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(CT Tr k); <br /> CERTIFT-- JNIFIED PROGRAM AGENCY, ; <br /> SPILL PREVENTIG. —JN-TRO COUNTERNMASt 'PCC)PLAN <br /> STATUS/REFERRAL FORM <br /> Mail a copy of the completed form to: CUPA Inspect�o/r: ' <br /> Califo 'a Re Tonal Water Quality Control Board Address:30 7" G• <br /> � Attn: <br /> OIV/ <br /> SPhone:( <br /> Date: <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: FC4 <br /> Facility Address: ( D) b <br /> Contact: l�'�4(��'l Ul � Phone: (O 4 ) 416 (Q <br /> The Facility is in compliance with H&SC Section 25270.5(c), the preparation of an SPCC plan. <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 its compliance with H&SC Section 25270.5(c). <br /> Thus form constitutes a referral to the Regional Board for correction of the following violation. <br /> ElThe facility does not have a certified SPCC plan in place. <br /> 7T heowner or operator was unaware of the Aboveground Petroleum Storage Act. A copy of the <br /> State Water Resources Control Board,Aboveground Tank Program brochure was provided to <br /> the owner or operator. <br /> cc: Carol Julian <br /> V State Water Resources Control Board <br /> Division of Clean Water Programs <br /> X11 �o P.O.Box 944212 <br /> Sacramento,CA 94244-2120 SWRCB,CWP Form AGT 1 (06/28/99) <br /> 1 <br />