The URL can be used to link to this page

Home My WebLink AboutFile 2 A_RedactedENVISION INPUT/UPDATE FORM Master File Record Information } CREATE NEW RECORD [] FILE [] LABEL FACILITY NUMBER FA# Existing FA = FA0005116 ] CHANGE OF OWNERSHIP I) TANK OWNERXJI BUSINESS OWNER PROGRAM NUMBER PR# J UPDATE BILLING INFO. PROGRAM ELEMENT PE# ]] PERMANENTLY INACTIVATE FACILITY AS OF: [ ] TEMPORARILY INACTIVE FACILITY AS OF: DATE OF NEXT SCHEDULED INSPECTION: March 19, 2014 RETURN TO INSPECTOR: k]YES[]NO DESCRIPTIONOF CHANGES: 1) Change of ownership; 2) Change of Business Name Note: Program Elements to remain the same. BILLING INFORMATION: PLEASE SEND OUT PRO -RATED INVOICE FOR BALANCE OF THE YEAR. Number of Materials: 1-4 Number of Waste Streams: 1-5 Number of Tanks (capacity/compartment): N/A Facility Name: MEINEKE SUPER CENTER SAN LUIS OBISPO Site Address: 286 HIGUERA STREET, SAN LUIS OBISP09 CA 93401 (CITY, STATE, ZIP CODE) Facility Phone Number: (805) 541-0898 Owner Name: Ryan Keller Postal Address: Same as Above (CITY, STATE, ZIP CODE) Requested By: Kerry Boyle Entered By: Date Requested: March 21, 2013 Date Entered: C1Documenls and Settings\klaoylelLocal Senings\Temporary lnmf TE#11*1IdFR HAINAT IZ).DOC 16-Jan-13 CRY� O( 0\J) / 1'1$ (,Q e7.\\'-AA\17 COUNTY OF SAN LUIS OBISPO ENVIRONMENTAL HEALTH SERVI. tzi DIVISION 2156 SIERRA WAY PO BOX 1489 SAN LUIS OBISPO, CA 93406 805-781-5544 PUBLIC HEALTH DEPARTMENT INVOICE - FIRST NOTICE TO KELLER, RYAN 286 HIGUERA ST SAN LUIS OBISPO, CA 9M01 ATTN: RE: MEINEKE SUPER CENTER SAN LUIS OBISPO 2B6 HIGUERA ST SAN LUIS OBISPO, CA 93401-4215 Invoice 10 Data IN00B52]3 3121/2013 OggillbEID Due Dale FA0005116 4I1V2013 W Penal 1/1/2013 iHRU 12031R013 PLEASE RETURN INVOICE NOTICE WITH PAYMENT Prsgrwry Date Element 0e Wptan Asmm 03/21113 0762 SLO CITY -HAZARDOUS MATERIALS HANDLER 1-4 $ 196.00 03121113 1176 SLO CITY- WASTE GENERATOR(1-5 waste streams) $ 196.00 03/21/13 0755 SLO CITY- STATE S ITE SURCHARGE $ 35.00 03/21/13 DISC GENERAL DISCOUNT $ -77.00 TOMIDue For TNslnwam. $354.00 We now accept VISA, MastorCard and DiscoweL over Me phone and at our once. PAYMENTS RECEIVED AFTER THE DUE DATE ARE SUBJECT TO PENALTIES. PENALTY OF 25% WILL BE ADDED TO THE INITIAL FEE FOR LATE PAYMENT OR NON-PAYMENT AFTER FIRST NOTICE DUE DATE PENALTY OF 50% WILL BE ADDED TO THE INITIAL FEE FOR LATE PAYMENT OR NON-PAYMENT AFTER SECOND NOTICE DUE DATE 100%PENALTY FOR FAILURE TO OBTAIN INITIAL PERMITS WILL BE CHARGED UNPAID ACCOUNTS AFTER THE LAST NOTICE DUE DATE WILL BE REFERRED TO A COLLECTION AGENCY AND MAY BE SUBJECT TO PERMIT SUSPENSION som.rN 1.e.1MM d FAV Of Sub Clm e LE COP Suit Wgbrliteourcer Conwl Board w +3 CERTIFICATION OF FINANCIAL RESPONSIBILITY FOB UNDERGROUND STORAGE TANKS CONTA NINO PETROLEUM A. 1 em wgviM wdeemmeu Fwmirl A.yeedbgiryu rM rogaiud semen er rprarwdu.LWm tBe'1. Cupbr Ia Av.; Te• x; cca: Qe Wpdalewperm sw Q1 minim dabnwewl rppwple AND �1 minim aalm. wr«mne.w �xmaim ddl.wmeml.Nnwre BYr� _ h mbycenlfms theta s in compllence wdh the requiremenh of Section 2Ao1, tAa.. wT.ea...sop.. 1 AMcle.%Chapter 13, DA*bn e, TAN 2A, CeMma Cod* of Regubtom All mechenkrr�upedb QertloMgefe llnrcel res rreldlAyWr0gNrodb Sectbn29o)ereMfolbee.' D. m 111e fAee Wr Mectu ge Coverage Corrective ird arty Number Amount Period Action Com . 3 �9- Ao� /1,3 Note:Ifyou ere using ere Sbfe Fundes anyparrofymw derrionst2lbn of Arrerialsi spcnslWAy, yourexecutbn endsubmission oltlrts cerYAcedon e/so oergAec that ero Ar eom /srq:e mM e/l rorMAom/or rtb' tbn Ar the Fund. D. Mgxew vap9.mrm /J eleI2,/ I ��YV G� .- -J ry P.IDg PWIgNwe xaap /J�/ F.dOgNme Pwfflq m remlryHwa PvdryAm,s -wopme. �[� rnuaTmx,Gr%% ma a.m m.awm�.N.my CF11 i) I '00or msonem+-mlA mqs-P•aagslY•l cFmx3F3Clxtor OF P13MUCIAL MSFOM/2s2LIr3 FORM Platy typo or Prim clearly oil Information an Certification of financial Suggestibility form. all UST facilltteg andlor sites mend or epersted may be listed an oma form; therefore a osperate certificate is not impaired for smah alb. WULLENT INFORMATION A. amount Impaired - Check the appropriate boxes. S. Name of Tart alai - Full rlama of either the tank ounor or the "Orator. or Operator C. Nechmnls Type - Indicate Mich State approved mtehenima(s) are beiry wed to shma flrmaail responsibility either as contained In the federal regulations, 40 CIA, part 2800 Subpart N, Section 250.90 through 280.103 (Sae Financial Nponibitity Wide, for gore information), or Section 2500.10 Chapter 18, 0ivislen 3, Fitle 230 M. goes of l9 - List all nos and eddrgmtre of companies speller IrdividwlS {sawing coverage. NeNsprima Water - List identifying saber for each machanima wed. Emaeple: insurance Policy n okr or file rsmear as indicated on bond or dooment. (If wing State Cleanup Fad (State I") leave blank.) Coverage aaeait - Indicate nawnt of coverage for cash type of machanisme). if sore than one machan om is indicated, total cat mpwl 100K of financial resporoibility for each facility. Coverago Period - Indicate the effective date(s) of all financial machaniw(s). (State Fund coverage mould be centinsom as long as yes maintain cagllanca toad remain eligible to continue pertic)pation in the Fred.) Corrective action - Indicate yes or ro. Deem the specified financial mechanism provide coverage for corrective action? (if wing State Fund, indicate "YmseA Third Party - Indicon yes or M. Doors the sWified financial mechanism provide coverage for Compensation third Party cOpen6ation? (If wing State iald, indicate eyes".) D. Facility - Provide all facility and/or site ragas and addresses. laforrtion E. S)gnotwe Block - Provide signature and date signed by tank caner or operator; printed or typed name and title of tank owner or operator; signature of witness or notary and date signed: and printed or typed name of Nitness or rotary (if notary signs as witness, Please piece notary seal rest to notary's signature). Where to Nafl Certificatien: Please send original to your local S9moy (agency d,o isewa your UST Permits). Keep a copy of the certification at each facility or sin listed on the form. g do , If yes have questions on financial responsibility rmpuiraments or on the Certification of financial Responsibility Fore, please contact the State LIST Cleesp Fond at (916) 227-6307. Note' Penalties for FallFallUm to Commoly Mith Financial R'bil-tv Itmirements, Failure to comply may result In: (1) Jeopardizing claimant eligibility for the State UST Clmanp Furd, and (2) liability for civil Densities of up to $10,000 dollars For day, Or inderyround storage tank, for each day of violation as stated in article 7, Section 25299.76(a) of the California Health and Safety Code. r ACORD CERTIFIC. X OF INSURANCE `� P` 'mw°" 0/27/" " 10/27/93 •RMD K MIS CERTIFICATE IS ISSUED AS A MATTER OF INF'ORSIATION ONLY AND THORSON AND ASSOCIATES CONFERS NO RIGHTS UPON TEE CERTIFICATE ]LOWER. MIS CERTIFICATE INSURANCE SERVICES DOES NOT AMEND,E%TEND OR ALTER TEE COVERAGE AFFORDED BY TIE: 21MO E. COPLEY DRIVE, M100 MUCIFSTIEIAW. DIAMOND BAR, CA 91765- COMPANIES AFFORDING COVERAGE 909-WO-1143 �Q A ANERIGAM IMYL SPECIALTY TINES NMPANY B Il 11 HSONO TUNE CORPORATECORPORATEM: L L ATTATTNURE JEFFREY EY A. STFWRi^ 1ATrER C 4911 BIRCH STREET NEWPORT BEACH, CA 92660 D O RAN E larrm COVERAGES IRIS ISM CERTIFY THAT ME fOLICUM OF INSURANCE LISTED BEIDW HAVE BBEN ISSUED 101NB INSURmJ NAA®ABOVe WRTHe PoIJCY PBRroD HIDICAT®, NOYNTINSTANO:NO ANY REp11REAEi'f, TEDS OR CONDITION OPANYCONT OROTHERDOCUMENTWITRMPECFTDWHICH THIS Cm RH13MO ORMAYPERTAIN.IIiEINSURANCBAPERRDEDBYIISBPoUMDESCR®8D TIERED!IS SUBIBCTN ALLIHe TERMS, SIATHASITY E%CLUSIONS AND CONDDlONS OP SUCH PoECTES.IRATS SHOWN MAY HAVE BE@7 RBDUC®BY PAm CLAWS. CO TYN OI DI9VYNC6 LTII POLICYNVMR6l POLICYBPl81.TN8 P®YATmN L°ATm D"TBMMTM'YI DANm QAM2D!YY1 IFAW OPNBIW.LWD.RY 0dPAA1. AWMATE d LtlADIPRMLOENERALLWMII'Y MROgICTBG MPA00. 1 CIIJMS MADE -OCCUR. SFH.94NALAADV.WUAY L 0M 'SA(X) P CI'OR'SPROT. FACN OLti11R40K6 L PHJI DAAUOL (Np'®6sl L "Hm. ExeaAvelAv®w"N 4 AROtlS10611.8 LWD.ITY I;IMmm®Sd018 ANYAVIO IA1rt 4 AILOWNEDAUTW BODD.V D011RY F 9b0IDVIH1ANU4 ImDJA°N tlCD.Y1N11RY 4 ImNOWNED AVNd mOPelTY 0AMA06 4 6ZCPm LWD.FIY PACNm.CVMFNG'E 3 LMEROLALOW OPllm TNAX IIgR®1A FOMN AOORPoATE 3 WOR®R9COSOENATSON BYATIRORY WIFIE PACN ACCEEVY S Aro IXA+AZ4+rFO11CYlAQY 4 iFMYYeN'LW WFIY DLRAb1LBACN E.VLOME d GSTmR A 'POLLUTION UST M0702 07/20/93 07/20/94 I,OOD,000 EACH LOSS LIABILITY 2,000,000 AGGREGATE AnoNrvamcl,EdarmaAl,Praw LIMITS OFF INSURANCE: $1,0000000 PERPOLLUTINSE ON INCIDENT/S2,000,000 ANNUAL AGGREGATE PROOF PROVIDED FOR: SITE 5107-2E6 NIGUEM, SAN LUIS OBISPO, GA 93401 CERTETCATEBOIDER CANCBLLATTON SHOULD ANY OP 1f I8 ABOVE DBSCRmHD 3 V 1lCtRt BH CANCS IJJID BR W R81H8 EISMIAEON DATE THEIXF, THe ISSUING COMPANY W EINAVOR TO MAIL 3D DAYS WRIi!@i NONCE T011®CEIiIFlCATB HOIDOINAM®IO ME JAMES P. JONES TRUSTEE LID'Y.HUTFAH➢RRIOMAH.SUCHN M3HALLDDOSBNOODUGATNINOR 717 MUSLIN STREET EABIETY OPANY @JD UPON DISH COMPANY, ITS AO@ES OR REP➢HSETIAllVR4. SAN LUIS OBISPO GA 93401 VYmmlzm"PAIRS ATm ACOITD IIS f1/901� " ACDRD CORPORATTON IDRO r r_• city Fire Deoanment o SM LL e 748 Pismo St. • San Luis 1 recr, OBISp0 Ca. 93401 • 781-7387 Ired ECONO LUBE AND TUNE 286 HIGUERA DATE' 10/07/93 SAN LUIS OBISPO, CA 93401 IS REQUIRED TO OBTAIN A PERMIT TO MAINTAIN, STORE, USE OR HANDLE MATERIALS, OR TO CONDUCT PROCESSES, OR TO INSTALL EQUIPMENT AS DESCRIBED BELOW: 1) STORE/HANDLE/USE CLASS III PLAM. LIQUIDS S 45 2) U.G. STORAGE TANK PER ORD 999 - NEW $175 3) HAZ MAT INVENTORY/BUSINESS PLAN - ORD 1075 $270 CHECK TO THE CITY OF SAN LUIS 11-01-94 PERMIT WILL BE VALID UNTIL 2594 L1F iING THE ENCLOSED ENVELOPE WITH A IN THE AMOUNT OF: $ 490.00Payable within 30 days RECEIVED APR 2 21994 CLEAN UP FUND PROGRAM U,,LFIED PROGRAM CONSOLIDATED FOR-pt. TANKS 2 6 0002 YFEB UNDERGROUND STORAGE TANKS - FACILIT (one page per site) Page I of TYPE OF ACTION I. NEW SIm PERMIT ❑3, RENEWAL PERMIT ®5.'HANOR OF INFORMATIpIL-ER 7. PERMANENTLY CLOSED SITE (Chock one ilan only) may Angs mat we Mly U W IV [14. AMENDED PERMIT 6.TEMPORARY SITE CLOSURE S. TANK REMOVED eon L FACILITY / SITE INFORMATION BUSINESS NAME (Srm a FACILITY NAME a DEA-DommBummusAIl FACILITY IDR ECONO LURE N' TUNE #107 2sv , NBARESTCROSSSTREET ur,Lrc� 401 FACILITY OWNER TYPE ❑4. LUCAL GHNCTr mI [] 1. CORPORATION 5. COUNTY AGENCY' ® 2. INDIVIDUAL 6, STATE AGENCY* BUSINESS 1. GAS STATION Lj 3. FARM N 5. COMMERC AL TYPE [] 2. DISTRIBUTOR ❑4. PROCESSOR[] 6. OTHER so ❑ 3. PARTNERSHIP 7. FEDERAL AGENCY* 402 TOTAL NUMBER OF TANKS Is facility on Indian ResMMI(in or alf owner of LET is a public egerey: name 01 banner Of connote, canon oranme come REMAINING AT SITE Bombards? opemta the GET (This is the amtmet pera fir the mak nods.) 4a [] Yes ® No 405 406 H. PROPERTY OWNER INFORMATION -PROPERTY OWNER NAME PH ONE 409 JAMES P. JONES, TRUSTEE 805)543-9643 MAILING OR STREET ADDRESS 409 3820 SEQUOIA DRIVE CITY STATE 411 ZIP CODE SAN LUIS OBISPO CA 93401 PROPERTY OWNER TYPE ULCORPORAGON U11NDIVIDUAL []4.LOCALAGENCY/DISTRICT U6.STATEAGENCY 3. PARTNERSHIP 5. COUNTY AGENCY 7. FEDERAL AGENCY 413 III. TANK OWNER INFORMATION TANK OWNER NAME 414 PH AMES & PATRICIA WILMORE 805ONE 541-6007 MAILING OR STREET ADDRESS 4' STREET CITY 41 STATEate ZIPCODE 41 SAN LUIS OBISPO I CA 93401 IDUAL 4 ALAGENCY DISTRICT U10.2iLAIVAGENCY 42 3. PARTNERSHIP rl 5. COUNTY AGENCY 7. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER z 1 uestions arise 421 V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(') ❑ L SELF -INSURED []4. SURETY BOND [] 7. STATE FUND ❑ 10. LOCAL GOVT MECHANISM [] 2. GUARANTEE ❑ 5. LETTER OF CREDIT [] R. STATE FUND be CFO LEVIER ❑ 99. OTHER: ®3. INSURANCE []6. EXEMPTION []9, STATE FUND &CD an VI. LEGAL NOTIFICATION AND MAILING ADDRESS Check one ma to indicate wmaddress a ou r legal restrictions Rod MIGIRE VII. APPLICANT SIGNATURE Cee;Ecatiom a ratify that the information provided but 4 true and accurate to tic best army location. SIONA' ❑OP APPLICANTDATE 414 PRONE 'u 01 / I S / 02 BOS 544-2 9 76 NAME OF P ICAN'I'(prin) 4e TITLE OF APPLICANT TITLE WIL ORE OWNER STATE UST FACILITY NUMBER (For local use only) 4B 1998 UPGRADE CERTIFICATE NUMBER (Far local am only) 429 UPCF (1/99 revised) 171 Formerly SWRCB Form A I ETATEOFCAUFORNIA STATE WATER RESOURCES CONTROL BOARD QN I UNDERGROUND STORAGE TANK PERMIT APPLICATION- FORM A ICE COMPLETETHM FORM FOR EACHFACILRYISIIE MARK ONLY LVJ NEW PERMIT S RENEWAL PERMIT ❑ 5 CHARGE OF INFORMATION ❑ T PERMANENTLY CLOSED SITE ONE ITEM O 2 INTERIM PERMIT I] i AMENDED PERMIT ❑ S TEMPORARY SItE CLOSURE 1. FACILITYISITE INFORMATION & ADDRESS - (MUST BE COMPLETED) DBAORFACILITY NAME l (tom OF OPERATOR � �•�.t/�l ,� O /VG' . C' Pc-GjLi�l�� ADDRESS NLAnCSTc/nam BTnEET PARCELAPm AU CITY NAME STATE ZIPOJGE ITEP N WITH AREA CODE �.. L Ia9 C 4-1. CA -2 T NDCATE oG TWA INXVIBUAL o PARTNERSHIP o WCAL.ABDICY o COUNIYAGENCY [::I TE.b&CY E:) FFLERM.ABFNCY DISTRICTS TYPEOF BUSINESS Q I GAkSTATM L�j 2DISTRIBUTOR Q ✓ IFINDIAN EOFTANKSATSIT E. P.0. 10, i IeFwme) Q S FARIA, 4 PROCESSOR �Au S OTHER RESERVFTbN . OR TRUSTLANOS / [�� EMERGENCY. CT PERSON (PRIMARY( EMERGENCY CONTACT PERSON (SECONDARY -optional OAYS:NAuc�eST.�JRI AYS: NAME (LAST.PI�iI� II. PROPERTY OWNER IITHANEACOGE _ ��I NIGHTS: BE COMPLETED) NAME GuGO 'T,.// n„c OAREOFAW as NFOHMATIDN MAILING OR STREET ADDRESS ✓INNN, =INIVIWAL 0L=RAHFNOY STATE AGENCY S / O9RPCRATION O PARTNERSHIP 0 COUMYAGENGV t] FEDERALYaNCY NAME STATE ZIP WOE PHONE a WITHAREACODE �9 141� III. TANK OWNER INFORMATION - (MUST BE COMPLETED) NAME OF OWNER 'M per r✓ /a' Y.. %.,,/ CARE OF ADDRESS INFORMATION I "All -7 11.,E I/i //4 ` T CORPJR4TOH L] PARTNERSHIP 0 CNINIYAGENCY O FECEML#AENCY CITY NAME S✓Y/L/ r'/ %Lb rS V7i4 0 s�ATE l fl 21PDfE /�yei f PHCNEAWITHAREAGOCE -�% f� IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NU¢IBER TY(TK) HQ 4 4 -�nl. ;I/ V. PETROLEUM UST FINANCIAL RESPONSIBILITY• (MUST BE COUPLE ✓ OxbMNFN 1� 1 SELF .Ix RW T-1 2Buz E'Eo� O 5 LETIEROF.CREDT Q o EYEMP VI. LEGAL NOTIFICATION AND BILLING ADDRESS Legal notilicMlanand CHECK ONE BOX INDICATING VMICHpBOVE ADDRESS SHI BE USED FOB LEGAL F "CIGTI THIS FORM HAS BEENCOMPLETEDUHDER PENALTYC£PEflJURV, ANU TO LOCALAGENCY USE ONLY COUNTY N JURISDICTION /t l I019 )LOCATION CODE - DPTroNAL CENSUS THACT 0- 0PLON.IL SU THIS FORM MUST BE ACCOMPANIED BY AT LEAST (1) OR MORE PERMIT APPLICATIO FORM A I591) Call (916) 323-95551t questions arise. ED)— IDENTIFY THE METHODS) USED ag 3 INSURANCE ff4GURFIY N Ll W OTHER )ling wil eseM to the lank owner unless box for ll is checked. 18 BILL ANDLO II.[—] ILL 4EBEST OFM IwaNLEDGE, IS TRUEAVDCORRECT „P D Y 7? lLh1 / �L n«71 1 UNLESS THIS IS A CHANGE OF SITE INFORMATION ONLY. FCRW]SAS 1N.51'RUC:IItr,NS FQ.: CUM1'1.I.11NO iON`,1'A" GHMRA1. INS 1 Kl lt: fl()W 1 Onc I ORAi "A" •111111 itc tvnl,.lr'ad L,r all INW P RA IN, I'1!R11i11' MANI;t:S or any FAC:II.TI'Y/SI'I'I{ 1NF ORMA HON Cl IAN(il :;. ? SI1fIM11- ONLY 01v1i (1) Yi.11(At 'rA' for .t the aunty. r (if Lowed :n tl,, utc :1. ttti, faint r,iumllt b! !u+npl.'.t..I hs t.illwr III,- I'1'1V,Ifl AfYll(iAi\ff or the LOC:Ai. MWNC'Y UNI)FM ;WK:\1) 1A„K Itd'ir't'r'!''tR 1. 1'It•:rx it.po of p,mi cl="o1; :!I 1ry,, _!-tl inlr.::r.ahon S Use. it I .tJ polnt nliunl} n..l,n ucul y,tu aft- nulkulr, 1 CnpIt, 'IY)I' 011 110KAM1: 'MAlttt ONLY ON;-' l ll.A1' ,M011, nn (X) Ill the tsox nst lu the iu:rn that bast dexcrill. .:: Ih(- reason Ittc fmm I.. brim: ctllrtpteted. I. mcu fCY/5f11( iNPORMA110N k Al)Ilkl•S,; (MOfil At., C OMIT H1110) 1. 1tcmId name a I I d atItIIv., (Ilh)^:ic.11 hlcaliulll ,.1f Ihr ud.Ir.rrrAunI1 Iank(,1. Nt i I F: Addre s i�Il �11' h,tvc n s:!hd phyxir ll 11 -•natant including ci}y, and nit 4:odit, T!O_ HON INI)lsT}WRS ARE NCYI' ACt(1Y17AM-F Inr,lude nrarcla r:oq,. surer and imme of Ihr operrurir. 1_ 11lonc lllttlll,rt In11%1 h^r an !IU a it t}x nlrhl n4111111'i i'. I:.:. • anic, u'tile 'SAMI In prupor Wieat1cm .3. Check ilia ;Ippinpri,d,: lw-A fol 'i 1'I'1- r)F ISIsS}�' t;s OWNI 1)1;1IN' (cx C:(AWORA'l ION. I`:DIVIl)UM . Vic.) 4. Check the tlpImpfirtltc 1N,x fur 'I Y11' Oi• lzl;SI1Nl SS. S. if Itacitily/Site is luvated wllhin an Indian ir,rNatioll or ntlief iodian imst land::, cheek the ht.tx mashed b. htdicalc the. 1N1 RsIRFR of 'l'ANKS al Ihi, SI H!, 7. Rccosd the F.YA. 11) # or wrllc "NON1:" in the sltath: I)MVId;d. 11. PROPEKlY OWNER INP0RMA71ON & AT)DRl:� (Ml1Si' lift (Y)MPiJ_I11)) Complete all items in this section, little" ell item-k :Ir.- the` same ns SV(7l10N 1; if the mime. wtile 'SAME AS Soli" acnMs this section. Ile sure to check PROPER"IN 0\0- t'.l(51111' 1'YPl; box. Ili. TANK OWNER lNFO MA i1ON & Ai)i►Rt _C5 (AlI15l' f{Fi COMP1.l'.111I1) C:omplcte rill hems ill thi;, xcrtion, lime,-. 1411 ilcnu, :,re the ,::mc a:, WC110N 1; if the :,sane, wlitc '.SAME AS 5111i' ;tit+•w tilts w•ction. Ilk +arc to check '1ANK 0WNl.W%1IIP YYPl: be , iV. BOARD Olt iX)ilA137A1 PON 11St' SI'0RAGE 1-117 AC'CO tiff NOMAT'R (MUST' lift C..-OMPiJfiMD) linter yetur Ronnl of Fqualirnlion (1101 1 USI' xtnrnge (cc account mintier which is requited before your Ilcrns}t applit'alirin can be prctc'essed. Rcgi>;trulion with the 1101: will ca%ure that you will receive :I quarterly stooge fee return in refiorting Illy St)dl(ilt (G mills) per gallon (cc due on tit,- mtmbrr of pllnns pinred in )snr 171,Mr 'lltc 110E will ixlde petsnns 1;; enlpl front Impoq the storige fcc rso returns \sill alit tic m'm. If yttu do n()I hive lilt account number wish the 1101" lit if yom hack any quemicills teranling Ilse; fir. or exrmptious, please call she BOE it 'Jab 311- t555 lit wrilC to the 11101s M the follow•inl; nddres.: lioord of l plilir_Ilion, i'usdt Imcntal I rr--s Unit, P.0 f}q.c 9•L:R7c), S:It•Iallle,lt(t, CA 91 79-pl'101. V. PItirizomruM t1Sr FIN.ANCfAl. RPt•P0Ns7RiTJT'i (MUST' TCF'. COMPIE171)) Identify the melhgd(s) u" d h) thr, t,wncr awl/o1 tq;r.ralot in muctinlr the_ {'Weral and Stale (marmal respontabihty rcquimmenis. US1> os,ned by .illy Fct:cl.Il lit :tint,- al;rncy are crcmpl hum this. Icquircmem Vf. IJIGAI. N(Y1111C'A'FION AND 111IMN(i Ai);)RiiriS Check ONH ROX for tlt(* itddr<•: Iliat trill he aced lot' 110111 WJAL AND IlllJ]NG N(YI1111CA'110NS. Armicwr NOM' SIGN ANP i)S ?'11W 1'(MM AS 1Ni)3l'i1'I1'1). INSFAUC HON FOR'1111s IA)C AL A(iHNC'IHN 1'hc county and jurisdiction number: site predetermined and rain he oblaincd Ity cnlliltg the State 114vird (91(P)739.2.121. 'Illc farilily nurlthrr may be ntisi,bnctl by the h-r:11 ,;cncy; hrrties•er, lhe: numlict must be muncrical and c'amint romain oily nlphabetiral. If the local ogency prefers tau: Slate Poatd it) assign the facility aumbcr, please (Cave 11 blank. Cl' Lti'ITllt Ki?5mmsi 3IiriY 0It Hill. I.f)r"A1. ACiEM-*Y'11IA"C INSPFd'1t 11111 FAC3lXIY'PU VERIFY 'flit! ACCURACY Olr'111F. INFORMA'l10N. '1111S Al'I'll( 'LION CANNLYI' 1311 11110C'L15ED Ill'11111 OOH ACCOI1Nr NUMBER iti NU'r f•II I m) iN. 'mv i ocAl. AGIII+ICY iti 11IttiPOM51f LE 17OR 1111t COMPLtm. ON 011111ti 'LOCAL A(,FI. iCY US1' ONLY' tPll1)RMA'110N liOX ANT) I'OR FORWARDING ONI( FORM 'A" AND AS.%K3ATV1D Il7RM -Fs-(X) 'FC) 'IIIF F01 I OWIN(i ADDRI_1S. SIA'1T. (W CiAI.11'ORNIA S(SIE WMV.R RI'YHJIt(-1:S CX)NMOL WARD c/0 S W I A _- I)A'1'It IIIMUI_MINIG Cl-?"IT'.R P.O. 11OX 5t7 PAKAMMINY, CA 9(MI STATEOFCAURGRMA ^•• STATE WATER RESOURCES CONTROL BOARD s UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B ram` COMPLETE A SEPARATE FORM FOR EACKTANE SYSTEM. MARK ONLY ❑ 1 NEW PERMIT ❑ B RENEWN PERMIT ❑ 5 CHANGE OF INFORMATION ❑ ] PERMANENTLY CLOSED ON SITE ONE ITEM ❑ 2 INTERIM PERMIT ❑ < AMENDER PERMIT ❑ 6 TEMPORARY TANK CLOSURE ❑ 0 TANK REMOVED DBAOR FACILITY HAW WHERE TANK M INSTALLED: I. TANK DESCRIPTION COYPLETEALLREMS.. SPECIFYIFUNKNOWN A. OWNER'S TMIK LO.P / B. NMIUFACNREO BY: C. RATE INSTALLER IMONAYNEAR) TANK COMITY IN GKLONB: N TAKIMPTIM rc A. ❑ 1 MOTOR VEHICLE FUEL �, < OIL B. G ❑ IeREGU ERO UNLEA❑ 3 DIESEL ❑ 6 AVIATK21GA6 2 PETROLEUM ❑ BD EMPTY ❑ 1 PRODUCT❑ 10PREMIUM 0 GASMIOL ❑ T METHANOL ❑ 3 CHEMICALPROJUZT ❑ 0 UNKNOWN ❑-' 2 WASTE UNUAOEO ❑ 2 LEADED 5 AT FUEL 99 OTHER TOESCRIBE IN REM D. BELOW U. IFIAtI IS NJTMARKEO ENTER NAME OF SUBSTANCE. STORED GA S.3: III TANK CONSTRIICTION uA2VefmElTEUnNIYwRnxPAA. B.ANDGANDALLTHATAPPU20INADKR A. TYPE OF 1P I DOUBLE WALL ❑ 3 SINGLE WALL WITH EXTERIOR LINER ❑ 05 UNKNOWN SYSTEM ❑ 2 SINGLE WALL ❑ < SECONDARY CONTAINMENT (VAUTEDTANIQ ❑ OP 0114ER ❑ I BARE STEEL ❑ 2 STNNLESS STEEL ❑ 3 FIBERGLASS 4 STEELCLAD WIFKIEINRABSREWFOROMPLASTC S. TANK MATERIAL ❑ 5 CONCRETE O 6 POLYVINYL CHLORIDE ❑ T KWINUM ❑ S IOM METHANOL COMPATIBLE WIFRP (PNmMTanM) ❑ 0 BRONZE 10 GALVANIZED STEEL ❑ 08 UNKNOWN ❑ BB OTHER . I RUBBER LINED ❑ 2 ALKYD LINING ❑ 3 GROW LINING ❑ a PHENOLIC LINING 'rfERIOR - ❑ 5 GLASS LINING ❑ e LAMMED ❑ 35 UNXNOWN ❑ W OTHES �L'f )LINING 0 UNING MATERIAL COMPATIBLE WRH IM METHANOL? YES_ NO_ D, CONROBICN ❑ 1 POLYERIYLENE WRAP ❑ 2 MATING ❑ 5 MNYL WARP %� < FIBERGLASS REINFORCED ELASTIC PROTECTION ❑ 5 CATHODIC PROTECTION ❑ 91 NONE ❑ 05 UNKINOWN W OTHER IV. PIPINCINFORMATION n.IWAP AI FARtnKDRNINDIKIM MUNDERGROND. BOTNIFAPINGABLF S. CONSTRUCTION AU I!SINGUE WALL My 2 DOUBLE WALL -. A U 9 LINED TRENCH A U 05 UNGGWN A V 90 OTHER C. MATERIAL AND CORROSION A U U U I &ARE STEEL S KUMINUM 0 GALVNJffL:G STEEL A U A U A U 2 STAINLESSSTEELA U 6 CONCRETE A U 10 CATICOICPRGTECTON 3 POLYVINYL CHLORDE evo A(U T STEELWICOATNG A U A U 95 UNKNOWN A U < FIBERGLASS PIPE B 1WM METHANOL COMPATIBLE WIPROTECTION N OTHER 0. LEAK DETECTION ❑ 1 AUTOMATIC LINE LEAKCETMTOR ❑ 2 LNETGHTNESSTEBT IG ❑ 5 NONRORNG ❑ M OTHER V. TANK LEAK DETECTION ❑. 1 VISUAL '"6CV ❑ 2 INVENTORY AMOMAIMTION ,© 3 VAPOR MOMTOFNO❑ 0 AUTCMATICTANKOAUGINO ❑ 6 AROUND WATERMONITORINO ❑ , TANK TOT1NO F_T INTERSTITIALMONITORING ❑ 01 NONE ❑ 96 UNOIDWM ❑ 99 OTHER VI. TANK CLOSURE INFORMATION I. ESTIMATED DATELASTUSED IMDNAWYR) 2.ESTIMATMOLUNTITVOF 3. W",TMMFILLECWRH YER ❑ NO SUB STANCE REMAINING GALLONS IMERT MATERIHLT THIS FORM HAS B EN COMPLETED UNDER PENALTYOFPERJURY, AND TO THE BEST OF MY KNOWLEDGE, IS TRUE AND CORRECT pTollih a STATE I.D.N IPERMITNUMBEB PERMIT APPROVEC BYNATE PERMITEKPIHATNINWTE FORM B AS M THIS FORM MUST BE ACCOMPANIED BY A PERNIT APPLICATION - FORM A, UNLESS ACURRENT FORM A HAS BEEN FILED. TOWMMBAL INSTRUC11ONS POR (OMDli11N(i IzORM'A' GRNBRAE, INSIRUCDOW. 1. One FORM 'IF shall be completed for such tank for all NAW PRIKKIP S, PBIIMIT CI bWGIA REMOVALS and/or am other TANK INIORMA711ON 01ANOD 2. This farm should be completed by either the PIRMIT APPL ANI'or the U)", Armljq Y UNDBRGRO MI) TANK IN.ITI!C--11M. 3. Please type or print clearly all requested information. L Use a hard point writing instrument, you arc making 3 topics 'POP OF IORM:'MARK ONLY ONE DIM L Mark an IS) In the box next w the Item That best describes the reason the farm is being completed. _. Indicate The IYM or Facility name where the tank is installed. 1. 'TANK DI-s .RiFnoN - (OMPII?Il! AL.L, nlIM3 . W UNKNOWN - SO , P nIR A. Indicate nursers lank ID A- If there is a tank number that is used by the owner to identify the tank (ex. ARld789). 11. Indivaro the time or the company that manufactured the tank (ex. ACME LANK MM.). C. Indicate the year life lank was imwlled (ex. I"?). O. Indicate the tank capimity in gallons (cx.2.t,hoq or RldiD etc.). IL TANK(Y)NILNIS A. L If NIMOIf VEIIICI-14 IU13f., check box 1 and complete ilea' B & G 2. If not M(YI'Olt VJAIICUd MR, cheek the appropriate box In section A and complete items B & D. 13. Check the nppropdtite box. C. Check the type of MOTOR VEHICLE FUEL (if box 1 is checked in A) D. Pent the chemical name of the hazardous substance stared in the tank and the C.AS.R. (Chemical Abstract Service number). if bat 1 L NOT billeted in A, Ill. TANK CONSI'RIMMON - MARK OND rll,M ONLY IN BOX A B, C & D 1. Cheek only one item in TYPE OP SYSTEM, TANK MATERIAL, INTERIOR LINING and CORROSION PROTBCUON 2. If G'111ER, print in the spied provided. IV. PIPING INfORMAUON 1. Circle A if ahuve ground; circle U if underground; and cin9e both d applicable. 2 If Cbe"OV6N, mrtk; car if Uri ❑iR print in spur provided, 3. indkule the LEAK bT11lrCIlON nyxwm(x) used m unmply with the monitoring requirement -fro the piping. V. TANK IAAK DIfIL.CnON L latWam the LEAK DI'fl?CI ION system(s) used to comply with the monitoring requirements for the lank. VI. INIORMAOON ON'1'ANK PERMA1,11WILY CUMIO W PIACl: I. hII1MA'ILD DA'll! LAST USIiD - MONPII/YEAR (January, lM or nl/KS). 2. ESTIMNILD QUANITIY of HAZARDOUS SUBSTANCE remaining in the wok (in Callow). 3. WAS TANK FILLFD Wrl'H INERT MATERIAL" Chad'Yes' of'NO'. APPLIC/sNT MUST SIGN AND DXM TI W FORM AS WORA TIO. I451RUCOON IOR'niv UH'N.AGI'NCWS The state underground storage lank Identification number is composed of the two digit county number, the three digit jurisdiction number, the six digit facility number and the six digit tank number. The seamy and jurisdiction numbers arc predetermined and an be obtained by calling the State I)nard (916)T39-242L 'Ihe facility number most he-0 the time U ehrMa In form 'A', The tank number MAY be assigned by the local Agency, financier, this number Most be numerical and cannot contain an alphabet. If the kcal Agency prefers the State Board to assign the conk number, prose leave it blank IT IS'IIM RISI'ONSIBILOT OP 111B LOCAL AGENCY 11INT W SPBMN TIIP. PACUIIY TO VI!RMy'nll! ACCURACY OF 1DB HIFORMAIION. TIM URAL. AGENCY IS RPSPONSIRIE MR 11W COkBCFOION OF MM N.00AL. AGENCY UST! OKLY' WPORMAMON BOX AND LIM IIMWARDMG ONII IORM'A- AND AggBC A1LU FORM -WD) IU hill VOIXOVVIING ADDRESS SI'A'D! OP CAUIORNIA Cliff .uirs WRESOURCESlAN1ROL BOARD DATA PROCIiSSWG (TNDIR P.D. BOX 521 PARAMOUNT, CA 90l)3 04-21-03 09:22AM FROM KERN CONSTRUCTION P02 11NIFIEDPROGRAM CON%01,1DA1TD FGNAT TANKS UNDERGROUND STORAGE TANKS - FACILITY(limposon ' Nt Pw I Pry 1CX`rc000PM ATION 1H0FfANLN YC ID MlIOX LX[W BITP PBMfIT 1_RENRW ImIwwIY RI TAnA 11MWFD )lMoymlWllON» [JO AM6ND90 RRMIT NoA%Mob ey O 6 T6MPoYPM1Y flT[ CLOII%M[ I. FACILFIY I MTL INFORMATION TYPE I.colroRAnoN Or. cal AOEl COMM CIAL ❑ ZDADIVIDUAL 136. STATE AGENCY' OTNCR to❑]. PAaTNBRSNIP 01. PEDEFAL AOENCV w 0 YN Z No ' 11. PROPERTY OWNER INFORMATION eN eN Ll 2. INDI. Nutlet u t----- ❑1. FEDERAL AlN SNIt O OUNri OBN Y GENCY III. TANK OWNER INFORMATION eD ele one IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER al C CU1 916 322.9669 It MUMS Rii6e Y. PETROLEUM UST FINANCIAL RESPONSIBILITY 1. 88Li-INEUR® ❑6.6UR8rieOND Qi, STATE FUND ❑ 10. LOCAL DOW MKHANISM I OUARANTEE ❑S LETTER OF CRBDIi ❑ESTATE FUNDlGP0 LlII8R OPS.I-TIHBR', w I.INSURANCR ❑6. eREMrt10N ❑9. STATB %INDICD V1. LEGAL NOTIFICATION AND MAILING ADDRESS tl0ap0bllb Wb Ae Ryingi8eouane;1 llq. ]� I. Fill 13B.FRMERFYORARR p].TANRDWNBR 'D villbxNUMlxM1am,uAW lu lot toelmYtl. VIL APPLICANT SIGNATURE UPCF (IN9 mvieab) E FMmIAY SWRCB P01nIA 04-21-03 09:22AM FROM KERN r"WRUCTION TANKS lVlj9MTYP9 o1.YR6191IR8 L,L911LI Wn+.'�^"•••• p� µf LMyT9unlox 1.'"Na"'WALL ❑]. LMQDIPHICH 0 91. 01MLR 9M p...lMDLQ wAu p91. UNRNOwN ❑1.00V9US VALL ❑99.OTNBR NOMAUNNES I.WVRLB WPLL p9f.IMM.40wN yl MAXUPACTURBR MANY/AC I p 6. PRPC%1PAi1lL8 a^Imx XITNNOLP d 1 .lA88 STEEL ❑0.FRP COM9ATIRLQ WIMX YMIIAXDSITUL A p1.MR89r88t 1,OALVN➢ZPA ST84 00 19TAMLE5 SUES �i. GALVAN128DfT8QL pN OmN p]. ILASTIUAMLCCOM IIlLP wICOMBMT! p9.PL8%IQL91ND90J p99. OT16R ❑1%ABNC COMPAI%LB WICONTBM9 p Uslow 04 , nON99 p9. CA1NODK'%OiBCTIOX pav18E80LASE _.. p1. PLE%ISSE INMRIrn� W p1. Sit,wAEAT❑9L UNKNOWN SINGLE vvAW. PIPING QA PRESSUMNED P11MD (CNe] N1 .MI SIN O I.OFCOAOLEALS QTBMPAILURR ANDS TSM MSTUNNEUtloN 9NVi AUDDlLEANDVIMIALALPANM0. p I. MNITNLYO.IOW YEET p 1. AtmtIAL MT/DUTr ien ro.l Orro n L DAILYVISUAL WONT BY9TEME ❑1. DINTLYOUTSYATET(ONITGEM OOF MINPMOIYETEM IiA1OM1Al n91A0 !A%aVLT10N HYMNS NO VALUFBMABLOWITUEN mOl: p1.EELPMOETOUNO OMVITYTLOw ❑ SGIM eQcoN V AEIr coNrAMee nnnc PRE9SUUZ¢OnPMO(cMY MmeWbY _ _ ALA%i6 ANDILYM e^O pA ADlurunrvnU,v........ -__...--- p 1. AUTO OMI PU�MPNUT O% FOK LNABA SYSTEM FAILUEL AND SYSTEM D Qe. NO AUTO FUMP ENYl Off pII a"ORSESTIUCTION NB KDlTECTOF130G%}SBTI b'I}NPLOW SNUT p IL ANNUALMiLOUTYTASTl0.1 GPM SDC{ION/DBAYITY SYSTEM [313. CONFIMUOU99UMP %NIOA. AUDIDLD AND VMUALALAIN 9MEROSNCY WNBMTOAS ONLY IaO 10"WE) p 14 AWNYINIOUTUSW AURSSu SUALALER aM AU10MPWUPONF- pI1.AUTOMATIC LIPS UtYR NO OEM TEST) WI00111 PLOW 010. ANNUALMMWV UP 401 OW) ❑1) GALYVMUALCNRCN DATENETALLED All [31, 1EUY NJCLINELZN MIWbk pI. SHLIGIFPOR" L"YanttM ITADML AMD Ys p%MMMBC�uTXW, AUD%LQANDNBWLALARMI. p1 MONTMLYO]OFNT rlr pMrLANMUALM IUUro.lo%I TYTIEP p4. GAILY VISUAL CNECIf CONVENTIONAL SUCTION SYSTEMS MINA A"/YH pL DMLYVISUALMONITOIIMOOEEIPINOANDPUMFOIUBYSTSM 139. TUEAMIAL N"Mi TEE I01"M E%NCTEtl SYaTLML(NOV.A M840w ORO1M0"N ) pf. iuv MONITMUNO DAVITS /IAW tC1NAIW WPIl1' pE DAILYVUUALMONNORMG p a. ElmanALMTEGANYTEsrI SSCarvoAYLVM CODT1MEDrVING PRWVIUZQD NMNOIOtlNM W11Y 10 COXTINUOU9NRBMa9UNP frNS'IRYIIIN AVDOILEAND VISWI' pe NOAUIO%MINUTOIP p It. AUMMAMLEAKDNTPCTOR [311, AMNALINTIIGMY iBtt(O.I OPN1 "FIGNMEAVITYSYSTEM p 11. MNTMUOLB BYMP S@ISOR' AYOISLL AND VMUAL ALARMS W CROQMCY 0[N[PATOPI ONLY Iwu M ea ypvl ❑ la, LONlMl0U46VMP0EN0OaW1TRO{G AUTO4IME RMOPP AUDIBLE AND VISUAL ALSEM4 (3, AUTOMATIC GMELEAKOPTRCHMO.DOPE TEST) p IOPM I. PLOATMOUROALAn mm _.._._.._._ ME.ppIppN1TOUNG 1 CnnnMIIIUq DMxEQUES>AN 40SWNIORYUGH ULTO NUTIMPWR MMS 06NQ9R TIPCF (l2N9 %vUNd) 12 FODDEIy SWRCB FO B ACORD CERTMk ATE OF INSURANCE cstl Pl. W�P•0/277//93m PR9DLSsa THIS CERTIFICATE IS ISSU® AS A A/ATIPR OFDNFORAIAnoN ONLY ANSI IN== AND ASSOCIATES COMERS NO RIGHTS UPON THE CFRTTEICATE HOLDER. THIS CER=CATE INSURANCE SERVICES DOESNOTAAWID,EnZNDORALT13i COVFRAGEAHYOROEDBYTHE 21700 E. COPLEY DRIVE, P100 POLICIES BELOW. DIAMOID BAR, GA 91765- COMPANIES AFFORDING COVERAGE ... 909-060•Hi3 / AAA AMERICAN INT•L SPECIALTY LINE riCL LRTTRA ECON) LOBE HI TUNE CORPORATE ..1 ... ...._. ..— ATM: JEFFRET A. STEWRT �M C 4911 BIRCH STREET HEMPDRT BEACH, G .......- ".... .,,,.._ „ ..., ..... _.,. rnoAxr 92W D ulna .. ........ ..._. .._ .......... mA@ANY I.;�y� MtITp E COVERAGES Iws la TO cwITTPr THAT TlmrouoHs OF BrsuPAxce uaT>m BHTnw HAVE BEEN IasN®Tn Txewaln®xAM®AeovBwn>He eoucY emHon NTIGIIDJ, ANY PHp1ANA T, OPANYNNIR D(IL1JLffiif WniAERPHCTIO WHICH 11J18 mAvRTRSTANDURO ajpaw AN pzN SHOD C.=SIONSNDODIRIONSOPUCIInv MAY MU T,LIMISSHO vAMAYHD)eE�nrv...u= Bel�..J•�:.^^�S� .....'^A•LnS ^......�. ILCCWa10Na AND CONDITIONS OFSUCH IODCIRI. LIMITS SHOWN MAY NAVE H®T 88DUC® BY PAm CLAIMS. Lv. YreHarTrrwxn Ia.ICL•MumR Ya.levvPUY{as RpAcvmnnOR Lome _. DATSDDNDwY»-VATRPOMPBTD - -cBMRY.MYU'DY '.WHERAL AOOR60Af8 1 WFD®IMLOFHOIALMNYlIY lWgFTYNIPARAW. 1 .., dN1aNAC8. .. OOL1R. ......... _. .. _..... " IFitlNLLAADV. WVAY { OMNFA'9A NNLaACfOR'e iAOl. g♦p:9q.TlMpltB 1 _..._ '. ITIIEOAMAWMymewa �. N®.HNTTRl6Mq®1�..{ .1VfUYMQ3LWDl1Y LIMBp®®MH .VIYANo '' IJRI' 1 •. _. ALLOWS®AVM4 _ _...._ _ WIRY ow 1 pOR11AID ANlOt '.. -O�rW IDIREXIMIMM RDDE.YEUUIY -L MUMOWMb A1TM PN,rN.D _... O.W06MNOlRY IEEE...... •.. m0FORTY IMMM E 1 IRLYMLW IUW BAOIOtt'UMWICB 1YB1101AFOW AMORWA'19 OIIDiTHANILYYHlAF01W WWRyVRCDRMRMMI'ION WATIIIORYLMM Y0 Gt9 YYIMYY'LWdT' Iowmm-IOLYYuvI F C(PbA�NAnIFY1{DYES { 0p1 A POLLUTIW UST 7730702 07/20/93 07/20/94 1,000,000 EACH LOSS LIABILITY 200000000 AGGREGATE DSOnmOM woesunaMe�LWAnonwcmo.vxrHnu. mw LIMITS OF INSURANCE: S1,000000 PER POLLUTION INCIDENT/R,000,OOC ANNUAL AGGREGATE S 500:000 DEFENSE COSTS LIMIT IN THE ICE OF CAMC!ttAIZCN WILL �nKctwt. PROOF PROVIDED FDA:PSITE yjpD7�28, IOUERA, SAM LUIS OBISPO, u 93401 ClmincATEHomm ... CANCELLATION .; axouLO ANY OPTNeAB0V8DIDLRO®rouCB1 BB GNCHI]D)B&OPNINB >sauAnoN DAnTNBRBOp, T/IB WumOODeDANY ww.HROBAvoeTn MAD 30 MYL WIUTTBN xOTICB TD Tf®CBR161GTBHOTJ�INAHJm ro'INB JAMES P. JONES TRUSTEE LJDT, NUTPADJ@BTD MALL SULNLNOnCB SOnti BDOSBNO OBDOA]ION OR 717 MARSH STREET LLABIDiY OP ANY fII1D UPON IHBCONQANY, n1 AO@I'R OB RBPR®SNTATTVBL. UN LUIS OBISPO G MOT uR ATTVR - - -- �� ACORD]SS am) ' ACOAD CORWItATTON 19" ��N�� ►►��i�� a�u� � city Of SM tins OBISPO Fire Department • 748 Pismo St. • San Luis Obispo, Ca. 93401 • 781 - 7387 �erznit required ECONO LUBE AND TUNE 286 HIGUERA DATE, 10/07/93 _ SAN LUIS OBISPO, CA 93401 IS REQUIRED TO OBTAIN A PERMIT TO MAINTAIN, STORE, USE OR HANDLE MATERIALS, OR TO CONDUCT PROCESSES, OR TO INSTALL EQUIPMENT AS DESCRIBED BELOW: 1) STORE/HANDLE/USE CLASS III FLAN. LIQUIDS $ 45 2) U.G. STORAGE TANK PER ORD 999 - NEW $175 3) HAZ HAT INVENTORY/BUSINESS PLAN - ORD 1075 $270 THE CHECK TO THE CITY OF SAN LUIS OBISPO IN THE AMOUNT OF: 11-01-94 4/9�00.00�Payable within 30 days PERMITWILL BE VALID UNTIL - `/ f��Y 2594 /. I.D. NO. BY: � � ,0'1�/ FIRE MARSHAL ECONO LUBE N TUNE a3a2 II E 1� Steve Pipkin 286 H GUFRA, SAN LUIS OBISPO, CA 9340' - (805) 544-2976 Facility Information as Of 10/11/2022 Pages. FaeiIIN IIXFA0006118 Data. 10MI12022 Requested by: S [ ] NEW FACILITY RECORD [ ] OWNERSHIP CHANGE: [ ] Business [ I Property [ I Tank l9 INFORMATION CHANGE [ ] UPDATE BILLING INFORMATION CLOSE FACILITYAS OF. Date: /_/_ [ ] UPDATE UST INFO (sys, type, capacity, etc.) OWNER FILE INFORMATION Owner ID: O9Y0006190 New Owner ID: Omar Name; SIMCAT ENTERPRISES New Name: Owner DBA: New DBA: Owner Addri es: 2505 THEATRE DR BA New Address: PASO ROBLES, CA 93446 Home Phone: New Home Phone: Alo* Phone: 605i23-5921 New Work Phone: Mailing Address: 2505 THEATRE DR M New Mailing Address: PASO ROBLES, CA 93446 Care of. JOE SIMONIN New Care of - FACILITY FILE INFORMATION Facility ID: FAOM116 New ID: Fill Nave: LURE-N-GO New Name. 266 HIGUEMST New Site Address: SAN LUIS OBISPO, CA W4014215 Phone: 805-7664056 New Phone: Melling AddNas: 286 HIGUERAST New Mailing Address, SAN LUIS OBISPO, CA 9MO14215 Care of: JOSEPH SIMONIN New Care Of: CERS ID: 10437337 New CERS ID: GIS 35.27240 -120.67016 New GIB ACCOUNTS RECEIVABLE FILE INFORMATION - PRIMARY FOR ALL BILLING AND PERMITTING CORRESPONDENT Accoum ED. AR00205o9 New Amount ID: Account Name: Carl New Account Name: Mailing Address: 286 HIGUERAST New Mailing Atldress. SAN LUIS OBISPO, CA 934014215 JOESIMQNIN Wei -iniii Account Balance as of 101112022: E000 Mail lnvalus to AcrauntDiscount Cada: DisocuntlnwNoes9:Y LINKED PROGRAMS Transfer (Cards One) UST(e) Program to Adivaa/Change Linked New Owner! Anactvaa OM2-SLOCITY-IWIARDOUSMAMMLSHANDLERI4 P110007504 SE0000517-110ATHESONBDSS AWw Y N A C I LWAcbvay.0824/2022 - REGULAR INSPECTION 1176-SLOCR%NNSTEGENEMMR(14waeta Mma ) PROOmfi05 EE0000517-MATHESONIMUSS Ative Y N A C I Last Activity. !)MM022 - REINSPECTION 035E-SLO CITY -RMEYML-USTANNIALM MM FEE Mogul Inadlve 1 Y N A C I Last Activity: 04212004- CONSTRUCTION / EQUIPMENT INSPECTION 0755- SLD CITY. STATE SITE SURCHARGE Mail Heat" Y N A C I Last Activity: No Previous Activity IR51-SLOCRY-AGTANNIALPERMIT PROOn9Te2 GENOM17-MATHESON BLISS Ine01M 1 Y N /� / 11/ C I Lest Activity. dgiti 012- REGULAR INSPECTION V 4505-SERNIMSTATION PRN17378 EE0000152-LUCASMLLIS Inadhe Y N A C I LaetActiviy. 10/162015- REGULAR INSPECTION Defemm IWHr2o223:27:29PM COUNTY OF SAN LUIS OBISPO Reports MFR1 Facility Information as of 1WI112022 pap* 2 [ ] CREATE NEW FILE FOLDER HAZARDOUS MATERIALS SPECIFIC: [ ] UPDATE EXISTING FILE FOLDER LABEL PE Number of Materlals UPDATE NEXT INSPECTION DATE: Date: / / Number of Waste Streams Copy to: File Olher•. Number ofTanks (list Update CERSrHazMat Portal? YCN:)f yea, forward to CERS/podal admin for update) rapacity/oompartme rr0 Entered by: W w Dale: � 0 /('b 1Z . UNRHED PROGRAM CONSOLIDATED -IRK FACMTY INFORMATION BUSINESS OWNERIOPERATOR IDENTIFICATION p.re_ _ I. IDENTDITCATION FACRRTY mN MOIOI0151111161 I I I III BEGINNING DATE IN I E WGDAM lol BOS SSNA (e "FAcn NA wDm-o gnmm.ra) T BUSE•IFB.q PBom Im LUBE-N-GO 8057864056 BUSINESSSUEADDRBSS am BUSMEMS FAX IOU 286 HIGUERA ST 8057864057 BUSINRSSSTTECITY Im MCODE Im COUNTY Im SAN LUIS OBISPO cA 93401 DUN & BRADSTRBBT am PRIMARYSIC Im PRDdARYNAICS IN, BUSINESS bW GADDRESS Was 286 HIGUERA ST BGSINEss hw GTTY Iah arATe INN ze conE am SAN LUIS OBISPO CA 93401 BOSINHSSOPERATORNA IN BUSS 80PERATORPNONE lid JOSEPH SIMONIN 8054235921 11. BUSINESS OWNER 0W NAb1R III OWNFBPRONB 119 SIMCAT ENTERPRISES 8057864056 OIIWM B.INGADDRESS Ilr 286 HIGUERA OWNER MAH.ING CITY I STATE IU MCODE Da SAN LUIS OBISPO CA 1 93401 M. ENVIRONMENTAL CONTACT COWACTNA III CONTACT PEONS Ile JOSEPH SIMONIN 8052399301 CONTACTMAII.WGADDRESS 119 CONTACTEMAB, Ilk G . CCWACTMAU.INGCRY in STATE Im ZIFWDE In PASO ROBLES CA 93446 -PRIMARY- W. EMERGENCY CONTACTS SECONDARY - NA Iv NA IA JOSEPH SIMONIN OMAR MORALES Mu IN TITLE In / OWNER If MANAGER DD SS PHONE In DDMMUS PHon In 8052399301 8057864056 2 HOUR PRONE. ]u 4 HOnR PRONE 8054235921 L' CRLL/PAGER# ]TI CELL/PAGER# IL ADDITIONAL LOCALLY COLLECMD WORMATION: U Cmtificatan: Bared on my inquiry ofthnae ivdivNuale reepomW for oldmirring the inf ation, I terrify underpaWh oflau• thetIlurepusonally examined and am femiam udtL the iotormatlon eubmiemd mMbeliere the mfomlmbv is Ime, saturate, avdcompkm. SIONAi QFOWNPA/OPFP/. ORD17IiIGNAIEO[EPRP36NTATNE DAM IM NAA®OF OOL[1A10NTPAPPARBR 1]3 02/28/2022 CAMILLE SUNDAHL NAn¢OF SmNP.R (print) 130 TIn.aDF SIU14M 13 - CAMILLE SUNDAHL 1 OFFICE MANAGER IIPCP 9". 1L 7) �2 3 w W gN � 4 = 0 E E 0 W LL LL Z a F V 0 o0000 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY — CHEMICAL DESCRIPTION n e.wum , []ADD []DELETE []REVISE Page of I. FACILITY INFORMATION BUSINESS NAME (gene M FACILITY NAME or DBA— Doing Business As) 1 LUBE-WISO CHEMICAL LOCATION a CHEMICALLOCYRONCONRIEENTIALEPCRA 202 10 YES MAPN(o0anwl ma GRIDq (nNiO..p toe FACILITY IDS F A 0 0 0 5 1 1 6 01 b-04 IL CHEMICAL INFORMATION CHEMICALNAME zm TRADE SECRET Yes 106 AUTOMATIC TRANSMISSION FLUID rzs.ym mRPCRA. an,mi..,.mm. COMMON NAME K7 AUTOMATIC MR EHS* ❑ Yes TRANSMISSION FLUID CASq 10 *If EHS is"Yes. all anmuma below must be in lbe FlRE CODE HAZARD CLASSES Icanpenlfmwre ny CUPAI z TDKIC(TO%) HAMOUS1) TYE BHw& arcAIAL iemRm Y) Oa WRE Oh MIXTURE Oc WASTE SII RADIOACTIVE ❑To 212 CURIES PHYSICAL STATE (Check ensues only) OMSOWDOh LIQUID OaGAS M4 LARGESTCONTALYHR 'ZD.G FED HAMM CATEGORIES - PHYSICAL 'FLAMMABLE GAB UNDER PRESSURE UEXPLOSISELP HEATING (oM1wkaIJthmaEdy) ❑PYROPHORIC ❑OXIDIZER []ORGANIC PEROXIDE ❑SELFREACPNE ❑PTMHORICOAS ❑CORROSIVEIDMETAL ❑CONTACTWATEREMITEFLAMMABLEGAS ❑COMBUSTABLETO DUST ❑HAMRDNOTOTHERWISECIASsDHED FED HAMM CATEWRIES-HEALTH: ❑CARCIGONECITY RJACUTETOXICGY ❑REPRODUCTIVETOXICITY ❑SKINCORISMONORIRRRATION (Ow,kell Lot µply) ❑ RESPIRATIORY OR SKIN SENSITMATION ❑ SERIOUS EYE DAMAGE OR EYE IRRIATIION ❑ SPECIFIC TAGEr ORGAN TOXICITY ❑ASPIRATIONHAMIU) ❑ GERM CELL MUTAGENICITY ❑ SIMPLE ASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASSIFIED AVERAGE DAILY AMOUNT L MDAILY AMOUNT La ANNUAL WASTE AMOUNT z STATEWASTECODE 2I0 60.0 zan 0 vI UNITS' OaGALLONS Oh CUBIC FEET Oc. POUNDS Od IDNS DAYSONSITE: eitem and If SH3 emoum noel be in ounds 385.0 STOMRAGRAGE CONTAINER ❑e. ABOVE ❑ePLASTICMONMETpLLIC DRUbI❑i FIBER DRUM ❑n GLASTICSIGE ❑q. GIBECAR NDERGR UNDTANNK ❑b, UNOERGROUNOTANK ICAN [-]I BAG ❑n. PLASTIC BOTTLE ❑cOTHER R Oe TANK INSIDE BUILDING L]g. CARBOY ❑REHR ❑o. TOTEBIN ❑d STEEL DRUM ❑h SILO ❑L CYLINDER ❑p TANK WAGON STORAGE PRESSURE O e AMBIENT O G ABOVE AMBIENT O e, BELOW AMBIENT 10 STORAGE TEMPERATURE @m AMBIENT Ob. ABOILAMBIENT Oc BELOW AMBIENT Od CRYOGENIC GE %WT HAZARDOUS COMPONENT (For mixture or wash only) EHS CAS # 195.0 EN hydrocarbons 1n ❑Yes 11g 219 2 5.0 210 BTEX GI ❑Yes 231 211 S na 235 ❑ 4 no z []Yes 240 NI 5 242 Ene 1 Dyes 244 245 Rmm<n...,aeu.a.Po.nn.ra rn+em.l s.®Ie. u..lx nrweam B.e.e.�.:o .e.sg.rxq wa�v....wyn;e.u..n.amm.1.I..a..rwn.e.onnne x. .s��a�.ro.m.m.. ADDITIONAL LOCALLY COLLECTED INFORMATION UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY — CHEMICAL DESCRIPTION ewaiY ktlMi w ❑ADD QDELETE ❑REVISE ING Pea°_N_ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME m DBA - Doing Business As) LUBE-N-GO CHEMICAL LOCATION NI CHEMICAL LOCATION CONFIDENTIAL EPCHA ens ❑ YES 1 MAPII (apymap im GRIDY(o96m.B PIG FACILITYID# F A 0 0 0 5 1 1 6 01 b-04 H. CHEMICAL INFORMATION CHEMICALNAME us TRADE SECRET LJ Yes 206 MOTOR OIL Rs y'ammaq rcr.m;aremedam COMMON NAME EHse ❑ YC9 MOTOR OIL CAS% w9 8474254-7 e1fHER ts`Yes'', all Pressures below moat be in Ibs. FIRE CODE DAZARD CLASSES RumplamlPrteul 16y CDPA) 210 Toxic(Tox) HAZA13 TYPE(Cluack oklrn onOLPIIRE@NMMuEU Oc WASTE DOUS MATERIAL 311 RADIOACTIVE ❑Yo 313 CLIFFS 1 PHYSICALSTATE 219 (CMck om ilem only) 0a50LIO OE. LIQUID OeGAS LARGFSTCOM'Ntm 3 120.0 FED HAZARDCATEGORIES-PHYSICAL JX FLAMMABLE GASUNDERPRESSURE LJEDIFLOSEYE HEATING ShmkeliflOtapply) ❑PYROPHOWC [-]OXIDIZER []ORGANIC PEROXIDE ❑SELFREACTIVE ❑PYROHORICOAS ❑CORRosIVETOMETAL ❑ CONTACT WATER EMITS FLAMMABLE GAS ❑COMBUSTABLETODUST ❑ HAZARD NOT OTHERWISE CLASSIFIED FBDHAZARDCATEGORIES-HEALTH: ❑CARCIGONECOY OACUTETOXICITY ❑REPRODUCTIVE'IOMCITY ❑SKINCORROSIONORIRRRATION (elrskallthenepply)❑RESPIRATIORYORSKINSENSITIZATION ❑SEMOUSEYEDAMAGEOREYEIRRIATHON ❑ SPECIFIC TARIFF ORGAN TOXICITY ❑ASPIRATIONHAZARD ❑GF.RMCRLLMUTAORNICITY ❑ SIMPLE. ASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASUFIED AVERMiEDA1LYAMOUM tl'/ 1vI 8DAILY AMOUNT 214 ANNUAL WASTE AMOUNT ]I9 STATE WASTE CODE tID 388.0 75.0 UNITS' Qe.GALLON3 OfI CUBIC FEEF QcPOUNOS Od. TONS DAYS ON SITE : s are item only) If ITS, mnmwmuss hair mmdv 36.5.0 STORAGE [J.,❑e ❑ i FIBER DRUM ❑mGLA5560TTLE ❑4RAILCAR CONTAINER ABOVE GROUND TANK PLASTICMONMETALLIC DRUM UNDERGROUND OTTLE ❑a -OTHER Oa Elm TANKINSIDE BUILDING LJKCARBOY Ell, BOX TOTEBIN ❑&STEEL DRUM ❑I. SILO ❑L CYLINDER ❑R TANK WAGON 221 STORAGE PRESSURE Q b. AMBIENT O b. ABOVE AMBIENT Q I. BELOW AMBIENT 334 STORAGE TEMPERATURE Qa ANGUENT O b. ABOVE AMBIENT Oc BELOW AMBIENT Qd CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS 4 195.0 226 hydrocarbons a]] ❑Yes so M9 z 5.0 230 BTEX 231 ❑Yes 232 233 3 134 335 ❑ 336 ll] 4 338 239 ❑Yee ul Dyes BnnnhwMuemnpenauarcpvneeayaae.Jr blwegM1tiewrsernwgsigv.0.t%by weleYlllun'ivgmlq MmehndtlndxtlieNaMMPenpNdna Me eWbatl iwrrcmafvn. ADDITIONAL LOCALLY COLLECTED INFORMATION N6 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY— CHEMICAL DMCRH2TION ransoms rkil n DADD EIDELETE OREVISE Pvge_af_ I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA-Doing Business As) LUBE-N-GO CHEMICAL LOCATION IS, CHEMICALLOCATIONCONFIDENGALEPCRA cor ❑ YES FACILITY ID# F A 0 0 0 E 1 1 6 ID MAPp 3 Ewws) GRID#(W1mee 01 d-10 IL CHEMICAL INFORMATION CHEMICALNAME is TRADESECRET Yes ms WASTEANTIFREEZE Ifsuhieelm EKRA, nfeem ifta lwv COM1BMON NAME In Mk WASTEANTIFREEZE EHS' ❑Yes CASp 209 107-21-1 ^If ITS is`Yes", all amamae below must be in [N. FIRE CODE HAZARD CLASSES (eomplemi Fcw ldq CGRA) 210 Toxic (Tax) HAZARDOUS MATERIAL ^ TYPE(CheckorelMnonly) C)a PURE Oh MIXTURE Oe WASTE 213 RADIOACTIVE❑Yee 212 nY CARIES PHYSICAL STATE (CM4 oneiem only) Oe SOLID Oh. LIQUID 0AGAS 214 2 LARGESTCONTAINE0. 55.0 ff4N FED HAZARD CATEGORIES -PHYSICAL FLAMMABLE GAS UNDER PRESSURE EXPLOSIVE SELFHEAT\MO (ebackalHM,pply) ❑PYROPHORIC [:]OXIDIZER []ORGANIC PEROXIDE ❑SELPREACTIVE ❑PYROHORICGAS ❑CORRWIVEMNESTAL ❑ CONTACT WATER EMITS FLAMMABLE GAS ❑COMBUSTABLETODUST OHAZARDNOTOTNERWISECLAR WIM FEDHAZARDCATECARIES-HEALTH: ❑CARCIGONECITY OACUTETOXICITY ❑REPRODUCTIVETOXICITY ❑SKINCORROSIONORIRRITAUON (check all scat gply) ❑ RESPRkTIORY OR SKIN SENSITIZATION ❑ SERIOUS EYE DAMAGE OR EYE IRRIATIION ❑ SPECIFIC TAGET ORGAN TOXICITY ❑ASPIRATION HAZARD CELL MUTAGENICITY ❑ SIMPLE ASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASSIFI ED AVERAGE DAILY AMOUNT 319 MDAB.Y AMOUNT 218 ANNUAL WASTE AMOUNT a STATE WASTE CODE na 53.0 155 575.0 ulsme Qc GALLONS 0ECUBICFEET 0cPo1MDS QE,TONS DAYS ON SITE: Check weilmn mi If EHR mm,tm,glocisnocuins, 365'0 STORAGE CONTAINER [].,ABOVE GROUNDTANK ❑Ke PLASTICMONMETALLIC DRUM❑i. FIBER DRUM ❑m GLASS BOTTLE ❑µ MR, CAP ❑M UNDERGROUND TANK ❑f.CAN ).BAG ❑n. PLASTICBOTfLE ❑r. OTHER ❑c. TANK INSIDE BUILDING ❑y CARBOY k. BOX ❑o TOTEBIN ❑d STEEL DRUM ❑h. SILO L CYLINDER ❑p, TANK WAGON n3 STORAGE PRESSURE O a. AMBIENT O E ABOVE AMBIENT Q c BELOW AMBIENT STORAGETEMPERATURE Oa AMBIENT ON ABOVE AMBIENT O¢ BELOW AMBIENT O6 CRYOGENIC %WT HAZARDOUS COMPONENT (For mixture or wasta only) EHS CAS # 1 50.0 226 an5freneze XD ❑Yes 229 229 2 50.0 DO y/ater 231 ❑Yes 232 03 3 234 235❑ 236 237 4 238 239 []Yes Me 211 5 AD ❑Yes21a IfemepmNnw mnpnnenM1mprwryvlpnnbr0u l%kYn*3CMR.n.arei.aynigrc4l%p�rveyhliRaebnamie. elYA niJXnel ryeeb olpaRrrryM1rin6lM1equLW LAminlm. ADDITIONAL LOCALLY COLLECTED INFORMATION 26 UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY — CHEMICAL DESCRIPTION mww pol una. ❑ADD ❑DELETE ❑REVISE loo vnge_ar_ 1. FACILITY INFORMATION BUSINESS NAME (Some as FACILITY NAME or DBA-Doing Business As) 3 LUBE-N-GO CHEMICAL LOCATION ml CHEMICAL LOCATION CONFIDENTIAL EFCRA So ❑ YES FACILITY ID# ] P A 0 0 0 5 1 1 fi MAPS DISma) sin GRIDB(rotlmsp seat 01 c09 II. CHEMICAL INFORMATION CHEMICAL NAME zs TRADE SECRET Yes WASTE OIL xsngaa W EYRA,,m,ro COMMON NAME lm me EHS' ❑ Yes WASTE OIL CAS% mg 6002-05-9 *If EHS is'Yes", all amounts blow must be in Ds FIRE CODE HAZARD CLASSES IComplwinwnwd by ClAbo 310 Toxic(Tox) HAZARDOUSM EYES(Ceck eu itomly) c CURB Qh MIXTURE Oc WASTE 311 RADIOACTNE ❑Yu 313 13 TORTES 3 PHYSICALSTATE (CFakmaihmmly) O¢ SOLID Oh. LIQUID Oc GAS xl< lla LARGESTCONTAWER 550.0 FEDBAZARDCATEGOEM PHYSICAL FLAMMABLE UGASUNDERGRESSURE EXPLOSIVE SELFHEATING (eheekallpalapsy) ❑PYROPHORN []OXIDIZER ❑ORGANICPEROXIDE ❑SELFREACTIVE ❑PYROHORICGAS ❑CORROSIVETOMETAL ❑ CONTACT WATEREMITS FLAMMARLEGAS ❑COMBUSTABLE TO DUST ❑HAZARDNOTOTHERWISECLASSDBD FFDHAZARDCATEGORIES-HEALTH: ❑CARCIGONECTFY ❑ACUTETOXICOx ❑REPRODUCTNETOXICITY []SKIN CORROSION OR ]ROTATION (check all Set way) 13RESPIRA71ORY OR SKIN SENSITIZATION ❑ SERIOUS EYE DAMAGE OR EYE IRRIATHON ❑ SPECIFIC TAGET ORGAN TOXICITY ❑ASPIRATIONHAZARO ❑ GERM CELL MUTAGENICFY ❑ SIMPLE ASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASSIFIED AWRAGEOAILYAMOUNT 211 ]MUM DAILY AMOUNT 2ig ANNUAL WASTE AMOUNT 219 STATEWASTE CODE 2m 260.0 z0.a 40000 I 1 221 UNITS' &GALLONS Q6 CUBICFEET QcPoUNDS ORION5 ul DAYS ON SITE: check oneitem onno ITENS. Sweet most he in mina.. 365.0 IOUKAGE CONTAINER Ea. ABOVE GROUND TANK ❑e.PLASTICMONMETALLIC DRUM❑L FIBERDRIIM ❑m GLASS BOTTLE ❑q.RA1LCAR ❑G UNDERGROUND TANK ❑fCAN ❑y BAG ❑n. PLASTICBOTILE ❑e,OTHER ❑e TANK INSIDE BUILDING SCARBOY Elk, k, BOX ❑a TOTEB ❑d STEEL DRUM �h. SILO ❑L CYLINDER ❑0. TANK WAGON y1 STORAGE PRESSURE O a AMBIENT Q G ABOVE AMBIENT Q e. BELOW AMBIENT 2U STORAGETEMPERATURE OaAMBIENT Q B. ABOVE AMBIENT Ow BELOW AMBIENT OR CRYOGENIC xxf %WT HAZARDOUS COMPONENT (For mixture or Wahte only) EHS CAS # 1 96.0 vs hydrocarbons 227 ❑Yes = 2 5.0 xw BTEX 331 ❑Yes T xsa xis ❑ DE 91 4 v ❑Yes NO MI 5 x<x 2D 1 ❑Yes ITm,ehmdummppasbaroabbnlaayab Mn l%ha„el�tlrnnrve,.Ynaenn,ea.IMhyvigM1lircnmbeyNe.enneM1egalXxtl inns pprmpNinglM1equlMMWrnutln. ADDITIONAL LOCALLY COLLECTED INFORMATION As UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page Iof I. FACILITY IDENTIFICATION ;AC ITY IDOnly) F A 0 0 0 5 1 1 6 EPAIDY(Hazardous Waste Only) CAL000387770 BUSINESS NAME (Sam as Facility Name of DBA-Doing Business As) LUBE-N-GO a BUSINESS SITE ADDRESS 286 H IGUERA ST 103 RUSINESSSITECITY SAN LUIS OBISPO m I CA ZIP CODE 93401'aa II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, lease submit the Business Owner/ O eratoridentificttion page. Wes your facility... If Yes, chase CM lose there vansofthe UPCF.... A. HAZARDOUS MATERIALS Have on site (for any purpose) at any one time, hazardous materials at or above HAZARDOUS MATERIALS 55 gallons for liquids, 500 pounds Ran solids, or 200 cubic feet for compressed ® YES INVENTORY - CHEMICAL gases (include liquids in ASTs and USTs$ or the applicable Federal threshold DESCRIPTION quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency Ian is required trursumit to 10 CFR Parts 30, 40 or TO? B. REGULATED SUBSTANCES Have Regulated Substances stored onshe in quantities greater than the threshold quantifies established by the California Accidental Release ❑YES Coordimmwith Your local agency prevention Program (CBtARPJ? responsible far CalARP. C. UNDERGROUND STORAGE TANKS (USTO UST FACILITY Why swacn corm x) Own or operate underground storage tanks? ❑YES UST TANK an, n.wn=, Man Fv,n al D. ABOVE GROUND PETROLEUM STORAGE Youmuyaanhowbamhan Own Cr operate ASTs above these thresholds: ABOVEGROUND PETROLEUM Some greeter than 1,320 gallons of petroleum products (new or used) in ❑ YES STORAGE TANK FACILITY aboveground ranks or containers. STATEMENT. Click On dwilx E. HAZARDOUS WASTE Generate hazardous waste? ®YES EPA IDNUMBER-provide mac ropof @apese Recycle more than 100 kglmanth of excluded or exempted recyclable materials (per HSC 2143,2)? []YES RECYCLABLE MATERIALS REPORT hnumwlnp Treat hazardous,+asm on -rim? AYES ON -SITE HAZARDOUS WASTE TREATMENT -FACILITY ONSDE HAZAI WUS WASTE TREATMENI IINII (.,�P=-e=pnmK) Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? ❑ YEg CERTIIICKI'IDN OF FINANCIAL ASSURANCE Consolidate hazardous waste generated at a remote site? YES REMOII. WASTE/CONSOLIDATION SITE AN UAL NOTIFICATION Need to report the closurehemoval of a Fork that was classified as hazardous waste and cleaned on -site? ❑YES HAZARDOUS WASTE TANK CLOSURE CERTIFICATION Generale in any single calendar month 1,000 kilograms (kg) (2,200 pounds) or Obtain federal EPA ID Number, file more of federal RCRA hazardous waste, or generate in any single calendar YES ❑ Biennial Report(EPA Fore 8700, month, or Accumulate m any time, 1 (2.2 pounds) of ache and satisfy requirements for ents in wale; or gerrerete or accumulate te any time more than or n 100 k Pounds) o (220 pounds) of RCRA, RCRA Large Quantity Generator. Quan Quantity spill cleanup materials contaminated with RCRA acute hazardous waste. az rd Household Hazardous Waste(HHW) Collection sin? []YES See CUPA for dforms. require ((�� y^ F. LOCAL REQUIREMENTS / a� VVD� H (Youmryalwbereq dtopm addilimWi rionbyynur CUPAo,Iozin cyJ UPLF Rev. (12411007) UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION or 1. IDENTIFICATION FACILITY IW 01010151111161 00511 LV•, ^ I BEGINNING DATE '°° ENDING DATE tot BUSINESS NAME Fo,w0 FA(ILITY NAME or Dee - Done DWIOM AS) BUSINESS PHONE I LUBE-N-GO 8057864056 BUSINESS SITE ADDRESS 103 BUSINESSFAX 103e 286 HIGUERA ST 8057864057 BUSINESS SITE CITY too ZIPCODE 103 COUNTY 1°0 SAN LUIS OBISPO CA 93401 DUN & BRADSTREET 're PRIMARY SIC 'm PRIMARYNAICS IMe BUSINESS MAILING ADDRESS 108, 286 HIGUERA ST BUSINESS MAILING CITY Read STATE lux ZIP CODE lord SAN LUIS OBISPO CA I 93401 BUSINESS OPERATOR NAME Im BUSINESS OPERA I OR PHONE '10 JOSEPH SIMONIN 8054235921 11. BUSINESS OWNER OWNERNAME. III OWNERPHONE 112 SIMCAT ENTERPRISES 8057864056 OWNER MAILING ADDRESS 113 286 HIGUERA OWNER MAILING CITY IF< STATE Nf ZIPCODE 116 SAN LUIS OBISPO I CA 1 93401 111. ENVIRONMENTAL CONTACT CONTACT NAME °' CONTACT PHONE its JOSEPH SIMONIN 8052389301 CONTACT MAILING ADDRESS 139 CONTACTEMAIL 119, 2505 THEATRE DRIVE CAMILLE LUBENGO.NET CONTACT MAILING CITY '° STATE 1 ZIPCODE 122 PASO ROBLES CA 93446 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY. NAME IV NAME 129 JOSEPH SIMONIN OMAR GODINEZ TITLE 124 TITLE 129 OWNER/OPERATOR MANAGER BUSINESS PHONE 123BUSINESS PHONE 110 8052389301 8057864056 2iHOURPHONE Int 24-HOURPHONE Im CPLLIPAGERN 127 CELLIPAGERN lID AIL EMAIL ADDITIONAL LOCALLY COLLECTED INFORMATION: Cctlification: Bawd on my inquiry ofthase individuals responsible for obtaining the infnnation, I certify under penalty of law that l have personally examined and am familiar with the information submitted and believe IFe information is trust, aacamm, and complete. SIGNATDREC£OWNERIOPERATORORDESIONATEDREPRE5ENTATIVE DATE IL 1 NAME OF DOCUMENTPREPARER 135 01125/2019 ICAMILLE SUNDAHL NAME OF SIGNER Ipmp 15e TRLEOFMUNER CAMILLE SUNDAHL OFFICE MANAGER FREE It UncoO UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY — CHEMICAL DESCRIPTION a (]ADD ❑DELETE QREVISEM• Page_oT_ I. FACILITY INFORMATION BUSINESS NAME (Swore as FACILITY NAME or DBA—Doing Business AB S LUBE-N-GO CHEMICAL LOCATION "I CHEMICAL LOCATION CONFIDENTIAL EPCRAart ❑ YES FACILITY ID P A 0 0 0 5 1 1 fi I MANopaoup Ow01 GRIDYNomi a) ON b-04 ❑. CHEMICAL INFORMATION CHEMICALNAME Se TRADESECRET LJ Year me AUTOMATIC TRANSMISSION FLUID Irsmimi mExnA, armor mm,mdm. COMMON NAME 207 Yak EHS* ❑ Yew AUTOMATIC TRANSMISSION FLUID CA3IO 20 9fLIPS is"Year. all amounts Maw inlet be in lbs PURE CODE HAZARD CLASSES SOmem, f ql by MEAr 210 Toxic (TOR) HAZARDDUSMATERIAL TYPE(Cbackoreilmn only) Qw PURE Ob. MIXTURE OarWASTEIL RADIOACTIVE Ely" 313 3U CURIES PHYSICALSTATE (Check on ioLa n only) O a SOLID OIx LIQUID Oc.GA3 215 LAROF3TCONTAINER 120.0 FED HAZARD CATEGORIES - PHYSICAL KFLAMMABLE GAS UNDER PRESSURE EXPI OSIVE ❑SELF HEATING (oheok all that apply) ❑PYROPHORIC ❑OXIOIZBR ❑ORGANIC PEROXIDE ❑SELFREACTIVE []PYROCORICUM ❑CORROSIVETO METAL ❑CONTACT WATER EMIIR FLAMMABLE GAS ❑COMHI ISI AR I F TO OCS I 11 HAZARD NOT ITIHERWISE CLASSIFIED FED HAZARD CATEGORIES - HEALTH❑CARCICANECITY OACUTE TOXIC I IY ❑C,VR000CHVET0XICITY []SKIN CORROSIONORIRRITATION (check ell that apply) ❑RESPMATIORYORSKINSENSUITATION ❑ SERIOUS EYE DAMAGE OR EYE IRRIATHON ❑ SPECIPIC CADET ORGAN TOXICITY ❑ ASPIRATION HAZARD ❑ACUUETOXICITY ❑ SIMPLE ASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASSIFIED AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASfEAMOUNT 219 STATEWASTECODE Be 60.0 1 240.0 1 1 UNITS' @a, GALLONS Oh CUBIC DEBT QaPOUNDS Od. TONS E1 1 DAYSONSHE: 222 Check me it=ml • If EHS amount moat be in pasunds. 365.0 STORAGE ❑a ❑e. PLASTICMONMETALLIC DRUM 'FIBER DRUM GLASS BOTTLE CONTAINER ABOVE GROUND TANK ❑�, ❑m. ❑q. RAILCAR []h UNDERGROUND TANK FCAN JBAC OrPLASTICBOTTLB ❑e, OTHER El Or Ore TANK INSIDE BUILDING IF CARBOY HKBOX DUE BIN ❑d. STEEL DRUM ❑ E. SILO ❑I. CYLINDER p. TANK WAGON 223 STORAGE PRESSURE Q L AMBIENT O h ABOVE AMBIENT O a BELOW AMBIENT 3N STORAGETEMPERATURE Qa AMBIENT O4 ABOVEAMBIENT Oc BELOW AMBIENT Or. CRYOGENIC 2)J %WT HAZARDOUS COMPONENT (For miXlum or more only) EHS CAS N 1 95.0 226 hydrocatons 227 Yea 2211 229 2 5.0 230 BTEX nI wee 2A 233 3 v4 BIC ❑Yes d Its 239 ❑YeS lain 111 5 242 mi ❑YeS N4 vO Bm.nnv�Lu.mnw..meem P�.^IYk��IarlLx Ix erw<Iwrinrmrineyilo+w.)u alwndt iOartbaraq xnW .amlwlLSW efpepre.pNMr lke�mlalrta mromm�w. ADDITIONAL LOCALLY COLLECTED INFORMATION 34a UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRHRTION tr ll 'Wild, ore aDREVISE am DADD (]DELETE pace- or-1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Wing Business AB 3 LUBE-N-GO CHEMICALLOCATION 101 CHEMICAL LOCATION CONFIDENTIAL EPCRA No .. ...�_..,,, ❑ YES 1 5 MAIsforowen me GRID#Gerievl FACILITY IDX F A 0 0 0 5 1 1 6 01 1 b-04 IL CHEMICAL INFORMATION CHEMICALNAME 205 TRADE SECRET Lj Yes xm MOTOR OIL RRnymnEPERA, na'e,w1na,mIme COMMONNAME xm z EHS• ❑Yes MOTOR OIL CASX 109 64742-54-7 •IFEHS is "Yes %all amounts below must be in Heil FIRE CODE HAZARD CLASSES (Ccoplac vwyliric" CUPN Mb TOXIO (TOK) NAZARmI I,¢ MATFRIAI. ill TYPE(Clo,damitemntly) O&PURE Ob.MIXTURE Oc.WASTE RADIOACTIVE 2. L-lll, 213 CUn1E5 -215 iPHOKIo (Cla ALSTATE xl< (Check one item only) OaSOLID Ob. LIQUID OpGA3 LARGEST CONTAINER 12QB FEE HAZARD CATEGORIES - PHYSICAL OFLAMMAHLE [-]GAS UNDER PRESSURE ❑EXPLOSIVE ❑SELFHEATING (,back all&n apply) ❑PYROPHORIC ❑OXIDIZER ❑ ORGANIC PEROXIDE ❑SELF REACTIVE ❑PYROHORICGAS ❑CORROSIVE TO METAL ❑ CONTACT WATER EMITS FLAMMABLE OAS ❑COMBUSTABLETO OUST ❑ HAZARD NOT OTHERWISE CLASSIFIED FED HAZARD CATEGORIES -HEALTH: ❑CARCICANECITY OACUTETOXICITY ❑REPROOOCTIVETOXICITY ❑ SKIN CORROSION OR IRRITATION (check all that apply) ❑ RESPIRATIORY OR SKIN SENSITIZATION ❑ SERIOUS EYE DAMAGE OR EYE IRRIATTON ❑SPECIFIC TAOET ORGAN TOXICITY ❑ ASPIRATION HAZARD ❑ACUTETOXICITY ❑ SIMPLE ASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASSIFIED AVERAGE DAILY AMOUNT 2C MAXIMUM DAILY AMOUNT x ANNUAL WASTE AMOUNT 219 STATE WASTECODE Do 388.0 775.0 UNITS' &GALLONS 0b. CUBIC FEET 0QPOUNDS Od TONS xxI DAYS ON SITE: xxx 365'B ore items 'If EH9 nm uv be In ulNa. STORTOR AGE 1''l CONTAINER❑¢ABOVE GROUND TANK ❑aPLASTICMONMETALLIC IMUM❑FTi. FIBER DRUM Unc GLASS BOTFL2 ❑p, RAILCAR BAD n. ECAN PTOTEBIN OTTLE ❑nIyTRER ©c TANK IN$IDE BUILOIIND &CARBOY BOX Ho []it STEEL DRUM ❑FSAJO I. CYLINDER ❑P. TANKWAGON 223 LJY STORAGE PRESSURE O e AMBIENT O b. ABOVE AMBIENT Q e BELOW AMBIENT xx< STORAGETEMPERATURE Oe AMBIENT 04 ABOVEAMBIENT O e BELOW AMBIENT Oct. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# 1 95.0 2M hydrocarbons ' ❑Yes 226 ' 2 5.0 2A BTEX nl ❑Yes 232 711 3 ZE 235 []Yes 236 TO y 238 x []Yes Me MI 5 Us 1 []Yes M If,wrekmNmanmponmb nn pmnlnq�xbrmn 3%byxtlPblllnmwm,emk.,r0.1%bywe1p11lea,tlmynpmuttr nWlamnl aemoflmm/npnbnglM rtbaLeJ Inln,nbw. 246 ADDITIONAL LOCALLY COLLECTED INFORMATION UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY —CHEMICAL DESCRIPTION mach ewBi 3 FIADD ❑DELETE ❑REVISE 2001 Psai 1. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 iLUBE-N-GO CHEMICAL LOCATION 201 CHEMICALLOL'AHONCONFIDENDIALFFCILI ❑ YES 1 FACILITY IDp P A 0 0 0 5 1 1 6 0 MAPK(opeo" e0 GRIDM(esam0 01 d-10 H. CHEMICAL INFORMATION CHEMICALNAME 3m TRADE SELREf Yes 30e WASTE ANTIFREEZE INSIRIM 0EF(RA, IN Nlvmo m COMMONNAME 307 3ep EHS' ❑Yes WASTE ANTIFREEZE CAN Eps 107-21-1 *If EHS A "Yw', all amounts below must be in He FIRE CODE HAZARD CLASSES (Cm.pkN'nmemmm by CHEM 210 Toxic (TDx) HAZARDOUS 311 oneminn ulAL r) ON PURE OL MIXTURE Ott. WASTE RpOIOACTIVE Y E13 ❑ O En CURIES PHYSICAL STATE (Cbck IN ow, Only) 0 a SOLID Ob. LIQUID OcGAS 314 211 LARGESTCONTAINER 55.0 FED HAZARD CATEGORIES - PHYSICAL FLAMMABLE GASUNDERPRESSURE EXPLOSIVE SELFHEATING (dmckall Mn apply) ❑PYROPHORIC ❑OXIDIZER [-]ORGANIC PEROXIDE ❑SELFREACTIVE ❑PYROHORICGAS ❑CORROSIVE TO METAL ❑ CONTACT WATER PARTS FLAMMABLE GAS ❑COMBUSTABUE DUST O HAZARD NOT OTHERWISE CLASSIFIED END HAZARD CATE➢ORIES- HEALTH: ❑CARCIGONELITY OACUTETOXICITY ❑REPRODUCTIVETOXICITY [-]SKIN CORROSIONORHRRATION (Neck Jlllbetepplil ❑RESPIRATIORY OR SKIN SENSITIZATION ❑ SERIOUS EYE DAMAGE OR EYE IRNADION ❑ SPECIFIC TAGET ORGAN TOXICITY ❑ ASPIRATION HAZARD ❑ACUTE TOXICITY ❑SIMPLEASPHYXIANT ❑ HAZARD NOT OTHERWISE CLASSIFIED AVERAGE DAILY AMOUNT 314 MARIANM DAILY AMOUNT 31B ANNUAL WASTE AMOUNT E19 STATEWASTECODE 330 63.0 1 165.0 675.0 UNITS' &GALLONS Oh CUBIC FEET 0QPOUNDS Od, TONS E31 DAYS ON SITE: 3E3 0][EmkoneftmadvI IfENS amount mutt bew uMe. 365.0 STORAGE ❑a. ❑ ❑LFIBER DRUM13nALASS BOTTLE ❑l RAIL CAR CONTAINER ABOVE GROUND TANK Ke. PLASTICMONMEI'ALLIC O0.UM K UNDERGROUND TANK ❑L CAN I. BAG & PLASTICBOTTLE ❑r. OTHER a. TANK INSIDE BUILDING ❑g CARBOY ek. BOX Ha TOTE BIN ❑d STEEL DRUM ❑h S11A EllCYLINDER ❑p TANK WAGON 223 STORAGE PRFSSURE O a AMBIENT O h ABOVE AMBIENT O c. BELOW AMBIENT 324 STORAGETEMPERATURE Oa AMBIENT Oh ABOVEAMBIENT Oe BELOW AMBIENT Od CRYOGENIC 333 %WT HAZARDOUS COMPONENT(For mixture or waste Ugly) ENS CASN 1 50.0 M6 antifreeze 227 ❑Yee MR 229 x 50.0 230 water D1 ❑Yee 232 233 3 334 335 ❑Yes 216 vT d 239 339 ❑Yea MR 241 5 243 w ❑Yea 344 us V mnkuaeewrunpuubwpmenitlpealer Nenl%" non nrtiwynlgora.l%eyea urtngk..eu'hnJJYlontlaeuafpapvupprNr Ma rep.IM inlnvJu. ADDITIONAL LOCALLY COLLECTED INFORMATION NJ UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS HAZARDOUS MATERIALS INVENTORY— CHEMICAL DESCRIPTION mmuim asla' OADD []DELETE ❑REVISE pw—"- 1. FACILITY INFORMATION BUSINESS NAME (Same w FACILITY NAME or DBA-Doing Business As) 3 LUBE-N-GO CHEMICAL LOCATION wl CHEMICAL LOCATION CONFIDENTIALERCRA ❑ YES I MAPS(°ficima H GRIN (.0") 204 FACILITY 109 F A 0 0 0 5 1 1 S 01 C-09 11. CHEMICAL INFORMATION CHEMICAL NAME SM TRADESECRET LJ Yes IM WASTE OIL Ifsubject m MEDIA mr ra mmmmeas COMMON NAME zm tw EHs* ❑Yes WASTE OIL CASH 209 8002-05-9 9fEHS is "Yes", Amnls I eoubelow must be in Ibs FIRE CODE HAZARD CLASSES I,mPlnarrcWild y CUEq SIU Toxic(TDX) NP9A RGras m M Eyes MI. ill TYPE (CM1ee4onenem mly) Qe, PURE OL. MIXTURE Oc WASTE FAUIvnCTI'v"c :IS 1-J F"' D ��" P314 OYSOLID Ob, LIQUID OaGAS LARGBSTCONTAMER 550.0(Cleackoemommey) FED HAZARDCATEUORIS PHYSICAL OFLAMMARLE [-]GAS UNDER PRESSURE ❑EXPLOl ❑SELFHEATIG (ebmk all has apply) ❑PYROPHORIC []OXIDIZER ❑ ORGANIC PEROXIDE ❑SFIFREACTIVE ❑PYROHORICGAS ❑CCHROSIVETOMEFAL ❑ CONTACT WATER EMITS FLAMMABLE GAS ❑COMBUSTABLETODUST ❑ HAZARD NOT OTHERWISE CLASSIFIED FEDHAZARDCATEGCRIES-HEALTH: ❑CARCIGONECITY OACUTETO%ICITY ❑REPRODUCTIVETOXICITY []SKI CORROSION OR IRRITATION (cbak all that "ply) RESPIRATIORY OR SKIN SENSITIZATION ❑ SPECIFIC TAGET ORGAN TOXICITY ❑ ❑SERIOUS EYE DAMAGE ❑gSPIRATION HAZARD ACUTETOXICITY HAZARD NOT OTHERWISE CLASSIFIED ❑ AVERAGE DAILY AMOUNT SIT MAXIMUM DAILY AMOUNT 310 ANV8 ALWASTE AMOUNT SIP STATE WASTE CODE SM 260.0 1 520.0 4800.0 221 UNITS' @&GALLONS Q IN CUBIC FEET Qa POUNDS Od TONS D1 I DAYS ON SITE: M2 .555'D CM1eckmeilem an 'If EN O an be in u^ds CONTAIINNER X❑a ABOVE GROUNDTANK ❑e. P1A37ICMONMBTALLIC DRUM❑r FIBER DRUM ❑m. GLASS BOTTLE ❑y RAILCAR E. TANK ❑e. OTHER NSIDEBUILDINO HBCARBOY �k. BOX ❑a. TOTE BINNTLLE �¢TANKLGROUND ❑A. STEEL DRUM ❑ b SILO ❑I. CYLINDER ❑R TANK WAGON SD STORAGE PRESSURE O a. AMBIENT O b. ABOVE AMBIENT Q a BELOW AMBIENT SM OURAGETEMPERATURE Oc AMBIENT Ob. ABOVE AMBIENT Ow BELOW AMBIENT Ott CRYOGENIC 225 %WT COMPONENT (For mixture or wasle only) EHS CAS# 1 95.0 SSA „HAZARDOUS hydrocarbons 237 []Yes 2 5.0 230 BTFX Tr ❑Yee 233 m+ 3 24 us ❑Yes Us DP 4 2A 239 []Yes 5 u ❑YC5 V4 M5 IIm^rcM1wNaoae^mp^nnb m'e Prtb^r arpeaprlai 1°A byae¢FI Yax4mm�oynitoa0.1%yael¢er Ymmin^pmignlrrtM1 WOiibA Aeere W ppauPwrla¢me^WIrtO hroamnXon. Us ADDITIONAL LOCALLY COLLECTED INFORMATION UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page I of 1. FACILITY IDENTIFICATION FACILITYNN F A 0 0 0 5 1 1 6 n EPAID0 Rhaurdom Waste Only) a (Ageay Use Only) CAL0003,717, BUSMESSNAME(Sa=NFacilityNameofDBA-Doing BasinsAs) LUBE-N-GO r BUSINESS SITE ADDRESS 286 HIGUERA ST IBr BUSMESSSITECITY SAN LUIS OBISPO EaI CA I ZIP CODE 93401 ER It. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, lease submit the Business Owner/ O orator Identification page. Does your facility... If Yes, lease con IeW thesetimes of flat UPCF.... A. HAZARDOUS MATERIALS Have on site (for any purpose) at any one time, hazardous materials at or above HAZARDOUS MATERIALS 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed ® YES INVENTORY - CHEMICAL gases (include liquids in AS Ir and CSi s), or the applicable Federal threshold DESCRIPTION quantity for an extremely banardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency Ian is squired pupation to 10 CFR Parts 30, 40 or 70? B.REGULATEDSUBSTANCES Have Regulated Substances stored entire in quantities greater than the threshold quantities established by the California Accidental Release ❑YES Coordinate with your local agency prevention Program (CaIARP)? responsible fbr CdARP. C. UNDERGROUND STORAGE TANKS (USTs) USTFACILITY(rosmysws®snn At Own or operate underground swage tanks? YES UST TANK too, pose pet ink) actions Awn D. ABOVE GROUNDPETROLEUM STORAGE You may reed m submit an Own or operate ASTs above these thresholds: ABOVEGROUND PETROLEUM Store greater than 1,320 gallons of petroleum products (new or used)in YES STORAGE TANK FACILITY aboveground taroks or containers. STATEMENT. Clink fin dtlnlde.,l= E. HAZARDOUS WASTE Generate hazardous wasR7 JjWq EPA ID NUMBER -provide n the top of Recycle more than 100 kg/month of excluded or exempted recyclable am Pass RECYCLABLE MATERIALS REPORT materiels (per HSC 25143.2)? ❑YEs (w p.n.osol.) Treat hazardous waste on -site? �YFS ON -SITE HAZARDOUS WASTE TREATMENT -FACILITY ON -SITE HAZARDOUS WASTE TREATMENT -UNIT (menainrunal Treatment subject to financial assurance requirements (for Permit by Rule and Conditional Authorization)? AYES CERTIFICATION OF FENANCIAL ASSURANCE Consolidate hazardous waste generated U a ramose site? YES REMOTE WASTE/CONSOLIDATION SITE ANNUALNOTIFICATION Need in report the closure/removal of teak that was classified a5 YES HAZARDOUS WASTETANK hazardous waste and cleaned on -Mite? CLOSURECERTIFICATION Generate In any single calendar month 1,000 kilograms (kg) (2,200 pounds) or Obtain federal EPA ID Number, file same orfiederal RCRA hazardous waste, or mincrate m Day single calendar MYER 13A/B), and satisfy requirements for month, or accumulate at any time, 1 its (2.2 pounds) of RCRA acute hazardous waste; or generate or accumulate at any time more than 100 its (220 pounds) of RCRA Large Quantity Generator. spill cleanup materials contaminated with RCRA acute hazmdous waste. Household Hazardous Wrote (HOW) Collection sift? YES t SeeCUPAformiumedfmnn. F. LOCAL REQUIREMENTS is ry (You walso be vatirttl to provide Wtit vino by rr CUPAorloodrgmo) UPCF Rev. (122007) FORM S— SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY BUSINESS OWNER/OPERATOR IDENTIFICATION I. IDENTIFICATION BUSINESS NAME(8. m FAcanY NAME a DBA - Doing gala. Ail LUBE-N-GO BUSINESS PHONE 8057864056 BUSINESS SITE ADDRESS 286 HIGUERA ST CITY SAN LUIS OBISPO CA ZIP CODE 93401 COUNTY San Luis Obispo BUSINESS %PERGTORNAME JVOtYFI �IMMVVNN�INN 8�423SSS OPERATOR PHONE 5921 IL BUSINESS OWNER OWNERNAME SIMCAT ENTERPRISES OWNER PHONE 8057/4056 OWNERMAH ING ADDRESS 286 HIGUERA CITY SAN LUIS OBISPO I STATE ZIP CODE ICA 193401 Ill. ENVIRONMENTAL CONTACT CONTACTNAME JOSEPH SIMONIN CONTACT PHONE 8052389301 CONTACT MAILING ADDRESS 2505 THEATRE DRIVE CITY PASO ROBLES STATE CA ZIP CODE 93446 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME JOSEPH SIMONIN NAME OMAR GODINEZ TIME OWNER/OPERATOR TILE MANAGER BUSINESS PHONE 8052389301 BUSINESS PHONE 8057864056 I4HOUR FIR GFIN 24-HOUR PHONE PAGER #/CELL PHONE% PAGER p/CELL. PHONE ADDITIONAL. LOCALLY COLLECTED INFORMATION: Certification: Based on my inquiry oftlwe individuals responsible forabmining tfe infmmalio141 comity under penalty oflaw that l have personally aamined artl am familierwiN the information avbmitted eelm believe Me i�ometion is tme, azcumte, arW completa SIONATORE OF OWNEWOPERATOR OR DF IONATEOREPRESENTATIVE Submined via Public Portal DATE 02/1312018 NAME OF DOCUMENT PREPARER CAMILLE SUNDAHL NAME OF SIGNER Imq CAMILLE SUNDAHL TITLE OF SIGNER OFFICE MANAGER FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) CHEMICALINVENTORY Come ' page permareritl rbam araw OADD QDELETE REVISE I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA—Wing Easiness As) LUBE_N_GO CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL EPCRA OYES ONO FACILITY IDa FA0005116 MAN101 CiRID11 b-04 tAgnryoe.unlyl IL CHEMICAL INFORMATION cxBMICALNAME rRADESECRET []Yes rvd AUTOMATIC TRANSMISSION FLUID Irsubjeer ro EPCRA, rerer ro ingmelrom COMMONNAME AUTOMATIC TRANSMISSION FLUID EHg• ❑Yes ❑ No CAS11 *1fEHN is "Yes", all smnnnh below mug be in lbs. FIRE CODE HAZARD CLASSES (CwpM1nifimu ned by CUPA) Toxic (Tox) HAT.ARDOUSMATERIALIVPE 13S.. IIKMIXTURE 13a WASTE RADIOACTIVE DY%ONa CURIES (Chew am dent only) PHYSICAL STATE On SOLID ®b. LIQUID Oc GAS LARGEST CONTAINER 120.0 v (Chkoreircmanly) FED HAZARD CATEGORIES WaFIRE Ob. REACTIVE ❑QPRESSURERELEASE Od_ACUTE HEALTH O a CHRONIC HEALTH (CM1ak all Cat epplY) AVERAGE DAILY AMOUNT MAXIMUM DAILY AMOVNT ANNUAL WASIB AMOUNT STATEWASTECODE 6( 240.0 UNITS' MaOMLONS Ob CUBIC FEET Dc PoUNUS Od. TONS DAYS ON SITE: s awlmmgny STORAGE 0 a ABOVE GROUND TANK 0 a PLASTICMONhWTALLIC DRUM LFWERDRUM UnIGLASSROCTLE CONTAINER 4 UNDERGROUND TANK D[CAN Dj.BAG Dn PLASTIC BOTRE ❑q. RAIL CAR c TANK INSIDE BUILDING O B CARBOY D k BOX O a TOTE BIN ❑ e OTHER Dd STEEL DRUM ❑h. SILO DI. CYLINDER DP TANK WAGON STORAGE PRESSURE Da. AMBIENT OKABOVEAMBIENT Da BELOW AMBIENT STORAGETEMPERATURE M&AMBIENT DbABOVEAMBIENT ❑ c. BELOW AMBIENT D6 CRYiIDENIC %WT HAZARDOUS COMPONENT (For mi#om or waste only) EHS CAN 1 95.0 hydrocarbons ❑ Ye: ®No 2 5.0 BTEX ❑ Yea ®No ❑ Yes ❑ No 4 ❑ Yes ❑ No ❑Yes No Smoahx"Ah", Po^nu en promise rrt"MrNn I%Ar xelosso YONogls140ee.1%by"East irvmiagmk. tlYA WdlWatelYun ormpm Connotes the wallets! UOemohl. ADDITIONAL LOCALLY COLLECTED INFORMATION If EBCRA Please ago Hen FORM I—SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) CHEMICALINVENTORY (one Ene per maltrinl perbuildin or area) OADD (]DELETE ORLVISE L FACILITY INFORMATION BUSINESS NAME(Seme in FACILITY NAME or DBA—Doing Business Ae) LUBE_N_GO CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL EPCRA DYES ENO FACILITY IV FA0005116 MAN 01 GRID# b-04 (AymryuaonlY) 11. CHEMICAL INFORMATION CHEMICALNAME MOTOR OIL TRADE SECRET Yee No If Subject to EPCRA, refer 0Instructions COMMON NAME MOTOR OIL ENS" ❑Vea ❑No CAS# 64742_54-7 9f EHS be gym", all summers below must be in Ilya FIRE CODE HAZARD CLASSES(ro 11, r Rand by CUPA) Toxic (Tox) HAZARDOUSMATERIALTYPE CIA FIRE ME, MIXTURE 1]e WASTE (GwE ens Uses Only) RADIOACTIVE Dym 1]Na CURIES PHYSICAL STATE 1]n SOLID iH b. LIQUID Oe GAS LARGEST CONTAINER 120.0 (C orwUsynenio END HAi?ARDl CATEGOM� QaFIRE Ob. REACTIVE ❑ c PRESSURE RELEASE �d ACUTE HEALTH �e CHRONIC HEALTH AVERAGEDAILYAMOUNT MAXIMUMDAI.YAMOUNT ANNUALWASTEAMOIRR STATE WASTECODB 388.0 775.0 ONES' Q¢GALLONS Ob,CUBICFEET ❑e PoUNDS 13d TONS DAYS ON SITE:36 ,Mn (CM1eckcgOnly) 'If Risen be lv poaMw .O 5 STORAGE a. ABOVE GROUND TANK D e, PLASTICMONMETALLIC DRAM Oi. FIBER DRUM U mGLASS BOTTLE CONTAINER O Is. UNDERGROUND TANK 0 f CAN (]j, BAG D es PLASTICBOTTLE O q. RAIL CAR 0 u TANK INSIDE BUILDING C6CARBOY (]1:. BOX El a, TOTE BIN 0r. ErGUER 0 d. STEEL DRUM 13 k SILO (] L CYLINDER O p. TANK WAGON STORAGE PRESSURE ® a AMBIENT Cl K ABOVE AMBIENT O c. BELOW AMBOfT STORAGETEMPERATURE ®A AMBIENT Oh ABOVE AMBIENT ❑e BELOW AMBIENT Od CRYOGENIC %WT HAZARDOUS COMMONEST (For mixture or waste only) EHS CAS 1 95.0 hydrocarbons ❑ Yee ®No z 5.0 BTEX ❑ Yee ®No n ❑Yes ❑No 4 ❑Yes ❑No 5 ❑Yes ❑No M mortewNaw coan"Mnvn PSI m pvnv W" 1%er weight nxmlmgNtor o.l%b'Ginu rnnlnmekessen MnYUU Web orwFaTSMv the nmi,,d oam. ADDITIONAL LOCALLY COLLECTED INFORMATION IfEPCRA Pleax Here FORM 1—SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) CHEMICAL INVENTORY on e per material rbuilJin o DADD ODELETE REVISE 1. FACILITY INFORMATION BUSINESS NAME (Same an FACILITY NAME or DBA— Doing Bminessm) LOBE-N_GO CHEMICAL LOCATIC" ' ' ' CHEMICAL LOCATION CONFIDENTIAL EPCRA OYES ONO FACILITY IDN FA0005116 MAPH 0 1 1 GRIDU ... only) (Anwar,d-10 H. CHEMICAL INFORMATION CHEMICAL NAME WASTE ANTIFREEZE TRADESECRET []Yes No usubjert W EPCRA, relay to instructions COMMON NAME WASTE ANTIFREEZE EHS' ❑Yes ❑ No CAS% 107-21-1 •If EHS is •Yee', all amounts below most be in Tbs. FIRE CODE HAZARD CLASSES Icnnplanamsuingby Clroq Toxic (Tox) HAZARDOUS MATERIAL TYPE Qo. PURE I]HMIXTURE ®v WASTE RADIOACTIVE DYea ONo CURIES (Chubs am Yam only) PHYSICALSTATE (]a SOLID ®GLIQUID C!aGAS LAROESTCONTAINER 55.0 (Chwamelmnonly) FEE HAZARD CATEGORIES Da FIRE I]d REACTIVE DePRESSURERELEASH OJ. ACUTE HEALTH aCHRONIC HEALTH (Check BI )apply) AVERAGE DAILY AMOUNT MAXIMUM DAILY AMOUNT ANNUAL WASTE AMOUNT STATE WASTE CODE 83.0 1 165.0 1 675.0 UNITS' 00%GALLONS 0b. CUBIC FEET Op. POUNDS Od TONS DAYSONSITE: am am y mavmt s po STORAGE 0 &All GROUND TANK a PIASTICMONMFr"E DRUM LI i, FWmIRUM U m.OW33 BOTTLE CONTAINER O b. UNDERGROUND TANK DfCAN CIj BAG o. PLASTIC BOTTLE ❑%RAILCAR O c TANK INSIDE BUILDING 1]BCARBOY 131EBOX Bo.TOTE BIN I]c OTHER ❑d STEEL DRUM /]h SR.O DI. CYLINDER OP. TANK WAGON STORAGE PRESSURE ®a AMBIENT 04 ABOVE AMBIENT ❑p BELOW AMBIENT STORAGE TEMPERATURE ®&AMBIENT 13 h ABOVE AMBIENT ❑c BELOW AMBIENT 13 J. CRYOGENIC %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CASH 1 50.0 ant'Ifreeze ❑Yes ®No Z 50.0 water ❑ Yes ®NO 1 ❑Yes ONo ❑Yes ❑No 5 ❑Yes ONO Irmap Ym,rmeennp,,mM1 r,peas m man,&an 1%by mdont lrm, migm4x0.1%hyw,mMVunMyr.tlYr\midimrl OemelpgrnpNAa R, ra,antl mmmm_ ADDITIONAL LOCALLY COLLECTED INFORMATION irEPCRA. Neal SlasNre FORM I —SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) CHEMICALINVENTORY ouc rouse per msteriJ rbuB' OADD ODFIETE REVISE L FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME Or DBA—Doing Business As) LUBE_N_GO CHEMICALLOCATION a rigs CHEMICAL LOCATION CONFIDENTIAL EPCRA OYES ONO FACILITY ID# FA0005116 "�^"� 01 Da'D# (Ayauy�nNyl c_09 H. CHEMICAL INFORMATION CHEMICALNAME WASTE OIL TRADESECRET ❑Yes No If Subject to EPCRA, refer to instructions COMMONNAME WASTE OIL EHS" Oyes ONO CASS 8002-05-9 'If ENS b Wn", JI amouuh blow most Be is Ibs FIRE CODE HAZARD CLASSES oknnA bKr mlmd by CMA) Toxic (TDx) HAZARDOUSMATERIALTYPE D&PURE Ob. MIXTURE MQ WASTE (Geckoncom,only) RADIOACTIVE QYw QNo CURIES PHYSICAL STATE U&SOLID Mb.LIQND On GAS LAROESTCONTAINER 550.0 (CLxk pro Mom only) RED HAZARD CATEGORIES 0e11" Ob, REACTIVE O a PRESSURE RELEASE Md,ACUTEHEALTH N.e CHRONIC HEALTH (Lnakalmmpoph> AVERAGE DAILY AMOUNT MAMMUM DAILY AMOUNT ANNUAL WASTE AMOUNT STATE WASTE CODE 260.0 1 520.0 1 4800.0 221 UNITS" QeGALLONS O&CUBICFEET i3aPOUNDS I36TONS DAYS ONSITE rw 365.0 (Cook now imn only) "IFEH"Mount Mgt be In pounds. STORAGE a ABOVE GROUND TANK D e. PLASTICMONMETALLIC DRUM U LFIBER DRUM Um. GLASS BOTTLE CONTAINER [] E. UNDERGROUND TANK 0LCAN jBAG OnPASTICBOTTLE 0q. RAL CAR 13o-TANKINSHIEBU1LDING DE. CAREOY ]GBOX Do TOTE BIN 0¢OTHER 9 06 STEEL DRUM Oh SILO I. CYLINDER OPTANK WAGON STORAGE PRESSURE 0 e. AMBIENT 0 h ABOVE AMBIENT 0 c BELOW AMBIENT STORAGETEMPERATURE ®a AMBIENT OhgBOVB pMBIBMT O c. BELOW AMBIENT [3 .myOGENIC %WT HAZARDOUS COMPONENT (For miztme BE waste only) EHS CAS # 1 95.0 hydrocarbons ❑Yes ONO 2 5.0 BTEX ❑ Yes ® NO ❑Yes ONO 4 ❑Yes ONO ❑ Yes QNo IfmweM1wNnmmnpnnmbertpeaulurrn,enM1u 1%bywdeY,IM1nn:erchryeelgar0.lM M1ywAyJfnnliq wlgeme MaM,i AM ap AllossbtlneMryuindu ern" n. ADDITIONAL IACALLY COLLECTED INFORMATION If EPCRA, Please Si oHrre �!�I�IiIIIIII��flllllllll �11°° City of Sall WAS OBISPO Fire Department • 748 Pismo St. • San Luis Obispo, Ca. 93401 • 549-7380 000002 20 2274 it-04-BB MISC. 1 490.00 OOiOOi5045070 DAME: CASH '2'TOTAL 1 490.00 SAN LUIS OBISPO, CA 93401 HAS PERMISSION TO MAINTAIN, STORE, USE OR, HANDLE MATERIALS, OR TO CONDUCT PROCESSES, OR TO INSTALL EQUIPMENT AS DESCRIBED BELOW: ALL REQUIREMENTS SHALL BE PER THE UNIFORM FIRE CODE AND ITS STANDARD. THIS PERMIT IS NON -TRANSFERABLE. IT SHALL BE POSTED IN PUBLIC VIEW AND SHALL NOT BE REMOVED - BY ORDER OF THE FIRE CHIEF. AMOUNT PAID: $ EXPIRATICIN DATE I.D. NO. �\ BY: FIRE MARSHAL ul 'In i I it I City Of SM WIS OBISPO ';1 Fire Department • 748 Pismo St.* San Luis Obispo,Ca.934O1 •549-7380 permit ADDRESS; 286 Hlguera - Econo Lube N' Tune DATE: September 30, 1987 B & B Contractors HAS PERMISSION TO MAINTAIN, STORE, USE OR HANDLE MATERIALS, OR TO CONDUCT PROCESSES, OR TO INSTALL EQUIPMENT AS DESCRIBED BELOW: To install I-h50 gallon waste oil tank in accordance with Art1^10 re ALL REQUIREMENTS SHALL BE PER THE UNIFORM FIRE CODE AND ITS STANDARD - THIS PERMIT IS NON TRANSFERABLE- IT SHALL BE POSTED IN PUBLIC VIEW AND SHALL NOT BE REMOVED - BY ORDER OF THE FIRE CHIEF - AMOUNT OF PERMIT: $ EXPIRATION DATE L In. Nn. Paid with check M16265 BY: �/! CITY OF SAN LUIS OBISPO - FIRE DEPARTMENT 748 PISMO STREET SAN LUIS OBISPO, CA 9,401 805/549-7380 IHSFWTION imo m / FORT CZED AT JOBUin 1410. CITY 1 INSK=IONS: Please call for an inspector only When each group of inspections with the sane nU r are ready, They will run in consecutive order beginning with number 1. DO NOT cover work for any numbered group until all items in that group are signed off by the PemStting Authority. Following these instructions will reduce the number of required inspection visits and therefore prevent assessment of additional fees. - TANKS A BACKFILL - INSPECTION DATE TNSPWMR Hack ill of Tank (a) S r Test Cert cation yV?� Ait- ICathodic Protection of Tanks) } - PIPING SYSTEM - Pi i 6 Racewayw eation S i mod- '- Corrosion Protection o Piping, Jo nts, F Pipe �L Isolation or PipiN From Tank(s) _[Electrical Cathodic Protection S taa-Pi U -ZlD - SEOONDARY CONTAINMENT, OVERFILL PROTBCTION, LEAK DLTBCT Liner Installation - Tank(s) -ttzr Liner Installation - Pi i Vault With Product Com ti le Sealer Level Gauges or Sensors, Float Vent Valves Product C tlble Fill Boxes) - Product L ue Leak Detector(s) Leak Detector(s) for Annular S ce-D,W, Tanks) / Monitori Weli'a) Sump(s) Leak Detection Dev ce(s) For V ose Groundwater monitoring veils, caps 6 Locks Fil Box Lock Monitori cements d d P SAN LUIS ODISPO CITY APPLICATION FOR PERMIT TO CONSTRUCT UNDERGROUND HAZARDOUS MATERIALS STORAGE TANK Construct New Tank Modify Existing Tank Transfer of Ownership Operate New Tank In or on the premises at 2� 2C (c PART I OWNER: Mailing Address OPERATOR: Mailing Address: V0, rtN rRfU &WIM-1 CheaM Q'/(61X iel: CONSTRUCTION: (Complete onl if application to construct or modify tank) Company: A107 i4a f er.u�Gzra'2c1. Contact: a Mailing Addres � )j1L b.P— Q klae�aJ spd (f74c Tel: ( ) State Contractor License No.: Construction Start Date: Attach a Plot Plan Showing: (for new construction and modification only) Location of all tanks and piping and & Leak Detection System their secondary containment Overfill Protection System Scale North Arrow Property Line Nearest Intersection or Road rquipmont summary }( see Plumb,YwCl PP -I Orctu)ings ew Equipment If this is an application to transfer ownership or operation of tank, complete following: Previous Owner: Y)wContact: Address: Tel: ( ) Previous Operator: Contact: Address: Tel: ( ) Start Up Date: Date Installed: (for existing tanks ,Deue 10Vrnen f Plan Approved w w `Date of Approval/Disapproval Plan Disapproved _ ��'� Dat nsiructi.en-.Gemplei-ign— Authorizing Agent Signature Return this copy to San Luis Obispo Fire Depl.of FOP 268 SAN LUIS OBISPO CITY APPLICATION FOR PERMIT TO CONSTRUCT UNDERGROUND HAZARDOUS MATERIALS STORAGE TANK PART II DIRECTIONS: Complete one form for each tank being instal led/moddifled. PROPOSED USE OF TANK: lnxAaWxbon I,InAer7"1raind +PCA Y1'I MATERIAL(s) TO BE STORED IN TANK: VOLUME OF TANK IN GALLONS:-roM aQA U.IIL. MANUFACTURER OF TANK!, f r ii� U£p rTL. IF TANK USED PREVIOUSLY: Past Use of Tank: n (?;W -rn rl L Material(s) Stored in Tank: (,tXlS jL,l TYPE OF CONTAINMENT• concrete r7 Fiberglass Q Fiberglass Coated Steel ® Other carbon Sfee-1 Thickness of Primary Containment: JIL on lqi TYPE OF SECONDARY CONTAINMENT OR DRIP -PAN AS APPLICABLE:" Concrete Fiberglass Coated Steel Fiberglass Other Thickness of Secondary Containment or Drip -Pan as applicable: DC)l W-C L.t'1Q 1L PIPING MATERIALS OF CONSTRUCTION: 15� Steel Fiberglass Egj, Other t)(Do"e U_rdtQd (prirhar7) second_o.r) pipe. Describe the leak detection system you plan to use for tank pressure linesoL on s the approximate depth of Attach a certification from the manufacturer, or his authorized representative, of the tank and piping materials as to the capability of the tank and piping material with the proposed stored materials, (This applies onl n=Mot i-CtLlrrl th'iso C VY tdl 2 of 2 <i� P=L9(s ��°spo (=fire Dept, FOP 268 r I .. CITY OF SAN LUIS OBISPO_- FIRE DEPARTMENT 748,PISMO STREET SP*' LUIS OBISPO, CA 934ul 805/549-7380 INSPECTION 1ox= E"LyJEWTT•7lim5 =i � Vd CITY I INSTRUCTIONS: Please call for an inspector only when each group of inspections with the same n r are ready. They will run in consecutive order beginning with number 1. Do NOT cover work for mil numbered group until all items in that group are signed off by the permitting Authority. Following these instructions will redure the number of required inspection visits and therefore prevent assessment of additional fees. TANKS & BACKFILL - INSPECPION OATS TNSPFr`IY1R il Back l Tank(s) S r Testof certitication Cathodic Protection of Tank(s) PTPTNG SYSTEM — Piping & Raceway W/Collection Sump Corrosion Protection or Piping, joints, E ectr ca Ism ation Of PipiFrom Tank(s) Ca c Protection systen-pxping INIMP&ROW>M e". Liner Installation - Tank(s) Liner Installation - Pipin Vault With Product Can t b e Sealer Level Ga ea Or Sensors, Float Vent Valves Product C tib a III sox (ea) Product Line Leak Detector(s) Leak Detector(s) forAnnujar Space-D.W. Tank(s) Mon for Wells) S (s) LeaK Detect on Device(s) For V ose Groundwater C31#W.Tom Monitoring Wells? Caps & Locks Fill BOX Lock Monitoring Recjuirsnsots CONTRACTOR LICIIIBE CONTACT. PH # „� >, > I” -� � �- �„ ,' PACIFIC GEOSCIENCE. INC. Geolechnical Research and Engineering Materials Tealing Laboratory M BUCKLEY RO. IrWI sa-M SAN WIr OBISPO, CA PWI September 15, 1986 Econo Labe N' Tune Attn: Mr. Larry Bell 4911 Birch Street Newport Beach, CA 92660 SUBJECT: PRELIMINARY SOILS ENGINEERING INVESTIGATION OF ECONO LURE N' TUNE SITE, 286 HIGUERA STREET, SAN LUIS OBISPO, CALIFORNIA. G2492 This report presents the findings of a Preliminary Soils Engineering Investigation performed by this firm at the above referenced site. It is our understanding that a single story structure with block walls up to 18 feet in height and a slab -on -grade are proposed. The building will encompass 2556 square feet and 9 parking spaces will be provided. A tube pit extending 7 feet below finish floor elevation is planned. The Preliminary Sails Engineering Investigation was based on a preliminary site plan provided by the client in August, 1986. The report and recommendations are intended to comply with the considerations of Subsection c of Section 2905, Chapter 29, Subsection e of Section 7006, Chapter 70, Uniform Building Code 1985 edition, and standard soils engineering practice. Recommendations for site preparation, earthwork, foundations, slabs, and pavement sections are presented to 0 guide the development of project plans and specifications. It is requested that final plans be reviewed by this office to ensure Conformance wim me intent e of this repoft if changes in project plans become necessary, or if conditions are encountered that differ significantly from those anticipated, the soils engineer shall be consulted prior to construction. Analyses of erosion potential, erosion mitigation, potential for flooding, and the corrosive potential PACIFIC GEOSCIENCE, INC. Lube N' Tune, G2492 2 September 15. 1986 of soils u➢on underground utilities are beyond the scope of this investigation. SITE DESCRIPTION The 256 x 56 foot rectangular shaped site is located on the west side of Higuera Street in the City of San Luis Obispo, California. The property is relatively level and partially paved. It is our understanding that a building which occupied the site was demolished and removed prior to this investigation. The adjoining lot to the north is developed with an older building, Bianchi Lane is to the south and San Luis Creek lies immediately to the west. A block retaining wall extends along the north property line. The wall, which retains soil on the subject lot, varies in height from 1 foot near the center of the lot to 5 feet at the northwest corner. An evaluation of the structural integrity of the wall is beyond the scope of this report. The majority of the site is presently paved with A.C. The site is free of vegetation with the exception of two pine trees on the north property line and vegetation on the creek bank. Some minor amounts of fill have been placed at the top of the creek bank. The creekbankis estimated to be 15 feet in height with slones up to 50%. A 5 foot diameter concrete storm drain discharges into the creek near the southwest corner of the lot. The drain appears to cross the property in a northeast direction, beneath the proposed parking area. Location of the culvert was not indicated on plans provided by the client. FIELD AND LABORATORY INVESTIGATION On September 2, 1986, three borings were drilled on the site in the locations shown on the attached site map, Appendix A. A Mobile B53 drill with an 8 inch diameter continuousflight auger was employed to explore subsurface conditions to a maximum depth Or ec . Soils encountered were visually classified and logged in accordance with the Unified Soils Classification System; please refer to Appendix B for copies of the Boring Logs. As the site was drilled, Shelby thin tubes lined with a low shear strength, s microcrystalline wax were employed to retrieve four undisturbed soil samples. Locations PACIFIC GEOSCIENCE, INC. Lube N' Tune, 02492 3 September 15, 1986 and depths of the samples are noted in the left column of the boring logs. Representative surface soil samples were also collected at this time. In all 3 borings, Standard Penetration tests were performed at various depths. The Standard Penetration test is performed using a 2 inch (outside diameter) by 2 foot long split -spoon sampler attached to a 140 pound drop hammer. The hammer is repeatedly dropped from a specified height, driving the sampler into undisturbed soil. The number of blows, by the hammer, required to drive the sampler (in 6 inch increments) is recorded and used in empirically assessing a variety of soil and rock parameters. Standard penetration data is recorded in the second column from the left on the boring logs. To assess the bearing capacity of the soil, three of the undisturbed soil samples were tested for consolidation under normal loads in accordance with ASTM D2435-80. The results of these tests are presented as void ratio vs. pressure diagrams in Appendix C. An expansion index test was conducted on a representative sample of material. A description of the test and the test results can be found in Appendix D. Due to the cohesive nature of GENERAL SOIL PROFILE The subsurface profiles at the locations drilled were somewhat variable near the surface, becoming more uniform with depth. In Borings 2 and 3, 2.5 inches of A.C. were encountered above 4.5 to 6 inches of gravel base material. In Boring 1, a gravelly, rubble fill with a sandy clay matrix was encountered to a depth of 3 feet. In Boring 2, a somewhat cleaner gravel fill with occasional cobbles up to 6 inches in diameter was encountered to a depth of 2.5 feet. In Boring 3, a mottled sandy clay fill was encountered to a depth of 2.5 feet. Below the Lill, conditions were relatively uniform in all 3 borings. Native sandy silt and clayey silt was encountered from the base of the fill to a maximum depth of 9 feet where a transition to a dark brown to black sandy clay occurred. The sandy clay became brown in color and increasingly snndy with depth. Sandy soils PACIFIC GEOSCIENCE, INC. Lube N' Tune, G2492 4 September 15, 1996 predominated the profile in Boring 1 from 16 feet to the termination of the boring at 31.5 feet, and were encountered in Boring 3 from 15 feet to the termination of the Boring at 16.5 feet. The fill material was in a varied state of compaction. The native sandy and clayey silts were moderately stiff, the sandy clay stiff to very stiff, and the deeper sandy soils loose to moderately compact. The moisture content generally increased with depth. Subsurface free water was encountered in Boring 1 at depths of 18 feet and 23.5 feet and in Boring 3 to a depth of 16 feet. A piezometer was installed in Boring I to a depth of 34 feet. No subsurface water was encountered in Boring 2. No bedrock was encountered in any of the borings. CONCLUSIONS The site is suitable for the proposed commercial building provided that site development is in accordance with the recommendations presented herein. The exploratory borings revealed 2-3 feet of sandy clay and gravel fill material overlying cohesive native soils with sands predominating below a depth of 15 feet. No bedrock was encountered. The fill was in a varied state of compaction while the silts were moderately stiff, the clays stiff, and the sands loose to moderately compact. Free subsurface water was encountered below the depth of the proposed development. The field and laboratory test data indicate variable materials and conditions near the surface with some soft zones at depth. The primary concerns from a geotechnical standpoint will be to obtain uniform conditions within the fill and to accommodate the expansive nature of the soil. This can be accomplished with an earthwork program which will a outlined to th following section. The expansion index sample was taken from the sandy clay fill soil encountered in Boring 3 from a depth of 9 inches to 2.5 feet. The expansion index test yielded a value of 46, which is indicative of a soil with a low to moderate tendency toward expansion. PACIFIC GEOSCIENCE, INC. Lubc N' Tune, G2492 5 September 15, 1986 Expansive soils tend to swell with seasonal increases in soil moisture and subsequently shrink as soil moisture is reduced during the drier months. As such seasonal volume changes in the soil can stress acid damage slabs and foundations it will be necessary to incorporate precautionary measures into the construction process. Current engineering practice is to provide a deep perimeter foundation that extends below the expansive soil zone, and to protect slabs either by presaturation of sub -slab soils or by placement of a layer of non -expansive material beneath the slab. No R-Value (resistance to deformation under repeated loads) was performed due to the clayey nature of the soils. As even a moderate amount of fine particles within a soil render the R-value low, pavement sections have been developed using an estimated R-value of 10. They nre presented in a later section of this report. The existing paving appears to be relatively intact and may be overlain in accordance with the recommendations presented in the following section. In view of the variable soil types and states of compaction within the upper several for re -working the on -site soils which are considered cohesive and somewhat expansive. The second for imported non -cohesive, non -expansive fill. RECOMMENDATIONS - COHESIVE SOILS Site Preparation: The site shall be stripped of all organic and deleterious materials as described in Appendix G. Any voids resulting from the removal of tree roots, stumps, or other subsurface items shall be promptly backfilled and compacted to a minimum of 90% relative compaction. Immediate`backfilling is recommended to avoid losing the precise shall be removed or relocated outside of the proposed building areas. Portions of the existing block retaining wall which lie within the building footprint shall be removed. PACIFIC GEOSCIENCE, INC. Lobe N' Tune, G2492 6 September 15, 1986 It is recommended that the exact location of the storm drain culvert be determined prior to commencement of earthwork. Earthwork: The entire area within and extending a minimum of 5 feet beyond the foundation envelope shall be excavated to a depth of 18 inches below finish slab excavation. The excavated material shall be stockpiled. All deleterious material which doe not meet the earthwork material: requirements set forth in the appendices shall be removed. Excavations shall not extend onto the adjoining property to the north. The entire cut area shall be scarified to a depth of 12 inches and recompacted to a minimum 90% relative compaction. The on -site, stockpiled materials or if imported cohesive soils will be used as fill they shall be placed in lifts not exceeding 8 inches and recompacted to a minimum 90% relative compaction. If imported granular fill soils are used, they shall be placed in lifts not exceeding 12 inches and compacted to a minimum of 95% relative compaction. This program shall apply to soils within and extending a minimum of 5 feet beyond the foundation envelope. Compaction requirements for soils beneath paved areas may differ and are presented under Pavement Sections later in this report. To facilitate compaction, it is suggested that soil moisture be adjusted to within 3% of optimum prior to receiving eompactive effort. Soil moisture should be uniform throughout soils to be compacted. The contractor shall be aware that obtaining compaction in this type of soil may be difficult if earthwork is attempted when soil moisture is high, particularly during or following the wet season. Please see Appendices H through 7 for additional criteria for cohesive soils earthwork. expansive soil condition, all perimeter footings and interior spread footings shall extend a minimum of 21 inches below lowest adjacent grade; interior continuous footings may be per U.B.C. requirements. Minimum reinforcement shall consist of #4 bars top and bottom or PACIFIC GEOSCIENCE, INC. Lubc N' Tune, G2492 7 September 15, 1986 as directed by the structural engineer. Foundation design shall be based upon maximum soil bearing values of 1000 Dsf dead load and 1500 psf dead plus live. The bottoms of the footings shall be horizontal and stepped as necessary to accommodate the slope. The foundation along the northern property line shall function as a low retaining wall. —-- Slabs: Slabs shall have a minimum thickness of 4 full inches and shall be reinforced with #3 bars placed 18 inches on center each way. Slabs shall be tied to the interior and exterior footings by the use of dowels spaced 1B inches on center each way. The dowels shall hook over the outside of the upper stemwall horizontal rebar, extending vertically to 3 inches above the bottom of the footing, and a minimum of 3 feet horizontally into the slab. Rebar is recommended for slab reinforcement rather than wire mesh due to the expansive soil condition. Please note that these are minimum requirements only and may be superseded by the structural engineer. Presaturation of sub -slab soils is one method that may be used to protect against prior to construction of the slab; the casting of the slab then seals the moisture in, thus breaking the swell -shrink cycle. The procedure is performed after the foundation is cast, but prior to the casting of the slab. Moisture content shall be adjusted to 130 percent of optimum to a depth of 27 inches below lowest adjacent grade and tested. by the soils engineer. Once adequate saturation has been achieved, the moisture content shall be maintained until the slab is cast. With presaturation, a better work surface can be obtained by using clean.gravel (such as flontrock or 3/4 x 04) as capillary break material. A minimum.6 inch thickness of clean gravel beneath the slab will provide a stable work surface and will act as a barrier against infiltration of subsurface moisture. If preferred, four inches of clean sand with a vapor barrier sandwiched in the center can be substituted for the gravel. PACIFIC GEOSCIENCE, INC. Lube N' Tune, G2492 8 September 15, 1986 As an alternative to presaturation, 18 inches of non -expansive material can be placed beneath slabs. The non -expansive import is defined as a granular material exhibiting an expansion index of 20 or less and shall be placed in horizontal lifts having a maximum depth of 12 inches. A minimum of 95% relative compaction shall be obtained. If this alternative is preferred, provisions to allow for the 18 inches of import must be incorporated into the grading plan. The upper portion of the non -expansive material shall be 4 inches of clean sand, with a vapor barrier at the mid -section, or 6 inches of clesn gravel. To protect patios, walkways, etc., from damage due to expansive soils, a minimum 8 inch thickness of non -expansive material placed beneath such flatwork is recommended. A third option is the use of post -tensioned slabs. If further discussion of this method is desired, please contact this office. RECOMMENDATIONS - NON -COHESIVE SOILS Site Preparation: Same as for cohesive soils. Earthwork: The entire area within the building envelope and 5 feet beyond (except along elevation. All excavated cohesive and deleterious materials shall be removed from the site. The entire cut area shall be scarified to a depth of 12 inches and recompacted to a minimum of 90% relative compaction. The excavation shall be. filled with non -cohesive, non -expansive import placed in 12 inch lifts compacted to a minimum 95% relative compaction. Compaction requirements for soils beneath paved areas may differ and are presented under Pavement Sections later in this report. To facilitate compaction, it is suggested that soil moisture be adjusted to within 3% of optimum prior to receiving �airrhramrraarnt�.�rnrnrmanrr,a�tuanr.� sratrrion::>•rrrmw nan�.3ms�ra:r;.nm:m.� rr. � Please see Appendices K through M for additional earthwork criteria for non. cohesive soils. Foundations: Continuous and spread footing foundations may be used for the proposed PACIFIC GEOSCIENCE, INC. Lobe N' Tune, G2492 9 September 15, 1986 buildings. Continuous footings and column pads shall have a depth of 18 inches below lowest adjacent grade. Minimum reinforcement shall consist of #4 bars top and bottom; the structural engineer may supersede this as necessary. For 'nn design shall be based upon maximum allowable soil bearing values of 1200 psf r' -Q00 psf dead plus live loads. Along the northern property line the.f- p'�\ m \c; jr 21 inches '6 xy below lowest adjacent grade. The foundatlr o %�o o � all. Slabs: Slabs shall have a minimum thidd°,y�.a� oe reinforced per normal U.B.C. requirements. The sl• a�,��3b�® .mum of 4 inches of `�wa�a x� granular cushion material, i.e., a S' � $�c� .ed at the midsection of the sand is recommended to a infiltration of subsurface moisture. Care shall be taken to p, barrier, particularly around utilities, and to protect it from damage .ossible during construction. if preferred, six inches of clean gravel capillary br, material can be substituted for the grand ned vanor harrier. Please Dote that these are minimum requirements only and that addition slab thickness and reinforcement may be required by the structural engineer. Drainage: The sites shall be graded to direct surface runoff away from foundations at a minimum 2% grade for a minimum distance of 5 feet. Runoff from roof gutters, downspouts, etc., shall discharge in a non -erosive manner away from foundations and other improvements in accordance with the requirements of the City of San Luis Obispo. Under no circumstances shall uncontrolled runoff be allowed to discharge over the face of the creek bank. Stabilization of disturbed soils by vegetation or other means during and Concrete Paving Design: For concrete paving over reworked, cohesive soils, an estimated modulus of subgradc reaction of 150 pounds per cubic inch may be used for design purposes. For concrete paving over imported, non -cohesive soils, an estimated modulus of PACIFIC GEOSCIENCE, INC. Lobe N' Tune, G2492 10 September 15, 1986 subgrade reaction of 250 pounds per cubic inch may be used for design purposes. A 6 inch thick reinforced concrete slab overlying 6 inches of compacted Class III Base as per San Luis Obispo Parking and Driveway Standard 2110 may be used in lieu of an actual concrete paving design. Aspb.nt Coneretg Pavement Sections: The following pavement sections are based on an estimated R-value of 10 for, the native cohesive soils. The sections calculated are for Traffic Indices (T.I.) of 4.0 and 5.5. If heavy vehicles such as garbage collection trucks will be using certain areas, it is recommended that pavement in these areas be designed using the higher T.I. or that concrete aprons be provided. Additional sections based on different traffic indices or different proportions of asphalt and base are available and can be furnished upon request. R-value Traffic Index A.C. Class II Base Class ITT Base 10 4.0 2" all - 10 4.0 2" - 9" 10 5.5 2" 13" - 10 5.5 3" - 12" Native soils shall be competed to a minimum depth of 24 inches below the top of pavement in areas having a T.I. of 4.0. or to 30 inches in areas utilizing the higher T.I. A minimum of 90% relative compaction shall be obtained. Base material shall be compacted to a minimum relative compaction of 95%. Compaction testing shall be conducted in accordance with ASTM D1557 and ASTM 2922-78 or other methods acceptable to the soils engineer. In addition, the pavement shall comply with the recommendations presented in Appendix N. Pavement, curbs, and gutters shall be constructed in accordance with the City of San Luis Obispo Standards. To provide maximum stability for curbs, fills shall be extended to,a minimum of 2 feet beyond the edge of the curb. PACIFIC GEOSCIENCE, INC. Lube N' Tune, G2492 11 September 15, 1936 Pavement longevity will be enhanced if the surface grade drains away from the edges of the pavement. Pending of surface water against the upslope sides of curbs is undesirable and should be avoided by proper grading of swales in areas where no sidewalks are planned. The existing pavement appears to be relatively intact and a reasonable lifespan may be assumed with a 2 inch A.C. overlay. If significant damage occurs during construction, it may be necessary to replace the entire section. The soils engineer shall verify the pavement condition prior to an overlay. Labe Pit Retaining Wall, The footing for the lube pit retaining wall shall extend a minimum of 21 inches below lowest adjacent grade. The retaining wall shall be designed using the following values: Maximum toe pressure: 2000 psf Active pressure: 60 pcf Passive pressure: 240 pcf Coefficient of Sliding friction: 0.25 All pressures presented assume a horizontal retained surface with a native cohesive soil backfill and no surcharge. If a non -cohesive granular backfill, extending at a 1:1 (horizontal to vertical) slope from the base of the wall is used, an active pressure of 35 pcf and an at rest pressure of 50 pcf will apply. If the above criteria does not meet the design parameters, the soils engineer shill be contacted. Please note that no factor of safety has been incorporated into the above soil pressures. Although no subsurface water was encountered in the exploratory boring drilled in the area of the lube pit, installation of a sump and a sump pump is recommended for dewatering purposes. ' It must be recognized that the recommendations contained in this report are based t PACIFIC GEOSCIENCE. INC. Lube N' Tune, 02492 12 September 15, 1996 on a limited number of borings and rely on continuity of the subsurface conditions encountered. The soils engineer shall therefore be retained to interpret this report during construction and to provide construction monitoring in the form or testing and inspection. If the soils engineer is not retained to provide such testing and inspection the recommendations contained herein shall be null and void. Furthermore, it is the responsibility of the owner, contractor, or. project manager to contact the building official to determine what, if any, certification shall be required and to contact this firm so that the inspection program may be discussed and key inspection items outlined. The above must be accomplished prior to beginning earthwork. This report is valid for conditions as they exist at -this time for the type of development described herein. If changes with respect to building type or location become necessary, or if items not addressed in this report are incorporated into plans, the soils engineer shall be notified for modifications to this report. This report shall be used in its entirety, with no individual sections reproduced or used out of context. The client shall be aware that this report was prepared prior to city approval of a grading plan or specific building plans and as such may be subject to modification. Please note that the program presented herein is one of several possible approaches to development of the property. If discussion of alternate concepts or modification of recommendations is desired, please feel free to contact this office at your convenience. Thank -you for this opportunity to have been of service. PACIFIC GEOSCIENCE, INC. REVIEWED BY., /pAOFESS ROD MOnle, Jlaf 1 VeQlQgls1 ; IMS/RM.mm LUBETUNE.SEI Na. 33563 PACIFIC GEOSCIENCE, INC. Appendix A 5 bErfln u� 5f0 i2M 5' atw t;�GpNO WriE N, TUNE U-"z192 Hi6n rZA Sl SA o. !� Or t?,N6/ LOCA'nON5 LounoO OF r3oi�ow(- r;rab bossy, i2�MoJE9. k i! W z d I wf3E f/�r HIG-U59A 51- ' Rxrnw�^�cr W ALL i I MI cem q (:3JIL-01lJ it Lo Gh n o" PACIFIC GEOSCIENCE, INC. Geoleehllllyd 12caearclr and Engineering Niulerluls Testing LabGralory 3%BUCKLEY RD. (Ws) se -.me LOGGED BY: R.M. SAn LGir OBISPO. cn 9W' DRILL: B-53 Appendix B DIAMETER: B" FILE: G8 2792 DATE: 9-2-86 BORING NO. 1 ECONO LUBE N' TUBE Depth SAMPLES STANDARD MOISTURE SOIL DESCRIPTION EN og` Moderately compact, brown GRAVELS(GW) slightly Moist ;too-; cohesive, slightly plastic with SANDY CLAY 1 0 0. o matrix; asphalt concrete and concrete — — — — Very fragments to 6" diameter (FILL) 2 Moist . �a:o� o .O 3 Slightly Moderately stiff, gray -brown SANDY SILT (ML) Damp moderately cohesive, slightly plastic (NATIVE) 4 5 6 Moderately stiff, gray -brown CLAY SILT(ML) moderately_csive,oderately plastic ohe 7 -- SPT -- _ _ _ _ _m stiff B 9 TUBE 19" Very Very stiff, black SANDY CLAY(CH) highly y Moist cohesive, highly plastic SPT 5,9,7 11 12 13 Slightly Brown moderately cohesive, moderately plastic 14 Damp increasing in sand content 5PT 41929 16 Damp Moderately compact, brown SILTY SAND(SM) 17 slightly cohesive, non -plastic, very fine to course graned with occasional gravels to 1/2" 0 diameter .' Wet 19 20 LOGGED BY: R.M.- PACIFIC GEOSCIENCE. INC. FILE: GW2792 DRILL: B-53 DATE: 9-2-86 DIAMETER : 8" (cont.) ECONO.LUBE N'.TUBE < W Moisture SOIL DESCRIPTION 1 Slightl Very stiff, brown SANDY CLAY(CH) highly Damp cohesive, highly plastic 22 23 24 Wet Moderately compact, brown CLAY SAND(SC) slightly cohesive, non -plastic with gravels 2 to 1" diameter GRAB 26 27 28 — — —— ------------ pq Loose, increasing in sand content GRAB 31 3'. END OF BORING @ 31.5' Subsurface water encountered @ 18' & 23.5'. 33. Piezometer installed to 34'. 34 35. 37 33- 39. 40 ss Is NOTE: This log or subsurra Ce conditions is a slmplirica Clon UT aL[uai Co11UILIwlc encountered. It applies at the location and time of this excavation. Subsurface conditions may differ at other locations and times. LOGGED BY: R.M. DRILL: 8-53 DIAMETER: 8" PACIFIC' GEOSCIENCE. INC. Geoiet-knival RraeDreh anti Engineering Ntocriala l'ealing Laboratory At aucas.er AD. (rs) ra-ma CAN IW r D515", CA qw) FILE: GR 2792 DATE: 9-2-86 BORING NO. 2 .: ECONO.LUBE N'. TUBE c,,th SAMPLES STANDARD MOISTURE SOIL DESCRIPTION 2.5" Asphalt Concrete with 4.5" Very Compact, gray and brown GRAVELS(GMoist ,r}F�, J�base1 non -plastic th occasi2�oi'3 to Very Moderately stiff, gray -brown SANDTUBE 14" Moist moderately cohesive, slightly pla a SPT 1,3,3 6 7 _ — — — - _ -_ — — _ _ — _ Slightly _ _ _ _ _ _ _ _ _ Moderately stiff, gray -brown CLAY SILT(ML) 8 Damp moderately cohesive, moderately plastic 9 Very Very stiff, gray -brown SANDY CLAY(CL)highly 1. Moist cohesive, moderately plastic SPT 4,8,11 fl 12 13 -. _ _ _ _ _ _ _ _ — — _ _ — — — — — — — — — — — — Damp Stiff, brown, moderately cohesive, moderately 14 plastic, increasing in sand content g _ _ SPT 3,5,6 16 17 END OF BORING 0 16.5' No subsurface water encountered. t0 19 20 PACIFIC GECISCIENCE, INU. Geol,•vhnirnl ReBeareII and Engineering NialeriQIB 1'eeling L&6oralory m, BURLEY no. (ns) W JZ?6 LOGGED BY: R.M. Ben LUIS OB,r*o, CA BHBi DRILL: B-53 DIAMETER: 8" FILE: GN 2792 DATE: 9-2-86 BORING NO. 3 ECONO LUBE N' TUBE Depth SAMPLES STAPNDARD MOISTURE SOIL DESCRIPTION EN 2.5" As halt Concrete over 7" base Very Stiff, dark brown SANDY CLAY(CL) moderately 1 Moist cohesive, moderately plastic with gravels to 1/2" diameter (FIEL) 2 'NBE 8" 9 Very Moderately stiff, brown SANDY SILT(ML) Moist slightly cohesive, slightly plastic. with a occasional gravels to 1" diameter(NATIVE) 5 Very Moderately stiff, gray -brown CLAY SILT(ML) TUBE 13' Moist moderately cohesive, moderately plastic with s occasional gravels to 1" diameter SPT 2,3,5 7 Very Stiff, dark brown SANDY CLRY(CL) highly Moist cohesive, moderately plastic e 9 SPT 4,6,8 it __ -___ __--__` -___ Slightly Brown, moderately cohesive, moderately 13 Damp plastic, increasing in sand content 14 15 16 SPT_ 59122 a Damp non -plastic, very fine to very course to 1/2" _ _ _ grained with occasional gravels Net r diameter 17 " END OF BORING @ 16.5' 18 Subsurface water encountered @ 16'. 19 20 PACIFIC GEOSCIENCE, INC. Appendix C VOID RATIO VS. PRESSURE DIAGRAMS Void ratio vs, pressure diagrams depict the consolidation characteristics of the examined samples to normally applied loads. For this test, a specimen is carved from an undisturbed sample at the 2.8 inch Shelby tube diameter to a 2,5 inch diameter by one inch thick test sample. The test sample is placed in a consolidometer where it is loaded normally and restrained horizontally. Its consolidation is measured to within 0.0001 inch. Each sample is loaded past the point of precompression, if any, to establish the virgin compression curve. The apparatus procedure and report format of each consolidation test follows the ASTM Standard D2435-80, with the exception, of certain procedures modified for the specific project requirements. The results are presented in graphic form on the succeeding void ratio vs. pressure diagrams. VOID, M71O 1.]S V01O MTIO V5. NOIM4L p=SLM DIA N .......... PJWJEC1': EO" LOOE N' TI8V0 DATE: 9-I3•88 WOIN'.. NO.: R 092. S--3.5 MY SOIL: DU BROM SANDY My OGISITY: 00.9 PCP 1. 00 V2 pEN51'IY! 85.5 Pa 8gISjuR C2NYD : 10.'� I.20 1.15 1.05 VOID MTIO VS. N %L MMSSU DJA W.1 MO9ECf EOOW LURE N' TL9JG MTC: 9-15-60 6 INO ND.: 0 02-5' SOILt 61R1: WMW SAtmY CLAY r MY p SITY: 109.4 P WE! D S1 TY: 11'I.0 FC AD16'MIE OONI'EM': I�.956 VOID MTIO .65 0. 60 0.55 0.50 0.45 1000 ID. 000 100.000 ! 9 NONMAL Pl1ES5URE--KC/M 1yE/FT ) ISDAI-LOCARI TIM IC SW.E) VOID PATIO vs. N Al, IW]55L5iL LlvA l ------------------------------- _______ MIDI LCI': occvO LUM N' '1'49B IN'1'Ci: 9-15-99 1ojI W.: 0 05-G' SOIL: MM OMN SAd CIA ❑tY OpdS.rm- 92.5 FU WCf O ITY: 110.9 P WIMl . COIVRXI': 20. 91G volD mrio 0.50 1000 10,000 (905) (00501 3 9 NDfC�W. PRESSOR[--KG/M (LB/Ff ) (SWI-LOGY I1 IC SCALE) PACIFIC GEOSCIENCE, INC. Appendix D EXPANSION INDEX The expansion index value for a given soil is determined in accordance with the procedure of Uniform,,Building Code Standard No. 29-2. The numeri- cal value relates to the soils characteristic of rapid volume chance upon saturation with water. The higher the index value, the more the soil will swell with increased moisture content. The referenced procedure begins with a soil sample at 50 percent satura- tion (assuming a specific. gravity of 2.70), which is loaded with a surcharge of 145 pounds per square foot. The sample is allowed to absorb water for about 24 hours, at which point the change in volume is determined. Sample Depth Expansion Index 1-2' 46 PACIFIC GEOSCIENCE. INC. Appendix E RECOMMENDATION SCOPE Recommendations contained herein are considered minimum guidelines to allow for the preparation of the development of plans in accordance with stan- dard soils engineering practices. The owner, architect, engineer, and/or governing governmental agencies may have other requirements. If these addi- tional requirements have the effect of lessening or negating the intent of the recommendations contained herein, the soils engineer shall be consulted for modification of this report so that its overall integrity is maintained. Conclusions and recommendations contained within this report are profes- sional opinions made in accordance with accepted soil and foundation engineer- ing practices. These opinions have been developed using the observed soil pro- files in test borings and laboratory test results of the acquired soil samples at the bases of formation. Similarity of soil type and engineering character- istics has been supposed. Soil. eggineering solutions other than those discussed within this report may be possible for problems peculiar to this site. Discussion of such con- cepts is encouraged. The use of locally obtained materials, construction equipment, and construction techniques is usually a primary objective in order to minimize improvement costs. The proposed grading and foundation plans shall be reviewed prior to mendations have been incorporated. Prior to construction, there sna ii oe an on -site conference between the grading plan engineer, foundation design engineer, owner, general contractor, earthwork subcontractor, soils inspector, and soils engineer for the purpose of reviewing the intent of construction documents with respect to the planned earthwork program. PACIFIC GEOSCIENCE, INC. Appendix F QUALITY CONTROL 1.00 Toe grading operation shall be completed with the knowledge of the soils engineer. To reduce the potential for misunderstandings, the earthwork contractor and soilsengineer shall review the grading plan, recommendations of the soils report, and the intended grading approach prior to commencing work. The soils engineer shall perform a site inspection after stripping and before compaction. If unusual conditions are exposed during the initial earthwork, direction for treatment will be given at that time. 2.00 The soils engineer shall provide sufficient inspection and tests during the grading operation to verify that a uniform and acceptable condition exists when work is completed. 3.00 Unless otherwise designated, the inspections shall -be at random times and when requested by the contractor or owner. 4.00 ''Compaction tests shall be obtained in each material, with a minimum of one test per soil type. The degree of compaction in scarified soils shall be determined prior to placing more than one foot of additional fill material. Engineered fills or backfills shall have a minimum of one compaction test per 18 inch additional thickness, or one compaction test per 1,000 cubic yards, whichever results in the greatest number of r IL_ • lnnut ♦hraa rmmnarti.nn tests shall be obtained at any one visitation. 5.00 Compaction results shall be obtained prior to placing more than three or five feet of clay or sand material, respectively, in any given location although increased testing may be desired at the contractor's option to decrease potential earthwork resulting from poor compaction values. 4 1 PACIFIC GEOSCIENCE, INC Appendix G 517E PREPARATION 1.00 Procedure: 1.01 All fill areas shall have existing organic material removed. Organic material may be either surface or subsurface. This m3teri- al shall not be used in any engineered fill. Other deleterious substances, foundations, etc., shall be removed from the applica- ble areas. Those items leaving a large void shall be promptly backfilled with compacted on -site material at the time of removal. Prompt backfilling of such areas is essenti.al so that the precise location of the void is not lost. 1.02 Existing underground utility lines which are not going to serve the the proposed structure shall either be relocated outside the build- ing area or abandoned. Abandonment of such lines shall require that the lines be removed from the building area and cappedoff at a minimum of ten feet outside the building area in such a manner that the lines are not capable of transmitting water or other potentially harmful materials to the soil beneath the building. Such abandonment shall be completed with the knowledge and in accordance with the recommendations from the represented utility company. 03 While no evidence of old septic tanks, abandoned wells, or other such subsurface features were apparent, IT is pO5S101e cnaL uiey may be present and discovered during the earthwork operation. If found, they shall be brought to the attention of the soils engi- neer so that recommendations may be given concerning their dispos- al in order that no future hazards remain. 2.00 Definitions: 2.01 A fill area is defined as that horizontal surface area to receive fill and extending a minimum of five horizontal feet beyond the limits thereof whgre soil, gravel, aggregate base, and/or other materials are/is fo be placed with the objective of raising the 'subgrade elevation to the desired level from the bottom of an excavation or from the.existing surface. Where the fill is to be rigid boundary, the limits of the fill area shall be defined by such boundaries. 2.02 Organic material is considered to include grasses, bushes, trees, tree stumps, tree roots over three inches in diameter, or similar deleterious materials. COHESIVE MATERIAL APPENDICES H, I, J PACIFIC GEOSCIENCE INC. Appendix H EARTHWDRK MI ERIALS 1.00 All fill material shall be approved by the soils engineer. Qualities of proposed fill material shall include, but not be limited to, the capa- bility of being compacted in a uniform manner. Unsuitable material shall include such materials which are excessively wet, excessively dry, or containing deleterious substances which would be deemed unsuitable by the soils engineer. The on -site soils are considered suitable as fill material, although the moisture content may have to be adjusted. 2.00 Select, non -expansive material shall be approved by the soils engineer. Qualities of such material shall include having a granular nature, con- taining no organic matter, having the majority of the material exhibit a maximum particle dimension of three inches after being compacted, and an expansion index of 20 or less as determined by the procedures outlined by .Uniform Buildirt inLode Standard 29-2. There• shall be sufficient binder present to matain vertical sidewalls while trenching for foot- ings and the like. 3.00 Capillary break material is also considered non -expansive and shall com- prise the upper four to six inches of material directly beneath the building slab on grade. It shall have less than 4 percent passing the #200 sieve and a maximum particle size of one inch. Typical materials that conform to this requirement include concrete, sand, pea gravel, c:,i --.,d .,,le&nArca annranatp. and liohtweiaht shale rock locally termed "floatrock." The use of moisture membrane placed about mid -depth of the capillary break material would be considered good prac- tice when the finer capillary break materials are utilized. When the coarser rock or gravel materials are utilized, considerable penetration erd tearing of the membrane usually occurs. 4.D0 Utility trenches within the building area shall be backfilled with a clean sand capable of being readily compacted with minimum effort. The following specifications usually define such a material. Sieve Size Percent Passing 1n'1 1Do #200 0a PACIFIC GEOSCIENCE, INC. Appendix I EARTHWORK EQUIPMENT 1.00 To ensure uniformity of compaction throughout the site, all site work the shall be compacted by the use of a compactor conforming to one of following descriptions. 1.01 A vibrating compactor having a drum diameter of not less than three feet. The roller shall consist of a single drum with at least one tamping foot per 100 square inches of drum surface. The area of each tamping foot shall be at least six square inches and less than ten square inches.. The face of each tamping foot shall be at least four inches and no more than eight inches from the drum sur- face. The entire compactor shall weigh at least 3,000 pounds. Equipment meeting this recommendation is locally termed "vibrating sheepsfoot." A vibrating sheepsfoot shall not be used within 5' of existing buildings. 1.02 An approved, self-propelled, segmented foot compactor. 1.03 Aggregate base material shall be compacted with a steel -wheeled flat roller or flat vibrating plate having sufficient weight to adequately compact the material uniformly and to the specified density. 1,04 Earthworking equipment such as bulldozers or front-end loaders on rubber tires or steel tracks may be used on fills not exceeding 3' in depth. PACIFIC GEOSCIENCE, INC. Appendix d EARTHWORK PROCEDURE 1.00 All fill, fill material, scarified soils, and import material shall be compacted to a minimum of 90 percent relative compaction, unless other- wise noted as determined by ASTPI U1557-78, method C; D2922-78 and D3017- 78. 2.00 Material receiving conpactive effort shall have a moisture content that is within 3 percent of optimum moisture, unless otherwise noted in the conclusions. If drying or wetting is necessary to achieve the proper moisture content, it shall be done prior to the compactive effort. The soil shall be thoroughly mixed to obtain a uniform moisture content. 3.00 All fill slopes shall be constructed on a 2:1 (horizontal to vertical) or flatter ratio. Cut slopes in soil material shall be constructed on a 2:1 or flatter ratio. 4.00 Materials designated to be scarified shall be ripped by parallel shanks extending below the original surface ten inches (plus or minus two inches). Such ripping shall be completed in two perpendicular direc- tions. 5.00 For trench depths below five feet, provide suitable shoring and/or slop- ing sidewalls prior to personnel entering such trenches to meet require- ments of Title 8, California Administration Code. 6.00 Flooding, jettino, and/or other means of water settling utility trench backfill material is prohibited within the building area. Outside the building area, the material may be water settled, if adequate compaction around the pipelines is obtained and a firm, stable, compacted backfill mass is obtained prior to the placement of additional backfill. The depth of water settled lifts shall be limited to four feet. A concrete vibrator, applied to the saturated soils at regular intervals may be necessary to facilitate compaction. 7.00 Compact general fill materials in lifts not to exceed eight inches, except where approval for deeper lifts is obtained from the soils enoineer. NON -COHESIVE MATERIAL APPENDICES K, L, M PACIFIC GEOSCIENCE. INC. Appendix K EARTHWORK MATERIALS 1.00 All fill material shall be approved by the soils engineer. Qualities of proposed fill material shall include, but not be limited to., the capa- bility of being compacted in a uniform manner. Unsuitable material shalt include such materials which are excessively wet, excessively dry, or containing deleterious substances which would be deemed unsuitable by the soils engineer. The on -site soils are considered suitable as fill material, although the moisture content may have to be adjusted. 2.00 Select, non -expansive material shall be approved .by the soils engineer. Qualities of such material shall include having a granular nature, con- taining no organic matter, having the majority of the material exhibit a maximum particle dimension of three inches after being compacted, and an expansion index of 20 or less as determined by the procedures outlined by Uniform Building Code Standard 29-2. There shall be sufficient binder presentto maintain vertical sidewalls while trenching for foot- ings and the like. 3.00 Capillary break material is also considered non -expansive and shall com- prise the upper four to six inches of material directly beneath the building slab on grade. It shall have less than 4 percent passing the P.200 sieve and a maximum particle size of one inch. Typical materials that conform to this requirement include concrete, sand, pea gravel, !411 . A .n.,r.nin r Arco anm•enato_ and liahtwBioht shale rock locally termed "floatrock." The use of moisture membrane placed about mid -depth of the capillary break material would be considered good prac- tice when the finer capillary break materials are utilized. When the coarser rock or gravel materials are utilized, considerable penetration and tearing of the membrane usually occurs. 4.00 Utility trenches within the building area shall be backfilled with a clean sand capable of being readily compacted with minimum effort. The following specifications usually define such a material. Sieve Size Percent Passing 1;2" 100 *200 0-7 PACIFIC GEOSCIENCE, IN �. Appendix L EARTHWORK EQUIPMENT 1.00 To ensure uniformity of compaction throughout the site, all site work shall be compacted by the use of a compactor conforming to one of the followino_ descriptions. 1.01 A vibrating compactor having a drum diameter of not less than three feet. The roller shall consist of a single drum with at least one tamping foot per 100 square inches of drum surface. The area of each tamping foot shall be at least six Square inches and _.less than ten square inches. The face of each tamping foot shall be at least four inches and no more than eight inches from the drum surface. The entire compactor shall weigh at least 3,000 pounds. Equipment meeting this recommendation is locally termed "vibrating sheepsfoot." 1.02 Aggregate base material shall be compacted with a steel -wheeled flat roller or flat vibrating plate having sufficient weight to adequately compaft thematerial uniformly and to the specified density. PACIFIC GEOSCIENCE, INC. Appendix M EARTHWORK PROCEDURE 1.00 All fill, fill material, scarified soils, and import material shall be compacted to an average of 95 percent relative compaction, unless other- wise noted as determined by ASTM D1557-78, method C; D2922-78 and D3017- 78. 2.00 material receiving compactive effort shall have a moisture content that is within 3 percent of optimum moisture, unless otherwise noted in the conclusions. If drying or wetting is necessary to achieve the proper moisture content., it shall be done prior to the compactive effort. The soil shall be thoroughly mixed to obtain a uniform moisture content. 3.00 All fill slopes shall be constructed on a 2.5:1 (horizontal to vertical) or _flatter ratio. Cut slopes in soil material shall be constructed on a 2.5:1 or flatter ratio. 4.00 Materials designated to be scarified shall be ripped by parallel shanks extending below the original surface ten inches (plus or minus two inches). Such ripping shall be completed in two perpendicular direc- tions. 5.00 For trench depths below five feet, provide suitable shoring and/or slop- ing sidewalls prior to personnel entering such trenches to meet require- ments of Title 8,in . California Administration Code. 6.00 Flooding, jetting, and/or other means of water settling utility trench backfill material is aoceptable within the building area and outside the building area. Adequate compaction around the pipelines shall be obtained and a firm, stable, compacted backfill mass obtained prior to the placement of additional backfill. The depth of water settled lifts shall be limited to four feet. A concrete vibrator, applied to the. saturated soils at regular intervals may be necessary to facilitate compaction. 7.00 Compact general fill materials in lifts not to exceed one foot, except where approval for deeper lifts is obtained from the soils engineer. PACIFIC GEOSCIENCE, INC. Appendix N ASPHALT CONCRETE STRUCTURAL SECTION 1.00 Structural sections recommended in this report have been developed in accordance with the oncept of the California Design Method as presented in the publication Soil Engineering and Asphalt Pavement Design, by Harry R. Cedargren, an: 0', R. Lover ng, 15 ns itu e o Transportation and Traffic Engineer, University of California. 2.00 The Standard Specifications referred to hereafter is the latest pub- lishe. e i ion prouce y he Department of Transportation, Business and Transportation Agency, State of California, entitled Standard Speci- fications. 3.00 All aggregate base and subbase materials shall be compacted to a minimum of 95 percent relative compaction. Native soils within the defined structural section shall be compacted to a minimum of 90 percent relative compaction, unless otherwise noted. In situ bedrock is considered to have 100 percent relative compaction. 4.00 Class-.11 aggregate base,,material shall conform to, be mixed, spread, and compacted to the requirements of Section 26 of the Standard Specifica- tions. 5.00 Class III Aggregate Base The percentage composition the following grading whpn Sieve Sizes 1 1/2" No. 4 No, 20D ni or aggregate oase s ned by Test Method No. Percentage Passing 100 40-50 0-15 if. 202, The aggregate base shall also conform to the following quality requirements: Test Method Test No. Calif,. Requirements Resistance (R-value)* Jul TO -- Sand Equivalent 217 25 *The R-value requirement may be waived provided the aggregate base has a sand equivalent of 30 or more. The work of furnishing, spreading and compacting the aggregate base shallbe done in acordance with these specifications, the special provisions and Section 26 of the State of California Standard Specifications. PACIFIC GEOSCIENCE, INC. Appendix 0 GLOSSARY Clean: Denotes a lack of fines in a granular soil. Damp: Moisture content slightly wetter than optimum moisture. Dense: Usually rock material or a very -highly consolidated naterial backhoe will skip with no penetration. Firm: A material that has undergone previous consolidation to some degree. Will hand shovel with difficulty. In situ: In the natural or original position. Moist: Moisture contest slightly drier than optimum moisture. Optimum Density: The maximum obtainable soil density, dry weight basis, expressed in lbs. per cu. ft., using a standard procedure. Standard Specifications: Publications entitled STANDARD SPECIFICATIONS, State of California, Business and Transportation Agency, Department of Transportation, January 1979. Soft: A material with very little resistance to penetration. tion included herein. Construction and/or other inspections called for to be completed by the soils engineer, regarding the project, may be completed by others only with the express written consent of,the soils engineer. Soil Fractions: When assigning description names to soils, grain size is the determinate. Sand: Grain size between 2 mm. and 0.05 mm. Silt: Grain size between 0.05 mm. and 0.005 mm. Clay: Grain size less than 0.005 nm. When combining sizes, the greater fraction is mentioned last and the lesser fraction first. Stiff: Description of a clay,soil. having a relatively high density. Very Damp: Soil moisture content over optimum, but less than wet. Very Dense: Usually reserved for unweathered rock units. Will require jack. hammer or powder. Very Firm: A material that has undergone considerable consolidation. Great difficulty will be encountered trying to shovel, but a backhoe will easily excavate. Wet: Moisture showing on exterior of sample when gently shaken. ENGINEERING & ASSOCIATES INC. CONSULTING ENGINEERS 14730 BEACH BLVD. SUITE 2070 LA MIRADA • CA 9D63e IT" 522.3220 (714) 5223221 TO San Luie Obispo Fire Dept. 748 Pismo San T ig nhi oFri CA 94401 GENTLEMEN: WE ARE SENDING YOU ❑ Shop drawings ❑ Copy of letter LtU1L�T�RANSIYIITTAL =ATTENTION ;r RaTdv 111 s 11 ❑ Attached ❑ Under separate cover Sit; the following Items: ❑ Prints ❑ Flans: ❑ Samples ❑ Specifications ❑ Change order ❑ ®�DESCRIPTION .. a S-Decs. for Fir 1•e THESE ARE TRANSMITTED me Checked below: ❑ For approval ❑ No exceptions taken ❑ Resubmlt_coptes for approval ❑ For your use ❑ Make corrections noted ❑ Submll_copies for distribution ❑ As requested ❑ Revise and resubmit ❑ Return_comeoted prints ❑ For review and comment ❑ ❑ FOR BIDS DUE 19_ ❑ PRINTS RETURNED AFTER LOAN TO US REMARKS Please review and if any questions call. Thank you. COPY To c SIGNED: II enclosures ere not as noted. kindly notify u et on ECON® LUBE N' TUNE , IN, April 2, 1987 Mr. Bahl Kavthekor B.S.K. Engineering 14730 Beach Boulevard, Suite 207 La Mirada, California 90638 RE: UNDERGROUND WASTE OIL TANK LEAK DETECTION SYSTEM ALTERNATE Dear Mr. Kavthekor: Attached please find an equipment description and catalog cuts for the API/Ronan Model X765-(2 thru 4)-RLW Leak/Level Detection System with (2) to (4) Model LS-3 sensor probes (number of probes as required per local governing agencies such as the local Environmental Health or Fire Prevention Department). We have determined the above systems to be equal to, or better than, the Universal Leak Alert System currently specified in our engineering drawings. As such, effective immediately, please show both systems in our equipment specifications, with the API/Ronan System listed first as we consider it a more cost effective unit with superior sales/installation/maintenance service. :II ment Manager LB/lh Attachment cc: Mr. Ray Williams Shamrock Control & Equipment 5731 Sierra Cielo Irvine, CA 92715 714/854-4911 4911 BIRCH STREET, STE. 100 • P.O. BOX 2470 9 NEWPORT BEACH, CA 92660 • (714) 851-2259 BSK ENGINEERING & API/ROWAN SPECIFICATIONS ASSOCIATES, INC. 14730 Beach Blvd. Attention: Bhal Kavthekar Suite 207 Attention: LaMirada, CA 90638 Page 2 API/ROWAN MODEL WILL-X76S-3 LEAK/LEVEL DETECTION SYSTEM, CONSISTING OF... Electronics for operation on 115V AC, 60 Hz. in a wall mounted NEMA-1 enclosure (9"W X 9-1/2"H X 4-1/2"D) complete with door mounted display window, annunciator horn, system test button, and acknowledge button. (2) X53 intrinsically safe field sensor interface module. (1) Intrinsically safe power supply. (3) Probe alarm module with LED status indicators and SPDT relay contacts rated 2 amps @ 110VAC for auxiliary control/alarm/pump shut down, etc. All of the above components are Factory Mutual approved. (3) Model LS-3 UL listed sensor of type 304 stainless steel/polysulfone construction with 18' 2-wire 20 AWG jacketed cable. CONSISTING OF", Electronics for operation on 115V AC, 60 Hz. in a wall mounted NEMA-1 enclosure (9"W X 9-1/2"H X 4-1/2"D) complete with door mounted display window, annunciator horn, system test button, and acknowledge button. (2) X53 intrinsically safe field sensor interface module. (1) Intrinsically safe power supply. (4) Probe alarm module with LED status indicators and auxiliary control/alarm/pump shut down, etc. All of the above components are Factory Mutual approved. (4) Model LS-3 UL listed sensor of type 304 stainless steel/polysulfone construction with 18' 2-wire 20 AWG jacketed cable. BSK ENGINEERING & API/RONAN SPECIFICATIONS ASSOCIATES, INC. 14730 Beach Blvd. Attention: Bhal Kavthekar Suite 207 Attention: LaMirada, CA '90638 Page 1 *kk****k*******kkk**k**k****k*k*k*kk***kkk*k***k****k*******## API/ROWAN MODEL X76S-1-RLW LEAK/LEVEL DETECTION SYSTEM, CONSISTING OP... Electronics for operation on 115V AC, 60 Hz. in a wall mounted NEMA-1 enclosure (9"W X 9-1/20H X 4-1/20D) complete with door mounted display window, annunciator horn, system test button, and acknowledge button. (1) X53 intrinsically safe field sensor interface module. (1) Intrinsically safe power supply. (1) Probe alarm module with LED status indicators and SPDT relay contacts rated 2 amps @ 110VAC for auxiliary control/alarm/pump shut down, etc. All of the above components are Factory Mutual approved. (1) Model LS-3 UL listed sensor of type 304 stainless API/ROMAN MODEL WILL-X76S-2 LEAK/LEVEL DETECTION SYSTEM, CONSISTING OP... wall mounted NEMA-1 enclosure (9"W X 9-1/2"H X 4-1/2"D) complete with door mounted display window, annunciator horn, system test button, and acknowledge button. (1) X53 intrinsically safe field sensor interface module. (1) Intrinsically safe power supply. (2) Probe alarm module with LED status indicators and SPDT relay contacts rated 2 amps @ 110VAC for auxiliary control/alarm/pump shut down, etc. approved. (2) Model LS-3 UL listed sensor of type 304 stainless steel/polysulfone construction with 18' 2-wire 20 AWG jacketed cable. SHAlf!IIA. ca CONTRnI L =.Qt➢rTeiiiv: 5751 S1, CA 2715 Genes XM IRYINF-, CA 92715 J 11�1J�7 (rlrfl Rba-4911 t714) 8%9zXt Vapor/L iqu a Detector System DI ROMAN_ __---.fpt Features ❑ Up to 9 Alarm Modules with LED indicators ❑ Intrinsically Safe Interface to Sensor. O Approved ❑ Field -Proven Circuit Design ❑ Background Vapor Suppression By Front Accessible Potentiometer ❑ NEMA Type t Enclosure ❑ Rugged Mechanical Design E) Vapor Sensor • Not affected by Continuous High Concentration of Vapor • Resistant to Sulfiu (H,S) and Chlorinate (CHCL,) Compounds • Designed for Long Life • Three Years Warranty • UL Listed ❑ Liquid Level Sensor • High Reliability • UL Listed • Compatible with Hydrocarbons • Maintenance Free ❑ Alan Contact Output per Sensor for Remote Indication or Telemeterhg X76S Vapor and Liquid mstadanons tot leakage of gasoline, diesel oil, waste o9 and other hydrocarbons. Two types of Liquid Level Sensors are horizontally or vertically positioned in the normally dry annular space of double -walled tanks. A reservoir level type is also available where the annular space is water -filled and the loss of water is detected. Vapor Sensors monitor well holes, drilled around the perimeter of single -wall ranks, or the annular space of double -wall ranks. individual alarm modules via FM approved intrinsically safe banters. This allows Installation of the sensors in Class 1, Division 1, Groups B, C, or D areas as defined in the National Electrical Code, without using costly conduits, conduit seals and explosion proof junction boxes. The X76S provides up to four level or vapor sensor alarms. gib= X76S Vapor/Liquid Detector System VInninsimily Safe Power Supply The Sensors Model LS-3 Tank Level Sensor The Model LS-3 is most suitable for positioned veritaUy on the bottom of the tank annulus or at maximum fuel level of a tank to prevent overflow. The all- polysulfone level switch features a single - pole, single -throw contact, actuated by the Float of the unit. The contact status is annunciated on the X76S monitor. Olisted E86797 Model LS-7 Tank Level Sensor The Model IS-7 Level Switch is designed for horizontal applications where access is difficult, such as a dual -wall fiberglass tank's annulus. The unit is engineered to provide high -reliability point -level sensing. Sensor Alarm Modules Field uniting Compartment Power Input _ . Terminals Model is-io Tank Level Sensor The Model IS-10 consists of a reservoir mounted on an Owens -Coming fiberglass tank ("P" style) annulus riser and an integral level sensor The reservoir and the annulus are filled with water to a[ r. Any nss or water due to a leak will be sensed and alarmed on the appropriate window of the - Model X76S. . Ul Listed E86797 tv carbon liquids, providing long, trouble -free performance. The Model HV Vapor Sensor is designed for industrial UL Listed 6yg7 and commercial applications with exposure to hydrocarbons over long periods of time. The solid -state - type sensor provides long trouble present free double -wall t and will not deteriorate due to continuous exposue to residual vapor, sumps, inherently present inNdouble-wall tanks, dry wells and sumps. 90 listed E100826 C m ( J/��fC�I ��.... max unw I III J t_'x.a x�:or SuuIX MWeI LS-i Wiring Information VWr sr r W&I NV Mwhom CiP (0 92 {Ill 0 ACF NW^Ng 0 Vr By Na BY N 0 V 0 At O spore No-1 C AI 4 . NCJ NOS Auzs MK NO, AUM 0 N[J C UR fCI M K3 K4 NO [ NC !b L NC NO t NC j WI k5[Imor#1 _ N3J]_Mj ��.�� AU%4 AU AU%2 AU%1 Im VAC ]ww RY WE rm f Mct mpi[ .uvm AWx MWM P( Area) wml 9.00 N. 22 N. Ula. Mec Dunensions 1226.NO a (5 59 mM m W xa 75 N. 7,50 it,-�I (1905 iw1q C 190,W50mm) II (1975Im O 1 0 m`s9mw�IwAww Specifications System, Model X76S Power: 115 VAC, 60112. Power Consumption: 100 VA Operating Temperature: 32 to 165OF (0 to 750C) Dimensions: 9x9.5x4.2 in. (22.86x24.13x10.67 con) Mounting: General purpose area; wall mount Q Approved: File it. 2N4A1.AX Annunciator Module Field Sensor: Dry contact Field Sensor Voltage: 115 VAC (supplied by X7CLS) Number of Inputs: One per module 0 Approved: File J.1. 2N4A1.AX Intrinsically safe Field Sensor Interface Module X53 Number of inputs: Two per module Sensors Voltage: 24 VDC, current limited Sensors: Dry contact Output Interface to Alum Module: Relay contact; normally open/normally closed; selectable Power Consumption: 750 mW per input Supply Voltage: 24 VDC from IS power supply O Approved: File J.I. 2N4A1. AX Power Supply IS Orilnnsic* Safe) Power Input: 115 VAC Output Volmgc: 24 VDC 0 Approved: File I.I, 2N4Al.AX Vapor Sensor, Model HV Detection Method: Solid-state diffusion type Detectable Gases: Hydrocarbons. gasoline, solvents, carbon monoxide, methane, ammonia, suffer dioxide, hydrogen sulfide Accuracy: t5% Response Time: Less than 15 sec. to 90% fud scale Sensitivity: 5 prim Sensor Life: 5 years minimum Zero Drift: Less than 5% per year Operating Temperature: —400 to 165OF (-406 as 750C) Electrical Classification; Class 1, Division 1, Groups B, C and D; hazardous atmosphere Cable Length: 25 feet; 3-conductor, number 2b AWG shielded; max. length 3,000 fee[ Approved: File E100826 Tank Leak Sensor, Model LS-3 Housing: 304 stainless steel Barley: 10 VA, 110 to 240 VAC Stem aml float material Fuel -proof poysulfone �I � RDNAN RONANmenuua COMPANY Y.O. BOX 1275 21200 OxAa,d Street command Hills, CatfomW 91367 U.S.A. (818) 883-5211 8 Tlex 699490 FAX (818) 992-6435 Operatbg TeorWratu7. J to 225OF (-18 to 1070C) Ptemum' 50 psi mazknum Leads: 22 AWG (V Approved: File E86797 Tank Leak Sensor, Model IS-7 For fiberglass tank Housing Material: ABS Mounting: Ye" NPT with ait" THD and luck not Pressure: 150 prig at 70OF (210C) maxim= Liquid SpG:.70 minimum Switch: Type: Single pole, single throw N.C, Rating: 10 VA. 110 to 240 VAC Leads: 22 AWG OApproved: File E86797 Reservoir Type Tank Leak Sensor, Model LS-10 Reservoir: - VOtmRe: Two gallons (7.57 liters) Dimensions (he4litxlvidthxdep1h): 13xllxll inches (33.02x27.94x27.94 cm) Material. Polyethylene plastic Switch: Type: Single pole, single throw Ratfrg: 10 VA, 110 to 240 VAC Stem and float material- Polysalfone Operating Temperature: 0 to 225 OF (-18 to 1070C) Pressure50 psi maximum Leads 22 AWG UI Approved: File E86797 Ordering Information The Ronan Model X76S Leak Detector Monitor System can be configured to meet the different local and state codes for underground storage by proper selection of sensors and monitor modules. For example a particular local code and/or type of facility may require leak detection of a tank annulus. The monitor system would consist of the following items: Model X76S-( L No.of alarm inputs (1 thm 4) max-4 Accessories cry. Type IS-3 (Vertical liquid level sensing probe) 1S-7 (Horizontal liquid level Sensing probe) IS-10 (Reservoir liquid level system) HV Vapor Sensor (Specifyproduct being monimred) Ronan from defects 0 material and workmanship under nal purchase. This warranty caries no IYabWry, either or Implied, beyond our oingatbn to replace the max which wamaray. RONAN ENGINEERING RONAN ENGINEEMNO RONAN ENWNCEt{WG LID. U.K. UMITEO (AUST.) PTY. M. I llUey Read 32 RNmondaey Road Unit 10, B I ummn Place Cmwlher D'¢We13 'Reonlo•Otario Hornsby, NaW 2077 Washington Tyne and Wear Untie M4BV5 Aminla United R'agd:.n IORUOEA (416) 752 thIO • Telex 63662 (02) 477-7M4 • 1Flex 73467 (091) 416-1689 8 Rlex 537-746 FAX (416) 752-8072 FAX (02) 477-6151 FAX (Nil 416-5856 1� K _. m,¢a6 Farms In Y.S.A Advanced Technology. Working today for the Future... The 00LI X=WAk� . It was a formidable challenge. In 1977, our missloh was to design an advanced type of durable storage tank— one which would withstand a wide range of adverse conditions. The Industry needed a wnk for permanent and safe containment of hazardous and flammable materials; a tank of superior structural characteristics to withstand any punishment Infflcted by unstable soil conditions and high stress loads. The tank had to be Impervious to corrosion, even In rigorous conditions such as sell flats, tidelands, or coastal areas. Joor Manufacturing, Inc. met this challenge with a new concept in tank design — the PLASTEEL® tank. By bonding the corrosion resistance of fiberglass to the strength of steel, we manufactured a tank with unmatched durability and reliability. Automatksubmerged arc "Wing ensures a Uniform puadly well. PLASTEEL®—SETTING NEW PERFORMANCE STANDARDS We created new standards of performance with the PLAS- TEEL^ tank. Tanks made only of steel or plastic are subject to the inherent weaknesses of these materiels. However, bonded together into PLASTEEL®, steel and fiberglass form a strong deterrent to the assault of external farces in underground installations. PLASTEEL® tanks are thus impervious to all except the meat violent scurces of den age; their development was a major advance in starege technology of hazardous materials. Since 1971. we've continually improved die PLASTEEL® tank through constant refinement of manufacturing tech niques and qualty control. Our system of quality checks and, balances through each step of menufeccre plays an nte- gral role in maintaining the high performance associated with every Jost, tank. The high standards adhered to in the manufacture we evident in the fact that them has never been documented in-service failure of a PLASTEEL®tank. - JOOR PLA STEEL 0 OUR TANKS RATE'rUL LISTING-COMPOSITE32 FOR ADVANCED TECHNOLOGY In 1980. after testing by Underwriter's Laboratories [UL], we introduced the technically advanced PLASTEEL® camp0Elte tank...Virtually trouble -free, the composite tank is ❑ Listed for corrosion reaiuuai and meets el federal [EPA], state, local, miitety, fire and env ental codes. The PLASTEEL® composite �OOUBLB-W ten: is the least complicated and most forgiving system that can be installed. Joor PLASTEEL° composite tanks surpass traditional UL standards and are recognized for their innovative tee nology by the "UL Listing -Composite" designation, the first underground storage tank manufactured to earn this label. PLASTEELP COMPOSITE 1DOUBLE-WALL] TANK: UNIQUE SELF-SUPPORTING DESIGN In 1983, to comply with California's new regulations (A.B. 1362), Jcor Manufacturing, Inc. constructed a uni eneWt nk confguration—thePLASTEEL®composite DOUBLE -WALL tank. The exteror structure is made of fiberglass-reinforced-polyester:reso [ERR] permanently banded to a welded steel vessel; this outer farm houses an inner steel tank whloh is totally supported by a syapem of interlocking rbi The double -wall design offers unsurpassed strength and reliability, and eliminates the possibility of a structural failure under normal use. It is completely self-supporting and requires ex I r . The design is a true complete 360° D&J8LE-WALL, tank including Pipe fitting penetrations. PLASTEEL° composite ]ffrUBLE-VJALL7, tanks are crafted to meet specific installation requirements. Cus- tomized fittings can be of any size, at any specified location; standard anchoring designs are available for pipe and trench secondary containment systems. The smooth outer surface, with flush pipe fittings and handling hooks on tank ends, simplify placement of a top -pan secundi cpntainer liner. °. - COMPOSITE--� _ 0� L�l�� tanks. Inner and outer tanks assembled Note Me true 3ao° DOUBLE WALL carfigurabon. EASY -ACCESS MONITORING PIASTEEL® banks are compatible with all monitoring sys- tems: electrical, mechanical, cr manual. Two 11/2 inch NPT fittings are provided for direct monitoring of the annulus between the tank walls. For additional stability, the annulus may be sealed after monitor kxsyellation. FAIL-SAFE AGAINST UNDETECTED DAMAGE The finished tank is virtually indestructible. If the exterior is impacted during installation, it is immediately apparent --- the struck arm turns white. Repairs, if aver required, can be made qucky on site, using the main a which is supplied to seal the fittings and lifting lugs after installation. Even minor in -ground damage represents no threat with PLAS- TEELe, due to the "self -healing" characteristics of the com- posite structure. "UL USTED's CORROSION RESISTANCE PLASTEEL® Composite FOIIBIEA—ALZ tanks are com- pletely corrosion resistant, and require no additional corrosion protection. The FRR exterior is inpervious to al stray electrical currants and soil contaminants, eliminating the need for dielectric bushings or cathodic prctection sys- tems. The FRP structure is tested by UL for strength, stability and ligggl Permeability. The UL Listed Composite FI751-BLE-WAIL tank is recognized and certigad by UL to have corrosion resistance and protection meeting the requirements of UL 1316. QUALITY ASSURANCE TESTING Through each step of manufacture. materiels and product are elbjected to comprehensive tesdng Procedures by a stringent and detailed Joor quality control program which is monitored by Underwriter's Laboratories. A holiday detec- tor operated at 35,000 volts insures that no pkrholes, holidays, or other flews are present in the finished product. These quality control measures are carefully retarded, and retained as part of the manufacturing history an every container shipped from our plant. Alter preparing steel surface by sandblast Ing ini application olhighest quality UL Listed PLASTEELematerlalguaramees permanent bonding with no weak spola Afinal 35,(b0 volt holiday test is Arlpperbrmetl 35'00n at holi sf ptiw 1p shipment ./ FAST INSTALLATION Ow of the m ny berg its of a PLASTEELO composite JOOLIBLEWtank is the simple installation. Thedesign of the tank [flush fittings, no external ribbing. Isrge diame- ter with shorter overall length, and flat heads] minimizes excavation size: These tanks require no special backfills. tamping, tank excavation liners. or vaults. The entire installation is com- pleted quickly and effectively, without the need for certified installers. The average installation cast of a Jcor PLASTEELa tank is documented to be a minimum of 15% less than other underground tads installations. wry. JOOR TRUCKS FOR ON -TIME DELIVERY The cost effectiveness of the Joe' PLASTEELO composite fbo(muE� tank 5 continued through delivery try our akin trucks direct to your site. Meeting your installation schedule, on time —every time —is a vital part of our coi mitment to customer satisfaction and product quality. Used far over a decade by major oil companies, industrial concerns, municipalities. and the U.S. government, PLAS- TEELe storage tanks have demonstrated their effeakea- ress in safely containing stared materials. They are ideal for storage of combustible and flammable liquids in hostile soil conditions. Even under extreme temperatures, the iso- phthalic-polyester resin preserves its integrity and provides good insulation. All PLASTEELO composite tanks meet, and in fact exceed. UL standards and Uniform Fire Code specifications. No PLASTEELO tank has ever been replaced or removed for "type of in-service failure. The UL Listing label on every Joor PLASTEELO tank is your guarantee of a superior product. PLASTEEL®Compos to DOUBLE WALL tanks leave on time and are expeditiously set in rank excavation Note fienummum excavation size required, handling hook placement and smooth, flush, top suffers at PLASTEELO tank C Tanks shall be ILL`Listed as composite underground tanks for the storage Of flammable liquids. Tanks shall be built of mild Steel plate, all welded construction, 100% construction, sell Supportin with no external ribs Tank fittings shall be of true �oQu@ Qe[,7 construction, allwhed to both the inner and outer tanks. and pressure tested for leak tightness. Monitor fittings shall penetrate the outer tank only. The outer surface shall be certified corrosion resistant using ILL Listed fiberglass reinforced polyester resin The annulus shall be UL Listed to be sealed (non vented) The tanks shall be ILL Listed for all motor fuels including, but not limited to, unleaded gasoline, leaded gasoline, gasohol In ary elcuhol blend per tentage, 100% methanol, 100% ethano, let fuel, and diesel fuel. Following fabrication ano leak resting of the IQr8IR1F.LTl6rT1 steel assembly, the entire ex prior surface shall be prepared per ILL Listing requlremerns for Die spray application of glass -fiber reinforced Isophfficho poyester resin to a sufficient thickness to show no holidays wren using a Tinker & Rasor Model AP-W holiday detector set an 35 000 volts. Tank supplier shall supply installation instructions and a kit of materials and resin for sealing all exposed metal after tank installation Tank to be installed per NFPA-30, applicable local codes and manufacturers instructions. Product Trade Name. PLASTLLL" Composite U4N 14-FWd l l Tank. Manufacturer. JOOr Nei ldacl„ring, Ina 1189 Industrial Avenue Escondido, California 92025 Telephone: 6191745-0971 WARRANTY As our final assurance of Is superior product, PI composite =IIMl P.WALLI tanks are warrant( internal and external corrosion for 30 years when and materials are warranted against defects for 5 years warranty available on request. UUNDERWRITERS L ABO ATORIES ISTED INC! TYPEII' SECONDARY CONTAINMENT COMP $TE UNDERGROUND TANK FOR FLAMMABLEL M Ad aI MFERENTUL DEGREES NO. JOOR MFG., INC. EBCDNOCa MSzms STANDARD TANK SIZES CAPACITY GALLONS SIZE OUTSIDE OVERALL DMMETERxLENWH WrIj LBS. (APPROX.) 500 4ay4"x 610" 1.100 1,000 66y4"x 67" 2.200 2.000 951st"x 67" 4,400 3,000 95V24x 9'6" 5,600 4.000 91 12'6" 61800 5.000 95yz"x 15'se 81000 6,000 951/2"x 18'5" 9,100 8.000 114"x 17'0" 11.200 10,000 114"x 21'0" 13,700 12,000 114"x 25'3" 15.700 15.000 114"x 31'S" 21,000 20,000 114"x 41'B" 301500 NOTEg- 4I Lift Lugs Provided at both ends of all tanks 5) Manwayisoplunalexba sl cuuornearvial dimemioin and largo<eal>aciueaareilaDle Cowull manufacturer lad ile r L A C 0 Jaor Manufacturing,Inc., 1189 Industrial Avenue, Escondido, California 92025 Telephone 6191745.0971 iZ r h pt JhN... r.-U iS-. �LiSf>C F+Rr Vic k'i Agr AT7En1 T" A%. S Ptir._. d+s c'ra�gi�o `/.3101 Ft)PMATtEW ON �IHI_.-- i_r 0f,q rA) e . 6 l.L-r"r� K 6,_ TL:c.7S f 2) bb6f.•Z !%ir:[. . r.Q r: reTHEK _ �cp0 iz•i--`z� (:O J ILTAttoa: N Pr'1 DTCc rG'�`S `r S var Tiers Qualified Facilfly SPCC Plan This template constitutes the SPCC Plan for the facility, when completed and signed by the owner or opt faclitymstmili the applicability Criteda in §112.3(g)(1). This template addresses the requirements of 40CFR Maintain a complete copy of the Plan at the facility R thefacility is na+mallyanended at least four hours per facility attended fewer than fourhoun; par day, at the nearest field office. When making operational changes it that are necessary to comply with the rule requirements, the uwmedopetafor should follow state and IOC21 Fault (such as for permitting, design and combustion) and obtain professio net assistance, as appropriate. valor of a part 112. ,or fora a facility Percents Facility Description Facility Name E1 FacilityAddress Vis I city Sr.._ It Oia:s4p State CA 2m County �iyis a1ryT Tel. Number Owner or Operator Name elaseua sanlYtO irt Owner or Operator Address ' Nt �j City 44FL) (iZ.n,'s" Stale 6.4 ZIP 9 IWL County 5f Wic, fYi Tel. Number �- 1. Se1fLeNtiwdon Statement (§112.6(a)(1)) ' The owner 0r 0permor Of a fmflity ce4 fees mw Bach Of the following is true in order to utlllze this templffi with the SPCC requirements: to comply ; 1p�.M certify thatthe following is accurate. 1. I am amiGarwith the applicable requirements of 40 CFR part 112: 2. 1 have visited and examined the facility; 4. Procedures lofrequlred inspections and testing have been established to accomancti industryinspection and testing standards or recommended practices; 5. 1 will fully imptementthe Plan: S. This facility meets the following qualification craeda (under §112.3(g)(1)): a. The aggregeteaboveground oil storage capacity of the facility is 10,000 U.S. gallons or less: am b. The facility has had no single discharge as described in §112.1(b) exceeding 1.000 U.S. gallows and no two discharges as described in §112.1(b) each exceeding 42 U.S. gallons within any twelve month period in the three years prior to the SPCC Plan seff-certification date, or since becoming subject to 40CFR part 112 ff the facility has been in operation for less than three years (not including ail discharges as tlescdbed in §112.1(b) Chet are the result of natural disasters, ads of war, Or lermdsm)p and c. There is no individual 04 sto rage cc stainer at the facilely with an aboveground capacity greater than 5.000 U.S. gallons. r. Thia Plan does not deviate from any requirement of 40 CFR pad 112 as allowed by §112.7(a)(2) (an iionmental equivalence) and §112.7(d) (impracticability of secordary containment) orinclude any measures pu uant to a §11-2e(cp6) for produced water containers and any associated piping; have committed the necessary MO UIceS to fully implement this Plan. .aCiury Name: LK)U" SW pager Tierlpuarifled FedlNry SPCCPlan I also understand my Other obligations relating to the storage of ail nt this faciay, Including, among others: vac 403-1a-1a 1. To report any oil discharge to navigable waters or adjoining shorelines to the appropnateauthodlies Notification Information Is included in this Plan. 2. To review and amend this flan vahme ow ftol is a material change at the facility that affects the pc fennel for an oil discharge, and at least once every five years. Reviews and amendments are recorded in an attac ted log [See Five Year Review Log and Technical Amendment Log in Attachments 1.1 and 1.2 ] 3. Optional use of a contingency plan. A contingegcy plan; a. May be used in lieu of secondary containment forqualaiad oll-figed operational equipment, in occatance with the requirements [alder §l12.T(k). and; b. Must be prepared to r Ilowl'ures and/or intw-facility gathering lines wNch do Out have seconds containment at an oil production facility, and; c. Must include an established and documented inspection or monitoring program; must f allowt IS provisions of 40 CFR pan 109; and must include a wmten commitment of manpower, equipment and me mals to expe lfi lously remove any quantity of oil discharged that may be harmful. If applitab Is, a copy of the contingency plan and any additional documentation will be attached to this Plan as Attachmen 12. 1 certify that I nave satisfied the iremwn to prepare and implement a Plan under §112.3 and all of the rest 'rementa under §112.6(eJ. 1 certay th h¢ inf anon conbina l in INS Plan is true. Signaturo Title: %0 C\'" Name I A Date: (UI j /S 2017, R. Record of Plan Review and Amendments Five Year Review (§112.5(b)): COTPIBtBBr¢VI¢WaM¢VHImlinO Of ml9 aPCL PI0O a11a¢a[onw every nupyvars. A58 nSalf of Me review, a no Nis Plan within six months min Aade mmc cffes1ve, prevenaonend control meavasformalaUlily,irappliuble. Lnplvvrorduiry PCa Plan amendmentassoon as possible,but no lalerthan six monlhsfollowing Plan amendment Dowmentcomple ion of them has anti evaluation, and complete the Five Year Review Login Adacnman11.1. ache reality no longermsetiner l quardiedfadit eligidllylhe owner or operator m ustrevise he Plan to meefTer II tussle d facility requirements, or Complete a full PE eerafied Plan. _ Table G-1 Technical Amendments N25fa , c and 1112,11(a)(2)) This SPCC Plan rill be amended when [hare is a change in the facility design, construction, operation, or maintenance Mat materially affects the potential fora discharge to navigable waters oradjoining shorelines. Examples include adding or removing containers. recap tYmction, replacement. or installationof piping systems, changes to secondary containment systems, changes In product stored at this facility, or revisions to standard operating mcedures. Any technical amendments to this Plan will bete ertllied In accordance with Section I of this Plan template. 112. ee Technloal Amendment Led in Attachment 1.21 FaciliNName: LW)if S .f1 Paget T-er l Oual',nMe Iey sPCC Man III. Plan Raquiremanta I. OS Storage Containers (§112.7(a)(3)6H: Tattle G-2 Oil SWER2 Canrainers and Ca acless This table includes a completeltsl of all all storage cantaitle s (aboveground containerseand completely buried tanW) with capacity of 55 U.S. gallons or more, unless Otherwise exempt from the rile. For mobilefpodable CdrdamelS, an estimated number of containers, types of oil, and anticlpated capacitles are provided. Oil Storage Wnialmer (Indicate whittler abov muntl W or completal boned (Ali Type of Oil Shell Capacity (gallons) 'L SSD 0 IA3SD Coll C�V% 6W -reolli& LSD as 15 I owl Alroveground storage Capacity e WW gallons Tool Completely grimed Storage Capacity yt—� gallons Facility Total Oil Storage Capacity t':j gallons Ihatmushe mcludedwhen calculating total facility oil storage capacity include. Wake and mobile of itional equipmert(eg. transformers): oaieroli-filled equipment, such as flow-mmugn process avcynu,mm nil, wnamers ulna exnuWveryrorwaerewaRrvealmenc pernanennydoaedmro iners:modvepowerwnminws: not-mlzaspnaltcomamers: heating ail contamers used solely at a single-famiy residenceand pesticide application equipmentor lelalad mi%pdntalners. Although the criteria to determine eligibility for qualified faditiesfoaseson me aboveground oil sturagemntaineraat me facility, the completely buried tanknat a qualified facility are stiilsubjectm are rule requirements end muatbe addressed Inure romplam; however. may are Trot counted sward the qualXled fadfiyapplkebidy Nreshold. Counts IowaM qualified funny applicabllityareshold. 2. Secondary Containment and Oil Spill Control (§§112.6(a)(3)(i) and (ill. 112.7(c) and 112.9(c)(2))' Table rM Seoandary Containment and at Spin Contest Ap prop hate secondary containment and/or diverslo b ry structures or equipments is provided for all oil handling containers, egUlpmeni and transfer areas l0 prevent a discharge to navigable waters or adjoining shorelines. The entire secondarycontainment system, including walls and floor. is capable of containing oil and Is constructed so that any discharge from a primary containment system. such as a tank or pipe, will not escape .he containments stem before ciennup occurs. -use one at meuniami rbinT 1 Imperviouero carman oil;(2) Cug: (3) CUNereng, gurRrs, or other drainage sysremx: (4)Weirs, booms, or oNer samara-. (S) Spill diversion ponds: (6) Retention ponds: or (7) Sorbentmatedals. FselluyName' LNtI SW base Trail QLAVIArl Facility spoc Olen / }) E! <\)� \) �! |\\t] | - � a ) ! /2L\ g \ { ) ! � ! ! ! / } ) Vec F-E4oG31&t0 3. Inspections, Testing, Recordkeeping and Personnel Training (§§112.7(e) and (f), 112.8(c) 8) and (d)(4)l, 112.9(c)(3), 112.12(c)(6) and (d)(4)): Table-t*O lnappeapns,; Testing, Rec - . aep ng and Personnel'Training An inspection andlorfesnng program is implemented for all aboveground bulk storage contai�a-n plpl at this facili 1128 c e and d 4 111. c 3. 112. 12 c 6 and a Tha folbedng rs a descdpron of me inpection andlor testing program (e.g. reference to Industry standard lined, scope, frequency, method of inspection orlest, a person wndwting eleinspection)forall aboveground tulkstorage containers and piping at this facility: art Inspection, tests, and records are co ucted in accordance with mitten procedures developed for thefaclll V. Records of inspection and tests kept under usual and customary business practices will suffice for purposts of e. tills paragraph. "1127(e)J A record of meinspections and tests are kept at the faclifty orwit SPCC Plan for a beficid of threat yalind 112.7e[See Ins ectim Log and Schedule in Attachment 3.1 Inspections and tests are sgned by the appropriatesupervisor orinspeclor.l§112.7(e)J [.r Parsonnd tralnin , end diech a rewnaon rowdum t127 Oil -handling parsonrlel are trained N the operation and maintenance of equipment to prevent discharges; �- dischargeprocedureprotocols; applicable pollution control laws, les. and regulaflons: general facility n eratiorw: and. the contents of the facility SPCC Plan, f§f 12 )(tJ awn o s NameMVP. (/1t rn 1•- ��rr�sQ S Discharge prevention briefings are conducted faroil-tmndiing personnel wnuiily to assure adequate understanding of the SPCC Plan for that facility. Such briefings highlight and describe past reportable discharges or failures, malfunctioning components, and any recently developed precaufionary measures. f§1127101 ee 01141andling Personnel Training and Briefing Log in Attachment 3.4 Faclervfdom: Lnn� S- SbNzt Page Tlerl PUallaed Fny SPCCFan vw. 4. Security (excluding oil oecunly measures are implemenled at this facility to prevent unauthorized access to oil handling, pracoesinj i, and store earea. The following Is a description of howyou secure and control access to the oil handling• processing and stom geenses: secure master flew" drain valves; prevent UMLAhorimd access to stzrtar oomrols on of pumps; secure o dof- service and loading/unloading connectionsof oil pipelines: address tbeappropnateness of secumylighdng [ both Prevent acts of vandalism and assist in the discovery of oil discharges: 5. Emergency Proceduresand Notfications (§112.7(a)(3)(N) and 11Z7(a)(5)): Table G•7 Description of �ergency Procedures and Notiflweioes The folowing Is a description of the immediate actions to bra en by facility personnel in the event o a disc large io navigablewaters or adjoining shorelines (§ffZ7r(a)(3)(rv).eeAd 112.7(a)(5)): 4fYnly, 1V0 IJhJi&ARL4- `JAir .S DiZ 54n4wdc-5 faeilily NameGageB Ter 1puslifies faxry SVCC Ran 6. Contact List (§412.7(a)(3)(vi1): Vet. C- O0 t&W Table GA Co ct Lie ization / Person Telephone Number nse Center NRC) 1-800424.8802 actor(s) pFaclilty ersonnelrson AceountableforDischarge Preverdion: _ Office . Emergency: Office: Emergency: SEmergency off low. SOO- - ss Offloe: Emergency: State Oil Pollution Corttml Agencies Other State. Federal. and Local Agencies Local Fire Department Local Po11Ca Department Rospltal Other Contact References (e.g., downshearn water intakes or neighboring iacibbes) a�,,RyNameL*)v %Lu tea, T. NRC Notification Procedure (§112.7(a)(4) and .,q evor m a msararge or on to navigame waters or adjoining shorelines. the followang information itler Attachment 4 will be provided to the National Response Center immediately following idemdlcation of a ,charge to nevigablewaters or adjoining shorelines (See Discharge Notification Form in Attachment • me exact address or location and phone • Description of all affectedmedm number of the facility; Cause of the discharge; • Date and time of the discharge; Any damages or injuries caused by the disharge; • Type of material discharged; Actions being used to slop, remove, and an ligale the • Estimate of the total quantity discharged: effects of the discharge; • Estimate of the quantity dischargeo to navigable • Whether an evacuation may be needed; an I waters; • Names of irdivid uals and/or oman®lions I VhO have S. SPCC Spill Reporting Requirements (Report within 00 days) (5112.4) Submit information to the EPA Regional Administrator (RA) and the appropriate agency or agencies in crags of oil pollution control activities in the State in which the facilityiS located within 60 days from one of thefolloiaingt scharge evems: A single discharge of more than 1p110 U.S. gallons of oil to navigable waters or adjoining shorelines or Two diseharg as to navigable waters or adjoining shorelines each more than 42 U.S. gallons of oil occur 'ng within any twelve month period You must aa6md fhn latuarm informatfort to the RA' (1) Name of the facility: (2) your name; (3) Location of the facilhy. (4) Maximum Storage orhandling capacity of the facility and normal daily throughput (5) Corrective action and countermeasures you have taken, including a description of equipment rspaas and replacemems. (6) An adequate description of the facility, imlWing maps, flowdiagrams, and topographical maps, es necessary; (r) The cause of the reportable discharge. including a failure analysis of thesystem or subsystem in which the failure Occurred: and (8) Additional preventive measures you have taken or contemplated to minimize the possibility of recurrence (9) Such other information as the Regional Administrator may reasonably require pertinent to the Plan or discharge NOTE: Complete one of the following sections (A, B or C) as appropriate for the facility type. Fadiity Name:. -ml II Page rear t Qualified r>Iwaty SPCC Plan Vor A. Onshore -Facilities Theowner, cr operator must mset dle generdl rule requirements arrived as requirements under this section. Noh tied not II provion maybe applicable to all owners/openaWrs. For example, a facility may not maintain completely Wnsd rllaGtic sbra9e ta Installs after January 10, tend, and thus would not have to abide by requirements in §§112.8(c)(4) and t12.i2(cgdf, pted below In caaas wham 8 Provision is not applicable, write "NrA' atilisi rV.C,=u;mu.RuteR uliershe go�pnsh'on:Ea m dked storage areas is restrained by valves to prevent a discharge into the dminlge cility effluent treatment system, except where facility systems ere designed to conhal such ❑ 7- Diked areas maybe emptied by pumps orejectore that must be manually activated after the condition of the accumulation to ensure no oil win be discharged. L§§i 12.e(b)(1) and vs�"fm anual, open-anddoaetl design am used for the drainage of diked areas. (§§112.8(b)(2) and 1 t812 b ❑ The containersat the facility arecompaa7Na with 1112termis slomd and conditions of storage such as reSSare and to eratum. 112 8 c 1 and 112.12'C 1 ❑ Bacondary otar ainrrentfor the bulk storage comainers (including mobBafportable off storage containers) holds the coPac+N of me largest container plus additional capacity to contain precipitation. Mob0e or portable oil storage containers are positioned to Prevent a discharge as miscrlbed in §112.1(b). f128a i tt MConteminal6tl rainwater from diked areas drains into a storm dram or open watercourse the following Procedures will be Implemented at the facility: S§1128(c)(3) and 11212(c)(3)J • Bypass valve is normally sealed closed ❑ • Retained rainwater is Inspected to ensure that its presence will not cause a discharge to navigable waters or adjoining shorelines El • Bypass valve Is opened and resealed under responsible supervision ❑ • Adequate records of drainage are kept [Sae Dike Drainage Login Attachmt 3.3] en ❑ For completely buried metallic tanks Installed on or attar January 10, 1976 at ails fadlity [§§7f2.8(C)(6) and 112.12(c)(4)): • Tanks have corrosion protection with coatings or cathodic protection compatible with local soil (Iran eglitingRegular leak tasting Is conducted. El For partially burled or bunkered metallic tanks (§f f28(c)(5) and§112. f2(c)(5)j • Tanks have comvion protection with coatings Of cathodic protacaon compatible with local soil conditions. Each aboveground bulk container is tested or inspected for integrity on a regular schedule and whenever material repairs are made. Scope and frequency of the inspections and inspector qualifications are in accordance with industry standards. Container aupPods and foundations ere regularly inspected. [Sea Inspection Log and Schedule and Bulk Storage Container Inspection Schedule In Attachments 3.1 and 3 112.8(c 5 and if 12.12 c 8 i DULsldes of bulk songs conbmers are frequernly Inspected for signs of deterioration, discharges, or accumulation of oil inside diked areas. [See Inspection Log and Schedule in Attachment 3.1] ❑ 1fa.So 6 and ff2.f2c 6 For bulk storage containers drat am subject to 21 GM part 110 which are shop-fabdoated, constructed 0f austenitic stainless steel. elevated and have no wnemal Insulafion. formal visual inspection is conducted ❑ On a regular schedule. Appropriate qualifications for personnel perfomdng tests and inspections are documented. [See Inspection Log and Schedule and Bulk Storage Container Inspection Schedule facilay Name: I44 V Jl/O pates 9 Tier t oua6fied raepy apcc e4r, VW.. MENUS ,v,.•.,�.a.ac. nw�iN uc..wa aa�vyaa�ry raxw wmwaeNWci Wmaual lacc rhmhr�wrr guy mry ❑ ❑ Sphetlule In Attachment 3.11. f 126 a 3 iir Visible discharges which result in a loss at oil from the container. including but rot Iimilad to seams, gaskets, piping. pumps, valves, nets, and bona are promptly connected and oil in diked areas is promptly nnuvagrourm valves. piping, and appurtenances sucn as range )pint& expansion loins, varve glands amp ❑ ❑ bodies, catch pans, pipeline supports, Idclang of v tuns, and metal surfaces are inspected ragulady. [See or replacement. (Sea Inspection Log and SchsdZZ in Attachment 3.1] menu name: N Y SL 3 Page 10 Tiff 1 puaffiff 4lty SPCA Plan cil B. Onshore Oil Production Facilities (excluding drilling and workouer facilities) (d)): The Omer or operator most meet the general rule requirements as well as the requirements under this section Now that Inot all prowslons nlay be appli� tble Ic all ovmerslapemtors. In bases where a provision is not applicable, write "NIA". Table Gil General RaleR InshOrOnstagreatifir pFrockWOM FACMISs NIA At rank batteries, separation and treating areas, drainage is closed and sealed except when draining uncontaminated rainwater. Accumulated oil on the ralmvater is returned to storage or disposed of in ❑ ❑ acwNance with all a roved methods. if2.96 1 Prior to drainage, diked areas am Inspected and l§112.9(b)(1)}. • Retained rainwater is inspected to ensure that its presence win not cause a discharge to ❑ navigable waters ❑ • Bypass verve Is opened and resealed under responsible supervision ❑ ❑ Adequate records of drainage are kept Sets Dike Drainage Ling in Attachment 2.31 ❑ ❑ Fred drainage systems and oil traps, sumps, a skimmers are inspected at regularly scheduled Intervals for ❑ ❑ ON. and accumulations of on are promptly mmuved [See Inspection Log and Schedule In Ataehment 3.t 112.9 0 2 The cants 1 used of dtis facility are compatible with materials stored and conditions of storage. ❑ ❑ 112 9 c / All tank betery. separation, and treating facility in rtalladons (except far flow-mrough process veavie) are ❑ ❑ constructed with a capacity to hold the largest single container plus additional capacity to contain rainfall. Drainage from undiked areas is safely confined In a catchment basin or holdi nd &IIZ9 cl Except far flow -through protean vessels, containers that are on or above the surface of the ground. ❑ ❑ including foundations and supports, are visually inspected for deterioration and maintenance needs on a regular schedule. See Inspection Log and Schedule in Attachment 3.111§1 12.9 c 3 New and old rank batteries at this tacitly are engineemd/updated in accordance with good engineering ❑ El W prevent discharges including at least one of the following: I. adequate container capacity to prevent overfill I regular pumping(gauging is delayed; H. overflow eoualizing lines between containers so that a full container can overflow to an adjacent mrhleiner iv. high level sensors to generate and Irarramit an Glenn to the computer where me fadlity, is subject to a computer production controls tam. &I f2.9 c 4 p1Ow-throu9h process vessels and associated components are: • Am constructed with a capacity to hold the largest single container plus additional capacity to ❑ ❑ contain rainfall. Drainage from undiked areas IS safely confined in a catchment basin or holding pond; !§112.9(c)(2)] and • That am on or above the surface of the ground, including fountlatens and supports, are visually ❑ ❑ inspected for detadomtion and mai... a, ante needs on a regular schedule. [See Inspection Lag and Schedule in Attachment 311 1§112.9(cp9)1 Or • Visually Inspected and)or tested periodically and on a regular schedule for leaks, corrosion, or ❑ El conditions that could lead to a discharge to navigable waters; and • Corrective action or repairs are applied to lbw -through protons vessels and any associated ❑ ❑ components as indicated by regularly scheduled visual Inspections, tests, or evidence of an oil discharge; and • Any accumulators of ail dischandes associated with flow -through process removed; and • FlOW-Ihmugh process vessels am provided with a secondary maads of containment 7enfire❑capacity of the largest single container andsufficient freeboard to contain precipitatiomonths of a discharge from flow -through process vessels of more than 1,000 U.S. gaa single discharge as described in §112.1(b), or a discharge mom than 42 U.S, gallo seen or two discharges as desonbed In §112.1(b) within any twelve month period. (§1129(e)(5)1 (Leave blank until such time Thal this pronsfai is applicabfe. Feebly Name: �A4- JVV page 11 norIQualified hiraPCC%an 1 I I,o Vr IIJ lliry VA_In Tal$e.G1SOenerd RWa Regunements for Onshore Oil Prodral"Faetiitles WA All aboveground valves and piping associated with transfer operations are inspected periodically and upon a regular schedule. The general condition of Flange joints, valve glands and bodies, drip pans, pipe ❑ ❑ supports, pumping well polish rod stuffing topless, bleeder and gauge valves, and other such items are Included in the in5piaction. TM Inspection Lou and Schedule in Attachment 3.11 MIZIP(d)(T FVI on spill Contingency plan and widened commitment of resources are provided for flowlines acid Infra- El gathering lines [See Oil Spill Contingency Plan and Checklist In Attachment 2 and Inspection El Log and Schedule in Attachment 3.1] (§112.9(d)(3)) or Appropriate secondary containment and/or diversionary structures m equipment is provided for flowlines ❑ ❑ and imra-facility gathering lines to prevent a discharge to navigable waters or adjoining shorelines. The entire secondary containment system, including walls and floor, is capable of containing oil and Is constructed so that any discharge from me pipe, will not escape the containment system before cleanup occurs. A flowllde/IWe-facility gamenng line maintenance program to prevent discharges from each Rawlins has been established at this facility. The maintenance program addresses each of the following: Fbwlines and inta-facility gathering lines and associated valves and equipment are compatible ❑ with the type of production fluids, their potential carom ivity, volume, and pressure. end Omar conditions expecked in the operational environment; • Flowlines, inta-fad Mty gathering lines and associated appurtenances are visually inspected ❑ ❑ anrllor nested on a periodic and regular schedule for leaks. oil discharges. corrosion. or other conditions that could lead to a discharge as described in §112.1(b). The frequency and type of testing allows for the implementation of a contingency plan as described under part 109 of this chapter. • Ccnective action and repairs to any flowlines and Intro -facility gathering lines and associated ❑ ❑ appurtenances as Indicated by regularly scheduled visual inspections, tests, or evidence of a discharge. - Accumulations of oil discharges associated will towlines, infra- tacky gathering lines, and associated a purfenences are promptly renrooved- f,4112,9 tl 4 The following is a description of the flowline/inba{aciliiy gathering line maintenance program Implemented a this facility I O.Onshm Oil Willing and Workover FxlWdn ffil lZ13@)r (c) and (d)k The owner or operator mint meet the general rule reguiremenis as well as the requirements under arts section. Table G42 General Rub Requireaments for Onshore On Grim and Workover Facilities Mobile drilling or worker equip ment is positioned or located to prevent discharge as described in §i 12.1 (b). ❑ 112. 1A Catchment basins or diversion structures are provided to intercept and contain discharges of fuel. crude oil, i ir ❑ Orly drilling fluids. 1§11110c A blowout prevention (BOP) assembly and well con"i system was installed before drilling below any Casing ❑ string or during workover opambons. j§112.1g(d)] The 8OP assembly and well rAntrol system is capable of cgnkolling any Well -Head pra5spf8 that may be encountered while the BOP assembly and well Conyol system Amon me well I l izio d FaoRy Nwne L14e S1A. e.�o2 Te„r lrk.cer`r. e,__ Ver. ATTACHMENT 1 — Rea Year Raview and Technical Amendment logs [have wmpleted a naview and evaluation of the SPCC plan (artless rattily, and vAa WU not amend V" Plan as a result. Review Date Plan Amendment Name and *no we of person aulnor¢ed to re ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 1 ❑ tined Feeney Name Harel page 13 Tier I ouaHM Ver Any la WONI BP*n& t3 to WE phoebe re�@Mad N doewdme wei Se n I of d Plan temo[s . Ra%kW Data Desc+Om oFTBdmical Mwndnlenl Naon and signature of parson certifyin tedinicalamandmenl this I I I I Fadllly Name. Page 14 T IQuwed sv BPCQ Pan Ver M oil spill contingency plan and written commitment of raasurces is required tor. • Fkailines and ilNafaaEh/ gatlrerinQ Jim at oil produc5an fadliiies and • Qualified oiLfilbd operational eouipral which has no sscondery canbinnrent art led`, as aescnoeo cerow, ariaewnaen ❑ expeditiously contrd and rercrove any qua oil Rads the ch Contingency to veidy came the receseary aperetions autlinetl ken w CFR pmt 10g-Crtterb for SMe. l.oml(aM Regional OII RBrrlmal Carrorpency PIanB • 14w1 Egan illtlutled I (a) Definition of the autnoriees, responsibilities and duties of all persona, organizations or agencies which 4 re ❑ to be involved In planning or directing op removal operations. (b) Establishment of notification procedures for the purpose of earty detection and timely not fmaborr of an i it discharge including: (1) The identification of critical water use areas to fadlimte the reporting of and response to oil discha ❑ (2) A wrient list of Mamas, telephone numbers and addresses of the responsible persons (with ahem ) ❑ and organizations to be notified when an al discharge is discovered. (3) Provisions for access to a reliable communications system for finality rgafil:dtipfl of an oil discharge, ❑ and the capability of iMerconnectiort with the communications; systems established under misted of removal contingency purls, particularly State and National plans (e.g., NCP). (c) Pmvlshom to assure that M resource capability ice rmown and can be committed during an dl discharg situation including: (1) The identification and inventory of applicable equipment materiels and supplies which are availif ❑ locally and regionally. oil discharge to be anticipated. (3) Development of agreements and arrangements In advance of an oil discharge for the acquisition of ❑ equipmeK materials and supplies to be used in responding to such a discharge. Provlslons for well defined and specific actions to be taken after discovery and notification of an all discharge including: (1) Specification of an oil discharge response operating team consisting of trained, prepared and avail le ❑ operating personnel. (2) predesignation of a property qualified oil dscharge response coordinefor who is charged with the ❑ responsibility and delegated commensurate authority for directing and coordinating response opera nit and who knows how to request assistance from Federal authorities operating under edsdng national I and regional contingency plans. (3) A prepanned location for an oil discharge response operations writer and a reliable communicaU system for directing the coordinated overall response operations. (4) Provisions for varying degrees of response effort depending on me seventy of the oil discharge. ❑ than une water use may be adversely affected as a result of an oil discharge and where response operations may not be adequate to protect all uses. (s) SperJfic and well defined procedures to facilitate recovery of damages antl enforcement measures a pmvlded for by State and local statutes and ordinances. The confingency plan mule tea wnaiakent wan all applicable slake ant local plane, Pratt Contingenry Plans, and the National Contingency Plan (NCP) Facility None: Lry Y SW Pape is liar I awl" Fa lily SPrx Am m � ❑ ❑ ❑ ❑ ❑ b ro E t u O �9 pq Ti a C � C Cps claw 4 To comply whh Integrity u spection requirement for bulk storage Containers, inspedtt each shopAwitt ahoy no, vner on a e ular acMdub In atc� with a moogrr e w iner impecdon sbndad based on nre the MlowingR le. Container Size and Design Specification IrupacUoa raquirarrrent Portable containers (including drums, totes, and intemtodal VmUafiy inspect monthly for signs of clear ration, bulk containers (I8C)) discharges or accumulation of oil inside d areas 55 to 1,100 nova with sized secondarywnranmam venally Inspect monthly for signs of deals discharges or accumulation of 00 inside di wation. ad areas 1.101 to 5,000 gallons with sized secondary crntainment and a means of leak defection' plus arty annual inspection elements per i dusey inspection standards 1,101 to 5,000 gallons with sized secondary containment and Viil ly inspect monthly for signs of paper Nation, no method of leak detection' discharges or accumulation of cif inside d ad areas, plus any annual inspection elements and User specific integrity tests that may be require per industry inspection standards a Examples of leak defection imiude. but are not imilaf lo, double -walled tanks and slewted containers where a denanad. Facility Name: LAY Sw Pageir Teri t k \ k ' � w! e o c ) e o e o c c c o 2� ;{o �o o 0 0 0 = c =' >TOO c c = o e = o n ! � � ! \ � | u VH FeaIINNS :yU(i C:;A Pry 10 Tv ousN In me event of a discharge of oil to navigable wafers or adjoining shorelines, me Mai inlorma0on sell be provided m the Response Center (also we me noWcadan Information provided in Section 7 of the Plan]. Discharge lDb covery Date Tgpe In Notional Facility Name Fadllty location (Addressi Long/Sei Townahip Range) Name of reparang Individual Telephone A Type of materisoh al dargetl Fs6mafed total quantity discharged GallonsBanais Source of the discharge Media affected ❑ Sal El Water (spec ) ❑ Dow (sped ) Actions taken Damage or injuries ❑ No ❑ Yes (specify) Evacuation needed? ❑ No ❑ Yes (PaCM Organizations and individuals contacted National Response Canter 800d24-8802 Tune ❑ Chwnup wrtheciar (Specify) Time ❑ Faality pasonnei (Specify) Time ❑ State Agency (Specify) Time ❑ oeify) other tSpaThree 1 Facility Name: L I�r Y_ ZUv I awafiea safetywoo Pen Divmngnviro m� lealth M of San Luis Obispo P.O. Box 9 P.O.B8 Was 11 Fire Department(805) 781-7380 21565ierm Way *San Wis Obhpo, CA 9J406 I� 2160 Santa Barbara Avenue Department of AIt e/M t San Luis 0Ne09 CA 93401.5240 - Standards (805i 781-5910 2156 Sierra Way Suite A. San Luba ONSpo, CA 93401 UtbilOea Deparrment 0005) 781-721S 879 Morro Street , San Luis Obispo, CA 93401 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS Date: ATERIALS INSPECTION FORM CZ- /�/ 'Time:/ EFW data entry by: FACILITY ID NO: FACILITY NAME: L v ADD ESS: o t PHONE: AGENCY ❑ DEH ❑ AGDEPT CITY FIRE CITY UTILITIES INSPECTION TYPE ❑ Routine Reinspection Complain Compin Other PROGRAMS INSPECTED ❑ sodneo Plan ❑ DW Generator UST ❑ AGT ❑ Tiered Permkdng HEINSPECTION REQUIRED: NO ❑ YES ❑ Business Plan ❑ B W G major ❑ UST ❑ AGT ❑ Tierctl Permitting ERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and co Ith ads ed codes. GRA TED BY AME/P1TLE g,,.. PYi/nLLg records, and determining compliance (\ BUSINESSPLAN il"aY/wY\1'''�V'Ys'✓YY`YKC A�Mir%f/f.Cf��il El ❑ �t IJ ❑ ❑ COMMENTS: BPOI Business plan is complete, urrel7(, @ ayva&uri ing an �U n (HSC 235035, iae 1 "CCR 11102 Inventory of hazardous materials is complete MSC 25504, Title 19 CCR 2729) BP03 SitelayouflPacility maps are accurate(H.SC 2S504, Title 19 CCR 2729) TRAINING PLAN TROI Facility has appropriate training program (Title 19 CCR 2732 & 22 CCR 66265.16) TR02 Training documentation is maintained on site for current personnel (Title 19 CCR 2732&22 CCR 66265.16) EMERGENCY RESPONSE PLAN ER01 Contingency plan is complete, updated, and maintained on site (HSC 25504, Title 19 CCR 2731 & 22 CCR 6 66265.53154) ER02 Facility is operated and maintained to PreveNUndnimiaNmitigate 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 CCR 66265.31-A3) 1/ 6 (A -f Vli/R n/Aw n,.tbJ /<,r <I. Y J._.,66. ,,,Z, .r-_ I W i1,� m / INSPECTOR: pro 1001 rev 1 OMO CUMENTUeffp\FORMS\Inspection forms\CUPA Inspection fonns.doc 10-Sep 01 .� ''8. � -1, � 'I As ACallkmin—Emimnm•n Nuclei Are O APpmed OMB No. 2050-00391 opine T� 991 See Instructions on bock of eb. 4av Ptlnr air hpa. formdesgnad Fg, ten dib ll APikM1f N'. items DepoMnenl of bye $aEepnm Caned, 5 - UNIFORM HAZARDOUS . elofa USEPAIDNo. 1 'e AloniknD unenll i manb, Cnll m ie 2. Pagel Isdompeamn Are•Aad•d amen WASTE MANIFEST C L 0 0 0 0 0 817121 5 0 annmgairedbyFedemllaw- Icy 1 0 0 0 i 3. GwxraMl Name and Mailing Addi Attn: WILNOAE A. SdN Manifest Dommenl Numbm 286 23376506 BAN LUISEOBISPO, CA 92401 D. sme, Gunmatwr ID A. Dengmmrs Phone 1605 ISI4- 2476 5. irompoMr I CampanY Nome A. US EPA ID Nambn D. Shads, Tm,,Nftes ID lg4RtlPll.i po' ADA619 9EF.NICE$ r INC. F' '1 ) 1 d S D. Tmsp,Abi Plolq DO ,y'. ]. Traci 2 Company Nama W^rbr P Y B. US EPA ID Number E $nth Uanaponeh ID Loz.I i Q F. iransparle(• PMne R2>as®EEInNp�!iT> rb Addm,r 10. US EIA ID Numbs G. HdrioeJly 10 )$ 2000 N. ALA) iA STREET C T -� CCHPTi CA 90222 H. fwigh'. Phen. 310 537�70D )O C T 0 8 0 0 1 3 3 16 11. US DOT Description liclWing Praiser Shipping Name, Hazard Class, and lD Numbm) IR. CaMoinen S. Jose IA. Unit No. i Quantity WIi A Wa•k Number Z (OIL s 'WATER) $Nm 191 _� 3 G 1 T T G EPA/aA.r mE N b_ slate as E H R EPA/Other v A g T D Slme ea R EPaom.. d Z amk U EWOUer OF1/ ad.IuwL. •,Yll� y 'N•��O"• K. Handling Cade, Far Wei Usual A mi, b. Use A 1 d. Q JE Z F 15. Speeml Hondlirp lnNm hers ad Addifiaml lnformoHon iCl �yy AWlEr LYY ODB3'BCI G wail Biffil G311VEB ECOND}.UBE �._ 266 Hiqua a-8t.— - San Luts In.spo , CA Cmtzsoces: i.m Cetmtg Cmae:eaetim, im. 92�U1 - s a J 16, OENRAMR'S CER71MANON: I hereby declare IW the mnNnk of IN%«ntlp IammllY'i... i da,eibd a" by mip' Allp ices name and am dasHBed, pocked, marked, and lobebd, and am In at copeck in Proper condition for tmnspen by hbli = rding a apprci international and reads gemmmml reaction. i If I am a large q..n2y ganermor, l ukily, that 1 how a p'os in plow b rNuce the wa! me aM toxicity 1 wasp generated to the Anima I hma determined is he aca"oaimll pro iicaLle and Ihal 1 F dened [hepacgwble method d Iredmenr, ebrape r disposal certainly evoiluble to ma whicminimum IM parent and fabre Ihmar b human I= Alba navir' wi OR,IIF I om a'eP1 " ily generator, I haw mode a goodafoihd(eit b minimize may wana availoNa to me and Ihot I can ward, g "e amen and sele t Am Ixn vane measurement melhd Nedis / N;nkdrtrpd Name Si a Man DIn Y ay T 17. Te r 1 Aekmw Iof bwi i of Malriab yY PAT ypd Name Siprwmre u 5 ay p 18. Tre" 2Ackrgwl Omni of Rwei Iaf Mmlaria4 E"i mor,I me Name Signature Month Day Year S" DkempanglndieaHan m sea Is19, A c L I M. Fa I awnsm N. PaHiliwliandmei loth1 On I aniids.a airI I IMsI A ... Ium aneled In turn To, T nimM/rYped Noma Signal Mach Day Year Y DO NOT WRITE BELOW THIS LINE. DIX W22A II/991 blue: GENERATOR SENDS THIS COPY TO DISC WITHIPP 30 DAYS. EPA Si To: F O. 8m 4W, Sanamekb, CA, 95812-04W ME = ��Mmmmmmmm iiiiiiiiiiiE ■� ��■■■■■■■■■■■■ OMMiiiiiiiii + �OMMiiiiiiiii\ ��111111111� , a ; ®Cl111111111 ; ii®11�111111111 . SIN 1111111 .- c .'.a E a-d 08S0-SbS(SOS) odspgp sing U&S -DODOS d10:E0 60 SO gad Feb 05 04 03:01p Secon- San Luis Obispo l6O51546-0553 p.3 2-5-01� �c�ia Lru6e-N 7une S l o /�dTbsela!4 1 Jos IZervrB��'�zo� .�,ys8bt`7 �rn�Eco'w Gum :•✓-�u.1eJ �� so�vrvl �tP�ern.�'t. 62 u8E ,r ftr"2 �aPP , 5 i �— CgQP�. to bo�l�j �B� pEd�z a asp�w it/Gcrcr�k2 cwi 7zsr Jr S(Q 2, tz wk rwovoJ- 04-21-03 09:22AM PROM KERN CONSHUC110N P05 VIC uwj e e G VI f n K Z W d' �e 7ne ko yy _o as u W H W 1- CCyy �� @ VJ r ❑ ZX=i i„ �5 I I I I glNne nw- u,%,,I rb^. x,gs.;gt 11WOloI-F 9� zoozaot twe coed '01 .r v iiuu�uulA�Pa,I ��llll city of Jsan WIS osIsro Sta I?II�Sg & Sai Division • 990 Palm Street • San Luis Obispo, CA 934913249 • (805) 7e1 ' Fire AI /,1oi y�d� � L Fire Date Routed 04/17/03 Property Owner JONES PATRICK T THE ETAL Application Number 030407 Mailing Address 3162 ROSE AVE City/State/Zip SLO CA, 93401-5905 Application Date 04/17/03 Contractor's NameKERN COUNTY CONST INC Project Address 286 HIGUERA Phone Number 661-634-9950 Assessor's Parcel Number002-482-024 Zoning C-R-MU Fax Number 661-634-9233 Project Description REMOVE WASTE OIL TANK/INSTALL Project Manager JOSH SIMMONS NEW TANK Phone Number 661-203-3094 Print/Type Name KERRY BOYLE Department Phone Number(805) 781-7380 REC'D 3 SETS OF PLANS. ROUTED TO BLDG. PLNG, & KERRY BOYLE AT FIRE. BLDG APPROVED OTC. SB wk-� . nl `� A pltnr, Date APRIL 21, 2003 Status OK Our department will conduct a final inspection on this project Yes KKK No „/"•"”' Kern County Construction, Inc. P.O. Box 6096, Bakersfield, CA 93386 Contractors License # 481053 (661)634-9950 Fax(661) 634-9233 March 185 2003 Attn: Jim Wilmore Econo Lobe N' Tune & Brakes 286 Higuem St. San Luis Obispo, Ca From: Josh Simmons Re: Waste oil tank removal and installation of new above ground tank and piping. Scope of Work 1. Sawcut, remove, and dispose of concrete around waste oil tank. 2. Excavate tank and piping and remove. 3. Triple rinse and dispose of existing tank and piping. 4. Provide soils samples in area of existing tank and piping. 5. Backfill excavation and replace concrete paving to match existing. 6. Poor concrete pad in location of new tank. 7. Provide new above ground double wall steel tank and piping. 8. Provide permit to be issued by San Luis Obispo City Fire Department. Equipment list: 1- Modem Welding 500 gallon UL 2085 storage tank ue eW sty , aBli AL17 OdSIaO SIf17 NVS 1-Kreugar H-2 style guage :,ta cmya 8 1 -7 Va gallon spill bowl with drain and lid 1 -6" emergency vent WWI 1 -opw 23 vent cap f1tl38(1a NOLLNEAUd E81d 1 -decal kit M81AH11 CI791d O.L.I.J9faris 7 VAOtldd V 1-Warren Rupp SIFBIAHWANS000 1" diaphragm pump Exclusions 1. Price excludes any soils remediation. 2. Price does not include any additional regulatory requirements after March 18, 2003. 3. Price is good up to thirty days after Marchl8, 2003. Price to perform the above stated work is: $14,840.00 UN PROGRAM CONSOLEIATED FORM HAZARDOUS WASTE HAZARDOUS WASTE TANK CLOSURE CERTIFICATION 1 a 1 I. FACUM EDENTTFICATTON BUSHWF SNARII og =FAcanrxumarcM-o.taam " 31 FACILI IM 1; ECONO LUBE IN TUNE TANK OWNER NA im JIM WILMORE TANK OWNER ADDRESS Pral 286 HIGUERA ST. TANKOwNERCUY SAN LUIS OBISPO ya I SPATE CALIF. TO MOODE 93401 U. TANK CLOSURE INFORMATION Teak m r (Amd.miuoW ePt. Coaceevadoe of FlammeNe vapor Comeowtioa of Oxygen TANK aft ran ar..rta® gage ama Tro CeasesBarrant Top teeter BOaam INTSWOR ArMomIIERE t rb Ol ran. 0% xe, 0% wa 07 nr. 20.4% MW 20.4% me 20.4% READINGS .j N/A rah rab ____ rob ____— 74% __--_ ____ JSr6 __—__ lam S N/A ra' +�. am '� rm rsz III. CERTIFICATION Oa exasunfim of me Oak. I cer* me iaek is visually free from Product sludge. sole the, fatty residual of rack cbdean), rimeam sat debris. 1 buma reniy mar the Hdam moe provid hcrcie is ate srW aesssaw w me best of my krmwlWge. SIGNATURE OF CERTIE ER STATUS OR AFFTLNTION OF CERTIFYRJG PERSON Certifier is a mp mdve of the CUPA, amho a . "L : rm KG Yes ❑ No NAME OF CERTBW &tD rsr D. Kerry Boyle Name ufCUPA satlmrized R' ageroy, or L1A: San Luis Obispo City Fire Department ITTLE of CU71FMR 'ne Hazardous Materials Coordinator Seesdfier is than CUPA/ LU check appmpriam We helow: rm s. Certified" ,t Hygiamst MIR) ADDRESS rss 2160 Santa Barbara Ave. ❑ b. Cetdfied Safety PFofessi ml(CSP) ❑ o. Ceaifmd Manse ora ist(CMC) CRY m San Luis Obispo ❑ d. Regiuered Eevvmwenm Health Specialise(REILS) a Pnefessktd Eagineer(PH) PHONE (805) 781-7383 f loss H Regbmbd Eavirocmemal Ilswmr ❑ 8. Cootracbre' SUMLkems: Bmtd IkeamE ceosacmr (wim hvudaus DATE CERTIRCAMON TD1E 2/5/04 1:00 P.M. substance rcmrvd cenifteau* TANKPREYIOIRLYHEID FLAMMAUZORCOMBUSIMUE TERIAtS Ptaa. ar art m:vtrudgnemmee:sewrca.im.metwxkm�meru o:�n waaeNsmmoeamme s:t.l XEJ Yes No CIItTIFffit'S TANK MANAGEMENT 1NSTRV=ONS FOR SCRAP DEALER, DISPOSAL FACRITY, SIC: No flammable vapors evident. Tank has been triple rinsed with a caustic cleaning agent an then visually inspected. Tank may be recycled as scrap metal. Tank held waste oil only. AeWYofmt wdmm mm awmpraYmurk mar rmyctiq EgrW farWry nogfepbvRedmme CB PA William CUPA. mpW WBhe bdM ae! UPCF (1r99) 201 Faxamiy DTSC 1249 (6199) oil �2 § ` §/ ! IS § ^ ; 2\ a ) 7� � f/ / S E C O R February 24, 2004 Mr. Josh Simmons Kem Construction Post Office Box 6096 Bakersfield, California 93386 Subject: Waste Oil Tank Removal Soil Sample Results Econo Labe N' Tune 286 Higuera Street San Luis Obispo, California Dear Mr, Simmons: SECOR INTERNATIONAL INCORPORATED www,semrcom SECOR Job No. 100T.05971 SECOR International Incorporated (SECOR) is pleased to present this letter -report documenting the results of soil sampling activities conducted during the removal of an underground waste oil tank and associated piping at the above referenced site (Figure 1). The scope of work included the following: • Collection of soil samples from the boundaries of the tank excavation; • Preparation of this letter -report. Project Location and Current Use The subject property is located on the west side of Higuera Street, at the intersection with High Street, in the City of San Luis Obispo, California (Figure 1). The property is currently developed with an automobile servicing facility. Soil Sampling the excavation and tank removal activities. On February 5, 2004, three soil samples were collected (two from the bottom of the tank excavation and one from the trench associated with the removed piping) for laboratory analysis as directed by a San Luis Obispo Fire Department (SLOFD) inspector (Figure 2 depicts soil sample locations). B437 Empresa Drive, Suite 4 San Luis Obispo. California 93401 Tel: (805) 546-0455. Fax: (805) 546-0583 Mr. Josh Simmons February 24, 2004 Page 2 Soil samples were collected from the teeth of the backhoe bucket and placed into laboratory -supplied glass sample jars. The sample jars were immediately sealed with Teflon -lined screw lids, labeled and placed on ice for transport to a California certified laboratory. Analytical. Methods The soil samples were delivered to ZymaX Envirotechnology in San Luis Obispo, California, a State of California Department of Health Services certified laboratory, and analyzed for Total Petroleum Hydrocarbons (TPH) characterized against a motor oil standard (TPHo), volatile organic compounds (VOCs) including benzene, toluene, ethylbenzene, and total xylenes (BTEX), and CA LUFT metals by Environmental Protection Agency (EPA) Test Methods 8260, 6020 and California LUFT GUMS Combination. Copies of certified analytical reports, quality assurance documents, and minimum detection limits for the soil analytical results are attached. Soil Sample Results TPHo and VOCs (including BTEX) were not detected in any of the samples analyzed. LUFT metals, including cadmium, chromium, lead, nickel and zinc were either not detected or detected in the samples at concentrations below the Total Threshold Limit Concentration (TTLC). Thank you for the opportunity to provide environmental services for this project. If you should have any questions regarding the information contained herein, please do not hesitate to contact the undersigned at (805) 546-0455. SEECOORRInternational , Z: or�'—� Chris Prevost, P.E. Associate Engineer Attachments: Figure I Figure 2 — Site Plan Soil na ica Laboratory Reports and Cain of Custody Documentation Cc: Mr. Kerry Boyle, San Luis Obispo Fire Department, 2160 Santa Barbara Avenue, San Luis Obispo, California 93401 XALetters\SLO Econo Lu be N Tune\Soil Sample Results FIGURES SITE h* ._.AIL' 4 o Well a1 (Scele I I Feet) .� 2, 'E w e 2,000 e4� Y I w R' Gray 0i cri VICINITY MAP ECONO LUBE-N-TUBE S E C 0 R 286 HIGUERA ST 3437 Empresa Drive, SUite A, San LUIS Obispo, C 93401 SAN LUIS OBISPO, CA FILENAME: PROJECT NUMBER: DRAWING DATE: FIGURE: F:W0\Pe.se LvxnmxoW6alNGU[uUvn.5M 100T.059I1.001 17 FEB 04 1 ,e -% SOUTH HIGUERA ST FORMER PIPING RUN LURE SAYS S1 PIPING RUN (APPROX. 5' B.G.) 1 zz /CONC� I � /% S3-SOUTH PIT BOTTOM L A.C. (APPROX. 10' B.G.) PAVING // 52-NORTH PIT BOTTOM (APPROX. 10' B.G.) LURE 7 NOT TO SCALE LEGEND ® 501Lsw!Ui WCATIN I S ECOR 3637 Empresa Drive, Suite A, San Wls Obispo, CA 93W3 E NAME: RRW ECT NUMBER: XnAiAWNese� DNeFnNOi2Nameuawn. laaT.0s9n.B01 OF ASPHALT/CONCRETE CUT SITE MAP ECONO LUBE-N-TUBE 286 HIGUERA ST SAN LUIS OBISPO, CA 'E: FIGURE: 1 ] FEB 04 Z SOIL ANALYTICAL LABORATORY REPORTS AND CHAIN OF CUSTODY DOCUMENTATION ,MEMO ��ommmmmmmommom ��MENEEMEMEMEM' ��EEEEEMENEEME IWAWAMOSOMEME ME fl NIN a "PORT OF ANALYTICAL RESULTS ZY�-^ , Page 1 of 3 Client: Chris Prevost Lab Number: 34678-1 SECOR International Inc. Collected: 02/05/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: Si -Piping Run Project Number: 10OT.05971.00.0001 Analyzed: 02/06/04 Collected by: Rich Bosco Method: EPA 8260 CONSTITUENT PQL* RESULT** mg/kg mg/kg VOLATILE ORGANIC COMPOUNDS Benzene 0.005 NO Bromobenzene 0.005 NO Bromochloromethene 0.005 ND Bromodichloromethane 0.005 NO Bromoform 0.005 NO Bromomethane 0.005 NO n-Butylbenzene 0.005 NO sec-Butylbenzene 0.005 NO tert-Butylbenzene 0.005 NO Carbon Tetrachloride 0.005 NO Chlorobenzene 0.005 NO Chloroethane 0.005 NO 2-Chloroethylvinyl ether 0.010 NO Chloroform 0.005 NO Chloromethane 0.005 NO 2-Chlorotoluene 4-Gh.arete,dene 0.005 NO 1,2-Dibromo-3-Chloropropane 0:005 0.010 NO NO Dibromochloromethane 0.005 NO Dibromomethane 0.005 NO 1,2-Dichlorobenzene 0.005 NO 1,3-Dichlorobenzene 0.005 NO 1,4-Dichlorobenzene 0.005 NO Dichlorodifluoromethene 0.005 NO 1,1-Dichlaroethane 0.005 NO 1,2-Dichloroethene (EDC) 0.005 NO 1,1-Dichloroethene 0.005 NO ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit eported-f-present-atoraboveIhe listed Put. MSD #2 34678-1.xls JMM/ash/pvlra 805.5a4 4696 r� Z"V I/ ' -PORT OF ANALYTICAL RESULTS 7 Page 2 of 3 Client: Chris Prevost Lab Number: 34678-1 SECOR International Inc. Collected: 02/05/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Luba-n-Tune Sample Description: S1-Piping Run Project Number: 100T.05971.00.0001 Analyzed: 02/06/04 Collected by: Rich Besco Method: EPA 8260 CONSTITUENT PQL* RESULT** mg/kg mg/kg VOLATILE ORGANIC COMPOUNDS cis-1,2-Dichloroethene 0.005 NO trans-1,2-Dichloroethene 0.005 ND 1,2-Dichloropropane 0.005 ND 1,3-Dichloropropane 0.005 NO 2,2-Dichloropropane 0.006 NO 1,1-Dichloropropene 0.005 NO cis-1,3-Dichloropropene 0.005 NO trans-1,3-Dichloropropene 0.005 NO Dichlorotrifluoroethane 0.005 NO Ethylbenzene 0.005 NO Ethylene Dibromide (EDB) 0.005 NO Hexachlorobutediene 0.005 NO Isopropylbenzene 0.005 NO 4-Isopropyltoluene 0.005 NO Methylene Chloride 0.005 ND Naphthalene 0.005 ND Styrene 0.005 NO 1,1,1,2-Tetrachloroathane 0.005 NO 1,1,2,2-Tetrachloroothene 0.005 NO Tetrachloroethene (PCE) 0.005 NO Toluene 0.005 NO 1,2,3-Trichlorobenzene 0.010 NO 1,2,4-Trichlorobenzene 0.010 NO 1,1,1-Trichloroethane (TCA) 0.005 ND 1, 1,2-Trichloroethane 0.005 ND Trichloroethane (TCE) 0.005 ND ZymeX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit MSD #2 34678-1.xls JMM/ash/pv/ra K5.544.4696 J ZYMOT "FPORT OF ANALYTICAL RESULTS Page 3 of 3 Client: Chris Prevost SECOR International Inc. 3437 Empress Dr., Ste. A San Luis Obispo, CA 93401 Project: Econo Lube-n-Tune Project Number: 10OT.05971.00.0001 Collected by: Rich Besco VOLATILE ORGANIC COMPOUNDS Lab Number: 34678-1 Collected: 02/05/04 Received: 02/05/04 Matrix: Soil Sample Description: S1-Piping Run Analyzed: 02/06/04 Method: EPA 8260 Trichlorofluoromethane (freon 11) 0.005 NO 1, 2,3-Trichloropropane 0.005 ND 1,1,2-Trichiorotrifluoroethane (Freon 113) 0.005 NO 1,24-Trimethylbenzene 0.005 NO 1,3,5-Trimethylbenzene 0.005 NO Vinyl Chloride 0.005 NO Xylenes 0.005 NO Percent Surrogate Recovery 93 ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 "PQL - Practical Quantitation Limit "Results listed as ND would have been reported if present at or above the listed PQL. Submitted by, ZymaX envirotechnology, inc. VS20206 #2 346 34678-i.xls John Mach urphey V JMM/ash/pv/ra Laboratory Director 805.544.4696 ZyM*! .PORT OF ANALYTICAL RESULTS Client: Chris Prevost SECOR International Inc. 3437 Empress Dr., Ste. A San Luis Obispo, CA 93401 Lab Number: 34678-1 Collected: 02/06/04 Received: 02/05104 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S1-Piping Run Project Number: 10OT.05971.00.0001 Analyzed: 02/09/04 Collected by: Rich Besco Method: See Below CONSTITUENT PQL* RESULT** mg/kg mg/kg TOTAL PETROLEUM HYDROCARBONS Total Petroleum Hydrocarbons Percent Surrogate Recovery 10. ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit **Results listed as ND would have been reported if present at or above the listed PQL. Note: Analyzed by GC/MS Combination. Note: Extracted by EPA 3550 on 02/06/04. None: Analytical range is C8-C40. Note: TPH quantitated against motor oil. MSD #5 34678-1t.xls JMM/ash/kg/yl/sd/kd Submitted by, ZymaX enviroteechh-n-olooggy, Inc. /) 'Jit ;1acM rphey Laboratory Director ND 2E 805.544.4696 ZI M� , A 4 ?PORT OF ANALYTICAL RESULTS 34678-1 Client: Chris Prevost Lab Number: SECOR International Inc. Collected: 02/05/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S7-Piping Run Project Number: 100T.05971.00.0001 Analyzed: 02/10/04 Collected by: Rich Basco Method: EPA 6020 CONSTITUENT PQL* RESULT** mg/kg on TOTAL METALS Cadmium 1.0 NO Chromium 1.0 120. Lead 1.0 6.2 Nickel 1.0 210. Zinc 1.0 62. ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory *PQL - Practical Quantitation Limit **Results listed as NO would have been reported if present at or above the listed PQL. Submitted by, ZymaX envirotechnology, inc. , ICPMS #1 C 34678-1 m.xls J n Mach urphey JMM/sks/mm/balam Laboratory Director 80554.L4696 a �z/ -'SPORT OF ANALYTICAL RESULTS ZY�Rr�$� Page 1 of 3 Client: Chris Prevost Lab Number: 34678-2 SECOR International Inc. Collected: 02/05/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S2-North Pit Bottom Project Number: 100T.05971.00.0001 Analyzed: 02/06/04 Collected by: Rich Beeco Method: EPA 8260 CONSTITUENT PQL• RESULT** mg/kg mg/kg VOLATILE ORGANIC COMPOUNDS Benzene 0.005 NO Bromobenzene 0.005 NO Bromochloromethane 0.005 NO Bromodichloromethane 0.005 NO Bromoform 0.005 NO Bromomethane 0.005 NO n-Butylbenzene 0.005 NO sec-Butylbenzene 0.005 ND tert-Butylbenzene 0.005 NO Carbon Tetrachloride 0.005 ND Chlorobenzene 0.005 ND Chloroethane 0.005 NO 2-Chloroethylvinyl ether 0.010 NO Chloroform 0.005 NO Chloromethane 0.005 NO 2-Chlorotoluene 0.005 ND 1,2-Dibromo-3-Chloropropane 0.010 NO Dibromochloromethane 0,005 NO Dibromomethane 0.005 NO 1,2-Dichlorobenzene 0.005 NO 1,3-Dichlorobenzene 0.005 NO 1,4-Dichlorobenzene 0.005 ND Dichlorodifluoromethane 0.005 NO 1,1-Dichloroethane 0.005 NO 1,2-Dichloroethane (EDC) 0.005 NO 1,1-Dichloroethane 0.005 NO ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 "PQL - Practical Quantitation Limit MSD #2 34678-2.xls JMM/ash/pv/ra 805.544 4696 FW- Zy- SPORT OF ANALYTICAL RESULTS 1� 110�� v Page 2of3 Client: Chris Prevost Lab Number: 34678-2 SECOR International Inc. Collected: 02105/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S2-North Pit Bottom Project Number: 10OT.05971.00.0001 Analyzed: 02/06/04 Collected by: Rich Besco Method: EPA 8260 CONSTITUENT PQL* RESULT** mg/kg mg/kg VOLATILE ORGANIC COMPOUNDS cis- 1,2-Dichloroethene 0.005 NO trans- 1,2-Dichloroethene 0.005 NO 1,2-Dichloropropane 0.005 NO 1,3-Dichloropropane 0.005 NO 2,2-Dichloropropane 0.005 NO 1,1-Dichloropropone 0.005 NO cis- 1,3-Dichloropropane 0.005 NO trans- 1,3-Dichloropropene 0.005 NO DichlorotrifIuoroethane 0.005 NO Ethylbenzene 0.005 NO Ethylene Dibromide IEDBI 0.005 NO Hexachlorobutadiene 0.005 NO Isopropylbenzene 0.005 NO 4-Isopropyltoluene 0.005 NO Methylene Chloride 0.005 NO Naphthalene 0.005 NO Styrene 0.005 ND 1,1,1,2-Tetrachloroethane 0.005 NO 1,1,2,2-Tetrachloroethene 0.005 NO Tetrachloroethene (PCE) 0.005 NO Toluene 0.005 NO 1,2,3-Trichlorobenzene 0.010 NO 1,2,4-Trichlorobenzene 0.010 NO 1,1,1-Trichloroethane (TCA) 0.005 NO 1,1,2-Trichloroethane 0.005 NO Trichlcroethene (TCE) 0.005 ND ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit MSD #2 34678-2.xls JMM/ash/pv/ra 805.544.4696 - 'FPORT OF ANALYTICAL RESULTS Page 3 of 3 Client: Chris Prevost SECOR International Inc. 3437 Empresa Dr., Ste. A San Luis Obispo, CA 93401 Project: Econo Luba-n-Tune Project Number: 100T.05971.00.0001 Collected by: Rich Bescc VOLATILE ORGANIC COMPOUNDS Lab Number: 34678-2 Collected: 02/05/04 Received: 02/05/04 Matrix: Soil Sample Description: S2-North Pit Bottom Analyzed: 02/06104 Method: EPA 8260 Trichloroflu orom ethane (freon 11) 0.005 NO 1,2,3-Trichloropropane 0.005 NO 1,1,2-Trichlorotrlfluoroethene (Freon 113) 0.005 NO 1,2,4-Trimethylbenzene 0.005 NO 1,3,5-Trimethylbenzene 0.005 NO Vinyl Chloride 0.005 NO Xylenes 0.005 NO Percent Surrogate Recovery 93 ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitatlon Limit **Results listed as NO would have been reported if present at or above the listed PQL. Submitted by, ZymaX envirotechnology, inc. VS20206 MSD #2 � M- 34678-2.xls J n MacMurphey JMM/ash/pv/ra Laboratory Director Zy -PORT OF ANALYTICAL RESULTS Client: Chris Prevost SECOR International Inc. 3437 Empress Dr., Ste. A San Luis Obispo, CA 93401 Lab Number: 34678-2 Collected: 02/05/04 Received: 02/05/04 Matrix: Soil Project: Econo Luba-n-Tune Sample Description: S2-North Pit Bottom Project Number: 100T.05971.00.0001 Analyzed: 02/10/04 Collected by: Rich Basco Method: See Below CONSTITUENT PQL* RESULT** mg/kg mg/kg TOTAL PETROLEUM HYDROCARBONS Total Petroleum Hydrocarbons Percent Surrogate Recovery 10. ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit **Results listed as NO would have been reported if present at or above the listed PQL. Note: Analyzed by GC/MS Combination. Note: Extracted by EPA 3550 on 02/06/04. Note: Analytical range is C8-C40. Note: TPH quantitated against motor oil. MSD #5 34678-2t.xls JMM/ash/kg/yl/sd/kd Submitted by, Zyy(rmjaaXX envirotechnology, inc. � Jc n Ma= he Laboratory Director ND m 805.544.4696 ZY a _- ,11, :PORT OF ANALYTICAL RESULTS Client: Chris Prevost SECOR International Inc. 3437 Empress Dr., Ste. A San Luis Obispo, CA 93401 Lab Number: 34678-2 Collected: 02/05/04 Received: 02/06/04 Matrix: Soil Project: Econo Luba-n-Tune Sample Description: 512-North Pit Bottom Project Number: 100T.05971.00.0001 Analyzed: 02/10/04 Collected by: Rich Bosco Method: EPA 6020 TOTAL METALS Cadmium 1.0 1.3 Chromium 1.0 140. Lead 1.0 12. Nickel 1.0 220. Zinc 1.0 79. ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 'PQL - Practical Quantitation Limit "Results listed as NO would have been reported if present at or above the listed PQL. ICPMS #1 34678-2m.xls JMM/sks/mm/ha/am Submitted by, (ZZyyjm,�aaXenvirote/chhno�logy, Inc. Jln ' Machey v Laboratory Director 805.544.4696 'SPORT OF ANALYTICAL RESULTS &TIO, Page 1 of 3 Client: Chris Prevost Lab Number: 34678-3 SECOR International Inc. Collected: 02/05/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S3-South Pit Bottom Project Number: 100T.05971.00.0001 Analyzed: 02/06/04 Collected by: Rich Bosco Method: EPA 8260 CONSTITUENT PQL" RESULT** mg/kg mg/kg VOLATILE ORGANIC COMPOUNDS Benzene 0.005 NO Bromobenzene 0.005 NO Bromochloromethane 0.005 NO Bromodichloromethane 0.005 NO Bromoform 0.005 NO Bromomethane 0.005 NO n-Butylbenzene 0.005 NO sec-Butylbenzene 0.005 NO tert-Butylbenzene 0.005 NO Carbon Tetrachloride 0.005 NO Chlorobenzene 0.005 NO Chloroethane 0.005 NO 2-Chloroethylvinyl ether 0.010 NO Chloroform 0.005 NO Chloromethane 0.005 NO 2-Chlorotoluene 0.005 NO 1,2-Dibromo-3-Chloropropane 0.010 NO Dibromochloromethane 0.005 NO Dibromomethane 0.005 NO 1,2-Dichlorobenzene 0.005 NO 1,3-Dichlorobenzene 0.005 NO 1,4-Dichlorobenzene 0.005 NO Dichlorodifluoromethane 0.005 ND 1,1-Dichloroethane 0.005 NO 1,2-Dichloroethane (EDC) 0.005 NO 1,1-Dichloroethene 0.005 NO ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 •PQL - Practical Quantitation Limit MSD #2 34678-3.xls JMM/ash/pv/ra 805.544.4696 r 'SPORT OF ANALYTICAL RESULTS ZA i Page 2 of 3 Client: Chris Prevost Lab Number: 34678-3 SECOR International Inc. Collected: 02/05/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Luba-n-Tune Sample Description: S3-South Pit Bottom Project Number: 10OT.05971.00.0001 Analyzed: 02/06/04 Collected by: Rich Bosco Method: EPA 8260 CONSTITUENT PQL* RESULT** mg(kg mg/kg VOLATILE ORGANIC COMPOUNDS cis-1,2-Dichloroethene 0.005 NO trans-1,2-Dichloroethene 0.005 NO 1,2-Dichloropropane 0.005 NO 1,3-Dichloropropane 0.005 NO 2,2-Dichloropropane 0.005 NO 1,1-Dichloropropane 0.005 ND cis-1,3-Dichloropropene 0.005 ND trans-1,3-Dichloropropene 0.005 NO Dichlorotrifluoroethene 0.005 NO Ethylbenzene 0.005 NO Ethylene Dibromide (EDB) 0.005 NO Hexachlorobutadiene 0.005 NO Isopropylbenzene 0.005 NO 4-Isopropyltoluene 0.005 NO Methylene Chloride 0.005 ND Naphthalene 0.005 ND Styrene 0.005 NO 1, 1, 1,2-Tetrachloroathane 0.005 ND 1, 1, 2,2-Tetrachloroathane 0.005 ND Tetrachloroethene (PCE) 0.005 NO Toluene 0.005 NO 1,2,3-Trichlorobenzene 0.010 NO 1,2,4-Trichlorobenzene 0.010 NO 1,1,1-Trichloroethane (TCA) 0.005 NO 1,1,2-Trichloroethane 0.005 ND Trichloroethene (TCE) 0.005 ND ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit efesaits risred as NO wound have been napol[¢tl7i'7present at or al5ave0re usteu rut. MSD #2 34678-3.xls JMM/ash/pv/ra HO:.S -A^Ac - =PORT OF ANALYTICAL RESULTS ZYa ° 1 111p(,, . iv Page 3 of 3 Client: Chris Prevost Lab Number: 34678-3 SECOR International Inc. Collected: 02/06/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S3-South Pit Bottom Project Number: 10OT.05971.00.0001 Analyzed: 02/06104 Collected by: Rich Besco Method: EPA 8260 CONSTITUENT PQL* RESULT" mg/kg mglkg VOLATILE ORGANIC COMPOUNDS Trichlorofluoromethane Ifreon 11) 0.005 NO 1,2,3-Trichloropropane 0.005 NO 1,1,2-Trichlorotrifluoroethane (Freon 113) 0.005 NO 1,2,4-Trimethylbenzone 0.005 NO 1,3,5.Trimethylbenzene 0.005 NO Vinyl Chloride 0.005 NO Xylenes 0.005 NO Percent Surrogate Recovery 91 ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 "PQL - Practical Quantitation Limit *"Results listed as NO would have been reported if present at or above the listed PQL. Submitted by, ZymaX envirotechnology, Inc. VS20206 MSD #2%'L� 34678-3.xls Jon MacMurphey JMM/ash/pv/ra Laboratory Director 805.544.4696 Zym 11 ,v :PORT OF ANALYTICAL RESULTS Client: Chris Prevost SECOR International Inc. 3437 Empress Dr., Ste. A San Luis Obispo, CA 93401 Lab Number: 34678-3 Collected: 02/05/04 Received: 02/05/04 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S3-South Pit Bottom Project Number: 10OT.05971.00.0001 Analyzed: 02/10/04 Collected by: Rich Bosco Method: See Below CONSTITUENT PQL" RESULT*" mglkg mg/kg TOTAL PETROLEUM HYDROCARBONS Total Petroleum Hydrocarbons Percent Surrogate Recovery 10. ZymaX enviratechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 "PQL - Practical Quantitation Limit "Results listed as ND would have been reported if present at or above the listed PQL. Note: Analyzed by GC/MS Combination. Note: Extracted by EPA 3550 on 02/06/04. Note: Analytical range is C8-C40. Note: TPH quantitated against motor oil. MSD #5 34678-3t.xla JMM/ash/kg/yl/sd/kd Submitted by, ZZ'yym]Va,XX envirotech'nolog�y, inc. John MaccM phey V Laboratory Director NO 55 805.544.4696 e`PORT OF ANALYTICAL RESULTS Client: Chris Prevost Lab Number: 34678-3 SECOR International Inc. Collected: 02/06/04 3437 Empress Dr., Ste. A Received: 02/05/04 San Luis Obispo, CA 93401 Matrix: Soil Project: Econo Lube-n-Tune Sample Description: S3-South Pit Bottom Project Number: 10OT.05971.00.0001 Analyzed: 02/10/04 Collected by: Rich Besco Method: EPA 6020 TOTAL METALS Cadmium 1.0 1.5 Chromium 1.0 130. Lead 1.0 8.8 Nickel 1.0 220. Zinc 1.0 80. ZymaX envirolechnology, inc. is certified by CA Department of Health Services: Laboratory #1717 *PQL - Practical Quantitation Limit "Results listed as ND would have been reported if present at or above the listed PQL. ICPMS #1 34678-3m.xls JMM/sks/mm/ba/am Submitted by, ZyymaXX envlrotechnology, inc. `Rmaac eey Laboratory Director 805.544.4696 QUALITY ASSURANCE REPORT ZY�qa ,-• e,nTl SPIKE RESULTS Client: Lab Number: QS VS20206 ZymaX envirotechnology, Inc. Collected: 71 Zaca Lane, Suits 110 Received: San Luis Obispo, CA 93401 Matrix: Soil Project: iption: EAnalyzed: Quality Assurance Spike Project Number: 02/06/04 Collected by: See Below CONSTITUENT Amount Spiked Amount Recovered Percem mg/kg mglkg Recovery VOLATILE ORGANIC COMPOUNDS Benzene 0.033 0.028 85 Chlorobenzene 0.033 0.029 88 1, 1 -Dichloroethene 0.033 0.031 94 Toluene 0.033 0.027 82 Trichloroethene (TCE) 0.033 0.027 82 Percent Surrogate Recovery 96 ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 Note: Analyzed by EPA 8260 and GC/MS Combination. Submitted by, ZymaX envirotechnology, inc. VS20206 MSD #2 VS2O2O6q.xls John MacMurphey JMM/ash/pv/am Laboratory Director 805. 544.4696 QUALITY ASSURANCE REPORT 7 � � ` Zym SPIKE DUPLICATE RESULTS Client: Lab Number: QSD VS20206 ZymaX envirotachnology, Inc. Collected: 71 Zaca Lane, Suite 110 Received: San Luis Obispo, CA 93401 Matrix: Soil Project: ption: EAnalyzed: Quality Assurance Spike Duplicate Project Number: 02106/04 Collected by: See Below CONSTITUENT Amount Spiked Amount Recovered Percent Relative Percent mg/kg mg/kg Recovery Difference VOLATILE ORGANIC COMPOUNDS Benzene 0.033 0.029 88 Chlorobenzene 0.033 0.030 91 1,1-Dichloroethene 0.033 0.031 94 Toluene 0.033 0.028 85 Trichloroethene (TCE) 0.033 0.028 85 Percent Surrogate Recovery 95 ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory N1717 *Relative Percent Difference of the spike and spike duplicate Note: Analyzed by EPA 8260 and GC/MS Combination. Submitted by, ZymaX envirotechnology, Inc. VS20206 MSD #2 r�--- VS20206q.xls Jo MacMurphey JMM/ash/pv/sm Laboratory Director 805.544.4696 QUALITY AS! 'DANCE REPORT -BLANK RESULTS Zy"Iffi Page 1 of 3 Client: Lab Number: BLK VS20206 ZymaX envirotechnology, Inc. Collected: 71 Zaca Lane, Suite 110 Received: San Luis Obispo, CA 93401 Matrix: Sell Project: Sample Description: Method Blank Project Number: Analyzed: 02/06/04 Collected b Method: See Below CONSTITUENT PQL" RESULT" mglkg mg/kg VOLATILE ORGANIC COMPOUNDS Benzene 0.005 NO Bromobenzene 0.005 NO Bromochloromethane 0.005 NO Bromodichloromethane 0.005 NO Bromoform 0.005 NO Bromomethane 0.005 NO n-Butylbenzene 0.005 NO sec-Butylbenzene 0.005 NO tert-Butyl benzene 0.005 NO Carbon Tetrachloride 0.005 NO Chlorobenzene 0.005 NO Chloroethane 0.005 NO 2-Chloroethylvinyl ether 0.010 NO Chloroform 0.005 NO Chloromethane 0.005 NO 2-Chlorotoluene 0.005 NO 1,2-Dibromo-3-Chloropropane 0.010 ND Dibromochloromethane 0.005 NO Dibromomethane 0.005 NO 1,2-Dichlorobenzene 0.005 NO 1,3-Dichlorobenzene 0.005 NO 1,4-Dichlorobenzene 0.005 NO Dichlorodifluoromethane 0.005 NO 1,1-Dichloroethane 0.005 ND 1,2-Dlchloroethene (EDC) 0.005 NO 1, 1 -Dichloroethene 0.005 NO ZymaX enviratechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 "PQL - Practical Quantitation Limit MSD #2 VS20206b.xls JMM/ash/pv/ra 805.544A696 QUALITY AS.` `ANCE REPORT - BLANK RESULTS Zya fi�I I. I�� 1 Page 2 of 3 Client: Lab Number: ELK VS20206 ZymaX envirotechnology, Inc. Collected: 71 Zaca Lane, Suite 110 Received: San Luis Obispo, CA 93401 Matrix: Soil Project: Sample Description: Method Blank Project Number: Analyzed: 02/06/04 Collected by: Method: See Below CONSTITUENT POLO RESULT*" mg/kg mg/kg VOLATILE ORGANIC COMPOUNDS cis-1,2-Dichloroethene 0.005 NO trans-1,2-Dichloroethene 0.005 ND 1,2-Dichloropropane 0.005 ND 1,3-Dichloropropane 0.005 ND 2,2-Dichloropropane 0.006 NO 1,1-Dichloropropane 0.005 NO cis-1,3-Dichloropropene 0.005 NO trans-1,3-Dichloropropene 0.005 NO Dichlorotrifluoroethane 0.005 ND Ethylbenzene 0.005 NO Ethylene dibromide (EDB) 0.005 NO Hexachlorobutadiene 0.005 NO Isopropylbenzene 0.005 NO 4-Isopropyltoluene 0.005 NO Methylene Chloride 0.005 ND Naphthalene 0.005 NO Styrene 0.005 NO 1, 1, 1,2-Tetrachloroethane 0.005 NO 1,1,2,2-Tetrachloroethane 0.005 NO Tetrachloroethene )PCE) 0.005 NO Toluene 0.005 NO 1,2,3-Trichlorobenzene 0.010 NO 1,2,4-Trichlorobenzene 0.010 NO 1,1,1-Trichloroethane ITCA) 0.005 ND 1,1,2-Trichloroethane 0.005 NO Trichloroethane (TCE) 0.005 NO ZymaX envirotechnology, inc. is certified by CA Department of Health Services: Laboratory #1717 •PQL - Practical Quantitation Limit MSD #2 VS20206b.xls JMM/ash/pv/ra 805.544.4696 Zymadc Client: ZymaX envirotechnology, Inc. 71 Zaca Lane, Suite 110 San Luis Obispo, CA 93401 Project: Project Number: Collected by: VOLATILE ORGANIC COMPOUNDS QUALITY ASSI ',NCE REPORT - BLANK RESULTS Page 3 of 3 Lab Number: ELK VS20206 Collected: Received: Matrix: Soil Sample Description: Method Blank Analyzed: 02/06/04 Method: See Below Trichlorofluoromethane (freon 11) 0.005 NO 1,2,3-Trichloropropane 0.005 NO 1,1,2-Trichlorotrifluoromethane (Freon 113) 0.005 NO 1,2,4-Trimethylbenzene 0.005 NO 1,3,5-Trimethylbenzene 0.005 ND Vinyl Chloride 0.005 ND Xylenes 0.005 ND Percent Surrogate Recovery 96 ZymaX envirotechnology, Inc. is certified by CA Department of Health Services: Laboratory #1717 "PQL - Practical Quantitatlon Limit "Results listed as ND would have been reported if present at or above the listed PQL. Submitted by, ZymaX envirotechnology, Inc. VS20206 MSD #2 t - VS20206b.xls Ahn MacMurphey JMM/ash/pv/ra Laboratory Director 805.544.4696 Feb 12 04 08:16a Secor- San Luis Obispo (8053546-0583 p.1 to SECOR IN.ERNATIONAL INCORPORATED 3e37 rmpreaa Drive Suite A wwwWoccom S E C O R 00544eoassarpuaeosCA pa08a0re. xas If a x faxno: 5y3)— 1t Cjq attention: kZrr r e0wrle, company: 5(U ♦ > date/time: 1Zy lfr-/C from: CPlriS frt✓o'� number of pages (including cover): 17 ReSVlls F, o Labe Al Tome /�;� Lerti S4-e Disclaimer: The information transmitted herein is intended only for the person or entity to which 11 is addressed an may contain confidential andlor privileged material. If you are not the intended recipient of the message, you are hereby notified that any use, raview, retransmission, dissemination, distribution, reproduction or any action taken in reliance upon this message is prohibited. If you received this communication in error, please notify Oe sender immediately and delete the- agand all attachments from I q n files Feb 12 04 O0:17a Secor- San Luis Obispo (805)546-0583 p.3 FEB It 2004 16:22 HP LRSERJET 3200 P.3 REPORT OF ANALYTICAL RESULTS Zyo Page i of 3 CI'xnt: Clair Prevost Lob Nonall 34678-1 SECOR Lnternwenal Inc. Collected: 02R19l04 3437 Empras i Or., Sts. A Received: 02IM04 S1-PIPbig Run Pioism Number 100T.05971.00.0001 Analyzed: 02I0411M Collected Inv Rich Basco M tlrod• EPA 8290 CONSTITUENT POLO RESULT'• rruft muft VOLATILE ORGANIC COMPOUNDS Benzene 0.005 NO Bromobenzene 0.005 No Bromochloromotharve 0.005 ND Bromodichlommethans C.005 ND Bromotorm 0.005 NO Bromomethane 0.005 NO n-Butyibenzens 0.005 NO sec-Ourylhenzene 0.005 NO fart-Butylbenzerle O.D05 NO Carbon Tetrachloride 0.005 NO Chlorobenzers 0.005 ND Chloroethane 0.005 ND 2-Chloroe/hylvinyl ether 0.010 ND Chloroform 0.006 NO Chloromethene O.005 ND 2-Chlorotuluene O.D05 ND 4-Chlorotoluene 0.D05 NO 1.2-Dibromo-3-Chlomprapane 0.010 NO Dibromochloromathane 0.005 NO Nbromomethwo 0.005 NO 112-Dichlorobenzane 0.005 ND 1,3-Dichlorobenz0ne 0.005 ND 1,4 Mchlorobwzene D.005 ND Dichlorodifluuromethem 0.005 NO IA-Dichloroethwe 0.005 ND 1,2-Dichlormthane IEDCI 0.005 NO 1-1-01chlorwthans 0.005 NO zvmax mmOroischnoiogy, Inc. is cortl0od by CA Departmant of 110a1th Sarvicr: leboretury #1717 'POL- Practical Ouon itedon limit ••Results listed az NO would have bosh reported If prevent at or above the listed POL. MM a2 JMWork/pWra 805.544.4696 n z m"° Sm Wh CbNpe G Y3rer WIMyZvTOitUSO.COT ke a0551{atlb Feb 12 04 08:17a Secor- San Luis Obispo (805)546-0583 p.4 FEB 11 2004 16:22 NP LRSERJET 3200 p.4 Client: Chris Provost SECOR Intametiarel Inc 3437 Empress Dr., Sts. A San Luis Obispo, CA 93401 Number: tODTA)MI.00.0001 VOLATILE ORGANIC COMPOUNDS ds-1.2-DlcNometicne tranv1.2-Ditddoroathene 1,ZMhbropropan4 1,3-D'chlompropene 2,2-Dichlompropans 1,1-Okhloropropene dr1.3-Diehl oroproperab trans-1,3-Dichloropropene Didnlaotdpuoropthane Ethylbeniene Ethylom Dibromide IEDB) Nexachlombutadiene Impropylbemene 4-Isopropyholuena. Methylene Chloride Naphthalene n-Piopylbenzerm Styrene 1,1,1,2-7eoechlommhane 1,1,2,2-TstrecMaronhane Tabachlorosthane IPCE) Toluene 1,2,3=Tdchlabbenzene 1,2,4-Triehlaobenzene 1.1,1-TrIChlorroethane ITCA) 1,1,2-TrIChI0nHnl1ane Trichloroethene ITCEI REPORT OF ANALYTICAL RESULTS Page 2 M 3 Lab umbar: 34678-1 CoO=: 02/05/04 Received: 02/05104 Matrix: SIDE Sanple Description: Sl-Piping Run Analyzed: 02JOS104 Method: EPA 8260 0.005 ND 0.005 ND D-005 NO 0.005 ND 0.D05 ND 0.D05 NO 0.DO5 ND 0.005 ND 0.005 ND 0.005 NO 0.005 ND 0-005 ND 0_D05 ND 0,005 ND 0.005 NO D.o05 NO 0.005 NO 0.005 ND 0.006 ND 0.005 ND 0.005 NO 0.005 NO 0.010 NO 0.010 ND 0.005 NO 0.005 ND 0.006 NO ZynlaX anvimmalamlogy, Me. is Ca rifled by CA DapMbnent of He" Services: Labaaaery #1717 aPOL - Practical Ouaahation Ulnit '•Resuhs liisted as NO would heirs been rapo0ae if present an or above the Ibted POL. MSD e2 JMM/eahWrs 805.544.4696 71 za,a Ime 5m lws OGvpeQ 9MOI ~vZymaXuse.c0m m 805.st4 M Feb 12 04 08:17a Secor- San Luis Obispo (805)546-0583 P.5 FEB It 2004 16:22 HP LRSERJET 3200 P.5 COam: Chile Prevent SECOR hWnwiend Inc. 3437 Empress Or., Sta. A San Lade Ob(apo. CA 53401 Eonn l Lubaar-Time lProject: pact Ma disc 100T.05971.00.0001 Collectild Rich Boom VDLATiLE ORGANIC COMPOUNDS REPORT OF ANALYTICAL RESULTS Papa 3 913 lab y11ar16R: 34978-1 Co6scled: 02/05104 RseMvad. .' 02/05/04 Maa R: Sd 51-0ipinp Run 02/06M Trlchkawfucromethane (freon 11) O.DO5 NO 1.2,3-Triehlmopropane 0.005 NO 1.1,2-Trlchlorotrifluoroethane (Freon 1131 0.005 NO 1,2.4-Trimethylbenzvne 0.005 Nit 1,3,b-Trimethylbanzene 0.005 NO Vinyl Chloride O.DO5 NO Xylenee 0.005 NO Pernem Surrogate Recovery 93 ZymaX anviresechndogy, Inc. Is credited by CA Daparinrent o1 Health Services; Laboratory P1717 •POL-PracdOd Quandtadon Lim" "Results (bled m NO would here been reconnect it present at or above Me holed PQL. Sti m6�a — ZymaX wwlrelacheroki Inc. VS20206 MSD 12 34676-11.ds J MecMurphey JMM/aaNpyha Labadory Matter 505.544.4696 sm laaowraauyu9l wwwZyrna)(use.corn 1�eas.sussae Feb 12 04 06:17a Secor- San Luis Obispo (805)546-0583 P.5 FEB 11 2004 16:22 HP LASERJET 3200 P.6 zYmm REPORT OF ANALYTICAL RESULTS U678-1 Client: Chris Prevost Lab Number: SECOR Intemadonal Inc. Collected! 02/05/04 3437 Empress Dr.. Ss- A Received: 02l05f04 San We Obispo. CA S3401 Msirix: Soil Deamiptlon: PlWxi; Eeono LUbsn-Tune S1-Piping Pun Projeei Numble: 10DT.05g71.00.000t : F:d 02108X14 Cokettad Rkdr Resea : us Below CONSTITUENT POL" RESULT'• mg/kg mafkg TOTAL PETROLEUM HYDROCARBONS Total Petroleum Hydrocarbons Permrn Surrogate Recovery 10. "X envirotachnology. Inc. N cardOW by CA Delta it art of Health Seiviae: Laboratory d1717 -POL - Praetieal Connotation Limit ""ResWs listed as NO woWd have base reported 8 present s or above toe IIsted POL. Note: Anol"od by OCRMS COmbinndon. Note: Extracted by EPA 3550 on 02106104. Nos: Analytical range is C8-C40. Note: TPH WaMHated against motor ad MSO a5 34678-1t.AF JMMI®h/kg/yl/ad/kd Submbted by. Zvevur envinnecrhnolO�gy`Nle�.( J/ jMsclgurphW _ Laboratory Director Uj 63 805.544.4696 y1 Zara l'"r sv. testa Jbrpo G s3mi uvWw.ZyfildXu5:3.com Ito 9peJK.9110 Feb 12 04 O6:17a Secor- San Luis Obispo 18051546-0583 p.7 FEB 11 2004 16.22 HP LRSERJET 3200 p.7 ZOREPORT OF ANALYTICAL RESULTS Eab Numbr: =etted: 34678-1 CFienl: Chris Prevost SECOR International Inc. O7JOSM4 3437 Empress Dr.. Ste. A Retahred: 02O5104 SNt Llris , CA 93401 MNdc Sail Pao": Caa1r0 Lubeat-Tuna Sample DaeogOon: S144onp Run Pnijeat Number. 1O0T.O5871.00.00O1 Andvaad: 02/10IO4 OaNeetad RIM Sweo Matlrod: EPA W2O CONSTTUENT �'fSEBULT46 m9Rte waft TOTAL METALS Cadmium 1.0 ND Chromium 1.0 120. Land 1.0 6.2 Mckel 1.0 210, Zinc 1.0 62. ZVnmX a nvirchmarology. ins. In w Mlad by CA Deper4nent o1 HadM SWvfCM: Latrandory N1717 `PQL - Practical Questitation Limit "banuln Ilated w NO world have bean reprated i1 prerem at or above mir lists PQL. Subanted by, Zyma% am Wrechnob9y, ins., 1pMSI1 �.1�� 3"Mim.sis J MsdRumhey JMMhbImmRWem Labamlo Director 8O5.544.46V6 lrn larD ux(at y3401 waw.ZymB%UBB.eMI be a03.N1.r1N Feb 12 04 00:18a Secor- San Luis Obispo 18051546-0583 p.B FES 11 2004 16:22 RP LBSERJET 3200 P.8 Client: Chile Prevost SECOR InternstlorW Inc. 3437 Empress Dr., Ste. A San Luis Obispo, CA 93401 Project: Econo Lube-n-Tuns Project Number: 100T.06971 A0.00p1 Colected Rich III VOLATILE ORGANIC COMPOUNDS Benzene Bromooenzane Bromochloromathane eromodichioromethena Bromofolm Bromomethane n-Butyibenzene sec-Burylbanzene tart-Bulylbenzens Carbon Tetrachloride Chlorobenzene Chloreethane 2-Chlcroathylvinyl ether Chbletorm Chlommethane 2-Chlormoluene 4-ChlorotoWens 1,2-Dibromo-3-CNoropmpems Dibro mochlo ro methane Dibsomornamone 1,2-Dichlorobenzane 1.3-DI010Tobenzens 1,4-Dichbrobarrzene DicWorodifIuoromethana 11-Diohlomethans 1,2-Dichloroetheno 1EDCI 1,1-Dichloroethene PBORT OF ANALY71CAL RSU-TS Pga1 of lsm Nunbar: - 34/78.2 Collected: 02105/04 Received: 021OL404 Matrix- SoA S244orth PN 0p0eel 02/06104 0-005 NO 0.005 ND 0.005 ND GA05 ND 0.005 NO 0.005 ND 0.005 ND 0.005 ND MOOS ND D.005 ND 0.005 ND 0.005 ND 0.010 ND 0 005 NO 0.005 ND 0.005 NO 0.005 ND 0.010 NO 0.005 ND QDD6 Nn 0.005 NO MOOS ND 0.005 ND 0.005 ND 0.005 ND O.00S ND 0.005 ND Zyma1L mvirobchrpbpy, Inc. Is castled by CA Department of Health Senators: Laboratory 01717 •POL - Preclical Duamhsdan Limit • •Results Isted as ND would have beam reported 11 present act absent the fisted Pt1L. MSD 02 JNMleshlpv(rs aOS.544.4696 ri.�.om cmwo u 95401 v v+. ZymaXusa.com baCS 544.5226 Feb 12 04 00:18a Secer- San Luis Obispo 18051546-0503 P.9 FEB I1 2004 16:22 HP LRSERJET 3200 P.9 IIEPOIIT OF ANALYTICAL RESULTS Z"NX Pegs 2 of 3 mber: 34678-2 Client: Chds Prevost SECOR IMemadmal Inc. oSeot se: 141mlivix: 02/OSf04 3437 Ernprra Or., Sta, A Recall 02/05r04San Luis Obis . CA 93401 Solt Project: Eeooe Lukern-Tune SampD Descripaan: S2� mh Pit Bottom Proper Weather: 100T.05971.00.0001 lColleGlead JAnalyzed: 02106/04 by; Rich Beare MotMd: EPA 8260 CONSTITUENT POLr RESULT" nig/killi mglkg VOLATILE ORGANIC COMPOUNDS cb-1,2-Dichloroetheno O.005 NO vans-1,2-Dichloroethene 0.005 NO 1,2-Dichbroprepane 0.005 NO 1,3-Dlchbroprepenn 0005 NO 2.2-Dlchloropro pane 0.005 ND 1,1-Dichloropropene 0.D05 ND cis-1,3-Dichiompropone 0.005 NO trans-1.3-01chlaropropene 0.005 NO Dichlwotri0uomethane 0.005 ND Ethyibenzene 0.005 NO Hhylene Dibromide (EDBI 0.005 ND Hexachlnrobutadiene 0.005 ND Isopropylbmzene 0.D05 NO 4160propyltoluena 0.005 ND Mnhyfene Chloride 0.005 ND Naphthalene 0.005 NO n-Propylbenzene 0.005 NO Styrene 0.005 NO 1, 1, 1,2-Tetrachloroethene 0.005 NO 1, 1,2,2-Tetrachioronhane ND Tatmchloroethens IPCE) O.ODS ND Toluene 0.005 NO 1,2.34iichlorabanzans 0.010 NO 1,2,4.TrichbrobanzeM 0.010 ND 1,1,1-Trichlarpathane ITCAI 0.005 ND 1,1,2-Trichloroetherm 0.005 ND Trichlcroethene ITCEI 0.005 NO 2ynmX snvirotaehncloay. Inc. is certified by CA Deperanam of HUOh S"ry s: Labornory 61717 •POL - practical Ouandtaeon Umit "Assults Bread as NO would have aeon rep Mad If present at or above the listed POL. MbD 42 JMMfnh/pv/n 805.544,4696 vrww.ZymaXus0.com 11LNvua SntWa06 CAr3401 Imeassu.ezz4 Feb 12 04 08:18a Secor- San Luis Obispo (8053546-0583 p.10 FEB It 2004 26:22 HP LRSERJET 3200 P.10 Z"Nx NEPORy OF ANALYTICAL IESULTS PeBe3M3 Client: Clubs Parrot [Recoevoil: b Number: 34678-2 SECOR ImernalbaN Inc.ollocted: 02ID5/04 3 17 Empreee Or., Ste. A 02/05/O4Ban lute OMa - CA 93s01 ertz: Shc lProject: Econo Lube-n-Tune I Semple Oaeriptim: Morih Pit Bottom Projecl Number: 100T.05971.00.00D1 Anelyz": 02006/04 Callectuld by EPA $260 CONSTITUENT PGLv RESULT•• m91kg m9Rt9 VOLATILE ORGANIC COMPOUNDS Trichlorofluorometheoe Mean III ODDS NO 1,2.3-Trichloropropine O.DO5 NO 1,1,2-Trichlorutrifluoroethono (Freon 1131 0.005 NO 1,2,44thrwthylbanzene 0.005 NO 1,3,5-Trimethylhanzene 0.005 No Vinyl Chloride O.OD5 NO %ylenes 0.005 NO Percent Surrogate Recovery 93 Zymalt enwhooc tnology, ins. is carti5ed by CA Department of Health Services: laboratory #1717 a POL - Practical 0rwrtitation Unit "Results sated as NO would have base reported H preasm of or above the ltsted POL. MonaX (mdrotedatokBy, Inc. VS20206 ILA MSO 02 /-- 34878-2.ab 4 nMdWu; JMMIs"i r/ra Laboratory Director 805.544.4696 r1 r°m' son ma ONsoo C 93401 vdy@i.Zymaxusa corn b, 305.544 9226 Feb 12 04 O6:18a Secor- San Luis Obispo 18051546-0583 P.11 FEB 11 2004 16:22 He. LRSER3ET 3200 p-11 17 CSwt Chda Prevoal SECOR lnterne6onal Inc. 3437 Empress Dr.. Ste. A Son Lit Obispo, CA 93401 rCollsoed : Ecalo Lube Ter* Number: 100T.06971.00.0001 by: ace Basco TOTAL PETROLEUM HYDROCARBONS Total Petroleum Hydrocarbons percent Sufroome Rewwry REPORT OF ANALYTICAL RESULTS Lab Humber.=346718.2Caaeeted:Relived:Matrix: Sample Decor'"un: S2-Nortli Pt Bottom Arwlyzed: 02110/04 Method: See Below 10, Zyme c onvirutachnuloSy. inc. in mnifred by CA Departmnt of Heeltb Sondow: Leborwory 01717 •POL - Practical CIUMIUtetlen 6Ht ••Result listed as ND would have been reported If present M or stove tbe listed PM. Not: Analyzed by GC/MS Cumbinatbn. Not: Extractd by EPA 3E50 on 021011ifOe. Nab: Anaytical range Is C8-C40- Nob: TPH quantibted agaimt mutr w. ND U-3 edenstuel. 1, . Z"Wx rawireaelaahw. Inc. MSD 06 /-- 34678-2t.As jormRib Munow JMMfayhlkglyl/sdhd Lsbor"W Dilater Zl Zcnc n 805.544.4696 sw L,,:tobiwoasa.m wwwZymeXusa.eom k. w� srasne Feb 12 04 08:19a Seeor- San Luis Obispo 18051546-0583 P.12 FEB 11 2004 16:22 HP LRSERJET 3200 1 P•12 A `S" RE"RT OF ANALYTICAL RESULTS CIISM: Ch1N PnvMt lab Number: 9487&2 SECOR International Inc. CdMted: 0205/04 3437 Empress Dr., Ste. A Raulvad: 0205/04 Son Luis Obisu, CA 93401 MaU{R: SOS ProjsU: Emno Lube-n-Tuna Semis Description: S24dorlh Pit Balsam Project NumMr: 100T.06871,00.0001 Analyzed: 02110/04 icc9mcw by: Brat Besco Method: MA 8020 CONSTITUENT POL• RESULT" mglkg W401ko TaTAL METALS Cadmium 1.0 1.3 Chromium 1.0 140. Lead 1.0 12. Nickel 1.0 220. Zinc 1.0 79. ZymaX savbotechnology, Inc. Is cerdfled by CA Depertmwrt of Health Services: laboratory a1717 OP12L • Ptaedgel O mdta0an Limit "RMUIO listed M NO would have been reported If Present at w above "Rsttl POL. Submitted by, 2yma% envirottchnology. Inc. ICPMS 81 VF�1—� t 34678m -2sb Jogs mumunew JMNvakBi momm laboratory Dimmer 505.544.1496 3rn Win Ob C 93401 vwa ZymaXuw.com In. Ms.s«.ena Feb 12 04 08:19a Secor- San Luis Obispo I8051546-0583 P.13 FEB 11 2004 16:22 HP LRSERJET 3200 P.13 Zy REPORT OF ANALYTICAL RESULTS Pale 1 at 3 Client Chris Prsvaat lW Numbw: 3467a-3 SECOR Intame6onal Inc. CaExted: 02/05/04 3437 Emprome Or.. Sle. A MRso 02/06/04 n L San Obispo, CA 93401 Melriz: Sall Project: Ecano Lub►n-TUM Semple D modpdan: 83-Sam Pit Softom project NwWer: 1 OOT.05071.00.0001 Analyzed: 02mwm lCalected Ridr Sseca Mwhod: EPA U260 CONSTITUENT POLO HESULT" mgleg - MOB VOLATILE ORGANIC COMPOUNDS Samem 0.005 NO BremobsnzMe . - - 0.005 NO Brpmochloromethens 0.005 NO Bromadichlmomethom 0.005 NO Bromoform 0.005 ND Brwnomethans 0.005 NO r Butylbenzene 0.005 NO wc-Butylbenzane 0.005 ND tert-Butylberuene 0-005 NO Carbon Tetrachloride 0.005 NO Chbrabonzene 0.005 NO CMaoethene 0.DO5 NO 2-Chlomethylvinyl ether 0.010 NO Chloroform 0.005 NO Chlaromethane 0.005 NO 2-CMoratoluene 0.005 ND 4-Chlamtoluene 0.005 NO 1,2-Dibramo-3LWWOPropene 0 010 NO Dibromochloromethem 0.005 NO Dibromomethene 0OD5 NO 1,2-Dichlorabenzene 0.005 NO 1,3-Dlchlorabenzens 0.005 NO 1,4-Oichlorobenzens 0.005 NO Dichlorodilluaromethme 0.0m NO 1,1-DichlorowNne 0.006 NO 1,2 Dichloromhene 1EDCI CA05 NO 1,1-Dichloroathene 0.005 NO zymeX enWroteehnwogy. Inc. is cemfied by CA Deperaromft of Health Benicia: LaborMory 11717 e POL - PraeOeal Oubrlllmton Unit ••Results lievd as NO wowd heve been reported it promect w or abow the bled POL. MSD e2 JMM/ashlpv/ra 805.544.4696 mn wu Oe'a,o cn 93ap1 www2ymaxusamr m � ecs 5"122e Fob 12 04 00:19a Secon- yen Luis Obispo I8051596-0563 p.19 FED 11 2004 16:23 HP LRSERJET 3200 p.14 BROW OF RMaLY11CRL FZSul popI 6ECOR MNMe0Mn1Yw. 3N] OnplMa Oc. S5N A IxY+we: a.., D3seuw FN Dpbnn 02M+MM, VOLATILE OOGNNK DOO POUNDS cis-1,SpidHorwtlwM D.005 ND ro Trans D.COS ND t)-Ditlio:oNOMne OWN ND 1,}pldAoNMWane MOST ND0_005 2,3 picnlMeprepene 0005 ND 1,1.Oitl�IdapWeM 0005 NO 0e1.3wcM1lorepropeDe O.COS ND ns-1,1DMIercpr O D005 ND plcnlornrHngreecnem D005 ND EtMbMSaN D.005 ND Mlrylne OMOmib IEOBI NO NaMMImabYWine .005 ND 0.005 445DPFOPY� we 0.005 w MnbNew Chloride o 005 ND NephmNene nJwS ND NPreprlMlwM 0.005 ND sw:ene 0.005 0005 - NO 1, 1.1.2-Tev¢MomeNuw NO 1.1,2,2-TMCMomeMare DA05 NO TNgMDeNene (PCEI 0.005 No Tdwm 0005 NO 1,2.}LINYp105nieM 0.010 NO 1.24THdJoroHnzeM 0.010 NO 1,1,f-TN[NwpO1HSMITGI OMIT NO 1,1,2-TriptbrpelMM 0.005 NO TrieNw othom MR 0.005 ZO:sic MMgIpdMYDydMw Y eMywy w ryL peprrenml Y1 Hse110 fisviow: Lebarnbxy AtJI] ePpL - PrwrYl Ouenwwbn lMY • Merrlls MYH � YD wMiE MM �r rFMwN N P:MM eL uebw W 6ma POL. MDO 92 3xTUJr BDS,SN.169A L.wocuY.y Mb�l rM'N%iDax115B.4Olr� by, Im MR) 92 HO.h-S.b J n MCYYrpner JMMhaNlwra Veer'wry 4n+'tarr B&T SRRVICE STATION CONTRACTORS ems) 481-0412 12/09/02 01:33P P.002 MONITORING SYSTEM CERTITICATION ray Use By All Jurididiom Vt tit in she Sate of(nfihma ,futhociry Cixd..Clropler 6.7, Hea!!h and Safey Code; Chapar fb, Diviran J, Tisle73. Californla Code ofRegulanoda' TUb form must be Acted he docusn"tactsng and damicing of monitoring egatpntcttL narcd �OL9rA ptol ingred by She technician who performs the work. A copy Of this torn mud be PeoAded to the tank system ownaloperaac. The ownssloperator mud submit a copy of III= foam to the toasts( agency regulating (1ST systems within 30 daytofastdate A. Genes al Infor'maGon ridaily Nemr. _ G QO @ Bldg. No.: Sitenddress: '/ F3 fn NI-eY.¢.rn 54- cis/< Ss=^ L •ja—moo zip. S'2�fn I rocllity Contact Pasoan• Contact Phone No.:('00 =',S4y_2S�'� MakdModelnf Monitorag System: ) L / f'WI /i. CI DnkofTeding/Servicine: L/4 jAr— C. Certiren tion-I tertify that the equipment tdendned in suit document WAS lmpecndlswked In accordance with the menurseninn' paiddia¢. Anahed to this Cedincadon it inferaanon (eo Iwautaeturtn' chaddives) Sects ary to verify, that this information is naxune•Plat Pbnshowiog hetryovt afmaNmeitq Ndptmne. For sky Nuipmeat espableofpeoerating Inch rePAT, t have also ma4ted a copy d he reports(AerA an chat as*)' aSystem set-ap O Ahem Watery repast Techmdhm Name(prinl)' -_ Signature: . '6utianNo.: License. No.: Toetitg Cm)gany Numc: Phone No.:OL_�) Lg I - L.s tr Site Address 1�7f7•' 0 220r ru), 4r,t^ts� Date of Tcdinp/Samicing: —1 L—IA-VF—Z- �i'1'pII!!�Iil!Ilfll111111l�� hIIIIIi 111111 City Of San WIS OBISPO 1�..''LS9��1Ayu@ry�1]tji' �r I FIRE DEPARTMENT +nGI�" l I� 2160 Santa Barbara Avenue •San Luis Obispo, CA 93401-5240. W517817380 "Courtesy & Service" GENERAL MONITORING 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 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. 9 Nt tV I 71 !7 FACH.RY NAb1E: ece o 6 Lu (— '1% % FACU.RY m NUMBER: O .3 nn S U 2 FACILRYADDMS:d,g& H2rv2✓A 1NSPEMONDATE: FACIA PHONE NUMB- EIt: T�7A? INSPEMONTYPE: ROUI ✓ FOLLOW-UP: I\...(I ]RID: '7Sd%y TWEIN: /n f?/" TM_EOUT: /6 YO fH� Upgrade Deadlines 01-01-84 0 Cutoff date for new and existing USTs. 07-01-85 0 Existing USTs must install monitoring system (H&SC 25292 (a)). 07-01-87 0 Secondary containment required for piping connected to tanks installed after this date (exceptions) (CCR 2636 (a)). 10-26-90 0 Evidence of responsibiily for UST system by mvnerloperator for corrective action release (H&SC 25292.2 (a)). . 12-22-90 0 Existing pressurized piping equipped with automatic leak line detector (H&SC 25292 (a), (CCR 2666 (b)). 01-01-91 0 Operative date for violations; civil/criminal penalties (H&SC 25299 (g)). 07-01-91 0 Independent approval for primary containment construction and design of UST components (CCR 2631 (b)). 01-01-92 0 Independent approval for primary containment construction and design of UST piping components (CCR 2631 (b)). 1 - - 08-09-92 0 Tank lining material and process listedlcertified by and independent testing organization (CCR 2663 (a)). 01-01-93 O 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)). 01-01-95 0 Automatic tank gauge systems installed after this date are to generate a hard copy of the calculated leak rate and leak threshold (CCR 2643 (b)(l)). 12-22-98 0 Existing UST(s) replaced or upgraded to prevent releases due to corrosion, spills, and overfills (H&SC 25292 (d), CCR 2665). 0 All single wall tanks (steel) are retrofitted with secondary containment or by one of the following options (CCR 2662 (b)): . 2. Bladder system, interior lining, and cathodic protection 0 Existing pressurized piping is retrofitted with secondary containment (CCR 2666 (b)).. o Audiblelvisual alarm attached to pressurized piping (CCR 2666 (c)). 0 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 2645 (c)). o Manual inventory reconciliation is no longer acceptable (CCR 2646 (b)) 0 Striker plate installed under all openings used for manual dipsticking (drop tube -mounted bottom protector is acceptable) (CCR 2662 (it)) dnli t- The City of San Luis Obispo is committed to include mo disabled In all of its services, pro9,ame and afrvil os �� "relecommunicalions Device for the Deaf (805) 781-7410. NOTE: VIOLATIONS NEED TO BE CORRECTED WITHIN 30 DAYS OF DATE SIGNED BELOW RE -INSPECTIONS: /'" �"L RECEIVED BY: IN! TELEPHONE NUMBER: H&SC = CHAPTER 6.7, HEALTH AND FETY CODE CCR = TITLE 23, DIVISION 3, CHAPTER 16, CALIFORNIA CODE OF REGULATIONS (MAY 5, 1994) UFC = UNIFORM FIRE CODE (1994 UNLESS NOTED) GENERAL MONITORING INSPECTION CHECKLIST R thin facility has cars thin 4 "Af s, Plss,a phmacaEy the 04CLES1 hdau sampmmn. H&SC - CHAPTER a 7. CALIFORNIA HEALTH & SAFER CODE CCR - TITLE 23. INVASION 3. CHAPTER la. CALIFORNIA CODE OF REGULATIONS If 9941 FOR - TITLE 40. FEDERAL CODE OF REGULATIONS UFC - UNIFORM FIRE CODE (1004 unfair mud) ar e.. I �TANK1 yTANK2 MTANK3 WTANK4 REQUIREMENTS PRE -INSPECTION DOCUMENT REVIEW ParmitA licalians and Fees too crate: WINM-2-Ferm y 9 . forms A&B submilted lH&SC 25286(a), CC 2711, UFC 7901.3.10)(4)I. C submitted ICCH 2635(a)(6),(d)). .O eralin lees a id lHIM 252B71a), CCR 2711(c)I. . Slate surcher a paid IH&SC 25287(b), CCR 2711(c)). Current Permits, Records. and Plans . Facilit lot Ian submitted(CGR 2711(a)). . Previous violations corrected within 30 days (H&SC 252881h1, CCR 2712(f)). . Business plan to mitigate a release ors ill on file. .Statement of financial Ees onsibilt submitted IH&SC 25292.2fa), UFC 8001.5.2.51. . Wriltencantraet exists between osunerlo eralor(H&9C25293(h), CCR 2620(b)). ,4 Approvedwritten routine monitoring plan submitted (CCR 2632(b), ld)(1),26411R. . Unauthorised release reported within 24 hours lH&SC 25295(a)(1), CCR 2652(b)). . Unauth. release Plastic nse ODD submitted (CCR 2632(d)Q), 2634), UFC 0001,5.2.3). e in ownership reported within 30 days R!MC 25284161. CCR 2712(d)I. es to op era linglmonilorin9 procedures of UST system reporled within 30 days (H&SC 25286(dl, CCR 2711(b). UFC 7901.3.1(51, 7902.1.2). _1}-&4liledic pmfee lion insp eclion recorded. Corriactive Action I.0 radians specified in the p revious loss action implemen led wi thin 30 d a ys of ree 'Hal the inspection report (CCR 2712(f)). 2. Work ansubmilled(CCR2722(01. (CCR 27 (a)). 4. Corrective tion complies with policies for water quality control plans (CCR 27211 I)), 5. Corrective actr includes at least one of the follmvin phases: (CCR 2722la)) Preliminary site ssessment. Soil and wafer im li anon. Corrective action PIN impl omen la lion. Verification manilorin base. 6. Interim remedial plan and Lion initiated (CCR 2722(hll. Man'farm Methods and Reports . Approved monitoring system installed and operating under permit conditions RI&SC 25291(bl, 25292(al, 25293(a), CCR 2632fh1, 2641(a), UFC 7901 8 q.4.11. ' Integrity Testing 1. Tank Test in last 12 mgnlhs (H&SC 25292(b)ll). UFC 7901.B.4.4.2). r lest in Iasi 3 years (CCR 2643(d)l. 4. Gravity pie test in last 2 years(CCH 264314). �rl / 5. Test results submitled within 30 days (CCA 26431 ), UFC 7902.6.16.31. \a�A'— AnnuaElmo intenance andlor calibre lion performed on line leak detection equip. `\ 1` . Local agency contacted 48 hours prior to a tanklpipe integrity y test (CCH 2643()4 Cathodic Protection ?dfi-n,',', .. ...2. .. ..,_ v.. avided for secondary containment of tank and for UST piping (CCR 2631(d), 263G(h), UFC 7901,11.3, 7902.6.15.4). sled within 6 months of installation and every 3 years thereafter (CCR 2635(alMIA1). ' e Sy stem tests indicate that the system is functioning of ape Hy. REQUIREMENTS TANK TANK TANK TANK4 Piping I. Continuous monitoring of piping in performed(CCR 26361 2643(e)(111. _2,_Vaew&H*oxaiarkg of suction product piping performed daily (GDR 26431dl. ntar Recaoc"'a'ioo)void alter 1222961 with an annual tank li htness test (CCR 2641301)eeding the allowable variation is reported to local agency within (CCR26461e111)1.art V submitted verifying that data on monthly reports didn't exceed " its, or a list of dates and times of releases exceeding the allowable A2 1). 6la lisli a{lave n for Reeo nci li o lion 1. Ped medwilh bienadal lanktihtness lest(CCA 26461ch1)1. 2. Annu I SIR re ort submitted (CCR 2646.11l). 3. Fre nl or2 or more inconclusive inventories reported (CCR 2646..1Id11. 4. Tanklighlaess less performed for inconclusive results(CCR 2646.1I101. .1irlounualliIiink Gauging 1. Amemalliank ine ril test eerformed(CCR2645(b)l. - Automatic Tank Gouging 1. Monthlitiatincometic tank gauging results submired (CC R 264311hi -Upgrades BRepairs I. Any unto orized releasels) has been reported to the local agency prior to repairs R 26611aD. 2. Nonmetal p ing and tanks tightness tested within 30 days of repairs (CCR 26611f) 3. Repaired cash is protection systems have been tasted within 6 months of repairs ICI 26 (n)), -Tan Closure 1.A licatlan forlank closure submitted within 90 days of the cessation of the sto a of hazardous substances ICCA 267010)). 2. Prop al of compliance with lank closure regulations submitted within 30 da s o osure IGDR 2670@I. 3. UST sys I onlmned an mom lore pursuant to rtice J an Until actual completion osure ICCA 267C1e11. 0etenion of Leak or Unauthorized Release ° "^.C= "'• Election of an unauthorized release andlor sudden loss of product has ® been reported to the local agency within 24 hours (CCR 2fi52IM). . A I wroan repro s been submitted by the owmerloperator to the local agent vzithin5 ing days of detecting on unauthorized release CCA 2 2( 3. Update is ubronted to the local agency quarterly, or more frequently, to ro' tau dal regarding cleanup and initial abatement anions (CCR 2652(d)l. ON -SITE DOCUMENT REVIEW MINIM cogent Permits, Petards, and Plans ..Validoperating ermil musite(H&SC 25266, CCA 27121i1. UFC 7907.3.1). Ylrilleri records maintained omsita (H&SC 25293(a), CCR 2630(d), 2641('). 2712(hl). Gaina an verbally describe features of the pffan. athod' m kept for 6.5 years(CCA 2712(b)). '-rsaenaslaims for release detection systems kept for 5 years (CCR 2712 W). and Upgrade records keg t on site for the life of the UST (CCR 271211:1). . Sa [cry and trifining records on file. 'Moulorinit Methods and Reports *� &IoniIorin!main Inters(itiahMonitorin are rice records k apt tfor3 yasea (CCP 2712(b)). - 1�`a?, Tank monitored visually ai required Irequancy (H&SC 252921h), CCR 2632 lallll, 2G411dh 26421a1, UFC 7901.0.14.11 or . Continuous non -visual interstitial monitoring for double walled tanks (II&SC 2529lp). CCR 26321c11211A1, 2641(i)l. tactical at the time of inspection (CCR 26321c) RFUUIREMFNTS TANK TANK2 TANK TANK4 ' lhodic Protection' 1. m ressed currents stems) is ins ecled every 60 calendar do a (CCR 263501129AH. 0is. set Meters M1 1. 0isp ser meters inspected by department of weights and measures (Proper stickers trend) 1CCR 26461i11. 2. nis eager Its calihfat ed annual( (CCfl 2fi46.11k). 3. Dispenser one ressuri of and suction pushed. and sum s do not show visual si as that a se ma have occured. Pi in . Continuous mceitorin of i in is performed (CCR 2676I11111, 2643(dl1)l. . Visualmonimrin of suction Induct DiDingireeformed dapirl6ith 264$08. _u yqu,.Vv Ian Ilnventer Reconciliation 1. M all Inventor Reconciliation each month(CCH 26461d)). 2. US uantily measurements based an liquid elevation measurement ' re of enls(CCR2643.1, 2646(CI1111Cb(DII. * Ste sticelinventor Reconciliation I.S listical inventor reconciliation performed each month(CCR 2646.1(cl.( IL 2. Fre am or 2 or more inconclusive inventories reported (UCH 2646.110)1. 3.Tank mess test erfomed for inconclusive results (CCR 2646.IIh11. _ Msn al Tan Gauging 1. Aggitual tank integrity test Eerfornned ICCR26451b11. 2. Man al tank auf Indif performed weekly (2,000 Gar. or Lessl(CCR 264511l, 3. Tank ken out of service 48 72 hours, and at least l2 hours before gau gart begins CR2645(al). 4. Manual to padding measurements exceed the weekly or monthly limits in 2 eonsecua tests and a tank integrity test has been performed within 72hours(CCH 6451d11311. tomalic Tank Gau in 1. 4onthl automaliatank gouging results submitted (CCR 2643(b)(1)1. c4i Tnnk osure 1. US stem contained and monimred pursuant to Arlide3 and 4until actual ' col e c osure Iel. FACILITY WALKTHRUU Gil • Interstitial Ma mtonn X Interstitial monimrin checklist completed. f •II h mac' __ Im re current s slam instal led ando or n I iMn fr. CH26351a)(211A11. . ispe III ele to re7*^p- ep t of !ei Measur as in spec lie n stickers present and Curren l . Continuous IT, aniIarin al iin is aIaImed(CCR 2636(1111), 2643(clllll. . 3econd3re cc tainmeal of Pi2ing is present(CCR 2636(a), UFC I802.6.I 11. • ManitvL' al in is erformed in sum s (CCfl 2635(e)( Il). . Automatic line leak detection equipment installed IH&SC 25291 @, 25292 11 CCR 2636p1121, UFC IuU2.6,121- Leek detection checklist for piping competed. fire: d monflood omlar s checklist completed. " Up desendflram" 1. A roved UST system up es andlor repairs made RI&SC 25292.11cl, 25 98. CCR 26602 1. 2. Inte erlinin aft tank replaced no mme than once(CCR 2661(c)L 3. Hales report u ad (CCR 2666101H. 4. Metal ipi ,fittings, and lank fittings that have released product have been replac CCR 26611e11. 5, Vat or roundwater monitoring system installed to continuously manimr . kgtepm ed by linin if on secondary containment exists (CCR 26611 IL REQUIREMENTS TANK TANK TANK TANK •Upgrades and Repairs (cont.) ,`.- s' .'Secondar containment provided (CCR 2662(h), UFC 7902.6.11. 6001.4.5.1.21. . Overfill prevention equipment installed IH&SC 25291(c), CCR 2665, 2635(b), UFC 7902.6.5.3). Spill containment provided (H&SC 25291(c), 25292(d), 25292.2(a), CCR 2665, 2635(b), UFC 7901.0.1, 7902.6.5.2). . Audible and visual alarms are connected to the continuous monitoring system ICCR 2632(cl(2)(B), UFC 7901.0.4.4.1). shut-off capability CCR 26361ll3p4)I. .W. Pie joints are liquid tight UFC 7901.11.8). ear valves provided at dispenser base (UFC 79.904(e)(2) -'91 UFC CODES). .T nkMeow" v 1tis'• r4it closed M&SC 25298(c). CCR 267072, UFC 7902.1.7.2, 8001.11). e LUBE TNUNE #iw FILE O Steve Pipkln SECTION SYSTEM CERTIFI 1 �r 1 286 RIGUERA, SAN LUIS 0815P0. CA 93404 • (805) 544-2975 p'SERVICE COMPANY: 1--CL)YIO---- �81n i�(cluev<n TECHNICIAN PERFORMING TEST/CERTIFICATION: TECHNICIAN NUMBER: # LEAK DETECTION SYSTEM MANUFACTURER: /,�,41< lA( evfi LEAK DETECTION.SYSTEM MODEL: was rv9:�rni xx: PRODUCT LINE PRODUCT TANK WASTE. OIL TANKk/ TYPE: TYPE: TYPE: MONITOR MONP1'OR - - MONITOR NON -EXISTING NON -EXISTING NON -EXISTING OPERATIONAL OPERATIONAL - OPERATIONAL NON -OP-. - NUN -OF 'NON -OP. DEAR SIRS. -� �f U This is to certify that"the annual monitoring systemtest was performedat'thg:'above referenced-faciiity,t.he method usedto testthe-"monitoring system is approved by, and AAROYOGRANer exceeds the specifications according to the system P.O. Buk22 manufacturer. nRoyo Crude, CA W42. (803) 481-255.. SINCERELY, - - - FA%(8(I5)48L0IL / / VENTUR-' (80)M 1-931 TECHNICIAN SIGNATURE`.. DATE Fax S05)64P142 Please forward copies to facility and appropriate agencies$PNTABARBAIL - . 1',O. M444. Sm w Boib*m' CA 9814G619 (505) 96 -571 Ventura. CA a V �•..6&T FILE Ear Aa�� z.PE! Service Station Contractors as Maintenance and Construction Limnos M. U39M ry P. B GBv690, Haznal CerYfimuon O LEAK DETECTION SYSTEM CERTIFICA b' l�le `ti FACILITY LOCATION: -SERVICE COMPANY: YR: Econo 1 Toe / / �l 3 _28(n i�lS VPva TECHNICIAN PERFORMING TEST/CERTIFICATION: TECHNICIAN NUMBER: # 'I LEAK DETECTION SYSTEM MANUFACTURER: k. d}1< l Pv� LEAK DETECTION SYSTEM MODEL: S OZ PRODUCT LINE PRODUCT TANK WASTE OIL TANK&/. TYPE: TYPE:' - TYPE: MONITOR MONITOR- MONITOR NON -EXISTING NON -EXISTING _ NON -EXISTING OPERATIONAL OPERATIONAL OPERATIONAL NON -OP- NON -OP - NON - OF / DEAR SIRS; ` ✓'''Y' %'IqurU This is to certify that the: annual monitoring system test was performed at'the?above referencedfacility, the method used.to test. the monitoring, system is approved by, and ARROYOGRARor exceeds the specifications according to the system P.O. Box 31:' manufacturer: - "Arroyo Crande, CA 9342'. caW) 4s1•z5s- SINCE RELY, FAX (805) 481,.011 _ VUMR : P.O. 242) Ventua, CA M, TECHNICIAN SIGNATURE, DATE - (W 641.93, Y•• - FA%(8m)MI,14T Please forward copies to facility and appropriate agencies PANrn eARRAR. '.O. Bnx 441. 1 'S W aorbara, CA 9314049 (803) 962-591' Ventura. CA u ` 1995 11j)erground itoring Procedures for Storage Tanks n]E For: ECONO L BE N'TLTNE �,07 286 HIGUERA • SAN LUIS OBISPO, CA 93401 • (805) 544-2976 SAN LUIS OBISPO FIRE DEPARTMENT Spencer Meyer, Hazardous Materials Coordinator 748 Pismo Street San Luis Obispo, CA 93401 (805) 781 - 7380 Prepared by: 1923 North Fine, Suite 1o1 Fresno, California 93727 (209) 251-4060 FAX (209) 251 - 5534 This report is based on available information and may have some incomplete answers. For further information please contact Steve or Gregory Pipldn at Econo Lube N Tune (805) 544-2976. ROUTINE MONITORING PROCEDURES FOR NEW UNDERGROUND STORAGE TANKS Facility Name: Econo Lube N Tune #107 Facility Address: 286 F iguem Street San Luis Obispo, CA 93401 UST Installed: Date - January. 1988 Type- Double Wall —Primary Steel and Secondary Fiberglass Piping Installed: Type- Single Piping with Fiberglass Monitoring System: Gravity A. Frequency of Monitoring Monitoring is performed on the: Double wall UST and its sumps: Continuously Product nin_M Not available B. The methods and equipment used to perform monitoring are: Monitoring system used: Universal Sensor Devices_ Inc. --Leak Alen Model LA-02 In -tank detection used: Line leak detection used: Liquid and vanor sensors in interstitial some Sensors are used in the: UST' mr aiat space overflow and kb1pen linings of Iank UST interstitial space Fill sump Turbine/piping sump Dispenser pan These sensors differentiate between hydrocarbons and other liquids (water). C. Locations where monitoring is performed: Continuous monitoring and leak detection audible @ visual are performed in the: Interstitial space Interstitial space of the double -wall UST Primary tank Fill sump Turbine/piping sump Pressurized primary supply line D. Monitoring Personnel: The Facility Supervisor, Steve Pipkin, is responsible for performing: Operational monitoring On -site record keeping The reporing of any discrepancies and alarms with the monitoring system, UST, piping and/or associated hardware. Econo Labe N' Tune, #107 is responsible for all maintenance and repairs to the UST monitoring system, UST, piping and associated hardware. E. Reporting Formal: Weekly reports are generated by Leak Alert LA-02 for on-sim documentation and record keeping. Econo Lube N' Tune, #107 does not use a computer programmed for accessing/polling all facilities with Leak Alert LA-02 of all inventory, alarms, warnings, and in -tank leak detection. F. Preventative maintenance, calibration, certification to manufacturer's specification and repair of the UST monitoring system and associated hardware shall be performed at lease annually. Steve Gregory directs, manages, and schedules all maintenance and repairs for Econo Labe N' Tune, #107's USTs, piping, associated hardware, and the UST monitoring systems' preventative maintenance, calibration, certification and repairs. Currently, Ecemo Lube N Tune, 4107 does not have an annual contract with Universal Sensors and Divices, Inc. 9205 Alabama Avenue, Unit C, Chatsworth, Calfor at 91311. To contact them to perform field services, their number is (818) 998-7172. G. Training: Econo Labe N' Tune, #107's Written Practice/Procedures, Petroleum Storage Tank's Maintenance, Monitoring and Record Keeping describe the procedures company employees follow for underground storage tank and monitoring systems. This document outlines the maintenance, monitoring, testing, calibration/certification, record keeping requirements, and responsibilities for underground storage tanks owned and operated by Econo Labe N Tune, #107. Operating instructions for the UST and the LA-02 monitoring system 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 or at least annually. If you have any questions or need additional information, please contact Econo Lube N Tune, #107 at (805) 544-2976. Gregory Pipkin Owner NEW USE RESPONSE PLAN Facility Name: Econo Labe M Tune, #107 Facility Address: 286 Higuem Street San Luis Obispo, CA 93401 UST Installed: Date -January, 1988 Type - Double -Wall Steel 550 Gallons for Waste Oil Piping Installed: Type - Single Piping with Fiberglass Monitoring System: Leak Alert System LA-02 A. An unauthorized release of any hazardous substance and/or water from the interstitial space, fill sump, piping sump and/or dispenser pan will be removed by one of two methods: 1) hand/electrical pump for small quantities or 2) vacuum truck for large quantities. Small quantities of any hazardous substance will be placed into steel drums. Large quantities will be placed into a vacuum truck tank. Removal, disposal, or in the event of catastrophic failure and/or if an emergency response is required, the vendor listed below will respond or (another agency -approved vendory Black Gold 527 North Rice Avenue Oxnard, CA 93030 Phone: (805) 9814616 possible. B. Steve Gregory is responsible for authorizing any work necessary under this Response Plan and can be reached a (805) 544-2976. Gregory Pipking Owner Econo Lube N' Tune, #107 ��m��iiii��►n��nl!IIIINB �111'°��H I city of son luis oBispo '• FIRE DEPARTMENT ' 1h�="'+'•_''- ' 748 Pismo Street • Ban Luis Obispo, CA 93401 4 BOW81-7380 GENERAL MONITORING INSPECTION CHECKLIST IN ACCORDANCE WITH THE STATE OF CALIFORNIA HEALTH AND SAFETY CODE, DIVISION 20, CHAPTER 6.79 SECTION 25280 at. 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. FACB.ttY NAME: L4+ a FACdrtY m NUMBER: YD OZ3 OOSO2, FA CUIrY ADDRESE: WBPECIIONDATE: o-R•9C FACdITY PNONE NUMBER: S4Y-24]b INSPECTION TYPE: ROUTINE: FOLLOW-UP: Bm: ZS4 TP/E W: I:Sa TIMEOUT: 1:36 — s�c ey,pk.r (COO e.e l Upgrade Deadlines 0I-01-84 0 Cutoff date for new and existing USTs. 07-0I-85 0 Existing USTs must install monitoring system (H&SC 25292 (a)). 07-01-87 0 Secondary containment required for piping connected to tanks installed after this date (exceptions) (CCR 2636 (a)). 10-26A0 o Evidence of responsibiity for UST system by owner/operamr for corrective action release (H&SC 25292.2 (a)). 12-22-90 o Existing pressurized piping equipped with automatic leak line detector (H&SC 25292 (a), (CCR 2666 (b)). 01-01-91 0 Operative date for violations; civil/criminal penalties (H&SC 25299 (g)). 01-01-91 0 Permits issued shall comply with H&SC 25299.3. 07-01-91 0 Independent approval for primary containment construction and design of UST components �.-4a� wuopraaarnr approvui for pnmary containment construction ana assign or U51 piping components (CCR 2631 (b)). 08-09-92 0 Tank lining material and process listed/certified by and independent testing organization (CCR 2663 (e)). 01-01-93 0 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)). 01-01-95 0 Automatic tank gauge systems installed after this date are to generate a hard copy of the calculated leak rate and leak threshold (CCR 2643 (b)(1)). 12-22-98 0 Existing UST(s) replaced or upgraded to prevent releases due to corrosion, spills, and overfills (H&SC 25292 (d), CCR 2665). 0 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 0 Existing pressurized piping is retrofitted with secondary containment (CCR 2666 (b)). Auclubliviosuat alarm attached o pressurized ptpmg e. 0 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 2645 (c)). 0 Manual inventory reconciliation is no longer acceptable (CCR 2646 (b)) 0 Striker plate installed under all openings used for manual dipsticking (drop tube -mounted bottom protector is acceptable) (CCR 2662 (d)) �4 :o oaI e wl I , Ali tvltle,. :uo-.ei o 0eD-a h3uJ,81 NOTE: VIOLATIONS NEED TO BE CORRECTED WITHIN 30 DAYS OF DATE SIGNED BELOW •a s ` f .� i-l�\C��iRECEIIED • 'I.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) eAKw'we�n.rm. GENERAL MONITORING INSPECTION CHECKLIST If rbb hniRly has more thin 4 tanks, pleam photocopy thin choukEsl before completion. ,d H&SC - CHAPTER 1.7, CALIFORNIA HEALTH & SAFETY CODE CCR - TITLE 23, DIVISION 3, CHAPTER 10. CALIFORNIA CODE Of REGULATIONS(1994) FCA - TITLE 40, FEDERAL CODE OF REGULATIONS UFC- UNIFORM FIRE CODE 11994 unless noted) Z I,y L_ U.¢o W. �TANK3 REQUIREMENTS TANK TANK2 TANK4 PRE -INSPECTION DOCUMENT REVIEW Permit A lice !ions end Fees too orate:;gC Forms A&6 submitted IH&SC 25286(a), CCR 2711, UFC 7901.3.10)(4)). k. Farm Csubmltledl6CRWIM 2635(a)(6),fd)). eratin tees aid IH&SC 252VW, CCR 2711(OL N. Slatesurchar epaid lH&SC 25287(b), CCR 2711(c)). Current Permits, Records, and Plans L Facility let plan Submilted ICCR 2711(a)I. .2' Previous violations corrected within 30 days (H&SC 25288(b), CCR 271210). . Business plan to mill ate a release ors ill on file. . Statement of financial res onsiEI submitted IH&SC 25292.2(a), UFC 8001.5.2.5). . Written contract exists between ownedO erator(H&SC 25293(b), CCR 2620(b)). A rovedwria 'autine manitorin lan Submitted(CCR2632@LId111L 2641111. X . Unaulhari:edreleasere atled Wilhin 24 hours(H&SC 252951a)(1), CCR 2652(h)I. UnSpin. release response plan submitted (CCR 2632(d)(2), 26341, UFC 8001.5.2.3). . Chan e in ownership reported within 30 days (H&SC 25284(b), CCR2712(d)1. . Changes to op eratingfmortharing procedures of UST system reported within 30 days IH&SC 2528Bid), CCR 2711(b), UFC 7901.3.1151, 7902.1.2). . Cathodicpro eclon inspection recorded. Co_rJACUUtAothon M 1. Corrections specified in the previous inspection implemented Within 30 days of rech eminsd lion rart ICCR 27121U1. 2WsuhitpecCCR2722(c)I. 3. Corrective action process initiated for reported unauthorized release ICCR 272]is)). . Corrective (CCR action complies with politics for water quality control plans 2721(b), Ic11. 5. Corrective action includes at least One of the following phases: ICCR 2722(a)I Preliminary site assessment. Soil and water investigation. Corrective action plan implementation. Verification monitoring phase, 6. Interim remedial pan and action initiated (CCR 2722(h)). Monitoring Methods and Reports 1. Approved monitoring system installed and operating under permit conditions (H&SC 25291(h), 25292(a), 25293(a). CCR 2632(b, 2641(a). UFC 7901.8.4.4.1). �Inte rit estin . Tank tTest in last 12 months (H&SC 25292(b)(1), UFC 7901.8.4.4.2). yPressurised pipe test in last 12 months (CCR 260013),H&SC 25291011. .,ilr'Suction pipe tightness test in last 3 ears CCR 26431d)). ra'/Ily 1 e IISI 10 a3I aar3 2 4 ,9. . Test results s ted W uhmitilhin 30 da s (CCR 2643( ), UFC 7902.6.16.3). Annual maintenance and!or calibration performed an line leak detection equip. Local agency contacted 48 hours prior to a tankli a integrity test [CCR 2643O). Cacho' -'on '^ , I. Cathodic protection provided for secondary containment of tank and for UST piping (CCR 26311d), 2636!hl, UFC 7901.11.3, 7902.6.15.1). Calhadic Pmlaclian tested wi:hln 6 months of installation and every 3 years �IC3I2 :.1 t 1112/:� ri I SI,.at l a n'ai flEOUIREMENTS TANK TANK 1 TANKS TANK4 • Pipirg 1, Continuous monitoring of piping is verformed (GGR 26361UI11.26431c1101. 2. Visual monitoring at suction product piping performeLdailly(CCR 2643(d)). • Manuel Inventory reconciliation (void after 12.22•8$1 1. Performed with an annual tank tightness test (OCR 2646411). 2. MIR(s) exceeding the allowable variation is reported to local agency within 24 hours (CCR 2646(e)(1 D. 3. Annual report submitted verifying that data on monthly reports didn't exceed allowable limits, or a list of dates and times of releases exceeding the allowable limits (CCR 2646( )1. • Statistical Inventor Reeon011ietian 1. Performed with biennialtankti I ass test (CCR 2646(c),(6. 2. Annual SIR report submitted (CCR 2646.10). 3. Frequent ort of more Inconclusive inventories reported CCR 2646.1(d)). 4. Tank fi htness test performed for Inconclusive results (CCA 2646.1(h)). Manual Tank Gauging 1. Annual tank Wetly test erformed (CCR 2645(b)l. Automatic Tank GaU111111111- ^ , 1. Monthly automatic tank gauging resultssubmilted CCR 2643(b)(1)I. Upgrades and Repairs WMEMO I. Any unauthorized release(s) has been reported to the bealagency prior to repairs CCR 2661(al). 2. Nonmetal piping and tanks tightness tested within 3U days of repairs (CCR 2661 fill. 3. Repaired cathodic protection systems have been tested within 6 months of repairs (CCR 2660(n)l. Tank Closure •t 'ee •, I. Application for tank closure suhrritted within 90 days of the cessation of the storage of hazardous substances ICCH 2fi70(e)l. 2. Proposal of compliance with lank closure repulalions sularoutted within 30 da s of closure CC 2670(gl. 3. UST system contained and monitored pursuant to Article 3 and 4 until actual cam lesion closure (CCR 2670(e)). . D etectmn o eak or Unauthorized Release _ 1. Detection of an unauthorized release andlor sudden loss of product has been reported to the local agency within 24 hours ICCH 2652(h)). 2. A full written report has been submitted by the ownerloperator to the local agency within 5 working days of detecting an unauthorized release (CCH 2652(d). 3. Update reports submitted to the local agency quarterly, or more frequently, to provide updates regarding cleanup and initial abatement actions (CCR 2652(d)l. ON -SITE DOCUMENT REVIEW Current Permits. Retards, and Plana iYValid operating ermit on -site (H&SC 25266, CCfl 271261, UFC 7901.3.1). Ytritten retards maintained on site (H&SC 25293(a), CCR 26301d), 2641('L 2712(h)1. Emer enc response plan on siteloperator can verbal) describe features of the plan. athodic protection records kept for 6.5 years CCR 2712(bll. 5. Performance chime for release detection systems k Repair. lining. and upgrade records kept onslta for the ll of the UST (CCA 2712(b)). Safes and trlivin records on file. MonitoringMethods and Reports x 1. hlonimrin !maintenance recrr2s kept for 3 years CCR2712 gal. Interstitial hlonitorin Tank monitored visually ct ccui ed frequency (H&SC 25292(b), CCR 2632 .110,'. 2642'a`. U-: 7P61.B.4.4.11 or 4 i _o REQUIREMENTS TANK1 TANK TANK TANK4 Celha rotection 1. Impressed currentsysam(s) is inspected every 60 calendar days (CCR 2635(all2HA)1. s . Cispenser meters inspected by department of weights and measures (proper stickers presentl(CCR 2646(I). 2�isp enser meters cantered annual) (CCR 2646.1(k)). *.'lisp enser p anels, pressurized and suction piping.and sumps do not show visual signs that a release may have occured. 1. Continuous monitoring of piping is performed(CCR 26360)(1h 2643(c)(1)). 2. Visual monitoring of suction product piping performed daily (CCR 2643(d)). Manual Inventor meiliation " ua Inventor Reconciliation each month(CCR 2646(d)). 2. UST quantity measurements based an liquid elevation measurement requirements (CCR 2643.1, 2546(c)(1)(C), ML S - " Ilnventor Reconciliation 1. Statistical inventory reconciliation art, named each month (CCR 2646.11c),1 II. 2. Frequent or 2 or mere incandusivei entarie re orted )CCR 2646.1(d)I. 3. Tank tightness test perfamed for inconclusive esults(CCR 2646.1(h)I. Manual Tank Gauging nnua tank integrity test performed(CCR2645(h)), 2. Manual tank gauging performed week) (2,000 Gal. or less) (CCR 2645(d)). 3. Tank taken out of service 46-72 hours, and at least 12 hours before gauging be dns ICCR 2645(a)I. 4. Manual tank gauging measurements exceed the weekly or monthly limits in 2 consecutive tests and a tank integrity test has been performed within 72 hours (CCR 26450113)1. Auloma' ank Gauging 1. htonthl automatic tank gauging results submitted(CCR 2643(b)(1)I. jargkj�lasure :VM 1. UST system contained and monitored pursuant to Article 3 and 4 until actual connotation closure (CCR 2670(e)I. EACILITYW UH 'y - Interstitial Monitoring'<.. .. . Interstitial monitorin checklist completed. Cathodic Protection I I Leased currents stem installed and operating (CCR 2635(a)(2KA)). Is enser Meters T'%i?""M UO .,, I. Department of Weights and Measures inspection stickers present and current (CCR 264610). Piping a^: yOn` ate -._ 4i , art•. onlinuaus monitoring ofpiping is performed(CCR 2636(H(1), 2643101111. aconda containment of piping is present (CCR 2635Wa UM 7902.6.11). .,4,r`Mmnhmriag of piping is performed in sums (CCR 2636(gl(1)1. utomatic line leak detection equipment installed (H&SC 25291(f), 25292 (b)WpC). 25292(el(l). CCR 2636(f)(2). UFC 7902.6,12). k Leak detection checklist for piping completed. Grousudwater monitorin I. Munitcring wells checklist completed. Up endRSTairs I. Approved Usystem upgrades andlor repairs made(H&SC 25292.1(c), 25298, CCR 26602665). .Interior lining of the tank replaced no morethan once=R 2661(c)l. holes properly pluc ed (CCR 266611d1). _ fatal piping. futins and tank fittings that have released product have been -.c.. - - ; -v1. :ed c continuously monita' - 'ac a"s CCR 2691 REQUIREMENTS TANK TANK TANK TANK4 - Upgrades and Repairslcont.) 6. Secondarycontainment ruvided (CCR 2662166 UFC 7902.6.11, 8001.4.5.1.2). verfill prevention equipment instal d(H&SC252911c),CCR2665,2635Ib6 UFC r eX �c,',�•a,"q X ill containment provided MSC 25291(c), 25292(d), 25292.21al, CCR 2665, 2635(4 UFC 7901.0.1, 7902.6.5.2). udihle and visual alarms are connected to the continuous monitoring system (CCR 2632(c)(2)(9), UFC 7901.8.4.4.1). aic f CR2to ehit0C.636( 3)41.Au emtutfcFC 7i81 h—t ,F2cEmergency shear valves provided at dispenser base (UFC 79.904(e)(2) .'91 UFC CODES). Tank Closure I, UST property closed(H&SC 25298(c) CCR 267072, UFC 7902.1.7.2,8001.111. Other B & T RBMPf AO: P.O. Box 220. Arroyo Grande. CA 93421 INVOICE .., 5166 Service Station ❑ ARROYO GRAND$ ❑ V$NWRA ❑ SANrA BARBARA COntr&ctom P.O. Bur 220. Ar Grande P.O. H 24894, Ventura (805) 06ZS716 CAgMICA 93002 License # 623923 (481.2662 (605) 164 .9816 �' FA& (8W 4 -0418 LE TO: C /2 - 2y- 5 - @FYI Date: P.O. No. / �i / . O • s W � O O LL R Q. Q ' Q 0 3 JOBCOMPLETE YES❑ S NAME I ARRIVAL I DEPARTURE pay reaeorede coon of c iww IndualnD a HOURLY I AMOUNT LABOR COST $ TERMS:ASERVICECHARSEOF I I@ PERMONTH(ANNUAL RATE OF rS%)WILLSE CHARGED ON PAST DUE MUNCE500ER SO DAYS ECUIPMENT $ THIS IS TO CERTIFY THAT / MILEAGE CHARGE $ WORK WAS SATISFACTORILY / �G COMPLETED IN INDICATED { -` /~ _ -- OUTSIDE SERVICES $ TIME (GNAT RE- A A TAX $ TOTAL INV CE $ :e4 a ° gc nss'q °�C S fn'?$ 5' 'F x €@e fia11 F R` c_. 'e Lg e o Nil e y I 1 I I I I � I I I I _� I I I I I I I I I I 1 I I I I f�s yg' Sw'c` px 1� ar NPP (� .�^ (l$ < Fq$$ 6u; .0 Q' m .o a Y�.'C C A�F' %' P Nb '� c"0 p p O �,'e1 S' �'s Ge8 Sg8 ?� °' R s �F: Nom Sg &g E-`e_ a'a Ae' ag 7°a pSn o� Nga $ 3'_ U'? p's� ocOC, . g,s g� E' �5' �: �< :s p�� a:• �� ¢ �� Vie: d�:; _ • m � IF 1 . I I I I I I I I Imo' L I I� I I\ I Ind R 111111n�1ii�UIIIIi�P��ll�llllllhll l clay o f san this oBispo FIRE DEPARTMENT 748 Pismo Street San Luis Obispo, Califomla 93401 805/54&7380 nTO- I�I DATE V-LYI-SS7 FROIN. / °'`'e'`"�- SUBJECT uew- S 9�LPh� MEMORANDUM Date 03/23/89 ID:NUMBER 2594 STREET HIGUERA ADDRESS 286 BUSINESS ECONO LOBE AND TUNE GRID H13 BUS:PHONE 544-2976 EMER:PHONE: 805/544-1508 ASSIGNMENT: 4A RESP:PARTY: GREG PIPKIN LASTCLEAR 01-06-89 AREA 2880 OCC:LOAD 20 OCCUPANCY B1 FIREFLOW 1000 CONST:TYPE: 5-N STORIES 1 PROTECTION: F REMOTE F LOCBOX F FREQUENCY 1 MANHOURS 0.4 SPRINKLERS: 00-00-00 HOOD INSP 64 PROP:OWNER: ECONO LUSE AND TUNE MAILTO 286 HIGUERA CITY SLO STATE CA ZIP 93401 VIOL:ALRMS: M PREPLN:HAZ: 1-250 WASTE OIL TANK U.G. 2- WASTE OIL TANKS ABOVE GROUND. NOTES : F.L., NAZ MAT 11/89 PERMIT:HAZ: ART 4-18, 22 PERMIT MON: 11 PERMIT AMT: 490.00 PERMEXDATE: 11-01-89 PERMIT-INF: 1) STORE/HANDLE/USE CLASS I FLAM. LIQUIDS $ 45 2) U.G. STORAGE TANK PER ORD 999 - NEW $175 ADDRESS: £�o�e L L N Tnok7-a6 µ' SE. S s�cvt IIOKIvLW'�a�6 DATE REMARKS 46y For 3:00 „Y Z (tve ca .6 z. G gz Environmental Her__ �rvice 1.. 1805)781-6644 a city % satn Luis cimspo P O Box 1489 •e s09anta nwnrA.nu,•fn w„oww.wwm-uw'IwPn.no 2158 Berra Way Ste. B •Courtesy & Service" San Luis 0bisoo. CA 93406 CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Data: 10/14/2022 Time. Facility Name. LUBE-N-GO Aoencv Inspection Type ❑EHS ®Routine Site Address: 286 HIGUERA ST ®CITY FIRE ❑Reinspection SAN LUIS OBISPO, CA 934014215 ❑Chargeable Reinspection ❑Change of Ownership Phone: (805)7864056 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0005116 CERS ID: 10437337 ❑Chargeable Secondary Containment Testinr Serial Number: DADBSULOG PROGRAMS INSPECTED: OHazmat OHWGenerator OUST I9AGT oCawRP OTPE REINSPECTION REQUIRED: 01-lumat OHINGenerator OUST OAGT I OCMARP OTPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. YO ❑ NQ ❑ WA 1@ VIOL. # BP01 BUSINESS PLAN Business plan complete, current available during inspection and submitted electronically (HSC 25505, 5508(a)(1) T4 CCR38 ❑ ❑ ® B11102 Inventory of hazardous materials Is complete and submitted electronically (HSC 25505(a)(1), 26606, 25508(a)(1), 19 CCR 2852, 2664) ❑ ❑ 0 31303 Site layoW1 facility maps are accurate and submitted electronically(HSC 25505(a)(2), 25508(a)(1), 19 CCR 2662) TRAINING PLAN ❑ ❑ O TR01 Facility has appropriate training program, submiRed electronically(HSC 25506(a)(4), 25508(a)(1), 19CCR 2669, 22CCR66265.16) ❑ ❑ [9 TR02 Training documentation is maintain! on site for current personnel(HSC 25506(a)(4),22CCR66265.16) ❑ ❑ A ER01 Emergency responselcontingency plan complete, current, submiHed electronically, maintained onsib (HSC 25505(a)(3), 25508(a)(1), 19CCR 2858, 22CCR 58265.52,M) ❑ ❑ © ER03 Secondary containment is installed and sufficiently impervious to discharges. [CHSC 26270A.5; 40 CFR 112.5(c)(2S GENERAL EH VIOLATIONS ❑ ❑ IS FEN Environmental Health fees paid. ICBM 17200, Local Ordinance) GPS Coordinates: Latitude: 35.2724599999 GPS Coordinates: Longtitude:-120.6701500000 INSPECTOR: MATHESON BLISS FACILITY REP: FACILITY NAME: LURE -NI O ADDRESS: 286 HIGUERAST AOOVEGROUND STORAGE TANK (ho F) SAN LUIS OBISPO, CA 934014215 YES M NIA VIOL, # © ❑ ❑ Ant A Prevention control and countermeasure (spec) plan has been prepared and Implemented at facility (Note: An SPCC Plan is required for single tanks 1,320 gallons or greater or tanks/containem with a cumulative capacity of greater then 1,320 gallons of oil products; for farms, nurseries, construction sites: single tanks greater than 20,000 gallons or tanks with a cumulative capacity of greater than 100,000 gallons. (HSC 25270.4A/REF. 40 CFR it 2.1, 112.3(d), 112.6) © ❑ ❑ AT20 SPCC plan has been reviewed andor evaluated within the last 6 years and completion of the review has been documented (HSC 25270.4.5(ayREF. 40 CFR 112.5(b)) ® ❑ ❑ AT21 SPCC plan has been amended for changes (HSC 26270.4.6(a)/REF. 40 CFR 112.6(a)) 19 ❑ ❑ AT02 The Spill Prevention Control and Countermeasure Plan Is maintained on site or at the nearest field office. (HSC 25270A.51REF. 40 CFR 112.3(e )(1)) ❑ ❑ ® AM Secondary containment for the entire contents of the largest single tank, plus sufficient freeboard to allow for precipitation, has been installed and is sufficiently impervious to contain discharges. (HSC 25270.4.51REF. 40 CFR 112.7(c I, 112.8(cy2)) ❑ ❑ © AT22 Secondary containment drainage restrained by valveslpositive meanie and normally kept closed (HSC 26270.4.51REF. 40 CFR 111.8(b)(2),112.8(c)(3)) ❑ ❑ 0 AT06 Drainage of any uncontaminated rainwater from secondary containment is documented and recorded (HSC 25270.4.6; 40 CFR 112.8(c)(3)(iv)) ❑ ❑ ® AT07 Liquid level sensing device is present and tested regularly. (HSC 26270.4.5/REF.40 CFR 112.8(c)(8)(v)) ❑ ❑ p ATOS The master flow valve that will prevent direct outward flow of the tanks content to the environment Is securely lacked in the closed position when in non -operating or nonatandby status. (HSC 25270.4.6/REF.40 CFR 112.7(g)) ❑ ❑ p AT09 The master flow valve (i.e. gate valve, solenoid valve, etc.) and Emergency Shutoff switch are Inspected and tested regularly, documented, and records are maintained for three years. (HSC 25270.4.S/REF.40 CFR 112.8(d)(4)) ❑ ❑ ® Art Each aboveground tank is tested for integrity ('d applicable) on a regular schedule and whenever material repairs are made. (HSC 25270.4.5/REF.40 CFR 112.8(u)(8)) ❑ ❑ 99 AT11 Appropriate warning signs are posted at the loading/unloading rack and at the fuel island to prevent vehicular departure before complete disconnect of flexible or fixed transfer lines. (HSC 26270.4.SIREF 40 CFR 112.7(h)(2),112.8(tl iti)) ❑ ❑ IN AT12 Guard posts or other approved means are being provided to protect storage tanks and connected piping, valves, fittings, and dispensers from vehicular damage. (HSC 26270.4.SIREFAO CFR 112.7(a)(1), 112.70); CA FIRE CODE 5704.2.9.7.4) ❑ ❑ ® AT13 Visual Inspections of tanks, valves, piping, and appurtenances storing petroleum products are being conducted and documented regularly, and maintained for three years. (HSC 26270.4.6/REF.40 CFR 112.7(e), 112.8(d)(4)) ❑ ❑ 19 AT14 There are no visible leaks at tanks, pumps, master flow valve or aboveground piping. (HSC 25270.4.51REFAO CFR 112.8(c)(10)) ❑ ❑ ® AT15 Facility lighting is commensurate with the type and location of the facility, giving consideration to the discovery of spills occurring during hours of darkness both by operating personnel and non -operating personnel (i.e. general public, local policeMre) (HSC 25270.4.61REF.40 CFR 112.7(g)) ❑ ❑ IN AT16 FFacility Is fully fenced and locked when facility is unattended. (HSC 25270.4.6IREF.40 CFR 112.7(g)) Facility as documented spin nistory and corrective actions e. jHbU ZbZ10A51Kt:r.qU ® ❑ ❑ AT18 Spill prevention briefings for operating personnel covering the SPCC Plan am conducted and documented annually to assure adequate understanding of the SPCC Plan. (HSC 25270A.VREFAO CFR 112.7(f)) 13 13 ❑x AT19 Spill control equipment is maintained an site. (HSC 26270.4.5/REF.40 CFR 112.7(c)) SUMP/ W OF OBSERVATIONS'VIOI - TIONS © No violations of underground swrage tank, hazardous materials, or hazardou_ .caste laws/regulations were discovered. SLO CUPA greatly appreciates your efforts to comply with all the laws and regulations applicable to your facility. O 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 corrective actions required, please inform th CUPA In writing ALL VIOLATIONS MUST BE CORRECTED WITHIN 30 DAYS OR AS SPECIFIED CUPA must be informed in writing with a certification that compliance has been achieved. Afalse 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 andlor the proposed corrective actions. The issuance of this Summary of Violations does not preclude the CUPA from taking administrative, civil, or criminal action. FACILITY NAME: LUBE-N-GO ADDRESS: 286 HIGUERA ST SAN LUIS OBISPO, CA 93401-4215 INSPECTION COMMENTS: SPCC Plan review. INSPECTED BY: MATHESON BLISS NAME OF FACILITY REP: DATE: 10/142022 SIGNATURE OF FACILITY REP: STATEMENT OF COMPLIANCE Certification: I certify under penalty of perjury that this facility has compiled with the corrective actions listed on this inspection form. Signature of Owner/Operator: Title, Date: Environmental Hea ervims 18061781-b544 city o* Sdn Luis owspo P O.6or 1489 l no e: •a ,m&WeINUMMMS-ea, wboee%ca sea -Me -Pm n,.rxa 2156 Siena Wav Ste B San Luis Obispo. CA 93406 `- "Courtesy &Service" CERTIFIED UNIFIED PROGRAM AGENCY (CUPA) HAZARDOUS MATERIAL INSPECTION FORM Date: 09/08/2022 Time: Facility Name: LUBE-N-GO Agency Inspection Type OEHS ❑Routine Site Address: 286 HIGUERA ST ®CITY FIRE ®Reinspection SAN LUIS OBISPO, CA 934014215 ❑Chargeable Reinspection ❑Change of Ownership Phone: (805)786-4056 ❑Complaint ❑Secondary Containment Testing Facility ID: FA0005116 CERS ID: 10437337 ❑Chargeable Secondary Containment Testim Serial Number: DAFQOPNCZ PROGRAMS INSPECTED: 011azmat ®HW Generalor OUST ❑AGT OCaIARP OTPE REINSPECTION REQUIRED: OHazmat DHW Generator OUST MGT OCaIARP OTPE PERMISSION TO INSPECT: Inspections may involve obtaining photographs, reviewing and copying records, and determining compliance with adopted codes. = NQ WA VIOL. i/ BUSINESS PLAN ❑ ❑ IR BP01 Business plan complete, eunal available during inspection and submitted electronically(HSC 25605, 25508(a)(1); 19 CCR 2651) ❑ ❑ ® BP02 Inventory of hazardous materials is complete and submitted electronically(HSC 25505(a)(1), 2006, 25508(ai(t), 19 CCR 2652, 266U ❑ ❑ © B1203 she IayouO facility maps are accurate and submitted electronically (HSC 26505(a)(2), 26508(a)(1), 19 CCR 26521 TRAINING PLAN ❑ ❑ © TR01 Facility has appropriate training program, submitted elechnically (HSC 26505(a)(4), 26508(a)(1), 19CCR 2659, 22CCR66265.16) ❑ ❑ 111 TR02 Training documentation is maintained on site foreurm"monnel(HSC 25505(a)(4),22CCR66266.16) EMERGENCY RESPONSE PLAN ❑ ❑ O ER01 Emergency responaefcontingency plan complete, current, submitted electronically, maintained chaffs (HSC 25506(a)(3), 25608(a)(1), 19CCR 2651 22CCR 66265,52-.64) ❑ ❑ ❑s ER03 Secondary containment is Installed and sunlclen0y impervious to dischagea. ICHSC 26270A.5; 40 CFR 1128(c)(2)] GENERAL EH VIOLATIONS ❑ ❑ 19 FE01 Environmental Health fees paid. [CBPC 17200, Local Ordinance] GPS Coordinates: Latitude: 35.2724599999 GPS Coordinates: Longtitude:-120.6701500000 INSPECTOR: MATHESON BLISS FACILITY REP: Omar Morales