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�rTOTYPE F-� E L 'Cow" 11"7
<br />E(.
<br />NOTE::
<br />FUEL SYSTEM TO COMPLY WITH EXECUTIVE ORDERS:
<br />VR ---101-D (PHIL. -TIT -E PHASE 1)
<br />VR --202-A (HEALY PHASE 11 WITH ISD)
<br />FUELING POSITIONS: 12 GASOLINE: / 4 DIESEL
<br />FUELING NOZZELS: '12 GASOLINE / 4 DIESEL
<br />DISPENSER MAKE: GILBARCO
<br />DISPENSER MODEL: ENCORE
<br />SHEET INDEX
<br />FUEL_ SYSTEM
<br />F90.0 FUEL TITLE SHEET
<br />FS1.0FUEL PIPING PLAN
<br />�F1.0
<br />EQUIPMENT SCHEDULE 6 MPD
<br />F2.0�W��
<br />_
<br />TANK SLAB, SECTIONS do DETAILS
<br />F3.0
<br />FUEL PIPING DETAILS
<br />F4.0
<br />FUEL PIPING DETAILS ����
<br />_.. F6.0
<br />DISPENSER _SUMP _DETAILS
<br />F6.0
<br />HEALY VAPOR BLADDER SYSTEM
<br />F"1.0
<br />SPECIFICATIONS
<br />F7.1
<br />� SPECIFICATIONS
<br />F.O
<br />_ _
<br />_ _ _ TYPICAL.. ISOMETRIC LAYOUT 6 MPD
<br />EL.D1,0
<br />ENHANCED LEAK DETECTION SITE PLAN
<br />0DE)G�(2f,
<br />PAF�R MEN TT7 '"'TEM
<br />9330 BALBOA AVENUE
<br />SAN DIEGO, CA 9212.3
<br />Oc 1999 Jack in the Box Inc.
<br />These drawings and specifications
<br />are the property of Jack in the Box Inc;
<br />and shall not be copied or reproduced
<br />without its previous written consent.
<br />RELEASE: OC T. 25, 2004
<br />P° .(JIB ONLY):
<br />PERMIT:
<br />PID:
<br />CONSTRUCTION:
<br />revisions
<br />A
<br />A-
<br />A A
<br />A
<br />AA
<br />l _..�
<br />A
<br />Quick Stuff Compliance Documentation For JIB/QS Quick Stuff Compliance Documentation For JIB/QS
<br />Code Key
<br />CM = JIB Construction Manager Item Environmental Permits Responsible Verified Date
<br />The following documentation must be subrnitted to the GC mm General Contractor Party (initials)
<br />Construction Manager bound in a 3 -ring binder and labeled FSE. w Fuel System Engineer - - --.-____....__.._ _.._____..._.._...._...__..._.._.____._____.__
<br />"QS Compliance Documentation" and labeled with the site FC Fuel Contractor TANK REGISTRATION APPLICATION: (ECSC To be tank owner of record) (see examples below) FPE
<br />number, prior to release of final payment: FPE m Fuel Permit Expediter
<br />ECSC H Environmental Compliance 1. CA _._ Unified Program Consolidated Forms (Facility, Tanks, and Cert. FPE/FC
<br />Services Company
<br />Of Compliance - formerly known as Form AW BB and C
<br />QSO Quick Stuff Operations AZ -- Notification for Underground Storage Tanks.._ ^
<br />FFV = Fuel Equipment Vendor 3 TX - Underground Storage Tank Registration and Self Certification Form.
<br />RA = Restaurant Accounting
<br />JIB EE = JIB Environmental Engineer PERMIT
<br />9 4 TO CONSTRUCT/INSTALL FPE
<br />Item Construction Permits Responsible Verified Date 5 PERMIT TO OPERATE UST ECSC To be tank owner of record FPE
<br />Party initials _ _.....__. __ APPLICATION FOR TEMP CLOS�/TANK REMOVAL
<br />1 Tank manufacturer's installation checklist GC 6 Permit -to Close/Remove UST (as applicable) FPE
<br />� 2 Tank receivingretard GC
<br />UST Permit Received CM
<br />' 3 Piping manufacturer's checklist _. _......_...._ _ GC
<br />HAZARDOUS MATERIALS:
<br />_ _ _ _._ _ _ __._.
<br />4 Tank charts Leave second copy, gt, taare) ____..._.......__._.__..._..__..._____ ____�_. .... ....__.._.___.__ _ .__...._.._ __ .._.__..___.._�__._____.__ � 6 � Fire Permit (ECSC To be owner of record) FC
<br />5 Completed and signed JIB fuel s stem ins ection checklists and punch lists CMGROUP �NC.
<br />-.. -..._ _ .._ _._ _ _ _ _ _ _ __.
<br />6 ECSC Equi ment Slary_._ ._ _. ......._..._ FEV _ ___..__..__... _...... ....__... ___ _ 9 Hazardous Materials Storage Permit (ECSC To be owner of record) FC
<br />IROU
<br />1 Confirm ECSC receipt of fuel equipment su rve C _
<br />Cli
<br />6 Monitorine s kem re arts send na to ECSC GC _..____10 .._..._ Hazardous Materials Dispensing (ECSC To be owner of record)______._...__ _____ ___� _� __ _ _� _ FC
<br />ARCHITECTLRE
<br />_.__P.__ __Lst. __.___ _ _._.._ ____.._._._.._ ._..__.._.....___.___._.�_ �___
<br />__. _...._.__...�_... _......__._____._ 11 Hazardous Materials Business Plan a n CA Only) LANDSCM f.
<br />9
<br />Monitor s tem certification send ca to ECSC ___. __...__._._._.___.�_ ___._.,_.. GC ( JIB EE
<br />____._._..._.... _ _ _._.Y.__ _ __ ... __ ._ _.__ ____. ..__ _ _..____._.. _..___.___ _ _ __._.__._ DCHRM
<br />GC (ECSC To be tank owner of record AIR
<br />1 _._.._._..... Certification _ f moni.torinq_ tem installation send co _ttw ECSC_..__._._....__. _ __._.._..........._____.___ ___.._.... �
<br />1O of mons
<br />____. ra date states form FPE
<br />11 Current GARB executive orders u a QUALITY APPLICATIONS/PERMITS (ECSC "To be tank owner of record)
<br />12 Hazardous waste manifests far agy__A este enerated sgnd mop to ECSC ._..__GC _ _ ._._._. 3001 Dotilglas B14 #210
<br />13Co ies of all permits and approvals as follows:
<br />Rosevie, CA 95661
<br />__. __.__.___ ___. _ P -_ ._ __ .._,._.__.._._.._.__._._._.. _...___.__._.___.__.__..._.__.,______._.___....__.....___... 12 Application for Air Quality Permit to Construct/In stall (ECSC To be tank owner of record) FPE
<br />Zon inch Chane _ ____ ._..._.._._..__. GM __ _.___.._._ __._.__...._..___ __ __._......____..._...... ___._._....__ T 916-771-2555
<br />C .. ... Fay •- 1-
<br />__........Special Exce tion Conditional Use _____.._..... _. 13 Permit to Construct Install FPE
<br />_om
<br />Variances A roved CM9255
<br />___._ P _ _..__ _� _ . _ __. _ _. _ _ ._ _ c
<br />_ __,.. _ ____.n_._ _ ___,_______ ____._.______.._.__.._ _ ______ _._. ____ __.__.. _____ _ .._..._.._.. _... __. 14 Construction Completion Notification FC
<br />�» Site Plan A roved CM _._._._n _ _ __ _ �_____.. __ ____ __ _ __ _ _. _ _.._____ ____. __ __ __ _ _ ____._._
<br />P P _..___._ ___ n _. . _.__ ___ __ _____ _ _ _ _ __ ___._.___._ _ ________._..._ _ _ _ ___._.._.._.._._..._.-._.........._..._ CA Msthei, CA ,
<br />CA
<br />_.T Building Permit s M _ ._._ .. _._ _.._...__ _._.........._... 1 Air Quality Permit to Operate (ECSC To be tank owner of record) FC , A PcA
<br />_ _ _._. _ _.__.._. ..._ _ .................. _
<br />-.._Q_.--P- Ap r a a c h P e rm Lit s _ _ C _... _ _..__ ____._ _ __.._.._...__._ __ _.__ ___._,_._.._..._..._....._.____._....... _ _ ______._____.__. _ _..____ ___ _ __._____ __ _ _ ________. _. __ ___ _ __ __-___._.__ ___._ ....__._._.__._... _ _
<br />' State CM OTHER ENVIRONMENTAL PERMITSZAPPLICATTONS list below FPE CM RHl JOB #: JIB05O02.2
<br />_ �u n _._ _.. _ _ cM _ __._._..._. _ .,_. _ _ _ _. p y _._ _ _ _ _ _ _ site information
<br />Financial Responsibility Permit
<br />. y....___._ _...__n _._.._.._._._..__.__._ _. _. ._.__._._._.__..__._._.. _. _ _ _
<br />0 C"___ I�� Cit CM 16 CERTIFICATION OF FINANCIAL RESPONSIBILITY (CM to contact ECSC for certificate) ECSC
<br />0 T!__..__L5 3Gradin Permit _ _ _ _ _ _ _._..._.._._.___. K E: 8 E C Q R L N 6 8
<br />e Demolition Permit _ ._C_
<br />.._.._.__._ _ _ _ _ _.._ ._ 17 TX Only -"Volatile "Volatile Chemical Sales Permit". TX Health Department operations permit
<br />ij Sewa e S tem Permit C P P P, JIB PROTOTYPE
<br />.___. _._.._ _ _... _ _ _ __.. _ _ _ . __. CM _ _ _
<br />__ ____ Water Well Permit CM to sell absuable chemicals. Obtained from JIB Restaurant Accounting Dept.
<br />___ _____ _____... _. __.___ __ _. _ __ _.________.._ _ _ _..___._ _.._ .._._.____.__..____,__.. ADDRESS:
<br />[.� Sewer Connection A ravel CM ___.._._.__.._.�._ _.___..___..__._._.._,_.__.__-_.�._.....___.______..____..._..___._...._,___..____.___._.___.__.............___........._.__...___._ _..
<br />ABBREVIATIONS ONS _,........__.___._...__ _ _ _E _ __._....__._...__..___ ___..._._._. _ _ _ _ _._.. _ ENVIRONMENTAL TESTING: ______ ____ __ __ __ ._ __ __ _.____ ____
<br />, .p ___.._.___.._._ __ IATI.__.._.__ _ __ __. _ _ __ ED Architectural A rove! __.__ .__ � ___ _._.__.____ _ .. GM __..._.. ..__. _ ._..__._....._...__.__. ____ �__,_..._ ___.__.___._..___,_..._..__.__ ___...�__._________ _ ..___ _ _ � __ 10858 TRINITY f KY.
<br />__..._.._______ __._._. _�____.___�__.___ 1 B Tank integrity tests (send copy to ECSC) FC
<br />Landscape PIar7 A rove! CM.__._,_ _ _ _
<br />`" A.F.G. ABOVE FINISH GRADE --_-__ �._.. _ 19 Line integrity tests (send copy to ECSC) FC
<br />__ _._..._._.... _ Stormwater Man age: ent Permit _ _ _ CMM_ _ _....... __. _ _-_._._. _� _ __ _ ..__ _ ____ .__ _ __ __ ._. _ _ ___ _ _ _.__ __...__,._______. STOCK TON , CA 95219
<br />_ CM 20 Liquid removal rate test results (send copy to ECSC) FC
<br />DIA. DIAMETER �] ADA A ravel
<br />C) DTL. DETAIL _._._ .._. _. Unlit Relocation _Approval _ _ .__ _ _ __._. ..__...._.._.0 _ .._ _ _ Vapor recovery testing; DRAWN BY: WI_W
<br />F.R.P. FIBERGLASS REINF=ORCED PIPE . ..... C. _._.__Sin Permit __ ____ __ _._. _ _.___ _ _ _ __ _ __ ....___ __ .._._____ C __.._._ .....__ __._______......._ .__.._._ _ _ _.._ __.__ _.____ 2� _ _ ._...__ _____.... Pressure leak decay test results send Coda tc ECSC ______.___________.....______.._.____..___ . __ FC ________ _ __ _.___.._..__.___._ ...
<br />NONE
<br />-'0 E] Food/Beverage Sale Approval RA __......_.__._._,_. __ _. 2__. __ ___.___._..D Dynamic back rPssur_test results send co to ECSC FC _ SCA
<br />�v GAL, GALLONS _ _ ___ ..__.._...____. ._____ _ LE'
<br />__, ..._.._._. _.... .__ _ __. ._ ___._ _.____. _ _ __ _ __ _ _ _.__ _n __.._._____..._
<br />G.C. GENERAL CONTRACTOR _.__._._.......... Lotter L
<br />. Ap roval _ QSO __.__.. _._ __. Z3 Air i uld A L ratio test results send co tq_ECSC FC
<br />MIN. MINIMUM _..__.__Ne
<br />Performance Bond GC
<br />___.�...________..._.__.___...___ _. _,..,�_.__.,____... �.__..._.._....._._..�...,.__.______...___..__._______.__._ .___...__.�._ .._._�..___..,.__________ ,_._�__.._.__._._.__.__.. ._......_..___._..._..___ PHASE_ I_mVapor__.recovery FUELtestin.__.._..__..,.__..__._...______._._...._.___._..
<br />nl hway Bond GC
<br />MAX. MAXIMUM -Offsite/Driveways Approval _ _ .._� _ __.. _ CM 24 Pressure integrity of drop tube and drain valves (send copy to ECSC) FC SHEET
<br />MPDS MULTIPLE PRODUCT DISPENSER
<br />. ._ �------UtilitEasements CM _._._.._..__._...._____.___..._._..___._._____.__..__...__.___.__......____._..._..._......
<br />m O, C. ON CENTER ____. ___ _ _ _ ........_.....______.____...___,._...._.. ___.___._........_.__....._.__... 25 Swivel adapter torque test (send copy to ECSC) _ FC
<br />Beer/Vin e Permit RE__..._.__.__._.._..__
<br />TLM TANK LEVEL MONITORING Building/Canopy Sprinkler rySystem ____... .__ _. CM _._.._.. _ 26 Secondary Containment test results __ Tank, piping, sumps, UDCs (send copy to ECSC) FC
<br />TYPICAL Ej_._. Planniri De t� Env. Permit _ C FSOmO
<br />W/ WITH _._.._._..._ - _Oil Co. Ap rovalsp mm_ Tank Layout ____.___ __._____..___ _. _ _ _._ ___.___..____......_..._.........___ ___.__. ._ 27 ReverifiGation of all SeGkion 3 Testing (send copy to ECSC) FC
<br />Ej Oil Co. Approvals Sian Plan __. _ _. CM___,_.__,_._..__..__ __ __ ___ ._._.._._....__._... ___..___.__.. (CA Onlymust be Completed within 30 days of start up)
<br />[ Copy of Certificate of Occupancy (if required) C -- - - UST Certificate of Installation (send_ copy__ to_ EC C) FC
<br />
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