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Home My WebLink AboutBUSINESS PLAN 2/2/2007~ ~ pEASTHILLS MOBIL ,_ ~~2524 OSWELL STREET '~ ~-,_~ --II - -- ----- - --- ~ ~. _ _ - ~s 7 / ~l0 EAST HILLS MOBIL Manager ~., O (~/V (9-- ~~~~ Location: 2524 OSWELL ST City BAKERSFIELD CommCode: BFD STA 08 EPA Numb: BusPhone: Map 103 Grid: 23B SIC Code: DunnBrad: SiteID: 015-021-002469 (661) 345-6208 CommHaz High FacUnits: 1 AOV: Emergency Contact / Title Em rgency Contact / Title LOUNG CHAO / OWNER ~ O~/~/~ C~14'(~ / OFFICE MANAGER Business Phone: (661) 836-3766x Business Phone: (661) 393-8828x 24-Hour Phone (661) 345-6208x 24-Hour Phone (661) 319-8828x Pager Phone.: ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire React ImmHlth DelHlth Contact LOUNG CHAO Phone: (661) 345-6208x MailAddr: 2524 OSWELL ST State: CA City BAKERSFIELD Zip 93306 Owner LOUNG CHAO Phone: (661) 836-3766x Address 5609 STINE RD State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif ~ d: RSs : No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK PROG U - UST FNT~ ~~ a ~ Based on my inquiry of those individuals 1 certify information i th < ,2~ ~~~~ , e ng responsible for obtain f law that I have per~analty under penalty o e~camined and am familiar with the infprrnation submitted and believe the information is true, accurate, and complete. Sig t - -1- 01/30/2007. F EAST HILLS MOBIL SiteID: 015-021-002469 ~ - STORAGE CONTAINER DATA (UST FORM A) Last Action. Type: FACILITY/SITE INFORMATION Business Name: EAST HILLS MOBIL Cross Street Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper ICC Nbr: -- P RT ER FORMA N Name Address: City Type INDIVIDUAL Name Address: City Type INDIVIDUAL BOE UST Fee# Financ'1 Resp: SELF INSURED Legal Notif Date:02j13/2004 Name:LOUNG CHAO State UST # ROPE Y OWN IN TIO Phone: (661) 393-8828x State: Zip: TANK OWNER INFORMATION Phone: (661) 393-8828x State: Zip: Phone: (166) 124-07 x Ttl:OWNER 1998 Upg Cert#: -2- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz~ EPA Hazards Frm DailyMax Unit MCP SULFURIC ACID (BATTERIES) F R IH L 22.00 GAL Hi PREMIUM UNLEADED GASOLINE L 12000.00 GAL Mod UNLEADED GASOLINE F IH DH L 12000.00 GAL MOd DIESEL L 5000.00 GAL Low USED OIL F DH L 550.00 GAL Low USED OIL FILTERS F DH S 200.00 LBS Low USED ANTIFREEZE IH DH L 55.00 GAL Low ANTIFREEZE L 30.00 GAL Low MOTOR OIL F DH L 750.00 GAL Min WASTE BATTERIES IH L 4.00 GAL UnR -3- 01/30/2007 -4- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME SULFURIC ACID (BATTERIES) Days On Site 365 Location within this Facility Unit Map: Grid: SERVICE BAY/STOREROOM CAS# 7664-93-9 Liquid TMixture ~AmbRent~E ~ AmbientT~E IN MAOCHINE/EQUIPPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 1.00 GAL 22.00 GAL 22.00 GAL - t1E~GAKLVUJ 1:V1~lYV1VL"1V1b %Wt. RS CAS# 26.00 Sulfuric Acid (EPA) No 7664939 riAGl-1KL A~ SL'~~J1~1tS1V"1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH / / / Hi ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Location within this Facility Unit NW OF STATION Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 3000.00 GAL I1fiGEiCtLVUJ l,Vl~lt'V1VI;iV l~J %Wt. RS CAS# 100.00 Gasoline No 8006619 t1HGtiKL 1-x. 7 ~ L' .7 J1~1L' 1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Mod -5- 01/30/2007 F EAST HILLS MOBIL ~ Inventory Item 0005 COMMON NAME / CHEMICAL NAME UNLEADED GASOLINE Location within this Facility Unit NW OF STATION STATE TYPE PRESSURE Liquid TMixtur~mbient SiteID: 015-021-002469 ~ Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# 8006-61-9 TEMPERATURE CONTAINER TYPE Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 12000.00 GAL 12000.00 GAL 4000.00 GAL nt~Gxtc.uvu~ ~urirvlv~lvl~ sWt. RS CAS# 100.00 Gasoline No 8006619 tiHGL~tCL f~J JL' ~ J1~1L' 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0010 COMMON NAME / CHEMICAL NAME DIESEL Location within this Facility Unit Facility Unit: Fixed Containers at Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE Liquid. TMixture i Ambient TEMPERATURE CONTAINER TYPE Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 5000.00 GAL 5000.00 GAL 5000.00 GAL rit~Gl-11.[LVU~ ~uinruiv~ivla %Wt. RS CAS# 100.00 Fuel Oil No. 1 No 70892103 riHGL•i.tCL x~ ~n~arir,lvl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low -6- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME USED OIL Days On Site 365 Location within this Facility Unit Map: Grid: W OF SERVICE BAYS CAS# 221 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest .Container Daily Maximum Daily Average 55.0.0 GAL 550.00 GAL 200.00 GAL HAZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Waste Oil, Petroleum Based No 0 riHGI-~K1J f~551'~SS1~1JJ1V'1'~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low ~ Inventory Item 0008 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME USED OIL FILTERS Days On Site 365 Location within this Facility Unit Map: Grid: SW CRNR OF SITE CAS# 221 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid Waste Ambient Ambient DRUM/BARREL-NONMETAL AMOUNTS AT THIS LOCATION Largest Con55100rLBS Daily 200100m LBS I Daily 100r00e LBS rlti~r~tc.l~vu~ ~vrirvlv~iv 15 oWt. RS CAS# Waste Oil, Petroleum Based No 0 tiHGl-11.[L f'i~ J1;a~1~11;1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Low -7- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME USED ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: RECYCLER CAS# STATE TYPE Liquid TWaste = PRESSURE TEMPERATURE _ Ambient ~ Ambient AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 55.00 GAL 55.00 GAL Daily Average 25.00 GAL riHGH.ttLVUJ 1:V1~lYV1VI;1V 1.7 %Wt. RS CAS# Ethylene Glycol No 107211 riAGHtCL HJ 5iSa71~1iS1V17 TSecret RS BioHaz ,Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Low ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: SERVICE BAY/STOREROOM CAS# STATE TYPE ~ PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture I Ambient ~ Ambient ~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 30.00 GAL 30.00 GAL' ru-~atucLVUa ~vl~lrviv~lyl5 °sWt. RS CAS# 100.00 Ethylene Glycol No 107211 riHGHKL ADJI;JJI~1L'1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies / / / Low CONTAINER TYPE _ DRUM/BARREL-METALLIC -8- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: SERVICE BAY/STOREROOM CAS# 8020835 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture Ambient ~ Ambient ABOVE GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 240.00 GAL 750.00 GAL 325.-00 GAL ns~c~s-ucLVUa ~.vrirvlv~lvl~ %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 riHL,KKIJ AS JL~JJ1v1151V"la TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0009 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME WASTE BATTERIES Days On Site 365 Location within this Facility Unit Map: Grid: TRASH ENCLOSURE CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 1.00 GAL 4.00 GAL 2.00 GAL HAZARDOUS COMPONENTS ~ r- %Wt. RS CAS# tit~~rj.rcL e~,aa~~~i~i~lvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / UnR J~ -9- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/03/2006 ~ CALL 911 LOUNG CHAD WILL NOTIFY THE STATE AND LOCAL AGENCIES WITHIN AN APPROPRIATE TIME FRAM, UNLESS THE SITUATION REQUIRES URGENT IMMEDIATE RESPONSE BY THE AGENCIES, IN WHICH CASE THE DEALER SHOULD NOTIFY THESE AGENCIES. LOCAL AGENCY: BAKERSFIELD FIRE DEPT OFFICE OF ENVIRONMENTAL SERVICES 326-3979; CALIFORNIA OFFICE OF EMERGENCY SERVICES; 800-852-7550 (24 HOURS); LOCAL POLICE AND FIRE DEPTS 911 Employee Notif./Evacuation 06/05/2006 VERBALLY ANNOUNCE TO ALL PERSONS AT THE SITE: "THERE IS AN EMERGENCY. PLEASE TURN OFF YOUR ENGINES AND LEAVE THE STATION ON FOOT IMMEDIATELY." ALL EMPLOYEES MEET AT THE EMERGENCY ASSEMBLY AREA. Public Notif./Evacuation 06/05/2006 VERBALLY ANNOUCE TO ALL PERSONS AT THE SITE: "THERE IS AN EMERGENCY. PLEASE TURN OFF YOUR ENGINE AND LEAVE THE STATION OF FOOT IMMEDIATELY." ALL EMPLOYEES MEET AT THE EMERGENCY ASSEMBLY AREA. Emergency Medical Plan 06/05/2006 KERN MEDICAL CENTER, 1830 FLOWER ST, 326-2667, IS THE NEAREST DESIGNATED TRAUMA CENTER. -10- 01/30/2007 ---> F EAST HILLS MOBIL SiteID: 015-021-002469 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 06/05/2006 ALL REQUIRED VAPOR RECOVERY AND SPILL PREVENTION EQUIPMENT IS INSTALLED. SHOULD A SPILL OR FIRE (OR OTHER EMERGENCY) OCCUR WE WOULD FOLLOW THE FOLLOWING PROCEDURES: NOTIFY FIRE DEPT; EXTINGUISH FIRE, IF POSSIBLE; TURN OFF POWER; EVACUATE; NOTIFY UNOCAL; AND REPORT. ABOVEGROUND AUTOMOTIVE PRODUCTS ARE STORED IN UNBREAKABLE CONTAINERS AND IN MINIMUM QUANTITIES. THE .UNDERGROUND STORAGE TANKS ARE MONITORED USING AN APPROVED MONITORING METHOD TO DETECT LEAKS. ALL EMPLOYEES ARE TRAINED IN THE SAFE HANDLING OF HAZARDOUS MATERIALS. 9 9 = Release Containment 04/02/2003 INSPECTION TO BE CONDUCTED BY DEALER, SECONDARY CONTAINMENT MONITORING PROCEDURE, RECORD KEEPING FOR SECONDARY CONTAINMENT, ELECTRONIC MONITORING SYSTEMS. Clean Up 06/05/2006 SMALL SPILLS: ABSORBENT MATERIAL; LARGER SPILLS: REPORT TO TERMINAL BY DEALER OR DELIVERY DRIVER. SPILLS SHALL BE CLEANED UP WITHIN 8 HOURS. DEALER SHALL RECORD ALL SPILLS OVER 1 GAL. ANY SPILL OVER 1 GAL SHALL BE REPORTED TO LOCAL AGENCY OR CALIFORNIA OFFICE OF EMERGENCY SERVICES. V1..11C1 iCC .7 Vt111:C I'il~l.1 VC1L1V11 -11- 01/30/2007 F EAST HILLS MOBIL SiteID: 015-021-002469 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ J~lC ~:1Q1 nasal ua Utility Shut-Offs ,.. , i•ilc rlv~.c~.. /tavai.~. vra~.cl Building Occupancy Level 04/03/2006 ~~//~ EMPLOYEES t~ -12- 01/30/2007 x i e F EAST HILLS MOBIL SiteID: 015-021-002469 ~ Fast Format ~ ~ Training Overall Site ~ ~ Employee Training 06/05/2006 ~ MSDS SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES MUST BE GIVEN THIS TRAINING BEFORE STARTING WORK, AND REFRESHER COURSES MUST BE PROVIDED ANNUALLY. RECORDS MUST BE KEPT TO SHOW WHEN EACH STATION EMPLOYEE WAS GIVEN HIS/HER SAFETY TRAINING. rciyC a riciu iVi i~u~.uic vac nC11.1 1Vl PUI..uLC VAC -13- 01/30/2007 r: ~ 1: + EAST HILLS MOBIL ____________________________________ SiteID: 015-021-002469 + Manager BusPhone: (661) 345-6208 Location: 2524 OSWELL ST Map 103 CommHaz Moderate City BAKERSFIELD Grid: 23B FacUnits: 1 AOV: CommCode: BFD STA 08 SIC Code: EPA Numb: DunnBrad: +______________________________________________________________________________t Emergency Contact / Title Emergency Contact / Title LOUNG CHAO / OWNER / OFFICE MANAGER Business Phone: (661) 836-3766x Business Phone: (661) 393-8828x 24-Hour Phone (661) 345-6208x 24-Hour Phone (661) 319-8828x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Reac t ImmHlth DelHlth Contact LOUNG CHP:O ~ -- Phone: (661) 836-37-66x MailAddr: 5609 STINE RD State: CA City BAKERSFIELD Zip 93313 Owner LOUNG CHAO Phone: (661) 836-3766x Address 5609 STINE RD State: CA City BAKERSFIELD Zip 93313 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - COMM HOOD PROG H - HAZ WASTE GEN PROG T - ABOVEGROUND STORAGE TANK PROG U - UST BaSQd ~n my lh~uiry eff thc?a~~a rieltvJdualS responelbi~ fpf ~btai-~In~ tIAW IYI~f~Pf~1~4i@n, f certify under penalty cif I~~ that I I~av~ personally examined and am far~lll~tr wltfl tP~e in4arrnation submitt®d and believe tMe information Is true, accurate, and complete, / ~--~~ Dat ~N~~ ~i, ~/~ ~ ~ , ~QQ~ -1- 04/03/2006 T f~ •~= ;~ _ Prevention Services UNIFIED PROGRAM INSPECTION CHEC'r~LIST€ e E R s F. 0 9ooTruxtunAve., suite2lo _ -._. ~-_ ~_ _--.__~ __ - . _ _ _ _~-_ ~ ~ FARE Bakersfield, CA 93301 SECTION 1~: Business Plan and Inventory Program~j~ Tel.: (661) 326-3979 Is ~ Fax: (661) 872-2171 FACILITY NAME INSPECTION DATE INSPECTION TIME ~ ~- s-r ~ ~ cis mv.~ - L ~ >o Jz.c,~ a =t y L;~ ~ ADDRESS ` HON~ryE NO. r ~ O OF EMP YEES Z.. p S ~o E ~-t- 2 / FACILITY CONTACT BUSINESS ID NUMBER 15-021- ~ ~~ ~ , j ~ect)on 1: Eiusiness Plan and Inventpry Prog~a~n ^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ ^ APPROPRIATE PERMIT ON HAND G Q.M~ ~-T ~l~l ~ ,~ ^ BUSIn2SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~"~ T ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ a. ~ VERIFICATION OF MSDS AVAILABILITY {~ K.c"+ c~~ ~C>:~ N E ~ M 5 l~s S mot, ~ e ~ ~~~/"~ ^ VERIFICATION OF HAZ MAT TRAINING D ^ ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES O L~ ^ EMERGENCY PROCEDURES ADEQUATE . O ~ ^ CONTAINERS PROPERLY LABELED V V J f" -~ ^ ~IOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND 6 nor-Dula ANY HAZARDOUS WASTE O SITE? ~7 "ES O ~ EXPLAIN: ~ ~ ~ I QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1s` In /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09/05 S ,, 1 ~~~ INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM -- UNIFIED PROGRAM INSPECTION CHECKLIST ~' ~~ B III E R S F I L D F/IPE ARTM T FACILITY NAME: EA~~ ~~~-1--S M©t3i~ Section 2: Underground Storage Tanks Program INSPECTION DATE: 9~~ L~ ~6 ^ Routine Combined ^ Joint Agency ^ Multi-Agency ^ Complaint ^ Re-Inspection Type of ank 37~ ~~~ 'a*~ Number of Tanks '~ Type of Monitoring \9 E G ~ QresC' Type of Piping ~~w1~.~ v~1\•~. ~~-~a 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 (t7 Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ~ No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank Aggregate Capacity Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: `~~"'~ ' 1'' Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Pink -Business Copy 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 KBF-7335 FD 2156 (Rev. 09/05) _ _.cJ,y /S-. s 1 ~j o6 ~ . f•'Ii~E~ I L 524 i) ;IaIL:LL. 5.7.. Br~};ER:~FI1:1.D C~ =is;U6 t~i'T_'6. ;%I]LIE; 1 :.. 1 c. HN1 ,, i._ .t , ~~',: ~TEP9 ~T~ l U ~ RLL•t+I','1 riLt. FI.INi~'T1 C?tv.~; f`JURNIr`3I.. `C~ : Uh1L1=:~;L~~E:(~ ^,~ ~ !(°IE _ '111;5 uriLS ULLH~~E - 'r"!gib ~3~'~Lti r~jl~.;a UI_Lr=;GE- G4'`5 i:~~L.S T~' 1?s~I.l.ll•'lE = 7i~11 U ~ar~L`ti ~rE I GHT - 54 .3a 1 PJCHF~; l.Jf~TEk 1..+i?I. - ll SAL 4•JA'TER = U . LIU I NCHE Itf3LUNiE _ ~Q55 GriLS ULLr~GE - 8195 ~~HI.S a0."•U LILLrai>~`•= 7:~aU GraLA~ Ti_ ~.+~fLIJNIE = 3[I'~4 i~€;L5 HEI~~HT = '~".'33 INC:HES Wr~TER 11U5L = 0 i raLti l,Jf,TEk = U . OU I NCHE 'T'EMP = 7 ~l . U UE~ ~ 1= V~~L.UI^'IE _ ' .E..:'S GF3L.a y[C>~ IILL.HGE= r."1711 i.-;i~L 'Ti: V~;1..1 if°lE _ -~`.~~~'? Gr1L: HEI,::H'1' _ :31.E-! I1~1i~HE.3 lnlr3TEk -- CI , [IU 1 IJCHEA ri ~ EPJD * n '~" t _ _ ~{ BASERSFIELD FIRE DEPT ~ - `~ ~ Prevention Services IDNIFIED PROGRAM INSPECTION CHECKLIST ~ ~~~~ 900 Truxtun Ave., Sulte 210 a~,.:.~,.F,:~~,~~:.v~:~,Y, .... <., F .,:-„ :. ,, r.. -:u-...- -: -. ..,.:-, ..., .,. - :, :. ,:-.~ :_.:_ .. ~: ~~>r~r Bakersfield, CA 93301 .SECTION 1: Business Plan and Inventory Program ~ Tel.: (661) 326-3979 > J A ~ ~ ) ~ ~ /~ Fax: (661) 872-2 i 71 FACILITY NAME 6 NSPECTION DATE ~ NSPECTION TIME s r ~ ~~~ ADDRESS HONE NO. O OF EMPLOYEES ^~ C~~~ FACILITY CONTACT USINESS ID NUMBER (~ 15-021-Q~j 6 Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSIfiBSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ~"'~ ^ VERIFICATION OF INVENTORY MATERIALS ~~ ^ VERIFICATION OF QUANTITIES (~' ^ VERIFICATION OF LOCATION ~" ^ ~'' ^ PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSOS AVAILABILITY ~---^ VERIFICATION OF HAZ MAT TRAINING ~Itl~eD I+ ~q J ~j ~~' ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES off--"^ EMERGENCY PROCEDURES ADEQUATE tom-- ^ CONTAINERS PROPERLY LABELED ~. D HOUSEKEEPING ^ FIRE PROTECTION SITE DIAGRAM ADEQUATE & ON HAND r ~5 i i A/ SLiL~~~ ~--~-~ if ~ -- l ,t.o E,yzF~,~r~ ~Ir.°-~i c,c,,~~c ~(~c~1 zv b>=->!;<<+'~~. ANY HAZARD`O~US WASTE ON~aSITES ~~$ ^ NO EXPLAIN: ~Zr.~l~`_L-!.T~-Fih~~7,11u~2 - - ~ ?~'.~~-a6 ~--`~~.SS.,Q~G.?%---- - QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (861) 926-3879 rn v 7 ~' ~ ir~oY~,~ C~`~eti Ins or (Please Print) Fire Prevention / 1" In ! Shitt of Site/Stetion k ` Business Site/School Site Responsible Party (Please Print) ~l- G~ .. White -Prevention Sarvieea Yellow -Station Copy Pink - Suainesa Copy FD2048 (Rw. 02/05) 44~' T~ ~\ CITY OF BAKERSFIEI.U F IRE DEPARTMENT ~~ ~ F ~~ OFFICE OF ENVIRONMENTAL SERVICES ~`~ y.' UNIFIED I'ROGRAIVI INSPECTION CI~ECKl.IST \~'w ~gti,,~'~~ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 .~~~~ FACILITY NAME / /~~-f/~I ~Ylob,/ ~ INSPECTION DATE~b~~ Section 2: Underground Storage Tanks Program ^ Routine ombined ^ Joint Agency ^ Multi-Agency3 ^ Complaint ^ Re-inspection Type of Tank ~1~0~~~ „v.,6!'L. Number of ~l'anks Type of Monitoring .~ll bA2ty Type of Piping ~K61f w~~~ OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on the Permit fees current Certification of Financial Responsibility ~~ Monitoring record adequate and current /Jlsa /~ow~/L ,~u7Z-vn/ ~~~ ~eLS /ACa o~ Maintenance records adequate and current f7t ~~,6fQ~lD maws' ?gam 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 overfill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: ~/If ~~7~ Oflice of Environmental Services (661) 326-3979 ~'hitc - f-nv. Svcs. Pink -Business Copy b '~ o..r(1C-s~ Business Site Responsible Party w ± e v--~+ it a m ~ I t h'1\,E 1 I. 1:`H};IF:~~t' [ k=:f_.Li ;ri 9:;~i Ur=, . .. ,IHf`J ~iLl, --_'I.Ilif; 1'x:16 r;h'9 . NL.L F UhJGT I t_'hJt~ IVUi Iia°lAL' I N1?EhJT±>R';' kEI-'rJRT ! T I:IIfdI_EF~L)F.Li ' ~iLl°, Lii.I.~;UE= ?5ya GALh ' Ti:~ vi 51.15r°1E = 594' i=,AL~~ HEIGHT' _ ~?.4i:t IhJ~:HE: I.Jri'I~F'F; ''.'t?L: = D GHL~ inINTP,R = u.OLi INC:HE:=~ ' TEMP = 5E, . 1 LiEi.; F '1' :? : PREPS I L4°I LILLr=tiE = y~1i1~ ~~~L.:~~ 9il%„ IILL.F;~'_F'= ~'~'`~3 GfiiLS Ti'. 5,?C:~LUf"lE _ '.-~.13~ C.riL.~ HEIGHT = '~1.6~r IfV~HF= [:,Ii-1TE}c 1? 4~L = 0 Gi~LS ' tr,I;~TEF' _ U . LILI I NGHE: TEf°1F = 6'~ . 6 DEG F .L~iiE _ UI ??Sy i_;;L . `I'C 1?t?LUI"1E = 3?FBI i~~HL.S J ' HE 1 i; HT = ;~'~ . 5 ] I I'JG HE~i [,,INTER ~~' = 0 , 00 I IVC.HEti, 'LEP'iP = G5 . ~ DEG F' r, > ., _ . r i F/RE ARTM RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Preveniion Services 326-3653 2101 "H" Street Bakersfield, CA 93301 OFFICE: (661) 326-3941 FAX: (661) 852-2170 RALPH E. HL1EY, DIRECTOR PREVENTION SERVICES FIRE 8AFETY SERVK:ES • 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 March 31, 2006 Mr. Loung Chao East Hills Mobil 2524 Oswell Street Re: Failure to Perform /Submit Annual Fuel Monitor Certification 1'~TOTICE OF VIOLATION & SCHEDULE FOR COMPLIANCE Deaz Loung Chao, Our records indicate that your fuel monitor certifications is due/past due on 03-28-06. You are or will be in violation of Section 2638(a) California Code of Regulations, Title 23, Division 3, Cha}~ter 16. "All monitoring equipment shall be installed, calibrated, operated and maintained it] accordance with manufacturers instructions, and certified every 12 months for operability, proper operating condition, and proper calibration." Therefore you have 30 days (Apri127, 2006) to comply. Failure to comply may result in revocation of your Permit to Operate. Should you have any gtYestions, please feel free to contact me at 661- 326-3190. Sincerely yours, Ralph E. Huey, Director of Pre ntion Services %~ ~ j By: Steve Underwood Fire Prevention Officer REH/SU/db "Ser}ving the Community For More Sian A Century" UNIFIED PROGRAM INSPECTION CHECKLIST .SECTION 1: Business Plan and Inventory Program ~. BASERSFIELD FIRE DEPT a Prevention Services ~~~~ 900 Truxtun Ave., Suite 210 ~R>'~r T Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAME NSPECTI N DA E INSPECTION TIME ~~S`r ~ t (.C. S 1`'Yl0 ~ ~ (.. 3 ~s ~~ ADDRESS ZSZ~ ®.sw~c.c,. y,ONE NO. S4S-62o8 O OF EMPLOYEES FACILITY CONTACT USINESS ID NUMBER 15-021- ~~~ ~-p LNG' G }-~~4.0 Section 1: Business Plan and Inventory Program ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND Q~.gytn.o T~-f~ //~/~,2T2~,~/ ~L-~C.~ ~rJ(~~L•>Zp~ ^ BUSIPIBSS PLAN CONTACT INFORMATION ACCURATE t ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ENTtD APR ~ 2007 ^ VERIFICATION OF INVENTORY MATERIALS ~~~~..~~~ .w2i ~/G _ f rJS(~ ^ ~ VERIFICATION OF QUANTITIES (A ^ VERIFICATION OF LOCATION b( ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ~"'r~ .,~~1 ~!_.~ ~ ~ ~S ~ 5, t ,2 ,v ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND ROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED i~V~STC Ccx~'t~+NC2, CAl~CcIG~ ~ t•~5P ^ HOUSEKEEPING .~ .. ~~,".r~,` t~ or,r 1 ~ 5 0' cc>-~.r3v>rr ~s+.c-s cc..~ r~ Fc.~ . ~~ ^ FIRE PROTECTION ~~~u`AL ~~ ^ SITE DIAGRAM ADEQUATE & ON HAND a~ tru¢a~~ Cc~2r / carn,~ J ~.~., ANY HAZARDOUS WASTE ON SITE? YES ^ NO EXPLAIN: (W'~'~STC ~~111/INt.~J~.r'- Z1Qy'7S - --- QUESTIONS REGARDING THIS INSPECTION? PLeasl=_ cALL us AT (set) 328-3s~e ~I~~~ ~~~ Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Stetion q i White -Prevention Sorvicea Yellow -Station Copy Pink - Buaineos Copy FD2049 (Rw. 02/05) .1 y ~~~ ~~LD Fl~~z e ~~ ~ a t~ .y j f ~~F~ gti~~ CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301 FACILITY NAME Chi ~~ E-~t ~C.S ~~ f L- Section 4: Hazardous Waste Generator Program ^ Routine ~ Combined ^ Joint Agency ^Multl-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Hazardous waste determination has been made ~ f~~ d fig, ~Je/~ EPA ID Number Authorized for waste treatment and/or storage Reported release, fire, or explosion within 15 days of occurcence Established or maintains a contingency plan and training Hazardous waste accumulation time frames ~~ .G 1 a~ (~ o,,~ ~, Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed when not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks Used oil. not contaminated with other hazardous waste Proper management of lead acid batteries including labels Proper management of used oil filters Transports hazardous waste with completed manifest Sends manifest copies to DTSC Retains manifests for 3 years Retains hazardous waste analysis for 3 years Retains copies of used oil receipts for 3 years Determines if waste is restricted from land disposal , ~,=wmpuance tt ''v=viorai~on Inspector: W 1 ~'`> Office of Environmental Services (661) 326-3979 White -Env. Svcs. ._ Buse ~ onsible Party Pink -Business Copy INSPECTION DATE 3 S EPA ID # IL INSPECTIONS /~~'~ B E R S F I L D BUSINESS PLAN & ~RrM r INVENTORY PROGRAM UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ~ 51 ~~t-~-S ~~~iL Section 2: Underground Storage Tanks Program INSPECTION DATE: 3r S 7 ^ Routine .Combined ^ Joint Agency ^ Mulfi-Agency ^ Complaint ^ Re-Inspection Type of Tank Number of Tanks 3 Type of Monitoring '~S -3Sy Type of Piping O~-nr OPERATION C V COMMENTS Proper tank data on file jjll tl..(. ~(S(LR~c;2"(- C,~ppl~-~T'Y Proper owner /operator data on file j,J,L~ c~[-C,~ ~j (pCL~nrtS ,e~ $ g Permit fees current Certification of Financial Responsibility dt~. cSS~.JG- ~y(L C,~?.W i T2t2 Monitoring record adequate and current ~c~.t.l. C-n/f_ ~,,r~,. -- OK Maintenance records adequate grid current EjlG.. ~/ ~C.~Go'~euYVS rvo•i'~-r~ ~JC Failure to correct prior UST violations /V Has there been an unauthorized release? ^ Yes No No ~S ~ 'S Section 3: Ab ound Storage Tanks Program Tank Size(s) fz <<2~ ('S k ~ Aggregate Capacity Type of Tank Q ynit, Mvn- 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: ~t^1~5 Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services Pink -Business Copy 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 KBF-7335 FD 2156 (Rev. 09/05) CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT ~ ~ 6 ~ 1 Location Name ~~T 1~`~c.s ~,.6hlc., You are hereby required to make the following corrections at the above location: Cor. No. ~1.Cva5C'_ St~f3~ ~ T C,IS~ Ft's ~. f3 t~ T!-F~ ~J ~ n /~S ~ ~c~ r Completion Date for Corrections 3 ~t z ~ Date ~ ~ 7 ~~~ s Inspector Fo ~~ 326-3951 (HMMP) HAZARDOUS MATERIALS MANAGEMENT PLAN TM UNIFIED PROGRAM CONSOLIDATED FORMS CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIALS INVENTORY n l:..a._r._t. F/RL ARTAI Prevention Services n 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 C NEW ADD ^ DELETE ^ REVISE 200 (One form per material. per building. a area.) Paoe1 of 2 I. FACILITY INF RMATION BUSINESS NAME (Same as FACILITY NAME or OBA -Doing Business As) ~' ~-(t acs )tilo.)~jL(, CHEMICAL LOCATION 201 CHEMICAL LOCATION 20 - ^^ ~ ~ t~stn - W", CONFIDENTIAL (EPCRA) ^ Yes ^ N FACILITY ID No. 1 MAP No. (optional) 203, GRID N0. (aptionat) 20 Ii. CHEMICAL 1NF O RMATION _ CHEMICAL NAME ~ _ _ 205 2 ~n ~ ~ c _~A~ ^( t.,7y.; ~ ~N + TRADE SECRET C Yes ^ NO ~ ~. ~J 1/l. ICLCs~. COMMON NAME 207 EHS' C Yes ^ No 20 -CAS No. 209 •!f EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if requested by local fire chief) 21 TYPE 211 RADIOACTIVE: ^ Yes ~No 21 CURIES 21 0 p PURE ~ MIXTURE C w WASTE LARGEST CONTAINER 21 PHYSICAL STATE ^ s SOLID R~t'LIQUID ^ g GAS 214 Ss ~ ~ " FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTIVE ^ 3 PRESSURE RELEASE ~e ACUTE HEALTH 21 ^ 5 CHRONIC HEALTH (Check all that apply) (( ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 22 AMOUNT DAILY AMOUNT ~ I ~ DAILY AMOUNT ~~ CODE ~~ ^ UNITS r~q~0 a GAL 221 222 DAYS ON SITE _ ~Ii EHS, am nt muust be in lbs. ^ cf CU F7 ^ Ib LBS ^ 1n TONS 22 STORAGE CONTAINER ^ k BOX ^ p TANK WAGON (cneck en roar apply) ^ a ABOVEGROUND TANK ^ f CAN ^ b UNDERGROUND TANK G g CARBOY ^ I CYLINDER p q RAIL CAR ~ - ,, ^ cTANK INSIDE BUILDING ^ h SILO ^ d STEEL DRUM ^ i FIBER DRU M ^ n PLASTIC BOTTLE ' ,J~e PLASTICINONMETALLIC DRUM ^ j BAG ^ o TOTE 81N STORAGE PRESSURE f~ a AMBIENT ^ as ABOVE AMBIENT V ~- ^ ba BELOW AMBIENT 22 22 STORAGE TEMPERATURE a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT I~ c CRYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 227 ^ Yes ~ No 228 22 2 230 231 ^ Yes ^ No 232 23 3 234 235 G Yes ^ Na 236 237 4 238 .239 ^ Yes ~. Na 240 241 5 242 243 G Yes ^ No 244 24 -III. SIGNATURE PRINT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 31~~ ~ 2 ~ FD 2144 (Rev. 09105) (HMMP) HAZl~,RDOUS MATERIALS MANAGEMENT PLAN UNIFIED PROGRAM CONSOLIDATED FORMS CHEMICAL DESCRIPTION FORM HAZARDOUS MATERIALS INVENTORY C NEW ADD ^ DELETE C REVISE 200 A A_R.,,$.,_P,..T, D F/1[L AA11Y 1 BAKERSFIELD FIRE DEPT. Prevention Services 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 i0ne form per material. per building. or area.) Pana'I of 7 I. FACILITY INF RMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) X51 i-~ ~~~ MU~1(.. . CHEMICAL LOCATION 201 CHEMICAL LOCATION 20 I ,^ 1 S (~~ n w n t~~s 1 1 C~-~+`- 1'~ CONFIDENTIAL (EPCRA) ^ Yes ^ N FACILITY ID No. 1 MAP No. (optional) 203, GRID N0. (optional) 20 II. CHEMICAL iNF ORMATION CHEMICAL NAME ~ _ 205 2 /~ n 1 a .y ~• ~ C_./-~ ~- W ,\ TRADE SECRET C Yes ^ No COMMON NAME Z07 EHS• C Yes ^ No 20 'CAS No. 209 '!f EHS is "Yes," all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if requested by local fire'chief) 21 TYPE 211 212 CURIES 21 ^ p PURE ~m MIXTURE C w WASTE RADIOACTIVE: ^ Yes G No LARGEST CONTAINER 21 PHYSICAL STATE ^ s SOLID f®.LLIOUID ^ g GAS 214 ~~ 21 FED HAZARD CATEGORIES ^ 1 FIRE ^ 2 REACTIVE ^ 3 PRESSURE RELEASE ^ 4 ACUTE HEALTH ^ 5 CHRONIC HEALTH (Check all That apply) ANNUAL WASTE 217 MAXIMUM 218 AVERAGE 219 STATE WASTE 22 AMOUNT DAILY AMOUNT ],O DAILY AMOUNT CODE 221 222 ^ UNITS ~ga GAL DAYS ON SRE "Ii EHS, amount must be in lbs. 0 cf CU FT ^ Ib LBS ^ to TONS 22 STORAGE CONTAINER ^ k BOX ^ p TANK WAGON (C~eclr all Cher apply) ^ a ABOVEGROUND TANK ^ f CAN ^ b UNDERGROUND TANK G g CARBOY ^ I CYLINDER ^ q RAIL CAR • - ;.-,, ^ c TANK INSIDE BUILDING ^ h SILO ^ d STEEL DRUM ^ i FIBER DRUM ^ n PLASTIC BOTTLE ~e PLASTIC/NONMETALLIC DRUM ^ j BAG ^ o TOTE BIN 22 STORAGE PRESSURE ~a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT 22 STORAGE TEMPERATURE ~a AMBIENT ^ as ABOVE AMBIENT ^ ba BELOW AMBIENT G c C RYOGENIC %WT HAZARDOUS COMPONENT EHS CAS # 1 226 227 ^ Yes ^ No 228 22 2 230 231 ^ Yes ^ No 232 23 3 234 235 L; Yes ^ No 236 237 4 238 239 ^ Yes ~. No 240 241 5 242 243 ^ Yes ^ No 244 24 d -ill. SIGNATURE PRINT NAME 8 TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIGNATURE DATE 2 FD 2144 (Rev. 09105) UNOERGROUNO STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / S6989 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMIT NO. ~~~~ wiR~ ARTM f 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 TfSTttd ~ ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICATION . , , .. .. ;SITE-INFO RMATION FACILITY ~ ~t „ ~ (~ ~(~~ ~~k I „ ~~ ~ ,~(~~ ~U B C N ACT P RSON ADDRESS 5 ~ ~sv~~2~-~--- l ~ OWNERS NAME ~ ~~ OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING G IN TO BE TESTED? YES fJ NO K # VOL ME CONTENTS 1 ~ ~- ~ ~ ~~e wl - ~ ' TANK.,TES ING COMPANY NAME OFT T G C P ~ ~ ,^ ~l 1` / NAME PHON N OF ONTACT PE SO MAILING ADDRESS ~ I~ NAME 8 PHONE N M E OF TE TER PECIAL IN ECTOR ~ q CERTIFIC TION #: DATE 8 TIME T T TO BE CO DUCT O ICC #: TEST METHOD SIGNATURE OF APPLI }SIT ~ DATE _ APPROVED BY /~ DATE ~ 3 FD 2095 (Rev. 09/05) r ~ 5~ i Page ~ of ~ 2 SecondaY~y Containment Testing Report Form. I Tl~isfnrm 1s irua»dedfar ura by contractors parformfngpartadJc tasting of UST sacondory contalnmQnt syvtams. Usa thQ nppropriate pages oflhis jorm to report results for al! components tasted The compfetedfortn, written test procedures ahd printouts from tests (~fapp/icable}, shou!a beprovidedto thefocFllty owner/opera/odorsubmittal fo t/re lornlr¢gulafory agency. 7 FA!`TT.TTV TNFl1RMATTf1N _~ „ '~ ~ S~V'RG:$; January 20(1.2 Facility Name: mob l 5 Dale ofTestin . Facility Address: ,~ QSu3e S Facility Contact: Phone: (~ - llate Locai Agency Was otified of Testing : a ' -O ~ ?Varna of Local Agency ins eclat (Jf present during testln~: 7 TT'i C7'TNl~ MNTl7dnTtlA TNTrtIT?MATTf1N 3. SUMMAi2Y OF'TEST RB'Si1LTS:`.' `' = . Company Name: RICH ENVIRONMENTAL Technician Conducting Tesh p 1, _(Jt•' - Credentials•, ~8 CSLB Licensed Contractor 0 SWRCB Licensed Tank Tester LiccnseType. C6I1D90 License Number. 609850 ~, Manufacturer man asturer ~aininB om en Date Trainin E ices _ INCON INCON TS-STS Component ~ _ Fass Fait Not Tested Repair Made Component Pass Fali Not Tested ltepaifs Made ~~ ~ ^ O ^ Q ~~2 O D ^ ~ I ~.~.. a ^ ^ uoL+~~- ~ ^ ^ fl ~ e ~> ^ ^ ^ G ~- - o ^ ^ ci _ nc - ~ - A d ^ ; tl s~ a ^ ^ q ~ e,~c ^ ^ ^ ~ J ~ s> a o ~a r ~ ~ ~ o D ^ ~ 1 ~ '^ ^ ^ {~ 0 L7 Cl U ~ - D ^ ^ ~ n o ^ ^ ^ r~ n ~. p ^ ^ a ~ ^ ^ ~r~ s. '-~ . i Ef h ydrostatic testing was performed, describe what was done with the water after completion of tests: RECYCLE AND. REU~D~ f CERTIFICATION OF TECHNICIAN RESPONSIBLE >x'OR CONDUCTING THIS TESTING / To the best of my knowledge, Ure fads stated in tlrts docur;tent at+e accurate andlp jutl compliance _witlt legal tzgrttretttents Technician's Sigtlatuie•~ {/~~js ~~ ~'' ~~-v~ 'Date: ~~ ~,~ ~~ S~ ~` .... _..__... ..__._... ~ I t M`. S tC$; Jannaty 2002 i'agc ~ of I 3,~ Seconda~ y Containment Testing Report Form I 'J'J~isfnrm is intendedfor vsa by contract,u~sparformtngpariodlc testJng of USTsacondory contalnmant systems. Use the appropriate pages of thisjorm to report results far all components tested The completedform, written test procedures, nhd printouts from tests ~f oppltcable), shout:/ be provided to the facility owner/operatorfor submittol to the local regulatory agency. I. !''AC:ILL'l~Y !!Yr'Ult1V1A't'1VIV Facility Name: Date ofTestin Facility Address: ' Facility Contact: phone: llate Local Agency Was Notified of Testing Piame of Local Agency Inspector (ijpresent during testing: 2. TES'T'ING CONTRACTOR INFORMATION CompanyName:RICH ENVIRONMENTAL T'echniaian Conducting Test: Credentials: 'S CSLB Licensed Contractor 0 SWRCB Licensed.Tank Tester License Typo. Cfi11D4Q LiconseNumber. 8l)985t3 Manufacturer Mangfacturer ~e;ning Com nen s Date Trainin E free INCON INCON TS-STS 3. SUMMARY OF TEST RESULTS:'2' `' -• = . Component _ Pa95 Fsil iVOt 'fated It2pa~ri Mada Component Pala Fai! Not Tested Repairs Made ~eYl~- ^ ^ ^ ^ ^ ^ . . ^ ^ ^ 0 ^ ^ 0 Ll ~DcPt~e ~'cs„ ~ ^ ^ 0 ^ ^ D ^ `~ l ~ ~ ^ ^ ^ ^ ~^ ^ . Ci D ^ ^ U ^ ^ ^ D ^ ^ ^ ^ ^ ^ ^ r • o ^ a ^ ^ .^ Q o. ^ o ^ a ^ ^ a tt hydrostatic test'mg was perfprmed, describe what was done with the wafer atier completion, oftests: ` RECYCLE AND..REUSRb J CERTIP7CATiON OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To rh e h est oj/ny know/edge, t/ie facts stored /n th/s document an accuratt and !q juU Mrnplirutce ,wlitr legal requ/re»ients i Technician's Signature: Date; i SWRCB, ]anuary 2002 d 'TANK ANNiTi.AR TFC'C1N(: 1515 ~ Page •~ of Test Method Developed 13y: 0 Tank Manuflacturer ~ Industry Standard p Professional Engineer O Other ec~} Test Method Used: C3 Pressure ~ Vacuum O hydrostatic d Other (Spec{fy} Test Equipment Used: 4in. DIAL GAUGE EquipmentResolution:.5% ;,,. ~. >~`~'~ . ':'r~; ~ Tank#pi Tank#U',1 ~] Tank#~~ .. Tank# is Tank Exempt From Testing?r O Yes ~No lJ Yes t$1Vo ^ Yes ,t~fJVo 0 Yes C No Tank Capacity: Tank Material: ~ ~ ~ Tank Mmiufacturer: ~ ~ Product Stored: e~ V ~ " ~] ~ ~ Wait time betweera applying pressurelvacuum/water and startin test: ~ Y\ ~ t7 +Mi ~ ~ ~ ~ Test Start Time: ~' rvti. ; ~ Q ,' Q Initial Reading {Rr): l ~ O Q ~- Test End Time: ~ ` ~. DO YV~ ~ ~ ~ Finat Reading (R,:): Q jQ Test Duration: ~ (~ Change in Reading {R~-Rr): Pass/Faii Thres)told or Criteria: Test Result: Pass O Fail ss ^ Fail Pass O'F'alt d Pass ^ Fatl Was sensor removed for testing? es O No 0 NA s ^ No O NA es t7 No ^ NA U Yes ^ No f.'; NA Was sensor properly replaced and verified functional after testis ? ~ pNo (]NA QNo ONA ONo QNA QYes ONo ONA r 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 2631(a){6)) SWRCB, January 2002 K CF.(`!'17V~ARVATPF.?'F.CTTNC ` .Is~~t Page 7 of Test Method Developed 8y: D Piping.Manufacturer ii7Industry Standard O Professional Engineer D Othu (Spec~y) Test Method Used: ~ Pressure l7 Vacuum l] Hydrostatic Other (Specrfy) ° Test Equipment Used: 9 i n . DIAL C3AUGE Equlpmeni Resolution: .596 e pipinE Run Piping Rua if } 1~ Pip3nQ Run # 1'tping Run # Piping Material: - - ~ f/ Piping Manufacturer: Piping Diameter. Y " I.engthofPipIngRun: Q ~ (~~ /C~' Product Stored; I L)In ~ ~ Method and location of i in -rua isolation: U Wait time between applying pressurelvacuum/watertind startin test: ~ 1'V`i ~C) tai t\ , ~~ Pest Start Time: : ~ ~ ~ . ~ y4 Initial Reading (R~: Test End Time: O : ~ f 0 `. Final Reading (Rr): Test Duration: } , ` }~ ~ 4~ (~ Change in Reading (R,-R,): ~ ,~' ' Pass/Fail Threshold or ~ Criteria; • Test Result: ass O $atl O ss ail ss O Fatl O Pass p Fall, Comments- lnctudelnormation'onre absmade riot! testla,andrecomraended ollow~-u or alledtests ~~ • ~ , ;; • i S WRCB, January 2002 S CF!`llNTl A A V PTUF 7`F.CTTNf_` 1595c Page 5 of ~) L Test Method Developed By. D Piping Manufact~uer frJ ]ndustry Standard D Professions! Engineer D Other (S'pec(fyJ Test Method Used: ~ Pressure 0 Vacuum D Hydrostatic D Other (Spec{fy) . Test trquipment Used: 41 n . DIAL GAUGE Equipment Resolution: . 5?G ~~ Pi in Rua !# P is DiE~\ Pi in Rua # P S 7 Pi in Run # ( Pi in Run # P ~ P~ Piping Material: ~ ~ ~-y ~ Piping Manufactwer: ~ v~o 19.E 0 Piping Diameter: ~' " ~ " " Length of Piping Run: ' 1 ~ ~ Product Stored: ~~~ge,\ ~~ l.. p2.em l Method and iocation of i in -rua isolation: ~~obE-~v~ S~Cj o~'-~ ~5 u ~~~-~ r~5t)'C"1 Wait time between applying pressurelvecuum/watersnd startin test: ~~ ~ ~ ; c~ ~ Test Start Time: Cep ~y,,~ % / J~' vVt Initial Reading (R~: VJp!-'Ce b~-t' ~ S~ Test Bnd Time: ~O', 00 ~',1~4t./~ Final Reading (Rr): ,~' S ~ Test Duration: ~ ~tZ 1•{-'CZ. Change in Reading (RF-R,): Pass/Fail Threshold or Criteria: Test Result: ,~ PASS ^ Fail D Pass D Fafl jq' Pass O Fait D Pass D Faff Comments ti SWRCB, January 2002 b. PiP7N(~ CiTMA TFATiN(~ S9~o Page `E! of ~~ Test Method Developed By: p Sump Manufacturer ~ ladustry Standard ^ Professional Engineer D Other (Spec{fy) Test Method Used: 0 Pressure ^ 'Vacuum %I Hydrostatic 0 Other (Sped) Test EquipmentLlsed: INCON TS --STS Equipment Resolution:.oooin. Sump #D ttSP Sump # Sump # Sutnp ,e~ Sump Diameter: 3 " " ~ " ' Sump Depth: `~ t+ Sump Material: Height from Tank Top to Top of !li est Pi in Penetration: , , ,, ~~ Height from Tank Top to Lowest Electrical Penetration: ~ t+ `Z+ Q (~ , , Condition ofsump prior to testing: Portion of Sump Tested' Does turbine shut down when sump sensor detects liquid (both roduct and water D Yes L] No ~NA D Yes ^ No ~ 0 Yes DNo ~P'A ^ Yes DNo Turbine shutdown response time llJ /l1 Is system programmed for fail-safe shutdown7~ O Yes DNo A ^ Yes ^ No Q Yes Q No Q NA D Yes Q No Was fail-safe verified to be o erationai?~ Dyes ^ No A ~ O Yes O No ~ O Yes O No C 0 Yes O No Wait time between applying pressure/vacuum/water and starting test: O `' c~~ ` Test Start Time: ~~ X3(0 ~ ~ SS _ ~,( ti ''22 ]nitial Reading (R,): '' Z• a '~ r}'• ' 1 333.• _ i •~ _ ~ Test End Time: ~~ ; $~ ; ~ ~ • ~ ', ~ ~} },` Z' Q Final Reading(Rr): ~ Z, i3gS~ 3 • cja .9 '` 1.333' ."3 •~~ ~~ " TestDuration: ts"Mnh ti.~,•rl IS'~..~~ Sttit~fl 45•x.• w.. Sin l Change in Reading (RF-Rd; . ~ .~ ,003 •6U Z ,0~0 Pass/Fail Threshold or Criteria: , .GO7i .t;p~j , ~ • Z, Tesi Result: Pass 0 Fail [7 Pass 11 ass 0 Fall ass 0 Fail Was sensor removed for testing? Q Yes DNo ^ NA 0 Yes Q No DNA D Yes 0 No 0 NA 0 Yes 0 No t{~IA ' Was sensor properly replaced and verified functional after testin 7 Q Yes ^ No ^ NA ^ Yes 0 Na ^ NA 0 Yes 0 No 0 NA ^ Yes 0 No ~AA ComtneAts - (include information on repairs made pria~ ro testing, and recomme ~.. ~+ _ _t +_ r ' If the entire depth of the sump is not tested, specify how much was tested, if the answer to ~ of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160} l S95a S W RCB, January 2002 6. PYPYNG SUMP TESTING Page ~ of ~'y Test Method Developed By: D Sump Manufacturer N ladustry Standard D Professional Engineer ^ Other (Specify) Test Method Used: D Pressure ^ Vacuum ~[} Hydrostatic D Other (Sped) Test Equipment Used: INCON TS -STS Equipment Resolution:.oooin. Sump # ~ Sump # Qtaorn Q Sump # Sump # Sump Diameter, ° ` ~ " Sump Depth: y7 ~~ y 7' " Sump Material: t •Height from Tank Top to Top of Ili best Pi in Penetration: - t~t~ i ~ keibht from Tank Top to Lowest Electrical penetration: 1 r,2, t T~ ~ ~., ' Condition of sump prior to testing. C`e~ l't G~ ~ Portion of Sump Tested' ©~e2 2~C~ p~}~e(L, 1<•~C. Does turbine shut down when sump sensor detects liquid (both roduct and water ?~ ^ Yes U No ANA D Yes ^ No ,O~IA D Yes D No DNA D Yes ^Nv DNA Turbine shutdown response time . N Ka- t11~F~ Is system programmed for fail-safe shutdawn7~ D Yes D No `ANA ^ Yes 0 No ,~filA D Yes D No DNA ^ Yes ^ No DNA Was fail-safe verified to be o erational?~ Dyes D No A ^ Yes D No A D Yes 0 No 0 NA Q Yes D No ^ NA Wai[ time between applying pressure/vacuum/water and starting test: ~Yki p 1vv t Test Start Tune: ;p l',ZZ ~'.0~ ~ :2 Initial Reading (R~): 2.7Z " Z•,727 ~~ -Z`1to11 ,2951 Test EndTinte: :Iq w~ x'•37 i%-9 ',3~ Fituti Reading (Rr): Z•'( 27 t ` , ZZ7 " 7-L9(<'' Z;•L9G ~' Test Duration; lS~t ~) S `Yt 16w~~h \5 ' Change in Reading (RF-Rd: , ~ f , vCX~ . UW , Pass/Fail Threshold or Criteria: , vD2. • GI~Z . oOZ • Ott Test Result: Pass D FaU ass D Fail D Pass D Fait D Pass ^ Fail Was sensor removed fortesting7 es ONo DNA D es ^No DNA DYes ^No DNA DYes ^No DNA Was sensor properly replaced and verified functional after testin ? es D No DNA ^ Yes ^ No DNA ^ Yes D No DNA D Yes 0 No DNA Colmrnents - (include information on repairs mode prior to resting and recon/mended follow-up for jelled teslsJ ~R S~ ~ es•e l ~ os ~h ~... ~3 q .., ~ If the entire depth of the sump is not tested, specify how much was tested. If the answer to ~ of the gttestions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (Sec SWRCB LG-160) --- -------- 1S~5a SWRCB, January 2002 Page TJ of ~ v 7_ itiVl}F.R.niSPF.NSER ! f~NTAi1VME1VT fUDC) TESTING ' Test Method Developed By: ^ UDC Manufacturer (~ ]ndustry Standard ^ Professional Engineer d Other (Specify) Test Method Used: O Pressure O Vacuum ~ Hydrostatic D Other (Specify) Test Equipment Used: INCOR TS-STS Equipment Resolution::oooin. - - UDC # ~- UDC # - UDC # S UDC # - UDC Manufacturer; l~ UDC Material: UDC De the 7 " ' Height from UDC Bottom to Top of Highest Pi in Penetration: •, ~ , ~ ' r •~ Height from UDC Bottom to Lowest Electrical Penetration: . t , ~ ~ t °' Condition of UDC prior to testin Portion ofUDC Tested Does turbine shut down when UDC sensor detects liquid {both roduct and water 7~ D Yes D No ~'NA D Yes D No ~iA D Yes D No ~NA ^ Yes D No ANA Turbine shutdown res onse time /~f Is system programmed for fai{- safe shutdown?~ Dyes D No ~NA ^ Yes D No t~ddA ^ Yes ONo ~FA ^ Yes ONo Was fait-safe verified to be o erational7~ Dyes ^ No A ^Yes 0No ~ DYes ONo DYes ^No Wait time between applying pressure/vacuum/watergnd startin test ` ~ t'lti ~ Test Start Tune: rvt 'r { yt~ ' Initial Readin (R~ : 2 •{oll " 2-b 2.07~f " .O ~ Z (i r ', rv Test End Time: ; 51'~ _ ~ { ; ?1x • to '~ Final Readin RF): 2•to{1" Z• ~ 2~o7d 2.•0 2• " •{t2. u•7 • ~ ,r- Test Duration: 5 ', I~n~;n 6' +/~ •n rv~ /~ Chan einReadin (RF-Rt): :~Q .t3(30 ,~(SD ,cNp .~ p Pass(Fail Threshold or Criteria: . puZ .op , oOZ , pdZ Test Result: ass D Faii ass 0 Fail Pass D Fail ss 0 Fail Was sensor removed for testing? es D No DNA es 0 No DNA Yes 0 No DNA es 0 No DNA Was sensor property replaced and verified functional after testi ? yes D No DNA es ^ No DNA es D No DNA es 0 No ^ NA COmrnetttS - include information on repairs made prior to testin& and recommendedfa!!ow-upfor failed restsL ~ if the entve depth of the UDC is not tested, specify how much was tested, if the answer to a,~ of the questions indicated with an asterisk (~) is "NO" or "NA", the entire UDC must be tested (See SWRCB LG-160) ,1 1 ~ S~ISo SWRCB,January2002 Page~of 1 v 7. UNDER-DISPENSER CONTAINMENT C TESTING Test Method beveloped By: p UDC Manufactttter fd Industry Standard ^ Professional Engineer ^ Other (Specify) Test Method Used: ^ Pressure ^ Vacuum )~ H}drostatic ^ Other (Specify) Test Equipment Used: INCON TS-STS Equipment Resolution::oooi.n. UDC # -1 p UDC # UDC # UDC # UDC Manufacturer; UDC Material: ` UDC De th; Height from UDC Bottom to Top of Hitrhest P' in Penehation: , , Height from UDC $ottom W Lowest Electrical Penetration: ~ a Condition of UDC prior to testin +Q Portion of UDC Tested o,~ Does turbine shut down when UDC sensor detects liquid (both roduct and water ?~ ^ Yes O No [~A ^ Yes ^No ^ NA O Yes ^ No ^ NA ^ Yes ^ No ^ NA Turbine shutdown res once time t¢ Is system programmed for fail- safe shutdown?~ ^ yes ^No b~NA ^Yes ^No C1NA ^Yes ^No ^NA ^Yes ONo ^NA Was fail-safe verified to be o erational?~ ^ yes ^ No J~:NA {)Yes ^ No 1J NA ^ Yes ^ No ONA ^ Yes ^ No ^NA Wait time between applying pressurefvacuum/water and startin test 30 t'k t 1'1 ` Test Start Time: •.$~ ; (') [nitial Readin (R, : . cf7 '~ ,D"-!," Test End Time: (p :ld 4 Final Readin Rr): '~ " 3.07 Test Duration: ~ $.ti.`~r` t/,g' Chan a in Readin (RF-R~): . ~ Pass/Fail Threshold or Critetla: Test Result: ,~PeSS n Fail ^ Pass ^ F'aiI ^ Pass ^ Fai! ^ Pass q Fail Was sensor removed for Testing? ~S'es ^ No ^ NA ^ Yes ^ No Q NA ^ Yes ^ No ^ NA 0 Yes 0 No ^ NA Was sensor properly replaced and verified functional after testin ? Yes ^ No ^ NA ^ Yes O No ^ NA ^ Yes O No ^ NA ^ Yes ^ No ^ NA COm merits - (include information on repairs made prior to testlnR, and reeammendedfollow-up for fated tests) ~ if the enrire depth of the UDC is not tested, specify how much was tested. If the answer to a~y of the questions indicated with an asterisk (+) is "NO" or" NA", the entire UDC must be tested. (See SWRCB LG-Ib0) t5~5~ S W RCB, January 2002 8. FILL RISER CONTAINMENT SUMP TESTING Page ~v of ~? Facili is Not ui ed With Fill Riser Containment Sum d Fill Riser Containment Sumps are Present, but were Not Tested d Test Method Developed By: 0 Sump Manufacturer ~lndustry Standard O Professional Engineer D Other (Sped) Test Method Used: O Pressure 0 Vacuum ~ i-lydrostatic D Other (Sped) Test Equipment Used: INCON TS-STS Equipment Resolution:.000in. Fill Sam # Fill Sum # Fill Sum # Filt 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 testis Portion of Sum Tested Sum Material: Wait rime between applying pressure/vacuum water and startin test: ~O L} Test Start Time= Initial Readin ~ Test End TJrne: Final Readin (Rr Test Duration: Chan a in Readin R R~ Pass/Fail Threshold or Criteria: Test Result: ^ Pass ^ Faii D Pass ^ Fail ^ Pass D Fall 0 Pass 0 Fall Is there a sensor in the sump? 0 Yes ^ No ^ Yes 0 No ^ Yes ^ No D Yes DNo Does the sensor alarm when either product or water is detected? 0 Yes ^ No ^ NA D Yes ^Na DNA D Yes ^ No ONA D Yes DNo 0 NA Was sensor removed for testing? ^ yes ^ No 0 NA ^ Yes t7 No ^ NA ^ Yes 0 No ^ NA 0 Yes d No DNA Was sensor properly replaced and verified functional after testin 7 ^ yes ^ No ^ NA ^ Yes ^ No ^ NA D Yes DNo DNA D Yes ^No RNA Comments - (include informotron on repairs made prior to testing and recommended follow-up forfailed tests) ~,.F'i S V A,L ~~ S t 1-tP r !-Sgsd SWRCB, January 2002 o ePrrr.InVi;AG•rf.T.f~l1NTAiNMF.NTRfIXFC Page ,~-of 1Z Facili is Not ui With S ilUOverfill Containment Boxes D SpilUOverfil! Containment Boxes are Present, tart were Not Tested D Test Method Developed By: D Spill Bucket Manufacturer 1!D Industry Standard ^ Professional Engineer D Other {'Sped) Test Method Usod; D Pressure D Vacuum >9 Hydrostatic D Other (S eci~) Test Equipment Used: INCON 'TS-STS Equipment Resolution:. oooin . Spill Box # ~ Sp111 Box #t~ Spill 13ox # Spill Box # Bucket Diameter: \ ~~ t a" Bucket Depth: ~ u 1 ~ + t Wait time between applying pressure/vacuum/waterond startin test: ^2 ~ m ~ w cJv Test Start Time: ~ ~ l~,',t'J y ~ ~~ (~ ~%sSP Initial Reading (R~: . ~ ' ` ~j. ~" y. ~r]1+.r •3'Tl ~.- Test End Time: (: Z, ; 2 t{ ~ 5~1 1? ~: io jy Final Reading (R}): 7'' ti ~. 3'7) t+J ~ • ~(-„1 Test Duration: l ( r '' 65~latN tSM•taa Change in Reading (RF-RI): -~tp .~~p Pass/Fail TEtreshold or Criteria: ~ a 0 Z - t9 p Test Result: ass D Fall Pala D Fall Q Pass D Fail p Pass 0 Fail Comments .- (include l,+formarion on repairs made prior to testLr& rtnd recommended follow-up ~or failed tests) /5954 /~- ~2. 5989 TESTING FAILURE REPQRT sITE NAME Y~b:~ ~~s..~'t.V\ DATE: 3-S'°7. rZ6~~-( f'~w~lt~ ~- _ x~carrlcYAN 9.3~~ g 3YTE CONTACT • ~/" !~~ ~ ~ I THE FOLLOTIINt3 ~COMPONENT3 WERE.REPLACED/REPAIRED TO CO[~LETE TSE SB989 TESTINl3 . _ . LIST OF PARTS REPLACED/REPAIRED; REPAIRS: ~ ~?C'G ~~ ~~ i~ n g ZSi~ ~ f o c~UC~ C,~ I'yQ ~.5~-~ 50~? ~~n r/~er~ L ~y~~ ~ _ LABOR: ~f~P/ ~ • PARTS INSTALLED: U~J6c~°.- ,; > , - - l cr7~ Sd . ~i3i~35i 2007 1:1y --- - -- --- - -.._-._- -- - ._.. _ p3~05i2007 2:32 PM SUMP LEAK TEST REPORT SUMP LERK TEST REPORT 91STP 9ISTP TEST STARTED 1:04 PM TEST STARTED 03i05i20b7 TEST STARTED 2:17 PPi BEGIN LEVEL 1.3333 IN END TIME 03i0~i2007 ~ 1:37 PM ~ ~ TEST STARTED LEVEL 03i05i2007 3.4143 IN 1:19 PM AND ~ DEL 03~05i200? ~ SUM? LEAK TEST REPORT '• BEGIN ~, END TIME DATE -• p i 5 ? M 03 0.. 2007 1.3333 TN LEAK THRESHOLD 4.092 IN TEST ~ 91STP END ~~ END LEVEL 3.4145 IN 002 IN 0 RESULT PASSED , LERK THRESHOLD PASSED TEST STARTED 1:22 PM TEST RESULT 91PSUMP ~c~rL~c~ , TcST STARTED BEGIN LEVEL 03/95/2007 1.3334 IN ,,.,,~~ ,•.~ TEST STARTED 1:04 FM TEST STARTED END TIME END DATE 1:37 PM 03i05~2007 03i0Si2007 . BEGIN LEVEL 2.29b5_IN END I_EUEL LEAK THRESHOL 1.3350 IN D 0 002 IN END TIME i END DATE 1:19 PM TEST RESULT . ~?Eert'__ ! END LEVEL 93i05i2007 ~ ~ ~f ,pub LEAK THRESHOLD 8 002 IH TEST RESULT PAS ' 91PSUMP~A~~ -- _- _ _ . - - -- SED TEST STARTED _ 1:22 PM ' 03i05~2007 2:54 PM DSPSUMP ~~+ ~ ; TEST STARTED 03i05i2007 ~ SUM? LEAK TES'' REPORT ~, ~ BEGIN LEVEL 2,2959 IN ~ TEST STAR.TEO 1:04 PM TEST END TIME END DATE 1:37 PM 03i05~2007 UENTBO~S STARTED 03i05i2007 BEGIN LEVEL 2,7281 IN END Lf_UEL LERK THRESHOL 2.2967 IN D 9 002 IN TEST STARTED 2:39 PM END TIME END PATE 1:19 PM TEST RESULT . PASSED I TEST STARTED BEGIN LEVEL 03i05~2007 :, .. 5163 IN END LEVEL 03i05i2007 2.7276 IN END TIP1E 2:54 PM LEAK THRESHOLD 0, 002 IN TEST RESULT DSPSUMPTgrvY..brµ~ END DATE EUEL D 1 03i05i2007 5160 IN 3 PASSED TEST STARTED 1:22 PM ~ . _ EN LEAK THRESHOLD 0.002 IN ~~ TEST STARTED 03i05i2007 I TE5T RESULT PASSED DSLFILL ~ BEGIN LEVEL 2.7275 IN TEST STARTED 1:04 PM TEST STARTED END TIME END DATE 1:37 PM 03i05i2007 03i05~2007 BEGIN LEVEL 2 5921 IN END LEVEL 2.7273 IN E . END TIME 1:19 PM END DATE L AK THRESHOL TEST RESULT D 0.002 IN PASSED h3i05i2007 END LEVEL 2,5921 IN LEAK THRESHOLD 0,002 IN TEST RESULT OSLFILL PASSED TEST STARTED TEST STARTED 1:22 PM 03f05~2007 r~git~°,,i'?007 ' 3:10 PM BEGIN LEVEL END TIME 2.5920 IN l: s'7 PM . SUMP LERK TEST REPORT f_ND DATE 03~05i2007 ~ ! ~•JENTBOX END LEVEL 2.5919 IN TEAK THRESHOLD TEST RESULT 0.002 IN PASSED TEST STARTED 2:55 PM TEST STARTED 03r05i2007 BEGIN LEVEL 3.5'f59 IN END TIME 310 PM END DATE: 03i05i2007 ' END LEVEL 3.5159 IN LEAK THRESHOLD 0.002 IN TEST RESULT i PASSED DSLSTP TEST STARTED 21:36 AM T£S7 STFIRTE[L_, 83/@5/2047 BEGIN LEVEL 2,3964 IN END TIME 11:52 AM END DATE 03/05/2947 END LEVEL 2.39b1 IN LEAK THRESHOLD 0.662 IN TEST RESULT PASSED 91UPkSP TEST STARTED 11:36 AM TEST STARTED 03/05/2007 BEGIN LEVEL 4.3376 IN ENO TIME 11:52 AM END DATE 83/8512b07 END LEVEL 4.337S IN j LEAK. THRESHOLD 9,082 IN TEST RESULT PASSED 91FILSP TEST STARTED 03~Q532807 BEGIN LEVEL 3,7126 TN END TIME 11:52 AM . lND DATE 03145124@7 END LEVEL 3.7122 IN LEAK THRESHOLD 4.002 IN s TEST RESULT PASSED ! E f i I i I I i 93/9512007 5:10 PM SUMP LEAK 7E5T REPORT 87FILSP TEST STARTED TEST STARTED BEGIN LEVEL END TIME END DATE END LEI,tF.I LEAK, THRESHO; TEST RESULT 4:55 PM 03105/28@7 4.75&5 IN 5:10 PM 03/05/20@r' 4.7567 IN D 6.002 IN PASSED 87UPRSP TEST STARTED 4:55 PM TEST STARTED 03/05/2907 j BEGIN IEUEL 4.3717 IN END TIME 5:10 PM END DATE 93/05/2@b7 END LEVEL 4.3716 IN LEAK THRESHOLD 0,002 IN TEST RESULT PASSED 87STP I TEST STARTED 4:55 PM TEST STARTED 031051200? BEGIN LEVEL 3.9893 'IN EHD TIME 5:10 PM END DATE 83/05/2007 ENU LEVEL 3.9873 IN LEAK THRESHOLD 0.402 IN i TEST REStJLT FAILED DSLSTP `''S7 STARTED 12:08 PtA TEST STARTED 43/45/2007 BEGIN ± EU€L 2.3859 Ird END TIME 12:23 Ph; i END PATE 03/@5/200? END IEUEL 2.3857 IN LEAK THRESHOLD 0.002 IN f TEST RESULT PASSEU 91UPRSP TEST STARTED 12:0$. PM TEST 5TARTED 0314512Ei07 i BEGIN LEVEL 4.3375 IN END TIME 12:23 PM END DATE 03/05/2907 r END LEVEL 4.3374 IN . LEAK THRESHOLD 0.402 IN ' TEST RESULT PASSED j 91FILSP TEST STARTED 12:08 PM ~ TEST STARTED 03/45%2847 t BEGIN LEVEL 3.7126 IN j ENfI TIME 12:23 PM END DATE 03/frSr2007 END LEVEL 3.7225 IN LEAK THRESHOLD 0.042 TN TEST RESULT PASSED 1 S`3 5 0 0?r95r2007 4:54 PM BUMF LEAK TEST REPORT £t7F I LSP I TEST STARTED TEST STARTED BEGIN LEVEL END TIME ' END REVEL LEAK THRESH01 TEST RESULT 4:39 PM 03/05/2087 4.7564 IN 4:54 Pt1 93/g512007 4.7565 IN _D 0.002 IN PASSED 87UPP.SP TEST STARTED 4:39 PM 7E5T STARTED 03/05/2007 BEGIN LEVEL 4.3717 IN END TIME 4:54 PM EHD DATE 03/05/2007 END LEVEL 4.371b IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSED 8757P TEST STARTED 4:39 PM TEST STARTED 03/05/2007 BEGIN LEVEL 3.9931 IN END TIME 4:54 PM END DATE 43/05/2007 END LEVEL 3.'3900 IN LEAK THRESHOLD 4.002 IN TEST RESULT FAILED .___ .. . _ .._ __ _ _-- ---- - --------- !S~ 5 0 . - 03195%2007• 6:10 PM SUMP LEAK TEST REPORT j UDC1-~ - -- UDC3-4 rESr v TARTED TEST STARTED 4:39 pM oM :26 TEST STARTED 5: 5C ,PM ~ BEGIN LEVEL 93~@52007 ' TN END 2. E, P~r2~9Z - TESTSTRRTED 03/05/2907 BEGIN LEVEL 1.6749 IN ~ TIME 4?S4 p~; END DATE ~ ~~ EAK TE3~ REPCiRT ~ E A L R g2f65110~N ~p i S~ END DATE 03 H5~2R07 . TH SHOLD 0.002 IN TEST ~}UC3`a END LEVEL 2.4749 IN RESULT PASSED 11 Poi LEAK THRESHOLD... 0.002 IN ~i05i2gQ? TABBED TEST RESULT PASSED , ~Y S 0 0Z~9 ~~ TARSEU 2 S ~ . , Eg1 BEGIN 1-~U~l" 6= 2001 UDC5-6 END DA E Q~~0749 IN TEST STARTED 5:55 PM ENU K ~~~Egµ01-U O'pp55E4 L TEST STARTED 03~05i2007 EA RE~UI.Y ' BEGIN LEVEL 2.5272 IN TEST END TIME 6:10 PM END DATE @3f@512007 ' • y}pC5-6 ~ END LEVEL 2.6272 IN 6:11 PM LEAP, THRESHOLD y.002 IN ~•~ S.iflRTED 03i05~200Z TEST RESULT PASSED ` T` ~T 5YARTEU 2.6272 IN 6 P~ fiEG1N LEUE1- 6:2 5~2~07 UDC7-s3 TTM~ g3~¢ 9 2 6 2 ~~ p 0 E NQ Liu L OLD E SH Pfl5 RE TEST STARTED 5:55 PM j TEST STARTEG 0305/1087 Tµ , LE c~ RE5UL1 BEGIN LEVEL 4.7513 IN TE.~T END TIME 6:10 PM END DATE 03~05r2907 L~DC7'S END LEVEL 4.7522 IN 6; li Pr' ' LEAK THRESHOLD 0.002. IN TE51 STARTED 03~05~2007 6 IM D TEST RESULT PASSED 4.752 TEST STARTE EUE.L 6:25 i'M 1 - BEGIN 10 a0 0 UDC9-1H ~ ~2Z ~ EHp DA E ~' PR5 TEST- STARTED 5:55 PM r• - _ -._ _ . .__ . ..._ _.._ E.N©K THRE5HOl.D 5E4 Efl T TEST STARTED .. 03~05i2807 ~ ' UDC1-2 1. TEST RE51il. BEGIN LEVEL • 3:.0758 IN END TIME 6:10 PM END DRTE 03~05i2007 ~ TEST STARTEG 4:55 PM 1@ UDC9- END LEVEL 3 @768 IN TESr STARTED 03/05/2007 6:11 PM Z , LEAK THRESHOLD 0.002 iN BEGIN LEVEL 2.5120 IN ?E5~ STARTED a3i05~20~ ~ 3 I TEST RESULT PASSED END DRTE @3i05f2007 . ~ 26 TESS ~~~UEtn p '~ N END LEVEL 2.6120 IN LEAK THRESHOLD 0.002 IN ~~~ i0~i ~ IN TIC1E 03 DOSE '.0 ... ~ TEST RESULT PASSED ENU ~fl2 1N END LYµRE5HG1-D g' pASgED RESUt_T BES ~, , . ... .. T SG1'SO UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD! LINE TESTING / SB888 SECONDARY CONTAINMENT TESTING /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. . IlR/ ~@V@II~OII SClV~CE':8 .11!11 T 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 32b-3979 Fax: (661) 852-2171 Pep6, Ot, 3- a~~ 6~ PERMIT NO. © ENHANCED LEAK DETECTION L~NETESTING n ~~ n~a~rnowr_ rconnre7~n6t r~n(c, ~ oo~,~ ^ SB-068 SECONDARY CONTAINMENT TESTING ~/ .Inn .N... ~~GW .cv. ;.. . .~ _. .. ~.. ._..~.._. _ .._ _ . FACILITY ~ ~< ... ~ (~ ~(~ ~ ~ V B C N CT P RSON ADDRESS ~ ~ Y ~ ~- OWNERS NAME ~~ OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO 9E TESTED ~f ~~1 ,, _,TANK;T~§ 1NG COMPANY .. .. `. ....;,. . NAME OF G P -n C ~ / NAME PkON N 0 ONTACT P SO UWLINa ADDRESS ~ NA1dE ~ PHONE N hl E OF TER PECIAL IN ECTOR CERTIFI TION #: DATE ~ TIME T T 70 E CO UCT~ 1CC #: TEST METHOD 31GNATURE OF APPLICANT ~ DATE _ ' ARPROVED BY DATE l ~~. ( ,~ ~~; ~. I J ,I , ~ ~' ~ I ~; ,, ~;~ ~ . ~, FD 2095 (Rev. 09/05) BILLING & PERMIT STATEMENT BAKERSFiELD FIRE DEr~r-S~S~ Prevention Services rf~RS 900'FnixhJn Avenue, Suite 210 ~lrTar r Bakersfield, CA 93301 PERMR N~ ~~~'~ ~ - - . LOCATION OF PROJECT ('~ 0 ` ~ 1 - PROPERTY LETION GATE ~- O STARTING DATE - i NAME _ PROJECT NAME a ADOR PHONE N0. -~ PROJECT ADDRESS ~~ ~ ~~`~ CfTY STATE ZIP OE f •- •- • CONTRACTOR NAME CA LICENSE N0. , TYPE OF LICENSE EXPIRATION DATE PHON N . ~~ CONTI7ACTORCOMP ~ ~ ~ F~~' ADDRESS 1,. CRY /~ ZIP CODF.r] t~,~ u ~ • s 262 50 ^ a ~ Alarms -New & Modifications - (Minimum Charge) . $ 98 rmit fee 0! 3125 =P FL x S ~ ^ Over 20,000 Sq. FL . e q. 98 ^ Mi Ch i kl N & M difi ti i S $210 00 ~ mum arge) pr n ers - ew ca n o ons - ( . 98 ^ FL 000 S O 5 it fee Ft 042 = Per S ~ ver q. , x. m q. 98 ^ Minor S kler Modifications {< 10 heads) ri ] ; 93 00 [Ins ection Onl ~ p n y . p 98 ^ Commercial Hood -New 8 Modifications $ 398 26 ~ s . 98 ^ Addltiona! Hoods 00 S 36 ~ . 98 ^ S ra Booths - New ~ Modifications $458 00 ~ p y . 98 ^ Ab round Storage Tanks (lnstallation/lnsp.-1°7-une} $165.00 ~ ^ Additional Tanks $26.00 82 n Aboveground StorageTanks (RemovaAlnspection) $109.00 82 ^ Underground Storage Tanks (/nsta/tationJinspedion) $878.00 (pertank) 82 ^ Underground Storage Tanks (Modification) $878.00 (persrte) ~ ^ Underground Storage Tanks (Minor Modification) $155.00 82 ^ Underground Storage Tanks (Removap $675.00 (pertank) 84 ^ Oiiwell (Installation) $72.00 ~ 84 Mandated Leak Detection (Testl Fuel Monit. Cert. $ 61.00 (perSlte) ~ ~L ~ , f, '''" ~ ^ Tents $ 93.00 (perten~ 84 ^ Afterhoursinspectfon fee ;122.00 84 ^ Pyrotechnic - (Per event, Ptus Insp. Fee (gj $90 per hour) $ 60.00 + (5 hra min, stand -by fee Mspection) _ $510.00 84 ^ REdNSPECTlON(S) / FOL.LOWUP /NSPECTlON(S) $ 93.00 (per hour) 84 ^ Portable LPG (Propane): NO.OF CAGES? _ $66.00 84 ^ Explosive Storage $249.00 64 ^ Copying & File Research (File Research Fee $33.00 per hr) 25¢ per page ; 84 ^ Miscellaneous ~ 84 FO 2021(Rev. OSIO~ 1 ..ORIGINAL VYHITE (to Treasury) 1•YELLOw (to FUe) .a~gv,~„."' M "~._ ,,~ l J~~l ~~~ f`~. ~• MONITORING SYSTEM CERTIFICATION ~ r For Use By All ,jurisdictions Within the State of California Authority Cite& Chapter 6 7, Health and Safety Code; Chapter 16, Division 3, Tit a 23, California Code ofRegulations This fora: {must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepare for each monitoring svstem control panel by the technician who performs the work. A copy of this form must be provided to the tank system owner/operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information Facility Name: tMOtZI t_ _ Bldg. No.: • Site Address: oZSay DS W ALL S 1 City. ~R'~=~S~t~-1~ Zip: ~'}3~D ~ Facility Contact Person: Contact Phone No.: ~~ Make/Model. of Monitoring System: ~'l LB"~~ ~~ ~' Date of Testing/Servicing: 3/ S / a7 B. Inventory of Equipment Tested/Certified INSPECTOR ON-S1Tl~Y~~ NO NAME: Vn k.ne,...wJ Check the appropriate boxes to indicate specific eouioment inspected/serviced: Tank ID: V/1 L~~ Tank 1D,: / ES [n-Tank Gauging Probe. Model:: t/V1.~41r' l _ ~ In-Tank`Gauging Probe: Model: -'/{ (T ` ~(1 Annular Space or Vault Sensor. Model: ~ Annular Space or Vault Sensor. Model: O _ Piping Sump /Trench Sensor(s). Model: o`Z O Piping Sump /Trench Sensor(s). Model: O ,~~ti~FSumpSensor(s).,q-Tl~- Model: i~itt$umpSensor(s).¢}-7~(>' Model: ~a f$j 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 s eci a ui inept a and model in Section E on Pa e 2 . ^ Other s eci a ui ment a and model in Section E on Pa e 2 . ank ID': ~ Et/M1 -~ Tank ID: ~ In-Tank Gauging Probe. Model: _ ^ "In-Tank Gauging Probe. Model: Annular Space or Vault Sensor. Model: o O Annular•Space or Vault Sensor. Model: _ ~-Piping Sump /Trench Sensor(s). Model: O ^ Piping Sump /Trench Sensor(s). Model: j~ •~Itt Sump Sensor(s)..s47~ Model: a O ^: Fil l Sump Sensor(s). Model: ~[ Mechanical Line Leak Detector. Model: R ^ Mechanical Line Leak Detector. Model: O Electronic Line Leak Detector. Model: ^ Electronic Line Leak Detector. Model: ^ .Tank Overfill /High-Level Sensor. ModeL• ^ Tank Oveifill 1 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). Dispenser ID: ~ ''E-~ Dispenser !D: ~ ¢ g Dispenser-Containment Sensor(s). Model: Bo Dispenser Containment Sensor(s). Model: d~ Shear Valve(s). Shear Valve(s). ^ Dis enser Containment Floats and Chains . ~ (] Dis enser ContainmenGFloat -s and Chains . Dispenser !D: , Dispenser Containment Sensor(s). Model: Bo/ Dispenser ID: ¢-t t) • C~'.Dispenser Containment Sensor(s). Model: ~fl/ .~ Shear Valve(s). , IQ Shear Valve(s). ^ Dispenser Containment Eloat(s) and Chain(s). O Dis enser Containment Floats and Chains . Dispenser ID: ~'Ci Dispenser !D: ~f iENT w.•+~ p !~ Dispenser Containment Sensor(s). Model: Go ^ Dispenser Containment Sensor(s). Model: f~ Shear Valve(s).: [] Shear Valve(s). ^Dis enser Containment Floats} and Chain(s). ^ Di§ enser Containment Floats and Chains . *If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. CertifiCat10Y1 - 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 Plot Plan showing the layout of monitoring equipment: For any equipment capable of generating such reports, 1 have ptso attached a copy of the report• (check atl that a pty): ^ System set-up report Technician Name (print): ~~'~~) ~u-~ Signature: Certification No.: (9010 - OS - l ~r1$'~ License. No.: may lo~ ~7 -v ~' Testing Company Name: RICH ENVIRONMENTAL Phone No.:•~ 661 _392-8687 Site Address: °Z `J o'?y t9 ~c.r"~L S ~ F~~+X~Sf/r~~ .S9 Date of Testing/Servicing: a / ~ /~ Page I of 3 03101 Monitoring System Certification ~_ ~ t~~~% D: Results of Testing/Servicing Software Version Installed: g ~ ~'~ !'`mm~lnfn 4hu fnllnwinrt nhnnUlic}• Yes ^ o Is the audible alarrn o erational? Yes ^ o Is the visual alarm o erational? Yes ^ o Were all sensors visuall ins ected, functionall tested, and confin-ned o erational? Yes ^ o Were all sensors installed at lowest point of secondary. containment and positioned so that other equipment wilt not interfere with their ro er o eration? O Yes ^ o If alarms are relayed to a remote monitoring station, is all communications equipment (e.g: modem) ,~ N/A operational? -~ Yes ^ o For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ^ N/A monitoring system detects a leak, fails to operate, or is electrically disconnected? Ifyes: which sensors initiate positive shut-down? (Check all that apply) ~Sump/T'rench Sensors;...^ Dispenser Containment~Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? S$'Yes; ^ No. O Yes O o For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no 1$j N/A mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill oint(s) and operatin pro erl ? [f so, at what rcent of tank ca aci does the alarm tri er? ^ es No Was any monitoring equipment replaced? Ifyes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model foc all re lacement arts in Section E, below. es O No Was liquid found inside any.secondary.containment systems designed as dry systems? (Check all that apply) ^ Product; ~ Water. If es describe causes in Section E below. . Yes O o Was monitorin s stem set-u reviewed to ensure ro er settin s? Attach set u re orts, if a licable !?,~-Yes ^ o Is all monitoring equipment operational per manufacturer's specifications? t In aection ~ below, gescribe how anq when these geticlenctes were or will be corrected. E. Comments: (• ~ 5 min ,9-~vtoyn T DF L.l ~~ t ~ Za ~ S i~vr~~j t n.~ -~}~ u,nu ~ 5 v •~np ,q-~ i~~ Spy s;~ ~ '? ~ $ ~ •A-l..l L~ C~2~ t~ -t.~rv~S R-~- w+.8a~`~ . ~ - S_ 0'7 ~f~` Page 2 of 3 03101 r ; F. In-Tank Gauging /SIR Equipment: ~. ~ ~ _! G ,G~ 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. V V.~. ^ Yes ^ o Has all input wiring been inspected for proper. entry and termination, including testing for ground faults? O Yes . O o Were all tank gauging probes visually inspected for damage and residue buildup? ^ Yes O o Was accuracy of system product level readings tested? O Yes ^ o Was accuracy of system water level readings tested? ^ Yes O o Were all probes reinstalled properly? ^ Yes ^ o Were all items on the equipment manufacturer's maintenance checklist completed? ~` In the 5ectlon H, below, descr-be uow ana wnen tnese aencrencles.were or wul ne correcteu. G. Line Leak Detectors (LLD): O Check this box if LLDs are not installed. f mm~lata thw fnllnwina oharlrlirt• Yes ^ No* For equipment start-up or annual equipment certification, was a teak simulated to verify LLD performance? ^ N/A (Check all that apply) Simulated leak rate: J~(3 g.p.h., ^ 0. I g.p.h , ^ 0.2 g.p.h. ^ Yes o Were all LLDs confirmed operational and accurate within regulatory requirements? Yes ^ o Was the testing apparatus properly calibrated? Yes ^ o For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A ^ Yes ^ o For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? N/A ^ Yes ^ o For electronic LLDs, does the turbine automatically shut offif any portion of the monitoring system is disabled ,~ N/A or disconnected? O Yes ^ o For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions N/A or fails a test? . ^ Yes O o For electronic LLDs, have all accessible wiring connections been visually inspected? N/A - Yes ^ o Were all items on-the equipment manufaoturer's maintenance checklist completed? r -n the aecuon H, below, aescrlbe now ana wnen-these denclenctes were or will be corrected. gi. Comments: (• 7"I-~'E (> nL-&~ 1N1 L~.D ~-Arl l_ ~3~ ~T ~,.iv9'S Page 3 of 3 03101 Monitoring System Certification t~n~"/~ '~ UST Monit©rinS~te Pl ~ ~ ~, ~, ~~.~ Site Address: a 5a y °S ~ ~ ~-t" S~ $'~ ~~ ------------------------- ------vH-----~ ---- --------- ~Q ----------- ----_----- d------- ~p~ --------- au~-rf---------------------- ------ _.-_ ~--- --------- -- ----------- -- - - -- __ --- - ~m~e: - -sue-- -----------_=-------------~~~^:-- ~~ ---- ---~~ ~ w-ori,- ---- -- -- ---------------------- ----------------------- -------~~~_'----t~ g---------- ----- -~ ----------- --- -- 3IJY------------------ ------c'---------------- -------------q~i°--------- Date map-was drawn:.3 ./ S"/ °`~ Ins`:~uctions If you already have a diagram that shows all required information, you may include it, rather than this page, with dour Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations of the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, sumps, dispenser pans, spill containers, or other secondary containment areas; mechanical or electronic line leak detectors; and in-tank liquid level probes (if used for leak detection). In the space provided, note the date this Site Plan was prepared. Page of os~oo ' .' ` i .. 56~k~. BRCst?T~S ~ kC£RS$'x$LD,~.A.S33Q8 QF7F'TCE (661) 392-aG87 .& T.+",A~C (66~) ~9~~06a1. M]~'d3$t~Y.~A~'~3'~~}$~I2~y'".~!' ~TDR TEST TId~Q# L t Fla :~. ~ ~, ~~1' ~181.A1e ; ~ O L~ 1 L ST+~Z'IsYt,.) >aa~a.a.~.~y .~.aax~~~; asap-I oSca~c.~ ~si -'-~-- P~4c:luC~ Ta~.n+e ~yQ~ (Fresstzz~et Suctiaxe, c3z'avi,tyl ~~SSu.e~ . t PRc1LtfCT LEAK Z]ETECTUk2 T~Z~~ -TEST TR~k' FA~ S ~r~.a~~,L ~auz~as~x a~x~ow ~+~= a~. -. L/U 'x'7iI+R R~~ 3~4c.KET X>~.~ 1'Al9i3 un~-~ i '~ . S~x2T.A.L # "t -i i o - 2Q0.: `~,,PS ~ ,FATE! L/D TYP~_ ~ ~ ~- .~ s~z~zAx. # ~a ~ zoo ~~ ~s ~ ~,a.xL; DI ESIE C. RP-TES i T,,fA `,C7tk'~ ~"K~T ' ~&RTAT+ # ~Ccllr .. Ai~ ~'I~S.~ F,A.x2.' U/1 ~--~ . ' • I ~:;ertify .the above tests were ednducted: on this d,aC~ accozding I~o ~ted ~I'aaket Pumps field: e`.est appaxatua test~.zig pxo.aedure as limita~~.or~s. Thy: Mechanical ~',,eak Detector I'e~st pass ,/ fa~tl is" d-etex~nizied by using a lm,r flow threshold trip rate of 3. gallon per houx ox' less at lA .I~BI. I .xekn.owlQdg~ tka.at all cistta eo~,lected ie true azad ¢Qxz•+e1o~ to Ck~a :?asst of rrf~ knowledge . . ~~~h:_ 9.~.~.,~-Rev kQo Sigt;,rxture • Date: y -~ ~ ~ ~ a~. •. " ~:~i; . • ~~ j : i 't l J `7 ply swxcs, J Zoos i Spill~Bucket. Testing ~~eport Form i •I7iis form is intended for use by contractors perfot»Fing annual testyig of US`T spill containment structures. •The completed form aria printoutsfromlests (ifapplicable), should beprovtded to the fa~ility`.of~+tner/operatorfor submittal.to the local regulatory agency. t. FACILITY IluFOR11IA~1ZON FacilityName• W-of3tt_ ~i-~a--r~ ~sJ ~ ~ . Data ofTts ' ~-S °7• --- . Facility Address: a sa y • o s ~ ~ ST k3 ~ C i25' F 1 ~.~ , . ~l ' Facility Ctmtact+ ~ ~ Phone: Data Local Agency Was Noti>';ied of Testing : ; ' Name ofLocal Ageaay Iaspectdr (ffpresent. during testing: • lJn, k~. ~ ~-' S~'l4'f~ .. . • 2_ . 'tTi.~'i'111T[~ CnNTRA('TDR 1NF~RMATIDN. Compan Name: R 1'c. E iu v c Rar- w, E~t1t:+!~•L' .. .. • . .Technician Conducting Test+ . ,A-A'~ awJ K~~. Credeatials~: CSLB Contractor., CC Service Tec ~ SWRCB Teak Testier. Other ( ~eci ) License Number(s): S a y lQ I V n- ~ i CFrItTII+TCATTON OF TECffiVICIAN R,ESPO1vSIBLE FOR CONDUCTING TIH~S TESTING I hereby cerlify.that all the information contained in this report is true, accurati;'~and tic full eonipltanee with legal requirements. Technician's Signature: Dom; ~ State laws and regulations do not currently require testing to be performed by a qualified coatracobr. However, local requirements may be more stringent. • e;omments -(include Information on repairs made prior to testing, and recommended follow-up jorfailed tests') DSLSTP , TEST STARTED 11':36 TEST S ~Lt.. 03185 07 BEGIN'LEU 2 4 IN END TIME 11:52 AM END DATE 0512007 'END LEVEL 2. 01 IN. i ' LEAK TH HOLD 0.0 2 IN I .TEST SULT PASSED ! 91UPRSP i. i- TEST STARTED 11:36~TiM ~~ TES ED 03'05 BEGIN LEU 4' 6 IN END TIME 11:52 AM END DATE 0 007 END L 4.3 IN L:E THRESHOLD 0.802 IN.. i T T RESULT ,.:PASSED +~ 91FILSP EST STARTED 11:36 AM'~':' TEST STARTED 03~05~2007 BEGIN LEVEL 3.7126 IN C '~ END TIME 11:52 AM ! END DATE 03~05i2007 j END LEVEL 3.71 IN LEAK~THRESHOLD 0.'602 IN .° EST RESULT ~~PASSED 03/05/2007 .5:10 PM I SUMP LEA T REPORT 87FILSP • TEST STARTED 4e5 M' TEST STARTED 03i05~200 BEGIN LEVEL 4.7'565 IN , END TIME 5:10 PM END DATE 03~05i2007 END LEVEL 4.7567 IN LEAK THRESHOLD O~PpSSED~ TEST RESULT :.' ;5. 4:55 007 TEST STA . •TEd:=:::: TEST STA E~:" 0 • 717 I.N ~ BEGIN LEU ~ 5;10 PM END DAME 031.05/2007 END VEL 4.3716 IN ~I THRESHOLD •002 IN r '~ EST RESULT PASSED '; ~. ,;..~. 87STP . '. I,'~. . 'TEST STARTED . :55 RM TEST STARTED 0 i05~2007 ~~ :: BEGIN LEVEL 3.989 PM , END TIME 0512007 END DATE 3,9873 IN END LEVE LEAK ESHO D O'FRILED TEST SULT i DSLSTP . •TEST•S7ARTED 12:08 PM TEST STARTED 03/05/20 BEGIN L L- _• E~'` ,_2.'38 IN •23 PM ~:~;r..: END TIM END DATE i05i2007:. END LEVEL •2.3857 I.N.: .; ` LEAK TH OLD `a.002 SIN '•' . ' TEST ULT . `~` PASSED ..,~ 1:.. 91UPRSP TEST STARTE ~M. 12•~2~07 .TEST STARTE • BEGIN LEUE 0 4.3375'IN END TI TE 12:23 PM 3/05/2007 EN IEUEL 3374 IN , LEAK THRESHOLD. 0`PRSSED TEST RESULT _ 91FILSP TEST STARTED TEST STARTED '12:08 PM 3712 ~ . BEGIN LEVEL • N I END TIME END DATE 12;23 PM 0~05i2007 . 8.7125 IN ENO LEVEL OLD 0 • p0 2 • I • SE TEST RESU~ ! i ! p D S I .. , 4:54 PM ~. 03i~5~2007 'i. SUMP LE EST REPORT ; 87FILS 1. 4:39 P TEST STARTED TEST STARTED 0 410 964 ~ N BEGIN LEVEL 4:54 PM ~ END TIME 03/05/2007 END DATE 4.7565 IN. END LEVEL LEAK THRESHOLD 0•PASSED ~ TEST R. 7E57 STARTED 4:39 PM TEST gTARTED 04 37 ~20ZN ;~ BEGIN LEVEL ;54 PM i` END TIME 0512007 END DATE 4, 716 IN END lEV ESHOLD 0. 2 IN I, LEAK p SSED t_ RESULT TEST S1H ~~~ •-12007 TEST STA ED 3,9931 IN BEGIN •LEU 4:54 PM END TI E 0310512@07 END 8,9900 IN LEVEL 0,002 IN • EAK THRESHOL FAILED TEST RESULT a 03/65/2007 .. i : i y ~ .. SUMP LEAK TEST REPORT .~~ 91STP :- -:.: ~ S'fRRTED 1: Phl TEST ARTED 031 12007 BEGIN L L .3333 IN i END TIME ~ 1:19 PM ' END DATE s85~2807 END LEU 1. 3 IN s ~ ~ LEAK RESHOLD 0.0 IN TE RESULT PASSED 91 PSUMP e~h~ob[.. TEST STARTED 1: PM 'j T STARTED. 0 007 . BEG LEVEL .296S6t:iN END T 1:19 PM ~~ END DATE 03/05/2007 END .LEU ~~.Z„ 2 IN LEAK ESHpLD 0.00 IN TE RESULT PASSED DSPSUMP~ ST STARTED 1: PM TE STARTED 83~ 12887 BEGI UEL .7281 IN END TIM 1:19 PM. j ..END DATE 83i85~2087. 1 END LEU 76 IN i LEAK RESHOLD IN. I TES RESULT ~ ED OSLFILL ~ TEST STARTED 1:04 pM TEST STARTED 03~05i2887 BEGIN LEVEL. .2.5921 IN i END TIME 1:19 PM. END DATE ^03/0512007 END LEVER 2.5921 IN LEAK THRESHOLD 0.002 IN ~ TEST RESULT PASSED i ~~ 03~05i2007 1:37 PM SUMP LEAK TEST REPORT 91STP T T STARTED 1:2 M TE STARTED 03/ 007 BEGI FUEL ' 34 IN END TIM 1:3? PM END DATE 03/05/1007 END LEVE .3350 .IN LEAK T ESHOLD 07 IN TEST ESULT J~16REfl8Ed ~ 91PSUMP•~~~K~~ TEST STARTED 1:2 M STARTED A3~ 12087 BEGI EUEL .2959 IN END TI 1:37 PM END DATE 385/2087 END LEU IN LEAK ESHOLD 0.002 IN T RESULT; PASSED. DSPSUMPT~4.~ T STARTED 1: PM '~ TE RATED 83/ /2007 BEGIN L .7275 IN END TIME 1:37 PM . END DATE 512007 END LEU 2.7'13 IN LEA RESHOLD 0.002 IN TES RESULT PASSED DSLFILL TEST STARTED 1:22 PM ~. :' TEST STARTED , 03/85/1007 BEGIN LEVEL 2.5928 IN ' END TIME 1:37 PM END DATE ~ 83/05/2087 END LEVEL 2.5919 IN LEAK THRESHOLD 0.002 IN TEST RESULT PASSEO ~ ~ v ./y..~ 03/@5/2007 2:32 PM SUMP LEAK TEST REPORT 91STP T STARTED 2:17 PM TEST TARTED !05/2007 BEGIN UE 3.4143 IN END TIME 2:32 PM END DR 03/05/2007 END UEL 3,4145 IN L THRESHOLD 0•PASSED ST RESULT n a nn~ .wan 93/05/2007 2:54 PM SUMP LEAK TEST REPORT UENTBOX TE STARTED .39 PM 7~ST TARTED /052007 BEGIN EUE 3'~ 154 PM END TIM END DAT 03~05i2007 END L 3.5160 IN LE THRESHOL ~~PASSED T RESULT 83/A5/2807 3:10 PM SUMP LEAK TEST REPORT UENTBOX. .. , . TEST ST TED ,05 X007 TEST STAR D .BEGIN LEU 3 3:10 Pr9~ END TIME. 3/05x2007 END DA. .: ,5159 IN END ~ '.~` LE THI2ESHilLD ~ASSED ~, TEST RESULT `l~~ n. `~ yy MOBIL COMMUNICATIONS SETUF - - - - 2524 OSWELL ST - - - r . BAKERSFIELD CA 93306 PORT SETTINGS: ' ~ MAR 5. 2007 6:43 AM ~ COMM BOARD : 1 {RS-232) ' BAUD RATE : 1200 ODD SYSTEM STATUS REPORT - - - - - -. - - - .- - - PARITY STOP BIT 1 STOP , DATA LENGTH : 7 DATA ALL FUNCTIONS NORMAL AUTO TRANSMIT SETTINGS: AUTO LEAK ALARM LIMIT • DISABLED AUTO. HIGH WATER LIMIT ;I DISABLED AUTO OVERFILL LIMIT i ~ DISABLED SOFTWAR& REVISION LEVEL AUTO LOW PRODUCT VERSION 8.05 SOFTWAREtt 349500-008-F DISABLED AUTO THEFT LIMIT CREATED - 95.07.06.08.33 DISABLED AUTO DELIVERY START NO SOFTWARE MODULE DISABLED AUTO DELIVERY END SYSTEM FEATURES: PERIODIC IN-TANK TESTS DISABLED ~ EXTERNAL INPUT ON ANNUAL IN-TANK TESTS AUTO DISABLED AUTO EXTERNAL INPUT OFF ~; DISABLED AUTO SENSOR FUEL ALARM DISABLED AUTO SENSOR WATER ALARM DISABLED SOR OUT ALARM DISABLED SYSTEM SETUP -; MAR 5. 2007 6:43 AM _ OTY 32 OOOOO CdDE SYSTEM UNITS u.s. SYSTEM LANGUAGE ENGLISH PIOHIL RS-232 END OF MESSAGE 2524 OSWELL ST DISABLED BAKERSFIELD CA-93306 SHIFT TIME 1 DISABLED SHIFT TIME 2 DISABLED SHIFT TIME 3 DISABLED SHIFT TIME 4 DISABLED PERIODIC TEST WARNINGS DISABLED ANNUAL TEST WARNINGS DISABLED TY EM CODE OOOOOO PRINT TC VOLUMES ~ ~~, ~ ENABLED TEMP COMPENSATION , VALUE {DEG F ): 60.0 IN-TANK SETUP T 1:UNLEADED PRODUCT CODE 1 THERMAL COEFF :.000700 TANK DIAMETER : 113.75 TANK PROFILE 1 PT FULL VOL 15023 FLOAT SIZE: 4.0 INCHES WATER WARNING 2.0 HIGH. WATER LIMIT: 3.0 MAX OR LABEL VOL: 15023 OVERFILL LIMIT : 90% 13520 HIGH PRODUCT 95% 142?1 DELIVERY LIMIT 30% 1502 LOW PRODUCT 50U LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 50 TANK TILT 0.00 MANIFOLDED TANKS Tit : NONE LEAK MIN ANNUAL 1502 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNK TST SIFHON BREAK:OFF DELIVERY DELAY 15 MIN T 2:PREMIUM PRODUCT CODE THERMAL COEFF :.00070D TANK DIAMETER 90.00 TANK PROFILE 1 PT FULL VOL 11550 FLOAT SJ2E: 4,0 INCHES WATER WARNING 2,0 HIGH WATER LIMIT: 3.0 MAX OR LABEL VOLT. 11550 OVERFILL LIMIT : 90% HIGH PRODUCT 10955 DELIVERY LIMIT : 1010 • 1200 LOW PRODUCT LEAK ALARM LIMIT: 599 SUDDEN LOSS LIMIT: 50 TANK TILT 0,00 MANIFOLDED TANKS T#: NONE `. LEAK MIN ANNUAL 1200 PERIODIC TEST TYFE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TNt{ TST SIPHON BREAK:OFF ~ DELIVERY DELAY 15 MIN T 3: D I ESEL !~ l ~' THERMAL COEFF TANK DIAMETER ''000450 TANK PROFILE 90.00 FULL VOL 11550 FLOAT SIZE: 4.0 INCHES WATER WARNING HIGH WATER LIMIT: 2,0 3,q MAX OR LABEL VOL: OVERFILL LIMIT 11550 g0% HIGH PRODUCT 10395 95% DELIVERY LIMIT 10972 l Oi • 1200 LEAKPALARMTLIMIT: 500 SUDDEN LOSS LIMIT: 50 TANK TILT 0.00 MANIFOLDED TANKS T#: NONE j LEAK MIN ANNUAL 1200 PERIODIC TEST TYPE STANDARD ANNUAL TEST FAIL ALARM DISABLED PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED PER TEST AVERAGING: OFD TANK TEST NOTIFY: OpF TNK TST SIPHON BREAK:OFF DELIVERY DELAY 15 MTN i LIQUID SENSOR SETUP L 1:87 STP TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 2:87 ANNULAR TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE L 3:91 PRQBE-SUMP TRI-STATE (SINGLE FLOAT) CATEGORY PIPING SUMP L 4:91 STF TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L 5:91 ANNULAR TRI-STATE (SINGLE FLOAT) CATEGORY ANNULAR SPACE L 6:DIESEL PROBE-SUMP TRI-STATE (SINGLE FLOAT) CATEGORY PIPING SUMP L 77DIESEL STP TRI-STATE (SINGLE FLOAT) CATEGORY STP SUMP L B:DIESEL ANNULAR TRI-STATE (SINGLE FLOAT} CATEGORY ANNULAR SPACE OUTPUT RELAY SETUP R 1:87 STP TYPE: STANDARD NORMALLY CLOSED LI~dUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM R 2:91 STP TYPE: STANDARD NORMALLY CLOSED j LIQUID SENSOR ALMS flLL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHQRT ALARM R 3:DIESEL STP TYPE: STANDARD NORMALLY CLOSED LIQUID SENSOR ALMS ALL:FUEL ALARM ALL:SENSOR OUT ALARM ALL:SHORT ALARM R 4:REMOTE ALARM TYPE: STANDARD NORMALLY CLOSED u..~ uu ~ i ~+w71 V1'KY J'CtYVh'`1^~ l~ ----- SYSTEM ALARM ----- PAPER OUT MAR 5. 2007 6:37 AM PRINTER ERROR MAR 5. 2007 6:37 AM BATTERY IS OFF JAN 1. 1994 8:00 AM ALARM HISTORY REPORT ---- IN-TANK ALARM - T 1:UNLEADED LEAK ALARM JAN 1. 2007 4:00 AM JAN 2, 2006 3:30 AM JAN 3. 2005 3:30 AM OVERFILL ALARM FEB.28,-2007 3:50 PM FEB 26, 2007 -7:42 PM FEH 19. 2007 9:36 PM LOW PRODUCT ALARM AUG 12. 2005 5:58 AM DEC 17. 2004 7:46 AM AUG 22, 2004 9:18 PM SUDDEN .LOSS ALARM JAN 1. 2007 2:45 AM JAN 2. 2006 2:37 AM JAN 3, 2005 2:38 AM HIGH PRODUCT ALARM FEH 14. 2007 2:44 PM JAN 8, 2007 4:14 PM SEP 25, 2006 4:08 PM. INVALID FUEL LEVEL AUG 12, 2005 6:00 AM DEC 17. 2004 7:50 AM AUG 22, 2004 9:23 PM LIQUID SENSOR ALMS i ALL:FUEL ALARM ... . LEAK TEST METHOD TEST ANNUALLY: ALL TANK JAN WEEK 1 MON START TIME : 2:30 AM TEST RATE :0.20 GALiHR DURATION 2 HOURS DELIVERY NEEDED MAY 12. 2006 10:28 AM AUG 12, 2005 3:25 AM MAR 6, 2005 8:13 AM MAX PRODUCT ALARM MAY 1. 2005.11:39 AM ALARM HISTORY REPORT ALARM H1SrUxr n~=~`~ y~ ALARM HISTORY REPORT SENSOR ALARM ----- SENSOR ALARM ---'- PROBE-SUM ---- IN-TANK ALARM ----- L 2:87 ANNULAR L 6:DIESEL PIPING SUMP T 2:PREMIUM ANNULAR SPACE FURL 5LA2 L 6LA2007 2:19 AM 007 2:30 AM MAR LEAK ALARM JAN 1. 2007 4:30 AM FUEL ALARM FUEL ALARM 2006 11:40 PM MAR 27. 2006 11:36 PM MAR 27. OVERFILL ALARM MAR 1. 2004 6:34 PM _ 0 8LA M L A2005 2:30 AM I L . 05 2:39 2 2 AR AM 2g • MAR LOW PRODUCT ALARM SEP 1. 2006 9:38 AM SUDDEN LOSS ALARM JAN 1. 2007 3:20 AM JAN 2. 2006 3:07 AM ~~ JAN 3. 2005 3:59 AM INVALID FUEL LEVEL SEP 1. 2006 9:13 AM ALARM HISTORY REPORT ALARM HISTORY REPORT DELIVERY NEEDED ----- SENSOR ALARM ----- ----- SENSOR ALARM --°' 7:DIESEL STP JAN 28. 2007 5:10 AM NOV T4. 2006 6:09 AM L 3:91 PROBE-SUMP PIPING SUMP L STP SUMP NOV 4. 2006 2:37 AM L 5LA RL 5LA2007 2:18 AM 2007 2:22 MAR AM MA FUEL ALARM MAR 27. 2006 11:38 PM FUEL ALARM MAR 27. 2006 11:41 PM FUEL ALARM MAR 28. 2005 2:26 AM FUEL ALARM MAR 28. 2005 2:29 AM ALARM HISTORY REPORT ~. i ---- IN-TANK ALARM ----- T 3:DIESEL ~ ALARM HISTORY REPORT ALARM HISTORY REPORT , DELIVERY NEEDED JAN 25, 2007 8:09 PM ' ----- SENSOR ALARM ----- ------ SENSOR ALARM ---' ANNULAR OCT 20, 2005 5:39 PM SEP 15. 2005 4:16 PM L 4:91 STP STP SUMP L B:DIESEL ANNULAR SPACE ° ' FUEL ALARM MAR 5. 2007 2:21 AM FUEL ALARM MAR 5. 2007 2:16 AM FUEL ALARM MAR 27. 2006 11:36 PM FUEL ALARM MAR 27. 2006 11:42 PM FUEL ALARM MAR 28. 2005 2:25 AM FUEL ALARM ~ MAR 28. 2005 2:29 AM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 1:87 STP STP SUMP FUEL ALARM MAR 5. 2007 2:24 AM ALARM HISTORY REPORT SETUP DATA WARNING JUN 28. 2006 7:24 AM ----- SENSOR ALARM ----- L 5:91 ANNULAR FUEL ALARM ANNULAR SPACE » JUN 28. 2006 6:57 AM FUEL ALARM MAR 5. 2007 2:21 AM ' FUEL ALARM MAR 27. 2006 11:39 FM FUEL ALARM nnoa ~q • X005 2 : 25 AM 6cJ'7~ M T SITE i~TAME' yd~ a Ci / L .. ~T~-T1~1 •... DATE: 3 - 5' ro7 DItE S: ~ S ~ y o s v ~ 5?" TECHNI ~ ~'~ '~~'~ CITY,.. ~,q.-K.~S ~c'~•r~ c,D ~ ~A SIGN -' TgE~FOLLOWING COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. .,' LABOR: ~ N ° '"~~ ,,. PARTSINTALLED: ~ . 2~i~ ~-k~zT FX u 1 v-~ NAMES TI'I'LE• THE ABOVE NAMED PERSON TAKES FULL RESPONSIBYLITY OF NOTTIH'YING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR T~ ABOVE LISTED PROBLEMS AND NOTYFYIl~TG RICH EN'vIItOrTMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIItONMENTAL OF ANY FINES OR PENALTIES OCCURIl~TG FROM NON-COMPLIANCE. A COPYOF TSIS DOCUMENT HAS BEEN LEFT ON-SITE FOR YOUR