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Home My WebLink AboutBUSINESS PLAN 8/20/1992City of Bakersfield TRANS.~.~en',~'~ SLIP Date...~:.~-°...~...9..~ ................................ m ..,...~.~..e..~..,.~....:...~..~.~..~...~.~..s.~...~....,..,.: ....... ._ .................................... Fro m~.~.~.......<-~. ~.~.~.~...-....~.~.:~..~.~ ........... For Your:-- ~n ~'~ile FI Signature ["1 A~ion formation Pleose:-- [] Return [] See Me [] Follow Up. [] Prel:mre Answer Copy to: ...................................................................................................... Memo: ......................................................................................................... ................. ? ................................................................................................................... BULK TRANSFER (business) BUSINESS NAM£ '7-~/~-~ ~.~ SITE LOCATION OLD O~ER N~E NEW ' O~ER N~E NEW O~ER ~D. ACCOST N~ERS INVOLVED APPROX. DATE/~~ER. THIS INFORMATION IS TAKEN FROM THE DAILY REPORT AND SHOULD BE %~RIFIED PRIOR TO ANY CHANGES. DISTRIBUTION: Sanitation Business Licenses Hazardous Materials 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 1 Overall Site with 1 Fac. Unit General Information · Location: 800 34TH ST Map: 103 Hazard: Low Community: BAKERSFIELD STATION 04 Grid: 19D F/U: 1 AOV: 0.0 Contact Name Title ~ Business Phone 24-Hour Phone] THOMAS STALLINGS OWNER I (805) 323-9694 x (805) 831-7875! IKENNETH STALLINGS MANAGER (805) 323-9694 x ~.(805) 326-1783.1 I ~'~'~' ,,~ z~,,~ ~,j. I/ I Administrative Data Mail Addrs: 800 34TH ST D&B Number: 95-241-3696 City: BAKERSFIELD State: CA Zip: 93304- Comm Code: 215-004 BAKERSFIELD STATION 04 SIC Code: 5541 Owner: THOMAS STALLINGS Phone: (805) 323-9694 Address: CC0 3~T[! ST CZ/ ~ ~K30 ~Q~. State: CA City: BAKERSFIELD Zip: ~ ~33~ Summary .I~.EC__: I~AY 0 '~ 1992 HA? M~T, DIV. Ci/''''/ I, 7~/x';~...~/_~/_~..S DO hereby, certify that , have reviewed the attached hazardous materials manage- ment plan fo~u.,,~s~,,_,.~nd that it along with ' (Name of Susl~e~) - ' any cOrrections consUtute a complete and correct man- agement plan for my facility. 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 SUPREME UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret:~No / Form:'Liquid Type: Pure Days: 365 Use: FUEL/~ Daily Max GAL Daily Average GAL ----~~ual Amount GAL I oo,ooo.oo Storage IIPress T Temp Location UNDER GROUND TANK IAmbient~AmbientlW SIDE OF LOT -- Conc Components· MCP ~List 100.0% IGasoline ModerateI 02-002 WASTE OIL Liquid 1000 Low · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GALI Daily Average GAL I Annual Amount GAL 1,000 I 600.00 1,500.00 Storage~~Press T Temp Location UNDER GROUND TANK IAmbient~ambientlN OUTSIDE -- Conc Components MCP List 100.0% IWaste Oil, Petroleum Based ILow I 02-003 R-12 DICHLORODIFLUOROMETHANE Gas 120 Minimal ·'Fire, Pressure, Immed Hlth FT3 CAS #: Trade Secret: No Form: Gas Type: Pure Days: 365 Use: OTHER Daily Max FT3I Daily Average FT3 I Annual Amount FT3 m 120 ~ 36.00 240.00 Storage Press T_~Temp Location PORT. PRESS. CYLINDER Above IAmbientlSTORE ROOM -- Conc Components ~ MCP List 100.0% IDichlorodifluoromethane IMinimal I 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-004 MOTOR oIL Liquid 400 Minimal · Fire, Delay Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL Daily Average GAL I Annual Amount GAL 400 I 1,200.00 2,400.00 Storage ~~Press T Temp Location PLASTIC CONTAINER IAmbientlAmbientlSTORAGE ROOM -- COnc Components MCP List 100.0% IMotor Oil, Petroleum Based IMinimal I 02-005 TRANSMISSION FLUID Liquid 70 Low · Fire, Delay Hlth GAL CAS #: 64742-55-8 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GALI Daily Average GAL I Annual Amount GAL -- 70 ~ 10.00 300.00 Storage~~Press T Temp Location PLASTIC CONTAINER IAmbient~AmbientlSTORAGE ROOM -- Conc Components MCP List 100.0% ITransmission Fluid (Petroleum-Based) ILow [ 02-006 ANTIFREEZE Liquid 150 Low · Fire, Delay Hlth GAL CAS #: 107-21-1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLANT/ANTIFREEZE Daily Max GAL I Daily Average GAL [ Annual Amount GAL -- 150 I 75.00 300.00 Storage Press T Temp Location PLASTIC CONTAINER Ambient~Ambient I STORAGE' ROOM -- Conc Components MCP List 100.0% IEthylene Glycol ILow --~ ~ 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-007 RE~JLAR CASSLi~E ~ ~~b~.~ ~U~Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-~1-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL Annual 'Amount GAL I 135,ooo.oo Storage Press T Temp cation UNDER GROUND TANK IAmbientlAmbientlW SIDE OF -- Conc Components MCP ---~List 100.0% IGasoline Moderatel 02-008 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL __~j~ily Max~GAL I 2/~6~DDaily Averageg~GAL I Annual/~mount450,000.00GAL StorageIIPress T Temp ~TLO~tion PLASTIC CONTAINER ,AmbientlAmbient,W SIDE OF -- Conc Components MCP List 100.0% IGasoline IModeratel 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification IN CASE OF AN EMERGENCY INVOLVING RELEASE OF HAZARDOUS MATERIAL 911 WILL BE CALLED. DEPENDING UPON THE EMERGENCY, CHEVRON HAS AN EMERGENCY PHONE NUMBER TO CALL. ALSO AVAILABLE ARE 1-800-852-7550 AND 1-916-427-4341 WHICH WILL NOTIFY FIRE DEPARTMENT AND STATE OFFICE OF EMERGENCY SERVICES. <2> Employee Notif./Evacuation ALL EMPLOYEES WILL BE INFORMED OF THE EMERGENCY AND IF THE EMERGENCY WARRANTS EVACUATION ALL EMPLOYEES WILL BE INSTRUCTED TO LEAVE THE PREMISES. HAVE ALSO INFORMED EMPLOYEES IN THE PROPER USE OF SAFETY EQUIPMENT. <3> Public Notif./Evacuation IF THE EMERGENCY WARRANTS ACTION INVOLVING THE PUBLIC, THEY WILL BE INSTRUCTED AND EVACUATED IN THE SAFEST POSSIBLE WAY. <4> Emergency Medical Plan MEDICENTER - 820 34TH ST MEMORIAL - 420 34TH ST 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 6 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> ~Release Prevention LEAK DETECTORS HAVE BEEN INSTALLED AT FACILITY. EMERGENCY SHUT OFF SWITCH IS LOCATED IN FRONT OF STATION TO THE RIGHT OF THE FRONT DOOR AND BLACK SEAM. TANKS ARE CHECKED DAILY'FOR LEAKS. ALL TANK LIDS ARE LOCKED. <2> Release Containment IN THE EVENT OF A'SPILL.OR LEAK, CHEVRON HAS SUPPLIED THE FACILITY WITH A GUIDE WHICH IS TO BE STRICTLY FOLLOWED. THIS INFORMATION IS FOUND IN THE SERVICE STATION GUIDE. <3> Clean Up SMALL SPILLS WILL BE CLEANED UP BY THE EMPLOYEES AND DISGARDED IN THE PROPER MANNER. LARGE SPILLS OR LEAKS WILL BE REPORTED TO THE PROPER AUTHORITIES. ACTION WILL BE TAKEN ACCORDING TO THEIR INSTRUCTIONS. <4> Other Resource Activation 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 7 00 - OVerall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility. Shut-Offs A) GAS - BEHIND STATION ON BACK WALL. B) ELECTRICAL - INSIDE STORAGE AREA - EAST WALL C) WATER - SIDEWALK OF 34TH STREET D) SPECIAL - EMERGENCY SHUT OFF FOR PUMPS - BY FRONT DOOR E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - THREE FIRE EXTINGUISHERS AVAILABLE. FIRE HYDRANT - 50 FT ON 34TH AND Q ST. <4> Building Occupancy Level 04/14/92 THOMAS STALLINGS CHEVRON 215-000-000359 Page 8 00 - Overall Site <G> Training <1> Page 1 WE HAVE 6 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETs ON FILE EMPLOYEES HAVE BEEN INFORMED AS TO THE HANDLING OF HAZARDOUS MATERIALS. THEY HAVE BEEN TRAINED TO HANDLE SMALL CAR FIRES AND MINOR MEDICAL INJURIES. THEY ARE ALSO SHOWN THE MATERIAL SAFETY DATA SHEETS. EMPLOYEES HAVE BEEN INFORMED TO CALL 911 IF IT WARRANTS THE SITUATION. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use Bakersfield Fire Dept. RECEIVEn Hazardous Materials Division 2130 "G" Street IqAR § 1990 Bakersfield, CA. 93301 Ans'd ............ ZARDOUS MATERIALS MANAGEMENT PLAN 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 brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA BUSINESS NAME: Thomas Stallings Chevron LOCATION: 800 3hth Street MAILING ADDRESS: Same as above .CITY: Bakersfield STATE: CA ZiP: 95504 PHONE: 523-9694 DUN & BRADSTREET NUMBER: Tax # 95-241-3696 SIC CODE: PRIMARY ACTIVITY: Servlce Statlon OWNER: Thomas Stallings MAILING ADDRESS: 800 34th Street SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. Thomas Stallings Owner 323-9694 831-7875 2, Kenneth Stallings Mgr. 323-9694 326-1783 Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBE'R OF EMPLOYESS: MATERIAL SAFETY DATA SHEETS ON FILE: "/es BRIEF SUMMARY OF TRAINING PROGRAM' Employees have ,been informed as to the handling of hazardous materials. They have been trained to handle small car fires and minor medical injuries. They are also shown the MSDS. Employees have been informed to call 911 if it warrants the situation. 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 REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, Thomas Stallings CERTIFY THAT THE ABOVE INFOR- MATION IS ACCURATE. I UNDERSI'AND 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 THAT INACCURATE INFORMATION..CONSTITUTE~S PERJURY. "'~- - SIGNATURE TITLE DATE Bakersfield Fire Dept. ~'"'~ Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: Thomas Stallings Chevron SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: In case of an emergency involving release of hazardous material 911 will be called. Depending upon the emergency~ Chevron has an emergency phone number to call. Also available are 1-800-852-7550 and 1-916-427-434] which will notify fire dept. and state office of of emergency services. B. EMPLOYEE NOTIFICATION AND EVACUATION: All employees will be informed of the emergency and if the emergency warrants evacuation all employees will be instructed to leave the premises. Have also informed employees in the proper use of safety equipment. C. PUBLIC EVACUATION: If the emergency warrants action involving the public~ the~ will be instructed and evacuated in the safest possZble way. D. EMERGENCY MEDICAL PLAN: Medicenter - 820 34th Street Memorial Hospital - 420 34t~ Street "911" Employees have been instructed to dial 9~ if they cannot handle the emergency properly. Bakersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: , Leak' detectors have been installed at facility. Emergency shut off switch is located in front of station to the right of the front door and black seam. Tanks are checked daily for leaks. Ail tank-lids are locked. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: In the event of a spill of leak~ Chevron has supplied the facility with a guide which is to be strictly followed. This information is found in the service station guide. C. CLEAN-UP PROCEDURES: Small spills will be cleaned up by the employees and disgarded ~n the proper manner. Large spills or leaks will be reported to the proper authorities. Action v.~ill be taken according to their instructions. SECTION B: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' NATURAL GAS/PROPANE: Behind station on back wall. ELECTRICAL'. Inside storage area- east wall Sidewalk on 3~th street WATER: SPECIAL: Emer~enc~ shut off for l~umps - by front door, YE~ IF YES, LOCATION: LOCK BOX: SECTION 9:' PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: 3 fire extinguishers available. B, WATER AVAILABILITY (FIRE HYDRANT): Fire hydrant 5Oft away on 3~th & "Q" Street. NOTES .... . : "i ' :." '.: ~ ..... :"~,",,,'"-" ........ · ';,.l ;~..' [' , "',, ~. ,,,,;; ,~ ~-~ ~-- " '~ ' /'HEW A.I'.IIV 'G .... . .' i, ' '" ' ' : i ....... , ....~. .,, , _ , ,,,, ,..,. ,. ~.__ ~,- . . ,~ ,:.... .... . .,,., ..,,,, . ,. .... %:?,~,;..' ..._. ...... . '"~ r ~ '? ~':".~.:~;~'~' ' ~ . ' .~ )- .', ' / - ~,,~.,,, ;-- ~i-~,,~. i '"'2'"( ......... . :' __._.X:~'-'-..'.~: ..... ~ ............. ~ ' " '"' I / ' '"'"~"' ............."" "'" '" I~:~:~,:.t ,,v,,,o., ~,o.... ~..., ~,,. . ,,,. ....... · .... ¢ ........ :::; ,, ~ ............................. ' ............ ~. '. ~ ....... ' ........... ~ ,,'¢~* ,'~¢'¢ F ~ -',~ · ............. · ................. ~ .......... FART~'RTP , ~ CI1-Y of BAKERSFIELD HAZARDOUS MATERIALS INVENTORY ~m and ~kgticulture El Standard Business l~ NON--TRADE SECRETS BUSINESS NA~4F,'Tom Stallings Chevron OWNER NAHE:_Tho~as Stalin,s NAME OF THIS FACI.LITY' None LOCATION: ~'00 'Sa~ ~treet_~. ADDRESS; 6~'1 El Serene Drive 'STANDARD IND. CLASS CODE~I ClIY. ZIP_: Ba~~e~ V.~u~ CITY. ZIP~ ~aKers~'~e d ~()b. ~~~~~-~-Number PHONE PHONE ~'~ ~3~.2A2~.' ..... '-- ' 95- - 2 ~ - .~g-9'6 - REFER .OJmaI~oo'f IONS~~ROPER CODES --. Trane Tyqe Pax Average Annual Heasure I ~y~ Cent ConC Cent Use Location.Whece ~6y ~la,es er ~ixt,Jre/~c~eonents Code COOL AmC AmC Est Un,Cs on 51ce Type Frees Temg Code SCored in Pac~/]CyW~ See ]nstru:C~cns / ~ ~ I ~o.oo$ ~ooo hoo,oool~ml>~ I o~ I~ Ig I ~9 ~Vest side of lot 1~ Supreme Unleaded Ga~ ~h~si~al and ~ea]~h ~azard C.~.S. ~u=ber 8006-6~-9 C0~pone~t II ~a~e ~ C.A.S. (Check ali that apply) 108-88-5 20 Toluehe Component f2 Name & C.A,S, Number ~ Fire Hazard ~ Reactivity ~ OelayedHe~lth ~ Sudd~n. Releaseor Pressure ~ ]m~ediateHealth 3~0-20-7 20 Xylenes, Component f3 Name & C,A,S, Humber 16~-0~-~. 10 MTBE / U ~M ~10~000~ 2~00 1135,0001Ga11~65Iol I1 I~ 19 ~/est side of lot 1~ Regular Gas PhySical ,nd He,l~h H,z,rd C.A.S. Nu,ber 8006-61-~ Co,,o~enLl/~ame S C.A.S. (Check .all that a~]y)10~-~-~ 20 Comoonen[ 12 Name ~ C.A.S. Number ~ Fire Hazard ~ Reactivity ~Delayed ~ Sudden Release ~ Immediate 1330-20-? 20 Xylenes Health of Pressure Health Consonant 13 Name S C.A.S. Number / ~ 63g-o~-~ ~o H~3s p/__ uI ~ I~o,ooo1~ooo g~o,ooola~ml~ I o~ I~ [~ I 19 ~Vest side of lot 1~ Unleaded Gas Physical 8nd H,~l~h Nsz~rd C.A.S. Number 8006-61-9 C0~p0nent II N~ t ~.A.S. Number (Check ali th~t a~ly) 108-88-3 20 Toluene C0~0nen~ 12 ~a=e ~ ~.A,S. ~u~ber ~ Fire~zard ~ Re~c~ivit~ ~Belayed ~ Sudden ~elease ~ l=~ediae 1330-20-7 20 Xylenes Hearth of Pressure Health ComDonent 13 Name & C,A,S. Number :-u Iw I ~oool ~oo I~o~ la-mi ~ 1o~ I ~ I ~ I~o I~o=~ Outside l~Waste011 PhysiC~l ~nd Health ~Hsrd C,A,S, Nu~b~ W-221 Componen~ I1 ~e I ~,~,S, Number (~h~ck ~11 ~h~pplH ~ Highl~ reflned base oi1~ Component 12 Name ~ C,A.S. Number ~ Fire H~zard B R~c~ivi~y ~ DelayedHeaKh B Sudd~nof ~r,ssure~le~s~ B I~$~i~ j15 Additives inc~ inhinito~-s Component J3 Name ~ C,A.S, Number EHERGENCY CONTACTS 1Ha,aTOm S~A~in~s ' Tl~teOwner ~oneS~ 1-~8~ ,~,.eKen S~in~s T~. C~rLific~Lion (Re~d and sign after completing.all secti~n~) l'c~rtl~ un~r ~n~l~[ o~]~ ~h~L l h~v~p~rson~Jll.~x~ln~qdj~ fs~il]~r.~i~ the ~nior~ac]gn ~u~iLLed in ~his.lnd ~11 submitted information ~s true, accurate, 8no complete, ~oma8 ~111~g~ / Ow~e~ ' ~/~/90 ' ~~r~i~e of o~netlooerator U~ o~neF~cor'S authorized reoreSenCaCive ~ur~ ~, b/ I T UI DARErtOFIELU · HAZARDOUS MATERIALS INVENTORY ~arm and Agriculture (-J Standard Business F1 NON--TRADE SECRETS BUS~NESS NAHE: ~CO~O~" OWNER NAHE: NANE OF THIS FAC]LZTY; ,, Trane ]y,e Hex Avtr~ge Annual Neasure I ~[e {ont gont Cont Us Location ~he(e. ~ype ~ress lemD Co~e~t See Ins:ru:L~ons Stored ~n Fact~ty Code [ooe ~[ A~[ EsL Un~Ls on ~ I ~ I~o ! ~ I =~o ~l~ I o~ I ~ I= I~Isto:~eRoom ~ R-12 Refrigerant (Freon) ~sical l~d NealthNazard C.A.S. Number Coe~onen~ II Na~e I C.A.8. Number ICheck al/ :hat a~lyj Coeponen: I~ Naee I C.A.S. Nueber ~/~re ~azard ~ ~eactivity ~ Oelayed ~ Sudden ~elease ~ I~media~e Neat:h of Pressure Health Component 13 Na~e I C.A.S. Number = I ~ I=oo I~=oo I ~oo I~=l~ I~o I~ I~ I~ I sto~=~ ~oo= m =o~o~ o~ Physical l~d Nealth~a~ard C.A.S. Nueber CoI~onent II Naee I C.R.S. Nueber ICheck al/ that a~Iyl Coeponent I~ Naee I C.A.S. Number ~ Fire ~azard ~ Reactivity ~ Oelayed ~ Sudden ~elease ~ le~i~ HealCh o[ Pressure Coeponent 13 Naeet ¢.A.S. Nueber Physical and ~ealt~ Hazard C.A.S. Number 647~2-55-8 Coe~onen: II Naee I C.A.S. Number 85 High refined base oils IC~eck all that ~ly~ ~ ~tre Hazard ~ Reaatvity ~ Oelayed ~ Sudden ~elease ~ ~i~Co~onent Na~e I C.A.S. Nueber incl, 15 Additives inhibitor ~ea/:h of Pressure Component 13 Naea I C.A.S. Nueber ~'A I P I 150 I 75 I 300' IGal1365 I10 I 1 I ~ I09 IStOrage Room ~ Antifreeze Physical and Health ~ard C.A.S. Nueber 107-21-1 Coe~onen: II Naee I C.A.S. Nueber I:heck ali that a~Iyl 95 Ethylene Glycol ~ Fire Nazard ~ ~eactivity ~ Oelayed ~ Sudden ~elease ~ le~i~c°e~°nent Name C.A.S. Number Hem/Ch of Pressure Componen~ 13 Name I C.A.S. Humber EHERGENCY CONTACTS fll ~ame T~le ~r Phone R~me Title erLi[jgaLioq ,(~e~ ~.n~.~fgn after comp~Cf~g.all secCf~n~) .cer[~Ty unoer pena~tX ~IUf [nqt l navepersonal~Y examinq~aqalm ~ami~tac. vit~ the )n[~cmau~n ~u~eittpd in this.and all at'~acned.dqcgment~, ane [pac oasea on.my Inquiry 9t.tnose lnaivloua/s responslo/e lot oboe1 trig: e ln~ormaclon. [ bel~eve [hat the suomlt:ea IAlorMClOfl IS [rue, accurate, aha toepiece, ~~r~le Of o~nerloperator UH o~nerloperator's authorized represen:ative ~ature BAKERSFIELD CITY FIRE DEPARTI~ENT BAKERSFIELD, CA 903011 ~ ~'cElv[~ (805) 326-3979 JUN 2 3 19117 Ans"d USINESS N~ HAZARDOUS ~TERI ALS BUSINESS PLAN AS A WHOLE FORM 2A' INS~UCTIONS: , ~ " 1. To avoid fu~the~ action, ~etu~n this forum b~ 3. Answer the questions belo~ for the business as a ~hole. 4. as s~c~io~ ~ ~s~NEss i~~c~o~ ~ [~'~ BUSINESS NA~E: Thomas' S~al~ngs Chevron LOCATION / STREET ADDRESS: 800 34~h St CITY: Bakersfield ZIP: 93304 BUS.PHONE: (805) 323. SECTION 2: EI~IERGENCY NOTIFICATIONS In case of an emergency involving the release ov threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. Kenneth Stallinqs Ph# B. Perry Swinford Ph# SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: Front of station ~igh~ ba~ B. ELECTRICAL: Labeled Emerqencv shut off C. WATER: D. SPECIAL: E. LOCK BOX: YES / ~ IF YES, LOCATION: v IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE Fire extinguisher in lube bay and two on gas island SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE Med~ ~enter , 820 34th St which is next door Memori~ HOspital, 420 34th St 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 0R NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS MATERIALS: . . .- ..................................... WITH RESPONSE AGENCIES: .......................... NO C PROPER USE OF SAFETY EQUIPMENT: .................. J ' · NO D EMERGENCY EVACUATION PROCEDURES: ................. NO E B0 YOU MAINTAIN EMPL0¥EE TRAINING RECORBS: ....... NO SECTION ?: I~..th~DOlJS I~TERI.~L CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, 55 ALLONS OF A LI~UID,~200 CUBIC FEET OF A COMPRESSED GAS: ...... ~ NO ~ C ~-~ertify that the above information is accurate. I understand that this information ~ill be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CITY FiRE DEPARTmeNT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY BUSINESS NAME: f~ - - BUS I NESS PLAN SINGLE FACILITY UNIT FORM 3A INSTRUCTIONS 1. To avoid further action, this form must be returned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE YACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. SECTION 1: MITIGATION, PREVENTION, ABATE,~EN~r PROCEDbqlES Ma.~,ure n_o.zz!e~.s ~n ta_nk bef%r.e depining gas. W~ .,/~/'/~~ USE CAT LITTER FOR S?ILLED GASOLINE. NO REMOTE PUMP SHUT OFF. WASTE OIL IN UNDERGROUND TANK. AUTOMATIC SHUT OFF NOZZLES. SECTION 2: NOTIFICATION BzNq] EVACUATION PROCEDbqlES AT THIS b~IT ONLY The area is open and everyone moves away SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~yES~ NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES ~ 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 f'~7 Lfst only'the trade sec~els-on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION Three fire extinguishers SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E~%{ERGENCY RESPONDERS 50 ft on 34th and Q North/East SECTION 6: LOCATION OF'UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS/PROPAN~ Right rear corner of station B. ELECTRICAL: Inside store room · C. WATER: Out by curb on 34th st D. SPECIAL: Emergency switch for poer to pumps be the first tube door. E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO BAKERSFIELD CITY FIRE DEPARTMENT 1 I.D. ~ g5 2413696 FORM 4A-1 Page __of .----- NON-TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NAME: mham~ .q~al 1 ing.~ ~.h~rwnn OWNER NAME: Thama~ g~.al ] ~ua~ FACILITY UNIT ~: ADDRESS: 800 3afb St ADDRESS: - FACILITY UNIT NAME: C I TY, Z I P: Baker~fie!~, Ca Q?Zal C I TY, Z I P: .. PHONE ~: 323 a~a~ ..... PHONE ~: ICIAL USE CFIRS CODE .... ~ 0NL% 1 2 3 4 5 6 7 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T %MOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NA~E CODE GUIDE ~ 25000 815000 Gal 01 19 West side outside 100 Gas ooo 900 ~"r~ O1 26 North outside Oil Waste ~ 3x351b 105 ~FRIGE~T - DI~LORODI~UORO- z. 30,570. 30,570. C~-. 0q O~ STO~ ROOM ~E ~) ¢ 400 gal 2,400 Gal. ~3 'Z~ STOOGE ROOM MOTOR OIL ~b~_ 70 300 Gal. [O ~ STOOGE ROOM T~SMISSION FLeD '~ ~ ' 'E: NAME: TITLE: n~r ~n,~.~./J~ F DA 6-1~-87 EMERCENCY CONTACT: [ep~eth ~e~::q~q TITLE: Assist P~ONE · ~OURS~ 323 969A ...... - AFTER BUS HRS: a~ 7~ E~RSENCY cONTACT: TIT~E': .. PHONE [ BUS ~OURS: 'PRINCIPAL BUSINESS ACTIVITY: Service S~a~ion AFTER BUS HRS: - 4n-1 - (tyue or Drin~ name) RECEIVED Do herebT certifi that I have revie~,-ed the FEB221 8 HAZ. MAT. DIV. attached Hazardous Materials business plan (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for m,v facility. signature// date ' BUSINESS NAHE THOMAS STALLINGS CHEVRON I0 NUMBER Z 1S-GGO-OGG3SB LOCATION 80(~ 34TH ST HIGH HAZARD RATING Z }. OVERVIEW LAST CHANGE 05/t3/B8 BY ESTER JURIS CODE 215-G04 JURIS BAKERSFIELD STATION 04 MAR PAGE 103 GRiD 19D FACILITY UNITS ! HAZARD R~TING Z RESPONSE SUMMARY Z~ SEC 4.) FIRE EXTINGUISHER tN LUBE BAY AND TWO ON GAS IGL. AND. EMERGENCY CONTACTS ZR SEC KENNETH ST~LLINGS - 323-B694 OR .................... "' ~4 ~,, ~ 8773- ~JTILITV ~HUTOFFS 2R SEC ¢~) GAS - FRONT OF S'['~TION RIGHT HAND SIDE OF FRONT DOOR AND BL~CI< SEAM B) .ELECTR!CBL - LABEL. ED EMERGENCY SHUT OFF SWITCH C) W4TER - ? D) SPECIAL - NONE E> LOCI< BOX - NO NOTIFICATION / PUBLIC EVACUATION LAST CHANGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > PAGE ! 12/Z3/8~.1 12:55 MATERIAL .S~FETY DAl'~q S¥STEMS~ INC. (805) 648--68G~ BUSINESS NAME TI-lOMAS ST~ILLINGS CHEVRON !'O NUMBER 215-008-.-0003S9 LOCATION 800 34TH ST HiGH HFIZARD RATING Z 3. HRZ HAT TRAINING SUMM~IRY LAST CHP~NGE / / BY < NO INFORMATION RECORDED FOR THIS SECTION > LOCAL EMERGENCY MEDICAL ASSISTANCE LAST CHANGE 05/73/88 BY ESTER SEC S) MEOICENTER - 8Z0 34TH ST MEMORI~tt.. - 420 34TH ST' PAGE Z 12/Z~/88 lZ:SS MATERIAL SAFETY DATA SYSTEMS, INC, (80S) G4.8-G800 BUSINESS NAME THOMAS STALLINGS CHEVRON ID NUMBER 215--OOO-OO(~359 LOCATION B~ 34TH ST HIGH HAZARD R~TING 2 F~CILITY UNIT 0t A. OVERALL HAZRROOUS M~TERIRLS INVENTORY LAST CHANGE ~5/13/88 BY ESTER I0 TYPE NAME MAX RMT UNIT HRZARO LOC~TI ON CONTAINMENT USE ~ PURE GASOLINE ~S~0 GAL HIGH W S10E OUTSIDE UNDERGROUND TANKS FUEL .!D PERCENT COMPONENTS HAZARD LIST Z WASTE WASTE OIL 988 GAL UNKNOWN N OUTSIDE UNOERGROUNO TANKS LUBRICANT ID PERCENT COMPONENTS HAZARD LIST ~598.8~ 1~8.8 U~STE OIL UNKNOWN 3 PURE R.-iZ DICHLORODIFLUOROMETHANE 385?8 FT~ LOW STORE ROOM PORTABLE PRESS. CYL. COOLANT ID PERCENT COHPONENTS HAZARD LIST ; 888. ~ ~ ~D. 9 DI CHL. ORODI FLUOROMETHRNE .' ' · LOW 4 PURE MOTOR OIL ~88 GAL UNKNOWN STORAGE ROOM METAL CONTAINERS LUBRICANT ID PERCENT COMPONENTS . HAZARD LIST Z888.~ 188.8 MOTOR Oft. UNKNOWN S PURE TRANSMISSION FLUID 78 GAL UNKNOWN STORAGE ROOM PLASTIC CONTaINER[SI LUBRICANT tD PERCENT COMPONENTS HAZARD LIST 12Z4.~8 !88.8 8RAKE FLUID, HYDRAULIC UNKNOWN PRGE 3 12/23/88 IZ:SS MATERIAL SAFETY DATA SYSTEMS, INC. (80S) GAB-G8~O BUSINESS N~ME THOMAS STALL. INI:~S CHEVRON ID NUHBER 215-000-000359 LOCATION 8~ 34TH ST HiGH HRZRRO R~TING Z B. FIRE PROTECTION / IJRTER SURe, LIES L. RST CHANGE 05113188 BY ESTER 3R SEC 4) THREE FIRE EXTINGUISHERS FOR FIRE PROTECTION, 3~t SEC S)' FIRE HYDRf~NT S0 FT ON 34TH ENO Q ST. EMPLOYEE NOTIFICATION / EVACUATION LAST CHANGE 05/t3/88 BY ESTER 3R SE(: 2) THE AREA IlS OPEN AND EVERYONE MOVES Ag/t¥ & CALL 911,, PAGE 4 1Z/Z3/88 1Z:SS MATERIEL SAFETY DAT8 SYSTEMS, INC. ¢805) 648-6800 BUSINESS NAME THOMAS ST~LLINGS CHEVRON ID NUMBER ZtS-(~-O(~3S9 LOCATION 8(~ 34TH ST HIGH HAZRRO RATING E. MITIGATION / PREVENTION / ABATEMENT ,L~ST CHANGE 05/13/88 BY ESTER SEC 1) USE CAI' LITTER FOR SPILLED GASOLINE,. NO REMOTE PUMP SHUT OFF. WA£;TE OIL IN UNDERGROUND TSNK. AUTOMATIC SHUT OFF NOZZLES. P~GE S 1Z/Z3/88 IZ:SS MATERIAL SAFE'fY DATA SYSTEHS~ INC. (805> 648-,B800