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Home My WebLink AboutBUSINESS PLAN (2),~, ~~ /r~ II l~ ~; ~~i-~ ~~~~nr ~ ~ -, - ~,~,, ~ ~ ~ _~ ~~~~~~ ~~ -~ ~~ -~ I~ ~ ''~ CIRCLE K CORP. `'~ ~~~~ ~ 2222 F STREET '~~ ~e~ I ~ '' '~ y~~~®I ~ UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY) / NEW TANK INSTALLATION (EXISTING FACILITY) / MODIFICATION / 8~ MINOR MODIFICATION - FACIUTY PERMIT NO. ~An/JD[f/~9/~ ~~. B 8 S A I D ~1~~ ARTN T 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 TYPE OF APPLICATION: es NEW TANK INSTALL /NEW FACILITY Es NEW TANK INSTALLATION /EXISTING FACILITY (Check one item only) .es MODIFICATION OF FACILITY a MINOR MODIFICATION OF FACILITY STARTING DATE 4 / O 9 / O 7 PROPOSED COMPLETION DATE 4 / 12 / 0 7 FACILITY NAME Circle K Store #2708825 EXISTING FACILITY PERMIT N0. 015-021-000993 FACILITY ADDRESS CITY IP CODE 2222 F Street Bakersfield 93301 PE OF BUSINESS Gasoline Dispensing Facility PN # ANK OWNER Circle K Stores Inc. PHONE NO 951-270-51.93 DDRESS 222 F Street ITY Bakersfield IP CODE 92879 CONTRACTOR CA LICENSE N0. ICC NO. Fueling and Service Technologies Inc. 794519-AHAZ 21 DDRESS ITY IP CODE 7050 Village Dr. Suite D Buena Park 90621 PHONE N0. BAKERSFIELD CITY BUSINESS LICENSE N0. ORKMANS COMP NO. INSURER 714-523-019 104478 W6436218 Reawooa Fire Casualty BRIEFLY DESCRIBE THE WORK TO BE DONE Minor repair: 87 Turbine sump - Replace (2) 2" penetrations rTn~ ~ ~/7 _ rc~l~trP (3) e1Pf''t~'~ ra1 ~'Pf~1~rPr }asnt~ , WATER TO FACILITY PROVIDED BY unknown DEPTH TO GROUND WATER n/a SOIL TYPE EXPECTED AT SITE unknown N0. OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE n/a .ES YES n/a .eSNO .AYES ,cSNO THIS SECTION IS FOR MOTOR FUEI TANK NO. OLUME UNLEADED REGULAR PREMIUM DIESEL VIATION 1 10,000 g X 2 10,000 g 3 10,000 THIS SECTION IS FOR NON MOTOR FUEL STORAGE TANKS TANK NO. OLUME UNLEADED REGULAR PREMIUM DIESEL VIATION n a FOR OFFICIAL USE ONLY APPLICATION DATE FACILITY N0. NO. OF TANKS FEES $ The applicant has received, understands, and will comply with the attached conditions of the permit and any other state, local and federal regulations. This form has/~e,~gn compl~d under penalty ofperjury, and to the best of my knowledge, is true and correct. APPROVED BY: ~ APPLICANT NAME (PRINT)~.1' 1(SSC~.1~;N~W (~~.(te~ APPLICANT SIGNATURE ~^"~5~~""~~ THIS APPLICATION BECOMES A PERMIT WHEW APPROVUED FD 2086 (Rev. 09/05) Cluis Rodriguez Ptojea Manager '~ cro'~iiguez@fastechus.com i LIC. #794519-A HAZ C21 ~FASTECH 7050 Village Dc, Suite D Buena Park> CA 90G21 Office (714} 523-0194 Cell {714) 809-6816 Fax (714)523-4235 TESTING • MAINTENANCE • EQUIPMENT SALES APS 1 ~ '" CAIJIFORNIA ANNOTATED SITE ~IAP PREPARED BY: BUSINESS NAME CIRC LE K STORE #2708825 7 2002 DESIGN CoR®UP ~)bC. DATE BUSINESS ADDRESS 22 22 'F' STREET BAKERSFIELD ZIP CO E 933Q1 DRAWING SCALE A B C D E F G H MAP SYMBOLS NORTH E ELECTRICAL PANEL ~ MC DON ALD S sHUT-oFF 1 O NATURAL GAS SHUT-OFF OW WATER SHUT-OFF 23RD STREET Y PUMP 0 RG SHU OFF TMA TANK MONITORING ~ ALARM ^T TELEPHONE 2 ~ FIRST AID KIT FIRE EXTINGUISHER ® STORM DRAIN S 5 SANITARY SEWER A LD . T STaGING AREA i J EVACUATION/ 10,000 GAL ~, C Q HMMP HMMP, AND MSDS J ~- MS05 LOCATION 3 ; 10,000 GAL~~ G W ~ FIRE HYDRANT 10,000 - GAL~~ J G ~ -~- FENCE ERE EMERGENCY RESPONSE -- ~ --- EQUIPMENT/AB50RBENTS I I O ABOVEGROUND J STORAGE TANK 4 Q ~ OO 0 ~ I~ ~I UNDERGROUNp ~ - ~' STORAGE TANK F. W W W C Q E O J GASOLINE G 3 ~ CASHIER I O Q Z (FLAMMABLE LIQUIDS) ~ ; ~ ~ ' ~ ~MA I Q ~ DIESEL FUEL OD STIB I UIDS CO B E ( ( M Q ) U L L LL I MSDSO I RR n MOTOR OILS & LUBRICANTS J ~/ (COMBUSTIBLE LIQUIDS) F Q CARBON DIOXIDE CG 5 ~ (COMPRESSED GAS) Z ' PROPANE OP ~ ERE W ~ (FLAMMABLE LIQUID) I O ANTIFREEZE/COOLANTS { ~ Q ~ { O WASTE OIL ~. U ~ W (FLAMMABLE LIQUID) CW CAR WASH PRODUCTS 6 ~ ~ - ~- ~ - -~- ~- - -~- iF - ~ J I = Q -- X ELECTRONIC MONITORING POINTS SUMP. SENSOR ~ OA ANNULAR SENSOR VACANT LOT/ JEWELRY ST ORE LD ELECTRONC LINE LEAK DETECTOR ' AUTOMATIC TANK GAUGE Scope of Wark 87 Turbine Sump - Replace (2) 2"penetration: 1- 2" vent piping penetration 1- 2" vapor piping penetration. (Blueline part number SBL3.SX2.5) VLI. ~ 1~2' Replace (4) Electrical boots (Blueline part number SR1.8X1.4 and Blue Line part number SI1.4X.1.0) UNDERGROUND STORAGE TANK •~ PERMIT APPLICATION 8 S R a A l D TO CONSTRUCT-INSTALL NEW TANK (NEW FACILITY) / IIR/ NEW TANK INSTALLATION (EXISTING FACILITY) /u r MODIFICATION / 8~ MINOR MODIFICATION -FACILITY T PERMIT NO. TYPE OF APPLICATION: ,es NEW TANK INSTALL/ NEW FACILITY (Check one item onl) ,es MODIFICATION OF FACILITY BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 7 of 7 .es NEW TANK INSTALLATION /EXISTING FACILITY a MINOR MODIFICATION OF FACILITY TARTING DATE 4 / 0 9 / 0 7 PROPOSED COMPLETION DATE 4 / 12 / 0 7 FACILITY NAME Circle K Store #2708825 EXISTING FACILITY PERMIT N0. 015-021-000993 FACILITY ADDRESS ITY IP CODE 2222 F Street Bakersfield 93301 YPE OF BUSINESS Gasoline Dispensing Facility PN # ANK OWNER Circle K Stores Inc. PHONE NO 951-270-5193 DDRESS 222 F Street CITY Bakersfield IP CODE 92879 ONTRACTOR A LICENSE N0. ICC NO. Fueling and Service Technologies Inc. 794519-AHAZ 21 DDRESS 7050 Village Dr. Suite D ITY Buena Park IP CODE 90621 PHONE NO. 714-523-019 BAKERSFIELD CITY BUSINESS LICENSE NO. ORKMANS COMP NO. INSURER lt R a Fi C a 104478 W6436218 asua woo re y e BRIEFLY DESCRIBE THE WORK TO BE DONE Minor repair: 87 Turbine sump - Replace (2) 2" penetrations rrnr ~ "I I7 - ra~l-~6g (3Te lect~'i cal ~'educe~' laent~ ~ _ - WATER TO FACILITY PROVIDED BY unknown DEPTH TO GROUND WATER n/a SOIL TYPE EXPECTED AT SITE unknown NO. OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE n/ a eS YES n/ a .eS NO ,eS YES .eS NO THIS SECTION IS FOR MOTOR FUEL TANK NO. OLUME UNLEADED REGULAR REMIUM IESEL ViATION 1 10,000 X X 2 10,000 X 3 10,000 PHIS SECTION IS FOR NON MOTOR FUEL STORAGE TANKS TANK NO. OLUME UNLEADED EGULAR PREMIUM DIESEL VIATION n a FOR OFFICIAL USE ONLY APPLICATION DATE FACILITY N0. N0. OF TANKS FEES $ The applicant has received, understands, and will comply with the attached conditions of the permit and any other state, local and federal regulations. This form has been completed under penalty of perjury, and to the best of my knowledge, is true anld correct. APPROVED BY: APPLICANT NAME (PRINT) f~~~ra4ir J~~,(ytCl iA~~Z APPLICANT SIGNATURE ~'~`~~'-1''( THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD 2086 (Rev. 09/05) IAP~ 1 ~~ ° ~ " BUSINESS NAME CIRCLE K STORE X2708825 BUS[NESS ADDRESS 2222 'F' STREET CALIFORNIA ANNOTATED SITE ~ BAKERSFIELD ~IAP' DATE ~ 7 2002 ZIP.. CO' E 93301 PREPARED BY: `,~ , ESVGi~ CoR®UP dFdC. DRAWING SCALE A B C D E F ~, G H MAP SYMBOLS NORTH O ELECTRICAL PANEL MC DONALD S SHUT-OFF O NATURAL GAS 1 SHUT-OFF OW WATER SHUT-OFF 23RD STREET 0 SHUTG~FFY PDMP T~AA ~ TANK MONITORING ALARM ~ TELEPHONE 2 44 'P ~ FIRST AID KIT - _ - - - - '` ~ FIRE EXTINGUISHER ~ ® STORM DRAIN ' S S SANITARY SEWER A LD T STAGING AREA _ _ W EVACUATION/ ~ 10,000 GAL~IOC Q HMMP HMMP, AND MSDS _ ~ MSDS LOCATION 3 ; 10,000 GAL ~I~ GO W c~ FIRE HYDRANT , Q 10,000 GAL~1~ GO ----- J W -~~- ERE O FENCE EMERGENCY RESPONSE , ~ ~ EQUIPMENT/ABSORBENTS ~ I O ABOVEGROUND J I STORAGE TANK 4 Q OP O }. I~-~I --' UNDERGROUND STORAGE TANK z L+" - W W , W ~ ~o E ~c J ~ G GASOLINE ~ CASHIER ~ O Q Z (FLAMMABLE LIQUIDS) ~ ~ ~ ~ ~ ~ ~TiMA` I O ~ DIESEL FUEL COMBUSTIBLE LIQUIDS ~ ) ( I MSDSOP ~ RR (~ MOTOR OILS & LUBRICANTS W v (COMBUSTIBLE LIQUIDS) F Q ~ CO CARBON DIOXIDE 5 W (COMPRESSED GAS) Z ' PO PROPANE ERE W ~ (FLAMMABLE LIQUID) AO ANTIFREEZE/COOLANTS ~ Q I ~ /1 WASTE OIL ~. U ~ W ~/ CW (FLAMMABLE LIQUID) CAR WASH PRODUCTS 6 ' ~ Q 3F - -~E- 3F - -~-- ~ . - ~-- iE - - ~E--- ~ X = ELECTRONIC MONITORING POINTS SUMP SENSOR ~ ®ANNULAR SENSOR VACANT LOT/ JEWELRY STORE LD ELECTRONIC LINE LEAK DETECTOR AUTOMATIC TANK GAUGE Scope of Work 87 Turbine Sump - Replace (2) 2"penetration: 1- 2" vent piping penetration 1- 2"vapor piping penetration. (Blueline part number SBL3.SX2.5) unc#liZ- Replace (4) Electrical boots (Blueline part number SR1.8X1,4 and Blue Line part number SI1.4X.1.0) M Y .d i(.- _. ~~ 51 7 F CIRCLE K STORE 2708825 Manager RANDY LORMAND Location: 2222 F ST City BAKERSFIELD CommCode: BFD STA Ol EPA Numb: ~~,~~~Y SiteID: 015-021-000993 BusPhone: (661) 324-1758 Map 102 CommHaz Extreme Grid: 25B FacUnits: 1 AOV: SIC Code:5541 DunnBrad:10-5457662 Emergency Contact / Title Emergency Contact / Title SERVICE CONTACT CTR / 24 HOURS KEVIN QUINN / DISTRICT MGR Business Phone: (866) 805-4357x Business Phone: (559) 647-6910x 24-Hour Phone (866} 805-4357x 24-Hour Phone (559) 639-9228x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact LORRAINE SOFFE Phone: (951) 270-5183x MailAddr: 495 E RINCON ST 150 State: CA City CORONA Zip 92879 Owner CIRCLE K STORES INC Phone: (951) 270-5193x Address 495 E RINCON ST 150 State: CA City CORONA Zip 92879 Period ( t/' ~'~ to ~~-I3~/o7 TotalASTs : ~ _ - Gal Preparer : STEVE SKANDERSON TotalUSTs : 3 = 30 0 0o Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG U - UST ~ l~ ~;.` ' C .~ E3ased on my inquiry of those Indlvi~uals ~~ rt ..~ ~ ~ ~~.~~ responsible for obtaining the information, I o~;rtify under penalty of law that I have pprsanally examined and am familiar wi±h the lnfarmation submitted and t-,~3~i~;ve the information is true , a rate, and comp .te. Q pp~~ ! ~ ~~ V ignature ~ Date -1- 07/10/2007 -` 5 ~ F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: CIRCLE K STORE 2708825 Cross Street 23 Ro ~'~rcf Business Type: Gas S-4AZ,oN Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper CIRCLE K STORES INC ICC Nbr: PEKO0020 PROPERTY OWNER INFORMATION Name ~'_'_'~'-r~•' ~rT-ri.T''T C-f'f.~C K S'I-Oft&S ~ -1L Phone : - Address : ,~q $ E. R~NC~N ST. -~ IS a ~.9 S~~ 2~0- 5193 City COR~aa State :C~ Zip : 9 Z~79 Type CORPORATION Name Address: City Type TANK OWNER INFORMATION ~~_~~ ~-~ C,rclt K S~'orE'S Inc. Phone : (5 5~7-v z : '~~^~Y ~t95 E. 2~NCod S-t ~ Isa C9'SI) 2~0- 593 COfJna State: C,4 Zip: 9279 CORPORATION BOE UST Fee# 032073 Financ'1 Resp: GUARANTEE Legal Notif ~4si- z7o- Si93 Date : '~' ~ ^ ~ ~ "-° ^ ^ $~3~~0'- _ _ _ Phone : ~(~ - x Name : R~cN VD~SETT Ttl :REGIONAL COMPLIANCE S AC-~`- State UST # 1998 Upg Cert#: 00800 v~~c.n4y'Q,Y' -2- 07/10/2007 ;'. ~ ., F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PROPANE E F P IH L 60.00 GAL Hi PLUS UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod REGULAR UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod PREMIUM UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod CARBON DIOXIDE F P IH G 2610.00 FT3 Min WASTE GASOLINE FILTERS S 5.00 LBS UnR -3- 07/10/2007 ~ % S 1' -4- 07/10/2007 i ~ } F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: W SIDE OF SITE CAS# 74-98-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Above Ambient Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5.00 GAL 60.00 GAL 30.00 GAL • HAZARDOUS COMPONENTS ~Wt. RS CAS# 65.00 Propane Yes 74986 35.00 Propylene Yes 115071 6.00 Ethane Yes 74840 5.00 Butane Yes 78285 0.10 Ethyl Mercaptan Yes 75081 iltil~riRL 1•iJ JL' JJ1.1LalV 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Hi -5- 07/10/2007 F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PLUS UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF SITE CAS# 8006-61-9 Liquid TYPE PRESSURE TEMPERATURE CONTAINER TYPE TMixture ~ Ambient ~ Ambient ~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 3000.00 GAL ttAG1iKLV V ~ 1:V1~lYV1V~1V'1'~ aWt. RS CAS# 100.00 Gasoline No 8006619 9.00 Toluene No 108883 14.00 Xylene, Mixed No 1330207 5.0'0 1,2,4-Trimethylbenzene No 95636 5.00 Ethylbenzene No 100414 riHGtlltL H5.5~.7.71~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -6- 07/10/2007 F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF SITE CAS# 8006-61-9 Liquid T Mixtur~ mbient~E ~ AmbientT~E ~ UNDEROGROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5200.00 GAL ti1~GAtCLV U J ~v1~tr~tv~iv l a ~Wt. RS CAS# 100.00 Gasoline No 8006619 9.00 Toluene No 108883 14.00 Xylene, Mixed No 1330207 5.00 1,2,4-Trimethylbenzene No 95636 5.00 Ethylbenzene No 100414 riAGF~KL HJJtS~~l~11"~1V l a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -7- 07/10/2007 F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF SITE CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixtur~ Ambient ~ Ambient -~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 3000.00 GAL tu-~~tucLVUS ~V1~irViV1J1V15 %Wt. RS CAS# 100.00 Gasoline No 8006619 9.00 Toluene No 108883 14.00 Xylene, Mixed No 1330207 5.00 1,2,4-Trimethylbenzene No 95636 5.00 Ethylbenzene No 100414 nr~~HxL tiaa~a~l~ir:lv~l-~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ ..,..,.,,.» ..~,,,,,,-, ~ ~.,,-,,,,r,.,,r _..,,..,-, AMOUNTS AT THIS LOCATION Largest C2610100rFT3 Daily2610100m FT3 I Daily1805r00e FT3 t1HGHiCLVUw7 1.V1"!t'V1VI:,1V 1.7 %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 riEiGEitCL 1~~J~J.71~11:,1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -8- 07/10/2007 ~GasATE TPureE ~-AboveSAmbEent AmbientT~E TankCinsAdeEBuildEn~ F CIRCLE K STORE 2708825 ~ Inventory Item 0007 COMMON NAME / CHEMICAL NAME WASTE GASOLINE FILTERS Location within this Facility Unit W SIDE BLDG BY PROPANE TANK STATE TYPE PRESSURE Solid TWaste -~mbient SiteID: 015-021-000993 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient DRUM/BARREL-METALLI~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 200.00 LBS 5.00 LBS 3.00 LBS riAG11KLVU~ lrV1~lYV1V1'~1V'l~ °sWt. RS CAS# 5.00 Gasoline No 8006619 t1E~GHtCL L-15J~JJ1~1r,1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UnR -9- 07/10/2007 F CIRCLE K STORE 2708825 SiteID: 015-021-000993 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 10/23/2006 IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIV 326-3979 AND, WITHIN 24 HRS, STATE OFFICE OF EMERGENCY SERVICES 800-852-7550. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT 911; BAKERSFIELD POLICE DEPT 911; BAKERSFIELD CITY HAZARDOUS MATERIAL DIV 911; AND STATE OFFICE OF EMERGENCY SERVICES 800-852-7550 OR 916-262-1621. 9 9 Employee Notif./Evacuation 04/18/2006 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWNS OF HIS/HER AREA OF RESPONSIBILITY BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL METHOD TO A PREDETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR. IF WARRANTED, EVACUATE TO THE DESIGNATED ASSEMBLY AREA LOCATED NORTH OF THE Public Notif./Evacuation 10/23/2006 IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED, IF POSSIBLE: AMERICAN GENERAL, 2225 F ST, 327-2241 AND MCDONALDS, 2310 F ST, 327-1720. Emergency Medical Plan 04/18/2006 BAKERSFIELD MEMORIAL HOSPITAL, 420 34TH ST, 327-4647 OR KERN MEDICAL CENTER, 1830 FLOWER ST, 326-2000. -10- 07/10/2007 }. '~ a ~ ~ ~ F CIRCLE K STORE 2708825 SiteID: 015-021-000993 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 03/21/2007 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 QUANTITIES AND STORED IN SMALL, UNBREAKABLE CONTAINERS. ALL UNDERGROUND STORAGE TANKS ARE MONITORED USING AN APPROVED MONITORING METHOD. Release Containment 03/21/2007 SMALL INCIDENTS: FOR LEAKS AND SPILLS, ISOLATE THE AREA AND CONTAIN WITH ABSORBANT 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 OFF PUMPS USING EMERGENCY PUMP SHUT-OFF, CALL 911, EVACUATE TO EMERGENCY ASSEMBLY AREA, WAIT FOR EMERGENCY PERSONNEL TO RESPOND. IMMEDIATELY CONTACT THE DISTRICT MANAGER AND THE SERVICE CONTACT CENTER. Clean Up 03/21/2007 SMALL INCIDENTS WILL BE HANDLED WITH THE ON-SITE CLEAN-UP EQUIPMENT, IE, BROOMS, SHOVEL, ABSORBANT MATERIAL, MOPS, ETC. FOR LARGER INCIDENTS, THE ON-SITE MANAGER WILL TURN OFF THE PUMPS, CALL 911, AND THE SERVICE CONTACT CENTER 866-805-4357. THE CONTACT CENTER WILL DISPATCH A MAINTENANCE CONTRACTOR TO ASSIST IN ABATING THE HAZARD. FOR SUSPECTED LEAKS THE OPERATOR WILL NOTIFY THE SERVICE CONTACT CENTER AND HIS/HER DISTRICT MANAGER WHO WILL INVESTIGATE THE INCIDENT. IF A UST LEAK IS CONFIRMED, THEN REPORTING WILL BE DONE BY CIRCLE K, WHICH COMPLIES WITH UST REGULATIONS. CIRCLE K WILL COORDINATE WITH ANY CONTRACTORS REQUIRED TO STOP A RELEASE, CLEAN UP A RELEASE AND/OR DISPOSE OF MATERIALS. ALL MATERIALS WILL BE DISPOSED OF IN ACCORDANCE WITH STATE, FEDERAL, AND LOCAL LAWS AND -11- 07/10/2007 F CIRCLE K STORE 2708825 SitelD: 015-021-000993 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~,_ v~,itc1 iccavut~.c t]l.L1VGil.1V11 -12- 07/10/2007 S ~ .• ~ F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ .especial nazaras Utility Shut-Offs 03/21/2007 ELECTRICAL - INSIDE BACK RM OF STORE (BREAKERS); E WALL OF BLDG N END (METER) WATER - N WALL OF BLDG E END (MAIN LINE GATE VALVE) SPECIAL - EMERGENCY GAS SHUT-OFF SWITCH AT CASHIER STATION CONSOLE; N WALL OF BLDG OUTSIDE Fire Protec./Avail. Water 04/03/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, 3 IN STORE AND ONE AT PUMP ISLAND. FIRE HYDRANT - NE CRNR OF SITE. Building Occupancy Level 04/03/2006 3 EMPLOYEES -13- 07/10/2007 -: .. F CIRCLE K STORE 2708825 SiteID: 015-021-000993 Fast Format ~ Training Overall Site ~ Employee Training 01/29/2007 MATERIAL SAFETY DATA SHEETS ON FILE BRIEF STJNIMARY OF TRAINING PROGRAM: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIALS IS PROVIDED IN THE FOLLOWING AREAS: PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT; USE OF ABSORBENT FOR SMALL SPILLS; EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL, AND CIRCLE K ENVIRONMENTAL DEPARTMENT; AND EACH CIRCLE K GASOLINE STORE HAS A COMPANY-SUPPLIED GASOLINE MANUAL WITH MSDS FOR GASOLINE AND CO2. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUT-DOWN (INCLUDING THE LOCATION OF TURN-OFF VALVES FOR GAS AND ELECTRICITY), AND THE PROPER USE OF 9 9 rays a _~ ~ r_ aiciu ivi t• u~.utc vac -14- 07/10/2007 ;:.~ a ; >., .. F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ Fast Format ~ ~ Training Overall Site ~ ~ Held for Future Use -15- 07/10/2007 2. i FASTECH, INC. Construction, Compliance Testing, Engineering, & Station Maintenance May 8, 2007 Steve Underwood Bakersfield Fire Department SB989 POST-REPAIR TEST 900 Truxton Ave., Room 200 Bakersfield, CA 93301 SUBJECT SITE: SB 989 COMPLIANCE TESTING AT CIRCLE K STATION 2222 F. STREET, BAKERSFIELD, CA 93301. COST CENTER #2708825. Dear Mr. Underwood, Enclosed, please find the secondary containment testing results for the above-referenced site. These results are being sent to you per the requirement of SB 989. A summary of the results is listed below. Agency Notification Date: 4/24/07 Test Results Overview: Test performed: Turbine Sumps Test performed: Under Dispenser Containment Test performed: Spill Buckets Pass®. Fail^ Pass® Fail^ Pass® Fail^ FASTECH was contracted by the underground storage tank system owner to insure that this facility complies with all of the rules and regulations that govern the operation of underground storage tanks and their related components. If you have any questions please call the undersigned at (714) 523-0194, extension 27. 7050 Village Drive, Suite D Buena Park, California 90621 Phone (714) 523-0194 Fax (714) 523-4235 Secondary Containment Compliance Testing Circle K 2222 F. Street Bakersfield, CA CC# 2708825 Page 2 of 2 Sincerely, FASTECH, Inc. v ~ 6°Z-- Glen Ragle Program Manager Attachments -Secondary Containment Testing Results Cc: Lorraine Soffe - Circle K Stores, Inc. Steve Robinson -Triangle Environmental, Inc. 7050 Village Drive, Suite D Buena Park, California 90621 Phone (714) 523-0194 Fax (714) 523-4235 Page 1 of 4 Secondary Containment Testing Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: Circle K Store #2708825 Date of Testing: 4/27/07 Facility Address: 2222 F Street, Bakersfield, CA 93301 Facility Contact: Phone: Date Local Agency Was Notified of Testing : 4/24/07 Name of Local Agency Inspector (f present during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Fueling & Service Technologies, Inc. (FASTECH) Technician Conducting Test: Alberto Rodriguez (ICC#5250581-UT} Credentials: X CSLB Licensed Contractor ^ SWRCB Licensed Tank Tester License Type: A, HAZ, C21 License Number: 794519 Manufacturer Training Manufacturer Com onent(s) Date Training Ex fires Furnished on request 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Re M pairs ade 87 Turbine Sump ® ^ ^ ^ ^ ^ ^ ^ 87 Vapor Bucket ® ^ ^ ^ ^ ^ ^ ^ 89 Vapor Bucket ® ^ ^ ^ ^ ^ ^ ^ UDCI/2 ® ^ ^ ^ ^ ^ ^ ^ ° a ° a ^ ^ 0 0 0 a ^ ^ ^ ^ ^ ^ ^ ^ ° a ° a ° ° ^ ^ ^ ^ o 0 ^ ^ ^ ^ ^ ^ ^ ^ 0 0 0 0 0 0 0 0 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ If hydrostatic testing was performed, describe what was done with the water after completion of tests: See attached testing procedures. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's Signature: ~~~~~'~ Date:_4/27107 Page 2 of 4 6. PIl'ING SUMP TESTING Test Method Developed By: ^ Sump Manufacturer ^ Other (Sped) Test Method Used: ^ Pressure ^ Other (Specify) Test Equipment Used: See attached testing procedures ~~~ ~3 Sump #87 STP Sump Diameter: 42" Sump Depth: 57" Sump Material & Manufacturer: fiberglass -TCI Height from Tank Top to Top of Highest Piping Penetration: Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: Portion of Sump Testedl Does turbine shut down when sump sensor detects liquid (both product and water)?' Turbine shutdown response time Is system programmed for fail-safe shutdown?~ Was fail-safe verified to be Wait time between applying i pressure/vacuum/water and starting test: Test Start Time: Initial Reading (Ri): Test End Time: Final Reading (RF): Test Duration: Change in Reading (RF-RI): Pass/Fail Threshold or Criteria: Test Result: Was sensor removed for testing? Was sensor properly replaced and verified functional after testing? 25" 15" good Above highest Industry Standard ^ Professional Engineer Vacuum ®Hydrostatic Equipment Resolution: ~- - ~ -M:. Sump #87 STP Sump # Sump # 42" 57" fiberglass -TCI 25" 15" good Above highest Above ^ Yes ^ No ®NA ~ ^Yes ^ No ®NA ~ ^Yes ^ No ®NA ~ ^Yes ^ No ®NA ^ Yes ^ No ®NA ~ ^Yes ^ No ®NA ~ ^Yes ^ No ®NA ~ ^Yes ^ No ®NA ^Yes^No®NA 30 minutes 3:11 3.1112 3:26 3.1123 15 min 0.00103 0.002 ® Pass ^ Fail ® Yes ^ No ^ NA ®Yes ^ No ^ NA ^Yes ^ No ®NA ~ ^Yes ^ No ®NA ~ ^Yes ^ No ®NA 30 minutes 30 minutes 30 minutes 3:31 3.1132 3:46 3.1140 15 min 0.00083 0.002 ® Pass ^ Fail ®Yes^No^NA ®Yes ^ No ^ NA 0.002 ^ Pass ^ Fail ®Yes^No^NA ®Yes ^ No ^ NA 0.002 ^ Pass ^ Fail ®Yes ^ No ^ NA ®Yes^No^NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) 1 If the entire depth of the sump is not tested, specify how much was tested. If the answer to a_y of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page 3 of 4 Test Method Developed By: ^ UDC Manufacturer ®Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum ®Hydrostatic ^ Other (Specify) Test Equipment Used: See attached testing procedures. Equipment Resolution: - -- ~ _ _ _ _ .., r ~. UDC#1/2 UDC#1/2 UDC# UDC# UDC Manufacturer: Bravo Bravo UDC Material: steel steel UDC Depth: 10" 10" Height from UDC Bottom to Top of Highest Piping Penetration: penetrations from bottom penetrations from bottom Height from UDC Bottom to Lowest Electrical Penetration: penetrations from bottom penetrations from bottom Condition of UDC prior to testing: good good Portion of UDC Tested Above highest enetration Above highest enetration Above highest enetration Above highest enetration Does turbine shut down when UDC sensor detects liquid (both product and water)?* ^Yes ^ No ®NA ^Yes ^ No ®NA ^Yes ^ No ®NA ^Yes ^ No ®NA Turbine shutdown response time Is system programmed for fail- safe shutdown?* ^ yes ^ No NA ® ^Yes ^ No ®NA ^Yes ^ No ®NA ^Yes ^ No ®NA Was fail-safe verified to be operational?~ ^ yes ^ No ®NA ^Yes ^ No ®NA ^Yes ^ No ®NA ^Yes ^ No ®NA Wait time between applying pressure/vacuum/water and starting test 30 minutes 30 minutes 30 minutes 30 minutes Test Start Time: 4:03 4:19 Initial Reading (RI): 0.6688 0.6685 Test End Time: 4:18 4:34 Final Reading (RF): 0.6686 0.6681 Test Duration: 15 min 15 min Change in Reading (RF-RI): 0.00027 0.00035 Pass/Fail Threshold or Criteria: 0.002 0.002 0.002 0.002 Test Result: ®Pass ^ Fail ®Pass ^ Fail ^Pass ^ Fail Pass ^ Fail Was sensor removed for testing? ®Yes ^No ^ NA ®Yes ^No ^NA ®Yes ^No ^ NA ®Yes ^No ^ NA Was sensor properly replaced and verified functional after testing? ®Yes ^No ^ NA ®Yes ^No ^NA ®Yes ^No ^ NA ®Yes ^No ^ NA Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) 1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer to ~ of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC must be tested. (See SWRCB LG-160) 9. SPILL/OVERFILL CONTAINMENT BOXES Page 4 of 4 Facility is Not Equipped With SpilUOverfill Containment Boxes ^ SpilUOverfill Containment Boxes are Present, but were Not Tested ^ Test Method Developed By: ^ Spill Bucket Manufacturer ®Industry Standard ^ Professional Engineer ^ Other (Specify) Test Method Used: ^ Pressure ^ Vacuum ®Hydrostatic ^ Other (Sped) Test Equipment Used: See attached testing procedures Equipment Resolution: Spill Box #87 vapor Spill Box #87 vapor Spill Box #89 vapor Spill Box #89 vapor Bucket Diameter & Brand: 12" - OPW 12" - OPW 12" - OPW 12" - OPW Bucket Depth: 11" 11" 11" 11" Wait time between applying pressure/vacuum/water and starting test: 30 Minutes 30 Minutes 30 Minutes 30 Minutes Test Start Time: 3:10 3:42 3:12 3:30 Initial Reading (RI): 3.7977 3.8209 3.2535 3.2536 Test End Time: 3:25 3:57 3:27 3:45 Final Reading (RF): 3.7969 3.8206 3.2536 3.2537 Test Duration: 15 min 15 min 15 min 15 min Change in Reading (RF-RI): 0.00081 0.00032 0.00010 0.00007 Pass/Fail Threshold or Criteria: 0.002 0.002 0.002 0.002 Test Result: ®Pass ^ Fail ®Pass ^ Fail ®Pass ^ Fail ®Pass ^ Fail Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) ~L®~T- hydPO=P/tervP~stPsn~/- iwe/~~®~-~2 ` { F ~ ~~ ~~? -:gym ~ `T~es#-Parameters `Test Status - Function Menu„ , YY"-.~, n '6:FfC~.~' d w~R.5.wwf.4hSSr~... _.L . .. 3L.. - C ..Lcs.::;it' £,C°.-.c.t.Sr F~ _ F .t.-..t3 'N~k .13,. ~ :Test Site - ~, ~-_ ~~~ ~` ~ Status ~, ~ ~~ - Restart -Abort _ , circle k ~ ~ ~~ Saving = ~ ,ter. t _ ~ ~~: ~. ~~v 2222 F st 1=` ~ ~ ~ ~ ~~ Change: ,,Y Pf,SS ~ ~ ~ ~ 'ds ~ i 5?-r 3~-`k 4 } ~- ~ eturn~ bekersfield, CA 93301-XXXX 0 00103 R ~' "' ~ ~~~~ ~~ _ - r1 `Product >? _ ~ ~ -- --- --- - - - - }' p ~ _ ~, d:~>TYpe . .. 3.~1.2s x - 3:1125 Tank Sump Turbine .` '. 7 ~ . ; ~ 3.~12a. , ,. Test Start Time Y ~ ~ 3.~ 123 _ _ .Fri, Apr 27, 2007 3 11 PM t 31izz- ' ~ ... i Test End Time 1'3.1121 _ _ „~. ~...........d~,_ T ,.~ ~- 3 1120 ~Fri, Apr 27, 2007 3:26 PM . a, J 3.1119. . Length (mm~~~_ ~ Limit (m) ~x ~~ -~_., __ , _ '; ~~ 1 ~ ,, Y. c. 3.1118 s ' ' ~ 15 ~ 0.0020 ~ 1117- 1~ 3 . T@St R@SU~t 3.1116 ",„.!Test passed ° 3.111b COlnmentS ~ 4 3.1114 ` ~y~~~ ~ ~ ~ 3 1113 , ~ 3'1112 J-L.L.}. J I ~. j~ .I.. i -J-~ _~ .1 -L 1!. i~J 1 1 i. 1 I I ~...... JLJ-I _J._ __ I ~_,1_ L ~ 1 ~~_ ~_. r _ ~. ~_ I..1 I 11.~L~_ - ~ I I I _ ~ ~ I I_ tl1 ~i ~r ~~ , ~ I ~~ i ~ ~ -Ty I I~ I I ~ .~ I ~ ~_ ~ '~- .. ~~~ ~, I ~.- _~ ~~ I 1 -~` ~-- ~~y ~~-II~i I I I ~~--11 : I ~1 I I I _ ~ ~I If J I____ . _._-I ._J_I I j l L~ 1 ~ I -- I ~-. ~ - _ _ - _. -- ?- L ~~ -~-+-~~ _ ~ L_ I I L--- ~ ~ ~ i I-I I I rte- ~ ~ -7- -±-~ - ~ - I -1 ~ I ~ i ~ ...- I ~;T L'- 1JJ ~ '_ - ~i '~ -1- I I I I 1 I -I I I Ti ' I i =- ~ ---L- - , -, 1- ~- - fi a~ ~ ~ t -iT Y~ f om " ~ ~ i ~} ~ ~ ' I I i _ i - j ~ I , ~~ ~ I- . t . ~~ . ITI._ ~ ~ i ~~~i ~ ~ ~ - ;. f ~ I I . 7 ~ TT y ~~T~ ' I 1 ' _ -. _ 1 ~ . _ ~ - - ~ __L .....Ls -l- ~~ I I L !~ I ! 1 I I~ I '' I I ~_t ~5 °~:~~ t ,~ ~s ' II - I t I .. I I . '~ 03';11:53 PM 03:15:00 PM 03:18:00. PM ' 03:21:00 PM 03:24:00 PM 03:26:53 PM ~~~ "' i 04/27/2007 04127/2007. 04/27%2007 .04/27/2007 04/27/2007 04/27/2007 Test Tune ~ . ELD~ ~ ~lyd%'B ~/te TestPa~e/ - leire%~~ebe ~ _ - ~ - ' _- ~~i ~~~ Testt~Parameters - ~ Tes~tNStatus -Function _ Menu ~ =Test;Site ; ~ ~ Status 1 ;~ P r ~ ~ F asslFail Restarf Abort" ' ~; circle k ~,' Saving... ~~ - ~~ 2222 F st fi 4~ =Change . ~ PASSE, ` - -,- r Return ~ ~ ~bekers eld, CA 93301-XXXX 0 00083 :t .~ _ , _ _ - . L i _ . _. Product ~` .. y _ . -4 .~~- - T r '; ~. . .. 3 ' ..' .'.. h ,, :..Type:;- - 3.1141 _ i ~ ~ 3.1140 ~ =Tan p Turb ne ~~ ~ 3:1139 . : ., ~$ .Test Start ,Time _ ~~. . . .«.. . . ~ ,~J, 3.1 i 3a- f . . . .. ~~s .Fri, Apr 27, 2007 3 31~PM . p. ~ 3.1137- A ~ ~ - ,, .. ~' :Test End Time ~ ~ ~ ~ 3.113s ~~ .._~.. ~ - ' Fri, Apr 27, 2007 3:46 PM I ? > 3.1135 J 3.1134 _ ` Length (min) Limit (in) .,~, ~ _., _~ ~ , Y c ..3.1133 ;, 15 0.0020 '~ ~ ~! ~ 3..1132- . Test ReSUit - . , " ~ ~~. 3.1131- ; :~; Test passed ~ 3.1 i3o 4 : Comments.:: ` '3.1129- .:~.~-°__:~:sm.~a_ ..~~ ,~~.., ._~~r.~ ," :b . .- - - 3:1128 J ~ L _ - ~ ~ l--i-1 ~_ ~ - $ . ~~~~_ ~r~i I ~ _ 1 -~ i_ I. I I tT- ~- I I. .i. 1 I -.I - I. ....~ 1 _ .. _. . i ~ I -'- _ i-~1 - ~ I ~ ~ . I ..'i.. ~ ._ . I I- 1 _- .~ -, . I L1J_L _~ --1 ~ -~ ~ L~._ 1 I -.--- I . . - . ~ - -' ~ ~ - - - ~ I ~ L'_- - ~ l.. LI- I~ '~ , ~j 1 J -I- - l.. JJ I ~ I I I! ~~_ I I I.- I. ~ I i '~ I ~ ~ I ~ I _ i _~ ~ , 111 .. I I ~ ;.~ ~_. .... . ~F _ T ~ ~Y-'-` _ i.. I .. . , _ ~ ~. y.. I ~. ~ -~-.. I I - I .. i i II i I I lY ~ri' ~" j ,.! f a~ f .' r 3.1127 ~T I I I I I I I I I I ' I ' 03:31:05.PM. 03:36:00 PM 03:39:00 PM, 03.42.00 pM 03:46:05 PM' .04/27/2007, . 04/27/2007` :04/27/2007 04/27/2007. 04/27/2007 `. `ij . ~ .. ,, Test Time ~; - ~. ~, ti"'f.: ~ o.~aoc ~,~ Spill Containment Vapor Bucket ~ ~ ~ 3.?sa1 ~ ~~ ' ~ 3.7980 -Test Start Time ~ - _ _ .~.:~ ~ « ^ M { 3.7s7s Fri, Apr 27, 2007 3 10 PM f . ~ , 3..7978 Test End Time ~~ , ~ ww ..., ,~, _ . ~ _ y + ~ ~ I ~,, 3.977 Fri, Apr 27, 2007 3:25 PM a 3.7976 I ~ ~ 3 7975 I Limit in ~ ~ Len th min ~ - ~ . . y 15 - ry 0.0020 ~ F-, ~ 3.,7974 "`:. Test .Result ~: ~ 3.7673 °-..:~:-`;:~°:°~-'` - Test assed ~ . 3.7972 . p ' 3.7971 Comments 3.79io- 3 7969- L L+_LL~ L1~ i 1 1~ ~ ~T - ' I I 1 I I ~ I I. ~ I ~ ~ T ~ ~ I ~^r I I I I I I I I ~ ~- I I I _ ~~ I I ~ ._J-_L_ 1J-l_ I L-~~~- i l --~- I I I y i , ~ I I. . ~~~ ~1_ _ ~ ,~ ii u~"~i L-~ ~ I 1 I I 1 I I ~~ _ ~_~.I I I ~ _ I- L _ I , 1 -~`~~j'_j- ~ 1_~ ~~, I ~~~~_~~,~ I I i I_~. I ~ I i_ I ~ L I ~I I L- I i-~ ~- ~ I 1 I C I -~ ` ice I~ ~r . ~- -~--~r- :- ' ~ _~.. I I I ~ ~ ~~'. "t -~~i- - ' I~ I ~ I I I ~i- I I I~ I -i i ~ -~ + i; i I ~ I r-i ~ 'I~ ~~® ~I ~~ I --~- - I j;.'~ I I I I -I I i~ I _ ,. -.-ter ...- ..-,.~ 1 I I ~I TI ~~ r r -I I t~ I -1-' ~ ~.,.-..~r.l--~ l i I-~-I i I I ~ -~ I :- ..., . I i ~~ I! i .. .. - I I - I I ~ ~I~ ~~ I L~f~- I I ~ L_ I~ _ -~- i 1 ' I -~ - I i- - '~ ~ - ' 1 - _ _ r _. i ~~ _i ~~ I rI~1I III '. I~III~-II- iII ~ ~ ~ L.- _ L I iI-i I'1- I1 I trl r ~~"~ ~~~ ;, II 'I ~ ' 03:10:55 PM 03:15:00 PM 03:18:00 PM 03:21:00 PM 03:25:55 PM ,, 04127!2007 04!2712007 04!2712007 04/27/2007 04/27/2007.1 i Test Time ` ! - ~ ~> ~~ ~fLDS/ly~~e T/fe~Test,~aoe/ Lere/P~®be 1 ~-~ - - ~ ~~~ ~4 - _ - I~ _ ~ ~, Test.Paramete~rs ~ Test Status Function Menu ~ - ( ..._._...s.:t:: a ~ -. -Un .... s < ~. ....~-. -x-.,.~,.r -~.., w s '~ Y_r.. ~ ten, ,,. ..3a. ...,,~ ~- s _ ~ ~- `~ .-Test-Site Status 2 y ~ j ~ .~ ~f~ , Pass/Fail s Restart `, :Abort`- I ~ _ .circle k ~ Saving... t ~- ,~: 2222 F st ~ Change PASS ='. ~ - .~~ I .,.~r_ ~,g..~ ~ ____ ____. ~ _ bekersfield, CA 93301-XXXX .~~ ~' :Return: ~~- ~ = _ - .; 0 00032 _ r ~ 'Product ,~~- _ _ -~--- _' ~ ,. ,,.. _.~.. ~~...._~. .__y _ ._ _...~ ~ ~.... _... ~ ..~ . . ~ ,.s _. ~. t - Type. ~ i ~ 3.8219 - f s ~ Spill Conta nment Vapor Bucket ' ~ ' ' ' , ~ '~ 'Test Start Time 3.=8210- ~~ ' Fri, Apr 27, 2007 3.42 PM ' ... _ ; Test End Time ~ 3.8209 - ~ _ . ,., . ~,.. .~ _ _ _ a~ •~~Fri, Apr 27, 2007 3:57 PM ~` 'a ~ -~ 3.8208 ,E Length (min) Limit (in) Y. . r ~~~.T +, 5 0.0020 ~ `~ ~ ~; 3.8207 ` ~ Test Result Test passed 3 8206 . Comments' .~, ~ " 3..8205 ~! I J I I C I I I I I I ! I i I I I " 1 ,~,,;,,a_1 _; I ~ I I I II !~II II~':I ~ II ': II ' ~~I I ~ I I I ~- ~-- '' _ I~ '_ ~i iii II i I i fi ! ~ ~-- ~ -~- Tom- ' _ --~--~- ~ L -I . --~ - ~., ~ ~» . ~.a..,i ~ » I I I ' -. I 1i1 f! ~! !111 .1 1 ~, i- '' 11 ~;~! I- I! I i. T-` i- I i 1-ti l i 7 i I ~ ! ICI ~_ ~,~_~ I ,~~~I L -r i I I I ~ --P° ~ I i I J i - 1 T L~ i T I I ! I I ~ fi I 1- 1 11 I i LI I. I '..1 I ; ~ „~~ ' l I !. .. I• ~ ~~~ ' LTi... I 11 ~ I ~ I I+ ~ I I `i f~_~i I~ii'~~~i I I I'I it 1 L I _ ~ _~ I l-,, I I ~ II ~- I I lliil~ I _ I _L._ i _ I~ ~~ ~~ ~~ .~ R 1 I I ~ ~ .I~ 'I 11.~ 41 ~ 03:42:13 PM 03:45:00 PM . 03:48:00 PM . 03;51:00 PM 03:54:OO.PM 03:57:13 PM, 04/27/2007 04/27/2007 04/27/2007 04/27/2007 04/27/2007 ,' 04/27/2007 `~ r Test Time ;'° _ w .. ~.., ., , ! , :: ..1 ,, !~ '' ~ 3.2540= r~ '; Spill Containment Vapor Bucket ~ 3 2535 ~.~Test Start Time .~- . - € W ~---~ ~ -- ~~~ ~ e~ 3.2530 .• _ _ -~ _~ . ---~ _ ~-- 2007 3 12 PM Apr 27 ~ 4~ ~~ Fn 3:2525 , . , `~Test~End Time ~ ~ ' ~ '~~ ~ 3:2520 ~~4~~~ ~. ~.....,~ _._..~ Fri, Apr 27, 2007 3:27 PM ~ ~ ~ , , , ~ ~ 3.2515 ' (mm) :;Limit(n) Length .., Y 3:z51o N ~ ,~~ ~...~ ~ 0.0020 - ~ i ~= ~- 3.2505 3.2500 Test _ReSUit ~ 2495 3 . Nest passed ~ ~ ~3.z4so Comments ~ ` ~ ` ,.,,~, _,~ 3.2485 ~ h i l l I I I ~ ~ I ----~-~- L - 4 - 1 1 1 I I r----~ T ~- ~ - ~- l=- . , T ~;- -~- ~ ~ I I I ~ ~-~~-~ i I ~_ I ! ~~ I ~7 L I ~~-~ i~i ~ , ~ ~ ,~ I - j ~~ ~:_~ _ - - ~_L__ _ _l -`- . I l I I I T I ~~ ~~ I -I I; ~ I ~ I f _ _ - I, i. _ I~ I I I I _ I. I ~ ~ ~ ',, I - - - _ - - - ~- 4. ~. Y L.. th ~-i _ ~' .f` ~; d. , ' .3.2480-, I! I l I i l l I I ~ I I I i l l i ~ ', ro 03:12:37 PM , ~ 03:18:00 PM .:03:21 OO PM 03:24:00. PM 03 27:37 PM s. I '1 ~ 04/27/2007 04/27/2007 0412712007,: .04127/2007 04127!2007' `' ~~ ~ ~ Test~Time ~ .. ~ , ,.~ ,. ... , ., ~ .... ,,. ,.... yr ~~ ~~ W.W ~,~~ s.z5sa `'k' w~~ Spitl Containment Vapor Bucket n . ~ ` Test Start. Time '~:a : .;~---`. _ _. .., .~ _ _._. _ _ -~-----~- _ _ _ . __ __-~--- Fri, Apr 27, 2007 3:30 PM ~ _ a 3.2538 . Test End Time ~ ,~ . _ -..~._ ~ n__s.~ 2007 3:45 PM ~ Fri Apr 27 " ~,. a', ' ' ; , , ~ ~ .. -~~ 3.2537 ~~ . (min) ~ ~~-Limit (m) L`erigth ~c _ ,Y _ ,k.~. 15 0 0020 ~` ~ Test R@SU~t „ 3.2536 Test passed ;. , . Comments - ~ ' I i_I I I ~ I I_ ~~ , I I I I I I I I -` , ~ ~ ~ ~ I - ~ I I i ~- + 1-- , -,-_~_,~-- i l '. ~ I ' j-~-- ~~ I .~~1_~ i I _ , ~ ~ wr.r~ - I I I L II I I I I I ~ T ~i- ~ i I i l i ~ ~ ~~ ~ J~ ~: ` I I ~ Y_~ ~--~-- ~ ; LJ ~~ ~ I ! I I I ~ I ~ ~ I ~ ~ - _ ~ ~ ` ~-- I ~ I I _ - I I I I J ~~I - I I I ~~ I I I - i~ ~ ~.,L_Ll I ~ ~~ I~ I - r I -LI I ~ I ~ ~I I .. I ~- - i I . . ce - -1-- :T ~ Y~-- -~,~_ I I ~ ~~"l ~ I I I - I ~ ~ i ~ ~ ~ ~ i_~~L ~ LJ--~L- ~ ~ I _ . _ ~ .1 L_ I l 1-1_ f L1 ~ i I I 1 4 ~ _l/ L - ~ _ a _ - _ - -- ~-= 1 - i--~~-~"-T`~ ~i i ~_ r 0 L 1 ~ - ~ . _~_+ i j- - ~o -1 -1_ ~- - i. ~ ~ i _ L.LL i J`. i 1 ' i j I I I L ~TI I I - I I I I I ~- ~L~ ~ ~ ~ _ ~ ._ I I ~ ;_t L~-- t~ I I I . ~I I .. I _1 I _L _ L I ~ _-_ ; I L y~~~ L ' - ~ i '~ I -f=1- ~ I I 4- _I-_ _ ~ I ~_ -~-~ ~--- - y I I '~ ~ I ~ ~ _ ~~ ~~ L ~ ~- I _ ~, I ~ ~ I ICI Il- I ~ ~_ i- L I-` I-I I I I ~ I _ - _ I I_ ~ I , I ~~ ~ - -_IT r }- ~i 1-- { ~~ ,:. ,;~. t,..,>; 3.2535-, ~ ~ ~ ~ ~ ~ ~~ `_ '~ 03:30:17 PM 03:33:00 PM 03:36:00 PM 03:39:00 PM 03:42:00 PM 03:45:17 PM t ~ 04/27!2007 04/27/2007 04/27/2007 04/2Z/2007 04/27/2007 04127/2007: , Test Time ,_,. . a ~l~S - Nyd~p T~1~ Tesl~Paoe/ Jere/~~®be}1 ~ ~ _ I~ TestrtParameters _ Test~$#atus ~ ? Function Menu -~ - .. J.~'E Yt ~ .a ..n-Y'~+. ELi~[°.:«a.a~l ..-5+... .d 4. - .as.%:sr -.M+r v. • w1S. - ~ ~ °~Test-.Site `~ ::,~ < ,~ ; - Status y _ ~. j~ ~_ ~ 5 ~- PasslFail ' ~~- :: , circle k ~ , ~ ~ ~ j Saving ~` a - Restart, f t A bart* , E ~ ,, ` 4 , _ n~ ~ _ , - ~~ 2222 F st '`~ Change PASS.. ~ ` ~ ~ ~ ~ ~~ ~ ~Retufn ~ Y,. T :~~ bekersfield, CA 93301-XXXX ~ ~ ~ ~ ~° . ~~ ., ~ ~ X0.00027 `~ _ .: ~~Product ~; - - a - - - _ - - k ~ u d c ' ~ .~ ~ ~:: .~ ~ ~.~..._, _ ,_~..~- ~ _T e. ~ o.ss9o= s ,>' Dispenser 1-2 - ~ ~ ~~ 0.6689 Test Start Time Fn, Apr 27, 2007 4 03 PM - 3 .°' . j ~. ` o,6sas- .. Test End Time ~. ..,~~ _ _ ~.~. ~~~:~, o PM ~Fn, Apr 27, 2007 4:18 ~ .s687 J Limit (in) t Length (min) ~ _ o s6a6 s u ~ ~~. _ i 15 0.0020 r' ~ . . i Test Result ~ a66s5 _ . Test pasw.~~ .. _ ~.~~ sed ~~~ 1 ~. Comments. ~ ~~0:6684 . ' ~ 0 6683 I L ~ ' ~ I~ Al i l ~~ i~~ ~ ~ ~~ ~ -~ - -f ~ I- ~ ~ I i I I I I ~ __j i I I I I I l i l I I _ . I I I I I I I I I ~ 1 1 I I ' I ~ I ~ ~ I .I I l l ~ I I - l i I ~ j_~~ I I I i I I ~ I I I ~ ~ I IJ_ ~_,.LLI-I-_ ~ Lf1 I _L ~_II ~ I I I L I .i.. .. I -_. ~I i I i ~ ~ I ~ I ii ^ ..i - ~ ~~ ~ I L~ I ~ I I ~~ ~I I i i I -~--~ I ~ I ' I I i ~ L ,j --~ ~ I I ~' I ~ I I ~ i ~ i i ~ j ~ I ~ I I I I I i j_f II _I I ~ ~I _ ~ ~ ~ ~ I I ~ I ~~~ ' ~ I~~ L I 1. I , L~.L I I _ ~._ I I ~ I i I I ~_j I I f ~ I L . i I_ I ~ ~ ~~ I , ~~L, I ~ ,I' I ~ ~ ~ r l I i ~ ~ , ~ I ~ ii I L~ ' I L L ~ _i ;l ~ i ~ ~1 I I I ~. •~I~ T - _ ~ ~ ~_____~~ ~ I I_ ~~ I I _ ~ I I I I~ I I i ~l -,-- - ~ yl ~ l i l I ~- t 111 I I I I ~'~ I I . - ._.- . I I ~. I ! III- I L1 .~ - ~ ~ - .J _ I I I I I '~ ~ _. jl.~'~ ~ I I~_ ~1~ ' y ~- i I ~, I ~ - ~ C ~_ --U I . - . L _ .. --- ~ - _ _I I I - Ll _ _ TI i I ~ I I Ilil _ -~--~_ ~~ I ! --'-~-- ' III I I it I _ _ ~ x"~ ~ ~ 4~ s> r~ . ~ i ~ i ~ ii 04:03:09 PM 04:06:00 PM ` 04:09:00 P.M 04:12:OO.PM. 04:15:00 PM , 04:18:09 PM ~ `~ 04/27/2007 0412712007- 04/27/2007 .0412712007 04/27/2007 04/2712007 ~ ~ Test Time - , . ~ ,.. I ~~~ Type. ~.tin~n- t C ~Dispe ser 1 2 F j E '~ Test Start'Time ~ .' ~ 0.6685- Fri, Apr 27, 2007 4 19 PM 'Test End Time- ,, ! ~ d ` oasea- `Fri, Apr 27, 07 4:34 PM ' :Len th min Limit in .~c ?' - 15 .. ~ 0.0020:~.,T ~ R , 0.6683 Test Result LL ~ ~ .Te p sed o.sss2 ~~Coininents ~ ~ : '~ ' 0 6681 I I I J_;_L ~ _ I I I mMwr~ , I I ~ I I I f I I I I I I ~~_ T~i~ ~ ~ - -I ~ -1-1_ 11 I __. I I T I- r~ ~-r ~ I I I ~, ~~ I II ~ ~ . I ~ I ~ .l ~ I. I I I r-- I r- + - ~~I~~ -~ ~. ~__t- -1-. ~~ I `~~-I l w ~ I i ~- ~~ - -L I ~-~ I-! ~-FS -+-1- I ~ ~ I I ~ r - ~I~ I I I ~ ~ I ~ I I I I II : ~ ~ L LI _~ ~ ~ k:~-~ ~ i~_~~~_I~~~~ ~ _- ~ ~- ~, ~ L~ I ~ ~` -- I - I I I -i ~ ' ~ -~-+-~ ~_ 1 -_ -~_ _ I I I i ~ .. ~ I - - _1 _~ _ - ~~_t 1 i I I - I I ~~~ ' I :~I j ~ ~ -~_~ r'- -' - I +, , _ __~ I I i t ~ I i i ''. - - i I i I I I I I I~ I I F ~' ;. ~, ~~, ,. ~ ~ ~ ~ ~ ~ ~ ~ I 04:19:10.PM 04:24:00 PM 04:27:00 PM 04:30:00 PM 04:34:10 PM 04/27/2007 04/27/2007 ,04/2712007' ,04/27/2007 04/27/2007' } ~ ~ : ~ Test Time Testing Procedures Secondary Containment Testing, Underground Storage Tank Systems Contractor: Fueling & Service Technologies, Inc. (FASTECH) Testing Technicians: Site Manager, Primary Tester: Alberto Rodriquez Cesar Plascencia Abe Reintord Jim Simeone Steve Acosta (714) 325-9477 (714) 403-5439 (714) 325-7495 (714) 926-3165 (714) 809-6018 Site Safety Officer: Primary Tester Qualifications: • FASTECH currently holds business license number CA 794519 - A, Haz, C21 • Information regarding Worker's Compensation and Employers' Liability (available upon request). • FASTECH provides HAZWOPR training for employees. FASTECH develops aaite-specific Health and Safety Plan w/ Confined Space Permit for each testing location (available on-site, day of testing). Test Equipment: • FASTECH utilizes third party certified hardware and software for all hydrostatic tests (attached). The primary tester is certified, by the manufacturer of the equipment used (Enhanced Leak Detection Systems, Inc.), to test containment sumps, under dispenser containment, and spill buckets. • Pressure Gauges, Ametek-U.S. Gauge, 0-15 psi pressure range, 4.5-inch diameter, glycerin filled, .5% span of scale, calibrated every six months. • Vacuum Gauges, Ametek-U.S. Gauge, 0-30 in-hg vacuum range, 4.5-inch diameter, glycerin filled, .5% span of scale, calibrated every six months. • Vacuum Pump, Gast Model 22866, 120 volt AC. Pump mounted greater than 18-inches (about 3.5-feet) above work surface (surface grade), with outlet tubing terminating outside the work zone. Test Procedures: • Local CUPA will be notified of testing schedule a minimum of 48-hours before the test is scheduled to begin. During testing, station's dispensing equipment may remain in operation providing no health and safety concerns arise for either the public or test crews. Testing will be performed within an exclusion zone. If, at any time, the site safety officer or local CUPA deems any situation unsafe, the site safety officer will shut the station's dispensing equipment down. Testing will only be conducted when all health and safety concerns are met. • Sump Cleaning and Preparation. FASTECH will steam clean all turbine sumps, dispenser pans, and spill buckets. The water and waste generated during the cleaning process will be temporarily stored on-site in a labeled drum (dated, Haz Waste Label). The client will classify the drum, and provide transportation for drum disposal in a timely manner. Once the site has been cleaned, it will be ready for testing. Page 1 of 3 • Use of Test Fluid. FASTECH's testing fluid is comprised mostly of water with low concentrations (<2%) of surfactants and stabilizers. California Regulations allow for the transportation and reuse of water that is used as testing fluid. D.O.T. regulations mandate that the test fluid never contain more than 2% by volume of a hazardous material. Because of the extensive cleaning of the sumps prior to the introduction of the test fluid, the test fluid has never been determined to be hazardous. • Tank Annular Space. For tanks less than 20,000 gallons capacity, apply a vacuum of 10" mercury to annular space. After establishing a stable vacuum, maintain this vacuum for 60 minutes. At the end of the test period, if the vacuum reading has not changed from the established test vacuum, the test is complete and has achieved a "pass". For tanks greater than or equal to 20,000 gallons capacity, apply a vacuum of 10" mercury to annular space. After establishing a stable vacuum, maintain this vacuum for 120 minutes. At the end of the test period, if the vacuum reading has not changed from the established test vacuum, the test is complete and has achieved a "pass". If the tank does not maintain the test vacuum, the contractor may re-test the annular space. If, after the second test the tank does not achieve a "pass", the secondary containment must be considered not liquid tight. Repairs may be made by the tank manufacturer or authorized representative per the requirements of the local CUPA. Product, Vent, and Stage II Vapor Piping Secondary Containment An inert gas shall be used. The secondary containment shall be made airtight with either the rubber test boot or fiberglass test fitting installed at time of installation. If the test boot is missing or damaged, an approved replacement test boot or fiberglass test fitting may be installed. Pressurize secondary containment piping to 5 psig and allow to stabilize for 10 minutes. Maintain test pressure of 5 psig for 60 minutes. At the end of the test period, if the pressure reading has not changed from the established test pressure, the test is complete and has achieved a "pass". If the piping does not maintain the test pressure, the contractor may tighten clamps and fittings, if necessary, and re-test the piping. If, after the second test, the piping does not achieve a "pass", the secondary containment must be considered mot liquid tight. Repairs may be made by the piping manufacturer or authorized representative per the requirements of the local CUPA. • Containment Sumps and Under Dispenser Containment. The containment sump shall be free of dirt, debris and residual petroleum product. Place test fluid in the sump a minimum of 2-inches above the highest piping penetration. Electrical penetrations do not need to be included unless located below a product, vapor or vent piping penetration. Piping shall include primary/secondary product piping, vent piping, vapor recovery piping and siphon piping. After test fluid has stabilized for 30 minutes, the liquid level shall be measured using test equipment third party tested to below .0007-inches resolution. The test period shall consist of two 15-minute tests. At the end of each 15-minute test period, the test equipment must confirm a hydrostatic change in level no greater than .002- inches in order to achieve a "pass". If the containment sump does not pass the test, the contractor may re-inspect the sump, tighten penetrations/clamps and fitting, and re-test. If after the second test the containment sump does not achieve a "pass", the secondary containment must be considered not liquid tight. Repairs may be made using the sump manufacturer's procedures per abiding by the requirements of the local CUPA. Page 2 of 3 • Spill Buckets The spill bucket shall be free of dirt, debris and residual petroleum product. Place test fluid in the spill bucket f - inch below the highest portion of the bucket's containment. After test fluid has stabilized for 30 minutes, the liquid level shall be measured using test equipment third party tested to below .0007-inches resolution. The test period sha-I consist of two 15-minute tests. At the end of each 15-minute test period, the test equipment must confirm a hydrostatic change in level no greater than .002- inches in order to achieve a "pass". If the spill bucket does not pass the test, the contractor may re-inspect the bucket, tighten drain valve fittings and re-test. If after the second test. the spill bucket does not achieve a "pass", the spill bucket must be considered not liquid tight. Repairs may be made using the spill bucket's manufacturer's procedures per abiding by the requirements of the local CUPA. Reporting: A final report documenting secondary containment testing shall be submitted to the local CUPA within 30 days of the completion of the test. The report must include all data collected as part of the testing and indicate any deviation from the approved Work Plan. All reports shall be evaluated for the completeness and accuracy. Failure to submit a satisfactory report will result in test results not being accepted and may require additional testing. The Secondary Containment Testing Report Form shall be used. Page 3 of 3 <` i Prevention Services UNIFIED PROGRAM INSPECTION CHECKLIST.. B E R 5 e, ,,, 90oTruxtiinAve., suite 210 F~Rr= Bakersfield, CA 93301 SECTION 1: Business Plan and Inventory Program aR'"' Tei.: (661) 326-3979 - ~ Fax: (661) 872-2171 FACILITY NAME - w ^ ~/ It P l AT~ INSPECTION TIME ~ ~ ~ ~.~D ~oj 'QJ-V ,r~J ~ ~~ ~ Q ADDRESS ~ ~ I~ HONE NO. NO O PLOYEES ~ ~ `~~~ ^ ~~ FACILITY CONTACT - ~ BUSINESS ID NUMBER 15-021- ~t;~~ •, Section 1: Business Plan and Inver-#ory, Program ^ ROUTINE L1..COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIt1eSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY J~ ,~ / 66' ^ VERIFICATION OF INVENTORY MATERIALS oo~ ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ~~^ VERIFICATION OF MSDS AVAILABILITY - IC ^ 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: QUESTION EGARDI G HIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # Business i e / s nsibl Part (le rint) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 ^ YES ~10 INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~~Cc~c. ~ ~tL B E R S F I L D P/RE ARTM r 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 INSPECTION DATE: 7 aS Section 2: Underground Storage Tanks Program ^ Routine l~/t;ombined ^ Joint Agency ^ Multi-Agency Type of Tank Q41E~'S _ Number of Tanks Type of Monitoring t~I/1 Type of Piping 3Complaint ^ Re-Inspection Ouli= 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 OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Pink -Business Copy Aggregate Capacity Number of Tanks KBF-7335 FD 2156 (Rev. 09/05) .`\ - ~ r°n^ c .-~--....-- - SM 495 East Rincon St Suite 150 Corona, CA 92879 December 21, 2006 Bakersfield Fire Department 2130 G. Street Bakersfield, CA 93301 ~~ UPS: K054 558 389 7 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 CERTIFICATE OF INSURANCE NAME: SEE SCHEDULE BELOW ADDRESS: SEE SCHEDULE BELOW POLICY NUMBER: ST8089599 ENDORSEMENT: Not applicable PERIOD OF COVERAGE: t 2/17/06 - 12/17/07 .NAME OF INSURER: AMER1CAid.I6~1rERNATIONAL 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 Convenience Stores, LLC ADDRESS OF INSURED: 1130 West Warner, Building B Tempe, AZ 85284 CERTIFIGATION: 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 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 tank(s1 identified above. The limits of liability are 51,000,000 each occurrence and 52,000,000 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 its 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 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 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 ~: '•Y "~' "' notice is received ~ tiy` ~h`e ' ii~•sured. Cancellation for non-payment of premium • or ~~~I'sE'~: misrepresentation by th.B 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, it applicable, and prior to such policy renewal or termination date. Claims reported during such extended reporting period are subject to the terms, condit)ons, 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 (b? t2) and that the Insurer is eligible to provide insurance as an excess qr surplus lines insurer to one or more- states. Sign~ture ~f~uthorized Representative of Insurer Jota Shohtbb u Authorized Representative of American International Specialty Lines Insurance Company 777 South Figueroa Street, 131h Floor, Los Angeles, CA 90017 CI2567 2 Circle K Tank Schedule 112/17/06-07 ~ __ _____ -- ------ - F---- - --------- ------ - ----- --- West Coast Region ias of 12113/06 ADDRESS LOC~# ( Region ~ CITY t STATE LUST # .. . W .. . ^, ._,__.__.__.. ._._m-.__ 2708691 '~WC `:766 S MAIN ST ,...__._. ........._._._.....-... _,w....._ YSAN LUIS . .. __ .... AZ ; 01 2708_691 WC ;766 S MAIN ST ;SAN LUIS AZ 02 2708691 ;WC ;766 S MAIN ST 'SAN LUIS AZ 03 2708691 ~WC 1766 S MAIN ST =SAN LUIS iAZ 04 2701939 WC ;121 E MAIN S_T 2701939 ; W C ~ 121 E MAI N ST 2701939 !WC ^ =121 E MAIN ST 2705709WC~ _ _ X1415 E 16TH ST~ 2705709 WC ,1415E 16TH ST _ _ 2701849 ~WC ~ ;1798 4TH AVE ,~ 270184 9 !WC 17984TH AVE _ - - ~ 2701849 ' W C 1798 4TH AVE 2700684 WC ;2089 AVE A 2700684 WC 2089 AVE A 2700684 ' WC 12089 AVE A 2701847 WC 2090E 32ND ST 2701847 jWC 2090E 32ND ST 2701847 ~WC !2090 E 32ND S T 27_01800 ~WC_... _ 2398AVE.B 27_01800 WC =2398 AVE 8 2701800 {WC '2398 AVE B 6 WC 27017_5 ;2400 S ARIZONA AVE ~~-- - . ~ w _ _ . 2701756 ~WC ,. ~..~.~-_ ._-._._._. _.-.-.,. ~ 12400 S ARIZONA_AVE - 2701756 4 WC 2400 S ARIZONA AVE 2701394 WC 12409 8TH AVE m 701394 ;WC 2 , 2409 8TH AVE , _ _ -- .-..-.e 701394 ,WC 2 .~.~... ~, _..____~.._ _...~.._.~_~,. `2409 8TH AVE _ 2708475 ' W C 2505 W 8TH ST_ _ ~ - 2708475 ~ WC _. _ _ 12505 W 8TH ST _..: _w_.._.._..~_. _ _.... _.______-_~__ 27 5 ''WC 0847 j2505 W 8TH ST _ _ 2700212 WC :3650 8TH ST --~ _ _. 2700212 WC _ !3650 8TH ST 2700212 WC 3650 8TH ST 27_01930 ~ W C 0 :379_ W 1ST ST .~.-_ ~~ 270193 WC ' 379 W 1ST ST 2701930 ` W C _ i 379 W 1ST ST 2701923 WC 1637E 32ND ST 2701923 WC 637E 32ND ST ~ ~~ .w.,_. 2701923 ' W C _...-_...._.~.~.~.____. j 637E 32ND ST _ 2701948 4WC ;6544 E OLD HWY 80 .. ~. 2701948 WC _ ._ 16544 E OLD HWY 80 2701948 'WC _ ;6544 E OLD HWY 80 2701948 'WC 6544 EOLD-HW Y 80 2701736 'WC _ Yym _ 1695 S 4TH AVE 2701736 WC 1695 S 4TH AVE 27_01736 +WC X695 S 4TH AVE _ - _ - 2701356 WC ;7110 E HW Y 95 ~ 2701356 ; WC _ }7110 E HWY 95 2701356 'WC (7110 E HWY 95 2701754_ WC ;820 W 32ND ST_ - 2701754 '. WC '820 W 32ND ST ~~ ~~ ~ ~..__. ~~ 2701754 ' WC 820 W 32ND ST mm 2700990 WC ~29105 HWY 80v_„-w YT_ 2700990 IWC . 129105 HWY 80 __.. 2700990 WC _.- - ;'29105 HWY 80 2705008 a WC __. ......~~.__ 111424 CHAMBERLAINE A ..._. _ __...___ _ . _ . _. 2705008 WC , _ _ . -_ _. .._._.-w._ :11424 CHAMBERLAINE A CAPACITY GALLONS 30 ~, 981 05 _ _981 ..-, ._. . 05 ~ 981_ _4 INSTALL RETRO DATE DATE 1-J 1-J 1-J SOMERTON AZ i 01; 20 ; 9816S FG I 1-Mar-86j _.._ ._._.m_..._ SOMERTON `AZ 02 ;05 ~ 9816S a FG ; 1-Mar-86 ___... ______._.._.___Y... SOMERTON _ . _..____.___.,....,~.___....__...~._ ~.. ___-__.. .__w_ AZ __... ._.._ .. 03 ~. . 30 .r._ .__.. __ .. 9816`S ...,_. ._...;~.._ __ FG ' w__-... ~__..-...__ 1-Mar-86' ~,_. YUMA AZ 01 U °30 € + 12023FD NSF € 1-Jan-934 AZ Y U M A 02 U 05 1 ' 12023 D SF € 1-Jan-93~ _ _ _ _ 'IYUMA AZ 01iU X20 ; ~ 9728'S~ FG 1-ilu1.85,~ .,~._.._.._.m._.__,_... YUMA AZ 02 U 30 _. _. 9728 S FG ; _~.. 1 Jul-85 YUMA~~_ __ _ __ _____.- . _______.....___.... AZ _ w.._. 03 U __ .._._._ ~ 05 _ . ___ ~ ~~ _~ 9728 S FG i ' ' ~,w_._ ~__._ 1 Jul-85 - ..~____ _____., 17-Dec-03 17-De_c-03 17-Dec-03 ^17-Dec-03 17-Dec-03 17-Dec-03 17 Dec-03 17-Dec-03 17 Dec-03 17-Dec-03 17-Dec-03 :YUMA AZ 01 U 05 9728 S FG i 1 Apr 84+ 17 Dec-03 }YUMA AZ 02 U 30 9728IS FG ~ 1-Apr-84` 17-Dec-03 _.._.______ IYUMA _.-.._._,._._._r___._..__..__, _-...__...._ AZ _..~. -~. 0310 , ..._ _..__ 20 ._.___ 9816 S FGA .,_...,_._._~_ 1 Apr-84; _._._.._...,_.., 17-Dec-03 ::YUMA 'AZ 01'U 20 9816 S FG 1 Ju185~ 17„Dec 03 YUMA ~ AZ ~ 02 U 30 9816 S FG ' 1 Jul 851 17 Dec 03 =YUMA AZ ~ 03 U '05~ 9816 S FG ~ 1 Jul-85, 17-Dec-03 IYUMA AZ 0110 30 i 9816 ~S FG ? 1 Nov=85 17-Dec-03 -____.___ ;YUMA _ ~ ___.._ ____..~._..._. __,_._ _._... AZ _. -_ 02'U ._ _~ . 05 ~ .._ . ~..._ .._ .. 9816'S FG ~ _..- _-____m 1-Nov-85 ,.,..._. _. 17 Dec-03 EYUMA AZ 03 U 20 g 9816 S FG ~ 1 Nov 85 17 Dec 03 YUMA IAZ 01!U ;20 , 9816 S iFG ~ 1-May-85~ 17-Dec-03 ;YUMA +AZ 02`U '30 1 9728 S FG 1'May-851 17 Dec 03 -YUMA AZ 03 U 05 9728~S FG { . ' 1-May-85 17-Dec-03 -YUMA AZ 01 rU 30 9684 D : FG 29-Jun-043 17 Dec 03 . M_s.__._.....__ ...._,......~.___,. ~------.__.___, _.,_. , _ ._-._. .,,. . :.YUMA AZ _ 02`U '05 9684D FG { 29-Jun-04 17 Dec 03 IYUMA +AZ 03 U _ 20 9684,D FG 1 '29-Jun-04= ~ 17-Dec-03 . ._,____,~.._ . :YUMA ............_-___...._.____._.._. _ _. __,...., c-_~ AZ _ . ~. _ 01 U 20 - _ ~_... _.- . _._~.._ ; :9816;S FG `s. __... ._ ._ 1-Nov-87~ __--.__..._....__. 17 Dec-03 'YUMA PAZ 02 U 05 9816iS .FG 1-Nov-87' 17-Dec-03 :YUMA AZ ± 03'U 30 9816';S FG ~ 1-Nov-871 17-Dec-03 ~__-_._._. :YUMA ..a____.._._._ _. _...__-_ _._.,~ ._. _,_,.__ iAZ ..._,......'..... 01 rU 20 ~' 9816 S FG 1-Nov-851 17-Dec-03 ._ ... -YUMA ~ ..........~. -.-__...___.-w._w +AZ F ., 02 U .__.., 05 s _.µ 9816 S FG . ._,-...._.. 1 Nov-85 _.~..._.._ 17 Dec-03 _m_ ._.-.~. ~YUMA ._:_._-_____ ~`AZ a .__.. 03;U _.__ 130 ~ _ _. ` + 9816 S FG ~ .-. j. - 1'Nov 85+ ~_~__ 17 Dec 03 pµ IYUMA m „ ,T... w ._ . ,.._..... ~AZ 01 ,U L 9816;5 ;FG ~ ~ 1 Nov86 20 17 Dec -03 YUMA ~. AZ ,w .rr 02~U ~m - 30 t ' „ 9816 S FG ` 1-Nov=86t M 17-Dec 03 _. _. _-°.-. 'YUMA _..,_.__ .._...__.._,..__..__,._. {._...___. __ _. _ AZ ..__._. 03~U X05 ;~~ 9816 S FG 1 Nav,86: 17-Dec-03 .YUMA `AZ 1 01'-U ~ ._.-_.._ _ °05 € , ._ -_~~--. 9816!S MFG i' _,~__.,___.-._ 1=Dec-85 -.~_____.__- 17-Dec-03 'YUMA AZ 02'U -30 p ~ 9816 S FG ~ ~ - 1 Dec 85 ___._ 17-Dec-03 :YUMA AZ 03 U 20 { 9816 S FG , 1 Dec-85 17 Dec-03 YYUMA AZ 01 U 45 ; r` 20029'S FG ' 1-Jul-87€ 17-Dec-03 YUMA AZ 02 U ~30 9816 S FGA 1-Jul-87~ 17 Dec 03 YUMA AZ 03 U 105 ~ 9816 S ,FG I ~ 1-Jul-87~ 17-Dec-03 _..~, _.._..-. IYUMA __._._..... _.,.,....~._- AZ ~ ~__ 04 U ._.~- 20 (~ _ ,- ~._ 9816 S .FG ~ -_.____m__-___..- 1-Jul-87~ _ . -__-_..._...._.__.r 17-Dec-03 - IYUMA -. ~~ 1AZ ~ 019U A5 ? 9816'-S iFG I 1-Apr-851 17-Dec-03 ~ w ___ ~ ~.__.___. ._... _ 30 ~ 9816 S FG ~ 1-A r 85 17 Dec-03 IYUMA AZ ~ ~ _rv,-~~~~ - ~ -.._ __. _.... ~. ~. w _...,y.._.._~._p_.e. _..._._ __._.._...... IYUMA AZ 03~U 20 } 9816;S FG ; 1-Apr-85;, 17-Dec-03 ;YUMA AZ ~ 01 U ~~ ; 20 97281S FG t 1-Dec-86~ 17-Dec-03 _.._,_.__ ..._..n._.__,~._._.._._..._.__, _. ....._,~.,.._.. ...__ _r.___ ..,w.w_..a ~ ______M__..,-_,_.~._-.._,.__...._---._. ;YUMA AZ 02 U 05 9728~S MFG 1-Dec-86; 17-Dec-03 _ v 30 9728;S =FG 1-Dec-861 17-Dec-03 `YUMA AZ_ 03~U __.. .r._...._.... _._.~__ ;YUMA AZ 01'U 05 ~ 9728IS FG 1-Apr-851 17-Dec 03 .. __..._.._ .__. _. ~ F _...._.-...~.. ~ .__r._-_. IYUMA AZ 02tU 30 ' 9728~S tFG 1-Apr-85 17 Dec-03 IYUMA IAZ 031U 20 ~ 9816 S MFG § 1-Apr-85? 17-Dec-03 ~WELLTON ,AZ 010 + 45}~ 9728 S FG I 1-Apr-851 17-Dec-03 __. g.____._.___.__...__._. __ ____.._._ .__ ___._ _.__.-.--I__~.__., ~ __.a_._ ...__...___._.__ ;WELLTON AZ 02 0 ! 30{ 9728S FG = 1-Apr-85~ 17-Dec-03 m_____,__-..__._.~.__._...____ .................... ._._.......,.._._.__._. __..._ s. ._~ ._.____ _..._. ._..__._._,_.._,_,__._____.__._-... 'WELLTON AZ 03„O ~05~ 9728S FG ;.~ 1-Apr 85 17 Dec-03 VE ~ADELANTO ,CA 01'U '•05 ! 98161D FG `: 1-Nov-88. 17 Dec-03 _... _,._...._.._________.-___...._.. _..._._.__ ,_~._._.._ _..._.__ __~_ ,,._._..pm....._ _ . ._ ,__ ,.,.._~ .._..____..__.. VE £ADELANTO CA 02rU 20 I 9816 D 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 West Coast Region 12117106-07 as of 12113106 ---- CAPACITY I NSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS - DATE DATE - 2705008 WC ? 11424 CHAMBERLAINE AVE _ -- ADELANTO CA 03 U ' 30 F 9816D iFG 1-Nov-88 17-Dec-03 _..~.~ ,..,....___W 2708644 ~WC _.,..,.._~..__..._.~_.....__._..__._..__._._ 11724 AIRBASE RD _.. ;ADELANTO .__.. .,_..,~ w.. CA ._..._ _...._N~..__ 01'.U _._..._....._._ ' 30 _ __~,._:._.:__.__ __ 9816`D FG ,..__.~.._.._ .._. 1-Jun-88 17-Dec-03 2708644 WC .11724 AIRBASE RD ADELANTO CA ~ 02~U 05 s E 9816`D ,FG 1 Jun 88 17 Dec 0. 3 2708644 ~WC :11724 AIRBASE RD ADELANTO CA .. 03U - _..... _. ,. 20 s 9816D FG 1-Jun-88 17 Dec 03 .~..__. 0736 `WC 270 _._ _ ___._,.._._.w_..___ ............. °56621 STATE HWY 371 iANZA !CA s 01 U 05 } 14976~D FG = 15-Jun-98 17-Dec-03 _ 2700736 "WC 56621 STATE HWY 371m~V ANZF1 ._....__.~._..___ .__....~ CA 02U 30 I _- 11849~D MFG I 15 Jun-98' 17 Dec-03 2700858 ~WC X18465 US HWY 18 iAPPLE VALLEY ICA 01U ~20 : 9816 D'FG 1-May-88~ 17 Dec 03 2700858 WC 18465 US HWY 18 APPLE VALLEY CA 02;U 05 ; 98161D rFG , 1-May-88~ 17 Dec-03 __._._..~.._~,_~.. 2700858 iWC ..~..._.._._._._ .._.__.....~. _ 18465 US HWY 18 ____.._,._... -APPLE VALLEY .._ CA .._...w~ 03 U 30 ~ ..~._._...._. 9816D FG t n ~ _.__.....~.. 1-May-88~ 17 Dec-03 2701232 = W C ~ , 4381 EL CAMI NO REAL _.-...._ ~_ ATASCADERO .__~ _ _..._.._ CA ~ __. 01 U ...-_. OS ,14976 D FG ~ ~ --v~ ~n~~µ -~ 20 Oct 98i 17-Dec-03 ~+ __._.___ _._._ 2701232 WC __,_.~._..,_._.._.._..m.. ..._.__~._____ 4381 EL CAMINO REAL .,.w___.__._._._.._.~._____ ATASCADERO .__.____.___ ...__.. CA _ 02`U 30 ' 11849°D FG = 20 Oct 98 17 Dec-03 2701197 WC `6930 MORRO RD ___ ATASCADERO ~ _....__ CA 01'U 20 9816~D MFG € 1 Jan 85 17 Dec-03 2701197 ~WC .6930 MORRO RD °ATASCADERO CA s 02 U 30 { 9816 D IFG = 1 Jan 85t 17-Dec-03 2701197 ;WC 6930 MORRO RD ATASCADERO ACA 03':U '05 ~ 9816'.D FG ,1 Jan-85 17-Dec-03 _-.._._..._. iw._.__. 2705018 ,WC .~.. ___.,.._._.____....___._..,.__ 1021 SHAFFER RD ,._.w._-~.__.__.__ __.~.. ';ATWATER ..._....___._._ __._µ_ ,CA .,. , _.. c 01'U _ ~ 20 k .__ _._. 9816+D FG __ .._.._ 1 Nov-88' 17 Dec-03 2705018 ~WC X1021 SHAFFER RD ATWATER CA 02iU , 05 9816 D `FG . 1-Nov-88 17 Dec-03 w_____- -.-,m.__ _ 2705018 ?WC . __~__._,...v,__..._.._......__~._.__._.._.._ '.1021 SHAFFER RD ...~..._._. ._._._ +ATWATER _______. .. _._.__. CA ..~ _.w.. __. 03 U _. _. 30 _.._ __ ,_._ 9816;D FG _. ___µ.,.._________._..__. 1 Nov-88s 17-Dec-03 _._,~.. 2701178 WC _.____..... w.______._. 4428 SKYLINE BLVD .._.._.__...___._.. iAVENAL __ ,__._ _ CA ._. 01 U 05 ~ 11849 D FG s . __..__-_.._.~. ..__..__. 10-Dec-98 17 Dec-03 2701178 ~WC -428 SKYLINE BLVD 'AVENAL CA ~ ~ 02~U 30 ' '11849iD FG 10-Dec-98f 17 Dec 03 2708606 ~WC 10300AKST ?BAKERSFIELD SCA 01,U 06 9816;D FG - 1-Ma -88' 17-Dec 03 2708606. WC 1030 OAK ST BAKERSFIELD CA g 02aU ~30 9816 D FG 1-May-88j 17-Dec-03 2708606 WC 1030 OAK ST~~W~~~~~TM W~~~-~ _ ;BAKERSFIELD _ ~ ~ ,CA _ 0 U 20 9816 D FG = 1-May-881 17-Dec-03 2708825 iWC :2222 F ST :BAKERSFIELD CA 01 U 20 9816 D FG 1-Mar-87; 17-Dec-03 2708825 iWC 2222 F ST 'BAKERSFIELD 'CA 02 U f05 9816 D FG ; 1 Mar-87; 17-Dec 03 .~... . _~ , . 2708825 =WC .., .~ - 2222 F ST .~..-,. ........ mm BAKERSFIELD .........~.__._ _ jCA .~. .... 03'U ?30 _ 9816`D MFG ..........-y ..~...... 1-Mar-87~ 17 Dec 03 2708605 '..WC :5600 AUBURN ST , .., _M~..._..._ _ BAKERSFIELD ._.~...____. sCA ___ 01'U 30 , .. 9816iD `FG s ._.___..._..,__. 1-Mar-88~ 17-Dec-03 2708605- WC '5600 AUBURN ST BAKERSFIELD iCA 02'U r20 ° ~ 9816~D FG ' 1-Mar-88 17 Dec-03 _.._._ _.__~.m._.,~._ 2708605 =WC . _ __.,_.. _.._ ...._..,_. ,.._w__m. 5600 AUBURN ST ______..___._.,_,_._.µ_.~ ;BAKERSFIELD .,.._..____.w__w ~CA . _. _ _ 03 U --._ 05 . ~ _ s__. ,. 9816D _FG ; .____._.._.. w_.._,.__..._._.. 1-Mar-881 17-Dec-03 _.._...,..__._.y_...... 2701270 ,WC _ __. __._,__.__..____..__..__..____..__.-..w. 5634 STINE RD ..~._____._.._...._._.___. BAKERSFIELD _._.._,.__._ _._ CA ~_ _ ._ _.. 01 U 05 __ _ . w_ 14976 D `FG __.,__._.___.,-_._..._._._._..,.___. 17-Dec-03 24-Aug-98' 2701270 iWC 5634 STINE RD BAKERSFIELD CA 02 U 30 11849,D ~FG~^ - ~24-Aug-98~ 17 Dec-03 2705731 'WC 1501 E MAIN ST _ _ BARSTOW _ ~~ CA 01 U 05 15154 D FG 1 Nov 96~ 17 Dec 03 2705731 WC . ~~~~~ 1501 E MAIN ST .. _ ... -_ BARSTOW .. w. ._.._._-.~__,.,__~ CA ._____..__.__ ._.__ 02 U ... __.._._.. 30 15154 D FG i Y Nov 96 17 Dec 03 2701096- `WC 500 RIMROCK RD BARSTOW CA § 01 U 30 11849 D FG ~ 22-Jan-99i 17-Dec-03 ._, _....___ __..__._._.x 2701096: ;WC ._._ ~.._._.. ~._._..._.._.___._._ __:_ 500 RIMROCK RD __.._.,_._,.... _.._....w..__..._n_. =6ARSTOW .__...___._. _ :. _ CA _ _. __, '~ 02 U 05 t __ _ . ,. : 11849;D FG r ,____.m ::.._._.._._._____.... 22-Jan-99 17-Dec-03 _._ _ _.,_~_, 2700358 3WC ._.....,__. __ ...__.__._.. _.___ .-~ .540 W BIG BEAR BLVD 'BIG BEAR CITY .,.M_-__-w_..__. _ ACA . 'y ~ 01 U 05 _ _ m 11849mD FG __... 30 Nov 98~ 17 Dec 03 .._ 2700358 ~WC 540 W BIG BEAR BLVD BIG BEAR CITY CA I 02"U 30 ' 11849~D FG 30 .Nov-98~. 17-Dec-03 2700951~`WC ....___ _ _.. 5809 MANZANITA AVE . ~..: _.__.m__. tCARMICHAEL ~ ;CA 01:U ?05 ? ~_14976'.D FG s 10-Apr-98~ 17-Dec-03 . __ . 2700951 WC !5809 MANZANITAAVE ______ ...__ .._. __.__._~. _ .__ ._. iCARMICHAEL __ _....______ w..__.__._.____.. _ ACA _____.__~. __ _ 02 U z 30 i _ __ 1.1.849&D FG ..- ~ . ~.._._.... ..._,___ ___. 10 Apr;98~~17-Dec~03 2705728 'WC 4200 CHINO HILLS PKWY ~CHINO HILLS CA 01 jU !05 1 12037'D SF 1 Jan-91 } 17 Dec-03 2705728. ?WC '4200 CHINO HILLS PKWY w ;CHINO HILLS iCA _ _ 02~U ~` ~ - 30 ~~ '~ 12037: D SF --- ~ -____ . 1 Jan 91 17 Dec-03 2702964 ?WC 360 BROADWAY ~ -CHULA VISTA ICA __ _ ~01 U -05 ~ 9942`S SF i 1 Apr 81 ~ 17-Dec-03 _.._..._ _ 27 0 2964 '~WC .._ ..,..___.. ...~.~.w.___._..._._..~.___ _.__ _ 60 BROADWAY CHULA VISTA __ ~ =CA 02~U ~ 30 , ..._.__._ .... 99421S SF ._ ._. _ ~ __ 1 Apr-81 17 D ec-03 _ _ 2705708 ;WC _ 98 BONITA RD ~ ____ _ CHULA VISTA ICA 01 U 05 4 _ 15154~D NSF ! _ 1 Jan 96 17-Dec 03 2705708 WC .98 BONITA RD 'CHULA VISTA ECA ; 02iU ;30 15154 D SF ~ 1-Jan-96r 17 Dec-03 2705423 `WC .7796 SUNRISE BLVD ICITRUS HEIGHTS ACA . ~ 01 U :05 11682iD FG ; 1-Jan-95~ 17-Dec-03 2705423 WC 7796 SUNRISE BLVD CITRUS HEIGHTS jCA 02 U '05 i 11682iD `FG 1-Jan-95~ 17-Dec-03 2705423 'WC -.7796 SUNRISE BLVD CITRUS HEIGHTS CA 03 U 20 i 11682 D FG 1 Jan 95i 17-Dec-03 2705423 WC 7796 SUNRISE BLVD ,CITRUS HEIGHTS CA 04 U 30 11682 D FG 1 Jan 95E 17 Dec-03 2701922 IWC: 'o1cO MAGNOLIAAVE ;CORONA CA 01 U 20 9816.D FG ; ~ 1-Jan-87, 17-Dec-03 ~ ._____._,....___.. 2701922 ~WC , ..~...___.._._._,_.,~ _._...~.._ <13120MAGNOLIAAVE .__..,.__.__..._w.__..._..__,. ;CORONA _ ,_ _.,:__._ CA 02 U 05 .~... .. 9816:D'FG E _._..._..~..._,__ _..,_...w.~....__~_ 1-Jan-87 17-Dec-03 , __-. 2701922 WC __..___..__.__~___.___________._._.___ +3120 MAGNOLIAAVE _....~....m.~_-._...___.......~.,~..___ CORONA _._..._._.,__ CA 03 U _ ._. __ 30 ~ ___._,......_ ~_..._._~._ 9816 D iFG ; _.....__..___..__._~___.__,__ ~...._, 1-Jan-87; 17-Dec-03 2705705 WC 304 S MAIN ST `CORONA CA 01 U 30 15154-D SF ? 1 Jan 95 17 Dec-03 2705705 -WC ;304 S MAIN ST __.f___._ ICORONA CA 02.U :05 ; w _ 15154~D SF _ ........_..e . __._. _._.~.. w_.w., 1-Jan-95 17-Dec-03 2701914 .: WC ~~ ~ _.___.__w_.__.___ -1930 LAKE BLVD ~.~..._.._ !DAVIS ... CA 01 U ''-05 _ ~ 9816=D FG ._ ~_~_-_._..~___m.__ 1 May 87' 17-Dec-03 _ _ 2701914 ;WC 1930 LAKE BLVD DAVIS _.____. _.___.__ .____ ._....__ CA 02 U ;30 9816 D FG 1 May 87 17~Dec 03 2701914 FWC ;193 0 LAKE BLVD ;DAVIS CA 03 U X20 7950•D FG _ 1-May-87; 17-Dec~03 2705017 ~ WC _ ~i2549 BLOSSOM ~ _ __ _ ~ SDOS PALOS ~ M ~ _ __. `CA _ ~ 01 U ' 30 ~~ ~m imm~9816' D <FG ' 1-Dec-88 17-Dec-03 ___. 2705017 ~ WC __. ._.. _~ _ X2549 B LOS SOM _..w_ __._. ___..___ ,DOS PALO S _..._.._._...- __._ CA . 02 U _ ' 05 _ _ . 9816 D FG ` .. ______,____._._.._._._. 1 Dec-88; 17-Dec-03 2705017 !WC _ _ _ 12549 BLOSSOM ~ ~~~ _ _ 'DOS PALOS ~~ _.. ,CA _ ~ 03~U '20 i~ ~ 9816?,D `sFG ? _ 1-Dec-88i~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 Region _ _ as of 12/13/06 __ __ ____ _ _ _ __ ___ ___ ___ CAPACITY I NSTALL RETRO LOC. # Region ADDRESS - - - CITY STATE UST # GAL LONS DATE DATE 2708545 WC 1161 EVALLEY PKWY ESCONDIDO !CA 01=U =20 I 9816 D iFG 1-Oct-87~ 17-DecM03 2708545 `WC ~ 1161 E VALLEY PKWY : -„ rv P ESCONDIDO i ~vH~ ~~ ICA 02 U ...... ........_, '05 E ._..._..,... _ ;_..._ 9816 D ,FG __.._.~,...._.__ 1-Oct-87~ 17 Dec-03 2708545 !WC !1161 EVALLEYPK WY ESCONDIDO ACA ~ 03"U 30 1 9816 D'FG 1-Oct-87s 17-Dec-03 __._..°._ 2701527 ~WC_ _ .~ ._. ____..__._. ~685PARKERRD FAIRFIELD .__....--_ ~CA , 01°U .~...__;~.__- ___.~ _ . E30 ~ ~ 98161D•FG, s;~.m~ ~.. -_..___..._..d._.~__ 1-Mar-87' ...._._..__-- _ __ . 17-Dec-03 __ 2701527 ,WC 685 PARKER RD `FAIRFIELD ICA 02~U 05 9816:0 iFG 1-Mar-87 17-Dec-03 2701527 =WC s685 PARKER RD 'FAIRFIELD ICA 03 U 20 s 9816`:0 ,FG I 1-Mar-87; 17-Dec-03 2700489 WC 14906 VALLEY BLVD FONTANA 'CA 01'U 05 9684=D ,FG 1-May~955 17-Dec-03 ~ 2700489 # WC .. 14906 VALLEY BLVD _ ~ FONTANA ~ ~~~ .~.. E CA . 02 U - _ 30 -9684 D ' FG k ^ 1 May 95j 17-Dec-03 2705802 'iWC 16900 FOOTHILL BLVD FONTANA 1CA ~ 01 U 05 11783 S SF 1 Jan-831 17-Dec-03 2705802 iWC 16900 FOOTHILL BLVD FONTANA ICA 02 U _ 30 A1783 S~SF 1-Jan-83{ ~ 17 Dec-03 __.w 2708734 FWC __. __ 247 E OLIVE AVE __..~._____.___. w..... FRESNO .,..... __.__ ,_ iCA _ 01 U _ .. 05 _.._ __r __.. _.µ..___ 9816=D FG ..._,..__._._ .r _ 1-Aug-88~ _,._.._____ 17-Dec-03 2708734 <WC '247 E OLIVE AVE FRESNO sCA 02 U 20 98'1610 =FG ;~ 1 Aug-88; 17-Dec-03 ,._._._~._ ... 2708734 WC ._....._. .k ..____-_ ... ;247 E OLIVE AVE FRESNO _,~.m.._.mm_ ~_ 3CA 03 U 30 _ _ " 9816,0 iiFG 1 Aug.88! ___.______.,_ 17-Dec-03 2705063 iWC 8190'MISSION BLVD. 6GLEN AVON CA 01U 20 9816?D IFG 1 Jun-89; 17-Dec-03 2705063 WC '8190 MISSION BLVD (GLEN AVON iCA ~ 02,U 05 9816'0 xFG '- 1-Jun-89¢ 17-Dec-03 ,_._.,.__ .._ 2705063 'WC .... .,......... ':.8190 MISSION BLVD , __._..,..__..,_..._._.,....~ ,.._,_.......-.. SGLEN AVON - .._..,....„..d !CA 03 U 30 ' ._._ 9816~D EFG ,... _. 1 Jun 89 .....__ 17 Dec-03 2701028 WC 1665 W HANFORD ARMONA R D'HANFORD CA ~ ~ 01 `U n05 t 14976 D sFG 10-Jul-98' 17 Dec-03 _._-._.___.. ~~...,,. 2701028 iWC .,__...m._ ._ .., m.. _..._.__r____ . _~..._ _,_....___.____...__,_.,._._ '16651N HANFORD-ARMONA RDH RD ANFO ~ _.__...,. r ACA ~~ 02rvU =.30 i ~ 11849+0 MFG ~F 10-Jul-981 17 D ec-03 2705619 ~WC _ _ _ X1150 W PACIFIC COAST HWY HARBOR CITY ?CA W 01 U 05 12023 D SF ~ 1-Jan-88~~ _ °17-Dec 03 2705619 ;WC `1150 W PACIFIC COAST HWY °HARBOR CITY ACA ~ 02 U 30 i 12023 D SF 1-Jan-88; 17-Dec-03 2705057 ?WC 8197 I ST ?HESPERIA !CA s n__ __~.._.._-~ 98160 ,FG ` ~..._.._.._.....-.m ~ "1-Nov-881 ....~,__..~.__ 17-Dec-03 2705057 ',WC 8197 1ST HESPERIA ACA I 02~U ;05 9816 D FG 1 1-Nov-88~ 17-Dec-03 2705057 WC _. __. ~___..... 81971ST HESPERIA ICA s 03 U __. .____. _..____ _.a-.._. _ .-,_. __._,~._.._.~_,__.... ~ # __.._~,. ~ _.~, _._,_.._,~__,:___ 20 s ,., 9816:0 FG r_. ... ._ . 1-Nov-88 _.__...m._..., _ 17 Dec-03 _~.. ._.,_ . __. 2705242 WC ._. __....__._.... `3405 E HIGHLAND AVE'. _.. _.-_.__ -__ ~._..___.._.._.__.._ _..._... HIGHLAND _~.______ _ ~.,_...._._.- - , dCA _. ... . . ~ 01 ~U - 30 `, . 11849;0 FG 18-Aug-98 17-Dec-03 2705242 3WC .3405 E HIGHLAND AVE .;HIGHLAND _.. _ , _.. .._._._,_. _ _....- iCA µ-- _, __. 02-U , .._ X05 11849 D FG 18-Aug-98= 17-Dec 03 2700538,;WC 43955CLINTONST iINDlO _ ':CA m ~ 01~U `05 149471.D,FG 2-Nov-98 17-Dec-03 _. _._ 2700538 WC 143955 CLINTON ST .. _..-,...,.__.~, ._, INDIO _.___.._.__..._ CA ~... . _m. 02 U 30 , _ 11849/0 FG _ 2 Nov 98, _.,._..., 17 Dec-03 2705786 fWC 5793 ALTON-PKWY IRVINE !CA 01 U 05 FG "14976g.D `s 1-Nov-0.1 ~ 17-Dec-03 _. 2705786 ;WC ,5793 ALTON PKWY IRVINE 1._~..~ _-_ ;CA 02 U 30 . 14976~D iFG „ 1-Nov-01 ; 17-Dec-03 2705911 VNC E78364 US HWY 111. LA QUINTA CA 01 U 05 1497610 }FG ~ 14-Jan-021 17-Dec-03 2705911 ?WC 78364 US HWY 111 LA QUINTA CA 02 U 30 14976 D ,FG ~ "14 Jan 02~ 1T Dec 03 2705911 : WC __ 78364 US -HWY 111 _ LA QUINTA =CA 03 U 45 14976 D iFG ~ 14-Jan-02! r 17-Dec-03 2700837 'WC _ _ _ _. __.. .~ _,_ .17671 GRAND AVE. _ . _...._._.~..__.._._.,.°,~_._. LAKE ELSINORE , m.._____.,__.~,_.._..~._ .. _ CA 01 U _ _.,. 30 ,.._ ..~,,.._ .~ 11849 D FG ~ _._~.__mw._.~. ._ . 13-Jul-98° ..,.._._.______.. 17 Dec-03 . . _ ... 2700837. WC .. 17671 GRAND AVE ` . . ,...aw.__-..__ SLAKE ELSINORE _._._ ,_vw _._ CA _ 02 U -05 ~ _ 11849 D FG < __ 13 Jui-98 17-Dec-03 2701205WC 16470 CAMBRIDGE LATHRDP CA 01>U 05 11849 D IFG i 2-Jan-98s 17-Dec-03 2701205 IWC ._ 16470 CAMBRIDGE ..,.,,.:______ _,_ .. ~, ~. ILATHROP .._ _.....~ . _. CA _ ~. _ 021U _..w 30 • 11849 D FG 2 Jan-981 17-Dec-03 ~_ _ 2701215 LWC _ 1421 OCEAN LOMPOC +CA 011U ,. -05 11849 D FG 1 Feb 991 17-Dec-03 ..-.._ 2701215 $WC ` 1421 OCEAN __ _ ..~ __._, .W ...._._. _ .__._.., t E xLOMPOC aCA ~~ 02 U X30 1 = ~ ' v ~~~ 11849 D .FG _~-- _ 1 Feb.99?. ~ ' ___µ_.___,._. 17-Dec-03 _~ 2709200 WC _..._.~,, __, ___ ~__ 1400 N HST _ _ ~ . ~LOMPOC p 1CA a 01 05 i 9684 D ,FG 14 Jun 05 17 Dec-03 m . 2709200 ? WC _ .,_... __....-.._.._ ._..~,__. .1400 N HST . _.__._.~----~.____~_. LOMPOC a_. ...~..,~. _,__.._,.. _,__ 1 CA _._ 02' _ !05 ~ 9684 D FG ._ ` •14 Jun-05{ ~ .___- ~~ 17-Dec-03 2709200 `WC ,1400 N HST ~LOMPOC sCA 031 301 9684=D FG 14 Jun 051 17-Dec-03 2709200 `WC ~ 1400 N H ST~~~ -.__w_ , LOMPOC ICA ~ 04 45 96840 FG 14 Jun 051 { 17-Dec 03 __~______. __ 2703621 ;WC ________._...,______a_ 1704 E PACHECO _____,_.,_...._.__, sLOS-BANGS _.,,._._....._x....~..____f ACA ~ 01 U . 05 ; t . __. D FG 96841 __ _ 14 Jun 95~ __...._._ 17-Dec 03 .____,_~._vw..~_,..__.,.~ 2703621 iWC _- ___ .-...___._.._,_ X1704 E PACHECO _.,~.~__..~-___.___._.___..__..~.. iLOS BANGS .~,_..._.._...,w._.___,._ ACA __ 02 U `30 ' _ ._w_.~_.~_ 9684SD MFG ; _ -_ 14 Jun-95' _m_.._._._ 17 Dec-03 2703621 WC 11704 E PACHECO LOS BANGS ACA 03 U 45 9684:0 °FG ` 14 Jun-95~ 17 Dec-03 2703614 ;WC ... ~ ~. ___ ._._. !403 MERCY SPRGS RD . LOS BANGS ACA 01 U 05 9684 D 1FG ~ 13nFeb-96' 17 Dec~03 1 , ~ 2703614 sWC µ rn ~ ~ X403 MERCY SPRGS RD ~ -___. LOS BANGS _~ CA 02 U '20 9684!0 ,FG ; ~ 13 Feb 96~ 17 Dec 03 2703614 WC 1403 MERCY SPRGS RD LOS BANGS fiCA 03 U 30 , 9684: D'FG ; 13 Feb-96 17-Dec-03 2705431 IWC 1830 E ST MARYSVILLE 'CA 01 U `20 , 981610 MFG ; 1-Jan-861 17-Dec-03 2705431 iWC 1830 E ST rMARYSVILLE CA 02 U 05 { 9816'.0 ,FG s 1-Jan-86~ 17 Dec-03 2705431~iWC `830 E ST ?MARYSVILLE ICA 03 U 30 9816:0 FG~, 1 Jan 86, 17 Dec 03 2708735 WC -2097 MENTONE BLVD 1 MENTONE ACA 1 01 U 05 G 9816.0 FG ~ ~ 1 Dec 881 17-Dec 03 _..___..__._._, .. 2708735 WC w,.., .,_ ._..w,._.,_ :2097 MENTONE BLVD MENTONE --__~__._._.__. !CA ; . _ 02°U _ 20 _ __._. 9816 D !FG ' __.___.._w~._._. 1-Dec-88 _.~.. 17-Dec 03 2708735 IWC 2097 MENTONE BLVD MENTONE }CA r ! 03sU 30 ' 9816 D FG I 1-Dec-88~ 17-Dec-03 ..„..m._____._..__.._ _ 2700337 IWC _._,...__.__.._,._,_,.,_ _, _. ...._ _ 10597 JURUPA RD ...._~_. _.__. .. .__........_ ~_._~. _._....~___._. .. .__...__._ ;MIRA LOMA _.w_~..._... _,._.. .__...__,._.__m._ __.,..._...._____,g. __..._.~.. .... ICA . .._... _. _~ __...... _... 01 U _.. . _ .... 30 __.. __.._.__... ..._. 11849 D FG _.___.__m__._..___m.i 17-Dec-98€ .._.._.........._.........~_... 17-Dec-03 2700337 iWC ;10597 JURUPA RD . 'MIRALOMA . . ... _ __ _, CA , , 02sU ___ '05 ~ ....._.,._.__ _ 11849 D FG ____ .._..._ ~ 17-Dec-98 .._____ __..__.. 17-Dec-03 2708843~WC ..._.._._ ._~ 11640 N. CARPENTER RD =MODESTO 3CA 01'U 05 981610 ~FG 1 Oct-87 17-Dec-03 __ 2708843 IWC _..._..,.____ 1640 N CARPENTER RD . MODESTO __ ____._.~m.____.~. ICA _ 02 U 20 ,. 9816 D =FG 1 Oct 87s _._.~__. 17 Dec-03 2708843 WC ;1640 N. CARPENTER RD MODESTO rCA 03U 30 , 9816;0 !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 12117106-07 _ West Coast Regi on as of 12/13/06 LOC. # Region ADDRESS CITY STATE UST # __ __ CAPACITY GALLONS _ INSTALL DATE _ RETRO DATE _ _" _ -- _ - 2705432 IWC ,899 HAWTHORNE ST ;MONTEREY +CA € 01 U 05 9816YD ~sFG , 1-Jan-901 17-Dec-03 2705432 IWC X899 HAWTHORNE ST 'MONTEREY ?CA 02'U 20 ` 9816;D FG 1-Jan-90 17-Dec-03 _.__..._.______~-.__,._.__ 2705432 WC _w_,..__M_..__. w._..._.._._.__ ____..___ ?899 HAWTHORNE ST ._.._.._._w_._.._._~...__._.__.....-,,_ MONTEREY ____~.....__ __ ACA ._._~ _._ 03~U _. m. 30 ' ~._......_.,-~__.~ Y 9816 D IFG __.~___ .--.__,_ F 1-Jan-90 17 Dec-03 2705432 IWC '899 HAWTHORNE ST MONTEREY ~ ¥CA x 04`U 45 9816DFG ~ 1 Jan-90; 17 Dec-03 2700872 'WC ;13261 PERRIS BLVD ~MORENO VALLEY w -~- 'CA s 01~U '30 11849sD `FG 4 31-Jul-98 17-Dec-03 ..__.___...._-_._.~ 2700872 ?WC .~.. ._._.__.._.____ ,.13261 PERRIS BLVD __.,_ ..~ . MORENO VALLEY CA 02iU ~ ._ 05 ~ _~,_, _ 14976D ,FG E .. ___._..__. t.-. _.___ 31-Jul-98' 17 Dec-03 ___. _ 2701775 4WC .- _..._.. _.._ 24051 JOHN F KENNEDY D _._,_.____._..___,~, R =MORENO VALLEY .._._, CA 01 U _.._ 30 W. ~. _ 98 6198 sD~ FG ____.__.._____ 1-Jun-88, 17 Dec-03 ..._.__._ _ ._.~_..._ _ 2701775. iWC ._ ._.,...... __..,. ___._._w..__. '24051 JOHN F KENNEDY D _.__ . _..____..._.,_____..___._ R ~MORENO VALLEY _._.._. ..__.__,. „___.__.~_._... ~CA 02°U ._ _ 05 ._ .~ _,., ._.__ ___ 9816~D _FG _m..._..~_.._... _..._ ...____._,,. 1-Jun-88; 17-Dec-03 2701775 '1NC :24051 JOHN F KENNEDY D R MORENO VALLEY CA 03 U 20 9816 D FG ~ 1-Jun-88; 17-Dec-03 _,~ __._.-._.... 2700770 WC . ,. _._.__.._., -.__._.__._.~_ '.49594 29 PALMS HWY _.,~w._._.___~-------------_------_.__. IMORONGO VALLEY _.~. ____...__ _. CA ____.._ ..~... 01 ~U 30 __ 11849 D FG ___.._._.._ _~...___. 1-May-98, 17 Dec-03 . ...._,_ 2700770 WC 149594 29 PALMS HWY " nMORONGO VALLEY °`" CA ~ 02 U 05 - - 14976 D FG . --~------______ 1-May-98' 17 Dec-03 .___.. _.~.__ 2701045 `WC _ 11408 VENTURA AVE ~.__._.. _....._....._..._.,M..._,____. :OJAI ,.__. _.~,. !CA 01 U 05 ._ '9816 D , FG ', ....,.._.__.._.__.,._ 1-Aug-87 17-Dec-03 _ 2701045 WC ;1.1408 VENTUR A AVE ;OJAI CA 02 U -05 9816 D FG ..~.__ 1 Aug 87t 17 Dec-03 2701045 'WC _ _ 11408 VENTURAAVE ~ OJAI CA 03 U 30 ' 9816'Dl. FG v 1 Aug 87 17 Dec-03 w _.__.,._, __~~.., ._._..._ 2705230 IWC _.~...,-_._._.,__ __.._.___ .,.._ .. ;164080RANGE _M, ,...--._...___-.._._.._._. PARAMOUNT ____.,.._...__._ _. ICA ~.____ ...._ 01 U ~_ ,_.. 20 , ' ___..__..._. _.. 98.16;S FG .._..m_,_._~_ __ ~.~.__._.- ? .1-Jul-83 17-Dec-03 2705230 pFpWC '164080RANGE PARAMOUNT CA __ 02 U ____.._ ._ 05 ,_..,.._. _ 9816 S FG : .... 1•Ju1-831 17 Dec-03 ._.._._...____.. __......._....~w__, 2705230 =WC ,164080RANGE-. .PARAMOUNT ¢CA 03~U 30' 9816,S :FG ' '1 Jul-83! 17-Dec-03 2705245 =WC .~._____ 3:. ;61.05 CLAY PEDLEY .~.... =CA ~ _.__._~.. ._. 01 U ~_.._. _ 20 ..._. 9816. D sFG _ 1-Nov-87 17 Dec-03 2705245 IWC 6105 CLAY PEDLEY ACA 02 U '30 ` 9816 D sFG 1 Nov-87E 17 Dec-03 __._.. 2705245 sWC -.___.._ ~.. m..___ ._ -:6105 CLAY __ -._~...~ , _~- PEDLEY __~ !CA 03 U _, __ 05 _ _ _ ._...., 9816[D gFG 1 Nov 87~ 17 Dec-03 2705659 iWC ~ X8451 SLAUSON AVE ~PICO RIVERA ;CA { 01sU 05 -19703 S ;FG 3-Dec-01# 17-Dec-03 ._.......___ .~~.,. . 2705659 IWC .w.-. ..~ __., ~..,._._.~ __.._ '8451 SLAUSON AVE _,~--.,_____....__w_.m_~.A_.__. ~.._...,_ PICO RIVERA ___ _ __. ~... __ CA __,__~. _d_. 02 U 30 ~. _.._ ._._.. - 11863`S .FG 4 ..._. ___._._...~...__ 3-Dec-01j 17-Dec-03 _.~__._.,.~, 2705659 WC _ _._._..~, _....._.. _ 18451 SLAUSON AVE ___..______._~.. ~.. _.,__ xPICO RIVERA _~.. -__.__ _ _ CA .... _._ ._ 03'U 45 _.- __.._ 10369'S =FG 3-Dec-01 ~µ 17-Dec-03 _,.._.._ _ 2702970 1WC _.. 1704 MAIN ST ._~._.._~..-~ RAMONA _ _.~.._ __. CA ~ ~... ~ .__ 01 U 05 __. __. 11849 D FG r_..._.__..,, _.. 28-Oct-98j 17 Dec 03 2702970 WC ;704.MAINST ~RAMONA .._____..__..,_,_.,.__..__._ :CA I 02,U X30 .._...._ _ . 11849;D 'FG . ~ 28 Oct 98~ 17 Dec-03 ~~ _______.__.__,___.. 2705020 WC .. _.._-.,_._._____ __. _ ~ 1598 N ORANGE __.~_..~.__....-.m....~._~.m.w.~..._._._.- REDLANDS - ,_ CA _..m 01=U ... 05 .. . 9816 D FG 1-Oct~89, 17-Dec-03 2705020 ?WC 1598 N ORANGE REDLANDS CA ~ 02 U `20 9816 D FG 1 Oet 89`'s 17-Dec-03 2705020 ,WC 1.598 N ORANGE REDLANDS CA 03'U ;30 ~ 9816'D FG - 1-Oct-891 17-Dec-03 2705214 :WC 765 W REDLANDS BLVD :REDLANDS CA 01 U 30 f 11682 D FG ' 12-Dec-01! 17-Dec-03 2705214 WC 765 W REDLANDS BLVD REDLANDS CA 02 U ~ 20 ~ ~ 11682' D FG 12 Dec 01 ~ 17-Dec-03 _..,,_,__..._ ._.~.~. 2705214 iWC _,~__._..w._.._______...__ _ 765 W REDLANDS BLVD- __..._...._._ _____....__._~___._.._ REDLANDS ___.._. __.._..... 'CA ._. ~ ,. _..__.. 03 U _...__. _ 05 ; 14976 D FG _e.~ _,._...__ _._ 12 Dec-0.11 17-Dec-03 2705252 iWC 518 W FOOTHILL aRAALTO _ ~CA 01 U 20 = 9728'D FG ' `1-Nov-88, 17-Dec-03 2705252. =WC !518 W FOOTHILL RIALTO ICA 02'U 30 9728D FG 1-Nov-88: 17-Dec-03 270525 2 ,WC ;518 WFOOTHILL - ?RIALTO ~ _ CA _____ 03iU __ 05 _ _. 9728 D MFG = k ,__.___w_______. . 1-Nov-88( 17-D ec-03 _ _ _ 2700801~WC 'm18965 VAN BUREN BLVD RIVERSIDE _ ~ ~._ ~._.._v~:_._ _____ ~ `CA ~~ } 01 U __.,,_ s. __v..._ _ __ '30 _ 11849,D tFG 8'Se 98 17 Dec 03 ~ p 2700801 IWC ;18965 VAN BUREN BLVD RIVERSIDE ?CA E 02~U 05 149760 FG 8 Sep 98~ 17 Dec 03 .~~...,,.... 2705221 ?WC ..__.,_ ;8609 GARVEY AVE _ .~ . ~____..:._... ~.~. aROSEMEAD ~~ __m ~... ~...__m.._~_ ICA ? ._.,__.. 01 ~U 20 10310~D FG 31 Oct-90 17 Dec 03 ~ 2705221 WC 18609 GARVEY AVE M - ROSEMEAD ECA I ..M_._ 02 U '05 :. 10310gD ,FG 31-Oct-90~ 17-Dec-03 2705221 'WC ,8609 GARVEY AVE ROSEMEAD CA I 03.U 30 10310 D FG ~ 31 Oct-901.17 Dec-03 2705733 IWC '998 SUNRISE BLVD ROSEVILLE ACA ? 01 U X05 15154D SF TJan 961 17-Dec-03 2705733 IWC 1.998 SUNRISE BLVD IROSEVILLE £CA 023U 130 , 15154 D .SF 1 Jan 96 °17-Dec-03 2705247 WC _..-.. 5804 MISSION BLVD ~RUBIDOUX 'CA I 01PU X05 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 03'U 20 9728 D FG 1 May 88~ 17-Dec 03 2705203 's,WC 16290 MISSION RUBIDOUX ~~~-~- ~~ ~µT~~~ 'C A W 01 U 105 ` 9816 S FG 1-Jan-82j 17-Dec-03 2705203 {WC _ ~6290MISSION ~ .__ ;RUBIDOUX ~~~ _ _ !CA ~ 02:U ;20 ` 9816'S .FG 1-Jan-82 17-Dec-03 2705203 ?WC ~6290MISSION +RUBIDOUX ACA 03'U q30 98161S =FG 1-Jan-821 17-Dec-03 2701057 WC .5 555 HEMLOCK _ SACRAMENTO _ CA _.. 01 U .. -30 ~ 11849D FG 8 Apr 9~ 17 Dec-03 2701057 WC~ _ ~ ;5555 HEMLOCK SACRAMENTO CA 02 U :05 ~ 14976D €FG f ~ ~ 8 Apr 98; 17 Dec 03 2701212 IWC :600 RIO TIERRA AVE SACRAMENTO CA 01 `U 05 = 14976FD FG 1-Apr-98 17- Dec-03 2701212 'WC .600 RIO TIERRA AVE :SACRAMENTO ? CA 02' U 30 s ~~11849 D~ FG _ 1 A r 98 17 Dec 03 p _... __..,_ _ 2705439 s1NC __._ ., ~.,., _ . _._.. __ _ _ ._~ -- 1240 N MAIN ST _ ... _. , _,_.__.. ,._._.._. SALINAS _ __ m._~ , CA __ 01 U 30 9816+D FG ___ __ a ...___._ _____ . ". 1-Jan-89` 17-Dec-03 2705439 WC !1240 N MAIN ST SALINAS !CA 02 U '20 F 9816 D FG ` 1-Jan-89; 17-Dec-03 _._._ _____._..,.. 2705439 IWC ~...,......_ .._, __.......__...__._._......._ ;1240 N MAIN ST x_..._._,___._~.,,.._.__.__.___...._.:. SALINAS .____...M...:.. ~CA ~03 U 05 9816 D FG _._..._..,_....~..__.,_. 1-Jan- 89~ 17 Dec 03 2705439 WC _._. 1240 N MAIN ST . ~SALINAS iCA 04 U 05 9816'D FG E _ _ 1-Jan-89` 17 Dec 03 . -...__,__ . 2705239 „WC .M.. ._ ...._._.. ._-_.._.__ !2734 DEL ROSA SAN BERNARDINO CA 02 U 05 11849iD FG 18-Aug-98j 17-Dec 03 2705239 WC {2734 DEL ROSA - SAN BERNARDINO ~CA ~ ~ 03xU ;30 11849 D FG 18-Aug-98 17-Dec-03 2708641 WC b295 N WATERMAN AVE {SAN BERNARDINO CA ~ 01 U X20 I 9816D'FG 1 Mar-881 17 Dec 03 ___._...._..._,.~.., _.._____.__._ ..._.,_._ __.._ __. __. ___.____--.~.. ___M_._,_ 2708641 ;WC 1295 N WATERMAN AVE ;SAN BERNARDINO ';CA __ 02 U ~~05 ~ 9816?D ,FG 1-Mar-88-' 17-Dec-03 G:\data\WCBU_Environmental_Compliance\Certificate of Financial Responsiblity12007 CFR\Circle K WC Region Tank Schedule 2006 12 13 Circle K Tank Schedule 1 211 710 6-0 7 West Coast Region _---~------------ as of 12/13/06------- ~ --- ----_ --__--_--_- ------ LOC. # Region I ADDRESS I CITY 2708641 !WC ;295 N WATERMAN AVE :SAN BERNARDINO 2708688 WC -10520 CAMINO RUIZ SAN DIEGO 2708688 !WC _,_, _._._____._._,-_____ ._._w _ :10520 CAMINO RUIZ -.._..w__..- SAN DIEGO 2708688 'WC 110520 CA MINO RUI Z ;SAN DIEGO ~i_.,.,N . 705095 WC 2 _ _ _ a_.,.,_, €4360 GENESEE AV E ••~ _,~_.-,_-_--__ SAN-DIEGO _ 2705095 (WC _ X4360 GENESEE AVE _ SAN DIEGO ..~..,._..,w._..- 27050_95 `WC ~ _.._~. ~.___._._.. ;4360 GENESEE AVE ~._______..._ ._..__.-_m...-__. _ __ ~~ - iSAN DIEGO_ _ ._ 2703608 jWC j21.998 COLORADO 'SAN JOAQUIN ~ r~mm 2703608 WC :21998 COLORADO ;SAN JOAQ UIN 2705784 ' WC 98'1 FR ANCISCO BLVD _ _ SAN RA FA EL 2705784 IWC _ _ ;981 FRANCISCO BLVD _ _ • :SAN RAFAEL _-.._,_ ~-._.._w 2705784 '.WC _.._ __M_..__....__ __.__._n_ ._r..._ 981 FRANCISCO BL V D ~_....~._ -...._.. .-_..~..-_ -.SAN RAFAE L 2705238 ?WC~ _ _ . 765 W'HARVARD BLVD _ _ :SANTA PAULA 2705238 +WC ~:765:1N:HARVARD BLVD SANTA~PAULAY 12708755 '. WC ___.._ 12790 WHITSON RD ~ ~ _~_ ..~ ...._.._ _ -..... :SELMA .•.___._..___.__._._.. _ _w u.,_. 2708755 WC . . _ !2790 WHITSON RD SELMA 2708755 ='WC =2790 WHITSON RD SELMA 2705684 IWC :27180 MCCALL BLVD '.SUN CITY 2705 684 ?WC ALL BLVD ~_ 27180 MCC ;SUN CITY _ 2700010 'WC _ '302 E TEHACHAPI BLVD _ TEHACHAPI 2700010 iWC 302 E TEHACHAPI BLVD ,TEHACHAPI 2700564 IWC ;73010 R AM ON RD THOUSAND PA LMS 2700564 iWC _ _ _ ~ E73010 RAMON RD _ _ THOUSAND PALMS 2701940 IWC 1600 W MAIN ST TURLOCK 2701940 ;'WC 1600 W MAIN ST TURLOC K 2701940 1WC ~ ' 1600 W MAIN ST ~~~. , _ TURLOCK ~~--~ 2700348 iWC _.._ 5681 ADOBE RD TWENTYNINE PALMS ,____...-~v_.w_.w 2700348 'WC ~ _ _ .~___.___.~ ~~_....... ._ :.5681 ADOBE RD ! ...._..-v_ __,....__ _ .___-_ _ TWENTYNINE PALMS .M____._._.~.,, ..__._ 2700743 eWC .. _-._.~.._..~._..-....________._ '73-943 29 PALMS HWY : - . _,..._.._____._~.__w._~,,_~_. ENT YNINE PALMS T W 2700743 'WC 73-943 29 PALMS. HWY ~ _ _ _ ::TWENTYNINE PALMS 2701984 `WC w. . 795 SHADOW RIDGE DR VISTA ~ _ __ 2701984 iWC __ ...._ ,795 SHADOW RIDGE DR , ._ S ~VSSTA - - 2701984 ?WC . ~ ;795 SHADOW RIDGE DR ~ - Aw•_ `VISTA _..._._...-..._.., -. ..._ . 2701161, iWC _._...... ~._.._-.____._._....-..___..,.. _.~,_._._,. ?.1395 PALM AVE ~.,, -_.__......~.,.._...____.~..w_._.__ WASCO ' _._ 2701161„ ' WC ._..~_.,.__..m___. mm' ~ 1395:RALM AVE T , _ _ WASCO 2701391- iWC ~ '123 E MAIN ST _ _ _ WESTMORLAND~ 2701391. "WC X123 E MAIN'ST.. '. .. w.e__ . ._ _ _. _ . .„ WESTMORLAND , , ._ . _ 2701391 iWC __._____.._._..._.~_~,..,_~.._...__ 123 E MAINST WESTMORLAND 2701156 IWC 1263 FRANKLIN AVE ~ ~ YUBA CITY 27011_56WC ___ 11263 FRANKLIN AVE ;YUBA CITY 2_7_00902 `WC _ ';6940 OLD WOMAN SPRG ;YUCCA VACLEY~M~__ 27 00902 WC N ?6940 OLD WOMAN SPRG ~`YUCCA VALLEY ~.--w_ _ 2700902 iWC ~ 16940 OLD WOMAN SPRG _^YUCCA VALLEY 2700686 ;WC _ 10000 GIBBON SW _-__. ~ ~IALBUQUERQUE .-~....._..._._.._.._..__ 2700686 IWC _.._ _.___._...._.__--_r__..._______...~_.. 10000 GIBBON SW i .. .___.___.._,._m....__.__...__. ALBUQUERQUE _i___._. 2700379 IWC .._.._ _..____._._.w.~_~....__,,.._-_..._ _.._.__. ;1200 SAN PEDRO DR SE _ _.__ 'ALBUQUERQUE 2700379 WC 11200 SAN PEDRO DR SE ALBUQUERQUE~~ 2701255 iWC __._._ . _. ,12900 INDIAN SCHOOL RD NE ALBUQUERQUE . _ _. _ 2701255 'WC ...,._.~_.....,_. _w_.___....__.__...___.,~__._.__ ___ .___... _ ...._...._____.._._,_. `.129001NDIAN SCHOOL RD NE.ALB000ERQUE 2701255 iWC __._._. _ _ _,..._ ;12900 INDIAN SCHOOL RD NE :ALBUQUERQUE 2701313 ?WC ;1316 YALE SE ALBUQUERQUE 2701313 {WC M_._,____,_.~.___ =1316 YALE SE _ .__...___.._ ., ALBUQUERQUE 2701313 IWC . s , ,__ ..............._.__._ '1316 YALE SE . _ _..-. __ ._....,_...__._~___ .ALBUQUERQUE _ ._.._.__-_... .,.._._ 2708779 'WC _. _ _.,_._._..._..~,__._ ,_.,..,_ 1401 WYOMING NE _~., _._,. .._.__..~.._..._.,___.__ ALBUQUERQUE 2708779 IWC '1401 WYOMING NE _ ... ALBUQUERQUE ._ _ _. 2708779 WC ;1401 WYOMING NE .. _.,....._.. -. - ALBUQUERQUE 2701777 WC ,2001 MENAUL BLVD NE ?ALBUQUERQUE 2701777 ' WC 2001 M ENA UL BLVD NE ALBUQUERQUE ~~~~_~._ 2701777 WC _ _ _ ~ X2001 "MENAUL BLVD NE ~~ALBUQUERQUE~~ L IN R EA RO STATE1 UST # ~ ~GALLONS ~ DATE ~ D i CA 03 U ":30 ; 9816 1D ~FG g 1-Mar-881 17-Dec-03 CA 01 ' U -30 9816 D FG 1-May-89 17 Dec-03 j CA 02 t U 20 9816 D FG i 1 May 89 17 Dec-03 _ CA 03'U '05 9816 D FG , 1-May-891 m 17-Dec-03 ,CA 01'U 30 9684..D'=FG ~~ 1-Nov-89, 17-Dec-03 j CA 02 U ' 05 I 9684 D FG 1-Nov-89 17-Dec-03 `CA 03 U 2 9684 D FG t 1 Nov 89~ __.~. 17 Dec-03 CA 01 ~ U ; 05 3 14976 D z FG ? 15 Sep 97 17 Dec-03 i CA ; 02 , U ~ 30~ 11849I D~;FG t ' ~ . 1.5 Sep 97I ~17Dec-03 ~ _ ICA r 01`,U __.._ 05 1.0058 D , 'SF ~ 1 Jan 94Q 17-Dec-03 _.__.._ __.. ~._..~_~ .__ iCA ~ _.. -~. _.._ 02;U _ 05 10058 D ,.SF __._ _~. 1-Jan-941 17 Dec-03 'CA ~ 03 U ~30 •12079 D SF 1 Jan-94 17 Dec-03 :CA ;~ 01'U 05 , _ _9816 D ' FG : 2b Feb 8_5 17 Dec,03 ~~CA ~~ I ~03iU =30 ~ ; _9816 D !FG < 25 Feb `85 17 Dec-03 ; l CA . 01' U 05 '9816 D, FG ~ 1 Apr 88 17 Dec-03 ~ w.. ~ ;CA 02 U 20 ~ FG ~ 9816 D ~1 Apr-88 17 Dec 0 3 -~~-ACA ~.. ~- 03 U-~~~ ~;30 q _ ~-~~~-9816;D~;,FG ~ _ ~1-Apr-88 _ _ 17-Dec-03 i CA 01 ± U 05 , 12023 D ' S F 15-Apr=87 17-Dec-03 ICA a 02? U ~ 30 12023 D ' SF e ~ . ~._ _~ . 15 Apr 87 _. 17N Dec 03 -....._ _._. . ~._. CA _._ . 01 "U ._._ 30 ' ._ . , 11849 D FG 29-Jul-98 17 Dec-03 ECA 02-U 05 14976 D FG . 29 Jul 98. 17 Dec-03 !CA 01U 30 ~ 14976 D FG ' 29-Jul-98 17-Dec-03 CA ~ 02~U :05 , , ~' •14976 D FG 29-Jul-98 17-Dec-03 _ CA I 01 EU X20 C 9816 D FG 1 Jul 87 17 Dec-03 iCA , 1 ~ 02;U °05 _.. _ _ 9816=D. FG ~ . ,M. 1 JUI-87 ~.... 17 Dec-03 _ ICA 'rn 03iU 30~ `"9816sD~ FG ~~1-Jul-87'° 17-Dec-03 . ._....... iCA -w __. 01 ~U ._ _.. 30 • __.._ ~... ._.. _ 11849°D 'FG ° __ ._. 15 Dec-98 _. ..._._. 17 Dec 03 ICA 02,U 05 ; 11849:D FG 15-Dec-98 17-Dec-03 ICA 01 U 30 11849'D FG .1-Jul-98 17-Dec-03 'sCA 02iU 105 ~ : 11849 D FG 1-Jul-98 17-Dec-03 q .-._..__. CA __ _ 01 U _ 30 ° ~ _ 9816' D FG _ _. 1 Apr-87 _ -......_.._ 17 Dec-03 _ _ ~~CA 02`U 20 ( ~ 9816' D , FG 1-Apr-87 17=Dec-03 iCA 03;U 105 ~ 9816 D' FG _ ~1,Apr87; 17~Dec-03 . ._-_~. ____._.._ _..__..~. __,_. "CA 01 U _.....-_ 05 + .. _ _ 1#976=D FG ._ _...m___._ 12 Jun 98~ m_._-,_~, _.,.,._. 17-Dec-03 ,CA 02=U 30 '118491D FG II 12 Jun-98 17 Dec-03 ._......_ sCA ........ <_ 01 U . ..- 30 ._. .. .... 9684 D . FG . _ 1~Sep 91: .. _..... :17 Dec 03 ,05 9684~.D FG 1-Sep=91 47-Dec-03 9CA 03tU 20 9684,D FG 1-Sep=91 17-Dec-03 ;CA i 011U ?05 ~ 14976 D.FG ' 17-Feb-98 17-Dec-03 CA ~ 02 U ~ 30 ; 11849. D FG E 17-Feb-981 17-Dec-03 CA ~ 01 U ?30 ( 9816FD FG ~ 1-Oct-87' 17-Dec=03 A e 02 U C €05 ;4 9816 D FG ; 1 Oct 87 17 Dec-03 _ ~~ hCA~ ~ 03 U M _ ~ 20 .. _ 9816: D FG i 1 Oct 87 _ 17 Dec-03 ~ NM 4 _ 01 U 30 11849 ` D i FG s ~5-Mar-99 17-Dec-03 7__._.,._._ ti ~NM 02,U 05 I ~i,. 11849~D FG ° ..__-.-__...___ 5-Mar-99~ 17 Dec-03 NM 01 U 05 r 9816 S FG t 12-Mar-96` 17 Dec-03 L ! NM 02 ~ U 30 9816 S FG 12-Mar-96' 17 Dec-03 -- -.__ ._._.... _. ~NM I r P 01 U 05 10152 S SI 1 Mar 79§ 17 Dec 03 . ~.,.- ._.._._..__.. .___.,.._._.,.___ _......_ iNM 02;U 20 • ___,._,__..._...,.w-. __._._...__ .____-k... ...~._...~_._. _ _ 10152 S SI ..___._,__._.._ .. ._._..._._,_,_..,... 1-Mar-79 ~_.,_._.__,___. .~._.__._.,._._. 17-Dec-03 NM 03~U 30 10152 S SI 1-Mar-79 17-Dec-03 _-~,...-, _._._ __- INM - .- 01 U _ _ 20 ' ~ ~-__._._ ._ _ 10152 S ,SI .__... 1 Mar-79 17 Dec-03 '•NM 02 U X05 ` 10152'S SI ' 1 Mar 79' 17 Dec-03 ~NM 03,U j30 I 10152gS ~SI ~ 1 Mar 791 17-Dec-03 NM 01 U 20 ~ 9816 S FG ~1 Jan 89~ 17~Dec03 ~NM 02,U X05 r 9816'S FG 1 Jan 89- 17-Dec-03 _._.._.~NM _._ _ v_ __.,____ _ _ _._,_ ._-.03 U ,__..__ -._.__.__ 830 i ~__..n._ ____. .,-. ,. 9816S ,FG ; ____,_.__. ,. .._._ __._..._ _._.____._.. 1-Jan-891 17-Dec_-03 _-._....~..,, ._ . iNM x 01 U 30 ; 9816'S FG !, . 1-Nov-86 ~ 17-Dec-03 -_._._ ,NM 02;U _ X05 i 9816;S ,FG _-,-_~_, M.____ 1 -Nov 86 17-Dec-03 _ iNM~rv ~ _ _ 03 U -;20 i __ ~ 9816iS FG t ~1-Nov-86 1 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 1211 1 0 3 6 _ _ _ __ _ ___ _ _ . _ _ _ _ CAP ACITY INSTALL RETRO LOC. # Region ADDRESS CITY STATE UST # GALLONS DATE DATE 2708748 WC `-2019 CARLISLE NE ALBUQUERQUE NM 01 `U ~ 105 9816:S FG ~ .. 1-Oct-88' _._ 17-Dec-03 _.___ ..__._._ _.. __._ __ 2708748 :WC ~,...___....__.___ .. ......... ..._.._.._______ 2019 CARLISLE NE _..r_._._ R. _.._.. ~..__.~,_ ALBUQUERQUE _..____.......~ .,.__._ !NM ._ ...w_.u. .. ...__ 026U __,,. _._._._. 20 j ..__ .~_, _ 9816 S ,`FG ! _. _. 1 Oct 88 17 Dec-03 2708748 WC 2019 CARLISLE NE ;ALBUQUERQUE NM ~ 03 U _ 30 ? 9816;S FG 1 Oct 88 -. _._.. 17 Dec-03 ._.___...__. _,... . 2708551 WC _~._.. _.. ._.,.._.w__..._~....._. :'2934 EUBANKS NE ____.._, .,..,..___..-,._....._.. !ALBUQUERQUE _ ___..._..~__a NM ~01U _ .' .~_. 30 ; _ •~~~__ _ 9816°S FG 1-Jan-881 17-Dec-03 . _______.___.~,. _.. _ 2708551 IWC _r_~......_.....,._. _._____._.,_„ ...~_..._~ 2934 EUBANKS NE ALBUQUERQUE NM 02U $05 i 9816; S FG 1 Jan 883 17-Dec-03 2708551 ;WC 12934 EUBANKS NE ;ALBUQUERQUE ;NM ' 03U ~ ~20 ; 98163S FG ~ 1-Jan-88;' 17-Dec-03 2700376 IWC 1343 WYOMING BLVD NE ;ALBUQUERQUE ,NM 01 U ~ '05 ? 9816'S FG i 10-Feb-96, 17 Dec-03 2700376 IWC ~ X343 WYOMLNG BLVD NE ALBUQUERQUE NM 021U _ 30 " ~ ~ , _._ _.... 9816°S FG . ___.__ .. 10 Feb 96~ ..-.._.,_ _. 17 Dec-03 ..~ _._..~_ 2701472 WC ;397 AL:AMEDA NE . IALBUQUERQUE ~NM `• " -, 01 U X05 10143;S SI 1-Mar-83t .97-Dec-03 2701472 IWC `397ALAMEDANE IALBUQUERQUE NM 02U `30 ; 101433S ,SI ~ ~.; 1-Mar-83` 17 Dec-03 2701472 WC 397 ACAMEDA NE ALBUQUERQUE NM 03iU 20 10143 S SI 1 Mar 83 17 Dec-03 2700403 =WC 4212~OAL AVE SE ALBUQUERQUE NM 0130 30 t 9816`Sm FGA 16 May 96? 17 Dec 03 2700403 :WC :4212-COAL AVE SE ALBUQUERQUE - ,NM 3 02!U 05 9816 S FG ; 16 May 96, 17 Dec-03 ,~....__~._.,.___„.. 2700610 'WC _ . _~........___.._.._. ____ __. -14400 COORS BLVD SW _.~.._..... _ _, _.___...~____ ,ALBUQUERQUE ._.___._...~.._~ _.. ;NM _,. ..__.__._..~_._.. x 01'U _ '05 9816 S FG ~ ._W...~. _.. 1 Feb 96` .,. .___..__ 17 Dec-03 2700610 WC 34400 COORS BLVD SW ;ALBUQUERQUE NM ~ 02~U =20 9816 S FG ' 1-Feb-96 17 Dec-03 ,....__. .._.. 2700610 tWC ....„_.....~___._.. __._.__.__ _.._ ., . __. x'4400 COORS BLVD SW . .__._._...._.... ___.____....._„ ALBUQUERQUE ~ ._____._....... _.. _._. NM __„.e.,,._.,..__._m....__ ` 03U 30 9816~S °FG E - 1 Feb 96 17=Dec-03 2707962 ?WC ,5101'SAN MATED NE ,ALBUQUERQUE ~ _ NM 0110 :05 11682`S• FG 1 4wApr-94 17 Dec-03 2707962 WC '5101 SAN MATED NE ;ALBUQUERQUE NM ? 02~U r20 • 9816=S FG ~ 4-Apr-94 17-Dec=03 2707962 WC ... ...~ _ a. ;5101 -SAN MATEO NE . ~ IALBUQUERQUE NM „~..,__... 03 U ~ 30 ' ~ 9816 S 'FG _.,.a.. .. 4 A r 94 .,___ p.~._.. 17 Dec-03 .~__. _ . . .. ~__ 2700741 WC '-5501 ACADEMY NE _.. , ~____. ALBUQUERQUE 'NM ._~.... i 01 U _- . 30 ` ~ ___ .. ~ 9816~S FG 1 16-Feb-96 17 Dec-03 2700741 `WC ':5501 ACADEMY NE 'ALBUQUERQUE z NM 02 U 20 1 9816;S iFG 46-Feb-96 17 Dec-03 _-.,., 2700741~WC _.._.. ~ .~.m.._.._,._ _..._.._,. .5501 ACADEMY NE . _. ALBUQUERQUE ~ 'NM _.. i 03 U ;05 _ ._ 98161S FG .~,.. 16 Feb 96 _.__ 17 Dec-03 2701428 WC 6130 EDITH BLVD NE ~ALBUQUEF:QUE u NM ~ 01 ~U_ ~ '20 101521S SI 1 Mar 81 '17 Dec 03 2701428 WC '6130EDITFiBLVDNE IALBUQUERQUE NM ~ mm 02~U 05 10152?&~SI 1 Mar-81 17-Dec-03 2701428 'WC 6130 EDITH BLVD NE 'ALBUQUERQUE NM ~ 03`U 45 , ~ 10152'~S SI ,1-Mar-81 17=Dec-03 2708745 =WC 6300 CENTRAL AVE SE ALBUQUERQUE NM 01°U 30 9816 S..FG ~ 1 Oct 88 1Z-Dec 03 2708745 IWC `6300 CENTRAL AVE SE IALBUQUERQUE - NM ~ 02 U 05 > ~ ' ' :9816~S FG ~ 1-Oct-88, 17-Dec-03 2708745 'WC ~ _ :6300 CENTRAL AVE SE ALBUQUERQUE INM _ ~ •03 U 20 9816 S MFG 1-Oct-88 17 Dec-03 ..._....,, w._,_.__ _.. 2708934 '. WC ~ ~ .._.~.._.._.. ~...~__.._ .._..____.._._.~ ,1535 COORS BLVD NW ALBUQUERQUE : NM _ 01, 10000 ~ ~ ! ~ ~w 1"May 90 14-Dec-05 m~~-µ~ ..._._~.- ~. . ____~_ 2708934 dWC _.,.,__.._._..._.__._._._..,~~_, ,.__.-_. 1535 COORS BLVD.NW _ ALBUQUERQUE ~-_..___~.__ ~NM 02 10000 ~ 1 May 90s __ 14 Dec-05 2708934 `WC 1535`000RS BLVD.NW ALBUQUERQUE ;NM 03 ;10000• - s 1 May-90, 14-D.ec-05 ~.m__ 2708935 WC _ :53'11 QUAIL AVE NW ____.__~... ALBUQUERQUE ___....~_.~ NM ~ ._~.__ -_.~_ ~ 01 , ~,~ .__ _ 20000, ~ __ 1 Dec-96 _ . w_ ~ _, 14 Dec-05 2708935 ' WC -.,._w __ _.__.-.._._. _ m -._.___ ._..~ ' 531'1 QUAIL AVE NW __.._..___-._~.,,.. . .. , _.. ~ ._..._._.__~~. a_____ <ALBUQUERQUE _. __._~_.~.__ _, ._.. '. NM ~.. E . ~02p _ _ m_.__..__ __ _ 10000 ~ _ . ~..~ ~___ .. 1-Dec-96! .,..,...___~. 14-Dec-05 . 2708936 'WG . ~ ... , ._ ;5210 CENTRAL AVE SE _.___~._~_...__ gALBUQUERQUE __._._.___ ;NM _.._ ~ 01 _ t 1200018000, , t _,_ __.~ 1 Jul-98 ____ ____ 14 Dec-05 2708936 ~ WC ~ ~~ 152'10_.CENTRAL AVE SE~~ ;ALBUQUERQUE: _ ~~ _ ~ _ ~, INM .~_..,._. .._ ~ ~~~'~ ._ ' 02x ...N .. ~~ ' ~ _ 6000 1 Jul 98 14 Dec 05 .._. 2708937 ' WC 44701 PASEO DEL NORTE ALBUQUERQUE NM r 01 r ~ 20000;.: i 1 Ma 99 ' 14 Dec 05 __.._. _.-._ 2708937 ~WC __._- _ ~ ' ._. _. _._..._ ._ ..._ 4701 PASEO DEL NORTE ,ALBUQUERQUE _ sNM ____M. ,.~._. _ ~ _.__._ .~. ~ 02 ~ ~ _.~_ ,-___. - _~_. . _ 100001 , s 1 May~99} ~ ~... ,- ._ _ _ 14 DEC 05 ___.~. _ _,.__W 2708937 WC .4701 PASEO DEL NORTE iALBUQUERQUE ~ tNM ~ 03 € ? - 10000''. ; ' ' 1 May-99t 14-Dec-05 2708940 WC 38601 CENTRAL AVE NE ALBUQUERQ-UE cNM ~` 01 ! ~~ X200001 I ' 1 Feb 00~ 14 Dec-05 2708940 !WC -.~.,~._._._...._ 8601 CENTRAL AVE NE . ...._.___... ;ALBUQUERQUE __.~..____~.~_.~...,~_ 6NM _. _ ._-~ ~_ 02; _.t__.-_,___ 3 i .__. .___,.. __ ..~._ _ 100002 I , __.__ r _. ' 1-Feb-00# ..,. _.a. _..._ _,,, 14-Dec-05 2708940 ;WC _ ._.,_..._ •8601 CENTRAL AVE NE _.__ _,._,,._ ''':ALBUQUERQUE _.~___._.. _ NM .__._.._...__._,u._..._ ! 03j _ _ ~ _~ ~ j ~~ 100001 ~~ i ._.m._..~..._._._ _ 1-Feb-00~ _... ...~., 14 -Dec=05 2708941 IWC X4300 OSUNA RD NE ;ALBUQUERQUE ~ ~~tNM m _ ~ 01~ ~ ~ 20000 ~ ( 1 -Sep-00; ~ 14 Dec-05 ^ __ __ 2708941 :WC ~ .. _ _. 4300 OSUNA RD NE ._ IALBUQUERQUE ~ _ . ~ . iNM w ~.. i 02 ^ ~- _,- _. r , 12000/8000¢ ~ ~ 1 Sep 00; ~_ 14 Dec-05 2708942 fWC .8181 HARPER NE IALBUQUERQUE NM 01 ~ 20000 ~ C 1-Jul-98; 14- Dec-05 2708942 WC _.___~_____~___._.~.... 8181 HARPER NE _w ___.__.._w___. . . __~._ ALBUQUERQUE _ -NM ~ I 02= `-` ~ ~~"~' "-~"'""'~" ' - _.~._ 10000 c .__,..,._..,._.,.,_ 1-Jul-98; _ `14-Dec-05 2708943 ;WC _,..,._ _ .___. !300 LOMAS BLVD NE ~.._ _.~.____..~_..._.____._.._._ IALBUQUERQUE __._. NM 01 ~ 20000: i ; _ _ 1-Dec-OOi 14-Dec-05 _.Y...___,_.._._._.____._ 2708943 !WC _._...__._._.__;._... _.__ __________._______._____._~~..___.____,__,_. _____.~__._.w.__.._, ;300 LOMAS BLVD NE xALBUQUERQUE .._.____..._ _ .W.., ___. _. ___,._....__m_____.. 'NM _..._ __. ~~ 02 _._ _..w.__ ._,__ _..~ 10000'= _._._____-_MV..__.~ 1-Dec-00 __..__........ 14-Dec-05 2708944 IWC _ _.___...,._ __...~ .1400 MONTANO NE ALBUQUERQUE NM .__ .__.-___.__..~.~_.____.__.____ _.... ~ ~ e ~~01 ~._.._.__ __ ~_ __. _ .. 20000: E _ ~ __ 1 Au 02 g __ ~ w..~____..... 14-Dec-05 _ 2708944 'WC , X1400 MONTANO NE IALBUQUERQUE NM ' 02 ' 12000/8000- 1 Aug 02 14 Dec-05 ___% .w_..~ _ __ 2708946 WC __.~__. _• _ _____ 9320 COORS BLVD NW sALBUQUERQUE NM 01 00` `. 200 1-Dec-031 1 4-Dec-05 _ 2708946 `WC ..._ .9320 COORS BLVD NW _. ._..._...__,._. ALBUQUERQUE ~~ NM ~ ~02 ~ _ _ _ _ ~ , 12000/8000' _ _ ~ _ 1-Dec-03 _ _ _ 14-Dec-05 2708698 WC ,6600 2ND ST NW ;ALBUQUERQUE NM M ¥ 01 U 20 _ _ 9816 S FG ____......_,.. 1-Jun-87~ ...~ 17 Dec 03 2708698 ;WC }6600 2ND ST NW ,ALBUQUERQUE _ . ___, ,NM ~ 02fU 05 9816rS FG I 1-Jun-871 ~ 17-Dec-03 .._.~ 2708698 °WC ._, ____.~__.____ ;6600 2ND ST NW 'ALBUQUERQUE NM w ~. 03 U 30 } .__,. _ 98161S FG ~ 1 Jun 8T __.......~_.. 17-Dec-03 2701041 IWC 7660 LOUISIANA BLVD NE !ALBUQUERQUE NM 1 01 U 205 i 9816 S ;FG's 7 Apr 96 17 Dec-03 2701041 ;WC 37660 LOUISIANA BLVD NE ALBUQUERQUE NM ' 02 U ?30 9816 S FG 1 7 Apr 96? 17 Dec-03 ......._.___.__.,,..._ 2701447 :WC ...,.,.. ..._ ..._.,_ _._,__..__.-. 7817 CENTRAL AVE NE ,_._.,a_.. _..._..,.,.,. _....._~ _ ..,_.. _.._.. ;ALBUQUERQUE ._ _..., __ ._ ..._ 3NM ._.._.. ...___. .... 01 U . ......_ =30 ~ ~ 8060'S {SI .~_..~...__ .............____ 1-Mar-82~ 17-Dec-03 __._ 2701447 WC _ _ ,7817 CENTRAL AVE NE , _ _ ;ALBUQUERQUE _ __ _ ~ ~ NM ~ _. 02 U X20 ; _. 8060 S 'SI ~ a 1 Mar 82 17 Dec-03 _.__-._.~ ..._. __.._ .~w..~._._..__ ...~_.._..._.._.._ 2701447 IWC ;7817 CENTRAL AVE NE ._,___._._,..__....._..__.. IALBUQUERQUE .._.___.._.__.~.. ___ ~NM ..___ . _.__,_._ 03,U __ -.. 05 _~__ __. _ .,_._.~ 8060S SI ( .__. .__..__ 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 12/17106-07 _ 1 West Coast Region------------------- as of 12113/06.-----_-.-,__ _ ---- -__-------- - - ------_ --- - CAPACITY INSTALL ~ RETRO LOC. # Region ADDRESS CITY ~ STATE UST # GALLONS DATE DATE 2705323 WC E8311 GOLF COURSE RD NW :ALBUQUERQUE €NM [ 01U '30 9816iS iFG 22-Jun-96` 17-Dec-03 2705323 5 WC _ .._..,,, _rV _.___.~._.__ _..._, _.._._ _ .._ _ _..___:.. -,8311 GOLF COURSE RD NW ;ALBUQUERQUE ,NM 0210 20 9816;S FG 22 Jun-96 17 Dec-03 2705323 WC 8311 GOLF COURSE RD NW 'ALBUQUERQUE NM 03~U 05 } 9816~S FG 22 Jun 96 17 Dec-03 2700810 WC ;712 W MAIN ST ;ARTESIA ;NM 01 U 45 1~ . 9816 S FG ~ 4 Jun 96 17 Dec-03 2700810 iWC ;712 W MAiN ST :ARTESIA NM 02U-_._' __ .___.,._.,,,,~._ ___ _ ......._,_,_..__.__,-.,_...._._.__,_____. _ :30 9816 S ,FG 4-Jun-961 17-Dec-03 2700810 WC 712 W MAIN ST ARTESIA NM 03`:U 05 9816.S FG' 4-Jun-96 17-Dec-03 .._ _.._.__..._.. _.._. _..W._......_n_. ____._____.._._ ~ _. _ ,,.__._ 2700289 WC 1700 N MAIN ST BELEN NM 01 U 30 5960!S SA 28 May 96, 17 Dec-03 2700289 WC 1700 N MAIN ST BELEN ~NM 02U 05 ~ r 5960~S ;SA ` 28-May-96, 17-Dec-03 ' 2700699 'WC '115 W HWY 44 BERNALILLO 'NM 01.U 20 9816'S FG 3 1-Mar-88~ 17 Dec-03 2700699 WC ;115 W HWY 44 BERNALILLO NM x 02 U 05 ~ 9816 S 'FG ;1 Mar 88; 17 Dec-03 ._,._,_ ...,__w ..._.,.._._,.._._,____.,~_...__ ..__ _ _._____..__.._,. _..._..._.. ..__..~._ ...____.. ...._..,.._s_..._._ .__.,,_...... .. _ _._..:._._ ___.,_.._...._ 2700699 IWC. ` ~ ;'115 W-HWY 44 BERNALILLO NM 031U ~30 , 9816~S .FG • . 1-Mar-881 17-Dec-03 ,_. 2700561 WC ;HWY 550 GEN L DELIVERY CUBA NM a 01,U 105 , 9684 D. FG 21 Nov-95s 1.7 Dec-03 ..____. _ w_,_______._,______ _..., _._ w.__._._~ 2700561. =WC 'HV1/Y 550 GEN L DELIVERY CUBA ;NM 02 U 20 9684~D FG 21 Nov 95' 17-Dec-03 2700561WC IHWY 550 GEN L DELIVERY CUBA NM 03~U ;30 968410 FG 21 Nov-95 17'Dec-03 - - ...,_..- t , ..__ ~.. E _-.. 2708945 WC X6401 HWY 550 CUBA NM ~~ 01 ` „ ~ 20000 - 1 Jun 03 14 Dec 05 ._._,6401 HWY 550...__._.........._:._. :CUBA _. ___ .___,_. _._..;NM'__ 02~ ~ _.___,._ _ ..._.__ _ ..----- ---... 2708945 'WC 12000/8000P 1-Jun-03 14-Dec-05 2701436 IWC X844 HIGHWAY 516 _ FLORA VISTA .._- __._....w,NMw.. _-01IU ~ X45 , ~W 98161S ;FG 16-Oct-95~ .17<.Dec-03 _.__,_,.___„_;.~,.. _;,-_..__.~____ ._ w._..~.._ __..w_..,_. ,..______.,~..,.,. ..~._ .~_._e20 , ___.._9816S FG ~ 16-Oct-95~ 17-Dec-03. 2701436 sWC #844 HIGHWAY 516 FLORA VISTA :NM OZ.U , E 2701436 'WC X844 HIGHWAY-516 FLORA VISTA NM 03.U 05 9816S FG ~ '~16-Oct-95 17-Dec-03 2700278 IWC '617 W PICACHO AVE LAS CRUCES `.NM 01 U ?30 9816S FG ' 24-Feb-951 17-Dec-03 2700278 ' WC 617 W PICACHO AVE LAS CRUCES ~NM 02 U 05 ` 9816 S -FG ~ 24-Feb-95 17-Dec-03 _ ._. ._ , .. __,._ ___. ..~.__.___,,._ ,._ .-W..__~._.. 2700278 ' WC i 6b7 W PICAGHO AVE LAS CRUCES NM 03 U 20 , 9816 S FG ~ 24-Feb-95 17-..Dec-03 _______ _.. .- ... ._._.._______..w _ .. 2708938 WC :1860 MAIN STREET NW LOS LUNAS NM 01 20000 1 Aug 99 14-Decm05 ___....._.... ,. __....,_ _ _ ~z. _ _~_ _._, _ .,.,. _ .._. _ .__... ,M_ 2708938 LWC 1860 MAIN STREET NW LnS LUNAS jNM 02! •1,0000110000 1-Aug-99 14-Dec-05 __,.,__... .. ,.,___._._ _ _ -_-_,r.,.,._._ 2708939 WC ':1100 NM HWY 528 RIO RANCHO ;NM 01 _ T .'20000 _w,µ.µ_. ~~~~ ,_ ~..___.~ ' ~ 1-Apr-00 14-Dec-05 ' ...,_,_ __ _ _,.__...,._.__.... ._... _ ..__.,....__._, _._,____. ,._ _.____. __...,_.~,.. ~-..._ ...,__ _.._.~..._.L,_ 2708939 -WC 1100 NM HW.Y 528 RIO_R_ANCHO NM 02 .1.0000110000:.. , 1-Apr-00 14-Dec-05 __.._...,.,.w .._.,~... w_. ,._ ...._ ._. . ..-__ .. _---___ _......___ a__...M.,_ _ _... _.... ._,.__.,,,_.,__._. _._ ~n...~..,___......_ 2701481 »WC 3213 N MAIN ROSWELL ,NM ~ 01vU =45 ~ 9994sS SI 1-Mar=83p 17-Dee-03 2701481 `WC 3213 N-MAIN ROSWELL iNM _02 U 30 ~ 9994+& SI 1'Mar-83( 17 Dec-03 M...w._. ..._._.__,-_,. ~ _ 2701481 WC ;3213 N MAIN ROSWELL rr 3NM~..._ w.~_ 03~U E05 8994 S SI T Mar 83 17 Dec 03 .,.._,..,_,n._ __...,,. .. 2701481 iWC • T3213 N MAIN `:. ROSWELL __.,.... NM 04,U .,_-_ -~~~ ` 20 9994 S SI 1-Mar-83 17-Dec-03 2701341 WC ,HWY 70 PO 8OX 907 RUIDOSO DOWNS NM E 01 U '20 f 1015ZS SI 1-N1ar-79 17-Dec 03 2701341 "4WC ;HWY 70 PO BOX 907 ~RUIDOSO DOWNS NM 02U ;30 ? ;'10152 S SI 1-Mar-79 17-Dec-03 _ ._.. _ _~. ~.. __ ~.._..-~.. _ M.._ 2701341 .,WC ;HWY 70 PO BOX 907 RUIDOSO DOWNS NM 03~U 05 ~ ~~;-10152 S .SI 1-Mar-79 17 Dec 03 ._.._,..,_._,._-~._, .,._ -,. _.__..__,_ .._...,_ w. _._ .._ _.,m__..___.___....___.__.._..~.~...__,_ ._.___ ._~.._.~. _._.,__._ _ . _ _..._.____.m.-. 2708933 ,WC '1.315 E WILL ROGERS DR .SANTA ROSA NM 01 i 10000 ~. 1 Jul-92 14-Dec-05 ..__,_ __ _.. _.._.___ ._µ,.____ __. _._,_ ___,_._....., ~.~,~ __._,_..._, _ ___.. _ _. ._.___- 2708933 ,WC :1315 E WILLROGERS DR SANTA ROSA !NM 02; 's, , 10000 1 Jul 92 14 Dec-05. _ .___._.__-,-_ ... ... ... _.__... _._ ~__...__.__.__ _~..,.~.,.. ___._.... .~,.-._. .__.._,.__..___w.__...~ t,_ _..._~ .._. _ _._ _.. 2708933 4WC `.1315 E WILL ROGERS DR SANTA ROSA - =NM 03~ ' x,10000 1 Jul 92 14 Dec-05 2700515. `WC ;.918 N DATE ST TRUTH OR.CONSEQUENCESlNM 011U s30 r ~, 9816`S FG 1.Nov-88:. 17-Dec-03 2700515 WC ;918 N DATE ST TRUTH OR CONSEQUENCES iNM ` 02;U 105 ~ .~ 9816;S ;FG 1~Nov-88', ;17-Dec-03 ~._ ._. _ ......_.__....__ ___ a__ ._ 2700515 WC 1918 N DATE ST TRUTH OR CONSEQUENCES 3NM 033U 20 r 9816 S FG ~~ 1 Nov 88 17~Dec 03 ,......~.. . .. .. _._.,_...~..« ._,... .,...~...._...... .... F , 2700839 9WC `601 E TUCUMCARI BLVD • TUCUMCARI - ,NM 0110 30 f 9816 S FG 1 Mar 87 17 Dec-03 2700839 ;WC =.601 ETUCUMCARI BLVD TUCUMCARI NM r 02 U 05 ! 9816,S FG ` 1 Mar 87! 17-Dec-03 2708931 ,'WC 2624 SOUTH 1ST STREET -,TUCUMCARI NM 011 10000 I ~ 1 Jul 79~ 14 Dec-05 ..._._. _ _L._____.,., ____~__.. ._ _. _. ,_,..._.__ 2708931 WC 1.2624 SOUTH 1ST STREET TUCUMCARI ~~~ NM _ ° 02€ _ 10000" 1 Jul-79 14 Dec-05 .- .m ,__....m...~._ n._,~.____.M._._ n,___-... ..._... _,_._.-_._...._._.___.._.__._ _....~....,,_m_,.. _._. _ __._.W..__.._s._ __ _,__.....w,.,.. ..~,._._,_,____.. 2708931 WC 12624 SOUTH tST STREET 3TUCUMCARI NM 1 03 100001 1-Jul-79' 14-Dec-05 _... _.__.__~.__ ~..____.._._. ,.........m,,,___.,.___.__._ ._. _.___......_. ... _ _.._._ .. _...._.__.____,. 2708931 WC +2624 SOUTH 1ST STREET TUCUMCARI NM 04: _ 100000+ _ ~-µM1-Jan-90 14-Dec-05 2708932 iWC ;201ETUCUMCARIBLVD TUCUMCARI ~NM 01, 7500: 1-Jan-86: 14-Dec-05 _.__ ._._.. ..._._,...__.,__.___.__._._,__.__.,__ ._...._._ ,, ~.__._____._,_._._,...~.._._ _. ........____.___.,_._._..__ . - __ _.~._ ___._ _. _ _ - .._. __.......w-._.._ _._,~.~._._.,__.. 2708932 ;WC X201 ETUCUMCARI BLVD :TUCUMCARI sNM 02 7500. ~ 1-Jan-86' 14 Dec-05 2708932 'WC 1201 E TUCUMCARI BLVD .;TUCUMCARI NM 03: 7500'; 1-Jan-86~ 14-Dec-05 2701641 IWC 1 - _.____~,__ ._ _.._....__,_ . _. _.__ _._.,.- ___._,.-..__.~.. ,601 S MAIN ;ANTHONY TX 011U 30 10152S FG 1-Mar-85~ 17-Dec-03 2701641 'WC 3,601 S MAIN 3ANTHONY TX 02 U 05 = 10152 S FG ' 1-Mar-85; 17-Dec-03 _._. _.. 2701641 `WC 1601 S MAIN `ANTHONY TX _ 03~U ~20 10152 S FG 1 Mar 85 17 Dec 03 2706104 WC X10100 MONTANA `sEL PASO TX 01,U X05 i 120321S :SA 1-Feb-87+ 17-Dec-03 2706104 IWC ~~-_._______, ......_._.__.._. .,.__._,.____ __ _._ ~ # _.___..___~._ .__...__......__._ ._,m. ;10100 MONTANA ' EL PASO TX 02sU 20 10152 S SA 1 Feb 87 17 Dec-03 .....___ _.__„__ __..„_ _ _,_.,. ~. _.._......__F 2706104 SWC _~_,._.._.._,_..._,,,__.._,...__.___..,__._,__. _ , ._.~ .,_._____.__.M._,.,____ .._ __:,.....m:.._.._,..~ ,10100 MONTANA EL PASO TX 03: U 30 12032iS SA 1-Feb-87~ 17-Dec-03 2701257 ! WC -10567 RUSHING RD EL PASO TX O1 ~U !20 10152' S SI S 1-Mar-78 17 Dec-03 2701257 WC 310567 RUSHING RD EL PASO TX 02'U 30 10152'S SI 1 Mar-78 17-Dec 03 ,__. ................_...1__,_____..___.._..~____. _ _____..~_ ,....._..__.k_.__,_..._.....,_._.... _..__._.._ _...... . ,_.___.~ _ _ __., .._...___......._,...- ___.. __-__.. 2701257 WC 10567 RUSHING RD DEL PASO TX 03=U 05 10152+S SI s 1-Mar-78 17-Dec-03 2700481 WC 310616 MCCOMBS ST EL PASO TX 011U 05 ~ 11682 S ;FG = 1-May-94 17 De_c 03 2700481 ; W C ' _._._w_ _ _.._,.___.._,.__._, __ _:. _._._ ...__,..__m_ __. __..,~. ._ .._ . _. ~_, _._,. _. ,_..._ _~_ _._ _. ;10616 MCCOMBS ST EL PASO !TX 02 U ;20 9816~S ~FG I 1-May-94. 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 ~ ' ~ ~ `- _ __ _ LOC. # Region ADDRESS CITY STATE UST # CAPACITY INSTALL RETRO GALLONS DATE DATE 2700481 `WC 110616 MCCOMBS ST DEL PASO TX ~ 03SU `30 `s , 7950 S FG 1-May-94~ 17-Dec-03 2708515 'WC :1073 COUNTRY CLUB RD EL PASO TX __..._.. 01 U 05 ; 10152 S 'FG 1-Jan-87, 17-Dec-03 2708515 ~WC '1073 COUNTRY CLUB RD EL PASO TX ~ 021U 20 ~ 10152'S FG " 1 Jan 871 17-Dec-03 2708515 WC 1073 COUNTRY CLUE RD EL PASO TX __ ..__..__.-, _,._--,k ____.....__._ ~.._____ ~ 03U +30 = , ~ 10152.S 'FG ~ 1-Jan-871 17-Dec-03 2700020 WC 10744 VISTA DEL S_OL EL PASO ~ TX ~ ~ ...-~..~.-_ _ ._- 01 IU 05 _-_.__~._,,._. __-..-.____-___.-. ~ 11682 S : FG ~ 2S-Nov-93 17-Dec-03 _ ~~m-..,_.___„~ iTX 2700020 WC 90744 VISTA DEL SOLD EL PASO _ 02 U 20 6 9816.S MFG 25-Nov-93 17-Dec 03 10744 VISTA DEL SOL EL PASO ~_v____M_____.-.._-aTX ` 2700020 WC __. _ __ 03tU 30 ~ _ _ _ 7950 S iFG ; 25-Nov-93~ 17-Dec-03 W.__ 2701674 i WC 10770 DYER ST EL PASO _ TX ~ ~ 2 701674 WC 10770 DYER ST _. 01 `U 30 ~~ 9728' S ' FG ~ 1 Mar-85 ~ 17 Dec-03 ~ _ _ E_L PASO TX e _~..__._ ...... ....__.~..,_.,,_...__..... - 02fU 05 ~__ ,, 9728'S FG ~ T Mar-85k 17 Dee-03 _........~_,._~_.,L~.__I,~_,_. - -._-, 2701674 WC 10770 DYER ST EL PASO ; ' TX 03 U 20 ~ 9728: S I FG `t 1-Mar -8 5~ 17 Dec-03 2700213 .WC 1.i 096 PEBBLE HILLS BLVD EL,PASO _ TX 01 U 05 _ ~~-9816 B~ _ _ FG ~ ~4-Aug-94,:.._.17-Dec-03 2700213 WC 11096~.PEBBLE HILLS BLVD _ EL PASO _ TX 02 U 20 9816 S ~,.__ fG ' ` 4 Aug-94~ 17 De c-03 2700213 WC 11096 PEBBLE;H4LCS BLVD EL :PASO TX 03 U 30 ; : ' . .9816 .S _ _ FG ~ 4;Aag-94; 17-Di?c-03 2700890 WC 11101 MONTWOOD DR EL PASO - _ _ . TX ___ '01 ~ U 30 9728 S .m.~... _ -..._.._.._._._ FG ~ 1 Jan-861 .47-D ec-03 2700890. WC 11101 MONTWOOD DR EL PASO TX 02 U 05 9728 S _ FG : _1-Jan-86;m 17-Dec=03 2700890 WC 1.1101 MONTWOOD DR EL.PASO _ TX : 03 __ U 20 9728 S: FG f~ • 1 Jan-861 17-Dec-03 2706309 WC . 11390'MONTWOOD DRIVE:. EL PASO TX 01 U 05 . 11682 S FG ;. :~8-Jan-99 17-D ec-03 2706309 WC 11390MONTWOOD DRIVE EL PASO ~~ TX 02 U 20 9816 S _ FG t~-~8-Jan-99!~y17=Dec-03 2706309 WC. 11390 MONTWOOD DRIVE EL PASO " ' _ TX 03 _ U 30 '" 9816~ _., S _ _~..~._b_-..._ FGA w 8 Jan-991 '17-DeC03 2706309. WC . ~ 11390 MONTWOOD.DRIVE- : EL,PASO _ TX 04 U 45 - 7950~ S~, FG I~ 8 Jan-99 17 Dec-03 2705312 WC 11701 MONTWOOD.DR' EL PASO TX _ 01 U _ ~ 30 9816- S ; FG 1 Now 9417-Dec-03 2705312 WC 11701 MONTWOOD'DR EL PASO TX 02 U 20 9816? S I _ FG , , 1-Nov-94 17=Dec-03. 2705312 . WC. 11701 MONTWOOD.. DR EL PASO. TX~ 03 U 05 11682. S~ FG 1 ~ 1 Nov 941.,17 Dec 03 2706308 WC 1320 GEORGE DIETER " EL PASO _ TX 01 U 05 11682 S r FG ; 5-Mar-98 "17-Dec-03 2706308, WG .. 1320 GEORGE DIETER EL PASO TX 02 U 20 ",:11682 S FG ~ ~~ 5 Mar=98 17-Dec-03 2706308 WC' 1320 GEORGE"DIETER EL PASO TX 03 U 30 9816 S` .FG € 5-Mar-9817=Dec-03 2706454 - .WC 1400 LEE TREVINO ' EL PASO TX 01 U 05 ~ . 20055 S FG { 2 Aug=01 17 Dec 03 2706454 WC 1400 LEE TREVINO . EL'PASO _ . ` TX 02 UC1 30 ~ '12068 S FG , w 2-Aug=01 17-Dec-03 2706454 WC - 1400 LEE TREVINO EL PASO _ TX 03 _ UC2 45 7981 S r....,...,._.._,..._. ,_-._..,._..._._. FG ' 2-Aug-01 :17-Dec-03 2701227. WC " 1400 W YARDELL DR EL PASO TX 01 U 30 9728 S FG µ ~1 Apr 84~ 17=Dec-03 2701227 WC ~ ` 1400 W YARDEL:L DR - EL PASO. ' TX 02 U 05 - .9728 S FG ; 1 Apr 84 17=D ec-03 2701227; WC 1400 W YARDELL- DR EL-PASO ' ; TX 03 U 20 , ..9728 S _ FG 1 Apr 841 1T Dec 03 2705305 .WC 14.71 N ZARA. GOSA _ EL PASO TX. 01 U 30 __ 9816 S FG ~.~;w1~May-961 `17-Dec-03 2705305. WC 1471 NZARAGOSA EC:PASO _ _ TX 02 U 20 '..:,`9816 S; 'FG ~ .`1=May-96 '1~7-Dec-03 2705305 WC' ; 1471 N ZARAGOSA . EL'PASO ~ - TX 03 U 05 ~ 11682 S , FG ~~, 1-May-961 17=Dec-03 2701506 . WC : 1500 GEORGE DIETER DR ::. EL PASO ~ 'PX . 01 U 20 ,:: 10152 S FG ~ : 1 Jan,87 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 10152 S FG e - 1 Jan-8~ 1Z~D^ec~03 2708775 .WC : 1520 LEETREVINO: EL~PASO ` .TX 01 U 20 :,:.9728 S. FG £ 1-Sep-88' 17=Dec-03 2708775: WC 1520 LEE TREVLNO _ _ _ EL PASO TX 02 U 05 ' 9728 .S _ __~._._.__K.__..__. FG _ 1--Sep-88 TM 17~Dec-03 2708775 WC 1520 LEE TREVINO EL PASO _ TX 03 U 30 9728 S FG 1-Se p-8 8 17-D ec-03 2706307 WC~ ~ 1600 ZARAGOSA EL PASO _ _ TX__ _ 01 U O5 11682 S _ _ _ _ FG ! 19-Mar-98 ? 17-Dec-03 e 2706307 e 2706307 WC ; .-....___..-.. WC 1600 ZARAGOSA 16 Z EL PASO _ .TX _ 02 U _ 20 11682 S _ __.__.,.m__.,_ ~._-____.~w.. FG ~ 19-Ma_r-98 17-D ec-03 ~ F ~ 00 ARAGOSA EL PASO _ TX 03 U 30 9816 S _ FG ~ 19rvMar 98~ 17-Dec-03 2701482 I WC } µ ~ 1798 GEORGE DIETER DR EL PASO __ _TX 01 U 20 9816 S ~ y x FG ; ~1-Mar-84~ 17-Dec-03 2701482 ~ WC 1 ~ 1798 GEORGE DIETER DR EL PASO TX _ 02 U 05 9816 S FG ( 1-Mar-84~ 17-Dec-03 2701482 j WC ' ... __. _v. 1798 GEORGE DIETER DR _ ~. _ EL PASO ~ TX 03 U 30 9816 S FG i~ 1-Mar-841 17-Dec-03 2706130 WC 2200 N MESA EL PASO TX 01 U 05 11682 S w._.... FG 25 M 9 W a - ar-9 ~ 17-Dec-03 2706130 C '2200 N MESA .__ EL PASO TX 02 U 20 9816 5 FG 25 Mar 99 17-Dec -03 2706130 IWC 2200 N MESA _ --- _ ' EL PASO TX 03 U 30 9816 S -r r - _ FG 25-Mar-998 17-Dec-03 2700026 WC .3101 MCRAE BLVD ~._ _ EL PASO __ TX 01 U 05 10152 S _ _ SI ~ _ 1-Apr-79~ 17-Dec-03 2700026 WC :3101 MCRAE BLVD EL PASO__ TX 02 U -_-~ 20 1 101521.S __.__.~,..~..._.. Y_~ SI 1 1 Apr-791 17-Dec 03 2700026 ; WC :3101 MCRAE BLVD I..___.__.. __ EL PASO _ _ TX 4 ~~~-' -_I 03;U = ~° "" 30 ; 10152 S -•`°"" SI 1-Apr- 79 17-Dec-03 2701418 ;WC 3910 A DYER ST _ EL PASO - TX 01U ~ 20 ~~~ 101526S _ . SI ; ~ 1-Apr-81~ 17-Dec-03 2701418 ~WC :3910 A DYER ST EL PASO TX _- 02, U 1 05 1 10152' S . _.--_._.~._.._;-_._.__.____._. SI 1 Apr-81; 17-Dec-03 2701418 iWC ;3910 A DYER ST EL_PASO _ ~ __~ ~ ___ TX a 03?U _ X _ ~~ M ~µ 30 ~ 10152 S ~ ~ µ-~~y4W"-~~~µ`-"' SI s 1 Apr-8 11 17-D ec-03 2708516 :WC 14101 N PIEDRAS EL PASO _ ______ ~ _ TX y _ ~ 01°U 1 _ _ 05 1 9816S _ _ FG ~ 1-Apr-87~ 17-Dec-03 2708516 WC `4101 N PIEDRAS___ EL_PAS_O_ _ _ _ i __ TX_ _ ; 02U ____ 20 I 9816 S __.. _.-._.__...... FG I 1 Apr 87, 17-Dec-03 2708516 !WC !4101 N PIEDRAS ~L PASO TX ? 031U ; 30 ' 9816;S _ _ _ FG 1~~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 -`h Circle K Tank Schedule 1 - ------------------------------------ - 2!17/06-07 - --------- ------- - - ------ - - - -- - West Coast Region a of 1 2/13/06 s LOC.# __ __ _ __ Region~_ ADDRESS ----------------------- . _ _____ CITY ---- STATE UST# GALLOT -- ~ - INDATEL RDEARO 2705313 `WC -4501 WOODROW BEAN-TRANSMOUNTAIN I EL PASO TX „ 01 # U 30 9816 ' S FG 23 Nov 94' 17 Dec-03 2705313 ?WC x4501 WOODROW BEAN-TRANSMOUNTA~N EL PASO TX 02! U 20 9816 ' -S FG ; 23 Nov 94 17 Dec-03 2705313 WC ;4501 WOODROW BEAN •TRANSMOUNTAIN EL PASO TX 03 U 05 ; 11682°S FG ~ 23 Nov 94E 17-Dec 03 2706288 ¢WC :5665 ED SE TR SOUTH BL EL PASO TX 01 U 05 ~ 11682`S FG 25-Jun-99' 17-Dec-03 _ 2706288 `:WC ;5665 DESERT SOUTH BL _ EL PASO TX 02 U 20 '~ 9816'S FG ~ 25-Jun-99? 17-Dec-03 2706288 !WC ;5665 DESERT SOUTH BL fL PASO TX 03 U 30 : _9816''-S - FG ~ 25-J_un-99 17 Dec-03 ~ 2706288 'WC~-~5665 DESERT SOUTH BL EL PASO TX 04 U ~ ~9816S 45 25-Jun-99„ 17-Dec-03 FG 2705306 §WC :6095 MONTANA AVE _ EL-PASO TX 01 U 45 i - 7950S FG 12 Sep 95j 17 Dec-03 -.._._ .r_.,.__.._ 2705306:?WC 6095 MONTANA AVE EC PASO TX 02 U _ 30 E 9816S H FG ~ .12 Sep 95 17 Dec-03 2705306 WC ~~6095MONTANAAVE EL PASO :: ~ TX 03 U_ ~ ,'~9816S 20 ~~ FG r 12-Sep-95 17-Dec-03 2705306 iWC 416095 MONTANA AVE ~ ,__. EL PASO TX _ __ 04 U 05 ~ ~~11682:';S~ FG .µr12-Sep-95; 97-Dec-03 _. __ _ 2706126 •}WC _:6148 GATEWAY E _ EL PASO TX 01 U 05 ~ 12032aS SF i 1 Nov 85, 17 Dec-03 - _ 2706126 WC 6148 GATEWAY E . ~ EL PASO TX 02 U 20 ~ ~ m12032 S 7 Nov 85,w 17 Dec~03 SF E ~ _ _ 2706126 '=WC _;6148 GATEWAY E _ 2706098 WC~~ }6200 N MESA ~ __ EL PASO EL PASO ~ ~ TX TX 03 ~ ~01 _ U U 30 ; ~:.. • 8068'S: 05 ~~~~17-682_S~ SF ?.' 1-N_o_v=85 '17-Dec-03 FG ~25-Feb-99 ~17-Dec-03 2706098 WC =6200 N MESA' _ _ EL PASO . TX 02 U 20 d 9816`S FG 25-Feb-991 17-Dec-03 2706098 W C ': 6200 N MESA ` . - EL PASO TX 03 U 30 ` , . 9816'. S . FG ~ .25-Feb-99; 17-Dec-03 . _, ~.~ - -- 2706098 WC ;6200 N MESA . - ----- EL PASO - TX 04 U__ _m_.~__.._. 45 t 7950 S. ~ _..~.,. .. -,,_..~..__.._..,_.. FG ~ - 25 Feb 99.`• 17-Dec-03 __ a_w-.-___....~-._ ~ _ 2700616 =WC ;6398 DONIPHAN DR ' _ __ EL PASO TX 01 U ?`11682` S 05 ~ FG ~~ _1-Nov-93i _ 17-Dec-03 - 2700616 WC ~ ':6398 DONIPHAN DR EL PASO . TX 02 U ~ 9684'.S 20 17-Dec-03 FG ? - 1 Nov-93' 270061.6 `WC ;6398 DONIPHAN 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 30 _ 9816S. fG ' _ 1-Feb-8_6.17-_Dec-03 2701.534 'WC 1650 N RESLER DR' __ EL PASO ' TX 02 U 05 X9816;5 . FG `. 1-Feb-86 17-Dec-03 2701534 WC ;6'50 N RESLER DR - --- ` _. EL PASO TX 03 - U 20 ' 9816~S FG , . .1 Feb-86- 17-_Dec-03 2705315 1WC 5680 E REDD RD` EL PASO TX 01 U 30 :: ' 9816'S. FG 5-Feb-96 17-Dec-03 2705315 WC 680 E REDD RD EL PASO TX 02 U 20 ~ 9816^S FG 5 Feb 96 17 Dec-03 2705315. WC 680E REDD RD .._ _w _.. - EL PASO TX 03 U 05 „ '~ 981.6~S ~ - N__ FG 5-Feb-96. 17-Dec-03 - __ ---- 2701190 'IWC !6996'ESCONDIDO - EL PASO . - .. TX 01 - U .. ; 05 . 1168215. FG ' 1-Apr-94: 17=Dec-03 : 2701190.=WC 6996 ESCONDIDO ~ __ __ EL PASO . TX 02 _ U 20 9816i'S' FG 1-Apr-94 17-Dec-03 2701190 WC -16996 ESCONDIDO : EL PASO TX `~ ' 03 U 30 , 7950~S FG ; 1 Apr-94 17-Dec-03 2706333 ~WC ;700`AMERICAS AVE 'EL PASO TX 01 U 05 > ~ _ 11682S FG ; 7-Oct-99 17-Dec-03 2706333 'WC X700 AMERICAS AVE' ' :' - . ELPASO - TX. 02 U 20 a 9816`:S FG ~ Z-Oct-99 .17-Dec-03 _ 2706333 ?WC 700 AMERICAS AVE EL PASO : ' TX 03 U 30 ; . ' 9816`S FG 7-Oct-99 17=Dec-03 2706333 'WC 700 AMERICAS AVE EL PASO : TX 04 U 45 ~ ' .: 9816S FG ° 7-Oct-99, 47=Dec-03 2700450 WC 7100 N LOOP RD _ - ` . EL PASO ". TX 01 U ! Z950'_S, 30 f m FG ~H: 7 Apr 94~ 17 Dec-03 2700450 WC =7100 N LOOP RD . ~ _ EL PASO -~ TX 02 U .. A 05 I ; :.; 11682 .S FG •• 7-Apr-94~ 17-Dec-03 2700450 iWC X7100 N LOOP RD .: EL' PASO .:. TX:: " : 03 U 20 „ ". 9816'S FG ; -` 7-Apr-94( 17-Dec-03 . _ _m- , .------- 2701429 ;WC !7300 N MESA ST . ------- EL PASO TX - - '01 - U - _.w__.~ ._._ 30 , 10T52S _ .._...-.._ .._...__._..__._._.. SI 1-Mar=82a 17=Dec-03 2701429. IWC 7300 N MESA ST ~ v,_._ ,___ EL PASO ~ TX 02 U OS 1015215 SI 1 Mar-82' 17-Dec-03 i 2701429 iWC =7300 N MESA ST EL PASO TX 03 U 20 •s '10152=S SI L 1-Mar-821 17-Dec-03 2706112 WC ;7800 GATEWAY E 2706112 iWC 17800 GATEWAY E EL PASO EL PASO TX TX 01 02 _ U U 05 11682'S 20 ~ 9816'S FG 17-Jun-98; 17-Dec-03 FG '. 17-Jun-98! 17-Dec-03 2706112 ~WC ;7800 GATEWAY E EL PASO TX 03 U 30 9816~S FG ? 17-Jun-98 17-Dec-03 2706112 ~WC '7800 GATEWAY E EL PASO TX 04 U 45 9816S FG ~ 17-Jun-98j 17-Dec-03 2701508 iWC '8726 MONTANA AVE EL PASO TX 01 U 20 ! 9816:S FG 1-Feb-86 17-Dec-03 2701508 WC ' 8726 MONTANA AVE EL PASO TX 02 U 05 , 9816S FG 1-Feb-86' 17-Dec-03 2701508 ?WC ::8726 MONTANA AVE EL PASO TX 03 U 30 r 9816S FG , 1 Feb-86~ 17 Dec-09 2708743 WC '8855 N_LOOP __ ~ EL PASO _ TX 01 U__ 30 9816'S FG 1 Aug 88, 17 Dec 03 2708743 ~WC ;8855 N LOOP EL PASO TX 02 U 05 ~ 9816?S FG 1-Aug-88 17-Dec-03 __ ____ 2708743 .WC ;8855 N LOOP 2706089 =WC ;9497 DYER 2706089 ;WC X9497 DYER __ __ 2706089 $WC '9497 DYER EL PASO EL PASO EL PASO_____ ___ EL PASO TX TX TX TX 03 01 __02 03 U U U__ U 20 ; 9816~S 05 ~ 12032 S 20 3 12032 S 30 3 10128S FG 1-Aug-881 17-Dec-03 SA 1-Aug-88` 17-Dec-03 SA 1-Aug-88# 17 Dec-03 SA ~ 1-Aug-88 17-Dec-03 2701136 ~WC -204 S MAIN .._-.------- -- 2701136 WC ;204 S MAIN 2701136 WC 204 S MAIN - -H--- - - - -- --- 2701452 [WC ;2415 GRIFFIN AVE ELLENSBURG ---- ELLENSBURG ELLENSBURG - -- - - ENUMCLAW WA WA WA WA 01 - 02 03 ---- 01 U -- U IU -- _ U 05 9816S ___.~ 20 , 9816S 30 9$166S 30 9816;S FG 30 Apr-95 17 Dec-03 - _ . __...~. -----__.__.w._. FG 30-Apr-95 17-Dec-03 FG 30 Apr 95 17 Dec 03 - ~ - FG • 21 Apr 95 17 Dec 03 2701452 WC ,2415 GRIFFIN AVE 2701452 WC :2415 GRIFFIN AVE ENUMCLAW ENUMCLAW WA WA 02 03 U U 20 ~ 9816 S ~05 i 9816S FG ; 21 Apr-95 17 Dec 03 FG 21-Apr-951 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 12/17106-07 as of 12/13/06 -- ~ --~ - ----- --- ------------ ------ LOC. # Region ADDRESS CITY CAPACITY INSTALL RETRO _ ___ _ STATE UST # GALLONS ~ DATE DATE 2701546 ~WC ;10255 SE 240TH ST __ - - ---- KENT --------------- WA -- 01 U 30 9728.S i - - FG : 1 Mar 85 17-Dec-03 2701546 WC :10255 SE 240TH ST _ __ KENT __ - WA 02 __ U ...__.. ~. _._~ 05 9728;.5 _,. ...__. ._. _.~~_._-. _,. FG ' 1-Mar-85 17-Dec-03 2701546 WC ',10255 SE 240TH ST KENT _ WA 03 U -" ~""~ `°"°`-`s 20 9728,5 °" _°' ''.~..`_~.~w.-_-- FG 1 Mar-85~ 17-Dec-03 2701602 ?WC 20727 108TH AVE SE KENT WA 01 U _ 05 _ 9728 5 FG ' 1 A r 85s 17 Dec-03 --- 2701602 =WC !20727 108TH AVE SE _ ---- -- KENT ____ WA - 02 U _..__, _._...__~_ 30 9728~S -_.m ...~p ... ......~..... ___ FG ~ 1-Apr-85 17-Dec-03 2701602 SWC ;20727 108TH AVE SE 2708878 'WC {8007 STATE AVE .- KENT MARYSVILLE WA WA 03 01 U U 20 `~ ~~9~728}S 20 ~~9816'S FG 1 1-Apr-85s 17-Dec-03 FG • 1 Se 87 17 D 0 _ 2708878 WC rv~ _ ~ ec- 3 _ p.. # i 8007 STATE AVE MARYSVILLE : WA 02 U 05 9816~S ... _...._...~_~._. FG 1-Sep 87~ 17-D ec-03 2708878 ;WC 18007STATE~AVE ~~ ~ ~ 2708567 WC 31700 132 ST SE - ~ MARYSVILLE ~. MILL CREEK _. WA WA 03 01 U~ U 30 a ~ 9816~S 20 i ~ 9816;S - _ _ FG ~ 1=Se_p-87~ 17-D_ec-03 FG ~ ~ 1-Oct-88! 17-Dec- 03 2708567 i WC _ '1:700 132 ST SE 2708567 `WC .1700 132 ST SE _ - _ _ MILL CREEK MILL CREEK WA WA 02 03 U U 05 + ~ rv~ 9816S 30 , 9816~S _ FG i ~1 Oct-88. 17=Dec-03 FG : 1 Oct 88 17 Dec 03 2705925 tWC 9061 DECRIDGE WAY SW - . SEATTLE WA 01 U ~~- _.--' 20 8025+D .._. ~-~~-'~~ -W~W ~""'Wmm`~' SF ' 1 J 2705925 I ~- WC ;9061 DECRIDGE WAY SW • SEATTLE WA 02 U . 05 ¥ 10058D an-91 17-Dec-03 SF 1-Jan-91 17-Dec-03 2705925 WC _ (9061 DECRIDGE WAY SW -- SEATTLE '. WA 03 _ U 30 ~ ~~ 8025 D u- '--'~~~ ~' -~~-`~~~ SF 1 Jan 91 17 D 03 2705925 WC 9061 DECRIDGE WAY SW _ __ _ SEATTLE WA 04 U , 45 ~` ` °""' ' 6048>D SF - - ec- " "~ °"~-" -"'-"°""~~ ; 1 Jan-91, 17-Dec-03 2708795 ~ WC ;4704 OAKES ST, SUITE 100 TACOMA __ WA 01 U 30 ~9816t.D FG ~ 1-Apr-89~m 17-Dec-03 2708795 IWC !4704 OAKES ST, SUITE 100 TACOMA _ WA : '02 U 05 1 ,~ ~~9816~D FG ~ :~ 9-Apr-89 17-Dec=03 2708795 i 2706000 WC X4704 OAKES ST, SUITE 100' - WC _. ___ TACOMA WA _ 03 - U ~ 20 ~ ~~ 9816=D _...___..... _ fG I ~~ 1 A r 89 17 Dec-03 . p _ 924 S HWY 85 :: SOCORRO NM 01 U 05 -. 12000 S FG k t.. , ...._. ....u,....___..... 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 - s~~ 1 Oct-96 17-Dec-05 2706001 _ WC 801 E THORPE.RD LAS CRUCES NM 01 _ _ U 05 -12000 S FG 1-Jan-00 1Z=Dec-05 2706001 __ WC 801 E THORPE RD _ LAS CRUDES ': NM 02A U , 05 _ ; 15000 5 FG ~1-Jan-00 17-Dec-05 2706001 WC 801 E THORPE RD _ _ LAS CRUCES __ NM 02B D 30 __ ~ ~ ;:6000 S' FG . 1;-Jan-00 17-Dec-05 2706001 _ _ WO ' 801 E THORPE RD _ LAS 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-Eeb,02 17-Dec-05 2706003 WC 29955:HAUN ROAD < _ SUN CITY CA '02B D 45 5000 D SF 1-Feb-02 17-Dec-05 G:\data\WCBU_Environmental_CompliancelCertificate of Financial Responsiblity\2007 CFR\Circle K WC Region Tank Schedule 2006 12 13 "l'JN13`ERGROUND STOR~\GE TANKS - ~~'~ b axsP>b~.n AP~~ICAT~®~ T~~ P~RF®R ARTM~NT C~~G°~~ TT-- ~ 3 ~.1 . . Sake>rs~eIld 1F'axe wept. ~aawIl>r®>mme>rntaIl Sea-vaces 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel: (661) 326-3979 Fax: (661) 852-2171 ~~~~9~~ tl v ~ s SITE fNFORMATION FACILITY: Csrcle K#2708825 i ,ADDRESS: 2222 F St. Bakersfield, 93301 i (OPERATORS NAME: CIrCIe IK Stores, Inc. WNERS NAME TANK# VOLUME 1 9684 CONTENTS Supreme (91) Gasoline 2 9684 Ptus (89j Gasoline 3 9684 Regular (87) Gasoline TESTING C OMPANY NAME OF TESTING COMPANY: TanknOlOgy, InC. i MAILING ADDRESS: 41785 Enterprise CIrCIe S. Unit D Termecuia, CA 92590 NAME & PHONE NUMBER OF CONTACT PERSON: Wesley COUIter (800) 666-2176, ext. 12 DATE & TIME TEST TO BE C ~UCTE 1 /12/06 8AIVI ICC # /mar ~ % ~~ - IGNATURE OF APPL GAS / DATE: 1I5IO6 i ! . ~ / , , , PPLICATI,ON BECOMES; A PE:RM.ITW.HEN' APPRQ.VED ,, _ PPROVED BY DATE ~~ 3 FD2106 ,:~ - UNIFIED PROGRAM INSPECTION CHECKLIST t4..: '..<~., -1!?+Y7:'.tiY43F e::..J,,• v r ;,~ r ......: a~-. :.. ::.. '.r ,.<..' .u :..., .. s.... .SECTION 1: Business Plan and Inventory Program BASERSFIELD FIRE DEPT p Prevention 8ervicea ~Ita 900 Trfixtun Ave. , Suite 210 air Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 / FACILITY NAME 1, /~ ''T f~ - ~ NSPECT/I~ON DATE INSPECTION TIME y~ / l ~/ ) X 1 C/ V UCJ ~/ ~ "Z- ~ /i ~ S~ ADDRESS HONE NO. O OF EMPLOYEES S 3z _f7 7 FACILITY CONTACT USINESS ID NUMBER 15-021- ~~ Section 1: Business Plan and Inventory Program _~"~ ~~''~'~ ^ ROUTINE MBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (~=Compliance` OPERATION V=Violation J COMMENTS ^ APPROPRIATE PERMIT ON HAND ~^ $USinesS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ,Q{ ^ VERIFICATION OF LOCATION v 1 ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY l~"- ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND CEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ,P~ IRE PROTECTION V ~^ SITE DIAGRAM ADEQUATE 8 ON HAND ~~ ~~~~l~iQ.~- /I-~ !L~ -~~ ANY HAZARDOUS WASTE ON //SITE? p~'ES ^ NO EXPLAIN: ~~ Z ~ r!7~r~S - -- .._- --------------- - 0U STIONS REGARDING THIS INSPECTION? PLEABE -CALL U9 AT (881) 328-3979 ~mon~ ~r~4~z,1-~ ~~ Inspector (Please Print) Fire Prevention / 1'~ In / Shift of Sile/Stetfon # White -Prevention Sarvicea Yellow -Station Copy Pink - 8usineaa Copy FD2049 (Rw. OQ/05) 4`~Lli pl~~w CITY OF BAKERSFIEI,D FIRE DEPARTMENT F ~~ OFFICE OF ~;NVIRONI~~IENTAL. SERVICES ., y~~ UMFIED PROGRAM INSPEC'T'ION CI~ECKLIST ;W ~Rti,~~°~ 1715 Chester Ave., 3`'`' Floor, Bakersfield, CA 93301 FACILITYNAME_ ~i~I~ f; INSPECTION DATE 2_g~~ Section 2: Linderground Storage Tanks Program ^ Routine t~`ornbined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection Type of Tank 'i~bu6r'~ ui.4!/ Number of 'hanks .-~ Type of Monitoring _ Type of Piping G~ubl~_ c.~.Al.~ OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on the Permit tees 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 ~~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank OPERATION Y N COMMENTS SPCC available SPCC on the with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? [f yes, Does tank have overt711/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: +, /'j10AJ ~~ ~ C Office of Environmental Services (G61) 32G-3979 N'hitc - inv. Svcs. AGGREGATE CAPACITY Nwnber of Tanks Pink - t3utiinets C~~Py I Bustness ite Respon tole Party 1 C:11;~'1.L' --- } T:SHk' I:!?: r.. h l ~1 h 1 ~c.;_ ~ r i T t ..~~~u"'F'r:' . lJ , 1 UI~Lr=+,i~1= - HEIR=aHT = ~,:.1.:~='_ 1`Il~:'LiF:::~ ~J~TE '' .. C;I-. - i I ;~1..; I:Jh"fEF' _- I i . CII_J 1 fl~_ Hk.i_~ .. .. t. ~~f .. I~~ I~t} I .. .. z~oaazs UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION ~ ~J, HAZARDOUS MATERIALS BUSINESS PLAN a~ J CERTIFICATION FORM 2006 Pursuant to Section 25503.3(c) of California Health and Safety Code (HSC), the Hazardous Materials Business Pian (HMBP) certification described below is hereby submitted for the following facility: Facility Name: Circle K Store #2708825 Facility Street Address 2222 F Street City: Bakersfield Zip: 93301 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) ~N~'~ ~ ~ R ~. ~ ~QQ~9 Site Map form Emergency Response Plans and Procedures 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 sting oft "` Signature of Owner/Operator: Tit e: Name of Owner/Operator (pri ~ Date. Return all forms to: Bakersfield Fire Department 900 Truxtun Avenue, Suite 210 Bakersfield CA 93301 661-326-3979 Business Plan Certification 2006 27oas25 - UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES ~- Page [ of I. FACILITY IDENTIFICATION !FACILITY ID# 1 EPA ID# (Hazardous Waste Only) 2 CAL000278518 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) 3 Circle K Store #2708825 __ _. I: ACTIVITIES DECLARATION NOTE: If you check YES to any part of #his ist, please submit the Business Owner/Operator Identification page (OES Form 2730).; Does your facility.:. If Yes, please complete These pages of the ,IJPCF... 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 bl F f l d ©YES ~ NO 4 ~ HAZARDOUS MATERIALS INVENTORY - applica e ederal threshold quantity or an extreme y hazar ous 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) ~ES ~ 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 UST TANK (One per tank ~I 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-0ne 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 NUMBEF~-provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted ~ YES ©N010 ~ RECYCLABLE MATERIALS REPORT recyclable materials (per HSC § 25143.2)? (one per recycler) 3. Treat hazardous waste on site? ~ YES ©N011 ~ ONSITE HAZARDOUS WASTE TREATMENT -FACILITY (Formerly DTSC Form 1772) 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 J CERTIFICATION OF FINANCIAL by Rule and Conditional authorizaton)? ASSURANCE(FormerlyDTSC 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 ©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.) UPCF (1/99) 2708825 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Page of I. IDENTIFICATION ~ 1 BEGINNING DATE 100 ENDING DATE FACILITY ID# 101 ~ 01 /01 /2006 12/31 /2006 BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 BUSINESS PHONE . 102 ~ Circle K Store #2708825 661-324-1758 BUSINESS SITE ADDRESS 103 2222 F Street (CITY 104 CA ZII' CODE 105 Bakersfield 93301 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, lnc. 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 CITY 114 STATE 115 ZIP CODE 116 Corona CA 92879 III. ENVIlZONMENTAL 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 TITLE 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 those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is tnre, accurate, and complete. SIGN F PE T D 1 4 NAME OF DOCUMENT PREPARER 135 `'~' RHL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT. SI NER (print) 1 TITLE OF SIGNER 137 Lorraine Soffe Compliance Manager UPCF (1/99 revised) 167 OES FORM 2730 (1/9 AP# 1 BUSINESS NAME CIRCLE K STORE #2708825 BUSINESS ADDRESS 2222 'F' STREET CALIFORNIA ANNOTATED SITE BAKERSFIELD MAP DATE 03/16/2004 ZIP CODE 93301 PREPARED HY: J ]~FSIGN Q'DROUP INC DRAWING SCALE A B C D E F G H MAP SYMBOLS NORTH MC DONALD'S O ELECTRICAL PANEL SHUT-OFF NATURAL GAS G SHUT-OFF O WATER SHUT-OFF 23RD STREET Y PUMP O TG SHU OFF TMA TANK MONITORING ~, ALARM T^ TELEPHONE 2 FIRST AID KIT ~ FIRE EXTINGUISHER ® STORM DRAIN _-- A LD T _ -S ~ SANITARY SEWER STAGING AREA EVACUATION/ ~ 10,00 0 GAL ~O HMMP HMMP, AND MSDS I J MSDS LOCATION 3 w ~ ~ 10,000 GAL~~O J ~ FIRE HYDRANT (~ Q --- ; 10,00 -- 0-GAL J~ GO ~>F FENCE ERE EMERGENCY RESPONSE Q , EQUIPMENT/ABSORBENTS ~-- I © I O ABOVEGROUND ~ I STORAGE TANK 4 Q P O ~ _J Q I~ -I UNDERGROUND ~ - ~ STORAGE TANK W CO E O J z ~ W J W O GASOLINE Q ~ CASHIER O Q Q (FLAMMABLE LIQUIDS) ~ F ~ n T~-~ I W DIESEL FUEL O W ( (COMBUSTIBLE LIQUIDS) Q ~ z I 12x5 GAL MSDS OP RR ~ O MOTOR OILS & LUBRICANTS (COMBUSTIBLE LIQUIDS) PROPANE F CARBON DIOXIDE CO 5 (COMPRESSED GAS) PROPANE O I ERE I (FLAMMABLE LIQUID) T T ~ OA AN IFREEZE/COOLAN S I I O WASTE OIL (FLAMMABLE LIQUID) CW CAR WASH PRODUCTS 6 ELECTRONIC MONITORING POINTS ~$ SUMP SENSOR 7 OA ANNULAR SENSOR DR. OFFICE LD ELECTRONIC LINE LEAK DETECTOR AUTOMATIC TANK GAUGE EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK MINOR INCIDENT: (less than 5 gallons 2708825 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: 2222 F 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: Justin Peterson 951-270-5163 Compliance Manager: Lorraine Soffe at (95I } 270-5 183 or (951) 453-9067 FACILITY CONTACTS Primary: Service Contact Center 24 Hours Day: 866-805-4357 24-hour: 866-805-43 57 Secondary: Justin Peterson District Manager Day: 661-978-4822 24-hour: 661-978-4822 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 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) 845-8911 c) LOCAL POLICE AND FIRE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) Spill/Release Response Procedures for Carbon Dioxide (C02) 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. I:\IiAZMAT\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: Tn 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-FRONT OF BUILDING, 1-PUMP ISLANDS ~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: STOCKROOM ~-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: 1-REAR OF BUILDING, 1-STOCKROOM ~k WATER SHUT-OFF: The water shut-off maybe necessary in some cases. Location: ALONG F STREET ~c NATURAL GAS SHUT-OFF: If your facility has natural gas, it maybe necessary to shut-off the flow in case of an emergency. Location: NONE * 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 * 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: 3-IN STORE, 1-CASHIER ~k 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 AT CASHIER ~c RESPONSE EOUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: STORAGE Shovel: STORAGE Gloves: STORAGE Goggles: STORAGE * FHtST AID KIT: Use for minor incidents and treatment. Location: CASHIER ~c EVACUATION ASSEMBLY AREA: All employees must know where to meet in the event of an emergency. Location: NORTH OF SITE ~k ENVIRONMENTAL DOCUMENTS / HMMP MSDS SHEETS: Location: CASHIER EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: BAKERSFIELD MEMORIAL HOPS. 420 34th ST. BAKERSFIELD 661-327-4647 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. FIItST 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, RIIL Design Group, Inc., 800-765-1025 Last Updated: 28-Mar-O6 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 ~c 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. r UNIFIED PROGRAM INSPECTION CHECKLIST a~~~...;,a+,.sssr,~~a,:~vr~,ur_<........,~^_~,r..-;=-:-. •:.r.. .>..t-,: :.... ... .,~T-... .-.:,:.: :~:W~..: ~..... .,..:. a<; :: SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT ra Prevention Services R/t~ 900 TYuxtun Ave., Suite 210 ~•>rr Bakersfield, CA 9330] ~~ Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME ~ ~ Q' NSPECTI N D E NSPECTION TIME s-~ 6 ~ ~ ~~ ~ ~ ~~. , C t ADDRESS HONE NO. O OF~MPLOYEES ~~ ` * ~~T~ FACILITY CONTACT USINESS ID NUMBE Section 1: Business Plan snd Inventory Program ~/ S ~ ~~_ O ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=Compliance` OPERATION J COMMENTS V=Violation ^ APPROPRIATE PERMIT ON HAND ~~ ~, ^ BUSIt1t3SS PLAN CONTACT INFORMATION ACCURATE ~/~ V ^ VISIBLE ADDRESS ~O . - / LAY ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS 1 ^ 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 Ily EMERGENCY PROCEDURES ADEQUATE _ ' ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING t ^ ^ FIRE PROTECTION SITE DIAGRAM ADEQUATE 8 ON HAND {'~~ ~Pt:.SCht;t~ ~( Ih ANY HAZARDOUS WASTE ON SITE? ^ YES ~/NO . ~vVl~` ~~`"' EXPLAIN. - _ --- ^--- _~~ `J --- - - V~' OUESTIO REGARD~IC~THIS INSPECTION? PLEASE CALL US AT (881) 328-3979 Inspector (Please Print) Fire Prevention / 1`~ In / Shift of Sile/Station p `business SH I Sile Re ponsi le aAy (Please Print) White -Prevention Services Yellow - Sletion Copy Pink -Business Copy FD2048 (Rw. 02105) ,~~tw~~'~ ~~~ \ ~C:ITY OF BAKERSFIEI,D FIRE DEPARTMENT I~ ~~ ~. ~.. ~~ E CARo~ ~.~ii FACILITY NAMEV tec~~, ~ 3~r~-S INSPECTION DATE: ~ ~ ~__ Section 2: Underground Storage Tanks Program ^ Routine Combined ^ Joint Agency ^ Mu1ti-Agenc ^ omp(aint ^ Re-inspection 'T'ype of Tank ~t~~J^C 5 Number of Tank ~ Type of Monitoring C.LM Type of Piping OPERATION C V COMMENTS Proper tank data on the Proper owner'operator data on the Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? YeS NO Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks 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 overtilVoverspill protection? C=Compliance V=Violation Y=Yes N=NO Inspector Office of Environmental Services (661) 326-3979 l~'hitc - 1'nv. Svcs ro; OT+'FICE OF' ~;NVIRONMC'NTAL SERVICES y~' 1JNIFIED PROGRAM INSPECTION CHECKLIST w '~ ~ ~~`~ 1'~ 15 Chester Ave., 3'~`' Floor, Bakerstield, CA 93301 Basin ss ite Responsible Party Pink -Rosiness Cnpv ,.,I,~~ ? ,~ - Ts~-/1~'~2G1/t~-t~lY 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 /05/2007 Order Number: 3150322 Dear Regulator, ~~ d~ Date Printed and Mailed: 01/23/2007 Enclosed are the results of recent testing performed at the following facility: CIRCLE K#2708825, CO. 123 2222 F ST. @23RD ST. BAKERSFIELD, CA. 93301 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 • , ,~ , ~/ TANKNOLOGY CERTIFICATE OF TESTING ~I ~ ~ ~ .7~ 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: 01/05/07 WORK ORDER NUMBER: 3150322 CUSTOMER PO: 100887 CLIENT: CIRCLE K STORES SITE: CIRCLE K#2708825, CO. 123 495 E. RINCON, STE. 150 2222 F ST. CORONA, CA 92879 @23RD ST. BAKERSFIELD, CA 93301 LORRAINE SOFFE MANAGER -RANDY (951)270-5193 (661)324-1758 Prnrlnr_4 Pinp Tinh4npcc Tpc4 Rpcul4e ~ IMPACT LINE LINE LINE DELIVERY TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL TYPE A B C _D lOk 1 SUPER FIBERGLASS PRESSURE Y lOk 2 PLUS FIBERGLASS PRESSURE Y lOk 3 UNLEADED FIBERGLASS PRESSURE Y Fxic4inn 1 ina 1 aalr Ila4ar4nr Taco EXISTING LEAK DETECTOR #1 EXIST ING LEAK DETECTOR #2 LINE ID MANUFACTURER MODEL # SERIAL # RESULT- MANUFACTURER MODEL #: '- :'- SERIAL # RESULT lOk 1 VEEDERROOT ELECTRONI 204905 P lOk 2 VEEDERROOT ELECTRONI 119018 P lOk 3 VEEDERROOT ELECTRONI 012171 P Npw Ranlar_ampn4 I ina I aak Ilatar+nr Tact REP EAL D LEAK DETECTOR #1 REPLA ED LEAK DET E TOR #2 LINE ID MANUFACTURER MODEL # SERIAL # ~ RESULT: MANUFACTURER MODEL #:. ; SERIAL # RESUL ror owner aetaiiea repon miormanon, vise[ www.tantrnotogy.com ana select un-Lme xeports-wxar, or contact your iocall anxnoiogy otnce. Tester Name: TIMOTHY COULTER Technician Certification Number: -~--~ Printed 01/23/2007 08:22 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS `i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/05/07 WORK ORDER NUMBER: 3150322 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE K#2708825, CO. 123 TANK INFORMATION Tank ID: iok i Tank manifolded: No Bottom to top fill in inches: 89 . o Product: SUPER Vent manifolded: xo Bottom to grade in inches: Capacity in gallons: 9, 684 Vapor recovery manifolded: YES Fill pipe length. in inches: Diameter in inches: s9 . oo Overfill protection: YES Fill pipe diameter in inches: 4. o Length in inches: 364 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST r2ESULTS Test Method: LEAK DETECTOR TEST RESULTS 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: vESDERROOT Fluid volume in gallons: Model: ELECTROxic Tank watE;r level in inches: S/N; aossos 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. o0 Result: Results: rASs COMMENTS COMMENTS ULLAGE TEST RESULTS Test Method: LINE TEST RESULTS Test,type - ~. Test time: Material: FIBERGLASS Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 125. 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 Vol change CC: TESTED TESTED TESTED Test 2: Start time: TESTED Flow rate Cfh : T ( ) ESTED Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Tem erature: P 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: FE PETRO COMMENTS Impact Valves Operational: YES Printed 01/23/2007 08:22 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS 'i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/05/07 WORK ORDER NUMBER: 3150322 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLE K STORES SITE: CIRCLE R#2708825, CO. 123 TANK INFORMATION . Tank ID: iok 2 Tank manifolded: No Bottom to top fill in inches: s9 . o Product: PLUS Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: 89 . oo Overfill protection: YES Fill pipe diameter in inches: 4 . o Length in inches: 364 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATC Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS T,4 K TEST RESULTS :lest Method: . LEAK'DETECTOR TEST RESULTS '.>.x : s-,:TesYmethod: ' ,.'~ ~~ 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: vsEnERROOT Fluid volume in gallons: Model: ELECTRON=c Tank water level in inches: S/N: iisoie Test time: NoT Open time in sec: Number of thermisters: TESTED Holding psi: xOT 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: a . 00 Result: Results: PASS COMMENTS COMMENTS ULLAGE TE;iT RESULTS Test Method: ' ` . LINE TEST R7=SULTS Test type ~~ - ~* ~. - "C. Test time: Material: FIBERCLASs Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 1.25. o 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 fate Cfh : T ( ) ESTED 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: FE PETRO COMMENTS Impact Valves Operational: YES Printed 01/23/2007 08:22 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tanlv~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 01/05/07 WORK ORDER NUMBER: 3150322 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CIRCLB K STORES SITE: CIRCLE K#2708825, CO. 123 - TANK INFORMATION Tank ID: lok 3 Tank manifolded: No Bottom to top fill in inches: a9. o Product: UNLEADED Vent manifolded: No Bottom to grade in inches: Capacity in gallons: 9, 684 Vapor recovery manifolded: YES Fill pipe length in inches: Diameter in inches: s9. oo Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 364 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw FIBERG Installed: ATG Stage II vapor recovery: BALANCs CP installed on: / / COMMENTS TANK TESTRESULTS :~ '°: -Test Method: - - ..v i ~ LEAK'DETECTORsTEST RESULTS s;--': 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: vssnaaaooT Fluid volume in gallons: Model: ELacTROxxc Tank water level in inches: S/N: olal,l Test time: NoT Open time in sec: Number of thermisters: TESTED Holding psi: NoT Specific gravity: Resiliency cc: TssTED 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 TE;~T RESULTS Test Method: LINE TEST RESULTS Test type . ~~, Test time: Material: FIBERGLASS Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 125. 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 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: FE PETRO COMMENTS Impact Valves Operational: YES Printed 01/23/2007 08:22 ACRAMER . MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitoring 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#2708825, CO. 123 Site Address: 2222 F ST. @23RD ST. Date of Testing/Service: 01/05/2007 Facility Contact Person: MANAGER -RANDY Make/Model of Monitoring System:TLS-350 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced City: BAKERSFIELD CA Zip: 93301 Contact Phone No: 324-1758 Work Order Number: 3150322 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/Trench Sensor(s). Model: V/R 208 Piping Sumprrrench 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 PLLD X Electronic Line Leak Detector. Model: V/R PLLD X Tank Overtill/High-Level Sensor. Model: FLAPPER Tank Overfill/High-Level Sensor. Model: FLAPPER Other (spec:ify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Tank ID: _ Tank ID: In-Tank Gauging Probe. Model: MAG 1 In-Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: V/R 409 Annular Space or Vault Sensor. Model: X Piping Surcipffrench Sensor(s). Model: V/R 208 Piping Sump/Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: MechanicaE Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic line Leak Detector. Model: V/R PLLD Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Tank OverfilVHigh-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 Dispenser Containment Sensor(s) Model: Dispenser Containment Sensor(s) Model: X^ Shear Valve(s). X Shear Valve(s) QX Dispenser Containment Float(s) and Chain(s). X 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): TIMOTHY COULTER Certification No.: 634132 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: 01/05/2007 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 2222 F ST. Date of Testing/Service: 01 /05/2007 @23RD ST. D. Results of Testing/Servicing Software Version Installed: 16. Complete the following checklist: x Yes No * Is the audible alarm operational? ^X Yes ~ No' Is the visual alarm operational? Q 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' ~ 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 Sumplfrench 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' XQ 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' Qx 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: ~~~~ ~ eT Date of Testing/Service: 01 /05/2007 @23RD ST. 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°perfon'n`tee~etec Ion oni oring. Complete the following checklist: Q Yes ^ No * Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ^X Yes ~No' Were all tank gauging probes visually inspected for damage and residue buildup? 0 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? 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) Complete the following checklist: Check this box if LLDs are not installed. x^ 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: x^ 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? Q Yes ^No * ^ N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes ^No * ^ N/A 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? 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 SecUOn H, below, describe now 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 District Inspector Phase II System Type CIRCLE K#2708825, CO. 123 None Present Phase II System Type 2222 F ST. Device Type Used Balance @23RD ST. MANOMETER Assist BAKERSFIELD,CA 93301 Hirt Phase I System Type Hasstech Permit # S_2145-1-4 EVR OpW Healy Other E.O G-70-52 2 Point Coaxial Manifolded? YO or N Date of Last Calibration:12/05/2006 Type of Test: Wet / Dry Leak Check: Pass / Fail Dynamic Back Pressure, Inches H ~J Nozzle Grade Result 20 CFH 60 CFH 100 CFH #1 E.W.4005 ALL .04 .24 .54 PASS #2 E.W. 4005 ALL .03 .27 .56 PASS #3 E.W .4005 ALL .03 .26 .43 PASS #4 E.W. 4005 ALL .05 .25 .46 PASS Test Conducted By: Test Company: Date of Test: TIMOTHY COULTER Tanknology 01/05/2007 Signature: Confirmation # Tester Certification # r~...r, 07-7487 T-6037 . .San Joaquin Valley Unified Air Pollution Control District Pressure Decay Test TP201.3 Confirmtion. No.: Permit No: Site Name: Address: 07-7487 S-2145-1-4 CIRCLE K#2708825, CO. 1 2222_F ST-~f - BAKERSFIELD Phone: 661324-1758 Phase I System? E / 2 t. / Coaxial Phase II System? BALANCE / ASSIST /OTHER Total Number of Nozzles: 4 Nozzles for Tank # 1: 4 Nozzles for Tank # 2: 4 Testing Company TANKNOLOGY Address: 41785 Enterprise Circle S Suite D Temecula Cp 92590 Phone: (951)676-4060 Tanks Manifolded? Yes Work Order: 3150322 Nozzles for Tank # 3: Nozzles for Tank # 4: 4 Balance "Nozzle End" hoses must be drained prior to test. Number of hoses over 100m1: N/A Tank Information 1 2 3 4 All 1. Product Grade 91 89 87 2. Actual Tank Capacity, gallons 9684 9684 9684 0 29052 3. Gasoline Volume, gallons 2035 2368 8263 0 12666 4. Ullage, (V) gallons (line #2 minus line #3) ..._ 7648 7316 1421 0 16386 5. Start Time 1230 1245 1245 6. Initial Test Pressure, inches H2O 2.00 2.00 2.00 7. Pressure after 1 minute, inches H2O 1.90 2.00 2.00 8. Pressure after 2 minutes, inches H2O 1.99 1.99 9. Pressure after 3 minutes, inches H2O 1.96 1.96 10. Pressure after 4 minutes, inches H2O 1.94 1.94 11. Pressure after 5 minutes, inches H2O 1.93 1.93 12. Allowable Final Pressure (See table 1A or 1 B) 1.91 1.91 1.91 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: 2.89 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 ). 0.02 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 3:35 Enter Calculate ullage fill time, t2. <7:10 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 TesterlD: T-6037 ~~ Signature: Test Date: 01/05/2007 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS ,~ TanEcnology TEST DATE:oi/05/2007 WORK ORDER NO.: 3150322 CLIENT: CIRCLE IC STORES SITE: CIRCLE R#2708825, CO. 123 495 E. RINCON, STE. 150 2222 F ST. ®23RD ST. CORONA CA 92879 BAKERSFIELD CA LORRAINE SOFFE 951-270-5193 Tank Interstital Tests TANK PRODUCT MANUFACTURER RESULTS: SUPER --- - ----- iPLUS I UNLEADED Piping Interstital Tests 93301 LINE -'. PRODUCT':;`` MANUFACTURER RESULTS: SUmD &Under-Dispenser Containment Tests Sump! DISP.# MANUFACTURER -, P/F 87 FILL OPW Pass 89 FILL OPW Pass 91 FILL OPW Pass representative: BRIAN DERGE Services conducted by: TIMOTHY COULTER i~ UMP TESTS ~_ ~~~~~0'0~~ SECONDARY CONTAINMENT TEST RESULTS Test Date: Work Order: 01/05/2007 3150322 T e yp Tank or Disp # Manufacturer Model or Material Diam./Width/Length (") Depth (") Test Method Start Time Initial Level Level Change Finish Time Final Result Pass/ Fail Spill Container 87 FILL OPW Plastic 10 7 0945 6 0 1015 6 Pass Spill Container 89 FILL OPW Plastic 10 7 0945 6 0 1015 6 Pass Spill Container 9t FILL OPW Plastic 10 7 0945 6 0 1015 6 Pass Comments: Spill containers were tested using a thirty minute visual. - Tanlv~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:Ol/05/07 WORK ORDER NUMBER3150322 CLIENT:CIRCLE R STORES SITE:CIRCLE R#2708825, CO. 123 COMMENTS Annual Vapor Recovery Testing, Monitor Certification, Leak Detector Testing & Spill Bucket Testing. Conf.#07-7487, all tests passed, replaced (1) 6' GY hose. Parts billed on WO # 3150581 PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) .- • ITEMS TESTED " HELIUM PINPOINT LEAK TEST RESULTS Printed 01/23!2007 08:23 ACRAMER ITE DIAGRAM ~ Tanknology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 01/05/07 WORK ORDER NUMBER3150322 CLIENT:CIRCLE R STORES SITE: CIRCLE R#2708825, CO. 123 C-Store ~~ VENT DUMP- STER A O S PLUS V 10K O '4 REG ~ #2 O S 10K 0 A SUP Q CANOPY #1 O S #4 10K O #3 Q~~~O -~ Printed 01/23/2007 08:23 ACRAMER WcSrk Order: 3150322 - I ' ' 9. BPILI.I4VE~FII~L CONTAINMENT BQXES ~e 1 nf t Facility is Not Equepptd With 5pil11pverfdl Con#aint~,rt foxes _ ~ -~ SpilUdverFtll Car~taittuicttt Boxes are present, but were Not Tested Zest Method Developed By: S pi118ucket Manufactu rer Other (S~ec~f Industry Standard Professional Engineer TestMetlwd iTsed: Prrssura Vacwm Hydrostatic • Test ui they (5~ecif}') ~ pmeitt used: .(J r~ u . ~~ ~ Equipment Resolution: ~ Sp1ilI Boi #F7it $"5 S~fll Box #/t ~7/ Spi11 t3ox # Becket Diameter: !p ~ ~~ Box # Bucket Depth; rD l~ _ Wait time between gFph~ng. / ~ M f ~5 press~elvacuurnhvatcr ~ 5 t~'7'7y ~ ~ .~ J S r77N S end sfarhng teSL• , Test Start Time: 9'y~ c7 if 5~ .. ~~ Initial Reading {R~: 6 Test End Time: !0 ~ S DI 6 Pinal Reading (RF): ,~ ~ ~ 5 Tcst Dtu•ation: 1*•v5 '~p~ rk5 Change in Reading (R~.- - G 3oMZ.vS - .. _ PasslFail Tlueshold or ~` Crite[ia: ~-- '-,~- Comments , {include in, jinrrnalion on repQirs treads prior to testing, and reconuner~ded ollow- f u~ jot failed tests) .4 •• +tb Tanlrnology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 EVR Maintenance Station QQ ` NO. Z~'0'U87i"J • OPW VR-102 Required Maintenance (Place checks in the boxes wchen completed) For reference, use CARE Phase 1 Executive Order (VR-102-A, B, C, or D) N N Ir1 0 u, ~i M i~ N b N .~ ~. O PressureNacuum Vent Valves (Husky) -Annual Splll Container Drain Valve -Annual Remove top cever screws, remove debris in lower cover Check drain holes in lower cover for blockage `~pon't remove screens, reinstall top, tighten screws Inspect and clean interior of container "Inspect and clean drain valve screen Remove dirt and grit, if screen is clogged remove the valve and soak in water using high-pressure air to clean, reinstall drain valve PressureNacuum Vent Valves (OPW) • Annual ~ ~ Test drain valve using appropriate TP-201.1 C or D Upper Screen - ^ If fail, proceed to next step ^ Remove vent top by depressing tabs, lift top upward, slip screen up and out Replace drain valve (1 DK-2100-EVR) and retest ^ Clean or replace filter screen (OPW H14895M) as needed, and reinstall Dr op Tubes (Overfill Prevention) -Annual ^ Reinstall top, make sure tabs are inside valve body, rotate until tabs seat Lower Screen - (leave pipe adaptor on riser to service lower filter screen) ^ Remove valve from pipe adaptor by gripping lower flat above pipe adaptor Ensure flapper Is open by looking down through opening Test seals using TP•201.1 D ^ If fail, proceed to next step ^ Lift filter screen (C05086M) out, clean or replace as needed and reinstall ^ Reinstall valve on pipe adaptor & tighten (wrench on with C05102M tool only) ^ Replace seal (OPW H11931M) and retest ^ If still failing, replace drop tube and retest Bail Floats - """Trlennial"*" Drop Tubes (3tralght) -Annual ^ Ensure ball moves freely in cage ^ Inspect o-ring for nicks or tears, replace if needed ^ Ensure bleed hole allows free and proper air flow Tank Gauge Components -Annual ^ Ensure assembly isn't damaged, corroded, or contaminated, and reinstall isually inspect seal in cap, replace if needed Product & Vapor Recovery Adaptors -Annual Dust Caps -Annual nspect adaptors for large dents, cracks, or deformations, replace if needed Visually inspect seal in cap for nicks, tears or deformations, replace if needed I certify that the above information is accurate: ~ "~ V Maintenance conducted by: ~ M cQJ(~1~. Date: ~ ~ ~ Company: ") -~~F-~a~~ y 3 I II VJ~ork Order: 315 0 3 2 2 . ---- IN-TwNK . _ F;I_ARf4 --• -- •--- Ifl-TANK Fa1.Hk1•f ---- - T I:SUPER ---- iN-TNNK ALHRhI ---- T 2:PLUS T 3:UNLEADED SETUP ABTA WARNtt~u 3FTU& DKTH WARNING U?-02-9B i 6:19 U7-112-98 1 e: 19 S1;7'U>' GATA Wrtkfll roG 07-D2-98 16:19 HIGH WFiTt~R ALH]'t!i HIGH WATER AI.ARAf tll-D5-07 11:40 D1-05-07 11:411 LEAK ALARM 01-12-06 9:21 01-12-Ofi 9:~1 03-17-u^ 13:28 01-25-05 13:3? 01-25-05 13::3b HIGH ><JATER ALARM ~' OVERFILL ALARM OVERFILL ALARM 01-05-07 1:": 4D O1-05-U7 11:`0 Dl-05-07 11:20 01-12-DE 9:37 01-12-06 9:00 01-12-a6 9:D0 01-:5-Q5 13:48 06-23-i]2 4:02 SuDD£N LOSS ALF;kM OVERFILL A1-AT<9~1 01-05-07 11:47 SUDDEN L4~ AI.ARIi 01-D5-07 11:20 DI-12-06 8:34 01-05-07 11:42 i~-~1-06 ?3:50 04-19-D5 17:?3 01-Q5-07 11:15 II-28-06 21:53 ~I-12-06 9:46 HIi1H PRODUCT ALARM SUDDEN LASS ALARM tll-[75-07 11:2E NIGH PRODUCT ALARM 01-05-07 11:E5 D1-I~-De 5:1a O1-D5-07 11:21 Dl-12-06 b;:35 ^1-35-05 13:'%4 01-12-Ofi 9:18 09-17-03 B:U3 01-25-05 13:2i I NVN1.1 D FUEL LEVEL HI~,H PRODUCT ALARM 01-05-07 1i:I8 INVALID FUEL 1r'VEL 1 U1-05-07 11:21 O1-D5-07 11:13 D1-•05-D? . 11:44 OB-15-Oo 12:00 O1-12-06 9:47 O1-D5-07 11:17 Oc-23-Oe 1:26 PROBE GUT 01-05-07 11:16 01-05-07 11:46 PROFiE DUT INURLID FUEL O1-05-07 LEVEL 11:17 D1-D5-u7 09-15-06 11:12 8:32 O1-D5-D7 11:42 12-04•~Gt 14:00 01-05-07 11:15 11-28-06 18:39 H I C+H 1~TfrR WARiV t Nv D i -12-06 9:51 O1-05-07 ^1-]2-06 11:4D 9.21 HIGH WATER WARNIN~3 PRO&E OUT D1-OB-~7 11:45 01-25-05 13:36 OI-D5-07 11:40 01'05-D7 11:13 Ut-12-06 9:21 01-12-06 9:58 01-25-05 13:31 DELIVERY NEEDED HIGH WATER WARNING 41-05-07 12'07-tl6 11:11 7:56 DELIVERY NEET~ED D1-05-07 01-1c-06 11:4^ 9:37 08-23-06 13:D5 01-0,5-07 11:15 Ul-25-05 13:32 01-12-OE 9:a~, MAX PRODUCT ALf~RM 1 1-01-f15 14:50 01-tl5-D7 41-12-Q6 11:21 9:]8 MAX FROLUCT ALRint DELIVEk1' NEEDED 1?-04-06 1:-:41 ^1-?$-05 13:29 OI-05-07 11:21 11-26-DE 17:26 01-12-Oo 9;18 10-15-0ti 12:4a D1-25-D5 13:29 LOW TEMP Wq$~INV fintC PRODUCT RLARM D1-05-07 11:47 U1-Q5-07 11:x! L1-12-OE 9:18 01-25-DS 13:29 LOW TEMP WHRNIN~; OI-25-D5 14:23 ^9-17-D3 9:i2 Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 Work Order: 315 0 3 2 2 ----- S1:N90R ALHIu"7 ----- ~ I:SUFER ANN;sLAR SPACE S1;NSGR OUT ALARM O1-[15-07 1 ! :Oo FUIrL r1LARM 01-05-t17 10:42 S£fibDGB-02T 06L ! gM45 _---- SENSOR ALARM --'-- L 2:PLUS STP SLfifP SEI~p it 05TO7~iRM o6 FUEL ALflRM 01-0507 10:57 S1=NS40R-O~T06LAg q7 L 3:UNl.EHDE:D hNµULAR SPF~'E S£PL50R OUT ALARI'1 01-05-07 11:06 FUEL ALARM D 1-D5-0~7 lit : Atia EiENSaR OZTUAfiLAB!`!47 ----- SENSOR Ai_ARM ----- L a:SUPER STP SUMF 51;NSOR OUT aLHRM Dl-D5-07 1l:Oe FUEL ALARM U1-05-07 11:[l2 FUFL FILARM U4-05-06 18:36 ----- SirNSOR ALARM ----- L 5:PLUS ANNULAR SQr~E £iENSCR OUT ALf~RM 01-05-07 11:06 FUEL r-LARM 01-05-D7 1u:50 SENSOR OUT HLARM 01-12-06 8:47 ----- SENSOR ALARM ~---- L 6 : UNLEr~D1:D STP SUMP ~EN'aoR fl5TDA4F1RMDb FUEL ALARM 01-05-U7 10:59 ----- 5~NSOR HLARM ----- ~ 1: Pi.u~ FLLA 5HUT~WN ALf~RM 01-05-G? 10:10 GROSS LINE FA1L O 1-05-177 l 0:10 FLLD SHUi~,;]lJN ALARI'1 D8-42-06 19:34 ---- SENSOR ALARM ----- 9 2:SUPER PLLD 5HU"fDOWN kLARr! 01-05-v7 lO:15 GROSS LINE FAIL 41-U5-07 l~7:15 PLLA gHUTUGW1i ALARM D8-31-06 4:37 ----- SENSOR HLi~RM -____ ~ 3 : UNLEADED PLLADSHU5D071~10~ARM GR06~ L1 NT; Fh i L Ot-U5-07 10:07 PLLii SHUTUUWN ALARM 11-2'3-06 lU:St c1RC1,~ x 2222 P STREET &HKERSFIELD CH Q`l3G! bbl-324-1758 O] -G5-07 i 3:,i5 - 8Y8TEhf STATUS kFFURT ALL FUNC'PIOrJ3 NORMAL Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 q ~, . ;« .~ _„r,. ... ~- - ~~ CIRCLE K STORE 2708825 SiteID: 015-021-000953 Manager (2q.v~d. L.l7rW-Gtt~~ BusPhone: (661) 324-1758 Location: 2222 ~ ST Map 102 CommHaz Extreme City BAKERSFIELD Grid: 25B FacUnits: 1 AOV: CommCode: BFD STA O1 SIC Code:5541 EPA Numb: DunnBrad:10-5457662 Emergency Contact / Title Emergency Contact / Title SERVICE CONTACT CTR / 24 HOURS / _. Business Phone: (866) 805-4357x Business Phone: _ ~~SS'~? ^~~~-G91~ 24-Hour Phone (866) 805-4357x 24-Hour Phone : ~ ss9'_) 63~ -_`~Z2$' Pager Phone ( ) - x Pager Phone ( ) - x ............... Hazmat Hazards: Fire Press ImmHlth DelHltfi ............... Contact LORRAINE SOFFE Phone: (951) 270-5183x MailAddr: 495 E RINCON R3S 150 State: CA City CORONA ST Zip 92879 Owner CIRCLE K STORES INC Phone: (951) 270-5193x Address 495 E RINCON Ij~ 150 State: CA City CORONA S'r Zip 92879 ............... Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: ._... Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG U - UST EN~~ ~'AR ~ p 2007 l~ N~~ -1- O1/29/2~07 . T ~ ' ' F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ STORAGE CONTAINER DATA (UST FORM A) Last Action Type: Business Name: Cross Street FACILITY/SITE INFORMATION CIRCLE K STORE 2708825 Business Type: Org Type: Total Tanks IndnRes/Trust: No PA Contact: Dsg Own/Oper C iV-G~ ~ ~~Dv~Q.B ~~~ ICC Nbr: PEK00020 PROPERTY OWNER INFORMATION - Name ~, Ua~r~-TL r~~i~3 C ~ r c l ~. ~C ~-u~~ , TVttC_.. Phone Address : ~' ~ F , 2 i nLph St-~ ~ l S~ City ~ r o V~G~. State : ~~Q- Zip Tune CORPORATION Name Address: City Type Cqs~ ~a~v~~ 3 ~ Z B~ TANK OWNER INFORMATION C t rc.(2 ~ ~ S'~-p~e..~ ~ ~C . Phone r-p ~~. State : C~ Zip CORPORATION ~ =~`L2x 9'~~ ®2 ~ -- J~ ! 4 3 ~ zg~ BOE UST Fee# 032073 Financ'1 Resp: GUARANTEE Legal Notif Property Owner Mailing Address Date:01/02/2004 Name:MICHELLE WILSON State UST # Phone: (390) 951-93 x Tt1:REGIONAL COMPLIANCE SPECIALIST 1998 Upg Cert#: 00800 -2- O1/29/2b07 T ~f F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit N~~P ............... PROPANE E F P IH G 6~ GASOLINE - REGULAR UNLEADED F IH DH L 10000.00 GAL I~+Yt~d GASOLINE, PREMIUM UNLEADED F IH DH L 10000.00 GAL NICid CARBON DIOXIDE REFRIGERATED LIQ F P IH L 2610.00 FT3 1'~In GASOLINE, UNLEADED PLUS F IH DH L 10000.00 GAL U31R WASTE FILTERS S S~ ~ ~ S ~ ~~ .~- -"~ ~' ~T -3- O1/29/~b07 T 1 ~. ~ -4- Ol/29/~007 ,~ F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PROPANE Days On Site 365 Location within this Facility Unit Map: Grid: W SIDE OF FAC CAS# 74-98-6 STATE T TYPE PRESSURE ~~ TEMPERATURE CONTAINER TYPE ~GaS I Pure Above Ambient I Ambient PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum /!Daily Average 5` ~~-L, 6 a ~ 6.o s~ n-o-c-v ~'~ i~ su ~ 0 C9'I~FL ~ r~ o n . n n I Z • ru•~~.ytcL~uS ~~lnr~ivrivl~ %Wt. RS CAS# 100.00 Propane Yes 749$6 HHGE~KL Aa a1;551~1L"~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M~C1 No No No No/ Curies F P IH / / / Hi ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME GASOLINE - REGULAR UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: --- N SIDE OF LOT CAS# 8006-61-9 Liquid TMixtur~Ambient~E ~ AmbientT~E UNDEROGROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 5200.00 GAL t1E~GL-1CCLVU.7 1.V1~lYV1VJ~,1V 1 J ~Wt. RS CAS# 100.00 Gasoline No 800619 t1EiGHPCL Li. 7a7L"~7J1~1YS1V1w7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MRCP No No No No/ Curies F IH DH / / / Mod -5- O1/29/~007 ~ - , F CIRCLE K STORE 2708825 ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME GASOLINE, PREMIUM UNLEADED Location within this Facility Unit N SIDE OF LOT STATE TYPE PRESSURE Liquid TMixture ~ Ambient SiteID: 015-021-00093 ~ Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 3000.00 GAS tu~~rjxLVU~ ~.:vi~irvlV~ly 1~5 oWt. RS CAS# 100.00 Gasoline No 800619 riAGEiKL AS aL'~~~1~1L1V 1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCI? No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE REFRIGERATED LIQUID Location within this Facility Unit STOREROOM STATE TYPE PRESSURE _ Liquid TPure -Above Ambient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 124-38-9 TEMPERATURE CONTAINER TYPE Cryogenic INSUL.TANK / CRYOGENIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 2610.00 FT3 2610.00 FT3 1805.00 FT3 ................ HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 riAGKtCL AJ 7i55 J1~1.C;1V~l a TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCI No No No No/ Curies F P IH / / / Mii -6- Ol/29/~007 .~ ` F CIRCLE K STORE 2708825 SiteID: 015-021-000983 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME GASOLINE, UNLEADED PLUS Days On Site 365 Location within this Facility Unit Map: Grid: N SIDE OF LOT CAS# 800661.9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~Ambient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 10000.00 GAL 10000.00 GAL 3000.00 GAL t1E~G1itt1JVUJ ~VrlrVlv~lvlb °sWt . RS CAS# 100.00 Gasoline No 8006619 T11'aL~HKL H. 7.71",.7.71Y1L" 1V l A TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M~C1 No No No No/ Curies F IH DH / / / UriR ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE FILTERS Days On Site 365 Location within this Facility Unit Map: Grid: ---- TRASH ENCLOSURE CAS# 8006619 STATE TYPE PRESSURE TEMPERATURE SolidWaste ~ Ambient ~ Ambient CONTAINER TYPE DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION L~ea/~r~~ges1l1t_(~Container D1y~aily Maximum Da(il~y Average j~V~ l1'Jr • -CC (_1 !1 !"~71T - ~ ~J~ ~ ~ ~ i~~l r IlEiGEitCL V U w7 1. V1~lY V1V ~1V 1 .7 oWt. RS CAS# 5.00 Gasoline No 8006619 I1HGtitCL Li.7 .7iS.7.71~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / UizR. -7- Ol/29/~007 i . _ ~ . ~. F CIRCLE K STORE 2708825 SiteID: 015-021-00093 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 10/23/2006 ~ IF EMERGENCY RESPONSE ASSISTANCE NOT REQUIRED, NOTIFY: BAKERSFIELD CITY HAZARDOUS MATERIALS DIV 326-3979 AND, WITHIN 24 HRS, STATE OFFICE OF EMERGENCY SERVICES 800-852-7550. IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY, PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY NOTIFY: BAKERSFIELD FIRE DEPT 911; BAKERSFIELD POLICE DEPT 911; BAKERSFIELD CITY HAZARDOUS MATERIAL DIV 911; AND STATE OFFICE OF EMERGENCY SERVICES 800-852-7550 OR 916-262-1621. Employee Notif./Evacuation 04/18/2006 UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWNS OF HIS/HER AREA OF RESPONSIBILITY BEFORE EVACUATING. THIS INCLUDES ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF FLANIl~IABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE NOTIFIED TO EVACUATE BY VERBAL METHOD TO A PREDETERMINED EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTEt7 FOR. IF WARRANTED, EVACUATE TO THE DESIGNATED ASSEMBLY AREA LOCATED NORTH OF THE Public Notif./Evacuation 10/23/2006 IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL BE NOTIFIED, IF POSSIBLE: AMERICAN GENERAL, 2225 F ST, 327-2241 AND MCDONALDS, 2310 F ST, 327-1720. Emergency Medical Plan 04/18/2006 BAKERSFIELD MEMORIAL HOSPITAL, 420 34TH ST, 327-4647 OR KERN MEDICAL CENTER, 1830 FLOWER ST, 326-2000. -8- 01/29/2007 ,~ ,, ,: I F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ ~ Release Prevention 04/18/20016 ~ 1. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION .WITH PUMPS. 2. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS, WHICH ARE OF' FIBERGLASS CONSTRUCTION. 3. ANTI-LOCK NOZZLES AT PUMPS. 4. NO SALES TO UNAUTHORIZED CONTAINERS. 5. NO SMOKING SIGNS POSTED, SELF-SERVE INSTRUCTIONS POSTED. 6. TANK MONITORING PROGRAM IMPLEMENTED. THE HAZARDS AT THIS BUSINESS ARE FIRE AND SPILLS. Release Containment 04/18/2006 1. PREVENTIVE DIKING WITH ABSORBENT MATERIALS. 2. SHUT-OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. 3. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC. 4. AVOID PERSONAL EXPOSURE TO FUMES/VAPORS AND CONTACT WITH LIQUID. 5. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS. 6. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND PLACE IN SEALED CONTAINER FOR DISPOSAL. Clean Up 04/18/2006 NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR 602-530-5089 FOR COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS, IF REQUIRED. CARBON DIOXIDE A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLY SECURED. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE, IF SAFE TO DO SO; OPEN ALL DOORS/VENTILATE. C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN CONTAINER/VALVE. -9- Ol/29/~007 . .~~ F CIRCLE K STORE 2708825 SiteID: 015-021-00093 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ v~iier xesourc:e r~cLivaLion -10- O1/29/2n07 F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ Fast Form~:€ ~ ~ Site Emergency Factors Overall Site ~ special Hazaras Utility Shut-Offs 04/18/20175 A) GAS - NONE B) ELECTRICAL - INSIDE BACK RM OF STORE (BREAKERS); E WALL OF BLDG N END (METER) C) WATER - N WALL OF BLDG E END (MAIN LINE GATE VALVE) D) SPECIAL - EMERGENCY GAS SHUT-OFF SWITCH AT CASHIER STATION CONSOLE; N WALL OF BLDG OUTSIDE E) LOCK BOX - NO Fire Protec./Avail. Water 04/03/2006 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS, 3 IN STORE AND ONE AT DAD ~' C-/-~-g~ L~ FIRE HYDRANT - NE CRNR OF SITE. Building Occupancy Level 04/03/2006 EMPLOYEES -11- 01/29/2007 n F CIRCLE K STORE 2708825 SiteID: 015-021-000993 ~ Fast Forme ~ ~ Training Overall Site ~ ~ Employee Training 01/29/2007 ~ MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING PROGRAM: SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIALS IS PROVIDED IN THE FOLLOWING AREAS: PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT; USE OF ABSORBENT FOR SMALL SPILLS; EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT, EMERGENCY MEDICAL, AND CIRCLE K ENVIRONMENTAL DEPARTMENT; AND EACH CIRCLE K GASOLINE STORE HAS A COMPANY-SUPPLIED GASOLINE MANUAL WITH MSDS FOR GASOLINE AND C02. A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL BASIS. SAFETY AND EMERGENCY EQUIPMENT TRAINING WILL PROVIDE FAMILIARIZATION WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE EXTINGUISHERS; THE LOCATION OF AND PROCEDURES FOR FACILITY SHUT-DOWN (INCLUDING THE LOCATION OF TURN-OFF VALVES FOR GAS AND ELECTRICITY), AND THE PROPER USE 01" rage ~ Held for Future Use -i2- of/29/zoo? r r. F CIRCLE K STORE 2708825 SiteID: 015-021-000993 Fast Format ~ Training Overall Site nC1lA 1VL 1'UI.UIC VAC -13- 01/29/2007 27osa25 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page of I. FACILITY IDENTIFICATION FACILITY ID# ~ ~ i 1 EPA ID# (Hazardous Waste Only) 2 ~ ~'~ ~ ~! ~ ~ CAL000278518 BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business AS 3 Circle K Store #2708825 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 h F d l ©YES NO 4 ~ HAZARDOUS MATERIALS INVENTORY - era reshold quantity for an extremely hazardous applicable e t 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 UST TANK (One per tank iI ~ 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 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) 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 Conditional authorizaton)? ASSURANCE (Formerly DISC Form 1232) 5. Consolidate hazardous waste generated at a remote site? YES ©NO 13 ~ 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 ©NO 1a / HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DISC Form 12x9) E. LOCAL REQUIREMENTS 15 (You may also be required to provide additional information by yourCUPA or local agency.) UPCF (1/99) 2708825 ~ ~ UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION iFAC1LiTY 1D# I ~ r I ~ y ' ~--' - ~ --~- ~BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) Circle K Store #2708825 BUSINESS SITE ADDRESS 2222 F Street Page of ,NTIFICATION ~ { ~ ~ 1 1 (BEGINNING DATE 100 iEND1NG DATE 101 __ _ _ _ _i ___ ~_ . 01 /01 /2007 I 12/31 /200.7_ __ ~- - ' 3 (BUSINESS PHONE 102 661-324-1758 __ --... - ---- ---- -- - .....-- - -- - - __ .._:..--- - --- -- ---- - 103 ------ CA - - . _ _ - --- -- _ - -- -. _. - - i----- -------- CITY _ -f ----^ ---104 I -- - (,ZIP CODE - . 105 Bakersfield I i 93301 DUN _BRADS"FREE"r 106 jSIC CODE (4 digit #) 107 ~ 10-5457662 I ~ 5541 .COUNTY 108 ~ Kern BUSINESS OPERATOR NAME 109 I BUSINESS OPERATOR PHONE 110 ~, Circle K Stores, Inc. - ---- ---- - --- ---- - - - ---- -- --- ---- --------- --------- - -- _ (95.1) 270-51.83 II. BUSINESS OWNER _ _ _ _ iOWNER NAME 111 (OWNER PHONE 112 Circle K Stores, Inc. (951) 270-5193 OWNER MAILING ADDRESS 113 495 E. Rincon Road, Suite 150 r -------- -- --- ---- ------ ---------- CITY 114 'STA TE 115 ~ ~,71P CODE 116 Corona ~ CA 92879 ' III. ENVIRONMENT AL CONTACT _ (CONTACT NAME 117 ',CONTACf PHONE 118 ~ Lorraine Soffe 951-270-5183 i - - -- ----- ----__ ---- ---_ CONTACT MAILING ADDRESS . _ --- -- --.__ ----__. 119 ' 495 E. Rincon, Suite 150 ~~~CITY 120 STA TE 121 ZIP CODE 122 Corona ~ I ------------------------------ CA ~ 92879 PRIMARY IV. EMERGENCY CONTACTS SECONDARY ':NAME 123 ( NAME 128 I Service Contact Center ~ ' I Kevin Quinn ~ ..--- - -- ------ ---- ----- --- ---------- ----- --- TITLE 124 -------- ----- ---- - TTTLE - ---- -- -- -- --- -- _ _-----.._..---- -- -- - - - - - - 129 24 Hours ~ District Manager BUSINESS PHONE 125 ' BUSYNESS PHONE 130 ( 866-805-4357 559-647-6910 ,24-HOUR PHONE 126 ~ _ 24-HOUR PHONE - -- - 131 866-805-4357 ~ 559-639-9228 t...------------------- --- ------- - - ----- - - .__..- _ __ i._ _ _- - - ...-- - - .... __ __ .- ..... - .__ _ -- -- .... ._ . ~PAGER# 127 PAGF,R# I 132 'ADDITIONAL LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the inform n submitted and believ information is true, accurate, and complete. SIGNATU I~RA~'- -- - - -- - - rD~~-~_ NAME OF DOCUMEN"f PREPARER 135 l ~~HL DESIGN GROUP, INC. -ENVIRONMENTAL DEPT. NAME O , NE (print) 136 TITLE OF SIGNE 137 Lorraine Soffe Com (lance Marta er ~ - - ------- --- - -------- --- - ----------- ----p ----------- -g -- -- ------- - -- ------. -- UPCF (1 /99 revised) 16 OES FORM 2730 (1 /9 ' UNIFIED PROGRAM CONSOLIDATEll FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEM ICAL DESCRIPTION One page per material per building or areal I ~ ADD ( DELETE IX REVISE 200 --- , ~ I I Page of ,... .._. _.. -... -_ _. _..__ _. _.. ---------- -...------ -- ___. -_ j I. FACILITY INFORMATION BUSINESS NAME 3 ' C ircle K S t ore #2708825 2708825 ' _ _ __ _ _ __ ___ _ _ _ jCHEMICAL LOCATION :CHEMICAL LOCATION CONFIDENTIAL 202 NORTH SIDE OF LOT ~EPCRA ~ _1vES (_x~ No ; I------- --- -- - _. - - _ FACILITY ID# I ~ ~~ I 1 ~ ~ ~ I ~ ~ 1 ~ MAP# (optional) ~ I 1 I ~ ~ 203 i GRID# (optional) ' F3 1 204 ' - -- _- -1 ------ - --- ---- --- ---- ------------ -- - -- - II. CHEMICAL INFORMATI O N _ .. ___._ .. ... - - --.. _ . -- -- --..__.. _ .. .. , _ ___ _ _ _ __ _ _---------- - ------ ------ ----- _ I (CHEMICAL NAME 205 TRADE S ,_..._-I------,~_ - -- - ECRET ~ Yes X iNo 206 GASOLINE . ' . --- - --- _---__--. _ .__....- -__--- - _--------------- ----------------.---_ _-. -- If Subject to kPCRA, refer to instructions - . ;COMMON NAME 207 E"s ' 208 ' REGULAR UNLEADED GASOLINE x! No ~ Yes fCAS# 209 " " I 8006-61-9 If EHS is , all amounts below must be in lbs. Yes ;FIRE CODE HAZARD CLASSES (Complete if required by CUI'A) 210 I-B FLAMMABLE LIQUID i j i _ ._ . (HAZARD MATERIAL i -t ~- ~ t _._ I RADIOACTIVE l ;Yes ( i-- - a PURE ~ X ~ _ I (TYPE Check one item _ - - _ -_~ b. MIXTURE I ~ c. WASTE _, . - ---- - - - - _. ~X No .CURIES . 213 ' _ (PHYSICAL STATE ~ -I r- ~- -' 214 j J a. SOLID LX~ b. LIQUID L c. GAS LARGEST CON'1'AINF.R L ~ 00~~ 215 - ((Check one item only) - ----- - - ---- ----- - - --- - - ' ~IFED HAZARD CATEGORIES i X j, a. FIRE ~ , b. REACTIVE I - c.PRESSURE RF.LE ~ ! ASE ! X ' d. ACUTE Hf:AI." fH X ; e.CFIRONIC f-fEAl..I'li 216 - ;(Check all that apply) , AVERAGE DAILY AMOUN"I' 217 (MAXIMUM DAILY AMOUNT 218 jANNUAI. WAS"fE AMOUNT ' i ~ 219 ;STATE WASTE CODE 220 ' -5200 ___ 1000.0_.____ -- ---- _------.- - .- - -- ----------- __- __ I_ ...- -- _--- -..-.----- - --__- _. ._ .. # I j ~ -; - ~UN1TS X a. GALLONS b. CUBIC FEE"f ~ c I I POUNDS ~ ~ d. TONS I 221 DAYS ON SITE: I 222 - - (Check one item only) 365 _ ~£ ENS. amounLmust be_in..pounds.______ ___ _ ._ _._ - __ ---- - --- -------- --...------ - , STORAGE r ~CONTAINF.,R I- a. ABOVE GROUND TANK I--- e. PLASTICMONMETALLIC DRUM ~ -- i. FIBER DRUM ~ j ,m.GLASS BOTTLE I lo. RAIL CAR ~ - I ~ X b. UNDERGROUND TANK ~ C CAN ! I i ,j. BAG I ,n. PLASTIC BOTTLE , !p. OTHER ~ ~ - c. TANK INSIDE BUILDING g. CARBOY II 1 k. BOX ~ jo. `f0'I'E BIN r I ~ - d. STEEL DRUM L ~ h. SILO I 1 1. CYLINDER I Ip. TANK WAGON - - , ~ _ __ - - ------------- ------- ----- ---- -- --..-.._ ...---- - _ . _ _ - -- - -- - - - . .. - - - --- ..._ - _ 223 , .. , f ~ STORAGE PRESSURE ~ X ~ a AMBIENT ~--~b. ABOVE AMBIENT ~ -~a BELOW AMBIENT 1 224 .--------------- ---- -------------------------- -- ---------- ---- -- --------- ----- -- I STORAGE TEMPERATURE j x j a• AMBIENT I ;b. ABOVE AMBIENT _c. BIiLOW AMBIEN f r_______---____-.__-____. - _ ... _._...._ .-..._._ _- _- _- _.__.- _ . .... ....... . .. - - -_ ._.....- -- - --- - --- - - -- --- --- _ _, !d. CRYOGENIC __ ._- ..___ _._.._.___ __ -._ _..-... ..___ - .. __ . 225 .. i j %W"f j HAZARDOUS COMPONENT (For mixture or waste only) EIiS L CAS# - -- - _ _ _- I ' I 100 226 ' Gasoline 227 I !Yes i X ;No - __.._ ._... - - --- - - --.... _ 226 ~ 8006-61-9 -_ . 229 ' r , '2 1-9 230 TOLUENE 231 Yes X `No - I 232 108-88-3 233 ! - --- ---- ------------------------ ------- --- - -. _.- .. - . - - 234 'i 235 13 1-14 I XYLENES Yes IXTIo 236 1330-20-7 237 14 1-5 238 ~, 1,2,4-TRIMETHYL BENZENE- --- -- - - _ _ 239 Ycs Ix!No z40 95-63-6 241 i --t- ------- ---- --- -- --- - - ~ j .Yes 242 - 243 -' IS 1-5 Ethyl Benzene ;X~lo 244 I ~ 100-41-4 245 , I 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 captu ring the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 I If EPCRA, Please Sign Here UPCF (1/99) 169 OES FotTn 2731 i UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION I One page per material per building or area) r v . ^ ~ ADD ~ DELETE - ~X j REVISE 200 i Pagc of _ _ 1. FACILITY INFORMATION iBUSfNESS NAME 3 Circle K Store #2708825 z7ossz5 CHEMICAL LOCATION 'CHEMICA L LOCATION CONFIDENTIAL 202 NORTH SIDE OF LOT :EPCRA YES x i No -- ;FACILITY ID# ~ ^I i ~ ' 1 -MAPN (optional) 203 GRIDf! (optional) 204 ~ ; i ~ ,. 1 F3 ---. ~.__.._._-. _.. .._-_ - I ..-.._-I_ ...__... .- - - - - 11. CHEMICAL INFORMATION _ __ _ -- ~CHEMICAL NAME - -- ---~-- ---- --------~ ---- - --------- ---- - - - - - - 205 TRADE S ECRET _. __L- _ IYes ; X No 206 ' GASOLINE ------ - - -- - - - - - - - - - - If Sublect to EPCRA, refer to instructions 207 ~ ;COMMON NAME -- 208 ' PLUS UNLEADED GASOLINE ' E"S - - -- -- --- --- -- - I --- - - - - Yes ~X~ No I -- - - - - - - -- , ---- ------- ---- ---- --- --------- --- - ~CAS# 209 , 8006-61-9 ~ if EHS is " Yes", all amounts below must be in lbs. iFIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 ~ I-B FLAMMABLE LIQUID ! }IAZARD MATERIAL ~--------------_-- - ---- - _ 211 - " _.... _ _.-.. - - -- -- - - - - 212 13 _ ~ ' RADIOAC TINE !_-.: Yes ~ a. PURE X b. MIXTURE ! ' c. WASTC [--- ~ em I I ! X No ;CURIES .. I ! i - ~- - - - ---- - - --- ---- - - -- - - - - -- -- - - ~ -- - -- - - _ - -- _ PHYS CAL ST T E 214 -- ~- -- ~ - - - _ _ .. - i _. _.. - -. _ _ ; 215 I A SOLID X b. LI D I ~ AS ;(Check one item only) ,_ _~ a. ~- ~ QUI i ~ o: G ~ LARGEST CON"fAINER ~ ~~~~ -_ - - _ FED HAZARD CATEGORIES - - I X ~ a. FIRE I ' b. REACTIVE ! !• c.PRESSURE RELEASE ! X d. ACUTE HL'AL L I i - TH ' X ~' c.CHRONIC HEALTH 216 i _ -~ !_-._ _. - _. (Check all that apply) AVERAGE DAILY AMOUNT - - 217 jMAXIMUM DAILY AMOUNT - ---218' - -- _ ; _. _.. ___ ._- ._ - !ANNUAL WASTE AMOUNT _ .- _l_-_. .---- - _ _--- .---- -- -_ ~--.--. 219 S"fATE WASTE CODE 220 1 ' - - - - 3.000_ -- 0000- -- - -..-- - - - --------~--- --- -- •- - _ _ _ UNI'TS* ~ X j a. GALLONS ! ': b. CUBIC FEE"f '~ c. POUNDS I d. TONS 221 DAYS ON S(TF.: 222 .. -, `- `- -' ',(Check one item only) if EHS, amount must be in-pounds, - ... 365 'STORAGE ' ----, ~ la. ABOVE GROUND TANK ! Ie. PLASTIC/NONMETALLIC DRUM ,i. FIBER DRUM ;m.GLASS BOTTLE. ,o. RAIL-CAR CONTAINER --' ~ X ±b. UNDERGROUND TANK if. CAN I,j. BAG ,' ' !n. PLASTIC BOTTLE 'p. OTHER - I--- ', ; Vic. TANK INSIDE BUILDING g. CARBOY i ~k. BOX ~ ~o. "f0'fE BIN - I, '~ Jd. STF,EL DRUM h. SILO ( ,I. CYLINDER I jp. TANK WAGON I `-. - 223 i S"FORAGE PRESSURE ~X j a. AMBIENT ~ ~b. ABOVE AMBIENT ~ jc. BELOW AMBIEN"f 224 -- ' STORAGE TEMPERATURE ~ a. AMBIENT ~'b. ABOVE AMBIENT ,. ~c. BELOW AMBIENT ----- --- - --- - - --- -- - - - - - - . _ - ' - - -- - - -- - ; , d. CRYOGENIC .... _ 225 ' I ' %WT j HAZARDOUS COMPONENT (For mixture or waste only) , El IS I CASH r --- - --- --, ---- -- ---- ---_ __- - -- - --- _- _ ~I 100 226 GASOLINE 227 ~ ~ Yes jX!No 228 ~ 8006-61-9 229 2 1-9 230 TOLUENE 231 , ~ Yes X No --- ' ~ 232 ; 108-88-3 ! 233 ___ - __ _- I --- --- --- ---- ----- -- --- -- - 234 ! 235 ~ 1---; ~ i3 1-14 ! XYLENES Yes X !No - - - ---- - 236 I 1330-20-7 237 !4 1-5 238 1,2,4-TRIMETHYL BENZENE 239 i Yes ~X ~No 240 '. 95-63-6 241 5 1-5 242 ,Ethyl Benzene 243 ,.. ',Yes f X No 244 ~ 100-41-4 245 I(more hazardous components are present al greater than 1 % 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) ADD DELETE ---- --_- --__---_ iX; .REVISE - - - _- - - 200 Page of I. FACILITY INFORMATION I - __ _ ------------------------------------------------------ _--------------------__-- - BUSINESS NAME Circle K Store #2708825 ._ ...._.. ..__ -. _ .. _ z7o8sz5 3 CHEMICAL LOCATION (CHEMICAL LOCATION CONFIDENTIAL 202 ' WEST SIDE OF FACILITY ~F.PCRA i _ _ wES X ; NO ~._..~ -- - - -- --- i FACILITY ID# T-- ~~ "" - - - 1 i MAPti o uonal '~ 1 203 i GRID# (optional) I D4 204 --- ----- --- ------ -- 4/ ?;-- !-----1 - t- __ --- - - I ---- I- _'---- - - - __.._ _ ~ - - -- - - - - - -. -..._ . II. CHEMICAL IN FORMATION i ----- . _. ----- --- -- ------- - ICHEMICAL NAME _ _ _ ~- - 205 I TRADE SECRET ~ !Yes ~ X Tlo I 206 Propane ~--- '~ ~. - J If Subject to EPCRA, refer t° instructions COMMON NAME 207 ~ 208 PROPANE ; EHS I Yes i X j No ~... ~CASN 209 j I 74_gg_6 i [f EHS is " Yes", all amounts below must be in lbs. '' - ----- - ---- ----- -- -- --- - --- -- - - -- ---- - ---- - - - -- - - - _ . _... ~ FIRE CODE HAZARD CLASSES (Complete if required by CUPA) ._ _. .. . _ i 210 I Flammable Gas i --- ------------- ---- - -- ------------- , !HAZARD MATERIAL i'I'YPE (Check one item ~ a. PURE X I b. MIXTURE c. WASTE , - - 211 ~ - - - - - _~ RADIOACTIVC Yes 212 ; X'No I CURIES 213 ' -- - ._ _. . . . --- PHYSICAL STATE --I i(Check one item only) a. SOLID X 1 b. LIQUID ~ ! e GAS ~ ~---- I---~ . 214 1 ! LARGEST CONTAINER 5 215 jFED HAZARD CATEGORIES '- - - ` _ ~ X~ a. FIRE I ~ b. REACTIVE rX ; c.PRESSURE RELFiASE X ! d. ACUPF. HF,AI_ TH e.CHRONIC HEALTH 216 Pp y) ,(Check all that a 1 -__. ,._-.. I _ - IAVERAGE DAILY AMOUNT 217 I _. , - , - - MAXIMUM DAILY AMOUNT 218 LANNUAL WASTE AMOUNT _. . 219 STATE WASTE CODE 220 . r -30 ---- ----60----- ------ _ I_ . -- --- - - _ _ _ ..-- i- ~~ X I a. GALLONS ~ j b CUBIC FEET ~ I c __, POUNDS ~ I d TONS 221 !DAYS ON SITF: 222 ~ . . I ( y) I Check one Item onl . ~ 365 -.. __.____- .__ --_..__if._ENS, atnount-must be.. - in_pounds. STORAGE ~ i ~ STIC/NONMETALLIC DRUM i !i. I B R DRUM ~ I o' RAIL CAR ~ CONTAINER ~b. UNDERGROUND TANK ~ --I -- I ~ f. CAN _ ~ A G _ ~ --d I ~ -' ,n. PLASTIC BOTTLE - ~ '---~Ip. O-fHER I ~ ~c. TANK INSIDE BUILDING ~ g. CARBOY ~ k. BOX ~ lo. TOTE BIN j ~ d STEEL DRUM I ' - ~ h. SILO ~ X I. CYLINDER I !~ip. TANK WAGON _ _.__ - - 223 I STORAGE PRESSURE ~ a• AMBIENT X b. ABOVE AMBIENT J I Vic. BELOW AMBIENT !.-_._ ' 224 ' ~ - 1 STORAGE TEMPERATURE X ~ a. AMBIENT i _ 'b. ABOVE AMBIENT --- --., _ !a BELOW AMBIENT 'd. CRYOGENIC 225 ; I %WT HAZARDOUS COMPONENT (For mixture or waste only) ~ EHS ' CAS# - -- - - ', I >65 226 PROPANE 227: ~ iYes ~ X INo 228 j 74-98-6 229 , I 230 i2 <35 ~ Propylene I_. _..------ ----- ---- --------------------- ----- -- -.. ... --__-_ _ 231 ;Yes ; X No - _ - 232 115-07-1 233 234 ~3 <6 I Ethane f ; 235 Yes X No _ _ -. 236 '' 74-84-0 237 I -- 238 i - ------ -- ---- - -- -____ ___ - - - -- - -- '4 <5 Total Butanes - - 239 ~ _-. ~ . ' Yes ~ X 1Jo _ ... - -- - --- - - - .. 240 78-28-5 . _.. 241 'S <0.1 242 j Ethyle Mercaptan 243 Yes X'No 244 75-08-1 245 j If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carc inogenic, attach additional sheets of paper capturing the required information. ' ! ADDITIONAL LOCALLY COLLECTED INFORMATION I 246 i If EPCRA, Please Sign Here UPCF (1/99) 169 OES Form 2731 ' UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATF,RIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building °r area) ~ ~ j ADD ~ DELETE IX REVISE 200 ~ Page of - _ -_ I. FACILITY INFORMATION --- -------- ---- -- ------------------- ---- - - BUSINESS NAME '~ Circle K Store #2708825 Z~o8az5 3 (CHEMICAL LOCATION ICHEMICA I. LOCATION CONFIDENTIAI, 202 !EPCRA f NORTH SIDE OF LOT !YES I X j NO ,_-__, r !FACILITY ID# n T - - - -r- -I , I i I ! i 1 ' MAP# (optional) ~',. i ~I , , 1 ., ~, I J i i I -- _. i--- --. 203 GRID# (optional) F3 204 - . --. --_ ---- ~ - - - -- - - - Il. CHEMICAL INFORMATLO N - --- - -i - --- - - - , i - _ CHEMICAL NAME 205 ;TRADE SECRET I JYes X ,No 206 GASOLINE ~ - If Subject to EPCRA, refer to instructions - COMMON NAME 207 EHS ' zoa PREMIUM UNLEADED GASOLINE , No ;Yes X ~. _ ' _ _ 'CAS# ------ -------------------------------------- --- -- - - ---- - - -- 209 If EHS i " . . _ t b i lb Y ll t b l " s 8006-61-9 ow mus n es amoun s e e s. , a 'FIRE CODE HAZARD CLASSES (Complete if required by CUPA) I-B FLAMMABLE LIQUID 210 (HAZARD MATERIAL _ 211 ~ I t -' ~~! TYPE (Check one item I- -1 a. PURE ~ X~ b. MIXTURE ~ ~ c. WASTE I RADIOACTIVE t !Yes 212 ~ XiNo ~ CURIES ,- ~ 213 ' (PHYSICAL STATE ~- ~ a. SOLID LX i b. LIQUID L ~ c. GAS 214 ~ LARGEST CONTAINER ~ OOOO I 215 I __ (Check one item only) rFED HAZARD CATEGORIES -i 216 ! I ~ X~ a. FIRE ~ b. REACTIVE f ; c.PRESSURE RELEASE ~ Xl d. ACUTE HEAL TH ~X I e.CHRONIC HEALTH - - )(Check all that apply) - ~ -- _.-. ;AVERAGE DAILY AMOUNT 217~AXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 jS'fATE WASTE CODE 220 _ . _ ._. -.- ~- --- --_- 3.0.00__...--------~-------10000_--- --___ _ ~- ----_--- -- ~- ---_ -- - _ _ ~ i i - X a. GALLONS ~__i b I -' d. TONS ~ ~--- I J 221 I DAYS ON SITE: 365 222 ' (Check one item only) ifEHS,-amount-must be_ nOounds.- - ;STORAGE ' ,a. ABOVE GROUND TANK I !CONTAINER I--- I-- 1 e. PLASTIC/NONMETALLIC DRUM i 'i. FIBER DRUM ~ .---{ r im.GLASS BOTTLE o. RAIL CAR - ! ' ~X b. UNDERGROUND TANK I f. CAN ; j. BAG ;n. PLASTIC BOTTI.I 'p. OTHER I I-'_ c. TANK INSIDE BUILDING i' g. CARBOY i jk. BOX ~ !o. TO"fE BIN -~ ' ~Id. STEEL DRUM ~ ~ .- ..... - - h. SILO II. CYLINDER gip. 'TANK WAGON 223 STORAGE PRESSURE ; X i a. AMBIENT i - b. ABOVE AMBIENT ;c. BELOW AMt31EN1' - - 224 I STORAGE TEMPERATURE X ~ a. AMBIENT I ~b. ABOVE AMBIENT ~c BELOW AMBIENT I ~--~ '--- ~~. .; d. CRYOGENIC 225 ---~ -- %WT ~ HAZARDOUS COMPONENT (For mixture or waste only) EFIS ~ CAS# i1 100 226 ~~ GASOLINE 227 i Yes ~X,No :_._, _.. 228 ~ 8006-61-9 229 12 1-9 230 TOLUENE 231 ~ Yes ~ X No ' -- 232 ~ 108-88-3 233 ' _ _ - ---_ Yes .-'tX'No 235 i 3 1-14 XYLENES ~ i ' 23~ _. _.. _ . 236 ! 1330 20-7 _- 237 - _ -- _-_ -- _- --- -- -- --- -- - --- -- _ . _ - - - - -- _._... _ , 238 ~ 239 ~ I,--', 4 1-5 I 1,2,4-TRIMETHYLBENZENE I ;Yes iXiNo 240 I ~ 95-63-6 241 5 1-5 242 I Ethyl Benzene 243 ii ~ (Yes IXjNo zaa 100-41-4 245 If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0, I % by weight if carcinogenic, attach additional sheets of paper captu ring [he required information, I ! ADDITIONAL LOCALLY COLLECTED INFORMATION 246 if EPCRA, Please Sign flerc UPCF (1 /99) 169 OES Form 2731 i~ ' UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or areal ADD ~ DELETE - ~X; REVISE 200 Page of 1. FACILITY INFORMATION ,BUSINESS NAME Circle K Store #2708825 2708825 3 ICHEMICAL LOCATION ,CHEMICA L LOCATION CONFIDEN'1lAl. 202 , STORE ROOM EPCRa ' ~~~ ~ IYES x ! No --- --------- - --- (FACILITY ID# --~ --~ I ~ - _'_ _ .L ~ p onal) i i 1 MAPH (o u M ~ 203' GRID# (optional) 1 204 ~ ~ ~ I ~ I F4 I----------------- ~-- --_ ~-- -- - --- - - - - - 1_ _ - _.._ . t _ .. -.. ~ - --- - - II. CHEMICAL INFORMATION _ _ _ _ __ _ _ _ _ __ CHEMICAL NAME 205 !TRADE SECRET i jYes ~ X INo ~ _ 206 ~ CARBON DIOXIDE - - - ---- - - li Sub~ect to EPCRA, refer to instructions -- COMMON NAME 207 208 ~ CARBON DIOXIDE GAS i EHS , ~ _ ~ Yes `X ~ No t- - _ - --- ---- -- ----- --------------------- ----- ----------- ----- -- -- - - ~CAS# 209 ~ " ' --- -- - - ---- - _ _ --- - -- - _ - - " - If EHS is ~ 124-38-9 i 1 Yes , all amounts below must be in lbs. (FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I NON-FLAMMABLE GAS , l _-- --- ---- .. ---...------------- ---------------- -------- ------- - _ ------- - __- _ _ - .- IHAZARDMATERIAL _ __ r--_, 211 ~ X a. PURE b. MIXTURE c. WASTE ~ RADIOACTIVE ~ _ ~ Yes `TYPE (Check one item ! ~ ~ l I ~ -. _. _ - . . , 212' ~ X INo ,CURIES 213 _ ' ~ PHYSICAL STATE 2141 ~ a. SOLID ~ J b. LIQUID ~ X l c. GAS I LARGEST CONTAINER ~ 26~ 215 ` (Check one dem onl Y) FED HAZARD CATEGORIES r-' - I 1 a. FIRE I b. REACTIVE ! X I c.l'RESSURE RELEASE I X d. ACUTE HEAL I ~ TH ! e.CHRONIC HEALTH 216 ' !(Check all that aPPIY) ---' --- L- ~ I - ---' f I r---------- ---------- --- ---- _ -- - - - -.. _. _. __... __ . .AVERAGE DAILY AMOUNT 217 ,MAXIMUM DAILY AMOUNT 218 ;ANNUAL WASTE AMOUNT __ - 219'S"FATE WASTE CODE 220 1805 26 10 1 ~ ': _ . __._ _ . . __ _._ _ ..._ ____... ---- ------- - -- ------ - - _ - IUNITS* '~ a. GALLONS X I b. CUBIC FEET 'I ~ l c. POLJNDS I d. TONS - .. -- - _ 221 DAYS ON SITE: 222 _ !(Check one item. and If EHS,-amountmus ~ Y) t be_in pounds.-- __ _ 365 . - .. _ . - !STORAGE I Ala. ABOVE GROUND TANK I e. PLASTIC/NONMETALLIC DRUM 'i. P16ER DRUM '. m.GLASS BO'1"fLE o. RAIL CAR CONTAINER !- - `- 1 I ,b. UNDERGROUND TANK j {f. CAN Ij. BAG I gyn. PLAS'ftC BOTTLE ip. OTHER _ -- -1 ~ ~ X Ic. TANK INSIDE BUILDING ~ Ig. CARBOY k. BOX ~ jo. TOTE BIN i i- - ' d. STEEL DRUM ~h. SILO ~ ~I. CYLINDER ~ gip. TANK WAGON _ - j t 223 ' , ---- ---- ----- ------------------ - ------ ----- --- ..---- - -- - -- - -- -- --- - - -- - - - -- - - STORAGE PRESSURE ~~ a• AMBIENT LX jb. ABOVE AMBIENT L Vic. BELOW AMBIENT ~ 224 - - -- -- - - -- STORAGE TEMPERATURE X~ a. AMBIENT _~b. ABOVE AMBIENT ~_~c. B1?LOW AMBIENT - - I id. CRYOGENIC ,__: 225 i ~I %WT ; HAZARDOUS COMPONENT (For mixture or waste only) i EHS ; CASE! i I 100% 226 I CARBON DIOXIDE 227 Yes ~ X No I 228' 124-38-9 229 j2 230 i 231 ~ ~ ;yes ~ X ~10 232 ~~ ~ ~ ~ 233 I - -- _- --- -- i ' 234 235 - 13 I ~ ~IYes i X ~No _. _ - .. 236 i 237 ' I - - - - - _ _ i4 238 239 ~ iYes I X No I - - - - 240 241 i _._.__.... ----- - --- ------ --...--- - - - -- - --.._._..- -- - i 242 ~ 243 ~ ~ 5 I ,Yes ~X;No ' - -- --- - --- ----I---- - ---- -- _ . _. - - - - - 244 ~~ ~ - 245 _ __ _ -- - ----- ' If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0. I % by weight if carcinogenic, attach additional sheets of paper captunng the required information ADDITIONAL LOCALLY COLLECTED INFORMATION 246 If EPCRA, Please Sign Here UPCF (1/99) ]69 OES Form 2731 I ,~ r UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATF,RIALS HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION One page per material per building or area) ADD ~ DELETE ~X~ REVISE 200 I Page of - -- ----------- -------r--------------- ----- -- -- - - -- - ~ I. FACILITY INFORMATION __ (BUSINESS NAME _ 3 , Circle K Store #2708825 27o8s25 ~~CHEMICAL LOCATION 'CHEMICA L LOCATION CONFIDENTIAL 202 ~ WEST SIDE BLDG BY PROPANE TNK ;epcRA ! I - eves x ~ No - iFACILITY 1D# - ~ -- --- ~ --T - T--- ~ ---- - --; - ii ~ ~~ ~ ~ i i ~ 1 MAP# (optional) ~ ! ; ~ 1 ~ 203 ~ GRID# (optional) 3 ~ 204 i --- - - -- . , - ... 1 i - I -- t- -!.__ _ ~ !_ i ~--- - -- - .... _. - _ _ I1. CHEMICAL INFORMATION ~-_ ________-__ ._ _ - __ _ ____-_ ___ _ __ _ iCHEMICAI. NAME 205 ~ TRADF. SF.CRF.T , 1 '.- -'-- - - -~ ,Yes X 'No 206 If Subject to LPCRA, refer to instructions ;COMMON NAME 207 208 '! USED GASOLINE FILTERS E"S ' ves ;X, No r- - --------...------ ------ ---- ---- --- --_ ------------- - --__ . - - - - ___ .. CAS# 209 i _ _ 8006-61-9 If EHS is " Yes", all amounts below must be in lbs. '(FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I-B FLAMMABLE LIQUID HAZARD MATERIAL _ __ 211 t -~, r ~ IOA TIVE 212 ~ X ~ CURIES 213 : ' C L..- i Yes b. MIXTURE ~ X c. WASTE RAD a. PURE "TYPE (Check one item L _] I I ~-_ _I ~ -- - No I ' - : -- ----- - -- - - --- -. i -- - PHYSICAL STATE - _ _ 215 214 X a. SOLID ~ ~ b. Ll UID c GAS LARGEST CON"fAINER ^ I! Q ~ ~ 200 , I (Check one item only) 4 --- -- ---- - --- -- -- ---- -- ---- --- -- --- ------ - -- --- -- ---- ---- - - __ (,FED HAZARD CATEGORIES " -I - X~ a. FIRE rr b. REACTIVE ~~~ c.PRESSURE RELEASE X ~ d. ACUTE HEALTH ! X e.CHRONIC HEALTH I 216 ' PP y) L__~ ,..__! ',(Check all that a I ---I L__._ , -- - ------ ------ -- - ---~ -- ------ ------- -- --- - AVF'RAGE DAILY AMOUNT 217 jMAXIMUM DAILY AMOUNT 218ANNUAL WASTE AMOUN"1' - ._. _ _...._---- - --- - --. l 219 iS'fATE WASTE CODF _ 220 200 ------ - -~--- -------~---- - -5 ---------------I - - ------- - - _ _ -- __ ! 213 ....-..._i.- - --- - - _. _ _ ' f--1 ~ r.-.., iUNITS* a. GALLONS ~ ! b. CUBIC FEET ! X ! c. POUNDS ~ d. TONS 221 ' DAYS ON SITE: 222 ((Check one item only)--- --------------------- if lrHS.amount_must_be..in-pounds.------------ _--- -- ___--- -- - .. I- .- - _ -- --- -.365 -- _._-- .-...- - .- _ - ' T RA E a. ABOVE GROUND TANK ~ ~~ ( CONTAINER i---~ _ -- -- e. PLASTIC/NONMETALLIC DRUM ~ Ii. FIBER DRUM I ~ , _ - im.GLASS BOTTLE ! ;o. RAIL CAR ; _ , , I ~b. UNDERGROUND TANK I ~ f. CAN ~ j. BAG ; gin. PLASTIC BOTTLE ~ ip. O"fHER r---; I c. TANK INSIDE BUILDMG i I ~ I ;__ _. CARBOY ;k. BOX I g~ - I:o. TOTE BlN _ I- ! ~ X jd. STEEL DRUM ~ _ h. SILO t. CYLINDER , ;p. TANK WAGON - ~ _ _ -- - - _ 223 ' i STORAGE PRESSURE X '! a. AMBIENT ib. ABOVE AMBIENT c. BELOW AMBIEN"f 224 r... _---- -------- - _ _-- -- ---------------- ----- --- - --- --- --- -___ ._.. _ - - _ - - _. . _ . r-- STORAGE TEMPERATURE i X i a. AMBIENT ~_ _ib. ABOVE AMBIENT c. BELOW AMBIEN"I' _ _. d. CRYOGliN1C 225 %WT i HAZARDOUS COMPONENT (For mixture or waste only) EIIS CASH ! - - - - -- -- -- - -- - - -.... - - _.. _ 227 i --- I- i GASOLINE Yes XiNo , 5 ~ 8006-61-9 229 t -._-__-_-- -230 - -__ 231 ~ ~ 2 ~ FUEL FILTER i 'iYes ~X INo __ ~ _ _. 232 ! 233 3 234 235 i ~__jyes ~ X ~~No 236 j 237 238 , -- - - ------ I- - - - ---- ---- -- I 239 ~ Yes X,No 240 241 i5 242 - -- -- - -- ------------- ---- ---- --- - ---- -------- - --- 243 j--lyes rX~No t I ~ ~ 244 ~ 245 -- _ If more hazardous components are present at greater than I % by weight if non-carcinogenic, or 0.1 % by weight if carcinogeniq attach additional sheets of paper captu ring the required information ADD("f10NAL LOCALLY COLLECTED INFORMATION i 246 I If EPCRA, Please Sign I-lere UPCF (I /99) ] 69 OES Forth 2731 APS 1 BUSINESS NAME CIRCLE K STORE #2708825 BUSINESS ADDRESS 2222 'F' STREET CALIFORNIA ANNOTATED SITE BAKERSFIELD MAP DATE 03/16/2004 ZIP CODE 93301 PREPARED BY: IGN GROUP 9NG DRAWING SCALE 1 "=30'-0"f A e c ~ E F ~ H MAP SYMBOLS NORTH MC DONALD'S O L PANEL TR OFF SHUT ' O NATURAL GAS SHUT-OFF WO WATER SHUT-OFF 23RD STREET O SHUTGOFFY PUMP TMA ~~ TANK MONITORING ALARM T^ TELEPHONE 2 ~ FIRST AID KIT FIRE EXTINGUISHER ® STORM DRAIN S SANITARY SEWER A LD T ~ STAGING AREA EVACUATION/ ~1 000 G L PRE iO HMMP HMMP, AND MSDS , MSDS LOCATION 3 ~ ~ 0,000 L REGj O ~ FIRE HYDRANT IW U Q - --- ~ ,000 ---, L PLUS O -x-~ ERE FENCE EMERGENCY RESPONSE J Q ~ _ _ _ , _ _ _ ~ EOUIPMEN T/ABSORBENTS O- ~ O ABOVEGROUND ~ STORAGE TANK 4 = OP O W J Q t~ ~I - ~ UNDERGROUND STORAGE TANK ~ ~ W CO E O J W O GASOLINE Q ~ CASHIER O Q 0 (FLAMMABLE LIQUIDS) ~ ~• • ~ n T~~ I W O DIESEL FUEL COMBUS718LE LIQUIDS) J ( Q W 12x5 GAL MSDS OP RR ~ O MOTOR OILS & LUBRICANTS (COMBUSTIBLE LIQUIDS) z PROPANE F CO CARBON DIOXIDE 5 (COMPRESSED GAS) O PROPANE ERE (FLAMMABLE LIQUtD) I ~ I O ANTIFREEZE/COOLANTS WASTE OIL (FLAMMABLE LIQUID) Cw CAR WASH PRODUCTS 6 ELECTRONIC MONITORING POINTS SUMP SENSOR 7 ~ ANNULAR SENSOR DR. OFFICE LD ELECTRONIC LINE LEAK DETECTOR TG AUTOMATIC TANK GAUGE SECTION I z~osazs 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. l . 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 I (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 INCIDEN"T': Name:.Ser_vice__Contact Center..___.- _- _ Telephone:_ 866-805-435.7. Name: Kevin._Quinn-_.____ Telephone:_.5.59--64Z-6910 ..- __.. B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAI. FACILITY OR MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR POTENTIAL ACCIDENT SCENARIOS: NAME: BAKERSFIE__LD M_E_ MORLAL_HOPS.__ - _ _ -_, -. ... _ ---. . ADDRESS: 420 34th ST. CITY: BAKERSFIELD PHONE: 6.6_L-32.7_-4.64_Z---- ------ - - - ---------- - ---- -- 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 quantities 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. "Che 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 spills,_isolate the area and contain with absorbent material. Clean up the sill immediately to prevent_spreading. For fires,_turn off pumps, use fire ,extinguisher if it can be done safely,........ Lamer incidents: Turn off~umps using emergency~ump 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? Sma_ll_inc,idents.will b_e_handled_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,_cal_l_9_1-1, and the Service Contact Center_~__1-866-805-4357.. The Contact. _ Center will dispatch a maintenance contractor to_assist._in,__abating_the h.azard___For suspected. leaks the_operator_will notify th_e_Serv_ice Contact Center and his/her Distrct_Manager_ ____ who_will_ investigate the incident... If a U_ST lea_k_is confirmed _then_reporting will ______ __ __ be done by_Circle. K which complies with UST regulations,_________ ___ Circle K will coordinate with any_.contractors_required_to_stop a release,,_clean _ _._. _ _ _ _ up a_release and/or dispose of_materials._All_materials_will be disposed of in _ __ __ __ . accordance with state, federal and local laws. and__regul_ations. _ _ __ 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 OF SITE The manager or lead employee will take a head count to verify 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 only take place after the dealer or manager verifies with the respondin ag genepersonnel 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 proper disposal or recycling_ 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 Response plan provided bX Circle If a released hazardous substance reaches the environment, increases the fire or explosion hazard, is not cleaned up from the secondary containment within 8 hours, or deteriorates the secondary containment, then the local a ency will be notified IMMEDIATELY 3 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; p 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; y, 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 for record keeping. EMERGENCY RESPONSE PROCEDURES MAJOR INCIDENT: FIRE SPILL OR SUSPECTED LEAK 2708825 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. l . 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." Call 9-I-1: Give the following information: "THERE IS A FIRE/GASOLINE SPILL at the Circle K service station at: 2222 F 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. ATTEMPT to contain the spill if you can do it safely. 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. 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 Quinn 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 b ty he 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 I c) LOCAL POLICE AND FIRE DEPARTMENTS: 9-1-1 d) NATIONAL RESPONSE CENTER: (800) 424-8802 (24-Hours) SpilURelease 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\Circle K Stores\zForms\Propane-Spill Plan.doc SpilURelease Response Procedures for Carbon Dioxide (COZ) 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. 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. Trainin~• 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. 1:\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 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-FRONT OF BUILDING 1-PUMP ISLANDS ~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: STOCKROOM * 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: 1-REAR OF BUILDING, I -STOCKROOM * WATER SHUT-OFF: The water shut-off may be necessary in some cases. Location: ALONG F 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: NONE * 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-t as necessary. EMERGENCY EQUIPMENT * 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: 3-IN STORE, 1-CASHIER ~r 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 AT CASHIER * RESPONSE EQUIPMENT: These items are to be used to prevent skin contact with hazardous materials Broom: STORAGE Shovel: STORAGE Gloves: STORAGE Goggles: STORAGE ~Ic FIRST AIll 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 OF SITE ~c ENVIRONMENTAL DOCUMENTS / HMMP MSDS SHEETS: Location: CASHIER EMPLOYEE TRAINING PLAN (con't) MEDICAL FACILITIES: PRIMARY FACILITY: BAKERSFIELD MEMORIAL HOPS. 420 34th ST. BAKERSFIELD 661-327-4647 ALTERNATE FACILITY: KERN MEDICAL CENTER 1830 FLOWER STREET BAKERSFIELD 66l -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. [f 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. i» L ~~~ 1 L SWRCB, January 2002 Page of _ Secondary Containment Testing Report Form Tlris jornt is intended jo use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for al( components tested. The completed form, written test procedures, mrd printouts from tests (ija~pp(rcable), should be provided to the facility owner/operator for submittal to the local regu/aton• agency. 1_ FA("'ii,iTY iNFC1RMATiON Facility Name: ~-~1..~ ~ ~ ~ ~ S"~ Date of Testing: ~ ~ }~ `~ ~ c7 ~~- Facility Address: ~~ ._ ~- a~-~. ~`~. ~ ~ ~-'~ ~ 2~~ ~ ~~ ~ •3 ._ 0 Facility Contact: ~L'~ +~ ~- E ~ Phone: I ~- `3 2 ~ ~ c`~ Date Local Agency Was Notified of Testing Name of Local Agency Inspector (if present during testing): ~ Q~ C. 2_ TFCTiNf,' f'(1NTRA(''TnR iNF[1RMATinN Company Name: Triangle Environmental nc Technician Conducting Test: i L ~'~ ~ ` ~ ~~ Credentials: v C SLB Licensed Contractor SWRCB Licensed Tank Tester License Type: A License Number: 673971 Manufacturer ~ Manufacturer Training Com Went s Date Trainin Ex fires Trian le Env ~ TEI 5000 ~ - • 1- 1 - 08 Dw er 475 3: SUIVIlVIARY ()F TEST RESULTS Compone ~ nt p~ F~ Not Tested Repairs Made ~mponent p~ p~ Not Tested Repairs Made ~~~ v ~ p R-S . . ` ~\ \~ \"\~I ~V M~Q~S ~~ +~, v ~ ~~- ~ ~ ~ ~ ~~- I ~ c ~ ~- I ~ U ~C 3 -~ ~ ' ~ I t0 performed, describe what was done with the water after completion of tests: CERTIFICATION OF TECI~iICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knoiledge, tlu fads mated to this docurtient an in full compliance with legal r~egrtiremettts ~. ~ 11 Technician's Signatut+e Date: `.:.. ~~ ~ '~ d~ ~ ~'~~ \'. ~~ S:WRCB, Januazy 2002 Page of TANK ANNULAR TESTING Test Method Developed By: X Tank Manufacturer Industry Standard Professional Engineer Other (Specrfi~) Test Method Used: Pressure X Vacuum Hydrostatic Other (Specify) Test Equipment Used: Dwyer 475 Equipment Resolution: 0.01 Tank 87 Tank 91 Tank ~ Tank Is Tank Exempt From Testing?' Yes X No Yes X No Yes ~ No Yes No Tank Capacity: ~ ® OCq (~ OCR CO OC~~C Tank Material: ~ \ ~~~ t_.~ $~ f , r~E2~ ~ h r ~' 1 f5'C 2~i ~,~ Tank Manufacturer: ~~ R-~FS F (Z.,~ ~ S ~- jZ ~C f Product Stored: r-> S ~ v,~ .~ <~ S 'Wait time between applying pressureJvacuumJwater and startin test: 30 Minutes 30 Minutes 30 Minutes 30 Minutes Test Start Time: ', ©~ '; ~ S ~, C~ S Initial Reading (R~: C7 ~ ~ ~ ,~~ l - ~ ,~~~e` Test End Time: (~ ; ~.~ ~ 2 : oS f2 ; ~?S- Final Reading (RF): td ,~c~ ~ ,C~ ~~ ~ `Op . Test Duration: 1 Hour ~ 1 Hour 1 Hour 1 Hour Cltiauge in Reading (R~R~: ,~ -~ ~-- P~ssJFail Threshold or Criteria: ~ 0.20 0.20 0.20 0.20 TestResult:. ass . Fail . Fail •' Pass Fail Pass ~ Fail Was sensor removed for testing? No NA es No NA es No NA Yes No NA Was sensor properly replaced and verified~functional after testin ? ~ . No -NA ~ ~ No NA es No NA . ~ ..1'es . No NA COttllrients - (include information on repairs made, prior to testing, and recommended follow-up for failed tesuj SWRCB, January 2002 F.~ 6. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page of Test Method Developed By: X UDC Manufacturer Industry Standard Professional Engineer Other (Specrjy) Test Method Used: Pressure Vacuum X Hydrostatic Other (Specify) Test Equipment Used: TEI 5000 Equipment Resolution: 0 .00001 UDC 1-- Z UDC 2 ~ UDC 3 UDC 4 UDC Manufacturer: 2 ~~ O ~ ~ UDC Material: ~ ~- ~ ~- _ r ~C--L ~ UDC De the ~ ~ , , ~•, Height from UDC Bottom to Top of Hi hest Pi in Penetration: Height from UDC Bottom to Lowest Electrical Penetration: Condition of UDC prior to tes6n : ~~,0 ~ ~` ~~ ~7 Portion of UDC Tested t'la `tE , ~~ o ~ v ~ ~JVc ~ v N ~ Does turbine shut down when UDC sensor detects liquid (both roduct and water ?~ Turbine shutdown nse time Is system programmed for fail- safe shutdown?~ Was fail-safe verified to be o 'oral?~ Wait time between applying ptessurelvacuum/water and startin test '^ *~'~••~°° ~© ~,w,.. ~ 30 Minutes Test Start Time: ~ ~ r •~ ~ l ~ ~ Initial Reading (Rt): Test End Time: f ~ , cr c~ ` ~ : ~ .3 Final Reading (RP): ~-, 0 2-0 ~{-~ ~ I ~ Test Duration: $5-i~ ttabes 15 M inutes 15 Mi nutes 15 M inutes (Mange in Reading (Rg-R~: p ,o o ~--O , 0 0 ti . Pass/Pail Threshold or Criteria: -0.002 -0.002 -0.002 -0.002 TestResut>t _ '. 1 ~ 1 ~:~ ~ 0~) ''~ S'~ ~ _ Was sensor removed for testing? N/A N/A N/A N/A Was sensor ptnperly replaced and verified futtdional after ? N/A N/A N/A . N/A Comments - {include information on repairs made prior to~testing, and reconunended follow-up for failed tests) t If the etltire depth of the UDC is not tested, specify how touch was tested. H the answer to ~tty of the questions indicated arith an asterisk ('~ is `T10" or `TTA", the entire UDC must be tested. (Soe SWRCB L(3~-160) SWRCB, January 2002 5. PIPING SUMP TESTING Page of Test Method Developed By: X Sump Manufacturer Industry Standard Professional Engineer Other (Specify) Test Method Used: Pressure Vacuum X Hydrostatic Other (Specify) Test Equipment Used: TEI 5000 Equipment Resolution: 0.00001 Tank Tank ~ Tank ~ Tank Sump Diameter: '' ~` Sump Depth: ~ ~ ~. ~ ` , U 3 Sump Material: ~ , Fiberglass Fiberglass Fiberglass Fiberglass Height from Tank Top to Top of Hi hest Pi in Penetration: ~ ~ ~ ~ ~ 1 Height from Tank Top to Lowest Electrical Penetration: ` ~ ~ ` t ~ 1 `> y I Condition of sump prior to testin Good Good Good. Good Portion of Sump Tested' 2" above highest pen' 2" above highest pen' 2" above highest pen' 2" above highest pen' Does turbine shut down when sump sensor detects liquid (both roduct and water ?~ ~ ~ ~ ~ ~ F ~ ~ J ~~ Turbine shutdown response time ~ ~ C Z S C~ C_ `~ S c ~ , Is system programmed for fail- safe shutdown?~ ,~ ~ ~ ~ C . (~ J Was fail-safe verified to be o tional?~ ~ ~ J ~ ~ ~ . ~-~ Wait time between applying pressurelvacuum/water and startin test: 30 Minutes 30 Minutes 30 Minutes 30 Minutes Test Start Time: ~ ~`Z ! 2. ~ 2 ` !~ j,S ,3 ' ~ O 3 '. S' ~ J ~ . c~ Initial Reading (Rt): , ~ 2c~ ~ cQ ~ ~. S'S 1 . ~ ~ • ~Z . 52 Test End Time: L- . 3 S ~ 2 : S'-'O ~ ~ ° ~` : o~ /S; ©~ / S : 2 Final Reading (R~): ~ ~ . g 28 , 8 3 ~ J a "~ , S Z i, Test Duration: 2 ~ 15 Minutes 'Z X 15 Minutes 2. ~ 15 Minutes 15 M inutes Change in Reading (R~R~: - ~ , oo ~ -c , oo ` 0.O ~ S -O. oZ~`~ --o . o o { - ~ ,oo.l . Pass/Fail Tht~cshold or Criteria: -0.002 -0.002 -0.002 -0. 002 ~esE;Result~ ~ ~? CS ASS pt~ :~~m l t.,~ t?~~`~ ~.~ . Was sensor removed for testing? yes ~ Yes yes yes Was sensor properly replaced and verified functional after testin ? Yes Yes ~ Yes ~ Yes Comments - (include i-{formation on repairs made prior to testing, and recommended follow-up for failed tests) ~ ff the entire depth of the sump is not tested, specify how much was tested. ff the answer to n + of the questions indicated with an asterisk ('~ is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160