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CER' ;TJ JNIFIED PROGRAM AGENC, ,T ) , <br />SPILL PREVENTION _-JNTROL ;AND: COUN IBRMEASIJR, NSPCC) PLAN <br />:STATUS/REFERRAL FORM . <br />Mail a copy of the completed form to: ' <br />Califomii"a Regional Water Quality Control Board <br />I-IJ Attn: <br />-73 <br />CA <br />Date: <br />CUPA Inspector: I ((oylo Wed <br />Address: <br />coq C AVCfi� , <br />S -v C <br />Phone: ( 2Lf(OV - �00q) `[ <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: ,) um A—m4yo-ow <br />�M a <br />Facility Address: <br />R6 <br />L0 <br />W <br />P. o. BoxT41b <br />��.c� as3c�� <br />Contact: 1 {1�Phone: ( 2M) 667q— 156) �Q <br />The Facility is in compliance with H&SC Section 25270.5(c2, the preparation of an SPCC plan. <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 the Regional Board for correction of the following violation. <br />MThe facility does not have a certified SPCC plan in place. <br />The owner or operator was unaware of the Aboveground Petroleum Storage Act. A copy of the <br />M- State Water Resources Control Board, Aboveground Tank Program brochure was provided to <br />the owner or operator. <br />cc: Carol Julian <br />State Water Resources Control Board <br />0 a Division of Clean Water Programs <br />P.O. Box 944212 SWRCB, CWP Form AGT-I (06/28/99) <br />Sacramento, CA 94244-2120 <br />