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CERTI D yUNAM IFIED-PROGRAGENCY,f <br />... <br />} SPILL PREVENTIO., CONTROL AND COUNTSRIVIEAS u. <br />_ '9TATUS/REFERRALTORM ::. - <br />CUPA Inspector: I I S 1 0� <br />Address:fJC— v t l rb �' �" v' ` <br />TPA). <br />(SPCC) PLAN <br />Mail a copy of the completed form to: ' <br />California Regional Water Quality Control Board <br />Atm: 61 yl al d I ✓to r a r �P_ <br />3y- u <br />o-�.� L <br />CA R 5 a <br />Date: ogo-c, D <br />�`9 <br />i ..; �. . <br />The following facility is storing "petroleum" in a single storage tank greater than 660 gallons or in <br />multiple storage tanks with a cumulative storage capacity greater than 1,320 gallons. "Petroleum" <br />means crude oil, or any fraction thereof, which is liquid at 60 degrees Fahrenheit temperature and 14.7 <br />pounds per square inch absolute pressure. This includes petroleum based substances comprised of a <br />complex blend of hydrocarbons, such as gasoline, diesel, jet fuels, residual fuel oils, lubricants, some <br />petroleum solvents, and used oils. Ap example of a substance that is not "petroleum" is liquid propane <br />gas (LPG). Note: The backside of this form identifies storage tanks and facilities exempt from the state <br />Aboveground Petroleum Storage Act SPCC requirement. <br />Facility Name: <br />M <br />Facility Address: �j �J P�,c.C�' 0 <br />6fvc�o(A � a5�o7 <br />Contact: l �l- l� Phone: c�oq) Vl �`7"— ✓O <br />o an SPCClair. <br />The Facilityis ill. <br />co Bance fvith H&SC Section 25270.5 c t/�e re oration <br />A complete copy of the facility's SPCC plan, certified by a Registered Professional Engineer, is <br />maintained at the facility, which is normally attended at least 8 hours per day. If the facility is <br />not attended at least 8 hours per day, the SPCC plan is maintained at the nearest field office. <br />The facility is not in compliance with H&SC Section 25270.5(c). <br />This form constitutes a referral to <br />the Re Tonal Board or correction o the ollowin� violation. <br />The facility does not have a certified SPCC plan in place. <br />The owner or operator was unaware Control Board fthe AbovA ground Tank Program btroochure was rov provided to <br />State Water Resources C <br />the owner or operator. <br />cc: Carol Julian <br />0 D State Water Resources Control Board <br />Division of Clean Water Programs <br />P.O. Box 944212 SWRCB, CWP Form AGT-1 (06/28/99) <br />Sacramento, CA 94244-2120 <br />Did . <br />