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HomeMy WebLinkAboutUNDERGROUND STORAGE TANK~ - - I. ~~;-=(UNDERGROUND STORAGE TANKS) FILE # - - -- - - ;' JOHN STUART DEL TACO MOBIL - i ~ - i 3624 CALIFORNIA AVENUE _ - - i ~,, ,~ ., _i a ~, --~- ~jl ~' ~;, ' ~: {~ 'rte t.U ~~~' ti lSl ~a 1 ~~ `: ,) ~~ `, ,~~ r i ~f UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. fiR~ Prevention Services A1~TIl T 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMR NO. ~~ ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING n T4NK TI[;NTNFRS TFST ~ Tn PFRFnRM FI IFI M[1NITnRINA CFRTIFICATInN TE:I F R TI FACILITY 1 1 ~i~ ~ NgME 8 PHONE NUMBER OF CONTACT PERSON ~~-~ s-t-~~•~- 5 -~~o ADDRESS 2/ ~,~I v ~1 ; ~~,. ~ ~~~ 7 U/ `~l . ~ L OWNERS NAM E ~S ~l/QI'~~-+' " ~ OPERATORS NAME ~y-~ _ _ 'C~~1~ J PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED I IN I T T T D? ^ YE ^ E T 1 g -? Z iI 3 ~~~ .TANK TESTING COMPANY„ , NAME OF TESTING COMPANY GG ,/~ ' ~~J ~ ~~ 1~. NA~MJE~ P NE NUMBE IJ OF ONTACT PE~ 0~~ 77 MAILING ADDRESS ~~~~ "i7 _ ~', .~ (~ -(~~ ~ `~ ~ ,y~~ N & PHONE NUM Q`F', rT~ TER OR 3PECIA~SPECTOR CERTIFICATION #: DATE 8 TI~M~E TE T T OBE CONDUCT . ~ ~- ICC #:~ ~Q J~~ ~ ' ~T l TEST METHOD SIGNATURE OF AP T - DATE ~ ~ ~ APPROVED BY DATE ~'~ Q Q FD 2095 (Rev. 09/05) r, ~~J~~~ ~ ~~~~ ~s ~ ~C ~' ~~FROM :BSSR,INC FAX N0. :6615882786 Oct. 18 2006 09:16AM P9 . ~ ~3SSR, ~IlC. , • - 6630 Rosedale Hwy., # B, 8a3cersfield, CA 9'3308 Phone (661 } 588-277 )"ax (6f 1) 588-2'786-~..-:.; :. , , 1V.It~NIT~7~RING SYSTEM CE~t'~'X~ICA'TION. ~ . _ - • ~ ~ • . . This form must be used to document testing. and servicing of monitoring: equipment. A s~arate • t;tstifcation . oI Et3~t}It •til11SI zl3t'. ' nrenaLr(1 ~r each moth o ing sus pontrol p~ by t)te technician wlao pe.~forms:;the•.wor3i;: A copy ofthis •form.musf be provided to the tank system owucr%operetar.. T3ie ~owaerloperatar must submit a• copy!, of•,.ttiis,; ~'oi~zi`;tfis: the ;lbeaf agtncy re$ulat~g UST systems .. _. ... :,~:. wir~ir<3o days of.test;aace_ .~ - ..., :, ........ .. ... • .. A. ~ Gel~e~r>'<i Info tion ., ~.. ~: ~ ~~~ ' • 1;acility Name: ~~~~~ _ ~ ~~~~' ~ - ~ fi ~. _ ~ _. ~ _ ~ . ~dg. No.' ., .. .. . : ~ Site Address: _ ~ . ~i City: Facility Contact Pexsoa: ~~, ~~~~ 4~~ ~ _ Coatsct Phone No..~~~/) ~~~~/ Make/Modal of Monitor-ing System: ~- ~ - - 1?ate of..Testi~ag/Scrvicing ~,l~l~ ~$.• 1(nventory of Egn~pment Tested/Certifled _.. ~ .. - :. ~ ~ , .. Tank Ib: ~' ~ I In=Tank Gaugittg Pro ' . Model: ' •Annular Space.or Vau'It Sensoi..: . - Model: Piping Sump I Trench s) 'Sump' Sensor(s). / ~ ~ D~c~ r Modeh" ' Model: Mechanical L• ine.Leak - . Model: EEcctronic Line Leak Detector: Model; ~ ' C •Tank Overljll ! High~E,evei •5ensor. Model:. Ta»it ID: `~ In-Tank Gauging Probe. Mocl 1~Annular Space•ar Vault Sensor. Model: O Piping Sump /Trench Se r(s). Model: ~ ~!liSSamp Sensors}.'~f /I+(/~%,~ ModaL• 1. i8B Mechanical Line Leak Detector. Model: - `iC7] Electronic I:ins L.eak~Detector. ModeL•' ^ Tank OverflI•! Nigh-C.evel Sensor. Modal: ^ Other fsoecifv equipment tune and model iu Section E on Page 2). ' in= >~: Annular Space~or Vault'Sensor. Mood: O Pipiisg SttmplTrench §en r s). Model: u ~$ump:5ensor(sj. ~(f~~/1f~..Mode1: Mechanical.Line.LCak'Detet;t7Cr:.• ~ ~ ]lilodel: ,. Eiectrorric I;ine Leak l7etecttsr. Modei: ' ' ^ Tank Overfill l Hig#i-I;evel Sensor.' Model: d Other ('pecif~ ectut~~t~pa attd model in Section E on page 2): • Tank l[D: . © In-Tank Gauging Probe. Model: ~ •:e, _ _ . _ Q Anauiar Space as Vault Sensor. Model: ' ^ Piping Sump 7 Trench Sensor(s). Model: ' ©l ill Surxrp Sensor(s). ModeE: ' . ^ Mechanical Line Lea#c Detector. Modei: [3 Electronic line f.,eak Det~tor. lvIodel: O Tank Overfill ~ Fligh-Level Sensor. Model: 1)ispeaser !D: ~" nispenser >i1D: Dispenser Containment Sensor(s)... Model: ~LDispenser Containment Sensor(s). Model:. , hear Valve(s). ~ Shear.Velve(s}. Dis ser Containment F oa s and Chains . ^ Di enser Corttai>a t Float s and Chains . D peaser TD: Dispenser 1i7:. ~'" Dispenser Containment Sensor(s)- Modei: •~ lispenser Containment Sensor(s). Model: . hear Valve=s}. • .. Shear Ya1vC(s). • D DlsnEnser Containrnelit 1?laatCsl and Chain(sl. l7 Dispenser Containment Float(s) artd.~hain(s). 171spenaer I:ID: ~'' • Dispenser Cantainrrient Sensor(s). Modei: Shear Valve(s). ' ~ " " Dis4ieaser Containrncrit Floats and Chain s). Disperser lA: ' _ - ^ pispenser Containment Sensor(s). Model: ^ •Shear Valve(s). ... ' . ^ Dispenser Containment Bloat{s} and Chain(s). _ _ ' if the facility Contains more tanks or dispensers, Dopy this term. inWuac mtorlrianorc ror every um,c w~v a,npc~wc- ~• u.G =a~~•=v.• ~. C~t't~1~CAtlOri •- [ eBYtify that the equipment identified In tats docutrieat~ was. inspected/serviced is xecordaace With file tgaaafactnrers'-gutdcffaas-' Attached to,tltis Certiticatfnn is tnformatioa (eg. manufacturers' check) aec~ssary to vrrisy wet thts information fs correct.attd a plot Plan sirorwfag the layout of taanitarlug equipment ors equipo3eat capable of generating such reports, I hove also a ed ca of th rt• (clb 1l chat aPPtYI: ~S SC ~r 'story report Technician Name (print)~_~~~~ Signatur : • Certification No.: ! ~~~. ~ License.-No.• •~~~~~. Testing Company Name:' .C.3 ~ Phon No.:{ •/ ~~~'~~. //~~ Sire Address: ~~ ~ ate of Tcatisxg/Setvieing:~l //L~ . ~ ,PagB i of 3 03rot Monitorlag System Certitlcatioa • . t` FROM :BSSR,INC FAX N0. :6615882786 Oct. 18 2006 09:17AM P10 . ~ . ~: Results ofTesting/Servecing - ~ . Sofrware Version Installed: ~~-ate Yes ^ No"' Is the audible alarm o drational? Yes ^ No" Is the visual~alarmo erationa]? Yes ^ Noy' Were all sensors visual! ins sated functional! tested, and confirmed o erational? Yes D Nq"' Were all sensors installed at lowest paixtt of secondary containment and positioned so that other equipment will not interfere with their ro r o cratlon? Yes O Nn* If alarms are relayed to a remote monitoring station, is al] communications equipment (c.g, modem} N/A operational? Yes Q No' For ps-essurizod piping systenos, does the turbine automatically shut down if the piping secondary containment © NIA monitoring system detects a leak, fails to op rate, or is electrically discoanected7 If yes' which sensors initiate positive shut-down? (Check all that apply) ump~l"rench Sensors; Q Dispenser Containment Sensors. Did ou conf'trnt ositive shut-dawn due to sake sensor fai]ure/disconaection? Yes; l7 No. Yes ^ Nq'~ For. tanlt sysfiems that utilize the ndoriitoring system as the primary tank overfill warning device (i.e. no ~' NIA mochanica! ovcrfiIi prevention valve is installed}, is the overf'xll warning alarm visible and audible at the tank fill' ain s and o a ' rl ? Lf so at what resat of tank ca aci does the alarm tri er? Yes' ~i No . Was any raonito:[iEng equipment replaced? If yes, idandfy specific seasors,'probes, or other equipment replaced and 1}st the manufacturer name and model for all r laccmegt arts in Sectiots E below. '~ts* No Was liquid fatutd inside any Secondary coutain>ztent systeuts designed as dry systems? (Check all chat Qpply) In Section ]~ below, describe how and wl`~en these deficiencies yvere ar wiU be corrected. ~. Comm~ents- Page 2 of 3 43!41 FROM :BSSR,INC FAX NO. :6615882786 • _ _, Oct. 18 2006 09:17AM P11 ~~.~ • . ' F ri<n-'~'~nk Gaugin.g / SIIx !/quiprcteot: ^ Check this box if tgnk gauging is used only ~fot inv~rtivry cbniro.i. • ?' .. D Check this box if no tank gauging, or SIR equipmetrt;s installed. This%~ection.must be completed if in~tank gauging ec}uipment:xs:used to perfotm~lea#c detection Inotutoring. ~~ • ~ • Cam Iete the fdllawin tliecklfst: • ,~ ~ Yes.. . C] ..Na* Has sll•iaput wiring been inspected forpraper entry acid terminaWioa, including testing for ground. faults? . ~ Yes ©No* Ware all tank gauging probes visually inspectrd for damage and residue buildup? '~ ~ •• Yes C] No* Was accuracy of system product Level readings tested? Yes ^ No* Was accuracy of system. water level readings tested? ' Yes Ci No* Were all Rrobes reinstalled.properly? Yes ^ No* Vlrere ell items an the equ:ilsmeut manufacturer's maintenance checklist camlrieted? ` * Ity the Section ?~, belh~w, describe bow and Frbea these deffclencies were or wi!! be oorrected. . G. Lie beak betectors {I<.:1~D): ^ Check this box if LLAs aro not installed. • 'cs D No* For equipme~•starwup or• annual equipxxient ceati~cation, was a leak• smulat$d aD .{3 NIA' (C aII that apply) Simulated leak rate:3 g.p.h.; ^ 0.1 g.p.h.; Q'0.2 g.p.i~. os O No* Weca all LLDs confit~d opezatianal and• aCtvrata within regulatory re4uiremeuts? testing Yes ^ No* For mechanical LLDs, does the I..T.D restrict product flaw ff it detects a leak? , ~ ~ ^~ .>,. © N/A • ^ Yes ~ O No* For electronic LLDs, does the turbine automatically shut off if the LY,p detects'a• leak? ~ • NIA O 'Y. es Q No's For elac'tranic LXJT~s, does file turbine automatically shat o~ if any partiou of the monitoring system is disabled ' ~ N/A or discormected? • • ^ 'Yes No" `Far siactmuic LI.Ds, does tlse turbine automatically shut afl;' if any pomou of the morittorix~g' 'system . i3/A malfuxtctions ar fails a test'? ' ^ Xas O No* For electronic L]:,J~s, have aIl accessible wiring cannectioi•:s hem visually iz~ NIA ~ ~ . Xes C] No* Were all itetns.an the equiptuent:panufacturer's maintenatlce checklist compl • ~"' Yt: the Sectlou H, below, describe how and when these detldeucies pvelt-e or wail be Carreeted. ;n . FROM :BSSR,INC FAX N0. :6615882786 Oct. 18 2006 09:18AM P12 ~ F. ;. .. .... .. ... ... Mauitoring~Systemi Certit9catloa ~ . .. .., ~. . ,..' ~ ~`S'~' Monitoring Site ~Ialn . Site Address: "~ G 2 ~{ Cq 4 t Fo i~>J ~ A ~~ E.. . 5. ... _ ~ ~ ~ ~ . ' . _ '.~"~""(-CCU !'Z~, ~-~r~ ... .. ..... .. _ .................. . .. ....... ................. ... ~;~. . .:: ~. . .• , . _ Date map was drawn; ~ ~. /~,/~„¢ p. . ,,~. O91xtl Olin If you already l~ave.a diagram tf~t, shows all required inforrnaifon, you may include it, rather than this page, with your Monitoring System C~r~fiaation. Om your site plan, show ;the general layout of tanks and piping. Clearly identify locations of the follawin~ equipmexst, if installed: tnonibaring system control panels; sensors inonitaritig tank annular. spaces, sumps; dispeaser'p~, spill cantsiners, or other Secondary cantainaaent areas; mechanical or electronic tine leak detectors; and in-tank liquid level probes (if used for leak detection}. ht the space provided, note the date this Site Plan was prepared. .. rage of ~ ~ ~ osroo FROM :BSSR,INC FAX N0. :6615882786 • .. Oct. 18 2006 09:18AM P13 • ~ ~ swRCS, January 2006 Sp~iU bucket Testing Report Form This farm is intended far use by contractors performing mmuol t~stfrrg of US7'spill contaiRnrerst structures. The camplered forme and printouts from tests (tf applfcable), should be provided to the facility owner/operator far seafim;tta! to the local regulatory agenry. ti ~r~rrr.rrvnv~'nunas~rr~ra' Facility Name: fG 7~~e~ r~ ~ Date of Testing: p l:acili.Cy Address: .. r . Facility Gont$ct: ~ _~. Phone: Date Local Agency Was Notified of Tasting Name of Local Aget~y Inspector (~prpsent during testing): ' TESTING CONTRACTOR INFORMATION Company Name: ~' Technician Cotuhtcthtg Pest: Credentials4: ^ CSLB Contractor CC Service Tech. ^ SWRCB Tank Tester ^ tJther (S eci License Number(s): '-~^ 3. SPII.I, ROCKET TESTING INFORMATION Test Method Used drastatic ^ Vacuum ~ Other Tes# Equiptnetit Used: Equipment Resolution: Identify Spill Bucket {Ey Tank Nuriiber SYorsd Aroduct eta 1 ~~~`~ ~ ~ ~'~' 3 ~ 4 Bucket Instatlstion't~yrpe: ~irect Bury ^ Contained in irect Bury ^ Contained in S ~irect Bury ^ Contains S ^ Direct Bury ^ Contained in Sum )3ucket,biameter: 7. Bucket Depth: f Wait time between applying vacuum/watsr and start of test: ~ ~ .~ Test Stsrt Time (T~: c 1 . Initial Aesdurg (R~: ~ - ~~' Test End Time (TF): f ~ • Final Reading.(Rr): Test I7uraiion (TF - T,): Change in Reading (RF - R,): +~ ~ pass/Fail 'Threshold or Criteria: Teat Result: .Pass. , ^ Fail •Pass [] Fail.. ass ^ Fail ^ Pass ^ Fail Comments - include informatiote on repairs made prtpr to testing and recona»tended follow-up fou'jailed tests} CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THLS TESTING I kereby t:eriffy that ell tke irformatlotr taltaed Irt tllrls report ds hue, arxrualte, attd itr full rntnpllaece evlth.legal requlnetdreats 'I'echnicj~n's Si~ature: ~ 1?ate: .~lJ°~~~~ i State taws and regulatie~ns do no[ currently require besting to be performed by a qualified contractor. T-Iowever, local requirements ,Mqv }w mmw ewinnnnr . r~ FROM :BSSR,INC FAX NO. :6615882786 Oct. 18 2006 09:19AM P14 Monitor $ Getti~tCatiwt Farm: A,d~dum iha• V Interstitial Senad:s . I.G 161, ice. ri ~. ~~. t~L4 Q~ ~~1~,1q~ ~A4~A'1~~ ~'iCjIIl[~[ltCltl~ "~~Rg . '1 his page should t~ used w document testing and servicing of vacviam and gressure ix:terstitial sensors. A copy of this foam trust De incltxied with the Moniooritig System Certification Form, whicdt mast be provided to the tank system owner%bperabor.'i~ owner/operstor must submit a copy of• the Monitoring System Certifieatian farm to the iocai agency rcgulatin~g U5T systems within 3U days offset date. ~~ ' If the so~or t'olly detects a si~ulaGad vacuutnEpressure k~k inttrodnood i}t the intaradtial space at the furthest polnt from the sensor. eacumnlp~ess~e bas been deanonaitated m be ~conmmmicadug thrnughairt the hioei~stice. lfia~r ~atsinini ae ~edZ ^ Leak Introduced at Far Bnd of i 5pace;' ^ Crau Visual Inspection;. [~ Other (Describe irc Sec. J; below) Faea~ was to operas~g lev+ela let sd1 ~ spa Q Yee 0 l~tv f~~+a, des+crib~e in •Sec. J, below? . D F/BE ARTM T RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Prevention Services 32b-3653 2101 "H" Street Bakersfield, CA 93301 OFFICE: (661) 326-3941 FAX: (661) 852-2170 RALPH E. HUEY, DIRECTOR PREVENTION SERVICES FlRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 OFFICE: (661) 326-3979 FAX: (661) 852-2171 David Weirather Fire Plans Examiner 326-3706 Howard H. Wines, III Hazardous Materials Specialist 326-3649 April 10, 2006 Ms. Angie Lievana Del Taco Mobil 3624 California Avenue Bakersfield, CA 93309 REMINDER NOTICE Re: Guidelines for Unsupervised Dispensing Dear Ms. Lievana: . It has come to our attention that many convenience stores who sell gasoline, like yourselves, are closing late at night. If you are using card readers and leaving your fuel pumps on, this is defined in the California Fire Code as: "Unsupervised Dispensing." Unsupervised dispensing is allowed when the owner or operator provides, and is accountable for daily site visits, regular equipment inspection and maintenance, including any unauthorized release or spills, posted instructions for safe operation of dispensing equipment, and posted telephone numbers for the owner or operator. Signs prohibiting smoking, prohibiting dispensing into unapproved containers and requiring vehicle engines to be stopped during fueling shall be conspicuously posted withiri site of each dispenser. In addition, a sign shall be posted in a conspicuous location reading: In case of spill or release: 1) Use Emergency Pump shut-off 2) Report the accident 3) Fire Department Telephone 4) Facility address During the hours of operation; stations having unsupervised dispensing shall be provided with a fire alarm transmitting device. A telephone not requiring a coin to operate is acceptable. The fuel leak detection system must have a remote or phone modem to insure off-site monitoring during hours of unsupervised dispensing. During hours of darkness, sufficient lighting must be maintained so that all signs associated with fueling operation are .conspicuous and readable. A gallon container of an absorbent material used for spills must be made available to the public during hours of unsupervised dispensing. Afire extinguisher with a minimum 2A, 2B, and 2C rating must be located on dispenser island during hours of unsupervised dispensing. ~* 70: Mailing list of Valued Customers Reminder Notice Re: Guidance for Unsupervised Dispensing %~ April 10, 2006 Page 2 If you are currently having hours of unsupervised dispensing, you must comply with the above-mentioned requirements. . Starting April 15, 2006, this office will conduct random checks of all fueling stations within the city limits for compliance. If you shut your station down after normal business hours and are not pumping fuel, please disregard this reminder notice. Should you have any questions, please feel free to call me at 661-326-3190. Sincerely, Ralph E. Huey, Director of Prevention Services r. l~~fr By: Steve Underwood, Fire Prevention Officer REH/db UNDERGROUND STORAGE TANKS F3AKERSFIELD f~~IFL~ UF:f'! ~ .~_.r~..;!-r_.' !'r•~vention Services APPLICATION ~ : ~,;~ , ,I I+ . : ~, +'; •, . . 1'O N~RFORM F{LU / UNL fEn$ fING ~ , . , iUf, ! 1 : ;!(, : ~` ~ SEI~189 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST ANO TU PEHFURM t Ull MONITORING CEf2TlFICATIUN i ~ ., PEI IT NO. ' '~~" ©2~(~j {~ i A i ' ^~ ENFIAN ~D I kAK ~li I F.'i: I IQ^i ^ LIF;E ; I-~ I ~fJCI ~ ~ :•, :LCvNG.~;~ ; ';Utv I Ai+~i.tc(~,' ... ^ TAN T~GHTNESSI f ('S I ^ I~. I• ~;, . Hh:', t,lvfll l~_,1'i 'r.; ~:E.f~ . ~r _. , $ITE ItiFORMATIUN -- - - FACILITY ~ 1 . NAME &, PHONE r;~;L+i;E'R 0~' CONTACT PERSON _.. ADDRESS OWNERS NAME ` • -..._ .. ............--~-- -..L . .. .._----- -_..._ ... -- ~- ---._ ... OPERATQRS NA61 PERMIT 1'U UPENA'ErrJ NUMBER OF TA~iKS TO (3F 11~SfED '` • ~ + (' C;'.~ • ~ s tr; i3E tESTI:.G'• _ TANK q VOLUME I I o K, '~ IotL .. 3 ~ I-a ~ t +'~ CONTENTS 0 U • TANK TESTING COMPANY NAny, OF TESTING COMPANY NAM & PHONE: !t•;r,+U'ri~ OF C'ONrACr FERSUr+ MAILI GAO RESS ~ yr~,, r ...____ Y.~... v~__l 5~1. _._~'? ..----- ;~A `~ 3302. _..... NAME & PHONE N BER OF TESTER ORS CIAL IPi ~;I~ECTOfi _ CERT IFI:;l, i .'. _._.__ - _-...~.._...~041 ~39a. t~ ~ 7... ..._.. __ oSo_3S iaq --• oSo3S ~ 3a DATE TIME TEST•TO~BE CONDUCTED !~ ~~(~~T"- ICC a. TES? METn;C -.. _ _ -- SIGNATURE OF APP CANT DATE ~ p..l 3'Oj C~~~~S APPI,ICA r ION Et~,COMES A PERMIT WFI =r~ APPfiOVE~ i1f~E'IiuVi::U ti'. ~ __- DATF. '-' ._._ _... l0 0~ ~ ~~ r~• I (UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPT, ~~~' Prevention Services AP~PL.I~G~~t`TIC~N ~Rtw r ~~uo~r--«Xil„~~ n~~~., sl~~, zi~~ I~~~ikcraf~i<~I~~, (:n ,x.3.301 TO PERFORM ELD /LINE TESTING 'I,cl,; (661 J; ;.32f~-:.3f974~ / SB889 SECONDARY CONTAINMENT TESTING I~ clx: (661) X52-2 1 7 1 /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION Page 1 of t PERMIT NO, ,? '~_~~~ r ^ ENHANCED LEAK DE1 EC71UN ^ LINE TESTING ~ SE;~9fi9 SECONDF4RY CUNTAIt~lMENT TESTING ^ TANK TIGHTNESS TEST ^ TO PERFORM ~tJE ;. MONI'iORING CERTIFICATiGN SITE INFORMATION _ _ - _ ._T,_~____... ~__~__. (FACILITY ~~' `~v'K.' ~JAME & PHONE NUMBER OF CONTACT, PERSON ADDRESS 3 I~~-~-- 01....«. __ _-~~-~-!~ ~--~~~.~Q.dl j G4 ;K~WNERS NAME ~PERATORS NAME PERMIT TO OPERATE N0. -- -- -------- NUMBER OF TAt~IKS TO BF "TESTED r1S f (PING GOlhd.a TO BE TEST ~__.._.^._ . _____ ____.___ __________.____T..._______.."_. _.. - _. _ ' ~ _ TED? YES CJ NO ^~ ~ U Celt LANK H __ VOLUM_E_ _. CONTENTS I o IL. r_______J_.__ ~ , , _ ___... l o <<" ------ - ---------_.. 3 ~ TANK TESTING COMPANY ANA OF T- ES71NG COMPANY'~~~~~ n -~~NAM & PHONE NUMBER OF CONTACT PERSON AIL( GAD RESS JT _ _d_ ~. I_Sc~1 ~ _) CA__ __93302 _ _ AME & PHONE N BER OF TESTER ORS CIAL It1SPECTOR -C~ERTIFICATiOPI ii. "'-'____.__._ __....___.______._.__T_~,_______.__ ~~ ~~i- 39a-_8~~2______ oSo3Sr~q -_-_D_ S__o__35~3_~_____ _ ATE TIME TEST TO BE CONDUCTED ~, rICC W: -~- ~ '^~ ~ ES METHOD ^~~-^- IGNATURE OF APP ANT ~ pATE i . ._ . - APPLICATION 9ECOMES.A PERMIT~Y~IFy~~~.PPRQYED PPHOVED L1Y ` _ _._ .. _.__. ---.__.... _ _ ~pAT~ .[_-©/_~Y//dS. --..___:---- ---- ~.~L _ __._.__~ _-_.__._..___----___ .. _ _. _... _ ... .. _. ~._ - - - FD210E r~. ~ ~, F/RE ARTM RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Prevention Services 326-3653 December 1, 2005 Del Taco Mobil 3622 Califomia Avenue Bakersfield, CA 93309 FINAL REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31, 2005 of Underground Storage Tank (s) Located at the Above Stated Address Dear Valued Customer, Over the last six months this office has continued to send reminder notices regarding secondary containment testing. Code requires that all secondary containment systems must be tested 6 months post construction and every 36 months there after. 2101 "H" Street Senate Bill 989 became effective January 1, 2002, section 25284.1 (Califomia Bakersfield, CA 93301 ! Health & Safety Code) of the new law mandates testing of secondary containment OFFICE: (661) 326-3941 components upon installation and every 36 months, thereafter, to insure that the FAX: (661) 852-2170 ! systems are capable of containing releases from the primary containment until they are detected and removed. RALPH E. HLTEY, DIRECTOR PREVENTION SERVICES FIRE SAFETY SERVICES • ENVIRONMENTILL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 OFFICE: (661) 326-3979 FAX: (661) 852-2171 David Weirather Fire Plans Examiner 326-3706 Howard H. Wines, III Hazardous Materials Specialist 326-3649 Our records indicate that your facility is due prior to December 31, 2005. Those sites that have not been tested and have not pulled a permit prior to December 31, 2005, will have their permit to operate revoked. This office does not wish to take such action, which is why we will continue to send monthly reminders. Contractors are already booked several weeks in advance. I urge you to schedule your testing date as soon as possible to avoid possible revocation of your permit to operate. Should you have,any questions, please feel free to call me at (661) 326-3190. Sincerely, RALPH 1~, HUEY, Director of Prevention Services h ~ry l///~firr= __..~~3w4 j y', Steve Underwood Fire Prevention Officer SU:db ~j~uisa~ ~re Uin~ss~rt~ai~ ~ ~~~lo~~s ~J~ ~~~~Uen~sr~ ,,: -=_ __-. - - ~-~ - __~L~-~ _ _ ~-~~. r' ~ ,'. S i , ~ f . ' ~ ,.;2 i~. ~~ ~~., , SEIr~O~J'~YSTEM CERTIFICATION F4It1Vi ~, ~~ ` ! ! U 0S` . ~ ~ . nA '4~=,' ~ FdCILI JD! ~1~?Lo FACILITY AbbRE3~ G j,, .. ~!" ~' r~4`~ [l'S-T Atua~alsr Space ~ '~ . :::. ._~t', . ~-+ fi i. ~',.; ~/, . ~'enk ~ (~ Tank 3 ~'arilc 4 ~ ~ ~~ ; ' fart Th~ae ;~~ g:•~~ ° `~ ,:~- - D . ,,; .,, . ~ Lnd Ttrne ~:~ jr ; ~~ ~; `.• ~~ 1~tPreaseere ./o ~~~ ~ ~ '~~ `C ~~ ~ ~;e~ft®tlo n ~~. ~~S 1 ,\V•~. `, R ti l . .. i $ ~ xis a `~/ . Ise ~ 1~ ~ ~;f~~ a . , . ,~..'~~ ~7~ • ~ .: ••~Of'~_ r' - ~ ~~~1 ! Air ~ ' ic ~~~~ ' ~ T~ ~~d 9•~asA~ 930 ,~ j :;. ~ ~ ~ ,i '~. ~ RI't~l`A~0t1 ... . F ~S P ~! r.' M `vim) ` '~.~:, ? :;.; ^s: , C X44;+' 1~ ~ ~ .. ~ !.\~ `,}1~, ~.: ~ Paga ] of ~3 ~.. ;~~ . ~. - ~ , ,; .;~ ~~ ~.. ~: ~~, ~ , I(3 ~~ ;, ~. ... ,Y , ;1 ~.. ,; 1 .'. ;: "t'.:. ' ~:.. . SECONYf'•!t' SYSTEM CERTIFICATION FARM DATE ~ ~ ~ ° o S FACILITY ID T a G d FACILITY ADDR135 ~~~'a~ C_r~~-~'o /'yt acv ~ . Turbine Sumps 5iu~tp 1~ 1 ,.~ Sump 2 ~ Sump 3D'S L Sump 4 Start'Tune ~ .. ; ap Iultbd Height df Water . a %;;! • Af I ~i ,~ ~ I (%..~ 'd'ime g' . I ~• ~A 'hVater Hel~ght 7 • ` • ~ ~ /o • .3.01(; ~ ~t"nme ~' d ~ ~ - ~ V1-at~er xe~ghc i aa~%,:~ ~: ~ • 9i~:.~ 3 • oi~~,~ ~rm~ 8~ S~~evl .: ~.•s7~. ,•s~~ Water Hdght . ~ ~os,•/ ~ . I/.~-~ . b 10, ;~ CendUicadon (Slgnatare) R5S ~ . ~:: ASS r ~ • / / OverllU Buckrta ' Uv~erltll I:. ~ ;; . C?verllU 2 / QverRll 3 ~ pvertlU B '.Mart Time ~-:U?~s~ ~ ' , GY~i'iyl ~~11q Initial Height bf Water , : _ O; a . 1 1 ,~ D ~I.,~ . lime :/S~/ .~~ ~. 9%~~ ~•~S~ Water Height . ~ p ,~ ~. . _ : . 1 `j t .~ . 301.+ "Time :.3Q~ ` .... 9 ~.y/ WaterHelght ~p'~r.:_..~' "~ .11 I.-~ /• 3d3:a ~CertilfcaHo~t rSlg~tawre) ~ ~ ~. ASS ~ ~~S ` ~ .: ~ ~ Page 2 of ,~ ;. ~. _- ~~ _r' - - - ,;; r.. ~' ~, . ' STCOND~iRY SYSTEM C1ERTiFICA"I'ION FO~ttil ~~:. 1t~.° FACILITY ID ~C~.C~ -:.. r vu.c.~- v ~. ~ ° FACILTIY ADDRRSS ~- .. ,~;~~ ~;~ ; . ,;.. UDC TES'fiNG ' t~ .. . ±~~r . ,,' . ,, ~.. A~:. '~ ;,~ ., ?~. . ;. ~: '.;;: ,, i ' Y, 1+ ~: , :; . a• ~.:.. DISP~N-i. ,,: .DISPENSER 2 DISPENSER 3 DISPENSER a START TIME ; UUA,~~ ~ ~: ~/~„/I -' ~S ~• INY'['[AL 1~EiGRT OF . WATER q WATER ~$IG~r ~: i~ ° •`x'03 ~ • (0 7~,~.., ' ~~S7ol... CFRTtFICATIQN (SIGNA`TtiR~ ~~~.. ~ .. ` PA3 ys'g S d / / /~ DNS^~ :: DISPENSER 6 DI~PEI~iSLR ~ DISPENSER 8 START TIME ~,'G/s" ~ . INITIAL HEi6HT OF WATER ~ '/ (~ ~~ ' TIME l0.• o WATER IIEIGxT . ~ ' . l 18 %N~ : :; ~ v, /S' . ~V1'ATER ~IEIGHT , .~ i ~-!... . ?c~tC~Tiorr xsscxwrux~) ~An ; Page 3 of _ ~ 1 ~~ ~ ~- i rr .. .. ^, _._....~ ~iL { ~~~ ,'*11 ` _ _ ___ _ .. . __ _._. _ ____- __ _ _ _ ____ ~ f l Sl'4. 7~;~ :. .,;i' ;..y ~ , ;. . f '{ , ta. ~ SE~~`~~YSTEM CERT~FICATI4N k'UR1VI ~ y.Fr ~~ j 0 ~ ~ A 11 r ~ t;' . ~ n Fd YD ~ f 1 ~G~ `~° FdCiLITY A3fDI~E~ ~:~~ ' C~ ~ b-cc,i ~' "~ ~4 ~'~! I l `~ v i - ~'~~~ ~ UST Anaalar Sp4ce //JWv,~ fi ,::_ .; _ - ~~ 'I'a~ic 1 ~ :~" : ;~' Tank ~ [ , Tanis 3 1''anr~t 4. ~ ~ . , .ir ~ Mart Tie~e : ~ ~•/S` . ~~;; 11 Iyeil~i Pressure p . p~~ I ~ : t,,. ~ ; ~ ' ? Y ~.. ' ~ • ~ ~~~ 'eet~tratfOn ~ ~ = ~~. ~f~-' i` { ~ ~: -'j~1 ~Ab. i ' 1 ~ ~[' ~. l~~, ~ . 1,,'J._ ' 'tss ,~ Line i ,8 `~,, 'Line 2 ~ ~ Line 3 ~ L ,Line 4 . ~;~, ~ . ~o ~~~ 'as~a 930 ,, ~; ~ ~: `•~ ~.,r. . ; ~~ Pressure - r :. j.:;~= ~ ,- ~~ ~ " Ga"tifieatioa ~ ~" ' ~S ~ ~ ~ /~ F... ~',~ ~~ ' ,:..~ { . C4^ _ ,. ~ ,' ' -E . :°~'. ; ' r Page l of ~ ,F .. "+~'' '~'~ ~r ,i., __~ ~~ "~~ ~{ ~ ~~ ~ti ~~ t 1~~ ~, . "~ ~ SECONYf~C SYSTEM CERTIFtCATIUN FARM .; w~ '~~ FACILITY ADDRIWSS _ ~ ~'_a~-E ~r~~-~v /'vi ~c~ :t~ ,. ~~. , Turbine SuRnps v< :. ',~. ~. ;.., ,~. . s. ,, , ~~ ~. ,: .. ,~. '~, .. ,^ . SWaP 2 D 1 ,; Sump 2 l Sump 3~5 L Sump 4 Start T~rne ~ ; ap Xnlti~d Height df Water .. ~;;..: : ~ 1 ~; ,~ ~ I I %,.~ Water xsigM ~•` ~ . ~ i ~o ~ • 3. o ~ f~ ' ~'1-ater Height ~ aa~i.~~ • 9/loin. 3 ~ 4///,.~ VNAter Hdght , a (o~..i . . J~ S-~ . b I o, .,. ~roxs<~atiam ~Sigaatare) ass ~ :..: Ass r ~ {~YePn~ BRC)C[et8 QPerN11:.. ~ ;; . (}verAU 2 / OverRil 3 L ~ t3verti~l ~ ~t~sit Time ~.:1~~ ~ ~~ ~ O~ Initid Height df wst~r , . o ~ a ~ . ~ ~ ,~ o yl.~ water xeight . ~ D ~ ~~. . ~ `~ t ~, .30~1.~ grime ,,3q~ ` .. 9- lyf water Height (o•~,,; ~ :. , I~~ ~,-~ /- 303'. ?CertMcaevn rSi~aatucel ~ ~ .~. ass ~ ~.~5 ` ~ ~ / Page 2 of ,~ _ _ y r ;. ;~;. ~~; ' ,;, . r.. ~' ,~ .~r,' , ''~.. ~ .. SECQND~iRY SYSTEM CERTiFiCA'~'ION P'plia~i . ,,, DA ~~ .t o GS ' `` FACILITY ID TG.C~ "'H FACILITXADDR~SS CC~rw..cf-- (~,~~. .. ,.•~, ,.;~, . UDC TE~STII~G ?~,~. -. . ,, ;., ~. , ~~ ,. .:r; -, :. ~. ;': :~ `Y ~:; ~i ~ . ;~, . ~: . t '!;J ;. :~, ~:'. .. D~SPINSt.~l• ~ .IyISPENSEIi 2 DISPENSER 3 DISPENSER 4 START T211+IE ; UDF1~/I . ~: ~~r/! ~ ys ~, Ir1I'TIAL $EiGR1' OF , 'CATER i'VATER 1gSIGAT /. l ~ '~ • ~'O ' .~ • (0 71~., ~~ Sao I ,~ ~ER'TTFiCAT101V (S1GNA'TUR1Lj t~~~ . ~ . PA3 ~5 S 6~ / / ~ DVS^~k :: DISPENSER 6 , DISPENSER ? DISPENSER 8 START TIME 9. G/ j "" INITIAL HEI(;AT OF WATER ; . . (r ~/ TIME ~~ • ~ ' WA'T'ER IISIGAT • I rg~~ ., v, ~s- , ~1YATER ~IEIGHT ~ ,,.i , ; • . ~c~TCx~TC~TZVx ~A~ _ . . Page 3 of `. ~ j ~~~