HomeMy WebLinkAboutBUSINESS PLAN (2)~ ROSEDALE SHELL
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TANKS
UNDERGROUND STORAGE TANKS -TANK PAGE 1 rtwopagespertank,
- -'-~ Page ~ of 7
TYPE OF ACTION h 1. NEW SITE PERMIT h 4. AMENDED PERMIT h 5. CHANGE OF INFORMATION) h 6. TEMPORARY SITE CLOSURE
(Check one item only)X 2. OPERATOR CHANGE r 7. PERMANENTLY CLOSED ON SITE
r 3, RENEWAL PERMIT (Specify reason -for local use only) (Specify change -for local use only) r 8. TANK K REMOVED 430
BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 FACILITY ID # 1
Rosedale Shell #2 -
LOCATION WITHIN slrE (oprionapa3l -3605 Rosedale Hwy, Bakersfield, CA 93308
I. TANK DESCRIPTION (A~sceled plot plan with the location of the~UST system including buildings and landmarks shall be submitted tb the local agency.)
TANK ID # - - - - - _-- - _ - - _ 432 TANK MANUFACTURER _ - - _ _-- 433
COMPARTMENTALIZED TANK I, Yes X No 434
135069 -Premium OWENS CORNING IfAYes_,completeonepageforeachcompartment.
DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437
1987 10 000 ONE
ADDITIONAL DESCRIPTION (FOr local use only) 438
II. TANK CONTENTS
TANK USE 439 PETROLEUM TYPE 440
X 1. MOTOR VEHICLE FUEL I' 1a. REGULAR UNLEADED r'2. LEADED h 5. JET FUEL
(If marked, complete Petroleum Type) ~( 1b. PREMIUM UNLEADED r 3. DIESEL r 6. AVIATION FUEL
NON-FUEL PETROLEUM
h 2
'
.
4. GASOHOL h 99. OTHER
I' tc. MIDGRADE UNLEADED I
I'. 3. CHEMICAL PRODUCT
r 4. HAZARDOUS WASTE (Includes COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442
Used Oil)
h 95. UNKNOWN
III: TANK CONSTRUCTION
TYPE OF TANK ~ h 1. SINGLE WALL I1 3. SINGLE WALL WITH h 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443
(Check one item only) ~( 2. DOUBLE WALL EXTERIOR MEMBRANE LINER r 95. UNKNOWN
I~ 4
SINGLE WALL IN A VAULT
.
r 99. OTHER
TANK MATERIAL -primary tank r 1. BARE STEEL X 3. FIBERGLASS /PLASTIC r 5. CONCRETE r 95. UNKNOWN 444
(Check one item only) r 2. STAINLESS STEEL r 4. STEEL CLAD W/FIBERGLASS r 8. FRP COMPATIBLE W/100% METHANOL r 99. OTHER
REINFORCED PLASTIC (FRP)
TANK MATERIAL -secondary r 1. BARE STEEL X 3. FIBERGLASS /PLASTIC r 8. FRP COMPATIBLE W/100 % METHANOL I~ 95. UNKNOWN 445
tank
h 2. STAINLESS STEEL I~ 4. STEEL CLAD W/FIBERGLASS I~ 9. FRP NON-CORRODIBLE JACKET I~ 99. OTHER
(Check one item only) REINFORCED PLASTIC (FRP)
h 10. COATED STEEL
I' S. CONCRETE
UNKNOWN446 DATE INSTALLED 447
TANK INTERIOR LINING r 1. RUBBER LINED r 3. EPOXY LINING r 5. GLASS LINING r 95
.
OR COATING
r 2. ALKYD LINING r 4. PHENOLIC LINING X 6. UNLINED r 99. OTHER
(Check one item only) (For local use only)
OTHER CORROSION I' 1. MANUFACTURED X 3
UNKNOWN 448 DATE INSTALLED 449
FIBERGLASS REINFORCED PLASTIC I, 95
.
.
PROTECTION IF APPLICABLE
CATHODIC
r 4. IMPRESSED CURRENT r 99
OTHER
.
Check one item onl PROTECTION
( Y) (For local use only)
r 2. SACRIFICIAL ANODE
SPILL AND OVERFILL YEAR INSTALLED TYPE (FOrlocal use only)451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452
450
(Check all that apply) ~( 1. SPILL CONTAINMENT X 1. ALARM X 3. FILL TUBE SHUT OFF VALVE
X 2. DROP TUBE I' 2. BALL FLOAT h 4.. EXEMPT
X 3. STRIKER PLATE
iV. TANK LEAK'DETECTION (A.descripL., ;the monitoring program shall be submitted to c c,,.oal agency
IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK Oft TANK WITH BLADDER (Check one item only): 454
I' 1, VISUAL (EXPOSED PORTION ONLY) I~ 5. MANUAL TANK GAUGING (MTG) I~ 1. VISUAL (SINGLE WALL IN VAULT ONLY)
I~ 2. AUTOMATIC TANK GAUGING (ATG) I~ 6. VADOSE ZONE X 2. CONTINUOUS INTERSTITIAL MONITORING
h 3. CONTINUOUS ATG I' 7. GROUNDWATER h 3. MANUAL MONITORING
I' 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + I` 8. TANK TESTING
BIENNIAL TANK TESTING 1199. OTHER
V. TANK CLOSURE INFORMATION /.PERMANENT CLOSURE IN PLACE
_ .
ESTIMATED DATE LAST USED (YR/MO/DAY) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457
gallons r Yes r No
UP CF (1/99 revised) Formerly SWRCCB Form B
~~ ~ ~NIFIED PROGRAM CONSOLIDATED FO
_ ~ - TANKS
UNDERGROUND STORAGE TANKS -TANK PAGE 2
VI. PIPING CONSTRUCTION (check all that apply) `-
~~
UNDERGROUND PIPING ABOVEGROUND PIPING
SYSTEM TYPE ~( 1. PRESSURE r 2. SUCTION r 3. GRAVITY r 1. PRESSURE r 2. SUCTION r 3. GRAVITY 459
X 1. SINGLE WALL r 3. LINED TRENCH r 99. OTHER r 1. SINGLE WALL r 95. UNKNOWN 462
CONSTRUCTION
/ I' 2. DOUBLE WALL h 95. UNKNOWN I' 2. DOUBLE WALL h 99. OTHER
MANUFACTURE
R MANUFACTURER 46t MANUFACTURER 463
I~ 1. BARE STEEL I' 6. FRP COMPATIBLE W/ 100% METHANOL I~ 1. BARE STEEL I' 6. FRP COMPATIBLE W/ 100% METHANOL
MATERIALS AND h 2. STAINLESS STEEL h 7. GALVANIZED STEEL h 2. STAINLESS STEEL h 7. GALVANIZED STEEL
CORROSION
PROTECTION h 3. PLASTIC COMPATIBLE WITH CONTENTS h 95. UNKNOWN h 3. PLASTIC COMPATIBLE WITH CONTENTS h 8. FLEXIBLE (HDPE) I' 99. OTHER
X 4. FIBERGLASS h 8. FLEXIBLE (HDPE) I' 99. OTHER I' 4. FIBERGLASS r 9. CATHODIC PROTECTION
I' 5. STEEL W/ COATING I^ 9. CATHODIC PROTECTION 464 h 5. STEEL W/ COATING h 95. UNKNOWN 465
~~ .,.,
VII. PIPING LEAK DETECTION (Check all that applv)(A dascnption oI the'nonitoring program sha(Lbe submitted fo the local agency.)
UNDERGROUND PIPING ABOVEGROUND PIPING
SINGLE WALL PIPING 466 SINGLE WALL PIPING 467
PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply):
X t. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR I` 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK,
LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS
ALARMS I~ 2. MONTHLY 0.2 GPH TEST
h 2. MONTHLY 0.2 GPH TEST
I' 3. ANNUAL INTEGRITY TEST (O.t GPH)
X 3. ANNUAL INTEGRITY TEST (0.1 GPH)
r 4. DAILY VISUAL CHECK
CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check all that apply):
I~ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY r 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM
TEST (0.1 GPH) I~ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH)
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):
I' 7. SELF MONITORING h 7. SELF MONITORING
GRAVITY FLOWN GRAVITY FLOW (Check al/ that apply):
r 9. BIENNIAL INTEGRITY TEST (0.1 GPH) r 8. DAILY VISUAL MONITORING
I' 9. BIENNIAL INTEGRITY TEST (O.1 GPH)
SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING
PRESSURIZED PIPING (Check all that apply): ~ PRESSURIZED PIPING (Check all that apply):
10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND
(Check one) 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (check one)
r a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS r a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
I' b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM I' b. AUTO PUMP SHUT OFF FOR LEAKS
SYSTEM FAILURE AND SYSTEM DISCONNECTION
DISCONNECTION ,
h c. NO AUTO PUMP SHUT OFF h c. NO AUTO PUMP SHUT OFF
I~ 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR j' 1 t. AUTOMATIC LEAK DETECTOR
RESTRICTION
I~ 12. ANNUAL INTEGRITY TEST (0.1 GPH) h 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUCTION/GRAVITY SYSTEM: SUCTIONlGRAVITY SYSTEM:
I' 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS I~ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Check all that apply) EMERGENCY GENERATORS ONLY (Check all that apply)
I~ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF +AUDIBLE AND r 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF +AUDIBLE AND VISUAL
VISUAL ALARMS ALARMS
I~ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR I' 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST)
RESTRtCTION
I~ 16. ANNUAL INTEGRITY TEST (0.1 GPH) I' 16. ANNUAL INTEGRITY TEST (0.1 GPH)
r 17. DAILY VISUAL CHECK
--- - - r 17. DAILY VISUAL CHECK
VIIL DISPENSERCONTAINPIIENT
DISPENSER CONTAINMENT I' 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE I~ 4. DAILY VISUAL CHECK
DATE INSTALLED 468 I' 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS I~ 5. TRENCH LINER /MONITORING
_1998 X 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER I~ 6. NONE 469
I certify that the information provided herein is true and_accurate to the best of my knowledge.
SIGNATURE OF ER/OPERA DATE 470
~ 10/2/03
NAME OF O OPERATOR (print) 471 TITLE OF OWNER/OPERATOR 472
Bruce T. Marubashi for Shell Oil Products Permit Analyst 925-766-3498
Permit Number (Forloca/ use only) 473 I Permit Approved (Forlocal use only) - 474 I Permit Expiration Date (Forloca/ use only) 475
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09/01 /05
PRODUCER:o::: :........................................................................ _................................_.............
R. F INFORMATION
THIS CERTIFICATE IS ISSUED AS A MATTE 0
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
FEDERATED MUTUAL INSURANCE COMPANY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
5701 W. Talavi Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Glendale, AZ 85306 COMPANIES AFFORDING COVERAGE
Phone: 602-944-5566 COMPANY FEDERATED MUTUAL INSURANCE COMPANY OR
Home Office: Owatonna, MN 55060 A FEDERATED SERVICE INSURANCE COMPANY
INSURED - 306-283-1 COMPANY
FLEETCARD FUELS NIKOLAUS TANK g
LINES INC
PO BOX 81685 COMPANY
BAKERSFIELD CA 93380 C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER POLICY EFFECTIVE
DATE (MM/DD/YY) POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
GEN ERAL LIABILITY GENERAL AGGREGATE S 2 OOO 000
X COMMERCIAL GENERAL LIABILITY PRODUCTS -COMP/OP AGG S 2 OOO OOO
A CLAIMS MADE ~ OCCUR 9338046 11 /01 /05 11 /01 /06 PERSONAL & ADV INJURY S 1 000 000 -
_ OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE S 1 000 000
FIRE DAMAGE (Any one fire) S 100 000
MED EXP IAny one person) S
AUT OMOBILE LIABILITY
X ANY AUTO COMBINED SINGLE LIMIT S 1 ,000,000
ALL OWNED AUTOS 80DILY INJURY
SCHEDULED AUTOS 9338046 11 /01 /05 11 /01 /06 (Per person) S
X
X HIRED AUTOS
NON-OWNED AUTOS _
-~
BODILY INJURY
IPer accident)
S
PROPERTY DAMAGE S
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY;
EACH ACCIDENT S
AGGREGATE S
EXCESS LIABILITY EACH OCCURRENCE S 4 000 000
A X UMBRELLA FORM 9338047 11 /01 /05 11 /01 /06 AGGREGATE S 4 000 000
OTHER THAN UMBRELLA FORM S
WORKERS COMPENSATION AND WC STATU- OTH-
TORY LIMITS ER
'
EMPLOYERS' LiloILITY
IncnlT
grr
EL_pnf1H
g
~--- -°- - - _
THE PROPRIETOR/
PARTNERS/EXECUTIVE - --
INCL --- - - - - _.. _ _ - _ _ _
_
_.
EL DISEASE -POLICY LIMIT S
OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE S
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
CITY OF BAKERSFIELD
BAKERSFIELD FIRE DEPARTMENT
900 TRUXTON AVE STE 210
BAKERSFIELD CA 93301
149 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
`~Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMP ITS AGE TS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIV / /l
=i UNIFIED PROGRAM CONSOLIDATED FO
TANKS
UNDERGROUND STORAGE TANKS -TANK PAGE 2
_ .s' _, ~-
Vi: PIPINGCONSTRUCTION (ChecxaRthatapp~y)
UNDERGROUND PIPING ABOVEGROUND PIPING
SYSTEM TYPE X 1. PRESSURE I' 2. SUCTION I~ 3. GRAVITY r 1. PRESSURE r 2. SUCTION I~ 3. GRAVITY 459
CONSTRUCTION X 1. SINGLE WALL r 3. LINED TRENCH I' 99. OTHER r 1. SINGLE WALL I' 95. UNKNOWN 462
/ r 2. DOUBLE WALL r 95. UNKNOWN r 2. DOUBLE WALL r 99. OTHER
MANUFACTURE
R MANUFACTURER 461 MANUFACTURER 463
I' 1. BARE STEEL I~ S. FRP COMPATIBLE Wf ioax METHANOL r i. BARE STEEL I.6. FRP COMPATIBLE vw 100% METHANOL
MATERIALS AND r 2. STAINLESS STEEL h 7. GALVANIZED STEEL I' 2. STAINLESS STEEL I~ 7. GALVANIZED STEEL
CORROSION
PROTECTION
r 3, PLASTIC COMPATIBLE WITH CONTENTS r 95. UNKNOWN
r 3. PLASTIC COMPATIBLE WITH CONTENTS r 8. FLEXIBLE (HOPE) r 99. OTHER
X 4. FIBERGLASS I' 8. FLEXIBLE (HOPE} I' 94. OTHER 1' 4. FIBERGLASS. I' 9. CATHODIC PROTECTION
r 5. STEEL W/ COATING r 9. CATHODIC PROTECTION 464 r 5. STEEL W/COATING r 95. UNKNOWN 465
,, _ _ _
VII. PIPING LEAK DETECTION (Check aN that apply) (A descriplron of tine monitgnng progtarr+ shall be sutirmtted 1o the loAaf agoncy.)
UNDERGROUND PIPING ABOVEGROUND PIPING
SINGLE WALL PIPING 466 SINGLE WALL PIPING 467
PRESSURIZED PIPING (Check all that appy): PRESSURIZED PIPING (Check aH that apply):
X 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST MATH AUTO PUMP SHUT OFF FOR 1' t ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK
LEAK, SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL SYSTEM FAILURE, AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS
'ALARMS r 2, MONTHLY 0,2 GPH TEST
h 2. MONTHLY 0.2 GPH TEST r 3. ANNUAL INTEGRITY TEST {D.1 GPH}
X 3. ANNUAL INTEGRITY TEST (0.1 GPH}
r 4. DAILY VISUAL CHECK
CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (ChetkaMthatappry):
I' S. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNALL PIPING INTEGRITY I' S. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM
TEST {D.1 GPH} r 6. TRIENNIAL INTEGRITY TEST (0.1 GPH}
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS {NO VALVES IN BELOW GROUND PIPING}:
7. SELF MONITORING r 7. SELF MONITORING
GRAVITY FLOW: GRAVITY FLOW (Check alt that aPP1Y)=
9. BIENNIAL iW'fEGRRY TEST (0.1 GPH} I~ 8. DAILY VISUAL. MONITORING
r 9. BIENNIAL INTEGRITY TEST (0.1 GPH}
SECONDARILY CONTAINED P[P1NG SECONDARILY CONTAINED PIPING
PRESSURIZED PIPING (Check al! that apply): - PRESSURIZED PIPING (Check all Neat apply):
t0, CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE RND VISUAL ALARMS AND
(Ghedcone} ' t0. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (check one)
r a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS r a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
r b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM r b. AUTO PUMP SHUT QFF FOR LEAKS, SYSTEM FAILURE ANO SYSTEM DISCONNECTION
DISCONNECTION
T c NO AUTO PUMP SHUT OFF I' a NO AUTO PUMP SHUT OFF
I~ i i. AUTOMATIC UNE LEAK DETECTOR (3,0 GPH TEST) WITH Fi.Ow SHUT OFF OR T 11. AUTOMATIC LEAK DETECTOR i
RESTRICTION
I' 12, ANNUAL INTEGRITY TEST (0.1 GPHy
r 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUGTtONiGRAVITY SYSTEM'. I
SUCTIONIGRAViTY SYSTEM:
13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS I
r 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Cherie alt that apply) EMERGENCY GENERATORS ONLY (Cfleck a8 that apply)
T` 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF +AUDIBLE AND I~ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF +AUDIBLE AND VISUAL
VISUAL ALARMS ALARMS
I' 15. AUTOMATIC LINE LEAK DETECTOR (3.4 GPH TEST) WITHOUT FLOW SHUT OFF OR I~ 15. AUTOMATIC LINE LEAK DETECTOR {3.0 GPH TESTY j
RESTRICTION
r 16. ANNUAL INTEGRITY TEST (0.1 GPNj r 16. ANNUAL WTEGRI'IY TEST (D.1 GPH)
r 17. DAILY VISUAL CHECK r 17. DAILY VISUAL CHECK
r_
V111: D15RENSER CONTAINMENT ' : ';
."
DISPENSER CONTAINMENT r i. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE r 4. DAILY VISUAL CHECK
DATE INSTALLED 468 F 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS I' S. TRENCH LINER /MONITORING
1998 X 3, CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FQR DISPENSER I. 6. NONE 469
I certify that the iniormatian provided herein is true and accurate to the best of my knowledge.
SIGNATURE OF ER10PE OR GATE 470
laiz/ros
NAME OF O OPERATOR (print) 471 TITLE OF OWNERIOPERATOR 472
Bruce T. Marubashi for Shell Oil Products Permit Analyst 925-766-3498
f Permit Number (Far klcat use only} 473 I Permit Approved (For kcal use oMy) 474 I Permit Expiration Oate (Forklcat use oMy) 475
' .~ '' +' ~ U~IED PROGRAM CONSOLIDATED RM
TANKS
UNDERGROUND STORAGE TANKS -TANK PAGE 1 (two pages per tank)
Page ~' of
' TYPE OF ACTION I' 1. NEW SITE PERMIT I' 4. AMENDED PERMIT I' 5. CHANGE OF INFORMATION) h 6. TEMPORARY SITE CLOSURE
(Check one item on/y)X 2. OPERATOR CHANGE r 7. PERMANENTLY CLOSED ON SITE
r 3. RENEWAL PERMIT (Specify reason -forloca/ use only) (Specify change -for local use only) r B. TANr K REMOVED 430
BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 FACILITY ID # ~ ~ 1
Rosedale Shell #2
LOCATION WITHIN SITE (Optional)431 3605 Rosedale Hwy, Bakersfield, CA 93308
_, _ ~ ~ ~ P p _- ~ _ ..
. - . ~ ~. - -:I. TANK DESCRIPTION- A. scaled lot Ian with the location of the UST system including buildingsandYandmarks sha/(be submitted to the local agency.}
TANK ID # 432 TANK MANUFACTURER 433
COMPARTMENTALIZED TANK I~ Yes X No
434
135069 -Plus OWENS CORNING If Ayes=, complete one page for each compartment.
DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437
1987 10 000 ONE
ADDITIONAL DESCRIPTION (For local use only) 436
_.. _.
- . II. TANK CONTENTS
TANK USE 439 PETROLEUM TYPE 440
X 1. MOTOR VEHICLE FUEL I' 1a. REGULAR UNLEADED I' 2. LEADED I' S. JET FUEL
(If marked, complete Petroleum Type) r 1b. PREMIUM UNLEADED r 3. DIESEL r 6. AVIATION FUEL
I' 2. NON-FUEL PETROLEUM ~( tc. MIDGRADE UNLEADED h 4. GASOHOL 1199. OTHER
I~ 3. CHEMICAL PRODUCT
r 4. HAZARDOUS WASTE (Includes COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442
Used Oil)
h 95. UNKNOWN
-III. TANK CONSTRUCTION.
~
TYPE OF TANK h 1.
~SINGLE WALL h 3. SINGLE WALL WITH h 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443
(Check one item only) ~( 2. DOUBLE WALL EXTERIOR MEMBRANE LINER r 95. UNKNOWN
I^ 4
SINGLE WALL IN A VAULT
.
r 99. OTHER
TANK MATERIAL -primary tank r 1. BARE STEEL X 3. FIBERGLASS /PLASTIC r 5. CONCRETE r 95. UNKNOWN 444
(Check one item only) j' 2. STAINLESS STEEL r 4. STEEL CLAD W/FIBERGLASS r 8. FRP COMPATIBLE W/100 % METHANOL r 99. OTHER
REINFORCED PLASTIC (FRP)
TANK MATERIAL -secondary I' 1. BARE STEEL X 3. FIBERGLASS /PLASTIC I~ 8. FRP COMPATIBLE W/100% METHANOL I~ 95. UNKNOWN 445
tank
h 2. STAINLESS STEEL h 4. STEEL CLAD W/FIBERGLASS h 9. FRP NON-CORRODIBLE JACKET r 99. OTHER
(Check one item only) REINFORCED PLASTIC (FRP)
h 10. COATED STEEL
h 5. CONCRETE
TANK INTERIOR LINING r 1. RUBBER LINED r 3. EPOXY LINING r 5
UNKNOWN446 DATE INSTALLED
GLASS LINING r 95 447
.
.
OR COATING
r 2. ALKYD LINING r 4. PHENOLIC LINING X 6. UNLINED r 99. OTHER
(Check one item only) (For local use only)
UNKNOWN 448 DATE INSTALLED 449
OTHER CORROSION I' 1. MANUFACTURED X 3. FIBERGLASS REINFORCED PLASTIC Il 95
.
PROTECTION IF APPLICABLE
CATHODIC
r 4. IMPRESSED CURRENT I~ 99
OTHER
.
PROTECTION
(Check one item only) (For local use only)
r 2. SACRIFICIAL ANODE
SPILL AND OVERFILL YEAR INSTALLED TYPE (Forloca/use on/y)451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452
450
(Check all that apply) X 1. SPILL CONTAINMENT X 1. ALARM X 3. FILL TUBE SHUT OFF VALVE
X 2. DROP TUBE I~ 2. BALL FLOAT I~ 4. EXEMPT
X 3. STRIKER PLATE
IV. LANK LEAKDETECTiON ,,;,r,,, when ,,,,..a, ;~ogramsha/l,besubmitt- ; me;oaa :,nay,;
IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only): 454
h 1, VISUAL (EXPOSED PORTION ONLY) I~ 5. MANUAL TANK GAUGING (MTG) h 1. VISUAL (SINGLE WALL IN VAULT ONLY)
I~ 2. AUTOMATIC TANK GAUGING (ATG) I~ 6. VADOSE ZONE X 2. CONTINUOUS INTERSTITIAL MONITORING
h 3. CONTINUOUS ATG I~ 7. GROUNDWATER h 3. MANUAL MONITORING
I~ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + I~ 8. TANK TESTING
BIENNIAL TANK TESTING r 99. OTHER
_ _,
' V: TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE
ESTIMATED DATE LAST USED (YR/MO/DAY) ~ 455 ESTIMATED QUANTITY OF SUBSTANCE~REMAINING 456 TANKFILLED WITH INERT MATERIAL? 457
gallons r Yes r No
~r ~,r ~ uya revwea) Formerly SWKGGti Form tS
6
- :~ ~
~_ ... -~
UNIFIED PROGRAM CONSOLIDATED FO
TANKS
UNDERGROUND STORAGE TANKS -TANK PAGE 2
~ .~
' VI; PIPINGG4NSTRl1CT10N (Check ali Fhat apply)
UNDERGROUND PIPING ABOVEGROUND PIPING
SYSTEM TYPE X t. PRESSURE I' 2. SUCTION I' 3. GRAVITY I' 1. PRESSURE r 2. SUCTION I_ 3. GRAVITY 459
T
TION X 1. SINGLE WALL r 3. LWEO TRENCH r 99. OTHER r 1. SINGLE WALL r 95. UNKNOWN 462
RUC
CONS
1 I' 2. DOUBLE WALL I~ 95. UNKNOWN I' 2. DOUBLE WALL I' 99. OTHER
MANUFACTURE
R MANUFACTURER 461 MANUFACTURER 463
r 1. BARE STEEL r 6. FRP COMPATIBLE Wf 10096 METHANOL I~ i. BARE STEEL r 6. FRP COMPATIBLE Wl 100% METHANOL
MATERIALS AND r 2. STAINLESS STEEL r 7. GALVANIZED STEEL I` 2, STAINLESS STEEL r 7. GALVANIZED STEEL
CORROSION
PROTECTION 1^ 3. PLASTIC COMPATIBLE WITH CONTENTS r 95. UNKNOWN r 3. PLASTIC COMPATIBLE WITH CONTENTS r 8. FLEXIBLE {HOPE) r 99. OTHER
X 4. FIBERGLASS I' & FLEXIBLE (HOPE} I' 99. OTHER I' 4. FIBERGLASS- r 9. CATHODIC PROTECTION
r 5. STEEL Wf COATING r 9. CATHODIC PROTECTION 464 r 5. STEEL W! COATING r 95. UNKNOWN 465
_..._
, -. ,
VII; PIPING LEAK. DETECTION (Check aH that apply}iA'dascriptrat of the mon>loring Aro9ram shalt be.suWrntted to ttie [Dear agency.]
UNDERGROUND PIPING ABOVEGROUND PIPING
SFNGLE WALL PIPING 466 SINGLE WALL PIPING 467
PRESSURIZED PIPING (Check afl that appy): PRESSURIZED PIPING (GheCk aN that apply):
X 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR I' t ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK
LEAK, SYSTEM FAILURE, ANO SYSTEM DISCONNECTION +AUDIBLE AND VISUAL SYSTEM FAILURE. AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS
ALARMS r 2. MONTHLY 0.2 GPH TEST
r 2. MONTHLY 0.2 GPH TEST r 3. ANNUAL WTEGRITYTE57 (0.1 GPH)
X 3. ANNUAL INTEGRITY TEST (0.1 GPH} 1' 4. DAILY VISUAL CHECK
CONVENTIONAL SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check aR that appy):
r 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY h 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM
TEST (0.1 GPH] r 6. TRIENNIAL INTEGRITY TEST (0,1 GPH)
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPINGJ; SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):
r 7. SELF MONITORING r 7. SELF MONITORING
GRAVITY FLOW: GRAVITY FLOW (Check at! that apply):
I' 9. BIENNIAL INTEGRITY TEST (0.1 GPH) r 8. DAILY VISUAL. MONITORING
r 9. BIENNIAL INTEGRITY TEST (O.1 GPH)
SECONDARILY GONTAINED PIPING SECONDARILY CONTAINED PIPING
PRESSURIZED PIPING (Check ad that apply): PRESSURIZED PIPING (Check aAthat apply):
10, CONTINUOUS TURBINE SUMF SENSOR VV1TH AUDIBLE AND VISUAL ALARMS AND
(Check ane) 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (cltedc ane)
)" a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS r a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
r b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM r b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION
DISCONNECTION
T G NO AUTO PUMP SHUT OFF r c NO AUTO PUMP SHUT OFF
r 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR T 11. AUTOMATIC LEAK DETECTOR ~
RESTRICTION
C 12. ANNUAL INTEGRITY TEST (0.1 GPH)
1' 12. ANNUAL INTEGRITY TEST (0.1 GPH)
SUGT10NtGRAVITY SYSTEM: SUCTIOWGRAVITY SYSTEM:
r 13, CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS r 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS
EMERGENCY GENERATORS ONLY (Check afl that appy) EMERGENCY GENERATORS ONLY (Check all that apply} '.
h 14, CONTINUOUS SUMP SENSOR WITHOUT AVTO PUMP SHUT OFF +AUDIBLE AND r 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL
VISUAL ALARMS ALARMS
r~ 15, AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR I_ 15. AUTOMATIC LINE LEAK DETECTOR (3A GPH TEST)
RESTRICTION
I' 16. ANNUAL INTEGRITY TEST (0.1 GPH) I~ 16. ANNUAL INTEGRITY TEST (0.1 GPH)
r 17. DAILY VISUAL CHECK r 17. DAILY VISUAL CHECK
,.,..
VIII: DISBENSER CONTAINMENT
DISPENSER CONTAINMENT I' 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE r 4. DAILY VISUAL CHECK
DATE INSTALLED 468 r 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS r 5. TRENCH LINER f MONITORING
1998 X 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER r 6. NONE 469
I Certify that the information provided herein is We and aCwrate 1o the best of my knowledge.
SIGNATURE OF ER/OPE OR DATE 470
1o~2ros
NAME OF O PERATOR (print) 471 TITLE OF OWNERlOPERATOR 4T2
Bruce T. Marubashi for Shell Oil Products Permit Analyst 925-766-3498
Pernit Number (For krcal use only) 473 ~ Pernft Approved (For k~caf use onty) 474 I Permit Expiration Dale (Forlocaf use b++lY) 475
UNDERGROUND STORAGE TANKS
APPLICATION
TO PERFORM ELD /LINE TESTING
/ S6989 SECONDARY CONTAINMENT TESTING
(TANK TIGHTNESS TEST AND TO PERFORM
FUEL MONITORING CERTIFICATION
PERMR N0. ~" ~~'~
f/R/
~Rrr r
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 DEFECTION ^ SB-989 SECONDARY CONTAINMENT TESTING
^ TANK TIGHTNESS TEST (~ TO PERFORM FUEL MONITORING CERTIFICATIO
. .
FACILITY NAME 8. PHONE NUMBER OF CONTACT PERSON .
Y
I
ADDRESS ~ Q C~
__..
OWNERS NAME
OPERATORS NAME 1 , ~` ~ ~ Q~ ~~/
~~' 'PERMIT TO OPERATE NO.
NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YE ^ NO
T N V L ME CONTENT
. ~~
TANK TESTING COMPANY
NAME OF TE G C PANY , ~~ n NAME 8 HONE NUMBE F CO TACT PERSON
MAILING ADDRESS ~ ~ ^
NAME & PHO NUMBER O TESTER ~,~PECIAL INSPECTOR
Y %// ~UG ~8 ERTIFICATION #:
DATE S TIME TEST TO BE ON UGTED^ /` O '„\
U /
`
(~ ICC #: TEST METHOD
SIGNATURE OF APPLICAN
~
~' DATE a -a $ O
APPROVED BY / DATE 3
FD 2095 (Rev. 09105)
,;
tJNIFIE® PROGRAM INSPECTION CHECKLIST
SECTION 1 Business Plan and Inventory Program
FACILITY NAME
Bakersfield Fire Dept.
Enironmental Services
1715 Chester Ave
Bakersfield, CA 93301
Tel: (661)326-3979
INSPE TION.DATE INSPECTION TIME
~~SI~L~~--~~~ ~-------...-------------- -------------..-..--------------- PH~~ O -_~~--- No. of E PloYees -----.
ADDRESS
------ ------ a~------- ----------------
FACILITYCONTACT ~ Business ID Number
15-021- ~~
Section 1: Business Plan and Inventory Program
^ Routine ombined ^ Joint Agency ^Mvlti-Agency ^ Complaint ^ Re-inspection
C V (V=Volationncel OPERATION COMMENTS
J /~~~
~^ APPROPRIATE PERMIT ON HAND v
--s--/----- ---- ---- -------- ------ - ---- -- --- ---- ....._ _ ----- -
LW ^ BUSINESS PLAN CONTACT INFORMATION ACCURATE
C~/ ^ VISIBLE ADDRESS
~^ CORRECT OCCUPANCY ~
IW ^ VERIFICATION OF INVENTORY MATERIALS
LTV ^ VERIFICATION OF QUANTITIES ~~ /'1~~
bJ~ ^ VERIFICATION OF LOCATION Z"~~
Lam' ^ PROPER SEGREGATION OF MATERIAL
LW ^ VERIFICATION OF MSDS AVAILABILITYE
^ VERIFICATION OF HAT MAT TRAINING
L!V ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
LA' ^ EMERGENCY PROCEDURES ADEQUATE
--
CONTAINERS PROPERLY LABELED __ ~Ql,(t-1-.-- ,n ~It~e~(~^ ~rt Q/ ~ ,{--~t~~ Q~~ --
^HOUSEKEEPING ~ - c - ~ ~ ~~
^ ^ FIRE PROTECTION - t_(_ / , t 1
--- ------ -- ---------- ---- ------------_--- --- --- - - --- --------- -~I.CC~- ~~--s-~ -- -1~~-~i1'fi.'1'~ f ----!'~C ~L~`_~. C---- -...
^ ^ SITE DIAGRAM ADEQUATE St ON HAND
ANY HAZARDOUS WASTE ON SITE?: ^ YES ^ NO
EXPLAIN:
QUESTIO EGARDING ISM SPECTION~ PLEASE CALL US AT ~GG'I~ 326-$979
I ~ ~'
Inspector ~ Badge No., Business Site Responsible Party
White • Environmental Services Yellow -Station Copy Pink -Business Copy
'~ `~~ ~ CITY OF BAKERSFIELD FIRE DEPARTMENT
F ~~ OFFiCE OF ENVIRONMENTAL SERVICES
~p~ UNIFIED PROGRAM INSPECTION CHECKLIST
w ~gw,,!' 1715 Chester Ave., 3~d Floor, Bakersfield, CA 93301
FACILITY NAME RC3~iccU~I,L ~~~ ~~ INSPECTION DATE `g O
Section 2: Underground Storage Tanks Program
^ Routine ~ombined ^ Joint Agency ^Mutti-Agency ^ Complaint ^ Re-inspection
Type of Tank ~cALS Number of Tanks .~
Type of Monitoring C L (~ Type of Piping ~l i=
OPERATION C V COMMENTS
Proper tank data on the
Proper owner/operator data on the
Permit tees current
Certification of Financial Responsibility
Monitoring record adequate and current
Maintenance records adequate and current
Failure to correct prior UST violations
Has there been an unauthorized release? Yes No
Section 3: Aboveground Storage Tanks Program
TANK SIZE(S)
Type of Tank
AGGREGATE CAPACITY
Number of Tanks
OPERATION Y N COMMENTS
SPCC available
SPCC on 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
r
Inspector: ~
Office of Environmental Services (805) 326-3979
White
N=NO
nv. Svcs.
Pink -Business Copy
Business Site Responsib e Party
C-ORRECTION NOTICE
0512
BAKERSFIELD FIRE DEPARTMENT
Location ~ ~~.~ KoSc~~~~ ~~~
Name ~Co~cd~.~L ~I~cl~
You are hereby required to make the following
corrections at the above location:
Cor. No.
..
o~ - ~ ~
« s _ ~,
~~ o
r+v ~(n ~ s s o ~
f~ ~ ~ ~ ®~
U 5 F'
~- ~(~ 0 f .~'c e~~-c~
Completion Date for Corrections ~ b ~
Date ~-L ~ D ~
FD 1950
Inspector
326-3951