Loading...
HomeMy WebLinkAboutUNDERGROUND STORAGE TANK q ~, I} ~ ~ ~! ~ ~ ~; ~ ~ ~ ~II ~ t1~ ~~ ~ C~ ~. y ~ \j4 ~ ~1 ~ i. '~ ~'' '' ~ ~'" ~~ ",~ `;' i, ..' (UNDERGROUND STORAGE TANKS) - -- -- CHEVRON ' - 2525 WHITE LANE - l ,, x UNDERGROUND STORAGE TANKS "~: .=..i. .+.[.. _.,~....e.-..,..., ......~. ti ~ En:l~l, tiY.W:Uwc^W'iJUlAiAU,13i'JYT.YY'PNL'FJ?:L6ir^KAd~kY~'s.YriJi:.M.J 3~'i APi~LiCATIOIV 1-. TO PERFORM ELD I LINE TESTING / SB989 SECONDARY CONTAINMENT TESTING .. !TANK TIGHTNESS TEST AND TO PERFORM FUEL MONtTORlNG CERTIFICATION PERMiI" NO. ~ _~ O .3 ~ BAKERSFIELD FIRE DEPT. ~-,1R>i Prevention Services A~l,r ! 900 Truxtun Ave., Ste. 210 .~. Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661).852-2171 Page 1 of 1 ^ ENHANCED LEAK DETECTION ^ LINE TEST ^ S&989 SECONDARY CONTAINMENT TESTING n TANK TIGHTNESS TEST TO PERFORM FUEL MONITORING CERTIFICATION FACILITY NAME 8 PHONE NUMBER OF CONTACT PERSON ADDRESS 5 OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED IS PIPING GOING TO BE TESTED? ^ YES ^ NO TANK # V LUME CONTENTS 1 p OD ~ a ~n ono -~~ 3 v ooO TANK~TESTING COMPANY NAME OF~STIN COMPANY NAME 8 PHONE NUMBER OF CONTACT PERSON MAILING ADDRESS ~ V _ n /' Cam/ NAME 8. PHO NUMBER OF TESTER OR SPECIAL INSPECTOR C TIFICATION ##: DATE 8~ TIME TES TO BE CONDUCTED 0 ~ ~ ICC #: TEST METHOD SIGNATURE OF APPLIGIANT ~ DATE ~ APPROVED BY ~ ~ DATE FD 2095 (Rev. 09!05) ~~~.:SING & PERMIT STATEMENT ~~ERMIT IVO.: BAKERSFIELD FIRE DEPT. Prevention Services pfRt 900 Truxtun Avenue, Suite 210 ~Rrr r Bakersfield, CA 93301 . LOCATION OF P OJECT - • PRORERTY ER rr~~ V START"ING DATE COMPLETION Cji~TE % O~ _ , _ ^ .' _ ('~ COX Y ` NAME PROJECT NAME ~ s ~~ ADDRESS - PHONE N0. PROJECT AllDRESS CfTY^ ~ STATE LP C ~ . O CONTRACTO NAME CA LICENSE NO. TYPEOf LICENSE. EXPIRATION DATE PHONE N0. 2 CONTRACTOR CO NY E FAX NO. ~~ I ADDRESS i CITY ~ ZIPC E ~~ J ~ ~ ~ ^ Alarms -New & Modifications - (Minimum Charge) $262 50 ' ~ . 98 Over 20 000 Sq Ft Ft x 013125 =Permit fee Sq ~ ^ . , . . 98 ^ rinklers -New & Modifications - (Minimum Char e) S $210 00 ~ g p . 98 ^ Over 5 000 Sq Ft Ft x 042 =Permit fee Sq ~ , . . . 98 ^ Minor Sprinkler Modifications (< 10 heads) 00 [Inspection Only) $ 93 ~ . 98 ^ Commercial Hoods -New & Modifications $ 398 26 ~ . 98 ^ Additional Hoods $ 36 00 ~ . 98 ^ Spray Booths -New & Modifications $458 00 ~ . 98 ^ Aboveground Storage Tanks (Installation/Insp.-1~` Time) $165.00 82 ^ Additional Tanks $ 26.00 82 ^ Aboveground Storage Tanks (Remova/llnspection) $109.00 82 ^ Underground Storage Tanks (Installation./lnspedion) $878.00 (per tank) 82 ^ Underground Storage Tanks (Modification) $878.00 (persite) 82 ^ Underground Storage Tanks (Minor Modification) $155.00 82 ^ Underground Storage Tanks (Removan $675.00 (per tank) 84 ^ Oilwell (Installation) $ 72.00 ~ Mandated Leak Detection (Testi /Fuel Monit. Cert. $ 81.00 (per site) 82 ^ Tents $ 93.OQ (per tent) 84 ^ After hours inspection fee $122.00 &4 ^ Pyrotechnic - (Per event, Plus Insp. Fee @ $90 per hour) $ 60.00 + (5 hrs. min. stand -by fee /Inspection) _ $510.00 84 ^ RE-INSPECTION(S) /FOLLOW-UP INSPECTION(S) $ 93.00 (per hour) 84 ^ Portable LPG (Propane): NO.OF CAGES? $ 66.OQ 84 ^ Explosive Storage $249.00 ~ ^ Copying & File Research (File Research Fee $33.00 per hr) 25¢ per page ; 84 ^ Miscellaneous ; ~ FD 2021 (Rev. 09/05) F/RE ABTM f May 12, 2006 RONALD j. FRAZE FIRE CHIEF Mr. Raghida Najawi Gary Hutton, Najawi Chevron Senior Deputy Chief 2525 White Lane Administration ' Bakersfield, CA 93304 326-3650 Re: Submit Annual F0~1 Monitor Certification Deputy Chief Dean Clason Operations/Training REMINDER NOTICE 326-3652 Deputy Chief Kirk Blair Dear Mr. Najawi: Fire Safety/Prevention Services Our records indicate that yrtilr fuel monitor certifications is due/past due on 326-3653 i OS-19-06. 2101 "H" Street i You will be in violation of` Section 2638(a) California Code of Regulations, Title Bakersfield, CA 93301 23, Division 3, Chapter 1~~ OFFICE: (661) 326-3941 FAX: (661) 852-2170 "All monitoring ~gtzipment shall be installed, calibrated, operated and maintained iri Accordance with manufacturers instructions, and certified every 1~ irionths for operability, proper operating condition, RALPH E. HLTEY, DIRECTOR and proper calibration." PREVENTION SERVICES FlrtE SAFEIY8ERVICE3•ENVIRONMENTALSERVICES Therefore you have 30 days to comply 900 Tn,ixtun Avenue, Suite 210 Bakersfield, CA 93301 Should you have any questitrns, please feel free to contact me at 661- 326-3190. OFFICE: (661) 326-3979 FAX: (661) 852-2171 ~ Sincerely yours, David Weirather Fire Plans Examiner Ralph E. Huey, 326-3706 Director of Prevention Services 1? Howard H. Wines, III Hazardous Materials Specialist 326-3649 By: Steve Underwood Fire Prevention (~tf cer REH/SU/db "Serving the Community ~'or ~l~lore 7~an A Century" :~ _ _ ~; ,. ~ ~. ---- .-- -- 13 t 0 MON~TURING SYSTEM CERT`~FICAT~~N For U.se By All.lurisdictions Wlthtn the State ojCali~ornia Aut oriry C'lted: Chapter 6.7, Health and .Safety Code; Chapter 16, Dlvlsion 3, 7Yile 13, California Cade ojRegulations This fornt ust be used w doctuent testing and servicing of monitoring equlpmenC A saQartlte cm:i_fli~.tlon o£ ret~oaim}~t ti' nrena.*ed c ' •tt svstem control 1~ by the technician who performs the work A copy of this form roust be provided to the tank system o er/ope::~itor. The owner/operator must submit a copy of this form to the local agency regtilating UST systems within 30 days of tes date. A. Genie t Lntbrnaationi p~~_' 131d No.: Facility N' e:.~~.l~.tw-v_ _ ~• Site Addre : ~~j~ ~/{'t'YC j,,~„_ City: 1~`G~,__ Ztp: Facility Co tact Plsrson: Contact Phone No.: (___~ MakeJMod [ of M:nnitoring Systetu: 7"LS "" -~~ Date of TtsstittgJSetvicing'. ~l ,>'U /off B. 1<gve tory e~f Equitpment Tested/Certified ai- --SR. ..i.. • in .MUD/eaw.I i.I1I• a,n[Clf 1GC ^ D rliK~: Wwii •V .YVI~w. ~ - - g "' Tank ID: L ~'~ / 1 Tank TD: ~~.. 19 ln-Tank': auginp Probe. Model: ~~•t ¢l in-Tank dauging Probe. Modek _ [ ~ Annular pace a: Vault Sensor. Model: ~O ....- l>g Annular apace or Ysult Sensor. Model: ~• Q 181 Piping S mp / Ti•I:nch Sensor(s). Model: . ~~~. ~ Piping Sump !Trench Sensor(s). Model: `s~C O Fill Sum ,, ^ Sensmis). Model: ___ 4 Fill Sitmp Sensor(s). Model: ^ Mechani a1 Line I:cak Detector. Model: ll Mechanical Line Leak Detector. Model: _._,__ Electrohii LGte I.~tt Detector. Model: P,~if•(3 ~ l;lectroniq Line Leak Detector. Model: Q6~~ ^ Tank Ov tfill ! F.iigh-Level Sensor. Model: ^ Tank Overtlll /High-Level Sensor, Model: ^ Others I eS~ii mcnt and ntodcl in Section E on e 2 . ^ Other uE ment and model in Sxtion E on Pa e 2 Tank TD• Tank TD: ~) In-Tank sugint; Probe. Model: ,~,/,~~+.-f C7 In-Tank Qauging Probt. Model; Mnular pace or Yault Srnsor, Model: ____ ^ Annular Space of Vault Sensor. Model; JB Piping 5 p J TiY:ncth Sensor(s). Model: 2 ^ Piping Sump / Trench Sensor(s). Model: ^ Fill Sum Sensag,9)• Model: O FIU Sump Scissor(s). Model; O Meehan' Linc'i.eak Detector. Model: ^ Mechanical Line Lcak Detector. Model: Thy Elccuoni Line I.~lt Detector. Model: j7~`t,.f) O Electronic Line Leak Detector. Model: D Tank 0 nil / >`[igh-Level Senscu. Model: ^ Tank Overf H /High-Level Sensor. Modci: ^ Others ci ~ni meet a and mcxlel in Section E on Pa e 2 ^ Other it ui roent a and model in Section E on P e 2 . Dispenser : _1-~. _ Dispenser TD: O Dispens ; Containment Sensor(s). Wtadcl: _ Q Dispenser Containment Sensor(s), Model: ~ Shear Y e(s). J!~ Shear Valve(s). ~.S Drs rase Containment Plo s d Chai s . D! eraser Containment F! s d Chai s , Dispenser ~ , ~ !p Dispenser ID: O Dispens ' Containment Sensor(s). Model: _ Q Dispenser Containment Scissor(s). Model: ~ Shear Vhil e(s). J!!( Shear Valve(s). Dis ens Contaiumeai Fioa 's and Chain Di user Containment Fla s d Chai s . Dispenser I : _ _ Dispenser TD: ^ Dispense Containment Scissor(s). Model: ^ Dispenser Cohrtainment Sensor(s). Model: Q Shear Val els). O Sheer Valve(s). ^Di et; ontail~ment P1o sand Chains . ^Dis ser Containment Floats and Chains . ~ifine taciU contains more tathks or dispensers, ecrpy this form. Include information for evoty tank and dispenser at the facility. ~.'. Ge .i t;atii19 n -1 certify that rile equipment identified In t[hu document wits iaspected/serviced la accordatlce with the ta>iaut'actttrers' Quideli}h Attached In this Certification is Information (a~. manufacturers' checklists) nacasaary to verify that this inror~urHoo is correct nd a :Plot Plau showing the Ipyoat of monitoring ;~+ipment. For qny a uipment capable of generatlog such reports, I have also attache a copy of the report; (check all shat apply): ~l System set-up ~Acf rm bisto r report Technician ame (print): ~,~F~-.~SC2'~ Signature: Certificatio No.: _ /)l7/s-Oft - ~ _~~ License. No.: 1'csting Co pony 1Jame: ~- ,~'.r/~!/~CDti/jt~Q~,~jrr'~~ _ _ Phone No.:{~L~ ~~'[PyJ Site Addre' ~'~s- w1~7g L~ ~ ~,~~ Date of Testing/Setvicing: SI.~IJ/~ Page l of 3 0310! Monitoring Systt:ln Certification D. Res is of']'esting/Seu^vicing Software'. etsion L~stailed: L~3' ~~ ~.VO] lace ue iuu~iw ~+~ uia ~ wa. Yes O No" is the audible alarm . erational? Yes ^ No" is the visual alarm o erational? Yes ^ No" Were all sensors visuall ins cted, function tested and confirmed rational't Yes ^ No" Were ail sensors installed at lowest point of secondary containment and positioned so that other equipment will not interfere with their ro er o eration? ^ Yes ^ No' It alarms are relayed to a remote monitoring statton, is all communicarians equipment (e.g. modem) lg N/.4. operational? Ycs ^ No" For pressurized piping systems, does the turbine automatically shut down if the piping secondary containment ^ N/,4. monitoring system detects a leak, Faits to operate, a is electrically disconnected? if yes: which sensors initiate positive shut-downs (Chock all that apply) ~ Smnp/I'rench Sensors; O Dispenser Containment Sensors. Did u ponfirm ositive shut-down due to leaks n d sensor failure/discoanectlan7 Xes' ^ No. ^ Yes O Noy' For tank systems that utilize the monitoring system as the primary tatsk overfill warning device (i.e. no bZ N/,q, mechanical overfill prevention valve is installed), is the overfill warning alarm visible and audible at the tank fill oint s and o tin o er] ? If so at what cent of tank ca aci does tht: alarm tri er? °!o ^ Yes* 6r Na Was any monitoring equipment replaced? If yes, identify specific sensors, probes, or other equiptnettt replaced and list the manufacturer name and model for all re lacement arts in Section E below. ^ Yes* No- Was Iiquld found inside any secondary contaiement systems designed as dry systems? (Check al! that apply) O Product CD Water. if ec, describe causes in Section 13 below. Yes ^ No" Was monitorin s stem set- reviewed to ensure ro r settln s? Attach set u if a livable Yes ^ Nei' is all monitorin e. ui tnent o rational mattufacturer's s ecifieations7 t ~~ 07 ---~_ F. In T nk G.mugjag / SIR Equiplment; ~ Cheek this box t>•tank gauging is used only for inventory control, p deck this box if no tank gauging or 31R equipment is installed. This sect n must be completed if in-tank gauging equipment is used to petfor~tn Ieak detection monitoring. _._„_~_ c;om re: ^ Yes e{ ne ~o-teN No'r rsn caae.ra~s.: Has all input wiring been inspecbod for proper entry acrd termination, including testing for ground faults? Q yes No' Were all tank gauging probes visually inspected for damage and residua buildup? ^ Yes ! No+' Was accuracy of system product level readL}gs tested? ^ Yes No•- Was accuracy ofsystem water level readings tested? ^ Ycs No' Were all probes reinstalled properly'! t7 Yes _ No' Were all items on the equipment manufacturer's maintenance checklist completed? in the S describe how apd when these deficiencies were or will be corrected. below ion I•l , , G. Lilac eak 1)eteetors (LLD}: ^ Check this box if LLDs are not installed. Com fete, a fellt~wln checklist: ~ Yes No's For equipment start-up or annual equipment certification, was a leak simulated to verify LLD performance? j N/f!; (Check all that apply) Simulated leak rnte: '~ 3 g.p.h.; ©O.l g.ph ; ^ 0.2 gp.h. Yes No° Were all LLDs confirmed operational end aeeurate within regulatory requirements? Yes No'' Was the testing apparaa~.s properly calibrated? ^ Yes No" For mechanical LLDs, does the LLD restrict product flow if it detects a ]eak? N/A. '~ Yes No" for electronic LLDs, does the turbine suwmatically shut off if the LLD detects a leak? w~, Yes No+' For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled N/A, or disconaccted? 6D Yes No" For electronic LLDs, does the turbine aatomatically shut off if any portion of the monitoring system malfunctions N/?, or fkils a test? 153 Yes No" For electronic LLDs, have ell accessible wiring connections been visually inspected? NlA. ~ Yes No" Were all items on the equipment manufacturer's maintenance checklist completed? '~ In the S e tfon H, below, describe how and when these deficiencies were or will be corrected. Mouitoriu System CerCificatloe UST Site Addre s: Z C~ r.J 1 ~1 ~ / ~ _ 431D~3 Site Plan :.~.: :::::::::::::~:::::::::::::: :o. ~ ~': ::::::: :::~ r ::::::::::::::::::::~::::::: ~, ::::::: ~. ::::~ :::::::~IiJ~:):::::::L:' ::::::::::::::::::::::::: Date map wry drawn: ,~ j /,Ltd/,~ Instructions If you alr: dy h¢we a diagram that shows all required information, you mey include it, rather than this page, with your Monitoriti Sys•n;m Certification. On your site plan, show the general layout of tanks and piping. Clearly identify locations the following equipment, if installed: monitoring system control panels; sensors monitoring tank annular spaces, su ps, cLispenser pans, spill containers, or other secondary containment areas; mechanucal or electronic line leak detectors;: d in••taak liquid level probes {if used for leak detection). In the spacx provided, note the date this Site Plan was Wren d. Page ~ of ~ QS~p ~~~ ~~ 5643 BROOACB C'~ k3R3~"I~LD,CA.93308 oFFTCB (&61) 392-86$7 8c F,A~C (6b1) 3~9~~Ofi21 tS1F+.C'di~&4I7'C,.b t,~3+ ~;'Y'RC'raR m~`RT W/0#r Sae i.1 i ty Name C l~'~~G'iJ k'ac:Llity ,A.ddxe~~e: ~J~~_~-L~S~I~[.r~~_ t~ /~" PrOc$uGt Line Tk'Qe (FX'eesure, 6uctiau, 6z~av~,ty) y32 R~c,~nucT Lax nET~eT©zt Tx~~ T~sT TRT~ PA88 S~.azzv~ ~uz+~~t 8~+LrOW PBI OR SERZA.L #~...[.f~/ ~o ~ $71IL _~7 LfD `L'SfPB ~ 1~! 1 !3 ~ ~~ ssRxA~. ~ - ~ ~ ~ a~a ~ O`t7/l- L/D TYP$,~~ Y B L.Ik] TxP&t YR8 Pg88 SRRZ,A,~, # Di0 p~,IL x ::ertify tb.e aboue rests were conducterl on thin date acaoxding to +Red ~:~aak®t Pumps field test. apparatus testing Qxocedure an limitations. II Thy°: Meek~anical Leak Petectaz Te&t pass / fail is determined by using la lo~rr flow threshold trip rate of 3 gallon Qer kiour or leas at 10 PSI. I •acknowledge tAat a7.1 data eo],leCted in Crue fond aoz'xeat Co the beat of rrf~ knowle/d~ge . Tech: 2 rtiti~3~ sigtk:~ture; pate, s '~ ~. , 1' ~~ SOFTWARE REVISION LEVEL VERSION 115.01 SOFTWAREit 346115--100-B CREATED - 97.10.23.11.08 S-MODULEq 330160-O10-A SYSTEM FEATURES: PERIODIC IN-TANK TESTS ANNUAL 1N-TANK TESTS PRECISION PLLD SYSTEM SETUP 05-30-06 3:10 PM- SYSTEM UNITS u.s. SYSTEM LANGUAGE ENGLISH SYSTEM DATF/TIME FORMAT MM-DD-YY HH:MM:SS xM NAJDAW[ CHEVRON 2525 WHITE LANE BAKERSFIELD.CA.93304 805-832-9781 SHIFT TIME 1 :•DISABLED SHIFT TIME 2 DISABLED SHIFT TIME 3 DISABLED SHIFT TIME A DISABLED SHIFT BIR PRINTOUTS ENABLED DAILY HIR PRINTOUTS ENAHLEA TANK PERIODIC WARNINGS DISABLED TANK ANNUAL WARNINGS DISABLED LINE PERIODIC WARNINGS DISABLED LINE ANNUAL WARNINGS DISABLED PRINT TC VOLUMES ENABLED TEMP COMPENSATION VALUE (DEG F ): 60.0 STICK HEIGHT OFFSET DISABLED H-PROTOCOL DATA FORMAT HEIGHT PRECISION TEST DURATION HOURS: 12 DAYLIGHT SAVING TIME DISABLED RE-DIRECT LOCAL PRINTOUT DISABLED sYeT~w Iasc uR I TY cops; oooooa IN-TANK SETUP COMMUNICATIONS SETUP T I:DIFSEL ------ ------ PRODUCT CODE 1 THERMAL COEFF :.000450 TANK DIAMETER 1 11.00 PORT SETTINGS: TANK pR E 1 VOL FULL 2022 COMM HOARD 1 (RS-232) g3.3 INCH VOL 9677 ', BAUD RATE :9600 55.5 INCH VOL 6011 PARITY EVEN 27,8 INCH VOL 2357 STOP HIT 1 STOP DATA LENGTH: 7 DATA ~ FLOAT SIZE: 4.0 IN. 8496 AUTO TRANSMIT SETTINGS: WATER WARNING : 2.0 HIGH WATER LIMIT: 3.0 ' ' AUTO LEAK ALARM LIMIT DISABLED MAX OR LABEL VOL: . 12022 '; AUTO HIGH WATER LIMIT OVERFILL LIMIT 90% DISABLED 10819 AUTO OVERFILL LIMIT HIGH PRODUCT 95% DISABLED 11421 AUTO LOW PRODUCT DELIVERY LIMIT 12% . DISABLED 1442 AUTO THEFT LIMIT DISABLED LOW PRODUCT 500 AUTO DELIVERY START LEAK ALARM LIMIT: 32 DISABLED SUDDEN LOSS L1M1T: 25 AUTO DELIVERY END TANK TILT 3.70 ; DISABLED AUTO EXTERNAL INPUT ON ~ MANIFOLDED TANKS DISABLED Tyt: NONE AUTO EXTERNAL INPUT OFF DISABLED AUTO SENSOR FUEL ALARM LEAK MIN PERIODIC: 0% DISABLED 0 AUTO SENSOR WATER ALARM DISABLED LEAK MIN ANNUAL OX AUTO SENSOR OUT ALARM 0 DISABLED PERIODIC TEST TYPE STANDARD RS-232 SECURITY ANNUAL T~piLARMLDISAHLED CODE 000000 PERIODIC TEST FAIL ALARM DISABLED GROSS TEST FAIL ALARM DISABLED + RS-232 END OF MESSAGE • DISABLED ANN TEST AVERAGING : OFF PER TEST AVERAGING : OFF '. is J " "'~ .`-` - .~ . ` TANK TEST NOT i FY : OFF TNK TST SIPHON BREAK:OFF DELIVERY DELAY ~. 3 MIN --r ~ - _ ___ 1 I LEAK TEST METHOD T 3:REGULAR TEST ON DATE ALL TANK T 2:SUPREME PRODUCT CODE THERMAL CO£FF :. 3 000700 JAN 1. 1996 START TIME DISABLED PRODUCT CODE THERMAL COEFF :. 2 000700 TANK DIAMETER TANK PROFILE 111.00 4 PTS TEST RATE :0.20 GAL/HR TANK DIAMETER 111.00 FULL VOL 12022 DURATION 2 HOURS I TANK PROFILE 4 PTS 83.3 INCH VOL 9677 ' FULL VOL : 12022 55.5 INCH VOL 5011 83.3 INCH VOL 55.5 INCH VOL 9677 6011 27.8 INCH VOL 2357 LEAK TEST REPORT FORMAT 2?.8 INCH VOL 2357 NORMAL FLOAT SIZE: 4.0 IN . 8496 FLOAT Si2E: 4.0 IN . 8496 WATER WARNING 1.0 HIGH WATER LIMIT: 3.Q ' WATER WARNING 2.0 HIGH WATER LIMIT: 3.0 MA}{ OR LABEL VOL: 12022 MAX OR LABEL VOL: 12022 OVERFILL LIMIT 90% 10819 ~ .OVERFILL LIMIT 90% HIGH PRODUCT 95~ 10819 11421 HICH PRODUCT 951 11421 DELIVERY LIMIT 12••~ PRESSURE LINE LEAK SETUP DELIVERY LIMIT 12s 1442 - - - - - - - - - - 1442 LOW PRODUCT 500 LOW PRODUCT 500 LEAK ALARM LIMIT: M T 32 25 A 1:DIESEL LEAK ALARM LIMIT: 32 SUDDEN LOSS LI : I TANK TILT 2:00 SUDDEN LOSS LIMIT: 25 PIPE TYPE: FIBERGLASS TANK TILT 2.50 MANIFOLDED TANKS LINE LENGTH: 180 FEET T#: ~~ 0.20 GPH TEST: ENABLED MANIFOLDED TANKS 0.10 GPH TEST: DISABLED Tq: NONE SHUTDOWN RATE: 3.0 GPH LEAK MIN PERIODIC: Os1 T 1:DiBSEL DISPENSE MODE: LEAK MIN PERIODIC: OX 0 STANDARD 0 LEAK MIN ANNUAL 0:+ SENSOR: LION-VENTED LEAK MIN ANNUAL Oi 0 D PERIODIC TEST TYPE PERIODIC TEST TYPE STANDARD . STANDARD ANNUAL TEST FAIL ANNUAL TEST FAIL ALARM DISABLED ALARM DISABLED PERIODIC TEST FAIL PERIODIC TEST FAIL ALARM DISABLED 0 2:PLUS ALARM DISABLED GROSS TEST FAIL GROSS TEST FAIL ALARM DISABLED ~ PIPE TYPE: FIBERGLASS LINE LENGTH: 180 FEET ALARM DISABLED ANN TEST AVERAGING: OFF 0.20 GPH TEST: ENABLED ANN TEST AVERAGING: OFF PER TEST AVERAGING: OFF 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GpH PER TEST AVERAGING: OFF TANK TEST NOTIFY: OFF T 2:SUPREME DISPENSE MODE: TANK TEST NOTIFY: OFF TNK TST SIPHON BREAK:OFF BTANDARD TNK TST SIPHON BREAK:OFF SENSOR: NON-VENTED DELIVERY DELAY 3 MIN DELIVERY DELAY 3 MIN A 3:REGULAR ' PIPE TYPE: FIBERGLASS LINE LENGTH: 180 FEET 0.20 GPH TEST: ENABLED 0.10 GPH TEST: DISABLED SHUTDOWN RATE: 3.0 GPH. TANK : N{}NE • SENSOR: NON-VENTED LINE LEAK LOCKOUT SETUP LOCKOUT SCHEDULE DAILY START TIME: DISAHLED STOP TIME : DISAHLED LIQUID SENSOR SETUP L 1:DIESEL ANNULAR NORMALLY CLOSED CATEGORY ANNULAR SPACE L 2:DIESEL TURHINE SUMP TRI-STATE <SINGL£ FLOAT) CATEGORY STP SUMP L 3:SUPREME ANNULAR NORMALLY CLOSED CATEGORY ANNULAR SPACE L 4:SUPREME TURBINE SUMP DUAL FLT. HIGH VAPOR CATEGORY STP SUMP L 5:REGULAR ANNULAR NORMALLY CLOSED CATEGORY ANNULAR SPACE L 6:REGULAR STP SUMP DUAL FLT. DISCRIMINATING CATEGORY STP SUMP ~- t ALARM HISTORY REPORT ___-- SYSTEM ALARM ----- PLLD LINE DISABLE SETUP ! P~E05 6-06 5:16 AM -----' ------ PRINTER ERROR D5-16-06 5:16 AM 0 1:DIESEL BATTERY IS OFF 01-01-96 6:00 AM IN-TANK ALARMS T I:HIGH WATER ALARM T 1:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 1:FUEL ALARM L 2:FUEL ALARM L 2:HIGH LIQUID ALARM Q 2:PLUS * x ~ ~ ~ END x * x ~ ~ I N-TANK ALARMS T 2:HIGH WATER ALARM T 2:LOW PRODUCT ALARM LIQUID SENSOR ALMS L 3:FUEL ALARM L 4:FUEL ALARM Q 3:REGULAR IN-TANK ALARMS T 3:HIGH WATER ALARM AI,gRM HISTORY REPORT T 3:LOW PRODUCT ALARM ---" IN-TANK ALARM -'--- LIQUID SENSOR ALMS L 5:FUEL ALARM • T 1:DIESEL L 6:FUEL ALARM L 6:HIGH LIQUID ALARM HIGH WATER Al-P'RM 06-19-02 3:32 PM SUDDEN LOSS ALARM 6:16 AM 01--21-04 1 6:07 PM 06-a9-02 [NVA05p 506 L6:57 PM 04-26-06 6:01 AM 04-19-06 7:14 AM RECONCILIATION SETUP ------ ------ PROBE OUT 07-02-02 10:12 AM 06-19-02 6:27 PM AUTOMATIC DAILY CLOSING 06-19-D2 6:07 PM TIME: 2:00 AM AR9109 R0 WAO HIGH AUTO SHIFT itl CLOSING ~ 4 ~ I TIME: DISABLED 06-19-02 3:32 PM AUTO SHIFT tt2 CLOSING ' TIME: DISABLED DELIVERY NEEDED 05-25-06 8:26 AM AUTO SHIFT tt3 CLOSING D5-22-06 1:08 PM T1ME: DISABLED 05-17-06 2:44 PM AUTO SHIFT tt4 CLOSING TIME: DISABLED LOW TEMP WARNING 07-02-02 10:15 AM PERIODIC RECONCILIATION • ALARM: DISAHLED TEMP COMPENSATION ssaN~RA 8US SLOT FUEL METER TANK TANK MAP EMPTY - - - - - * ~.~ K K END * +~ * ~ ~` ALARM H I a'I'ORY REPORT ALARM HISTORY REPORT ----- SENSOR ALARM ----- ---- 1N-TANK ALARM ----- L 1:DIESEL ANNULAR ALARM HISTORY REPORT ANNULAR SPACE T 3:REGULAR FUEL ALARM ---- IN-TANK ALARM ----- 05-34-06 2:34 PM OVERFILL ALARM T 2:SUPREME 05`04-05 11:45 AM FUEL ALARM 05-OB-03 6:30 PM 05-23-05 9:13 AM HIGH WATER ALARM 05-02-03 7:36 PM 03-29-05 4:54 PM FUEL ALARM LOW PRODUCT ALARM 05-17-04 9:45 AM SUDDEN LOSS ALARM 05-09-06 4:51 PM D3-29-05 4:41 PM 09-20-05 7:31 AM 12-22-03 12:31 PM ~ OB-23-05 ll:l6 AM 02-03-00 7:59 AM SUDDEN LOSS ALARM HIGH PRODUCT ALARM 12-19-97 5:11 PM 03-29-05 4:51 PM HIGH PRODUCT ALARM INVALID FUEL LEVEL 05-OQ-05 11:47 AM 02-27-06 12:19 PM 10-08-02 7:58 AM 02-02-06 4:42 PM 0?-09-02 4:51 AM x ~t * ~ x END * * * ~ 08-23-05 12:11 PM INVALID FUEL LEVEL PRONE OUT 05-09-06 4:26 PM 03-29-D5 5:23 PM 04-24-06 1:51 PM 03-29-05 5:20 PM 02-02-06 7:43 PM 03-29-05 5:14 PM PROSE OUT HIGH WATER WARNING 03-29-05 4:42 PM 03-29-05 4:54 PM 06-24-99 1:3~ PM DELIVERY N~EAED ALARM HISTORY REPORT 05-28-06 12:31 PM DELIVERY NEEDED 05-21-06 6:04 PM 05-26-06 1:27 AM ----- SENSOR ALARM ----- 05-17-06 4:51 PM 05-09-06 11:19 AM 1, 2:DIESEL TURBINE SUMP 04-24-06 6:01 AM STP SUMP MAX PRODUCT ALARM FUEL ALARM 03-29-05 4:51 PM 05-3D-06 2:33 PM ~ LOW TEMP WARNING 03-29-05 4:55 PM FUEL ALARM LOW-TEMP WARNING I 06-2q-99 1:34 PM 03-17-06 10:59 PM 02-03-00 1:53 PM FUEL ALARM O 05 9'13 AM x x x~~ END x~ x~ * x ~ x * END ~ ~ ~ * ~ ***~*END~*~** i 3 t.o7 ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 3:SUPREME ANNULAR ANNULAR SPACE FUEL ALARM 05-30-06 2:36 Pi'1 FUEL ALARM 05-30-06 2:34 PM FUEL ALARM 05-23-05 9:14 AM xxxxx END * x x x x ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 4:SUPREME TURBINE SUMP STP SUMP FUEL ALARM 05-30-06 2:32 PM FUEL ALARM 05-23-05 9:12 AM FUEL ALARM 06-22-04 10:09 PM ALARM HISTORY REPORT ----- SENSOR ALARM ----- L 5:REGULAR ANNULAR ANNULAR SPACE FUEL ALARM 05-30-06 2:35 PM FUEL ALARM 05-23-05 9:15 AM FUEL ALARM 05-17-04 9:35 AM xxxxxENDxxxxx ALARM HISTORY REPORT ALARM HISTORY REPORT -- SENSOR ALARM ------ G 1:DIESEL PLLD SHUTDOWN ALARM ' 05-30-06 3:06 PM GROSS LINE FAIL 05-30-06 3:06 PM PLLD SHUTDOWN ALARM 05-30-06 2:33 PM xxxxx END x x x x x ALARM HISTORY REPORT ----- SENSOR ALARM ----- A 2:PLUS PLLD SHUTDOWN ALARM 05-30-06 2:56 PM GROSS LINE FAIL 05-30-06 2:56 PM PLLD SHUTDOWN ALARM 05-30-06 2:34 PM ----- SENSOR ALARM ----- L 6:REGULAR STP SUMP STP SUMP HIGH LIAUID ALARM 05-30-06 2:31 PM HIGH LI~dU1D ALARM 05-30-06 2:18 PM HIGW LIGUID ALARM 05-23-05 9:09 AM xxxxx END x x x x x x x x x x END x x x x x xxxxx END x x x x x ALARM HISTORY REPORT ----- SENOR ALARM ----- 0 3:REGULAR PLLD SHUTDOWN ALARM 05-30-06 2:48 PM GROSS LINE FAIL 05-30-06 2:48 PM PLLD SHUTDOWN ALARM n~-an-nA 2:31 PM l~~o~ ____.~ 1M~01~TI~'OR C~I~T. F.AtILLf REPUR'I' ~..`.....r ~..r ~~..~~Frr' wir. rn ~r..ui.~i i~~~.ar.r~.rr^ ~~~ NAIWIE: C.~I~UQG~ DA~ti: ,S--3D~ OL~_ ~~~ LA~~tOR• ~~~~~ PA~~TS Il~~LL]CD• x~~~~E: TixLEj THE: ABOVE NAMED PERSON TAKES FULL RE9PON$I~II~'PY (~F NOTIFYING THOE~ APPROPRIATE PARTY TO RAVE CORRECTIVE ACTION TAKEN TO REPAIR TI]C16: ABOVE LISTEn PROBLEMS AND NOTIFYING RICK ENVIRUNMANTAL FUR AN1~ NEEDED RI;TESTI1rTG. THIS ALSO RELEASES RICH ENVLRONMENTAL OF AAf'1.' FINES OX2 PTtiNALTIES OCCURING FROM~NON-CUNIPLIANCE. A ~=~7PY ©F THIS DOCUMEN'A' HA~4 BEEPrT I.,FFT ON-STYE FO~t YOUR ccrr~VIENENCr. RT~'AIItS• I~1O~rn} ~V~'hi.:'..• .~a~ai ;uy 2DC2 Paget ~ ,of d..... Sec©;ald.a~y ~on.taieA~ ~'es~ing pert Fornol 7'1„s farm !s. ender?,Par use by co»tractors•perfvr»~Y»g•~~'o,dl~ tatting of iJSTasco»dary catttplnbitQi~tsytclQm,~ Usa thQ ngn,•opriare. ages cy'thls form to report results far a!! aotr:ponetttt tested Pke eompletedforra, wrltt~sre tastproasdta~as, and pr;r,[otus fro rests ({~'oppilcable), should be provided to tlf+e focil~flj+ awnerlapei^atarfor srebmfupl fa tha loco! regttlatary aggnc}+. x. F~.~xz~ T~or~ Facility NFl e; ~~y~ Aate o~T - CJ - d _i ..l-ucifiry A •ess~a-,S' s.:a]d~4'~ C• ~ _ .u Phone: F~,cilit ~ Cat Last: n9te Lacsl gettgy Was NQLi$.ed of'~'estiu; •r Na[n4 of L sl Ag.e:ncy lnspaotQr (if resent u'uring testt . G~~ ~~ 2. TFSTIl~IG ~C0~1 _ ~3 TI41~( C.an, any e:1;t.ZCH ENVTZtQNPIEN"k'•AL 'I'ecluucian; onductEagTest: 1'~''t~ /,•-c/~~,G~y _ C re~antials• ~~ CSLI3 Liaet~sed Cantraotor 0 S~Ii.CB L~ic~nsed Tl~nl[ Tesler • _ a license Tv e. (;611D4Q I.i~enseN>:mber; 84954 .._.i A II~dC01d TNCQN Ts-5TS it 3. SUGARY bF T~S~ B~~~TL'TS omp~uiaeat Russ .t7a!! ~°~ Tes d ~ Eprur9 e Corapoaent Pegs F>itl T Repai s d _ ~2L !, v 0 ^ 0 ^ .^ 0 D alt i/~ t~dX ~ , ~ Q Q ~ ^ [] ^ D ~ L ~ ^ a a ^ ^ ^ o? ^ o ^ o ^ ^ Q o _ _. ^ ^ 0 Q~ ^ ^ Q Q: ~ ^ 0 ^ ^ ^ Q D .. O D ^ p Q ^ C1 D _....~._ .. ^ ^ D © ^ ^ © p ~.- .. ^ o ^ o a ^ ^ ^ If hydrostatic ' ttng was pert~jtmed, describe what was d~e• with Ghe water a oa~ctpletion of tests: C RT1J;'iCATIC>~N O~Tn 'TECT31,lACiAl~i ~~i93BI.E EOM C4NDUCTI~T~ T~3S TAG 7'r~ the best of iy knurNledge,llia facts stated An tltts dq~cumeset ttte acc{u'aXe anti !it fu11 ctrmp~vnca Wltle legal requlrrtrt:e~tts 1 tclarucian's S [[e: )sate; ~ ~~ "U,~ t~ro'1 S W RCB, J ua1'Y ~ ~2 page ~ of __~ 9. S~~g..T~/~YI+~'R~`:C!Or1'!T~~~41' BL3~~ Faciti is . of nipped Wz'ih spill~Ovezfill Contalntneni B ^ S ill/Ov Cc~RG~nment Boxes era pxeseat, but veere Not +esied p ' Test lwleth' Devf::iuped By: D Spin Bucket R~a~r ^ Industry Standard 0 Pra:fessional Engifleer ^ Other (~pac~y} -- . Tesc ~@~ o Pt~esstuae ~ vast a xydrostatic Used: ^ Other eCffj~ Test Equl U.;~ed: 1r mutton: r ` SpSll diox # 9pi1175ox # S iIi Box #~ 5p111 Box ~# Bucket lak1 PrtBI: ( •, ~ µ 1 Bucket De tl-: ..L,,y._._._.._ J ~' ~ ~ V Wait tirnc pressure/ ~ etwee~i applyln$ tunharater and ,~ +/~?'C.) 3Q r'11'v 3Q t"1 "l~'t, ~ startin tcs ___ Test 5tffxt __ 'me: ,-~ ~ ' (' . Initial (ii.i;~; ~S Y• ~ ~ _ __ ~ TestEndT a: O ,~ r-1 a=,~ .m Final Itea - ' (RF); Teti Durati Il:, ~ r-~ .~J ~ ~.+ .~ ~ /t ~~ Chau~e in adtsw~ (~-~~ © 0 c Pass/Fail reshol.d or D ~ O " ' Criteria: ~ Test Res _ t: ;8~ Pass . Q Faia p~ ^ Fail ,~I Fats 0 gala ~ ~ D pass ^ l?ail SB9°~9 .TESTING F.~.ILIJRE R~PC~~T S~ ~r N 11~E; ! ~ ~6-c? - - d g~;cr . S • ~ lJ-J TEi~T]NG~ CCDNik"ONEfiT X'S ~~p ~~~ ~~ P~~a~'S_INTALIIED~ ~(~~~" NAB 3I~:. . TIl3C A~~NAMEI~ PERSON AS~7L~. R~8F01~3SITY OF 1~OT~lING TI~~; APPRE~FRIATT E'AA~'I'Y TU 3SA~Nlu CORRl~CTI'tTE AC~QAT TAKEN TO REPA~t TI~I. ABOVE LISTED PAVrQiBL,EM,S .ANA ~filT~'YING RICH El'~VIR~ONMA}~TTAL FOR APV~I NEE17ElI RJ+.7C'ES7'ING. THIS Ai:~SO RELEASES RICH ENVIFLO~'AL OF APV~t FZNNES OR I'ENAI.7CIES OCCUR~LG FROM Ir10N=C011+IFLIANCT. A. C+OEX OF '.C~Ti](S ~20t,L7Td[IENT JkIAS BEEN LEF71' ON~S~'TE 1TOR YOiIXz CIJiNVTENENCE. 1 D 3~~ UhIDERGROUND STORAGE TANKS ~F, ~; ...... ...< .... .s~:i.w.::t5s.rw~d+~+U::~..~s.1./1KYa1P~M>tYS.Z+.,Iti~YY ELF :Yf'; Jai APPLICATION ~`' 70 PERFORM ELD 1 LINE TESTING I S8989 SECONDARY CONTAINMENT TESTING (TANK TIGHTNESS TEST AND TO PERFORM FUEL MONITORING CERTIFICATION BAKERSFIELD FIRE DEPT. ~«~ Prevenl3on Services f A 900 Truxtun Ave., Ste. 210 ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. ^ ENHANCED LEAK DETECTION ^ LINE TES ^ SB-989 SECONDARY CONTAINMENT TESTING T'1 uTwiCC[. tce.T Tn OC OCl~O AA CI IGI YMIIJT^OI~I/! f FGTIFII`CTICI-1 FACILI'~Y NAME b PHONE NUMBER OF CONTACT PERSON ADDRESS 5 'OWNERS NAME OPERATORS NAME PERMIT TO OPERATE NO. NUMBER OF TANKS TO BE TESTED 1 P I OI ~ p o0 Q a /n promo ~ _ 3 v o00 TANK.TESTING COMPANY NAME OF 37'tN COMPANY ~ NAME & PHONE NUMBER OF CONTACT PERSON MAILING ADDRESS J`~ O V r ~ ~T/~/ NAME & PN^"'~ w""'°QO OF TESTER OR SPECIAL INSPECTOR C IFICA7K)N #: DA7 & TIME TES 70 BE CONDUCTED n/~ ~ V ICC tk TEST METHOD SIGNATURE OF APPLICANT DATE APPROVED BY DATE FD 2095 (Rev. 09105) .. .~ ~: BILLING & PERMIT STATEMENT --- ~ ~3f BAKERSFIELD FIRE DEPT. Prevention Services E/R~ enn m...,,,r.,n eoPn„n Snirr 21(1 pER1411T NO.: ~ '~~;~~r sai~r~~ia, CA 93301 -~ --- LOCATION OF JECT PROPERTY R Sl'ARTWGDATE COMPLETIONL}!~E , OQ~ ~ ~ I `~'~ . ~~ PROJECT NAME JIDURESS PHONE ND. PROJECT ADDRESS CtrY~ STATE ~ D ~ t- CONTRACTO NAM CA LICENSE ND. ' ' • 1'YP OF LICENSE. EXPIRATION DATE PHONE ~. n ~ Q L V CONTRACTDR CD Y FAx N0. f'J ADDRESS CRY ZIP E ~ • ~ 50 G Ch $262 dif ti M i ^ N 8 • ~ . arge) ica num ew ons - (M n Alarms - ~ o . 98 O 20 000 S F 0!3125 = Per ^mlf fea S FL x ~ ^ ver , q. t. , q. . 98 ^ dif Ch kl N ti Mi i S ri & M 00 $210 ~ g ans - ( n mum arge) p n ers - ew o . 98 ^ 000 S Ft O r 5 Ft x 042 =Permit fee 5 ~ q. ve , q. . 98 ^ rinkler Modifications (< 10 heads) Minor S 00 (fnspecciion Onl $ 93 ) ~ p . y 98 ^ Commercial Hoods -New & Modifigtions $ 398 26 ~ . 98 ^ Additional Hoods 00 a 36 ~ . 98 ^ Spray Booths -New 8~ Modfcations $458 00 ~ . 98 ^ Aboveground Storage Tanks (Installatiorrltnsp.-1"Tune) $165.00 82 ^ Additional Tanks 3 26.00 82 ^ Aboveground Storage Tanks (Removalflnspection) $109.00 82 fl Underground Storage Tanks (lnsta!latian.Anspeciion) $878.00 {pertank) 82 ^ Underground Storage Tanks (Modification) ~ $878.00 {per site) 82 ^ Underground Storage Tanks (Minor Mod"~ication) $155.00 82 ^ Underground Storage Tanks (Removal) $875.00 (per tank} 84 ^ Oilweil pnstalration) $ 72.00 ~ 84 Mandated Leak Detection (Tes / Fuet MonR. Cert. $ 81.00 (perslte) 82 o Tents $ 93.00 (pertent) 84 ^ After hours inspection fee $122.00 84 ^ Pyrotechnic - (Per event, Plus Insp. Fee @ $90 per hour) 560.00 + (5 hrs. min. stand -by tee nnspecson) =$510.00 84 ^ R6.INSPECTlON(S) /FOLLOW-UP fNSPECTION(S) $ 93.00 (per hour) 84 ^ Portable LPG (Propane}: NO.OF CAGES? ~ $ 66.OQ 84 ^ Explosive Storage $249.00 84 ^ Cop + & Fle Research (Fite Research Fee $33.00 per hr) 25¢ per page ' 84 ^ Miscellaneous ; 84 FD 2021 (Rev. 09/OS) E R S F I D F/RE ARTM T RONALD J. FRAZE FIRE CHIEF Gary Hutton, Senior Deputy Chief Administration 326-3650 Deputy Chief Dean Clason Operations/Training 326-3652 Deputy Chief Kirk Blair Fire Safety/Prevention Services 326-3653 December 1, 2005 Chevron 2525 White Lane Bakersfield, CA 93309 FINAL REMINDER NOTICE RE: Necessary Secondary Containment Testing Requirements by December 31, 2005 of Underground Storage Tank (s) Located at the Above Stated Address Dear Valued Customer, Over the last six months this office has continued to send reminder notices regarding secondary containment testing. Code requires that all secondary containment systems must be tested 6 months post construction and every 36 months there after. 2101 "H" Street ~ Senate Bill 989 became effective January 1, 2002, section 25284.1 (California Bakersfield, CA 93301 ~ Health & Safety Code) of the new iaw mandates testing of secondary containment OFFICE: (661) 326-3941 ~ components upon installation and every 36 months, thereafter, to insure that the FAX: (661) 852-2170 systems are capable of containing releases from the primary containment until they are detected and removed. RALPH E. HLTEY, DIRECTOR PREVENTION SERVICES FIRE SAF'ET'Y SERVICES • ENVIRONMENTAL SERVICES 900 Truxtun Avenue, Suite 210 Bakersfield, CA 93301 OFFICE: (661) 326-3979 FAX: (661) 852-2171 David Weirather Fire Plans Examiner 326-3706 Howard H. Wines, III Hazardous Materials Specialist 326-3649 Our records indicate that your facility is due prior to December 31, 2005. Those sites that have not been tested and have not pulled a permit prior to December 31, 2005, will have their permit to operate revoked. This office does not wish to take such action, which is why we will continue to send monthly reminders. Contractors are already booked several weeks in advance. I urge you to schedule your testing date as soon as possible to avoid possible revocation of your permit to operate. Should you have any questions, please feel free to call me at (661) 326-3190. Sincerely, RALPH ),/. HUEY, Director of Prevention Services Steve Underwood Fire Prevention Officer SU:db :, "~~ ~~ r _~ ~% .--~. ; o: t ,t ~~i. i~P ;~ ~; ~`"~ ~ SEeQND'•~t SYSTEM CERTIFICATiUN FORM ,; :. *_, ~ , . . {~"` DATE . t: . ~~ ~ ~' FACIL:tTY ADDRESS ~S~ Wes( n/ . ~i~~l E'[ ~ ~~, ~ , ` >`~` T~f'iliife $u1~pE ~~ ~. A ~ ~. . ;.• .. ;, . ~'Y, ',. i ,- `s ;.. ,. 5~: :~. `~ . ,.;. . Sbi~p I $> ~ . ° Sump 2 Sump 3~jL, Sturip 4 ~Ctitid ~#eight ' '~'imt ~ .:' ~~ .~ '~Yeter Height ~ `~ 0 1 ~ / ~~ a.~3~ - ~ s Weber Refight $ i,~',: ~~ °1 DS f ~ ~Ii..i 'd'ime f~ ~ ,a~ . ~- Certiigmt~an ts+~~~ s Oh~ertQ[ Buckets / ~ ~ ~ ~ . Ov~irlif! i~ ~;y ... dverlip z Overfill 3 ~ ~UvertiYl ~ stort Time . ,~. in~,~ Right of Weber Titer ~ -;: , Weber Height ~ . Time ~ . Wster Height . ~Cetiflication rSi~neture) ~ ~ t ~fv Page 2 of ;w . ~,. ~;,-~ ~~ • ~}":' DACE ~ ~[l~ ~`.'"" l "~l FACIL i'~ •'. FACILITX ADI ~~• , ~~ '~' UDC 'IT„STII!~G . ~~..' . ,, 'r.., ~.. . ~Y'~ ~ ~. ~ . .y 'i Y'. ~: i;.; . ii -: `.'1, ,,~;. . `` ~. ,{ ,; , . :, ,;; . ;,,. ';: ,. „t ;ir:. :~~ ~; r` ~.~ . s~coxa~aY svsTEM c~cATtiox ~axM DISPFx9~• ~. :DISPEN3ER 2 DISPENSER 3 I?LSPENSE~i 4 START TIME .• ~~ 1~TIAL ~IG~rr o~ ~ . 1 I 1~-ATER ~/ `~ , w~yA1*T~~t1 il6lGiIl ~ ~. ~ ~ ~~ ~~' r //~ ~ ~ .. .~~i./ ~ cJ(/ /~i/ ~ VPV//`/ ~E~T~~C~~~ N ~ _ ; ~ f~i ~~ 5 ~. ~/~~~ tSiCiNA`I'UR~ . i 1 y j DNS`~E :: ~ DI8P'P:NSER b DISPENSER 7 I1TSPEN5ER 8 START TIME . .~IwITIAL ~ItiR'T OF WA?BR TIME WATER . ~GHT T~ WAtEit hEIGHT . C~CTlF1CA'f ION 1(Si(;lYA7'URL~ Page 3 Qf 1113 ~..,~ UNQERGROUND S70RAGE TANK APPLICATION TO PERFORM LINE TESTING /TANK TIGHTNESS TEST /SB989 SECONDARY CONTAJNMENT TESTING ![[3~ BlIKI~RflFIBLD FZRB DEPT. Praventloa 8es~iaes 900 TYuxtun Ave.. Ste. 210 wlt/ Bakersfield, CA 93301 w~ TeI: [661)326-3979 Fax: (661) 852-2171 Page 1 of 1 PERMIT NO. ^__ TANK TIG=HTNESS TEST ^ LINE ~~FACILITY ~ ~ A~~HtS~ c,~h~.Q. . q' 33a .,,, .~ e ~ ~ OPERATORS NAME I PERMIT TO OPE ATE NO. ~----- OWNERS NAME S,~ ^ ^ -` ~ ~r ~ 5 , 1 ~ Q. C ~-~ ~ NUMBER OF TANKS TO BE TESTED ~ ~ i S PIPING GOING TO BE TESTED 0 YE3 p NO ~...~. _ j TANK N0. CONTENTS VOLUME ~_ _~-. __ )moo ~ ~~~$ ~ ~a , ~ ~, ~~ b ~r~~ ~1 ~ o o e ~. -- ---- j----- _ _ ___ 'I TANK TESTING COMPANY _ ~! ~ MAILING ADDRESS ~ cis ~r ~- d ~ ~ ~ 3 NAME & PHONE NUM6EA OF CONTACT PERSON i TEST METHOD i F-- NAME OF TESTER O SPECIAL INSPEC~i CERTIFICATION NO. pATE & TIME TEST IS TO SE CONDUCTED I i o -- l~~-a S O m SIGNATURE OF APPLi ~+ ATE ~j APPROVED BY ATE s~ FD20S4 w..~~ i I ~-