Model: 794380-208 ®Piping Sump/Trench Sensor (s): Model: 794380-208 ^Piping Sump/Trench Sensor (s): Model: ®Fill Sump Sensor (s): Model: 794380-208 ^Fill Sump Sensor (s): Model: ^Mechanical Line Leak Detector. Model: ^Mechanical Line Leak Detector. Model: ^Electronic Line Leak Detector Model: ^Electronic Line Leak Detector Model: ®Tank Overfill/High-level Sensor: Model: 790091-001 ®Tank Overfill/High-level Sensor: Model: 790091-001 ^Other, S ecify equi . t e and model in Section E on Page 2 ^Other, S ecify equip. t e and model in Section E on Page 2 Tank ID: Tank ID: ^In-Tank Gauging Probe: Model: ^In-Tank Gauging Probe: Model: ^Annular Space or Vault Sensor: Model: ^Annular Space or Vault Sensor Model: ^Piping Sump/Trench Sensor (s): Model: ^Piping Sump/Trench Sensor (s): Model: ^Fill Sump Sensor (s}: Model: ^Fill Sump Sensor (s): Model: ^Mechanical Line Leak Detector. Model: ^Mechanical Line Leak Detector. Model: ^Electronic Line Leak Detector Model: ^Electronic Line Leak Detector Model: ^Tank OverfilUHigh-level Sensor: . Model: ^Tank Overfill/High-level Sensor: Model: ^Other, S ecify a ui a and model in Section E on Page 2 ^Other, S ecify e uip. e and model in Section E on Page 2 Dispenser ID: CONT. PAN FOR DAY TANK Dispenser ID: ®Dispenser Containment Sensor(s): Model: 794380-208 ^Dispenser Contairunent Sensor(s): Model: ^ Shear Valve(s). ^ Shear Valve(s). _ ^Dispenser Containment Float(s) and Chain(s) ^Dis enser Containment Float(s) and Chain(s) Dispenser ID: Dispenser ID: ^Dispenser Containment Sensor(s): Model: ^Dispenser Containment Sensor(s): Model: ^ Shear Valve(s). ^ Shear Valve(s). ^Dis enser Containment Float(s) and Chain(s) ^Dis enser Containment Float(s) and Chain s) Dispenser ID: Dispenser ID: ^Dispenser Containment Sensor(s): Model: ^Dispenser Containment Sensor(s): Model: ^ Shear Valve(s). ^ Shear Valve(s). ^Dis enser Containment Float(s) and Chain(s) ^Dispenser Containment Float(s) and Chain(s) *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certll~Cat10II - I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the -ayout of monitoring equipment. For any equipment capab of generating such reports, I have also attached a copy of the report; (check all that apply): x^ System set-up Alarm history report Technician Name (Print): S. GRAHAM Signature: Certification No.: A24322 License No.: 588098 Testing Company Name: TAIT ENVIRONMENTAL SERVICES Phone No.: (714) 560-8222 Monitoring System Certification Site Address: 1520 20TH STREET, BAKERSFIELD, CA 93301 -Date of Testing/Servicing: 4/11/07 D. Results of Testing/Servicing Software Version Installed: 120.00 Complete the following checklist: ® Yes ^ No* Is the audible alarm o erational? ® Yes ^ No* Is the visual alarm o erational? ® Yes ^ No*. Were all sensors visually ins ected, functionally tested, and confuined o erational? ® Yes ^ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ro er o eration? ^ Yes ^ No* If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) ® N/A operational? ® Yes ^ No* For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ^ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) ®Sump/Trench Sensors; ®Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ®Yes; ^ No ® Yes ^ No* For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ^ N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill oint(s) and o erating pro erl ? If so, at what ercent of tank ca aci does the alarm trig er? 90 ^ Yes* ®No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement arts in Section E, below. ® Yes* ^ No 'Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ® Product; ^ Water. If yes, describe causes in Section E, below. ® Yes ^ No* Was monitoring system set-u reviewed to ensure roper settings? . ® Yes ^ No* Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected. E. Comments: APPROX. THREE GALLONS LIQUID FOUND IN TURBINE SUMP -LEFT ON SITE. 2. DAY TANK HAS BELLY PAN ENCOMPASSING ALL PIPING ON FOURTH FLOOR THAT DOES SHUT DOWN TURBINE IF AN ALARM OCCURS. CONTROL SYSTEM IN SAME ROOM AS DAY TANK WITH AUDIBLE AND VISUAL ALARM AND PSD. Page 2 of 4 Site Address: 1520 20tH STREET, BAKERSFIELD, CA 93301 Date of Testing/Servicing: 4/11/07 F. In-Tank Gauging /SIR Equipment: ®Check this box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: ® Yes ^ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ® Yes ^ No* Were all tank gauging probes visually inspected for damage and residue buildup? ® Yes ^ No* Was accuracy of system product level readings tested? ® Yes ^ No* Was accuracy of system water level readings tested? ® Yes ^ No* Were all probes reinstalled properly? ® Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): ®Check this box if LLDs are not installed. Complete the following checklist: ^ Yes ^ No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ N/A (Check all that apply) Simulated leak rate: ^ 3 g.p.h.'; ^ 0.1 g.p.h.Z; ^ 0.2 g.p.h.Z Notes: 1. Required for equipment start-up certification and annual certification. 2. Unless mandated by local agency, certification required only for electronic LLD start-up. ^ Yes ^ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ^ Yes ^ No* Was the testing apparatus properly calibrated? ^ Yes ^ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A ^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^ N/A ^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ^ N/A or disconnected? ^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system ^ N/A malfunctions or fails a test? ^ Yes ^ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ^ N/A ^ Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 4 Site Address: ~J~~ ZD ~ f~ ~~~~°~-~~e/0~ ~•O Date of Testing/Servicing: 1!'tonitoring System Certification ~JST Monitori~ Site Plan .~ . ~< .................................................... . ;~ . .~~r,. . . °1~;~t. • n~• Ate I bv,~ ~•`^~ . ' N . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .~.. . . . . . . . 6~,~,N ~ ,„j . ~ ~ t . . . . . . . . . . . . . . . . . . . ?` J . a p~ ~~r~ ~s° 6„l- . . . . . . . . . . , ., y ~i. ~t.,r ~ . . . . . . . . . . . . . . . . . i . .t'. C). . .~. . ~~,.~ r.° . . ~'ti~ o~~~l:l) . .,. . ~. a o.O . .Oj~~cl. . .............................. ` ...O.... B~~ . Date map was drawn: ~ /~/ G~ Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment; if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers; or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page of Page _of 9. Spill Bucket Testing Report Form This form is intended for use by contractors performing annual testing of UST spill containment structures. The completed form-and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. FACILITY INFORMATION Facility Name: ATT LEGACY T SITE Date of Testing: 4/11/07 Facility Address: 1520 20TH STREET, BAKERSFIELD, CA 93301 Facility Contact: RICHARD HANSON Phone: (661) 332-9901 Date Local Agency Was Notified of Testing : 4/9/07 Name of Local Agency Inspector (if present during testing): STEVE UNDERWOOD TESTING CONTRACTOR INFORMATION Company Name: TAIT ENVIRONMENTAL SERVICES Technician Conducting Test: S. GRAHAM Credentials': ®CSLB Contractor ®ICC Service Tech. ^ SWRCB Tank Tester ^ Other (Specify) License Number(s): CSLB = 588098 ICC = 5240926 - UT SPILL BUCKET TESTING INFORMATION Test Method Used: ®Hydrostatic ^ Vacuum ^ Other Test Equipment Used: MARKER AND TAPE Equipment Resolution: VISUAL Identify Spill Bucket (By Tank Number, Stored Product, etc.) 1. DIESEL FILL 2. 3 4 Bucket Installation Type: ^ Direct Bury ®Contained in Sum ^ Direct Bury ^Contained in Sum ^ Direct Bury ^Contained in Sum ^ Direct Bury ^Contained in Sum Bucket Diameter: 11.5" Bucket Depth: 14.0" Wait time between applying vacuum/water and start of test: 15 MINUTES Test Start Time (T~): 10:50 Initial Reading (R,): 9.0" Test End Time (TF): 11:30 Final Reading (RF): 9.0" Test Duration (TF - T~): ONE HOUR Change in Reading (RF - R~): -0- Pass/Fail Threshold or Criteria: 0 Test 'Result: ®Pass; ^ Fail ^-.Pass ^ Fail ^ Pass ^ Fail ^ Pass ^ Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) ALL WATER LEFT ON SITE WITH WATER PUMPED FROM TURBINE SUMP. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the information contained in this report is true, accurate, and in full compliance with legal requirements. Technician's Signature: Date: 4/11/07 ' State laws and regulations do not currently require testing to be performed by a qualified contractor. However, local requirements maybe more stringent. B~};Ek'~ .F I ELL:' iTT tiPk l U. '~'.U1:1~' S: 51 F'f'9 4 5 _ `, _ i .~;'.~TEt°i :~T'H'TU.J kEFt;kT' r~LL FUtSli='TI~~~hJS tdUkt°1~L I PJL+EtVTti ik''.' REF'i ~1='T T 1:LIE~EL '~liiLUl"lE = 6115 i:,rL:~i ULLHi:;E = 1 SB5 i_arL: 9U~s ULL~;i=,E= 1 U>35 i;AL HEIUHT = 5E:5? I PJi=-HE: W~TEF? L+L;L = 12 ia;~LS t~JF=tTEk = U . ?6 I t'Ji'HE TEN1F' = 6U . 6 LiEi F T '? : Dti'' Tr"N}: VCiLUI"lE = 219 iarLS ULLf~iaE = 31 UhL 90~~ ULLI-tiE = E ur=1LS HEI~~HT - ~5.9~ IfVi='HE~: WHTEk UvL = U C:r";LS WriTEk = U : u0 I N~'HEtii TEh1F' _ ?U . 1 DECa F f k x EtdD ~ ~ ~ ~ x Y~~TEf"1 I_ItV I T; ~'Y~~ T Et°1 l.i=ifJGl Ir~E E I'J+_~L I 5 H E;' ~ T EI"1 IifiTE;:T i t^9E F~.RI°1HT 1"1C;i,,! LiD •~.~~;,,,;'' Hr, :1•'li"i Bh);Ek~ .F I ELL! 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'-'~'• '-'003 11:14 Hf~1 H UTOt~1HT I !_: DH I L`~' C:LOS I IVC~ T I t~}E : ~~ : OU Ht°i PERIODIC' RECOPJC? I L I HT I OtV MODE : f~90NTHLY TEMP i`t~IhPEtVE:HT I ~ aN ~THIVDHRD EPJD x * _: x y X 7(. ? jr 13 U ;LOT FUEL I°IETER THIV);: THN}; NIHP EN1PT'';' TEST DATE: 4/11/07 CLIENT: CAKO10 BKFDCA01 PAGE ~_ OF 1520 20TH ST, BAKERSFIELD, CA 93301 riLfk'f`9 HIBTtiiFs'Y REF'~iRT ---- i N-THtV}; tiLr~kt"1 - T ~ : Do't' Tr~Nr; .~~'ET UP Ur;TFy l:di-ik t'J I PJi=~ SEF 5. 200 l I : l '? tit•1 H I c=~ H WF;TEk hLF'~kt°1 FiPI<' 1 J .x'006 8:56 Pt°J HPR '= 1 . x'005 1 1 :08 r'h'1 ~iVEI:'F I LL fiLnkt~1 tiF'k 11. 2006 9:'t1 PM L+36~1 F'F~.ULiU~'TriLFikl°1 r~F'k ? i . '~Ou5 1 1 : U3 FYf°J t~t_ T i U . '~'00'~' 10:14 ht°1 EF 5. 200' 11:1:3 Ht"1 HI~:~H F'kC>LyU~'T r'=;LHkt°J HPk 11.'006 8:5:3 Pt°1 HF'k~ 1 . 2005 1 1:05 rit°l HF'k '~ 1 . 2005 1 1 : 0'~' HM I tVVF~L I Li FUEL LEVEL `: AFk 11. 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'x'005 1 1 : U`3r'if°1 _: x x x EfVLi x *: ~ x HLFtRM H I 5T~k1' kEPukT -- EENSGk ~LhkM ----- L 4:DH:' TAtV}: HIVIVULF;k HIVNULHk SF'F~uE SEN;~Gk UUT F;Ltikt°1 HF'R 11. 2006 9:5'~ Pt°t FUEL HLF;kM F~Pk 11. 200E 8:50 PN1 SENSUR CiUT F~LHRt°1 FrF'k 21 . 2005 11 :Oy Ftt°1 n f x ~ EPdLi *. * * ~ x TEST DATE: 4/11/07 CLIENT: CAK010 BKFDCA01 PAGE OF~ TH 1520 20 ST, BAKERSFIELD, CA 93301 hLtikf°1 H I ~'ttiaF''', REF'~aF'T ----- ;EIV~Cak rLr1<9°1 ----- L 5:EMC.UIE EL F;tV(VULtik SF~;~'E SEtV Uk UUT HL~Rt'9 fi,Pk 1 1 ~ ''UU6 9 5'~ Pt°t FUEL ~Lr~kM F',F'k 11. 200E 8:4b PNl FUEL r'Lr~kt°1 i~F'k 1 1 . 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'x'007 1 U : 44 PP•i ---- I tV--TFtVk: i~Lhkh9 ----- T 1 : Ii I ESEL F'Riib'E c>UT HF'k 10, 2007 10:50 F't°1 ---- I tU-TH(V}; hLHkf"1 ----- T 1 : Li I ESEL H I i;H PkC'+LiUC'T hL~;kf°1 rFk 1u, 2007 10:50 PM ---- I tV-THN}: hLHkf"1 ------ T I:LiIE~EL. UUEkF I LL HLHkt°i iF'k 1 U, 21107 10:54 F't°1 ----- I tV-TF;tV}; ~LhRh7 ----- T 1:LiIE~EL F'}?1>13E t~UT rF'k 10, '2'Ou7 10:54 Ft"1 TEST DATE: 4/11/07 CLIENT: CAKO10 BKFDCA01 PAGE ~ OF~ 1520 20TH ST, BAKERSFIELD, CA 93301 T ? :UIE EL I PJL~EP}Ts?k'~' I hJi'kEASE I PJ~'kEASE NTAkT 1i +LUI°lE = 61 15 UrL HE I uHT = 58.5? 1 Ni='HE.=; 6~JATEk = 0 . ?? I f+JCHE; TEf°1F' = 68.6 DE~~ F I NCkEA ~E EtVLi AF'R 10. '~'0U? 1 U : 56 Pt'9 VcJLUt°lE _ ?6U3 ~~AL;~ HE1~aHT = ?4.U,~ ItdC'HEE WATEk = U . uu I t'JC:HEw TEt°iF' = 67.3 UECa F --_.-- JE.NN~1x ~,L~,F?Pl -_---_ L 3:DAYTAhJ}: )<.'UPTUkE BrE,PJ ±iTHEk ~EtV~CIk FUEL ALAkt°1 APk 1 U. '~UU? I 1 : 16 F't°1 ---- } t+J-TAN}; ALAkt`9 ----- T '~ : Lih, TANY: MA': F'kGLiUr.T ALAkP~I APk 1 U, '?UU? 1 1: 1 9 Pf°1 GI='ta JiJ I fVCREH ~E= 1488 ---- I fV-TAPJ}: ALAkt°i ----- T' ~' : LiH',' TAN}; FkGEE c~UT APk 1 U. tUU? 1 1 : 1 ? Pt°1 --- I tV-TAIV}; ALAkf°1 ----- Pk~ sBE 4UT AF'I<' lU.~U07 11:'x'1 Pt°i BH};Ek~~F 1 ELD ATT AF'k i u, ~UU? 1 1 : Uy Pf°t ---- I tV-THt'J}; ALAkNI ---- T '~' : UAY TAN}: I NVAL I Li FUEL LEilEL APk 1 u. '~'UU7 l l: 1 b Pf°t BA}Ek F 1 ELU HTT :,' ~TEt°1 ;3TATU~ kEPUkT ;LL FUN[~TII?N5 fd~~kt°1AL ----- 5Et'JStiR ALAkh'1 --- L 4:DA,' TAtd}: ANNULAR APJtVULAR :~F'A~•E FUEL ALAkth AF'R 10. 'UU7 11 :15 Pt~9 ---- I tV-TAN}; rLAkt"1 -----~ T '~ : LiA,' TANY, HIiaH F'kUUUC;T ALAkt°l AF'k 1 U. '~'UU7 1 1: l y F't°1 APk 1 U. '~'UU7 1 1 :'?8 PP'f ~Y~ TEM NTATU ,, kEF'UkT ALL FUtd~'T1vhJ~ fdGkt°lAL TEST DATE: 4/11/07 CLIENT: CAKO10 BKFDCA01 PAGE ~ OF~ 1520 20TH ST, BAKERSFIELD, CA 93301 }~~y}EkSF I ELLi F',TT Jlf JTEt°1 STrTU:; kEPOkT~~-~ r~LL FUI+J~_ T I ~+P1S Nfikl°1r;L I151'JEPdTUI<'"' kEF'OkT T 1 : LrI E.EL +Ji3LUl°lE = 6111 ~:~HLS ULL~;~.:E = 1889 GtiLS 9C1°a ULLHGE= 1 0189 GAL S HEIuHT = 58.53 IIVC:HES WF~TEk ttUL = U GF;LS W€;TEk = L . OU I NGHES TENIP = 68.6 LiEG F T '~' : liA;' THIVI; IrULUI°1E _ ~ 19 GHLS ULLF~~3E = 31 ~.~€~LS 9U~~ ULLHGE= 6 CaALS HEICaHT = ':=5.93 INCHES WF~TEk Vt?L = U i;~1LS 6JHTEF. = Ci . DU I PJCHES _ TEMF' = 7U . 1 LiEC~ F _x n x x x EI'JLi TEST DATE: 4/11/07 CLIENT: CAKO10 BKFDCA01 PAGE ~ OF~ 1520 20TH.ST, BAKERSFIELD, CA 93301 UNDERGROUND STORAGE TANKS /4PPLICA-TI®I~i TO PERFORM ELD /LINE TESTING 1 SB989 SECONDARY CONTAINMENT TESTWG /TANK. TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. ~~_~ ~~ -~ =~,. Q ~ ARTM~~ifT ~.. ~._ ~ ~.,. EAI~ERSFIELD FIRE DEPT. Pr@WeY8~1011 S(:1'~T1C@S 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST .~ O PERFORfv1 FUEL MONITORING CERTIFICATION SITE INFORMATION _ _ FACILITY ~~~ NA ~G~~ OMB's OF yONTACT PERSON ,iv ~i ADDRESS _ D Q ~~/ r~~~~~ O ~ ,OWNERS NAME /~"~~ - -- ~ OPERATORS NAME PECtMiI' TO OPERATE NO. NUMBER OF TANKS TO BE TESTED ___ IS PIPING GOING TO BE TESTED? ^ YES ~0- TANK# VOLUME CONTENTS -- I --- - - ~ ~~-- - - - -- - TANK TESTING COMPANY ~ NAME OF TESTING COMPANY /~c _ ~~~~7 _ NAME 8 PHONE NUMBER OF NTACT PERSON /~/ C~~°- 95-7- G'~G--~o6D MAILING ADD~RE~iSS --~~' ~~ ~ . ~~`'~_ e~,~G-. G~%~'L .S' ~ Sl~I> '~Nl F~ Zt~/I' ~ ~aZSr7 d NAME & PHONE NUMBER OF TESTER OR SPECIAL INSPEC fiOR CERTIFICATION #: ~fe~ C~v~'~'z2- _ _ _ DATE /~ TIME TEST TO BE CONDUCTED ICC #: TEST METHOD ~ ~ J7 ~ _-___- _. ____- __ 51GNATURE OF APPLI NT DATE ~~6^O -- - '~- 6. __ __ _ APPLICATION BECOMES A PERMIT EN APPROVED AP PROVED BY '+ ~~ DATE I _ -- - FD 2095 (Rev. 09105) >-" //).p ( I 1 f~ P ~ . !! ~ „=9 ~} i--~T~t~t~imt~rlo ~~Y 8501 N. MoPac Expressway, Suite 400` Austin, Texas 78759 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFF{CE OF ENVIRONMENTAL SERV{CES INSPECTOR STEVE UNDERWOOD 900 TRUXTUN AVE., STE. 210 BAKERSFIELD, CA. 93301 Test Date: 04/12/2006 Order Number: 3146148 Dear Regulator, Date Printed and Mailed: 04%28/2006 Enclosed are the results of recent testing performed at the following facility: ATT -BAKERSFIELD 1520 20TH STREET BAKERSFIELD, CA. 93308 Testing performed: Monitor Certification Secondary Containment-Spill Container Sincerely, 0~~ ~a~~~ Dawn Kohlmeyer Manager, Field Reporting MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitoring system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this fomt to the local. agency regulating UST systems within 30 days of test date. A. General Information Facility Name: ATT -BAKERSFIELD Site Address: 1520 20TH STREET Facility Contact Person: MANAGER Make/Model of Monitoring System:TLS-350 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: DIESEL Tank ID: DAY TANK X In-Tank Gauging Probe. Model: MAG 1 X In-Tank Gauging Probe. Model: MAG 1 X Annular Space or Vault Sensor. Model: VAR 420 Annular Space or Vault Sensor. Model: V\R 420 )( Piping Sump/Trench Sensor(s). Model: V\R 208 Piping Sumplfrench Sensor(s). Model: )( Fill Sump Sensor(s). Model: V\R 208 Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. ~ Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: ATG Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Tank ID: Tank ID: In-Tank Gauging Probe. Model: In-Tank Gauging Probe. Model: Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model: Piping Sump/Trench Sensor(s). Model: Piping Sump/Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: Tank OverfilllHigh-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). Other s eci a ui ment (p fy q p type and model in Section E on page 2). Ispenser RUPTURE Dispenser ID: O Dispenser Containment Sensor(s) Model: V\R 208 Dispenser Containment Sensor(s) Model: XD Shear Valve(s). Shear Valve(s) Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). DispenserlD: DispenserlD: Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). DispenserlD: DispenserlD: Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s). Model: Shear Valve(s). Shear Valve(s). Dispenser Containment Float{s) and Chain{s). Dispenser Containment Float(s) and Chain(s). If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): ~ System set-up ~ Alarm history report Technician Name (print): STEPHEN COULTER Signature: ~ - ~~~~ Certification No.: 006-05-0953 License. No.: Testing Company Name: Tanknology Phone No.: (800) 800-4633 Site Address: 8501 N. MoPac Expressway, suite 400, Austin, TX 78759 Date of Testing/Servicing: 04/12/2006 City: BAKERSFIELD CA Zip: 93308 Contact Phone No: 555-1212 Date of Testing/Service: 04/12/2006 Work Order Number: 3146148 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 1520 20TH STREET Date of Testing/Senrice: 04/12/2006 D. Results of Testing/Servicing Software Version Installed: 120.00 Complete the following checklist: Q Yes ^ No ` Is the audible alarm operational? Q Yes ~ No ' Is the visual alarm operational? O Yes ~ No • Were all sensors visually inspected; functionally tested, and confirmed operational? Yes ^ No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not . interfere with their proper operation? Yes ~ No ` X N!A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? Yes ~ No ' ~ NIA For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment - monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) x^ Sumplfrench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ^x Yes ^ No Yes ~ No ` ~ NIA For tank systems that utilize the monitoring system as the primary tank overfill waming.device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? so `% Yes' Qx No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ~x Yes' ~ No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) ~ Product; ^ Water. If yes, describe causes in Section E, below. ~x Yes ~ No ` .Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. Ox Yes ~ No ` Is all monitoring equipment operational per manufacturers' specifications? ' In Section E below, describe how and when these deficiences were or will be corrected. E. Comments: Small amount of Diesel in STP sump. Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: 1520 20TH STREET F. In-Tank Gauging /SIR Equipment Date of Testing/Service: 04/12/2006 ^ Check this box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes ^No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes ^ No ~ Were all tank gauging probes visually inspected for damage and residue buildup? Yes ^No • Was accuracy of system product level readings tested? Yes ^No' Was accuracy of system water level readings tested? ^x ves ^No ~ Were all probes reinstalled properly? Yes ^ No • Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) : ~ Check this box if LLDs are not installed. Complete the following checklist: ^ Yes ^ No' ^N!A For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: ^ 3 g.p.h ^ 0.1 g.p.h ^0.2 g.p.h Yes ^ No ' Were all LLDs confirmed operational and accurate within regulatory requirements? ^ Yes ^No • Was the testing apparatus properly calibrated? ^ Yes ^ No ~ ^ N,rA For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ Yes ^No' ^ NiA For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^ Yes ^No ° ^ NiA For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? ^ Yes ^No ~ ^ NiA For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ^ Yes ^No ' ^ NIA For electronic LLDs, have all accessible wiring connections been visually inspected? ^ Yes ^No • Were all items on the equipment manufacturers' maintenance checklist completed? In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 Based on CA forth dated 03/01 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS i Tankno{oc,,,~r TEST DATE:o4/12/2006 CLIENT: HANSOM PROFBSSIONAL SBRVICSS 1525 SOUTH SZXTH STR88T WORK ORDER NO.: 3146148 SITE: ATT - BARBRSFIBLD 1520 20TH STR88T SPRINGFIELD IL 62703 TIMOTHY R. GOETZ 217-747-9209 Tank Interstital Tests TAN K PRODUCT MANUFACTURER RESULTS DIESEL DIESEL HARERSFIELD CA 93308 Piping Interstital Tests LINE PRODUCT MANUFACTURER RESULTS Sumn & Under-Disuenser Containment Tests 5unipl DISP.# MANUFACTURER P1F DSL FILL Phil-Tite Pass Tanknology representative: BRIAN DERGE Services conducted by: STEPHEN COULTER ~_ "~'~ .~, Test Date: 04/12/2006 ' Work Order: 3146148 SECONDARY CONTAINMENT TEST RESULTS SUMP TESTS Type Tank or Disp Manufacturer Model or Diam./Width/Length Depth Test Method Start Initial Level Finish Final Pass/ # Material ~ ") ~ ") Time Level Change Time Result Fail &pill Container DSL FILL Phil-Tite Plastic 11 10 900 8.5 0 930 8.5 Pass Comments: Spill container was tested using a 30 minute visual test. ~ 7an 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:04/12/06 WORK ORDER NUMBER3146148 CLIENT:HANSON PROFESSIONAL SERVICES SITE:ATT - BAICERSFIELD COMMENTS Monitor and bucket passed. PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED H€LIUM PINPOINT LEAK TEST RESULTS Printed 04!28!2006 07:38 SHOWERS ITE DIAGRAM . ranlv~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512) 451-6334 FAX (512) 459-1459 TEST DATE: 04/12/06 ClIENT:HANSON PROFESSIONAL SERVICES WORK ORDER NUMBER3146148 SITE: ATT - BAKERSFIELD 1 K _ O~ J ~ LL~ O aW ~ 2W 4 N Z ~ AT&T 1520 20TH ST. Q oo BAKERSFIELD, CA. 93308 L3 a o ov V/R IN BASEMENT VENT VR DSL E ST i L5 N 8K .- . Printed 04/2812006 07:38 SBOWERS Work Order: 314 614 8 II --•- IN-T„NK ALA12M ----- ~ I i ---. iN-TANK ALARtt ----- ' T 1 :I~ l ESEL ~ ~ T 2 ~ UriY TANK HIGH WATER ALARM DAT A :JrIRNI kPk il, 2GUE 8:28 PM SEP; 5 C iU 12 Hh tiVERFILI. ALARM ~ HIG WATER ALARM NPR 11. 2J06 9:25 FM ; APR: 11. 2006 8:5ti PM APR 21, '005 9:31 HM NPR ' 1 . 20D5 11 :08 PiM DEC 22. '?003 I1:UB AP1 pV£ ILL ALHRM LOW PRJDUCT ALNiiM AFk~ 11. 2006 9:21 PM APR 1 :. 2006 8:?3 FM i APR ~l - 2005 5'31 Fih'I LOW : RODLh~T Hi.ARhl SirY 5. 2002 1 fi:19 AM KpR : 1 . 2005 l 1 :03 HM OCT ' l 0. 2J)U2 10:1 A rirl HIiilt F'k(iDl1CT hLwRM SEP . 5. 20b? 11 :13 HI'I AFk ll. 2006 9:26 PM AFR 2l. 2005 9:30 AM HIG PRGDtt~'T ALARM NGV 7. 2003 7:55 NM APR ~ 11. ?006 8: 5;t PM APR : 1 . '?005 11 :05 Art I IVV:+t..tD FUEL LEVEL HPR : 1 . 2005 11 :02 AM AF•R l 1. 2006 13:40 pM ~ HPk 2l. 2005 9:31 AM ~ INV ID FUEL LE11£L AYk 2l. ?005 5:29 AM I HPR' II. ?006 9:52 PM I APR ~ i . 3005 11 : V3 NM PkG$E OUT ° . i NPR ~ 1 . 2005 1 1 :dl AM APR 1:. 2006 5:~9 PM APR 1;. 200E 8:43 PM ; ~ PRD JUT AF•R 1 1 . 20U6 6:23 PM i HFF : t . 20u6 9:-~3 PM !AFR ~ 1 t . 2006 8 :51 PM HiGN wHl'!rR WARNING I APR : 't . ?005 11 :13 AM HF'R 11. 2]Uo 8:28 Phl I i HIG WATER WARMING i APR < 11 . 2006 8:56 PM DELIVERY WEeDED , ~ AFR° k. 2u05 11:08 AM HPR ll. 20D6 8:23 PM .I HFR 2t. 2f~G5 9:31 AM SEF 5. 2QD2 10:19 AM '~ I MAX RODUCT HLHRH I APR ' 1. 20D6 6:5:] PNI MHX F•k'.~.GUCT ALAIcI-E ; ': APR . 1 . 2005 11 :Oa HM NUO 7. '?002 9:5I! +ihl I I . ;APR : ! . 2U05 11 :D'e AM PER TST NEE[iED WRN I ~ ~-- ~ ~ L 4 CiE~~SOR ALARM ----- D ' TA ANNUL R M.~R 3D. 2002 13:00 AM I ~ ANN` H: A NK AR SFAr E MAR 2. 2D02 12:00 HM 1 sT= . R ~~uT ALHkr'J FEb 3. 2002 12 : J}0 AM ~ APR ~ 1 1 . 2006 9:52 F'F7 PER TS7 NEI~DED HLF1 FUE ~ ALHRh1 SEP E,. 2J02 12:UG Hhl APR ii. 2DOE 8:i0 PM r111G 30. 2602 12 : UO HM _ Jf+t~k 3. 2DD2 12:0(] AM I ~ ? SE R ouT ALHRM -- SENEGk :+LARM --- • - ' ~ ~ APR : 1. 2Du5 11:09 AM L 1 :SUMP lvEST i3TP °JhiP I .'-- _ _ SFrvS::R h1.ARM -- - SEt~uR OUT HL+iRM L 5. EMC.U1£3Et. FFR 11 . 2thlF; 9:52 F1i Ht1N L.fiR SPki:E ' ~ ? Sgl JR OUT HLi.RM FUPL HLHRM II~ ~ APR ll. 2006 9:52 PM HPR 11. 20Uti 8:46 PJ'9 ~ f FU r;LHRM S1rNSQk GUT ALAkI-I i HPR 11. '2006 8:.76 PM AFR ~1. 20Q~ 11:09 AM I FU k H1.Akr ----- 'IVri'JR ALARM --'-- S1; i flPR° I1. ?L'f13G B:16 PM L 2:3UM6' EAaT , PIPING SUMP i SENSOR GUT HLHRM tiPR ll. 2UD6 9:52 PM FUEL ALHkt" i AFR l1. 20U~ 8:45 PM ~. FUEL H1-HRM SEP 1. 20135 9:09 HM - SENSOR HLHRM - •~ --- ~ j L 3::~H'ITNNK RUPTURE BASIV i OTHEF. SENSUkS SEMSJk OUT ALAkht AFR 1!• 2006 9:52 PM I FUEL HLHRM ~ APR 11. `1.ODe 8:50 Phl i SENSOR GisT ALARM APR 21. $Lt35 11:05 AWI I !~ Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 O~ > ~~ Work Order: 314 614 8 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 ~ Prevention Services .UNIFIED PROGRAM INSPECTION CHECKLIST" H E R s F , ~ 9o0'IYuxtun Ave., Suite 210 _ _ _ _:, r____ ~_.» - __~____________ _ _ __ _~.. FIRE - --- Bakersfield, CA 93301 SECTION 1:~Business Plan and Inventory Program ARTM r Tel.: (661) 326-3979 i, ~ Fax: (661) 872-2171 ~~ FACILITY NAME C intc-, L z,J l r2~.~ ~ - INSPECTION DATE 11- 3v- t~ INSPECTION TIME AD{DRESS A,,~ n l ~ !~ 44 PHONE NO. NO OF EMPLOYEES FACILITY CONTACT BUSINESS ID NUMBER 15-021-c~7p { 2" -. ~ ~ ~ ~ ~ Section 1: ~Busin+ess Plan and Inventory Program ~ ~~ (~ ^. ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND ^ ^ BUSIf1@SS PLAN CONTACT INFORMATION ACCURATE :r ^ ^ VISIBLE ADDRESS ° ^ ^ CORRECT OCCUPANCY ^ ^ VERIFICATION OF INVENTORY MATERIALS ^ ^ VERIFICATION OF QUANTITIES ^ ^ VERIFICATION OF LOCATION ^ ^ PROPER SEGREGATION OF MATERIAL ^ ^ VERIFICATION OF MSDS AVAILABILITY ^ ^ VERIFICATION OF HAZ MAT TRAINING // 4j ((// ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES C ^ ^ EMERGENCY PROCEDURES ADEQUATE ^ ^ CONTAINERS PROPERLY LABELED ^ ^ HOUSEKEEPING ^ ^ FIRE PROTECTION ^ ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: ^ YES ^ NO QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 C%~., ~NavJ [ ~ Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # Business Site /Responsible Party (Please Print) White =Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 '= ~' Prevention Services UNIFIED PROGRAM INSPECTI~'N'~HECKLIST ~ e E R s F _, _D 90o Truxtun Ave., suite 210 __. _. ____ _ _______ _-~. _.. - FIRE Bakersfield, CA 93301 ~Rr~- r Tel.: (661) 326-3979 SECTION 1: Business Plan and Inventory Program ~ ~ Fax: (661) 872-2171 FACIL TY NA E INSPEC ON DAT ~ ~ INSPEC~191~1 TIME ADDRESS 1 5 Z~ 20 -~~, s~ PHONE N0. ~ is • os~ NO OF EMPLOYEES _~ FACILITY CONTACT BUSINESS ID NUMBER 15-021- ~~-~ _ ~ ~ Section 1: S~siness Plan~and It>rvet~tory Program ~("t, ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ( C=Compliance OPERATION V=Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND N-Z4.~ c~v~ ~7 B ~1 f ~ ~ ~ ~ " ~ Y~ / ^ BUSInBSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ENT'D D ~ C ~ 2 ~p ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL \ ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING \ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ~~ ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ~ n( Y ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 ~-°-~ Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # siness Site /Responsible Party (Please Print) White -Prevention Services Yellow -Station-Copy Pink -Business Copy ^ YES ^ NO FD 2155 (Rev. 09/05 I;rit;t~r:c_t 11:1.Ii riTT DEC ''1.~UUr~ ?:ii] F'f"1 :_~'~;',:SfEf"I i3Tri`l'1Jt= REF~Gk'I' riLL. F'Uf•Ji::'T' I1 ~ h•J:.. PJ!::F;'(1i-iL '1' 1 : I'~ 1 F';=DEL. f~-111 ~x! 11' _ `~y . 5" I f••J~:'HE: 6JH`fEk = I_I.?k: If~JCHE=_~ ULLr;~:~E _ ~ I GhLS 9U'%~ lJL1.HC~E= i ~ i:~rLS NE I CaHT = '?5 . +:;'=-i I fJi_:HE:-~ WATER = 0 . Coo I t'~u='HEi-~ TEMP = ~4 . ;3 LiE+:_~ F ,. F'fdi; p ~ ,. °'i , := _~ INSPECTIONS - BUSINESS PLAN ~ INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST B E R S F I L D F/li<E AI~TM T FACILITY NAME: G I ~ 6N ~A~ ~ t~ ~Ss Section 2: Underground Storage Tanks Program INSPECTION DATE: 1~~ ^ Routine ~,~j Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank'17~ ~ clad C~b•%.i~~Number of Tanks ~ Type of Monitoring ~ a Type of Piping $wc,'t'tc~ D OPERATION C V COMMENTS Proper tank data on file ~~ Proper owner /operator data on file 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 ~.Qlo Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Aggregate Capacity Number of Tanks "L- ess Site Responsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) ~- UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1 Business Plan and Inventory Program Bakersfield Fire Dept. Enironznental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAtv1~ ~ ' INSP TIO DATE INSPECTION TIME ADDRESS r1 J A PH NE N~~`- No. of Employees FACILITYCONTACT Business ID Number 15-02 I - `a-7 Section 1: Business Plan and Inventory Program ^ Routine ~ Combined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection ~. V (C=Compliance OPERATION COMMENTS /~ yj V=Violation /j/ M ^ APPROPRIATE PERMIT ON HAND J / ~^ BUSINESS PLAN CONTACT INFORMATION ACCURATE L'`f ^ ~/ISIBLE ADDRESS L~ ^ CORRECT OCCUPANCY I L'J ^ VERIFICATION OF INVENTORY MATERIALS ----- ----- ^ VERIFICATION OF QUANTITIES ~~ ---- -- -- -----------~--- -- --- - ------- __ -- -- - --------- ---- _ ~;p~ ~ - ~-z------ -- - __ _ __ _---- - - - - - ~^ VERIFICATION OF LOCATION E ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITYE ^ VERIFICATION OF HAT MAT TRAINING VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ~^ HOUSEKEEPING --- - - - -- - - ^ FIRE PROTECTION LJ ^ SITE DIAGRAM ADEQUATE 8c ON HAND ANY HAZARDOUS WASTE ON SITE: ^ YES L1uN0 EXPLAIN: QUESTIO ~~ EGARDI % T IS INSPECTIONS PLEASE CALL US AT ~F)6'I ~ 326-3979 -- - - ---. -- _ -- --- - - _ --___-- ------- ----- --- l`F~ ~ _ _ Inspector Badge No., ~-a~ ~ Business Site Responsible Party White -Environmental Services Yellow • Statbn Copy Pink • Business Copy ~,~ ,. ,','~4~. T~~ ~6 ~ - ~ b1 \~~ y ~1 `. ~ ~~ -~ ~ _W~ cAgid .~~i FACILITY NAME R CITY OF BAKERSFIELU FIRE DEPARTMENT OFFICE OF >E:NVIRONI~'iEN7'AL SERVICES UMFIED PROGRAM INSPEC:TION Ci~ECKL.IST 1715 Chester Ave., 3rd L~ toor, Bakersfield, CA 93301 INSPECTION DATE- ~~~Q~ Section 2: Underground Storage Tanks Program ^ Routine ^ Combined ^ Joint Agency ^Mulfi-Agency ^ Complaint ^ Re-inspection Type of Tank .Y~U~S Number of Tanks Type of Monitoring .~~f.,llt~ Type of Piping ~Ct9~ OPERAT•tON C V COMMENTS Proper tank data on file Proper owner/operator data un file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current ~~c -F a rl~.Y' 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 OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection'? C=Compliance ~ V=Violation Y=Yes f i Inspector: Office of Environmental Services (661) 326-3979 \~'hitc N-NO Env. Svcs. Pink -Business Copy \ ~ ~` ~ _ t~ sines Site Responsible Party .-..~ _...~ ~T~~ One AT&T Way Bedminster, NJ 07921 March 28, 2006 Mr. Joe Canas, Chief EHS _ County of Kern Certified Unified Program Agency (CUPA) Environmental Health Department 2700 M Street, Suite 300 Bakersfield, CA 93301 Re: AT&T Corp., 1520-32 20th Street, Bakersfield, CA A T ve, A US'T`-F~~aneial..BespoasibrJi~. Dear Mr Canas: Attached please find a copy of the UST Financial Responsibility document for the above referenced facilities. If you have any questions please call me at (908) 234- 4675. ~. Sincerely, ~ ~ ~ ~ ~ ~~ Douglas G. Frey, P.E. EH&S Copy (wJencl.) to: City of Bakersfield Certified Unified Program Agency (CUPA) Ralph E. Huey Director of the Office of Environmental Services Fire Department 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 ~' ~~ For State Use Only State of California State Water Resources Control Board Division of Clean Water Programs P.O. Box 944212 Sacramento, CA 94244-2120 CEI~TIFICt~~'I®l~ ®F FIIa1AloTCIAI, I~SP~l®TSI~II..IT'Y FOR UNDERGROUND STORAGE TANKS CONTAINING PETROLEUM A. I am required to demonstrate Financial Responsibility in the required amounts as specified in Section 2807, Chapter 18, Div. 3, Title 23. CCR: ^ 500,000 dollars per occurrence ^ 1 million dollars annual aggregate or AND or ®1 million dollars per occurrence ®2 million dollars annual aggregate B. AT&T Corp. hereby certifies that it is in compliance with the requirements of Section 2807, (Name of tank Owner or Operator) Article 3, Chapter 18, Division 3, Title 23, California Code of Regulations. The mechanisms used to demonstrate financial res onsibili as re uired b Section 2807 are as follows: C. Mechanism Name and Address of Issuer Mechanism Coverage Coverage Corrective Third Party T e Number Amount Period. Action Compensation Insurance AT&T Corp. 409- $1,000,000 per December 31, Yes Yes One AT&T Way 1 UST001 occurrence and 2005 to Room SC 109E $2,000,000 December 3 I , Bedminster, NJ 07921 annual 2006 aggregate Note: If you are using the State Fund as any part of your demonstration of financial responsibility, your execution and submission of this certification also certifies that ou are in com Hance with all conditions for artici ation in the Fund. D. Facility Name Facilih~ Address See Attachment A. Facility Name Facility Address Facility Name Facility Address Facility Name Facility Address Facility Name Facility Address Facility Name Facility Address Facility Name Facility Address Ej Signature of Tank Own Operator Date _~ - ` -,rz.t?,c ~~~e~/t:3 ~ Name and Title of Tank Owner or Operator Douglas G. Frey igrmNr tmess or Nota Dale / ~; ~JL ~~~U~ p Name of Witness or Notary Debbie Petrocy Submit origi`r~ial to local UST regulatory agency. Keep a copy at each UST facility. (Instructions on Reverse) UN-049 - 1/2 www.unidocs.org 01/29/02 - ~~ _ _- . ; ' :. : - ., <,... ;~~ =-,,:~~„>; ,_ - p~~.:~- = .. .: ~,..:,z,. , ~ _ ,~~; ~°', d"~a ISSUE DATE 03/24/2006 PRODUCER THIS CERTIFICATE [S L55UED AS A MATTER OF 1NFORA/ATION ONLY AND CONFERS NO RIGHTS UPoN THE CFATUTGTE HOLDER 77iLS CERTIFICATE p ~ DIRECT DOES NOT AM®VD, EXTEND OR ALTER tHE COVERAGE AFFORDED BY THE eouclFS BELOW COMPANIES AFFORDIPiG COVERAGE coMPAM LETTPAt A GATEWAY RIVERS II~ISURANCE CO. Con~eANY INSURED ~.~ R AT&T Cor p. coMPANY LEITRa C 175 E Houston Street ~,E,,, . San Antonio, TX 78205 LETTER D COMPANY LETTER E _. ---....- - ----.._.. -- --°- - n - -- - -- - - • ,~ : ~. ~~ ~, ,~ =''ate-~ ~~~~ ~~ ~F ~-~~~ - - ~ ~.:~~.~ -- .~ -- - _ ~ THIS 6 YO CERTIFY THAT THE PDLICIES OF OiSIlRANCR LISTED BELOW HAVE BEEN LSSUID TO TBE LNSORED NAND ABOVC FOR THE POLICY PERIOD HiatCATID. NOTwl7HSTANDING ANY BEQOdEMEM, TERM OR CONDFRON OFAM CONTRACT OH OTHER DOCIRdEPff wiles RTSPF1Ci TO WHKH T86 CERTIFTCATE MAY HE 65UED OR MAY P~[TAIN. ~ INSURANCE AFFORDED BY THE POLICE'S DFSCR®FD HEREBY IN 6UBJEC7 TO ALL THE 7ERR$ BX [ANFNS AND COND NS OF SUCH POL LBNI[S SHOWN MAY HAYEBEEN REDUCED BY PAm CLADRS. CO LTA TYPE OF aSURANCE POLICY NUMBHt POLICY EFF. DATE POLCY E%P. DATE A LUOTS GENERAL AGGREGATE COMM CENEJIAI. IlABH1TY PPOD{OMP(OP AOG. eumis MAffi ^ occ eERS ~ ADV. BxRmx OwNER$ 6 COMAC75 PILOT EACH OCCURRENCE FIRED DAMAGEao:2rt a MED. EXP. pNY. tPA AVFO LGBOATY COMBINED SINGLE ANY ADTO LII.i1T ALL OWNID AUTOS BODILY INJURY SCHW WED AIROS ROIPeaFUM H@FDAOTOS BODILY INJURY NON-0RT{ED AUD05 JiBwcaoen> CARAGR LUBHJN PROPERTY DAMAGE ET LESS LIAB6TEY EACH OCCURRENCE UMBBELLA FORM AGGREGATE OTIFR TRAM VA46RFLIA FOIU1 .,~, A p~~ 409-tUST001 i2/31/OS 12/31/06 $1,000,000 PerOccuclEnce Environmental Impairment Liability for Undcrgroood and Above Cromld $2,000.000 Annual AggIL-ga[e Storage Tanks DESCRIPTION OF OPERATIONSQ,OCATIONS/VEHICLES/SPECIAL ITEMS As pertains to the covered location(s) referenced in the attached list. n Std'te of CalifDfllla SHOUID ANY OF7H¢ABOVE DESCRIB®POLICIE$BE CANCW,IED BEFORE THE State Water Resources Control Board EXPHUTTON DATE THEREOF, THEISSUING COMPANY WILL ENDEAVOR TO Division Of Clean Water Programs - MAH.60 DAYS WRI'rIFN NOr[CE TO THE CERTTFTCATE HOLDER NAMED TO THE P.Q. Box 944212 LFFi, gUf FADDRE TO MAH. SUCHN071CE SHALL BHPOSE NO OBLIGATTON OR 0 Satiramento CA 74244-2120 , -. LIADH.IIYOFANYXINDUPONTHECOMPANYITSAGENTSORREPRFSENTATiV&5. Certificate no: OS-186 with attached Endorsement a~nvLa AUTHOALrEDREPAESEMATIT'E Replacing: New ~:Gbiin(97~65~"°r". _ ... _ ~-~~s;.7"~ r='+,a„- m., -•~ a~,.x,>,- ;~ ~__ ... _ ..~~'d°'i(~1~x ~1~a?if_~. _.. 'a° i'a°~N's- s:kisklwordltemplacooni.doc Endorsement to Certificate of Insurance 05-186 Name: [name of each covered location] See attached list. Address: [address of each covered location] See attached fist. Policy Number: 409-1UST001 Endorsement (if applicable): IVot Applicable Period of Coverage:l2/31/2005 -12/31/2006 Name of Insurer: Gateway Rivers [nsurance Company Address of Insurer: 78 St. Paul Street, Suite 500, Burlington VT 05401-4477 Address of Insured: per Certificate of insurance Certification: 1. Gateway Rivets insurance Company, the "insurer," as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tank(s): See attached list of sites. for taking corrective action and/or compensating third parties for bodily injury and property damage caused by either sudden accidental releases or non-sudden accidental releases or accidental releases; in accordance with and subject to the Limits of fiabiliiy, exclusions, conditions, and other terms of the policy; arising from operating the underground storage tank(s) identrfed above. The limits of liability are $1,000,000 each occurrence and $2,000,000 annual aggregate, exdusive of legal defense casts, which are subject to a separate limit under the policy. This coverage is provided under policy number 409-1 UST001. The effective date of said policy is 12/31/2005 to 12131/2006. 2. The Insurer further certifies the following with respect to the insurance described in Paragraph 1: a. Bankruptcy or insolvency of the insured shall not relieve-the Insurer of its obligations under the poticy to which this certificate applies. b. The Insurer is liable for the payment of amounts within any deductible applicable to the policy to the provider of corrective action or a damaged third-party, with a right of reimbursement by the insured for any such payment made by the Insurer. This provision does not apply with respect to that amount of any deductible for which coverage is demonstrated under another mechanism or combination of mechanisms as specified in 40 CFR 280.95-280.102. c. Whenever requested by a director of an implementing agency, the Insurer agrees to furnish to the director a signed duplicate original of the policy and all endorsements. d. Cancellation or any other termination of the insurance by the Insurer, except far non-payment of premium or misrepresentation by the insured, will be effective only upon written notice and only after the expiration of 60 days after a copy of such written notice is received by the insured. Cancellation for non-payment of premium or misrepresentation by the insured will be effective only upon written notice and only after expiration of a minimum of 10 days after a copy of such written notice is received by the insured. e. The insurance covers claims otherwise covered by the policy that are reported to the Insurer" within six months of the effective date of cancellation or non-renewal of the policy except where the new ar renewed policy has the same retroactive date or a retroactive date earlier than that of the prior poticy, and which arise out of any covered occurrence that commenced after the policy retroactive date, if applicable, and prior to such policy renewal or termination data. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. 1 hereby certify that the wording of this instrument is identical to the wording in 40 CFR 280.97(b}(2) and that the Insurer is licensed to transact the business of insurance, or is eligible to provide insurance as an excess or surplus lines insurer, in one or more states. ¢2~' Signature of authorized representative of Gateway Rivers Insurance Co. Type name: Robert Bourdon Title, Authorized Representative of Gateway Rivers Insurance Co: insurance Officer Address of Representative: 76 Saint Paul Street, Suite 500, Burlington, VT 05401 s:lrisklwordUe mplaccord.doc CLLI Codo Geo Code Street Address City Sfate Invamory Ownor CorNalner Type Yank Name Contalnor Location Capacly CKemical Name BKFOCA07 CAKO10 7520 20TH ST BAKERSFIELD CA ABS - AT&T BUSINESS SERVICES BELOW GROUND Mein Fuel Tank Next to Builtling 8000 DIESEI. FUEL #2 CORNCAI O CA4360 3950 S MAIN ST CORONA CA ABS • A7AT BUSINESS SERVICES BELOW GROUND DEFAULT South of Building 15000 DIESEL FUEL i72 DNGNCA01 CAIC342 PO BOX 209 DUNNIGAN CA IFOPS -INTERCITY FIELD OPERATIONS BELOW GROUND IN Ground Tank North of Building 20000 DIESEL FUEL #2 ELMNCA71 CAK358 3640 N EL MONTE AVE EL MONTE CA FOPS -INTERCITY FIELD OPERATIONS BELOW GROUND UST #t Parking Lot 10000 DIESEL FUEL #2 HWTHCANE CA3174 2301 W 120TH 3T HAWTHORNE CA NEO • AEN3 BELOW GROUND FUEL TANK #/ LOADING DOCK 25000 DIESEL FUEL #2 HWTHCANE CA3174 2301Wt2GTHST HAWTHORNE CA NEO-AENS BELOW GROUND FUELTANK#2 LOADING DOCK 25000 DIESEL FUEL#2 HWTHCANE CA3774 2307W1207H ST HAWTHORNE CA NEO-AENS BELOW GROUND FUEL TANK #3 LOADING DOCK 25000 DIESEL FUEL#2 HWTHCANE CA3174 2301 W t2rITH ST HAWTHORNE CA NEO-AEN3 BELOW GROUND FUEL TANK #4 LOADING DOCK 25000 DIESEL FUEL #2 HYWRCA81 CAK147 1391 BST HAYWARD CA (FOPS-iNTERCITYFIELD OPERATIONS BELOW GROUND round double wall Weal of8ullding 200 DIESEL FUEL#2 LODICA02 CAK482 J110 W TURNER RD LODI CA (FOPS -INTERCITY FIELD OPERATIONS BELOW GROUND underground storage tank North of 8ulitling 15000 DIESEL FUEL #2 TFPSCAES CA7002 1700 S BARDMAN AVE MALIBU ~ CA 1FOPS - INTERCfTY FIELD OPERATIONS BELOW GROUND Mein UST W est of Binding 15000 DIESEL FUEL #2 MSYJCAII CAK548 28302 MARGUERITE PKY MISSION VIEJO GA (FOPS • INTERCITY FIELD OPERATIONS BELOW GROUND 10,000 Gallon Underground Tank Perking Lot 10000 DIESEL FUEL #2 MOJVCA02 CA0580 9 mi. E of Mojave on Hwy 58 kkojave CA ABS - ATBT Bl151NE53 SERVICES B£lOW GROUND Meln Fuel tank South of Builtling 7400 DIESEL FUEL #2 OXNRCA07 RDCYCA02 CA031Y CAK131 1050 C ST 3175 SPRING ST OXNARD REDWOOD CITY CA CA (FOPS -INTERCITY FIELD OPERATIONS NEO - AENS BELOW GROUND BELOW GROUND MAIN TANK GenetalOrs 4&5 Mein Tank Parking Lol Weat of Building 5000 8000 DIESEL FUEL #2 DIESEL FUEL ?Y2 RDCYCA02 CAK131 3775 SPRING ST REDWOOD CITY CA IFOPS -INTERCITY FIELD OPERATIONS BELOW GROUND Turbines 1 d 2 Meln Tank Parking Lot 7200 DIESEL FUEL #2 SNBRCA01 CAK753 455 W 2ND ST SAN BERNARDINO CA IFOPS -INTERCITY FIELD OPERATIONS BELOW GROUND Xerxes Double Well Fherglass Tank w/ Basement 20000 DIESEL FUEL #2 SNJLCAZE 400 Holger Way Sen Jose CA NEO -AENS BELOW GROUND UST Next to Building 20000 DIESEL FUEL #2 SNLOCA01 CAK1)1 872 MORRO ST SAN LUIS OBtSPO CA (FOPS- INTERCITY FIELD OPERATIONS BELOW GROUND DEFAULT West M Building 5000 DIESEL FUEL #2 SNLOCA03 CAK734 9401 LOS OSOS VALLEY ROAD SAN LUIS OBISPO CA NEO - FORMER IFM BELOW GROUND Mein Diesel Tank West of Building 25000 DIESEL FUEL #2 SNANCAAV CA6051 1241 ALTON AVENUE SANTA ANA CA (FOPS-INTERCITY FIELD OPERATIONS BELOW GROUND TANK#1 Perking Lot 2000 DIESEL FUEL#2 SNBBCA01 CA8970 819 CHAPALA ST ~ SANTA BARBARA CA (FOPS- INTERCITY FIELDOPERATIONS BELOW GROUND DEFAULT Sou87 of Building 2600 DIESEL FUEL #2 SNRSCA02 CA1800 5203RD ST SANTA ROSA CA (FOPS-INTERCITY FIELD OPERATIONS BELOW GROUND doube wall Parking Let 12000 DIESEL FUEL#2 SHOKCA02 CAK146 14800 VENTURA BLVD SNERMAN OAKS CA IFOP9 - INTERGTY FIELD OPERATIONS BELOW GROUNp UST #1 Easl of Building 20000 DIL•SEt FUEL #2 SHOKCA02 CAK146 14800 VENTURA BLVD SHERMAN OAKS CA (FOPS - INTERGTY FIELD OPERATIONS BELOW GROUND UST #2 Eest of Bvtltling 2000 DIESEL FUEL #2 VTVLCAAA wNCKCA50 CA9960 CAK207 16612 UNION S7 2741 N MAIN S7 VICTORVILLE WAWUT CREEK CA CA (FOPS • INTERCITY FIELD OPERATIONS (FOPS -INTERCITY FIELDOPERATIONS BELOW GROUND BELOW GROUND DEFAULT Vlplewall metal Perking Let West of Building 10000 1000 DIESEL FUEL#2 DIESEL FUEL#2 WLCKCA00010 CA0300 6M SOUTHWEST OF GRA55 VALLEY WOLF CREEK CA (FOPS -INTERCITY FIELD OPERATIONS BELOW GROUND DEFAULT Parking Lol 12500 DIESEL FUEL #2 . ~., -. " + CINGULAR WIRELESS'NEW ~~~~ ~_________________________ SiteID: 015-021-001274 + Manager ~~i ~a~ rnQitl~ih<~ BusPhone: (425) 580-7515 Location: 1520 20TH ST Map 103 CommHaz Moderate City BAKERSFIELD Grid: 30C FacUnits: 1 AOV: CommCode: BFD STA Ol SIC Code:4813 EPA Numb: DunnBrad:006980800 ,, Emergency, Contact / Title Emergency Contact / Title JOE LUQUE ~~~/ SUPERVISOR GNOC / Business Phone: (661-)325-0572x Business Phone: ( ) - x 24-Hour Phone (661) 3~33~4080x 24-Hour Phone (908) 234-3337x Pager Phone ( ) -~~ x Pager Phone ( ) - x Hazmat Hazards: React ImmHlth Contact Phone: (425) 580-7515x MailAddr: PO BOX 97061 State: WA City REDMOND Zip 98073 Owner NEW CINGULAR WIRELESS PCS LLC Phone: (425) 580-7515x Address PO BOX 97061 State: WA City REDMOND Zip 98073 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ~ PROG A - HAZMAT CO (OG~ S r ~ ~-1-~ T o wh s ~a~ -~"L~c. based on my inquiry of those individuals ~~ responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and b~±iieve the information is true, accurate, and complete. ,i Sig lure D e ~~~~ . ~°`°~ ~~ ~' ENrn .~uN o i 2oos -1- 03/22/2006 ~s,'.- ANNOTATED SITE MAP Business Name: Site Address: Map #: ~ wt f ~a<' k O A B C D E F G H Y r~ z O fi~ ~Fn~" ,/-~Tt W~ f ~ r Y=~.T ~i Y ? x~ ..ova iclnz~ Scale: 1 °= Feet ~~ N N N m m w w 0 3 N i N Q~1 m F~ --I D N Q1 Q1 lD N m ~ I ` ~ ~ NNOTATED SITE MAP Business Name: Site Address: Map #: 2 o w k t.es ; cld o !~ B C D E F G H I z o Sfiz~~t N~ _ $ ., C 8 y - s ~ ~ASr'ivl~~/ ~Yr ~+~ sari t nw~Ta! s SA~a7tt[S (/let d1 Tw+uk I'1eve~lSl~ 1~ I ICY Y T X-~ Scale: 1"= Feet NNOTATED SITE MAP Business Name: Site Address: Map #: 3 a k .~e A B C D E F G H I ~ o k 3-F-n,~ ~ N Y C~ ~sr-: I s y C3l- ~n-~+S (A ~d) ~7a' s'~~"t T~:a~1 r-'rao,~ 1~I1 Y T X -~ Scate:1°= Feet :. ,3 D a~ N N N m m Ul w w 0 3 I} m ro N .A i Q1 0 -~ o N N Q~ m tD N 00 00 I NNOTATED SITE MAP Business Name: Site Address: Mag #: ~/ B C D E F G~ H I zo ~, s~«-r N j; 4 2SO Gwl. ~r~ s~•~~ r yyyy~~ ~As~+~a~ frMb+w /-} 1! c-y Y T X ~ Scale: 1°= Feet ...ea ivna~