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I !. _1 _ ~, ~~ - ~ •\lv ~ _ // /~ 1 \ w ~ ~ ~~ 1~ 0 0 ~ 1I o w cn x ~ r ' z o ' ~ N "i 1 UNDERGROUND STORAGE TANKS APPLICATION TO PERFORM ELD /LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION PERMff NO. ` ~.i B 8 P I D w~~~ ARTA/ 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 ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANKTIGHTNESS TEST ^ TO PERFORM FUEL MONffORING CERTIFICATION ~ Cathodic Protection Testing SITE INFORMATION FACILITY Beacon NAME 8 PHONE NUMBER OF CONTACT PERSON ADDRESS 6495 S. Union Ave. OWNERS NAME Same OPERATORS NAME Same PERMIT TO OPERATE N0. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS 1 87 UL 2 91 UL TANK TESTING COMPANY NAME OF TESTING COMPANY Cal-Valley Equipment Bruce W. Hinsley 661-327-9341 MAILING ADDRESS 3500 Gilmore Ave. Bakersfield, Ca. 93308 Bruce W. Hinsley 661-327-9341 CERTIFICATION #: 006-05-~ ~ 7$ DATE & TIME TEST TO BE CONDUCTED AUgUSt 1, 2008 ~~OO ICC #: SIGNATURE OF APPLI T- y ~ DATE July 26, 2006 APPROVED BY DATE FD 2095 (Rev. 09/05) UNDERGROUND STORAGE TANKS ~~ B H R S F I D - F/B® APPLICATION ~Rr~ ~ PERMIT NO. ~T' `~ 3CJ ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ~ TO PERFORM FUEL MONITORING CERTIFICATION TO PERFORM ELD /LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING YANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION ____ __ ` ~ -SITE INFORMATION FACILITY l NAME & PHONE NUMBER O ____ _ F CONTACT PERSON ~ DDRESS lo~ 5~ ~e.~L~ ~ 330 WNERS NAME PERATORS NAME iPERMIT TO OPERATE NO. ~ NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO ~ TANK# VOLUME CONTENTS ~ i i ~ ~ ~ D l~ ~ l~'~Q,cco I 3 ~ i o L _ ~ ~~~ I _ ~ ~ - i ,_. -- -- - TANK TESTING COMPANY ~ - - AME F TESTING COMP Y NAME PHONE NUMBE OF CONTACT PERSON ~ (0 1-~3 -~~1 Q3 AILIN~ AODDR S 5 ~~ Cf~ 933oa- ~ !NAME & PHONE NUMBER OF TE ER OR SPECI N PEC OR - 3 -~R9 ERTIFICATION #: ~.2.o(po~~ ~DAT TIME TEST TO BE CONDUCTED /-' 1 vv I; ao Pry ~ ICC #: S~ ~q ~ ~l~ - EST ME D ~ ~ j SIGNATURE OF P LIC ~ DATE ~_~~ ~O ~~ IE~A !Q~ BE~~.fi~ S €~E~M. ~!~ P~~'3~E~ ~ p,PPROVED BY ' ~ ~ -,~~ DATE (/ ~ ~ Q~ ~ BAKERSFIEI,D FIRE DEPT. Predention Seavices 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 FD2106 :3~1~3Ei~G~~tlND STORAGE TANKS ~ ~S~+I~L~ ~°~12~: D~~'. 3 ~ E R S F I ~ i~B~~~~~~i~~ ~~''~1~ °~J _a~_~ _. ~~..~ . ~~ ~. 900 Trtaxtun !eve. Ste. 210 ~~~~~~~~~ - _ , Bakersfield., CA 93301 TO PERFORM! ELD /LINE TESTING Tel.: (661; 326-3979 / SB989 SECONDARY CONTAINMiENT TESTING FaX. (66I1 852-2171 /TANK TIGHTNESS TEST AND TO PERFGR~~ FiJEL i~90NiTORiNG C~RTiFiCATiON P^r:~ - 'Vli . PER4aIT Nc ~ (--~ ~~~ - ^ ENHANCED LEAK DF i EG T !CPJ ^ LINE TESTING ~1 SB-989 SE00'~^ARY CONTAINPAFNT TESTING ^ I P.NK TiG'.-iTNtSS TtST ^ I G !=ERFGRFvi Fi;tL PACJNi I O^-SING ^~c I IFIG;-.TiGI.~ - j TF INF=.ORib7F,TiOt~ 'FAGILI~~<K-r'v"„- ~ ~~ _ y ~ -- ~ ~ ~, pr - yAaRE & Pr-iON>,~ fv:3aRBER Cs= C{3i`dTAC7 ;/ERSO~f !ADDRESS ~ ln~ 4 S ~ (,1in,,..d~ Gam,-e,~ ~~ja.~ ~ ~ C~ 9 330 7 OV~JNERS NAir1E 'OPERATORS idAPt9E PER~iiT TO OPER.~ITE NC. i NiJ,~BER CF TANKS TO BE TESTED IS PI?iNG GOIt~~G TC BE TESTED? _ YES ^ NC __ ~Q ----- -- --- _T,~ N K n ____ V O !. i! Mi E - -- -- ----CONTENTS -- I ----~---- - , a K --- ~ ~ - ~2 ~aK g~ .. T,4N!( TESTil~G COMPANY NAME F TESTING COMPANY NAr'sE Pii01'JE ,'1iJP,"$ER 0= t,°.~,i~JTACT ;-^ERSOl~a ' / p ~ jMA1LIN ADDRESS a _ ~ . o . ~~ 330 ~ NAME PHONE NUMBER OF TESTER OR SPECI iNSPE OR CERTIF!C.=1TiON =: ~a~ ~n~pi-,39~- .P~~7 b5b3~^-aq - oSo3Sl3a- DAT- Yx tME TEST TO BE CONDUCTED iCC =~ TEST METHOD ~o cos ~~P~ ' sa ~ ~ ~ - u-~ ~.~ SiGtvATURE O A P ANT DATE 2~ O ' ~ ~i~~_3~~~~~~~ ~~.1..E-7.-~~.~ ~1 ~E.~~~~ . ;~'~: ~ QiF~--` ~ Ft~r-ti~EQ ----- A??RGV_D B'; 1\ e e .~ --/ %ei//~...t:xe- l DHTE 1 / ~l ------- FD2iCe BAKERSFIELD FIRE DEPT. UNDERGROUND STORAGE TANK Pr@p@IItlOri SeTV1Ce8 s a x s F I n 900 Truxtun Ave., Ste. 210 ~~' FUr! Bakersfield, CA 93301 PERMIT APPLICATION ~:_ ~Rrr r TO OPERATE AN UST ~~ ~ Tel.: (661) 326-3979 Fax: (661) 852-2171 PERMIT NO. ~ Page 1 of 1 - TYPE OF APPLICATION (CHECK) - / l ~S aS ~ ^ OPERATE NEW FACILITY ~ TRANSFER OF wNERSHIP ^ TO OPERATE AN EXISTING FACILITY _ ,. ,.,, PREVIO STANK`. '~~R`ifa` ACable ` ~ ~_ NAME. HONE NO ADDRESS ITY IP CODE .~ r NEWTANKOWNER` s: , '[ ~ ,' AME HONE N d1 fir' ~ ~ '~~ ~3~-- 3~-~-2 i -a~ DR SS ~ ITY /~ IP CODE ~f~S non ~~ ~''f r~ CAt ~3~ ! LING ADDRESS ITY IP CODE G ._ - .-~ ; '' ~. _'. ' _ =~,TANK-_;QP-ERATOR(rfdifferentfromowner)_ _ ~ S E HONE NO DRESS ITY IP CODE ,._ ~ °' ;. ~ ~ " : ___~~ .._r ._ ._ ; ' ~ ' APPLICANTS NAtiAE~(rf drfferent from owner), ~ .. - _ _ _~, . _ .. AME HONE NO ___ DDRESS ITY IP CODE Y~_ ~__- ° TANKL4CATION Y __ ~ ~ AGILITY NAME PPERATOR NAME HONE NO DDRESS Il'Y IP CODE -~''~` - -" = ".~-_ ,-. >:. EMERGENCY.CONTACT s ~ _ _. _ _ r AME HONE NO art ~ ~ 6t d3 - ~~~ ,~4- ~ ~ ~ IT~Yt / ~~ /~ IP CODE ~~ nr ~~ ~ !s- e ~o( Cif ~3~b ~..,. ~ ~ __ `TANK INFORMATION _ e TANK NO. VOLUME DATE INSTALLED SUBSTANCE STORED PREVIOUS SUBSTANCE Do you have a HAZARDOUS MATERIAL RESPONSE PLAN? ^ YES ^ NO Do you have an OWNER -OPERATOR AGREEMENT? ^ YES ^ NO Have you filled out a HAZARDOUS MAT ERIAL BUSINESS PLAN? ^ YES ^ NO FOR OFFICIAL USE ONLY The applicant has received, understands, and will comply with the attached conditions of the permit and any other state, local and federal regulations. This form leas been completed under penalty of perjury, and to tl:e best ofmy knowledge, is true and correct: APPLICANT SIGNATURE: APPLICANT NAME (PRINT:) APPROVED BY: ~' THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD2087 (Rev. 09105) - ~. . .: . . UNDERGROUND STORAGE`TANKS `~ ~. - ~ BAKERSFIELD FIRE- DEPT. . Prevention Services b.~ £"~ - ::p~e~:; ARTM T 900 T'ruxtun Ave.; Ste: 210 APPLICATION `Bakersfield, `CA 93301 TO PERFORM ELD /-LINE TESTING Tel • (661)" 326- 3979 / SB989 SECONDARY GONTAINMENT,TESTING ?~' ' , F1x: (661); 852-2171 ZTQNK TIGHTNESS TEST AND 70 PERFORM FUEL - 'MONITORING CERTIFICATION - Page t of 1 /D / - PERMIT NO . ^ ENHF~NCED LEAK DETECTION ^ . LINE TESTING . ~ ~ S6-989 SECONDARY CONTAINMENT TESTING -TANK TIGHTNESS TEST ^ TO PERFOrr.1 F UEL n;10NITORING CERTIFICATION . ___ ___ _ - : _ ,. . SITt= INFORMAT,ION_=~: ~ _ . - _ _ _ IFACI Y ' ~IAME_8& PHONE NUMBER OF"CONTACT PERSON' I ~~~ ~: ~ L ; a «r~ ~ a ~ 1 3~, - 3aa ~ ~ -~~~ ~ ~~~ (ADDRESS ~ ~ I ^: ~ 0 i OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO: - `_ . .- i NUMBER OF TANKS TO_BE TESTED IS PIPINGGOING TO BE TESTED? - ^ -YES ^..'NO . TANK # :, VOLUME- CONTENTS. J i i •: I ~ ~ ~ I I i I __-- - - ~. :- - <: ~~ -. T~ -- - TANK TESTING COMPANY- : _ _' ~. - _. ~. ~V ME ?ESTING COMPANY AME :&. PHONE"NUMBER. OF CONT CT P RSON - ~IA (LING AD RESS ~ d _ ` 33 ~ ~ c~ a ~P, ~ ~~~ ~ ~ I ~-ss- ~ ~ l a, 1 0 a ~lA E & PHONE NUM ER"OF-TESTER_ OR SP AL NSPECTOR: ERTIFICATION #- - . ~ Cr ~ ATE & IME TEST TO BE CONDUCTED ' ~ CC #: EST METHOD hvrsc~ oZO~~ ~ --9 C.OA/ IGNATURE OF A PLI ANT ATE.. :~"~~ -ro ;. APPROVED BY DATE: ~ ~~ ~ _- . FD2106 ~~ SWRCB, 7anuary 2002 Page ~ of Secondary Containment Testing lZeport ForTn This form is intended for use vy contractors performing periodic testing of TIST secondary containment systems. rise the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (f applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1 F®t`i-I.i'I'V iNF(lR1VIA"9'TnN FaciIityName: Beacon Liquors ' -Date of Testing: 7726107 Facility Address: .6495 South Union Avenue, Bakersfield, CA 93307 - Facility Contact: Singh Phone: 661-832-3222 Date Local Agency i~+"as Notified of Testing : 'T/16/07 City of Bakersfield-Fire'Department Name of Local Agency Inspector (if present during testingj: 2 'TESTING CONTRAC'~OR Il~ORNdA'TION Company-Name: Redwine Testing°Services, Inc. Technician Conducting Test: Ruben Becerra Credentials: X CSLB Licensed Contractor ^ SWRCB Licensed Tank Tester License Type: A HAZ License Number: 532878 Manufacturer Mlanufacturer Training Com onent(s) Date Training Ex fires Incon Incon TS-STS 3. SUIVIIVIAItY ®F TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass `Fail Not Tested Repairs NYade i t -- ~.-. J fl G ~ ^ ^ 'J ^ ^ '' ^ " -~ ~; ~~ Lei,; ~ ^ ~; ~ ^ ~ ^ If hydrostatic testing was performed, describe what was done with the water after completion of tests: and reused. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in fuU compliance with legal requirements Technician's Signature- Date: 7 `~_ ` ~~' Page fi-of~ SWRCB, .ianuary 2002 Test method Developed By: ^ Tank Manufacturer X Industry Standard Professiona~ Engineer ^ Other (Specify) ^ Pressure X Vacuum ~ Hydrostatic Test Method Used: Other (Specify) j Equipment Resolution o • ~ - - Test Equipm°n~ Used 4 m Dial auge _ ~ .~~ .~ ~ ~ fi ~ ~ Tank # Wank # ~, Tank ~ Is Tam Exempt From Testi-ig?' ^ Yes ^ ivTo ' '! Yes ^ No ^~ Yes ~~ Tan_k Capacity-: !I ~, Tank Material: -~~ Tank lylanufacturer: ,~ ~ Product Stored: '~ Wait time beriveen applying ~ ~ j q pressure/vacuum,%tivater and !I j starting test: ~ Test Start Time: ~! ~ i ~: Initial Reading (Ri): i d Test End Time: ~ Final Reading (RF): II I Test Duration: ~ n Change in Reading (RF-R,): ~ p ~T' ~I Threshold or Criteria: ~ ~ ~ Tank # o -Yes ~ No ~ ass, ai i ' Vest Result• ^ Pass ^ Fail j ^ Pass ^ Fail ^ Pass ^ Fail ^ Pass ^ Fail Was sensor removed for test g? ~ i !Yes ^ No ^ NA ~! Yes ^ No ^~ NA `Yes ~ ' No ^ I``A j -Yes ^ No = NA Was sensor properly rep ced and ; ^; ^ No ^ NA I ^! yes ^~ No ^ NA ^ Yes ~ No ^ NA ~ ^ Yes ^ No ~_ NA Yes ,; ;; verified functional a r testing? C®~1ffielitS - (include information on repairs fnade prior tAc testing, and recernn2ended follon°-up for failed tests) •- r Ji i 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 periadic containment testing. {California Code of Regulations, Title 23, Section 2637(a}(5)} SWRCB, January 2002 Test Method Developed By: Test Method Used: 5e SEC®I~~R~.' PILPE 'TES~'>~~ !Piping Manufacturer ~! Other (Spec~j X Pressure Jther (Scecifvl X Industry Standard r V"acuum Paged of ~~ Frofessionai Engineer Hydrostatic ~~ Test Equipment Used• 4" Gauge Equipment Resolution .~% ing Run # ~ # Pi I x °~ ~~ ~ Pi i e R Piping Rnn # Piping Run # ;, p un n .. ~ ~M - 1 - ~=-= Piping Material: ~ ~ 1/- ~ ~ ~ ! Piping Manufacturer: ~ ti~'1.~~~--C~ {'~ ~}-~\ t ~ ~%i~ ~ ~L l ~ ~ Piping Diameter: r ~- ~ ~ ~ ~ rr I' Length of Piping Run: ~ ~ ` ~ ~ ~ r I ~ ~ Product Stored: ~~ ~ t {``. ~ ~7 ~ t ~~ ~ ~ ~~-t"~ f ~ ~t I r ! Method and location of i ~ _ tT~ 7~ ~~ r-~ _-- ~~"~ ~ ~ ~ ~~~~~ iping-run isolation: l i Wait time between applying N pressureivacuum%water and ~ i ~ , ~0~ I ~ ~til t v~ ti ~ ~j ~ ~L,~, ~'~ ; _ ~1~j(1 d~1 L~?~ ~ !i I I starting test: ! i Test Start Time: ~ ~ ~ ~;..1• ~ '~ ~'s~4~ ~ ~ • ~~ v ! i 4 Initial Reading (RI): `' ~ ~ =* ~~" J~ `~ l Test End Time: ~ j(~ ~~ ' S9-~?~. ^ r• ~ ~~ C~D L• ~ ii ~~ ~ h Fir_al Reading (RF): ~ ~ ~j J:ri- ~ ~.~ : i ,. Test Duration: _ j' :~ ~ ~ i. I v ~ r~ ' Change in Reading (RF-RI): ! ~y~;; ' •c% ~ ~ w '.~ti,' ~ C-~~~ C Pass;'Fail Threshold or j _ c- I~ ~~~`'~~ ~ i ~ i -~ ~ ~ ~ '' .: u Criteria: - e Test Result: i -Pass ^ Fail ass ^ Fail ass ^ Fail I ^ Pass ^ Fail II Cot~nle~lts - (include information on repairs made prior to testing, and recommended follow-up for failed tests] r Page ~ of SVVRCB, 3anuary 2002 6. PIP~ti~ ~><Tt~'1[~ TEST~T~ Test Method Developed By: ^ Sump Manufactivrer X Industry Standard ! :Professional Engineer ~. 9 ~ Other (Sped) ~ Test Method Used: ~ :Pressure ~~ Vacuum X Hydrostatic t ^ Other (Specify) Test Equipment Used Incon TS-STS ~-., .. , - , ~, ~ Equipment Resolution: 000 m. ~ ~ ~ ~ ~ ~ ~ ~ ~~,. ~' ~~'. i' a , ' ~i1m11 ~$ Sllmp i~ G $um # 1' Sump # - . Sump Diameter: 1 it th: De S f ~ ~ ~ `~ ~ ~ ~ ~ I ~..~- ~` ~" p ump ~ Sump Material: ~ ~ J~~l ~' ! ~1 ~~t ~- `~" %~ Wit/ Height from Tank Top to Top of i P , or_: enetrat Highest Piping ~' Height from Tank Top to Lowest II Electrical Penetration: Condition of sump prior to testing: ~ ~ ; ~ ~~ ~1~ tJ ~ i ~ ' ~~ G+~.~ '~ ~_ ~ ---f ~ ~'`~ ' ~ Portion of Sump Tested' ~ ~ ~~ ~G'~ ~~ ~~ ~ ~ Does turbine shut down when sump sensor detects liquid (both ~1'-es- ^ No L NA ~ es ~~ No ~~ NA i es ^ No ^ NA i '^ Y es ~' No '- NA product and water)?~ ~~ _ _ Turbine shutdown response time Z ~~ ~ ~ ~~ ~~ ~ ~~~ ~ Is system programmed for fail-safe I ~„~,,,,, y No ^ NA ,~Y-es _~ No ^ NA .~5'es ^ No ~ ~ NA ~ -Yes =1`jo ^'~A shutdown?` I~~ tip,%as fail-safe verified to be ~ No ^ NA ~ es ! No ~~ NA I ^ Yes '~ No ^ NA ~'e~ ^ No _ NA ~~'es- operational?F V I Wait time behveen applying ~ pressure; vacuum/water and starting j~ _ I ~.t,, ~ ~1 '~-~ I _ ;~ ~ ~ v! ~ i _ i ~v !~l ~ ti'l~ ~ ~ test: I Test Start Time: Initial Reading(R,): /,f7: 35Aeti ~l'~: ' ~ ~•~lL.r- ~j•~~~~N ~: 3 ;i'a /Z•'S3 ~~ ~3-h6YZ,~ 3.f6S7~N /?-'3~ iZ:" ~y is .YZE6.a ' ~~ Test End Time: fU.',~~1 f1%U? ~ 1Z."Sz ~~ •i/ ~ ,iz; SZ ' 1 •%1 ~ ~ I Final Reading (RF): .. I ~ . ,~L7~ N ~ -(v~~~: u _ ~.F-~i~ .~ G~ d sJ~'~ i ~ , = ZG ~, N ~%. ~ ' : " ; .! Test Duration: i~Si~ljjl3 ! jru~zS %~itf%~=~ i ~rc~7,,~:5 ~.a~~.%yt5 7~ui~sS ~~ r Change in Reading (RF-RI): '~ Pass/Fail Threshold or Criteria: ~.s~5~~; ~GC~C~~,~ ~t , ~~.? ant !~_ C)~L:N ' ,c~~j~'r~. -~'-~ C~ ~'~~~~ ~_ ADZ%~" ~~ ~~b~;, C~, i~C~~~a b~DOZ+a~ . ~CjZ~ ~ ' ,; ~ il j ^ F Test Result: ,{Pass ^ Fail `~ ~' Pass ^ Fail ass ^ Fail a ^ Pass !Was sensor removed for testing? ~ ~ Yes i ~ No a NA % ;Yes C! No NA es r No ^ NA '- Yes ^ No =' NA W'as sensor properly replaced and ~• es , No !~, NA verifted functional after testing? Yes ^ No G NA Yes ^ No ^ NA ,Yes ^ No ^ NA ~~ C~ffi~ents - (inch~de information on repairs made prior to testinb and recommended follow-up for failed tests) 1 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-ib0} 'SWRCB; January 2002 7. iJl@TD~It-I)ISPE?~TS~1~ C~ Test Method Developed By: ^ UDC Manufacturer ^ Other (Sped) Test Method L'sed: '~ Pressure ^ Other (Spec) E ~ • ent Resolution- 000 in '~ Test r.quipment Used• Incon TS S r S gaipm _ ~ . • ~ $~~~ Jj ~J /'`' JJ, '_.~ ~ ' y'iD y7 .{.C j Vt3C tt ~ b - ~J EIC 1'Y LJ J ~ ~.f •~ __ ,_r4~ ~ lIJLiC }t I G, I L }/ ~ I f ~ ~ ~ ~~L q U'DC:Vlanufacturer: I, Nk:-~~.~: e3 :~ ~ I • t.3 .:t?~.a.: tJ .t ~ w j ~ UDC Material: , i,A ~~'`c _~ zG ^ - • '~-~; ~ 2 C- `• ; G I ~ ~ ~ `' I ~ j UI?C Depth: ~ j ~~ . ~ ,. . h Height from UDC Bottom to Top i ~ ~ ~, ~ ~ •. ~~ `' /~ 'r 41 Penetration: in t Pi h f Hi g p es g o ~I Height from UDC Bottom to j (O ~ I l~ ' ' I ~ ~ `` I f O i !' V Lowest Electrical Penetration: i Condition of UDC pror to ~-~- J t`-•' ~ ~l~ ~ ~ ~1~-~-J...; ~j~~ 6._ is testing: I ° ~ n ; ~ I; Portion of L?DC Tested j ~~ ~D ~ a ~ a "~ I Does turbine shut down when L'DC sensor detects liquid (both ^ Yes G No NA ! Yes a No C NA I Tto =~ NA ~-= . I ~ es =~ No -~ NA u N ct and water)? d I u ro Turbine shutdown response tine j 2 ~~~=- ~ I N r Is system programmed for fail- j safe shutdou~m?~ ~ 'es ^ No ^ NA , r~Yes ^ No ~ ~ NA ! Yes ^ No. ^ NA j es ^ No ~ NA ~~ I Was fail-safe verified to be X i ~I es ^~ No a NA ~~,Q ~ r ~" s ~ No ^':vA T es~"-^ No =~ :`A ~ !" es ~ No =i'`iA ational? oper , p Wait time between applying pressure;'vacuum!water and II ~~ ts~.t 1 ~ ~ ~~ ~e ~ ~ ~ I ~ ~ ~.L i-~ ~ II ~ •,~.~ ~- r ~U II g test rti t i n s a ~) ~ ~ Test Start Time: • /u {~ /' : 7 '3 ~ '/ ~.' l 'i ` Initial Reading (R~): a •~~~ ~ s . L sr- ~ ~ .~' . ~ 'S3" Z sZG ! Z~ f 3~: ~ Test End Time: ' 3Z r~ ' S/ a~ .' ~" • , ~, /~ ~! 1 Final Reading (RF)~ I •~ ~ a ~ 1 ~ a • ,3Y /.: ,~ • Z~. 7 N `, ,; I Test Duration: I i : GK / µ ~ t ~~~ ~ ' r /Lt i~. s 1 Mrn+% ' ~ ' ~M 1/./ J• ?~/ ~/e'Y/ a • ~X~ f ~ ~ ~ • . ~'/ 1.5 ~ j ~1, ~~~'i ~ '~ ~ i• Change in Reading (RF-RI): ~ : E,~9.~ ' itXY ; O.~ ` . ~ •s~r r ~C~,~; ~ -~ !W ~ °O~ ~ i 3 ,:, e . i b. ~c~ ~• `~~'O, ~•~~"~ ~'~~''~ Pass!Fail Threshold or Criteria: ~%r~ ,~• ~L f~•c~c~Z: >• • ~ ° %' . Z ! 'I T t Result- ,i Pass ^ Fail Pass ^ Fail Pass ^ Fail , Pass ^ Fail ; es ^ No '^ NA j l' ,Was sensor removed for testing? ~ 'Yes ^ No _~ NA es ~! No ^ NA es = No ^ NA es r,~ Was sensor properly replaced and it es ^~ No ^ NA ~ Yes = No ~ ~ NA j ~1'es ^ No ± ~ NA ~ Yes No Nr`~ ~I ~! verified functional after testing? ! Co~1~e~ts - (include information on repairs made prior to testing, and recommended follow-up for failed tests) Page ~ of ~TNdI!1l~TT (tJl~Cj 'T~ST~G X Indus' Standard ^ Professional Engineer ^ Vacuum X Hydrostatic ' If the entire depth of the UDC is net tested, specify hosv much was tested. if the answer *_o arw of the questions indicated with an asterisk (*) is "NO" or "NA", the entire L'DC must be tested. (See SWRCB LG-Ifi0) SW'RCB, 3anuary 2002 8. SILT. RISER C~I~i'TA~ i ' l~~' S~.T1VI~ `I'E5'~I1~1~ Facility is Not Equipped With Fill Riser Containment Sumps G Fill Riser Containment Su.-nps are Present, but were Not Tested Test Method Developed By: ^ Sump Manufacturer X Industry Standard ^~ Other (Spec~j Test Method Used: ^ Pressure ^ Vacuum ^ Other (Sped/ Test Equipment Used: Incon TS STS ~ Equipme Page ~ of Professional X HVdroStatlC ~~ ~u -• ~x~ Fill S~canp # ;Fill Sut~ap # _ Fill Sump # Sump Diameter: Jlj ~ , iry Height from Tank Top to Top of I; Highest Pi ing Penetration: Height from Tan1c Top to Lowest jj Electrical Penetration: ~ Condition of sump prior to !testing: Portion of Sump Tested !I Sump Material: N Wait time between applying ' pressureivacuum~~vater and starting test: Test Start Time: N Initial Reading (RI): I Test End Time: q Final Reading (RF): ,, Test Duration: '~ Change in Reading (RF-RI): Pass/Fail Threshold or Criteria: ~~ 'Test Result: ~~ Is there a sensor in the sump? it Does the sensor alarm when either product or water is I detected? io 000 in . Fill Sump # ass ^ Fail ^ Pass ^ Fail ^ Pass ^ F'ail ^ Pass ^ Fail Yes ^! No ^ Yes ~ No ^~ Yes ~' No ^ Yes ^~ No ^ Yes ~' No ^ NA ~ ^ Yes ^~ No ^ NA ~ ^ Yes ^ No ~~ NA ~ ~ Yes ~ No _ NA Yes ^ No ^ NA ~ ~~ Yes ` No ^ N.A '~ Yes ~ No ~ NA ~ ~ Yes No ~ NA Vii as sensor removed for to ng? ~ ~ Y es C No ^ NA ' ^ Yes No '_ NA W'as sensor properly re ced and ^ Yes - Nro ^ NA ^ Yes ~ No ~! NA ,, verified functional af~esting? ~.t9ifl3ffieYTits on repairs made prior to testing, and recommended ~ zr ._ /t SWRCB, January ?002 9. S~~.IJ®~RF'i~,i, C®l~TEI~TT' B®XES Page ~ of Facility is Not Equipped With SpilUOverfIl Containment Boxes a SpilUOverfill Containment Boxes are Present, but were I`TOt Tested = it Test Method Developed By: ^SpiIl Bucket Manufacturer X Industry- Standard _ Processional Engineer ':' -Other (S~ecifvJ Test Method Used: u Pressure ^ Vacuum X Hydrostatic t ~! ` ^ Other (Spec~j ; ;Test Equipment Used: Incon TS-STS j Equipment Resolution: .000 in. ~ ~ ~ Y ~ I ~ ~~ ~ ~, ~ J Spill Box ~ 1 ~ SpiIl Box # ~{ 3~ Spill Bos #C Pc i, ~}~ SpiIl Box #1} P II Bucket Diameter: i ~ i ~ ~ °' ~~ i 'I ~I Bucket Depth: ' ! ~ `~ t/ `~ i ~ ~% ~i Wait time between applying I l pressurelvacuumiwater and ~ t rti g t ~ ~/~ -~ '-"~'s~tii'~ '~ ~ i ~ i~ C c~e,S ~ °' "~ I! ~'~"~ ~~i~ I v~ i';'~~ s a n est: . Test Start Time: ~ ' lc' #*~ ~d `_~~~ `( lJ.' ~ ~`v~ ~ Z~ I ~.~C~ ~~. ~ ~' Initial Readin R g( r)~ '~ °~,~.n.~;w ~ ~ ~ ,~~. < 57~rj~,~ a. ~: 5~. r !' ~ I~/I<~;w S I ~~ r Test End Time: I (~': >`~ ~~ ~?.`5~~;~+, (~''' ~r~ ~.` _ ~M I ' ~.'~ ~.` _"~ ~ ~ ~ ~(a~i /'1 l ~~ ~ ;I Final Reading (RF): ; i~ ~ . ~~-, ~ j ~-. i ~~ Test Duration: 1~qu r „t ~ ~j~u f +~ 5 - ivt _ tvt I ~l4 r~ ~~L6 rte C t ~,i~ 1~>41 N ~ li 4 Change in Reading (RF-RI): 1`?!'1 ~ "~; tt ~.+~1~G /~ r::~ <.~. C7f~ j~~ u ~~~~~is~ .~I~r~ (~. G~j~'~ !~ ,~,~~?L~ Pass/Fail Threshold or i Criteria: ' ~ ~~-(,~~i~ i ~~~~jj~ ~ ~~ ~~fe~ ~, ~~~~ t!~.~~i~ ~ , ~ii ~~`!V i~. ~~jni ~`~rtv' Test Result: ^ Pass ^ Fail ^ Pass ^ Fail ^ Pass ^ Fail I C Pass ^ Fail ~I Coin~ae~$S - (include information on repairs made prior to testing, and recomrnended feiiow-up for failed tests) ~Y TEhI tiETUF - ;~.'STF.t°1 UiVITS U.S. ENGLISH S`. STEhI Di~TE: •'T I t;lE Fi >RhIHT t°tijN DD '1`!,`'Y HH :-t°tt°1: SS xt°t BEA~,OP•J L}i~lUvR 0495 S. UfVIC>t~! BAKERSFIELD. CH SHIFT TIME 1 : 0:UU Ahl SHIFT T I P1E : T:! I BAWLED SHIFT TIME. 3.: DISABLIyU SHIFT T I t•1E 4 Li I SHELE~~ TAfV}•; FERI~:'DIC I~JHRNIrdiaS DISABLED THNK HPJNUHL. WHRiVItVGS D i ABLED L I tVE PER I OD I ~_ 4~JAR hJ I PJGS D I SABI.ELi L I rJE H(VPJUHL 6JHRr•J I NGS DISABLED FRItVT Ti~ l?~+LUt'•tE EPJHBLED TEMP COf°1F'EfJSHT I r %PJ° VALUE CDEG F ): OU.o ST I ~- K HE I is HT' OFFSET DISABLED DA`!L I i_aHT SHL+ I fVG T I hiE DISABLED S:'STEt"i :SECURITY :.ODE u00UUU COh9t°lUN I CHT I vtV SETUP FORT SETT I rJGS rJOrJE FOUND RS-'3'3~ SECURIT'`. CtjDE Ouuuu0 RS-'L':~2 EPJLi OF MESSHGE D%:~HBLED I rJ_TrirJ}: SETUF'_ - T i :REia U(VLLi PRtjDUCT i_~OL;E 1 THERMAL i_;cjEFF :.ODU?UU TtiN}~: DIHt"1ETER 95. UU TAfVk: F'ROF I LE i F'T ~- F_ILL VOL 9930 ~4 FLOAT SIZE: 4.U IPJ. 84 WATER WHR PJ I tVG '~ . t HIGH ~+1t=iTER LIt"li'T: 4.i- f•9r:~ OR LABEL V~sL : 9930 OVERFILL L I h'1 I T 9U% 8937 HIGH F'}~ODUCT '' 95~ 9433 LiEL.I VER~; L I t"1 I T 4%: 39? LOW PRODUCT 3UU LEA}<: HLARt"1 .L I rvl I T : 99 SUDDEfV LOSS L I t"1I T : 99 TAN}: TILT U . 50 t°1HN I FOLDED 'PANT: S T#: NtjtVE LEAK M I rJ PER I ti ~D I C: U% 0 LEAk: h1I N Ht'JPJUHL U%4 C• FEk I OD I C T'EST' TYPE STN r•JLiHRD HfVPJUHL TEST FAIL HLHkt°t DISABLED FERItiiLiIC TEST FAIL HLARf 1 DISABLED GROSS TEST FAIL ALARM DISABLED HhJN TEST HVERHia I NG : OFF F'Ek TEST HVERAi:; I PJia : OFF TANK TEST tVuT i FY' : OFF TNK TST S I PHOIV BREAK :OFF DELIVER.' DELAY : 15 M I tV __ ' '? :PLUS UNLD - 'RODUCT i=;ODE "LHERh1AL i~OEFF :. UUU E!JU THtVt: DIHNIETER 95.U0 T'HtV}; F'kCiF I LE I PT FULL iiOL 9930 FLOAT SIZE: 4.u IN. 849E 4JHTER WAR tV I Ni3 '~ . U H I iaH t~JATER L I t°l I T: 4. P9H;~: OR LABEL VcjL, : 9930 OVERFILL LIt"1IT 9U"<: ti9`i7 HIGH PRODUCT 95'% 9433 DELIVERY LIMIT 4 ~y7 LOW PRODUCT 3UU LEAK HLARht LIf°1 } T : 99 SUDDEN LOSS L I i"1 I T: 99 TAPJk: TILT 0.5u h1HIV I Ft?COED TtiNk:S T#: NUKE _~---- -- iHi;~ M I N FER I OD I i-; : C!=. LEAK t"1I tV HtVNUHL U°~ . 0 FER I i iD I i` TEST T'~'F'E STHtVDHRD HNNtJAL TEST FHIL ALHRt°1 D I SHBLED PERIODIC TEST FHIL riLr=iRM D I .~~-'tiBLED GROSS TEST FHIL ALHRt°t D I SHBLED AtVrJ TEST HVERHi~IPJi;: OFF PER TEST HVERHGING: UFF THNk; TEST rJOT I F'~~ : cjFF ThJ1<: T5T I F'H(iIV BREAI-:: •~}FF DEL i VERY DELH'I' 15 f°1 I '• T 3:SUPER UNLD r~RODUGT :ODE 3 THERMAL COEFF :. uuu7i=!U TANK Li I At°IETEk 95 . UU TANK PROFILE - i F'T FULL VOL 9930 FLOAT SIEE: 4.U IN. 8490 WATER UJHR t+J I NG '~' . 0 HI°GH L+IHTER LIt"1IT: 4.U t"lfi;~: UR LABEL VOL : 9`_13U OVERFILL LIf"1 I T 9U%~• 893' HIGH PROL'UCT . 95% 9433 DEL I VER'B` L I t°1 I T 4;v . J97 LOW PRODUCT 3C!U LEAK ALHRhI L I hl I T : 99 SUDDEN LOSS L I r"9 I T : 99 TANK TILT J.UU t°1HN I FOLDED TANk:S T# : NGtVE LEAK M I iV F ER I ~jD I C: U" U LEAK t"1 i tV HNtVUHL : U% ` ~.! DER I CsLi I i_' TEST T i''F'E ,THrJI?HRD HNNUHL TEST FAIL HLHki°i Li I SHBLELi PERIODIC TEST FAIL ALhRf°t D I HBLED iaRUSS TEST FHIL ALHRP'1 D I _:HBLEL=~ HtVN TEST HVERF;i=; I pJG ; OFF F'ER TEST HVEkHia I NG : cjFF THi'JI; TEST tVt;~T I FY : cjFF i (Vk: TST S I F'HOJV BREAK :OFF DEI . T uFRL~ nrT ;,+~ , ~ ..... .EwK TE~~T t°IETHUli L I i~U I Lr SEh•; SUR HLF1S _ _ _ _ _ _ _ _ _ _ L 3:FUEL ALARP'i `'EST WEEKL''i` ALL TAdk: L 4 : FUEL ALARNI i~N L 5:FUEL ALARNI TART T I fhE 12:01 AI°i L 6 : F UEL ALARf°i TEST RATE : u . ?u i=,r~tL . HR -• ? :FUEL riLF~RM , LrURAT I UfV '? Hi rURS --• '-' :SENSUR GUT ALARP~ . ~1:SEf'lSGR GUT ALARM -~ 5:SEPySUR UUT ALARf°1 i b :SENSUR GUT ALARI°t 'LEA}; TEST kEP~L7kT FURt°lAT L -? :SEPJSt?R GUT AI_ARt°t fVURN1AL L '~ : SHG+RT r~Lr~RM L ~:SHURT ALARNI LIuUID SEf'dSGR SETUP L 5:5HURT ALARM -_ - - - - - - - - - - - L G : S HURT ALARf°1 L 7:SHGRT ALARf°1 L 1:REi~ STF' TR I -STATE { S I fVGI.£ FLUATr k ;3 : SUPEP STF' RELA'X' GATE~~GR''f STP SUf°iP T,`PE: STAIVLr~RD fVURMALLI' i :LU SELr L ' :PLUS STP• TR I -STATE s: S I f'•ii ~L.E FLUAT 1 GATEUUR`; S"fP DUI°1F L 3:SUPER STF' TRI-STATE tSiNiaLE FLUAT> ~:ATEGGRY : STF' SUMP L ~i:LrISF' PhN 7-~i TR I -STHTE (:~ I fVi~LE FLUHT CATEUGR`1 : DiSF'EN.~~'ER F'F. L S:UISF' PHN 5-G TRI-STATE tSINi;LE FLUAT i'ATEC~UR`, D I:~PEIVSER PAS L• b:LriSF' PAN 3-4 TR I -STATE 4 S I fVi~LE FLUf~T :• ~'A T EGURY : D I SPEIVSER F'Atd L ? : L~ i SF' PAN I -' TR I -STATE (S I f••l~al_E FLUAT'' GATEi~GRY D I SF'EfV SER FA. CiUTPUT RELA;' :ETUF' R I : kEia STF RELA4` T':PE: STANDARD fVUR(°lALL1` ~'Li:-SEU LI~iUIU SErJS UR ALMS L I:FUEL ALARNI L 4:FUEL ALARNI L S:FUEL ALARM L G :FUEL ALARI°i L ? :FUEL ALARI°t L I:SENSUR UUT ALF=iRN1 L 4:SENSGR GUT ALARNI L :SENSUR GUT ALARNI L 6:SENSUR UUT ALARNI L 7:SEIVSUk GUT ALARf°t L 1 : S HGRT ALARf 1 L 4 : SHGkT ALARI°i L S:SHGRT ALARNI L G:SHURT ALARI°1 L 7 : SHGRT ALAkf L I U U I Lr SEPJSUR ALf°1S L 3:FUEL ALARI°t • L A :FUEL ALARf°t L 5`:FUEL ALAR(°1 L% 6:FUEL. ALAkf°1 L ? :FUEL ALARNh L: 3 : SENSUR UUT ALARf°I L ~:SEIVSUR UUT ALrRt°1 L 5 : SF N ~GR GUT ALARP'1 L 6:SENSC}k t}UT hLtRf°1 L 7:SEIVSGR GUT ALARf°t L 3 : SHGRT ALARI°t L 4:SHGRT ALARNI L 5:SHURT ALARNI L G:SHuRT ALARM L ?:SHGRT ALARNI --~-- --~ -- ~-'iii;: -- _ -.:tea- _ -;._ ~'v . ~-a~~.~ .._- _3 . . k '':PLUS STP RELA.' T ,'F'E STAPdDARLr nu iDto+_ sT T ? % i"'T il!-:1-'T•'1 -~~~._- t; ~ ' ' - ... ~. _.-_ Li-' -_.--- ._ - _ 1- •R~-...-i -- ~..:. ---._ _ ::F -..- _.___ _-___- --.-3~_~ - - ::;~_ , ~__ _.' _.. ~..._L ~Js = ftir~ . ~3 f i~ ~ ~ ~+~' \W y~1; -~ ~k'E GAR~iI - ~ ~.~ii FACILITY NAME 13c~~ CITY OF BAKERSF'IEL.U FIRE DEPAR'I'MF.NT OFFICE OF F,NV[RONI~IENTAL SERVICES iJNIF[EU PROGRAI<1 INSPECTION CI~ECKLIST 1715 Chester Ave., 3r`' Floor, Bakersfield, CA 93301 LlQUU2~ INSPECTION DATE l Z- ~ ©S Section 2: Underground Storage Tanks Program ^ Routine ^ Combined ^ Joint Agency [~ Multi-Agency ^ Complaint ~ Re-inspection Type of Tank ~ L Number of Tanks 3 Type of Monitoring l LS - 3S'Z~ Type of Piping OPERATION C V COMMENTS Proper tank data on file U~n~rtL Q/~ /~/S-J° Proper owner;operator data on file (( Permit fees current Certification of Financial Responsibility I-(UPr/~j L`Z S-I-iL~ ~ ~~ i~9onitoring record adequate and current Maintenance records adequate and current W fNC ,~5 ~ . ~~ 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 overtillioverspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: W ~~~ s Office of Environmental Services (661) 326-3979 ~'l'hitc - f?m~. Svcs. B si es Sit Responsible; Party Pink -Business Copy I E~EtiC:v!'J L I ~~iU~_+k I 6495 :~. UPdls:~hd E~rhEk_F I ELLS . i tt~l-c~.i~-';'~'~' I, I P•1VEPJT~=:~F:`i kEF'',?kT ' T 1 : kEG LIPJLL! yU%o ULLi=ii:.;E= 5r,''0 [~i-iL~' HEIGHT = =,~t.5~_ Ii'JC:HE_ t:JrTEk V~~ I. = i i ~ ~~L: 4JF',TEk = u . uu I f'd[_ I-iE ; T ''_':FLU:~~ IJP~JLL:~ ULLHGE _ ~J51 +»1_ ; Ti; 1+'ULUN1E _ '45'- ~FiI-.:.; HEIGHT = '`'r,'_~~ Ih~Ji=;HE:3 UJr~TEk 'E;ti~L = ~ i GHL ,, . 6JrTER = U . Cu_i 1 fJC'HE:=, T 3::~UFER UfJLli ULLr`i[~E = 61'1 !aril:=J y0:o LiLLrd_E= 51':_. GriL:~ T~ - 'JCL UP9E _ ' ~ `~' 1 ~= r;L ; HEIGHT = ?, IfJi='HE:_' ~',IrTEk ~Ji'L = 0 iariL ;; WHTEk = U . i iiJ I fdi=:HE _~ E P•JLi DISFIyf'J~Ek Frf4 FUEL FiLrik_(°1 ~ ~ ~oa._X~ I C > :i.~;t-tr:i: C > Misclnfo < > Ilhu'slsl.€ss~ <) SiteMaps < > i~~~x° - __to.X _ Iia~aCpds: Fiwnb: ; . 8`PI! 8'~A I~5 __ __ SIG DunnR~ ad: 5541 ~ ~«~r . _ 3~~3ress '' b495 .S UhFI01i ADE Phone: Cb61) l~32-3222x City L~1HEI~SFIELD State: CA Zip: 933~*!' c,o;~~ ~ ,~ €~ ,fkt1£ . Adclre~s - 6495 S uFrl Plane: C6~) 532-3222x City ;;: , I~~PITs~A Stater CA Zig: 43307 i~iv. _ . e~$ JAIL' SIF1C;ii ~44~ S k~tll ON AUK Phone: Cfi61) 835,-1890x:. city : I#iItERSP'I ELI3 State = CA aid= 9330? ~;~~~~~~ r;o ~, ~~~ ~t~t State :_ P~r~e: Zip: C ) - x C > Ef~.~nsst• < > Misclnfo [ > F~tr;F~~1t;~~ < > SiteMaps < ? ~~x Iaast i~ctian Tea: Cross .Suet Total Tanks 3 Res.i~ynAa~t l:8itt4~ Flo FA Contact: Dsg +GFw4iil1*~E'kf31E`: IL'C Mla4her i °rr~ibr ~~~.a~~~-~ ~UPtl~1pEF~ SIhtGH ~ ~ ~~hu~ee: ~€f~~fii} 833-3222x. gttdxess: b49S S0. tfNIi1~1 AlIE. C~-ty=: l~l€~IiSlalE~ State: Cf1 Zip= 933 ~ Orgr T.y~er.Iltli~UII1~lAI. ii .,_ :~ ~ ~~~6~> -I#111PIFtDEB SIFf4A1 Phocte: (561) 832-3222x Add~c~aau = 6~#'~5 St?, . IIHI t~#i AtlE ' City= FlAl~3tSl~l Stater {:A Zip= 4337 .~ ~y~= ICE # - UHF I'inanc%al Resp= ' STA~~ FIlFiI~ .Legal Ffotif II'usi.nesa Mail3.ng Adctreas bate:08/ti13/i999 Plwne- C&61} 832-3222x e:I#I(iPihlD~t SIlK~i Ttl:t~"NER '~~ae~, 8$T ~ 1948 _Up+,I Certlt= QM7Y.$ ~ < > Ha~t~aL C'3 Misclnfo < > ~?Iin's~l.~se t }SiteMaps C > ~~h~ 09105/2006 15:11 6613252529 CAL VALLEY ~'° ~~ PAGE 02 ' 5'" CAL VALLEY EQUIPIIiENT 35fl0 Gclrrfor~e Ave ... ~ BBke~fiiehl, Ca 93.3c}8 6B'f-327-9341 Fax 669-322529 OMP~SSED Ctg4RFAfT CATNOWC PROTECTION CERi7F1CAT1ON PATE; fJ'~'~6 51TE: _~?2CaY~ ~C..,~~, _~p~S GONT'ACT: _(.~,.~. C~6r%odr f~i/G PHONE: ------ ~•~.'C~, G~rd~'a-~ Ler'v"dSinn ~or~~-u~ InshaltatlonTJeteti ______.-- Model~Gl~.~sEz.4~8=~2-6-5~ seasl~:_S22Y/ Hours:_.1901~ ~OraJ~~a~rbtaQd Vakage: ~$ Amps: _ S2. _ Ad~ustment:,,.;„~ ~. Course: ~ Fine: .~' strwctore to Boll Pctentca! Readings For Previogsly irtsfalled Systems ~Syatern off } Tank Number Tank ~S"~ Fuel T Product Line Vent Line S or E End of Tan Center of Tanfc N ar' W End of Tan Electronic Conduct ~- p. g - D. -- ~, ~ a. .na ~a~6ss ~~s' -~ ~~o, ~ . btr ~,.vfx Structwe to Soil Potential aead~ings For I~viousry Irtstaiied syr~ems (system on } Tank tank ~ Fuel Pmduc# Vent S or !~ Center N pr W Electronic N~tllyer S'~e T lJrae E.ine End of tan of Tank End of 7 Conclsit 1722- ~^4- $ . ~ -0~ - Y y6 .~ s -~ ss x # hereby certify that the mintmUm s7ts#em potential requln~merns nor lrnpressed Ca~rrent CathOrliC Protection: Have Been Met HaVB Not seen ARHt for the systems refar~enCed shave: taken in aoDOrdanoe with the rrtinirnum star~darcis of the National Association at Cornrsian Er~ln~s~ and as done to r,~omply with EPA and State Oirocthres Technician Performing Ted . .;: ~:: MONITOR SYSTEM CERTIFICATION Authority Cited: Chapter 6, 7, Health and SafetyBCodle Chapter 16, Div s on 3~, TNe 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. A separate certification or report must be prepared for each montorina cry-tern ~~( oaf b the technician who system owner/o Y Parforms the work. A coPY of this form must be provkied to ftte tank Aerator. The ownerloperator must submit a of this form to the local agency regitlatino UST svstamc ,.,:n,:., zn days of test dale. - SPY A. General Information . Facility Name: Beacon Liquor Site Address: 6495 South Union Avenue Bldg. No. Facility Contact Person; City' Bakersfield. CA Ztp: 93307 - Make/Model of Monitoring System: Veeder--Root TLS350 SM 80850502105003 contact Phone No. (s6t) a32J222 - _ Date of Testing/Servidng: 5 / t / 06 B. Inventory of Equipment TestedlCettified IanklD: T-1 S7 Re ular -""--~~- -~~~W~~•~•"°' x In-Tank Gauging Probe. Model: Ma Xank ID: T_2 gg pt~ Annular Space or VauR Sensor. Model: WA x In-Tank Gauging Probe. Model' Ma Piping Sumptirench Sensor(s). Model: p794380.208 x Annuar Space or Vault Sensor. Model: N/A Fill Sump Sensor(s). _ Model: - Piping Sump/TrenUt Sensor(s). Model: 0794380-208 - Mechanical Line Leak Detector. Model: - Fin Sump sensor(s). _ - Model: Electronic Line Leak Detector. Model: _ Mechanical Line Leak Detector. MCI Tank Overfill /High-Level Sensor. Model k Electronic Line Leak Detector. Model' Dispenser Containment Sensor(s). Model: 0794380-208 X Tank Overfill /High-level Sensor. Model: Shear Valve(s). Dispenser Comairtment Sensor(s). Dispenser Containment Float(s) and Chain(s). Model: 0794380.208 Shear Valve(s). Other s e " e ui ment and model in Section E on P e Z Dispenser Containment Float(s) and Chain(s). . Tank ID: T-3 91 Su r X Other (sped equipment type and model in Section E on Page 2). In-Tank Gauging Probe. Model Ma Tank ID: Annular Space or Vault Sensor. Model: N/A X In-Tank Gauging Probe. Model: Piping Sump/Trench Sensor(s). Model: 0794380.208 Annular space or vaun Sensor. Model: Fill Sump SenSOr(s). Model; Piping SumplTrench Sensor(s). Model: Mechanical Line Leak Detector. Mode(: Fin sump sensor(s). Model: Electronic Line Leak Detector. Model: Mechanical Line Leak Detector. Modes: Tank Overfill /High-Level Sensor. Model: X Etecbcnic Line Leak Detector. Monet -Dispenser Containment Sensor(s). Model: 07gggg0.208 Tank Overfill /High-Level Sensor. Model: Sheaf Valve(s). Disperser Containment Sensor(s) Dispenser Containment Float(s) and Chain(s). . Model: Shear Valve(s). Others ui ment and model 10 Section E on Pa e 2 ) - Dispenser Containment Float(s) and Chain(s). . - - ~ - _ Other (specify equipment pe and model iri Section E on Page 2). C. Certification - I certify that the equipment identified in this dowment was inspec:ted/serviced in accordance with the manufacW Attached to this Certification is irifortn f ti a on (e.g. manufacturers' checklists) n showing the layout of montoring equipment. For any equipment capable of re s guidelines. ecessity to verify that this information is cored acrd a Ptot Plan (check atl that apPlY) = generating such reports, I have also attached a cosy of the report; X System set-up x^ Alarm history report Technician Name (print): Michael Moore/Jim Albitre 5248968-UT Certltic. No. 562060899 Signature: ~ Testing Company Name: Redwine Testng Services Inc t ~ ~ ~~ Phone No.. goo 582-6368 1~~ ~~ ,// '~~,t Page 1 of 3 l Monitor System Certification Site Address: 6495 South Union Avenue, Bakersfield, CA Date of Testing(Servicing_ 5 ! 1 / O6 D. Results of Testing/Servicing Veeder-Root TLS-350 # 80850500105003 Complete the followinn .-ho.wr.~.. u nto- Were all sensors visual) ins eced, functional tested, and confirmed o erational? X Yes No' Were all sensors installed at lowest intertere with their ro er o eration ant of secondary containment and positioned so that other equipment will not Yes No' ff alarms are relayed to a remote monito ^ N!A ~9 Nation, is alt oommunica6ons equipment (e.g. modem) operational? x Yes No' For pressurized i in P P 9 systems, does the turbine automatiplty shut down fi the piping secondary containment ^ N/A monitoring system detects a leak, farts to operate, or is electriglty disconnected? ff yes: which sensors inifiate posfive shut-down? (Check all that apply) ~ Sum Did ou Confirm prTrench ~ns~: ~ Dispenser Cornainment Sensors. X Yes Positive shut-down due to leaks and sensorfailure/disconnection? Yes; No' For tank systems that rr6lize the monitoring system as the primary tank overfill warning device (I e_ no medianical ^ N1A overfill prevention valve is installed), rs the overfill warning alarm visible and audible at the tank fill point(s) and o eratin ro erl ? If so, at what rcem of tank ca aci does the alarm tri eR 90 %. Yes X No` Was any monitoring equi ment P replaced? ff yes. identify spetdfic sensors. probes, or other ui and list the manufacturer name and model for all re lacement arts in Section E, below. ~ pment replacer) X Yes No' Was liquid found inside any secondary containment systems desi ned as d s Product: Water. If es, describe causes in Section E9belaw. ry ystems? [Check all that apply) X Yes No' Was monitorin s stem set-u reviewed to ensure ro er settin s? Attach set u re orts. rf a livable. X Yes No' Is all monitorin ui ment o rational r manufacturer's s cifications? * In Section E bebw, describe how and when these deficiencies were or will be corrected. E. Comments: Cate o Form S!N T-1 Regular Tri State N/A N/A Page 2 of 3 03/01 Monitoring System Certification Site Address: 6495 South Union Avenue, Bakersfield, CA Date of TesCnglServidng 5 r t r ~ F. In-Tank Gauging /SIR Equipmem: 0 Check this box A tank gauging is used only for inventory comrol. ^ Check this box if no tank gauging or SIR equipment rs installed. This section must be completed if in-tank gauging equipment is used to perform leak detection monitoring. Page 3 of 3 03lot G. Line Leak Detectors (LLD): ~ Check this txuc fi LLDs are not installed. H. Comments: lnfirin in all sum s needs to be ut inside unction box and sealed. . 19'tonito~°ing Sv stepn ~erti~ication ~T~`~' ~l~~t~r~>~~ ~~~e l~l~ Site Address: ~ ` { t ~~ ~. S ~ L~ ~ 1. C9 V~ ~ cJ L ~ ~c -vr l..cq ~ ~ci \~e ~ s ~i~ ~.-~c °t 3 3 a 7 --....~; ............................................1 0 .~ .~. tl . ~. .O-O Ste. G. .(~eS. ° . a _ _ .~. ----~-~.,8. G sip . -. ~- _ I E~~S i ~ - - - - ~ - - - - - - - - ~ - - 3,,,;, ~-r-lf - - - - - ~ - - - - - - - - - - .I - - - - -i - - - - - - I _ . . _ . . . . _ . . . . .. .. . . . . . . . . . . . . . . . ('(~(Oh~~y . . . _ . . ~. gate reap was draw: ~ 1 1 / D,6 finst~actg®'~s If you already have a diagram that shoavs all required information, you may include it, rather than tlis page, with your 1~?onitoring System Certification. Qn 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 mor~itor_ng tank annular spaces; sumps, dispenser pans, spill contaianers, or other secondary containment areas; rneehavrical or electronic line leak detectors; and in-tank liquid Level probes {if used for leak detection). In the space proti~ided, note the date this Site flan was prepared. S~~RCB, January 2442 Page of Seconcia>~y Con~a~~r~e>t~t 'Te~t~n~ deport dorm This form is intended for use bi- cor~L~-actors per forming periodic testi.zg of %1ST secondan~ co~tainmertt sy°stems. ~,'se .:ae appropriate pages o{this form to report reszdts for all components tested The comoleted fo~z, ~rittpn lest p?-oceau2-es, artd printouts from Tests (if applicablej, should be provided to the facilitt% cwtaeri'oDerator for submittal to the local regulatory ageneti>. 1. FACILI~'Y i(~VFOR~~T~TJi® d Company ~vTame: 1?~ ~„` G „M C,~e.~v ~~~ Technician Conducting Test: ~ ~ ~~ '~'~ ac ~~„ ~L -5 .`j~~. ~~ Credentials: ~CSLB Licensed Contractor r SWRC$ Licensed Tatit~ Tester License Type: 53~ ~~ ~ a ~ ~ ;License \TUmber: , ;VIa_nufacturer l~lanufacturer Traini~a Date T 3. S~?sL1'v1~1ZX ®F VEST IZE~~I.~'S '~ Com onent , ' I \ot 1 Repasrs I mot I I:epa9rs p Pass j Fail 1 ~ dam anent Pass Fail 1 i ~ I Tested I Made P ~ I ;Tasted ! A4ade r i I I= j _ I i, 1 1 i_ i ~ _ I - ~ - d-- ! I - ~ - h d ~ ti...7 ~~ S Imo; 1 - ~ _ ~ _ c ' - I - - I - 1 4 - I ~ ~ I 1- i ~~ a ~ ~ I ~ ~ ~- I I ;~ I- I - ' - li 4 i ~ _ _ -~-~ - j - ~ I ! I - - ~ - - ; - i - 1 ~ - ~ - M I - ~ ' - p I ~ ~ - - N ' 1~ -I _I _ ~- ' i-~ I ~` a `!`-I-_ _ ~ ~- - I = i - I - I - ~ - I '- - - k If hydrostatic testing ~~~as performed, describe what was done. with the eater after completion of tests: CERT'IFICATIO\ OF TECI~ICI_~ RESPONSIBLE FOR CO'_VDI?CTI\G THIS TESTIlG _7-o the best of m}~ krrt~wledg~ the fates stated in this document are ~securate and in felt compliarsce avitlt leau_1 resguirerr~en#s Technician's Signature: V\ ,. Date: ~ - ~ - 0 2. TESTLNG CO~ITRACT€3R Il_aE~R1~TI® SWRCB, January 2002 9. SPILLIOVERFILL CON'l'~'V"VIE~T BOXES Page of Facility is Not Equipped ~~'ith SpilUOverfill Containment Boxes SpilL'Overfill Containment Boxes are Present, but.were Not Tested Test Method Developed By: ~ Spill Bucket Manufacturer -Industry Standard ~ ProfessionaI Engineer ~~ u Other (Spec~j by t,,, ;' Test Method Used: .Pressure _ Vacuum J Hydrostatic ~ ~-G~e ~'= a \ ~ Other (Sped) Test Equipment Used: ~~,Stti~ ~~ - - - _ _ _ L....~~Q~,. ` i Equipment Resolution: - r- - - - - - - _ _ = = _ - _ ~ Spill Box # ~ ~ Spill Box # ~~ --- ~ Spi91 Box # ~(,~,5 ~ Spali Box # ~,vs~ Bucket Diameter: 'j„ %t t ~Z, ~i C -L/t ! li t~ Bucket Depth: O 't ~' 10 n ' tt (6 I Z6 TVait time between applying press•~tretvacuum/water and i 5 IM, ~ v~ 5 y1A ~ h j IM ~ ~ I ~ Nn, 4 u~ p i start ng test: y Test Start Time: ~ `~ o I 3 S ~ ~ ~. ~t o { ~ t fS Initial Readies (R,): ~ ~( i~ L{'~ i u ~t i ~ ~ s Test End Time: 2 0 a I 2 ~~ ~ ~ I b I ~ is ~ Final Readin¢ (RF): ~ ! ~~ ~° ~ ~~` I ~~i ~~' Test Duration: ~ v~ i „~ _J° ten ~ „~ ~ ~ tiVt ~ ~ 3° N,~,;.,,y h Change in Reading (RJR,): I ~,~ Via ~~ ha Pass;'Fail Threshold or a Criteria: ' ~ 4 S5 ' q" ~`=4 `~5 ~ ~ j ~ C.~. S 5 ~ty5 5 'l'est Result: ~ ~ . Pass = Eail ~ ~= Pass _i Fail ~ ~--Pass ~ Fail ~ `~~ Pass ~ Fail ~OII9tiletl$S - (include information on repairs made prior to testing, and reconsnzended fcllc~v-up forfailed tests) ,. .. SWRCB. January 2Q(?2 Page of ___ 9. SPIILi,l~1~'~;IE~LL C~~TAA~cti:O~IJEIV'ff ~~XES F:+,:i'it} is 1^t F~~u~rk;d With Spill,'i~i'erfi}l C4nta!zunenY Saxes _ Si„ ~" ~' . n*..a+nmPrt ~aaes are Present but w-ere Ni~Y Tested ~. Test 14fethed Developed A~. ~ Spill Bucket Manufacttuer ^ Industry Stand~r;-3 ~ Professio;3a1 EngirLeer Tcs• ,'tifethod Used: ^::,;st~: = ~ ~%acuurn _ :ti•,~c.~ _•~?< ~ - {~i -~~~zS~ `_ -, t~~he- rsne.c'~7 ~rt,2.P~- ~,l° N --------------- ' Tsst F~atp~ent Used ~,~„ I Fauipnaent ~ S t vy ~Ji-[c~ G~ eaolu~io~ - ..., 5+ +~^ a"tZgg c ,~;:~ 1,~~ y ~.. ...> .? ---~- .<..C;'~~ _ ,-:,;..~e..,t'A L„~ T~,a,e.i.. a- -.u-F. °ny 4 s ~`>.'.v.- .a..^d^ i a Y-e.>.. -~;< y - •-~. .. ~y~ m^ .v x --:3i ~ a~~ !71sa r SIJYL s .:-a~w`sa {~ ~tiY # SV ~7~ll.E II?ii~ # ~ apF37 IIM1x Bu..k .. L?tametr.~ 1Z , ; t 2 r, j -- -. -- _ Bucket Depth- -(} f 6 N ~A ,t b r! -fi--- __ ~ - } ~,.:. e;..,o lwturPt- aDD~' Ll^ ~ - ~ ____..__._} ~-_-_~-- - ---- --±- - - ~p i ressurc:,.vacuum~water and ~ ,,Nj ~~ h f ~ YV~ 4 `'~ ~ ~ y '~ ~iaia%ag ~; ._.~ I i I t ~--- 1. - -----~ ;_ Test Smart Tirru;_ __~ 5 a ~ ~ $ s -~----- Inital Readin€: (rTt,)~`~ ii ~---_-!, --~---_. - -._ . . ,~ 5 - _r ---r-----~---- Ftnal Reading (~)~ _____ ~ ~{ r! ~ ~ ~!i -~-.~_, - ~-~, __~ ~J- -- - ~ ~ ~ --- - -1 -- . Test Duration: ~ p ~ ~ ,^ ~ ~ p ~. ~ ~ _...~_J _~-_T_--_____ _~__ ___. ~ _____ Pass, Fail Thr~:shold or ~est RQSU9t:. ~ Pass ~ Fagl ~ ~ Piss :~ Fail l_ra~ ~ a~~ ; _ Pass ~ Fair c._ it _..... ~ toCL;J fli€llflBgrdlti: - (:ncl ude infarmatio>7 on re trs matte rior tP destifr? and r~?comme~uc~: ~~ ,,:. _..-- ¢, - f~xdly ,{ ~ ~. 4 UNDERGROUND STORAGE TANKS BAKERSFIELD FIRE DEPT. ' B B R 9 F I D Pr ti S i ~-- _,_v;~-~.t~~ ~ v ,.->~_~._ even i ~f~e on eav ces APPLICATION ~RS~ ~ 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 TO PERFORM ELD /LINE TESTING - Tel.: (661) 326-3979 / SB989 SECONDARY CONTAINMENT TESTING - /TANK TIGHTNESS TEST AND TO PERFORM FUEL FaX: (661) 852-2171 MONITORING CERTIFICATION P2g21 of 1 !~ PERMIT NO ~~ ~ JQ . ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ SB-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ~. TO PERFORM FUEL MONITORING CERTIFICATION ' ~ SITE INF.QRMATION j ,FACILITY i NAME & PHONE NUPABER OF CONTACT PERSON l ~ PDDRESS I ~~ 5 ~Lvein,u 2 ~ `.3.30 ,l7WNERS NAME ~ (OPERATORS NAME I (PERMIT TO OPERATE NO. ~ UMBER OF TANKS TO BE TESTED _ IS PIPING GOING TO BE TESTED? ___ ^ YES O NO f- TANK # -- - ------ ---~ OLUME ----- ___ a _ __________ CONTENTS I - --------- j ~ ~, ---- - -------- -- ~ a iC I ~ d 1 .,~~,. 3- - I _ i o L--- -- ~ q!_ -- I ~ TANK TESTING COMPANY NAME F TESTING COMP Y NAll9E PHONE NUMBE OF CONTACT PERSON p q p ~uIAILIN~ AODDRE„SS ~ ~ 330~- ~-~Cf,I~IC~. ~ ~~ ~O AME & PHONE NUMBER OF TE ER OR SPEC( N PEC OR ERTIFICATION ¢: - 3 - roR ~ I, ~.Z. o~ o ~ ~DAT~~ TIME TEST TO BE CONDUCTED 1CC ik: NEST ME D SIGNATURE OF P LICa~I /~~ DATE ~_l ~(-a (, ~ v" _ '~ iAPPROVED BY ~,~ / ~ ~~/e ~,p~kn ) rDATE (( ~l~ Obi ~-_~__ __-__.-_-. FD2106 B E R S F I D May 15, 2006 F'/RE ARTM T Mr. Singh Bhupinder Beacon Liquors 6495 S. Union Avenue Bakersfield, CA 93307 RONALD J. FRAZE NO'~ICE OF VIOLATION FIRE CxIEF & SCH~C~ULE FOR COMPLIANCE Gary Hutton, Re: Failure to Perform di' submit Three Year Cathodic Protection Certification Senior Deputy Chief Administration Dear Mr. Bhupinder: 326-3650 Our records indicate that your three year cathodic protection certification is past Deputy Chief Dean Clason due. If you have performed this test, please forward those results to my attention Operations/Training immediately. If you haven't performed this test you are in violation of Section 326-3652 2635 2(a) of the California Code of Regulations, Title 23, Division 3, Chapter 16 Deputy Chief Kirk Blair Underground Tank Regulations. Fire Safety/Prevention Services ~ "Field-installed cathodic protection systems shall be designed ~ 326-3653 and certified as adequate by a corrosion specialist. The cathodic protection system shell be tested by a cathodic protection tester 2101 "H" Street within 6 months of installation and at least every 3-years Bakersfield, CA 93301 thereafter." OFFICE: (661) 326-3941 Therefore, prior to June 12, X006 you will perform the necessary testing as FAX: (661) 852-2170 required by Code. Failure to Comply may result in revocation of your Permit to Operate. RALPH E. HLTEY, DIRECTOR Again, if you have recently performed this certification test, please forward the PREVENTION SERVICES results to~my attention and disregard this notice. FlRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 Should you have any questions, please feel free to call me at 661-326-3190. OFFICE: (661) 326-3979 FAX: (661) 852-2171 Sincerely, David Weirather Ralph f. Huey, Fire Plans Examiner Director of Prevention Services 326-3706 Howard H. Wines, III Hazardous Materials Specialist `~ ~ C 326-3649 By: Steve Underwood, Fire Prevention Officer REH/SU/db ~~~~ ~ ~C!i~CZ~l?/l1'ruG%~!~ e~((~9~ ci~ ~/ZQ//G ~ C~~C~1'2~~i~ ~ UNDERGROUND STORAGE TANK PERMIT APPLICATION TO CONSTRUCTaNSTALL NEW TANK (NEW FACILITY) / NEW TANK INSTALLATION (EXISTING FACILITY) / MODIFICATION / 8 MINOR MODIFICATION -FACILITY PERMIT NO. ,AA _ ~ t , TYPE OF APPLICATION: ^ NEW TANK INSTALL /NEW FACILITY (Check one item onlvl fl M~DIFICOTInN nF FOCILIT'Y B S R 8 P I D p~Ra ARfM 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 ^ NEW TANK INSTALLATION /EXISTING FACILITY r1 MINYIR MnnlclceTlnul nc cerll ITV TARTING DATE OPOSED COMPLETION DATE ' AGILITY NAME ;~ _ ~ ~ ~\~ ~ O~ ~ XISTING FACILITY PERMIT NO AGILITY ADDRESS ~ ~ ~ r ~ l,1 `~"l (O~Y) ~e J ITY (, G~~~ A T( ~ ~ l1`~' "V J IP C~ ~ ~ ~~ PE OF BUSINESS /~ N # ANK OWNER ~/-~ ~~a-P DLt~ Sre~l~,h..f HONE NO DRESS ~-~ ~/Y ' ITY IP CODE ONTRACTOR A~jL{CEN//SEA~N//O,, CC NO DRESS A ITY IP CODE HONE NO s bs~-/~ ~ AKERSFIELD CffY BUSINESS LICENSE NO ORKMANS COMP NO INSURER BRIEFLY DESCRIBE THE WORK TO BE DONE "^ WATER TO FACILITY PROVIDED BY C.~ (/-~ `~ ~ DEPTH TO GROUND WATER SOIL TYPE EXPECTED AT SITE N0. OF TANKS TO BE INSTALLED ARE THEY FOR MOTOR FUEL ^ YES ^ NO SPILL PREVENTION CONTROL AND COUNTER MEASURES PLAN ON FILE ^ YES ^ NO TN13 SFCTIAN 1_Q FAR IIAATAR FI IFI TANK NO. OLUME NLEADED EGULAR REMIUM IESEL VIATION THIS SECTION IS FOR NON MOTOR FUEL STORAGE TANKS TANK NO OLUME NLEADED EGULAR - REMIUM IESEL VIATION FOR OFFICIAL USE ONLY APPLICATION-DATE FACILITY N0. NO OF TANKS FEES $ The applicant has received understands, and will comply with the attached conditions of the permit and arry• other state, local and federal regulations. This form been completed under penalty of perjury, and to the best of my larowledge, is true and correct. / ~~` c ~• 1 APPROVED BY: ~ APPLICANT NAME (PRINT) APPLICANT SIGNATURE THIS APPLICATION BECOMES A PERMIT WHEN APPROVED FD2086 (Rav. o9/OSI