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Home My WebLink AboutUNDERGROUND STORAGE TANK #1 ~, ,~ '~ ,. ~ ~ t ~ (UNDERGROUND STORAGE TANK) FILE #1 ' I VOWS FUEL CTR BKFD #2512 • ~ 2100 WHITE LANE ~. V' ~i d. -- 1 i ~. December 14, 2006 BAKERSFIELD FIRE DEPARTMENT 900 TRUXTUN AVENUE, ROOM 200 BAKERSFIELD, CA 93301 RE: Statement of Compliance and Designated Operator Dear Sir or Madam: Gilbarco/Veeder-Root, acting as the authorized agent of Hertz Corporation is submitting on behalf of the company, the attached Owner Statements of Designated Underground Storage Tank (UST) Operator and Understanding of Compliance with UST Regulations for the subject fuel facility to register this site and Designated Operators with the county. The owner understands that with the submission of this document, Gilbarco/Veeder-Root is stating, on behalf of Hertz Corporation that each location is in compliance with all applicable UST regulations. Further, as specified in regulations Title 23, Section 271 S (c)-(f), the individuals listed as designated operators for the location will complete and document a monthly inspection to be maintained in accordance with the applicable requirements. Each statement of compliance being submitted herein is based on: (1) Gilbarco/Veeder- Root reasonable and good faith review of facility operations to evaluate compliance with applicable UST regulations, as well as information provided by facility operations as of the date the statement of compliance is made, and (2) Gilbarco/Veeder-Root's understanding of the applicable UST regulations and requirements as of the date the statement of compliance is made. Should you have any questions or require further information please do not hesitate to contact me at (303) 986-8011. Sincerely, Q~'iZ~ Sherry Peczka Designated Operator Program Manager Gilbarco/V eeder-Root Enclosures - DEC-12-2006 17 87 DONS FOODSRFETY 6268213636 P.02 II Owner Statements of Designated Underground Stozage Tank (UST) Operator and Understanding of and Compliance with UST Requirements Facility Name: SAFEWAY / VONS #2512 Facility ID #: 152858 Facility Address: 2100 WHITE LANE Reason Rr Subtrdtriag this Porm (Check One) HAKERSFI$LD, CA 93394 Facility Phone #: 661-396-0161 X1219 ~ Ghange ofDesignatcd Operator Update ICC # and/or Expirarion Date Designated UST' Operator(s) for this Facility Aesignated Ope}actor's Name: Ise Moorhead ,• ~ , . Relation to USfi Facility (Check One) Business Name ((f d~fferentfrom above): G1lbaredVeeder`Root ^ Owner ^ Operator ^ Pmployea Designated Operator's Phone #: 916-947-5265 ^ Service Technician ®Third-Parry International Code Council Certification #: 5250115 -UC Expiration Date: 10-31-2008 ALTERNATE 1(Ontlonall Designated Opaator's Namo: Eric Banghart Relation fi UST Facility (Check One) Business Nemc (~J'd(gerertt from abovo): Gtlbarco Yeeder-floor ^ Owna ^ Oprnalor Q Etnployea Designated Operator's Phone #:310-467-2529 ^ Service Technician ®Third•Perty Intcrnatlonal Code Coundl Certification #:5250118-UC Expiration Date: 12-09.2006 ALTERNATE 1(Ovtloaal) Designated Operator's Nerae: Denial Perez Relation to UST Facility. (Check One) Business Name (~f djfferent from above): Gfl6arco VasdewRoot ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 916-718-0139 ^ Service Ixhniciatt ® Third-Party International Code Coundl Cetti$cation•#:3246161-UC ExpitationDate: 11-30-2006 I certify that, for the facility indicated at the top of this page, the individual(s) listed above will serve as Aeaignated UST Operator(s). • The individual(s) will conduct and document zuonthly facility inspections and annual facility employee trainiuag, im accordance with California Code of Regulations, title 23, section 2715(c) - (f). ~ ~tthermore, I understand and am in eompl3ance with the requirements'(stututes, regulations, and local ordlnanees) applicable to underground storage teaks. NAME OF TANK OWNER (Please Print):' SAFE ~ Y /PONS - LLA GEL,MAIV SIGNATURE OF T.A.NI{ OWNER: ~ RATE: ].]./09x2006 OWNER'S PI~(oNE #: (626) 821-5608 Npvotnb~ 2004 h `~`, ALTERNATE 3 (Optional) Designated Operator's Name: Blake 1-lerness Relation to UST Facility (C.'hec•h, Onel Business Name (/f different fi•nm above): Gilbcu•co/I'"ceder-/loot ^ O~1 ner ^ Operator ^ Employee Designated Operator's Phone #: 93]-388-1319 ^ Service Technician O Third-Party International Code Council Certification #: 3249180-UC Expiration Date: 12-19-2006 ALTERNATE 4 (OptionrrQ Designated Operator's Name: Danny Edmonds Relation to UST facility (C'hec/c OneJ Business Name (lfdiffercral•~•om above): Gi/barc•o/h'eeder-Roos ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 636-848-4490 ^ Service "Technician ~ Third-Pai1y International Code Council Certification #: 3272034-UC Expiration Date: 11-08-2(107 ALTERNATE ~ (OptionuQ Designated Operator's Name: Eric Banghart Relation to UST Facility (C/reek One) Business Name (/f different from above): Gilbar•c•o/1'~eder-Root ^ O~a~ner ^ Operator ^ Employee Designated Operator's Phone #:310-467-2329 ^ Service Technician ^O Third-Party International Code Council Certification #:3230118-UC Expiration Date: 1 I-09-2008 ALTERNATE 6 (Optional) Designated Operator's Name: Darren Austin Relation to UST 1•acility (Check One) Business Name (If different firona above): Gilborco/feeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 838-699-2731 ^ Service Technician ~ Third-Party International Code Council Certification #: 3230436 -UC Expiration Date: ] 1-1 ]-2008 ALTERNATE 7 (Optiorrrrl) Designated Operator's Name: Darrell Riley Relation to UST Facility (Check One) ` Business Name (If different frrom above): Gilbarco,/feeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #: 6] 9-206-8379 ^ Service Technician ^D Third-Party International Code Council Certification #: 3248973-UC Expiration Date: 12-13-2006 ALTERNATE 8 (Optiorra!) Designated Operata-'s Name: Brain Ellsworth Relation to UST Facility (Check One) Business Name (If different from above): Gilborco/feeder-Root ^ O,a~ner ^ Operator ^ Employee Designated Operator's Phone #: 707-813-2311 ^ Service Technician O Third-Party International Code Counci] Certification #: 3263224-UC Expiration Date: 7-7-2007 ALTERNATE 9 (OptionaQ Designated Operator's Name: Shane Flores Relation to t1ST Facility (Check One) Business Name (lf different from above): C:ilbcu•co~Peeder-Root ^ Owner ^ Operator ^ Employee Designated Operator's Phone #:408-438-0334 ^ Service Technician O •i•hird-Party International Code Council Certification #: 5249001-UC Expiration Date: 12-12-2008 NovemUer 2004 SWRC~B, January 2002 ~, ~7~"4 ~-3 Page of Secondary Containment Test Report Form This form is intended for use by contractors performing periodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. 1. FACILITY INFORMATION Facility Name: Safeway-Vons Date of Testing: 9/6/2006 Facility Address: 2100 White Lane Bakersfield Ca 93304 Facility Contact: Mandy Mentzer Phone: 661-396-0161 X1219 Date Locai Agency Was Notified of Testing: 8/28/2006 Name of Local Agency Inspector (if present during testing Howard Wines 2. TESTING CONTRACTOR INFORMATION Company Name: Shirley Environmental Corporation echnician Conducting Test: Hensley Barbour Credentials:O CSLB Licensed Contractor ~ SWRCB Licensed Tank Tester License Type: A HIC HAZ License Number: 814027 Manufacturer Manufacturer Training Component(s) Date Training Expires Incon TS-STS Computer and probes 3/2006 3. SUMMARY OF TEST RESULTS Component Pas Fail Not Tested Repairs Made Component Pas Fail Not Tested Repairs Made Unl. Fill Bucket ® ^ ^ ^ ^ ^ ^ ^ Unl. Va or Bucket ® ^ ^ ^ ^ ^ ^ ^ Plus Fill Bucket ® ^ ^ ^ ^ ^ ^ ^ Plus Vapor Bucket ® ^ ^ ^ ^ ^ ^ ^ Supreme Fill Bucket ® ^ ^ ^ ^ ^ ^ ^ Supreme Vapor Bucket ® ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ If hydrostatic testing was performed, describe what was done with the water after completion of tests: . . . . . . . . . . . . . . .. . .. . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . .. . .. . .. . .. . .. . .. . .. . .. . . . . . . . .. . .. . .. . .. . .. . .. . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . .. . .. . .. . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . I~fk.~?r~-Site ................................................................................................................................................................................................................................................ . . . . . . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . .. . .. . . . . . . . . . . .. . .. . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . .. . .. . .. . .. . .. . .. . . . . .. . . . . . . . .. . .. . .. . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of my knowledge, the facts stated in this document are accurate and in full compliance with legal requirements Technician's Signature: ~ 7?~""~ - Date: 9/6/2006 SWRCB, January 2002 9 SPILL /OVERFILL CONTAINMENT BOXES Page of Facility is Not Equipped With Spill/Overfill Containment Boxes ^ Spill/Overfill Containment Boxes are Present, but were Not Tested ^ est Method Developed By: O Piping Manufacturer O Other (Specify) ~ Industry Standard O Professional Engineer est Method Used: O Pressure O Other (Specify) O Vacuum OO Hydrostatic est Equipment Used: Incon TS-STS Equipment Resolution: +-0.002" Spill Box # 87F Spill Box # g7V Spill Box # ggF Spill Box # 89V Bucket Diameter: 10.5" 10.5" 10.5" 10.5" Bucket Depth: 10" 10" 10" 10" ait time between applying pressure/vacuum/water and starting test: 5 min 5 min 5 min 5 min est Start Time: 10:16 / 10:37 13:02 / 13:19 11:16 / 11:46 12:08 / 12:25 Initial Reading (R,) 2.4261 / 2.4249 2.3500 / 2.3498 2.2408 / 2.2403 2.9311 / 2.9307 est End Time: 10:32 / 10:52 13:17 / 13:34 11:31 / 12:01 12:23 / 12:40 Final Reading (RF) 2.4255 / 2.4241 2.3499 / 2.3502 2.2405 / 2.2403 2.9306 / 2.9305 est Duration: 15 min / 15 min 15 min / 15 min 15 min / 15 min 15 min / 15 min Change in Reading (RF R.) -0.0006 / -0.0008 -0.0001 / 0.0004 -0.0003 / 0.0000 -0.0005 / -0.0002 Pass/Fail Threshold or Criteria: +-0.002" +-0.002" +-0.002" +-0.002" estResult'.. - ®-Pass ^ Fail ~ Pass ^ Fail ~I=Pass ^fail ®Pass ^ Fail Comments - (include information on repairs made prior to testing, and recommended follow-up failed tests) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. . .. . . . . .. . .. . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . .. . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . .. . .. . .. . .. . . . . . . . . . . . . . .. . . . . . . . . . . .. . .. . .. . .. . .. . . . . . . . .. . . . . . . . .. . .. . . . . . . . .. . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . .. . .. . .. . .. . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . .. . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. . .. . .. . . . . .. . .. . . . . . . . . . . . . . . . . . . . . . . .. . .. . .. . .. . .. . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ~~ Shirley Environmental Corporation r 9595 Lucas Ranch Road, Suite #100 Rancho Cucamonga, CA 91730 California State Contractors License #814927 A HAZ MECHANICAL /ELECTRONIC LEAK DETECTOR CERTIFICATION SITE: State Facility # Safeway-Vons 2100 White Lane Bakersfield Ca 93304 DATE: 9/6/2006 CONTACT: Mandy Mentzer PHONE: 661-396-0161 X1219 JOB #: T7 036694 Sump # 1 2 3 Product 87 89 91 LD Manufacturer Veeder Root Veeder Root Veeder Root LD Model PLLD PLLD PLLD Sump Condition Clean and dry Clean and dry Clean and dry Operating 28 28 28 Pressure (PSI) Opening Time (Sec N/A N/A N/A Metering N/A N/A N/A Pressure (PSI) Functional Elemen N/A N/A N/A Holding Pressure Leak Rate LD 3.0 gph 3.0 gph 3.0 gph Detected (GPH) Does LD Detect Yes Yes Yes 3 GPH Leak Rate? LD Serial N/A N/A N/A Technician: Hensley Barbour Comments: Electronic Line Leak Detectors, All Passed Moni~~~~~ur~i~~s~~e deg-~~4.~ation Authority Cited: Chapter 6.7, Health and Safety Code; Chapter 16, Division 3, Title 23, California Code of Regulations This form must be used to document testing and servicing of monitoring equipment. Separate certifications or reports must be prepared for each monitoring system control panel by the technician who perfroms the work. A copy of this form must be provided to the tank system Owner /Operator. The owner/operator must submit a copy of this form to the local agency regulating UST systems within 30 days of test date. A. General Information acility Name: Safeway-Vons Bldg ite Address: 2100 White Lane acility Contact Person: fake /Model of Monitoring System: Mentzer Veeder Root TLS 350R SET Job#: T7 036694. Bakersfield Ca Zip: 93304 Contact Phone No.: 661-396-0161 Date of Testing /Servicing: 9/6/2006 B. Inventory of Equipment Tested or Certified Check the appropriate boxes to indicate equipment inspected or serviced; Tank ID TK1 Unleaded Tank ID TKZ Pius ® In Tank Gauging Probe 109 ®In Tank Gauging Probe 109 ® Annular Space or Vault Sensor 420 ® Annulaz Space or Vault Sensor 420 ® Piping Sump /Trench Sensors) 208 ®Piping Sump /Trench Sensors) 208 ® Fill Sump Sensor(s) 208 ® Fill Sump Sensor(s) 208 ^ Mechanical Line Leak Detector ^ Mechanical Line Leak Detector ® Electronic Line Leak Detector PLLD ®Electronic Line Leak Detector PLLD ® Tank Overfill /High-Level Sensor 709 ®Tank Overfill /High-Level Sensor 709 ^ Other (specify equipment type and model in Comments. ^ Other (specify equipment type and model in Comments. Tank ID TK3 Supreme Tank ID ® In Tank Gauging Probe 109 ^ In Tank Gauging Probe ® Annular Space or Vault Sensor 420 ^ Annular Space or Vault Sensor ® Piping Sump /Trench Sensors) 208 ^Piping Sump /Trench Sensors) ® Fill Sump Sensor(s) 208 ^ Fill Sump Sensor(s) ^ Mechanical Line Leak Detector ^ Mechanical Line Leak Detector ® Electronic Line Leak Detector PLLD ^ Electronic Line Leak Detector ® Tank Overfill (High-Level Sensor 109 ^ Tank Overfill (High-Level Sensor ^ Other (specify equipment type and model in Comments. ^ Other (specify equipment type and model in Comments. Dispenser ID ~-2 Dispenser ID 3-4 ® Dispenser Contaitment Sensor(s). 208 ®Dispenser Containment Sensor(s). 208 ® Sheaz Valves(s). ® Shear Valves(s). ^ Dispenser Containment Float(s) and Chain(s). ^Dispenser Containment Float(s) and Chain(s). Dispenser ID s-s Dispenser ID ~-8 ® Dispenser Containment Sensor(s). 208 ® Dispenser Containment Sensor(s). ® Sheaz Valves(s). ® Shear Valves(s). ^ Dispenser Containment Float(s) and Chain(s). ^Dispenser Containment Float(s) and Chain(s). Dispenser ID 9-10 Dispenser ID ® Dispenser Containment Sensor(s). 208 ^Dispenser Containment Sensor(s). ® Sheaz Valves(s). ^ Shear Valves(s). ^ Dispenser Containment Float(s) and Chain(s). ^Dispenser Containment Float(s) and Chain(s). If the facility contains more tanks or dispensers, copy this form. Include information for every tank and dispenser at the facility. C. Certification - I certify that the equipment identified in this document was inspected/serviced in accordance manufacturers' guidelines. Attached to this certification is information (e.g. manufacturers' checklists) to verify this information is correct and a plot plan showing the layout of monitoring equipment. For any equipment capable of generating such reports, I have also attached a copy of the report (check all that apply) ® System set-up ®Alarm history Technician Name (print): Hensley Barbour Signature: #~,p,~/ ~~~ Certification No.: 006-OS-0110 License No.: 90-1189 Testing Company Name: Shirley Environmental Corporation phone No.: (909) 476-7443 Testing Company Address: 9595 Lucas Ranch Road, Rancho Cucamonga, CA Date of Testing /Service: 9/6/2006 Monitorine System Certification Paae 1 of 3 3/01 City /State H. Results of Testing/Servicing Software Version Installed: 123.00 Complete the following checklist: ®Yes ^ No' Is the audible alarm operational? ®Yes ^ No" Is the visual alarm operational? ®Yes ^ No' ere all sensors visually inspected, functionally tested, and confirmed operational? ® Yes ^ No* ere all sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their proper operation? ®Yes ^ No ^ NA If alarms are relayed to a remote monitoring station, is all communications equipment(e.g. modem) operational? ® Yes For pressurized piping systems, does the turbine automatically shut down if the piping secondarycontainment ^ No monitoring system detects a leak, fails to operate, or is electrically disconnected? If ves: which sensors initiate ^ NA positive shut down? (Check all that apply) ®Sump/Trench Sensors ®Dispenser Containment Sensors ^ f Did you confirm positive shut down due to leaks and sensor tanure/disconnection'! ®Yes ^ No ®Yes ^ NA For tank systems that utilize the monitoring system as the primary tank overfill waming device (i.e. no ^ No mechanical overfill prevention valve is installed), is the over-fill waming alarm visible and audible at the tank 90 ill point(s) and operating properly? If yes, at shat percent of tank capacity doe the alarm trigger? ^Yes ®No as any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equipment replaced and list the manufacturer name and model for all replacement parts in Section E, below. ^Yes ®No as liquid found inside any secondary containment systems designed as dry systems? (Check all that apply) ^ Product ^ Water If yes, describe causes in Section E, below. ®Yes ^ No as monitoring system set-up reviewed to ensure proper settings? Attach set up reports, if applicable ® Yes ^ No" Is all monitoring equipment operational per manufacturer's specifications? * In Section E below, describe how and when these deficiencies were or will be corrected: E. Comments: Monitoring System Certification Page 2 of 3 3/01 F~ In-Tank Ganging /SIR Equipment: ^ Check this box if tank gauging is used only for inventory control. ^ Check this box if no tank gauging or SIR equipment is installed. This section must be completed if in tank gauging equipment is used to perform leak detection monitoring ®Yes ^ No* Has all input wiring been inspected for proper entry and termination, including testing for ground faults? ®Yes ^ No* ere all tank-gauging probes visually inspected for damage and residue buildup? ®Yes ^ No* as accuracy of system product level readings tested? ®Yes ^ No* as accuracy of system water level readings tested? ®Yes ^ No* ere all probes reinstalled properly? ®Yes ^ No* ere all items on the equipment manufacturer's maintenance checklist completed? G. Line Leak Detectors (LLD): ^ Check this box if Leak Detectors are not installed. Complete the following checklist: ®Yes ^ N/A For equipment start-up or annual equipment certification was a leak simulated to verify LLD performance? ^ No* (Check all that apply) Simulated leak rate: ®3.0 GPH; ^ 0.2 GPH; ^ 0.1 GPH ®Yes ^ No* ere all LLDs confirmed operational and accurate within regulatory requirements? ®Yes ^ No* as the testing apparatus properly calibrated? ^ Ye ®N/A * ^ No For mechanical LLDs, does the LLD restrict product flow if it detects a leak? ^ N/A ®Y e * ^ No For electronic LLDs, does the turbine automatically shut off if the LLD detects a leak? ®Yes ^ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled ^ No* or disconnected? ®Yes ^ N/A For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a ^No* est? ^ N/A ^ No * For electronic LLDs, have all accessible wiring connections been visually inspected? ®Yes ^ No* ere all items on the equipment manufacturer's maintenance checklist completed? * In section H below, describe how and when these deficiencies were or will be corrected: H. Comments: Monitoring System Certification Page 3 of 3 3/01 09/0712006 08:15 9094767114 SHIRLEY ENVIRONMENTL PAGE 01/01 UNp~RGROUND STORAGE 7ANK,3 $,~KERBI~IF~D F]I~ DEPT, ~~~, `` Preveat~n Sesvicaes a d~ ~~T~ 94Q Ave., S#+r:. 210 TO P>:Ft~ORM ELD t LINE T63TBfG '~'e~.= (661) 32b-3979 156969 SECONpAitY OO~fI'AIMMENT TE3TINQ FaS: (661) 552-2171 YANK TiQNTNES$ TEST AND TO PERFY~RRY F't.IEI.TIA014170Ra1G CERT~IjF,ICA'iiDN page 1 oft PERMfT'NO. ~~ ~ T ^ HYHRNC® LEAK DEIZ-CT1oN d lR+IETESTttdq ^ se.s®secolmAmrconrrAEO~~TTr~sTwo R rAUVrrnuYUaeeTCer ~ Tnococnon~nin nnn~nrnenrnne~rrmr~ar~nu FACiLfTY NANE'. B PHONE NV BER OF CONTACT PERSON ADDRESS ~ ! p ~ 9'.30 OWNERS NAME OPLRATOR9 NAAOE PERRIIT TD OPF3WT'E, NO. R T KS 6i:T p Gdl O Tq~ ~Sr~Lr"T~ l~"ab !Ot>G~+~ ~GL ryG(1... TANG Ti;$T1N3 CfJINpANY . NAME OF TE8Ti~1B COMPANY .~c nJvlltor~M"~~ Co+~P NAWIE 8. PMpNE NUMBER OF CONTACT PPJiSON ~ t3ouU X04' 3~6 75k~3 x~~3 MAIL,WB ADDRESS `T+~ L-uc+4~ ~,.tG1~ f~.6 ~d f uo fQl!t.>3 L ~~ c ~uCpl-t.noa-+6 a. ~ r14 d'73 ~f NAME a RHONE N ER of TESTER OR SPECIAL INSPEG7Y~R ,.rs~ ~1ok-t~ 9 55~ y S CERTIF1Cnr~ N #; g w iR <. t~ . 1~• o~~- p5~~ II a qo r 11 ~`t oATe a T7=.gr t'v 1}E CpROUCIEp 9 5 a~ b on tCC ~ ,.r Io~Jf~f~'Z~~r~ TrraT rAET-i0A SIGNA RE GF APPLICANT ~_. ~,~ 7 D I R•~ViE4). APPROVED BY ~,'~~~ pIRT~ ~ FD 3[A9!i (R6Y. 09J6S7 .xaexe~ x,'~ rooiroo ~0~a eZ ~ 8 9002/L/6 xE,~~w~~a E R S F I D F/RE ~RrM r April 10, 2006 Ms. Cheryl Frye Von's Fuel Center 2100 White Lane Bakersfield, CA 93304 RONALD }. FRAZE REMINDER NOTICE FIRE CHIEF Re: Guidelines for Unsupervised Dispensino Gary Hutton, Senior Deputy Chief Dear MS. Frye: Administration 326-3650 It has come to our attention that many convenience stores who sell gasoline, like yourselves, are closing late at night. If you are using card readers and leaving Deputy Chief Dean Clason your fuel pumps on, this is defined in the California Fire Code as: "Unsupervised OperationslTraining Dispensing." 326-3652 Deputy Chief kirk Blair Unsupervised dispensing is allowed when the owner or operator provides, and is accountable for daily site visits, regular equipment inspection and maintenance, Fire Safety/Prevenrion Services including any unauthorized release or spills, posted instructions for safe operation 326-3653 of dispensing equipment, and posted telephone numbers for the owner or operator. Signs prohibiting smoking, prohibiting dispensing into unapproved 2101 "x" Street containers and requiring vehicle engines to be stopped during fueling shall be Bakersfield, CA 93301 conspicuously posted within site of each dispenser. OFFICE: (661) 326-3941 In addition, a sign shall be posted in a conspicuous location reading: FAX: (661) 852-2170 In case of spill or release: RALPH E. HUEY, DIRECTOR 1) Use Emergency Pump shut-off PREVENTION SERVICES 2) Report the accident FlRE SAFETY SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 ' 3) Fire Department Telephone Bakersfield, CA 93301 4) Facility address OFFICE: (661) 326-3979 FAX: (661) 852-2171 During the hours of operation; stations having unsupervised dispensing shall be David Weirather provided with a fire alarm transmitting device. A telephone not requiring a coin to Fire Plans Examiner operate is acceptable. The fuel leak detection system must have a remote or 326-3706 phone modem to insure off-site monitoring during hours of unsupervised dispensing. During hours of darkness, sufficient lighting must be maintained so Howard H. Wines, 111 that all signs associated with fueling operation are conspicuous and readable. A Hazardous Materials Specialist gallon container of an absorbent material used for spills must be rnade available 326-3649 to the public during hours of unsupervised dispensing. Afire extinguisher with a minimum 2A, 2B, and 2C rating must be located on dispenser island during hours of unsupervised dispensing To: Mailing List of Valued Customers Reminder Notice Re: Guidance for Unsupervised Dispensing April 10, 2006 Page 2 of 72 To: Mailing List of Valued Customers Reminder Notice Re: Guidance for Unsupervised Dispensing April 10, 2006 Page 2 If you are currently having hours of unsupervised dispensing, you must comply with the above-mentioned requirements. Starting April 15, 2006, this office will conduct random checks of all fueling stations within the city limits for compliance. If you shut your station down after normal business hours and are not pumping fuel, please disregard this reminder notice. Should you have any questions, please feel free to call me at 661-326-3190. Sincerely, Ralph E. Huey, Director of Prevention Services ~~ ~C ~~. c ~~~ By: Steve Underwood, Fire Prevention Officer REH/db ~. . •~_a, UNDERGROUND STORAGE TANKS ~~ BAKERSFIELD FIRE DEPT. b E 9 p I n Prevention Services F/R! IIRTM t 900 Truxtun Ave., Ste. 210 APPLICATION i'` ~ Bakersfield, CA 93301 ,,:. TO PERFORM ELD /LINE TESTING ~ :. Tel.: (6G 1) 326-3979 ~ , / S6989 SECONDARY CONTAINMENT TESTING °= Fa~c: (661) 852-2171 /TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION Page 1 of 1 PERMIT NO. l ~O3S~o ^ ENHANCED LEAK DETECTION ^ LINE TESTING ^ 5B-989 SECONDARY CONTAINMENT TESTING ^ TANK TIGHTNESS TEST ~ TO PERFORM FUEL MONITORING CERTIFICATION - _ .• SITE INFORMATION AGILITY _ NAME & PHONE NUMBER OF CONTACT PERSON ~ - 3~ib-olt~l DDRESS ~`. ~~ ~\'~~ ~ 3~0 1NNERS_NAME~_ - _ ~.____ - ~---..--__,_-~--- ----- .__ OPERATORS NAME PERMIT TO OPERATE NO. UMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK# VOLUME CONTENTS - TANK TESTING COMPANY - OF TESTING MPANY i 'r ~~~ NA E & PHONE NUMBER OF CONTACT PERSON I'1 1 ~.r u -~ ~C~% ~ 7!D - "7 AILING ADDR S I ~ ~ R-GL VL 1"~ 7 r^~ AME & PHONE NUMBER OF TESTER OR SPECIAL INSPECTOR u ERTIFICATION #: ~D - o ATE.&_ ~!M TEST -BE-GONDUCTEO - b• --- ~ - - ICC-#:-- - --- -- °~-~--- - ~-- 03- EST'METWOD "' " ` IGNATURE OF APPLI AN ~ ATE T I AP L' :ATLON B: O. ~ _ P~- M: ; ^ , - ~N .. PPR01/~D. PPROVED BY DATE ~3 FD2106 SWRCB January, 2002 Job #: T7 028137 Page of ` Secondary Containment Testing Report Form CUPA This form is intended for use by contractors performing periodic testing of US7' secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operator for submittal to the local regulatory agency. Facility Name: Safeway-Vons Date of Testing: 9/6/2005 Facility Address: 2100 White Lane Bakersfield Ca 93304 Facility Contact: Manager Phone: 661-396-0161 X1219 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (if present during Testing) None Present 2. "1'L+'~'1'liV(i C:UNl'KA(:'1'UK 11VP'UKMA'1'lU1V Company Name: Shirley Environmental Testing Technician Conducting Test: Anthony Martinez Credentials: ®CSLB Licensed Contractor ^ SWRCB Licensed Tank Tester License Type: A HIC HAZ License Number: 814027 Manufacturer Training Manufacturer Com oueut(s) Date Trainin Es fires Analog Gauges Incon TS-STS _ _ _. __ 3. SiTMMARY nF TEST RESITLTS Component Pass Fail Not Tested Repairs Made Component pass Fail Not Tested Repaw•s Made 7 Annular ® ^ ^ ^ .D.C. 1J2 ® ^ ^ ^ 9 Annular ® ^ ^ ^ .D.C. 3/4 ^ ® ^ ^ 1 Annular ® ^ ^ ^ .D.C. 5J6 ® ^ ^ ^ 7 Secondary Line ^ ^ ^ .D.C. 7J8 ~ ^ ^ 9 Secondary Line .D.C. 9/10 1 Secondary Line 7 Fill Bucket 7 STP Sump 9 Fill Bucket 9 STP Sump 1 Fill Bucket ump ~ ump I ump l ump If hydrostatic testing i~-as performed. describe ~1°1-at ~ti-as done ~t-iW the ~ti-ater after completion of tests: CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDUCTING THIS TESTING To the best of mJ' knoirledge, the facts stated in this documc~zt are accurate and in full compliance iritlr legal requircmtt~tts Tecluuciau Name (print): Anthony Martinez Technician's Signahrre: /,~_,r..~ _ ~ -~~ _ Date: 9/6/2005 S~JJRCB January, 2002 Job #: T7 028137 Page ` of i Job #: T7 028137 4. TA1vIi ANNULAR TESTING • Test Method Developed By: p^ ^^ Tank Manufachirer ®Iudustr~• St~tindard QProfessional Engineer Other (Sped f •) Test Method Used: p^ Q Pressure ®^ Vacuum ^^H~~drostatic Other (bpecifi~) Test Equipment Used: Analog Gaug es Equipment Resolution: +/- 0.25% Tank # 87 Tank # 89 Tank # 91 Tank # Is Tank Exempt From Testing?' ^ Yes ®No ^ Yes ®No Yes ®No ^ Yes ^ No Tank Capacity: 20,000 10,000 10,000 Tank Material: DW Steel DW Steel DW Steel Tank Manufacturer: Unknown Unknown Unknown Product Stored: - Fuel Fuel Fuel Wait time between applying pressure/vacuum/~t-ater and startin test: 15 Min 15 Min 15 Min Test Start Time: 12:00 PM 12:00 PM 12:00 PM Initial Reading (R~: 10" 10" 10" Test End Time: ,` 2:00 PM - - -2:00 PM __ .2:00 PM ,_, _ _ Final Reading (RF): ~ 10" 10" 10" Test Duration: 2,Hr 2 Hr 2 Hr Change in Reading (RF Rr): 0 0 0 Pass/Fail Threshold or Criteria: 10" 10" 10" .- eSU1~t: Test 'R ~ ®Pass °^ Fail ~(xPass "^ Fail .:~. _.~. _ _ ~ - _ ~~Pass~- ^ Fail, r_:~ ~ ^ Pass ^~Fa~l 4. ~ b Was sensor removed for testing? ®Yes ^ No ^ NA ^ NA ®Yes ^ No ®Yes ^ No C7 NA __ _ ^ Yes ^ No ~ NA Was sensor properl~~ replaced and verified functional after testing? ®Y~ ~ ~ ^ ~ ®Yes ^ No ^ NA ®Yes ^ No ^ NA ^ Yes ^ No ^ NA . Comments - (include infornmfion opt repairs.made prior to testing, and recommended follow-zip, for failed tests) 91 & 89 SPLIT TANK. ' Secondary containment systems where the continuous monitoring automatically monitors both the primary and secondary containment, such a c`mtomc +}.ot ~w hvAmetntiroll<~ mnnitnmA nr »nAar r~~c+ont ~rnrnnm ora nvmm~t frv~rn rurinr~i~ rnntoinrr~ant tacfinrt I(''ohfn,-.,io !'nAn of S`J~1RCB 7anuary, 2002 Job #: T7 028137 Page of J~'OLV1llJ Lll(1L (lly 11 ~'U1V JL[1LLyUll~' 111V1LLV1yV Vl LL11L1y1 yV11~l lLllll Vf1yLLLL1Ll, 4Ly ynylLl~ll 11V111 ~1y11VViy yV11L411LL1Iy11L LyJ1111b, tl+(L11V 1111(1 <rVLLy Vl Regulations, Title 23, Section 2637(a)(6)} 5. SECONDARI' PIPE TESTING Job #: T7 028137 Test Method Developed By: ~^ Piping Mamdachirer ®htdustn• Standard ^ Professional Engineer Q Other (S~eci• f ~1 Test Method Used: Q Pressure ^ Vacuum ^ H}-drostatic 0 Other (~Specifi~l Test Equipment Used: Analog Gauges Equipment Resolution: +/- 0.25% Piping Run # 87 Piping Run # 89 Piping Run # 91 Piping Run # Piping Material: Plastic Plastic Plastic Piping Manufachirer: U.P.P. U.P.P. U.P.P. Pipug Diameter: 2++ 2+' 2++ Length of Piping Run: 60' 60' 60' -Pioduct Stored: Fuel Fuel -Fuel Method and location of piping-nm isolation: Test Reducer Boots Test Reducer Boots est Reducer Boots Wait time beh~~een apph~iug pressure/~~acuuin/«~ater and starting test: ~ _ 10 Mins. __ 10 Mins. 0 Mins.~ ,. . _. __ _ . Test Start Tune: 1:15 PM 1:15 PM 1:15 PM Initial Reading (RI): 5 psi 5 psi. 5 psi Test End Time: 2:15 PM 2:15 PM 2:15 PM Final Reading (RF): 5 psi 5-psi 5 psi Test Duration: 60 min. 60 min. 60 min. .Change in Reading (RF-RI): 0 0 0 Pass/Fail Threshold or Criteria: 0 0 _ -- 0 - ' :... Test Result: r;~_ . ~ ~ ..may i ®Pass' ^ Fail .~ v_~..< _ .,§~~: ®,~Pass ^ F$ad~ ~,- .. '.-a~-' :. Pass ^ Fail =~~,~~ .._. Y~ 7~~'~3+ 3.•y ^,Pass CI`:Faifn Comments - linchrde inforntafio~7 o~z repnirs mode prior to testing, rnrd reconnnendec/•follou~-up,for_fai/ed tests) S WRCB January, 2002 Page of .lob #: T7 028137 6. PIPING SUMP TESTING Test Method Developed By: ^^ Sump Maiudachlrer 0 hidustn- Standard ^Q Professional Enguieer ^ Other tSpeci~~1 Test Method Used: ~^ PressLUe ^Q Vacuum 0 Hydrostatic ^ Other t5~ecif i~.l Test Equipment Used: Incon TS-ST S Equipment Resolution: +/- 0.002 Inches Sump # 87 Sump # 89 Sump # 91 Sump # Sump Diaaleter: 52" 52" 52" Sump Depth: 43" 43" 43" Sump Material: Fiberglass Fiberglass Fiberglass Height from Tack Top to Top of Hi hest Pi iu Penetration: 18" 18" 18" Height from Tack Top to Loi~~est Electrical Penetration: 24" 24" 24" Condition of camp prior to testing: .Fair Fair Fair Portion of Sump Tested' 2" above i e 2"above i e 2" above ~ i e Does turbine shut do«~n when snmp sensor detects liquid (both roduct and ~~~ater)?` ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ^ NA Tiubiue shutdon•u response time N/A N/A NIA Is system prograuuued for fail-safe Sllutd0\Z'nh ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ^ NA Was fail-safe ~~erified to be o eratioual?4 ^Yes ^ No ®NA _ _ -- Yes ^ No ®NA - . ^ Yes ^ No ®NA .. .. ^ Yes ^ No ^ NA Wait tune bett~-een applying pressare%~aciluiu/;rater and starting test: 30 Mins 30 Mins 30 Mins Test Start Tirue: 3:35 PM/3:51 PM 4:50 PMl5:06 PM 3:35 PM/3:51 PM Initial Reading (RI): 2.544112.5451 2.573012.5730 1.036811.0370 Test End Time: 3:50 PM/4:06 PM 5:06 PMl5:21 PM 3:50 PM/4:06 PM Final Reading (RF): 2.5450/2.5452 2.572912.5730 1.036911.0371 Test Diuation: 15 min. 15 min. 15 min. Change 111 Reading (RF RI): +A0091+.0001 -.000110.0000 +.0001 /+.0001 Pass/Fail Threshold or Criteria: +l- 0.002" +/_ 0.002" +l- 0.002" Tesf Result: ,. ®Pass Q=Fall : , w~~ ~__~,.... .__ a -Pass ^ Fait _.: ~. ®Pass O'Fa~h`• x~. ,. ^ Pass ^'Fa~l ..~....: ~_,. ,,. i Was sensor remoeed for testing? ®Yes ^ No ^ NA ®Yes ^ No ^ NA _ ®Yes ^ No ^ NA ^ Yes ^ No ^ NA . Was seusorproperly replaced and ~-erified fimctiollal after testiu Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA . ^ Yes ^ No ^ NA COIrimeIItS - (include i~lforntation on repairs made prio~~ to testi~ag, and ~•ecominended fo/lo~i~-~~p_fo~~,fai/ed testsl ' If the entire depth of the sump is not tested, specify how much was tested. If the answer to ~ of the questions indicated with an asterisk (*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) SWRCB January, 2002 r ' Page of 7, UNDER-DISPENSER CONTAINMENT (UDC) TESTING Job #: T7 028137 Test Method Developed By: ^QUDC Manufach~rer ®^ htdustr<- Standard ^0 Professional Engineer Q^ Other (bpeci fyl Test Method Used: ^QPress<~re ^Q Vacuum Q H}~drostatic ^Q Otlter (Specify) Test Equipment Used: Incon TS~ . TS Equipment Resolution: _ +l- 0.0021nches " - ' ~~.~ • _ ~, ~~'°F.~; UDC # 1/2 ~. a, . .,, .. UDC # 3/4 , UDC # 5/6 - UDC # 7/8 UDC Mam>fachirer: Total Containment Total Containment Totai Containment Total Containment UDC Material: Fiber lass Fiber lass Fiber lass Fiber lass UDC Depth: 36" 36" 36" 36" Height fromUDC Bottomto Top of Highest Piping Penetration: 12" 12" 12" 12" Height from UDC Bottomto Lowest Electrical Penetration: 5" 5" 5" 5" Condition of UDC prior to testing: Fair Fair Fair Fair Portion of UDC Tested 2" above i e 2" above i e 2`' above i e 2" above i e Does h~tbine shut down when UDC sensor detects liquid (both product and ~~°ater)?' , ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA _Tutfiineslnrtdonn response-tune _.- - NIA - N/A- - NIA - NIA Is system programmed for fail- safe shirtdo~ti°n?# ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA Was fail-safe verified to be operational?x ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA ^ Yes ^ No ®NA Wait titue behveen applying pressure/vactmntlwater and starting test 30 Mins 30 Mins 30 Mins 30 Mins Test Start Titue: 4:50 PMI5:06 PM 4:50 PM/5:06 PM 12:02 PM/12:18 PM 12:02 PM/12:18 PM Initial Reading (RI): 0.4878/0.4878 2.5995/2.5959 3.154013.1540 2.732012.7326 Test End Time: 5:06 PM/5:21 PM 5:06 PM/5:21 PM 12:17 PM112:33 PM 12:17 PM112:33 PM Final Reading (RF): 0.4878/0.4879 2.596012.5917 3.1540/3.1540 2.732612.7326 Test Duration: 15 min. 15 min. 15 min. 15 min. Change in Reading (RF-RI): 0.0000 +0 0001 -0 0035 / -0.0042 0.0000 / 0.0000 + .0006 / 0.0000 PasslFail Threshold or Criteria: +/- 0.002" +/- 0.002" +/- 0.002" +/- 0.002" .- Test Result:. ,. _ • ~®,Pass ^ Fail ~... ~ _~ ~_. ,,~ ^ Pass ®_ Fail. _ ®.Pass . ^-Fail - ®P,ass.- p Fail `'" r. Was sensor removed for testing? ®Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA Was sensor pmperh- replaced and verified fi~nctional after testing'? ®Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA Comments - (inchrde iir forntafion on repairs made prior to testi~lg, and recontn-e~uled• folloir-up for failed tests/ UDC 3,4 Failed. Possibly will need to remove Dispenser for repairs. ` If the entire depth of the UDC is not tested. specifi- how nu~ch was tested. If the answer to aiiv of the questions indicated with an asterisk (~=) is `'NO" or "NA", the entire UDC nnist be tested. (See SWRCB LG-160) SWRCB January, 2002 .~ Page of 7. UNDER-DISPENSER CONTAINMENT (UDC} TESTING Job #: T7 028137 Test Method Developed By: p^ ^ UDC Mamifach~rer 0 Iudustn~ Standard ^^ Professional Engineer Other (,S~eci~i~i Test Method Used: ^^Pressure ~ Vacnnm ®^ Hydrostatic ^ Other (~Sj~ecifvl Test Equipment Used: Incon TS~ TS Equipment Resolution: +!- 0.0021nches UDC # 9110 UDC # UDC # UDC # UDC Mannfachirer: Total Containment UDC Material: Fiber lass UDC Depth: 36" Height from UDC Bottom to Top of Highest Pipuig Penetration: 12" Heighi fi-omUDC Bottomto Lowest Electrical Penetration: 5~~ Condition of UDC prior to testing: Fair Portion of UDC Tested 2"above ipe Does twine shut do~1u ~~•hen UDC sensor detects liquid (both product aitd «~ater)?` ^ Yes ^ No ®NP` ^ Yes ^ No ^ IVA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Turbine slwtdon-n response tine N/q Is s~~stem prograuuned for fail- - safe shutdoctn?~ ,. -.__-- - - ~ Yes - ^ No ®NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Was fail-safe ~~erified to be operational?" ^ Yes ^ No ®Nq ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Wait time beh~~een applying pressor-eh~acnumlwater and starting test 30 Mins Test Start Time: 12:02 PM/12:18 PM Initial Reading (RI): 4.6708/4.6709 Test End Time: 12:.17 PM/12:33 PM Final Reading (RF)` 4.6709/4.6709 Test Duration: 15 min. Change iu Reading (RF-RI): +.0001 0.0000 Pass/Fail Threshold or Criteria: +/- 0:002" Test.Result: ~~ Pass;_ ^ Fail ^ ^ Passe. ^~Fail ^ I^ Pass ^ Fail ^ _ ^ Pass ^_Fa~l ^ I Was sensor remo~~ed for testing? ®Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Was sensor proper/} replaced and ~~erified fiinctional after testing? ®Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Comments - (include i~ fot~nntion on repairs made p~~or to testing, and r•ecommended_ follo~i~-rtp, for_ failed tests) 1 If the entire depth of the UDC is not tested, specifi~ ho~~~ unich «-as tested. If the ansiti-er to au~- of the questions indicated «ith au asterisk (*) is "NO" or "NA`', the entire UDC umst be tested. (See SWRCB LG-1G0) SWRCB January, 2002 Page of 8.. FILL RISER CONTAINMENT SUMP TESTING Job #: T7028137 Facility is Noi Equipped With Fill Riser Containment Sumps ^ Fill Riser Containment Sumps are Present_ but ~ti~ere Not Tested ^ , Test Method Developed By: ~ Sump Manufacturer Qlndustn~ Standard ^~Professional Engineer ^ Other (:Spedfj~j Test Method Used: Pressure ^^ Vacuum ~H)~drostatic ^ Other (Specifi~l Test Equipment Used: Incon TS-ST S Equipment Resolution: +/- 0.002 Inches Fl'ill Sum # g7 Flll Sum # g1 Fill Sum # gg Fill Sum # Su Diameter: 52" 52" 52" Su De the 48" 48" 48" Height fromTanl: Top to Top of Hi est P- in Penetration: 22" 22" 22" Height fromTanl; Top to Lo~~-est Electrical Penetration: 23" 23" 23" Condrtton of sump prior to __. _. ._ ~_ __. _ festin _ _ _.._ Fair.--___._-. - Fair,. _; _. _._ . Fair__;._ . . Portion of Su Tested 2" above i e 2" above i e 2" above i e -Sump Material: fiber lass Fiberglass Fiberglass Wait time Ueh~een applj•ing pressure/eacuum/n-atei-and startin test: 30 Mins 30 Mln5 . 30 Mins Test Start Time: 1:36 PM/1:52 PM 1:36 PM/1:52 PM 1:36 PM/1:52 PM Iuiti<~1Readin (R/): 1.792811.7926 3.3095/3.3106 4.6748/4.6745 Test End Time: 1:51 PM/2:07 PM 1:51 PM/2:07 PM 1:51 PMI2:07 PM Final Readin (RF): 1.792fi/1.7924 3.310413.3121 4.674614.674fi Test Duration: 15 min. 15 min. 15 min. -Chan e iu Readin (RF-Rt): 0 _ + 0 + + Pass/Fail Threshold or Criteria: +/- 0.002" +l- 0.002" +l- 0.002" Test_Result ~ Pass, ~,fa~1,,~ ®~PassY ~_Fail __ ,®Pass~ ~ Fail ,c_._ ~,^ Pass~_ 0-Fail ¢~ ~' Is there a sensor iu the su ? ®Yes ^ No ®Yes ^ No ®Yes ^ No ^Yes ^ No Does the sensoral<1rm~~hen either product or water is detected? ^Yes ^ No ~ NA ^Yes ^ No ®NA ^Yes ^ No ®NA ^Yes ^ No ^ NA Was sensorremr.~ved for testin '? ®Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA ^Yes ^ No ^ NA Was sensorproperh~ replaced and ~~erified functional after testut ? ®Yes ^ No ^ NA ®Yes ^ No ^ NA ®Yes ^ No ^ NA ^Yes ^ No ^ NA COmmentS - (777Ch/L/C 7/7)rOllllC//7079 O)7 /'epCl7TS 777pL/L' pl'70T r0 1CSI//7~, n/9d reconunended,follo»>aTp,foT••failed tests] S WRCB January, 2002 Page of 9. SPILL/OVERFILL CONTAINMENT BOSS Job #: T7028137 Faciliri~ is Not Egiupped With SpiIUO~~erfill Contaiun>ent Boses 0 SpilUOcerfill Coutaiumeut Boses are Present, but `here Not Tested ^ TestlVlethodDeveloped By: 0 Spill Bucket Manufach~rer ~ Iudustn Staudanl ^OProfessioual Engineer ^0 Other (Specif_~) Test Method Used: ^^ Pressure ^~ Vacmim QH}~drostatic 0 Other (S~ecif ,'1 Test Equipment Used: Incon TS STS . - - - - Spill Bos # $7 Spill Bos # 89 Equipment Resolution: +l- 0.002 Inches ~ ,~ Spill Bos # 91 Spill Boz # Bucket Diuueter: 12" 12" 12" Bucket-Depth:-._,._ .. , , ...-_. _ - - .. . _~ 12"-.,__, .. . - ; _ _. - . 12" . _ . _ - --- - 12" - - .,, _ - Wait tine beri~-eenappl~-iug press<ire/~~acnum/n~ater and startiug test: 30 Mih 30 Min 30 Min Test Start Time: -1:36 PM/7:52 PM 4:50 PM/5:06 PM 3:35 PM/3:57 PM Initial Readiug (RI): 3.077013.0168 4.4228/4.4234 4.8894/4.8885 Test Eud Time: 1:51 PM/2:07 PM 5:06 PM/5:21 PM 3:50 PM/4:06 PM Final Reading (RF): 3.0168/3.0168 4.4233/4.4239 4.8895/4.8896 Test Duration: 15 Min 15 Min 7 5 Min Clumge in Reading (RF-RI): -.0002/0.0000 +.0005/+.0005 +.0001!+.0001 Pass/Fail Threshold or Criteria: +/- 0.002" +l- 0.002" +l- 0.002" Test Result:; ~® Pass [] Fat{~ _ 'Pass_ ~ Fail, `® Pass ' ^ Fail _ ^ Pass ^`Fail ~- Comments - (include information orr repairs nrade~rior to testing, acrd recommended follo~r-up.for•• failed tests) ~ SWRCB January, 2002 <, rt Job #: T7030450 Secondary Containment Testing Report Form Page of CUPA This form is intended for use by contractors performing periodic testing of US7' secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completed form, written test procedures, and printouts from tests (if applicable), should be provided #o the facility owner/operator for submittal to the local regulatory agency. Facility Name: Safeway Vons Date of Testing: 12/13/2005 Facility Address: 2100 White Lane Bakersfield Ca 93304 Facility Contact: Mandy Mentzer Phone: 661-396-0161 X1219 Date Local Agency Was Notified of Testing: Name of Local Agency Inspector (if present during testing) (None) Z. '1'FS"1'l1V(.T C:U1V'11ZA(;'1'UlL 1N1+'UKMA'1'lU1V Company Name: Shirley Environmental Testing Technician Conducting Test: Anthony Martinez Credentials: nCSLB Licensed Contractor IIat1~w1ZCB Licensed Tank Tester License Type: A HIC HAZ License Number: 814027 Manufacturer Training Manufacturer Com onent(s) Date Trainin Ez fires Incon TS-STS Comauter and Probes 3. SUMMARY OF TEST RESULTS Component Pass Fail Not Tested Repairs Made Component Pass Fail Not Tested Repairs Made . D.C. 3/4 ® ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ If h}~drostatic testing ~~•as performed. descriUe n~hat ~ti~as done ~ti-ith the ~~~ater after completion of tests: a er was pu In o a ga . po y rum an a on-s a or a er p~c -up. CERTIFICATION OF TECHNICIAN RESPONSIBLE FOR CONDIICTING THIS TESTING To the best of mJ' )rnmi~ledgc; tltefacts stated i~z this documcmt are accurate and in full compliance frith legal requiremcntts Technician Name (print): Anthony Martinez Tecluucian`s Signature: ~ _ _ ~ -~~ Date: 12/13/2005 w r4~ SWRCB January, 2002 %i Page of 7. UNDER-DISPENSER CONTAINMENT (UDC) TESTING Job #: T7030450 Test Method Developed By: ^QUDC Mannfachirer ®Lulnstn~ Standard ^ Professional Enguieer ^~ Other (.Syeci, f ~l Test Method Used: ^QPressnre QVacuum ®^ Hydrostatic QOthet (Specify) Test Equipment Used: Incon Equipment Resolution: +/- 0.0021nches UDC # 314 UDC # UDC # ~ iTDC # UDC Marmfach~rer: APT UDC Material: Fiber lass UDC Depth: 31" Height from UDC Bottom to Top of Highest Piping Penetration: 11" Height from UDC Bottom to Lo~~-est Electrical Penetration: 5" Condition of UDC prior to testing: Fair Portion of UDC Tested 2" above i e Does turbine shut done when UDC sensor detects liquid (both product and ~°ater)?` ^ Yes ^ No ®NA ^ Yes ~ ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ..Turbine slnrtdown response time N/A- Is s}stem programmed for fail- safe shirtdo`vu?• ^ Yes ^ No ®NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Was fail-safe verified to be operational?` ^ Yes ^ No ®NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Wait time beriveen applying pressare/~acnumlwaterand starting test 30 Mins Test Start Time: 6:33PM/6:49PM Initial Reading (RI): 0.6493/0.6497 Test End Time: 6:48PM/7.04PM Final Readuig (RF): 0.6496/0.6499 Test Duration: 15 min. Change in Reading (RF-RI): +.0003/+ 0002 Pass/Fail Threshold or. Criteria: +/- 0.002" Tesf Result: ` ': Y ., f~ Pass p Fail ~_._ []FPass ^ Fail _ ,~q Pass ^ Fay{~ ^ Pass,,p-Fail. Was sensor removed for testing? ®Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ Nb ^ NA ^ Yes ^ No ^ NA Was sensor properly replaced and verified fimctional after testing'? ®Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA ^ Yes ^ No ^ NA Comments - (inchrde inrormation on repairs made prior to testi~rg, arzd recommended follo~+~-up.for failed tests) Installed three 1 1/4" clamps on three electrical conductive pies. ' If the entire depth of the UDC is not tested, specify how rm~ch «-as tested. ff the answer to auv of the questions indicated with an asterisk (*) is "NO" or "NA", the entire UDC nmst be tested. (See SWRCB LG-160) 12/1312005 10:47 9094767114 SHIRLEY ENVIRONMENTL PAGE 02/09 3wR~B Jacuary, 2ooa Job ~: Ti 0,8137 Pale ~'... -- Secondary Containment 'Feting Repot Fo~'m price T1~irs firm is tnherid¢d for use try catttracx+ors performirt~ per4odiC testing of I1ST' seaandary oontaennient systems Use the apprnnriat~ pages oJtlris fora to repcart results for dlI co.-r~ponents lashed. Tfte pamplet¢d farm, wrrtterr test p»oaedrrr~s, mad prl~etouts from tests rjapplir~hle), sharrld be provided to rite fi~ilit}+awner/operafar far submifta! la the lara~f regulatory age-rcy. acuty Name: Safeway-Vans ~ Da'be of Testing: 91612pp5 aciMyAddress: 2100 White Lane l3akersfleld t',a 93304 acuity Corttart: Manager Phone: 06t-396-0161 7t1Z19 ate Local ,4gency Wss Notified of Testa~g: ame of Local agency Inspector (lf priitisent alurrng te:~tingf) None Present 2. TE,S'I'JEi~G C~PiTRACTOR INFURMATIOIV Company Name: Shirley Environmental Testing Te~cllmiitcian Conducting Test: Anthony Martllnez Credentials: CSL13 Licensed Ccmtractor SWRCB LicensCd Tank Testa l;.ioanse Tye: A FIIC HAZ I~.icen~ Number: 81402T Maaefactarer Trsinine Manufacturer Ca~opoment(s} bate Tra' Et ' Analog Gauges Incon TS-STS 3. S[T11~M1~R.x O.~"~'EST ~t~SULTS (aoa~popeirt pmsla Fs8 l~ Tewfieci Rcpsir+,c Made Component Pms ~'nij Not 3'e9ted ~c~mitx ]-'~ade 7 Annular .d.C. 112 ,. ~. _. - 9 Annular ~ CI 0 ^ , .D.C. 314 _ ^ l~ Q ^ i Annular ® _ ^ ^ ^ .D.C. sls ® ^ ^ ^ 7 Secondary Ling .D.G. 718 9 Secondary ine .D.G. 9114 '1 Secondary l,lne 7 Fill Bucket STP ur>Iap r I ticket 9 ump i rll tic et ump ump .--_...__ _...~._ .. _ ~ ump . r ump If hydrostatic testier sus perforbned. describe ~vfiat was done w7t1~. the water after aomlaletaia><x of ocsts: onrs e. . CERTII~ICATTON OF TECHNICIAN RESPONSIBLE FOit CONDIIG~~,l1TG T)Sl~i TESTING To tl:e hest of my lwimnledge, dre facts stated in 1Jrns d~~cmeeAt mgr accur,arte ar~d is full rntrtplimioe nth legal rcquatrrrt~rttx Tecl~uiciaaName (pzim): Anthony Martinez /~' ~.f ~' --~t/ei_.e-~~w~ fie. 9181~1m5 Technicians 5igoatuie:~,6r~e ~~~ 12/1312005 10:47 9094767114 SWRGB January, 2042 SHIRLEY ENUIRONMENTL Job #: ~ n~137 Page a. ~r.~,rn~: ~uvrr~L~ T~srn+rG .lostA ~: PAGE 03109 of T'7 n2$137 Tcst. Method 1]evdoped ~y: 0 Ta~nlc Manvfaeturrr Int3ttstry Standard p^Pro~essioual E:u~inep' Qlficr•(.S}~ecffil Test Method Used: ®Pressurc ®Vacuum Q Hi;dmstatic Tcst Fgnipment iJsed: Analog Gaug es Equipment Rcsolttrion: +!- 0.25°/. Tank # 87 Tank # 89 Tank. # 91 Tau~lc # Is Tauk~cempt From Teshing71 ^ Yes ®No ~ Yes ®No Yes ®No ^ Y'es O No '~aAlc Ca~aty: 20,OQ0 1 O,OQD 10,000 Tatalc Materiel: pIN Steel DW Steel DW Steel Tank Maaufa~cturer: Unltnawn UntCnown Unknatnm ]?rodvc~ ~tot+ed: Fuel Fuel Fuel Wait time behveea flppl~ ing pre~ssnreJvacvum/n-ater anal stal'l' test: i S NVlin 13 Mln 1 S Mln Vest Start Time: 12:W1 PM 12:00 PIVA 1x.00 PM Jiautial Readiuxg (li;~): 10" 10" 10" Test EndTimc: 2:44 PM 2;OQ PM 2:00 PM Final ReadSng (~?: 1tt" 1 O" 10° t 17nTation: T es ~ 2 Hr Z Wr Z ttr y .~ - .~ ~+~ ~ +~°~ 4+~Fz~3f ~ ~ ~ Q Pass/Fai1 Threshold ar t~iteria: Wes scnsorrcmoved for testing? ~ 10" ~ Yes [] Pin ©MA- 1 O" Ri!Q Yes ^ No ^ NA i 0" Yes ^ llfo DNA Q Yts ^ [Yo ^ NA Was scntc+r pmpexl}' rcplaocd and i~et~fied functional after testis ®Yes ^ Pb ^ NA I® YPS ^ Ilb ^ tdA Ye_s ^ No ^ NA ^ YFS ^ Nc+ ^ NA Comments - (mclr~de info77trminrv ~n r4pcriry mcfdeprfnr rn t~e~clf~ig, erzCf rerotm~ertdrtd•~ollrnt~-,.rpfar failed tes~s7 .~& B~S~L~fi..~ANK.~. ` Second%y oontainmem systems whew the oontinaiovs ?anonitouing sutonratically momtozs both the pritnat3+ and scaondacy containment, such a ~roFn~ f1~~f ~b 1n+.irr.efwt:Nally ri~nnii~nsx~1 nr~+nAnr 7~nr~ctord~ ~roi+~w~~n one n....,s ~S...r, n.br:ruiin .-r.M4in.*.e,H 4apF:nn f!`wiif ...ice /~..As ~vf 12/13/2005 10:47 9094767114 SHIRLEY ENUIRONMENTL PAGE 04/09 S'aVRCB Ja~nuar~ 2Q()2 Jab #: T7 0287 37 Pagc nt .7JCWL.L'1 WYL Oly .I~MIVb{pLLyp11~ •...•LIWI,Al Vl WXlly. yMJ b4054~ •pW~V LR~ ply VAyl14/111V111 ~/WLLWy yvY VJLUaya.4 IWLWa'~. ~,..~1YiViLYU vaNav V. Regulations, Tit1c 23, Section 2637(a)(6)} 5. :"sECONDARY E~ TESTING Job #: 17 QZ$137 Test Method Dewelopod tiy; ©PiP~ Mamn~ctuler ®Indostn S~andard ^ lsrufessiooal Engineer Older (.Spec~l Test 1Viettmtl Used: ~ Fnesaurc ^ VaCa[rrn Hydmstal'ic TcSt F.quipttt~ttt Used: Anatog Gauges Er,~ipment R~SOlution: +/- 0.2596 Piping/tun # g7 k'iping ~n # gg Piping Rur # g1 PipiAg Ruo # Piping Material: Plastic Ptasfic Plastic Piping Mam~t'actu~r: U,P,P, U.P.P. U.P.P. 1?ipitag Diamieter. ~+. ~-+ Z+• I,eugtll of Piping Inn; Oa' 60' SO' P,nxtuct Stared: Fuel FUeI Fuel Method anti lacatian a1' i in mn isalatiozL Test Reducer Boots Test Reducer Boots est Reducer Baats Wait time between. applying pTxe/saCWndtiy~textlnd sl:arting tcst: 70 Mies. 10 Mins. 1D Mins. .__. • Test Start Tiume: T:15 PM '1:~5 Phil '#:1S PI111 ~~ Reading (R~)= 5 si 5 si 5 si Ted Fxid Time: 2:15 PM 2:15 PM 2:15 PM k'iAal Readiiog (1La): 5 psi 5 psi 5 Irsi Test Duration- t;t1 tt~ln. 6tl nlin. 60 min. Cvangc in Riding (R~R~; 0 0 !) pass/F'ail Tlneshgld yr Critezis: 0 0 O Test ltestrlt: .~ .~. ',~ .T,r,~~ a ~:: .~;; ~: ..:r Ursa:<" ~ a,:;.~.: Comments - (include infornralion arv repairs naarle prior to testing, and recronrmerrded, follrnr~p for failed Lasts) 12/13/2005 10:47 9094767114 S'JVRCB Jannaary, 20p2 SHIRLEV ENUIRONMENTL PAGE 05/09 Pa~c of G. PIPING SUMP 'I'ES'I7NC 'lQb #: T7 0289 37 Test Mdbad Dcwdoped Ay: Q Sump Mam,:faetxrer ~] lltdustn• Standard ®Pcnfiessiooal Engineer t7t~ex !%Spr~~:) Test TNetltod Used: ~p Pressure ®Varnutn ~ H3~drostaiic Other (.Special Test PquipMttent Used: lncan TS.;3'i 'S Bgttipmcnt kcsolutaazt: +l~ O.D021nches Sump # 87 Sump # 89 Suml- # 91 w!~urtap # Snmp Diameter: S2" 52" 52" Stmtp Depth 43" 43" 43" Sutrip Meal.: Fiberglass Fiberglass N;ibergLass Height from Taal: Top to Top of Pi .i- Penetration: 18" 1 S" 18" Height from Taul: Top to I.otrest ~,. 24" 24" . Electric PenetrAtiort: CoQdition of sump prior to testing: per Fair Fair Portion of Snmp Tested 2" above i 2"above i 2"above i Does turbine shirt dmrt[t ti;~i~ea sump seiti~ detects 1ic}nad (both Q Yes ~ hIo ~ nIP, Yps (~ Nn ~ NA ^ Yes ^ Na ~ NA G] Yes ^ Na ^ NIA roduct and srater ?` Tuthi~ sb~tdomrn respo~ase tame NIA N!A NIA Is system programmed for fail~safc D Yes p No ~[ NA Yes ^ lyo ($( H+°~ ^ Yes ©~ ®NA Q Yes d No D 1~1A slwtdoti~~?~ Was :fail-safe rerifted to he Q Yeas A No ~ PIA Yes Q No I~ NA ©Yes Q No ~ ~ CI Yes ^ hlo ^ NA a attarjal7 Wait titnc bet~'cen applt~ing pressurefc°acuum/n~ter and stattiugg 30 Mlns 3q Mins 3t1 Mins tesE: Test Start Tm~e: 3:35 PMI3:51 PM 4:50 PM15:t)B p14q 3:35 PMIS:Si PM Indti:al. Rt~ding (Rt): 2.5q+1G1l2.5451 2.5f3012.5730 7.03613/1.D3T0 TestEnd'I'ivae: 3:50 PM14:06 PM 5:06 PMI5:21 PM 3:5D PMl4:Q6 PM Final Reading ~F)= 2.545012.5452 Z.S7Z91Z.573D 1.D369l1.0377 Test i7tuation: 15 min. 15 Hilo. 15 min. Ci~ange in lieadmg (12~.RI): +.DOD9I+.DD(31 -.Dgg11D~Ogqq ~•.Og011~.00g1 P /Fail Tb eshald or Criteria: s r a s +!- 0.002" +!- D.DD2° +l- D.U02` T } y ~ ~ y 1' .~Di L ~~+a~[E:. 7 % ~ 'y+~ R`] i _ J . ~ •, f •E ~f..'o'~`e~i +~. + Was sensor removed for testing? ~ Yes ^ Na ^ ldA Yas D No ^ NA ®Y~s ^ No ^ NA GI Yes ^ 1Va [7 NA was sensur,properly replaced and vied iunctioval after ? ~, p nia ^ aw ~ qd Yes ^ ntn D l~ ®Yes ^ No ^ lVA . ^I Yes ^ Na ^ NA Comments - (inclarde i~ fontreriorr on rey[rirs made prior m tesli~~ ~vrrd recoanr~erided follrnr-alp fdr felled tests} ' If the entire depth of the sump is mot tested., specify how much was icsted. If the answer to a~ L,f tke questions indicated with an asterisk ('"~ i4 PTO" ar "1V'A", the entire camp must be tested, (See 5 W,RCB Lt3-160) 12113!2005 10:47 9094767114 SWRCF3 JBan~ary, ~(l2 7. UNDE>E Method D~cvcloped 13y: shod Ilsod: SHIRLEY ENUIR^NMENTL PAGE 06109 Page of .,"~IVTA.1iPfM~NT C TESTING dot #_ TT028137 I1rlatwfactuo;r flll Itrdus4~ Standard Ptafessioiral Eegitreeer ' !fi~ly~ _ V~cauAa ©Hydrostat:tc T~ ~ ~fl~ Incon TS~`i T3 Ecluipm~ ltesalution: +/- 0.0021nches UDC # 112 UDC # 314 UDC # ~ i~~C # 718 UDC AQa~muFactvrcr. Total Containment Total t;,on#ainmerrt Total Cantaalmerrt 'total Containment lblatx;rial: Fibs lass F'i lass Fibs lass Fibs lass UDC Depth: ~~+ 3g+~ ~++ 36" Height from UDC Bottom to Top of Higltiest Aipi~ng Penetration; 12° 12" 12" 1 Z" 1leight from UDC Bottom to ia~est Electrical. Penetration: r~,+ 5" S, 5» Condition of UDC prior to Fair Fair Fair Fair ~ .__ Portion oaf cared 2" above pr ~ x" above pe 2" above Dine 2° above " Does rnrbine shut down Rhea UDC seztsar detects liquid (both 0 Yes Q fllo I~ NA p Yes ^ Nv ~ filA d Yes p Pb ~ MA („~ Yes ('~ No ~ NA and upter)'?' 1lrrbinc slu~triowxt response time NIA NIA NfA NIA is sgstempragrarmnod fqr fail- ~ shetdawxt? Q Yes Q Na ®NA d Yes ^ nb ~ IdA ^ Yes [~ Ma ~ NA ^ Yes ^ No ~ NA Was:Fait-safe venifed to Ue operational?' [] Yes ^ IYo ®NA fl Yes ^ P1o ~( NA ^ Yes p No ~ tilA ^ Yes ~ Ilb ~ NA Wait timee betaeeti applyyng pressutt•JvactnrnN~vaterand 3D Mina 3D Mina 30 Mies 30 Mins starting test _ _ Tit St•utt Timie: __ , . 4_5Q PMfS:06 P ~ Q~(~0 6 P M •S '~02 PMf12:18 PM 1;~-0 - 8 initial Reading (ltt}; ,_ 0~81D.g87$ _.. _ . _ _ _ 2.599512.5959 ._. 3154013 X640 ~,Z3~,011!.~3~.6 T~End rare: 5:06 laM/6:21 PM 5:06 PM1521 PM 1,2.17 PIIlU'13:33 PM 1;t:17 PM/12:33 PM FinaiRcOdtag(R.F): .:.~ 0„487810,1879 •--~~~ - ~ 2.596012.5377--- 3.184_013.154+0 x.732t3/2.T3as Ted ,awn: 15 grin. 1S min. 15 mih. ~ 15 main, clrang~ i,r Reading (itr-ltll: 3 ~o a a o l?9ss/Fad 'I9rreshold or ntetya: ~f- 0.002" +1- OA02" *I- 0.003" +f_ 0.00 " Test)l~srrlt: as sensor remavcd for testing? ~ Yes Q ivo DNA Yes ~ No DNA ~Na ~ NA Jib Ye~ ~ Yes ^ No ^ NA WA5 SenSbr ptvP~S' r~1laCed and ,~_ ~•etit"ied fanctiarrai after testir~? E~ Yes C~ Na 1~ HU4 ~ Yes ©Pb ^ tjlA ~ Yes ^ Ab ^ IYA ®'Yes ^ No Q NA Ctnarrnents - (m UDC 3,•4 F~~ 'ori opt r~irs m~c~prior xo tr~trrt~ a»d rernmmendc~d_~Ilow-ups Ibly will need to remove Dispenser for re lec~:g} ~ If the entirr dept!( aFthe UDC is not tested. speeiFr lbw march v4as bested. if the ansttier to ~ of the questions indicated pith as astcxisk ('-') is "NV" or "NA". fire entire UDC ~tst be tested- {See S11~VRCB LC~lbo) 12!13/2005 10:47 9094767114 SHIRLEV ENVIRONMENTL PAGE 07/09 SWRCB January, 2042 Page of 7. [INbER-DISPEI+lSER CONTAINMENT (LTDC) TESTIlYG fob #' T702813? Test Method Developed Hy: ~p LtbC 11r1arnxfach~rn~r ®hrdustrr- Standard ®Prafessiorn~f Engineer Other (Slaacr.' fi.1 Test Method Used: ~PresKtrte p^ Vacrmrtr ©Hydrostatit: Other (Specify! 'l>;rst ~~ment ~~~ Incon TS-S TS Eq~ ~~~= +/- O.OQ2 Inches UDC # 9!10 UDC # UDC # U1DC # UDC Manufacturer. TaRal Containment ~~.,,^.^. U}]C Material: Fibe lass UDC Depth 3~" Heaghi from [JDC Bottom to Top of FTi rest Piping Penetration: i2" w HeigU:t fzo~aa UAC Haltom to ~,~ Lowest 1leeetacal Penetratian~ Candilion of UDC prior ro pair testing: Portion of C est 2" above 1 e Does turbiaoe shut dorva n~en t7bC seasar detects liquid (bath ^ Yes ^ Na ~i NA ^ Yes ^ No ^ NA ^ Y~ ^ hln ^ NA ^'fes ^ Pb ^ Nal roduct aped watez)?~ 'Itirrbine slz4tdo`ru response linos N!A Ts system ptag~arrnrrod for fail safie slBrtdontt?~ ^ Yes ^ No ~ NA ^ Yes C] No Q NA ' ^ Yes ^ Ab ^ NA ^ lfes ^ No (~ NA Was fail-salts zee 'died to be ~ ©Yes G] No ®NA ^ Yes ^ Ncy ^ NA ^ Yps ^ Na ©NA ^ lies ^ No [I NA opettttiolbal? wait brae between apph~ing . p~.sru~ehacunm~naterarrd 30 Minn staxtinigtest Test Stax# Tune: - 1~;g 8 P Initial Reading ~~~ 4.G70$l4.ti 09 'l'est Ruud Tinne: 12:171'MJ12:33 ISM Pins! Reading (Rr}: 4~5709l4.1i709 Test }anratipln: 1 S min. ' Cltau~e in Reading (Rx-Ri): + _ 1?ass/Faii Tlueslrold or Coterie: +!- t).QQ2" Test Resnlt: ~ ,~ ~ ~ ~ i , .. ~ ~"". Was seASOr rernp~-et1 for to ~ Yes ~ No ^ NA ^ Yes p No ^ NA ^ Yes ^ INa ^ NA p 1'es ^ PIo ^ IYA Was sensor pn-perk- replaced aad ~•er~ed frurctio.nal 8fter testing'? ~I Yes ^ No ^ NA ^ Yes ^ Na ^ NA ^ Yes [] Na ^ tr1A ^ ti'es (~ No ^ NA Cornment~ ~- (iitCl7idC 17~nrmOtf077 oie rtipnirs,arnde prr'or r~ tesri,~g, and rerntunaertded,iFirlmr--up far,failed rest,.} e ff the entire depth of the UDC is not tested. spec+fr Iron ytroc:Ti nos tested. ff the a~asnez tv i~ t!f the quegtio~4 indic~#ed ~~itlr an asterisk (*) is "NO" ar NA' . the cntine UbC zrnst be tested. (See SWRGB LG•I.GO) 12/13!2005 10:47 SWRC:1~ ]snooty, 2(aQZ 9094767114 SHIRLEV ENVIRONMENTL PAGE 08/09 Page oi' _ 4_ SPiI~L1~VERF1CLlL CUNTA[NMENT BUXLS 'I°~ ~: TT 02$937 Faalin~ is Not Equipped With Spill/t)verfill t,,o»taituncnt Bogies ^ 5pi1V(h~erFill Contai~unexrt Doves arc Present. bnt mere Nat TestEd 'i~stMethod Dcvclopcd By_ ®Spill Bucher Man~ufacinrer ®IAdnslzl St~-ndard ~Pt+ofessiava[ Engineer ~,7 Uther (5pecifi~) _ TestMsthod Used; p~ P~ssane p~ Vacaunn ~1is~drastatic ©4tbeT f,S~ci,,~v) TestEgnipmeat Used: Incvn TS STS ~~~~ +/- D.OOZ inches. Spiff Boa # 87 SpOI lae~ # $9 5p~ Boa # 91 S1;~ill Bea ~# BncletDiameter.: 12" 1Z" 12" . Bucloct Deptlt: 1 Z," 12" 12" Walt tittt¢ betwccn applging pressvieh~acumd~~atesand • Rt~t~ , 30 Mln 30 Mm SO Evliin Test Statt'i'~e: x:36 PMM:52 PM 4:50 PMf$:06 PM 3:35 RM13:S1 PM TAiti~~ Riding (R~: 3,0170!3.0168 A~A~$f4~4~34 4.8$9414.$$95 Tcst End Time: 1:s1 PMIZ:07 PM 5:06 PMlS:Z1 PM 3:50 PM14:D6 PM Final Reading (1L~): 3.0168l3A16$ 4A233t4.4239 4.889514.8896 Test Duration: 15 Min 15 .Min 15 lUlin Change inReadin~ (Rx-~): ,,D00210.0000 +.0005!+.0005 +,000'EItAp01 >?ass/k'Ail, 'Lhn:sltoM or Crxtctia; TBS~ISG$~ii +!- 0.002" i..~~ .~ 'a...~eyw_ +1- D.OOZ" s ~ r .„.wv:s~w ,lan.~®~I~ ~:..s~n4~ +/- 0.002'• .xo~r ~e~lw_;: ~ nr~ s T~ i~.a~rrrm:rNC.,.'. ~N s ~prnments •- (irrclrtde in~prnrurian on repairs rr~rrcle print to t¢stin~;, mrd l~co-~rniencled_follm~~-trp fvr fafl~ tells) 12/13/2005 10:47 SWRCB January, 21102 9094767114 SHIRLEV ENVIRONMENTL S. FILL Ri.S'13t C~QNTAYNMTr;NT SUMP 7'E.~77N[~ Job #: PAGE 09!09 Pegs of T7 02137 Teei.lih is Not u' ed With FillRiaerCor~#aintxient Suna~F ; Till Miser C'ontritimcitt Sumps are Present, but were Tot Tented TestMu~od Developed By: ~,9ttnop Mant]ft~ottmr ®Induslrt• Standard pQI'mfessio,nal ~tl8meer © other ~sp~~;~~1 TestA~Ie'd~od Used; ~Eressuce ~Vacnunl ~H~~drastatic Other rspeci,~~1 Testlgniptpeut.Uwd; Incon TS~,T S ~fp~nt 1;tesolutioa: ~-- t1,Qi12 Inches X111 Sum # 1!"~Il Snm # )hill Sum # Fill Scapa # Su Diameter: 52" 62" 52" 5n De the 48" 48" 48" Height #'m rn Tan!;, ~'np to Top of ' ~„ 22" 2Z" Hi st . in Pctxel:ration: IleightfmmT.wlcToptoLotir~est Electrical Penetratiot}' ~~~ Z3" ~*~ Gnnditipu. of. sump praor to Fair Fair Fair testin : Por(idn of Su Tested 2" above i 2" above i 2" above i ,Stt Material: Fibe lass Fibe lass 1=iibe lass Wait timie behti~en apply lag piessvre%acuumh~atar and 30 Mins ~ 30 Mins 30 Mins stn test: Test:itart Tim: 1:36 PIiA11:~i2 PM 1:36 PM11:52 PM 1:36 PM11:62 PM Initial Read' 1.792811.7926 3.309513.3106 4,674814.8745 TestEnd Time: 1:51 P1f11,2.07 PAS 1:51 PM12;(tT PM 7:51 PM12:07 PM Final Readm. (RF): 1.792611.7924 3.3104/3.3121 4.874614.6746 Test duration: 15 min. 15 min. 15 min_ Chan a iu Kendra (~-~): .r, t i Thre9,bOld pt' [:.'feria: a9S P ~F ai t +. O.Q02" t(. 11.002° fit- Q.00 " T T ` y ~l ~'i l~cgu~ ~ 'N' ~ F .r".' 4:' w: y~' ~ nT . Is there a segsvr in the su, , a7 YES ©NO YeS ^ NO YES Q NO Yes ^ N0 Dies the sensor alarm when eith¢rproduct or tE~atcr is ^ Yes ^ Alo ®NA ^ Yes ^ No ®I+IA ^ Yes ^ i+b ®NA ^ Yes D No ^ MA detected? Was sensarremnved for testis '? ®YQs ^ idn ^ NA {~ Yes ^ Irlb ^ IIFA ~ Yes ^ tiln ^ NA ^ Yes ^ No ©NA WaF sensorprorerly replaced cad verified #i~nctionalafterte&tiua: , ~ Yes ^ hb ^ NA ~ Yes ^ No ^ NA ~ Yes Q No ^ NA ^ Yes ^ lyo ['~ NA CDmrme>nts - lirtclude irt~oreralion an repairs made prior 70 le,sfnrg, onci recvmnre»ded follaiva~p,forfarled rests) _~; VONS 2512 X3'11 Manager CHERYL FRYE Location: 2100 WHITE LN City BAKERSFIELD CommCode: BFD STA 05 EPA Numb: SiteID: 015-021-001217 BusPhone: (661) 396-2344 Map 124 CommHaz High Grid: 18C FacUnits: 1 AOV: SIC Code:5541 DunnBrad:009137209 Emergency Contact / Title Emergency Contact / Title CHERYL FRYE / STORE MANAGER LOSS PREVENTION / MANAGER Business Phone: (661) 396-2344x Business Phone: (626) 821-7545x 24-Hour Phone (626) 821-7545x 24-Hour Phone (626} 821-7545x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire Press React ImmHlth DelHlth Contact GILBARCO INC - CMS Phone: (303) 986-8011x MailAddr: PO BOX 22087 MAIL STOP F76 State: NC City GREENSBOROUGH Zip 27420 Owner GILBARCO INC - CMS Phone: (303),986-8011x Address PO BOX 22087 MAIL STOP F76 State: NC City GREENSBOROUGH Zip 27420 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG C - AA COMM HOOD ~~ro ~ U N ~ 3 ~QU7 PROG U - UST Qased on my inquiry of thosz individuals responsible for obtaining the information, I certify ~~ under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and co~m/~plete. naturF Date -1- 05/18/2007 F VONS 2512 Last Action Type: SiteID: 015-021-001217 ~ STORAGE CONTAINER DATA (UST FORM A) Business Name: VONS 2512 Cross Street FACILITY/SITE INFORMATION Business Type: Org Type: Total Tanks 3 IndnRes/Trust: No PA Contact: Dsg Own/Oper CINDY PATERSON ICC Nbr: 5243667-UC PROPERTY OWNER INFORMATION Name LOSS PREVENTION Phone: (626) 821-7545x Address: City State: Zip: Type TANK OWNER INFORMATION Name LOSS PREVENTION Address: City Type BOE UST Fee# Financ'1 Resp: SELF INSURED Legal Notif Date:09/02/2002 Name:TANK OWNER State UST # Phone: (626) 821-7545x State: Zip: Phone: (816) 281- Ttl:AUTHORIZED AGENT 1998 Upg Cert#: x -2- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Hazmat Inventory By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP LAWN CARE/FERTILIZERS E IH DH S 15.00 LBS Ext BLEACH R IH L 700.00 GAL Hi AEROSOLS E F P L 250.00 GAL Hi AQUA CHEM E R IH L 166.00 GAL Hi STRIPPER IH L 50.00 GAL Hi BREAK UP F IH L 40.00 GAL Hi POOL CHLORINE (HYPOCHLORITE) R IH L 20.00 GAL Hi POOL ACID E F R IH DH L 15:00 GAL Hi REGULAR UNLEADED F IH DH L 20000.00 GAL Mod MIDGRADE UNLEADED GASOLINE F IH DH L 20000.00 GAL Mod PREMIUM UNLEADED F IH DH L 10000.00 GAL Mod INSTANT LITE BRIQUETTES/LOGS F S 2000.00 LBS Mod POWDER BLEACH F IH DH S 1500.00 LBS Mod DRY CHLORINE R IH DH S 250.00 LBS Mod ALL PURPOSE CLEANERS F IH DH L 150.00 GAL Mod LYSOL IH DH L 100.00 GAL Mod CHARCOAL LIGHTER FLUID F IH DH L 70.00 GAL Mod SCANNER CLEANER F DH L 25.00 GAL Mod ALGACIDE F R IH DH L 20.00 GAL Mod FREON R22 P IH G 3000.00 FT3 Low ANTIFREEZE DH L 60.00 GAL Low MAINTEX WAX IH DH L 50.00. GAL Low INSECTICIDE (SOLID) F IH S 35.00 LBS Low SODA ASH F IH S 10.00 LBS Low CARBON DIOXIDE F P IH G 500.00 FT3 Min HELIUM P IH G 500.00 FT3 Min MOTOR OIL F DH L 75.00 GAL Min CHARCOAL BRIQUETTES F S 4600.00 LBS UnR INSECTICIDES F IH DH L 55.00 GAL UnR WASTE WATER/FUEL MIXTURES F DH L 55.00 GAL UnR -3- 05/18/2007 -4- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0012 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME LAWN CARE/FERTILIZERS Days On Site 365 Location within this Facility Unit Map: Grid: AISLE CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~mbient ~ Ambient BOX AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average LBS 15.00 LBS 7.00 LBS riAGF~KLVUJ 1:V1~lYV1VL"1V1J ~Wt. RS CAS# 11.00 Dichlorophenoxyacetic Acid No 94757 12.00 Dimethylamine Yes 124403 8.00 Nitrogen No 7727379 riHL+t-1KL t1JJ~JJ1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Ext ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 6/BACKROOM CAS# 7681-52-9 Liquid TMixture ~mbient~E ~ AmbientT~E ~PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 700.00 GAL 240.00 GAL I1LiGtittLVUA l.Vl°lYV1Vr,1V1J owt. Rs cAS# 100.00 Bleach No 7681529 I1HGHiCL liJJ~J.71~1~1V 1 iJ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi -5- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0013 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME AEROSOLS Days On Site 365 Location within this Facility Unit Map: Grid: THROUGHOUT BLDG CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid T Mixture ~mbient ~ Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 250.00 GAL 200.00 GAL /"i /~T RT1 /~TTTITTT A I11iGHICLV U.7 1.V1~lYV1VL~1V 1 .7 ' oWt. RS CAS# 70.00 Isobutane Yes 75285 20.00 n-Butane Or Butane Mixture Yes 106978 10.00 Propane Yes 74986 riAG1iK1J AS~L~~1~1t;1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P / / / Hi ~ Inventory Item 0003 COMMON NAME / CHEMICAL NAME AQUA CHEM Location within this Facility Unit Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# STATE TYPE PRESSURE Liquid. TMixtur~mbient TEMPERATURE CONTAINER TYPE Ambient ~STIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 166.00 GAL 100.00 GAL ruyc'ru~LV l~ a ~.vllrviv lJly t J ~Wt. RS CAS# 100.00 Muriatic Acid Yes 7647010 l1HGtitCL tia JP~.7.71~1P~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi -6- 05/18/2007 _ _ i F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0020 Facility Unit: Fixed Containers on Site ~ i COMMON NAME / CHEMICAL NAME STRIPPER Days On Site 365 Location within this Facility Unit Map: Grid: BACKROOM CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture =Ambient Ambient PLASTIC CONTAINER I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 50.00 GAL 20.00 GAL ' HAGAKJJUU~ C:UMYUN~N'1'S °sWt. RS CAS# Ethoxylated Nonylphenol No 0 2-Butoxyethanol No 111762 Ethanolamines (family name) No 141435 t1E~GEIKL 1-~aJ~~~1~1~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH / / / Hi ~ Inventory Item 0023 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME BREAK UP Days On Site 365 Location within this Facility Unit Map: Grid: BACKROOM CTR CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 40.00 GAL 10.00 GAL I1HG1-1.[CLVU.7 l.Vl`7YV1V1~,1V1.7 %Wt. RS CAS# 2.00 Potassium No 7440097 2.00 Ethylene Glycol Monobutyl Ether No 111762 7.00 Tetrapotassium Pyrophosphate No 7320345 11HGEitCLJ 1-~J ~~J~I°1~1V 1 7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / Hi -7- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0014 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME POOL CHLORINE (HYPOCHLORITE) Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 16/HABA BACKROOM CAS# 7681529 Liquid TMixtur~ Ambient~E ~ AmbientT~E ~PLASTICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 20.00 GAL 12.00 GAL tiHGHKLVU~ 1.U1~lYV1V~1V1J %Wt. RS CAS# 11.00 Sodium Hypochlorite No .7681529 t1E'~GH.KL 1-~,~JI;JJL~11;1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH / / / Hi ~ Inventory Item 0016 COMMON NAME / CHEMICAL NAME POOL ACID Location within this Facility Unit AISLE 6/HABA BACKROOM Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# Liquid TMixture ~ AmbRent~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 15.00 GAL 10.00 GAL r L11iGKRLVUJ COMPONENTS oWt. RS CAS# 34.00 Phosphoric Acid No 7664382 32.00 Hydrochloric Acid Yes 7647010 I1tiGt1RL Y~ J AP~.7.71"1P~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Hi -8- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0027 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME REGULAR UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 Liquid TMixtur~ Ambient~E ~ AmbientT~E UNDER GROIINDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 20000.00 GAL 20000.00 GAL 20000.00 GAL - til-~GKKLUU~ 1:U1~lYV1V1;1V1J -- oWt. RS CAS# 100.00 Gasoline No 8006619 t1AGEitCL A5 ~L' ~ ~1~1L' 1V 1 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0029 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MIDGRADE UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: CAS# 8006-61-9 Liquid TYPE PRESSURE TEMPERATURE CONTAINER TYPE TMixtur~ Ambient ~ Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 20000.00 GAL 20000.00 GAL 20000.00 GAL - ruic~rucLVU~ ~vi~lrvsvl,ivta °sWt . RS CAS# 100.00 Gasoline No 8006619 t1.L~GL-1KL 1-1J w7~JD1~1L"1V1~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA. USDOT# MCP No No No No/ Curies F IH DH / / / Mod -9- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0028 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: CAS# • 8006-61-9 Liquid TMixture T Ambient~E ~ AmbientT~E UNDER GROIUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 10000.00 GAL rlt~~titu~~ua wlnr~lv~lvl~ %Wt. RS CAS# 100.00 Gasoline No 8006619 riAGKKL A55L'~551~1J;1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards •NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME INSTANT LITE BRIQUETTES/LOGS Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 16/BACKROOM CAS# ~SolidE TMixture ~ Ambient~E ~ AmbientTURE BAG CONTAINER TYPE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average LBS_ 2000.00 LBS 1000.00 LBS ilL~iGlitCLVU.7 l..Vl"lYV1VL' 1V 15 %Wt. RS CAS# 25.00 Mineral Spirits No 8030306 nxc~tucl~ r-»ar,~al~inlvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / Mod -10- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0009 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME POWDER BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 6/BACKROOM ~ CAS# 497198 ~SolidE I Mixture~~ PRESSURE TEMPERATURE CONTAINER TYPE I Ambient ~ Ambient BOX AMOUNTS AT THIS LOCATION Largest ContainerLBS Daily1500100m LBS I Daily AOOr00e LBS rua~tL:cLVU~ ~vi~irvlv~ly l5 owt. Rs cAS# Sodium Carbonate No 497198 Sodium Perborate No 7632044 t11~iG1-1ttL Haa~aa1~1~1V1J TSecret RS BioHaz Radioactive/Amount EPA'Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0015 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME DRY CHLORINE Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 16/HABA BACKR.OOM CAS# ~SolidE TMixture ~ AmbRient~E ~ AmbientT~E ~PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average LBS 250.00 LBS 200.00 LBS ZARDO S 1~ U COMPONENTS ~Wt. RS CAS# Sodium Dichloro-s-triazinetrione No 2893789 Calcium Hypochlorite No 7778543 rLtiL~tiRL tiJ Jl'.iJ J1•li'ilV1J - TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies R IH DH / / / Mod -11- 05/18/2007 i F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0010 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ALL PURPOSE CLEANERS Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 5 CAS# Liquid TMixtur~Ambient~E ~ AmbientT~E -~STICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 150.00 GAL 90.00 GAL nx~tittLw~ ~:Ulnrvlv~ly t S °sWt. RS CAS# 7.00 2-Butoxyethanol No 111762 ru~c~t~tcL s-~aa~~al~ir,iv 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0006 COMMON NAME / CHEMICAL NAME LYSOL Location within this Facility Unit AISLE 7 STATE TYPE PRESSURE Liquid ~Mixtur~mbient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 7757-82-6 TEMPERATURE ~~ CONTAINER TYPE I' Ambient i PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 100.00 GAL 85.00 GAL I1HGEiiCLVU.7 ~.U1~lYUlVL"1V1~ ~Wt. RS CAS# 79.00 Ethyl Alcohol No 64175 I11-~GKRL Ha 7~7L' .7.7P7L' 1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Mod -12- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0024 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CHARCOAL LIGHTER FLUID Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 16/BACKROOM CAS# 800-66-42 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 70.00 GAL 30.00 GAL t1HGE~KL V U .7 lL V l~lr V1V L' 1V 1 b oWt. RS CAS# 100.00 Naphtha No 8030306 riEiGHKL L~JJr,JJ1~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0022 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME, SCANNER CLEANER Days On Site 365 Location within this Facility Unit Map: Grid: BACKROOM CTR CAS# STATE TYPE ~~ PRESSURE TEMPERATURE T CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 25.00 GAL 18.00 GAL nr~~rsL~LVUa ~.vrirvivr,ivlS oWt. RS CAS# Isopropanol No 67630 Ethylene Glycol Diethyl Ether No 629141 I1tiL~tiiCL tiw 7 J L' J ~J L~11.,LV 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod -13- 05/18/2007 STATE TYPE PRESSURE TEMPERATURE ~ CONTAINER TYPE Liquid TMixture ~ Ambient ~ Ambient -I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 20.00 GAL 12.00 GAL •'1 t1HGH.tCLVU~J LV1~lYV1V~1Vla %Wt. RS CAS# 10.00 Alkyl Dimethylbenzylammonium Chloride No 8001545 2.00 Ethanol No 64175 6.00 Polyoxyethylene No 25322683 t11~GL~iCL A~ aL' J J1~1J;1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F R IH DH / / / Mod ~ Inventory Item 0026 COMMON NAME / CHEMICAL NAME FREON R22 Location within this Facility Unit Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 75-45-6 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure ~-Above Ambient Ambient OTHER - SPECIFY AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average FT3 3000.00 FT3 3000.00 FT3 I1tiGt1RLVU~J ~.V1~lYV1V ~1V 1.7 oWt. RS CAS# 100.00 Chlorodifluoromethane No 75456 11tiG1~tCL Ljw 7w7~.7.71"1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P IH / / / Low -14- 05/18/2007 ~ F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0017 Facility Unit: Fixed Containers on Site ~ ...,.....,.~~ ..,,.,~ ~ ,..,r,.,r~„r „r,,,r ___ F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 8 ~ CAS# 107-21-1 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid TMixture~-Ambient ~ Ambient ~ PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 60.00 GAL 30.00 GAL ---- t11~GKKLVUa 1.V1~lYV1VL"1V15 %Wt. RS CAS# 100.00 Ethylene Glycol No 107211 rlti~titu~ tiaa~~aln~lyl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies DH / / / Low ~ Inventory Item 0019 COMMON NAME / CHEMICAL NAME MAINTEX WAX Location within this Facility Unit BACKROOM CTR Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# Liquid TMixture~mbRent~E ~ AmbientT~E ~ PLASTOICTCONTAINERE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 50.00 GAL 30.00 GAL I11iGL-i1CLVUJ l.Vl"lYV1V 2S1V1J %Wt. RS CAS# Ethylene Glycol Diethyl Ether No 629141 Ethylene Glycol No 107211 11tiGEiiCL 11. 7.7L~.7J1°1P~1V 1 ~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies IH DH / / / Low -15- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0011 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDE (SOLID) Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 5 CAS# 67-63-0 ~SolidE I" Mixture~~ PRESSURE TEMPERATURE ~~ CONTAINER TYPE I Ambient ~ Ambient I PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average LBS 35.00 LBS 25.00 LBS HAZARDOUS COMPONENTS oWt. RS CAS# 4.00 Metaldehyde No 9002919 95.00 Boric Acid No 10043353 t1AGHKIJ H5~1"~55iY11"~1V 1-5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / Low ~ Inventory Item 0018 COMMON NAME / CHEMICAL NAME SODA ASH Location within this Facility Unit AISLE 16 STATE TYPE PRESSURE Solid PureAmbient Facility Unit: Fixed Containers on Site ~ Days On Site 365 Map: Grid: CAS# 497-19-8 TEMPERATURE CONTAINER TYPE Ambient BAG AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average LBS _ 10.00 LBS 6.00 LBS L11iGL-liCLVUJ L.vl•1rv1vP~1v1.S %Wt. RS CAS# 100.00 Sodium Carbonate No r 497198 - -- 11tiGEiiCL HJ JP..,JJ1"1P~1V 1 J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / Low -16- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0021 Facility Unit: Fixed Containers on Site ~ MM HEM NAME CO ON NAME / C ICAL CARBON DIOXIDE Days On Site 365 i id ty Unit Location within this Facil Map: Gr : SERVICE DELI CAS# 124-38-9 STATE T TYPE ~GaS I Pure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE PORT. PRESS. CYLINDER AMOUNTS AT THIS LOCATION - Largest Container Daily Maximum Daily Average FT3 500.00 FT3 250.00 FT3 t1E1GE~KLVUJ 1~V1~lYV1V~1V1J %Wt. RS CAS# 100.00 Carbon Dioxide No 124389 t1HGHKL 1'~JJI;JJI~1J~J1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0025 Facility Unit:. Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME HELIUM Days On Site 365 . L ati ithi ilit thi F it U M id G oc on w n ac y n s ap: r : FLORAL DEPT CAS## 7440-59-7 ~GasATE TYPE TPure PRESSURE Above Ambient TEMPERATURE Ambient CONTAINER TYPE ~ PORT. PRESS. CYLINDER I AMOUNTS AT THIS LOCATION Largest ContainerFT3 Daily 500100m FT3 I Daily 500r00e FT3 11KGHKLVUJ L.V1~lYV1V~1V 1.7 %Wt. RS CAS# 100.00 Helium No 7440597 I11iGHKL t]J .71;~JJ1~11;1V-1~7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies P IH / / / Min -17- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME MOTOR OIL Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 5 CAS# 64742-54-7 Liquid Mixture PRESSURE TEMPERATURE CONTAINER TYPE T ~ Ambient ~ Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 75.00 GAL 20.00 GAL r~ZARDOUS COMPONENTS %Wt. RS CAS# 100.00 Motor Oil, Petroleum Based No 8020835 t1HGHKL 1'~.7J~~51~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Min ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CHARCOAL BRIQUETTES Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 16/BACKROOM CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Solid TMixture ~ Ambient ~ Ambient BAG AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average LBS 4600.00 LBS 2000.00 LBS HAZARDOUS COMPONENTS , %Wt. RSA CAS# HAZARD AS SESSMENl~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F / / / UnR -18- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME INSECTICIDES Days On Site 365 Location within this Facility Unit Map: Grid: AISLE 5 CAS# 67-63-0 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 55.00 GAL 1 40.00 GAL r1t~Ltuc.uvua ~:vl~ir~iv~ivla %Wt. RS CAS# 100.00 Insecticides No 0 r1ti~.ytcL r~~a~a~l~ilJlvla TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No Noj Curies F IH DH / / j UnR ~ Inventory Item 0030 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE WATER/FUEL MIXTURES Days On Site 365 Location within this Facility Unit Map: Grid: CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Liquid TWaste Ambient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GAL 55.00 GAL 55.00 GAL HAZARDOUS COMPONENTS r owt. RSA CAS# riL-~GHCCIJ 1-x.7 ~J L" .7 ~71~11;1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / UnR -19- 05/18/2007 F VONS 2512 SitelD: 015-021-001217 Fast Format ~ Notif./Evacuation/Medical Overall Site ~ Agency Notification 04/19/2006 IN THE EVENT OF A SPILL, THE ATTENDANT AND THE SITE MANAGER ARE INSTRUCTED TI IMMEDIATELY NOTIFY ALL POLICE, FIRE, HAZARDOUS MATERIALS, UTILITY, AND VONS ENVIRONMENTAL PERSONNEL. IN THE EVENT OF A SPILL, THE KIOSK AREA WILL BE SECURED AND ALL AGENCIES WILL BE CONTACTED FROM THE EXISTING VONS MARKET BUILDING. FOR NON-EMERGENCY SPILLS, THE BAKERSFIELD FIRE DEPT 326-3979 WILL BE CONTACTED ALONG WITH ALL FUEL AND ENVIRONMENTAL PERSONNEL FROM VONS. A PRE-APPROVED CLEAN-UP CONTRACTOR WILL ALSO BE CONTACTED FOR CLEAN UP PURPOSES. IN THE EVENT OF AN EMERGENCY SPILL, THE OFFICE OF EMERGENCY SERVICES AND 911 WILL BE CONTACTED. SCOTT MILLER (VON FUEL PROGRAMS MANAGER 626-821-7781) IS TO BE CONTACTED AT ONCE. GAS, WATER, AND ELECTRICAL UTILITY COMPANIES WILL ALSO BE CONTACTED. A PRE-APPROVED HAZARDOUS MATERIALS MAINTENANCE CLEAN-UP COMPANY WILL ALSO BE SUMMONED TO THE SPILL. 9 Employee Notif./Evacuation 04/19/2006 THE INITIAL RESPONSIBILITY TO CONTACT THE APPROPRIATE AGENCIES LIES WITH THE KIOSK ATTENDANT AND THE SITE MANAGER. IT WILL BE THEIR RESPONSIBLITY TO NOTIFY VONS CORPORATE AND TO CONTACT THE CLEAN-UP CONTRACTOR AND EQUIPMENT MAINTENANCE CONTRACTOR. ONCE THE INITIAL CONTACTS ARE MADE AND SCOTT MILLER HAS HAD AN OPPORTUNITY TO ARRIVE AT THE SITE, HE WILL ASSUME ALL RESPONSIBLITIES TO CARRY THROUGH WITH THE CLEAN-UP-AND RESTART PROGRAM. THE FUEL PROGRAMS MANAGER WILL VERIFY AND APPROVE ALL CLEAN-UP ACTIVITY, EQUIPMENT REPLACEMENT, AND SYSTEM RESTART PROCEDURES. ALL NECESSARY PAPERWORK AND FORMS REPORTING THE SPILL AND VERIFY THE CONTAINMENT AND CLEAN-UP WILL BE PRODUCED AND SUPERVISED BY THE VONS FUEL PROGRAM MANAGER. Public Notif./Evacuation 04/27/1999 MANAGER ON DUTY WILL HANDLE PUBLIC EVACUATION IN THE SAME WAY AS EMPLOYEES. -20- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Emergency Medical Plan 04/19/2006 ~ IN THE EVENT OF A SPILL, THE FUEL CENTER FACILITY WILL BE SECURED AND ALL REMAINING PERSONS EVACUATED. A PREDETERMINED MEETING LOCATION WILL BE ESTABLISHED AND ALL PERSONS WILL GATHER AT THIS LOCATION. IN THE EVENT A MEDICAL INCIDENT HAS OCCURRED, THE FIRST PHASE OF MEDICAL ATTENTION WILL COME FROM THE LOCAL FIRE DEPARTMENT PARAMEDICS AND AMBULANCE CORE. ALL PERSONS INVOLVED IN THE MEDICAL EMERGENCY WILL BE MOVED TO A SAFE LOCATION, IF POSSIBLE. THE AREA NEAR AND ADJACENT TO THE MEDICAL EMERGENCY WILL BE SECURED AND PROTECTED IF THE PERSON CANNOT BE MOVED. BASED ON EMERGENCY ROOM ACTIVITY, THE PARAMEDICS WILL PRESCRIBE THE CLOSEST AND FASTEST ROUTE TO A FOLLOW-UP MEDICAL FACILITY. -21- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 04/19/2006 THE DESIGN AND CONSTRUCTION OF THE FUEL CENTER WAS COMPLETED TO INCLUDE ALL OF THE LATEST STATE-OF-THE-ART SAFETY MEASURES AND DEVICES. ALL TANKS AND PRODUCT PIPING ARE DOUBLE-WALL AND ARE PROVIDED WITH SECONDARY CONTAINMENT. ALL TANKS AND DISPENSERS ARE PROVIDED WITH EMERGENCY SHUT-OFF VALVES AND SENSORS TO IMMEDIATELY SHUT DOWN THE SYSTEM IN THE EVENT OF AN EMERGENCY OR SPILL. EMERGENCY SHUT-OFF SWITCHES ARE PROVIDED IN THE STORE AND NEAR THE DISPENSERS. ALL NECESSARY SAFETY EQUIPMENT HAS BEEN PROVIDED FOR THE SAFE TRANSFER AND DISPENSING OF FUEL. BREAKWAY NOZZLES HAVE ALSO BEEN INCORPORATED INTO THE CONSTRUCTION OF THE PROJECT. 9 Release Containment 04/19/2006 IN THE EVENT OF A SPILL, THE FIRST ACTION TAKEN IS TO SECURE THE FUEL CENTER AND PROHIBIT ANY FURTHER FUELING ACTIVITY. THE ENTIRE FUEL SYSTEM AND UTILITIES ARE SHUT OFF AND ALL PERSONS ON THE SITE ARE ESCORTED TO THE EVACUATION MEETING POINT. ONCE ALL PERSONS HAVE BEEN ACCOUNTED FOR THE SITE MANAGER OR ATTENDANT WILL UTILIZE THE ONSITE HAZARDOUS MATERIALS CLEAN-UP KIT TO MAINTAIN THE SPILL IN AS SMALL AN AREA AS POSSIBLE. APPROVED MATERIALS WILL BE USED TO CONTROL THE SPILL AREA AND TO PROTECT AGAINST ANY FURTHER EXPOSURE. THE ATTENDANT WILL CONTACT THE PRE-APPROVED HAZARDOUS WASTE CLEAN-UP OR MAINTENANCE CONTRACTOR WHO WILL BE RESPONSIBLE FOR THE MAJORITY OF THE CLEAN UP AND THE DISPOSAL OF ALL SPILL AND CLEAN-UP MATERIALS. AT THE CONCLUSION OF THE CLEAN-UP, THE ATTENDANT WILL PREPARE A Clean Up 04/19/2006 IN THE CASE OF A SMALL SPILL, THE ENTIRE FUEL SYSTEM WILL BE SHUT OFF AND THE ATTENDANT WILL UTILIZE A SPILL CONTAINMENT AND CLEAN-UP KIT 'I'O CONTAIN AND SECURE THE SPILL. ALL CLEAN-UP ACTIVITY WILL UTILIZE DRY MATERIALS THAT WILL BE PROPERLY CARED FOR AFTER USE UNTIL THEY ARE PROPERLY DISPOSED OF BY THE HAZARDOUS WASTE DISPOSAL CONTRACTOR. IN THE EVENT OF A MAJOR SPILL, THE FUEL SYSTEMS IS IMMEDIATELY SHUT OFF AS ARE ALL UTILITIES. THE ATTENDANT WILL SECURE THE PROPERTY AND FUELING AREAS AND WILL THEN CONTACT A LOCAL PRE-APPROVED HAZARDOUS MATERIALS CLEAN-UP AND MAINTENANCE CONTRACTOR. THIS CONTRACTOR WILL BE RESPONSIBLE FOR COMPLETE CLEAN-UP OF THE SPILL. -22- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Other Resource Activation -23- 05/18/2007 F VONS 2512 SiteID: 015-021-001217 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ especial tiazaras Utility Shut-Offs 04/19/2006 A) GAS - BACK DOOR B) ELECTRICAL - NE CRNR BLDG INSIDE C) WATER - NW CRNR BLDG D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AND SPRINKLERS. FIRE HYDRANT - EACH CRNR OF BLDG AND MIDWAY IN FRONT OF BLDG 5. 01/17/2007 Building Occupancy Level 04/03/2006 75 EMPLOYEES -24- 05/18/2007 ~, F VONS 2512 SiteID: 015-021-001217 ~ Fast Format ~ ~ Training Overall Site ~ Employee Training 01/17/2007 MATERIAL SAFETY DATA SHEETS ON FILE IN MANAGERS OFFICE. BRIEF SUMMARY OF TRAINING PROGRAM: NEW EMPLOYEE TRAINING IS CONDUCTED AT THE TIME OF ORIENTATION. REFRESHER TRAININGS ARE CONDUCTED AS REQUIRED AND RECORDS ARE MAINTAINED. EMERGENCY PROCEDURES ARE REVIEWED PERIODICALLY AND UPDATED AS NECESSARY. rcayc ~ Held for Future Use azc~.u iii ru~.uiC v5c -25- 05/18/2007