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HomeMy WebLinkAboutBUSINESS PLAN ~' ,~ ~~ ~~ ,~ `a a. ,, I~' ~. .;'~~ ,~ i ,~ _d _ ~,; ~, ~~ CHEVRON SERV STA #zo3s~6iisaa - - - - ~~ ._-.-__ __.___, _ _.__ _ ..~~_~ T . ~,__ ~ 1125 COFFEE ROAD ~ ^ ;; ~, 1T~ .= V r ~ ~ ~ Prevention Services I~NIFLED PROGRAM INSPECTION CHECKLIST'; R F R S F _, ,- n 900 Truxtun Ave.;'Suite 210 • F-RiE Bakersfield, CA 93301 SECTION 1;. ~ Business Plan.and Inventory Program aRrM Tel;: (661) 3z6-3979 i Fax: (661) 872-2171 FACILITY NAME ~ ~~ INSP rCT N DATE INSPECTION TIME . ~~~ ADDRESS ~ P NE NO. NO OF EMPLOYEES t 5~~ ' 9`© FACILITY CONTACT - BUSINESS ID NUMB 15-021- ~~~~ ~I ^ ROUTINE i Section 1: Business Plan and Inventory Program BINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION ` -` C V (C=compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ` / (9~ ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE SI~ ( ^ VISIBLE ADDRESS - / Lkd~ ^ CORRECT OCCUPANCY (SV ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES 4 i~^ VERIFICATION OF LOCATION ~ T ^ PROPER SEGREGATION OF MATERIAL l~^ VERIFICATION OF MSDS AVAILABILITY , . ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES I~ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED _ ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN: QUESTI01~;6 REGAIjpI~G THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 (Please Print) Fire Prevention / 1" In /Shift of Site/Station # i White -Prevention Services Yellow -Station Copy Pink -Business Copy ^ YES "~ NO FD 2155 (Rev. 09/OS ry* Sl, INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM - UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~'`ft1~'bN B E R S F I L D F/Ift E AIPTM T Section 2: Underground Storage Tanks Program 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: A~1~1-s~.L ^ Routine ^ Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of Tank I~ ~'C' g Number of Tanks 3 Type of Monitoring L` vlVl Type of Piping { UI 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 o Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: ~ Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services ~1..~ B siness Sit esponsible Party Pink -Business Copy KBF-7335 FD 2~.5U (ReV. 09/05) Emer enc ~ont~~t / : flit°le ...... . Em+~ac ez~,c Gon~act T.~Ie CH~SVR4)N I~INTENi~,NCE.: ~ ~ISPA~`CH.. ::. C~HEVRt}N- ~~GEN ... ~.: II~TF~ CENT.FR. Business ,PhUZne'z {866) 8~5 4254 Business: PhQize (SQp} . 231~4623x 2~-Ht~uir Pone 18fli}} .:~3~-~:6~3x. _ ... 24-H+aur P3~one= t:800~ 23I:~:tl~23~t Pager Pizone ... { ~ . ~ :.. X _. _ ... _ - Fader ~htine.. { . }. - . _ ~ . Hazmat Hazards:: :.. Firms Fares _ ImntHlth: ~elHltlr Can~a+ct C~E'i78.E}N .PRRN+IIT DESFC L23'~5 B-~ phone X925} 84Z-~0£}2a~: MailAd~r-: ;. .F4 BOX 6i~{}4 _... - . _ State, ~A:..... G t _. s~ u~ror7 ©wner ;CHEVRt)N PRODCTCTS :: Pnoxe . (:92 ~) :8~ ~ - ~ D p 2x . :Andress Fa $Qx 6~0~ ~_. . s~~~e ~t~ :::: c` S:AN Ra~M~itl . __ _ _ _ ~a:~i::: 94583: Period to: TotalASTs ;_ Gal! Pzeparer _. fiQta7.USTs, . Gala. Cea:tif' d: _. Nc Pa:r~~1No Emergezicy "I?zrec~v~s l .. __ _ . o~ ~ll~~c~~. s~z~ __. ` ~ CHEUhI. 24357.6 . III] It ~,S i~21-4t}1522` ( ' ~ ~ N ? , S` ? : S~ ?R~G~ : C3N ~ I ~3R:. ~LT A~~ ~ .:I ~RM ~1} I _- Last 13~t1.C)17,: +~ Ty~? - -- F~CI ~T f I E 'O TT ~AT _ _ . L Y $ T IN~ ~ t Business..3lame:; CH~~TR~1+T 2:43~~ Cress Street . Total Tank, 3 Ind~aR~s/fit;: Nca ~?A_ Cr~z~itac:~ _. . ~~~ (Jw~a/t3~ar ::.:MAURICE TI~NI~~N ICC N'bx': 5`25~2`:~1 UC Name - C1~i[.RC~I+i 'RGEL,T~Y .: Phone ~ ~`8Qt3 } _231-.0~23x Adaress_ City :... State:: Zip; . '~'YPe CC)RPflRATI4~i WN ....... ~T ~T t3 T~::fl ~R. FflR I N :I 'Alat~e . .. CH~SVR(~riT E1~RGE~C'~ Fhc~ne _ fS.f3(?~ ;23I {~S23x . Adclres City s~tE Zip; : 'rYPe C~JRRATTC3~ 9- ~'_a~~ At7TUMt?TIZrE .CAR . ASH_. LIQUID AI~KA:: ; :: ~ +; (? . 0 Q GAL. ~: i AUTY?M~TIVE C1~R STASH LIQUID :#,L~f'A _ . _ .. :. Ii: ;60.00 GAS F1Z_ . REGULAR tJI~TI;F~IDEU GAS~?i,~ _ :: F_ : ICI _ I7F~ T~ 32.0{} .:CkQ C,~L Mae"l: MIDGRc~1DE :~71!ILEADBD .G,A,SC~~INE . _ ... F _ ~H: 1~H L 12t}(}4..~:Q GAL: Nf~d SUPREME t3~3~.;EI~'f.)EI~.'G1~.SOL E~ TH': DPI :'Ii: - 12t}:E~t}:::..4:U: :GAL , .M~ti AUTOMC3TIVE I3ET~tGE Ft3R CAR WA L 3 3 ~? . ~ U: . GAti r~oa_ . AuT~~toTl s CAS ~rASx ~EG~rr ~ ~s v o o ~~r- r~oa:. AUT©M~?TIV~S Cam': '~~: I)~TGT L 11~ ~0 G1~I;. Mod AUTOMOTIVE :CAR T!TASIH- U~TBRGLNT _ . L L30 Q_0 GAL MoGI: -.. AUTC)Mf3TIVE :CAR :WAS~i ..CU~DZTIQNBR.:... L 63 .;00 GAL: Mod. cA~t urASx coLn _. _ ;y ~~ ~o: -GAL: rno~.. CLEAR _ :CDA'T::CAR WASH :PRSECT+3T. L _ ::6 0 ~.fl GAI Mod Q Px BLEAR coAT: ;~LV~ ~ s a:. 4 0 ~.~ Mod AUTl3MC)TIVE::.CAFt wASx_ PR~~~A~ nE~r ~ - . ~~ s ~~ ~raa ACJZ'4MC:3TIVE Z 'WASH: I]'A~NT SEALS: ~ 64 .0~ GAL Mod; AUTQI~IQTIVE: CAR WASIX PRESQAK; I3ET ::: _ I; 60 , {~Q GAL - Mad: AUTOMOTIVE= :CAR Tri'ASH: "I-IQUI]D ~F€I . _.. L - - - `6t? Ot# GAL Moc CARBOH . I~IUXIF3E F P IH G, 2429 _: {30 FT3 1~#xx _. , CAR- WASH .LIQL7ID ~IEHICLE ,DASH B~,. L:. 60 , Ofl -GAL Uri:F2:' cAS ~~~~~ ysz3oT# ~~ H~ ........ ANIC3L7iiT~ AT :THIS LQCATIt3 Larg~s~ C4ntex Tlaily:Maxmu~ _ L~~~~~ Average 3a3. flQ .GAL :. .. _ .. 6f3 :.t~Q .:GAL::: 1.~, 0~? ..:G~s ~ CH~VRQN Zf3 576 ..: 'S~.te~B t~:15 (~21 tJ(}15~2; Ix~verxtt~ry Item 40~1~ Fac_l~.t~r tl7t7t~t ~+~:~ed CozzC~ti.neris a.t S~.t G4MMQN AIAME / CHTCA:L NAME ,_ .. REGLI'L~t. U~LEAI3$D GASQL . - :... D~~ts° C7n...51~~, 8"7 C?CTANE .. 365. . Loeat~~n :u~th~:n: th~:s Fac~33ty ~n~~ Niap :. Grad:: ~+1 SIh~ ..C}F `:I~~ . _ ........ .... SAS #. . _._ 86.~.~:a-815 .. 5~'AzE: ~~:. PR~SS~:: ~Pi~C3R.E`: -.... . Cf~I~T~1~1R.'~'~'~E :...... Liquid 1~!t~t,tre... int.. A~ez~t - ~~I3~R GxoU~'n TANS +tC>UN'TS A`F' CIS L ~TIC N A3 ) : ~ fl _. Largest Corzt~a.ner ~}a~l~r P~ Da~l~ Average::: 12~QU . ~Q.:CAL I2~Qf3 :: (3Q..:. - 60QU::.43€3: GAii :. x~AR~u~ co~tPbr~rs ]:(IQ. QO GasQasne ..._:. _ No $6294815 4.90 _ Benzene _ _ Nc3 . 714 3 2 3 Otf Sthylben~~~ _ _ No T0{?4].~k 2.4f1 Napthalene _ R7a:.. 91203 : l E3 . Q O ~thantil :. - Nci~. _. 6417 5 ASSES~NIR~'~5:..... H~~ R33 .. : 1 T5eeret RS" :B~~Ha.z R:adioacta:ve/~i~nt~ EPA Hazards NFPA ~ IISDOT#~ A+iCI' N~ INt~=: =~ _ o j . yes= =~ - =~~ = ~f~- - . / / : f - =~ori= ...... ~-:7- ..::: _. 48~21~20:Ci.7: I~~US `CQi~FQI~f~TS RS_ 'CAS #~` .:...... No . . 86291381:5 N€~ 71:432 I3c. 1~t}0414 Na 9T2 ?3 No: 6417 5 -:.: ~ C~i~VRC3N ~Q3576 : _. S~.teTD ~3~a fl2Z QQ1522: ~; . I~ven~cax~ _Itez~ ~~ta3 F~c~:~~ty. €Jn~t. Fixed Containers at Sites ~ = Cc~r~aN CMZCZ~L ~ SL7PREi+2E LTAILEADEI~ GASDL~~E _ :_ .:::: Days: on site _ . _. 91 OCTANE.::.::.. :... 3 ~ 5 . . - _, I;ocata.c» sa~ithn tk~:~s Facil~t~ _ II~it Mafia - , . Grid : . _. W . S~D~ . OF T~t??T .. _ . ~AS#~: . 8629:0 81.=5.: : STA~`E..:: - .::APB :.............: FRE~S~RE '~FERA:2'tTRE .. CC}NTAINER TYFE.: I~1C~111d - 1~I1Xti,lrt3:... ..~tII1~31E31~ . <~2~21t ."." :: I~NI?ER :GROT3I3I3 ~~ , .. ~ ' T 'I S ~ ~S A;T #T LOCA~~ t I~ Larg~st.Contazn~r ~aal~ T~xmum: pa~.ly:Average _ 12QCt.b Qp. . ]_2 QO D.: ~ t~ ~A.L, . fi 0 0:~ , p 0 ...:G:i~:I .... . . ZA~3QI1~ £OM ONEA~T ___ _ i P :. ~Wt . _.:. ........ _ RS: .:. CAS#:.. . 1~Q.00 Gaso .ine No:. . 4 . ~0 Benzene _ ... _ ... __ _ NQ 71432 3 00. EthyZlaenzene No _ .. 1~JE?~14 2 Q0 Naphthalene; .Crude or _Re~ned , , ~Tc4:. 912;(>3: , 10 • QQ EtYa~oI: _ : N~ 6417`5: P ZAR AS~ESSNI£ NTS .. ........... . . ~:: H : ~ ..::. TSecret RS. :BiaHaz Radia~~tave/,i'ount ~ E~:?A I3azarrls NFPA ~ USIaQT# MCP. Nc~---= 1~Tc~ =RTc ~r~~_~____~~___Ct~ir~.e~ -F= =I~--T)H- _ / ~ / =Mt~d 4. may. Larq~:st 'Cvzta.~n~r _.. 55 . UO GAL AMC)IIIVTS P`~. TAT-S I,C?~PiT~C}I+~ 7)ai~~ Nt~cimum- : ~a~iy . &v~rage: . 110.: Qfl: ~ 25 Q4. G~iL FtS C'.~i.S# No ?7929 N~ ~515~3(} No 6763fl. No 647.4288'I No I34_Z4 9 T ,~ :.~a~.~ar~rvsa. TSecret RS 'B~c3Haz ~ta.cla:c~Gt~rejAmount. ~ SPA H~Zax'c7.s _. . A_ USDUT#: MCP:. CFI~QN 2t33:57~ F ~~~eI~7 t115 fl21 +D~25~2 ~ ~ Izven~.ory Item ~t~14 Faczl_i.ty Unit: F~.x~r3 +~onta:ners- at. ~~.t~ CONlM4N ~iA~M~'. CHEMICAL: 1~A1+ AtJZ'Z3MC?TI41'E :CAR WA~H_ I~ETFR~TN~= Dada Cri Site CWX. 3.~aa: - ECULAB ~+~~ .. . I~ocat2on ~ritl~x~a this F'aci3ty.UX~.zk Is~iap: £~d: CAR W~!iSH BLDG _ CAS# STATE TYPE FRES~t1R:B TEM'~?~fiCt~E _ ~~~INER.: TYKE Liquid Mixture Amk~7.e21t. Amhen.t 3)R~7A4fBARREL ~1~I~META.I, _. Largest Co~nta~ner T~aily~ mum Daily ~+ivexage: 5 5 tT:O GAL 11 {2..~.;Q 0 : _ :GAZA 2 5::; tf Cf GAL C}3T IS : C Z S _ ! T -~ ,.-.. HAZAR~tQC C 3M ` .. Wt ::.: IBS` CAS#: Z,{~U Potassu~ii H~rz~oxde-. -. 1+Tv 13.05$3 5 OQ. .SOdium Metas:illC~t~? ::::: NG1 ~i83~92:0 : ASSESS~ Z S AR~. ~ T TSe~ret RS Bz€~~ia~ Ra~3~vaCtzve/Amount; EFA €i~~arci;~ NFPA } ~ISDE3T# NICP ICI Nc~ +Te No< Ct~rzes= - - _ - -. / / / 1--~. MG?f~- __ ~ Ixven~;ary Item ~~59 FacY~.ty :Unit: Fixed Contam~rs a~. S~.te N AT C©MMQ 1~~ / C~IC ,::.N AUTOMC}TIVE: CAR : W~H . fJETERGE;NT' Dal.~s Cn: Site . . 3aCt~ItAB 38U BRESCAK :. : ~~.~ _.. _. LocatYCin -within this :Faeil~:t~r IInzt i~Ia~_ Grid:^ CAR. WASH $I;llG.: _ _ _ . _ . _ . ~ : ~#; . ~ S'rA:TE _ -~- ;TYPE- ----~-~-~-- PRESS~3RE ------~- T~'IPER~i.T[7RE : -~=---- CDI~'~A.INER. ~'Y},'E : -=---~ .~ .. rrru~rc~vua c.:vt~trvts~~t_~ : . °st~t .... _ . I2S CAS# 26 QQ St~l~ur~.c..Aczd f~~,~~ ~c~ '7.6:64939 2O . Q4 _. Noia::i:c~nc ~urfa~tant::Blend : : :.... : : :. No :: MT. XT.tTR ;t~xt~ x,~.~~ss~-~. Z'Secret: ~tS BiaHaz ~ar3a:~iactve~Rmo'EZa~~ EPA: Ha2a~ds.. NFPA: USUiJT# MCP ~~ . No Na .: .., _ Na j_ Cuxes ~ 1' / _ Mid E C?~ 2 ' 1 3 3 R t A~ VR tI 5 F C r 76 :. .~ .S ? ~~~ O ~~~~~; xnvezzto~r : z~e~im . t}ft:2°o Faclit~. Us~a.t Fixed `Contai.x~e~-s a:~ s~.t.~ ~ .. CflMMflN NA C~EMICA~ I 7 At+~iE , ME - : ti . A:UTflMDTIVE :CRR WASH. i3~s~'ER.G~ T)ays t'3n ~~.te ECQLAB ;C6JX '3688. FR~SL?AK _.... 35a .:. Location w~.t.~Zn t~i.s Faczla:~y TTi1it Map: Grid CAR WASH :BT3I~G: CAS:#.. a~TATE.. TYPE : PRESSURE T~E~2A'i'UF~,E Ct)1~TTAI~TEPt TYPE ..... Le~ttici Mixture .. Amk~~.erkt Arnb~ent .. I)RUM~~AREZ~EL-NCJiYMETAL ..... f1UI~S A ~1T T i~S Lfil~+ T _. . : ; . i IC3N ~ ~' Largest CQnta~.~.er - _. ~-a~ly Maximum ~a~7:~ Average°°. 55 _ fl~I GA.~ I1.Q ;:#~fl : G~ .. 25... OQ. fl.~L _. 2,(3 d U G1 `Sada.cz~i~i.:.~-Iydrox~de _ I3~a . I:31 fl 7 3 ~. ~. aQ ~}_Glucori.c ;~czd; :Sadzurtm Salt ... No 5274.77: TSecret RS .B~:c>Ha.z _.. ~cZ.E~3:QaG~I:~~~`iICi4>lIi'1~ EPA:: Haza~rs~;s :.. N~P~ ...: ITSIjC?Z'# MCP. No Nt~.: M~ fiio~. rtes .. . ~ ~:. ~:: _ Mod TSec~:et_ _ RS B3{aHa~ RadioaCta~t~Ji©urt ~P~ Hazards NF`PA : USDt~~# ~~P No N~ Na `3~[~ Curies .. ~ / ~... Mid ~ G~TEs"VRC?1~7 20376 . Si~e~D 4:15 X21 OQ15~2; ~ Inventory Item f?QU6 Fa~lzty. t3`t~.t:: Fixed Cc~n.t~a.ners. a.t : Smote ~IfIC AI~ ;NAME M ~ ~ . , CQ MaN. _: : `CAR :WASH C[3LT3 : WAX= - . i~y~? t3n : ~ ~ ~ ~ : E~f~T~AF3 : I)RYII~TG AGENT AND : aI~S _ENHANCER' FOR C:A.~S ... . 65; Locati€~x_ _wit3~~ this: Facila:t t3n~t_ . Nta ~ p. Grid.:..:. C'AR. WASH BLDG .. 0:235# . 111-76.-~: STATE TYPE PRESSURE : IPERA~`~3RE CE)~'AIN~~ _ TYPE Lqu~d_ ~4x~ure Am~z~ex~t . A~nba~nt ~3Ri~B~RREL 1r3aNTA.L. _. ADO AT ~'HI - CA IC? T Largest: E©n~ai~.er ~7aily Mmu~. I~a_l~i Average... 30.40 .~. 60 ;.E?(}.. GAL;.. - .. 2.S::Oq? GI~h:..: . . ~.I)t3U s C~MP4~EN~~ ,. : ~L~t RS: .: C:AS#: 6. Q.d __ 2 _Butoxyet~a~:csl NtS:. 1.117162 3QtI'4 r _.. Nt~.i~.+~ral Seal ~~1 :,~larzes:} 1~7© _ 647~428U~ HAZARD ASSLSSME~TTS TSecret RS B~oH~.z Radrsactite/F~nount ~ ' ' SPA. I~azards NFFA U'SIJ()T~_ _ MCP 111n ~1Tn 1Jn. A tn~ C 'iiri eaa 1 1 / Mnr3 ,. _. ,- ~ _ ~HEt~R~W 2 t?3 ~7 ~.~eD A15 4~ £~a1522 1 ~ Ii7v'ez~tory :Iterci (}4(37 Facr]it~r Unmet:: F~~ced Containers at: Site ~ . CO1~UN 1tifAMR CHEMICAL SAME _. - .. CT;F..AR COAT `~ ~+TASH' PRUTECT.A~7~ Z~ays On .Ss~e C.AR 6~ASH CQN'DITif}1±TER ECOLAB::LI¢UID : 65::. -: IiOC1~3Q~1 :W3t~II:Xi ~~23.5 F3o1I~'~" :I1ii3~- M&~; Gr-mod _ .::..: CAR Su1l~.SH _ BliI~~ - _ : - CAS:.#:. _ . . STATE.: TYPE : PRESSL3RE- TEERATC~~ C{~A~TATNER T'~PE Lqusc3 . Mixture= Arr+~erit dent= = 1)RL3A![ j~3ARREIs-N4AIA~#ETAt- QTJ~'~ AT TFI IA? A TS L TI Nt G S . CA Largest:: Can~~~.er Dai~:y Mart. i~!a~hy A~rerage ~~ oo ~ s~.~a ~: Zs.oo c .,_,~....,..._ ~A~r~QU~ :cQM~~s . swt _ . - - - . - Rs c.~s# 2 00 2-ButQxyetnaYo~ Nea 111`762 5 t7tl _. 2-Proganol ..... - _ _ _ Na ;6.730 5 ~?Q __ Msrie~al: eal C3i3: :;Vaxes:~. fiTo . : 64'7423t3` - -... H~ZAR13 .,~1SSTSSME~3'I`S . ; TSeeret RS B~oHaz RadioactvelAmc~u~:t= EpA F~az~rd;s ~~FP~--~- :-LTSD~T~ ~=MCF= Na__ No Nt~..... Nra/ Cu~~Ea:. - ~ / :~ .. MQd ~ Inventory :It~in t?t3fl9 Faeil.3t~r 'tl'~~.t:; Fixed Cz~x~.~.aaners at Site GQMM~}~ SAME ~ SIC N~iME LO PI3 _CF~` Ct?A?' BLUE Days . Qn::Slte ECC~LAB LIQUID AI3D CAR.. WASH -~(33~DIZ`lE}NER :.. ~ 65. : LoGdtion wx:~hn t~ix~;s Faeil:ty .Lln`~ :. I~ap. G~C`d : C`AR: WASH BI;i?G........... - - ..... _ _ _ . _ ....... _ .... - - .......... -. _ . C.AS#: . S.TATF .. T~'PE PRESSITRE . TENiPF4RAT[]R.E CQNTA~I~FR TYPE; Lau~.d Mi.~ture _ : .Amkiient Am=bient l?RtJM/BARREx, 2sTUNMETAL ,_. -.. AI!~~')UIdTS A'T TAIS~ Lt3C~i.TTf3N _. Largest :Container I3aily Maxnt~in Daa:I~ Av~rag 3:E? ~}~ ::CAIr.... 5:€}. X43 GAL:.. 2~: Cif. GA.L ~ARI}t3tT~ :Ct~+IP(SNF1~S _. 5 OO: Phvsphore Acid _ PTo 7~6438~ . _- ,.. HA:ZAR~] AS SESSNf +iTS .. TSeeret RS. SioHaz _ Rad~vactve f Auiezt . 8PA Hazards NFPA- LTSI~C3T#. MCP No .... No No .. ~ : .::. - Cures / ~ ! ~ Mod ~ GHE~7R0~ 2035?~ : ~~.~~~~3 {~1~ ~ZI 0t~:1~22. ~ ~rivezitory :Iterri :OQ11 Fac~:lsty .Q~zit_ Fzxed Containers at Site: ~ i ' _.. . NAARE ~I-IEICA~; 1 A CaMP?IC7 N AUTC3MC3~I~ CAR WAS~T PRESt}AK : D~TETtGE1tTT Days: C)~ ~.~e ECOT~AB ~YSTEA+i I{33:... _ .. . 3.~5 .. , . . I~r~ca~~.on w~t2i;:~ tbzs Raca.lty IIn~.t ~+tap : . . _ Grid.;; , WASH B~I}G - _ _ _ . _ - C~S# . S:TA.TE - ` :TYP:E PRESSE3~Is. T~PERATL3R$ ~C3NTAI~ `'T'~PH I2C~1'11:f~. 'M23Ct1lrL'.: ATClb1#3YIt : ~iI1~1:Piit' - ~~T~~$1~RR'LA~a-'I~7~~3I`~~'".~`~i :... . ~Nf~U TS fi THIS I Q~P f) _.. _ TI N A « N _.. I;arges~ `Car~ta~ue~ ~aii~ Maximum I3ai1y Average 3O ..D:O :: 6:0:: 00: GAL 25:.. a0 . :G.AL: _.. HAZARDOUS COM~?C3NE~I~7TS _ .. : _ ~Wt . _ .. : :. Its.. ::: ~AS# . 22 00 Phosphoric Add:_ _: _. - No 76?64382 5 . flfl:' ..... Citric Arid _ : - Nci 77 92'9 3 C3fl. ~ Buto e~haino2 - _ - No:. 11~.?62. 2(J ~Ci. ,.. Nonon~.c:: Surfactiant BT.enci lIt~ 9.Q164S9: :. ,. F AR S TS A ~ ~: AS~ ~ MEN H .... - .. TSecret RS BiQHaz Rads~act~e j~+~ncait ~P,~ : Hazard; _. NFP~A; .... t7SI30T# MCP`. N€~ h3'tc~: Ncr Nt3f:. furies _ . ,~ ~: f NSt3d -~s oslz~./2~0 ~ CHE~7R~33 2835'16 ~~.telD MI5 421 4:1522; ~ ~ Zaven~4ry_ Item 4Q~3 Faci].~~~r :Unat ~ F~xec1 Contar~exs at Site CC?NIMC}N NAME CHENITCAL: NA~4E: ALITOMOTIITE BAR ..~8 . PATI~fi SEALER ~ay~ .t?n :S~.~e _. EC~JLAB S~AI~ER WAX_ : b5 IiQCe~~.2.G-~I W1~~7.131 :t~'11.5 ~?3C1~1_ ~~F LTl'~7.~.:.. ... 1~e1~3: ~~:I:t~ - _.... CAFt WASH BLDG _.: _ - STA.TE T~FE PF.ESSE _: "T~P$RA~'F7~,E : ~O1~TI',A~7:~R : 7:'YRE Lqu~.d ~~tixti:~r~ Amten~ -~,[r€ber~t I?~LTM/BARREL NCINN~ETAL I 3 N OC t N C AN II TS AT: THIS L ATI ? . Largest Gontasner :. Dail~l~axmum. Da~l~r.A~e~age ~~.~4 : 6.40 z:~ : :. l~:oa ~. C us cP ~~ ~ D ~ O~s - x 2.44 2~Btztt~xX`et'[~o1 No ];x.1762 5.44 ~-Prapario3 No &.7:634 H~+2ARI3 ASSESSMENTS : TSscret R5: B~©Haz Rad~.<iact~:ve/.~~nouxzt EPA. Hazards: NFPA USi~4T## MCP No NO ~fo Nod'` :. Cur~.es : ~ / / :.:. .... Tod __ __.... _... ~ CK~QN 2T33:~?~ 5~.~~~ Q35 Q21-OU2522 ~ Iriven~i~ry.Ite~i 4EII'7 F'ac3~~t~ I7n~t Fi:~ci Containers at:Site' C3MM ' N I~T N iE / ` 4 . C C .I . ,. ATJTC}M4TI~E :CAR, `I~dASH PR~SCQAK `I)ET~RGENT ]3ays ~ S.te _ _ ~c~r. s~,~ sx~ a:~ o: ~ ~ ... _ ,.. I~ca;'t:zon: with~.n this :F'aci.~~:ty IIzxat . Nta P' Grid CSR. W;~SH :BL73G ..... CAS# STATE TYPE - :PF.FS~U TEi+!fP~RAT~fiR~ _ C43N'I'AI TYPE .. . L;:qu~.d i~iixtur~ en~ ~ "Amia~ut 'I'1RUNif BAR~~L-33~?NMETAL ... . I3MUUi~' T Id3~T E~N S T ........ .. ~ : HIS I A` Largest :CQnt~~.n~r Iaal3r N1a~cmum:. ~a:~:1~- A~t~ras~E : 34 . t3 Q .G.AI :. 6 ~ , 0 4 GAI :: . 15 . Q ~ G:A~ . __ HA~E?US C(4MFf?NENTS gWt. _. _. RS. ~` 21.00 Su3.furc. l~~id {EPA} _ `3~a 7664~~~ 17 4 4 Pk~r~sphoxic Acit;~ No _ 7~ 64 3 8 2 7 OA 2 $utoxcyethano2:: ::::: :: Na . 11.~7~2 29 Q,tJ N€~ni;oxizc::Sur_factaztt ~leA~ ;Na . 9t}I.69:5:9' :.: HA AR~3 SSE~SME TS ~ ..A N .: TSecret RS BitOHc~1Z Ra€~ioactiv~e j..,Amoun~ .. EPA Ha~arc~s NFPA LTSUL?T# _ MCF NQ ~Tci : . ~o . No f ° Curies / /` / Mad ~HEVR~3N 2t?3576 SitelD, f~l~ t?21 p~1522 ~ Irivent~ry Item Ot118 Fa~lit~r .t7~.t: ~'~:xed Cont~i.ners at Site ~ C:HEP!tI~I; ~AP+IP CC1MM~3N i~T~NfE ;/ _. 1~,'Ci'I`COMD'TII?E :C1~R Y3A~H :LIQ~II~ VBHI~~E PATI~P ~F~,4EFt ~a s; ©xi: 'Site _.. EC~LAB VEfi,~CITX CL~ CQAT I?RCtTBCTANT _ _ .. s~5 Location .w~t~~z~ this i?ac~~~ty :Unit :: Map: ~rci _ _. CAR WASH BLDG _. _ . : EAS#. T~tPERATT?~tE .. STATH TYPE £?8~:3SS ~t?NTP.IN~2 TYPE Lqu~et ~ M~cture' : Ambient : Amb~er3t .:.. I31tIIMf BAIL Nf3I.TA.L A .T~F3I AMC}~J~!ITS AT. THIS L4~' Lazg~s~: Canta~ner ~Ja~y Maximum. :. T~a~l.y Average::. 3Q., X2:0::GAIL 6tl :.:QQ ,: 2S . (3~ GAL . _.. c or~PQ~Ts HA~A~s : 2 t?0 2 Butoxyet~azi41 ... - . Ncs 111762 2O. QC} Mineral Seal: Dil 'fVares} .. Aio fi4'~423C}9 2 f7 . i3:0 SURFACTANT Ncs . MIXTURE: oo Isoprapy~ Alcohol ~: ~~s3o _.. BSS rr ~~~~R~ s A ~ s s Tsetret : RS' BiaHaa F,:~d~oact:ve/Rrnc~iint HPA Hazard ~VFPA I3~I'~?T# : : t~~P Na : Na: Aicx . . ;Na/ : _ Curses: _ _ 1 / Mod ~: Inventory .-Item _ Q~.{?S `I?aci.la~ty Un:~.t z F~eci, Containers at >Sa.te Ct~i~iC3N ~ :~ C~E~~CA~.i NF1 :. CARBQN DIUXZDS I~~:ys :On Szt~ . 3&5 Lt~cation w~ttr~ tYi~s Facility ~3ri.it Map Grlci:= TNS~T7E ~TQR __.. . ~.. _ 124_3.8 9. ATE : TURE Pu g o~S ~ S ~Ga~ ~ r . ~ e Ab A ex~ A€aba ~ ~4~tTPRE~~L~I~7I Largest= Conta.3xxez` 249 00. ~'T3 - :: AI~C~L~T:S AT THIS- LC3C'.PiTIt~I3. Dax3y Maximum I~a.~.~.y Average 2429.Ot3 FT3 - '1215 : ~~f FT3 r~;E,t3tu.~c3.v~. ~.vrx~c~.w'~.~s _ _.. _. ~ht`,: RS CAS#`. ~.Oo tea} Carbon. Iizaxde N'o: ;1243:89 rfti~KU ~~ ~~~~~~: TSetret. RS BioHaz Rati~.aact~relA~iiic~unt . EFA Hazards 1~3FFA. LTSTi4T#` ~~P N'o No g?c3 NQ/ . Curies: F. P IH j f .I . Mari TSe~x~t RS ~3s~Haz =Rac3~oact~ze/iout3.t= =BPA . Hazaircis= =NFPA----~ ~TS~)<3T~ =MCP= ~+7~ Nca : : Nti.: ~o/ r~.es ~ :/ . f ` Ui~R GKEVT~QN 2€?3575 :.. _ 5a.~e3IJ~ Q15 (?21 {?152'2_: ~. _... .. . st Formal F __ a ~ M~~gat~.an/Frezrentj;Ab~.temt C3vera1.1:: Site Release Prezrerit:orx t)5/E35/1998 } _ _.. ,. BRIERS: INSTA,L'EI? TQ:; PREVENT .'tIEH=:CILE CflLL~SIQN WI~'H FLTNiFS _.. _... B} VAF~R RE~fl~tERY SYST~fS ~S~ WHEN FILLING UN?~ERC~tC3tTNI~ TANKS ; ~:3 . ANTIL+O~: Nd~ZLES : ON PUi~PS.-. l~) : - Nt? SALES T't~ CFNAt1THC~RI~EL~ CtJA1T1RS , _ _. E.): "N{? : SI~KII-iG": SIGNS ~?E3S~ED . S~I~-- SERtTE . IP3ST'R.tTIflNS : PUS:TFI} . . ~.) :MC)'t+i.ITflR~G . PitOGPQ 31~iFI:NT~:. - - - I~OUBZ.;F a~EID:: TA~~S: - :WITH LEAK: DETECTTflN SY$T8N! Re;7:~as~ Contaanmer~t _ C1;5/Q5~19~$ ~} STC1P SOTJRCE :QF REI,E~I.SE AS :i~ECESSARY 1~NU SAF'8. IE GASOLII~TE, .:STt~P :SC~FJR:CE QF R:ELEASE BY A,C'TIVI3:TING: FNIEI2GCY' _ PUNF S~I[~C7FF SW3T'~. ~3} . EVACUATE': AI:*~ 'I~Tt71+IESSEN'I`TAi:: FERSC?~NEL: FRC}~1 .F~3.:; _. C} EXTINGUISH DR IE~~E. ;~iT•T~ _ IGNT:T.IE}~I :SC?L]~tC'E~ E3`SL FIRE- BXTINGL3ISHER IF . ;. - NEfiESSARY ;::. _ . _. ,. _ ... . T~!.} WH2~E USING P'R:OPEF~ PEf31L PFtE'QTECT~IE. EQff~PM~NT, CC?~StT~IN ~I~ID ABS4R8: SPTLL WITI: INERT AB~L?RSEI3T _ {SA~TI?: C}R ~TTTY LETTER} ; - . A~;fit?ID. B..RTHING GA.;SOLINE VAPORS BY AFF~ttflACHING FRflM IIINID _ - _ - 12; Z6; 2006 1 1 : I i AM UNdERORQUNd $TORA~E TANKS APPLICATION TO F~OpIYi ELO r uNE Tl.E7'N~Ip r slelvev S6CONQARY CONTAINMENT TEOriNO ftaNK nal~nr~ss 7E6T ANO ro PEItFORIM FUEL MONITORINi3 CERTIFICATION Tanknology 9096766061 I/3 BAK~RSFIELa FIRE DEPT. ~b90Ylt~0II $dIV~COi ~~sw 90o Truxtun ~-v~., $te. alo Hakcrs~field, CA 93301 Tel.; (6bli 3~6-3979 Fax; (661 ~ 852-2171 Pepe 1 of 1 PERMIT NO. `T~'~ ~~`~ D ENFIANCED LEAK DETECTION i~ LINE TE8TIN0 ~ e&qev SECONDARY CONTAINMENT TEBTINd tANK TIOHTNEBS TEST QI TO PERFORM FUEL MONRORING CERTIFICATION BITE F ~. _ FACILITY Cb~'~la~~~~~ NAIMH >! PHONE NUM9ER QF Ce7NTACT PERSON Mseage--661~569.90G6 - ADDRESS 112Q Copse Rd. -~ ~~ _ owNEasNAME Chavron $tatlons, Inc. _ _ _.._. OPERATORS NAME PERMIT Tp OPERATE NO. NUMBER F'~ K8 TESTED NG TO BE O YES ® NO _ V CONTENTS 1 12Q82 _ Supreme (9'l ) 2 'f 2083 Regulaxr (87) 3 12482 Plus (89) TANK TEiTIN4 COMPANY ~ ~- NAME CF TESTING CgMPA11Y Tawnkno lnG. NAMC s PHONE NUMBER 0- WNIoy COU1t1Sl• $OD~B~-~~~8 ~~~ CONTACT PERSON 0.12 MARJN®ADDRESa 41786 Enterprise Circle S. Sultw p Tem®cufa, CA 8Z89Q NAME S PHONE NUMille OF Tlm Coulb*r - (Eb7) #~84-1 TZ1 CERTIFICATION ;s; ^ ~ - -~ TEETER dR •PSCUL INSPECTOR: BATE 3'IIME TEST TO rs' .~T' •~ ~ CONDUCTEOt IGC N: 1'NST 1 METHOD /KiNATURE OF APPLI T DATE: 1 ~ Zd (o~ APPRONt¢n SY pAl'B FO x093 (Rae. 0®108) i ~~QRRECTION NO CE BAKERSFIEID FIRE DEPARTMENT N°_ 607 j,p~~pn ry6~6~'1' C~~C~IIfO h t' S S Sub~Div. ~I a5 Co~~Ce. Qc~ ~: Blk. . Loy You are hereby required to make the following corrections at the above location: cos. No 1 as c, ~c~ f f 't e. .~ Ml~' C ~` ~ Y' .g4'Q tip L [ C c. -~1~~ Q d" ~ (c. t(~ J r rct(d t~(~ o ~c cs c. (Q Ot (' Ti ~l'C. ~cas e/'L It~~toks QCK. ~ N fr S Completion Date foz• Correctio ~ ? 9 ~ Date ~'~ T~9 ~ Inspector 326-3979 •. D~f Incident: ~ °`~ Time of Incident: ~ ~~ ~• BENETO, .INC. Incident Report Supervisors Use Only Non-Chargeable Chazgeable ~i `- Loss of CTE days r--~ Loss of Incentive days Safety File Record Number Product Spill (loading) ~ Product Spill (unloading) -Personal Injury Product Contam (loading) Product Contam (unloading) Called in Sick Wrong Station Delivery ~ Vehicle Accident Policy Violation Other (explain) Driver: ~eti~~S; ~~ ~ Employee No.: ~3r1. ~ Terminal: ~i~~r...~ ~~u.~ -Truck Number: 47L~ Semi: Q /2~ or, Truck/Trailer: 9735 Shipper: ~/,epc/ P!J ~ Location: ~L-ri' a 20~57~ ~ // ~S ~f{~~ ~D Description of Incident: ~ll~`')r ~iF>~T~rZ. % ~L[,l~t~rc.~ .ZrE ~~. ftrhJ ~ ~ci_~T` /~~J(/ ff/lD/lESS , !T~ ~OLi9-,rA!~/) 7rU il.~E. fft .fin /T /~i~.t lr~F,r.c.lG.7 ~9-f 7}~m- 7~in.[E_ What unsafe act or condition contributed to the incident? Dispatch or Supervisor's Signature: DO NOT WRITE ON THE BACK OF THIS PAGE ~H~o '''''' could this Have been prevented? !/OUP Gf /1I~~r.~~ ~LL L~o~uy~rru~JS 7b ~t:~~ SurLE ~~~ ,Fi2~ ,~ . Damage to Company property: MAMA r~EMENT REVIEW • Costs, etc.: _ ~ ~~N~~_,~:.~ic~,d /~ /~17 S 77N'yE Conclusions and Target Date: Signature: f... , F y_=, f. -~. " "; CHEVRON 203576 SiteID: 015-021-001522 Manager ~~ Location: 1125 COFFEE RD City BAKERSFIELD BusPhone: (661) 588-9066 Map 102 CommHaz High Grid: 33A FacUnits: 1 AOV: CommCode: BFD STA 11 EPA Numb: SIC Code:5541 DunnBrad:00-914-0559 Emergency Contact / Title Emergency Contact / Title CHEVRON MAINTENANCE / DISPATCH CHEVRON EMERGENCY / INFO CENTER Business Phone: (866) 845-4254x Business Phone: (800) 231-0623x 24-Hour Phone (800) 231-0623x 24-Hour Phone (800) 231-0623x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact CHEVRON PERMIT DESK L2375 B-1 Phone: (925) 842-9002x MailAddr: PO BOX 6004 State: CA City SAN RAMON Zip 94583 Owner CHEVRON PRODUCTS CO Phone: (925') 842-9002x Address PO BOX 6004 State: CA City SAN RAMON Zip 94583 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST l id `~ ~~07 s ua ~;a.~.ed on etiy In~~iry of those indiv re~,~Gi1SICi6 fGr pt}f~IrlinC tha Information, I certify under ponalty of -~t~' that I have parronally examined ;end em famll-nr wlth the information gi omitted and bc~ligvP, the Information is true, ~.~rate, and campiete. , ~,Rira ~y,~ /~i ?.001 Signature Da -1- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-001522 ~ STORAGE CONTAINER DATA (UST FORM A)' Last Action Type: FACILITY/SITE INFORMATION Business Name: CHEVRON 203576 Cross Street Business Type : MAv~E TAMANZ'AlJ Org Type Total Tanks 3 IndnRes/Trust : No PA Contact : ~ 52 5020-UG Dsg Own/Oper ICC Nbr: A49K96~8~i'. PROPERTY OWNER INFORMATION Name CHEVRON EMERGENCY Phone: (800) 231-0623x Address: City State: Zip: Type CORPORATION Name CHEVRON EMERGENCY Address: City Type CORPORATION TANK OWNER INFORMATION Phone: (800) 231-0623x State: Zip: BOE UST Fee# 032934 Financ'1 Resp: SELF INSURED Legal Notif 66l 313^ 638(0 Date : ^" ~'' ~ ~'' ^ °" 2~I to ~2~0? Phone : x Name : "~Eg$-~ ~~ Tt1: RETAIL ESH SPECIALIST State UST # 1998 Upg Cert#: 00856 -2- 01/29/2007 F CHEVRON 203576 SitelD: 015-021-001522 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... 5pecHaz EPA Hazards Frm DailyMax Unit MCP AUTOMOTIVE CAR WASH LIQUID ALKA L 60.00 GAL Hi AUTOMOTIVE CAR WASH LIQUID ALKA L 60.00 GAL Hi REGULAR UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod MIDGRADE UNLEADED GASOLINE F IH DH L 12000.00 GAL Mod SUPREME UNLEADED GASOLINE- F IH DH L 12000.00 GAL Mod AUTOMOTIVE DETERGENT FOR CAR WA L 110.00 GAL Mod AUTOMOTIVE CAR WASH DETERGENT L 110.00 GAL Mod AUTOMOTIVE CAR WASH DETERGENT L 110.00 GAL. Mod AUTOMOTIVE CAR WASH DETERGENT L 110.00 GAL Mod AUTOMOTIVE CAR WASH CONDITIONER L 63.00 GAL Mod CAR WASH COLD WAX L 60.00 GAL Mod CLEAR COAT CAR WASH PROTECTANT L 60.00 GAL Mod LO PH CLEAR COAT BLUE L 60.00 GAL Mod AUTOMOTIVE CAR WASH PRESOAK DET L 60.00 GAL Mod AUTOMOTIVE CAR WASH PAINT SEALS L 60.00 GAL Mod AUTOMOTIVE CAR WASH PRESOAK DET L 60.00 GAL MOd AUTOMOTIVE CAR WASH LIQUID VEHI L 60.00 GAL Mod CARBON DIOXIDE F P IH G 2429.00 FT3 Min CAR WASH LIQUID VEHICLE WASH BR L 60.00 GAL UnR -3- 01/29/2007 -4- 01/29/2007 F CHEVRON 203576 SitelD: 015-021-001522 ~ ~ Inventory Item 0015 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME AUTOMOTIVE CAR WASH LIQUID ALKALINE VEHICLE WASH CONCENTRATE Days On Site ECOLAB WONDER WASH 365 Location within this Facility Unit Map: Grid: CAR WASH BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 15.00 GAL HAZARDOUS COMPONENTS $Wt. 2.00 2-Butoxyethanol 5.00 Monoethanolamine HAZARD ASSES TSecret RS BioHaz Radioactive/Amount EP No Na= =Nc = No/ Curies= _ _ -5- RS CAS# No 111762 No 141435 SMENTS A Hazards NFPA ~ USDOT# MCP __ _ _ _ / / / - = =Hi = 01/29/2007 F CHEVRON 203576 SiteID: 015-021-001522 ~ ~ Inventory Item 0016 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME AUTOMOTIVE CAR WASH LIQUID ALKALINE VEHICLE WASH CONCENTRATE Days On Site ECOLAB SUPER SUDS 6062 365 Location. within this Facility Unit Map: Grid: CAR WASH BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TMixture ~-Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 15.00 GAL HAZARDOUS COMPONENTS ~Wt. 2.00 Potassium Hydroxide 5.00 Sodium Metasilicate 4.00 Sodium Phosphate, Tribasic HAZARD ASSES TSecret RS BioHaz =Radioactive/Amount= =EP No No No No/ Curies -6- RS CAS# No 1310583 No 6834920 No 7758294 SMENTS A Hazards= =NFPA--~ =USDOT#= =MCP= / / / Hi 01/29/2007 ~ CHEVRON 203576 ~ Inventory Item 0001 COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE 87 OCTANE Location within this Facility Unit W SIDE OF LOT STATE TYPE PRESSURE Liquid. TMixture Ambient SiteID: 015-021-001522 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 36S Map: Grid: CAS# 86290-81-5 TEMPERATURE CONTAINER TYPE Ambient -~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 6000.00 GAL HAZARDOUS COMP NENTS O ~Wt. RS CAS# 100.00 Gasoline No 86290815 4.90 Benzene No 71432 3'.00 Ethylbenzene No 100414 2.00 Napthalene No 91203 10.00 Ethanol No 64175 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount I EPA Hazards NFPA ~ USDOT# MCP No- No= =No- = No/ Curies= =F= _ =IH=DH= _ / / / - _ =Mod-- -7- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-001522 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Sits ~ COMMON NAME / CHEMICAL NAME MIDGRADE UNLEADED GASOLINE Days On Site 89 OCTANE 365 Location within this Facility Unit Map: Grid: -- W SIDE OF LOT CAS# 86290-81=5 Liquid TMixtur~AmbRentURE ~ AT~E~MPeRATURE -~EROGROUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 6000.00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 100.00 Gasoline No 86290$15 4.90 Benzene No 71422 3.00 Ethylbenzene No 100414 2.00 Naphthalene, Crude Or Refined No 91203 10.00 Ethanol No 64175 HAZARD ASSESSMENTS =" TSecret RS BioHaz Radioactive/Amount I EPA Hazards NFPA ~ USDOT# M~~ =No- No= =No- = No/ Curies= =F= _ =IH=DH= _ / / / - _ =Mod -8- 01/29/2007 F CHEVRON.203576 SiteID: 015-021-001522 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers at Side ~ COMMON NAME / CHEMICAL NAME - SUPREME UNLEADED GASOLINE Days On Sits 91 OCTANE 365 Location within this Facility Unit Map: Grid: -- W SIDE OF LOT CAS# 86290-8~:=5 Liquid TYPE PRESSURE TEMPERATURE CONTAINER TYPE TMixture ~lAmbient ~ Ambient -~ UNDER GROUND TANK AMOUNTS AT THIS LOCA I N . T O Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 6000..00 GAS HAZARDOUS COMPONENTS -- °sWt. RS CAS# 100.00 Gasoline No 86290815 4.90 Benzene No 7142 3.00 Ethylbenzene No 100414 2.00 Naphthalene, Crude Or Refined No 91203 10.00 Ethanol No 64175 HAZARD ASSESSMENTS --- TSecret RS BioHaz Radioactive/Amount I EPA Hazards NFPA I USDOT# MCA? No- No= No- = No/ Curies= =F= _ =IH=DH= _ / / / 1- = M~i~1 -9- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-0015~~ ~ ~ Inventory Item 0010 Facility Unit: Fixed Containers at Si€~ ~ COMMON NAME / CHEMICAL NAME --- AUTOMOTIVE DETERGENT FOR CAR Wp,SH Days On Site ECOLAB 688 PRESOAK I 365 Location within this Facility Unit Map: Grid: -- CAR WASH BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TMixture. Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 55.00 GAL 110.00 GAL Daily Average 25.00 GAL nti~tucuvu~ ~:vinrvivn:lvt-S ~Wt. RS CAS# 15.00 Citric Acid No 77~~9 20.00 Sodium Dodecylbenzene Sulfonate No 2515590 10.00 2-Propanol No 6730 10.00 Mineral. Spirits No 647423$7 6.00 Ammonium Bifluoride No 1341497 tiHL,At~C1J L~S~SaMt;1V'1"5 - TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MAP No No No No/ Curies / / / Mc3t3. -10- O1/29/~007 F CHEVRON 203576 SiteID: 015-021-001522 ~ ~ Inventory Item 0014 Facility Unit: Fixed Containers at Side ~ COMMON NAME / CHEMICAL NAME AUTOMOTIVE CAR WASH DETERGENT Days On Site ECOLAB CWX 3600 365 Location within this Facility Unit Map: Grid: -- CAR WASH BLDG CAS# Liquid TMixtur~AmbRentURE ~ TAE~MPeRATURE DRUM/BARRELENONMETAL~ AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 55.00 GAL 110.00 GAL Daily Average 25.00 GAL - -- HAZARDOUS COMPONENTS ~ Inventory Item 0019 Facility Unit: COMMON NAME / CHEMICAL NAME AUTOMOTIVE CAR WASH DETERGENT ECOLAB 180 PRESOAK Location within this Facility Unit Map: CAR WASH BLDG STATE TYPE PRESSURE TEMPERATURE Liquid TMixture ~-Ambient ~ Ambient Fixed Containers at Site ~ Days On Site 365 Grid: CAS# CONTAINER TYPE _ DRUM/BARREL-NONMETAL - AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 110.00 GAL 25.00 GAL ruiGruu.~vua ~.vinrvlv~lvia %Wt. RS CAS# 26.00 Sulfuric Acid (EPA) No 7664939 20.00 Nonionic Surfactant Blend No MIXTU~2E !'1HGKKL EiJ b~JJ1~1L'1V 1.'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCA No No No No/ Curies / / / MC~d gWt. RS CAS# 2.00 Potassium Hydroxide ~ No 1310583 5.00 Sodium Metasilicate No 6834920 HAZARD ASSESSMENTS -- TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCp No- No= No- = No/ Curies= _ _ _ _ _ _ _ / / / - _ =Mod -11- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-00153 ~ ~ Inventory Item 0020 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME -"" AUTOMOTIVE CAR WASH DETERGENT Days On Site ECOLAB CWX 3688 PRESOAK -365 Location within this Facility Unit Map: ~ Grid: -- CAR WASH BLDG CAS# Liquid TMixture ~-Ambient~E ~ TAmbient~E DRUM/BARRELENONMETAL~ Largest Container 55.00 GAL AMOUNTS AT THIS LOCATION Daily Maximum 110.00 GAL Daily Average 25.00 GAS, t1AGHKL V U.7 l: Vl~lY V1V i'i1V'1' S %Wt. RS CAS# 20.00 Sodium Hydroxide No 1310732 5.00 D-Gluconic Acid, Sodium Salt No 527071 t1EiGHK1J A77t555ML51V'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mind ~ Inventory Item 0012 Facility Unit: COMMON NAME / CHEMICAL NAME AUTOMOTIVE CAR WASH CONDITIONER ECOLAB CLEAR COAT CONDITIONER-RED/BLUE/YELLOW Location within this Facility Unit Map: CAR WASH BLDG Fixed Containers at Site ~ Days On Site 365 Grid: CAS# Liquid TMixture ~-Ambient~E ~ AmbientT~ DRUM/BNARRELENONMETAL~ AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum I Daily Average 7.00 GAL 63.00 GAL 21.00 GAS HAZARDOUS COMPONENTS - %Wt. RS CAS# 5.00 Phosphoric Acid No 76643$2 ril'~GtitCL H5 5L'iLiT51~1L"ilVl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / MCSd -12- 01/29/3007 F CHEVRON 203576 SiteID: 015-021-00152 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers at Side ~ COMMON NAME / CHEMICAL NAME ~- CAR WASH COLD WAX Days On Site ECOLAB DRYING AGENT AND SHINE ENHANCER FOR CARS 365 Location within this Facility Unit Map: Grid: -- CAR WASH BLDG CAS# 111-76=2 ~E T T~ E Liquid TMixture ~mbRent ~ Ambient DRUM/BARREL NONMETAL~ AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 25.00 GAL HAZARDOUS COMPONENTS ~Wt. RS CAS# 6.00 2-Butoxyethanol No 111762 30.00 Mineral Seal Oil (Varies) No 647428©9 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / M(5+~ -13- 01/29/2007 p CHEVRON 203576 SiteID: 015-021-001522 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers at Side ~ COMMON NAME / CHEMICAL NAME -~- CLEAR COAT CAR WASH PROTECTANT Days On Site ECOLAB LIQUID CAR WASH CONDITIONER 365 Location within this Facility Unit Map: Grid: -- CAR. WASH BLDG CAS# Liquid TMixtur~_AmbRent~ ~ TAmbient~E DRUM/BNARRENLF-NONMETAL AMOUNTS AT THIS LOCATION Daily Maximum 60.00 GAL Largest Container 30.00 GAL Daily Average 25.00 GAL -~ HAZARDOUS COMPONENTS ~Wt. RS CAS# 2.00 2-Butoxyethanol No 111`]62 5.00 2-Propanol No 67630 5.00 Mineral Seal Oil (Varies) No 64742309 HAZARD ASSESSMENTS - TSecret RS BioHaz =Radioactive/Amount= =EPA Hazards= =NFPA- ~- =USDOT#= =MCP= No No No No/ Curies I / / / Med ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME -- LO PH CLEAR COAT BLUE Days On Site ECOLAB LIQUID ADD CAR WASH CONDITIONER 365 Location within this Facility Unit Map: Grid: - CAR WASH BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 25.00 GAL HAZARDOUS COMPONENTS -- ~Wt. RS CAS# 5.00 Phosphoric. Acid No 76643$2 HAGAKU ASS~SSM~N'1'S TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MAP No No No No/ Curies / / / Maid -14- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-0015~~ ~ ~ Inventory Item 0011 Facility Unit: Fixed Containers at Sits: ~ COMMON NAME / CHEMICAL NAME ~- AUTOMOTIVE CAR WASH PRESOAK DETERGENT Days On Sits ECOLAB SYSTEM 103 ~ 365 Location within this Facility Unit Map: Grid: ------- CAR WASH BLDG CAS# = STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _°~- Liquid T Mixtur~Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION --- Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 25.00 GAi, HAZARDOUS COMPONENTS gWt. RS CAS# 22.00 Phosphoric Acid No 7664362 5.00 Citric Acid No ~ 7759 3.00 2-Butoxyethanol No 11152 20.00 Nonionic Surfactant Blend No 901659 HAZARD ASSESSMENTS -- TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M No No No No/ Curies I / / / M~5c3 -15- Ol/29/~007 F CHEVRON 203576 SiteID: 015-021-0015~~ ~ ~ Inventory Item 0013 Facility Unit: Fixed Containers at SitC ~ COMMON NAME / CHEMICAL NAME -- AUTOMOTIVE CAR WASH PAINT SEALER Days On Site ECOLAB SEALER WAX 365 Location within this Facility Unit Map: Grid: ---- CAR WASH BLDG ~ CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TMixture TAmbient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 15.00 GAS HAZARDOUS COMPONENTS -- ~Wt. RS CAS# 2.00 2-Butoxyethanol No 11172 5.00 2-Propanol No 67€30 HAZARD ASSESSMENTS = TSecret RS BioHaz Radioactive/Amount I EPA Hazards No No No No/ Curies NFPA USDOT# MCA / / / Mid -16- O1/29/~d07 F CHEVRON 203576 SiteID: 015-021-0015 ~ ~ Inventory Item 0017 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME -~ AUTOMOTIVE CAR WASH PRESOAK DETERGENT Days On Site ECOLAB SMART SHINE 130 365 Location within this Facility Unit Map: Grid: - CAR WASH BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixtur~Ambient ~ Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOC ON - ATI Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 15.00 GAL HAZARDOUS C NENT OMPO S ~Wt. RS CAS# 21.00 Sulfuric Acid (EPA)' No 7664~~9 17.00 Phosphoric Acid No 7664$2 7.00 2-Butoxyethanol No 11162 20.00 Nonionic Surfactant Blend No 901659 HAZA ASSESSM -- RD ENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# M No No No No/ Curies I / / / MOd -17- O1/29/~007 ~ CHEVRON 203576 SiteID: 015-021-0015,22 ~ ~ Inventory Item 0018 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME -- AUTOMOTIVE CAR WASH LIQUID VEHICLE PAINT SEALER Days On Site ECOLAB VELOCITY CLEAR COAT PROTECTANT 365 Location within this Facility Unit Map: Grid: - CAR WASH BLDG CAS# Liquid TMixture ~Ambient~E ~ TAmbientT~ DRUM/BNARRELENONMETAL~ AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 15.00 GAS HAZARDOUS COMPONENTS ~Wt. 2.00 2-Butoxyethanol 20.00 Mineral Seal Oil (Varies) 20:00 SURFACTANT 5.00 Isopropyl Alcohol HAZARD ASSESSMENTS = TSecret RS BioHaz Radioactive/Amount I EPA Hazards No No No No/ Curies ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME CARBON DIOXIDE RS CAS# No i l i'~ 6 2 No 64742309 NO MI XTt5f2E No 67630 NFPA USDOT# MCP / / / Mt~E3 . Facility Unit: Fixed Containers at Site ~ Days On Site • 365 Location within this. Facility Unit Map: Grid: --- INSIDE STORE CAS# 124-38=9 ~GasATE TPureE ~AboveSAmbEent Ambpe~T~ PORTCOPRES~RCYLINDER -- AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 2429.00 FT3' 2429.00 FT3 1215.00 FT3 - t111GHKJJUUS (.:VMYVNI;IV'1'.5 ~Wt. RS CAS# 100.•00 Carbon Dioxide ~ No 124389 riAGL~iVJ A.7 Jt55.~1~1151V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min -18- 01/29/2(507 F CHEVRON 203576 SiteID: 015-021-00152 ~ ~ Inventory Item 0008 Facility Unit: Fixed Containers at Side ~ COMMON NAME / CHEMICAL NAME --- CAR WASH LIQUID VEHICLE WASH BRUSH DETERGENT Days On Sits ECOLAB CAR WASH CLING & CLEAN 365 Location within this Facility Unit Map: Grid: - CAR WASH BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TMixtur~Ambient _ ~ Ambient DRUM/BARREL-NONMETAL • AMOUNTS AT THIS LOCATION -- Largest Container Daily Maximum Daily Average 30.00 GAL 60.00 GAL 25.00 GAS HAZARDOUS COMPONENTS -- ~Wt. RS CAS# t11iGH.ttl.l 1'-5 5 ~ 5 5 M~N'1.5 TSecret RS BioHaz =Radioactive/Amount= =EPA Hazards= =NFPA~ =USDOT#~ =M~~= No No No No/ Curies / / / Ui~2 -19- Ol/29/~007 p CHEVRON 203576 SiteID: 015-021-0015~~ ~ Fast Formal ~ ~ Notif./Evacuation/Medical Overall Side ~ ~ Agency Notification 10/20/2005 ~ IN ANY INCIDENT THAT JEOPARDIZES HUMAN HEALTH AND SAFETY: ACTIVATE APPROPRIATE EMERGENCY SHUT-OFF; EVACUATE PERSONNEL FROM FACILITY USING SAFEST ROUTE AVAILABLE ACCORDING TO THE SITUATION; AND GO TO AN UPWIND AREA AND MAINTAIN A SAFE DISTANCE. COINCIDENT WITH EVACUATION NOTIFY EMERGENCY RESPONSE AGENCIES BY DIALING 911 IF INCIDENT REPRESENTS AN IMMEDIATE THREAT. DENY ENTRY TO THE AREA BY ANYONE OTHER THAN 911 EMERGENCY RESPONSE PERSONNEL UNTIL AREA IS DECLARED-SAFE. STAND BY TO ASSIST EMERGENCY RESPONSE PERSONNEL. ANY INCIDENT INVOLVING A FIRE, RELEASE, OR THREATENED RELEASE OF A HAZARD0~5 MATERIAL MUST ALSO BE REPORTED TO THE STATION MANAGER. THE STATION MANAGER WILL NOTIFY THE CSI TERRITORY MANAGER AND CHEVRON MAINTENANCE DISPATCH IMMEDIATELY. CHEVRON USA MAINTENANCE DISPATCH WILL: DISPATCH COMPANY /CONTRACTOR ASSISTANCE IF NECESSARY AND NOTIFY CHEVRON USA ENVIRONMENTAL MARKETING ASSISTANT FOR PROPER NOTIFICATION TO REGULATORY AGENCIES. Employee Notif./Evacuation 10/20/2005 NOTIFICATION WILL BE ACCOMPLISHED VERBALLY AND VIA THE INTERCOM SYSTEM. Public Notif./Evacuation 10/20/2005 THE STAFF DUTY CLERK WILL ANNOUNCE THERE IS AN EMERGENCY. PLEASE LEAVE THE STATION ON FOOT IMMEDIATELY. IF EVACUATION FROM THE AREA IS DEEMED NECESSARY, THE NEIGHBORING PROPERTIES LISTED BELOW WILL BE NOTIFIED, IF POSSIBLE: FASTRIP, 1200 COFFEE RD, 589-6305. -20- O1/29/~007 F CHEVRON 203576 SiteID: 015-021-001522 Fast Form2lt ~ Notif./Evacuation/Medical Overall Sid ~ Emergency Medical Plan 08/22/2046 BAKERSFIELD HEART HOSPITAL, 3001 SILLECT AVE, 316-6000. 9 -21- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-0015~~ Fast Forma ~ Mitigation/Prevent/Abatemt Overall Sits ~ Release Prevention 05/05/1998 A) BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS. B) VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS. C) ANTILOCK NOZZLES ON PUMPS. _ D) NO SALES TO UNAUTHORIZED CONTAINERS. E) "NO SMOKING" SIGNS POSTED. SELF-SERVE INSTRUCTIONS POSTED. F) MONITORING PROGRAM IMPLEMENTED. G) DOUBLE WALLED TANKS WITH LEAK DETECTION SYSTEM. 9 Release Containment 05/05/1958 A) STOP SOURCE OF RELEASE AS NECESSARY AND SAFE. IF GASOLINE, STOP SOURCE OF RELEASE BY ACTIVATING EMERGENCY PUMP SHUTOFF SWITCH. B) EVACUATE ALL NONESSENTIAL PERSONNEL FROM AREA. C) EXTINGUISH OR REMOVE ALL IGNITION SOURCES. USE FIRE EXTINGUISHER IF NECESSARY. D) WHILE USING PROPER PERSONAL PROTECTIVE EQUIPMENT, CONTAIN AND ABSORB SPILL WITH INERT ABSORBENT (SAND OR KITTY LITTER). AVOID BREATHING GASOLINE VAPORS BY APPROACHING FROM UPWIND. Clean Up 04/04/2045 A) KEEP NONESSENTIAL PERSONNEL AWAY FROM AREA. B) NOTIFY CHEVRON MAINTENANCE DISPATCH 800-423-6911 FOR COORDINATION WITH HAZARDOUS MATERIAL CONTRACTOR TO REMOVE CONTAMINATED ABSORBENT MATERIALS IF REQUIRED. C) MATERIALS INVOLVED IN CLEANUP WILL BE DISPOSED OF IN ACCORDANCE WITH ALL APPLICABLE FEDERAL, STATE AND LOCAL REGULATIONS. ~u1Cl xes~urce HCL1VaLlOn -22- 01/29/2007 F CHEVRON 203576 SiteID: 015-021-0015~~ ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ ~ Special Hazards --- Utility Shut-Offs 08/22/2005 A) GAS/PROPANE - TANK N SIDE O.F LOT B) ELECTRICAL - INSIDE FOOD MART BACK ROOM (MAIN IS IN BREAKER BOX) C) WATER - METER: NE SIDEWALK OF BRIMHALL RD D) SPECIAL - EMER PUMP SHUT-OFF: CASHIER CONSOLE & NE CRNR OF FOOD MART OUTSIDE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS. NEAREST FIRE HYDRANT - SW CRNR BRIMHALL & COFFEE RDS. O1/29/20~`1 Building Occupancy Level 03/17/2046 9 EMPLOYEES -23- Ol/29/~007 F CHEVRON 203576 SiteID: 015-021-001522 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 08/22/20~3~ ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: TRAINING INCLUDES BUT IS NOT LIMITED T0: A) HAZARD COMMUNICATION PROGRAM, WRITTEN AND AUDIO/VIDEO PROGRAM, INCLUDING MSDS REVIEW. B) HAZWOPER, WRITTEN-AND AUDIO/VIDEO PROGRAM. C) AT A MINIMUM, ALL EMPLOYEES ARE TRAINED INITIALLY (UPON HIRE) AND TRAINING IS REFRESHED ANNUALLY. rage ~ nciu i~L ru~urc u5c nc1.u ivi r u~.utc vac -24- 01/29/2007 C~ -,~ ~ r- Tar~kn+r'lo 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: 12/20/2006 Order Number: 3150110 ~~~~~s Date Printed and Mailed: 12/29/2006 Dear Regulator, Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Leak detector tests Monitor Certification Secondary Containment-Spill Container Sincerely, ~r ~a~~~rr~. Dawn Kohlmeyer Manager, Field Reporting ~~ ~~ Tan I PURPOSE: COMPLIANCE TEST DATE: 12/20/06 CLIENT: CHEVRON PRODUCTS COMPANY P.O. BOX 6004 L-2375B1 SAN RAMON, CA 94583 BRETT BONACCI (925)842-5047 TANKNOLOGY CERTIFICATE OF TESTING 8900 SHOAL CREEK, BUILDING 200 AUSTIN, TEXAS 78757 TELEPHONE (512) 451-6334 FAX (512) 459-1459 TEST RESULT SUMMARY REPORT WORK ORDER NUMBER: 3150110 CUSTOMER PO: 4671044 SITE: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA 93308 MANAGER (661)588-9066 Product Pine Tightness Test Results IMPA LINE LINE LINE DELIVERY TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL TYPE A B C D A B C D FUNCTION 12k 1 SUPREME DW FIBERG PRESSURE Y 12k 2 PLUS DW FIBERG PRESSURE Y 12k 3 REG UNLEAD DW FIBERG PRESSURE Y Fxic4inn 1 ina I aalr Ilo4or4nr Tcc4 EkiSTfNG LEAK DETECTOR #1 EXISTING LEAK DETECTOR #2 LINE R ID MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL.#, SERIAL # ESULT 12k 1 VEEDERROOT ELECTRONI 011505 P 12k 2 ~IEEDERROOT ELECTRONI 013652 P 12k 3 VEEDERROOT ELECTRONI 013649 P Npw Rpnlar_pmpnt I ina I aalc Ilafar+n~ Toc4 REP LACED LEAK DETECTOR #1 RE LACED LEAK DET ECTOR #2 i LINE MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESULT ID r~~ ~wuc~ ucuxucu icpun wi~uuauvu, visa www.iauKt~u~ugy.cum gnu SG~GCt VII-LIIIC KCpORS-WIWY, OC CO11[8GI your IOC81 13I1KllOlOgy OIIICC. Tester Name: TIMOTHY COULTER Technician Certification Number: Printed 01/09/2007 11:29 BDERGE INDIVIDUAL TANK INFORMATION AND TEST RESULTS .~ Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 12/20/06 WORK ORDER NUMBER: 3150110 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CHEVRON PRODUCTS SITE: CHEVRON 203576 TANK INFORMATION - Tank ID: ilk 1 Tank manifolded: No Bottom to top fill in inches: 165. o Product: SUPREME Vent manifolded: No Bottom to grade in inches: 170. o Capacity in gallons: 12, 068 Vapor recovery manifolded: YES Fill pipe length in inches: 54. o Diameter in inches: iii. oo Overfill protection: YES Fill pipe diameter in inches: 4. o Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS Test Method: LEAK DETECTOR TEST RESULTS: 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: vEEDERROOT Fluid volume in gallons: Model: ELECTRON=c Tank water level in inches: g/N; oiisos 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: is9. o Determined by (method): Metering psi: Leak rate in gph: Calib. leak in gph: 3. o0 Result: Results: PASS COMMENTS COMMENTS ULLAGE TEST RESULTSTest Method: LINE TEST RESULTS Test type: Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 225.0 Results: Test psi: Bleedback cc: DATA FOR UTS-4T ONLY: Test time (min): Test 1: Start time: Time of test 1: Finish psi: xOT NOT NOT NOT Temperature: NOT VOI Change Cc: TESTED TESTED TESTED Test 2: Start time: TESTED FIOW fate (Cfh): TESTED Finish psi: Time of test 2: Vol change cc: Test 3: Start time: Temperature: Finish psi: Flow rate (cfh): Vol change cc: Time of test 3: Final gph: Temperature: Result: Flow rate (cfh): Pump type: PRESSURE COMMENTS Pump make: FE PETRO COMMENTS Impact Valves Operational: YES Printed 12/29/2006 08:11 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS - Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 12/20/06 WORK ORDER NUMBER: 3150110 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CHEVRON PRODUCTS SITE: CHEVRON 203576 TANK'INFORMATION~`~- ~.-~- ' .:~;~ ~.~,:. , ~. Tank ID: 12k 2 Tank manifolded: No Bottom to top fill in inches: 166. o Product: PLUS Vent manifolded: No Bottom to grade in inches: 171. o Capacity in gallons: 12, 068 Vapor recovery manifolded: YES Fill pipe length in inches: 55. o Diameter in inches: ~ 111. oo Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS 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: vssDERROOT Fluid volume in gallons: Model: ELECTRON2c Tank water level in inches: S/N; oiaesz 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: ia9 . o Determined by (method): Metering psi: Leak rate in gph: Calib. leak in gph: 3.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE TEST RESULTSTest Method: uNE TEST RESULTS Test type: ,. _ Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2 . o Ullage pressure: Length (ft): 225.0 Results: Test psi: Sleedback cc: DATA FOR UTS~T ONLY: Test time (min): 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 12/29/2006 08:11 ACRAMER INDIVIDUAL TANK INFORMATION AND TEST RESULTS Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 TEST DATE: 12/20/06 WORK ORDER NUMBER: 3150110 AUSTIN, TEXAS 78759 (512) 451-6334 CLIENT: CHEVRON PRODUCTS SITE: CHEVRON 203576 - TANK INFORMATION ,:, .. ~.: . ; -, ~~;' Tank ID: 12k 3 Tank manifolded: No Bottom to top fill in inches: 165.0 PfOdUCt: REG UNLEAD Vent manifolded: No Bottom to grade in inches: 170. o Capacity in gallons: 12, 068 Vapor recovery manifolded: YES Fill pipe length in inches: 54. o Diameter in inches: iii. 00 Overfill protection: YES Fill pipe diameter in inches: 4 • o Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK:TEST RESULTS 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: vEEnERROOT Fluid volume in gallons: Model: ELECTRONIC Tank water level in inches: S/N: 0136,9 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: ie9 . o Determined by (method): Metering psi: Leak rate in gph: Calib. leak in gph: 3.00 Result: Results: PASS COMMENTS COMMENTS ULLAGE:TESTRESULTSTest Method.. LINE TEST RESULTS Test type: , Test time: Material: Dw FIBERG Ullage volume: Diameter (in): 2.0 Ullage pressure: Length (ft): 225.0 Results: Test psi: Bleedback cc: Test time (min): DATA FOR UTS-4T ONLY: Test 1: Start time: Tlme Of test 1: Finish psi: NOT NOT NOT NOT Temperature: NOT VOI Change cc: TESTED TESTED TESTED Test 2: Start time: TESTED FIOW ratio (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 12/29/2006 08:11 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: CHEVRON 203576 Site Address: 1125 COFFEE RD. Facility Contact Person: MANAGER Make/Model of Monitoring System:TLS-350R B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspectedlserviced TanklD: 87 TanklD: 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 420 Annular Space or Vault Sensor. Model: V/R 420 X Piping SumplTrench Sensor(s). Model: V/R 208 Piping Sump/Trench Sensor(s). Model: V/R 208 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 ^ Electronic Line Leak Detector. Model: V/R PLLD X Tank Overfill/High-Level Sensor. Model: ATG ® Tank Overfill/High-Level Sensor. Model: ATG Other (specify equipment type and model in Section E on page 2). ^ Other (specify equipment type and model in Section E on page 2). Tank ID: Tank ID: In-Tank Gauging Probe. Model: MAG 1 ~ In-Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: V/R 420 ~ Annular Space or Vault Sensor. Model: X Piping Sump/Trench Sensor(s). Model: V/R 208 ^ Piping SumplTrench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: V/R PLLD Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: ATG Tank Ove~ll/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). ^ Other (specify equipment type and model in Section E on page 2). Ispenser 1-2 Dispenser ID: 3-4 X^ Dispenser Containment Sensor(s) Model: BEI 406 ~ Dispenser Containment Sensor(s) Model: BEI 406 X^ Shear valve(s). X Shear Valve(s) Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). DispenserlD: 5-6 DispenserlD: 7-8 Dispenser Containment Sensor(s) Model: BEI 406 ~ Dispenser Containment Sensor(s). Model: BEI 406 X^ Shear Valve(s). ® Shear Valve(s). Dispenser Containment Float(s) and Chain(s). ~ Dispenser Containment Float(s) and Chain(s). Dispenser ID: 9-10 Dispenser ID: 11-12 Dispenser Containment Sensor(s) Model: BEI 406 ~ Dispenser Containment Sensor(s). Model: BEI 406 X^ Shear Valve(s). ~ Shear Valve(s). Dispenser Containment Float(s) and Chain(s). ~ Dispenser Containment Float(s) and Chain(s). 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 ail that apply): ~ System set-up ~ Alarm history report Technician Name (print): TIMOTHY COULTER Date of Testing/Service: 12/20/2006 Work Order Number: 3150110 /~ Signature: Certification No.: 634132 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: 12/20/2006 City: BAKERSFIELD CA Zip: 93308 Contact Phone No: 588-9066 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification = Monitoring System Certification Site Address: 1125 COFFEE RD. Date of Testing/Service: 12/20/2006 D. Results of Testing/Servicing Software Version Installed: 324.03 Complete the following checklist: Q Yes No * Is the audible alarm operational? ^Q Yes ~ No' Is the visual alarm operational? ^X Yes No' Were all sensors visually inspected, functionally tested, and confirmed operational? Yes ^ No' Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No' X N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? 0 Yes ~ No' ~ N/A For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) ^X Sump/Trench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ~ Yes ^ No Ox Yes ~ No' ~ NiA For tank systems that utilize the monitoring system as the primary tank oventll warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? so ^X Yes' ~ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. 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. ves ^X 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: Replaced Veeder-Root 420 annular sensor on 91 tank. Sensor failed to reset after testing. Unable to test the 87 annular sensor due to it being stuck in the riser, all other tests passed. Will return after repairs have been made. Page 2 of 3 Based on CA form dated 03/01 Monitoring System Certification Site Address: ~ ~ ~~ rnGGGG an F. In-Tank Gauging /SIR Equipment Date of Testing/service: 12/20/2006 ^ Check this box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes ^ No' Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ^x Yes ^ No * Were all tank gauging probes visually inspected for damage and residue buildup? Yes ^ No' Was accuracy of system product level readings tested? QYes ^ No' Was accuracy of system water level readings tested? Yes ^ No * Were all probes reinstalled properly? Yes ^ No * Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) Complete the following checklist: ^ Check this box if LLDs are not installed. Q 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: Q 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/A For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^X Yes ^No * ^ N/A For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ^x Yes ^No * ^ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? Q 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? O Yes ^No * ^ N/A For electronic LLDs, have all accessible wiring connections been visually inspected? Yes ^No * Were all items on the equipment manufacturers' maintenance checklist completed? ' In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 Based on CA form dated 03/01 SB-989 SECONDARY CONTAINMENT SUMMARY RESULTS ~~ TanKnology TEST DATE:12/20/2006 WORK ORDER NO.: 3150110 CLIENT: CHEVRON PRODUCTS COMPANY SITE: CHEVRON 203576 P.O. BOX 6004 1125 COFFEB RD. L-2375B1 SAN RAMON CA 94583 BRETT BONACCI 925-842-5047 Tank Interstital Tests BAKERSFIELD CA 93308 Piping Interstital Tests PRODUCT MANUFACTURER-_ TANK RESULTS: PRODUCT - MANUFACTURER _ LINE RESULTS SUPREME PLUS REG UNLEAD Sume &Under-Dispenser Containment Tests Sump/ DISP.# MANUFACTURER P/F 87 FILL Phil-Tile Pass 89 FILL Phil-Tile Pass 91 FILL Phil-Tile Pass Tanknology representative: BRIAN DERGE Services conducted by: TIMOTHY COULTER Test Date: 12/20/2006 Tan~cnology Work Order: 3150110 SECONDARY CONTAINMENT TEST RESULTS SUMP TESTS Type Tank or Disp Manufacturer Model or Diam./Width/Length Depth Test Method Start Initial Level Finish Final Pass/ Fail # Material ~ ") ~ ") Time Level Change Time Result Spill Container 87 FILL Phil-Tite Plastic 10 7 1030 6 0 1100 6 Pass Spill Container 89 FILL Phil-Tite Plastic 10 7 1030 6 0 1100 6 Pass Spill Container 91 FILL Phil-Tite Plastic 10 7 1030 6 0 1100 6 Pass mments: Spill Containers were tested using a thirty minute visual. { I ~~ I 4 I I ~ Work Order: 3150110 9. SPILLIOVERFILG CONTAINMENT BOXES I~z -°f - Comments - {inelade information on repairs made prior to tesiixg, and recommended follow-up far failed tests} .e Faoility is Not Equipped With Spi]UOverfill Containment Boxes Spi lUOverfill Containment ]Boxes are Present, but were blot Tested Test Method Developed By: Spill Bucket Manufacturer Industry Standard Professional Engineer _ Othar t`~cllY) _p~3r~ ~? Tr' Test MethodLlsed: Pressut+e ~ VacuFlrrl ydrostat~c tither (S~ecify} Test Equipment Ussd: ~!Y S U G. Equipment Resolution: •- ~ Splll Box #fs[y -a"` Splll Boz #fi-¢ `~I ~ Spill Boz #ff~ Spill Boz # Hucket Diameter: ~. ~ /O !O Bucket llepth: ...._. Wait time between applY`ng. prtss~ue/vacuurn/water and starting test: ~) n~,rg 3r~ -ti~$ 3CJ ~z'~ S Test Start Time: (p p /rj ~ 0 1 T 3 n Initial Reading (R~}: ~~- T 6 6 Test End Time: ~- [ ©6 (!00 .. - lI b b -- .__ Final Reading (RP): - ~ ~ ..._ Test Duration: ~'O,tir,~wj _ rMy,e.S 3o.ti?~'S . Cbange in Reading ~ ~) ~ . . ~ -- ._._-_ ~ ~ .. PasslFail 'Ct~reshold or Criteria: __ ~,, Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 ~ 7antmalogy 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:12/20/06 WORK ORDER NUMBER3150110 CLIENT:CHSVRON PRODIICTS COMPANY SITE:CH$VRON 203576 COMMENTS Monitor Certification, Leak Detector Testing, & Spill Bucket Testing. (2) hours labor trouble shooting system, unable to test the 87 annular sensor due to it being stuck in the riser, all other tests passed. PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 12/29/2006 08:11 ACRAMER ITE DIAGRAM ~ Tanlv~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 12/20/06 CLIENT:CHEVRON PRODIICTS COMPANY WORK ORDER NUMBER3150110 SITE: CHEVRON 203576 • '~ L2 N S L STP 82KO OI OV OF L3 87 L6 CANOPY STP 12KO O O O z w L4 91 L5 > STP 12 OA OI OV OF .. DUMP- STER C-STORE (D AIR/ ICE v H2O Printed 12/29/2006 08:11 ACRAMER Vviork Order: 3150110 T i:supREME T 2:PLUS HIGH tw-TER ALAC,t't DEC 2G. 2006 1J:20 kIGM WATER ALARM JAN 10. 2006 9:58 AEC 20. 20U6 14:23 T 3:REGULAR JAN 10. 2Ct06 9:58 OVERF[I.t ALARM HIGti WATER ALARM DEC 20. 20G6 14:25 OVERFILL ALARM ' DEC 0. 2006 1x:22 AEC 12. 2006 14:56 DEC 20. 2006 14:26 JAN 10. 200b '3:58 OCT 21. 20D6 8:44 JRN 10. 2006 10:05 JAN 10. 2006 9:49 OVERFILL ALHRPI SUDDEN LOSS HLARM DEC Z0. 2D05 14:25 AEG 20. 2006 14:16 HIGH PRODUCT MLHR11 DEC 6. 2GG6 12:21 DEC 20. 2006 14:x6 DEC 5. 20G6 2D:16 HIGH PRODUCT ALARM JAN 10. 20D6 ID=16 LEC' 20. 2D06 14:25 JAN I0. 2006 9:49 SUDDEN LOSS ALARM JAN 10. 2006 10:27 Dl+C 2D. 2D06 14:17 JAN 1D. 2006 10:07 INVALID FUEL LEVEL DEC 20. 2006 14:21 .iIGH PkUDUCT ALARM 1 f+i++ALID FU>~L LEVEL APR 6. 2006 2G:33 DEC 20. 20Uti 14:25 DEG 20. 2006 14:17 JAM 10. 2006 1D:28 JAN t0. 20D6 10:27 JAN 30. 200b 101:31 JAN 10. 200b 1D:07 PROBE OUT PROBE OUT DEG 20. 2006 14:59 INVALID FUEL LEVEL D>:C 2D. 200n 15:02 DEf; 20. 2006 14:19 DEC 20, zad6 14:19 DEG 20. 2GD6 14:16 APR 7. 2005 8:40 DEC 8, 2006 12:06 APR 7. 20D6 8:40 CEP 2. 2D06 14:21 HIGH WATER wRkNINu HIGH WATER WARNING DEC 20. 2DUE 14:54 FROBE UUT D1rC 20. 20D6 14:20 AEG 20. 20D6 1x:23 DEC 2G. 200ii 15:00 JAN ]d. 2006 9:58 JAN 10- 20D6 9:58 pJ;C 20. 2DOe 14:17 APR 7. 2006 8:40 DELIVEPY NEEDED DELIVHRY NEEV£D H1GH WATER WARNING DEC 20. 2006 14:17 DEC: ZQ. 2006 14:2p DEC 20. 2006 14:54 JUL 20. 2006 18:54 AUG 3. 2006 8:45 DE7i: 20. 2006 14:22 RPR 13. 2006 14:32 APR 6. 2006 1a:28 JAt~ 10. 2006 9:58 MAX PRODUCT ALARM MAX PRODUCT ALARM DEC 20. 2000 14:50 DEC 2D. 2006 14:55 U8L1vERY NEEDED JAN 10. 2006 10:27 JAN 1D. ?OOo lD:ib DEC 20. 2006 14:19 DEC 1D. 2006 14:09 DEC B. 2006 10:52 LUW TEMP WARNING LOW TEMP WAR NING DEC 20. ~nD6 15:03 DE]C 20. 2D06 15:00 hWX PRODUCT ALARM DEC 20. 2006 14:Y0 D5C 20. 2UD6 14:50 JAN 10. 20D6 10:27 - SEN£i0R ALARM - ~ - -- SENSOR ALARM ----- - _ SENSOR ALF+T.'M ----- L 1:SUFREM€ TURBINE SUMP L 3:REG TURFI INE SUIiP L 5:PLU° TUR91NF. SUMP STP SUMP STP SUMP STP SUMP SENSOR OUT ALARM SENSOR OUT ALARM SE1~3t5R OUT ALARM DEC 20. 2D06 12:27 DEC 2D. 200b 12:27 DEC 20. 2006 12:27 FUEL ALARM FUEL ALARM 2006 DEG 20 10:25 FUEL ALARM DEC 20. 2006 10:21 . r~~,C: 20. 20U6 10:26 SENSOR 4UT ALARM SENSOR OUT AI~RM 5ENS012 OUT ALARM JAN 10. 2006 9:40 JAN 10. 2006 9:40 JAN 1G. 200b 9:4U ----~- SENSOR ALARM -••--- - SENS~K' HLARM -=---~ ____ SEh15UR ALARM ----- L 2:SUpREME pNNULHR t 4:PLOS ANNULAR L 6:REGULHR f~NNULkR ANNULAR SPAC)r ANNULAR SPACE ANNULAR SPACE FUEL ALARM DEC 20. 2065 13:46 FUEL ALARM D£C 20. 2006 13:44 SENSOR OUT ALARM I~EC 20. 20Gb 12:27 FUEL ALARM sE1VSOi2 OUT ALFjRM SENSOR OOT AL ARM p£C 2D. 2006 13:31 DEC 20. 2d06 13:31 JHN IJ. 2006 9:.10 8E'I'UP DATA WARNINu DEC 20. 2006 13:17 FUEL HLARM DEC 20. 20Do ]3:31 Ft1EL ALARM JAN 10. 2uU6 9:29 Tanknology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 ,. -" " Work Order: 3150110 ----- SENSOR ALARii ---__ G f:SUPREM£ PLLD :sFIUTDOwN HLARM [SEC 20. 2406 13:19 GROSS LINE FAi[. DEC 2b• 2006 13:19 PLLD SHUTDOWN ALARM LtEC 20. 2006 13:16 PLLD 9HUTDGWN ALARM DEC 20. 2006 12:21 PLLD SHUTDOWN ALARM [3EC 20. 2306 11:26 PLLD SHUTDOWN ALARM DEC 20. 2006 10:22 PLLD SHUTDOWN ALARM D£C 20. 2096 10:2 PLLD SHUTDOWN ALARM DEC 20. 2006 10:21 FLLD SHUTL~DWN ALHRM PCT 27. 2006 17:27 ----•- S$~iJR ALARM - ----• Q 2:PLUS PLLD SHUTDOWN ALARM DEC 20. 2Dfl6 t1:I0 GROSS LINE T•'AIL DEC 20, 20+36 11:10 PLLD gHUTD(x,6N ALARM DEC 2D. 2006 10:30 PLLD SHUTDOWN HLARM DEC 20. 2006 10:29 PLi.D SHUTDOWN ALriRI.1 UEC 20. 2006 19:29 PLLD SHUTOOWN ALARM DEC 20. 2006 14:29 PLLD SHlf1•DOWN ALAftM DEC 20. 20116 19:28 PLLD SHUTDOWN ALHRM D1;C 20. 2006 10:27 PLLD SHUTDOWN ALARM DEC 20. 2006 10:27 ----- SENSOR ALARM ----"' 9 3:REGULAR DECD 2flHU200bN 1fl~06 GROSS LINE FAIL D~.C' 2G. 209£ 11:06 PLLD sHUTDO[dN ALARi-1 DEC ?0. 2006 ID:?5 FUEL. Oti}T Dom; 9. 2006 1'2:27 Fll£L OUT 5Ep 2. 29Ua 14:39 FUEL UUT HUG d• 2006 13:40 FUEL GuT JUN 16. 2006 1:42 FUEL OUT ~uN 2. 2001; 17:a1 FUEL OUT ~~ a6 MA: 12• 2006 '..-~ r,R06S L l NE FA I L OGT 27. 200£ 17:27 FLLD SHUTDOWN ALARM DEC 2D. 2006 10:25 FUEL OUT i1AY 12. ?t3a6 9:26 Tanlrnology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 ~~ i ~_ Tanla~o/ogy 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 /04/2007 Order Number: 3150321 Dear Regulator, Date Printed and Mailed: 01/17/2007 Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Monitor Certification Sincerely, ~ o~ ~a~ Dawn Kohlmeyer Manager, Field Reporting MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within the State of California Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3 Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. If more than one monitoring system control panel is installed at the facility, a separate certification or report must be prepared for each monitorino system control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: CHEVRON 203576 Site Address: 1125 COFFEE RD. Facility Contact Person: MANAGER Make/Model of Monitoring System:TLS-350 B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced TanklD: 87 TanklD: In-Tank Gauging Probe. Model: In-Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: V/R 420 Annular Space or Vault Sensor. Model: Piping SumplTrench Sensor(s). Model: Piping Sump/Trench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). Tank ID: Tank ID: In-Tank Gauging Probe. Model: In-Tank Gauging Probe. Model: Annular Space or Vault Sensor. Model: Annular Space or Vault Sensor. Model: Piping Sump/Trench Sensor(s). Model: Piping SumprT'rench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: Tank Overfill/High-Level Sensor. Model: Tank Overfill/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). ispenser 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) an d 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.: B-34132 City: BAKERSFIELD CA Zip: 93308 Contact Phone No: 588-9066 Date of Testing/Service: 01/04/2007 Work Order Number: 3150321 Signature: _ License. No.: Testing Company Name:Tanknology Phone No.: (800) 800-4633 Site Address: 8501 N. MoPac Expressway, suite 400, Austin, TX 78759 Date of Testing/Servicing: 01/04/2007 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification ~~--- Monitoring System Certification Site Address: 1125 COFFEE RD. Date of Testing/Service: 01/04/2007 D. Results of Testing/Servicing Software Version Installed: 324.03 Complete the following checklist: ^X Yes No • Is the audible alarm operational? ^X Yes ^ No' Is the visual alarm operational? ^ Yes No • Were all sensors visually inspected, functionally tested, and confirmed operational? ^ Yes ^ No * Were all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? Yes No' N/A If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? ^ Yes ^ No * ^ NIA For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) ^ Sump/Trench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? ^ Yes ^ No ^ Yes ^ No * ^ N/A For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? ^ Yes' ^ No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ^ Yes* ^ No Was liquid found inside any secondary containment systems designed as dry systems? (check all that apply) ^ Product; ^ Water. If yes, describe causes in Section E, below. ^ ves ^ 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: 87 Sensor Test on{y. Page 2 of 3 Based on CA form dated 03/01 ~ Tan/Q~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:O1/04/07 WORK ORDER NUMBEFZi150321 CLIENT:CHEVRON PRODIICTS COMPANY SITE:CHEVRON 203576 COMMENTS 87 Annular Sensor Retest. All tests passed. PARTS REPLACED QUANTITY DESCRIPTION ~ . HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ~:;. ;~.~ ITEMS TESTED J - ,:F ~ ~+4r„? ,-~.~: . HELIUM PINPOINT LEAK TEST RESULTS - . ~ ~ "" Printed 01/17/2007 13:26 KOHLMEYER , ,, SITE DIAGRAM ~ Tanlv~ology 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 01/04/'07 WORK ORDER NUMBER3150321 CLIENT:CHEVRON PRODIICTS COMPANY SITE: CHEVRON 203576 • ~~ L2 N S L STP 82KO OI OV OF L3 87 L6 CANOPY STP O O O O • 12K ~ z w L4 91 L5 > STP 12 OA OI OV OF ~. DUMP- STER C-STORE cD AIR/ ICE H2O Printed 01/17/2007 13:26 KOHLMEYER Y.. __ Work Order: ~ 315 0 3 21 ----- SEN:4R ALARM ----- I. 6:REGUI,FiR flNNULFIR ANNULAR SPACE FUEL w(,ARM JAN 4, 2007 15:23 G.S. f .~fiEURON SHg2 1725 COFFEE RD. ERSFIELD.CA.93312 b6~-588-9066 203576 JHN 4. 20117 t 6:37 SYSTEM ~THTI~.S REPURT ALL FUNCTIOKS NQRMAL Tanlaiology Inc. 8900 Shoal Creek, Building 200 Austin, Texas 78757 12/13/4008 08:87 PN UNDERGROUND STORAQE TANKS APPLICATION TO PERFORM ELD! LINE TESTING !86989 SECONDARY CONTAINMENT TESTING (TANK YKiHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION Tanknology 9096784081 1/1 B~AIL_R~FIELD FIRS DSPT. w~r~ Prevention Services Irff'~ 900 Truztun Ave., Ste. 210 Bakersfielc2, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of t PER1dNT NO. ° ENFU4IVCED LEAK DETECTK~N ~ UNE TESTWG ^ SB-868 SECONDARY CONTAINMENT TESTING D TANK TIGHTNESS TEST ~ TO PERFORM FUEL MONITORING CERTIFICATION SITE INFORMATION ---....- . _--- . _- -~ FACILITY NAME 6 PHONE MB R Of CONTACT PERSON Qon~# - -I~c~6 l~~~G~ ~ ADDRESS ff L , ~ a OWNERS NAME K _ _. _..`~TPtTz-orv_ S~, .._~. N_ Cam. _ OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPINd dOING TO BE TESTED? O YES L] NO TANK ~ VOLUME CONTENTS -~- 7~0~ 8 4 E. ~ ~ V+~~D~ ~~ Z- ~ ~ ~ ~ _ _ --- ~-~5 ~g~~~~t.~0~~ Gds--- - 3 Zo ~ti~ ~S ~~ ~!2 ~~~~ .._.-_ _ _ . . -- -. - - •-. - -- TANK Ti=STINfi COMPANY .~ NAME OF TESTINO COMPANY --- W~5 ~~NU. M pR OF Cppl~~ ~" N~~ v MAILING ADDRESS I ~P ~_ ~c~.A CA q Z D ' NAME IE PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR ~</'~~ CERTIFICATION S: _ DATE S TIME TES; j0 Z UC ICC #: TEST METHOD SIGNATURE OF AP f -_ .. _ DATE Z ~ GATE ~'~ © ---.. _- APPROVED BY '~ " ~ FD 2095 {Rev. 09!05) ;~. CALIFORNIA Certified Unified Program Agency HAZARDOUS MATERIALS BUSINESS PLAN HMBP 2006 Chevron Stations, Inc. #203576 ~p~, 1125 Coffee Rd `'~'~' ~ A~~ ,~ 1125 Coffee Rd, Bakersfield, CA 93308 (661) 588-9066 CHEVRON PRODUCTS COMPANY P.O. BOX 6004 SAN RAMON, CA 94583 (925) 842-9002 FOR POSTI NG I N THE EMERGENCY RESPONSE BINDER at the CASHIER ARE PHON E ~'~~5 ~s~ ~Q06 Jeanni Loven ~,~203576 HMBP.pdf ~~~~~~~ ~'~~~~~ ~ ~ ~ ~~'~~~~'~ ~~ ~~~~~~~~~ Page 2 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATI ON BUSINESS OWNERIOPERATOR IDENTIFICATION P<ge Of I . I DENTI FI CATi ON FAgLITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 BEGINNINGDATE 100 ENDINGDATE ~~ 01/0112006 12131/2006 BUSINESS NAME(semeesFACIU7rNAME«oeA-Doitgau9re$AS) 3 BUSINESSFHONE +~ Chevron Stations Inc. #203576 (661) 588-9066 BUSI N ESS SITE A DDRESS ~~ 1125 Coffee Rd . qTY ioo ZIPCODE ~~ Bakersfield CA 93308 DUN&BRADSTREET ias SICCODE(4digit#) ~~ 00-914-0559 5541154111753817542 OOUNTY ~~ Kern BUSINESSOFS=RATORNAME im BUSINESS OPERATOR PHONE nu Chevron Stations Inc. #203576 (861) 588-9066 II.BUSINESS OWNER OWNER NAME »> OWNERF1iONE iiz Chevron Products Com n Attn: Permit Desk L2375 B-1 925-842-9002 OWNERMAILINGADDRESS E na P.O. Box 6004 t N qTY i+a SPATE ns ZIPCODE ~ San Ramon CA 94583 III.ENVIRONMENTAL CONTACT CONTACT NAME ++~ CONTACT FHONE iie Chevron Products Com an Attn: Permit Desk L2375- 61 925-842-9002 CONTACT MA I L I NGADDRESS »a P.O. Box 6004 qTY +zu SPATE izi ZIPCODE ~~ San Ramon CA 94583 PRIMARY- IV.EMERGENCY CONTACTS -SECONDARY- NAME +z,+ NAME ~~ Chevron Maint@nanCe Dis tCh Chevron Emergency Information Center (CTEIC) TITLE ~n TITLE ~za SOlve One H el Desk Chevron Emergency InformalionCenter (CTEIC) BUSINESSFHONE izs BUSINESSRiONE its 866-845-4254 8oo-23i-a623 24HOURPHONE ~zs 24HOURR-IONE ~2s CJ~ron InfOmlati0n CelitCi 80x231-0623 Chevron Emergency Information Center 8oo-23i-0623 Fi4GER# in PAGER# 13z ADDITIONALLOCALLYOOLLECTEDINFORMATION: Catifirdion : Ela3ed on my irpuiry of hose indvidusls re~onsibleforobtaning theinformAion, I oetify ands perry of IaN th3 I haiepeson8ly ecaninei aid anfanilia with theinfixm9ion submitted aid b9ieve theinform@ionistruG anir8e aidcompl6e SIGNATURE OF OVlN93lOPFJtATOR ORDESIGNATED REPRESENTATIVE DATE Tao NAME OF DOCUMENT PREPARER ~3s C(rewon Mats Cmnpmry~Rtr~~ SA~c ~R,~-7LS 3/112006 Richard S. Allen, R.E.H.S. NAME OF SIGNER (prirt) 136 TITLE OF SIGNER 137 Chevron Products CompanylRichard S. Allen, R.E.H.S. Retail H Spedalist ~~,~ / UFCF (1/99) ~~ ~' OES Form 2731 ~~~' ~' ~~ 5~~' 5 ~~~ ~~pD ~y~~- f~ao~ Jeanni~Loven -~ 203576 HMBP pdf ~~ r ~~ ~...~x....,~~ ~ PageY7 =_ t EMERGENCY RESPONSE PROCEDURES GASOLINE and CARBON DIOXIDE FIRE OR EXPLOSION DATA Carbon dioxide is not flammable. CAUTION: Compressed Gas Cylirxier may explode in heat of fin;. HEALTH HAZARD CAUTION: 1. Vapors may cause dizziness or suffocation. 2. Contact with liquid carton dioxide may cause frostt~ite. In the event of a fire, spill, leak, or suspected leak in the tanks, piping, or cylinder, or natural disasters such as an earthquake or flood, the following steps are to be taken as applicable 1. TURN OFF PUMPS using khe Emergency Pump Shut-0ff witch. 2. EVACUATION : If there is any immediate danger, ANNOUNCE to all persons on the site: 'There is an emergency. Please tum off your engines and leave the station on foot immediately." 3. CALL FOR HELP in case of an emergency by dialing 9-~ -~ and giving the fdlowing information: 'THERE IS A FIRE /GASOLINE SPILL at the station (1125 Coffee Rd, Bakersfield )." If anyone is trapped or needs medical atterrtion, tell the answering dispatcher. Stay on the phone and be prepared to answer arty questions erring the situation. 4. LOOK AROUND to assure that all others have left the station if necessary, particularly those in vehiGes who may need assistance or may not have heard the emergency anrarm cement. Assist or direct assistance to, anyone having difficulty leaving the station area, ar>d anyone who may be irqured. 5. ATTEMPT TO EXTINGUISH arty small or incipient fire if you can do so safety. Have the fire extinguisher rezdy to use in the event of any spill. Try to contain any large spill, or use absorbent on smaller spills. 6. REPORT to arriving emergency response personnel to provide them with arty information or assistance they might need using the Hazardous Materials Business PlanlEmergency Response Procedures. 7. CONTACT the station Operator 'rf slime is not already at the station. Use the List below for emergency contacts: Station Manager I I o,ome 8. NOTIFY Ctmevron Maintenance-Sdv a One by phone WITHIN 24 HOURS 1-866.8454254 or CHEVRON EMERGENCY INFORMATION CENTER 1.800-231-0823 Chevron will notify the appnop riate State and Local agencies unless the situation reaui res urgent immediate response by the aosncie~, in which case the OPERATOR should notify these agencies: 1. LOCAL UST AGENCY ;Bakersfield City Fire Department 1 (661) 326-3979 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES (24 Hours), SOOS52-7550 3. NATIONAL RESPONSE CENTER (24 Hours), 80024-8802 9. Operator should attempt to isolate leak location by inspection. 10. Chevron will coordinate whatever coredive acYron s need to be taken beyond the Operators capabilities. Chevron will file whatever reports need to be filed with local and state agencies, and send a copy to the station for the Operator's files. 11. EVACUATION: In the event evacuation is necessary, the attendant will announce for all customers and personnel to evacuate the building using the nearest exit door. All persons should go to the emergency assembly area as designated on the site map. Bring the Hazardous Materials Business PlanlEmergency Response Procedures to assist emergency responders. 12. RE-ENTRY : If evacuation has occurred and emergency resporxie rs have been called, re~rrtering this facility should take place with extreme caution and Drily under the direction of the senior emergency responder on site and Chevron personnel. THESE END=RGENCY RESPONSE PROCEDURES MUST BE POSTED CONSPICUOUSLY ON SRE ALONG WITH THE ATTACHED SITE PLAN UR"F (1/99) OES Form 2731 Jealini Loven - 203576 HMBP pdf~~~~~~ ~~~~~ ~ ~~ ~ ~ ~~~~ ~~ ~ Page 8 k SIT SPECIFIC EMERGENCY RESPONSE TRAINING PLAN Employees must be given this training before starting work, aril refresher courses must be provided annually. Records must be kept to shcwv when each station employee has been given his/her safety training. Use the fdlowing outline and make copies as needed. Have employee date and sign this document upon completion of training. Retain these records for a minimum of three years. I. FIRST THINGS TO IQWOW: A EMERGENCY PUMP SHUT-0FF: This toms off the turbine pumps that provide flow to the dispensers from the undergro~uid tanks. Incase of a leak, shutting offthe pumps will help to prevent spills. LOCATION: 1-CASHIER AREA. 1-0IJTSIDE BUILDING. 1- DISPENSER ISLAND B. ELECTRICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. LOCATION: BACKROOM OF STORE C. WATER SHUT-0FF: The water shut-0ff may be necessary in some cases. LOCATION: LANDSCAPE AREA ON MAIN D. NATURAL GAS SHUT-0FF : If your station has natural gas, it may be necessary to shut-aff the natural gas flow in an emergency. LOCATION: NONE E. FIRST AID IUT: LOCATION: BACKROOM OF STORE F. FIRE EXTINGUISHER : Use only on small fires that you can handle. Do not attempt to extinguish large fires on your own; call &1-1 for help. LOCATION: 1-AT CASCASHIER AREA 1- BACKROOM OF STORE G. SPILL RESPONSE KIT: Use FM-186 in accondarxe to manufactures recommendations. FM-186 is to be used to immediately dean up small Gasoline and Diesel spills. Incase of large spill, merely try to contain it; a vacuum truck should be used to dean up any large spills. LOCATION: BACKROOM OF STORE H. EMERGENCY EVACUATION AND ASSEMBLY AREA: LOCATION: EAST SIDE OF BUILDING ON MAIN I. NEAREST MEDICAL FACILITY: Employees should know what fadlities are available in case customers or other employees need medical attention. Bakersfield Heart Hospital (661) 316-6000 3001 Sillect Ave ,Bakersfield, CA 93308 3.OmiNE uracF ~vss~ oES Form zral ~Jeanni Loven - 203576 HMBP.pdf ~ ~~'~'~~~~ ~~~ ~~~~~~~~~~~~~~ ~~~~ ~~~ ~~Page 9 I I. All employees should review the Service. Station Monittxirxl Plan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emergences, and know how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the Emert3ency Response Plan filed by your business to the appropriate local agency. Thirdly, employces should review and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials s><xed at the station and must be drilled in all emergency response procedures contairred herein. III. FIRST AID PROCEDURES for EXPOSURE TO GASOLINE AND DIESEL FUEL A EYE CONTACT: Flush with water for 15 minutes while hddirg eyelids open. Get medical attention. B. SKIN CONTACT: Flush with water while removing contaminated cothing and shoes. Fellow by washing with soap and water. Do not reuse cothing or shoe s until cear>ed. If irritation persists, get medical attention. C. INHALATION (Breathing: Remove victim to fresh air and provide oxygen 'rf breathing is difficult. If rat breathing, give artificial respiration. Get rrredical attention. D. INGESTION tSwallowimpl: DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. E. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, kbnvk~si ons or urxanscousne ss occur before emesis, gastric lavage using a cuffed endotracl>eal tube should be considered. F. For further information, ccrosult the Materials Safety Data Sheets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. ANNUAL CLASSROOM EMPLOYEE TRAINING TOPICS ' Hazwoper ' Hazard Communication ' LodcoutlTagout ' California Impact Valve & Nozzle Operation ' Fire Safety ' Safety Orientation ' SB 198 Injury Illness & Prevention Program ' Emergency Response & Spill Cleanup Procedures ' Robbery Prevention System ' Alcohol and TobacooAwareness Document prepared by: Chevron Products Company/Richard S.Allen, R.E.H.S., Retail HES Specialist UR"F (1/99) OES Form 2731 Jeanni Loven - 203576 HMBP,pdf ~ ~ ~ ~~ ~~~~~'~~~ ~~"~ ~~ ~~~ ~ ~~ Page 10 ,r Hazardous Materials Business Plan/Emergency Response Employee Training Log BUSINESS NAME: Chevron Stations, Inc. #203576 ADDRESS: 1125 Coffee Rd, Bakersfield, CA 93308 Em to es must si n this rm to rove the received their INfIIAL and/or ANNUAL Emer en Re once Traini EMPLOYEE SIGNATURE DATE OF TYPE OF TRAINING EMPLOYEE NAME TRAINING Initial orAnnt,ial Refresher UPCF (1/99) OES Form 2731 .- UNIFIED PROGRAM INSPECTION CHECKLIST;:' .Y.., .....,. , . :~:.,... .,.. :..,... .SECTION 1: Business Plan and Inventory Program ~ Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME 3 ~~~ NSP CTIO DATE INSPECTION TIME ,c ti c ADDRESS H ENO. O OF EMP EES FACILITY CONTACT USINESS ID NUMB R ~ ~~ 15-021- r Section 1: Business Plan and Inventory Program ~ ~ ~ ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^SP ION C V (c=Compliance OPERATION V=Violet;on COMMENTS ^ APPROPRIATE PERMIT ON HAND CA/. ^ BUSltlt?SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS l~^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ~^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PRO DURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINENS PROPERLY LABELED E{~1~a_'j r o ,~~ ~~I ~~ ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON 51TE9 EXPLAIN: __ QUEST S REGA I THIS INSPECTION? PLEASE CALL US AT (681) 926-3979 ns or (Please Print) Fire revention / 1" In /Shift of Site/Station q Btutn Sde/School Site Responst a Party (Please Prnt) White -Prevention Services Yellow - Station Copy pink - Business Copy FD2049 (Rw. 02105) ^ YES ^ NO BASERSFIELD FIRE DEPT a Prevention Services r~I~s 900 Truxtun Ave., Suite 210 Arw>riM t Bakersfield, CA 93301 1~' M ~ `d ~ _ ~ ro 1 \W y1 ~a ~ ,~1 1 ;,~!{, ~g~~~l ..~~ FACILITY NAME_ O 1 CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF I~,NVIRONI<'IF.NTAL SERVICES UNIFIED PROGRAM INSPEC:T'ION CHECKLIST 1715 Chester Ave., 3r`' Floor, BakiersBeld, CA 93301 INSPECTION DATE ~ ~~ ~_ Section 2: Underground Storage Tanks Program ^ Routine ombined ^ Joint Agency ^ Multi-Agenc ^ -'omplaint ^ Re-inspection Type of Tank (k~F'CS Number of "Tanks Type of Monitoring _ ~L ~ Type of Piping OPERATION C V COMMENTS Proper tank data on the Proper owner,'operator data un 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 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 the with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overtill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: Office of Environmental Services (661) 326-3979 4Vhhitc - f-nv. Svcs. ~ ~ ~~~.~~ Bus n ss Site Responsible Party Pink - 13usincss Ci~ry Chevron Products Company ppri12o06 ~~, 2006 Financial Responsibility Station List ~ -- ST A 0r; Name City of Bakersfield Office of Emergency Services 1715 Chester Ave., Third Floor Bakersfield CA 93301 'i,'6RtlYTVfI - -. ?;Fadl~ty No. - ORerator Al?DR 98109 CHEVRON STATIONS INC 1131 OAK ST 201527 CHEVRON STATIONS INC 6601 MING AVE i 203576 CHEVRON STATIONS INC- ---' - 1125 COFFEE RDA 206561 CHEVRON STATIONS INC" -~ 3360 PANAMALN CST.1' STATE - 2IP - BAKERSFIELD CA 93304-1063 BAKERSFIELD CA 93309-3446 BAKERSFIELD CA 93308-5747 BAKERSFIELD CA 93313-3695 April 29, 2005 Chevron City of Bakersfield Office of Emergency Services-UST 1715 Chester Ave., Third Floor Bakersfield, CA 93301 Chevron Products Company, Inc. P.O. Box 6004 Attn: Permit Desk San Ramon, CA 94583-0904 Charles Bittle HES Permits Specialist Phone No. 925-842-9002 Fax No. 925-842-9585 RE: FINANCIAL RESPONSIBILITY FOR UNDERGROUND STORAGE TANKS Please find the following documents enclosed: 1} Proof of Financial Responsibility 2) Certificate of Financial Responsibility 3) .Chevron Facility List under your jurisdiction These documents meet the financial responsibility requirements for all UST's owned by Chevron and have previously been submitted directly to the State. If you have any questions feel free to contact me. Sincerely, Charles Bittle HES Permits Enclosure Che~~~ April 27, 2006 UST FINANCIAL ASSURANCE To Whom It May Concern: Stephen J. Crowe Vice President and Chief financial Officer Chevron Corporation 6001 Bollinger Canyon Road San Ramon. CA 94583-2324 Tel (925) 842-3232 Fa~(425)842-6047 I am the Chief Financial Officer of Chevron Corporation, 6001 Bollinger Canyon Road, San Ramon, California. This letter is in support of the use of the financial test of self-insurance and guarantee to demonstrate financial responsibility for taking corrective action and compensating third parties for bodily injury and property damage caused by sudden accidental releases andlor nonsudden accidental releases in the amount of at least $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate arising from operating underground storage tanks. Underground storage tanks at the following facilities are assured by this financial test or a financial test under an authorized State program by this guarantor: all underground storage tanks owned by Chevron U.S.A. Inc. are assured by this financial test. A financial test and guarantee are also used by this guarantor to demonstrate evidence of financial responsibility in the following amounts under other EPA regulations or state programs authorized by EPA under 40 CFR parts 271 and 145: EPA REGULATIONS AMOUNT Closure (§§264.143 and 265.143} $204,987,223 Post-Closure Care (§§264.]45 and 265.145) $55,496,995 Liability Coverage (§§264.147 and 265.147) $8,000,000 Corrective Action (§264.101(b)) $21,652,392 Plugging and Abandonment (§ 144.63) $225,500 California State Pro~ram Closure $84,786,473 Post-Closure Care $67,753,740 Liability Coverage $42,000,000 Corrective Action 0 Plugging and Abandonment 0 April 27, 2006 Pane 2 Louisiana State Program Closw-e Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment Kansas State Program Closure Post-Closure Care Liability Coverage Corrective Action Plugging and Abandonment Total 0 $3,619,442 0 0 0 0 $ l 65,000 0 0 0 $488,686,765 This guarantor has not received an adverse opinion, a disclaimer of opinion, or a "going concern" qualification from an independent auditor on his financial statements for the latest completed fiscal year. ALTERNATNE II 1. Amount of annual UST aggregate coverage being assured by a test $ 2,000,000 and guarantee 2. A-nount of corrective action, closure and post-closure care costs, $488,686,765 liability coverage, and plugging and abandonment costs covered by a financial test and guarantee 3. Sum of lines 1 and 2 $490,686,765 4. Total tangible assets $120,535,000,000 5. Total liabilities $63, l 57,000,000 6. Tangible net worth $57,378,040,000 7. Total assets in tl~e U.S. $42,965,000,000 April 27, 2006 Page 3 8.~ Is line 6 at least $10 million? 9. Is line 6 at least 6 times line 3? 10. Are at least 90% of assets located in the U.S.? (If "No", complete line 11.) 1 1. Is line 7 at least 6 times line 3? 12. Current assets 13. Current liabilities 14. Net working capital (subtract line 13 from line 12). 15. Is line l4 at least 6 times line 3? 16. Current bond rating of most recent bond issue 17. Name of rating service 18. Date of maturity of bond Yes No X X X X $ NIA $ N/A $ N/A $ N/A AA Standard & Poors June 1, 2025 Yes No 19. Have financial statements for the latest fiscal year been filed with X the SEC, the Energy Information Administration, or the Rural Electrification Administration? I hereby certify that the wording of this letter is identical to the wording specified in 40 CFR part 280.95(d) as such regulations were constituted on the date shown immediately below, except that information concerning California, Kansas and Louisiana was added to make disclosure more complete. ~; ,~ , ,,~ Stephen J. Crowe Vice'President and Chief Financial Officer April 27, 2006 April 27. 2006 Page 4 GUARANTEE Guarantee made this April 27t'' day of 2006, by CHEVRON CORPORATION, a business entity organized under the laws of the State of Delaware, herein referred to as guarantor, to EPA Regional Administrators and/or state agencies implementing underground storage tank regulation for the states listed in Paragraph 2 (hereinafter collectively refen~ed to as the "implementing agencies"), and to any and all third parties, and obligees, on behalf of CHEVRON U.S.A. 1NC. ("CUBA"), of 6001 Bollinger Canyon Road, San Ramon, California. RECITALS 1. Guarantor meets or exceeds the financial test criteria of 40 CFR 280.95(b) or (c) and (d) and agrees to comply with the requirements for guarantors as specified in 40 CFR 280.96(b). 2. Guarantor otims or operates the following underground storage tanks covered by this guarantee--al] underground storage tanks owned by Chevron U.S.A. Inc. in the following states: Alaska Arizona California Florida Hawaii Oregon Texas Washington This guarantee satisfies 40 CFR part 280, subpart H requirements for assuring funding for taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases arising from operating the above-identified underground storage tanks in the amount of $1,000,000.00 per occurrence and $2,000,000.00 annual aggregate. 3. On behalf of our subsidiary, CUBA, guarantor guarantees to implementin; agencies and to any and all third parties that: L~ the event that CUBA fails to provide altenlative coverage within 60 days after receipt of a notice of cancellation of this guarantee and the Director of the implementing agency has determined or suspects that a release has occun-ed at an underground storage tank covered by this guarantee, the guarantor, upon instructions from the Director, shall fund a standby trust fund in accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. In the event that the Director determines that CL'SA has failed to perform corrective action for releases arising out of the operation of the above-identified tanks in accordance with 40 CFR 280, subpart }:. the guarantor upon written instructions from the Director shall fund a standby trust in - April 27, ?006 - Page 5 accordance with the provisions of 40 CFR 280.108, in an amount not to exceed the coverage limits specified above. if CUSA fails to satisfy a judgement or award based on a determination of liabi{ity for bodily injury or property damage to third parties caused by sudden and/or nonsudden accidental releases arising fl-om the operation of the above-identified tanks, or fails to pay an amount agreed to in settlement of a claim arising from or alleged to arise from such injury or damage, the guarantor, upon written instructions from the Director, shall fund a standby trust in accordance with the provisions of 40 CFR 280.108 to satisfy such judgement(s), awards}, or settlement agreement(s) up to the limits of coverage specified above. 4. Guarantor agrees that if, at the end of any fiscal year before cancellation of this guarantee, the guarantor fails to meet the financial test criteria of 40 CFR 280.95(b) or (c) and (d), guarantor shall send within 120 days of such failure, by certified mail, notice to CUSA. The guarantee will tern~inate 120 days from the date of receipt of the notice by CUSA, as evidenced by the return receipt. 5. Guarantor agrees to notify CUSA by certified mail of a voluntary or involuntary proceeding under Title 11 (Bankruptcy), U.S. Code naming guarantor as debtor, within 10 days after commencement of the proceeding. 6. Guarantoa- agrees to remain bound under this guarantee notwithstanding any modification or alteration of any obligation of CU SA pw-suant to 40 CFR part 280. 7. Guarantor agrees to remain bound under this guarantee for so long as CUSA must comply with the applicable financial responsibility requirements of 40 CFR part 280, subpart H for the above- identified tanks, except that guarantor may cancel this guarantee by sending notice by certified mail to CUSA, such cancellation to become effective no earlier than 120 days after receipt of such notice by CUSA, as evidenced by the return receipt. 8, The guarantor's obligation does not apply to any of the following: (a) Any obligation of CUSA under workers' compensation, disability benefits, or unemployment compensation law or other similar law; (b) Bodily injury to an~employee of CUSA arising fi-om, and in the course of, employment by CUSA; (c) Bodily injury or property damage arising from the ownership, maintenance, use, or entrustment to others of any aircraft, motor vehicle, or watercraft; (d) Property damage to any property owned, rented, loaned to, in the care, custody, or control of, or occupied by CUSA that is not the direct result of a release from a petroleum underground storage tank; April 27, 2006 . Page 6 (e) Bodily damage or properly damage for which CUSA is obligated to pay damages by reason of the assumption of liability in a contract or agreement other than a contract or agreement entered into to meet the requirements of 40 CFR 280.93. 9. Guarantor expressly waives notice of acceptance of this guarantee by the implementing agency, by any or all third parties, or by CUSA. 1 hereby certify that the wording of this guarantee is identical to the wording specified in 40 CFR 280.96(c) as such regulations were constituted on the effective date shown immediately below. Effective date: April 27, 2006 CHEVRON CORPORATION ~~~- By r r' Step n J. Crowe Vick Presidel~t and Chief Financial Officer ~" By f~~~,,f 1` ~ a t :.-Assis a t Secretary 0 April 27, 2006 Page 7 CERTIFICATION OF FINANCIAL RESPONSIBILITY CHEVRON U.S.A. INC. hereby certifies that it is in compliance with the requirements of subpart H of 40 CFR part 280. The financial assurance mechanisms used to demonstrate financial responsibility under subpart H of 40 CFR part 280 are as follows: Financial test and corporate guarantee of Chevron Corporation in the amount of $I million per occurrence, $2 million annual aggregate, for the period commencing April 29, 2006 and which is anticipated to be renewed annually, with the next renewal scheduled to occur during the first 120 days of 2006. Said guarantee covers taking corrective action and compensating third parties for bodily injury and property damage caused by either sudden accidental releases or nonsudden accidental releases or accidental releases. April 27, 2006 CHEVRON U.S.A. INC. ~. ,9 t 'isa ~ Leinanczyk / -., ~.. Senior Counsel Y _ ~• Antoinette M. Long Legal Analyst ~F =~>,=~ 7050 Village Drive, Suite D Buena Park, CA 90621 714-523-0194 ;714-523-4235 (fax) DATE: 2/24/2006 FASTECH REPORT TRANSMITTAL LETTER DELIVER TO: Inspector Steve Underwood SENT FROM: Vanessa M. Ragle Bakersfield Fire Department FASTECH 1715 Chester Avenue, 3rd Floor 7050 Village Drive, Suite D Bakersfield, CA 93301 Buena Park, Ca 90621 TYPE OF REPORTING: Results of SB 989 Testing Method of Transmittal X^ Regular Mail ~ Fed Ex ~ Fax ~ Hand Deliver Items Sent Address Description 1 Chevron 20-1527 - 6601 Ming Ave. & Ashe, Bakersfield, CA SB 989 post repair test 2 Chevron 20-3576 - 1125 Coffee Rd. & Brimhall, Bakersfield, CA SB 989 post repair test 3 4 5 6 7 8 9 10 Signature: Vanessa M. Ragle sb 989 transmittal letter Bakersfield FD 1 -~ ~.__ ' 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 /10/2006 Order Number: 3144548 Dear Regulator, Date Printed and Mailed: 01!24!2006 Enclosed are the results of recent testing performed at the following facility: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA. 93308 Testing performed: Leak detector tests Monitor Certification Secondary Containment-Spill Container Sin~cere{y, yy// Dawn Kohlmeyer Manager, Field Reporting ~j°i ~ T'd/7 f PURPOSE: COMPLIANCE TEST DATE: 01/10/06 CLIENT: CHEVRON PRODUCTS COMPANY P.O. BOX 6004 L-237561 SAN RAMON, CA 94583 BRETT BONACCI (925)842-5047 TANKNOLOGY CERTIFICATE OF TESTING 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 TELEPHONE (512) 451-6334 FAX (512) 459-1459 TEST RESULT SUMMARY REPORT WORK ORDER NUMBER: 3144548 CUSTOMER PO: 4660040 SITE: CHEVRON 203576 1125 COFFEE RD. BAKERSFIELD, CA 93308 MANAGER (661)588-9066 TEST TYPE: TLD-1 Prnrlnc+ Pina Tinhtnacc Tact Racnl4c LINE LINE LINE DELIVERY IMPACT TEST RESULT FINAL LEAK RATE (gph) VALVE ID PRODUCT MATERIAL NpE A B C D A B C D _ FUNCTIO 12k 1 SUPREME DW FIBERG PRESSURE 12k 2 PLUS DW FIBERG PRESSURE 12k 3 RSG UNLEAD DW FIBERG PRESSURE Fxiefinn 1 ina 1 aa~ flatar*nr Tnc+ EXI STING LE;RK DET -- ECTOR #1 ` °EXiST " tNG LEAK"DETE CTOR #2 LINE --- - - - r - - r ID MANUFACTURER MODEL # SERIAL # RESULT MANUFACTURER`` MODEL # SERIAL # RESULT 12k 1 VEEDERROOT __ ELECTRONI _ 011505 P 12k 2~ VEEDERROOT ELECTRONI 013652 P 12k 3 VEEDERROOT ELECTRONI 013649 P Now 12nn1~rcmnnY 1 inn 1 n~4 flnFnn4~~ Tech REP CAGED LEAK DET,ECTO #1 . ___ L A ED LELtK DET E_ 2 LINE Ip MANUFACTURER MODEL # ~ SERIAL # RESULT MANUFACTURER MODEL # SERIAL # RESUL .....••...,......~..,,., ...N.,.....,.,. u~a.w~y v.„~ www.wuni~u~ugy.wni auu xicct vu-L,u~e ieepuns-wnHr, or conwcl your local lanKDOlOgy OIIICC. Tester Name: STEVEN GALLARDO _~.. Technician Certification Number: Printed 01/24/2006 07:37 SBOWERS INDIVIDUAL TANK INFORMATION AND TEST RESULTS j - Tan TEST DATE:O1/10/06 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3144548 CLIENT:CHEVRON PRODUCTS AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CHEVRON 203576 TANK INFORMATION Tank ID: 12k i Tank manifolded: No Bottom to top fill in inches: 165. o Product: suPREriE Vent manifolded: No Bottom to grade in inches: 170. o Capacity in gallons: 12, 068 Vapor recovery manifolded: YES Fill pipe length in inches: 54. o Diameter in inches: 111.00 Overfill protection: YES Fill pipe diameter in inches: 4 . o Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS Test Method:VacuTect 'LEAK DETECTOR TEST RESULTS Test method: LT- 1 Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: vEEDERROOT Ingress Detected: Water Bubble Ullage MOdel: ELECTRONIC Test time: SIN: oiisos Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: NOT ReSlllenCy CC: NOT T VacuTect Probe Entry Point: ESTED Test leak rate mUm: 1a9. o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: s . 00 Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS LI ETE~t~ ST RESULTS Testtype:Tr~-1 LINE A B C D Material: Dw FIBERG Diameter (in): 2.0 Length (ft}: 225. o Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSIIRE Pump make: FE PETRO COMMENTS Impact Valves Operational: UNKNOWN Printed 01/24/2006 07:37 INDIVIDUAL TANK INFORMATION AND TEST RESULTS ~ Tan/atology TEST DATE:O1/10/06 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER9144548 CLIENT:CHEVRON PRODUCTS AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CHEVRON 203576 TANKJMF~RMATION Tank ID: 12k 2 Tank manifolded: No Bottom to top fill in inches: 166. o Product: PLUS Vent manifolded: No Bottom to grade in inches: 171. o Capacity in gallons: 12, 068 Vapor recovery manifolded: YES Fill pipe length in inches: 55. o Diameter in inches: 111. oo Overfill protection: YES Fill pipe diameter in inches: 4. o Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TAN_ K TEST RESULTS Test ME.ahcd:VacuTect LEAKDETECTOR TEST RESULTS Test method: LT'-1 '~` Start (in) End (in) Dipped Water Level: Newlpassed Failedlreplaced New/passed Failed/replaced L.D. #1 L.D. #1 L.D. #2 L.D. #2 Dipped Product Level: Probe Water Level: Make: vEEDERROOT Ingress Detected: Water Bubble Ullage MOdeI: ELECTRONIC Test time: SIN: oi3esa Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: NOT Resiliency cc: NoT VacuTect Probe Entry Point: T ESTED Test leak rate ml/m: ia9.o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: s.oo Water table depth in inches: Results: PASS Determined by (method): Result: COMMENTS COMMENTS -LINE TEST RES ULTS Test type: TLn-1 LINE A B (' D Material: Dw FIBERG Diameter (in): 2.0 Length (ft): 225. o Test psi: Bleedback cc: Test time (min): NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: PUmp type: PRESSURE PUmp make: FE PETRO COMMENTS Impact Valves Operational: UNKNOWN Printed 01/24/2006 07:37 INDIVIDUAL TANK INFORMATION AND TEST RESULTS i Tan TEST DATE:01/10/06 8501 N MOPAC EXPRESSWAY, SUITE 400 WORK ORDER NUMBER3144548 CLIENT:CHEVRON PRODUCTS AUSTIN, TEXAS 78759 (512) 451-6334 SITE:CHEVRON 203576 TANK INFORMATION Tank ID: 12k 3 Tank manifolded: No Bottom to top fill in inches: 165.0 Product: REG UNLEAD Vent manifolded: No Bottom to grade in inches: 170. o Capacity in gallons: 12, 068 Vapor recovery manifolded: YES Fill pipe length in inches: 54. o Diameter in inches: 111.00 Overfill protection: YES Fill pipe diameter in inches: 4.0 Length in inches: 292 Overspill protection: YES Stage I vapor recovery: DUAL Material: Dw STEEL Installed: ATG Stage II vapor recovery: BALANCE CP installed on: / / COMMENTS TANK TEST RESULTS Test MethodvacuTect LEAK DETECTOR TEST RESULTS Test method: LT-1 Start (in) End (in) Dipped Water Level: New/passed Failed/replaced New/passed Failed/replaced Dipped Product Level: L.D. #1 L.D. #1 L.D. #2 L.D. #2 Probe Water Level: Make: vEEDERROOT Ingress Detected: Water Bubble Ullage MOdeI: ELECTRONIC Test time: S/N: 013"' Open time in sec: Inclinometer reading: Holding psi: VacuTect Test Type: NoT NOT Resiliency cc: T VacuTect Probe Entry Point: ESTED Test leak rate ml/m: is9.o TESTED Pressure Set Point: Metering psi: Tank water level in inches: Calib. leak in gph: s . 00 Water table depth in inches: Results: Pass Determined by {method}: Result: COMMENTS COMMENTS LINE7EST RESULTS Test type: .LD-1 LINE A B C D Material: DW FIBERG Diameter (in}: 2.0 Length (ft}: 225. o Test psi: Bleedback cc: Test time (min}: NOT NOT NOT NOT Start time: TESTED TESTED TESTED TESTED End time: Final gph: Result: Pump type: PRESSURE Pump make: FE PETRO COMMENTS Impact Valves Operational: UNKNOWN Printed 01/24/2006 07:37 - SB 989 SECONDARY CONTAINMENT SUMMARY RESULTS TEST DATE:01/10/2006 WORK ORDER NO.: 3144548 CLIENT: cHEVRON PRODUCTS COMPANY SITE; CHEVRON 203576 P.O. BOX 6004 1125 COFFEE RD. ~ L-2375B1 ~ SAN RAMON CA 94583 BAKERSFIELD CA 93308 BRETT BONACCI i 925-842-5047 Tank Interstital Tests Piping Interstital Tests TANK PRODUCT MANUFACTURER RESULTS SUPREME PLUS IREG UNLEAD LINE PRODUCT MANUFACTURER RESULTS Sum & Under-Dis enser Containment Tests Sumpl DISP.# MANUFACTURER P/F 87 Phil-Tite Pass 89 Phil-Tite Pass 91 Phil-Tite Pass Tanknology representative: BRIAN DERGE Services conducted by: STEVEN GALLARDO Test Date: 01/10/2006 ~~ ~ 3144548 Work Order. SECONDARY CONTAINMENT TEST RESULTS SUMP TESTS Type Tank or Disp Manufacturer Model or Diam./Width/Length Depth Test Method Start Initial Level Finish Final Pass/ F il # Material (") (") Time Level Change Time Result a Spill Container 87 Phil-Tite Plastic 12 11 1005 5 1i2 0 1035 5 1!2 Pass Spill Container 89 Phil-Tite Plastic 12 11 1005 5 3/4 0 1035 5 3/4 Pass Spill Container 91 Phil-Tile Plastic 12 11 1005 5 3/4 0 1035 5 3/4 Pass Comments: Hydrostatic test. MONITORING SYSTEM CERTIFICATION For Use By All Jurisdictions Within fhe State of Califomia 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: CHEVRON 203576 Site Address: 1125 COFFEE RD. Facility Contact Person: MANAGER Make/Model of Monitoring System:TLS-350R Work Order Number: B. Inventory of Equipment Tested/Certified Check the appropriate boxes to indicate specific equipment inspected/serviced City: BAKERSFIELD CA Zip:-93308 Contact Phone No: 588-9066 Date of Testing/Service: 01/10/2006 3144548 Tank ID: 1-91 Tank ID: 2-89 X In-Tank Gauging Probe. Model: MAG X In-Tank Gauging Probe. Model: MAG X Annular Space or Vault Sensor. Model: VR 420 X Annular Space or Vault Sensor. Model: VR 420 X Piping Sump/Trench Sensor(s). Model: VR 208 Piping Sump/Trench Sensor(s). VR 208 Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: Electronic Line Leak Detector. Model: VR PLLD ^X Electronic Line Leak Detector. Model: VR PLLD Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER QX Tank Overfill/High-Level Sensor. Model: ATG/FLAPPER Other (specify equipment type and model in Section E on page 2). Other (specify equipment type and model in Section E on page 2). TanklD: - TanklD: X In-Tank Gauging Probe. Model: MAG In-Tank Gauging Probe. Model: X Annular Space or Vault Sensor. Model: VR 420 ~ Annular Space or Vault Sensor. Model: X Piping Sump/Trench Sensor(s). Model: VR 208 Piping SumplTrench Sensor(s). Model: Fill Sump Sensor(s). Model: Fill Sump Sensor(s). Model: Mechanical Line Leak Detector. Model: Mechanical Line Leak Detector. Model: X Electronic Line Leak Detector. Model: VR PLLD Electronic Line Leak Detector. Model: X Tank Ovefill/High-Level Sensor. Model: ATG/FLAPPER Tank Ove~ll/High-Level Sensor. Model: Other (specify equipment type and model in Section E on page 2). Other s eci a ui ment (p fy q p type and model in Section E on page 2). Ispenser 1/2 Dispenser ID: 3/4 O Dispenser Containment Sensor(s) Model: BEI 406 ~( Dispenser Containment Sensor(s) Model: BEI 406 X^ Shear Valve(s). X Shear Valve(s) Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 5/6 Dispenser ID: 7/8 XD Dispenser Containment Sensor(s) Model: BEI 406 ®Dispenser Containment Sensor(s). Model: BEI 406 X^ Shear Valve(s). Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). Dispenser ID: 9/10 Dispenser ID: 11/12 Dispenser Containment Sensor(s) Model: BEI 406 X Dispenser Containment Sensor(s). Model: BEI 406 ~X Shear Valve(s). X Shear Valve(s). Dispenser Containment Float(s) and Chain(s). Dispenser Containment Float(s) and Chain(s). If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification I certify that the equipment identified in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this certification is information (e.g manufacturers' checklists) necessary to verify that this information is correct. and a Site Plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the (Check all that apply): ~ System set-up ~ Alarm history report Technician Name (print): STEVEN GALLARDO Certification No.: 006-05-1226 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 TestinglServicing: 01/10/2006 Page 1 of 3 Based on CA form dated 03/01 Monitoring System Certification Monitoring System Certification Site Address: 1125 COFFEE RD. Date of Testing/Service: 01 /10/2006 D. Results of Testing/Servicing Software Version Installed: 324.03 Complete the following checklist: Yes ^ No ~ Is the audible alarm operational? Q Yes ~ No' Is the visual alarm operational? Q Yes ~ No ~ Were all sensors visually inspected, functionally tested, and confirmed operational? 0 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? ^X Yes ~ No ' N,'a If alarms are relayed to a remote monitoring station, is all communications equipment (e.g. modem) operational? Ox Yes ~ No • ~ NIA For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment monitoring system detects a leak, fails to operate, or is electrically disconnected? If yes: which sensors initiate positive shut-down? (check all that apply) ^x Sump/Trench Sensors; ^ Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Q Yes ^ No Yes ~ No ' ~ NIA For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e.: no mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill points(s) and operating properly? If so, at what percent of tank capacity does the alarm trigger? Yes• ~X No Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. Yes• x0 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. Qx Yes ~ No' Was monitoring system set-up reviewed to ensure proper settings? Attach set-up reports, if applicable. Qx 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: 1125 COFFEE RD. Date of TestinglService: 01/10/2006 F. !n-Tank Gauging /SIR Equipment Check this box if tank gauging is used only for inventory control. Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Complete the following checklist: Yes ^No • Has all input wiring been inspected for proper entry and termination, including testing for ground faults? Yes ~ No ` Were all tank gauging probes visually inspected for damage and residue buildup? Yes ~No' Was accuracy of system product level readings tested? ^x Yes ~No' Was accuracy of system water level readings tested? ^x Yes ^No • Were all probes reinstalled properly? Yes ^ No ~ Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. G. Line Leak Detectors (LLD) : ~ Check this box if LLDs are not installed. Complete the following checklist: 0 Yes ^ No' ^NrA For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? Check all that apply) Simulated leak rate: Q 3 g.p.h Q 0.1 g.p.h ~0.2 g.p.h x Yes ~ No ~ Were all LLDs confirmed operational and accurate within regulatory requirements? ^x Yes ^No' Was the testing apparatus properly calibrated? Yes ^ No " ~ NiA For mechanical LLDs, does the LLD restrict product flow if it detects a Teak? Yes ^No' ^ NIA For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? Yes ^No • ^ NIA For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? a Yes ^No' ^ NIA For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? a Yes ^No ` ^ N;A For electronic LLDs, have all accessible wiring connections been visually inspected? Yes ^No • Were all items on the equipment manufacturers' maintenance checklist completed? * In the Section H, below, describe how and when these deficiencies were or will be corrected. H. Comments: Page 3 of 3 Based on CA form dated 03!01 ~ Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE:O1/10/06 WORK ORDER NUMBER3144548 CLIENT:CHEVRON PRODUCTS COMPANY SITE:CHEVRON 203576 COMMENTS Monitor Certification & Spill Bucket Testing. All tests passed. PARTS REPLACED QUANTITY DESCRIPTION HELIUM PINPOINT TEST RESULTS (IF APPLICABLE) ITEMS TESTED HELIUM PINPOINT LEAK TEST RESULTS Printed 01/24/2006 07:37 SBOWERS ITE DIAGRAM i Tan 8501 N MOPAC EXPRESSWAY, SUITE 400 AUSTIN, TEXAS 78759 (512)451-6334 FAX (512) 459-1459 TEST DATE: 01/10/06 WORK ORDER NUMBER3144548 CLIENT:CHEVRON PRODUCTS COMPANY SITE: CHEVRON 203576 • ~ L2 L ST $2KO OI OV OF L3 87 L6 . CANOPY ST 12K~ ~ ~ ~ ~ I- z w L4 91 L5 > ' ST OA OI ~V ~F .. 12K DUMP- STER C-STORE AIR/ H2O ICE N S Printed 01/24/2006 07:37 SBOWERS Work Order: 314 4 5 4 8 C.S.I.CHI°+il.:i)N 111.1>! 7 s:r.[~=•vLHk 11'S ':iif'FF E RL• T ?:PI.II, YI•'v:.i.0.""[' CJ~F' :I . RAKF.ktiFTELL+.CR.9331.2 1•'kGLUL'7 Ci%Lli ' ?++:'Fr+~+[ ,:JEFF :.uDu700 1,61-f]itFl-90ob 303~7b TNERhIt;L C•.+1J'1' :.I I,I:':~ ~: ' ' ?.,i~l}": IfIt-thlfiT)vR : 111.x0 T HF;b' l~;Hl?£7£k 111 .5u rc-jNE; PROt'II.I: t P'1' JAN 10. 2C10ti G : 05 Tr~bL' f RC 1= [ :.E 1 PT FULL. x'01- : 12068 FULL ~'.•L l'~068 FLt~HT S!':.:1:: 4.0 I N . 3'i:~TFr'I :~1'F;1'Ui REPOR'T' 'L~'~,T S['`::F:: •t.ll IN. ._ _ _ _ _ L.IHTF.P, hIARIV! IVG 2 , f1 r,F! F'~IN+'T[JN^ Nt)kriHi. Wtil'tlk WriRNING '3.13 ri[`iri W~tTER LII•IIT: 3.G HIGH WAT>wR LIMIT: 3.0 llv-Tt,~11; S'E7•~I• ;•Ut.'•, V}? LABEL ~l;>L: 1'•_'068 - - - - - - - - MAX OR LABEL VOL: 12068 ;:,;EF'.E'II.L LIMIT '/'Jr:: 017ERI'ILI. L1MIT 79 % g,3g T 1;SUPRFI"IE 9533 a l+;H PRUtd It:'I' 75% PRODUr:T CODE 1 MI~:;H PROlillt:'1' •7hst 9CIF1 'rHl•:kMHL c~Ur:r'r' :.Oi10•iUQ 9851 d:ELt:~ER; LtrIIT 101 THNK DIAMF.TEk tll.6U 1-iE:'1:I11F.RY LIhIIT 10't 120? Tt~id}; T RnF I LE 1 PT 1~ I I' 1 "rULL 1~OL 1 ~!Ut,l] L~~vl i°F.':GUC'T 500 T.~IAI FF+'C}1'iUCT 5UU L£h;: HL?FM L[hl[T: .I:' LEf tK. f~tl-ARM L I I'1I T : 32 ~ULI:E%, L•-':~r~ L I hl I T : ? r pLOAT SIZE: ~l.U llv. SUlil)E1V Li)tiS I.1M1'f: ~!', Tr-+rl}~ •I'~ r ;I.aU •fANJ; T'I1,T 2.50 T'k68E {:FEET +l-fhl WATER WP+RN I N~~ ? . fl PROBE OFF~]rT 0 . UO llli9H WH'fla; L.lMIT: 3.G SIPHON I-1HI;IF~:+:.:`ri'`• f,.N}:fi <.'.,= ~' [_HbtL 'J:i[.: 12068 SIPHON I"1tN11"iila!lai 7'NrJI'.•`: T#: NUI'i); UVL:1•:I~Ii.-L 1 I!1i; 7a'•d Tic 1VGIV1 LINE MAIVIF~~LUEL Tf,.r~l':: ';`.~:~ 1.1 N1: hIh1V1FU1.Pl:li '1'Hldk::: '1'll: NONE IllC;ll PkODUi:T - 75% Ttt: NONE 4pG1 C1~LiVF.RY I"TM.f'f 10N LEAK MIN PERIODIC: 0% lauy I.1,A1ti r~1N PER1oL1C: n>:: 0 U LUW FhGUU~'7 SGu LL:r~E: MIN ANNLIHL : 0 [.EAK ALr'1Rh1 Lii'1IT: ~+' I.l'.HK MIN HNNIIAI. fly fl hULDEN LOSS I..It•117': 3~ u 'TANK TILT ='•~U f•R.E~ ~F'E•'SET O.OIt 1"£F:::'[=' TEtiT ?:FE PERIODItT TEST TYPE ST~tNGrtRD STr'tIVL+fikL SIpHUN. P~HNiFOLLEI~ TAN)lS t;rdtrUr;L 7E~'7 F~,IL. y 'fU: NONE ANNUAL TE::9' FATI. HLHkI''1 I~}.iHL•LEI' LINE hlaN[FOL.Ul:I~ '1'HNKS t:tLt'ikl°I L+ISABLED Tb: IvGraE PERIODIC' TE:~1' I=HI,L F• £Rd t)P i C TEST FALL. F tLiiRM 17 I : ~H13LED HLstfthl GISr~BLEL I.l,HK hIIIV F'EkIUUIC: U% i:F;?.::.; 'i'L't~;' k'H1L 0 G£,::~~:: "'_"E'ST F:j t L ai_nP.r'I V [ : ~tit3LEC+ -;Lr,k~ I :~ I ~, tELED LEAK IhIIV ttIVIVUHL u•. ANN TE5't r"tVEkt=tG] Ni;: GFF ' I I HIdN 'ff:NT tit+l Er~';d NC; ~ _-Fr PER 'T'E:: ~ I' H+,II ,RAG I IJ~:: OFT P£k TEST f;.~ET:F++:11vG: pF}"' ?'~rd} TE~C NOTIFY: UrF PERTC'iP1C '1'1::ST TYPE 'I'HNY+ '1't;'a•T Nti)'I'll''C: OFF STANL~ftkD TIVK Tfi'1' :.1}'llt)Id ~kEi+}:~::Fr "fNK TST ::fb'HON BREAM.=OFF ' rtlvUti..i. ;_:_: P~[L I?ELIV1iE;'f IiI:LAY 5 M1N. HLHI''I.7 L1Sr+3LcI: DEL:11+'I:hY DF.tx1'~ 5 MIN E'Ilr'IP THkESHt)LD : 111..00%:. PUhIF' THRESHUL.L~ : 10.004 r'tLitRM HIaTOk'~' l•a:H'~k7 F•£R1GDTt' TT'`~1' FAIL AT.HI+M lltSftl3L.ET1 :.i)1"TInIHRE..kL'b'1:.IS1N LEVFI. - SYLfI'L-'hl ALr'tRl`1 ----- 1lF;k;IUIV a;'.l.fl'; PAPER C)IIT Gh'u:::~ TES7 Fr,1L 50FT4.IAREt1 =a,~gq-!U!! ! JAN 10. 2DOe _':24 HLHI•;hl D1l~iFtBLEI, :'kt..+"['EU - l]h.U6.06,15.a1 PRIN'1'L:1•! Eldh'UI•! IriN 10. x'006 2:2~ ANN 'l'I:ST AVERiI~;ING: f)FF S-M4bLl I'FU *~!rf'`"'-t:lil ri BFITTERY Iks OFF PEk T!~br t~VENHt;1NU': OFF - oYBTEhI I'Ei1TURES: .TIIN 6: :'U05 8:G0 UFF PER I GI:+1 c. 1 N TANY, TESTS k]rMOTE P I SPL.H'~ L'RROR Tr,t;S; ;E, w:~T[FY: HIVIVU::L !N-TAit}: ~F~TS' . DE~~ !7. 3045 16'.~,fl i •Lt.i;+ TIV}~ TST 511-'IIUr} E3kErt};:GFF 11,10 REPETI'I'I1/ .0'20 Rl=PET17T+1 T)ELIV£RY UELHY 5 hIIN ~,,'r"LLU PUMP Tt.ll+E::I It )LD ! 0 . DCIYa 0. l I I AUTO 0.20 RL:J••}TlTlti Q.t Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Work Order: 3144548 ~:L'a":•• .._ Crk: ktk~•:K'C t;!.%:iF" :.'~T.:•R~, REPURT .. ;'-,~;I: ;-~L;~Rr'I ----- ---- Lr:-''.'H+aF: r+L:tRrl ----- ------ ,3EN!tsrb: HI,HRM ----- L 3:1;'Lt; 'fUkBIIVi; SUI'~IP T 1 : ~-~rTF.E~•9E 'i s:F;Ei;ULi1R $TP SUI°If• OVERF 1 LL r,1.P.Fa 1 ' ,5i!FRF [ LL i 1L.i 1RI"I rrT:c: 1.1 . 2005 '~ : F~: <. J~iN ~. ~UU6 1 y : b4 NbV 1Ci. 20DG 8:aE -JAM 3: zuuf., tti:ilr, IV9V 9. 2UU5 5:5~ JtiN '~. ?006 13:04 HIi_:H Pkt1Dl.1[:T HLi;kl"I lli~ill FRnAUCT ALARM UEC' 14. 2605 2:~a? JtaN. 7. ;'I'llli~ :':111 N~ri/ li.. 2UU!~ IV4V 1' 2000 1'!:11:1 12: ~1 JflN 5,. 200b 19:~ • .,3 « K « * :,. 1:Nli ~. .. , ... . JAN 4. 2uu~ ` 1:4u PF!UIIL: UUT INIIA[.:TD FUEL LEVEL. 3EF' 88 • .0'7 a 15:15 qiT `l l ~ 2005 9:46 PROBE UU"f LEL1'~/l:k`: !~ELr•£~• s£p 28. '?OGr 1G:1G JHN 'i. ;'Init. 1'y:2b n1;~ ~ 1 , ~ C1CiG 23:32 C~EL"IVEkY IvEEL~ ED JAN 9: 2006 21:11 DEC ~'. 2005 0:28 AL,r;A~•1 IIIS'1'gRY kEFrrR'F NJV ?8i '2005 21:13 - ~ :-71;IV°OR ALARM ----- L 4:F'LU6 ANPdULAR HNNIII.HI•: SFACE x x ;rt ;: Lral, ;~ x x ., H1.Hkl`I Mlwl•_~r;: ;i=F;:F'C ---- IN-TANK HI-AkM _---- . r io _.,• ~_.. i,I.r,F~~o '-'i.=TAR': s•:k~~';~F?T Al..:~RM'HI:;fORY REPGR'f . _.. trVI,kFILL ALr;RI"I - -- SPIV~'iiFC HLAk1h IVbV 1';. inrl5 10:31 I". l:N'UYkF:r91: 'ruktiiNE ,jU1'fP •--~--. SENSUk AL.AftI°I ----•- STF .ril IMP t.. ~ : E'LUa '1'UkHI NE 5Ui'IP H CGH F'R~~PUC~T At.HI:M 3TP SUP1F F'kVHE . ONT F,F:F 28: 2U0~ 15:1 h I;l iL 1 VERY IVE~DEL DEC 1 l1. 211115 15: u0 ;~ ~ * * ~ F.ND ~ * « ~ +~ t1C'C l8: :200r 7:Uh ~ ~ a e 1'N[1 ~ ~ ~ * « ALARM H 16'FOR I kEF' :>RT 1F « « w « fiI~L r. x ~ t L '~'::;Ub?kEME ANNULAR ANNUL:Ak SFACE ~, L Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 Work Order: 3144548 FiI.HRM H 1 STC>F:'i 1•~L1-CiR7 - - SEIV FOR HLr+RM -- -- ;,+6~};1;itllLHh ANNULi1R - ~;rarauL„F Eii~:E :.;~x ~ ~, x ENP1 !;~~ ~ R ~ MLARNI H I S PukY I•, f;Yt)RT Q 3~R~GULHF; SETT It-` DftTA hIFaRN l Nid SET r:. : -,~.~ is ~1 ALAI•;M }tI57UK'i 1•,f:,~OKT (d 1:£fUPREMF: .'s:~!'LR L~~t'Psj I~IAI;Nl N~3 ~; ,S. I .CHE`~'R{?N 18x2 1.125 C:VFI );E F:I', BHI:ERSF I El.l i, Gr i .9:131 bGt-- ~i~:lJ STEM STH GU8 Ri:F'ORT At.L FUIVCI' I C?NEi NURMf 11_ is 2'(}`I.IIS ~'ETUF'. GATt~ L.IAkf~ING ~3 Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 pWork Order: 3144548 ' : ~ .'!IE'vk;~N tt1~t:~ T 2:F'LUS T 3:REGULr;R . , 1 ; E ": F;'!: RG. t?kU1JUCT i s}IIE 2 PRUUUCT rGDE 7 ~ 1 I't11=RMRL: I:I)I:I'1' : OOD.DU &f;}'.1=kSFIFiL: •~_H.1'T3!'_' THEkMHL t:iiF:F'F' :.IlCli1'/flfl . TANK UTAI"IETER }11 .5U 661-588-'JUi:c 2U35?6 TAN}: L)THI"IETEk : 111.0 TANK- PROP I I:E 1 PT ~~ JAN 10- G06 11:26 TFaN}: F'RO!' 1 LE I Y'1• 1-'IIT.T. UOI. 12058 YIIT.T. Vt,L 12[168 FLUHT S'I~E: 4.0 IIV. 1't~)~+T SI;:;k:: 4.0 IN. SYSTEM ":•~ l'HTUS REF'URT ._ _ _ - .. _ WitTER Wf1RNING : 2 0 Wf~;1=E ~..~;cF, I N,,~ 2.0 .,LL F at•' t ~?~98 UJRI"IHL. . H 1.GH. WA'1'F;k t .1 P119' : : I . I t H1GH WHFEk L'c':T~ '3.0 iir~ir;l,i. ._,_i~_~f MAX {)R LflB>:L VOL~ 12068 I!1~1X.OR I:f;1~EL.11C,1. 1,::UU[s OVERFILL LI1°I1T yn'; _ _ _ _ - - - OVERFILL L1MIT yp,p !0$bl T 1:UUPkF.19E 10861 HIGH. PROTJIIi:'1' ')tiXa HIGH PRODUCT y5i 114E4 PRt~1"~Ilc'C cc>L?1 1 11464 GELt~+ER: L"irtIT ltl~>; 'I'HEF~I''IF;1. C[r1=.FF :;~}~i,°00 11F:I,I+II:k'~ LIMIT - 10°0 12tl5 TANp: Dit,PIETET: ~ 11 t.SU 1309 Tr,IJI: S~h~:'r ; ~£ 1 F°l• t~l ll.l: Vui.. 1 ~'U6fi LUW 1•'I~UUI ICT rifl~l LUW Pk:iliU~:T ~ "517[9 Sy 11.71'1'.:. H}: ALHRIi 1 L F LEAK ALAF:I"I LII°I1T: 32 , . . . £iUDUI~N LO S LINI1'1': 25 SUDpEN Lt1:;,i I:Ir•11'I': 25 3.3U 'I'tiNK TILT '!;~'F `.= t .'F : a . D 1 N . FI TF1N}: TILT' . 2.50 , " F'R4$E OFF131;T 0 . DO _ PROBE OFFI~ET - 0.00 !:INTER I+IHRNl NC '? • U HICUI Wr,T>rk l:lt-t1T~ J~'~ aif•Hc]N rIHN}F9LU£L~ Titl'1}:8 !~1YHUty r~7~;rJtrt:L_•;:~~ ':Ht'1F:.° P1Hi; Ok 1•r+1sEL 'vi.i.: S''~F'I Tqi Ni~NE. ' T>3: NrxvL LAVE MANIFOLDEli 'I'r+WKS CSVEkk"ILL I:IMIT 90'`b _irJF. rwN:tF;?LDF.D THNF:a T•p; NONB :0961 Ta; 1:vaE Pkl1UL1CT `jH~ HIGH . .. : 1404, LEh1: P1i l~ i'~~'t~l[Ll._ t 0^:. litLIVEFtY L.INIIT lllio LEriK I°IIIV F'Ek.1UL]~': u% ~ [j 1~U4 U 5U0 LEA;}` hl I IV ANIVUftL u LEA}: I"II N ftIViVUAI. 0"~ LEAK ALftRI"I LIMIT: ~~ . D ~'uL:i'~F:i L<»;: LIMI'C: ~5 TfaIVK T1L'1' x•4[1 f)U at;T O P£R10IiIl:• TEST TYF•E }•Ek1~~:I~l~- '__:~ T::PF ~' r;~:~FC . FS::_?F OFF S'1'HNl )AI•a i „ . raNF:ti F31FHr,la I.1r,I~iF3i,L•'D HNNUr-1L TL.rr rH1L ANNUAL T'trr FAIL ALHF,P9 1lTSABLEU '1' It : WANE: .ALARM DISHDLF.P , L;;;F P•1+1H[F''LUEIt Ta11VK8 PEF I VD I ~ TEST Ff1I L PERIODIC TEST !-'H71; T # : NOPIE . . ALARM I) T SA1:9LEU FiLARM 'U I SABLED il`; L>^F,K r11 N 1:'E}21 Oil t i< : GRC):;C'~.'I'1:5T FAIL ;k,i:3 TENT FHIL .aI .ARr•I U t SABLED n flLi 1RI•I U I Sf iJ3LED L>~AN: MIIV ftIVNUAL U% ANN 'I'I;'I' AVERAGING' OFF ANN TES7 r..Ef'Sr•ri:r~: •:FF P1=R TE:',1'"r;'•JEF:r•~:it~~;: ~~FF 0 PER TEST AIlF.RAG1Wi;: OFF TANK:. 'I'f';:~T IVUTIFY: UFF TANK TEkiT WOTIF;`: C.]7' F'L"R1.GUlt: 'I'I::;T T'ri-•i". ' ' '' ' ' ' 'iIFtION $T{EfiY:OFF 't'Nl{ TST ' 8'1'ANi,ykD ~, [ Nl: 1 .3 1 IPHC>N FF.'F;AK : C,FT= , AIVIVUHI, TEST. FH 1 L, UEL I VERY LSLH't r" 111 q llEL I VE>$Y LdL1 tY 5 P1 j N u0% b'LIMY 'fHR1: ;HULD : 10 WI:ARr'I UI:;aBLT:D PUMP THRI::'ft+i11, II;,!,t~': . ... '-TEST I'HiL 1~ERit11)I! •`?SiFTI.J~iFE' ,i<;viai„rv LEvEI .,L~tRrl HI: tz1kY REPORT At:ARI°I Dl:;aBLEU . vERS1tiN 32x.03 ` :iU)='T W(sRE~f 3a53''J t ~'D-L. ----- ~:`Jl'EM HLf1Rf'I -'--- G:F.GSR 't'E:~f FtjIL ,'R1~,iTED - 05.uH.06.i'.•11 `' %~=E:k JUT :;~~FiArl DI:;HBLED Jnt~ ta. '3uuo 2::d ' `•`+i+',uUI,cF[ ;-i301n~1-O11J-A ;•Rt";ITEI2 ERROR.. HNN TE:'FC HVEkFtG1Ni;: i1F} sYh`TEt•9 FEA1'URE»: ~li,tJ 1~~I. ?t706 '~:1J F'Ek '1'F.S'i n~'£Rr+';I;b~: i~FF FEk'1i,(.(,~ tJJ-TFII'iK 'PESTS F•.r,TTFf2~~ t:.i UE'F ' FNNUf;L I N-TANK; T>:STS Jul; o • ?005 8.:00 T;+.SII' 'I'tS'C .NC'TiI•"I: OFk PLLP ICE' 6: TE b ISF•LA:' ERR[>R O.1 D RL'>'F.TITIV !:E::' k ~. !rltl ~ lo:5U TNK T5T FSTPHCtN BRF~K:CIr'F L L'D RF..FE7I't"ti; 1AIP i DELIVE}:`1 IiELr-;Y 5 h111,1 0.) 0 rul'!'.; PUMF' THRE~HOLU : lO.Ull~ 0.20 kEpF•t•1TIi! ~~ Tanlrnology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 L b Work Order: 3144548 AI.ARI~1 H I STURY REPORT "L-,RP1 H[ T,;R~: kEFvFcT ALAkr9 111 ~7'?k': kEPC:r•:1. I N THIVY. HLttRI°I ----- - --- I N-THN1C r;LrtKP1 -.---- 3EN~;nR HLtjRhl ---- - T 1:~aUPREME i. '~:!:IIF'RI;I•IE t'1NNULHk T 3:kl;t:IIL,AR HNNUIrHR SPHC1: FIIGH I.JHTL'kr.Lrl•:I'? SENSOR GU'' ~+i-t+~tl •7fiIV 1D. ''fd'~r. `'i:=.:, H1GH L1HT1=k i:Lhrc',+ 1i+IJ I;;• ?t7ilt~ '1:40 JF,N : is . ciao 9 : `j$ :ut'.F.F1i:1 .;ktl FUEL ALFIRM !H;•+ !-~• ;'~li~:~ 11J''F, JvERFiLL HLARP1 JHN 3U. ?nGi6 9:3a •l~,t~ lti. '_OU6 1U:U7 JHN 1I1. 2006 1u:?6 JAN lil: 2000 9:49 •iAN 10, 2006 10:06 JAN .l D. ;'I ujE, 9:49 HIGH PROllUC"1' r1LAkP1 Jr~N 1D. ~nnf, ln:?~ HJrl1 ~~1•:i;DUC° tt>_t~ii~s~ JAN 10. ::uut 10:07 •J+t1'1 :_~, ;Cis,+:; ti;:~'I JAN 1D. '~UUo 9'4y •O;,k It1. 'UUti 1u:ill .TAN Cu. 2006 9:49 l NIlwl.l I, FUEL LEVL:L JHN ! 0. 2006 10:31 I NI/HI ~ 11) FUEI. LEVEL Jt9N I D. ;!I 11 if ~ 1 11::11 :e ~ * * ~ E''iC~ R R x .R .~ F'•RC1UF: f]lJ'1• OCT 11 • 2005 9 e~6 JAN 10. ~Illli, 111:.`x:' JAN i0. 20Ut5 `~:a_ PkUB1= ~UT SEP 28. Sul,:, 1:,:1'- JArI 1G. :a~"::; 1~i:5i1 Jests tu. ~uuo y:4~1 HIGH L.I~;T1=F. L,i,ka'tu=; 7EP 28. 20l]5 15:15 •Jr;IV J 0: ?Cecic 9:58 HIGH WATER WHRNING .JAN l U. 21717E 9:58 arsa I iY: .066 10::31 J.tN 9. ?ooc 19:28 LEI_TV>=R~t• ra~tL~t>_, ~lr,f?r•I H[STtif?: REf~ORT I~Et G~ 2005 23:32 JHN 1 G. ; Lut; : ~.:: ~ t J::1. '~. _Ou6 =1:11 - -- SErd:;111•; AI HF:r~ ------ - MHX PRODUCT f1Lt~1kM uf~' ~?. 2005 0:28 L '-i:l•:1'~; T-1'CFittlE aVh,li• . JAN 10. ~'llllf~ 111:?7 aTE' SUPIr' hIAX PRODUCT HLHkM : ~l:N:.aUK Ul1T taLHRih JAN 10. 2006 10:2'7 JAN 10. '~UlJ6 9:40 HLtRl~1 ri l ti i ~:~h--.: F.tF'J,'~'C F.:EL hLhf,r~ ;+<-TMw1' ~+L~aRr1 JHN iu. 2006 3:'?9 T :'':k'l.tl.3. H1~H. WATEk F1Lrtklh JHN 10. ~I.IDi~ 9:513 OVERFILL r'tL+'tRhl JF1N . I l7: 2006 1 D : D6 :JAN l'rl. 2006 9:49 n R ~ ~ * END ~ * ~ ~ :+: NOI/ 13. ~ nf15 10:31 1 { .6 ~ ENL~ ;: k ~ h ~ HIGH Pkt>pUCT ALARM JAN 10. 2006 10:16 iNVAT.ID 1'111"1. i.FtIFT. JtiIV 1 D. 2006 1 D: ~'8 PkC,EI}; t N IT JHIV 10: 2UUG i C.::: 'iini:~ I rl L i'l'.iF'Y REPtiRT !~ia•• :~li; ;•nr1=. 1`.';~ ••---- SI~N60R ALARM --• • ALt~RM HI:';'r'or,".' r,1:F'~r.T L I:SUPRl:r1l; 7'IJkBINE SUMI; HIGH WATfF' L1i~F:r~dNa: u7'P SUMP --°- SENSOP :~L~-,k!! ----- JAN 10. 2•uGe +: FLi SENSOR C;U'r ftL ~,kl-: 1 4 : ~:..::: ~NNULHR •~~t.-''~ lu. ?~nit~ y:4U ni~L'iULrR !:I-''r+i:l' SENStiR oUT r'1Lr1Rhl DELIVF.R`~ roEELE`:~ FUEL 11Lf11,T1 JAN 10. '1uu~ 'J:nn JHN 1D, cuue :L:~~ JHN lu. ?n06 9:33 DES: 1 D. euU1 ! :;:7t: FUEL H1,r;RlH tiir'1' lu. ,:ui~~.. •~: I`:. -JAN ICi• _....,_~ :,:.~u MHX FhvllU! -T hLrkl' ,TriN 1.0. :~ 17176 1 U :16 S•~ Tanlrnology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 . Work Order: 3144548 AT.HRM II1RT~)RY F:I:F'UL:'1 - SEfdaOR HLARIH - L ~ : f I-US TURBINE SUr1}` STP sur•sP :a:N•_,7R OIfC HLHRM Jra~ : •s • ;:uut 9:41 I' JAN ] CI. 20CIF, '~:';) 1=UEL ALARM JFtN l0. .006 y::J(1 * s :.: iE .: ENll * •t ~ * e HLftRM 111:~1'S''rk[ Y£S`')k'f ----- :iliN:~f)K ALARM - L tr:R~GI.ILAR HNNULAR Strl~_'~F. :LET +-1C.Hkr'I JAN 1 0. :Gut a : -1U FUEL HI.tiY'.r7 IAIV 10• :OOb `~, ::7 ALr~i/r~ -;,q'~F.', kEFvkT -- ... :7C:NSQF. ALARM. ----- ii l:CiIIPREMI; vLLD ~iHUTDOWN ALARM .1tiM IU_ ?fll7F~ 111:?~f ~:kUGS' L ] NE Fn: L .hfV .117_ _;~tc IU:~J F'LL;~ .3HUTh!)4.IN HLHRM .T~fV l ll • 2UV4 4: ~g PLLD SHU'I'I')c)WN HI_ARM JHN 10. '2006 9:40 F•1J.1) :11111TLOla~s ~,L:,Rf•I F`LLD SHUTDOWN ALARhI JAN 10. 2006 9:33 £i1wTUP UF~1'A I,Ir~}'rlllVr; HI.F1T3r1 IIT Ti>kl' RF:R()I•:1' ----- `~iENSOR r'tLrlldl"I - ~' _:F'l.ll:i Jr'sIV t u, LOGe s ~ ~ ?~1 GROS£i L 1 NE F(t I L ,IHN 10, :'I.IIJi, 10:~4 FLLCt t3HUT:~C>IJN ALHkr~ PLL.D .^~HIITDTtI,.IN ALHkM JFiN 1 u. 2DD6 9:41 I F'LLI- ~'1{JT"` ~'iiPJ t1l.ARM ~. _ JAN 1 U, }'DUE 4: c 1 FT.t.D SHUTDOWN ALARM ~'riN lil. ?lulf~ 9:30 PL.LD,'r±Nll'1'I)[)I.JN ALFtRM .IAN "10. 2066 9: aU $ETUF'-DATA hIN1;fV1N~~ :7kiP 28. 20D~ 14::1u f'tLAkM HI^7'U!•^' YET•L~R^ C,, $:kFialrL,IR PLI..Ii SHUTIi()WN ALfiRM Jnw 1n. 2ooE. )I~:I? Jr.;v lU, z011f, 10:17 F'LLL~ $HU'1'DOWIV F~LARrt JHN 10, 20UE. 9:5$ Pl.l.~ $HU1'llUWN ALAA.I~ .TAN 1D. _•:::,c ^~:~0 T'LLD ESI1l1T:'ra;fr :,:.:y};~I FI.I:D ~'Ni17~1%i. ~.~:( nLn RPI Jnr~ lu, ~OOb 9:29' SEF• 28. 2005 1~J:30 i:.S, I .CHEVh'UIV lsa.: ! l25 i;OFFl:6 1';D: n FsH1!i;R~I iEL,;.•~?.4'3'Ii- ots 5g'? !IObf. ~IT.i57Fi JAN l u, 20ur~ 1.1 :'+'.! SY:~IEM.::Ti,"S'1~~ F:F.I"JI~T r ALL FUN~'TIUIVS NURMFIL ~' Tanlrnology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 - s Work Order: 3144548 9. S~ILLfQ~'ERFILL Cl7:~iTAIVI1•I~~'T' SOXE Facility is Ngt Equipped With SpillrChrerfiil ~:ontairuncnt Boxes 5pi11,'Uvertil: COT~tainmc'nt Boxes are Present, but.~~ere ?got Tested Test Method Developed ]3y: 5pi11 Bucket Manufacturer Industry Stat),dard ~ Professional ~:ngineer _ 4thcr (Specy~J - Test Method Used: Pressc>FZ y acuun;. Hydrostat c Other (Sfrer.~fyf Teat Equipment G sed: Equipment Resolution: , Spill Boa #`~• S_piil Box # je`t' Spill Box ~ f Spill i13os # ~ueket .Diameter: 1 2 ~ s,2 ~ f 2 kit;ckcE Depth: l.t (i - 1 t .... _._._ W;,it lime berivecn _._..... .-_-..'. .. -_..-- _ _ 3pplg[ng ~ `~j .r sn-r I ~ ~' ~t r rt. i r . . pit ssurelvacuumlwater .~ti anc3 slartin~ test: .Wes: Stai S `1 ltr,e: 1 0 ~ i ~ oo j --,------9 fooj Inicial2Zeading {ft[}: .~ ~(~ ~ s~,~ ~ . . ~ ~~ •-- °5 ` - -.__.- L~3S ra 35 , f +-s3 ~FtnalIteadit~g{R[.?: S'(~ E ;'~•i ~ ~'~/`t ~. ~Tes.l~urntitm: i r Chan e in l~eadi R ~e} M1i r~ .. ~3 r-i~~. _ ~!H,r„ -~. ._-_ g t~,g ( r- ~ ~ ~ I{}~ ~ ~ ~ lr'a"ss~'kaal Threshold or ~ '"~-~~ ~ '- ? Gritc'riA: i ~~3L~il~t~lil~~.-: -. _. .. .::. .....:.:• ,~ . _ - - . _ , : s'~_.~r °>t~ _ - _~--- acs • ~~jH•;-il. C4rnmenta - (include i1 formation on.re~~air:s_rnude priUr to testing. artd recgntitaan~et~ fndlnw-,gyp fog- fililed tea•lsJ Tanknology Inc. 8501 N. MoPac Expressway, Suite 400, Austin, Texas 78759 FASTECH, INC. Construction, Compliance Testing, Engineering, & Station Maintenance February 24, 2006 Mr. Steve Underwood 989 POST REPAIR TEST Bakersfield Fire Department 1715 Chester Avenue, Third Floor Bakersfield, CA 93301 SUBJECT: SB 989 COMPLIANCE TESTING AT CHEVRON STATION 1125 COFFEE RD. & BRIMHALL, BAKERSFIELD, CA 93308. FACILITY N0.20-3576. Dear Mr. Underwood: Below 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. Initial testing was performed by another contractor. At that time, all under dispenser containment components failed hydrostatic testing. Wayne Perry, Inc. completed permitted repairs and FASTECH performed retesting as notified to your Agency on 2/16/06. A summary of the components tested is listed in the table below. CONTRACTOR: FASTECH.; License No: 794519 TECHNICIAN: Cesar Plascencia Components Tested Component Manufacturer Date Tested Type of Test Performed Pass / Fail Dis enser 1&2 Total Containment 2/21/06 H drostatic Pass Dis enser 3&4 Total Containment 2/21/06 H drostatic Pass Dis enser 5&6 Total Containment 2/21/06 H drostatic .Pass Dis enser 7&8 Total Containment 2/21/06 H drostatic Pass Dis enser 9&10 Total Containment 2/21/06 H drostatic Pass Dis enser 11&12 Total Containment 2/21/06 H drostatic Pass If you have any questions regarding the attached results, please contact the undersigned at (714) 523-0194. Sincerely, F S EC Inc,~_ Q len A. Ragle Program Manager Attachments - SB 989 Testing Results & Procedures Cc: Caroline Dollemore -Wayne Perry, Inc. -Buena Park 7050 Village Drive, Suite D Buena Park, California 90621 Phone (714) 523-0194 Fax (714) 523-4235 SWRCB, January 2002 Page % of~ 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 (if applicable), should be provided to the facility ownerloperator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: ~LLV~ , ~ Date of Testing: ©` - ,L % -~~ ~ Facility Address: l%~5 ~'~/=~~= rev- ~~f1-jCC`s~j`%-/FZ~J (,~,4 ~,.5'° Facility Contact: Phone: Date Local Agency Was Notified of Testing : - Name of Local Agency Inspector (ifpresent during testing): 2. TESTING CONTRACTOR INFORMATION Company Name: Fueling & Service Technologies, Inc. (FASTECH) Technician Conducting Test: G~ES~~ ~~~} ~N,~ j~el,.}- Credentials: X CSLB Licensed Contractor ^ SWRCB Licensed Tank Tester License Type: i C C A, ~, C21 License Number: 794519 ManufacturerTraining Manufacturer Co onent(s Date Trainin E ices Furnished on r uest 3. Si1MMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made t /-~ ^ ^ ^ ^ ^ ^ ^ Lip' C' ,~ ~ 5i ^ ^ ^ ^ ^ ^ ^ (.~'.~L. ~ Gr ~ ^ ^ ^ ^ ^ ^ ^ ..YG. ~- ~ ^ ^ ^ ^ ^ ^ ^ " ,vL rf-iZ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 0 ^ 0 ^ ^ ^ ^ ^ 0 ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ If hydrostatic testing was performed, describe what was done with the water after cc SB 989 Pst-Rpr Tsting of UDC's 1/2, 314, 5/6, 7/8, 9/10 & 11/12 - See attached testing procedures. WO# 060216-042 CHEVRON CC# 203576 _ 1125 Coffee Rd 1 Brimhall ~aKersneia, c;A a~sua CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THI5 TESTING To the best of my knowledge, the facts stated in this document are accurate acrd in full compliance with legal requirements Technician's Signature:~,~~/1..~~' ,~!~,~~~~~ ~,~` Date: UZ - 2 i - C C ' SVi~%RCB, January 2C02 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page 2- of Test Method Developed By: ^ UDC Manufacturer X Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum X Hydrostatic ^ Other (Sped) Test Equipment Used: See attached testing procedures. Equipment Resolution: -- - ~ ~ ~ _., , . - . _ ~rz .. ~. ;~ ~. UDC # - ZY UDC # y UDC # # 3 _ UDC UDC Manufacturer: C; j ~' ~ '~ UDC Material: , = fi?E ;~? i` L~Jff ~ •~ ti UDC Depth: ~ r. 4 '° Hei t from UDC Bottom to To p H ~~ ` ~~ ~ ~ ~~ est Pi ing Penetration: of Height from UDC Bottom to ,. % ~ ~ ~ ~ ` Lowest Electrical Penetration: ' Condition of UDC prior to testing: ~1-~-j~~ ,~ `' Portion of UDC Tested Above highest Above highest Above highest Above highest enetration enetration enetration enetration Does turbine shut down when UDC sensor detects liquid (both ^ Yes ^ No X NA ^ Yes ^ No X NA ^ Yes ^ No X NA ^ Yes ^ No X NA roduct and water)? Turbine shutdown re once time Is system programmed for fail- safe shutdown?` X Yes ^ No ^NA - X Yes ^ No ^NA - X Yes ^ No ^NA - X Yes ^ No ^I~TA - Was fail-safe verified to be o erational?s ^ Y~ X No ^NA - ^ Yes X No ^NA - ^ Yes X No ^NA - ^ Yes X No ^NA - Wait time between applying pressure/vacuum/water and 30 minutes 30 minutes 30 minutes 30 minutes starting test Test Start Time: f' % / / ~ ° ~ 7 -"~ % L7 ~7 %% • ~ 5`'.Y Initial Reading (RrJ: / , 7 ~ ~ 7 G 3. 2 G°~~ ,.3 . Z C% ~~ ~' Test End Time: // ~ „~ '7 f/ % 5~.~- ,~, .G.% ~- ' Final Reading (RF): `7 7 7C ~1 ,`3 ; 2 C/ S~ ~ . 2 O `7 (-~ Test Duration: / /.,~ ~- c, a Change in Reading (RF-Rr): fJ r O U C1 U ~ ~' U C ~ U ~ , . CJ C: ('J- 2 G - U ? C~ Pass/Fail Threshold or Criteria: 0.002 0.002 0.002 0.002 Test Result: ~ Pass . ^ Fait ~ Pass ^ Fail Pass ^ Fail ass 0 Fail ~~Vas sensor removed for testing? X Yes ^ No ^NA X Yes ^ No DNA X Yes ^ No ONA X Yes ^ No ^NA Was sensor properly replaced and verified functional after testing? X Yes ^ No ^NA - X Yes ^ No DNA - X Yes ^ No ^NA - X Yes ^ No ^N;4 - Ca~ncttents - (include information on repairs made prior to testing, ar7d recon~nzended follotiv-up for failed tests) SB 989 Pst-Rpr Tsting of UDC's - 1/2, 314, 5/6, 7/8, 9/10 & 11112 _ WO# 060216-042 CHEVRON CC# 203576 - 1125 Coffee Rd / Brimhall - Bakersfield, CA 93308 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 "1~1A", the entire UDC must be tested. (See SWRCB LG-160) SWRCB, January 2CC2 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page o~ of Test Method Developed By: ^ UDC Manufacturer X Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum X Hydrostatic ^ Other (Sped) Test Equipment Used: See attached testing procedures. -- - Equipment Resolution: -- ~. _ ~n _.~_._ ,.,.____.. ~,:~. _ _ _ _ __ _ - s __;~ ~ ~x~ rr:__ _ ~ ~. _ : ~ UDC # ~ - UDC # S- lr _ _ .~_~ ,~:,.:.~. ,-:_ a _.~.:.. ::,,. . _ _:~: <~_.- UDC # ~J ~ ~ UDC # •-- ~' UDC Manufacturer: 7G / ` ~ r ~% UDC Material: F~~~ ~ U G~Sl ~ c. ~~ UDC Depth: _~ '~ ~ 4 G Height from UDC Bottom to Top ~ / / cl ~~ of Highest Pi ing Penetration: Height from UDC Bottom to J~ ~, j.~ ,• ~ Lowest Electrical Penetration: Condition of UDC prior to ~~! i2 ~' Y t testing: / Portion of UDC Tested Above highest Above highest Above highest Above highest enetration enetration enetration enetration Does turbine shut down when UDC sensor detects Liquid (both ^ Yes ^ No X NA ^ Yes ^ No X NA ^ Yes ^ No X NA ^ Yes C No X NA roduct and water)? Turbine shutdown response time Is system programmed for fait- ` X Yes ^ No ^NA X Yes ^ No ^NA X Yes ^ No ^I~IA X Yes ^ No ^NA safe shutdown? - - - - Was fail-safe verified to be operational?` ^ Yes X No ^NA ^ Yes X No ONA ^ Yes X No ^NA ^ Yes X No uNA Wait time between applying pressure/vacuum/water and 30 minutes 30 minutes 30 minutes 30 minutes starting test Test Start Time: /i ; J ~j ~ J ; ~ __ , : ~ ,,_ ; ~ Initial Reading (RI): . 2. ~ , Z % ~ . ~ ~ : ~Y3 j Test End Time: // ; ;~ j / d ~' : r7 5L ~~ : /U Final Reading (RF): Z ~3 Z ,Z cL ~ , ~ ~ Test Duration: /' ~ ~,..< Change in Reading (RF-R~: O • G~ (j / `~ ~ • ~~ Ca G~'`7,3 U • iv C1 ~ (7 .% ~ i.1 (j ~'S Pass/Fail Threshold or Criteria: 0.002 0.002 0.002 0.002 Test Result: Pass ^ Fail i Pass ^ Fail ,~ Pass ^ Fail ass ^ Faii Was sensor removed for testing? X Yes ^ No ^NA X Yes ^ No DNA X Yes ^ No DNA X Yes ^ No CINA Was sensor properly replaced and verified functional after testing? X Yes ^ No ^NA X Yes ^ No ^NA X Yes ^ No ^NA X Yes ^ No ^NA C~Ltt~tent5 - (include infor•nzation on repairs made prior to t~Stizzg, arad recor~anzerzded folloti~~-up fa• failed tests) SB 989 Pst-Rpr Tsting of UDC's 112,314,516,718,9110&11112 _ WO# 060216-042 _ CHEVRON CC# 203576 1125 Coffee Rd I Brimhall - Bakersfield, CA 93308 _ 1 If the entire depth of the UDC is not tested, specify how much was tested. If the answer to ~ of die questions indicated with an asterisk (*) is " leTO" or "NA", the entire UDC must be tested. (See SWRCB LG-! 60) ' SWRCB, January 2C02 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Page ~ of Test Method Developed By: ^ UDC Manufacturer X Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum X Hydrostatic ^ Other (Sped) Test Equipment Used: See attached testing procedures. Equipment Resolution: .: ~~,_ j ~ . .. J. ~ `~ _3~~~A~.._ UDC # - /~ uDC # 9- /d uDC # % - ~Z # //v ~Z uDC _ UDC Manufacturer: '7 C / r* ~ t UDC Material: ~ /va f--~ ~: ~ ~• 5.1 ti 4 5 UDC Depth: ~ ._, z: t~ Height from UDC Bottom to Top ~1 ` ~ ~ of Highest Pi ing Penetration: ~ U v ° Height from UDC Bottom to ~ ~ :, Y ` 2 ~ Lowest Electrical Penetration: Condition of UDC prior to ` c. ~ testing: _ ~ ~ t ~ .. Portion of UDC Tested Above highest Above highest Above highest Rbove highest enetration enetration enetration enetration Does turbine shut down when UDC sensor detects liquid (both ^ Yes ^ No X NA ^ Yes ^ No X NA ^ Yes ^ No X NA ^ Yes ^ No X NA roduct and water)? Turbine shutdown response time Is system programmed for fail- safe shutdown? X yes ^ No ^NA - X Yes ^ No ^I~IA - X Yes ^ No ^NA - X Yes ^ No ^NA - Was fail-safe verified to be operational?` ^ y~ XNo ^NA - ^ Yes XNo ^NA - ^ Yes XNo ^NA - ^ Yes XNo ^NA - Wait time between applying pressure/vacuumlwater and 30 minutes 30 minutes 30 minutes 30 minutes startin test Test Start Time: ; ,•„Z '3 /." J ~ ~ Initial Reading (RI): -'~ ~~'~;<ly ~~, ~;L/ .3j cj . S ~ (',3 Test End Time: j - / : S . ~,~ . ` ~` Final Reading (RF): r . ~"5< ~ r / % • .S(o C7 , S' ~ G Test Duration: ~ /y ~..,, u ~ ~- Change in Reading (RF-R~: p . O p ~7 O f~ p . ~J O ~/ ~ - ~ C7~ G Q ~ U ,J () /~ Pass/Fail Threshold or Criteria: 0.002 O.fl02 0.002 0.002 Test Result: Pass ^ Fail ass ^ Fail (`Pass ^ Fail Pass ^ Fail Was sensor removed for testing? X Yes ^ No DNA X Yes ^ No DNA X Yes ^ No DNA X Yes ^ No ^NA Was sensor properly replaced and verified functional after testing? X Yes ^ No DNA - X Yes ^ No ^NA - X Yes ^ No DNA - X Yes ^ No ^NA - Caanmerets - (i~zclude it formation on repairs made prior to testing, and reconx~neraded follow-up for• fcrilec7 tests) SB 989 Pst-Rpr Tsting of UDC's 112,314,516,7/8,9110&11112 WO# 060216-042 CHEVRON CC# 203576 1125 Coffee Rd / Brimhall Bakersfield, CA 93308 ' 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 "110" or "NA", the entire UDC must be tested. (See SWRCB LG-160) ~DS~=~S•y~~o=T/te~Test~Pan%-lee/P~ebe 1'~ - fi~~ °.7.:~ ~.... ~es;~t P~~r~am_eters Test Status Function Menu ' Test Site _ - - - i Status ~ R~- ~ PasslFail ~ - ~ ~:, "Ch ~~ S i ~ - '.Restart Abort evron 1125 Coffee Rd ~; av ng ~ ' -` Ch n ~ ~ RAS S'` . - ' ` Y'' a ge ,~ .:~.,, e ~ Return Bakersfield, CA 93308-XXXX ~. ~ 0.00076 . ~ ' u : ., - x,. Prod ct - ~ __ •- _ - ~,~ ~ ~ , . 3.2080 I Type .. ~ - - ---_ _..._..... ~. - _ - -~ _ . _. - _ _ ...-__ ~~ . 3.2078- , - ~ ~ ~ ~ - -- - -- - ~ i - - ~ -~ ~ ~ _~_,; . ~ ~ Dispenser 3-4 ., 3 2076 I - _. ~ a ~ ~. ~ , =.. ~ ~ - - ~ ! , , .Test Start Time ~ r ~, 3 2oi4 - ~ ~ ~ - i '=~- ~ ~ I ~ - `-f - -~ ~ L» ,. i -+ ., ~. _ d~_ -1 Tue, Feb 21, 2006 11:43 AM ~ ~ ~~ .~r 3 2072. ~ - --~ - ~ --* , ;.~ ", _ _ . ~ ~. -- ~- ~ ~ , i - ~ -~--~~--- ~, Test End Time , , ~ ~- ~ ~ 3 2o s8- w 11.58 AM ue, e , , d ' - j - , ~ ~~ ~ ~ .2066. --~ 3 .. ... ... t ~ ..~__: _... ... . ~ . .j » ~ ~ ; f r ~ Lim~t (in) ' th~ ~ L ~ ~ ~ ~ ~~~'~' ~ ' ~ ' . _eng (mm) ,,, . - __ ; : c 3.2064- _ _ _. _ ~ _.~_.._.. ...., ~ ~ ~ , _ .. ~- ~ ~, . ~ .__ :; , ~ ~~ ~~ 15 0.0020 - ~ 3 2iis2 ~- , ~ _ ~ ~ _ ;_ . ., . .. _._., »_~~', ~ ; ».... -~- ~. Test Result 3.2060= - , 3.2058 _ ~ _ ~ _ _ _ . ~ ~ r , ._ _ .Test passed ij ,, ~ Comments ,; ~ ' .~ ; ; , --~- - _ -- 3.2054 _ . ,. ,. 3.2052 ~ ~~ ~~~~ ~ ~~ ~~~, _i,, ~ 11 43 42,,AM ~ ;, 11:48:00 AM'„ , 11,51;00 AM ,11.54:00 AM , .; 11:58 42 AM " 02/21!2006 , 02/21/2006 ~ 02/21/2006 02/21%2006 02/2112©06 : ' .. " ~ . Test~Time,~ _ _ :.,, : : ;; ` Type : ? z Dispenser 5-6 ~ ~ s. x ~. - ; .-~ _ . St artTime Test ` 25 AM R ~ ~~ 21 2006 11 Tue Feb ~ , . 1 ~a ~ ~ s: Test End Time _ _ _ _ ~ Tue Feb 21 2006 11:40 AM J s. , , ~ i ' length. (mi n)~ . Limit (m)d ~ 3. ~- - ` ` 15 0.0020 ~~c ~~ ~ 3 . 'Test Result ~..~~ 3 ~. i :. .; . ., ~~Test passed 3 i :. :... Comments _ - _ _ : _-__ ~ -_. { s. °' 3. i+1 _ i ,11:25:51 AM 1.1:30:00 AM, 11 33:00 AM ;11 36;00 AM ,11:40:51 AM - ~ 02/21/2006 02/21/2006 02/21/2006 02/21/2006,, ` 02/21/2006 pM Test Time _ ,_ ~_ ~ .: -- ~ w, --- „. ; TM - __ ~ .., - - __.~_... _.__ _...__.__. _ _ _. -. _. , ~._.. _ .. rr _..__ _.__ ~._ ___ .___.__ ___-___-_. _ ~,_.._uv.___.. ..-_..-_,-__. _ _~.,__~_ --_. .~_.,.....,.6 _. ____ tDS~= Byd~o=~T/te TestPaoe%-~lere/P~obe 4 - y~ 3 est~rParameters T ~ 5 est Status Menu FurSCt~o n ~ _ ~._ _ . ____ _ __ _ ~ ~ ~~ _ ;: .Test Site _ _ j ~ Status PasslFa l ' Chevron ;~~ Saving i , ., ~- ~ start_ Re - Abart, ~ ~ . ~ '~ 1125 Coffee Rd ' B k f ld CA 93308 XXXX Cha"nge ~ ~ PA S,S~ ~ ~; . Return „ a ers ie , - ;~0 00042 ~" - ~` V Product , - -- - -- - - - ~ ~U ~ _ ~ _ 1~-.~ _ _ - ' 1-12 ©ispenser 1 1.3so4 - _,.. 1 ~ - ~ _ ; ~, i.. , _ ....~ ._I _ ' :.,.. :. ts . _ a L fi ,.Test St rt Time ~ ; ._. ..__._ - -- - 1.3603. . ~ - 1 _ 1 ~ _i. ~ _. .. ,_, 1 2006 1 17 PM f ~Tue Feb 21 ~~~ , , `7 - I I I I IY 3 ~ ~ ~~ Test End Time . _~ . ~..-.-..... ~.,...r......-.... _ - ~ ~ F ' ... ~ - - 1.3602- ~ ,._ ._ !__i ..__ __ . _ _ ~ ~~ ~ ;- i - - _. _ - ' . . __I ~ . ~... .. , a ~ ~' Tue 2006 1.32 PM Feb 21 ~ ~ , ° ~ 1.3so1 _ _ ,_.~ -_ _ _ 1 j , ~ n ~ Li t~ ' , ii I mi i ' .. ._ c .,~, 15 0.0020 H 1 3600- ~ _- -- _ . . _ i i__~._ ~ _._ .~_ _ ._ __ -- ,_ __; ~ - - - - ' i T t Re lt i . es su 99 _. . .... ... .. .. ... L.i_1.. ... .. - _ i _. - ,r Test passed ~ , ~ , o n 1.3598 -- - i_., , __. __ __ - - - - ._.~-~ ~ - _ - - - - _ - - - --,-~ - - mme ts. _. .. ~ ~ n i , ~~~ ~ , - - . 1.3 5 9 7- i i 01:17:44 pM 02/21/2006 ~ ~ i i i i i i i I ~ { t OT:21:OQ:PM 01:24 00 PM,;; 01 27:00 PM ,; 01.30:00'PM 01:32.44 PM': 02/21/2006 02/21/2006 02/2'1%2006 02/21/2006 02/21/2006;; s ,,,, `- ~J 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, (714) 325-9477 Jose Dethier, (714) 306-3075 Abe Reintord (714) 325-7495 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 asite-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, last calibrated 8/04. • Vacuum Gauges, Ametek-U.S. Gauge, 0-30 in-hg vacuum range, 4.5-inch diameter, glycerin filled, .5% span of scale, last calibrated 8/04. • 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. 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 .0014-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. 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 .0014-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 Jea~-rn l.oac~n - 203576 HMBP_pd#~ ,..,~.~.,..y ..- ~. ~~.,~__,.~~~.s_~~w,.~...w,_.~w.~,. ~ys.~ m.,.~.,a.......~,....... Page ~`~ CHEVRON PRO DUNS COMPANY P.O. BOX X004 SAN RAMON, +~A 94583 (925) 842-'002 CALI FOFNIA Certified Unified Program Agency HAZARDOUS MMTERIALS BUSINESS PLAN HMBP 2006 Chevron Stations, Inc. #203576 1125 Coffee Rd 1125 Coffee Rd, Bakersfield, CA 93308 (661) 588-9066 ENT'D Mph 17 2 FOR POSTING 1 N THE EMERGENCY RESPONSE BINDER at the CASHIER ARE PHON E ~Je~nni Lo~~n 203576 HMBP pdf ~ ~~ Page 2 UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATI ON BUSINESS OWNER/OPERAT~R IDENTIFICATION P~ ............... ~ I . I DE NTI FI CATION FAgLITYID# O O _ 0 0 0 -- 0 0 0 0 0 0 + BEGINNINGDATE teo ENDING DATE 1e+ _ ., . 01/01/2006 12/31/2006 BUSINESS NAME(~nemFAaurv NAME voeA -oaro euenesA~ 3 BUSINESS FHONE toz Chevron Stations Inc. #203576 ..... (661) 588-9066 BU9 NESS SITE A DDRESS +«+ 1125 Coffee Rd .......... GTY +~ ZIPOODE tos Bakersfield ........... CA 93308 DUNRBRADSTREET +os SCCODE(4digit#) +07 0 0 -914-0 559 ...... 5541154111753817 542 COUNTY +~ Kern .............. BUSINESSOFERATORNAME +os BUSINESSOFER4TORPNONE tto Chevron Stations Inc. #203576 ............. (661) 588-9066 I I. BUSI NESS O NER OWNER NAME +++ OWNERFliONE ++z Chevron Products Com n Attn: Permit Desk L2315 B-1.,.,,.. 925-842-9002 OWNERMAILINGADDRESS +73 P.O. Box 6004 ............. qTY it SPATE ++s ZIPCODE ++6 San Ramon ,........ CA 94583 III . E NVI RONM E NTA4..CONTACT CONTACT NAME ++~ CONTACT FHONE tte Chevron Products Com an Attn: Permit Desk L2375- 61., 925-842-9002 CONTACT MAILINGADDRESS tte P.O. Box 6004 qTV tzo SPATE +zt ZIPCODE +~ San Ramon CA 94583 -PRIMARY- IV.EMERGENCY CONTACTS SECONDARY- NAME +~ NAME +~ Chevron Maintenance DiS atch Chevron Emergency Information Center (C1'EIC) TITLE tza T TLE tza SOlve One N el Desk Chevron Emergency Information Center (CTEIC) BUSINESSRiONE t2s BUSINESSRiONE 725 866-845-4254 ..8~23i-x+23 24HOURFHONE 726 2 HOURRiONE 7z6 ChevrDrt Information CatteT 800-231-0623 Chevron Emergency Information Center Boo-237-0623 A4GER# tz7 GER# ......., +3z ADDITIONALLOCALLYCOLLECTEO INFORMATION: .............. Ce•tific~on : Ba6ed on my inquiry of fioseindividuds re~tor7sWeforobtanirtg theinforYfii#ion, l certify under petAty of lav tlta I haiepeson9ly ecattined atd anfarriliawithlheinforrr~onsubmittedaWt)dieaetheinformAionistruQawr3G aidtomplde SIGNATURE OF OWN62IOP6tATOR ORDESIGNAT® R@RES6JTATNE DA"t~ 73a NAME OF DOCUMBJT PR~AR62 736 Checsen 4~~'ts Co/tRi~+r~ SA!(eq, 4jrE.7f.S 3/ 112006 Richard S. Allen, R.E.H.S. ~ NAME OF SIGNl32 (prim) 736 TIT6E OF SIGNB2 737 Chevron Products CompanylRlchard S. Allen, R.E.H.S. Retail HESSpeciallst UPCF (1/99) OES Form 2731 Jeanni Loren - 203576 HMBP.pdf ~~~~~~~~~~ ~ ~~~~~ ~"~~~~ ~~~ w Page 3 6 UNIFIED PROGRAM CON~+bLI DATED FORM HAZARDOUS MATtI21ALS HAZARDOUS MATERIALS INVENt~RY -cHeMlcAl_ DESCRIPTIOni (ore Pepe Per meleri elPer 6tri I N m ar area, ^ADD ^DELETE i~REVISE,,...,,., ~ of I. FACILITY INFb~2MATION ..........., BUSINESS NAME(S=1fle ~ FAgLITY NAMEor DBA -Ddng Busness As) 9 Chevron Stations Inc. #203576 CHEMICAL LOCATION zot CHEMICAL LOCATIONOONFlDENTIALEFORA ~ WESt9de0fLot .........., ^YES ® NO ' t MAP#(oPtianei) ~ GRID#(agiorni) 2p9 FAauTYID# 0 0 ''- 0 0 0 - 0 0 0 0 0 0 1 ~ II. CHEMICAL INF!l~!RMATION CHEMICAL NAME 275 TRADESECRET ~ Yts ^ No 20e R#rolaxn drOC3I)OnS If 9ioject toEF>rRA, refertoirt4ruCtioris COMMON NAME 207 EHS ^ Ye; ®No 208 ula"Ufdeaded C~Ollne 870ttale ................ CAS# 209 1~ 'IfEHSis"Y~', AI artountsb9ow mu5tbein Ibs. Fl RE ODDS HAZA RD CLASSES (COmpleteif req~iredb9 cuFl4) 2t0 RaTtm~le Li aids pass 3 ........... HAZARDOUS MATERIAL TYPE (Check °re Ilan arty) ^ a PURE ®b MIXTURE ^ c WASTE 2tt .... RADIOACTIVE ^ Yes ®No 2t2 ....... CURIES 2t3 PHYSICAL STATE eta (Check are Ilan oAy) ^ a SOLID ®h LIOUID ^ c GAS LARGEST CONTAINER 12,000 215 FED HAZARD CATEGORIES 216 (Check AI th9~iy) ®a FlRE ^ h REACTIVE Q c PRESSURERELEASE ~ ii ACUTE HEALTH ®e CHRONICHEALTH AVERAGE DAILY AMWNT 217 MAXIMUM DAILY AMgJNT 2te ANNUAL WASTE AMOUNT 279 STATE WASTE CODE 220 6000 12 000 ~ DAYSON SITE: ~ UNIT5 ~ a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d tOFfS Check are Ilan orr ' If EHS afloat mat bein ............. STORAGE CONTAIN62 ^ aABOVE GROUNDTANK ^ ePLASTIC/NONMETAL LIC DRUM ^ i. ~IBERORUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ~ h UNDERGROUND TANK ^ f. CAN d j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY ^ k §OX ^ n TOTE BIN ^ d STEEL DRUM ^ h SILO O,,,I,,_CYLINDER ^ P TANK WAGON zza STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOWAMBIENT 2za STORAGE TEMP62ATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT ^d CRYOGBJIC 275 %Wf HAZARDOUS COMPONENT (Fa rrdxUre awa4e «;iyj ............. EHS CAS# t 100% zze C~EBOIIne zzi ^Yea ~ No zxa $6290-$1~5 2ze 2 .1-4.9% x+p Bgiz3le zit ^ Ys ~J No zaz 711,3-2 xct 3 .1~3% 234 Ethyl Ba1Za1C ~ ............ ^Ys ®No zse 100111-4 231 4.1-2°/p x+a N~hth~ate z~ ^Ys ~ No 2ao 91-20-3 zat 5 0-10% za2 Ethatol zae ............. ^ Yta ®No 24a 64-17 245 s 0-15% tae Methyl Tat Butyl Etha(MTBE) ...247 ^Yts ~ No tae 1634-Od-4 zae ~ 0-17% aso Tertiay Amyl Methyl Etha(TAME) z5, ............... ^Ys J8f No zsz 994-05-8 z5a a 0-18% 254 Ethyl Tat-Butyl Etha (ETBE) -~ ^ YtS ®No z5s 637-92-3 2~ Ifffaelrawtlanwnpufr baraPMrtatprmUr tlen t%M welphti rv.cerdrepaio,a0.t%M'Mty+r if eerdroperit/efarh aditimel efemao}pepar ceptfrirptMr radirfamsem ............... ADDITIONALLOCALLYOOLLECTEDINFORMATION DOT#1203 tae If EF~RA, Femme Sign Hae URA (1/99) OES ForTn 2731 ~Je~nni Loy~~ti 203576 HMBP.pdf _.m._M~.~..a,N ~A~~ b~~~.~ Page 4~ UNIFIED PROGRAM CON~CyLIDATED FORM HAZARDOUS MAtEi21ALS HAZARDOUS MATERIALS INVENTf~RY -cHEMICaL oESCRIPTioN (~~~~~~~~~I°Iroag~) ^ADD ^DELETE ®REVISE........... zro ~ ~ ~ I. FACILITY INFI~~MATION ~ BUSINESS NAME(Sene a;FAgLITY NAMEor DBA-Ddng Busnsss As) 9 ~ Chevron Stations, Inc. #203576 q~EMICAL LOCATION 2D1 CHEMICAL LOCATIONCONFIDENTIALEFCRA 2Dz Wt~t9deofLOt ^YES ® NO , MAP#(optiord) 209 GRID#(optior~el) 204 FAaurrlD# 0 0 }- 0 0 0 ,- 0 0 0 0 0 0 1 ~ li. CHEMICAL INFM2MATION CHEMICAL NAME 205 TRADESEgiET iffi Yes ^ No ~ Ft#rolaOTi drO~pr)5 If 9IDj°cltoEFLRA, rAerto in4ruclims COMMON NAME zo7 EHS" ^ Ye, ®No zoe Mid-GradeUrdeBded C~oline 890daie ......... CASs ~ 86290.81 ................ `IfEHSis`Ye:, ~I arauntst~ow mustbein Ibs. FIRE CODE HAZARD CLASS (CompeteifregriredtyCUF14) 210 AanmabieLi 'dspas3 HAZARDOUS MATERIAL TYPE (Check One item oriy) ^ a PURE ®a MIXTURE . ^ c WASTE 211 ....... RADIOACTIVE ^YES ®No 2t2 . CURIES 219 PHYSICAL STATE 2,a (Chetlc are item My) ^ aSOLID ®h LIQUID ^ c GAS ....... LARGEST CONTAINER 12 OOO ~ ....... 2t5 FED HAZARD CATEGORIES 2,8 (Check gl f~~taT{fy) ®a FlRE ^ h REACTIVE ^ c PRESSURERELEASE ~ G ACUTE HEALTH ®e CHRONICHEALTH ~ AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 2,e ANNUAL WASTE AMOUNT 2,9 STATE WASTE CODE 220 6000 12 000 22, DAYSON SITE: 222 UNITS' ®aGALLONS ^ h CUBIC FEET ^ cPOUNDS ^ d'f't7tJS Check are itenai • If EHS anoint bein ....._..... STORAGE CONTAINE2 ^ aABGVE GROUNDTANK ^ ePLASTICINONMEfAL LIC DRUM ^ i. ~IBERDRUM ^ m GLASS BOTTLE ^ q RAIL CAR ~ h UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY d k i30X ^ a TOTE BIN ^ d STEEL DRUM ^ hSILO 0,,,,L .CYLINDER ^ p TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOW AMBIENT .............. z2a STORAGE TEMPERATURE ®a AMBIBJT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT ^d CRYOGB~IIC 225 %WT HAZARDOUS COMPONBVT (Far mixhre orwa~e ally) 9iS CAS# ~ 100% 2ze C>a3oline zii ^Yes $I No zze 86290-81-5 22s 2 .1-4.9% 230 BeflZene 281 ................ ^ Ye; $I No z9z 71-432 xc, 3 .1-3% 234 Et I Berle za ............... ^ Ye; )~ No 29s 100-41-4 z97 a.1-2% z9e N~hthale~e z93 ........... ^Ye; ~ No 2ao 91-Z()-3 za, s 0.10% 2~ Ethaal 243 ............... ^ Ys ®No zaa 6417 zas s 0.15% zas Methyl Tart Butyl Ether (MTBE) za7 ^YES ®No zaa 1634-04-4 zas 7 0-17% ~ TErtiay Amyl Mdhyl Ether (TAM E) ~1 ............... ^Ye; $I No ~ 994-05.8 ~ & 0-18% 25a Ethyl Tat-Butyl Ether (ETBE) 255 .............. ^ Yts )~ No zse 637-923 z~ Ifm°ro herarmncanp,wZS°ropwrtatgeeter tten 1%M vdthlifronmrd,opai4 or 0.1% MvwiA+l ifealydmpMepttech emtloml ae°bdp°pw ceptvirotro rp,iradiAOrnutim ..,. ADDITIONALLOCALLYOOLLECTEDINFORMATION DOT#1203 za5 If EPCRA, Femme 9gn Hae UPCF (1/99) OES Form 2731 ~Jeanni Loy~n 203576 HM,BP pdf ~, ~v ~y~.,~,y. ~__~.~.....~__.~Q._~. _ Page 5` UNIFIED PROGRAM CON~IOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENt~7RY -cHEMlcn~ Or=_scRlPrloN (ore ~ Der met eri elper tad I ~ r V ar aree> ^ADD ^DELETE ®REVIS`,,,,,,,,,,,,, 200 P~6 of ~ I. FACILITY INF~7~tMATION ~ rBUSI NESS NAME( ~ FAq LITY NAMEor DBA - Ddng Bttsirleas As) 3 ~ Chevron Stations, Inc. #203576 ~ giEMICAL LOCATION 201 giEMICAL LOCATIONCONFlDENTIALEfCFiA 202 WESt 9de01LOt ^ YES ® NO 1 MAP#(aptiorel) 203 GRID#(optiorel) 204 FAquTYID# 0 0 - 0 0 0 0 0 0 0 0 0 .... 1 C4 II. CHEMICAL INF!RMATION CHEMICAL NAME 2°6 TRADESEg2ET ®Ye; ^ No 206 R#roletan drorabor>5 If 9ihject toErCRA, rdertoirNructiarn COMMON NAME m7 EHS ^ YES ®No zos 31 UNeaded Gasoline 91 Octane .,.. ~ ~ 209 8629 0-81-5 .............. "IfEHSis`Y~', ~I ariountsbAarr rttustbein Ibs Fl RE CODE HAZARD CLASgS (COmpeteitregwred6yIXlA4) 210 Ramm~leLi uidspass3 ............. HAZARDOUS MATERIAL zt1 TYPE (Check are itlan Orly) ^ a PURE ®h MIXTURE ^ a WASTE ..... RADVOACTIVE ^Yes ENO 212 ........ CURIES 213 PHYSICAL STATE 214 (Chsdc are itan ady) ^ a SOLID ®h LIOUID ^ c GAS ...... LARGEST CONTAINER 12,000 ........ 215 F® HAZARD CATEGORIES 216 (Check all tfta appy) ®a FIRE ^ h REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ®e CHRONIC HEALTH AV62AGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 2te p,NNUAL WASTE AMOUNT 21B STATE WASTE CODE 220 6000 12 000 221 DAYSON SITE: m UNITS ®a GALLONS ^ h CUBIC FEET D c POUNDS ^ d TONS ~ C ite7t orl 'If EH snout mat bein ..... STORAGE CONTAINER ^ aABOVE GROUNDTANK ^ e PLASTIC/NONMETAL LIC DRUM d i. FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR ~ h UNDERGROUND TANK ^ f. CAN d j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER ^ aTANK INSIDE BUILDING ^ g CARBOY d k BOX ^ a TOTE BIN ^ d SiffL DRUM ^ hSILO Cj,,,,L,.CYLINDER ^ Q TANK WAGON 223 STORAGE PRESSURE ®a AMBIBJT ^ h ABOVEAMBIHJT ^ c BELOW AMBIENT .............. 22a STORAGE TBv1F82ATURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOW AMBIENT ^d CRYOGBJIC ................ 225 %WT HAZARDOUS COMPONBdT (Far mixhre orwa~e tY;iy) ................ 9iS CAS# 1 100% zza Gasoline 227 _...... ^Ye: ®No z2a $629(}81-5 zzs 2 .1-4.9% ~0 Be13Ile 231 ^ Yes ®No zaz 7132 233 3 .1-3% xu Ethyl Belaale ...z~ ^ YES ®No zas 100.41-4 z37 4.1-2% gas Naphth~Ene eas ..,. ^ Ys ~J No zoo 91-20~ za1 5 !}10% zaz EthaTOl 2d3 .............. ^ Ye; ~ No zaa 6417ti5 246 s 0-15% zas Mdhyl Tat Butyl Ethef (MTBE) zdi ............... ^Yes ®No zaa 1634-OMd zae 7 a17% 25o Teti Amyl Methyl Ethar(TAME) ~~ ^Yes ®No z5z ssa-oss z5a a 0-18% zs4 Ethyl Tat-Butyl Ethe' (ETBE) z55 ............. ^ Ye; ®No z5e 637-92-3 257 Ifmora terarrEumnpuriYSerepre®rtatgeeterthen 1%bd vwi~tlf rer,oerdrWedG Or O.f% MvaiyY If drdrnpnicattach atltlaml9wtsd paper mptviiptlr regdreGir(ormetian ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT#1203 gas If EFCRA, Flte$e Sign Hae UPCF (1/99) OES Form 2731 ~Jeanni Lo~2n - 203576 HMBP.,pdf ~.,.~,..~..~., ~.~.~~,.~,~~ .,...~~.~ _ .~_.~~~__„~~.~.~_...~..u.. ~,~w._.~..~.,_ Page~6~ UNIFIED PROGRAM CON~GLI DATED FORM HAZARDOUS MATEf21ALS HAZARDOUS MATERIALS INVENt+r~RY -cHeMICAL DESCRIPT1oN ...... (are pepaper meterietper ddldirgoreree) ^ADD ^DELETE ®REVISE,........,.. 200 ~ ~ ~ I. FACILITY INFt~~tMATION ~ BU9 NESS NAME (S~me a; FAq LI TY NA MEor DBA - Ddng Buenas As) 3 ~ Chevron Stations, Inc. #203576 .... ~ CHEMICAL LOCATION 207 CHEMICAL LOCATIONOONRDENTIALEPCRA 202 irlStde$0~ ^ YES ® NO ................ t MAP#(optiorel) eat GRID#(aptiord) 204 FAquTYID# 0 0 ;;- 0 0 0 - 0 0 0 0 0 0 1 F3 11. CHEMICAL INF.N2MATION giEMICAL NAME 205 TRADESECRET ^ Ye: ®No 206 Oat~on DIaXIde If 9rajecttoEfCR4,refertoir44ructiare COMMON NAME zm EHS' ^ Ye, ®No 2oe Cabon Dioxide 002 ............ cASn 208 124-3&9 ................ "IfEHSis"Yet", 91 anamfsb~ow mustbein Ibs. Fl RE CODE HAZARD CLASSES (COmgeteif rasa reahy CuPA) 270 Can Gas pass 22 HAZARDOUS MATERIAL 277 TYPE (Ct7edc ae iten arty) ®a PURE ^ d MIXTURE ^ a WASTE ..... RADIOACTIVE ^YES ®No 272 ........ CURIES 273 PHYSICAL STATE z7a (Chadc ae iten arty) ^ aSOLID ^ h LIQUID ®c GAS ....... LARGEST CONTAINER 2429 ....... 215 FED HAZARD CATEGORIES 275 (Check all that atpy) ^ a FIRE ^ h REACTIVE ~ cR2ESSURERELFI7SE ~ d ACUTE HEALTH ^ e CHRONIC HEALTH AVERAGE DAILY AMOUNT 277 MAXIMUM DAILY AMWNT 27a~ ANNUAL WASTE AMOUNT 279 STATE WASTE CODE 220 121 2429 ... 227 DAYSON SITE: 222 UNITS' ^ a GALLONS ®A CUBIC FEtT ^ a POUNDS ^ d fbNS 3~ Check are i en aril If EFi arrxn[ bein ............... STORAGE CONTAIN62 ^ aABOVE GRWNDTANK ^ e PLASTIGNONMETAL LIC DRUM I~ i. kiBERDRUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ^ h UND62GROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER ^ aTANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ a TOTE BIN ^ d STS DRUM ^ h910 ~.,.I,,,.CYLINDER ^ P TANK WAGON 223 STORAGE R2ESSURE ^ a AMBIENT ®d ABOVEAMBIENT ^ a BB_OW AMBIENT .............. 224 STORAGE TBdP6tATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ a BB.OW AMBIENT ^d CRYOGENIC ............. z25 %WT HAZARDOUS COM PONBdT (Far mixGre a wa4e cHy) ............... BiS CAS # 1 100% z26 Carbon Dioxide 22i pYe; ®No 2ze 12439 228 2 2 3 0 2 a 1 ................ ^ Yes ^ NO 232 233 3 234 285 ............ ^Ye; ^ NO 236 237 4 23e 239 ^Yei ^ NO 240 247 5 242 243 . . ^Ye: ^ NO 244 245 If mars harar~ramnpuertearepe®rtatpaeter then 1X bar veidYit mrtmrdmpaiq a 0.1X b7wdyY If cdrdmperiepttaeh ad3timel deetadlspr npvirgtro regirMiMamW m ................ ADDITIONALLOCALLY COLLECTED INFORMATION DOT#1013 24a If ER~iA, Reese 8gn Hae UFOF (1/99) OES Farm 2731 eanni Loven - 203576 H~MBP.~pdf~~=~~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~-~~~~~ ~~ ~~~~~~~ Page~7 ~ EMERGENCY RESPONJSE PROCEDURES GASOLINE and CAREtON DIOXIDE FIRE OR EXPLOSION DATA Carbon dioxide is not flammable. CAUTION: Compf~essed Gas Cylinder may explode in heat of fire. HEALTH HAZARD CAUTION: 1. Vapors may cause dizziness or suffocatiofl: 2. Contact with liquid carbon dioxide may cause frostbite. In the event of a fire, spill, leak, or suspected leak in the tanks, piping, or cylinder, or natural disasters such as an earthquake or flood, the folioilVing steps are to be taken as aaDlicable 1. TURN OFF PUMPS using the Flnergency rump Shut-0ff 5Vi+itch. 2. EVACUATION : If there is any immediate danger, ANNOUhiCE to all persons on the site: 'There is an emergency. Please tum off your engines and leave the station on foot ihtmediately." 3. CALL FOR HELP incase of an emergency by dialing 9~~,~,~ and giving the fdlowing inFomiation: 'THERE ISA FIRE/ GASOLINE SPILL at the station (1125 Coffee Rd, Bakersfield).° If anyone is trapped or needs medical attention, tell the aruwering dispatcher. Stay on the phone and be prepared to answer any questions rbrrcernirxj the situation. 4. LOOK AROUND to assure that all others have left the statiah if necessary, particularly those in vehicles who may need assistance or may not have heard the emergency annttUn cement. Assist or direct assistance to, anyone having difficulty leaving the station area, and anyone who may be injured. 5. ATTEMPT TO EXTINGUISH any small or incipient fire if you can do so safely. Have the fire extinguisher ready to use in the event of any spill. Try to contain any large spill, or use absorbent on smaller spills. 6. REPORT to arriving emergency response personnel to proVi de them with any infonnation or assistance they might need using the Hazardous Materials Business PlahiEmergency Response Procedures. 7. CONTACT the station Operator if s/he is not already at the station. Use the list below for emergency contacts: Station Manager ~ I dome 8. NOTIFY Chevron Maintenance~Soly a One by phone VJfT1911V 24 HOURS 1-866.845-0254 or CHEVRON EMERGENCY INFORMATION CENTER 1-SOf1~31-0623 Chevron will notify the approp riate State and Local agences unless the situation reaui res urgent immediate resoaise by the aoencies , in which case the OPERATOR. shordd notify these agencies: 1. LOCAL UST AGENCY :Bakersfield City Fire Department / (661) 326-3979 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES 2d Hours),800852-7550 3. NATIONAL RESPONSE CENTER (24 Hours), 800-42 9. Operator should attempt to isdate leak location by inspecticii: 10. Chevron will coordinate whatever corrective action s need tb be taken beyond the Operator's capabillties. Chevron will file whatever reports reed to be filed with local and state agencies, and send a copy to the station for the Operator's files. 11. EVACUATION: In the event evacuation is necessary, the atterxiarrt will annormce for all customers and personnel to evacuate the building using the nearest exit door. All per§r~hs shordd go to the emergency assembly area as designated on the site wrap. Bring the Hazardous Materials Business PIanlEmergency Response Procedures to assist emergency responders. 12. RE-ENTRY : If evacuation has occurred and emergency respphde rs have teen called, reerrtering this facillty should take place with extreme caution and ordy urxier the direction of the senior emergency resporxier on site and Chevron personnel. THESE EMERGENCY RESPONSE PROCEDURES MUST BE POSTED CONSPiCUbUSLY ON SRE ALONG WRH THE ATTACHED SITE PLAN UR'F (1/99) OES Form 2731 Jeantii Loven - 203576 HNIBP.pc1f ~ ~~-~.~..__..~~H~.~_._~...~,_.~.~~_Y.~,~..._ ~~~~,~~~~~ ~ ~ ~_~~~~,„M~ Parge 8 k SITE SPECIFIC EMERGENCY ~i~SPONSE TRAINING PLAN Employees must be given this training before starting work; and refresher courses must be provided annually. Records mom. 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 this document upon completion of training. Retain these records for a minimum of three years: I. FIRST THINGS TO KNOW: A EMERGENCY PUMP SHUT-0FF: This toms off the turtiirte pumps that provide flow to the dispensers from the urxJergnorurd tanks. Incase of a leak, shutting off the pilmps will help to prevent spills. LOCATION: 1-CASHIER AREA. 1-0UTSIDE BUILDING.....1.-..DISPENSER ISLAND B. ELECTRICAL PANEL :The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. LOCATION: BACKROOM OF STORE C. WATER SHUT-0FF: The water shut-off may be neces§ary in some cases. LOCATION: LANDSCAPE AREA ON MAIN D. NATURAL GAS SHUT-0FF : If your station has natural gas, it may be necessary to shut-0ff the natural gas flow in an emergency. LOCATION: NONE E. FIRST AID KIT: LOCATION: BACKROOM OF STORE F. FIRE EXTINGUISHER :Use only on small fires that yoU can handle. Do not attempt to extinguish large fires on your own; call 9-1-1-1 for help. LOCATION: 1-AT CASHIER AREA 1- BACKROOM OF STORE G. SPILL RESPONSE KIT: Use FM-186 in accordance tb manufactures recommendations. FM-186 is to be used to immediately clean up small Gasoline and Diesel spills. Incase of large spill, merely try to contain it; a vaanun tn~ck should be used to dean up any large spills. LOCATION: BACKROOM OF STORE H. EMERGENCY EVACUATION AND ASSEMBLY ARElil9 LOCATION: EAST SIDE OF BUILDING ON MAIN I. NEAREST MEDICAL FACILITY: Employees should know what facilities are available in case customers or other employees need medical attention. Bakersfield Heart Hospital (661) 316-6000 3001 Sillect Ave Bakersfield, CA 93308 3.0 m i N E UFCF (1/99) OES Form 2731 ~Jeanrn Loven - 203576 HIVIBPpdf ~~~~f~~;~~~ ~~/~~~ ~W~~~~~~~ ~~„~ Page 9~ Ii. All employees should review the Service Station Monitoring flan, of which this training plan is a part. Specifically, each employee should understand the procedures to be used in responding to various kinds of emerger>cies, and know how to monitor fa leaks of hazardous materials. As a supplement to this package, employees should also review the Errrer~gency Response Plan tiled by your business to the appropriate local agency. Thirdly, employees should review and have access tt9 the Materials Safety Data Sheets you have on file for each of the hazardous materials shred at the station and milst be drilled in all emergency response procedures cxxrtained herein. III. FIRST AID PROCEDURES for EXPOSURE TO GASOLIhI~ AND DIESEL FUEL A EYE CONTACT: Flush with water for 15 minutes while hddifig eyelids open. Get rrtedical attention. B. SKIN CONTACT: Flush with water while removing contarriiriated Gothing and shoes. Follow by washing with soap and water. Do rwt reuse clothing or shoe s until cleaned. If initation persists, get medical attention. C. INHALATION (Breathing): Remove victim to fresh air and piovide oxygen if beathing is difficxdt. If not breathing, give artificial respiration. Get medical attention. D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLJNE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into lungs. Get medical attention. E. NOTE TO PHYSICIAN: If more than 2.0 ml per kg has beefi ingested and vomiting has not occurred, emesis should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms such as loss of gag reflex, convulsions or urrc6ftsciousne ss occru before emesis, gastric lavage using a cuffed endotracfreal tube should be c~rrsidel~ed. F. For further information, consult the Materials Safety Data ~Haets for these products and for other hazardous materials. FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to the MSDS for that product. ANNUAL CLASSROOM EMPLO''IfEE TRAINING TOPICS Hazwoper Hazard Communication LodcoutlTagout California Impact Valve & Nozzle Operation Fire Safety Safety Orientation SB 1981njury Illness & Prevention Program Emergency Response & Spill Cleanup Procedures Robbery Prevention System Alcohol and Tobacco Awareness Document prepared by: Chevron Products Company/Richard S.Allen, R.E.H.S., Retail HES Specialist UFarF (1/99) OES Form 2731 Jeanni Loren 203576 HMBP pdf ~~~~'~~y'~~~~~~~µ `~"°`~~~Q"~" ~~~~~°~~-•°.~~ ~.~,.~.~.~.~D.u~.w.~......Page 10 ~ Hazardous Materials Business ~'I~n/Emergency Response Employee Trai~rhg Log BUSINESS NAME: Chevron Stations, Inc. #203576 ADDRESS: 1125 Coffee Rd, Bakersfield, CA 93308 E to a must si n this form to rove the r i their INRIAL, and/or ANNUAL Emer en Re on Trainin DATE OF TYPE OF TRAINING EMPLOYEE NAME EMPLOYEE SIGNATl113E TRAINING Initial or Annual Refresher .............. ................ ., ........... .............. ................ ............... .., .............. ............... .,.. ................ ..... ................ .. ............... ............ UFCF (1/99) OES Form 2731 Jeanni LdYen ~3576~HMBP (Car Wash Only) pdf ~~-~~aa..~~..~.. ~~ ,~w. ~.Pa9e=1 i UNIFIED PROGRAM CON~OLI DATED FORM HAZARDOUS MAt~RIALS HAZARDOUS MATERIALS INVEN~CyRY -c>aEnntcAL ~ESCRtQ-rtont ~rtg,~ GriIEi ^ADD ^DELETE i$REVISE ,, . 200 Pie of I. FACILITY INFI~~tMATION BUSINESS NAME(Sane ~ FAgLITY NAMEOr DBA -Ddng Blsne3s As) 3 Chevron Stations Inc.#203576 CHEMICAL LOCATION 207 CHEMICAL LOCATIONCONflDENTIALEPCRA ~ Ca- Wash Bulidl ^ YES ® NO 7 MAP#(opionel) 2ro GRID#(opiantl) 204 FAquTYID# 0 0`- 0 0 0 - 0 0 0 0 0 0 1 Of 2 D2 II. CHEMICAL INF+C)12MATION CHEMICAL NAME zos TRADE~CRET ^ Yes ®No 2os Car Wash Cold Wax uscjed7°Exw,. retertc in4ructian 20~ COMMON NAME EHS ^ Y~ ®No ........ EODLAB D i A aTld 91ine Enhaloa for Cas CAS# z~ 'IfEHSis°Yes", ~I anountsbAow mtutbein Ibs 111-76-2 Fl RE CDDE HAZARD CLASSES (Comprteitregwre~CUPA) 270 wA .... HAZARDOUS MATERIAL 277 TYPE (Check are iten a1y) ^ a PURE ~ h MIXTURE ^ a WASTE . RADIOACTIVE ^ Yfs ~ No 272 .~.~ CURIES 273 PHYSICAL STATE (Chair ae Itenaiy) ^ aSOLID ~ h LIOUID ^ c GAS ~a .... LARGEST CONTAINER 30 .... 215 F® HAZARD CATEGORIES 27s (Check AI that spy) ®a FIRE ^ h REACTIVE ^ a PRESSURERELEASE ~ d ACUTE HEALTH ^ e CHRONICHEA LTH AVERAGE DAILY AMOUNT 277 MAXIMUM DAILY AMOUNT z7e ANNUAL WASTE AMOUNT 270 STATE WASTE CODE zz0 25 60 " ....... ~ DAYSON SITE: 22z UNIT5 ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d tdtVS 36J Chadc ate i an °ri ' If EH bein ............ STORAGE CONTAINER ^ aABOVE GROUNDTANK ®e PLASTIC/NONMETAL LIC DRUM ^ i. EIBERORUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ^ h UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n ELASTIC BOTTLE ^ c OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY ^ k i30X ^ a TOTE BIN ^ d STl~L DRUM ^ h5L0 d I. ,CYLINDER ^ P TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ G ABOVEAMBIENT ^ c BELOW AMBIENT 224 STORAGE TEMPERATURE ®a AMBIBJT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT Q d CRYOGBJIC .............. 225 %Wi HAZARDOUS COMPONBJT (For mixhre awasDe Qtly) B-IS CAS# 1 6% zzs BUtoxydhatoi zzi ^ Ye; $) No zze 111-76.2 ~ z 30%a z30 Mirx~d Sad Oil ~7 ... ^Ye3 )~ No 232 64742-849 z33 3 1-5% z~ SLrfadants r~ ^ Yes ~ No r,~ 61789-400 ~~ 4 23a ~ .............. ^ Yes ^ No zao za7 5 ~ ~ ............. ^ YES ^ No zaa gas If mare MtumsampmortaaaRwrtrt Qeatrr than 7X h1' xWl>K if nmeardriopaiq n 0.1X lywiyY If W dropMtcpltedl a09ttad dertadlalx aptvirptle rplratlirfamrtiat ........... ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# r10Re 2a5 If EFCRA, Reese 9gn Hae UFCF (1/99) OES Form 2731 JeanniTLBven - 203576 HMBP (Car Wash Only).pdf ~_ 1e~y~,W__~_~~ aY Page 2 ~~~ UNIFIED PROGRAM CON~iCJJLI DATED FORM HAZARDOUS MA~~121ALS HAZARDOUS MATERIALS INVENTORY -cHeMlcaL DescRIPTION (°rePe9e0er met«ieperlul6rg«eree) ^ADD ^DELETE ®REVIg..., 200 ~ of ~ I. FACILITY INFC~~MATION ~ BUSINESS NAME(Ssne ~FAGLITY NAMEor DBA -Ddng Busn~s As) 3 Chevron Stations, Inc.#203576 ~ GiEMICAL LOCATION zo, CHEMICAL LOCATIONOONRDENTIALEFG7A ~ Cs W2sh BUlldl ... ^ YES ® NO j , MAF#(optionei) 203 GRID#(opliorW) 2~ FAGUTYID# 0 0 ' 0 0 0 - 0 0 0 0 0 0 ,~ 1of 2 D2 II. CHEMICAL IN~'~J-~2MATION CHEMICAL NAME zos TRADE~CRET ^ Yes i$i No tae Clear Coat Car Wash Protestant If 9AjeottoEPCRA, rdertoir>grutliotn .,, .,. COMMON NAME ~~ zoe EH5 ^ Ye: ®No ' EOOLAB L trid Ca' Wash Conditions ......,.... 209 CA9~ ......., I f EHS is °Ye; , ~I anounts b~av must bein Ibs. RREOODEHAZARDCLASgS (Competeifregrireo°yCUH1) zto wA ... HAZARDOUS MATERIAL TYPE (Check ore Ilan arty) ^ a PURE ®hMIXTURE ^ c WASTE 2„ ..... RADIOACTIVE ^ Ye3 ®No 2,2 .. ... CURIES 2,3 PHYSICAL STATE 2,4 (Check are itan aiy) ^ aSOLID ®h LIQUID ^ c GAS LARGEST CONTAINER 3O 215 FED HAZARD CATEGORIES 2,6 (Ctedc all that afpy) ^ a FlRE ^ d REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ^ e CHRONICHEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 2t8 ANNUAL WASTE AMOUNT 2,9 SPATE WASTE CODE 2p 25 z2, DAYSON SITE: 2~ UNITS ®aGALLONS ^ h CUBIC FEET ^ c POUNDS ^ d tOfVS Check are it • If EHS amotrt fain ,........ STORAGE CONTAINE2 ^ aABOVE GROUNDTANK ®e PLASTIC/NONMETAL LIC DRUM d i. FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ h UNDERGROUND TANK ^ f. CAN ^~ j. BAG ^ n FtASTIC BOTTLE ^ r.OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ a TOTE BIN ^ d STffI. DRUM ^ hSILO (~ I. CYLINDER ^ Q TANK WAGON ~3 STOF;AGE PRESSURE ®a AMBIENT ^ b ABOVEAMBIENT ^ c BELOW AMBIENT z24 STORAGETEMP62ATURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c gELOWAMBIENT ^ d CRYOGENIC - 275 %WT HAZARDOUS COMPONBJT (Far mixhre orwasDe crly) l3iS CAS# 7 2% 225 ButOxyethalol 2Z7 ............... ^ YES ®No 2za 111-762 220 2 1,5% 2~ 2-Rop3[ol z31 ............ ^ Yes ®No z3z 67$3-0 ~ 3 620% 2~ QLk71tETT13)/ SZlffat3lt gas ^ Y~ ®No 235 7~J$-6Q.$ z37 a 1~% 235 NaOrucR.Irfadart tae ^Ye; ®No zoo 61789-262 za, 5 1-5°/, z4z Minsal ~ C81 zaa ..... . ^Yes $I No 24a 64742-30.9 24s Ifm«e tmmtrasoanrawtsarewaextetQasO«t°sn 7%M xdytifrowrdno9ai°,«0.1% Mwid~ If°dtcim9ari°ptraaramfi«.19.«.apaper arpt«IrptMrepYredinf«metlon _.. ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# None 245 UFCF (1/99) OES Form 2731 Jeanni Loven - 2b3576 HMBP (Car Wash Only) pdf ~~..~._.~..,..x..~,.,~.w,..,.~ g ~K~~ Pa a 31 x~.._ry._,__,~m,~,~ .~. ~~,9w._.~ ...~.,.~..,~._M~~.~...N~._~~~.....,.,~.~.~ .M _, ~.~.~.~..-~_~...~~~..._._~.~,.m~, .,~.m..r,xm..~n_~,x.w~.v~...~.~~.~~..._.,.~..,_.~. UNIFIED PROGRAM CON~OLI DATED FORM HAZARDOUS MA'1"II2IALS HAZARDOUS MATERIALS INVENI~C~RY -cHeMICA~ DESCRIPTION (ve owe car meteri a~uer hei I d ro n arse) ^ADD ODELETE ®REV15=, 200 ~ of ~ 1. FACILITY INFt~RMATION ~ rBUBNESS NAME(Sbrle ~FAGLITY NAMEor DBA - Ddng Bul;ines As) 3 Chevron Stations, Inc. #203576 ........ GiEMICAL LOCATION 201 GIEMICAL LOCATIONCONFiDENTIALEPCRA z~ L'd Wa;h BLOIdI ^ YES ® NO t MAFyf(°ptimel> eat GRID#(octimei) 20a FAGLITYID# 0 0 0 0 0 - 0 0 0 0 0 0 1of2 D2 II. CHEMICAL IN~IJ,~2MATION CHEMICAL NAME zo5 TRADESEGiET ^ Ye; ®No zoe l:a Waah Li uidVdiide Wa;h Brush Dt# uspatt°I:FCRArdat°i~n,~lio„e COMMON NAME zoo zoe EHS ^ Ys ®No ECOLAB Car Wash Clin 8r Clean ... GASk 200 N/A .............. `IfEHSis"V e", dl arlounts blow nwstbein Ibs Fl RE CODE HAZARD CLASgS (c«epeteitrequiremy CUFH) 210 HAZARDOUS MATERIAL 211 TYPE (Check ae Iten Orly) ^ a PURE ®a MIXTURE Q c WASTE RADIOACTIVE ^YES ®NO 212 ...... CURIES 213 PHYSICAL SPATE eta (Check ae Ilan afy) ^ aSOLID ®h LIQUID ^ G GAS ~~ LARGEST CONTAINER 30 ~~~~~ 215 FED HAZARD CATEGORIES 2te (Ctradc 91 that at;.ly) ^ a FlRE ^ h REACTIVE ^ a PRESSURERELEASE ~ it ACUTE HEALTH ^ e CHRONIC HEALTH AVERAGE DAILY AMOUNT 2n MAXIMUM DAILY AMWNT 2t8~ ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 60 .... 2zt DAYSON 9TE: zzz UNITS' ®aGALLONS ^ h CUBIC PEEP ^ a POUNDS ^ d TC1NS ate Ilan aY ' If EH argrt bein ONTAINER ^ aABOVE GROUNDTANK ®e PLASTIGNQNMETAL LIC DRUM Q i. FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ h UND6tGROUND TANK ^ f. CAN ^~ j. BAG ^ rt PLASTIC BOTTLE ^ r.OTHER ^ aTANK INSIDE BUILDING ^ g CARBOY ^ k BOX D a TOTE BIN ^ d STffi DRUM ^ h SILO d,.l. ,CYLINDER ^ R TANK WAGON T~3 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ a BELfSW AMBIBJT ............ 22a 5TORAGETEMPERATURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 2a5 °/oWi HAZARDOUS CCMPpVENT (Fa~ mixtire awake oriy) ....... BiS CAS # 1 zzs ArriOr>icS,ufadarts 2P7 ^Ye5 $i No zze MIXtUTe z29 z 230 NormionicRirfacta~ts zat .............. ^Yes ®No z32 Mixture xct 3 230 235 ^ Yei ]~ NO 236 237 4 23e 23s ^ Ys ^ No zao zat 5 zaz 2-03 ........... ^ Yet ^ No za4 gas Ifmve hew0ueanRreKsereRasrtat9iaeter tfen l%by xWdtifrmurdmpric,v eiX hfwefdt If trdrdrepariCNtech atldtl°rml Aaetsd PePK mptvlrpne reyiradlARmWm ............ ADDITIONALLOCALLY COLLECTEDINEORMATION DOT# nOnB tae UPCF (1/99) OES Form 2731 ~Jeanni Loven 203576 HMBP (Car Wash On~ly~~pdf~~~~~~' ~ ~~~~~~ ~ ~~ ~~~ ~~_~~~ Page 4 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MA~M2IALS HAZARDOUS MATERIALS INVENTbRY -CHEMICAL oESCRIP-rloN core IeOB ver meteri Alper hui I rn no a erm) ^ADD ^DELETE ®REVISE,_. :. ~0 ~ ~ ~ I. FACILITY INF(~~MATION ~ BUSINESS NAME (Ssrte a; FAg L I TY NA M Eor DBA - Ddng Busing As) 3 Chevron Stations, Inc. #203576 -J giEMICAL LOCATION zo7 q~EMICAL LOCATIONCONFlDENTIALEFCRA zaz C.3 Wa~T BUlid't ........ ^ YES ® NO t MAR'~(aptior~) 203 GRID#(aptiard) 284 FAquTYID# 0 0 -~ 0 0 0 - 0 0 0 0 0 0 ......... 1 of 2 D2 II. CHEMICAL INF.!~J!~MATION q~EMICAL NAME 2os TRADEgCRET ^ Yrs ®No zas Lo PH Clear Coat Blue us,l>jeatoEFCR4,refert°iMruchore OOMMON NAME zo7 z~ EHS ^ Yes ®No EOOLAB Li uid Add Ca' Wash GDnditior>r~ .. ~~ zos 'If EHSis°YES', ~I 3n0Un1S tt~Od/ n7u5f bein lbs. Fl RE OODE HAZARD CLASSES (Competeif regriredbyCUPA) 2to N/A ............... HAZARDOUS MATB2IAL 277 TYPE (Check OE itan Orly) ^ a PURE ®a MIXTURE ^ c WASTE ...... RADIOACTIVE Q Yes ®No 212 ....... CURIES 2t3 PHYSICAL SPATE ~ 214 (Check 0rt8 itenariy) Q aSOLID ®ti LIQUID ^ c GAS LARGEST CONTAINER 30 275 FED HAZARD CATEGORIES 278 (Check ell that eruly) ^ a FlRE ^ h REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ^ e CHRONICHEALTH AVERAGE DAILY AMOUNT 277 MAXIMUM DAILY AMIXINT 2te ANNUAL WASTE AMOUNT 2ta STATE WASTE CODE 220 25 60 2zt DAYSON SITE: zzz UNIT5 ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d TdNS 36J heck it Ri ' If Ftl artOmt mat bein ...... STORAGE CONTAIN62 ^ aABOVE GROUNDTANK ®e PIASTIC/NONMETAL UC DRUM ^ i. FIBER DRUM ^ m GLASS BOTTLE O q RAIL CAR ^ h UNDBtGROUND TANK ^ f. CAN [~ j. BAG ^ n PLASTIC BOTTLE ^ c OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY [y k gOX ^ a TOTE BIN ^ d STEEL DRUM ^ h 5L0 d.l. ,CYLINDER ^ P TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVE AMBIBJT ^ c BELf1W AMBIENT 224 STORAGE TEMPERATURE ®a AMBIBJT ^ tt ABOVE AMBIENT ^ G BELOW AMBIENT ^ d CRYOGENIC 225 "~°Wf HAZARDOUS COMPONB~IT (Far Tni~tre Orw~e DYIy) BiS CAS# f 5% ~ Rx>,sphoric Add 227 ............. ^ Yes ®No z2e 7664-382 2za 2 5-21)% z3o ANONCSlJTfr~#31tS eat ^Yes $i No z3z 233 3 z3a gas .,. ^ Ys ^ No z3a z37 4 239 tae ^ Ye; ^ No zao zat 5 zaz za3 ,,.....,,,. ^Ye; ^ No zaa zas Ifmore ne:ardr.. me e®rtat ..ter then l% wi ifrm~rd M pt i carnPareKa P ? by f/K mpaie, or 0.1X wal falfamparitpttach aoYltiorml Aeetsapepv teptvlrptte regiretlirformMian ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# UN1805 tae If EFCRA, Flease 9gn Hae UR'F (1/99) OES Farm 2731 Jeann Lbyen 203576 HIuIBP (Car V11ash OnIY).Pdf~~~„~a„%_.._..h....~. x~...~,,,~~,..a.~_.,_~.W.....,.ro.~~~..a..~,~ ~.-~~-~,~W_~.~.°µ--~~° Page 5 UNIFIED PROGRAM CON$OLI DATED FORM HAZARDOUS MA"I'SRIALS HAZARDOUS MATERIALS INVEN~"C~RY -cHeMICAL eESCRIPrION (ons cane ver metxi giber to I d ng or aee) ^ADD ^DELETE ~REVISt zoo Page d I. FACILITY INFbRMATION ~ rBU9NESS NAME(~ne aFAGLITY NAMEor DBA -Ddng Busnea As) a I Chevron Stations, Inc. #203576 ~ CHEMICAL LOCATION zot CHEMIG\L LOCATIONCONRDENTIALEFCRA ~ CcT W351'113tri1d1 ^ YES ® NO . .. i MAF~F(ogiorel) 203 GRID#(optiord) 204 FAGLITYID# O O - 0 0 0 '- 0 0 0 0 0 0 1 II. CHEMICAL INF+C~I2MATION CHEMICAL NAME zas TRADESEGiEI' ^ Ys ®No ~ ECOLAB 688 Presoak I If 3iCject toEFCRA, refstoi~utiorb COMMON NAME zw EHS' ^ Ye; ®No 2os AutomotiveDda art for Cavlraslt CASs 3~ 'IfEHSis'Ye;, all araunfsl)dow rttlutbein Ibs. R RE OODE HAZARD CLASSES (COmpldeif requireoot. ouRq) ~0 C,onosve pass tl .._. HAZARDOUS MATERIAL TYPE (Cfedc are Ilan arty) ^ a PURE ®hMIXTURE ^ a WASTE 2tt .... RADIOACTIVE ^ Yes ®No 2t2 ...... CURIES eta PHYSICAL SPATE eta (Cltedc one Ilan arty) ^ aSOLID ®h LIQUID ^ c GAS LARGEST CONTAINl32 55 216 FED HAZARD CATEGORIES 2t5 (Cttadc 91 tltii a~+y) ^ a FlRE ^ ~ REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ®e CHRONICHEALTH AVERAGE DAILY AMOUNT 2t7 MAXIMUM DAILY AMOUNT 2ta~ ANNUAL WASTE AMOUNT 2t9 STATE WASTE CODE 220 25 11 2zt DAYSON 9TE: zzz UNITS' ~ ®a GALLONS ^ h CUBIC FEET D c POUNDS ^ d TOHS Cftsdc i ad If EH bein ..........,. STORAGE CONTAINER D aABOVE GROUNDTANK ®e PLASrICINONMETAL LIC DRUM ^ i. ~IBERDRUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ^ h UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHFJt ^ cTANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ a TOTE BIN ^ d SrffL DRUM ^ hSILO d I. CYLINDER ^ p TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOW AMBIBJT 22a STORAGE TEMPERATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 225 %VVT HAZARDOUS COM FIONBdT (Far rrdxhre or wade orily7 B-IS CAS # i 15% zzs QtricAdd zz7 .............. ^Yes )~ No 22a 77-92-9 zze 2 15-20% zao ~d'lum DodeO/Ibataa~su Ifonate zit ^Yes ~ No zaz 25155-30-0 z~+ 3 5.10% zaa 2~rDp3r101 (Isopropyl AlChol, IP14) zaB ^Ys $l No zao 67-63-0 z~ a 5-10% gas M i nErd ~ ri is 239 ^ Ye; $l No zao 64742-88J eat s 3$% zaz AmmorriLrnBifluoride zaa ~~~~~~~~~ ^Yes ^ No zaa 1341-447 zas Ifmaolerartlwa aro artM aoM tfen l% o P ? q' wayYifrenrmtlre~io, Or 0.1% MvwipY If etlrtlrepariep[tod~s0ltiarol leatadpopr mpdrirptle raplro0idormsUon ADDITIONALLOCALLYCOLLECTED INFORMATION DOT# 2922 246 If EF~RA, Rene 9gn Hae UR'F (1/99) OES Form 2731 }Jeanni LoHen - 203576 HMBPr(Car Wash Only) pdf ~~~~~~~~~s~~~ ~ F~~ ~ ~~* ~4~V~~tt~~V~ ~j~~~~~~~i~ Page 6 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MA7SRIALS HAZARDOUS MATERIALS INVENTORY -CHEMICAL DESCRIPTION (one Pe9e Per meld el Per di I Ai n9or gee, ^ADD ^DELETE ®REVISE 20D ~ of ~ I. FACILITY INFCI~MATION ~ rBUSI NESS NA ME (Sme ~ FAq LI TY NA MEor D BA - Daing eusne~ As) s I Chevron Stations, Inc.#203576 ............. ~ CHEMICAL LOCATION 201 giEMICAL LOCATIONCONFlDENTIAL EI~RA 202 Ca Wash BUlidl ^ YES ® NO .... , 1 MAF#(oPtiorei) 2oa GRID#(opionei) 204 FACILITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 .... 1 D3 II. CHEMICAL INFOMZMATION CHEMICAL NAME 205 TRADESECRET ^ Ye; ®No Z06 ECOLAB S stem 103 ira,yecuoElrna.. ~fertoin4ntctime COMMON NAME ~~ EHS ^ Ys ®No Zoe AutorcrotiveCa• Wash R'eso#c Deter .__. CASH 209 'IfEHSis"Yd', AI anountsbAaw mustt7ein Ibs. Fl RE ODDS HAZA RD CLASSES (Competeif rer}ti reNy CUPA) 210 wA ... . HAZARDOUS MATERIAL 27t TYPE (Check are itarl orgy) ^ a PURE ®a MIXTURE ^ c WASTE ~ ~~~ RADIOACTIVE ^ Yes ®No 272 ~~ CURIES 279 PHYSICAL STATE zta (Check °rte Iten °rly) ^ a SOLID ®b LIOUID ^ c GAS ..... IARGEST CONTAINER 3O ., 2t5 FED HAZARD CATEGORIES 2t5 (Check 81 th3 Spy) ^ a FIRE ^ h REACTIVE ^ c PRESSUREREI.FASE I8) d ACUTE HEALTH ®e CHRONICHEA LTH AVERAGE DAILY AMOUNT 2t7 MAXIMUM DAILY AMOUNT 2te ANNUAL WASTE AMOUNT ~ 279 SPATE WASTE CODE 220 2 60 227 DAYSON SITE: 222 UNIT5 ®a GALLONS ^ h CUBIC FEET Q c POUNDS Q d tt'XJS ~ Check I ai If EHS in ...,.. STORAGE CONTAINE2 ~ aABOVE GROUND TANK ®ePLASfIC/NONMETAL LIC DRUM ^ i. PIBER DRUM ^ m GLASS BOTTLE ^ Q RAIL CAR ^ h UNDH2GROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ c OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY ^ (t gOX ^ a TOTE BIN ^ d STff1 DRUM ^ h SILO ^ I. CYLINDER ^ F TANK WAGON 229 STORAGE PRESSURE ®a AMBIENT ^ d ABOVEAMBIHJT ^ c BELOW AMBIENT ............ z2a STORAGE TEMPB2ATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGBJIC 225 %Wr HAZARDOUS COMFIONBVT (For mixhre awake ol'ly) ........... EHS CAS# t 22% 22a Ft105p1KNIC Add Uzi ..., ^Yes ®No zze 76643&2 229 2 1~% zero Citric Add z3, ^ Yes ®No zzz 77-92-9 z~+ 3 3% za4 Butoxyethanol z35 ^ Ys ®No 235 111-76-2 xn a 1-5 zae A-tiorBCS,ufa2ard z~9 ^Yes ^ No 2ao 27176-87-0 eat s 5-20% zaz Noroonic9.nfadant zaa ^Yes ®No za4 9016-4.ri9 2a5 Ifntore hswdasounpueKSUepwrtetpaatar tlenl bir rwiyYif,mcerdrepeic,a0.1%b/rdyY lfaafdmpuiesttachaCdtloirl9rtedpepu mptvirptte regiiretliMormMfan _....... ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# 1805 24e If EFCRA, Re®e 8gn Hse UPCF (1/99) C)ES Form 2731 .leanrn Loven 203576 HMBP (Car~VVash Only) pdf ~~~~M g _~~ z~~~~ ~~r~~Page 7 UNIFIED PROGRAM CONSiJLIDATED FORM HAZARDOUS MA7`~~ZIALS HAZARDOUS MATERIALS INVENTORY -cHeMICAL DESCRIPT1oN 1~ materielpertxrildlrgoreree) ^ADD ^DELETE ®REVISE 200 i'sW of ~ I. FACILITY INFO~tMATION ~ BUSINESS NAME (S'3rle ~ FAq LITY NAM Eor DBA - Ddng Bus rtes As) 3 Chevron Stations, Inc. #203576 ~J q~EMICAL LOCATION zot CHEMICAL LOC4TIONCONFlDENTIALEPCRA ~ Ca Wa#I BUlldl ^ YES ~} NO ..., t MAPJI (opliaretl) 200 GRID#(optiaM) 206 FACILITYiD# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INFI~!MtMATION giEMICAL NAME ~ TRADESEgiET ^ Ye; ®No z~ ECOLAB Clear Coat Cond itioner-Redl BluelYellow ~fs,gatt°E~w• ~°r«t°i~r~u°m COMMON NAME zoo ~ EHS ^ YESS ®No AutomotiveCa Wa#I Conditioner CASK 'IfEHSis`Ye;", AI artoltntsbsow rtputbein Iba Fl RE CODE HAZA RD q_ASSES (Competeif regal redly aian> zto wA ............. HAZARDOUS MATERIAL TYPE (Check ore Ilan aiy) ^ a PURE ®ti MIXTURE ^ c WASTE zn ..... RADIOACTIVE Q Ye; ®No 212 ... CURIES 213 PHYSICAL SPATE 2ta (Check are itanmy) ^ aSOLID ®h LIQUID ^ c GAS ....... LARGEST CONTAWER 7 ....... 2t5 FED HAZARD CATEGORIES 2t6 (Chair dI the may) ®a FlRE ^ h REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ^ e CHRONICHEALTH AVERAGE DAILY AMOUNT 2i7 MAXIMUM DAILY AMOUNT 2f8 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 21 63 z2t DAYSON SITE: 222 UNITS ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d'ftfFlS Chsdc are it ai ''If EH mat bein STORAGE CONTAINER ^ aABOVE GROUNDTANK ®a PLASiIC/NONMETAL LIC DRUM ^ i. ~IBERDRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ (t UNDERGROUND TANK ^ f. CAN ^ J. BAG ^ rt ELASTIC BOTTLE ^ r.OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY ^~ k BOX D a TOTE BIN ^ d STEEL DRUM ^ h SILO ^,.I. ,CYLINDER ^ µ TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BFIOWAMBIENT 22a STORAGE TEMPERATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 225 %WT HAZARDOUS CpNPONBdT (Far mixhre arw~te arty) ............. 6iS CAS # I 5% zzs RbsphoricAdd err .,.. . ^YES ®No zze 7664-3&2 2zs z 5-20°f° r~° Ardornc9irfacta~ts 23t .... ^Yes ~ No z3z 61791-26-2 2~ 3 23E 2a5 ^ Ys ^ No z3s 237 4 z3s tae ^ YES ^ No 2ao zat $ zaz ze3 ._...... ^ YES ^ No zaa za6 Itmve rowdwacanponertsme pasntat V aemr then 1x M waiyt irmtcerdnoeaiq or 0.1% trlvei{rtr If drdmgari~Art+eh aditiarml areted PPer eeptvinptro regiredintormatim ADDITIONALLOCALLY COLLECTED INFORAAATION DOT# OOn@ tae If EFCRA, Felse Sign Hse UPCF (1/99) OES Farm 2731 ~Jeann Loven - X03576 HMBP (Car Wash Only):pdf ~~~ ~~ ~~~ ~~~ ~ ~~~ Page 8~ UNIFIED PROGRAM CONK©LIDATED FORM HAZARDOUS MA'~~RIALS HAZARDOUS MATERIALS INVEN1~l7RY -cHEMlcnt_ cESCRiPrioN (onepapepar matulgper bntoirpa mee) ^ADO ^DELETE ®REVIg,,, 200 P8J8 of ~ I. FACILITY INFC~~2MATION ~ BU9NESS NAME(~rle ~ FAGLITY NAMEor DiBA -Ddng BtrvnESS As) a Chevron Stations, Inc. #203576 CHEMICAL LOCATION zot CHEMICAL LOCATIONCONRDENTIALEPCRA zoz CcT WatiT E0.uld1 ^ YES ® NO t MAP#(optimd) 20a GRID#(opliorel) 20a FAGLITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 ........ 1 D3 II. CHEMICAL IN~'+C')RMATION CHEMICAL NAME zos TRADESEGiET ^ Ys ®No ~ ECOLAB Sealer Wax If s,eject loEFrRA, refertoin4rucliore .. ., COMMON NAME 2~r EH5 ^ Ye; ®No zoe Automotivel;a Wash Pant Beeler .,.. cAS~ zoa ..,..... 'IfEHSis"Y~', all arquntsbAow mustbein Itla R RE OODE HAZARD CLASSES tco~npeteirregdrearycur~al 2to Oxidiaa ... _... HAZARDOUS MATERIAL TYPE (Check ore itemany) ^ a PURE ®a MIXTURE ^ c WASTE 211 RADIOACTIVE ^ YES ®No 2t2 CURIES 213 PHYSICAL STATE 214 (Clerk are itenaly) O aSOLID ®h LIQUID ^ c GAS LARGEST CONTAINER "9O 215 FED HAZARD CATEGORIES 218 (Check all ttMarpy) ®a FlRE ^ o REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ^ a CHRONICHEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 15 60 zz1 DAYSON SITE: zzz UNITS' ®a GALLONS ^ b. CUBIC Fly ^ c POUNDS ^ d PONS ~ C are Ilan ' If EHS amprt bein ....,. STORAGE CONTAINER ^ aABOVE GROUNDTANK ®e PLA5TIC/NONMETAL LIC DRUM ^ i. FIBERORUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ d UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ c OTHER ^ GTANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ o. TOTE BIN ^ d STEEL DRUM ^ h SILO ^ I. CYLINDER ^ p TANK WAGON ............. 22a STORAGE PRESSURE ®a AMBIENT [) h ABOVEAMBIBJT ^ c Bl30WAMBIENT .............. 22a STORAGE TBr1PH2ATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ c BELOW AMBIENT ^ d CRYOGENIC 225 %WT HAZARDOUS COMPONENT (Far mixhre orwa~e Orly) .,. EHS CAS# 1 2% 2ze EiUiOXyfti13101 22~ ^ Ye; ®No 2za 111-76-2 2zs 2 1~5% xro AniOrtiC.~lLfadaliS zat ...,.... ^Yet ~ No zaz 61791-ZCr2 2aa 3 1-5% 2aa 2-FtDpaiol ias ^ Ye; $I No 238 67.63-0 z37 4 23B gas ^ Ys ^ No zao za1 5 za2 24a ^ Ye; ^ Na zaa zas Ifmr<.f.mraaerpmpv.rt„roRwrt>Hatl~tf~lx ey vdyeir n,nwarn~ia QO.1x rywei~'t iraArdnopenicettaarameaei sraaaDeper cepcv.ir0ehe r.y~realrtorrtmNu. ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# NDDe 248 If ER3Z4, Rase SlgnHee UR'~ (1/99) OES Farm 2731 Jeanni~LoVen - 203576 HMBP (Car Wash Onlyjtpdf~~~~~~~~~ ~ ~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~-~ Page 9b UNIFIED PROGRAM CONI~OLIDATED FORM HAZARDOUS MA7'EI2IALS HAZARDOUS MATERIALS INVENtC~RY -CHEMICAL DESCRIPrioN (onePepePer n,977YiPoper drilrb nprerw) ^ADD ^DELETE ®REVISE„ 200 PBBB of ~ I. FACILITY INF~IM2MATION ~ BU9 NESS NA ME (5<rne as FAG LI TY NA M E or D BA - Ddng Bus mess As) 3 I Chevron Stations, Inc. #203576 CHEMICAL LOCATION Z01 CHEMICAL LOCATIONCONFlDENTIALEFCRA ~ Ca Wad Ekriidl ^ YES ® NO .... t MAPk(gxiaiei) 203 GRID#(°ptimel) 204 FAGLITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INFC~!M2MATION CHEMICAL NAME ~ TRADESEGiET ^ Ye; ®No ~ ECOLAB CWX 3600 usmjecaoexRA rdert°linnwu°re COMMON NAME zo2 2ae EHS" ^ Yes ®No AutomotiveCa Wash Deter .... cASrr z~ ~~~~~~~ ~ 'IfEHSis"Y~', sl araunts bsaw rr7ttstbein Ibs. Fl RE OODE HAZARD CLASSES (C°mpeteff require®y WR4) ....... 270 HAZARDOUS MATERIAL 27t TYPE (Check are item arty) ^ a FURE I$ h MIXTURE ^ n WASTE ~~~~~ RADIOACTIVE ^ Yes I$i No 272 ~~ CURIES 273 PHYSICAL STATE 27a (Check are item gray) ^ a SOLID ®ti LIOUID ^ c GAS ...... LARGEST CONTAINER ~ ....... 275 FED HAZARD CATEGORIES 276 (Check dl that ecvly) ^ a FlRE ^ h REACTIVE ^ n PRt5S5URERELEASE ~ d ACUTE HEALTH Q a CHRONICHEALTH AVERAGE DAILY AMOUNT zt2 MAXIMUM DAILY AMOUNT 279 ANNUAL WASTE AMOUNT 2t0 SPATE WASTE CODE 220 25 110 zz7 DAYSON SITE: 2zz UNIT5 ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d TONS C are iten ara • If EHS mst bein .............. STORAGE CONTAINE2 D aABOVE GRWNDTANK ®a PLASTIGNONMEfAL LIC DRUM d i. FIBER DRUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ^ GUNDERGROUND TANK ^ f. CAN ^ j.BAG ^ n PLASTIC BOT'flE ^ cOTHER ^ nTANK INSIDE BUILDING ^ g CARBOY ^ k BOX ^ n TOTE BIN ^ d STEEL DRUM ^ h SILO O._I,, CYLINDER ^ R TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ n BELOW AMBIENT ............. 22a STORAGE TBdP62ATURE ®a AMBIENT ^ h ABOVEAMBIENT ^ n BELOW AMBIENT ^ d CRYOGBJIC 225 %WT HAZARDOUS COMPONENT (Far tnixhre arv~e arty) ..,. EFTS CAS# ~ 2% 2ze Fbtassitun Hydroxide ~ .............. DYE ~ No zzs 1310-58-3 229 2 1-5% 23o Sodium Metailifsate ~7 ............. DYE ®No 232 6834-92-0 233 3 1-5% z3a Ctl~~lrl9 Agerrt 235 ^Yes ®No z3e ~fleta)/ z37 4 4% 236 Sodlum I~Splkte z3s DYe; }~ No zero 775$~J-¢ zat 5 5-20% zaz Noni Orll C & Ani Onl c 3ufaxa~ts zaa ^ Ys )~ No zaa Mixture za5 If mva IrrerAaswnpaeMeerepaartat(twhr then 7X tN vrelyt if reneerdre[siq a 0.1% tyrwi$t Itdtdropericpttech e°dtimel tlwtsdpepw arptvlrptte rapire°Idermetian ADDITIONALLOCALLYODLLECTEDINFORMATION DOT# NOrle 29B If EFCRA, Re®e 9gn Here UR'~ (1/99) OES Form 2731 ~JeanrnuLoven -z~03576 HMBP (Car Wash Only)~pdf un.~w~,.~.~.~ ~~~~ ~_...~,.. "~...~,~.~~.~~.~, Page 10~ UNIFIED PROGRAM CONI~OLI DATED FORM HAZARDOUS MA'f~~21ALS HAZARDOUS MATERIALS INVENTORY -cHEMICaI_ DESCRIPTION caneMOaDer mmerielper twildl rgor am) ^ADD ^DELETE ®REVIS<., ..., 200 ~ of ~ 1. FACILITY INFO~2MATION ~ BUSINESS NAME(Serle ~ FAgLITY NAMEor DBA -Ddng Busines As) 3 ~ Chevron Stations, Inc.#203576 ~ CHEMICAL LOCATION zo, q~EMICAL LOCATIONOONRDENTIALEPCRA z~ Car Wash Etuildl ... ^ YES ISSS N0 , MAP#(olxiorel) 203 GRID#(optiorel) 204 FAgLITY1D# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INFORMATION CHEMICAL NAME zos TRADESECRET ^ Ys ®No zas ECOLAB Wonder Wash Irs,gecc+cEPIYtA, rder,OirNnw,iore COMMON NAME zw EHS ^ Ye; ®No zoe AtrtomotiveCarWashLi t~idAlkalineVdtideWashCortoartrate ..._.. CASs z~ .,. 'IfEHSis"Y s", 91 arauntsbdow mlrstbein II>s RRE ODDE HAZARD CLASSES (Cmrfleteitra,aretllryCA,Ri) Zt0 Corrosive Li Ldd pass III ............... HAZARDOUS MATERIAL TYPE (Check One it9n Orly) ^ a PURE ®hMIXTURE ^ c WASTE 2„ RADIOACTIVE ^ Yes ®No 2,2 CURIES 2,3 PHYSICAL SPATE 214 (Check are iten arty) ^ aSOLID ®h LIQUID ^ c GAS LARGEST CONTAINER 3O FED HAZARD CATEGORIES ~ 2,8 (Cherk~>ll that eFgy) ®a FIRE ^ h REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ^ a CHRONICHEALTH AVERAGE DAILY AMgJNT 2,7 MAXIMUM DAILY AMWNT 218 ANNUAL WASTE AMOUNT 2,e STATE WASfE CODE 220 1 60 221 DAYSON SITE: 2x2 UNITS ®a GALLONS ^ Q CUBIC FEET ^ c POUNDS ^ d TCiNS Check i ' If EH bein ...... STORAGE CONTAINER ^ aABOVE GROUNDTANK ®e PLASTIC/NONMETAL LIC DRUM d i. FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ h UNDERGROUND TANK ^ f. CAN d j. BAG ^ n PLASTIC BOTTLE ^ c OTHER ^ aTANK INSIDE BUILDING ^ g CARBOY d k i30X ^ a TOTE BIN ^ d STEEL DRUM ^ hSILO d...,t,,,CYLINDER ^ (x TANK WAGIXJ 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIBJT ^ c BELQWAMBIENT 224 STORAGE TBu1PEItATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ c gELQw AMBIENT Q d CRYOGENIC 225 %WT HAZARDOUS COMPONBVT (For mixhre arwa~e cfly) ............ BiS CAS# 1 2% zze B1110XyetI13101 +n ............. ^ Y~ $~ No zza 111-762 22B 2 15°/a x,o Anitxric5llrfactarrts 23, .............. ^Yt>s ®No 23z 61791-262 233 s 1-5°/a z34 Mor>oL#hanolaTtine Zak ^ves $I No 23e 141-4.45 zn a 1~5% z3e Alkyl FYasphate z58 ^Ye; ~ No 240 6gg39-57-6 z4, s 1-5°/a 24z Alkali 9licate 243 ^Ys ®No 241 68.~-92-0 246 Ifmara termAOrscvnpoertsmalresrtetQaeEU °an 1%ty vdpYitrcncudropaiq a 0.1% yrxaidY If wrdrglaricptlacha0dtlad Asatsdpe{w ceptvirptK rat}irWirfnmetla~ ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# 1760 248 If EFCR4, Re3se Sign He'e UI~F (1/99) LIES Form 2731 ~Jeanni Loven~- 203576yHMBP (Car Wash Only) pdf ~~l~A~~=~ µ'rt~'0.f~'~~FJ~~Sry~N~~Wrc ~ ~ ~ p~~Page 'I1~ ~~ UNIFIED PROGRAM CONSt7L1 DATED FORM HAZARDOUS MA's@FUALS HAZARDOUS MATERIALS INVEN'~~RY -cHenntcat_ DI=_scRttrrtotu (arel~0ar mdxitlper tXtiltliry0r area) ^ADD ^DELETE ®REVISE, 200 ~ d ~ I. FACILITY INFt~MZMATION ~ BUSINESS NAME (Sane as FAq LITY NA M Eor DBA - Ddng i3usnes As) a ~ Chevron Stations, inc. #203576 _J CHEMICAL LOC?~TION 20t giEMICAL LOC/\TIONCONRDENTIALEPCRA ~ ~ Wash Btrildl ... ^ YES ($~ NO t MAP#(optiorrel) 203 GRID#(optiorel) ~ FACILITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INFCS!~2MATION giEMIC/1L NAME 2os TRADESEgiET ^ Ye; ®No zos ECOLAB Su ~ Suds 6062 1t s~jectl°exw. rdenelr6nw0ore COMMON NAME zo1 ~ EH5 ^ Ys ®No AutorrativeC~ Wash Li uidAlkalineVdTideWash . zoa cASa 'IfEHSis"Ye;, 918TIOIdltsbdow mustbeinlbs Fl RE CODE HAZARD CLASSES (campetdt regidre~yCU134) 210 Conosve Li uid Class III .............. HAZARDOUS MATH2IAL 211 TYPE (Check ore Iran arty) ^ a PURE ®h MIXTURE ^ c WASTE RADIOACTIVE ^ Y~ ®No 212 CURIES 213 PHYSICAL STATE zta (Chair are Iran aiy) ^ a SOLID ®h LIOUID ^ c GAS LARGEST CONTAINER 3O 2t5 FED HAZARD CATEGORIES 218 (Check gl that8p{fy) ^ a FIRE ^ h REACTIVE ^ c R2ESSURERELEASE ~ d ACUTE HEALTH O e CHRONICHEALTH AVERAGE DAILY AMgJNT 217 MAXIMUM DAILY AMWNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 1 60 zzt DAYSON SITE: zzz UNITS' ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d TOIJS Clsic ore i If EH ariart mat bein ......... STORAGE CONTAINER ^ aABOVE GRWNDTANK ®e FIASTICMONMETAL LIC DRUM ^ i. FIBER DRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ h UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER D cTANK INSIDE BUILDING D g CARBOY ^ k gOX ^ a TOTE BIN ^ d STEEL DRUM ^ h SILO ^ I. CYLINDER ^ R TANK WAGON 723 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIBJT ^ a BELOWAMBIENT 2za STORAGE TEMFt32ATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ a BELOW AMBIENT ^ d CRYOGENIC 215 %WT HAZARDOUS COMPONENT (For rrlixhre a wa5ne Orly) 13iS CAS # i 2% zzb FbtaSSil.RTl Hydroxide 22i .............. ^Ye: )~ No 228 1310-58-3 zze 2 1,5% x+o Sbdi tuT1 M etasi I i cote rbt ^ Yes ~ No 2az 6$3~.g7-Q z~ 3 4% z~ Sbdi tim R1oSPhat~ Tri lrasi C r~ ^ Ys ~ No zae 7758.29.4 zs1 4 1~5% zae Q1datIrlCJ AgaTt ase ^Yes ~ No 2ao 64-02$ zat 5 5-20% zaz Norri om c and ATU oni c SLrfad2nts z48 ^ Ye; ~ No zaa mi xttue zas Itmve MmrAaswnpaeibmepesrtatQaeter flan 1X t7r xeiyYifrmcerdrnpnlq or 0.1% MxalpY if imrdrwparicpttach aMtiorol8rdsdppr arptvirytte re¢/radldumetion ADDITIONALLOCALLY COLLEGTEDINFORMATION 2~ If EFCRA, Re®e 9gn He-e UR'F (1/99) CIES Form 2731 Jeanni Loven tl- 23576 HM~BP (Car Wash Only),pdf tf~~ T W~~ ~~~~k~j0.~z ~ Page 12 UNIFIED PROGRAM CON~CJLIDATED FORM HAZARDOUS MA~'E121ALS HAZARDOUS MATERIALS INVENI~C~RY -CHEMICAL nESCltl~lOlu (onePeBaPg rneferielpar Wild Igor uee) ^ADD ^DELETE ®REVISE... 200 Page of ~ I. FACILITY I NFf7~MATION ~ BUSINESS NAME(Slane ~ FAgLITY NAMEor DBA -Ddng Busness As) 3 Chevron Stations, Inc.#203576 ~ giEMICAL LOCATION ~+ q-IEMICAL LOCATIONCONFlDENTIALEFCRA 202 C3 Wash BUlldl .. ^ YES ® NO + MAPa(olxiorel) 2a1 GRID#(optlorel) zoa FAgLITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INF(~MtMATION giEMICAL NAME 205 TRADESEg2ET ^ Yes ®No 2oe ECOLAB Smart Shine 130 If sIl>jeol loEFCRA, refertoin4uliom OOMMON NAME zm 2~ EHS ^ Yes ®No ALltomotiveCa Wash R'BSOak Dda Casa z~ `IfEHSis"Y d', dl arlouMSU9ow mustUein Ills Fl RE CODE HAZARD CLASSES (C°mpaaf raµreeb~CUflq) 2to Corrosive Li Llid pass III .............. HAZARDOUS MATERIAL 211 TYPE (Glade ae Ilan ady) ^ a PURE ®h MIXTURE Q c WASTE ....... RADIOACTIVE ^Yee ®NO 2+2 ...... CURIES 273 PHYSICAL SPATE 214 (Check ate itatl arty) ^ a SOLID ®h LIOUID ^ c GAS LARGEST CONTAINER 30 215 FED HAZARD CATEGORIES 218 (Chedcallth3apliy) ^a FIRE ®h REACTIVE ^ cPRESSURERELEASE ~d ACUTE HEALTH ^ eCHRONICHEALTH AVERAGE DAILY AMOUNT zt~ MAXIMUM DAILY AMOUNT z+s ANNUAL WASTE AMOUNT z19 STATE WASTE CODE 220 15 60 221 DAYSON SITE: 22z UNITS ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d YCNS ~ C are f enori ' If EHS mat in ..,...... . STORAGE CONTAINH2 ^ aABOVE GROUNDTANK ®e PLASTIC/NONMETAL LIC DRUM ^ i. FIBER DRUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ^ h UNDBtGROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY d k: BOX ^ a TOTE BIN ^ d STEEL DRUM ^ hSILO d I. CYLINDER ^ P TANK WAGON .., 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOW AMBIBJT ............... 22a STORAGE TBuIPB2ATURE ®a AMBIENT ^ h ABOVE AMBIBJT ^ c BELOW AMBIEM ^ d CRYOGENIC 2255 %WT HAZARDOUS COMPONB~IT (Far mixh,re orwa~e arty) BiS CAS# ~ 21% zzs ~LlfUricAdd 2z~ ^Ye; ®No 2ze 7664-9~9 zze 2 17°/a zza ~horicAdd 75°/a ~ ^Ye; $I No zee 766438-2 2~+ 3 7°/a zze BUtoxyethanol zrr ^ Yes )~ No 2ze 111-76-2 z~ a 1a`% z3o ArliorricS,ufaclarrts za1 ^Yes )~ No 232 27176$7-0 z4, 5 5.20% zaz Norli oni C S~rfadarlt zd3 .....,.. ^ Yes )~ No z44 X16.45-9 z4s Ifmva IamdaamnpowtsuaPUrtatVaNU flan lXM welpYifrwrearampaio, or 0.1X Iryxdl>ht if trAfciroparicattaehad6tiorol aratsd Pnu eaplvirptro raµiredidorrrmtlon ADDITIONALLOCALLY COLLECTED INFORMATION: 24s If EPCRA, Rte Sign Hae UR'~ (1199) OES Form 2731 Jeanni Lovers - 203576 HMBP_(Car Wash ~Only).pdf ~~_ ~u ~~~~~~j~~~~~ ~ _ e~~~yM~~~~x ~~ Pagep 13 UNIFIED PROGRAM CON~IOLIDATED FORM HAZARDOUS MA'~~rtIALS HAZARDOUS MATERIALS INVEN~"C~RY -CHEMICAL cESCRIPTION («~aaeaa~ mmeriNperlxdldrgoreree) ^ADD ^DELETE ®REVIg 200 ~ of ~ I. FACILITY INFC~~tMATION ~ BUSINESS NAME(~rie asFAgLITY NAMEor DBA -Ddng Burnes As) 3 I Chevron Stations, Inc. #203576 -J giFJ~AICAL LOCATION 207 CHEMICAL LOG4TIONOONRDENTIALEPCRA ~ ~' Wash BlLldl ^ YES ® NO i MARy (opliard) 203 GRID#(gxiorel) 204 FACILITYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL IN~'f~~2MATION CHEMICAL NAME 2a5 TRADESEgiET ^ Yes ®No 208 ECOLAB Veloci Clearcoat Protactant Ifs,l3,dt°EtcRn, rererl°in4fucnorn COMMON NAME zm EHS ^ Yg ®No ~ AutorrativeCa Wa;h Li trid Vf#tideParrt Steer 209 CASIf `IfEHSis"Vas", ~I arauntslt~ow nufstbein Ibs. RRE OODE HAZARDCLASSES (compet~irreyuireceycum) zfo Corrosve Li uid pass III HAZARDOUS MATERIAL TYPE (Clfetlc ante iten arty) ^ a FORE ®Iz MIXTURE ^ c WASTE eft ... RADIOACTIVE ^ Ye; ®No 2iz ..... CURIES 2f3 PHYSICAL SPATE 214 (Ctfedc One Item aAy) ^ aSOLID ®h LIQUID ^ c GAS LARGEST CONTAINE2 30 213 FED HAZARD CATEGORIES 2ta (Check 91 flat a):gly) ®a FIRE ^ h REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ^ e CHRONIC HEALTH AV~2AGE DAILY AMOUNT 2t7 MAXIMUM DAILY AMWNT 2ta ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 15 60 zzf DAYSON SITE: zzz UNIT5 ®a GALLONS ^ a CUBIC FEET ^ c POUNDS ^ d TOWS C Ten of If EHS arrant mat bein STORAGE CONTAINER ^ aABOVE GROUNDTANK ®e PLASTIC/NONMETAL LIC DRUM ^ i. FIBER DRUM ^ m GLASS BOTTLE ^ 4 RAIL CAR ^ h UND~GROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHF72 ^ cTANK INSIDE BUILDING ^ g CARBOY d k.90X ^ a TOTE BIN ^ d STEEL DRUM ^ hSiLO d I. CYLINDER ^ 0. TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c B~OWAMBIENT ............. 2za STORAGE TEMPERATURE ®a AMBIENT ^ h ABOVE AMBIBJT ^ c 9ELdW AMBIENT ^ d CRYOGENIC 225 %WT HA7ARDOUS Colu1PONEiVT (Far mixtxre orwa~e arty) BiS CAS# t 2% 228 BUI:oXydh3101 zzz ^ vs )~ No zza 111-76-2 229 z 5-20% zaz M i rlaal SeA Oi I 243 ., ^ Yes )~ No z4a 64742-3Q9 2~+ 3 5.20% 234 9.trfada~tS gas ^Yes ®No z3s Mixture 237 4 1-5% z3a 190prOpyl AlQOhd (2-propcn0l, IP)4) 239 ^Yfs ®No zoo 67-63.0 eat 5 1-5% z4z ~"d10B zd3 ^YES ®No 244 F~d~gy 245 Ifmva IerarAasampverbuepe®rtatgmW then l%by vsit/t if n4,emdmpai4n0.1X MwWyt Iflzrdmp,depttadmtldtiad 9raatad paper ppirirptle raplre°irfametl°rt ADDITIONALLOCALLYOOLLECTED INRJRMATION: 24a If EPCRA, Re®e Sgn He•e URA (1/99) OES Form 2731 =Jeanni Loven - 203576 HMBP (Car Wash Only),.pdf Tq•_ NP ~Yd,~ r~,AM „~~'M__ ,~~~y ~ Page 14~ ~.~ UNIFIED PROGRAM CON~OLI DATED FORM HAZARDOUS MA~IZIALS HAZARDOUS MATERIALS INVEN~"ORY -CHEMICAL nESCRIPTION ^ADD ^DELETE ®REVISE,. 20D Pa)e of I. FACILITY INFO~tMATION BU9NES5 NAME(53ne a; FAgLITY NAMEor DBA -Ddng Butine~ As) 3 Chevron Stations Inc.#203576 ............ giEMICAL LOCATION 201 CHEMICAL LOCATIONCONflDENTIALEPCRA ~ Cc? Wa;h Btriidl ^ YES ® NO MAP#(opHmm) 203 GRID#(optiorrel) 2p1 FAquTYID# 0 0 '- 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INFORMATION CHEMICAL NAME z~ TRADESEg2ET Ys ®No ~ ECOLAB 180 Presoak .......... Ita,ye°tt°EICRArelal°Ir>sruc°°~ COMMON NAME zoo EHS" ®Ys ^ No z~ AutomotiveCawa;Il Deter CAS# z~ "If EHS is "Y~', ~I arqunts bAow must bein Ibs 7~-~9 FlRECODEHAZARDCLASSES (C°mgeteifreairemyCUR4) 21° RDRA C"orTOSive D002 HAZARDOUSMATERIAI 2n TYPE (Chedr ore item oriy) ^ a PURE ~ b. MIXTURE ^ c WASTE ~~~ RADIOACTIVE Q Ye; ~ No 2t2 ~~ CURIES 213 PHYSICAL STATE (Cleric ere Ilan aiy) ^ aSOLID ~ h LIQUID ^ c GAS 214 ...... LARGEST CONTAINER SJ ~~. ~ 2t5 F® HAZARD CATEGORIES 2t5 (Chair 91 flat arx+y) ^ a FIRE ^ h REACTIVE ^ c PRESSURERELEASE ~ d ACUTE HEALTH ®e CHRONICHEALTH ., AVERAGE DAILY AMOUNT 2t7 MAXIMUM DAILY AMWNT zta ANNUAL WASTE AMOUNT eta STATE WASTE CODE 220 25 110 zzt DAYSON SITE: zzz UNITS' ®a GALLONS ^ h CUBIC FEET ^ c POUNDS ^ d TdJS ~r C Ilan ai • If EFi arrant mat bein .............. STORAGE CONTAINER ^ aABOVE GRCUNDTANK ®a PLASTIC/NONMETAL LIC DRUM ^ i. ~IBFRDRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ h UNDERGROUND TANK ^ f. CAN Q j. BAG ^ n PLASTIC BOTTLE Q r. OTHBt ^ cTANK INSIDE BUILDING ^ g CARBOY ^ k gOX ^ a TOTE BIN ^ d STEEL DRUM ^ hSILO ^._L,CYLINDER ^ P TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c BELOW AMBIENT .............. 224 STORAGETEMP92ATURE ®a AMBIENT ^ h ABOVEAMBIENT ^ c gEL()W AMBIENT ^ d CRYOGENIC 225 %Wf HAZARDOUS CCMPONH~fT (For mixhre awaCe arty) BiS CAS # ~ 26% zzs Rilfuric Add (IZ~ortable onlyasaid B8'OSDI) 2n ^Yes $I No zza 7664-939 zza 2 5.20% z3o NoruOrricsLrfacttraits zit ^Ye ~ No z3z Mixture z33 3 z3a 235 ^ Ye ^ No z36 z3~ 4 z3s ~ ^ Ye ^ No zero eat 5 zaz 243 ............. ^ Yts ^ No zero 2a5 Ifmve humduet°mrpeplsua poantetQaebr then tY. t7r vwiytifrcneerdrePiq n 0.1% tyrwirlit if iytcirgPricptt4chatldtfaN SretscfpePer uptvirythe ra4Jre0irfametlan ............. ADDITIONALLOCALLYCOLLECTEDINFORMATION DOT# SUIfUriC Acid SdIUti00, 8 UN2796, II 245 If EPCRA, fre39a 9gn Here UFCF (1/99) OES Form 2731 `Jeanni Loeen -703576 HMBP (Car Wash OnIY) Pdf __ mmµ~u~ _,~m ~ "`"~`~"~`"y°."„~`~~~ ,""_.~. .~,..._._~__,._.uPa9e49.~5 UNIFIED PROGRAM CON~OLI DATED FORM HAZARDOUS MAC"@~21ALS HAZARDOUS MATERIALS INVENtC~RY -cHeMlcaL DescRlP-rlonl ~gi huiltH ^ADD ^DELETE I$REVISE 200 Pie of I. FACILITY INFCJI2MATION BU 51 NESS NAME (93ne i~ FAq LI TY NAMEor Df3A - Ddng &snea As) 3 Chevron Stations Inc. #203576 giEMICAL LOCATION 201 q~EMICAL LOCATIONCONRDENTIALEPCFiA zaz Wash e~idl ^ YES ® NO 1 MAR'i (opliaal) 203 GRID#(optiaal) 2b1 FAquTYID# 0 0 - 0 0 0 - 0 0 0 0 0 0 1 D3 II. CHEMICAL INF+C~~2MATION GiEMICAL NAME za5 TRADEgCRET ^ Ys ®No zee ECOLAB CWX 3688 Presoak Ifs,yec7t°EI~ rdertci M1Yruc7iaa 207 COMMON NAME EHS" ^ Ye; ®No AUtOmOtlVe(',eT Wash Deter .. CASE ~ "IfEHSis°Yts', AI arlolu7ts b9aa mustbein Ibs. RRE CODE HAZARD CLASSES (campdeif ra~rireCbyCUR4) 210 Corrosve ... HAZARDOUS MATERIAL 217 TYPE (Check ore lien arfy) ^ a PURE ~ h MIXTURE Q c WASTE ..... RADIOACTIVE ^ Yea ~ No 212 ~ . CURIES 213 PHYSICAL STATE (Glade are ~i~noriy) ^ a SOLID ~ h LIQUID ^ c GAS 274 ...... LARGEST CONTAINER 55 ..~~ 275 PED HAZARD CATEGORIES 218 (Check 81 th~~1y) ^ a FIRE ^ h REACTIVE ^ c PRESSURER~EASE ~ d ACUTE HEALTH ®e CHRONICHEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMWNT 218 ANNUAL WASTE AMOUNT 279 STATE WASTE CODE 228 25 110 .. . . 721 DAYSON SITE: 222 UNITS' ®aGALLONS ^ h CUBIC FEET ^ c PWNDS O d PONS Cherie are itatl onl • If EH alert mst bein ,.,,........ STORAGE CONTAINER ^ aABOVE GROUNDTANK ®e PLASTIC/NONMETAL LIC DRUM ^ i. FIBERDRUM ^ m GLASS BOTTLE ^ q RAIL CAR ^ d UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n PLASTIC BOTTLE ^ r.OTHER ^ cTANK INSIDE BUILDING ^ g CARBOY d k SOX ^ o. TOTE BIN ^ d STE4:1 DRUM ^ hSILO - ~ L,CYLINDER ^ p TANK WAGON 223 STORAGE PRESSURE ®a AMBIENT Q h ABOVE AMBIBJT Q c BELOW AMBIENT 22a STORAGE TEMPERATURE ®a AMBIENT ^ h ABOVE AMBIENT ^ a BELOW AMBIENT ^ d CRYOGENIC ............. 225 %WT HA7ARDOUS COMPONEM (Far mixgre orwa~e ariY7 9iS CAS# .......... i 20% 2zs 9xlium Hydroxide z27 ^Ye; ®No zza 1310-732 zze 2 15% z3o d-Gluoonicadd, monosodiums~t z~+ ^Y~.s p~ No z3z 527-07-1 z~ $ 234 235 ............. ^ Y6 ^ NO 236 237 4 238 tae ^ Yts ^ No 2ao zat 5 2az 2d3 .,.. ^ Y~ ^ No zaa za5 Ifm°re haartlwaovnpwarfsmepgdetQasbr flan 1%hy aMyYitmtmrd,atVaiG u 0.1% M'"Mtiti If eiFdnopaicptfachaMtiael Aadsdpepar a,ptvirytla raµiratlldamsti°n ADDITIONALLOCALLYODLLECTED INRJRMATION DOT# UN1824 80dIUl(1 HydroXlde $DIUtlOn, Class8,Packing group II 248 If EPCRf1, Reese 9gn Hae UPCF (1199) OES Form 2731