Laserfiche WebLink
CER IE TN>FIED PROGRAM AGENC CZ <br />SPILL'PREVENTI(N I,uNTROL�AND.COUNTERMEASUR�. NSPCC) PLAN <br />... <br />. ;STATUS/REFERRAL FO r <br />Mail a copy of the completed form to: <br />Californ' Re ional Wate quality Control Board <br />Attn: X, V1 D 16 1 v1 � <br />fK (m*v ;S <br />iJ i/fir ,CA� <br />Date: P / g / tX0 <br />CLTPA Inspector: l Jc <br />Address:.. �a�l.�/�'r <br />Co. — rAb <br />jt(il d 4UtFt <br />f.Pi h , CA U�ig-6 lz__ <br />Phone: ( Z0q) `""f `'s d — -1 9AY <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.1 11 <br />n ,�— = ^ t <br />Facility Name: aA�e <br />Facility Address: <br />0 L'Jt <br />Contact: (''i f� �-ti �0 <br />e, Phone: ��� 1 <br />The Facili is in com liance with H&SC Section 25270.5 c the preparation of an SPCC plait. <br />A complete copy of the facility's SPCC plan, certified by a Registered Professional Engineer, is <br />Elmaintained 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 it, compliance with H&SC Section 25270.5(c). <br />This orm constitutes a re erral to the Re Tonal Board or correction o the oliowin violation. <br />Flo] The facility does not have a to <br />SPCC plan in place. <br />rage Act. A <br />y of <br />The owner or operator was unaBo��a f Abovegroundhe Tank Program bround Petroleum rochure a was provided to <br />tilestate Water Resources Control <br />the owner or operator. <br />/C:,7r <br />cc: Carol Julian <br />State Water Resources Control Board <br />`po Division of Clean Water Programs <br />i� P.O. Box 944212 SWRCB, CWP Form AGT-1 (06128/99) <br />Sacramento, CA 94244-2120 <br />