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830 union ave business plan
00 M C) > -< `3 + GAS -N -SAVE ____ ______ ____________ ___-------- _____ ___--= SiteID. 015 - 021 - 001531 + Manager : BusPhone: (661) 324 -6016 Location: 830 UNION AVE Map : 103 CommHaz : Moderate City BAKERSFIELD Grid: 32A FacUnits: 1 AOV: CommCode: BFD STA 08 SIC Code:5541 EPA Numb: DunnBrad: -- -_+ == = = =__+ Emergency Contact / Title- Emergency Contact Title MANSOUR S MANSOUR / OWNER YADWINDER SINGH / Business Phone: (818) 366 -0914x Business Phone: (661) 324 -6016x 24 -Hour Phone (661) 832 -6237x 24 -Hour Phone (661) 832 -6237x Pager Phone { ) - x Pager Phone ( ) - x +------------- - ------------------------- +--------------------- ---- -- - ---- -+ I Hazmat Hazards: I Fire De- I +--------------------- --___- _---------------- -- - - - - -- - -+ Contact Phone. (661) 324 -6016x MailAddr: 830 UNION AVE State: CA City : BAKERSFIELD Zip : 93307 +------------------------------------------ - - - - - -- --- _ _+ Owner Phone. (661) 324 - 6016x Address : 830 UNION AVE State: CA City : BAKERSFIELD Zip : 93307 +------------------------------------------------------------ _------ - - - - -- -Gal+ Period to TotalASTs: - Preparer: TotalUSTs: - Gal Certif ' d: RSs : No ParcelNo: +--------------------------- - - - - -- 7 ------------------------ .----------------- - - --t- Emergency Directives: PROG A.- HAZMAT PROG U - UST Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. r Sig ature Date C� Av'-G� �s,�ti3n�r� �s a 00"A DD ENT ��N o b 206 _1_ 05/26/2006 E GAS N SAVE SiteID: 015 - 021 - 001531 Manager : Location: 830 UNION AVE City : BAKERSFIELD CommCode: BAKERSFIELD STATION 08 EPA Numb: BusPhone: (661) 324 -6016 Map : 103 CommHaz : UnRated Grid: 32A FacUnits: 1 AOV: SIC Code:5541 DunnBrad: Emergency Contact / Title Emergency Contact / Title MANSOUR S MANSOUR / OWNER YADWINDER SINGH / Business Phone: (818) 366 -0914x Business Phone: (661) 324 -6016x 24 -Hour Phone (661) 832 -6237x 24 -Hour Phone (661) 832 -6237x Pager Phone ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth De1H1th Contact : Phone: (661) 324 -6016x MailAddr: 830 UNION AVE State: CA City : BAKERSFIELD Zip : 93307 Owner MANSOUR S MANSOUR Phone: (818) 366 -0914x Address : 830 UNION AVE Stater CA City : BAKERSFIELD Zip : 93307 Period to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: =� ����� �e� Do hereby Certify that i have reV1E?'' eo the allaChed hazardous MaWdafs Ment plan for 6 �y • ,1�L4Rd $ $ i $ 9 a Builnom) ��� ��h any Mrrec$i®ns const'i$u$® &Comps (s$® and C�rPC 0 4 ' manu 89emen$ plan for spy facmvo A-k-� /VJ /`l7 �• 2- a -1- 07/22/2004 t w F GAS N SAVE SitelD: 015 -021- 001531 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY /SITE INFORMATION Business Name: GAS N SAVE Cross Street : Business Type: Org Type: Total Tanks 3 IndnRes /Trust: No PA Contact: PROPERTY OWNER INFORMATION Name YADWINDER SINGH Phone: (661) 324- -6016x Address: City State: Zip: Type - -- TANK OWNER INFORMATION Name : YADWINDER SINGH Address: City Type Phone: ( 6 61) 324-6016x State: Zip: BOE UST Fee# : UNKNOWN Financ11 Resp: SELF INSURED Legal Notif : Property Owner Mailing Address Date:11/06 /2000 Phone: (818) 366 -0914x Name:MANSOUR S. MANSOUR Tt1:OWNER State UST # 1998 Upg Cert #: -2- 07/22/2004 GAS N SAVE SiteID: 015 -021- 001531 9 Hazmat Inventory By Facility Unit 9 MCP +DailyMax Order Fixed Containers at Site 9 Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PREMIUM UNLEADED F IH DH L 10000.00 GAL Mod UNLEADED REGULAR F IH DH L 10000.00 GAL Mod DIESEL F IH DH 10000.00 GAL Low -3- 07/22/2004 F OAS N SANE SiteID: 015 - 021 - 001531 Inventory Item 0002 Facility Unit: Fixed Containers at Site COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: SE CRNR OF LOT UNDERGROUND CAS# 8006619 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid. Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LUUNZIUN Largest Container Daily Maximum 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS %Wt. 100.00 Gasoline Daily Average 10000.00 GAL RS CAS# No 8006619 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive /Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod MISC. LOCAL AGENCY DATA' Ag.Definedl: Ag.Defined2: Ag.Defined3: Ag.Defined4: Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: Ag.Definell -4- 07/22/2004 n F GAS N SAVE SiteID: 015 - 021 - 001531 = Inventory Item 0002 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY - DEFINED) Page 1 of 2 Last Action Type: Location In Site: SE CRNR OF LOT UNDERGROUND TANK DESCRIPTION Tank ID #: 2 Mfr: UNKNOWN Installed: 03/1985 Capacity: 10000 Gals No. Additional Info: TANKS LINED IN 11 -1999 BY TANK LINERS INC. TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: PREMIUM UNLEADED Matl Name:PREMIUM UNLEADED Compart Tank: N. Of Comparts: C O I N Cas #: 8006619 TANK CONSTRUT Type SINGLE WALL W /INT LINER & C.P. i Material (p) : BARE STEEL Material(s): BARE STEEL i Lining : EPDXY LINING Installed: Corr Prot: CATHODIC PROTECTION Installed: Spill Cnt 2000 Alarm Exempt: No Drop Tube 2000 Ball Float Striker Plate: 2000 Fill Tube S /O: 2000 Sgl Wall: Last Used: TANK LEAK DETECTION AUTOMATIC TANK GAUGING Dbl Wall: TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE Qty Remaining: Was Filled: No -5- 07/22/2001 F GAS N SAVE SiteID: 015 - 021 - 001531 Inventory Item 0002 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY- DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: SINGLE WALL Mf gr : UNKNOWN Mtl : BARE STEEL Corr CATHODIC PROTECTION Prot PIPING LEAK DETECTION UnderGround Piping AboveGround Piping AUTOMATIC LEAK DETECTORS DISPENSER CONTAINMENT Installed: 04/12/2004 Type: DISP. PAN SENSOR W/ POS. SHUTOFF OWNER /OPERATOR SIGNATURE Date: 11/06/2000 Name:MANSOUR S. MANSOUR Prmt Number: 1531 TANK /LINE TEST :04/16/2004 CP CERT. :10/16/2000 MANWAY INSP. :12/22/1998 UST MONIT. CERT:04 /12/2004 Ttl:OWNER Approved: Yes AGENCY DEFINED PASSED Expiration Date: 06/30/2006 -6- 07/22/2004 F GAS N SAVE SiteID: 015 -021- 001531 Inventory Item 0003 Facility Unit: Fixed Containers at Site COMMON NAME / CHEMICAL NAME UNLEADED REGULAR Days On Site 365 Location within this Facility Unit Map: Grid: SE CRNR OF LOT UNDERGROUND CAS# 8006619 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 10000.00 GAL - HAZARDOUS COMPONENTS %Wt. 100.00 Gasoline HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive /Amount EPA Haza No No No No/ Curies F IH RS No CAS# 8006619 rds NFPA USDOT# MCP DH / / / Mod MISC. LOCAL AGENCY DATA Ag . Def inedl . Ag . Def ined2 : Ag . Def ined3 : Ag . Def ined4 : Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: Ag.Definell -7 07/22/2004 MISC. LOCAL AGENCY DATA Ag . Def inedl . Ag . Def ined2 : Ag . Def ined3 : Ag . Def ined4 : Ag.Defined5: Ag.Defined6: Ag.Defined7: Ag.Defined8: Ag.Defined9: Ag.Define10: Ag.Definell -7 07/22/2004 TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -8- 1 07/22/2004 F GAS N SAVE SiteID: 015 -021- 001531 F== Inventory Item 0003 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY - DEFINED) Page 1 of 2 Last Action Type: Location In Site: SE CRNR OF LOT UNDERGROUND TANK DESCRIPTION Tank ID #: 3 Mfr: UNKNOWN Compart Tank: N Installed: 03/1985 Capacity: 10000 Gals No. Of Comparts: Additional Info: TANKS LINED TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: REGULAR UNLEADED Matl Name:UNLEADED REGULAR Cas #: 8006619 TANK CONSTRUCTION Type ; SINGLE WALL W /INT LINER & C.P. Material (p) : BARE STEEL Material(s): BARE STEEL Lining : EPDXY LINING Installed: Corr Prot: CATHODIC PROTECTION Installed: Spill Cnt : 2000 Alarm Exempt: No Drop Tube : 2000 Ball Float Striker Plate: 2000 Fill Tube S /O: 2000 TANK LEAK DETECTION Sgl Wall: AUTOMATIC TANK GAUGING Dbl Wall: TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -8- 1 07/22/2004 E E GAS N SAVE SiteID: 015-021-001531 Inventory Item 0003 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY-DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: SINGLE WALL Mfgr : UNKNOWN Mtl : BARE STEEL Corr : CATHODIC PROTECTION Prot : PIPING LEAK DETECTION UnderGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/12/2004 Date: 11/06/2000 Name:MANSOUR S. MANSOUR Prmt Number: 1531 TANK/LINE TEST :04/16/2004 CP CERT. :10/16/2000 MANWAY INSP. :11/03/2009 UST MONIT. CERT:04/12/2004 AboveGround Piping DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. OWNER/OPERATOR SIGNATURE Ttl:OWNER Approved: Yes AGENCY DEFINED PASSED SHUTOFF Expiration Date: 06/30/2006 -9- 07/22/2004 a F GAS N SAVE SiteID: 015- 021 - 001531 9 F✓ Inventory Item 0001 Facility Unit: Fixed Containers at Site 9 COMMON NAME / CHEMICAL NAME DIESEL Days On Site 365 Location within this Facility Unit Map: Grid: SE CORNER OF LOT, UNDERGROUND CAS# STATE TYPE PRESSURE TEMPERATURE -- CONTAINER TYPE Mixture UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS %Wt. 100.00 Fuel Oil No. 1 HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive /Amount EPA Haza No No No No/ Curies F IH Daily Average 10000.00 GAL RSI CAS# No 70892103 rds NFPA USDOT# MCP DH / / / Low MISC. LOCAL AGENCY DATA Ag . Def inedl • Ag . Def ined2 : Ag . Def ined3 : Ag.Defined5: Ag.Defined6: Ag.DefinedB: Ag.Defined9: — Ag . Def inel l Ag . Def ined4 : Ag.Defined7: Ag.Define10: -10- 07/22/2004 MISC. LOCAL AGENCY DATA Ag . Def inedl • Ag . Def ined2 : Ag . Def ined3 : Ag.Defined5: Ag.Defined6: Ag.DefinedB: Ag.Defined9: — Ag . Def inel l Ag . Def ined4 : Ag.Defined7: Ag.Define10: -10- 07/22/2004 0 F GAS N SAVE SiteID: 015- 021 - 001531 � Inventory Item 0001 Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY - DEFINED) Page 1 of 2 Last Action Type: Location In Site: SE CORNER OF LOT, UNDERGROUND Tank ID # :. installed: Additional TANK DESCRIPTION 1 Mfr: UNKNOWN 06/1985 Capacity: 10000 Gals Info: TANKS LINED IN 11 -1999 TANK LINERS INC. TANK CONTENTS Tank Use: MOTOR VEHICLE FUEL Petrol Type: LEADED Matl Name:DIESEL Cas #: TANK CONSTRUCTION Type SINGLE WALL W /INT LINER & C.P. Material (p) : BARE STEEL Material(s): BARE STEEL Lining : EPDXY LINING Corr Prot: CATHODIC PROTECTION Spill Cnt : 2000 Alarm Drop Tube : 2000 Ball Float Striker Plate: 2000 Fill Tube S /O: TANK LEAK DETECTION Sgt Wall: AUTOMATIC TANK GAUGING Dbl Wall: Compart Tank: N No. Of Comparts: Installed: Installed:. Exempt: 2000 No TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE Last Used: Qty Remaining: Was Filled: No -11- 07/22/2004 F GkS N SAVE SiteID: 015 -021- 001531 9 Inventory Item 0001 - Facility Unit: Fixed Containers at Site STORAGE CONTAINER DATA (UST FORM B and AGENCY- DEFINED) Page 2 of 2 PIPING CONSTRUCTION UnderGround Piping AboveGround Piping Type : PRESSURE Const: SINGLE WALL Mf gr : UNKNOWN Mtl : BARE STEEL Corr : CATHODIC.PROTECTION Prot : PIPING LEAK DETECTION UnderGround Piping AUTOMATIC LEAK DETECTORS Installed: 04/12/2004 Date: 11/06/2000 Name:MANSOUR S. MANSOUR Prmt Number: 1531 TANK /LINE TEST :04/16/2004 CP CERT. MANWAY INSP. :11/03/2009 UST MONIT. CERT:04 /12/2004 AboveGround Piping DISPENSER CONTAINMENT Type: DISP. PAN SENSOR W/ POS. OWNER /OPERATOR SIGNATURE Ttl:OWNER Approved: Yes AGENCY DEFINED PASSED SHUTOFF Expiration.Date: 06/30/2006 -12- 07/2.2/2004 ,, GAS N. SAVE SitelD: 015- 021 -- 001531 Manager ./ � r" BusPhone: (661) 324 -6016 Location: 830 UNION AVE Map : 103 CommHaz.: UnRated City BAKERSFIELD Grid: 32A FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 08 SIC Code:5541 EPA Numb: DunnBrad: Emergency Contact / Title Emergenc nta t u Title �Ikl HIV � ff MANSOUR s Business SOUR. OWNER MAN / Phone: (818) 366 -0914x Business Phone: 661)U4 -6o \dx U 932 -6237X • 24 -Hour Phone (661) 832 -6237x 24 -Hour Phone Pager Phone ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Hazards Frm Phone: (661) 324 -6016x Contact MailAddr: 830 UNION AVE State: CA City : BAKERSFIELD Zip 93307 Owner MANSOUR S MANSOUR Phone: (818) 366 -0914x Address : 830 UNION AVE State: Zip CA 93307 City : BAKERSFIELD L 8000.00 Period to TotalASTs: - Gal Gal TotalUSTs: Preparer: RSs: No Certif'd: Emergency Directives: n, d TT n i f i La A T. i q t" f Hazmat Inventory All - Materials at Site As Designated Order Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP F IH DH L 6000.00 GAL Mod MIDGRADE GASOLINE F IH DH L 6000.00 GAL Mod PREMIUM UNLEADED F IH DH L 8000.00 GAL Mod UNLEADED REGULAR 1,P104 � ° . S • , Do hereby certify that I have (Type or print nam reviewed the attached hazardous materials manage- ment plan for 36�,,1'kivand that it along with (Name W siness) any corrections constitute a complete and correct man' agement plan for my facility. -1- i mature 10/03./200 F GAS N SAVE SitelD: 015 -021- 001531 1 Inventory Item 0001 Facility Unit: Fixed Containers at Site 'l COMMON NAME / CHEMICAL NAME MIDGRADE GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SE CORNER OF LOT, UNDERGROUND CAS# 8006619 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid 7Pure �I Ambient Ambient UNDER GROUND TANK Largest Container 10000.00 GAL PkWt. 100.00 Gasoline AMOUNTS AT THIS LOCATION Daily Maximum 6000.00 GAL HAZARDOUS COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive /Amount EPA Hazai No INO No No/ Curies I F IH Daily Average 4000.00 GAL RS CAS# No 8006619 ds NFPA USDOT# MCP DH / / / Mod Inventory Item 0002 Facility Unit: Fixed Containers at Site COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED Days On Site 365 Location within this Facility Unit Map: Grid: # SE CRNR OF LOT UNDERGROUND 8006619 STATE TYPE PRESSURE TEMPERATURE — CONTAINER TYPE Liquid 7Pure Ambient Ambient UNDER GROUND TANK Largest Container 10000.00 GAL 1Wt. 100.00 Gasoline AMOUNTS AT THIS LOCATION Daily Maximum 6000.00 GAL HAZARDOUS COMPONENTS HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive /Amount EPA Hazaz No lNo No No/ Curies F IH Daily Average 4000.00 GAL RS CAS# No 8006619 ds NFPA USDOT# MCP DH / / / Mod -2- 10/03/2000 i. F GAS N SAVE SiteID: 015- 021 - 001531 9 f Inventory Item 0003 Facility Unit: Fixed Containers at Site 9 COMMON NAME / CHEMICAL NAME UNLEADED REGULAR Days On Site 65 Location within this Facility Unit Map: Grid: SE CRNR OF LOT UNDERGROUND CAS8 8006619 STATE TYPE - PRESSURE TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum 10000.00 GAL 8000.00 GAL HAZARDOUS COMPONENTS Wt. 100.00 Gasoline HAZARD ASSESSMENTS TSecret RS BioHaz Radioactive /Amount. EPA Hazaz No lNo No I No/ Curies F IH Daily Average 6000.00 GAL RS CAS# No 8006619 ds NFPA USDOT# MCP DH / / / Mod -3- 10/03/200( F GAS N SAVE SiteID: 015-021-001531 Fast Format Overall Site Notif./Evacuation/Medical Ov01/16/1998 F== Agency Notification CALL 971-1 CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES BAKERSFIELD FIRE DEPT Employee Notif./Evacuation 01/16/1998 = PROPRIETOR ONLY. = Public Notif./Evacuation 01/16/1998 NEAREST EXIT, OUT TO STREET. Emergency Medical Plan 01/16/1998 911 OR BAKERSFIELD MEMORIAL HOSPITAL. -4- 10/03/200( F GAS N SAVE SiteID; 015- 021- 001531 Fast Format 9 Mitigation /Prevent /Abatemt Overall Site Release Prevention 01/16/1998 EMERGENCY PUMP SHUT -OFF. KITTY LITER USED AS AN ABSORBANT. Release Containment 01/16/1998 USE KITTY LITER IF SMALL RELEASE, OTHERWISE CALL BAKERSFIELD FIRE OES. Clean Up 01/16/1998 KITTY LITER AS ABSORBANT, THEN PROPERLY DISPOSE OF IN SEALED CONTAINER, AND HAULED OFF BY LISCENSED WASTE HAULER. Other Resource Activation -5- 10/03/200 t • GAS N SAVE SitelD: 015 -021- 001531 Fast Format Site Emergency Factors Overall Site = Special Hazards Utility Shut -Offs 01/15/1998 A) GAS /PROPANE - NONE B) ELECTRICAL - MAIN BREAKER IN BACK OF STORE C) WATER - BACK OF STORE D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec. /Avail. Water 01/16/1998 PRIVATE FIRE PROTECTION - 1 FIRE EXTINGUISHER. NEAREST FIRE HYDRANT - LOCATED AT 9TH AND UNION. Building Occupancy Level -6- 10/03/200( ...................................... ............................... i GAS N SAVE eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee SiteID: 015-021-001531 ieeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee Fast Format ie Training eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee eeeeeeee Overall Site i fee Employee Training eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee 01/16/19 0 ° WE HAVE 1 EMPLOYEE AT THIS FACILITY. ° ° 0 0 ° WE DO HAVE MSDS SHEETS ON FILE. 0 • BRIEF SUMMARY OF TRAINING PROGRAM: OPERATOR IS WELL VERSED IN UNDERSTANDING ° • MSDS'S AND SHUF -OFF OPERATION OF FACILITY. 0 ° �eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee ....................... ............................... ieee Page 2 eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee °eeeeeeeeeeeeeeeeeeeeeee� 0 0 0 �. eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee ieeee Held for Future Use eeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee� 0 ° ° 0 .......................................................................................................... ............................... aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee ieeeee Held for Future Use eeeeeeeeeeeeeeeeeeeeeeeeeeeeeoeeeeeeeeeeeeeeeeeeeeee� 0 ° 0 .................................................... ............................... aeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES ,1-4 UNIFIED PROGRAM INSPECTION CHECKLIST ;gti,,�' 1715 Chester Ave., 3" Floor, Bakersfield, CA 93301 FACILITY NAME 6AS t-J �:AJC INSPECTION DATE 4 -7 /Wkt3 Sec tion 2: Underground Storage Tanks Program T b Rj C1FtV FUEL Ra CAI_t&mriaN 4 S TC -M i ST`rrfG 0/4t-Y/ n/a ( Foal 'SAL6s ❑ Routine ❑ Combined ❑ Joint Agency ❑ Multi- Agency ❑ Complaint 4Re- inspection Type of Tank L f -- 03 Number of Tanks Type of Monitoring A i & Type of Piping SwS ?b-S. 940—iO4--F OPERATION C V COMMENTS Proper tank data on fide fo(C -A'se sj9fi..1T' j -A ^1li= f >leo�tS Proper owner /operator data on file {PLC -� 15kjorn IT- -t'A WK 1 -ofzms Permit fees current Certification of Financial Responsibility _5L)&M rj'_ F'iN • ;ZCSP, Monitoring record adequate and current f)PtC-ASE C, C cGp..n,TC Mt6R JZ re.-JAL Scv,c-cN�ro v Maintenance records adequate and current 1�J2 „�G, 1,��sP .�6i / ✓ LC�•5� k�EP C��- P� � dti1 �T �Cc� Failure to correct prior UST violations ,,�PC.� � S Gv2c= 1.�- rvfJ�'JG� 1/�L.Y� Has there been an unauthorized release? Yes 0No r?AlE '�t,C -use CALL - ee-tclZ ID UGt 14 2605 �z �'rnr�� rnrsP�c�tc�� � - PC -aM��” T� df�ac�, Section 3: Aboveground Storage Tanks Program TANK SI AGGREGATE CAPACITY Number of Tanks 1 7 { J V W1 ,/ i OPERATION Y NJ COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding /labeling Is tank used to dispense MVF? If yes, Does tank have overfill /overspill protection? C= Compliance V= Violation Y =Yes N =NO Inspector: r AJ C---S Office of Environmental Services (805) 326 -3979 White - Env. Svcs. Pink - Business Copy r Business Site Responsible Party v, 4 Gcy� J �sz L J(nkUS A,A,,,./, D Fly CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES Y 1715 Chester Ave., Bakersfield, CA (805) 326 -3979 CAg- INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. ?, 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA �---(� BUSINESS NAME: Cr LOCATION: 5 30 0 kc w MAILING ADDRESS: M- ilk to V%- 66 12-q-60 6 CITY: Gakc -tot e(Z STATE: C` R-- ZIP: 43) 9 7 PHONE. DUN & BR.ADSTREET NUMBER: SIC CODE: PRIMARY ACTIVITY: d0v'O(M -c- 2�0-1r... - OWNER: ° MAILING ADDRESS: 3 0 t1 �1 co n -c�c.r SECTION 2: EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR. PHONE M4 L / 01V . 91 I. 2. I • HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING NUMBER OF EMPLOYEES: ! MATERIAL SAFETY DATA SHEETS ON FILE: .1 4 5 BRIEF'SUNEVIARY OF TRAINING PROGRAM: Ep ra -�- @r t5 wetl Vev[scc( ,'n ,,jvjkrs�- af�cl�n� fny0* s i- -Ad+ ©Ff pet r 4mix a f- 46C,6�- SECTION 4• EXEMPTION REQUEST I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS- WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIME EXCEED THE MRgIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION �5 aup I CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THA IN CURATE INFORMATION CONSTITUTES PERJURY. i p �, c.. _ SIGNATURE TITLE N b jwv HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES A. AGENCY NOTIFICATION PROCEDURES: t, q ti rm4te(,e( c(- Ll i+roh PAcL\ Sr(J(' 3. 9VQ(, �icc, ocol B. EMPLOYEE NOTIFICATION AND EVACUATION: Qtoper Awr o vO C. PUBLIC EVACUATION: Tica�'c5f e�tf, av - 1-0 S�ccef- D. EMERGENCY MEDICAL PLAN: t a 11 V �4• 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION PREVENTION AND ABATEMENT PLAN A.' RELEASE PREVENTION STEPS: 5:Wcr fctic y 00tu p -S� J © f , f V,t-�Y Ii tcr J ,9ri ci s atx a4soc �actf- B. RELEASE CONTAINMENT AND /OR MINIMIZATION: 0,5L ELfty r�- SttAa!( V'c (ea st, ID 4crCULCJC- Oat( 'oka. C. CLEAN -UP PROCEDURES: hr a 5 ac eor 6awf +kcK properly Cts eycq see( a*f Lh �CGL �ct� l�DC 4 0'lC r , 6, v\� {t"le( ©C-�- /h y AK&A !eel WO-4k- , Liu cJfcr SECTION 8 UTILITY SHUT OFFS (LOCATION OF HUT -OFFS AT YOUR. FACILITY'S ELECTRICAL: c' WATER: bacle iv-(- S SPECIAL: LOCK BOX: YE /I O ) IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY A. PRIVATE FIRE PROTECTION: —Ht' B. WATER AVAILABILITY (FIRE HYDRANT): y C S r i t CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES _ s 1715 Chester Ave., Bakersfield, CA (805) 326 -3979 HAZARDOUS MATERIALS IIWENTORY FACILITY DESCRIPTION CHECK IF BUSINESS IS A FARM [ BUSINESS NAME (;,6 S , L - S' Q,\ N � FACILITY NAME SITE ADDRESS <' l'a Q n ' ,wa l A- CITY STATE _ CIA ZIP of 03 NATURE OF BUSINESS _Co ttl SIC CODE DUN & BRADSTREET NUMBER -3 6o 16 OWNER/OPERATOR PHONE 04 z,,. - 4c f MAILING ADDRESS w CITY y6d STATE ZIP !�l i EMERGENCY CONTACTS NAME TITLE &Jlx=-� ! eS t BUSINESS PHONIkjl-����� 24 HOUR PHONI��- NAME TITLE , „ tafi`� r- BUSINESS PHON 24 HOUR PHONES,�e, Z- 3-a- 7 OZARDOUS MATERIALS INVEN Y Page of � Business Name C`p N- S A VC= Address Un t2 wQL us—, CHENUCAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ tsi [ j Deletion [ ] Check if chemical is a JyTrade Secret EL/] Trade Secret [ j 2) Common Name: U n 1Ca&Z M E V 3) DOT # (optional) Chemical Name: AHM [ J CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ v f Reactive [ ✓J Sudden Release of Pressure [ ] Immediate Health (Acute) M Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3 -digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ Vj' Gas [ J Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount 10 i mD D Lbs [ ] ] ft3 [ ] a) Container. Average Daily Amount arias [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container , J.os aim O # Days on Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM [ ] the three most hazardous I ) any AHM components 3) y t 0-c—, chemical components or 2) TA 10)LOCATION any AHM components 3) y g (e"- I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. I 10)LOCATION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: = 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical 8c Health PHYSICAL " " HEALTH Hazard Categories Fire [ ✓j Reactive [ %,rSudden Release of Pressure [ J Immediate Health (Acute) ( 44Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3 -digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ "f Gas [ ] Pure [ ] Mime [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount . f_D_ 1 06 Lbs [ J Gal ( ?(J ft3 [ J a) Container. Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container u0i019 d # Days on Site _ Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM the three most hazardous 1) �i��.��hc _ [ J chemical components or 2) r;a,� _ any AHM components 3) y t 0-c—, 10)LOCATION I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. I believe the submitted information is true, accurate and complete. M��ed PRINT amNam a & Title of Authorized Company Representative Signature Date Signature HRDOUS MATERIALS INVENTO Page 7- of Z Business Name S -A-dc--- Address 930 O n f c r- CHEMICAL DESCRIPTION 1) INVENTORY STA S:_New ] Addition ( i�Revision [ ] Deletion [ J Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] �; l � 3) DOT # (optional) 2) Common Name: t— 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ t rkeactive [ Lj,'gudden Release of Pressure [ ] Immediate Health (Acute) [y] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3 -digit code from DHS Form 8022) USE CODE 6) PHYSICAL STATE Solid [ ] Liquid [ Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount to# Ca 0 Lbs [ ] Gal [ ] ft3 [ ] a) Container: Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container 10t.0 a o # Days on Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM [ ] the three most hazardous I)- GeK a kL [ J chemical components or 2) -1-do It a L. [ ] any AHM components 3) Y%i jax - 10 )LOCATION 1)1NVENTORY STATUS: New[ ] Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret[ ] Trade Secret [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3- digit code from DHS Form 8022) - USE CODE 6) PHYSICAL STATE Solid[ ] Liquid[ ] Gas[ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ] 7) AMOUNT AND TRv1E AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal [ ] ft3 [ ] a) Container. Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container # Days on Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AIM [ J the three most hazardous 1) [ ] chemical components or 2) [ ] any AHM components 3) 10)LOCATION I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. I believe the submitted information is true, accurate and complete. a J L A� iZ 1 PRINT ame & Title of Authorized Company Representative Signa a Date Business Name OZARDOUS MATERIALS INVEN Y Page of Address CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ J Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON Trade Secret [ ] Trade Secret [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ J CAS # 4) Physical & Health PHYSICAL HEALTH Hazard Categories Fire [ J Reactive [ ] Sudden Release of Pressure [ J Immediate Health (Acute) [ j Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION (3 -digit code from DHS Form 8022) USE CODE b) PHYSICAL STATE Solid { ] Liquid [ ] Gas [ ] Pure [ j Mixture [ ] Waste [ J Radioactive [ J 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal [ ] ft3 [ ] a) Container. Average Daily Amount Curies [ ] b) Pressure: Annual Amount c) Temperature Largest Size Container # Days on Site _____� Circle Which Months: All Year, J, F, M, A, M, J, J. A, S, O, N, D 9) MIXTURE: List COMPONENT CAS# % WT AHM [ J the three most hazardous 1) [ ] chemical components or 2) [ ] any AHM components 3) 9) MDCI`URE: List 10)LOCATION 1) DWENTORY STATUS: New [ ] Addition [ ] Revision [ ] Deletion [ j Check if chemical is a NON Trade Secret [ J Trade Secret [ ] 2) Common Name: 3) DOT # (optional) Chemical Name: AHM [ ] CAS # - 4) Physical & Health Hazard Categories Fire [ ] Reactive [ PHYSICAL HEALTH J Sudden Release of Pressure [ J Immediate Health (Acute) [ J Delayed Health (Chronic) [ J 5) WASTE CLASSIFICATION __._____ (3 -digit code from DHS Form 8022) USE CODE _ 6) PHYSICAL STATE Solid [ ] Liquid { ] Gas [ ] Pure { j Mixture [ ] Waste { J Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount Lbs [ ] Gal [ ] ft3 [ ] a) Container. Average Daily Amount _ Curies { J b) Pressure: Annual Amount c) Temperature -- Largest Size Container # Days on Site Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D 9) MDCI`URE: List COMPONENT CAS# % WT AHM [ ] the three most hazardous 1) [ ] chemical components .or 2) [ ] any ARM components 3) 10)LOCATION I certify under penalty of law, that I have personally examined and am familiar with the information on this and all attached documents. I believe the submitted information is true, accurate and complete. PRINT Name & Title of Authorized Company Representative Signature Date CUST RPE 8t NO. `f � . MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE 27 NEW ACCOUNT ADDRESS CHANGE CLOSE ACCT FINANCE CHARGE OTHER ADJ CUSTOMER NAME oAq5ou C MAILING ADDRESS l t 3 aS �c� C, K) c) CODE �(Q TY STATE ZIP c SITE ADDRESS PARCEL NUMBER OFAPPUCABLE-) ADJUSTMENT CHG DATE CHARGE CODE ADJUSTMENT AMOUNT r APPROVED BY STATEMENT OF ACCOUNT CITY OF BAKERSFIELD 1501 TRUXTUN AVE BAKERSFIELD� CA ?3301-0000 (805) 326-3979 TO: GAS N SAVE MANSOUR/NAGAT 11181 ORION AVE MISSION HILLS, CA 91345 DATE: 4/01/97 CUSTOMER NO: 3940 CUSTOMER TYPE: ES/ 3940 -------------------------------------------------------------------------- — - A OVA OUNT CRARlgr— DATE DESCRIF I I Uff REF—NmvffE —iyuE, D-A7E ------ -------- ------------------------- ----------- -------- ------------ — 3/01,"97 BEGINNING BALANCE 687.36 FOR QUESTIONS OR CHANGES TO YOUR ACCOUNT PLEASE CALL THE NUMBER AT THE TOP OF THIS STATEMENT. -------------- -------------- -------------- CURRENT OVER 30 OVER 60 -------------- -------------- -------------- DUE DATE: 5/01/97 -------------- OVER 90 -------------- 687.36 PAYMENT DUE: 687.36 TOTAL DUE: $687.36 = . .......... ~= ... ........ .......... .... ....... ........ W-1 ...... --------------- PLEASE DETACH AND SEND THIS COPY WITH REMITTANCE DATE: 4/01/97 DUE DATE: 5/01/97 iro REMIT AND MAKE CHECK PAYABLE TO: CITY OF BAKERSFIELD P. D. BOX 2057 BAKERSFIELD CA 93303-2057 CUSTOMER NO: 3940 CUSTOMER TYPE: ES/ 3940 TOTAL DUE.- $687.36 interoffice M E M O RAN D U M to: ESTHER DURAN - ENVIRONMENTAL SERVICES from: DREW SHARPLES - FINANCIAL INVESTIGATOR subject: ENVIRONMENTAL SERVICES ACCOUNTS date: September 25, 1996 ♦ 3940 -ES 830 UNION AVE GAS N SAVE CppY Business license information shows a new business at this location as of 6 -1 -96. Please have an inspection done and close this account if needed. 5/ 0&7 1 On; To1 CIT)' BAKERSFIELD Business Master Inquiry siness control 30574 Location ID . . . one and Address Mailing Address IVARES' AUTO SERVICES 830 UNION AVE O UNION AVE BAKERSFIELD KERSFIELD CA 93307 to opened . . . : 6/01/96 deral tax ID . : 609148156 siness phone . : 805 861-1260 atus . . . . . : A ner Information OLIVARES, JOSE 9/20/96 11:04:59 7914 CA 93307 Contractor flag . . : Type of ownership . : I Emergency phone . . : Status date . . : 5/21/96 Phone Social security . . : Drivers license . . . Date of birth . . . : ess Enter to continue. =Exit F5= Display officers F7 =Misc information F9= Display licenses 2= Cancel |--------~-------�------------------------------------------------------------' ' h�� -K no ll Li �/� C 0��d� �nd/�1�eI�~� � \ 12/02/94 Ri'g -�m- no��N�u � y omm /��� � GAS N SAVE 11 � Overall Site. with 1 ' 8eneral Information |{----------- .... .... --- .... .... .... --------------------------------------------------�------ 1 830 UNI0N �V M�p' 10� H��mrd� Unreted | �| Location . || C1�� � 8�NERSFIELD �rid/ 3�� � 1 A0V/ 0.0 .' _ -------�--------------| �\----------_-----------_----_---------_-_~-----_----- - |'--- 0ontamt Name ------- T1tl� ------\|--- .,o act Name ------- Title ------ M0NG0UR 8 M0NG0U� / 0NN�R / | ' 8u�1neoa Phone: �H05) 395-084gx( }| 8ue1ness Phone/ { � - x | x �4-Mmur Phone 3G 5- 0217 � 24 H our Ph one | Pager Phone ` � | |Pager Phone - -----------------------------| ||-------------------------------~-----|.------ - ' ' Administrative D�t� --------~----------------- ||--------------------------- -- Mall �ddrs� 830 UNION AV D&8 Number; \ C1t y/ 8AKER-SFIELD State: CA Zip: 93307- -mmm :ode: 01S-908 �0UNTY/BFD-ST� 8 RESPONSE SI� Code ' 5541 ( .. - -------------------------------- \| ------------------------------------- ---- Owner; M0N80UR S M0N80UR Phone: {010) �85-0�17 \ Address., 111M1 0RI0N AV S t�te/ 0A C���� MIS��I0N HILLS Zip: 91345- | .. --------------__--_-------_------------- }>------------------------------------ '' _______-----__-----------------------| \� summary ------------------------------ . MINI MA�T #ITM �A� PUMP� L00ATED 0N THE SE CRN� 0F UNI0N AV AND NINTH ST | /| �0LIN� PUMP IGLANDS ARE 0N W SID� 0F ST0RF 0KIFNTATED PARALLEL T0 UNION |8A | \\AV. ' �} /}------------------------------------ |----------------------------------------------------------------------------- = � 12���/A4 R��ht-�o-Mno''ll List/b�/ 0mmm0ode and/ ��1t�ID pa e 2 ' ~m=" \----------------------------------------------------------------------------- ^ 8AS N GAVE 015-010-000047 02 - Fixed 0mnta1nere on Sitm Hazmat Inventory Detail in Reference Number 0rder ------------------_---_--_------------------_--------_-_--~---------_------_-- 02-001 8AS0LINE 1.. 1qu1d 8000 Moderatv » FIre' Immed Hlth 8AL CAS #/ 8006618 Trade Secret: No Form: L1quid Type: Pure Days, 365 Us e PUEL ---- Da1ly Max (*.')Al-. ---- ) - - Dally Average G'AL --|-- Annual Amount (.3A I... ' 6,000.00 1 4'000.00 | u0,000.00 ------ Storage -------/ Press, | Temp -|------------ Location --------' UNDE� GA0UND TANK |Amb1ent(Amb1ent|UNDEQ�R0UND SE 0RNR 0P L0T ' () t | MOP /(�u1' - 0mno -/---------------------- mmp�nen e -------------.- --. i (Mo��re�e 2' 100,0% \(�asol1n� . . ---_--_-------------------_---_------_---------------------------------~----_-. 02-002 UNLEADED GASOLINE Liqu1d 8000 Modenatv > F-ire, Immed With, Delay Hlth 8AL --�-_-----__-----_--------_---~---------------_----------------------' CAS #' 000G6 18 Trade Secret No Licluid Type' Pure Da 365 Use, FUEL — ---- . 8AL Dm1l� M,-.ix 8AL Daily Average . Annual Ammunt GAL.. 8'000.00 1 6'000.00 1 300'000.00 ------ Stormge rems } Temp -|------------ LOoat1mn -------- UNDEN 8N0UND TANK 'Ambient Amb1ent|UNDERGR0UND SE 0RNRI 0F L0T - Cono -�---------------------- 0mmpon�n�e -------------|- MOP -- 8u1' ` |���er�t�| 2^ -100,0010, \8asol1ne . . \ ------------ - - - - ------------------------------------------------------------- 12/02/84 Right-to-Kno 41 11 List/by 0ommCmde and/ elD Page 3 �--------------------_--------------------------_-�-------_------_~---------. , 8AS W SAVE 015 -010-000047 02 - P1xed Conte1nors on Site Mazmat Inventory Detail in Reference Number order ---------_-------------_-----_--------------------------_---------_-----------. L1 1d �00� Moderate ��-003 PREMIUM 8A��0LINE qu > Fire' Immed 1-11th, 0elay Mlth (3AL --__-------_----_-_----------_--------_-_--_----------___--------_^_-' 0AS # 8006610 Trade Secpet o Porm` LIqu1d Type' Pure Dmys' 36 5 Uee� FUEL ---- Dm1ly Max (.-,Al... ----/-- Da1l\/ Average 8AL --{-- Annuel Amount 8AL ' 8,000.00 1 4,000.00 1 50,000.00 ------ Storage -------> Press / T9mp -i------------ Location ------~-' UNDEN QR0UND TANK |Ambient ( Ambient |UNDER8R0UND SE C:RNR 0P LOT - CIon� -}---------------------- Cmmponent� -------------|- M0� --lWu1� ' �Mo��ra�e� 2'1 -10'0,0% \8aeol1nm . . \-------------------------------------r--------------------------------------- ./ 12/02/04 Right -to- ll List/by C..mmm0ode 1teID Page 4 / ` 8W: N SAVE 015-010-000047 00 - Overall SIte «D» Not1f./Evmouat1on/Med1cml 0» Agency Not If1 cat 1on ----------------------- . CALL 011 � «2» Employee Not1f./1'--vecuation ------------------------------ N0TIPI0ATI0N W0ULD 8E �Y �0RD 0P M�UTH <3> Public Nmt1f./Evacumt1on ---------------------------- <4» EmergencY Medical Plan -------------------------- MEAC'f TRAUMA �E,NTE R 2215 TRU)(TUN AV BAKEHR8FIELO, 0A (80.5) 327-3871 I ^`. 12/02/84 Right-to-Knou&/ll Llst/by 0mmmCode mnd/j&SiteID Page 5 �u�_ -��' ~ ------------------' >~-----------------~---- ---------------------~-- ---- - � 0�� � N SAVE 015-010-000047 00 - 0verall Site «E» Prev./Minimization/Cleanup -----------__----------~--_------_~-_-------_-----------_----__--_------------' «1� Release Prevention ---------------------- DAILY IN�}PE0TI0N «2> Relea-Se 0Ont;0nment ----------------------- A8S0R8ANT & METAL 1.-ZEC:EPTI CI- LE 0» e a n Up ---------~-~ AS DIR�0TED 8Y A UTH0RIZ8Q A8EN�Y <4» Other Resource. Activation ----------------------------- N/A \-----------------------------------------------------------------------------' ` ^\( -_'12/02/94 -�-/-�-�-� ~�-4 --R-1 -_h ~�--�--m -- -K -n -l-1 --L_l --t-/-by - ~_(.,.om-mC-od-e and/* S-1_t-e-I-D ------_-_--P-a-g-e 6 - - � WAS N SAVE 015-010-00004Y 00 - Overall Site. «p> Site 'L:**mergency Factors ---------------_--_----_--_--------------_-_---_---_-------------------_------- «1» Special Hazardm --__--_-----_--_--- / N/A Utility Shut-0ffq --------------------- A) 0AS/PR0PANE - NONE 8) ELE0TRI0AL - SE 0RNR 0P MINI MARKET 0} W ATER - ALLEY E 0F TAT' APPROXIMATELY 50 FT PR0M NINTH ST D) �P0IAL - 8AS0LINE GHUT0�P OEHIND STORE 00UNT�R NEXT T0 PM0NE E) LO0K 80# - N0 0» F1re Protec./Ava1l. Water ----_----_-_---------_----_-- 1 FIRE GXTINGUI8HER, FIRE HYDRANT AT 81-11 AMD UNION, <4> l--,.mrthquake Vulnerability ----__~_-----__---------_--- N/A .\' --- ___ -- .... ----- I'll ------~---^�-N�--^-l-1 --L-1-�-�- /-b-y - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - ------ - S1 t� Page 7 �omm� �12/02/94 Right.to-Nno �m� _________________----------_--------------- \----------------------------------- � 8AS N SAVE 015-010-000047 00 - overall Site «8� Training ------------_------------_-----------�--_--^--------_-----------------_-------- 0> Training Record Location IN 0FPICE :5T0RE <2» Describe Program ----------------------------- <3> Emer. Agency Coordination ----------------------------- ` . <4> Emer. Aeepmnee Equ1pment ------_--------------_----~- ----------------_-_---------------__--~---_- i-------------------^-------------- �' ( / - R�ght-��-Mn�� ill List/by ------ -and/ S--1t - ID ---------P-mg^e 1�/0���4 - - - - - - - - ----- - ----0 - ---___------- � 8A S N S AVE 015-010-00004? 00 - Overall Site <H> 8c.M00L8 #ITHIN 1/2 MILE ----------~-------------------------- «1» H1Qh Schools ---------------- N0ME «2» Jr. High Schools ---_----_----------- N0NE ` ��� le � h <:3> �lementary Schools N0N� <4> Private & Pre Schools - ------- - - - - - - ----------- NONE h 12/12/91 GAS N SAVE 015 -010 -000 Page Overall Site with 1 General Information 11 Location: 330 UNION AV Map: 103 Hazard: Unrated IlCommunity: "BED" RESPONSE AREA" Grid: 32A 1 AOV: 0.01 1 1 --- - Contact Name ---- 1 -- ----- Title --------W I-- Business Phone --I 24-Hour Phone I j1MONSOUR S MONSOUR 10WNER 1(805) 326 -8231 x 1(818) 365 -10421 x 1C ) 1 11 - -- - - __-__- -- -_ -_ I ------------------- I -------------------- I ---- _-_-- --_r -1 11 - _- Administrative Data ---------------------------- I Ij Mail Addrs: 830 UNION AV D &B Number: 11 City: BAKERSFIELD State: CA Zip: 93307- 1 I j Comm Code: 015-901 " B FD' � w RESPONSE AREA' �------------ S I C� code_-___--_-_--- � 11 Owner: SAN DIEGO ARMOUR OIL Phone: ( ) �- (1 Address: PO BX 85302 State: CA 1 1 1 City: SAN DIEGO �..� -- ---. ---- �__�._ -- Z� --p: - 92138- __---- ---- -_-- -- II Summary --___-_-_-----_ ____-__-_---- ____---- ---- -- ._---- ---- -- MINI MART WITH GAS PUMPS LOCATED ON THE SE CRNR OF UNION AV AND NINTH ST GASOLINE PUMP ISLANDS ARE ON W SIDE OF STORE ORIENTATED PARALLEL TO UNION AV. 4i 12/12/91 OAS N SAVE 015 - 010-000 Page Hazmat entory List in Reference tuber Order 02 - Fixed Containers on Site Pln -Ref Name /Hazards Form Quantity MCP 02001 REGULAR GASOLINE Liquid 5,000 Moderate > Fire, Immed Hlth GAL 02 -002 UNLEADED GASOLINE Liquid 8,000 Moderate > Fire, Immed Hlth, Delay Hlth GAL 02 -003 PREMIUM GASOLINE Liquid 8,000 Moderate > Fire, Immed Hlth, Delay Hlth GAL 12/12/91 GAS N GAVE 015- -- 010 -000 Page 02 W Fixed Containers on Me Hazmat Inventory Detail in Reference Number Order 02 --001 EGULAR GASOLINE Liquid 6000 Moderate > Fire, Immed Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL. r- V ----- Daily Max GAL - w--- Daily Average GAL Annual Amount GAL - 6,000 j 4,000.00 j 300,000.00 ------ Storage - ----- -- ( Press ( Temp -1 ------------ Location --------- UNDER GROUND TANK (AmbientjAmbientjUNDERGROUND SE CRNR OF LOT -- Conc -1 -- - - __---- _-_ ----_. - -- Components -------------- I- MCP w- j Li s 100.0` (Gasoline jModeratej �Q2 -002 UNLEADEDwGASOLINE -- Liquid 8000 Moderate > Fire, Immed Hlth, Delay Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL - ---- Daily Max GAL Daily Average GAL Annual Amount GAL - 8,000 j 6,000.00 j 300,000.00 ------ Storage ------- ( Press ( Temp -1 -------- - -- Location --------- UNDER GROUND TANK jAmbientjAm bient(UNDERGROUND SE CRNR OF LOT �- Conc -1 -- - - ____-------- ---- -- Components -------------- I- MCP -- j Li s 100.0 %,(Gasol -ine jModeratej M02-- 003Y-/PREMIUM-GAGQLINE-W- __ ---------------------- Liquid 6000 Moderate > Fire, Immed Hlth, Delay Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL ---- - Daily Max GAL --- - (--- Daily Average GAL Annual Amount GAL -W 6,000 ( 4,000.00 ( 50,000.00 ---- --- Storage ------- ( Press j Temp -1 -------- --- Location --------- UNDER GROUND TANK (Ambient(Ambient(UNDERGROUND SE CRNR OF LOT -- Conc -1 ----- - _-__-_-------- Components -------------- I- MCP ---- j Li s 100.0% )Gasoline (Moderate( 12/12/91 GAS N SAVE 015 -010 -000 Page 00 - Overall Site <D> Notif. /Evacuation /Medical <1> Agency Notification IN CASE OF AN EMERGENCY DIAL 911 <2> Employee Notif. /Evacuation NOTIFICATION WOULD BE BY WORD OF MOUTH <3> Public Notif /Evacuation <4> Emergecny Medical Plan MERCY TRAUMA CENTER 2215 TRUXTUN AV BAKERSFIELD, CA (805) 3273371 12/12/91 0. GAS N SAVE 015 - 010 -0000 Page 00 - Overall Site <E> Prev. /Minimization /Cleanup <1> Release Prevention UNDERGROUND TANKS MONITORED WEEKLY. HOSES VISUALLY INSPECTED WEEKLY. <2> Release Containment <3> Clean Up <4> Other Resource Activation 12/12/91 GAS N SAVE 015 - 010 -000 Page E 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut -Offs A) GAS /PROPANE - NONE B) ELECTRICAL - SE CRNR OF MINI MARKET C) WATER - ALLEY E OF STATION APPROXIMATELY 50 FT FROM NINTH ST D) SPCIAL - GASOLINE SHUTOFF BEHIND STORE COUNTER NEXT TO PHONE E) LOCK BOX - NO <3> Fire Protec. /Avail. Water ----------------------------- - - 1FIRE�EXTINGUISHER. FIRE HYDRANT AT 9TH AND UNION. <4> Held for Future use 12/12/91 GAS N SAVE 015010 -0000 Page 00 - Overall Site 0 <G> Training <1> Page 1 <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 12/12/91 GAS N SAVE 015 - -010 -0000 0 Page 00 Overall Site <M> Events Ledger "M" 10/19/88 ANNUAL /OK mu 12/12/91 GAS N SAVE 015.010 -0000 Page 00 - Overall Site qw <M> Inspections List 10/19/88 ANNUAL /OK CHANGE OF OWNERSHIP AND EMERGENCY CONTACT. FIRE DEPARTMENT M. R. KELLY FIRE CHIEF Gas -N -Save 830 Union Avenue Bakersfield, CA 93307 Dear Business Owner: CITY o BAKERSFIELD r7, "WE CARE" January 11, 1995 1715 CHESTER AVENUE BAKERSFIELD, 93301 326 -3911 Because of the annexation of the location of your business on November 10, 1994, the Hazardous Materials Business Plan and Inventory reporting requirements of both Federal and State "Community Right to Know" regulations, as well as the underground storage tank regulations, will now be administered by the Bakersfield Fire Department Hazardous Materials Division. We have made arrangements to transfer the plans that you have previously filed with Kern County, to our office. Therefore, we will not need a new business plan and inventory from you at this time. California law does require all inventories to be updated annually and your business plans to be amended within 30 days of any one of the following events. 1) A 1 o0% or more increase in the quantity of a previously disclosed hazardous material subject to the inventory requirements. 2) Any handling of a previously undisclosed hazardous material subject to the inventory requirements. 3) Change of business address. 4) Change of business ownership. 5) Change of business name. You should also report any significant changes to your business plan such as contact information, telephone numbers etc., as well as your annual tank maintenance and monitoring reports to this office. We will be issuing you a new Underground Storage Tank Operating Permit as soon as we verify fees and compliance with existing regulations. For any of these changes or any questions regarding the handling or storage of hazardous materials on your site please contact us at 1715 Chester Ave., Bakersfield, CA 93301, or call 326 -3979. Sincerely yours, Ralph E. Huey Hazardous Materials Coordinator 11 �• p `I/0 ��ti Fj�� �� CITY OF BAKERSFIELD FIRE DEPARTMENT 511 OFFICE OF ENVIRONMENTAL SERVICES 4►! UNIFIED PROGRAM INSPECTION CHECKLIST '�.. `C gti,, 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME C✓ INSPECTION DATE �? ? Q � tcEC Etr/t �"v Vic. FoC�2, eAC.I 8r?I.l't'roN Section 2: Underground Storage Tanks Program O TESTi January 15, 2009 Yadwinder Singh 830 Union Ave Bakersfield, CA 93307 Ronald I Fraze Fire Chief RE: Gas -N -Save cathodic protection failure Gary Hutton Dear Mr. Singh: Tyler Hartley Our records indicate that all eight (8) of the existing anodes of Douglas Greener the cathodic protection device that protects your underground fuel storage tanks are non - functional. This letter is to advise you Deputy Chiefs for the intermediate correction of the violation of Title 23 of the California Code of Regulations, Chapter 16, Section 2635 (a)(2)(A). Please make the necessary arrangements to properly correct this violation by 2/15/2009. Failure to correct the deficiencies will result in the closure of your HOWARD H. WINES, III fuel tanks and civil penalties of not less than five hundred dollars ($500) or more than five thousand dollars ($5000) for each DIRECTOR underground storage tank for each day of violation under Chapter 6.7 of the California Health and Safety Code, Section PREVENTION SERVICES 25299 (a)(2) 1501 Truxtun Ave., 1st Floor Note: Any major repairs to correct deficiencies shall be performed under a Bakersfield, CA 93301 valid permit issued by this office, and witnessed by an inspector from this VOICE: (661) 326 -3979 office. FAX: (661) 852 -2171 If you have questions regarding this correspondence, you may contact me at (661) 326 -3979. Yours truly, Craig Perkins REA Hazardous Materials Specialist UNDERGROUND STORAGE TANK uv x;< ^,n,y,K,�.'i.i -' � Je'4 sS +K�nrJn�a' r,Ssna �ai'..r "+'�x:S'•��'�s'i�l° �xh����'�i'k�7+i �'��'�Fi �.�'i��. 44M�'... r,"P��y � � z M.�U�r'.L�..�•'zT. �7r W t.Te'�.:��.. �:N .t..,..c �CaY�`n.z'�, i,'- AC:�i":�.:., tA'::�i..�a".'v:.,.:rv�u �•�. .ec. C,c��N.�F�'..�dtr a...s {x,?ir . ..�.,,�: , .�.. L=il.. ,y_ PERMIT APPLICATION J r FOR REMOVAL OF AN UNDERGROUND STORAGE TANK :. . ,. • ... :.. SIT Ii�dFORMA`i0N SIT.. v CA 5 �n/p 6 ADDRES �j� Ll"16 A) FACI NAME 1 ('��jS'� �/1rIo v Ici CROS .' TANKOWNE ERAT R y� c7iff PHON f ) � 4 016 APN # MAI NO, ADDRESS CI 's Z ::.. • . 'Y :cOw"CTO CO p.. ....., PHONE = LIC E ADD SS � , Ci ,. /G�✓ ZIP V IN RANCE CARRIER woArmW # D ol :. E�aMINAEt f. S:S SSMENT..:T-NIF.ORiON ..: , COM ANY PHONE AD ES CITY ZIP CODE �^ a C)o ! 2V WOR5W/jf V INSURANCE CARRIER cf TAN . .... COMPANY. -• Ilk NE *N- E ADD l ) CU � J%��irT ZIP O E INSURANCE CARRIER -7. �'lt J WORKt ENS COMP # taee WASTE TRANSPORTER ID FACILITY ID NAME OF RINSATE DISPOSAL FACILITY ADDRESS ®•g CITY ZIP CODE . t� J ff �N $� COMPANY a p -;-y+� ,C�� 'VJ (V t� PHONE # / ..r LICENSE # ADDRESS � � o CITY � ZIP CQD ,[ TANK DESTINATIOOJN�� 1 d. �` � .•.. ...:. . , T,pNK�:It�frO;RI�I�"�:';h�i • .: • . -.:... ', .. '; .. TANK # AGE VOLUME CHEMICAL STORED DATES STORED CHEMICAL PREVIOUSLY STORED l L�` �o Da R :. �` � Q,� ff .tom P �� FOR OFFICIAL USE ONLY APPLICATION DATE OF FACILITY TANKS E $ THE APPLICANT HAS RECEIVED, UNDERSTANDS, AND WILL COMPLY WITH THE ATTACHED CONDITIONS IONS OF THIS PERMIT AND ANY OTHER STATE, THIS FORM HAS BEEN COMPLETED UNDER PENALTY OF PERJURY, AND TO THE BEST OF MY KNOWLEDGE IS LOCAL, AND FEDERAL REGULATIONS. TRUE AND CORRECT. - .- APPROVED [3Y .. APPLICANT NAME (PRINT) APPLICANT SIGNATURE Tt ,�s�.�✓- - Cam~ LY THIS APPLICATION WILL BECOME A. PERMIT WHEN APPROVED FD2088 (Rev 06/07) im 10 Z e