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Home My WebLink AboutBUSINESS PLAN SITE/FACILITYFORM § DIAGRAM' NORTH SCALE: " ' 5 " '~'e.., ~. ~ ~ ~ :~~d~ ' X~~ . x ~- '-.., ':' ....X-' - .-:-~ .- ..... L:_ ........ :.: . '-.."-.~-, ~~, ~,~ , ..:.:...... . . .. · Inspector's Comments') ' ;: ~FFICIAL ~SE ONLY- · - 5A - .: 19'tH STREET MOBIL ~. ,aTH STREET BAKERSFIELU ~ 805-691-1049 NOV 1~, 2001 10:~ AM - iLL FUNCTIONS NORMAL INVENTORY REPORT T i:uNLEaDED vOLUME = BBOB GALS ULLAGE = 2192 GALS 90~ ULLAGE= 1592 GaLS TC VOLUME = 3?66 GALS HEIGHT = 50.2~ INCHES w~TER XYOL = O GALS wATER = 0.00 INCHES TEMP = 75.6 DEG F T 2:SUPER VOLUME = 4108 GALS ULLAGE = 1892 GALS 90~ ULt-aGE= 1292 C"'S TC VOLUME = 4056 ~ HEIGHT 62.13 ES WATER VOL = 0 GALS WATER = 0.00 INCHES TEMP = 77.9 DEG F T 3 :DIESEL VOLUME = 3553 GALS ULI.AGE = 447 GALS 90% ULLAGE= 47 GaLS 3520 C~LS TC VOLUME ..~ 6B. l § INCHES HE I GHT O GALS t~qTER VOL "' TEMP . BO.2 DEC ~ ~ ~ w ~ END ~ ~ ~ ~ ~h,.I ..... ~ ,_ , , , ~ SiteID: 215-000-000282 ~ger : ~ ~Phone: (805) 322-2850 ~on: 101 19TH ST ~ APR ~ 1997 ~ : 103 co--az : Low City : BAKERSFIELD ~ ~ ~d: 30D FacUnits: 1 AOV: Co--Code AKERSFIELD STATION 6~v .............. S_I~'. Code: 5541 EPA Numb: ' -'~ ......~nBrad: Emergency C / Title Emergency Contact / Title JOHN H. AXT / REX A. PHINNEY / FATHER Business Phone: ( 5) '322-2850x Business Phone: (805) 322-2850x 24-Hour Phone : (8 398-1598x 24-Hour Phone : (805) 366-6953x Pager Phone : ( - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Agency-Defined Topic Title ~ Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... EPA Hazards[ Frm DailyMax lUnit[XCP UNLEADED GASOLINE F IH DH L 6301 GAL Mod UNLEADED PLUS GASOLINE IH DH L 6301 GAL Mod SUPER UNLEADED GASOLINE IH DH L 4000 GAL Mod WASTE OIL F DH L 220 GAL Low ANTIFREEZE F DH L 60 GAL Low MOTOR OIL F DH L 574 GAL Min Do hereby certify that I have ~' "' Om, erp~ntna"~ reviewed the attached hazardous materials manage- and that it along With ment plan for ~,..~e~.~e.) - any corrections constitute a complete and correct man- agement plan for my facility, c:::3~.~.~ ~~,~d -' ,4/'0 JOHN AXTS BP SERVICE ~ SiteID: 215-000-000282 = Inventory Item 0001 Facility Unit: Fixed Containers on Site UNLEADED GASOLINE t Days On Site 365 Location within this Facility Unit NE CORNER ON SITE CAS# i 8006-61-9 F STATE --T- TYPE , PRESSURE . TEMPERATURE CONTAINER TYPE Liquid /Pure I Ambient I A~lent UNDER GROUND TANK AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax th~s Loc GAL DailyAvg this Loc GAL 16301.00 2500.00 I DailyMax Stored GAL DailyMax Ope~ Use GAL DailyMax Closed Use GAL I .sl 100.00 Gasoline INo I 8006619 -2- JOHN AXTS BP SERVICE ~ SiteID: 215-000-000282 = Inventory Item 0002 FaCility Unit: Fixed Containers on Site UNLEADED PLUS GASOLINE Days On Site 365 Location within this Facility Unit NE CORNER ON SITE ! CAS# 8006-61-9 Liquid PureI, Ambient Ambient UNDER GROUND TANK AMOUNTS STOREI AND IN USE Lrgst Cont.this Loc GAL DailyMax thJ,s Loc GAL DailyAvg this Loc GAL 6301.00 2500.00 DailyMax Stored GAL DailyMax Ope~ Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTSI I EHSl CAS# 100.00 Gasoline No ; 8006619 -3- JOHN AXTS BP SERVICE ~ SiteID: 215-000-000282 ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site SUPER UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit NE CORNER ON SITE CAS# 8006-61-9 Liquid /Pure Ambient Ambient UNDER GROUND TANK & AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 4000.00 200.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONETTSI %Wt. EHS CAS# 100.00 Gasoline No ~ 8006619 -4- JOHN AXTS BP SERVICE ! SiteID: 215-000-000282 ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site WASTE OIL Days On Site 365 Location within this Facility Unit UNDERGROUND TAND W SIDE CAS# 221 AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 220.00 120.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS j %Wt. JEHSJ CAS# 100.00 Waste Oil, Petroleum Based J No J 0 -5- JOHN AXTS BP SERVICE ,t SiteID: 215-000-000282 ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME ANTIFREEZE Days On Site 365 Location within this Facility Unit ON DISPLAY IN BLDG CAS# 107-21-1 IAmbient I Ambient Pure Liquid BOX AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL 60.00 35.00 DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL HAZARDOUS COMPONENTS %Wt. EHS CAS# 100.00 Ethylene Glycol No 107211 -6- JOHN AXTS BP SERVICE ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site MOTOR OIL Days On Site 365 Location within this Facility Unit METAL STORE ROOM IN BLDG I CAS# /Liquid-STATEPureTYPE I AmbientPRESSURE--~TE'PERATUREAm~ient [BOX CONTAINERTYPE AMOUNTS STORED AND IN USE Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL I 574.00 350.00 DailyMax Stored GAL DailyMax Ope~ Use GAL DailyMax Closed Use GAL ' I HAZARDOUS COMPONENTS %Wt. ' EHSI CAS# 100.00 Motor Oil, Petroleum Based No I 8020835 F JOHN AXTS BP SERVICE ~ SiteID: 215-000-000282 Fast Format = Notif./Evacuation/Medical ~ Overall Site -- Agency Notification ~ 03/06/1990 CALL 911 I -- Employee Notif./Evacuation , 03/06/1990 TURN EMERGENCY PUMP SWITCH OFF. CALL FIRE DEPT. STAND AWAY FROM EMERGENCY IF OUT OF CONTROL. Public Notif./Evacuation I 03/06/1990 WOULD NOT APPLY TO ME. Emergency Medical Plan ~ 03/06/1990 SHOULD MEDICAL EMERGENCY OCCU~ WE WOULD CALL: GOLDEN EMPIRE PARAMEDICS 801 18TH ST 327-9000 OR HALL AMBULANCE 1001 21ST ST 8 F JOHN AXTS BP SERVICE = Mitigation/Prevent/Abatemt -- Release Prevention ~ 03/06/1990 OUR GASOLINE NOZZLE'S HAVE RUBBER BOOTSlTHAT CATCH VAPORS THAT GO IN OUR VAPOR RECOVERY SYSTEM. IF WE DO HAVE A)SPILL OF HAZARDOUS MATERIALS WE USE QUICK ABSORBENT AND DISPOSE OF AT A HAZARDOUS WASTE DISPOSAL SITE. WE ALSO INSPECT NOZZLE HOSE PUMPS DAILY. Release Containment Clean Up Other Resource Activation F JOHN AXTS BP SERVICE ~ SiteID: 215-000-000282 , Fast Format F Site Emergency Factors .~ Overall Site ISpecial Hazards ~ -- Utility Shut-Offs · 03/06/1990 A) GAS - REAR OF BUILDING A NORTHWEST CORNER B) ELECTRICAL - EMERGENCY PUMP SWITCH FBONT OF BUILDING, PANEL REAR ROOM IN BUILDING C) WATER - SOUTH SIDE OF SITE DIAGRAM D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water ~ 03/06/1990 PRIVATE FIRE PROTECTION - WE HAVE 2 FIRE EXTINGUISHERS WITH PURPLE K DRY CHEMICAL I FIRE HYDRANT - SOUTHWEST CORNER OF 19TH ,AND UNION. Building Occupancy Level -10- JOHN AXTS BP SERVICE · SiteID: 215-000-000282 ~ Fast Format = Training ~ Overall Site -- Employee Training · 04/10/1991 WE HAVE 3 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS'ON FILE WE HAVE A SAFETY MEETING APPROXIMATELY EVERY 30 DAYS TO COVER ANY HAZARDS AND THE USE OF MATERIAL SAFETY DATA SHEETS. -- Page 2 ~ I -- Held for Future Use ~ Held for Future Use ,! I -11- .... Bakersfield Fire Dept. RECEIVED Hazardous Materials Division 2130 "G" Street Bakersfield, CA. 93301 HAZARDOUS MATERIALS MANAGE~AN\ INSTRUCTIONS: 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business aS a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA LOCATION: /o / /~'7-~ MAILING ADDRESS: DUN & BRADSTREET NUMBER' ,,'rOT" ,47,~L/'¢., SIC CODE: PRIMARY ACTIVITY: ~'~ ~'o ~,',~'-~,, SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. pHONE 24 HR.'PHONE FD1590 ~, Bakersfield Fire Dept. Hazardous Materials DiVision HAZARDOUS MATERIALS MANAGEMENT PLAN NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEET'S ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: 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 TIMEEXCEED THE .MINIMUM REP.ORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, 'X~A, ,."1;:¢,,~.~'''' CERTIFY THAT THE ABOVE INFOR- · MATION IS ACCURATE. I'UNDERSTAND THAT THIS INFORMATION WlLL 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 THAT · -IN~RMATION CONSIITUTES PERJURY. ~ SIGNATURE TITLE DATE .' FD1590 Bakersfield Fire Dep~' Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: r B. EMPLOYEE NOTIFICATION AND EVACUATION: C, PUBLIC EVACUATION: D. EMERGENCY MEDICAL PLAN: '/f"' ~ ~-~'~,.,..r C~Z~ ~o /.D~,.,/ /%~n,~ff ~ ~ ~ ~// Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: B. RELEASE CONTAINMENT AND/OR MINIMIZATION: C. CLEAN-UP~'ROCEDURES: ~ ~ ~ ~¢¢~%,2T , SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILffY)' NATURAL GAS/PROPANE: ~¢~ i~~ Co'a~ ~ ~. SPECIAL: LOCK BOX: YE~' IFYES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: 3 ~XT'Tk/¢'~ ;,~ ~, 6'~ C/9-.%~ ~0_., WATER AVAILABILITY (FIRE HYDRANT): /¢ 4, FD159o CITY OF' BAKERSFIELD HAZARDOUS HA'I'~RXALS INVEN'IY)RY ~ Farm and Agriculture~Standard Business , Page. / of ~.. NON - TRADE SECRET LOCATION: /p/ /~7'4 ..,.~'.~-~ c4 ADDRESS: . ..~,/./~t" /~'F_.M~9~/'~) ])A~. STANDARD IND. CLASS CODE: CITY, ZIP: ~~,'~./~ ~.!33C~/ CITY, ZIP~/~$~ W~ ~'j~O7 DUN ~D B~ST~ET N~BE~O~'~'I~ ~R ~ IN~U~IONS ~R PROPER ~DES I 2 3 4 5 6 7 8 9 10 11 12 13 · r~s ~e ~x Average ~nual ~asure ~ Days Con~ Cent Cent Use Location ~ere % by N~s of M~ture/C~nents Cods C~e ~t ~t ~t Units on Site ~ Press ~m~ Code Stored in Fac$1it~ ~ See Instructions (Chec~ all ghat apply) of Pressure H~l=h H~l~h Componen~ 9 3 N~ & C.A.S. N~er ~,~.,~.~ ..~ ..~, ....~ ~.~.,..~.~ ~o ob 6/-? ~o~o..n~ ,, .--, ~.~... (Check all that apply) ~ Fire Hazed ~ Sudden ~lease ~' .activit~ ~ Im~iate ~Delay~ .... Co~onent ~ 2 N~ & C.A.a. of Pressure H~lth H~lth Co~onent 9 3 N~ & C.A.B. N~ .... . ., Phyaloal and ~1~h ~aza=d ~.~.8. N~e= ~omponent ~ ~ N~ $ ~.~.8. N~e~ (~he~g a:: ~ha~ apply) of Pressure Healgh H~lgh Componeng ~ 3 N~ & C.A.8. N~ ~ I m liso I 7o I/3~o IG~L. I~~1 ill / I F I;~l~m~ Ro~/~,~,,;~.:~ MoYo~ Physical and H~lth Hazard .~.,~ .. C.A.S. Nu~er ; ~ _ Component ~ 1 N~ & C.A.8. N~er apply)'~ that of Pressure H~h H~l~h Componen~ ~ 3 Na~ & C.A.S. Na~ Title 24 ~.'Phone Title 24 Hr Phone Certification (~ ~D SIGN AFTER COMPLETING ~L SECTIONS) I certify ~der p~nlty of law t~ I hayer ~rsonally ~ln~ and ~ f~lli~ with the ~nfo~t~on su~tted in this ~d all a~tached d~ts ~d ~hat ~sed on ~ ~n~i~ of individuals rem~nsible for ob%aiLing the info~ion. I believe that %he suni%ted ~nfo~t~on ~s t~e, actuate, and c~plete. N~ ~ ~FICI~ TI~ OF ~~R OR ~OP~R'S A~D ~P~S~TI~ ~ SIG~D CITY OF BAKERSF I Er-D · H~Z~DOUS ~RIALS Farm and Agriculture L--] Standard Business ~ Page~ of~' NON - ~E SEC~T BUSINESS N~.. ~~ ~'~ ~ ~ ~/~ O~ER N~ ~~ ~ N~ OF THIS FACILITY: 1 2 3 4 5 6 7 8 9 l0 il 12 13 14 Trans ~e ~x Average ~nual Measure ~ Days Cont Cont Con% Use Location ~ere % by N~s of M~ture/C~nents Cd, portent ~.2 N~ & C.A.S. ~ Fire Hazed ~ Sudden ~lease '~ R~ctivity ~ I.~iate ~ Delay~ of Pressure H~lth H~lth Component 9 3 N~ & C.A.S. N~er of Pressure H~lth H~lth Co~onen~ ~ 3 N~ & C.A.8. N~er Physical and H~lth ~azard ¢.A.8. N~r component 9 I N~ & C.A.8. N~r (Check ail that apply) Component $ ~ Na~ & C.A.a. N~er of Pressure H~lth H~l%h Component ~ 3 N~ & C.A.~. N~er I I I I I I I I I I I Physical and H~lth Hazard C.A.S. Nu~er Component ~ ~ N~ & C.A.~. (Check all t~ apply) Component ~ 2 N~ & C.A.5. N~er of Pressure H~lth H~lth Componen~ ~ 3 N~ & C.A.B. Na~ ' Title TStls 24 Hr Phone Csrtification (~ ~D SIGN AFTER COMPLETING ~L SECTIONS) I certify ~der p~nlty of law t~t I hayer ~rsonally ~l~ and ~ f~ili~ with the ~nfo~at~on su~itted in ~him ~d all at~ached d~ts ~d that ~sed on ~ in~iry of' %hose ' H ]~M'P .. PLA~ MAP SiTE DIAGRAM ~ FACILITY DIAGRAM ~ Business Nc:me: -~0[~/ A~'7'¥ ~ F ~E~/~ ~'~;~ " /-/~-~ For' Offibe Use Only .. First In Station: Area Map # of Inspection Station: NORTH Bakersfield Fire Dept. ~ ~ ~ c ~_ ~v ~_ ~ H~dous Material. s Inspection APR 6 ~990 ~ ~ ~~ ~~e Com~,e~ed~.. ~' ~ ~"__ ............ Loca~on: /~ i / ~ ~ ~ ~- ~Plan ID ~ 21B-000~ ~ (Top dgh~ come: Business Plan) "~a'~io~ ~o. ¢~ sm ~ '~pe~o~ ~Co~/~o* ~ Adequate Inadequate Verification of Invento~ Mated~s ~ ~ Verification of Quantities < ~ ~ Verification of Location ~ ~ ~°per Se~egafion of Matefi~ ~ ~ Co~: Verification ofMSDS Availabfli~ ~ ~ Nmber of~ployees ~ Vehficafion of Haz Mat Trai~ng ~ ~ Co~B: Verification of Abatement Supplies & Procedures ~ [-~ Comments: Emergency Procedures Posted _¢ [--] Containers Properly Labeled [~ [--] Comments: Verification of Facility Diagram ~'/ [-~ Special Hazards Associated with this Facility: Violations: FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station CopY Pin'k:~Jsiness Office ,' ,~ · .. ..".~ ., .... ~ z , . , ~ ~y .... ( t~-~e or Drin~ n~le) Do hereby certi~-- ~ ' za that I have ~evie~ea the 2 ~s'~ ............ attached Hazardous ~aterials business Dian (n&me of bus,/ness) and that it along with the attached additions or corrections consti~uu~e a comDlete and correct Business Plan for my facility. . //~' ...... ~' - ciate BUSINESS NAME REX PHINNEYS MOBIL SERVICE ID NUMBER 215-000-000282 LOCATION 101 19TH ST HIGH HAZARD RATING 2 1 . OVEi:~V I EW LAST CHANGE 03/23/88 BY ESTER JURIS CODE 215-001 JURIS BAKERSFIELD STATION 01 MAP PAGE 103 GRID 30D FACILITY UNITS 1 HAZARD RATING 2 RESPONSE SUMMARY 2A SEC 4) IF EMERGENCY SHOULD OCCUR IE. SMALL FIRE - WE WOULD GET THE FIRE EXTINGUISHER AND EXTINGUISH THE FIRE. IF FIRE SHOULD GET OUT OF CONTROL WE WOULD THEN CALL FIRE DEPT. EMERGENCY CONTACTS 2A SEC 2) JOHN H. AXT - 322-2850 OR 398-1598 FRANK BALTAZAR - 322-3850 OR 324-7704 UTILITY SHUTOFFS 2A SEC 3) A) GAS - REAR OF BLDG A NW CORNER B) ELECTRICAL - EMERGENCY PUMP SWITCH FRONT OF BLDG, PANEL REAR ROOM IN BLDG C) WATER - SOUTH SIDE OF SITE DIAGRAM D) SPECIAL - NONE E) LOCK BOX - NO 2 . NOT IFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE 1 12/15/88 11:46 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME REX PHINNEYS MOBIL SERVICE ID NUMBER 215-000-000282 LOCATION 101 19TH ST HIGH HAZARD RATING 2 3 . HAZ MAT TRAINING SUMMARY LAST CHANGE / / BY 4 . LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 03/23/88 BY ESTER 2A SEC 4) SHOULD MEDICAL EMERGENCY OCCUR WE WOULD CALL: GOLDEN EMPIRE PARAMEDICS 801 18TH ST 327-9000 OR HALL AMBULANCE 1001 21ST ST 327-4111 PAGE 2 12/15/88 11:46 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME REX PHINNEYS MOBIL SERVICE ID NUMBER 215-000-000282 LOCATION 101 19TH' ST HIGH HAZARD RATING 2 FACILITY UNIT 01 A . OVERALL HAZARDOUS MATERIALS INVENTORY LAST CHANGE 03/23/88 BY ESTER ID TYPE NAME MAX AMT UNIT HAZARD LOCATION CONTAINMENT USE 1 MIXTURE UNLEADED GASOLINE 6301 GAL HIGH NE CORNER ON SITE UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LISTS 1182,00 100.0 GASOLINE HIGH 2 MIXTURE REGULAR GASOLINE 6301 GAL HIGH NE CORNER ON SITE UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LISTS 1182.00 100.0 GASOLINE HIGH 3 MIXTURE SUPER UNLEADED GASOLINE 4000 GAL HIGH NE CORNER ON SITE UNDERGROUND TANKS FUEL ID PERCENT COMPONENTS HAZARD LISTS 1182.00 100.0 GASOLINE HIGH 4 MIXTURE MOTOR OIL 574 GAL UNKNOWN METAL STORE ROOM IN BLDG BOX[ES] LUBRICAN~ ID PERCENT COMPONENTS HAZARD LISTS 2808.00 100.0 MOTOR OIL UNKNOWN 5 MIXTURE ANTIFREEZE 60 GAL UNKNOWN ON DISPLAY IN BLDG BOX[ES] COOLANT ID PERCENT COMPONENTS HAZARD LISTS 2802.00 100.0 ETHYLENE GLYCOL UNKNOWN 6 WASTE WASTE OIL 220 GAL UNKNOWN UNDERGROUND TAND W SIDE UNDERGROUND TANKS WASTE ID PERCENT COMPONENTS HAZARD LISTS 1598.00 100.0 WASTE OIL UNKNOWN PAGE 3 12/15/88 11:46 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 BUSINESS NAME REX PHINNEYS MOBIL SERVICE ID NUMBER 215-000-000282 LOCATION 101 19TH ST HIGH HAZARD RATING 2 S . FIRE PROTECTION / WATER SUPPLIES LAST CHANGE 03/23/88 BY ESTER 3A SEC 4) WE HAVE 2 FIRE EXTINGUISHERS WITH PURPLE K DRY CHEMICAL FOR FIRE PROTECTION. 3A SEC 5) FIRE HYDRANT LOCATED ON SOUTHWEST CORNER OF 19TH AND UNION. D . EMPLOYEE NOT I F I CATION / EVACUAT ION LAST CHANGE 03/23/88 BY ESTER 3A SEC 2) TURN EMERGENCY PUMP SWITCH OFF. CALL FIRE DEPT. STAND AWAY FROM EMERGENCY IF OUT OF CONTROL. PAGE 4 12/15/88 11:46 MATERIAL SAFETY DATA SYSTEMS~ INC. (805) 648-6800 BUSINESS NAME REX PHINNEYS MOBIL SERVICE ID NUMBER 215-000-000282 LOCATION 101 19TH ST HIGH HAZARD RATING 2 E . MITIGATION / PREVENTION / ABATEMENT LAST CHANGE 03/23/88 BY ESTER 3A SEC 1) OUR GASOLINE NOZZLE'S HAVE RUBBER BOOTS THAT CATCH VAPORS THAT GO IN OUR VAPOR RECOVERY SYSTEM. IF NE DO HAVE A SPILL OF HAZARDOUS MATERIALS WE USE QUICK ABSORBENT AND DISPOSE OF AT A HAZARDOUS NASTE DISPOSAL SITE. NE ALSO INSPECT NOZZLE HOSE PUMPS DAILY. PAGE 5 12/15/88 11:46 MATERIAL SAFETY DATA SYSTEMS, INC. (805) 648-6800 CITY of BAKERSFIELD ' NO N-- t R. A, D E .S E C R E T S ' ~,g,..~_ LOCATION: /*?~')~' '~ ~ ADDRESS: ~JO~ ~O~]M4 ~ STA"DARD IND. CLASS CODE ~C~e C~e ~t Mt Est Units m Site T~ ~ T~ ~ ... St~ in F~tltty ~ ~ I~t~ti~ ~lth of P~ ~lth ~l. th of ~ ~lth ................ Certificatim (Read and sJ~ after complet~nE all sections) ..,. for obca,ini~ t~ inf~tfm. I ~iM tMc t~ suMi~t~ info. tim is t~. accurate, ~ c~piete. /~ - // /~ ' ' ,' CITY of BAKERSFIELD NON--TRADE SECRETS ' P.q..~ot~_ LOCATION: __/0 I ] Y'I~/, ~ /' ADDRESS: ~7~ ~ 7~/~&~ STANDARD IND. CLASS CODE ~ Ith of P~n With '' ..... ~lth of ~ ~lth ...... _._L_L .... 1 L I. I ., I ! t t, I ....... (C~k all t~t ~lth of Pr~su~ blth Clrtificlti~ (~ld and. 3J~ ~fter completing ail sections] BA E.SFIEr, D CI ' FIRE DEP,' Z. Wr 213o s SST 805) 326-3979 OFFICIAL USE ONLY BUSINESS NAME HAZARDOUS MATERI A_~LJoL~!~ "" BUS I NESS PLAN AS A FORM 2A INSTRUCTIONS: " 1. To avoid further action, return this form by 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 B. LOCATION / STREET ADDRSSS: /0/ SECTION 2: E~RGENCY NOTIFICATIONS In case of an emergenc~ involving the release or threatened release of a hazardous material, call 911 and 1-800-852-~550 or 1-916-42T-4841. This ~ill notify your local fire department an~ the State 0ff]ce of Emergency Services as required by EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: D. SPECIAL: ,,f,/~,~'.~_.. E. LOCK BOX: YES ~'N~/ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: L'dd~I/E1WERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ~ATERIALS:.... .................................... ~ NO ~ NO B, PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... YES (~ (Y~NO C. PROPER USE OF SAFETY EQUIPMENT:... ................ (~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. YES~ E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES SECTION ?: HAZARDOUS MATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUND,~F A SOLID,/,~_55 GALLONSm/'~/~OF A,LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... I, #~.~ ~. ~/F~~t, , certify that the above information is accurate. I undersffand that~this info~atio~ ~ill be used to ~ulfill ay obligations undee the new California Health ~nd Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25800 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: ..... BUS I NESS PLAN SINGLE FACILITY UNIT FORM gA INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Ans~er' the questions be]ow for THE FACILITY UNIT LISTED BEI, 0~. 4. 8e as gRIEF a, nd CONCISE as .possible. FAC!LI~ UNIT~ / FACILI~ D~IT NAME: ~'~ SECTION 1: MITIGATION, PRE~NTION, ABATEME~ PROCEDURES SECTION 2: NOTIFICATION AND EVACUATION PRO~:.)~RESC ~ l[ [ ' AT THIS ~IT ONLY .zo , A' SECTION 3: HAZARDOUS MATERIALS FOR THIS b~IT ONLY A. Does this Facility Unit contain Hazardous Materials? ..... 5 Y~NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES N~ If No, complete a separate hazardous' materials inventory form marked: NON-'TRADE SECRETS ONLY (white form !4A-l) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow 'form #4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONDERS ~.-Y' / ~/~' ,.,,,,w,,~ SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS./PROPAN~': B. ELECTRICAL: D. SPECIAL: E. LOCK BOX: YES IF YES, LocATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES ./ NO - 3B - / BAKERSFIELD CITY FIRE DEPARTMENT' I.D. # FORM 4A-1 Page . of NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY ADDRESS: l 0 '~ i~'1'~ ADDRESS: ~2,{O~ 'l'"~,~{q~{"/~,~. FACILITY UNIT NAME: C~TY, Z~: ... 6~{~/~ ~3~Op CITY,ZIP: PHONE ~: ~O~ v33~~O' PHONE ~: ~gk Z~Y3- {OFFI~IA'L USE' CFIRS CODE ONLY , 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL 'CONT USE LOCATION IN THIS ~ BY HAZARD D.O.T qODE AN..OUNT AMouNT U.NIT CODE CODE FACILITY UNIT ~ WT. CHENIqAL OR COMMON NAME · CODE GUIDE ,, E~,ERGENCY' '-CONTACT: ~o~ A~. TITLE: ~MAT{.~ ....... ~'PHO~E ~ BU~ HOURS: DAT~_~O ~n.~A~ TITLE: ~~~/~ . PHONE' ~ BUS HOURS: ~- ~~--~ ' ~/~ . ~~ ~~ ~ AFTER BUS HRS: .. , ~ ~,~ E~IERGENCY CONTACT: PRINCIPAL BUSINESS ACTIVITY: - / / - 4A-1 - SITE/FACILITY D I AGRA,, NORTH SCALE: I'~ 10' BUSINESS NA,~E: f~, ?~;.~ ~o~* S*~ ~00~: /0~ / ~ DATE: d,/ g/F/FACILITY N~ME: ~g~'t UNIT ~:'/OF/ (CHECK ONE) SITE DrAGRA>Z FACILITY DrAGR.~ f ~ 0 0 (Inspector's Comments): rOFFICIAL USE ONLY- SITE DIAGRAM e i Items) 1. Address: Identify the 9. Lock (key) Box principle buildings by. the Street numbers', lO, MSDS Storage Box 2. Street(a). Alleys. 11. Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. -. b. Masonry 3. Storm Drains. Culverts, Yard Drains c. Wood 4. Drainage Canals, Ditches, d. Gates Creeks, ., 13. Powerllnes 5. Buildings a. Frame construction 14. Guard Statics b. Masonry construction 15. Storage Tanks: Identify the c. Metal construction ': capacity in gal. a. Above ground d. Access Door b. Underground 6. Utility Controls a. Gas 16. Diking or Berm b. Electricity 17. Evacuation Route c. Water 18. Evacuation Area: ' Identify the ?. Fire Suppression Systems: location where a. Fire Hydrants employees will maat. b. Fire SPrinkler 19. Outside Hazardous Connections Masts Storage c. Fire Standpipe 20. Outside Hazardous Connections Material Storage d. Water Control Valves 21. Outside Hazardous for protectionsysteme Material ~ Use/Bandling e. Fire Pimp {2. Type oH Hazardous Material/Waste Stored 8. Fire Department Access or Used (See .... ' Below) TYPE OF HAZ~J~DOUS MATERIAL F - Flammable E - Explosive L - Liquid R - Radlological C - Corrosive 0 - Oxidizer O - Gas P · Poison W - Water Reactive T - Toxic $ - Solid B - Cryogenic O - Waste B - Etiological Example: Flauabie Liquid · FL FACILITY DIAGRAM (Required items la addition to the above) l. Risers for Sprinklers ~ 8, Fire Escapes - ~. Partitions - 9. Air Conditioning Units .. 3. Stairways: Indicate the ~ 10. Mindows levels served from highest to lowest, ~ 11. Inside Hazardous Waste Storage. -,4. Escalator: Indicate the levels served from ~ 1~. lnelde Hazardous highest to lowest.' Mater/als'Storage '. 5. Elevator ~, 13. Inside H'azardous.. Mater/aim Uae/Handling 6. Attic ACCelS :'14. Sewer Drain Inlets 7. Skylight. ',.