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HomeMy WebLinkAboutUNDERGROUND STORAGE TANK ~~ t ____ _ _ _ ~ _ ____ _ _ _ _ ___ _ (UNDERGROUND STORAGE TANK) FILE #2 -- - ;' .LUCKY 7 FOOD STORE #8 2601 S. CHESTER AVENUE .;, _ MUNITURING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.1, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form mast be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each monitoring system control gavel 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. GeneralInformataon Facility Name: LUCKY 7 #8 Site Address: 2601 SOUTH CHESTER Facility, Contact Person: Bldg. No.: Zip: 93304 Contact Phone No.: 6( 61 )836-1794 Make/Model of Monitoring System: INCON TS1000 Date of Testing/Servicing: 02 / 23 / U7 B. Inventory of Equipment Tested/Certified t7~edc tine aoomnriate hnsca to indicate sn~riiic eauinment imnerled/serviced: Tack ID: UNL SUPER Tank ID: UNLEADED PLUS ® In-Tank Gauging Probe. Model: ®In-Tank Gauging Probe. Model: ^ Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: ® Piping Sump /Trench Sensor(s). Model: ®Piping Sump /Trench Sensor(s). Model: O Fill Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Model: ® Mechanical Line Leak Detector. Model: ®Mechanical Line Leak Detector. Model: O Electronic Line Leak Detector. Model: ^ Elearonic Line Leak Detector. Model: O Tank Overfill /High-Levet Sensor. Model: O Tank Overfill /High-Level Sensor. Model: ^ Other ( ui ment and model in Section E on Pa e 2 . O Other ui ment and model in Section E on 2 . Tank ID• Tank ID: ® In-Tank Gauging Probe. Model: ^ In-Tank Gauging Probe. Model: O Annular Space or Vault Sensor. Model: O Annular Space or Vault Sensor. Model: ® Piping Sump /Trench Sensor(s). Model: O Piping Sump /Trench Sensor(s). Model: ^ Fill Sump Sensor(s). Model: ^ Fill Sump Sensor(s). Model: ® Mechanical Line Leak Detector. Model: O Mechanical Line Leak Detector. Model: 0 Eiecbronic Lute Leak Detector. Model: ^ Eiectronic Line Leak Detector. Model: O Tank Overfill /High-Level Sensor. Model: O Tank Overfill /High-Level Sensor. Model: O Other 'went and model in Section E on P e 2 . O Other ( ui ment and model in Section E on Pa a 2). Dispenser ID• 1/2 Dispenser ID: ® Dispenser Containment Sensor(s). Model: 4~'-'4 O Dispenser Containment Sensor(s). Model: ® Shear Valve(s). ^ Shear Valve(s). O Containment Floats and Chains . O user Containment Floats and Chains . Dispenser ID: Dispenser ID: ® Dispenser Containment Sensor(s). Model: - O Dispenser Containment Sensor(s). Model: ® Shear Valve(s). O Shear Valve(s). ^ Di user Containment Floats and Chain s). O Di Containment Floats and Chains . Dispemer ID: Dispenser ID: ^ Dispenser Containment Sensor(s). Model: O Dispenser Containment Sensor(s). Model: O Shear Valve(s). O Shear Valve(s). Obis user Containment Floa s and Chains . O Di Containn~nt Flo sand Chain s). ~If the facility contains more tanks or dispensers. copy this form. Include information for every tank and dispenser at the facility. C. Certlfit~tlOII - I certify that the egtpment identified in this document was ' serviced in accordance with the manufadnrers' guidelines. Attached to this Certification is information (e.g. manufacture to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For auy uipmeat a of generating such reports, I have also attached a copy ~ the report; (check aU that apply): ®System set-up ® ry report Technician Name (print): RON OGERS Signattue• Certification No.: 2122253760 License. N .: 813616 A HAZ / ICG5246218-UT Testing Company Name: ACE PETROLEUM SERVICES INC Phone No.:~ 661 ~ 387-6522 Site Address: 15540 STREBOR DR /BAKERSFIELD / CA 93314 Date of Testing/Servicing: 02 / 23 07 City: BAKERSFIELD Page 1 of 3 03!01 Monitoring System CertiScation rs. ~. D. Resutts of Testing/Servicing Software Version Installed: •9914 (`mm~lntn tha fnlinwino t~hnrklict~ ® Yes ^ No* IS the audible alarm o tional? ® Yes ^ No* Is the visual alarm o "oral? ® Yes ^ No* Were all sensors visuall ted, functionall tested, and con5rrned o rational? ® Yes ^ No* Were all sensors installed at lowest point of secondary containment and positioned so that other equipment wrll not interfere with their o ration? ^ Yes ^ No* If alarms are relayed to a remote monitoring station, is all communications equipment (eg. modem) ® N/A operational? ® Yes ^ No* For pressurized piping systems, does the turbine automafically shut down if the piping secondary containment ^ N!A monitoring system detects a leak, fails tci operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check all that apply) ®Sumpfl'rench Sensors; ^ Dispenser Containment Sensors. Did ou confirm sitive shut-down due to leaks and sensor failureJdisconnection? ^ Yes; ^ No. ^ Yes ^ No* For tank systems that utilize dre monitoring system as the primary tank overfill warning device <i.e. no ® N/A mechanical overfill prevention valve is installed), is the overfill wanting alarm visible and audible at the tank fill int(s and o 'n rl ? If so, at what rt of tank ca aci does the alarar tri r? ~ % ® Yes* ^ No Was any monitoring equipment replaced? Tf yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all lacement in Section E, below. Q0 Yes* ^ No Was liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ^ Product; ®Water. If es, describe causes in Section E, below. ® Yes ^ No* Was monitorin s stem set reviewed to ensure settin ?Attach set , if licabie ®Yes ^ No* Is all monitorin ui runt o lions! manufacturer's 'cations? * In Section E below, describe how and when these deficiencies were or wiII be corrected. E. Comments: 2SPESERS PANS HAVE STAND ALONE SENSOR$~NSTALLED 02/23!07- INSTALLED SENSORS {N STP SUMPS TO LOWEST PO{NT AND PROGRAMMED STP SENSORS TO 02/26/07- REPLACED 89 STP SENSOR AND TESTED Page 2 of 3 03101 F. III-Tank Gauging !SIR Equipment: ^ Check this box if tank gauging is used only for inventory control. O Check this box if no tank gauging or SIR equipment is installed. This° section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Co lets the folio checklist• ®Yes ^ No* -- - ___-- Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ® Yes ^ No* Were all tank gauging probes visually inspected for damage and residue buildup? ® Yes ^ No* Was accuracy of system product level readings tested? ® Yes ^ No* Was accuracy of system water level readings tested? ® Yes ^ No* Were all probes reinstalled properly? ® Yes ^ Na* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD): Complete the following checklist: ^ Check this box if LLDs are not installed ® Yes ^ No* For equipment start up or annum equipment certification, was a leak simulated to verify LLD performance? D N/A (Check all that apply) Simulated leak rate: ®3 g.p.h.; ^ 01 g.p.h ; ^ 0.2 g.p.h. ® Yes ^ No* Were all LLDs confirmed operational and accurate within regulatory requirements? ® Yes ^ No* Was the testing apparatus properly calibrated? ® Yes ^ No* For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A O Yes ^ No* For electronic LI Ds, does the turbine automatically shut off if the I.LD detects a leak? ® N/A ^ Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ® NIA or disconnected? D Yes ^ No* For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system maifimctions ® N/A or fails a test? ^ Yes ^ No* For electronic LLDs, have all accessible wiring connections been visually inspected? ® NIA ® Yes ^ No* Were all items on the equipment manufacturer's maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: OZIp6107- REPiAGED 84 AND Q1 )_INE LEAK DETEGTDR~ AND TESTEL) Page 3 of 3 03/01 onitoring System Certification UST Monitoring Site Plan Site Address: LUCKY 7 #8 / 2601 SOUTH CHESTER / BAKERSFI LD CA 93304 . .STORE .OBSERVATION . :`.,,;,~ . . . . . . . . . . . . . . . . . . . . FILL . . . . . . . STP . . . . . . . . . . . . . . . . . . . . . S7 . . .~ ~' . . . ~~~~. . . . ~ ~ . . . . . . . ..................................................... ..................................................... ..................................................... ..................................................... . .....................NORTH . 5 =SENSORS. ~~. . ............:........................................ ..................................................... ..................................................... ..................................................... .~-~. ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... ..................................................... Date map was drawn: 02 / 23 / 07 , Instre-ctions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in--tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page of osioo _ SWRCB, 3anuary 20D6 Spill Bucket Testing Report Form This form is fntended for use by contractors performi>~ a-mual testing of LIST spill corrtainrnertt structra~es. The completed form and primouts from tests (;f'applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1_ RA[`I?d7'Y IINi~YIRMATEnN Facility Name: LUCKY 7 #8 Date of Testing: 2/26/07 Facility Address: 2601 SOUTH CHESTER / BAKERSFIELD / CA 93304 Facility Contact: Phone: 661-838-1794 Date Locat Agency Was Notified of Testing :2/20/07 Name of Local Agency Inspector (ifpresent during testing): STEVE UNDERWOOD 2_ TESTIlITG CONTRACTOR INFORMATION Co y Name: ACE PETROLEUM SERVICES INC Technician Conducting Test: RON ROGERS Credentials': ®CSLB Contractor ®ICC Service Tech. ^ SWRCB Tank Tester D Other crfy) License Number(s): 3. SPILL BUCKET TESTIN(x llYFUKMA11UPt Test Meffiod Used: N H drostatic ^ Vacuum ^ Other Test Equipment Used: Equipment Resolution: Identify Spill Bucket (By Tank Number, Stored Product, etG 1 7 2 9 3 1 4 Bucket Installation Type: ~ Direct Bury ^ Contained in Sum ®Direct Bury ^ Contained ![! Snm ®Direct Bury ^ CoIItained in S ^ Direct Bury ^ COlltalned m $ Bucdcet Diameter. 11" 11" 11" BucketDepth- 13" 12 1/2" 14" Wait tine between applying Test Start Time (T~: Initial Reading (R~: 10 1/2" 10" 1" Test End Time ('I'F): Finah Reading (RF): 101/2" 10" 1" Test ]?oration t;Tp - T~: Change in Reading (Ra-R~: PassJFa$ Threshold or Criteria: Test Result: ®Pass ^ Fail 0 Pass ^ Fail ®Pass ^ Fail ^ Pass ^ Fail CommeIIt3 - (include information on repairs made prior to testing: and recommended follow-up for failed tests} 02/26/07- REMOVED FILL DRAINS AND CLEANED; REINSTALLED AND TESTED CERTIFI ATIO ~CHNICIAN RESPONSIBLE FOR CONDUCTING TffiS TESTING I hereby c~3- that all the Inf contained yin this report is true, accxu»~te, and Inlau compliance with legal requirements. Technician's Sigoattu~'~ (~ Dote-02/26/07 ' State lays and regulations do not cimenihy Yequire testing to be performed by a qualified contractor. However, local requirements may be more stringent. LUCKY ? ND.B 2601 S0. CHESTER AGE. BAKERSFIELD GA 93304 SITE # 805 836-1794 2/23/2007 09:13 AM TANK SETUP REPORT TANK N0. 1 6000 GAL UNLEADED SUP • TANK TYPE STEEL TANK DIMS 8 K 17 TANK SIZE 6800 TANK SHAPE. CYLINDER DIAMETER 96.00 LENGTH 2®4.00 PRODUCT UNLEADED SUP OFFSET P 0.00 OFFSET W 0..00 MANIFOLD NONE PROBE STD 101 FLOATS 2 FLOAT TYPE GASOLINE GRADIENT 9..0322 SENSOR LENGTH' <`1+01 ---` HIGH LIMIT 85.00 LOW LIMIT 750.00 HIGH-HIGH 90.80 LOW LOW 500.00 WATER LIMIT 4.08 TEMP COMP API 68546 pPI GRAVITY 51.30 ALPHA 320.00 N0. RTDS 5 RTD LOG 1 11.49 RTD LOC 2 30.93 RTD LOG 3 45.81 RTO LOG 4 60.47 RTD LOG 5 77.19 STRAPPING DATA INCHES GALLONS 0.000 0,0 5.000 127.0 10.000 353.3 15.080 638.0 20.000 965.0 25.000 1323.8 30.000 1706.9 35. @00.. .., .. -21:8$.0` :- 40.000 2521.4 45.000 2942.4 50.0@8 3366.2 55.000 3788.1 60.000 4203.5 65.000 . 4607°4 70,000 4994.6 75.8@@ 5358.8 80.000 5692.9 85.000 5987.1 90.000 6226.9 95.000 6381.8 2501 SOCKGHESTERBAUE. BAKERSFIELD: GA 93304 SITE # 805 836-1794 2!2312007 09:14 AM TANK SETUP REPORT TANK NO. 2 10000 GAL-::°. UNLEADED RE6 TANK TYPE • TANK DIMS STEEL • TANK SIZE 8 X 28 TANK SHAPE 100.00 CYLINDER • DIAMETER LENGTH 96.00 PRODUCT 336.00... UNLEA[3ED;:RE6 OFFSET P 0,00 OFFSET W 0.00 MANIFOLD PROBE NONE FLOATS STD 101 FLOAT TYPE 2 GASOLINE GRADIENT 8.8931 SENSOR LENGTH i$i HIr,H LI+tIT` 85.00 LDW LIMIT 780,00 HIGH HIGH 90,00 LOW LOtJ 500:0@ WATER LIMIT 4.00 TEMP``COMP API 68!546 API GRFlVITY 63.58 ALPHA 320.00 N0. RTDS 5 RTD LOC. -1 11.49 RTD.LOC 2 30.93 RTD :LOG 3 45.81 • RTD LOC 4 6$,47 - RTD LOC 5 77.19 STRAPPING:DATA INCHES "GALLONS 0.000 0.@ 5.000 209.1 °i8.C~00 5$f:9 15.000 105®8 20.000 1589.3'` 25.000 2180.4 30.000 2811.4 35.000.. 3471,9 40.000 4153.0:`::` 45.000 4846.4- . -....:.50.000 - 5544.3 55,000 6239.2 ... 60, f~80~ ` _... 6923:4 65.600 7588.7 70.000 8226..3 7-5.000 8826.3 80.080 9376.5 • 85.000 9861.1 90:-000 i~256.1 i 95,000 1955.1.2 LUCKY 7 N0.8 ---~- 2601 S0, CHESTER AUE, BAKERSFIELD, GA 93304 SITE # 805 836_1794 2~23i2007 TANK SETUP 09:16 AM . REPORT TANK NO, 3 10000 GAL UNLEADED PLS TANK TYPE TANK DIMS STEEL TANK SIZE 8 X 2$ TANK SHAPE DIAMETER 10000 CYLINDER - LENGTH 96.00 PRODUCT 336.00 UNLEADED OFFSET p pLg OFFSET W 0.00 MANIFOLD 0,00 PROBE NONE::;:; FLOATS STD 101 FLOAT TYpE GRADIENT 2 GASOLINE SENSOR LENGTH 8.876$ HIGH LIMIT 101 LOW LIMIT 85.00 HIGH HIGH 750.00 LOW LOW 9®•00 WATER LIMIT. 500.00 TEMP COMP API 4.08.. API 581846 GRAVITY ALPHA 62.80 N0, RTDS 320.00 RTD L0C 1 RTD LOG 2 5 11.49 RTD L0C 3 30.:93.:;:.. RTD LOG 4 45.81 RTD LOC 5 50.47 77.19 STRAPPING INCHES DATA 0.00@ GALLONS 5.000 10.008 0.0 209,1 15,0®0 581.9 20.@00 1050.8 25.000 - __ 1589.3 30.000 2 r80 ~# 35.000 2811.4 40.000 3471.9 45.000 4153.0 50.000 4846.4 55.000 5544.3 60.000 6239.2 65.000 5923.4 70.000 7588.7 75.000. 8226.3 80.000 8826.3_ $5.000 9376.5 90.080 9861.1 95.000 10256.1 10511.2 ~, LUCKY 7 NO.,S 2601 S0. CHESTER~AVE. BAKERSFIELD~ GA 93384 SITE # 895 836-1794 2r23r29@7 09:17 AM SYSTEM SETUP REPORT SOFTWARE VERSION 0.9910 LOCATION i LUCKY 7 N0.$ LOCATION 2 STREET 1 2691 S0. CHE STREET 2 STER AVE. GITY 1 BAKERSFI.ELO CITY 2 STATE CA ZIP CODE 93394 SITE ~ 8@5 `836=:1;7:9.4,,::;: UOL UNITS GALLONS LEVEL UNITS INCHES 9 TEMP UNITS FAHRENHEIT TIME STYLE `22 HOCTR DATE STYLE MM~DD~VM DAYLIGHT SAV ENABLED SET TIME 9:18 AM SET.DATE 02~23i2807 N0. TANKS 3 LEAK LIMIT 2.88 THEFT LIMI7 19.9@ DELiV LIMIT 20@,8@ SNTNL MODE OFF START SNTNL_.- 12%@8 AM -- END SNTNL 12:00 AM DELIU DELAY 30 .,.REPORT- DELIU EMABLEi} REPORT ALRRS ENABLED REPORT TESTS ENABLED N0. OF ALARMS 18 PRINT INTERVA L 5.88 MODE GRAN 1 NATIVE BAUD GHAN 1 1208 DATA BITS 1 8 STOP BITS 1 1 PARITY~1 NONE SEGURITV l AGGESS 1 PHONE 1 REDIAL 1 DISABLED AGGESS 2 PHONE 2 REDIAL 2 DISABLED ACCESS 3 PHONE 3 REDIAL 3 DISABLED ACCESS 4 PHONE 4 REDIAL 4 DISABLED DIAL DELIU DIAL ALARM DIAL LEAK ' SGHD INVTRY flAILY TIME1 INVTR 5:@® AM TIME2 INVTR 12=99 AM TIMES INUTR 12~@@ AM SCHD INURC NDNE TIMEI .INVRC 12:99 AM.~ TIME2 INURG 12:00 AM TIMES INURC 12:98 AM SCHD DLHST NDNE TIME1 DLHST i2:@@ AM TIME2 DlHS3 22.80 AM TIMES DLHST 12.99 AM SGHD ALHST NONE TIME1 ALHST 12:08 AM TIME2 ALHST 12:89 AM TIMES ALHST 12:@@ AM SCHD ACT AL NDNE TIME1 ACTAL 12s@@ AM ... - TIME2 AGTAL f2%90 AM TIMES AGTAL 12:0@ AM SGHD ALST NDNE _.T_LME1 ALST.. 12:00 _AM TIME2 ALST 12@6 Ri7' TIMES ALST i2.88 AM CONFIDENCE LEAK TEST SCHD TEST TANK 1 TANK 2 TAN'-` 3 TIME ~~~EST TANK 1 TANK 2 TANK 3 99, 9Y, 9:1~ LAST DAY LAST DAY LAST DAY STD RELAY -!._ --V---- ALRRM 1 OFF ALARM . 2 OFF .' ALARM 3 OFF ALARM 4 OFF ALARM 5 OFF ALARM 6 OFF ALARM 7 OFF ALARM 8 OFF STD ALARM 1 S.U. SUMP ALARM 2 R.U. SUMP ALARM 3 M.G. SUMP ALARM 4 NONE ALARM 5 NQNE :.- .. ALARM 5 _ NONE ALARM 7 NONE ALARM 8 NONE SENSOR TYPE SENSOR 1 gTD - SENSOR 2 STD SENSOR 3 STD SENSOR 4 STD SEN5DR 5 STD SENSOR 6 STD SENSOR 7 STD. SENSOR $ STD GONTROL OUTPUT GRACE PERIOD'- @: LOW LOW 1 NONE 1:@9 AM LOW LOW 2 NONE 1:@0 AM LOW LOW 3 NONE,' 1:00 AM LOW LOW 4 NDNE ALARM TIMEOUT 68 HIGH LIM ON LOW LIM ON HIGH HIGH ON LOW lDW ON WATER LIM ON LEAK LIM ON SYSFAIL OFF THEFT DN RELAY TIMEOUT 15 HIGH LIM:. _ . OFF LOW LIM OFF HIGH HIGH OFF LOW LOW OFF WATER LIM OFF LEAK LIM OFF SYSFAiL OFF THEFT OFF STD ALARM. ALARM I ON ALARM 2 ON. ALARM 3 ON ALARM ~ OFF ALARM 5 OFF ALARM 6 OFF ALARM 7 OFF ALARM 8 OFF LOW 1 NONE LOW 2 NONE LOW 3 NONE LOW 4 NONE HIGH WTR 1 NONE- HIGH WTR 2 NONE HIGH WTR 3 NONE HIGH WTR 4 - NONE :HIGH; i NONE HIGH 2 NONE.:.:... HIGH 3 NONE HIGH 4- NONE HIGH HIGH 1 NONE HIGN. ..HI6H 2 NOP~E Hd 6Fi' '`W I GH 3 " NONE -HIGH HIfiH`°4 NONE SYSTEM FAIL NONE STD 1 ~ GL"`tom STD 2 ~~ PF6t#E 'STD 3 ~~ ~$HE STD,. -4.._.... ;:;NONE:;,::::-.--. STD 5 NONE STD 6 HONE STD 7 HONE STD 8 NONE 2~23f2887 18.09 AM ALARM REPORT 2j23i2007 1009 AM M.6, SUMP LUCKY 7 NO.B 2601-S0. GHESTER AUE. BAKERSFIEL©`~ CA;=9338.4 SITE # 895 836=1794 .:. - 2o23f2807 10:iQ.AM ALARM REPORT 2f23~2@07 10:10 AP9 S.U. SUMP LUCKY 7 NO,$ 2601 S0. CHESTER AVE. -BAKERSFIELD~ CA 93304 SITE # 805 836-1794 2~23~290~ 18:20 AM ALARM REPORT 2!23!2987 10:20 AM S. tS. SUMP LUGKY 7- MO:B - .- 2691 S0. CHESTER AVE. BAKERSFIELD~ GA 93364 SITE # 805 836-17'94 i~23/2697 16.23 AM ALARM REPORT 2i23E2807 10:23 AM -'- R` lG> S-UMP LUCKY 7 N0.8 2601 SO. CHESTER AVE. ;- BAKERSFIEl.D, CA 93304 ``SITE # 805 836-1794 - 2~23~2907 16:23 AM ALARM REPORT 2~~1'~S~~KGN~STkR$AVE. BAKEF~SFIELDr CA 93384 SI:E ~ 50S 536-1794 Zr16f2O87 12:34 Pt9 FtLAkM~.,HISTO RY REPORT: 2x26/2887 12:88 Pt9 1•t.r. SUMP 2r26~2987 12:89 P~1 st~t. C;. SUPfP 1x26<2887 12;81 ~M t+t. G. SUt9P r26r2887 12:83 F"M r~..~~. SUMP 2r26r2097 12:85 P[h r~. G. SUMP ~r26f2887 12:11 Ph! tt. r . SUMP 87 ?rf~~F~28 12:15 Pr's M i1. 6. :3U17P .. ?!2tr2887 12:16 Ph1 ~ [,. `SUi9P %£6:2887 12:22 PM r~. S. SUMP {r26~2O67 12:22 Ft•1- 'l. ~s ~ SUMP 2i23~2697 19.•23 AM Pt, 6. SUMP 02-04-' 05 10;11 F1~0[~-Fleet Card Fuels 661-323-0126 T-154 P03/10 U-476 ~~ `~"-C.il _ ~.llll~' .., ...._ Q~+ID~IItAVH7 ef~ll/ ~~ff3~'~ ",l16N~ lii~ia'OtL-l/lfl~l~'diN ~~l-! o Gr. ~1-~aat Tba~k yatt for selecti~ag Cal.-Valley Equipment as your Y]~ignated UST Operator. Beginning January 1 a, 2005, CVE will schedule a UST Operator to yotu site on a tenthly basis. The 4'~ 'Y'bnradav of e$cb~ momth at:x;QQPM Please have available at your l~ visit the required documentationhecords far your site. Training Sor your em~ployees/sta~w%ll begin May 1 ~ ; 2005.Enclosed you will also find the Sarin needed to be tilled out by you and sent by you to the approprriate agency. This must be sent to the appropriate agency by January 1", 20Q5_ If you have any questxoz~s, lalea.sc don't hesitate in calling the Compliac~ce Department. Cal-Valley Equipment Compliance Department ~7~pE'PLeI~Ce Q~~ Knowledge Comm~tr~t~nt 1 i ~ .. 08/01/2006 14:35 6613252529 CAL VALLEY PAGE 01 =~_. CAI= VALLEY EQUIPMEI~IT 3500 ~fLMdRE AVE. BAKEFtSF1E1.D, CA 93308 ` . ~ . {6G1)327-934? FAX= {667}32a-2529 ~' ~' CQNTRACTdR'S LIC.#784770 A HAS ~'_ pro: .1~ ~= d~ ~ .~~.. ~' (~ Frog,: F~~ ~ ~~d2 ~ ~ ~f f Pages: ~ INCLUDING COVER Art: _ ~~iC1.P. (.r(1Y_ flR Date: g/1 /fl ~o Re: CC: ^ Urgent O For Review ~ please Cametent Q Please Reply D Fle~sse Recycle Comments= ~~~ -- ~1P~I ~ 08/01/2006 14:35 6613252529 CAL VALLEY PAGE 02 CAL VALLEY IzQIfIPAAENT 35tH} Gilmore Are .. Betcersf~eld. C.a 933Q8 6Bi~327~9341 Fax ~s~-~x~-zsas 1MP~SS~D Ct/FtREIVT CATHGryIC JaRQTEL`T7iDN C!!i~?7AC~1Ti411f DATE; ~ l Q~ 51TE: ~ ~~~ PHONE: ~~.#~~ ~~~=. .. .T~:,~7~ec~y; ~ rnsta~ation Late: Modal ~ ~ t~erisi ~:~~LZ~~. Hours: ~~~ fie: .,~/ Rmps: _ S` Adjustment•~ ~~ ~ Course: ~ Fria: ~ - Str~chue 'bo doll Paffirttlai Readdings Pqr Previously Installed Sysl~emna (System t7~tf ) attk Tank Fuel Product Vent 5 or E Center N or W Electronic Number Sipe T Ltrie Llne End of Ta u# Tank End of Tan Cor~uik ~~ ~0.$2 --p• .~~& -p• zs~ Z Stru~ure tv Sail Rotaentlst Readings Far i~revpaetsly Igstalled Systaem$ { Syst~tr pn ) rodaCt Vent S ur E ~ Center Nor Line Line End of Tan of Tank Errd of • 67 --0• -~ (•t ~ .n .s~ •zs~ l herby fY that the mlr~itt'rurtt system potential requirements fdr Impr'essacl CumerK Cathodic Pfjot@ctlgn: e Have Baer Met Have Nat Been Mat for the systems refer+eneed agave: taken in e~oCOrdance wifh the rrtilnimium standards of the National A-ssaclatlan ai ru~siorr Engineers, and as dune to comply with EPA end state Dir+edNes ~~ ~ ~~~~~ Technk~ran Perfuming Test RESERVE TIME SHEET Name Starting Time Station Apparatus No. Departure Time Company Officer ACTIVITY LOG Alarm Finished Activity Incident No. Time Time Note: All Training is to be recorded on an off-site Training/Drill Report and attached hereto COMPANY OFFICER'S EVALUATION Skill Interpersonal Relationships Knowledge Attitude Work Habits Personal Fitness Learning Ability Safety _ Rating Scores: i-Unacceptable, 2- Improvement needed, 3- Standard, 4- Above Average, 5- Outstanding ~ Comments: Please substantiate ratings Signature Date Distribution: WHITE- Training, PINK- Reserve FD1554 (rev. 12/92) PARAQON PRINTING Bakersfield Fire Dept. 2101 'H' Street Bakersfield CA Shift Date Total Hours UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. '~ e r H B R 9 A I D wi~~ ART/1 1 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 ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANKTIGHTNESS TEST ^ 70 PERFORM FUEL MONITORING CERTIFICATION ~ Cathodic Protection Testing SITE INFORMATION FACILITY Lucky 7 #8 NAME 8 PHONE NUMBER OF CONTACT PERSON ADDRESS 2601 S. Chester Ave. OWNERS NAME Same OPERATORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS 1 87 UL 2 91 UL TANK TESTING COMPANY NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341 MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308 Bruce W. Hinsley 661-327-9341 CERTIFICATION #: 006-05-1178 DATE 8 TIME TEST TO BE CONDUCTED AUgUSt 1, 2006 08:00 ICC #: SIGNATURE OF APPLIC ~ -y.~ DATE July 26, 2006 APPROVED BY DATE FD 2095 (Rev. 09/05) ~, ti~ v~ v~ ,~° y ~ UNDERGR®UND STORAGE TANKS O° . ;,.._.._ ,` .,,~, ~ R~F'~' T.~ ~'`~' ~~' . ~~~~-~~:.~~-~~+ra4~:~~: ~~,.tt~~r= -y'~a ~ , - &'.Y~3'1$1(AII s~+iaY I~1S°~~ ~ ~ ~~ ~;° ~ ~Y~ .* ~` 900 Truxtun Ave.. Ste. 214 PP~~~~~~ ~:; ~~,." Bakersfield, CA 93301 TO PERFORR4 ELD 1 LINE TESTING Tel.: (6F>1) 326-3979 / SB989 SECONDARY CONTAINMENT TESTING Fax: (661 852-2171 !TANK TIGHTNESS TEST AND TO PERFORfl~ FUEL MONITORING CERTiFICATiON Page 1 of 1 PERMIT NO. ~ ~ - O3 ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTWG ^ TANK TIGHTNESS TEST ~I TO PERFORM FUEL MONlTORIPlG CERTIFICATION ~SITi' INEORiV1A-ION ~'~ ~FAClLITY N,&E1t1E & P!?ONE I'.UR~IBER OF CONTACT" PERSON ! `~ ~~ (~f~l-83b- i~tq~ ADDRESS ~ ~O ~ ~ ~~ „ ~ ~ 3 3 D OWNERS NAME ~ ~, i !OPERATOf~S NAPv7E PEfi~71T TO OPERATE NO. I I ~ 'NURABER OF TANKS TO BE TESTED - - -_ ~ ^_ YES ___ ~ NO ____,__,__,____._ I IS PIPING GOING TO BE TESTED? _ _ ~ TANK# -------G _ ___ VOLUME i CONTENTS I ------- -- ------ ----- ------~ ! i i ~oK ~ ~l I ~ cotL ~-~ 3 ~. ,----- , ----- -------------1_v <<- -----___-.-- 8 ------ --- i TANK<TESTIi~G`COil1PANY DAME TESTING COMPANY INANE PHONE NUMB R OF CON"!'ACT PERSON / q p--- -_- i ~ ~ -l0 l fJ ulA1L1NG DDRESS ~~ ~ s t~~ Ba.Je~l.ot,~l . Cr'~ q 330- ! TAME & PHONE NUMBER OF TESTER OR SPECIAL SPEC OR CERTIFICATION #: ~I _(.~Qyc~~, (o V I -~3~- ~ R 93 ! ~ 3113° S~ SATE & 1ME TEST TO BE CONDUCTED ;ICC #: EST PviETHOD .~~d-~., ~~.ua.~.a, Jo,aoo(~ Ia,:ooP/~'~ 15~ y89~~-ur itGNATURE OF AF~LIC~i~d~ff /~~~ ~~..~ DATE ~ ~ - 3 ~ - O APPROVED BY ~ `y/, , / /~~/,Q/,~},~ ) !DATE ~ /C/h ~_ FD2106 6 F/BE ARTM RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Prevention Services 326-3653 2101 "H" Street Bakersfield, CA 93301 OFFICE: (661) 326-3941 FAX: (661) 852-2170 RALPH E. HLTEY, DIRECTOR PREVENTION SERVICES FlRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 OFFICE: (661) 326-3979 FAX: (661) 852-2171 David Weirather Fire Plans Examiner 326-3706 Howard H. Wines, III Hazardous Materials Specialist 326-3649 May 15, 2006 Saleh Alnajar Lucky 2601 S. Chester Avenue Bakersfield, CA 93304 I~MINDER NOTICE Re: Deadline for Three "~"~ar Cathodic Protection Certification Dear Saleh Alnajar: Our records indicate that yoUl` three year cathodic protection certification is due on 08-03-06. This test is part of your leak detection system as stated in Section 2635 2(a) of the California Code t1f Regulations, Title 23, Division 3, Chapter 16 Underground Tank Regulatlt511s. Please make every effort to have this completed by the above-mentioned date. Failure to comply may result in further enforcement action. Should you have any questi~lls, please feel free to call me at 661-326-3190. Sincerely, Ralph E. Huey, Director of Prevention ServiC~s ,, By: Steve Underwood, Fire Prevention Ofia~er REH/SU/db ~. - - w .. 1' MONITORING SYSTEM CERTIFICATION For Use By Ail Jurisdictions Within the State of Cal'rfomia Authority Cited: Chapter 6, 7, Health and Safety Code; Chapter 16, Division 3, Td}e 23, Calffomia Code of Regulations This form must be used to document testing and servicing of monitoring equipment..A separate cert~cation or report must be prepared for each mondonnp system control Dane{ by the technician who performs the work. A copy of this forth must be provided to the tank - _. ' system ownedoperafoc The owner/operator must submit a copy of this form to the total agency regulating UST systems within 30 - days of test date. A. General Information Facility Name: Lucky 7 # 8. Bldg. No. Site Address; 2601 South Chester Avenue City: Bakersfield, CA Zip: 93304 Facility Contact Person: Akhem CoMaa Phone No. (661) 836-1794 Make/Model of Monitoring System: Incon TLS-1000/4P Dafe of Testing/Servicing: 1 / 2~/ 06 B. Inventory of Equipment TestedtCertified rtie,.4 ttia ~.,........;~to t,.,,,o~ f.. ~.,.~~~~ro o... a...,,om ~.,~.,an~fr~c.,~~on~ - Tank ID: T-1 Su er - - - Tank ID: T-2 Pius X in-Tank Gauging Probe. Model: ' Incon Lt2-101 X^ 4n-Tank Gauging Probe. Model Incon LL2-101 Annular Space or Vautt Sensor. Model: Annular Space or Vautt Sensor. Model: X Piping Sumplfrench Sensor(s). Model: Incon X^ Piping Sumplfrench Sensor(s). Model: Incon Filt Sump Sensor(s). Model: Fill Sump Sensors}. Model: Mechanical Line leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overtill /High-Level Sensor. Model: Tank Overfill / Higtt-Level Sensor. Model: ^ Dispenser Containment Sensor(s). Model; ^ Dispenser Containmem Sensor(s)_ Model: , ^ Shear Valve(s). ^ Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s). ^ Dispenser Comainment Float(s) and Chain(s). Other (specify equi mem type and model in Section E on Page 2). ^ Other (specify equipment type and model in Section E on Page 2). TanklD: T-3 Unleaded TanklD: Q In-Tank Gauging Probe. Model: Incon LL2-101 ^ In-Tank Gauging Probe. Model: Annular Space or Vautt Sensor. Model: Annular Space or Vautt Sensor. Model: X Piping Sumplfrench Sensor(s). Model: Incon Piping Sump/Trench Sensor(s). Model: Rt{ Sump Sensor(s). .Model: _ Fill Sump Sensor(s). Model: Mechanical Line Leak',Detector. ~. Model: Mechanical Line Leak Detector.. .' Model: Electronic Line LeaK Detector. Model: Electronic tine Leak Detector. Model: ^ Tank Overfill /High-Level Sensor. Model: ^ Tank Ovefill /High-Level Sensor. Model: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensors}. Model' ^ Shear Valve(s). ^ Shear Valve(s). ^ Dispenser Containment Float(s) and Chain(s). ^ Dispenser Containment Float(s) and Chain(s). ^ Other (specify equi ment ty a and model in Section E on Page 2}. ^ Other (specify equipmem type and mode{ in Section E on Page 2). DispenserlD: DispenserlD: ^ Dispenser Containment Sensor(s). Model: ^ Dispenser Containment Sensor(s). Model: ^ Shear Valve(s). ^ Shear Valve(s). Dispenser Containmerri Ftoat(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). Dis enser 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: e Shear Valve(s). _ _ ..,.. ^ Shear Valve(s). Dis nser Containment Float(s) and Chain(s). ^ Dispenser Containment Floa[(s} and CFtain(s). ~~ u~r racuny wrnaurs wore ranRS yr aispensers, copy this rprtn mciuae mrormatwn for every tank ana aispenser at the tawny. _ C. Certification - I certify that the equipment identified in this document was inspectedlserviced in accordance with the manufacturer's guidelines. ` Atfaefted to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, !have also attached a copy of the report; (check al! that apply} : [] System set-up ~ Alarm history report Technician Name (print}: Jim Atbitre Cert.JLic. No. 532878 A HAZ Si re: Testing Company Name: Redwine Testing Services, Inc. Phone No. (661) 834-6993 Page 1 of 4 y , Y 1 Monitoring System Certfication D. Results of Testing/Servicing Software Version Installed: X Yes No' Is the audible alarm o ~onal? X Yes No' Is the visual alarm o ational? X Yes No' Were all sensors visuaft 'sns ed, functional! tested, and cociEmted o rational? X Yes No' Were all sensors installed at lowest point of secondary corrtainmern and positioned so that other equipment will not interfere with their ro r o ration? Yes No' If alarms are relayed to a remote monitoring station, is alt communications equipment (e.g. modem) operational? ® WA Yes No" For pressurized piping systems, does the turbine automatically shut down if the piping secondary wntainmern X^ NlA monitoring system detects a leak, fails too rate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (Check a!1 that apply) ~ Sumpfirench Sensors: ^ Dispenser Corrtainment Sensors. Did you confirm sitive shut-down due to leaks and sensor failure/disconnection? ^ Yes; No. X Yes No' For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no mectianical ^ N!A overfill prevention valve is instaNed), is the overfil{ warning alarm visible asxl audible at the tank fit{ points} and o eratin ro rl If so, at what ercern of tank ca ac' does the alarm tri er? ~ . Yes X No` Was any monitoring equipment replaced? ff yes, identify speafic sensors, probes, or other equipment replaced and fist the manufacturer name and model far a{I re tacemern aAs in Section E, below. Yes X - . No` Was liquid found inside anysecondary cornainment systems designed as dry systems? (Check all That apply) Product: ^Nater. ff es, describe causes in Section E, below. Yes No' Was monitorin s stem set-u reviewed to ensure o r settin s? Attach set u re rts, rf a ticabfe. X Yes No' is all monitoring equipment operational manufacFruers specifications? m Section a below, descnue now and when these aencrenues were or wtu be correctea. E. Comments: Cateaorv Form SIN T-1 Piping Sump Incon NIA Tank Probe TSP-LL2-101 570835 T-2 Piping Sump Incon N/A Tank Probe TSP-LL2-101 510218 T-3 Piping Sump Incon WA Tank Probe TSP-LL2-101 510117 Beaudreau 404-4 54529 Beaudreau 404-4 54505 Page 2 of 4 03!01 ,` ' G. Line Leak Detectors (LLDj:neck this box if LLDs are not instaned. Complete the following checklist: Yes No* For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? ^ NIA (Check all that ap I Simulated leak rate: ^ 3 . .h.; ^1 .h.; ^0.2 .h Yes No' Were all LLDs confirmed o rational and accurate within r ulato r uirements? Yes No" Was the testing apparatus property plibrated? Yes No' For mechanical LLDs, does the LLD restrict product flow if it detects a leak? N/A Yes No' For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A Yes No' For electronic LLDs, does the turbine automaticall shut off if an N/A or disconnected? y y pomO° of the monitoring system is disabled Yes No' For electronic LLDs, does the turbine automatical shut off if an N/A or fails a test? ty Y portion of the monitoring system malfunctions Yes No' For electronic LLD, have all accessible whin connections been visual) ms ~ N/A g Y pected . Yes No' Were all items on the equipment manufacturer's maintenance checklist com )elect? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 4 03101 F. In-Tank Gauging 1 SIR Equipment: ^Check tnrs box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ..~V~..~a dui aygaC[n L'ertifcati®n UST 1V1®nit®r°in~ Site Plan Sate Address: ~Q~ ~~ ~-~~~~=~ ~ ~ . .t~~}P~3~ =-~.~ ~. ~. . . .i Date map was drawn: / --- -C~ .~. .~.~.. i~ . 7~ . . ~- i .. Itastructions If you already have a diagram that shows all required information, you may include it, rather than this page, wfith your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring kank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or. electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space pro~~ded, rote ttte date this Site Plan was prepared. REDVVINE TESTING SERVICES, INC. P.0. BOX 1567 ~ BAKERSFIELD, GA 93302-1567 PH (661) 834-6993 Fax (661) 836-3177 Email: redwinetestC~prodigy.net Tank and Pipeline Compliance Experts Testing ®Installation ®Removal ®Closure Monitor and Cathodic Protection Testing MECHANICAL LEAK DETECTOR TEST WORK SHEET w/o#: License No. A-532878HAZ HG No. 415 RG No. 5761 Facility-Name: Lucky 7 # 8' Facility Address: 2601 South Chester Avenue, Bakersfield, CA 93304 Product Line Type (Pressure, Suction, Gravity) Pressure PRODUCT LEAK DETECTOR TYPE TEST TRIP PASS sERIAL # BELOW PSI OR 3 GPM FAIL UD TYPE Red Jacket YES PASS 87 SERIAL # 012-560-2 NO YES FAIL UD TYPE Red Jacket YES PASS 89 SERIAL # 012-560-2 NO YES FAIL UD TYPE Red Jacket YES PASS 91 SERIAL # 012-560-2 NO YES FAIL UD TYPE YES PASS . SERIAL-#-- ~-- -- -- - NO FAIL I certify the above tests were conducted on this date according to Red Jacket Pumps field test apparatus testing procedure an limitations The Mechanical Leak Detector Test pass /fail is determined by using a low flow threshold trip rate of 3 gallon per hour or les at 10 PSI ( acknowledge that all data collected is true and correct to the best of my knowledge. Tech: Michael Moore/Jim Aibitre Signature: ~ ~ ~`~"~ Date:1/10106 r~< Ti~v? E [ct::~ ~ r~ S L. ~Pn . ~~° _:'.'.;-~Jj ;~, `~ °_... ~C a'.~rl!T _ ~~ ~_ ~, ..~~,,.~ > .ter- n~ ~:-~w~.tD'_=:~;XDti~.,!:v~. ~ _i\=--..-;ny~ s o`er-989Jtv!Jt~=.SV~ ::~~~ =.!.v"i_i~ _~.~~~C -__ ~~~-5~~ ~ ~ ~ cc~ ~ ~~ ~' ot:~ L~ ~.`-.i~r~J .~. 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'~A :%ti J' sang ~,L ~ , ~ ~~~ tII X~.I'II~T~,~ // ~.L~a . ~~. .:,; ~>>y .;~,~ ;~ .:,: ~.rt.~.. ~~..' ~: . .. -~ DATE . FAcY~, m ., FACII.TTY AITI ', ;; . ~~ UDC'~'ES'fiNG ,:+: . .; r,- ,;..• ~.~ ~,. , . ... ,,. :,: ~,:.: '. ,, . ;': ,.~ . ~. is :, :; ..;. SECOI~Dlt~Y SYSTEM CER'E'iFiCA'~`ION FORM Dl~~• • :bI5F'ER 2 DISFTNSER 3 DTSPENSE~i 4 START TIME O _, ~ ::O 1'IVI'TIAL 1'~GR'T OF 1~VATER • ~ yl,~. ~ .':. .~ t 1 ~ '~IMR O~' ~NA7LR ~~' 9y~~~ : ;,~ 'k[ME Dq ~~ ~p i'PATSR ~GRT ~. 3 ~ i.a~~;~, DbS~'`~ ~': ° I~[SP~'ER b , DTSp'ENSER 7 DISPENSER 8 START T~ ~NiTUL , . HEIt~AT DF • WATER TtME ~YATER $EtGRT . 'I~1~ ~ WATER '~ HEIGHT ~ . j ~Cb1t'Z'I!'iCA't'10~t G~NI-TUR$) .. jlyCrt --~._.~ Pale 3 of _ tfNDERGROUND STORAGE TANKS ; `'~ ~,~, ~-;~ B - H R 3 P ~$~L D ~er~~ ~ ~l APP~tCATfON ~~~~'~ „ ~,.; TO PERFORM ELD /LINE TESTING ~~ / SB989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. ~ 1 ~ ~~ BAI~ERSFIELD FI]l~E DEPT. ]Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DETECTION ^ LINE TESTING ~ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ^ TO PERFORM FUEL MONITORING CERTIFICATION _ _ _ I~FACILITY _ SLT.E INFORMATION _ __ __ NAME & PHONE NUMBER OF CONTACT PERSON DDRESS a o ~ ~. cA 4~~30(~ WNERS NAME PERATORS NAME PERMIT TO OPERATE NO. UMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? YES ^ NO TANK# ~ VOLUME CONTENTS 3 AM F TESTING COM ANY TANK TESTING COMPANY NAME & PHONE NUMBER OF CONTACT PERSON to ~ " AILI G ADDRESS , a -~ 9 3301 AME & PHONE NUMBER OF TESTER OR SPE L INSP GTOR ERTIFICATION #: ATE TIME TEST TO BE CONDUCTED ~ a3 ao~ ~ ICC #: S ~a~l ~- u-~ EST METHOD IGNATU E OF APPLICANT .~t DATE I ~ _ r~ _O ~ A ~. 1®i B ~ IV~~S A (~ PPROVED BY 1 ~ '. p ~;;i",y f DATE ~ ~ Q o FD2106 ~d~~E~aC~E~flE~~iD STOF?~~E T~4diiS ~`' ~~-~ a~ ~ ~ ~ '~~ J00'~'~~n ~ve_, See. 2 ~ ~J ~~~~~~ ~, ..~ Ba'>tiers~el~, ~A 933x1 To PE~FO>~s~ ELD, ~s~E TEST4P~€a Tel.: (331; 32G-3979 ,r sss~s ~~co~~A~Y coy oAT~ti~E~T rES T ~~~;~ ~'ax_: (6~ 1 ~ 852-217? ,`sP,i+TTf TsGFTT~TESS TEST AhTD T~ PE~~=CR~,~ ,=EEL - ~C;NfTG41?~€fa ~E~.`~.T4ET~r$TI43?~: page i pf .~- '~ ~ ~ PER~,~fTNO. L 1 D2(o ~ ^ =NHnNCED LEAK DETECTION ^ ~ INE TEST}NG ! ~ S8-989 SECONDARY CGNTA!NivTEN I TESTIivG TANt TIGHTNESS TEST ^ TO PE"-'.EORf4i EUEL i`!jOM!TORiIG CERTiF;C~'1 I iOf~' ^ _ _,_, p:4CILiTY - ~y -{~-- -- ------ ~'~;aa+:(E ~ ;=~0s'~E t~U,dT~?.~sR /OF ~:GNTsCT f~'ERut7.~' ` ~ ---- - ( 1~ IA.P~ t~l i -` ~ ' r.A.~ ~ o nti-. lv~o ~ ° ~ :~(o ° l ~ ~ `I ?DRESS NiNERS NAP/iE a~E1r~TOS:S F~~.1f,E i~'e_n~rT[T TO ~3FEs=i:=.TE?~C•. /~ _ ~ _ST~D _ IS . I ING GCING TO B_ T_S - --' --- U~nBER GF TAN TA, ~'ati` i'i`T~ c ------- -~ P_-- VCJ~ ~~9E cD? ------------ ~ ~FS -- ----~ ;JG ~ETpa~~-~-(' ---- _------- ---- -- -- ---- --------- ----------- -- ----- ------- ~------___._._ - - __ --t, O ~: T ~ tai 7S --~--- U - -- 3 - - -- al-ali~wr. nqa-p_~ !(t~ _[~ 'fitt+n n qpp~~~[ _.,, f t "cn haI airy Y- ~~dd41'iiLii/1- T~JTI}YG l.V~l M~5 C -_. _ __ Ifl~~yr.^ +~µ '7.L. G.Y3..: ~5 Z ~i163 Ee J~'. '4~i L•FY Y, 1. 1 ~}Y'+ /'Si :t ~ ..'-~ _~e~.u-t~-2._ ~ n-C.~ ~ ~v 4 - ~' ~~- ~ raifAlL4!~Tu ADl7RESS d ... i 1 ~~~ ,,~~ - C~ ~ 338 ~ NAgiE ~ F fO~fE NtikV18ER OF TESTER OP ST3E ~iL ;{VSPi=CTOR DER f IEiCATiON =- DLSTE TTNTE TEST TO EE COPa'DUCTED j°CC =~ TEST ttETl-fOD ~ ~3 X40 ~ g ~~~ ~ a~ ~ -- ~-~-- ~ -~ ~fGNATtT~E GE APPLiCI~" ~ iptlTE ~ ~ -- e-~ -O'~/ gFpRGVEDBY _~.iXPO ~VON~DIOJ'I'li' 1 'DATc I/I7I~ r~%?Oc .~ ~1-~- DATE Bakersfield Fire Dept. PREVENTION SERVICES Fire Safety.Services • Environmental Services 900 Truxtun Ave., Suite 210 Bakersfield, CA 9330 t Tel: (661) 326-3979 USTIA :PERMIT, TANK• TESTING G~1!`".~ ('~ 82 i STATE SURCHARGE 86 ERMITS 84 TENTS, LPG, FIREWORKS, POWOER/OTHER P COPIES/REPORTS 89 FOLLOW-UP INSPECTION INSPECTOR: GATE TIME SPENT: CHARGES: ~°~ CHARGES CODE: REASON and DATE l FOR INSPECTION: LOCATION OF, INSP ~ `, ~ ,,..,J V s.,. F~^ /_ n ~ 'K.3 BUSINESS N TELEPNONE NUMBER(S): '~~. BILL TO: PAY BY: ~ ii _,,..11....~^' ~ .~--~-F 9 `~ fir` /~ f't '~ NOTES: .,~.. ~- t '~.,. CUSTOMER SIGNATURE: I~SPECTOR/RECENER SIGNATURE? ,µ '~,~ F"`} "~-~"L .f k.r'~~ ORIGINAL WHRE: FINANCE CUSTOMER PINK OFFICE: YELLOW FD1734 a .12/03) F/RE AR1M T RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Prevention Services 326-3653 2101 "H" Street Bakersfield, CA 93301 OFFICE: (661) 326-3941 FAX: (661) 852-2170 RALPH E. HLTEY, DIRECTOR PREVENTION SERVICES FIRE SAFETY SERVICES • ENVIRONMENTAL 3ERVICE3 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 OFFICE: (661) 326-3979 FAX: (661) 852-2171 David Weirather Fire Plans Examiner 326-3706 Howard H. Wines, 111 Hazardous Materials Specialist 326-3649 December 1, 2005 Lucky 7 2601 S. Chester Avenue Bakersfield, CA 93304 FINAL REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31, 2005 of Underground Storage Tank (s) Located at the Above Stated Address Dear Valued Customer, Over the last six months this office has continued to send reminder notices regarding secondary containment testing. Code requires that all secondary containment systems must be tested 6 months post construction and every 36 months there after. Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Health & Safety Code) of the new law mandates testing of secondary containment components upon installation and every 36 months, thereafter, to insure that the systems are capable of containing releases from the primary containment until they are detected and removed. Our records indicate that your facility is due prior to December 31, 2005. Those sites that have not been tested and have not pulled a permit prior to December 31, 2005, will have their permit to operate revoked. This office does not wish to take such action, which is why we will continue to send monthly reminders. Contractors are already booked several weeks in advance. I urge you to schedule your testing date as soon as possible to avoid possible revocation of your permit to operate. Should you have any questions, please feel free to call me at (661) 326-3190. Sincerely, RALPH E. HUEY, Director of Prevention Services ~c~ Steve Underwood Fire Prevention Officer SU:db J~ >~ fer~ai~p ~ ..~~vt~ ~J~ ~~~~~~ •,