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UST-REPORT 7/19/2007
J (UNDERGROUND STORAGE TANKS) ~ _ - ( -FILE # ,CIRCLE DELI 1416 GOLDEN STATE AVENUE UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMrr NO. ~~ O ~ H B R H P ~i~~ AI~1N T '~ BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 ^ ENHANCED LEAK DETECTION ~ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANKTIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICATION SITE INFORMATION FACILITY Circle Deli NAME 8 PHONE NUMBER OF CONTACT PERSON >~rDDRESS 1416 GOlden State Ave. OWNERS NAME Circle Deli OPERATORS NAME Same PERMIT TO OPERATE NO. NUMBER OF TANKS TO 8E TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS 1 87 UL 2 91 UL TANK TESTING COMPANY NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341 MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308 Bruce W. Hinsley 661-327-9341 ---- CERTIFICATION #: 04104900 ~ rNCo"~223 ~/3 7.C/ DATE 8 TIME TEST TO BE CONDUCT August 16, 2006 08:00 CC #: SIGNATURE OF APPLICANT ~~ DATE July 19, 2007 APPROVED BY :~~ DATE ~ ~ FD 2095 (Rev. 09/05) ,~ 09f2012006 13:28 6613252529 CAL VALLEY PAGE 01 "r ~u: CAL-VALLEY EQUIPMENT 3500 GILMORE AVE. BAKERSFIELD, CA 938as (661)327-9341 FAX: (EB1)325-2529 CONTRACTOR'S LIC.#78~i7f1 A'HAZ Cc~ '1'0: Frvma Fay ~ ~.~~/~~ Pages: W~LUDING COYER ' Ate ~..e~~ r I~~)G~[ ~ Datse 9 ~/.~l/l~L~ Re: GC: ^ IJrBent ^ For Rev~ie~w ^ Pleose Comment ©Pl~se Reply ^ Please Recycle Comments: ~, 09/20/2006 13:28 6613252529 CAL VALLEY PAGE 02 SWRCB, Januery20U6 Spill bucket Testing Repolrt Form Trbs jrerne is emended fog rrse by oo~ractors perfarmFng an.,ua! testing of t/ST spill contai,rmeru structures. 77ee eoneptet~ed form and primotrts jr+ora testa (ijapplicable), should be provided to flee f~iliry owrrerfopeP»tor jor submittal to the local regulc~arl' QSe~Y 1. FA.CII..TT'Y Ily'~'Q~MATI~IV FacilityNa~ne' ~ _ _ Date otFTesting: Facility Address: Facility Genteel: l'hene: 1]ate Local Agency Was Noti 5ed of Testing : ' Name of Local Agency Inspector ~f presem drtrmg testingJ: A •rs~c~rn..r~ ~Awri+'6 ~ r+rna iATLV1nMATirIN Connpany Name: t/a~ / Technician Cot-duct3ngTest: rc.C~ tv. h Crerlerotials': ~CST;B Gorrtracbor 0 iCC Service Tech, Q SWRCB Tank Tester ^ ether (gpecijy) Lioensc Number(s): 0 3. SPILL BUCKET TESTING A~TFO~MATION Test Method Used: ~Hydrnamtic ^ Vacuum ^ {lther Test Equipment Used: ~.S'f.« Equipment Resolution: identyfy Spill Bucket (By TuraF Number, ,Stored Product, eta I $ t/~- ~ ~f ~~ 3 d Bucket installation Type: 17J!Direet Bury ^ Contained is Sarn Direct Bury ^ Conitaimed in Sum p Direct Bury ^ Contained in Sum C7 Direct Bury D Contained in Sum $utJlcct Diameter: 1 • '' Bucket " '~ Wait time between applying vacuts~~ulwater ~d steer: o~tesit ~, Test Start Time ('i'~}: ,(~ " ~ initial Reading t;R~: fl p„ ,, Test End Time (TP): Q 0 '~ Final heading (RF): ~' '~ Test Duration (i'R - Tt}: Change in }leading (RF - R~): ' 1 .~} Pass/Fafl Threshatd ur Criteria: .2S' ~ .,.-: 2S" :']Chat ~,esui~ ~ tS3. Pam d ]Reif ~t?.Itigg ^ Ftl~'l. ^. Pass ^'~ Fs~il D Psis ^ Fad C:olnments - (inclrale injornation on repairs made prior to :eating, ~I recommended ~ollow~up~or failed tests) CER~'IFICATION Olw 'T'ECHNICIAN ItESI'ONSIIiI.E FOR CONDUCTING THIS TESTING ,!hereby cerJity rhrn aH tae i+Rfort~atfon corueefrted in tki~s report is tare; a~ccetrate, and lie julf oonr, pl~ateoe wftk lega~f ~!~ Technician's Si~ature• _ --~,.r ~~_ T]ate~ ~'^~6'-~~ ~; ,_, ' State Taws and r~egrrT,ati~ons do nak curremly require besting to be performed by a quaTifled oamtracnx. However, total m.ay lye more striar~genl re9uirennents CAL VALLEY PACE 02 09/2012006 13:29 6613252529 MI~~TTTI~RIN'G ~YS~M CF~Z'~k'ICA~'I(~N Far Use By All Jw isdictfoP.s Wftlrin she State rx~f Califo„tia Amharty Cited: Clsgprer t5 T, Hetettlt and Safety Code; Clwptsr 16, Division 3, Z'itfe 23, Grslffornicr Code pf Regyfations This fprrtt trust be used to document testing and aetvicing of tnortitoring etluiptneatt, A segaretts cernificatiop~t must d ntortitottna.s corttm) Dane) by the technician who perfattns the work. A copy o1'this form must be provided to the tank system ownerlaperator. Tate owttedoperdtnr must submit a copy of this form to the Iocs) agatey regulating UST sysiettts .vithifl 30 days of test done. .~, Gtnerai Facility Name: Site Address: _ Bldg. No.: city: ~otr~~Vl~x`'P~` dip: Facility Contact Person: _- - _ Contact Phone Na,: ( ~> MaicefModcl of )t+lttnitaairtg Systems: ~'i7ter, t7~D Date of Testing/5etvacing: /.1~~ B. Inventory of Egaipment')t'estedlCertified 1'.~1R '1~[ bbEQB 74 i~dE~lC t~l lid: Tattle ID: ~_~_7. Cd,C _ 'Wank m: Jiit I»-'s'ank Gauging Pndbe. Model: ~L_, Z D Ta-Tank Gar~ng Ptnbe. Model: d .4»twlar space ar Vault Sensor. Model: ^ ArMnular space or Vault Settsvr. Model: ~ P1pdn$ Sutap f Tt+each Sensor(s). Model: --~--~ U S' 4 piping Sump / Tt~toh Sensor(s). Model: ~ FiII Sump Savant(s). Model: O Fill snrpp Senspris). Model- _ - ~ Mcchanleal I ire Leak Detector. Model: ~~~ - I] Mcchaniesl [,ire Leak Uetactor. Model: D Elcc4ronie Line Leak Detector. Model: [] EItW~unic Line Leak Detector, Model: _ O Tank Overftil !High-Level Sensor Model: O Tank Overfill ! iiigt~-Level Berndt. IC+lgdel: O Other (apccifr eauiLmeni tVOE and tttsxid in Section E on Pace 2l. O Outer fst-ecifv epuiomeat tune and mode] is Section E on Pa¢e 2l. Tsnk ID: '~_ ~1 Cjd. 41~)s-Tank Gauging probe. D A,tntula>i S~ce nr Vaah Sratsar. ~ l+iping Sump / Trench Sensor(s}. D Pil] Sutnp 5dt9tn(s). ,1Q Mechanical Line xsak Dt3eator. q 1;itxlronic Litre Leak Detetxpr. D Tank Qverfrll f high-Lever sen9nr. Model: Iulodei: ~5 t Madel- Model: Model: - - Modal; todei in Section E utt pa¢c 2). Tank l;si: ~ Dispenser Camttunmiettt 3ensa(s). Model: ~ Sheer Valve(s). ©1?ia ettser Can mcat>?inat s and Chain DlID: _~" BO Dispettscr Containment Sensor(s). Model: ~ Shear Valve(s). r m: .s ~- IB Dispenser Cdnesintttent Sensor(s). Mode]: 6d Shear Valve(s). q 1n-Tank Gaugittg Probe. O Annular 3pacc or Vault Sensor. D Piping Sump ! 7'ronch Scnista{s). ^ I-tl] Sump Sensor(s). O Mectanical Litre Leak Detector. D $lectrotldc LinaLe:ak Dctoctor. 4 Tattit Overt ll !High-Laval Sensor Mode]: ' Mrtdel: Modd- Model: Model: Model: - ModcL xID: D Dispenser Cotttaiamettt Sensor(s). Model: © Shear Vatve(g}. ©Dispenser ('nrttainrot•1tt Floatfat and C'Itstin[e blepenser ]m: -- 0 Dispenser Corttsiameat Sratsor(~), Model: D shear Valvc(s~ Aispeaset~ III: _ O DispcnserC4ntainmetttScnsor(s}_ © Sheer Valve(s). Model: *If the fan Hty contains ma~~e ranks or dispett sets, copy this fdtrn. lnclade ittfatnatiott for evwy tank sad dispens~x at the facility. ~. ~BTiti~C81]O>A - I ct:rtil~y that the egaipntent identiFad in t1tiB dotatma+tt was xesp0eted/aerviced in wooardao~ with the tnattoiPaactnrers' gn+ddintx Attached to dtis CcrtlScadon is tttEOtmalfgtt (e.g. roarmfiaetareeg' cheeidists) neoessnxy to vet3[~ drat this lnfnrmtdlon is correct and s Plot Plan s>tiowinig the ]ayuot of mo~toriag equiptacttp 1FaT aiup ~lPm~ c~sble d generating such erpoxts, I have elan attaeirr~l a copy of tltt {cJrsr.~ a$ tt'4at ply): Q 8pstem set-uIr ^ Alarm higtaty repprt TechrdciaQt Name fpriat): ~, /~~~.~, j~~_ Signatatce• "~--~~,~~ ._ -~L- ~,f~eu.~~y _. Cet'tiftcation 1*io.' i~/ ~~ ' f 6 ~O f~ ~~ .`~... • ~~~1' ~ ~ Liacnse. Na.: Testing Cowpatty, Name: ~'.~ ~ ~a.I~~~~~" ]Phone No.: E~~' }~Z ~ $,~ sr,~ Site Address: -f ~~~ ~A+~~67F~y`'~ ~ ,.f'a~-'~ 8,~,~e2 . Dare of TestingfSetviCing. '~ ~ ,~e4' j~'„ ~S' Monitoring Sgstetlt Certlficatlioat ~ I of 3 aamt 09/20/2006 13:29 6613252529 CAL VALLEY PAGE 03 D. ~esuutkg of Tesljngl5ervnc9ng 3aftvrare version Installed: E. Co/~mntenlts: 0 ' _i1/~ 5'~l c~.ar,~yl oa, ~!,;5~'?.~~,t_.J~P.f' ~u /~ ~~ y/rJ~~y,~ ~y'~ ~ /~ •+L 1/~7/?.I/ A L~ ~Jy..~ ~. A 1. ~_ ~ ~ __ . w _ _ ~ry~~~RJ-dLL~P~/J ere the ilbll a~tet:kllst: Xes D Na* ,Ts the audible alarm tIaatal3 ~ Xes O No* Is the visual alarm 'aural? ~ Yes D No* Were afl sensors visuals in acted fttnctional tested, and confirmed o 4ana]? ~ Xes d No'" Were all sensors installed at lowest point of secondary ctmtainenettt and positioned so that other equiprneatt will not interfere with their 'a~n? O Yes O No• If alSrrttA aro relayed to a remote mrmitamng station, is all communications Cquipment (e.g. modem) ~$ NIA operational? Yes O No* ~+or pressurized piping systems, does the dlrbine gatomaricany shut dawn if the n second NIA monitorin P~ S cry contairuteent g systpn detects a leak, fails to operate, or is electriealty disc~nnecGed9 ll' yG3: wr~~ sensors irtitiatt: positive shut~down7 (CJrrek alt tifarr apply) 61.Sttrnp/1'tench Sensors: ^ TJispenses Camtalnment Sensors. Uid confirm osifive shut-down due to leaks sensor failure/discv~anectioan? ~ Yes• ©No. D Xes O No* For tank systems that ntilize the moruitoring systetn as the primary tank averfili warning device (i.e. no ~ N/A mecheniral overfill pt+evention valve is installed), is the overfill warning alarm visible and audible at the tanQt fi1i nt s and . If so, at what t of tank ea ci does the alarm tri r7 gl, Q Xes* ®No Was any monitoring equipment replaced? If yes, ide~rtify specs&c sensors. and list the manufacturer name and model far all probos, or outer equipment replaced » Yes• O No Was li utd found inside an acement srtc in Seetiorl belaa. 9 ~ y se~andary c~oustaittntent systems designed as dry systemsT (Check at! altar apply) ^ profiler; Water. If ,describe causes in Section E, below. ® Yes O No* Was monitoriit s ~_ reviewed to ensure er settin sT Attach set u re ~ if livable C.7 Yes Na* Is all rnonitorin - t 'anal martufaetut~r's s cificatiaas7 • 1<rr See4on E below, describe >~ow s>3d when these defiideapes were mr win be ~rreeterL Fage ~ of 3 a3lot 09/20!2006 13:29 6613252529 CAL VALLEY PAGE 04 F. ~tR-Ttl~k, Garr~iang / StR Eylwipme~tt; O Check this boa if tank gaugjng is used only for inventory control. D Check this box if no tank gauging or SIR equipment is installed. ' * to the Seetiorn H, below, describe bow and wlsen these detieiet~es were ur wgl be corrected, G. Lame Lealt Deteetor•s (LLA): 0 Check this boy if LLbs are not insealled. i9 Yes D No* For equipment start-up or annual equipment certification, was a leak s;rrtulabed to veri LLD D NIA (Clteick o1l that apply) Simulated leak Pate: bil.3 h.; ^ 0. ~ ~' perfoztnancc7 w[ x es ~ Yes ~.I No• ^ N • Wet+e all LL.Ds cottfirrue~d operational and accurate within regulatory 1eq~tts? . o Was the testing slpparatug pt?dperly calibrated? ~ Yes 4 No* ^ NIA For mechanical LLDs, does the LI.D >,~~ ~p~ {low if it detects a leak? O Yes Q No* N/ For electronic LLDs, does tlwe arrbinc avtomatica,lly shut atl: if the >~Lp detects l k? A a ea ^ Yes ^ No; I Pot elec~onic LLDs, does the teubine sutotnatically shut ofF if an orti IA . NIA on of the monitoring system is ar disooenaected7 Y p O Yes O No"° Ilr< NfA }~~ ~ecttbatic ~~ does the Iurbtine automatically shat off if an ortiorr of the or fait's a Best? Y P monitotng s ste lt . y m ma Q Yes C] No* ~. NIA For eIe~tonic Ll;.bs, have all avicessible wiri connections beets viauall t '~ Y 'nsPected? Yes * D NoM Were a0 items orA the equipment mina factita+er's nReillterwace checklist Cpmpletea? In the Seetiom H, below, de~en'be haw and when these deficiendea were or ~i1l be ditt ect~l, D. Comments: t'age 3 a~ 3 a3ni This section dust lie completed i~ in-tank gauging equipment is used to perform Iealc detection lnoaitoring. AL VALLEY PAGE 05 09120!2006 13:29 6613252529 Monltaring Sysbea~ Certl~eabton UST Monitolri>Et~ Si#e Fian Site Address: ;~__~_~ ~~_~ ___. ~.____. ~.___. ._..__. inst~ru ons If you already }save a diagram that shows all required inforniataoa, you. may include it, rather thaq this page, wYth your Monitoring Systean Certification- Qn ycxi~x site plea, show the general Isyaut of tagics and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring taalk annuiax spies, sumps, dispenses pans, spill containers, +~ other secondary containment areas; txtecltanical or eleetmnin line leak detectors; arbd in-tank liquid level prates (if used far leak detectiart}. In the space provided, sate tF~e date this Site Plan was prepared. gage ~ of 09/20!2006 13:29 6613252529 CAL VALLEY PAGE 06 v~~a~~ss ~~u.~a>`crrc, aavc. Ll)T-890 i.eak betector Test Record. - ~a r . G_ sf,r Lo ~ Bl2T' ~ ~ cL~r' ~~ " ~_ J ~ / ~~,,~/,~ Product a~ ~~ t~ ~ Subtttersible Pump Ideatitcation c odcl p- ~ dal Numbed Leak be[ectar Idemtifieatfon M ac#tmt Descrira 'on they ,fit -1e, ak ,Det or D'aPhia~tYpe Piston-type, Tamper-proof seal ~instatled? ye ~~ Na Leak Detector iA Submetaible Fume Test at Dispenser 1 _ Operating purrap Presstue _- ~ Dsi (para. lS) 2. Lallans pex hour, rate ~J. a (para. 2Z) 3. Lice p~,essw a with putty shut off- ~ ~ psi (pam, Z3) 4. gleedbaclc Test wiith pump off ,ml (para.2ti} ~- Step-through tithe to fitil flow~~seconda (para. 30) ~• Leak Qetectar stays is leak search position. (pare, 42) Yes No LEAK DET~C'I'OR xES',i' 7~otr: Pays = t,cak drtectar fits test protocol Fap1=Reek dcDeeter fa~7s test protocol Pass L~ Fail --~s Form $40C (9-1-96) *Con~lete thermal expansion tes# before Failigg leak detector. 1946 Vaporless Mamafacturiug, Inc., Prescott Valjey~ AT ' 09120/2006 13:29 6613252529 CAL VALLEY VAPO~I.ESS MANUF,A.GTURING, INC. PAGE 07 LIfT-,$9Q Leek Detector Test Record S•o~s~r ~ Product ~'..~'~~' /4~ Gnu ~~-~'P~~x~'~i'~ ~ ~ ~l f~L 8ubsncrsible Pump Identi#lcaklon Man~ufacturcr Madel No. mat Number ~rA~a.c,,~eT____ Leak Detector Iden4~icabion ~a cturer Descrittion tJther Stile Leak Detiectog /~f' j_aG,~~~`' DzapbraSm-t3'Pe_,_~__ Piston-type v Ta>~+er proof sea! iastalled? Xes___`____ No Leak letector iQ 5ubrnorsible Putmp Tes# at ~]ispenser 1.. Qpcrating Ptur~ Pressure .~ psi' {para. 15) 2. Crallons per b~our raft ~~~ (para. 2Z} 3. line pressure with pump Shut off':~ps~ (pars. 23) 4_ Bxeedback Test with pump off'____~j(~7 ~nt! (pia. 2b} 5_ Step-through nixie to full ~lopv~,~ secn~uds {para. 30} 8. Leak detrstpi stays in leak search position. (para. 42) Xcs er No LEAN. DETECTOR T£ST Note: PasA ~ Leak dEbecDOr fitg fret pmsncoi Fai! ~ Leak detector fails best protocol ~a39 i~~ Fail Form 890 {9-1-9~) *CoatYtplete thermal expaasian test beforc failing leak detector. 1996 Vaporless Ntaaufactutv~g, Ino„ Prescott Valley, AZ m w a a W J J a J Q U O~ CV lf7 CV LL7 [V fY) e-1 lA ' lD C`J {7 l0 m m CY r, N i o, m R~i~9Y'~Y~1Mitii i~~RirYy~111 -Y'~f~T • t0~i 3 ~~P4 69~ ].~ A Bdit~E1~a~~ ~A ~~~~~ .. _ P#.t4i-X27-~~~~ F~~~1-32~-2~~9 Boa"ooatr~~: car _~~t ~~ Ot~4aeme~ed~ereaNrat~esil~iae(i~.sirlaaul~4A~fl.wr~v+~~aeee~va~e~ere~t~a~~r+rrnaet~~aea~erneur, 1118 C01YVOfS~erkQQ11R~~ '~ ~ ItJ t'k~{9kk i1Sl[. e~ -- - - - C~.)AQI$; Nye ,~ .4w~ ~ ~~~are ender peaatty of perjury fat ~ am~ a 1lco~a6~d tank tesfar ~n Ifie 5tats of Ca~lfamie and ttiar _ the lnforreixtton contained in this report is trw ^+•~+ ~~~-~• •_ ... _ . - CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES f~Rt 1715 Chester Ave., CA 93301(661) 326-3979 AR fM T _ ,,,,, ~ ~. „~,~. UNDERGROUND STORAGE TANK FACILITY ^ 1 NEW SITE ^ 3 RENEWAL PERMIT ^ S CHANGE OF INFORMATION (Stag type of charge) ^ 7 PERMANENTLY CLOSED SITE TYPE OF ACTION PERMIT ~j AMENDED PERMIT ^ 8 TANK REMOVED f Check one item ony) ^ tl TEMPORARY SITE CLOSURE 400 I. FACILITY /SITE INFORMATION ~ BUSINESS NAME F9amra as FACIL NAME or 0t1A - Ookg Buakwss As) 3 FACILITY ID N 1 I ~ NEAREST CRO33 STREET 401 FACILITY OWNER TYPE ^ 4 LOCAL AGENCY/OISTRICT' ~ ~ ~ ^ 1 CORPORATION ^ S COUNTY AGENCY' I NESS '~+" 'NOMOUAL + TMP GAS STATION ^ 3 FARM ^ 3 OTMER 403 ^ 9 STATE AGENCY` E ^ 2 DISTRIBUTOR ^ a PROCESSOR ^ O COMMERCIAL ^ 3 PARTNERSHIP ^ 7 FEDERAL AGENCY' 402 TOTAL NUMBER OF TANKS Irf faWly on Indian Reservatlon or 'H owner of UST a publk spsncy. name of wpsrvisor of REMAINING AT SITE tnatlands9 dMsbn, ~eeUOn or olllce whkh operates IM UST. 404 ~ (This b tits oor>nct Dew ~ the tank records.) 108 403 ^ Yes 11. PROPERTY OWNER INFORMATION DRf1DERTY [rIVNER Ma~AE n •fl7 DLMNF ~~ ~Vlcr ~,~~ s i MAILING OR STREET ADOR PROPERTY OWNER TYPE ^ 1 CORPORATION L72 INDMDV/1L ^ 4 IOCAI AGENCY /DISTRICT ^ 3 PARTNERSHIP ^ S CGUNTY aI,EFICY. III. TANK OWNER INFORMATION r t~f ~ 1 ~ ~`3~_ ^ 8 STATE AGENCY ^ 7 FEOERALAGENCY 413 I TANK OWNER NAME ccrry~ 414 PHONE 415 ~ S i'~ ~ v ~ ~3~'~3y~ rc .~ Kr~rc~,n c. MAILING OR STREET ADDRESS 416 g t ~~ S~ o R~~c I ~ CITY 417 c STATE " 418 ~~- ZIP - R 330 5 419 ~5 TANK OWNER TYPE l rD INOMOUAL ^ 4 LOCAL AGENCY /DISTRICT ^ 8 STATE AGENCY 420 ^ 1 ODRPORATION ^ 3 PARTNERSHIP ^ 5 COUNTY AGENCY ^ 7 FEDERAL AGENCY N. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY (TK) HQ 4 4 - Call (918) 322-9669 if questions arise 4z1 V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(S) ^ 1SELF-INSURED ^ 4 SURETY BOND 7 STATE FUND ^ 10 LOCAL GOVT MECHANISM ^ 2 GUARANTEE ^ S LETTER OF CREOtT ^ d STATE FUND d CFO LETTER ^ 99 OTHER: ^ 3 INSURANCE ^ 0 EXEMPTION ^ 9 STATE FUND d CD 422 VI. LEGAL NOTIFICATION ANO MAILING ADDRESS Check one box to IrWlcate whkh addms should be used Dot Ispal notllleatkms and rtnWnp. ^ 1 FACILfTY 2 PROPERTY OWNER 3 TANK OWNER Lepsl. notifleatlon and mNgnp wIN be saM to IM tank owner radsss box 1 or 2 b checked. 17J VII. APPLICANT SIGNATURE CeNllutlon: I aN(y that tM Infonnatlon provided herein N bus 8 accwaN to tM best oI my krlowladpe 81GNATURE OF APPLI DATE 424 PHONE 413 NAME OF APPLICANT (prlnq 42E TITLE OF APPLICANT _ 427 -- ~ -- Form A UST MONITORING PROGRAM WRITTEN MONITORING PROCEDURES Page 1 of 1 This monitoring program must be kept at the UST location at all times. The information on this monitoring program are conditions of the operating permit. The permit holder must notify the Office of Environmental Services within 30 days of any changes to the monitoring procedures, unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCR. /Ut/ AREA/ T Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661)326-3979 FACILITY NAME ~ ~ '~, FACILITY ADDRESS l DESCRIBE THjjE FREQLUENCY OF PERFORMING THE MONITORING: TANK l° b~l~,\ 1~©v S PIPING C Q ~r7VLL7 }'~ WHAT METHODS ANO EQUIPMENT, IDENTIFIED BY NAME AND MODEL, WILL BE USED FOR PERFORMING THE MONITORING: TANK T~t^ e PIPING ~(~~' DESCRIBE THE LOCATION(S) WHERE THE MONITORING WILL BE PERFORMED (FACILITY PLOT PLAN SHOULD BE ATTACHED): ~~~~kd. ~~~ ~{to- LIST THE NAME(S) AND TITLE(S) OF THE PEOPLE RESPONSIBLE FOR PERFORMING THE MONITORING ANDfOR MAINTAINING THE EQUIPMENT: NAME TITLE ' 1'I~cccc~c S ~cs~ ~,re ~o ~~~~c I'' REPORTING FORMAT FOR MONITORING: TANK ~~(1 PIPING r Ih[C... ~l'LL~ C~CP~-e~ S DESCRIBE THE PREVENTIVE MAINTENANCE SCHEDULE FOR THE MONITORING EQUIPMENT. NOTE: MAINTENANCE MUST BE IN ACCORDANCE WITH THE MANUFACTURER'S MAINTENANCE SCHEDULE BUT NOT LESS THAN EVERY 12 MONTHS. L~clcv~y IJ~. t~o~•t4~.S ptr W~~j. DESCRIBE THE TRAINING NECESSARY FOR THEiOPEpRATIOrN OF UST SYSTEM, INCLUDING PIPING, AND T/HEM NITORING EQUIPMENT: I~tkccf f~ f ~r't~Tt1~S -~-~~N .S~cCtCt.Gf~~ "-~ fi R CtT1r" OF B~-KERSFIELD { ~ OFFICE OF ENVIRONMENTAL. SERVICES i71S Che9ter Ave., Bakerst~eld, CA 93301 (bbl) 31b-3979 UNDERGROUND STORAGE TANKS • TANK PAGE t Pp• -.. a wQ. F •CTgN ' ^ ~. New 31T! Pe1GAT ^ a. AMENDED PERMIT ^ 3. CHANGE OF INfONMATION) ^ d. TEMPORARY SITE CLOSURe ~~CA.GM JM •~I O.h'I ~,~,. ^ i. PERMANENTLY CLOSED ON SITE O ~. ReNewAL PeAMtT (sa•cb ~••+on • .w bcN uie o.ry/ (soech cnup• • .ar uc.1 we Dirt! ' ^ d. TANK REMOVED 9USINES$ Wa•.E l~^~ ~ ><AGLITY NAAIH 4t QBA • Oanq Buera•t A!I ~ c ~ r~~~fde~ s~.4~ I. TANK OESCRIPT'fON i Ann w . ~ ~.si I ~~mc MAMJrA(:iuRER a33 COMPARTMENTALIZED TANK ^ Y•e [~-_ r ~ /~G /A of .. > we K •Y•.'. Dorn Wet• one peq• rot •ecn compartr++•ra. ua• k TANK CONTEt~fTs TANK USE u9 PETROLEUM TYPt: ,~ (~ IpTOR VEHICIII FUEL ^ 1a UN1.FJ10fD ^ 2. LEADED ^ S..)ET FU0. ' (dmanbd, ebt~N '~ ~) ~~Ul1.F.ADEO ^ ]. OtF.SEI• D 6. AVIATION FU0. ~ ^ 2. NONFUEL PETROLEUM ^ iG ~ UNLEADED ^ 4. GASOHOL ^ 98. OTHER ^ ~, p+EMiCAL PRODUCT ^ a. HAZARDOUS WASTE (>;+ulydorr COMMON NAME (host hYzaNOUS A1•AUtf/s !nr•nbryDei>+) Ott CAS t (hom ttararvbus ~t1•t•rYb rrn•nbryp~•) 4.. uaa oq i ^ 9s. uNKNOwN { ~ I0. TANK Cal19TRLIC710M ~ TYPE OF TANK ~ 9NC)I.E WALL ^ >. SIt1LTt.E WALL W{TFt ^ S. StNGI.E WALL wrtH INTERNAL BLADDf12 SYSTEM sa;. ~ (Check one .4rn o~ ^ 2. DOUBLE WALL E)CTFRIOR A67.IBRANE lilt ^ 95. UW WOWN t ^ ~. 39101.E WALL Y1 A VAULT ^ yQ• OTHER ' TANK MATERIAL • prrn•ry Conk ^ 1. BARE STEEL ^ ]. FIBEROlA9S /PLASTIC ^ s. CONCRETE ^ 45. UNKNOWN 4a1 t~ o.,. ~«n ~ ^ z 3TAWLES3 STEEL ^ 4. STEEL cuD,Nn:reFRC~uss ^ a. FRP COMPATIBLE wnoox MET}{ANOL ^ 9i). oTHEA REINFORCED PLASTIC (FRP) ~ TANK MATERLAL • •~OOndOfy tank ^ 1. BIJte 9TeEL ^ ]. F18EROLAS$ /PLASTIC ^ 6. FRP COMPATIBLE w/100% METFIANOL ^ 95. UNQIOWN aaS lCAxk oM ~^ ~Y) ^ 2. STAIIrIES,s STEEL ^ 4. 9'IEEL CLAD W/fIBERGlJ~4S ^ 9. fRP NiON•CORR0p18LE JACKET ^ 9G. OTHER REINFORCED PLIL.4T1C (FRP) [~ 10. COATED STEEL ^ s. CONCRETE TANK INTERIOR LWNO ^ 1. RUBBER LINED EPOXY t1t11N0 ^ S. 0LA88 LM~NKT ^ 96. ut6o+OwN 446 CurE WSTA1 l F(] 4aT OR COATING D z ALKYD t1rP10 O 4. PHEtdDUC LM~10 ^ a 1x1LLNED O t>a. oTHER rGfeok on• tm oNN rFe. ~ ~. n.r„f OTHER CORROSK)N DATE INSTALLED u9 PROTECTION IF APPLICABLE ^ 1. MANLM*ACTUFfJ<D CATTiODIC ^ ]. c3t~ AExIFORCeD PLASTIC ^ ss. UNKNOWN 446 PROTECTION prp~ggEO CURRENT ^ 40. OTHER (CAeck oM ~bnr orvr) ^ 2 SACRIFICLt1. ANODE (For kxa/ ut• oNy) SPILL ANO OVEfifILL ,_.,~ YEAR tNSTAl1.ED 450 TYPE (Fdkx•1 ua• a-'Yj I51 OVERFIU. PROTECTION EQUIPMENT: YEAR INSTALLED ~2 Crt.ck ,r m•t epp/yj ,~.~., ~tom. SPILL CONTAINI~NT 1 a[[~5Q4~y..._ ~^, 1./ALARM ^ ]. FILL TUBE SHUT OFF VALVE _____- ~-d' j• DROP TUBE ~-t l b L.~: BALL FLOAT ~ ^ 4. EXEMPT 4S 7. sTRnceRP+.ATE ~~ ~~''v 4~. - - t1r.(" 1~f +u:;~ 1 - SiNGI.t WALL TANK (GMdt d IMt I. I9UAL (EXPOSED PORTION ONLY) AUTOMATIC TANK QALKWIO (ATO) ]. COKTINUOUS ATO ~, TTATI$TIC~4. RNeNTOAY RECONCtLU1TION (SIR) DIENNW. TAN(TBBTIlVO ^ S. MANUAL TANK OAUOINO (A(TO) ^ e. vADOSe zoNe ^ 1. OROUNOWATER ^ a TANK TESTWO _ __ O ,ao. OTNeA ____. K TANK CLO~URQ INI~OI~MATKkI / PORMANQNT CL03URd IN PLAC![ ,~~ 466 TANK FIU.IIO WITH INERT MATEAVY7 461 7TIMAiID•OAT! LAST UAlD (YR/MOIOAY) 466 1S116NTII0 QUAHTTTY OF 9UBSTANC! ABAA+VHM10 ~ ^ YN ^ No 1- t/ OOUSL,B WALL TAtIK OR TANK MATH BtJ1DplR (CA•tk on• b ^ I. VISUAL (BINDLE WALL iN VAULT ONLY) ^ 2 CONTINUOU9INTERSTfTULL MONITORING ^ ]. MANUAL MONROAINO ~F (7/99) S:ICUPAFORMS~.SWRC~'~~ CITY OF BAKERSFIELO OffICQ Of ENVIRONMENTAL SERVICES 1715 CIMStK Aw., 9ak~nMld, CA 9JJ01 (6a1) J20~21r79 'i WT • TANK LAO! .. ~ d K fl/M1O CON3TRUCTTON (Cheat M awl apyy) . UNDERGROUND vtWNO ~ ABOVEGROUND PIPING SYSTEM TYPE PRESSURE ^ I. SUCTION ^ ~, GRAVITY ~Sr! ^ ~ PRESSURE ^ Z. SUCTION ^ 7. GRAVIT`/ ~< ' CONSTRUCT~Ow' ~'~~ 91NGLfl WALL ^ 7. LINED TRENCH ^ 9Y. OTHER CEO ~ ^ I. SINGLE'NALL ^ 93. UNKNOWN ~,; MANUFACTURERt^ j, DOUBLE WALL ^ 9tS. UNKNOWN I ^ 1. OOUBLE'NALL ^'99. OTHER ' MANU~CTURER stlt MANUFACTURER ~ BARE STEEL ^ 0. FRP COMPATIBLF W/ t00% METTIANOL MATERIALS ANO ^ j, gTAINLE3$ STEEL ^ 7. OALVANVRn STEEL CORROSION PROTECTION ^ ]. PLASTIC COMPATIBLE WRH CONTENTS ^ 9d. UNKNOWN ^ ~. FIBERGlA.9S ~^ B. F~18LF (HOPE) ^ 91i. OTHER ' ^ S. STEEL wl COATiNG L.y~4. CATHODIC PROTECTION abt ^ t. BARE STEEL ^ d. FRP COMPATIBLE W/ 100% METI1ANOl ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ ]. PLASTIC COMPATIBLE WITH CONTENTS ^ B. FLEXIBLE (HOPE) ^ 99. OTHER ^ 1. FIBERGLASS ^ 9. CATHODIC PROTECTION ^ 3. STEEL W/ COATING ^ 9S. UNKNOWN ~~; VM. P~M~O LEAK DETECT)ON (CMch aI rh•t aPM') -- UNDERGROUND PIPING I ABOVEGROUND PIPING PRESS IZED PIPING (Cheek a/ that apply): - - t. ELECTRONIC LINE LEAK DETECTOR ].0 GF'H TEST mjj! AUTO PVAP SiNIT OFF FOR LEAK SYSTEM FAII.UR!~ AND SYSTEM DISCOnl1ECTION +AU018LE AJ~D VISUAL ALARMS ^ 2. MO/ITHLY 02 GPN TEST ^ ]. ANNUAL O~ITEGRITY TEST (0.1 GPN) CONVENTIONAL SUCTION SYSTEMS: ^ 3. GAILY VISUAL MONITORING OF PUMPING SYSTEM • TRIENiAL PpWO lfTEGRfTY TEST(O.t GPH) SAFE SUCTION SYSTEMS (MO VALVES OV BELOW GROUND PIPINGk j ^ 7. SELF MONITORING GRAVITY FLOW: ' ^ 9. BIENNIAL v1TEGRITY TEST (0.1 GPt~ SECONDARILY CONTAINED PIPINfi PRESSURIZED PfPMK3 (GNtk aI filet apply): 10. CONTINUOUS TURBINE SUMP SENSOR 1MT11 AUOt81E AND VLSt)AL ALARMS AND (Ct,ecx an•) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ o. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE ANp SY$TFJ,1 OISCANNECTK)N ^ c NO AUTO PUMP SIt1.1T OFF ^ t t. AUTOANTIC LINE LEAK DETECTOR (3.0 GPH TEST) ~}T j FLOW SHUT OFF OR RESTRK;TION ^ t 2. ANNUAL INTEGRITY TEST (O.1 GPH) suCTbNrGRAVrrY SYSTEMt ^ , ~. CONfIMIOUS SUMP SElrSOR . AUOIBLB AND vtstlAL AWtMB EMERO ENCY GENERATORS ONLY (Check a/ Mat apply) ^ ,.. CONTINUOUS SUMP SENSOR 70~!!4l,fI AUTO PUMP SHlti OFF • AU016LE AN0 VISUAL At.~RMS ^ t S. AUTOMATIC UNE LEAK DETECTOR (].0 GPH TEST) j FLOW 3F11!'f OFF OR RESTRICTION „~. ^ t8. ANNUALtNTEGRITYTEST(0:1GPH) ~ Cot1~l'.\oal~\( 1~~g1~t fq t 7. DAILY VISUAL CHECK PRESSURIZED PIPING (C/t•cR a/ tlfat appJy).~~~ ••~~ • .• .•^ x ^ t. ELECTRONIC LINE LEAK DETECTOR ].0 GPH TEST ~T} AUTO PUA~P SHUT OFF FOR LEAK SYSTEM FAILURE, ANO SYSTFJN OISCANNECTION + AUDIBLE AND VLSt1AL ALARMS ^ t AgNTHLY 02 GPH TEST ^ ~. ANNUAL INTEGRITY TEST (Q t OPH) ^ 4. DAILY VISUAL CHECK COhIVENTIONAL SUCTION SYSTEMS (Ch•ok a/ Ntat apply): ^ S. DAILY VISUAL MONffOR1NG OF PIPING MID PUMPING SYSTEM ^ 6. TRIENNUL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPINGK ~ ^ 7. SELF MONRORING GRAVITY FLOW (CAetk aI that apply): ^ B. OMLY VISUAL MONITORING ^ 9. BIENNIAL IMEGRITY TEST (O.t GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Gack of (hat apply): t0. C.ONTINl10US TURBINE SUMP SENSOR V_}~_Tl{ AUDIBLE AND VISUAL ALARMS AND (CIteC* one) ^ a. AU70 PUMP SHUT OFF WHEN A LEAK OCCURS ^ D. AUTO PUMP SHUT OFF FOR LEAKS. SYSTEM FAILURE ANO SYSTEM DISCONNECTION ^ c NO AUTO PUMP SHUT OFF ^ t t. AUTOMATIC LEAK DETECTOR ^ 1 Z ANNUAL INTEGRITY TEST (0.1 GPH) stICTIONn..RAVmr sYSTEMI: ^ 17. CONTINUOUS SUMP SEItSOR . AUDIBLE ANO VISUAL ALARMS EMERGENCY GENERATORS ONLY (CMCk a/ that apply) 14. CONTINUOUS SUWP SENSOR AUTO PUMP SHUT OFF +AUDIBLE ANO VISUAL ALARMS 13. Al1TOMATIC LINE LEAK DETECTOR (].0 GPH TEST) ^ 78. ANNUAL INTEGRITY TEST (0.1 GF~Fi) ^ t 7. DAILY VISUAL CHECK ,.k,.. `tf.r;.. '~CIQKTAINMENj.~• c~s, ~'• .z:;(>. .a•.r { ,• >:c is .~i.•~~i._... .:,'.?F4Z'"v.'.fr'.' DISPENSER CONTAINMENT^ 1. AT MECHANISM THAT SHUTS OFF SHF/1R VALVE ^ t. DAILY VISUAL CHECK r OATEpINS~TALLEO 468 LTI~`!, CONTINUOl190tSPEN$EAPANSENSOR+AU018LEANDVISL1AlALARMS ^ S. :i.~:ru-llr w~:;S.<'%t` i.+l~(~,. IIt4K~~.~" I I_ ^O Z ^ g, coNTwuoue DISPENSER PAN SEPISOR ~ AUTO SHUT OFF fOR DISPENSER + AUDIBLE AND v13UAL ALARMS ~ 489 IX.OWNERlOPERATOR 910NATURE I sentry wl m• ~neormanon proNOed her awe and aoaxate to tM Daat at my ktwtMedpe. SIGNATURE OF OWNER/OPERAT ~ DATE J 470 OF PCF (7/99) G O~ S:ICUPAFORMSISWRCB'R•~D C1T~" OF B~-KERSFIELD ~ OFFICE OF EYVIROIYrtEiYTAL SERVICES 1715 Che9ter Ave., Bakersfield, CA 93301 (66l) 326-3979 !~ ' • ; UNDERGROUND STORAGE TANKS -TANK PAGE t Pspe _. d ,,,a R ACTION ^ I. NFW IJTp vpla+IT ^ 4. AAlNOEO P~RA41T ^ !. CHANGE OR INFORA/A rIONI ^ a. rEMPORARY SITE Cl09uRE ,N%'Cnoc~ ~M •nin oM'I "~" ^ 7. ApNpWAL PlRM/T ^ i. PERA4ANENTLr CLOSED ON 9iTE (SDae1y ~+on • ,br bcav use oM'1 (S'*/Y ~+Ps • •br>ocav wo oM'1 ~ ^ e. TANK REMOVED 9uSINES9 NAME l ~^~ +~ RACIUTY NAlu6 ar OBA • Oarq Eurnaaa Aal ] FACAfTY IO • I I ----~' COCA rroN win+xv xre (gaalxwJ ------ I. TANK OE3CR1PTidd r.4NK i s A COA4PARTMENTALIZED TANK ^ Yes ^ Np ` + f M'YM'. COTdel1 atO P~ (a e~W1 GAmOYtrt~Aft(. OA r IN ALL ( ) IN N NU : ADDITIONAL OE (fw+bW wr avyJ M. TANK CGIiTENTM TANK we u9 PeT170tE11M TYPE .. MOTOR vo+icle FUEL ,r< REQULAit UNLFaCEO O 2. t.pADEO ^ s. JET FuE.1 (nma~ra. oo~IwMr PWoMan zyp.J ^ ,e. PREMU-1 Vf~Ea0E0 O ~. OtESEI. ^ e. Av1AT10N FUEL O z. NDN•rvEl. PETROIEUAi ^ ,c A~DORADE Uf~aFADED ^ .. CiASOHOI ^ 9s. OTHER ^ ~. cHEMICAI. PRODUCT ^ •. HA7JVtDOUS WASTE (AxJUOoa CO~a-i0n NAAAE (11Wn /frzwabla A/alrrbM /rtrrnWYOaDr) 44t CAS I (hDnt F42srWus A4te/lab !^++nlxYO+prJ M Uaad OQ i ^ %. UNKNOWN ~ ip. TANK COff9TRUC TiOM TYPE OF TANK 1. Ss40LE YMALI ^ 3. 91NOLE WALL MRTH ^ S. S?lGLE WALL WRH INTERNAL. BLADDER SYS'rEJ~I 1a3 ~ (C1+ocX oM Asrrr eM'1 ^ 2. DOUBLE WALL EXTERIOR AEA$IWE LJNFR i ^ 4. S WALL W A VAULT ^ 99. OTHER TANK ANTERIAI • pllatrry tOr~ ^ 1. BARE 9TEEL ^ 2. F18ER01/133/PLASTIC ^ S. CONCRETE ^ ~. UNKNOWN 14-I (Cnecx ono Arm oNYJ ^ t STAINlE33 STEEL ^ /. STEEL CLAP W1FiBEROlAS3 ^ 8. FRP COA4PAT18LE W!100% METHANOL ^ 9D. OTTER REINFORCED PLASTIC IFRP) ~ TANK MATERSAL • f~oOIWKY tanlt ^ 1. BARE STFB ^ 1. FIBEROlA33! PLASTIC ^ 8. FRP CCiPAT18LE WM00% A£iHANOL ^ 95. UMO~OWN 445 i (Cnocx aw Arm ody) ^ 2. STAJNLESB STEEL ^ 1. STEE1 CLAD W1fIBERGLASS ^ 9. FRP NONCORRODIBIE JACKET ^ 99. OTHER REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ s. cDNC~IETE TANK IMERIOtt Ll4MX1 EPOXY lMaNO O s. O1A88 L1iIIXi O 96. txgolovlN IIe ,DATE INSTALL FO 44r OR COATING ^ 1. RUBefJt LllsaO ^ 4. ALKYD L.NMILI ^ 1. PHENOLIC LNILNO ^ 8ti UNLY~ED ^ 9D. OTHER (CJleek oM [ar11 OIIM (FOtbW Iesr OrW) OTHER CORRDSIDN ^ 1. AAAIrUFACTtJRr<O CAT11001C ^ ~. c31.ASS REx•IF;ORCED PLASTIC ^ D6. UNIWONR4 448 GATE INSTALLED 449 PROTECTION IF APPiJCAeIE PROTECTION . IMPRESSED CURRENT ^ 90. OTHER (Chock one Arm orYy1 ^ 2. SACRLFICLAL ANODE (For.bcal usa oMyJ AND OVERFILL sI mat atWM1 YEAR INSTALLED 450 TYPE (Fw btN use o~y) ,.`~/' • sP+u CONTAINANENT ~gg_ lfl 2. DROP TUBE ~,~_ srRSCpR PLATE ___Lq 4'~_ -- - - - - OVERFILL PROTECTION EOVIPMENT: YEAR INSTALLED ~~ ^ t. ALARM ^ J. Flll TUBE SHUT OFF VALYE ~- ^ 2. BALL FLOAT ^ 4. EXEMPT .,. .. ,. . . .. ..;~. ~~,i. :~ ;k:i:: r:. alk~'T~INKt.Q/UC :,~}t`:4f'v;x:.:"~t.:;:~' ~:~:~:; ~`:;• „~;.. If 31N01.8 WALL TANK (Cheek aI IAat Mv%R ... aW V OOUBId WAIL TANK OR TANK MATH BLJ1D0lR (CMck ohs Rrr+, oNYx 154 I, 13UAL (~XPOBlO PORTK)N O-IlY) ^ !. A4ANVAL TANK OAUOINO (ALTO) ^ 1. VISUAL (BINDLE WALL IN VAULT ONLY) AUtOMATK; TANK OALK11N0 (ATO) ^ 8. VADOSE ZONE ^ 2 CONTINUpU9 INTERSTfiUL MONRORINO 1. C.OMIN000B ATO ^ 7. OAOUNDWATER ^ 3. MANUAL MONRORINO t 4. lTATI$TK;JW IMIlNTORY RpCONCIIIATK)N (SIR) • ^ e. TANK TEATINO (~ `{ ~O ~\'~ t+~ ~ 0 ~ S S CC dnSO. r"~ ~`) ~ 01~ ~ ~ G Ir DIENNIAL TANK TBdTIlVO ^ pp OTHER ' V. TANK CLOa11RII INFORMATION / PdRMANdNT CL03URR IN PLAC>II `_ 488 TANK FN1E0 MATH INERT A4ATERLAL9 s67 571A4ArlO OAT( ll1QT UAfO (YR/btO/OAYJ 188 4STIMATQO QUANTITY OF 9U88TANC! RSAAALNMIO ON°~~ ^ Yea ^ No _~-=- 451 ;F (7199) 9:1CUPAFORMSISVVRC~•~O CITY OF BAKERSFIELO Ot*FICQ Of ENViRONMENTAI SERVICES 171! CMatK Aw., 8ak~nA~ld, CA 9JJ01 (6a1) J20-J979 WT • TANI( /AG! -- - PLO. d _ Vl'NMIQ CON9T1tUCTION (Cnaat r drat apply) . UNOEROROUNO PIPING ~ ABOVEGROUND PIPING SvSfEM'rPE t PRESSURE ^ 2. SUCTION ^ ]. GRAVITY 4S0 ^ ~ PRESSURE ^ 2. 4UCTIQN ^ ], GRAVITY a< ColvsraucTlDw'^ ' 41NGLe wAU ^ ]. UNEO TRENCH ^ 99. OTHER .60 ' ^ I. SINGLE'NALL ^ 93. uNKNOwN ,,; MANUFACTURERI~DOUBIE WALL ^ 93. UNKNOWN ^ 2, OOUBLE'NALL ^'99. OTHER ~', ' MANUFACTURER 40t MANUFACTURER ~ ~ ^ t. BARE STEEL ^ 0. FRP COMPATIBLE W/ 10016 AETTU-NOL ^ t. BARE STEEL ^ 0. FRP COMPATIBLE W/ 100>< METFtANOI MATERIALS ANO ^ 2. 4TAINLE99 STEEL ^ 7. OALVANIIF.D STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ ]. PLASTIC COMPATIBLE VIfTH CONTEMS ^ 90. UNKNOWN ^ ]. PUSTIC COMPATIBLE WITF1 CONTENTS ^ 8. FLEXIBLE (HOPE) ^ 98. OTHER ^ s. FIBERGLa3S ^ 0. FLEXIBLE (HOPE) ^ 9D, OTHER ^ ~. FIBERGLASS ^ 4. GTHOOIC PROTECTION ^ S. STEEL W/ COATING ^ 9. GTHOOK; PROTECTION 401 ^ S. STEEL W! COATING ^ 93. UNKNOWN ~~; VM. PIPNO LEAK DETECTION (CMat r an.c,PPy) - UNOERGROUNO PIPING ~pnvt=rant lun alwur: ,P,,R,E~URlZEO PIPING (CAack al Il4t apply): l1Y t. ELECTRONIC UNE LF.aK DETECTOR ].0 GPH TEST ~{ ALRO PUUP SflllT OFF FOR LEAK SYSTEM FAILURE. ANO SYSTEM ON:SCONi1ECT10N + AUOfBLE MD VtSLIAL ALARMS ^ I. MONM.Y 02 GPM TEST ^ 3. ANNUAL 04TEGRtTY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. OAiIY VISUAL MONITORING OF PUMPING SYSTEM + TRfE!lNM, PIPINp MITEGRITY TEST(O.t GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPVIG); j ^ 7. SELF MONITORING GRAVITY FLOW: "^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONQARILY CONTAINED PIPtlq I PRESSURIZED PIPOJG (Gledr a/ llhsf apply): 10. CONTiN0003 TURBINE SUMP SENSOR ~ AU018LE AND VLSUAL ALARMS ANO (Cl+edc ans) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ D. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ e. NO AUTO PUMP SHUT OFF ^ t t. AUTOMATIC LINE LEAK DETECTOR (7.0 GPH TEST) ~ FLOW SHUT OFF OR RESTRICTION ^ , 2. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIONM,RAVTIY SYSTEM ^ t ~. CONTINUOUS SUhP SENSOR + AUOIBL$ AND VISUAL ALARMB EYEROEI4CY OENlRATORB OMLY (CMcR of IW +WaY) ^ 14. CONTINUOUS SUMP SENSOR mjj~ jj AUTO PUMP SfAlT OFF + A110161.E A10 VISUAL ALARMS ^ t5. AUTOMATIC LINE LEAK DETECTOR (J.0 GPH TEST) ~ FLOW SHUT OFF OR RESTRICTION ~ 1!~I~\ S ^ 10. ANNUAL INTEGRITY TEST (0.1 GPH) ~ CO~~~ t',\ utJ !(Y (,i47t~ ~ v f 7. GAILY VISUAL CHECK tX. OMMER/OPERATOR SIGNATURE ISPENSER CONTAINMENT ^ 1. AT MECHANISM THAT SFiltT3 OFF SIfFJ1R VALVE DATE INSTALLED 400 CONTINUOUS DISPENSER PAN SENSOR +AUOIBIE ANO VISUAL ALARMS ^ ]• CONTIMIOUS DISPENSER PAN SENSOR ~ AUTO SHUT OFF FOR DISPENSER • AUDIBLE AND VISUAL. ALARMS ^ 4. DAILY VISUAL CHECK 1 469 a+nu~e ~nt~ nnnu 46; PRESSURIZED PIPING (CMek M Opal apply} ^ t. ELECTRONIC LINE LEAK DETECTOR 7.0 GPH TEST I' T}~ AUTO PUhIP SHUT OFF FOR LEAK SYSTEM FAILURE. AND SYSTEM DISCONNECTION + ALIOIBLE MID VISUAL ALARMS ^ t MONTFILY 02 GPH TEST ^ 7. ANNUAL RlTEGRTTY TEST (0.1 QPH) ^ 4. GAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS (CAsak M O'lat apply): ^ S. GAILY VISUAL MONffORY1G OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PtPINGx ^ 7. SELF MONRORING GRAVRY FLOW (Glech al tlfat apply): ^ 8. GAILY VISUAL MOMTORING ^ 9. 81ENNtA1 WTEGRITY TEST (O.1 GPN) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Greek a/ tllat apply): t0. CONTINl/0US TURBINE SUMP SENSOR WIT}I AUDIBLE AND VISUAL AW2M$ AND (dtedc one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ D. AUTO PUMP SHUT OFF FOR LFAK,S, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c NO AU70 WMP SHUT OFF ^ t t. AUTOMATK: LEAK DETECTOR ^ 12. ANNUAL INTEGRRY TEST (0.1 GPH) SUCTION/GRAVRY SYSTEAk ^ 71. CONTWUOU3 SUMP SENSOR +AtJO18LE ANO VISUAL ALARMS EMERGENCY GENERATORS 0lQY (CAaek tl lAaf apply) ^ 14. CONTINUOUS SUMP SEM40R AUTO PUMP SHUT OFF +AUDIBLE AND VISUAL ALARMS I S. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) ^ 18. ANNUAL INTEGRITY TEST (0.7 GF1i) ^ 17. GAILY VISUAL CHECK I only Ihat IM mPortnatbn v~ovtd.dll affln Ia m,. and amxata to IM ttaal d my krlowbdp.. WI ~CF (7/99) DATE ~~~ d~0 I I TRLE OF S:ICUPAFORMSI3WRC&B•~C UST MONITORING PROGRAM EMERGENCY RESPONSE PLAN Page 1 of 1 This monitoring program must be kept el the UST location at all times. The in/ormation on this monitoring program are conditions o/the operating permit. The permit holder must notify the Office of Environmental Services within 30 days o/ any changes to the monitoring procedures, unless required to obtain approval before making the change. Required by Sections 2632(d) and 2641(h) CCR. w/R/ AR1II f Bakersfield Fire Dept. Environmental Services 1715 Chester Ave Bakersfield, CA 93301 Tel: (661}326-3979 FACILITY NAME FACILITY ADDRESS ~~ ~ ~~~ l-llj Q IF AN UNAUTHORIZED RELEASE OCCURS, HOW HALL THE HAZARDOUS SUBSTANCE BE CLEANED UP? NOTE: IF RELEASED HAZARDOUS SUBSTANCES REACH THE ENVIRONMENT, INCREASE THE FIRE OR EXPLOSION HAZARD. ARE NOT CLEANED UP FROM THE SECONDARY CONTAINMENT WITHIN B HOURS. OR DETERIORATE THE SECONDARY CONTAINMENT, THEN THE OFFICE OF ENVIRONMENTAL SERVICES MUST BE NO FIED VNT IN 24 HOURS. ~t~~ t~{~~- tut~l b~ ~Scd ~s a~ c~,~s©`~iQ~~f-'. ~av~~~ S~+rt(S mill ~c~ 4t1 DESCRIB1E,THELIPROF'OSEO 1METHOIDS AND EOUIPMENTrT_O 8E USED FOR REMOVING AND PROPERLY DISPOSING/OF ANY FWZARO'O/US SUBSTANCE. 1Lt-T~ SV~Lf~~1 ~ ~IaCC~ r V~ j l~al~n~t ~tFGC.IC~ U? c~h SCf.13~t, GlcLt ~rm city ~ is ®S cc~ Q-~ C~In~~l ~ ~~ ~ P 3.DESCRIBE THE LOCATION AND AVAILABILITY OF THE REQUIRED CLEANUP EQUIPMENT IN ITEM ABOVE. DESCRIBE THE MAINTE''NANCrrE SCHEDULE FOR}. THE CLEANUP EOUlPMENT: ~~C~LC~ ~e.C1,~ LIST THE NAME(S) AND TITLE(S) OF THE PERSON(S) RESPONSIBLE FOR AUTHORIZING ANY WORK NECESSARY UNDER THE RESPONSE PLAN: NAME in TITLE f~CrCcc~-tS V'C~1L~.Y'c~-b ~Ctl R(r~ E R S F I D May 15, 2006 F/RE ARTM T Ms. Mercedes Penarejo Circle Deli 1416 Golden State Avenue Bakersfield, CA 93301 NO~"ICE OF VIOLATION RONALD J. FRAZE ; FIRE CHIEF & SCH~~ULE FOR COMPLIANCE Gary Hutton, Re: Failure to Perform t~t"..submit Three Year Cathodic Protection Certification Senior Deputy Chief ~ Administration Dear Ms. Penarejo: 326-3650 Our records indicate that your three year cathodic protection certification is past Deputy Chief Dean Clason due. If you have performed this test, please forward those results to my attention Operations/Training immediately. If you haven't ~~rformed this test you are in violation of Section 326-3652 ~ 2635 2(a) of the California Cdde of Regulations, Title 23, Division 3, Chapter 16 Deputy Chief Kirk Blair Underground Tank Regulatl~ns. Fire Safety/Prevention Services ~~ "Field-installed cathodic protection systems shall be designed 326-3653 and certified as adequate by a corrosion specialist. The cathodic protection system shill be tested by a cathodic protection tester 2101 "x" street within 6 months of i0i~tallation and at least every 3-years Bakersfield, CA 93301 thereafter." OFFICE: (661) 326941 Therefore, prior to June 12, ~b06 you will perform the necessary testing as FAX: (661) 852-2170 ~ required by Code. Failure tt~ oomply may result in revocation of your Permit to Operate. RALPH E. HLTEY, DIRECTOR Again, if you have recently ~~rformed this certification test, please forward the PREVENTION SERVICES ~ results to my attention and disregard this notice. FIRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 Should you have any questiohs, please feel free to call me at 661-326-3190. OFFICE: (661) 326-3979 FAX: (661) 852-2171 i Sincerely, , David Weirather Ralph E. Huey, Fire Plans Examiner ; Director of Prevention ServiCOs 326-3706 ' Howard H. Wines, III ~ Hazardous Materials Specialist 326-3649 ~ ' By: Steve Underwood, Fire Prevention Officer REH/SU/db ~~~aZ4~ ~ C~~~Z~!7/I!GG%~i~ e~'!!X ~i~ ~/~Q/ni ~~~~/.~% VC~J'2~~1~ ~ .'.1 ~\ ~:. ~ 2655 S W RCB, January 2002 Page ~ of 8 Secondary Containment Testing Report Form This farm Is intended for rcre by contractors- performing periodic resting of UST serondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completedform, written tes! procedures, and printouts from tests (rf applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: ~y~ Date ofTestin - Facility Address: ~o~ v~1t>zts.~lt'. Facility Contact: Phone: Date Local Agency Was Notified of Testing Name of Local Agency Inspector ({jpresent during testing: 2. TESTING CONTRACTOR INFORMATION CompanyName:RICH ENVIRONMENTAL Technician Conducting Test: ', pp~~ pyn~ Q~ G Credentials: tIdCSLB Licensed Contractor Q SWRCB Licensed Tank Tester License Type. C611D40 License Number: 809850 Manufacturer Manufacturer TraininE Com oven s Date Trainin Ex Tres INCON INCON TS-STS 3. SUMMARY OF TEST RESULTS if Hydrostatic resting was performed, describe what was done with the water after completion of tests: RECYCLE AND REUSED Component Pass Fail Not Tested Repairs Made Component Pass )waif Not Tested Repairs Made N~ K ^ ^ ~ D ~ -s ~~ rf~ ~ ^ ^ ^ rJU U ^ 6~ ^ 0 ^ ^ Cl - t D O CJ -~ ^ ^ ^ ^ - t ~ N otn. ^ ~ 0 D t ,w ^ ^ ^ a - r ~ 0 0 ^ ^ ^ ^ '^ ^ ^ U ^ O ^ ^ 3 ~ ^ ^ ^ a a ^ r $ - ~ u ^ ^ ~l ^ ^ ^ ^ ^ ~ ^ Q D ^ ^ ^ ^ CERTIFICATION OF TECHNTCIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of-ny knowledge, t/ie facts stated in this document are «ccurcte and in full compliance wi!!t legu/ regtt/rements Technician's Signature: Date; ~ ` 3 t - O(~ to ~l~Gti--~- ~ 2 0 55 __--_--- SWRCl3, January 2002 4. TANK ANNULAR TESTING Page ~ of 8 _ Test Method Developed By: 0 Tank Manufacturer ~ Industry Standard ^ Professional Engineer O Other (Sped) Test Method Used: ^ Pressure ~ Vacuum D Hydrostatic 0 Other (Specie) Test Equipment Used: 4in- DIAL GAUGE i ~ i~~t ti ? for ~ .~i ~~ ti~{., ni. _ ~. .~ s pct _ _ a ~F~-'r:?~~ ~,f,.. '~~'~" ;r~~'k Tank# $~ Tank# ~~Y EquipmentResoiution: .5% ,"' ... ,~ -~z-. ~i :. ~ii. Tank# Tank# , is Tank Exempt From Testing? r ^ Yes "-L9~No D Yes ~No ^ Yes D No ^ Yes ^ No 'l'ank Capacity: Tank Material: Tank Manufacturer: UnK-~at,~--, Vvt 1Cr+Otav~ Product Stored: Wait time between applying pressure/vacuum/water and startin ~ test: 1110 14rnvlMR ~ W~1 ~~ ~~1nu rlo pwlnu~r~Yt ; ~ ~xal~ ~qn}[ Test Start Time: Initial Reading (Rr): Test End Time: Final Reading (RF): Test Dut'ation: Change in Reading {f~.R,): Pass/Fail Threshold or Criteria: Test Result: D Pass ^ Fall D Pass ^ Faii ^ Pass ^ Fail ^ Pass D Fait Was sensor removed for testing? D Yes ^ No DNA ^ Yes ^ No DNA ^ Yes D No ^ NA D Yes 0 Na f.?NA Was sensor properly replaced and verified functional aRer testin ? ^ yes ^ No DNA ^ Yes D No ^ NA ^ Yes ^ No ^ NA D Yes ^ No 0 NA Comments - (inc/ude r~ fvrmotion on r~atrs made prior [o testtn~ and reconrntendedfollow-vpfor jaded tests) S ~Y,c,~~ 1~a1~ ~"'r4R1~~ nl~ ,a~~,.,~~,nc ~ Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such as systems that are hydrostatically monitored or under constant vacuum, are exempt from periodic containment testing. {California Code of Regulations, Title 23, Section 263~(a)(6)) ~ 20 55 .~----.. SWRCB, January 2002 5. SECONDARY PIPE TESTING Page ~ of 8 Test Method Developed By. ^ Piping Manufacturer ~ Industry Standard ^ Professional Engineer O Other (Specify) Test Method Used: fd Pressure ^ Vacuum ^ Hydrostatic ^ Other (Specify) Test Equipment Used: 4 i n . DIAL GAUGE Equipment Resolution: . 5% ro_ti~... ':,'~ ~ Piping Run # ~ 7 Piping Run # ~ ! Piping Run # Piping Run # Piping Material; g ib 1~SS Piping Manufacturer: Dµ. vrkrowv~ Piping Diameter: h ~ " Length ofPipingRun: y5 ? y5 ff' Product Stared: ~YG~ - ~i~ Method and location of i in -run isolation: y~rj ~77f f $~twa T~s-t- ao DS ~ „$uM Wait time between applying pressutrJvacuum/waterend startin test: d /Vl ~ N , ~ (~ W+ + .~ Test Start Time: 0 ~ ~S M ~ (~ ~j ~,~ Initial Reading (RI): / 5 s'~ Test End Time: ; /$ )', R'tr Final Reading (RF): ~ FJ PS 1 Test Duration: ~ -~ ou a Change in Reading (Rr-R,): -$- g ~ S r Pass/Fail Threshold or Criteria: ~_ PSI ~- ~S; Test Result: Pass O Fall {Pass ^ Fail ^ Pass ^ Fail t7 Pass ^ Fsii Comments - (include information on repairs made prior to testing and recommendedfollow-upfo_, failed rests) ~ ~ o s _s S14'RCB, January 2002 6. PIPING SUMP TESTING Page 4 of 8 Test Method Developed By: D Sump Manufacturer N Industry Standard D Professional Engineer ^ Other (Specify) Test Method Used: D Pressure ^ Vacuum 1t1 Hydrostatic ^ Other (Specify) Test Equipment Used: INCON TS-STS Equipment Resolution:,oooin. _ Sump # ~ Sump #rj Sump # Sump # Sump Diameter: -• 3(, h 3G M Sump Depth: (.} ~j ~' y 5 4 M Sutnp Material: ~ *1 ; leer ~qS3 S Height from Tank Top to Top of Hi hest Pi in Penetration: ..~0 i ti `~ ~ ' ti Hei~tt from Tank Top to Lowest Electrical Penetration: ~p ~ 1n ~s ~ h Condition of sump prior to testing: ~ ~p 1U t Ponion of Sump Testedt 1 ~ 1 ~ ~ Does turbine shut down when sump sensor detects liquid (both roduct and water ? ^ Yes L'1 No ~A ^ Yes ^ No `9,NA D Yes ^ ~NA ^ Yes ^ No ^ NA Turbine shutdown response time l.)Y'tk~no'Wr'+ is system programmed for fail-safe shutdown?' ^ Yes ^ No ~ NA ^ Yes ^ Noll NA q~NA ^ Yes ^ No DYes ^No DNA Was fail-safe verified to be o erational?` ^ Yes ^ No'~NA D Yes ^ No~NA D Yes ^ No ~IA ^ Yes ^ No ^ NA Wait time between applying pressure/vacuum/waterend starting test: :,~ n, ; (~~ r L~ . ~A~i t +~ Test Start Time: }0'..~~q~w ~p',yt i~r,n ',~Q ~: ys y;v~ Initial heading (R[): 3 i n 3. y ; r o! .~10 i .$~~ 1 ~/ Test End Time: 1.38 1D'.56a+ 1'.45 a ~ 03~ in 109 r Final Reading (Rr): .t1"l1 ir. 3.L143ih .8`I`lin o1.$ybit, ~k3S Stft,u Test Duration; ~Rj w~C ~ ~ Ca y„~; „~ Mu/ r Change in Reading (Rr-R[): .0,.1',r~ . pa . uc[ i n •tXl~•n ,00/ nv PassiFail Threshold or Criteria: t\ rays ~a~v2 v rJt-2 M Test Result: D Pass'Fail Pass ^ Fait 'fil7P8SS ^ Fail ^ Pass ^ Fail Was sensor removed for testing? Yes D No ^ NA YZ(Yes ^ No ^NA Yes ^No ^ NA ^ Yes ^No ^ NA Was sensor properly replaced and verified functional after testin 7 Yes ^ No ^ NA `~ Yes ^ No ^ NA ~9,es ^ No o NA ~• ^ Yes ^ No ^ NA Comments - (include in ormation o» re airs mode rior to testis ,and recommended ollow-u or oiled tests ~LIN ~ 5~ ~ v~ ~ ~~ k *1~,,tJ<Tlta u ~ I~ ~t„~ . ,~~t+~~L t~,~?~rt ,,E,,~~iL "~ 9 i ~ j If the eniine depth of dte stJmp is not tested, specify how mach was tested. If the answer to qty of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) I ~ 0 5S SWRCB, January 2002 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTIlYG Page 5 of 8 Test Method Developed By: ^ UDC Manufacturer l~ ]ndustry Standard O Professional Engineer ^ Other (Specify) Test Method Used: ^ Pressure 0 Vacuum ~ Hydrostatic ^ Other (Spec~J Test Equipmern Used: INCON TS-STS Equipment Resolution: . oooin . -~~~=~ ~ unc # ! ~a ~ viac a 3 }~l uil~c' ~ +6 unc # UDC Manufacturer: n\Crowr b'r1 't~~.'n Vr~Zr-os.'-~ UDC Material: ~ ~wss 'bat ~sS ~ S UDC De the * `' `+ Height from UDC Bottom to Top of Hi hest Pi in Penetration: y~~ y~, `l'~ t '1 Height from UDC Bolton: to Lowest &lectricaf Penetration: / o7y ' a ~ ,,a<< Condition of UDC. prior to testin : 1~'A~1 ~~.;o.N G~~ Portion of UDC Tested r+. o Cri Does turbine shut down when UDC sensor detects liquid (both roduct and water ?` ^ Yes ONo ~QNA ^Yes pNo~NA DYes ^No~9NA ^Yes DNo i7 NA Turbine shutdown res onse tune 1Z dWtn W as (s system programmed for fait- safe shutdown? 0 yes ^ No ~s.NA ^ Yes D No ANA ^ Yes O No 19 NA O Yes ^No ^ NA Was fail-safe verified to be o erational?` ^ yes Q Nom NA D Yes D No~C7 NA ^ Yes 0 No~EJ NA ^ Yes ^ No 0 NA Wait time between applying pressure/vacuum water and startin test ~ ~ w-* v, \ 0 r~ ~ •.. \Q rn: ~ Test Start Time: 5' tj3>ah, O san. ',33,~,A `!$Opv~ ~', ain 9 :.5O'p*^ Initial Readin (Ri : ,7 ~ iw .7~(~'~r i .1.1$~n .~ \~1'-~r. Test End Time: ~ ~ g a \O:OS ar+ 9'.4 nt++ 10105~,N 5.48a \0'.0 Ar Final Readin RF):. .~~;r .773 ~h. 3,L4g~n 3 .bl :~ ~•glelil. 4.~18~~~ Test Duration• IS w.,,,. \g r• ;~. T t„~;r~ Chan a in Readin RF-Rr): `9 . oQl,,,. ,001 iv. .[~Oa~i. "61, .oo1'~n Pass/Fail Threshold or Criteria: `Q 'P~q 1 p S aSS P>4fS rtSS nSl Test Result: Pass ^ Feil Pass ^ Fail `~' Pass ^ Fail D Pass ^ Fail Was sensor removed for testing? 0 Yes ^ No A D Yes D No A ^ Yes ^ No A ^ Ves D No ^ NA Was sensor properly replaced and verified functional after testin ? Dyes ^ No .BNA ^ Yes Q No ~iA ^ Yes ^ No ~NA ^ Yes ^ No [7 NA Commetlt3 -- include information on repairs made prior folesting, and recomnrendedfollow-up for jailed tests N o SG•nso2s 't •r. d;sPCv~casts. ' If the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk (*) is "NO" ar "NA", the entire UDC must be tested. (See SWRCB LG-160) t ~o ss SWRCB, January 2002 A FTT T RTCRT? !`fINTATNMTNT CTiMP TFS:TTNC Page ~ of Facili is Not E ui d With Fi11 Riser Containment Sum Fill Riser Containment Sumps arc Present, but were Not Tested ^ Test Method Developed By: ^ Sump Manufacturer ~lndustry Standard ^ Professional Engineer ^ Other (Spec) Test Method Used: ^ Pressure ^ Vacuum ~ Hydrostatic O Other (Specr~) Test Equipment Used: INCON TS-STS Equipment Resolution:.000in. Fill Sum # $ Fill Sum #t"7 l FUI Sum # Fill Sum # Sum Diameter. Sum De the Height from Tank Top to Top of Hi est Pi in Penetration: Height from Tank Top to Lowest Electrical Penetration: Condition of sump prior to testing: Portion of Sum Tested Sum Material: Wait time between applying pressure/vacuum/water and startin test: Arc :~~ Su mY's ~ 0 4:~\ SuM~ Test Start Time: Initial Readin R~): Test End Time: Final Readin R Test Duration: Chan a in Readin R R,): Pass/Fail Threshold or Criteria: Test Result: ^ Pass ^ Fail ^ Pass D Fail ^ Pass ^ Fail D Pass ^ Faii Is there a sensor in the sump? ^ Yes ^ No ^ Yes ^ No ^ Yes ^ No ^ Yes ^ No Does the sensor alarm when tither product or water is detected? ^ Yes D No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No 0 NA 0 Yes D No fl NA W as sensor removed for testi ng? ^ Yes Q No 0 NA ^ Yes D No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Was sensor properly replaced and verified functional after testin ? ^ yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA D Yes ^ No f? NA Commeats - (include information on repairs made prior to resting and recommended o!!ow-up~orfailed tests) I Z~SS SWRCB, January 2002 9. SPILVOVERFILI, CONTAINMENT BOXES Page ? of 8 Facili is Not B tti ed With S iJUOverfill Containment Boxes ^ Spill/Overfill Containment Boxes arc Present, but were Not Tested ^ Test Method Developed By: ^ Spill Bucket Manufacturer B Industry Standard ^ Professional Engineer ^ Other (Sped) Test Method Used: ^ Pressure ^ Vacuum ~ Hydrostatic ^ Other (Sped) Test Equipment Used: INCO r,, . r 3~~ .. N TS-STS tyn~ Spill Box # ~ QreynSpilt Bo= # a~ Equipment Resolution:. oooin . Spill Bor # Spil! Box # Bucket Diameter: ~ pa ~b~' Bucket Depth: ti4'' ly~~ Wait time between applying pressureJvacuum/water and startin test: tv-; r+ 1d 1rr.: r. Test Start Time: p'.~gbn 1~`.t{\ AY+ IU`.~R Ip'.y\ A1n Initial Reading(R~: .990+n •e1 0~• 1.31'i->^ 1.31y~r Test End Time: 1t)`,'3agy.~ 10'.5bgw. It); q \D'. b>Ar Final Reading(R,.): .°lalp-~. :v~ ~.'31~1•-t. ~• W:r Test Duration: ~~j. w.; y~ 1 rJ Ir; r, Change in Reading (Rr-Iir): ,-~ '8„ ~ ~ Pass/Fail Threshold or Criteria: ~q5 S ~pSS Test Resalt: - Pass ^ Fail ass ^ Fail ^ Pass ^ Fail ^ Pass ^ Fail Comments - (include information on repairs mode~rior to testing, and r¢commendedfollow-upforfailed tests) ~z.o 5 S g ~~ SB989 TESTING FAILURE REPORT SITE NAME: C.irG,t ~t,- DATE: ~ "3`" O~D r,DDRESS: \llll. r~~r~ ~e k~w1.1 TECHNICIAN;-~ Q-C~ CITY: 3t~ktxs-field sIGrIATIIRE:~~ti~ K(YDrVt~-~ SZTE CONTACT: THE FOLLOWING COMPONENTS WERE REPLAC&DIREPAIRED TO COMPLETE THE SB989 TESTING. LIST OF PARTSp REP`L~ACED/REPAICRED: ` REPAIRS r Z7~ 1\l~ 1i ~,7~Y1 ~ft~~ ~`A~Ye(y LABOR : ~~p'r,Q,, _ PARTS INSTALLED: NOh-~. l~oSS ...~-- ~;4 i :' _ - _.. - _~4t' in :., .. .ti-•~- _ _.... _ - ,.---- =`~~' iii - - ~nILE:t? ~.' i 5i;~\ ~o- .. ~_95ri~_. IN _ - '~ ~!~ ~=t' _ ,.. ; .... _ Q _ :'. .:t ,..._ ...., ~i~5c _ 71iy~1~ 17CCY's'~. . _~ric 7:r 1•'! iif'I _.. __ _ i~~t IN _~.. ~h:~~~EG' :3., ; _ _ --_ ~ C;r~ti t9£ ti~~E;` _ -~;C~~.1-y84-c GGa SU`r'= ._.~7t•`.. TEST REPO~:T Sri: TE~7 3TiyRTEC' l c~i%?,1i2~9kj6 L.U=_ G,Er,•If•i .493 IN , ENC~ TI."` 16:3 AM EtaD I:!ri fE ~~i•'•:,1!2bb6 ErtU Lrl,~; .4?13 IM ~ !1.092 IIJ ' "'Ai:: I !-!i•:E~HULD -iE`+-- ta'E~ULT FAILEC' ~saa iE'::T `'Trli'•'.TEC. f9: 2:: nM TEST `.>''rit~ 1 Ei~ 01131%'2~?Nb SECIta '•~ *_'.''.fEL ~t.g997 IN. LI`IC? Tii'Ic. f0:,x,$ Ilt'1 ENC' !`'riTE •3'i!31/164~6 cNC' LE~,;EL 0.546x' IN LEAK THRcaHCiLD 6.60'2 Ihi rc ~ r T~_. i i~:ESI ~~ ~ 'E'EL' PN:,_. ~1\ gQ:\\ Rfo~l• t+~'t~ =• T C.ST _Ttti~'.TEi"! 16~ z3 Hf9 TEST '="'if=iRTEU t~f!'ir"i96G ;±EGi}~i LL~JEL 1.3146 I}+ Er!D T it'1E 1rt~38 AP. ENCa LE~!I._. 1..:.145 I1~ l,.t_titi i I-it~-".L SiiCl Ll.' L4. EI'!it IN Tf~ST i"<'.c`JLT PASSEG 0 yj I=ILL DIS i DI•J hcc~ r~E e~~i, 01!~i!'~66r 1: YQ Pt'. SUt'ip LEAK TEST REP>JRT ~~ 5v M;~ ~~ TE=: T STr~RTE~ i : ~~ Pt4 TEST STARTED 61!31!'!606 SEGiN LEUEL 2.s~50,= IN Et•!D TIME 1:4,`i PPt END C±ATE E+1131-~2aa6 Ertn LEUEL ~.6,~~~ rN LEiiK THRESHOLD 6.002 IN TEST RESULT Pr~SSED 41 s=ILL DI f C'IS Sr1GC+ ME 040'2 i-~66-~!~+~-G1hG 01,13.1; 2666 2:63 Pht SUMP LEAK TEST kErJORT DSP?-t TEST STARTED i:4$ F19 TEST STriRTED 01/~f.2006 ;BEGIN LEUEL 2.84;5 IN END TIME z=03 pM END DATE 9f%31!2+66 ENC} LEUEL 2. _:4aE. IN LEnK THRESHOLD 0.602 TN TE'a'T RESULT PASSEC~ I z- ~ S .S ~~1. i-ALC_ ~,I`. L~~' _ bHl,i i hiE FaYP f 1 l~j,'_:j.'~4iklr, tel. Y?~'J' F1C"i C? =;F? -~ TEST STt;RTEU F=?t ~:3'_-'''£~fi6 ~!EL :Et=~It~i LE "'ii3 I:..1 ' ~ _ EF+6 T.Lai~ .ir1~ Fltl 1G7 -_.At; (;-iREEHULU _.~~~U'~ T^( TEST REEISL',' ?ri:~SEC; 3- `1 TEST S f ni?TEu - : `?~• €~P1 TE~,T S 1 r"t6:TED i2 ',"y r"~ Yt!_~h BEfiIht LE~JEL _.?'•"t~=~` its, AND TIt7E .i~:i75 r~t9 ENU [?ATE vljr~.jr20~e• r_r9L~ LEUEL U.Gir`_i IN LEAK THRESHULG F'.4tl~i IN ?T~ T ~ESUL1' FAS~•EL1 C;SF:S-r. TEST t.TriRTED ';: alt At1 TEST STARTED Ei:':il%'20t~t• c~Et=Tint LEt}EL ~#.•aj~s~ 'N ENU TIME 1@:65 APi Ei~tD LEUEL. 4_uit3~ If-~ LEAP. THRESHGLti c.r~t'? ::N TEST RE°~ULT ?riSSEI:~ 91 SILL UIS i ijTt; SACD PiE 94ei7~ 1-300-9is4-6~'b! F1 j : ~; f .''2~tF1~ .a: 4~ ANi SUtt!~ (~At: TE'=T s~EFU<T USFi=? TCST STriRTE"u 9::ia 1117 TE~7 STARTEU J1•':~j=200b oEGIN LEUEL 'G 7??' IN END 7IriE 9:-its Att ENU C?riTE tai%~1%~b66 ENU LE~IEL :.T74 IN i_cAK THRESHOLC~ b.k3@2 IN TE--^_•T RESULT FFSSED 3 ...t JSFt'~.' TEST STryF,TEU 9: ~'; APi TEST STARTED bi%31%'~E•t~9b BEGIN LEUEL 3.6Lti4 IN END TIf1E 9:45 r~M ENU UATE 61%?1128@e. END LEUEL :.6290 IN LEAk: THRE$HuLCi 9,562 IM TEST REstJLT PASSED DSFS-6 TEST STA(~TEU ?: ~3 riM TEST STAP,TED 61%31f206b EEGIN LEUEL 4.4197 IN ENU TIt'iE 9:4~. Ari ENU UATE B1r31%~0bo ENU LEUEL 4.9191 IN LEAK 7HRESHULD O.JFJ2 IN TEST RESULT pAJJEU r Zd SS' .~ r C~ /Ni7/y@0u 4:4a1 PM SUMP LEAK TEST REPORT 57STP TEuT STARTED 3:46 Pht T:E$T STARTED t~4/@7/'20@6 BEGIN LEUEL 4.4362 IN t_ND TIME 4:01 PM END DATE @4/07/2@06 END LEUEL 4.4355 Ito LEliK THRESHOLD 0.002 IN TE~,T RESULT PASSED 94/g7.'2006 4:27 PJ9 SUMP LERK TEST REPOF'T 87STF TEST STARTED 4:02 PM TET cTRRTED 94/07/24305 BEGIN LEUEL 4.436a IN E~hID T I ME 4:17 PM END DATE @4/07/2006 END LEUEL 4.438 IN LERK THRESHOLD 0.@@2 IN TEST RESULT PASSED s, • •UNDERGROUND STORAGE TANK APPLICATION TO PERFORM A TANK TIGHTNESS TEST /SECONDARY CONTAINMENT TESTING ~r _ Bakersfield Fire Dept. ° Environmental Services w/R~ ~rrr~r s 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel: (661)326-3979 ~ ~PjERMIT NO. ~_, ~3~~ IXI TAAII! TI!_NTAICCC TCCT ~ ~I_~~ I-I 1 InIC TCCTWh I1 CFr(1NflARV (`(•1NT41NMFNT TFCTIN(; FACILITY 'ADDRESS i ~ i ~ ~ic~~~ ~e ~-~~; ~.~ F~` ecd ~ C-A G 33~ i OPERATORS NAME PERMIT TO OPERATE NO. WNERS NAME ~Q.UP~ a4Vrvi i~rU s~~.;t NUMBER OF TANKS TO BE TESTED ,., ~ IS PIPING GOING TO BE TESTED YES i.i NO '` TANK NO. CONTENTS VOLUME ~ 2ti,c ~ Unl~cP~.el a ooc~ ~- - U~-~l~.c ~' ~ . ANK TESTING COMPANY i~,-Glx~ c c Seri c c~ S , .~nc MAILING ADDRESS 3755 N - t3us1 • ess C~rt~~~r i~~n~,z ~~cSVh, !~2 ~5"7a5 AME & PHONE NUMBER OF CONTACT PERSON CCj~j~_ r rn~ ~nnme 5~~~~5-G~3~ 0~ sr,~.~a rn~~(~n .,~ ~L~~ EST METHOD ~~ ~~~~ OF TESTER O CIAO0L INSPECTOR '~'U lZ2 r _M~rV ¢.G~ - Will S2i'LG( /YCX ~ ~.>"~'1 rr" W ~Yl'~1F1 CCU CERTIFICATION NO. _ ins 1 ~\ kl? Sn n"f' wL..~-j1 /tu~~t CCt'~1Cit~ DATE & T E TEST IS 70 BE CONDUCTED ~ " "1-o Cle.+~'t M~J'`GIeO -_1,•31 l a1'2Q ~rt~_ Wl'1'i7 r'1U~_lcli .c~t~ . SIGNATURE OF APPLICAN DATE PPROVED BY DATE z~ ~~ fd2063 `===~PRAXAIR Praxair Services, Inc. UST 12,000 gal Gasoline Dispenser • ® Vents Tank I I I• Probe • = Proposed Probe Installation Note: the final determination of the probe placement will be made on site by a CA licensed tank tester after the location of the vent lines, risers without sumps, and fuel lines are confirmed. A site map with exact probe locations will be sent with test results. I I I I I--- '\ i I I Sump \ • i \ i ~ j I Fill • \r~~ ~ /,' 1 1 I ~ \ ,' UST I I 1 I I I ~ \\ • , 12,000 gal I I I I i • \ ~~ Gasoline I I I ~ \ ' I I I ~ • \ ,' I i l l v I I I I i\ O • I I I I \ 1 X11-- ---- ~ j I I I • Sump Tank • I I.1 I Fill Probe I I I I I I 1 I • I I I I I I I I I I I I I 1 I I • I I I I i I I 1 I I I I 1-------~-j-T~-------------------------------------------~ ~•~-------1-~-------------------------------------------1•~ II--------J-~---------------- ~ -------------~---------~I I I I I I I I I I I I Dispenser Dispenser Canopy Support (Typ~) Legend Piping Probes: 1-2' depth, 15' spacing Tank Probes: > or =mid point of tank (typical 10') 10' spacing Tank Ridge Probes = depth of tank top (typical 3') ------- Approximate Pipeline Location N 0 5 10 f e e t Approximate 38717EL-0000 C i r c l e D e l i M a r t 1 4 1 6 G O L D E N STATE A V E N U E H A K E R S F I E L D C A L I F O R N I A S A M P L I N G L O C A T I O N S F i g u r e 1 Reviewed by David Rabb Appro~~~d by Randy Golding Update 9-13-05 Praxair Service, Inc. QA Tracer Tight® Version V-5 Work Plan Site Name Address Site Ci~cie ~~. rY1ux~ 1411n C lden ~ `Coa~~i~ld ~ C,R 38'7 i'`~~L City and State In Service Enhanced Leak Detection Protocol (IS-ELD) (The IS-ELD Method Utilizes an Onsite Site Laboratory for Real-Time Results) Introduction In Service Enhanced Leak Detection (IS-ELD) means a test method which is approved by the California State Water Resources Control Board that ascertains the physical integrity of an underground tank system by introduction, and external detection, of a substance that is not a component of the fuel formulation that is stored in the tank system while the system is in service. The test method is third party certified for the capability of detecting both vapor and liquid phase releases from the underground storage tank system. The Enhanced Leak Detection test method is capable of detecting a leak rate of at least 0.005 gph or less, with a probability of detection of at least 95% and a probability of false alarm no greater than 5%." Concept Tracer Tight° is a unique method of testing underground storage systems for tightness. A unique chemical called a tracer is added to the product stored in the tank. The tracer is an inert chemical that evaporates readily from the fuel. After tracer is added to the system, it is distributed between the. vapor and liquid inside the tank. Use of the system carries the tracer throughout the piping. If any small leak exists in the system, the tracer is allowed to escape from the system, either as a vapor or as a dissolved component of the liquid. Once outside the system, the dissolved tracer evaporates from the liquid and the tracer vapors begin to migrate away from the location of the leak in all directions. After an appropriate waiting period, the tracer vapors are detectable at least ten feet or more away from the leak in all directions. Samples of air collected from the soil within the radius of detection of the tracer reveal the leak as a presence of the tracer chemical. Because the tracer chemical is not normally found in the environment or in fuel products, the Tracer Tight® method is able to discriminate between previous contamination and current leakage. Contractor It is important that before Praxair arrives on site that the tanks are full and that you discontinue future fuel drops till the test is completed. It is not desirable for the station to run out of fuel. If a fuel drop becomes necessary in order to keep the station open then contact Praxair's site proiect manager and schedule the drop while the crew is onsite. A clean fuel drop reduces the possibility of having to retest the site. A contractor capable of repairinsl any exposed component in the system including having spare parts must be onsite to expedite repairs. The contractor skills must include the ability to operate and make adiustments to the settings of the electronics controllins the fueling system. Because of the nature of tracer testing the contractor must be capable and committed to working loneer hours and extended days outside of normal work week. The owners contractor will be in complete control of the fueling system and it is the contractors responsibility to operate the fueling system properly and to reassemble the system back into a pretest configuration. Praxair Service, Inc. is only responsible for testing the fueling system and is not responsible for it's operation. THIS INFORMATION IS THE PROPERTY OF PRAXAIR SERVICE, INC Reviewed by David Rabb Approved by Randy Golding ,Update 9-13-05 Description The process is described in the following steps: • Preparation • Probe Array Installation • Confirmation Test • Inoculation • Leak Simulation • Sample Collection • Analysis • Spill Bucket Test • Reporting Praxair Service, Inc. QA Tracer Tight® Version V-5 Preparation All necessary permits must be acquired and appropriate notices to local regulators must be given prior to arrival at the site. Upon arrival, the crew reviews the tank information that has been made available and uses this information to plan the installation of the sampling probe array. If "as built" plans or site plans have not been made available, the crew inspects all accessible portions of the system to learn as much as possible about the location of all UST system components. If the site is under remediation, soil vapor extraction systems, air-sparging systems and bio-venting systems must be turned off during the test. Groundwater measurements are to be taking within the tank excavation zone. Probe Array Installation The following ELD probe installation was approved by the California State Water Resources Control Board. Vertical PVC sampling probes are installed within eight horizontal feet of all possible leak locations (a maximum of 15 feet apart). In situations where tank pits and piping trenches do not contain engineered backfill (sand or pea-gravel), the sampling probes are installed with a maximum 10-foot spacing. Tank probes are installed along the side of each tank, generally at a depth centered on the tanks. Maximum probe depth is 15 feet (or just above the water table if applicable). Additional probes are installed near any appurtenances along the tank ridge where a containment sump is not present. Piping probes are placed along the product distribution, vapor recovery and vent piping trenches, to one half the depth of the piping or until the end of the probe is within engineered backfill. Probes are generally installed at a depth of 1 to 1.5 feet below grade. Probes are installed by coring a hole in the pavement and inserting a sampling probe into the excavation zone of the tank or pipe using soft install technique. Lowering and/or wiggling the probe into the backfill as the backfill material is being evacuated through the center of the probe by a high volume vacuum pump, completes the soft install. Upon installation, the top of each probe is fitted with a PVC sampling cap that will allow access for the collection of samples. Confirmation Test Confirmation Test (Pre-certification tightness test) is completed before the system is inoculated. The test is used to confirm the tightness of all the accessible fittings. This is done to ensure that the facility is tight before adding the tracer. A repair technician should be on site with all tools and parts to complete repairs to any and all components that are accessible. The technician should be qualified/certified to program and operate the electronics controlling the fueling system. Inoculation Inoculation is the process of adding chemical tracer to the product in the system to be tested. Product is inoculated with a predetermined amount of tracer, though the fill riser. Tracer is mixed by circulating the product using the turbine pump and a tracer mixing apparatus or by adding product to the tank. Once sufficient amount of tracer labeled product has been moved through each dispenser, the product is tested at each dispenser to confirm that tracer is present. By keeping the dispenser nozzle inside a receiving container, additional product is pumped into the container to push tracer labeled vapors through the vapor return piping back to the tank. The tracer/vapor mixture is then pushed from the UST out to the vent riser into a container of sufficient size that the tracer/vapor mixture has displaced the entire volume of the vent piping. The concentration of the tracer in the receiving container is then measured. THIS INFORMATIONIS THE PROPERTY OF PRAXAIR SERVICE, INC Reviewed by David Rabb Approved by Randy Golding ,Update 9-13-OS Leak Simulation Praxair Service, Inc. QA Tracer Tight® Version V-5 Injecting a tracer into the backfill performs a leak simulation. The leak simulation tracer is not one of the tracers used in testing the system. The migration period of the leak simulation tracer is monitored through the sampling probes. The minimum migration time required for the test is equal to the time required for the leak simulation tracer to move an acceptable distance. The minimal acceptable distance is the longest distance that the test tracer would have to travel from any leak location to the location of a sampling probe. Sample Collection Once the leak simulation migration period is determined satisfactory the inoculation and waiting period is completed and sampling can begin. Vapor samples are collected from all sampling probes. Additional vapor samples may be collected from sumps containing UST components, UDC's and from the interstitial spaces of double walled components. Sample Analysis Samples are analyzed using an on site laboratory grade gas chromatograph (GC). The GC is calibrated using an external gas standard. Samples are analyzed by direct injection into the GC. The results are evaluated by comparison to the analytical standard. Whenever tracer is detected in the subsurface samples, blanks are run to validate the tracer detection. Spill-Bucket Testing Over-spill-buckets are tested hydro-statically. A decrease in water level indicates a leak. If leaks occur, spill bucket seals should be repaired or replaced. Reporting The findings of the Tracer Tight° ELDT"' test and site evaluation will be summarized in a written report and sent to the client within two weeks of the completion of the fieldwork. All data acquired from probe and sump samples will be reported along with spill bucket hydro-test results. For questions or assistance contact: David Rabb Praxair Services, Inc 3755 North Business Center Drive Tucson, Arizona 85705 Tucson Office 520.545.0250 Ce11520.906.5474 Tucson Fax 520.293.1306 David Rabb@Praxair.com Contractor TNIS INFORMATION IS TKE PROPERTY OF PRAXAIR SERVICE, INC - ~RA~Ci4/R Praxair Services, Inc. Tracer Tight•Probe Installation Detail 3" Hole with Concrete Fill C Probe Plug ~C Probe Cap Coupling Plug -Ring ~e -_~~ Standard Tracer Tight Probe Installation Detail in Concrete AirllNater Tight Caulking Seal (Polyurethane Sealant) 1.5" Hote in Concrete Praxair Services, Inc. PVC Probe Plug ^ ":=~~PRAXAiR ~~~ Services, Inc. Surface Concrete Probes . ~ ~~~~ . . ,.. ~~~n Y. ~' ~ ~ lira ;z.. 5 ~- - 4' • . ~~ ~. :~ ~ : ~- 10, a.; ~ . . ,N Y J ~ ~3 a ~;o ~ ~..% , ~. ~ 3x a Art x ~ ` ~~` ~~~~ ~ Tank 1 Tank 2 Tank 3 Y :.. r .S ~•~~Y `~~~ ~ 8' Dia 8' Dia. 8' Dia. Y .. ~ ~~! dE> C~ :ASA ~ ~ . frt. # ~ ~ t.~a { `" n *a >zS •vcx * . . . x s. .-. :.^.y Gravel ~~ ~ • ~ .M1 ~ S ..t.'Yt' iR ~ ~# K ~, ` + ~ u.il ~ h c~ :.'.k, v ~ ~ ~ A Y A 9 a } It S P rt:. Y ~ „ ,~Fc.u ft. „ ~ ~ y ~ r 5' . '~ ' k.R:i X~.'" - X3' 1 .~".~L .r .. .w c t . ~.. "YCt ~s. i * ~ R M n ~ .. . i ~ ..~ ~ 'R ;. ~ ~ ~. r~•n2. x2k5 WawrY M. !~. .~ ^ ._. .. . .. 3.S N .. Cross Section of Tank Farm u, E R S F I F/RE ARTM December 1, 2005 RONALD J. FRAZE Circle Deli FIRE CHIEF 1415 Golden State Bakersfield, CA 93301 Gary Hutton, Senior Deputy Chief FINAL REMINDER NOTICE Administration ~ RE: Necessary Secondary Containment Testing Requirements by 326-3650 ~ December 31, 2005 of Underground Storage Tank (s) Located at Deputy Chief Dean Clason i the Above Stated Address Operations/Training 326-3652 Dear Valued Customer, Deputy Chief Kirk Blair ~ Over the last six months this office has continued to send reminder notices regarding Fire Safety/Prevention Services secondary containment testing. 326-3653 Code requires that all secondary containment systems must be tested 6 months post construction and every 36 months there after. 2101 "H" Street ! Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Bakersfield, CA 93301 ~ Health & Safety Code) of the new law mandates testing of secondary containment OFFICE: (661) 326-3941 ~ components upon installation and every 36 months, thereafter, to insure that the FAX: (661)852-2170 ` systems are capable of containing releases from the primary containment until they are detected and removed. Our records indicate that your facility is due prior to December 31, 2005. RALPH E. HUEY, DIRECTOR PREVENTION SERVICES Those sites that have not been tested and have not pulled a permit prior to December 31, FIRE SAFE7YSERVICE3•ENVIRONMENrALSERVICES j 2005, will have their permit to operate revoked. 900 Truxtun Avenue, Suite 210 This office does not wish to take such action, which is why we will continue to send monthly Bakersfield, CA 93301 reminders. OFFICE: (661) 326-3979 FAX: (661) 852-2171 ! Contractors are already booked several weeks in advance. 1 urge you to schedule your testing date as soon as possible to avoid possible revocation of your permit to operate. David Weirather Fire Plans Examiner Should you have any questions, please feel free to call me at (661) 326-3190. 326-3706 '~ Sincerely, Howard H. Wines, III ~ RALPH Fm HUEY, Director of Prevention Services Hazardous Materials Specialist ! ? ' ~ 326-3649 ~ / f ~1 l .. ~ Steve Underwood j Fire Prevention OfFcer SU:db B AI E R S F I F/RE ARTM T RONALD J. FRAZE FIRE CHLEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Prevention Services 326-3653 February 17, 2006 Mr. Steve Armburster Circle Deli Mart 1416 Golden State Avenue Bakersfield, CA 93301 Dear Mr. Armburster: Per your request, I have verified that you currently meet all regulatory compliance for the above-mentioned facility. However, our records do show that your facility will be due for your three year cathodic protection certification on July 1, 2006. 2101 "H" Street It is our understanding that your facility is in the process of being sold. Please Bakersfield CA 93301 remind the new owner that he has 30 days from date of transfer (new owner) to , complete Forms A, B, and C Statement of Financial Responsibility, Written OFFICE: (661) 326-3941 Routine Monitoring Plan and Unauthorized Release Plan (enclosed). This office FAX: (661) 852-2170 would be more than happy to assist them in completing these necessary documents. RALPH E. HUEY, DIRECTOR PREVENTION SERVICES FIRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 OFFICE: (661) 326-3979 FAX: (661) 852-2171 David Weirather Fire Plans Examiner 326-3706 Howard H. Wines, III Hazardous Materials Specialist 326-3649 If I can be of further assistance, please feel free to contact me at 661 - 326-3190. Sincerely yours, Ralph E. Huey, Director of,Prevention Services C~~~ ~ ~~ 1 By: Steve Underwood, Fire Prevention Officer REH/db Enclosures (3) D ~4'B E R_S F I D F/RE April 10, 2006 ~RrM r Ms. Mercedes Penarejo Circle Deli 1416 Golden State Bakersfield, CA 93301 RONALD J. FRAZE REMINDER NOTICE FIRE CHIEF Re: Guidelines for Unsupervised Dispensing Gary Hutton, Senior neputy Chief Dear Ms. Penarejo: Administration 326-3650 It has come to our attention that many convenience stores who sell gasoline, like yourselves, are closing late at night. If you are using card readers and leaving Deputy Chief Dean Clason your fuel pumps on, this is defined in the California Fire Code as: "Unsupervised Operations/Training Dispensing." 326-3652 Deputy Chief Kirk Blair Unsupervised dispensing is allowed when the owner or operator provides, and is accountable for daily site visits, regular equipment inspection and maintenance, Fire Safety/Prevention Services including any unauthorized i`elease or spills, posted instructions for safe operation 326-3653 of dispensing equipment, and posted telephone numbers for the owner or operator. Signs prohibiting smoking, prohibiting dispensing into unapproved 2101 "x" Street containers and requiring vehicle engines to be stopped during fueling shall be Bakersfield, CA 93301 conspicuously posted within site of each dispenser. OFFICE: (661) 326-3941 In addition, a sign shall be posted in a conspicuous location reading: FAX: (661) 852-2170 In case of spill or release: RALPH E. HUEY, DIRECTOR 1) Use Emergency Pump shut-off PREVENTION SERVICES 2) Report the accident FIRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 3) Fire Department Telephone Bakersfield, CA 93301 4) Facility address OFFICE: (661) 326-3979 FAX: (661) 852-2171 During the hours of operation, stations having unsupervised dispensing shall be provided with a fire alarm transmitting device. A telephone not requiring a coin to David Weirather operate is acceptable. The fuel leak detection system must have a remote or Flre Plans Examiner phone modem to insure off-site monitoring during hours of unsupervised 326-3706 dispensing. During hours ofi darkness, sufficient lighting must be maintained so Howard H. Wines, 111 that all signs associated with fueling operation are conspicuous and readable. A Hazardous Materials Specialist gallon container of an absorbent material used for spills must be made available 326-3649 to the public during hours of unsupervised dispensing. Afire extinguisher with a minimum 2A, 2B, and 2C rating must be located on dispenser island during hours of unsupervised dispensing: To: Mailing List of Valued Customers ~f Reminder Notice Re: Guidance for UnsupF used Dispensing April 10, 2006 Page 2 If you are currently having hours of unsupervised dispensing, you must comply with the above-mentioned requirements. . Starting April 15, 2006, this office will conduct random checks of a!l fueling stations within the city limits for compliance. If you shut your station down after normal business hours and are not pumping fuel, please disregard this reminder notice. Should you have any questions, please feel free to call me at 661-326-3190. Sincerely, Ralph E. Huey, Director of Prevention Services -~ ~~,,,~ ~~ By: Steve Underwood, Fire Prevention Officer REH/db