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Home My WebLink AboutSLOUNIFLOW_FS1 Admin iRC3926i Color_0147_081ffi P.O. Box 1489 2156 Sierra Way San Luis Obispo, CA 93406 styof srnuJS fiqt0 ' .','.,.,', Fire Department (8OS) 281-7980 2160 Santa Barbara Avenue San Luis Obispo CA 93401-5240 CERTIF'IED UNIFIED PROGRAM AGENCY (CUPA) ,,,H AZARDOUS MATERTALS tNspEcilorv'io-nru f/-JDate: Time NO N/A!! rrrT lcl,,'#EFW data entry by: YES W 8",a' dw BPOl BPO2 BPO3 BUSINESS PLAN Business plan is complete, current, & available during inspection (Hsc 25503.5, Tige 1g ccL2729)rnventory of hazardous materiars is comprete (HSC 25504, Tite 19 cc,^2729)site layouufacility maps are accurate (HSC 2s504, Title 19 ccL2729) TRAINING PLAN Facirity has appropriate training program (Title 19 ccR 2732 & 22 CCf. 66265.16) #;ltlfru*"mentation is maintained on site for current personnet (Tirte 19 ccR 2732 & 22 CCR EMERGENCY RESPONSE PLAN 88TT?a|E!3Hl*-n,ete, updated, and maintained on site (HSC 2ss04, ritre le ccl2731 &22 Facility is operated and maintained to prevenvminimize/mitigate fire, explosion, or release ofhazardous materials/waste constituentr-to fitu.ioi"rnment. Maintains ail required or appropriate"r[]in-u"t i"cluding an alarm ""a "o--oni;;il". system (Tifle 19 ccR 2731 & 22 ccR 66265.31- ABOVEGROUND PETROLEUM STORAGE TANK ACTsPCC Ptan is reviewed and certified ty u ""girtu*d engineer within rast 5 yrs. (40 c.R rr2.5(b)SPCC Plan is mainrained on site or nearest fieta ornce.-(Hs a;:;;;;;'"" " ' dxrdxr TROl TR02 EROl ERO2 EEW ATOl AT02 FACILITY NAME: ADDR PHON E: EHS AG DEPT CITY FIRE: Routine Reinspection Complaint Other PROGRAMS INSPECTED Business plan HW Generator UST E rcr DcelnnpREINSPECTION REQUIRED:NO N YES I Business ptan E Hw Generator n usr fl ncr Ecal*npINSPECT:RMISSION TO lnspections may involve obtaining raphs,photog andreviewingliancewith copying andrecords,codes.BY COMMENTS Go to http://www GPS Coordinates:Latitude: .htm,to obtain forms to comply with Bp0l_Bp03, TR01 and ER0l INSPECTOR: C deg \Temp\c.lotus.notes.data\l-lnSpedion Form page j.doc .l 3-Jun-OS mtn mrn FACILITY REP: j L. FACI-LITY NAM ADDRESS HAZARDOUS WASTE GENERATOR r Lbs or gals (average)EPA ID NUMBER: Tiered Permit: Treatment Equipment: Total generated/month: Waste oil: Solvents: Antifreeze: Others:ukf,, YES- NO N/A@ E-E I vroL.# GTOl EPA ID NO/PERMITS Generator has an EPA ID number to treat, store, dispose, transport or transfer hazardous waste (Title 22CCR566262.12) If Not, Calt (S00) 618-6942 to obtain your CAL EPA ID number. HAZARDOUS WASTE DETERMINATION Hazardous waste determination conducted (Title22 CCR $66262.11) nown knowledge lanalysis nother Hazardous waste analysis/test records are kept for at ledst 3 years (Title 22 CCR $66262.40.(c)) DISPOSAL/TRANSPORTATION Hazardous wastes were transported and/or disposed to a facility with an EPA ID NO. and permit or Manifests and/or receipts are properly completed/retained by generator for 3 years (Title 22 CCR 966263.421 66262.23) STORAGE AND MANAGEMENT OF CONTAINERSITANKS Hazardous wastes are accumulated on site as follows (Title22 CCR 566262.34) fl m Oays if waste generated per month is greater than or equal to 100 kg (220 lbs.) D ftO days if waste generated per month is less than 100 kg (see note) JZIO days if waste generated per month is less than 100 kg and transported more than 200 miles (see note) Note: Applies only if hazardous waste accumulated on site never exceeds 6000 kg(13'200 lbs.)and no acutely/extremely hazardous waste over 1 kg (2.2 lbs.) is held on site for over 90 days. Hazardous waste "satellite" collection is managed properly (complete labeling/accumulation time/55-gal or l-qt timit) (Title 22 CCR*66262.34(c)) Ignitable or reactive wastes are located 15 m (50 feet) from facility's property line (Title 22 CCR 86626s.176) Containers of hazardous \ilaste are properly labeled (includes appropriate date, "HAZARDOUS WASTET,' waste composition/physical state, hazardous properties, name/address of generator) (Title22 ccR $66262. 31, 66262.34) Containers/tanks containing hazardous wastes are in good condition/handled to minimize release or reaction (Title 22 CCR $66265.17 ll.l9\, 66265.177 (c)) Containers/tanks/liners are compatible with waste stored or transferred (Title22 CCRS66265.172) containers storing hazardous wastes are closed/sealed (Title22 CCR $66265.173) Weekly inspection of areas where hazardous waste containers are stored is conducted (T itle 22 CCR$ 6626s. 174) Daily inspection of all tank systems is conducted and documented (Title 22 CCR $66265.195) Empty containers or inner liners greater than 5 gal has date when emptied and are managed properly within one year of date emptied (Title 22 CCR $66261.7 (f)) RECYCLABLE WASTE Used oil is managed as hazardous waste until recycled (includes proper labeling, storage, etc) (HSC $2s2s0.4) Used oil filters for recycling are managed properly (drained of free flowing liquid, stored in closed rainproof container, labeled "drained used oil filters," and transferred for metal reclamation) (Title22 ccR$ 66266.130) Spent lead-acid batteries are being properly stored and transferred offsite under manifest or bill of lading for recycling, reuse' or reclamation (Title22 CCR $66266.81) Sotvents/other recyclable materials are managed as hazardous wastes until recycled (Title 22 CCR $66266.3) SOURCE REDUCTION: For facilities generating >12,000 kg./yr. of hazaidous waste on site. Generator is subject to SB14 and has prepared and retained current source reduction documents or is able make them available to the inspector within (5) days. (HSC 525244.19,25244.21) Source Reduction Evaluation and Plan contains the following five elements: certification, amounts of wastes generated, process description, block diagrams, and implementation schedule ofselected source reduction measures. (HSC $25244.19) tr tr T I trTT nI B" wil g' w d dd B, w 8",w E dw I ITn IT T n n T 8,, B/ dr dT n/rwn GTO3 GT04 GTO5 GTO6 GTOT I cros GTO9 GTlO GTl1 GT12 GT13 GT14 GT15 GT16 GTIT GT18 GT19 GT20 GT2I GT22 GT23 I.. I /"\ $,\,t-7 i../i ,#.h( C:\DOCUli/E-1\Hepro\LOCALS-1\Temp\e.lotus"notes"data\Z-Hazardous Waste Generator.doc 7-lV{ar-05 7-Mar-05 SWRCB, January 2002 page -- of _ Secondary Containment Testing Report Form This form is intended for use by contractors performing pertodic testing of UST secondary containment systems. Use the appropriate pages of this form to report results for all components tested. The completedform, written test procedures, and printouts from tests (if applicable), should be provided to the facility owner/operatorfor submittal to the loial regulatory agency. 1. FACILITY INFORMATION. Facility Name UPS Date of 12-t9-200s Facility Address:3601 Sacramento Dr. San Louis Obispo Facility Contact:Phone: Date Local Agency Was Notified of Name of Local Agency Inspector (if present duing testing): 2. TESTING CONTRACTOR INFORMATION 3. SUMMARY OF TEST RESULTS If hydrostatic testing was performed, describe what was done with the water after completion of tests: Company Tank Specialists of California Technician Conducting Test: Jesse Arias Credentials: X CSLB Licensed Contractor SWRCB Licensed Tank Tester License Type:A-8, HAZ License Number: 745065 Manufacturer Manufacturer Training Comoonent(s)Date Training Expires Incon Incon Sump Testing Monitor System 12-01-06 Component Pass Fail Not Tested Repairs Made Component Pass F'ail Not Tested Repairs Made 1-Sump X 1-Udc X l-Secondary Line X l-Direct Bury Spill Bucket X Tank has wet annular. nr CERTIFICA To the best of my FOR CONDUCTING THIS TESTING compliance with legal re quirements Technician's Signature accurate >')?'o( SWRCB, January 2002 Page of 5. SECONDARY PIPE TESTING CommentS - (include information on repairs made prtor tu testing, and recommended fotlow-up for faited tests) Industry Standard Professional EngineerTest Method Developed By Other Piping Manufacturer ) swcruB I Pressure Other (Specify) Test Method Used:Vacuum Hydrostatic Test Equipment Used:O-5 P.S.L Piping Run#dsl sply Piping Run # Equipment Resolution: Piping Run #Piping Run# Piping Material:Fiberglass Piping Manufacturer:Smith Piping Diameter: Length of Piping Run:12' Product Stored:Diesel Method and location of piping-run isolation:Term. Boot Term. Boot Term. Boot Term. Boot Wait time between applying pressure/vacuum./water and starting test: 30 Minutes 30 Minutes 30 Minutes 30 Minutes Test Start Time:1430 5 psiInitial Reading (RJ: Test End Time:1530 Final Reading (Rr)5 psi Test Duration:60 Minutes 60 Minutes 60 Minutes 60 Minutes Change in Reading (Rp-R):0 0 0 0 Pass/Fail Threshold or Criteria:5 psi=pass 5 psi=pass 5 psi=pass 5 psi=pass t )l SWRCB, January 2002 Page of 6. PIPING SUMP TESTING Comments - (inctude information on repairs made prior to testing, and recommended follow-up forfailed tests) I If the entire depth of the sump is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk 1*) is "NO" or "NA", the entire sump must be tested. (See SWRCB LG-160) Test Method Developed By:Sump Manufacturer Other (Specify) SWCRB Industry Standard Professional Engineer Test Method Used:Pressure Other (Specify) Vacuum I Hydrostatic Test Used: Incon Sump Testing Monitor System Sump # dsl pip # Equipment Resolution: #Sump # Sump Diameter:42" Sump Depth:s6,, Sump Material Fiberglass Height from Tank Top to Top of Highest Pipine Penetration:24" Height from Tank Top to Lowest Electrical Penetration : 15' Condition of sump prior to testing:Clean Clean CIean Clean Portion of Sump Testedr Bottom 26"Bottom Bottom Bottom Does turbine shut down when sump sensor detects liquid (both product and water)?* Yes No lNa Yes No lNl.Yes No lNn Yes No [Ne Turbine shutdown response time N/A N/A N/A N/A Is system programmed for fail-safe shutdown?*Yes No INe Yes No lxe Yes No lN,+.Yes No lNa Was fail-safe verified to be operational?*Yes No lNe Yes No lNl Yes tn lNe Yes No lun Wait time between applying pressure/vacuum,/water and starting test: 60 Minutes 60 Minutes 60 Minutes 60 Minutes Test Start Time:11z23 am Initial Reading (R)4.7786 Test End Time:11:39 am Final Reading (Rp)4.7785 Test Duration:15 Minutes 15 Minutes 15 Minutes 15 Minutes Change in Reading (Rr-&)-0.0001 Pass/Fail Threshold or Criteria: Was sensor removed for testing? +/- 0.002In. X Yes No NA +/- 0.002In. XYes No NA +/- 0.002In. XYesNo NA +/- 0.002 Yes No NA Was sensor properly replaced and verified functional after testing? XYes No NA XYes No NA X Yes No NA Yes No NA li \\)r SWRCB, January 2002 Page - of -7. UNDER.DISPENSER CONTAINMENT TESTING Comments - (include information on repairs made prior to testing, and recommended follow-up for failed tests) 1 ff the entire depth of the UDC is not tested, specify how much was tested. If the answer to any of the questions indicated with an asterisk 1x) is "NO" or'NA", the entire UDC must be tested. (See SWRCB LG-160) Test Method Developed By Industry Standard Professional EngineerUDC Manufacturer Other )SWCRB Pressure Other (Specify) Test Method Used:Vacuum I Hydrostatic Used: Incon Sump Testing Monitor System UDC # Test UDC # dsl mst UDC#UDC# Resolution: UDC Manufacturer:Environ UDCMaterial Polyethylene UDC Depth:1.2" Height from UDC Bottom to Top of Hiehest Pipine Penehation: 0" Height from UDC Bottom to Lowest Electrical Penetration: 0" Condition of UDC prior to testing: CLEAN CLEAN CLEAN CLEAN Portion of UDC Tested'Bottom 8"Bottom Bottom Bottom Does turbine shut down when UDC sensor detects liquid (both product and water)?* Yes No ilNe Yes No lue Yes tto lxL Yes No lNe Turbine shutdown response time N/A N/A N/A N/A Is system programmed for fail- safe shutdown?*Yes No lNe No lNaYes Yes No lN.t Yes No $Ne Was fail-safe verified to be operational?*lNeYes No Yes No lNe Yes No lNe Yes No $Ne Wait time between applying pressure/vacuum/water and startins test 60 Minutes 60 Minutes 60 Minutes 60 Minutes Test Start Time:2:57 pm Initial Reading (Rr)2.3760 Test End Time:3:l2pm Final Readine (Rn):2.3762 Test Duration:15 Minutes 15 Minutes 15 Minutes 15 Minutes Change in Reading (Rr-Rr):+0.0002 +/- 0.002In. Yes No NA +/- 0.002In. xYes No NA PasslFail Threshold or Criteria; Was sensor removed for testing? +/- 0.002In. XYes No NA +l- 0.002 xYes No NA Was sensor properly replaced and verified functional after testing?NA lYes No xYes No NA xYes No NA xYes No NA SWRCB, January 2002 9. SPILL/OVERFILL CONTAINMENT BOXES Comments - (include information on repairs made pior to . and recommended follow-uo for failed tests) Page of Facility is Not Equipped With SpilVOverfill Containment Boxes SpilVoverfill Containment Boxes are Present, but were Not Tested Spill B ucket Manufacturer Other (Specify) SWCRB Industry Standard Professional EngineerTest Method Developed By: Pressure Other (Specify) Test Method Used:Vacuum I Hydrostatic Spill Box #Spill Box # Resolution:Test Equipment Used: Incon Sump Spill Box # Monitor System Spill Box # dsl spl Bucket Diameter:12" Bucket Depth:t6 60 Minutes 60 Minutes 60 Minutes 60 Minutes Wait time between applying pressure/vacuum/water and starting test: 2:57 pmTest Start Time Initial Reading (R):3.6977 Test End Time:3:t2pm 3.6976Final Reading (Rr): 15 Minutes 15 minutes 15 Minutes 15 MinutesTest Duration: Change in Reading (Rp-R):-0.0001 +/- 0.002In.+10.002 In.+/- 0.002In.+/- 0.002 In.Pass/Fail Threshold or Criteria: r"\ t) Jr.rrI..iiit''ll$iH;ug-' I'.I.', "it ./"'flff$r"'r+ Ptl , , -f,ry" TF51 t4EFllRT UP5 3681 $ficRfiHEt{Tn trF: SRI{ LUIS OHISFT l?/lgrlggg ilr39 qp1 .SUI'IF LfftH TIST fiEPBHT SsL PIP TEST s"tf#TED lle:3 ffl,tTEsr srftRTfp trrig.'zgurBEGrht_LzuEL q. irac ru Flif I1IE r r; ss Apr Ffifl [Ett. '$llF;g-?fri# #gff+'* --FH3_IH '?5L gPL lF:.ffi'*:l;T+4h t:f''il ::l; rtriPr':'an-iil: ;i+r'-., "i.a+'l* tt't iP!. '':tryuu ;;u*g*tg ?'r.v" '*ri\JL t ;9L l'ltT ;ti ;l$$,H ''T;?h[-[-wi,*i#ffi$ TE! "l.e'; rLr Diyision of Environm ealth (80s) 781-ss44 P.O. Box 1489 2156 Sierra Way rSan Luis Obispo, CA 93406 Deoartment of Asriculture/Nleasu rement Standards (tos) 781-s910 2156 Sierra Way Suite A rSan Luis Obispo, CA 93401 / of San Luis Obi spo Fire Departrnent (805) 781-7380 2160 Santa Barbara Avenue San Luis Obispo CA 93401-5240 Utilities Departmsnl r (805) 781-7215 879 Morro Street r San Luis Obispo, CA 93401 EFW data entry by:Alf CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM I /3'1 |o/Date: Time r: ."l:.tt:, ,:l: :.irji: .aat F'ACILITY ID NO:'Mi' )/FACILITY NAME: ADDRESS: 1,4il l-t/ t PHONE v/- t tl AGDEPT CITY FIRE CITY UTILITIESB AGENCY LJ nnn Routine Reinspection Complaintfl ott "t Business PIan ,F gw c.n".uto"PROGRAMS INSPECTEDI ffiusr E ncr E Tiered Permitting N NO f] YES n Business PIan n HwGeneratorREINSPECTION REQUIRED:n usr I ncr n Tiered Permitting TO INSPECT: rnspections may involve obtaining photographs, reviewing and copying records, and determining compliance codes. GRANTED BY YEYtww W.w d NO N/A BUSINESS PLAN Business plan is complete, current, & available during inspection (HSC 25503.5, Title 19 CCR2TZg) Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729) Site layout/facility maps are accurate (HSC 25504, Title 19 CCR27Z9) TRAINING PLAN Facility has appropriate training program (Title 19 CCR2732 & 22 CCF- 66265.16) Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 ccR 6626s.r6) EMERGENCY RESPONSE PLAN contingency plan is complete, updated, and maintained on site (HSC 25s04, Title 19 ccR 2731 &22 CCR $ 66265.s3l54) Facility is operated and maintained to prevenVminimize/mitigate fire, explosion, or release of hazardous waste to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 ccR 2731 & 22 ccF. aazas.lt-.a21 BPOl BPO2 BPO3 TROl TRO2 EROl ERO2 COMMENTS INSPECTOR:FACILITY REP: L}/)I -z v- Fleprr: '1 001 rev 1 o:\DocUM ENT\Jcffp\f oRM$\lnspection fornrs\cu pA inspection forms.cloc 1 0-$ep-p1 4+ FACILITY NAME YES NO N/A DATE INSPECTOR: DOUBLE-WALL UNDERGROUND STORAGE TANK (UST) INSPECTION cHsc ! H H tr tr tr tr u UTOl UTO2 UTO3 UTO4 UTO5 UT06 UTOT UTOS UTO9 UTlO UT1 1 UT12 UT13 UT14 UT15 UT16 UT'17 UT18 UT19 UT20 ur21 UT22 UT23 UT24 UT25 UT26 UT27 UT28 UT29 REQUIREMENT Site has a permit to operate. Permit is kept on the premises. Change of ownership is reported to the permifting agency within 30 days. Contractor trained properly. Contractor has Class A,C- 10,C34,C36, or C61 license? UST system leak response plan. Facility maintains evidence of Financial Responsibility. UST System information forms (Form A&B) are on file, accurate and entered into database. Facility has BOE number. lf not call 916-324-2166 to obtain. Testing qgrformed as required. flSecondary containment testing, jflAnnual Certification. ! ELD Oversfitlvcontainers pass liquid tightness test, with no leak through drain valve. Containers without sumps are tested. Overspill Container drain functional or altemative available. Secondary containment & overspill containers are liquid/ debris free. Leak Monitoring Console has proper leak detection and overfill notification programming. Continuous alarm history is maintained. Audible and visual alarms functioning properly. Under Dispenser Containment (UDC) present. UDC has approved operational leak detection equipped with pump shut down. Leak detection sensors are properly secured at lowest point in sumps and tank annular spaces, at time of inspection. Pumping system shuts off when leak is detected or when the monitor is disconnected or fails. Annual piping integrity test detects 0.1 gph. NA if yes on UT 1g Line leak detector detects 3.0 gph and is certified annually. Overfill prevention system installed and operational, Emergency Shut Off switch (ESO) is functioning properly. No liquid leaks visible. Shear Valves are in place and functioning. Secondary Piping is open at the turbine and transition sumps. Fuel filters managed properly. Monitoring system checked daily (Emergency generators only) Monitoring Wells are maintained properly. Cn WAt Standards; County Well Ordinance Documentation of hazardous and restricted waste disposal ccR TITLE 23 25284 2712 2528a@) 2528a.1(a)(s)(D) 2637(bX1XB) 2632 25292 25286 Chapter 6.7 2637 2635(bX1) 2635(bX1Xc) 2631(dX4), 2635(bX1) 2634 2632(c)(2)(B), 2636(0(1) 2528a.1(a)(s)(c) I] tr n 2528a1{€)@)(c) 25189.5(a) 2636(0(1) & (s) 26a1@) 2636 2636(D(4) 263O(d),2632 2635 2632 2632 2632 2636 ! H tr tr tr tr ! ! n il H fl u u 2636(gX5) 2632 6,6263.42t662 62.23Title22 flon*il,C&1-Z?- QE O:\DOCUMENT\Forms\HAZMAT\UST tnspection (DW) Report#2.doc 11-Feb-03 repro I (r28 \)Nl+d Milr{, 5sl,/& tlnlut EPA ID NO: US WASTE GENERATOR 'liWhAxqlM'rL l&10t ." ) r- ''-) SUMMARY OR OBSERVATIONS/WOLATIONS No violations of underground tanlq hazardous materials, inventory, and hazardous waste laws, regulations, and requirements were discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicabte to your facility. Violations were observed/discovered as listed below. All violations must be corrected by implementing the corrective action listed by each violation. If you disagree with any of the violations or proposed action, please inform us in writing. ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED. CUPA must be informed in writing certifying that compliance has been achieved. A false statement that compliance has been achieved is a violation of the lew and punishable by a tine of not less than $2,000 or more than $25'000 for each violation. Your facility may be reinspected any time during noimal business hours. You may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. The issuance of this Summary of Violations does not preclude CUPA from taking administrative, civil, or criminal action as a result of the violations noted or that have not been corrected within the time specified. H T NUMBER VIOLATIONS MINOR MAJOR CORRECTIVE ACTION REQUIRED l!, COMMENTS: Inspected Facility Rep Name: Signature:Date O:\DOCUMENT\Jeffp\FORMS\lnspectiorr forrns\CUPA irrspection forms.doc .10-Sep-0,1 B&T SERVICE STATION CONTRACTORS (AA5) 4AT-@4TZ @?/24/@4 @?=23P P.@@? ) MONITORING SYSTEM CERTITiICATION ,1urhoriry (itd ehapter t,r. [:;Y;:!l!]]i';'&!i'U,if;!'io'';,1,'r:!:,"{';!,:{:?;'!cotyn,nio code or Regutationlt This fonn mlst bc uscd ro docunrcnt tcsting and scrvicing of rnonitoring cquipmcrt. A scperitc c€nification or !;!qt! must bc orcqlle4 fo/e{chrr'o@lrytIrctcclrnici4whopcrformstlrcrmrk.AcopyoftlrisformmusrbcarovidcAtothgtank systcm ownc/opcraror. Thc o*ner/opcralor must submit o copy of this form lo thc local egcncy rcgulating UST systcrns wilhin 30 days oftcsr datc- A- C,cncrnl Fsciliry Nrmc: Sitc Addcss: Info Bldg. No.;_ 3/^a I &c,c-v.*, na nLn ci Facility Contact I'crson: Makc/ModcloiMonitoringSy,rcm: L,t. eP- t 7 < ?SO DatcofTcsting/Scrvicing; QZtfuAtt B. Irrvcntory of trquiporent Tcstcd/Ccrtificd Cic 'lf the fxility conlrirg mcre lar*s or d.ispcnrs:. copy this fono. lncludc infometion for cvcry tlnk and di3pcnfct i( thc frcilily. C. CeffifiCatiOO . t ccr(lfy lhrt the tqulpmcnt idcnti(ir<t in rhir docuruent rver inrpccterd/raniccd itr rccor{rlrc. with thr rrrnuufrcrurnrr' fluldclllct. A0rclcd lo thir Ccdi(icr6on lr informa(ion (t.g. r[Ltrufec(urcrr' (hecHirtr) !cr6frt? to verlfy thrt tbiJ lnforur:tion is .orfrt{rhdrPlo.Plrnrhowiog(f,cleyoutofmonitoringcquiFnrcrrt. Forrnyequipmcnrca?ablcof gcocrttingrrrctrrcpor6, IIavcllso aIIthatapply); FSystcm rct-up v":%":?EY rcpor(.ti.ctr.d r copy of thc Tcchnicirn Nrnp (print): C,srificetion No.: tQ s igrLlturc: Uccnsc. No.: 1'asting Company Neme: Sitc Ad&crs: 'P-, A7'-Prro". No.:(9d rl qE!t'2{5 TanklD: . -P. )<-c l Il ln-T*hGr$trng?reb.. @ $bAnnnlusprccot Vault Scnsor, Modcl:-?1gt-Aylra--9-d4 El Fiping Sump / Tnnclr Sensor(s) Mo&'l&}-Z--lt-c,- O Filt Sunp $cnro(r) Mo'dcl: - Q Mcchmicrl Linc k.!k Dcf ccror'. Mo|lcl: . [\ea( .lo,ll+ L O Etcckortic t.ina lrJrk l)e,lc-ctor. Modct: It Trnk Ovqfill / l{i6h-l-cvcl Scrrsor. Modcl: O Ohcr(rn<cify cquipmcnt typc and modcl in Scction E on I'aFs 2) a- uvur B (n-1'rnk $ruging Probc, nt! Annulrr Spact or Vluh Scnsor. tr Piping Sunrp / Trtnc| Scnto(r), tr Fill $ump Scnsor(r) O Mochanical Lrne Leak Dclc€lor. E l:lcclronie Line Lcalc Delector. Modcl: Modcl: Model: lylqdcl: Morjcl: O T:rnkOvcrfrll I Iligh-Lcvcl Srnsor- Modcl: ..".-. B Othcr (spccifo cquiprucnt typc lnd ruodcl in Scction ti on llagc 2). Trnk lD: Model: ln'Tmk Gruging Probe. &rrrulrr Spacc or Vaul( Scnsor. I'ipinr Sutrlp / Trtnch Sclrtol(5), fill Sultp Scnso(r). Mcchanitzl Li:rc lrrk Dctcctor. lllcctronic Linc l..cdi Oclcctor. 'l.rnk Orcrfill / Hixh-kvcl $cnror, a o EI D o D o o Modd: Modcl: Model; Modcl: Mtrlcl: Mod:l: Mo&l: Othcr(spcci& cquiolt)crl tYpc rnd rnodcl in Scction [ 9n faqe 2). Tenlt lD D ln.T:rnk Grtrging Probc. Mod!?l: 0 Anntrlar Sp.rcc or Varrlt Scnsor. Morlcl: Q liping Sump/ Trcnch Scnso(s), Modcl: O Fill Srrrnp Scnror{s}. Modcl: O Mqch;rnicrl Linc Lcrk Dcrcclor. Modcl: O Elccionic Linc Lcak Dctator. plodcl: tr TukOvcrtill / t{igh-lrvcl Senror. Modcl: D Oficr fro*ifv c4lrinrncnl tvnc and rbodcl in Sclion ll on Frf e 2). T:rnk ID: Dirrrcnrcr Contrinrurnt Rotr(r) urt Cluin(r). z;ar,E/ J.) Fo Dispcucr ID: O tlirpot r Strcer Vrl'a(r). Scnso(s). Modct I DirFnrcr lD, O DirparaCanlainrxnt Scnsor(s). Modcl: O Slran Vrtrc(r), O Dirpar:cr Conlaimrnt Floct(s) and Chain(:). Q Dirparrer Clntrinmnt Sarso(s). Modcl: O Shclrvrlv.(r). O Disncn:cr Cnnlainmnl Float(rl ud Chain(s), Dirptucr l0ll)irD€hr.r lD: O Dirrrcrs Contrinmcnt Scnlo(s), Modcl: Cl SharVrlvr(r). O Dirfnccr Cnatriamat F'lort(s) :tnd Qlein(r1. O DirpascrContrinDcnt Senso(r). Modcl: O Skcr{VrlYc(s), ODispcnra Conlainmcn{ Float(s) and Chein(s). Dirprnrer lDl D Dispcnscr C.ontainrocnt Scnco(s). Modc[: O Shcrrvrlvc(r). O Dirpcnser Coatriarucnt Flort(s) ;rnd Orein(r). Dh1xr13sl ID' Date of Tcsting/ScMcing: J-/}il g B&T SERVICE STATION CONTRACTORS (BO5) 4AL-a41.?O?/?4/@4 @?.23P P.6@3 I'rt:c I of l A{orrituring Syllcnr (i:rlificrtiorr D. Results of 'l'cstirtg/Servicing Softwrrc Vcrsion I rrstallccl: Clom tfie followln clicckl irl: ' ln Scc(ion E bclorv, dcscribc lrow arrd \rlrcrr thcsc rlcticicrrcics \rere or rritl bc corr(ctcd, l,.l/0 I E Ycs El No'ls thc audiblc alrrtrr opcrational? F Ycs [] No'ls thc visurl allm oocra(ional? E Yas O No.' Wcre ill *cnsr)rs visuolly inslxctcd, li.rnctionrlly lctted. tnd conl'inrrcd ofrcrnrionil? p Ycs O No'Wcrc all scnsors instillcd at lou.cst Foint ol scconchry contiinrucnt rnd positioncd so that othcr cquiprrrcnt will not intcrfcrc with lhcir propcr oDc(triou l p Ycs 0 No' O N/A lf rlanrts rrc rclryid to t rcnlotc rrronitoring slation. is all conrurr:nications cqrripnrcnt (c..:. rrrodon) opcra(ionat'l F Ycs O No' O N/A For prcssurizcd piping systcurs. docs thc turbinc autornrtically shut down if thc piping secondrry contirinrrrcnr ruonitor'inrt systcrn dc{ccts o leak, fails to oDcralc. or is clcctrically di:iconncctcd? I.lycs: which scn:ors irririarc posiri''c shsr-down? (Chcckall rhor u14tl.t'1 Q Suurpfl'rcnch ScnsoLs. Q Di4cnscr Corturinlllgrl Scrrsors. Did you confinrr posi(ivc shst-dc\^tr duc to lcaks il!d scnsor failurcy'dirconricctiorr? O Ycs; D No. pYcs u o No' N/A For tank systc,r'rs thot utilizc thc rnonitolirr..r syslcin ns ttrc pr'ilrur'y tank ovcrfill waminl dcvicc (i.r:.,ro rltcch:trlrctl ovcr{ill prcvcrr(ion r,:rlvc is irrstallcd). is thi orcrfill rvilnrirtc alarrn -isiblc and rudiblc irr rhc trrrk fillpoint(s)rodol)c-nlingpropcrlvlt lfso.rr rvlurf)crccntoflrnkclpircirvtlocsthcalnnltriqscL? n/n p Ycs'ONo \\'asanyrnohitorinlcquillrtrentrcplaccdl, llycs,idcntifysfxcil'icscnsoru.probcr,orothcrcquipnlcnrr'r.nlnccd and lis{ (hc lnit nufrcturcr notttc arttl rrrotlcl for all rcplaccrncn( pilrls irr SccriOrt l:. bclorv. Wus liquid forrn<t insidc airy scctrndary corunirrrlrcnr systc:lrs <lcsigrrcrt 09 dry systcrr$? (Checl;oll thtt opltl.r')Q Producr: O dcscr-ibc catrscr in Scction E belorv Wll rlqtnitorin? sys(cnr sct.u0 rcvis\\'c(l to r:rrsurc t)rot)ct:ic((ings'.) Arrach sul (rD rcrrorts. ilann!icahlc B Ycs'FNo Fly:-=p Ycs (] No' E No'lr all_-rrronilorirrl cquipnrcnl ooeraliolllpcr rl\;tnuf6ctu{cr'g Spccificationl? E- Comnrcnts: B&T SERVICE 5TATION CONTRACTORS (El65) 4AI-@412 @Z/74/84 6?=73P P -@@4 F. In-Tank Gauging / SIR liquipmcnt:D Clrcck tlris box if tank gruging is uscd only for invcntory conlrol. O Chcck this box if no tank gruging or SIR cquipmcnt ir insullcd. This scaion tuust bc comptcted if in-tank gauging cquiDmcnt is uscd to perform leak dctcction monitoring. thc clrccklist: * In (he Sccfion E below, dcscribc horv and rvhcn lhcse dcficiencics wcrc or will be corccted. G. Linc l*ak Detcctors (t LD): O Checl.- this box if LLDs re not instrllcd, Corn lhd ' In the Secfiofl ll. bclorv, describe how rnd rvhcn these dcficicncicr were or will bc corrcc(cd- II. Commcnts: FYcs O No.Has rll input wiring bccn inspqtrd for propcr cntry and tcrminatioq including rcsting for ground faultrT FYcs O No'WcrE dl tank gauging probcs visualty inspccttd for darnrgc lnd rcsiduc buildup? El Ycs E No'Wls rcuacy of qncn D(duct lcwl rcadings rc*cd? E NorFY"s Was rccwrcy of sytum rratcr lcvcl rcadings tcstcd? 8-Ycs Wcrc rll probcs rcinnalled jt<oporly?lJ No' EFYss D No'Wcrc all itcrns on lhc cquipmcnt nrrnufactracr's mai;rtanancc checklist complctcd? p Ycs og No' N/A For cquipnrcnt starl-up or arururl cquipment cenification,.was a lcok simulatcd to vcrify LLD Jxrfor:rrr"rncc? (Chcck oll $ot afiply) Sinrulatcd lcak &rtc: 8'3 g.p.h.; E 0.1 g.p.h ; El 0.2 g.p,lr. D Nol Wcrc all LLDs corrfrnncd ogrcr.rtional and rccuratc wit[il rcgulatory rcquircrnents?F Y.,s FPYc:O No.Was the (csting apprra(us ilropsrly calibra(cd? E Ycs o o No' N/A For rnechanical LLDs. does t.lre LLD rcskict product flow if ir detccts a lc.ak? El Ycs O Ycs D No' .E N/4- O No' F bu^ [:ot clcctrouic LLDs. docs tlc trrrbirte au(omatically slrut off if tlrc [D dctccts a lcak? clcckonic LLDs. docn Ilrc turbinc auromstically slrut off if any portion of rlrc rrronirorirrg syslem is <lisablcdl'or or disoonnectcd? o Yc.O No. F lv^ For clcckonic LLDc. doca thc turbins aulonudcally shut offif Eny pqnion of rlre nonitoring systcm malfunctions or fails l tect? Q Ycs o EI No' DVA Forclccqonic LLDs. have nll acccssible wiring cooaoctions bccn visually inspcacd? FYcs O Noa Wcrc all i0ccrs on tfic cquipmcnt manufactr.qc{'s oaintatnccdrocklist complacd? '' tr B&T SERVICE STATION CONTRACTORS (BA5) 4AI-a'41.?12/1-1-/67 64-.47P P.@@? MONITORING SYSTEM CERTMICATION For Use Ry AII Jurisdictiottt Within thc Statc o[Ca.li.lo11ia- ,.- Authority Circd: Ctwplar 6.r. Hcalth ard Saft;'6;;:'ei"iii it,br'"i'-n 'J, nic zl, Celiprnia Codc of Resutatiow Ilis forrn must bc used to docutent tcsting rnd scrvicing of monioring oguipmcnt' A separatc,c'{rificotion or rcood forc@byrlrctcchnicLwhopcrformsthcwork'Acopyofthisformmustbcprovidcdtot}retarrk ;i;@o,*u,tsubmitlcopiofr}risformtcthetocalagcncyrcgulatingUST$ystcfn$wi'hin30 drp oftestdarc, A. Gencral I on Facility Namc: Sitc Mdrcss: Focility C.ont oct Derso n: Mrkc,nvlodct of Monitoring SYsrnr; B. lnvcntory sf Equipment TestedlCcrtificd lo lnrlicrll flcility conlrins morc hn,r-s or ditTrentcrs. copy TLE -gEQ Datc of Tcsring/S ou;cint: /2-S -lJ Q City: Blds' No':- ?.ip'-f connct Phonc No,:I rhis forrt. tncludc inforsrlion for cwry tar* and dispcnscr st the facility- TcstingC,omPanY Namc: Pith rhe taanufrcturenl thrt thir infornndon ir I lteve nko lhonc No. Ceroficrtion No.Uccnsc. No.: Tltrk lD: Tltrk lD: Cl ln.Trnk Gauging Probe. O Annular Splcc or Vluh $cnsor- tr Piping Sump / Trcnch Scnso(r)' O FillSump Senro4sl- tr Mechanicat Linc Lcak Dclcclor. O Eloctrpnic gjns lcak Oclcclot. O TankOvcr{ill t Hig.tt-Lcvel Scnsor tr ln-Tank Cuuging Probc. O AnnularSprcc or Vaull Scrrsot. Ct Piping SumP / Trcnclr Scnsor(s). O Fill Surup Scnso(r)' 0 Mcchanicrl Linc Lcak Dclcclor. O Elcctonic Linc Lqrk Dcleclqr- O TankOverfill / High-lrv?l Scnsor. Eon modcl ia Sa:lion tr Othcr ond Modcll Modcl: Model: Modcl: Model: Modrl: Modct: Modc[: Modcl: Model: Modcl: Modcl: Modcl: Modcl: O Othcr Tank lt): O Mcchaniel Linc Lcak Dctcctor' Modcl: - Ct Elcctronic Linc Lc* Dcl€clor. Model: --O Tank Ovcrlill I l{ighJ-cvcl Scnror- Modcl: tr ln-Tank Geuging Probc, O AnnrrlrrSPacc or V:tull Scntot- O Pifiing Sunlp/ Trench Sunsor(s). O Fill Swp Scnsor(s). O Mcchmical Linc trrk Deteclor- O Electronic Linc Lcrk Dctcctor- Eon Modcl: Modcl:Frobc.Grugng Model:Vrultor ScnsorSpacc Madcl:Tftnch Sexor(s). FillD Scnsor(s).Surop O T6nlcOwrfrll / lligh.trvcl Sasor. Modcl: modcltr Modcl: Modcl: Modcl; Modcl: Modcl: Modcl: 0 Dirpcnscr Conlainocnt Scnso(s). O ShcarVelvc(r). Modcl: Dhpeuer lDl Modcl: ID: Scnro(s).Contsinroento Yrlw(r). and Dlrlxnrar lf)t - El Di3rrrrer Coouittsnt Scnso(r)' Modcl: . Cl Shcar Vrlvc(s). orndo Sensods). Mod.l: cl Shcarvrlvc(r). o Dirpcnscrcontritnrcnt Scnsor{s)- Modcll - 0 ShmrVrrlvc(s). Ditpcnser lD: D rnd Chl Dirpenrer lD: -- -.. - 0 Dispcnrcr Cotlritnrrl Scnso(s), Morlcl: - O ShclrV&lvc(5). BDisncnsc ContsinrD.nl !'[oot(s) md L Sitc Addrcss:Darc of Tcsting/Scricing: -l -l - B&T SERVICE STATION CONTRACTORS (AA5) 4A1-@47?L7/II/@7 @4)47P P.@63 I'rr1;r I rtf .l ltonirorin g Systtm (lcrtilic:ttitttt D. Rcsults ef Tcsting/S6r'vicing Sofl wlrrq Vcrsion tnsla tlcttr qliccklisr: * lrr Soclion E trclorv. dcso'ibe ltolv and tYllcn lhtrt dcl'iricrrsir:5 lv(:l'c or rvill Lrc con'ccrcd, ) ol/ol (:i) tr No'ls rhc nudiblcVY/* B No'Vvc{ O No'V{t{ t,isuttl nlan:r inrcrlcrc witlr tht'ir l2 andlirnctronilvrsuArcWc ilwiencdthrtqoothcrprlrcncontatrntllltrlcnlCq\trolnosilinsltlnlIou,cst sccontltrrylcdrcWcrl5gn5o15rJoilt{ ti(xt l/t'cs D No" ll alnntrs urc rclnycd to I rcllt(rlc lrloltilorillg \tnlton is irll conrtllurttcali(nts et'luiptrlcrrt (c': rrrutlcltt) oncfllti0tull l D Ycs D Nolg.fin O No' I N/n VYc: E/Ycs D No' O N/A lr7Nofl Ycs' @/Fto oolt')rtts?ls u1t1tl.t(Checkconllr llrr)lun (lIy systcinsidefounddcsignc<lsystcnrswti\id sccondarvauyqu ron bclowEc;r USC ltl ScctfWltcr sc(tl ,\troclt scl ritt iona l rllOnu calrlcl{r.:tlSul'Cnl\vils ificntio*s?nll rtrorritrtrin D Ycs' -Cl No-iJ4rs - O No'tll-rfcs E. Cotnnrcnls; B&T SERVICE STATION CONTRACTORS (8e'5) 4SI-@+I?IZ/lr/@? @4.47P P.@@4 F. In-Tnnk Gauging / SIR EquiPment;/Ctrcck 0ris box if tank gauging ir used only for invcniarl aonbol' D Check this box if no unk gauging or SIR e4uiprf,cnt is inshtlcd. this scctibn musr bc complEted if in-tank gauging equipmcnt is uscd to pcrform leak detection monitoring' . In thc Scction H, bclow, dclcri$c how end whcn t}csc dcficicncics wcrc or will bo concctcd. G. Linc Lc:rk Dctectors (LLD): O Check tlris box if LLDs :rrc not installcd, checklist: , l In thc Section H, belorv, dcscribe how gnd whcn thcse dcficicnticr wcrc or will hc corcctcd. thc If- Comments: O No'I{as all input *iring bccn iaspcctcd for propct crrqy ood icmhation, including qqrng fofglund fagltslVYA Wcrc all trnk gauging Drobcs visurlly inspeacd and rcsiduc buildup?tr NgZ(fYcs Vl1tJd sscuracy rcadingsO Ycs 9{No'Was of uakrlwcl roadingsO Ygr' Wcrc oll probcsCl No' Wes O No"\ilcrc all itcnx cquipmsnt runufacturcr's maintcnancc completcd?chccklistthcon E4cs E No' tr N/A For cq utpmcnt sla(.up or arurual cquipmcnt cgdiffCation. was I leak simulrtd ro apply) Simulatcd lcak ratc: Bi g.p.h.; O 0.1 g.p.h ; O 0.2 g.p.h. veriS LLD lxrfonnancc? (Check all ,hot Vvs*'Q No'Wcrc all LLDs confinncd opcrational and accuratc widrin rcgulatory rcqu ircnrcnts? wa{O No'Was thc tcsting appnratus properly calibratcd? El'Yes tr o No' N'A For mechrnical PDs, does LLD restict produa flow ifit dctccts a lcik? El Ycs 0 tlor-{we.elcc(ronic LLDs. docs fte rurbinc autotllstically sht t off if the LLD detects il l€nk? O Ycs O Not- wKts clcckonic LLDs. docs (hc turbrnc outomatically shut uny portron of tlrc monitoring $yskm is dilablcd or disconncctcd? E Ycs g]Nr' cl'firl For clcckonic LLDs. docs thc turbinc automatically shut offif any porlion of lhc monitoring syslcm rulfunctions or faits a !csr?ot7 € Ngr.wfirt clccuonic LLDs, hrvc all aoccssiblc wiring comcctions bccn visually inspctcd? E/Yes E No'trYcrc all itcmr on fte cquipmcnt monufachrrcr's maintcnaicc ctrccklist complctcd? Division of Environr tafnea$ (80s) 781-ss44 P.O. Box 1489 2L56 Sierra Way o$an Luis Obispo, CA 93406 f)enartment of Asriculture/Measurement Standards (8os) 781-s910 2156 Sierra Way Suite A oSan Luis Obispo, CA 93401 File Depar t (805) 781-7380 2160 Santa r-ibara Avenue San T,rris Ohisno CA 93401-5240 Utilities Department o (805) 781-7215 879 Morro Street r San Luis Obispo, CA 93401 /& /olf t0€. CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM EFW data entry by:Date: Time YES NO N/A TT T T BPOl BPO2 BPO3 TROl TRO2 EROl ERO2 BUSINESS PLAN Business plan is complete, current, & available during inspection (HSC $25503.5, Title 19 CCR $2729) Inventory of hazardous maferials is complete (HSC 525504' Title 19 CCR S2729) Site layout/facility maps are accurate (HSC 525504' Title 19 CCR$ 2729) TRAINING PLAN Facility has appropriate training program (Title 19 CCR $2732 & 22 CCR 566265.16) Training documentation is maintained on site for current personnel (Title 19 CCR $2732 & 22 CCR $6626s.16) EMERGENCY RESPONSE PLAN Contingency plan is complete, updated, and maintained on site (HSC 525504' Title 19 CCR $2731 & 22 CCR S6626s.s3ls4) Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release of hazardous waste to the environment. Maintains all required or appropriate equiprnent including an alarm and communications system (Title 19 CCR $2731 & 22 CCR 566265.31- .43) FACILITY ID NO FACILITY NAME:! Reinspection Routine DEPT FIRE UTILITIESCITY DEH UST n lcr E Tiered Permitting! Business Plan n uw GeneratorPROGRAMS INSPECTED n lcr n Tiered Permittingf, uw Generator UST/No ft YES n Business PlanREINSPECTION REQUIRED: TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining with adopted codes. GRANTED BY (NAME/TITLE): COMMENTS: NglLi NI fi'ufi^h l{,,,\A :\{-: LJ l'n/r i ns ptltlir'ln lrirrris.dr;r: 1 $-$e p-$2 4^ 1ry l,/V .l l 7 ii:i (i l ; i:r il 'i.,':' la ,."!J \'r i:: r r Page _ of_ a Enolrotrrtretttol All Your 58989 Needs: 909-681-0708 Technician's Si gnature: R.C.U.S.T.COM F'ACILITY II\ F'ORMATION TESTING CONTRACTOR INFOR]VIATION SUMMARY OF TEST RESULTS DEC - ? 2JC,2 FaciliE Name:United Parcel Service Date of Testing:t1t20t02 Facility Address: 3601 Sacramento Dr., San Luis Obispo CA. Faciliry Contact: Plant Engineer Phone: 805 544-7184 Date Local Agency Was Notified of Testing 9126t02 Name of Loeal Agency Inspector Present:D. Kerry Boyle Name A & J Environmental Technician Conducting Tesl Jason Credentials: X CSLB Licensed Conmctor I SWRCB Licensed Tank Tester License Type and #:A-HAZ 653381 Training by Manufacturer Date TrainManufacturer Xerxes / Brine Filled UST'S 200s Xerxes U d Sum S 200s AO Smith 2005 Environ UDC Box 2005 Number of Tanks Tested:0 Number of Pipine Runs Tested: I Number of Submersible Pump Sumps Tested: I Number of UDC Boxes Tested: I Number of Fill Sumps Tested:I Number of Overhll Boxes Tested: 0 Comoonent Pass Fail Comments Diesel Turbine Sump X Diesel Fill Sump X Diesel Product Line X Dispenser 01 X *All pressure testing must utilize an inert gas. Date: December 200 I Test Method Developed By:X Piping Manufacturer ! Other (Specifu) tl Industry Standard I Professional Engineer Test Method Uses:X Pressure ! Other (Specify) tr Vacuum I Hydrostatic Measuring Equipment Used for Testing:Filled lYoDial Accuracy Piping Run # I Piping Run #Piping Run # Piping Material:Fiberglass Piping Manufacturer:AO Smith Piping Diameter:J Length of Piping Run 20' Product Stored:Diesel Method and location of pipins-run isolation:Smith Isolation Boot Wait time befween applying pressure/vacuum,/water and starting test: 15 Min Test Start Time:r 0l5 lnitial Reading (R1):5 P.S.I Test End Time lll5 Final Reading (Rp)5 P.S.I. Test Duration:1 Hour Change in Reading (Rn-&):0 PasslFail Threshold:0 Test Result:Pass ) Page _ of 5. SECOhIDARY PIPE TESTING Comments - (include information on repairs made to facilitate a passing test and indicate whether a permit was obtainedfor the repairs) Note: Pressure testing of piping secondary containment systems should be performed at 5 PSI, which is generally consistent with testing performed at time of installation. R.C.U.S.T.COM December 200 I Test Method Developed By:! Sump Manufachrer ! Other (Spectfy) X Industy Standard D Professional Engineer Test Metlod Uses:I Pressure I Other (Specifu) ! Vacuum X Hydrostatic Used for INCON TS-STS V2.I Sump # D Tur Sump #Sump # Sump Diameter:36 Sump Depth 5'-0" Sump Material Fiberglass Height from Tank Top to Highest Pipins Penetration:12" Height ffom Tank Top to Lowest Electrical Penetration:35" Condition of sump prior to testing:Dry Portion of Sump Tested.2" Past Highest piping penetration Does turbine shut down when sump sensor detects either product or water? Yes Turbine shutdown response time.4 Sec Is system programmed for fail-safe shutdown?Yes Was fail-safe verified to be operational?Yes Wait time between applying pressure/vacuum/water and starfing test: 15 Min. Test Start Time I l:55 Initial Reading (R1):3.2804 Test End Time:l2:10 Final Reading (Rn):3.2804 Test Duration l5 Min Change in Reading (Rr-Rr)0 Pass/Fail Threshold:.002 Test Result:Pass Was sensor removed for testing?Yes Was sensor properly replaced after testing?Yes ) ofPage 6. SUBMERSIBLE PUMP CONTAINMENT SUMP TESTING Comments - (include information on repairs made to facilitate a possing test and indicate whether a permit was obtained for the repairs) All hvdrostafic test erformed twice to insure testins results Note: Hydrostatic testing of sumps should, at a minimum, provide for a liquid level that tests the tank/saddle juncture and the highest tank piping system projection into the sump. R.C.U.S.T.COM December 2001 UI'U Test Method Developed By:f] UDC Manufacturer ! Other (Specify) X Industry Shndard ! Professional Engineer Test Method Uses fl Pressure ! Other (Spectfu) ! Vacuum X Hydrosatic Measuring Equipment Used for Testing:INCON TS-STS V2.I UDC #0l UDC #UDC # UDC Manufacturer:Environ UDC Material Plastic UDC Depth:12" Height from UDC Bottom to H ighest Piping Penetration: 0" Height from UDC Bottom to Lowest Electrical Penetration: 0" Condition of UDC prior to testins: Dry / Dirty Portion of UDC Tested.All Does turbine shut down when UDC sensor detects either product or water? No Turbine shutdown response time. N/A Is system programmed for fail- safe shutdown? No Was fail-safe verified to be operational? No Wait time between applying pressure/vacuum/water and starting test: l5 Min Test Start Time:I l:55 Initial Reading (Rr):0.6886 Test End Time:12:10 Final Reading (Rr):0.6884 Test Duration 15 Min. Change in Reading (R"-R'):.0002 Pass/Fail Threshold .002 Test Result:Pass Was float removed for testing?No Was float properly replaced after testing? N/A l ofPage 7. TT}IDER-DISPENSER CONTAINIVIENT TESTING Comments - (include information on repairs made to facilitate a possing test and indicate whether a permit was obtained for the repairs) All hvdrostatic test twice to insure testins results Note: Hydrostatic testing of the IIDC should, at a minimum, provide for a liquid level that tests to the highest point of piping projection into the containment vessel. R.C.U.S.T.COM December 200 I Test Method Developed By:tr Sump Manufacturer ! Other (Spectfi) X Industy Standard ! Professional Engineer Test Method Uses ! Pressure ! Other (Specfy) ! Vacuum X Hydrostatic Measuring Equipment Used for Testing:INCON TS-STS V2.I Fill Sum #DFiil Fill Su #Fill Sum # Sump Diameter:12" Sump Depth:16" Height liom Tank Top to H iehest Pipine Penetration: 0" Height from Tank Top to Lowest Electrical Penetration: N/A Condition of sump prior to testins: Dry Portion of Sump Tested All Sump Material:Plastic Wait time between applying pressure/vacuum/water and starting test: l5 Min. Test Start Time:I l:55 InitialReadine (&)s.9836 Test End Time:l2: l0 Final Reading (Rr)5.9835 Test Duration l5 Min. Chanee in Readine (Rr-R'):.0001 Pass/Fail Threshold .aaz Test Result:Pass Is there a sensor in the sump?No Does the sensor alarm when either product or water is detected? N/A Was sensor removed for testins? N/A Was sensor properly replaced after testins? N/A ) Page 8. FILL RISER CONTAINMENT SUMP TESTING Comments - (include information on repairs made to facilitate o passing test and indicate whether a permit was obtainedfor the repairs) of_ All hvdrostatic test nerformed twice to in sure testins results R.C.U.S.T.COM December 2001 UHITfilr !rftl'l[ti-'.I[RUC l6E1 S6[Rftt'lENTL] 'jFrf.,l L.r-iI';t IFI5PD SB5 54,+ 7ii$4 1 i.iftat/ lrltB:11! 54 flr'l $Ui'lF LEfil: T[tl REP|]RT [ 'ilriq TEST $TARTE[} 11;.J? ftI'I l[9jT :i-ifiRTtt] 112?B"ttlBz BEGII'J LEUTL 3.27tT II'I i:t{D Tii,lt. 1i;54 til,l EHD DfiTE IL/ZA/?BFJ? END L[U[L ].TBE] IH LEffI,i THRE$HI]LI,'. E'611': It'I TIST F,:[5ULI PASSED L:,FILt- l-tltliID rrFlEr::EL :ltRUC ."\bU I sfi CRtitl"lEHTtr:irri,l i_tili 0FI5P0gB5 544 t1S4 1i./::JE,"liJa: 1I:1a p1,1 sul'1F LtfiH TES]- REPL-IRI ;,r ilrFi TEST $TfiETII,Tlir STfiET[j"l BtGIt'l LEUEi_ [:1.]D Tt:t]t El.lD [,ftTt iliD l_iuEl LEfi[. lggg511g16tT[iT h:EiULT 11:55 6i1,1 11./:9,'::kt0t J.2gkr4 IN 1lr lff pM 1Irtft.l26g2 l. ^:'SB4 Il.l I.J. EEz II.J PrjlSgED [i F]LL TEST 'iTilRTEL) TEST STftETEIT EETJIN LIUTL Et..lF TIl,l[ EI.ID I]HTE END LEUEI. l_[:ffti THRETjHT]LD TEST RESULT 11t 3? rtl"l fi/2At?682 5.98f,9 IH 1i ! 54 ftt'l 11../:B/':BB2 5.9S37 iN B.BB2 IN PfisSED TTST sTiiRT[Li TEST STftRTEDg[!-"i]tl LLLTEL END TII']I El.lD Dr:iTf- EI']F LEUEI- Li:-irili; I HREi:;H0LI) TEST REgULT 1 1 :55 '1Xllr16r2qg1 .-r. _an'jt, lN 12l1gi Pf itLrtg726q, 5.9St5 IH r:1. BB2 Itl PfigsEti Ljl::iF [J1|JITP 81 TEST STfiRTEf' TT.5T :;TfiRTEi) BETJIF] LEVEL EttF Til'1[ EHD IIATII g11p 1*guEL IEAF; THRESHILI. TL-i'T IXI;CI II TI Lir I r'\LsrJL r 11: 3? ftt'1 1 1/?B/?Eg? 6.6S94 IH i 1 :54 Al'1 71/2A{28A2 B.6BE8 lhl B.Bgz IN PASSED TtgT :lTriETEtr TTST IiTfiRTEIi BESII.] LEUTL Et.tD Trf,rt END DTiTE Ii'll]' t-[UfL LEAP; THRESHOLI. TI"'5T FJESULI 11! 5i fil'i 1.tt76r2gg2 8.688€, IN 12i 1B FtdII126.t2qg; ra.6BE4 IN EI. BE: I N PfiSSrD I Atr tol- Division of Environm rl Health (80s) 781-ss44 P,O. Box 1489 2156 Sierra Way .5sn Luis Obispo, CA 93406 Department of A sriculture/lVleasurenoe4t Standards (80s) 7s1-s910 2156 Sierra Way Suite A .San Luis Obispo, CA9340l Fire Departr (805) 781-7380 2160 Santa Ba- rara Avenue San Lrris Ohisno CA 93401-5240 Utilities Department. (805) 781-7215 879 Morro Street o San Luis Obispo, CA 93401 dlt& EFW data entry by: CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORMDate: Time: YES NO TTT Tn tr T N/A MMg cd {t BPOl BPO2 BPO3 TROl TRO2 EROl ERO2 BUSINESS PLAN Business plan is complete, current, & available during inspection (HSC $25503.5, Title 19 CCR $2729) Inventory of hazardous materials is complete (HSC $25504, Title 19 CCR $2729) Site layout/facility maps are accurate (HSC $25504, Title 19 CCR$ 2729) TRAINING PLAN Facitity has appropriate training program (Title 19 CCR $2732 & 22 CCR $66265.16) Training documentation is maintained on site for current personnel (Title 19 CCR $2732 & 22 CCR $6626s.16) EMERGENCY RESPONSE PLAN Contingency plan is complete, updated, and maintained on site (HSC $25504, Title 19 CCR $273r & 22 CCR $6626s.s3ls4) Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or lelease of hazardous waste to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 CCR $2731 & 22 CCR $66265.31- .43) ] il :: i,..!: tl' . - FACILITY ID NO:A A PftRr/.,1 SFACILITY ADDRESS: -'(tfl ) St ,^ki oA AGENCY L_I DEHn 4cDEPr [trKcrrv nrnnn crrv urrr-rrrEs fl Reinspection Routine t PHONE:-r J ! tiered Permitting! Business Plan n Hw Generator dy"n lcrPROGRAMS INSPECTED: n nw Generator du,,n lcr I Tierert PermittingREINSPECTION REQUIRED:dNo ft YES n Business Plan PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAME/TITLE): I rn i*r'rns.cluc I 9-Sc1:-0?A:\{l COMMENTS \ Xtt ,ililltililtillilll Gtyofsanluls oBtspo Re FIRE DEPARTMENT 2160 Santa Barbara Avenue . San Luis Obispo, CA 93401-5240 . 805/781-7380 "Courtesy E Service" Apil25,2002 Mr. Paul Bendixen, Environmental Supervisor United Parcel Service 1201 W. Olympic Blvd. Los Angeles, CA 90015 Senate Bill989; Testing Secondary Containment Systems of Underground Storage Tanks Dear Mr. Bendixen: Senate Bilt 989 requires that all owners/operators of Underground Storage Tank (UST) systems test their secondary containment on tanks, dispenser pans, tank sumps, and piping. The testing is to be completed before the end of calendar year 2002, and then every three years after that. The testing must be conducted by a state licensed company and submit their testing protocols to San Luis Obispo City Fire for review prior to testing the UST system. I have included the following companies for your use if so desired. S. L. O. City Fire does not endorse or recommend any of them, this is merely a listing of companies available to provide this service. Please contact me if you should have any questions at (805) 781-7383. Sincerely, N, D. Kerry Hazardous Materials Coordinator COMPAI\IES PROVIDING TESTING FOR SB 989 Tait Environmental Systems 1863 North Veville Street Orange, C492865 Calif. License - 588098 Telephone - (714) 560-8222 Shirley Environmental Testing, LLC 1928Tyler Ave., Suite K South El Monte, C1^.91733 Calif. License -798892 Telephone <626) 444-7 447 Wayne Perry, Inc. 8231 CommonwealthAve. Buena Park, CA 90621 Calif. License - 300345 (714) 826-03s2 Banks and Company 2403 E. Belmont Ave. Fresno, CI*93701, Calif. License - 383550 Telephone - (800) 284-1109 H,:.:',lY'ri,j.?gl,5l5ooi'38"n? in"I#lit Fui'rtY-9?.,'3." disabred in arr or its services' prosrams and activities' @ t 2/2L/2681 L2:25 818-347-4878 To: VAN NUVS AUTO/P.E Frx: E05-543-8019 \ I Unitecr r'arcel Service 16000 Arminta Sffeet Van Nuys, CA 91406 PAGE 61 D. Kerry Boyle llazardous lvfaterials Coordinator From: Paul Bendixen Dste: December 21, 2001 Re: Rcpairs Peger: 9 t a a aaaa fl For&ryhr D PlesoComrrt tr PlGeFRcdy tr PlouRoclple l',lobo: Here are the repair records for the San Luir Obispo UPS fuel islands. carrnrrrlouharrcenyquerirrne 30Pl SthW(WeW Paul 12/21/266L 12"25 818-947-4878 PO. Box 820 Arroyo Grrande, CA 99491 (805) {81-Ui5g e- T Selr{cc jtation Contractors VAN NUYS AUTO/P.E PAGE b8 Ng 7311 To: U 36o ,frtu 5 ,fr+cZ*z-rA^rr5 ffi FhX (8OD {81-0412 Llcense # 693983 Date:-o P.O. No. o u, tro ILr IrJA Ytro 3 MATEFIIAL LABOA COSI EOUIPMENT MIL€AGE CHARGE OUTSIOE SEBVICES r i)'r''; ,' TAX- tOtAr- INVOICE s 3 3 s, -- JO8 COMPLETE YES ii0 tr I o ui6l J tr tuF o(l. o0 u.l(r LlJ Et- AMOUNI s Iot! ., ,r'.f;."1.., .,.,. r, ,,11,.,,,,i.-.;r11..; !f;1 "ii.'-' r ; O€gC AtF trO{OUAfu FAICE / " ,c./,en/nflt4D /- t-t ft*.,Ecrt ( / NA ME ACFIIVAL IIMF DEPAqTUqE TIME LABOA HOURS I AAvE L nouRs 'OTALHOuns HOUALY RATE.4J. l)3'v,trP '/aV,'^t-f /z / I f Albrnat! Fe€t:Should ilre rsrviec olan anornet b€ raquired roento(ce eny pan ol he credit ilgteetneEl. oi 16r 'te (Ollcclicn bl6 delinquenl actount lmm the under rlgned o/aomsr or 0urrlnlFr, lt lr agreod fial tho dcbto. velll pay oaaonable corl! ol colffi1ion indudlng a rla:onable onorney't lee. TEFMS: A SERVTC€ C)IARGE OF ! l/2r3 pER ltONTt{ (aNNuAL FATE OF tO%l uilLL BE CHAFCEO ON PAgf DUE BATANCES OVEN 30 DAYS THIS IS TO CEA'IFY ?HA' WOR|( WA6 SATISFACTORII.Y COMFLETED IN INOTOA'ED TIME, I |;. 72:25 A7B-347-447A Sarvrce LA VAN NUYS AUTD/P.E PAGE 89 PMI CHECKUST oNe-!L-o z r 6-L rUEL ISLTflD OI DTSPEllSER8.-C('ldiUq! ol t,tllt flOZtr-GS-Sieor ot Dmr4n XOSE STJIYEt,g-Signc d Onnrgc HOgEF.8lgns d Durrgc BREAXIW Y O(xrPuilfr-8lgil cl DorpolsllffD rfiD DRllti AE ARFI-Srgr d-Spuc orrrrfrI^llHO!€ COVEnS-h PlaFlll COIGRS-|n pt6 rrrl todcd ltllltrC"+ecrOlg Aopnty sIGHS*ln Flae or! lrgibh ilo sloxtit(UsHuT oFF Excll{E FISE EXDilOUISHER €TEfiGEr{CY STIUTOFF GASOUXE DIESEL FIRE EXnfGUtSHERg-ln pte lnd R tVChrrsod Piiil gI -DAILY ' -.?as l-Mot{THLy sEtil-(N ANNUAI. suPV. CHECK mt I{AI/lE sTrrKtf{ 3 wRm uPs IF CRMCAL t/Dis,oongrs /lJoz> les (/'lose ,luivc l( /ilo<e< Brr^knuo* lstaad st [.(^n th (t T () 6 leg (! (I e_() () /..a o^(I{.''H<n\elz tcve/^ < /trrll Cauesj (-.'L;nll;^- S)qn. , \T t/Ar*rr&+rM!l)a 5^o (I (t )I t , tc () lle €n ,t ) () t/ l-/ N/,+ ,/r€S ()f;r- 5**l.ru:,Ie,l.o< *'Jln {) (': t l () t SIGI.IATURE SUPER14SOBS SlGl|lArUnE DATE t2/2I/2681 77.25 818-947-4878 Seffrce Nirro VAN NUYS AUTO/P.E PAGE A7 PMI CHECKUST DN:'/9--: 3!-J ?J FJELEIII{DOI DGPEXSEFS{ondidon ot Ufi1 t(@ltEF$gso(Oarugc $OSE Sftl\rEt gn$gns ot Durage rlosEi*Sg*dDtrrltge EBEIT(IYCAY CilTPUHG-Signs ol DemeEa tSL fiO AfO DR II{AGE AREA-Si?ns d SftlB o( laks lr^lclot E @!lEf!Hn Flact F[l. OC]VER$-h Plsca &ld Lod(ed UGffUC-Opcrong Fmpcrty Scr€--h P?alrrl Ltgible' t{o sraofiNG/SHUTOFF Er{crrirE FNEEru{GUISHER EIIER(EI{Cf SHUTOFF Gtsott{E D(EsEL HRE E(fiNGUSHERS-|n Ple and Fu0y Ctr.ergeo PMI ol AILY 05 L-- M ONTHLY SEMI.02 ANNUAL f SUtr/. ct(ECN rEH I{AME st{noN JI wRm uPs IF FREYIOUS CRMCAL Fuet lSL4,1 J ol [*I {}a/ Disaaqer I t /- L6 I () avrki n i () 7,/622(zs,() t/ose 9qt) vo [-r I? I I k () H o.., . v 9. rc n? ^t^rt N"() <t IL(1at\A € rzo.I &r () J Le srt () J A.*( 0{.,.. hci a t nrtet I n ) Frtt (1a,r rt la Jlo4_() A"4;l y p.open /y () tr S'i1n s l)o S^ol;n.15/,/ffienc,'rte- - Frtr.n/t F;o Erl:^t/er-Se4/ o^ {.. e*4rn /"s( ) J-e-a I (l (n5"/rn" -D l"-s"/-,^-/- 6 /^",(l Firz *Arwis/"rS a t ^^J C' /r ck ()c ,{3 z 4 / I'ECTIANICS SIONATURE*4-4 , aornt-fioat arr OATE o j.st PER1,ISORS la ,o/t6/ 12/27/2881 r2125 818-347-4874 &" T Service Contractors PAGE 85 ' 6754 VAN NUYS AUTD/P.E t O. Box ?3O Arroyo Grande, C.A, 99491 (805) {8f -2558 FA)( (805) 481-0418 Ltce,nsc # 698998 To: U.?.5 -Date:-L -o/ P.O. No. - 3-t--o- lzno t JoBcoMPLETE vesEf r'roD AMOUNT AMOL'NT MATEFIAL LASOR COST EOUTPMENT MILEAEE CHAFGE ouTstoE sEFlvlcEs TAX - TO1AL rNVorcE o u.l 2troIt G UJ& )lfo 7 o urvl f J tr t1l F o Tfo Oulq ul !- g g o l$ $ s Fo PRICEouaNDCSCFTPtTOr{ 2/n $t*,'u*/.s LAEOR HOUR S TFIAVEL iOiJnS YOTAL hCtrRS HOURLY RANAMEAnFrvaL tIME oEpaRrunE TIME 'l rvo ,/z-l/*-I/,44- € -, r c. o-r 73o Atbrruy'rFo€e: Should tho 3eryler olrn rlorney bo roqul.cd to enlotcetny Prtlolfisctedil .0rsment, or loi the coll€c{on ol r dollnquent rccount lom ile under ligned cueorner or gurranot, lt lg aoreed hrt th6 dabtor wll pey reeeonabls cotlt ol coll*rion lndudlng r rerronable anornly'r lee. TE BMS: A SERVICE CI.IARGE OF I t/Ar PER l/OlrTH {ANNUAL n rE OF r 8%} WTLL BE CHARG€D OT{ PAST OI,E BAI-ANC€s OVEF 30 DAYS ' 'HI9 'S TO CERTIFV THAT WOR( WAS SATISFACIOAILY COMPLETEO IN INOICATEO ''ME, L2/n./26a1 ).2:25 818-947-4476 Prrcel Scflree VAN NUYS AUTD/P.E PAGE 85 PMI CHECKLIST Q34t) TRAC€orc o-7d/---.tp/- R€LStliool DtSFEllSERS...{0.rdidon ol Unit tlFn 3<-ffi ol Orlnige tldiE SltntElS-Sagns d Darnage HGg-SgltidDemaEa BnETXAiVAY crITPUNG-Signs o( Dornge ISLTXO At@ EF IIIAGE AREA-SigrE d Sdtls or t.ears IfrclOfE ColtERs-ltr Pttce FII @tlERS{r Placc rnd t odtcrl ftGlililcroecdng Propcdy $Gtt$-ln Ptcnd [agble, NOSTOIOHG/SHUT OFF ENGII{E FIRE EXII!{GUISHER E ICRGET{CY 5HUT OFFc sorfiE OIESEL FIRE qT0{ct tSl{ERS-tn Plu end Fu0y Awged PMI fl -DAILY 05 02 ._4 SEMI- NNUAL t suPt/. o{Ec1( rTEM *wRm uPs IF CRlTlCAL )Ub4 tul 4 /t ,-rcz/.c- -(_4u<.,A*.{G -l- tlnz-?,{a\ , ( ) i t) () , c(-) o Lo't ( I/'1) /. /'l t * ^C /,-\-ft'-t ou,l- (- I lt o ) p ( () i) ,'t I () () () () (l {) () OATE !l'{rr{orar.a1l 7,Il' ol 1.2/ 2I / 266I ).21?5 818-947-4878 Parcel Setrlce 2 o Ftll{oo1 Plc rtrd tulty Clta ged f }.TECHANICS SIGNATUFE PMI CHECKUST VAN NUYS AUTO/P.E PAGE A4 o{;:d,g' I c r.-QJ a OGPEIISE |S--Cdtdtdon ol Uni{ H@d.ES-llgrEo( Oarnage HOSE SmrElS-liigts d Drrnege nosEs.-Sl'lri d thtnogt BRE X W YCCIJPIJIIG-Sbrso(Demrye lSl-AlD lf{D DR IIIAGE AREA-Slgns ol Sillr 0r lraks lllXHOtE OorER$--ln Pltca FI.L CdrEH$--tr Ptece rnd l-odcd uc$nilG-A.rdtlg ProP€rtY Sl6t(HnPtlesd LGgible. NO SIIONNG/SHUT OFF EI{GII{E HTC ETflHGUISHEB ETENGE'IC1rSHUTOFF c4sg.NErflEEf,,drurcu*ens-tnnnE PMI fi LY 05 u *'NTHLY SEMI. 02 ANNUAL CRMCAL WRITE UPs IFsuFt cHECI( tTEM E () ;9 tso oC L,,o-a a- ?tu tah 4l,e(() (au tt O/-€ir () ool c, l^r ( f 2-.&() pol. () () () t) (l ) () )o otlaat t*t cta t-int SUPEFNflSORS SIGI{AruRE DATE L2/2t /2861. 12:.25 8L8-947-4876 Parcel Servlce VAN NUVS AUTO/P.E PAGE 83 DATE PMI CI{ECKUST TNACE o*y!_A_13:-Q-l PMI ot ---DAILY os X MoNTHLY sElil- 02 6161ggtDm DEP€ilSEnBJo(ttl0on dl Unit ItdEd.Es-liaqlsot Damege )|OSE SmuE.S-Stgnr ol D8tn89e lrosEg-sitadDilllqe BREAX Wav ocIJPUNG-SiErc ol DeneEe lSLlflD lfltl DfiAllllBE AREA-SEnI ol Serlb 0r r'rir trrotOllCOVEBFIn Proca F[,] 9ilEns-f! PleEs srtc tctcd LFtdIlG.-O0.rdrE P'ogartY tan€-*t Fbct lttl l,glhlt llosHtilc/sHur oFF E {Gll{E FREEIITilGUIEHER flCRCAlcISHUTOFF GrsoulE O€sEL nng EIIIXCUCTERS-|n Pb rtrtl Rr0y Cltttscd e o SlGNA'ruBE t, -'JJotJ!y't--. LilL.alVl CBMCALSENCN #WRITE UPS IF PREIflOUssun. cr{Ecr( fTE'N flA*IE )(,-a'D () {} l^O s )s h () 4qt Co ) I ) e.€ F B.-. () () )I h ()o () () () It {} {) I l {) cro.$ t-ft crr t{rl 12/21./2A8r 12:.25 818-947-4878 VAN NUYS AUTO/P.E l PAGE 62 o PiJiI OI -DAILY 05 -lrOltlTHLY SEMI-02 ANNUAL Prrccl Sorucc q o ot Unlt d 4, d Drrnrgr PMICHECKUST lsl.AllD0l ) a8Ell(lw Y Euflo AllD f, ltll{Ot-E CttltEf, S- ln Phcc FlllcorEnhh PIE .lU rdd uotlf lNG'#ndttg PtoPedY 8l6XS-ln Plu t{ l.egtbL NO $ECIXI}IG'8HUT OFF Efi GIIIE RRE EXNilGUIEHEF EI€FGENCY sXUT OfF G ltouile OIESEL RRE emt|GUISHER9-ln Pts rd RillyChsrgrd COUPUIIo-glgtu d Drlttr{c DF/I$IAGE AREA-Signe d Sgllr or teelr DATE lt SUPV. clrEcK lTEH NAME srmoil{WR|TE UPS IF PRB'IOU8 cRmeAt, i.L",or-lc---( a,tF Fuu( lslq^-J () u/oL- /4 ll looLs ,> )r- (-ht-eL-anl ( , ou[- A.<o t-ttl.6,- ,,fOfr^^ (.r,r,bJ;t ( ] 1<-e.- rno Itol.-s.i. ho<tc.,rlozzu^i ,( l b.to-t l. - r,-* - . i lr. c-.F+qejcrrs c lt ,/a<-.() 6tr,a- -4tJ;rtult /nnl- lt'/tn- ) b,s ( ) lsa !-ine L l*t /4* k'han bvottt /,L.1 ) av._L- l,,a I L<-..i d ae a .l U/ 4 u+ear () L;rt. t),,^e alt- 4 l,n,'.-/oa'Ls. I I {t^r- [tahr- iq tForLru; olc_.(I Ct-r,-c,,Lr--l c-l/ Atan.\ r/ctL-(t e d v-+- ) ," o nool aon'i l'on''tt. CL-alEJl P'-' t, n-u*l-t--.Q/./Z{^tr /es}- ( i set;,c-.)) FoJ lor zooo. th",,Lr|l l b<- Le-e ,t ,'o.r) 4.rtr,n ,(l (II {) {I )(t MECHANICSSGNAruRE EUPEM/FORS SIGI{ATUNE B&T SERVTCE STATION CONTRACTORS (B@s) 4AI-6412 L?/L9/@L 143 41.A P .@Oz ,,-),,,-.) Facility Sitc o Phonc No:o FacilityConuet v*e/.tv{odcl of Monitoring systffi; J-t S :'35O l'ocation of Controi r*a-i-ns;t: lu; /L"€ au#de o'tfrre Makcllr,Iodcl of Line l-colc irt: system is oPernblc FEr rnsnufacturc's spccificntion? Audiblc slsrEn is oprntronul? Visrral alum is oPcrationul? Monitoring sYsiem is thc Monitoring *or prcssurircd Piglng {tc moni(Erurg sYstcm diseonncctcrl? lfYes, Tpnk lfl X -s*,p scnror? -)Cp'"u'urc )'ine I'cak Dctectots? ------P- sccurcrl from {:c r,rnartttorizcd tumyrrirtS? Systcms, dctccts a do dre twbines automaticallY drut down if lcnt. fails lO oP€rrtc,or is electricallY which morutoring deviccs iruiiatc Jnsitivc shut do\ m? docs of tank Tilu* ID Elcctrical Line l-cak Dc(ector llleclncal Linc Lcak Dctcctor Tank ID Arnulor SPacc Scnsor Scnsor In-Tank Probc Co$tarnmcnt Mcstnnical Linc l,cak Dctector Elcctrical Line lrak Dctcctor thc TanklD Elcctricat Linc Lcak Dctcc(or rl( kl No' No'x No'Y No'Y No' NIA Ycs X N/A No' V Arrnular Spacc ScnsorAnnular SBacc Sensor/'rvrulor Spacc Scnsor Piping Sump Sensar - Pipi*g Srunp SensorScnsor In-Tnrrk Grrug.in g ProbcIn-'fo!&Probci,n-Ttlk OnuginE Probe spcnser Contaiqmcnl Scnso(sDiDiqenrcrCrn-ta inmeat Scnsof(s lDbnenscr Cqq,atnrnglqSc*lort(sl Mechrnicnl Line l,c'ak Dc(cctorDetectorLclkMerhenical'LheDetcctorL,cskLineMcchorical NOYES Arc dl valvcs 'ln lhc commcnts rcc(ton Commclts: mnnufacfurtt'r werc or will be concclcd. I ccrlifY thr? rhc Nan€ Sigratuc; equipoeat lr ln qccordrncc with m Division of mental Health P.O. Box 1489 2156 Sierra Way.San Luis Obispo, CA 93406 Department of Agriculture/lVleasurement Standards (8os) z8r-s9lo 2156 Sierra Way Suite A.San Luis Obispo, CA 93401 ilililrililliilllllil Citv of San Luis Obispo CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) Utilities Department. (805) 78f -7215 955 Morro Streeto San Luis Obispo, CA 93401 Date Time In HAZARDOUS MATERIALS INSPECTION FORM WLTwt/{U) YES NO YES NO N/A N/AlT n u vIoL. # TROI TRO2 EROI ERO2 VIOL. # BPOl BPO2 BPO3 GENERAL REQUIREMENTS TRAINING Facility has appropriate training program (Title 19 CCR2732 &22 CCR66265.16\ Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR 66265.16) CONTINGENCYIEMERGENCY PLAN Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR S 6626s.53t54) Facility is operated and maintained to prevent/minimize/mitigate fire, explosion, or release of hazardous materials/waste constituents to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 CCR 2731 & 22 CCR 66265.31-.43) BUSINESS PLAN Business plan is current & available during inspection (HSC 25503.5' Titte 19 CCR2729) Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729) Site layouVfacility maps are accurate (HSC 25504, Title 19 CCR 2729) rrf o/oo' MR rrld, Svc Result Action Insp Min.Facility ViolationRecord ID Prog/Ele CODES: (insert codes for above box using new Envision codes) TYPE OF INSP: ! noutine l-l n.-inrp. lComptaint INSPECTING AGENCY: AG DEPTf nrH pei,o crrv ENVISION FACILITY ID FACILITY NAME: F'ACILITY LOCATION: TEL. No.(Site): ! Business Plan ! Business Plan ! uw Generator I ttw Generator flusr ! usr I lcr ! acr PROGRAMS INSPECTED: REINSPECTION REQUIRED:qfio IYES CONSENT: Consent to conduct inspection which may involve obtaining photographs, review and copying of records, and determination of compliance with UST, AGT, and hazardous materials/waste handling requirements. l-l Granted By (Nam €co{t \L A:\CUPAIN$P.DOC 1 9-Jan-00 vNS 3bo1 pw,,q.fr ts,L./,Mdr/w furo)UNDERGROUND STORAGE TAI\K (UST)/ Permit No. # PERMITTED TANKS # I.INPERMITTED TANKS Owner & operator as indicated on permit:il"r, nNo If no, new owner name & address new owner name & address MONITORING CODES 1. No monitoring 2. Standard Inventory Control 3. Modified Inventory Control 4. Statistical Inventory Rec. 5. Automatic tank gauge (list type) 6. Continuous monitoring in tank annular space/secondary containment 7. Visual monitoring 8. Manual monitoring annular space 9. Temporarily abandoned under permit 10. Another method N/Atrtrnn n nnnnnn NOnnnw YES!nn! nIntrntrtr vIoL. # UTOOl UTOO2 UTOO3 UTOO4 UTOO5 UTOO6 UTOOT UTOO8 UTOO9 UTO1O UTO1l PERMITTING Site has a permit to operate (HSC 25284) Permit is kept on the premises Change ofownership is reported to the permitting agency within 30 days (HSC 25284(c)) All UST(s) are properly permitted to operate or properly closed (HSC 25298) MONITORING UST(s) monitored using method specified on the permit or approved by the permitting agency (HSC 25293) (Write monitoring code(s) observed --------- - Monitoring records are provided to regulatory agency upon request Automatic line leak detection system is installed & kept operational for all pr€ssurized piping (HSC 25292) An UnUe! report is submitted to regulatory agency Tank tightness test and/or piping test is being performed as required (fitle 23 CCR) Written Monitoring Plan submitted for electronically monitored tank system (Iitle 23 CCR 2632134) Facility maintains evidence of Financial Responsibility for corrective action and for compensating third parties for bodily injury/property damage caused by a release from the tank system (HSC 25292) Products Stored:lGasoline f]Crude oil SPCC Plan is prepared and certified by a registered engineer within last 3 yrs. SPCC Plan is maintained on site or nearest field office. ABOVEGROUND PETROLEUM STORAGE TAIIK ACT No.ofTankst Ol Total Volum", E"TOOD g l,/ Note: SPCC required for tanks with total storage capacity of > 10,000 galtons; for fsrms, nurseries, construction sites individual storage capacity of >20,000 gal or total storage capacity of>100,000 gallons. YES NO N/A!nrntn N/fi vrol. # AT()Ol ATOO2 e "flfo tlN^ ( UPs 'ou'// M y{,Lfft ,W,')\N,| , tr SUMMARY OR OBSERVATIONS/VIOLATIONS No violations of underground tank, hazardous materials, inventory, and hazardous waste laws, regulations,,and requirements were discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility. Violations were observed/discovered as listed below All violations must be corrected by implementing the corrective action listed by each violation. Ifyou disagree with any ofthe violations or proposed action, please inform us in writing. All minor violations must be corrected within 30 days or as specified. CUPA must be informed in writing certifying that compliance has been achieved. A false statement that compliance has been achieved is a violation of the law and punishable by a fine of not less than $2,000 or more than $25,000 for each violation. Your facility may be reinspected any time during normal business hours. You may request a meeting with the Program Manager to discuss the inspection findings and/or proposed corrective actions. The issuance of this Summary of Violations does not preclude CUPA from taking administrative,civil, or criminal action as a result of the violations noted or that have not been corrected within the time specified. VIOLATIONS NO MINOR MAJOR CORRECIVEACTIONREQUIRED TR ER BP GT ryUT AT It n COMMENT: Inspected By:Facility Rep: Title: lD Date: M:\COMMOMIdf\DOCUMf NT\JPOEL\fCIRMS\CIFFlCt97\FORM$\CIJPAINSP.DOC 29-Mar^00 B&T SERVICE STATION CONTRACTORS (AOs) 4Br-a41'?]I/L5/@@ @Lt1,@P P.@@3 COUNTY/CITY Ol'SAN LUIS OBISPw A CERTIFIED UNTFIED PROGRAM AGENCY MONITORING SYSTEM EQI'IPMENT CERTIFICATION FORM l,cstcd/.cerviccd onnually or orr a schcdulc spccilicd hy thc monufocturcr, whichcvcr is morc frcqucrtt. 'lhi.c form, or a sorvicc rcport with cq[ivltlcnt intbrmution, musl bc Lrscrl to douumrnt tcsting md survicing of monitoring crlripmr;nt, lf morc thrm onu momioring systcm (r:,g. Vccdcr Root TLS-]50, Romun X76S, ctc ) is rnstullcd nt Lhc fucility, n ricplunlc Ecr(ificution or rcport musl bc prcplrrcd for cuch monrtoring systcm, Facilily Namc:Dnlc o[ Srtc Acldrcss: =/n / S,rnn rut,Lz'l c iq 9+.+ Lu.s Oh-o<' t'aci tity Contact l'crsol].l€r*./<1"/lrt Contact Phonc Mnkcr'lvlodcl of Monitc,nng Sy"lrntj,lealo. P<vL 'T1S- E|9T) I-ocation of Control Far'el .a)>4x ('i<* €]qzt*t/ MaksAvlodel ol Lirlu Lcak Dslcctot(l,l,D).Ll)l.cak'llrrcshold-g.p h. es No'Moililoring systern is operoble pcr ln0llltthcNre's specilic0lioll? Audibl". olorm is oporotionol? Visuul slurm is opcrutionrrl? Monitoring, systcnl is rccurcd lrom thc unaudronrcd tampcrittgf For prcssurizcd piping syslcms, do thc turbincv urrtomnticnlly shut down if thc monitoring systcm rlutcct$ tr lcrrk. lhils 10 opcrtrlu. or is clcctricttlly disconncctcd'/ lf ycs, wlrich monitoring dcvtccs initiatc posrtivc shur down? _Srunp Scnsor?Prcssurc Line Leak Delcctors? For monilonng syslLTns which scrvc lrs t{|nk ovcrlill rvoming <lcviccs, tlocs the overlrll rvarning lunction opcratc propcrly'I If sn, at whut pcrccnt ol tank caprcity docs tlc ricmr triggcr? %h NoiYcr Y Clt Not ^fcs No' Ycs t Not h-,lv Nor N/A I' Torrl. ID buxcr to I )l.lcctrical Lirrc l.cak f)utcctor ifit Tank ID Elcctlical Linc Lcnk Dctcctor Tank ID Elcctrical Linc Lcnk Dctcctor Tm*ID Annullr Spucc Stnscrr Scnsor ln-f'ank l)robc Cotrtainrncnt Mcchonicol l.irrc l-cak Dctector Elcctricnl Linc Lcrrk Dctsqtor Annuhu Spucc Scnsorfmrulnr Spacc Scnsor Annuhr Spncc Scnsor Prning Sumrr Scnsor.l'ining Sumft Scn$orl' p'!rg sumD Scnsor In-Tar$i Gauciua I'robcIrTur*, Guugius Probe br-Tunl Cuusing ltobu Djvpqrtscr Cortuiruncnt Srx$or($,Dispcnscr Contrrinmcnt $cnsor(slDispcnscr Containmcnt Scnso(s) Mr:shunicul l,inc l,cak l.)ctcttorMcchnnicol Linc Lcak Dctcctor Mcchonicul Linc Louk l)ct*ctor YES No.Arc lll valvcs rnnnufncturcr's tic comrncntg scction bclow, dcscribc wLTc ot wl ttc Narnc lhat thc ir adcntitlcd Tcsting in nrcordttnsc with mln I Gtyofsanluls ontspo Re: FIRE DEPARTMENT 2160 Santa Barbara Avenue . San Luis Obispo, CA 93401-5240 ' 805/781-7380 "Courtesy E Service" October 11, 2000 U.P.S. PLANT ENGINEERING DEPARTMENT 1201 WEST OLYMPIC BOULEVARD LOS ANGELES CA 90015- l--o,' : 760l Sc,rrc.*,tq*o ,9nLws )bqo,C4 Annual Monitoring System Certification lnspections Underground Fuel and Waste Oil Storage Tank Systems Dear Busine'ss Owner/OPerator: This is a reminder to make sure you get your annual underground fuel storage tank system monitoring certification done before the end of this year (2000). The City Fire Department will need to witness this work to meet the new Senate Bill939 req:uirements, which specify yearly inspections by local agencies of all underground fuel storage tank systems. please provide the City Fire Department with a minimum of 48 hours notice for all monitoring certification inspections. Please call Kerry Boyle or myself at 805-781-7383 to schedule an inspection. Thank you very much for your cooperation' Sincerely Molly Brown Hazardous Materials Section H:/ MONITORING SYSTEM RECERTIFICATION REMINDER 101100 [El tn" City ol San Luis Obispo is committed to include the disabled in all of its services, programs and activities. [\-rLl feteconimunications Devic'e for the Deaf (805) 781-7410.@ ) CA Cert. No. 0658G illll ililillllll lll ill lllll "'w orIsan Luts oBtspo Fire Department r 2160 Santa Barbara Avenue San Luis ObisPo, CA 93401-5240 lssued Date:\l-\4-oo An upgrade compliance certificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on this facsimile matches the number on the certificate displayed at the facility. )K illarr o;rli$tcd[tUNITED PARCEL SERVICE 3601 SACRAMENTO DRIVE SAN LUIS OBISPO, CA 93401 FACILITY TDII 40_023-3T02 iSs".zd- Instructions to the issuing agency: Use the space below to enter the following information in the format of your choice: name of owner; name of operator; name of facility; street address, city, and zip code of facility; iacility identification number (from Form A);name of issuing agency; and date of issue. Other identiffing information may be added as deemed necessary by the local agency. ")'-\) ^) United parcel Service IOOOO Arminta Street, Van Nuys, .ialifornia 91406 November 13,2000 City of San Luis ObisPo Fire Departrnent 21 60 Santa Barbara Avenue San Luis ObisPo, Califomia 93401 RE:UST Inspection Van Nuys Facility ID #40-023-31'02 Dear Mr. Boylq During the site inspection conducted on November 08, 2000, it was found that our fuel dispen"sing equipment was missing the certification sticker. The fill tube tag around the fill tube was intact. As per your adviie, we are tequesting a replacement decal For our site. I am enclosing a copy of onr .,rrrent California Certificate # 06575,which was issued by the City of San Luis ObisPo on JulY 17,1998. If you have any further questions please feel free to call me at (818) 9474831 or (805) 490- 3065. Sincerely, Fred Castillo Plant Engineer '{r FAPA: SAI\ LUIS OBIS- - FEB-1999 FUEL SIGNS, CERTIFICATE INSTALLED. SPIL KIT OIC CONTACT LIST STATE COMPLIANCE.{ND a ) Unfied Parcel Servlce 1201 West Olympic Blvd., Los Angeles, CA 90015 (BOO)742-5877 March 10, 1998 San Luis Obispo City Fire Department 21 60 S anta Barbar a Avenue San Luis Obispo, California 93401-5240 RE: NEW MAILING ADDRESS FOR CORRESPONDENCES REGARDING BUSINESS PLANS. Dear Gentlemen: Enclosed please find an updated Business Plan and Inventory F'orm for the disclosure of hazar dous material waste. Please be aware that all future conespondences regarding Business Plans and Chemical Inventory Forms for the UPS facility located at360ISacramento Drive, San Luis Obispo, California, shall be mailed to address listed below: United Parcel Service Attn: Plant Engineering Dept. 1201 West Olympic Boulevard Los Angeles, CA 90015 If you have any questions, please call Fred Castillo at (805) 375-1811 Sincerely, W,l^^,! gfu;p Michael F. Bost District Plant Engineering Manager MFB/gm Enclosure NITED 3601 SA SAN LUI CA Cert. No. 06575 llllll c'wor san tur oBrspo Fire Department o 2160 Santa Avenue San Luis ObisPo, CA 9340 lssued by: Date:7 o'o ililil1 upgrade compliance ceftificate has been issued in connection with the operating permit for the facility indicated below. The certificate number on thls facsimile es the number on the displayed at the facility. information in the format of , city, and zip code of facility; of issue. Other identiffing space below to enter the name of facility; street A); name of issuing agency; necessary by the local agency Instructions to the issuing agency: Use your choice: name of owner; name of facility identifi cation number (from information may be added as Underground Storage Tank Facility UPGRADE COMPLIANCE CERTIFICATE This upgrade compliance cerlilicate is issued pursuanl lo Chapler 6,7, Seclion 25284G1' Calilornie Health and Salely Code, FAC|LITY lD # 40-023-3102 FIRE DEPARTMENT 2160 Santa Barbara Avenue . San Luis Obispo, CA 93401-5240 . 805/781-7380 "Courtc.sl & ScrLicc" July 17, 1998 Mr. Fred Castillo United Parcel Service 1501 Rancho Conejo Blvd. Newbury Park, CA 91320 Dear Fred: Please find enclosed the certification, certification sticker, and fill tube tag which shows that your facility at 3601 Sacramento Drive in San Luis Obispo is in compliance with the December 22,1,998 regulatory requirements. I have also included UST Forms A and B. Please fill these forms out completely and return them to this office as soon as possible. You must keep a copy of the certification on site, you should place the sticker where your fuel delivery person can easily see it and you should place the tag around the fill tube as slrown in tlre enclosed diagram. Please do this no later than December 22,1998. If you have any questions please feel free to call me or my supef; 805-781-7380. Thank you for your cooperation and have a grea Sincerely, Leah Stanley Underground Storage Tank Program enc. certified or cltyoFsan luls oBtspo roo)o) EoII U) o-The City of San Luis Obispo is committed to include the disabled in all ol its s //o -up5 Postage $ Cerlifisd Fee Special Delivery Fea Rosldcled Delivery Fee toRelumReceipt &Whom Date Retun TOTAL postage & Fees $ Telecomasnications Device lor the Deaf (805) 781-7410. 7'kt Division of Environmental Health (80s) 781-5s44 P.O. Box 1489 2156 Sierra Wayo$6n Luis Obispo, CA 93406 Department of Agriculture/Measurement Standards (805) 781-5910 Fire Department (805) 781-7380 2160 Santa Barbara Avenue San Luis Obispo CA 93401-5240 9,14 "1,5"^ l";, Utilities Departmentr (805) 781-7215 879 Morro Streeto San Luis Obispo, CA 9340f lil illt llllI Date:/{- t lt t/) 2156 Sierra Way Suite AoSan Luis Obispo, CA 9340f CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIALS INSPECTION FORM EFW data entry by: Time FACILITY ID NO: FACILITY NAME: ADDRESS: Routine Reinspection TYPE I OtherCITY UTILITIES A/t) AGENCY DEH DEPT FIRE PHONE I lcrGeneratorvfil*.[l Business PlanPROGRAMS INSPECTED: ffiwW*^ro,fi",Iacrl-l Business PlanWfto IYESREINSPECTION REQUIRED: PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. GRANTED BY (NAME/TITLE) YES NO BUSINESS PLAN Business plan is complete, current, & available during inspection (HSC 25503.5' Title 19 CCR2729) Inventory of hazardous materials is complete (HSC 25504, Title 19 CCR2729\ Site layouVfacility maps are accurate (HSC 25504' Title l9 CCR2729) TRAINING PLAN Facility has appropriate training program (Title 19 CCR2732 & 22 CCR 66265.16) Training documentation is maintained on site for current personnel (Title 19 CCR2732 & 22 CCR 66265.16\ EMERGENCY RESPONSE PLAN Contingency plan is complete, updated, and maintained on site (HSC 25504' Title 19 CCR 2731 &22 CCR S 6626s.53/s4) Facility is operated and maintained to prevenUminimize/mitigate fire, explosion, or release of hazardous waste to the environment. Maintains all required or appropriate equipment including an alarm and communications system (Title 19 CCR 2731 &22 CCR6626531- .43) W 6 BPOI BP02 BPO3 TROI TRO2 EROl ERO2 INSPECTOR: L FACILITY REP: COMMENTS t-, L yps 3btl k^"/,erfo^t SAa^ lrr',^ g[,an" ,C n n/ul ,t UNDERGROUND STORAGE TAIIK (UST) Permit No. #PERMITTED TANKS #LINPERMITTED TANKS Owner & operator as indicated on permit:YES nxo Ifno, new owner name & address new owner name & address MONITORING CODES1. No monitoring 2. Standard Inventory Control3. Modified Inventory Control4. Statistical Inventory Rec.5. Automatic tank gauge (list type)6. Continuous monitoring in tank annular space/secondary containment7. Visual monitoring 8. Manual monitoring annular space9. Temporarily abandoned under permit 10. Another method NO N/A (r No. of Tanks: Total Volume: Products Stored:nT Diesel lGasoline lCrude oit Others w VIOL. # UTOOl UTOO2 UTOO3 UTOO4 PERMITTING Site has a permit to operate (HSC 25284) Permit is kept on the premises Change of ownership is reported to the permitting agency within 30 days (HSC 252g4(c)) All UST(s) are properly permitted to operate or properly closed (HSC 25298) MONITORING UST(s) monitored using method jggci{iey' on the permit or approved by the permitting agency (HSC 25293) (Write monitoring code(s) observed 4 , t- . Monitoring records are provided to regulatory agency upon request Automatic line leak detection system is installed & kept operational for all pressurized piping (HSC 25292) An annual report is submitted to regulatory agency Tank tightness test and/or piping test is being performed as required (Title 23 CCR) Written Monitoring Plan submitted for electronically monitored tank system (Iitle 23 CCP.2632134) Facility maintains evidence ofFinancial Responsibility for corrective action and for compensating third parties for bodily injury/property damage caused by a release from the tank system (HSC 25292) ABOVEGROUND PETROLEUM STORAGE TANK ACT UTOO5 trtr UTOO6 UTOOT UTOO8 UTOO9 UTOlO UTO11 gals Note: SPCC required for tanks with total storage capacity of > 10,000 gallons; for farms, nurseries, construction sites individual storage capacity of >20,000 gal or total storage capacity of>100,000 gallons. YES NO N/AInn!xn vIoL. # ATOOl ATOO2 SPCC Plan is prepared and certified by a registered engineer within last 3 yrs. SPCC Plan is maintained on site or nearest field office. N(t+0: W^fw1frrt) t\ ryUr{rv'q bt!.. Ntt ^il{ffir,^,wrnffiAW@,ry N., (nf rcfzott STATE OF CAUFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION. FORM A COMPLETETHIS FORM FOR EACH FACILTY/SITE MARK ONLY ONE ITEM .I NEW PERMIT 2 INTERIM PERMIT l--'l g nelewar- penurr ['-l l aneruoED PERMTT l]R s cxnnee oF TNFoRMAToN [-l z penulltENrLy cLosED srrE l--l o reuponARY srrE cLosuRE i{ I. FACILITY/SITE INFORMATION & ADDRESS.BE EMERGENCY CONTACT PERSON (PRIMARY)EMERGENCYCONfACTPERSON (SECONDARY)-optlonal q NAME (LAST, FIRST)at hli PHONE # WTH AREA CODENIGHTS: NAME (LAST, Ff\nK - PHONE # WITH AREA CODE( 8of) II. PROPERTY OWNER INFORMATION.BE III. TANK OWNER INFORMATION.UST BE COMPL lV. BoARD OF EOUALIZATIoN UST SToRAGE FEE ACCoUNT NUMBER - Call (916) 322-9669 il questions arise. TY (rK) HO a 5 2tg-zl ql"l4:4- v. PETRoLEUM UST FINANCIAL RESPoNSTBILITY. (MUST BE CoMPLETED) - IDENTIFY THE METHOD(S) USED NAME OF OPERATORU,vit€ D PArac gl Sefrvr6gDBA OR FAC|L|TX NAME i.orvltFD PAacal SErLvrt€ NEAREST CROSS STREET PARCEL fl (OPrloNAt) 3601 SACYaArnfdro 5)eADORESS ZIP CODEct414\6 Sttg *.2 { 8.1 SITE PHONE(8osl I WITH AREA CODESTATE CA CITY NAME SArv Luis .,*\sPo ,/ nxrolrffire t--t conponnroH r_l rr{DrvrDuAl r-1 pmtlERsxtp n brf;i\&!r}tY E . lf oi/nsr d UST ls a public agoncy, corplde lhe lollowlng: narns ol Sup€rvisor ol divlslon, 6oclion, ot oflice whlch opolates COUI,ITY.AGEI{CY rhe usT f_lsrArE-AGENcy' f-l FEDERAL.AGET'|CY I OF TANKS AT SITE tI E. P. A. l.O.r (qiona\ 4AD TttL{I azzOR TRUST LANDS / IF INOIAN RESERVATION TYPEOFBUSINESS T-l f-l 2 DrsrRrBUroR n 4PRocEssoR S sonen 1 GAS STATION 3 FARM DAYS: NAME (LAST, FIRST) -J'Arr'r c E Kr PHONE # WITH AREA CODE(8os) 5vY-7 /dqo\lb I c-l'rl t DAYS: NAMEILAST.FIRST} PHONE*WITHAREACODE tvrA A\{ schi \\ferle (8oS) 5qq-'1t84 CARE OF AODRESS INFORMATIONf IndT E IVGIM€€.tqI^/G D€ pT.UI'/ lT E b F A zuE t* 5-E &V, c€NAME T-l rNDrvrDuAt f-l PARTNERSHTP n LocAL.AcENcY T-l couMIY.AGENcY f--l STATE.AGENcY f-] FEDERAL.AGENCY ./ boxbindicalo ffi coReonlrtol MAILING OR STREET AODRESS"t.{X i'",:j"i""otrryrroic g) vd ZIP CODEc4o0l-YcrrY NAME I 'Los AneElt:\CA STATE PHONE # WITH AREA COOE(erb) 6t z- {V? o CARE OF ADORESS INFORMATIONPl Aa/ r e r/G tn/ E€ *q'w c t)€SI-uil tteD ptrv?*cE"L Seev?ceNAME OF OWNER () y' borbindicato f-l tNOtVtDUAt F[coRpoRnrroH f-l pmrHERstttp f-l toclL-lcercv T-l couNrY.AGENcY [--l snru-lceHcY fl reoERlr-.leelcv MAILING OR STREET AODRESS-Tio i'-w ;-i; Wvrrn rt e)vo[ STATE<A ztP cooEq oa t-s PHONE # WITH AREA COOE(2t\> 6{Z- tY*t0 crryNAME Los r{vaELgs T-l 1 SURETY BoND3 INSURANCE 99 OTHEB [-l z eumlHreE T-] 6 EXEMPTToN 1 SELF.INSUBED f_] r LeneRorcneott ./ borblndicate CHECK ONE BOX INDICATING WHICH ABOVE ADDRESS SHOULD BE USED FOR LEGAL NOTIFICATIONS AND BILLING:r.E ttt.l-lt. VI. LEGAL NOTIF]CATION AND BILLING ADDRESS nolilicalion and billing will be senl to lhe tank owner unless box I or ll is checked. THIS FORM HAS EEEN COMPLETED UNDER PENALTY OF ANDTOTHE BEST OF MY KNOWLEDGE, ISTBUE AND CORFECT LOCAL AGENCY USE ONLY TH|S FORM m'l{rr BE ACCOMPANTED By AT LEAST (1) OR MORE PERMIT APPUCATTON . FORM B, UilLES9THF lS A CHAIIGE OF $IE l}SOBrAnOil ol{-Y. OWNER MUST Fll."E THF FoRM WIm THE LoCAI AGENCY lltPtEiEl{tll{G IHE UNDERGRoUND STORAGE TA}IK REGULAnoilS FOFM A(sS!) Fmo83A{7 p\n"V T €rvGtVrUNttrSErz:ltr & STGNED) ru( €.1 E COUNry#JURISDICTION f FACLTTY * VM CI L 3 LOCATION GODE . OPTIONAL lcENSUs rRAcrr - oPfloNAL SUPVISOR - DISTRICT CODE . OPIlo./|,,,,L STATE OF CALIFORNIA STATE WATER RESOURCES CONTROL BOARD UNDERGROUND STORAGE TANK PERMIT APPLICATION . FORM B COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. l. TANK DESCRIPTION coMpLErE ALL rrEMs -- spEcrFy tF uNKNowN MARK ONLY ONE ITEM 1 NEW PERMIT 2 INTERIM PERMIT 3 RENEWAL PERMIT 4 AMENDED PERMIT 5 CHANGE OF INFORMATION 6 TEI,IPORARY TANK CLOSURE 7 PERMANENTLY CLOSED ON SITE 8 TANK REIUOVED DBA OR FACILITY NAME WHERE TANK IS INSTALLED: A. OWNER'S TANK I. D. #B. MANUFACTURED BY:p* C. DATE INSTALLED (MO/DAY/YEAR)q-q3 D. TANK CAPACITY IN GALLONS I oo ll. TANK CONTENTS rFA-1 rs ITEM C. lll. TANK C0NSTRUCTION MARKoNETTEMoNLyTNBoxESA,B,ANDc,ANDALLTHATAppLTEsTNBoxDANDE lV. PIPING INFORMATION crRcLE A TFABovEGRouNDoR u TFUNDERGRouNo,BoTHTFAppLTcABLE V, TANK LEAK DETECTION FL t t',toron VEHICLE FUEL l--l z pErRolEut',t [--l g cueurcAL PRoDUcr EE 4 otL 80 EMPry 95 UNKNOWN A. XI r enooucr 2 WASTE B.1a REGULAR UNLEADED 1b PREMIUM UNLEADED 2 LEADED D. IF(A.1)ISNOTMARKED, ENTER NAME OFSUBSTANCE STORED 99 OTHER (DESCRIBE IN ITEM D. BELOW) c.A.s.# 3 DIESEL 4 GASAHOL 5 JETFUEL 6 AVIATION GAS 7 METHANOL Fl r oouele wru- f-l + sEcor.roARy coNTATNMENT (vAULTEDTANK) n 95 UNKNOWN 99 OTHER 3 SINGLE WALL WITH EXTERIOR LINERA. TYPE OF SYSTEM 2 SINdLE WALL l--l z srnrrulesssrEEl X| s rreencuss f.l e polvvrr.ryL cHLoRloE f_l z elur,,tnrur,r f-l ro enlvrr'rzED srEEL l---l ss ur.lxr,lowr,l B, TANK MATERIAL (PrimaryTank) [-l r enne sreeL l---] s corucnere 9 BRONZE 4 STEEL CLAD W/ FIBERGLASS REINFORCED PLASTIC 8 1OO"/" METHANOL COMPATIBLEW/FHP 99 OTHER C.INTERIOR LINING l-l r nuggen Lrlleo 2 ALKYD LINING f-l s emss utttrue lX e ur.rr-rrueo IS LINING MATERIAL COMPATIBLE WITH 1OO% METHANOL ? f_l g epoxv t-tr'rnro f_-l gs uttxt'towru yes K lro- 9S OTHER fl + pueruor-lc LtNtNG D. CORROSTON PROTECTION fl r polverHYLENE wRAP t]2 COATING l--l s cnrnoorc pRorEcrtoN Kl st t'totle 3 VINYL WRAP 95 UNKNOWN fl + rreenelAss REtNFoRcED pLAsrrc 99 OTHER E. SPILL AND OVERFILL SPILL CONTAINMENT INSTALLED (YEAR)OVERFILL PREVENTION EQUIPMENT INSTALLED (YEAR)I 6lcl A. SYSTEMTYPE A U 1 SUCTION A(g/r2 PREssURE A U 3 GRAVIry A U 99 OTHER B, CONSTRUCTION a u 1 srNcLE wALL A@ e oouale wau A U 3 LINEDTRENCH A U 95 UNKNOWN A U 99 OTHER C. MATERIAL AND c0RRostoN PROTECTION .I BARE STEEL 5 ALUMINUM 9 GALVANIZED STEEL A U 2 STAINLESSSTEEL A U AU 6CONCRETE AU A U 10 CATHODTCPROTECTTON 7 STEELWCOATING A U 95 UNKNOWN AU AU AU 3 POLYVINYL CHLORIDE (PVC)4 FIBERGLASS PIPE A U I 1oo"/" METHANoL coMpATtBLEWFRp A U 99 OTHER D. LEAK DETECTION Xl r rurounrtc urue lenr oerecfbn fl e uruE rcurNEss rEsrNG E 3 INTERSTITIA MONTTONIN( K] r vrsual cuEcx l-l 2 rNvENToRy REcoNctLrATroN l-l e rnrux rEsrNG K z rrurEnsrlAL MoNrroRrNG 3 vADozE MoNrroRrNG ffi + eurouelcrANKGAUGING 91 NoNE f_-l ss ullxruowru 5 GROUND WATER MONITORING 99 OTHER VI. TANK CLOSURE INFORMATION THIS FORM HAS BEEN COMPLETED UNDEB PENALW OF KNOWLEDGE, IS TRUE AND CORRECT LOCAL AGENCY USE ONLY THE STATE I.D. NUMBER Is CoMPOSED OF THE FOUR BELOW 1. EsIMATED DATE LAST usED lir,roroavnrnl 2. ESTIMATED OUANTITY OF SUBSTANCE REMAINING GALLONS vEs f-l No fl3. WAS TANK FILLED WITH INERT MATERIAL ? APPLICANT'S NAME (PRINTED & SIGNATURE)FR[b Costr\lo z)qgDATE7 COUNTY # JURISDICTION #FACILITY #TANK # STATE I.D.#l\L I'v 0 PERMIT NUMBER PERMIT APPROVED BY/DATE PERMIT EXPIRATION DATE F9RM B (7-e1) THIS FORM MUST BE ACCOMPANIED BY A PERMIT APPLICATION . FORM A, UNLESS A CURRENT FORM A HAS BEEN FILED. FORO(B4B.R5 ffi tr,y Untted Parcel Servtce 1201 West Olynrpic Blrrd., l-os Angeles, CA 9tji.rl, (800) 742-[;r i ,' March 10, 1998 San Luis Obispo City Fire Department 2160 Santa Barbara Avenue San Luis Obispo, California 93401-5240 RE:NEW MAILING ADDRESS FOR CORRESPONDENCES REGARDING BUSTNESS PLANS. Dear Gentlemen Enclosed please find an updated Business Plan and Inventory Fonn for the disclosure of hazardous material waste. Please be aware that all future correspondences regarding Business Plans and Chemical Inventory Fonns for the UPS facility located at 3601Sacramento Drive, San Luis Obispo, California, shall be rnailed to address listed below. United Parcel Service Attn: Plant Engineering Dept. 1201 West Olyrnpic Boulevard Los Angeles, CA 90015 If you have any questions; please call Fred Castillo at (805) 375-1811 Sincerely, 'Vttttlr'^,! ;1 75"*/ P Michael F. Bost District Plant Engineering \4anager - - MFB/grn Enclosure l0:1\0tc l(J rlte From: Leah Stanle' RE: RESULTS OF UST INSPECTION: 3601 Sacramento Drive; United Parcel Service Consistent with the Califbrnia Underground-Storage Tank Regulations, I inspected the underground storage tzmk system at the above referenced address on March 11, 1998 with the help of Fred Castillo of UPS and Danny of B & T Contractors. Dan Goulet was also present. When we arrived, Danny had the dispenser, turbine sump, and fill sump open. All paper work was out and ready for inspection. The monitoring system was certif-ied within the last l2 nronths.- Danny pulled the sump probe and simulated a leak. The operating permit that Fred had in his records had expired in 1996. I checked with Carrie and they are paid up to date and were issued a valid operating permit. Apparently it has been misplaced. They are due to renew this month. No violations were noted, all items are in order at this site. Decenrber 22, 1998 Regulatory Requiremeuts: There is a 12,000 gallon diesel tank at this site installed 9/93. The tarrk is clouble walled fiberglass with an interstitial monitor and ATG. All piping is double wall pressurized fiberglass. Automatic line leak detection is present and functioning. A spill container, striker plate and tlll tube valve overfill protection are present. The is a clisperrser containnrent pan with a sensor under the island. To the best of my knowledge, this site nreets the 12122198 regulatory requirements at this time. ol"lro Fred Castillo District Plant Engine.ering West Los Angeles District United Parcel Service 1501 Rancho Conejo Blvd. Newbury Park, CA 91320 Phone: (805) 375-181 | (805) 339-5087 Fax: (805) 37s-1824 qQ9 Gtyo[san luls oBtspo FIRE DEPARTMENT 2160 santa Barbara Avenue o san Luis obispo, cA 93401-s240 o 905/7g1-73g0 "Courtesy E Service" March 20, 1998 Mr. Fred Castillo District Plant Engineer United Parcel Service 1501 Rancho Conejo Blvd. Newbury Park, CA 91320 RE; Results of UST Inspection: 3601 Sacramento Dr., San Luis Obispo, United Parcel Service Dear Fred: Consistent with the California Underground Storage Tank Regulations, I inspected the undergrouncl storage tank (UST) system at the above referenced address on March 11, 1998. With the help of Danny from B & T Contractors and yourself, the UST system, the dispenser island, monitoring systems, and all records were inspected and found to be in compliance with all state and local laws and ordinances regarding the operation of UST systems. During the UST inspection, no violations were noted; all items are in order at this site. Please find enclosed a copy of your current operating permit for this facility. Apparently it was issued and paid in full in February by someone at 3601 Sacramento Dr. in San Luis Obispo. From this point on permit payment requests for this facility will be sent directly to you. To the best of my knowledge, this site is in compliance with the December 22,1998 regulatory requirements at this time. This office will contact you regarding the upgrade compliance certificates at the appropriate time. I would like to thank you for the professional manner in which the inspection was handled. Your knowledge of the UST systems, attention to detail, and professionalism are greatly appreciated. Sincerely C Leah C. Stanley Underground Storage Tank Program B +Jl3.3',Y#.,igl,5Hf ooJ,,:3","? in",l"SXF?rSrjTJy-9?,t3." disabred in al or irs services, pros,ams and acriviries @ MEMORANDUM Date: March 11, 1998 To: Note To File From: Leah Stanley RE: RESULTS OF UST INSPECTION: 3601 Sacramento Drive; United Parcel Service United Parcel Service 15O1 Rancho Coneio Blvd Newbury Park, CA 91320 Phone:(805) 375-18j1 (805) 339-5087 Fax: (805) 375-1824 Consistent with the California Underground Storage Tank Regulations, I inspected the underground storage tank system at the above ref'erenced addreis on Marclil1, 1998 with the help of Fred Castillo of UFS and Danny of B & T Contractors. Dan Goulet was also present. When we arrived, Danny had the dispenseri turbine sump, and fill sump open. All paper work was out and ready for inspection. The monitoring system was certified within the last 12 months. Danny pulled the-s3mP probe and simulated a leak. The operating permit that Fred had in his records had expired in 1996' I checked with Carrie and they are paid up io date and were issued a valid operating permit' i Apparently it has been misplaced. They are due to renew this month. No violations were noted' all items are in order at this site. tl'lta Fred Castillo District Plant Engineerino West Los Angeles District December 22, L998 Regulatory Requirements: There is a 12,000 gallon diesel tank ar this site installed 9/93. The tank is double walled fiberglass with an interstitial monitor and ATG. All piping is double wall pressurized fiberglass' Automatic line leak detection is present and functioning. A spill container, striker plate and t'ill tube valve overfill protection are present. The is a disienser containment pan with a sensor under the island' To the best of my knowledge, this site meets the 12122D8 regulatory requirements at this time' QAa cffiyo[san lt"tls ontspo FACILITY PHONE NUM ,*;-L/L/ -' '7/8 t/ FIRE DEPARTMENT 2160 Santa Barbara Avenue . San Luis Obispo, CA 93401-5240 . BO5/781-7380 "Courtesy E Seruicc" GENERAL MONITORING INSPE,CTION CHECKLIST IN ACCORDANCE WITH TFIE STATE OF CALIFORNIA HEALTH AND SAFETY CODE, DIVISION 20, CHAFTER 6.7, SECTION 25280 et. seq., AN INSPECTION OF EVERY UNDERGROUND STORAGE FACILITY SHALL BE CONDUCTED TO DETERMINE WHETHER THE TANK SYSTEM(s) COMPLIES WITH THE APPLICABLE REQUIREMENTS AND REGULATIONS AND TO DETERMINE WHETHER THE TANK SYSTEM(s) IS IN A SAFE OPERATING CONDITION. FACILITY NAlvtE:FACILTTY ID NUMBER:z FACTLTTY ADDRESS:INSPECTION DATE: INSPECTION TYPE: TIME IN: ?,'3 bBID: 3 /o ?-#tn TIlvlE OUTr )o:qfM- Upgrade Deadlines nl-nr 84 o Cutoff date for new and existing USTs Existing USTs must install monitoring system (H&SC 25292 (a)), Se*ondary conLainment required for piping connected to tanks installed after this date (exceptions) (CCR 2636 (a)). Evidence of responsibiity for UST system by orvner/operator for corrective action release (I{&Sc 25292.2 (a)). Existing pressurized piping equipped rvith ar.rtonratic leak line detector (FI&SC 25292 (e), (ccR 2666 (b)). Operative date for violations; civil/crirninal penalties (FI&SC 25299 (0). Permits issued shall comply with tl&SC 25299.3. Independent approval for prinrary containnrent construction and design of UST components (ccR 263r (b)). Independent approval for primary containment construction and design of UST piping components (CCR 2631 (b)). Tank lining material and process listed/certified by and independent testirrg organization (CCil 2663 (e)). Manual inventory reconciliation allowable only when the unclerlying groundwater is at a depth greater than 20 feer below the bortom of rhe UST (CCR 2646 (b)). Automatic tank gauge systems installed after this date are to generate a hard copy of the calculated leak rate and leak threshold (CCR 2643 (bXl)). Existing UST(s) replaced or upgraded to prevent releases due to corrosion, spills, and overfills (H&SC 25292 (d), CCR 2665). All single wall tanks (steel) are retrofittecl rvith seconclary containment or by one of the following options (CCR 2662 (b)): 1. Interior lining and cathodic protection 2. Bladder system, interior lining, and cathodic protection Existing pressurized piping is retrofitted with secondary containnrent (CCR 2666 (b)).. Audible/visual alarnr attached to pressurized piping (CCR 2666 (c)). Manual tank gauging no longer an acceptable method of non-visual monitoring for UST systems having a capacity of 1,000 gallons or greater (CCR 26a5 (c)). Manual inventory reconciliation is no longer acceptable (CCR 2646 (b)) Striker plate installed trnder all openings used for manual dipslicking (drop tube-mounted bottom protector is acceptable) (CCR 2662 (d)) FOLLOW.UP: 35o J7a )00 ,0O lo lo lo zo zo to io io o o o o o Llr.ll,l li' '''l liili tlAR 11' l' r'j :r'i:' 1 Hi'1 L I :fft'ltlrtl i,1': l;['iit':l'] SEI'lF0Ft llliit jt"lFiL L t :TI-IFBI 11p sl-ll'1ll SENFTIR I!t.]Fjl'lFlL LEAH TEST RE:ii;lLi fi"8.''in-[*r.'ll] i'[ll;l' I';rr:i''i SYI:TEI'I STATUI:I REF+ET ALL FUt'lCTIttl'15 ll+Rl'lAL B +:n*,j{"iJffi15Hi'&Y,,.?",ii i,ii"#:i?.3.j"r"J1-'r?iJ." disabreci in arr or its services' prosranrs an. activities @ COM NOTE: VIOLATIONS NEED TO BE CORRECTED \YIT}IIN 30 DAYS OF DATE SIGNED BELO\Y RE-INSPECl]ON RECEIVED BY INSPECTOR TELEPHONE NUN{BER: H&SC : CHAPTER 6,7, HEALTH AND S CODE CCR : TITLE 23, DIVISION 3, CHAPTER 16, CALIFOR UFC : UNIFORM FIRE CODE (1994 UNLESS NOTED) mrm/prcwnu\*1/PillJ' f mr NIA CODE OF RECULATIONS (MAY 5, 1994) GENENAL MONITORING INSPECTION CIIECKLIST ll thb trciliry hrr mort thrn 4 lrnlt, plertr photocopy ths chrcll'rtt bolotr complolion. HgSC - O|APItR 8.7, CALlt0RlllA HTALTH & SAttIY C00E ccR - ItIt E 23, Dl',/lSl0N 3. CHAPITR lS, CAtlFORlllA C00E OF RiCUtAIIoNS (199{l rCR - TIILI 40, TTOTRAT COOT OF RIGULATIONS UFC - Ufllt0RM tlRt C00t 11901 unlorr nolod) '0,/,tu 0, ^n, UML ,-r".. ?b3 tut h/24 TAIi K 2 TANK 3 TANK 4 .it4i{::!::.:(+-Yl{ Xar.il{,: TANK 1REOUINTMENTS PR E.INSPECTION DOCUI/IENT R EVIEW rate:P e rmit lications and Fees to 0 0 ccR 2ilr, uFc 7901.3.1(l 4 ati a), CCR 2i I I (c)).fees aid (H&SC 2528 ))C submitted (CCR 263 tl rms A&B submitted {H&SC 2528 ffit.r#*$U\iJr:*iYr :?*1.:iAR$i.tsN+3]f] ffiZlt:il'{tqYi}}{N,;k tlu ill.9.)i.'.fi $Y.t{+}it{::: . .. .,,, , ,,,,,,1 3:ittiff*;.ii$tgi--l ilSlate sutchar aid lr&sc 25287(b), CCR urrent Perm Records. and Plans IC7 I a)).2tdeCRollanstFa,rY # '!ir!ld?)Virti,Y#:rf.i{l4'x!:.S:qs\Y 7:7s 288(b), CCR 27tPrevious viola trons co rrected rvithin 30 da ill on lile.usrnSss an to miti ate a release or &sc 25292.tleStalement ol linancial re , UFC BOO .5.2.5).onsibil t sub ror (H&SC 2 233(b), CCR 2620(b))V/ritten contract exists betlveen o,,vner/0 cR 2632(b), {d)(l),2641tten routine monitori n sub ).d ccR 2652(b))zed release t orled Itrshou&sc 224(H 2634), UFC 8001.5.2.3th. release re 0nse lan subnritted (CCR 2632 orted thin 30 s (H&SC 25284(b), CCR 2 I 2(d)).ownershi t in0 procedures of UST system teported within 30 days &SC 25286(d), CCR 27ll(tr), UFC 7S01.3.1(5),7s02'1.2],. nges to operatinglnro (H olectron tion recorded iii:r*^Yilli$I$:$u$--*-lKrrxivdfsis us inspection implemented within 30 days ofrrections specified in the prev rrective Action ceivina the insnection report (CCR 271 lan subnrirred ICCR 27 22I tive action process initiated for reported unau thorized release3. Co 72 1 (a)). action complies tvith policies lor l'rater quality control plans (CCR 2 I (b), (c)) 4. Cotr hases: (CCR 2722lal)aclion includes at least one ol the lollotrin5. Correc Prelinrina srte assessnrent Soil and lv er tnvestt a tion t0n lan i ementationCorrective a rto il haseV eri fica tion an and action initiated {CCn 2722(b)}.6. lnterinr renredia lrlonitorin lvlethods and Re orts Approved mon (ll&sc 252s 1 g system installed and opera CCR 2632(b), 264 1 (a), UFc 7901.8,4.4. 1 ). ng under perrnit condi J 252921a\,2529 3{a), I test in last 12 nronths (CCR 2643{c){3),ll&SC 2529111 lnte rit Testin Pressurized I o 242C25o 1 FCU I .4 ).21 rhm0n 5 &S 2(b)(),(H R 2643(d))etr tness test in last 3 ears est in last 2 years CCR 2643(e)). FU lC 6902 0 .J)3 )bSU thin da0 s CC bqRLseul ts tednlr t formed on line leak detection eAnnual maintenance and/or calibra tio n ...,,,,r'. rrr 1!::I $itiiii'iJilii|iir:riii:i]':,,:i,:::iiiiiriiti.:i:ii:iiini:i:iii-\ Caihodic protection provided for secondary contalnment o e5 t RC o-l2 3 )(cil0atoatsec0natcdh4B0t0cen I tank and for UST piping cR 2631 ), 2 63 6{rl ), UFC 7S01.1 1.3, 7902.6.15.1) nthodic Protection odic Protectlon tested tvilhin 6 months oI installation and every 3 yearsC2 Iter (CCR 2635(a)(2)iA)). of sacrificial anode systent tests indicate th:t tlre systent is func lro nrn q :rly 3. fircoi l TANK 4TANK 3TAITK 2TANK 1 R E OU IREMENTS ts 2643 )( I )1.rmed (ccR 263 6(l0nnni to0um0trnunCo CR oq2 3(it (cd0tmol suction roduct .22 .92d0l0ten0(vc0ctnRnuaI lnventot tness test (CCR 2nkualannanwith0rmerI lion is reported to lo cal agency vrithinallolvable vaerceedingthe rs {CC R 2646(e)(124 2 6 ex ceednidortsdat0nm0thadverif '1i sorl lelhdloutabexce edi0ea sesel n0timesoldandtesdlistts0r limits (CCR all ovt abl 3. Annu Reconc iationtonvestt;tctae 646(c)2ccRtesltn essrinknialtabrhwlmed0rP 11 s2. Annual SIR rted (CCR 264 6.1 d)t.2 616ortedinventories rc0nauentor 2 or more cR 2646.(h)) tness testri4. Ta esul tsrslveIdI0co ncluln0em CCR 2erlormerittest GauTanAutom at 2643 lrlon AUritank0tamau agency prior toocalto therelease(s) has been rePortey unauthoril ed irs (CC R 2661(a)). 30 days ol rePairstightness testedtal piping and tanks (CCR 2.N dic protection systems 6 months olbeen testedh ave3. Repaired c re n ClosureTa ethe cessation of0 days ofclosure submitle within I of hazardous substances cR 2670 ation tor ta stor re (CCR 2670(f)). vrithin 30tions submiltednk closure regulaof compliance with ta da of 2. Propos CR 267re )) 4 until actualcle 3 andArtottdursuani tonl0tarnadnd p letion 3. UST sYste hadu0sudenpasedldelunauantho0tectton 65CC')2 (b )).n42hothincallotoheb the ov,'nerloPerator an unauthorired rele 652 (c)) to the local ase bnritted by f detecting vrrilten rePort y vrithin 5 l';or has been su king days o (CC 2.4 ag ardi torluenm0evleI0reqaenclocYledrhqutosubtsml0rleaUpd6522(d)).L ocria0n5bamentlndtialdilcleada0vleu and Plansc0rdrmBUn(e P e ts,C , uFc i901.3.1 Valid o ri 72 2CRCoH25SC6,280.st emit ,712(b)).,264'lCCR 26&sc 252S0nteedtaindsmalnilY/rec0 an. nseEnrer rhofbeaurllverbe(a castelon R 2712 (b)).t lor 6.5 t5ecords k lor 5 2R 7 (b2 ))5 nn netectto sys temsdms0relcl I7 2(b)).CR 2CerhSTUlilee00rrh0tn.srl ekdseedrec0a and trtnin records on lileSafet orlsonitoriNlethods an dRe tlor3l,lonitorin 72 2sR (b))(ccmainlenance reco rds nters itial Nlonitorin ), ccR 2632(H&SC 252S2(bt tequired lrequencYally aVIsu (c)(1),2611(d ),2642(a)UFC 7901.8.4.4.1)or e.l'ralled tankstial nronitorino lor doublContinuous non .visual intersti (ir&sc 2 529 r{b}ccft 2632(cl(2)(A), 264 I (i)). Liquitl lc .;el in the ta nk recorded al tlre tinre ol inspection (CC R 2637-(c) TANK 4TAIIK 2 T AIIK 3TANK I REOUIREMENTS Colhodic 2)(Al)CR 26360 calendar dactedls lnsleressed cutrent r Mete rs by department ol 'lr 0pereights and measures 2 64 6fi)). meters lnsp 8S l. D stick ers ccR 2646.'l(k))s ca librated annu2.0 do not shol'tand sumIressurized and suc tronen3.0i ave 0ccuredease mans thavl 2643(c)(lccR 2636(t)(llserloroltiln0m0nJnCotrnuouI R 2643erlormed dailoduct0n5U anual lnvento Be conciliation R 264alron ea ch monthRlnventotnu allY1 measuremen0nuidelevan0btsasedsurSmenmeaSTrir,/quan )(cl364Rc2tsemen(c 2 0nBeconciliaStatistical lnvento CCR 2 1montherlormed eaationtelnveSta 6.1(R2rtedes 2.entnvn clu sivetnc0e2m0r0r0uent 6.1(CCR 2r lnc0n lesuf3.7 htness test anual Tank Gau n test 564dR2 )).(btm(ccerf oAnnual tank inte cR 2645(2,000 Gal. or L 2 rlormed weeanual tank a ours be 0re 0augln0ce 48.J2 hours, a nd at least 12taken out o (C CR 2645(a)). 3 y limits ed within ri 0 m0nwetheeklexctseedvmensuremeankaungg rm0beeerlohI est asnktaint pnddaegrityVEe5 R 2615(d 3))72 hours in2 4. il1a ank Gauomatic n I )).642RCCdtomatic lank AUlvl o n thli ClosureTa CR 2670{e))TE 4 until actualcle 3 antottArursunm0ntoraanedndpT syst c0 U0 HGTKRHWYLAcLTAF etedchecklist colnterstitial monito iln odic Proleclion installed and o a tlned currenl s 2 A)()).62nCn 3s(l. I tersenser resent and currenlction stickershts and lrleasures tntofY/'I 64 6(i)) 1))o{Continuous nronit r), 2643ormed (CCR 263lserl esenlls ),2 .6FU790tr2CR6(a)63 Secondar containment of s (CCR 2636(erlormed in suN1onitoofls 11,2525252IaL 'I de &cn stn a ll (Htnrentectionneaedk0tticmatiAU , UFC 7902.6.1252(b)(4 ccR 2636({) letedchecklist co alrsrades andU 25292.l'c]r,ndlor repairs made (H &SCades(tentSUT 0uppproved OQ ccn 2660.2666) 62 16 cnceCRCna0ceda0nrhnr0reeplof ther linin2.lnt ed (CCfl26661{d))3. Holes 2661(e)). sed product have beenings that have releattings, and ta nk fitt re :1. t\ietal to continuouslY ntonitorter ntonitorlng sYstent instalied if no secortdarY contain ment exists (CCn 2E6l()) t:rrks re,raired bY p0r 0r 0r0tln REOUIREMENTS TANK 1 TANK 2 TANK 3 TANK 4 Upqrades and Bepairs lconl.) ,f Secondary conlainmenl provided {CCn 2662(b), UFC 7902.6.1 I,B00l .4.5.1 .2). y'. Overlillprevention uFc 7s02.6.5.31. equipment installed (H&SC 25291(c), CCR 2665,2635(b), ,X, Spill c o n t ai n m en t p r o vi d e d ( H &S C 2 5 2 9 I (cl, 25292(dl, 252 2635b), UFC 7901.8.1, 7902.6.5.2). 92.21a1, CcR 2665, / maiArc and visual alarms are connected lo the continuous monitoring system lccR 2632(c)(21(B), UFc 7s01.8.4.4.1). J,01Automatic pump shut.of f capability {CCn 2ffi6(q)(3)(a}). e are dri FC 1.1 l.B fiffi,gencyfiear vafves provided at dispenser base IUFC 79.904(e)(2] .'gl uFc c0DEs). .'hnk Clo:(lo 1.\S{properly a &SC 2529 B(c), CCR 267 0-7 2, U FC 7902. 1.i.2, 800 1.1 I l..otl6i\ ?n ,ililililililiililllllll Gtyofsan luls oBtspo FIRE DEPARTMENT 2160 Santa Barbara Avenue o San Luis Obispo, CA 93401-5240 . 805/781-7380 "Courtesy E Seruice" February 20,1998 RE: UNDERGROUND STORAGE TANK FACILITY INSPECTION Dear Business Owner/Operator: Greetings from your City Fire Department. Spring is right around the corner here in San Luis Obispo and with the absence of major fires, heavy rains, and flooding, the Fire department, like your business, is taking the opportunity to get back to our regular schedule. State regulation requires that any facility containing an underground storage tank (UST) system must be inspected by the local agency that implements the state regulations. As you are aware, the fire Department is the local implementing agency in San Luis Obispo. According to our records, your UST system is due for inspection. Your facility is scheduled to be inspected by this department within the next two rveeks. The purpose of the inspection is to determine whether or not the UST system is in compliance with all applicable regulations. Compliance includes, but is not limited to, design and construction standards, verification that the operator has monitored and tested the UST system as required by the permit, and detennination of whether the UST system is operating in a safe condition. Every effort will be made to minimize the impact of the inspection on the daily routine of your business. In order to help you prepare for the inspection, a list of deficiencies found in our files of your facility and/or documents expected to be reviewed at the inspection has been enclosed. Ifyou have any questions about the inspection or are concerned because you have not received additional contact, please don't hesitate to call me at 781-7380. Sincerely, a-( Leah Stanley Underground Storage Tank Program encl. Th.e City of San.Luis-Obispo.is committgq-lo,!nrclqqe the disabled in all of its services, programs and activities. mTelecommunications Device for the Deal (S05) 781-7410 \l/ l+ )I United Parcel Service, 3601 Sacramento Records that will be requested for viewing: a Current operating permit a a Written contract between the owner/operator for monitoring, maintenance, reporting, etc. Written routine monitoring and response plan - specification of monitoring method and equipment Monitoring records kept on site - Daily inventory records, automatic leak detection readings, and daily visual monitoring records if used. o a Safety and training records for employees a Calibration/maintenance records Interstitial monitor testing records Unauthorized release reports Note: In order to minimize the impact of the inspection on the daily routine of your business, you may wish to have your maintenance contractor present for the inspection as we will ask you to open the dispensers, all sumps, and to demonstrate the operation of your monitoring system. I will call you to set up an appointment. a a SAN LUIS OBISPO COUNTY HEALTH DEPARTMENT DIVISION OF ENVIRONMENTAL HEALTH 2156 Sierza Way o P.O. Box 1489 . San Luis Obispo, California 93406 TEIIPHONE (8os) 781-sW o FAX (805) 78r421r '7"0'f .t,t January 29, L997 Mr. Ray ShawPlant Engineering Depaitment Uni-ted Parcel Service 252OL Paseo De Alicia, Suj-te 20O Laguna Hi1ls, CA 92653 '?""1 tL/ ' ,.* - 4 '* ' "fiu1 \"1 This letter is written to verify that our Department had enforcement responsibility for the United ParceI Servi-ce underground storage tank (UST) facility located at 360L Sacramento Drive in the City Of San Luis Obispo, California prior to 1990. During Lhe pre-1990 period this facility operated under a permit issued by our office and is deemed to have been in substantial compliance during that time. Our staff contacted the current enforcement aqency, City Of San Luis Obispo Fire Department and we were informed that no enforcement actions are currently pending on this site. Records for the above-mentioned facility were forwarded to the city at the time that the area, whj-ch includes Sacramento Drive/ was annexed to the City. However, those records have since become lost or misplaced. Should you have any questions regarding this matter, please contact our office at (805) 78L-5544 JOHN SCHOLTES, R.E.H.S. EnvironmentaL Health Specialist IfI Judy Reid, SWRCB Spencer Meyer, SLOFD John, A DEPAFTMENT OF THE SAN LUIS OBISPO COUNTY HEALTH AGENCY {.\ MO ITORING PROCEDURES JOR UNDERGROUND STORAGE TANK rfficoPr Facility Name: United Parcel Service Facility Address:3601 Sacramento Drive San Luis Obispo, CA 93401 UST Installed:November 1993 Piping Installed:Type- Pressurized double wall - Primary Fiberglass with secondary fiberglass MonitoringSystem: Veeder-Root TLS-350 A. Frequency of Monitoring Monitoring is performed on the: Double wall UST and its sumps: Continuously Productpiping: Continuously B. The methods and equipment used to perform monitoring are: Monitoring system used: Veeder-Root TLS-350 In-tank detection used: Automatic Tank Gauge Line leak detection used: Red Jacket Lead Detector Sensors are used in the: UST interstitial space Turbine/piping sump These sensors are levei Switch type and are activated by changes in fluid level or presence of liquid in the piping sump. UPS CONFIDENTIAL DO NOT DUPLICATE OR DISTRIBUTE. C. Locations where monitoring is performed: Continuous monitoring and leak detection are performed in the: Interstitial space of the double-wall UST Primary tank Turbineipiping sump D. Monitoring Personnel: Mark Schilling Janice Kiichli The Facility Coordinators are responsible for performing: Inspections of the monitoring system and reporting of any discrepancies and alarm with monitoring system, UST piping and associate hardware. The Plant Engineering departrnent is responsible for all record keeping; repairs and documents regarding permits, registration and calibration of all equipment. United Parcel Service has a service contract with B & T Service Station for all maintenance and repairs of the UST monitoring system, UST and piping. E. Reporting Format: Daily reports are automatically printed by the leak detector indicating the sensor status and the product inventory. Leak detector is programmed for weekly leak detection test to veriff tank and piping integrity. This report is collected by the facility coordinator and attached to the weekly inspection form for review by the Plant Engineering Department. All records are retained by Plant Engineering. t F*!!'trw uPs CoNFIDENTIAL DO NOT OUPI-ICNTE OR DISTRIBUTE. F. Preventative maintenance, calibration, certification to manufacturer's specification and repair of the UST monitoring system and associated hardware shall be performed at least annually. United Parcel Service has a service agreement with: B&TServiceStation P.O. Box 220, Arroyo Grande, CA 93421 (80s) 481-2ss2 B & T Service Station who performs the preventive maintenance inspections per UPS procedures on a monthly, semi-annual and annual frequencies. These inspections includes all testing, calibration and certification as required by local agencies. G. Training: United Parcel Service has written procedures for company employees to follow. These procedures are reviewed annualiy with the facility coordinators. The procedures include the weekly fuel island operation training video and leak detector operation. The document outlining these procedures are kept at the facility. Operating instructions for the UST and (monitoring systems used) are on-site. On- site training is performed on initial start-up of the UST monitoring system and refresher training is performed on an as-needed basis. If you have any questions or need additional information, please contact United Parcel Service Plant Engineering department at (805) 375-1811 or (213) 612-1890. Fred Castillo Facilities Engineer Plant Engineering Department West Los Angeles District UPS CONFIDENTIAL DO NOT DUPLICATE OR DISTRIBUTE. t UST RESPONSE PLAN Facility Name:San Luis Obispo Faciiity Address:3601 Sacramento Drive San Luis Obispo, CA 93401 UST Instailed: November 1993 Piping Installed: Pressurized Double-wall Reinforced Fiber-glass MonitoringSystem: Veeder-RootTLS-350 A. All in-tank alarms and restricted-flow problems on the pressurized product line will be investigated to determine their reason and cause. If during the investigation, it is determined that a leak is possible, and integrity test will be conducted to determine the integrity of the UST and piping system. If it is determined that a release has occurred, the product in the UST and piping system will be removed and a site assessment will be conducted. Removing the UST and/or piping system and remediating it will be included if required. The facility spill coordinators shall follow the action step for an oil spill incident. In the event of a catastrophic failure and/or if an emergency response is required, the vendor listed below will respond. N.G. Chemical,Inc, 2260Mahoney Road Santa Maria, CA 93455 (805) 925-03e1 All hazardous waste will be recorded on a Uniform Hazardous Waste Manifest and will be recycled if possible. B. United Parcel Service - Plant Engineering Department is responsible for authorizing any work necessary under this Response Plan and can be reached at (213) 612-1890 or (805) 375-l8II 24-hours a day. If you have any questions or need additional information, plbase call United Parcel Service - Plant Engineering Department at (80s) 375-181 1 or (213) 6t2-t890. Fred Castillo Facilities Engineer Plant Engineering Department West Los Angeles District l!@.ffi4-q* UPS CONFIDENTIAL DO NfrDUPUC,ATE OR DISTRIBUTE 9 'a N cltyo[s.po FIRE DEPARTMENT 748 Pismo Street . San Luis Obisp GENERA" T"O'V''OI IN ACCORDANCE WITH THE STATE OF CI CHAPTER 6.7, SECTION 25280 et. seq., AN J FACILITY SHALL BE CONDUCTED TO DEl WITH THE APPLICABLE REQUIRFMENTS I THE TANK SYSTEM(s) IS IN A SAFE OPER., FACTLTTY NAME: FACILITY ADDRESS: FACILITY PHONE NUMBER:1 BID:bt oz TEl,lF ..' |l,i, . t_l Llri:i ll li r:: i. ir x Fl'Jfr t I :t r ; l"lAR 1 4, 1 1J,:r6 il : l:l! *l'1 tr I .i. i:l r,l.l 1 El*t:rF.if tl'II f']'f{:t i:i*l'l LLi I ll {:rl1 J f,il-'{i ElllS !:i,X4 ';'l fl..l I N\JEll'f,ill+i,', l',irl'I !ii'i T 1 :Ul'll-.Eitl.tlilr u,tLLttlE LILLFlL]E 9l:-tl'i 1'ttOt-U TC VIlL.III,IH HE ] GH]' ti*T'EFi \fitl., hr/"il'ER IST CODE, DIVISION 20, OUND STOMGE 'sTEM(s) COMPLIES IRMINE WHETHER iOLLOW-UP:r, Intf,- 'l8ll I after this date ;tive action release (H&sc 752e2 (e), ). of UST components of UST piping sting organization (CCR :oundwater is at a depth r hard copy of the ion, spills, and overfills or by one of the rcR 2666 O)). ,nitoring for UST r) lrop tube-mounted = ::r t.l'i l]r * , LLI'tr:r = 'r'l'lilfi ,. ..il_ll.,f , rj., I t. tJI..l i-;ALFi GALF-I {-;AL Er flFrLi:l i llt:HLlt-:i l-;irrL.Li I I'lr-: I ll-_li:r Upgrade Deadlines 01-01-84 I 07-01-85 ? 07-01-87 C to-2,6-90 o L2-22-90 0 01-01-91 0 01-01-91 0 07-01-91 o 01-01-92 0 08-09-92 0 0l-01-93 0 0i-01-95 0 12.22-98 o o o o o o U A^'tY Cutoff date for new and existin; Existing USTs must inslall mon Secondary containment requirec (exceptions) (CCR 2636 (a)). Evidence of responsibiity for U (H&sc 25292.2 (a)). Existing pressurized piping equi (ccR 2666 (b)). Operative date for violations; ci Permits issued shall comply wit Independent approval for primai (ccR 2631 (b)). Independent approval for primar components (ccR 2631 (b)). Tank lining material and proces 2663 (e)). Manual inventory reconciliation greater than 20 feet below the b Automatic tank gauge systems i calculated leak rate and leak thr Existing UST(s) leplaced or up! (H&SC 25292 (d), CCR 266s). All single wall tanks (steel) are following options (CCR 2662 (t 1. Interior lining and cathodic 2. Bladder system, interior lit Existing pressurized piping is re Audible/visual alarm attached tc Manual tank gauging no longer systems having a capacity of l,( Manual inventory reconciliation Striker plate installed under all r bottom protector is acceptable) I ->/J< 'L^str 'fl aL',)),; \ F. ,1r *. 1,1( ' ,,1 li, ,. I ll,l 'l j L ii i f Lltiilr i ilt- r-;l lf''lf lfTF i:lLll''iF FLlliL i"tl-Hiii'l t'1AFi 14. 1'l':ri, 'r1 l',' iri 'l N\\ SlnS!" ^ L, F,F:e'$il] r:r h r_r I riiir. Rr:11'1F.l,l'l"t_r SAI'I l"l-l I i:j i l]:i i i-il.''ll, F[ttj 544 ','1r:r4 t'lAl'l I ,+." I 'J':il:' ':t ; -;i: ; ll l ,5YSTEi,l l:i'f tl',lUii liL,:1r{,r1i'1' L l:FUEL r'll-*il?l''] SENSLTR AL*RI'IL 1:ANNULAF SFAT:E OTHEF SENSORS LI\I.,I LIALIID f,LARI.l t'lAR 14. 1996 9:39 Al'l cnauy'prcrr nt/*p/pJ 13. f m tfti t tl" City of San Luis-Obi.spo.is committed-t9-il.iVO-, lhe disabled in all of its services. prcgrains and activities. frN-.ivl Telecommunications Device for the Deaf (805) 781-7410 " V ( ,: GtyoF rlr,ils oBtspo FIRE DEPARTMENT 748 Pismo Street . San Luis Obispo, CA 93401 . 805/781-7380 GENERAL MOMTORING INSPECTION CHECKLIST IN ACCORDANCE WITH THE STATE OF CALIFORNIA HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.7, SECTION 25280 et. seq., AN INSPECTION OF EVERY UNDERGROUND STOR4GE FACILITY SHALL BE CONDUCTED TO DETERMINE WHETHER THE TANK SYSTEM(s) COMPLIES WITH THE APPLICABLE REQUIREMENTS AND REGULATIONS AND TO DETERMINE WHETHER THE TANK SYSTEM(s) Is IN A SAFE OPERATING CONDITION. FACILITY NAME:FAcrlfry rD NTJMBER: t o- oL3 - FACILTTY ADDRESS:INSPECTION DATE: INSPECTION TYPE:FACILITY PHONE NUMBER BID:)t oz TIME IN:O"lo Upgrade Deadlines 01-01-84 0 07{l-85 ? 07-01-87 e t0-26-90 0 12-22-90 0 01-01-91 0 0t-01-91 0 07-01-91 0 0i-01-92 0 08-09-92 0 01-01-93 0 0l-01 95 0 12-22-98 o o 'o o U o a) A^.,tY iL',)), ; \ F:"d C-sti \\-(vos) 3?s-l8l\ Cutoff date for new and existing USTs. Existing USTs must install monitoring system (H&SC 25292 (a)). Secondary containment required for piping connected to tanks installed after this date (exceptions) (CCR 2636 (a)). Evidence of responsibiity for UST system by owner/operator for corrective action release (H&sc 252e2.2 (a)). Existing pressurized-piping equipped with automatic leak line detector (H&SC 25292 (e), (ccR 2666 (b)). Operative date for violations; civil/criminal penalties (H&SC 2t299 (g)). Permits issued shall comply with H&SC 25299.3. Independent approval for primary conLainment construction and design of UST components (ccR 2631 (b). Independent approval for primary containment construction and design of UST piping components (CCR 2631 (b)). Tank lining material and process listed/certified by and independent testing organization (CCR 2663 (e)). Manual inventory reconciliation allowable only when the underlying groundwater is at a depth greater than 20 feet below the bottom of the UST (CCR 2646 (b). Automatic tank gauge systems installed after this date are to generate a hard copy of the calculated leak rate and leak threshold (CCR 2643 (bXl)). Existing UST(s) replaced or upgraded to prevent releases due to corrosion, spills, and overfills (H&SC 2s2e2 (d), CCR 266s). All single wall tanks (steel) are retrofitted with secondary containment or by one of the following options (CCR 2662 (b)): 1. Interior lining and cathodic protection 2. Bladder system, interior lining, and cathodic protection Existing pressurized piping is retrofitted with seconclary containment (ccR 2666 (b). Audible/visual alarm attached to pressurized piping (CCR 2666 (c)). Manual tanli gauging no longer an acceplable method of non-visual monitoring for UST systems having a capacity of 1,000 gallons or greater (CCR 26a5 (c)), Manual inventory reconciliation is no longer acceptable (CCR 2646 (b)) Striker plate installed under all openings used for manual dipsticking (drop tube-mounted bottom protector is acceptable) (CCR 2662 (d)) cnrcy'prcveot/*p/pJ 13. f m tEt tn," Crty of San Luis-obi.spo.is committed to-11c.lud-e the disabled in att of rrs services. prcgrains and acriviries. BN,,tvJ Telecommunications Device for the Deaf (805) 7Bl-7410 \a/ t s is N) -YJo C'<.i^ -r:t O NOTE: VIOLATIONS NEED TO BE CORRECTED IVITHIN 30 DAYS OF DATE SIGNED BELOW RE-INSPECTION D RECEIVED BY INSPECTOR TELEPHONE NUMBER:- H&SC : CHAPTER 6.7, HEALTH AND SAFETY CODE CCR : TITLE 23, DIVISION 3, CHAPTER 16, CALIFORNIA CODE OF REGULATIONS (MAY 5, 1994) UFC : UNIFORM FIRE CODE (1994 UNLESS NOTED) O(-)V.&\ mrcy'prcrcntl*p/$l3.fm ,0,u r0J OJ r,*r ( )u ltaJ '-r,. f -1? Ltu.i/r fu. TANK 1 TAI'IK 2 TANK 3 TANK 4REOUIREMENTS PRE.IN SPECTION DOCUMENT REVIEW Permit Applications and Fees to 0perate: il)(4)).rms A&B submitted &sc 2528 FC 2. Form C submitted (CCR 2635(a)(61,(d)) 7.0per ns lees paid (H&SC 25287(a),CCR 271l(c)) , CCR 2il l{c)).-4 State surcharse paid (H&SC 25287|b Current Permils, Records, and Plans llRotlan submitted 2. Previous violations correcled within 30 days (H&SC 25288(b), CCR 2712(f)1. ate a se 0rBusin ess nto 0n \ Statement of financial r submitted &sc 252 &sc 25293(b ccn 2Y/ritten conlract exists between owner/o era tor oved written routine monitori ccR 2632SU ted within 24 hours (H&SC 2529 ccfl 2652nauth0flzed release re h?nauth. release re n sub0n5e .2.31. ccR 27 r 2(d)).9. Change in ownership reported within 30 days (H&SC 25284(b), 0. Changes to operating/monitoring procedures of UST system teported within 30 days (H&SC 25286(d), CCR 27ll(b), UFC 7901.3.1(51,7902.1.2t. I KN,,- tion r ed.athodic tectron tns orrect ve Actio n 1. Corrections specified in the previous inspeciion implemented within 30 days of receivino the inspection report (CCR 27lzltll. 2. V/orkplan submitted lccq 27 22(cll orrective action process initiated for reported unauthorized release '3.C (CCR 2721(a)). 4. Corrective action complies tvith policies for water quality control plans (CCR 2721(b), (c)). 5. Corrective action includes at least one of the follovring phases: (CCR 27221a)l Preliminary site assessment. Soil and vrater investiqation Corrective action plan implementation Verification monitoring phase. 6. lnterim remedial plan and action initiated (CCR 2722(b)). l\1oni-toring Methods and Feports !-ffi proved monitoring system installed and operating under permit co CCR 2632(b), 2641(a), UFC 7901.8.4.4.1). nditions (H & S C 252s I (bl, 25292(a), 252931a lnte n Testin V. Iank test in last 12 months (H&SC 25292(b)(l), UFC 7901.8.4.4.2). \,, essurized e test in last l2 months CCR 2643(c)(3), H&SC 25291(f)).O -3.-Suction pipJ tiqhtness lest in last 3 years (CCfl 2613{d)). ' .H Grauity pipe test in last 2 years (CCR 2643{e)} UFC 7902.6.',16.3est results subnritted l.rithin 30 a s (CCR 264 ><nnual maintenance an d/or calibration ed on line leak detection e ul rloata etn tesl {CCR 26.1 )).cal contacted 4B hcursn ProtectionCath athodic proteclion provided lor secondary containment of tank and ccR 263 r (d), 2636(b), UFC 790 l.l 1.3, 7902.6.1 5.1 ) f or UST piping 2. Cathodic Prolection tested lrithin 6 months of installation and every 3 years thereaf ter (CCB 2635{a)(2)(A)). 3. Records of sacrificial anode system tests indicate that tha systen is functioning properly. GENERAT MONITORING INSPECTION CHECKI.IST ll thb frcility hr: morr lhrn { lrnkr, plersr photocopy lh's chocklst boforr completion. HSSC . CHAPTER 0.7. CATITORNIA HIATTH & SAFIIY COOE ccR - TTTLE 23, orvrsrol{ 3, cHAPTER ls, cALlFoRiltA cooE Ot REGULATT0Ns il9941 FCR - TITTE 40, FEI]€RAT COO€ OF REGUTATIONS UFC - UlllF0RM FIRE C00t 11904 unless not p .u,. tr,l:e^j\^ss f^), I l); f )1 TANK 3TANK I TAIIK 2 TANK 4REOUIR EMENTS .Pipinn ot ls rmed 263 I I Il. Continuousmo,nitorin ::lllrlltittillFl.N\\$\NSHNIlrtPi-:^S\ W (ccR 2 fler I 2.2 2.9 ?Visu al m0nt to of suction ro du ct I Perlormed with an annual lank tightness test (CCR 2646(d)). 2.I fullR(sl erceeding the allowabl e variation is reported to local agency within 24 hours (CCR 2646(e)(lll d verifying that data on monthly reports didn't exceed llowable limits, or a list of dates and times of releases exceeding lhe allowable nual report sub mits (CCfl 2646{s)) tical lnvento R e co nci liatio nSt biennial tank tness test ccR 2 al SIR cR 2646.1tted I 2646.1uent or 2 or more inconclusive to ries rted htness lest for inco e resuk4 lTa Gaan rrt test 264s(b)). Auto a Tank Gau tn matic tank d Iresults submitted ccR 2 allsdes and R unauthorized release(s) has been reported to the local agency to1 R 2661(a)). on.metal piping and tanks tightness tested within 30 days of repairs cR 266r(f)) ?ilepaired cathodic protection systerns have been tested within 6 months of repairs (CCR 2660(n)). nk ClosureTt ,|Application lor tank closure submitted within 90 days of the cessation of the storage of hazardous substances (CCR 2670(e)). 12.Proposal of compliance with tank closure regulations submitted within 30/ days of closure (CCR 2670(f)). contained and monitored pursuanl to Article 3 and 4 until actual completion closure (CCR 2670(e)). 3. UST system Detection of Leak or Unauthorized Belease an unauthorized release andlor sudden loss of product has been reported to the.local agency rrrithin 24 ho 1. 0etection of urs (CCR 2652(b)) 2. A full vrritten reporl has been submitted by the ownerloperat0r to the local agency vrithin 5 working days of detecting an unauthorized release (CCR 2652{c)) 3. Update reports submitted to the local agency quarterly, or more frequently, to provide updates reqarding cleanup and initialabatement aclions (CCR 2652(d)) ON.SITE DOCUMENT BEVIEW Current Permits, Becords. and Plans alid o t on.silelin &sc 2 286, CCR 2712(t, UFC 7901.3.1 2641 ), 27 r2(b)).cords maintained on.site (H&SC 25293(a), CCR 2Iten describe features of the lanenclan on sitelo ator can verbales0nse t lor 6.5 (ccR 27 r2 (b))Ca tho Cic roteclion records ,& Perfornance claims {or release detection systems kept i or 5 years (CCR 2712 (b)) -€Repai,lining, and upgrade records kept on.site lor the life ollhe UST (CCR 2i12(b)). records on lile.Safet and trfnin lvloniloring l'lethods and Beporls I iiriiiiiriiriiiiiiir:iiiriii';ri t '!tlll l. :ij::iNii.x:.:::::: :rj : :i.:i :\:'l:il:ii:1..j: : ::r:\:r'.. 1:::::l tior3 eats ccR 27r2 ft))j\'lonitcrin lmaintenance records k lnters itial l'lonitorin Tk^k "*ru ed viiualty at required f requency (H&SC 25292(b), CCR 2632 {c){l), 26ll(d), 2612(a), UFC 7901.8.4.4.1) or 2. Continuous non.visual interstilial nronitoring for double.lralled tanks (H&SC 2529lib), CCR 2632(c)(2)(A), 2641{i)). Liquii la;:l in the tank recorded at the tirne of inspection (CCfl 2632(c) iliiS,rCll J ?8