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Home My WebLink AboutBUSINESS PLAN S# 1367 CHIEF AUTO PARTS BRUNDAGE LANE ./ I¢ ® I I I I ,o,ooo iHMMP~ I ~ - Z ' TRASH ENCLOSURE ....... ~ ~ NORTH DAY CARE CENTER ~ULL SERVICE STATION LEGEND SCALE= 1"=30'-0"~ ~DATE, 4/06/93 ~ EMERGENCY PUMP ~ MONITORING WELLS SHUT-OFF A O~SERV*~ON WZUUS SI TE PLAN ~ ~LZCTm,C*L P*N~L ~ N*TUm*L~*S '1501 BRUNDAGE LANE SHUT-OFF ~ BATTER~ STORAGE ~ WATER SHUT-OFF ~ GREASE (BARREL) A ~MA~ TANK MONITORING ALARM ~ MOTOR/TRANSMISSION OIL ~ '~ ~ /-,I,,E-, SFIELD, CALIFORNIA ~ TELEPHONE ~ A.O. PRODUCT TANk ~ FIRST AID KIT ~ FIRE EXTINGUISHER ~) U.G. PRODLICT TAI',IK SS~ 1567 ~ STORM DRAIN ~ SOLVENT SINK HMMP HMMP, AND MSDS '~', MSDS LOCATION ~ WASTE OIL FILTERS ~O~ERT H. LEE ASSOCIATES, INC. ~ HOIST (SERVICE BAY) ~ WASTE ANTIFREEZE ~ FIRE HYDRANT I~L~ ARCHI~CTURE ENOINEERINO EN~RONMENTAL SER~CES ~ WASTE BATTERIES /!~l .............. ~ .............. (,o~) ...... FENCE COMMERCIAL O' BRUNDAGE LANE I I ~CMU WALL L:_____ I , !1~I ~ ~ z ~ ~ i W ~ ~ -- ~ ~ W I ~ COMMERCIAL ~LL 8ER~ 8TARN L~ND 8OA~: 1"=30'-0"~ DA~: 1/16/92 EMERGENCY PUMP SHUT-~F ~ H~ST (SER~CE BAY) SITE PLAN [~C~IC~ PANEL SHUT-~ ~ SOL~NT SINK NA~RAL GAS SHUT-OFF ~ AN~FREEZE .~ s.~-o.. ~ .o~o,/~..~,~s,o. o.~ 1501 BRUNDAGE LANE ~R[ EX~N~ISHER ~ BAT~RY ST~AGE TANK MONIT~ING A~EM ~ ~,~(,,~,~) BAKERSFIELD, CALIFORNIA 93304 [~[~[.c~ *SS[~L~ ~[~ ~ u.~. w*s~ o~ ~*.~ SS~ 1567 H~P ~ND ~S L~A~ON ~ A.G. PR~UC~ TANK ST~U DRAIN ~ ABS~BENT SANITA~ON SE~R ~ ~AS~ ~L FILERS ~ONITORINO ~S ~ ~AS~ AN~FREEZE ~ ROBERT H. ~E k A88~IA~8, INO. OBSERVA~ ~LLS ~ ~AS~ BA~RIES~ ~I~C~RE EN~NEERING PLANN)NO COMMERCIAL BRUNDAGE LANE HYD 1 OM SU ~ < I CMU WALL ~ ~ i ~ ~ ~ ~ ~OM RU j I ~ ~ I /~ ~ Z o I ~ SOLVENT ~ o I~- ENCLOSURE I VACANT ~ FULL SERVICE STATION LEGEND SCALE: 1"=30'-0"~ DATE: 10/24/90 ~ EMERGENCY PUMP ~ MONITORING WELLS ~ ELECTRICAL PANEL ~ GREASE (BARREL) 1501 BRUNDAGE LANE SHUT-OFF ~ U.O. PRODUCT TANK BAKERSFIELD, CALIFORNIA WATER SHUT-OFF ~ STORM DRAIN ~ MOTOR/TRANSMISSIONoiL ~ HOIST (SERVICE BAY) ~ TELEPHONE ROBERT H. LEE · A880ClATES, INO. HYD HYDRANT ~ EMERGENCY MEETING ~ ARCHIECiURE [NOINGERIN6 PLANNING PLACE .~ ~K~u. L~.~ ~.OL~. ~. ~K~.. C* ~.~ · ~:~) .~:-~o ~'~' ~ JUN 8 s UNION 76 215-000-000163 ~¢~[ /~..~verall Site with 1 Fac. Unit General Information ~ Location: 1501 BRUNDAGE LN Map:103 Haz:2 Type: 1 Co--unity: BAKERSFIELD STATION 06 Grid: 31C F/U: 1 AOV: 0.0 Contact Name Title Business Phone ~ 24-Hour Phoneq NOLAN W. BERST ~DEALER (805) 325-4141 x (805) 871-1814~ EDWIN a. BERET ~MANAGER (805) 873-1727 x ~(805) 871-1727~ Administrative Data Mail Addrs: P O BOX 2390 D&B Number: 09-944-7344 City: BREA State: CA Zip: 96222-390 Co~ Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 5541 Owner: NOLAN W. BERET Phone: (805) 871-1814 Address: 3109 OAK TREE State: CA City: BAKERSFIELD Zip: 93304- Sugary 03/08/94 NOLANS UNION 76 215-000-000163 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-006 TEST GAS Gas 100 Extreme · Fire, Pressure, Immed Hlth LBS 02-001 UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-002 SUPER UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-005 SOLVENT Liquid 20 Moderate · Fire, Delay Hlth GAL 02-004 WASTE OIL Liquid 550 Low · Fire, Delay Hlth GAL 02-008 ANTIFREEZE Liquid 30 Low · Fire, Delay Hlth GAL 02-003 FREON R-12 Gas 1000 Minimal · Fire, Pressure, Immed Hlth FT3 02-007 MOTOR OIL Liquid 240 Minimal · Fire, Delay Hlth GAL 02-009 GEAR OIL Liquid 120 Minimal · Fire, Delay Hlth LBS 03/08/94 NOLANS UNION 76 215-000-000163 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-006 TEST GAS Gas 100 Extreme · Fire, Pressure, Immed Hlth LBS CAS #: Trade Secret: No Form: Gas Type: Mixture Days: 365 Use: AEROSOL/INFLATION Daily Max LBS I Daily Average LBS I Annual Amount LBS 100 i 100.00 30.00 Storage I Press T Temp I Location PORT. PRESS. CYLINDER ~ BACK ROOM NW CORNER -- ConcI Components I MCP ---TGuide 1.5% iCarbon Monoxide (Liquid) IExtreme I 18 11.0% ICarbon Dioxide Minimal I 21 0.5% IPropane Extreme I 22 87.0% INitrogen Low ! 21 02-001 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 GALI Daily Average GAL 1 Annual Amount GAL -- 10,000 ~ 5,000.00 259,000.00 StorageIIPress T Temp Location UNDER GROUND TANK IAmbient~AmbientlNORTHEaST OF STATION -- Conc Components MCP ---TGuide 100.0% IGasoline IModeratel 27 02-002 SUPER 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 GALI Daily Average GAL I Annual Amount GAL 10,000 ~ 5,000.00 220,000.00 Storage~~Press T Temp Location UNDER GROUND TANK IambientlAmbientlNORTHEaST OF STATION -- Conc Components MCP ---TGuide 100.0% IGasoline ]ModerateI 27 03/08/94 NOLANS UNION 76 215-000-000163 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-005 SOLVENT Liquid 20 Moderate · Fire, Delay Hlth GAL CAS #: 8030306 Trade Secret: No ~ Form: Liquid Type: Pure Days: 365 Use: CLEANING Daily Max GAL20 I Daily Average15.00GAL I Annual Amount50.00GAL Storage Press T Temp Location OTHER - SPECIFY IAmbientlAmbientlBACK ROOM SE CORNER -- Conc~ Components iModeratelMCP ---~Guide 100.0% INaphtha 27 02-004 WASTE OIL Liquid 550 Low · Fire, Delay Hlth GAL CAS #: 221 Trade Secret: No Form: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GALI Daily Average GAL I Annual Amount GAL 550 ~ 175.00 1,300.00 Storage~~Press l Temp Location UNDER GROUND TANK IAmbient~AmbientlSOUTH OF SERVICE BAYS -- Conc~ Components MCP --TGuide 100.0% IWaste Oil, Petroleum Based Low ! 27 02-008 ANTIFREEZE Liquid 30 Low · Fire, Delay Hlth GAL CAS #: 107-21-1 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: COOLING Daily Max GALI Daily Average GAL ] Annual Amount GAL 30 ~ 15.00 120.00 Storage Press I Temp~ Location PLASTIC CONTAINER .AmbientlAmbientlIN STORAGE BAY -- Conc Components MCP ---TGuide 100.0% IEthylene Glycol ILow ~ 27 03/08/9~ NOLANS UNION 76 215-000-000163 Page 5 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 FREON R-12 Gas 1000 Minimal · Fire, Pressure, Immed Hlth FT3 CAS #: 75-71-8 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: COOLING -- Daily Max FT3 I Daily Average FT3 I Annual Amount FT3 1,000 ~ 500.00 1,020.00 Storage ~~Press T Temp Location PORT. PRESS. CYLINDER IAmbient~AmbientlIN STORAGE SHED W CORNER -- Conc~ Components ~ MCP --~Guide 100.0% IDichlorodifluoromethane IMinimal I 12 02-007 MOTOR OIL Liquid 240 Minimal · Fire, Delay Hlth GAL CAS #: 64742-18-3 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL I Daily Average GAL I Annual Amount GAL 240 ~ 200.00 1,440.00 Storage ~ Press T Temp~ Location PLASTIC CONTAINER IAmbient~AmbientlIN SVC BAY & STORAGE BLDG -- Conc~ Components MCP --~Guide 100.0% IMotor Oil, Petroleum Based Minimal I 27 02-009 GEAR OIL Liquid 120 Minimal · Fire, Delay Hlth LBS CAS #: 64742-26-7 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max LBS120 I~ Daily Average75.00LBS I Annual Amount480.00LBS -- Storage ~ Press 7 Temp~ Location DRUM/BARREL-METALLIC IAmbient~AmbientlIN STORAGE BAY - Conc~ Components ! MCP ----~uide 100.0% IMotor Oil, Petroleum Based IMinimal I 27 03~08/9~ NOLANS UNION 76 215-000-000163 Page 6 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911. UNOCAL WILL NOTIFY THE APPROPRIATE STATE AND LOCAL AGENCIES UNLESS THE.SITUATION REQUIRES URGENT IMMEDIATE RESPONSE BY THE AGENCIES, IN WHICH CASE THE DEALER SHOULD NOTIFY THESE AGENCIES: LOCAL AGENCY: BAKERSFIELD FIRE PREVENTION HAZARDOUS MATERIALS DIVISION PHONE NUMBER: 805 326-3979 CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) 852-7550 (24 HOURS) CALL FOR HELP IN CASE OF AN EMERGENCY BY DIALING 9-1-1 <2> Employee Notif./Evacuation NOTICE WILL BE VERBAL. EMPLOYEES WILL EVACUATE BUILDING AND MEET AT EMERGENCY ASSEMBLY AREA. <3> Public Notif./Evacuation IF THERE IS ANY IMMEDIATE DANGER, ANNOUNCE TO ALL PERSONS ON THE SITE THERE IS AN EMERGENCY. PLEASE TURN OFF YOUR ENGINES AND LEAVE THE STATION ON FOOT IMMEDIATELY. <4> Emergency Medical Plan NEAREST MEDICAL FACILITY: EMPLOYEES SHOULD KNOW WHAT FACILITIES ARE AVAILABLE IN CASE CUSTOMERS OR OTHER EMPLOYEES NEED MEDICAL ATTENTION: MERCY HOSPITAL 2215 TRUXTUN AVE (805) 327-3371 03)08/9~ NOLANS UNION 76 215-000-000163 Page 7 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention GAS PUMPS HAVE SHEAR OFF VALVES. GAS PUMP SHUT OFF (EMERGENCY SWITCH) IN FRONT OF BUILDING SOUTHEAST CORNER MAIN POWER CUT OFF INSIDE BUILDING ON WEST SIDE OF NORTH WALL. GAS SPILLS CLEAN UP WITH SAND (SMALL SPILLS) LARGE GAS SPILLS CALL FIRE DEPT. <2> Release Containment INSPECTIONS TO CONDUCTED BY DEALER, PRODUCT TANK GAUGING PROCEDURES, RECORD KEEPING FOR FUEL TANK, WASTE OIL TANK GAUGING PROCDURE. <3> Clean Up SMALL SPILLS (LESS THAT 1 GALLON AND ONLY REQUIRING 15 MINUTES TO CLEAN UP) SHALL BE CLEANED UP USING ABSORBENT MATERIALS. LARGER SPILLS OCCURRING DURING PRODUCT DELIVERY SHALL BE REPORTED TO THE TERMINAL BY THE DEALER AND/OR BY DELIVERY TRUCK DRIVER. THE TERMINAL SUPERVISOR WILL NOTIFY A LOCAL PETROLEUM MAINTENANCE CONTRACTOR WHO IS EQUIPPED WITH N.F.P.A. APPROVED TYPE HAND PUMP, VACUUM AND TRANSPORT CONTAINER. LARGE SPILLS NOT CAUSED BY DELIVERY SHALL BE REPORTED IMMEDIATELY TO YOUR REPRESENTATIVE. SPILLS SHALL BE CLEANED UP WITH 8 HOURS OF DETECTION, RETURNED TO LOCAL TERMINAL AND/OR DISPOSED OF IN A LAWFUL MANNER. DEALER SHALL RECORD ALL SPILLS WHETHER OR NOT IT IS DUE TO DELIVERY OVERFILL OR ACCIDENTAL SPILLAGE, WHICH EXCEEDS APPROXIMATELY ONE GALLON, AND ACTION TAKEN ON THE "UNAUTHORIZED RELEASE REPORT". <4> Other Resource Activation 03~08/9% NOLANS UNION 76 215-000-000163 Page 8 O0 - Overall Site <E> Mitigation/Prevent/Abatemt <4> Other Resource Activation (Continued) 03~08~9% NOLANS UNION 76 215-000-000163 Page 9 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - IN STORAGE ROOM AT NORTH END OF SERVICE BAY C) WATER - OUT FRONT EAST SIDE ALONG CHESTER AV D) SPECIAL - EMERGENCY SHUT OFF SWITCH FOR GAS PUMPS EAST SIDE BUILDING E) LOCK BOX - NO (EACH GAS PUMP HAS ONE SHEAR VALVE) <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF BRUNDAGE LN & CHESTER AVE. <4> Building Occupancy Level 03/08~9~ NOLANS UNION 76 215-000-000163 Page 10 00 - Overall Site <G> Training <1> Page 1 WE HAVE 4 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING: EMPLOYEES MUST BE GIVEN THIS TRAINING BEFORE STARTING WORK, AND REFRESHER COURSES MUST BE PROVIDED ANNUALLY. RECORDS MUST BE KEPT TO SHOW WHEN EACH STATION EMPLOYEE HAS BEEN GIVEN HIS/HER SAFETY TRAINING. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use HAZARDOUS MATEII~L.S INSPECTION ~!;~i ~ersfield Fire Dept. Haz'~Fdous Materials Division ~? Date Completed Business Name: ~O~N5 ~1 ON ~ Location: /~O I ~AU ~ Business Identification No. 215-000 /~ ~ (Top of Business Plan) Sta~on No. ~ Shift ~ Inspe~or ~D~I ~ Arrival Time:~ Depa~re Time: ~ Inspe~on Time: Adequate Inadequate Veri~ca~on of Invento~ Mate~als ~ Verification of Quan~es Verification of Location Proper Segregation of Material~ Commen~: of MSDS Availabili~ ~ Number of Employees: Verifica~on ~ Commen~: Verification of Abatement )lies & Pr( ~ Commen~: procedures Posted Containor~ ~ropor~ kab~lod Comm~n~: Vorifica~on o[ Faeil~ Diaflram ~ ~'~- 8p~l Hazard~ ~sociatod ~ ~i~ Facili~:. / All Items O.K Business Owner/Manager PRINT NAME SIGNATURE Correction Needed White-Haz Mat Div Yellow-Station Copy Pink-Business Copy AN ESOP COMPANY ROBERT H. LEE &.ASSOCIATES, INC. ARCHITECTURE ,, ENGINEERI.NG * ENVIRONMENTAL SERVICES 1137 NORTH McOOWELL BOULEVARD · PETALUMA, CALIFORNIA 9,4954-1,4~9 (7D7) 785-1680 Mailing Address: P.O. Box 750908, Petaluma, cA 94~75-O908 Fax (707) 785-9908 BRIAN I::. ZITA A~chitsct June 24, 1994 ~"" 1715 Chester Ave., 3rd Floor B~ersfield, CA 93301 Clos~ Unocal stations 1501 Bmndage Lane, 2502 Ming Ave. ' De~ Mr. Ralph Huey; .' A~ach~ ple~e find two HMMP form packets for Unocal Se~ice Stations which have been perm~ently clos~ ~d ~e sch~ul~ for demolition. If you have ~y questions, feel ~ee to chll. Sincerely, Robert H. Lee & Associates, Inc. Steve Skanderson Project Manager Attachments F:\HAZMAT\U NOCAL\ 1023\B AKERS FI. LET SACRAMENTO, BELLEVUE. WA LA HABRA, CA MARIETTA, CA Arq ESOP COMPANY ROBERT H. LEE & .z SSOCIALTES, liMO. ARCHITECTURE - ENGINEERING o ENVIRONMENTAL SERVICES 1137 NORTI'4 Mc[DOWELL BOLII_EVAFID - PETALUMA. CALIFORNIA 94954-1469 (707) 765-1660 Mailing Address: P.O. Box 750908, Petalums, CA 94975-0908 Fax (707) 765-9908 December 23 1993 .O.N'~. JO..SON Ralph Huey ' DEC Aroh~t.ct Bakersfield Fire Department JO.N s..,cKs 2130 G Street Bakersfield, CA 93301 ~ ~v A~,~o~ 1994. SUBMISSION OF HAZARDOUS MATERIAL MANAGEMENT PLANS AND ,-~ -. ~ RELATED DOCUMENTS Civil Engineer Dear Ralph Huey: 0n behalf of Unocal Corporation, Robert H. Lee & Associates, Inc. (RHL) has been selected as the contractor to prepare the HMMP documents tBr ~e Unocal facilities throughout California. Attached is a list of facilities within your jurisdiction that RHL will be preparing updates for. RHL requests your.cooperation in managing our schedule. Due to the high demand of submissions required during January, February and March, RHL requests ~at you grant us until June 30, 1994 as the deadline for these submissions. If you require an alternate deadline, please indicate this below. Please sign the Ac'knowledgement of Receipt and return it to: Mr. Steven Sk~derson, Robert H. Lee & Associates, Inc. P.0. Box 750908, Petaluma, CA 94975. Please address all ~ture invoices and correspondence to: Mr. David Corder, H~ardous Materials Compliance Coordinator, Unocal·Corporation, P.0. Box 2390, Brea, CA 92622-2390. You can reach Mr. Corder at 714-572-7651. Sincerely, ROBERT H. LEE & ASSOCIATES, INC. ~anderson Project Manager ACKNOWLEDGEMENT OF RECEIPT: Date: Comments: cc: Mr. David Corder, Unocal File ,~,.~,~..~..v .... ~-'*~.m MARIETTA, GA SACRAMENTO, CA SELLEVUE, WA LA HABRA, CA Bakersfield Fire Department 1367 ,/~2'2 4888 5488 NoLan W. Berst ,.?.~ NoLan W. Berst ~y/L~ James D. Summers Notan~s Union Service #1367 No[art's Self Serve #4888 Stockda[e 76 #5488 1501Brundage Lane 2699 Nt. Vernon 5401Stockda[e Highway BakersfieLd, CA 93304 Bakersfield, CA 93306 BakersfieLd, CA 93309 Steve E$layed Country Club Union, Inc. L. Morgan UNOCAL SS# 5573 Country Club Union #6089 Town & Country Union, Inc. 2502 Ming Avenue 2524 Oswell Street 8200-A Stockdale Hwy. Bakersfield, CA 93304 Bakersfield, CA 93306 Bakersfield, CA 93311 James Stante¥ Grapevine Oil Co. Inc 524 Do[ores Street Bakersfield, CA 93389 Unocal Refininl;I & M~trketing Division Unocal Corporation ~ 911 Wilshire Blvd., $~1010 Los Angeles, California 90017 Telephone (213) 977-6399 Facsimile (213) 627-1231 C UNOCAL( April 15, 1993 Nolan W. Berst Nolan's Union Service #1367 1501 Brundage Lane Bakersfield, CA 93304 RE: HAZARDOUS MATERIAL MANAGEMENT PLANS Dear Nolan W. Berst: Attached is the Hazardous Materials Inventory and Business Plan Update for your station. This new HMMP is intended to replace the current HMMP. The "DEALER" copy should be kept on the premises, and available to all employees and agency personnel at any time. THESE FORMS MUST BE RETURNED TO ROBERT H. LEE & ASSOCIATES, INC. AS SOON AS POSSIBLE. FAILURE 'TO RETURN AND IMPLEMENT THIS PLAN MAY RESULT IN FINES AND/OR CIVIL PENALTIES By GOVERNMENT ENFORCEMENT AGENCIES. Instructions for signing and returning the packet: 1. Please sign all 4 copies of the HMMP where flagged and indicated with a "X". 2. Return the 3 copies marked "UNOCAL", "AGENCY" and "FILE" to Robert H. Lee & Associates in the pre-stamped envelope provided. 3. Have your employees read and understand the contents of this package and sign the attached training log. 4. Keep the "DEALER" copy at the site and available for inspection. Copies of the HMMP will be sent to the Bakersfield Fire Department within 30 days. If you have any questions regarding the content of the HMMP please contact Robert H. Lee & Associates, Ms. Marion Miller, (707) 765-1660. If you have any additional questions please contact Mr. Bill Arbogast of Unocal at (213) 977-7850. Sincerely, Marc Lallanilla Environmental Compliance Coordinator Enclosures cc: Robert H. Lee & Assoc. File 0unoeal\forma\Dealrltr. MRG') UNION 76 ~ i 5-.0C)0-00 3 F'age i Overall Site with 1 Fac. UrJit Ger~e'ra 1 Ir~fc, rn~at ic, r~ Locatior,: 1501 BRUNDAGE LN Map: 103 Hazard: Low Cor~n~ur~ity: BAKERSFIELD STATION 06 Gri.d: 31C F/U: I AOV: 0.0 Cor~tact Nan~e T Title ~ Busir~ess Phor~e --~ 24-Hour Phor~e] /NOLAN W. BERST IDEAL_ER /(805) 325-4141 x~..(805) 871-1814 Mail Addrs: 911 WILSHIRE BLVD ~il~ ~L~. D&B Nur~ber: 09-944-7344 City: LOS ANGELES State: CA Zip: 90017- Cc, n~n'~ Code: 215-006 BAKERSFIELD STAT'ION 06 SIC Code: 5541 Owr~er: NOLAN W._.BERST' ~ ,~'~ Phor, e: (8~.~)"')~ ~ Address: 310~9 OAK .'~ ~v State: CA ~z/-l~/Y ~ City: BAKERSFIELD Zip: '~330~'--~ Sun, mary ~ANS UNION 76 215-000-00~3 Page :mat I~ventory List ir~ MCP ~rder 0o _ ~ Fixed Cor~tair~ers or, Site Pl r~-Ref Name/Hazards Form Quar~t ity MCP ~02-006 TEST GAS Gas 100 Extreme Fire, Press~?e, Immed Hlth LBS 02-001 UNLEADED GASOLINE Liquid 10000 Moderate Fire, Immed Hlth, Delay Hlth GAL 3~-OU~ SUPER UNLEADED GASOLINE Liquid 10000 Moderate Fire, Immed Hlth, Delay Hlth GAL 02-005 SOLVENT Liquid ~ Moderate ~ Fire, Delay Hlth GAL x02-004 ~WASTE OIL Liquid o~. Low Fire, Delay Hlth GAL 02-008 ANT I FREE Z E L i q u i d [ ~ Low Fire, Delay Hlth GAL 02-003 FREON R-12 Gas , ~ ~ Mir~imal Fire, Pressure, Immed Hlth ~T3 02-007 MOTOR OIL Liquid Minimal Fire, Delay Hlth GAL 02-009 GEAR OIL Liquid ~ - Mir~imal F i re, De 1 a~,~-~ ...... LBS · - 1 .xJ,~,-.~/~J ANS UNION 76 )3 Page O2 - Fixed CoK~tainers oK~ S Hazmat I'nver~tor7 Detail iK~ MCP Order 02-008 TEST GAS Gas 100 Extreme Fire, Pressure, tm~ed Hlth LBS CAS ~ 'Trade Secret: No Form: Gas Type: Mixture Days: 365 Use: AEROSOL/INFLATION Daily Max LBS100 ..((.. Daily Average Storage [ Press I 'Femp ) Locatior~ PORT. PRESS. CYLINDER ~v~ S~ ~ BACK ROOM NW CORNER -- Corec --~-- Compor, er, ts ( ....... MCP ~-7~uide 1.5%~Carbc, n Mor, oxide (Liquid) ~Extren~e ) 18 11.0% )Carbor, Dioxide ~Mir, in~al ~ 21 0.5% ) Propar, e ~Extreme 87.0% ~Nitroger, )Low 02-001 UNLEADED GASOLINE Liquid 10000 Moderate Fire, In~med Hlth, Delay Hlth GAL CAS~/S): 8006-61-9 Trade Secret: No orris: Liquid /Type: Pure '/Days: 365 Use: FUEL Daily Max GAL ~--T---Daily Average GAL Ar, r~ual A;nour~t GAL ~ 10,000 ~ 5,000.00 ) 259,000.00 Storage ~ Press T Temp --~ Locatior~ UNDER GROUND TANK )An~bier, t)Ambier, t~NORTHEAST OF STATION -- Corec Con~por~er~t s MCP ~ui~e 100.0% ~ Gasol ir~e ~ Moderate ~ 2, 02-002 SUPER UNLEADED GASOLINE Liquid 10000 Moderate Fire, Immed Hlth, Delay Hlth GAL CAS $): 8006-61-9 Trade Secret: No Forn~: Liquid Type: Pure Days: 365 Use: FUEL ~-- Daily Max GAL ~ Daily Average GAL/~- Anr~ual Amour, t GAL Storage F Press T Temp ~ Locatior, UNDER GROUND TANK )Ambierrb)AFnbier~t)NORTHEAST OF STATION - Corec Compor, er, t s MCP ~uide 100.0% IGasolir~e ~Modera'te) 27 ~/~.ld~ ANS UNION 76 215-000-00 3 Page 4 o2 - Fixed Corstair~ers ors Site Hazrnat Inver~tory Detail ir~ MCP Order 02-005 SOLVENT Liquid 80 Moderate Fire, Delay Hlth GAL /CAS ~: 8030306 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: CLEANING Daily Max GAL/~~~~ Daily Average GAL ~T~Ar~r~ual Arnour, t GAL- ~/~ 50.00 Storage T Press T Ten]p ---[ Lc, catic, r~ OTHER - SPECIFY lAn]bientlAn~bier~t IBACK ROOM SE CORNER -- Cc, nc~ Con~pc, r~er~t s .~ Moderate ~MCP --~u;~7i d e 100.0% ,Naphtha 02-004 WASTE OIL Liquid 550 Low Fire, Delay Hlth GAL For~: Liquid Type: Waste Days: 365 Use: WASTE Daily Max GAL550 I Daily Average GAL2b~0.00 / '[ A r~r~ual Amou~ r~t GAL --7 Stc, rage ~ Press ~ Ten~p -] Locatior~ UNDER GROUND TANK lArnbier~tlAn~bie'ntlSOUTH OF SERVICE BAYS -- Corec ~ Cornpor~er~t s ~,,MCP ~uide 100.0%lWaste Oil, Petroleun~ Based lL~w ~ 27 02-008 ANTIFREEZE Liquid 60 Low Fire, Delay Hlth GAL CAS $~: 107-21-1 Trade Secret: Nc, Forn~: Liquid 'rype: Pure Days: 365 Use: COOLING Daily Max G~~ Daily Ave~age GA~ Ar~rn.~al An~o~G[~L ...... Stc, rage -Press ? Ternp - Locatior~ PLASTIC CONTAINER ~Arnbier, tlArnbier, tlIN STORAGE BAY -- Corec -- Compor~er~ts MCP -~uide 100.0% ~Ethyler, e Glycol 1L°w I 27 03/25~/93 UNION '76 215-000-00~3 Page 5 (}2 - Fixed Cor~tairsers orl Site Hazr~lat Inver~tory Detail ir~ MCP Order 02-003 FREON R-12 Gas 16(}(} Mi rsir~la 1 Fire, Pressure, Immed Hlth FT3 CAS 45: 75-71-8 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: COOLING Daily Max FT3 1,~00~ ~0~.00vii 1,020.00 Storage - I Press T Te[np ~. Locatior~ PORT. PRESS. CYLINDER l Ar~bier~tlA~nbier~tlIN STORAGE SHED W CORNER -- Cc, r~c I Cc,~por~er~ts -~ MC~ .... ~Guide 100.0% 02-00? MOTOR OIL Liquid 240 Mir~i~al Fire, Delay Hlth GAL CAS 45: 64742-~5b~/ Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL~-~ Daily Average GAL~ 2(}0.00 ~ Anr~ual A~our~t GAL ~-i,44(}.00 Storage ~ Press T Te~p -~ Locatior~ PLASTIC CONTAINER ~A~bier~t~A~bier~t~IN SVC BAY & STORAGE BLDG -- Corec ~ Co~por~er~ts T-- MC~ ~uide 100.0%~Motor Oil, Petroleu~ Based ~Mir~i~al ~ 27 (}2-(}(]}9 GEAR OIL Liquid 240 Mirli~a 1 Fire, Delay Hlth LBS CAS 45: 6474~-~6-7 Trade Secret: No Forr,~: Liquid Type: Pure Days: 365 Use: LUBRICANT / / Daily Max"i'"l'~~ ..... I Daily Average. i '~75. LBS/--i ' "00-- Ar~r~ua 1 A~our~t48(]}.LBS00~ Storage . Press T 'Ter~p Locatior, DRUM/BARREL-METALLIC ~rnbient~abier~t I IN STORAGE BfiY -- Corec - I Cornpor~er~t s ~ MCP -~Guide 100.0%~Motor Oil, Petroleu~ Based ~Mir~i;~al~ 27 · BAKEI FIELD CITY FIRE DEP :{TIVIENT HAZARDOUS MATERIALS INVENTORY Page 1 of 2 1367 Business Name Nolan's Union Service #1367 Address 1501 Brunda,qe Lane, Bakersfield CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ! Addition [ ] Revision [X] Deletion [ ] Check if chemical is a NON TRADE SECRET IX! TRADE SECRET [ ] 2) Common Name: WASTE ANTIFREEZE 3) DOT # (optional) 9189 Chemical Name: ETHYLENE GLYCOL AHM [ ] CAS # 107-21-1 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire | ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [X] Delayed Health (Chronic) [X] 5) WASTE CLASSIFICATION 343 .(3-digit code from DHS Form 8022) USE CODE 40 6) PHYSICAL STATE Solid [ ] Liquid [X] Gas [ ] Pure [ ] Mixture [X] Waste [X] Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 5 lbs | ] gal IX! fi3 [ ] a) Container: 06 Average Daily Amount: 3 curies [ ] b) Pressure: 1 Annual Amount: RECYCLE ON SITE c) Temperature: 4 Largest Size Container: 5 # Days On Site: 365 Circle Which Months: All Year J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) WASTE ANTIFREEZE 107-21-1 100.0 [ ] chemical component or 2) [ ] any AHM components 3) [ ] 10) Location: OWNS RECYCLER CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision [XI Deletion [ ] Check if chemical is a NON TRADE SECRET [X] TRADE SECRET [ ] 2) Common Name: WASTE OIL FILTERS 3) DOT # (optional) 9189 Chemical Name: PETROLEUM HYDROCARBONS AHM [ ] CAS # 800-20-59 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) [ ] Delayed Health (Chronic) [X] ~)) WASTE CLASSIFICATION 223 (3-digit code from DHS Form 8022) USE CODE 40 6) PHYSICAL STATE Solid [ ] Liquid [X] Gas [ ] Pure [ ] Mixture IX! Waste [X] Radioactive { ) 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 200 lbs [ ] gal [X] fi3 [ ] a) Container: 06 Average Daily Amount: 50 curies [ ] b) Pressure: 1 Annual Amount: 5 c) Temperature: 4 Largest Size Container: 55 GAL # Days On Site: 365 Circle Which Months: All Year J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1) WASTE OIL FILTERS 800-20-59 100.0 [ ] chemical component or 2) [ ] any AHM components 3) [ ! 1 0) Location: IN THE TRASH ENCLOSURE I certify underpenalty of law, that I have personally examined and am familiar with the information submitted on this and all attached documents. I beliew the submitted information is true, accurate, and complete. PRIN¢~ ~ T/tie of A~t~oriz~d Company Representative Sign~ "''/ ..... ~ate BAKEI FIELD CITY FIRE DEPi II:ITIVIENT HAZARDOUS MATERIALS INVENTORY Page 2 of,?. 1367 Business Name Nolan's Union Service #1367 Address 1501 Brunda.qe Lane, Bakersfield CHEMICAL DESCRIPTION 1) INVENTORY STATUS: New [ ] Addition [ ] Revision IX| Deletion [ ] Check if chemical is a NON TRADE SECRET IX! TRADE SECRET [ ] 2) Common Name: WASTE BATTERIES 3) DOT # (optional) 2794 Chemical Name: LEAD\ACID BATTERY AHM ! ] CAS # MIXTURE 4) PHYSICAL & HEALTH PHYSICAL HEALTH HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) IX| Delayed Health (Chronic) [ ] 5) WASTE CLASSIFICATION 162 .(3-digit code from DHS Form 8022) USE CODE 40 6) PHYSICAL STATE Solid [ | Liquid IX| Gas [ ] Pure [ ] Mixture [XI Waste IX| Radioactive [ ] 7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES Maximum Daily Amount: 15 lbs [ ] gal IX| ft3 [ ] a) Container: 10 Average Daily Amount: 7 curies [ ] b) Pressure: 1 Annual Amount: 60 c) Temperature: 4 Largest Size Container: BATTERY # Days On Site: 365 Circle Which Months: All Year J, F, M, A, M, J, J, A, S, O, N, D 9) MIXTURE: List COMPONENT CAS # % WT AHM the three most hazardous 1 ). LEAD DIOXIDE 1309-60-0 31 [ ] chemical component or 2) SULFURIC ACID 7664-93-9 34 IX| any AHM components 3). LEAD 7439-92-1 34 [ ] 10) Location: IN THE TRASH ENCLOSURE certify under penalty of/aw, that / have personally examined and am familiar with the information submitted on this and ail attached documents. / believe the subm~/nfTtion is true, accurate, and complete. PRINT N~rr~e'& Title of Au~orized Company'Representative - S~g~r~'7 ~ ~' - - / I ~at'e~ ~~~3/25/93 ~ANS UNION 76 215-000-00(~3 Page 6 00 - Over. all Site -' <D> Notif. /Evacuation/Medical <1> Agency Notification CALL 911. UNOCAL WILL NOTIFY THE APPROPRIATE STATE AND LOCAL AGENCIES UNLESS THE SITUATION REQUIRES URGENT IMMEDIATE RESPONSE BY THE AGENCIES, IN WHICH CASE THE DEALER SHOULD NOTIFY THESE AGENCIES: LOCAL AGENCY: BAKERSFIELD FIRE PREVENTION HAZARDOUS MATERIALS DIVISION PHONE NUMBER: 805 326-3979 CALIFORNIA OFFICE OF EMERGENCY SERVICES (800) .... 8~=-~ (24 HOURS) CALL FOR HELP IN CASE OF AN EMERGENCY BY DIALING 9-1-1 <2> Employee Notif./Evacuation NOTICE WILL BE VERBAL. EMPLOYEES WILL EVACUATE BUILDING AND MEET AT EMERGENCY ASSEMBLY AREA. <S> Public Notif./Evacuation IF THERE IS ANY IMMEDIATE DANGER, ANNOUNCE TO ALL PERSONS ON THE SITE THERE IS AN EMERGENCY. PLEASE TURN OFF YOUR ENGINES AND LEAVE THE STATION ON FOOT IMMEDIATELY. <4> E~ergency Medical Plan NEAREST MEDICAL FACILITY: EMPLOYEES SHOULD KNOW WHAT FACILITIES ARE AVAILABLE IN CASE CUSTOMERS OR OTHER EMPLOYEES NEED MEDICAL ATTENTION: MERCY HOSPITAL 2215 TRUXTUN AVE (805) 327-3371 ~/,-'~/d~ UNION 76 215-000-00£/3 Page 7 00 - Overall Site <E> Mit igat ion/Prevent/Abater~t <1) Release Prevention GAS PUMPS HAVE SHEAR OFF VALVES. GAS PUMP SHUT OFF (EMERGENCY SWITCH) IN FRONT OF BUILDING SOUTHEAST CORNER MAIN POWER CUT OFF INSIDE BUILDING ON WEST SIDE OF NORTH WALL. GAS SPILLS CLEAN UP WITH SAND (S~ALL SPILLS) LARGE GAS SPILLS CALL FIRE DEPT. <2> Release Containment INSPECTIONS TO CONDUCTED BY DEALER, PRODUCT TANK GAUGING PROCEDURES, RECORD KEEPING FOR FUEL TANK, WASTE OIL TANK GAUGING PROCDURE. <3> Clean Up SMALL SPILLS (LESS THAT 1 GALLON AND ONLY REQUIRING 15 MINUTES TO CLEAN UP) SHALL BE CLEANED UP USING ABSORBENT MATERIALS. LARGER SPILLS OCCURRING DURING PRODUCT' DELIVERY SHALL BE REPORTED TO THE TERMINAL BY THE DEALER AND/OR BY DELIVERY TRUCK DRIVER. THE TERMINAL SUPERVISOR WILL NOTIFY A LOCAL PETROLEUM MAINTENANCE CONTRACTOR WHO IS EQUIPPED WITH N.E.P.A. APPROVED TYPE HAND PUMP, VACUUM AND TRANSPORT CONTAINER. LARGE SPILLS NOT CAUSED BY DELIVERY SHALL BE REPORTED IMMEDIATELY TO YOUR REPRESENTATIVE. SPILLS SHALL BE CLEANED UP WITH 8 HOURS OF DETECTION, RETURNED TO LOCAL TERMINAL AND/OR DISPOSED OF IN A LAWFUL MANNER. DEALER SHALL RECORD ALL SPILLS WHETHER OR NOT IT IS DUE TO DELIVERY OVERFILL OR ACCIDENTAL SPILLAGE, WHICH EXCEEDS APPROXIMATELY ONE GALLON, AND ACTION TAKEN ON THE "UNAUTHORIZED RELEASE REPORT". <4> Other Resource Activation 03/25,/93 LANS UNION 76 215-000-00( ~3 Page 8 00 - Ove~all Site <E> Mi t i gat i on/Prever~t/Abat e~t <4> Other Resource Activation (CorJtirJued) i}3/~-q/9~ ~ANS UNION 76 215-000-00( Page 9 00 - Overall Site ' <F> Site Ers~ergerscy Factors <1> Special Hazards <2> Utility Shut-Offs B) ELECTRICAL - IN STOR-AGE ROOM AT NORTH END OF ~ERVICE BAY C) WATER - OUT FRONT EAST SIDE ALONG CHESTER AV D) SPECIAL - EMERGENCY SHUT OFF SWITCH FOR GAS PUMPS EAST SIDE BUILDING E) LOCK BOX - NO (EACH GAS PUMP HAS ONE SHEAR VALVE) <3> Fire Protec. /Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS FIRE HYDRANT - NORTHEAST CORNER OF BRUNDAGE LN & CHESTER AVE. <4> Buildir, g Occupancy Level ~:~3/2~/93 .ANS UNION '76 215-000-00[ Page O0 - Overall Site <G> Trai~i ~g <I> Page i / ¢ WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE BRIEF SUMMARY OF TRAINING~ EMPLOYEES MUST BE GIVEN THIS TRAINING BEFORE STARTING WORK, AND REFRESHER COURSES MUST BE PROVIDED ANNUALLY. RECORDS MUST BE KEPT TO SHOW WHEN EACH STATION EMPLOYEE HAS BEEN GIVEN HIS/HER SAFETY TRAINING. <2> Page 2 as r, eeded <3> Held for Future Use <4> Held for Future Use ~}3/2~/93 .ANS UNION 76 215-000-00( Page 11 00 - Overall Site <H> RMPP DATA ( 1 ) Re 1 ease Corot a i rm~er~t <2> Offsite Cor~sequer~ces <3> In House Capabilities <4> Plar, t Shutdowr, Instruct ior, 00 - Overall Site <I> Not Used <1> Not Used <2> Not Used <3> Not Used <4> Not Used ~3/25/93 ANS UNION '?6 215-000-00(~ Page O0 - Overall Site <J> Topic "J" rsot defirsed <1> Wir~dow J/1 <2> Wir~dow 3'/2 <3> Wir~dow J/3 <4> Wir, dow J/4 ~3/25/93 ~ANS UNION 76 2i5-000-00( Page 14 00 - Overall Site <K> Topic "K" held for Picture <I> Wir~dow K/1 <2> Wir~dow K/2 <3> Wir~dow K/3 <4> Window K/4 EMERGENCY RESPONSE PROCEDURES 1367 MAJOR INCIDENT: FIRE, SPILL OR SUSPECTED LEAK 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. EVACUATE: verbally ANNOUNCE to all persons on the site: "There 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 Unocal service station at 1501 Brundage Lane" 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. LOOK AROUND to assure 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 leaving the station area, and anyone who may be injured. 5. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 6. CONTACT the station dealer if s/he is not already at the station. Use the list below for emergency contacts: Primary Contact: Name: Nolan W. Berst Title: Dealer Address: 3109 Oak Court Bakersfield, CA. 93304 Bus #/Home #: 805-325-4141 / 805-871-1814 Secondary Contact: Name: Ed Berst Title: Manager Address: 2604 Mirador Dr. Bakersfield, CA. 93305 Bus #/Home #: 805-325-4141 / 805-871-1727 7.NOTIFY Unocal Maintenance Dispatch by phone IMMEDIATELY 1-800-723-7600 NOTIFY your Territory Manager IMMEDIATELY TERRITORY MANAGER:Jim FosterPhone Number:209-237-5141 Unocal will notify the appropriate State and Local agencies within 24 hours, unless the situation requires urgent immediate response by the agencies, in which case the DEALER should notify these agencies: 1. LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES, (800) 852-7550 (24 HOURS) 3. LOCAL POLICE AND FIRE DEPARTMENTS, 911 MINOR INCIDENT: FIRES: Extinguish with fire extinguisher. Recharge fire extinguisher, if necessary. 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. MEDICAL: Treat with on site first aid kit or take to nearest hospital. Employee training plan lists the nearest hospital. RECORD: Record the event in the daily monitoring log. NOTIFY: the dealer of the event. 3_ EMPLOYEE TRAINING PLAN 1367 Employees must be given this training before starting work, and refresher courses must 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 this document upon completion of training. Retain these records for 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: In storage room at north end of svc bay 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: In storage room at north end of svc bay C. WATER SHUT-OFF: The water shut-off may be necessary in some cases. LOCATION: In sidewalk on Chester Avenue D. 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: NONE E. FIRST AID KIT: LOCATION: In storage room F. 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: 3-in sales room G. ABSORBENT: In the form of kitty litter, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spill, merely try to contain it; a vacuum truck should be used to clean up any large spill. LOCATION: N-W CORNER OF SERVICE BAYS H. EMERGENCY RESPONSE EQUIPMENT: These items shall be used by employees to prevent direct skin contact with a hazardous material. 1. Broom: IN STOREROOM 2. Shovel: IN STOREROOM 3. Gloves: IN STOREROOM 4. Goggles: IN STOREROOM II. NEAREST MEDICAL FACILIT mployees should know what facilities available in case customers or other employees need medical attention. I. NAME: Mercy Hospital ADDRESS: 2215 Truxton Ave., Bakersfield PHONE NUMBER: 805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: 2. NAME: UCLA Hospital and Clinics ADDRESS: 10833 LeConte Avenue, Los An.qeles PHONE NUMBER: 213-825-2111 Ill. All employees 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 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 (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 clothing and shoes. Follow by washing with soap and water. Do not reuse 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 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. E. 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 symptoms such as loss of gag reflex, convulsions or unconsciousness occur before emesis, gastric lavage using a cuffed endotracheal tube should be considered. F. 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 for that product. I have reviewed, understand and have been properly drilled in the above employee training program. Employee Signature Date Initial Training Refresher Training Employee Name (Please Print) Document prepared by:Environmental Staff,Robert H. Lee & Assoc., 707-765-1660 LOG~ TRAINING SIS #: 1367 BUSINESS NAME: Nolan's Union Service #1367 ADDRESS: 1501 BrundaRe Lane EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR INITIAL AND/OR ANNUAL ;AFETY TRAINING. DATE OF TYPE OF EMPLOYEE NAME EMPLOYEE SIGNATURE TRAINING TRAINING ROBERT H. LEE & AISSOCIATES, INC. ARCHITECTURE PLANNING ENGINEERING 11;37 NORTH MoOOWEI. L. BOULEVARD $ PL=TALUMA, CALIFORNIA ~tc~4..14Bc! ('707] 7elS-lei=10 AN EBOI= COMPANY FAX [70'7] ?B~-BBOB BRIAN F, ZITA JOHN W, JOHNSON February 6, 1992 Nolan W. Beret UNOCAL # 1367 1501 Brundage Lane Bakersfield, CA 93304 Dear Nolan W. Beret: Attached is the new Hazardous Materials Management Plan (HMMP) for your facility. This new HMMP is intended to replace the previous HMMP currently on file at your facility. The new DEALER copy should be kept up to date on the permises. Please sign and date all 4 copies of this new HMMP on the flagged pages where~indicated with an "X". Make any necesssary corrections on each copy and initial each correction. Return the copies marked FILE, UNOCAL and AGENCY to Robert H. Lee & Associates (RHL) in the envelope provided. Keep the DEALER copy at the site for the training of all personnel and as a reference source in an emergency. Copies of the signed/certified HMMP will be sent to the local agency and to UNOCAL by RHL upon receipt. Please do not delay in returning these document to RHL. Call if you have any questions. Sincerely, ROBERT H. LEE & ASSOCIATES, INC. George K. Hyne~ AKNOWLEDGE~NT OF RECEIPT Environmental Specialist ~8i enclosures g co: Jim scott, ~ocAL . ~/~ 0~//Z/~_ File Ti-tie ' ~a~e (~) OFFIGE~% i. ARKBPUR! CA BAGRAMENTO~ GA BBI. LEVUE! WA 1367 Bakersfield Fire Dept. Hazardous Materials Division RECEIVED 2130 "G" Street fi§ 2 7 1992~ Bakersfield, CA 93301 ~ HAL M~T. DIV. HAZARDOUS MATERIALS MANAGEMENT PLAN I_N. STRUCTION__.S: ~h 1. To avoid further action, retur in 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH· 3. Answer the below for the business as a whole. 4. Be brief and concise as possible. SEC'nON 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: Nolan's Union Service LOCATION: MAILING ADDRESS: 1501 Brundage Lane CITY: Bakersfield STATE: CA ZIP: 93304 PHONE: 805-325-4141 DUN & BRADSTREET NUMBER: 09-944-7344 SIC CODE 5541 PRIMARY ACTIVITY AUTOMOBILE REFUELING STATION OWNER: UNOCAL Corporation MAILING ADDRESS: 911 Wilshire, Los Angeles, CA. 90051 SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE j 1. Nolan W. Beret DEALER 805-325-4141 805-871-1814 2. Ed Berst DEALER 805-871-9759 805-871-1727 BAKERSFIELD FIRE DEPT. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: 4 MATERIAL SAFETY DATA SHEETS ON FILE: YES (SEE SITE PLAN FOR LOCATION) BRIEF SUMMARY OF TRAINING PROGRAM: Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. 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, N01an W. Berst , CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH & SAFETY CODE" ON HAZARDOUS MATERIALS ( DIV. 20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE ,.O ONSTITUTES PERJURY. ,'~/~/////~~ --'- Dealer SIG[~ATUF('E - - TITLE DATE BAKERSFIELD FIRE DEPT. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN ' FACILITY UNIT NAME: N01an's Union Service SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION AND EVACUATION PROCEDURES: - UNOCAL wilt notify the appropriate State and Local agencies unless the situation requires urgent immediate response by the agencies, in which case the DEALER should notify these agencies: 1. LOCAL AGENCY: Bakersfield Fire Prevention Hazardous Materials Div. PHONE NUMBER: 209-326-3979 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800)852-7550 (24 HRS.) 3. CALL FOR HELP in case of an emergency by dialing 9-1-1 B. EMPLOYEE NOTIFICATION AND EVACUATION: NOTICE WILL BE VERBAL. EMPLOYEES WILL EVACUATE BUILDING AND MEET AT EMERGENCY ASSEMBLY AREA. (SEE SITE PLAN FOR LOCATION) C. PUBLIC EVACUATION: IF THERE IS ANY IMMEDIATE DANGER, ANNOUNCE TO ALL PERSONS ON THE SITE: " THERE IS AN EMERGENCY. PLEASE TURN OFF YOUR ENGINES AND LEAVE THE STATION ON FOOT IMMEDIATELY." D. EMERGENCY MEDICAL PLAN: PLEASE SEE EMERGENCY RESPONSE PLAN ATTACHED BAKERSFIELD FIRE DEPT. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION. PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: ABOVEGROUND AUTOMOTIVE PRODUCT ARE STORED IN UNBREAKABLE CONTAINERS AND IN MINIMUM QUANTITIES. THE UNDERGROUND STORAGE TANKS ARE MONITORED USING AN APPROVED MONITORING METHOD TO DETECT LEAKS. ALL EMPLOYEES ARE TRAINED IN SAFE HANDLING OF HAZARDOUS MATERIALS B. RELEASE CONTAINMENT AND/OR MINIMIZATION: STOP A RELEASE- BY TURNING OFF THE PUMPS AND USTNG EITHER A9SOR9~.N? MATERIAL OR A FIRE EXTINGUISHER AS NECESSARY C. CLEAN-UP PROCEDURES: CLEAN UP WITH ABSORBENT MATERIAL, BROOM AND SHOVEL,OR BY VACUUM TRUCK IF NECESSARY SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: None ELECTRICAL: In storage room at north end of svc bay WATER: In sidewalk on Chester Avenue SPECIAL: EMERGENCY PUMP SHUTOFF LOCATION: In storaqe room at north end of svc bav LOCK BOX: NO SECTION 9: PRIVATE FIRE PROTECTION/~NATER AVAILABLE: A. PRIVATE FIRE PROTECTION: NONE B. WATER AVAILABILITY (FIRE HYDRANT) PLEASE SEE SITE PLAN FOR LOCATION OF NEAREST FIRE HYDRANT LOCATION 4. z367 CITY of BAKERSFIELD U~ Standard Business I~an 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 ' Farm and Agriculture N O N - T R A D E S E C R E T S Page 1 BUSINESS NAME: Nolan's Union Service OWNER NAME: UNOCAL Corporation NAME OF THIS FACILITY: LOCATION:1501 Bmndage Lane ADDRESS: 911 Wilshire Blvd. STANDARD IND. CLASS CODE: 5541 CITY, ZIP: Bakersfield 93304 CITY, ZIP: Los Angeles, CA 90051 DUN AND BRADSTREET NUMBER PHONE #: 805-325-4141 PHONE #: 213-977-6252 09-944-7344 REFER TO INSTRUCTIONS FOR PROPER CODES 1 2 3 4 , 5 6 7 8 9 10 11 12 13 14 Trane Type Max Average Annual Measure #Dys Cont Cont Cont Use Location Where % by Names of Mixture/Components Code Code Amt Est Est Units on Site Type Press Tamp Code Stored in Facility Wt See Instructions Physical and Health Hazard C.A.S. Number 8006-61-9 Component #1 Name & C.A.S. Number / < 15.0 METHYL TERT BUTYL ETHER / 1634044 (Check ell that apply) ,dill, 6.5 TOLUENE Component #2 Name & C.A.S. Number I~ Fire Hazard r-] Reactivity I~] Delayed I--'] Sudden Release [] Immediate 108883 Health of Pressure Health < 4.6 XYLENE Component #3 Name & C.A.S. Number 108383 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Trans Type Max Average Annual Measure #Dys Cont Cont Cont Use Location Where % by Names of Mixture/Components Code Code Amt Est Est Units on S,te Type Press Tamp Code Stored in Facility Wt See Instructions U I M I 10,0OO I 4,000 I220.000 I GAL I 365 I 01 I 1 I 4 I 19 I N-EOF STATION SUPER UNLEADEDGASOLINE Physical and Health Hazard C.A.S. Number 8OO6-61-9 Component #1 Name & C.A.S. Number ( 15.0 METHYL TERT BUTYL ETHER (Check all that apply) ~ 1634044 Component #2 Name & C.A.S. Number [] Fire Hazard D Reactivity I~ Delayed O Sudden Release r~ Immediate~j < 14.0 TOLUENE Health of Pressure Health 108883 Component #3 Name & C.A.S. Number < 8.8 XYLENE 108383 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Trane Type Max Average Annual Measure #Dys Cont Cont Cont Use Location Where % by Names of Mixture/Components Code Code Amt Est Est Units on S,te Type Press Tamp Code Stored in Facility Wt See Instructions U I M I 240 I 200 I 1440 I GAL I 365 I 10 I I I 4 I 26 I STORAGE BLDG/IN BAY MOTOR OIL Physical end Health Hazard C.A.S. Number 64742-65-0 Component 81 Name & C.A.S. Number //> 70.0 DISTILLATES (Check all that apply)/ 94742547 Component #2 Name&C.A.S. Number ~. / D Fire Hazard O Reactivity [~ Delayed O Sudden Release D Immediate~j < 25.0 ADDITIVES MIXTURE Health of Pressure Health Component #3 Name & C.A.S. Number < 5.0 SYNTHETIC BASE OIL MIXTURE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Trane Type Max Average Annual Measure # Dye Cont Cont Cont Use Location Where % by Names of Mixture/Components Code Code Amt Est Eat Units on S,te Type Press Temp Code Stored in Facility Wt See Instructions u I w221 1 550 I I I GAL I 365 101 I I I 4 140 I SOUTHOFSE,V,CES^YS WASTE O,L Physical and Health Hazard C.A.S. Number 800-20-59 Component #1 Name & C.A.S. Number /1OO.0 WASTE OIL (Check ell that apply) 800-20-59 D Fire Hazard D Reactivity []HealthDelayed Oof PressureSUdden Release HealthD Immediate Component #2 Name & C.A.S. Number Component #3 Name & C.A.S. Number EMERGENCY CONTACTS #1 I~.olen W. ~eret pealer 805-871 - 1814 #2 Ed Beret Manager 805-871 - 1727 Name Title 24 Hr Phone Name lltle 24 Hr. Fhone ;ertitication (Head en~ $/gn.after completemg _ell sectton$~ ............... Icertify und,rpenalty of.. t.het' .hay, per.so"allye.xa.mined a..nd .em. familiar with the information submitted inthis and allre'~ ~c/c~ attached documents, and that based on my ,nquiry ot those individuals responsible for obtaining the information. I believe that the submitted information ia true, accurate, and complete Nolan W. Burst Dealer 4~Z Name and otficml t~tle o! owner/operator Ol~ owner/operator's authorized rapresentitive .Signatu Date Signed 136, CITY of BAKERSFIELD r~ ~-. HAZARDOUS MATERIALS INVENTORY' Farm end Agriculture Standard Business N O N - T R A D E S E C R E T S Pe0a 2 of BUSINESS NAME: Nolan'a Union Service OWNER NAME: UNOCAL Corporation NAME OF THIS FACILITY: LOCATION: 1501 Brundage Lane ADDRESS: 911 Wilshira Blvd. STANDARD IND. CLASS CODE: 5541 CITY, ZIP: Bakersfield 93304 CITY, ZIP: Los Angeles, CA 90051 DUN AND BRADSTREET NUMBER PHONE #: 805-325-4141 PHONE #: 213-977-6252 09-944-7344 REFER TO INSTRUCTIONS FOR PROPER CODES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Trens Type Max Average Annual Measure # Dys Cont Cont Cont Use Location Where % by Names of Mixture/Components Code Code Amt Est Est Units on Site Type Press Tamp Code Stored in Facility Wt See Instructions Physical end Health Hazard C.A.S. Number 800-20-59 Component #1 Name & C.A.S. Number 100.0 USED OIL FILTERS (Chock all that apply) 800-20-59 Component #2 Name & C.A.S. Number D Fire Hazard D Reactivity ~] Delayed D Sudden Release C~ Immediate Health of Pressure Health Component #3 Name & C.A.S. Number 1 2 3 4 S 6 7 8 9 10 11 12 13 14 Trans Type Max Average Annual Measure # Dys Cont Cont Cont Use Location Where % by Names of Mixture/Components Code Code Amt Est Est Units on S~te Type Press Tamp Code Stored in Facility Wt See Instructions A Iw162 I 10 I 6 I 48 I1butt' I 365 I 10 I1 I 4 I 40 I IN SERVlCE BAY WASTE BATTERIES Physical and Health Hazard C.A.S. Number 7664-93-9 Component #1 Name & C.A.S. Number 34.0 LEAD (Check all that apply) 7439-92-1 Component #2 Name & C.A.S. Number D Fira Hezord O Reactivity [~] Delayed r-'l Sudden Ralaase 0 Immediate 31.0 LEAD DIOXIDE Health of Pressure Health 1309-60-0 Component #3 Name & C.A.a. Number 34.0 SULFURIC ACID 7664-93-9 EMERGENCY CONTACTS #1 Nolan W. Berst Dealer 805-871-1814 #2 Ed Berst Manager 805-871-1727 Name Title 24 Hr Phone Name Title 24 Hr. Phone ;ertificatJon IReed and sign after completeing all sections/ I certify under penalty of.law that I have personally examined and am familiar with the information submitted in this and all submittedattached documents, and that based on my inquiry of those individuals responsible for obtaining the information. I believe that t hain formation is true, accurate, and complete Nolan W. Berst Dealer CZ Z/~,, Name and oftJcial title ct owner/operator OH owner/operator's authorized representlt~ve 5ignature /'// Date 5lgnejl~l UNOCAL S : VICE STATION HAZARDOUS MATERIALS MANAGEMENT MONITORING PLAN DEALER: Nolan W. Berst UNOCAL SERVICE STATION: 1367 ADDRESS: 1501 Brundage Lane CITY, STATE, ZIP: Bakersfield, CA 93304 TELEPHONE: 805-325-4141 24-HR. TELEPHONE NUMBER: 805-871-1814 UNOCAL BUSINESS MANAGER: TELEPHONE: UNOCAL EMERGENCY PHONE: (800) 723-7600 (24 HOURS) LOCAL AGENCY: Bakersfield Fire Department ADDRESS: 2130 G Street TELEPHONE: 805-326-3979 CALIFORNIA OFFICE OF EMERGENCY SERVICES TELEPHONE: (800) 852-7550 UNDERGROUND STORAGE TANKS: CONST. SW/DW 87 OCTANE: 10,000 GAL SW 89 OCTANE: BLENDING VALVE 92 OCTANE: 10,000 GAL SW DIESEL: GAL WASTE OIL: 550 GAL SW PIPING CONTAINMENT: Single Wall MONITORING METHODS: Inventory Reconciliation T~BLE OF CONTENTS~ EHERGENCY RESPONSE PROCEDURE ...................................... Page ~ A copy of this page must be filled out and posted conspicuously on site. HOW TO USE T~IS BOOKLET ........................................... Page 4 DAILY VISUAL MONITORING ........................................... Page 4 MONITORING FOR SINGLE NALL TANKS .................................. Page 5 Inspections To Be Conducted By Dealer Product Tank Gauging Procedures Record Keeping For Fuel Tanks Waste Oil Tank Gauging Procedure What To Do If You Exceed The Allowable Variation MONITORING DOUBLE NALL TANKS ...................................... Page 6 Inspections To Be Conducted By Dealer Secondary Containment Monitoring Procedure Record Keeping For Secondary Containment Electronic Monitoring Systems OVERFILL/SPILL PROTECTION /%ND CLEAN-UP ............................ Page 7 Deliveries/Gauging Ball Vent Line Float System Waste Oil Tank Clean-up/Records INSPECTIONS TO BE COORDINATED BY UNOCAL ........................... Page 8 Yearly Inspections and Testing Vadose/Groundwater Monitoring Wells EMPLOYEE TRAINING PLaN ......................................... Pages 9-10 Outline for Mandatory Safety Training for All Employees FOP. MS TO BE COMPLETED (Copy these forms for your own use) Quarterly Report ................................................ Form A Daily Visual Monitoring Log ................ , .................... Form B Inventory Reconciliation Sheet .................................. Form C Waste Oil Tank Gauging Sheet .................................... Form D Release Evaluation Checklist .................................... Form E Unauthorized Release Report ..................................... Form F Equipment Test Log .............................................. Form G Safety Training Log ............................................. Form H NOT ALL INFORMATION IN THIS BOOKLET WILL BE APPLICABLE. REFER TO THE COVER SHEET TO CONFIRM WHAT EQUIPMENT IS ON SITE. Page 2 of 10 EMERGENCY RESPONSE PROC~E In the event of a fire, spill, leak or suspected leak in the tanks and/or piping, the following steps are to be taken as applicable: 1. TURN OFF PUMPS using the Emergency Pump Shut-off Switch. 2. If there is an immediate danger, ANNOUNCE to all persons on the site: "THERE IS AN F2~ERGENCY. Please turn off your engines and leave the Station on foot immediately." 3. For more SEVERE emergencies CALL FOR HELP by dialing 9-1-1 and giving the following information: "THERE IS A FIRE/DANGEROUS GASOLINE SPILL at the UNOCAL Station at (give address.)" Report to the answering dispatcher, whether anyone is trapped or requires immediate medical attention. Stay on the phone and be prepared to answer any questions concerning the situation. 4. If EVACUATION is necessary direct everyone to meet at the emergency assembly area and account for everyone at that location. LOOK AROUND to assure that all have left, particularly those in vehicles who may not have heard the emergency announcement. Assist, or direct assistance to anyone having difficulty leaving the service station area, and anyone who may be injured. 5. ATTEMPT TO EXTINGUISH any fire if you can do so safely. Have the fire extinguisher ready to use in the event of any dangerous spill. Try to contain any large spill, or use absorbent on smaller spills. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station dealer if s/he is not already at the station. Use the emergency contacts listed below: 1. Name/Bus/Home: Nolan W. Berst 805-325-4141/805-871-1814 2. Name/Bus/Home: Ed Berst 805-871-9759/805-871-1727 8. NOTIFY UNOCAL and your Business Manager by phone WITHIN 24 HOURS. 1. UNOCAL EMERGENCY PHONE: (800) 723-7600 (24 HOURS) 2. UNOCAL BUS. MANAGER/PHONE NUMBER: Matt Fischer (510)277-2465 You must mail a completed Unauthorized Release Report to the Business Manager within 24 hours. UNOCAL will notify the appropriate State and Local agencies unless the situation requires urgent immediate response by the agencies, in which case the DEALER should notify these agencies: 1. LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800) 852-7550 (24 HOURS) 9. Dealer should attempt to isolate leak location by inspection. 10. UNOCAL Business Manager will coordinate with UNOCAL Environmental Compliance Dept. (UECD) whatever corrective actions need to be taken beyond the dealer's capabilities. UECD will file whatever reports need to be filed with local and state agencies, and send a copy to the station for the Dealer's file. A COPY OF THIS PAGE MUST BE FILLED OUT AND POSTED CONSPICUOUSLY ON SITE. Page 3 of 10 The cover sheet °f~his booklet contains use information about the underground facilities at your station. Depending on the information given, you must use different forms in this booklet: 1. If your station has any single wall product tanks, use Form C. 2. If your station has any double wall product tanks, use Form B. 3. If your station has a single wall waste oil tank, use Form D. 4. If your station has a double wall waste oil tank, use Form B. 5. If your station has any double wall piping, use Form B. 6. If your station has a piping trench liner, use Form B. 7. If your station has an electronic monitoring system for any double wall piping or trench liner, you need not use Form B for any double - wall tanks or piping. 8. If your station has vadose or groundwater monitoring wells, you still need to use Forms C and/or D as applicable. 9. If your station has other hazardous materials (see Daily Visual Monitoring, below), you are responsible also for that portion of Form B. Also. all stations must complete Form A and send it in every 3 months to the local aqen~y Shown on the.cover.sheet. In case of a leak or spill,~ you must complete Form E to attach to Form A, and you must send a copy of Form F to your UNOCAL Representative within 24 hours. You.~ust also notify your representative by phone (and/or call the UNOCAL Emergency Phone after hours). You must post a copy of Page 3 at a conspicuous location in your cashiers area. You must keep a copy of Form H to document the training received by your employees. KEEP COPIES OF ALL FORMS YOU MAIL OUT! D~ILY VISUAL MONITORING Hazardous Materials stored underground include: Gasoline Diesel Fuel Waste Oil These products are monitored for leaks in the underground tanks and piping. Hazardous Materials stored aboveground include: Propane Waste Oil (prior to dumping in underground tanks) Motor 0il Transmission Oil Gear Lubricant (80W/90) Grease Solvent (including parts cleaners) Battery Acid Antifreeze If your station stores any of these materials, the storage areas must be visually inspected every day for signs of leakage. If there is a leak or spill of any of the hazardous materials, whether stored above or underground, you must follow the Emergency Response Procedures outlined on Page 3, as applicable. Page 4 of 10 ~ONITORING FOR SlNG]~-WALL TANKS INSPECTIONS TO BE C~UCTED BY DEALER 1. Daily reconciliation shall be made of theiKPentory control records. 2. Daily visual inspection for leaks shall be made in the areas of: - Submerged pump - Tank fill (also inspected after each delivery) 3. Dealer MUST be aware that a reduction in product flow to 3 gallons per minute (gpm) indicates a potential piping leak. PRODUCT TANK GAUGING PROCEDURE 1. Use a gauge stick (dipstick) to measure the level of gasoline in each tank. Lower the stick slowly until it hits the bottom of the tank. The use of fuel-finding paste is recommended. 2. Slowly pull the stick back out, and observe the point where the stick begins to be discolored by the liquid. 3. Write this number down, and repeat the same procedure. If the two number are not close, repeat the procedure until the numbers agree. 4. Enter the final number in your dealer books. If it is raining, water can spoil thp. upadings, and should not be allowed to enter the tank. If' it does not stop raining, care must be taken to ensure the stick readings are accurate. RECORD KEEPING FOR SINGLE-WALL TANKS 1. Use your dealer books to keep track of your daily dipstick r~ading. 2. Record ~ailv all dispenser, meter readings in your dealer books. 3. Reco~d all deliveries in your dealer books. 4. The'dipstick, dispenser meter, and delivery recordings are to be used daily in filling out the "Inventory Reconciliation Sheet" (attached). WASTE OIL TANK GAUGING PROCEDURE 1. To monitor the inventory level in the waste oil tank; be prepared to have the tank locked for at least 12 hours or longer if required by your local agency. This shall be ~one weekly. NO INPUTS OR WITHDRAWALS SHALL OCCUR DURING THESE PERIODS. 2. Stick gauge the tank immediately before closing access to the waste oil tank, and immediately after reopening the tank, and enter those numbers in columns C and D of the "Waste Oil Tank Gauging Sheet" (attached) in both inches and gallons. 3. The difference between those two columns is the actual variation (column E). 4. For allowable variation (column F), use 2.8 gallons if you have a 280 gallon capacity, or 5.0 gallons if you have a 520 or 550 gallon tank. NHAT TO DO IF YOU EXCEED THE ALLOWABLE VARIATION If you EVER exceed the allowable variation es indicated on the Inventory Reconciliation Sheet C, column 13, or on the Waste Oil Tank Gauging Sheet D, column 7, follow the RESPONSE PROCEDURE shown on Page 3. Notify your UNOCAL representative within 24 hours of discovery of a suspected leak. UNOCAL will be responsible for coordinating one or more of the following: - Performing a metered vs. measured inventory reconciliation. - Contacting the appropriate State and Local agencies. - Visually inspecting for leaks. - Calibrating the dispenser meters. - Hiring a tank tester to determine if there is a leak. - Having the tank(s) and/or piping repaired or replaced if necessary. The "Unauthorized Release Report" must be sent to UNOCAL within 24 hours. The #Release Evaluation Checklist" must be attached to the "Inventory Reconciliation Sheet", or the "Waste Oil Tank Gauging Sheet" where the allowable variation was exceeded. Page 5 of 10 ~NSPECT~O~8 TO BE ~OHDUCTED BY DEALER 1. Daily reconciliation shall be made of the lnventor~ Control Records. 2.Daily visual inspection for leaks shall be made in the areas of: -Submerged pmnp - Tank fill (also inspected after each deliver~) 3. Dealer MUST be aware that a reduction in product flow to 3 gallons per minute (gpm) indicates a potential leak. 8BCOND~RYCONTAINMENTMONITORING PROCEDURE Tank or Piping Secondary Containment (annular space or Piping Trench Liner) shall be monitored ~ by the .dealer, unless & less frequent period is allowed. This is done to determine if product is leaking from the primary container or if water is entering from an outside source. This Drocedure is not necess~FV ~f an electronic monitorina system is installed to monitor these iteEs. Contact your UNOCAL represent&tire for monitoring port locations. 1. Use a gauge stick (dipstick). to detect any liquid in the tank annular space, double wall piping monitoring ports, or piping trench liner monitoring wells. Lower the stick slowly until it hits the bottom of the tank annular space. 2. Slowly pull the stick back out and observe whether the stick has been discolored by liquid. If product and/or water is detected, immediately contact your representative. 3. Write this number down, and repeat the same procedure. If the two numbers are not close, repeat the procedure until the numbers agree. 4. Enter the final number in the "Secondary Containment Recording Sheet (attached). NOTE: Piping trench monitoring wells consist of slotted PVC pipe which allows liquid intrusion and a manhole for access. Wells are located at the lowest point of the fiberglass trench liner. RECORD KEEPING FOR DOUBLE-WALL TANKS & PIPING 1. Keep track daily of the liquid level on the "Secondary Containment Recording Sheet**. 2. If ANY fuel and/or water is discovered in the trench liner, call your representative IMMEDIATELY, and explain the situation. 3. If the representative has been notified, but after 8 hours it has not been possible to remove all the liquid from the secondary containment, dealer_must contact the local'agency shown on the cover sheet. ELECTRONIC MONITORING SYSTEMS If this station is equipped with an electronic monitoring system for underground tanks and piping, in the event of a leak in containment, product will be contained in the annular space. Theprimarysensors for the electronic monitoring system are located at the low end of each tank, and at the low end of the piping where the product will drain back into the tank. There may be sensors at additional locations. Sensors will signal the presence of a leak. Xf a leak is discovered, the #Unauthorized Release Report" must be sent to UNOCAL within 24 hours. The ~Release Evaluation Checklist" must be attached to the "Quarterly Report". Page 6 of 10 1. DELIVERIES/GAUGING 'Dealer is responsible to ensure that the delivery he or she requests is not in excess of the tank capacity, taking into consideration the amount currently in tank. Dr~ver is to gauge tank to assure capacity is available for the entire load and ~Bst remain in attendance during the entire delivery to monitor the operation. 2. BALL VENT LINE FLOAT SYSTEM (Only for double-wall tanks.installed after July 1986.) The ball float valve system installed with the tank substantially prevents the possibility of overfill occurring. If the tank is filled to the ball float level, the petroleum product delivery will be cut to 3 gallons per minute alerting the dr~ver of a potential overfill condition. In the event that this occurs, the'following actions will be taken: 1. The delivery truck dr~ver shall turn off the petroleum product supply at the truck, leaving the hose fully connected to the tank fill pipe line and the truck. 2. The small amount of petroleum product remaining in the hose shall be slowly drained into the tank. Since the ball float valve is 2 to 3 inches below the top of the tank, there remains a 100 + gallon capacity within the tank at the moment when the ball float closes off delivery. The bleed hole in the ball float valve allows the remaining petroleum product in the hose to completely drain through the fill pipe into the tank. 3. The hose shall be disconnected from the fill pipe only when it has fully drained. In the event that spillage occurs upon hose disconnection, the remaining small amount of petroleum product will be properly contained. 3. N~BTE OIL TANK 1. Station is equipped with waste oil buckets which hold a maximum capacity of 3 gallons (about 3 to 4 carst worth of waste oil). 2. Prior to dumping any waste oil, dealer is to gauge the tank to assure that holding capacity is greater than that which will be put into the tank. 3. Waste oil is poured directly through fill/pump out pipe, using a. funnel. Should any waste oil spill during this operation, it will be properly contained using absorbent material. Page 7 of 10 4. CLE~N-UP/RECORD~ 1. Small spillsWess than I gallon and onl~equiring 15 minutes to clean up) shall be cleaned up using absor~lSent materials. 2. Larger spills occurring during product delivery shall be reported to the terminal by the dealer and/or by delivery truck d~Liver. The terminal supervisor will notify n local petroleum maintenance contractor who is equipped with a N.F.P.A. approved type hand pump, vacuum and transport container. Large spills not caused by delivery shall be reported immediately to your rep. 3. Spills shall be cleaned up within S hours of detection, returned to local terminal and/or disposed of in n lawful manner. 4. Dealer shall record al! spills whether or not it is due to delivery overfill or accidental spillage, which exceeds approximately one gallon, and action taken on the "Unauthorized Release Report" (attached), and send it to UNOCAL within 24 hours. 5. Large spills (more than I gallon) must be reported to the local agency indicated on the cover sheet within 24 hours. If the spill is large enough to pose n significant haz&rd, it must also be reported to the California Office of Emergency Services at 800-852- 7550. IN CASE OF EMERGENCY CALL 9-1-1 INSPECTIONS TO BE COORDINATED BY UNOCAL YEARLY INSPECTIONS AND TESTING Yearly testing shall be made of the following: 1. Pressurized piping systems shall be monitored using in-line leak detectors. Leak detectors shall be tested annually for proper operation. Dealer MUST be aware that a reduction in product flow to 3 gallons per minute (gpm) indicates a potential piping leak. 2. Tanks and piping shall be.tested annually for tightness, using a State-Certified test system. (For non-secondarily contained tanks and piping only.) 3. Electronic monitoring systems shall be tested nnnually for proper operation. (For secondarily contained tanks and piping only.) 4. Dispenser core holes, shear valves, and blending valves shall he annually inspected by UNOCAL for signs of leakage. 5. Dispenser meters (recording total sales in gallons) shall be calibrated once nnnually by UNOCAL. Any additional calibration will be the r~pons~bilitv of the dealer. Use the "Dispenser Meter Calibration Form". VADOSB/GROUNDWATER MONITORING WELLS This section is not applicable unless "Monitoring Methods" line on cover sheet shows "Vadose #ells" or "Groundwater The monitoring of vadose wells and groundwater monitoring wells is contracted out to Applied Geo Systems. Monitoring is performed monthly for vapor analysis of the vadose wells and subjective analysis for traces of product in the groundwater monitoring wells. Monitoring is performed quarterly for laboratory analysis of groundwater samples. Monitoring records are maintained on-site in the dealer's office, and are available for inspection. Page 8 of 10 New Employees must be given this training before staring work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been give his/her safety training. Use the following outline: 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 willhelp to prevent spills. LOCATION: In storage room at north end of svc bay B. ELECTRICAL SHUT-OFF: The panel allows you to selectively cut off power to lights, signs, pumps, etc. The main switch kills all power at the site. LOCATION: In storage room at north end of svc bay C. WATER SHUT-OFF: The water shut-off may be necessary in some cases. LOCATION: In sidewalk on Chester Avenue D. FIRST AID KIT: LOCATION: In storage room E. FIRE EXTINGUISHERS: 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: 3-in sales room F. ABSORBENT: In the form of crystals or cloth, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spills merely try to contain it; a vacuum truck should be used to clean up any large spills. LOCATION: N-W CORNER OF SERVICE BAYS G. NEAREST MEDICAL FACILITY: Employees should know what facilities are available in case customers or other employees need medical attention: NAME: Mercy Hospital ADDRESS: 2215 Truxton Ave. CITY:Bakersfield PHONE NUMBER: 805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: NAME: UCLA Hospital and Clinics ADDRESS: 10833 LeConte Avenue CITY: Los Anqeles PHONE NUMBER: 213-825-2111 Page 9 of 10 ~I. All employe~shguld review the Servic~tation Monitoring Plan, of which thi~ralning plan is a part. S~ifically, 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 Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station. III. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: For direct contact, flush the affected eYe(S) with clean water. If irritation or redness develops, seek medical attention. B. SKIN CONTACT: Wipe product from skin and remove soaked clothing. Cleanse affected area(s) thoroughly by washing with soap and water. If irritation develops and persists, seek medical attention. Do not use solvents or thinners to remove product from skin. C. INHALATION CBreathina): If symptoms of exposure develop, move victim away from source of exposure and into fresh air. If symptoms persist, seek medical attention. Symptoms include: flushing, blurred vision, dizziness, nausea, headache, drowsiness, loss of coordination, and fatigue. If victim is not breathing or if breathing difficulties develop, artificial respiration or oxygen should be administered by qualified personnel. Seek immediate medical attention. D. INGESTION (SwallowiDq): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If victim is conscious and alert, give 2 to 3 cups of milk or water to drink. Seek medical attention. E. 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 for that product. Page 10 of 10 OUARTERLY REPORT A Fill out this form quarterly S/% #: BUSINESS NAME: and send in with all other forms, as applicable. Address: KEEP COPIES OF ALL FORMS YOU MAIL OUT. Quarter # Tank ~ Capacity (gal) Product Start Date: End Dote: Year: CHECK ONE BOX BELOW AS APPLICABLE: ---) I hereby certify under the penalty of perjury that oil product level variations for this facility were within allowable limits for this quarter. ("NO" in cloumn 12, Inventory Reconciliation Sheet; "NO" in column 7, Tank Gouging Sheet; "OK" in applicable columns of the Doily Visual Monitoring Log). Inventory variation at this facility exceeded the allowable limits for this quo,tar. I hereby certify under penalty of perjury that the source for the vorfotion(s) was not due to on unauthorized (leak) release. ("YES" to any of the above). --] There was on unauthorized (leak) release at this facility during this quarter. I hereby certify under penalty of perjury that all necessary corrective oct;oas hove been or ore being taken. DEALER'S SIGNATURE/DATE: LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS THAT EXCEEDED THE ALLOWABLE LIMITS: DATE TANK # AMOUNT THIS QUARTERLY REPORT SHALL BE SUBMITTED TO THE REGULATING LOCAL AGENCY WITHIN 15 DAYS OF THE END OF EACH QUARTER: QUARTER 1 JANUARY-MARCH Submit by April 15 QUARTER 2 APRIL-JUNE Submit by July 15 QUARTER 3 JULY-SEPTEMBER Submit by October 15 QUARTER 4 OCTOBER-DECEMBER Submit by January 15 IFill out this form DAILY VISUAL MONITORING LOG I~o,,, o,, ,,,~ ,, lunocol s/s#: Business Nome:. __ __ Iwith the Quorterty I Address: Month of: I IRePorr' UliOCAL~ INVENTORY tI~CONCILIATIOI~ ~,,, form with the Ou~rter: Tonk *: ~ Ouort~rly Yeor: Copocity/Contents: Report. -~ ~ ++ ~ · ~ _ WASTE OIL TANK GAUGING SHEET D IS/S ' Fill out this #: Business Nome: Address; form week!y and send it with the Quarter: I I Tank ,: Quarterly Year: Copoci~ y:.__ Report. GAUGING PERIOD INVENTORY VARIATIONS 1 2 5 4 5 6 7 Opening Closing Actual Allowable Allowable FROM TO Dipstick Dipstick Variation Variation Vor;otion Reading Reading (4-3) * * Dote/Time Dote/Time Inches Gal. Inches Gal. Gallons Gallons Yes/No · Allowable variation is based on tank size: ~ Allowable Variation 280 gallons 2.8 gallons 520 gallons 5.0 gallons 550 gallons 5.0 gallons you answered "Yes" in column 7 (Col. 6 > Col. 5), then on unauthorized release (leak) shall be assumed to hove occurred. Follow the Release Evaluation checklist and ot~toch to this form. UNO [: AL RELEASE EVALUATION CHECKLIST S/S #: Business Nome: rill out this form Address: whenever the ~:llowoble voriotio~ Tank #: Capacit)c is exceeded and Product: send in with the Date & Time Allowable Variation was Exceeded: ' Ouarteriy Report. CHECK OFF EACH STEP AS IT IS COMPLETED. Performed by: within 2 hours. STEP 2I~]NEW RECONCILIATION Date/Time: Should be done PERFORMED Performed by:. within 24 hours. STEP 31j'--jCALL UNOCAL, REP. AND Dote/Time: Should be done SEND UNAUTHORIZED Performed by: within 24 hours. RELEASE REPORT TO REP. · STEP 41j~]RECORDS. REVIEWED FROM Dote/Time: Shoutd be done I LAST STATIC STATION Performed by:. within 24 hours. (BY DEALER OR REP.) ! STEP 5 PHYSICALLY INSPECT Doi. e/Time:. Should be done --FACILITY FOR EVIDENCE Performed by: within 2 days. OF LEAKS STEP 6I )DISPENSER METER Dote/Time: Should be done CALIBRATION CHECKED Performed by. within 3 days. (COMPLETE TEST REPORT) STEP 7 D HYDROSTATIC PRESSURE Dote/Time: Should be done TEST PERFORMED ON PIPINC Performed by:. within 4 days. STEP 8 r~l PRECISION TANK TEST Dote/Time: Should be done PERFORMED Performed by. within 5 days. STEP 9 r'-IADDITIONAL INVESTIGATION Date/Time: Should be done PERFORMED AS REQUIRED Performed by: within 5 days. Briefly describe the reason the allowable variation was exceeded: J I hereby certify this is to be o true and accurate report. Dealer's Signature: Dote: UNAUTHORIZED RELEASE REPORT F I S/S #: Business Name: Complete this form Address: in the even~ of t3 confirmed le<~k or I Tonk #: Copocity , ~)III Qnd send to )~Dur Unoco! rep. Product: within 24 hours. TO BE COMPLETED BY THE DEALER Dote leok wo~' discovered: Approximate date leak began: Describe fully the cause of the leak: How was the leek discovered? TO BE COMPLETED BY THE UNOCAL RETAIL REPRESENTATIVE Has the leek been stopped? Dote: How wos the leek stopped? List resources offected: Yes No Thr¢otened ~ of wel!~ Soil Creek or Storm droins Buildings or Utility Voults Groundwoter Public Drinking Woter Privote Drinkin9 Woter Agriculturol Other Instruction8 tO Uno(;of Reto[I ReDresentotives: This form must be forworded to Unocol Mointenonce & Construction Deportment IMMEDIATELY so they con submit to the opproprlote Iocol ogency within 5 doys of discovery of ony leok. EOUIPMENT TEST LOG G S/S #: Business Nome: JFill out this Jform for each Address: tonnuaI Contractor: linspection Nome of person completing test(s): , ~..~; keep on Signature: Dealer's Signature: Check off each test when performed: Shear Valve Inspections - Date: 2.~ Blending Valve inspections - Date: I 3.~ Leak De~ector Product Model Leek Full Line Pressure (PSi) Simulated Line Leek Test Inspection Detector. Open Max. 12 Close Min. 26 Pass Fail Dote Super Unleaded Unleaded Diesel Other 4. j~J Dispenser Meter Calibration Procedure: 1. Before starting calibration runs, wet the calibration con with product and return product to storage. 2. Run 5 gallons with nozzle wide open into the con. Note gallons and cubic inches drawn, and return product to storage. 3. Run 5 gallons with nozzle one-half open into the con. Note gallons and cubic inches drawn, and return product to storage. 4. If the volume measured in o 5-gallon calibration can is more than 6 cubic inches above or below the 5-gallon mark, the meter requires calibration by a registered device repairman. Fast Flow Slow Flow Vol. Returned Calibration Date/time Nozzle /J Product 5-Gal. Draft 5-Gal. Draft to storage Required? Gallons Gal. Cu.ln. Gal. Cu.ln. YES,/NO · Note dote of Calibration & Device(s) used: SAFETY TRAINING LOG H S/S #: Business Name: Address: EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR ANNUAL SAFETY TRAININO. Date of Initial Employee Nome Training Dates of Annual Refresher Training ARCHITECTURE FILANNIN{g ENI]INEERINQ 1137 NORTH M=I3OWELL BQULEVARD [70'/] 7E~-1E~80 I=AX [707] BRIAN F, ZITA d~'~HN W. JOHNBON BEORQE H. MIl. LB Jrohite¢c JAMEB H. RAY C~vi, E.~, .... Apr i 1 11, 1991 Ralph Huey Bakersfield Fire Department 2130 "G" Street Bakersfield, CA 93301 Dear Mr. Huey: On behalf of UNOCAL, the following is being submitted by Robert H. Lee & Associates (RHL) in response to your letter of April 2, 1991. The RHL letter sent to you on February 21, 1991 was merely RHL's attempt to schedule any Hazardous Materials Management Plan (HMMP/BP) or Hazardous Materials Inventory Statement (HMIS/Tier II) submissions. These HMMP/HMIS submissions may be required on a one or two year cyclical basis by your agency during the 1991 calendar year. This letter was one of approximately 90 letters sent to various agencies throughout California to gather the latest changes in submission requirements and deadlines. RHL understands per your conversation with Mr. George Hynek of this office on January 8, 1991, that The City of Bakersfield prefers to receive only those submissions with regard to major changes occurring at any specific UNOCAL location. This would be simple enough to do with the assumption that no annual or biannual submission would then be necessary. Concerning your comments regarding the status of RHL's most recent UNOCAL submissions, please note that RHL, as of this date has already completely addressed and submitted the requested changes. It is RHL's understanding in our conversation with Ms. Valerie Pendergrass of your office that these changes have met your requirements and that all of our UNOCAL submissions are now considered to be current by your agency. (See attached list of UNOCAL locations) In addition, please note that RHL had submitted underground storage tank (UST) registration forms A and B to the Kern County Department of Environmental Health earlier this year and that the UST permits for the stations under your jurisdiction are current until 1996. OFFICEB,' LARKBPUR, CA 8ACRAMEN?O, CA BELLEVUE, WA I~HOENIX, AZ Should there be additional requirements or clarification regarding the above submissions, please feel free to call. Very Truly, ROBERT H. LEE & ASSOCIATES ACKNOWLEDGEMENT OF RECEIPT Signature Maria T. Porciuncula Environmental Technician Date cc: Ms. Corrina Dominguez, Unocal file Bakersfield Fire Department ~OBEI:IT H. LEE ~- A~OCIATE~ 11-Apr-91 Bakersfield Fire Department Page 1 1367 3507 3655 Nolan W. Berst Loie W. Perry Witty N. Hawatmeh 1501Brundage Lane 930 Oak Street 2600 Pierce Road Bakersfield Bakersfield Bakersfield CA 93304 CA 93304 CA 93308 805-325-4141 805-322-3106 805-833-8438 4888 5488 5573 Notan W. Berst James D. Su~ners Steve Es[ayed 2699 Mt. Vernon 5401Stockda[e Highway 2502 Ming Avenue Bakersfield Bakersfield Bakersfield CA 93306 CA 93309 CA 93304 805-871-9759 805-832-5333 805-833-9825 6089 6106 7048 Country Club Union, Inc. Sarm~y Babbas Thaerre[[ D. Ming 2524 Oswe[[ Street 1700 California Avenue 2518 White Lane Bakersfield Bakersfield Bakersfield CA 93306 CA 93304 CA 93304 805-871-1331 805-324-7676 805-832-3402 7393 Daniel L. Morgan 8200-A Stockdale Way Bakersfietd CA 93311 805-398-5515 I:IOBEI:IT H. LEE ~. AS-~OCIATES Bakersfield Fire Del Hazardous Materinl~ Division 2130 "G" Street Bakersfield, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: To cvoia furmer oc,ion, return :hi, form wi,~i~ ~0 ~M, of 2. ~EIPRINT ANSWEP$ IN ENGLISH. 3. Answer the auestions Delow for the Dusiness aS a whole. 4. Be bnef onQ concise as po~ible. SECTION 1: BUSINESS IDENTIFICATION DATA LOCATION' 1,5'01 ~f~u~z:)x~:~' ~,~,~__. MAtLING ADDRESS: I~O1 CITY: DUN &BRADSTREETNUMBER: PRIMARY ACTIVITY' AL)ToHO'J~L~: l~-F-v~t',,/~, ~ ~yC.,. OWNER: /'~o~,,t,q W. '~----F~,~T' MAILING ADDRESS: J~"O! "~i~gA[.~ L/~.J .,. SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE 1. ~o~,~ w'. '~,~-T ~ ~o~-,G25'~-14-I ~~Tl-J~l'~,-- 2. tWoNJ~ +' ~' ' Hazardous ~faterials' Division ; -' HAZAOOUS MATERIALS MAUAGEMOT PI. AU SECTION 3: TEAINING: SEE UNOCAL MONITORING PLAN FOLLOWING FOR DETAILED EXPLANATION NUMBER OF EMPLOYESS: SAFETY SHEETS ON FILE' MATERIAL DATA BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEE TRAINING PLAN ' Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. -~ SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE ~EPORTING 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 $: CERT1FlCATIOH: I, ~/OL.,~)~/ ~N'. '~---~-J- 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. SIGNATURE TITLE DATE Bakers~eld Fire Dept. I-Iazardous ~faterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN Facility Unit Name: NO SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: SEE UNOCAL MONITORING PLAN FOLLOWING FOR DETAILED EXPLANATION A;. AGENCY NOTIFICATION PROCEDURES: UNOCAL will notify the appropriate State and Local agencies unless the situation requires urgent immediate response by the agencies, in which case the DEALER should notify these agencies: 1. LOCAL AGENCY: Kings Co. Div. of Envir. Health Services PHONE NUMBER: 209-584-1411 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800)852-7550 (24 HOURS) B. EMPLOYEE NOTIFICATION AND EVACUATION: CONTACT the station dealer if s/he is not already at the station. Use the list below for emergency contacts: 1. Name/Bus./Home: Nolan W. Berst 805-325-4141 / 805-871-1814 2. Name/Bus./Home: None C. PUBLIC EVACUATION: 2. If there is any immediate danger, ANNOUNCE to all persons on the site: "There is an emergency. Please turn off your engines and leave the station on foot immediately." D, EMERGENCY MEDICAL PLAN: NEAREST MEDICAL FACILITY: Employe~s should know what facilities are available in case customers or other employees need medical attention: NAME: Mercy Hospital ADDRESS: 2215 Truxton Ave., Bakersfield PHONE NUMBER: 805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: NAME: UCLA Hospital and Clinics ADDRESS: 10833 LeConte Avenue, Los Angeles PHONE NUMBER: 213-825-2111 B~kersfield Fke Dept. Hazardous .%[a~:er~aIs Division~ HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND ABATEMENT PLAN: SEE UNOCAL MONITORING PLAN FOLLOWING FOR DETAILED EXPLANATION A. RELEASE PREVENTION STEPS: ~ OVERFILL/SPILL PROTECTION AND CLEAN-UP, Del iveries/Gauging " Ball Vent Line Float System Waste Oil Tank Clean-up/Records . RELEASE CONTAINMENT AND/OR MINIMIZATION: )NITORING FOR SINGLE WALL TANKS MONitORinG DOUBLE WALL TAI~ Inspections To Be Conducted By Deale~ /~c~s To Be Conduct.ed B.y Deal?~~ Product Tank Gauging Procedures Secondary.' ent Mo ' 'Procedure Record Keeping For Fuel Tanks Record Kee ' Containment Waste Oil Tank Gauging Procedure What To Do If You Exceed The Allowable Variation · C. CLEAN-UP PROCEDURES' Small spills: Absobent material Larger spills: Report to terminal by dealer or delivery driver Spills shall be cleaned up within 8 hours. Dealer shall record a{{ spills over 1 gallon - any spill over 1 gallon shall be reported to local agency or Calif. Office of Emerg. Svcs. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY)' SPECIAL: ~M~:=r,,IC.W/ :F~H.P ..~~ I~ E:,-T'O1a,,'~,~ ~ LOCK BOX: YE~ IFYES, LOCATION: SECTION 9:' PRIVATE FIRE PROTECTION/WATER AvAILABILITYi A. PRIVATE FIRE PROTECTION: B.' WATER AVAILABILITY (FIRE HYDRANT): CITY of BAKERSFIELD Farm and AgticulLure il Standard J-IAZARDOUS MATERIALS INVENTORY BOS in~. " NON--TRADE SECRETS Page CV~ V_.:. i~C:~l '~UNC)Z~.GfE~ L-~N~=:: . ADDRESS; I~-0! 7~RUNO.~ l.Al. S/ NDAHD IND. CLASS COUE[~J_ "- -- / REFER TO~NE~~N~ROP~ ' ~ 2 3 4 5 6 ~ 8 S tO Il t2 13 Trqns !Y,e ,ax Average Annual ,easure I Y[e cent ~ont cent us~ location?e[Q. ,w~y Hames of ,ixture/components (:ode ieee A~t Aat Est Units on Type yress Tamp CoueStored In facility See Instructions Physical and Health Hazard C.A.S. Hu~ber ~~1~ Component II HaBe I C.A.a. Humber CoepoflenL I~ HaBe I C.A,S. Humber ~Fire~azard ~ Reactivity ~Delayed ~ Sudden Release ~lmmedia:e ~ealth of Pressure Health Couponeflt 13 ~ame I C.A.S. Humber Physical(check al/l°dthatHealthapp/ylUaZard C.A.a. Number ~~/~ Component II Name I C.A,S. Number Co~ponenL t2 Ease I C.A.S. Nu~ber ~Fire Hazard ~ Reactivity ~ O, layed ~ Sudden Release ~ Health of Pressure Component 13 Name I C.A.S, Number Physica) and Hem}th UHard C.A.S. Number , Component II Name ~ C.A.S. Number (Check all that apply) Component ~2 Name I C.A.S. Number ~FireHazmrd ~ Reactivity ~Delayed ~ Sudden Release ~ Immediate HeaKh of Pressure Health Component 13 Name ~ C,A.S. Humber Physical and Health Ualard C.A.S. Number ~T~- 1~ -~ Component II Name I C.k.S, Number ~' [Check 811 that app/yl Component I~ Name I C.A.S. Number M Fire Hazard fl Reactivity ~Oelayed ~ Sudden Release ~ Immediate ~ ~ Health of Pressure Health Component 13 Name I C.A.S. Number ENER6ENCY CONTACTS fllR~~ ~.~~ nC~~ fl2 erLifi aLio Re and ~ n ~ r c~m ~ :fd9 ~ ec~fons) this.lnd al'l certify un'er pen,l~[ 9~ thqL l~,v~pe{son;~.examinq~,q~ 1, fami,lac, vitCthe ,nformation Su~eittpd in UOm!tteo iAlorBatlofl Is [rue, accurate, 8no comp/eta, ~ ~,d bfieial title of o,flerloperator uH owner/operator s authorized representative . Sl9~ture CITY of BAKERSFIELD Farm andAgticul:ure FI Standard Business j~HAZARDOUS MATERI'ALS ~NVENTORY · NON--TRADE SECRETS Pa~ _Z .... of'2"--___ BUS[NESS NAHE- OWNER NAHE: NAHE OF THIS FAC~LHY: L0CAT]0N; ' ADDRESS; STANDARD IND. CLASS CODE[-- CIiY, ZIP: CITY. ZIP: DUN AND BRADSTREE! NUMBER PttONE #: PHONE ~; - - REFER TO-TN~TR~7-~ON$--FOR-PROPER CODES -- I 2 3 i 5 6 7 8 9 10 I1 12 14 ~a~es of ~ixture/Co~onents Code come Act ~ec Es~ Units on Ir~e ~ress le~ ColeStore~ ~n ract~t:y See Instructions Physical IOd Health Hazard C.A.S. Humber ~0"7-~-[-[ Component II Hame I C,A,S. Humber ComponenL 12 Name I C,A,$. Number ~ Fire Hazard !-] Reactivity .:El~O. ela~ Fl Sudden Release ~i:]mmediaLe Heafcfl of Pressure-- Health Component 13 Name I C.A,$. Number Phy,ical(Check ,,,'°d thatHealthapp/y}Uazard C.A.$. Number ~+'7 ~"~ZCP -7--- ---- -- Component ,1 Name, C.A.$. Number t,,,-"~__ltC_./k,.q~ Co~poAen~ 12 Na~e I C.~.$. Number Fire Hazard n Reactivity ~lq'.Oelayed I-1 Sudden Release D Immediate -"'-' Health of Pressure Health Component 13 Name I C,A.S, Humber Iill II Iltll Physical and Health PeTard C.A.S. Humber :. Component II Name I C.A.$. Number (Check ali that 4pp/yJ Component U Name I C.A,S. Number ~ Fire Hmzmrd [-] Reactivity [] Delayed I-I Sudden Release I-I Immediate Health of Pressure Health Component 13 Name I C.A.S. Humber '1 :PhYsical end Health Ualard C,A,$. Humber Component II Hame I C.A,$. Number (Check all that app/yl Component 12 Name I C.X.S. Number [] Fire Hazard [] Reactivity I-1 DelayedHealth ~ Suddenof PressureRelease I-] Im~i~ Component 13 Name I C,X,S. Number EHERGENCY CONTACTS #1 #2 Name TTtle ZqHr PhOne Rame TiTle erti[i~atioq .(Ro~ ~.nd.~ign after co,~p7~tiOg.~77 secCi,on~) his lnd all ~,// certify under penalt[ pl)a~ tnqt i navepecsonal~.examlnqglqolm famillac.¥itb the !nlormaHpn ~u~mittpd in f believe that th C~acned.doc~menc~, InQ tpac pasco on.my Inquiry qT.tnose iflOlVteUa/S responsible lor obcalnin9 cna Information. uem~t:eo in/ormlctofl 15 true, Accurate, AnD complete, I~e eno ofiti41 cltl~ of o~nerfoperacor UH o~ner/operator's authorized representative Sl~re Bit~'-St~r,e~ UNOCAL SERVICE STATION MONITORING PLAN DEALER: Nolan W. Berst UNOCAL SERVICE STATION: 1367 ADDRESS: 1501 Brundage Lane CITY: Bakersfield PHONE: 805-325-4141 24-HR. STATION NUMBER 805-325-4141 UNOCAL REPRESENTATIVE: Jim Foster PHONE: (209)237-5141 UNOCAL EMERGENCY PHONE: (415)867-0760 (24 HOURS) LOCAL AGENCY:Bakersfield Fire Department ADDRESS: 2130 "G" Street PHONE: 805-326-3979 CALIFORNIA OFFICE OF EMERGENCY SERVICES PHONE: (800)852-7550 (24 HOURS) UNDERGROUND TANKS 87 OCTANE: 10,000 Single Wall 89 OCTANE: BLENDING VALVE 92 OCTANE: 10,000 Single Wall DIESEL: WASTE OIL: 550 Single Wall PIPING CONTAINMENT:Single Wall MONITORING METHODS:Inventory Reconciliation (Rev. 11-90) Prepared by Robert H. Lee and Associates TABLE OF CONTENTS EMERGENCY RESPONSE PROCEDURE ...................................... Page 3 A copy of this page must be filled out and posted conspicuously on site. HOW TO USE THIS BOOKLET ...... . ..................................... Page 4 DAILY VISUAL MONITORING ........................................... Page 4 MONITORING FOR SINGLE WALL TANKS .................................. Page 5 Inspections To Be Conducted By Dealer Product Tank Gauging Procedures Record Keeping For Fuel Tanks Waste Oil Tank Gauging Procedure What To Do If You Exceed The Allowable Variation MONITORING DOUBLE WALL TANKS ...................................... Page 6 Inspections To Be Conducted By Dealer Secondary Containment Monitoring Procedure Record Keeping For Secondary Containment Electronic Monitoring Systems OVERFILL/SPILL PROTECTION AND CLEAN-UP ............................ Page 7 Deliveries/Gauging Ball Vent Line Float System Waste Oil Tank Clean-up/Records INSPECTIONS TO BE COORDINATED BY UNOCAL ........................... Page 8 Yearly Inspections and Testing Vado~e/Groundwater Monitoring Wells EMPLOYEE TRAINING PLAN ......................................... Pages 9-10 Outline for Mandatory Safety Training for All Employees FORMS TO BE COMPLETED (Copy these forms for your own use) Quarterly Report ................................................ Form A Daily Visual Monitoring Log ...................................... Form B Inventory Reconciliation Sheet .................................. Form C Waste Oil Tank Gauging Sheet .................................... Form D Release Evaluation Checklist .................................... Form E Unauthorized Release Report ..................................... Form F Equipment Test Log .............................................. Form G Safety Training Log ............................................. Form H NOT ALL INFORMATION IN THIS BOOKLET WILL BE APPLICABLE. REFER TO THE COVER SHEET TO CONFIRM WHAT EQUIPMENT IS ON SITE. Page 2 of 10 EMERGENCY RESPONSE~OCEDURE In the event of a fire, spill, or a leak or suspected leak in the tanks and/or piping, the following steps are to be taken as applicable: 1. TURN OFF PUMPS using the Emergency Pump Shut-Off Switch. 2. If there is any immediate danger, ANNOUNCE to all persons on the site: "There is an emergency. Please turn off your engines and leave the station on foot immediately." 3. CALL FoR HELP in case of an emergency by dialing 9-1-1 and giving the following information: "THERE IS A FIRE / DANGEROUS GASOLINE SPILL at the UNOCAL Station at (give address)." 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. 5. ATTEMPT TO EXTINGUISH any fire if you can do so safely. Have the fire extinguisher ready to use in the event of any dangerous spill. Try to contain any large spill, or use absorbent on smaller spills. 6. REPORT to arriving emergency response personnel to provide them with any information or assistance they might need. 7. CONTACT the station dealer is s/he is not already at the station. Use the list below for emergency contacts: 1. Name/Bus./Home: Nolan W. Berst 805-325-4141 / 805-871-1814 2. Name/Bus./Home: None 8. NOTIFY your UNOCAL Retail Representative by phone WITHIN 24 HOURS (also use the UNOCAL Emergency Phone, after hours): 1. UNOCAL REPRESENTATIVE/PHONE NUMBER: Jim Foster/(209)237-5141 2. UNOCAL EMERGENCY PHONE: (415) 867-0760 (24 HOURS) You must mail a completed Unauthorized Release Report to the Rep within 24 hours. UNOCAL will notify the appropriate State and Local agencies unless the situation requires urgent immediate response by the agencies, in which case the DEALER should notify these agencies: 1. LOCAL AGENCY: Bakersfield Fire Department PHONE NUMBER: 805-326-3979 2. CALIFORNIA OFFICE OF EMERGENCY SERVICES: (800)852-7550 (24 HOURS) 9. Dealer should attempt to isolate leak location by inspection. 10. UNOCAL Retail Representative will coordinate with UNOCAL Maintenance and Construction whatever corrective actions need to be taken beyond the Dealer'capabilities. UNOCAL Maintenance and Construction will file whatever reports need to be filed with local and state agencies, and send a copy to the station for the Dealer's file. A COPY OF PAGE MUST BE FILLED OUT AND POSTED CONSPICUOUSLY ON SITE. Page 3 of 10 HOW TO USE THIS BOOKLET The cover sheet o~is booklet contains use/ information about the underground facilities at your station. DepUTiZing on the information given, you must use different forms in this booklet: 1. If your station has any single wall product tanks, use Form C. 2. If your station has any double wall product tanks, use Form B. 3. If your station has a single wall waste oil tank, use Form D. 4. If your station has a double wall waste oil tank, use Form B. 5. If your station has any double wall piping, use Form B. 6. If your station has a piping trench liner, use Form B. 7. If your station has an electronic monitoring system for any double wall piping or trench liner, you need not use Form B for any double wall tanks or piping. 8. If your station has vadose or groundwater monitoring wells, you still need to use Forms C and/or D as applicable. 9. If your station has other hazardous materials (see Daily Visual Monitoring, below), you are responsible also for that portion of Form B. Also, all stations must complete Form A and send it in every 3 months to the local agency shown on the cover sheet. In case of a leak or spill, you must complete Form E to attach to Form A, and you must send a copy of Form F to your UNOCAL Representative within 24 hours. You must also notify your representative hy phone (and/or call the UNOCAL Emergency Phone after hours). Your must post a copy of Page 3 at a conspicuous location in your cashiers area. Your must keep a copy of Form H to document the training received by your employees. KEEP COPIES OF ALL FORMS YOU MAIL OUT! DAILY VISUAL MONITORING Hazardous Materials stored underground include: Gasoline Diesel Fuel Waste Oil These products are monitored for leaks in the underground tanks and piping. Hazardous Materials stored aboveground include: Propane Waste Oil (prior to dumping in underground tanks) Motor Oil Transmission Oil Gear Lubricant (80W/90) Grease Solvent (including parts Cleaners) Battery Acid Antifreeze If your station stores any of these materials, the storage areas must be visually inspected every day for signs of leakage. If there is a leak or spill of any of the hazardous materials, whether stored above or underground, you must follow the Emergency Response Procedures outlined on Page 3, as applicable. Page 4 of 10 MONITORING FOR S~NGLE-WALL TANKS INSPECTIONS TO BE (~DUCTED BY DEALER 1. Daily reconciliation shall be made of the inventory control records. 2. Daily visual inspection for leaks shall be made in the areas of: - Submerged pump - Tank fill (also inspected after each delivery) 3. Dealer MUST be aware that a reduction in product flow to 3 gallons per minute (gpm) indicates a potential piping leak. PRODUCT TANK GAUGING PROCEDURE 1. Use a gauge stick (dipstick) to measure the level of gasoline in each tank. Lower the stick slowly until it hits the bottom of the tank. The use of fuel-finding paste is recommended. 2. Slowly pull the stick back out, and observe the point where the stick begins to be discolored by the liquid. 3. Write this number down, and repeat the same procedure. If the two number are not close, repeat the procedure until the numbers agree. 4. Enter the final number in your dealer books. If it is raining, water can spoil the readings, and should not be allowed to enter the tank. If it does not stop raining, care must be taken to ensure the stick readings are accurate. RECORD KEEPING FOR SINGLE-WALL TANKS 1. Use your dealer books to keep track of your daily dipstick reading. 2. Record daily all dispenser meter readings in your dealer books. 3. Record all deliveries in your dealer books. 4. The dipstick, dispenser meter, and delivery recordings are to be used daily in filling out the "Inventory Reconciliation Sheet" (attached). WASTE OIL TANK GAUGING PROCEDURE 1. To monitor the inventory level in the waste oil tank, be prepared to have the tank locked for at least 12 hours or longer if required by your local agency. This shall be done weekly. NO INPUTS OR WITHDRAWALS SHALL OCCUR DURING THESE PERIODS. 2. Stick gauge the tank immediately before closing access to the waste oil tank, and immediately after reopening the tank, and enter those numbers in columns C and D of the "Waste Oil Tank Gauging Sheet" (attached) in both inches and gallons. 3. The difference between those two columns is the actual variation (column E). 4. For allowable variation (column F), use 2.8 gallons if you have a 280 gallon capacity, or 5.0 gallons if you have a 520 or 550 gallon tank. WHAT TO DO IF YOU EXCEED THE ALLOWABLE VARIATION If you EVER exceed the allowable variation (Inventory Reconciliation Sheet, column 13, or Waste Oil Tank Gauging Sheet, column G), follow the RESPONSE PROCEDURE shown on Page 3. Notify your UNOCAL representative within 24 hours of discovery of a suspected leak. UNOCAL will be responsible for coordinating one or more of the following: - Performing a metered vs. measured inventory reconciliation. - Contacting the appropriate State and Local agencies. - Visually inspecting for leaks. - Calibrating the dispenser meters. - Hiring a tank tester to determine if there is a leak. - Having the tank(s) and/or piping repaired or replaced if necessary. The "Unauthorized Release Report" must be sent to UNOCAL within 24 hours. The "Release Evaluation Checklist" must be attached to the "Inventory Reconciliation Sheet", or the "Waste Oil Tank Gauging Sheet" where the allowable variation was exceeded. Page 5 of 10 1. Daily reconciliation shall be made of the ~entory Control Records. 2. Daily visual inspection for leaks shall be made in the areas of: -Submerged pump - Tank fill (also inspected after each delivery) 3. Dealer MUST be aware that a reduction in product flow to 3 gallons per minute (gpm) indicates a potential leak. SECONDARY CONTAINMENT MONITORING PROCEDURE Tank or Piping Secondary Containment (annular space or Piping Trench Liner) shall be monitored daily by the dealer, unless a less frequent period is allowed. This is done to determine if product is leaking from the primary container or if water is entering from an outside source. This procedure is not necessary if an electronic monitorinq system is installed to monitor these items. Contact your UNOCAL representative for monitoring port locations. 1. Use a gauge stick (dipstick) to detect any liquid in the tank annular space, double wall piping monitoring ports, or piping trench liner monitoring wells. Lower the stick slowly until it hits the bottom of the tank annular space. 2. Slowly pull the stick back out and observe whether the stick has been discolored by liquid. If product and/or water is detected, immediately contact your representative. 3. Write this number down, and repeat the same procedure. If the two numbers are not close, repeat the procedure until the numbers agree. 4. Enter the final number in the "Secondary Containment Recording Sheet (attached). NOTE: Piping trench monitoring wells consist of slotted PVC pipe which allows liquid intrusion and a manhole for access. Wells are located at the lowest point of the fiberglass trench liner. RECORD KEEPING FOR DOUBLE-WALL TANKS & PIPING 1. Keep track daily of the liquid level on the "Secondary Containment Recording Sheet". 2. If ANY fuel and/or water is discovered in the trench liner, call your representative IMMEDIATELY, and explain the situation. 3. If the representative has been notified, but after 8 hours it has not been possible to remove all the liquid from the secondary containment, dealer must contact the local agency shown on the cover sheet. ELECTRONIC MONITORING SYSTEMS If this station is equipped with an electronic monitoring system for underground tanks and piping, in the event of a leak in the primary containment, product will be contained in the annular space. The sensors for the electronic monitoring system are located at the low end of each tank, and at the low end of the piping where the product will drain back into the tank. There may be sensors at additional locations. Sensors will signal the presence of a leak. If a leak is discovered, the "Unauthorized Release Report" must be sent to UNOCAL within 24 hours. The "Release Evaluation Checklist" must be attached to the "Quarterly Report". Page 6 of 10 Dealer is resp¢ .ible to ensure that the very he or she requests is not in excess of the tank capacity, taking into consideration the amount currently in tank. Driver is to gauge tank to assure capacity is available for the entire load and must remain in attendance during the entire delivery to monitor the operation. 2. BALL VENT LINE FLOAT SYSTEM (Only for double-wall tanks installed after July 1986.) The ball float ~stem iDstalled with the tank__s_~bstantially ~even~~he possibility of overfill occurriDg. If the tank is f~lled '~--~he ball flo~t---level, the petroleffm product delivery, will be cut t~_g. allons per minute al~t-i~-~the driver of a _potential overfill condition. In the event that this occurs, the following actions will be taken: 1. The delivery truck driver shall turn off the petroleum product supply at the truck, leaving the hose fully connected to the tank fill pipe line and the truck. 2. The small amount of petroleum product remaining in the hose shall be slowly drained into the tank. Since the ball float valve is 2 to 3 inches below the top of the tank, there remains a 100 + gallon capacity within the tank at the moment when the ball float closes off delivery. The bleed hole in the ball float valve allows the remaining petroleum product in the hose to completely drain through the fill pipe into the tank. 3. The hose shall be disconnected from the fill pipe only when it has fully drained. In the event that spillage occurs upon hose disconnection, the remaining small amount of petroleum product will be properly contained. 3. WASTE OIL TANK 1. Station is equipped with waste oil buckets which hold a maximum capacity of 3 gallons (about 3 to 4 cars' worth of waste oil). 2. Prior to dumping any waste oil, deale_r is to gauge the tank to ~gssu~---~e that ~oi~i~g ~apaci%yi~greater~ha~'-~ch Will be pUt %~ff~b' the tank-~ 3. Waste oil is poured directly through fill/pump out pipe, using a fu__nn~l[ Should any waste oif-~iil during this operat-i-6-ff, i-~-~ill be properly contained using absorbent material. Page 7 of 10 4. CLEAN-UP/RECORDS 1. Small spill.less than i gallon and on,requiring 15 minutes to clean up) sh~l be cleaned up using abs~ent materials. 2. Larger spills occurring during product delivery shall be reported to the terminal by the dealer and/or bY delivery truck driver. The terminal supervisor will notify a local petroleum maintenance contractor who is equipped with a N.F.P.A. approved type hand pump, vacuum and transport container. Large spills not caused by delivery shall be reported immediately to your rep. 3. Spills shall be cleaned up within 8 hours of detection, returned to local terminal and/or disposed of in a lawful manner. 4. Dealer shall record all spills whether or not it is due to delivery overfill or accidental spillage, which exceeds approximately one gallon, and action taken on the "Unauthorized Release Report" (attached), and send it to UNOCAL within 24 hours. 5. Large spills (more than 1 gallon) must be reported to the local agency indicated on the cover sheet within 24 hours. If the spill is large enough to pose a significant hazard, it must also be reported to the California Office of Emergency Services at 800-852- 7550. IN CASE OF EMERGENCY CALL 9-1-1 INSPECTIONS TO BE COORDINATED BY UNOCAL YEARLY INSPECTIONS AND TESTING Yearly testing shall be made of the following: 1. Pressurized_pi in--stems shall be monitored using in-line leak ~etectors. Leak detectors shall be tested annually -or~~r ~pe~ Dealer MUST be aware that a reduction in product flow to 3 gallons per minute (gpm) indicates a potential piping leak. Tanks 2. ~_____~and--piping shall_b_e__tes~e_d_annu~!!y__for tightness, using a State-Certified - test system. (For non-secondarily contained tanks and piping only.) 3. Electronic monitoring systems shall be tested ~nn~ally for pr~oper ~ion. (For secondarfiy contained tanks and piping only.) 4. Dispenser~_e~9~s, shear valves, and blending valves shall be annually inspected by UNOCAL for signs of leakage7. 5. Dispenser meters (recording total sales in gallons) shall be calibrated once annually by UNOCAL. Any additional calibration will be the responsibility of the dealer. Use the "Dispenser Meter Calibration Form". VADOSE/GROUNDWATER MONITORING WELLS This section is not applicable unless "Monitoring Methods" line on cover sheet shows "Vadose Wells" or "Groundwater Wells".) The monitoring of vadose wells and groundwater monitoring wells is contracted out to Applied Geo Systems. Monitoring is performed monthly for vapor analysis of the vadose wells and subjective analysis for traces of product in the groundwater monitoring wells. Monitoring is performed quarterly for laboratory analysis of groundwater samples. Monitoring records are maintained on-site in the dealer's office, and are available for inspection. Page 8 of 10 EMPLOYEE TRAINING PLAN Employees must be given this training before starting work, and refresher courses must be provided annually. Records must be kept to show when each station employee has been given his/her safety training. Use the following outline: 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: In storage room at north end of svc bay 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: In storage room at north end of svc bay C. WATER SHUT-OFF: The water shut-off may be necessary in some cases. LOCATION: In sidewalk on Chester Avenue D. FIRST AID KIT: LOCATION: In storage room E. FIRE EXTINGUISHERS: 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: 3-in sales room F. ABSORBENT: In the form of crystals or cloth, absorbent can soak up small spills of gasoline, diesel fuel, or other petroleum products. Absorbent should be used rather than washing spills down a drain. In case of large spills merely try to contain it; a vacuum truck should be used to clean up any large spills. LOCATION: In storage room G. NEAREST MEDICAL FACILITY: Employees should know what facilities are available in case customers or other employees need medical attention: NAME: Mercy Hospital ADDRESS: 2215 Truxton Ave., Bakersfield PHONE NUMBER: 805-327-3371 NEAREST DESIGNATED TRAUMA CENTER: NAME: UCLA Hospital and Clinics ADDRESS: 10833 LeConte Avenue, Los Angeles PHONE NUMBER: 213-825-2111 Page 9 of 10 II. All employee~should review the Service~ation Monitoring 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 Materials Safety Data Sheets you have on file for each of the hazardous materials stored at the station. III. FIRST AID PROCEDURES (For exposure to gasoline or diesel fuel): A. EYE CONTACT: For direct contact, flush the affected eye(s) with clean water. If irritation or redness develops, seek medical attention. B. SKIN CONTACT: Wipe product from skin and remove soaked clothing. Cleanse affected area(s) thoroughly by washing with soap and water. If irritation develops and persists, seek medical attention. Do not use solvents or thinners to remove product from skin. C. INHALATION (Breathinq): If symptoms of exposure develop, move victim away from source of exposure and into fresh air. If symptoms persist, seek medical attention. Symptoms include: flushing, blurred vision, dizziness, nausea, headache, drowsiness, loss of coordination, and fatigue. If victim is not breathing or if breathing difficulties develop, artificial respiration or oxygen should be administered by qualified personnel. Seek immediate medical attention. D. INGESTION (Swallowing): DO NOT INDUCE VOMITING BECAUSE GASOLINE CAN ENTER LUNGS AND CAUSE SEVERE LUNG DAMAGE! If victim is conscious and alert, give 2 to 3 cups of milk or water to drink. Seek medical attention. E. 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 for that product. Page 10 of 10 UNOCAL( ) QUARTERLY REPORT A Fill out this form quarterly S/S #: BUSINESS NAME: and send in with all other forms, as applicable. Address: KEEP COPIES OF ALL FORMS YOU MAIL OUT. Quarter # Tank # Capacity (gal) Product Start Date: End Date: Year: CHECK ONE BOX BELOW AS APPLICABLE: r--] i hereby certify under the penalty of perjury that all product level variations for this facility were within allowable limits for this quarter. ("NO" in cloumn 12, Inventory Reconciliation Sheet; "NO" in column 7, Tank Gauging Sheet; "OK" in opplicoble columns of the Daily Visual Monitoring Log). Inventory variation at this facility exceeded the allowable limits for this quarter. I hereby certify under penalty of perjury that the source for the variation(s) was not due to an unauthorized (leak) release. ("YES" to any of the above). There wos on unouthorized (leok) releose ct this focility during this quorter. I hereby certify under penolty of perjury thot oll necessory corrective octions have been or ore being taken. [ DEALER'S SIGN ATURE/DATE:I LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS THAT EXCEEDED THE ALLOWABLE LIMITS: DATE TANK # AMOUNT THIS QUARTERLY REPORT SHALL BE SUBMITTED TO THE REGULATING LOCAL AGENCY WITHIN 15 DAYS OF THE END OF EACH QUARTER: I QUARTER 1 JANUARY-MARCH Submit by April 15 QUARTER 2 APRIL-JUNE Submit by July 15 QUARTER 3 JULY-SEPTEMBER Submit by October 1,5 QUARTER 4 OCTOBER-DECEMBER Submit by January 15 UNOCAL4~) DALLY VISUAL MONITORING LOG Unocal S/S~: Business Name: with the Address: Month o~ Report. SlOR~Ut oo o~ ~.- · ~Z ~ ~ ~.~ ~eq~O . o%~ st!o ~o~o~ g~ ~uoi ~ ~ ~ ~uoi ~._ ~ ~uoi ~ ~uoi R x g~ ~uoi ~ ~ o , UmOC~L~) · C INVENTORY RECONCILIATION .i,, form d~ily S/S #: Business Name: and send it ' with the IOuarter: Tank.: IQuarterly Year: Capacity/Contents: Report. ~ I I I I~ II I II I I I I I I I I I I I I I I I I I I, I I - WASTEOIL TANK GAUGING SHEETD Address: form weekly and send it with the [Quarter: J [ Tank ,: J Quarterly Year: Capacity: Report. GAUGING PERIOD INVENTORY VARIATIONS 1 2 3 4 5 6 7 Opening Closing Actual Allowable Allowable FROM TO Dipstick Dipstick Variation Variation Variation Reading Reading (4-3) * * Date/Time Date/Time Inches Gal. Inches J Gal. Gallons Gallons Yes/No ,Allowable variation is based on tank size: Tank Size AIlowc~ble Variation 280 gallons 2.8 gallons .520 gallons ,5.0 gallons 5.50 gallons 5.0 gallons **If you answered "Yes" in column 7 (Col. 6 > Col. 5), then an unauthorized release (leak) shall be assumed to have occurred. Follow the Release Evaluation checklist and attach to this form. UlIOCALG)e RELEASE EVALUATION CHECKLIST S/S #: Business Nome: .qll out thig form Address: ~henever the =llowoble voriotior Tank #: Capacity. is exceeded and Product: send in with the Date & Time Allowable Vari(]tion wes Exceeded: Quorterty Report. CHECK OFF EACH STEP AS IT IS COMPLETED. STEP 1 E~RECORDS REVIEWED Date/Time: Should be done Performed by: within 2 hours. STEP 2 E~ NEW RECONCILIATION Oote/Time: Should be done PERFORMED Performed by:. within 24 hours. STEP 5Ii---]CALL UNOCAL, REP. AND D(~te/Time: Should be done SEND UNAUTHORIZED Performed by. within 24 hours. RELEASE REPORT TO REP. STEP 4J~'-] RECOROS REVIEWED FROM Date/Time: Should be done LAST STATIC STATION Performed by. within 24 hours. (BY DEALER OR REP.) STEP 5[[-'-] PHYSICALLY INSPECT Date/Time: Should be done FACILITY FOR EVIDENCE Performed by: within 2 days. I OF LEAKS STEP 6 ~DISPENSER METER Da[e/Time: Should be done CALIBRATION CHECKED Performed by. within 3 days. (COMPLETE TEST REPORT) STEP 7 ~ HYDROSTATIC PRESSURE Dote/Time: Should be done TEST PERFORMED ON PIPING Performed by. within 4 days. STEP 8[[--~ PRECISION TANK TEST Date/Time:. Should be done PERFORMED Performed by:. within 5 days. STEP 9 ~'~ ADDITIONAL INVESTIGATION Date/Time: Should be dane PERFORMED AS REQUIRED Performed by:. within 5 days. Briefly describe the reason the allowable variation was exceeded: I hereby certify this is to be a true ond accurate report. Dealer's Signature: Date: ueeocJu..G) UNAUTHORIZED RELEASE REPORTF S/S #: Business Name: IComplete this form Address: I in the event of ~ ;onfirmed look or /Tank#: Capacity. I ~pill crud send t°~ur Unocal rep. Product: ;~ithin 24 hours. TO BE COMPLETED BY THE DEALER Date leak wes discovered: Approximate date leak began: Describe fully the cause of the leak: How was the leek discovered? TO BE COMPLETED BY THE UNOCAL RETAIL REPRESENTATIVE Has the leak been stopped? Date: How was the leak stopped? List resources ~ff~cte~: Ye~ NO Threatened # of well~ Soil i Creek or Storm drains Buildings or Utility Vaults Groundwater 'Public Drinking Water Private Drinking Water Agricultural' Other Instructions to Unocal Retail Re0resentatives: This form must be forwarded to Unocal Maintehance & Construction Department IMMEDIATELY so they can submit to the appropriate local agency within 5 days of discovery of any leak. UNO£AL EQUIPMENT TEST LOG G S/S #: Business Name: Fill out this form for each Address: annual Con tractor: inspection Name of person completing test(s): and keep on ...Signature: file. Dealer's Signature: Check off each test when performed: j---'] Shear Valve Inspections - Date: 1. [2.~ Blending Valve Inspections- Date: 3. J-'-J Leak Detector Product Model Leak Full Line Pressure /PSI) Simulated Line Leak Test Inspection Detector Open Max. 12_ Close Min. 26 Pass Fail Date Super Unleaded Unleaded Diesel O[her 4. J-"-] Dispenser Meter Calibration Procedure: 1. Before starting calibration runs, wet the calibration can with product and return product to storage. 2. Run ,5 gallons with nozzle wide open into the can. Note gallons and cubic inches drawn, and return product to storage. 3. Run 5 gallons with nozzle one--half open into the can. Note gallons and cubic inches drawn, and return product to storage. 4. 'If the volume measured in a 5-gallon calibration can is more than 6 cubic inches above or below the 5-gallon mark, the meter requires calibration by a registered device repairman. Fast Flow Slow Flow Vol. Returned Calibration Date/time Nozzle # Product 5-Gal. Draft 5-Gal. Draft to storage Required? Gallons Gel. Cu.ln. Gal. Cu.ln. YES,/NO *Note date of 'Calibration & Device(s) used: UNOCJIL~ SAFETY TRAINING LOG H I "~/S #: Business Name: I Address: EMPLOYEES MUST SIGN THIS FORM TO PROVE THEY RECEIVED THEIR ANNUAL SAFETY TRAINING. Bate of Initiol Employee Nome Troining Bores of Annuol Refresher Training , 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 lOFFICIAL USE ONLY VqCgl oo0t63 USINESS NAME HAZARDOUS MATERI ALS BUSINESS PLAN AS a WHOLE FORM 2A INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA B. LOCATION / STREET ADDRESS: CITY: ~°%--KeP6F,~,~,J ziP: CAL'q330qBUS.P.0NE: (~O3') 3Z6-- Wt"-t I SECTION 2: EMERGENCY NOTIFICAT~0NS 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 law. EMPLOYEES T0 NOTIFY IN CASE 0F EMERGENCY: NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE: ff~;~g;~'~ , E. LOCK.BOX: 'YES / 90 IF YES, L0dAT~N: ~ v~s, Does ~ CONr~ S~TE PLmS* YES / ~0 ~SDSS¢ YES ! ~0 FLOOR PLANS9 YES / NO KEYS9 YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING. EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS ,MATERIALS:...' .................................... ~ NO YES B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... ~ NO YES C. PROPER USE OF SAFETY EQUIPMENT:... ................ ~ NO YES D. EMERGENCY EVACUATION PROCEDURES: ................. NO YES ~_ E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO YES SECTION ?: HAZARDOUS NATERIAL CIRCLE YES OR NO DOES YOUR BUSINESS HANDLE HAZARDOUS ~',IATERIAL IN Q~ANTIT~ES LESS THAN 500 POUNDS OF A SOLID, 55 GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... th.t the info .tion I understand that this information ~ill be used to fulfill my firm's obligations under the new California Health and Safety code on Haza~d0us Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 OFFICIAL USE ONLY ID# BUSINESS NAME: BUS I NESS PLAN SINGLE FACILITY UNIT FORM SA INSTRUCTIONS 1. To avoid further action, this foFm must be retui'ned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. S. Answer' the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY UNIT# FACILITY UNIT NAME: SECTION 1: MITIGATION, PREVENTIONt ABATEMENT PROCEDURES SECTION 2: NOTIEICATION AND EVACUATION PROCEDURES AT THIS UNIT ONLY SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT ONLY A. Does this Facility Unit contain Hazardous Materials? ...... ~ NO If YES, see B If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form#4A-1) If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form #4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION SECTION $: LOCATION OF WATER Sb~PLY FOR USE BY EMERGENCY RESPONDERS SECTION 6: LOCATION OF UTILITY SHUT-OFFS AT THIS UNIT ONLY. A. NAT. GAS/PROPANe5 D. SPECIAL: E. LOCK BOX: YES / NO IF YES, LOCATION: IF YES, SITE PLANS? .YES / NO MSDSs? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO BAKERSFIELD CITY 'FIRE DEPARTMENT I.D. # FORM 4A-1 Page ._Df ---r--. ' NON--TRADE. SECRETS HAZARDOUS MATERI ALS INVENTORY .BUSINESS NAME: -=~b~.A~ '.5' ~~ ~ OWNER NAME: mo~ ~v~ ~~ ' FACILITY UNIT { , ,,ONLY I 2 3 4 ~ - 6 7 8 .... 9 10 TYPE MAX ANNUAL 'CONT USE LOCATION IN THIS m BY HAZARD D.O.T cou~ ~.ou.~ ASOUN~ UNiT COU~ COU~ ~AC~TV UNIT. WT. C.S.~qA~ O. CO..O. NA.S COUS OU~U~ EMERGENCY CONTACT: TITLE: ~(P~ PHONE ~ BUS HOURS: AFTER BUS HRS: PRINCIPAL BUSINESS ACTIVITY: u~d,L ~~ ~~~ AFTER BUS HRS: SITE/FACILITY DI R~B~I / 50l ~'/F~L,I/~/~)/~~:~ ~o~ ~ ~ 1~7 SCALE: BUSINBSS N~M~: FLOOR: OF DATE: / / FACILITY N~: UNIT ~: OF (CHECK ONE) SITE DIAGRkM FACILITY DIAGR.~M Inspector's Commen~s):. -OFFICIAL USE ONLY- - SA - ~iTE DIAGRA~4 (Requir~[l~itema) 1. Address: Identlf1~R~e 9. Lock principle buildings by the Street numbers. 10. HSDS Storage Box 2. Street(s), Alleys, 11. Railroad Tracks Drlveuaye. and Perking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. Nasonry 3. Storm Drnina, Culverts. Yard Drains c. Wood 4. Drainage Canals, Ditches. d. Gates Creeks, 13. Powerllnes S. Buildings a. Frame construction 14. Guard Station b. Masonry construction 15. Storage Tanks: Identify the c. Metal construction capacity In gal. a. Above ground d. Accees Door b. Underground 6. Utility Controls a. Gas 16. Diking or Bern b. Electricity 17. Evacuation Route c. Water 18. Evacuation Area: - Identify the ?. Flr~ SuppressiDn Systems: locatloo where a. Fire Hydrants employees will neet. b. Fire Sprinkler 19. Outside Razardous Connections Waste Storage c. Fire Standpipe 20. Outside Hazardous Connections ~atsrial Storage d. Water Control Valves 21. Outside Hazardous for protection systems ~aterial · Uae/Handling e. Fire Pump 22. Type of Hazardous Material/Waa~e Stored 8. Fire Department Access or Used (See aelom) F - Fishable E - ~zploalve L - Liquid R - Radlologlcnl C - Corromiva 0 - Oxldlzor G · Gas P - Poison W - Water Reactive T - Toxic S - Solid 'H - Cryogenic -, O - Waste B · Etiological Emple: Flaaaable Liquid - FL FACILITY DIAGRA~. (Raqulred /tens Iff addition to the above) 1, R/sofa rot Sprinklers 8. Fire Escnpel 2. Partitions 9, Air Conditioning Onlto 3. Stairways: Indicate the 10. #lndoue levels served from highest to lowest. Il. Inside Huardous Waste Storage 4. Escslator: Indicate the levels served free 12. Inside Hazardous highest to lowest. Mater/als Storage 5. Elevator 13. Inside Hazardous Materials Use/Handling. 6. Attic Access ! 14. Se~r Drain Inlets ?. Skylights DATE ADDRESS ~- ZIP CODE FEE O I BLOCK NO. ,/_/~ /.//~_._/. BUSINESS LICENSE NO. PERMIT REQUIRED PERMIT 7~/-s7~/ / ~ ~o~5/ ~ BUILDING CLASS/TYPE OF OCCUPANCY ~ BUSINESS NAME BUSINESS OWNER n~ BUSINESS MGR./RESPONSIBLE . BUSINESS PHONE ~ [~ [ ~ /~ HOME PHONE . ~o. o~ ~oo~ / ~~ . ~ ~o~.~oo~/~ VIOLATION NOTICE ISSUED7 OCCUPANT LOAD OTHER DATE OF REINSPECTION (1) (2) (3) '