HomeMy WebLinkAboutScanned fileSTATE OF CALIFORNIA GEORGE DEUKMEJIAN, Governor
CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD —
CENTRAL COAST REGION mti
1102 A LAUREL LANE •�
SAN LUIS OBISPO, CALIFORNIA 93401
(805) 549-3147
August 7, 1989
FILE
Mr. William Braun, Deputy County Counsel��'f
County Government Center, Room 386
San Luis Obispo, CA 93408 ,
Dear Mr. Braun: rr
SUBJECT: BROOK WOODCRAFT, SAN LUIS OBISPO
This letter is in response to your consultant's final remediation
report for this site (Earth Systems Environmental, May -31, 1989).
The report indicates your soil remediation project is complete.
Accordingly, we have no further requirements for this case.
Although we consider this case closed, based on current
information, this letter does not relieve you of responsibility
mandated under the California Health and Safety Code and California
Water Code for additional pollution problems related to this site,
if any should arise.
Questions regarding this letter may be directed to Michael Thomas
or Bob Baldridge at this office.
Ver truly yours,
lLLeI, --AM R. LEO=
Executive Officer
MT/se
braun.ltr/27
c: Steve Little, Earth Systems Environmental, 4378 Santa Fe Road,
San Luis Obispo, CA 93401
Mike Smith, San Luis Obispo Fire Department, 748 Pismo Street,
San Luis Obispo, CA 93401
k
JOSEPH W. DIEHL,JR.
RODERICK A. RODEWALD
FREDERICK J. WOOD
DIEHL 8 RODEWALD
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
1011 PACIFIC STREET
P. O. Box 1207
SAN LUIS OBISPO, CALIFORNIA 93406
March 4, 1988
Hand Delivered
Mr. R. K. Miller
City of San Luis Obispo
Fire Department
748 Pismo Street
San Luis Obispo, California 93401
Re: Property Owned by Mr. Kenneth Brooks
2087 Santa Barbara Avenue, San Luis Obispo, CA
Dear Mr. Miller:
TELEPHONE:
(805) 541-1000
TELECOPIER:
(805) 541-6870
This will confirm our telephone conversation of March 4,
1988, wherein I indicated to you that this firm would be representing
Mr. Brooks with regard to a contamination claim at the above -referenced
site. We would be interested in reviewing any files maintained
by the fire department which relates to this matter, and you
courteously agreed to permit such review and copying of the
file documents upon receipt of a written request. Please consider
this letter to be such a request to review your files on behalf
of Mr. Brooks.
Again, thank you very much for your cooperation in this
matter.
Sincerely,
DI a E-RL & ROD EW D
Roderick A. Rodewald
RAR:slm
cc: Kenneth Brooks
STATE OF CALIFORNIA GEORGE DEUKMEJIAN, Governor
CALIFORNIA REGIONAL WATER
CENTRAL COAST REGION
1102 A LAUREL LANE
SAN LUIS OBISPO, CALIFORNIA 93401
(805) 549-3147
February 26, 1988
QUALITY CONTROL BOARD -
Mr. William Briam, Administrative Officer Fi�E
County Government Center
County of San Luis Obispo
San Luis Obispo, CA 93408
Dear Mr. Briam:
SUBJECT: BROOKS WOODCRAFT, 2087 SANTA BARBARA AVENUE, SAN LUIS
OBISPO, CA
San Luis Obispo County owned and operated a fueling station as
part of its corporation yard at 2087 Santa Barbara Street before
it sold the parcel to Kenneth Brooks in 1978. Recent evidence
indicates that the tanks (or piping) leaked fuel to soil and
ground water. As Mr. Brooks has not used the fuel complex, the
county is the next obvious discharger. Consequently, and
pursuant to the California Water Code, we are formally notifying
you of the county's responsibility to resolve this matter.
Mr. Brooks removed the tanks in September, 1987, and, during
excavation, soil and ground water contamination were discovered.
Laboratory analyses confirmed gasoline anad diesel contaminants
in soil and ground water.
This Board is responsible for protecting all state waters within
its region. Accordingly, we are requesting submittal of a
technical report delineating the vertical and lateral extent of
soil and ground water contamination. The report must be prepared
and signed by a registered geologist, engineering geologist, or
registered civil engineer.
We are requesting you, as County Administrative Officer, to
submit the report by MAY 23, 1988. This request is made pursuant
to Section 13267 of the California Water Code.
If this request is not honored, a formal Cleanup and Abatement
Order may be issued naming the County of San Luis Obispo and
Kenneth Brooks as responsible parties. If the report is not
received as requested, we will issue a formal complaint assessing
civil liability. Potential liability in cases involving
hazardous waste may amount to up to $5000 per day for each day a
report is late or incomplete.
Mr. William Briam
Page 2
February 26, 1988
Questions regarding this letter should be directed to Michael
Thomas or Bert Van Voris at this office.
Very truly yours,
WILLIAM R. LEONARD
Executive Officer
MT:sg
cc: Mr. Kenneth Brooks, Brooks Woodcraft, 2087 Santa Barbara
Avenue, San Luis Obispo, CA 93401
Mr. Randy Miller, San Luis Obispo Fire Department, 748 Pismo
Street, San Luis Obispo, CA 93401
BRIAM.LTR/8
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:::ll'_is!�i!•�3:::�=E-:�1':�iLi[I:i: i I']iF 31�'[:�j�!
city of sAn luis OBISPO
FIRE DEPARTMENT
748 Pismo Street • San Luis Obispo, CA 93401 a 8051549-7380
January 18, 1988
Michael Thomas
Regional Water Quality Control Board
1102-A Laurel Lane
San Luis Obispo, CA 93401
RE: Brooks Woodcraft, 2087 Santa Barbara
Dear Mr. Thomas:
On November 2, 1987, this department gave Mr. Brooks written notice to initiate
removal of contamination from his site.
As of this date no action has been initiated. It is my concern that due to recent
seasonal saturation of our area, ground water contamination is threatened, thus
threatening other significant water bodies. Possibly effecting domestic, agricultural or
industrial water supplies.
Regarding the unauthorized leak report, I am giving formal notice as to the section
indicated "case type" is here by amended to indicate "groundwater" threatened.
This act has been brought about due to the lack of response from either Mr. Brooks
or the County of San Luis Obispo. Since your office is responsible to protect all waters
of the State, I am giving notice of primary regulatory responsibility over to the local
Regional Water Quality Control Board for action.
Unfortunately, due to this delay legal action now must be in your hands. If the
San Luis Obispo City Fire Department can be of any help in clearing up this matter
please do not hesitate to call.
Very truly yours,
R. K. Miller
Hazardous Materials Inspector
RKM:p js
Attachments
cc: Michael Dolder, Fire Chief
,.-Erwin Willis, Fire Marshal
Roger Picquet, City Attorney
George Rosenberger, General Services
Brooks Woodcraft
p3-(90)
UNDERGROUND STORAGE TANK UNAUTHORIZED RELEASE (LEAK) / CONTAMINATION SITE REPORT
EMERGENCY HAS STATE OFFICE OF EMERGENCY SERVICES
REPORT BEEN FLED?
YES NO Q YES Q NO
FOR LOCAL AGENCY USE ONLY
k.:HEREBY-CERT)fY':T RAT :1:-AMIA DESIGNATED GOV�U NMENT EMPLOYEE JlN7 THAT l:}fkl�
REPORTED THI .':..ORMATIOH I LOCAL CIFTC1 S PURSUANT TO SCCTON 251K) OF
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REPORTDATE
CASE#
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NAME OF INDIVIDUAL FLING REPORT
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PHONE SIGMA
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REPRESENTING ❑ OWNER/OPERATOR ❑ REGIONAL BOARD COMPANY OR AGENCY NAIv(E
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DATE DISCOVERED �%
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HOW DISCOVERED a INVENTORY CONTROL ❑ SUBSURFACE MONITORING ❑ NUISANCE CONDITIONS
❑
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TANK TEST _TANK REMOVAL ❑ OTHER
DATE DISCHARGE BEGAN
METHOD USED TO STOP DISCHARGE (CHECK ALL THAT APPLY)
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[!�I--tlNKNOWN K-REMOVE CONTENTS ❑ REPLACE TANK Q CLOSE TANK
HAS DISCHARGE BEEN STOPPED?
❑ REPAIR TANK ❑ REPAIR PIPING ❑ CHANGE PROCEDURE
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❑ YES NQNO IF YES, DATE
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SOURCE OF DISCHARGE
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❑ SPILL ❑ OTHER
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CHECK ONE ONLY
NDETERMINED ❑ SOIL ONLY
❑ GROUNDWATER ❑ DRINKING WATER - (CHECK ONLY IF WATER WELLS HAVE ACTUALLY BEEN AFFECTED)
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CHECK ONE ONLY
SITE INVESTIGATION IN PROGRESS (DEFINING EXTENT OF PROBLEM) ❑ CLEANUP IN PROGRESS Q SIGNED OFF (CLEANUP COMPLETED OR UNNECESSARY)
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CHECK APPROPRIATE ACT)ON(S) (SEE BACK FOR DETAILS)
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❑ TREATMENT AT HOOKUP (HU)
❑ NO ACTION REQUIRED (NA) ❑ OTHER (OT)
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city of sAn Ills owspo
FIRE DEPARTMENT
748 Pismo Street • San Luis Obispo, CA 93401 • 8051549-7380
Date : November 2, 1987
. Brooks Woodcraft
. 2087 Santa Barbara
. San Luis Obispo, CA 93401
RE: 2087 Santa Barbara
Dear Sir:
This department has reviewed the report from the designated geological firm
regarding your property. As indicated, results show that the soil is contaminated with
petroleum hydrocarbons at a concentration exceeding established levels by both State
Department of Health Services and the regulatory agency (San Luis Obispo Fire
Department). Therefore, this department will require that all contamination be removed
and lawfully disposed of as hazardous waste.
Prior to removal of the contamination you must submit a written plan of correction
to this department showing the following:
1) Clean-up method to be used.
2) Identify professional consultants, labs, clean-up companies and haulers to be
used.
3) Final destination of the wastes (State permitted disposal site, treatment or re-
cycling facilities).
4) Date the work is scheduled to be completed.
5) Plot plan of your facility.
6) Necessary permits from applicable agencies (Fire, Police, Water Department,
etc.).
Approval is required from this department prior to clean-up activities commencing.
Should you have any questions contact me at (805) 549-7380. Thank you.
y truly yours,
R. K. Miller
Hazardous Materials Inspector
RKM:p js
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p SENDER: Complete items 1, 2,3 and 4.
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Put your address in the "RETURN TO" space on the
reverse side. Failure to do this will prevent this card from
being returned -to you. The return receipt tea will provide
o4 the name of the person delive►ed to and the date of
deitver . For adaltionek fees the following services are
available. Consult postmaster I`ar- eas and cheek box(es)
for service(s) requested.
1. ❑ Show to whom, date and address of delivery.
2. ❑ Restricted Delivery.
i
3. Article Addressed to: r
Brooks Woodcraft
2087 Santa Barbara
SLO, CA 93401
4. Type of Service:
Article Number
Registered 13 Insured
Certified ❑ COD
p135 882 394
❑ Express Mail
Always obtain signature of addressee or agent and
DATE DELIVERED.
5. SignaturAddressee
X
6. Signature — Agent
X
7. Date of Deliv ry
U�
8. Addressee's Address (0NL ;RF
BROOKS WOODCRAFT
QUALITY UNFINISHED FURNITURE
2087 SANTA BARBARA AVE. . PHONE 544.2505 • SAN LUIS OBISPO, CALIF. 93401
FURNITURE FINISHING * FREE DELIVERY
Carl Hysen
Chairman
December 17, 1987
s
San Luis Obispo County Board of Supervisors CONI ENTI L
Dear Mr Hysen,
In February of 1978 I purchased from the county the old county yard on
Santa Barbara St -adjacent to my busines s., Brooks " Noodcraft. The yard and
old metal buildings have been very useful to me. At the time of the
transaction I was aware of the two abandoned underground fuel tanks on
the property. They had been used by Ban Luis Obispo County when the yard
was active and before the facility was moved to the Camp San Luis Obispo 0
property. The tanks have never been used by me. In recien t years we've `
all read in the media that all old abandoned fuel tanks should be removed.
In September of this year, 1987, I contracted with the Negranti
Construction Co. from Caycucos (they specialize in tank removal) to remove
the tanks.Their bid for the job including backfill was $2963.00. They had
to apply for a tank removal permit from the San Luis Obispo City Toxic
Waste Agency through the SLO fire Dept, Mr Randy Miller in charge. On Sept.30 th
the Negranti donst. Co., equipment and crew were on site with 1hr Randy 1Lller
in attendance. The first few deep scoops of the backhoe exposed a strong
toxic smell and h1r Miller distrnbuted nose mask to all the crew. He asked
me to call a chemical analys company to take samples on site as the digging continued
and to call a representive from the county as he said the tanks were last
used by the county. Ur George Rosenberger from county property management
was called and came on site. The Chemical Eesearch Laboratories Inc from
Sr.nta Maria were called and an engineer from their Co. arrived on site.
As near as Lcan recall the tanks hadn't been used for sixteen years, but the
toxcidity was as prevelent as if the tanks had been used yesterday.
As of this date I've paid the origional 12963.00 plus r677.88 to
Negranti Cnast. for the overaged due to the complexity and standby on
the job and still have two huge holes and a yard full of dirt. I've paid
the Chemical Research Laboratory $3,541.00 for their multi page chemical
analysis of the site. Mr Randy Miller has kept the county property
management dept. informerd of the chemical reports and proceedings.
The site has beenleft open for two and one half monthsnow to aerate
the exposed holes and dirt. At this point another agency or firm has to
1]P_ Called in nnalygp the cbemirai report and to nroosei with the 0 a''�' p
to state standards and backfill.
cont.
Every channel I've checked with is of the opinion that the
removal of the toxidity is the responsibility of the agency or persons
who owned the property at the time of the contamination, in this case,
the County of San Luis Obispo. i.
Since I knew of the tanks existance when I purchased the property,
but not the toxidity, I feel I should pay the'urigional tank removal'
fee of $2963.00, but nothing since or to be incured including the $32541.00
chemical annalys charge and the overage charge on the origional contract
to Negranti const. of $677.88.
As a taxpaying concerned citizen of San Luis Obispo County, I am
interested in keeping this clean up charge at a minimum. Having
three quarters of the service yard closed off is very inconvenient, but
not an emergency situation. If on site clean up is more economical but
takes more time, then I'm in favor of it.
I'm hopaing to hear from the county soon as the rains are turning
that eleven foot deep pit into a green contaminated water awiming pool.
I
Sincerly,
f
r 2= SKYWAY ORM
CRL GAS RESEARCH SMT"MMV& CA 93-455
sc� A OIViSION OF CHEMICAL. RESEARCH lAE10MTaR1ES
yMj0nMr (805) = 2"0
INVOICE 10870
Invoice Date: 29-Oct-87
Brooks Woodcraft Invoice Number: 10870
2087 Santa Barbara
San Luis Obispo, CA 93401 Date Sample Rec'd: 9/30 & 10/1/87
ATTN: Ken Brooks Job Number: Batches 1231/1234
Sampling Date: 9/30 & 10/1/87
P.O. Number:
Nature of Sample: Tank Removal, Brooks
1.5 % per month on
unpaid balance over 30
days.
Price
Total
Quantity
TEST
Each
Price
7
EPA8015 TPH (soil)
85.00
$ 275.00
$ 595.00
1925.00
7
EPA8240 Volatiles
15.00
135.00
9
1
Lead
EPA8015 TPH (water)
110.00
110.00
245.00
1
EPA624 Volatiles
245.00
25.00
200.00
8
Sample preparation
SUB -TOTAL
$ 3210.00
30.00
150.00
5hrs
Field Service
0.30
21.00
70
Mileage
160.00
160.00
1
HNU meter rental
PLEASE PAY THIS TOTAL AMOUNT $ 3541.00
PIXASE ENCLOSE PHOTOCOPY OF INVOICE AND REMIT TO:
CRL Gas Researcn
A Division of Chemical Resear Laboratories
7440 Lincoln Way
Garden Grove, CA 92641
Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
7440 Lincoln Way • Garden Grove. CA 92641
(714)898•6370 • FAX: (714)891.5917 + (800)LAB-ICRL
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
VOW
S4o�-� ( FILE
LABORATORY REPORT
ANALYSIS NO.: 727519-001/008
ANALYSES: EPA Method 8015, 7421
DATE SAMPLED: 9/30/87.
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE TYPE: Solid
PROJECT: Brooks Woodcraft/*1231
TOTAL PETROLEUM
TOTAL
HYDROCARBONS
LEAD
EPA METHOD 8015
SAMPLE
IDENTIFICATION
(MgLkcL)_
(ma/ka)
1231-1
BTM OF
BIG TANK
NW Q 6'
15.
1960.
1231-2
BTM OF
BIG TANK
SW ® 9'
4.8
566.
1231-3
BTM OF
BIG TANK
SE @ 8'
2.8
150.
1231-4
BTM OF
BIG TANK
NE ® 9'
8.2
930.
1231-5
BTM OF
BIG TANK
MIDDLE @ 9'
13.
415.
1231-6
BTM OF
BIG TANK
MIDDLE ® 11'
2.3
ND(1.)
1231-7
BTM OF
SMALL TANK MIDDLE ® 7'
1.
880.*
1231-8
BACKGROUND
248.
*Sample
content
evident
of diesel which
in turn called
for quantitation to
be based upon
the diesel
standard.
This report pertains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive
use of the ciiens to whom it is addressed. My reproduclion of this report or use of this Laboratory's name for advertising or publicity purposes Mhout authorization is pruhbilf!( I
06 Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
7440 Lincoln Way a Garden Grove, CA 92641
(714)898-6370 • FAX: (714)891-5917 • (800)LAB-1CRL
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
SAMPLE ID: 1231-1 Bottom of big tank
NW ® 6'
'LABORATORY REPORT
ANALYSIS NO.: 727519-001
ANALYSES: EPA.Method 8240
DATE SAMPLED: 9/30/87
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE TYPE: Solid
PROJECT: Brooks Woodcraft/#R1231
EPA METHODS 624/8240 VOLATILE POLLUTANTS DATA SHEET
ma/ka
ma/kq
Chloromethane
ND(5.)
1,2-Dichloropropane
ND(2.)
Bromomethane
ND(5.)
Trans-1,3-Dichloropropene
ND(2.)
-Vinyl Chloride
ND(5.)
Trichloroethene
ND(2.)
Chloroethane
ND(5.)
Dibromochloromethane
ND(2.)
Methylene Chloride
ND(2.)
1,1,2-Trichloroethane
ND(2.)
Acetone
ND(5.)
Benzene
ND(2.)
Carbon Disulfide
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
1,1-Dichloroethene
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
1,1-Dichloroethane
ND(2.)
Bromoform
ND(2.)
Trans-1,2-Dichloroethene
ND(2.)
4-Methyl-2-Pentanone
ND(5.)
Chloroform
ND(Z.)
2-Hexanone
ND(5.)
1,2-Dichloroethane
ND(2.)
Tetrachloroethene
ND(2.)
2-Butanone
ND(5.)
1,1,2,2-Tetrachloroethane
ND(2.)
1,1,1-Trichloroethane
ND(2.)
Toluene
ND(2.)
Carbon Tetrachloride
ND(2.)
Chlorobenzene
ND(2.)
Vinyl Acetate
ND(5.)
Ethylbenzene
ND(2.)
Bromodichloromethane
ND(2.)
Styrene
ND(2.)
Total Xylenes
ND(2.)
This report pertains only to the samples investigated and does not necessarily apply to ocher apparently identical or similar materials. This report is submitted for the exclusive
use o! Iho client to whom it is addressed. Any repraductian a! this report or use of l is Laboratory's name for advertising or publicity purposes without authorization is prohibited.
Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
® 7440 Lirwln Way • Gaiden Grove, CA 92641
(714) 898-6370 • FAX: (714) 891.5917 • (800) LAS-1CRL
LABORATORY REPORT
CRL OAS RESEARCH ANALYSIS NO.: 727519-002
2325 Skyway Drive, Unit K ANALYSES: EPA -Method 8240
Santa Maria, CA 93455 DATE SAMPLED: 9/30/87
ATTN: Rashmi Shah DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE ID: 1231-2 Bottom of big tank SAMPLE TYPE: Solid
SW ® 9' PROJECT: Brooks Woodcraft/*1231
EPA METHODS 624 8240 VOLATILE POLLUTANTS DATA SHEET
m k
mg/kcf
Chloromethane
ND(5.)
1,2-Dichloropropane
ND(2.)
Bromomethane
ND(5.)
Trans-1,3-Dichloropropene
ND(2.)
Vinyl Chloride
ND(5.)
Trichloroethane
ND(2.)
Chloroethane
ND(5.)
Dibromochloromethane
ND(2.)
Methylene Chloride
ND(2.)
1,1,2-Trichloroethane
ND(2.)
Acetone
ND(5.)
Benzene
ND(2.)
Carbon Disulfide
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
1,1-Dichloroethene
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
1,1-Dichloroethane
ND(2.)
Bromoform
ND(2.)
Trans-1,2-Dichloroethene
ND(2.)
4-Methyl-2-Pentanone
ND(5.)
Chloroform
ND(2.)
2-Hexanone
ND(5.)
1,2-Dichloroethane
ND(2.)
Tetrachloroethene
ND(2.)
2-Butanone
ND(5.)
1,1,2,2-Tetrachloroethane
ND(2.)
1,1,1-Trichloroethane
ND(2.)
Toluene
ND(2.)
Carbon Tetrachloride
ND(2.)
Chlorobenzene
ND(2.)
Vinyl Acetate
ND(5.)
Ethylbenzene
ND(2.)
Bromodichloromethane
ND(2.)
Styrene
ND(2.)
Total Xylenes
ND(2.)
i1ns rnpun anains omy to the samples rnvesugateu aria goes not neGessanty apply to other apparently identical or similar materials. This report is submitted for the S1xcllisiv0
use of the c lent to whom it is addressed. Any reproduction of this report ar use of this Laboratoq's name tar advertising or publicity purposes without authorization is prahibitLO
0 ft
Chemical Research Laboratories, Inc.
SOUTHERNCALIFORNIADIVISION
7440 Lincoln Way • Garden Grove, CA MA i
(714)W6370 ■ FAX: (714)M-5917 • (600)1.AB-1CRL
CRL OAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
SAMPLE ID: 1231-3 Bottom of big tank
SE ® 8'
LABORATORY REPORT
ANALYSIS NO.: 727519-003
ANALYSES: EPA Method 8240
DATE SAMPLED: 9/30/87
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE TYPE: Solid
PROJECT: Brooks Woodcraft/*1231
EPA METHODS 624 8240 VOLATILE POLLUTANTS DATA SHEET
mg/ka
mq/kq
Chloromethane
ND(5.)
1,2-Dichloropropane
ND(2.)
Bromomethane
ND(5.)
Trans-1,3-Dichloropropene
ND(2.)
Vinyl Chloride
ND(5.)
Trichloroethene
ND(2.)
Chloroethane
ND(5.)
Dibromochloromethane
ND(2.)
Methylene Chloride
ND(2.)
1,1,2-Trichloroethane
ND(2.)
Acetone
ND(5.)
Benzene
ND(2.)
Carbon Disulfide
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
1,1-Dichloroethene
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
1,1-Dichloroethane
ND(2.)
Bromoform
ND(2.)
Trans-1,2-Dichloroethene
ND(2.)
4-Methyl-2-Pentanone
ND(5.)
Chloroform
ND(2.)
2-Hexanone
ND(5.)
1,2-Dichloroethane
ND(2.)
Tetrachloroethene
ND(2.)
2-Butanone
ND(5.)
1,1,2,2-Tetrachloroethane
ND(2.)
1,1,1-Trichloroethane
ND(2.)
Toluene
ND(2.)
Carbon Tetrachlbride
ND(2.)
Chlorobenzene
ND(2.)
Vinyl Acetate
ND(5.)
Ethylbenzene
ND(2.)
Bromodichloromethane
ND(2.)
Styrene
ND(2.)
Total Xylenes
ND(2.)
This report pertains only to the samples investigated and does nor necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive
use of the client 10 whom it is addressed. Any raproduolfon of ibis report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibiled.
Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
711. irtcoln Way • Garden Grove, (O W6
(714898637-)0 • FAX: (714)891591I * (B00)LA&1CRL
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
SAMPLE ID: 1231-4 Bottom of big tank
NE ® 9'
LABORATORY REPORT
ANALYSIS NO.: 727519-004
ANALYSES: EPA Method 8240
DATE SAMPLED: 9/30/47
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE TYPE: Solid
PROJECT: Brooks Woodcraft/*1231
EPA METHODS 624/8240 VOLATILE POLLUTANTS DATA SHEET
Chloromethane
Bromomethane
Vinyl Chloride
Chloroethane
Methylene Chloride
Acetone
Carbon Disulfide
1,1-Dichloroethene
1,1-Dichloroethane
Trans-1,2-Dichloroethene
Chloroform
1,2-Dichloroethane
2-Butanone
+1',1,1-Trichloroethane
;Carbon Tetrachl6ride
Vinyl Acetate
Bromodichloromethane
m k mQ/ka
ND(5.)
1,2-Dichloropropane
ND(2.)
ND(5.)
Trans-1,3-Dichloropropene
ND(2.)
ND(5.)
Trichloroethene
ND(2.)
ND(5.)
Dibromochloromethane
ND(2.)
ND(2.)
1,1,2-Trichloroethane
ND(2.)
ND(5.)
Benzene
ND(2.)
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
ND(2.)
Bromoform
ND(2.)
ND(2.)
4-Methyl-2-Pentanone
ND(5.)
ND(2.)
2-Hexanone
ND(5.)
ND(2.)
Tetrachloroethene
ND(2.)
ND(5.)
1,1,2,2-Tetrachloroethane
ND(2.)
ND(2.)
Toluene
ND(2.)
ND(2.)
Chlorobenzene
ND(2.)
ND(5.)
Ethylbenzene
ND(2.)
ND(2.)
Styrene
ND(2.)
Total Xylenes
ND(2.)
This report pertains only to the samples investigated and does not necessarily apply to other app"On"y identical or similar materials. This report is submitted for the exclusive
use of the client to whom it is addressed- Any reproduction of this report ar use of this Laboratory s name for advertising or publicity purposes without authorizalion is prohibited.
wo -
j t Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
7440 Lir=ln NJay • Garden Grove, CA 92641
(714)898-6370 F{U(: (7,4)891.5917 • (800)LAB-1CRL
LABORATORY REPORT
CRL GAS RESEARCH ANALYSIS NO.: 727519-005
2325 Skyway Drive, Unit K ANALYSES: EPA Method 8240
Santa Maria, CA 93455 DATE SAMPLED: 9/30 87
ATTN: Rashmi Shah DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE ID: 1231-5 Bottom of big tank SAMPLE TYPE: Solid
MIDDLE Q 9' PROJECT: Brooks Woodcraft/*1231
EPA METHODS 624 8240 VOLATILE POLLUTANTS DATA SHEET
m k
mQ/ka
Chloromethane
ND(5.)
1,2-Dichloropropane
ND(2.)
Bromomethane
ND(5.)
Trans-1,3-Dichloropropene
ND(2.]
Vinyl Chloride
ND(5.)
Trichloroethene
ND(2.)
Chloroethane
ND(5.)
Dibromochloromethane
ND(2.]
Methylene Chloride
ND(2.)
1,1,2-Trichloroethane
ND(2.)
Acetone
ND(5.)
Benzene
ND(2.)
Carbon Disulfide
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
1,1-Dichloroethene
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
1,1-Dichloroethane
ND(2.)
Bromoform
ND(2.)
Trans-1,2-Dichloroethene
ND(2.)
4-Methyl-2-Pentanone
ND(5.)
Chloroform
ND(2.)
2-Hexanone
ND(5.)
1,2-Dichloroethane
ND(2.)
Tetrachloroethene
ND(2.)
2-Butanone
ND(5.)
1,1,2,2-Tetrachloroethane
ND(2.)
1,1,1-Trichloroethane
ND(2.)
Toluene
ND(2.)
Carbon Tetrachloride
ND(2.)
Chlorobenzene
ND(2.)
Vinyl Acetate
ND(5.)
Ethylbenzene
ND(2.)
Bromodichloromethane
ND(2.)
Styrene
ND(2.)
Total Xylenes
ND(2.)
This roparl pertains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive
use of the client to whom it is addressed. Any reproduellon of this report or use of this Laboratoryrs name for advertising or publicity purposes without authorization is prohibited
Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
7440 Lincoln Way • Garden Grove, CA 92641
(714)890.6370 • FAX: (714)891.5917 * (800)LAS-1CRL
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
SAMPLE ID: 1231-6 Bottom of big tank
MIDDLE ® 11t-
LABORATORY REPORT
ANALYSIS NO.: 727519-006
ANALYSES: EPA Method 8240
DATE SAMPLED: 9/30/87,
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE TYPE: Solid
PROJECT: Brooks Woodcraft/*1231
EPA METHODS 624/8240
VOLATILE POLLUTANTS DATA SHEET
ma/kq
m k
Chloromethane
ND(5.)
1,2-Dichloropropane
ND(2.)
Bromomethane
ND(5.)
Trans-1,3-Dichloropropene
ND(2.)
Vinyl Chloride
ND(5.)
Trichloroethene
ND(2.)
Chloroethane
ND(5.)
Dibromochloromethane
ND(2.)
Methylene Chloride
ND(2.)
1,1,2-Trichloroethane
ND(2.)
Acetone
ND(5.)
Benzene
ND(2.)
Carbon Disulfide
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
1,1-Dichloroethene
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
1,1-Dichloroethane
ND(2.)
Bromoform
ND(2.)
Trans-1,2-Dichloroethene
ND(2.)
4-Methyl-2-Pentanone
ND(5.)
Chloroform
ND(2.)
2-Hexanone
ND(5.)
1,2-Dichloroethane
ND(2.)
Tetrachloroethene
ND(2.)
2-Butanone
ND(5.)
1,1,2,2-Tetrachloroethane
ND(2.)
1,1,1-Trichloroethane
ND(2.)
Toluene
ND(2.)
Carbon Tetrachloride
ND(2.)
Chlorobenzene
ND(2.)
Vinyl Acetate'
ND(5.)
Ethylbenzene
ND(2.)
Bromodichloromethane
ND(2.)
Styrene
ND(2.)
Total Xylenes
ND(2.)
This report pertains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive
use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or pubticily purposes without authorization is prohibile i
;heroical Research Laboratories, Inc.
-SOUTHERN CALIFORNIA DIVISION
744O Lincdn Way ra Garden Grove, CA Mj
(714)898-6370a FAX: (714)891-5917 • (817p)LAg-1CRL
CRL GAS -RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
SAMPLE ID: 1231-7 Bottom of small
tank MIDDLE ® 7'
-LABORATORY REPORT
ANALYSIS NO.: 727519-007
ANALYSES: EPA,Method 8240
DATE SAMPLED: 9/30/87
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/08-13/87
SAMPLE TYPE: Solid
PROJECT: Brooks Woodcraft/*1231
EPA METHODS 624 8240 VOLATILE POLLUTANTS -DATA SHEET
m k
m k cf
Chloromethane
ND(5.)
1,2-Dichloropropane
ND(2.)
Bromomethane
ND(5.)
Trans-1,3-Dichloropropene
ND(2.)
_Vinyl Chloride
Chloroethane
ND(5.)
Trichloroethene
ND(2.)
Methylene Chloride
ND(5.)
ND(2.)
Dibromochloromethane
1,1,2-Trichloroethane
ND(2.)
Acetone
ND(5.)
Benzene
ND(2.)
ND(2.)
Carbon Disulfide
ND(2.)
cis-1,3-Dichloropropene
ND(2.)
1,1-Dichloroethene
1,1-Dichloroethane
ND(2.)
2-Chloroethylvinyl ether
ND(5.)
Trans-1,2-Dichloroethene
ND(2.)
ND(2.)
Bromoform
4-Methyl-2-Pentanone
ND(2.)
Chloroform
ND(2.)
2-Hexanone
ND(5.)
ND(5.)
1,2-Dichloroethane
ND(2.)
Tetrachloroethene
ND(2.)
2-Butanone
1,1,1-Trichloroethane
ND(5.)
ND(2.)
1,1,2,2-Tetrachloroethane
Toluene
ND(2.)
Carbon Tetrac$loride
ND(2.)
Chlorobenzene
ND(2.)
ND(2.)
Vinyl Acetate
Bromodichloromethane
ND(5.)
ND(2.)
Ethylbenzene
Styrene
ND(2.)
Total Xylenes
ND(2.)
ND(2.)
This report panains only to the samples invasligated and does not necessarily apply to other apparently identical or similar materials. This report is submitted far the exclusive
use of the client to whom it is addressed. Any reproductivn of this report or use of Ihis Laboratory's name tar advertising or publicity purposes without authorixalion is prohibited.
0., Chemical Research Laboratories, Inc.
4 SOUTHERN CALIFORNIA DIVISION
7440 i inwh Way • Gafricn Grove, CA 97.641
�(714)898-6NO • FAX: (714)891-5917 • (800)LAB-1CRL
October 19, 1987
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria CA 93455
Attn: Rashmi Shah
ANALYSIS NO.: 727520-001
ANALYSES: EPA Method 8015,Lead,8240
DATE SAMPLED: 10/01/87
DATE SAMPLE REC'D: 10/03/87
PROJECT: Brooks Woodcraft
#1234
Enclosed with this letter is the report on the chemical and physical
analyses on the samples from ANALYSIS NO: 727520-001 shown above.
The samples were received by CRL in a chilled state, intact, and with the
chain -of -custody record attached.
Please note that ND( ) means not detected at the detection limit expressed
within the parentheses.
D
z
/"t:� -,z
D
TE -
This report perlains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive
use of the client to whom it is addressed. Any reproduction of this report or use o this Laboratory's name lot advertising or publicity purposes without authorization is prohibited
0 ft
Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
l44D Lincoln Way • Garden Grove, CA 92641
(714)8M 6370 • FAX: (714)891.5917 • (800) LAS-1 CRL
LABORATORY REPORT
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria CA 93465
Attn: Rashmi Shah
Sample ID: Big Tank Groundwater
1234-1
ANALYSIS NO.: 727620-001
ANALYSES: EPA Method 8240
DATE SAMPLED: 10/01/87
DATE SAMPLE REC'D: 10/03/87
DATE ANALYZED: 10/12/87
SAMPLE TYPE: Liquid
PROJECT: Brooks Woodcraft
#1234
EPA METHODS 624/8240 VOLATILE POLLUTANTS DATA SHEET
u L
uq/L
Chloromethane
ND(10.)
1,2-Dichloropropane
ND(5.)
Bromomethane
ND(10.)
Trans-1,3-Dichloropropene
ND(5.)
Vinyl Chloride
ND(10.)
Trichloroethene
ND(5.)
Chloroethane
ND(10.)
Dibromochloromethane
ND(5.)
Methylene Chloride
ND(5.)
1,1,2-Trichloroethane
ND(5.)
Acetone _
83.
Benzene
ND(5.)
Carbon Disulfide
ND(5.)
cis-1,3-Dichloropropene
ND(5.)
1,1-Dichloroethene
ND(5.)
2-Chloroethylvinyl ether
ND(10.)
1,1-Dichloroethane
ND(5.)
Bromoform
ND(5.)
Trans-1,2-Dichdoroethene
ND(5.)
4-Methyl-2-Pentanone
ND(10.)
Chloroform
ND(5.)
2-Hexanone
ND(10.)
1,2-Dichloroethane
ND(5.)
Tetrachloroethene
ND(5.)
2-Butanone
ND(10.)
1,1,2,2-Tetrachloroethane
ND(5.)
1,1,1-Trichloroethane
ND(5.)
Toluene
ND(5.)
Carbon Tetrachloride
ND(5.)
Chlorobenzene
ND(5.)
Vinyl Acetate
ND(10.)
Ethylbenzene
ND(5.)
Bromodichloromethane
ND(5.)
Styrene
ND(5.)
Total Xylenes
ND(5.)
ND Denotes compound was not detected above the value indicated.
This report parlains only to the samples investigated and does not necessarily apply to other apparently identical or similar malerials. This report is submitted for the exclusive
use of the client to whom it is addressed. Any reproduclion.of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibited
ow � Chemical Research Laboratories, Inc.
+4 SOUTHERN CALIFORNIA DIVISION
01 14
7440 L''inw n Way • Garden Grove, CA 92641
-0 (714) 898 fi iT0 • FAX: (714) 891 5917 • (apQ) LA8 1CRL
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria CA 93455
Attn: Rashmi Shah
SAMPLE IDENTIFICATION
Big Tank Groundwater 1234-1
LABORATORY REPORT
ANALYSIS NO.: 727520-001
ANALYSES: EPA Method 8015, Lead
DATE SAMPLED: 10/01/87
DATE SAMPLE RECID: 10/03/87
DATE ANALYZED: 10/08/87
SAMPLE TYPE: Liquid
PROJECT: Brooks Woodcraft
#1234
Total Petroleum
Hydrocarbons
EPA Method 8015
--MgZL
MI
Total Lead
- Mg/L
ND(0.02)
Note: Sample did not show characteristics of diesel therefore confirmation
by headspace for gasoline quantitation based on gasoline standard.
This report pertains only to the samples investigated and does not necessarily apply to other apparently identical or similar materials. This report is submitted for the exclusive
use of the client to whom it is addressed. Any reproduction of this report or use of this Laboratory's name for advertising or publicity purposes without authorization is prohibileri
® Chemical Research Laboratories, Inc.
SOUTHERN CALIFORNIA DIVISION
7440 Lincoln Way • GardeftGrove. CA 92641
(714) 898.6370 • FAX: (714) 891-5917 ■ (ODO) LAB-1CRL
October 21, 1987
CRL GAS RESEARCH
2325 Skyway Drive, Unit K
Santa Maria, CA 93455
ATTN: Rashmi Shah
ANALYSIS NO.: 727519-003
ANALYSES: EPA Method 8240
DATE SAMPLED: 9/30/87
DATE SAMPLE REC'D: 10/03/87
PROJECT: Brooks Woodcraft/*1231
Enclosed with this letter is the report on the chemical and physical
analyses on the samples from ANALYSIS NO: 727519-001/008 shown above.
The samples were received by CRL in a chilled state, intact, and with the
chain -of -custody record attached.
Please note that ND( ) means not detected at the detection limit expressed
within the parentheses.
REVIEWED
")"64 -
DATE
This report pertains only to the samples investtgaled and does not necessarily apply to other apparently identical or similar materials. This report Is submitted for the exclusive
use of the clieni to whom it is addressed. Any reproduction of This report or use of Ihis Laboratory's name for advertising or publicity purposes without authorization is prahibiled.
DATE
lell
- r P.O. Box' 405
- .�.=• ;�• w�. ,'- t �
Cayucos, C
A 9343
�- CIN RING CONT R
' a
(805) 995-3357 or 927.8000
. i
f '•' 1 TERMS: NORETURN WlTN YOUR FIEMtTTANCE
VLEASEOETACNA
= ':'': �� ":A �;� is �•:=; ::: }} CHARGES AND CREDITS
aALANCE FORwA�
ST ATE)WE ITT
DA E C]
NUMBER '' ]
0
a
r-.j
s
BALANCE
k1
PAY LAST AMOUNT
n ll 1
M E M O R A N D U M
TO: Warren Stephenson, Captain
FROM: Spencer Meyer, Inspector 461t?
SUBJECT: 2087 Santa Barbara - Brook's Woodcraft
DATE: 2 February 1988
Review of Woodshop (H-3 Occupancy) and storage agea of Classes I/II
liquids (H-2 Occupancy).
Regarding sales building consisting of B-2 occupancy in front and H-3
occupancy at the rear of building (with 1-hour occupancy separation):
Question regarding upgrading of H-3 occupancy ventilation electrical
fire -doors, etc. UFC Section 1 102(bl: Except that conditions legally
in existance at the adoption of this code and not in strict compliance
therewith, shall be permitted to continue only if, in the opinion of
the Chief, they do not constitute a distinct hazard to life or property.
This does not relieve the owners of their responsibility for maintaining
all electrical in good working order (switches, receptacles, fans, etc.),
nor does it relieve the owners of responsibility of good shop -keeping
practices (control of dust and reduction of flammable materials not being
used) .
uestion regarding occupant's storage of combustible li ids:
1) Storage within H-3 occupancy, UFC 79.201(d), Class I, II or IIIA:
Liquids shall not be stored (including stock for sale) near exits,
doorways, stairs, nor in a location that would impede egrees (storage
building).
2) Storage of flammable and combustible liquids (adjacent property),
UFC 79.201(e),(4),(i): Storage shall not exceed 60 gallons of
Class I -A, 120 gallons of Class I-B, 180 gallons of Class I-C, 240
gallons of II or 660 gallons of Class III -A liquids or 240 gallons
in any combination of Class I Class II liquids.
Subject to the limitations of the individual class. Quantities
exceeding these limitations shall be stored in an approved, inside
liquid -storage warehouse in accordance with Sections 79.202 and
79.203.
Impression of subject property:
1) Section 1.103(b) does apply to H-3 occupancies.
2) Replace defective or worn electrical equipment (open electrical
3) Good shop -cleaning is required (remove excess materials) and review
frequently for compliance.
4) Limit storage of flammable and combustible liquids (per building),
UFC 79.201(e)(3) and (4).
5) Secure a permit (for record purposes), UFC 4.101(18).
Submitted respectfully for your final determination.
SM:cb
77
(CLIENTI
�FIELD
DATA SHEET
��
/j tj�j0
0OAr-r
PROjF,gT- NAME t
COLLECTED BYa
SAMPLING
SAMPLE
SAMPLE
ID
DATE TIME
MATRIX
om
A
610
t�m
SM, T<
�n M
M IhM Lv 515
5 �Ot�
TESTS
go vo ,
If -
CONT.
WATER S SOLID G—GAS — FGGRAB C—CQMPOSITE I —INTEGRATED
;SAIM71PLEEiICED? N CDC ATTACHED? Y N PHONE RESULTS? Y N RUSH? Y N
DATE REQUIRED1 AUTHORIZED BY$
SAMPLE NOTES/ COND I T INNS DIAGRAM OF SAMPLING SITE G
WEATHER a C�1t L 1
MATRIX CONDITIONa � }alp{5� �ti��,T �
SAMPLE EQUPT. USED a J
CONTAINER TYPE/ VOLU VVopm.MIl,rg
m
�1H�li.Nf Ala�f�lN�S
�X(avTD. 50i� 250 -„o Pp ROM - :�_
IF. NO PC ww ►2ua eoi5 (VOL) VAL,
,DATE/TIME
RE.InINQUISHED BYa RECEIVED By!
RELINQUISHED BYo RECEIVED BYo
,RELINQUISHED BYa RECEIVED BYa
city of sAn lugs oBispo
„De��p0 eriiiSan t� "�* 549-7380
DATE:
SAN LUIS OBISPO, CA 93401 HAS PERMISSION TO MAINTAIN,
STORE, USE OR HANDLE MATERIALS, OR TO CONDUCT PROCESSES, OR TO INSTAL
EQUIPMENT AS DESCRIBED BELOW:
Excavation/removal of 2 (unknown sizes) fuel tanks per Uniform Fire Code Arti
Section 18. Fire Department to observe pumping out & installatir
`Remove tanks from — excavation. Nu
ALL REQUIREMENTS SHALL BE PER THE UNIFORM FIRE CODE AND ITS STANDARD.
THIS PERMIT IS NON -TRANSFERABLE. IT SHALL BE POSTED IN PUBLIC VIEW AND SHALL
NOT BE REMOVED - BY ORDER OF THE FIRE CHIEF.
EXPIRATION DATE
I.D. NO.
AMOUNT PAID: $
BY:
FIRE MARSHAL
L: Chemical Composition of Materials Stored:
Tank # Chemical {common name} Dates Stored Size Previousl
Stof � aAE��On
LL red Chem
?
to
to
E. Final Destination of Tank:
Address Phone No.
__.._[FIRE DEPARTMENT USE ONLY]
Describe Method for Retrieving Samples:
Samples Will be Analyzed For:
Laboratory That Will Perform Analysis:
Address:
THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY AND TO THE BEST OF
MY KNOWLEDGE IS TRUE AND CORRECT. .
Signature: Title: APT ce N`1' ! Date: 9 8 �
RKM13-2
San Luis Obispo City Fire Department
748 Pismo Street
San Luis Obispo, CA 93401
Permit No.
Application Date
—%==:;�=
No. of Tanks to be removed
APPLICATION FOR PERMIT FOR TEMPORARY OR PERMANENT
CLOSURE REMOVAL OF UNDERGROUND
HAZARDOUS uUBSTANCES STORAGE FACILITY
r
Tyne of ARRIiLcation (Fill Out One Application Per Facility)
[ ] Temporary Closu a Permane et Closure 'tv] Removal
A. Facility ame:1
Address: Contact Person:
Phone: (days) (nights
Owner: I l Phone:
Address: zip - a'
Phone:
Address:
B. Water to Facility Provid
Depth to Groundwater:_
C. Tank Removal Contractor:
Address: C) ej-5( ��:
Proposed St ting Date:G
insurer: U-C�C\ �
L.
by:
• CA License No.
ip Phone: 01 -
ed Completion Date:
Chemical Composition of Materials Stored:
Tank # Chemical {common name] Dates Stored Size Previousl
� 071� S�t�ored Chem.
- to
to
E. Final Destination of Tank: rM
�,� I
Address Phone No.
DEPARTMENT USE ONLY]
Describe Method for Retrieving Samples:
Samples Will be Analyzed For:
Laboratory That Will Perform Analysis:
Address:
THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY AND TO THE BEST OF
MY KNOWLEDGE IS TRUE AND CORRECT. '
Signature:ate: 7/0S $
RKM13-2