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1089 CARLSBAD VILLAGE DR; ; CB101822; Permit
10-06-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Commercial/Industrial Permit Permit No. CB101822 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: Project Title: Applicant: VERDUGO TESTING COMPANY 862 STARBOARD ST CHULA VISTA, CA 91914 619-691-0600 1089 CARLSBAD VILLAGE DR CBAD Tl Sub Type: INDUST 2033203100 Lot#: 0 Status; $6,000.00 Construction Type: NEW Applied: Reference#: SW100338 NEW 7-11 Plan Approved: REMOVE UNDERGROUND WASTE OIL 550 GAL STORAGE Issued: Inspect Area: Plan Check#: Owner: ALLAHYARl FAMILY TRUST 07-17-02 ISSUED 10/06/2010 Entered By: 10/06/2010 10/06/2010 JMA 19TIERRAVISTA LAGUNA HILLS CA 92653 Building Permit Add'l Building Permit Fee Plan Check Add'l Plan Check Fee Plan Check Discount Strong Motion Fee Park Fee LFM Fee Bridge Fee BTD #2 Fee BTD#3Fee Renewal Fee Add'l Renewal Fee Other Building Fee Pot. Water Con. Fee Meter Size Add'l Pot. Water Con. Fee Reel. Water Con. Fee Green Bldg Stands (SB1473) Fee Fire Expedited Plan Review $81.41 Meter Size $0.00 Add'l Reel. W ater Con. Fee $52.92 Meter Fee $0.00 SDCWAFee $0.00 CFD Payoff Fee $1.26 PFF (3105540) $0.00 PFF (4305540) $0.00 License Tax (3104193) $0.00 License Tax (4304193) $0.00 Traffic Impact Fee (3105541) $0.00 Traffic Impact Fee (4305541) $0.00 PLUMBING TOTAL $0.00 ELECTRICAL TOTAL $0.00 MECHANICAL TOTAL $0.00 Master Drainage Fee Sewer Fee $0.00 Redev Parking Fee $0.00 Additional Fees $1.00 HMPFee $0.00 TOTAL PERMIT FEES $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $136.59 Total Fees:$136.59 Total Payments To Date:$136.59 Balance Due:$0.00 FINAL APPROVAL Date: 08/ <£Q/i( NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as 'lees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32,030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. 10-12-2010 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Storm Water Pollution Prevention Plan (SWPPP) Permit Permit No:SW100338 Job Address: Permit Type: Parcel No: Reference #: CB#: Project Title: 1089 CARLSBAD VILLAGE DR CBAD SWPPP 2033203100 Lot#: NEW 7-11 REMOVE UNDERGROUND WASTE OIL 550 GAL STORAGE Priority: M Status: Applied: Entered By: Issued: Inspect Area: Tier: ISSUED 10/06/2010 JMA 10/06/2010 1 Applicant: VERDUGO TESTING COMPANY 862 STARBOARD ST CHULA VISTA, CA 91914 619-691-0600 Emergency Contact: FERNANDO VERDUGO JR Owner: ALLAHYARI FAMILY TRUST 07-17-02 19TIERRAVISTA LACUNA HILLS CA 92653 619-778-8543 SWPPP Plan Check SWPPP Inspections Additional Fees $49.00 $208.00 $0.00 TOTAL PERMIT FEES $257.00 Total Fees:$257,00 Total Payments To Date:$257.00 Balance Due:$0.00 LEARANCE. CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax 760-602-8558 www.carlsbadca.gov Plan Check No. Q£) \ Q ^ Est. Value Plan Ck. Deposit Date /6 swppp JOB ADDRESS . _ _ 1,1 ) / ' // A/O8<? CffSl$h#d Vina*{ Or.</ CT/PROJECT* LOT# PHASE* # OF UNITS # BEDROOMS NA HA SUITE#/SPACE#/UNIT# APN # BATHROOMS TENANT BUSINESS NAME N$ Cofl^had fyas -^ i DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) f^e-iM^\jal of UfiaefQ Wvrio '5-^-o^O.qC TOflr' 1 (AJQS~i~£ Oil ) ^</ </ *- •* EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ... „ , .tft~ flLy/!&£ ADDRESS /•»'//••/ '/ •»>/OSf Qar (shoe Village J?f. CITY /»••/..// STATE ZIP PHONE FAX EMAIL I i \ ^~\ IC.e>rl£*>ad g&S (*J rontarvnver. Cor* PROPERTY OWNER NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL ,.-,.,... i: ,...;.'": V.' • • • : '•'•:•:•' '•• • . : • ARCH/DESIGNER NAME & ADDRESS STATE LIC. # PATIOS (SF) DECKS (SF) FIREPLACE AM Affl YEsQ# N APPLICANT NAME o^i ef CONSTR. TYPE OCC. GROUP tyopant S~O Zfd i/fftfS,(/ * AIR CONDITIONING / FIRE SPRINKLERS^ jfTI YES | |NO [yf YES | [ Nopn ADDRESS CITY STATE „. ZIP PHONE FA EMAIL CONTRACTOR BUS. NAME , i y ere* u#o ADDRESS J < 7eS%:«:n^',:,^/c;.,:,. ;:. ]t:. ; .J-;. .;:;;; :, ,;;- ,; CITY /> t 1 STATE ZIPChuiw. \/($T% CA: ^fZ/ PHONE FA EMAIL r 1 /^, 1 STATE LIC.# CU o£>K>3&/ < '(*. 1 1~ ,'33(3.. " tyS&ty " :,. 1%fQ^ C#M ; ; , ,.:: .. SS . CITY BUS. LIC.# /? /22.P 2=^ (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires theapppcant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commending with Section 7000 of Division 3 of theBusiness and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: U have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. l^n I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co -^fl-Ve Fu^cl i___^_ Policy No. ./iSSTP. 17-"? •••'.,..:.,' Expiration Date ::: "T"/ ~ 2&// f : This section need not be completed if the permit is for one hundred dollars ($100) or less. | | Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. JS$ CONTRACTOR SIGNATURE '^[==r~l.. -£& \f^J( X [vfAGENT DATE /Q~f-/O / tereby affirm that I am exempt from Contractor's License Law for the following reason: | | I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). | | I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractors) licensed pursuant to the Contractor's License Law). | [ I am exempt under Section Business and Professions Code for this reason: ^_^ 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. I lYes I INO 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): jgSTpROPERTY OWNER SIGNATURE fjAGENT DATE ' Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? I I Yes I iNo .—. .—. Is the applicant or future building occupant required to obtain a permit from the air pollution control district or afrouality management district? I—|Yes |_J No I^N";^^EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I certify that I have read the application and state thatthe above information Is correct and thatthe information on the plans is arajrate.lagree to comply with all Cityordinancesand State laws relaBngto building construction. I hereby authorize representative of the City of Carlsbad to enterupon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'ff deep and demolition or construction of structures over 3 stories in height. EXPIRATION- Every permit issued by the Building Official underthe provisions of this Code shall expire by limitation and become null and void if the building orwork authonzed by such permit is not commenced within from the date of such permit or if the building orwork authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). (PLICANT'S SIGNATURE DATE Inspection List Permit*: CB101822 Type: Tl INDUS! Date Inspection Item 03/25/201119 Final Structural 03/25/2011 19 Final Structural 03/25/201129 Final Plumbing 03/25/2011 29 Final Plumbing 03/25/201139 Final Electrical 02/28/201119 Final Structural 02/28/2011 39 Final Electrical 02/25/2011 21 Underground/Under Floor 02/25/2011 31 Underground/Conduit-Wirin MC AP Inspector MC MC MC MC MC MC MC MC Act Fl Fl Fl Fl Fl PA PA AP NEW 7-11 REMOVE UNDERGROUND WASTE OIL 55 Comments RECEIVED FINAL REPORTS-FOR BACKFILL & HAZMAT RECEIVED FINAL REPORTS FOR BACKFILL & HAZMAT NEED SOILS REPORT COMPLETE METER REMOVAL REMOVAL OF TANK OK, NEED SOILS REPORT FOR BACK FILL DISCONNECT OF LOW VOLTAGE TO TANK OK, NEED TO VERIFY STRUCTURE DISCONNECT Monday, March 28, 2011 Page 1 of 1 CITY OF UNSCHEDULED BUILDING INSPECTION B-44 Development Services Building Division 1635 Faraday Avenue Carlsbad CA 92008 750-602-2700 DATE:INSPECTOR: He. PERMITS CONTACT: PHONE #: JOB ADDRESS: DESCRIPTION: CODE DESCRIPTION AC'COMMENTS Bldg Inspection Form Page 1 of 1 Rev. 06/09 CITY OF CARLSBAD UNSCHEDULED SWPPP INSPECTION B-49 Development Services Building Division 1635 Faraday Avenue Carlsbad CA 92008 760-602-2700 DATE:INSPECTOR: PERMIT #:EMER CONTACT: PHONED: JOB ADDRESS: CODE DESCRIPTION ACT COMMENTS 600 601 , 602 603*;; 604 -, 605, 606 607 608 6Q9 , 610 , PRE-CON NPDES ROUTINE INSPECTION FOLLOW-UP INSPECTION COMPLAINT INSPECTION NOTICE TO CLEAN ILLEGAL DISCHARGE j WRITTEN WARNING STOP.WqiRK NOTICE , NOTICE PJF VlOlATION **' VERBALivARNING 7 ,' ' AP = Approved; . ,^, " .'•"/". / , CO =, Correctidn^: • ^ r ''" ' = Wrong Code, ~ 'SW=StppWcSrk'.'4 " N RE-CHECK DATE: B-49 Page 1 of 1 Rev. 06/10 Carlsbad Fire Department BLDG. DEPT COPY Plan Review Requirements Category: FL , Date of Report: 10-25-2010 Reviewed by: Name: Address: VERDUGO TESTING COMPANY 862 STARBOARD ST CHULA VISTA, CA 91914 Permit #:US100134 /cu5 jo/?* Job Name: TANK REMOVAL Job Address: 1089 CARLSBAD VILLAGE DR CBAD Conditions: Cond: CON0004232 THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF BUILDING PERMIT. THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON, CONDITIONS IN CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE REGULATIONS. CFC 3404.2.14. THIS APPROVAL SHALL NOT BE HELD TO PERMIT OR APPROVE THE VIOLATION OF ANY LAW. ++ A COPY OF A DOCUMENTS AND REPORTS PREPARED FOR THE REMOVAL, TESTING AND DESTRUCTION OF THIS TANK SHALL BE PROVIDED TO THE CARLSBAD FIRE DEPARTMENT ++ Entry: 10/25/2010 By: GR Action: AP www.mtglinc.com MTGL Project*:. Permit! Corporate: 2992 E. La Raima Ave. Ste. A Anaheim, CA 92806 Tel: 714.632.2999 Fax: 714.632.2974 Dispatch: 800.491.2990 San Diego/Imperial County 6295 Ferris Square, Suite C SanEfiego, CA92121 Tel: 858.537.3999 Fax: 858.537.3990 ft Dispatch: 888.844.5060 J Inland Empire: 14467 Meridian Pkw., Bldg. 2-A Riverside, CA 92518 Tel: 951.653.4999 Fax: 951.653.4666 Dispatch: 800,491.2990 Indio: 44917 Golf Center Pkwy, #1 Indio, CA 92201 Tel: 760.342.4677 Fax: 760.342,4525 Dispatch: 800.491.2990 DAILY INSPECTION REPORT DSA/CITY File #:_ DSA/OSHPDAPPL#:_ Report #_PG OF_DSA/LEA#: Special Inspection Reports must be distributed to the parties listed below within 14 days of the inspection. Reports of non-compfant conditions must be distributed immediately. Separate reports shall be prepared for each type of special inspection, on a daily basis. Each report shall be completed and signed by the speciaj inspector conducting the inspection. PROJECT NAME DATE ARCHITECT TIME ARRIVED TIME DEPARTED ENGINEER TRAVEL TIME LUNCH TIME CONTRACTOR SUB CONTRACTOR INSPECTION ADDRESS ADDRESS OF PROJECT TYPE OF INSPECTION Q ENGINEERED FILL D FOUNDATION U BACK,FILL D BATCH PLANT D PT CONCRETE D SHOTCRETE D CONCRETE D MASONRY D HIGH STRENGTH BOLTING D WELDING D SHOP WELD n FIREPROOFING D ANCHOR/DOWEL D NDE FIELD D NDESHOP D CEILING WIREn 'nn DSA/OSHPDfPRQJECT: APPROVED DOCUMENTS: AVAILABLE: APPROVED PLANS YS ND SOIL REPORT I\P SPECS: YS? ND APPROVED SHOP DRAWING YD ND MATERIALS USED BY CONTRACTOR (INCLUDE RESEARCH REPORT NO. OR MATERIAL TEST REPORTS):Ms. CONTRACTORS EQUIPMENT / MANPOWER USED: AREA, GRID LINES, PIECES INSPECTED: STRUCTURAL NOTES, DETAIL, OR RFIS USED: REMARKS, INCLUDING MEETINGS: REWORK AS PERGENT OF ALL WORK TODAY:PERCENT PROJECT COMPLETE: THE WORK WASD WAJSNOTD Inspected in accordance with,the requirements of the DSA/OSHPD/PROJECT approved documents. '' MATERIAL SAMPLING WAS D WAS NOT D N/A n Performed in accordance with DSA/OSHPD/PROJECT approved documents. cc Project Architect Contractor Structural Engineer Building Department DSA Regional-Office Owner School District THE WORK INSPECTED METD DID NOT MEET D The requirements of the DSA/OSHPD/PROJECT approved documents. Samples taken:_ & "'^•it"^' —F-TT~ ::aa! ( jgnaiure ofSpfcial Inspector Certification Verified, by: County of San Diego Department of Environmental Health Hazardous Materials Division 1255 Imperial Avenue P.O. Box 129261 San Diego, CA 92112-9261 OfFlCE. USE ONLY ACTIVITY CODE 428T23 Permit #_AT5481 Establishment # 201155 Date: October 4. 2010 Expiration Date: October 4.2011 Permit for Underground Storage Tank Construction/Closure SITE NAME: Carlsbad Gas & Propane SITE ADDRESS: 1089 Carlsbad Village Dr.. Carlsbad. 92008 OWNER NAME: SAME OWNER ADDRESS: SAME DESCRIPTION OF PROPOSED WORK: Remove one Ml Underground Storage Tank and associated piping; conducisojisajripjjnfl. In accordance with SDCC Ordinance Title 6, Chapter 10, Section 68.1004 (b), UST must be removed within 180 days of permit approval. The deadline to remove USTs is April 4,2011. r PERMIT CONDITIONS: For tank systems that are to be removed, the excavation shall be exposed prior to the scheduled inspection and sampling points identified by the DEH inspector. Sampling is required for both tank(s) and piping. The tank(s) and piping must remain in the excavation until the DEH inspector approves the removal. 1. All piping (if applicable) and underground storage tank must be removed at the same time. Failure to do so will result in a re- inspection and $709.00 re-inspection fee. 2. At least one sample must be analyzed for MTBE and related oxygenates (DIPE, TAME, ET8E, TBA) using EPA Method 8260B (OR AS DIRECTED BY THE DEH SAM INSPECTOR ONSITEV 3. Certificate of Disposal/manifests are required for the tank(s). 4. Forms HM-9715 (Formerly Form A) and HM-9717 (Formerly Form 8) are required to be submitted. Please be advised: All underground storage tanks that are to be removed must be cleaned and properly inerted prior to the removal. Failure to have the tank properly cleaned will result in the cancellation of the removal and will require a re-inspection and $709.00 fee. 1) The tank is visually free from all product, sludge, rtnsate and debris. Residual staining caused by soil and waste consisting of light shadows, slight streaks, or minor discolorations, and soil and waste in cracks, crevices and pits may be present. 2) Tanks that held a Hazardous material or hazardous waste that had the potential to generate flammable vapors, must be properly inerted. A combustible gas indicator (CGI), which is properly calibrated, shall be used to measure the concentration of flammable vapor at the top, center and bottom of the underground storage tank. The concentration of flammable vapor must be below twenty percent of the Lower Explosive Limit (LEL) for the material that was contained in the tank(s) and the oxygen concentration shall be the same as that of ambient air, approximately 20.8%. The underground storage tank(s) must inerted with dry ice using a minimum of 15 pounds for every 1000 gallons of tank capacity. • NOTE: A $143.00 per hour fee will be applied by the EHS if an inspection activity exceeds 4 hours. Inspection activities include, but are not limited to, field inspections, paperwork review and travel time. City of Carlsbad 10-04-2010 Fire Department Permit Permit No: US100134 Job Address: 1089 CARLSBAD VILLAG E DR CBAD Permit Type: FL Status: ISSUED Parcel No: 2033203100 Lot#: 0 Applied: 10/04/2010 Issued: 10/04/2010 Fire Dept Ref#: US100134 Building Permit*: Entered By: BSW Location: Project Title: TANK REMOVAL Description: WASTE OIL TANK REMOVAL Contractor: VERDUGO TESTING COMPANY Phone: 619-691-0600 862 STARBOARD ST Fax: CHULA VISTA, CA 91914 Total Fees: $123.00 Total Payments To Date: $0.00 Use Fee $0.00 Dispensing Fee $0.00 Storage Fee $0.00 Tanks Fee $123.00 Re-Inspection Fee $0.00 Other $0.00 Additional Fees $0.00 TOTAL PERMIT FEES ?«* ^ $123.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date thfe permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth In Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure wit! bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. Carlsbad FireDepartroent Plan Review Requirements Category: FL,, Date of Report: 10-25-2010 Reviewed by: Natoe; Address: Permit*: US100I34 VERDUGO TESTING COMPANY 862 STARBOARD ST CHULA VISTA, CA 91914 JobName: TANILJEMOVAL Job Address: 1089 CARLSBAD VILLAGE DR CBAD Conditions: Cond: CON0004232 [MET] ** APPROVED: THIS PROJECT HAS BEEN REVIEWED AND APPROVED FOR THE PURPOSES OF ISSUANCE OF BUILDING PERMIT. THIS APPROVAL IS SUBJECT TO FIELD INSPECTION AND REQUIRED TEST, NOTATIONS HEREON, eONBITlONS,.IN ' . " CORRESPONDENCE AND CONFORMANCE WITH ALL APPLICABLE SEGULATIONS. GFC 3404-2:, 14. THIS APPROVAL SHALL NOT BE HELD TO PERMIT QR APPROVE THE VIOLATION OF ANY LAW- +-f A COPY OF A DOCUMENTS AND REPORTS PREPARED FOR THE REMOVAL TESTING AND DESTRUCTION OF THIS TANK SHALL BE PROVIDED TO THE CARLSBAD FIRE DEPARTMENT -H- Entry: 10/25/2010 By: OR Action: AP f LAND AND QtJALITY DIVISION UNDERGROUND TANK CLOSURE REPORT \ ESTABLISHMENT NO. .;;? f 1 / s _ \r x / .- / v " ; i' TENAME f ft i<fi,t<rf ;>•*'.< «! {•'; 0 fv vwfl PLAN CHECK NO. ,s$T /^/ /?Y PHONE 76?0- "^.j'1 ^'^ /l/i SITE ADDRESS / {/ /T<7 ( ,-; f.; l"f- f/* '{/.f/'r . fl /)/ CITY C' « t- (t; L . I ZIP -?,//,^,:7 CONTRACTOR l/-?vrluf,Ji J'^'J'.t'-... { t 1%>< <,, PHONE T^/-'. ^/l iAyfi-i.^, Iff'/ -(:••?/ £4 fr/J Number of tanks to be removed /I* '23456 a | £ -'•;*'/•• Decontamination by /'V% f t*H *J <\|; f^-7 7 8 Manifest No. fu%ll *>/ i' «4 1 X "' ."TO V v v \>.,. .4 f- v > . , * ,- <J "' ^1 Tank rinsate/(arnount & destination) U l^- i, <*.,rt' t" fK-rs,, £_•/'< Tank ID No. Capacity Tank Construction Materials stored % L.E.L Dry ice/other (arnt.) Tank condition Backfill type Backfill condition Native soil type Native condition Odors? Tank Destination 1 ater present?/Depth? ' Ponded product? Piping removed? /•Y,/V ^•V-l^, . /!K:/ //O r.',. A n.-iv'i*!fi/ i ',)C lj,A/ ? * fo.-r /,,-€ Jw^'L' \ '-'ttf.fi t /">,• A ./fA :r/-' yf *V>. r.v,,.Uft.p,.% ,1f: ^/r./i ^ t W •• ',:. .«'? < »• „., (-!'<•; . / "': ' /' i.',' *- '.tit JA •:..•,."*>- >' J l)ft^\ 4, , / />^j r •:•• / . ./ • , --; '•• '' At,^,i,? > ^.- ..<•!• ,.i •^•'•- 0 *''' '"• •> *• ' " " U FIRE AGENCY PRESENT ('YE| NO Dept/Phone No. ( <. *• /f /.<?£'/ /*".*,., 1 Permit No. {,» T /AS t~*(s Inspector /, , „ , ,-, i) , / , , A W REMARKS <• *~h 7,-v*. J-f „ * f. » tic n.'n- •/ 1 i s-;;, . / -.JL..,./., ,'- J,//*"y»,7 ..» C" , , . ,R •; .vil- (, ^J~f t-i r \- ,. V /,' * t Jr* {i * 0 c», « y» .«-• </»' . j-i,/f /A ii, rf•,>-'-! i ,»- y jjji-,, J, i- ' *}•''• . .fl i Ll^i s*... I/, /{ t'V, ..41. -/ e.Of /',1 .£.* " > ./J \l ftf.,--^f f.t,- '•(' * i.'^rf :.,A|.-, /,- f ' rV I * ^ , f '" > /«, '., " - "' / " J'1" f1 " " •'/" ..>"^fi^,i"J'"/. , ,~ f ,?€*>,'/ ,?'!' L,« •?»',«.. , i' .. , r - i u "" "''*,• 1 AW // - Av/, / /'/A A" - X ?l|fl i C"t':< ..,-."i._0 x* f.s // LJ ,:-.,,., ' *, U J. fl'l rt -V*-.-. . '* : vi, *1 l $ / , , '1-, , V ". * ) 1 ' * " , • \ •" ) "' t" * ' "' ."•- ,!ia'* 4(1 <J!l*lI,,~ ,f- L.l.-rt? '-V'^.s REINSPECTION REQUIRED YES /'NO'\ If yes, explain M---^ AlJJ! "LI*- C-l <i Aa*.'?, NOTICE: You are hereby notified that c of r ,, d hazardoi D An unauthorized release of a t required to initiate Corrective $ D A determination of this site's stat results for the samples taken fr days. Please request that the la at the address provided below. >n 4 / '* ^ ' / i i - an En js substance underground st lazardous substance has bee Action measures (See Page < us is pending the Site Assess om the tank and/or piping cl< boratory send a copy of the a ("I* '«.<,• u*A,r,,( (\, s/ironmental He orage tank(s) < sn observed by t for details). ment and Mitig jsure site. A 1 nalytical report if ..J L.I salth Specialist conducted an inspection for the closure and/or piping. A summary of the conditions follows: the Environmental Health Specialist. You are hereby ation (SAM) Program's receipt and review of analytical aboratory report must be submitted to SAM within 30 directly to // ,. // if ... i ,-- — t \, > ."»,.— v, • ••,-*-••<, -j •, ifi, • • It is the responsibility of the tank owner/operator or their agent to maintain the tank closure site in a safe and secure manner. • Notify the local Fire Department and the SAM Program immediately whenever a fire or explosion hazard is present * Authorization to backfill the tank excavation for safety purposes does not indicate that a suspect or known unauthorized release has been mitigated to the satisfaction of SAM or any other regulatory agency. RECEIVED BY H-- -1--' V'"v/ * //.,,. It lit » a-r" 7TC/f VTlf- \ al'L '* PRINTED NAME /'"r .-•.-•..,,,..''.. ' ''V* ,•,«'••».• /v. "'HONE NUMBER £ /-/ s-vV • V.-^'/o Environmental Health Specialist (Print Name and Phone'No.) SAM - P.O. Box 129261 San Diego, CA 921 1 2-9261 (64%33S^2g2 DEH:SAM-916 (Rev. 3/08) NCR Page 3 of 4 County of San Diego Department of Environmental Health Page 1 of 12 alscience aboratories, Inc. February 28, 2011 Fernando Verdugo Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91 921 -1958 Subject: Calscience Work Order No.: 11-02-1785 Client Reference: Carlsbad Gas + Propane w/o Tank Pull Dear Client: Enclosed is an analytical report for the above-referenced project. The samples included in this report were received 2/25/201 1 and analyzed in accordance with the attached chain-of-custody. Calscience Environmental Laboratories certifies that the test results provided in this report meet all NELAC requirements for parameters for which accreditation is required • or available. Any exceptions to NELAC requirements are noted in the case narrative. The original report of subcontracted analysis, if any, is provided herein, and follows the standard Calscience data package. The results in this analytical report are limited to the samples tested and any reproduction thereof must be made in its entirety. If you have any questions regarding this report, please do not hesitate to contact the undersigned. Sincerely, Calscience Environmental Laboratories, Inc. Ranjit Clarke Project Manager NELAP ID: 03220CA * DoD-ELAP ID: L10-41 * CSDLAC ID: 10109 • SCAQMD ID: 93LA0830 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 Page 3 of 12 alscience SSV:.:. Environmental aboratories, Inc. Analytical Report Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91921-1958 Project: Carlsbad Gas + Propane w/o Tank Pull Date Received: Work Order No: Preparation: Method: Units: 02/25/11 11-02-1785 EPA 5030C EPA 8260B ug/kg Page 1 of 2 Client Sample Number T-1 8.5 Lab Sample Number 11-02-178S-1-A Date/Time Collected 02/25/11 09:40 Matrix Solid Instrument GO/MS Z Date Prepared 02/25/11 Date/Time Analyzed 02/25/11 18:08 QC Batch ID 110225L01 Parameter Acetone Benzene Bromobenzene Bromochloromethane Bromodichloro methane Bromoform Bromomethane 2-Butanone n-Butylbenzene sec-Butyl benzene tert-Butylbenzene Carbon Disulflde Carbon Tetrachloride Chlorobenzene Chloroethane Chloroform Chloromethane 2-Chlorotoluene 4-Chlorotoluene Dibromochloromethane 1 ,2-Dibromo-3-Chloropropane 1 ,2-Dibromoethane Dibromomethane 1 ,2-Dichlorobenzene 1 ,3-Dichlorobenzene 1 ,4-Dichlorobenzene Dichlorodifluoromethane 1,1-Dichloroethane 1 ,2-Dichloroethane 1,1-Dichloroethene c-1 ,2-Dichloroethene t-1 ,2-Dichloroethene 1 ,2-Dichloropropane 1 ,3-Dichloropropane 2,2-Dichloropropane 1 ,1 -Dichloropropene Surrogates: Dibromofluoromethane Toluene-d8 Result ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND REG (%) 101 99 EL 120 5.0 5.0 5.0 5.0 5.0 25 50 5.0 5.0 5.0 50 5.0 5.0 5.0 5.0 25 5.0 5.0 5.0 10 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 Control Limits 63-141 80-120 DF Qua! 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Qual Parameter c-1 ,3-Dichloropropene t-1 ,3-Dichloropropene Ethylbenzene 2-Hexanone Isopropylbenzene p-lsopropyltoluene Methylene Chloride 4-Methyl-2-Pentanone Naphthalene n-Propylbenzene Styrene 1,1,1 ,2-Tetrachloroethane 1 ,1 ,2,2-Tetrachloroethane Tetrachloroethene Toluene 1 ,2,3-Trichlorobenzene 1 ,2,4-Trichlorobenzene 1,1,1-Trichloroethane 1 ,1 ,2-Trichloroethane 1 ,1 ,2-Trichloro-1 ,2,2-Trifluoroethane Trichloroethene 1 ,2,3-Trichloropropane 1 ,2,4-Trimethylbenzene Trichlorofluoromethane 1 ,3,5-Trimethylbenzene Vinyl Acetate Vinyl Chloride p/m-Xylene o-Xylene Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TEA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol Surrogates: 1 ,2-Dichloroethane-d4 1 ,4-Bromofluorobenzene Result ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND REG (% 103 95 EL 5.0 5.0 5.0 50 5.0 5.0 50 50 50 5.0 5.0 5.0 5.0 5.0 5.0 10 5.0 5.0 5.0 50 5.0 5.0 5.0 50 5.0 50 5.0 5.0 5.0 5.0 50 10 10 10 250 1 Control Limits 62-146 60-132 DF Qual 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Qual ^^k. RL - Ri IwLkM RL - Reporting Limit , DF - Dilution Factor , Qual-Qualifiers 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL:(714) 895-5494 • FAX: (714) 894-7501 t ^science sagas: : Zjivironmental Quality Control - Spike/Spike Duplicate ^ aboratories, Inc. Verdugo Testing Company Inc. P.O. Box 211958 Chula Vista, CA 91921-1958 Project Carlsbad Gas + Propane w/o Tank Pull Date Received: Work Order No: Preparation: Method: Page 5 of 12 02/25/11 11-02-1785 EPA 3550B EPA8015B(M) Quality Control Sample ID T-1 8.5 3arameter Matrix Solid MS %REC Instrument GC47 MSP %REC Date Prepared 02/25/11 %REC CL Date Analyzed 02/26/11 RPD RPDC MS/MSD Batch Number 110225S13 L Qualifiers TPH Gas/Diesel 60-140 0-30 RPP - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 • FAX: (714) 894-7501 ^jivironmental Quality Control - LCS/LCS Duplicate » aboratories, Inc. Verdugo Testing Company Inc. P.O. Box 211958 Chula Vista, CA 91921-1958 Project: Carlsbad Gas + Propane w/o Tank Pull Date Received: Work Order No: Preparation: Method: Page 7 of 12 N/A 11-02-1785 EPA 3550B EPA8015B(M) Quality Control Sample ID 099-14-071-21 Matrix Solid Instrument GC47 Date Prepared 02/25/11 Date Analyzed 02/26/11 LCS/LCSD Batch Number 110225B13 Parameter TPH Gas/Diesel LCS %REC 97 LCSD %REC 94 %REC CL 70-130 RPD 3 RPDCL 0-25 Qualifiers RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 t Page 9 of 12 alscience , ivironmental Glossary of Terms and Qualifiers ; ! li l? aboratories, Inc. tf' ** Work Order Number: 11 -02-1785 Qualifier Definition * See applicable analysis comment. < Less than the indicated value. > Greater than the indicated value. 1 Surrogate compound recovery was out of control due to a required sample dilution, therefore, the sample data was reported without further clarification. 2 Surrogate compound recovery was out of control due to matrix interference. The associated method blank surrogate spike compound was in control and, therefore, the sample data was reported without further clarification. 3 Recovery of the Matrix Spike (MS) or Matrix Spike Duplicate (MSD) compound was out of control due to matrix interference. The associated LCS and/or LCSD was in control and, therefore, the sample data was reported without further clarification. 4 The MS/MSD RPD was out of control due to matrix interference. The LCS/LCSD RPD was in control and, therefore, the sample data was reported without further clarification. 5 The PDS/PDSD or PES/PESD associated with this batch of samples was out of control due to a matrix interference effect. The associated batch LCS/LCSD was in control and, hence, the associated sample data was reported without further clarification. B Analyte was present in the associated method blank. BU Sample analyzed after holding time expired. E Concentration exceeds the calibration range. ET Sample was extracted past end of recommended max. holding time. J Analyte was detected at a concentration below the reporting limit and above the laboratory method detection limit. Reported value is estimated. ME LCS Recovery Percentage is within LCS ME Control Limit range. ND Parameter not detected at the indicated reporting limit. Q Spike recovery and RPD control limits do not apply resulting from the parameter concentration in the sample exceeding the spike concentration by a factor of four or greater. X % Recovery and/or RPD out-of-range. Z Analyte presence was not confirmed by second column or GC/MS analysis. Solid - Unless otherwise indicated, solid sample data is reported on a wet weight basis, not corrected for % moisture. All QC results are reported on a wet weight basis. 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL:(714) 895-5494 • FAX: (714) 894-7501 Page 11 of 12 V) 0s?b (0 CO M ti ansodiflioo avao ainon anos U09KH08 Q31VN3OO1VH L 81-f Vd3Hdai -SVOJi HdL co S^ P RELINQUISHED BYSignatureCDaLU CO a ZimCC 0 ^ CO •o ._ ol CompanyT3 •i LX (0Q. O 0 CD•z. T3 .0) |V CRECEIVED BYeSign(1) CO Z 73 CompanycraQ. o0 H Z±ounty of San Diegovironmental HealthCEDeponsible PartyLaboratoryContractoriteYelloPinkNCR| 1 I Page 1 of 12 alscience __=nvironmental m i mm aboratories, Inc. February 28, 2011 . Fernando Verdugo Verdugo Testing Company Inc. P.O. Box 211958 Chula Vista, CA 91921-1958 Subject: Calscience Work Order No.: 11-02-1785 Client Reference: Carlsbad Gas + Propane w/o Tank Pull Dear Client: Enclosed is an analytical report for the above-referenced project. The samples included in this report were received 2/25/2011 and analyzed in accordance with the attached chain-of-custody. Calscience Environmental Laboratories certifies that the test results provided in this report meet all NELAC requirements for parameters for which accreditation is required or available. Any exceptions to NELAC requirements are noted in the case narrative. The original report of subcontracted analysis, if any, is provided herein, and follows the standard Calscience data package. The results in this analytical report are limited to the samples tested and any reproduction thereof must be made in its entirety. If you have any questions regarding this report, please do not hesitate to contact the undersigned. Sincerely, Calscience Environmental Laboratories, Inc. Ranjit Clarke Project Manager NELAP ID. 03220CA • DoD-ELAP ID: L10-41 • CSDLAC ID: 10109 • SCAQMD ID: 93LA0830 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 Page 2 of 12 alscience nvironmental * aboratories, Inc. Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91921-1958 Analytical Report Date Received: Work Order No: Preparation: Method: Units: 02/25/1 1 11-02-1785 EPA 3550B EPA8015B(M) mg/kg Project- rar|Qhari fins + Propane w/o Tank Pull = I T-1 8.5 TPHC6-C10 TPHC10-C28 Surrogates: I Method Blank TPHC6-C10 TPHC10-C28 Surrogates: Result ND ND 100 Result ND ND REC (%) 93 Lab Sample Date/Time M,,mh«r Collected Matnx 11-02-1785-1-A 02/25/11 Solid09:40 RL DF Qual Parameter 15 •) TPHC28-C40 15 1 TPH C6-C40 Total Control Qual Limits 60-140 099-14-071-21 N/A Solid RL DF Qual Parameter ^5~ 1 TPH C28-C40 15 1 TPH C6-C40 Total Control Qual Limits 60-140 Date Instrument prepared GC47 02/25/11 Result ND ND GC47 02/25/11 Result ND ND Date/Time Analyzed 02/26/11 12:07 RL DF 15 1 15 1 02/26/11 10:53 RL DF 15 1 15 1 QC Batch ID 110225B13 Qual 110225B13 Qual RL - Reporting Limit , DF - Dilution Factor , Qual - Qualifiers 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL(714) 895-5494 • FAX: (714) 894-7501 Page 3 of 12 alscience Sf Environmental aboratories, Inc. Analytical Report Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91921-1958 Project: Carlsbad Gas + Propane w/o Tank Pull Date Received: Work Order No: Preparation: Method: Units: 02/25/11 11-02-1785 EPA 5030C EPA 8260B ug/kg Page 1 of 2 '•f; -..!:• Client Sample Number T-1 8.5 Lab Sample Number 11-02-178S-1,A Date/Time Collected 02/25/1109:40 Matrix Solid Instrument GC/MS Z Date Prepared 02/25/11 Date/Time Analyzed 02/2S/11 18:08 QC Batch ID 110225L01 Parameter Acetone Benzene Bromobenzene Bromochloromethane Bromodichloromethane Bromoform Bromomethane 2-Butanone n-Butylbenzene sec-Butylbenzene tert-Butylbenzene Carbon Disulfide Carbon Tetrachloride Chlorobenzene Chloroethane Chloroform Chloromethane 2-Chlorotoluene 4-Chlorotoluene Dibromochloromethane 1 ,2-Dibromo-3-Chloropropane 1 ,2-Dibromoethane Dibromomethane 1 ,2-Dichlorobenzene 1 ,3-Dichlorobenzene 1 ,4-Dichlorobenzene Dichlorodifluoromethane 1,1-Dichloroethane 1 ,2-Dichloroethane 1,1-Dichloroethene c-1 ,2-Dichloroethene t-1 ,2-Dichloroethene 1 ,2-Dichloropropane 1 ,3-Dichloropropane 2,2-Dichloropropane 1 ,1-Dichloropropene Surrogates: Dibromofluoromethane Toluene-d8 Result ND ND ND ND ND ND ND ND ND ND ND - ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND REC (%' 101 99 RL D_E Qual 120 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 25 1 50 1 5.0 1 5.0 1 5.0 1 50 1 5.0 1 5.0 1 5.0 1 5.0 1 25 1 5.0 1 5.0 1 5.0 1 10 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 1 Control Qual Limits 63-141 80-120 Parameter c-1 ,3-Dichloropropene t-1 ,3-Dichloropropene Ethyl benzene 2-Hexanone Isopropylbenzene p-lsopropyltoluene Methylene Chloride 4-Methyl-2-Pentanone Naphthalene n-Propylbenzene Styrene 1 ,1 , 1 ,2-Tetrachloroethane 1 ,1 ,2,2-Tetrachloroethane Tetrachloroethene Toluene 1 ,2,3-Trichlorobenzene 1 ,2,4-Trichlorobenzene 1 ,1 ,1-Trichloroethane 1,1,2-Trichloroethane 1 ,1 ,2-Trichloro-1 ,2,2-Trifluoroethane Trichloroethene 1 ,2,3-Trichloropropane 1 ,2,4-Trimethylbenzene Trichlorofluoromethane 1 ,3,5-Trimethylbenzene Vinyl Acetate Vinyl Chloride p/m-Xylene o-Xylene Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TBA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol Surrogates: 1 ,2-Dichloroethane-d4 1 ,4-Bromofluorobenzene Result ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND REC (%) 103 95 RL 5.0 5.0 5.0 50 5.0 5.0 50 50 50 5.0 5.0 5.0 5.0 5.0 5.0 10 5.0 5.0 5.0 50 5.0 5.0 5.0 50 5.0 50 5.0 5.0 5.0 5.0 50 10 10 10 250 Control Limits 62-146 60-132 D_E Qual 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Qual RL - Reporting Limit , DF - Dilution Factor , Qual-Qualifiers 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL:(714) 895-5494 • FAX: (714) 894-7501 Page 4 of 12 a/sc/ence= m^nvironmental •» aboratories, Inc. Analytical Report Verdugo Testing Company Inc. P.O. Box 21 1958 Chula Vista, CA 91921-1958 Project: Carlsbad Gas + Propane Client Sample Number Method Blank w/o Tank Pull Date Received: Work Order No: Preparation: Method: Units: Lab Sample Date/Time . Number Collected Matnx Instrument 099-12-796-4,549 N/A Solid GC/MSZ 02/25/1 1 11-02-1785 EPA 5030C EPA 8260B ug/kg Page 2 of 2 Date Date/Time Prepared Analyzed Qc Batch ID 02/25/11 02/25/11 110225L01 14:04 Parameter Acetone Benzene Bromobenzene Bromochloromethane Bromodichloromethane Bromoform Bromomethane 2-Butanone n-Butylbenzene sec-Butylbenzene tert-Butylbenzene Carbon Disulfide Carbon Tetrachloride Chlorobenzene Chloroethane Chloroform Chloromethane 2-Chlorotoluene 4-Chlorotoluene Dibromochloromethane 1 ,2-Dibromo-3-Chloropropane 1 ,2-Dibromoethane Dibromomethane 1 ,2-Dichlorobenzene 1 ,3-Dichlorobenzene 1 ,4-Dichlorobenzene Dichlorodifluoromethane 1,1-Dichloroethane 1 ,2-Dichloroethane 1,1-Dichloroethene c-1 ,2-Dichloroethene t-1 ,2-Dichloroethene 1 ,2-Dichloropropane 1 ,3-Dichloropropane 2,2-Dichloropropane 1,1-Dichloropropene Surrogates: Dibromofluoromethahe Toluene-d8 Result ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND REG (% 103 100 RL DF Qua! 120 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 25 1 50 1 5.0 1 5.0 1 5.0 1 50 1 5.0 1 5.0 1 5.0 1 5.0 1 25 1 5.0 1 5.0 1 5.0 1 10 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 5.0 1 Control Qual Limits 63-141 80-120 parameter c-1 ,3-Dichloropropene t-1 ,3-Dichloropropene Ethylbenzene 2-Hexanone Isopropylbenzene p-lsopropyltoluene Methylene Chloride 4-Methyl-2-Pentanone Naphthalene n-Propylbenzene Styrene 1,1,1 ,2-Tetrachloroethane 1 ,1 ,2,2-Tetrachloroethane Tetrachloroethene Toluene 1 ,2,3-Trichlorobenzene 1 ,2,4-Trichlorobenzene 1,1,1-Trichloroethane 1 ,1 ,2-Trichloroethane 1,1 ,2-Trichloro-1 ,2,2-Trifluoroethane Trichloroethene 1 ,2,3-Trichloropropane 1 ,2,4-Trimethylbenzene Trichlorofluoromethane 1 ,3,5-Trimethylbenzene Vinyl Acetate Vinyl Chloride p/m-Xylene o-Xylene Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TBA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol Surrogates: 1 ,2-Dichloroethane-d4 1 ,4-Bromofluorobenzene Result ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND ND REG (% 106 98 Sk 5.0 5.0 5.0 50 5.0 5.0 50 50 50 5.0 5.0 5.0 5.0 5.0 5.0 10 5.0 5.0 5.0 50 5.0 5.0 5.0 50 5.0 50 5.0 5.0 5.0 5.0 50 10 10 10 250 1 Control Limits 62-146 60-132 DF Qual 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Qual RL - Reporting Limit , DF - Dilution Factor , Qual - Qualifiers 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL:(714) 895-5494 • FAX: (714) 894-7501 Page 5 of 12 alscience ^ijivironmental Mm aboratories, Inc. Quality Control - Spike/Spike Duplicate Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91921-1958 Date Received: Work Order No: Preparation: Method: ; '02/25/11 11-02-1785 . EPA 3550B EPA8015B(M) Project Carlsbad, Gas + Propane w/o Tank PulJ Quality Control-Sample ID •' • | T-1 8.5 Parameter TPH Gas/Diesel Matrix Instrument Solid GC47 MS %REC MSP %REC 89 88 Date Prepared 02/25/11 %REC CL 60-140 Date MS/MSD Batch Analyzed Number 02/26/11 110225S13 | RPD RPDCL Qualifiers 2 0-30 RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 Page 6 of 12 sllscience jivironmental Quality Control - Spike/Spike Duplicate m aboratories, Inc. Verdugo Testing Company Inc. P.O. Box 21 1958 Chula Vista, CA 91921-1958 Project Carlsbad Gas + Propane w/o Tank Pull Quality Control Sample ID 11-02-1566-5 ^arameter Benzene Carbon Tetrachloride Chloro benzene 1 ,2-Dibromoethane 1 ,2-Dichlorobenzene 1 ,2-Dichloroethane 1,1-Dichloroethene Ethyl benzene Toluene Trichloroethene Vinyl Chloride Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TBA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol Matrix Solid MS %REC 100 100 98 96 95 96 102 101 99 98 99 86 97 98 94 92 119 Date Received: Work Order No: Preparation: Method: Instrument GC/MS Z MSP %REC 102 101 98 96 93 98 103 102 100 101 108 94 109 99 96 94 132 Date Prepared 02/23/11 %REC CL 61-127 51-135 57-123 64-124 35-131 80-120 47-143 57-129 63-123 44-158 49-139 57-123 30-168 57-129 55-127 58-124 17-167 RPD 2 1 1 0 3 2 1 1 1 3 9 7 11 1 2 2 11 02/25/1 1 11-02-1785 EPA 5030C EPA 8260B Date MS/MSD Batch Analyzed Number 02/25/11 110225S01 RPDCL Qualifiers 0-20 0-29 0-20 0-20 0-25 0-20 0-25 0-22 0-20 0-20 0-47 0-21 0-34 0-20 0-20 0-20 0-47 RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 • FAX: (714) 894-7501 Page 6 of 12 alscience nvironmental Quality Control - Spike/Spike Duplicate * aboratories, Inc. Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91921-1958 Project Carlsbad Gas + Propane w/o Tank Pull Quality Control Sample ID Matrix | 11-02-1566-5 Solid Date Received: Work Order No: Preparation: Method: Date Instrument Prepared GC/MS Z 02/23/11 02/25/1 1 11-02-1785 EPA 5030C EPA 8260B Date MS/MSD Batch Analyzed Number 02/25/11 110225S01 j Parameter Benzene Carbon Tetrachloride Chlorobenzene 1,2-Dibromoethane 1,2-Dichlorobenzene 1,2-Dichloroethane 1,1-Dichloroethene Ethylbenzene Toluene Trichloroethene Vinyl Chloride Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TEA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol MS %REC 100 100 98 96 95 96 102 101 99 98 99 86 97 98 94 92 119 MSP %REC 102 101 98 96 93 98 103 102 100 101 108 94 109 99 96 94 132 %REC CL RPD 61-127 51-135 57-123 64-124 35-131 80-120 47-143 57-129 63-123 44-158 49-139 57-123 30-168 57-129 55-127 58-124 17-167 2 1 1 0 3 2 1 1 1 3 9 7 11 1 2 2 11 RPDCL 0-20 0-29 0-20 0-20 0-25 0-20 0-25 0-22 0-20 0-20 0-47 0-21 0-34 0-20 0-20 0-20 0-47 RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 ajscience ESS ~jivironmental Quality Control - LCS/LCS Duplicate im aboratories, Inc. Verdugo Testing Company Inc. P.O. Box 211958 Chula Vista, CA 91921-1958 Project: Carlsbad Gas + Propane w/o Tank Pull Date Received: Work Order No: Preparation: Method: Page 7 of 12 N/A 11-02-1785 EPA 3550B EPA8015B(M) Quality Control Sample ID Matrix Instrument Date Prepared Date Analyzed LCS/LCSD Batch Number 089-14-071-21 Solid GC47 02/25/11 02/26/11 110225813 Parameter TPH Gas/Diesel LCS %REC LCSD %REC %REC CL RPD RPD CL Qualifie 97 94 70-130 3 0-25 RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 Page 8 of 12 alscience_.~: i-Jivironmental Quality Control - LCS/LCS Duplicate mm aboratories, Inc.t Verdugo Testing Company Inc. P.O. Box 21 1958 Chula Vista, CA 91 921 -1958 Project: Carlsbad Gas + Propane Quality Control Sample ID 099-12-796-4,549 Parameter Benzene Carbon Tetrachloride Chlorobenzene 1 ,2-Dibromoethane 1 ,2-Dichlorobenzene 1 ,2-Dichloroethane 1,1-Dichloroethene Ethylbenzene Toluene Trichloroethene Vinyl Chloride Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TEA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol Date Received: w/o Tank Matrix Solid LCS %REC 96 97 94 95 91 96 100 97 95 96 105 94 84 96 93 91 109 Pull Instrument GO/MS Z Work Order Preparation: Method: Date Prepared 02/25/11 No: Date Analyzed 02/25/11 LCS/LCSD N/A 11-02-1785 EPA 5030C EPA 8260B Batch Number 110225L01 I LCSD %REC %REC CL ME CL RPD 96 97 94 99 92 97 97 96 95 95 94 94 87 95 94 94 96 78-120 49-139 79-120 80-120 75-120 80-120 74-122 76-120 77-120 80-120 68-122 77-120 68-122 78-120 78-120 75-120 56-140 71-127 34-154 72-127 73-127 68-128 73-127 66-130 69-127 70-127 73-127 59-131 70-127 59-131 71-127 71-127 68-128 42-154 0 0 0 3 1 1 3 1 0 0 12 0 3 0 0 4 12 RPDCL 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 Qualifiers Total number of LCS compounds : 17 Total number of ME compounds : 0 Total number of ME compounds allowed : LCS ME CL validation result: Pass RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 Page 8 of 12 alscience _nvironmental Quality Control - LCS/LCS Duplicate Mm aboratories, Inc. Verdugo Testing Company Inc. P.O. Box211958 Chula Vista, CA 91921-1958 Project: Carlsbad Gas + Propane Quality Control Sample ID 099-12-796-4,549 Parameter Benzene Carbon Tetrachloride Chlorobenzene 1 ,2-Dibromoethane 1 ,2-Dichlorobenzene 1 ,2-Dichloroethane 1,1-Dichloroethene Ethyl benzene Toluene Trichloroethene Vinyl Chloride Methyl-t-Butyl Ether (MTBE) Tert-Butyl Alcohol (TBA) Diisopropyl Ether (DIPE) Ethyl-t-Butyl Ether (ETBE) Tert-Amyl-Methyl Ether (TAME) Ethanol Date Received Work Order No: w/o Tank Matrix Solid LCS %REC 96 97 94 95 91 96 100 97 95 96 105 94 84 96 93 91 109 Pull Instrument GC/MS Z Preparation: Method: Date Prepared 02/2W11 LCSD %REC %REC CL 96 97 94 99 92 97 97 96 95 95 94 94 87 95 94 94 96 78-120 49-139 79-120 80-120 75-120 80-120 74-122 76-120 77-120 80-120 68-122 77-120 68-122 78-120 78-120 75-120 56-140 Date Analyzed 02/25/11 LCS/LCSD N/A 11-02-1785 EPA 5030C EPA 8260B Batch Number 110225L01 | ME CL RPD 71-127 34-154 72-127 73-127 68-128 73-127 66-130 69-127 70-127 73-127 59-131 70-127 59-131 71-127 71-127 68-128 42-154 0 0 0 3 1 1 3 1 0 0 12 0 3 0 0 4 12 RPDCL 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 0-20 Qualifiers Total number of LCS compounds : 17 Total number of ME compounds : 0 Total number of ME compounds allowed : LCS ME CL validation result: Pass RPD - Relative Percent Difference , CL - Control Limit 7440 Lincoln Way, Garden Grove, CA 92841-1427 . TEL:(714) 895-5494 . FAX: (714) 894-7501 Page 9 of 12 alscience nvironmental Glossary of Terms and Qualifiers aboratories, Inc. Work Order Number: 11-02-1785 ' Qualifier Definition * See applicable analysis comment. < Less than the indicated value. > Greater than the indicated value. . • , 1 Surrogate compoand recovery was out of control due to a required sample dilution, therefore, the sample data was reported without further clarification. 2 Surrogate compound recovery was out of control due to matrix interference. The associated method blank surrogate spike compound was in control and, therefore, the sample data was reported without further clarification. 3 Recovery of the Matrix Spike (MS) or Matrix Spike Duplicate (MSD) compound was out of control due to matrix interference. The associated LCS and/or LCSD was in control and, therefore, the sample data was reported without further clarification. 4 The MS/MSD RPD was out of control due to matrix interference. The LCS/LCSD RPD was in control and, therefore, the sample data was reported without further clarification. 5 The PDS/PDSD or PES/PESD associated with this batch of samples was out of control due to a matrix interference effect. The associated batch LCS/LCSD was in control and, hence, the associated sample data was reported without further clarification. B Analyte was present in the associated method blank. BU Sample analyzed after holding time expired. E Concentration exceeds the calibration range. ET Sample was extracted past end of recommended max. holding time. J Analyte was detected at a concentration below the reporting limit and above the laboratory method detection limit. Reported value is estimated. ME LCS Recovery Percentage is within LCS ME Control Limit range. ND Parameter not detected at the indicated reporting limit. Q Spike recovery and RPD control limits do not apply resulting from the parameter concentration in the sample exceeding the spike concentration by a factor of four or greater. X % Recovery and/or RPD out-of-range. Z Analyte presence was not confirmed by second column or GC/MS analysis. Solid - Unless otherwise indicated, solid sample data is reported on a wet weight basis, not corrected for % moisture. All QC results are reported on a wet weight basis. 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL:(714) 895-5494 • FAX: (714) 894-7501 pZO/6-86! QtrooUJ Q O CO —DO ' O "S rs eo o>Q o- Ills°i pS ^§«S ^^ S00as!? -3 I in 3 -3 o j o5 0t (0UJ 0)REQUESTED ANAD 5 DAYSROUNDE DAYTURNARD S+[£-01] (6) Hdi (00/29) JO ((H£9)sVNd (OOZZ8) SOOAS (9E09) d3Jd 3J03U3 (809Z8) sajBuaBXxo (90928) SOOA 3aiw / xaia (8) Hdi STS Y APPLYnCOELTEDFCS<s £S28 SoUJ IL PLEX Oo V I F liatSignature/t Ythe Green and Yellow to ClientT/Cs are printed on the?^g-CM^•s ™<N U=T3 DISTRIBUTION: WhitePlease note that pages Page 9 of 12 a/science , nvironmentalL Glossary of Terms and Qualifiers aboratories, Inc. Work Order Number: 11-02-1785 Qualifier Definition * See applicable analysis comment. < Less than the indicated value. > Greater than the indicated value. 1 Surrogate compound recovery was out of control due to a required sample dilution, therefore, the sample data was reported without further clarification. 2 Surrogate compound recovery was out of control due to matrix interference. The associated method blank surrogate spike compound was in control and, therefore, the sample data was reported without further clarification. 3 Recovery of the Matrix Spike (MS) or Matrix Spike Duplicate (MSD) compound was out of control due to matrix interference. The associated LCS and/or LCSD was in control and, therefore, the sample data was reported without further clarification. 4 The MS/MSD RPD was out of control due to matrix interference. The LCS/LCSD RPD was in control and, therefore, the sample data was reported without further clarification. 5 The PDS/PDSD or PES/PESD associated with this batch of samples was out of control due to a matrix interference effect. The associated batch LCS/LCSD was in control and, hence, the associated sample data was reported without further clarification. B Analyte was present in the associated method blank. BU Sample analyzed after holding time expired. E Concentration exceeds the calibration range. ET Sample was extracted past end of recommended max. holding time. J Analyte was detected at a concentration below the reporting limit and above the laboratory method detection limit. Reported value is estimated. ME LCS Recovery Percentage is within LCS ME Control Limit range. ND Parameter not detected at the indicated reporting limit. Q Spike recovery and RPD control limits do not apply resulting from the parameter concentration in the sample exceeding the spike concentration by a factor of four or greater. X % Recovery and/or RPD out-of-range. Z Analyte presence was not confirmed by second column or GC/MS analysis. Solid - Unless otherwise indicated, solid sample data is reported on a wet weight basis, not corrected for % moisture. All QC results are reported on a wet weight basis. 7440 Lincoln Way, Garden Grove, CA 92841-1427 • TEL:(714) 895-5494 • FAX: (714) 894-7501 Page 11 of 12 golthieeal Page 12 of 12 WORK ORDER #: 11 -02- Ine*SAMPLE RECEIPT FORM Cooler ]_ of } CLIENT:DATE. TEMPERATURE: Thermometer ID: SG1 (Criteria: 0.0°C -6.0 °C, not frozen) / Temperature I .3> °C + 0.5 °C (CF) = I .f$ °C Q Blank D Sample D Sample(s) outside temperature criteria (PM/APM contacted by: ). D Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling, D Received at ambient temperature, placed on ice for transport by Courier. Ambient Temperature: D Air D Filter Initial: CUSTODY SEALS INTACT: D Cooler 0"Sample n n D No (Not Intact) D No (Not Intact) ffl Not Present D Not Present D N/A Initial: \}J Initial: -L<?fv SAMPLE CONDITION: Yes No Chain-Of-Custody (COC) document(s) received with samples 0 D COC document(s) received complete \3s D D Collection date/time, matrix, and/or # of containers logged in based on sample labels. D No analysis requested. D Not relinquished. D No date/time relinquished. Sampler's name indicated on COC H D Sample container label(s) consistent with COC [vf D Sample containers) intact and good condition H^ D Proper containers and sufficient volume for analyses requested.. M D Analyses received within holding time 5r D pH / Residual Chlorine / Dissolved Sulfide received within 24 hours D Q Proper preservation noted on COC or sample container D D D Unpreserved vials received for Volatiles analysis Volatile analysis container(s) free of headspace.... D D Tedlar bag(s) free of condensation D D CONTAINED TYPE: Solid: Q^ozCGJ DSozCGJ D16ozCGJ DSIeeve ( ) DEnCores® DTerraCores® D_ N/A n n a n n a a Water: DVOA DVOAh DVOAna2 D125AGB D125AGBH D125AGBp D1AGB D1AGBna2 DIAGBs D50QAGB D500AGJ DSOOAGJs D250AGB D250CGB D250CGBs D1PB D500PB DSOOPBna D250PB D250PBn D125PB D125PBznna D100PJ D100PJna2 D D D . Air: DTedlar® DSumma® Other: D Trip Blank Lot#: Labeled/Checked by: ^f Container: C: Clear A: Amber P: Plastic G: Glass J: Jar B: Bottle Z: Ziploc/Resealable Bag E: Envelope Reviewed by: vf £•• Preservative: h: HCL n:HN03 rufciNazSzOj na: NaOH p: H3P04 s: H2S04 znna: ZnAc2+NaOH f: Field-filtered Scanned by: _ SOP T100_090 (09/13/10) J Page 12 of 12 WORK ORDER #: 11 -02- LD Ll SAMPLE RECEIPT FORM CLIENT: Cooler \ of J DATE. 02 /JiS/11 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 °C -6.0°C, not frozen) /' Temperature L«^_°C + 0.5°C (CF) = \_.Q_°C O Blank D Sample D Sample(s) outside temperature criteria (PM/APM contacted by: ). D Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling. D Received at ambient temperature, placed on ice for transport by Courier. Ambient Temperature: D Air D Filter Initial: CUSTODY SEALS INTACT: D Cooler D B'SarrSample D_ D No (Not Intact) D No (Not Intact) Not Present D Not Present D N/A Initial: Initial: SAMPLE CONDITION: Yes No Chain-Of-Custody (COC) document(s) received with samples 0 D COC document(s) received complete w D D Collection date/time, matrix, and/or # of containers logged in based on sample labels. D No analysis requested. D Not relinquished. D No date/time relinquished. Sampler's name indicated on COC C3 D Sample container label(s) consistent with COC GT D Sample container(s) intact and good condition a'" D Proper containers and sufficient volume for analyses requested M D Analyses received within holding time 5r D pH / Residual Chlorine / Dissolved Sulfide received within 24 hours D D Proper preservation noted on COC or sample container D D D Unpreserved vials received for Volatiles analysis Volatile analysis container(s) free of headspace D D Tedlar bag(s) free of condensation D D CONTAINER TYPE: N/A D D D D D D D Solid: O4ozCGJ DSozCGJ D16ozCGJ DSIeeve _) DEnCores® DTerraCores® D_ Water: DVOA DVOAh DVOAna2 D125AGB D125AGBh D125AGBp D1AGB D1AGBna2 DIAGBs D500AGB D500AGJ DSOOAGJs D250AGB D250CGB D250CGBs D1PB D500PB DSOOPBna D250PB D250PBn D125PB D125PBznna D100PJ D100PJna2 D D D Air: DTedlar® DSumma® Other: D Trip Blank Lot#: Labeled/Checked by: Container: C: Clear A: Amber P: Plastic G: Glass J: Jar B: Bottle Z: Ziploc/Resealable Bag E: Envelope Reviewed by: Preservative: h: HCL n: HN03 na2:Na2S2O3 na: NaOH p: H3PO4 s: H2S04 znna: ZnAc2+NaOH f: Field-filtered Scanned by: .. I v( >~- SOP T100_090 (09/13/10) lN3Hd(n3A309NI833NION3/1Wmmi.lH:>aV ' of CARLSBAD HIDING DEPT. Check a License - Contractors State License Board Page 1 of2 ' Of Contractors State Li Contractor's License Detail - License # 866381 DISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this information, you should be aware of the following limitations. ••» CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the link or button to obtain complaint and/or legal action information. * Per B&P 7071.17 , only construction related civil judgments reported to the CSLB are disclosed. •* Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. ••» Due to workload, there may be relevant information that has not yet been entered onto the Board's license database. License Number 866381 Extract Date: 10/6/2010 ^ ~ " -————ig^jNG CO'TNC '"'" PO BOX 211958 Business Information CHULA VISTA, CA 91921 _ _ Business Phone..My.Qberi6J_9]J91 ;0600 ..Entity^ _ Corporation _ Issue Date ,„, .JO/24/2005 Expire_Date___ ___J,0/31/2011 __ _ _ ______ License status This license is current and active. All information below should be reviewed. Additional Status: CLASS DESCRIPTION D40 SERy!GESTjffiQN..£^^ Classifications: """" A GENERAL ENGINEERING CONTRACTOR jll^==^^ .^.===^^ CERT DESCRIPTION Certifications:HA£___ JjAZARTOU^UBSTANC __ ______ CONTRACTOR'S BOND This license filed Contractor's Bond number 548885C in the amount of $12,500 with the bonding company DEVELQEERS^^^ Effective Date: 01/01/2007 .ContragtQr:s.BoMing.lii|tary^^_ BOND OF QUALIFYING INDIVIDUAL 1. The Responsible Managing Officer (RMO) VERDUGO ANTONIO FERNANDO certified that he/she owns 10 percent or more of the voting stock/equity of the corporation. A bond of qualifying individual is not required. Bonding: Effective Date: 10/24/2005 BQI's Bonding History 2. This license filed Bond of Qualifying Individual number 100105353 for VERDUGO MARCO ANTONIO in the amount of $12,500 with the bonding company AMIBICAJN_CJ^^ Effective Date: 11/24/2009 BQI's Bonding History 3. This license filed Bond of Qualifying Individual number 100115221 for VERDUGO ANTONIO FERNANDO JR in the amount of $12,500 with the bonding company https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum:=8... 10/06/2010 Check a License - Contractors State License Board Page 2 of2 Effective Date: 02/27/2010 .B.Q!'s_Bondln.g_Hj3tQ.ry This license has workers compensation insurance with the aME.CQMPENSMJOMJMSyRANCE.FUND Policy Number: 1350677 Effective Date: 07/01/2005 _JExpire Date: 07/01 /2011 ^ Personnel listed on this license (current or disassociated) are listed on other licenses. Condjtjan§_QfJJse | Privas_ Copyright © 26113 State of California https://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNum=8... 10/06/2010 oCD 111 s z z ngineeringI !Use:Oo§ o c?c? ?) S1 s f=• 3 •3o D 2 1