HomeMy WebLinkAboutBUSINESS PLAN (3)DEC 11 2002 15:54 BKSFLD FIRE PREVEHTIOH {GG1}852-2172 p.2
CITY OF BAKERSF~LD '-
OFFICE OF ENVIRONMENTAL SERVIC :E.S
1715' Chester Ave., Bakersfield, CA (661) 326 3979
.APPLICATION TO PERFORM A TANK TIGHTNESS TEST/
SECONDARY CONTAINMENT TESTINGfYRACER TESTING
PERMIT TO OPERATE #
o~,~A~S'~f,~/,e /( ~,~ '.,
TANK ii VOLUME ,.,CONTENTS
/ 9 0o
~T~CA~ON $
~A~~ mTmTo ~ CO~UC~ ~/
~PRO~D BY [ DA~ ~IGNA~~F APPLICA~
Hazardous Materials/Hazardous Waste Unified Permit
~ CONDITIONS OF PERMIT ON REVERSE SIDE
This ~ermit is issued for the followin_o:
[] Hazardous Materials Plan
13 Underground Storage of Hazardous Materials
Permit ID #:: 015-000-001297 n Risk Management Program
D Hazardous Waste On-Site Treatment
CIRCLE K STORES INC #I
LOCATION: 5600 AUBURN ST 2 ~ ~ -~ ;,%
~'~. ~ ~'"~.. -"' :' ' ''i~, ,~,.
TANK HAZARDOUSS0~§~AN'(~E '~:~.: CAP~C~ ~ii~::,, DISPENSER':~ANS*MONITORING
0~5-000-00~2~7-0002 MI~GRAD[ U~kE~D[D GASOCI~[~)}~ ' ~;:':)~:;~00 'FcO~T ~EeU. SHUTS:~ SHfiAR VAC.
015-000-001297-0003 REGULAR UNLE4DED GASOLINE ;:~ .'~: ~'00~0'ELOAT MECH~"SHUTS 6~F SHEAR VAL.
OFFICE OF ENWRONMENT~L SER WCES
1715 Chester Ave., 3rd Floor Approved by:
Bakersfield, CA 93301 om~ors,~s~i~ '
Voice (661) 326-3979
F~ (661) 326-0576 Expiation Date:
ITE DIAGRAM FACILITY DIAGRAM
Circle K Stores Inc. #8605
Business Name:
Area Map # 1 of 1
North Name of. Area: Circle K Stores Inc. #6605
5600 Auburn St., Bakersfield CA
S T 'U-V
P Q R Vacant Maxwell's Today
Vacant
Vacant Vacant 4/95 Restaurant Cleaners
4/95
5600 Fairfax Rd.
Driveway
Scale 1" = 26'
Store #8605 Parking
5600 O
Shopping Avburn St.
Center r-
Parking Lot
Shutoff
Gas
Exit ~ Pumps
Counter
Exit % 1 OK
K*'~. ~ Gal
O ~" 10K
~""~ ~ Gal
~' 1OK '~.
:Plai~t~ .......................
Driveway ~lewalk
-5-
, 'SYMBOLS
GAS ".. I MSD$] MSDS STORAGE."
FENCE (ALL-TYPES)
ELECTRIC ~ INDICATE HEIGHT
-- STANDARD DOOR
spRINKLER FIRE DEPT.
CONNECTION
I 0,000 ! STORAGE
Ga.l i TANKS- LIST
FIRE
HYDRANT
- PUBLIC L. - .... CAPABILITY
t"'t'"tT't'"~ RAILROAD TRACKS
(~ FIRE HYDRANT - PRIVATE ......
0,000 ABOVF..GROUND TANKS
( ~ AUTOMATIC SPRINKLERED Ga.l
FIRE ALARM P,,:STICID= AREA
TYPES OF HAZARDO IS MATERIALS
FLAMMABLE <~> LIQUID
<~ CORROSIVE ¢> SOLID
· :POISON EXiPLOSIVE GAS
"' I MP PLAN .
· Si[TE'DIAGRAM ~ FACILITY DIAGRAM
Business Name: Circle K Corporation #8605
. .. Area Map #1 of
North Name of Area: Circle K Corporation #8605
5600 Auburn Street, Bakersfield CA
0 P Q Scoops T U V
Today
Rage Vacant Vacant 'N' Cafe Vacant Cleaners
Salon Slices Mad
:::::::::::::::::::::::::::::::::::::::::::::::
5600 Fairfax Rd.
D ri vewa ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
[iiiiiiiii d Store #8SOS iii!iiiiiii Parking. t
[ii::::!i::::!::: 5 8 0 0 ' ::::.~::::
S h o p p i n g [::~i;i~i~?:~ B av b u r n S t. · : ;ii~::: L
Center
a
P a r k ir, g L o t[~i~i~i??i~i E x ,. . ;i~i~ii?~;iii~. n
£~X~__/ ~ ~ -, .Pumps
t~!~,~ .' ,co,,.,.,
'-Joi".
'-.~o~'-/'.-/
/" '-.'-.Gal ", I
'...~o~'-::-.-.~
I
........................................ D~,~,~.~ ............
SITE ~DIAG'RAM ~ FACILITY DIAGRAM
'- Business Name: Circle K Corporat~ion //8605
Area Msp # 1 of i
·
North Name of Area: ~Cirele K Corporation:
figO0 Auburn St.,'Bakersfield
o P o ~*-ee*, ~a~e's~;'"~a v
· Today
Rage Vaoant Vaaant I 8 '
Sal°n~ I II T [ U IGle&ner'
t t t'
80oop8 El Pollo Vaoant
5600, Fairfax Rd. '~' Plu8 '
Scale
1"
" 811oe8
Drlvewa
Parking t
"' :.~ ~ 6 o o ~ .
. ~:~ E x t. ~ · d
~U mp *~l '
~}~ ~:, ..................... : .................. ~m~m ~ ~ :'
&l
'.-.,o~'4:-.-.'~
,. .....Dr I veway
CITY OF
BAKERSFIELD
-- 5-- ·
Circte K Corporation #8605 (¢) E.M.S.S. - 04/89
'SYMBOLS
'G{~r GAS ' ~_MSD$1 MSDS STORAGE
· FENCE (ALL TYPES)
ELECTRIC ~ INDICATE HEIGHT
WATER '~'"" · GATE IN FENCE
J-- STANDARD DOOR
: SPRINKLER FIRE DEPT.
CONNECTION
---~ UNDERGROUND
I 10,000 ~ STORAGE
I
//~ Ga.I I TANKS -' LIST
FIRE
HYDRANT
- PUBLIC L - CAPABILITY
FIRE HYDRANT- PRIVATE iii i i. i! RAILROAD TRACKS
'~ 0,000 ABOVEGROUND TANKS
(~ AUTOMATIC SPRINKLERED Gal.
BUILDING OR AREA
O EVACUATION AREA
(~ FIRE ALARM .. ~ PESTICIDE STORAGE
AREA
TYPES OF HAZARDOUS MATERIALS'
FLAMMABLE <~ LIQUID ,
,' <~ CORROSIVE <~ SOLID
<~:' WATER REACTIVE <~ GAS
<,~ EXPLOSIVE <~ RADIOLOGICAL
WASTE EX, AMPLE: FLAMMABLE
~RCLE K STORES,~N~ ~#8605 siteID:.0tS-021'Z001297 +
Manager :.T~-~.I ~ .......... - BusPhone: (661) 871'27979..
· LOcation: 5600 AUBURN ST 2 ~ .Map : 103 CommHaz':·Low
City : BAKERSFIELD ~' Grid': 13C ~Facunits: 1 AOV:
CommCode:· BAKERSFIELD STATION 08 SIC Code:5541
,_ EPA Numb: · - DunnBrad:04-856-4975'
· Emergency,Contact' / Title.' EmergencY'contact / Title
SERVICE CONTACT, CTR / ~ ,[JUSTI~ PETERSON / RETAIL TERR SUP
BusineSs Phone: (866) 805=4357x Business Phone: (661) 978-4822x
24-Hour Phone : (866) 805-4357x 24-HOur Phone : (661) 978-4822x
Pager Phone· : ( ) - x Pager Phone : ( ·) - k
Hazmat Hazards: Fire press ImmHlth DelHlth
Contact : jANETTE THOMPSON Phone:, (925) 277-2404x
MailAddr: 2000 CROW CANYON PL 400 . State: CA
City ,: SAN RAMON Zip ': 94583
Owner ~ CIRCLE K STORES INC Phone: (602) 728-7080x
Address': PO BOX 52085 ~ . State: AZ
City : 'PHOENIX. · Zip : 85072-2085
............. =Z ..................... d ........... = ....... ...... , ............... +
Period ,': to TotalASTs: =~ Gal
Preparer: .TotalUSTs: = GaI
Certif'd: RSs: No
ParCelN0:
Emergency. Directives:
,, ~-~CL~_ ~)'LU~Do hereby ce~i~ .th~ I have
" reviewed the a~ed haza~°us m~efials manage- .-
maRt
plan
for
· any corrections conaitute a complete and co~ect man-
agement plan ~or my facili~.
~RCLE K STORES INC~'#8605' ~i.teID:~ 015-021-001297
.... ~ STORAGE CONTAINER DATA (UST FORM. A) --
Last-Action ,Type:~ ~
+--~-= ......... ~--' ........ -FAcILITY/SITE INFORMATION ........... 2'---' ....... '----+
BUsiness Name: CIRCLE K STORES INC #8605
Cross Street : ~
Business Type: Org Type:
Total Tanks 3 IndnRes/Trust: No. PA Contact:
....... a .... £r-- ......... PROPERTy OWNER INFORMATION-.7-r--~ ..................
Name. : JUSTIN PETERSON Phohe: (66.1) 978-4822X
Address:
City . : State: ZiP:
Type :
TANK OWNER INFORMATION .............................
Name : jUSTIN PETERSON Phone:' (661) 978-4822x
Address:
City · State: ...Zip:
Type :
+-~ .......... ~ .... ' ...... ~ ......... ---- ............................ r ..... r ......
BOE UST,Fee# : 032073
Financ'l' ResP: GUARANTEE
Legal NotifI : Tank Owner-~Mailing Address
....... ~'~ .......... .__. ................. . .....................................
Date:04/25/20.00 Phone: ('925), 277-2404x
Name:LANETTE THOMPSON Ttl:REGIONAL COMPLIANCE SPEC.
State UST # : 1998 Upg Cert#: 00835
~= =
,- -2- - .' 03/05/2004
'+.~iRcLE K STORES INC #.8~05 ~ ': '' SitelD:'015-021-001297-+
+= Hazmat Inventory-~ ~' By Facility Unit +
+== MCP+DailyMax Order. = ' ' ' .FiXed cgntainers., on'Site +'
+ + .... ~-~+ + ..... + .......... +-J--+---+
~1 Hazmat Comm°n'Name.-~ - " ISpooHazlEPA'HazardSl 'F'rm I DailyMax IunitlMCPl
PROPANE "~ " E F P' IH' G 60.00 FT3 Hi.
UNLEJ~ED PLUS GASOLINE· F IH DH L 10000.00 GAL .Mod
MIDGRADE UNLEADED GASOLINE F ''IH DH L ' 10000.00 GAL Mod
REGULAR.UNLEADED GASOLINE· F IH DH L 10000.00 GAL Mod
CARBON DIOXIDE . F P iH G 2610.00 FT3 .~Min
-.3- 03/05/2004
~IRCLE K ST?ORES INC #8605 " ~ .SiteID:' 0-15-021-001297 +
Invent~ry'~Item 0005"~ Facility. Unit ' Fixed. Containers:on Site +
= COMMON NAME / CHEMICAL NAME" ...... ' ~ =+
Location ,within this .Facility Unit Map:. '.Grid: +___._ .... z~ ......
LOCKED CAGE S .WALL OP"STORE '" ' ¥ ' : " ~: cAs#'
.: .',.. ' ~ . '~. .. 74-98-6
+=== -- ~__ +
+=~STATE + TYPE' ===+=='PRESSURE +'TEMPERATURE ==+==== CONTAINER TYPE +
Gas "' I Pure' I 'Above Ambient I Ambient I PORT. PRESS. CYLINDER I
%==========4 ~ ~-~-- --7
+ AMOUNTS AT THIS LocATION + .
Largest C°ntaine~ ~/ ' Daily Maximum- I" Daily Average
· '. 5.00 FT3 60.00 FT3 20,00 FT3~,
.... ~ ~ ==+
~ ' HAZARDOUS COMPONENTS +===+ .... +
%wt.
100.00 Propane RS
yesl' CAs# I.
74986
~ =+===4 +
~===~ +=== HAZARD ASSESSMENTS ===4 + ~= .... +
TSecretl RS Bi0HazI Radioactive/Amount I EPA Hazards ] NFPA .. USDOT# MCPI
No NO ii N° ' No/ Curies F P IH. ,~ / / ,/ Hi
+ + + . ~ ~ ,7= ~=====+
:= MISC. LOCAL AGENCY DATA --+
Ag_.Definedl: A~.Defined2: A~.Defined3: .. A~.Defined4:
A~.Defined'5: Ag.~Defined-6: A~.Defined7:,
A~.Defined8: .A~.Defined9: .A~.Definel0:
+- Ag. Definell ....... · ............................. ' ..... --,,- ...... ~ ....... ~.-+
+ CIRCLE K sToRES iNC #8605 SiteID: 015-021-.001297
+=.Inventory item 0001 Facility Unit.: Pixed Containers on Site
+== COMMON NAME /'CHEMICAL NAME =~ ==+
UNLEADED PLUS GASOLINE:. . " '~ [ Days On Site
--Location within, this Fa¢.ility Unit .Map: Grid: -* ....... ~--~--~--~+
SE CO~ER(OF PROPERTY ' '" ' ' I' CAS#8006-61-9
+ ....... ~
+= STATE =+= 'TYPE '===+== PRESSURE ===+'TEMPE~TURE ==+===' CONTAINER TYPE
Liquid [ Mixture I A~ient I, A~ient ,[ ~DER GROUND TANK
+=== ~ ~ ~ ~== ==+
': ~'AMO~TS' AT THI'S LOCATION -
t0000 00 GAL 10000.00' GAL 7000.00 GAL
+ ~ ~
q += HAZARDOUS COMPONENTS +===+ ....
~1'00.00 Gasoiifie No 80066'19
+ + ~===+
+ ....... +===+== ~ ~ZARD ASSESSMENTS ===q .... ~ +=====+
ITSecret[' No NoRSlBi°Hazl Radi°active/Am°untNo No/- Curies EPA HazardsF IH DH NFPA/// USDOT# I MCP
+ ~===~ ~-. ~ ~===== ~ +
~ MISC. LOCAL AGENCY DATA
Ag.Definedl: A~..Defined2: A~.Defined3: A~.Defined4:
' .Ag.Defined5: Ag.Defined6: Ag.Defined7:
Ag. DefinedS:~. Ag.Definedg: Ag,Definel0:
.- -5-' 03/05/200
.~IRCLE K STORES INC #8605 · SiteID: 015-021~001297
+= Inventqry ~Item 0001 --- Facility Unit:.Fixed Containers.on site
STORAGE CONTAINER DATA (UST FORM,B and~-AGENC¥-DEFINED)~ Page 1 of 2~'
Last Ac~i°n Type~ ....
.-LOcation I~',Site: sE CORNER OF PROPERTY
..... ~------,--'--' .............. TANK. DESCRIPTION ' ' '
I 'Tank'ID#: 1 'Mfr:.UNKNOWN '"' Compart Tank: N
' Installed: 3/1988 capacity: 10000 Gals , No'. Of Comparts:
Additional.~info: -.~ ..
............ ,-' ..... ~---' .... ~ ..... TANK,CONTENTS ...... ' '- ....................
T~nk Use: MOTOR VEHICLE'FUEL Petr°l Type:'PREMIUM UNLEADED
· Marl Name:UNLEADED PLUS,GASOLINE' Cas #: 8006261-9
...... ' .... r-,- " TANK CONSTRUCTION ..............................
Type : DOUBLE WALL'
Material(p);:: FIBERGLASS ..
Material(s).:'FIBERGLASS
Lining : UNLINED Installed:
Corr Prot: 'FIBERGLASS REINFORCED PLASTIC Installed:
.Spill Cnt : 1988 · .. Alarm .. .: Exempt: No
Drop Tube : 1988, Ball FlOat :
Striker'Plate: 1988 t Fill Tube S/O: 1988
+ ............................ TANK LEAK-DETECTION·
Sgl. Wall: ~. Dbl Wall: INTERSTITIAL MONITORING
TANK CLOSURE INFORMATION/PERMANENT CLOSURE IN PLACE
Last' used:. Qty Remaining: Was Filled: No
~ ~-6- 03/05/2004
+ ~IRC~E~ SToREs !Nc #8605 ~ "SiteID: 015-~021-001297 +
%= Invent~rYItem 00011= ~ "' FaCility Unit: Fixed Con~tainers on Site +
+ STORAGE CONTAINER~.DATA (UST .FORM B and AGENCY-DEFINED) Page 2 of 2
+--- ' ---~-t:[-' ....... ~,---~-,,- PIPING CONSTRUCTION .: ........ ~'- - ..... ~-.- +'
," underGroundPipSng . Abo~eGr~und Pi'Ping'
Type : PRESSURE "- .-,. " . '..
-Const: DOUBLE WALL .. ·
Mfgr : · · ....
· Mtl-:-FIBERGLASS
Corr .:
Prot:
+ ........................ ~-- PIPING LEAK DETECTION ..... 't ......... · ...... · .......
.underGrouhd Piping 'AboveGround Piping
AUTOMATIC LEAK DETECTORS
+ ........................... DISPENSER CONTAINMENT .............. · ..............
I Installed: 06/01/1998 Type: FLOAT MECH. SHUTS OFF SHEAR VAL.
+ ........ + ............... -- OWNER/OPERATOR SIGNATURE ..........................
IDate: 04/26/2000
Name:MERLIZA Z. ALCALA Ttl:REGIONAL COMPLIANCE SPECIALIST
· Prmt Number,: 1297 Approved: Yes~ Expiration Date: 06/30/2006
+-' ........... ~ ............. ~---- AGENCY DEFINED ...............................
TANK/LINE TEST :08/26/2002 PASS
CP CERT. :
MANWAY ~INSP. :07/01/1999
UST MONIT..,CERT:02/19/2003
'- " " : -7.- ' : '. 0~/05/2004
+'CIRCLE K ST6REs INc #8605" - ~' ' SiteID: 015-021~001297
.~-_+=,Inv%ntory ittem 0002 Facility Uniti Fixed:Containers on Site
+== COMMON NkME:/ CHEMICAL NAME --
MIDGRADE UNLEADED GASOLINE
' ' · "-. ' :'I ' 6s '
LocatiOn within this Facility Unit Map; Grid -+- ·
SE CORNER OF PROPERTY ....... CAS#
- . '~ ' ' 800'6-61'-9.
+= STATE =+= TYPE ===+== PRESSURE ===+ TEMPERATURE ==+~=== CONTAINER TYPE .....
I .LiqUid .I. Pure I Ambi'ent . I Ambient I UNDER GROUND TkNK
~+= 4 ~
+- + .AMOUNTS AT THIS LOCATION =
I' Largest C°ntainer I ' ' 'Daily Maximum' Daily Average
~10000.00'GAL 10000.00' GAL. 6550.00 GAL
+ t. ~= ....
+ =~ " HAZARDOUS COMPONENTS ~==~4'
100.00 Gasoline " No. 8006619
+=======%, ~===+
~ ~===~ ~ HAZARD ASSESSMENTS =='=~ ~ + .....
[TSecret ~SIBioHaz Radioactive/Amount' EPA HazardsI NFPA I USDOT# I MCP
No ' No No/ '~' Curies F~ IH DH· / /-/ Mod
· 4 ~===~ ~ ~ ~ ~ +=====+
4 MISC.'LOCAL AGENCY DATA
Ag. Definedi: Ag. Defined2: Ag.Defined3: Ag.Defined4:
Ag.'Defined5: Ag,·Defined6: ~ Ag.Defined7:
At,Defined8: Ag.Defined9 . Ag.Definel0:
+- Ag.Definell '- _ ................................... = .... ·
'CIRCLE K ~STORES INC #8605~~ -SiteiD' 015-021':001297
+= Inventory i%tem 0002 ~' ,Facility Unit: Fixed.containers on Site
STORAGE CONTAINER DATA (UST~FORM B and AGENCY-DEFINED~)~Page 1 of 2
Last .Action. Type: · : ~ '~
~Location 'In Site: SE' CORNER OF~PROPERTY ' · '~
.... u ...... '____=_£L_i_u_2_, TANK DESCRIPTION ·----~ ............... r.~ ......
Tank ID#: 2 ' Mfr: Unknown ~ Compart Tank:~·N
Installed:· /1988 Capacity:, 10000. Gals ~ No. Of Comparts:
Additional iInfo: ~ . : ,
+---' ....... ~ ..... ~- TANK CONTENTS --~---+
~Tank'Use:~MOTOR vEHICLE FUEL Petrol Type: UNLEADED· PLUS/MIDGRADE
Mati~Name:MiDGRADE UNLEADED GASOLINE · Cas #: 8006-61-9
~- - - - - ...................... , TANK CONSTRUCTION .... - ~.- ........ ~ .... ~ ............
~Type : DOUBLE WALL~
~Mate~ial (p): FIBERGLAss
Material(s): FIBERGLASS ~. ·
Lining : UNLINED,' Installed:
Corr Pro·t: FIBERGLASS REINFORCED PLASTIC Installed:
Spi~l 'Cnt : 1988 Alarm :. Exempt: 'No
Drop Tube ~:' 1988 Ball Float. :
Striker Plate: 1988 Fill Tube S/O: 1988
............. ~--~ ............ ~TANK LEAK.DETECTION .... ' ....... ' ................ --+
Sgl Wall: ~ Dbl Wall: INTERSTITIAL MONITORING'
TANK cLOSURE INFORMATION/PERMANENT,CLOSURE IN PLACE
Last used: Qty Remaining:, was Filled: No
+ CIRCLE ~.-STQRES INC ~8605 .v ~., == SiteID: 015-021-001297
+= InventOry item 0002 Facility Un~t: Fixed Containers on Site
+ ..... STORAGE CONTAINER DATA '(UST FORM B and,AGENCY..DEFINED) Page 2 .of 2
+-- ' .... ' ~-, ........ ' .......... PIPING CONSTRUCTION ............................
underground Piping · AboveGround Piping
Type.: PRESSURE
Const:'DOUBLE WALL'
Mfgr :
Mtl: FIBERGLASS
Corr :
Prot :
+ ............... PIPING LEAK'DETECTION .......... ..................
UnderGround Piping AboveGround Piping
AUTOMATIC LEAK DETECTORS
............................ DISPENSER CONTAINMENT .................. . ..... r .... +
Installed:-~06/01/1998 Type: FLOAT MECH. SHUTS OFF SHEAR VAL.
............. f .............. OWNER/OPERATOR SIGNATURE ........... ............... +
Date:, 04/26/2'000
Name:'MERLIZA Z. ALCALA Ttl.:REGIONAL COMPLIANCE SPECIALIST
Prmt Numbe~: 1297 Approved: Yes Expiration Date: .06/30/2006
+ ..... ---~ ...................... AGENCY DEFINED ................................
· TANK/LINE TEST :08/26/2002 PASS
CP CERT. ~ :
MANWAY INSP. :07/01/1999
UST MONIT. ~CERT:02/19/2003
+
~CIRCLE K STORES INC #8605 -'--'=--~ ~ siteID: 015-021-001297
+= Inventory Item 0003' ' FacilitY.Uni~: Fixed Containers on Site
+== COMMON NAME / CHEMICAL NAME . +=
I -REGUI.~R UNLEADED GASOLINE -, Days On Site
· 365
'Location within this Facility Unit Map: ' Grid: +,---~-, .........
I~-.SE CORNER, OF' PROPERTy. · : ' ~ . 8006-61-9 CAS#.
+
+= STATE.=+= TYPE +== PRESSURE ===+ TEMPERATURE ~=+==== CONTAINER TYPE
Liquid 'l Pure I Ambient. I Ambient I UNDER GROUND TANK
+ AMOUNTS AT THIS LOCATION
~Largest ~Container Daily Maximum I Daily Average
10000.00 GAL 10000.00 GAL 8000.00 GAL
==+=
~ -- HAZARDOUS COMPONENTS + +
10.0 00 Gasoline. No . 8006619
==+,===+
~===4 += HAZARD ASSESSMENTS ==:+== ~ ~ .....
TSeCretI RS .BioHazI Radioactive/Amount EPA~HazardsI NFPA. USDOT# MCP
.No No. "'No .~ No/ Curies F IH DH / / '/ ,Mod
~===~ + t =4 ~= ~=====
MISC. LOCAL AGENCY DATA . ==+
Ag.Definedl: Ag.De'fined2: Ag.Defined3: Ag.Defined4:
Ag.'Defined5: Ag.Defined6: Ag.Defined7:
Ag.DefinedS': Ag.Definedg: Ag.-Definel0:
: ' -11- - 03/05/2004
+'~CIRCLE K.STORES~INC #8605~ SiteID: 015-021-001297
+= Invent6ry :Item 0003~ Facility 'Unit": Fixed Containers on Site
4 STOP~AGE CONTAINER DATA~(UST FORM B and AGENCY-'DEFINED)'Page 1 of 2 ,
i Last' Action.Type:~
LocationlIn Site: SE CORNER OF PROPERTY
~, +_u .......... ~ ....... =___ ........ TANK DESCRIPTION -~ ...................... ~ .....
Tank ID#: ~3 Mfr: Unknown, Compart Tank: N
Installed: 3/1988 Capacity: 10000~Gals No. ,Of Comparts:
Additional Info:
.............. , ....... ~__i ........ TANK CONTENTS ....... ~ ........................
I Tank Use~: MOTOR VEHICLE FUEL Petrol Type': REGuLAR'UNLEADED
. Matl Name.:REGULAR UNLEADED GASOLINE Cas #: 8006-61-9
+ ................ ' ............ TANK CONSTRUCTION ............ ~-' ..... ...........
Type : DOUBLE' WALL
Material(P): FIBERGLASS
Material(s)i: FIBERGLASS
Lining : ~UNLINED ,,~ Installed:
~ Corr Pr°t: FIBERGLASS REINFORCED PLASTIC Installed:
Spill Cnt : 1988 ~- Alarm : Exempt: No
Drop, Tube : 1988 Ball Float :
Striker Plate: 198'8 ~ ~ Fill Tube S/O: 1988
,+ ............................ TANK LEAK DETECTION '
Sg! Wall: ~ Dbl Wall: INTERSTITIAL MONITORING
TANK cLOSURE INFORMATION/PERMANENT CLOSURE IN ?LACE
Last Used: Qty Remaining: Was Filled: No
+
- ,' -12- ,03/05/2'004
% ~IRCLE K STORES INC. #8~605. , ~ siteID: .01'5-021-001297 +
+= Inventory item 0003 ,Facility Unit: Fixed Containers on Site +
~ ....... STORAGE CONTAINER DATA'(UST FORM. B and AGENCY-DEFINED) Page 2 of .2
...... ~-~--.-.r--- ............. x-PIPING 'CONSTRUCTION ........ -~ ..................
-Und~rGroundPiPing AboveGround-Piping
Type :, PRESSURE '
' Const: DOUBLE~WALL
Mtl : FIBERGLASS
+ ........... PIPING LEAK DETECTION ---' .....................' ....
UnderGround Piping AboveGround Piping
AUTOI~TIC LEAK DETECTORS.
· ,+ .... - ............ ~ .......... DISPENSER CONTAINMENT ............................
I Installed: 06/01/1998 .Type: FLOAT.~ECH. SHHTS OFF SHEAR VAL.
+___, ....... 2_'__'_2 ......... oWNER/OPERATOR SIGNATURE '- ..........................
Date: 04/26/2000
Name:MERLIZA Z. ALCALA Ttl:REGiONAL COMPLIJ~q'CE SPECIALIST
Prmt Numbe~: 1297 ' Approved: Yes Expiration Date: 06/30/2006
· ~~ ....... ~ ...................... AGENCY DEFINED ..... = ..... '-' ...... = ...... r .....
I TANK/LINE TEST. :08/26/2002. PASS
CP CERT. :
MANWAY INSP. :07/01/-1999
. UST MONIT. CERT:02/19/2003
+ CIRCLE K sTORES INC #8605 - SiteID:, 0115-021-001297
+= InventoryilItem'0004 Facility Unit: Fixed Containers on' Site
'+=='COMMON NAME /. CHEMICAL NAME
I.,CARBON DIOXIDE.~ Days on-site
'~ .. 365
LoCation.'within this FaCility Unit Map: Grid: + '
IN STOREROOM BACK OF STORE ,I "CAS# '
+--~-~-~-
+= STATE + TYPE ===+== PRESSURE ===.+ TEMPERATURE ==+==== CONTAINER TYPE =+
Gas I Pure- I Above Ambient
+ .... ~ AMO,UN'TS AT THIS LOCATION
'Largest"C°ntainer I ' ' Daily Maximum I Daily Average
2610'.00 FT3 · 2610.00 .FT3 1805.00 FT3
~= ~ ~
+= +'= HAZARDOUS. COMPONENTS ~==4
100.00 Carbon. Di°xide No 124389
+ +===+ ~ ~HAZARD ASSESSMENTS ===4 =4 + .....
TSecretINo NoRSIBi°HazINo. . Radi0active/Am°unt I EPANo/ Curies F P Hazards IH "NFPA/.// I' USDOT# ' MCP I' Mis
4 +===4 4 + t =4 ~=====+
4 MISC. LOCAL AGENCY DATA =+
Ag.Definedl: A~.Defined2: A~.Defined3:' A~.Defined4:
A~.Defined5: Ag. Defined6: A~.Defined7:
A~'.Defined8: A~.Definedg: A~.Definel0:
+- Ag. Definell ' --
· ' -14- 03/05/2004
+ ~I'RCLE K ~STORES.INC #8605 'SiteID: 015-021-001297
- 4 .... 'Fast Format
+= Notif.~ilEvacuation./MediCa! Overall Site
= 04/27/2000
+== Agency Notification'
IF EMERGENCY-RESPONSE ASSISTANCE. IS REQUIRED NOTIFY:
BAKERSFIELD CITY ENVIRONMENTAL SERVISES 326-3979 AND WITHIN ~24 HRS NOTIFY
..~'STATE OFFICE.: OF EMERGENCY SERVICES 800-852-7550.
IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY,
PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY
NOTIFY: ~
FIRE DEPT - BAKERSF~IELD' FIRE DEPARTMENT· 9-1-1
POLICE'DEPT -'BAKERSFIELD POLICE DEPARTMENT 9-1-1
BAKERSFiELD'CITY ENVIRONMENTAL SERVICES· 9-1--1
.STATE.OFFICE OF EMERGENCY SERVICES 800-852-755'0 OR 916-262-1621
+ =+
+=== Employee Notif-./Evacuation 01/18/2000
uPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY. (SHOUTING)
NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF HIS/
HER AREA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. THIS INCLUDES
ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE RELEASE OF
FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES (IF
UNOBSTRUCTED) AS DIAGRA~MED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE
NOTIFIED TO EVAUCATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED
EVACUATiON.STAGING AREA-WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR.
+-----
..... Public'Notif./EvacuatiOn · 08/13/1997
IF EVACUATION FROM AREA DEEMED NECESSARY,· THESE NEIGHBORING PROPERTIES WILL
BE NOTIFIED IF POSSIBLE:
TODAY CLEANERS 5600 AUBURN STREET SUITE U/V ·872-6920
MAXWELLi'S 5600 AUBURN STREET SUITE T 873-8106
RAGE SA~ON! 5600 AUBURN STREET SUITE P,Q,R,S 872-2360
HIGHLANb HIGH SCHOOL 2900 ROYAL SCOTTS ROAD 872-2777
4 Emergency Medical Plan 01/18/2000
MERCy HOSPITAL - 2215 TRUXTUN AVE - 327-3371 OR
KERN MEDICAL CENTER -1830 FLOWER ST - 326-2000.
+~CIRCLE K STORES'INC~#8605 '-' ' SiteID: 015-021~001297
,~ .. Fast.~Format
~= Mitiga~i°nl/Prevent/A~Latemt ==---=~--=- overali'. . Site
- == 04/11/2002
· + ' .Release Prevention _ ~
Lil.'STORETANK-AND/OR CYLINDERS WITH VALVE PRoTEcTION CAPS INSTALLED.
'2' TANK AND CYLINDERS SHOULD BE STORED URIGHT AND FIRMLY SECURED TO PREVENT
FALLING-OR BEING KNOCKED~OVER'.
3. CONTAINERS~SHOULD BE STORED IN A COOL, DRY, wELL VENTILATED AREA AWAY
.FROM SOURCES OF. HEAT oR .IGNITION AND-DIRECT.SUN LIGHT.
'4'.~'iIF yOu SUSPECT _AN~-PROBLEMS WITH THE TANK NOTIFY THE SUPPLIER IMMEDIATELY
''TO HAVE THE sYSTEM INSPECTED.
+===.Release Containment - 04/11/2002
'1" 1. DIAL 912 INFORM EMERGENCY PERSONNEL THAT THERE IS A RELEASE FROM THE
I REFRIGERATED LIQUID CO2 TANK AND'THE LOCATION OF THE TANK.
I. 2..'EVACUATE EMPLOYEES AND CUSTOMERS FROM THE SITE AND DENY ENTRY TO
~ UNAUTHORIZED PEOPLE.'- ~ ~. .. ,. · .. '
I 3. sTaY UPWIND OF THE SPILL-AND OUT OF LOW-LYING AREAS.
/ 4 ~DO NOT TOUCH OR WALK THROUGH sPILLED MATERIAL. ~
~'5. AVOID BREATHING GASES. ·
~ .6. DO NOT' ENTER THE~.BUILDING UNTIL 'EMERGENCY PERSONNEL HAVE NOTIFIED YOU
~ THAT IT iS SAFE. .. .
/,7.-CONTACT.MANAGEMENT.USING THE EMERGENCY ,PHONE LIST PROCEDURE.'
..... clean uP =- 01/i8./2000
NOTIFY CIRCLE K.ENVIRONMENTAL DIRECTOR (602)'530?5089 FOR COORDINATION~WI~H
HAZARDOUS WASTE DISPOSAL COMAPANY TO REMOVE cONTAMINATED ABSORBENT MATERIALS
IF REQUIRED.
CARBON DIOXIDE
A. RELEaSE'PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND FIRMLy sECURED.
m. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO,
OPEN a5~' DOORS/VENTILATE.
C. CLEAN,.UP PROCEDURES: 'VENTILATE AREA IMMEDIATELY. CONTACT sUPPLIER IF
LEAK IN CONTAINER/VALVE.
%
Other~Resource Activation
+=====
+ ~IRCLEK S~ORES INC #8605 SiteID: 015-021-001297 +
-~ -- Fast Format.+
+= Site Emergehcy Factors Overall site +
+== Special Hazards ---+
+~_
+=== .Utility~Shut~Offs. 08/13/1997 +'
A)' GAS - W~WALL OF'BLDG ON S END (METER) " '
· B) ELECTRICAL - N SIDE OF BLDG E END (METER); BACK RM OF STORE (BREAKERS)-
C) WATER -,sE'CORNER OF SITE (METER) '
D) SPECIAL - EMERGENcy GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
.-E) LOCK BOX - NO
+ .... .Fire Protec./Avail. Water 08/13/1997 +
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER LOCATED ON PREMISES FOR USE BY
CLERK ON DUTY.
FIRE HYDR.ANT-. SE CORNER OF LOT.
...... Building OCcupancy Level +
+--
-17- .4 ~. 03/05/2004
+ ~IRCLE K STORES INC #8605 SiteIDi 01'5-021-00i~97 +
+ Fast Format +
+=~Training ~ ~, Overall, Site +
~+='= Employee:Trainin91~== ~ . . 01/18/2000.~+
WE HAvE 3 EMPLoYEEs A~'THtS FACILITY.
WE 'HAVE/MATERIAL SAFETY DATA SHEETS ON FILE
BRIEF~SUMMARY OF TRAINING PROGRAM: SPECIAL ON-THE-.JOB TRAINING .IN THE'
HANDLING OF HAZARDOUs MATERIAL(S) IS, PROVIDED. IN 'THE FOLLOWING AREAS:
· 1) pROPER MAINTENANCE ANDYUSE OF GASOLINE EQUIPMENT.~
2) USE OF ABSORBENT FOR SMALL SPILLS.
3) EMPLOYEES ARE INSTRUCTED' ON PROPER RESPONSE. TO POLICE, FIRE DEPT,~
EMERGENCY MEDICAL AND CIRCLE K~ENVIRONMENTAL'DEPT.
4) EACH. CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GAsoLINE MANUAL WITH
MSDS'S~FOR GASOLINE AND CO2.
A 'REVIEW OF THE CONTENTS OF THE EMERGENCy RESPONSE pLAN WILL BE MADE BY ALL
NEW EMPLOYEES WITHIN ONE MONTH OF HIRING ANDiBY ALL EMPLOYEES ON AN ANNUAL
BAsis.'
SAFETY ANDEMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION
WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE
EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN
(INCLUDiNGiTHE LOCATION OF TURNOFF VALVES FOR GAS AND~ ELECTRICITY) AND THE
+---- +
+===-Pagei~2 == +
+== Held for Future Use -- =+
+ Held for Future U~e =+
.. · ~;~ > -18- 03/05/2004
-'~/ CONOCOPHILLIPS
ConocOPhillips o.
Phoenix, AZ 85072-2085
(602) 728-8000
March 13, 2003
Circle K Stores, Inc.
Circle K Stores, Inc.
5600 Auburn Street
Bakersfield, CA 93306
RE: HAZARDOUS MATERIALS MANAGEMENT PLANS
Dear Debra Sital:
Attached is the new Hazardous Materials Inventory and Business Plan for your station. This new HMMP is intended to
replace the current HMMP. The "SITE COPY" should be kept in your "Success at the Pump" binder
and available to all employees and agency personnel at all times.
THESE FORMS MUST BE RETURNED TO RHL DESIGN GROUP AS SOON AS POSSIBLE
FAILURE TO RETURN THIS PLAN WITHIN 30 DAYS WILL RESULT IN A $25.00 LATE FEE CHARGE
TO YOURACCOUNT.
FAILURE TO RETURN THIS PLAN MAY ALSO RESULT IN FINES AND/OR CIVIL PENALTIES BY
GOVERNMENT ENFORCEMENT AGENCIES.
Instructions for signing and returning, the packet:
I. Please sign all 3 c'opies of the HMMP where flagged and indicated with a "X".
2. Please return the 2 copies marked "AGENCY" and "RHL FILE to RIlL Design' in the pre-stamped envelope provided AS SOON AS 'POSSIBLE.
3 Keep the "SITE COPY" of the HMMP in your Success at the Pump binder~ and available for inspection.
Use your Site Copy for employee training and have employees sign the training log.
Keep training records at your station.
A copy of the HMMP will be sent to Bakersfield Fire Department
If you have any questions regarding the content of this HMMP, please contact RI-iL Design Group, Ms. Jennifer
Carey or Mr. Steve Skanderson at (707) 765-1660. If you have any additional questions, including invoicing questions,
please contact Para Ruesga, ConocoPhillips, Hazardous Materials Coordinator at (602) 728-4970.
Sincerely,
ConocoPhiIlips
cc: RIlL Design Group, Inc.
2708605
Enclosure
2708605 '~ ali IFIED PROGRAM CONSOLIDATED FOt
'i J . ' FACILITY INFORMATION
BUSINESS ACTIVITIES
, Page I or
BUSINESS NAME (same as FACILITY NAME or DBA-Doing Business AS 3
Circle K Stores, Inc.
A. HA~RDOUS MATERIALS
Have on site~(for any purpose) hazardous materials at or above 55
gallons for liquids, 500 pounds for solids, or 200 cubic feet for
compressed gases (include liquids in ASTs and USTs); or the ~YES ~ NO 4 ~ HA~RDOUS MATERIALS INVENTORY-
applicable Federal threshold quantity for an e~remely hazardous
I~1
CHEMICAL DESCRIPTION(ocs 2731)
substance sPecified in 40 CFR Pa~ 355, Aappendix A or B; or
handle radiol0gical materials in quantities for which an emergency
plan is required pursuant to 10 CFR Pa~s 30, 40 or 70?
B.
UNDERGROUND
STOOGE
TANKS
(USTs)
~YES ~ NO 5 ~ UST FACILITY (Formerly SWRCB Form A)
1. Own or operate underground storage tanks? ~ UST TANK (One page per tank) (Formerly Fd~m B
2. Intend to upg(ade existing or install new USTs? ~ YES ~NO 6 ~ UST FACILITY
~ UST TANK (One per tank
! ~ UST INSTAL~TION - CERTIFICATE OF
COMPLIANC~one page per tank)(Formedy Form C
3. Need to repo~ closing a UST? ~YES~NO 7 ~ UST TANK (closure potion-one page per tank
C. ABOVE GROUND PETROLEUM STOOGE TANKS (ASTs)
Own or ~perate ASTs above these thresholds:
---any tank capacity is greater than 660 gallons, or ~ YES ~ NO 8 ~ NO FORM REQUIRED TO CUPAS
--the total ~pacity for the facility is greater than 1,320 gallons?
D. H~RDOUS~WASTE
1. Generate hazardous waste? - ~ YES~NO 9 ~ EPA ID NUMBE~provide at the top of this page
2. Recycle.mor~than 100 kg/month ofexcluded orexempted ~YES~NO~O ~ RECYC~BLE ~TERIALS REPORT
~ecyclable materials (per HSC ~ 25143.2)? (one per re~cter)
TR~TMENT- FACILI~
: (Formerly DTSC Form 1772)
' ~ ONSITE H~RDOUS WASTE
~~ TREATMENT-UNI~one page per unit)
; (Formerly DTSC Form I~,B,C,D, and L
4. Treatment subje~ to financial assurance requirements (for Permit ~ YES,,,~NO12 ~ CERTIFICATION OF FINANCIAL
by Rule and Conditional authorizaton)? ASSU~NCE(Formerly DTSC Form 1232)
ANNUAL NOTIFICATION (Fo~edy
DTSC Fo~ 1232)
6. Need to repo~ the closure/removal of a tank that was classified as ~ YES~-~NO14 ~ H~RDOUS WASTE TANK CLOSURE
hazardous:waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249)
E. LOCAL REQUIREMENTS 15
(You may also be requi~ed to provide additional info~ation by yourCUPA or local agency.)
UPCF (1/99) 2 .
2708605 i ~ PROGRAM CONSOLIDATED 'FOR.
;; FACILITY INFORMATION
· BUSINESS OWNER/OPERATOR IDENTIFICATION
I. IDENTIFICATION
FACILITY ID# ~] ~ I 1 BEGINNING DATE ,, 100 ENDING DATE lol
BUS1NESS NAME (Sarape as FACILITY NAME or DBA - Doing Business As) 3 BUSINESS PHONE 102
i Circle K Stores, Inc. 661-871-7979
BUSINESS SITE ADDRESS 103
~ . 5600 Auburn Street
104 CA ZIP
CITY i CODE .lO5
'. Bakersfield . 93306
IDUN BRAI)STREET:;, 04-8564975 - lO6 SIC CODE (45541digit #) 'i07
COUNTY ' 108
! KERN
BUSINESS OPERATOR NAME . lO9 BUSINESS OPERATOR PHONE 1 lO
;" Circle K Stores, Ific. 866-805-4357
~ II. BUSINESS OWNER
IO WNERNAME . , 111 OWNERPHONE 112
C~rde K Stores, Inc. 602-728-7080
OWNER MAILING ADDRESS '113
P.O. Box 52085
114 iSTATE 115 iZIP CODE :: 116
CITY Phoenix I AZ i 85072-2085
IlL ENVIRONMENTAL CONTACT
117 CONTACT PHONE 118
CONTACT NAME Janette Thompson 925-277-2404
CONTACT MAILING ADDRESS 119
i . 2000 Crow Canyon PI. Suite 400
, 120 STATE 121 ZIP CODE . 122
ICITY San'Ramon CA. 94583
PRIMA'RY IV. EMERGENCY CONTACTS SECONDARY
iNAME 123 NAME 128
I Se,h/ice Contact Center Jutsin Peterson
TITLE 124 TITLE 129
24 ,Hours Retail Terr. Supv.
BUSINESS 125 BUSINESS PHONE 130
PHONE 866-805-4357 ' 661-978-4822
24-HOUR PHONE' 126 24-HOUR PHONE 131
866_805_4357 661-978-4822
PAGER# '' 127 PAGER# 132
ADDITIONAL LOCALLY'COLLECTED INFORMATION: "
Certification: Based on myI inquiry of those individuals responsible for obtaining the information, I certi0/under penalty of law that [ have personally examined and am
familiar with the in£ormatio.n submitted and believe the information is true, accurate, and complete.
. , . ]BATE ' / 134 INAME OF DOCUMENT PREPARER
UPCF ( 1/99 revised)" : 167 , OES FORM 2730 (1/9
., . UN~D PROGRAM CONSOLmATED F~4 ~
· " . ~ HAZARDOUS MATERIALS
'_ HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRIPTION
· ' , ' ' - ' One page per material per building or area)
· I lADD I' IDELETE I I REVISE 200 i Page '~ ofq
I. FACILITY INFORMATION
BUSINESS NAME Circle K Stores, Inc. 2'708605 3
CHEMICAL LOCATION CHEMICAL LOCATION CONFIDENTIAL 202
SOUTHEAST~.~ CORNER LOT~ EpcP.~[~YES [~]] NO
~i!i ~¢;~ 1 MAP~ (optional) 203 GP,2D# (optional) 204
FACILITY ID# ~.~ -
.' 1 D,E5
II, CHEMICAL INFORMATION
: MIcALN , S C ZT [__]¥es
PETROLEUM HYDROCARBON
If Subject to EPCRA, refer to instructions
207 208
COMMON N,~E REGULAR UNLEADED GASOLINE ~us [~] Yes ~] No
CAS# 209 '
8006-61-9 If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD '
CLASSES (Complete if required by CUPA) 210
I-B FLAMMABLE LIQUID
HAZARD MATERIAL 211 ~ CURIES
PHYSICAL, Check one temSTATEonly) ~ 214 ~ 215
~] a. SOU~ ~]] h. LIQUID ~.~ c. GAS L~¢EST CONTA~NE~ 10000
216
FED HAZARD CATEGORIES [X~ a. FIRE ~], b. REACTIVE ~ c. PRESSURE RELEASE ~]. d. ACUTE HEALTH' ~] e. CHRONIC HEALTH
Check all that apply)
AVEILAGE DAILY AMOUNT 2a7 !MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 22o
8_®O I ~0000 ·
UNITS* t ,~ a. GALLONS [ b. CUBIC FEET ~ I c. POUNDS ~[~ d. TONS 22'11
DAYS
ON
SITE:
222
Check one item only), ifEHS, amount mujt be in pounds. . [ 365
c. TANK INSIDF BUILDING CARBOY . BOX [--~o. TOTE BIN
d, STEEL DRUM SILO CYLINDER [__]p. TANK WAGON
223
STO EPRESSURE AMBIENT OVEAM IENT BELOWAMBI T
%WT , HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS#
1 ~0-100 22~ GA$OI_INF: 227 ~Yes ~[~No 228 8006-61-~ 22~
2 1-14 230 XY[.ENE$ 2a~ ~__~¥es ~No. 232 1330-20-7
4 1-9 238 TOLUENE 239 [~¥es ~]N° 240 108-88-3
241
!5 1-5% 242 ETHYL BENZENE 243 [~Yes ~o 244 100-41-4 245
Imore components are at greater by weight non-carcinogenic, or by weight carcinogenic, paper capturing required
preseni
hazardous
than
if
0.
I%
if
additional
sheets
tbe
M formation·
i ADDITIONAL LOCALLY COLLECTED INFORMATION 246
: If EPCRA, Please Sign Here
UPCF (1/99) 169 OES Form 2731
PROGRAM CONSOLIDATED
· HAZARDOUS MATERIALS
HAZARDOUS MATERIALS INVENTORy- CUEMXCAL )tSCRn'TION
One page per material per building or a~ea)
IADD [ IDELETE I IREVISE 200 I Page ~ of q.
I. FACILITY INFORMATION
BUSINESS NAME
Gir¢le K Stores, Inc. 2708805
CHEMICAL LOCAIION CHEMICAL LOCATION CONFIDENTIAL 202
SOUTHEAST CORNFR LOT EPC~' ~'rES [~ NO
~s ~ I ~ (optional) GRID# (optional) 204
C~~AL I1. CHEMICAL INFORMATION
NAME PETROLEUM HYDROCARBON 205 TRADE SECRET [__~Yes ~X_~qo 206
If Subject to £PCRA, refer to instructions
COMMON [q~ 207 208
PLUS UNI_EADFD GA$OLINF EHs []]] Yes []No
1 209
8008-15 i -9 If EHS is "Yes", all amotmts below mast be in lbs.
IFIRE CODE HAZARD CLASSES (Complete if required by CUPA) 2'I 0
I-B FLAMMABLE LIQUID
211 2'12 213
TYPE (Check one item
PHYSICAL STATE 2'14 ,. 215
(Check one iyem only) [~ a. SOLID ~ b. LIQUID [~ c. GAS LARGEST CONTAINER -
Check all that apply)
AVERAGE DAILY AMOUNT 2~7 MAXIMUM DAILY AMOUNT 2~8 ANNUAL WASTE AMOUNT 2~9 STATE WASTE CODE 220
__
7000' 'I0000
DA
YS
ON
SITE:
222
385
iCheck one item only) if EHS. amount must be in pounds
STORAGE ~a. ABOVE GROUND TANK ~e. ?LASTiCFNONMETALLiC DRUM [~ji. FIBER DRUM ~Z-]m. GLASS BOTTLE ,b. . ,~]~o. R. AIL CAR P.
CONTAINE}~ [ X UNDE~Oi~OUNDT~Ni~' ! If. CaN ~^O I In. PLASTIC BOTTLE OTi4E}~
STEEL DRUM i Ih. SILO CYLrNDE~ liP. T,,~Ni4 WAGON
223
STORAGE PRESSURE ~ a. AMBIENT ~b. ABOVE AMBIENT [~]]c. BELOW AMBIENT 224
%WT .' HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS#
I ~0-100 226 GASOLINE 227 ~]Yes X~,'N o 228 8008-61-~ 229
2 ~-~4 230 XYLENE$ 231 ~¥es .~No 232 1330-20-7 23~
3 <10.0% 234 ETHANOL 235 [~]Yes []~No 236 84-17-5 237
14 1-9 230 TOLUENE 239 ~-]Yes ~No 240 108-88-3 241
i5 1-5% ETHYL BENZENE Yes o 1004%4
If more hazardous components are pr~-~nt at greater than I% by weight if non-carcinogenic, or 0. I% by weight if carcinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED [NFOR. MATION 246
. If EPCRA, Please sign Here
UPCF (1/99) 169 OES Form 2731
~D PROGRAM CONSOLI])ATED F~I
~ HAZARDOUS MATERIALS
HAzARDoUS MATERIALS INVENTORY- CHEMICAL DESCRIPTION /
· ' One page per material per building or area) -
I. FACILITY INFORMATION
BUSINESS NAME i;,.,~ ~;,":r2'e K ot"ores,, Inc. 2708605 3
l C~ICAL LOCAnO~. C~CA~ LOCAr~O~ COfFeE,trIAL ~0~
SOUTHEAST CORNER LOT [PC~ [~s E~ NO
~ ~ 1 MAP~ (optional) 203 GRD# (optional) 204
FACILITY ID# 1 E4,5
II. CHEMICAL INFORMATION
CHEMICAL N.~v~E PETRQLEUM HYDROCARBON 205 TRADE SECRET · [_dYes X[~No 206
IfSubiect to EPCR.& refer to instmcdons
COMMON NAME 207
PREMIUM UNLEADED GASOLINE E.s ~ Yes []No 206
CAS# 2O9 ·
8006-61-9 If EHS is "Yes", all amounts below must be m lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210
I-B FLAMMABLE LIQUID
HAZARD MATERIAL 211 212 2:13
PHYSICAL STATE [] E~ [] 214 ¢ 215
Check one item only) a. SOLID b. LIQUID c. GAS LAROEST CONTAINER 10000
FED'HAZARD CATEGORIES 216
i(Checkalltha, apply) : ~ a. FIRE ~ b. REACTIVE ~ ¢.PRESSURE RELEASE ~ d. ACUTE HEALTH
AVERAGE DAiLY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220
, 65_0_0 · 10OQ0
Check one item only) ifEHS, arn~_unt mu~st be in poun~l~ . 365
II.d. STEEL DRUM SILO CYLINDER IIP. TANK WAGON
223
~ %WT '~ I ~IAZARDOUS COMPONENT (For mixture or waste only) EHS CAS#
I ~0-~00 22~ GASOLINE 227 ~Yes [~No 228 8006-61-~ 22~
232
233
~ / es o 1330-20-7
3 <10.0% 2341
/ iETHANOL 235 ,~Yes [~No 236 64-17-5 237
5 1-5% 242 i ETHYL BENZENE 243 [---~lyes ~No 244 100-41-4
245
if more hazardous comp.hems are present zt grea[er than I% by weiBht if non-carcinogenic, or O. I% by weight if carcinogenic, altacb additional sheets of paper cap[urin~ [ha required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246
IfEPCRA, Please Sign Here
UPCF (1/99) 169 OES Form 2731
PROGRAM CONSOLIDATED F~ ~RiALS i
', I HAZARDOUS MATE
HAZARDOUS MATERIALS INVENTORY' CI~EMICAL ~)EscmeTION'
One page per material per building or area)
I. FACILITY INFORMATION
BUSnqESS NAME
Circle K Stores,' Inc. 2708605
CHEMICAL LOCATION : CHEMICAL LOCATION CONFIDENTIAL 202
NE CORNER NEXT TO ENTRANCE EPC~ E~Y~S 1~ NO
FACILITY ID# [ ~ MAPtt (optional) 203 GRID# (optional) 204
II. CHEMICAL INFORMATION
CHEMICAL NAME PETROLEUM HYDROCARBON 205 TRADE SECRET ~__jYcs XL~o 206
If Subject to EPCRA, refer to instructions
CON~VION NAN~ 207 208
PROPANE EHS Yes No
209
74-98-6 If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210
I-A FLAMMABLE LIQUID
HAZARD MATERIAL 211 . 213
TYP£ (Check one item [~ a. PURE ~-~ ~.MIXTURE [] c. WASTE RAD,OAOTIVE [] Yes ~[No 2'12 CURIES
PHYSICAL STATE 214 ~. 215
:Check o.e,tem o,,y) [] a. SOUr~ E~.b' L[QU~D [] c. OAS LA*OEST CONT~E~5
FED HAZARD CATEGORIES 216
l(Check all that apply, ~ a. FIRE ~ b. REACTIVE ~ c. PRESSURE RELEASE [~ d. ACUTE HEALTH U e. CHRONIC HEALTH
lAVER. AGE DALLY AMOUN? 217 MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT ¢19 STATE WASTE CODE 220
I 2_0 . 60
IUNITS* ~ a. GALLONS ~-b. CUBIC FEET ~ c. POUNDS [~ d. TONS 221 DA YSONSITE: 222
](Check one item only) <'-- if EHS_ amount mu~'~t be in pounds. 365
STORAGE ~i--~a AB6VE GROUND TANK :[~e. PLASTIC/%IONMETALLIC DRUM ['~i. FIBER DRUM [---~m. GLASS BOTTLE ~---]o. RAIL CAR
i !c. TAN~: ~s~=E ~U~Dr~O ~g. C~BOY ~. BOX ~o. TOTE Bm
~. STEEL DRUM ~h. S,LO ~l. CYL~DER ~,. *AN* WAOOS
223
STORAGE PRESSURE [~ a. AMBIENT ~b. ABOVE AMBIENT ~c. BELOW AMBIENT 224
%WT ." HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS#
1 226 PROPANE 227 Cpfes X~No 228 74-98-6 229
2 230 ETHANE 231 ~Yes .~'qo 232 74-84-0 233
!4 238 239 [~es _~qo 240 241
5 242 24:3 [--~Ye, ~-~qO~ 244
iIf more hazardous components are prc~cnt at greater than I% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information.
i ADDITIONAL LOCALLY COLLECTED INFORMATION 246
If EPCRA, Please Sign Here
UPCF (1/99) i. 169 OES Form 2731
· PROGRAM CONSOLIDATED
HAzARDous MATERIALS INVENTORY- CHEMICAL DE_SCRIPTION
~ One pase per material per buildin
I xl~o I )DELETE . I IREVISE 2oo I' Page r~ of'
I. FACILITY INFORMATION
BUSINESS NAME ~ !: 3
Circle K Stores, Inc. 2708605
CHEMICAL LocATION CHEMICAL LOCATION CONFIDENTIAL 202
STORAGE AREA EPCRA []Y'E'S [~ NO
FACILITY ID# g~ g~j}*" ' [ 1 ~1 (optional) 203 OKI33#B3 (optional) 204
II. CHEMICAL INFORMATION
CHEMICAL NAME CARBON DIOXIDE 205 TRADE SECRET ]lYes ~40 206
1£ Subject to EPCRA, refer to instructions
COMMON NAME 207 208
CO2'- REFRIDGERATED LIQUID E~S ~] Yes ~ No
L CAS# ' 209
1 24-38,9 If' EHS is "Yes", all amounts below must be in lbs.
CODE HAZARD~ (Complete if required by CUPA) 210
HAZ CRYOGENIC LIQUID
ARD MATERIAL ' 211 213
215
PHYSICAL STATE 214
{(Check one item onty) ~ a. SOLID ~] b. LIQUiD ~] c. GAS LAROESTCONTAINER 2610 ':
FED HAZARD CATEGORIEs 216
](Check allthat apply) ' . []~] a. FIRE ~ b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH ~ e. CHRONIC HEALTH
IAVERA. GE DALLY AMOUNT 217 MAXIMUM DALLY AMOUNT 218 ]ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220
](Check one item onlyi g_EH& amount must be in pounder 365
STORAGE ,l~a. ABOVE GROUND TANK ~le. PLASTiC/NONMETALLiC DRUM ~ii FIBER DRUM ~,im. GLASS BOTTLE ~: RAiL CAR
CONTAINER , b. UNDERGROUND TANK ~_~f. CAN BAG ' n, PLASTIC BOTTLE OTHER
¢. TANK INSIDE BUILDING I {g' CARBOY . BOX Io. TOTE BIN
d. STEEL DRUM ~_~h. SILO . CYLINDER p. TANK WAGON
. . 223
STORAGE PRESSURE [] a. AMBIENT ~]b. ABOVE AMBIENT ~-'~¢. BELOW AMBIENT 224
STORAGE TEMPERATURE ~---~a. AMBIENT ) ~ b m ABOVE AMBIENT ~¢. BELOW AMBIENT ~d. CRYOOENIC 225
%WT ,"' HAZARDOUS COMPONENT t For mixture or waste only) EHS CAS#
I 100% 226 CARBON DIOXIDE 227 ~Yes [?~2No 228 124-38-9 229
12 230 231 ,~es ~,~No 232 233
i5 24g 243 ,~Yes ~X[~N O 244 245
if more hazardous components are present at greater than I% by weight it'non-carcinogenic, or 0.1% by weight ii'carcinogenic, attach additional sheets ofpape( capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION 246
· . ffEPCRA, Please Sign Here
UPCF (1/99) ' 169 ocs Form 2731
SECTION I
m S?ESS EMERGENCY 'LANi EMERGENCY 'ROCE Um;S
Emergency response plans and procedures are an integral part of the Business Emergency Plan. By
taki.ng the time to review these procedures for your establishment, you will avoid complications
resulting from inaction or misguided action during an emergency. Once these plans.and procedures
are impldmented, your employees vdll have an informative guide to follow in the event of an
emergency.
1. EMERGENCY RESPONSE PLANS AND PROCEDURES
A. If you have-a release or threatened release of hazardous material, your business is
required by State Law.to provide immediate notification of the following agencies
Immediately call:
LOCAL FIRE EMERGENCY RESPONSE PERSONNEL 911
(Fire, paramedics, police, or sheriff)
STATE OFFICE OF EMERGENCY SERVICES: (800) 852-7550
or (916) 845-891
Bakersfield Fire Department
THE HAZARDOUS MATERIALS MANAGEMENT DIVISION: 661~326-3979
PERSON(S) WITHIN THE FACILITY WHO ARE NECESSARY TO RESPOND TO A
HAZARDOUS MATERIALS 1NC'DENT:
Name: Serv i ce_ComackCenle r Telephone:_866-805-4357
Name: Jx/isin Pelerson Telephone:A61-978-4822
B. IDENTIFICATION OF THE LOCAL EMERGENCY MEDICAL FACILITY OR
MEDICAL ASSISTANCE AVAILABLE TO YOUR BUSINESS APPROPRIATE FOR
POTENTIAL ACCIDENT SCENARIOS:
> NAME: KERN MEDICAL CENTER
ADDRESS: 1830 FLOWER ST
CITY: BAKERSFIELD
PHONE: fi61-326-2000
; 2. 'PREVENTION
Describe the kinds of hazards associated with the materials present at your business.
Provide information On the steps taken at your business, or the policies or procedures now
in place, to help prevent an accidental release of a hazardous material. Issues for
discussion may include safety, storage, and containment procedures. Be ~pecific for each
type of hazardous material at your business.
The hazards at this business are fire and spills associated with gasoline dispensing.
Gasoline dispensing is supervised by trained personnel. Additional hazardous materials
are stored in minimum quantities and stored in small, unbreakable containers. All
underground storage tanks are monitored using an approved monitoring method.
3. MITIGATION
Describe the procedures to be followed to reduce ttie severity of a release or threatened
release of a hazardous material at your business. The procedures should detail the actions
to be taken by empl_oyees to stop a release, contain a release, or to reduce the problems
associated with a release. What is your immediate response to a spill fire, explosion or
airborne release at your facility?.
Small incidents: For leaks and spills, isolate the area and contain with absorbent material.
Clean up the spill immediately to prevent spreadin_g. For fires, turn off pumps, use fire
extinguisher if it can be done safely.
Larger incidents: Turn off pumps using emergency pump shut-off, call 9-1-1, evacuate to
emergency assembly area, wait for emergency personnel to respond. Immediately contact
the business owner, if not already on site, the Wholesale Territory Supervisor or
Retail Territory Supervisor 'and the Service Contact Center.
4. ABATEMENT
Describe what you would do to stop and remove each hazard. How do you handle the
complete process of stopping a release, cleaning up, and disposing of released materials at
" your business? What aspects, of the response are beyond your ability and need to be
handled by others? Who would you call to handle the relase?
' Small incidents will be handled with the on-site clean-up equipment, (i.e., brooms, shovel,
:absorbent material~ mops, etc.).. For larger incidents, the on site manager will turn off the
pumps, call 9-1-I, and the Service Contact Center ~ 1-866-805-4357. The Contact
Center will dispatch a maintenance contractor to assist in abating the hazard. For suspected
leaks the operator will notify the Service Contact Center and his/her Wholesale Territory__..
Supervisor or Retail Territory Supervisor who will investigate the incident. If a UST leak is
confirmed, th?n reporting will be done by ConocoPhillips/Circle K, which complies with UST
re~ulations. ConocoPhill!ps/Circle K will coordinate With any contractors required to stop__a
release, clean up a release and/or dispose of materials. All materials will be disposed of in
. accordance with state, federal and local laws and regulations.
5. ~EVACUATION AND RE-ENTRY
Describe the procedures to be followed for immediate notification and evacuation of your
facility
If warranted, evacuate to the desigg_ated assembly locate at:
NORTH SIDE OF LOT
The manager or lead employee will take a head count to verify all employees have
evacuated safely. The manager or employee will confer with the responding agencies to
indicate the magnitude of the emergency. Re-Entry into the facility will only take place
after the dealer or manager verifies with the responding agency personnel and
ConocoPhillips/Circle K that it is safe.
EARTHQUAKES
Identify the areas and equipment in your business that would require immediate
inspection or isolation due to their vulnerability to earthquake related ground motion.
Check for equipment such as gas cylinders, piping, drums, etc., that may need to be
secured or spillage that may require mitigation or abatement.
Key areas to inspect are the UST tank monitor alarm panel, dispenser islands, and any
additional hazardous materials storage areas. ;
7. HAZARDOUS WASTE CONTINGENCY
Specific procedures for prevention, mitigation and abatement of a release of hazardous
waste generated at your business. This section only applies to hazardOus waste generators.
The hazardous wastes generated at this business are usedmotor oil and antifreeze. These___
items will be handled in the same manner as new motoi' oil or antifreeze. Use absorbent
material or rags to clean up spills and place in a container for proper disposal or recycling. ~
8. UNAUTHORIZED RELEASE RESPONSE PLAN
Specific procedures for mitigation, abatement and reporting of an unauthorized release from
an underground storage tank (UST). The plan must address a release from a single wall or
double wall tank system as applicable. This plan should cover the entire UST system. This
section only applies to UST oWner/operators.
Refer to the Underground Storage Tank Monitoring and Response plan provided by
ConocoPhillips / Circle K Stores, Inc..
If a released hazardous substance reaches the environment, increases the fire or explosion
hazard, is not cleaned up from the secondary containmnent within 8 hours, or deteriorates
tile secondary containment, then the local agency will be notified IMMEDIATELY.
SECTION II
BUSINESS EMERGENCY TRAINING
Employers are required by State law to have a Program providing employees with initial and
refresher training, The Business Emergency Plan shall include a training p.rogram that is reasonable
and appropriate for the size of the business and the nature of the hazardous materials handled. The
training program shall take into consideration the responsibilities of the employees }o be trained.
The training program Shall, at a minimum include:
A Methods for the safe handling of hazardous materials stored at your business, including
familiarity with the characteristics and hazards of each material and measures employees
~ can take to protect themselves from chemical hazards;
B. Procedures for coordination with local emergency response organizations:
C. Correct use of emergency response equipment and supplies under the control of the
business;
D. The Cai OSHA Hazard Communication Standards;
E. The prevention, abatement and mitigation p~'ocedures you have developed for your
business and explained on the Business Emergency Plan;
F. The emergency evacuation plans you havedeveloped, the notification procedure
used to alert people to evacuate, and the closest location to obtain appropriate
emergency medical care;
G. Procedures to coordinate with and assist the local emergency personnel that may
respond to your facility;
H. Who and how to call f6r immediate assistance in the event of an accident
involving hazardous materials;
I. Procedure for ensuring the appropriate personnel receives initial and refresher
training.
ALL EMPLOYEE TRAINING SHALL BE.DOCUMENTED AND UPDATED ANNUALLY.
Use the attached employee training log or similar form for record keeping.
MAP// ~ CALIFORNIA ANNOTATED SITE MAP P.E.^.ED
BUSINESS NAME. CIRCLE K STORE #2708605 DATE 03/12/2003
DRAWING
SCALE
BUSINESS 'ADDRESS 5600 AUBURN STREET BAKERSFIELD ZIP CODE 93506
1"=30'-0"+
~ A _ B C 'D E- 'F: G H MAP SYMBOLS
..... TODAY'S CLEANERS ~ ELECTRONI~ MOi~ITORING POINTS . , Q ELECTRICAL PANEl:
NATURAL GAS
1 -- ~ .~ / O ANNULAR SENSOR Q SHUT-OFF
' \ / I ~ [L[C*RONIC .NE tEAK OETECTOR ® WATER SHUT-OFE
G .../ ~/~i t ~ AUTOMATIC TANK GAUGE Q^ SHUT-OFFEMERGENCYTANK MONtTORINGPUMP
I ' TMA ALARM
i [] .TELEPHONE
SANITARY SEWER
~Z EVACUATION/
FY CASHIER -IPROPANE J J ' I ~ (~ NM~4P HMMP, AND MSDS
(]- ~C~ ' ~)~ FIRE HYDRANT
(]~ )( × FENCE
~ ®1 ~ EMERGE.CY RESPONSE
wZ r-- ) / EQUIPMENT/ABSORBENTS.
o u l, / C-- 'ABO' GROUNO
/ STORAGE TANK
4 Oz~-I i~-~} UNDERGROUND
-- ~--~ STORAGE TANK
O t Q GASOLINE
(FLAMMABLE: LIOUIDS)
U) I , , ~'~W G OIESEL FUEL
(COMBUSTIBLE LIQUIDS)
Q MOTOR OILS & LUBJTS
(COMBUSTIBt~E LIOUm
(~.. CARBON DIOXIDE
(COMPRESSED GAS)
5
I /Ex PROPANE
(FLAMMABLE LIQUID)
I ~ AN TIFREE ZE/COOLA-NTS
~ WASTE 0,L
(FLAMyABLE LIOUID)
. j ~ CAR WASH PRODUCTS
I
AUBURN STREET
AM/PM MINI MART
Spill/Release Response ProCedures for Carbon Dioxide (CO2)
The refrigerated liquid CO2 used at many locations to produce Carbonated beverages can
be hazardous in the event'of a spill or release, or if there is a fire at the station. Although
CO2 is not flammable, in the event of a fire, the container could explode due to the high
heat of the fire.
Releases and Spills of the CO2 may cause dizziness or suffocation without Warning.
When released, the vapors are initially heavier than air and spread along the ground.
Contact with the refrigerated liquid may cause burns, sever injury and/or frostbite.
Spill or Release:
In the event of a spill or leak from the CO2 container, do the following:
1. Dial 911 - inform emergency personnel that there is a release fi:om the refrigerated
hquid CO2 tank and the location of the tank.
2. Evacuate employees and customers from the site and deny entry to unauthorized
people.
3. Stay upwind of the spill and out of low-lying areas.
4. Do not touch or walk through spilled material.
5. Avoid breathing gases.
6. Do not enter the building until emergency personnel have notified you that it is safe..
7. Contact management using the emergency phone list procedure.
Fire:
1. Follow the Fire and EXPlosion evacuation procedures.
2. NotiB) emergency personnel of the tank location.
Prevention Procedures:
1. Store tank and/or cylinders with valve protection caps installed.
2. Tank and cylinders should be stored upright and firmly secured to prevent falling or
being knocked over.
3. Containers should be stored in a cool, dry, well ventilated area away fi:om sources of
heat or ignition and direct sun light.
4. If you suspect any problems with the tank notify the supplier immediately to have the'
system inspected. '
[:kHAZMAT~ToscokFORMS\co2-Spill plan.doc '.'
·
EMERGENCY RESPONSE PROCEDURES
MA. JOR ~IDENT: FIRE~ SPILL OR SUSPECT1
1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch.
'2. EVACUATE: Verbally ANNOUNCE to all persons on the site: "This is an emergency. Please turn off your
engines and leave the station on foot immediately. All employees meet at the emergency assembly area."
3. CALL 9-1-1: Give the following information:
"THERE IS A FIRE/GASOLINE SPILL at the ConocoPhillips/Circle K service station at.: 5600 Auburn Street
If anyone is .trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared
to answer any-questions concerning the situation.
4. ATTEMPT. i0 contain the spill if you can do it safely.
5. LOOK AROUND to ensure that everyone has left the station, particularly those in vehicles who may need
assistance or may not have heard the emergency announcement. Assist or direct assistance to anyone having
difficulty legving the station are and anyone who may be injured.
6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might
need.
7. CONTACT the station operator if he/she is not already at the station. Use the list below for emergency contacts:
Emergency Coordinator: Service Contact Center Title: 24 Hours
Address:
Bus#/Home#/Alt#: 866-805-4357 / 866-805-4357 /
Alternaie Emergency Coordinator: Jutsin PetersQrl Title: Retail Terr. S~lpv.
Address: 1380 Lead Hill Blvd. Suite 120. Roseville. CA 95661
Bus#/Home#/Al~: 661-978-4822 / 661-978-4822 /
8. NOTIFY the following IMMEDIATELY to assist in the emergency and agency notification process:
Service Contact Center: 1-866-805-4357
Wholesale Territory Supervisor or Retail Territory Supervisor.
Environmental Compliance Coordinator: North: Janette Thompson (925)277-2404
South: Stephen Boyd (714)428-6572 or (714)454-8334
Conocophillips/Circle K Stores, Inc. will notify the State and Local administering agencies within an appropriate
time frame unless the situation requires urgent immediate response by the agencies, in which case the
Opemto! should notify these agencies.
a) LOCAL AGENCY: Bakersfield Fire Department
PHONE NUMBER: 661-326-3979
b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS)
c) LOCAL POLICE AND FIRE DEPARTMENTS, 911
d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS).
MINOR INC,EDENT: Any incident that can be contained and cleaned up as part of the routine operations. Whenever in
doubt, consider the incident a major release and use the above procedures.
1. FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if used
2. SPILLS: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire
extinguisl~er ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H
for additional direction.
3. MEDICAL: Treat With on site first aid kit or take to nearest hospital. Employee training plan lists the nearest
hosPital.
4.· RECORD': Record the event in the'daily monitoring log.
5. NOTIFY:' the dealer of the event.
EMPLOYEE TRAINING PLAN
Employees mustbe given this starting work, and refresher cour.~ ~st be provided annually.
Records must be kept to show when each station employee has been given his/her safety training. Use the following
outline and make copies as needed. Have employee date and sign the attached training log upon completion of
training. Retain thse records for a minimum of three years.
I. FIRST THINGS TO KNOW:
A. EMERGENCY PUMP SHUT-OFF:This turns offthe turbine pumps that provide flow to the dispensers from the
underground tanks. In case of a leak, shuttingoff the pumps will help to.prevent spills.
Location: I-CASHIER 1-NORTH SIDE BLDG
B. ELECTRICAL PANEL: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main
switch kills all power at the site.
Location: BACK STORAGE ROOM
C. TANK MONITORING ALARM: Monitoring panel for the Underground storage Tanks. This panel will indicate
when a leak is detected by a visual and audible alarm.
Location: BACK STORAGE ROOM
D.WATER SHUT-OFF: The water shut-off may be necessary in some cases.
Location': CORNER OF FAIRFAX AND AUBURN STREET
E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-off the natural gas flow
in an emergency.
Location: BUILDING REAR /
F. PROPANE/LPG: If your station has propage or liquefied petroleum gas tank - In the event of a release or fire,
turn off the manual valves and shut'off the power to the dispensing pumps. Call your supplier or dial 9-I-1 as
, appropriate~
G. FIRE EXTINGUISHER: Use only on. small fires that you can handle. Do not attempt to extinguish large fires on
your own,; call 9-1-1 for.help.
Location,: 1-NEXT TO STORAGE DOOR, 1-FRONT DOOR, 1-PUMP ISLAND
H. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or off/er
petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill,
merely t~ to contain it, a vacum truck should be used to clean up any large spill
Location.: SPILL KIT IN STORAGE RooM
I. PERSONAL PROTECTIVE EQUIPMENT: These items shall be used by employees to prevent direct skin
contact ~kith a hazardous material.
1. Broom: REAR STORAGE
2. Shovel: REAR STORAGE
3. Gloves: REAR STORAGE
4. Goggles: REAR STORAGE
J. FIRST A'ID KIT;.
Location! .BACK STORAGE RoOM
K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency.
Location! NORTH SIDE OF LOT
HAZARDOUS MATERIAL MANAGEMENT PLAN (HMMP)_MATERIAL SAFETY DATA SHEET
(MSDS):
Location: GASHIER ·
II. NEAREST MEDICAL FA{ Employees should know what facilit available in case customers or
other employees need medical atten,
1.NAME: KERN MEDICAL CENTER
ADDRESS: 1830 FLOWER ST BAKERSFIELD
PHONE NUMBER: 661-326-2000
NEAREST DESIGNATED TRAUMA CENTER:
2.NAMe: KERN MEDICAL CENTER
ADDRESS,: 1830 FLOWER STREET BAKERSFIELD
PHONE NUMBER: 661-326-2000
III. All employees should review the Hazardous Material Plan, of which this training plan is a part. Specifically,
each employee should understand the pi-0cedures to be used in responding to'various kinds of emergencies, and know
how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the
Emergency Response Plan filed by your business to the appropriate local agency.. Thirdly, employees should review
and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the
station and must lie drilled in all emergency response procedures contained herein.
IV. FIRST Ali) PROCEDURES (For exposure to gasoline or diesel fuel):
A. EYE CONTACT: Flush with water fc~r 15 minutes while holding eyelids open. Get medical attention.
B.SKIN CON~'ACT: Flush with water while removing contaminated clothing and shoes. Followed by washing with
soap and water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention.
C. INHALATION (Breathing):. Remove victim to fresh air and provide oxygen if breathing is difficult. If not:
breathing, give artificial respiration. Get medical attention.
D. INGESTION (Swallowing):
DO NOT INDUCE VOMITiNG BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE
LUNG ,DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into
lungs. Get medical attention.
F. NOTE TO PHYSICIAN: If more than 2.0 mi'per kg has been ingested and vomiting has not occurred, emesis
should be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If syrhptoms
such asiloss of gag reflex, consulsions, or unconsciousness occur before emesis, gastric lavage using a cuffed
endotrachael tube should be considered.
For further information, consult the Materials Safety Data Sheets for these products and for other hazardous materials.
FIRST AID FOR EXPOSURE TO OTHER MATERIALS: COnsult the warning advice on container labels or refer to
the MSDS fo'r that product.
This hazardous material management plan meets the requirements of a hazardous waste contingency plan.
Document prepared by: Environmental Staff, R J-IL Design Group, Inc., 800-765-1025 Last updated: Dec. 3, 2002
1137 North McDowell Boulevard, Petaluma, CA 94954-1110 Telephone: (707) 765-1660 Facsimile: (707) 765-9908
John W. Johnson
Co_President~ .. April 10, 2003
Architect
Brian E Zita Bakersfield Fire Department
Co-President Ralph Hue¥
Architect 1715 Chester Avenue. 3rd Floor
Bakersfield, CA 93301
John B. Hicks
l, Tce President
HAZARDOUS MATERIALS MANAGEMENT PLANS FOR
i~ . CONOCOPHILLIPS/CIRCLE K STORES, INC.
Cecil R. Spence~ '
Vice President
; Dear Ralph-Huey:
RegionalManagqrs Enclosed please find the Hazardous Material Management Plans, HMMP(s), for the
· ,~ ConocoPhillips/Circle K Stores, Inc. station(s) as listed on the attached sheet.
Jesse E. Macros ~!
RoyW. Pedro
!i These inventories and HMMP(s) are being submitted for your review and approval.
Alan K. Shimabukuro
John W. Strobeh If there are any further correspondence or invoices related to these submissions,
Blythe R. Wilson please direct them to:
Regional Compliance Specialist
ConocoPhillips/Circle K Stores, Inc.
" P.O. Box 52085
i~ Phoenix, AZ 85072-2085
Sincerely,
RHL DESIGN GROUP, INC.
Environmental Department
Enclosure
2708605 ~ "~
Circle'K Stores, Inc. '
5600 Auburn Street'
Bakersfield, CA '93306 -
site: / Tosco Facility # 2708605 ~ · -. ... .
Address: [ 5600 AUBURN ST.t ' .
City: ~ BAKERSFIELD, CA .
,~.
~_ PETCON:TECHNOLOGIES, INC. -~ontractor License
Testing. . '"~.1~ 8 S. I NGLEWOOD AVE.~=tAWTHORN E, CA' #.675998
Performed bY:
Technician:
JESU ' ,- '
Equip ~ype" Description Test Date Type* ResUlt Comments
TankS: Manf Wall Material INITIAL PRESSURE 7"
89 - O/C DBL PLASTEEL 05 07 02 VA PASS HOLDS AT 7" Hg FOR 1 HR
91' O/C DBL. PLASTEEL' 05 07 02 VA PASS HOLDS AT 7" Hg FOR 1 HR
'~Lines: 'Manf -Wall-: ' Material: "-' -~ - ' - :~
Sumps: Type Sensor Type Lid (Y/N) .
~ 87 TURBINE VEEDER-R Y 05 07 02 HY FAIL DOESN'T HOLD WATER
89 TURBINE VEEDER-R Y 05 07 02 HY FAIL DOESN'T HOLD WATER
91 TURBINE VEEDER-R. Y 05 07 02 HY FAIL DOESN;T HOLD WATER
Disp Pans: Pan Manf Model/Type
~ 1/2 BRAVO SHALLOW 05 07 02 HY FAIL DOESN'T HOLD WATER
3/4 BRAVO SHALLOW 0507 02 HY FAIL DOESN'T HOLD WATER
iNotes: SECONARY LINES NOT TESTED, NO TEST BOOTS.
i- .... : ..... .- -~-.-~ ' ,.~ ~.'"',
'87 ANNULAR NoT-TEs-~E[~. ""/ -
" 81GNED BY: OY'I'UN TURUI~ITAY
· Test[Types:lilY- hydrostatic with testing fluid, PN - pneumatic with nitrogen, VA - vaccuum
-ToscO Standard Form SB-989.5/23i01· .- ~ .- .... . :
Secon Containment Testing R p Fo
This form is intended for use by .contractors performing periodic testing of UST secondary containment systems. Use Ihe
appropriate pages of this form to report results for all components tested The complete form, written test procedures.
and printouts.~om tests ~ applicable}, should be.provided to the facili~ owner/opera/or for s~bmitta/ to the
Date LOcal Agency Was Notified of Testing:
~ ~ame of Local Agency Inspector Present:
2. TESTING CONT~CTOR INFO~TION
Company Name: ~co~ ~, ~ C.
Tec~i~ian Conducting Tes~: ~O~ ~
Credentials, :, i': ~ CSL~bicense&Con~acto_ _ .y ~i: ~ SWRC~ Licensed Tan~T~ster~ '~L"~'~
Training by Manufacturer
Manuhcmrer Component(s) . Date Training Expires
3. SUMMARY OF TEST RESULTS
Number of Tanks Tested: ~ Number of Piping Runs Testedi
Number bf Submersible Pump Sumps Tested: ~ Number of UDC Boxes Tested:
Number Of Fill Sumps Tested: ~5' -Number of Overfill Boxes Tested:
! Component Pass Fail ,, Comments
,o°q:ql A,,,,,,,,l"r o
i)b£, o . __
. ~ .~All pr~: ire testing must utilize an inert gas.
December 2001
' , : PO, e .Z- of
' " ' ' '~', 4. TANK ANNULAR TESTING
.. ' 'Test Meth0'd De~e!oped By: FI Tank Manufacturer 81 Industry Standard. 121Professi'onal·Engineer
· Test 'Methqd Uses: [] Pressure I~ Vacuum'. D Hydrostaiic
[] Other (Specify)
MeasuringEquipment Used for Testing: ' ' " ~
Tank #~;'7 Tank # ~ Tank #
i TankCapacity~' . .... },.O. I/3 ·' {.{~ I/Q Lo ]~
Tank Manufacturer: . O~te,~.~ 6or~n~ C)~erl~. ('~,r~/.~ OWer~
Wait time between'a~plying x~ .
pressure/va6uun'gwater and starting.'
Test Start Time: ......... 1 2.: z¢'~' ~;
Test End T me: ........... qb ,
Test D~ation: { ~-I'ottlF , ~
Change:' reReading (R~-R0: ~
P~s~'F:~il Tkreshold:
Was 'senior l~r0peily replaced after ' } "
testing? ~'~ ..1. ,, '~_..$
Comments - (include information on repairs made to facilitate a passing test and indicate whether
permit was obtained for the repairs,)
December 200 1
: :"' ' 5. SECONDARY PIPE TESTING
Test Method Developed By: D Piping Manufacturer O' l~dustry Standard O Professional Engineer
D Other (Specify) .
Test Method Uses: I~ Pressure O Vacuum [3 Hydrostatic
Q Other (Specie) '
Measuring Equipment Used for Testing: . ~
"Piping Run ~ ~1 Piping Run
Piping Diameter: Za~r;m.? " '
Length of PiPing Run: .... ~ t ' ' ' ~ t ' ' ~O / '
Method ~and location of
piping-~,n,isolation: ~0 R~fe~ ~-- ~o_ .~_' ..-~
~Wait ti~be~een a~lyin~
pressure/vacuum/water and
sta~in~ test: ~ ~
Test Sta~ Time: ~ / , / ,,
lnitial R~ading (R~): ~ /
Test End Time: / / , ,
Final Rek~ing (Rr): / /
Test Duration: / /
Change (n Reading (Rr-R~): / ~ .
Pass~aif T~eshold: ~ /
Test ReSult: : ~:~[,~;??~ '::~{~;::~3i~7'}'~:: ~ ..... : ' ~: :: '~7'~' :~.~Or ~:'.:::~.~'
Commgnts - (include information on repairs made to facilitate a passing test and indicate whether a
, permit was obtained for the repairs)
Note: Pressure testing of piping secondary containment systems should be performed at 5' PSI,
which is generally consistent with testing performed at time of installation.
December 2001
',:, ': 6. SUB~ S][BLE PUMP CONTAI]NMENT SU ESTING .... '...
Test Method Developed By: ~. Fl Sump Manufacturer II Industry Standard Q Professional Enginee~ '
,~ . [] Other (Specify)
. ], Test Method Uses: [] PressUre [] Vacuum II Hydrostatic
,D Other (Specify)
MeasUring Equipment Used for Testing:. ..
SUmp # ~'7 Sump # ~ Sump # Ct
Sump Dmmeter: ~..~ ~..~n ,~7~ v
Sump, Depth:` ~ 0 ~/~'t 5 [' t
Sump Material: ~l'~r~la~$ ~';]0ev'0 [o155 1~ ber-~
Heigh! from Tank Top to Highest ., t ~
Piping Penetration:.. VI..t ~ I I [ I
Height from Tank TOp to Lowest t t ~ '- ~,,
Electrical Penetration: ~ -7 .
Condii'ion Of sump prior to testing: ~'Y~_~ ~¥'~/. ·h~&y:-'':
- Portio~[~0f-Sump Tested. ........ - ....... ,~ ---'-' ~.'
Does turbine shut down when .......
sump sensor detects either product
Turbin~ shutdown response time. ~ /,' /
Is systdm programmed for fail-safe
shutdown? / / /'
Was fail-safe verified to be
operational? / /
Wait ti~e between applying
/...:',: pressure/vacuum/water and starting
Test Sta, rt Time: /" f /
Initial Reading !R0: / f
Test End Time: / f
Final Re, ading (Rr): /.' '/f
Test Duiati°n[, ,r' /"
Change 'in Reading (Rr-R0: f /"
PassFfai} Threshold: /' /"
- Was senior' refndqed fSF:t~s~ti~-g5, r- t,,
Was sensor properly replaced after' "
Commlnts. (include information on repairs made to facilitate a passing test and indicate whether a
Re?mit ,was obtained for the repairs)
Note'.' Hydrostatic testing of sumps should, at a minimum, prOvide for a liquid level that tests
the tank/saddle juncture and the highest tank piping system projection into the sump.
December 2001
' }'age ~'or
-
7. -DISPENSER CONTAINMEN (U-DC) TESTING - : '""-: ' : !~i!!!-~!:?~::? t
ITest Meth;d Developed By: 12 UDC Manufacturer ~ Industry Standard D Professional Engineer
D Other (Specify) . . ·
:..,JTest Method Uses: rq Pressure gl Vacuum W Hydrostatic
g Other (Specify) :
Measuring,Equipment Used for Testing: .i
. ur, c, y, . ' ur, c, 3/.v. '" uDC,'--
UDC ManU'facturer: ... ~vqO _~ roa/'O .
UDCMaterial: , , , . · ,.,~¢~ , ,J~'~-~ I ' ..
UDC DePth,: ,' '"
Height fro~ UDC B~ttbm to
Highest Piping Penetratkm:
;
Height from UDC Bottom to
Lowest Ele;trxcal Penetration:
Condition of UDC prior to
_Portion of UDC-T-ested: ....... - ' '- ' :'
Does turbine shut down when ...
UDC sensor detects either
product or water?' // /'
Turbine shut~t°wn'r.espohse //'
time. '}. :
Is system pr0grammed for fail- ,
sar, shutdow:n? / // . ':5:~' :if':
Was fail-safe verified to be ,// / · ..','
operational?
Wait time betWeen applying
: "stamng test' /'
Test Start Time: / / '.
Initial Readin'g (R0':" ' /r. ,r ...
Test End Tim~: / /
Final P. eadin~ (R~): ' / /
Test Duration'; /
Change in Rei~ding (Rr-R0:, / /
Pass/Fail Threshold: / /
Test Result:i ' :. '~C,;..I
Was sensor re?nov'ed for ..............
testing? .... ' ...... . ~ ~----~ ~-~-----,/ .............. '-~- . _
was sensor properly replaced ..
after testing? /" /."
Comments ~- (if~cIude information on repairs made to facilitate a passing test and indicate whether a
,permi(was obtained for the. repairs)
Note: Hydrostatic testing of the UDC should, at a minimum, provide for a liquid level that tests to
the highest point of piping projection into the containment vessel.
December 2001
, '~ TOSCO MARKETING COMpANy
1500 N. 'Priest Drive
: Tempe, Arizona 85281
,, Telephone: (602) 728-8000
-TOSCO
March 07, 2002
.Circle K Stores, Inc.
· 5600 Auburn Street
Bakersfield, CA 93306
RE: HAZARDOUS MATERIALS MANAGEMENT PLANS .'
Dear Debra Sital - Mngr.:
Attached is the new Hazardous Materials Inventory and Business Plan Certification for your station. This updated
HMMP is intended to amend the current HMMP. The "DEALER" copy should be attached to your current HMMP
and kept in your "Success at the Pump", and available to all employees and agency personnel at all times.
TI-IESE FORMS MUST BE RETURNED TO RHL DESIGN .GROUP AS SOON AS POSSIBLE.-FAILURE
TO .RETURN AND IMPLEMENT THIS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES BY
GOVER1YMENT ENFORCEMENT AGENCIES.
Instructions for signing and returning the packet:
I. Please sign all 3 coPies of the CEKTIFICATION where flagged and indicated with a "X",
2.Please return the.2 copies marked "AGENCY" and "RILL FILE" to RHL Design in the pre-stamped
enclosed envelope.
3. Keep this "DEALER" copy in your Success at the Pump binder, and available for inspection.
4.Have your employees read and understand the contents of this package and sign the attached training log.
Keep the training log at your station.
A cqpy of this~ HMMP Certification will.be sent to: Bakersfield Fire Department within 30 days
If you have ahy questions regarding the content of this document, please contact RHL Design Group, Mr. Roger
Beach at (707~)~ 765-1660. If you have any additional questions, including invoicing qUestions, please contact
Tosco Marketing Company, Hazardous Materials Coordinator at (602) 728-7080. .
Sincerely,
Tosco Marketing Company
cc: RHL Design Group, c.
Enclosure ~ '2708605
... 1715 Chester Avenue, 3¢d FloOr
_. . Bakersfield CA 93301
HAZARDOus MATERIALS BUSINESS PLAN / INVENTORY 2002 CERTIFICATION FORM '
Circle K Stores, inc.
Business Name:
Owner/Operator Name: Circle K Stores, Inc.. . Phone: 661-871-7979
5600 Auburn Street
Business Address:
City: . i' Bakersfield State: CA , Zip: 93306
Environmental Contact: Janette Thompson Phone: 925-277-2404
Mailing Address: 2000 Crow Canyon PI. Suite 400
San Ramon CA 94583
City: State: Zip:
BIENNIALI REVIEW AND RECERTIFICATION: .
I certify that the complete Business Plan filed on . has been reviewed, and the information
~7" contained in it is accurate and complete as of the date below.
/~ complete HMBP was submitted within the last three (3) years.
I certify that I have reviewed the sUbmitted Business Plan'and have the
updated
folloWing
items on the attached pages.
__ Emergency contacts names and/or phone numbers.
~ Site/Facility map.
' '~ Other Updates:
ANNUAL INVENTORy UPDATE:
Inventory Forms are correct for the upcoming reporting year. NO Changes are necessary.
~. Inventory Forms require updating. ATTACHED are only the revised pages.
In,ventory Forms required updating. Replace previous inventory with attached inventory.
As the BuSiness Owner or its official designated representative, I can sign and attest to all statements in this
certification and that we are not USing the certification statement to comply with the annual federal reporting
requiremehts under the Emergency Planning and Community Right-to-Know Act (EPCRA).
Based on my inquiry of those individuals responsible for obtaining the information, I believe that the submitted
information is true, accurate and complete.
(Type or-Print) - "
-- · FACILITY INFORMATION
BUSINESS OWNER/OpERATOR IDENTIFICATION
· P~ge __ of__
..... I. IDENTIFICATION
FACILITYIDg. : '',' lii ii!l - I I:iii ,i:;i:l I I-'' '' '1BEGINNINGDATE3/01/2002 . 100 I ENDING.DATE03/1/2003 ,0,
BUSINESS NAME (Same a~ VACmrrY NAME or DBA - Doing B~ineas A~)' 3 ]. BUSINESS PHONE 1o2
Circle K Stores,' Inc. · I 661-871-7979
BUSINESS SITE ADDRESS ... 1o3
5600 Auburn street
CITY. . _ : - ' loa CA ZIP CODE ~ 1o5
Bakersfield ' · 93306
DUN & BRADSTREET . 1o~ SIC CODE (4 digit #) 1o?
04-8564975 5541
COUNTY 1o8
BUSINESS OPE,RATOR NAME io9 . BUSINESS OPERATOR PHONE i1o.
Circle K Stores, Inc, ~ 661-871-7979
II. BUSINESS OWNER
OWNER NAME. l~ OWNER PHONE t~2
Circle K S~Ores, Inc. 602-728-8000
OWNER MAILING ADDRESS . u3 ·
P.O. Box 52085
CITY u,~ I STATE 115 ZIP CODE 116
Phoenix I AZ 85072-2085
III. ENVIRONMENTAL CONTACT
CONTACT NAI~I~ E 117 I CONTAQT PHONE lis
Janette Thbmps0n I 925-277-2404
CONTACT MAILING ADDRESS 119
2000 Crow Canyon Pl. Suite 400
CITY 12o I STATE 121 I ZIP CODE 1:22
San Ramon - I CA ] 94583
_pRIMARy_ IV. EMERGENCY CONTACTS -SECONDARY-
NAME 123 NAME ' 12s
Tosco Maint. Call Center Teri Nicholson. .
TITLE ' 124 TITLE 129
Dispatch BDM
BUSINESS PHONE ~2~ BUSINESS PHONE l~o
800-726-2312 909-270-5123
24-HOUR PHONE 126 24-HOUR PHONE 131
800-726-2312 800-697-1388
PAGER # 127 PAGER # ~32
ADDITIONAL LOCALLY COLLECTED INFORMATION:
Certification: l~ed on my inquiry of those individuals responsible for obtaining the information,.I ~ertify under penalty of law that 1 have personally examined and
am familiar with We information submitted and believe the information is true, accurate, and complete.
SIGNATUYlE OFJOWNER/OPEIj~AT~R OI~DESIGNATED REPRESENTATIVE DATE 134 [ NAME OF DOCUMENT PREPARER 135
'N - ~-FS/G~;ER!iprint) /') ~ / '/ ' 136 TITLEQ.,~GNER 137
UPCF (,1/99 revisgd) ' ' ' 167 OES FORM 2730 (1/99)
--- 0~IFIED PROGRAM CONSOLIDATED FORInt
. CHEMICAL DEscRIpTIoN - One Page Per Material Per Building or Area
' ' '.- . HAZARDOUS MATERIALS INVENTORY
. - I. FACILITY INFORMATION'
BUSINESS NAME (Same' as FACILITY NAME or DBA - Doing Business As)
Circle K Stores, Inc. 2708605
CHEMICAL LOCATION 2ol CHEMICAL LOCATION 202
CONFIDENTIAL- [] YES [] NO
STORAGE AREA~ EPCRA
I
" II. CHEMICAL INFORMATION
CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No . 2o6
CARBON DIOXIDE ~e subjm to ~pc~,
COMMON NAME 207 208
EHS* [] Yes [] No
co2- rmr)o v, Z .D
CAS# ....
*If EHS is "Yes", all amountS below must be in lbs.
124-38-9
FIRE CODE HAZARD CLASSES (Corapl~ ifrequ!redby CUPA) 210
NON-FLAMMABLE GAS
t 213
HAZARDOUS MATERIAL.,
TYPE (Check one ~tem only) PURE I'-Ib. MIXTURE I-lc. WASTE 211 RADIOACTIVE I-lYes [~No 212 CURIES
Pm, s~cAL sx^x~ ~ 214 L~O~ST coman, m~ 2610
(Check one i~em on!y) [] a. SOLID [] b. LIQUID - . GAS
~EV ~ZA~ c^TEoom~s ~.P ~*A
(Check all that apply) ~ ~. FIRE [] b. REACTIVE RESSURE RELEASE CUTE HEALTH [] e. CHRONIC HEALTH
~b. 221 I DAYS oN SiTE: 222
tnmTS, [] a. OALUO~4S CtmIC FE~Z [] c. POUNDS I-I'c~ :ro~qs 365
(Check one item only) ? *'If EHS, amount must be in pounds.
STORAGE
CONTAINER 13'1 a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. Gi~ASS BOTTLE~ [] q. RAIL CAR
~c. TANK INSIDE BUILDING [] g. CARBOY [] lc BOX [] o. TOTE BIN
[]id. STEEL DRUM [] h. SILO [] 1. CYLINDER [] p. TANK WAGON 223
!
STORAGE PRESSURE [] a. AMBIENT . ABOVE AMBIENT [] c. BELOW AMBIENT 224
AMBIENT · [] b. ABOVE AMBIENT [] ¢. BELOW AMBIENT ¢ CRYOGENIC
STORAGE
TEMPERATURE
%WT. HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS #
I 100% 22~ CARBON DIOXIDE " 227 . [] Yes [] No 228 124-38-9 229
2 23o 231 [] Yes [] No 232 233
3 234 235 [] Yes [].-No 236 237
4 238 / 239 [] Yes [] No 240 2al
5 242 243 [] Yes [] No 2~4 245
'If more hazardous components are present at greater than 1% by weight if non-carelnogenle, or 0.1% by weight if corelnogenle, attaeh additional sheets of paper copmrlng the requh'ed Information.
246
If EPCRA, Please Sign Here .
~UPCF (1/99) j, 169' - 'OES Form 2731
,MAP// l' ... CALIFORNIA ANNOTATED SITE MAP
BUSINESS NAMR..__ClRCLE K STORE JJ2708605 DATE 03/15/01
.: DRA~NG scA~
BUSINgSS ,AD])RgSS 5600 AUBURN STREET BAKERSFIELD ZIP CODE 93306 ' ' 1"=30'-0"+
.,%.1; A' . B C "-D' ' E 'F a "H", 'MAP SYMBOLs
· : VACANT LOT. ' · .,,'"~'%~ ELECTRICAL'PANEL
, . NORTH ~ . NATURAL CAS
' . ALARM , ..
TELEPHONE
~- . ' "~. F, RE EXT, NGU,S.ER
~Z i ' ' I '"~ STAGING AREA'
~ I J r-I ~ 5 GALLON ~, , .- EVACUAnON/
CASHIER I J F----- -IPROPANE I I ' I
~ ~ / -~ ~so~ LOCA~ON
r~ m Ill t L.J HM.P H~MP, AND MSDS
CI' ~- ~j,~ HMMPt'~/ ~j J I ~ Z ~)= FIRE HYDRANT
X '
~ x × FENCE
~- ®1~- ~ EQUiPMENT/ABsoRBENTs
4 z i , i~--~! UNDERGROUND
~- ~--'~ STORAGE TANK
O I , GASOLINE '
(FLAMMABLE LIQUIDS)
.' . MOTOR OILS & LUBmC~IJ
· ~ , ,' ..~ . . .' '(COMBUS]]~LE UQUIOSI
5
(FLAM.ABLE uOU~D)
AN~FREEZE/COOLANTS
· /~ WASTE OIL
(FLAMMABLE LIQUID)
,, AUBURN STREET ·
.~: . ~' SpilFRel~ase ResponSe ProCedures for Carbon Dioxide (CO2)
The refrigerated liquid CO2 used.at many locations to produce carbonated beverages can
be hazardous in the event of a spill or release, or if there is a fire at the station. Although
CO2 is not flammab~!e,.in the event of a fire, the container' could explode due to the high
heat of the fire.'
Releases and' spills of the CO2 may cause dizziness or suffOcation without Warning.
When.released, the 'vapors 'are initially heavier than air and spread along the ground.
Contact with the refrigeratedliquid may cause bums, sever injury and/or frostbite.
Spill or Release:
In the event of a spill or leak from the C02 container, do the following:
L Dial 911 inform emergency personnel that there is a release frOm the refrigerated
liquid CO2 tank and the location of the tank.
Evacuate employees and customers from the site and deny entry to unauthorized
people.
3. Stay upwind of the spill and out of low-lying areas.
4. Do not touch or walk through spilled material.
5. Avoid breathing gases. '
6. Do not enter the building until emergency personnel have notified you that it is safe, '
7. Contact management using the emergency phone list procedure.
Fire: "
11 Follow the Fire and Explosion evacuation procedures.
2. Notify' emergency personnel .of the tank location.
:Prevention ProCedures:
1., ·Store tank and/or cylinders with valve protection caps installed.
2. Tank and cylinders should be stored upright and firmly secured to prevent failing or
being knocked over.
3. Containers should be stored in a c°ol, dry, well ventilated area away from sources of
.- heat or ignition and direct sun light.
4. If you suspect any problems with the tank notify the supplier immediately to have the
system inspected.
',i ~ ii." '. · IikHAZMA'ISToscokFORMS~co2-~pill Plan.doc
· , 2708605
~ EMERGENCY RESPONSE PROCEDURES
.... · ~. ~ MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK
i.:" TURN OFF PUMPS using the' Emergency Pump Shut-Off Switch:
EVACUATE: verbally ANNoUNcE to all persons on the site: "There is an emergency. 'Please turn offyour
engines and leave the station: on foot immediately. All employees meet at the emergency assembler area."
'3. cALL 9-I-1 Give the following:information: ·
"THERE IS A FIRE / GASOLINE 'SPILL at the TOsco 76 service station at 5600'Auburn Street" If anyone is
traPPed or:needs medical attentiOn, tell the answering dispatcher. StaY on the phone arid be prepared to answer. '
any questions concerning the situation.
4. 'ATTEMPT to contain the spill if you can do it safely.
5. LOOK AROUND to ensure that everyone has left the station, particUlarly those in vehicles who may need
'assishnce'or may not have heard the emergency announcement. Assist or direct assistance to anyone having
difficulty leaving the stafiofi: area, and anyone who may be injured.
6.REPORT to arriving emergency response personnel to provide them with any information or assistance they
might need.
7. CONTACT the station operator if s/he is not already at the station. Use the list below for emergency contacts:
Emer~gency Coordinator: Tosco Maint. Call Center Title:.Dispatch .
. Ad,ess:
Bus#/Home#/Alt#: 800-726-2312 / 800,726-2312 /
Alternate Emergency Coordinator: Teri Nicholson Title: BDM
Adffess: 495 E. Rincon Rd. Suite#150 Corona ,CA 92879
Bus#/Home#/Altg: 909-270-5123 / 800-697-1388 /
8. NOT~IFY the following IMMEDIATELY to assigt in the emergency and agency notification process:
Tosc6 Maintenance Call Center: 1-800-726-2312
Tosco Business Operations Manager or District Manager
TOsco Environmental Compliance Coordinator: North: Janette Thompson (925) 277-2404 '
· South: Stephen Boyd (714) 428-6572 or (800) 759-8888 pin#1267507
ToscO Corporation will notify the State and Local administering agen'cies within an appropriate time frame, unless
the situation requires urgent immediate response by the agencies, in which case the OPERATOR should notify'
thesei agencies:
a) i LOCAL AGENCY: Bakersfield Fire Department
PHONE NUMBER: 805-326-3979
b) CALIFORNIA OFFICE'OF EMERGENCY SERVICES, (800) 852-7550 (24 HOURS)
c) LOCAL POLICEAND FIRE DEPARTMENTS,' 911
d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HOURS).
MINOR iINCIDENT: Any incident that can be contained and cleaned up as part of the routine operations..Whenever
~n doubt, consider the incident a major release and use the above procedures.
1. FIRES: Extinguish with fire extingUisher. Recharge fire extinguisher, if used.
2. sPILLs: Clean up with absorbent materials on site and dispose of according to all regulations. Have a fire
extinguisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H
for a~diti0nal direction.
3. MEDICAL: Treat with on .site first aid kit or take to' nearest hospital. Employee training plan lists the nearest
4. REcoRD: Record the event inthe daily monitoring log. . '
5. NOTIFY: the dealer of the event. : :' ". . .-~
~' EMPLOYEE TRAINING PLAN.
EmPloye~s must-be .g~vea'tl~is training before starting work, and refresher courses must be ~rovided annually.
Records must be kept to show when each station employee has been given his/her safety training. Use the following'
.'outline arid make copies as'needed.: Have employee date and. sign the attached-training log upon completion of
training. Retaih these records for a minimum of three'Years. '
I. FIRST THINGs TO KNOW: ' "
A. EMERGENCYPUMP SHUT-OFF: This tums offthe turbine pumps that provide' flow to the dispensers from the
,under'ground tanks. In case of a leak, shutting offthe pumps will help to prevent spills.
Location: 1-CASHIER 1-NORTH SIDE BLDG
B. ELECTRICAL PANEL: The panel allows you to selectively cut °ffpower to lights, signs, pumps, etc. The main
switch kills all power at the site.
Location: BACK STORAGE ROOM
C. TANK MONITORING ALARM: Monitoring panel for the Underground StorageTanks. This panel willindieate
when:,a leak is detected by fi visual and audible alarm.
Location: BACK STORAGE ROOM
D. WA2;ER SHUT-OFF: The water shut-offmay be necessary in some cases.
.Location: BUILDING REAR
E. NATURAL GAS SHUT-OFF: If your station has natural gas, it may be necessary to shut-offthenatural gas flow
m an ,emergency.
Location: BUILDING REAR
F. pROPANE/LPG: If your station has a propane or liquefied petroleum gas tank - Inthe event ora release or fire,
turn 6ffthe manual valves and shut offthe power to the dispensing pumps. Call your supplier or dial 9-1-1 as
appropriate ....
G. FIRE, EXTINGUISHER: Use only on small fires that you can handle. Do not attempt to extinguish large fires on
your ~wn; call 9-1-1 for help.
Location: DNEXT TO STORAGE DOOR, 1-FRONT DOOR, 1-PUMP ISLAND
H. 'ABSORBENT:In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other
petroieum Products. Absorbent should be used rather than washing.spills down a drain. In case of large spill,
merely try to containit; a vacuum truck should be used to clean up any large spill.
Location: SPILL KIT IN STORAGE ROOM
I. EMERGENCY RESPONSE EQUIPMENT: These items shall be used by employees to prevent direct skin
conta& with a hazardous material.
1. Broom: REAR STORAGE
2. Shovel: REAR STORAGE
3. GloVes: REAR STORAGE
4. Goggles: REAR STORAGE
J. FIRST AID KIT:
Location: BACK STORAGE ROOM
K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency.
· ~Locafion: NORTH SIDE OF LOT ·
~.~ .., HAZARDOUS MATERIAL. GEMENT pLAN (HMMP) & MATE SAFETY DATA SHEET'
-' LoCfition{ CASHIER
;' ': 'II. . NEAREST MEDICAL FACILITY: Employees. should know what facilities are available in case custOmers or'
· 'other employees need medical attention. .
1. NAMe' KERN
" ADDRESS: 1.830 FLOW .R ST BAKERSFIELD.
~ PHONE NUMBER:661-326-2000 .
NEAREST DESIGNATED TRAUMA CENTER:
2. NAMEi KERN MEDICAL CENTER
" ADDRESS: 1830 FLOWER STREET BAKERSFIELD
PHONE NUMBER: 6613262000 ~
III. All emp!oYees should review the Hazardous Material Plan, of which this training plan'is a part. Specifically,
each emPloyee should understand the procedures to be used in responding to various kinds of .emergencies, and know
how to monitor for leaks of hazardous materials. As a supplement to this package, employees should also review the
Emergency Response Plan filed bY'your business to the appropriate local agency. Thirdly, employees should review
- and have access to the MaterialsI Safety Data Sheets you hav. e.on file for each of the hazardous materials stored at the
station and must be drilled in all emergency response procedures contained herein.
IV. FI!iS.' T AID PROCEDURES (For exposure to gasoline Or diesel fuel):
· .A. EYE CONTACT: FlUSh with water for 15 minutes while holding eyelids open. Get medical attention.
B. SKIN CONTACT: Flush with water while removing contaminated cloth/ng and shoes. Follow by washing with
soap!and water. Do not. retise Clothing or shoes until cleaned. If irritation persists, get medical attention.
C. INHALATION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. If not
brea/hing,, giVe artificial respiration. Get medical attention.
D. INGESTION (Swallowing):
E. DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LuNGS AND CAUSE SEVERE
'LUNG DAMAGE! If vomiting occurs spontaneously keep head below hips to prevent aspiration of liquid into
lung~. Get medical attention.'
Fi NO~FE TO PHYSICIAN: If more than 2.0 ml per kg has been ingested and vOmiting has not occurred, emesis
shou!d be 'induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms
suchias loss of gag reflex, convulsions or unconsciousness occur before emesis, gastric lavage using a cuffed
endotracheal tube should be considered.
For furth,er information, consult the Materials Safety Data Sheets for these products and for other hazardous materials.
FIRST Ail) FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to
the MSD'S for that product.
This haZardous material management Plan meets the requirements of a hazardous waste contingency plan.
Document prepared by: Environmental Staff, RHL Design Group, Inc., 800-765-1025 Last update& March 7, 2002
-HIAZARDOUS' MATERIALS TRAINING _REQUIREMENTS
As the owner/operator of a'busineSs that handles hazardous materials, you must have the following:
· A Hazard Communication Plan (alsoknown as an Employee Right,to-Know Plan) :
· 'A SARA Tier. II Chemical inventory Report (in California this .report is included in the Hazardous
Materials' Management Plan,-also known as the CA Business Emergency Plan)-
* An Emergency Response Plan
-- ·' An UndergroUnd Storage Tank Monitoring and Leak Detection Plan
· A Release Reporting Plan
Each of these plans reqUires employee training. Training must be documented by a written
description of the topics covered and by a dated signature of the employees receiving the training.
Annual !refresher training is required. The intrOduction of new hazardous materials or changes in
procedqres .requires immediate retraining. Training requirements that are common to more than.
one of !these plans only needs to be .given once to' satisfy all of the plans containing that
requirement as long as the training addresses the concerns of each plan. '
· Training for the Hazard Communication Plan must include the following elements:
· An overview of the requirements contained in the Hazard Communication Regulation and the worker's
rights under the Regulation.
· Locations of any operations in their work area where hazardous substances are present,
· ' Location Where a copy of the written Hazard Communication program is made available to them.
· How',to read labels and Material Safety Data Sheets (MSDS) to obtain appropriate hazard information,
incluUing physical and health effects of hazardous substances in the work place.
· How to detect the presence of Or the release of hazardous substances in the work place.
· How~to minimize their exposure tothese hazardous substances by proper use of engineering controls,
work practices, and/or personal protective equiPment (gloves, etc).
· Emergency and first aid procedures to follow if employees are exposed to hazardoussubstances.
ARCHITECTURE · E N G I NEE RI N'G · E NV IRO N ME N T A L S E RV I C E S
GROUP INC.
1137 North McDowell Boulevard, Petaluma, CA 94954-I110 Telephone: (707) 765-1660 Facsimile: (707) 765-9908
John W. Johnson, Archite'ct E s t a b I i s h e d 1 9 6 6
JOHN W. JOHNSON
Co-President Avril 06. 2001 ~ ~":
Principal ~" % -~ '~ '~
Bakersfield Fire Devartment
B R I A N F. Z I z A Ralph Huev
Co-Vre~ide,t 1715 Chester Avenue. 3rd Floor
Prihcipal Bakersfield, CA 93301
HAZARDOUS MATERIALS MANAGEMENT PLANS FOR TOSCO/CIRCLE K
JOHN B. HICKS
Vice President Dear Ralph Huey:
Principal
Enclosed please find the Hazardous Material Management Plans, HMMP(s), for the
Tosco Corporation station(s) as listed on the attached sheet.
These inventories and HMMP(s) are being submitted for your review and approval.
CECIL [-~. SPENCER
Vice President
Pr i ncip a I If there are any further correspondence or invoices related tO these submissions,
please direct them to:
Regional Compliance Specialist
Tosco Corporation
P.O. Box 52085
CHRIS LAWTON Phoenix, AZ 85072-2085
Regional Manager
Associate
Sincerely,
RHL DESIGN GROUP, INC.
JAMES E. PRESTEN
Regional Manager
A ..... 'ate Environmental Department
GARY M. SEMLING
Regional Manager Enclosure
Associate.
ALAN K. SHIMABUKURO
Regional Manager
Associate
BLYTHE R., WILSON
Regi.onal _Manager BELLEVUE, WA LA HABRA, CA MARTINEZ, CA PETAEUMA, CA
Associate SACRAMENTO, CA SCOTTSDALE, AZ VANCOUVER., WA
2708606. ' ' ' -:
~Circle K Stores,~Inc. ~
1030 Oak Street
" Bakersfield, CA' 93303,
~/ -'
TOSCO MARKETING cOMpANY
1500 N. Priest Drive
Tempe, Arizona 85281
Tele@honei (602) 728-8000
"rosco ~
.March 20, 2001 ·
Benita Duma .
Circle K Stores, Inc.
5600 Auburn Street ' ' ~
Bakersfield, CA 93306
RE: HAZARDOUS MATERIALS MANAGEMENT PLANS
Dear Benita Dunn:
· ' Attached is the. new Hazardous Materials Inventory arid Business Plan Certification for your station. This updated
HMMP is intended to amend the current HMMP. The "DEALER" copy should be attached to your current HMMP
and,kept in your "SUccess at the Pump: Keeping the Zone in Compliance Manual"? and available to all employees and
agency personnel 'at all times.'
THESE FORMS ·MUST BE RETURNED TO RHL DESIGN GROUP AS SOON AS POSSIBLE. FAILURE
TO ~ETURN AND IMPLEMENT THIS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES BY
GOVERNMENT ENFORCEMENT AGENCIES.
!nstmctio,ns for signing and returning the packet:
'1. Please sign all 3 copies of the CERTIFICATION Where flagged and indicated with a "X";
2. Please return the 2 copies marked "AGENCY" and "RILL FILE" to R.HL Design in the pre-stamped
enclosed envelOpe.
3. Keep this "DEALER" copy in your Environmental COmpliance Book, and available for inspectiOn.
4.Have your employees read and understand the contents of this pack~ige and sign the attached training log.
I~eep the training log at your station.
A copy of this HMMP certification will be sent to: Bakersfield Fire Department within 30 days
' Ifyqu have any questions regarding the contentof this document, please contact RHL Design Group, Mr. Steve
Skanderson at (707) 765-1660. If. you have any additional questions, including invoicing questions, please contact
Tos6o Marketing Company, Hazardous Materials Coordinator at (602) 728-7080.
Sincerely, '
Tosco Marketing Company
cc: RHL Design Group, Inc.
Enclosure 2708605
·" AGENCY USE' ONLY
", , BakerSfie~ld.Fire. Department ' ..... .
· "' ; .1~15 ChesterAgenUe, 3rd Floor '
· ' ' ' · 805-326-3979 ' . Date: ·
HAZARDOUS MATERIALS BusINESS PLAN' /.INVENTORY
.t. , 2001 CERTIFICATION FORM
Circle K Sto?es, Inc.
Bus~ness ·Name:
LOwner/Operat0r Name: BenitaDunn' Phone: 661-871-7979
..BusinesS, Address: 5600 Auburn St'reet
Bakersfield CA '-93306
.. City: State: Zip:.
.Environmental Contact: ' Tina Bei'ry -. Phone: 925-~>77-2319
2'000 CrowCanyon PI. Suite 400 '
Mailing Address:-'
.City: .. ~ San Ramon ' ' State: CA Zip:':'.. 94583
"BIENNIAL REVIEW AND RECERTIFICATION:
I certi~ that the Business Plan has been reviewed and the information contained in it is accurate
and. complete as of the date below.
I certify that I have. reviewed the previously submitted Business Plan and have updated thefollowing
items on the attached pages.
" ' '.. ' Eme?g~ncy contacts names and/or phone numbers.
" ~ Site/Facility map.
.... Other Updates:
ANNI JAL INVENTORY UPDATE:-.
Inventory. Forms are correct for the upcoming repo.rting year. NO changes are necessary.
~ Invent0ry Forms require updating. ATTACHED are only'the revised pages.
Inventory Forms required Updating. Replace previous'inventory with attached inventory. .
I certify un,der penalty of law; that I have personally examined and I am familiar with the information ·submitted
~n this andlall attached documents, and based on my inquiry of those individuals responsible for·obtaining the
information, I believe that the submitted information is true, accurate.and complete. '. .
· . ' (Type or Print) ... · .... . .
2708605 IFiED PROGRAM CONSOLIDATED -.
' FACILITY INFORMATION'
BUSINESS ACTIVITIES
I, ·FACILITY IDENTIFICATION
FACILITY ID# ' ' ' ' ' I 1 I EPA D# '. (Hazardous Waste Only) 2
I
E~USlNESS NAME (Same as FACILITY NAME or DBA-Doing Business AS) . 3
· '- Circle K Stores, Inc.
~, 1.' ACTIVITIES DECLARATION
NOTE: I[ you check. YES to any Part of this list,
please submit the Business Owner/Operator IdentificatiOn page (OES FOrm 2730).
.: Does your facility... If Yes, please complete these'pagesof the UPCF...
A. HAZARDOUS MATERIALS
Have onL site (for any purpose) hazardous materials at or above 55
gallons {or liquids, 500 pounds for solids.-or 200 cubic feet for .
compressed gases (include liquids in ASTs and USTs); or the~"ESI Ir---I NO 4 v/ HAZARDOus MATERIALS INVENTORY-
applicable Federal threshold.quantity for an extremely hazardous- -- CHEMICAL DESCRIPTION(eKE 2731)
substan~:e specified in 40 CFR Part 355, Aappendix A or B; or
handle r,adiological materials in quantities for which an emergency
plan is required pursuant to 10 CFR Parts 30, 40 or 70?
B. UNDERGROUND STORAGE TANKS (USTs) ~.~YES [] N° 5 v/ UST FACILITY (Formerly SWRCB Form A)
1. Own or 0perat~ underground storage tanks? ·
: ,v// UST TANK (One page per tank) (Formerly Form B)
2. Intend to upgrade existing or install new USTs? [~ YESI~ NO 6 %//' ' UST FACILITY
,v,/ UST TANK (One per tank
· ~/ UST.INSTALLATION - CERTIFICATE OF
COMPLIANCE(one pa~e per tank)(Formedy Form C)
3. Need to report closing a UST? [] YES NO 7 ~ UST TANK (closure portion-one page per tank)
C. ABOVE 'GRO~IND PETROLEUM STORAGE TANKS (ASTs~
Own or o.'perate ASTs above these thresholds:
--any tank capacity is greater than 660 gallons, or E~] YES'~ NO 8 v/ NO FORM REQUIRED TO cupAs
---the total capacity for the facility is greater than 1,320 gallons? ·
D. HAZARDOUS{WASTE
I. Generate hazardous waste? [~YES ~NO 9 v/ EPA ID NUMBER-provide at the top of this page
2. Recycle!more than 100 kg/month of excluded or exempted [~ YES [~ NO l0 ,,// RECYCLABLE MATERIALS REPORT
?ecyclable materials (per HSC ~1 25143.2)? - (one per recycler)
3. Treat'hazardous waste on site? E~ YES ~ NO 11 ~ ONSITE HAZARDOUS WASTE
· . '7-- ' TREATMENT.- FACILITY
(Formerly DTSC Form 1772)
,,~ ONSITE HAZARDOUS WASTE
· TREATMENT-UNIT(one 'page per unit)
(Formerly DTSC Form 1772A,B,C,D, and L)
4. Treatment subject to financial assurance requirements (for Permit ~-~ YES NO12 ,,,/ CERTIFICATION OF FINANCIAL
by Rule and Conditional authorizaton)? ASSURANCE (Formerly OTSC Form 1232)
5. Consolidate hazardous waste generated at a remote site? ~--~ YES"~ NO13 ~/ . REMOTE WASTE/CONSOLIDATION SITE
ANNUAL NOTIFICATION (Formerly
DTSC Form 1232)
6. Need to'r,eport the closUre/removal of a tank. that was classified as [~ YES [~/NO 14 ~ HAZARDOUS WASTE TANK CLOSURE
· hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249)
E. LOCAL REQUIREMENTS 15
(You may' also be ~'equire,.d to provide additional information by yourCUPA or local agency.)
UPCF (1/99) : 2
2708605 CONSOLIDATED
FACILITY INFORMATION
iBUSINESS OWNER/OPERATOR IDENTIFICATION
i. IDENTIFICATION
BUSINESS NAME (Sa~¢ aS FACILITY NAME or DBA - Doing Bus!ness As) 3 BUSINESS PHONE i02
Circle K Stores; Inc. ' ' 661-871-7979
BUSINESS SITE ADDRESS 103
5600 Auburn Street
:ITY '" 104 CA ' ZiP CODE 105
Bakersfield :. 93306
DUN BRADSTREET 106 SIC CODE (4 digit #) 107
04-8564975 5541
COUNTY 108
KERN
iBUSINESS-OpERATOR NAME 109 BUSINESS OPERATOR PHONE 110
i Benita Dunn 800-726-2312
i II. BUSINESS OWNER
'OWNER E OWNER PHONE
111 112-
NAM:___Gircle_~K Stores, Inc. 602-728-7080
OWNER MAILING ADDRESS 113
, P.O. Box 52083
· 114 STATE 115 ZIP CODE 116
crrY Phoenix AZ 85072-2085
, IlL ENVIRONMENTAL CONTACT
CONTACT NAME. Tina Berry 1~? C0NTACTPHONE 925-277-2319 . ~6
ICONTACT MAILING ADDRESS 119
Ii 2000 Crow Canyon PI. Suite 400
iCITY 120 STATE 121 IZIP CODE .122
~ San Ramon CA I 94583
PRIMARY IV. EMERGENCY CONTACTS SECONDARY
NAME 123 NAME 128'
Tosco Maint. Call Center Ted Nicholson
TITLE 124 TITLE 129
Dispatch BDM
BUSINESS PHONE . 125 BUSINESS PHONE 130
~ 800-726:2312 909-270-5123
i24-HOUR PHONE - '126 24-HOUR PHONE 1_3.;I
~ 800-726-2312 800~697-1388
IPAGER# 127 PAGER# 132
ADDITIONAL LOCALLY COLLECTED INFORMATION: ' - ............
Certification: Based on my inquiry of those individuals responsible for obtaining the intbrmation, I certify under penalty of law that I have personally examined and am
~famdmr w~th the ~nfom]anon submitted and beheve the ~ntormauon ~s true, accurate, and complete.
SIGNATURE OF O~ER/OPERATCYR-x' . ~DATE 134 NAME OF DOCUMENT PREPARER X~- 135
i.?,~~~ ~l~.J~ i~3 ~'}~ / RHL DESIGN GROUP, INC.-ENVIRONMENTAL DEPT.
!N~vlE OF S[GNE,~._~rili¢/ r~ 136 jTITLE,OF SIGNER 137
UPCF ( 1/99 revised) 167 DES FORM 2730 (1/9
: Uv,rr'IED PROGRAM CONSOLIDATED I~gRM . HAZARDous MATERIALS
HAZARDOUS MATERIALS INVENTORY- CHEMIcAL DESCRIPTION ' '=
One page pet material per building or area)
t XI ADD " -I IDELETE " I REVISE' 20O I ' Page ~ or-~
I. FACILITY INFORMATION
BUSINESS NAME 3
Circle K Stores, Inc. 2708605
CHEMICAL LOCATION ~ CHEMICAL LOCA~ON CONFIDENTIAL 202
' NE CORNER NEXT TO ENTRANCE. EPCRA []YES [] NO
FACILITY ID# ~> ~;3~~
" II. CHEMICAL INFORMATION
:HEMICAL NAME" 205 TRADE SECRET ~Yes' XL~No 206
; PETROLEUM HYDROCARBON . _
!. If Subject to EPCRA, refer to instructions
:OMMON NAME 207 [:-G3 208
I PROPANE ' EHS ~ Yes,^' No
iCAS#. 74-98-6 209 I [fEHS is "Yes", ali amounts below must be in lbs.
~ ·
FIRE CODE HAZARD CLASSES (Complete if required by CUPA) - .210
I-A FLAMMABLE LIQUID ' '
HAZARD MATERIAL ' .. 21_ 1 212 215213
rYPE (Check one item . Ia. PURE [~D.M[XTURE [~]c. WASTE RADIOACTrVE [~Yes E~[No CURIES
PHYSICAL STATE' [] a. SOLID ~-~ b. LIQUID [~ c. GAS 214 LARGEST CONTAINER 5 GALL
Check one item only) _
218
Check all that apply)
+ MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220
AVERAGE DAILY AMOUNT 217
20 60 .
UNITS* ~-] a. GALLONS ~-] b. CUBIC FEET [~] c: POUNDS ~ d. TONs 221 DAYS ON SITE: 222
Check one item only)if EHS. amount must be in pounds. 365
CONTAINER. UNDERGROUND TANK CAN - BAG. ~2~n. PLASTIC BOTTLE OTHER
TANK INSIDE BUILDING CARBOY BOX I Io. TOTE BIN '
STEEL DRUM SILO CYLINDER [ 'lP' TANK WAGON
· ' 223
sTORAGE PRESSURE ~.___i a. AMBIENT~__~[-~-[b' ABOVE AMBIENT [~c. BELOW AMBIENT 224
STORAGE TEMPERATURE '~a. AMBIENT [~b. ABOVE AMBIENT ~]c. BELOW AMBIENT ~]d. CRYOGENIC 225
%WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS# --
226 PROPANE 227 ~Yes [~[No 228 74-98-6 229
I 230i ETHANE 231 [~es [~[No 232 . 74-84-0' 233
234 BUTANE 235 [--?}Yes [-~No 238 106-97-8 ~' 237
i3
'238 239 ~yes ~I, o' 240 241
If more hazardous components arc present at greater than I% by weight ii' n~n-carcinogenic, or 0. I% by weight if carcinogenic, attach additional sheets of paper capturing the required infommtion.
ADDITIONAL LOCALLY COLLECTED INFORMATION 248
If EPCRA, Please Sign Here
UPCF(1/99), " ' 169 OESF0rm2731
MAP/J ~ CALIFORNIA ANNOTATED SITE MAP , P.~.PA".D
BUSINESS ~J^ME~CIRCLE K STORE JJ2708605 DATg 05/15/01
. DRABrlNG SCALE
BUSINESS ADDRESS_ 5600 AUBURN ·STREET BAKERSFIELD ZIP CODE 93506 1"=30'-0"+
X- A B ' ' C' ' ...... D' ..... E.' - - ' ,F - ' O' H MAP__...____
VACANT LOT ' ~ ·
. , - - - , . - - ~ ELECTRICAL -PANEL
.k~ SHUT-OFF
NORTH G' NATURAL GAS
( SHUT-OFF '
-- ' Q WATER
SHUT-OFF
G EMERGENCY PUMP
I T~A TANK MONITORING
· . -l-- ~ ALARM
I Lid TELEP.ONE
~ ) ' . .' . . . '. ~=' 'FIRST AID KIT
OI--' ~ (j~ ~ FIRE EXTINGUISHER
Z [~ r----- .. STAGING AREA
_~ I' ---r ' . 12 x 5 GALLON . EVACUATION/
Pr' I / ~ HMMP HMMP, AND MSDS
~ F,RE HYDRANT
FY' / ~ )( )( FENCE
~ EMERGENCY RESPONSE
EQUIPMENT/ABSORBENTS
oUT F- I II · I· ~ ~
C)
ABOVEGROUND
k.~ STORAGE TANK
Z~-~!. . I~-~J UNDERGROUND
~_ ~-- ~ STORAGE TANK
(FLAMMABLE LIQUIDS)
(/3 I ~ DIESEL FUEL
(COMBUSTIBLE LIQUlOS)
MOTOR OiLS & LUBRICA~
~ (COMBUSnBLE UQU~OS)
~ (COMPRESSED GAS)
I i ®. PROPANE
· (FLAMMABLE LIQUID)
J Q ANTIFREEZE~/COOLANTS
~, ® WASTE O'L
(FLAMMABLE LIQUID)
(~ CAR WASH PRODUCTS
I
I
I
' t AUBURN STREET
;
';. ' MAJOR-INCIDENT:~ ~-~ SP~' ~'-~' sUSPE CTEO
1. TURN, OFF ~PUMP_S ·using the Emergency Pump Shut-Off Switch.
2. EVACUATE: Verbally ANNOUNCE to all personson thesite: "This is an emergency. Please turn offyour
. engine~ and ~leave the station on.foot immediately. All employees meet at the emergency assembly area."
3. CALL'9-1-1:: Give the following information:
"THERE IS 'A FIRE / GASOLINE SPILL at the Tosco.76 service station at 5600 Auburn Street
If anyone is trapped or needs medical attention, tell the answering dispatcher. Stay on the phone and be prepared
to answer any questions concerning the situation.
4. ATTEMPT to cohtain the spill if you can do it' safely. -
5. LooKiAROUND to ensure that everyone has left the station, particularly those in vehicles who may need
assistan.' ce or may not have heard the emergency announcement. Assist or direct assistance to anyone having
· difficulty leaving the station are and anyone who may be injured.
6. REPORT to arriving emergency response personnel to provide them with any informati6n or assistance they might
need. · ' ·
7. CONTACT the station operator if he/she is not already at the station. Use the list below for'emergency contacts:
Emergency Coordinator: Tosco Maint. Call Center Title: Dispatch
Addresls:
Bus#/Home#/Alt#: 800-726-2312 / 800-726-2312 / -
Alternate Emergency Coordinator: Teri Nicholson Title: BDM
Addres}: 495 E. Rincon Rd. Suite#150 Corona .CA 92879
Bus#/Home#/Alt#: 909-270-5123 / 800-697-1388 /
8. NOTIFY theI following IMMEDIATELY to assist in the emergency and agency notification process:
Tosco Maintenance Call Center: i-800-726-2312
Tosco Business Operations Manager or District Manager·
Tosco Environmental Compliance Coordinator: North: Tina Berry (925)277-2319 or (888)671-4350
South: Stephen Boyd (714)428-6572 or(800)759-8888 pin#1267507
Tosco Coporation will notify the State and Local administering agencies within an appropriate time frame, unless
the s~t.ua, tmn reqmres urgent immediate response by the agencies, in which case the Operator should not~fy these
agenmes~.
a) LOCAL AGENCY: Bakersfield Fire Department -
PHONE NUMBER: 805-326-3979
b) CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800)852-7550(24 HOURS)
c) LOCAL POLICE AND FIRE DEPARTMENTS, 911
d) NATIONAL RESPONSE CENTER 1-800-424-8802 (24 HoURS).
MINOR INCIDENT: Any incident that can be contained and cleaned up as' part of the routine operations. Whenever in
doubt, consider the incident a major release and use the above procedures.
1. .FIt~. S: Extinguish with fire extinguisher. Recharge fire extinguisher, if used
2. SP~LS: Clean up with absorbent materials on site and dispose of according to all regulations.' Have a fire
exti~guisher ready for spills of flammable materials. Restock absorbent as necessary. See Training Plan item #H
for additional direction.
3. MEDICAL: Treat with on site first aid kit 'or take to nearest hospital. Employee training plan lists the nearest
· hospital.. · . ..
4. REcoRD: Recoi-d.the event in the daily monitoring 10g.,
5. -' NoTIFY:'the dealer of the event.
EMPLOYEE TRAINING PLAN
Employees ~imustlbe given this training before starting'work, and refresher courses must be provided annually.
Records mus't be l~ept to show.when each station employee has been given his/her safety training. Use the following
outline and make copies as needed. Have employee date and sign the attached training log upon completion of
training. Re{ain thse records fro' a minimum of three years.
I. FIRST THINGS TO KNOW: '
A. EMERGENCY PUMP SHUT-OFF:This turns off'the turbine pumps that provide flow to the dispensers from the
underground tanks. In case of a leak, shutting off, the pumps will help to prevent spills.
Location: 1-CASHIER 1-NORTH SIDE BLDG
B. ELECTRICAL PANEL: The panel allows youto selectively cut off power to lights, signs, pumps, etc. The main
switch kills all power at the site.
Location:: BACK STORAGE ROOM -
C. TANK MONITORING ALARM: Monitoring panel for the Underground Storage Tanks. This panel will indicate
when a 16ak is; detected by a visual and audible alarm.
k, ocatiom BACK STORAGE ROOM
D. ' WATER. SHUT-OFF: The water shut-off may be necessary'in some cases.
Location:: CORNER OF FAIRFAX AND AUBURN STREET
E. NATURAL GAS SHUT-OFF: If your Station has natural gas, it may be necessary to shut-off the natural gas fl0w
in an em6rgency. ', ..
Locanon: BUILDING REAR
F. PROPANE/LPG: If your station has propage or liquefied petroleum gas tank - In the event ufa release or fire,
turn off the manual valves and shut off the power to the dispensing pumps. Call your supplier or dial 9-1-1 as
appropria, te.
G.FIRE EXTINGUISHER: use only on small fires that you can handle. Do not attempt to extinguish large fires on
your owE; call 9-1-1 for help.
Locatiom 1-NEXT TO STORAGE DOOR, 1:FRONT DOOR, 1-PUMP ISLAND ·
H, ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of. gasoline, diesel fuel, or other
petroleurh products. Absorbent should be used rather than washing spills down a drain. In case of large spill,
merely try to contain it, a vacum truck should be used to clean up any large spill
Locationi SPILL KIT IN STORAGE ROOM
I. PERSONAL PROTECTIVE EQuIpMENT: These items shall be used by employees to prevent direct skin
contact v~ith a hazardous material.
1. Broom: REAR STORAGE
2. Shovel: REAR STORAGE
3. Gloves: REAR STORAGE
4. Goggles: REAR STORAGE .
J. FIRST AID KIT:
Location:i BACK STORAGE ROOM
K. EMERGENCY ASSEMBLY AREA: Location where all employees are to meet in the event of an emergency.
Location>NORTH SIDE OF LOT
HAzARDous MATERIAL MANAGEMENT PLAN (HMMP) MATERIAL SAFETY DATA SHEET
(MSDS):
Location: .CASHIER
* II. NEA~ST:MEDICAL FAc~TY: Employees should know what are available incase customers Or
-'.,other employees need medic'al attention.
1.NAME: KERN MEDICAL CENTER
ADDRESS; 1830 FLOWER ST BAKERSFIELD · ·.
PHON, E NUMBER: 661-326-2000 ·
NEAREST DESIGNATED TRAUMA CENTER:
2.NAME: KERN MEDICAL CENTER'
ADDRESS:· 1830 FLOWER ST BAKERSFIELD
'PHONE NUMBER: 66'1-326-2000
III. All emp!oye~es should review the Hazardous Material Plan, of which this training plan is a par~. Specifically,
each employee shoUld 'understand the procedures to be uSed in responding to various'kinds of emergencies, and know
how to monitor for leaks of hazardous materials. As a sUpplement to' this package, emplOYees should also review the
Emergency RespOnse Plan filed by your business to the appropriate local agencyY Thirdly, employees should review
and have access to the Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the
· station and must be drilled in all emergency response procedures contained herein.
IV. FIRST AID PROCEDURES (Fo[ exposure to gasoline or diesel fUel): ·
A.' EYE CONTACT: Flush With'water for 15 minutes while holding eyelids open. Get medical attention.
· B. -SKINCONTACT: Flush with water while removing contaminated clothing and shoes. Followed by washing with
soap arid water. Do not reuse clothing or shoes until cleaned. If ittitation persists, get medical attention.
C. INHALATION (Breathing): Remove victim to fresh air and provide oxygen if breathing is difficult. If not
· breathing, give artificial respiration. Get medical attention.
D. INGESTION (Swallowing):
DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE
LUNG[DAMAGE! If vOmiting occurs.spontaneously keep head below hips to prevent aspiration of liquid into
lungs, i'Get medical attention. .
F: NOTE.?O PHYSICIAN: If more than 2.0 ml per kg has been ingested and vomiting has not occurredl emesis
should ~be induced with medical supervision. Keep victim's head below hips to prevent aspiration. If symptoms
such asl loss of gag reflex, consulsions, or unconsciousness occur before emesis,'gastric !avage using a cuffed
endotrachael tube should be cOnsidered.
For further information, consult the Materials Safety Data Sheets for these products and for other hazardous materials.
FIRST AID FOR EXPOSURE TO OTHER MATERIALS: Consult the warning advice on container labels or refer to
the MSDS f6r that product. .' ' -'
This hazardous material management plan meets the requirements of a hazardous waste contingency plan.
Docume. nt prepared by: Environmental Staff RHL Design Group, Incl, 800-765-1025 Last updated: December 21, 1999
TRAINING LOG
II '
UNIT # 2708605 BUSINESS NAME: Circle K Storesl Inc.
ADDRESS: 5600 Auburn Street
TO BE MAINTAINED ON SITE
EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEI.VED THEIR INTITAL AND/OR ANNUAL SAFETY TRAINING.
DATE OF, TYPE OF
EMPi'OYEE NAME EMPLOYEE SIGNATURE TRAINING ,, TRAINING
('updated: Feb'r,uary 15, 2000)
"-'-." ,. ,"UNDERGROUND STORAGE TANKs :,FAClEITY: -' ',
i' ' : '" i' ~ 'J:' "' ':- ;~ ':' ~'" ' ' ,~' ' -' : ' ' ~ ' ' ' (one page per site) i
- '~" · · ' · ., : * " . Page __ o)'-'
- ~f~E OF AC~TION · :Ell. NEW SITE PERMIT'. 'Fi3. RENEWAL'PERMIT. J~5. CHAN'GE:dF INFORMATION ~Specifyc~'a'nge ~ El7. PERMANENTLY CLOSEI~ SITE ¢"---
(Check one ifem only) . -, [] 4.~AMENDED PERMIT ' local use only) ' ~ El8. T_ANK REMOVED 400' '
; · ' - ' "; El61TEMPOR~RY SITE CLO~URE
Ii :I~ACILIT~ tiBIaE INI~ORMATION
BUSINESS NAME (Sam~, as FAC,ILll~Y NAME or DBA- Doing Business, As) 3 · ~AC~-t~::::::::::::::::::::~:i::i:::::::::::::::::~::::::::::::::~:~:i~:i::iii 1::i
Cir~:le K Storeslnc. #2708605 / / 08605 ~;. '"
~EARESTC~OSSSTREE~ ~' ' '
40! ' .~ FACILITY OWNER TYPE · , [] 4. LOCAL AGENCY/DISTRICT'
NWC AUBURN' ST/!FAIRFAX RD' I~.1. CORPOI~ATIDN . .El 5. COUN'I~ AGENCY*
' ~ ~ ' : : :. 'El 2. INDIVIDUAL. ; ..- [--]1~ 6. STATE AGENCY'
BUSINESS TYPE IXih. GAS ~TATION [] 3. FARM .; [] 5. coMMERCIAL [] 3. PARTNERSHIP : - . "'~ [] 7. FEDER~kLAGENCY* 402
' ' ~I2' DISTRIBUTOR [] 4. PRocEssoR' [] 6, OTHER ' '
. i " : ' 403 ' . .....
TOTAL NUMBER OF TANKS Is facility on Indian Reservation or . *If owner of UST is a public agency: name of supervisor of '
REMAINING AT SITE trust!ands? division, Section or office which operates the UST..~
· · . (This is the contact person for the tank records. ' · ' '
3 404 .L ~ [~] Yes [] No 405 406 . . . .
IEi~ROER~OWNERilNFOR~A~IOH
PROPERTY OWNER NAME 407 PHONE 408
RUPERT, JAM~8 E, ·: 805"589-5795
MAILING OR STREET AD, DRESS 409 ) '
13104. SAN JUaN AVE .
CITY 410 " ~ ~. .STATE . 411 I zIPcoDE 412
BAKERSFIELD'~, " ' .CA J93312
PROPERTY OWNER T~PE[] ~ 2. INDIVIDUAL [] 4. LOCAL AGENCY I DISTRICT [] 8. STATE AGENCY 413
1. ~ORPORATI~)N B 3. P/~RTNERsHI~ iJ"~ 5. COUNTY AGENCY . [] 7, FEDERAL AGENCY .
.::.]:::::::::. u:;:::;::,:;::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: JJJ~i~A~J(:.OW~ERi J~J:ORU~JO~i
TANK OWNER NAME i' 414 ' J PHONE 415
-Circle K Stores ,Inc. ':' . "J (925) 277-2319
MAILING OR STREET ADDRESS 416 ? ,
P:O. Box'52085
· ' i; ' ,.. " "
CITY 417 418 ZIP. CODE 41~
Phoenix .~ . .~.TE' - .
'.'" ,. 850.172
TANK OWNERTYPE ' ' [] 12. INDIVIDUAL [] 4, ' LOCAL AGENCY I DISTRICT [] 6. STATE AGENCY 420
i []~'1. CORPORATION - [] 3. PARTNERSHIP [] 5. ~OUNTYAGENCY [] 7. FEDERALAGENC~; .,
!
TY (TK) HQ .42t
................. f ........... ..: ..................... ...: .............. ~::::: ~ ................... ...:..:::::::~ ........ ................ .:.......: .............. : ............ ..: ...... : ........ .: ......... : ........... ...... : ......................................................................... .................. ;~-: ............. --.: .=
.. [] 2. GUARANTEE ' [] 5. LETTER OF CREDIT . [] 8. STATE FUND&CF0 LETTER [] 99. OTHER: . ': ......
' '~ q'3. ,N. SURANCE · g 6. EXEMPTION _ . [] g.-STATEFUND,&CO _ . . . .....422
Legal notifications and Mailings will be sent to th& ~nk owne~ unless box 1 or 2 is checked· ' ~ ' ' ........ '~ --'":- ~ - ....................
Ce~ification: I ce~i~ tha~ the information provided herei~'is~rue a~ ~;curat~ f~ {~;'~es{'~'~ k~;;i;~'~;. ~ ; .
SIGNATURE OF APPLICANT_ ~ ~ ' DATE . / ~ ." 424 PHONE 425
f°rLT°sc0 '"~ - ';-" - - -'-: I Regional, Compliance Specialist - ...._.. . .
Mefliz~
z:
Nca!a
STATE. .UST'. FACILI~,. , NDMBER~,,, ._ . (F~.: ~ I~1 use only); ._ ....., .' ..,.,. ' ', ' '~ ¢ ;':. '?' .~' ~.; -' ~ ' . ",,.,,427¢:..,~ 1998 UPGRADE CERTIFICATE. NUMBER, .-~, (~.. ",'l~al use...only).:,L ,-.* · 428. - ,' . .. .~,. .' . ,
UPCF (1/99revised) , L - ~ ._ , , ' :.. '; . '. ' ' ¢, , :/ 5 :: . ? . ' FormerlySWACB Form'A-
--~- · ,.~=: . . E P OG M:.cON iD DFO
· :~-: ' ~ .' ' ' ~: ~ .... .: :-FACILITY INFORMATION, "-'. .... ."
.:.., .... _~ . . ,.- BUSiNESS<ACTIVITIES/ ~ .:. .::
...... ' < I FACILITY IoENTIFICATIOS '
"~ ;' : ""= ' : :'" I ' 'i' : CAL000013022~, "
· BUSINESS NAME (S~me' as Facility. Name 9f DBA-D0iflg Business As). , '~,
Cifcie-K Sioresilnc. #2708605'/ 4'08605 . - '-' . . :
. ~i .;-.' < ':': 'II. ACTIVITIES DECLARATION. ' :.~' · - ,
'. - .- . ..... ;~ .: ' NOTE: Ifyo,U check YES t° any'p~u.t:of this list,, ' ' ' .. ·
'' ' ' ~please submit the.Business Owrier/OPerator Identificat{on page' (OES Foi'm'2730).'
~ ' Does your'facility.~. ' ...... . " ~ If Yes, please complete these pages Of the UPCF:..
A. HAZARDOUS MATERIALS . · ~. ·
Have on Site (~or any purpgse) hazard0us;mateHals at ~or above 55. gallons
'for liquids, 50,0' pgunds for. solids, or.200 cubic ]:eet for compressed gases ' ' HAZARDOUS MATERIALS INVENTORY
(include liquids'in ASTs and USTs); or. the applicablg Federal threshold.. [] YES [] NO 4'- - CHEMICAL DEScRIPTiON (OES2731)
quantity for an extremely hazardous sub§tance spe6ified in 40 CFR Pa~t (This is repoerted with the HMMP.)
355, Appendi~ A o~'B;' or.handle radiologiCa! materials in quantitie~ 'fOr.
which an eme.~gency plan is required'pursuant-to 10 CFR.Pans 30,. 40 or . . .
70?. . ' -
B. UNDERGROUND STORAGE TANKS (USTs) " UST FACILITY fformer~y SWaC~ ~orm ^)
1. Own o? operate underground storage tanks? .. [] YES [] NO 5' UST TANK <one page per t.a~k. ! (F~rmerly Form B)
2. Intendlto Upgrade existing or install new 0STs? [].YES [] NO 6 ' UST FACILITY
=i UST TANK (one per tank)
;!.. !, UST INSTALLATION - CERTIFICATE
OF COMPLIANCE (one page per tank) (Formerly
' Form C)
3. Need ?,report closing a UST? [] YES [] NO 7 UST TANK (¢~osur¢ portion-one page per tank)
C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) ·
Own 6r operate ASTs above these thresholds:. , '
-Tanyitank CapaCity is'greater than 660 gall.ons~ or. [] YES." [] No 8 .' :NO FORM REQUIRED TO CUPAs
. ---the ,!otal ~apacity for. the facility is greater than 1 ;320 ·gallons? ....
D. HAZARDOUS WASTE ' '
· ~i , ' EPA ID NUMBER - provide at the top of
11 Generate hazardous wa~ste? ,, [] YES [] NO 9 .this pag~
2. . RecYCle more thhn 100 kg/month of excluded or exempted ,.. . · .. . .
',' ' , RECYCLABLE MATERIALS REpoRT (one
recyc!able materials (per HSC 25143.2)? [] YES [] NO . 10 perrecycler)
3. .Treaf!hazardOus waste On site? . ONSITE HAZARDOUS WASTE
· - · [] YES [] NO 11 'TREATMENT - FACILITY (Formerly DTSC
!" , ' ':" Forms 1772)
:: -. ONSITE HAZARDOUS WASTE
, ' TREATMENT L UI~IIT (one page per unit)
i i . (Formerly DTSC Forms ITJ2 A,B,C,D and~)
4. Treatment subject to financial assurance requirements (for · ' CERTIFICATION OF FINANCIAL
Permit by Rule and Conditional Authorization)? [] YES [] NO 12
· . ASSURANCE (Formerly DTSC Form 1232)
5. Consohdate-hazardous waste generated _at a remote site? · ' REMOTE WASTE / CONSOLIDATION
:! i' . ·~ : [] YES []' NO '13 SITE ANNUAL NOTIFICATION (Formerly '
. , DTSC Form 1196)
6. Need, to report'the.closure/removal 6f'a tank that was classified as [] YES [] NO i4 HAZARDOUS W3~STE TANK CLOSURE
hazardous waste arid Cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249)
· E. LOCAL-REQuIREMENTs, "
;' (You may also be required to provideadditional information by your CUPA or l~}cal agency.)
· ..+ "~ ~' i'-,, i'.--' , , , ~ . .'..,':. "' "'"
._ ,:' . -..,' .,:,. ,,:..""..'....~ ,: .:. :'.~-':~ . , ~- : .,_=..,. '.-, '.,. ,:, :~':.-.
":'" ./ '-." "" '--i,'.":,-' '-~ '" "~ ': 'i-' .'· "', :
:: "'':%i. 4 ..... -~"' ''-;" ' '-., - : · :'~ -,.' ,, "'
'"' ' ' '"' i '~' .' ~- Y ON " .... '
"' :. F.~ ILIT INFoRMATI ' ': "'~ ~:/' ' '~: '
' BUSINESS OWNER/OPERATOR IDENTIFICATION ' ........ '
· { · , ... . . :- ~ .
:~ ' ":- ' '", ,!:. i !i ': ,. .. .: . '.I, IDEN~IFi~A'TI0~"'.i. ;..; . ' '" . ~'' . i' '..".':
i: . . FACILITY.!D~:~: . i 'f' ] ,. ~.'[iii}iiiiiii:~ .',iliiiiiii!ili .'. '~.!, '. '. - i'..B£GINNI~GDATE. ' '°° . .ENDING.D.^TE
-~, BUSINESS NAME (Sa~.,?,~.'BACI'LITY NAM~0;~BA- Doi.agBusines? As) (. 2¢.~ ".-:,.. ',' .: :.31' :. BUSINESS PHONE. -i, '
[....,.'~Circ;¢.K!~iorcsiln~.'.';2708~}/.'/'..;'8~i 'i".'. .... ' -" : "q'i6~iSE71179;9 ' "'
. ' - '. ' ,BUSINESS SITE ADD~RESS ....... ~ , .: -. ' . .
· :i5600AUBURNsT. '(' '.. '",' '"" ..... ? "::~ i-;L:.' : '' :":
CITY ..' - ' '~ ~ . 1o4 ' .'5 ZIP CODE: - ~ .
. .., ~ .. :. ,.CA 93306 '~. .'
BAKERSFIELD ~'.. .- . .... . .. ~ . . .
DUN & BRADSTREET ::. ' ' i: . .... . -.' ~06 SIC CODE (4 digit #) ~ lO7
_.__~.__~m-gs~oTq ." ,:..:!~ ". .~. '. " ' 15541 ~ . ' ~ ';
COUNTY · : - .- .- : . t,:
BUSINESS OPERATOR NAME , .~ . ...... .; ~ .? ~o9 I BUSINESS OPERATOR PHONE.~ 11o
.. '.'-".. .- . 6618717979 . ."' .
"· ' II. BUSINESS' OWNER ~ ~
OWNER NAME ' ~ · - ~' · -: .... ' 111 OWNER PHONE
(925) 277-2319 '
OWNER MAILING ADDRESS · -~ ~ · -
CIT,Y :[ . .... n4 STATE ns. . ZIP CODE
~enlx ' A:~ 85072-2085
'; ' ' III...ENVIRONMENTAL CONTACT
CONTACT NAME
:117 . CONTACT~^~_. ~ ~.~PHONE 118
CONTACT MAiLING:ADDRESS . , 11~
CITY · :. ~2o I STATE 121 : ZIPCODE '
· CA ' · 94583
:[ ~PRIMARy- · ~v. EMERGENCY CONTACTS ~SEcoNDARy~
NAME .r lZ~ NAME - 128
[ . 'Tosco Maintenance Call Center
TITLE ii ~ 'i 124 TITLE . . 129
BUSINESS PHONE : ..:. - ~' BUSINESS PHONE. ~ · ~0
~'~~. 1-800-726:2312
24-HOUR PHONE ~6 24.HOUR~PHONE : 1~
r' 1-800-726-2312 ' ~
PAGER # " 127- PAGER # ~1~2
ADDITIONAL LOCALLY COLLECTED INFORMATION: . '
Certification: Based on my inquiry of tho~e individuals responsible ~(~r obtaining the information-, I ceriify under penalty of iaw'that. I have personally examined
and am familiar ~w~th the information'submitted and believe the information is tree, accurate; and complete.'
· D, 7/ ·
.REPRESENTATIVE ' 134 - NAME OF DOCUMENT PREPARER 135
'////~Otp '1 Kathy strickland
NAME OF SIGNI . 136 ' TYFLE OF'SIGNER .. . · ' . 137
Merliza Z. a for Tosco ' . I Regional Compliance Specialist
~:~. -:~, ! ..... '. ii:-~ .... . ::
~-~'. .: .':. ':: :t- ' ' ' ' ' '- ~ '- ": :",: '., 't,-~' ','.: : . ".'..".-:,"'/:
· : ~ .::'.?;.':- ..,.. , ~ .... ~ : , ..~: ; :~¥..'~ .~ ~,...~
F "~UPCF:(1/991~revis~d). . ,:; ~: · , .... . ': 5:.. · -~ · i;: ': , /OES'FORM 2730 (1/99)-
"~' '~r ' ~' ~ 7 ~".. Ulq~IED PROGRAM CONSOLIDATED .FoR]~ '
UNDERGRouND sTORAGE ' A K ' ~ ' ' "
~: :'TANKS ' T N -PAGE i
~ . ~- ' · ' ' ~ ' ; ' (twopagesper. tank}
TYPE OF ACTION [] 1. NEw SI~ PERMIT ~-] ,4f~uMENDED~ PERMI~ .': i[~ ~' CH/(N~E-OF~ .INFORMATION). . . ' - [] 6. .TEMpoRARY. . SITE cLOSUREr..
(Ch~k.one item only) - ./ ~ ..... . -: ' ' ' , ' .[-I 7. PERMANE~qTLY~LO~ED O~ SITE
~:' " - i [] 3. RkI~'EWAL PERMIT~ ~ "(Specifyr-e .... fo-rlocalu, iy) ' , ($pecifychange-forlocat ..... ly) " : ,FI .~1.' TANK REMOVED: ~ .430
BUSINESSNAME(SameasFAC1LITYNAME°fDBA'DpingBusines~AS)Inc # 2708605/08605 ~; '"~ ''ill SACILm ID #., ' ' ' ; " - ' ~ i . "i. . '
Cii~cle K-Stores ; . . . : : .
LOCATION WITHIN SITE (Option&0 ' ~ ' . ' '' , · ' . ' · ' . - . . ; 431
: .. , L,TANK- DESCRIPTION (`4~scaledpl~tplanwiththel~ati~n~ftheU$Tsystemincludingbuildingsandlandmarks~hal~besubmittedt~the~calagency.)
TANK ID # . ~, , ' 432 TANK MANUFACTURER' ~,33 COMPARTMENTALIZED TANK · [] Yes ~ No 434
. ~ ' If 13YesEl, c6mplete one page for each eompaxtment.
DATE INSTALLED (yEAh/MO),: ;435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437
ADDITIONAL DESCRIPTION (For local u~e only) 438
;:
n. TANK ¢0NT~.NTS '-
TANK USE ' ' 439 PETROLEUM TYPE 440
Xl. MOTOR VEHICLJ:, FUEL Fl la. REGULAR UNLEADED [] 2. LEADED , .. , [] 5. JET FUEL
(If marked, ¢ompletePetroleum~ rXoO ~]~b, PREMIUM UNLEADED ' Fl '3. DIESEL . [] 6. AVIATION FUEL
[] 2. NON-FUEL PETROLEUM ~'
,) ["l. lc. MIDGRADE UNLEADED Fl 4. GASOHOL [] 99, OTHER
Fl 3~ CHEMICAL PRODUCT
, ~ COMMON NAME 0er orn ~lazardou* Ma'terial# Inwntorypa~O 441 CAS # O~om ttazardoux Materials lnwntorypage)
[] 4. HAZARDOUS WASTE (lnclude* .
Uxed Oil) '~ , , ,.
Fl 95. UNKNOWN i ·
~ III. TANK cONsTRUCTION
TYPE OF TANK ~ [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL W1TH INTERNAL BLADDER SYSTEM 443
'Check one item only) " .~ 2. DOUBL[~ WALL . , EXTERIOR MEMBRANE LINER Fl 95. UNKNOWN"
Fl '4 SINGLE wALL IN'A VAULT [] 99. ~)THEK
TANK MATERIAL ' primar~ tank ' [] .1. BARggTEEL'.- ..X3. FIBERGLASS/PLASTIC [] 5: CONCRETE Fl 95. UNKNOWN ' 444
Check one item only). . i [] 2. STAINLESS STEEL '[] 4. STEEL CLAD W/FIBERGLASS [] 8. FRPCoMpATIB£EW/100% METHANOL' Fl 99. OTHER
~ REINFORCED PLASTIC ~FRP}
TANKMATER..IAL:seco~darytank [] 1. BARESTEEL: . ~3. FIBERGLASS/PLASTIC Fl 8. FRPCOMP./,.TIBLEW/100%METHANOL Fl.95. UNKNOWN
'Check one item only) Fl 2. STAINLESS STEEL ·' Fl 4. STEEL CLAD W/FIBERGLASS [] 9. FRP NON-CORRODIBLE JACKET.. [] 99. OTHER'
(. - REINFORCED PLASTIC (FRP) [] 10] COATED STEEL
' ' ' ' [-]' 5. CONCRETE
TANKi iNTERIOR LINING Fl 1. RUBBER LINED [] 3~ EPOXY LINING' [] 5. GLASS LINING' Fl 95. UNKNOWN446 DATE INSTALLED 447
OR COATING ' :i .
', [] 2. ALKYDLIN1NG [] 4. PHENOLIC LINING ~'~6. UNLINED ' [] 99. OTHER --
(Check one it .... 1/2 t . ~o~ local .....
OTHER CORROSION i [] 1. MANUFACTURED' '. ~ 3. FIBERGLASS REINFORCED PLASTIC [] 95. UNKNOWN 448 DATE INSTALLED 449
PROTECTION IF APPLICABLE . CATHODIC Fl 4. IMPRESSED CURRENT [] 99.· OTHER
(Check one item only) - PROTECTION ' ' .. (For local ~e only)
[] 2. SACRIFICIADANODE ' '
SPILL AND OVERFILL ,~, ' YEAR INSTALLED 450 TYPI~ (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED ' . 452
· ~ i IV. TANK LEAK DETECTION bt description of the monitoringprogram shall be submitted to the local agency.) .'
IF SINGLE WALL TANK (~h~ck alI that apply): .. 453 1FDOUBLEWALLTANKORTANKWlIHBLADDER(Checkoneitemqnly): 454
[] 1, VISUAL (EXPOS~ED POR'HON ONLY) Fl 5., MANUAL TANK GAUGING (MTG) Fl I. VISUAL (SINGLE WALL IN VAULT ONLY) -
[] 2. AUTOMATIC TANK GAUGING (ATG) Fl 6. VADOSE ~ONE 2. CONTINUOUS INTERSTITIAL MONITORING
Fl 3. CONTINUOUS ATG , Fl 7. 'GROUNDWATER [] 3, MANUAL MONITORING
Fl 4. STATISTICAL INVENTORY RECONCILIATION ~SIR) + '[-I 8. TANKTESTING
BIENNIAL TANK:TESTING., :[] 99. '~ER '
.,: . .: UNIFIED. PROGRAM CONSOLIDATED 'F0~I - ~ ' ~ . ~ SITE~ 2708605/08605
UNDERGRoi~ND STORAGE'TANKS ~- PAG
' .'~ ' .' '/yi..P!pINGCONSTRU~ION(Che&agaata~¢Iy) . ' .... P~e ~ of .
-' - - ~ UNDERGROUND PIPING " .' ABOVEGROUND PIPING
SYSTEM T~E I. P~SS~ ~ 2. SUC~ON ~ 3] O~Y 4~8 ~ 1] P~SS~ . ( - ~ 2. sucTIoN'.' . ~ 3. O~Y . 459
CONS~U~iON/ '~ 1. S~GLEW~L' ' ~ 3. L~D~ ~ 99.'O~R'- 460 '~'{.'S~OLEW~L ' ~' 95.]~O~ , . 462
~AC~R ~2. DOYLE W~L '~ 95: ~O~. : '~ 2. DOYLE W~L ' ~ 99. O~R ' ' .
~AC~R : 461 ~A~R ' · ~ - 463
'~ 5. S~LW/COA$O ~'9. CA~ODiCPaO~CUON 464 ,~ 5. S~ELW/CdA~O - ~ 95. ~0~ 465
~. ~I. PIPING LEAK DETE~ION (cae& all that ~ly)' ~ description of the monitoring program shall be'~bmitted to the loom
'; UNDERGROUND PIPING ' - -' ABO~GROUND PIPING
S~GLE W~L P~G · S~E W~L P~
P~ESSURIZED ~IPING (Check all that apply): . ' ' ' P~SS~IZED PIPING (Check all that ap)ly):
~ 1. ELEC~ONIC LINk LEAK D~CTOR 3.0 GPH ~ST W~ A~ PUMP SH~ OFF (Ok ~ 1. ELEC~ONIC LINE. LEAK D~OR 3.0 GPH ~ST ~ A~ PUMP SH~ OFF FOR
LEA~ SYS~M FAILU~; AND SYS~M DISCO~EC~ON ~ AUDIBLE ~D ~SU~ ' SYS~M FAILURE, AND SYS~M DISCONNE~ON + A~IBLE AND ~SUAL ALARMS
ALARMS' . ~ 2. MO~L~ 0.2 GPH'~ST . ' ' '
~ 2, MO~LY0.ZG~H~S~ ' '
t , : D 3. A~AL~Q~ST(0.1GPH5 '
~ 3. A~U~ ~GRI~ ~ST (0.1 GPH) ~. 4: DAILY VISU~ CHECK
CONVE~ONAL SUC~ON SYS~MS: CON~ONAL SUC~ON SY~EMS (Check aa~hat ~pply):
~ ' ~ 5. DAILY VISUAL MON~ORING OF PIPING AND PUMPING SY~M
~ 5. D~LY VISUAL MON~O~NG OF PUMP~G SYS~M + ~IENN~ PIPING ~G~ . , . '
~ 6. ~lENNIAL I~GR~ TEST (0.1 GPH)
~ST (0.1 GPH) .
SAFE SUC~ON ~yS~M~ ~O'~ALVES IN BELOW GKO~D PIPING): S~FE SU~ON SYS~MS ~O VALVES IN BkL~W. CROWD PIPING):
~ 7. SELF MONITORING ' ~ 7: SELF MON~RING
G~V~ FLOW:, ' ' ' ' G~V~ FLOW (Check aH that apply):
~ 9. BIE~ I~GK~ ~ST (0.1 GP~ ~ 8. D~LY ~SU~ MON~NG ~
~ 9. BIE~AL ~G~ ~ST (OA
~ SECO~Y CO~D P~G, SECO~Y CO~D P~G
P~SSUR~ED PIPING (Cqeckall th'at apply}: " P~SS~IZED PlP~G (Checkall that apply}: . ~ .
lO. CO~NuOUS ~RB~E SUMP SENSOR W~ A~IBLE ~D ~SU~ ~S AND
(Cheek one) ? ~ , 10. COPIOUS ~BINE S~P SENSOR W~ AUDIBLE ~D yISU~ ~A~S ~D (cheek one~ .
~ a.' A~ PUM~ ~H~ OFF ~EN A LE~ OCC~S ~ a. A~O PUMP SH~ OFF.~EN A LEAK OCCURS
~b. A~PUM~SH~OFFFORLE~S, SYS~MF~LU~DSYS~M ~ b. A~OP~PsH~oF~FORLE~S, SYS~MFAILURE~DSYS~MD~CONNE~ON
DISCO~E~ON ' ' , " ·
~ c. NO A~O P~MP ~H~ OFF' ' ~ ~' . " ~' c. NO A~O P~P S~ OFF .
~11. A~OMA~C LINC LEAK DE~CTOR (3.0 GPH ~S~ ~ PLOW SH~ OFF OR ~ 11. A~C LE~ DE~OR
RES~ON '
SUC~ON/G~V~ SY~M: SUC~ON/G~ SY~M: ..
~ 13. COPIOUS SUMP SENSOR + AUDIBLE AND VISU~ ~S ~ 13. CO~NUOUS SUMP SENSOR + AUDIBLE AND VISU~ ~A~S
EMERGENCY GENE~TO~S ONLY (Check ~ that ~ply) ' EMERGENCY GENE~TORS O~Y (Check a~ that apply)
~ 14. CO~INUOUS SUMP S[NSgR W~HO~ A~O PUMP SH~ OFF + AUDIBLE AND ~ 14. CO~UOUS suMP SENSO~ W~O~ AWO PUMP S~ OFF + AUDIBLE AND ~SUAL
VISUAL ALARMS, , ALA~S
RES~IC~ON
~ lO. ANNU~lmEG~(0. t OPH)
~ 17. DAILY ~SUAL CHECK :' ~ 17. DAILY ~SUAL CHECK
[ ' ' ~. DISPENSER CO~E~
DA~ INSTALLED ' ,A68 ~ 2. CO~NUOUS DISPENSER PAN SENSOR + A~IBLE ~D ~SU~,~MS ~ 5. ~NCH L~ER / MON~G
'[ ~ O~OPE~TOR SIGNA~E
I ceffi~ ~at ~e ~fo~afi~ ~o~fleO here~ ~ ~e ~d acc~ale ~o ~e ~e~ of~ ~owledge.
OF ' . '= ~ , 471 ~E OF O~E~OP~R .' . ' 472
. ~tNmber~orloe~sqohly) f-'473 ~ '- : :~e~t.Approve~or~ocqlu,eoM~) . ' ' ' :'.474 .[ P~tExp~fonDate~orlocd .... d~) 475
':' ' ~:' ' .i'i"'Ulq~I~D PROGRAM CONSOLmATED FOR'I~: '~ . -' ·
"" · ' UNDERGROUND·STORAGE TANKS TANKpAGE 1 : '."
TYPE OF ACTION . []-1. NEWSITEPERMIT , [] 4. AMENDED'PERMfff' ¥ [] 5. CHANGE oF INFoRMATIoN) S '6. TEMPORARY SITE CLOSURE
'Ch~ckone . item only) ~- ' ' :: '' , ' ' ' [] 7.: PERMANENCY CLOSED ON SITE .--
Circle K Stores hc St 2708605/08605 '/'~- '- ' . · . ,
LOCATION WITHIN SITE (Option'al): . ' ' ,~. - ' ' " ., 431
· LITANI~ DESCRIPTION (A tCaledplot pla~ with the location, oft~e UST ~xtem including building~ and landm~rl~ ~halt be ~ubmitted to the toeat ~geney.) ,. -~ ~,,
TANK ID # . . ' , 432 TANK MANUFACTURER , .. ' · 433 COMPARTMENTALIZED TANK []' ~s ~J~ I~o 434
' DATE [_N STALI.,EB ~EA~MO) .- 435 TAN,K CAPACITY IN GALLON S ' 436 NUMBER OF COMPARTMENTS ,., 43?.
'AD . NAL D RIP~.rON (For'loenlu.re only) 438 . . '
~[ II. TANK CONTENTS · '
TANK USE . , ' 439 ,- PETROLEUM TYPE ', " { ' . . 440
;R":. MoTOR' .:CL i'" , OULAR LEADED LEADED [] ,ET EL' , l. ·
· (lfm~rk,d, compl,tePetrole~m T.~i)' [] lb. PREMIUM UNLEADED [] .3. DIESEL [] 6. AvIATIoN FUEL.
[] '2. NON-FUEL PETROLEUM
[ · ,. '~10. MIDG~EUNL~ED · [] ~. OASOHOL ' []99. O~R
[] 3. CHEMICAL PRODUCT : '
[] 4. HAZARDOUS W~STE (Inelude~ COMMON NAME (froraH~a/'dou~Mat~rial~Inventorypagz) 441 CAS # (pomHa~ardou~Material#,Inventorypage) 442
Used Oil) ._ .
[] 95. UNKNOWN
i III. TANK CONSTRUCTION : . ·
TYPE OF TANK [ . [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM - ' 443
EXTERIOR MEMBRANE LINER [] 95. UNKNOWN
(Check one item only) ,: i 2. DOUBLEWALL [] 4. SI~qGLE WALL IN A VAULT
~ [] 99. OTHER'
TANK MATERIAL - pfima~r tank. ,, [] 1. BARESTEEL- ~3' FIBERGLASS/PI.;AsTIc [] 5. CONCRETE., [] 95, uNKNowN . 444
(Check one item only) · [] 2: STAINLESS STEEL [] 4. STEEL CLAD W/FIBERGLASS [~ 8. FRPCOMPATIBLEW/100%METHANOL [] 99. OTHER
:[ · : REINFORCED PLASTIC (FRP) '
TANK MATERIAL ' scc°n.~C?ry tank :' ' [] 1. BARE STEEL . X3. FIBERGLASS/PLASTIC [] 8. FRPCOMPATIBLEW/IOO%METHANOL [] 95. UNKNOWN 445
(Checkon~itemonly) [] 2. STAINLE'SS.S.TEEL [] 4. STEEL CLAD W/FIBERGLASS [] 9. FRPNON-CORRODIBLEJA~KET. [] 99. OTHER
: , REINFORCED PLA~'TIC (FRP) [] 10. COATED STEEL
TAN INTERIOR LINING; [] 1. RUBBER LINED [] 3. EPOXY LINING [] 5. GLASS LINING [] 95. UNKNOWN446 DATE INSTALLED
OR COATING
'~ i: [] 2. ALKYD LINING []' 4. PHENOLIC LINING ~t'6. UNLINED - [] 99. OTHER --
(Cheek one ite~ only) (~o~ lo,d ~ o,,ly2
~ERCO"XOSION ' ' ~ S mE,GLAsS REINFORCED PLASUC [] ~S UNKNOWN ~4~
KOTECTION IF APPLICA. BLE ~ [] 1. MANUFACTURED ' DATE INSTALLED 449
CATHODIC [] 4. IMPRESSEDCuRRENT [] 99. OTHER
J PROTECTION
(Check one item only)
(For locd u*e only)
· [] 2. SACRIFICIAL~NODE :
fiP1LL AND OVERFILL
,YEAR INSTALLED 450 TYPE (For loealuse only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED . 452
STRIKERPLATE I q
ii , IV. TANK LEAK DETECTION ~/description of th .... itoring program shall be ~bmi;ted to the local agency.} .
1F SINGLE WAL[L TANK (Cheek all that apply): . . 453 IFDOUBLEWALLTANKORTANKWITHBLADDER(Checkoneitemonly}: 454
[] 1, VISUAL (EXPOSED PORTION ONLY) - [] '5. MANUAL TANK GAUGING (MTG) [] 1. VISUAL (SINGLE wALL IN VAULT ONLY) ' '
[] 2. AUTOMATIC TAN~ GAUGING (ATG) [] 6. VADOSE ZONE · ~ 2. CONTINUOUS INTERSTM MONITORING
-[] 3. CONTINUOUS. AT0' [] 7. GROUNDWATER [] 3. MANUAL MONITORING
[] 4. STATISTICALINV~NTORYRECONCILIATII~N(SlR)+ [] 8. TANKTEST{NG
. BIENNIAL TANK TESTING [] 99. OTHER ' '
':._ ~ :. 'i ' ' '~" '' ' '1" "'~ ' "' ' '8aIl°ns' ' ' '~ I~ []Yes'. []"No - , -
~ UNIFIED PROGRAM CONSOLIDATED FORM SITE#2708605/08605
UNDERGR~' --N-OUD STORAGE '~'
':'i il -) .. '~ . :,.. .VI.:PIPINGCONSTRUCTION (ch-ech'allthat'app(y? ' ':':~ Page
· ; ' I~NOERGROUNO pIpING, '~ ' ABOVEGROUND PIPING.. .: '
sYsTEM TY~E" ~1. PRESSI~' ~' [] 2. SUCTION'" ,' [~ 3. GRAVITY 458 [] ~: PRES~UR.E [] 2.SUCTION [] 3. OP~vrrY' · 459
6ONsTRuCTi6N/ [']i1.. S]NGLEt WALL' ' · []' 3. LnqED, T~qG~'.. '.. ..[]. 99. OTHER . 460 [] 1. SINGLE WALL, - ' [] 95. UNKNOWN " ' ," '.: 462
mma*ACrCauR ]8(2. DOUULEWALL [] bS. Um~OW~ : [] 2. DOUU~EWALr . .In ~5. OTim~
' MANUFACTURER ~ ' 461 MANUFACTURER "
'" [] 1.B~ST~EL - []:6. FRP¢OIv~ATI~LEwt~00~METHANO~ ' [] 1. BAKE STEEI, ." ' []'6. FRP'¢oMI'ATIBLE W/100%METHANOL
MAT~KIALs AND :[] 2.'sTAI},ILESS STEEL. '[] 7. OALVANIZEDSTEEL. .~ ~. STAINLESS STEEL- [] ?. ~ALvANIZED STEEL '
C6m~OSION [] 3. p~,ASnCCO~Arm~,E.wrmcom'a, rrs [] 9LuNk~ow~ i'[3 3. P~.Asnccova, Am~.~.wrm6om~rrs [] 8. F~EXmn~ame~) [3 ~.o~-m~
" [] 5. STEEL' W/ COATINO [] 9. CATHODICPROTECTION 464 [] 5. STEELW/COATINO- [] 95. UNKNOWN 465
,~ VII. PIPING LEAK DETECTION (Check all that apply) ~ description of the'monitoring program shall be submitted to the local agency.)
UNi~ERGROUND PIPING, ABOVEGROUND PIPING
467
~ SINGLE WALL PIPING ' SINGLE WALL PIPING
PKESSURiZED~iPiNG(Checkallthatapply}: . PRESSURiZEDPlPING(CheckallthaJapply):
[] i..ELECTRoNiCLiNkLEAKDETECTOR3.0GPHTEsTWlTH- AUTOPUMPSHUTOFFFOR ~ [] 1. ELECTRONIC LINE LEAK DETECTOR3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK,
· ' LEA~, SYS~M FAILURE ~D SYS~M DISCONNECnON + AUDIBLE'AND VISUAL - SYS~M F^ILU~,'~p SYS~M DISCON~ECnON + AUDIBLE A~.D VISUAL ALarums
: [] 2. fi0NTHLY 0.2 GPH TEST "
ALARMS ~ ' ' .'
[] 2. MONTHLY 0.2 Gm ~ST' . '. " [] 3. ANNUAi. n'rrEORrrVTEs:r(0. IbPH)
[] ~. ANNUAL INTEOKITYTEST(0.10PH) ' - ' . ; '
CONVENTIONA~ SUCTION SYSTEMS: CONVENTIONAL SUCTION SYSTEMS (Check all.that apply):
[] 5. DAILY viSUAL MONITOmNG OF PUMPING sySTEM + TmENNIAL PIFING lm~aRrpr [] 5. PAtaY VISUAL MoNrrOmNO OF PIPING AND FUMPINO SYSTEM' .-
· 'mST (0.~ Gm) [5]: 6. ~X!ENNIAL n~rmGm/X mST (0.1 OP~)
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):
[] 7. SELF MK~NITORING [] 7. SELF MONITOKING ' '
GRAVITY FLOW: GRAVITY FLOW (Check all that apply):
[] 9. BIENNIAL [NTEGRIrY TEar (0,1 GPH) [] 8. DAILY VISUAL MONITORING
· ' [] 9. BIENNIALINTEGRITYTI~ST(O.I GPH)
sEcO~Am~Y cor,rr~DPIPING '. - ~ SECOmYum~Y CO~AmmPIPING
PRESSURIZED. PIPING (C?&! ~ that applyfi . ''. PRESSURIZED PIPING (Check aH th~ appfyfi
10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND vISuAL ALARMS AND ' 10. CONTINUOUS TURBINE SUMP SENS~)R WITH AUDIBLE AND VISUAL ALARMS ~qD (check one)
(Cheek one)
[] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ', , . ' . [] a. AUTO PUMP SHUT OFF WHEN A LEAK occuRs
~b, AUTO PU~P SHUT OFF FOR LEAKS, SYSTEM FAILUKE AND SYSTEM [] b, AUTO PUMP'SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION
-. DISCONNE?I~ON I ' .
[] ¢. NO AUTO P, UMP SHUT OFF [] ¢' NO AUTO PUMP SHUT OFF
~ 11. AUTOMA~ICLINELEAK'DETECTOR(3.0GPHTEST)WITHFL(~WsHUToFFOR ' ' [] II. AUTOMATIC LEAK DETEcTOR
RESTRICTION
F1 12. ANNUAL INT~GRITY TEsT (0.1 GPH) [] 12. AIqNUAL I~rr~oP~n'VTEST(O.l GP~)
SUCTION/GRAVITY SYSTEM: ! SUCTION/GRAVITY SYSTEM:
[] 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS [~ 13. CONTINUOUS SUMP SENSOR + AUDIBLE AND VISUAL ALARMS
' EMERGENCY GENERATORS ONLY (Check ~l that apply) EMERGENCY GENERATORS ONLY (Check all that apply)
[] i4. CONTINUOUSSUMPSENSORWITHOUTAUTOPUMPSHUTOFF+AUDIBLEAND [] la. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP. SHUT OFF + AUDIBLE AND VISUAL
ALAR3dS - .
VISUAL ALARMi' ,. ~ ~ . ~
[] 15. AuToMATIC LINE LEAKDETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR [] 15. AUT{~MATIC LINE LEAK DETECTOR (3:0 GPH TEST)
RESTRICTION [ ' ' ','
[] 16. ANNUAL INTEG,PdTY TEST (0.1GPH) [] 16. ANNUALINTEGRITYTEST(0.1 GPH?
[] 17, DAILY VISUAL '.CHECK [] 17. DAILY VISUAL CHECK
· ;[ vm. DISPENSER CONTAINMENT
}ISPENSER CONTAINM~ENT ~1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE [] 4. DALLY VISUAL CHECK
: DATE INSTALLED 468 [] 2. CONTINUOUS DISPENSER PAN SENSOK+ AUDIBLE AND VISUAL ALARMS [] 5. TRENCH LINEK/ MONITORING
I IX. OWNER/OPERATOR sIGNATuRE -
I certify that the informafi, on provided herein is h-aa and accurate to the best of my knowledge.
· '[ '474 iPermitExpirati°nDate(F°rl°cal"'e°nly)'75"
' permit NUmbe~·(Fo~: local .... ~ly) 473 . ~ .Pc .nnit Approved (Fo[ Ideal uJe 5nly) '~ ." ,. .
~ . · ~ D PROGRAM' N LIDATED FOR~ '
._ -. . UNDERGROUND STORAGE TANKS- TANK-PAGE 1 ' '
· . ~ . ... ,, . ', - ~' ' ' (twopage#per tank)
' i' ': :- '-i' '. !' '" .~, -' ' . , · ' · ,: .. . Page__of__
.TYP, EO. FACTIQ.N, .. ' ~ [].1. I~EWS _ITE'PERMIT, [] '4. AMENDED PERMIT . ,. ' [5~5. CHANGE OF INFORMATION) · '[] 6. TEMPORARY SITE C'LOSURE
'C-he& one item only): :'; "'; ; ' · ~- '~ ' · ~ [] 7. PEPdVIAN'ENTLy CLO~ED ON SITE r
' : '['q 3. :RENEWAL !~Ei~VIIT "~' " -~ ~'
· ' . . , (~pecify ? ...... for. lo. eM .... nly5 . , . (Specify change -for local .... niy),,. .-. , []- 8. TANK REMOVED. '. 430
LOCATION WITHIN SITE (Optional) .. - , . .- . ; 431
, ~- ' ? L TANK DESCRIPTION (Asca~ed~6tp~an~it~the~cati~n~fthe.U$~y~teminduding~mi~dingsandbmdmar~h~1~be~bmittedt~the~ca~agency.)
TANK ID # .: ~ ~ , ' 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ' [] Yes ~¢No
434
plete olde page for each c0mpallment,
DATE INSTALLED (YEAR/MO) ~ 435 ,TANK CAPACITY IN GALLONS '. ~436 NUMBER OF COMPARTMENTS · 437.
ADDITIONAL DESCRIPTION (Fo}- /oca/ use only) '- ' ' 438 · . .
" ' , IL TANK CONTENTS. . . ' '
TANKUSE · 439 .. . PETROLEUM TYPE
afma~d, com~leteP~t~l~ ry~e) [] lb.- PREMItJi~UNLEADED "[] a/DIESEL · [] 6.: AVL~'nON EUEL
[] 2. NON-FUEL PETR0~.EUM, [] lc. ~IDGR.ADE UNLEADED ' []' 4. GAS'OHOL [] 99. OTHER
[] 3. CHEMICAL PRODUCT
· ~ COMMON NAME (/rom Ha~ardou$Materia/s Inventorypage) 441 CAS # (from Hoza;-dous Materials/nventorypage)
[] 4. HAZARDOUS WASTE (Inkludes , . ,' .
Used Oil}. . ~ ~.
[] 9:5. UNKNOWN' .. .. '.
· : . m. TANK CoNsTRUcTION . .
TYPE'OF TANK ' . I [] 1. SINGLE WALL [] 3. SINGLE WALL WITH [] 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443
i - . EXTERIOR MEMBRANE LINEP.. [] 95. UNKNOWN
(Check one item only) i, , . ]~ 2. DOUBLE WALL' · [] 4. SINGLE WALL IN A V.~ULT
~ ,, [] 99.' OTHER
TANK MATERIAL - ~fim~,,'y tank
[] 1. BARESTEEL ,,~3. FIBERGLASS/PLASTIC [] 5. CONCRETE.' [] 95. UNKNOWN .. 444
(Chee!co;{itemoniy) ~. [] 2. STAINLESS STEEL' . ' [] 4. STEEL CLAD W/FIBERG'LASS [] S. FRPCOMPATIBLEW/100%METHANOL [] 99. OTHER
: REINFORCED FLAS'?C O~RF) ,
TANK MATERIAL- sec. o, nda~ tank [] 1. BARE STEEL '. X3' FIBERGLASS / PLASTIC . [] R FPP COMPATIBLE_W/100% METHANOL [] 95. UNKNoW~q ~ 4a5'
(Ch~cl,. one it .... ly) '~ [] 2. STAINLESS STEEb ... '[] 4 .~;TEE[, CLAD W/FIBERGLASS [] ~. FPP NON-CORRODIBLE IAGKET []'99. OTHER
. · , ~INFOReED PLASTIC (FPP) 'iq 10. COATED STEEL
; ' {3 .S. C0SCP, ETE
TANK INTERIOR LINING [] 1. RUBBER LINED ' [] 3. EPOXY LINING ]-] 5. GLASS LINING [] 95. UNKNOWN4A6' DATE INSTALLED
OR COATING ' -
~ 2. ALKYD LINING . ' []]] a. PI-IENOLIC'LIN~NG /~6. UNLINED [~ 99. OTHER __
OTHER CORROSION ; ' [] 1. MANUFACTURED~ ' ' "~3. FIBERGLASS REINFORCED PLASTIC . [] 95. UNKNOWN kM8 .. DATE INSTALLED 449
PROTECTION IF APPLICABLE CATHODIC/'~
PROTECTION
· . (For 1o~1 us~ only)
(Check one item only) i [~ 2. SACRIFIcIAE A~ODE
SPILL AND OVERFILL ! ' YEAR INSTALLED 450 TYPE (For }ocnl~ae only) 451 (SVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED ~52
i : ~V. TANK LEAK DETECTION (/1 descriptio~ of the monitoringprogr~m shnllhe .~uhmi,ed to the local agency.)
IF $lNO~. E W '~ALL TA~K (Check nil tha~ apply): 453 IF DOUBLE WALL TANK OR TANK WlTIt BLADI)ER (Chech one item oniy): 454
[] 1, VISUAL (EXPOS~ED pORTION ONLY) ' [] 5. MANUAL. TANK GAUGING CMTG) [] 1. VISUAL (SINGLE WALL IN VAULT ONLY)
[] 3. CONTINUOUS ~TG ~ [] 7. GROUNDWATER [] 3.' MANUAL MONITORING
[] 4. STAT1STICAL INVENTORY RECONCILIATION (SIR) +' [] S. TANKTESTING -
· BIENNIAL. TANK TESTING ' ' [] 99. O'I~IER
· ~' '- V..Tm~rI~CLOSta~ m-~0R~ano~ / ~'~m~Vi~NT CLOStm~ ~ P~¢~
,. - . . .? '. ;~ .-' . . . .--.. '~.,. .' -. . : : , -.'" .-' . .:-' ,. '.' .
· .. .'..- fi': .. :
-'5 ';" : ~ -': ' ' : .... · · ':~ ' "i~ .'':-~"
' ' ~" ', ,- ' ' ' "':' ~- _UNIFIED PROGRAM cONSOLIDATED FORM-- q:'' ~ q' ~
~' ' -~ "::;' ': UNDERGROUND STORAGE'TANKS TANK pAGE 2
';" .... .; . '.,-~ . ; 'VI. PIPING CONSTRuCTIoN '(Chec)eall }hat apply) ' -' Page
~'UNDERGROUND PIPING .' ' I ' ABOVEGROUND PIPING, ' ·
SYSTEM TYP~ 1. PI~E~SUR.E [] 2~..SUCTION. '. ' ' [] 3. GRAVITY 458' 1. PR.ES~URE [] 2: SUCTION . , - [] 3.'GRAVITY 459
CONSTRUCTION/ "[]Il. SINGLE'WALL [] 3: LINED TRENCH '.-[] 99~0TH~R. 460 [] 1. SINGLEWALL . [] 95. UNKNOWN :; 462
MAm~^CVtnUm ~..Z DO~3£~ WAL~ ' [] ~. U'aCNsv~ ' '- [] 2. DbU~L~ WALL. i - ,[]'~9'. OTUUR ' "
:' . ~ . .. ' "~ '- 463
MATER]ALS AND'. []'2. sTAINLEss STEEL · [] 7. OALVANIZED STEEL [] 2. STAIN-LESS STEEL [" "' [] 7. GALVA]'TFIZED STEEL
CORROSION' [] 3. PLASTIC COMp^TIBLE WITH CO~S '[] 95. UNKNOWN- [] 3. PLASTIC cOMPATI~LE WiTH coNTENT~ '~ .[] 8. FLEXIBLE (HDPEi [] 99. OTHER.-
PROTECTION ~4. . ' ~' ~" '
· . '... - FiBeRGLASS ~ []'$.FLEXlBI~E(HDpE) [] 99. oTI~R · [] 4. FIBeRgLASS ~ · 71 , ' [] 9. CATHODIC PROTECTION
[].5. STEEI~W/COATINO '[] 9. C~THODIC PROTECTION 464 [] 5. STEEL ~/COATING' ' '- [] 95. UNKNOWN 465
: ·; ' .-. . . VII. PIPING LEAK DETECTION (Check all tOat apply} ~4 de~bription ofth~ monitori~gprogram shallb, ~uhmitted to the local agency.)
:UNDERGROUND PIPING ' '-. ' ABOVEGROUND PIPING
. . SINGLE WALL PIPING ~ · SINGLE WALL PIPING 467
.PRESSURIZED PIPING (Check all that apply}:" ; ' : ' ' PRESSURIZED PI?ING (Check'all that apply): ;
[] 1. ELECTRONIC LINE, LEAI~ DETECTOR 3.0 GPH TEST WITH AUTO PUMP sHUT. oFF FOR [] 1. ELECTROnIC'LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUT OFF FOR LEAK,
' LEAK, SYSTEM FAILURE, ,/,ND SYSTEM DISCONNECTION + AUDIBL~ AND VISUAL ? SYSTEM FAILURE, AND SYSTEM DISCONNEi~TION +AUD. IBLE AND VISUAL ALARMS
ALARMS ' . '' '" ' ' [] 2. MONTHLY'0.2GPHTEST ' ' ' .' ' .~ · ' ' . .
[] ' 2. MON~LY 0.2 ~PH TES~ ' [] 3. ANNUAL INTEGRITY TEST (0.1 GPI~ ' - ·
[] 3:ANNUALINTEGR[I~YTEST(0.1 GPH) ' ' ' " [~ 4. DAILYVISUAL'CHECK '
~ ,I cONvEN'~IONAL SUCTION SYSTEMS (Check all thqt apply}: '
CONVEN~ONAI: SUCTION sySTEMS:
[-] 5. DAILY VISUAL MONITORING'OF POMPING SYSTEM + TRIENNIAL PIPING IN~rEGP'yrY ' ~]-'5.. DALLY VISUAL MONITORING OF. PIPING AND PUMPING SYSTEM
TEST(0.! GPH) .. []' *. TRIENN!A[:INTEURITY TEST (0.1 G/m) '
SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): SAFE SUCTION SYSTEMS (No VALV. ES lI~ BELOW GROUND PIPING):
[] 7. SELF MON1TORINGi ' [] 7. SELF MONITORING - .
GRAVITY FLOW: ~l ~' ' GILa,~"ITY FLOW (Check all that apply): '
[] 9. BIENNIALINT~GRITYTES~(0.1GPH) - ' . [] 8. DAILY VISUAL MONITORING
' . .... -:_ ~ . .' . '. -, [] 9: BIENNIAL~rr~GRITYTEST(O.rGPH)
SECONDARILY CONTAINED PIPING· ' ' SECONDARILY CONTA~ED PIPING .
PRESSURIZED PIPING (Check all that apply):~ ~ PRESSURIZED PIPING (Check all that apply}: . '
10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL: ALARMS AND i0. CONTINUOUS TORBINE sUMP SENSOR WITH AUDIBLE AND VISUAL ALARMs AND (check'one)
' (Checkone) 't .
[] a. AUTO PUMP~ SHUT (~FF WHEI~ P~ LEAK 0CCmS . - [] a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS
b. AUTO PUMI~ SHUT OFF FOR LEAKS, SYSTEM FAILURE AND S~STE~I [] b: AUTO PUMP SHUT OFF FOR LI~AKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION
DISCONNE(~TION · - . ,.
[] c. NO AUTO POMi~ SHUT OFF [] c. NO AUTO PUMP SHUT OFF
~ 11. AUTOMATICLINELEAKDETE~TOK(3.0GPHTEST)WITHFLOWSHUTOFFOR -., [] Il. AUTOMATIC LEAK DETECTOR
RESTRIC'nON :I '-
~] 12. ANNUALINTEG~ITYTES;i'(0. I. GPH) '. · : [] 12. ANNUAL INTEGRITY TEST (0,1GPH)
'lSUCTION/GRAVITY SYSTEM: , . ' SUCTION/GRAVITY SYS'~EM:
· : [] 13. CONTINUOUS SUMP SEN.SOR.+ AUDIBLE AND VISUAl. ALARMS [] 13. CON'ITNUOUS sUMP SENSOR + AUDIBLE~AND VISUAL ALARMS
EMERGENCY GENERAToRs ONLY (Check all that apply} : EMERGENCY GENERATORS ONLY (Che~k all that apply)
~ 14. CONTINUOUSSUMPSENSORW1THOUTAUTOPUMPsHUToFF+AUDIBLEAND . , [] 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUT OFF + AUDIBLE AND VISUAL
VISUAL ALARMSI, ALARMS '
[] 15. kUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW sHUT OFF OR. [] 151 AUTOMATIC LINE LEAK DETECTi~R (3.0 GPH TEST) ' ·
· RESTRICTION ~t - .
[] 16. ANNUAL INTEGR?Y TEST (0,1 GPH) [] 16. ANNUAL. INTEGRITY TEST (0.1'GPH) ' '
[] 17. DAILY VISUAL C'~tECK [ [] 17. DAILY VISUAL CHECK -' '
': Vlli. DISPENSER CONTAINMENT '
DISPENSER CONTAINMENT Xl. FLOAT MECHANISM THAT sHUTs OFF SHEAR. VALVE · [] 4. DAILY VISUAL CHECK
DATE INSTALLED , 468 ' [] 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS ,- . [] 5. TRENCH LINER / MONITORING
Iqq6
I [] 3. CONTINUOUS DISPENSE~ PAN ' ' ' [] 'B. NONE 469
. SENSOR WITH AUTO'SHU'r OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS
.~ IX. OWNER/OpERATOR SIGNATURE
I cea/fy that the informal/oh provided herein is true and accurate to the best of my knowledge./ ' . '
NAME?FOWNER~.~OR.~rtn0 '.'.. 'i .." '' ' :-:' '~. · :; . 471 :TITLE OFOV~'/ER]OIfERATOR .... '472
M~RLIZA Z~ ~,~I~CALA, FdR TOSCO . ~',.' ~ .'.-' ,_ '.'. ' '" ' REGIONAL COI~ipLIAN(~E SPEcI~LIsT'
Pem~i[Numbcr(For']o&al;tsei>nly) t 4~3.~ ]."lI pgrmitA~prov~d(Forlocaluseonly}..- . ..'' . - '' '~' -: 474 'PchnitExpirafionDate(Forlocaluseonly)'475
.. _ .' _ . . . . -~.. ~.- ~ - -. . . -
BUSINESS NAME" , (SameasFAClLl~:N~EorDBA-DoingBusin~ssAS) '~-:' '. 3 . - ' '~ . . .' .- ~ ,-.
,r:¢p[ea e ;s u h us n:e s rio p e r.ato r:l d entail cat,on : eaa (0 ES ,F O't 7:3
~' ' Have on site q~r any purpose) hazard0us.materials at or above 55 - ' ' '~ .- '
.. - gal'Ions ;for liquids; 500 pounds for solids, o'r 200 c~bic feet for - ~' '/. ": ,. .~ ,' ~ ', ' - · ' · , ,
· compressed gases (include liquids in ASTs and USTs); or the . ~ yF~ ~ N~ ~ ~RDOUS MATERIALS INVENTORY -
apPl ca~ eFedera threshb d quant ~ for an e~reme y hazardous ~---.~ "~:- ~
- CHEMICAL DESCRIPTION (OES2731)
substance.specified ~n 40 CFR Pa~-355, ~ppend~x A or B; or · -.= ' - -. ., . .
' .'handle fadiological materials in quantities for which an emergency -' . ..
plan is required pursuant to 10 CFR Pa~s 30 40 or ~07 . ..... - '
1. Own or'~pera{e undergroun~ St0ra~e tanks?...~ ~ .~ UST FACILI~ (F0r,,,eHy~
S~CB
ForA)
2. Intend to upgrade existing 0r install ~ew USTs? '~ ~ ;YES .6 ~ UST FACI~I~ , '
· ~ . -' ~ UST TANK (One ~r ~nk -
" ' ' ; ' ~' usT iNSTAL~TION - CERTIFICATE,OF
..... . : .- - , COMPLIANC~one page per ~hk)(F0~efly Fo~ C)
3. Need to~repoR closing a UST?. ' ' " ' ~ yES~ NO 7~ ' UST TANK .. (d~SGm ~i~n~ne page ~
C. ABOVE GROUND PETROLEUM ST0~GE TANKS (ASTs)~'- ~ ~ ~ : - . ,.
--anyOWn or,,,0perate, ASTs. . above these, thresholds:. ' ' ' ' ' .' 'N 8
tank ~pacl~ Is greater than 660 gallons~ or- ~ NO
REQUIRED
TO
CUPAS
--the total~ capacity:, for~ the facili~.is greater~...than. 1,320. gallons? ' , ,,~ .. .
D. ,H~RDOUS.WASTE " ' ', . ' ~-, ~,. :
. . rec~clable,materials (per HSC ~ 251~3.2)?: - .: (one per'r~der)i
3~ T~eat hazardous waste on site? .. ..... ~ YES ~ 'NO 1~ ~. -ONSITE ~RDOUS WASTE .- ·
· ' .... TR~TMENT -~FACILI~
- ' ' , R~TMENT-~NIT(one page per unit) .
(Fo~
DTSC
177~,B,C,D,
and
L)
'4. Treatment Subject to financial assuran~ Fequi~ements'(f~r'Permit ~ YES~'NO 12'
OF
FINANCIAL
by Rule and Conditional authorizaton)9,/, ~ ~. Assu~NCE (~o~edy DTSC Fo~ 1232)
5. Consolidate h~zard0us Waste generated a~a remote site? ~ YES~,,.y13 ~' ' REMOTE WAST~CONSOLIDATION SITE
·:~/:'. ' - · ANNUAL NOTIFICATION (Fo~e~
6.' Need to :repoR_ the clo~ure/rem0val of a ta~k that was classified as: ~ YES 14,~ ' ~RDOUS WASTE TANK C'~OSURE
.- hazardous waste and cleaned o~site? ... ' ' ' CERTIhlCAIjlUN- -- (F~edy DTSC F~ 1249)
E. LOCAL REQUIREMENTS ': : . ,: ' . 15 . :.
:~;(You may also ~e required to provide:additional.i~fomation by y~u~UPA or Jotul agency.)...',
2708605 " -: - UN. IgI'EDPROGRAM coNsOLIDATED-FO~nn' _ i-
"._ . ". FACILITY INFORMATION
....------------_________ .___lil'JglNES,N OWNER/OPERATOR--------------- -------- ,------v.---v.., ~,/D'F, NTIFICAT]ON-:- ,:-. ' .... :~ -: ./' ,-
i.;.: :" .... ' '-~ ..- '
- -.. ~ .. .. t. : ' -" , L .;IDENTIFICATION.' ' ~' "* :.'.:,,..., . -. '
ID# BEOINNINGDATE' '~ '100 ENDINODATE ' ' 101
'.--*./ 11112000' '; '....' .... '
BUSINESS'NAME (Same as FACILITY ,N_AMEor DBA--.Doing Business As) . .. - :. ..... . ' "' 3, BUSINESS PHONE . . - ' ' 102:,
' - ' -
.... - - , .- Circle K Stores, In~: ' ' "~ ' ~"-::' ~
BIJSINESS SITE ADDRESS -.~: .': _ -' · :': - · ' · '- -
.... . 5~0OAuburn Street - - ': ' ~ ''~ '"' -
,~o4 cA ' ' ziP CODE.
CITY Bakersfield ': :
..... ' ,l' · .L ~... 93306
DUN
:BRADSTREET
· : 106- SIC CODE (4 digit #) _ , 1 o?
04-8564975
?.OUNTY - - ~o~
KERN - -_
lO9 BUSINESS OPERATOR PHONE 11
Manager " '1" i'' 909,270-s12a
- ' II. BUSINESS OWNER .-~
OWNE~N~E Circle K Stores, Inc. ~t~ - OW~E~P~ONE_ ~02-728-7080
OWNER. MAILING ADDRESS -. .
P.O. Box 52085
' , aaa STATE . '115 ZIP CODE 1~
crr~ ~ ~hoenix AZ - ' 85072-2085
CONTACT NAME III. ENVIRONMENTAL CONTACT
Merliza Alcala ~? -__. . CONTACT PHONE ~25-277-23~
CONTACT MAILING ADDRESS
2000 Crow CanyonPI. Suite 400 "
S
crrY San' Ramon' . ¢^
PRIMARY IV. EMERGENCY CONTACTS : ' SECONDARY -
NAME - ~2a NAME: · 128
Teri Nicholson Tosco Maintenance
TITLE 124 TITLE '~ 129
Dist. Mgr -' -. - '~ Dispatch Ctr
~OSINESS PHONE ~s BUSINESS P~O~ 800_7_~_L-_,i2~62S
' ' 909-270~5123
- 131
24-HOUR PHONE 800-697-13~]8 ' 126 24-HOUR PHONE
800-726-23
1
2
PAGERg 127 PAGER// ' '~-' 132
ADDITIONAL LOCALLY COLLECTED INFORMATION:
Certification: Based on my i: of those individuals responsible for obtaining the information, I certify, under penalty of la~ ~hht I have per,4onally examined andam
familiar with the information and believe the information'is true, accurate,'and complete.
OF ~Jl~TE/~/~ '134 INAME OF DOCUMENT pREPARER' 135
"~ ~"~l,~'' ' "1' RHL DESIGN GRouP IN'c. - ENVIRONMENTAL DEPT.
· -._ ::.,. i ,_~::~...::-._:. .-~..:; -:....~:-..,( .... - . -~-..¥. ~...~_.: ..:... :- .. _-..-::. ),~11 _-..:, ....~: HAZARDOUS MATERIALS-
"~': ' ';" :'1'. I:~D':';;--:'' "~-I-"-:1'-~ELETE'?5 ,-,..'.~_ ' '1 I ~VISEA:-: ~'' " :;. :':' :'{2 ..,20P,-I '- '. ': ' ' .... Page. ~ of ~,'..
: '.:.:.: '-',;, -~: '-'.?- : --.~' -" ~.':~ ' :.:~..I;FACILI~YINFO~TION:-.','.: :'-,:..::':,' '.:~ _' , . -.., · . , .
BUS~ESSN~E:"- .':: ' -:--: ,~-" ' :-. ",''.-':':"~}~. -'-. :' ' '- '' - ' ...... ':' : ~" ' "' .¢ · - :':-' , -' :...: ' 3
'. ..'-~"-. 'CircleKStores,"lnc.' ' · .... -'.-" -- :'.- ... '-' ':. '~ '- '. '~ :'"/;" . '2708605 ."
. ' "" "-' '~; - '; -- 202
,. ' SOUIH~STCORNERLOT '-':-.. · . .: :. Etch: I I~S.'/:IXI':N~
: . . .. . - . ..... . .~: ..'~.' .: . .
. .... ' " : ' -:. ' - IL CHEMICAL~FOR~TION . .- -' "' ' .::'.
C~C~N~. P~RoLEuM~YDROCARBON:: .' .' 205 ~E. -SEC~T .-~Yes ~o
' ~"'. · . - ~' . ~- " ' ' IfSubj~tm~C~,refermin~ctions :
' ,.": , 'REGU~R UNLADED ' ' - ' - : ' '. ... ':_ :'~ Y~s~ No.
CAS~ "': 8006-61-9 : - '. . : . . .'~ .. '209 ~EHS is "Yes", ~l ~o~ ~lb~ must ~ in Ibs.-
F~CODE~C~SSES' (Compl~,ifr~uir~byC~A) ' I-B F/.' MABLE~ LiQuiD.. .:. ' . · ': ' . ' ' .... . 210
~ ~ , ' ' 211 213
(CheckP~SiC~0ne itemSTA~°nly)" ,'.~ a: SOLiD ~ ;.:~iQ~D ~ c. GAS 214 ~GEST CO~R. '.,0000 : . - - 215
~D~ CA~S .... ~ 210
': 8000 ' , 10000, ' ' : ' : ' , '', ' . ' '
eo s a. o* os
(Check one item only) -" ifEHS, mount must be in pounds. ' 365.
CO~ERSTO~GE .' ~a.' ~ovE GReeD T~ ..~ c. PLASTIC~OmET~LIC__ DRUM. i. FIBER DRUM'..: ." ~:' m. GLASS'BO~LE ~o~ ~L C~
b. ~DERGRO~D-T~ t' C~ j. BAG · n. P~STIC BO~E · [ [p. O~R
.... __ c ov "- k. ... -- o. TOT
d. S~EL DRUM '. '-.' h'.-SILO ' I. C~ER ' -- p. TANK WAGON
~. ' ' - ~ :- -223
STOOGE P~SS~ .: .~ a: AMBIENT- -. b. '~oVE AMBI~T · c. BELOW ~BI~T 224
sTO~GETEMP~TU~ ~k ~BI'~'... '~'b. ~OvE~i~T '~c.'-BE[0W mBIEN~-',' ~d. cRYoG~IC
'- · %WT ' ' ' . ~OUS. COMPON~T (For mixture or w~teonly) . EH~',' ' ." CAS~
1 15%' " 2~6 METHYL TEaT BOWL ETHER '. ' 227. ~cs' o. :22~. 16~-044 . ' 229
2 i5% 230 TOLUENE ' ' 231 .~c~ ~o. 232- '}108-88-3' 233
3 21%· · . 2~' ~,LENE .... , . "' - . . ': 235 ."' e, - . ..236. 1330-20-7
237
4 5% ' '2~8 BENZENE · .- 239 ~
. c o 240' 7.143.2 · 24~
5's~ .'-~2t2,4-!mUETHYLBE.ZeU~ ' . .m ~V~ ~o ~nn ~S~3~'' .
.If more h~dou~ mm~m'~ prm~t.at ~tar ~ 1% by wei~t itnon~cinog~ic, or 0.1% by Wei~t if c~cinogeniq a~a~ ~difion~ sh~ of pa~ capturing ~ r~ui~'information.
~mnON~ LqC~LV COLLEen mFO~T[ON' :. ' ' ---
;.'. '~:~ ;'.':5.'. :' ',-~'.' -~' :~' ' ' ' :' ' '":' ~ --4'"- . -,'
.... HAZARDOUS. MATERIALS:iNVENTORy
' ~)D ~' ~ .-_-- DELETE;-': .' ' ~VI}E --' . _. -'"::: ,"' = "< -_ 2bo: - ": -.,'P~ge' 'of
" ' ' ~ :I. FACILITY'INFORMATION (- -" -~". :.'
BUS~ESSN~E:-.- 7':' -"' " ' : -:' L - - -'-, .' -: ' ' : ,', '".- . ' ~ - - 3
. Circ~e.KStqres, Inc. '.-_.~ , -;". - .. : '. ) :; '.-.'-_. '..'..' .' . ,. 2708605 ' ': '
c~c~'
2o2
' . '~C~ '~S ~No' ' :"
SOUTH~ST CORNER LOT- - ....< '. . .~ . .
FACm~ ; . o ti n '29 Grog (o~tion~). 204
.., .
II, CHEMICAL ~FOR~TION ': .... .
C~C~N~ P~ROLEUMHYDROCARBON- ' ' 205 ~E.SEC~T.. ~Y~s ~ 206
'~ If'Subj~t m ~C~, refer m ins~ctiom
co~o~ 2oz~.~ ~- 200
PLUS UNLADED ~ Yes.'. ~ No
CAS~ 209 · - '
8006-61-9' IfEHS is "YcJ", ~11 ~o~ below must'be in lbs.
~ C~SSES (~ompl~e if requir~ by C~A) : 210
- I-B F~MMABLE LIQUID " .....
~ ~ 211 213
~E(Chcckonei,~ ~ a. PU~ ~ b.~XT~- ~ c. WAS~ ~IOAC~~ ~;YcS-' ~o 212 CmL
P~SlC~STA~ ' ~a. SOLID~b. LIQUD ~c. OAS 214 ~RGESTCONT~ER " 2'5
apply) . . ' '
AVE~GED~LY~O~ 217 ~MUMD~LY~O~T 218 ~U~WASTE~O~T.].. ' 219 STATE ~ASTE CODE 22o
7000 I ~'' ~oooo . - '. ' ' '
itcm only), ifEHS mount must bc in pounds. ,] 365
· ~c. TA~mSIDEBUL~m9 ~. C~OY ~k. BOX .-~O. TOT~m .,
~a. s~[ ~uu . ~. s~[o ~t. c~*~~ ',~.. ~wx°o~ . ..
.- .·223
STO~OE P~SSU~ ~ a. mmENT ~b. ABOVE AMBIENT ~c.'--BELOW AMB'IE~T'. ': '224
STO~GE~MPE~TU~ ~a: ~BIENT '~b.'~OVE~BIENT ~6.:' BELOW~BIEN+ '~d. CRYOGENIC .225
%~ . ~OUS COMPON~T (For mixture or W~te only) . - EHS ~. CAS~
15% '226 MECHyL TEat BUWL ETHER "' .. 227 ~eS ~0'. 228 ~16~-044
15% 230 TOLUENE . . :. ~' 231 ~¢s ~o .232 108-88-3 233
21% 234 XYLENE -.: 235 ~es ~o. ' 236' 1330-20-7
237
5% . 23~' BENZENE : . 239. ~ ~"°
5% 242 ~,2~4.TRiME~YLBENzENEy . 243 '~Yes '~6~ '2~ 95~3-6 245
If more h~om mm~nena ~c pr~mt at grater ~ I% by wei~t if non~cino8~ic, or.O. 1% by wei~t if ~cino8~niq a~ ~difional,~h~ ofp~p~ ~pmfins' ~e'r~ui~ info~ation. '
~DITION~ LOCALLY COLLECTED ~F0~TION ' . . . ' 246
-,
.:. ; :.. :;: :] :. :,. ,: .: .:: ~ : , :' ~ ~,---,lf EPC~, Ple~e Si~n Him
· ::.. . . :??.' _ . . , -'-. ..... ~ -.' ~:'- ~.~ .' .'; .j" .';'L ..... : .". . . .. .. .. . . ' .
' '" ":?l"-~-ADD,',': -. 'l ~'DELETE'-x ;-:':: -:: .,' .~ 'I'~VISE .... .:, ".:~ ;..., .: 200',' :";-':'-': ':.. ':' Page
B~S~ESSN~E.'- ..;..~.., '. ~.......' .,' . .' ~... ' ,-. .... -. - c-- ...:-'
' ..... .. 2708~05'4 .
~C~LOCAT)ON. . ',:.~: '.':'..: ~- ..' .... ~' : . :. '" - . ' '. ~' '. '.' ~f ' C~LOCA~ON~O~E~ .. "· 202 -
. ' SOUTH~TCORNER LOT;'" :': . - . % '. ': ; - .
· .;: . .. . .,: - .:..... - . ..... ..',: . · , .. --.; .-.. .
-"~ ' '-' .."~' L. :' II, CHEMICALINFOR~TION.' - .. , , ~ ' '. ':- '. ~ '
:~C~N~' -P~ROEEUM HYDROCARBON ' ' " . 205- ~E. SEC~T .'~y¢s ~o' .. - 206
' ' '" - ".'.~' '" ' .; ' ' ' · ' '" ' . ifSubj~t~C~ referm instmaio~s . . ~ .
CO~ONN~ PREM: ' ' ' ": ' """ - ' ~ '" 20~ ' '- ' ' ' - : ' ' '20~
· {UMUNL~DED.' , . . '- ~ " EHS, ' " ''"~ Yes
'~006- . . . .... v . ,
CASff ' ' ' ~l-g , ' ~ "- ': 20g .~ EHSis "Yes", all ~o~ ~low must,be in lbs. " :
F~ CODE ~C~SSES (Complete ir rquira bY C~A)'" . .... Q0 " ". -. ' . -': .. .210
:: . .... : , FB F~MMABLE LI ID .. . .
· . 212
~E (Check one itm , . , - -
P~SIC~ STA~ :' ~ - c'. GAS LARGES+ CONT~ER ' ' :' "
Check on* item only) -. .a, S b. LIQUID': . · 2~ -
Check~l~atapply) [' . ,, . ........ . ' . . . ~ -
,VE~OE D~LY mq~)'-. .... ,~Z )~MV~ Dm~Y~O~ ...~ ~ W~S~ ~O~T. .~' ~ STATE'W~STE CODE ~0.
' 6500. , . '1 -"--,~..'.':10000 : - , .. . " ' '~. :.' , ' _ ' ' '."
' 221' DAYS
(Check One item'qnly) ., .- ifEHS; mount must be in pounds, ' ' "'' ' . .. 365,, -'
CO,T~E~~b' ~PE~oRO~D+~' ~ r. C~. ~. ~AO. ' - ~ h. PLASTIC BO~E- ~p. O~
~ '.- . .' ~. '.',. .. , . ',<'"- "' ~.: · .:" . ' 223
' ' ' ,."SMm '
'.' '-'.- ...
%~ . ~ ~A~OUS COMPON~ (For mixtuie 0r w~te'only) -., · ,. EHS. ~'- ' ' ' . CAS~ .
1 ~0~. .-. 2.2~' 'METHYL TERT. BU~LETHER ~ 227.' )e} ~o, 228 . ~6~-0~4 . .22~
'' · .......
2' g~o 230. ' TOLUENE~ ".C' : .- -. ' 23~ es'. .2a2 '~08-88-3 _ 23a
3 14% : 234 XYLENE " '' ' - . .' 235 ~cs ~o' ' 236. -~330~2'0-7 237
4 5;~;' 23~ 1,2 4.TRiMETHYL BENZENE',. ,. ..' " -. ''.' 239 .~cs ~o; 240 95~6' ' ' '241',
5 5% 242- BENZENE ". Yes .' .
If'mo~ h~m ~m~n~ ~e p~ent at grater ~ I% by wei~t if non~rcinogenic,'or O. 1% by weisht if carcinogenlq aRach Mdifional ah~ of pap~ ~pm~n8 the requi~d informatidn.. ~ "' . , ".
~DITION~ LOC~LY~COLLECTED ~FO~TION . · . -. . . .
' ' ' · '- ".' .'- ':. , '-' 24~
-' ' ~ ',:; ~' ~-' ~ sign H~re
,- .- .,~ :-' : : . . . .: : . .' . : ..:_ : .- If. EPq~;~le
:-'--'"'; ""--"'?:.. ""-: -: ' "" ' ""'"" :' '-' ...... .......
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:'M'AP/~ "~ 'CALIFORNI'A ANNOTATED SITE MAP
· BUSINESS NAME CIRCLE .K STORE ff2708605 "' " DATE ~/28/~0
'. BUSINESS ADDRZSS 5600 AUBURN STREET ' ' BAKERSFIELD ZIP CODS 93506
,' .... ' ~ . 1'"-30'20"+': ~. i. '
~N"{:"'~ ""' ' B C"
,. ,. .... , , ~ iz E- · : F, .
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" . ~' I / · . I[I ' '~ . I ~ · · ~ EVACU~TION/ '. -.
"'. ' ~ ' "' . / J CASHIER I I ~
". ' ~ / , / ~ ~ .
"'; ~' ~ / / ' ' / __ I I '' ' ~' ~ ~ FENCE ".' '.. ''' ",
: .,. 'o,,..'.. , '/ '~.
.' ' .'" ~' '..~... ' ' . ' · '. . ; /.' .~ ~ ' ' ': ' . . w . (~(,~e~t uau~s):-.;.,-..
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', '.':"". ' ',. ~'~ ~ -- - - .-' ~ ! ~ - - m '~'--' ' · . .' ";~.'...."'-', :...'. ;,- ".:'.
~ SE~I0~q I i. ...... ' '
-.~';'.~ ~': -::-~ Emergency resP0nse-pl~s ~d prpc~d~e~e.~-~te~ :p~'°f::~e: B~sin~ss:'Eme~geg~' ml~:'
':- ~ ~g ~ ~tf~e to.review-~e~e.:Proce4~e~ .~°r..y6~' e~ablis~em;:'YSfi-..~1i a~i~:'~mP~ifimi°ns~- ~./- .."
:'- : ~'- result~ ~om ~acti0n o~ ~sg~.ded.acti0n d~g.m ~m~rgenc~:'.once'.~es~ plms'.md proCedmes :. -,. ~.. ~.'
~e~ ~plemented,'' yp~ employees'Mi1 have'.~ ~omativ~ ~de~to .follow ~.~e-e~ent
-: 1 EMERGENCY ~SPoNSE PLUS ~D PROCEDU~S .
A. If You have a release or threatened rel6ase of hazardous material, y0uv business is - .
required by State Law-to provide immediate notification of the .fpll0wing.agencies
I~ediatel~ c~l: .... - ~"
LOC~ FI~ E~KGENCY ~SPONSE'PERSO~EL ~"~] (:'-' ' 911 .
~ire, p~edics, police, or shefi~
STATE. OFFICE.OE E~RGENCy SERVICES: (800) 852,}550
:or (916) 262-1621
B&ersfield Fire Dep~ent ........
T~ ~~OUS ~TEm~S ~AGE~NT'DI. vISION: 805-326-3979,
PERSON(S) ~~ T~ FACILITY ~O ~.~CESS~Y TO ~SPO~ TO A
~~OUS ~TE~S ~CIDENT: ~ - . '
Nme: Tefi Nicholson -: ~ ': Teleph6ne} 909-270-5123
Nme: Tosco 'Mainten~ce Telephone: 800-726-2312-
-'- B. IDENTIFICATION. OF ~ LOC~ EMERGENCY ~DIC~ FACILITY OR "
~DIC~ ASSIST~CE AV~L~LE TO YO~ BUS,SS ~PROP~A~ FOR
POTEN~ ACCIDENT SCEN~OS:
N~:. ~'~DIC~ CENTER
~D~SS: 1830 FLO~R-ST.'
--. . CITY: 'B~RSFIEED ~ ' '
PHONE: 805-326-2000 - - -
.. -.l" ~:..' "' -" ~ :- · _ : -- - :fl--.:-_-'-.-.- .l' : .~- . ..: -...- .... - ..... .- . .
"~ .,: '" ~ :._/ '" "i ,:.?~ ProVidb~inform~ii°~'O:n;'thelsteps men':at your b~s]ness, Or the pb'liSi~ Or Pr°Cedures no~
:'.:', :' :: . :' :':.:i 'i' .m~) inclddei..safety..; .?aotage, and: C0O/minrnent .pr°cedares.:iBe' ·Specific .fOr each .tyPe' of
:'. :-'..-.... ~:; , The hazardous. at this-buSineSs are fire and Spills .as§oci~ited.withi~g~line dispensing.
... .... "'. ~ 'Gasoline dispensing is supervised by trained, pers..onnel~ Additional hazardous materials are'
. '.: . . gtoredin minimum quantities and stored in small:, unbreakable containers. All underground.
... : - Storage tanks are monitored using an approVed monitoring metho&' ~.
3. MI'TIGATION '~ '-': · . .~ '
'- "Describe'the pr°Cedures'to be'followed tO r~duce.the seVeritY of a ie!ease or threatened
felease o,f a.h..ag~rdous .material at your business. The Procedures should deta!! the aCtiOns to
be taken by~..empl0Yees to stop a' release,. cofltain a release, or.to reddce:..the problems
. associated .With a release. -What is your immediate-respOnse, to a spill, fire; explosion.or
.. airbome releaSe at Your facility?" . .. .. .
Small incidents: For'ieakS and spills, isOlate the area and contain .with absorbent material.
Clean up the spill immediately to prevent Spreading. For fires, mm off pumps,-use fire
. extinguisher if it can be done. safelY. ~ .. /. ' . ':
'. Larger incidentS: Tum'.~ off pumps using emergency 'pump shut~off, call 9-1-1, evacuate to
emergency assembly area, wait for emergency personnel _to respond. Immediately contact.
. the businesS owner,, if.not' already on site, the Tosco Business Operations. Manager Or
~ .-. District Manager and the Tosco Maintenance:Call Center. ·
-- -4. ABATEMENT . . -. '~ -- . .
. . : ' ' Describe. what you would do to stop and remoVe 'each-hazard. HOw. do. you handle 'the
Complete process of stopping a releasei cleaning up,. and disposing of. released ~matefials .at-
'' your'business? What aspects of the,response are beyond yO~ur abilityand need to be
. handled by others? Who Would you Call to handle the release? '" ·
.small incidents Will be handled with the on-site clean,up equipment, '(i.e., brooms, shoVel,
absorbent 'material;.mopS, etc.): For larger .inCidents, the on site manager will turn off the
.. pumps, call 9-1-1, and the Tosco Maintenance Call Center ~ 1~800-726-231Z The Call
: Center will dispatch a maintenance contractor to'assist in abating the hazard. FOr. suspected
leaks the operator will .notify the-Tosco Maintenance Call Center and h/s/her Business
. .: Operations Manager or District Manager who will investigate 'the-incident. If a UST leak' is.'
confLrmed~ then reporting .will be done by 'Tosco Marketing, which Complies With UST
regulations. -ToscO Marketing. Will coordinate with any contractors, required to-stop a
release, clean up a release and/or dispose of materials. All materials .will be disposed of in
".:,.~:: "i -~ :--' ? ...... 'Describe-the proc~du~eg:'to 15eTollowed for qi~me-diMd hotificai6~a.and' eVacmti0n of'y°~:
:Q..'-.' ~: ..> ~... ;::'_:. hCiii¢..-,- "..,.~':.,..:..~._ .:':.:_ '-::::.[. :
....- ( :: .'-- :' * ~.If W~ted, evacume tO ~e designmed ~sembly located'.m:~NORTH-SIDE' OF LOT -'~
'" " :-.~e m~aget or lead:employee MI1-~e a-head-CO~t .'to~geh~.: all empldyees"have
' ' "- - -'-"eVacuated safely. ~e m~ager or employee Mll co~er ~e respOnding agencies t0 indicat6
~ ~e ma mdc 0f~e:emergency. "' -' -~:: '- .: ' - _ .i .. '--" : -"
- - ' ' Identi~ ~e!~e~'~d eqUipment in yo~ business ~at Woul&r6quire i~ediate:~specti0n
' 0r: i'~olmion due_to i~eir:.~nerabili~ to e~qu&e relined ~o~d-.m0tion~ Check fOr
· ' :'~:~' -~' '6quipment such ~ g~ cylinders, piping, ~s,~etc., ~a{ may heed to be.sec~ed:or, spillage
· at may require mitig~ti0n or abatement:
Key' ~e~ ~to .inspect '~e the UST t~ mo~t0r:,al~ p~el, dispenSer igl~ds~ .~d ~y
addition~-h~doUSmmefi~s st6rage ~e~.. ' '
7. ~~OUS WASTE'CONTINGENcy -
' -- Specific proced~es 'for[prevention, mitigation ~d abatement of a rele~e of h~ardous
waste' genefmed a[ yo~ b~iness. ~s section o~y applies to h~do~ w~te generators: -
' .~e ~icM-w~tes' generated at ~s bus,ess ~e.~ed motor oil ~d ~ti~eeze. ~ese items
-Mil be h~dled in ~e s~e m~er ~ new motor oil or ~ti~eeze. Use absorbent matefiM
· ~ or rags to cle~ up spills ~d place in a container for proper disposal or recycling.. ·
8. - ~AU/HOmZED ~LEAsE ~SPONSE.PL~
Specific prgcedmes for mitigation,-abatement ~d repon~g of~. ~au~ofized rele~es
~°m ~ underground storage tank ~ST).
w~l or double w~l t~ system ~ applicable:-~s'pl~ should cover.~e entire UST
system. ~s section o~y aPplies.to UST omer/0perators. ~ ' '
Rear to the Un&r~ound'Storage Tank Monitoring and Response plan provi&d bv ~osco
Marketing Company.
If a rele~ed h~doussubst~ce feaches~e enviroment, incre~es ~e f~e or explosion
-' · h~d, is not'clewed up from ~e second~ contaiment ~ 8 ho~s, or' deteriorates' ~e-
second~ contaiment, ~en ~e loc~ agency ~11 be notified I~EDIA~LY
· ~'?.': ":~. '..i'' ': ~mpl.~yers are'required, by State law'to i~ave a pf0gram providing employee§ With initihl, and/ -
":: r~fresher t~aining. The' Busines§-Emergency' Plan shall include'~a:tra' ..~_g Program'that is reasonable
~-:'. ': 'L" ' ' ~arid al~pr0priate forthe Sizel o.f ~ business _and the nature of the' hazardous materials'handled. 'The
~.- tra~ngiprogram Shall t,5.ke into'cbnsideration the responsibilities
The trai,ning program shall, at-~'minimum, include:
A. Methodk for the safe handling of hazardous materials stored at your business,
including familiarify with the characteristics and hazards. 9feachmaterial and
-.- . measures employees can take to protect themselves:from chemical hazards.
B. Procedures for-Coordination with local.emergency.response organizations.
C. ' correct use 0f._.emergency response equipment and supplies under the control of the-
business. - · ' --
'D. The Cal osHAHazardous Communication Standards.
E. The prevention, abatement and mitigation procedures you have developed for your
business and explained 'on the Business Emergency Plan.:
F.. The emergericy'evacuation plans you have developed, the notification procedure
used. to alert l~eople to evacuate, and the closest location to obtain appropriate
emergency medical care.
G: Procedures to coordinate with and'assist the local emergency personnel that m~iy
-- respond to your facility.
H. Who and. how.to call for immediate.assistance in the event oi' an accldent involving
hazardous materials;
I.. Procedure for. ensuring the appropriate personnel receives initial and refresher
training: . - '
ALL EMPLOYEE TRAINING SHALL BE DOCUMENTED AND UPDiTED ANNUALLY Use the ai-tached employee training log or similar form for record keeping.
'~ :' .1. ')-:'~' OF~"~S' d~ging~he E~e~gency p~mp'shut-off Swifch.- .' '~' .~'.~' · j;
" - ~ 7 ~' :
" 2. -- ~VA~UATE;;~V~rbailyf~~CE to all perions on'the_site: "Thi~ is an emergency. :Plbase
- '- enginos ~d leave ~e ~tfition oh foot. immediately..' All employees mebt &t'~eemergency:assemblYarea.'
" 3. ; ~.A~L ~l-l:'~Givethe following'info~atiOn: ' :' ~ ,--~ ' ~-- . -5 ' ' :
~ ' -. ' ~ .... ~. IS A'.FI~'L'GASOL~ SP~L at the Tosco 76'semite ~ion: al' 5600 Auburn S~eet '.
-tf anyqqe ~s ~apped or needs me&cai a~entmn, tell th~'~sWering-flispatcher. Sta~ on the phone ~d be prepared
'-'"' ~ ~0 answer ~ny-quesfions-conce~ing'the situation.. ~ ." -'
~4. A~E~'ig'contain'the ~pill ifyo~ c~n do it safely. ' : -- . '
5. .LOO~ ~O~ to ens~re-.that ~veryone has le~ the station, pa~icular.ly those in vehiclesWho may need
'assis~fice of may not have heard the emergency announcement. Assist or direct assistance t0 anyone having
"diffic~lW l~aving the statibn ~e and anyone who may be injured. '
6. ~POKT to ~iving emergency:response personnel topr0vide ~em with any info~ation or assistance they might
.need.- .- ..
7. CONTACT the station, operator if he/she isnot already at the station. Use the list below for emergency contacts':
E&ergency Coordinator: Teri Nicholson Title: Dist.
Address: '- - ·
Busg~ome~/Al~: 90%270-5123 / 800-697-1388 /
Altem~te Emergency COordinator~ Tosco Maintenance Title: .Dispatch Ctr
Address:
Busg~omeg/Al~! 800:726-2312 / 800-726-2312 /
8. NOTIFY ~e. fo!10wing I~DIATELY t0 assist in the emergency and agency notification process:
TOsco Mainten~ce Call Center: 1-800-726-2312
-Tosco Business Operations M~ager'0r Dis~ict M~ager. . -
Tosco Environmental Compli~ce Coordinator: North: Merliza Alcala (925)277~2319 or (888)671-4350
South: Stephen Boyd (714)428-6572 or (800)759-8888 ping 1267507
To~co C0Pomtiofi will n0ti~ the State and Loc~! administering agencies within an appropriate time frame, unless
the situation requires urgent immediate response by the agencies, in which case the Operator should noti~ thege
agencies. -
a) LOC~ ~GEN.C~: 'Bakersfield Fire Depagment .
PHO~ ~BER: 805-326-3979
b) CALIFO~IA.OFFtCEOF E~RGENCY SERVICES, (800)852-7550(24 HO~S)
c) LOC~-POLICE AND FI~ DEPARTMENTS, 911
d) NA~ON~ ~SPONSE CEN~R 1-800~424-8802 (24 HOURS):
~OR ~C~ENT: Any incident ~at Can be contained and clewed up as pan of the routine operations. ~enever in
doub( e0nsidbr the incident a major release and'use the above .procedures.
1. FI~S:' ExtinguishWith fire extinguisher. Rechmge fire extinguisher, if used
- 2. SPILLS: Clean up with absorbent materials on site and dispose of according to aH regulations.- Have a fire
extifiguisher ready for spills of flammfible materials. RestoCk absorbent as necessa~. See Training'Plan item gH
-for additional direction.
3': ~DICAL: Treat with on site first aid kit or take to nearest hospital. Employee training p]~ lists the newest
hospital. ~'.:, "--;"~.:~ --
' 4/ ~CO~:~ Re~ord ~e event.in [h~ . [ly glo -'
-.?: 5, '-NO~FY~;.thed~al6r.o'fthe.~hf)::;.'.:'/'..'.~ '~:'-" '- '~'
.- .:' .Q,.:'~-.? .,-~ ...., .,,_
".'~' . .- _:j..~, ?-.(:....: , ;. (-~ -..,:..::,..:,-.?-:,..... ~. _ _',:,. :. ~.:: .~(...j ~-:..:.'.i.'.~:
-. -".; :. ~ : : . ~i ~.'"~'~'- .'-". '-:' - : ,' '"" ':.- .. -'"'-' 2" .-'-. .'' '.- ,.. -. ' .:.;'2',' ' ~' :" - .'-.
· ~:-.'-/Employe~' :must:b6 giVen'thi~trai~l~efore:starting work,'andrefresher coUr~ust'be P?o~,id~dannua'll~,~ ~ ' 4- . : --'
_7,' . :',Records must. be kel~t-to Show-When each:station employee has :been given his/her safety.training." Use the fOlloWing
, '_:': outline an, d mak. e ~opies'as ._n'eeded._ 'Ha~;¢ ~employee da~e and sigfi'the..a~tached trai~!.:.ng ~1o.. g Upon c.:ompletiOn of
-"_ iraining-.:'Retain~se' record~ for:a mifiithurnt6f three.ye'ars.... !f:'i :;;'":'":i'?':'(':~'i; ..:.:."" ':._i '.
'iii!-i. FIRST THINGS TO KNOW: ' -:' '~:-.- - : ' ..... ."-;"-. ' ":'~. .~:' .-
'-' ::A. EMERGENCY PUMP. sHUT, oFF:This' turns'off the' turbine pumps that provide flow~t0' the dispensers' from the
,-uhderground t~ifiks. Iff case ora leak;,sha{'ting offthe:pumps will'helpto prevent spills...
' ' ' ~;NORTFI SIDE'BLDG
: .... Location: ~-CASHIER ....... ' :' ':'" '
. B.. ELECTRICA~Lp~MNrEL: -"The panel allows, you to selectively cut off po~ver to l'ights,~:~igns, pumps,'etc. The.main
' ' - switch kills al.l'p0wer.at th~ site.' - '-" -
- L0catiom BACK STORAGE ROOM .... ' ' - -
.C.TANK MONITORING ALARM: 'Monitdring panel for the Underground Storage Tanks: "This.panel will indicate
when a t. eak is detected by a visual and audible alarm.
.Location: 'BACK STORAGE ROOM :'
D. WATER SHUT-OFF: The water Shut-offmay be necessary in some cases. _
_Location: CORNER OF FAIRFAX AND AUBURN STREET
E.-NATURAL GAS SHUT-OFE: If your Station has natural gas; it may be necessary to ~hut-off the natural gas flow
in an em, ergency.
:-Lodation: BUILDING REAR .... '"
F. PROPANE/LpG: If your station has.propage or liquefied petroleum gas _tchk - In the event of a releasoor fire,
turn' offlthe manual valves and shut offthe power to the dispensing pumps. 'Call your supPlie.r_ or dial 9-1-.1 as
appropriate·
G. FIRE EXTINGUISHER: Use only.~sn small fires that you can handle~ Do not a~emp_t:to extinguisti large.fires on
your own; call 9-1'- 1 for help. -.--
. Location: 1-NEXT TO STORAGE~DOOR, 1-FRONTDOOR, 1-PUMP ISLAND : .-'
H. ABso ,I~BENT: In the form ofkitiy litter, absorbent can soak UP small spills ofgasoline,:dies'el..fuel, o~: other
'. petroleu.'m products~ Absorbent. shoifld'be used rather than washing Spills down a'dmiii. In:case Of large spill, ·
merely try to contain it, a vacum truck Should be used tO. clean up any large spill ' ' ' - ' · ' '
Locatioh: SPILL KIT IN STORAGE ROOM ~.', ' .
· I. PERSONAL..PROTECTIVE EQUIPMENT: These items shall be usedby employ~eeS.t0.prevent direct skin '.
contact ;with a hazardous material.. ' -. . . .. ·: .-.
. "t. 'Broom: REAR STORAGE ' · - · ' " ".-,.
' 2. Shovel:' REAR sTORAGE ' .' '- ' ' ": .. . '
'" 3. Gloves: REAR sToRAGE: · ' ." .
'. 4, Goggles: REAR STORAGE~. " .'.. : '..' '~
FIRST AID KIT: -" '.'. ' - . ' ' . . . :
~STORAGE ROOM' ' .
· EMERGENCY AssEMBLY AREA: Location Where all employees are to meet in the event of an emergency.,
Locatioh: NORTH SIDE OF LOT' , ...
HAZARDous MATERIAL MANAGEMENT pL,~N (HMMp) MATERIA~ SAFETY DA~A sHEET
...-:-.Q.'. (MSDS): ........ ~' '" '"' ':'.' ' ' ' .... '. 'i" i:..-'i.':':'" .'i.~. :':.j '.. '.- : _..:'..:
'- ~ "Ldcation': C~SHIER--- i:..:...(:,.. : '.':":':i'. ' ' ' "*':":"
:-"': ::~-:~-'. -': --: .- - ' ':-".' :' ' -'.- ~ '-- ' .. : ':~..". ~"." .'- ~.. ' :-':: "-'-'
'~'":" ~';'""' '":.~::;;" '.-'~: '~-)"' ':.' : '. ":':~ :'." ' :' ' - -"-¢~'.,';;..;' ')~.";i '.:¥ :':'-"" '.-.' '"'.
':'-.' ?'" *- ' :::' .. / ~J~ :" '¢%;'~':-5L2~ :/ .::. :'" -';'-'.'~. - ,':::f'- "-';:_'-' ' . . '...'.. - '.' ',:';.'-.".,'.;,.:-:.'._'-':'._--:. '."::'.' .._..ir-: ' '-
m.:,Aii' empioyees shoUld rev)ew.the HaZardbus Materia!'Plan,. ofwhichthi's training plan isapart. Specifically; -.'
· each employee Should understand the p'r°Cedur~s.to be u~ed in resPOnding to various ,kinds of emergencies; andknow
' . how to monitor for'leak~ of hazardoUs.materials. As a su. pplement to this package, err/ployees should als6 review the'
.'EmergencY Response Plan filed bY your business to" the appropi:iate local agency. Thikdly, emploYees should review
. 'and have acc.'ess to th.e Mate/'ials Safety Data Sheets you have on' file for each.of.the ha~ard0us m.aterials Stored at the
station and must be drilled in al!:emergencyjresponse procedures contained herein: . . ,..... . . -...
~ IV. FIRST Am PRocEDuRES~'(For exPoSure tO gasoline 'or diesel fuel)i :' . "· . . ,'
'A..EYE CONTACT:: Flush with Water.fo/':. 15 .minutes While-holding eyelids.°penl. Get medical attention.. .
-B. SKIN CONTACT: Flush With~Water'~vhile removingcontamihatedclothing and.sh°e~i :Followed'by Washing With
soap and water. Do not reuse clothing Or shoes until cleaned. If ittitation persists, get medical attention.
C. INHALATION (Breathing): ::~ '
.. Remove victim to'fresh'air and pr°vide 0xygen if breathing is difficult. If not
breathihg, g!ve artificial respiration.. Get. medical attentiofi. .
_D. INGESTION (Swallowin~l: ' ': " ' ' ~ -
DO NOT INDUCE VOMITING BECAUSE GASOLINE. cAN ENTER LUNGS AND CAUSE SEVERE'.-
LUNGIDAMAGE! 'If vomiting occurs SpontaneOusly keep'head belbW hips to.Prevent aspiration of'liquid into
' lungs.~ Get medical attention.' : ...... ·
' F. NoTE.tTO pHYSIcIANi Ifm0re than 220 mi per kg.has been ingest6d and'vomiting has not occurred;emesis
should !be induced with medical supervisiom Keep victim's head below hips to prevent aspiration.' If symptoms '
such a.q loss Of gag retlex,'~°ns~l~ions, or unconscioi~sness Occur.before emegis; gastric laVage using a cuffed .
endotrachaeltube should be considered. · . - .. ' ; . ....
For further i.nformation, cOns.Ult the Materials. Safety Data Sheetg. for these prOducts-and for other hazardous mhterials.
FIRST AID FOR :EXPOSURE TO OTHER MATERIA, LS: Consult the ~warning advice on container labels. or refer to
· the MSDS f6r that product. . ' . .." '
"Fhis hazard°,us material management plarfmeets the requir, ements'ofa hazardous wastec0ntingency plan. "
Document prepared by:~ Env/ronmentai Stc~ff, RHL Design Group," Inc., 800-'265-1025 Last updated: Decem[~er.21, ! 999
EMPLOYEES'MUST SIGN'THIS'FORM TO:PROVE.IHEY RECEIVED THEIR INTITAb'AND/ORANNUAUSAFE~ T~INING
-' "' '¢ :' "' ' ' """' UA/bUP--"------ "-'' ' . IYPbgt
-' '- EM~LOYEENAME ' '-";' ' ' ,-- EM~LOYEEsiGNA~URE '" '.TRAINING ' ' T~ININO-
(updated: Februa~ 15, 2000) .: ....
BAKERSFIELD CITY FIRE DEPA, gTMENT
OF E OF ENVIRONMENTAL SERVICESQ/~
1715 CHESTER AVENUE, 3RD FLOO~/.
BAKERSFIELD, CA 93301
~ . (805)326-3979 ~
H~RDOus MATERIALS INVENTORY
FACILITY DESCRIPTION
CHECK IF BUSINESS ISAFARM [ ]
BUSINESS NAME Circle K Store #8605
FACILITY NAMECi~cIe K Store #8605
SITE ADDRESS 5600 Auburn Street
CITY Bakersfield STATE CA ZIP 93306
NATURE OF BUSINESS Convenience Store / Gasoline Station '
r.
SIC CODE 554'1 DUN & BRADSTREET 06-294-4160
OWNER/OPERATOR Tosco Marketing Company PHONE (805) 871-7979
MAILING ADDRESS 3550 North Central Ave., 4th Floor -
CITy Phoenix ' STATE AZ ZIP 85012
EMERGENCY CONTACTS
NAME Staff TITLE Duty Clerk
BUSINESS PHONE (805) 871-7979 · 24-HOUR PHONE~05) 871-7979
NAME Teri Nicholson. TITLE Zone Manager
BUSINESS PHONE (8~0) 697-1399 Pager 24-HOUR PHONE (800) 697-1399 Pager
BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATERIALS INVENTORY Page1 of .3
Business Name Circle K Store #8605 Address 5_6/:)0 Auburn Street Bakemfteld_____~330~
, CHEMICAL, DESCRIPTION
1) INVENTORY STATUS: New[ ] Addition[ ] Revision ~] Deletion[ ] Check if chemical is a NON TRADE SECRET ~] TRADE SECRET [' ]
2) Common Name: Gasoline: UnJeaded Regular 3) DOT# (optional) 1203.
Chemical Name: G~bline Unleaded Regular ~ ' AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire ~X~ Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~] Delayed Health (Chronic)
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19
6) PHYSICAL STATE Solid [ ] Liquid IX] Gas[ ] Pure [ ] Mixture ~:~ Waste [ ] Radioactive [ ]
CHECK ,~J.J, T~AT,~p~J.y
7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum D',aily Amount: 10000 lbs [ ] gal ~ fi3 [ ] a) Container. 01
Average Da!ly Amount: 5000 curies [ ] b) Pressure: 1
Annual Amount: . 405739 c) Temperature: 4
Largest S~ze, Countamer: ~0000
# Days On Site: ;365 Circle Which Months: ~)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) Meth.vltert Butyl Ether 1614-04-4 16 [ ].
chemical componentS[or any
AHM components 2). Toluene 108-88-3 8 [ ]
3) M-Xylene 108-38-3 7 [ ]
10) Location Underground t~nk. ~,nprox 20 feet southeast of store
:~ , CHEMICAL DESCRIPTION
1) INVENTORY STATuS: New![ ] Addition[ ] Revision[;>(] Deletion[ ] Check if chemical is a NON TRADE SECRET D(] TRADE SECRET [ ]
2) Common Name: Gasoline. Unleaded Plus 3) DOT# (optional)
Chemical Name: GasOline Unleaded Plu~ AHM [ ] . CAS # 8006-61-9
4) PHYSICAL & HEALT,I;I PHYSICAL HEALTH
HAZARD CATEGORIES Fire ~] Reactive [. ] Sudden Release of Pressure [ ] immediate Health (Acute) ~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION (3-digit code, from OHS Form 8022) USE CODE 19
6) PHYSICAL STATE Solid[ ] Liquid ~ Gas[ ] Pure[ ] Mixture ~] Waste [ ] Radioactive[ ]
~ CHECK ALL THATAPPLY
7) AMOUNTAND ~riME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum D,a~yAmount 10000 ' lbs [ ] gal X] fi3 [ ] a) Container: 01
Average Daily Amount: 5000 cudes [ ] b) Pressure: 1
Annual Amount: 150516 c) Temperature: 4
Largest Siz~ Countainer: 10000
it. Days On Site: 365 Circle Which Months: ~)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) Methyltert Butyl Ether 1614-04-4 16 { ]
chemical componentslor any
AHM components 2) Toluene 10~- 8-3 8 [ ]
' 3) M-Xylene 108-38-3 7 · [ ]
I0) Location Underaround tank. ~o~rox. 20 feet southeast Of store
I certify under penalty of law' that l:have personally examinedand am familiar with the information submitted on thi~ all attached documents. I believ~t~e
submitted info~, ation is true, accurate, and, complete. '
P#nt ~lame & Title Of Authorized Co[npany Representative ' d . S~at~r~ ' ' '
BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATERIALS INVENTORY Page2__ of 3__
Business Name Circle K Store #8605 Address 5600 Auburn Stce~t~Bakersfield 93306
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New[ ] Addition[ ] Revision ~] Deletion[ ] Check if chemical is a NON TRADE SECRET ~' TRADE SECRET-[ ]
2) Common· Name· Gasoline. Unleaded Premium 3) DOT # (optional) 1203
Chemical Name: Gasoline: Unleaded Premium ' AHM [ ] CAS # 8006-61-9
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 OHS Form 8022) USE CODE 19
6) PHYSICAL STATE Solid [ ] Liquid {X~ Gas [ ] Pure [ ] Mixture {X~} Waste [ ] Radioactive [ ]
CHECK ALL THAT APPL¥
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum D,aily Amount: 10000 lbs [ ] gal {X~] ft3 [ ] a) Container: 01
Average Dai!y Amount: 5000 cudes [ ] b) Pressure: 1
Annual Amount: 98163 c) Temperature: 4
Largest Size',Countainer: 10000
# Days On Site: 365 _ Circle Which Months: (~Year, J, F, Mi A, M, J, J, A, S, O, N, D
9) MIXTURE: ~ List . COMPONENT CAS # % VVT AHM
the three most hazardous 1) Methvltert Butyl Ether 1634-04-4 16 [ ]
chemical components ar any '
AHM components 2) Toluene 108-88-3 8 [ ]
3) M-Xylene 108-38-3 7 [ ]
10) Location Underground~ tank: approx. 20 feet southeast of store
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition[ ] Revision( ] Deletion[ ] Check if chemical is a NON TRADE SECRET D¢~] TRADE SECRET [ ]
2) Common Name: Carbon Dioxide 3) DOT # (optional)
Chemical Name: C. arbgn Dioxide carbonic Anhydride AHM [ ] cAS # 124-38-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure D(] Immediate Health (Acute) ~] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION . (3-digit code from OHS Form 8022) USE CODE 99
6) PHYSlCAL STATE Solid[ ] Liquid '[ ] Gas [X~ Pure [X~] Mixture[ ] Waste[ ] Radioactive[ ]
,i CHECK ALL THAT APpL y
7) AMOUNT AND TIME '~T FAcILiTY . UNITS OF MEASURE 8) STORAGE CODES
Maximum D,aily Amount: 1044 ' lbs [ ] gal [ ] ft3 ~] a) Container: 04
Average Dai~lY Amount: 522 cudes [ ] b) Pressure: 2
Annual Amo,unt: 54288 c) Temperature: 4
Largest Size., Countainer: 174
# Days On S, ite: 365 Circle Which Months: (~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) Carbon DioxJde~?,arbonic Anhydride 124-38-9 · ' 100 [ ]
chemical components or any
AHM components 2) [ ]
3) [ ]
10) Location In Storeroom. northeast c~mer of store
I certify underpenalty of law, that l have personally examined'and am'familiar with the information submitted on this a~L~ll attach, ed documents. I believ/~-~e
· submitted infg~ation is. true, accurate,.ancl corn. plate. ' ~ '
Print Name & Title of Authorized.~ Company Representative J 5~gn~j ure - ' ' -- ~D~at/e ~(
BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATERIALS INVENTORY . Page3 of 3
Business Name CJr. cJeJ~S_tore #8605 Address 5600 Auburn Street Bakersfield 93306
· CHEMICAL DESCRIPTION
INVENTORY STATUS: New ] Addition IX] Revision '[ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ~X~ TRADE SECRET [ ]
2) Common Name: ProPane 3) DOT # (optional) 1978
Chemical Name: ProPrane AHM [ ] CAS # 74-g8-6
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire ~:] Reactive [ ] Sudden. Release of Pressure ~ Immediate Health (Acute) ~] Delayed Health (Chronic) [ ]
WASTE CLASSlFICA,TION ($-cligit code from OHS Form 8022) USE coDE: 19
6) PHYSICAL STATE ~ Solid [ ] Liquid IX] Gas ~ Pure IX~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 2296 lbs [ ] gal [ ] ft3 ~ a) Container. 04
Average Da!ly Amount: 1148 cudes [ ] b) Pressure: 2
Annual Amount: 119392 c) Temperature: 4
Largest Size, Countainer: 82O
# Days On Site: 365 Circle Which Months: ~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) Propane 74-98-6 100 [ ]
chemical componentslor any
AHM components 2) [ ]
3) [ ]
10) Location Locked cage= south wall of store
CHEMICAL DESCRIPTION
1) INVENTORYSTATUS~: New.[ ] Addition[ ] Revision[ ] Deletion[.] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ]
2) Common Name: 3) DOT # (optional)
Chemical Name: I 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 OHS Form 8022) USE CODE
6) PHYSlCALSTATE ~ Solid [ ] Liquid [ ] Gas [ ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ]
CHECK ALL THATAI=pLY
7) AMOUNTAND TIME ~,T FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum daily Amount: lbs [ ] gal [ ] ft3 [ ] a) Container.
Average Daily Amount: curies [ ] b) Pressure:
Annual Am~)unt: c) Temperature: *
Largest Size Countamer:
# Days On ~ite: Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D
MIXTURE: , List COMPONENT CAS # % ~ AHM
the three most hazardous 1) [
chemical component~ or any
AHM components 2) [ ]
3) [ ]
10) Location
I certify underpenalty ofl~w, that I have personally examined an¢ am familiar with the information submitted on this ~n"d-"~attached documents, fl.be~ieve th~/~
submi~d inform~ation is true accurate, ancJ complete. ' /' X ?~ f' ! [,. } { ,/ ~,~-~1~7
'Print Name & Title of'Autho~ed Company Representative . '
L
· BAKERSFIELD OFFICE OF CITY FIRE DEPARTMENT
ENVIRONMENTAL SERVICES
1715 CHESTER'AVENUE, 3RD FLOOR
BAKERSFIELD, CA 93301
~ '(805) 326-3979
H~RDOUS,MATERIALS MANAGEMENT P~N
INSTRUCTIONS:
1. To avoid further action, return this form within 30 days of receipt.
2. 'I:YPE/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: Circle K Store #8605
lOCATION:5600 Auburn Street Bakersfield 93306
MAILING'i; ADDRESS: 601 Union Street; Suite_t920
CITY:Seattle STATE: WA ZIP:~8101 PHONE: (80:;) g71-7979
DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541
PRIMAR~ ACTIVITY: Convenience Store / G~oline S~tion
OWNER:" Toscb Co~oration dba Tosco Marketing Company
MAILING ADDRESS: P.O. Box S2084 Phoenix AZ 85072
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR. PHONE .
1. Sxaff Duty Clerk (805) 871.7979 ' (805) 871-7979
2. Teri Nicholson Zone Manager (800~97-1399 Pager (800) 697-1399 Pager
· Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING
NUMBER OF EMPLOYEES: 3
MATERIAL SAFETY DATA SHEETS ON FILE: Yes
BRIEF SUMMARY OF TRAINING PROGRAM:
Special omthe-job training in the handling of hazardous material(s) is provided in the following areas:
1. Proper maintenance and Use of gasoline equipment.
2. Use of 4bsorbent for small spills.
3. Employees are instructed on proper response to police, fire department, emergency medical and Tosco Environmental
Department. !
4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2.
A review of the~ contents of the Emergency Response Plan will be made by all new employees within one month of hiring and
by all employees on an annual basis.
Safety and emergency equipment usage training will provide familiarization with the location and proper use of fire fighting
equipmen! (fire extinguishers), the location of and procedures for facility shutdown (including the location of shutoffs for gas
and electricity) and the proper use of equipment used in the day to day business.
SECTION 4: EXEMPTION REQUEST:
I CERT F,Y 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 MINIMUM REPORTING QUANTITIES.
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
MATIbN'iis'~C~3uRATE. I 61~DgRSTAND THAT THIS INFORMATION WILt BE USED TO
FULFILL! MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON HAT_~RDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
~JSIGNATURE .. Mana~e'~LE
2.
~ ' .Bakersfield'Fire Dept. '
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Facility Unit Name: Circle K Store #8605
SECTION 6:: NOTIFICATION AND EVACUATION PROCEDURES:
A. AGENCy NOTIFICATION PROCEDURES:
If emergency response assistance not required, notify:
BakerSfield City Hazardous Materials Division 326-3979 AND
State Office of Emergency Services 800-852-7550 WITHIN 24 HOURS
If release poses present or potential hazard to human health & safety, property or environment, and emergency
assistance is required, immediately notify:
Fire Department - Bakersfield Fire Department 91i
P~ olice:Department - Bakersfield Police Department 911
BakerSfield City Hazardous Material Division ' 911
State Office of Emergency Services (800) 852-7550 or (916) 262-1621
B. EMPLOYEE NOTIFICATION AND EVACUATION:
0pon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel. The clerk will
ensur~ the shutdown of his/her area of responsibility (if possible) before evacuating. This includes elimination of
potent, iai ignition sources in the case of the release of flammable material. Evacuation will follow the designated routes
Of unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting)
method to a pre-determined evacuation staging area where all employees will be accounted for.
C. PUBI21C EVACUATION:
If evaduation from area deemednecessary, these neighboring properties will be notified if possible:
Toda)~ Cleaners 5600 Auburn Street, Suite U/V 872-6920
Maxwell's 5600 Auburn Street, Suite T 873-8106
Rage Salon 5600 Auburn Street, Suite P,Q,R,S 872-2360
Highland High School 2900 Royal Scotts Road 872-2777
D. EMERGENCY MEDICAL PLAN:
The primary Company medical facility to treat employees injured by a hazardous materials incident:
MERCY HOSPITAL 2215 TRUXTON AVENUE 327-3371
Kern Medical Center 1830 Flower Road 326.2000
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7:1 MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS:
1. Barriers installed to prevent vehicle collision with pumps.
2. VaPor Recovery Systems uied when filling underground tanks which are of fiberglass construction.
3. Anti-lock nozzles at pumps.
4. No~ sales to non-authorized containers.
5. No Smoking signs posted, self-serve instructions posted.
6. Tank monitoring program implemented.
B'. RELEASE CONTAINMENT AND/OR MINIMIZATION:
1. Preventive 'diking with absorbent materials.
2, Shut off of all emergency switches to prevent further spillage.
3. Barricade area to prevent possible exposure to general public.
'~4. AvOid personal exposure to fumes/vapors and contact with liquid.
5. Eliminate all sources of ignition in area of spill or vapors.
6. AbSorb liquids with absOrbent materials and place is sealed container for disposal.
C. CLEAN-UP PROCEDURES:
Notify Circle K/Tosco Environmental Manager (602)200-4528 for coordination with hazardous waste disposal company
to remove contaminated absorbent materials if required.
CARBON DIOXIDE, PROPANE
A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured.
B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate.
C. CLEAN-UP PROCEDURES: Remove ignition sources. Ventilate area immediately. Contact supplier if leak in.
container/valve.
SECTION 8: UTILITY SHUT-OFFS {LOCATION OF SHUT-OFFS AT YOUR FACILITY):
NATURAL GAS/PROPANE: west wall of building on south end (me~er)
ELECTRICAL: a) Inside, backro0m of store ,(breakers), b) North wall of building at e~qt end (meter)
WATER: gouthe~qt corner of site (meter)
SPECIAL: Emergency gxq ~hutoff switch: At cxqhler station on console
LOCK BOX: YES~N/N/N/~ iIF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/VVATER AVAILABILITY:
A. !PRIVATE FIRE PROTECTION:
'Fire extinguishers
B. WATER AVAILABILITY (FIRE HYDRANT):
Hydrant! Southeast corner of site
4.
HMMP PLAN MAP
SITE DiAGRAM~ " FACILITY DIAGRAM
Business Name:. Circle K Stores INC.' #8605 ,. :
Area Map # 1 of 1
North Name of Area:~ Gir¢l~ K Stor~s inc. #8605
5600 Auburn St., Bakersfield CA
S T U-V
P O R Vacant Maxwell'$ Today
Vacant Vacant Vacant 4~95 Restaurant Cleaners
4/'95
5600 Fairfax Rd.
Driveway
· Scale~ 1" = 26'
.'(
Store #8605. Parking
5600 0
Shopping Avburn St.
Center r-
'Parking Lot
Pump
I Co unier, ~ <~
Exit ~' I~OK
· 1OK ~.
PROPANE '" Gal
14 CYLINDERS
" 'SYMBOLS
{~ GAS [MSDS ) MSDS STORAGE
( FENCE (ALL TYPES)
ELEcTRIc ~ INDICATE HEIGHT
(~' WATER ~ ~' GATE IN FENCE
J -- STANDARD ·DOOR
SPRINKLER FIRE DEFT.
COINNECTION
! 10,000 ' UNDERGROUND
-- I STORAGE -'-
FIRE HYDRANT PUBLIC I_ a. 1 I TANKS - LIST'
~ . ' .... CAPABILITY
~ RAILROAD TRACKS
O-FIRE HYDRANT - PRIVATE .......
1 0,000 ABOVEGROUND TANKS
(AU,TOMATIC SPRINKLERED Ga.l
BUILDING:, OR AREA O EVACUATION AREA
(~ ~ .... ~ PESTICIDE STORAGE
FIRE ALARM PESTI~ID=-. AREA
' ~PES OF HAZARDOUS MATERIALS
.WASTE EX. AMPLE: FLAMMABLE
- ' .:. LIQUID
CIRCLE K STORES INC #8605 SiteID: 215-000'001297
Manager : BusPhone: (805) 871-7979
Location: 5600 AUBURN ST 2 Map : 103 CommHaz : Low
City : BAKERSFIELD. Grid~ 13C Facunits: 1 AOV:
CommCode: BAKERSFIELD STATION 08 SIC Code:5541
EPA Numb: DunnBrad:06-294-4160
EmergencylCon~act / Title Emergency Contact / Title
STAFF ~ / DUTY CLERK TE~ NICHOLSON / DISTRICT MNGR
Business ~iPhone: (805) 871-7979x Business Phone: ( ) - x
24-Hour Phone : ( ) - x 24-Hour Phone : ( ) - x
Pager Phone : ( ) ~ x Pager Phone :~,,,.~)~-,__ , ,__~-9~x~
Hazmat Hazards: Fire Press ImmHlth DelHlth
Agency-Def!ined Topic Title
---- Hazmat Inventory One Unified List
-- MCP+DazlyMax Order All Materials at Site
Hazmat!i Common. Name... I SpecHaz EPA Hazardsl Frm I DailyMax l UnitlMCP
UNLE3iDED PLUS GASOLINE F IH DH L 10000 GAL Mod
UNLEADED GASOLINE F IH DH L 10000 GAL Mod
PREMIUM UNLEADED GASOLINE F IH DH L 10000 GAL Mod
CARBON DIOXIDE, 1~ P IH .G 1044 FT3 Min
t, ¢~'/~f-~'lf Do hereby certify that l have '
· "~" '~"~ h'~Z
reviewed ths _~..~:~.,,=d ardcus materials manage-
merit plan fo,~¢~, ~~and~ ',~-- that it along with
any corrections constitute a complete and corre~ man- --
agement plan for my facili~.
--1--
CIRCLE K iiSTORES INC #8605 SiteID: 215-000-001297 9
~ Inventory Iiltem 0001 Facility Unit: 'Fixed Containers on Site 9
-- COMMON iNAME / CHEMICAL NAME
UNLEADEDiiPL~S GASOLINE Days On Site
,.' , .- 365
LocatiQn within this Facility Unit
SOUTHEAST CORNER OF PROPERTY CAS#
8006-61-9
r STATE i TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Liquid ~ Mixture .Ambient I Ambient UNDER GROUND TANK
AMOUNTS STORED AND IN USE ~~
Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
10000.00 5000.00
DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL
HAZARDOUS COMPONENTS I
%Wt. EHS CAS#
100.00 Gasoline No 8006619
CIRCLE K!' STORES INC #8605 SiteID: 215-000-001297
~ I~nventory Item 0002 Facility Unit: Fixed Containers on Site
UNLEADED: GASOLINE Days On Site
~' 365
Locatil,on within this Facility Unit
SOUTHEAST CORNER OF PROPERTY ' CAS~
8006-61-9
Liquid Mixture Ambient Ambient UNDER GROUND TANK
AMOUNTS STORED AND IN USE
Lrgst Cent.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
10000.00 5000.00
DailyMax Stored GAL DailyMax Open Use GAL'~' DailyMax Closed Use GAL
HAZARDOUS COMPONENTS
%Wt. I EHS CAS#
100.00I Gasoline No 8006619
CIRCLE K STORES INC #8605 SiteID: 215-000-001297
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site
-- COMMON NAME / CHEMICAL NAME
PREMIUM UNLEADED GASOLINE. Days, On Site
365
Location within this Facility Unit
SOUTHEASTiCORNER OF PROPERTY CAS#
8006-61-9
STATE ~ TYPE PRESSURE TEMPERATURE CONTAINER TYPE ~
.AMOUNTS STORED AND IN USE
Lrgst Con, t.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
10000.00 5000.00
DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL
HAZARDOUS COMPONENTS
%Wt. EHS CAS#
100.00 Gasoline No 8006619
~.CIRCLE K sTORES INC #8605 SiteID: 215-000-001297
~ Inventory Item 0004 Facility Unit: Fixed Containers on Site
-- COMMON NAME./ CHEMICAL NAME
CARBON DIOXIDE · DaYs On. Site
~: i 365
Location within this Facility Unit
IN STOREROOM':BACK OF STORE CAS#
124-38-9
Gas · I'Pure { Above Ambient ] Ambient PORT. PRESS. CYLINDER
AMOUNTS STORED AND IN USE
Lrgst Cent.this Loc FT3 I DailyMax this Loc FT3 DailyAvg this Loc FT3
~1 1044.00 522.00
DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3
i ~i HAZARDOUS COMPONENTS EHS CAS#
%Wt. ,~ No 124389
100.00 Ca=ben Dioxide
F CIRCLE K STORES INC #8605 SiteID: 215-000-001297
Fast Format
~ Notif./E~ac~ation/Medical Overall Site
--Agency ~Notification ~05/03/1996
IF EMERGENCYi RESPONSE ASSISTANCE NO REQUIRED NOTIFY:
BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND WITHIN
STATE OFFiiICE! OF EMERGENCY SERVICES 800'852-7550 24 HOURS
IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY,
PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS REQUIRED, IMMEDIATELY
NOTIFY; ~'
FIRE DEPA~RTMENT - BAKERSFIELD FIRE DEPARTMENT 9-1-1
POLICE DEIPARTMENT - BAKERSFIELD POLICE DEPARTMENT 9-1-1
BAKERSFIEiLD CITY HAZARDOUS MATERIALS DIVISION 9-1-1
STATE OFFICE~OF EMERGENCY SERVICES 800-852-7550 OR
916-262-1621
-- EmploYee .Notif./Evacuation 05/03/1996
UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING)
NOTIFY A~L OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF
HIS/HER ~REA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. ~ tHIS
INCLUDES iELIMINATION OF POTENTIAL IGNITION SOURCES IN THE CASE OF THE
RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES
(IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE
NOTIFIED ~TO iEVAUCATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED
EVACUATION STAGI-NG AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR.
-- Public Notif./Evacuation 05/03/1996
IF EVACUATION FROM· AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL
BE NOTIFiED~ ~$$;~/e:
TODAY CLEANERS 5600 AUBURN STREET sUITE U/V 872-6920
MAXWELL'S 5600 AUBURN STREET SUITE T 873~8106
RAGE SALON 5600 AUBURN STREET SUITE'P,Q,R,S 872-2360
HIGHLAND iiHIGH SCHOOL 2900 ROYAL SCOTTS ROAD 872-2777
!
i
Emergency Medical Plan 05/03/1996
MERCY HosP I TAL 2215 TRUXTUN AVENUE 327- 3371
KERN MEDICAL CENTER 1830 FLOWER STREET 326-2000
CIRCLE K~:STORES INC #8605. SiteID: 215-000-001297
Fast Format
~ Mitigat~on/Prevent/Abatemtr Overall Site
-- Releas~ Prevention 05/03/1996
1. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS.
2. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF
FIBERGLASS CONSTRUCTION.
?
3 DUAL ..... SYSTEMS ~, ~UM~, ANTI-LOCK NOZZLES AT PUMPS
4. NO SALES TO NON-AUTHORIZED CONTAINERS.
5. NO SMOKING SIGNS POSTED, SELF-SERVE INSTRUCTIONS POSTED.
6. TANK~ Cq4ECKED PERiODiCALLY ~u~ LEAKS Bi COMPARING
-- Release Cont~'inment 05/03/1996
1. PREVENTIVE DIKING WITH ABSORBENT MATERIALS.
2. SHUT' OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE.
3. BARR!ICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC.
4 AVOI,D PERSONAL EXPOUSRE TO GENERAL PUBLIC.
5. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS.
6. · ABSORB LIQUIDS WITH ABSORBENT MATERIALS AN PLACE IN SEALED CONTAINER
FOR iDI SPOSAL.
-- Clea'n Up 05/03/1996
NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH
HAZARDOUS WASTE DISPOSAL COMAPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS
IF REQUI~RED.
CARBON DIOXIDE
A. RELEASE PREVENTION STEPS: TANKS ARE STORED UPRIGHT AND .FIRMLY SECURED.
B. RELEASE CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO,
OPEN '.ALL DOORS/VENTILATE.
C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER-IF
LEAK IN C'ONTAINER/VALVE.
Other Resource Activation
CIRCLE K :STORES INC #8605 SiteID: 215-000-001297
Fast Format
Site Emergency Factors Overall Site
~Special HaZards
-- Utility Shut-Offs 01/07/1990
A) GAS~- WEST WALL OF BUILDING ON SOUTH END (METER)
B) ELECTRICAL - NORTH SIDE OF BUILDING EAST END END (METER)
INSIDE~BACK ROOM OF STORE (BREAKERS)
C) WATER~- sOuTHEAST CORNER OF SITE (METER)
D) SPECIAL'-, EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
E) LOCK BOX- NO
-- Fire iProtec./Avail. Water 01/07/1990
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER LOCATED-ON PREMISES
FOR USE BY CLERK ON DUTY.
FIRE HYDRANT - SOUTHEAST CORNER~ OF LOT
Building Occupancy Level
-8-
cI~RCLE K STORES INC #8605 SiteID: 215-000-001297
× Fast Format~
Training ~? Overall Site
/' -- Employee Training 04/21/1992
WE HAVE 3 EMPLOYEES AT THIs FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
USE THE INFORMATION LEARNED FROM THE STUDY OF THE MSDS FOR EACH'APPROPRIATE
HAZARDOUS MATERIAL FOR TRAINING.
SPECIAL aN-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS
PROVIDEDi IN:THE FOLLOWING AREAS:
1) PROPER MAINTENAN~AND USE OF GASOLINE EQUIPMENT.
2) USE bF ~-~__g~_-~, FOR SMALL SPILLS
3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT,
EMERGENC~ MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT.
4) EACHi CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH
MSDS'S FOR GASOLI. NE AND CO2.
A REVIEWi'OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL
NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL
BASIS.
SAFETY ~ND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION
WITH TH~ LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE
EXTINGUIISHERS), THE LOCATION OF AND PROCEDURES .FOR FACILITY SHUTDOWN
(INCLUDItNG THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND -THE
-- Page 12
Held for Future Use
Held for Future Use I
· ~ .... ~.~,. * "/' ( /'.BAKER.~_FIELD CITY FIRE DEPAR{I~flENT~
·'~$;; , ;i " OFFICE.OF ENVIRONMENT S I1~/ ' 1 1997
· ~" ~'~ 1715 CHESTER AVENUE, 3RD FLOOR
HAZARDOUS MATERIALS-INVENTORY
- FACILITY DESCRIPTION
CHECK IF BUSINESS ISAFARM [ ]'
BUSINESS NAME Circle K Store #8605
FACILITY NAMECir~Ie K.store #8605~ ' '
SITE ADDR'Essr, 5600 Auburn Street
CITY Bakersfield ' 'STATE CA ZIP 93306
NATURE OF BUSINESS Convenience Store / Gasoline Station
SiC CODE 5541 . DUN & BRADSTREET 06-294-....4160 -' '
OWNER/OPERATOR Circle K Company a division of Tosc° PHONE (602), ,437-0600 [
MAILING ADDRESS~ P.O. Box.52084,~
CITY Arizona STATE Phoenix~ ZIP .85072-2084
' EMERGENCY CONTACTS'
NAME Staff "
~ TITLE Duty Clerk
BUSINESS PHONE (805) 871-7979 24-HOUR PHONE (805) 871-7979
NAME Terri NiChoNon
'. TITLE Zone Manager
,[
BUSINESS PHONE [800) 697-1399 .Pager 24-HOUR PHONE (goo) 697-1399 Pager
BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATERIALS INVENTORY Page1 of 2_
Business Name Circle K Store #8605 Address 5_600 Auburn Street Bakersfield 93306
.t
CHEMICAL DESCF~IPTION
1) INVENTORY STATUS: New [ ] Addition[ ] Revision.~] Deletion[ ] Check if chemical is a NON TRADE SECRET D(] TRADE SECRET [ ]
2) Common Name: Gasoline_ 'Unleaded Reoular · 3) DOT# (optional) 1203
Chemical Name: Gasoline. Unleaded Regular AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEAkTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [X~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19
S) PHYSICAL STATE Solid [ ] Liquid ~X0 Gas [ ] Pure [ ] Mixture ~] Waste [ ] Radioactive [ ]
. . ¢I~CKA~ 7~IATAPP~¥
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum, Da~ly Amount: 10000 lbs [ ] gat ~ ft3 [ ] a) Container. 01
Average Daily Amount: 5oo0 cudes [ ] b) Pressure: 1
Annual Afnount: 405739 c) Temperature: 4
Largest S'ize Countainer. 10000
365
# Days Oi Site: Circle Which Months: r~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) Methyltert Butyl Ether 1614-04-4 16 [ ]
chemical componenlts or any
AHM components i 2) Toluene 108-88-3 8 [ ]
3) M-Xylene 108-38-3 7 [ ]
10) Location Undergrou,'nd tank. aoerox. 20 feet southeast of store
CHEMICAL DESCRIPTION
1) INVENTORYSTAT,US: New [ ] Addition[ ] Revision [;K] Deletion[ ] Check if chemical is a NON TRADE SECRET IX:] TRADE SECRET [ ]
2) Common Name: Gasoline. Unleaded Plus 3) DOT# (optional) 1203
Chemical Name: Gasoline. Unleaded Plus AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEG0.~IES Fire ~ Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~X~ Delayed Health (Chronic
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19
6) PHYSICAL STATE", Solid [ ] Liquid ~ Gas [ ] Pure [ ] Mixture ~ · Waste [ ] Radioactive [ ]
[ CH~CK AI~. THATAf=PL¥
,[
7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum, Daily Amount: 10000 lbs [ ] gal {X] ft3 [ ] a) Container. 01
Average Daily Amount: 5000 cudes [ ] b) Pressure: 1
Annual A',rnount: 15_0516 c) Temperature: 4
Largest Size Countainer: .1~300 ~ -.' .....
# Days O~ Site: ' 365 Circle Which Months: ~)Year, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: i List COMPONENT CAS# % WT AHM
the three most hazardous 1) Methyltert Butyl Ether 1614-04-4 16 [ ]
chemical componer~ts or any
AHM components :i 2) Toluene 108-88-3 8 [ ]
3) M-Xvlene 108-38-3 7 [
10) Location Underero~nd_ ~ tank. ao~rox... 20 feet southeast of store
certify under penalty of=law, that I have personally examined and am familiar with the information submitted on this ced all attached documents. I believe the '
submittedTnf°rma~°nistrUe'accurate'andc°mplete'' tl/~/, " . "'~ '¢'~'/,,/ ~~'~Jd~"//')D~te
Pdnt /~/ame & Title of Authodzed (~o~n,~any Refiresenta~ive -~'Sigr(at'ur~
· ' BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATEPdALS INVENTORY' Page2__of 2__
Business Name !Circle K Store #8605 Address 5600 Auburn Street Bakersfield 93306
~ CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ) Actdition [ ) Revision ~] Deletion [ ) Chec~ if chemical is a NON TRADE SECRET ~} TRADE SECRET [ ]
,[
2) Common Name: Gasoline'Unleaded Premium 3) DOT# (optional) 1203
Chemical Name: Ga, soline. Unleaded Premium AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEALTH ~ PHYSICAL' HEALTH
HAZARD CATEGORIES Fire [X~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) {X~] Delayed Health (Chronic) ~
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19
6) PHYSICAL STATE. . Solid [ ] Liquid [X~ Gas [ ] Pure [ ] Mixture IX] waste [ ] Radioactive [ ]
7) AMOUNTAND TIM,I: AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount 10o00 lbs [ ] gal ~ fi3 [ ] a) Container. 01
Average Daily Amount 5ooo cudes [ ] b) Pressure: 1
Annual A,mount: 98163 c) Temperature: 4
.' Largest Size Countainer. 10000
# Days On Site:. 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS # % VVT AHM
the three most hazardous 1) Methyltert Butyl Ether 1634-04-4 16 [ ]
chemical componen~ts or any
AHMcomponents; 2) Toluene 108-88-3 8 [ ]
3) M-Xylene 108-38-:3 7 [ ]
10) Location Underoro,und tank. approx. 20 feet southeast of store
CHEMICAL DESCRIPTION
1) INVENTORYSTAT~IS: New[] Addition[] Revision[] Deietion[ ] Check if chemical is a'NON TRADE SECREm D(] TRADE SECRET [ ] .
2) Common Name: Carbon Dioxide 3) DOT # (optional)
Chemical Name: C,arbon Dioxide= CarbonicAnh.vddde AHM [ ] CAS # 124-38-9
4) PHYSICAL & HEAL, TH :' PHYSICAL HEALTH
HAZARD CATEGO. RIES Fire [ ] Reactive [ ] Sudden Release of Pressure D(] Immediate Health (Acute) {)(] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFIqATION (3-digit code from OHS Form 8022) USE CODE 99
:[
6) PHYSICAL STATEI Solid [ ] Liquid [ ] Gas [~ Pure [X~] Mixture [ ] Waste [ ] Radioactive [ ]
CH~CK ALL THAT APPf. Y
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum, Daily Amount 1044 lbs [ ] gal [ ] fi3 [X~] a) Container: 04
Average Daily Amount: .~22 cudes [ ] b) Pressure: 2
Annual A,rnount:: 54288 c) Temperature: 4
Largest Size Countainer. 174
# Days O~n Site: 365 Circle Which Months: ~Year, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS # % W'I' AHM
the three most hazardous ' 1) Carbon Dioxide. Carbonic Anhydride 124-38-9 100 [ ]
chemical componen, ts or any
AHM components I 2) [ ]
3) [ l
10) Location In Storempm: northeast comer of store '
I certifY under penal~y of i law, that ~ have pe~na~y examined and am fami~iar with the inf~rmati~n submitted ~n th~$ and/~ att~ched d~cuments~~ . I believe She
submitted information isl'true, accurate, and comple~e. ,~ * - // ~ ' 4 ~ r~r~/] ~/
Print ~lame & Ti~l~ o~ J~thodzed Company Representdti~;eI ~g~la~ure . , ' / ./' Date
HMMP PLAN MAP
SITE DIAGRAM7~ FACILITY DIAGRAM
Business Name: Circle K Stores [nc, #8605
Area Map # 1 of 1
N°rth Name of Area: ~ir¢l~ K Stor~s Inc. #8~05'
5600 Auburn St., Bakersfield CA
' ~ S T U-V
p ;I Q R Vacant Maxwell's mo---ay
Vacant ~!
Vacant Vacant 4/95 Restaurant Cleaners
5600 Fairfax Rd.
Driveway
Scale 1" = 126' '
Parking <
;Shop'ping
? Center r-
Parking Lot
Pumps
1OK
Driveway
~" '~ ~SYMBOLS',
GAS " IMSDS I MSDS STORAGE
:-, FENCE (ALL TYPES)
ELECTRIC '*~-~--~'~' INDICATE HEIGHT
wATER ~~' ' GATE IN FENCE
J -- STANDARD 'DOOR
SPR~INKLER FIRE DEPT.
CONNECTION
. i ! 10,000 '~ UNDERGROUND
; ! I STORAGE
~ Gal ! TANKS- LIST
FIRE HYDRANT- PUBLIC I,, ..... CAPABILITY
FIRE HYDRANT - PRIVATE ii i i i II,, , , · ~ , RAILROAD TRACKS
:~ 10,000
:'[ ABOVEGROUND TANKS
(~ AUT[OMATIC SPRINKLERED Ga.l
BUll' DING'.OR AREA O EVACUATION ARE, A
FIRE ALARM .... PESTICIDE STORAGE
I ~_ PESTICIDE .AREA
TYPES'OF HAZARDOUS MATERIALS
CORROSIVE ~:> SOLID
,.~ WASTE . EX, AMPLE: FLAIVINtABLE
.. LIQUID
BAKERSFIELD CITY FIRE DEPARTMENT
OFFICE ~OF ENVIRONMENTAL SERVICES
1715 CHESTER AVENUE, 3RD'FLOOR ' '
"" BAKERSFIELD,~ CA '93301'
· ~i - . · (805) 326-3979 ' .. '
'HAZARDOUs :MATERIALS MANAGEMENT PLAN
INSTRUCTIONS;. ''
1. ' To avoid further action, return this form Within 30 days of receipt.
2. TYPE(PRINT ANSWER,S IN ENGLISH.
3. Answer the questions below for the business as a whole.
4. Be bdef and concise as ~possible, - ·
SECTION '!: BUSINESS IDENTIFICATION DATA
BusINESS NAME: Circle K Store//8605 . ·
LOCATIQN:5600 Auburn Street ~Ba]rer.qfielcl 93306
MAILING~ ADDRESS: P.O. Box'52084 ,,
CITY: PhoerfixJ ' ' sTATEArJzona'ZIP 85072-2084PHONE: (,602,) 437.0600[
DUN & BRADSTREET NUMBER: 06-294-4160 SiC CODE: 5541
PRIMAR~ AGTIVITYi Convenience.Store / Ga~qoline Station
OWNER: Circle K Company a,DivLqion o£ Tosco Corp
MAILING ADDRESS: P.O. Box 52084[/._' Phoenix 'Anzonal 8'5072-20841
SECTION 2: EMERGENCY NOTIFICATION:
:
',, CONTACT TITLE BUS. pHONE 24 HR. PHONE
1..Staff !,: Duty Clerk (805) 871-7979 (805) g71-7979 -
._. 2. Terri Nicholson . Zone Manag.er (800) 697-1399 Pager (800) 697-1399 Pager
. . ~[~akersfield Fire Dept. ·
Hazardous Materials Division
HAZARDOUS MATERIALS ~MANAGEMENT PLAN
SECTION 3:! TRAINING ..
NUMBER oF EMPLOYEES: 3
MATERIAL SAFETY DATA S~HEETS ON FILE: Yes
BRIEF SUMMARY OF TRAINING PROGRAM:
Special bn-the-job training in ~,he handling of hazardous material(s)' is provided in the following areas:
1. Proper maintenance and uSelof gasoline equipment.
2. Use qf absorbent for small, s~ills.
3. Emp!oyees are instruCted on,' proper response to police, fire department, emergency medical and Circle K Environmental
Denartment. .
4.Each?Circle K gasoline storelhas a Company supplied gasoline manual with MSDSs for gasoline and COZ
A review of the contents of the Emergency Response Plan will be made by ali new employees within one month of hiring and
by all employees on an annual ibasls. .
Safety ahd emergency equipment usage training will provide familiarization with the location and proper use of fire fighting
equipment (fire extinguishers),;the location of and procedures for hcilit¥ shutdown (including the location of shutoffs for gas
and ele~nclty) and the proper use of eqmpment used in the day' to day' business.
SECTION 4: EXEMPTION REQUEST:
I CERTIFY UNDER PENAL'I~Y OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE
REPO*TING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH &
SAFE~ CODE" FOR THE ~OLLOWING REASONS:
WE DO NOT HANDLE HAZARDOUS MATERIALS.
, ~--.~'" WE DO HANDLE H/~.~RDOUS MATERIALS,' BUT THE QUANTITIES AT NO TIME
:i EXCEED THE MINIMUM REPORTING QUANTITIES.
: OTHER (sPECIFY REASON)
SECTION 5: CERTIFICATION:
I ~ *~'~ iF~" ~VI. ~ .~..~ CERTIFY THAT THE.ABOvE INFOR- ·
MATI~N IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO
FULFII}L MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH AND SAFETY CODE"
ON H,~RDOUS MATERIALS (DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT
INACClURATE INFORMATION CONSTITUTES PERJURY.
'SIGNATURE TITLE DATE
· e, rsfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
Fa¢ili~ Unit Name: Circle K Store 1#8605
SECTION 6: ' NOTIFICATIO~ AND E¥~CUATION' PROCEDURe8:
A. *GENCY NOTIFICATION PROCEDURES:
ff emergency response ~sistance not ~equired, notify:
Bakersfield City Hazardous Materials Division 326-3979 AND
State Office of Emergency Services I 800-852-7550 WITHIN 24 HOURS.
If release poses present or potential h~ard to human health & safety, property or environment, and emergency
assistance is required,' ' i ·
~mmediately notify:
Pire Department - Bakersfield Fire Diepartment 911
Police Department - Bakersfield Pohce Department 911
Bakersfield City Hazardous Matenal}D~vmon 911
§tare Office of Emergency Services · (800) 852-7550 or (916) 262-1621
B. EMPLOYEE NOTIFICATION AND! EVACUATION:
Upon recognition of a release, the Dhty Clerk will verbally (shouting) notify all other site personnel., The clerk will
ensure the shutdown of h~s/her area.of responsibility (if possible) before evacuaung. This includes ehmmauon of
' Potential ignition sources in the case!of the release of flammable material. Evacuation will follow the designated routes
Of unobstructed) as diagrammed on ~he Site/Plot Plan. Employees will be notified to evacuate by verbal (shouting)
method to a pre-determined evacuau'on staging area where all employees will be accounted for.
C. ' PUBLIC EVACUATION: , :,
If evacuation from area deemed necessary, these neighboring properties will be notified if pOssible:
:Today Cleaners ' 5690 Auburn Street, Suite U/V 872-6920
Maxwell's 5600 Auburn Street, Suite T 873-8106
Rage ~alon 56)0 Auburn Street, Suite P,Q,R,S 872-2360
Highland High School 2900 Royal Scotts Road 872-2777
D. iEMERGENCY MEDICAL PLAN:
............. iTh~ Primar}? Company medical faculty to treat employees injured by a hazardous materials incideni:
'MERcy HOSPITAL 221,5 TRUXTON AVENUE 327-3371
Kern Medical Center '1830 Flower Road 326-2000
": e field Fire Dept.
! HazardoUs Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
A. RELEASE PREVENTION STEPS: i · "
1.: Barriers installed to prevent vehicle !collision with pumps.
2. Vapor Recovery Systems used when~ £rlling underground tanks which are of fiberglass construction.
3. Anti-lock nozzles at pumps.
4, No sales to non-authorized containlrs.
51 No Smoking signs posted, self-servj instructions posted..
61 Tank monitoring program implemented.
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
materials.
1~ Preventive diking with absorbent ;
2! Shut off of all emergency switches t,o prevent further spillage.
3i Barricade area to prevent possible ekposure to general public.
47 Avoid personal exposure to fumes4vapors and contact with liquid.
5: Eliminate all sources of,ignition in area of spill or vapors.
'6;. Absorb liquids with absorbent materials and place is sealed container for disposal.
C. CLEAN-UP PROCEDURES:
Notify Circle K Environmental Dire ,ctor (206)442-7434 for coordination With hazardous waste disposal company to
remove contaminated absorbent matqrials if required.
QARBON DIOXIDE
A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured.
B. RELEASE CONTAINMENT A!SID~/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate.
C. CLEAN-UP PROCEDURES: Ve,ntilate area immediately. Contact supplier if leak in container/valve.
SECTION 8: UTILITY SHUT-OFFS {LO~ATION OF SHUT-OFFS AT YOUR FACILITY}: . "
NATURAL GAS/PROPANE: W~st wall'.o£, building on south end (meter).
;
ELECTRICAL: a/Inside, baekroom of store' (brealrers~. b/North wall of buildin~ at e~t end (meter]
,
WATER: Southeast corner of site (rnete0
SPECIAL: Fmervencv ~as shutoff switch: At'cashier station on console
LOCK BOX: E IF YES, LOCATION:
SECTION 9:' PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A.PRIVATE FIRE PROTECTION:
Fire extinguishers
B. WATER AVAILABILITY (FIRE HYDRANT):
Hydrant: Southeast corner o£ site
t 4.
cIRCLE K~iSTORES INC #8605 SiteID: 215-000-001297 =
Manager : BusPhone: (805) 871-7979
Location: 5600 AUBURN ST 2 Map : 103 CommHaz : Low
City : ~BAKERSFIELD Grid: 13C FacUnits: 1 AOV:
CommCode: BAKERSFIELD STATION 08 SIC Code:5541
EPA Numb: DunnBrad:06-294-4160
Emergency Contact / Title Emergency Contact / Title
STAFF / DUTY CLERK TE~ NICHOLSON / DISTRICT MNGR
BuSiness Phone: (805) 871-7979x Business Phone: ( ) - x
24-Hour:Phone : ( ) - ~ x 24-Hour Phone : ( ) - x
Pager Phone : ( ) - i x Pager Phone : ~)~-~x? .
Hazmat Hazards: ~ Fire Press ImmHlth DelHlth
Agency-Defined Topic Title
~ Hazmat Inventory One Unified List
-- MCP+DailyMax Order All Materials at Site
I I ' Unit MCP
Hazmat Common Name.,, SpecHaz EPA Hazards Frm DailyMax
UNLEADED PLUS GASOLINE F IH DH L 1,0000 GAL Mod
UNLEADED GASOLINE F IH DH. L 10000 GAL Mod
PREMIUM UNLEADED GASOLINE ~ F IH DH L 10000 GAL Mod
CARBON DIOXIDE . F P IH G 1044 FT3 Min
~, .~),,~ ,'~'n?~J~o hereby certify that" I have
reviewed the ~.~:.~..hed h~ardous materials manage-
ment plan for ~/~/~ and ~hat i~ along ~i~h
(N~me of ~s~e~)
any corrections constitute a complete and corre~ man-
agemem plan for my facili~.
1
CIRCLE K ,STORES INC #8605 Sit'eID: 215-000-001297
~ Invento~y Item 0001 Facility Unit: F, ixed Containers on Site
UNLEADED PLUS GASOLINE Days On Site
365
Location within this Facility Unit
SOUTHEAST CORNER OF PROPERTY CAS#
8006-61-9
Liquid Mixture I Ambient I Ambient UNDER GROUND TANK
AMOUNTS STORED AND IN USE
Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
10000.00 5000.00
DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL
HAZARDOUS COMPONENTS
%Wt. ~ EHS CAS#
100.00 Gasoline : No 8006619
-2-
CIRCLE K STORES INC #8605 SiteID: 215-000-001297
~ Inventory Item 0002 Facility Unit: Fixed Containers on Site
UNLEADED GASOLINE Days On Site
365
Location within this Facility Unit
SOUTHEAST CORNER OF PROPERTY CAS#
8006-61-9
,~ STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
I~ Liquid Mi'xture I Ambient Ambient I UNDER GROUND TANK
AMOUNTS STORED AND IN USE
Lrgst Cent.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
10000.00 5000.00
DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL
HAZARDOUS COMPONENTS
%Wt. I EHS CAS#
100.00I Gasoline No 8006619
CIRCLE K :STORES INC #8605 SiteID: 215-000-001297
~ Inventory Item 0003 Facility Unit: Fixed Containers on Site
-- COMMON NAME / CHEMICAL NAME
PREMIUM UNLEADED GASOLINE Days On Site
365
Location. wlithin this Facility Unit
'SOUTHEAST CORNER OF PROPERTY CAS#
8006-61-9
Liquid Mixture Ambient Ambient UNDER GROUND TANK
AMOUNTS STORED AND IN USE
Lrgst Cont.this Loc GAL DailyMax this Loc GAL DailyAvg this Loc GAL
10000.00. 5000.00
DailyMax Stored GAL DailyMax Open Use GAL DailyMax Closed Use GAL
HAZARDOUS COMPONENTS
%Wt. I EHS CAS#
100.00I Gasoline No 8006619
-4-
CIRCLE K STORES INC #8605 SiteID: 215-000-001297
~ Inventory I~em 0004 Facility Unit: Fixed Containers on Site
-- COMMON NAME / CHEMICAL NAME
CARBON DIOXIDE Days On Site
365
Location within this Facility Unit
IN STOREROOM BACK OF STORE CAS#·
124-38-9
STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE
Gas Pure Above AmbientIi AmbientIi PORT. PRESS. CYLINDER
AMOUNTS STORED AND IN USE
Lrgst Cont.this Loc FT3 DailyMax this Loc FT3 DailyAvg this Loc FT3
1044.00 522.00
DailyMax Stored FT3 DailyMax Open Use FT3 DailyMax Closed Use FT3
HAZARDOUS COMPONENTS
%Wt. EHS CAS#
100.00 Carbon Dioxide ~ No 124389
-5-
CIRCLE K :STORES INC #8605 SiteID: 215-000-001297
Fast Format
= Notif./Evacuation/Medical Overall Site
-- Agency Notification 05/03/19'96
IF EMERGENCY RESPONSE ASSISTANCE NO REQUIRED NOTIFY:
BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 326-3979 AND WITHIN
STATE OFFICE OF ~EMERGENCY, SERVICES 800-852-7550 24 HOURS
IF RELEASE POSES PRESENT OR POTENTIAL HAZARD TO HUMAN HEALTH & SAFETY,
PROPERTY OR ENVIRONMENT, AND EMERGENCY ASSISTANCE IS'REQUIRED, IMMEDIATELY
NOTIFY;
FIRE DEPARTMENT - BAKERSFIELD,.FIRE DEPARTMENT 9-1-1
POLICE DEPARTMENT - BAKERSFIELD POLICE DEPARTMENT 9-1-1'
BAKERSFIELD CITY HAZARDOUS MATERIALS DIVISION 9-1-1
STATE OFFICE OF EMERGENCY SERVICES 800-852-7550 OR
916-262-1621
-- Employee Notif./Evacuation 05/03/1996
UPON RECOGNITION OF A RELEASE, THE DUTY CLERK WILL VERBALLY (SHOUTING)
NOTIFY ALL OTHER SITE PERSONNEL. THE CLERK WILL ENSURE THE SHUTDOWN OF
HIS/HER ~REA OF RESPONSIBILITY (IF POSSIBLE) BEFORE EVACUATING. tHIS
INCLUDES ~ELIMINATION OF POTENTIAL IGNITION SOURCES IN THE,CASE OF THE
RELEASE OF FLAMMABLE MATERIAL. EVACUATION WILL FOLLOW THE DESIGNATED ROUTES
(IF UNOBSTRUCTED) AS DIAGRAMMED ON THE SITE/PLOT PLAN. EMPLOYEES WILL BE
NOTIFIED TO EVAUCATE BY VERBAL (SHOUTING) METHOD TO A PRE-DETERMINED
EVACUATION STAGING AREA WHERE ALL EMPLOYEES WILL BE ACCOUNTED FOR.
-- Public Notif./Evacuation 05/03/1996
IF EVACUATION FROM AREA DEEMED NECESSARY, THESE NEIGHBORING PROPERTIES WILL
BE NOTIFIiEDi~ F~$$;~[~ %
TODAY CLEANERS 5600 AUBURN STREET SUITE U/V 872-6920
MAXWELL'S 5600 AUBURN STREET SUITE T 873-8106
RAGE SALON 5600 AUBURN STREET SUITE P,Q,R,S 872-2360
HIGHLAND 'HIGH SCHOOL 2900 ROYAL SCOTTS ROAD 872-2777
Emergency Medical Plan 05/03/1996
MERCY HOSPITAL 2215 TRUXTUN AVENUE 327-3371
KERN MEDICAL CENTER 1830 FLOWER STREET 326-2000
CIRCLE K~STORES INC'#8605 SiteID: 215-000-001297
Fast Format
~ Mitigation/Prevent/Abatemt Overall ~Site
-- Release Prevention 05/03/1996
1. BARRIERS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS.
2. VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF
FIBERGLASS CONSTRUCTION.
3 DUAL.HO~E SYSTEMS ON ....... ANTI-LOCK NOZZLES AT PUMPS
4. NO SALES TO NON-AUTHORIZED CONTAINERS.
5. NO SMOKING SIGNS POSTED, SELF-SERVE INSTRUCTIONS POSTED'
6. TANK~ C~u~ECKED PERiODiCALLY FOR LEAKS Bx COMPAKiNG GALLONGAE
-- Release Containment 05/03/1996
1. PREVENTIVE DIKING WITH ABSORBENT MATERIALS.
2. SHUT'OFF OF ALL EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE.
3. BARRICADE AREA TO PREVENT POSSIBLE EXPOSURE TO GENERAL PUBLIC.
4 AVOID PERSONAL EXPOUSRE TO GENERAL PUBLIC.
5. ELIMINATE ALL SOURCES OF IGNITION IN AREA OF SPILL OR VAPORS.
6. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AN PLACE IN SEALED CONTAINER
FOR DISPOSAL.
-- Clean Up 05/03/1996
NOTIFY CIRCLE 'K ENVIRONMENTAL DIRECTOR (602) 530-5089 FOR COORDINATION WITH
HAZARDOUS WASTE DISPOSAL COMAPANY TO REMOVE CONTAMINATED ABSORBENT MATERIALS
IF REQUIRED.
CARBON DIOXIDE
A. RELE%SE PREVENTION STEPS: TANKS ARE STORED UPRIGHT'AND FIRMLY SECURED.
B. RELEASE ~CONTAINMENT AND/OR MINIMIZATION: CLOSE VALVE IF SAFE TO DO SO,
OPEN ALL DOORS/VENTILATE.
C. CLEAN-UP PROCEDURES: VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF
LEAK IN CONTAINER/VALVE. ~
Other Resource Activation
F CIRCLE K iSTORES INC #8605 SiteID: 215-000-001297
Fast Format
F Site Emergency Factors Overall Site
__~pecial Hazards
--Utility Shut-Offs 01/07/1990
A) GAS - WEST WALL OF BUILDING ON SOUTH END (METER)
B)~ ELECTRICAL - NORTH SIDE OF BUILDING EAST END END (METER)
INSIDE BACK ROOM OF STORE (BREAKERS)
C) WATER - SOUTHEAST CORNER OF SITE (METER)
D) SPECIAL - EMERGENCY-GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
E) LOCK BOX~- NO
-- Fire Protec./Avail. Water 01/07/1990
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER LOCATED ON PREMISES
FOR USE BY CLERK ON DUTY.
FIRE HYDRANT - SOUTHEAST CORNER OF LOT
Building Occupancy Level
CIRCLE'K STORES INC #8605 SiteID: 215-000-001297
Fast Format
~ Training · Overall Site
-- Employee Training 04/21/1992
WE HAVE 3 EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
USE THE INFORMATION LEARNED FROM THE STUDY OF THE MSDS.FOR EACH APPROPRIATE
HAZARDOUS MATERIAL FOR TRAINING.
SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS
PROVIDED,IN !THE FOLLOWING AREAS:
1) PROPER M~~E AND USE OF GASOLINE EQUIPMENT.
2) USE OF-~,~!TTY ~TTTE~ FOR SMALL SPILLS
3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT,
EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT.
4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH
MSDS'S FOR GASOLINE AND CO2.
A REVIEW iOF iTHE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL
NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL
BASIS.
SAFETY AND EMERGENCY EQUIPMENT USAGE .TRAINING WILL PROVIDE FAMILIARIZATION
WITH THE iLOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE
EXTINGUISHERIS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN
(INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE
-- Page 2.
-- Held for Future Use
Held for Future Use
BAKERSFIELD'CITY FIRE DEPARTMENT
lC NVIR NM NTA VICES
· " .1715 CHESTER AVENUE, 3RD.FLOOR
BAKERSFIELD, CA 93301
(805) 326-3979
.. HAZARDOUS MATERIALS INVENTORY
FACILITY DESCRIPTION
CHECK IF BUSINESS ISAFARM [ ]
BUSINESS NAME Ckcle_K Stores Inc. #g605
FACILITY NAME
SITE ADDRESS 5600 Auburn Street
CITY Bake~'sfield STATE CA ZIP 93306
NATURE OF! BUSINESS Convenience Store / Gasoline Station
SIC CODE 5541 DUN & BRADSTREET 06-294-4160
OWNER/oPERATOR Myron Smith: Compliance Manager PHONE (805) 871-7979
MAILING ADDRESS 3003 N. Central Avenue= 16th Floor
cITYPhoeni× STATE .AZ ZIP 85012
EMERGENCY CONTACTS ·
NAME· Staff,' TITLE Duty Clerk
BUSINESS PHONE (805) 871-7979 24-HOUR PHONE (805) 871-7979
NAME Teri!Nicholson TITLE ~ger
BUSINESS PHONE (805) 335-6032 Pager 24-HOUR PHONE (805) 335-6032 Pager
BAKERSFIELD CITY FIRE DEPARTMENT'
HAZARDOUS MATERIALS INVENTORY page1 of 2--
Business Name Circle K S_toms Inc. #8¢~0_5 Address 56_0D Auburn Sim_et BakeJ:sfteld 9_3_30¢
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition[ ] ~vision ~ Deletion [ ] Check if chemical is a NON TRADE SECRET IX] TRADE SECRET [ ]
2) Common Name: C.~soline. Unle~cled ReguJar ~/ 3) DOT# (optional) 1203
Chemical Name: Gasoline. UJ31eaded Reg~ar AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES . Fire [~(] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~] Delayed Health (Chronic) [X~
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19
6) PHYSICAL STATE Solid [ ] Liquid IX] Gas [ ] Pure [ ]- Mixture D~] waste [ ] Radioactive [ ]
C~ECK AL~ ~Ar AePL ¥
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 10000 lbs [ ] gal [X~] fi3 [ ] a) Container:. 01
Average Daily Amount: 5000 curies [ ] b) Pressure: 1
Annual Amount: 405739 c) Temperature: 4
Largest Size Countainer: 10000
# Days On Site: 365 Circle Which Months: ~F~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) Methyltert Buh/.I Ether 1614-04-4 16 [ ]
chemical components or any
AHM cqmponents 2) Toluene 108-88-3 8 [ ]
3) U-Xylehe. !08-38-3 7 [ ]
10) Location Ullde~round tank. approx. 20 feet Southeast of store
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition[ ,,] Revision IX3 Deletion [ ] Check if chemical is a NON TRADE SECRET IX] TRADE SECRET [ ]
2) Common Name: Gasoline: Unleaded Plus V/" ~3) DOT # (optional) 1203
Chemical Name: Gasoline. Unl~aded Plus AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire ~(] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X~] Delayed Health (Chronic)
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 19
6) PHYSICAL STATE Solid[ ] Liquid ~:3 Gas[ ] Pure[ ] Mixture [:x:3 Waste [ ] Radioactive[ ]
CHECK ALL THAT APP~ ¥
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 10000 lbs [ ] gal ~] ft3 [ ] a) Container:. 01
Average Daily Amount: 5000 curies [ ] b) Pressure: · . 1
Annual Amount: 150516 c) Temperature: 4
Largest Size Countainer. 10000
# Days On Site: 365 Circle Which Months: f'~Year, J, F, M, A, M, J, J, A, S, O, N, D
9) MIxTuRE: Lilt COMPONENT CAS # % WT AHM
the three most hazardous 1) Methyltert Butyfl~Ether . 1614-04-4 16 [ ]
chemical components or any
AHM components 2) Toluene 108-88-3 8 [ ]
3) M-Xylene 10_8-38-3 7 [ ]
10) Location UndercEound tau3~_approx. 20 feet southeast of store
submitted information is true, accurate, and complete. ' ( ~1 ~ lJ Z~.//~ (_~[/D?t~e '
P~nt Name & Title'of Authorized Company Representative Sign~..u~, ..... ~ ~ - .
.BAKERSFIELD CITY FIRE DEPARTMENT
HAZARDOUS MATERIALS INVENTORY Page2_ of 2_
BusinesS Name Circle K S_to[es Inc~J~6Q5 Address 5600 Aubum_Stm_et Baker_s~Jd 93_3_06
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition [ ] Revisio?/~(] Deletion [ ] Check if chemical is a NON TRADE SECRET IX] TRADE SECRET [ ]
2) Common Name: Gasoline. Unleaded Premium ~/ 3) DOT # (optional) 1203
Chemical Name: Gasoline. Unleaded Premium AHM [ ] CAS # 8006-61-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES · Fire [~] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~X] Delayed Health (Chronic) ~]
5) WASTE CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE lg
6) PHYSICAL STATE Solid [ ] Liquid D(] Gas [ ] Pure [ ] Mixture D(] Waste [ ] Radioactive [ ]
CHECK ALL THAT APPLY
7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 10000 lbs [ ] gal [X~] ft3 [ ] a) Container: 01
Average Daily Amount: ,5000 curies [ ] b) Pressure: 1
Annual Amount: 98163 c) Temperature: 4
Largest Size Countainer~ 10000
# Days On Site: 365 Circle Which Months: ~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) Methyltert Butyl Ether 1634-04-4 16 [ ]
chemical components or any
AHM components 2) Toluene 108-88-3 8 [ ] '
3) u-Xylene 108-38-3 7 [ ]
10) Location Urtderground tank. approx. 20 feet southeast of store
, CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [ ] Addition[. ] Revision [ ] Deletion[ ] Check if chemical is a NON TRADE SECRET [:x~] TRADE SECRET [ ]
2) Common Name: Carbon Dioxide 3) DOT # (optional)
Chemical Name: Carbon Dioxide. CarbonicArlhyddde AHM [ ] CAS # 124-38-9
4) PHYSICAL & HEALTH PHYSICAL HEALTH
H, AZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure ~] Immediate Health (Acute) ~ Delayed Health (Chronic) [ ]
5) WASTE' CLASSIFICATION (3-digit code from OHS Form 8022) USE CODE 99
6) PHYSICAL STATE Solid [ ] Liquid [ ] Gas ~ PuJ'e [:x~] Mixture [ ] Waste [ ] Radioactive [ ]
CHECK ALL THAT APPL¥
7) AMOUNTAND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 1044 lbs [ ] gal [ ] ft3 ~ a) Container:. 04
Average Daily Amount: 522 cudes [ ] b) Pressure: 2
Annual Amount: - · . 54288 c) Temperature: 4
Largest Size Countainer. 174
# Days On Site: 365 Circle Which Months: ~'A'~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) Ca[bon Dioxide. Carbonic Anhydride 124-38-9 100 [ ]
chemical components or any
AHM components 2) [ ]
3) [ ]
t0) Location In Storeroom. northeast comer of store
Myron Smith, Compliance Mana~r .' ,
Print Name & Title of Authorized Company Representative ,.. ' / ~ate
:BA SFIELD CITY FIRE DEl RTMENT
OFFICE OF ENVIRONMENTAL SERVICES
1715 CHESTER AVENUE, 3RD FLOOR
BAKERSFIELD, CA 93301
(805) 326-3979.
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTRUCTIONS:
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: Circle K Stores ]~nc. #8605
LOCATION:5600 Auburn Street Bakersfield 93306
MAILING ADDRESS: 3003 N. Central Avenue, 16th Floor
CitY:Phoenix STATE: AZ__ ZIP: 85DJ2~ PHONE: (g05) 871-7979
DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 554]
pRIMARY ACTIVItY: Convenience Store / Gasoline Station
OWNER: Circle K Stores Inc.
MAILING ADDRESS: P.O. Box 52084 Phoenix AZ 85072
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TITLE BUS. PHONE 24 HR. PHONE
~- 1. Staff Duty Clerk (805) 871-7979 (805) 871-7979
2. Teri Nicholson District Manager (805) 335-6032 Pager (805) 335-6032 Pager
Bakersfield Fire Dept.
" Hazardous Materials Division
· ' 'HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3:' TRAINING
NUMBER OF EMPLOYEES:
MATERIAL SAFETY DATA SHEETS ON FILE: Yes
BRIEF SUMMARY OF TRAINING PROGRAM:
Special onqhe-job training in the handling:of hazardous material(s) is provided in the following areas:
1. Proper maintenance and use of gasoline equipment.
2. Use of kitty!itter for small spills.
3. Employees are instructed on proper response to police, fire department, emergency medical and Circle K Environmental
Department.
4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasolipe ~nd CO2.
A review of the.contents of the Emergency Response Plan will be made by all new employees within one month of hiring and
by all employees on an annual basis.
Safety and emergency equipment usage training will provide familiarization wi:th ~he location and proper use of fire fighting
equipment'(fire extinguishe~rs), the location of and procedures for facility shutdown (including the location of turnoff Yalves for
gas and electricity) and the proper use of equipment used in the day to day business.
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 MINIMUM REPORTING QUANTITIES.·
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION:
I Myron Smith CERTIFY THAT THE ABOVE INFOR-
MATION 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 THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
ComplianceManager ' '
SIGNATURE .' TITLE DATE
2.
Bakersfield Fire Dept.
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT pLAN
Facility Unit Name:
SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES:
A. F AGENCy NOTIFICATION PROCEDURES:
If emergency response assistance not required, notify:
Bakersfield City Hazardous Materials Division 326-3979 AND
St'ate Office of Emergency Services ' 800-852-7550 WITHIN 24 HOURS
If release poses present or potential hazard to human health & safety, property or environment, and emergency
assistance is required, immediately notify:
Fire Department - Bakersfield Fire Department 911
police Department - Bakersfield Police Department 911
Bakersfield City Hazardous Material Division 911
St~te'Office of Emergency Services (800) 852-7550 or (916) 262-1621 .
B. v/ EMPLOYEE NOTIFICATION AND EVACUATION:
Upon recognition of a release, the Duty Clerk will verbally (shouting) notify all other site personnel.-.The clerk will
ensure the shutdown of his/her area of responsibility (if possible): before evacuating. This includes elimination of
potential ignition sources inthe case of the release of flammable material. Evacuation will follow the designated routes
(if unobstructed) as diagrammed on the Site/Plot Plan. Employees will be notified tO ev~icuate by Verbal (shouting)
method to a pre-determined evacuation staging area where all employe~s will be accounted for..
C. / PUBLIC EVACUATION:
/
If evacuation from area deemed necessary, these neighboring properties will be notified:
Today Cleaners 5600 Auburn Street, Suite U/V 872-6920 ·
Maxwell's - 5600 Auburn Street, Suite T 873-8106
Rage Salon' 5600 Auburn Street, Suite P,Q,R,S 872-2360
Highland High School 2900 Royal Scotts Road 872-2777
D. ff EMERGENCY MEDICAL PLAN:
The primary Company medical facility to treat employees injured by a hazardous materials incident.:
MERCY HOSPITAL . 2215 TRUXTON AVENUE 327-3371
Kern Medical Center 1830 Flower Road 326-~000
~ -'~ ' Bakersfield Fire Dept. .
Hazardous Materials Division
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT'PLAN:''
A. RELEASE PREVENTION STEPS: -
1. Barrie~:s installed to prevent vehicle c011ision with pumps.
2. Vapor RecoverY Systems used when filling underground tanks which are of fiberglass construction.
3. Dual hose systems on pumps. Anti-lock nozzles at pumps.
4. NO sal~s to non-authorized containers.
5. No Smoking signs posted, self-serve instructions posted. ..
6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records.
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
1. Preventive diking with absorbent materials.
2. Shut off of all 'emergency switches to prevent further spillage.
3. Barricade area to prevent possible exposure to general public.
4. Avoid personal exposure to fumes/vapors and contact with liquid.
5. Eliminate all sources of ignition in area of spill or vapors ....
6. Absorb liquids with absorbent, materials and place is sealed container for disposal. ..
C.. .CLEAN-UP PROCEDURES:
. Notify Circle K Environmental Director (602) 530-5089 for coordination with hazardous waste disposal company to
remove contaminated absorbent materials if required.
CARBON DIOXIDE
A. RELEASE PREVENTION STEPS: Tanks are stored upright and firmly secured.
B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors/ventilate.
C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve.
SECTION 8: UTILITY SHUT-OFFS !LOCATION OF SHUT-OFFS AT YOUR FACILITYi:
NATURAL GAS/PROPANE: West wall of building on south end (meter)
ELECTRICAL: 4' Inside, backroom of store ,(breakers), b) North wall of building at east.end (meter)
WATER: Southe~qt corner of site (meter~
SPECIAL: Emergency gas shutoff switch: At cashier station on console
LOCK BOX: YES~N/N~ IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A. PRIVATE FIREPROTECTION:
Fire extinguishers
B. WATER AVAILABILITY :(FIRE HYDRANT):
Hydrant: Southeast corner of site
4.
ITE. DIAGRAM FACILITY DIAGRAM.V]
Circle K Stores Inc. #8605
Business. Name:
///~ Area Map. # 1 of 1
North Name of Area: Circle K StoreS Inc. #8605
I I 5600 Auburn· St.,~ Bakersfield CA
I
· S [ T ' U-V
P Q . 'R Vacant I . Maxwell's Today-
Vacant Vacant Vacant 4/95 Restaurant Cleaners'
~/95
5600 Fairfax Rd.
Driveway
Scale 1" = 26'
.'(
Store g8605 Parking
5600
Shopping Avburn St.
Center r-
Parking Lot
Exit . k. 10K
::::: ::::: :::::i~:~:::::::::: ::: :::::::: :.::
GAS' -' .. i-MSD$i MSDS.STORAGE' .
{~) ELECTRIC -~ FENCE (ALL TYPES)
. INDICATE HEIGHT'
{~ WATER .. ~ '~' GATE IN FENCE
~' J -- STANDARD DOOR
· SPRINKLER FIRE DEPT,
CONNECTION.
! 10,000 ~ UNDERGROUND*
· !. STORAGE
Gal i TANKS- LIST
FIRE HYDRANT - PUBLIC L ..... CAPABILITY ..
~ RAILROAD TRACKS
(~ FIRE HYDRANT - PRIVATE .......
10,000
ABOVEGROUND TANKS
( AUTOMATIC SPRINKLERED
BUILDING OR AREA O' EVAcuATION AREA
FIRE ALARMPESTICIAREA
.TYPES OF HAZARDOUS MATERIALS
WAT'FR REACTrVE ,<~ GAS'
..- ,-. -POISON , EXPLOSIVE GAS.
Overall Site with 1 Fac. Unit
General Information By."~
Location: 5600 AUBURN ST 2 Map:103 Ham:2 Type: 3
· City ' : Bakersfield Grid: 13C F/U: 1 AOV: 0.0
Contact Name Title .-~'.¢.¢,]
uontact Name Title
MYRON SMITH / COMPLIANCE MANA I~::UCX TOMXOViC}[ / ZONE MANAGER
Business Phone: (602) 437-0600x I Business Phone:
24-Hour Phone : (602) 530-5089x I 24-Hour Phone : ~16) 2~
Pa~ger Phone : ( ) - x ~ Paggr Phone : (
Administrative
Mail Addrs: 3003'N. CENTRAL AVE., i~TH FLOOR D&B Number: 06-294-4160
City: PHOENIX State: AZ Zip: 85013-
Comm Code: 215-008 BAKERSFIELD STATION 08 SIC Code: 5541
Owner: THE CIRCLE K-COP. PO2~'TIONgr~/f~5I~. 'Phone: (805) 871-7979
"Address: P 0 BOX 52084 State:. AZ'
City: PHOENIX Zip: 850062
Summary
v (Type or pdntname)'
reviewed t, he, a~tacb.e~d b. az~:~do,.~'. ~a,.t,.~i.~l~ ~~-
men~. plan, for ~ k ~ ~¢~ ~ ~ ~ ~ ~
ageme~ plan ~r my ~df~ .... "'
06/05/95 i~ CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 2
Hazmat Inventory List in MCP Order
02 - Fixed Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-0'03 pREMIUM UNLEADED GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
02-002 UNLEADED GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
02-004 CARBON DIOXIDE ~--~.l Gas 1044 Minimal
· Fire, Pressure,~ Hlth FT3
06/05/95 ~, CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 3
02 .- Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth .. 'GAL
CAS #: 8006-61-9 Trade Secret: No
Form: Liquid Type.: Days: 365 Use: FUEL
~ Daily Max GAL Daily Average GAL Annual Amount GAL
o,ooo I ,ooo.oo I
Storage ~~Press T Temp Location
UNDER GROUND TANK IAmbient~AmbientlSOUTHEAST CORNER OF PROPERTY
- Conc Components MCP ---TGuide
100.0% I Gasoline I Moderate I 27
-- Notes
02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate
· ~ Fire, Immed Hlth, Delay Hlth GAL
CAS #: 8006-61-9 -Trade Secret: No
Form: Liquid Type: Purc Days: 365 Use: FUEL
Daily Max GAL Daily Average GAL [ Annual Amount GAL --
10,000 I 5,000.00 I ;_~7~036.0C
Storage Press T TempI Location
UNDER GROUND TANK AmbientlAmbientlSOUTHEAST CORNER OF PROPERTY
-Conc Components MCP ---~uide
100.0% [Gasoline IModerateI 27
--iNotes
06/05/95 ~ CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 4
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-002 UNLEADED GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
CAS #: 8006-61-9 Trade Secret: No
Form: Liquid Type: Du~e Days: 365 Use: FUEL
Daily Max GAL Daily Average GAL I Annual Amount GAL
10,000 I 5,000.00m ~
Storage~~Press T Temp Location
UNDER GROUND TANK IAmbient~AmbientlSOUTHEAST CORNER OF PROPERTY
- Conc Components MCP --TGuide
100.0% IGasoline IModeratel 27
-- Notes
02-'004 CARBON DIOXIDE Gas 1044 Minimal
· ~Fire, Pressure, Delay Hlth FT3
CAS #: 124-38-9 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: OTHER
Daily Max.FT3I Daily Average FT3 I Annual Amount FT3 7--
1,044 ~ 522.00_ 54,288.00
Storage Press T Temp '~ Location
PORT. PRESS. CYLINDER Above I AmbientlIN STOREROOM BACK OF STORE
-Conc Components MCP ---TGuide
100.0% ICarb°n Dioxide ILOw / 21
06/05/95 ' CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 5
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notif./Evacuation
EMPLOYEES ARE INSTRUCTED TO REPORT ANY INCIDENT SUCH AS A SPILL OR FIRE
IMMEDIATELY TO THE APPROPRIATE EMERGENCY RESPONSE TEAM IN THE IMMEDIATE AREA
SUCH AS ~IRE DEPARTMENT ETC. ADDITIONALLY THE STORE MANAGER IS INSTRUCTED
TO REPORT ANY ENVIRONMENTALLY HAZARDOUS CONDITION AS REQUIRED BY LAW AND TO
TAKE NECESSARY CLEAN UP EFFORTS. THESE NOTIFICATIONS WOULD BE BY PHONE IN
EVENT OF!!EMERGENCY REQUIRING QUICK RESPONSE. THE DUTY 'CLERK ON SITE IS
INSTRUCTED TO IMMEDIATELY SOUND A VOCAL ALARMS TO ALL PERSONS.IN THE
FACILITY AND ADJACENT AREA AND ADVISE THEM TO LEAVE THE AREA TO A PLACE OF
SAFETY MOST FACILITIES HAVE A BACK DOOR FOR EMERGENCY EXITS. THEN THE CLERK
IS TO REPORT THE INCIDENT OR HAZARD TO FIRE DEPARTMENT AS LISTED IN
EMERGENCY RESPONSE LIST OF PHONE NUMBERS AT STORE.
<3> Public Notif./Evacuation~
WE HAVE A LIST WITH PHONE NUMBERS OF OUR NEIGHBORING BUSINESSES, RESIDENCES,
SCHOOLS, HOSPITALS, ETC., IN AN EMERGENCY WE WOULD NOTIFY OUR NEIGHBORS
BY PHONE IF POSSIBLE.
<4> Emergency Medical Plan
DIAL 911 FOR TRANSPORTATION OF INJURY VICTIMS TO MERCY HOSPITAL ON
TRUXTUN AVE IN BAKERSFIELD IF NECESSARY. KERN GENERAL HOSPITAL -
1830 FLOWER.ST - 326-2000.
06/05/95 ~ CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 6
00 - Overall Site
<E> Mitigati0n/Prevent/Abatemt
<1> Release Prevention
GASOLINE - STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION WITH PUMPS.
VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF
FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT
PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED,
SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY
cAMPRING GALLONAGE MEASUREMENTS WITH SALES RECORDS.
CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED.
<2> Release Containment
GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL
'EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT
POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO
FU~ES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN
AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE
TO SAFE AREA FOR EVAPORATION.
CARBON DIOXIDE - CLOSE VALVE IF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE.
<3> Clean Up ~O~-~-~-~E$
GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR ~-7-14) 823-069~i-FOR
COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED
ABSORBENT MATERIALS IF REQUIRED.
CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN
CONTAINER/VALVE.
<4> Other Resource Activation
06/05/95 ~ ,:, CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 7
O0 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - WEST WALL OF BUILDING ON SOUTH END (METER)
B) ELECTRICAL - NORTH SIDE OF BUILDING EAST END END (METER)
INSIDE BACK ROOM OF STORE (BREAKERS)
C) WATER - SOUTHEAST CORNER OF SITE (METER)
D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
E) LOCK BOX- NO
<3> Fire Protec./Avail. Water
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER LOCATED ON PREMISES
FoR USE BY CLERK ON DUTY.
FIRE HYDRANT - SOUTHEAST CORNER OF LOT
<4> Building Occupancy Level
06/05/95 CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 8
00 - Overall Site
<G> Training
<1> Employee Training
WE HAVE 3. EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
USE THE INFORMATION LEARNED FROM THE STUDY OF THE MSDS FOR EACH APPROPRIATE
HAZARDOUS MATERIAL FOR TRAINING.
sPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS
PROVIDED IN THE FOLLOWING AREAS:
1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT.
2) USE OF KITTY LITTER FOR SMALL SPILLS
3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT,
EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT.
4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH
MSDS'S FOR GASOLINE AND CO2.
A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL
NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL
BASIS.
SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION
WITH THE 'LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE
EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN
(INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE
PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS.
<2> Page 2
<3> Held for Future Use
Environmental, Inc.
MOnitor certification InsPection
When aign~d By an authorized t!chnici~n, ~hia cor~ifioa ~t =h~?al'arm. paol .',
~d ~h~ ~ensors ar~ in ~he correct ~i~ion, ~d ~ho eys~om Is opera~ing
ADDRESS C'l~Cq~ ~ ~ ~O05 · DATE'
~NUFACTURER -& MODEL $: ~ (o ~ ~~a .)
· !
'sYs~ STA~S:- , ·
'3 ANNU~R SENSORS ~ -'-'; PAS~':~'"'
--' '"' .~ROSTATIC PASS
VADosE ' SENSORS PASS. N/A
.. -~ LINE P~SSURE PASS. N/A
~E~ HO~ITOR IS THR~ED OFF OR I~ ~ DOES ~THE TU~I~E SHUT
DOWN? . ·
YES ' NO ~' 'SUCTION.' ~
--. ~ ' :'""" ' SIGNATURE -
".'- ' '172 WEST ERDUGO ~VE., BURBANK, CA'91502-2 * TEL: (818) 840-7020 · FAX: (818) 8~0-6929
.- .... · Tr:iangle-.Env.mronmental,.'. Inc·. "_
: '. 172 .West verdugo Ave~, Burbank, .California 915~2' ). ... .
· .' FTA LEAK DETECTOR .TEST DATA SHEET
Product· Serial Number' Drain Trip Test Funct. Tripping pass ..
TYpe 'Detector Style Back Time . ·Rate .Eio. Pressure or
· mi 'sec ml/min · psi psi Fail
· .. : ~ODqo -211~ " : . .,
:DLD .PLD.-XLD xLP VPR ' ' ""
.~. DLD; PLD .XLD XLP .VPR - ,
I certify, {he-above tests .were. conducted on this date according to the
'equipment manUfacturer's procedures and limitations and the results as listed
are to my knowledge true and Correct.
The mechanical:Leak Detector Test pass/fail is determined using a low
flow threshold trip rate of 284 ml per m~nute or less at '10 psi .as set
by Red J~cket. Pump~ F~eld Tes~ Apparatus ~esting procedure.
'Copyrigh~ (c) .Triangle~Environme'n~al, .Inc., January t991. MRL
Triangle Environmental, Inc..
172 West Verdugo Ave., Burbank, CA 91502 _
T. E'~'I LT-3 Hydrostatic Product Line Test Result Sheet
PRODUCT '. /READING /READING PRESSURE. RATE RESULT.
~ . .00:OO~ML ooiOo2ML (psi) (GPM,) F4IL
' ': I '~ertifY tha~ 'the above line res'ts were Conducted on this
date: according to the equipment manufacturer"s..procedures and
limitations and'.the.results as ~isted are'to'-my~knowledge'true and
correct~ .... "..~ ..... . .... -'f~_ ' ' .."" ............. " ~ · ....
NOTE: ' .. ..
.. The 'test data. do-llection time period must be fifteen minute's.
": The ~est p.ass/.fai1 is 'determined using a thresho'ld of i90 ~1.'
per' hour (0. 05 GPH) rate at 150% working pressure or 50 psi. which
ever' is less. The GPH rate is calculatod as: ml/ ~ ~1~6
04/18~4'''~' ! CIRCLE K CORPORATION STORE #8605 215-000-001297 Page
~ Overall 'Site with 1 Fac. Unit
· ~ ~ General Information
Location: ~!600 AuBuRN ST 2 Map:103 Haz:2 Type: 3
Community: BAKERSFIELD STATION 08 Grid: 13C F/U: 1 AOV: 0.0
Contact i!Name~ Title Q ~s~ess ~one 24-Hour Phone~
· Administrative Data
Mail Addrs: D.O. BOX 5604~3~~;~;~'~/~P D&B Nu~er: 06-294-4160
Co~' Code: 215-008 BAKERSFIELD STATION 08 SIC Code: 5541
- Owher:: THE CIRCLE K CORPORATION Phone: (805) 871-7979
Address: P O BOX 52084 · State: AZ
Sugary
'.0, I/~qr~ ~m;-PJ~ Do hereby certify that ! have
I ~y~ ~ ~nt ~e)
reviewed the a~ached h~:~rdous materials manage-
~t plan for ~i~ ~~ and.~h~ '~ ~ong with'
' (~ of Busi~a)
04/18~/94.' :' CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 2
Hazmat Inventory List in MCp Order
02'Fixed 'Containers on Site
Pln-Ref Name/Hazards Form Max Qty MCP
02-003 PREMIUM UNLEADED GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
02-001 uNLEADED PLUS GASOLINE Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
02-002 UNLEADED GASOLINE Liquid 10000 Moderate
· .Fire, Immed H!th, Delay Hlth GAL
02-004 C~RBON DIOXIDE Gas 1044 Minimal
· Fire,. Pressure, Delay Hlth FT3
04/1~/94 ~.ii. CIRCLE K C'ORPORATION STORE #8605 215-000-00'1297 Page 3
02 - Fixed Containers on Site
Hazmat Inventory Detail in MCP Order
02-003~ PREMIUM UNLEADED GASOLINE Liquid. 10000 Moderate
~:iFire', Immed Hlth, Delay Hlth GAL
CAs #: 8006-61-9 Trade Secret: No
FOrm:ii 'Liquid Type:~ Pure Days: 365 Use: FUEL
~:Daily Max GAL Daily Average.GAL· ] Annual Amount GAL
' 10,000 I 5,000.00 43,719.00
': ~Storage I Press I Temp ' Location
UNDER GROUND TANK IAmbientlAmbientlSOUTHEAST CORNER OF PROPERTY
--conc Components MCP ---~uide
100.':~0% IGasoline Moderate{ 27
--i!Not:es
02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderato
~ Fire, Immed Hlth, Delay Hlth GAL
CAS #i: 8006-61-9 Trade Secret: No
Form:' Liquid TYpe: Pure Days: 365 Use: FUEL
~!Daily Max GAL Daily Average GAL Annual /i~nount GAL --
'- .~' 10,000 I 5,000.00 { 67,036.00
Storage' Press T Temp Location
UNDER GROUND TANK' IAmbientlAmbientlSOUTHEAST CORNEROF PROPERTY
--'Co~c Components MCP -~--~uide
100.O% IGaSoline {Moderate{ 27
-- Notes
04/14/94 ~,;i cIRCLE K CORPORATION STORE #8605 215-000-001297 , Page 4
02 - Fixed Containers on Site
Hazmat Inventory Detail .in MCP Order
02-002 UNLEADED GASOLINE Liquid 10000 Moderate
,ilFire, Immed Hlth, Delay Hlth GAL
" cas ~i: 8006-61-9 Trade Secret: No
Form: Liquid' Type: Pure Days: 365 Use: FUEL
-- Daily Max GAL Daily Average GAL I Annual Amount GAL --
10,000 I 5,000.00 ' 180,705.00
Storage. Press'T Temp' Location,
UNDER GROUND TANK' IAmbientI,AmbientlSOUTHEAST CORNER OF PROPERTY
-- Conc Components MCP ---iGuide
100.0% IGasoline ]ModerateI 27
-- Notes
02-004 CARBON DIOXIDE Gas 1044 Minimal'
,iiFire, PressUre, Delay Hlth FT3
CAS #: 124'38-9 Trade Secret: No
Form.~
.., Gas Type: Pure Days: 365 use: OTHER
--:!Daily Max FT3 Daily Average FT3 Annual Amount FT3
1,044 I 522.'00 1 54,288.00
Storage Press T Temp' Location
PORT.!'PRESS. CYLINDER IAbove /AmbientlIN STOREROOM BACK OF STORE
-'conc . Components MCP -~Guide
100.'0% ]Carbon Dioxide IMinimal I 21
04/14/94 · CIRCLE K coRpORATION STORE #8605 215-000-001297 Page 5
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> AgencyiNotification ~
CALL 911 · ~
<2> Employee Notif./Evacuation
EMPLOYEES ARE INSTRUCTED TO REPORT ANY INCIDENT SUCH AS A SPILL OR FIRE
II~EDIATELY TO THE APPROPRIATE EMERGENCY RESPONSE TE/~ IN.THE II~iEDIATE AREA
SUCH AS FIRE DEPARTMENT ETC. ADDITIONALLY THE STORE MANAGER IS INSTRUCTED
TO REPORT ANY ENVIROI~ENTALLY'HAZARDOUS CONDITION AS REQUIRED BY LAW AND TO
TAKE NECESSARY CLEAN UP EFFORTS. THESE NOTIFICATIONS WOULD BE BY PHONE IN
EVENT OF ~EMERGENCY REQUIRING QUICK RESPONSE.. THE DUTY CLERK ON SITE IS
INSTRUCTED TO IMMEDIATELY SOUND A VOCAL ALARMS TO ALL pERSONS IN THE
FACILITY AND ADJACENT 'AREA AND ADVISE THEM TO LEAVE THE AREA TO A PLACE OF
SAFETY MOST ~FACILITIES HAVE A' BACK DOOR FOR EMERGENCY EXITS. .'THEN THE CLERK
IS TO REPORT THE INCIDENT OR HAZARD TO FIRE DEPARTMENT AS LISTED IN
EMERGENCY RESPONSE LIST OF PHONE NUMBERS AT STORE.
<3> Public Notif./Evacuation
WE HAVE A LilST WITH PHONE NUMBERS OF OUR NEIGHBORING BUSINESSES, RESIDENCES,
SCHOOLS, HoSpITALS, ETC., IN AN EMERGENCY WE WOULD NOTIFY OUR NEIGHBORS
BY PHONE IF i~POSSlBLE.
<4> Emergency ~Mod~.cal :Plan
DIAl'. 911 'FOR TRANSPORTATION OF INJURY VICTIMS TO MERCY HOSPITAL ON
TRUXTHN AVE ~IN BAKERSFIELD IF NECESSARY. KERN GENERAL HOSPITAL -
1830 FLOWER :ST - 326-2000.
04/1~/94 ~ CIRCLE K CORPORATION STORE #8605 215-000'001297 Page 6
00 - Overall Site
<E>Mitigation/Prevent~Abatemt
<1> Release Prevention ~
GASOLINE'- STEEL POSTS INSTALLED TO pREVENT VEHICLE COLLISION WITH PUMPS.
VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF
FIBERGLASs~CONsTRUCTION~ DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT
PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED,
SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY·
CA~PRING~iGALLONAGE MEASUREMENTS WITH SALES RECORDS. ~·
· CARBON DIOXIDE - TANKS ARE'STORED UPRIGHT AND FIRMLY SECURED.
<2> Release Containment
GASOLINE ~- PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL
EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT
POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO
FUMES/VApORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION- IN
AREA OF SPILL OR VAPORS.~ ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE
TO SAFE AREA FOR EVAPORATION.
CARBON DIOXIDE - CLOSE VALvE IF SAFE TO DO SO, OPEN ALL· DOORS TO VENTILATE.
· <3> Clean Up
GASOLINE~- NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR
COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED
ABSORBENT MATERIALS IF REQUIRED.
CARBON D!OXI~DE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK IN
CONTAINER/V~.LVE.
<4> Other ResourCe Activation
04/1~/94 ' .~ ?,. CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 7
00 - Overall Site
<F> Site .Emergency FactOrs
<1> special Hazards
<2> Utility Shut-Offs
A) GAS'- wEST WALL OF BUILDING ON SOUTH END (METER)
B) ELECTRICAL - NORTH SIDE OF BUILDING EAST END END (METER)
~ INSIDE BACK ROOM OF STORE (BREAKERS)
C) WATER'-.SOUTHEAST CORNER OF SITE (METER) ~
D) SPECIAL ,, EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
E) LOCK BOx:i- NO
<3> Fire.Protec./Avai1. Water
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER LOCATED ON PREMISES
FoR USE BY'CLERK ON DUTY.
.FIRE HYDRANT - SOUTHEAST CORNER OF LOT
<4> Building Occupancy Level.
04/1~/94 ~ ii ~ CIRCLE K CORPORATION STORE #8605 215-000-001297 Page
! ~' 00 - Overall Site
~<G> Training
<1> Page 1
WE HAVE 3 EMPLOYEES AT THIS FACILITY
WE~HAVE MATERIAL SAFETY DATA SHEETS ON-FILE ·
USE THE INFORMATION LEARNED FROM THE STUDY OF THE MSDS FOR EACH APPROPRIATE
HAZARDOUS MATERIAL FOR TRAINING.
SPECIAL oN-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS
PROVIDED?IN ~THE FOLLOWING AREAS:
1) PROPER MAINTENANCE AND USE'OF GASOLINE EQUIPMENT.
2) USE .OF KITTY LITTER FOR SMALL SPILLS
3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE,~FIRE DEPARTMENT,
EMERGENCY MEDICAL .AND CIRCLE K ENVIRONMENTAL DEPARTMENT.
4) 'EACH~CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH
MsDs"s FOR GASOLINE AND CO2.
A REVIEW?.OF "THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL
NEW EMPL6yEES WITHIN ONE MONTH OF' HIRING AND BY ALL EMPLOYEES ON AN ANNUAL
BASIS. ~I
SAFETY AND EMERGENCY EQUIPMENT USAGE TRAINING WILL PROVIDE FAMILIARIZATION
WITH THE?LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE
EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN
(INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE
PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS.
<2> Page 2~.ias needed
<3> Held for Future Use
4..
<4>.Held for Future use
04/1~'/'94 a CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 9
00 - Overall 'Site
<G> Training
<4> Held for FUture Use (.Continued)
04~01/93 :i' CIRCLE K~ CORPORATION STORE $~8605 21'5-000-001297 ['age 1
t Overall Site with I ~Fac. Unit
Ger~eral I r~format i or~
Location- 5600 AUBURN ST ~ Map. 103 Hazard: Low
Communit~: BAKERSFIELD STATION 08 Grid: 13C F/U: 1 AOV:
:" ......... ' ~l~k--'~ ...................
~~-~'~ ~~~~-~~~ss Phor, e ........... ,~ R4-Hc, u~'-Phor, e]
, : T J ZONE'MANAGER : . ! ~~._.~..L .......
JOHN HART J~8.~) ~x I (8[~) ~l-~2J
Admir~ist rat'ive Data
Mail Addrs: P.O. BOX 5604 D&B Number: 06-294-4160
City~: SANTA MARIA State: CA Zip:
Cc, mm Code: 2~15-008 BAKERSFIELD STATION '08 SIC Code: 5541
Owr, er: 'THE CIRCLE K CORPORATION Phor~e: (805) 871-7979
Address: P 0 BOX 52084 State: AZ
City~: PHOENIX Zi~: 85006-
S u m m a r y
I, ~/~_vrz~/~ ~m;~- Do hereby certify that ~ have
, /type or print name)
roviewed the attached h~ardous materials manage-
ment Plan forOt~ k ~'~ and.that it along with
(~f ~t~)
~y ~e~ions ~nsfitute a ~mp~te and~rr~ ma~
~ement plan'~r my
04/01/~93 ~ ~ CIRCLE K CORPORATION STORE $~605 215-000-001297 Page - 2
i~ !! Haz~at IrJver~tory List ir~ blCP O~der .
'~ '~ 02 - Fixed Cor~tainers on Site
Plr~-Ref Na~eYHaza~ds ' For~ Quar~t ity ' ~'ICP
'02-003 PRE~I~UM UNLEADE~ GASOLINE Liquid 10000 -Mc, der. ate
.Fire, I~ed Hlth, Delay Hlth GAL
02-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate
Fire, .I~ed Hlth, Delay Hlth GAL
.02-002 UNLEADED GASOLINE Liquid 10000 Moderate
Fir~, I~ed Hlth, Delay Hlth GAL
02-004 CARBON DIOXIDE Gas 1044 Mir~imal
Fire, Pressure, Delay Hlth FT3
04/01/93 i CIRCLE K CORPORATION STORE ~$8605 215-000-00t297 Page 3
~ o~_ - Fixed Cor~tainers or~ site
Hazn~at~Inver~tory Detail ir~ ~CP Order-
OR-OOS PRE~iU~ UNLEADED G~SOLINE Liquid 10000 Moderate
Fi~e, Irar~ed Hlth, Delay Hlth G~L
CfiS ~: B006--61-9 Trade Secret :' No
Foprn Liquid Type: 'Pupe Days: B65 Use: FUEL
Daily ~a~ G~L [ Daily fivera~e G~L } ~nnual ~rnour~t G~L ---
10,000 5,000.00 ~ " ' ~
Storage .~ Press T Te~np -] Locatior,
UNDE~ G~OUND ]'fiNK ~fimbier~t/firnbier~t}SOUTHE~ST CORNER OF PROPERTY
-- Corec -] Cornpor~er~ts F- ~CP .. ~uide
:100; Og Gasolir, e ~Moderate~ ~7
0~-001 UNLEADED PLUS GASOLINE Liquid 10000 Moderate
~Fire, Ir~n~ed Hlth, Delay Hlth GIlL
C'AS ~: 8006-61-9 Trade Secret: No
Forr,~: Liquid Type: Pure Days: ~6o 'Use: FUEL
~ ..... Daily Max GAL ----- Daily Average GAL Ar, r~ual A~nour, t GAL --.-.
~ ~'10,000 W 5,000.00 I ~
Storage F Press T' Ternp ~ Loca*bior,
UNDER GROUND TANK' ~Ambier~t~Ar~bier~t~SOUTHEAST CORNER OF PROPERTY
-- Corec ,--I ~ Cor~por~errbs T-' MCP ~uide
100.0% ~Gasolir, e ~Moderate~ 27
-- Not es
04/01/93 i: i 'CIRCLE K CORPORATION STORE ~$8605 215-000.00i297 Page 4
' ~ : 0~ - Fixed 'Cor~tair~ers o'n Site
~ ~ Hazr~at~ Ir~ver~tory Detail ir~ MCp order
02-002 UNLEADED GASOLINE Liquid 10000 Moderate
Fire, I~ed Hlth, Delay Hlth ' GAL
CAS ~: 8006-61-9 Trade Secret: No
For~: Liquid Type: Pu~e Days:~ 365 Use: FUEL
~ Daily Max GAL ~~ Daily Average GAL T Armual A~ount GAL
10,000~ 5,000~ 00~ ~}0
,~ Storage T Pres~ T~'rer~p -7
Lc, cat
ior,
UNDER GROUND TANK ~Ar~bier~t~Ar~bier~t~SOUTHEAST CORNER OF PROPERTY
- Corec -- Ccm~por~err~ s .... MC~ ...... ~-Guide
:100:~ 0% ~ Gasc, 1 ir, e ~Mc, derate ~ 27
~ Not es
02-004 CARBON DIOXIDE Gas 1044 Mini~al
Fipe, Pressupe,'Delay Hlth FT'S
OAS ~: 124-38-9 T~ade Secret: No
Fop~ :' Gas Type: Pure Days :- 365 Use: OTHER
Daily Max FTS ~--Daily Average F]'3 -~ Annual A~mz, unt F'T3
1,044' ~ 522.00 ~ 54,288.00
Storage - F Press T Te~,~p --l -Lc, cat ior~
PORT., PRESS. CYLINDER lAbc, ve lA~,~bient~IN STOREROOM BACK OF STORE
-- Cc, nc -- Cc,~pc, r~ent s MCP ~uide
,10~.~. 0% Carbor~ Dioxide Minimal 21
04/01/93 ~i CIRCLE K CORPORATION STORE ~$8605 215-000-001297 Page 5
i 00 - Overall Site
<D) Notif./Evacuatior~/Medical
<1> ·Agerlcy Notificat~ior,
CALL 911
<2> Emploype Notif. /Evacuatior~
EMPLOYEES ARE INSTRUCTED TO REPORT ANY INCIDENT SUCH AS A SPILL OR FIRE
IMMEDIATELY TO ]'HE APPROPRIATE EMERGENCY RESPONSE TEAM IN THE IMMEDIATE AREA
SUCH AS FIRE DEPARTMENT ETC. ADDITIONALLY THE STORE MANAGER IS INSTRUCTED
TO REPORT ANY ENVIRONMENTALLY HAZARDOUS CONDITION AS REQUIRED BY LAW AND TO
TAKE NECESSARY CLEAN UP EFFORTS. THESE NOTIFICATIONS WOULD BE BY PHONE IN
EVENT OF EMERGENCY REQUIRING QUICK RESPONSE. THE DUTY CLERK ON SITE IS
INSTRUCTED~TO IMMEDIATELY SOUND A VOCAL ALARMS TO ALL PERSONS IN THE
FACILITYii AND ADJACENT AREA AND ADVISE THEM TO LEAVE THE AREA TO A PLACE OF
SAFETY MOSTiiFACILITIES HAVE A BACK DOOR FOR EMERGENCY EXITS. THEN THE CLERK
IS TO REPORT THE INCIDENT OR HAZARD TO FIRE DEPARTMENT AS LISTED IN
EMERGENCY RESPONSE LIST OF PHONE NUMBERS AT STORE.
<3) Public Notif. /Evacuation
WE HAVE A LIST WITH PHONE NUMBERS OF OUR NEIGHBORING BUSINESSES, RESIDENCES,
SCHOOLS,~ HOSPITALS, ETc., IN AN EMERGENCY WE WOULD N[]TIFY OUR NEIGHBORS
BY PHONE: IF POSSIBLE. "
<4> Er,~erger~cy'~ Medical Plar,
DIAL 911:1 FOR TRANSPORTATION OF INJURY VICTIMS TO MERCY HOSPITAL ON
TRUXTUN iAVEi IN BAKERSFIELD IF NECESSARY. KERN GENERAL HOSPI]"AL -
1830 F'LOWER' ST - 326-2000.
04/01/93 ii CIRCLE K. CORF'ORAT'ION STORE $~8605 215~-000--00t297 ' page 6
,i 00 - Overall Site
<E> M i t i gat i or~/Pr, ever~t/Abat er~'t
<1> Release Preverstiors . -.
GASOLINE- STEEL POSTS INSTALLED TO PREVENT VEHICLE COLLISION' WITH PUMPS.
VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF
.FIBERGLASS CONSTRUCTION. DUAL HOSE SYS~[EMS ON PUMPS. ANTI-LOCK NOZZLES AT
PUMPS. NO ~ALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS pOSTED,
SELF SER~VE. INSTRUCTIONS POSTED. -TANKS CHECKED PERIODICALLY FOR LEAKS BY
[]AMPRING GALLONAGE MEASUREMENTS WITH SALES RECORDS.
CARBON DIOXIDE - TANKS ARE' STORED UPRIGHT AND FIRMLY SEcuRED.
<2> ·Release Cbntairm~ent
GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS~. SHUT OFF ALL
EMERGENCY SWITCHES TO ~PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT~
POSSIBLE~ EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO
FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN
AREA OF sPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE
TO SAFE AREA FOR EVAPORATION.
CARBON DIOX'~IDE-- CLOSE VALVE IF SAFE TO DO S[], []PEN ALL DOORS TO VENTILATE.
<3> Clears
GASOL. INE- NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR ~714) ~"'~--~-.o~.,~ ~-~' FOR
COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY 'TO REMOVE CONTAMINATED
ABSORBENT MATERIALS IF REQUIRED.
CARBON DIOX'ilDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER F LEAK IN
CONTA I NER/VALVE.
<4> Other Resource Act i vat i ors
04101/93 ' CIRCLE K CORPORATION STORE ~8605 215-000-001297 Page 7
00 - Overall Si'te
<F) .Site Ernerger~c.y FaCtor-s-~ .'
.<1> Specia Hazards
,-/ Utility Shut-Offs
A) GAS - WEST WALL. OF BUILDING ON SOUTH END (METER
B) ELECTRICAL - NORTH SIDE OF BUILDING EAST END END ~(METER)
~i INSIDE BACK ROOM OF STORE (BREAKERS)
C) WATER-.SOUTHEAST CORNER OF SITE (METER)
D) SPECIAL ~ EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
E) LOCK BOXi - NO~
<3> Fire Protec. /Avail. Water
PRIVATE ~FIRE PROTECTION - FIRE EXTINGUISHER LOCATED ON PREMISES
FOR USE BY CLERK ON DUTY.
FIRE HYBRANZ -- SOUTHEAST. CORNER OF LOT
<~> Building 'Occupancy Level
04101193 ,, CIRCLE K-CORPORATION STORE ~8605 215-000-001-297 Page 8
,; 00 - Overall Site
<G> Tr. ainir~g
<1> Page 1 .,
WE HAVE 3 EMPLOYEES AT '[HIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
USE THE INFORMATION LEARNED FROM THE STUDY OF THE MSDS~FOR EACH APPROPRIATE
HAZARDOUS MATERIAL FOR 'TRAINING. ·
SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S) IS
PROVIDED IN ]'HE FOLLOWING AREAS:
1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT.
2) USE OF KITTY LITTER FOR SMALL SPILLS
3) EMPLOYEES ARE INSTRUCTED ON PROF.'ER RESPONSE TO POLICE, FIRE DEPARTMENT,
EMERGENCY MEDICAL AND~CIRCLE K ENVIRONMENTAL DEPARTMENT.
4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED GASOLINE MANUAL WITH
MSDS'S FOR GASOLINE AND C02.
A REVIEW OF' THE CONTENTS OF THE EMERGENCY RESPONSE F.'LAN WILL BE MADE BY ALL
NEW EMPLOYEES WITHIN []NE MONTH OF HIRING AND BY ALL EMPLOYEES ON 'AN ANNUAL
BASIS.
.SAFETY AND EMERGENCY EQU~IPMENT USAGE .TRAINING WILL PROVIDE FAMILIARIZATION
WITH THE LOCATION AND PROPER USE OF FIRE~ FIGHTING EQUIPMENT (FIRE
EXTINGUISHERS), THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN
(INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITY) AND THE
PROF.'ER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS.
<2> Page 2 as,~ r~eeded
<3> Held for Future Use
04/01/93 i; ~' CIRCLE. K coRpORATION STORE ~8605 2i5-0002001297 Page . 9
~ ~ 00 - Overall Site
<G> Trair~ir~g
~<4>~ ~Held for Future Use (Cor~tinued)
04/01/93 cIRCLE K ~CORPORATION STORE ~8605 ~l~.,-O00-O01~_9t Page 10
00. - Overall Site
. <H> RMPP DATA
< 1 > Re 1 ease. Cor~t'a i'nmer~t .
<2> Off site Cor~sequences
<3> .Ir~. House Capabilities
<4> Plar~t ~Shutdowr~ Ir~structior~
~.,;~'i~ ~/;, 'BAKERSFIELD FIRE' DEPARTMENT
2130 G Street, Bakersfield, CA.93301
~ (805) 326-3979
.~ ApPLicATION TO PERFO~ A TIG~NESS TEST
F~CILITY d'J~c /~ ~ ~6~ .~DRESS/~ ~
PE~IT TO OPE~TE $ Jfi
OPE~TORSN~E ~/mr/~. W co~ O~ERS N~E
~BER OF T~S 'TO 'BE TESTED J IS PIPING ~ING TO'BE TESTE~ .
T~$ VOL~E CONTE~S
T~ TESTING CO~~,~/~ ~.~.'~J ~r ~DRESS
TEST, METHOD ~ ~.~
N'~E..~OF TESTER ~,~4,~- ~4,./~z CERTIFICATION
STATE REGIST~TION %
DATE & TIME TEST IS TO BE CO~UCTED ~ /~, /~/~
. /_fl .
BAKERSFIELD FIRE DEPARTMENT
HAZARDOUS MATERIAL DIVISION
2130 G Street, Bakersfield, CA 93301
(805) 326-3979
APPLICATION TO PERFORM A TIGHTNESS TEST
FACiLiTY c/~c/~/6 '~'5~°~''- ADDRESS ~-Woo //~Z=~
PERMIT TO OPERATE ~ ~/
OPERATORS NAME ~/~- /( ~o,?,. OWNERS NAME
NUMBER OF TANKS TO BE TESTED I IS PIPING GOING TO' BE TESTED/~-S
TANK~ VOLUME CONTENTS
N~E OF TESTER ~4,~ ;J,/4~ CERTIFICATION %
STATE REGIST~TION ~
DATE & TIME TEST IS TO BE C0~UCTED ~. /~ /~/~
APPROVED BY: DATE S~GNA~RE OF APPLIC~
E.M.S.S., Inc.~
An Environmental Regulatory
Compliance Service Company
~ ~ April 10, 1992
Bakersfield City Fire Department~ '
Hazardous Materials Division
2101 "H" Street
Bakersfield, CA 93301
Gentlemen:
Circle K Corporation has contracted Environmental Management
Software Systems, Inc. (EMSS) . to provide the required changes to
the.Business Plan for the 1992 reporting period.
Enclosed are the updated Business Plans for the 5 Circle K
gasoline stores on the Bakersfield City update forms provided by
your office. Changes are highlighted.
Circle K Corporation has been instructed by EMSS to ensure that
every store .keeps the Business Plan resident at the store and that
all store employees be trained in the contents of the hazardous
material inventory and emergency response sections of the Plan.
If you have any questions regarding this submittal, please call
EMSS at (805) 925-6285.
Sincerely,
RDB:slc
Enclosures
E.M.S.S., Inc./Ro. BOX 5604/SANTA MARIA/CA 93456/(805) 925-6285/FAX: (805) 349-2753
Bakers eld Fire Dept.
H~ ~-azdous Materials Division
2130 "G" S~eet
B~ersfietd, C~_ 93301 RECEIVED
~ M^T. DIV.
HAZARDOUS MATERIALS MANAGEMENT PLAN
INSTI~UCTION$:
1. To ovoicl further action, return this form within 30 clays of rec_eiDt.
2. TYPE/PRINT ANSWERS IN ENGLISH.
3. Answer the cuestions Deiow for Ine Dusine~ as o whole.
4. Be =riel one concme ms pc,~[~te.
SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Circle K Corporation $8605
LOCATION: 5600 Auburn Street
Circle K Corporate
MAIk~NGADDRESS: P. O. Box 52084, Phoenix, AZ 85072
CITY: Bakersfield STATE: CA ZiP: 93306 PHONE: ( 805 ) 871-7979
DUN & BRADSTREET NUMBER: 06-294-4160 SIC CODE: 5541
PRIMARY ACTIVITY: Convenience Sto~e/Gas Station
OWNER: Circle K Corporation (602)229-8706
MAILING ADDRESS: P. o. 5ox 52084, Phoenix, AZ 85072
SECTION 2: EMERGENCY NOTIFICATION:
CONTACT TffLE BUS. PHONE 24 HR. PHONE
Beeper # Beeper #
1. Mike Spinuzzi - Zone Manager (805)321-8~22
2. Mike KarvelQ$ -...Environ. Dir. (714)R?q-R6ql (6191~7-~3~
Bakersfield F~e Dept. ~ .':
HazardOus Materials Divisiol'l"
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING: "
NUMBER OF EMPLOYESS:' 3
MATERIAL SAFETY DATA SHEETS ON FILE: Yes
BRIEF SUMMARY OF TRAINING PROGRAM:
SpeCial on-the-job training in the handling of hazardous material(s) is provided in the following areas:
1. Prop:~ maintenance and use of gasoline equipment.
2. Use of kitty litter for small spills.
3. Employees are instructed on proper response to police, fire department,'emergency medical and
Circle K Environmental Department.
4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2.
A review of the contents of the Emergency Response Plan will be made by all new employees within one
m°nth of hiring and by all employees on an annual basis.
Safety and emergency equipment usage training will provide familiarization with the location and proper
use of fire fighting equipment {fire extinguishers), the location of and procedures for facility shutdown
{including the location of turnoff valves for gas and electricity) and the proper use of equipment used
in the day to day business.
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, Mike Schumacher CERTIFY THAT THE ABOVE INFOR-
MATION 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 THAT
INACCURATE INFORMATION CONSTITUTES PERJURY.
~ Division Manager ~6/¢/
SIGNATURE TITLE DATE
FDI$90
~, Plot Plan - Circle K Store #8605 ~
V
o P Q 5600 Auburn Street, Bakersfield ,cday
Rage Vacant Vacant
I t t t ................................................
5600 Fair fax Rd. Scoops El Pollo Vacant :i:i:i:~:i:i:i:i:~?i::~:~:~.i:i:i:ii:i:~:i:i::i.
Scale 1" = 26' Slices i:i:i:i:i:i:i:~ .....................................
~ o iiii ~ n
DRAIN I
!i~i~?ii:.ii d Store #8605 Jili Parking t
S h o p p i n g ::!!!iiiiiiii B Ay b u r n S t. i[[i L
C e nte r !iiiiiiiiii o
Parking Lot iliiii::i::ii Fire x iiii a
n
I ...... .... × P u m p *~ [[[]
I Exit ~ ~ [[~ Gas
~ ~ff;;: H O
~ T ~ ~j ~ H MH
Counter ~ ~ FL
Exit ~-J0~".
~ ;"". '-.Gal",
.. -.10K'-.'.--'
, '-.'-.Gal",
"-.~ok'-%.-.". us
'-.~'; FL
Driveway
1" ' 100' - SCALE OF MAP iiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiil OF CONTAINER USING
THE FOLLOWING SYMBOLS,
IN GALS., LBS.. OR CU.FT.
[~ ELECTRIC METER
Z~ ABSORPTIVE MATERIAL (~) ELECTRIC SHUTOFF ABOVE GROUND TANKS
~00
-/~ ALARM Q ~^L'
[] DRAIN ~ GAS METER ,~LS ~L
~ ~ DRIVE~Y ~ GAS SHUTOFF BELOW GROUND TANKS
~ ~ DOORS ~ pump SHUTOFF /IOK~ F 1OK
~GALJ ~ GAL
~ EVACUATION ROU~E ~ ~TER METER ~
~ =wcu.~.o.~s~.~..~ ,.~. ~ ~. ~... ~.~ ~.~ v.~v= ~ ~.su~.~= ~..~s
FIRE DEPT. CORR - CORROSIVE
I ~ FIRE HOSE SPRINKLER CONNECTION C - COMBUSTIBLE
~ FIRE EXTINGUISHER f ~ FIRE DEPT. E - EXPLOSIVE
~ FIRE DOOR ~ STANDPIPE CONNECTION GF -_ FLAMMABLE GAS
FIRE ~LL FIRE HYDRANT L - LIQUID
' ' OXY - OXIDIZER
R - RADIOACTIVE
' GAS PUMPS ~,_, ATTIC SCUTTLE S - SOLID
~ ~-: COOLER oR ~ - ~ox~c
GUARD STATION ~-~ REFRIGERATION UNIT WR - ~TER REACTIVE
~ LADDER ~ HEATING UNIT
.AZA.DOUS MATER~AL
MATERIAL SAFETY DATA SHEET & ~RAILROAD TRACKS
EMERGENCY RESPONSE PLAN IIIll~ STORAGE AREA...HMS
~ PERSONAL PROTECTIVE EQUIPMENT ~ SEWER HAZARDOUS MATERIAL
...... , HANDLING AREA...HM H
PUBLIC TELEPHONE : SL ', SKYLIGHT
RR - REST ROOM HAZARDOUS WASTE
~ ~ STAIRS ~ STORM DRAIN STORAGE AREA...HWS
HAZAi~'DOUS NATEF~IALS I NV ENTOI-~Y
~nrmlndAgticulturi U StindlrdBusiness ~
USHISS tlAHG:~CiK]e K Corporation t 8~5 O~llER tlAH~: CiKle K Co~oration ttAH~ OF 111]S FACII]]Y: Circle K Corporation
0CA[J0rl; bbUU Abbdrn ~t~et . AOUI{ESS: P,0. ~x 5~4 ' GIAHDA!IP J/fl). CLASS COBE: .... 5541 - ' ' ·
CJI Y. Z IP~ ~k~rsfield, Ca 93~b*' CJIY. Z i P~- ~o~n~x, ~ a~u/2" DUN AIID' BRAUSIIIEE/ NUHBEFL ...........................
Irtns J ~ ~ lvFHe lnnu~l ~ta~ur~ I ~ont ~ont ~ont U~ toc~tio.
ICode LoOm )at A~t [SL Units on e lyre I'ress lemp Co~e See Instructions
Stored In [aClllLt
~e~ ~ nd an s~o~e ZOO G~so]ine _
Component I? 8~ I C.A.S. ~u~h~r
~ Fire 118lard ~ Reactivity [~ flel~ypd ~ Sudden Release [] In,edible 20 Xylene 1330-20-7
Ilea/Lb o/P~essu~e Ilealth
Component 13 Hane I C.A.S. Humber
10 ~e~hyl~erL Bu~yl Ether ~G34-04-4
~1 'P'l 1044 I 522 154288 I [T3I 365 104 i 2 ]4 I 99~ I In storeroom. S.W. and .....
~_E. part of .store 10~ Carbon Dioxide~ Carbon Anhydride..
.ySfcml mn4 ,emlth ,mlmrd C.A.S. Number 124-~9 Component II ,mme I C.A.S. ,,nbmr
Check mil tbmt mpp~l)
Component I1 Nmmm I C.A.S. Humber
· ~ ~ite IIm~mtd ~ Remctlvit~ ~ Delmy~d ~ Sudden ~l~ase ~ imm~dlat,
Ilea/th ol P~essure Ilealth
Component I) Hmmm I C.A.$. Humber
IPhysiol mhd P, lth flazmrd C.A.S. flu,bmr Component II Hame I C.l.S. Humber
Itheck all that 8pplyl
~ fire ~mzmrd ~ Remcthity Il ~hy~d U Sudden Relemse 1] I~dlnteC°mp°nent 12 Hame I C.A.S. Humber .~!
I/em Ith of Pressure IlemlLh .......
Component I) Hmmm I C.A.5. Humber
Phvsiol mhd Pemlth ~mlmrd C.l.S. Humber Component II ~nne I C.l.S. Number
ICheck mil thmt mpp/yl .........
Component I~ Hmne I C.A.S. Humber
U fire Hazard U Remctlvlt~ '~ OehyeO ~ Su~d~n Release ~ lm,edlate
Ilealth of Pressure Ilemlth
Component I) Nmme I C.A.S. Humber
EHEnfiErlcY CO, TACT~ Plnm~ike Spi,uzzi , Zone Mqr.. Fit~eper ~.(805).32]~.~p~Ofi~ ff2~e Karve]ot - Environ. ~i~.1F1~(714)8~-069~ or
cer~tl.unoer pennlt~ P/P~ ln~t I nnvfpetsona/ly.e~amlnqqlqo Om lamllll(.vltO the )nlormnt)pn ~u~lttfd In this.~nd nil .
ttfl~heo.oqcvnent~ in~ t~lt 01st0 on.my ~nqutry 9~.tnose InOlVlOOnl~ ~esponH0/e lot obtmlnin~ the ~n~ormaHon. I believe that the
~ke Schumacher- O4v~s~on ~anager
03/26/92 CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 1
Overall Site with 1 Fac. Unit
General Information
Location: 5600 AUBURN ST 2 ,~ Map: 103 Hazard: Low
Community: BAKERSFIELD STATION 08 Grid: 13C F/U: 1AOV: 0.0
Contact Name Title BusinesS Phone 24-Hour Phoneq
MIKE KARVELOT · ENVIRON DIoR (714) 823-0691 x (619) 247,1914!
~ SP~NU~Z~ ZONE MANAGER (805) 321-8522 x (805) 321-8522/
~ ~ Administrative Data
Mail Addrs: P.O. BOX 5604 D&B Number: 06-294-4160
City: SANTA MARIA State: CA Zip': 93456-
'Comm Code: 215-008 BAKERSFIELD STATION 08 'SIC Code: 5541
Owner: THE CIRCLE K CORPORATION Phone: (805) 871-7979
Address: P O BOX 52084 State: AZ
City: PHOENIX Zip:,85006-
Summary RE~%VED
., HAZ. MAT. DIV.
(Ty~ o~ print name) .
ment plan' for ~/~ ~~
......
any corrections con=~[tute a ~mpl~e'and ~rr~ m~=
agement plan for my facility.
03/26/92 CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 2
02 - Fixed Containers on Site
Hazmat Inventory Detail in ReferenCe Number Order
02-001 REGULAR GASOLINE ~[/~}~D ~L~5 Liquid 10000 Moderate
· Fire, Immed Hlth, Delay Hlth GAL
CAS 9:8006-61-9 Trade Secret: No
Form: Liquid TYpe: Pure Days: 365 Use: FUEL
Daily Max GAL Daily Average GAL Annual Amount GAL
10,000 I 5,000.00 ~ ' 469,006.00
Location
Storage Press T Temp
.UNDER GROUND TANK Ambient/ambientlSOUTHEasT CORNER OF PROPERTY
- Conc Components MCP ' List
100.0% IGasoline Moderatel
-- Notes
02-002 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 T Annual Amount GAL
10,000 I 5,000.00 / 107,871.00
Storage Press T TempI Location
UNDER GROUND TANK Ambient/AmbientlSOUTHEAST CORNER OF PROPERTY
-- Conc Components I MCP i List
100.0% I Gasoline
-- Notes
03/26/92 CIRCLE K CORPORATION STORE #8605 215-000-001297 .Page 3
02 - Fixed Containers on'Site
Hazmat Inventory Detail in Reference Number Order
02-003 PREMIUM 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 I Annual Amount GAL --
10,000 I 5,000.00 ! 290,784.00
Storage Press T Temp Location
UNDERGROUND TANK IAmbient~AmbientlSOUTHEAST CORNER OF PROPERTY
-- Conc Components MCP ' List
100.0% IGasoline I M°der~'-'
-- Notes
02-004 CARBON~IOXIDE Gas 1044 Minimal
· Fire, Pressure, Delay Hlth .FT3
CAS #: 124-38-9 Trade Secret: No
Form: Gas Type: Pure Days: 365 Use: OTHER
Daily Max FT3 Daily Average FT3 I Annual Amount FT3
1,044 I 522.00 54,288.00
Storage Press T Temp I Location
PORT. PRESS. CYLINDER IAbove ~Ambient IN STOREROOM BACK OF STORE
- Conc Components MCP List
100.0% Icarbon Dioxide IMinimal
03/26/92 'CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
<2> Employee Notify/Evacuation
EMPLOYEES ARE INSTRUCTED TO REPORT ANY INCIDENT SUCH AS A SPILL OR FIRE
IMMEDIATELY TO THE APPROPRIATE EMERGENCY RESPONSE TEAM IN THE IMMEDIATE AREA
SUCH AS FIRE DEPARTMENT ETC. ADDITIONALLY THE STORE MANAGER IS INSTRUCTED
TO REPORT ANY ENVIRONMENTALLY HAZARDOUS CONDITION AS REQUIRED BY LAW.AND TO
TAKE NECESSARY CLEAN UP EFFORTS. THESE NOTIFICATIONS WOULD BE BY PHONE IN
EVENT OF EMERGENCY REQUIRING QUICK RESPONSE. THE DUTY CLERK ON SITE IS
INSTRUCTED TO IMMEDIATELY SOUND A VOCAL ALARMS TO ALL PERSONS IN THE
FACILITY AND ADJACENT AREA AND ADVISE THEM TO LEAVE THE AREA TOgA PLACE OF
SAFETY MOST FACILITIES HAVE A.BACK DOOR FOR EMERGENCY EXITS. THEN THE CLERK
IS TO REPORT THE INCIDENT OR HAZARD TO FIRE DEPARTMENT AS LISTED IN
EMERGENCY RESPONSE LIST OF PHONE NUMBERS AT STORE.
<3> Public Notif./Evacuation
WE HAVE A LIST WITH PHONE NUMBERS OF OUR NEIGHBORING BUSINESSES, RESIDENCES,
SCHOOLS, HOSPITALS, ETC., IN AN EMERGENCY WE WOULD NOTIFY OUR NEIGHBORS
BY PHONE IF POSSIBLE. ~
<4> Emergency Medical Plan
DIAL' 911 FOR TRANSPORTATION OF INJURY VICTIMS.TO MERCY HOSPITAL ON
TRUXTUN AVE IN BAKERSFIELD IF NECESSARY. KERN GENERAL HOSPITAL -
1830 FLOWER ST - 326'2000.
03/26/92 CIRCLE K CORPORATION STORE ~8605 215-000-001297 Page 5
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
GASOLINE - STEEL POSTS INSTALLED TO PREVENT' VEHICLE COLLISION WITH PUMPS.
VAPOR RECOVERY SYSTEMS USED WHEN FILLING UNDERGROUND TANKS WHICH ARE OF
FIBERGLASS CONSTRUCTION. DUAL HOSE SYSTEMS ON PUMPS. ANTI-LOCK NOZZLES AT
PUMPS. NO SALES TO NON-AUTHORIZED CONTAINERS. NO SMOKING SIGNS POSTED,
SELF SERVE INSTRUCTIONS POSTED. TANKS CHECKED PERIODICALLY FOR LEAKS BY
COMPARING GALLONAGE MEASUREMENTS WITH SALES RECORDS.
CARBON DIOXIDE - TANKS ARE STORED UPRIGHT AND FIRMLY SECURED.
<2> Release Containment
GASOLINE - PREVENTATIVE DIKING WITH ABSORBENT MATERIALS. SHUT OFF ALL
EMERGENCY SWITCHES TO PREVENT FURTHER SPILLAGE. BARRICADE AREA TO PREVENT
POSSIBLE EXPOSURE TO GENERAL PUBLIC. AVOID PERSONAL EXPOSURE TO
FUMES/VAPORS AND CONTACT WITH LIQUID. ELIMINATE ALL SOURCES OF IGNITION IN
AREA OF SPILL OR VAPORS. ABSORB LIQUIDS WITH ABSORBENT MATERIALS AND REMOVE
TO SAFE AREA FOR EVAPORATION.
CAR~BON DIOXIDE - CLOSE VALVE iF SAFE TO DO SO, OPEN ALL DOORS TO VENTILATE.
/
<3> CleanUp
GASOLINE - NOTIFY CIRCLE K ENVIRONMENTAL DIRECTOR (714) 823-0691 FOR
COORDINATION WITH HAZARDOUS WASTE DISPOSAL COMPANY TO REMOVE CONTAMINATED
ABSORBENT MATERIALS IF REQUIRED.
CARBON DIOXIDE - VENTILATE AREA IMMEDIATELY. CONTACT SUPPLIER IF LEAK I
CONTAINER/VALVE.
<4> Other'Resource Activation
03/26/92 CIRCLE K CORPORATION STORE #8605 215-000-001297 Page 6
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs
A) GAS - WEST'WALL OF BUILDING ON SOUTH END (METER)
B) ELECTRICAL - NORTH SIDE OF BUILDING EAST END END (METER)
INSIDE BACK ROOM OF STORE (BREAKERS)
C) WATER - SOUTHEAST CORNER OF SITE (METER)
D) SPECIAL - EMERGENCY GAS SHUTOFF SWITCH: AT CASHIER STATION ON CONSOLE
E) LOCK BOX - NO '
<3> Fire Protec,./Avail. Water
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER LOCATED ON PREMISES
FOR USE BY CLERK ON DUTY.
FIRE HYDRANT - SOUTHEAST CORNER OF LOT
<4> Building Occupancy LeVel
03/26/92 CIRCLE K CORPORATION STORE #8605 '215-000-001297 Page 7
00 - Overall Site
<G> Training .. /~"
<1> Page 1 ~/
WE HAVE % EMPLOYEES AT THIS FACILITY
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE
USE THE INFORMATION LEARNED FROM'THE STUDY OF THE MSDS FOR EACH APPROPRIATE
HAZARDOUS MATERIAL FOR TRAINING.
SPECIAL ON-THE-JOB TRAINING IN THE HANDLING OF HAZARDOUS MATERIAL(S).IS
PROVIDED IN THE FOLLOWING AREAS:
1) PROPER MAINTENANCE AND USE OF GASOLINE EQUIPMENT.
2) USE OF KITTY LITTER FOR SMALL SPILLS
3) EMPLOYEES ARE INSTRUCTED ON PROPER RESPONSE TO POLICE, FIRE DEPARTMENT,
EMERGENCY MEDICAL AND CIRCLE K ENVIRONMENTAL DEPARTMENT.
4) EACH CIRCLE K GASOLINE STORE HAS A COMPANY SUPPLIED.GASOLINE MANUAL WITH
MSDS'S FOR GASOLINE AND CO2.
A REVIEW OF THE CONTENTS OF THE EMERGENCY RESPONSE PLAN WILL BE MADE BY ALL
NEW EMPLOYEES WITHIN ONE MONTH OF HIRING AND BY ALL EMPLOYEES ON AN ANNUAL
BASIS.
SAFETY AND EMERGENCY EQUIPMENT USAGE. TRAINING WILL PROVIDE FAMILIARIZATION
WITH THE LOCATION AND PROPER USE OF FIRE FIGHTING EQUIPMENT (FIRE
EXTINGUISHERS)~ THE LOCATION OF AND PROCEDURES FOR FACILITY SHUTDOWN
(INCLUDING THE LOCATION OF TURNOFF VALVES FOR GAS AND ELECTRICITy) AND THE
PROPER USE OF EQUIPMENT USED IN THE DAY TO DAY BUSINESS.
<2> Page 2 as needed
<3> Held for Future Use
Farm and Agriculture L___, KERN COUNTY FIRE DEPARTMENT
HAZARDOUS MATERIALS INVENTORY
Stand~rd
Business
LOCATION: ~O Au~ ~., ~ ~ ADDRESS: %qn~% ~ ~T., ..............................
..........................................~ ~ .... ~ Paq~
STA.DA.D'~' cL~ OOE~-~-' ~1~% ~A~E OF THIS FACZLZT~:_~.~
] 2 3 4 5 6 7 8 9
l,~ns [ype ~ax Average Annual Measure Cont Cont Cont Use % by Names of ~ixtu~e/,:omponen~s
Code Code Amt Amt Est Units lype PPess lemp Code Wt See [nstPuct ~ons
' ...... : ...................................................
Health ............................................... _ ........................................
~ Fire Delayed Health C.A.S. Number ...... _~_~_~.~).g .........
c ' Reactivity ~ ....' Sudden Release of Pressure on Site ~----J ..... [,~
.. _~.
..... ' Immediate ~ ..... ,~. ___~_t 3~_~ ..... ~1.~_ .... ~~ .... ~kC .......
Health '"
~ Fire ~ Delayed Health G.A.S. Humber ~
.................................
F --, F--- ~ 13) ~ Days i~l
L__ J Reactivity ~ .... ~ Sudden Release of Pressure on Site
.............................
~ _.7 ~] Immediate ._~~ ..... LS ....! :_..~_¢_~_. _~_[~____ ~~
Heai t h
~ Fire ~ Delayed Health C.A.S. Number ~G~
.................
r ~ , ...... '~ 13) ~ Days i s~l ...............................................
~---~ Reactivity ~--'~ Sudden Release of Pressure on Site
- ~EE .........................................................
[ m
~i[y~un~er penalty of law that I have personally examined and am familiar with the information submitted in
~nqui~y~o~ t~se individuals responsible for o~ining the ~nf~ation, I believe ~hat ~he submitted inform~ls~ru~, ~ccurate. ~nd complete.
~~ ~-- ~ate o~qr, ed
~ ~tTe of ownerTo6erator O~ ownerT[perator s autEor~ze~ repre, e~f~ve s~gn~ture
INVENTORY CODE SHEET
Trans Code (Column 1) · Use Codes (Column 10)
A = Add This Item 01. Additive ·
D = Delete This item 02. Adhesive
R = Revised Information 03. Aerosol/Inflation
04. Anesthetic
05 Bactericide
Type Code (Column 2) 06 Blasting
07 Catalyst
P = Pure Material 08 Cleaning
M =~Mixture of Substances 09 Coolant/Antifreeze
W = Waste (Must Also: Add 10 Cooling
Appropriate Waste Code from 11 Drilling
"Waste Code Sheet") 12 Drying
13 Emuis~fier/Demulsifier
1'4 EtChing
Measure Units (Column 6) 15 Experimental/Analytical
16 Fabrication
LBS = Pounds 17 'Fertilizer
TON = Tons (2,000 lbs) 18 Formulation/Manufacturing
GAL = Gallons 19 Fuel
BBL = Barrels (42 gals) 20 Fungicide
Ft3 = Cubic Feet 21 Grinding
CUR = Curies 22 Heating
23 Herbicide
24 Insecticide
Container Type (Column 7) 25 instructional
26 Lubricant
01. Underground Tank- 27 Medical Aid or Process
02. Aboveground Tank 28 Neutralizer
03. Fixed Pressurized Cylinders 29 Painting
04. Portable Pressured Cylinders 30 Pesticide
05. Insulated Tank (Includes 31 Plating
Cryogenics) 32 Preservation
06. Drums or Barrels - Metallic 33 Refining
07. Drums or Barrels - Non- 34 Sealer
Metallic 35 Spraying
08 Carboy(s) 36 Sterilizer
09 Glass Container(S) 37 Storage/In Storage
10 Plastic Container(s) 38 Stripper
11 Box(es) 39 Washing
12 Bag(s) 40 Waste
13 Metal Containers (Not Drums) 41 Water Treatment
14 In Machinery or Processing 42 Welding Soldering
Equipment 45 Well Injection or Service
15. Bin(s) 44 0il Treatment
16. Unlined Sumps 45 Resale
46 Aircraft Systems
47 Battery/Electrolyte
Container. Pressure (Column 8) 48 Breathing Air
49 Drafting Aid
1 = Ambient Pressure 50 Finished Product
2 = Greater Than Ambient Press 51 Fire Protection
3 = Less than Ambient Press 52 Hydraulic Equipment
53 Road/Hwy Maintenance
Container Temp. erature~_.__ (Column 9) 54 Testing
4 = Ambient ~%~p.e~. ature 55 Wholesale Chemicals
5 = Greater ~n%~g~'~----~mbient 99 OTHER-Specify on
6 = Less tha~'~.~en~ TemD but not another Da~e
7 = Cryogenic Conditions
Farm and Agriculture u_u KERN COUNTY FIRE DEPARTMENT
Standard Business ~ DUN
~,oca~o~:._~ ~%oz~ ~-'. %~-~ AuDR~ss: ~i' ~~L%~ ............
PHONE ~: PHONE ~: (~'4~ ~4q - ~l 40 .......
REFER ~0 INSTRUCTIONS FOR PROFER CODES
1 2 3 4 5 6 ? 8 9 10 ~1
lrans fype Max ~verage Annual MeasuPe Cent Cent Cent Use % by Names of Mixture/Components
Code Code Amt ~mt Est Units lype P~ess ]emp Code
See Instruct
u_J Immediate ~M ~- 16~ 6~ o]~___~~ ~%
Heal th ....................................... . .............. ~9~_ r_~~~._._~l.~_ _~%.
~Fire ~Oelayed tlealth C.A.S. Number ~~ ~ f~ "'
...............................
r -- ~ r -- ~ 12) ~ Oays u~i
u ....' Reactivity u__., Sudden Release of Pressure on Site
t. -~ Immediate
Hea 1 t h
t._j Fire t.._d Oelayed Health C.A.S. Number
............. ~ -_-_. ::..;. ........
r '--~ r--~ 13) 1I Oays i I
~---J Reactivity L._., Sudden Release of Pressure on Site '-----J
u__J Immediate
Hea I th
u _.2 Fire u ~ Delayed Health C.A.S. Number
r ..... , r .... '~ 13) I~ Days i I ........................................................................
L--J Reactivity L...J Sudden Release of Pressure on Site ........ ~
. ' .~ ' ~o~-C~-~-~-~
~N~me ......................... ~ .......... Till~ ......................................
MAR 2 ~ 198~ "~.~.~_~.:_~.~s._~_~_~..~~.~.C_~,,~ _ ........... ~-.~,~
- ~ name - -- /i~ ~e ~ ................ 2~"R~'-vn,)~ ..........
, certify u.de~ penalty of law ,hat , have pePsona]], exa. ined and am fatal]Jar ,ith ,he infoPmation submi,,~,~ t~s,a~d aJl attached documen,s and that ha'sod on
inquiry of those individuals respons~e for obtaining ~e Snformation, I believe that the submitted informa~i~ i~t~u~, a~urate, and complete~ my
Farm )riculture ~--~ ~RN O0l~ ' FI~ DEP~Eh"I'
HAZARDOUS MAT~.~I ALS INVENTORY
~ ~0 IWSTRUCTIOWS ~OR PROPER ~ODgS
frans [ype Ndx AvePage ~nu,sl Heasure Cont C~t Cont Use % by Names of
Code Code Amt Amt Est Units lype Press temp Code ~t See instruct
Health .............................................. O~ ..............
~ -' Reactivit,i L ...."Sudden ~ele~se of PpessuPe on Site ...... ~
Health ~ .... '.~___~.1~..~ .... ~1-~---.~~.. _~LL_ _ ~-~--- ~ !Y¢ ..... '
~ F~ ~ O.~v,d ,.,~h C.A.S. ,,,b,~ ...... ~_~M.~ ..........
r' '- ~ r-- ~ 13) I Oays i~G~ -
~ -.- ~ ~eactivity ' ...."Sudden Re]ease of PPessoPe on Site .......
HeN i t h ' . .........
~ Fire ~ Delayed Health C.A.S. Number ...... ~.~..Q.~_!.~ ........
1
r ...... '~ .L.. _Ai'"i>_ ....
,- -, ,.-~ 1~) , D~ ~'S~.C~ -- .............
~ ---' ~e.tcli~i(y ~" J Sudden ~ele~se ot PPessu~e on Site
N~b ................................................. Title ....................................
' "%--~--~.~ '- ~-s-~% ..... ;~ ~~--
I -~u~;~er pen,i]ty of ]a~ that I have pePsona]l~ examined and an taniliaP
~se individuals responsible fop o~ining ~he SnfoP~ation, believe [hat ~he submitted info~s~ru~, accucate, and complete~
~ai ~;tTe o~ o~ner/o~ena~oP O~ owner/~pePatoP s aut~orlze~ represe~[~({;e
,r . Form ADCrO~ed Otv~B fie. 2050-0C;2
Facility Identification OwnorlOperntor Name '~i
Tier Two ..~. CI~ K ~I~ ~ ~ 8605 rJn~. CI~ K ~k~E ~ ~. ~602 ~ 253-9600
EMERGENCY S"eet *.~,... 5500 5T~"~' ~m u.,, .~,.., P.O. ~X 52084~ ~~. ~. 85006 _
AND City nR~nO~T~r ~ Slate ~ Z'P ' ~' '~" .... ::.: '
HAZARDOUS ......... 93306 Emergency Conl~ct ..... ;:; · · .:' ...... .. '
CHEMICAL S~ ~R 'F Title ~ ~R
INVENTORY Name
~..~/,~ ~,o~.lsl 514111 o."~"'."~-I 21914 I-L411 le 10l ., .... ,805,871-7979 .... ,~ ~.~..~. , )
/.fo,motion ....... :~J' ~' ' :~
OFFICIAL ~..,. NI~ SPI~ZZI t~:
ONLY Oat~ ~.~v~ .~o.. ( 805 1833-8881 -,.~': ~'~% ~4 ~. ~ I ~
Reporllng Period r,om Jnnuacy I '~ Decem~'.~r 3I,
,~ Physical Inventory St ora~e~;~Codes., and: Locati
ons ......... ..,'.'
and Health ~. A~g. ~o. o~ .' ~;':~" on. C0nfldentlal) ;....~:'?.
'Chemical Descr on Hazards D~Ily Daily Days ,~.~: ,,/. <,. ~.::.,.. :... ::.2' .' , ~:r. :.::: ': .'
' Amount Amount On-sUe :~ :~ . ' ,~ :; "'.'"... ::: · :/.' :' '...'.. ,'
.... (ch~h all that apply) (code) (codc) (dn)'~) ~or~E ~O~E .~, ~Or~' ~OC~O~$".. . ".:: ....' - .:~::.: .... .:.~:~-:':..L. :
, .. ,. , .,. , .~
Chem. Name C~[,T~ ~ et P,e,su,e -- ---- :,
~ Imm~lale (acute] ' > ,',
~ OIlayed (chr~lc) ....
thor apply: Pu, e Mix Solid Liquid One
cas[ I I I I I I ~ ~6.,.tTrade~,, Fire ' ' :~t ''
Chem. Name :.: of P, essu, e --
~eacllvlty ~
Immedlale (acute)
~,sll II I I I~~Trade ~ 'Fire
S~ret Sudden Release
'Chem. Name olP~essure
Imm~lale (acute)
Delay~ [chr~lc) '
'~ .... '~ ~. Optional Attachments (Check ode;,
Cerllllcatlon (Rtad ~,d Jl~n after compl~llnX all ~cHons)
I certify under ~natty of law that I have ~onalty examined and am lamlitar w~h the Inlo~a[to~ suhmllted I~ Ihl~ and all ellach~ d~u~enta, n~ that bas~ : ~,'.
~ my I~ulry of I~le I~lvlduall rel~llblo f~ oblalnl~ Ihe Info~mall~. I ~lleve that Ihe sub,~d Information Is Irue, accuray. ~d c~plele. .~A ~~ I Pave illlchN I lite plan
PAT ~~ ~~~ DIOR ~B R. I ~ h.~. a,t.ch~ · ,,, of .,,.
I l.~,~*~ end nll'clal lille CI owner;ope~al~ O[1 owner,'oue~alot's aulhorlzed represenlallve Slgnalufe / Dale slgne~.. ~. , il ,
Yt V ~
Environmental Management NOV 2 I 1909
Software Systems Inc. H=~. MAT. DIV.
November 9, 1989
Bakersfield City Fire Department
Hazardous Materials Division
2130 G Street
Bakersfield, CA 93301
Gentlemen:
Circle K Corporation has contracted Environmental Management
Software Systems, Inc. to prepare a Hazardous Materials Management
Plan in accordance with the requirements of Chapter 6.95, Division
20, Section 25550 et seq. of the State Health and Safety Code and,
Title III of SARA. In most cases, this submittal is a replacement
of an existing plan. Circle K Corporation's intention is to
provide each store with a standard format so that· training of
personnel can be accomplished uniformly throughout the State.
If you have any question concerning these submittals, please
contact EMSS at (805) 925-6285.
Sincerely yours,
~~ Rivera Jr.
JVR:sb
Enclosure
RO. BOX 5604 I SANTA MARIA I CA 93456 / (805) 925-6285
~,,~0['~ RECEIVED
NOV 2 1 1909
Ha7 MAT. DIV.
CITY OF ....
BAKERSFIELD
HAZARDOUS MATERIALS
MANAGEMENT PLANS
Submitted Pursuant to
CALIFORNIA HEALTH AND SAFETY CODE
CHAPTER 6.95 (AB 2185/87/89)
AND CHAPTER 6.5 (Hazardous Waste Control Law)
FOR
Circle K Corporation ~8605
5600 Auburn Street
Bakersfield CA 93306
- 1-
CircLe K Corporation #8605 (C) E.M.S.S.-10/88
CITY OF
B~KERSFIELD
I declare that to the best of my knowledge and belief, the statements
and information provided in this document are correct and true. I
understand that additional information to that provided may be required
before plan approval from:
Bakersfield City Fire Department
I also understand that I am required by law to notify the
Administrating Agency within thirty days of any one of the following
changes:
1. The addition of one or more previously undisclosed material(s)
in quantities equal to or greater than 55 gallons, 500 pounds,
or 200 cubic feet at STP.
2. A 100 percent or more increase in the quantity of a previously
disclosed material.
3. A change in the business address.
4. A change in the business ownership.
5. A change in the business name.
Failure to notify.the appropriate Administrative Agency:
Bakersfield City Fire Department
may result in the imposition of civil penalties.
--~/'/~~ Division Manaqer
Signature ~' - Title
Name: Mike Schumacher Dated: !
Telephone Number: (916) 331-2540
FOR OFFICE USE:
Approved/Denied by Date:
- 2-
Circle K Corporation #8605 (C) E.M.S.$.-10/88
CITY OF
BAKERSFIELD
BUSINESS PLAN
ANNUAL CHEMICAL INVENTORY
1. BUSINESS NAME: Circle K Corporation #8605
2. FACILITY ADDR: 5600 Auburn Street
CITY: Bakersfield STATE CA ZIP: 93306
3. MAILING ADDR: 3437 Myrtle Avenue, Suite 440
CITY: North Hiqhlands STATE CA ZIP: 95660
4. BUSINESS PHONE NUMBER: (805) 871-7979
5. BUSINESS HOURS: 12:00 AM TO 11:59 PM SUN-SAT
: TO :
: TO :
: TO :
6. TOTAL NUMBER OF EMPLOYEES: 3 NUMBER OF SHIFTS PER DAY: ~
7. NATURE OF BUSINESS: Convenience Store/Gas Station
8. SIC CODE (Standard Industrial Classification): 5541
9. CONTACT PERSONS ABLE TO ASSIST EMERGENCY PERSONNEL:
PHONE NUMBERS
LAST NAME FIRST NAME T1TLE ~JSINESS AFItlRHRS
Staff Duty Clerk (805) 871-7979 (805) 871-7979
Spinuzzi Mike Zone Manaqer (209) 298-3036 (805) 833-8881
Lewis Don District office (209) 298-3036 (209) 291-5910
Schumacher Mike Division Manager (916) 331-2540 ( )
Wriqht Pat Environ. Director (916) 331-2540 (916) 966-9139
10. _ FARM OR AGRICULTURE ~ STANDARD BUSINESS
11. ASSESSOR's PARCEL NUMBER:
12. REASON FOR FILING:
INITIAL FILING
ANNUAL REPORT
CHANGE IN REPORTING STATUS
~ REPLACEMENT OF AN EXISTING PLAN #
13. NUMBER OF UNDERGROUND TANKS: 3__ TOTAL CAPACITY: 30000
- 3-
C~rc[e K Corporation #8605 (C) E.M.$.$.-10/88
FACILITY DESCRIPTION
The fOllowing information is used to orient new employees to the major
aspects of this facility.
BUSINESS NAME: Circle K Corporation #8605
FACILITY ADDR: 5600 Auburn Street
CITY: Bakersfield STATE: CA ZIP: 93306
FACILITY CONSTRUCTION: Stucco, Wood and Drywall
NUMBER OF FLOORS: 1 FACILITY SIZE: 4614 (sq. ft./floor)
THE TYPE OF FACILITY IS : Convenience Store/Gas Station
THE PRODUCTS OR SERVICES THAT ARE PRODUCED OR MARKETED BY THIS FACILITY
ARE:
a. Gasoline
THIS FACILITY IS 5+ YEARS OLD.
IT HAS BEEN USED IN ITS PRESENT CAPACITY FOR 5+ YEARS
HAZARDOUS MATERIALS ARE USED IN THE OPERATION OF THIS BUSINESS IN THE
FOLLOWING MANNER:
a. Gas sold to public
NAME OF OWNER: Circle K Corporation PHONE #: (916) 331-2540
ADDRESS: 3437 Myrtle Avenue, Suite 440
CITY: North Hiqhlands STATE: C_~A ZIP: 95660
- 4-
Circle K Corporation #8605 (C) E.M.S.S.-10/88
I
IDENTIFY
THE
TYPE
THE FOLLOWING SYMBOLS,
ABSORPTIVE MATERIAL [~ ELECTIRC METER ABOVE GROUND TANKS
°00
ALARM (~ GAL HMS
DRAIN ~ ELECTRIC SHUT-OFF
DRIVE~Y ~ GAS METER BELOW GROUND T*NKS
DOORS /1OK ~ ~ -- ~ '
EVACUATION ROUTE ~ GA8 SHUT-OFF ~GAL/
FIRE DEPT. CORR - CORROSIVE
FIRE HOSE SPRINKLER'CONNECTION C - COMBUSTIBLE
FIRE EXTINGUISHER ~ FIRE DEPT. E - EXPLOSIVE
FIRE DOOR ~ STANDPIPE CONNECTION GF -. FLAMMABLEGA8
FIRE ~LL FIRE HYDRANT L - LIQUID
OXY - OXIDIZER
coot;, o. T - TOXIC
GUARD STATION ~-~ REFRIGERATION UNIT WR - ~TER REACTIVE
LADDER
MATERIAL SAFETY DATA SHEET & ~ HEATING UNIT
HAZARDOUS MATERIAL
~RAILROAD TRACKS
EMERGENCY RESPONSE PLAN ~ STORAGE AREA...HMS
PERSONAL PROTECTIVE EQUIPMENT ~ SEWER HAZARDOUS MATERIAL
...... , HANDLING AREA...HMH
PUBLIC TELEPHONE ', SL ', SKYLIGHT
REST ROOM HAZARDOUS ~8TE
STAIRS ~ STORM DRAIN STORAGE AREA...HWS
CITY OF
BAKERSFIELD
H A Z A R D O U S M A T E R I A L S I N V E N T O R Y PAGE 1__ OF 2
FARM OR AGRICULTURE: _ STANDARD BUSINESS: ~ REPORTING PERIOD: JANUARY 1 TO DECEMBER 31, 1989
ADMIN AGENCY ACCT. #: REASON FOR FILING: _ INITIAL _ ANNUAL REVIEW _ CHANGE IN STATUS ~ REPLACE EXISTING PLAN
BUSINESS NAME: CircLe K Corporation #8605 SIC CODE: 5541 EPA#: ASSESSOR's PARCEL #:
FACILITY ADDRESS: 5600 Au~rn Street , BakersfieLd DUN & BRADSTREET #: 0__6-29__4-~60
ITITYPEI MAX I AVG I ANNUAL I IDAYSICONTICO"T ICONT I USEI DOT IRANGE I IDOTI
IcICODEI AMT I AMT I AMOUNT IUNITI O/SICODEIPRESSITEMP ICODEICLASS 1%WT I COMPONENTS CAS # IGD#1
JAIM I 10000 I 5000 176900 I GALl 3651 01 I 1 I 4 I 19 IFL I100 I////////////////////////////////////////////////I 8006-61-9l -
I CHEMICAL NAME: GasoLine I 25 ITo[uene 108-88-3127
I COMMON NAME: GasoLine, ReguLar I 20 IXy[ene 130-20-7127
I LOCATION: Underground tanks, approx. 20 ft. southeast of store I 10 IMethy[tert Butyl Ether 1634-04-4126
I ~ FIRE SUDDEN RELEASE OF PRESSURE ACUTE J ~ i
I _ REACTIVITY ~ CHRONIC - I I I
ITITYPEI MAX I AVG IANNUAL I IDAYSICONTICONT ICONT I USEI DOT IRANGE I IDOl
.ICICODEI AMT I AMT I AMOUNT IUNITI O/SICODEIPRESSITEMP ICODEtCLASS 1%WT I COMPONENTS CAS #
CHEMICAL NAME: GasoLine I 25 ITo[uene 108'88-3127 I
COMMON NAME: Gasoline, unleaded I 20 IX¥[ene 130-20'7127
LOCATION: Underground tanks, approx. 20 ft. southeast of store I 10 IMeth¥[tert Butyl Ether 1634'04~4126
X FIRE SUDDEN RELEASE OF PRESSURE ACUTE I I
-_ REACTI;ITY CHRONIC - I I I I
TITYPEI MAX I AVG i ANNUAL I IDAYS/CO.TICONT ICO"T lUSEI DOT IRANGE I IDOTI
ICICODEI AM~ I ANT I AMOUNT IUNITI O/SlCODEIPRESSlTEMP ICODEICLASS I ~WT I COMPONENTS CAS # IGD#1
IAIM I 10000 I 5000 111950o I GALl 3651 01i 1 i 4 i19 IFL 1100 I////////////////////////////////////////////////I 8006-61-9l - I
I CHEMICAL NAME: GasoLine I 25 IToLuene ) 108'88-3127
I COMMON NAME: GasoLine, Super UnLeaded I 20 IXylene I 130'20-7127
I LOCATION: Underground tanks, approx. 20 ft. southeast of store I 10 IMeth¥[tert Butyl Ether I 1634'04'4126
I FIRE SUDDEN RELEASE OF PRESSURE ACUTE I i I I
I - REACTIVITY ~ CHRONIC - I I I I
EMERGENCY CONTACT:
FIRST NAME LAST NAME TITLE BUSINESS PHONE/AFTER HRS PHONE
Staff Duty Clerk 871-7979 871-7979
Mike Spinuzzi Zone Manaqer 298-3036 833-8881
- V-
CircLe K Cor~ration #8605 (C) E.M.S.S. - 01/89
CITY OF
BAKERSFIELD
H A Z A R D O U S M A T E R I A L S I N V E N T O R Y PAGE 2 OF 2
BUSINESS NAME: Circle K Corporation #8605 REPORTING PERIOD: JANUARY 1 TO DECEMBER
ITITYPEI MAX I AVG I ANNUAL I IDAYSICONTICONT ICONT I USEI DOT IRANGE
~ICODEI AMT I AMT I AMOUNT IUNITI O/SlCODEIPRESSlTEMP ICODEICLASS 1%WT I COMPONENTS I CAS # GD#]
JAIP I 120 160 1288o I LBSI 3651 04 ] 2 i ~ i ~ iNFO 11oo
I CHEMICAL NAME: Carbon Dioxide, Carbonic Anhydride I
I COMMON NAME: Carbon Dioxide
I LOCATION: In Store Room, back of store
I - FIRE ~ SUDDEN RELEASE OF PRESSURE - ACU,E I
I _ REACTIVITY ~ CNRONIC I I
I I I
ITITVPEI MAX I AVG I ANNUAL I IDAYSlCONTICONT ICONT I USEI DOT leANGE DOTI
IClCODEI AMT I AMT I AMOUNT IUNITI O/SICODEIPRESSlTEMP ICODEICLASS 1%WT I COMPONENTS CAS # IGD#1
{i = i ~ iiei a ii i I///////i///////ll///////////I//////ll/I/////////I I
I CHEMICAL NAME= I I I I
I COMMON NAME: I I I I
I LOCATION= I I I I
I - FIRE SUDDEN RELEASE OF PRESSURE _ ACUTE I I I I
I - REACTI~ITY _ CHRONIC I I I I
I I I I I
ITITYPEI .AX I AVG I ANNUAL I IDAYSlCONTICONT ICONT I USEI DOT IRANGEI I IDOTI
IclCODEI AMT I AMT I AMOUNT IUNITI o/slCODEIPRESSlTEMP ICODEICLASS I X~T I COMPONENTS I CAS # IGD#1
II I I I I I I I I I I I 11//11/I///1111111111111111/////11/11/111111//1/11 I
I CHEMICAL NAME= I I I I
I COMMON NAME= I I I I
I LOCATION= I I I I
i _ FlEE SUDDEN RELEASE OF PRESSURE _ ACUTE I I i i
I - REACTIVITY - CNRONIC I I I I
ITITYPEI MAX I AVO I ANNUAL I IDAYSICONTICONT ICONT I USEI DOT IRANGE I I IDOTI
IClCODEI AMT I AMT I AMOUNT lUNITI O/SlCODEIPRESSITEMP ICODEICLASS I X~T I COMPONENTS I CAS # IGD#I
It I I I I I I I I I I I III/11111////////////////////////11///11/////////I I I
I CHEMICAL NAME:
I COMMON NAME: I I I I
I 'LOCATION= I I t I
I - FIEF SUDDEN RELEASE OF PRESSURE _ ACUTE i i
I _ REACTIVITY - CHRO. lC I I t I
ITITYPEI MAX I AUG I ANNUAL I IDAYSlCONTtCONT ICONT I USEI DOT IRANGE I I DOTI
~ICODEI AMT I AMT I AMOUNT lUNITI o/slCODE1PRESSlTEMP tCODEICLASS 1%"T I COMPONENTS I CAS # IGD#)
I CHEMICAL NAME: I I I I
I COMMON NAME:
I - FIRE SUDDEN RELEASE OF PRESSURE _ ACUTE I I i i
I - REACTIVITY -C.RONIC ) t I I
Circle ~ Corporation #8605 (C) E.M.S.S. - 01/89
INVENTORY FORM CODES
TC - TRANSACTION CODE (Column 1) TYPE CODE (Colun~l 2)
A = Add this new material to the Dusiness' inventory. P = pure, or Largely pure substances
D : Delete this material from the business' inventory. M = mixtures of pure substances
R = Revise the information about this material. W = waste (also append the three digit E.P.A. waste code).
CONT CODE - CONTAINMENT CODE (Co[un~ 8) CONT PRESS - CONTAINER PRESSURE (CoLumn 9)
01 Underground Tank 10 Plastic Container(s) 1 = Ambient Pressure
02 Aboveground Tank 11 Box(es) 2 = Greater than Ambient Pressure
03 Fixed Pressurized Tank 12 Bag(s) 3 = Less than Ambient Pressure
04 Portable Pressurized Cylinder(s) 13 Metal Container (not drums)
05 Insulated Tank (includes cryogenics) 14 In Machinery or processing
06 Drums or Barrels - Metallic equipment CONT TEMP - CONTAINER TEMPERATURE (Co[ten 10)
07 Drums or Barrels - non-Metallic 15 gin(s)
08 Carboy(s) 16 UnLined Sun~ 4 = Ambient Temperature
09 Glass Container(s) 99 OTHERS 5 = Greater than Ambient Temperature
6 = Less than Ambient Temperature but not cryogenic
7 = Cryogenic Conditions
USE CODE (Co[un~ 11)
DOT CLASS - DEPARTMENT OF TRANSPORTATION (DOT) HAZARD CLASS CODES (Column 12)
01 Additive 13 EmuLsifier 25 Instruction 37 Storage 46 Aircraft Sys.
.02 Adhesive 14 Etching 26 Lubricant 38 Stripper 47 Electrolyte EXP A = Explosive A PYRO = Pyrophoric or sponta- FS = Flammable SoLid
03 Aerosol 15 Experimental 27 Medical Aid 39 Washing 48 Breathing Air EXP B = Explosive B neous[y Combustible W = Water
04 Anesthetic 16 Fabrication 28 Neutralizer 40 Waste 49 Drafting Aids EXP C = Explosive C POIS A = Poison Gas RAD = Radioactive
05 Bactericide 17 Fertilizer 29 Painting 41 Water 50 End Product BA = Blasting Agent POIS B = Poison Liquid/Solid OXY = Oxidizer
06 Blasting 18 FormuLation 30 Pesticide Treatment 51 Fire Protect FG = Flammable Gas FL = Flammable Liquid OP = Organic Peroxide
O? Catalyst 19 Fuel 31 Plating 42 Welding 52 Hydrau. Equip NFG = Nonflammable Gas CL = Combustible Liquid ET! = Etiologic Agent
08 Cleaning 20 Fungicide 32 Preservative 43 Welt 53 Road/Hwy COR = Corrosive ORME = Hazardous Waste ORMA = Anesthetic,
09 Coolant 21 Grinding 33 Refining Injection Maintenance CR = Cryogenics ORMS = Other Regulated Materials Irritant
10 Cooling 22 Heating 34 SeaLer 44 Oil 54 Testing Chem. (materials B, C, and D)
11 Drilling 23 Herbicides 35 Spraying Treatment 55 WholesaLe
12 Dryer 24 Insecticides 36 SteriLizer 45 Resale 99 OTHER
ESTIMATED VOLUME OR WEIGHT RANGE IN POUNDS (Co[ 3,4,5) UNITS - MEASUREMENT UNITS (Column 6)
Range Code From To LBS = Pounds
1 0 99 GAL = Gallons
2 100 999 FT3 : Cubic Feet
3 1,000 9,999 TON = Tons (2000 tbs)
4 10,000 99,999 BBL = BarreLs (42 gaJs)
5 100,000 999,999
6 1,000,000 9,999,999
CircLe K Corporation #8605 (C) E.M.S.S. - 06/89
REPORTING PERIOD: JANUARY 1 TO DECEMBER 31, 1989
HAZARDOUS WASTES INVENTORY
GENERAL CHEMICAL AND MINERAL COMPOSITION
FACILITY NAME: Circle K Corporation %8605
FACILITY ADDRESS: 5600 Auburn Street
WASTE NAME/ MIN MAX MAX
CATE DESCRIPTION CONC CONC AMOUNT UNI~
% %
None
-10-
C~rcle K Cor~rat~on #8605 (C) E.M.S.$.-10/88
CITY OF
BAKERSFIELD
HAZARDOUS MATERIALS
EMERGENCY RESPONSE PLANS AND PROCEDURES
Submitted Pursuant to
CALIFORNIA HEALTH AND SAFETY CODE
CHAPTER 6.95 (AB 2185/87/89)
AND CHAPTER 6.5 (Hazardous Waste Control Law)
FOR
Circle K Corporation %8605
5600 Auburn Street
Bakersfield CA 93306
-il-
Circle K Corporation #8605 (C) E.M.S.S.-10/88
EMERGENCY RESPONSE PLAN
1. EMERGENCY RESPONSE PERSONNEL
The following persons have been designated to coordinate and
assist in the event of a hazardous incident at this facility.
a. EMERGENCY COORDINATOR: The Emergency Coordinator is responsible
for managing hazardous materials emergencies, and coordinating
all emergency measures. The Coordinator shall be thoroughly
familiar with the facility emergency response plan, the
facility's operations, hazardous materials, and facility
layout. Other tasks of the emergency coordinator include:
writing the emergency response plan, updating it when
necessary, and overseeing the training of personnel in its use.
LAST NAME FIRST NAME TITLE
Staff Duty Clerk
BUSINESS PHONE: (805) 871-7979 AFTER HRS. PHONE: (805) 871-7979
b. ALTERNATE EMERGENCY COORDINATOR: The Alternate Emergency
Coordinator shall be familiar with the duties and
responsibilities of the primary Emergency Coordinator and shall
perform those duties when the Coordinator is not available.
The Alternate Coordinator may also assist the Coordinator in
writing, updating the ERP, and to oversee the training of
employees and on-site emergency response personnel.
LAST NAME FIRST NAME TITLE
Spinuzzi Mike Zone Manaqer
BUSINESS PHONE: (209) 298-3036 AFTER HRS. PHONE: (805) 833-8881
c. EMERGENCY RESPONSE TEAM: The Emergency Response Team are those
individuals who have been trained to respond and handle
emergencies dealing with the mitigation, abatement or
prevention of releases or threatened releases of hazardous
materials.
PHONE
Lewis Don District office (209) 298-3036 (209) 291-5910
Schumacher Mike Division Manaqer (916) 331-2540 ( )
Wriqht Pat Environ. Director (916) 331-2540 (916) 966-9139
( )__-__( ) -
( )__-__ ( ).__-
( )__-__( )__-
(__) __-__ ( ) __-__
( )__-__( ) -__
-12-
Circle K Corporation #8605 (C) E.M.S.S.-10/88
HAZARDS ASSESSMENT AND NOTIFICATION PROCEDURE
2. HAZARDS ASSESSMENT
In the event there is a reported release or threatened release of toxic
or hazardous material, the Coordinator or Alternate Coordinator will
be advised. If, in their assessment, there is a need to call the
Emergency Response Team, this will be done before notification to any
required agencies is done.
3. REPORTING REQUIREMENTS
Section 25504 of the Health and Safety code requires that the release
or threatened release of hazardous materials be reported. This is
required even if the situation does not warrant emergency response
assistance.
A. REQUIRED TIME OF NOTIFICATION:
1. Immediate notification is required as soon as the release or
threatened release is acknowledged and as long as notification
can be provided:
(a) without impeding immediate control of the
release/threatened release, AND
(b) without impeding emergency medical measures.
2. Immediate notification is not required if:
(a) there is reasonable belief that the release or threatened
release poses no significant present or potential hazard
to human health and safety, property, or the environment,
AND
(b) the situation does not require emergency assistance.
B. NOTIFICATION PROCEDURES:
1. When the incident DOES NOT require immediate notification as
described above, contact your administrating agencies within 24
hours of the incident:
Bakersfield City Fire Department
Phone: 871-7979
and
State Office of Emerqency Services
Phone: (800) 852-7550
When a hazardous materials release or threatened release occurs
which DOES require immediate notification as described above,
refer to the Emergency Notification Roster on the next page
and following directions described in the reporting
requirements.
-13-
C~rcle K Corporation #8605 (¢) E.M.$.S.-10/88
EMERGENCY NOTIFICATION TELEPHONE ROSTER
4. EMERGENCY NOTIFICATION
Of the five agencies listed below, all (execpt Paramedics) must be contacted
in the event of a hazardous materials release or threatened release.
Reporting information required by these agencies is listed in the box below.
A. LOCAL EMERGENCY RESPONSE PERSONNEL C A L L 9 i 1
PARAMEDICS :
PHONE : ( ) __-__ (Non-emergency Number)
FIRE AGENCY: Bakersfield City Fire Department
PHONE : (805) 871-7979 (Non-emergency Number)
LAW ENFORCEMENT: Bakersfield City Police Department
PHONE : (805) 327-7111 (Non-emergency Number)
B. ADMINISTRATING AGENCY
AGENCY: Bakersfield City Fire Department
PHONE : (__) 911-__ (24-hour Emergency Number)
C. STATE OFFICE OF EMERGENCY SERVICES (OES)
PHONE: .(800),852-7550 OR (916) 427-4341
**************************************************************************
* REPORTING REQUIREMENTS *
, .
* The following information should be known when reporting an emergency *
* so that response personnel will know what to expect and how to react. *
* *
* 1. Time and type of incident (fire, chemical release, etc.)
* 2. The exact location of the release or threatened release. · *
* 3. Name and quantity of material(s) involved, if known. *
* 4. The extent of injuries. *
, *
* 5. Name of person reporting the incident. *
*
* 6. The potential hazards presented by the material(s). *
.
-14-
circle K Corporation #8605 (C) E.M.S.S.-lO/88
5. NEIGHBORING PROPERTIES
The followin~ (by name, address, and phone number, if available) list
the neighboring'businesses, residences, schools, hospitals, etc. which
could be affected by a hazardous materials incident from this facility.
These phone numbers are to be used in the event of an emergency to
provide notification if evacuation from the area is deemed necessary.
NAME ADDRESS PHONE
Today Cleaners 5600'Auburn St. Ste. V 872-6920
E1 Pollo Plus 5600 Auburn St. Ste. T 872-7587
Scoops "N" Slices 5600 Auburn St. Ste. S 872-2824
Raqe Salon 5600 Auburn St. Ste. 0 872-2360
6. COMPANY EMERGENCY MEDICAL ASSISTANCE
This section includes the names, addresses, and phone numbers of the
primary company medical facility and doctor, who would be available to
treat employees injured by a hazardous materials incident at this
business. Use this information in the event of an emergency.
DOCTOR : None
ADDRESS :
CITY :
PHONE : (__) __-__
FACILITY: Mercy Hospital
ADDRESS : 2215 Truxton Avenue
CITY : Bakersfield
PHONE : (805) 327-3371
7. ADDITIONAL CLINICS AND HOSPITALS
FACILITY:
ADDRESS :
CITY
PHONE : ( )
FACILITY:
ADDRESS :
CITY :
PHONE : (__) __-__
(Medical facilities continued on the next page.)
-15-
C~rcle K Corporation #8605 (C) E.M.S.$.-10/88
7. MEDICAL FACILITIES (Cont)
FACILITY:
ADDRESS :
CITY :
PHONE : (__)__-__
FACILITY:
ADDRESS :
CITY :
PHONE : (__) __-__
8. UTILITIES SHUT OFF LOCATIONS
GAS/PROPANE: West wall of buildinq on south eno (meter)
ELECTRICAL: a. Inside back room of store (breakers)
b. North wall of building on east end (meter)
WATER: Southeast corner of site (meter)
FIRE HYDRANT: Southeast corner of site
LOCK BOX: None
EMERGENCY
RESPONSE PLAN: At the cashier station
SPECIAL (IDENTIFY):Emerqency qas shutoff switch:
At cashier station on console
9. UTILITIES INFORMATION
DO NOT NOTIFY these companies in the event of an emergency. This
information is for reference only and may be helpful in assisting
emergency response personnel in responding to a hazardous materials
emergency at this facility.
UTILITY NAME PHONE
Electric Company: Pacific Gas & Electric Company (80~) 324-3981
Gas Company: Pacific Gas & Electric Company (805) 324-3981
Sanitation District:Kern County (805) 861-2481
Water District: Kern County (802) 861-~461
Number of underground tanks on site: 3__ Total Capacity: 30000
-16-
C~rcle K Corporation #8605 (C) E.M.$.$.-10/88
EMERGENCY RESPONSE PROCEDURES
1. EMERGENCY ASSESSMENT
Upon recognition of a release or threatened release, the Facility
Emergency Coordinator or the Alternate Emergency Coordinator
should be alerted (see Sec. la&b in the Emergency Response Plan of
this HMMP). In the event that neither of the above persons can be
contacted, then the next person on the Response Team roster should
be called. This roster is to be used until a member of the
Facility Response Team is contacted. It is then that Response
Team member's responsibility to contact and assemble the remainder
of the Response Team.
2. NOTIFICATION
a. (Local Agencies)
The Coordinator or Alternate will determine whether
immediate notification of local emergency response agencies is
necessary. In the absence of either of these persons, any
member of the facility response team or any designated
representative may make that decision. The individual making
this final decision should make use of the Reporting
Requirements outlined in Section 4 of the Emergency Response
Plan to gather the appropriate information and then utilize the
Emergency Notification Telephone Roster also on the same page.
b. (On-site)
If the situation so warrants, other employees of the facility
will be notified using one or more of the following step(s):
~ INFORM THE EMERGENCY COORDINATOR
~ ACTIVATE THE RESPONSE TEAM
~ NOTIFY ALL OTHER SITE PERSONNEL USING:
_ AUDIBLE ALARM SYSTEM PUBLIC ADDRESS (LOUDSPEAKER)
_ VISUAL ALARM VERBAL (SHOUTING)
TELEPHONE
3. EVACUATION
a. Evacuation of the facility, if required, will follow the
designated routes (if unobstructed) as diagrammed on the Site
Plot Plan. These are posted in highly visible areas through the
facility. Employees will be notified to evacuate by the
following signal:
_ AUDIBLE ALARM SYSTEM _ PUBLIC ADDRESS (LOUDSPEAKER)
_ VISUAL ALARM ~ VERBAL (SHOUTING)
TELEPHONE
-17-
CircLe K Corporation #8605 (C) E.M.S.S.-IO/BB
4. SHUTDOWN
Ail operation clerks or designated operators are responsible to
ensure the shutdown of their area of responsibility (if possible)
before evacuating. This includes elimination of potential
ignition sources in the case of the release of flammable material.
5. PREVENTION
A ~revention/maintenance program has been implemented for the
review of methods leading to the potential reduction of a
hazardous material release. One or more of the following methods
has been used:
~ PERIODIC INSPECTIONS
CORROSION MAINTENANCE
PERIODIC EQUIPMENT MAINTENANCE
APPROVED CONTAINERS
MARKED EMERGENCY EXIT(S)
FIRE EXTINGUISHER(S) SERVICED
CHEMICAL HANDLING TRAINING
SAFETY TRAINING
CORROSION MONITORING PROGRAM
~ DAMAGED CONTAINER INSPECTIONS
~ PROPER WARNING LABELS ON CONTAINERS
~ APPROVED FLAMMABLE STORAGE AREA
~ PROPER SEPARATION OF CHEMICALS
~ GENERAL HOUSEKEEPING
~ PROPER VENTILATION
~ OTHER
a. Steel posts installed to prevent vehicle collision with pumps.
b. Vapor Recovery Systems used when filling underground tanks.
c. Dual hose systems on pumps.
d. Anti-lock nozzles at pumps.
e. No sales to non-authorized containers.
f. No smoking signs posted.
g. Self-serve instructions posted.
h. Tanks checked periodically for leaks by comparing gallonaqe measure-
ments with sales records.
i. Underground tanks are of fiberglass construction.
See next page(s) for applicable Emergency Response Steps.'
-18-
C~rcle K Corporation #8605 (C) £.M.S.$.-10/88
EMERGENCY RESPONSE STEPS
MITIGATION AND ABATEMENT
A. FOR THE FOLLOWING SUBSTANCE(S)=
Gasoline - Ail Grades
MITIGATION:
1. Follow emerqency notification procedures as indicated in plan.
2. In case of spill take protective measures to control spread of
fluid such as preventative dikinq with absorbent materials.
3. Shut off all emerqency switches to prevent further spillaqe.
4. Barricade area to prevent possible exposure to qeneral public.
5. Avoid personal exposure to fumes/vapors and contact with liquid
6. Eliminate all sources of iqnition in area of spill or vapors.
7. Absorb liquids with absorbent materials and remove to safe area
for evaporation.
ABATEMENT:
1. Notify Circle K Environmental Director for co-ordination with
hazardous waste disposal company to remove contaminated
absorbent materials if required.
B. FOR THE FOLLOWING SUBSTANCE(S):
Carbon Dioxide
MITIGATION:
1. Evacute all nonessential personnel from affected area.
2. Close valve if possible.
3. Open all doors to ventilate affected area.
ABATEMENT:
Contact supplier of material release.
-19-
circle K Corporation #8605 (C) £.M.$.$. - 01/89
TRAINING OUTLINE
A. HANDLING HAZARDOUS MATERIAL
Special on-the-job training (OJT) in the handling of hazardous material(s)
is provided in the following area(s):
1. Proper maintenance and use of qasoline equipment.
2. Use of kitty litter for small spills.
3. Employees are instructed on proper response to police, fire department,
emerqency medical and Circle K Environmental Department.
4. Each Circle K qasoline store has a Company supplied qasoline manual.
The MSDS for each appropriate hazardous substance is used to provide:
1. Recognition of the physical and chemical properties of each
substance.
2. Knowledge of the toxicity involved in usage of the substance.
3. Knowledge of the potential health hazards from use of the
chemicals.
4. Understanding the first aid steps to counteract any effects
of improper exposure to the chemical.
5. Knowledge of any precautions or protective equipment which
must be used or worn when handling the chemical.
The information learned from the study of the MSDS for each appropriate
hazardous material will be reinforced through one or more of the following
methods:
1. Reading each appropriate MSDS.
2. Worksheets.
3. Classroom instruction.
_ 4. Use of videos/films where available.
5. Training Labs.
~ 6. OJT.
B. EMERGENCY RESPONSE PLAN
A review of the contents of the Emergency Response Plan will be
made by all new employees within one month(s) of hiring and by all
employees on an annual basis. During this review, one or more of the
following objectives will be accomplished:
1. Familiarization with the ERP in general.
2. Familiarization with the procedures for notifying the on-
site emergency response team
3. Familiarization with the procedures for notification and
coordination with local emergency response organization.
4. Familiarization with the use of the Emergency Telephone
Roster.
5. Familiarization with the evacuation procedures and routes
involved in the case of an emergency. Escape routes are posted
in highly visible sections of the facility and exit doors are
clearly marked.
-20-
Circle K Corporation #8605 (C) E.M.S.S.-10/88
TRAINING OUTLINE (con,t)
ERP training may be reinforced by:
~ 6. Practice emergency drills and exercises.
~ 7. Repeated. instructional tours of the facility.
C. SAFETY AND EMERGENCY EQUIPMENT USAGE
Formalized training will provide familiarization with one or'more of
the following:
1. The location and proper use of fire fighting equipment.
2. The location of and procedures for facility shutdown. This
includes the location of the turnoff valves for gas and
electricity.
_ 3. The proper use and wearing of protective gear and clothing.
4. The location and use of emergency communication equipment.
~ 5. The proper use of equipment used in the day to day business.
The training will be accomplished through one or more of the following
methods:
1. Reading of material.
2. Classroom environment.
3. Instructional Labs.
~ 4. OJT
D. RECORD KEEPING
Training records are kept on each employee as to:
Overall Traininq. Dates Traininq Received.
E. TRAINING COORDINATOR
The following person has been designated as the training coordinator:
Barbara Myatt - Corporate Trainer
He or she may be reached at (209) 298-3036.
-21-
circle K Cor~ration #8605 (C) E.M.S.S.-10/88
B~ERSFIELD CI~ FIRE DEP NT
21oo "G" STREET RECEIVED
BAKERSFIELD, CA 93301
(805) 326-3979 JUN 6 1988
OFFICIAL USE ONLY /~-/~ ~~~
IB~
HAZARDOUS ~TERIALS ~~
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
A. BUSINESS NAME: CIRCLE K COP. PORATIONS~RE.#8605
B. LOCATION / STREET ADDRESS-:---560,0 .AUBURN ST. BLDG #2
CITY: BAKERSFI~T.D ZIP: 93R~6 BUS.PHONE: (805). g71-7q7q
SECTION 2: EMERGENCY NOTIFICATIONS
In case of an emergency involving the release or 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
l~w.
EMPLOYEES TO NOTIFY IN CASE OF EMERGENCY: AT_LPH~ #2U~,F_ACODE 805
NAME AND TITLE DURING BUS. HRS. AFTER BCS, HRS,
A. URSULA H~SON Ph# 834-8422 Ph# 836-1325
B. ANN B~Y Ph# 871-7979 Ph~ 871-8553
SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE
A. NAT. GAS/PROPANE: WEST SIDE OF STOR~ BLDG, SQUTH END, EXTERIOR,
B. ELECTRICAL: NORTH SIDE OF BLDG, EAST END, EXTERIOR.
C. WATER: WEST SIDE OF BLDG,, CENTER EXTERIOR.
D. SPECIAL: GAS PUMPS, REDB~ ON CONSOLE, CASHIER AREA, INTERIOR.
E. LOCK BOX: YES / NO IF YES, LOCATION:
IF YES, DOES IT CONTAIN SITE PLANS?' YES / NO MSDSS? YES / NO
FL00R PLANS? YES/ NO KEYS? YES / NO
SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE
NONE, local fire dept is relied upon for fires and licensed contractors
are utilized in the event of a spill requiring cleanup.
SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOb~R BUSINESS AS A WHOLE
Dial 911 fortransportation of. injury victims to MERCY HOSPITAL
on Truxton Ave in Bakersfield, if necessarY.
SECTION 6: EMPLOYEE TRAINING ( see attached Section III , A., B., C,. and D.)
EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PR0VIDES EMPLOYEES WITH INITIAL AND
REFRESHER TRAINING IN THE FOLLOWING AREAS.
CIRCLE YEs OR'NO . INITIAL REFRESHER
WITH RESPONSE AGENCIES: ' ]~_Q~NO ~ NO ~rM/f~H~
C. PROPER USE OF SAFETY EQUIPMENT: ................. ~ NO ~ NO
D. EMERGENCY EVACUATION PROCEDURES: · NO NO f~c77d~/
DO YOU Y~INTAIN EMPLOYEE TRAINING RECORDS:., ..... NO NO ~
E.
SECTION ?: HAZARDOUS MATERIAL
CIRCLE YES OR NO
DOES YOUR BUSINESS HANDLE HAZARDOUS ~RTERIAL IN QUANTITIES LESS THAN 500 P~F A
SOLID,. 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ..... ~NO
I, Michael Schumacher ., certify that the above information is accurate.
I understand that this information will be used to fulfill my firm's obligations under
the new California Health and Safety code on Hazardous Materials (Div. 9.0 Chapter 6.95
Sec. 25500 Et Al.) and that inaccurate information constitutes perjury.
'SECTION III: ~PLOYEE TRAINING PROGRAM
A. Methods for Safely Handling Hazardous Materials: (Pertinent Excerpts from MSDS)
FIRE AND EXPLOSION INF~4ATION (Gasoline)
This material presents an extreme fire hazard. Liquid very quickly evaporates,
even at low temperatures, and forms vapor (fumes) which can catch fire and burn
with explosive violence. Invisible vapor spreads easily and can be set on f~re
by many sources such as pilot lights and electrical motors and switches.
Unusual Fire and Explosion Hazards: Highly flanxnable. Products of combustion
may contain carbon monoxide, carbon dioxide, and other toxic materials. Do not
enter enclosed or confined space without proper protective equipment includLng
respiratory Protection.
SPECIAL PROTECTIVE INFO~4ATION (Gasoline)
Eye Protection: Keep away from eyes. Contact can be avoided by wearing chemical
safety goggles.
Skin Protection: Keep away from skin. Contact can be minimized by wearing
impervious protective clothing including chemically resistant gloves. Launder
contaminated clothing before reuse. Extremely contaminated leather shoes should
be discarded.
Respiratory Protection: 'Avoid prolonged breathing of vapor by using approved
respiratory protection. In outdogr areas, ventilation is usually adequate to
Prevent prolonged breathing of high vapor concentration.
Ventilation: Use this material only in well ventilated areas.
SPECIAL PRECAUTIONS INFORMATION (Gasoline)
NEVER siphon gasoline by ~outh. READ AND OBSERVE ALL PRECAUTIONS WITHIN THIS MSDS.
Use only as a motor, fuel. Do not use for cleaning, pressure appliance fuel, or
any other such use. DO NOT USE OR STORE near flank, sparks, or hot surfaces. USE
AND STORE ONLY IN COOL, WELL VENTILATED AREA. Keep container closed. DO NOT TRANS-
FER LIQUID TO AN UNLAB~T.W.D CONTAINER. DO NOT weld, heat or drill container.
Replace cap or bung. Emptied container still contains hazardous or explosive vapor
or liquid.
NO S~4OKING: Signs should be posted, but if you see someone smoking on the
gasoline or diesel island, advise them over the intercom that
it is unlawful and dangerous to smoke in that area.
coNTAINERS: Gasoline and diesel containers should be red. Do not sell
product to customers who have containers which are various
colors other than red or who are using an unauthorized
container such as glass.
(Section III cont. )
B. Procedures for coordinating Activities with Response Agencies:
Store employees have emergency list of telephone numbers for fire department
and medical facilities and regulatory agencies for timely notification.
They are instructed to cooperate in spills reporting and clean-up if needed.
C. Proper Use of On-Site Safety Equipment by Employees:
Store employees are provided with emergency fire extinguishers and are aware
of its location and how to use it. They are trained in use of emergency~shut-
off switch for pumps.
D. Familiarization with the Business Emergency Response Plans and' Procedures (Sections I A through II B )
Store managers are ~responsible for acquainting employees with procedures in
event of emergency. Training includes Handling spills and checking equipment
to insure safe working order as well as reporting incident or situation
requiring correction.
: BAKERSFIELD CITY FIRE DEPA
'- ~ 2130 "G" STREET . '
BAKERSFIELD, CA 93301
OFFiCiAL USE ONLY
ID#
BUSINESS N~%[E:
BUSINESS PLAN
· SINGLE FACILITY UNIT .
FORM SA
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 FACILITY UNIT LISTED BELOW
'4. Be as BRIEF and CONCISE as possible.
FACILITY UNITg ~ ~ O ~-' FACILITY b~IT NAME: CIRCLE K STORE ~ ~ GO
SECTION 1: MITIGATION) PREVEN~ION~ ABATEMEN~ PROCEDURES
(see attached section I: procedures(with pertinent excerpts frcm MSDS. )
'FLSDS for Gasoline is located in Gasoline Operations Manual in Cashier area
SECTION 2: NOTIFICATION k~\q] EVACEATION PROC£DL'R£S AT TI~I$ I;~IT
A. :, ~l~ees ~e ~st~ct~ to repo~ ~y ~cident such as a ~ or f~e
~iately to t~ appropriate ~rgen~ res~nse t~ ~ t~ ~~te
~ea such as f~e dep~nt etc. ~dition~ly the store ~ag~ is
~st~ct~ to re~ ~y env~o~nt~ly ~ous condition
by 1~ ~d to t~ necess~ cle~-up effo~s. ~ese not~i~tions wo~d
~ by phone ~ event of ~rgen~ re~9 ~ick response.
B. ~d~te. Notification ~d ~acuation of Yo~ Facility:
T~ duty clerk on-site is ~st~ct~ to ~iately so~ a v~
to ~1 ~rsons ~ t~ facility ~d adjacent ~ea ~d advise t~ to leave
the ~ea to a place of s~ety. Most facilities ~ve a back d~r for'
~rgen~ e~ts.
.Then the .cl~k is to re~ the ~cident or ~ to f~e de~nt
list~ ~ ~gen~ res~nse list of phone n~rs at store.
- '3A -
SECTION 3: HAZARDOUS MATERIALS FOR THIS b~IT ONLY
A. Does this Facility Unit contain Hazardous Materials? ' V.E~N0
If YES, see B.
If NO, continue with SECTION 4.
B. Are any of the hazardous materials a bona fide Tradesecret YES~.
if No, complete a separate hazardous materials inventory
furm m~rked: NON-TRADE SECRETS ONLY {~hite form ~4A-1)
If Yes, complete a hazardous materials inventory form marked:
TRADE SECRETS ONLY {yellow form ~4A-Z) in addition to the non-trade
secret form. List only the trade secrets ~n form 4A-~.
SECTION 4: PRIVATE FIRE PROTECTION
FIRE EXTINGUISHER LOCATED ON PREP[[SES FOR USE BY CLERK ON DUTY. ~ · '~:~ '5 ' ~
SECTION $: LocAtIoN OF WATER SUPPLY FOR USE BY EMERGENCY RESP0~ERS ."<:-:"'..:':. -' '~'~"'"
ciTY '~:RE HYDRANT LOCATED '~T SOUTH/EAST coR~Z~ OF LOT.' .~' ... ',.: .:.: ,i~.¥: ~-......
SECTION ~: L6CATION OF UTILITY SHL~-0F~S AT THIS UNIT ONLY.
A. NAT. 'GAS!'PROPANE%
METER/VALVE LOCATED AT EXTERIOR OF BUILDING ON WEST WALL AT SOUTH END.
B; ELECTRICAL:
LOCK -BOX TYPE MAIN.. POWER BREAKERS LOCATED EXTERIOR OF NORTH WALL OF BUILDING
AT EAST END.
._ C. WATER:
MAIN METER/VALVE EXTERIOR WEST WALL, CENTER.
D. SPECIAL:
~I~ERGENCY SHUT-OFF SWITCH FOR .GASOLINE PUMPS INSIDE STORE, CASHIER AREA.
(RED BIfI'BDNON CONSOLE)
.~--.~
E. LOCK BOX:
~S,
LOCATION:
IF YES, SITE PLANS? YES / NO -MSDSs? YE~ / NO
FLOOR PLAXS? YES / NO KEYS? YES / X0
'; SECTION I: PROCED~
(Mitigation, Prevention, and Abatement of Hazards:) i '
A.I PREVENTION _ ~ ~
a. High impact steel posts are positioned to preVent vehicle collision with pumps.
b. Ap~r6ved vent hoses and anti-l~ck nozzles are 'used at pumps.
c. Patrons are prevented' from using non-authorized containers.
d. Tank gallonage is checked against sales to'detect leaks.
e. Fumes are properly collected during supplier deliveries.. ~.
f. Red Jacket Leak Detectors inst_a]]ed on pump supply line.
B. MITIGATION
IN CASE OF FIRE
Extinguishing Media: Use dry chemical, - foam, or carbon dioxide. ' .....
Special FLre Fighting Pr~ures: Water may be ineffective to ~x~in~ish,
but water should be used t~g~keep fire-exposed, containers c0ol.' -If a leak
or spill has not ignited, use water spray to disperse the vapor, and to protect
personnel attempting to stop a leak. Water spray may be used to flush spills
a~cay from exposure. ' '" ' '"" ~ -. ~' .~
Thi's material is flaccnable. Appropriate precautions should be taken. ' Contain
spill inmediately in sma]lest area possible. Recover as much of the product .
itself as possible by such methods as vacuuming, followed by soaking up of .....
residu~al fluids by use of absorbent materials. -Remove. 'contaminated items
including contaminated soil and place~ in proper containers for disposal.
Avoid washing, draining or directing material to storm or sanitary sewers.
WASTE DISPOSAL METHODS ..
Recycle as much of the recoverable product as possible. Dispose of nonre-
cyclable materials in a manner consistent with applicable federal, state
and local regulations as a hazardous waste. .~
EMERGENCY AND FIRST AID PROCEDURES ?~_
EYES: Flush eyes in~nediately with fresh water for at leaSt 15 minutes
while holding the eyelids open. If irritation persists, see a doctor..
SKIN: Remove contaminated clothing as soon as possible. Wash skin thoroughly
with soap and water. See a doctor if any symptons described in this
MSDS develop or if any skin irritation occurs. Launder contaminated
clothing. ,_ . - _ .~ - -
INGESTION If swallow~d, do not 'make person 'vomit. Call a doctor inv°ediately.
If vomiting begins, lower victims head in an effort to prevent vcrnitus
from entering lungs. Never give anything by mouth to an unconscious
person.
INHALATION If there are symptons as described in this MSDS due to breathing this
material, move the person to fresh air. If breathing has stopped, apply
-. artificial respiration.. Call doctor inrnediately.
(Section I cont.)
.IN CASE OF FIRE
iHit~ the red ~RGENCY button on the console and shut off any breakers
in the main electrical panel marked for the gasoline or dieSel island.
Call the fire department ~iately.
Have the phone number prominently posted.
Call your Zone Manager or District Manager.
Do~ not resume sellinG product until 'FLre Department apprOVal is received.
IN CASE 0F PRODUCT SPILL
If a Gasoline or diesel delivery transport driver allows product to
overflow on the driveway or if an amount is spilled at the pump islan~
large enough to endanger the public:.
'~ Hit the red EMER~NC~..~ Y button on the ~console.
· Ca] ] the fire department. "Clear' custaTars from the spill area..
Contain sPill. Call the Zone Manager or District. Manager.
Do not resume sellinG product until Fire Department approval is
received. '
IN CASE OF T,FAK. '-'- ·
Notify Zone Manager to institut~e__as~_r_ov~ed.__~_r~pa/r ......................... and testing pr_og__e~.~ur_es
· , . ..BAKERSFIELD CITY FIRE DEPARTMENT ' · '"' ;, :~,', .
I.D. # . .. " FORM 4A-1 Page
NON--TRADE SECRETS .:,4
HAZARDOU.S IVIATER T ALS J NVENTORY
~ S~O~'~ OWNER NA~E:~ CI~cL~ ~CO~f0~T/o~ ' FACILITY UNIT
ADDRESS:BUSINESS NAME:~O0 ~ I~C~~ ~ ADDRESS: {~ ~ '"'7~ ~ FACILITY UNIT NAME :. S~ -."
P,o~'~: (Zo~ ~7/- 7~ P.ON~ ~: F~zN~ _~ [O~CXAL US~ C~X~S COO~
1 2 3 4 5 6 7 8 9 10
TYPE MAX ANNUAL CONT USE LOCATION I~ THIS % BY HAZARD D.O.
CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT WT. CHEMICAL OR COMMON NAME CODE GUIU
..
NAME P~T ~~1~ TITLE: ~ ~l~c~ S GNATURE:Y~-/-/'//_~//~ DATE:
,EMERGENCY CONTACT: ~S~ ~~ TITI. E: ~~ ~g~ PHONE ~ ~US
,., L AFTER BUS HRS:
J~gRO~NgV CON~ACt: ~p9 ~(L~ TIT~B: f~R~. ~~A .....PHONg '~ BgS HOURS:
PRi~cIPAL.BUS~INESS ACTIVITY: ' BsrA~k ~ASo~,~ C ~v~c~ f~ AFTER BUS HRS:
Bakersfield Fire D?pt.
Hazardous Materials Division
2130 "G" Street
Bakersfielcl, CA_ 93301
HAZARDOUS MATSRIALS MANA®EMENT PLAN
INSTRUCTIONS',
1. To avoicl further c~ction, return this fo[m within 30 clays of rec. eipt.
2. TYPE/PRINT ANSWEES IN ENGLISH.
3. Answer 11ue Questions beiow for the Dusine~s c~$ a whole.
4. Be Drier oncl cohci~e c~s possil01e.
SECTION 1: BUSINESS IDENTIFICATION DATA
BUSINESS NAME: Circle K Corooration $8605
LOCATION: 5600 Auburn Street
Circle K Corporate
hAAILIN~ADDR=~S$: P. O. Box 52084, Phoenix, AZ 85072
CITY: Bakersfield STATE: CA ZIp:93306 PHONE:(805) 871-7979.
DUN & BEAD$IEEET NUMBEE: 06-294-4160 SIC CODE: 5541
PEIMA~Y ACTIVIIY: Convenience Sto~a/Gas. Station
OWNEE: Circle K Corporation ~(602)229-8706
MAILING ADDEESS: P. O. Box 52084, Phoenix, AZ 85072
SECTION 2: EMERGENCY NOTIFICATION:
CONTACI TELE BUS. PHONE 24 HE. PHONE
1. Mike SP~nuzzi -...Z°ne Manager (209)29B-3036 (S05) B33-BBB1
2. Don Lewis -.District Manager (209)298-3036 (209) 291-5910
FOI~
BakersMeld Fire Dept. .
· ~I Hazardous Material nivisioe
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 3: TRAINING:
NUMBER OF EMPLOYESS: 3
MATERIAL SAFETY DATA SHEETS ON FILE: Yes
BRIEF SUMMARY OF TRAINING PROGRAM:
Special on-the-job training in the handling of hazardous material(s) is provided in the following areas:
1. Prop~i' maintenance and use of gasoline equipment.
2. Use of kitty litter for small spills.
3. Employees are instructed on proper response to police, fire department, emergency medical and
Circle K Environmental Department.
4. Each Circle K gasoline store has a Company supplied gasoline manual with MSDSs for gasoline and CO2.
A review of the contents of the Emergency Response Plan will be made by all new employees within one
month of hiring and by all employees on an annual basis.
Safety and emergency equipment usage training will provide familiarization with the location and proper
use of fire fighting equipment (fire extinguishers), the location of and procedures for facility shutdown
(including the location of turnoff valves for gas and electricity) and the proper use of equipment used
in the day to day business.
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:
Mike Schumacher CERTIFY THAT THE ABOVE INFOR-
MATION 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 THAT
IN~T E~TES. P ERJ U RY.
Division Manager ~---/'/~F
SIGNACI~RE TtTLE DATE
FOI$~
it~'at~ersfield Fi~e Dept. -
'"Hazardous Materi~ Divisio~
H~RDOUS MATERIALS MANAGeMeNT P~N
Unit Name: Circle K Corporation ~8605
SECTION 6t NOTIFICATION AND EVACUATION PROCEDURES:
A. A,35NCY NOTIFICATION PROCEDURES:'
If emergency response assistance not required, notify:
Bakersfield City Hazardous Materials Division 326-3979 AND
State Office of Emereencv Services (BOO) 852-7550 WITHIN 24 HDUIL3
If release poses present or potential hazard to human health & safety, property or environment,
and emergency assistance is required, in~.,~dimtel~ notify:"
Fire Deoartment - Bakersfield Fire D~oar~ment 911
Police D~oartment - Bakersfield Police D~:~rtm~nt gI1
Bakersfield City Hazardous Materials Division 911
£~a~e O~i~ce of'~m, eroencv ~rv~ces (BDO) 852-7550 or (916) 427-4341
B. EMPLOYEE NOTiFiCAIiON AND ~VACUA~]ON:
Upon recognition of a release, the Duty clerk will verbally {shouting) notify all other site personnel.
The Clerk will ensure the shutdown of his/her area of responsibility {if possible) before evacuating.
This includes elimination of potential ignition sources in the case of the release of fla~able material.
Evacuation will follow the designated routes (if unobstructed) as diagramed on the Site/Plot Plan.
Employees will be notified to evacuate by verbal {shouting) ~thod to a pre-dete~ined evacuation
staging]area where all employees will be accounted for.
C. PUBLIC EVACUATION:
If evacuation from area deemed necessary, ~hese neighboring properties will be notified:
~AME ADDRESS PHONE
Today Cleaners 5600 Auburn Street, Suite ¥ 872-6920
E1 Pollo Plus 5600 Auburn Street, Suite T 872-7587
Scoops "N" Slices 5600 Auburn Street, Suite S 872-2824
Rage Salon 5600 Auburn Street, Sutie 0 872-2360
D. EMERGENCY MEDICAL PLAN:
The primary Co.any medical facility to treat employees injured by a hazardous materials incident:
Mercy Hospital - 2215 Truxton Avenue, Bakersfield - (805)327-3371
Additional Clinics and Hospitals:
B~ersfield FMe Dept~ ~.
Hazardous 5[ateria~ Di~sion
HAZARDOUS MATERIALS MANAGEMENT PLAN
SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN:
GASOLXI~.
A. RELEASE PREVENTION STEPS:
1. Steel ~osts installed to prevent vehicl'e collision with'pumps
Z. Vapor Recovery.Systems used when filling underground tanks which are of fiberglass construction
3. Dual hose systems on pumps. Anti-lock nozzles at pumps
4. No sales to non-authorized containers
5. No smoking signs posted, self ser~e instructions posted
6. Tanks checked periodically for leaks by comparing gallonage measurements with sales records
B. RELEASE CONTAINMENT AND/OR MINIMIZATION:
1. Preventative diking with absorbent materials
2. Shut off all emergency switches to prevent further spillage
3. Barricade area to prevent possible exposure to general public
4.'Avoid personal exposure to fumes/vapors and contact with liquid
5. Eliminate all sources of ignition in area of spill or vapors
6. Absorb liquids with absorbent materials and remove to safe area for evaporation
C. CLEAN-UP PROCEDURES:
1. Notify Circle K Environmental Director (714) 823-0691' ~or co-ordination with hazardous
waste disposal company to remove contaminated absorbent materials if required
~ARBON DIOXIDE
A. RELEASE PREVENTION STEPSt Tanks are stored, upright and firmly secured
B. RELEASE CONTAINMENT AND/OR MINIMIZATION: Close valve if safe to do so, open all doors to ventilate
C. CLEAN-UP PROCEDURES: Ventilate area immediately. Contact supplier if leak in container/valve
SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILffY):
NATURAL GAS/PROPANE: Nest wall of building on south end (meter)
a. Inside back room of store (breakers)
ELECTRICAL: b. North wall of building on east end (meter)
WATER: Southeast corner of site (meter)
Emergency gas shutoff switch:
SPECIAL: At the cashier station on console
LOCK BOX: YES~O~ IF YES, LOCATION:
SECTION 9:. PRIVATE FIRE PROTECTION/WATER AVAILABILITY:
A. PRIVATE FIRE PROTECTION:
Fire extinguishers
B. WATER AVAILABILITY (FIRE HYDRANT):
SoutheaSt corner of site
4.
CI'I'Y o'1: BAKEI-( I-:IELD
HAZARDO'US HATERTALS TNVENTORY
FIrB Ind <iculturl il StindArd Business El NON--TRADE SECRETS PAle 1 oil.._
..uc nc 'ruIs cACTLIlV. Circle K Corporation '
LOCAI]OU: 56oo Auhu~~ ' ~U~88: .... P. O. Box 5~084 ' ~
II
Ira,s ]~ P~ l~f.ge l~,u~l ~a~r~ I ~ont ~ont Us Location
Co~e See Instructions
Stored In
Code Loom ~mL let EsL units on e /ype s lamp
, I , I ~0000 I~000 1 4~900~ I~, I ~ I 01 ]1 1 .I 4 I-l'g IU~e;er6un~'an~m20- soOtheast of storeaPpr°x' __1°° Gasoline-Regular
I~ NA~ I C.A,S, HumbEr 20 Xylene 130-20~
Component
Ilelltb of Pre,sure lie4 ILh
ComponenL 13 H~me I C.A,S. Humber 1o Methyltert Butyl Ether 1634-04-4
...... I .Un'~eraround T~nk: approx. 10~ Gasoline - Unleaded
R j H 110000 15000 1107871 ,,,I GAL I 365 I 01]] 1 I 4 119 I~0 sou~east ct score ~,,
Ph?icll Iod ~elllh Ulilrd C.l.S: Number 8006-61~9 CompoflenL II 'HAme I C,A,S, Humber 25 Toluene 108-88-3
IChecL III Lhlt IPPlII ' -- ,, "'
Component Il HAme I C,A,S, Humber ~0 Xylene 130-20-7
~ Fire flmrd ~ Reactivity ~ OelByed ~ Sudden Release ~
I/el ILb of Pressure lies I Lh
Component I~ Hlel I C,A,S. Humber ~0~ Hethylte~t But~l E:he~ 2634-04-4
, ,, ~nde~ ~oun Gasol ~ne
,~hysiCll Ind fllllth fllllfd C.A.S, Humber 8006-61-9 Componefl[ II HILl I C,A,S, Humber 25 Toluene 108-88-3
~Check all that ~ppl~J .....
CoAponenk U Hams I LA,S, Humber
~ Fire flmrd ~ Reackivitl ~ DelAyed ~ Sudden ~elegse ~ Immediate
11811tb of Pressure IlealLh Component I] HAme I LA,S. Humber ]0 He~h~l~e~ Bu~s1 E~he~ 1634-
Physical Ind flellth ~lllrd C,A,S, Humber 124-38-9 Component II flame I C,A,S, Number
ICheck ,11 that applU
Component U Hame I C,A,S, Humber
U Fire Hmrd ~ R.cUvlt~ '~ Delp~e4 ~ Sudden ~elease ~ Immediate ~ ..
Ilealth of Pressure Ilealth Component I~ Hsme I C,A,S. Humber
Mike Spinuzzi Zone Manager (805)833-8881 fl2Ri_., llCll
SUDlltleO tnlOrmlLlOfl Il UUl, Iccurlte, Ino complect.
MIKE SCHU~CHER - DIVISION ~HAGER