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BUSINESS PLAN 7/23/2007
Ltd O ~o ao O N N L O Y d V _L V I - :`'-`= - _~ Prevention Services -- l~ UNIFIED PROGRAM INSPECTION CHECKLIST. e F R S F , . „ 900TruxtunAve.,-Suite 210 FIRE Bakersfield, CA 93301 _SECTION 1: -Business Plan and_Inventory Program ''R'"' Tel.: (661).326-3979 - _ _ ~ Fax:. (661) 872=2171 FACILITY NAME ~ ~ - '7 ~ ajf INSPECT 7 N DAT~ 3 0 INSPECTION TIME , - ADDRESS PHON NO . NO OF EMPLOYEES ~c~r~ -~ ~ FACILITY CONTACT BUSIN SS ID NUMBER 15-021- ~~ - - - Section 1: Business Plan and Inventory Program _ _- I ^ ROUTINE 6~J~COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^' COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS APPROPRIATE PERMIT ON HAND BUSItIeSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ZOOT ^ 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 ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTIONSG/S1RDI~It~`rlif~~NSPECTION? PLEASE CALL US AT (661) 326-397-9 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # White - Prevention,Services Yellow -Station Copy' ^ YES ^ NO Business ite /Responsible Party (Please Print) Pink -Business Copy FD 2155 (Rev. 09/05 :>_- INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~-I`,rU~ c B O E R S F I L D F/RE ~RrM r Section 2: Underground Storage Tanks Program INSPECTION DATE: ~_~~, ^ Routine m/Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank 1~GJtff~ Number of Tanks Type of Monitoring ~ ~Gr'L Type of Piping 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 No 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 overtill /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 Business Site Responsible Party Pink -Business Copy KBF-7335 FD 2156 (Rev. 09/05) I2; 28; 2UU6 I I : I I AN UNDERQRQUND $TORAOE TANKS APPLICATION To ~IERFORM ~~o r Lae ~stlNa ! SE4E0 IECONDARY CONTAINMENT TE$TINO rTANK TIOHTNF.B$ TEST AND Tp PERFORM FUEL MONtTiORIG!{s CERTIFICATIQN ^ >wNNANCED LEAK DETECTION ~ LINE TESTING ^ TANK TIOMTNEI3B TEST ~ TO PERFORM Tanknology 9096764061 2/S BAKERf$FIELD FIRE D$P'~. ~-~r Y~'revea~ion Services I+R!* ~00'Cruutun Ave., Ste. 210 ~~ s~kersfiela, c~A ~sso~ Tcl.; {6fi1) 326-974 Flax: (b61) 852-2171 Pie 1 of 1 ^ SB-4Bn SECONDARY OONTAINMENT TESTINt3 FUEL MONIT~RWp CERTIFICATION _ FACILITY Cfrcie K#~7QBbOS ADDRE$$ $6q0 Auburn St. NAME Cfrcfs ft Stores OPERATORS NAME NAME!; PHpNE NUMBER OF CONTACT PERSON Mon#Ber- 661.87>I-7979 PERMIT t0 OAERA"E No. NUMBER OF TgNKS TO BE TESTED fS PIPINti OQINC TQ 9E TEaT'ED9 YES ®~Q _ 1 8$16 Reguf$r (8T} 2 9816 Pfus (89) 3 8816 Pramfum {91) -~- TANK T~T1N0 COMPANY _ NAMf3 f?F TESTiNq COMPANY Tanknofa ~ InC^ NAME m PHONE NUM9?R OF Wofsley Gouftar B00-B66.2178 f~y CONTACT PERf3oN Axt.1Z "'A1iN°ADDi~~$ 41788 Enterprise Clrcle $, Sultl~ D Temecula, CA 8269q NAME R PHt3NE NUwISER OF y'~m OQUlter - (9a1) 8:14.1721 CERTIFICATION #~ TEdTfdR OR $PBCIAL IN$PCCTOR: DAT! L TIME 7EiT TO BE 1 ~ f :GQ AM ~~ fCC #; ~8T ' CONDUCTED: IAf:TNpD 1;IANKtyR! OF APPLICA DATE: ~ ~ ~~ ~ ~ ..~ . WHEN APPAQVED . _„~. AAPROVED BY DATE ---~- FD 20x6 (Rer. 08106) 27~sso5 ~ UNIFIED PROGRAM CONSOLIDATED FORM ~S BUSINESS ACTIVITIES ~ ~~ FACILITY INFORMATION Page of I. FACILITY IDENTIFICATION FACILITY ID# 1 EPA ID# (Hazardous Waste Only) 2 CAL000278510 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS 3 Circle K Store #2708605 I. 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 your facility... If Yes, please complete these pages 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 (include liquids in ASTs and USTs); or the F f ©YES NO a HAZARDOUS MATERIALS INVENTORY - ~ applicable ederal threshold quantity or an extremely hazardous CHEMICAL DESCRIPTION(oES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) YES NO 5 / UST FACILITY (Formerly SwRCB Form A) 1. Own or operate underground storage tanks? UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? YES ©NO 6 ~ UST FACILITY ~Nr'D n~, J UST TANK (One per tank Q f ~! ~ z ® o / 0~ ~ UST INSTALLATION -CERTIFICATE OF O P NC M C LIA E(one page per tank)(Formerly Form C) 3. Need to report closing a UST? YES ©NO 7 ~ UST TANK (closure portion-one page per tank C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or i YES ©NO 8 ~ NO FORM REQUIRED TO CUPAS ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE r 1. Generate hazardous waste? b YES . NO 9 J EPA ID NUMBER--provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted YES ©NO 10 ~ RECYCLABLE MATERIALS REPORT recyclable materials (per HSC § 25143.2)? (one per recycler) 3. Treat hazardous waste on site? YES ©NO 11 / ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (Formerly DTSC Form 1772) f ~ ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L 4. Treatment subject to financial assurance requirements (for Permit YES ©NO 12 / CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE (Formerly DISC Form 1232) 5. Consolidate hazardous waste generated at a remote site? YES ©N013 ~ REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as YES ©N01a ~ HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formery DTSC Form 1249) E. LOCAL REQUIREMENTS 15 ~/ (You may also be required to provide additional information by yourCUPA or local agency.) ~ ~(~O` f G' 6 UPCF (1/99) 2708605 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION _~ I. IDENTIFICATION --- - - ~FACILITY ID# - F i` j ~' ~ ~ i ; j 1 ~BLGINNING DATE -- _.----- ~- `, - -~ ~- L J - ~ _ ~ i __~-- I 0.1_/01/2_0__0.7 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) j Circle K Store #2708605 BUSINESS SITE ADDRESS 5600 Auburn Street i uy.. , 100 ;ENDING DATE 101 ' _ ~._-._ _ 12/31/2007 3 BUSINESS PHONE -- - --- - 102 661-871-7979 103 _._ --. CITY 104 CA "LIP CODE 105 Bakersfield ~ 93306 DUN .BRADSTREET 10-5457662 108 iSIC CODE (4 digit #) 107 ~' ...._-- - ' 5541 ~ -- 108 (COUNTY Kern ---- BUSMESS OPERATOR NAME 109 (BUSINESS OPERATOR PHONE 110 Circle K Stores, Inc. 951 270 518 II. BUSINESS OWNER NAME MAILING ADDRESS i (CONTACT NAME CONTACT MAILING ADDRESS Circle K Stores, Inc. 495 E. Rincon Road, Suite 150 111 OWNER PFIONE 112 (951) 270-5193 113 114 (STATE 115 ~"LIP CODE 118 Corona ! CA ~ 92879 -----------_----- --III. ENVIRONMENTAL CONTAC.. __--- -- --. .. - - -_~ _---- -----_ - - --- -- ..._ . - --.... . -------------- - - ---- ------------- - ---- - T- - __ -_ 117 'CONTAC'T PHONE 118 Lorraine Soffe 951-270-5183 119 495 E. Rincon, Suite 150 , ___ ... --- - - --- --- _ _ --------- - - - ---__ _- - .. - j. -- - ...._. _. - _ -- -- - - ~CITY 120 STATE 121 ;'ZIP CODE 122 ' Corona CA ' g287g F -- - - - - -- --- ---- --------- --- ---------- -- - ---- -- - ------ -- -- - _ _ - .... ~ - _ . .. _.. _ i - - PRIMARY iV. EMERGENCY CONTACTS SECONDARY jNAME 123 NAME 128 Service Contact Center Kevin Quinn j -- -- - - -- --- ---. _. -- .__.. _... - __ - _ - _ . . _ . (TITLE 24 Hours 124 iTl'I LL pistrict Manager 129 !BUSINESS PHONE 866-805-4357 24-HOUR PHONE I 866-805-4357 PAGER# -- --! - - .- 125 ;BUSINESS PHONE 130 559-647-6910 128 ~24-HOUR PHONE 131 i 559-639-9228 127 jPAGER# 132 ' LOCALLY COLLECTED INFORMATION: j iCertification: 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 [he information is true, accurate, and complete. iDATE 134 'NAME OF DOCUMEN"f PREPARER 135 __ _ ____ _ _ _ _ ~( ! RHL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT. N, _ A rF S1 OF OWNn R/OPERATOR - - --- -- - - - - 13s / ~- - - - -- - ~- _ _ .. - - _ _ ._.. __. __ (AAYMM~ F. O G CR (p t) ITITLF.. OF SIGNER 137 Lorraine Soffe ~ Compliance Manager UPCF (1/99 revised) 16 OES FORM 2730 (1 /9 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION ADD ~ ~ DELETE IX! REVISE One page per material per building or area) 200 !~ Page of ~ __________ I. FACILITY INFORMATION (BUSINESS NAME 3 j Circle K Store #2708605 z7o8so5 I CHEMICAL LOCATION !CHEMICAL LOCATION CONFIDENTIAL 202 ' ~ SOUTHEAST CORNER LOT (EPCRA ~ -- ~---~ __~YES ~ x ~ No --- -- -- I ~ FACILITY ID# - ~~ - . -- - .--- - - -~ ~ -- ~ i i - -; 1 I MAP# (optional) ~ r ~ I i , -- --- -__ .------ - _ --- - 2031 GRID# (optional) D E5 204 , ~ ~ I 1 , ~ - - - - --- ----- _ ~ - -~ - - ~-- -1----~ - --- --- -' __ -. t .. -I--- ~- ~ ---- ----- -- --- - -- - --- - .... - _ ~ _... - . _. . _... - - - . II. CHEMICAL INFORMATION 1 -- ---------------- - - ----------------------------------- ------- ----- ----- ~CHEMICAL NAME 205 I TRADE SECRET !Yes I X iNo 206 GASOLINE -- - If Subject to EPCRA, refer to instructions .COMMON NAME 207 ' EHS r- ` ' 206 I REGULAR UNLEADED GASOLINE : X ~, No Yes ~ ~-- ~CAS# - -- - ~- - - 209 ' 8006-61-9 i If EHS is " ! ~ Yes", all amounts below must be in lbs. . _ ... -. I----------------------------------------------_---------------...----~~------ -_. _._ ...__---...... .__._ .....-.. _._~ FIRE CODE HAZARD CLASSES (Complete if required by CUPA) i I-B FLAMMABLE LIQUID -. - ....-_-----~~ -~ 210 i}iAZARDMATERIAL '- _--~ - -.~ - --- - - 211 RADIOACTIVE ~ ~ Yes _ a. PURE X b. MIXTURE i ~ c. WASTE ~ TYPE Check one nem I ! I -- ( !X,No 212;, CURIES 213 _ ___ ____.. --- - --_ _ a. SOLID rX~ b. LI UID ~~--- c. GAS __..... _ _ ___. (PHYSICAL STATE rr 214' ~ I LARGEST CON"MINER Q I ~ ! ! _. QQQQ 15 ; ~ ___-i _ i(Check one item only) !,FED HALARD CATEGORIES j` ~! - ' ' - X ! a. FIRE ~ ! b. REACTIVF. ~ ~ c.PRESSURE RELEASE ' X !, d. ACUfE HEAL; i I'H ' X ; e.CHRONIC HEAI:I'H 216 _._. ~_.._; .- _~ ;(Check all that apply) _ -- AVERAGE DAILY AMOUNT 217 jMAXIMUM DAILY AMOUNT 219 jANNUAI, WASTE AMOUN"I' 219 - - - - STATE WASTE CODE 220 . -- - _ _.8000 ----- - -----~--- 10000 --- -- - ~ - - _ - _ * r -- r--~ "--_ ~ ' d. TONS 'iUNITS t X~ a. GALLONS L J b. CUBIC FEET ~ ~ c. POUNDS I 221 ; DAYS ON SITE: 222 _ (Check one item only) _if EHS> amount must be_in_pounds. ~ 365 _ __. ____._._ __.... !S"fORAGE ~^ l CONTAINER ` a. ABOVE GROUND TANK ~ ! ~ e. PLASTIC/NONMETALLIC DRUM li. FIBER DRUM i ~m GLASS BOTTLE o RAIL CAR ( ~ X b. UNDERGROUND TANK f CAN ~ j. BAG fin. PLASTIC BO'T'TLE ~ gip. OTHER ~ C ~ c. TANK INSIDE BUILDING --_ g. CARBOY ~ !k. BOX ~ ' - - 'o. TO"fE BIN - _ !, ~ d. STEEL DRUM r--- , h. SILO I I. CYLINDER j ,p. TANK WAGON 223 ' r --- ~ STORAGE PRESSURE ;~X-I a. AMBIENT ~ ~b. ABOVE AMBIENT ; -- - --- -------- --- c. BF,LOW AMBIF..NT ---- -- -------- .. ._.-----_. .. __. - -- I STORAGE TEMPERATURE ~~ a. AMBIENT ~_ fib. ABOVE AMBIENT - --- --- -- --. _....- - -.. _.__.. _. -. -----..-..._ ._ - ..-- _ is BELOW AMBIENT - -- - _.-.. -_ _.. d. __ CRYOGENIC _ _ ..... _ r %WT i HAZARDOUS COMPONENT (For mixture or waste only) EFTS ... - _ . - CASH I I 100 226 I Gasoline 227. I (Yes ! X No 228 ~~ 8006-61-9 2 1-9 23o TOLUENE 1 231 I I- -Yes ; X ~No '- ~ .._~ 232 I 108-88-3 234 23 ~ ` ~ 36 3 ~ ~ XYLENES 1-14 5 , :Yes ~XINo ~..- 2 ; 1330-20-7 I 238 i - - ~4 1-5 1,2,4-TRIMETHYL BENZENE i 239 Yes X:No ~.. 240 ~ 95-63-6 ' 5 242 1-5 i Ethyl Benzene 243 ~ ~ Yes ,X'No 244 I 100-41-4 I f If more hazardous components are present at greater than 1°o by weight if non-carcinogenic, or 0.10/ by weight if carcinogen ~ ------------- ----- .__-_..... ic, attach additional sheets of paper capturi ------ -- -' --. .- ...- ... --.. _.. - ng the required information. - - - -._.... .. _ . _.___ .._. _.. -_._ _.- .. - _.. ---- - ADDITIONAL LOCALLY COLLECTED INFORMATION 224 225 229 233 ; 237 241 245 246 , If EPCRA, Please Sign Here UPCF (1 /99) 169 OES Fot~rrt 2731 ' UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION I One page per material per building or area) ^I ADD I I DELETE iX! REVISE 200 I Page of 1. FACILITY INFORMATION ,BUSINESS NAME 3 Circle K Store #2708605 z7o8so5 jCHEMICAL LOCATION CFIEMICAL LOCATION CONFIDENIIAI. 202 ' SOUTHEAST CORNER LOT EPCRA _1YES ! x ~ No - --- i- - ~ - - --, - ~,: 7 _ _- - i 1 MAPa (optional) 203 GRIDtr (optional) 204 .FACILITY IDN I i i ~ i I ~ ; i ~ 1 E5 i ~ J , ,. ~ I----- ----- - -__ ~.. -- - - - _ - .- . _~- _ ~ .. - - II. CHEMICAL INFORMATION _ GASOLINE - - - i . - _..., _ .._ ,_ ....._ - - - _ _ __--- _ _ -- _ _- -- . -- -- - _ TRADE SECRET I (Yes ' X 'No 206 (CHEMICAL NAME 205 i If Subject to EPCRA, refer to instructions (COMMON NAME --- - -- - - ------- -- 207 '-- - - - - -... _ _ _ _ - ! PLUS UNLEADED GASOLINE ' E"S ~. I Yes X No 208 __~ ~CASN 209 I If EHS is "Yes", all amounts below must be in lbs. 8006-61-9 I FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID ------------- -- ---- 211 f - , 212 ! 213 HAZARD MATERIAL ____ a. PURE ~ X ~ b. MIXTURE ! c. WASTE RADIOACTIVE i,_.; Yes X ~No ~ CURIES ;TYPE (Check one item ~ _-' - - ------_~---- - - -- ._ -' :PHYSICAL STATE ' -' ' - 214' 215 ~ a. SOLID ~ X J b. LIQUID ~ c. GAS I LARGEST CONTAINER (Check one item only) ~--~ -- I i ~ ~~~~ FED HAZARD CATEGORIES j ~ 216 ' X~ a. FIRE r b. REACTIVE ~ 1 c.PRESSURE RELEASE X ; d. ACU'T'E HL'ALTH ~ X . e.CHRONIC HEAI: fH (Check all that apply) ~ ---~ ---I - __ -. '- --- (AVERAGE DAILY AMOUNT 217 (MAXIMUM DAILY AMOUNT 218 (ANNUAL. WASTE AMOUNT 219 !STATE WAS"fE CODE 220 -- 7000----- --------~------------1_0000- - --- ._. _ -- -_- !- - -_ - ..- .. _ - - I. - ----- -. _ ..._ .. !UNITS' ', X I a. GALLONS ~ I, b. CUBIC FEET j l c. POUNDS ~i ! d. TONS 221', DAYS ON SITE: 222 , ;(Check one item only) ~ l -- -- -- -- --- - -- ._..-..-- - - -- _-_----------- - - --if EHS, amounl_must-6e in.pounds. STORAGE ~ ~a. ABOVE GROUND TANK ~ ~e. PLASTIC/NONMETALLIC DRUM Ii. TIBER DRUM gym. GLASS BOTTLE i io. RAIL CAR CONTAINER ~---, ~ -- - ~ ~ ! , ~ I X I,b. UNDERGROUND TANK ! if CAN !j. BAG ~n. PLASTIC BOTTLE ~ ~p. OTHER I I c. TANK INSIDE BUILDING 4 Ig. CARBOY '~k. BOX ',o. "1'OTFi BIN ~ ---~ ~ ---! i- ~ i. . _ ! ; Id. STEEL DRUM !- Ih. SILO ,I. CYLINDER ;p. "fANK WAGON ~ STORAGE PRESSURE I X ~ a. AMBIENT ~ ib. ABOVE AMBIENT j L--- ---.., ~ STORAGE TEMPERATURE ~ X J a. AMBIENT I _ ib. ABOVE AMBIEN i _. ------------------------------------------- -%WT - - ~ HAZARDOUS COMPONENT (For mixture or waste only) 223 , T ; _ ic. BELOW AMBIENT I d. CRYOGENIC - -- ---- --- r 'c. BELOW AMBIENT 224 ~' (__._l r' 225 _ - -- EMS - i---- -- ----- - _ - -___._..__ . - ... CAS# ~I 100 I GASOLINE ~ ~ Yes t. -' LX jNo 228 ~ ~ 8006-61-9 229 ------ -- I 2 1-9 _---- 230 ~ - TOLUENE - --- ___----_---- -- 231 ------- r- -. ! „-Yes ~ ------ ,- i-X INo --- _ - - ! 232 ! ------- -_ --- -- 08-88-3 33 , ------------- - - ---- --t - ------ ------ - ------- -- - -- -------- ---- - ...--- --- ----- - - ~._ : -- -- --- _ _- --- - -... - ---- ---- - - _ _ ..- .. _ _ _ _ _ _ _ i3 1-14 234 ! XYLENES 235 i ;--' Yes I' ~ X!No 236 i 1330-20-7 237 . '4 1-5 236 ~ ~ 1,2,4-TRIMETHYLBENZENE _ 239 I _--- ~ Yes -. - ..- jXINo _.._.....i.. 240 ~ _ - - - -- ---- - -- 95-63-6 - 2a1 , !5 1-5 2a2 Ethyl Benzene i 2a3 ~ iYes X:No 2aa i~ ~ 100-41-4 2a5 ~~ If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0. I °,o by weight if carcinogenic, attach additional sheets of paper capturi ng the require __ _ d information ADDITIONAL LOCALLY COLLECTED INFORMATION 246 I i ~----~- -~- ----------~~ ----- - -. _.. - .. .. _. -. If F.PCRA, Please Sig -.. _ n Here UPCF (1/99) 169 OES Form 2731 ` UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ADD DELETE XI REVISE 200 ~ Page of I. FACILITY INFORMATION _ USINESS NAME 2708605 3 I __ __ _ _ __ _ Circle K Store #2708605 11CHEMICAL LOCATION CFIEMICAI. LOCATION CONFIDENTIAL 202 SOUTHEAST CORNER LOT (EPCRA 1YES '' x ~ No I r i.. _ --- - -- d" IFACILITY IDN ,I ( {i I ~ i 1 MAPtt (optional) 203 j GRID# (optional) 204 I _~ ~ ! ~ ! ll. CHEMICAL INFORMATION t- - -- ------ ----- - ----- --- --------------- - ------- --_ --- -- - _--- - -- - - - --- -- -__---- - - --- - - --_ _ CHEMICAL NAME 205 TRADE SECRF"T i ;yes I X No 206 GASOLINE ' ~ ~ -i If Subject to EPCRA, refer to instructions .COMMON NAME 207 208 - --- -- ------ -PREMIUM UNLEADED GASOLINE ___-__ - . __ - - . - ,EHS _ _.- i I - I Ycs ~ X' No !CASH 209 ; 8006-61-9 If EHS is "Yes", all amounts below must he in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) i I-B FLAMMABLE LIQUID _. _.__-- - - 211 i - (HAZARD MATERIAL - - ------_ - I -- - - -- -. I--. -- -- - -- ..-,.. _ _ TYPE Check one item a. PURE X ~ b. MIXTURE c. WASTE i RADIOACTIVE i ._.I Yes ~ ( __ I __~ ~_ I , PHYSICAL STATE a. SOLID (~X b. LIQUID c. GAS 2141 LARGEST CONTAINER !(Check one item only) ~ ~ L-~ 210 2121 213 IXNo CURIES ; 215 10000 FED HAZARD CATEGORIES ~ I- - - -- - - - ---- -__~ --------------- - --- - -- - - 216 X~ a. FIRE l~ b. REACTIVE r ~ c.PRESSURE RELEASE I X d ACUTE HEALTH X I e.CHRONIC HEALTH ((Check all that apply) I---• L--- ~ ' - - iAVERAGE DAILY AMOUNT 217 (MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 ~ISTAI E WASTE CODE 220 --- --- -65Q0 --- -- -t- --- - 10000 -- -- ---- - -i- ----- ____ ___ . _. i~ .-- ---- - - . IUNITS* I X ~ a. GALLONS j j b. CUBIC FEET r -i c. POUNDS ~ d. TONS 221 ', DAYS ON SITE: 222 - - - I- - 365 ((Check one item only) _ _ if_EHS,_amount.must_be_in.pounds,__ _.._..._. -- iSTORAGE I ~a. ABOVE GROUND TANK I 1e. PLASTICMONMETALLIC DRUM I ~i. FIBER DRUM I n1.GLASS BOTTLE I 'o. RAIL CAR IICONTAINER ~ X fib. UNDERGROUND TANK I ~f CAN ~ '~ I ~ OTHER I --_1 I - ~ . ,-- yiT. BAG I- --In. PLASTIC BOTTLE ;p. ' ~c. TANK INSIDE BUILDING I 1g. CARBOY I !k. BOX ' !o. TO'T'E BIN ~ ~d. STEEL DRUM ! ~h. SILO ~ I. CYLINDER i ';,p. TAN K WAGON - - 223 STORAGE PRESSURE ! X ', a• AMBIENT Ib. ABOVE AMBIENT j L -' _~ ~c. BELOW AM BIEN"I' 224 i I_..- , STORAGE TF,MPERATURE ~~ X a. AMBIENT ~ b. ABOVE AMBIENT ---- -- ------- ---- ------ ---------- - - -- - - - - -- -- -- _ 'c. Bk3LOW AM _ _ - - ..._ BIENT _ . ~ d. - CRYOGENIC _ _ 225 i a i /oWT i HAZARDOUS COMPONENT (For mixture or waste only) EHS CAStI !1 100 226 i GASOLINE 227: ~ ;Yes IXNo 226 ', 8006-61-9 229 ~ 2 1-9 I TOLUENE 230 -- ---- -- ------- ---- ---- - - -- i Yes 231 I ~ :- I _ X~No II ' 232 108-88-3 233 ~3 - 1-14 234 i XYLENES - .- 235 I ~ Yes ~._I ~ - ._ X'No L ._. I - 1 236 ~ 1330-20-7 237 ' - 4 ------- .. ---- -- - - -- --~- --- -- --- 1-5 238 1,2,4-TRIMETHYL BENZENE - 239 ~ ~-=~e5 _ I IXINo 24o I 1 95-63-6 241 ~5 --- -- --- r- - - - -- --------- -- -- - - -- 242 I 1-5 ~ Ethyl Benzene 243 ~ '-- ~ Yes r- IX,No 244 ~ _.... ._ 100-41-4 245 ' If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLEC'T'ED INFORMATION 246 If EPCRA, Please Sign Flere UPCF (1/99) 169 OES Form 2731 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MAT'F,RIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ! ~_- _----------- Xi REVISE 200 Page of ADD ! DELETE ' CILITY INFORMATION !BUSINESS NAME 3 NE CORNER NEXT TO ENTRANCE 2708605 l 'CHEMICAL LOCATION CONFIDENTIAL 202 EPCRA L - . ~yES ~ X J NO I MAP# (optional) 203 ~ GRID# (optional) 204 1 I D2 II. CHEMICAL INFORMATION CHEMICAL NAME _ _ __ _ _ _ _ 205 !TRADE SECRET i ~ ~ Yes ~ X No 206 Propane ~ L....__ ~ _ i i If Subject to EPCRA, refer to instructions -------------------- ~COMMON NAME -------- - --- - - _ . ------- -------- 207 i _, 208 PROPANE E"s ~ Yes ~xl: No t- - ------- --- --------- -- ---- ------- ~CASH 209 ! 74-98-6 If EHS is " Yes", all amounts below must be in lbs. _.--- ;FIRE CODE HA"LARD CLASSES (Complete if required by CUPAI F G 210 lammable as IfIA7.ARD MATERIAL _ ~'fYPE Check one Item ~ a. PURE X j 6. MIXTURE c. WASTE 1 211 I r--- ~ RADIOACTIVE ;. _ ' Yes ~ 2121-- _..._ ! X No ~ CURIES 213 ---- -----. _. __---- -- - - --- - - ----- ~- - ~ - ~ c. GAS- _ ~ ! ~ a. SOLID X ! b. LIQUID I A I 214 LARGEST CONTAINER _ _. 5 215 ~_ _I __ i ~._.__ (Check one item onl y) -- -- - - ------ --------- - ---- - --.._ - - ----- - __._... -_.. __ _ _ _., _. FED HAZARD CATEGORIES ~ ! X~, a. FIRE ~ ~ b. REACTIVE ' X' c.PRESSURE RELEASE. . X ~ d. ACUTE HF.AL' i TH ; e.CHRONIC HEAL."I'H 216 !(Check all that apply) ~ 1--.- -- --. j---- -- _ - ...- - - - I _ --- _.-. -.. - IAVERAGF. DAILY AMOUNT 217 !MAXIMUM DAILY AMOUNT 2181ANNUAL WASTE AMOUNT 219 iS'fA"1'E WASTE CODE 220 ------ ---20 ----------1--------- 60 ------------------ -~_ X * n ~ ~ ___ ... _ _ _ _ _ _ _ --- -...--- ----- ___. _.. -'--- . _. --- --- -_ __ _ _ .. _. -- - 221 ' DAYS ON SITE: - . 222 UNITS l ~ a. GALLONS b. CUBIC FEET ~ c. _ POUNDS . I d. TONS ~ 1,(Check one item only) r-------------- - --------- -----------------------If IyHS._amount_must_be_ - ~ in-Pounds.--- ---------_____.._ ~ 365 ----'-------------....._..-- .---------...____. _ ',STORAGE ja. ABOVE GROUND TANK Ir ~e. PLAS"f1C/NONMETALLIC DRUM j i. FIBER DRUM I Im.GLASS BOTTLE ~ !o. RAIL CAR CONTAINER ~- ~ '~ b. UNDERGROUND TANK ~ f CAN ;-- -{, ~ ~. BAG - i - -'• fin. PLASTIC BOTTLE ! p. OTHER ~ ~ ! c. TANK INSIDE BUILDING ~ g. CARBOY ~ ~k. BOX ! -- -- - Io. TOTE BIN I I ~d. STEEL DRUM ~Jh. SILO LXJI. CYLINDER ~ jp. TANK WAGON ------ ----------- - -- 223 r L I ~ STORAGE PRESSURE ~ Jj a AMBIENT X fib. ABOVE AMBIENT - I ,~~c. BELOW AMBIENT -- --- ----_ ... - - _..._ . _ . . _ . 224 I - ------------------------------------------- - ;' STORAGE TEMPERATURE 1 X a. AMBIENT Ib. ABOVE AMBIENT ~--- --- -------- ------ --- --------- ~ !c. BI?LOW AMBIF:N f L_-..-.. - -- - - --___ _--- -- -- --_ _ _ !d. CRYOGENIC _ 225 %WT j HAZARDOUS COMPONENT (For mixture or waste only) LhIS i CAS# -- i~ 1 >65 2zs ~ PROPANE 227 i Yes I X iNo 2zs 74-98-6 229 2 <35 230 ~ Propylene z31 Yes ~ X ~No 232 i 115-07-1 233 ' 234 ~3 <6 '~ Ethane 235 ! Yes !X'~,No ~ - 236 j 74-84-0 I 237 ..-.__- -_ ___._-_-_. .. ___._._ -___.. _._. .__._.-_- _. -__---.- -._-...._.. . _. .. .__ ... .. ....... .. .._.._.. .. '4 <5 238 ( Total Butanes i _ . .._-- - - _.. _ 239 Yes ! X No . _ ... .. .. _ - 2ao ' 78-28-5 2a1 i5 <0.1 242 I Ethyle Mercaptan 243 Yes X No zaa ~ 75-08.1 2a5 I If more ha~nrdous components are presem at greater than 1 % by weight ifnon-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper captu ring the required information. ; I ADDITIONAL LOCALLY COLLECTED INFORMATION 246 ' If EPCRA, Please Sign Here , UPCF (1/99) 169 OES FotTn 2731 Circle K Store #2708605 CHEMICAL LOCATION UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATF,RIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building ur area ) ~ I ADD I DELETE IXI REVISE 200 i ----------~- ~------------- ---- -- -- -- -___ - ~~~ Page of ---._.. - - -.. _._. . I. FACILITY INFORMATION !BUSINESS NAME 3 ~ Circle K Store #2708605 2~oasos ; CHEMICAL LOCATION CI IF.MICAI. LOCATION CONFIDENTIAL 202 , STORAGE AREA EPCRA I (YES ; x ; No _ FACILITY IDit ~ 1' ~--~-~ ~ ~ i-~ ~ --~ ~ I '- 1 ~MAPN ~~ ~ p ti al on ) -- - ----- _ GRIDi! (optional) 20 3 ~ 204 ~ I 1 B3 _ II. CHEMICAL INFORMATION CHEMICAL NAME 205 ~ TRADE S ECRE'T' ~ ;Yes ~ X 'INo 206 ~, CARBON DIOXIDE ~-' ----- - - - - - If Subject to EPCRA, refer to instructions . __ __...- - -- -- --- - - - - - - 'i COMMON NAME 207 ~ ,EHS I --I Yes fix] No 208 CARBON DIOXIDE GAS i 'CAS# 209 I 124-38-9 If EHS is " Yes", all amounts below must be in lbs. I _ FIRE CODE HAZARD CLASSES (Complete if required by CUPA) ~ ___ _ 210 ~I NON-FLAMMABLE GAS HALARD MATERIAL --------~ ------ -- 211 - - --- - - -- T-- -- _ - - ~X~ a PURE ~ b MIXTURE ~ ~ c. WASTE ~ RADIOACI IVC T_.. Yes T'YPE (Check one item .. • - _ ---- -- -- - - - --- - I' -_ _- 212 i X ~No CURIES - - 213 ~ PHYSICAL STATE a. SOLID i b. LIQUID X-i c. GAS 214 ! LARGEST CON"fA1NER 2 6 215 (Check one item only) t~_ __~ I , --- --- -- --- ..------_-.- ------ ---------- - ---- -------- __ - - ----- ------ - ~ (-~ ~ ~ ~FED HAZARD CATEGORIES ... _._ --- - -__ - . .._..- I - i - 216 jl ~ j a. FIRE ~ I b. REACTIVE X I c.PRESSURE RELEASE I X d. ACUTE HEAL TH c.CHRONIC HEALTH ((Check all that apply) ; (AVERAGE DAILY AMOUN"1' 217iMAXIMUM DAILY AMOUN1' 218IANNUAL WASTE AMOUN"f 219;S"FATE WASTE CODE 220 ' 1805 _ -- -- ' _261.0.._ . - _ - -- - - --- -- - _ _ ~- - ~ r- , UNI"fS* ~ a. GALLONS j X b. CUBIC FEE"f c. POUNDS d. 'I'ONS 221 • DAYS ON S1TF.: 222 - - (Cheek one item only) _ __- __ _if EHS,.amount.must be_in pounds. _ ... - I_.-..----_- - ----- ----- - ------- ----_. _..------- 365 S"FORAGE IIa. ABOVE GROUND'1'ANK ~ l (CONTAINER ,--i ~--- e. PLAS"IICMONMETALLIC DRUM i ii. FIBER DRUM j - ~ ~ ;m,GLASS B01'TLE io. RAIL CA i. ' " ' R Ib. UNDERGROUND TANK j f. CAN j. BAG ,n. PLAS 1CBOTTLE p. OTHER I X Vic. TANK INSIDE BUILDING j g. CARBOY .k. BOX io. TO'T'E BIN -- -.. i -, i d. STEEL DRUM I ih. SILO ~ I. CYLINDER i ~ ' , ' , ;p. "FANK WAGON __ __ 223 , STORAGE PRESSURE ~~ a. AMBIENT ~ X ~b. ABOVE AMBIENT ~ ~c. BELOW AMBIENT 224 - i.---~ I - - - ----------- - ---- - - - -- --- ---- ---- -- -- - -- ---- - - -- I STORAGE TEMPERATURE ~~ a. AMBIENT r Ib. ABOVE AMBIENT r ~c. BELOW AMBIENT I L.J {- -' , -- ..- . _.. -- - .... - ----- - - ---- - - - --- - ... 1d. CRYOGENIC I-- . 225 , %WT I HAZARDOUS COMPONENT For mixture or waste onl i CHS ( Y) ,. - CAS# , , ' I 100% 226 I CARBON DIOXIDE 227 ' ~ 'Yes i X rJo i_._ i 228 124-38-9 229 ' -- i j2 230 I 231 i i- - jYes `X iNo I _. 1------ -_._ ..._ _. . 232 233 ---- - - -- -- ~3 234 i 235 ~ ~ Yes X fNo f ' i -- 236 - _ _ 237 -_-- 4 238 -- - 239 i j` - ,Yes j X ~No - ---- - - --- - ---- --- --- 24o 241 , i I 242 243 -, 'i 5 ~ i ~X.No es 244 - - -..- .. - 245 If more hazardous components are present at greater than loo by weight if non-carcinogenic, or 0, I % by weight if carcinogenic, attach additional sheets of paper captu ring the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA. Please Sign Here UPCF (1/99) 169 OES Form 2731 ' UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) I ADD --_ DELETE---`- 1X; REVISE-------_--------_ _ ----_ -.200 ,! Page of I. FACILITY INFORMATION r----------- -- ~BUSINESS NAME Circle K Store #2708605 2708605 3 ~;~CHEMICAL LOCATION ,CHEMICAL. LOCATION CONFIDENTIAL 202 TRASH ENCLOSURE jEPCRA f _- _wES ;: x ~ No F------ --- ~ ~ ~ T-- ~ i I 1 ~ ~ 11 MAPtI (optional) 203 i GRID# (optional) 204 , FACILITY [D# ~ ~ I I I j II. CHEMICAL INFORMATION _ _ _ _- - - - - CHEMICAL NAME _ _ _ _ 205 TRADE SECRET ~ Yes ~ X iNo 06 (COMMON NAME -- _ . _ _._._ _ -. _ 207- , - - - If Subject lu F.PCRA, refer to instructions - -- - I, USED GASOLINE FILTERS EHS _ - i Yes x~ No 208 _ rCAS#----- ----- ----------- -- - 209 ; 8006-61-9 If F.HS is " Yes",all amounts below must be in Ihs. ,FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID --------- ------------- - - -----J . -_--- - - _ - - -.._..- -- __ - ... ; I _ _ __ 211 HAZARD MATERIAL PURE I l I MIXTURE X c WAS"fE b ~ a TYPE (Ch k n J ll RADIOACTtVF ~_; Yes I ' L 212 X jNo ,CURIES 213 ~i . . . one em ec ~ ---------------------L=--------___' ------_ -- -- ~- _~ -- --- - --------- - - ------- . - _. _ _ _ . -...- - -- -_ .L. _ _. 1 PHYSICAL STATE 214 ~ X a. SOLID b. LIQUID ~ c. GAS [ ~ L LARGEST CONTAINER 200 215 (Check one item only) - -- -J r -------------- --------------------------------------------~__---- --_ ---- ---- FED HAZARD CATEGORIES ! c.PRESSURE RELEASE ~ X j d. ACUTE HEAL ~ X~ a. FIRE ~~ b. REACTIVE ~ ' -- - _ - - -- TIi ; X i e.CHRONIC HEAL"fH 216 - ,(Check all that apply) AVERAGE DAILY AMOUNT 2171~MAXIMUM DAILY AMOUNT 218ANNUAL. WASTE AMOUNT 219 iSTATE WASTE CODE 220 i------ - -------------3 --- -~-------5 -----!------ --- --- --200 -.. _.__._`213--------- -- -- ----........ _ _ _ jUNITS* ~ ~ a. GALLONS ~~ b. CUBIC FEET rX ~ a POUNDS ~ ~ d. TONS 221 ~ DAYS ON SITE: 222 ((Check one item only) _ tf_EHS,_amount ~ ' must be.-in pounds..--------------._.-_--- -_ - 365 _ ~ ------------_.__ -. -- -_-._ _. _ . _ !STORAGE Via. ABOVE GROUND TANK ~ ~e. PLASTIC/NONMETALLIC DRUM !CONTAINER - ' -- - -. !i. FIBER DRUM ;--i 'm.GLASS BOTTLE ~o. RAIL CAR !b. UNDERGROUND TANK If. CAN ~ . ~ II. BAG ! fin. PLASTIC BO"I'TLE I gip. O"fHF.R I _ - - i c. 'TANK INSIDE BUILDING ~ g. CARBOY ~ !k. BOX I I --- ~o. -f0'fE BIN -_ ~ X~d. STEEL DRUM i ~h. SILO j il. CYLINDER ~ gip. TANK WAGON - j - 223 STORAGE PRESSURE ~X-~ a• AMBIENT ~ lb. ABOVE AMBIENT ~ -- -' ~ . i '~c. BELOW AMBIENT 224 _... ----- --= __ _ ---- - -- ----- --- --- - - ----- -- - -- _ '-X..i a f -~' ~ STORAGE TEMPERATURE ~_ AMBIENT b. ABOVE; AMBIENT i ~~ c. BI?LOW AMBIENT -~~ ~d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) El IS CAStI r -- ---------- ----- ---- -------------------- -- -- - - -- _ -- - - ~ 1 5 226 GASOLINE I _ - _- 227 ~ ~- Wes ~ X ~No _ _ _ _. 228 I 8006-61-9 . 228 -- - -- --- I- ----- --------- -- ---- 230 12 I FUEL FILTER 231 '-- ' i ~- 1'es ! X-~No 232 ~ 233 13 234 I --------- -- - - 235 ~ Yes ~ X jNo - - - - -- 236 ~ - - 237 238 ! ~!4 ~ I I--, r- 239 ;Yes I X~No 240 ~ 241 S--- ---- ----- - - 242 i --- --- 243 - f Yes X No I 1 i ! 244 _ -.. .- -,.. ._ .._ __ I 245 _ --- --- --- - - --- -_ .. ~ - -- - If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0, I% by weight if carcinogenic, a I ----------------------------------- ------- ttach additional sheets of paper captu - ----------------- --- - ring the required information. -._. _. - - .._.. - -- -... _ . _.._ - ..... ... . ... . . ~ - - ~ - -- - ' - - ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here L --- - -- ------ -- - - - _ -- -...-- - -- ---- - - - --... ------- - - - - UPCF (1/99) 169 OES FotTrL 2731 G C7 ~,,, T ~ a W a -f-I U~ ~ O ~' 2 ~ N7 6 II ~- Q `~ f A J O ~ ~ '.. ~ Q ~ N N w '' W a U ~ ~ a~ ~'- ~ ~ Ul Y y a a ~ a ~ r ~ 3 a ~ r- ~~ o a p a -~ U > > ~ w Y. U a N ~z O Q >~ O~ pr U W w N Z w O Z p Z Q } Q O ZQ Z p Z Z K W K W O QO w0 ~ O Q X ~ Oa O > w~ w Q ~ Q ~i ~t~c~i ~za r wgaZ~aF =wed >~w~ U~ ~~ ~ m~ za ~ '^ o z as ~~ w Z w~ Omo 00 ~_ 4= Q ~= a~ ~ rr r a ~-> .~O K ~O ¢ to ~crn wvi Ztn 3 win ra t= ~_ w cn in cnw =~ ~ ~ ww - 0 000 <~~0~~ ®~(~~ 0~ w o~; - z l%~ U in ~ ~ o m o in ~ ¢ O Q ~ p Ow ~ a Q Q p Oo w wm Nm OW w w m~ H J F W N m N Z Q ~- ~ Oj Z~ Z a w ~~wm ~m pa a~~ oa ~~ o~ m~ aQ ~ aw wo 00 ¢O ~J z U" o `J ~~ U" a~ ¢ 0 0 0° 0 0 o ~ ~ m OG w~ rs Qa 3~ 0 ~ U o a = N 3 U 0. _-___._ ~ O U In w _ Z W T Z ~ ° w u ~i31N~~ ~~1SOd ~ J O Z ~WZ ~z¢ ~ ~ w J r z Z (n U1 U U ~ U1 Q O 4 -~ ~= U a U U O ~ ° ~ Q W Q A~RFAX ROAD N ~ O 0 ~ F M w '- l.0 f~ _ .- - ~ ~ ~ _ _ ~ ~ --~~ \ ~ Q O _ W U ~ ~1 Q N ~ 3 O W _ / ~ Z/~ ~ \ / ~ i~ VP ~~i ^~ i ~0 i~ P~ ~ i V / ~ i i ~ t- 0 ~ Op /~~ /~~ F~ ~ ~ ~ ~ ~ ~ E-. ~--~ /~ , O ~ o , ~ 0 4 Q ~; C] z ~. /~ 0 i ` W~ ~' ~_~ W ~ ~ ~/ 0 W z U7 ~ 7 ~ ~ ~ i~ LiI `n ¢ X O ° J !- ~ CC YQ ~ N d L Z Q m - -____ __ ~ c G A A M Q LLl I--+-y N I 0 `l ~ { O W ~ W z I N O ~ o I ~n w ~ ~~ ~o ,_ J U I = ~ I N ~ ~- U7 Q - 0 W ~ ~ O w o m ~ o w~ ~o <~~ ,~ Y ¢ m ~ ~ O ~ - - _ _ U1 C=1 V] W Q Ca 2 d V7 ,~ ~; V1 w a 10~ ONI~INdd ~J~1N~0 ONIddOHS ~ z z. N (`~ d' ~ (~ I~ SECTION I z~ossos BUSINESS EMERGENCY PLAN: EMERGENCY PROCEDURES Emergency response plans and procedures are an integral part of the Business Emergency Plan. By taking the time to review these procedures for your establishment, you will avoid complications resulting from inaction or misguided action during an emergency. Once these plans and procedures are implemented, your employees will have an informative guide to follow in the event of an emergency. 1. EMERGENCY RESPONSE PLANS AND PROCEDURES A. If you have a release or threatened release of hazardous material, your business is required by State Law to provide immediate notification of the following agencies Immediately call: LOCAL FIRE EMERGENCY RESPONSE PERSONNEL 91 1 (Fire, paramedics, police, or sheriff) STATE OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916)845-8911 Bakersfield Fire Department THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: 661-326-3979 PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A HAZARDOUS MATERIALS INCIDENT: Name: S_etvice_C.ontact Center...___________ Telephone:_..86.6.-.80.5.-43.57_ __ _ ___ Name: Ke_vinQuinn__________...______.________ Telephone: _5.5.9_-64.Z.-69.10...___ __. _... B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: KERN_MED_ICAL_CENTER..__ __ . . ADDRESS: 1830 FLOWER ST CITY: BAKERSFTELD PHONE: _6.61-32.6-20.00_____ 2. PREVENTION Describe the kinds of hazards associated with the materials present at your business. Provide information on the steps taken at your business, or the policies or procedures now in place, to help prevent an accidental release of a hazardous material. Issues for discussion may include safety, storage, and containment procedures. Be specific for each type of hazardous material at your business. The hazards at this business are fire and spills_associated with gasoline_dispensing. __ __ _ _ Gasoline dispensing is supervised by trained personnel Additional hazardous materials are stored in minimum uantities and stored in small unbreakable containers..All ___ ____ underground storage tanks are monitored using an approved monitoring method. 3. MITIGATION Describe the procedures to be followed to reduce the severity of a release or threatened release of a hazardous material at your business. The procedures should detail the actions to be taken by employees to stop a release, contain a release, or to reduce the problems associated with a release. What is your immediate response to a spill fire, explosion or airborne release at.your facility? Small incidents: For leaks and smells, isolate the area and contain with absorbent material. Clean up the spill immediately to_prevent spreading._For fires, turn off pumps,_use fire extinguisher if it can be done_safely. _ __ __ Larger incidents:_Turn_offpurnps using emergency pump shut-off, call 9-1-1,_evacuate to emergency assembly area, wait for emergency personnel to respond. Immediately contact the District Manager and_the Service Contact Center. 4. ABATEMENT Describe what you would do to stop and remove each hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your business? What aspects of the response are beyond your ability and need to be handled by others? Who would you call to handle the relase? Small_incidents_ will_be._ha_ndled_with_the._on-site. clean-up equipment, (i.e„..brooms,_shovel,. _. absorbent material,_mops, etc.)__For larger incidents, the_ on site manager will turn off the pumps,_call 9-1_-l,_and_the Serv_ice_Contact Center @_1-866-805-435.7, The_Contact__. .,_ Center_will.dispatch amaintenance contractor to.assist in abating the._haz_ard. For_suspected leaks the op_erator_wil_I_notify the Service_Contact Center. and his/her District Manager , who_will inv_estigate._the mc_ident__ If a.UST leak is confirmed,. then reporting will be_done by___Circle K,_which_complies.with_UST regulations.,_ _. _ __ _ Circl_e_K__will coordinate with_any_ contractors required_to stop_a. rel,ease,_clean_ _._._____._ ._ _ up__a release and/or dispose of materials___All materials will_be_disp_osed, of in accordance with state, federal and local_I_aws and regulations.________ _______.__._______________ _ _ 5. EVACUATION and RE-ENTRY Describe the procedures to be followed for immediate notification and evacuation of your facility and the re-entry procedures after evacuation has occurred. If warranted evacuate to the designated assembly located at: NORTH SIDE OF LOT The manager or lead employee will take a head count to veri all employees have evacuated safely. The manager or employee will confer the responding agencies to indicate the magnitude of the emergency. Re-Entry into the facility will onl ty ake place after the dealer or manager verifies with the responding a~encypersonnel and Circle K Stores, inc. to ensure it is safe. 6. EARTHQUAKES Identify the areas and equipment in your business that would require immediate inspection or isolation due to their vulnerability to earthquake related ground motion. Check for equipment such as gas cylinders, piping, drums, etc., that may need to be secured or spillage that may require mitigation or abatement. Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any additional hazardous materials storage areas. 7. HAZARDOUS WASTE CONTINGENCY Specific procedures for prevention, mitigation and abatement of a release of hazardous waste generated at your business. This section only applies to hazardous waste generators. The typical waste that is generated at this business is Waste Fuel Filters from the fueling dispensers. This item will be handled in the same manner as used absorbent. Use absorbent material or rags to clean up spills and place in a container for proffer disposal or rec~g_ 8. UNAUTHORIZED RELEASE RESPONSE PLAN Specific procedures for mitigation, abatement and reporting of an unauthorized releases from an underground storage tank (UST). The plan must address a release from a single wall or double wall tank system as applicable. This plan should cover the entire UST system. This section only applies to UST owner/operators. Refer to the Underground Storage Tank Monitoring and Respons~lan provided b Cy ircle K Stores, Inc. If a released hazardous substance reaches the environment, increases the fire or ex lp osion hazard, is not cleaned up from the secondary containment within 8 hours, or deteriorates the secondary containment, then the local agency will be notified IMMEDIATELY SECTION II BUSINESS EMERGENCY TRAINING Employers are required by State law to have a program providing employees with initial and refresher training. The Business Emergency Plan shall include a training program that is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. The training program shall, at a minimum include: A Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards; B. Procedures for coordination with local emergency response organizations: C Correct use of emergency response equipment and supplies under the control of the business; D. The Cal OSHA Hazard Communication Standards; E. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan; F The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care; G. Procedures to coordinate with and assist the local. emergency personnel that may respond to your facility; H. Who and how to call for immediate assistance in the event of an accident involving hazardous materials; I. Procedure for ensuring the appropriate personnel receives initial and refresher training. ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDATED ANNUALLY. Use the attached employee training log or similar form i'or record keeping. EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK 2708605 MINOR INCIDENT: (less than 5 gallons) 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2~ SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See the Emergency Equipment Section for additional information. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the Daily Systems Inspection Form. 5• NOTIFY: The Service Contact Center if the spill flows off site, enters a storm drain or contacts bare soil or groundwater. MAJOR INCIDENT: (more than 5 gallons) Any incident that can not be contained and cleaned up as part of the routine operations, should be considered a major release and use the following procedures. 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. Ca119-I-I: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 5600 Auburn Street If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who may be injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. Immediately notify the Service Contact Center. EMERGENCY PHONE NUMBERS EMERGENCY RESPONSE CONTRACTOR Service Contact 24 -Hour Center Dispatch: 1-866-805-4357 CIRCLE K STORE PERSONNEL District Manager: Kevin Ouinn 559-647-6910 Compliance Manager: Lorraine Soffe at (951) 270-5183 or (951) 453-9067 FACILITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 Secondary: Kevin Quinn District Manager 24-hour: 866-805-4357 Day: 559-647-6910 24-hour: 559-639-9228 Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response by the agencies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-891 1 c) LOCAL POLICE AND FIRE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) SpilVItelease Response Procedures for Propane The Propane used can be hazardous in the event of a spill or release, or if there is a fire at the facility. Propane is flammable, in the event of a fire; the container could explode violently due to the high heat of the fire. Propane is an odorless, colorless, flammable gas. Often an odorant is added far fuel purposes. A release in a confined area may cause rapid breathing, diminished mental alertness, impaired muscular coordination, faulty judgement, depression of all sensations, emotional instability and fatigue. As asphyxiation progresses, nausea, vomiting and loss of consciousness may result. Spill or Release: In the event of a release from the propane tank/cylinder, do the following: 1. Evacuate all personnel from the affected area. 2. Stay upwind of the release and out of low-lying areas. 3. Avoid breathing gases. 4. If the leak is in a container or valve, contact the propane supplier for assistance. 5. Ventilate the area before attempting the re-enter the area. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: I . Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\Circle K Stores\zForms\Propane-Spill Plan.doc Spill/Release Response Procedures for Carbon Dioxide (C02) Carbon Dioxide in the form of compressed gas, liquefied gas or refrigerated liquid used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire, the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause burns, sever injury and/or .frostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dial 911 -inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire• 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. Training: 1. Employees shall be trained on the above hazards associated with carbon dioxide gas and the preventative measures to prevent a release. 2. Training shall include evacuation procedures in the event of a release. 3. If compressed gas cylinders are present, employees shall be training on the handling of the cylinders and the use of the valve caps to prevent accidental damage to the valve. I:\HAZMAT\Circle K Stores\zForms\co2-Spill Plan.doc EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum oI'three years. All employees should review the Hazardous Material Plan, (this document). Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor the site for leaks of hazardous materials. As a supplement to this package, employees should also review and have access to the the Emergency Response Plan and the Materials Safety Data Sheets. Each employee must be drilled in all emergency response procedures contained herein. UTILITY SHUT-OFFS * PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers from the undergroundstorage tanks. Shut-off pumps in case of a leak to help prevent spills. Location: 1-CASHIER 1-NORTH SIDE BLDG * TANK MONITORING ALARM: This is used to monitor the Underground Storage Tanks. This panel may indicate when a potential leak is detected by a visual and audible alarm. Location: BACK STORAGE ROOM * ELECTRICAL PANEL: The panel allows you to selectively cut power to lights, signs, and pumps. The main switch allows you to cut-off all power at the site. Location: BACK STORAGE ROOM * WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: CORNER OF FAIRFAX AND AUBURN STREET * NATURAL GAS SHUT-OFF: If your facility has natural gas, it may be necessary to shut-off the flow in case of an emergency. Location: BUILDING REAR etc PROPANE/LPG SHUT-OFF: If your facility has propane or liquefied petroleum gas, be sure to turn off the manual valves and shut off the power to the dispensing pumps in case of a release or fire. Call your supplier or dial 9-1-1 as necessary. EMERGENCY EQUIPMENT ~k FIRE EXTINGUISHER: Use only on small fires that you can contain. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: I -NEAR BACK DOOR 1-FRONT DOOR 1-PUMP ISLAND ~k SPILL/ CLEAN UP KIT: This can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, see the "Major Incident" section on the previous page. Location: SPILL KIT IN STORAGE ROOM * RESPONSE EQUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: REAR STORAGE Shovel: REAR STORAGE Gloves: REAR STORAGE Goggles: REAR STORAGE qtr FIRST AID KIT: Use for minor incidents and treatment. Location: BACK STORAGE ROOM ~Ic EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: NORTH SIDE OF LOT ~k ENVIRONMENTAL DOCUMENTS / HMMP _MSDS SHEETS: Location: CASHIER EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: KERN MEDICAL CENTER 1830 FLOWER ST BAKERSFIELD 661-326-2000 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 661-326-2000 FIRST AID PROCEDURES (for gasoline and/or diesel fuel): For further information, refer to the MSDS sheets. EYE CONTACT: If irritation or redness develops, move victim away from exposure and into fresh air. Flush eyes with water clean water. If symptoms persist, seek medical attention immediately. SKIN CONTACT: Removing contaminated clothing and shoes, flush affected area(s) with large amounts of water. If skin is not damaged, proceed to cleanse the affected area with mild soap and water. If symptoms become worse, seek medical attention immediately. INHALATION (Breathing): Remove victim from source of exposure and into fresh air. If victim is not breathing, give artificial respiration and seek medical attention immediately. INGESTION (Swallowing): Aspiration Hazard: DO NOT INDUCE VOMITING. do not give anything by mouth because it can enter the lungs and cause severe lung damage. If victim is drowsy or unconscious and vomiting, place on the left side with the head down. Seek medical attention immediately. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the Material Safety Data Sheet (MSDS) for that product. Document prepared by: Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last Updated: 12-Feb-07 Hazardous Materials Training Requirements As the owner/operator of a business that handles hazardous materials, you must have the following: * A Hazard Communication Plan (also know as an Employee Right-to-Know Plan) * The Hazardous Materials Management Plan _Chemical Inventory, also known as the CA Business Emergency Plan) * An Emergency Response Plan * An Underground Storage Tank Monitoring and Response Plan * A Release Reporting Plan Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. * Training for the Hazard Communication Plan must include the following elements: * An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under the Regulation. * Locations of any operations in the work area where hazardous substances are present. * Location where a copy of the written Hazard Communication programs is made available to them. * How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. * How to detect the presence of or the release of hazardous substances in the work place. * How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). * Emergency and first aid procedures to follow if employees are exposed to hazardous substances. :.. =' UNIFIED PROGRAM INSPECTION CHECKLIST ,.-~ .. ~ .x~~.,w:. ~ , ,. ~, .. .:.. . ,.. ... SECTION 1: Business Plan and Inventory Program BAS>ERSFIEILD FIRE DEPT Prevention Services r/t~ 900 Truxtun Ave., Suite 210 ~R>rr Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY,NAIN ^ n E NSPEC N E NSPECTION TIME C~~ ~ ~ ~o ~ ~ ~ ADDRESS HO NO. O OF Ey{QLOYEES ~ ~ ~ ~ ~ ~~ ~ (QJ FACILITY CONTACT USINESS ID NUM ER 15-021- Section 1: Business 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 ^ BUSItI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY _ ~ 7 ~ 9n~~ ^ 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 PROC DURES ~(~ ~.~., ^ EMERGENCY PROCEDURES ADEQUATE ~ i ,/ ^ CONTAINERS PROPERLY LABELED /Y o ^ ^ ^. ^ HOUSEKEEPING FIRE PROTECTION `~, ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES ^ NO EXPLAIN: - _ - THIS INSPECTION? PLEASE CALL U8 AT (881) 928-3878 (Please Print) Fire Prevention / 1" In / Shift of Site/Stetion # B irress Sft ool Site esponsib a Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rw. 02J0~ .~ ~- ~` T~ ~ CITY C)F BAKERSFIELU F IRE DEPARTMENT ro OFFICE OF ENVIRONMENTAL SERVICES '~~` IJ~NIFIED PR®C~RAM INSPECTICN CHECKLIST ;~ ~gti,,!'~~ 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301 FACILITY NAME ~t Y~c-~C- ~ ~~ rC-- INSPECTION DATE~I~' Section 2: Underground Storage Tanks Program ^ Routine ~mbined ^ Joint Agency ^ Multi-Age y Complaint ^ Re-inspection Type of Tank -~~~CS Numb'er of Tank 3 Type of Monitoring - ~G~ Type of Piping .- 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 No ~~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Tvpe 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? !f yes, Does tank have overfill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: Office of Environmental Services (661) 326-3979 white - I?nv. Svcs. ~M ~ ~ Busines Site Responsible Party Pink -Rosiness Copy .- j y __ , UNIFIED PROGRAM INSPECTION CHECKLIST SECTION 1: Business Plan and Inventory Program BAKERSFIEiGD FIRE DEPT Prevention Services ~f~a 900 Tnixtun Ave.,.Suite 210 ~Rrr Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAMES ~ / ~~ ~ , / / NSPECTION DATE INSPECTION TIME . " ~J L- I I~ o~~ / •-/~. ADDRESS HONE NO. O OF EMPLOYEES ~ 7J-7 7 f 7- ~ FACILITY CONTACT USINESS ID NUMBER /~~ J 15-021- /(-/ Section 1: Business Plan.and Inventory Program J `~ ~v ^ ROUTINE ,.'COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION 5 C V (C_Compliance~ OPERATION V_Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~- ^ BUSIfI@SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION r A) ~ ® 200 ' V ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND OCEDURES ~~ ^ EMERGENCY PROCEDURES ADEQUATE ~^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ,~^.. SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ~S ^ IVO EXPLAIN: ~~ t r< ~ i ~7£~S - _ QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (881) 328-3979 ~~~~~~ ~ ~ Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Station q White - Prwention Sarviees Yellow -Station Copy Pink - Business Copy FD20~8 (Rw. OY/05) - ' ~ ~... _ ~,~. ,.~ ~ Qw ~ ~ ~~ ~6 ro~ ~W ,' )'1 ~~ . , ~~ °'r • ~' ~k'E cAgii~ ~.~~i FACILITY NAME CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3"' Floor, Bakersfield, CA 93301 /~.u 2~e.I INSPECTION DATE ~'~O~- Section 2: Underground Storage Tanks Program ^ Routine ~mbined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection Type o Tank ~iu~~ c,~Qll Number of Tanks 3 Type of Monitoring l~ s_En rL. X02 "Type of Piping ~,/ /~ ~,4 /l OPERATION C V COMMENTS Proper tank data on file Proper owner/operator data on file Permit tees current Certification of Financial Responsibility Monitoring record adequate and current ~~ Z~' ti~`D ~°C'` `~~ 7 Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes _ ,~'l.~ 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 N=NO Inspector:~//Ylr1/tJ (r.~-~~~- ~~ Office of Environmental Services (661) 326-3979 ~b'hitc -I=nv. Svcs. usiness Site Responsible Party Piny -Business Ci~ry .__~, -.. -3_, __,__ _'._ - ` k K n as - - . - I - ~ riLl_ ~ FIJPd~.'T } C~Pd! ~ f'!' :?F'.I"l~rL ~ I T } :I_If'dLEryIiF'jj 41=1~;: LILI_.HC:E= :ai=+:~' +=~r;L.~ 1 I HE 1 ~ BHT = ~} ~ ~ ..'_~';' [ hdC'F}E ; t;.IriTF'Fi' - ~ i . Il0 1 !'~i~_'H1=::_, T = ~ F'LU;=: HE 1 ~~i~T.` = 31 . =i5 1 fVCHE:=~ 651r~'1'EI~ = r_l . I_It_i t t'dC_'HE..' r T :PF'L!•'ilUf9 i 9~f'IiLL-r=+r~EF- ~n50 +;r-;L.c-- '1 ~_ i4 fl..ut°IL - ' 1 r15 +.~r'iLL'`~----I HE I i~~HT = ''~ . _ ~ 1 I I'd~:='HEc:1 Wti1'F'R tfCrr.. = 1 1 ~J~Ltit _ =PdLi .. )~ _ _ _ , - ,-~ _.; ® SM 495 East Rincon St Suite 150 Corona, CA 92879 March 3, 2006 US Mail: Bakersfield Fire Department 2130 G. Street Bakersfield, CA 93301 -- - - - .RE:~Circle K Stores Inc..Submittal of Certificate ~f_Financial Responsibility _ __ Attached is the~Certificate of Insurance for Circle K Stores Inc., effective December 17, 2005 through December 17, 2006. Please call me at (951) 270-5183 if you have questions. Sincerely, Lorraine Soffe West Coast Environmental Compliance Specialist I- _ - ~- - Attachment - - _ _ _ _ _ _ _. . ~~ ~: ---r---~""'. CostCente~.' ADDRESS :CITY `.` `' STA COUNTY : ~ TK #'- PROD ' CUPAName' _ ':.'~ 2700010 302 E TEHACHAPI BLVD TEHACHAPI 1 30 Kern County Environmental Health 2700010 302 E TEHACHAPI BLVD TEHACHAPI CA . KERN : 02 05 Kern County Environmental Health 2700337 10597 JURUPA RD MIRA LOMA _ CA RIVERSIDE 01 30 Riverside Environmental Health Services 2700337 10597 JURUPA RD MIRA LOMA CA RIVERSIDE 02 OS Riverside Environmental Health Services 2700348 ' 5681 ADOBE RD _. PALMS _. _ CA , BERNARDINO _ ~ O1 30 San Bernardino County F.D., HazMat Div. . . . 2700348 5681 ADOBE RD PALMS CA _ BERNARDINO __ 02 05 _ y San Bernardino Count F.D., HazMat Div. 2700358 . 540 W BIG BEAR BLVD - BIG BEAR CITY CA . BERNARDINO 01 05 _ San Bernardino County F.D., HazMat Div. 2700358 540 W BIG BEAR BLVD BIG BEAR CITY CA BERNARDINO 02 30 San Bernardino County F.D., HazMat Div. _2700489 . 14906 VALLEY BLVD FONTANA CA BERNARDINO Ot 05 ;San Bernardino County F.D., HazMat Div. 2700489 14906 VALLEY BLVD FONTANA CA _ ~BERNARDINO - 02 30 San Bernardino County F.D., HazMat Div. 2700538 43955 CLINTON ST INDIO. CA RIVERSIDE 01 OS Riverside Environmental Health Services -2700538 _~ . 43955 CLINTON ST INDIO CA RIVERSIDE 02 ~ 30 Riverside Environmental Health Services 2700564 73010 RAMON RD PALMS CA RIVERSIDE 01 30 _ Riverside Environmental Health Services .2700564 _' 73010 RAMON RD 'PALMS CA _ ~ RIVERSIDE 02 OS Riverside Environmental Health Services _ . 2700736 56621 STATE HWY 371 ANZA CA RIVERSIDE . O1 OS Riverside Environmental Health Services .2700736 56621 STATE HWY 371 ANZA CA , RIVERSIDE 02 __ . 30 Riverside Environmental Health Services 2700743 73-943 29 PALMS HWY PALMS CA BERNARDINO 01 30 San Bernardino County F.D., HazMat Div. 2700743 73-943 29 PALMS HWY .PALMS CA BERNARDINO 02 05 San Bernardino County F.D., HazMat Div. 12700770 49594 29 PALMS HWY .VALLEY CA BERNARDINO .... ... 01 30 'San Bernardino County F.D., HazMat Div. :2700770 -49594 29 PALMS HWY VALLEY CA BERNARDINO , 02 _ 05 San Bernardino County F.D., HazMat Div. 2700801 ;18965 VAN BUREN BLVD _.._._.. _ _ -- ,RIVERSIDE _-.....~ - !CA ... -RIVERSIDE _ - __.. ~_ 01 .._ v 30 „_.__ Riverside Environmental Health Services ..._,_ _.. _ . __ ....._ . _ .___.__ :2700801 _ _ 18965 VAN BUREN BLVD . _ 'RIVERSIDE _..:.. CA RIVERSIDE 02 ! OS Riverside Environmental Health Services 2700837 _ _ 17671 GRAND AVE -- . ;LAKE ELSINORE ACA !RIVERSIDE 01 30 Riverside Environmental Health Services :2700837 ....__ :17671 GRAND AVE _ _ ... _ ,LAKE ELSINORE _.... __ _ CA . _.. ;RIVERSIDE _ _ .. .._ _ ,.__,... _. 02 _ _ . OS Riverside Environmental Health Services _ _ .. _.. _-- _... .. _ _...__ j 2700858 18465 US HWY 18 :APPLE VALLEY CA , BERNARDINO Ot 20 Y lSan Bemardino Count F.D., HazMat Div. 12700858 -- 218465 US HWY 18" _ _ _. ;APPLE VAL! EY -• --' .CA ,BERNABDiNO 02,_ OS SamBernardino Count _F.D., HazMat Div. - ~~ ~ ~ '2700858 :18465 US HWY IB _. .__~ ~ APPLE VALLEY . __.__. CA _ . ,BERNARDINO . . __ ._ ~~ . 03 _ _ 30 _.. - -- ~ ~Y :San Bernardino County F.D , HazMat Div. _ -_ .. . _.._.. _._ .._-- _ :2700872 ., .13261 PERRIS BLVD _ _ _ iMORENO VALLEY . .. CA .._ . . .. .__ RIVERSIDE . . . Ot 30 _ m .- _ ___. .__--_-- _ Riverside Environmental Health Services ;2700872 _. .13261 PERRIS BLVD . MORENO VALLEY CA RIVERSIDE 02 OS ,Riverside Environmental Health Services 2700902 '69.40 OLD WOMAN SPRG iYUCCA VALLEY CA ,BERNARDINO Ot _ 30 :San Bernardino County F.D HazMat Div ;2700902 ;6940 OLD WOMAN SPRG .YUCCA VALLEY CA iBERNARDINO 02 O5 San Bernardino Count F.D., HazMat Drv. _ y 2700902 6940 OLD WOMAN SPRG -YUCCA VALLEY CA i BERNARDINO 03 20 -San Bemardino County F.D , HazMat Drv :'2700951 _ _....__. 5809MANZANITAAVE . .... . w . .CARMICHAEL ._ . _.._ CA _ SACRAMENTO ~___. .__ . _ 01 05 _._. ~SacramentoCo Envir Health Division .._..._. _ .__... .._.. .. ._.._-- ~. ._ _ 2700951 _ _._ _.w • _ _. 5809 MANZANITA AVE .._.._. !,CARMICHAEL __ . CA - --_.. }SACRAMENTO __ 02 _ ~ 30 . __ . . :Sacramento Co. Envir Health Division j 2701028 RD HANFORD CA 3 KINGS 01 + OS _ Kings Co Drv of Envir. Health Sernces __ _ _ _ _ :`2701028 `RD HANFORD CA KINGS 02 30 Kings Co Drv of Envir Health Services ;2701045 '11408VENTURAAVE OJAI CA 'VENTURA ~ 01 OS _. _ ;Ventura County Environmental Health :2701045 11408 VENTURA AVE OJAI _ CA _ I VENTURA -. 02 '. 05 Ventura County Environmental Health _ _ ... 2701045 11408 VENTURAAVE OJAI ,CA VENTURA 03 30 !Ventura County Environmental Health 2701057 _.. _ SS55 HEMLOCK .SACRAMENTO ;CA :SACRAMENTO 01 30 ISacrameMO Co. Envir. Health Division 2701057 • .5555 HEMLOCK SACRAMENTO _ - iCA SACRAMENTO 02 ~ OS ,Sacramento Co. Envir. Health Division _ _ 2701096 ! 500 RIMROCK RD BARSTOW CA BERNARDINO 01 30 -San Bernardmo County F D HazMat Drv_ '2701096 -500 RIMROCK RD BARSTOW `CA 'BERNARDINO 02 OS :San Bernardino County F. D., HazMat Div. .2701156 1263 FRANKLIN AVE `YUBA CITY CA BUTTER Ot 05 :Sutter Department of Agriculture _ ... ._ 12701156 1263 FRANKLIN AVE !YUBA-CITY ,CA ,BUTTER 02 30 -Sutter De artmentofA nculture P g _...... _.__. 2701161 _.....,.__.... W_.__.__ __.. 1395 PALM AVE ._ ,___ ._. .._ .__-- WASCO .. CA _.. _._. _ ._ ;KERN ___. ._.. Ot ,. _. ___ 05 ...._.... .__ ....._._. ..__ ..._.__ .Kern County Environmental Health 2701161 :1395 PALM AVE WASCO CA KERN 02 30 .Kern County Environmental Health 2701178 :428 SKYLINE BLVD AVENAL CA KINGS Ot 05 Kin s Co Drv. of Envir Health Services •2701178 -428 SKYLINE BLVD AVENAL CA KINGS 02 30 -Kings Co. Div. of Envir. Health Services i 2701197 .6930 MORRO RD `ATASCADERO CA OBISPO 01 20 :San Luis Obispo Co. Dept. of Env. Health 2701197 __.. _ '6930 MORRO RD .. _.... __. __ ATASCADERO _.. - ......___ _ CA __ OBISPO __ .___ 02 _ _ 30 ~ _. .... ._ _... _ .. :San Lws Obispo Co Dept of Env. Health ~ _.. __. . _ . __ __ _. _ _ 2701197 ... 6930 MORRO RD - - ~ ATASCADERO CA . _ ._... t ; OBISPO _ 03 . . ~ 05 _ _ ._ __. _ -- _ _ .. San Luis Obispo Co. Dept. of Env. Health 2701205 16470 CAMBRIDGE ._..,_ __.___ LATHROP - CA - +SAN JOAQUIN . ._u . - - ~-- Ot . OS _ __. :San Joaquin Co. Enviro., Health Division _ _ ._ __ - _ _.- _. ._ _____ ' :2701205 16470 CAMBRIDGE ~ ~_ _~ LATHROP ,CA _ ;SAN JOAQUIN 02 . 30 _ ..._. .. ' ':San Joaquin Co Enviro Health Division _,. __ ...... ..... _. :2701212 600RIOTIERRAAVE SACRAMENTO CA `SACRAMENTO Ot OS .. :Sacramento Co. Envir. Health Division 2701212 600 RIO TIERRA AVE SACRAMENTO i CA .SACRAMENTO 02 30 ;Sacramento Co. Envir. Health Division :2701215 _. 1421 OCEAN ..._..~.. __._.__---___ LOMPOC . __ _ ACA ;BARBARA _ _.___ 01 OS ~._ __ . -Santa Barbara Count Fire De artment . .__ ____ Y _.. ... P 2701215 -1421-OCEAN - ~ - _- __ - LOMPOC CA .___. , a BARBARA ~ - - __ .W, 02 , :- 30 _._.._ ...... _ _. ._... ___ _ ..__ _ __ rSanta Barbara County Fire Department _ _ _ _ , :2701232 _ '4381 EL CAMINO REAL _.._ _..._.. _ ATASCADERO _..._. _• CA __ !OBISPO u_ _ . .......... .._ Ot _. . _. OS .__ _... . :San Lws Obispo Co.,Dept. of Env. Health .... . _. . _.._ _ __..__. . _. :2701232 . :4381 EL CAMINO REAL _ ATASCADERO CA OBISPO . . 02 : 30 p p . ._ . _ . San Lws Obis o Co. De t. of Env. Health 12701270 '5634 STINE RD BAKERSFIELD CA KERN 01 05 ;Bakersfield Fire Department [2701270 ,5634 STINE RD ;BAKERSFIELD CA :KERN 02 30 ;Bakersfield Fire Department_ 2701391 123 E MAIN ST __. .. __ __ r__ _... WESTMORLAND _ _._ _ _ ___._. CA _. _ IMPERIAL _ _ _.~_.._ 01 30 _~.__. ~Impenal County Health Department - _ .... _....__._ __ _ 2701391 . x123 E MAIN ST •WESTMORLAND CA . IMPERIAL 02 OS _ T_ -- :Imperial County Health Department 2701391 123 E MAIN ST , WESTMORLAND CA "[MPERL?L n3 20 lmpenal County Health Department 2701527 .._ ._ _ 685 PARKER RD ;FAIRFIELD CA ,. SOLANO Ot 30 Solano Co Dept of Resource Management 2701527 685 PARKER RD jFAIRFIELD CA SOLANO _. _. 02 ; 05 .. ',Solano Co. Dept. of Resource Management , 2701527 .665 PARKER RD FAIRFIELD • CA SOLANO 03 20 . Solano Co Dept of Resource Management ...._ _. :2701775 :24051 JOHN F KENNEDY DR MORENO VALLEY CA RIVERSIDE Ot 30 :Riverside Environmental Health Sernces _ .2701775 _24051 JOHN F KENNEDY DR jMORENO VALLEY 'CA 'RIVERSIDE _ ~ ,.,. 02 OS s _ _ :Riverside Environmental Health Services ... .2701775 :24051 JOHN F KENNEDY DR -- MORENO VALLEY . ... CA 'RIVERSIDE 03 20 ;Riverside Environmental Health Services ,._ _ `:2701914 _ _ 1930 LAKE BLVD ~ ___ ~ : DAVIS _ _~ _` ~ CA ~ YOLO ~_ ~ ~ v _ _ _Ot _ _ _ 05 _ Yolo Co Dept. of Environmental Health ~_ _ . , _ .. ___ _ .. ~. _ _...._ _ _, 2701914 1930 LAKE BLVD DAVIS ' CA YOLO 02 30 mental Health Yolo Co. Dept. of Environ 2701914 1930 LAKE BLVD DAVIS CA YOLO 03 20 Yolo Co. Dept. of Environmental Health ... .. _. 2701922 ;13120 MAGNOLIA AVE ;CORONA _ CA ,RIVERSIDE Ot _ _ _20 :Riverside Environmental Health Services .2701922 .13120 MAGNOLIA AVE 'CORONA CA 'RIVERSIDE _ 02 05 :Riverside Environmental Health Services _. .. 2701922 13120 MAGNOLIA AVE _ _ . :CORONA CA RIVERSIDE _ 03 30 !Riverside Environmental Health Services _ _ 2701940 . 1600 W MAIN ST _ TURLOCK .. ____ _ CA STANISLAUS _ 01 . 20 ._._ _ Stanislaus Co.,Dept, of Envir. Resources ~_. _ _.. _.. __ _ _ 2701940 ' 1600 W MAIN ST TURLOCK CA STANISLAUS _ _ 02 ; OS p .Stanislaus Co.,De t. of Envic Resources .2701940 1600 W MAIN ST TURLOCK :CA ~STANISLAUS 03 30 ;Stanislaus Co.,Dept. of Envir. Resources 2701984 795 SHADOW RIDGE DR `VISTA CA .SAN DIEGO Ot ~ 30 ;San Diego Health Services Department ;2701984 '795 SHADOW RIDGE DR VISTA CA SAN DIEGO 02 I 20 San Diego Health Services Department 2701984 ' 795 SHADOW RIDGE DR .VISTA CA .SAN DIEGO 03 , OS -San Diego Health Services Department ,~ 2702964 60 BROADWAY ' cle CHULA VISA K ~' es ~ a ~' a of hies sibil t ~ ~SATI-~(~N~ p®R y ~ Li ~ -~ ~ -" '~ fan Diego Health Services Department 2702964 60 BROADWAY CHULA VISTA t~trve ~~~ (3f~~~5 tnroughd~i ri06 30 _... _ San Diego Health Services Department 2702970 704 MAIN ST RAMONA CA SAN DIEGO 01 05 San Diego Health Services Department 2702970 704 MAIN ST RAMONA CA SAN DIEGO 02 30 San Diego Health Services Department . 2703608 21998 COLORADO .SAN JOAOUIN ~CA FRESNO 01 _. 05 y .. . ... . Fresno Co. Env. Health S stem 2703608 21998 COLORADO SAN JOAQUIN CA FRESNO 02 30 Fresno Co. Env. Health System _.r. . 2703614 ,403 MERCY SPRGS RD LOS BANGS CA ,MERGED O1 OS Merced Co. Environmental Health Dept. __- 2703614 403 MERCY SPRGS RD LOS BANGS CA MERGED 02 20 __ Merced Co. Environmental Health Dept. .2703614 _403 MERCY SPRGS RD LOS BANGS CA yMERCED 03 30 Merced Co. Environmental Health De t. _. 2703621 -1704 E PACHECO LOS BANGS CA MERGED 01 OS Merced Co. Environmental Healtfi Dept. 2703621 1704 E PACHECO LOS BANGS CA 3MERCED 02 30 . :Merced Co. Environmental Health Dept. 2703621 1704 E PACHECO LOS BANGS CA MERGED 03 45 Merced Co. Environmental Health Dept. :2705008 _. 11424 CHAMBERLAINE AVE ...... ......_ . ... ._... ADELANTO . CA . _ BERNARDINO _ -. .... ._._~ .. .. , Ot ... OS .._.t ... .San Bernardino County F D., HazMat Div. _ .. . _. ._. _. .. 2705008 -11424 CHAMBERLAINE AVE ADELANTO CA BERNARDINO 02 20 . . . San Bernardino County F.D., HazMat Div. '2705008 _ 11424 CHAMBERLAINE AVE ADELANTO CA , >BERNARDINO 03 30 San Bernardino County F.D., HazMat Div. 2705017 _ _ 2549 BLOSSOM DOS PALOS CA MERGED _ 01 30 Merced Co. Environmental Health Dept. _ - 2705017 '.2549 BLOSSOM DOS PALOS CA MERGED 02 05 .Merced Co. Environmental Health Dept. 2705017 2549 BLOSSOM _.. _ DOS PALOS CA 'MERGED _. ~ _ - _ 03 . . 20 .... _ Merced Co. Environmental Health De t. .. _. _ _ p - -. 2705018 ~ 1021 SNAPPER RD ATWATER _ - "CA : MERGED .. Ot . _ 20 . _ 'Merced Co. Environmental Health Dept. 2705018 ..1021 SNAPPER RD ATWATER . CA MERGED 02 05 Merced Co. Environmental Health Dept. 2705018 _ 1021 SNAPPER RD ATWATER CA _ MERGED 03 30 _ :Merced Co. Environmental Health Depi. _ 2705020 1598 N ORANGE :REDLANDS CA BERNARDINO 01 05 . 'San Bernardino County F.D , HazMat Div. _ 2705020 1598 N ORANGE REDLANDS CA BERNARDINO 02 20 San Bernardino County F. D., HazMat Div. 2705020 1598 N ORANGE REDLANDS CA iBERNARDINO 03 30 San Bernardino County F D . HazMat Drv. _ '2705057 8197 1ST HESPERIA CA BERNARDINO 01 30 San Bernardino County F.D., HazMat Drv :2705057 8197 I ST HESPERIA ,CA BERNARDINO 02 05 San Bernardino County F.D., HazMat Div. , ;2705057 =8,97 I ST -_ -"'' HESPER4A `__ CA jBERNARDINO 43 __ 20 _ ,San Berna_ rdrno County F.Dv HazMat Div. 2705063 8190 MISSION BLVD 'GLEN AVONY _ CA RIVERSIDE 01 20 Riverside Environmental Health Services "~ .2705063 8190 MISSION BLVD GLEN AVON ;CA _ RIVERSIDE 02 05 _. _ .Riverside Environmental Health Services !2705063 8190 MISSION BLVD .GLEN AVON CA 4RIVERSIDE _ _ 03 30 ?Riverside Environmental Health Services :2705095 4360 GENESEE AVE SAN DIEGO yCA :SAN DIEGO ~ 01 30 San Diego Health Services Department '2705095 4360 GENESEE AVE ,SAN DIEGO CA 'SAN DIEGO 02 05 San Diego Health Services Department :2705095 4360 GENESEE AVE SAN DIEGO _. CA , SAN DIEGO 03 20 San Diego Health Services Department '2705203 {6290 MISSION RUBIDOUX ;CA :RIVERSIDE 01 05 !Riverside Environmental Health Services -- - '2705203 --- 6290 MISSION RUBIDOUX CA (RIVERSIDE 02 20 ,. .. !Riverside Environmental Health Services _ _.. '2705203 _ 6290 MISSION _.. .. RUBIDOUX CA RIVERSIDE 03 30 ~Rrverside Environmental Health Serv,ces 2705214 . 765 W REDLANDS BLVD REDLANDS CA BERNARDINO 01 30 !San Bernardino County F.D HazMat Div 2705214 ,765 W REDLANDS BLVD REDLANDS CA {BERNARDINO 02 20 ;San Bemardino County F.D., HazMat Drv. ; '2705214 _ -765 W REDLANDS BLVD : . .. . _. .w . .. _ _ ;REDLANDS _ - 'CA --- `BERNARDINO _... .._ _:_. -_. 03 _ 05 :-- `San Bernardino County F.D HazMat Div. _ _ . _ _.. _...____ -.___. -_.__- _ 2705221 . ... ... ._ _ . _ . '8609 GARVEY AVE ._ . ROSEMEAD CA . _ (LOS ANGELES Ot 20 .. _ _ Los Angeles County Dept Public Works , ' 2705221 8609 GARVEY AVE ROSEMEAD CA ;LOS ANGELES 02 05 Los Angeles County Dept. Public Works 2705221 8609 GARVEY AVE ROSEMEAD CA _LOS ANGELES _ 03 ~ 30 :Los Angeles County Dept. Public Works 2705230 16408 ORANGE _ µ PARAMOUNT `CA _vLOS ANGELES 01 _ i 20 __ _ . . Los_Angeles _County Dept_ Public Works __ _ _ _.~ _.__.. _.._._ 2705230 16408 ORANGE ;PARAMOUNT CA ;LOS ANGELES 02 , 05 'Los Angeles County Dept. Public Works 2705230 16408 ORANGE .PARAMOUNT CA ;LOS ANGELES 03 30 _ . Los Angeles County_Dept. Public Works -2705238 765 W HARVARD BLVD SANTA PAULA =CA rVENTURA Ot 05 .. Ventura County Environmental Health 2705238 _ '765 W HARVARD BLVD SANTA PAULA CA !VENTURA , 03 ~ 30 ,Ventura County Environmental Health _ !2705239 -2734 DEL ROSA 'SAN BERNARDI NO CA __ ;BERNARDINO 02 OS _ ;San Bernardino Courrty F D , HazMat Div 2705239 2734 DEL ROSA .. .. SAN BERNARDI ~ NO~i CA , BERNARDINO 03 30 San Bemardino Count F D HazMat Drv y 12705242 3405 E HIGHLAND AVE 'HIGHLAND CA ; BERNARDINO 01 30 ;San Bernardino County F.D., HazMat Div. !2705242 3405 E HIGHLAND AVE HIGHLAND _ CA m ~BERNARDINO ~ _ ~ 02 05 San Bemardino County F D., HazMat prv. - 2705245 6105 CLAY PEDLEY :CA RIVERSIDE ~ 01 ` 20 f Riverside Environmental Health Services _..__ 2705245 ____ ~._.._- --_ 6105 CLAY ... _w.._ ,PEDLEY .- _. CA _. ~. _ __._._..~m__ 'RIVERSIDE .__. 02 _ 30 _ __ _ ___.__.___..___.___.. :Riverside Environmental Health Services X2705245 '6105 CLAY :PEDLEY ___,_ CA RIVERSIDE 03 05 iRiversideEnvironmentalHealthSeances '2705247 5804 MISSION BLVD RUBIDOUX CA RIVERSIDE 01 05 Riverside Environmental Health Sernces ;2705247 5804 MISSION BLVD RUBIDOUX ,CA _ .RIVERSIDE 02 30 Riverside Environmental Health Services ;2705247 5804 MISSION BLVD RUBIDOUX CA :RIVERSIDE 03 20 'Riverside Environmental Health Services 2705252 518 W FOOTHILL .RIALTO iCA 'BERNARDINO Ot 20 :San Bemardino County F D HazMat Div. ? -- - 12705252- _ 518 W FOOTHILL +RIALTO SCR- •BERNARDINO _ 02 ~ _. 30 ._ _ ;San Bernardino County F.D., HazMat Div- '2705252 _ _, 518 W FOOTHILL ;RIALTO CA fBERNARDINO 03 OS :San Bernardino County F D., HazMat Drv 12705423 ~ 7796 SUNRISE BLVD CITRUS HEIGHTS `CA SACRAMENTO Ot 05 `Sacramento Co. Envir. Health Division ;2705423 7796 SUNRISE BLVD CITRUS HEIGHTS CA SACRAMENTO 02 05 ;Sacramento Co Envir. Health Division ;2705423 7796 SUNRISE BLVD ;CITRUS HEIGHTS ;CA :SACRAMENTO 03 ~ 20 .Sacramento Co. Envir. Health Division :2705423 7796 SUNRISE BLVD CITRUS HEIGHTS ;CA SACRAMENTO 04 30 ;Sacramento Co. Envir. Health Division .2705431 830 E ST MARYSVILLE tCA YUBA Ot 20 _ :Yuba County CUPA 2705431 ,830 E ST MARYSVILLE rA 'YUBA 02 OS ;Yuba Ceu~ty CUPA 2705431 ,830 E ST •MARYSVILLE 'CA YUBA 03 30 :Yuba County CUPA ,2705432 899HAWTHORNEST MONTEREY ,CA ,MONTEREY 01 05 -. - ;Monterey Co. Heatlh Dept:: Monterey :2705432 ._899 HAWTHORNE ST .MONTEREY CA MONTEREY 02 20 :Monterey Co. Heatlh Dept.. Monterey _ '2705432 -899 HAWTHORNE ST __ ,MONTEREY CA MONTEREY 03 _ , 30 _ Monterey Co Heatlh Dept.: Monterey :2705432 899 HAWTHORNE ST MONTEREY CA :MONTEREY ~ 04 45 ;Monterey Co. Heatlh Dept.: Monterey !2705439, ,1240 N MAIN ST ,SALINAS `CA _ ,MONTEREY 01 30 [Monterey Co. Health Depart.: Salinas 2705439 1240 N MAIN ST_ _ SALINAS CA MONTEREY 02 20 _ __ , _ .__ , _-_ `Monterey Co. Health Depart Salinas :2705439 1240 N MAIN ST _ SALINAS CA MONTEREY 03 05 Montere Co. Health De art.: Salinas Y p 2705439 _. .1240 N MAIN ST _. SALINAS CA MONTEREY 04 OS ...... ... ,. _.. . Monterey Co. Hea11h DepaR.: Salinas ... 2705449 ' 7647 PACIFIC AVE STOCKTON CA 'SAN JOAOUIN 01 05 ,San Joaquin Co Enviro., Health Division 2705449 ' 7647 PACIFIC AVE STOCKTON CA SAN JOAOUIN 02 20 ._ ;San Joaquin Co. Enviro., Health Division 2705449 ._ 7647 PACIFIC AVE STOCKTON _. -.. iCA_ - :SAN JOAQUIN 03 _ 30 - _ `San Joaquin Co. Enviro., Health Division :2705619 :1150 W PACIFIC COAST HWY HARBOR CITY CA ;LOS ANGELES 01 OS ~ Los Angeles City Fire Dept. 2705619 1150 W PACIFIC COAST HWY HARBOR CITY CA ;LOS ANGELES 02 30 ;Los Angeles City Fire Dept. _ `2705659 8451 SLAUSON AVE PICO RIVERA CA LOS ANGELES _ 01 OS _ . ;Los Angeles County Dept Public Works . 2705659 8451 SLAUSON AVE PICO RNERA CA LOS ANGELES i 02 30 . Los Angeles County Dept Public W orks _ ~ :2705659 ;8451 SLAUSON AVE PICO RIVERA CA LOS ANGELES _ _ 03 ~ 45 _ :Los Angeles County Dept. Public Works _. 2705705 304 S MAIN ST 'CORONA CA ,RIVERSIDE _ O1 30 ,Riverside Environmental Health Services ~ `Ti Circle K Stores Inc. -Certificate of Responsibility Site List Effective Date 12/17/05 through 12/17/06 2705705 304 S MAIN ST CORONA CA RIVERSIDE 02 05 Riverside Environmental Health Services 2705708 98 BONITA RD CHULA VISTA CA SAN DIEGO O7 05 .San Diego Health Services Department 2705708 98 BONITA RD CHULA VISTA CA SAN DIEGO 02 30 San Diego Health Services Department 2705728 4200 CHINO HILLS PKWY _ ... CHINO HILLS CA _, BERNARDINO 01 05 San Bernardino County F.D., HazMat Div. '2705728 .4200 CHINO HILLS PKWY CHINO HILLS . CA BERNARDINO 02 30 -San Bernardino County F.D , HazMat Div. .2705731 ;1501 E MAIN ST BARST OW CA BERNARDINO 01 05 San Bernardino County F.D , HazMat Div. 2705731 •1501 E MAIN ST _ _ _ BARSTOW CA BERNARDINO 02 30 San Bernardino County F.D., HazMat Div 2705733 :998 SUNRISE BLVD ROSEVILLE CA PLACER 01 05 Roseville Fire Department w 2705733 _ .998 SU ISE BLVD NR _ ROSEVILLE _ CA _ ;PLACER 02 30 __ _ _ _ __ __ _ Roseville Fire Department 2705784 _ _ ; 981 FRANCISCO BLVD SAN RAFAEL ,CA MARIN 01 05 San Rafael Fire Department 2705784 :981 FRANCISCO BLVD !SAN RAFAEL CA 'MARIN 02 ~ 05 ,San Rafael Fire Department 2705784 ;981 FRANCISCO BLVD SAN RAFAEL CA MARIN 03 i 30 'San Rafael Fire Department 2905786 -- j5793 ACTON PKWY.- - IRVINE -_ :-ACA .~ORAN(?E, 01 }- 05 __ _ _ _ _ - Orange Co Environmental Health Div 2705786 -5793 ALTON PKWY IRVINE CA ORANGE 02 30 'Orange Co Environmental Health Div --° ,2705802 _._ .._ _ 16900 FOOTHILL BLVD _... _ _ _..._ ............ .- _._. _ . .._ FONTANA ... _ _ _ ~____. _-_ __-- CA - - ._ . BERNARDINO .~. _. __._._. _. - Ot ...... _ . . _- 05 __. _. _ -San Bernardino Count F D HazMat Drv. ~__. ~_._..--.-- __-..Y __. _._ .._ _. _._.____ _ -_____ . '.2705802 ~ 16900 FOOTHILL BLVD ~ FONTANA CA BERNARDINO ~ ~ 02 30 San Bemardino County F.D., HazMat Div. !2705911 178364 US HWY 111 `LA QUINTA :CA RIVERSIDE Ot 05 Riverside Environmental Health Services 2705911 '78364 US HWY 111 LA QUINTA _ _. W CA .._w ~ RIVERSIDE _ ~~ 02 _.. ._ _ 30 _., Riverside Environmental Health Services ___.~_ __.._. .._ _____._ __._ _ _ ___ _ _..__.. _ _____ 12705911 ;78364 US HWY 111 . LA QUINTA CA _- ~ ,RIVERSIDE , 03 45 iRiverside Environmental Health Services 2708545 .1161 E VALLEY PKWY iESCONDIDO CA SAN DIEGO 01 20 San Diego Health Services Department 2708545 -1161 E VALLEY PKWY ESCONDIDO CA -SAN DIEGO 02 05 San Diego Health Services Department _,__.__...._....~.__ 2708545 11161 E VALLEY PKWY f ESCONDIDO CA SAN DIEGO 03 i.. 30 €San Diego Health Services Department 2708605 _.__...._._.. :5600 AUBURN ST ,.._.__,._.. -- _ _ -_..._ _.. BAKERSFIELD ..._._..~ CA KERN Ot -_- _30 .. __ _ jBakersfield Fire Department .. .. :2708605 . 5600 AUBURN ST BAKERSFIELD CA KERN 02 , ~ 20 I f Bakersfield Fire Department ..2708605 5600 AUBURN ST BAKERSFIELD CA :KERN _ 03 OS _ _._...:_._. Bakersfield Fire Department ~ i _ ;2708606 ;10300AKST BAKERSFIELD CA _. _ 'KERN 01 I 05 IBakersfieldFireDepartment _____ __ __ 2708606 _ ._. ~ 1030 OAK ST _r _.. _ BAKERSFIELD _ _ ..__ CA KERN 02 30 _ ___ y i Bakersfield Fire Department _ _ _.. __ _____. .__. 2708606 . ._..... ;1030 OAK ST ... _....._ _... ..... ...... BAKERSFIELD .. .. ....... ..... CA . ~ KERN 3 03 20 ... _. +Bakersfield Fire Department _ ; :2708641 ,_._. '295 N WATERMAN AVE _.. _. SAN BERNARDINO CA _ __ _ ._. IBERNARDINO _ 01 20 :San Bernardino County F,D HazMat Drv. .___.__._~ W...__._.._ 708641 !2 . ;295 N WATERMAN AVE u __ _ ,SAN BERNARDINO CA BERNARDINO _ 02 .; OS _ HazMat Div. ~San Bernardino County F.D _ _ ?2708641 , _ 295 N WATERMAN AVE :SAN BERNARDINO CA BERNARDINO _ 03 i 30 _ _ _ __ ^_ _ ;San Bernardino County F.D., HazMat Div. .2708644 11724 AIRBASE RD ADELANTO CA BERNARDINO : Ot _. 30 `San Bernardino County F D HazMat Div '2708644 :11724 AIRBASE RD ADELANTO CA BERNARDINO 02 y 05 ;San Bernardirro County F.D., HazMat Div. '2708644 11724 AIRBASE RD ADELANTO _ i CA BERNARDINO 03 20 ;San Bemardino County F.D., HazMat Div. _ 2708688 10520 CAMINO RUIZ _ _. SAN DIEGO CA 'SAN DIEGO _ Ot 30 _ _ . -San Diego Health Services Department ,'2708688 :10520 CAMINO RUIZ _ SAN DIEGO CA .SAN DIEGO 02 20 ~San_Diego Health Services Department 2708688 ~ 10520 CAMINO RUIZ SAN DIEGO CA 'SAN DIEGO 03 OS :San Diego Health Services Department '.2708734 247 E OLIVE AVE FRESNO CA FRESNO O7 05 ;Fresno Co. Env. Health System 2708734 _....._ ._.. 247 E OLIVE AVE ____ - FRESNO CA FRESNO 02 20 _ _.. `Fresno Co Env Health System _ 2708734 ~ _. :247 E OLIVE AVE - FRESNO - - CA .._ _ - - ;FRESNO 03 --'r- 30 __._ __ _._. ___.__ ~__._.~.~. ;Fresno Co. Env. Health System •2708735 ,;2097 MENTONE BLVD _ :MENTONE CA BERNARDINO Ot 05 ;San Bernardino County F D , HazMat Div. .2708735 .2097 MENTONE BLVD _ _ _ MENTONE ,CA _ BERNARDINO _ _ _ _ 02 _ 20 'San Bernardino County F_D HazMat Div. 2708735 2097 MENTONE BLVD MENTONE rCA iBERNARDINO 03 ; 30 - San Bemardino County F.D., HazMat Div 2708755 _ _ 2790 WHITSON RD __ SELMA CA ?FRESNO O7 _ _ , 05 :Fresno Co. Env. Health System 12708755 ,2790 WHITSON RD._ . .. . SELMA CA FRESNO _ 4 02 _ ' 20 _ :Fresno Co. Env. Health System 2708755 2790 WHITSON RD •SELMA oCA _... FRESNO _ 03 30 ;Fresno Co. Env. Health System :2708825 2222 F ST _ BAKERSFIELD CA _ KERN 01 20 _..._, Bakersfield Fire Department '2708825 2222FST BAKERSFIELD CA •KERN 02 05 _ _ 'Bakersfield Fire Department ;2708825 2222 F ST :BAKERSFIELD ,CA ;KERNS _ 03 v 3 30 __ , ,Bakersfield Fire Department F2708843 :1640 N. CARPENTER RD MODESTO CA STANISLAUS Ot 05 'Stanislaus Co.,Dept. of Envir. Resources 2708843 :1640 N CARPENTER RD MODESTO CA 'STANISLAUS 02 20 iStamslaus Co Dept of Envic Resources 2708843 :1640 N. CARPENTER RD MODESTO CA STANISLAUS 03 ~ 30 ;Stanislaus Co.,Dept. of Envir. Resources Product Code: OS -unleaded regular 20 -unleaded plus 30 -unleaded premium 45 -diesel ~. . CERTIFICATE OF INSURANCE NAME: ADDRESS: POLICY NUMBER: ENDORSEMENT: PERIOD OF COVERAGE: SEE SCHEDULE BELOW SEE SCHEDULE BELOW ST8089599 Not applicable 12/17/05 - 12/17/06 NAME OF INSURER: AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY ADDRESS OF INSURER: 70 PINE STREET NEW YORK, NY 10270 NAME OF INSURED: Couche-Yard, Inc., Circle K Stores Inc., -- = -~_-- ~~- = ~ -- - -and.Mac's. Convenence_~tares LLC _~ ~_ _~ _ __ _ _ ADDRESS OF INSURED: 1130 West Warner, Building B ~ ~ -- - `` --- - -~" Tempe, AZ 85284 CERTIFICATION: 1. AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the following underground storage tank(s): See "Item 5. Covered Storage Tank System(s)" on policy referenced above, for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases in accordance with and subject to the limits of liability, exclusions, conditions and other terms of the policy arising from operating the underground storage tank(s) identified above. The limits of liability are 51,000,000 each occurrence and S2,000,000 annual aggregate, exclusive of legal defense costs, which are subject to a separate limit under the policy. This coverage is f provided under ST8089599. The effective date of said policy is December 17, 2005. 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 policy to which this certificate applies. b. The Insurer is liable #or the payment of amounts within any deductible applicable to the policy to the provider of corrective action or 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 CI2567 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 alt endorsements. d. Cancellation or any other termination of the insurance by the Insurer, except for 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 -eceived 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 or renewed policy has the same retroactive date or a retroactive date earlier than that of the prior policy, 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 date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. 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 eligible to provide insurance as an excess or surplus lines insurlej in o~..or~~~A states. Signal re f Authorized Representative of Insurer Jots Sh oku ___ _ _ Regions! Manager Authorized Representative of American International Specialty Lines Insurance Company 777 South Figueroa Street, 13"' Floor, Los Angeles, CA 90017 C12567 2 r z~oaso5 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION HAZARDOUS MATERIALS BUSINESS PLAN ~ ~"' CERTIFICATION FORM 2006 Pursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous Materials Business Plan (HMBP) certification described below is hereby submitted for the following facility: Facility Name: Circle K Store #2708605 Facility Street Address 5600 Auburn Street City: Bakersfield Zip: 93306 I have personally reviewed the Hazardous Materials Business Plan currently on file with the CUPA dated 3/18/2004 and certify that: (Check one.) The Hazardous Materials Business Plan is complete and accurate and no revisions are necessary* (See below for details); or Revisions to the Hazardous Materials Business Plan are necessary. The following new or revised form(s) and/or information are enclosed to reflect the necessary changes: Business Activities form Business Owner/Operator Identification form Hazardous Materials Inventory form(s) ^ Site Map form ENrp A ~R Emergency Response Plans and Procedures .~ $ ~~Os Employee Training Program *By checking the top box on this form, you are certifying that: a) The information contained in the annual inventory forms most recently submitted to the administering agency is complete, accurate, and up-to-date; and b) There has been no change in the quantity of any hazardous material as reported in the most recently submitted annual inventory forms; and c) No hazardous materials subject to the inventory requirements are being handled that are not listed on the most recently submitted annual inventory forms; and d) There have been no substantial changes in the facility's hazardous materials operations which would require revision of the current HMBP; and e) The most recently submitted annual inventory forms contain the information required by Section 11022 of Title 42 of the United States Code. OWNER/OPERATOR CERTIFICATION: I hereby certify under penalty of law that, based upon my inquiry of those individuals responsible for obtaining the information reported above, I believe that the submitted information is true, accurate, and complete. I understand that a revised HMBP must be submitted within 30 days of any change in this facility's storage or handling of hazardous materials which would require up ating of th P. Signature of Owner/Operator: Titl ~~~~:~ Name of Owner/Operator (print ~ Date: - ~ ~~ Return all forms to: Bakersfield Fire Department 900 Truxtun Avenue, Suite 210 Bakersfield CA 93301 661-326-3979 Business Plan Certification 2006 27osso5 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page ~ of ~i I. FACILITY IDENTIFICATION FACILITY ID# 1 EPA ID# (Hazardous Waste Only) 2 CAL000278510 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K Store #2708605 I. ACTIVITIES DECLARATION NOTE: If you check YES to alny part of this list, please submi# the Business Owner%Operator Identification page (OES Form 2730). -Does your facility... If Yes, please complete fhese pages 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 (include liquids in ASTs and USTs); or the d l l F h ©YES ^ NO 4 ~/ HAZARDOUS MATERIALS INVENTORY - e app icab e eral thres old quantity for an extremely hazardous CHEMICAL DESCRIPTION(oES 2731) substance specified in 40 CFR Part 355, Aappendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? BUNDERGROUND STORAGE TANKS (UST YES ^ NO 3 ~ UST FACILITY (FormerlySWRC6 Form A) 1. Own or operate underground storage tanks? UST TANK (One page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ~ YES ©NO 6 ~ UST FACILITY UST TANK (One per tank ~ f ~! UST INSTALLATION -CERTIFICATE OF COMPLIANCE(one page per tank)(Formerly Form C) 3. Need to report closing a UST? ~ YES ©NO 7 ~ UST TANK (closure portion-one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) 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 NUMBED-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted ~ YES ©N010 ~!I RECYCLABLE MATERIALS REPORT recyclable materials (per HSC § 25143.2)? (one per recycler) 3. Treat hazardous waste on site? ~ YES ©NO 11 ~l ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (Formerly DTSC Form 1772) of ONSITE HAZARDOUS WASTE TREATMENT-UNIT(one page per unit) (Formerly DTSC Form 1772A,B,C,D, and L) 4. Treatment subject to financial assurance requirements (for Permit ~ YES ©N012 ~ CERTIFICATION OF FINANCIAL by Rule and Conditions! authorizaton)? ASSURANCE(Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? ~ YES ©N013 y/ REMOTE WASTE/CONSOLIDATION SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1232) 6. Need to report the closure/removal of a tank that was classified as ~ YES ©N014 ~/ HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) i UPCF (1/99) 2708605 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMAT ION BUSINESS OWNER/OPERATOR IDENTIFICATION Page I. IDENTIFICATION 1 BEGINNING DATE 100 ENDING DATE FACILITY ID# 101 ~ I 01 /01 /2006 12/31 /2006 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE 102 ~ Circle K Store #2708605 661-871-7979 BUSINESS SITE ADDRESS 103 5600 Auburn Street C17'y 104 CA ZIP CODE 105 Bakersfield 93306 DUN BRADSTREET 106 SIC CODE (4 digit #) 107 10-5457662 5541 COUNTY 108 Kern BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE 110 Circle K Stores, Inc. 866-805-4357 ~ II. BUSINESS OWNER (OWNER NAME 111 OWNER PHONE 112 ~ Circle K Stores, Inc. (951) 270-5193 OWNER MAILING ADDRESS 113 495 E. Rincon Road, Suite 150 CpI'y 114 STATE 115 ZIP CODE 116 Corona CA 92879 III. ENVII20NMENTAL CONTACT CONTACT NAME 117 CONTACT PHONE 118 Lorranie Soffe 951-270-5183 CONTACT MAILING ADDRESS 119 495 E. Rincon, Suite 150 CITY 120 STATE 121 ZIP CODE 122 Corona CA 92879 PRIMARY IV. EMERGENCY CONTACTS SECONDARY NAME 123 NAME 128 Service Contact Center Justin Peterson TTi'LE 124 TITLE 129 24 Hours District Manager BUSINESS PHONE 125 BUSINESS PHONE 130 866-805-4357 661-978-4822 24-HOUR PHONE 126 24-HOUR PHONE 131 866-805-4357 661-978-4822 PAGER# 127 PAGER# 132 ADDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry of [hose 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. SIGNA RE OF OWNLR/OP TO X34 DATE NAME OF DOCUMENT PREPARER 135 ~ ~ f~(,J, RHL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT. N E F SIGNER (print) 136 E OF SIGNER 137 Lorraine Soffe Compliance Manager UPCF (1/99 revised) 167 OES FORM 2730 (1/9 i 0. o C~ ~ ^7 ~ ~ A 0. w W ~ -{-~ 'U O ~ I ~. Z~ ~ ~ (~- Q~ J ~ C G ~/~ VJ Q ~ ~ N w J w n. ~ ~ ~ am Z w0 ~ Z 2 w ~ WO pY DY d ¢ H 0.. O ~ 2 Z w w\ ~ Z ~ m j ¢ j ¢ aw Ow = crjw z 41 Y z ~ ~ ao ° ~ cri'- °~ °~ °o ao v' wa ° O ° ~ ° ~ c~~ ao ~ ww ~~ ~~ ~ I ~ I ~ C~ I ~~ d ~ W ~ F Z~ a h- 2 w U a > K w~ wO r=-Or wO Z¢~N wO Z¢¢~U wZw2 m0 ~0 wt2n ZV21 3 wc2il r¢-¢ Iw- ~ ~ v~i N v~iw =0 ~ ~ wOw QN Ot~il 0000<~~0~~ ®~c=~ 0~ w ~„ ~ z ¢~ !n UN ~ o ° m° ~ o z Q ° d O J O w~ O O = J w `y w ~ ° -J OU O ~ wm ~m °vl ~ w w wm ~~ ov~i °w w¢ w pm J~ w m ~ m p a Q~ ~ w~ 0¢N~O~~~O¢~~n¢ ¢~ wOU OOU ¢OU K~ Z ¢~ o 00 ° o00 ~ U O ~ a v2i 3 ¢ 0. 0 U H Z ° ~ I ° w Q ~I~1N~0 ~b'1SOd ~ ~ J ~ ~ O LJ z z Z 0 o w =, ¢ F- Z to cn U U ~ w Z ~ ~ ~ rn ¢ ~ a o ~ U d ~ U O ° ~ ~ w a AIRFAX ROAD F ° w00~~ __- - ~ \ `~ __. -- ~ f~ W ~ - o ~ _ - - a, 0 W U _ - - _- E--~ Q. 6 ~l N U" ; 0 w ^ / r-y ~ ~ / ~ \ ~~ CAP/~~ ^ I ~ ~~ p~ iii VP~%i I L-J ~ ~i O i - ¢ Q [~ ~ .O ~ 0` ~ ~ ~ O ~ ~~ ~ ~ ~ LL J 0 ~`' W I Q ~ ~ ~ ~ ` W z In C.7 w ~ 0 N I L ~ '~ ~ W I '~ a Q. o J ~ ' ~ ~ X m ~ d ~ \ c c L Q ~ I I ~ Q w I ~ I O v ' W ~ ` ' ~ n z w I ` ~ ~ ~~o I O J I ~ ~ ~ v I ~ w O ,~, V cn ~ N ~ ~ ~ (n Q W O o ~ I w ~ c~n m I w " ~~ ~ <~~ ~ Y~ m ~ -~ ~ J O 0 - -- _ - ~ ~p - - - - 0 U ~ W z a ~ ~ w w Q lOl ONI~I?~dd ~J~1N~0 ONId dOHS ~- p-, z z ~ ~ ~ ~ ~ ~ r N C`7 ~ In (p (~ EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIltE, SPILL OR SUSPECTED LEAK MINOR INCIDENT: (less than 5 gallons 2708605 1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used 2• SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See the Emergency Equipment Section for additional information. 3. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. 4. RECORD: Record the event in the Daily Systems Inspection Form. 5 • NOTIFY: The Service Contact Center if the spill flows off site, enters a storm drain or contacts bare soil or groundwater. MAJOR INCIDENT: (more than 5 gallons) Any incident that can not be contained and cleaned up as part of the routine operations, should be considered a major release and use the following procedures. 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your engines and leave the station on foot immediately. All employees meet at the emergency assembly area." 3. Ca119-1-1: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 5600 Auburn Street If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared to answer any questions concerning the situation. 4. ATTEMPT to contain the spill if you can do it safely. 5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having difficulty leaving the station are and anyone who maybe injured. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. Immediately notify the Service Contact Center. EMERGENCY PHONE NUMBERS EMERGENCY RESPONSE CONTRACTOR. Service Contact 24 -Hour Center Dispatch: 1-866-805-4357 CIRCLE K STORE PERSONNEL District Manager: Justin Peterson 951-270-5163 Compliance Manager: Lorraine Soffe at (951) 270-5183 or (951) 453-9067 FACILITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 24-hour: 866-805-4357 Secondary: Justin Peterson District Manager Day: 661-978-4822 24-hour: 661-97 8-4822 Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate time frame unless the situation requires urgent immediate response by the a encies, in which case the Operator should notify these agencies. a) LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 661-326-3979 b) CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 or (916) 845-8911 c) LOCAL POLICE AND FIItE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) Spill/Release Response Procedures for Carbon Dioxide (COZ) The refrigerated liquid C02 used at many locations to produce carbonated beverages can be hazardous in the event of a spill or release, or if there is a fire at the station. Although C02 is not flammable, in the event of a fire. the container could explode due to the high heat of the fire. Releases and spills of the C02 may cause dizziness or suffocation without warning. When released, the vapors are initially heavier than air and spread along the ground. Contact with the refrigerated liquid may cause bums, sever injury and/or frostbite. Spill or Release: In the event of a spill or leak from the C02 container, do the following: 1. Dia1911 -inform emergency personnel that there is a release from the refrigerated liquid C02 tank and the location of the tank. 2. Evacuate employees and customers from the site and deny entry to unauthorized people. 3. Stay upwind of the spill and out of low-lying areas. 4. Do not touch or walk through spilled material. 5. Avoid breathing gases. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. 1:\HAZMAT\Tosco\ZFORMS\co2-Spill Plan.doc Spill/Release Response Procedures for Propane The Propane used can be hazardous in the event of a spill or release, or if there is a fire at the facility. Propane is flammable, in the event of a fire; the container could explode violently due to the high heat of the fire. Propane is an odorless, colorless, flammable gas. Often an odorant is added for fuel purposes. A release in a confined area may cause rapid breathing, diminished mental alertness, impaired muscular coordination, faulty judgement, depression of all sensations, emotional instability and fatigue. As asphyxiation progresses, nausea, vomiting and loss of consciousness may result. Spill or Release: In the event of a release from the propane tank/cylinder, do the following: 1. Evacuate all personnel from the affected area. 2. Stay upwind of the release and out of low-lying areas. 3. Avoid breathing gases. 4. If the leak is in a container or valve, contact the propane supplier for assistance. 5. Ventilate the area before attempting the re-enter the area. 6. Do not enter the building until emergency personnel have notified you that it is safe. 7. Contact management using the emergency phone list procedure. Fire: 1. Follow the Fire and Explosion evacuation procedures. 2. Notify emergency personnel of the tank location. Prevention Procedures: 1. Store tank and/or cylinders with valve protection caps installed. 2. Tank and cylinders should be stored upright and firmly secured to prevent falling or being knocked over. 3. Containers should be stored in a cool, dry, well ventilated area away from sources of heat or ignition and direct sun light. 4. If you suspect any problems with the tank notify the supplier immediately to have the system inspected. I:\HAZMAT\ConocoPhillips\zFORMS\Propane-Spill Plan.doc EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline and make copies as needed. Have employee date and sign the attached training log upon completion of training. Retain thse records for a minimum of three years. All employees should review the Hazardous Material Plan, (this document). Specifically, each employee should understand the procedures to be used in responding to various kinds of emergencies, and know how to monitor the site for leaks of hazardous materials. As a supplement to this package, employees should also review and have access to the the Emergency Response Plan and the Materials Safety Data Sheets. Each employee must be drilled in all emergency response procedures contained herein. UTILITY SHUT-OFFS ~c PUMP SHUT-OFF: This turns off the turbine pumps that provide flow to the dispensers from the undergroundstorage tanks. Shut-off pumps in case of a leak to help prevent spills. Location: 1-CASHIER 1-NORTH SIDE BLDG ~c TANK MONITORING ALARM: This is used to monitor the Underground Storage Tanks. This panel may indicate when a potential leak is detected by a visual and audible alarm. Location: BACK STORAGE ROOM ~c ELECTRICAL PANEL: The panel allows you to selectively cut power to lights, signs, and pumps. The main switch allows you to cut-off all power at the site. Location: BACK STORAGE ROOM ~-c WATER SHUT-OFF: The water shut-off maybe necessary in some cases. Location: CORNER OF FAIRFAX AND AUBURN STREET ~c NATURA.I, GAS SHUT-OFF: If your facility has natural gas, it may be necessary to shut-off the flow in case of an emergency. Location: BUILDING REAR ~c PROPANE/LPG SHUT-OFF: If your facility has propane or liquefied petroleum gas, be sure to turn off the manual valves and shut off the power to the dispensing pumps in case of a release or fire. Call your supplier or dial 9-1-1 as necessary. EMERGENCY EQUIPMENT ~Ic FIRE EXTINGUISHER: Use only on small fires that you can contain. Do not attempt to extinguish large fires on your own; call 9-1-1 for help. Location: 1-NEXT TO STORAGE DOOR, 1-FRONT DOOR, 1-PUMP ISLAND ~Ic SPILL/ CLEAN UP HIT: This can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, see the "Major Incident" section on the previous page. Location: SPILL KIT IN STORAGE ROOM ~c RESPONSE EOUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: REAR STORAGE Shovel: REAR STORAGE Gloves: REAR STORAGE Goggles: REAR STORAGE ~c FIRST AID KIT: Use for minor incidents and treatment. Location: BACK STORAGE ROOM ~c EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: NORTH SIDE OF LOT ~c ENVIItONMENTAL DOCUMENTS / HMMP MSDS SHEETS: Location: CASHIER EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: KERN MEDICAL CENTER 1830 FLOWER ST BAKERSFIELD 661-326-2000 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 661-326-2000 FIRST AID PROCEDURES (for gasoline and/or diesel fuel): For further information, refer to the 1VISDS sheets. EYE CONTACT: If irritation or redness develops, move victim away from exposure and into fresh air. Flush eyes with water clean water. If symptoms persist, seek medical attention immediately. SKIN CONTACT: Removing contaminated clothing and shoes, flush affected area(s) with large amounts of water. If skin is not damaged, proceed to cleanse the affected area with mild soap and water. If symptoms become worse, seek medical attention immediately. INHALATION (Breathing): Remove victim from source of exposure and into fresh air. If victim is not breathing, give artificial respiration and seek medical attention immediately. INGESTION (Swallowing): Aspiration Hazard: DO NOT INDUCE VOMITING. do not give anything by mouth because it can enter the lungs and cause severe lung damage. If victim is drowsy or unconscious and vomiting, place on the left side with the head down. Seek medical attention immediately. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the Material Safety Data Sheet (MSDS) for that product. Document prepared by: Environmental Staff, RFIL Design Group, Inc., 800-765-1025 Last Updated: 28-Mar-06 Hazardous Materials Training Requirements As the owner/operator of a business that handles hazardous materials, you must have the following: * A Hazard Communication Plan (also know as an Employee Right-to-Know Plan) * The Hazardous Materials Management Plan _Chemical Inventory, also known as the CA Business Emergency Plan) * An Emergency Response Plan * An Underground Storage Tank Monitoring and Response Plan * A Release Reporting Plari Each of these plans requires employee training. Training must be documented by a written description of the topics covered and by a dated signature of the employees receiving the training. Annual refresher training is required. The introduction of new hazardous materials or changes in procedures requires immediate retraining. Training requirements that are common to more than one of these plans only needs to be given once to satisfy all of the plans containing that requirement as long as the training addresses the concerns of each plan. * Training for the Hazard Communication Plan must include the following elements: ,-c An overview of the requirements contained in the Hazard Communication Regulation and the worker's rights under-the Regulation. * Locations of any operations in the work area where hazardous substances are present. * Location where a copy of the written Hazard Communication programs is made available to them. * How to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information, including physical and health effects of hazardous substances in the work place. * How to detect the presence of or the release of hazardous substances in the work place. * How to minimize their exposure to these hazardous substances by proper use of engineering controls, work practices, and/or personal protective equipment (gloves, etc). * Emergency and first aid procedures to follow if employees are exposed to hazardous substances. e~,, SM 495 East Rincon St Suite 150 Corona, CA 92879 December 21, 2006 UPS: K054' 558 389 7 Bakersfield Fire Department `' 2130 G. Street . Bakersfield, CA 93301 , RE: Circle K Stores Inc. Submittal of Certificate of Financial Responsibility Attached is the Certificate of Insurance for Circle K Stores Inc., effective December 17, 2006 through December 17, 2007. Please call me at (951) 270-5183 if you have questions. Sincerely, Lorraine Soffe West Coast Environmental Compliance Specialist Attachments 2 CERTIFICATE OF INSURANCE NAME: SEE SCHEDULE BELOW ADDRESS: 5EE SCHEDULE BELOW POLICY NUMBER: ST8089599 ENDORSEMENT: Not applicable PERIOD OF COVERAGE: 12!17/06 - 12/17/07 NAME OF INSURER: AMERICAN Id~1rlERNATIONAL SPECIALTY LINf`S-QNSURANCE COMPANY ADDRESS OF INSURER: 70 PINE STREET - - - • - ' NEW YORK, NY 10270 NAME OF INSURED: Couche-Yard, Inc., Circle K Stores Inc., and Mac's Convenience Stores, LLC ADDRESS OF INSURED: 1130 West Warner, Building B Tempe, AZ 85284 CERTIFICATION: 1. AMERICAN INTERNATIONAL SPECIALTY LINES INSURANCE COMPANY, the Insurer, as identified above, hereby certifies that it has issued liability insurance covering the fallowing underground storage tanks}; See "Item 5. Covered Storage Tank System(s)" on policy referenced above, for taking corrective action and compensating third parties for bodily injury and property damage caused by accidental releases in accordance with and subject to the limits of liability, exclusions, conditions. and other terms of the policy arising from operating the underground storage tanks? identified above. The limits of liability are 51,000,000 each occurrence and S2,000,000 annual aggregate, exclusive of legal defense costs, which are subject to a separate limit under the policy. This coverage is provided under ST8089599. The effective date of said policy is December 17, 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 (ts obligations ' under the policy 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 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 C12567 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 for 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 ~: '•.v "" "' i notice is received by ` ~Iie 'insured. Cancellation for non-payment of premium ~ ar . ~~~~;!'`: misrepresentation by tiiB 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 excep# where the new or renewed policy has the same retroactive date or a retroactive date earlier than that of the prior policy, 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 date. Claims reported during such extended reporting period are subject to the terms, conditions, limits, including limits of liability, and exclusions of the policy. I hereby certify that the wording of this instrument is identical to the wording in 40 CFR ' 280.97 4b? l2) and that the Insurer is eligible to provide insurance as an excess or surplus lines insurer in one or more states. Sign tune f uthorized Representative of Insurer Jota 5hoht u Authorized Representative of American International Specialty Lines Insurance Company 777 South Figuerea Street, 13`" Floor, I.os Angeles, CA 90017 r CI2567 2 Circle K Tank Schedule , _ ____ _ 12/17/06-07 _______ ____ __ _ ____ __ __ __ ___ West Coast Region ias of 12/13/06. - - -- - - ------- CAPACITY INSTALL RETRO LOC. # Region ADDRESS ___. __ _.___.._..._._.CITY ~ _ STATE UST # ~ GALLONS DATE DATE _,._...__...___ ___._._ ...._..~ ____ ~_._._r _..... ____.__ _.._y ___.__._.__..m.__..-._____m....... 2708691 `WC ;766 S MAIN ST ;SAN LUIS iAZ 01'', ¢45 20029S FG 1-Jun-88 17-Dec-03 _..._._... _.__......___ ._...... _ .__._ v._.-.,_. _._ _.. _. 2708691 WC X766 S MAIN ST -SAN LUIS .AZ 021 30 9816 S FG 1-Jun-88` 17 Dec-03 2708691 WC 1766 S MAIN ST -SAN LUIS AZ 03 :05 9816sS FG 1-Jun-88= 17-Dec-03 2708691 WC [766 S MAIN ST 'SAN LUIS ~AZ 04' X05 ! 9816 S FG 1-Jun-88, 17-Dec-03 _......__ ~ _.._.____.~._.,___.__.._.___...__....._ .___,___... __..__,._..__.,W.._M-_.__.__......_.__.___,_._~_.._~._._.._ __._...... ~.____~.~....__._ 2701939 WC ;121 E MAIN ST SOMERTON -AZ 01~ 120 3 9816 S FG ~ 1-Mar-86= 17 Dec-03 2701939 WC121 E~MAIN ST~~ ~~~ `SOMERTON AZ ~02~ !05 9816;S FG 1-Mar-86 17-Dec-03 _...w_._.....__-..:._~..-_..„__._..__.~.._._.__.__..___..._.__~.. . _ ._.._~.__.___.____._._____..___._ ._____ _._____. ~__~__.__.._ ~ ________.__ _ __..._.. 2701939 `WC X121 E MAIN ST SOMERTON AZ 03 }30 ~~ 9816';S FG t 1-Mar-86.17 Dec-03 2705709 'WC ' 1415E 16TH ST PUMA AZ 01 U 30 t 12023D SF 1-Jan-93 17 Dec-03 ._.._,_... __,w~; _.__,.~_..,,._ _........_.I_-_____.._._.._. 2705709 sWC '1415 E 16TH ST YUMA AZ 02 U 05 s ' 12023'D SF 1-Jan-93 17-Dec-03 _-__ _ .r_____.,__,___._~..___._-,.._._W_,._,_..w___..._..-.~,.~.._._._..~.....,..__._., ....__._. _-.._ __ _,-_.~, _.___. __..._ _.~ ~,_.-~_.._._._. _..._F_ .__,~_ 2701849 ?WC ;17984TH AVE IYUMA AZ 01 U 20~' ~ 9728+S FG 1-Jul-85 17-Dec-03 _ _.... 2701849 WC ;1798 4TH AVE „YUMA AZ 02 U 30 9728 S FG "1-Jul-85, 17-Dec-03 2701849 WC :17984TH AVE `.YUMA AZ 03 U 05 9728 S FG ~ 1-Jul-85; 17-Dec-03 x~.. .-.._ __.~.~.._.__.~.,...-.._.__...___._ .-___.._._ ~._______....._~.._..___.__......_...___.___ M.,.~ _. __ _. ~......._. _ _..._w.__..._ 2700684 WC ;2089 AVE A YUMA AZ E 01 U 05 9728' S FG 1-Apr-843 17-Dec-03 2700684 {WC i2089AVE A YUMA AZ 02 U 30 9728 S 'FG 1 Aprp84' 17 Deo-03 2700684 tWC -,2089 AVE A .YUMA AZ s 031U 20 9816 S FG 1-Apr-84, 17 Dec-03 2701847 WC }2090 E 32ND ST -YUMA AZ - 01 U <20 9816 S FG 1-Jul-856 17 Dec-03 2701847 WC 12090E 32ND ST 'YUMA AZ ~ _ 02~U X30 9816 S FG ~ 1 Jul 85 17 Dec-03 2701847 WC ':2090 E 32ND ST ;YUMA AZ 03iU 405 9816 S FG 1-Jul-85 17-Dec-03 2701800 WC !2398 AVE B YUMA AZ 01 U 30 i 9816~"S FG 1 1 Nov=85? 17-Dec 03 2701800 IWC 2398 AVE B `YUMA AZ 021U 05 " _' 9816tS FG ~ `1-Nov-85I 17-Dec-03 __, ~, ._._._._.__. R _._._..__.._ _ _ __..______ 2701800 IWC -2398 AVE B 'YUMA AZ 03 U 20µ 9816 S MFG , 1-Nov-85 17 Dec 03 2701756 WC `2400 S ARIZONA AVE PUMA AZ 01 ~U ,20 ~~~ 9816;S FG ~1 MayW85y 17-Dec 03 __~. -_ ~ __~..~, ..___-._....-,,.~._ ___._.___._._ _.~.. .._____ w_-. .,~. .__,. ... ,_.,, 2701756 ' WC -.2400 S ARIZONA AVE YUMA AZ 02'U 30 1 9728 S 1FG ~ .~ 1-May-851 17 Deo-03 2701756 WC 2400 S ARIZONA AVE -YUMA _ AZ 03 U 05 9728tS ~FG `-;~` 1-May-8 17-Dec-03 .._m._...._.. .,......,-~.____...,___.._-.__...,___.._ ...~.~...___., _ __.._ __ -- 2701394 WC ;24098TH AVEYUMA _ ~~ AZ ~~ 01~U 30 9684.:D FG? 29-Jun-04 17 Dec 03 .2701394 tWC ;2409 8TH AVE IYUMA AZ 1 02 U 05 ~ 9684 D FG s 29 Jun-04 17 Dec 03 2701394 .WC ;2409 8TH AVE YUMA AZ 4 03 U 20 ; 9684 D FG~'S 29 Jun-04 17-Dec-03 2708475 'WC X2505 W 8TH ST YUMA AZ s 01 U 20 9816 S FG i 1 Nov 87, 17 Dec 03 _..___w.....w_..~..__.___m__ ~_.._,~...._,_.-_..~.__....._._..._._.___.._._-..... ,.._____ ...... __._ .....____ .,,____.~ .____..._.__ ..___.... _ _~ _ .,_....,....w...__..__...._.~w..m_~.__..._..._..~ 2708475 WC ':2505 W 8TH ST °YUMA sAZ 02 U 05 9816'S FG { 1 Nov 87, 17 Dec-03 ~. _ ..:...n .. _. __ 2708475 ?WC X2505 W 8TH ST YUMA 'AZ 03 U ,30 = 9816 S FG ' ,1.Nov-8T 17-Dec-03 2700212 ,WC X3650 8TH ST 'YUMA AZ 01~U 0 ~ 9816 S FG " 1 Nov 85 17 Dec-03 ~..._.._ 2700212 WC '3650 8TH ST YUMA 'AZ ~ 02 U X05 9816 S FG 1 Nov-85+ 17 Dec-03 2700212 ;WC_ X3650 8TH ST YUMA ;AZ 03sU `30 ? ~ ~ 9816 S FG - 1 Nov 85" 17 Dec-03 ,_ _.M._.-_,._..~...._. .,.. _..___-_._~. __...._...._.......__...m.~~ ~_.._, ___ _ . ~ ..,. .,_,,_ ...__._ __ .._ _m__ _ .... ... 2701930 'WC 3379 W 1ST ST YUMA AZ 01 U €20 E_~ ~~. 9816~S FG •- 1-Nov=86j 17-Dec-03 .~ _..._. .__~.,M_.,..,__._._.-,__.~.._.~..._----w----_______.-.M,._.__.~_.._.__...ti._....___~-._ __._,_K,__~._~._M... _..~_,.-~.__. . _ ._....-~ ___._.._._~..~. 2701930 ' WC 379 W 1ST ST YUMA IAZ 02aU 30 :'9816.S FG 1 ,Nov-86' 17 Dec-03 2701930 WC "379 W 1ST ST '.YUMA AZ 03"U t05 s ~ _ 9816 S FG ' 1 Nov 86~ 17 Dec 03 _._.. 2701923 sWC 637E 32ND ST YUMA 3AZ , 01 U '05-' 9816 S FG 1 1 Dec 85~ 17-Dec-03 2701923 IWC '637 E 32ND ST .YUMA +AZ ~ 02`U '30 ~ "9816 S FG 1 Dec-85' 17-Dec-03 ~..~, ..m..m__ ..._ __-~__.,.,.,~..~.....m_._.____.. ___~.._.____.._._.__...__ ~__...._ _.. __ _.. .-_.--~-~--_..~...__.._... 2701923 WC =637 E 32ND ST YUMA AZ ~ 03`U ;20 s 9816':S sFG~; 1 Dec-85€ 17-Dec-03 ..__ __...._-_,.._.__._,_._.~.__..._.._...~......_____.-....__._ _.._ _._.__.~...__.. __w_,_.. _ _.._....._ ...V ._._._ . ___.~...- ._ ____ __ _.~ . 2701948 ;WC £6544 E OLD HWY 80 IYUMA AZ. s 01 U `45 ~ 20029'S FG ~ 1-Jul-87T 17 Dec-03 2701948 WC 66544 E OLD HWY 80 YUMA AZ 02 U 30 I 9816. S FG 9 1-Jul-87t 17 Dec 03 .,.... _.i.. .____..,_.w._ ~ ._ _.~__._.__..__ _..~__a~.~_._.~_.. .... ..._ .__~,.._~ ..,.__.._ 2701948 IWC 6544 E OLD HWY 80 YUMA AZ I 03`U X05 ' 9816`S 'FG ; 1-Jul-87 17-Dec 03 2701948 IWC ;6544 E OLD HWY 80 `YUMA ,AZ 04"U }20 '; 9816 S FG ; 1-Jul-871 17-Dec-03 2701736 WC X695 S 4TH AVE IYUMA AZ 9 01 `U 105 9816 S FG I 1 Apr-85 17-Dec-03 _.__.___ ~. ~ __._-____._ ._._ 1._._._ _ ...___ _.,... ~~..~_._._... 2701736 ' WC X695 S 4TH AVE YUMA AZ ~ 02 U 30 9816 S FG I 1-Apr-85 17-Dec-03 2701736 'WC ~ ._...._._._____...___....._..._. ._.___ ._...... ..~_ ...,__..~.._..k _.,~_......~__._~~.~.~-._.__~_..~.,._ ;695 S 4TH AVE rYUMA AZ 03 U !20 9816.S FG 1-Apr-851 17-Dec-03 2701356 WC ;7110 E HWY 95 '-YUMA ~. AZ i 01 U 20 9728 S ' FG € 1-Dec-86, 17-Dec-03 2701356 iWC '7110 E HWY 95 'YUMA AZ ~ ~~ i 02 U `05 9728 S FG 1 1-Dec-866 17-Dec-03 2701356 WC 17110 E HWY 95 _ AYUMA AZ~x ; 03 U 30 9728'S FG ~ 1 Dec 8617-Dec 03 2701754 ;WC '820 W 32ND ST YUMA AZ ~ 01`U 605 ~ 9728tS FG ''s _1-A_pr-85( 17-Dec-03 2701754 WC '820 W 32ND ST YUMA ,AZ ~ ~~02~U $30 } 9728`S "FG ~ 1-Apr-85E 17-Dec-03 __. .x.__, ~.. _ - i .-.._._..___._..._. .--- _._ 2701754 I_WC 820 W 32ND ST YUMA AZ ~ 03"U '20 £ 9816 S FG 1-Apr-85 17-Dec 03 2700990 IWC j29105 HWY 80 WELLTON AZ 01°O 45f 9728:S FG s 1-Apr-85; 17-Dec-03 __._ ._.,.~ __.u~ _.w _._........ _ ____ ___ _~.__._..._.__.__..._, ___ ._ _~.._._ 2700990 WC j29105HWY80 WELLTON AZ 020 30~ V9728=S FG ~ ~1 Apr-85~ 17 Dec-03 _.. _... 2700990 WC ;29105 HWY 80 WELLTON AZ i 03.0 05 ! 9728kS FG ° 1-Apr 85 17 Dec 03 _._.__ _.____.._. ~._,._.~.,y_ .m..__._....--. _ _. ~___.____w. -a 2705008 WC 11424 CHAMBERLAINE AVE ADELANTO CA 01 ~U 105 " 98161D FG , 1-Nov-88 17 Dec 03 ___ w....._ __ ........ __ ~._. .~..~_~ _ _, ~., .-.r , ..,...._. _ _.._~.. .. _._s. .... _,., ..__.~..._._...~._. . __._ _._...~_. 2705008 WC ;11424 CHAMBERLAINE AVE ?ADELANTO iCA 02.U 120 9816D FG ~ 1-Nov-88 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule-2006 12 13 Circle K Tank Schedule 12117/06-07 ~ ______ __ West Coast Region as of 12/13/06 + 1 L I O LOC. # I Region ADDRESS ~ CITY ~ STATE I UST ~ 1 1 ~GALLONS DATE DATE 2705008 `, WC 11424 CHAMBERLAINE AVE ADELANTO _ _ CA ` ' 03 U _ X30 9816 D iFG 1-Nov-88~ 17 Dec-03 , _.-..~. .~._ . 2708644 3WC . ____ ....._ m __._ ._.._ ___._--..._._ "11724 AIRBASE RD ~._ ___m__M_._..__......__..___ ADELANTO _.__.-~~.-_._ ~ i .___.._. CA 01tU - '30 9816 D'FG 1-Jun-88 17 Dec 03 2708644 ,WC 1724 AIRBASE RD 1 ADELANTO ;CA ~ 02~U '05 ~ 9816,D FG 1-Jun-88 17 Dec-03 _ 2708644 rWC . . -11724 AIRBASE RD ADELANTO CA 03-U X20 9816'D FG 1 Jun 88. 17 Dec-03 _.._......~ ~ 2700736 ?WC .~__ .. _._ .._ _ _._.__. _ _._ _. ..-_,_._ -~.._ .. _. ____~.~.. .~.. 56621 STATE HWY 371 ANZA ICA µ01U X05 ~ ~ 14976'D~FG i~ -_w _. 15 Jun 98 ~ ______. 17 Dec-03 2700736 iWC }56621 STATE HWY 371 ANZA !CA • 02iU 130 I ~ 11849°D IFG ~ 15-Jun-98j 17-Dec-03 2700858 iWC 18465 US HWY 18 ;APPLE VALLEY CA 01jU 20 ' 9816 D FG ~ 1-May-88, 17-Dec-03 2700858 WC 18465 US HWY 18 ,APPLE VALLEY CA 07,U 05 9816:D iFG ~ 1-Ma -88a Y 17-Dec-03 2700858:.WC ;,18465 US HWY 18 'APPLE VALLEY __~ CA 03 U 30 9816 D FG r _ 1-May-88i 17 Dec-03 _M_.___- ~._.~..____ 2701232 WC _ _......~ _.___._~__..____._~_.._~ 4381 EL CAMINO REAL ....___~_...~..~.._,_~.,...___ ~ATASCADERO ._......__._r...~_-__,.._ ACA _._ 01'U _ ___ 05 .. ..~.~.~.._ ._. 14976rD ,FG S .~._~____~.. 20-Oct-98, _..._.._-..... 17-Dec-03 2701232 IWC 4381 EL CAMINO REAL IATASCADERO CA 02`U BO ' 11849,D ,FG ~ 20 Oct-98' 17-Dec-03 2701197 :WC 6930 MORRO RD tATASCADERO CA 01' U 20 9816~D FG 1 Jan 85i 17 Dec 03 2701197 ,WC 6930 MORRO RD 'ATASCADERO CA 02 U 30 9816'D'FG ` 1-Jan-851 17-Dec-03 2701197 iWC 6930 MORRO RD ATASCADERO ~ CA i 03 U -05 9816~D FG , 1 Jan-85 ' 17-Dec-03 2705018 ;WC "1021 SNAPPER RD ATWATER ACA ~ 01~U ~ 20 . _ . 9816 D FG __._ _. . 1 Nov88 ~ _ - .m ~ ,.. _r ___ 17-Dec-03 _.________.__.. _..,.... _~_,__.m~.._~... 2705018 `.WC _.__.__.__.M.._....___...._._.__.,.__. '1021 SHA FFERRD __... .-__. _....__.~._._.,~ jATWATER ...__. ..,.~......._.__._ jCA ._ .. _._.....-..... _ " 02~U _ ___. ._. 05 t _ 9816 D•FG . . . 1-Nov-8$ 17-Dec-03 2705018 WC _ 4021 SNAPPER RD~~ _ ~._ 1ATWATER ~ _.~~.~_ CA ~ ~. m 03 U ~ 30 € r-- 9816 D FG , 1 Nov-881 17-Dec 03 ___._.w_..._._._~._____..~, 2701178 ?WC , ....__w~_._.~._~ _._-._._.......... #428 SKYLINE BLVD _. .~._._._.... _._-..._._..____ iAVENAL ____.__...______ _._ .. =CA _ ... ..........~.. 01 U ~ _..~.._.. _ 05 x ._, .~__.~ ~11849D ~FG i _._____...._... w 10~Dec~98; 17 Dec-03 _____~.__..._..____ 01178 ;WC 2 7 __. __..___...._._.__.______._._ 428 SKYLINE BLVD- -. _.~_~._~____.______.~_.. AVENAL _._.__._._.._._._. ~CA _ 02~U 130 ~ 11849 D FG ; -10-Dec-98 .._W.-___..._. 17-Dec-03 _ _ 2708606. ' WC ..........~.. 1030 OAK ST .._. BAKERSFIELD __._..w_ CA 01 ~U ~ . _ 05 ; ~. ~ 9816 D IFG ._ ._.. 1 May 88 _ _.. 17 Dec-03 .,.~.._ _._._ .. _ 2708606. IWC a w. ~~.__...~.__ 1030 OAK ST __ ._ (BAKERSFIELD ....__...__..,_ CA 02;U ~ 30 ... ` 9816 D FG ` ~ .-._. 1 Ma -88, ~ y _.____m_ 17-Dec-03 ___ . _._.._..._.._ ~...._~.._ 2708606" jWC . ._ -_.__.._-.__._._.~.-._....._. _ 1030 OAK ST .. _..~..._.._____._..__..__.___. 'BAKERSFIELD m..._.~...._...__.- __._..__ CA ._ ___..._ _._ 03 U .. __ _.... •20 , ._ . __ _ _ ._ 9816' D FG 's ...~... _ __, `!" 1-May-88 _ .....__.__ 17-Dec-03 m 2708825 4WC _n ___.~., 2222 F ST ...,.-_w.._.~_._.__..__, ~BAKERSFIELD ,_.._ CA _m__. _~_ 01 U .,..._ 20 _. __ ., 9816 D FG ~ 1 Mar 87 , ; _.-__.. 97 Dec_03 2708825 ;WC . 2222 F ST~ ~ ~ r .w ;BAKERSFIELD . ~rv- .wm ~ ?CA - 02'U `05 i .~~ _ 9816'D FG ? , , 1-Mar-87 17-Dec-03 2708825 =WC 2222 F ST " BAKERSFIELD CA ~ 03'U 30 € 9816 D FG ' 1-M ar-87; 17-Dec-03 ~.__,_____._ 2708605-IWC . ___..__ _.._._ ..._._.._.,_....~___. ~5600AUBURNST __ _.....~__.__._____._..._.. ;BAKERSFIELD _~_.,....___n.~._____ iCA __ 01 U 30 ~ ~..9816D;FG _ _ ~~~~1-Mar-88' ._.___._.._.,.___ 17-Dec-03 2708605. IWC 5600 AUBURN ST BAKERSFIELD CA 02 U 20 9816 D FG ; 1 Mar 88~ 17 Dec-03 2708605 'WC ~5600AUBURNST BAKERSFIELD iCA '- 03 U AS .'. _ 9816 D,FG 1Mar-88x. .17-Dec-03 2701270 'WC 5634 STINE RD BAKERSFIELD CA ~ 01 U 05 14976~D FG 24 Aug 98 17-Dec-03 2701270 WC . ,'5634 STINE RD ,, BAKERSFIELD `CA 02`U 30 ,: :` 11849~.D FG 24-Aug=98 1.7-Dec-03 2705731 WC X1501 E MAIN ST BARSTOW CA 01 U 05 _ _ 15154 D FG i ____, -1 Nov 96 ~ 17 Dec-03 2705731 WC ,1501 E MAIN ST ?BARSTOW .._. CA ~,..._ __ 02•U .._ _.._ 30 ~ _v...._.__ _. 15154LD FG ' ....w.._.____. ~ ~ 1-Nov-96 N__.._.____M__ 17-Dec-03 ._._.._, 2701096 `WC '500 RIMROCK RD ____ ~BARSTOW .w CA _ 01~U .._ 30 ( _. .. 11849 D FG _._...._...__ _22-Jan-99 __~.,. 17 Dec-03 2701096. ,WC H :500 RIMROCK RD ~BARSTOW ;CA 02~U ~05 ~ 11849`D FG , ..22-Jan-99' 17 Dec-03 n 2700358 IWC _. _ - ;540 W BIG BEAR BLVD ~~~ _.__-._ ;BIG BEAR CITY n__ ___..,_____.._.__._ CA _ _ _ . , 01#U ~. ... #05 ~ _. ___.._.d._ _.. 11849"D FG I __._____.__..__. 30-Nov-98i ____..__....__ 17-Dec=03 2700358 'WC ~ 540 W BIG BEAR BLVD ~ - (BIG BEAR CITY a m =CA ~ 02U X30 ~ 11849 D FG ' 30 Nov 98~- 17-Dec-03 _._._.._..-._.. 2700951- IWC . .~_. __. 5809MANZANITAAVE .w..._. _._....__. _ iCARMICHAEL ____._..__ ._..__.._. CA _..-_____.,__ ~ 01~U ._-. X05 g __ .._ _ _.. 149761D FG ,~..~__._._~...--- 10 Apr98i __.-._...._~__.. 17-Dec-03 2700951 ;WC 5809 MANZANITA AVE 'CARMICHAEL CA ! M-m 021U ~ 30 ~ _._ ___,__ ~ 11849'_D ; FG ~ _.~._.. 10-Apr-981. ~-.-._..:___ 17-Dec-03 2705728 `WC 4200 CHINO HILLS PKWY CHINO HILLS CA 01 fU 05 i _ 12037 D~SF 1-Jan-91~ _ 17-Dec-03 2705728 ,WC 4200 CHINO HILLS PKWY CHINO HILLS CA 02 U 30 ~ 12037rD ,SF 1 Jan 91 ~ 17-Dec-03 2702964 IWC 60 BROADWAY ~~ _. ~ .~ _ ;CHULA VISTA ~ ~~. ACA 01 EU 05 ; 9942'S'SF ~ 1 Apr 81 i 17 Dec-03 r.._. 2702964 ,WC ...~. 60 BROADWAY ,.__ CHULA VISTA ._ CA _ . 02~U ;3D i 9942!S SF 1 ~_ 1 Apr-81~ ,___.-_.._._._.. 17-Dec 03 2705708 =WC ~ ~~. ;98 BONITA RD ~ .~~ ~ .CHULA VISTA ~~ ~~ CA 014U 05 ____~ V.. ~ 15154 D~SF s ~ _ 1 Jan 96 - 17 Dec 03 - _~ 2705708 IW C _ „ 398 BONITA RD ~ =,CHULA VISTA ACA 1 021U ,30 i 15154 D'SF I 1 Jan 96{ 17 Dec-03 _ ____..~... 2705423 ~WC ._ x7796 SUNRISE BLVD ~ .._ _._.~. :CITRUS HEIGHTS ~ ._-. m ,CA _ 01 U -~__ 05 ~ _.o~_-...~ 11682'D MFG .._ 1 Jan 95~ __-......__ 17-Dec-03 .._.._...._._____~.. 2705423 IWC __.._.__.. 7796 SUNRISE BLVD ..._~ __ ~...-.___~~ ' CITRUS HEIGHTS w_.~..._~_ _.._._ CA 02 U _. X05 t .__ ..~. 11682D `FG ~ ~ 1 Jan 951 _._~~.._, 17-Dec-03 2705423 f WC ;7796 SUNRISE BLVD , CITRUS HEIGHTS CA 03 U 20 ( 11682 D ,FG ~ 1-Jan_95~ 17 Dec-03 2705423 WC ...,.... ._-_w.. .. '7796 SUNRISE BLVD ....,...._._..,. CITRUS HEIGHTS __.~. ...~ CA .... ~ _ __ 04 U _ '30 i y . 11682kD FG ' 1 Jan-95~` 17-Dec-03 ..~... ______._~-_..__~...__..__ 2701922 IWC 13120 MAGNOLIAAVE CORONA CA 01iU 20 E 98161D,FG ~ 1- Jan-871 17-D ec-03 2701922 WC :13120 MAGNOLIAAVE CORONA CA 02=U 05 ! 9816D'FG s _ _ 1-Jan-87~ _ ~17-Dec-03 _..._._ 2701922 WC .....___...._._~._..__.__ 13120 MAGNOLIA AVE CORONA _. CA _._w w._ 03~U _.-.~_ ',30 ~ ..._. ___. 9816 D FG ~. 1-Jan-BT _._.__...___.._ 17-Dec-03 .M___ _~.. _.. .. 2705705 WC _~_ _m._~__... _ .~. _.._.._..._.~ . <304 S MAIN ST ~.__ _.. ~ _._ _____~_ __ -__ ,CORONA _._..-_.._.-_ CA _ 01iU 30 ! 15154::D SF + 1-Jan-95i 17-Dec-03 2705705 WC 304 S MAIN ST sCORONA CA 02fU 05~ 15154 D SF 1-Jan-95 17 Dec-03 2701914 WC~ _ X1930 LAKE BLVD _ _. gDAVIS CA 0190 ~ :05 i 9816 D FG 1-May-87'; 17-Dec-03 2701914 WC _..~..__.,._._. . . ~_ ~ 1930 LAKE BLVD DAVIS . ....... ~._ __.._..„.M..,..__,__~., ..~._._.~ ._..M.._., .____...~,.. _ ~ .~ CA _ _ _. . 0210 _._. 930 . ~ 9816'D FG ' .._ ._._. I A 1 May 87 _ 17 Dec-03 . __.. 2701914 WC 1930 LAKE BLVD DAVIS ~,_ _ _ _ !CA _ 03 U _. ,~....3 20 ; . _ , _. _ 7950iD FG ~_._...._.. _, 1-May-87( . ~....____._, 17-Dec-03 _..._. _ 2705017 WC _ __ __ '2549 BLOSSOM _ DOS PALOS ._________.__ _.___.__ CA . 01~U ~~.__w. rv30 • ._._. ..._.~,~_~_._.._~_ 9816 D FG I I .._.~._-___,. 1 Dec-8& .-..__._...._._..., 17-Dec-03 _.. _.a 2705017 ';WC _._ .~.__ 2549 BLOSSOM __ _._ ...... _ ~ ...._._..____ `-DOS PALOS ~...___ _.__.. 'sCA _ 02 U __ 05~ _ _._. . _._ ~_ 9816 D FG ; _, ~~ 1 Dec-88; ~~Yrv~~~ 17-Dec-03 2705017 WC :.2549 BLOSSOM =DOS PALOS 'CA 03 U d20 ? 9816'0 ?FG ? 1-Dec-88"s 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR1Circle K WC Region Tank Schedule 2006 12 13 Oircle K Tank Schedule 12117/06-07 West Coast Region___ ___ _ as of 12/13/06 __ ____ _ _ _ CAPACITY I NSTALL RETRO LOC. # Region ADDRESS CITY STATE US T # GA LLONS DATE DATE 2708545 WC `:1161 E VALLEY PKWY ESCONDIDO CA ~ 01 }U 20 9816 D iFG < 1 y0ct-87 - 17-Decw03 2 708545 `WC 1161 E VALLEY PKWY ESCONDIDO ~ !CA 02 U X05 ~ 9816 D ,FG i 1-Oct-87 , 17 Dec-03 _ ___ 2708545 tWC 1161 E VALLEY PKWY m._ ESCONDIDO ?CA 03U 30 t 9816 D ,FG " 1-Oct-87 ~ 17 Dec-03 ,___ _ __ 2701527 IWC 685 PARKER RD FAIRFIELD CA 01 ': U __ 30 9816 D ! FG ; 1-Mar-87' 17-Dec-03 2701527 IWC `685 PARKER RD FAIRFIELD _ iCA ~ 02'U '05 9816°D ;FG 1-Mar-871 17 Dec-03 27015 27 `WC 685 PARKER RD FAIRFIELD jCA 03 U 20 i 9816~D FFG $ 1-Mar-87: 17 Dec-03 _ 2700489 IWC 14906 VALLEY BLVD FONTANA !CA ' 01 U 05 96841D iFG ~ 1-May-95; 17-Dec-03 _ ._... _.__ __ -.. 2700489 ?WC . _ . , m. __ ,14906 VALLEY BLVD ... ,~ _____. _.~_,..._..,.,..-.. ~FONTANA .~ _....~,..._.-., ... _ .. !CA 02'U 30 -_.L_.._.-_,.~ 9684 D FG ! .M.._.___W _ _._..„_ ay-95j 1-M _.._.__ _.___ 17~Dec-03 v__.,,, _ 2705802 iWC _.__-_,__,___._.._..,._.,_.,,t._._._.- -16900 FOOTHILL BLVD __a..____.__.,..... ~._.._-.._.___ FONTANA _.~___....,.._____w_._. iCA 01 U ..., 05 _.__ r~..,_..._. 11783,5 ;SF ~ ~ _ 1-Jan-83 17-Dec-03 2705802 WC 16900 FOOTHILL BLVD FONTANA ACA 02' U _ _ 30 _ ... ~ '11783'S NSF i w~--~~~ ... 1-Jan-83g ~µ~~~ ~~~ 17 Dec-03 ry~~rv+~w--~ 2708734 IWC '247EOLIVEAVE FRESNO ~ #CA U 01 05 9816 D =FG g- 1 Au 88 17 Dec-03 ___.. 2708734 WC 247 EOLIVE-AVE __~_..,._.,,._. __._. =FRESNO ~,___._.....~..,.,-__._.. __ (CA 02`U 20 , : . ' ._98'16 D ,FG 1 Aug-88~ 17-Dec-03 ._......,~.... 2708734 •WC _ ,,_... ,_ 247 E OLIVEAVE _ __....~._.____,.. FRESNO __w_._,_._.___ ACA 03;U 30 9816 D FG~~ : 1-Aug-881 17 Dec-03 __._._., ..I____ 2705063 WC 8190 MISSION BLVD. _ _ _ IGLEN AVON ,~ !CA 01 U ;20 :9816"D 'FG ~1-Jun-89 _____ 17 Dec-03 2705063 WC '8190 MISSION BLVD ~GLENAVON 'CA ~ 02 U t05 9816 D'FG ~ 1-Jun-89 ' 17 Dec-03 ___~,._ 2705063 iWC wa X8190 MISSION BLVD µ _ _.._._. GLEN AVON '`cCA 03?U 630 , 9816•D FG ~ ,__ _ 1 Jun 89` . ._.___ 17 Dec-03 2701028 =WC ;1665 W HANFORD-ARMONA RDHANFORD jCA 011U 105 14976~:D =FG ; 10-Jul-98 17-Dec-03 2701028 'WC 1665 W HANFORD ARMONA RD'-HANFORD ICA 02 U 30 11849 D ! FG 10-Jat-98` 17-Dec-03 2705619 {WC 1950 W PACIFIC COAST HWY tHARBOR CITY 'CA 01 U X05 ' 12023 D ?SF 1 Jan 88 17 Dec-03 2705619 ;WC '.1150 W PACIFIC COAST HWY $HARBOR CITY CA i 02"U °30 12023 D ?SF ? -1-Jan-88 17-Dec-03 _-...~~.. ._.. 2705057 WC s _ 8197 1ST _ ._,,,_,___~_w.-._..___...,_. _~,~__..._._,. ;HESPERIA ICA 01~U .._ __._, 30 9616 D FG 1 Nov 88 ~.__._ 17 Dec-03 _._____,.,_-,.,,,.._ ,._.. 2705057 WC a _....._ '8197 1`ST . ,_._.__.. ........_ 'HESPERIA ____...._...._. _.__.~... _._ CA 02 U 05 9816 D FG ...... 1 Nov-88 __,._._._. _. 17 Dec-03 _ _.._._. ...~...._. 2705057 WC 8197 I ST HESPERIA ~CA _..._. 03 U 20 _ _ m m9816~D gFG ._ __._.._ 1-Nov-88 __~__,,. 17-Dec-03 2705242 iWC 4 ,3405 E HIGHLAND AVE'. ..HIGHLAND CA 01 U 30 - 11849;D 1FG - 18-Aug-98 _--..___.,...,.__ 17-Dec-03 2705242 ' WC 3405 E HIGHLAND AVE HIGHLAND ICA 02 U ~ 05 ,...~ 11849:D MFG _,~_,...___, 18~Aug-98 17 Dec-03 ~~ ,___.___.___ _ _.__,..__ 2700538 WC _r.._....,...._.._._-___...__.____.. _ ~43955CLINTON ST _ INDIO ICA 01 U 05 _ 14947~D,FG ' _ 2 Nµov-98 17 Dec-03 2700538 WC _ ___ ,43955 CLINTON ST INDIO µ ;CA 02'! U 30 _ 11849 D FG 2 Nov 98 17 Dec-03 2705786: }WC 5793 ALTON PKWY =IRVINE ;CA 01' U 05 14976;D IFG ° ;1-Nov-011 17-Dec-03 ...~_ 2705786 WC __....__._.,.___._~____w.__ 5793 ALTON PKWY ..._-,. ..._.,.._~ IRVINE ..__.___~__..._.. _ 'CA _ . 02 U 30 __._~. _.. __ 14976'D'FG s. __.. 1'Nov 01 . ,..._., 17 Dec-03 w.,_.... .__.., 2705911, 1NC _. ..-.~._,...~,_._._ w F78364 US HWY 111 . ~__.~._.~_m___. ~... rLA QUINTA _w....__._._.-,.__ ~.----_...__ : CA _ 01 U 05 _.__.. ._-,..,_._._._...~.... 14976 D,jFG l ____,.____~_ ..14-Jan-02! _._.______,.~. 17-Dec-03 2705911 ~WC ~ 78364 US HWY 111 ^^ ~ 3LA QUINTA w~ ~4 ~ ~ +CA 02 U 30 ry 14976 D ,FG 14 Jan 02i 1T Dec 03 __ ___ ..___ 2705911 ,WC ~,., ;78364 US HWY 11'1 ~ ALA QUINTA _._„..._n... CA 03 U - 1 45 14976 D FG ~~~' 14 Jan 02= .._._... 17-Dec 03 2700837 'WC 17671-GRAND AVE LAKE ELSINORE `CA % 01 U 30 ~ 11849 D ¢FG x 13 Jul 98 17-Dec-03 .. _. ~. ~,..____ ._w_ 2700837. WC _,.,_. _.___ ~._._. ~...._ ___.. 17671 GRAND AVE . ______..~.__ ._ LAKE ELSINORE ______. _ .___.. CA 02 U 05 ` _. x. . ~. . 11849gD :FG # _. 13 Jul 98 17 Dec-03 2701205.. WC 16470 CAMBRIDGE ILATHROP CA 01 U X05 E 118491D =FG r 2-Jan-98~ T47 Dec-03 2701205 (WC 16470 CAMBRIDGE LATHROP ~ CA = 02~U 30 ~ • ~ 11849 D :FG 2 Jan 98! 17 Dec-03 _._.,._...,~,_.-..._.,.._._ 2701215 ;WC . _ ~ 1421 OCEAN ._,__.._~..~. iLOMPOC .~ ._._...__ __,.._.~._ ICA _,__,_,.• -.-°~05 ' ~; 01 U 1.1849 D .FG~ _1-Feb-99~ 17-D ec-03 2701215 =WC . ,..._.._.,.~ 1421 OCEAN ~ _._._.___.,..,.. ILOMPOC ....~.., __. -.,..,__._ .._ _ ,r ~ 'CA i ~ _,._._ 02`U 130 ...._ 11849~D iFG _ 1 Feb 99 _ _ 17 Dec-03 __.__.._._.,_...,._~_,.w._.._ 2709200 IWC 1400 N HST ,_,__. ...._. iLOMPOC .w .,____..,~__._._.. ,._ CA ......~ .._ .k 01 _ Y_ 05 ..._ 9684 D FG _. 14 Jun 05 97 Dec 03 2709200 ,WC 1400 N. H ST LOMPOC -ACA 02~ 05 9684~D iFG 14 Jun 05 17-Dec 03 .___w._._,.___,._ 2709200 'IWC _____.,_--__-- ___.,.___ ~ 1400 N. H ST ~LOMPOC ~ . _ _ _.,. 'ICA ~ 03g _ _ 301 9684~D MFG .... '14 Jun 05i ____..._._.,._. 17Dec-03 2709200 iWC _.. . ,~,__ 1400 N. H ST ,. m, 'LOMPOC ~__ CA _ 04 45 .,_ 9684 D ;FG = X14 Jun 05 17-Dec-03 .__. _.__~..~_-_ 2703621 `WC _ __ ......__.__, -9704 E PACHECO ~~iLOS BANGS _.._,_,._..._._.-.._....,_._. =CA __ _ 01 U .. 05 9684iD1FG w,_ 14 Jun 951 ___.~._.M.-._.. 17-Dec-03 __,.~. _,. ~.~__ 2703621 WC _._,.__., _ _ .__.. _._.~_ _..... ;1704 E PACHECO .. _ .,..~, =LOS BANGS _ _..._ ~ _ ._, ~.._a.......~ _..w. .._ CA . 02 U 30 t 9684D 1FG = c ...~...,.. __. _ 14-Jun-95' . ____.. 17 Dec-03 ._ _~.,.,__. 2703621 'WC _. ._,.-___ ;1704 E PACHECO W_._._.__.. ~. ~_..______ ILOS BANGS .__.. ~ =CA 03,U 45 ,- ~,,-__ ,., 9684 D MFG ° __.___...___._w. 14-Jun-95 _______._._ 17-Dec-03 2703614 ;WC ,403 MERCY SPRGS RD iLOS BANGS CA 01 U 05 9684~D `FG 13-Feb-96~ 17 Dec-03 ~..,_-._ 2703614 WC ___._._..-_.._..ul.. . .. _.a 403 MERCY SPRGS RD .. ~ ~_._.~. _____ tiLOS BANGS _.._._____,__.__ , ..~.._...__ ~__.. ICA , _ 02 U 20 ; 9684~D IFG ~ ~ .,____ 13-Feb-96~ ~ ____,_ 17 Dec-03 -.. . .__._ ._.._,._ . _ _. , ._...._ _... ___ __., 2703614 IWC ;403 MERCY SPRGS RD ____ _.,_. _ _ _a-_-.. ~._.~. ,._..__,._._ ,._,., _ ,_ _ ,LOS BANGS 'CA ,..,._ _..__m _ 03 U _ _ . . _._. 30 _ . . ~ .__ _..._ __.,_.., ,..~._..~,. 9684~D !FG E ~ , _ ~_-,.,__.._.. - 13-Feb-96 . ~ ..., ... _ .. _.._. 17 Dec-03 ~~ _ 2705431 ~WC _.._.._ .___..~.1.-. 1830 E ST . . .._..._.w.. ..._ . sMARYSVILLE , . sCA 01 U . ., _ __. 20 .____ ._ _._,_..__...... 9816'D iFG ~ ~ _._..w,_,...., . _ 1-Jan-86l __ ~..__.._. 17-Dec-03 2705431 IWC . . _ _..- _ _~ _._.__w_-._. :830 E ST r. . __,..,~._,__.__._,_W___ MARYSVILLE __.___~.. _.,.,___-__._..~ _.__....._._. _ CA . 02 U _~ _ ..._. X05 `. , a ... _.._ ___ . _ ,....~_._._ 9816 D FG ~ ___.__._m__r_. ~. 1-Jan-86 _..~. __._.._... 17 Dec-03 2705431 ;WC X830 E ST ?MARYSVILLE !CA 03 U _._ "~30 ~ _.._ __ 9816 D FG ° ~1-Jan-861 17-Dec 03 2708735 IWC -2097 MENTONE BLVD ;MENTONE iCA , ~ 01 U 05 9816 D FG 1-Dec-881 17-Dec 03 2708735 ~WC 2097 MENTONE BLVD ~MENTONE _... __ .CA 02 U 20 , 9816 D'FG ? 1-Dec-88; 17-Dec-03 ~tl 2708735 WC 12097 MENTONE BLVD ;`MENTONE =CA 03 U 30 ( 9816 D iFG i 1-Dec-88 17 Dec-03 ._._._.____.~ _ 2700337 EWC w.__..__._..__ '10597 JURUPA RD ~ _ -MIRA LOMA _ _ ~~ ICA 1 U ~~ ':30 11849 D FG , ' .__. 17 Dec 98 _._. 17 Dec 03 .____ __~.,-,-_ 2700337 'sWC . _._ _.._,.._ ?10597 JURUPA RD _~_~_ _.__, 'MIRA LOMA _ ~ ~~=CA ~_ 02 U =05 ; 11849~D FG I __ ____,_ 17 Dec-98 _._.. ___... 17-Dec 03 _._._. 2708843 WC _ i 1640 N CARPENTER RD sMODESTO _ _ `CA 01-U °05 9816~D =FG ' 1 Oct-87 17-Dec-03 2708843 `WC L 1640 N CARPENTER RD z ;MODESTO ~-~MN~ sC A µ ~ 02 U mWY 20 ~ 9816 D MFG ~ ~ 1 Oct 87~ 17 Dec 03 _ _ __,. 2708843 IWC _. _e .__...,.. _. __.._._.__.__ ;1640 N. CARPENTER RD _ _ _ _._._. MODESTO~ ~-jCA _ ~ 03~U _ _ 30 _ 9816D !FG ~-- 1-Oct-871 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule 12/17/06-07 West Coast Reg ion as of 12/13/06 LOC. # Region ADDRESS CITY STATE UST # CAPACITY GALLONS INSTALL DATE RETRO DATE 2705432 IWC =899 HAWTHORNE ST MONTEREY ICA 01 U 05 9816?D +FG ~ ~ 1 Jan-90 17-Dec-03 2705432 'WC :899 HAWTHORNE ST MONTEREY CA ~----- 02 U :20 9816fD FG 1-Jan-90 17-Dec-03 2705432 WC X899 HAWTHORNE ST ;MONTEREY ACA 03CU '30 ? 9816!D !FG s 1 Jan 90" 17-Dec-03 2705432 `WC 899 HAWTHORN_E ST -- _.m. 'MONTEREY ___._..- .._ "CA 04`U 145' 9816=D FG t 1-Jan-90; 17-Dec-03 2700872 WC 13261 PERRIS BLVD jMORENO VALLEY CA 01 U 30 ~ 11849 D FG € 31-Jul-98; 17-Dec-03 2700872 !WC ;13261 PERRIS BLVD 'MORENO VALLEY ~CA 02~U i05 ' 14976'D FG = 3 1-Jul-98 17-Dec-03 2701775 1WC .24051 JOHN F KENNEDY DR IMORENO VALLEY _ CA 011U ~30 ` ~ ~ 9816D ;FG _ ~M1-Jun-88; 17-Dec-03 2701775. 'WC :24051 JOHN F KENNEDY DR rMORENO VALLEY ICA 02~U 105 9816 D .FG .-."-_ 1 Jun-88 17-Dec-03 2701775 ,WC _._._ _ 24051 JOHN F KENNEDY DR MORENO VALLEY _ ._._ M.._.. _ _..~.....~ __._~ ICA .__..~._.~__..._.._.. ~~031U ~ s20~ 9816'D FG ` 1-Jun-88 17-Dec-03 2700770 WC ' 49594 29 PALMS HWY +MORONGO VALLEY ?CA _ .. .. .-_ 01"U .-._ _ 130 ` ~ ____ _ 11849 D _ _ FG _.._.__.__._...._..._ 1-May-98~ _...T_¢__._.. 17-Dec-03 2700770 (WC 49594 29 PALMS HWY MORONGO VALLEY CA 02U X05 ~ 14976`D FG 1-May-98! 17-Dec-03 2701045 IWC ,._._ _ 11408 VENTURA AVE __. ___~____. OJAI -. _._ _._ CA 01 U .05 9816!D FG 1-Aug-BT, 17-Dec-03 2701045 iWC ;11408 VENTURAAVE ._...__ _._~ `sOJAI _ _~....__.,.._..~..._.._ .CA _.w,._._ 02~U 05 9816vD .FG ._ _ 1 Aug-87( __._ 17 Dec-03 2701045 WG ____.. 11408 VENTURA AVE _.._.__.- -0JAI . ~,~...~._ CA 03 U 30 = ~ ~~-~ ~9816=D . FG ~ _ 1=Aug-87~ 17-Dec-03 2705230 WC {164080RANGE _ .._. ._..~..~ _~ . PARAMOUNT ~._._.....~_.__ CA _ _.~._._"." ~___ 01+U ~ _ ,. ~20 _.~~.._. _.._. 9816'S FG _ ...-.,.R.,_._~.__..._..._.-..._._ 1-Jul-83r 17-Dec-03 2705230 ;WC --_-- ,164080RANGE PARAMOUNT ;CA 02€U 05 ~ 9816"S .FG ; 1rJul-831. 17-Dec-03 2705230 WC r164080RANGE> ,.-_.___.___.. PARAMOUNT ._._..___.-_.,-.._,.___. _. 'CA . __-_M__ 03xU _,._..... _. 30 __. _ .. _ 9616~S -- . :FG _ M ._...._._. _._.- _. y,JuI-83~ ,____,__.____ 17-Dec-03 2705245 WC ,6105 CLAY PEDLEY >CA 01~U _._.._.__M <20 ..._._._ 9816:D FG _ ,..,.__~.._.....~_ 1-Nov-871 ._..~.._."__._.. 17-Dec-03 2705245 IWC `6105 CLAY PEDLEY iCA 02 U 30 9816 D FG ._ 1 NOV 87 ____ 17 Dec-03 2705245 ~WC~ 6105 CLAY PEDLEY ICA _ 03 U =05 9816~D FG 1-Nov-87? 17-Dec-03 2705659- WC~ ~ ~h845'I"SLAUSON AVE PICO_RIVERA :CA " ~ ~~ 01U =05 19703'S FG 3-Dec-01! 17-Dec-03 2705659 "WC 8451 SLAUSON AVE PICO RIVERA ~ CA 02 U 30 11863 S FG 3-Dec-01 17-Dec-03 2705659 (WC _____..__.... 8451 SLAUSON AVE ~ PICO RIVERA +CA 03 U ~ ~ ~45 10369`S FG ' 3-Dec-01 17-Dec-03 2702970 IWC .~._ ~704,MAIN ST ~. RAMONA ..,.~_.-..,~. -. 'CA ..~.,._._- .m..- ~ 01!U _ =05 - 118491D _ .FG , . _..~__......~.,_ 28-Oct-98a .....~...____ 17-Dec-03 2702970 ,WC ;704 MAIN ST RAMONA~ CA ' ~02 U 30 11849';D ;FG 28.Oct-98 17-Dec-03 2705020 WC 1598 N ORANGE REDLANDS CA _ 011U 05 9816 D FG 1-Oct-89~ 17-Dec-03 2705020 !WC ,1598 N ORANGE REDLANDS CA 02=U !20 9816 D .FG ; 1-Oct=89'+ 17-Dec-03 2705020 IWC 1598 N ORANGE REDLANDS CA r 03 U 30 9816 D FG 1-Oct-89; 17-Dec-03 2705214 :WC ___-_ ..- 765 W REDLANDS BLVD _ _ .__..._ _ REDLANDS CA 01;U 30 ' 11682 D FG ; 12-Dec-011 17-Dec-03 2705214 WC .__. - 765 W REDLANDS BLVD .-_ REDLANDS .__ CA ~ t.._.__"~.. ..~.., _. 02xU 20 11682'D _ _ FG = _ ...~.._._ 12 Dec-01, ._,__..w..... 17 Dec-03 2705214 ,?WC ._.w ._ 765 W REDLANDS BLVD REDLANDS ACA 03'U 05 _ 14976;D FG ~ ..~...".~..~...~ 12-Dec-01! -____".,._w 1Z-Dec-03 2705252' ?WC 518 W FOOTHILL sRiALTO .a +CA _._ . 01 ~U - 120 9728'D FG ~ ~~ 1 Nov 88~ _.__........~-_". 17-Dec-03 2705252 'WC ~ ?518 W FOOTHILL .,RIALTO ACA 02>U 30 9728 D .FG 1-Nov-88~ 17-Dec-03 2705252 WC _"~. ~ 518W'FOOTHILL -- _ '-RIALTO _ _._ ,CA _ 03;U 05 ~ 9728°D 'FG 1-Nov-88~,~ 17-Dec-03 2700801 IWC __-- _.-_-.1 _. 18965 VAN BUREN-BLVD ,_ ._-_.____ _._ ... _ RIVERSIDE ___.._._.__.._ ___.~_,._. r__~ _._ _ ......-. __. iCA ~ _.. 011U""~ . 30 ~ _ 11849 D ,FG __ ""-"_'"'" 8 Sep 98..17 Dec-03 2700801_ IWC ;18965 VAN BUREN BLVD - RLVERSIDE ~CA 02#U X05 ` 14976?D FG 8 Sep 98r ~ 17-Dec-03 2705221 IWC ; 8609 GARVEY AVE ;ROSEMEAD ~ ~` ___ ;CA n ~ 01 U ~~~ .20 10310!D .FG 31 Oct 90t __.._. "' 17 Dec-03 2705221 IWC ___" ;8609 GARVEY AVE :~_.,_..._..~__ ,.. "..._........_...__._._ ROSEMEAD _.:._...._ ___.___-__..M____..._ ..."._-"._._ iCA ~ 02jU y05~; '~"~ 1.Q310 D _. FG .. """"" " 31-Oct-901 `-~'""" """""" 17-Dec-03 2705221 IWC ;.8609 GARVEY AVE ROSEMEAD ^...v ICA 03tU y30 " " 10310 D FG 31-Oct-90s 17-Dec-03 2705733 'WC '998 SUNRISE BLVD - ROSEVILLE CA 01 U _.....__ 05 ` _. 15154 D .. SF __ .u ____...._f....____-..___._._ 1` Jan-96; 17-Dec-03 2705733 ~WC .998 SUNRISE BLVD ROSEVILLE __.... ~ 'CA 02 U C30 " 15154 D SF ~ 1 Jan 961 17-Dec-03 2705247 jWC 5804 MISSION BLVD RUBIDOUX CA 01pU €05 9728 D FG '1-May-88 17-Dec-03 2705247 iWC ._ 5804 MISSION BLVD 'RUBIDOUX _ CA 02 U 30 9695 D FG 9-Jun-03~ 17-Dec-03 2705247 'WC ` 5804 MISSION BLVD _ ~RUBIDOUX _ ~ CA 'mm~ -._~.. 03 U . 20 ~' '" 9728~D FG °`""""'°"'.~_._._,~_ 1-May-88 _,"'~~" ~ "'" 17-Dec-03 2705203 WC 16290 MISSION RUBIDOUX _ _. ~ [CA 01 U _._ 05 __.._._ 9816 S _ FG ` ._,._..._.._,_...,._r, 1-Jan-82 ....._....___._._. 17 Dec-03 2705203 #WC ±6290 MISSION RUBIDOUX_ _ ~ ~ _ ICA _..~..._ 02 U _ 20 m _ 9816:S FG , 1-Jan-82 17-Dec-03 2705203 WC __.._ a .. +6290 MISSION _____~..-.. _,_., RUBIDOUX ..._. ..___ rCA 031U 30 ' 981j6' S FG 1-Jan-82€ 17-Dec-03 2701057- WC !5555 HEMLOCK _. __,,...____.._ .SACRAMENTO ICA A .__.. ....,~.., 01 U ., 30 - 11849 D FG 8 A r 981 -._.. .__,.e_ 17-Dec-03 2701057 IWC _._ :5555 HEMLOCK ._,__. __,. .. - SACRAMENTO ____ __.m___.._.:._ CA _ . 02 U 05 14976D 'FG 8-Apr-98 17-Dec-03 2701212 sWC ____. 600 RIO TIERRA AVE .. SACRAMENTO _ CA 01'U 05 14976D FG 1-Apr-98i 17-Dec-03 2701212 WC .__". ,600 RIO TIERRA AVE _ - SACRAMENTO .._ CA 02; U 30 11849 D FG 1-Apr-98 17-Dec-03 2705439 WC --°- 2705439 WC 1240 N MAIN ST a. ______._ w.w...... ....._.__. 11240 N MAIN ST - SALINAS _. _._,_...._ .__..~._._._ ~, - W-__-, CA _.._"___., .._.___. 01'U 30 9816~D .. FG __ . ....._ .. 1-Jan-89 __.____.._.._.._. 17-Dec-03 , SALINAS _ -~-_~.__- ' CA ._ . 02 U 20 9816 b FG 1-Jan-891 17-Dec-03 2705439 WC .1240 N MAIN ST _ SALINAS ~_._ _ ,CA ~ 03 U 05 9816. D FG ~-~'- ~~- 1-Jan-89i -~-'~~~-'~~~" 17-Dec-03 2705439 'WC 11240 N MAIN ST SALINAS {CA 04=U 05 9816 D FG 1-Jan-89E 17-Dec-03 2705239 WC 2734 DEL ROSA SAN BERNARDINO CA 02 U 05 i 11849~D FG .e 18-Aug-98; 17-Dec-03 2705239 rWC -_ -2734 DEL ROSA -SAN BERNARDINO _. CA .._...__ 03 U 30 " 11849D FG 18-Aug-981 17-Dec-03 2708641 iWC __..... .._~.._. _._._ 295 N WATERMAN AVE ._ ._~,....._.__._ .,__.._... _...._._ :SAN BERNARDiNO __...~ ___ ~___.__ ~ _____.._ CA _ ...W~-__, __ _"_ 8 01 U .... 20 9816 D +FG 1 Mar 88 17-Dec-03 2708641 ':WC X295 N WATERMAN AVE -.SAN BERNARDINO ?CA _ 02:U _ 05 ; ._~,... 9816%D MFG ~ 1-Mar-88 ___ 17-Dec-03 G:\data\WCBU_Environmentsi_Compiiance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 C-ircle K Tank Schedule 12117/06-07 ~ ~ _ __ _ West Coast Region __ __ _ as of 12 113 1 0 6 __ __ _ _ _ ___ __ _ ______ __ _ _______ __ _ _ ___ ________ __ _ . . _ ______ _ ___ ___ _ _ CA __ _ PACITY INSTALL RETRO LOC. # Regio n ADDRESS CITY STATE U ST # GA LLONS DATE DATE 2708641 IWC ;295 N WATERMAN AVE SAN BERNARDIN O iCA -- - 03[U t30 ~ 9816~D FG ~ 1-Mar-88 17-Dec-03 2708688 !WC 10520 CAMINO RUIZ _ iSAN DIEGO iCA 0140 •30 ~ 9816 D FG ` 3 1 May 89 17 Dec-03 -_..~.____..- _ 2708688 WC -10520 CAMINO RUIZ 'SAN DIEGO CA , 02?U 20 9816 D tFG~ ., 1 May 89" __~... 17 Dec-03 -.,_,.. .. _. 2708688 WC __. _._. ,10520 CAMINO RUIZ -~. _ ,.._w_...,_ S AN DIEGO __, .,_,.. ..,.__..u CA 03 U ~ 05 ( .. 9 816 D , FG 1 May 89 ._. ._ 17 Dec-03 2705095 fiWC ';4360 GENESEE AVE _ 'SAN~DIEGO _M__,._~_„-~ -~~-_{CA ~ 01?U X30' _ _ _ ~ 9684?D }FG iW 1-Nov-89~ 17-Dec-03 .._._.._ __. 2705095 EWC ~m.-__._._..~..._...~_.~_.._._____ 14360 GENESEE AVE _ _._._..~-_._.,.._.~,-_~-_.__,_._...-. SAN DIEGO _.,....-._~.__..~.~....~._- ;CA ~ ~ 021U ~__ 05 ; ~....~_~, 9684D ,FG ~ ._.w..~_....._.-_._. 1-Nov-891 _.____.__~ 17-Dec-03 2705095 IWC X4360 GENESEE AVE SAN DIEGO CA ` 03YU 20 ' 9684 D FG P 1-Nov-89 17 Dec-03 2703608 I,WC A-^ ,21.998 COLORADO _ _ . 'SAN JOAQUIN ~ _ ~ CA 01~U ~05 ~ 14976 D }FG a 15 Sep 973. 17 Dec-03 2703608 WC ;21998 COLORADO SAN JOAQUIN 4CA i ~ 021U ~~_ ;30 ; :. 11849`Dcf,FG }mm 15-Sep-971 17-Dec-03 2705784 .WC 981 FRANCISCO BLVD SAN RAFAEL ;CA 01.U 05 ~ 10058;.D SF ~ : 1 Jan 94~; 17-Dec-03 _......_.m..~,_,r,_..._ 2705784 IWC ..,_____..~_..._____ 981 FRANCISCO BLVD SAN RAFAEL CA ~ 02 U 05 10058' SF __,~ 1 Jan 94 17 Dec 03 2705784WC ;981 FRANCISCO BLVD _ ~$AN RAFAEL _ __ _ ~CA ~° 03 U 30 ? 12079 D •SF 1 Jan94 17-Dec=03 __...__._.._ 2705238 iWC -_- '765 W HARVARD BLVD ~~ _ ;SANTA PAULA - _ _ ~CA _ _. _._.~.. __.. 01?U - -- . !05 , ; ___. ._ .--.._ .__. 9816~D ,FG __.__._______-v 25-Feb-85, ....-..___...._. w 17-Dec-03 2705238 WC X765 W HARVARD BLVD t _ "SANTA PAULA ~~ !CA 03 U 30 9816 D FG 25 Eeb 85 - ~ 17 Dec-03 __.,.,__ _. __..__._ 2708755 'WC . _ . - .~__ ~._-,.,._..___-~.._. ._ 12790 WHITSON RD _ _. ~ ,_-._.._._ ~...._....~._____._... tlSELMA x .-..-._,._.- ___,_._ =CA ___ ..__ 01~U _ __ .. _ 05 __ .m...- _ _ _ -.-._, 9816sD !FG __._ _ .._ .... -..w....._ , `1-Apr-88 _. _, __. _. ._._.,.__...-.._. 17-Dec-03 ___......_.-..~.., ._.___ . _ . .._____ 2708755 iWC _-...- ._.___._.__w.._-_. .. ._,_. _ _ 2790 WHITSON RD .,.. __._._ _...,._.__..__.__._.w.- MSECMA ...~...-._.,,_.._...._.. ICA _..,.__- _.._ 02cU _ 20 . 9816 D FG . 1 Apr-88. 17-Dec-03 2708755 ;WC `2790 WHITSON RD ,SELMA CA 03 U ;30 , 981 6 D FG ._ 1 Apr-88, 17 Dec-03 2705684- IWC -27180 MCCALL BLVD. ;SUN CITY !CA p 01~U 105 . _ 12023 D SF 15-Apr-871 17 Dec-03 _..____-_____-I--_. 27 05 684 :WC ._. _.~_...-...4..~. 127180 MCCALL BLVD w SUN C1TY ~ CA ; 02 U X30 I 12023 D SF 15 Apr 87 .~... .. 17'Dec 03 _ _ _ 2700010 :WC _ 302.E TEHACHAPI BLVD - TEHACHAPI ~ CA 01 ~U 30 _ ~ 11849 D~FG 29 Jul 98 17 Dec 03 __-___ 2700010 #WC __..-.....,..._.a... _ _ ..:302 E TEHACHAPI BLVD .~-__._-_._.-_...._ _-.__-__.__ TEHACHAPI ____._.. ._.._ 3CA ? 02 U ._ ...~.. ,05 i • .~._.._..._..-.._,._._ - 149761D FG _ ~ a _ __ 29 Jul-98 17 Dec 03 wmm-___.__. ...,~. 2700564 iWC __.__..-__.-,_._.~.__ 73010 RAMON RD ._y_____ ___..._____ THOUSAND PALMS __. €CA ~ 01 U __. _ •30 3 ~ .~., ._...., 14976"D ,FG " ~29 Jul 98 _.~-~... 17 Dec-03 _.-...... __~_____ 2700564 ;WC ~~~_.~.~-._.__.~.u_ .73010 RAMON RD THOUSAND PALMS ACA , 02 U °05 -` •14976'D ;FG ~ 29 Jul 98 17 Dec-03 2701940 WC 1600 W MAIN ST TURLOCK ACA N 01 U 20 I ,.98161D MFG I ' ' 1 JuIN87 17 Dec-03 2701940 ;'WC `1600 W MAINST ~ TURLOCK ~ iCA ~ 02 U 05 ": 9816D fFG ` `1-JUI-87~ 17-Dec-03 ....-_____4~_______._ 2701940 4WC . _.__.__..__~._._._,__...._.. __w._. 1600 W MAINST ._.__, ..._____.._,__.._._._.__. `TURLOCK ._...._.-.._~__..-__--~ 1CA I ._._-_. ____ 03 U _ ~. _- 30 ` _.~. -.__. .,._ 9816~D"'FG l ._.._.._..-._w__. _. ]-Jul-871 _.~_-___.. 17-Dec-03 2700348 =WC 568T ADOBE RD t TWENTYNINE PALMS CA , 01 U 30 11849 D FG ~ 15 Dec 98 ~ 17 Dec 03 _._._.. -_. 2700348 '.1NC .~_ , -._... _,. ~.., ,5681 ADOBE RD • _.~.. _-_._..____..._ TWENTYNINE PALMS ,.. CA ~ .,__ .._ 02,U _ 05 11849 D MFG _ . 15 Dec 98 _....... 17 Dec 03 2700743 IWC ,73 943 29 PALMS HWY TWENTYNINE PALMS CA r 01 U :30 11849' D FG ~ 1 JuI 98 17 Dec-03 2700743 'WC _.~_, ~`73 943 29 PALMS HWY TWENTYNINE PALMS CA " 02 U 05 1 91849 D FG 1 Jul 98 17-Dec-03 2701984 ''WC s795 SHADOW-RIDGE DR VISTA CA ~ 01 U 30 " 9816'D FG y 1 Apr-87 17 .Dec-03 2701984 IWC __.__-. _._. ~__ j795SHADOW RIDGE DR _~ ~ ._._..-___-_._ - VISTA . CA 02 U 20 9816'D,FG I 1-Apr-87 17-Dec-03 2701984 IWC . _ .~ ___._._~,._.__ 795 SHADOW -RIDGE DR ._ __,.__ ._.___._..-...._,_.~....,--_ 'VISTA ..W....... _ CA _. 03;U __ X05 ~ 9816 D FG 1-Apr-87 _- ...v.-_--_. 17-Dec-03 2701161. WC _.~. ~. ;.1395 PALM AVE ~ IWASCO ~ ,CA ~ ~ 01 U ~ '05 , 1 14976~D FG 12-Jun-98 17-Dec-03 . . W. 2701161 'WC _ 1 395 PALM AVE ~ 'WASCO _.~...~_,~__ sCA __._~ 02 U __._ _ 30 ~ _ ... 11849 D FG 12-Jun-98 17-Dec-03 _..__ __~~_. 2701391- ?WC ._..._._. ~ , . ;423 E MAIN ST ... ._ _....-,__ WESTMORLAND - _.w.,~._~.-_.,_ _~_ CA _._ _..... 011U .. t ._ 30 9684:•D .FG 1-Sep-91 17-Dec-03 2701391. "WC ~ -___.. ;123 E MAINST .. ._~ ,. S WESTMORLAND __-..... ........_.. CA ..___.....,,..,..~.,....~ 02iU _ .,._.. _ ;05 .... 968A .D FG _... 1-Sep-91 _. _...____._..._ 17-Dec-03 2701391. IWC ,:123 E MAINST ._. WESTMORLAND "CA 03 U 20 9684D FG 1 Sep 91 ~ 17 Dec-03 2701156 IWC .._ __._~._._,.___m___,_..n_. 1263 FRANKLIN AVE _ .n_._ YUBA CITY ...__.._._.. ._. _ ~?CA~ _ ~ 01 ~U .._ . _ 05 14976-D FG 17-Feb-981 _._.._._____-_-- 17 Dec-03 2701156 `.WC ..,w....- .,~.~__ _, 11263 FRANKLIN`AVE ,_. _ ..-_._.___._._. YUBA CITY _......____ _ ___ `,CA 02~U _ m. ~30 I _v. 11849"D FG . _. 17 Feb 98~ _ ..._.. 17 Dec-03 . 2700902 iWC .,. . -_.-._____~ - ...~... s6940OLD WOMAN SPRG YUCCA VALLEY . _ _ ~~~CA r n 01~U ~ .. X30 I __.. 98161D FG __._ _ 1-Oct-87~ a __ 17 Dec 03 2700902 WC ~_~.~_.-. ___._ .. 6940 OLD WOMAN. SPRG .. ,.m .~. :YUCCA VALLEY ~,.~,_..~. ___...- +CA ~ 02 U ,._.. X05 } .~. n_ 9816,D FG w-~.__-.W,._,.__. .. 1-Oct-87j . 17 Dec 03 2700902 =WC 16940 OLD WOMAN SPRG gYUCCA VALLEY ~ i CA µ ; _ .. 03 U _~ 9816iD FG ..._W_--~- ~ - 1 Oct-871 17 Dec-03 ___.______.,,.,__ 2700686 IWC ~- _ _ ._-.. .10000 GIBBON SW _._.__._._...__._._ ALBUQUERQUE . ~.~....~. NM _ 01 U ._.,..-., [30 r ..._,.., w ~. 11849;D FG m. . 5 Mar-99; ____ 17 Dec-03 2700686 =WC ~I10000-GIBBON SW ;ALBUQUERQUE ____ ~____._~._... -_ _. ~._.-____W____ ~ NM_ ~ 02SU X05 ; 11849ID :FG~ _._._ 5-MarM99t ~ 17 Dec-03 2700379 IWC 11200 SAN PEDRO DR SE ALBUQUERQUE NM 01'U j05 1 9816.5 ,FG I 12 -Mar-96 17 Dec-03 2700379 iWC :1200 SAN PEDRO DR SE .,_._,... ._.. ~_. _._..___.__.._._____-.w_ "ALBUQUERQUE . r NM 02 U X30 ( 9816€S FG ~ d 12 Mar 96 ~ 17 Dec 03 2701255 iWC ~12900INDIAN SCHOOL RD _.. __~_. NESALBUQUERQUE _.. -M 'NM .. 01'U __ 05' _. _ 10152 S SI .. 1 Mar 79{ 17 Dec 03 -__._ 2701255 WC ~ 129001NDIAN SCHOOL RD __._.__...-_.___.___ NE.ALBUQUERQUE .-.______~_._.___ M jNM _ ~ --__ _ 02 U _._,.,-..~ 20' .__...-,.-...-. 10152 S SI : 1-Mar-79' ._.__._._.._,v..,._ 17-Dec-03 2701255 ?WC !12900 INDIAN SCHOOL RD NE`ALBUQUERQUE NM 03 U 30 ; 10152 S SI 1-Mar-79! 17-Dec-03 2701313 IWC 11316 YALE SE .._.._ ~ ~ _ _,._.._.._~.-____. ALBUQUERQUE ,.. , ~ _..._ __ .__._._ } !NM , ._.,~.a.m,__~_~.._. _ 01 U _ ~,_. _. 20 ~ _ 10152 S SI ~ -..___..~._ 1-Mar-79 17 Dec-03 -_._._.._._... 2701313 WC X1316 YALE SE ALBUQUERQUE jNM s 02 U 05 s 10152 S BSI 1 Mar 79 17 Dec-03 2701313 .WC ;1316 YALE SE ALBUQUERQUE TMWwW INM µ-_ 03~U 30 ~~ 10152S -SI ' 1-Mar-79 17-Dec-03 2708779 WC ________ X1401 WYOMING NE _ ~ "ALBUQUERQUE __.__ ..._._w-_ ;TNM - ~ 01 •U .20 1 9816 S ,FG g 1-Jan-89 17-Dec-03 2708779 '"iVC ._- j1401 WYOMING NE _ _.w__-___, ALBUQUERQUE .-.__-___ m .. iNM _._~_, 02 U '-05 ~ ._ __.., 9816'S'FG t ___ 1 Jan 89~ 17 Dec 03 2708779 'WC '1401 WYOMING NE ALBUQUERQUE iNM 03 U '30 ° 9816 S FG 1 Jan 89; 17-Dec-03 2701777 WC #2001 MENAUL BLVD NE ALBUQUERQUE INM 01 `U 30 ; 9816=S FG 1-Nov-86 17-Dec 03 2701777 'WC T :2001 MENAUL BLVD NE ALBUQUERQUE ;NM ; 02 U 105 ; 9816 S MFG x 1-Nov-86 1 µ17 Dec-03 2701777 `.WC '2001 MENAUL BLVD NE ;ALBUQUERQUE !NM 03~U `20 9816S ,FG 1-Nov-86; 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 ~_ Circle K Tank Schedule West Coast Region 12/17106-07 as of 12/13/06 LOC. # Region ADDRESS CITY 2708748 WC X2019 CARLISLE NE _ `ALBUQUE R QUE 2708748 WC _ _ -:2019 CARLISLE NE _ _ 'ALBUQUERQUE ~ ~~ 2708748 WC 2019 CARLISLE NE `ALBUQUERQUE 2708551 ' WC _ ``:,2934 EUBANKS NE _. ALBUQUERQUE __ __.___.__.__,____w ~..__ ..~.... __.__ 2708551 WC ._ 2934 EUBANKS NE ALBUQUERQUE 2708551 oWC -2934 EUBANKS NE ALBUQUERQUE 2700376 IWC 343 WYOMING BLVD NE ALBUQUERQUE _ ~ ~~ 2700376 iWC ~ 343 WYOMING BLVD NE ~ALBUQUERQUE 2 701472 :WC 397ALAMEDANE M :ALBUQUERQUE ~ _ 2701472 ?WC `397.ALAMEDA~NE~ ~_ ^~. =ALBUQUERQUE ,__ _~ _._ 2701472 {WC ._ .,~ .~.__ _...,_ ...._..,_..._...~.._.._. '397 ALAMEDA NE ~ _~.-w__ _....~._~ _.._._.. _ ...__,_. ALBUQUERQUE 2700403 WC ;4212 COAL AVE SE ALBUQUERQUE 2700403 WC ;4212 COAL AVE SE ALBUQUERQUE _ 2 7 00610 WC ,4400 COORS BLVD SW ,ALBUQUERQUE • _ _ 2700610 WC 4400 COORS BLVD SW ALBUQUERQUE 2700610 WC _ _ =4400 COORS BLVD SW . _ . __ ALBUQUERQUE _ . _.w____ _. ,.. __._~. .._ 2707962 WC _ _ _.___...._._.~_._._..____ . _ 5101 SAN MATED NE ,~.._~.~_. _._...~.,.. _ n ALBUQUERQUE 7962 WC 270 5101 SAN MATED NE ;ALBUQUERQUE " _ 2707962 jWC 5101 SAN MATED NE _ _ __ ALBUQUERQUE ~~ __...._ _.~___._ _ .__..~..____.. ~.w...._.__._ _..___- ~..~__ ._... _ _~.__..._ 2700741 ~WC '5501 ACADEMY NE ';ALBUQUERQUE L IN R E TRO STATE UST # GALLONS ~ ~ DATE D A NM 01'U ;05 ° 9816. S iFG , 1 Oct 88 17 Dec-03 NM 02U 20 9816sS FG ' 1-Oct-88. 17-Dec-03 ~.._ _..,_.W__ NM .~ ._ 03 U ..-...b_._._ 30 ~ ~~_ 9816?S ' FG _ ~. ~. 1 Oct 88 __.. , 17 Dec-03 _...__... .. , P .. NM _ .-~ M . _... 01'U 30 ; n 9816^S FG 1 Jan-88 .17 Dec-03 _ _ NM _ ~02;U <05 = ~ ~~9816`S'FG 1 Jan 88? 17 Dec-03 NM ~~ 03fU~ 120 ~ . 98163S FG ~ 1 Jan 88 17 Dec-03 NM _ 01,U t05 ~ ... 9816kS FG ` 10 Feb 96, .~ _.__ 17 Dec-03 NMI _ ~02'U ~ 30 ° . ~ 9816'S FG ~ 10-Feb-96?, 17-Dec-03 _.~_ N M ~ 01 U _ 05 .~_ 10143.S SI { 1 Mar 83 97 Dec-03 _ _ NM.~ ,___~_._ ~"~ 02;U -30 , ~ X10143 S SI z ~ "~~1-Mar-83 " 17 Dec-03 ,_,._~., NM .-~..-..~-- 03 U -- 20 . V " 10143.S SI ..m_ ,...__.,._ , 1-Mar-83 ..,~.-_.-.._.__. 17-Dec-03 " _.._ INM _~ ___~..,~~_ 01=U _ 30 ___ _ 9816'S FG ~ .e ....__ 16 May 96i _.-___._... 17 Dec-03 iNM 02 U 05 __ 9816 S FG ~ 16-May-96, __..._ 17 Dec-03 ;NM , 01'U OS 9816-S FG ? . 1 Feb-96' 1Z-Dec-03 NM _ _s 02,U 20 9816 S FG ~ 1 Feb 96 17 D ec-03 NM~~ ~ 03~U~ `30 ~~. 9816°S FG "~ ; ~ 1-Feb,96~ _ X17-Dec-03 _.__._.,,. _ ~,_.. NM .w ,~. __ _.._. ; 01}U . __ =05 ~ . _, _.. 11682 S FG _...~ 4 Apr 94 . 17"Dec-03 _..~...~..._. r_._.._.. NM ___.__.._.~_._._ 02. U .. ; 20 __.___w_WM _ 9816' S FG . .__......_.. . 4-Apr-94 ; 17-De.c=03 ~NM~^ , ~~ 03 U 30 ? 9816`S FG __...g_.~.u..______._~.... __. 4-Apr-94~ _ . 17 Dec-03 _ .__. ___~,._.. 9816~S 'FG 16-Feb-96 17,Dec-03 2700741 WC :5501 ACADEMY NE ALBUQUERQUE , NM 02 U k20 9816~S•;FG 16 Feb-96 17 Dec-03 2700741 ;WC 5501 ACADEMY NE ALBUQUERQUE" NM 03 U '05 9816"S FG 16 Feb-96 17 Dec-03 . __..v._.__.~__.. 2701428 ;WC 6130 EDITH BLVD NE ._._. ___ ALBUQUERQUE n ._~_. NM g ~.._.vw 01 U _ 20 ~ 10152iS .Sl . 1 Mar 81= _...,-.... 19 Dec-03 __... . _._.____._~.;.-.. _ 2701428 ;WC ,_...._ _m-.._.r_~._._.._.. __..._.._ `6130 EDITH BLVD NE ._...-..~, __A__._._-.-~,.-._-~.._._ !ALBUQUERQUE ~~ v_ .~....._._ :NM ! 02'U __ 05 ... ..._. _ 10152`S~ SI _ .._._. 1-Mar-81 . _ ._.__. 17-Dec=03 2701428 `WC 61.30 EDITH BLVD NEB >ALBUQUERQUE iNM 03 U 45 ~ 10152 S SI 1-Mar-81, •17;Dec-03 2708745 ~WC .6300 CENTRAL"AVE SE ALBUQUERQUE iNM ~ 01 U 30 ~ 9816 S FG 1 Oct 88i 17 Dec-03 2708745 iWC -6300 CENTRAL AVE SE ALBUQUERQUE NM g 02 U 05 9816 S 'FG 1 Oct88i 17 Dec-03 2708745 WC 6300 CENTRAL AVE SE .-. ALBUQUERQUE 'NM _ 03 U 20 9816•S FG ° 1 Oct88~ 17'Dec"03 2708934_ WC ;1535 COORS BLVD NW ^ T ALBUQUERQUE ~ ~._ j NM ~~ ~ 01 10000 1 May 90 _ ~ 14 Dec 05 2708934~WC " ' .1535 COORS-BLVD NW i ALBUQUERQU E NM 02 ~ ~ 10000. d : 1 May 90, 14 Dec-05 ___ ..___.. 2708934 WC - -~..._...-,.~... 1.535 COORS BLVD.NW ALBUQUERQUE ~ ~NM 03 i 10000 ~1 May:90 74TDec-05 2708935 WC 5311 QUAIL AVE NW ALBUQUERQUE jNM 01 i i 20000 r .. 1-Dec 96 14 Dec-05 ..__.._.. 2708935 WC _ ___ 531'1"QUAIL AVE NW _ ._ ALBUQUERQUE _.,. 'NM _ 021 .m._. ~ ._.. (10000s __ 1 Dec 96 _ 74-Dec-05 2708936 31NC ,5210 CENTRAL AVE SE iALBUQUERQUE NM , O1' ~ 12000/8000 ~ T Jul-98 14-Dec-05 2708936 -'WC 52'10 CENTRAL AVE SE ALBUQUERQUE NM ~ 02 i 6000, ~ ' 1-Jul-98 14-Dec 05 2708937. ;WC 4701 PASEO DEL NORTE ALBUQUERQUE iNM x 01 I f 20000=.: 1 May 99t 14 Dec 05 ~._... _._...~.w.____. ~. ~ .... _ ._...~ 2708937 WC ,47.01" PASEO DEL. NORTE ..__ ~__ w_ - .-- ~___. m ~ ALBUQUERQUE NM : _.__ _ 02~ ~ . < < . .~... _.: w-.. 10000 1 May-99 ~._ 14 Dec-05 2708937 ,WC ,4701" PASEO DEL NORTE :ALBUQUERQUE ~NM ? 03" I 100001. ; ' m 1 May 99, 14 Dec-05 2708940 WC 18601 CENTRAL AVE NE ALBUQUERQUE ~ NM _ 01 ~ ~ 20 000:. ! 1 Feb 00 14-Dec-05 _._._ _..,._.___r.. 2708940 WC 4 _.q.._w.__.___-......__.___ ;8601 CENTRAL AVE NE ._ .. ___ ;ALBUQUERQUE ~ _._~__.n. ~_ _ (NM ? . _.,_ 02t § i ~u~ _ ..-...._._,_._ 10000' 1 i _ 1 Feb 00~ ..._.-.._.__.__ 14 Dec-05 _..._ .._-_._ 2708940 WC _.,._.._..__.__r_ r_._ ..._ 8601 CENTRAL AVE NE _,M~.__._. .__.. _..__._ ;ALBUQUERQUE ,NM ~._.- 03. .- _._ _._... ; _-..___.._. 10000, F i 1 Feb 00, 14 Dec 05 ._._...____-_m,.._- ._._.._... ___ ~......_..__...__-_._.~...._....... 2708941 WC 4300 OSUNA RD NE _ ALBUQUERQUE __ 1 ~ ._._._... - __ _ , NM ____..___..1.~._.._ ___ __ 01' . _.._ .._ _. 20000 ~ ~ ..____ _.. 1 Sep 00~ _~, 14 Dec~05 - 2708941 WC X4300 OSUNA RD NE 'ALBUQUERQUE ~NM x 02 120 00/8000° s ' ~ 1 Se 00 p 14 Dec-05 ____._ ...,..n-.._.~ 2708942 IWC ._, _._ _... _._ . __ ._.____~..~ ~_ 18181 HARPER NE ~ __._.. -_ ~_... _ ..... _ ~_._ iALBUQUERQUE _..._.,,....~w_... ___.. _... `NM ~w-_ .~ 01€ - ..__ ...~ ___._- ~ ---- -. ~ 20000y~~ { ._ - .. ~.. 1-Jul-98' ._.-..___.....~.. 14-Dec-05 2708942 "WC 18181 HARPER NE ALBUQUERQUE NM 02r 10000' ~ I ~ 1-Jul-98 14-Dec-05 _________ 2708943 ~WC ..._....-.._....._ '300 LOMAS BLVD NE ___ __..._.._.___.__ ALBUQUERQUE 3 .__,.__ _._.___. NM I ._ 01 _ v_.... __ ... 20000. ' ~ _. ______. 1 Dec OO 14 Dec-05 _.__... 2708943 ~WC 300 LOMAS BLVD NE ._ ;ALBUQUERQUE ~ ~NM _ _ 02 ` 100001 ; 9 Dec 001 ____.~ 14 Dec-05 2708944 ?WC ;1400 MONTANO NE ALBUQUERQUE ~ !NM ` ~ 01 20000; i 1 Aug 02 14-Dec-05 2708944 'WC z X1400 MONTANO NE . ....._..~._ ~_...~.~_..__~.~. jALBUQUERQUE ..~...,~ ...._. _- ~NM ° ._.,_ 02{ _ _~_._..-i..._.__-_____~.--~- -__ ._._~ _ } 12000/80001 ( ~ ~ ._-. ~..~ ~ . 1-Aug-02 _.. 14 Dec-05 ...___,.-_----- __ 2708946 ;WC _._ ..~._ ___. __.~_..-..w. ;9320 COORS BLVD NW .__~--__.__ _ _.__.__._ _.__~ =ALBUQUERQUE _.Y._ ____ ...__. _.x.__. NM E ....__ _ _ 01~ _.._.-~_...~ F ! __ ~20000~ _., 1-Dec-03; .. _.. 14-Dec-05 2708946 ?WC '9320 COORS BLVD NW ALBUQUERQUE . _.~ _.__. a.__.___ ~_. ..___._ ..- . __..._~ . ___...... .. s.....__ ._.,. NM ¢ 02' ¢ 12000/8000; 1 ( __. ~-_ 1 Dec 03 14 Dec-05 _ ... ....~..... .._..__. ~ 2708698 ;WC 166002ND ST NW . ALBUQUERQUE ~NM I 01?U~ W--.._.. ~" 20 _~ ; 9816S FG ; , 1-Jun-87t . 17-Dec-03 ..,_.~. .,,._..___._ 2708698 iWC ._<~.._,___.._____.. ___-_m_ 166002ND ST NW _..... _ ;ALBUQUERQUE ___ µ__._.,__ INM~°-^ 02 U ~-x05-j ~- __~9816gS 4FG ~ ~- 1-Jun-87~v 417-Dec-03 2708698 1WC (66002ND ST NW ALBUQUERQUE iNM 03 U 30 3 ~ 9816S'FG 1-Jun-87; 17-Dec-03 2701041 {WC 17660 LOUISIANA BLVD NE =ALBUQUERQUE ~ _ _ ~ NM 01 l1 =05 9816:S ~FG 7 Apr-96~ 17 Dec-03 2701041 °WC 17660 LOUISIANA BLVD NE ___.....___ -__-___ _ ..r..~..__ _.-.__._._______. _._ ''ALBUQUERQUE __ _ _. _ ._~ ~ ~NM t 02 U 30 ~ 9816 S FG 7 Apr 96 a 17 Dea03 , 2701447 ?WC ~ . '7817 CENTRAL AVE NE ..._ _ .__... _. _ __ . ;ALBUQUERQUE ,.__ W._._.. W._ _..._ __. ~NM ___ . 01=U ._ -.__._. 30 i .__ _._ _ 80601S .SI _ ...___.~.. . 1-Mar-82; _ 17-Dec-03 2701447 IWC j7817 CENTRAL AVE NE iALBUQUERQUE ;NM 02 U 20 8060S SI ` 1-Mar-82 17 Dec-03 ...._ _.._---_.__..,_... 2701447 iWC ._~.~.~.._~..._._.... _ ._A._._.__.._..._.-.~ '7817 CENTRAL AVE NE .~ ~~___.._ .___w .._______ .ALBUQUERQUE _.._______,.~.._._ ... iNM ' _ 03~U __. __.... 05 = -....______ ~.. . _ 8060FS SI ~ _.._..._.._M__, 1-Mar-82" _.._._-_._.._- 17-Dec-03 G:~\data\WCBU_Environmental Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule-----_..__ _..._-~as,of 2/ 3/06--------------~-----~---}-----{---I-------~---~---1----------~- -------I West Coast Region LOC. # Region ~_ ADDRESS ~ CITY - STATE UST # ~~GALLONS DATE L DATE 2705323 WC 18311 GOLF COURSE RD NW 'ALBUQUERQUE iNM 01 ~U 30 9816sS ;FG 22-Jun-96! . 17-Dec-03 _..._._.. __.....__ _..____..-. 2705323 °WC , ,..~._,.._.__...._~_..____._...-..-_....-__ .8311 GOLF COURSE RD NW .,-.._. ,_.__._..._...,~.. _.,._,__... ,ALBUQUERQUE .____,. _.._ W_ ~e ,NM w___ 02':U _ 20 ___ ,y..,_._,. ._ w 9816S :FG ? _. 22-Jun-96; 17-Dec-03 2705323 =WC :8311 GOLF COURSE R D NW ALBUQUERQUE -~ ~ ~ NM 03 U 05 9816 S FG 22 Jun 96 17 Dec-03 2700810 !WC _ 1712 W MAIN ST ~ARTESIA ;NM 01 U 45 • 9816'S FG ; 4-Jun-96; 17-Dec-03 2700810 :WC ':.712 W MAIN ST IARTESIA NM 02aU 30 , 9816 S FG I 4-Jun-96~ 17-Dec-03 - 2700810 ;WC 1712 W MAIN ST ARTESIA iNM 03U :05 9816 S FG ' ~~ __ 4 Jun 96 17 Dec-03 2700289 `WC 1700 N MAIN ST BELEN NM . 01 ~U 30 ' 5960 S SA `: 28 May 96 , 17 Dec-03 ._ ._...-_. ._...._ .,.. 2700289 WC ~...__ ....~._. ___._ r , ..._ _ .._ ;700 N MAIN ST' ._.--._~~___..____..._._.,__.__ ~_.__ BELEN _..-.. .__.___. `NM ._.___.,..__. 02,U _ _. =05 _..~.___ _ __ ._. 5960'.S ,SA ..._._. _ _ 28-May-96` 17-Dec-03 2700699 'WC !115 W HWY'44' BERNALILLO :NM 011U `20 _ 9816~S FG 1-Mar-88, 17-Dec=03 2700699 ;WC 1115 W HWY 44 BERNALILLO NM v 02~U 05 ~ 9816 S. FG 1 .Mar 88 17 Dec-03 2700699. WC • ; 115 W HWY 44 ._. ._._._ . ___. _...... BERNALILLO NM ..._...__, 03 U _ ,30 ` W..._ __._~.... ._. 981615 ~FG ._........ . 1-Mar-88 _µ _~_ 17-Dec-03 270056tWC iHWY550GEN'LDELIVERY CUBA NM 01•U `05= 9684~D FG _~ 21-Nov-95 17-DeC03 2700561 WC `HWY 550 GEN L DELIVERY CUBA NM 02 U 20 ` 9684 D FG ~21 Nov 95 17 Dec 03 2700561 'WC " ~~~~-~ -__..._._.....__. -_ jHWY 550 GEN'L DELIVERY .CUBA iNM ~ 03~U ., .5 130 9684?Di:FG . 21-Nov-95~ ...... ..-.-- .1.7-Dec-03 .........__ .............. ........................._..m __.„.~.- 2708945µ(WC _ _!6401 HWY.550._ __ ._._. ... ..-.. CUBA. ...._-.__...,_._: ._ ....._ ~N.M_- _ , _,-~~i_____ -~_. +_.~__ __:...20000~ __ 1 Jun 03 14-Dec-05 2708945 `WC E6401 HWY 550 CUBA ~NM 02' ~ ` 12000/8000" 1-Jun-03 " 14-Dec-05 2701436 ;WC 844 HIGHWAY 516 FLORA VISTA ,NM 011U 45 9816=5 ;FG 16-Oct-95 , 17-Dec-03 2701436 WC 844 HIGHWAY 516 •FLORAVISTA NM 02<U 20 ! ~ 9816S'FG ~ 16-Oct-95 17-Dec-03 2701436 §WC 844 HIGHWAY 516 FLORA VISTA ,NM 03.U 05 9816~S IFG ; 16 Oct 95: 17-Dec-03 2700278 'WC _ ;617 W PICACHO AVE LAS CRUCES - 'NM 01 U '30 9816 S FG ` 24-Feb-95 17-Dec-03 2700278 !WC 1617 W PICACHO AVE LAS CRUCES . ;NM 02 U >05 . -.. 9816 S ,FG 24-Feb-95: 17-Dec-03 _..__.__...__. 2700278 WC _ .___._.__..._..____..~__•__ ._..-____ -.617 W PICAGHO AVE . __..~____.m-__._M._..._~ ___ L AS CRUCES .__. _~__.__,. ?NM ~._ 03. U 20 -. __._..9816'S F G 24=Fe b-95 17-Dec-03 .__.__ _.-- -_ ._ 2708938 !WC . _.._ _.. _ _._..~.~ _....__., _ _.__ -._.-W_ _ . - =1860 MAIN STREET NW _ _ ___ LOS LUNAS ~~ ._,..._.._.___.__.. _... ~ w NM ~ _ 01 ~ _ _ _ ~~~20000 .w.._ _.. _ . _ 1-Aug-99 _ _ 14-Dec-05 _....._._._.~_ 2708938 {WC ,1860 MAIN STREET NW 'LOS LUNAS NM 02 10000/10000• 1 Aug 99 14-Dec-05 y 2708939 WC '-1100 NM HWY 528 `RIO RANCHO ~'NM 01, `.20000- 1-J4pr-00 14-Dec-05 2708939 ~'WC 11100 NM HWY 528 : :RIO RANCHO NM i 021 4 10000/10000 1 Apr 00 14.-Dec-05 _ .. .. 2701481 WC . ._ _. _.. 13213 N MAIN - _ _ ROSWELL .__ .._.. _3 ;NM ___...~: 01~U e45 ~ _ _ 9994 S SI 1 Mar 83a _ 17 Dee 03 2701481 ~WC~ "321W3 N~MAIN rv ROSWELL ~~ NM ~ 02;U ,.m .. ._... M k30 I y TM _....,.__ ._ ~ 9994 S SI ._._ - __.... ... 1=Mar=831 ......~......___.- 17 Dec-03 - 2701481 , WC 3213 N MAIN ~ ROSWELL ~ NM 03`U {05 ~ : 9994,5 SI 1 Mar-83 17 Dec-03 2701481 ` ~ W C :3213 N MAIN _.__ ..... .... ROSWELL ....._. _..._._...._ ;NM __..„.~ 04!U " 120 ! :: ~ : 9994'S SI ,1.Mar-83Y 17-Dec-03 ____ _ 2701341 WC ,HWY 70 PO BOX-907 _,_ .m~.. RUIDOSO DOWNS ~ .. NM 01 U . 120 _ _ 10152 S SI ... 1 Mar79 _. 17-Dec-03 . ~__._., ,. _. 2701341 IWC . ___ ~ m...__ ... __.__ ..__ _ . _.. _.. _.. _. ,HWY 70 PO BOX 907 _ . - _ .,..._ _._.. ,.- _.._ RUIDOSO DOWNS ~ _._ . _. ;NM 02 U _ 30 ' ,. 10152 S SI ~ __ 1-Mar-79. ..,-___-. _ . 17-Dec-03 ..__, ,_.... ~.. 2701341 WC . . -__..,.___.._._.~.m______.-__~ .~._..,. ._ HWY 70 PO BOX 907 .. . .~._....M__..,..__w.._a.__.~._.. _..,_ RUIDOSO DOWNS .__. ,_ _....._..-, tNM 03.U _. _ 05 _ .. 10152 S ,SI ...-._ 1-Mar-79 _ _ ,..._-~_.__.,- - 17-Dec-03 _.,. _ _ _,_ . __ 2708933, WC ._...__. -_..~ .~...w.. _._..._.,_ 1315 E WILGROGERS DR m._._ __....__._,-.._______ _w_ .SANTAROSA ._._.._...-_.__.__ ;NM 01 _ 10000 _. .. 1-Jul-92. ._._._._ .__...... 14-Dec-05 2708933 WC '.1315 E WILL ROGERS DR SANTA ROSA .~,.__.__. _.- NM 02- __ 10000• n..._ .. 9 Jul 92 ..-_~ __ 14 Dec 05. 2708933 WC 1315 E WILL ROGERS DR SANTA ROSA NM 03 :,10000 i 1 Jul 92' 14-Dec-05 2700515 WC s 1918 N DATE ST TRUTH OR CONSEQUENCES NM 01 U 30 1 ~ 9816 S FG ~ 1 Nov-88 17-Dec-03 ._._. 2700515 WC _..~,..,~~ _.w,_.m__ 918 N DATE ST _,~..__---..._ TRUTH OR CONSEQUENCES NM 02 U 05 9816,S FG ~ 1 Nov 88 _.w_ ~..__.. 17-Dec-03 2700515 WC 918 N DATE ST TRUTH OR CONSEQUENCES iNM E _ ~~^03 U 20 9816 S 3FG 1 Nov-88: 17-Dec-03 _.m__ _.._ 2700839 .l'VC ___.__...__.._ ,_._ ;601 E TUCUMCARI BLVD _._ TUCUMCARI NM ~ 01 U 30 , 9816 S iFG a 1 Mar 87 .....„_,.. 17 Dec-03 2700839 '~WC . '•601 E TUCUMCARI BLVD .TUCUMCARI NM ! 02 U X05 i _ 9816 S FG .. 1-Mar-87I 17-Dec-03 2708931 ;WC ,2624 SOUTH 1ST STREET TUCUMCARI 3NM 011 10000 ~ 1-Jul-79 14-Dec-05 2708931 WC '2624 SOUTH 1ST STREET 'TUCUMCARI NM ` 02c r 10000° 1-Jul-79 14 Dea05 2708931 WC 12624 SOUTH 1ST STREET sTUCUMCARI ~~ NMmmm ~ ' 03 i "~- 10000` 1 Jul79i ,_._._..._ 14 Dec-05 _.___._..~..,..,~._._._ 2708931 iWC __~_.~_____,-._.,_.... ._ _~__..___.,,_.-.a_.__..~_...~-_ 12624 SOUTH 1ST STREET :TUCUMCARI - NM ._..._ ._...,~. - 04? ~ 100000' 1 Jan 90 14 Dec 05 2708932 1WC ;201 E TUCUMCARI BLVD TUCUMCARI NM 01 i 7500', s 1 Jan 86£ 14-Dec 05 2708932 WC , 1201 ETUCUMCARI BLVD +TUCUMCARI sNM 02! 7500 ~ 1-Jan- 86~ 14- Dec-05 . 2708932 WC _ 1201 E TUCUMCARI BLVD TUCUMCARI _.m_ _.. Nlyl - ~03¥ __ 1 7500 _ _ __ 1-Jan-86$ _ 14~Dec 05 2701641 iWC 1601 S MAIN . _ -__ . ;ANTHONY _ ~__ -,,_ - - ~TX 01!U Y 30 ; ~ , 10152~S FG - • 1-Mar-85 17-Dec-03 .__ ._..~..-~. __ ... 2701641 WC .___.~___......, .. r.__.w_-_--_.. . 601 S MAIN . _.~,,,,__.....,__._.,__,.. ,.,.,.. ANTHONY _w_ x_..,_.-_ TX ~ _,_..,_..-._. 021U _. ..._ 05 __. .__._. ._.w_ 10152`S :FG _... ,..__ ___ ,.. 1-Mar-851 _ _..._.,.,._.._.- 17-Dec-03 2701641 1WC 601 S MAIN ANTHONY TX 03 U 20 10152 S FG ~ 1-Mar-85~ 17-Dec-03 ..._ .. 2706104 WC _~ _ _...__ 10100 MONTANA EL PASO TX 01 U _~..~ '05 ? ,__.. 12032 S SA _-m_....._ 1-Feb-87~ 17 Dec 03 2706104 fiWC 110100 MONTANA EL PASO TX 02 U 20 ? 10152 S SA 1-Feb-87~ 17 Dec-03 2706104 ,WC .. . `,10100 MONTANA . °EL PASO TX 03 U 30 ~ 12032;S `SA I eb-871 1-F 17-Dec-O 3 . 1 _.__ __ 2701257 WC ___ _____. _..~..,~ 10567 RUSHING RD EL PASO _ TX 01 U X20 10152dS SI i _ ~ 1-Mar-78 _ 17 Dec 03 2701257 ;WC '10567 RUSHING RD EL PASO ITX 0210 30 10152~S SI t 1-Mar-78 17-Dec-03 2701257 WC 110567 RUSHING RD EL PASO TX ~ 03~U .~ 05 ___ 10152'S Si 1-Mar-78' 17 Dec-03 2700481 IWC X10616 MCCOMBS ST EL PASO TX 01lU 05 ._.. 11682 S FG 1 May 94; 17 Dec 03 ___..__._..__,___ .~ ~___.____ _ .~ _,.... E_ _. 2700481 ~WC 10616 MCCOMBS ST _- _,_.__.... ___ __. _.__ ___._ EL PASO' _.~_ ..... TX € _.__e._, 02 U ._ ~-_.- p20 ? ._._ _..__... _ ..._.. 9816~S 'FG ..-,..___._~.. ,. 1-May-94': µ 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule 12/17106-07 ~ _ _ ~_ '_ ___ ___ ________ West Coast Region _ ________ as of 12 /13/06 ___ __ __ _ _ __ __ __ __ _ ____ _ _ _ __ _ CAPACITY INSTALL _ RETRO LOC. # Regio~ ADDRESS CITY STATE UST # GALLONS DATE DATE _ _ _ 2700481 WC `10616 MCCOMBS ST 'EL PASO TX € 03's U 30 7950 S FG t 1 May-941 17-Dec-03 2708515 WC ,1073 COUNTRY CLUB R D EL PASO TX 01? U 05 ; 10152S FG ~ 1-Jan -87 17-Dec-03 _ 2708515 `WC ~~`1073 COUNTRY CLUB RD EL PASO TX € ~02 _ U m ;20 ~ N10152Sm FG ~ ~~1-Jan-87 17-Dec-03 2708515 WC .1073 COUNTRY CLUB RD EL PASO TX e 03 1 30 10152 S FG ~ 1-Jan-87. 17-Dec-03 0 __.._~_..._...~ _, _ _ _ _....~...._...__ _. _ __..._.. _. _,. .._...~.____.__.________ ______ _.. 2700020 WC 10744 VISTA DEL SOL EL PASO TX - . 011 .~ x~ _ _ U ;05 11682 S FG ; 25-Nov-93~ 17-Dec 03 2700020 ' WC ..10744 VISTA DEL SOL EL PASO ITX ~ 02; U 20 ~ 9816 S FG i 25-Nov-931 17-Dec-03 2700020 WC ;10744 VISTA DEL SOL DEL PASO TX I 034 U 30 € 7950.S FG 25-Nov-931 17-Dec-03 __.. ~_ .. ,._ __.._" ....~ t.. 2701674 WC .10770 DYER ST EL PASO €TX ~ _~_ _ 01 ~ t .., . 1__ _ F .__._ ~ ~_._ ~ I _ __ . U 130 9728 S FG 1-Mar-854 17 Dec-03 .__.~ __ ~ ~"- - .~ _,.,.__.,___ .._.__ _._. TX k 2701674 WC10770 DYER ST EL.PASO ~ 02~ ~05 + 9728'S FG h'-Mar-85~ 17-Dee 03 U ...._-_______._._..~__..._. ......_.,.,, ._ _.__ _. 2701674 `WC ? 1 0770 DYER ST 'EL PASO `TX € m _.__w__. 03' .., __..._._ _.._-w----.~ ___._ .._. U 20 ` 9728€S FG i 1-Mar-85~ 17-Dec-03 _ 2700213 WC ~ "1.1096"PEBBLE HILLS BLVD EL,PASO TX 01 U 05 +. 9816 S• FGA, 4-Au_g-94 17-Dec-03 RT L 2700213 WC " 11096~.PEBBLE HILLS BLVD EL PASO TX 02 U 20 -_ : 9816 S FG ~ 4 Aug-94; 17=Dec-03 . 2700213. WC' 11096 PEBBLE,H6LCS BLVD EL PASO _ TX . 03 U 30 9816 .S FG •4~Aug-94; 17-Dec-03 2700890 WC _ 11101 MONTWOOD"DR - EL PASO - TX ___ '01 U 30 !x9728 S FG ? 1-Ja_n-86` _17=Dec-03 ~ ~ 2700890. WC _ 11101 MONTWOOD DR EL PASO; TX 02 U 05 ~ 9728 S FG , ~ .1-Jan-86 17=Dec;03 2700890` WC 11101 MONTWOOD DR EL.PASO TX 03 U 20 9728 S. FG 1 1 Jan-86= 17-Dec-03 ~ 2706309 WC _ 11390'MONTWOOD DRIVE.. EL:PASO TX . 01 U _ 05 .- . 11682 S FG i 8-Jan-99! 17-Dec-03 2706309 WC 11390 MONTWOOD DRIVE EL-PASO TX . 02 U 20 9816 S FG ` '8-Jan-99'. 17-Dec-03 2706309 WC 11390"MONTWOOD DRIVE EL PASO TX 03 U 30 9816 iS FG ' 8-Jan-99' 17-Dec-03 ~__.._w_ . ___.._ .."_.._ ._._..-.__. ....__. 2706309 WC 11390 MONTWOOD DRIVE- = EL.PASO - TX 04 U 45 - 7950 :S iFG € 8-Jan-99 17-Dec-03 . 2705312 WC 11701 MONTWOOD DR' EL PASO TX 01 U 30 9816 µS ;FG " 1 Nov-94 17~Dec-03 2705312 WC 11701 MONTWOOD DR' EL PASO TX 02 U 20 ~ 9816 `FG E ~ 1-Nov-94 17=Dec-03 S 2705312 WC _ 11701 MONTWOOD DR' EL PASO. TX _ 03 _ U 05 11682 _ >_S ,FG ~~~~ ~1-N_ov-94F 17-Dec=03 ~ ~ 2706308: WC. 1320 GEORGE DIETER " EL PASO TX 01 U 05 '" 11682 ~S ar-98 1 Z-Dec=03 ___ rFG ~µ ~ 5-M 2706308, WC .. 1320 GEORGE'DI:ETER EL PASO TX' 02 U 20 11682 .S~ FG 5-Mar-98 ,17-Dec=03 2706308 WC 1320 GEORGE: DIETER EC PASO TX: 03 U 30 9816 S" FG ~ 5-Mar-98 17=Dec-03 2706454: .WC 1400-LEE TREVINO '' EL PASO TX ~ 01 U 05 20055 S _._. FG o 2 Aug 01 E 17-Dec 03 2706454 WC . - 1400 LEE TREVINO EL'~PASO '.. TX A2 UC1 30 `72068 S FG 2-Aug=O'I~ 17-Dec-03 2706454. WC - 1400-LEE TREVINO . EL PASO TX 03 UC2 45 7981 S FG 2-Aug-01;'.:17-Dec-03 2701227 WC 1400 W YARDELL DR > EL PASO TX 01 U 30 < 9728 S FG , 1 Apr=84~ 17Dec-03 2701227. - WC." ` - :1400 .W Y;4RDELL DR EC PASO. z TX -02 - U 05 -- .9728 S - - FG ~ ;; 1 Apr=84! 97=Dec03 2701227, WC _ 1400 W YARDELL DR EL PASO ":. TX 03 U 20 9728 S FG 1 '1-Apr=841 '17-Dec-03 2705305 WC 1471' N ZARAGOSA ' EL' PASO • ..: TX. 01 U 30 :: • 9816 S FG k. ; 1 May-96€ 17-Dec-03 2705305. WC" 1471 N ZARAGOSA. EGPASO.: - _ TX 02 U 20 "x'9816 .S _._ ; FG ¢ - 1 Ma_y-96~ '1+7 Dec-03 __ .a.._. w._ __. _w._,_ 2705305 WC 1471 N ZARAGOSA .> - EL!PASO TX 03 U 05 i;. ', 11682 S: FG r ~.,:1=May-96;.:.17=.Dec-03 2701506 . WC < 1500 GEORGE DIETER DR. <" EL PASO TX . 01 U 20 ; : 10152 S : FG p~~ 1 Jan,87Q 17-Dec-03 2701506 WC 1500 GEORGE DIETER DR' - EL;PASO." TX '02 U 30 "'; 1-,0152 ,S fG ~ 1 Jan=87 17-Dec 03' 2701506 .WC 1500 GEORGE DIETER DR EC.PASO` TX 03 U 05 101:52 S FG 1 Jari=BZ '1Z-Dec-03 2708775 WC 1520 LEE TREVINO _EL•PASO''> ,' _TX ` -'01 U 20 e .9728 S FG (_~ 1 Se 88 17-Dec 03 P f _ T ~ 2708775, WC 1520 LEE TREVLNO EL PASO _ TX 02 U 05 ' 9728 .S FG ~ 1-S_ep-88 17-Dec-03 ~~ 8 2708775 WC 1520 LEE TREVINO EL PASO TX 03 U 30 9728 S FG ~ 1-Sep-8 17-Dec-03 2706307 !WC~ ~ g1600ZARAGOSA EL PASO _ TX _ 01 U 05 11682 S FG ~ 19-Mar~98~17-Dec-03 2706307 IWC 11600 ZARAGOSA EL PASO TX 02 U 20 11682 S FG I 19-Mar-98~ 17- Dec-03 2706307 PWC ~ ~ 1600 ZARAGOSA EL PASO TX 03 _ U 30 9816 S _ _ _ FG ~ 19-Mar-98f 17 -De c-03 2701482 ;WC _ 31798 GEORGE DIETER DR EL PASO TX 01 U 20 9816 S _ _ FG = ~1- Mar-84 17-D ec-03 2701482 PWC 11798 GEORGE DIETER DR EL PASO TX _ 02 U 05 9816 S _ _ _ FG i _ 1-Mar-84? 17-Dec-03 2701482 s`WC .1798 GEORGE DIETER DR EL PASO TX 03 U 30 9816 S FG i 1-Mar-84~ 17-Dec-03 _w_. _ ,_._..__"._.._ ~ 2706130 'WC ;2200 N MESA EL PASO TX 01 U 05 11682 S ~ FG 25-Mar-99 17-Dec-03 2706130 ;WC :2200 N MESA EL PASO ~ TX 02 U 20 9816 S FG ~ 25-Mar-9 91 17-Dec-03 2706130 ___ iWC ,2200 N MESA EL PASO _ TX 03 U 30 981 6 S _ FG ~ 25wMar-99~~ 17-Dec-03 2700026 iWC 13101 MCRAE BLVD EL PASO_ ~a_._._._..__..- _ TX 01 U 05 1015 _..___.,_....___.... 2 S y " SI t 1-A r 79~ 17-_Dec-03 p- ~ 2700026 ~WC ;3101 MCRAE BLVD EL PASO_ ~ ~TX 02 U ~_ 20 . i 10152~S . SI ~~ _ 1-Apr-79~ 17-Dec-03 2700026 ~3101 MCRAE BLVD EL PASO IWC TX l 03~U 30 ~ 10152:S SI ? ~1-Apr-79~ 17-Dec-03 2701418 (WC w3910 A DYER ST EL PASO TX I 01 €U 20 I 10152;S SI , 1-Apr-81 17-Dec-03 _ 2701418 ~ __ jWC =3910 A DYER ST EL PASO TX " 02~ ?05 € 10152'S SI 1-Apr-81 j 17-Dec 03 2701418 IWC !3910 A DYER ST EL PASO - --- ~TX_ I ~ 03'U ;30 f ~~ 10152 S SI ~ 1 Apr 81 ~ 17 Dec-03 2708516 `WC 14101 N PIEDRAS EL PASO TX ; 01€U 105 9816 S FG ~ 1 Apr 87 17 Dec-031 _ _ _ _ 2708516 ~WC ,4101 N PIEDRAS PAS EL O TTX 02~U '20 ! 9816 S FG i 1 Apr 87 17 Dec-03 _ _ _ ___ ______ 2708516 !WC :4101 N PIEDRAS EL PASO _ ITX ~ 03,U 30 ! 9816S FG 1-Apr-87; 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule West Coast Region 1 2/1 710 6-0 7 as of 1 2/13/0 6 ~ + LOC. # Region1_ -ADDRESS . _ _____ CITY STATE UST # CAPACITY GALLONS INSTALL RETRO DATE DATE _ 2705313 ' W C 14507 WOODROW BEAN - TRANSMOUNTAIN I _-...._ ------ --- - - ___ _ EL PASO II TX 1 01 ~ - U ' 30 j - - 9816 S - FG ' --- 23-Nov-94 i 17-Dec-03 - 2705313 WC +4501 WOODROW BEAN-TRANSMOUNTAIN -------- EL PASO . _._....._ __,-_...._ --- TX 02: U ~-__~. 20 _.~._,_.__. ._;_ 9816,S .__..._.___.._~......__-_.....,._....- FG : 23 Nov-94 17-Dec-03 2705313 WC -4501 WOODROW BEAN•TRANSMOUNTAIN EL PASO __~__4 TX 03 U 05 ` 11682 S FG 23 Nov 941 17-Dec 03 2706288 4WC ,;5665 DESERT SOUTH BL__ EL PASO _ TX 01 U 05 ; 11682S FG = 25-Jun-991 17-Dec-03 2706288 WC _:5665 DESERT SOUTH BL EL PASO TX _ 02 _ U 20 ' _ _ m~ - 9816{S FG 25-Jun-99! 17-Dec-03 2706288 !WC 15665 DESERT SOUTH BL i __ EL PASO TX _ ~ 03 U 30 i• ~ _ --9816°S _ FG X25-Jun-99' 17-Dec-03 2706288 ~WC 15665 DESERT SOUTH BL .. EL PASO TX 04 U 45 j 9816'S FG € 25-Jun-991 17-Dec-03 2705306 iWC 6095 MONTANA AVE :. EL PASO TX 01 U 45 w__ 7950S FG ~ : 12 Sep-95~ 17-Dec-03 2705306 WC ;6095 MONTANA AVE - fC PASO TX 02 U 309816 S FG [ 12-Sep=951 1~7 -Dec-03 _ 2705306 =WC 6095.MONTANA AVE ~ _ EL PASO . TX 03 U 20 ~ 9816;5 _ FG 1.2-Sep-95~ 17-Dec-03 2705306 ;1NC 6095 MONTANA AVE - EL PASO TX 04 U 05 ; 11682 S FG } 12 Sep 95~ 17 Dec-03 _ 2706126 iWC (6148 GATEWAY E _ EL PASO TX __ 01 U 05 ' 12032, S SF 1 N ov 85, 17 Dec -03 2706126 WC 16948 GATEWAY E ~ EL PASO .. TX 02 U 20 12032;5 _ _ _ _ SF ..~~ 1T-Nov-85 . 17-'Dec-03 _ 2706126 WC ' +6148 GATEWAY E _ _ EL PASO TX 03 _ U: 30 ' .~ 8068;S SF 1-Nov=85! •17-Dec-03 2706098 iWC 16200 N MESA EL PASO TX 01 U 05 ~ ~ 11682 `.S .FG ? m25-Feb-99~ 17-Dec-03 2706098 iWC 6200 N MESA EL PASO ' : TX 02 U 20 ___~. 9816~S FG ~ 25 Feb-99, 17-Dec-03 2706098 WC 6200N MESA EL PASO 7X 03 U 30 I 9816iS FG 25-Feb-991 17-Dec-03 2706098 WC !6200 NMESA - . ; EL PASO _ ~ TX 04 U 45 f ~~-mmT m 7950~S. FG I X25-Feb-991 17-Dec-03 2700616 ~WC 6398 DONIPHAN DR EC PASO TX 01 U _ 05 I " 11682 S' . FG $~ 1 Nov 931 17- Dec-03 __ 2700616 ;WC ~+6398 DONIPHAN DR EL PASO . ' TX 02 U 20 ` ,~mm 96841S _ FG ~ 1-Nov-93~m17-Dec-03 _ 2700616 WC ,6398 DONiPNAN DR -_.. -- _ __ EL PASO - TX 03 U 30 ~ 7950''S FG + ~ 1-Nov-93; -:17-Dec-03 2701534.WC 650 N RESLER DR - -- EL PASO . TX --- 01 U - _ ......~F 30 ~ 9816'S _..._..~ __Y.__;-_--.___._._.....__ FG 1-Feb-86; 17-Dec-03 270 5 WC 650 N RESLER DR _. ._ _ _ EL PASO V TX 02 U 05 , ' 9816'.5• FG 1-Feb-86; 17-Dec-03 2701534 WC 6'50 N RESLER DR _ EL PASO ~ TX ` 03 _ U _ __.~ 20 9816=S: ~_ _ ._ ._..-._w ~ ...__.___ M_..,_ FG c 1 Fe b`-86 17-Dec-03 2705315 iWC 1680 E REDD'RD` EL PASO TX _ _ 01 U 30 ; 9816:S _ , FG ' ~ 5-Feb-96, 17-Dec-03 2705315 IWC 1680 E REDD RD EL PASO TX 02 U 20 98161S FG 5-Feb 96 1 7-Dec-03 2705315. ; W C 680E REDD RD EL PASO TX • 03 U 05 9816: S - : FG 5-Feb-96~ 17-Dec-03 190 € C !6996'ESCONDIDO ~ EL PASO .: ~ TX - : 01 U .-_ 05 11682>S _,_--__ -- FG 4 A r'94y 17 De 03 2701190 WC _ -:6996 ESCONDIDO EC PASO . TX 02 U . 20 ; 9816'S : p c- FG 1-Apr-94 17=Dec-03 2701190 ~WC 46996 ESCONDIDO.:. EL PASO ~ TX ` . • ' 03 U 30 7950S FG ~ 1 Apr-94~ 17 Dec-03 2706333 4WC 700 AMERICAS:AVE ~ r _~__ _ 'EL PASO _. --~ TX 01 U 05 , _' ' 11682S FG ± 7~Oct-991 ~ 17-Dec-03 2706333 'WC '700'AMERICAS AVE '-' ELPASO. TX 02 -- U -~ --_._._ ..__-_...M 20 ; ~ ' 9816;S ._.... ......_ ..___~,..._.. FG `s Z-Oct-99', 1Z-D ec-03 2706333 W C _ _ ' 700 AMERICAS A_VE _ `; EL PASO ~ __ _ TX 03 U 30 } 9816 -S _ _ FG I~ 7 Oct 9 9 1TDec-03 2706333 WC ~ :700 AMERICAS AVE _ _ EL PASO TX ~ 04 _ U 45 ~ N 981615 _ FG ~ 7 Oct-99 47-Dec-03 2700450 IWC '7100 N LOOP RD EL PASO " TX 01 -. U 30 ~ 7950. S• w •..~.._~. ~..___._~. FG 7 Apr-94! 17:Dec-03 2700450. IWC 7900 N LOOP RD ~ ~ ,._. "- ' EL PASO TX 02 __ U : 05 ~ ; 11682;5 FG ; 7 Apr-94` 1Z Dec-03 7 450 iWC 7100 N LOOP RD S EL PASO :: TX: ; 03 U 20 , 9816S. FG 7-Apr-944 1,7-D ec-03 2701429 :~WC .'7300 N MESA ST. EL PASO _ TX - :.:01 U 30 { 10T52~S _ SI 9-Mar-821 17=Dec-03 2701429 WC 7300 N MESA ST EL PASO.. TX 02 U OS s 10152 & SI 1-Mar-82f 17-Dec-03 2701429 WC •7300 N MESA ST_ _ EL PASO TX 03 U _m- 20 '10152S SI r 1-Mar-82~ 17-Dec-03 2706112 WC ';7800 GATEWAY E _ EL PASO - ~ TX 01 _ U 11682`S 05 { FG 17-Jun-981 17-Dec-03 2706112 iWC 7800 GATEWAY E EL PASO TX 02 U ~ 20 ; 9816'S FG 17-J 98' 17 D 0 __ ~ un- - ec- 3 2706112 ~WC ;7800 GATEWAY E_ 2706112 ~WC X EL PASO __ _ TX 03 U _ _ 30 ~~ 9816S ~ FG _ 17-Jun_-9$j _ 17-D_ec-03 ~ 7800 GATEWAY E EL PASO TX 04 U 45 1 9816':S FG 17-Jun-98I 17-Dec-03 2701508 WC 18726 MONTANA_AVE EL PASO TX 01 U 20 ; 98161S FG ! 1-F eb-86! 17-Dec-03 2701508 sWC ;8726 MONTANA AVE __ EL PASO TX 02 U 05 ` 9816gS _ _ FG ~ 1-Feb-861 17-Dec-03 2701508 4WC ;8726 MONTANA AVE EL PASO TX 03 U 30 9816S FG 1 Feb-86 17-Dec-03 2708743 WC 18855 N LOOP EL PASO TX 01 U 30 § 9816 S .-_. .~ _-,_...........__..~_, FG 1-Aug-88, 17-Dec-03 2708743 iWC ;8855 N LOOP 2708743 ~WC 8855 N LOOP EL PASO TX - 02 --- U 05 i 9816iS FG 1-Aug-88 17 Dec-03 .; -. _ _ EL PASO TX 03. U . 20 ' 9816S FG ' 1-Aug-88 17-Dec-03 2706089 IWC '9497 DYER -- EL PASO TX 01 , U ~ ..._._ .._ 05 ~ 12032`S -w _ _ ..___,._. ~ _ SA 1-A 88' 17 D 3 __` 2706089 !WC _ 9497 DYER __ __ ,__ _ _ 2706089 WC 9497 DYER EL PASO_ __ ~ TX _ __02 U___ 20 12032~S ug- - ec-0 SA 1 Aug 88117-Dec-03 t ~ x_ 2701136 iWC 204 S MAIN EL PASO _ ELLENSBURG TX WA 03 01 U U 30 10128',S 05 I 9816`S SA ' 1-Aug-88~ 17-Dec-03 FG 30-Apr-95j 17-Dec-03 2701136 ;WC _204 S MAIN 2701136 ~WC !_204 S MAIN _2701452 ; WC ;2415 GRIFFIN AVE ' ELLENSBURG ELLENSBURG _ __ ENUMCLAW WA WA WA 02 __ 03 01 U_ 10 U _ 20 9816sS 130 , 9816tS 30 ~ 9816 S FG 30 Apr 951 17-Dec-03 FG 30 Apr 95, 17 Dec 03 FG 21 Apr-95 17 Dec 03 2701452 IWC 2415 GRIFFIN AVE 2701452 WC ;2415 GRIFFIN AVE ENUMCLAW __- ------ WA 02 ---- U ------- 20 9816lS - -_ --_____- FG i 21-Apr-95 17-Dec 03 ~..-._.~.. __ __ -_..w.., ENUMCLAW WA 03 U 05 ~ 9816S FG ; 21-Apr-95. 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule ---------------------- West Coast Re ion 9 -------------------- 12/17/06-07 --------------------- as of 12/13/06 -------------- - -- ~ --- --~ --- (-------- - -- ---------- ------ LOC. # Region ADDRESS - ------------- CITY ------ STATE UST # CAPACITY GALLONS INSTALL DATE RETRO DATE 2701546 ?WC ;10255 SE 240TH ST -- KENT WA -- 01 - U 30 i 9728 S FG ~ `1-Mar-85i 17-Dec-03 2701546 WC `10255 SE 240TH ST _ _ KENT WA 02 U 05 = 9728 ~S FG ; 1-Mar-85 17-Dec-03 __ 2701546 WC :10255 SE 240TH ST __ ____ KENT WA 03 U -` _-" 20 , 9728 S ; "°"" ""` '-- ' FG 1 Mar 853 17 Dec-03 2701602 WC .20727 108TH AVE SE 2701602 WC "20727 108TH AVE SE KENT WA 01 U 05 _"9728S ' FG 1 Apr 85( 17 D_ec 03 - _ ~ KENT __ WA 02 U 30 , , 9728 S FG ° 1-Apr-8 5.17-D ec-03 2701602 WC 20727 108TH AVE SE _ KENT WA 03 U ~""`"~'" 20 " 97281S _ _ ~ °""" ' FG I ~1-Apr-85 17-D ec-03 2708878 !WC 8007 STATE AVE _._ 2708878 jWC 8007 ST MARYSVILLE WA 01 U 20 ' ~9816S _ FG i 1 Sep-87 17-Dec 03 ATE AVE ;,._.. 2708878 ,WC ..8007 STATE AVE 2708567 iWC `1700 132 ST SE ~'• -J--- ? __ MARYSVILLE _ MARYSVILLE MILL CREEK WA WA WA 02 03 01 U U U 05 9816~S 30 • 9816~S 20 , ~ _ `°°' 9816`S; FG 1-Sep-87 17-Dec-03 FG ! 1-Sep-87' 17-Dec-03 __.__.~._____ , ..__.-._...__._, FG , 1 Oct-88 17-Dec-03 2708567 !WC X1:700 132 ST SE` ._. _ -- MILL CREEK WA 02 U 05 ; ' 9816S FG :' i 1 Oct-88. 17=D ec-03 2708567 `WC :.1700 132 ST SE • . 2705925 ; WC I9061 DECRIDGE WAY SW MILL CREEK WA 03 U 30 9816 S ~ _ _ _m. FG _ 1 Oct 88, 17 Dec 03 - SEATTLE , . _ WA 01 U .: _ 20 8025'D _ SF I 1-Jan-91' 17-Dec-03 2705925 WC ,9061 DECRIDGE WAY SW -~--- __ SEATTLE _ _ WA _ 02 U _ 05 m.~ ._.._-.. 1005&D -._...._. -'-'-'-' _..~.._.._r_._ SF 1-Jan-91 ~ :17-Dec-03 25 ;WC =9061 DECRIDGE WAY SW SEATTLE _ WA 03 U 30 ~ 8025~D SF I 1 Jan 91 17-Dec-03 2705925 WC 19061 DECRIDGE WAY SW -... _ SEATTLE WA 04 U , `~ 45 6048E D _.._ ~"° "`- SF ` r. 1 Jan 91 17 Dec-03 2708795 WC `4704 OAKES ST, -SUITE 100 -- TACOMA- WA 01 - U __ ..._.. 30 ~ -:.9816= :D .~_w .,._.___ ..._.w..____.._ FG i . - 1-Apr-88 17-Dec-03 2708795 iWC ;4704 OAKES ST, SUITE 100 TACOMA _ WA _02 U 05 9816; - D .._.__~__ __..._._..__ FG ; 1 Apr-89 17-Dec-03 2708795 sWC ;4704 OAKES ST, SUITE 100' _w. _ _ _ TACOMA WA 03 U 20 ~ 9816E D fG = 1-Apr-89~ 17-Dec-03 2706000 WC 924 S HWY 85 - SOCORRO NM 01 U 05 12000 S FG f 1-Oct-96 17-Dec-05 2706000 WC ' 924 S HWY 85 _ SOCORRO NM _ 02 U 30 ~ 8000 S FG ' 1 Oct 96 17- Dec-05 _ 2706000 WC _ 924 S HWY 85 _ _ SOCORRO NM 03 D 45 ' 10000 S . FG W~ 1 O ct 96' 17-Dec-05 _ 2706001 WC 801 E THORPE RD _ LAS CRUCES NM 01 _ U __ 05 12000 S _ FG -~ .1-Jan-00~ 17-Dec-05 2706001 WC . 801 E THORPE RD LAS CRUCES NM 02A U _ 05 15000 S FG ~1-Jan-00 ' 17-Dec-05 _ 270600.1 WC 801 E THORPE RD _ _ LAS CRUDES __ NM 02B D 30 ~ x,6000 S' . FG 1~Jan-00 17-Dec-05 _ _ 2706001 WC ° 801'E THORPE RD L_AS CRUCES .. NM 03 U 45 8000 S: _ FG 1-Jan-00 17=Dec-05 _ 2706003 WC '. 29955 HAUN`ROAD _ _~ __ SUN:CITY ' _ CA 01 _ U 05 ~ 20000 .D: _ SF 1-Feb-02 1:7-Dec-05 _ 2706003 WC' 29955 HAUN ROAD __ ' _ SUN CITY ' . CA' 02A U _ 30 _15000 D _ , SF ~::1-Feb- 02 17-Dec-05 2706003 WG 29955"HAUN`ROAD SUN CITY CA 02B D _ 45 '~5000 D . SF 1-Feb-02 17-Dec-05 G:ldata\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 :« /~f~~ .~ -... r- T~rr~-~o%c~r 8501 N. MoPac Expressway, Suite 400 Austin, Texas 78759 Phone: (512) 451-6334 "'~`~ ` O f.~ 'Z Fax: (512) 459-1459 - Date Printed and Mailed: 01/18/2007 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 900 TRUXTUN AVE., STE. 210 BAKERSFIELD, CA. 93301 Test Date: 01 /04/2007 Order Number: 3150320 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CIRCLE K 2708605, CO. 123 5600 AUBURN ST @FAIRFAX RD. BAKERSFIELD, CA. 93306 Testing performed: Dynamic Pressure Source Leak detector tests Monitor Certification Secondary Containment-Spill Container Stage II pressure decay tests Sincerely, Dawn Kohlmeyer Manager, Field Reporting i ~; ~, ~n,i070~0 TANKNOLOGY CERTIFICATE OF TESTING 9y 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 01/04/07 WORK ORDER NUMBER: 3150320 CUSTOMER PO: 100885 CLIENT: CIRCLE K STORES SITE: CIRCLE K 2708605, CO. 123 495 E. RINCON, STE. 150 5600 AUBURN ST CORONA, CA 92879 @FAIRFAX RD. BAKERSFIELD, CA 93306 LORRAINE SOFFE SCOTT -MANAGER (951)270-5193 (881)871-7979 Prnrlur_t Pina Tinhtnasc Tact Rasnltc IMPACT LINE LINE LINE DELIVERY ~ - TEST RESULT FINAL LEAK RATE (gph) , VALVE ID PRODUCT MATERIAL TYPE A B C D" A B C D _ FUNCTIO lOk 1 UNLEADED DW FIBERG PRESSURE Y lOk 2 PLUS DW FIBERG PRESSURE Y lOk 3 PREMIUM DW FIBERG PRESSURE Y EYistine Line Leak Detector Test EXISTING LEAK DETECTOR #1 ~ • EXISTING LEAK DETECTOR'#2 LINE ID MANUFACTURER MODEL # = SERIAL # RESULT ' MANUFACTURER ~-MODEL # SERIAL # RESULT lOk 1 VEEDERROOT WPLLD 101164 P lOk 2 VEEDERROOT WPLLD 176093 P lOk 3 VEEDERROOT WPLLD 100575 P New Replacement Line Leak Deter-ter Test REP LACED IEO:K DETECTOR#1 REPL,4CED'LEAK DET ECTOR #2 LINE MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESUL ID ror owner aetauea report intonnanon, visa www.tan~mo~ogy.com and select l)n-1.me tteports-wtcar, or contact your Ioca1 tanKnoiogy oihce. Tester Name: TIMOTHY COULTER Technician Certification Number: --~---~ Printed 01/18/2007 08:26 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~ Tanlvro%gy 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/04/07 WORK ORDER NUMBER: 3150320 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE K 2708605, CO. 123 TANK INFORMATIQN Tank ID: lok 1 Tank manifolded: NO Bottom to top fill in inches: 92.0 Product: UNLEADED Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBEI2G Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS >TesfMethod: LEAK DETECTOR TEST RESULTS. ,. ' ' Test,method: ~~ -t << ~ ;. PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D. #1 L.D. #1 L.D. #2 L.D. #2 UFT/OFT: Make: vErDERROOT Fluid volume in gallons: Model: WPLLD Tank water level in inches: S/N; 10116, Test time: NOT Open time in sec: Number of thermisters: TESTED Holding psi: NoT Specific gravity: Resiliency cc: TESTED Water table depth in inches: est leak rate ml/m: Determined by (method): Metering psi: Leak rate in gph: Calib. leak in gph: 30.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE TEST RESULTS Test Method: ~ ~; °,~~ ; tINETE$T RESULTS ;Test type:.; + ~: .-~.~ Test time: Material: DW FIBSRG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 100.0 Results: Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time (min): Test 1: Start time: Time of test 1: Finish psi: NoT NOT NOT NOT Temperature: NOT VOI Change cc: TESTED TESTED TESTED Test 2: Start time: TESTED FIOW rate (CfFI): TESTED Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: RED JACKST COMMENTS Impact Valves Operational: YES Printed 01/18/2007 08:26 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~~ Tanlv~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/04/07 WORK ORDER NUMBER: 3150320 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE R 2708605, CO. 123 .r _ TANFCINFORMATION ,. ~. Tank ID: 1ok 2 Tank manifolded: xo Bottom to top fill in inches: 92. o Product: PLUS Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4 - o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: sALAxcE CP installed on: / / COMMENTS TANK TEST.RESULTS s •.:_ Test Method. ~ - LEAK DETECTOR TEST'RESULTS ~ -*,j~~ 4:; Test method; PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D. #1 L.D. #1 L.D. #2 L.D. #2 UFT/OFT: Make: VEEDERROOT Fluid volume in gallons: Model: wPLLD Tank water level in inches: SIN: 1,6093 Test time: NOT Open time in sec: Number of thermisters: TESTED Holding psi: NoT Specific gravity: Resiliency cc: TESTED Water table depth in inches: est leak rate ml/m: Determined by (method): Metering psi: Leak rate in gph: Calib. leak in gph: 3.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE,TEST RESULTS Test Method:.. ~%, ; ,= LI E TEST;;RESULTS ~- Test type ~~ ~- . ~. ,. , . Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): loo . o Results: Test psi: Bleedback cc: Test time (min): DATA FOR UTS-4T ONLY: Test 1: Start time: Tlme Of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT Vol change cc: TESTED TESTED TESTED Test 2: Start time: TESTED Flow rate Cfh : TESTED ( ) Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: RED JACKET COMMENTS Impact Valves Operational: YES Printed 01/18/2007 08:26 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/04/07 WORK ORDER NUMBER: 3150320 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE K 2708605, CO. 123 TANK',INFORMATION - Tank ID: lok 3 Tank manifolded: No Bottom to top fill in inches: 92 . o Product: PREMIUM Vent manifolded: xo Bottom to grade in inches: Capacity in gallons: 9 , 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST., RESULTS ~ Test Method: ' ': LEAK DETECTOF2 TEST"RESULTS r ` ~-*l~ :~ .Testmethod: ~ b, ~` PSI at tank bottom: New/passed Failed/replaced New/passed Failed/replaced Fluid level in inches: L.D. #1 L.D. #1 L.D. #2 L.D. #2 UFT/OFT: Make: vrsDERROOT Fluid volume in gallons: Model: AlPLLD Tank water level in inches: S/N; ioos~s Test time: NoT Open time in sec: Number of thermisters: TESTED Holding psi: NoT Specific gravity: Resiliency cc: TESTED Water table depth in inches: est leak rate ml/m: Determined by (method): Metering psi: Leak rate in gph: Calib. leak in gph: s . 00 Result: Results: PASS COMMENTS COMMENTS ULLAGE TEST RESULTS Test Method: LINE TEST RESULTS : ,:Test.type z ~',> Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): loo . o Results: Test psi: Bleedback cc: Test time (min): DATA FOR UTS-4T ONLY: Test 1: Start time: Time of test 1: Finish psi: NoT NOT NOT NOT Temperature: NOT VOI change CC: TESTED TESTED TESTED Test 2: Start time: TESTED FIOw fate Cfh : TESTED ( ) Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cfh): vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: RED JACKET COMMENTS Impact Valves Operational: YEs Printed 01/18/2007 08:28 ACRAMER . MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of Califomia Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, Califomia 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 svstem control panel by the technician who performs the work. A copy of this form must be provided to the tank system ownerloperator. The ownedoperator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CIRCLE K 2708605, CO. 123 Site Address: 5600 AUBURN ST City: BAKERSFIELD CA Zip: 93306 Contact Phone No: 871-7979 @FAIRFAX RD. Date of Testing/Service: 01/04/2007 Facility Contact Person: SCOTT -MANAGER Make/Model of Monitoring System:TLS-350 B. Inventory of Equipment TestedfCertified Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: 87 Tank ID: 89 X In-Tank Gauging Probe. Model: MAG 1 X In-Tank Gauging Probe. Model: MAG 1 X Annular Space or Vault Sensor. Model: V/R 409 Annular Space or Vault Sensor. Model: V/R 409 X Piping Sump french Sensor(s). Model: V/R 208 Piping Sump/Trench Sensor(s). V/R 208 Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: V/R WPLLD X Electronic Line Leak Detector. Model: V/R WPLLD X Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). TanklD: TanklD: In-Tank Gauging Probe. Model: MAG 1 In-Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: V/R 409 Annular Space or Vault Sensor. Model: ~( Piping SumplTrench Sensor(s). Model: V/R 208 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: X Electronic Line Leak Detector. Model: V/R W PLLD Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model:. ATG/FLAPPER 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). Ispenser 1-2 DispenserlD: 3-4 XD Dispenser Containment Sensor(s) Model: BEI 406 ~( Dispenser Containment Sensor(s) Model: BEI 406 X^ 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): ^X System set-up XD Alarm history report Technician Name (print): TIMOTHY COULTER Certification No.: 634132 Work Order Number: 3150320 Signature: _ 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: 01/04!2007 °,6~ __ Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 5600 AUBURN ST Date of Testing/Service: 01 /04/2007 t'cr).FAIRFAX RD. D. Results of Testing/Servicing Software Version Installed: 16.02 Complete the following checklist: ^X Yes No' Is the audible alarm operational? ^X Yes ^ No' Is the visual alarm operational? ^x Yes No' Were all sensors visually inspected, functionally tested, and confirmed operational? Q 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? 0 Yes ~ No' ^ N/A 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 Sump/Trench Sensors; ^x Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ^X Yes ^ No ^X Yes ^ No' ~ N/A For tank systems that utilize the monitoring system as the primary tank overfill warning 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 ~~a Yes' ^x 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. Yes' ~x 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. ^x 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: Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: 5600 AUBURN ST Date of Testing/Service: 01 /04/2007 @FAIRFAX RD. F. In-Tank Gauging / SlR 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? Q Yes ^ No' Was accuracy of system product level readings tested? QYes ^No' Was accuracy of system water level readings tested? x Yes ^No' Were all probes reinstalled properly? ^x 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: 0 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: 0 3 g.p.h ^ 0.1 g.p.h ^0.2 g.p.h x Yes ^ No' Were all LLDs confirmed operational and accurate within regulatory requirements? x Yes ^No' Was the testing apparatus properly calibrated? ^Yes ^No' ^x N/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^x Yes ^No' ^ N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^x Yes ^No' ^ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Yes ^No' ^ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? Q Yes ^No • ^ N/A 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 form dated 03/01 SAN JOAQUIN VALLEY AIR POLLUTION CONTROL DISTRICT Dynamic Pressure Source Test Source Information FACILITY PARAMETERS GDF Name and Address CIRCLE K 2708605, CO. 123 District Inspector Phase II System Type Phase II System Type 5600 AUBURN ST Device Type Used Balance @FAIRFAX RD. MANOMETER Assist BAKERSFIELD,CA 93306 Hirt Permit# S-2146-1-4 E.O G-70-52 Phase I System Type EVR 2 Point Hasstech Healy Other Coaxial Manifolded? YO or N Date of Last Calibration:12/05/2006 Type of Test: Wet / Dry Leak Check: Pass / Fail Nozzle Grade Dynamic Back Pressure, Inches H ~J Result 20 CFH 60 CFH 100 CFH #1 E.W.4005 ALL .04 .22 .36 PASS #2 E.W. 4005 ALL ~ .03 .20 .45 PASS #3 E.W. 4005 ALL .03 .21 .50 PASS #4 E.W. 4005 ALL .07 .23 .40 PASS Test Conducted By: Test Company: Date of Test: TIMOTHY COULTER Tanknology 01!04/2007 Signature: Confirmation # Tester Certification # C~ 07-7486 T-6037 .San Joaquin Valley Unified Air Pollution Control District Pressure Decay Test TP201.3 Confirmtion. No.: Permit No: Site Name: Address: 07-7486 Testing Company S-2146-1-4 CIRCLE K 2708605, CO. 123 5600 AUBURN ST BAKERSFIELD Phone: 661871-7979 Phase I System? E / 2 t. / Coaxial Phase 11 System? BALANCE I ASSIST I OTHER Total Number of Nozzles: 4 Nozzles for Tank # 1: 4 Nozzles for Tank # 2: 4 Balance "Nozzle End" hoses must be drained prior to test. Name: TANKNOLOGY Address: 41785 Enterprise Circle S Suite D Temecula CA 92590 Phone: (951)676-4060 Tanks Manifolded? Yes ' Work Order: 3150320 Nozzles for Tank # 3: 4 Nozzles for Tank # 4: Number of hoses over 100m1: N/A Tank Information 1 2 3 4 All 1. Product Grade 87 89 91 2. Actual Tank Capacity, gallons 9816 9816 9816 0 29448 3. Gasoline Volume, gallons 27770 2742 2108 0 32620 4. Ullage, (V) gallons (line #2 minus line #3) 70390 7074 7708 0 85172 5. Start Time 0900 0945 0945 6. Initial Test Pressure, inches H2O 2.00 2.00 2.00 7. Pressure after 1 minute, inches H2O 1.96 2.00 2.00 8. Pressure after 2 minutes, inches H2O 1.91 2.00 2.00 9. Pressure after 3 minutes, inches H2O 2.00 2.00 10. Pressure after 4 minutes, inches H2O 1.99 1.99 11. Pressure after 5 minutes, inches H2O 1.99 1.99 12. Allowable Final Pressure (See table 1A or 1 B) 1.93 1.93 1.93 13. Pass /Fail PASS Nitrogen introducing point. Phase I vapor coupler or Phase II vapor riser: Phase I / Phase II Record Vapor Coupler Integrity Test Assembly pressure after 1 minute: 2.15 What type of pressure device used : Incline Manometer ~ Mechanical ~ Digital -must do drift tes 12/5/06 Enter Calibration date for pressure device (90 days ). 0.50 Enter initial tank ullage pressure (Vent if over 0.5 in. w.c. ) 3 Enter flowmeter rate, F (Must be 1 to 5 CFM ). ~= V 4:47 Enter Calculate ullage fill time, t2. <9:34 Enter actual fill-time. [1522] F 0.00 Enter ending value of drift test (Must be 0.01 in. w.c. or less ). Tester: TIMOTHY COULTER --~ - Signature: Tester ID: T-6037 Test Date: 01 /04/2007 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS TEST DATE:oi/04/2007 ~ Tanknotogy WORK ORDER NO.: 3150320 CLIENT: CIRCLE R STORES SITE: CIRCLB R 2705605, CO. 123 495 E. RINCON, STE. 150 5600 AUBURN ST ®FAIRFAX RD. CORONA CA 92879 SAKERSFIELD CA LORRAINE SOFFE 951-270-5193 Tank Interstital Tests TAN K PRODUCT MANUFACTURER RESULTS UNLEADED PLUS PREMIUM Piping Interstital Tests 93306 LINE PRODUCT MANUFACTURER _: .RESULTS Sumu &Under-Dispenser Containment Tests . Sump/: DISP.# MANUFACTURER P/F 87 FILL OPW Pass 89 FILL OPW Pass 91 FILL OPW Pass Tanknology representative: BRIAN DERGE Services conducted by: TIMOTHY COULTER ~~ N - N N N ~ IL a (6 a f0 a l6 a m c ~ r r ~ L~ ~ 0 N N ~ M M 0 C (h ch M ('7 ~ O ~ ~ F LL ~_ O ~ ~ ~ ~ m ~ Q O` ~ ~ O O O N y U J L F- o m > n ~ ~ 'c ~ _ J J ~ E ~ M M M N ~ F W N I.fi N a L {~ r r O Z W 1~ a L .~. n Z - °v ao ao ao o w ~ m Q a^ O O o v z ~ ~ ~ ° //~~ ~ VJ `O ~ U U U N ~ N fq N ~ ~ (U a c0 a W a ~ N .~ .~ ~ ~ 5 C O o O m (0 N N a N _ O J J J N ~i O it LL LL lL ~ y ~ c0 W 01 C l6 H C W d c ' c ' c ' u g m m m w ~ N a~ ~ U U U 'n 'u 'n E ~ ~ ~ U Work Order: 315 0 3 2 0 9. BP~LLIOVERFILL CON`re~inr~.K*r un~rc ~~~ of eo Tanlrnology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 Comments - (include informQtio>r on i~atrs trade prior [o testing, and recomtrxended fo!!a-~up jar failed rests) ~ Tanla~orogy 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:Ol/04/07 WORK ORDER NUMBER3150320 CLIENT:CIRCLI3 R STORES SITE:CIRCLFs R 2708605, CO. 123 COMMENTS Annual Vapor Recovery Testing, Monitor Certification, Leak Detector Testing & Spill Bucket Testing. Conf.#07-7486, all tests passed, replaced (1) Husky 3360 Breakaway, parts billed on WO # 3150542 PARTS REPLACED QUANTITY :~. _: "DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ~ _ ... i ~. ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 01/18/2007 08:26 ACRAMER s SITE DIAGRAM i Tanlatology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 01/04/07 WORK ORDER NUMBER3150320 CLIENT:CIRCLE R STORES SITE: CIRCLE IC 2708605, CO. 123 ~ DUMP- t~ - T STER C S ORE *ATGs in STP sumps ICE PROPAN ST O ST '~ OF ~ ~~.~ O ST #~ CANOPY #3 O ~°' V NTS O,~o,~- OV on #2 #4 ~~ Q C nopy *Dispensers contain W AIR/ 0 ~~~ $ beaudreau stand- S N H2O alone sensors . -~ Printed 01!18/2007 08:26 ACRAMER W arlc Order: 315 0 3 2 0 T l:tlNLEAI)ED - ~• T 2_PLUS - --~-- i:i>~NSOR ALARM -- L 2:UNLEADED SUMP HIGH WATER ALARM JAN 4. 2D07 3:36 I~11 HIGH WATER ALHRhI 07 3:36 PM STP SUMP SENSOR OuT aLHkM JAN !2. 2006 11:57 AM JAN 4. 20 2006 11:57 AM JAN 12 JAN a. 2GtI7 3:iB PM ,IAN 26. zoa5 10:34 c1M . JAN 26. 2005 10:35 AM FUEL ALARM OVERFILL ALARM 2007 3:39 PM 4 OVERFILL ALARM JAN 4. 2707 3:D4 PM , JAN NOV 19. 2046 2:17 AM JAN 4. 2007 3::39 PM 2406 11:50 AM JAN 12 SENSOR OUT ALARM NOV ti. 2D06 3:04 PM . JAN 26. 2Q05 10:53 AM JAN 12. «006 11:A1 AM BUUA£.N LOSS ALARM ~Y 4. 20114 9:32 AM Ii1GH PRODUCT ALARM ~ - - - - ----- SENSOR ALAR1~1 ---- JAN 4, 1007 3:43 PM -_ L J'a9 ANNULAR litCH PRQDl1CT ALHRM 2007 3:43 PM 4 JAN 12. 2006 11:53 AM SAN 2E+• X05 10:3P raM 2~ ANNULAR SPACE SENSOR OVf HLA1 . JAN 6 1e :53 AM INVALID FUEL LEVEL 2M Jr~N 4, 2D07 3:IE: PM JAN iZ. 200 JAN 4. 2D07 3:33 PM FUEL ALARM INVALID FUEL. LPL JAN 4. 2007 3:2B PM 2006 12:36 PM JAN !2 JAf+! 4. 20x7 3:13 P^4 JAN 4. 2007 3:33 P~1 2046 12:28 PM 5 . SENSOR OLiT ALARM . OCT 1 AUG 16. 2D06 4:36 FP1 PROHE O1![ JAF~ 4, 2007 3:45 PM JAN 12. 2006 11:41 HM JAN 4. 2007 3:2$ PM PROBE 4i~ 20D7 3:da PM 4 HUG 29, 2006 7:2e AM - _.- -- SENSOR F+LriRM ----- . JAN JAN 4, 2107 3;24 PM 6 12:20 PM HIGH WATER WARNING L 4:99 STF SUMF STP SUMP ,IAN 12. 200 JAN 4. 2067 3:36 PM SENSOR OUT ALHRM HIGH WATER yyARN1NG 3:36 PP'1 JAN 12. PODS 11:57 AM SAN 26, 2045 10:35 ~ . .JAN 4. 2007 3:18 PM JAN 4. 2DR7 2gt16 11:57 AM FUkL ALARM JfaN 12. 2605 10:34 AM SAN 4. 200? 3:05 L'M JAN 26, DgLiVBRY NE£DEP DT±C lb. 2006 5:5n PM SEN50R QUT ALHRM ' DELIVER`t NE1rD&p SAN 12. 2046 12:36 pM JAN 12. 2006 11:41 rdi T~OV 2B. 2006 8:3a PM 11:23 AM MAX PR4DUCT ALARM _ ~;T 15, 2006 046 12:76 PM :IflN ,sl• 2007 3:43 ~ --- --- -- SENSY~R ALARM -- OGT 1 • 2 JAN 1~. 2DD6 11:53 AM L 5:91 ANNULAR AX PR4PUCT AL+~ ANNULAR SPACE SENSOR vU A RI'I M 2007 3=0.3 ~ q ' LA T . JRN 2DD6 11:53 r~M LOW TE14P WARNIN M JAN 4. ?007 3: 1 ai Phl JRp 12• 2065 3:17 PM 3 ' AUG 29. 2pD6 7:30 A . ,~ [ 1 FUEL HLARM Jf1N 4. 200'7 :! : ~B FM LOW Tip WARfyiNG 206fi 12:21 PM - •- ~. _. T 4:PIttEMI IJM SENSOR OUT ALARM JAN 12. JAN 12. 20D5 t 1 :41 AM SETUP AATa WARNING SEP B. 2006 1 :29 P!1 HLGH WATER ALARM "' SENSOR HLARM ----- L 6:91 STp SUMP JAN 4, 2007 3:36 PM STP ~:f.M1F OVERFILL ALARM SEt~lS9R OUT ALARM .FAN 4. 2007 3:40 PM ~ JAN 4. 2007 3:18 PM HIUH PRODUCT ALARM FUEL ALARM JAN 4. 2pD7 3:43 PM JAN 4. 20C17 3;06 PM INVALID FUEL LEVEL ~ SENSOR OUT HLARM JAN 4, 2007 3:47 PM JAN 12. 2006 1]:4t AM JAN 4. 2007 3:3? PM PROBE OUT JAN JAN 4, 4. 2Q07 2007 3:47 3:31 PM FYi - ---'- S€NSOR FARM JAN 4, 2007 4:34 flM -~ ~ 1'UNLEAIjED --- HIQH WATER WARNING WC'I.LL $H1ITDOG.IN AL.M JAN 4. 2DG7 2 JAN 4, X007 3,46 PM :16 PM , 3A~ 4, 2~4~ 3.36 Phl ~ROw~ L I NE FA i L .IAN 4. 2007 2:16 PM C0~1TiI•I000S FUMY ALM ~ER~' ~yEEDED a~1 z7, zn46 9:24 PM p~~l ~ 4. 2407 3:31 P~ i : as PM k,M 2. 2006 Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 - 'Y W drk Order: 315 0 3 2 0 ---- SENSOR ALARM -- W :PREMIUM WPLLD SHUTAOWfV ALM .TAN 4. 2007 2'1'0 PM GROSti L I IVE FAIL. ' JAN 4. 2007 2:10 PM j CONTIN~OIlS PUMP ALM J1JL 27, 2005 t 0: O1 PM - -- S1=NSOR HLAR~7 ----- W 3:PL1~ WPL1.D SHUT1.i0L1N ALM JHN 4. 2007 2:19 F'M GRUBS 1_INir FAIL JAN 4. :007 2:19 PM CaNT! NUaUe PUMP At.F1 JUL 27, 2006 lO:QI F'M CIki;L£ K 6685 56D0 AUSUF~N ST BAK£RSFlELD cR,93306 S61-B71-7979 JAN 4. 2007 4:2! PM - SYSTl:M`L=THTU; >?E'1+ORT AL.L FUlyGT14NS NORMflL Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 ~ S :. 8501 N. MoPac Expressway, Suite 400 Austin, Texas 78759 Phone: (512) 451-6334 Fax: (512) 459-1459 BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES INSPECTOR STEVE UNDERWOOD 900 TRUXTUN AVE., STE. 210 BAKERSFIELD, CA. 93301 Test Date: 01 /12/2006 Order Number: 3144555 Date Printed and Mailed: 01/30/2006 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CIRCLE K 2708605, CO. 123 5600 AUBURN ST @FAIRFAX RD. BAKERSFIELD, CA. 93306 Testing performed: Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, Dawn Kohlmeyer Manager, Field Reporting ~~- TANKNOLOGY CERTIFICATE OF TESTING ~ ~n 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451-6334 FAX (512) 459-1459 PURPOSE: COMPLIANCE TEST RESULT SUMMARY REPORT TEST DATE: 01/12/06 WORK ORDER NUMBER: 3144555 CUSTOMER PO: 100537 CLIENT: CIRCLE K STORES SITE: CIRCLE K 2708605, CO. 123 495 E. RINCON, STE. 150 5600 AUBURN ST CORONA, CA 92879 @FAIRFAX RD. BAKERSFIELD, CA 93306 LORRAINE SOFFE SCOTT -MANAGER (951)270-5193 (661)871-7979 TEST TYPE: TLD-1 Prnrlnr_4 Pina Tinhtnass Tact Rasults IMPACT LINE LINE LINE DELIVERY TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL TYPE A B C D A B C D FUNCTIO_m lOk 1 UNLEADF3D DW FIBERG PRESSURE lOk 2 PLUS DW FIBERG PRESSURE lOk 3 PREMIUM DW FIBERG PRESSURE Line Leak LINE MANUFACTURER MODEL # SERIAL # ID lOk 1 WPLLD 101164 lOk 2 WPLLD 176093 lOk 3 WPLLD 100575 RESULT MANUFACTURER P P P MODEL # I SERIAL # RESUL New Replacement Line Leak Detester Test E LACED LE;41c DETE OR # R PLACED LEAK DET E R #2 LINE ID MANUFACTURER MODEL # SERIAL # RESULT `MANUFACTURER MODEL # SERIAL # RESUL ror owner aetauea repon mtormanon, visit www.tanKnoiogy.com ana select vn-Lme tcepotts-wtcvr, or contact your local tanirnoiogy orrice. Tester Name: STEVEN GALLARDO _~~ ' Technician Certification Number: Printed 01/30/2006 08:36 SBOWERS INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~ Tart TEST DATE:O1/12/06 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER9144555 CLIENT:CTRCLE K STORES AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CIRCLE K 2708605, CO. 123 TANK INFORMATION Tank ID: lOk i Tank manifolded: No Bottom to top fill in inches: 92.0 Product: UNLEADED Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overft{I protection: YES Fill pipe diameter in inches: 4. o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BAZANCE CP installed on: / / COMMENTS TANK'TEST RESULTS T~.:st Method;VacuTect LEAKbETECTORTESTRESULTS Tcst method LT-1 Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: ingress Detected: Water Bubble Ullage Model: wPLt,D Test time: S/N: ioiiea Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: NoT Resiliency cc: NoT VacuTect Probe Entry Point: T ESTED Test leak rate ml/m: is9. o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: a . 00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE TEST RESULTS Test type: TLD-1 ..LINE A d C D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): io0. o Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Fina{ gph: Resuit: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNKNOWN Printed 01/30/2006 08:36 INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~ Tanla~ology TEST DATE:O1/12/06 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3144555 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CIRCLE K 2708605, CO. 123 TANK: INFORMATION Tank ID: i0k 2 Tank manifolded: No Bottom to top fill in inches: 92 . o Product: PLUS Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9 , 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 345 Overspil{ protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS ,. TANK TEST RESULTS Test Method;vacuTect LEAK DETECTOR TEST RESULTS Tell method: LT- 1 Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: Ingress Detected: Water Bubble Ullage Model: wPLLD Test time: SAN: i~coes Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: rroT Resiliency cc: NOT VacuTect Probe Entry Point: T ESTED est leak rate ml/m: ia9. o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: s . 00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE TEST'RESULTS Test type: TLD-i LINE A B C D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTER TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNKNOWN Printed 01/30/2006 08:36 INDIVI-DUAL TANK INFORMATION AND TEST RESULTS ~i Tan/a~ology TEST DATE:01/12/06 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3144555 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CIRCLE K 2708605, CO. 123 TANK INFORMATION Tank ID: 1ok 3 Tank manifolded: No Bottom to top fill in inches: 92.0 Product: PREMIUrs Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, sib Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS Tr~~;f Method:vacuTect LEAK DETECTOR TEST RESULTS TFSt method: LT-1 Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced Dipped Product Levei: L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: Make: Ingress Detected: Water Bubble Ullage Model: wPLLD Test time: S/N: ioos~s Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: rroT NoT Resiliency cc: VacuTect Probe Entry Point: T ESTED Test leak rate ml/m: 1a9. o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: a . 00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE TEST RESULTS Test type: TLS-i LI~}~ A Q C D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNKNOWN Printed 01/30/2006 08:36 MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of Califomia Authority Cited: Chapter 6.7, Health and Safety Gode; 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 svstem 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 form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CIRCLE K 2708605, CO. 123 Site Address: 5600 AUBURN ST AX RD. Facility Contact Person: SCOTT -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: 1-87 Tank ID: 2-89 X In-Tank Gauging Probe. Model: MAG X In-Tank Gauging Probe. Model: MAG X Annular Space or Vault Sensor. Model: VR 409 Annular Space or Vault Sensor. Model: VR 409 X Piping Sump/Trench Sensor(s). Model: VR 208 Piping Sump/Trench Sensor(s). Model: VR 208 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: WPLLD X Electronic Line Leak Detector. Model: WPLLD Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER X Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Other (specify equipment type and model in Section E on page 2). Other (specity equipment type and model in Section E on page 2). TanklD: - TanklD: X In-Tank Gauging Probe. Model: MAG In-Tank Gauging Probe. Model: ~( Annular Space or Vault Sensor. Model: VR 409 Annular Space or Vault Sensor. Model: ~( Piping Sump/Trench Sensor(s). Model: VR 208 Piping SumplTrench 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: WPLLD Electronic Line Leak Detector. Model: X Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER 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). Ispenser 1/2 Dispenser ID: 3/4 X~ Dispenser Containment Sensor(s) Model: BEI 406 X Dispenser Containment Sensors} Model: BEI 406 Shear Valve(s). X 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): STEVEN GALLARDO Signature: Certification No.: 006-05-1226 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: 01/12/2006 City: BAKERSFIELD CA Zip: 93306 Contact Phone No: 871-7979 Date of Testing/Service: 01/12/2006 Work Order Number: 3144555 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 5600 AUBURN ST Date of Testing/Service: 01/12/2006 @FAIRFAX RD. D. Results of Testing/Servicing Software Version Installed: 16.02 Complete the following checklist: 0 Yes ^ No' Is the audible alarm operational? Q Yes ~ No • Is the visual alarm operational? 0 Yes No * Were all sensors visually inspected, functionally tested, and confirmed operational? Q 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) Q Sump/Trench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ^x Yes ^ No Yes ~ No " ~X N/A 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 waming 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? Yes" ~x 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. Yes' ~x 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. 0 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: VR light bulb (power) inoperable. Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: 5600 AUBURN ST Date of Testing/Service: 01 /12/2006 @FAIRFAX RD. 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: Q Yes ^No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Q 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 Yes ~ No * Were all probes reinstalled properly? ^x 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 • ^ NIA For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: x~ 3 g.p.h Q 0.1 g.p.h ~0.2 g.p.h x Yes ~ No * Were all LLDs confirmed operational and accurate within regulatory requirements? ^x Yes ~No • Was the testing apparatus properly calibrated? Yes ~ No • ~x NSA For mechanical LLDs, does the LLD restrict product flow if it detects a leak? 0 Yes ^No * ^ NSA For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes ^No' ^ NSA 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 * ^ NSA For electronic LLDs, have all accessible wiring connections been visually inspected? ves ^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 form dated 03/01 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS Tc?t9 olo~ry TEST DATE:ol/12/2006 CLIENT: CIRCLE R STORES 495 E. RINCON, STE. 150 CORONA CA 92879 LORRAINE SOFFE 951-270-5193 Tank Interstital Tests TANK PRODUCT MANUFACTURER RESULTS UNLEADED PLUS PREMIUM WORK ORDER NO.: 3144555 SITE: CIRCLE R 2708605, CO. 123 5600 AUBURN ST ®FAIRFAX RD. BARERSFIELD CA 93306 Piping Interstitat Tests LINE PRODUCT MANUFACTURER RESULTS Sump & Under-Dispenser Containment Tests Sump/ DISP.# MANUFACTURER P/F 87 OPW Pass 89 OPW Pass 91 OPW Pass Tanknology representative: BRIAN DERGE Services conducted by: STEVEN GALLARDO N _ N N to N ll m a (NO n. N a N a ~ = C N ~ ~ N tL ~ (h O ~ L N ~ O O O O N 7 ~f C u' ~ ~ r r M O ~ ~ ~ Q O` ~ ~ O O O Y J L U ~ o ~ > N - :~ j v a ~ H' J ~ a~ ~E ~°n ~°n ~°n ~ ~~ W I- W o H ~ ~-- ~ Z a`~i W ~ Z _ Q w ~ e M M M Z o ,... O L V 01 C J Q ~~ N N N Q ~ ~.. Z - Q ' ~ W `p ~ U U U N ~ y N N -~ ~ (0 a N a tD a ~ a~ O O O m 0 o # Y ~ oo m m rn m ~ y C U N ~ N W ~ a ~ ~ ~ ~ ~ ~ ~ ~ S1 v° v v ~ ~ ' _n ~ c o. ~ n ~ ~ U ~ 7Shcf~Qi0~0~/ 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:O1/12/06 WORK ORDER NUMBER3144555 CLIENT:CIRCLS K STORES SITE:CIRCLE R 2708605, CO. 123 COMMENTS Monitor Certification & Spill Bucket Testing. Monitor system passes, the weeder-root console light needs to be replaced, Wes Coulter notified. PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 01/30/2006 08:36 SBOWERS ITE DIAGRAM i Tanla~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: Olf 12 f 06 WORK ORDER NUMBER3144555 CLIENT:CIRCLS R STORES SITE: CIRCLE R 2708605, CO. 123 ~ DUMP- `~ STER C-STORE *ATGs in STP sumps ICE PROPAN ST .. 0 ST ~~ O V ST #~ CANOPY #3 Q ~O o FO ~ O V NTS~ O,~o~ O on #2 #4 ~A ~ C nopy *Dispensers contain W AIR/ 0 ^o $ beaudreau stand- S N H2O alone sensors . -~ Printed 01/30/2006 08:36 SBOWERS Work Order: 314 4 5 5 5 ~ ~~ ti~Bl!kN PRODI]i"1' I uuE ~ 'C 3:PRENIIUM _i~1}:~ktbF_t$LL ~~rt,.93306_. ' ~ THEftI`IitL t~~!:1'I'" :.LiI~~iU7G ~ ;•pa,DllC,T !;iPE 3 r+i il :J'!1 ?a7~i THNK~,UfHI•'IETER 52.0~~ '1`ii1:kF1H_~ :•::EFF ~ ,.OUQ70p: TANK" l??zU~ l LF. 4 YTw THNK IiT HIhETEt: ?'3 . i:~~ JAN 1:!. 2006 11 :u5 tll"I. 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'~iiii; t..: ;:;t:;,-~ r,~7 _R 0~ J,(' iIVrJUr'tL TEST FrtIL 4YS'1'l:f"1 Fla'I'I1RES: pE~; 1~. 05 + it L'hi r-tL19xM U I aABI:ED I>ER I (?n I i; "I N T'HNl{ TE6Tfj 1•"k 1 rJT~k LrFuR ANNUr'1L, IIV-T(tNK T.F'.~I':i pEC 1"1. 2CICi:,': '~:~ r•I': icY ~C•::' TE3T FAIL PLI;I.': ~ BATTERY IS bFF-. .+l.rtRF1 f~ISHBI:ED ,1.!S CIiiNUidi.&O.h'U i.`ONT JAN 1.• 1"'1'16 8:00 f'il"I a!I~1_L:L SYS Sfii.~UR I TY WARNING GF•GSS TEF~T Fr+1L 11.16 1:1:;rJUHLGiJ._c, •'=~~+'S Jl-1N. 5; 2006 '1:51 AM .. HI_ARM D I Sr,13LEL :'LOCK "I S I Ni:ORkECT I-!~;, 4 • 2005 l' l : 5:] AM r~NN TEST ra~lERfli;ING : nFE F'ER TEST HV)=Rrt:~iN~~ : OFF TRI7K. 7E~T i,~', if'i ~ OFF TIVK TtiT S1F"H`~h b8t •~c::<!FF UI:LI~JT.F.'!i 15F.1.r-t•r ~:i r~: Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Work Order: 314 4 5 5 5 -'..?K" `''.•~I•!'f','' F.'El'Uk'1` Al.riltiM NI:~I'GF.i' kF.r(1RT HI.hWM I{,I aT•JkY kET•^kT :N=['AN}: GLHRM - ••- - - i rV-TriN}: HLi 1RM ~12Ntii%k HI:AAM ------ - L .I IIVr•T'ryUEU .r'3UI"II' T 1 : LuV1 +F'r.IrF'• ~:'1'P aIJMP ~ETUF' PA'1'A Wriff 1~ 1 PU; H 1 C-i l hIHTCR RLA!~h'I ' l ' AM H [i'H Wf'iTl:r~ Fi LARM fii+h' '/. :2005. 7 J ~ C~; Jr .rHrJ ^ o : ^0175 LU - JriIV ?i.: 2[IU" 1 CJ': a2 ~I ' ' IIIP IiP,Tf~ ~!r,F"N;li; . .:} r?.VERFILL HI.HRM ' UVEht'LLI HI ARt"I f1I'rR ^ 201,5 .'a ~i ~,!': : "q05 .1 rl'I !'~k, '10 L'EG !7 : ,~.5 :.' S:S. PM E?r , . •TAN 26, 2605 l U : `iA Hrv, SETUP LHT!+'WFiRI•+I Id; DEG .'5,„. 200K 12:14 I~I~I nfi~Jl. PkuDUi:T ALF'1RM r1I'R 7, ~U05: 7 -r % ~i5 '~;_"-~ti-riRPI SCIL~ii)rid ;u .IHN '~'.6, 'BOGS 1D:.:It:; HM , MAY ~[':. ~nnd 5': 3i: HIS ] ~,'~•,,~'. [•; EuE[: LEVEL H1CH kK~L`u~~:' ~L.r.F.~! ' tii1G ~~ .-'1105. JiiN 2G, 2pU5" 2:!iF~ t1 :05 PIh i~M 11-c PFD '~5° 2005 12 rc,^. a- ?riii5 1l a8" 1'M _AM !]EC ~~. _f~G`. 1 L - JG r'!'l PRJ13E~ UI I'r "l'•!HC'IL' FIEL. LEVEL %i[I,fi 22. '21105 f1UG.'?" 200 '2:K6 1 z:5E' Pr1 PI.1 ' PFG 17.., ;:G05 1 ::id . ~i JAN 2E • 20L'~ . + 0 : C•• l Ni h ~ :~ .ti ~:. " ~. '* END rJ~~V %3 211Q5 5:55 a?M , n . IV{)'v b: cw5 ~ :'::? 1;'IW H Ic:M W:'~ l'ER `WARNI Ni; :'K~?BE DIIT 'JAN :'ri zCIU:~ 1 i I : ar HV"I . :1HId iiG, y':al~ l- a'9 ril°I JRM 'til. ?I]05 1`G:!1 rN•i JAN;:/ri 2UUG .1'C.Ci>ii =aI•I ;IAN ~ '.6. "~00!i 1 ^::~4~ ~ rR1"I. HI.ARI°I HIfiTORY kE1;URT ~:ri,~5 HA;H WF:TFR i,Lr+F:': JAN 26: 1UU5 r6:'s~•:~'•: iri'ERF I L.L .FILEIRI`9:: JAN 26.` ~C1U5 1 U C 5;i rr•1 FI~_,H F'RGDUCT 'ALr?jRl°I .ItiN :!o:' ;:IIIIti 11.!:12 AM Jr+ri~Zc. ~c~.~~ ~a :oq r~rl ~ROIsE GUT .JAN ?tr. 2UC15 1 1 :}~ir , I^ JrtIV 2t. ,2005 1G:3; rl~l H1Cdli WATL:1;° WA1;NING JAN '?E • .2005 ~1~0 :35 AM. '~ ~~ - rt ~ r:YL at .S 1t iE +~;H~r~i rii.^,T<~RY 1?J:EnkT L-:~ :rarJNUl:iar. 37• - . HNNUI.AR °I'faGF. FUF l' " FT,i,,k: }:"„ HPR: 7, 2!]b5 T ; 03 I'I'1 .°~)=••J•pty-: ~.i.~'i ~i WHRNI Nla hPR ;9, 2GQ5 'Ia 17 fllh SEFi.S~k r};Jr HL.ARM :1r~N gib, 2005 1fY:S5 i,l~! x ~ ~ s ENU ~ ~, < . ALHRIN .R]:;i.JF f?EJ;;?rT -- E'y iii •NLrucM ----- r.lJl: .: k. '3Pril:E. °E';F• `~•riTr1 tdRRNi'Nu ~T k ` J r ii',i`I.y `'r 1: 1 1 1 FP7 :UF' C~~91'ra.r6~l~iRN1.NG; ~E;R, `!. 2005- '7,Ca2 AM S!~TUF,'.1_iRT~ l . Wf1RN L Nr ~:.E•n ~'z. ~2bb5" ~i.:a~1 Hrr ` STP Sl1N1F ~GG5 11:x6 AM GHTA Wr:tRIVIIVG. . :~ I lU5 11:37 AM DHTIt WF+RiV I NG '005 9:36 i tl~l Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Work Order: 3144555 eF<:~T: ~k•i1+Fl?I.riR At•;Tr," t•Jhk ~ ~ CND GUti~ .. ~'. rtpl UrTA MIARPJ] IJf: 200r 7:17" rl°I ~ ENC~ x .,. ! ..'X' H 1 S?CtRY REPORT 3EIVSOR ALHRf•1 ;---~•_ EITP "SUMP: HF I .t•1R1.1 ~~20D5 2;.33 ~)/1~1 I.r"tRM , " 205 1D:47 rtl9 1,f31v M 2DfJ5 12 ~ ~+6. rrll + * .;EPJD .* .* .* .* .* i7?gFC:k1: hL'F't:kT LEr1DEQ UOUS PIIh16' HLM . ?DDb a:37 AM rOMM ALA1~•1 c.:>:~~: 1::.~'3 PI°I HI5'1'URY RT:PC>kT $EN: ~CtRriL:r'iA.l°I .•.--,--.- Lr91 UI~'I >ur t iih1F• r;Lri 2llili~ 4:38 HNI UOUS PUMP :~?LI~I ,~u~~ FUtti- ~~i,rM1 ~Ullti 9c;32 1;1°I •~~i.;T~:Ri REFEIRT a[,:•I~..•k faG~ikM :7 CUr1r~ k:..Ki.::: i, 20D5 :2:,63 itl7 *..,~..ENLi ~"'~'•* "~. F: 86Ub' G6uh?N.. l-. y. EM; :Tt:iTUS REPORT - FIIN%TIUNS NOP.f1Af. 75 Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Vdork Order: 3144 5 5 5 ClAt:Ll. "1:. rtF.U5 hi~.lu? FIIF11ikN `h.;T 2~};Ek~FlFi.tt C~ft:y33Ub SYSTEhI"ti`l'rl'llk. b:L'1-`tai'l' i1LL- FUNr T<[!!NR NC;T,M~;T: IN_'fANK ~'-,I;TI1P_ I-r't illaS`I r itS',. i' THEkP1f~iL COE1=F :. f): ~ :~_ TFiN} DFHI~IETE12 `J2.uu T~YK :PRt}FII.E :" 4 k-`.`I':i : `:~L F" L ! 9514 , t9:0 1.ITGH 'vO1. S!fl`ill 46:0 I"NrH VaL :-y:-r 23.0 d NCH V(?L 'i $9$ FLi;~[iT S1~E: :<; :'1 . t)•1'~~F, WATER WNRNIIV' ~ 2,-!~ f.l'ltafl"ItiATL'1: L1MIT: &:G i'IF;:' "ti,i< `,"r+E~: vnf::: '11IIb OV)rkF1 li. LI i~11- 9i~ •a~'3a HIi;W I''kGuUf:T -+3E5 DEL"I VEkY .L~I Irl I,T I ~ • 98! La:i ;r ~',r:w:T' hl IL1 ~ULUE[a L ~:, ;~,'`I[";': Sri °1`ANl{='1'11.1: 3:48 P9N N i"i~ ULA f:]) . 'l'r~ IJi' ~ . T'tt~: ~NnNP,..,. II:Ah:`.M1N~)?F`h'~Itilil'c: a.fl~ • 4[~I I:f:aF: P11.N HNNIIFiI. IL1/o ,.. 9H1 C,Il1l,CK f-;NtdUFiL T1 >f ~ ni:_ HLf rl - : 3~tdLEL~ ,Yll?IULIr lia' 1'r;li ALAkh1 I~ l ~~~:..... GRORS" TE',~ 1' t'A 11. HLARM Li.S'r,BLEI• ANiv :TEST r~11f:F!H~aiNi:: C•FF Ff!F:. TE.::~i' Ai1ERAGING: .UfI' T~:I.1; rC ~T NOT t F1' : 4F°F 'r!~i; ;;_-' - I'~aN 2F,Ei 1K : tiFF T ?:RLU:: '1'I1G'F.'h~r-L aa~l ,u6aG?0 TF;hI:' I .~:;ETHR ga'.f1U .FULL a1JL : 'a[it6 b t .I"N~; i i `JOL 2058 =t:: iJ [NCH VQI, 4y'j _3.t7 "TIW~H VUL. tA9R f'I c)rt`1' ShZE: ~L.I,I, [N. '2496 WHTEF; WAhNING ~.0 HIuH uIgTER` LIM1T; 3.:u MAX' vR.'LA1;I:L.,CltR.t 9ts1b Ct1ERFi1:1..,."LIhIIT 90%: . 11834 HIGH 1:'•Rt)LU~T 951 43::~ l ~Fa, I GERY L l hI I!I' i L^.!Y: • 981 LC;hI.FRODU~:~T 5UU LZ~rt}i;t;YLt'ikrl`1:aHl'I': `)9 ~riAPF;N,iLO$~ LII~•1I-T: 50 TetNK."TIL`t" ~.3:e0 7R.: ~ j~r'N~;. i.E~ai: :liiv.;peR[~?TiiC'; 10%: ~~i l.J:c,l: :IIi•~ ~riNNLI!iL,. ~ !t~ o '3~l i FEP] :L `"TE'~T:TYPE i~L1Ii',K. ALARM 1) i SARI:EI1' i.•1•:F:li',[r[i; TI~I~T"Pt'iIL ' " -AL/~RM LiISA13L>rli GV~~1:;:i '1'EkfT FFiLL HT.HF.M A I SAEI:EA PER TE~T t~:`.i:n~~rld~~2 t)FF '~~~::-[k.',T .NOTIFY: U1=1= TNK TST`~IPHGIV 13k13i1Y.:4FF T)I:f,. I ilJrJ:)' I!1-:LAS' z i'I I N SGF`PWAIQI:,,RE1i1SI<?N LEVEI. Vr:r.~tnN l e:; l);~. !'kE,:EC' - :98,Ov.14.13.U~T s-hI~DULF# 330160-060•A SYSTEI I Fr h'1'Ukl?S ht:rvu~iL [ N -THNK TErriTS C iLJ) 0:ifl Mf:aNUALtku,:~rl r.ONT. LIPLLl) t '~ .~ , rkEel I Ur! . ':'r.WF: D[ACIETER 9~.I)0 7i•,1;i: .`Rt:it-' [ LE d F>TS. F'~LL VC?L 9816 Ar~,.i r ; hb-.n ~i~L . Jay"~ 23.0 [ I'~ !- . •~;.;;1. l 8a?3 FI.Ot-1T ar I ZE : 4 :; 0 i lv LJHTER WtiRNINC. H IuH . iJATER`: T : iD1 T ~l' , :,~ r alaEi. vol..: ;HIGH F'kt)L'iU~=7: 'D£I.IVERY::J.IMIT ~~ ~: I;RO.~UCT 'I'HIJK~ TII:7` n1AN{1'UiDFi(l "l'riN1CS ;:a :' r`it?NE $w4b 2.0. :l.II 9816 90% P.N:7J 9 ~~. fi ~`~ 10'x, 9ki1 500 S9 5U s.:~ .LEAK M1N PEkl~~l'+1~~: 3::°. yf~l l.k'Ah:h'-1~hfV.ANNUAL 1!J~4 '1f31. L'EkItiLlf: iF~t i:Fl-. :atlii'K HNNUAL TEST FhIL _ '' F~I:HRM `17 I :1n1-r1.EL PSRIOLIC TEST FATI. AI.F3RI'I 1:i I:~FiB1.E11 .R.•w' Ti~f3r FAII; Hl.iih'G'1 ll I SA13L.EL' hiJl~ Tear. rt1/ERFIGING: Ul'1' FEI•'.' '1' i' .yVEf•:Aii[NG: OEF THIVK ?E°`F v~F:i"rt' ~ :rFF ,TIV} TS7 ''_,.,~'ry 6REr.iF:=OFF lll?LIVEk: J,i:::r': 2 f'!TN =1 ".-R~ ! ,ti [,`-;TgR`'i RF.PC~RT `--- SYC l'FT1' HLHRM ...- --- i-'~k'•f,ld tiuT aftN 12, ?[uiG 1 1 : i 1 AM !'kl NTEF.:ERRbR .JAN- 1 cLUE _ ~ l ! til`I BHT''cP :S;:i~FF• J.~rJ 1 :•. "I^39e S:OI~ Jihl ~3 ~E~•URiTY WARNING :'t.11t:N I5 IIV~ ORRE!T Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Work Order: 3144555 T.N>,'fANK kLr;RIN •-••--••. i l : ~,r~l.li;tl,ci•. HlC;H ~+';TER -ALARM JiiIV '6., wu ',,'s;'i~! Ahl •:n/FRFILL .ALARM ftla`. 30. 10[15 1 ~2ti "rt ISEC ?7. ?rn ih 12:18 f'1~1 :71IfiDEiV LGBS 11Lf~Fa-, MHY ~. 2004 ~ '3:32 F•iY'I H1GFI F•kJl+11>T ,.;Li,i~:': JAN'l2. X006 11::53;HI•I i:F : .c~! . .:005 '13 ~ 15 EM!. 1~1.+t CC~'~UEL LEVEi, JNIV 1: ..wit :18 r•r'I -1:lEC "17> ~uOF 12: S6 I r~ N4!! a.a: 2005 a .5E{ ` E?r1 Y>tobi: v;T .IAN ~"1"~': 1006- .1"2 rr^,fl" Yf~l -'rti l''~-~-- UL16 kl:'?9~'At1. JAN ~G• ?IJG~- 1 ):::1:$ -?hl'. NIGH l•IATFR WrARNING JAN ~ E.. 'jUU5 1"G: 3~i ~!~! L?r.'LIVERY N1=EiiEI; ;'•AN 1•:~. 't106 1:,1.8 PI~1 I"lfd% F'ki,In,iT. riLhf~hl JAN 12. ~UU6 1`l °: l,3 i-t1~i :?r'T 1: i r '•'CJ05 ,`3 : i 7 F'M JHN. 7 2. ~O~Jc 1 ~ :.: P'"I .+L+~kr•I ,I[:'fl::?k': RE}?URT L 1:HNN,ULHR 8'7 ANNULHh' Shpt'1: SertSC+T2 ,BUT iiLr1RM J1,1: ; ? ''3Qp6 1 Y':7 ~11 HM 1~uEL AI:F;RM JAN l?. 2lJfir, i 1 t 32'' AIh FLEL iy1,~iRr'I Al •HRh h1 ~ :.ti,~., 4•:Ef. SAT 'I ~ : PI:Ufi HIGH W(~TER AI_HRM , ,1nIY. i ~; `,',l'•:it... 1' 1 : 5? AM JAN ~r!ir. '?D0~ 1fj::i5• r-11•i OVEKF 11,;1 • H]:HTtI'1' J,~pl 1;~?,: 2005 l 1 50 AM JHN r.'b, 2[1!15 1 U ~ 5"~; .r;:'1 HIGH !•'RvliU~J7 r•,1.r,Kl', JAN sri.. CUl7~: Y`uS'~'n' y~l -FNVHI.I D F uEI_ ii>~'EL •IWN i`3: GOOF ~ 1 ~ ~ 36 PM JriR i;~ ~u~5 "1 ; ~u taal FROHI"'OUT ~ F.NI. ~t7AN -t 2~: - "','mot ~, ~ ~! JAN t 2, 2006. 1 1 .29" "ql'I ~tily ::e..'.QJ` 1.1 .~3U AM n3~.ji 4wtTEt~;I.;IiiRNtIVG JFtN 12. 20Ut l 1 , 57 rii SA^l`2E+. `_'UD5 1q:,:Jh all' I,I:I•I'+rEfcr iV~,l:i%£L ,IAN `1'~2. 211[]6 1.2~:~JF, Frl"I hiHX PRtSI~IIt:T rtl:ARl~I r~l:fiRM 11;.'nk~,: F:EI?::T --- I N• Tt'tIU1{ r+l:raRM r.-- T -'":FFu'•TfUrl HIGH . hIHTE_,R N1 A}?1*I Jr',N 16,. 5~C105 1'0:"~1:~ AM JtiN l e. ;.:'n06 11- ~1~1 •AIw JAN'.26..2005 rU[R4.iJr rl`! GH'FROI)Ui:T ~ QIARM .IAN-"1?": ~UDE "1 ~°r ;`ii-1' JaJ,i ?r.'. 2ut~b 1u~:36.FirT. I'NVAI:11? ~F~UEL-l~E~JEL aUG 2'~. ;_001a . 2: hrj PI°i. Jf,N. 2f;: 2n05 11 :1;4 f;rf FRt)Elk .:OU'T' JAN .1 ~ : .'OG6 ~]_;<:-1 is t,r;; Jri~ ~•'-' 'Oue 11-:'ll ANI AUl,• 22. 2005 ?'S6 PM al~~r~ .d~;Tl;k Wf-jRNINi:; JAN 1.2: Qu06 ] 1 :57 AM JAN 'tiE: ;~'L'•L~r .iJ: il:: N('I J:aN t',',, 2UL1F, 1^_,: 15 b'M MAY PPC•c:l,,; T . H[.aRrj JHN 12. b'11D6 11:5:1 AM HI.HF?~1 'lIIt3T~1R'r . REPURI' JNW 3.'~". `~_1]Je.`l-1:41 fil•I FU1=i •-r+L•~lkhl J2!It C?: 3006 11:33 AM KT IF fu-iT~ WraRNI"NG, Fi~£ ~?; .'2005 11:'51 AM M~ M .M 'k:.f ~ EVIL ; ,~, ir„ ?G dE' 3G,, t.Li'Rr•I N:8TJR1' REPCIR7 Ft I V lil i.iL n i~':~ F`ide' F: . ~>=IV_:~ w 'cur „LftRlrl . .'.Hj'J"~S:f~. "?UUti l~l~~:~ll -:era FUEL nLr{t~Fl ... JAN' 1 ~7~~0 l L::3~ HNI . i< ie X ~i< .* .END iF<:,ii; K` w H i~1.ARM H 1 ~~ 1't:j2`,' kEF~~k'I °•• -•- SEN:a?l+ ALARM .----- L ~4,F~q >3T1'~~UIhI srE• :.u Ir1t~ SEN&t~R -OUT rlLikl°I ..Ii;N 1'2. ;'IIUL 11:41 .AM :1tiN i'~. ?ck:o 11:35 fil°I r~tU~ ::3. 2005 11 :46 "AM e' ~ Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Work Order: 3144555 ALHkt~1 rtl:~ri,h^,' F:E'P~:F..: HI.AI.P9 IIL$TflRY kF.T'~~F'7i nLr';RIH H1:::; _-.-. 1eE{:?$'I' _.. ._ ;;EtvSOk HLAJ~I~t ---~-- ----•• ~l;rd~3flR ALARM --~--- L -5:91 .APdr,111LA1e !•i t :UNLEAphat FNNIII,HIv SPACE t<~F-LL_• :-~>•IUTD?WN ALM aEIVFtflR OUT ALARM JAM 12 +;~Zr l?~ ~4 F'1'I JAN 1 E. 200b 1'1 : al r;l'1 GRtJ i:a 1.1 NE FA i 1: FUEi_ :r~LARNI JAN 12. 2006 12:14 F'I'1 •~~:. l'. 2006 ft": 36 .AM AriT_TNI:ICIUS PUMP AT.r1 . SE7Wi' ':Ji1iH :~h;RN[NG r,iCl ~~ ~OOb a:37 AM HFR 7<. %uuF ~ ! i ~t l Art - i.,! 's:F'LiJS 4JPLLD SFIUTDOWIY f1LM .ii~N 12. 2(106. 11;:1'] FM GROSS LINE FAIL. JAN '12. ' 2.OG6 i 2: 3: F~-~f f.'flNT.IhIU~•i~•~ F'r~rlt:.ALhI,. Jttla ° ~ci~~r' 4:38 ~al~l .. a;" ~ * ':~" FNJ)' * x. x K * * x * tc * EIVD * * ~t ALAF:r'I H1Srl'i)kY REPORT ~ r. ;' E F t7b05 Hl.riklt rii;""a4'C" REFC'RT ~EC'C~ n d 'F,'N ;t'. EI•lii>R nL~r%h'• - -~ RHKEF'~]• c.:. , ij.:`.i;3JUb- ----- SEIVSGR ALAF.P1 •---. lal 2F'4EIn1UI~1 661-8r1 iti7y L b : 91 . iTF : iL1htP b1FtL1.D SHUTDOIdN ' ALM ' ~T ' 3UME' *,.i„t .l?. ^006 1.?^O8, F'i't Jri1v 1 < '. GUUb ] : Yl: Ei1 .1HIV 1;e. cisc i'::~i 'AI~I (:ROSS lillVl; Fr.i1. . `FUEL .fila~tF!I~I JAN 12. 2006 "12:OR Yr1 ~': e`i 37'rtTl L; TP.Pt)RT JAN 1'e': ~'UI If, 1'1 ; 37 irt•! r;t1NT1IVUG1IS FRUMP AI:M .JkN ~.'-.01]6 ~:UB At~1 .:LI: FIINCT-IONS NORt"IAL FUEL NLAFtht HUG'25: ~UU5 2:3s PM '~~ Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 ~ q, Work Order: 314 4 5 5 5 Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 - /~ , . 8501 N. MoPac Expressway, Suite 400 Austin, Texas 78759 Phone: (512)451-6334 Fax: (512) 459-1459 Date Printed and Mailed: 02/41/2005 KERN CTY - ENVIROMENTAL HEALTH 2700 M STREET SUITE 300 BAKERSFIELa, CA. 93301 Test Date: 01 /26/2005 Order Number: 3138488 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CIRCLE K 2708605, CO. 123 5600 AUBURN ST @FAIRFAX RD. BAKERSFIELD, CA. 93306 Testing performed: Leak detector tests . Monitor Certification Secondary Containment-Spill Container Sincerely, Dawn Kohlmeyer 0 Manager, Field Reporting Tar~la~ology PURPOSE: COMPLIANCE TEST DATE: 01126/05 CLIENT: CIRCLE K STORES 495 E. RINCON, STE. 150 CORONA, CA 92879 MICHELLE WILSON (909)270-5193 CUSTOMER PO: 1001,79 SITE: CIRCLE K 2708605, CO. 123 5600 AUBURN ST @FAIRFAX RD. BAKER5FIELD, CA 93306 SCOTT-MANAGER (68171-7979 Prnrl~~r* Pina Tinh4nacc Tac* Rac~~14c TEST TYPE: TLD-1 fMPACT LINE LINE LINE DELIVERY TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL TYPE A B C D A B C D FUNCTIO T:1 1 DNLEADED DW FIBERG PRESSIIRE T:2 2 PLIIS DW FIBERG PRESSIIRE T:3 3 PREMIIIM DW FIBERG PRESSIIRE Fxic4inn I ina I aa~ Ila+artnr Tae4 EXISTING LEAK DETECTOR #1 EXIST ING LEAK DETECT01~ #2 LINE ID MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESULT T:1 1 VEEDERROOT WPLLD 101164 P - T:2 2 VEEDERROOT WPLLD 176093 P T:3 3 VEEDERROOT WPLLD 100575 P Npw Rpnlar_pmant I ina I pak I~a4pr_4nr Tpc+ Rt"P LA EDLEAK DETE T 1 PL ED Lt"A ET R #2 LINE MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESUL ID ror owner detatled report miormatlon, visa www.tanknology.com and select Un-Lme Keports-WKAY, or contact your local lanknology otiice. Tester Name: DAVID LASKY _`'~d~c~f _ d_ Technician Certification Number:ggg TANKNOLOGY CERTIFICATE OF TESTING 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451-6334 FAX (512) 459-1459 TEST RESULT SUMMARY REPORT WORK ORDER NUMBER: 3138488 Printed 02/01/2005 08:31 SBOWERS _ ~ INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~ Tan TEST DATE:O1/26/05 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3138988 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CIRCLE R 2708605, CO. 123 TANK INFORMATION Tank ID: T: i i Tank manifolded: No Bottom to top fill in inches: 92 . o Product: UNLEADED Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9 , 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: DW FIHERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: / / COMMENTS ' TANK TEST RESULTS Test Method: VacuTect LEAK DETECTOR TEST RESULTS Test rnc;thod: FTA Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: , Probe Water Level: Make: vEEnERROOx Ingress Detected: Water Bubble Ullage Model: wPnLD Test time: SlN: ~ ioiie+ Open time in sec: Inclinometer reading: j ; Holding psi: 20 VacuTect Test Type: NOT ~ NoT Resiliency cc: VacuTect Probe Entry Point: TESTED Test leak rate ml/m: ls9.o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: 3 . o0 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE TESTRESULTS Test type: TLD-i LINE A B C D Material: Dw FIHERG Diameter (in): 2.0 Length (ft): 100.0 Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: UNxxowrr Printed 02/01/2005 08:31 . INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~ Tan ' TEST DATE:O1/26/05 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3138488 CLIENT:CIRCLS K STORBS AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CIRCLE K 2708605, CO. 123 TANK INFORMATIQN Tank ID: T: 2 2 Tank manifolded: No Bottom to top fill in inches: 92. o Product: PLUS Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: s, s16 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FFBERG Installed: ATG Stage II vapor recovery: ASSIST CP installed on: / / COMMENTS TANK TEST RESULTS Test Method: VacuTec t .. LEAK DETECTOR TEST RESULTS Test method: FTA Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: vEEnsRROOT Ingress Detected: Water Bubble Ullage Model: WPLLD Test time: S/N: i~co9a Open time in sec: Inclinometer reading: Holding psi: i9 VacuTect Test Type: NoT Resiliency cc: NoT TESTED VacuTect Probe Entry Point: lest leak rate mllm: ia9. o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: a.oo Water table depth in inches: Results: Pass Determined by (method): Result: COMMENTS COMMENTS LINE TEST RESULTS Test type: TLn- i LINE A B C D Material: Dw FIBERG Diameter (in}: 2 . o Length (ft): 100. o Test psi: Bleedback cc: Test time (min}: NOT NOT NOT NOT Start tlme: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURs Pump make: RED JACKET COMMENTS Impact Valves Operational:. vNKxowN Printed 02/01/2005 08:31 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tan TEST DATE:O1/26/05 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3138488 CLIENT:CIRCLE K STORES AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CIRCLS K 2708605, CO. 123 TANK INFORMATION Tank ID: T: 3 3 Tank manifolded: No Bottom to top fill in inches: 92. o .Product: PREMIUM Vent manifolded: YES Bottom to grade in inches: Capacity in gallons: 9 , 816 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 92 . oo Overfill protection: YES Fill pipe diameter in inches: 4.0' Length in inches: 345 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II Vapor recovery: ASSIST CP installed on: / / COMMENTS TANK TEST RESULTS Test Method: vacuTec t LEAK!DETECTOR TEST RESULTS Test method: FTA mak Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced Dipped Product Level: L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: Make: vESnsxxooT Ingress Detected: water Bubble U41age Model: wPLLn Test time: S/N: ioos~s Open time in sec: Inclinometer reading: Holding psi: 21 VacuTect Test Type: NOT xoT Resiliency cc: VacuTect Probe Entry. Point: TESTED Test leak rate ml/m: ls9.o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: a . 00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LINE TEST'RESULTS Test type: TLS-i LINE A B C D Material: Dw FIBERG Diameter (in}: 2.0 Length (ft}: l0 0.0 Test psi: Bleedback cc: TESL time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: RED JACKET COMMENTS Impact Valves Operational: IINKNOWN Printed 02/01/2005 08:31 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS 1 u'~ Tanknology TEST DATE:ol/26/2005 CLIENT: CIRCLE R STORES 495 S. RINCON, STS. 150 CORONA CA 92879 MICHELLE WILSON 909-270-5193 Tank Interstital Tests TANK PRODUCT MANUFACTURER RESULTS __ - UNLEADED PLUS PREMIUM WORK ORDER NO.: 31384sa SITE: CIRCLE R 2708605, CO. 123 5600 AUBURN ST ®FAIRFAX RD. BARSRSFISLD CA 93306 Piping Interstital Tests LINE PRODUCT MANUFACTURER RESULTS Sumn &Under-Dispenser Containment Tests Sump/ DISP.# MANUFACTURER P!F 87 FILL OPW Pass 89 FILL OPW Pass 91 FILL OPW Pass Tanknology representative: JERRY BELLOLI Services conducted by: DAVID LASKY t a 'C_ t~ r'Y~'j t,~'~ N - N N N N lL 1O a f0 a R a c0 a c ~ LL .T ~ v ~ O W v L m E 0 rn O rn O rn N M W 1-' O O O O N O N N Q ~` ~ m~ 0 O O w ~ J U ~ ~ o ~_° ~ ~C v ~ a J N J ~ 0 E w o 0 0 ~ ~ F N W W ~ H H ~ Z W ~ Z Q L O-~ M f7 M Z 00 .... V ~ C NN I L ~ L Q _ ~^ ~ v w ~ Z E z _ ~ o U W J w ~/~ ~/~ p~ U U U W ~ 0 (NO N N -~ . ., ~ ~ a a na ~ 0 z J Q d ~ a a ~ O d O O O ~ ~ w ~ ~ 0 w fl. O N_ O ~ J J iy Q' O # _ LL _ LL _ lt_ W a Y C ~ W _ 01 (n ~ (A W W ~ ~ J d C C . C . ~ Q ~ m ~ N m ~ V U U w ~ ~ - - ~ 'a 'n 'n E ~ ~ ~ U MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of Califomia Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, Califomia Code of Regulations This fond 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 form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CIRCLE K 2708605, CO. 123 Site Address: 5600 AUBURN ST City: BAKERSFIELD CA Zip: 93306 Contact Phorie No: 871-7979 @FAIRFAX RD. Date of Testing/Service: 01/26/2005 Facility Contact Person: SCOTT -MANAGER Make/Model of Monitoring System: VR TLS 350 Work Order Number: 3138488 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced Tank ID: T1:87 Tank ID: T2: 89 X In-Tank Gauging Probe. Model: MAG 1 X In-Tank Gauging Probe. Model: MAG 1 X Annular Space or Vault Sensor. Model: 409 Annular Space or Vault Sensor. Model: 409 ~( Piping Sumprrrench Sensor(s). Model: 208 Piping Sump/Trench Sensor(s). Model: 208 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: W PLLD # 011164 X Electronic Line Leak Detector. Model: W PLLD #176093 Tank Overfill/High-Level Sensor. Model: FLAPPER/ATG X Tank OverfilUHigh-Level Sensor. Model: FLAPPER/ATG Other (specify equipment type and model in Section E on page 2). Others i e ui ment ( pec fy q p type and model in Section E on page 2). Tank ID: Tank ID: X In-Tank Gauging Probe. Model: MAG 1 In-Tank Gauging Probe. Modet: X Annular Space or Vault Sensor. Model: 409 Annular Space or Vault Sensor. Model: )( Piping Sump/Trench Sensor(s). Model: 2p8 Piping SumplTrench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: ' X Electronic Line Leak Detector. Model: W PLLD# 100575 Electronic Line Leak Detector. Model: X Tank Overfill/High-Level Sensor. Model: FLAPPER/ATG Tank WerfilUHigh-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). ispenser 1/2 Dispenser ID: 3/4 X^ Dispenser Containment Sensor(s) Model: BEI 406 X Dispenser Containment Sensor(s) Model: BEI 406 X^ Shear Valve(s). X 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 X^ Alarm history report Technician Name (print): DAVID LASKY Certification No.: 8766 ~~ Signature: ~~~x~~~~;J License. No.: Testing Company Name: Tanknology Phone No.: (800) 800-4633 Site Address: 8900 Shoal Creek, Bldg. 200 Austin, TX 78757 Date of Testing/Servicing: 01/26/2005 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 5600 AUBURN ST Date of Testing/Service: 01 /26/2005 @FAIRFAX RD. D. Results of Testing/Servicing Software Version Installed:. 16.02 Complete the following checklist: Q Yes No • Is the audible alarm operational? Yes No ` Is the visual alarm operational? 0 Yes No • Were all sensors visually inspected, functionally tested, and confirmed operational? ^X 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? 0 Yes ^ No • ^ NIA For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment i i t t l k f il i l t i ll t h i iti d t t di d? If hi iti t mon tor ng sys em ea , o operate, or y sconnec sensors n ve e ec s a a s s e ec r ca e yes: w c a e pos shut-down? (check all that apply) ^x Sump/Trench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to teaks and sensor failure/disconnection? ^X Yes ^ No ^ Yes ^ No ' ^x NIA For tank systems that utilize the monitoring system as the primary tank overfill warning 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? FLAPPER Rio 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 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; x^ 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. 0 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: Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: ~~nn ni IL2l IRnI cT Date of Testing/Service: 01 /26/2005 @FAIRFAX RD. 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: Q Yes ^ No ~ Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Q Yes ~No • Were all tank gauging probes visually inspected for damage and residue buildup? Yes ~No' Was accuracy of system product level readings tested? OYes ~ No • Was accuracy of system water level readings tested? ^x Yes Q No • Were all probes reinstalled properly? Q 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: a Yes ^ No • ^ NIA For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: 0 3 g.p.h ~ 0.1 g.p.h []0.2 g.p.h x Yes ^ No ` Were all LLDs confirmed operational and accurate within regulatory requirements? ^x Yes ^ No • Was the testing apparatus properly calibrated? Yes ^ No ' ~ N/q 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? ^x Yes ^No' ^ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? ^x 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: REPLACED V/R POWER INDICATOR LIGHT BULB. Page 3 of 3 Based on CA form dated 03/01 ~ Td17~Q10~~~/ 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:O1/26/05 WORK ORDER NUMBER3138488 CLIENT:CIRCLE R STORES SITE:CIRCLE R 2708605, CO. 123 COMMENTS Monitor Certification & Spill Bucket Testing. The 87 interstitial has no pull string, it does have a fish tape pushing the sensor into place, it also has a tube down the other side for what appears to serve as away to pump out the interstitial. We were able to certify the sensor, however, we. need to let Circle K know of this and give them the option to have it repaired. Certified system, buckets, changed password aad replaced indicator light bulb. Parts billed on WO # 3138612 PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 02/01/2005 08:31 SBOWERS ITE DIAGRAM . ~~ 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 01/26/05 CLIENT:CIRCLE R STORES WORK ORDER NUMBER3138488 SITE: CIRCLS R 2708605, CO. 123 C-STORE #3 #4 #1 #2 vents STP ~ on canopy STP O ~~~ STP O OV ^o~F- 0 o~o~ 0 Printed 02/01/2005 08:31 SBOW ERS Work Order: 313 8 4 8 8 Circle"K Gompli;nce'Precisiort And-Stage II Testing RFP ,Attachnrtent F•t UST FAC-L~TYlNSPECTIDN/AUDIT SHEET 1=8rility:y~ fGl.e 1 ~ ~ Facilay ;~ ? 7"Q $ ~ ~ ~ Test. Date: Jr3(~~JSr ', Gounty . ~~',f a~~`ve~~~ Cross Street: ~iLt Work #; ~~ ~` Ctsi.. r:..... ~..-_ •- _ IN o No} Prrxonl or UUuuevcd IG =,6atlsfarlnry 'l1 _ tlnaatisfnctory. Fill Cover: J=1EI Cap: rJ .Fill Cap•Sesl:"s Drop Tube: s Strike Plate: ~ WR Cover•S: ,V/R Cap'S: V/R Seol: V/R Q "ry Break: S Sub Parnp: a~~.~. Suh Putrip Saver: gvoifi11:5. Overf;IhMfgr: Q ~ • _ Ceexiaf P.~ Prascure : F n Flex _ Dual" A = Anr,~Ia QhAck ; M: e; Mcrvliic _'1Ja-Stage I: 'V"_ Vertical Chack' FIIlType ;Q~, Product"Line Type: `~ Tank`SvrlnpJointType:: ~. -Pt - Nol Rresen4 s ."satisfa:tury U c UnrafigfM:tnfy Impact Valve; "7 Vertl"cel Check Velve;:~> FilfNaprar SpiJ1, Buckets: S FIII.SpiU fjlffgr:-~:~' Fill Sufnp~~Present. [~ D Ispenser .Conte inmeM 3 Colnmertta: ~.U~ ~~e .. Ui~ ":g Q)^+~ ~~•~ . IQ Dlsp.~'• Hoses Regular: .Plus: " Premlurn c.t~ Diesel: `~ "Kerosene:. •CotltJ ~ of Gas Nozzles Stage II b =.Balance A"_ Aalsf' System Type; f~!! Asist.Nlfgr:~7ll' .GIr.CV LiQuld Remvl Regd: l~ ~ ~ ~ ~, Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3138488 .~..~. . ~~ ~a«« ~ u ~r~~l~ ` . Tanknology,-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 ~~ SPILLIUYE~'II:LCOl'~TATrFhIEV1`~3U~5 Work Order: 3138488 ~:,'t ~ I'1<P1 ::ETUP .IAN >'E,. 20U5 cJ::'itl AP1 :~ is ~ l't:hl UNIT: U:i~. ::'.-~1'EM LAlvt:uAGE ~IVGIC.I SFI '.': s'f L~'j Dr93.S:.j I Cd) F~ RMAT MUN DD N,'S^t HH:MMtS6 %li t RrLE i_•: ;8605 G600 AUbIJRN 13AKERSFIF.LD CA':.?33Ut 66a-8?t~?9?9 sHir'T "TIME 1 6::00" AP1 SHIFT T t MF.. 'd : P I,i;F-al.•ED 6H1FT. T1111; ~ : lil~taBLEL `SLilt'T TIP1F A DI~F181:tli TANK .1•'l.:k ] (,Ua i;. Wh;iP: f 1b~3 D I S~tBLED Ts~r~ti '.ANNUAL' WftRNI N(~ D I SHBLh=L LINE I'ERI9DIC twlAk:NNGF D I :;aNLED . L1t~E HNNUHL Ldr+b:NiPr~ D I SA}1I,1D PI~l N'f Tr VOLuIhES EIVAaLF.U` 'fEh1F COMPEIVSFiTIUN, , VAi.UE` (DEG,. k" ):,, 60.U: 6T 1 L•K HEIGHT (iFF.f.'f' ll 1 SflBLF.P !'.I:EC~ISION TEST-'UURATd,ON HGUR.~: .I~ DAYLIGHT GAVINC TIME: L 15r~BLSD ;;',±GTErI' SE~UR 4'fY CODE :. lIC1u000 c_UMMUNICATl.t1PJS SE'flli; ROR'I ' SE'PT 1 NGS IvGNE Fi~i)IVU R6-e:s~ ~£~:UkiT`: col~E uupooo Rf3-2'12 ENL~ OF ME53ctGF. DISi113LFV ' 1N-TANK .~t:TI.IP - - - - FLOH'F £sTZE: 4.U IN. ba'!G T 1 : UNLEflL1EU lk>Ti`R WARN.t N~.: : HIr;H WATER .LiM1;T: ~~ • 0 3~- PRODUCT Ct.)I~E t 3HERrWL ~~i:.EFI= :.-s~:v%u0 UR ;Lh1Bl:L :V01.,:: Mf'tX 5[,16 7r;lak: L~lrihlET£R ' ' Se.uJ T _ UvEkF1LL 1:lti[T" aCIYS 1 t;P~K, NlriiFlL£: 4 F y B83~. .FtifLL s~JL : ' 58 t o H1GH T'FwTittC.~: 95~ E5.0 :IIv~:N dt,l Filt~ft 90:5 46.0` I`hr'li v4L ,.: aSS~ DELIVERY L:I I't I;T ~% 23.0 , I NG H.. V(A:` : I d3 ~B. d9l] .FLOAT SIa 4:-0';1N. 8496 1_GW F;KGDU%T - 5q0 LgCiI~ ALttRlh I:~IM~Tfi: 94 WftTER WtakNLNG 2:0; . SUDDEN Loss L11h1T:: 3 :8Q' H t;H GIATER LIMIT: :3.U. . ThIVK T-I1:T . ' hIAN1FGLL'Eli TAWK3 rir~:,ti ,t)R , LABEt. -vnl:: •lt1tE, ia: NON£ Ov~RFILI: CtrIIT 90i 3834 H1G~~. Fl;i`in.u::T 'l5~:- K MIN P>rR:I0D1C.: LU% LE~ 93~ ~ ± !i81. `DEL~IVERY;`LI--MIT; ~:-~ 5~~ . a90~ 1:G%+ Efi1C rt3•N ANNUAL : t ygt . LOW PlitlIYUCT.- . : 500; . LEAK ALf1RNl: •LIMtT: 99 ~ULCiEN`LQ.~i3 LIMP(': 5U kI4LtC T8.`'~1 T'iPi: PF C TAIaY T1LT. .l.aH . K: b1Uf ~MHNIr01D1;I1 'f~±NKS, HNIVUr1L TEfiT:~ FFiIt .. ~. Tlt : NONE ALARM -D I S :AB1-FlJ. ` . PERI6I;I4• ~T Ey ~ L'EiiK N1IN. PET2IOPIG,:. 1.Oy^ . l)ISNf11;EL FtRM 'at3t ;LEAK ;MIN.:ANNUAL' : i0% uk+~~w ZL~f ,FAtIs' i1:;nS>FN ALI~RP1 I . • 981, , T AVERA,~ i N(s OI'F: ~ . ' .,t11i::'f~ FER TEb1' AVi=R1iGItVC OFF <fSN.I:?U:I~=TEST Tx FE .. ,. THrrl+ 7£ ST NC'I' F`., f.iIVIVUAi: T>rST .'FAIT; TriK..Tc~T $I PHON,`IiREAI~`fOFF'. A):/iRl°I D'I$ABLF:n M1.W 2 . 11EL:ItIEkX liELAY Y£k1OG1! TEST F,ri1L ALARM- 111:~ABLED GROSS •fiST,EHCl± i lU'iRM D t SA! Il:Jrll tiNN TE:~.T AvF.kH~:1 NG.: <,Ff 1•'ER TEk3T RVERF3GI-NG: 02't-' -:r;Mk' TEST NOTIFY: t)t.'E Z'NK TBT`831'HON BRF:AI::OrF T ;i IkHMIUM '3 ~ _ DIrI:I VER',' DEI:A~ 2 I'I I N PRODU~T G{1UF ~ pl,D'100 fi±ERM(1L CyBFF 9~' IiU: . 'fFiNK.:PiAMI:T>rR;. , ,F,TS `TAN14 I?ROFILL . 9EIt6 t.9'.ll~ L~U:~H `VOL- ~ ~ 4'3y2 GF.:O. 1NL:H,VtJI: ~ igc)8 23.u 11vCN, y01• FLOAT' sI2I:: a.u SN. •aa35 WWTEQ WAF{h1tlVCi 2:0.,- 6 ~ ' T 2 F,!LUS F : • H l GH. hIATER LI IN 1 FR.IUIJCT BODE ., TM£fcMr.1:• CC.F.!'P' : 2 iut?~s''l1_ 1.tr,;t-.uR`LAtiEL vOL.:.' ~ 6 TANK.-UTAhIET1k 9'.GG; 9C1 QvERFtLL LLMIT 13834. TANK;- PROt 1 LE ~i PTS - 15°v ;FUiL `-loI: 9816 .. It1~,41 F'R~JDUCT 9$~5 69.0 INCH VOL. ? 8055 5X ' 4E..0 l1vC~+ 1Jt}L .1392 UELIVEkY. L11~11'1 ~ A90 23.0 INCH V,OL 18Q6 Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3138488 ~.trtn HLHKPI i, i ri ~ i . iUDDf;N LOSS LIMIT:: 77 50 TR I -ST'AT)r (S 1 ANGLE .FLOAT ) , TAN}. T 1 LT 3:50 W "; F'RENI 111M CATEGORY ' $TF' S1ihIE` MANIFOLDt:U 'fANkS Ttr : NONH PIPE TYPT;: I'I NERGLASS L 5:9! . hrvMuL.Fah LINE LI:fVGTH : 100 FEET - T R I -STATE c S I NO:LE 1'1:OAT i h.~rl GPH TEST: J;NA1J1!'I+ lTATB~:ORY ANNULHF' SP' 'u'8 LEAK MIN F'ER I OD I i:: 1 Ox U ` ~"~' Ur''~ '''':i:'r : ~r1AbL£t~ ' . 9t31 aH:1FC WWN RATJ:: 3. ir" GPH I),.i0 GPH PEST MM:~[i[t LEAK MIN ANNIIAi. LIPa DHTB :" ??? 0 TANK: NONE 1 s : 41 STP Tkf-STtiTE Sur•IP , tSINGL:E"1•`I OAT)' 981 CATEGORY' : : STP SUrgF• FFRTOPIC TEST TYPE QUICK ftNNUAL T1;ST FAIL ftLriRl`1 UI£sfiSLEL+ PftRlnu[c: TEST FAIL ALARM DIfiABLED GROSS TE:;T FH I T ; t~J 3 : PLUS ALARhI L:IBE~BLEL WPLLD -1:1 NE%L+ISFL~LE S87Ji, ravN TEST AVERHGING: OFF ' ' PIPE T!1F'E: 1'1 tlhk(:IiASS L1NL•' 1-:CNGTH: 1D0-:FEET _ _ _ - - r ER rE:~r HVERAGlNC: OFF- D.20"GPH TEST:. LNAlll.iai W 1;:11NLEADED TANK 'PEST NnTtFY: I)F?E 0 10 GPH,TFfiT: ENA$L$Fi SHU'1'UUWN RATE: "3.0 •GIH LJ+iI~It~ 5EN3QR aILM:: TNK TST :ill:`tIUN H12EAK:OFF 0.,10:: GP.H TEST;'MMllil) DATE : `'~4'? 'U' L. 1",;f'IIEL ALARCI I 2:FUEL L=EL I ~ ERti' FFE:i;I•' 2 MI N . TANK , 'tat;N£ . ,HLARM ,. L 1 : S1:NSOR "OUT ALAkia : - - L 2:5E!~:riR~'GUT~.NlvARht L. t :SHORT ALARM L 2:SHOR'r" AI:ARM L I Qli I D-.:S1:NSOR .HEMS L S,:FU)rL•: ALARM 15 c:..,1-+:~GR :ili1T`:r•r:HRM. ~ ! o,:SEN$Ok'-,17UT,~;ALf-RM L .5:SHORT AL:rjRM. LEHK TE°,•1' Iti£TrkiL [:TNF-~F;EHY. LOCKOUT SETUP L .'i, :SHORT:' ALARM: ' ' " bJ HLI.R! HLL Tr11VY, '1'L ~,T oN DA1L• LOCKt?UT SCHEDULE' :7AN 1, 1996 ' • , •Ds1IL'f LI~]UID- SENSOR-AIMS: STAR I ["1 ME '. D I : ;H.NLED. ' START T I M8 : L~ I$ABLED E U>rL ALARM [ d ~ TEST Rr tTE :0':20,. GAL/HR STOP TIME : ll1:;ALlI.t:Li : L. ~:~UEI. AIsARM` 'apf2ATIJN 2: HOURS: L.3:~SNSOR .4UT ALHir~t' " 1.-, rt : SENEtpk~ ~Git2'" ~11'+iRM: L ,i"it$1i0R7 ,M[,HRM ~L. a:SiIURT flLr1RM~ LEAK TEST'REPORT'FORMAT . NUkr9AI. LIWUIL+ 73ENSOR fsETUI• L 1..:ANNULHR 87,' SOFTWAR>~ REVISION l'.L'41:1. 'TR1-:~fH'I')r fSINciI,F l'LUAT') VERSION Ir,.f1F Wi/I.1:D 'L1NE LEru:'BETI!F c'itTEl'%ORY f11VNUIiAk SPACE :iUt"1'L1HRLat'3A6u1 b-1"L•0-~_ - - - - - - - - ~ - , CREAT)rD - 98.05:14.! i`.1:~1 S-MODUI-Eit: 33D1 cU-u6t] -r1 t,~ i : tJlvl.i?r,l'~f::% L ~ : LIIJI_EtiLEI+ i~Ul'IP SYSTEM FFtiTUk£S : '1'k 1-STATE eS 1 NGLE FI.3f,T) . PERd GL i ~ ' 1 N FrrtK TESTS pjP1; TYP1=:: FIBTrRGI.A:',i CATF.f:;)R5' STF :UMF` r?NNUt-:L lN--trtNK '['E:E;T'~ LINE LF`NC.T! I :. t 00 FEET PLLL U.20 ~iF•H TB-~T: l:Svw9L~L• L:.1U f~.tN(.iHtdO,'.0 tONT O,IU GFH TI±ST: EIVABLED L 3:89 ANNULAR WPLLU SHUTIiOWN RATE: U . D GPW '[iH t ' `:~TATF (:'; [ NGLE FLOAT:) . L .a l: ~+NE1r1Ld0.217 CONT 0'. l0 GFtI 'CE:`:T MM;'L~D . :i-tTE~Or(V ItNNUf.:+~: SPait'F, 1~rrT5 ?•7•? E1 TANK : NONIi Tanknology,-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 313 8 4 8 8 ~` i'1F?GLE Y 860 Gc;;%3 ~,t!eURN FiHiERSFiELL ~:n.9s5~"E• b61-871'-797`1 .7AN ?6: 2005 11 :5:~ Hr~ ~aYfsTEM STA't't 4 ~ REPORT i:I.L 1'l'.Tk'T::iNS NCRbIHt I NVFN'1'OR ~ KEPORT T .1::11P~1.1Hn1:1, 110LUME - 164:1 ~AL$ ULLAGE. ~ 81.73 GAL:. ~~u : " liL::•1~~E - 7 l' 1 t GALt3 TC:-lOLUMI;: = 1t3;. ~:-+L~S HEIGHT = 20..80 iNrlJl:: WATER VOL-= 0 ~.r'tI=S tµ-TCf+ . _. 0 00 t NCHE6 :TEMP.' _: 68:7 ~£G f T :!•'LUS ULLAGE' ~ 82.~i6. GALS , 90"i~ UI.Lr3~:~E= Z-''15 ~AI.Fs t, !'{iLUhll-; _ l`555 c AL:S°. HY1`GHT. 2U;tla, ..liN£$ WATT~R `-Vt)l: _ 0 GALS 1JATER: = l f, 00 I INCHES TEI~p, _ 7 r, a •htG F T :1::PREMILUNI ' ULI:AGE 6yti:i 3r:;L8 q09/ UL1l~lf}1~ 5921'' GAI..i 11[~}.1IMF. ,CC _ Ut39o GitLS . , HE1~MT .". = ZS;.tl'_- l~~'4iES WH'1'k:R VOL fl ~AL.B W11TER ~ 0:04 I NC:I ll:,i •:•~h,p _ X1.1 nEu F ***:tiENP+~*XiE* f~1I.AF:M ;HI~TOR; 'kE)••c;1tT ---- GN-TAN}. ALARM -- -- T 1:,1lNLEHLEI! }~_ti.H WFaTER .AL.A1+M JAN ':'b: ;"2005 10: a4 ANI ti~fERF1LL HI:f+};h1 JitN 2E;: 20D5 ll:u'i AM .ihN 26~. 2.005 1 U:57 AM 'L~E4" 31': c0~4 ?:l:h PM SUfllllrN L013£s Hi.MKI'I F'IHY A:. x!004 9::1:! AM H[,3;I.PRODU~~T AI,ARhI TAN ~6., ~DG5 1L:5P hlh JAN :?b. 2005 l0: nil AM I WVAI:ID FUEL . I:EVEL :IANi 26~. -005 1>1 :~08.~ral•I .TAN d 8 . 2005 3: ~1~1 Yr7 DEG 1T. 200d 11:1'9"'AM PROHE OUT.. :::ant ;>>.. 2t~45 t f~:2~ AM H 1 GN . WATI,'K' .WE+kN I NG JAN 26. 2005 10:34 AM .MAX. ,PRODUCT ALARM JAN.26."2005'10:44 AM :~GtRRI H1$TORY FtIr:E'C1RT ---- '1 N TANK AP.AF:M ----- T ~:NLUS HIGH . W:+TER ;t=tLr~RM :]AN'?'o`, ',!005' "1.0:35 AM ,~1tT:k1'.1 L' L ALARM , Ji11V 26: 2005 l u:5:~ Ar'I' 111 ~H : PRODUCTS AL/tRh'I .THN": ~'b: `^l-IUS . I U : 32 F1hl: t tdt~at (;D FUEL "'~£VEL~ 1••kCBE CUT . , .]NN .2b. `'~UU9 1.1.:20 ftl-i ,JAN: 2F.., .20[1F".lll::l1. AF1. Ii1GH. WATER WARNI+NG :TAN 26: 2005.1G:,35.AM Al.pf•,'M "HISTORY F:i:F~f,-kt ---- I N-TfjN}: ALARM - -- T 3:: I'REM ), UM JHN 26. 2005 10:42 Art OVERFILL ri1.HF;M JAN 26: 2GG~ 1O:Sa rJi Ml~:H PRODUCT- HLf1RM Jr~N 26: " 2005 1 U ::'if Art IIVVr1I:.ID F'LIEI: LE'~EI.. OHN G_ f ,, EGGS 1 t : Oy Ahl Mf=6G 3. ~Zi]Oa' i PL: 57 'AM PkOBE Ol1T - JitN 26.'~'nD5 11 2L:r'uh JaN ~c~ . ;2GOS 10: s1 F~•1 Hl~;tc Wr`tT1;F;."WARNING JAN"26:.205 1.[}:42 AM HL:Ajtir?I I I f STORY REPORT L i :i,1v(VULiiR rl`/ ANNULi1R SPACE t~E,NSOR OUT ALARM .7riN 26.. 2UU:, 1 f!: 5`.. of t 1'tIEL_~AL'''ARM JitN` 26 2rul!, 10:16 AM `$E1+r,9'vfe i~Ui'": H(.ARhI FEH 1b. 2004 1.2:27 PM Tanlrnology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 3138488 ' ~ '~ HLtiRPI HI:~;fi1(v"; FdEPURT ----.- EiENSOR ALiAJ;r1 T; 2: UIVLEFiU1:T1 SUMP -STP " IiUJ'9p t~tl"JVR()R OUT: ALHkM. .•tiJ'1 _~b. '_ti,ti 10:55 HPt FUEL r1LHF:M .IAN 26...2005 10:1:1 HM F'uLl, NI:ARI'1 :7AN 26. "2005` .1 U : UU kP1 ALARM:: HL3Tt~kY RTPOk'1' ---- ----- SEIVNOR ALARM L :5:Q1 f'1NNULAR tiNNUCAR .iP/Ht:E SENSOR- AUT F1LAF2M JraN 3b• 2005 40:55 AM JriN ~16~. ~ t:dJ~, 1 G:U~ =•rt~ SENSOR OU'1: ALARIM F'F:r! FL. ~rlflrT 1~.:-27 PI'1; f'tLfaRM H I t ~ I'f>F^; REPORT - ---:::F'ENSC,k' Hc~kht rJ2i.4::LHk 3F'H~~E ;3EJ-ititiF;:OtI't' ALARM . .?ti N;. 'q... '200 ' f0,: 55 o-ar9 . 'FUEL QL'HRr7 :IHN.'~'G.:2005 10:'10 faM :SETUP- DATA WAF:NhNG UT:C• 3i , 2004 $ : 52 Ah1. r r x .t £NG ii ~ rf ~ ALHRPI HISTOJiY kEs'~`t7k'f --- • - ;;E:NSOR HLAkM I: 4 : E39 STP BUhII! STP SUMP :TN^oF! AUT ALARM JAIV 2b. 2005 10:5 AM FUEL ALARM JAN i'fi. 2005 10:UU AM [3I:TUI•' riATA WHkNI NG DEC 31. 2004 6:53 AM HLARIh H 1 STORY, kEF~C:kT. - -- sEIVa30R ALAkr~ ---- ~`L :6::,9i": f3TP SUNII' TF SuMy $EIV£JUR OUT' !'tL:ARM :Ti1N 26, o'l.ll.l5 10:55 itl"I F't.~£L fa~r~RM. .:MIS ~~: ?;;I;, 1a:[i4 Ater SETUP. DfaTA WHRIVJ IVG JAN 9. 2005 II::34;PM «««hw>»IVL*~cx~t~ AL:3RM HI::yCi1k•i REPORT - ----- :1'?~6,C:12 iiLaRhl --~-- b~ ~ : t;fJLEr;DEL ' I.IP1..].li SLi117`L'U4vN r;L'-t JAIV 26: 2005 11:'=? riJ•• GROIN ~ LINI: FAIL, . JriIV ~6: X005 11::'17 HM WPLLD SHUTDOWN AI.M JAN 18. 2(]05 e:~10 PM ;,.,***~END*..**x~, FSLiz'Kt't,. Jr! cTJF.:' REI'OR'C - -=' SI:WFsGk ALAR+': -- W 1:PREMIUM WPF:LI1 '';tJUTI)OWN H1:.M J%11V 26.. 2005 11 :32 AM GFal^~.+ L I-NF:. i"A 1 L J~~iN '26. 2005 11 ; 32 AM ~ONT:INUOUJ3.PUMp ALM 5EP 1?. 2004 3:59 PIh. * * * w * END w w « * w raL:f~RM HISTbRY RF:lrc1J~'F -•-- SENSOR ALARNI -- I:I, '7 : P,I J 15 taF;l`LC SHUTL~4WN AI.M J,41v 6. ; ~lii5 L l : 4? : tl~l r-;ROSS L1 NE FATI. JAN 26 2005 11:A2 AM CONTINU~U>3.PUMP Al.r~ ., :~[4• l a : '2004 3:59 PM :~ *: x: w .~: ENL * tE * ;~ lE Tanlmology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 78757 '~1idDERGROUND STOF;AGE TANKS ~ °'~ ~ ~~~ --K -~. r° ~r ........v..~-- .... - .., :- ._ .. .. _ ~ , ~, ~i x s a i B~ _n APPL9~A`T9®n9 T~® PIE~F®M ; a rM r tT- d31~ ~~~~~ ~, C~ ~ake>rsf eflcfl Fg~e Dept. ~anva$~®rrna~nea~tafl Sex~wices 900 Truxtun Ave., Ste. 210 Bakersfield, CA 9330 ]. Tel: (661) 326-3979 Fax: (661) 852-2171 5-., Page 1 of 1 ~ i O ~ M ~~ CEO p SITE INFORMATION FACILITY: ClrCle ~#2708605 DDRESS: 5600 Auburn St. Bakersfield, 93306 OPERATORS NAME: ClrCle K Stores, InC. OWNERS NAME TANK# VOLUME CONTENTS 1 9816 Regular (87) Gasoline 2 9816 Plus (89) Gasoline 3 9816 Premium (91) Gasoline TESTING COMPANY NAME OF TESTING COMPANY: TanknolOgy, InC. MAILING ADDRESS: 41785 (Enterprise Circle S. Unit D Temecula, CA 92590 NAME & PHONE NUMEiER OF CONTACT PERSON: Wesley COUIter (800) 666-2176, ext. 12 - t DATE 8. TIME TEST TO BE COND TED: / hUr ~l/1.2/06 1 PM i /~ ICC # SIGNATURE OF APPUCAN / / i ~ 1 i ~ i ~_ - - - DATE: 'I /5/O6 -- -- II .. : RPLICATIQ.N B.E,CO.ME3: Q PERMIT WHEN APPROVED APPROVED BY ~~ DA~ ~ - r FD2106