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HomeMy WebLinkAboutBUSINESS PLAN 8/3/2006 1 ~ _ ~L ~ STEVE THORNE CHEVRON ,.~~ 2700 OSWELL STREET __ _____ ~' J ''~A ~1 ~~ ~ `y ~°~ t i ~~ ~~~~ ~. ,,~ ~;~ ~~ ~ ~, ,. ~'~ ~. a, ~:. ,.~., + THORNE CHEVRON STEVE ________________________________ SiteID: 015-021-000605 + Manager BusPhone: (661) 871-1200 Location: 2700 OSWELL ST Map 103 CommHaz Moderate City BAKERSFIELD Grid: 15D FacUnits: 1 AOV: CommCode: BFD STA 08 SIC Code:5541 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title THORNEtiTon/~ / OWNER / Business Phone: (661) 871-1200x. Business Phone: ( ) - x 24-Hour Phone (661) 399-0262x 24-Hour Phone ( ) - x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact .Phone: (661) 399-0262x MailAddr: 2700 OSWELL ST State: CA City BAKERSFIELD Zip 93306 ? "" "' " J oc~,•~ harn~ Owner eTT - - Phone: (661) 871-1200x Address 404 PARTRIDGE AVE State: CA City BAKERSFIELD Zip 93309 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif~d: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG U - UST Bayed on my inquiry of those individuals responsible for oofataw9that ~I fhavetlpersonally under penalty examined and am familiar with the information submitted and believe the information is true, accurat .,and complete. ~ $ 3 0 ~6' ig atur Date ~~~ ~~~a~~,~ ENT A U ~ 10 2006 t______________________________________________________________________________+ -1- 03/30/2.006 UNIFIED PROGRAM INSPECTION CHECKLIST;; ~ir~r ~~sr .SECTION 1: Business Plan and Inventory Program ~ BARERSFIELD FIRE DEPT Prevention Services 900 Truxtun Ave., Suite 210 Bakersfield. CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 ,/I FACILITY NAME NSPECT D ~C ION IME ~ ~ J ~ ~~ ~ /~ ` , '1 ADDRESS HONE NO. 00 F EMPLOYEES ~/ FACILITY CONTACT USINESS ID NUMBER 15-021- ~~ Section 1: Business Plan and Inventory Program ^ ROUTINE OMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compiiance~ OPERATION V=VIOIatIOh COMMENTS ^ APPROPRIATE PERMIT ON HANG ~_ ^ BUSItIQSS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ~~~/// ~ ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND R CEDURES ^ EMERGENCY PROCEDURES ADEQUATE ~1 ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING (i~' j ^ FIRE PROTECTION ~^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON S~IT~E?~ '^ YES CJ NO ~,, EXPLAIN: -.-LL~~.(~ Zrt 7~~" ==~-~=~c~ ~'~ ~Z~Z ~ ~-~ ~l,tzz7-~ QUESTIONS REGARDING THIS INSPECTION? PlEA8E CALL U8 AT (881) 328-3978 ~inaN ~2z~- ~- i ~ ~ti.. Inspector (Please Print) Fire Prevention / 1" In / Shift of SSe/Stetion # Business SHe/School Ske Responsible Percy (Please Print) White -Prevention Services Yellow - Station Copy Pink - Buaineae Copy FD2lK8 (Rw. 02-p5} 1 g4~~LL Ff't'ev Pw~' fi \ CITY OF BAKERSFIEI~U FIRE DEPARTMENT ~~ ~ ~ ~~ OFFICE OF ENVIRONI~~IEN'TAL SERVICES `~' y~~~ UNIFIED PROGRAM INSPECTION CHECKLIST ~'w ~g~,,~~~ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 FACILITY NAME ~~~ti~A~ 1NSPECTIONDATE 1-•Z6~a~ Section 2: Underground Storage 'T'anks Program ^ Routine ombined ^ Joint Agency ^Mu1ti-Agency ^ Complaint ^ Re-inspection Type of ank „~" 5F-,.cf f w~~ Number of Tanks .~ Type of Monitoring ~5 3~~ Type of Piping " a ~~ ~./~L/ l , f~Ds ~t lrr~~ ~ OPERATION C V COMMENTS Proper tank data on the Proper owner/operator data on the Permit tees cun•ent Certification of Financial Responsibility ~, Monitoring record adequate and current f ~ T G Maintenance records adequate and current £ Failure to correct prior UST violations -~'J Has there been an unauthorized release? YeS ~~ Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks v OPERATION Y N COMMENTS SPCC available SPCC on the with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? [f yes, Does tank have overtill/overspill protection'? C=Compliance V=Violation l'=Yes N=NO Inspector: ~~ 19 ~Z.~ ~`~ Office of Environmental Services (661) 326-3979 white - Gnv. Svcs Pink -Business Cory Business Site Responsible Party .. n:..._-._ - -- - ... .. . ~; ., y ~ ~ ~ y~v a.~ ~ ,~ -"r' 111 I FI;1 ,..'1' . ICI ~ _. . .. - r-il.l i i I}a; ' 1 , :Ii::, Id' lik'1H1_ ~• ' ,~11., , ~ _ ~ ~ _ i„Iri~l~}~I ~I i_~Hl.. ' ' I ~ ~ } ~r ~_ f= T :}, T 3;1~:f::~;:i.1L.r;l ' '' 'r~- , ~: it-_ I_I};!, -- :,-;l I`. =- ; , ~ :, ;, ~ "' I i ~.,~ . I l - \ . .- ~ ~~ ,'~~y~_ ~~~ CITY OF BAKERSFIELD FIRE DEPARTMENT ,.~;,,., lm ~ OFFICE OF ENVIRONtiIF.NTAL SERVICES ~~~~ ~ ~ y~ UNIFIED PROGRAM INSPECTION CHECKLIST r> , ~C= ~, /~S `w ~~,i~` 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILIT NA E ~ (~+~ INSPECTION DATE ~ ~~ 03 _ ADDRESS ~ PHONE NO. 3Z7' ~ 7 FACILITY CONTACT f~ /t''~~1~ BUSINESS ID NO. 15-210- ~® INSPECTION TIME NUMBER OF EMPLOYEES D Section 1: Business Plan and Inventory Program Routine ^ Combined ^ Joint Agency ^Mulri-Agency ^ Complaint ^ Re-inspection OPERATION C V COMMENTS Appropriate permit on hand Business plan contact information accurate Visible address ~' %'-~ W _ Correct occupancy ~ ~,~ ti~ ,~; ~<' Verification of inventory materials Verification of quantities Verification of location / V Proper segregation of material Verification of MSDS availability Verification of Haz Mat training u Verification of abatement supplies and procedures Emergency procedures adequate Containers properly labeled Housekeeping Fire Protection Site Diagram Adequate & On Hand C=Compliance V=Violation Any hazar o wastepn site?: ~s ^ No Explain:~A (A l1 Questions regarding this inspection'.' Please call us at (661) 326-3979 White -Env. Svcs. Yellow -Station Copy Pink -Business Copy ~~~ ~ C (....:.-.. '. usi ess Site Responsible y Inspector: ~' ~ ~b2C~ l.~ s UNIFIED PROGRAM INSPECTION CHECKLIST'S ~1Rt ...n.... ... .. .: '. a'. .: ..~:...:.. ....~, .SECTION 1: Business Plan and inventory Program y BAKERSFIELD FIRE DEPT Prevention Services 900 Trtixtun Ave., Suite 210 Bakersfield. CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY N ME NSPE TIO DATE INSPECTION TIME 3 ADDRESS ~ ~©~ ©~" `~~ I HO~~ NOi ~~ O OF Ej PL_ OYEES C/ FACILITY CONTACT USINESS ID NUMBER / / 15-021- ~ l0 Section 1: Business Plan and Inventory Program ___ ~~~ ~ I~ - ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (~=Compliances OPERATION COMMENTS V=Violation L ~ ^ APPROPRIATE PERMIT ON HAND - / ~7/ ^ BUSin2SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS CORRECT OCCUPANCY ~ 111 ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL Q ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND ~ s~ ROC EDURES P ~< ~ / W ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING Ld ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES EXPLAIN: - _ ---- -- OUESTI REGA IN THIS INSPECTION? PLEASE CALL U8 AT (861) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Sfle/Station # ine Site/ ool a Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink - Buaineas Copy FD2049 (Rev. 02105) ~, d~'w4~' '~ ~~ CITY OF BAKERSFIELD FIRE DEPARTMENT ~~ ~ ~ ~+~ OFFICE OF ENVIRONMENTAL SERVICES y.' UNIFIED PROGRAM INSPECTION CHECKLIST `-,wE~g~,O'~ 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 FACILITY NAME STCVL `-C~hpa-[~C- J~Qt-{ INSPECTION DATE ~ ~~4 Section 2: Underground Storage Tanks Program Routine [~-Combined ^ Joint Agency ^Minti-Agency ^ Complaint ^ Re-inspection Type of Tank ~(~' 4 Number of ~l'anks Type of Monitoring ~~GN~ Type of Piping IQW~= OPERATION C V COMMENTS Proper tank data on the Proper owner'operator data,on the Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes No Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank AGGREGATE CAPACITY Number of Tanks OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have o~~ertilUoverspill protection'? C=Compliance V=Violation Y=Yes N-NO Inspector: Office of Environmental Services (661) 32 -3979 sines „ ~ esponsible Party white - inv. Svcs. Pink - Business Copy ,.,,l1N~FIED PROGRAM INSPECTION CHECKLIST .SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT a Prevention Services ~It~ 900 Truxtun Ave., Suite 210 ~R>rM Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY.NAME NSPE TIO DATE NSPECTION TIME 3~ ADDRESS HONE NO. O OF EMPLOYEES iI ~ n ` FACILITY CONTACT USINESS ID NUMBER 15-021- S®ction 1: Business Plan sand Inventory Program ~ ~~~ ^ ROUTINE COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (~=Compliance` OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ^ BUSInt?SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ^ VERIFICATION OF QUANTITIES ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ~/~ ~•i ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES C~O EXPLAIN: - _ QUEST S REG RDING THIS INSPECTION? PLEASE CALL US AT (881) 328-3979 Inspector (Please Print) Prevention / 1" In / Shift of SHe/Station # B ss . White -Prevention Services Yellow -Station Copy Pink - Buainese Copy FD2049 (Rw. tYtlOS) J ~ ?'~ ~~F ~ CITY OF BAKERSFIELU FIRE UEPAR'I'MENT b~ OFF{CE OF L;NY{RON1d~IENTAL SERVICES y~1 UNIFIED PROGRAM INSPECTION CHF,CKI.{ST ,:~ ~~ ;c~~' ;Rti,,;~ 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301 FACILITY NAME f~..s~h~ INSPECTION DATE ~~3r@~ Section 2: Underground Storage Tanks Program ^ Routine ~ombined ^ Joint Agency ^Multr-Agency 3 ^ Complaint ^ Re-inspection Type of Tank 1(~W~=~°S Number of-hanks Type of Monitoring ~_L-Gt/~ Type of Piping QW~_ OPERATION C V COMMENTS Proper tank data on the Proper ownen`operator data on tilt Permit tees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations / Has there been an unauthorized release? Yes No V 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 OF,S Adequate secondary protection Proper tank placardingJh3beling is tank used to dispense MVF? If yes, Does tank have overtill(overspil! protection'? C=Compliance V=Violation Y=Yes N-NO Inspector: Office of Environmental Services (661) 326-3979 ~~,'hitc -Env. Svcs. Pink - Rusinc I~ ;. _ - -.- - 1 sc~s MONITORING SYSTEM CERTIFICATION Fur U.re 1jy .AII Jurisdictions Within the State of Califi~rnia Authority Cite& Chapter 6 7, Health and.Safety Code; Chapter IG, Division 3, Title 23, California Code ofRegulatiuns This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be arepare for each monitoring system control ~~el by the technician who performs the work. A copy of this fotvrt must be provided to the tank system ownerioperator. The owner/operator must submit a copy of this forth to the local agency regulating UST systems within 30 days of test date. A. General Information Facilit} Name: STCVFi 1 ~~pj~/V~ G1~'EV1~n) Bldg. No.: Site Address: a~C70 OS~Ei.-lr t~VE City: ~A1G~~R.~>=~Ec~ Zip: FaciGt~' Contact Person: ST1".~/E Tk~O'E?Nt Contact Phone No.: (,, Make/Mode! of Monitoring System: ~~-5 -3 5U Date of Testing/Servicing: ~+ / ZO /07 B. Inventory of Eciuipment Tested/Certified INSPECTOR ON-SITE: YESi )'~O'~•IAME: ~k~NE Check the annrooriate boxes to indicate specific euuiomcnt inspected/serviced: 'T'eal: !D: ~~/~(~. ~ T;+nk ID: PLUS ~ T ,~In= Tank Gauging 1'robc. Model: /Yl ~ Ut-Tank C;auging Probe. Model !~~ ^ Arnndur Space or Vault Scrtsor. Model ^ Annular Space or Vault Sensor. Model: Piping Sunlp !'T'rench Sensor(s). Model: S Piping Sump /'frc:nch Sensor(s). Model: a O ~ ,Fill tiump Sensor(s). Model: C~ Fill Sump Sensor(s). Model. ~,'L) 8 ^ Mech:uticat Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Modal: ~ t „e=rElectrunic Line Leak Detector. ModcL V~~fl~. ~C:~~ f~Lilcctronic Line Leak Detector. ModcL . V~ ~ 12DCJ T ^ Tank'c:)vcrtill /High-L,evei Sensor. Model: ^ Tank Overfill /High-Level Sensor. Mexlel: ^ Other (s>ecif~~ e ui meat t • e and model in Section E on Paee 2 . ^ Other (specific a ui meat t . z and model in Seeaion E on Pa' a 2). TanklD; ~~ \ TanklD: ,'~ In= f ank Gauging Prohe. Modef: G ^ In= [rtn!< Gauging Probe. Model: ^ Annular Space or Vault Sensor. Model: ^ Annular Space or Vault Sensor. Model: ®. PipingSumpi'I'rcnch Sensor(s). Model' r~1 ^ Piping Sump i Trench Sensor(s). Model: ~ ryaFill Sump Sensor(s). Model: ~,t7 $ ^ Fill Sump Sensor(s). Model: ^ Mechanical Line Leak Detector. Model: ^ Mechanical Line Leak Detector. Model: I~Llecuonic l.,ine Leak Detctor. Model: Vt=~~ER- 2nd T I ^ Elecironic Line Leak Detector. Model: ^ Tank Overfill 1 !-[igh-Level Sensor. Model: I ^ "Tank Overfill /High-bevel Sensor. Model: 1 ^ 0(hcr (specify equipment type and model in Section G on Page 2). ^ Other (specify equipment type and mcxlel in Section E on Page 2). Dispenser %D: Dispenser fU: 3: ~ '~ I)ispcnser Col~nmern Sensor(s), Model: 0~0 ~ ~Dispenst;r Containment Sensor(s). Model: ~d Shear Vale(s). ~lhear Vrtlve(s). ^ Dis cnscr Containment I'luat s and Chain s). ^Dis cnscr Containment Floats and Chains . DispenserlD: ~p DispenserlD: ~, _$_ ~d.I)ispcnscr Containment Sensor(s). Model: b ~ ~.Dispenscr Containment Sensor(s). ModeL• ~ ~ d ~~ihcai 4'alve(s). c - - ,~Shcaf Valve{s). ~-^ Di:p~nscr C.ontammrnt I'loet(S) and C.haln(ti). ^ DIS cnscr Containment Float(s) and Chain(s). i llispeuser IU: Dispenser ID: Dispenser Containment Sensor(s). Mcrdcl: ^ Dispenser Containment Sensors}. Model: Shear Va1vc(s)• ^ Shear Valve(s). ~ ^Dispcnsu• Containment F'ioat(s) :tad Chain(s), ^Dis cnscr Containment Float s) and Chain s). * If the facility contains more tanks or dispensers, copy this form. Include infornrrtion for every tank and dispenser at the lttcility. C. CertifiCatlOri - I certify that the equipment identilietl in this document was inspected/serviced in accordance with the manufacturers' guidelines. Attached to this Certification is information (e.g. manufacturers' checklists) necessary to verify that this information is correct and a Plot Pian shnwitig the layout of monitoring e~pipmeut. For any equipment capable of generating such reports, I have also attached a copy of the re )ort; (cher/c ul/ brut apply): System set-up ~ Alarm history report 'l eclutician Naml' (printj: ~A~ ,~(j~ ry~~C~~N Signature: -~-~ ~.,..~ Certilcation Nc+.: ~,3t-(3e7,~ License. No.: _.~~..p~(q$ p 'T'esting Company Name: RIChI ENVIRONMENTAL Phone No.: ( 661 ~ 392-8687 Site Address: ~~t~ tQ Qs~ ~,LL, ~yE ~~~~~~~ZE-~ r~.~. Date of Testing/Servi~ing: ~/o~ / 07 Page 1 of 3 03101 Monitoring System Certification D. Results of Testing/Servicing Softyare Version Installed: a~~ . ~y Co,nplete the followin>; checklist: 1 SAS g Yes ^ o Js the audible alarrn o erational'? Yes ^ o Is the visual alarm o erational? ~ Yes ^ 'o Were all sensors visually ins ected, functional) ~ tested. and confin-ned o erational? ~ Yes ^ o Were a!I sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere tivith their proper o eration? ^ Yes ^ ° If alarms are relayed to a remote monitoring station, is all comlrunications equipment (e.g. modem) ~.NiA operational? 1'es ^ ~ ~ For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ^ ~.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/Trench Sensors; Dispenser Containment Sensors. Did you confirm positive shut-down due to leaks and sensor failure/disconnection? Yes; ^ No. Yes ^ ~ o For tank systems that utilize the monitoring system as the primary tank overfill warning device (i.e. no ^ NiA mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank till point(s) and operating properly? If so, at what rcent of tank ca acity does the alarm trig er? `~b ^ es Va Was any monitoring equipment replaced'? Ifyes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all re iacement arts in Section E, beio~~'. ^ es ~„ No 1~'as liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ^ Product: ©Water. ]f yes, describe causes in Section E below. 1'es ^ o Was monitorine system set-u reviewed to ensure ro er settin ~s?Attach set a re orts, if a licable es ^ ivo is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how ;tnd when these deTiciencies were or will be corrected. L-'. Comments: I'Age 2 of 3 U31Ut i ~ F. In-Tartk Gauging /SIR Equipment: ~ Check this box if tank gauging is used only for inventoq' control. 0 Check this box if no tank gauging or SlR equipment is installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. ('nntnlrtP the fnllntvino rhPrklict• ^ Yes ^ o Has all input wiring been inspected for proper entry and termination; including testing far ground faults? ^ Yes ^ o Were all tank gauging probes visually inspected f'or damage and residue buildup? ^ Yes ^ o Was accuracy of system product level readings tested? O Yes O ° Was accuracy of system water level readings tested? Yes ^ o Vetere all probes reinstalled properly? O Yes ^ o Were all items on the equipment manufacturer's maintenance checklist completed'? In the Section H, below, describe how uud when tnese aettciencres were or wul be correctea. G. Line Leak Detectors (LLD): ^ Check this box iF LLDs are not installed. CninnlPtP the fnllnwiua rhPrklictr Yes ^ No` For equipment start-up or annual equipment certifcation, was a leak simulated to verify LLD performance? ^ N!A (Check ul! that uppll) Simulated leak rate: ~; g.p.h.. ^ o. I g.p.h .. ^ 0.2 g.p.h. Yes ^ o Were alt 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? NIA .+~, Yes ^ o For electronic LLDs, does the turbine automaticall;' shut off if the LLD detects a leak? ^ N; A Yes ^ o For electronic LLDs, does the turbine automatically shut off if any portion o1'the monitoring system is disabled ^ N;A or disconnected? ~ Yes ^ o For electronic LLUs, does the turbine automatically shut off if any portion of the monitoring system maffirnctions ^ N!A or fails a test? Yes ^ ~o For electronic L.LDs. have all accessible wiring connections been visuall} inspected? ^ Ni=\ '~ Ycs + ^ ° Were all items on the equipment manufacturer's maintenance checklist completed? ur me aecnon n, oelof>'~, describe how ana when these deficiencies were or will be corrected. H. Cornmcnts: Page 3 of 3 03101 SC~S~ Monitoring System Certifcation UST M.~7onitoring Site P Site Address: ~ 7C70 ~S\ ~ G~~. ST r ~'S Ati.~t't,.~ fTL~-~ . u- -------------------------------------•------------- -------------------3 ------------------------------ - ---- - ---- - ---- -------------------------------- - ----y ~- _ - ~e ----v ~ ----------------------------- Date map was drawn: a /~/per Instructions If you already have a diagram that shows all required information, you may include it, rather than this page, with your Monitoring System Certification. On your site plan, show the general layout of tanks and piping. Cleazly 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 ~-{ 05,00 ;, ~5 (~S ~ ~~~~. 5613 HR.QQRS C`~' ~CTsRSFIRLD,CA.933Q$ O$'Fi TCE {661) 392-8687 & 1+'A:d (661) 392^•4621 ~y(c`N3TfY("'~~ S.K. J?T:iTR{"TOD mW.gT W/Q#: &'ae:Llity Name~S~~S..t~1~£ C~~EVRcrt/ ~, Fac;(.~.i.~.~ .Ac3dx~ss ; ~~o~ aS~ ~~.. bT , d~fi~a,4~~~~ , ~~ , PrOc:lue~ T,9,Ixe Tie {Pr~esstxre~ suo#i~szx~ (~ravitx)~~SVi2~`- Pbt(:1DUCT L.~A.K pETECTQl2 T~P~ T 7,'E5T TRTk PAi38 SR'.R~.ASa z`7UbxF3ER a~'+LQw PSG QR _. L/x) ~'xPr, ~E2 Q{x)\ X7s9 ~ "g7 Sk'RI.A.T, #~ROn/~L xc0 b'AIL: L/D 1'7fPL E E Q ~'C 8~ SFRT,A.~ #_~LT'~cJn/~-L Td0 FAT$ SRFtTA.L #.~~120ni~CL ^^ x+14 FAIL xa,/5~ ~3fPx~ 71x~B PASS 38RT.AuL #..~.~_ ~iTCI FAIL i I I I i .I 7 ::ertify t1~.e abo~re tests were cdnducted on this date aacorfling to Red ~;faa&et Paunps field. tesr_ apparatus test:9.zag loxocedux'e an limitatiana, Th~_> Mer_han.ir~a7. Leak netecr..ar. Test. pass / fail is determined by using a lerer flow tl~.reahr~ld trip rate o:E 3 gallon per kwur or leas at SO P6I. z •srckn.owledge L-l~,at a1.1. data enllected ie true as~d oox•reat to txse best of rrk~ knowle~~dgppe . Teal] : (J'_"~ N~'n~L,rt- ~Y ]/~-~ Sigzr.e~ture : _._, _ Date : -~0 '~'~~ I ~'- z lS(~Sg SWRCB, January 2006 Spill Bucket Testing Report Form -This form is intended for use by contractors performing annual testing of UST spill contairttnent structures: The completed form and. printouts from.tests (f applicable), should be provided to the facility.owner/operator for submittal to the local regulatory agency. ' T ~ /PTT tRR7 7'AtTATl1.(A Tin7V Facility Name: S~E.V ~- zG -- ----- Date of Testing: ao - d~ Facility Address: v~ GL~- T ~ l~`~SFT~ Facility Contact: b~ E 1/E ~T~.p~-.vK Phone: Date I,ocaE Agency Was Notified of Testing : $ p "7 ~ ' Name of Local Agency Inspector (ijpresent during testing: p~ ~ ~ ~r~e•r•nvr• nn~rrn ~ rmn1D TNtRl1DMA'TTf1N Compan Name: SC_t~ En3~1~ .JT L:. .Technician Conducting Test: +(zt'~ ^! DcvJ ~t S C~nJ . Credentialst: CSLB Contractor C ervtce SWRCB Tank Tester Other (S ec~) License Number(s): U- V C CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING I hereby certify that all the_ i~nform~ati'o'n contained in this report is true, accurate; and in full compliance wish legal requirements Technician's Signature: ~ ~- .,`. Date: O'2 -r~C~ ~ G ~ State laws and regulations do not currently require testing to he performed by a qualified contractor. However, local requirements may be more stringent. ~;ommeIIrS - (include information on repairs made prior to testing and recommended follow-up forPalled test j~S~S~ DND OF MESSAGE BL S SOFTWARE REVISIOfV LEVEL COMMUNICATIONS SETUP E SA D VERSION 20.04 SOFTWARE# 346020.100-E - - - - - - - - - - - - AUTO DIAL ALARM SETUP- - - - CREATED - 02.12,27.05.00 _ _ - - - - - PORT SETTINGS: S-MODULE# 330160-002-A SYSTEM FEATURES: ~ COMM BOARD 1 IRS-232) PERIODIC IN-TANK TESTS BAUD RATE 960D ANNUAL IN-TANK TESTS ~ PARITY EVEN CSLD STOP BIT 1 STOP . DATA LENGTH: 7 DATA RS-232 SECURITY CODE DISABLED COMM BOARD 2 GFXMOD) ~RD RATE OD O - - _ _ _ TANK SETUP IN T ~ D - ' STOP BIT 1 STOP DATA LENGTH: 7 DATA T 1:SUPREME 1 RS -232 SECURITY PRODUCT CODE 000700 SYSTEM SETUP CODE DISABLED THERMAL COEFF 00 92 DIAL TYPE TONE . TANK DIAMETER 4 PTS FEB 20. 2007 3:06 PM ANSWER ON 1 RING TANK PROFILE VOL ~ 9728 MODEM SETUP STRING FULL VOL : 7910 '. DIAL TONE INTERVAL: 32 69.0 INCH q6,0 INCH VOL :' 4864 1816 SYSTEM UNITS 23.0 INCH VOL U.S. SYSTEM LANGUAGE AUTO TRANSMIT SETTINGS: 0 IN. 4 ENGLISH . FLOAT S12E: SYSTEM DATF/TIME FORMAT AUTO LEAK ALARM .LIMIT -_ 0 1 MON DD YYYY HH:MM:SS xM DISABLED . ~,rATER WARNING 0 2 AUTO HIGH WATER LIMIT . HIGH WATER LIMIT: CHEVRON `; 2700 OSWELL ST ~: DISABLED AlrTO OVERFILL LIMIT MAX OR LABEL VOL; 9728 95y° BAKERSFIELA CA 93306 DISABLED OVERFILL LIMIT gP41 661-871-1200 AUTO LOW PRODUCT 90i ' DISABLED HIGH PRODUCT 8755 SHIFT TIME 1 5:00 AM S I I E I A AUTO THEFT LIMIT DISABLED LIMIT • 1~~° H FT T M 2 D S BLED DELIVERY 1167 SHIFT TIME 3 DISABLED AUTO DELIVERY START , SHIFT TIME 4 DISABLED DISABLED 4 AUTO DELIVERY END LOW PRODUCT 99 TANK PER, TST NEEDED WRN DISABLED LEAK ALARM LIMIT: 99 DISABLED AUTO EXTERNAL INPUT ON SUDDEN LOSS LIMIT: 00 D TANK ANN TST NEEDED WRN DISABLED . TANK TILT DISABLED AUTO EXTERNAL INPUT OFF B MANIFOLDED TANKS LINE RE-ENABLE METHOD SENSOR FUEL ALARM AUTO Tit: NONE PASS LINE TEST DISABLED LINE PER TST NEEDED WRN AUTO SENSOR WATER ALARM DISABLED LEAK MIN PERIODIC: 0% 0 DISABLED AUTO SENSOR OUT ALARM LINE ANN TST NEEDED WRN DISABLED 0~ DISABLED LEAK MIN ANNUAL 0 PRINT TC VOLUMES ENABLED TEMP COMPENSATION RECEIVER SETUP: PERIODIC TEST TYSTANDARD VALUE (DEG F ): b0.0 STICK HEIGHT OFFSET DISABLED NONE ANNUAL TEST FAIL ALARM ENABLED H-PROTOCOL DATA FORMAT HEIGHT PERIODIC TEA ARMIENAHLED PRECISION TEST DURATION HOURS: 12 DAYLIGHT SAVING TIME GROSS TEST FAIL ALARM ENABLED ENABLED START DATE ANN TEST AVERAGING: OFF OFF AFR .WEEK 1 SUN PER TEST AVERAGING: START TIME pFF 2:00 AM AUTO DIAL TIME SETUP: TANK TEST NOTIFY: END DATE OCT WEEK 6 SUN NONE TNK TST SIPHON BREAK:OFF END TIME 2:00 AM - _ 5 MIN . DELIVERY DELAY ' RE-DIRECT LOCAL PRINTOUT DISABLED SYSTEM SECURITY CODE 000000 .... . T 3:REGULAR T 2:PLUS PRODUCT CODE 3 PRESSURE LINE LEAK SET PRODUCT CODE 2 THERMAL COEFF :. 000700 - ~ - - - - ' THERMAL COEFF :.D00700 TANK DIAMETER 92 Oq TANK DIAMETER 92.00 TANK PROFILE , 4 TANK PROFILE 4 PTS FULL VOL 9728 0 I:REGULAR 7910 69.0 INCH VOL 7910 46.0 INCH VOL TYP:2.Oi3.0IN FIBERGLA! 46.0 lNCH VOL 48b4 23.0 INCH VOL l8bg 2.OIN DIA LEN:105 FEET 23.0 lNCH VOL 1818 3.OIN DIA LEN:ld5 FEET SHUTDOWN RATE: 3.0 GPI FLOAT S3ZE:."- ~4 _ .0 IN ~~ LOW PRESSURE SHUTOFF:NI FLOAT SIZE: 4. 0 1N. , LOW PRESSURE 0 PSI WATER WARNING WATER WARNING 1.0 HIGH WATER LIMIT: 2;p TANK: NONE HIGH WATER LIMIT: 2.0 N TE MAX OR LABEL VOL: 9728 O.UPSI OFFSET PRESSURE MAX OR LABEL VOL: 9728 OVERFILL LIMIT 95% OVERFILL LIMIT 95% 9241 9241 HIGH PRODUCT g0% HIGH PRODUCT 90% 8755 8755 DELIVERY LIMIT DELIVERY LIMIT 12% llb7 1167 LOW PRODUCT 400 LOW PRODUCT 400 LEAK ALARM LIMIT: LEAK ALARM LIMIT: 99 SUDDEN LOSS LIMIT: 99 SUDDEN LOSS LIMIT: 99 TANK TILT 0 Q0 TANK TILT 0.00 , MANIFOLAED TANKS G 2:SUPREME MANIFOLDED TANKS T#: NOryE T#: NONE TYP:2,Oi3.0IN FIBERGLAS 2.OtN DIA LEN:105 FEET LEAK MIN PERIODIC: Os; 3.OIN DIA LEN:115 FEET LEAK MIN PERIODIC: 0% 0 SHUTDOWN RATE: 3.D GFH • 0 LOW PRESSURE SHUTOFF:NO LEAK MIN ANNUAL 0% LOW PRESSURE 0 PSI LEAK M!N ANNUAL 0% 0 • 0 TANK: NONE SENSOR: NON-VENTED PERIODIC TEST TYPE PRESSURE OFFSET: O.OPSI PERIODIC TEST TYPE STANDARD STA NDARD ANNUAL TEST FAIL ANNUAL TEST FAIL ALARM ENA BLED ALARM ENABLED PERIODIC TEST FAIL PERIODIC TEST FAIL ALARM ENA BLED ALRRM ENABLED GROSS TEST FAIL GROSS TEST FAIL ALARM ENABLED ALARM EN ABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF 9 3:PLUS PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF TANK TEST NOTIFY: Opp TYP:2.Oi3.0IN FIBERGLAS: TNK TST SIPHON BREAK:OFF 2.OIN DIA LEN:105 FEET 3.OIN DIA LEN:115 FEET TNK .TST SIPHON BREAK:OFF SHUTDOWN RATE: 3.0 GPH DELIVERY DELAY 5 MfN DELIVERY DELAY 5 MIN LOW PRESSURE SHUTOFF:NO LOW PRESSURE 0 PSI TANK: NONE SENSOR: NON-VENTED PRESSURE OFFSET: O.OPSI LEAK TEST METHOD TEST CSLD ALL TANK Pd 99% CLIMATE FACTOR:MODERATE TST EARLY STOP:DISABLED Lt;AK TEST REPORT FORMAT LINE-LEAK LOCKOUT-SETUP ENHANCED LOCKOUT SCHEDULE DAILY START TIME: DISABLED STOP TIME DISABLED fS~oS~ PLLD LINE DISABLE SETUP ALARM HISTORY REPORT LIQUID SENSOR SETUP - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ _ _ _ ---- IN-TANK ALARM ----- L I.:RlrG-STP 9 1:REGULAR T !:SUPREME. TRI-STAT£ (SINGLE FLOAT) IN-TANK ALARMS ~AT£GORY STP SUMP T 3:HIGH WATER ALARM HIGH WATER ALARM T 3:LOW PRODUCT ALARM D£C 23. 2003 11:55 AM L 2:REG-FILL LIQUID SENSOR ALMS OVERFILL ALARM TRI-STATE (SINGLE FLOAT) L 1:FUEL ALARM .DEC 23. 2003 11:48 AM :ATEGORY PIPING SUMP L 7:FUEL ALARM LOW PRODUCT ALARM L B:FUEL ALARM L 9:FUEL ALARM .DEG-23....,2D03- 1.t:42 AM. - 3:SUP-STP TRI-STATE (SINGLE FLOAT) L10:FUEL ALARM L 1:SENSOR OUT ALARM HIGH PRODUCT ALARM :ATEGORY STP SUMP L 2:SENSOR 4UT A[,ARM DEC 23. 2003 11:46 AM L 7:SENSOR OUT ALARM L B:SENSOR OUT ALARM INVALID FUEL LEVEL 4:SUP-FILL L 9:SENSOR OUT ALARM DEC 23. 2003 11:42 AM fR!-STATE (SINGLE FLOAT) LlO:SENSOR OUT ALARM PR013E OUT :ATEGORY PIPING SUMP L 1:SHORT ALARM MAY 3. 2005 8:58 AM L 2:SHORT ALARM L 7:SHORT ALARM MAY 3. 2005 6:34 AM 5:PLU5-STP L B:SHORT ALARM DEC 23. 2003 12:01 PM fR1-STATE (SINGLE FLOAT) ;ATEGORY STP SUMP L 9:SHORT ALARM L10:SHORT ALARM HIGH WATER WARNING DEC 23. 2003 11:55 AM Q 2:SUPREME 6:PLUS-FILL CRI-STATE (SINGLE FLOAT> IN-TANK ALARMS AELiVERY NEEDED ;ATEGORY :PIPING SUMP T 1:HIGH WATER ALARM ~T 2. 2006 1:35 PM T 1:LOW PRODUCT ALARM FEH 28. 2004 FEH 6. 2004 5:28 PM 1:11 PM 7;DISP 7-8 "RI-STATE (SINGLE FLOAT> LIQUID SENSOR ALMS L 3:FU8L ALARM MAX PRODUCT ALARM ;ATEGORY DISPENSER PAW L 7:FUEL ALARM DEC 23. 2003 11:46 AM L B:FUHL ALARM L 9:FUEL ALARM L10:FUEL ALARM ' ~ . B:DISP 5-6 L 3 :SENSOR OUT ALARM `~ - - 'RI-STATE {SINGLE FLOAT) L 4:SENSOR OUT ALARM :ATEGORY DISPENSER PAN 17:S£NSOR'OUT ALARM L B:SENSOR OUT ALARM L 9:SENSOR OUT ALARM L10:SENSOR OUT ALARM ALARM HISTORY REPORT ' . 9:DISP 1-2 'R3-STATE {SINGLE FLOAT) L 3:SNORT ALARM L 4:SHORT ALARM ---- IN-TANK ALARM------ :ATEGORY DISPENSER PAN 17:SHORT ALARM L B:SHORT ALARM T 2:PLUS L 4:SHORT ALARM LlO:SHORT ALARM HIGH WATER ALARM .10:D1SP 3-4 DEC 23. 2003 12:00 PM 'kT-STATE (SINGLE FLOAT) ~ 8 3:PLUS SPENSER PAN :ATEGORY III LOW PRODUCT ALARM _ IN-TANK ALARMS DEC 23. 2003 11:43 AM ': T 2:HIGH..WATER ALARM T 2:LOW PRODUCT ALARM HIGH PRODUCT ALARM AUG 29. 2004 8:33 AM LIQUID SENSOR AIMS DEC 23. 2003 il:45 AM L 5:FUEL ALARM L 7:FUEL ALARM ~ INVALID FUEL LEVEL L e.:FUEL. ALARM DEC 23. 2003 11:43 AM L 9:FUEL ALARM LlO:FU$L ALARM pR09E OUT L 5:SENSOR OUT ALARM MAY 3. 2005 3:22 PM L 6:SENSOR OUT ALARM DEC 23. 2003 12:02 PM L 7:SENSOR OUT ALARM DEC 23. 2003 11:45 AM ~~UTPUT RELAY SETUP L B:SENSQR OUT ALARM - - - - - - - - - - L 9:S)~NSOR OUT ALARM HIGH WATER WARNING LIO:SENSOR OUT ALARM DEC 23. 2003 12:OU PM 1:OVERFILI ALARM L 5:SHORT ALARM YPE: STANDARD L 6:SHORT ALARM L 7:SHORT ALARM DELIVEF.Y NEEDED ORMALIY OPEN L B:SHORT ALARM AUG 11. 2005 10:18 AM L 9:SHORT ALARM JUN 14. 2004 3:55 PM L10:SHORT ALARM DEC 25. 2003 3:09 PM N-TANK ALARMS ALL:OVERFIIL ALARM MAX PRODUCT ALARM ALL:HIGH PRODUCT ALARM - DEC 23. 2003 11:45 AM t - - ALARM HISTO Y - REPOR T r rn c/ ALARM H J STORY ~ ` ~ s R ALARM HISTORY REPORT i~£ )~( i ---- IN-TANK ALARM ----- ----- SENSOR ALARM ----- L 5:PLUS-STP ALARM - T 3:REGULAR L 2:REG-FILL PIPING SUMF STP SUMP HIGH WATER AL ARM FUEL ALARM FEH 20 2007 1: FUEL ALARM FEB 20, 2007 1:29 PM AEC 23, 2003 11:58 AM , 31 FM OVERFILL ALARM FUEL ALARM FEH 2Q 2006 FUEL ALARM FEB 20, 2006 9:08 AM FEB 14. 2007 8:26 AM , 9:06 AM FEB 14, 2007 8:16 AM FUEL ALARM FUEL ALARM FEB 14. 2007 8:03 AM DEC 28. 2005 11:10 AM FEB 2. 2005 1:40 PM LOW PRODUCT ALARM ' APR 22. 2004 11:45 PM MAR 20. 2004 2:56 PM DEC 23. 2003 11:42 AM HIGH PRODUCT ALARM FEH l4, 2007 7:49 AM JAN 24. 2007 9:39 AM JAN 14. 2007 8:51 AM INVALID FUEL LEVEL * ~ * * * END * * ~ ~ x Ie * '~ * * E1JD * ~ ~ x x APR 22a 2004 11:32 PM MAR 20, 2004 2:53 PM DEC 23. 2003 11:41 AM PROBE OUT MAY 3, 2005 12:00 PM DEC 23, 2003 12:01 PM DEC 23, 2003 11:41 AM HIGH WATER WARNING DEC 23. 2003 11:58 AM ALARM HISTORY REPORT ALARM HISTORY REPORT IV7RY DE -- SENSOR RLARM -- _ L-3:SUP-STP - - -- SENSOR ALARM ----- MpLL P U MAR 2006 4:23 PM . STP SUMP IPING SU AUG 27. 2005 5:17 PM FUEL ALARM FUEL ALARM MAY 1. 2004 7:10 PM FEB 20. 2007 1:26 PM FEB 20. 2007 1:33 PM MAX PRODUCT ALARM FUEL ALARM FUEL ALARM AEC 23. 2003 11:48 AM FEB 20. 2006 9:09 AM JUN 15. 2006 8:47 AM FUEL ALARM FEB FUEL ALARM FEH 20, 2006 9:10 AM 2. 2005 1:42 pM ~ ~ * ~ x END * ~ *~*~~END***~* x****END~~~** ALARM HISTORY REPORT -- SENSOR L 1:REG-STP ALARM ----- ALARM HISTORY REPORT ALARM HISTORY REPORT STP SUMP FUEL ALARM ~ ___ `- SENSOR ALARM ----- L 4 ----- SENSOR ALARM ----- L 7:DISP 7-8 FEB 20. 2007 1:30 PM :SUP-FILL PIPING SUMP DISPENSER PAN ~ FUEL ALARM FUEL ALARM FEB 20 2 FUEL ALARM FEB 20. 2007 I:55 PM FEB 20. 2006 9:05 AM , 007 1:27 PM FUEL ALARM-- FUEL ALARM MAY 2 200 FUEI. ALARM FEB 20, 2006 9:23 AM FEB 2. 2005 1:37 PM , 6 4:03 pM SETUP DATA WARNING MAY 2 200 FEBL 22005 1:53 PM _ , 6 4:01 PM - - Is~sg LARM HISTORY REPORT ---- SENSOR ALARM ----- B:DISP 5-6 ISPENSER PAN UEL ALARM EH 20, 2007 1:53 PM 'UEL ALARM 'EB 20, 2006 9:21 AM 'UEL ALARM 'EH 2, 2005 2:O1 FM ~ ~ x x ~ END ~ x.x * ~ +RM HISTORY REPORT ALARM HISTORY REPORT •-- SENSOR ALARM ----- -- SENSOR ALARM ----- •'SUPREMI~ D SHUTDOWN ALARM e 1:REGULAR ' PLLD SHUTDOWN ALARM. ~ 20, 2007 2:08 PM FEB 20. 2007 2:15 PM SS LINE FAIL GROSS LINE FAIL 20, 2007 2:08 PM i FEB 20. 2007 2:15 PM PLLD SHUTDOWN ALARM FE9 20. 2007 1:55 PM PLLD SHUTDOWN ALARM FEB 20. 2007 1:53 PM PLLD SHUTDOWN ALARM FEB 20, 2007 1:51 PM PLLD SHUTDOWN ALARM FEB 20, 2007 1:50 PM PLLD SHUTDOWN ALARM FEB 20. 2007 1:30 PM ALARM HISTORY REPORT -- SENSOR ALARM ----- Q 3:PLUS PLLD SHUTDOWN ALARM FEB 20. 2007 2:12 PM GROSS LINE FAIL j FEB 20. 2007 2:12 PM PLLD SHUTDOWN ALARM FEH 20. 2007 1:55 PM PLLD SHUTDOWN ALARM FEB 20, 2007 1:53 PM PLLD SHUTDOWN ALARM FEB 20, 2007 1:51 PM PLLD SHUTDOWN ALARM FEB 20. 2007 1:50 PM PLLD SHUTDOWN ALARM FEB 20. 2.007 1:29 PM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 9:DISP 1-2 DISPENSER PAN FUEL ALARM FEB 20. 2007 1:51 PM FUEL ALARM FEB 20. 2006 9:15 AM FUEL ALARM FEB 2, 2005 1:49 PM * * ~ * ~ END * * ~ x ~ ALARM HISTORY REPORT SENSOR ALARM L10:D(SP 3-4 DISPENSER PAN FUEL ALARM FEB 20. 2007 1:50 PM FUEL ALARM FEH 20, 2006 9:17 AM FUEL ALARM FE8 2, 2005 1:46 PM PLLD SHUTDOWN ALARM FEB 20. 2006 9:36 AM GROSS LINE FAIL FEH 20, 2006 9:36 AM PLLD SHUTDOWN ALARM FEH 20. 2006 9:23 AM D SHUTDOWN ALARM , 20. 200? 1:55 PM D SHUTDOWN ALARM 20. 2007 1:53 PM D SHUTDOWN ALARM 20, 2007 1:51 PM D SHUTDOWN ALARM 20, 2007 1:50 Phl D SHUTDOWN ALARM 2D, 2007 1:26 PM D SHUTDOWN ALARM 2D, 2006 9:41 AM 3S LINE FAIL 20. 2006 9:41 AM D SHUTDOWN ALARM 20. 2006 9:23 AM PLLD SHUTDOWN ALARM FEB 20. 2006 9:3B AM GROSS LINE FAIL FEH 20. 2006 9:39 AM PLLD SHUTDOWN ALARM FEB 20. 2006 9:23 AM 1S~~~ MONITOR CERT. FAILURE REPORT SITE NAME:y~~Ey~ '~ t~pYL~v~ ~~4E.~~o~1 DATE: a.-~- r, `7 AnDRESS: a~c~ ~ 05 ~ ~.~- ~-~ TECaNrcL~N: ~~ft N ~ cv~/ m~~.ti CITY: ~ ~ E ~~ z~L~_ SIGNATURE:~~~ - .rte THE FOLLOWYNG COMPONENTS WERE REPLACED/REPAIRED TO COMPLETE TESTING. REPAIRS: ,n/a ~~ LABOR: /~~r.j P TS llVT LED:/1fa ,J ~ NAME• ~,E. THE ABOVE NAMED PERSON TAKES FULL RESPONSIBILITY OF NOTIFYING THE APPROPRIATE PARTY TO HAVE CORRECTIVE ACTION TAKEN TO REPAIR THE ABOVE LISTED PROBLEMS AND NOTIFYING RICH ENVIItONMANTAL FOR ANY NEEDED RETESTING. THIS ALSO RELEASES RICH ENVIIZONMENTAL OF ANY FINES OR PENALTIES OCCURING FROM NON-COMPLIANCE. A COPY OF TffiS DOCUMENT HAS BEEN LEFT ON-BETE FOR YOUR CONVIENENCE. ----.- - - - - -- 1"~rOs~1 UNDERGROUND STORAGE TANKS $AKERS~IELD FIRE DEPT. I-IRI P?CVeII~011 SCIV~CeB ~~rrr r 9001Yuxtun Ave., Ste. 210 APPLICATION sakersSeld, CA 93301 TO PERFORM ELD ! LINE TESTiNb ~ Tel.: (661} 326-3979 SB989 SECONDARY CONTAINMENT TESTING Fa7C' (661} 852-2171 (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION Pape 4 of 1 PERMR NO. n ^ ENHANCED LEAK DETECTION __ _y..-1.IN ^ S8-G8S SECONDARY CONTAINMENT TESTING 1~1 vc.~~- ~~ I~~Tn ocecnnu Cl lcl ^lA-IrrnDiWC rCOTZ1777Tf~ ... N .. FACILITY ~ ~O~ NAME i PHONE NUMBER OF CONTACT PERSON . ADDRESS ~„ OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BETE TED P . u~ -s ~ p~- .. :` . TAI~K~E& 3 COAdPANY NAME OF TEST! OMP Y NAME i P ONE NUMBER O ONT CT PER a-$~ JV1,41LIN(i ADDRESS ~ ^ C~ ~~ NA i PHON NUMBER O TESTER OR SPECIAL INSPECTOR A / CERTIFICATION ~I: DATE i TiME T T TO BE CON CTEO ~} ~ ~. ~ .yiz~ ~Jl,' ICC ~:. TES7INETHOD SIGNATURE OF APPLICANT ~~^ DATE -~tPPROVED BY DATE FD 2095 (Rev. 09/05) ~5~~ BILLING & PERMfT STATEMENT sA.xERSFiELn Fig ns Prevention Services r/e~ 900 Truxtun Avenue; Suite 2I0 PERMIT NO.: ~Rrr r - Bakersfield, CA 93301 i'el.~ (6611.326-3479_8 FflX' (fi 11 8S2 2171 LOCATgN OF PROJECT I~b - ~an~ awNER ~ $TARTiNG DATE , _ ~-pN OA~E ~ ; ~ ~ N~ . o PROJECT NAiNE ADDRESS S7' PHONE N0. PROJECTADORE6S o2 ~ sf ~~ sTATE cat- ZIP CODE 3 .- CONTRACTOR NAME CA IiCFJ-ISE NO. 1 ~ . .- TYPE OF tICFNSE EXPaiAT1pN GATE PHONE NO. ~. -$b CONTRACTOR. CO ANY FAX NO. ~. ADDRESS ZIP CODE J ~ • { 50 $262 i ifi & M ^ • 1 ~ ons - {Mnimum Charge> cat Alarms -New od . 88 FL 000 S 0 013125 = Permlt fee FL x S ~ ~ Over 2 , q. . q. 98 ^ Mink r Ch kl & Modif tions N S i s• $210 00 ~ ge) er ew ica • ( num a pr n - . 98 ^ Ft 000 S 5 O 042 = Permit fee FL x S ~ ver q. , . q. 98 ^ rinkler Modifications (< 10 heads} Minor S $ 93 00 [Inspection Only] ~ p . 98 ^ Commerciai Hoods -New 8 Modifications $398 26 ~ . 98 ^ Additional Hoods 536 00 ~ . 98 ^ Spray Booths -New 8 Modiflcations $458 00 ~ . . s8 ^ Abo round Storage Tanks {Irutal)a~avrArup.-1eTme) $165.00 82 ^ Additional Tanks S 26.00 82 ^ Aboveground Storage Tanks {Remove0inspection) $109.00 82 ^ UndergrDUnd Storage Tanks (lrtstsilaticvtJlnspeetion) $878.00 (pertank) 82 ^ Underground Storage Tanks (Modification) $878.00 (perslte) 82 ^ Underground Storage Tanks (Minor Modification) $755.00 d2 ^ Underground Storage Tanks (RerravaQ $675.00 (pertank) 84 ^ oiiwan prutauation) $ 72.00 ~ sa Mandated Leak DeteUion {Testing) Fuel $ 81.00 (persltej 82 ^ Tents ~ $ 93.00 (pertenQ 84 ^ Afterhours inspection fee $12200 84 ^ Pyrotechnk: - (Par event. Plus tnsp. Fee ~ 590 per tour) $ 60.00 ~ (s hrs. mr+,. stand •-try ree nnspec~on) _$510.00 - 84 ^ R[ tNSPECTION(S) /FOLLOW-UP INSPECTION(S) S 93.00 (per hour) 84 O Portable LPG (Propane): NO.OF CAGES? $66.00 8a ^ F~cplosive Storage $249:00 84 ^ Copying & File Researnh (File Research Fee 533.00 per tv) . 25¢ per page 84 ^ Miscellaneous ~ 84 FD 2021 (Rev. 09105) t - QRIGIt1AL WHITE (to T~sasury) 1-YELLOW (to Ftlo) 1~iNK (to Custaner) ;. , _' ~~ :, ., , . Y ~ 1; ~ r t ~~~ a _ , DAB _~°~Q ~'" ,~~'1 ~ . - ~ 1 ~ ~ , ~ rG~ t t .~ ~ ~' Q" d o Y 1 Q AOLL~iIiS'~ `, , y ; .., , W a~hingtgk~ A~utua6° w,.M~y nm w~ u ~= F r VJASHfNG7ON MUYttAt,BA ~,A ~ a ' eAK~5 ~ 38~ l' 4 ~R «, p , ~ x . r f ,~] !~ !~ v^~.~-~~1~~'! ~, AUTHORIZEQ 81<7NAT.LI~F.' .!~~ ~ QQ 1~r~^v` ~ n~.f ~ ~ `4 _ ~A - = 1.t .:t :, ',~5.. ~ ' ! f ~. ' .~ , , l _. . •. -er L i 'l ...... ~. d....' ..a.. ~ „__... .'3. :..,ce~,+.ck.l."~ !"SS~r,n <.. ...,. ..~ ..n _. Ik ,.~... ~ e ... .. R1CI ~CV1fIR0IVMlrNTJ~L- ; ~1:RVfGE STA, ;~JON SEf~1~1CE5 {~~~ , iJ~ X809$50 ~ .: : ) f 56tt$;BR(3tl14S~T 6AZC~fi$i:IELD CA 93308 348 ~, ti ~- , - ~ ~j~ YT07'f~ L~ QA[lEe OF " riy .F t ~ - j{ Y UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION 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 PERMff NO. ~ 1 ^ ~ J r ^ ENHANCED LEAK DEFECTION ^ SB-989 SECONDARY CONTAINMENT TESTING I-I TANK TI(;HTNFSS TF. ~Tn PFRFnRM Fl1Fl MnNITnRINr CFRTIF .. . SITE INFO _ R FACILITY ~ ~O~ NAME 8 PHONE NUMBER OF CONTACT PERSON ADDRESS OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TA # VOLUME NTENTS CO p ~~ ~ o ~=p = ~ TANK TESTI G COMPANY NAME OF TESTI OMP Y NAME 8 P ONE NUMBER O ONT CT PER n ¢ MAILING ADDRESS ~ ~ ~i` ~~ NA 8 PHON NUMBER O TESTER OR SPECIAL INSPECTOR 0 9 CERTIFICATION #: DATE & TIME T T TO BE COND CTED ICC #: TEST METHOD SIGNATURE OF APPLI NT C~~ DATE D . APPROVED BY DATE Cl FD 2095 (Rev. 09/05)