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Home My WebLink AboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF ~PERMIT ON REVERSE SIDE ' This permit is issued for the followin_~: [] Hazardous Materials Plan [] Underground Storage of HazardOus Materials Permit ID #:: 015-000-001286 [] Risk Management Program I [] Hazardous Waste On-Site Treatment FOODTOWN MARKET LOCATION: 430 BRUNDAGE LN IELD OFFICE OF ENVIRONMENTAL SER VICES JUN ~ 8 20~[1 1715 Chester Ave., 3rd Floor Approvedby: "(..~U~H.u[y,.D~ ~ssue Date Bakersfield, CA 93301 Ornc¢orEvironm~S~ices ~ Voice (661) 326-3979 FAX (661) 326-0576 Expiration Date: 'June 30, 2003 Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE This permit is issued for the following: FOODTOWN MARKET LOCATION 430 BRU N DAG E:,,:.'?~?/~ .......... ~[~, '~'.. ',~ ~'3 .1. '- :.'i H?' '~ ~. ~'~ · ~ ~;: ' , '. '~ "%' "-~ ': ~ '-..-.---. 2 ',~ ~ · -'.'":... ,:~' ~['= ;: ~,.~' B~ersfield Fke Depa~ment Approv~ by: Hu~ B~e~fiel~ CA 93301 Voice (805) 32&3979 F~ (805) 32~576 ' Expiration Date: Hazardous Materials/Hazardous Waste Unified Permit ~-CONDITIONS OF PERMIT ON REVERSE SIDE This ~ermit is issued for the followin_e: [] Hazardous Materials Plan [] Underground Storage of Hazardous Materials Permit ID #:: 015-000-001286 El Risk Management Program FOODTOWN MARKET ~ Hazardous Waste On-Site Treatment LOCATION: 430 BRUNDAGE LN OFFICE OF ~N~R ONMENTAL S~R VICES 1715 Chester Ave., 3rd Floor Appmvedby: ·Bakersfield,' CA 93301~~ -~OmceofEvm~S~ic~ ' r Voice (661) 3~6-3979 F~ (661) 326-0576 Expi~tionDate: Jun~ ~O~ ~OO~ Receipt Fee ~=naorsement Required) 'Poslma~~ Hem UNITED STATEs POSTAL SERVICE First-Class Mail Postage & Fees USRS Permit No. G-10 '~'° Sender: Please print your name, address, and ZIP+4 in this box · OFFICE OF ENVIRONHgNTAL SERVICES - 1715 CHESTER' AVENuE B~KERSFIELD, CA 93301 B. Date of Delivery · Complete items 1, 2, and 3. Also complete A. Received by item 4 if Restricted Delivery is desired. · Print your name and address on the reverse so that we can return the card to you. E;! Agent · Attach this card to tl~e back of the mailpiece, [] ,Addressee~ or on the front if space permits, from item 17 [] Yes enter delivery address below: [] ~ 1. ?Article Addressed tO: ~;, THE GRAIN ;ER? · f~30 BRUNDAGE LANE BAKERSFIELD, CA 93304 ', I I~ Certified Mail [] Express Mail , ' I [] Register? [] Return Receipt for Merchandise L [] Insured Mail [] C.O.D. __ '- ' .....................~"l' 4..~Restricted Delivery? (Extra Fee) [] Yes 2. Article Number (Copy from service label) 7000 0520 0021 9610 7592- ,, 102595-99-M-1789 PS Form 3811, July 1999 Domestic Return Receipt May 16, 2001 \ The Grainery ~ 430 Brundage Lane Bakersfield, CA 93304 Via certified F~RE C.~EF Subject: Revocation of The Grainery;,Permit to Operate RON FRAZE Dear Business Owner: ADMINISTRATIVE SERVICES ;~, 2101 "H" Street . Bakersfield, CA 93301 , VOICE (661) 3:>6-3941 Your "Permit to Operate" at.430 Bmndage Lane, known as The Grainery is being ~ FAX (661)395-1349 revoked effective Monday, May 28, 2001, at 5:00 p.m. This "Permit to Operate" is SUPPRESSION SERVICES being revoked due to failure to pay' current as well as past due fees. 2101 "H" Street Bakersfield, CA 93301 ¥O~CE (661) 328-3941 ']'his action can be avoided by bringing your account current prior to that time. I£ you FAX (661)395-1349 have any questions, please call me at (661) 326-3979. PREVENTION SERVICES 1715 Chester Ave. Sincerelv,_ Bakersfield, CA 93301 VOICE (661) 326-3951 ENVIRONMENTAL sERVIcES 1715 Chester Ave. Bakerslield, CA 93301 VOICE (661) 326-3979 Ralph E. Huey, Director FAX (661) 326-0576 Office of Environmental Services TRAINING mVlmON 5642 Victor Ave. RI-Bdb Bakersfield, CA 93308 VOICE (661)399-4697 FAX (661) 399-5763 CC: Walter Porr, Jr., City Attorneys Office' Steve Underwood, Environmental Services Esther Duran, Environmental Services Drew Sharpies, Treasury F OODTOWN MARKET //~;~O~/~sPh0ne:SiteID: 0i5-021-001286 Manager : (805) 327-3057 Location: 430 BRUNDAGE LN zC~l~_ ~ ~p : 103 CommHaz : Low City : BAKERSFIELD z//v/~n ., ;0~rid: 31D FacUnits:. 1 Lev: CommCode: BAKERSFIELD STATION 06 ~ SIC Code: EPANumb: ' c~t~unnBrad: · 1 Emergenc'~Contact / Ti~e Emergency contact / Title STEVE JO N_m % . / / JAY SHIN / AGER Business Phone.~~327-3057x / Business Phone: (805) 327-3057x 24-Hour Phone~,,~'~80~-3418x ! 24-Hour Phone : (805) 665-8724x Pager~~,~: ~~). ~~~ Pa~er Phone : ( .) - x Hazmat~ Hazards: /~'..~ ~~/.. Im~lth Do1Hlth Contact : Phone: ( ) - x MailAddr: 430 BR~DAGE LN State: CA City : BAKERSFIELD Zip : 93304 Owner .PATRICIA & ROBERT HO Phone: (805) 327-3057x Address : 8204 BIRGI~ ST State: CA City : BAKERSFIELD Zip : 93311' Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: C~GE OF O~ER: IN MO CHUG P~ GIVEN 1-20-99. ED SENT AGAIN 8-29-99 - NO REPLY. THI.S_IS_3~_~D_EIN~_NO~TI~E] ---- Hazmat Inventory One Unified List --As Designated Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm DailyMax IUnitlMCP BLEACH ~,/~~ IH DH n 150.00 GAL Hi " i, . cC~-~.....~ Do hereby certify that I have reviewed the attached hazardous materials rnaqage- ment plan fo~r-~.~_.f~_ ~---'.~)and that i~ along with (Name~Sf any corrections constitute a complete and correct man- agement plan for my facility. f FOODTOWN MARKET SiteID: 015-021-001286 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site BLEACH Days On Site 365 Location within this Facility Unit Map: Grid: AISLE CAS# 7681529 F STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid /Pure Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average GALI 150.00 GAL 50.00 GAL HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Bleach N 7681529 HAZARD ASSESSMENTS No No NoIIIN°/ Curies IH DH / / / Hi -2- 07/26/2000 F FOODTOWN MARKET SiteID: 015-021-001286 Fast Format ~ Notif./Evacuation/Medical Overall Site --Agency Notification 05/02/1991 CALL 911 -- Employee Notif./Evacuation 05/02/1991 VERBALL AND PUBLIC ADDRESS NOTIFICATION. CALL 911. -- Public Notif./Evacuation 05/02/1991 INSTORE PUBLIC ADDRESS SYSTEM Emergency Medical Plan 05/02/1991 NEA.REST HOSPITAL. -3- 07/26/2000 F FOODTOWN MARKET SiteID: 015-021-001286 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site9 --Release Prevention 07/30/1992 PRODUCTS ARE PACKAGED FOR RESALE IN SMALL QUANTITIES. -- Release Containment 07/30/1992 MOP AND BUCKET -- Clean Up 07/30/1992 MOP UP Other Resource Activation -4- 07/26/2000 F FOODTOWN MARKET SiteID: 015-021-001286 I Fast Format ~ Site Emergency Factors Overall Site i Special Hazards --Utility Shut-Offs 03/28/1990 A) GAS - OUTSIDE IN ALLEY NORTH B) ELECTRICAL - OUTSIDE IN ALLEY NORTH C) WATER - SOUTHWEST END OF PARKING LOT ON BRUNDAGE D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 03/28/1990 PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER, ANSOL SYSTEM FIRE HYDRANT - CORENR OF T & BRUNDAGE ST. Building Occupancy Level -5- 07/26/2000 FOODTOWN MARKET Training ~~~~~~~~ Overall Site i~ Employee Training ~~~/~~~{5~{5~ 05/02/1991 o WE HAVE 8 FULL TIME AND 12 PARTIME EMPLOYEES AT THIS FACILITY o o WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE o o BRIEF SUMMARY' OF TRAINING: TRAINED ON CLEAN-UP. INSTORE TRAINING ON o MOPPING AND DISPOSING OF WATER. ° o O i~eCe Held for Fumre Use i~¢~ Held for Fumre Use ~e~~~~e~e~¢~~i o o 04/14/92 FOODTOWNoverall 'MARKET '215-000'001286 I~Site with i Fac. Unit jUL 2~9.!99~ page General Information By. Location: 4'30 .BRUNDAGE LN ~ .Map: -103 Hazard: Low. Community:-BAKERSFIELD sTATioN 06. ~Grid: 31D 'F/u: 1 AOV: 0.0 Contact Name~ Title' ;Busi. ness~Phone 24-Hour Phone- STEVE JOHNSON MANAGER (805) 327-3057 x ~ (805) 836-3418 JAY SHIN MANAGER (805) 327-3057' x (805) 665-8724 Administrative Data Mail Addrs: '430 BRUNDAGE LN' _ D&B Number: City: BAKERSFIELD State: CA Zip: 93304- Comm Code: 215-006. BAKERSFIELD STATION 06 SIC' Code:. . Owner: PATRICIA & ROBERT HO Phone: (805) 327-3057 Address: 8204 BIRGINHAM ST~ State: CA City: BAKERSFIELD · Zip: 93311- ~ Summary ~~d ~h~ ~ached hazardous mmenal~ manag plan ~or~~d tha~ it along with (N~e of B~i~) . ~y ~ons ~ns~ule a compl~[~ and corre~ man- 04/14/92 FOODTOWN MARKET 215-000-001286 ~ Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number. Order 02-001 BLEACH Liquid 100 High ~ Immed Hlth, Delay Hlth GAL CAS #: / Trade Secret: No / Form: Liquid Type: Pure Days: 365 ~Use: CLEANING -/ -- Dai~y Max GAL Daily Average GAL Annual~Amount GAL · ~~~-,~*O ....... ~-,-'-~o0 I ~0.00 I ~,0oo.00 ~_,/'~ st°'rage PressT Temp Location PLASTIC CONTAINER IAmbientlAmbientlAIsLE -- Conc Components MCP List 100'.0% IBleach IHigh --~ 04/14/92 F00DTOWN MARKET 215-000-00!286 Page 3 00 - Overall Site <D> Notff./EvaCuation/Medical <1> Agency NotificatiOn CALL 911 · <2> Employee Notif./Evacuation VERBALL AND PUBLIC ADDRESS NOTIFICATION. CALL 911. <3> Public Notif./Evacuation INSTORE PUBLIC ADDRESS SYSTEM <4> Emergency Medical Plan NEAREST HOSPITAL.. 04/14/92 FOODTOWN MARKET 215-000-001286 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention' PRODUCTS ARE PACKAGED FOR RESALE IN SMALL QUANTITIES. <2> Release Containment <3> Clean Up MOP UP <4> Other Resource Activation 04/14/92 FOODTOWN MARKET 215-000-001286 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-O.ffs A) GAS -. OUTSIDE IN ALLEY NORTH B) ELECTRICAL - OUTSIDE'IN ALLEY NORTH C) WATER - SOUTHWEST END'OF PARKING LOT ON BRUNDAGE D) SPECIAL - NONE E) LOCK BOX - NO · <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHER,. ANSOL SYSTEM FIRE HYDRANT -.CORENR OF T & BRUNDAGE ST. <4> Building OccUpancy Level 04/14/92 FOODTOWN MARKET 215-000-001286 Page 00 - Overall Site <G> Training - <1> Page 1 WE HAVE 8 FULL TIME AND 12 PARTIME EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETy DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: TRAINED ON CLEAN-UP. INSTORE TRAINING ON MOPPING AND DISPOSING OF-WATER. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use 0'3/27/91 ~TOWN MARKET 215-000-( 86 Page~ 1 11 Site with 1 Fac. l~l~it General Inforrnation Locat~ion: 430 BRUNDAGE' LN Map: 1(:}3 Hazard: Low I ldent Nurnber: 215-000-001286 ,Grid: 3iD Area c,f Vul: 0~0~ Contact Name ~ Title. Business Phc, ne ~(80~) Adn~inistrative Data Mail Addrs: 430 BRUNDAGE LN D&B Number: City: BAKERSFIELD state: CA Zip:~ 93304- Comm Code: 215-006 BAKERSFIELD STATION '06 SIC Code: Surnrnary ~ECEI~D ~, ~_~'~-~_u¢ ~o~v'~___ Do hereby cer~iiy ~ha~ I h~e , (~ ~ print n~e) reviewed ~h~ ~'~tached '"'~:~"'~ '~' ~':: m~terials manage- merit plan for~ E~. ~-~d qhat it al°ng with ~n~ Oormclbns cons~i~u~ ~ compi~e ~nd correc~ m~n~ azr,~mt Ir, ver, tc~y List ir, MC~O~de~ )~ - Fixed Cor, tair, ers or, S~te Plr,-Ref, Narne/Haza~ds Fo~-r,~ Quar~t i'ty MCP O2-OO1 BLEACH Liquid 1OO .... Hi gh Ir~r,~ed Hlth~ Del~ay Hlth GA~L 03/~7/91 fOODTOWN MARKET 215-000- 86 Page 3 O0 - Overall Site <D> Not if. /EYacuat ion/Medical <1> Agertcy Notification CALL 911 <2> Employee Notif. /Evacuatior, VERBALL AND PUBLIC ADDRESS NOTIFICATION. CALL 91 . <3> Public Notif. /Evacuatiori · NONE LISTED 7~ X¢o~ Po61k ~oo~ sy~ <4> Emergency Medical Plar~ NEAREST HOSPI]'AL. 03/27/9i J~ODTOWN 'MARKET 2 i 5-000-(~886 page 4 ~ ' 00 - Overall Site <E> Mit igatior,/P~ever, t/A~ater~t <1> Release Preverltior, , PRODUCTS ARE PACKAGED FOR RESALE IN SMALL .QUANTITIES. <2> Release Cor, tairm~er, t <'3> Clear, Up <4> 'Other Resource Activatior~ 03/~7/91 OODTOWN MARKET 21 Page 5 O0 - Overall Site <F> Site Emerge~'~y Factors <1> Special Hazards _ <2> Utility Shut-Offs , A) GAS - OUTSIDE IN ALLEY NORTH B) ELECTRICAL - OUTSIDE IN ALLEY NORTH C) WATER - SOUTHWEST END OF P, ARKING LOT ON BRUNDAGE D) SPECIAL - NONE E) LOCK BOX - NO <3> .Fire Protec. /Avail. Water PRIVATE FIRE, PROTECTION FIRE EXTINGUISHER, ANSOL SYSTEM FIRE HYDRANT - CORENR OF' T & BRUNDAGE,ST. <4> Held f,-,r Future u'se 03/27/91 OODTOWN MARKET 215-000-~286 Page 00 - Overall site . . <G> Training <1> Page 1 WE HAVE 8 FULL TIME AND' 12 PARTIME EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF '[RAINING: TRAINED ON CLEAN=UP <2>. Page 2 as needed <3> Held for Future Use <4> Held for Future~ Use i CITY Of BAKERSFIELIJ HAZARDOUS MATERIALS INVENTORY ~'. '~ Farm and Agriculture U Starldard Business [] NON--TRADE SECRETS BUSINESS NAME: :OWNER NAME: ' : NAME OF THIS FACILITY: ' ,'- LOCATION: ADDRESS: ' . _ STANDARD IND CLASS CODE~' ! NSTRU~TIO~S FOH PROPER CODES 1 2 3 4 i 5 6 , 8 9 10 11 12 ~i!y Names of ~ixturetCo'~°nents Trans t~ Nax Average i: Annual Measure , ~y~ Cont. Cont Cont UsStoredl°Cati°n?eEe',n Pac,,,ty ' ,Code Ami . on Amt f' Est UflltS ~lte Type Press Temp Cole See Instructions , Physical And Health Hazard ~ C.A.S. Number Component l1 Name I C.A.S. Number ~ .~ , (Check all that apply) ' ~ ,. Fire Hazard ~ Reactivity ~ Oelayed ~ Sudden Release ~ Im~i~C°mp°nent 12 Name I C.A.S, Number · Health of Pressure . ~. Component 13 Name I C.A,S. Number Physical and Health Uazard [: C,A.S. Number Component l1 Name & C,A.S. Number (Check al/ that app/y/ ~ , , ~: Component 12 Name I C.A.S, Number ~ Fire Hazard 0 Reactivity~ ~ Oelayed ~ Sudden Release ~ Im~i~ . ~: Health of Pressure Co~ponenC 13 Name I C.A.S, Humber Physical and Health Haiard ~ C.k.S. Number Component Il Name & C,A.S, Number : (Check al1 Ch4C apply) ~ Component t2 Name I C,A.S. Number ~ Fire Hazard ~ ReactiviLy~; 0 Delayed ~ Sudden Release ~ Im Health of Pressure ~ , Component 13 Name I C.A,S. Humber PhysicAt"'lod Health Ualard ~ ' (Check a/libeL applyl ? C.A,S, Number Component l! Name I C.A.S. Number ~ Compon'en[ 12 Name & C,A.S. Number ~ Fire Hazard 0 Reactivit~ ~ Delayed ~ Sudden Release ~ Im~i~ , .. . Health of Pressure ~ Componen~'13 Name I C,A.S. Number .. ~Hr Phone ~et . - . :e~ti[jgatioq ,(Repd ond.,ign af~pr compl,tiog,all sectipnq) cerHty ,unaer penalty ol~w tnqc I nave personalS, examlnq~eqo am tami~ar. ~iLb the i ntormat~on ~u~miLtpd in this.and all Lt~acnea.aocgmenca, an~ t~c oasea on.my ~nqu~ry ~.tnose ~na~woua~s responsible tor obtaining the ~nrormaclon. ] be~eve that the ;uom,ttea,nTormationlscrue, acc=urate, anocomp,ece,':.-.I ~~ ~~fitl]i title ct o~nerloperacor uH o~nerlo~erator's authorized representative . CITY of BAKERSFIELD "WE CARE" FIRE DEPARTMENT ' 2101 H STREET D. S. NEEDHAM BAKERSFIELD, 93301 FIRE CHIEF "Febz-ua,x-y 20~ 199't " 326-3911 . Dear Business.Owner: Enclosed you will find a computer printout of the Hazardous Materials Managemen% Plan that is currently in our computer, we have highlighted the areas that need to be revised. Also enclosed you will find a blank inventory sheet, this shoul~ be used to update or make any necessary changes to your ~nven%opy. The printout along with any inven%ory changes should be returneO to this office by MarchlS, 1991. If you have any questions please don't hesitate to Contact hs at 326-3979. Sincerely Yours, . Valerie Pendergrass Hazardous Materials Division . Enclosures ~ BalrerSfieldFireOept. e~ Business Name: ~o0 ~~ RPn~,,, Location: ~3~ ~'~¢~ /~ ~E 2 f ;~1 . Business Identification No. 21~000 ~¢/~ e ~Cop of Business Plan) ~8'~ Station No. ~ Shift ~ Inspector P~ ~ ~ Adequate Inadequate Verification of Invento~ Materials ~ ~ ~ ~ Verification of Quantities ~ ~ Verification of Locaion ~ _ . _ Proper Segregation of Materi~ ~ Comments: Verification of MSDS Availabli~ ~ Number of Employees Verification of H~ Mat Training~ Comments: c~~ Aov/~ :~ ~-:/~ Verification of Ab~ement SUpplies & Procedures ~ Comments: Emergency Procedures Posted ~ Containers Properly Labeled ~ Comments: Verification of Facility Diagram ~ Special H~ards Associated with this Facility: Violations: ,.¢-~...~...~,o~.~: or'" ~-,~L.~,J All Items O.K. ~ ~:~ Co rre ct ion Needed ~ ne~lanager ( /D 1652~.~(~' 1-90) W11ite-Haz Mat Div. Yellow-Station Copy Pink-Business Copy . BAKERSFIELD CITY FIRE DEPARTMENT I.n. # FOR~{ 4A-~ Pag~ ,'j~__ NON--TRADE SECRETS HAZARDOUS MATERI ALS INVENTORY BUSINESS NA~E: .~~~ ~ owNER NAME: ~,TO~S~~ FACILITY UNIT ADDRESS:... ~ ~f~ ~ ._ ADDRESS:¢~Q~q~'[ ~ FACILITY UNIT NAME: PHONE 1: ~5~-~~7 PHONE t: ~o{~ [OFFICIAL USE CFIRS CODE ,9~LY , 1 .'2 3 ' 4 5 6 7 8 9 10 TYPE ~AX ANNUAL CONT USE LOCATION IN T~IS ~ BY BAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITY UNIT ~T. CHEMICAL OR COMMON NAME CODE GUIDE EMERGENCY CONTACT: ~~ ~~o~ TITLE: ~ PHONE ~ BUS HOURS:.~ AFTER BUS HRS: EMERGENCY CONTACT: (~~~_ TITLE~: ~~ . PHONE ~ BUS HOURS: ~ ~.7~ . PRINCIPAL BUSINESS ACTIVITY: '~~ ~~ AFTER BUS HRS: ~- - Q Bakersfield Fire De'pt. '~" . Hazardous Materials Inspection Plan D ~ 2Z5-O00~/~ (To2 right co.er Business Plan) NAZ. MAT. DIV. Station No. '~ S~ · Adequate Inadequate Verification of Invento~ Materials Verification of Quan~ies Verification of Location ~oper Se~egafion of Mated~ ComInents: Verification of MSDS Availability [] [-~ Number of Employees ~ ~'e, gZ Verification of Haz Mat Training Ve~cafion of Abatement Supples ~ Procedures Emergency Procedures Posted Containers Properly Labeled Comments: Verificafionof Facility Diagram x/oT' o.,J ~,~ .'~'~,,,/,,'¢"~'"'-~"'~'"--'Y I--I ~ · Special Hazards Associated With this Facility: Violations: . - FD 1652 (Rev. 3-89) White-Haz Mat Div. Yellow-Station Copy Pink-Business Office ;':" BAKERSFIELD CITY FIRE DEPARTMEN~T : %~" 2130 "S" STREET 7. //~]~'~ BAKERSFIELD, CA 93301 (805) $26-3979 f o ICtAL ONLY 1'3-3/D 001286 BUSINESS PLAN AS A WHOLE INSITlUCTIONS: 1. To avoid further action, return this fopm by. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA B. LOCATION / STREET ADDRESS: ~ ~~~~ ~~ CI~: ~~/~/3 ZIP: q~~ BUS.PHONE: SECTION Z: EMERGENCY NOTIFICATIONS In case of an emerMency involvin~ the release or threatened release of a hazardous material, call 911 and 1-800-8~2-75~0 or 1-918-427-4841. This will notify your local fire department and the State 0ffice of Emergency Services as.required by law. EMPLOYEES TO NOTIFY IN CASE 'OF EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. SECTIONo~-. LOCATION OF UTZLiTY. SH-oT-OFFS FOR BUSIneSS AS A %~rFIOLE A. NAT. GAS/PROPANE: f'Jfi-~[~ ~,tf PrUo~ /~/~3/~7~1~ B. ELECTRICAL: ~T~.~ l~&~g ~~ v- D. SPECIAL: E. LOCK BOX: YES ,~ IF YES, LOCATION: IF YES, DOES IT CONTAIX SiTE PLANS7 YES / ~.[0 MSDSS? YES / N0 FLOOR PLANS? YES / N0 KEYS2 YES ./ NO - 2A - SECTION 4: PRIVATE RESPONSE TE~ FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY .MEDICAL ASSISTANCE FOR YOLq{ BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING. EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH ~NIT!AL AND REFRESHER TRAINING IN THE FOLLOWING AREAS.. CIRCLE YES OR NO ~ iNITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS }~TERIALS: ....................................... NO 50 B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~'~'E~ NO ~.vE_~. NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO ~]~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. - NO YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO YES NO SECTION 7: HAZARDOUS .MATERIAL CIRCLE YES - NO - NONE DOES YOUR BUSINESS HANDLE HAZARDOUS MATERIAL !N QUANTITIES LESS THAN 500 ?0U'NDS OF A/- SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRE~SED GAS:¥ ..... ~ NO' I, /~/~'-~/~ , 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 Safe~¥ code on Hazardous .Materials (Div. 20 Chapter 8.95 Sec. ~00 Et Al.) and that inaccurate information constitutes perjury. ~ .... TITLE //~L/~ DATE'6~-'~'g,'~~-_¥ - BAKERSFIELD CITTI FiRE DEPART::E}:T 21,%0 "G" STREET BAKERSFIELD, CA 93801 BUS ti,TESS ', ..... BUSINESS PLAN L~ F.¢C!LiTL¢ UNIT ~OiqM ~ · INSTRUCTIONS I. To avoid further action, this form 2. TYP£.,'PR!NT YOUR ANSWERS IN ENGLISH. rAC~l,I:f UNIT LISTED BEY, OW 3. Aaswer :he questions below for THE ~ Be as ,BRIEF and .... ~':SZ as oossible FACI~I~f ~'ITm FACILI~ b~'IT N~: SECTION !: MITIGATION, ~R~5%%ONr AB~TEME~ PROCEDL~ES SECTION 2: WOTTF!CATiON AND ~,,',,'~mv=~.~o~, ~., PROCEDURES AT THTS_ L~."iT ONLY SECTION 3: HAZARDOUS MATERIALS FOR THIS b.~IT ONlY : A. Does this Facility Unit conr.~±n Hazardous 5[ateria!s? ...... 'YES if YES,. see B. tf NO, continue with SECTION 4. B Are uny of the hazardous materials a bona fide Trude Secret YES ~ ?~o, ~m~ie~.~ ...... a ~e_<..~=-~'~ hazardous materials inveh~orv for~ marked:'"'NO~-TRAOE SECRE%S ONLY (white rg ~es, com~Iet~hazardous materials invento[~ form marked: TRADE SECRETS O{rLY ~iiow form =4A-2) in addi/ion to the non-trade sec.~t for .... List on~ the fade sec ts on 4A SECTION S: LOCATION OF WATER SUPPLY Fa USE BY GENCY RESPONDERS SECTION B. ELECTRICAL: C. WATER: LOCK =0 ' LOC,~T~,..,: .... X YES .~'0 ~F YES ' ~" q':'r,? sr z':Zo ',,"ES...".k'O .qSDSs'? Y,'Y2 "~'~ FLOOR PT-A:'~S° YES ." 1,70 KEYS? YES >70 - 3B - FEBRUARY 12, 1991 TO: VALERIE, HAZARDOUS MATERIALS FROM: DREW SHARPLES, FINANCIAL INVESTIGATOR/~-~/~ 430 Brundage Lane sold on 10-17-90. I believe the businesses, Foodtown Market and The Grainary, were also part of the sale. New Owner: Robert ¥ong Kil Ho & Patricia Address: 430 Brundage Lane Bakersfield, CA 93304 RE: NM 464301- ~ HM 466901 - I']~.~ krc F:M.DS13 05714/90 )DTOWN MARKET 215-000-0( 36 - Page 1 Overall Site with 1 Fao. Unit General Information Looation: 430 BRUNDAGE LN .~<' "./ Map: 103. Hazard: Low Ident Number: 215-000-001286 I ['~, : Grid: .SID Area of Vul: 0.0 1 Contact' Name Title , Business Phone '11(24 Hour Phone- MATT .TASOS ](805) 527-5057 x (805) 593-5172 ALLAN JOHNSON 1(805) 527-5057 x 805) 871.-2173 Administrative Data Mail Addrs: 450 BRUNDAGE LN D&B Number: City: BAKERSFIELD State: CA Zip: 95304- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: Owner: BILL JOHNSON Phone: (805) 327-3057 Address: RT 4 80X 471A State: CA City: BAKERSFIELD' Zip: 93312- Summary !,/¢~ _ ;;~:,&~¢~ DO hereby certify that i have ' (r~.'F.~m;}' ' ' reviewed the attached hazardous materials ma~.age- ment plan for~ ~'~,,/,~'. . and thct i~ alon9 with any corre~ions ~n~e a ~mplete and co~e~ man- · agement plan for my faCile. 0¥/14/9o DTOWN MARKET 215-000-00, Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers '0~ Site Pln-Ref Name/Hazards Form Quantity MOP 02-001 8EEAOH' Liquid lO0. High lmmed Hlth, Delay Hlth GAL 05/14/90 )DTOWN MARKET 215-000-00 6 ' Page 5 · 02 - Fixed Containers on.Site Hazmat Inventory Detail i'n MOP Order 02~001 BLEACH Liquid 100 High Immed Hlth, Delay Hlth -GAL OAS ~: Trade SeoCet: No _. Form: Liquid Type: Pure DayS: 565 Use: CLEANING Daily Max GAL T--- Daily Average GAL, ] Annual Amount GAL -- loc I so 1' .s,°°° Storage F Press T ~emp -7 Looation PLASTIC CONTAINER ~Ambient~Ambient I AISL. E 100.0% .IBleach igh 05/i4/90 FOODTOWN MARKET 2i5-000-00i Pa~e O0 - Overall Site- <D> Notif./Evacuation/Medioal <1> Agency Notification OALL 911 <2> Employee Notif./Evaouation VERBALL AND PUBLIC ADDRESS NOTIFIOATION. CALL <5> Public Notif./Evaouation '.NONE LISTED <4> Emergency Medical Plan NEAREST HOSPITAL. o¥/14/90 M~RK~T. 215-000-00~ ~A Page 5 O0 - Overall Site .~E>' M.itigatiOn/P~event/gbatemt <1> Release Prevention PRODUCTS ~RE PACKgGED FOR RESgLE IN SMALL QUgNTITIES. .<2> Release Containment <5> Clean Up <4> Other Resource Activatzon 05/14/90 DTOWN MARKET. 2i5=000-00 ~6 Page O0 - Overall Site <F> Site EmergenOy Fao'~ors <1> op-olal Hazards <2> Uti'lity Shut-Offs A) GAS - OUTSIDE IN ALLEY NORTH B) ELECTRICAL - OUTSIDE IN ALLEY NORTH C) WATER - SOUTHWEST END OF PARKING LOT ON BRUNDAGE D) SPECIAL - NONE E) LOCK BOX ~ NO '<5> Fire Proteo./Avail. Water PRI~ATE FIRE, PROTECTION - ????????????' FIRE HYDRANT - '??~???7977 <4> Held for Future use 05/14/90 IDT'OWN .MARKET 2i5~000~00, S .... Page 7 co - o.venaii, site · _ <G> Training <1> Page 1 - WE.HAVE 2?'~EMPL. OYEES AT THIS FACILITY DO YOU' HAVE MATERIAL SAFETY DATA SHEETS ON FLEE?, BRIEF SUMMARY OF TRAINING: .... <2> Page 2 as needed <5> Held Con Future Use <4> Held Cot Future Use