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Home My WebLink AboutBUSINESS PLANS 4/10/08SITE MAP .5/T C / f) '-~ z-~ I 7 LEGEND DATE: 01110/01 (~ ~=WER FLOOR ~ ~U~ ~~OUS ~R~ DNISION ~~8 ~TER~ P~ BUSINE~ ~E: ~ FAClL~ I~ 01~ 8~ ~D~: t701 BRUN~GE ~E ~RSFIELD, ~NE~ A B C D E F G H I J FAMILYT ~ ~ ~ ~ WISE ~ BARBER-~ ~ ALL DAY MARKET ~ ~ ~ BUYS ....... S 0N ......... 5 0.aU S .... ........................................................................................................ 2 ~ : ..... (~.~P~) ................ ~ .......... .......................................................................... .~.'. ~ .............. [ .................. [~ .......... [ .......... ~~....== ..... ~ ....... ~ .................................. ~ ~ D~ ...~..~ ............. ~ .......... ~ ..... ~ ...... ~....~ ...................................... ::.~ ............. ~ .............. ~ ~ Z :~c: ~ c .~ ~ .~ ~ ~'~ ,~ · ~ w~ :~ ~ =8~8~ 8~ : ~C ~~ ~ ~i : :~ t M · ~ ~ROIL ................. ~.~.~ ..................................................................... , ~=~ ~/~ L~ ~ e TACO aEL~ ~ES~DENT~AL ~ CONTNNER ~ =, [ [ ~ == s~ ~'= ~Ft ~ ~ ~ON :~ ~" t~ M P P LA~: MAP SITE DIAGRAM ~ FACILITY DIAGRAM Business Name: J~t~\~ (l~t.~..o Wi, c,..* ~qto~ Business Address: ~"~,b\ ~vjq~r,.~ ~,o,N'c, ~6'¢.~.'¢'~:~ For Office Use Only First In Station: ' Area Map # of Inspection Station: NORTH ~/"'~ ~ ' " KEY NOTES: I ARCO 01960 Manager._ _:....SURJIT.,. BISLA .._ _ __ _ - Loca,t.ons 1701 BRUNDAGE LN City,- . ~ ;-: BAKERSFIELD CommCode :, BFD STA 0 6 .- - EPA ~ Numb :. ~ ___-_ __ . SiteID: 015-021-000417 _ Bus Phone : _ (6 61) 3.2____2 - 7 213 Map 102 CommHaz TModerate~ Grid: 36D FacUnits: 1 AOV: SIC.Code:5541 - DunnBrad`:~03-959-6507 - Emergency Contact / Title Emergency Contact / Title SURJIT BISLA / FRANCHISEE ELITE CUSTOMER / SOLUTIONS CTR Business Phone: (661) 322-7213x Business Phone: (888) 778-0763x 24-Hour Phone (661) 665-2394x 24-Hour Phone (888) 778-0763x -Pager Phone (661) 496-3372x Pager Phone ( ) - x Hazmat Hazards: - _ Fire Press - _ ImmHlth. _DelHlth Contact MARCELO PANELO Phone: (714) 670-5373x MailAddr: PO BOX 6038 State: CA City- ARTESIA Zip 90702-6038 Owner BP WEST COST PRODUCTS LLC Phone: (714) 670-5373x Address PO BOX 6038 State: CA City : ,ARTESIA Zip 90702-6038 Period-..; - - to . , . . TotalASTs: _ = Gal Preparers ~ - TotalUSTs`i = Gal Certif ~ d: - • .:_..: -:. ~ -. -,- _,, , ,, - ... RSs : No , _, : ~.: ~;. Emergency Directives`: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG U - UST ~+ ~~ J U L ~, ~ ~~~~ Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of lav~+ that I have personally examined and am familiar with the information submitted and believe the information is true , accurate, and complete. a _ ~~'~~ Signature Da =-~ -1- 06/29/2007 - =tJ~NI~'ED PROGRAM INSPECTION CHECKLISTPrevention Services A E k s r , „ 900 ZYUxtun Ave., Suite 210 Ft'RE~ Bakersfield, CA 93301 SECTION 1:. Business Plan and.lnventory Program aerM Tel.:- (s61~) 3zs-3979. - - ~ Fax: (661) 872-2171 FACILITY NAME ,~[ ~/) /~ ~ / /~ INS CTI N DA~ ~ INSPECTION TIME ADDRESS - ` ' ~ ~ - PHONE NO. NO LOYEES ? p . ! t d. 22~ a ~ FACILITY CONTACT BUSINESS ID NUMBER I~~ 15-021- e6N/ Section 1: i3usiness Plan and Inventory Program ^ ROUTINE L"Y.~COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~-C=Compliance OPERATION V=Violation COMMENTS APPROPRIATE PERMIT ON HAND ^ BUSIfteSS PLAN CONTACT INFORMATION ACCURATE . - ^ VISIBLE ADDRESS ^ CORRECT OCCUPANCY ^ VERIFICATION OF INVENTORY MATERIALS ENT°p 'r ^ VERIFICATION OF QUANTITIES . ^ VERIFICATION OF LOCATION ^ PROPER SEGREGATION OF MATERIAL ^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE & ON HAND ANY HAZARDOUS WASTE ON SITE? ^ YES '~NO EXPLAIN: QUESTIO RE%AiTj,~ly~ THIS INSPECTION? PLEASE CALL US AT (661) 326-3979 Inspector (Please Print) Fire Prevention / 1" In /Shift of Site/Station # 1 B ess es si le P y ( ase rin - White -Prevention Services - Yellow -Station Copy Pink -Business Copy FD 2155 (Rev. 09105 INSPECTIONS BUSINESS PLAN & INVENTORY PROGRAM - UNIFIED PROGRAM INSPECTION CHECKLIST FACILITY NAME: ,~V2~o ~u~.tl'd+.. Section 2: Underground Storage Tanks Program INSPECTION DATE: ~~ ^ Routine /Combined ^ Joint Agency ^ Multi-Agency Complaint ^ Re-Inspection Type of Tank p(i}1= Number of Tanks Type of Monitoring C~ (~ Type of Piping (xtJ'~ OPERATION C V COMMENTS Proper tank data on file Proper owner /operator data on file Permit fees current Certification of Financial Responsibility Monitoring record adequate and current Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? ^ Yes ^ No Section 3: Aboveground Storage Tanks Program Tank Size(s) Type of Tank OPERATION Y N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF?) If yes, does tank have overfill /overspill protection? C =Compliance V =Violation Y =Yes N = No Inspector: Questions regarding this inspection? Please call us at (661) 326-3979 White -Prevention Services KBf-7335 Aggregate Capacity Number of Tanks 0 BAKERSFIELD FIRE DEPT. Prevention Services B ~ E R S F I L D 900 Truxtun Ave., Ste. 210 p/RE Bakersfield, CA 93301 AIPTM T Tel.: (661) 326-3979 Fax: (661) 852-2171 Page 1 of 1 Pink - B~ FD 2156 (Rev. 09/05) l ~~ tel. ///~yy a F ARCO 01960 SiteID: 015-021-000417 Manager SURJIT BISLA Location: 1701 BRUNDAGE LN City BAKERSFIELD CommCode: BFD STA 06 EPA Numb: BusPhone: (661) 322-7213 Map 102 CommHaz Moderate Grid: 36D FacUnits: 1 AOV: SIC Code:5541 DunnBrad:03-959-6507 Emergency Contact / Title ~ Emergency Contact / Title SURJIT BI SLA / FRANCHISEE CUSTOMER / SOLUTIONS CTR Business Phone: (661) 322-7213x Business Phone: - 24-Hour Phone (661) 665-2394x 24-Hour Phone - Pager Phone (661) 496-3372x Pager Phone (~r~r~)?7~ -O7(n3x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact M~2GEl.O~f ~4N~L0 Phone: (714) 670-373 MailAddr: PO BOX 6038 State: CA City ARTESIA Zip, 90702-6038 Owner BP WEST COST PRODUCTS LLC Phone : ( 714 ) 67 0 - "-~-9~±~=-373 Address PO BOX 6038 State: CA City ARTESIA Zip 90702-6038 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT PROG H - PROG U - HAZ WASTE.GEN UST ~~ [,~,<<E:d g~ i~~ ir~~uir•,~ of those individuals responsible fir s~tdlrtlri~ fhc~ information, I certify ENT'D MAR 2 9 2007 under penal#y cif 1~w that I have personally examined an~1 ~r~ far~lliar with the information submitted and belisv~, the information is true, accurate, and complete. ~ Oate Signature -1- 01/24/2007 ~1 v. F ARCO 01960 Last Action Type: SiteID: 015-021-000417 ~ STORAGE CONTAINER DATA (UST FORM A) FACILITY/SITE INFORMATION Business Name: ARCO 01960 Cross Street Business Type: Org Type: Total Tanks 4 IndnRes/Trust: No PA Contact: 5 ~~ ~~ ~~ UC Dsg Own/Oper PtN~DfZCS 2~3it~ ICC Nbr: 53.6 tr~E PROPERTY OWNER INFORMATION Name : ~~ CUSTOMER 5~r~u Tj vNS ~ EN ~ e ~ Phone : ~~7- ~'; "z~4~ Address : ~~~-~'7 Sr- d7 fob City State: Zip: Type CORPORATION Name Address City Type TANK OWNER INFORMATION CUSTOMER Sr/~rT/`ONS CE~7"E~ Phone: (B.A~A, '-~-~'~.=.ti"~49Y ~~ -7 7~ 07 (0~ State: Zip: CORPORATION BOE UST Fee# 000506 Financ'1 Resp: SELF INSURED Legal Notif Business Owner Mailing Address Date:l2/26/0196 Phone: (237) 121- x Name:MICHAEL WILSON Ttl:ENVIRON ADMIN State UST # 1998 Upg Cert#: 00735 -2- 01/24/2007 ~; F ARCO 01960 ~ Hazmat Inventory = ~ MCP+DailyMax Order = SiteID: 015-021-000417 ~ By Facility Unit ~ Fixed Containers on Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP PREMIUM UNLEADED GASOLINE F IH DH L 10000.00 GAL MOd REGULAR UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod ~.DQ~B~ UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod PREMIUM UNLEADED GASOLINE F IH DH L .10000.00 MOd CARBON DIOXIDE F P IH G 400.00 FT3 Min WASTE ABSORBENT F IH S 55.00 GAL UnR WASTE FLAMMABLE LIQUIDS/SOLVENT F DH L 55.00 GAL UnR u r~ c.~ a-w ~,~ -3- 01/24/2007 -4- 01/24/2007 F ARCO 01960 SiteID: 015-021-000417 ~ ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME PREMIUM UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UNDERGROUND STORAGE TANK CAS# 8006-61-9 Liquid TMixture ~ Ambient~E ~ AmbientT~E ~UNDEROGROUNDRTANKE AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 6666.67 GAL t1HGKtCLVUJ trV1~lYV1VJ;1Vl~ %Wt. RS CAS# 100.00 Gasoline No 8006619 t1HGF1KL 1~~~JL",~71~1L'1V1J TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME REGULAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: UNDERGROUND STORAGE TANK CAS# 8006-61-9 STATE T TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid I Mixture TAmbient ~ Ambient ~ UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 6666.67 GAL riAGKKLVUJ lLV1~lYV1VL'1VlJ %Wt. RS CAS# 100.00 Gasoline No 8006619 tiE~GL-1KL 1-~~~L',JJ1~1L';1V l5 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -5- 01/24/2007 F A.RCO 01960 SiteID: 015-021-000417 ~ ~ Inventory Item 0005 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME M-~ UNLEADED GASOLINE Days On Site "- -" ._ =_ 2~~c..~ 365 Location within this Facility Unit Map: Grid: UNDERGROUND STORAGE TANK CAS# 8006=61-9 Liquid TMixtur~Ambient~E ~ AmbientTURE CONTAINER .TYPE -~ER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 10000.00 GAL 10000.00 GAL 10000.00 GAL HAZARDOUS COMPONENTS ~Wt• RS CAS# 100.00 Gasoline No 8006519 i11iGL~i.[CL HJ ~7 L~.7.71.1P~1V 1 ~ TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0008 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME a~ UNLEADED GASOLINE Days On Site FZEC~ ~~~ 365 Location within this Facility Unit Map: Grid: UST CAS# 8006-61-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Liquid Mixture Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 10000.00 10000.00 10000.00 HAZARDO US COMPONENTS %Wt• RS CAS# 100.00 Gasoline No 8006519 TSecret RS BioHaz L1tiL~tiLCL 1'iJ Radioactive/Amount JL' .7 ~J1"1L' 1V 1 J EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod -6- 01/24/2007 F ARCO 01960 SiteID: 015-021-000417 ~ ~ Inventory Item 0006 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE YARD NEAR BATHROOM CAS# 124-38-9 STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE Gas TPure ~-Above Ambient Cryogenic INSUL.TANK / CRYOGENIC AMOUNTS AT THIS LOCATION Largest Co400100rFT3 Daily 400100m FT3 I Daily 200r00e FT3 r~~r~.cLVU~ ~ui~irulv~lvl~ %Wt. RS CAS# 100.00 Carbon Dioxide No 1243$9 riHGKttL AJ~L~~1~1L"~1V 15 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F P IH / / / Min ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE ABSORBENT A~1Vl~ Sp~~ j FUEL ~(,~-:ERS Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE STORAGE CONTAINER CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE _ Solid TWaste ~ Ambient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container ,Daily Maximum Daily Average 55.00 GAL 55.00 GAL 25.00 GAL HAZARDOUS COMPONENTS -- ~ -, %Wt. RSA CAS# nrjZARD AS SESSMENTS TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH / / / UnR -7- 01/24/2007 F ARCO 01960 SiteID: 015-021-000417 ~ ~ Inventory Item 0007 Facility Unit: Fixed Containers on Site ~ COMMON NAME / CHEMICAL NAME WASTE FLAMMABLE LIQUIDS/SOLVENT Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE STORAGE CONTAINER CAS# STATE TYPE PRESSURE TEMPERATURE CONTAINER TYPE = Liquid TWaste -~mbient ~ Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container- Daily Maximum Daily Average 55.00 GAL 55.00 GAL 25.00 GAL riHGL~t<LVUS 1.:V1~lYV1V1'~1V 15 oWt. RS CAS# 90.00 MIXTURE OF WASTE OIL HEAVY PETROLEUM DISTILLAT No riEiGA.L[L L~J 51;551°lt'~1V 1 7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / UnR -8- 01/24/2007 F ARCO 01960 SiteID: 015-021-000417 Fast Format ~ Notif./Evacuation/Medical Overall Site Agency Notification 04/18/2006 IN THE EVENT OF MINOR TO MAJOR SPILL OR FIRE, EMPLOYEE OR OWNER WILL CALL 911 AND LOCAL AGENCY. EMPLOYEES ARE TRAINED IN THE USE OF PERSONAL PROTECTION EQUIPMENT TO MINIMIZE CONTACT WITH HAZARDOUS MATERIAL WASTE. OFFICE OF EMERGENCY: 800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD FIRE DEPARTMENT: 326-3979 9 Employee Notif./Evacuation 04/18/2006 FOR ANY EMERGENCY, CALL 911 AND REPORT. EVACUATE, IF NECESSARY, TO A SITE OPPOSITE DANGER AREA. CALL YOUR FIELD SUPERVISOR AND GIVE DETAILS OF EMERGENCY. YOUR FIELD SUPERVISOR WILL NOTIFY ATLANTIC RICHFIELD MAINTENANCE, AREA MANAGER AND MAIN OFFICE. Public Notif./Evacuation 04/18/2006 ALARM SHALL BE GIVEN BY SHOUTING OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL PERSONS LEAVE THE PREMISES BY THE SAFEST EXIT. ALL PERSONS WILL BE ASKED TO ASSEMBLE AT A SAFE ASSEMBLY AREA UPWIND. Emergency Medical Plan 04/18/2006 FOR SMALL INJURIES, THE OWNER OR STORE MANAGER WILL UTILIZE THE FIRST AID KIT. FOR MINOR TO MAJOR INJURIES, THE OWNER OR STORE MANAGER WILL CALL EITHER 911 OR MAY CONTACT THE CLOSEST MEDICAL/CLINIC CENTER WHICH IS LOCATBD AT BAKERSFIELD MEMORIAL HOSPITAL, 420 34TH ST, 327-4647. -9- 01/24/2007 F ARCO 01960 SiteID: 015-021-000417 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 04/18/2006 RELEASES ARE PREVENTED BY INSTALLED OVER-FILL DEVICES SUCH AS FLAPPER VALVES, HIGH LEVEL ALARMS, OR ALL FLOATS. OTHER SPILL PREVENTION DEVICES ARE IMPACT VALVES AND BREAKAWAY DEVICES. SERVICE STATIONS ARE ATTENDED BY TRAINED PERSONNEL AND GASOLINE IS DELIVERED BY TRAINED TRUCK DRIVERS. 9 Release Containment 04/18/2006 IN THE EVENT OF A LEAK OR SPILL: 1. ATTENDANT SHOULD SHUT OFF ELECTRICITY TO THE PUMPS/TURBINES AT THE MAIN ELECTRICAL PANEL AND CLOSE THE IMPACT VALVES. 2. THE ONSITE EMERGENCY COOORDINATOR OR DESIGNEE WILL CONTACT 911 (FIRE DEPARTMENT) AND EXPLAIN THE EMERGENCY AND WILL CONTACT ARCO MISSION CONTROL. IF NECESSARY, THE ONSITE EMERGENCY COORDINATOR OR DESIGNEE WILL REQUEST AN AMBULANCE OR OTHER MEDICAL ASSISTANCE. 3. EVACUATE. IF DEEMED NECESSARY BY THE ONSITE EMERGENCY COORDINATOR OR DESIGNEE, ALL TRAFFIC ONSITE WILL BE HALTED, AREA CONED OFF, AND ALL EMPLOYEES AND CUSTOMERS WILL BE DIRECTED TO A SAFE AREA OPPOSITE T~iE DANGER. THERE ARE TWO EXITS - FROM ENTRANCE AND REAR EMERGENCY EXIT. ALL PERSONS WILL EVACUATE THROUGH ONE OF THESE DOORS AND GATHER IN AN AREA FURTHEST FROM DANGER. MANAGER ON DUTY WILL ACCOUNT FOR ALL STATION PERSONNEL AND CUSTOMERS. 4. CONTAIN THE LIQUID BY CONTRUCTING BERMS AND/DR BY COVERING THE SPILL WITH FIREPROOF ABSORBENT MATERIALS. PREVENT LIQUID FROM ENTERING STORM DRAINS WHENEVER POSSIBLE. 5. SCENE MANAGEMENT SHALL E3E THE RESPONSIBILITY OF THE ONSITE EMERGENCY COORDINATOR OR DESIGNEES UNTIL THE ARRIVAL OF FIRE OR POLICE PERSONNEL. UPON ARRIVAL OF THESE PERSONNEL, THE EMERGENCY COORDINATOR WILL COOPERATE WITH AND OFFER ANY ASSISTANCE THAT IS REQUESTED. 6. IMMEDIATELY FOLLOWING AN EMERGENCY THE ONSITE EMERGENCY COORDINATOR WILL PROVIDE FOR THE DISPOSAL OF CONTAMINATED MATERIAL AS DIRECTED BY THE LOCAL FIRE DEPARTMENT OR COUNTY HEALTH AGENCY. (ALL SPILLS WILL BE REPORTD TO BP AT ~~~ ""., ^-z-r-i--~CT/g ~ . THE BP ENVIRONMENTAL COMPLIANCE SPECIALIST WILL MAKE REPORT TO PERTINENT AGENCIES, INCLUDING NRC, CA OES, WATER BOARD, AND COUNTY HEALTH AGENCY). ELi7ECuS/OM~~~dl~-io+yS Ce~`~~-2 ~1~~~77~~O~C~J -10- 01/24/2007 F ARC0.01960 SiteID: 015-021-000417 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site ~ Clean Up 04/18/2006 STATION PERSONNEL SHOULD APPLY ABSORBENT TO THE GASOLINE SPILL BY SWEEPING THE ABSORBENT ONTO THE SPILL. ONCE THE ABSORBENT HAS SOAKED UP THE LIUQUD, SWEEP UP THE ABSORBENT AND PLACE IT IN A 55-GALLON DRUM. IF THE SPILL IS LARGER, CALL 911, ATTEMPT TO CONTAIN IT, AND FOLLOW THE SCENE MANAGEMENT INSTRUCTIONS. LARGE SPILLS ARE CLENAED BY BP-DESINGATED CONTRACTORS, OR AS DESINGATED BY THE FRANCHISEE FOR FRANCHISE SERVICE STATIONS. EMPLOYEES WILL KNOW THE LOCATION OF THE NEAREST STORM DRAINS AND LOCATION OF ABSORBENT MATERIAL TO BE USED TO PREVENT THE SPILL FROM REACHING THE STORM DRAINS. IN THE EVENT OF A MAJOR SPILL, EMPLOYEES ARE INSTRUCTED TO CALL 911 AND REPORT. THE ONSITE EMERGENCY COORDINATOR WILL PROVIDE FOR THE DISPOSAL OF CONTAMINATED MATERIALS AS DIRECTED BY THE LOCAL FIRE DEPARTMENT OR COUNTY ENVIRONEMTNAL HEALTH IF NEITHER GIVES SUCH DIRECTION, CALL ELi-~E ~ug{r1tit~R Sd1~oN5 C~ ~~~' __ Other Resource Activation -11- 01/24/2007 F ARCO-01960 ~ ~ SiteID: 015-021-000417 ~ Fast Form~.t ~ ~ Site Emergency Factors Overall Site ~ Special Hazards i Utility Shut-Offs 04/18/2006 A) GAS - NO B) ELECTRICAL - ELECT PANEL IN BACK RM C) WATER - SIDEWALK D) LOCK BOX _ NO Fire Protec./Avail. Water 01/24/2007 FIRE HYDRANT - SW CRNR OF LOT ACROSS BEALE AVE SHUT-OFF SWITCHES. FIRE HYDRANT - NW CRNR BRUNDAGE & H ST FRONT OF 7-ELEVEN ACROSS BRUNDAGE L1~1'. Building Occupancy Level 03/16/2006 5 EMPLOYEES: 1-2 EMPLOYEES PER SHIFT - 3 SHIFTS -12- 01/24/2007 1 4 ~` F ARCO/01960 SiteID: 015-021-000417 ~ ' Fast Format ~ ~ Training Overall Site ~ Employee Training 04/18/2006 ~ MATERIAL SAFETY DATA SHEETS ON FILE: MSDS AND BUSINESS EMERGENCY PLAN IS LOCATED IN THE COMPLIANCE BINDER LOCATED IN THE OFFICE AREA. BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE TRAINED ON USE OF SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/WASTE. EMPLOYEES ARE TRAINTED AND REQUIRED TO DIAL FOR EMERGENCY CALL, 911, AND EVACUATE THE PREMISES. EMPLOYEES ARE TRAINED IN THE USE OF SPILL CLEAN-UP, FIRST AID KIT, FIRE EXTINGHUISHERS, ELECTRICAL AND GAS SHUT-OFF AND USE OF TELEPHONES. EMPLOYEES ARE TRAINED TO ADVISE ANY RESPONSE AGENCY AS TO THE NATURE AND LOCATION OF THE PROBLEM. INITIAL TRAINING IS CONDUCTED AFTER HIRING NEW EMPLOYEE. TRAINER IS THE OWNER OR MANGER OF THE STORE. REFRESHER TRAINING IS DONE EVERY YEAR. TRAINING TOPICS ARE: 1) HAZARD COMMUNICATION PROGRAM; 2) MATERIALS SAFETY DATA SHEETS; 3) SAFE HANDLING OF CHEMICALS; AND 4) EMERGENCY EQUIPMENT & EMERGENCY RESPONSE PLAN. ruyc ~ nciu ivt ru~.utc vac -13- 01/24/2007 f F ARC~1960 SiteID: 015-021-000417 ~ Fast Format ~ ~ Training Overall Site ~ Held for Future Use -14- 01/24/2007 i i r._--.~- ~ ~ ~ -BUSINESS ACTIVITIES ~ +'~ ~ UNIFIED PROGRAM CONSOLIDATED FORM `I FACILITY INFORMATION Page 1 of_ L FACILITY'. IDENTIFICATLON FACILITY ID # 1• EPA 1D # (Hazardous Waste Only) z. 1 5 ~ 0 2 1 0 4 1 7 CAL000244204 _ BUSINESS NAME (Same as Facility Name or DBA -Doing Business As) 3. ARCO # 01960 lL~° ACTIVITIES DECLARATION - -NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, lease com fete these ages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases t i l i d li id AST d UST th li bl F d l th h ld ' ®YES ^ NO a. .HAZARDOUS MATERIALS INVENTORY ( nc u n e qu s s an s); or e app ca e era res e o _ CHEMICAL DESCRIPTION (OES 2731) quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emer enc lan is re wired ursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTsI UST FACILITY (Formerly swxcB Form n) 1. Own or operate underground storage tanks? ®YES ^ NO 5. UST TANK (one page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? ^ YES ®NO s. UST FACILITY UST TANK (one per tank) UST INSTALLATION -CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) 3. Need to report closing a UST? ^ YES ®NO 7. UST TANK (closure portion- one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ^ YES ®NO s. NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? ®YES ^ NO 9. EPA ID NUMBER -provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC §25143.2)? ~®o~ 3 T h d i 3 ^ YES ®NO 10. per recycler) . azar reat ous waste on s te? [~ , ~ ONSITE HAZARDOUS WASTE M A 1 ` ~~,D ^ YES ®NO I L TREATMENT -FACILITY (Formerly DISC ~ Forms 1772) - ONSITE HAZARDOUS WASTE TREATMENT -UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by ^ YES ®NO 12 CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? . ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE /CONSOLIDATION ^ YES ®NO 13. SITE ANNUAL NOTIFICATION (Formerly DTSC Form ] 196) 6. Need to report the closure/removal of a tank that was classified as ^ YES ®NO la HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? . CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS (You may also be required to arovide additional information byyour CUPA or localquired to additional information CUPA or local a~ency l1 I5. - ~O~ ~~ 2S~ ~3~{ ;. ~~ ~~,-- -~ . UNIFIED PROGRAM CONSOLIDATED FORM FACII.ITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Paee of I. °TDENTIFIC.4TTnN FACILITY ID # I iEG1NNING DATE too. ENDING DATE tot. (Agency Use Only) 1 5 0 2 1 0 4 1 702/28/07 02/28/10 BUSINESSNAME(SameasFACILII'PNAMEor DBA-Doingl3usinessAs) 3 BUSINESS PHONE 102. ARCO # 01960 (661) 322-7213 BUSINESS SITE ADDRESS to3. 1701 BRUNDAGE LANE CTTY toa. ZIP CODE tos. C`~ BAKERSFIELD 93304 DUN & BRADSTREET toe. SIC CODE (4 digit #) to7. 03-959-6507 5541 COUNTY tos. KERN BUSINESS OPERATOR NAME tog. BUSINESS OPERATOR PHONE tto. SURJIT BISLA (661) 322-7213 `' II. 13USIlYESS OWNER ........... . OWNER NAME t t t. _ OWNER PHONE t ti. BP West Coast Products LLC (714) 670-5373 OWNER MAILING ADDRESS: tt3. P.O. BOX # 6038 CITY tta. STATE tts ZIP CODE tt6. ARTESIA CA 90702-6038 III. ENVIRONMENTAL` CONTACT CONTACT NAME t tz CONTACT PHONE t la. MARCELO PANELO (714) 670-5373 CONTACT MAILING ADDRESS: BP West Coast Products LLC 119. P.O. BOX # 6038 CITY 120 STATE t2t• ZIP CODE tzz. ARTESIA CA 90702-6038 -PRIMARY-'" IV. EMF.RGENCYCONTACTS -SECONDARY- NAME tz3. NAME tza. SURJIT BISLA ELITE CUSTOME R SOLUTIONS CENTER TITLE tea. TITLE t29. Franchisee BUSINESS PHONE tzs. BUSINESS PHONE t3o. (661) 322-7213 (888) 778-0763 24-HOUR PHONE* t26. 24-HOUR PHONE* tat, (661) 665-2394 (888) 778-0763 PAGER/ CELL tz7. t32. (661) 496-3372 ADDITIONAL LOCALLY COLLECTED INFORMATION:. t33. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiaz with the information submitted and believe the information is true, accurate, and complete. SIGNA OWNER/OPERATOR OR D SIGNATED REPRESENTATIVE DATE t3a. NAME OF DOCUMENT PREPARER t35. _ ~_ ~~--`C~ -fl~ Belshire Environmental Services, Inc. NAME` F S R (print 136. TITLE OF SIGNER 137. SURJIT BISLA . Franchisee Arco 01960, Belshire Environmental Services Page 2 of 20 :z ' ~ ~ ,r-. r UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) ® MATERIAL(NON-WASTE) ^ WASTE one page per material per buildin or area ^ADD ^DELETE ®REVISE REPORTING YEAR 2007 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO #.01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL zoz (EPCRA) ^ YES ® No UNDERGROUND STORAGE TANK MAP# (optional) 203 GRID# (optionaq ~ 204 FACILITY ID # 1 5 0 2 1 0 4 1 7 1_ _ ~ 1 of 1 H4 - K6 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os GASOLINE If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* ^Yes ®No zos cas# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required bycuPA) FLAMMABLE LIQUI D, CLASS 16, UN1203 z1o HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE .®b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS 214 I-ARGEST CONTAINER- 10,000 215 FED HAZARD CATEGORIES 216 (Check all that apply) ®a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 219 ANNUAL WASTE AMOUNT 2ts STATE WASTE CODE 220 20,000 40,000 N/A N/A 221 DAYS ON SITE: z22 UNITS* ®a. GALLONS ^b. CUBIC FEET ^ c. POUNDS ^ d. TONS * 365 Check one item onl If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ® b. UNDERGROUND TANK ^ f. CAN ^ j. SAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT z2a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVEAMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 ^Yes ®No zza 71-43-2 zzs 2 0-10 230 ETHANOL 231 ^Yes ®No zaz 64-17-5 233 3 8-15 234 XYLENE zas ^Yes ®No zas 1330-20-7 237 4 7-14 23t3 TOULENE 23s ^Yes ®No 2a0 108-88-3 241 5 242 243 ^Yes ^NO 244 245 If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION zas Arco 01960, Belshire Environmental Services Page 3 of 20 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Indicate material OR waste {Do not combine material and waste on one form) ® MATERIAL(NON-WASTE) ^ WASTE one age per material er building or area) ^ADD ^DELETE ®REVISE REPORTING YEAR 2007 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 201 CHEMICAL LOCATION CONFIDENTIAL CHEMICAL LOCATION zo2 (EPCRA) ^ YES ® NO OUTSIDE YARD NEAR FACILITY BATHROOM MAP# (optionap 203 GRID# (optionaq 204 FACILITY ID # 1 S ~ 0 2 1 0 4 1 7 i _~ 1of1 F11 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os CARBON DIOXIDE If subject toEPCRA,refertoinstructions COMMON NAME CARBON DIOXIDE 207 EHS* ^Yes ®No 2os CAS# 124-38-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by cupa) NON-FLAMMABLE C RYOGENIC LIQUID 210 HAZARDOUS MATERIAL TYPE (Check one item only) ®a. PURE ^b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS 21a LARGEST CONTAINER 400 215 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ^ b. REACTIVE ®c. PRESSURE RELEASE ®d. ACUTE HEALTH ^ e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 22° 200 400 N/A N/A 221 DAYS ON SITE: 222 UNITS* ^a. GALLONS ^b. CUBIC FEET ®c. POUNDS ^ d. TONS 365 Check one item onl * If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ®I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ^ a. AMBIENT ®b. ABOVE AMBIENT ^ c. BELOW.AMBIENT 224 STORAGE TEMPERATURE ^ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ®d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 'I 226 227 ^ Y2S ^ NO 228 229 2 230 231 ^Yes ^ NO 232 233 3 234 235 ^Yes ^ NO 236 237 4 236 239 ^Yes ^ No zao 2a1 5 242 2a3 ^Yes ^No z44 gas If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of papercapturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION gas Arco 01960, Belshire Environmental Services Page 4 of 20 UNIFIED PROGRAM (UP) FORM . HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) ^ MATERIAL(NON-WASTE) ® _ WASTE (one page er material per buildin or area) ^ADD ^DELETE ®REVISE REPORTING YEAR 2007 200 Page of " I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL zoz (EPCRA) ^ YES ® NO INSIDE STORAGE CONTAINER MAP# (optionaq 203 GRID# (optional) 204 FACILITY ID # 1 5 ~ 0 2 0 1 ' 4 I 7 , , ~ 1 of 1 E12 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os WASTE ABSORBENT 8c DISPENSER FUEL FILTER If Subject toEPCRA, refer to instructions COMMON NAME WASTE ABSORBENT & DISPENSER FUEL FILTER 207 EHS* ^Yes ®No 2os CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE SOLID 210 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ^b. MIXTURE ®c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE (Check one item only) ®a. SOLID ^b. LIQUID ^ c. GAS 214 LARGEST CONTAINER 55 215 FED HAZARD CATEGORIES 216 (Check all that apply) ®a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 25 55 110 352 zz1 DAYS ON SITE: 222 UNITS* ®a. GALLONS ^b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365 Check one item onl * If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ® d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # MIXTURE OF SILCATE & HYDROCARBONS . 1 89-90 z2s 227 ^Yes ®No 2zs N/A MIXTURE 22s & SPENT FUEL FILTERS , 2 230 231 ^Yes ^ NO 232 233 3 234 235 ^Yes ^ NO 236 237 4 238 239 ^Yes ^ NO 240 241 5 242 243 ^Yes ^NO 244 245 If more hazardous components are present at greater than 1 k by weight if non-carcinogenic, or 0.1 k by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION zas Arco 01960, Belshire Environmental Services Page 5 of 20 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) ^ MATERIAL(NON-WASTE) ® WASTE one page per material per building or area ^ADD ^DELETE ®REVISE REPORTING YEAR 2007 20o Page of - I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 (EPCRA) ^ YES ® NO INSIDE STORAGE CONTAINER MAP# (optional) 203 GRID# (optionaq 204 FACILITY ID # 1 S li Q 2 1 Q ~} 1 7 i 1 of 1 E12 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os WASTE FLAMMABLE LIQUID If Subject toEPCRA,refertoinstrudions COMMON NAME WASTE FLAMMABLE LIQUID 207 EHS* ^Yes ®No 2oa CAS# N/A 209 "If EHS is "Yes', all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by CUPA) FLAMMABLE LIQUID 210 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ^b. MIXTURE ®c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE 214 (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS LARGEST CONTAINER 55 215 FED HAZARD CATEGORIES 216 (Check all that apply) ®a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 22° 25 55 110 134 221 DAYS ON SITE: 222 UNITS* ®a. GALLONS ^b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365 Check one item onl * If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN' ® d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 22s %VVT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 89-90 z2s MIXTURE OF GASOLINE & WATER OR 227 ^Yes ®No 22a NIA MIXTURE 22s OTHER CONTAMINATION IN GASOLINE , 2 230 231 ^Yes ^ NO 232 233 3 234 235 ^Yes ^ NO 236 237 Q 238 239 ^Yes ^ NO 240 241 5 242 243 ^Yes ^No 244 zas If more hazardous components are present at greater than 1 % by weight ifnon-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION zas Arco 01960, Belshire Environmental Services Page 6 of 20 CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE TANKS -FACILITY TYPE OF ACTION ^ +, NEW SITE PERMIT ^ 3. RENEWAL PERMIT ® 5. CHANGE OF INFORMATION (Specilychange - ^ 7. PERMANEMLYCLOSED SITE (Check one-Bem only) ^ 4. AMENDED PERMIT local use onry) ^ 8. TANK REMOVED ^ 6. TEMPOH,4RYSITECLOSURE 400 I. FACILITY /SITE INFORMATION FACILITY ID 1! 1 5 ~ 2 1 ~ 4 1 7 t SITE NAME (Same as FACILITY NAME or DBA ARCO# 01960 3 BUSINESS ADDRESS 1701 BRUNDAGE LANE cITY BAKERSFIELD ZIP CODE 93304 NEAREST CROSS STfiEE7 SOUTH H STREET FACILITY OWNER TYPE ^ 4. LOCAL AGENCY/DISTRICT' ® 1. CORPORATION ^ 5. COUNTY AGENCY' BUSINESS - ® + GAS STATION ^ 3. FARM ^ s. COMMERCIAL TYPE ^ 2. INDNIDUAL ~ ^ 8. STATE AGENCY' FEDERAL AGENCY' 402 ^ 7 ^ 2. DISTRIBUTOR ^ 4. PROCESSOR ^ OTHER 403 . ^ 3. PARTNERSHIP TOTAL NUMBER OF Is facility on Indian Reservation or `If owner of UST is a puhlic agenq: name of supervisor of TANKS ON SITE trustlands9 ~ division, sectlon or office which operates the UST. 4 404 (This is the contact person for the tank records) ^ Yes ® No 4os MARCELO PANELO ao6 II. TANK OPERATOR INFORMATION TANK OPERATOR NAME SURJIT BISLA 407 PHONE .(661) 322-721.3 408 TANK OPERATOR TYPE ^ 1, CORPORATION ® 2. INDIVIDUAL ^ 4, LOCAL AGENCY/DISTRICT ^ 7. STATE AGENCY 413 ^ 3. PARTNERSHIP ^ 5. COUNTY AGENCY ^ 8. FEDERAL AGENCY Iil. TANK OWNER INFORMATION TANK OWNER NAME BP West Coast Products, LLC ~ PHONE (714) 670-5373 415 4+4 MAILING ADDRESS 4 Centerpointe Drive ~ - 4,s 'CITY ~ La Palma 417 CAE 418 Zip CODE 9O6Z3 419 TANK OWNER TYPE ® +. CORPORATION ^ 2. INDIVIDUAL ^ 4. LOCAL AGENCY /DISTRICT ^ 7. STATE AGENCY 420 - ^ 3. PARTNERSHIP ^ 5. COUNTY AGENCY ^ 8. FEDERAL AGENCY IV, BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT NUMBER TY (TK) HQ 4 4 - 0 4 1 4 6 5 Call (916) 322 - 9669rf questions arise azt V. PETROLEUM UST FINANCIAL RESPONSIBILITY INDICATE METHOD(S) ^ t, SELF-INSURED ^ 4. SURETY BOND ^ 7. STATE FUND ^ 10. LOCAL GOVT MECHANISM ^ 2. GUARANTEE - ^ 5. LETTER OF CREDIT ^ B. STATE FUND & CFO LETTER ^ 99. OTHER: ® 3. INSURANCE ^ 6. EXEMPTION ^ 9. STATE FUND & CD- 422 VI. LEGAL NOTIFICATION AND MAILING ADDRESS Chock one box+o indicate which address should be used for legal notifications and mailing. Legal notificatlons and mallings will ba sent to the tank owner ONLY, unless box 1 or 2 is ^ 1. FACILITY ^ 2. PROPERTY OWNER ® 3. TANK OWNER 423 checked. VII. APPLICANT SIGNATURE Certificatlon: 1 certify that the information provided herein is true and axurate to fhe best of my knowledge. SIGNATURE OF APPLICANT DATE 424 PHONE (714) 670-5373 _.. ,~ ~~7 NAME OF APPLICANT(prinf) MA CELO PANELO TITLE OF APPLICANT Environmental Compliance Specialist a2s STATE UST FACILITY NUMBER (For local use onfy) 428 +998 UPGRADE CERTIFICATE NUMBER (For local use onty) 429 Arco 01960, Belstvre Environmental Services Page 7 of 20 CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE TANKS -TANK PAGE 1 TYPE OF ACTION ^ 1. NEW SITE PERMIT ~ ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) 7. PERMANENTLY CLOSED ON SITE ^ 3. RENEWAL PERMIT ^ (Specify reason -for local use only (Specify change -for local use only) ^ B. TANK REMO VED 430 FACILITY ID # 1 BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 5 0 2 1 0 4 1 7 ARCO# 01960 __ BUSINESS ADDRESS - - CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 1'. `'TANK DESCRIPTION `' ; Ip of p _ . . ~ iST s stem includin buildings and landtn .~ _ ~~ agen_y? ` _ . TANK ID # ~ 432 , __ TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ® No 434 XefXeS If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) ~ 99OI1 O 435 TANK CAPACITY IN GALLONS ~ O,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 --- - -- II: TANK CONTENTS _ TANK USE 439 PETROLEUM TYPE ~ 440 ® 1. MOTOR VEHICLE FUEL ®1a. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (Ifmarked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL , ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) ^ 4. HAZARDOUS WASTE (Includes 442 Used Oil) GASOLINE 8006-s1-s ^ 95. UNKNOWN - - _____ _ _- - -- - IIL TANK CONSTRUCTION - TYPE OF TANK ^ 1. SINGLE WALL - ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) ®2~ DOUBLE WALL ~ EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN ^4 SINGLE WALL IN A VAULT . ^ 99. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 (Check one item only) ^ 2~ STAINLESS ^ 4. STEEL CLAD. W/ FIBERGLASS ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 95. UNKNOWN 445 (Check one item only) ^ 2~ STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER , STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ S. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2, ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN 44g DATE INSTALLED 449 PROTECTION IF APPLICABLE .PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check all that apply) ^ 2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (Forloca/ use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF.VALVE ® 2. DROP TUBE 1990 I~ 2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1990 i IV. TANK LEAK DETECTION (A description of the monitoring program shat/ be submitted to the /oca/agency)`. ---- -- IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) , ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR)+ ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (W/MM/DD) 455- ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No x/11/2002 Arco 01960, Belshire Environmental Services Page 8 of 20 ~ d . J vv ... J t (Check al! that apply) unoenurruun0 PIPm~ SYSTEM TYPE ~ ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY ~ 458 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99.OTHER 460 CONSTRUCTIOW ®2 DOUBLE WALL MANUFACTURER ^ 95. UNKNOWN MANUFACTURER: AMERON ^ 1. BARE STEEL ®6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND CORROSION ~ ^ 2. STAINLESS STEEL ^ 7. GALVANZED STEEL PROTECTION ^ 3. PLASTIC COMPATIBLE WITH CONTENTS -^ 95. UNKNOWN (check all thffi ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99.OTHER aPPIYJ ^5. STEEL W/COATING ^ 9. CATHODIC PROTECTION 464 Vii. PIPING LEAK DETECTION (cneckall tharapply)(a des UNDERGROUND PIPPIG SINGLE WALL PIPING ~ 468 PRESSURIZED PIPING (Check all that appy): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WRH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING ' GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all thatapply): 10. CONTINUOUS TURBINE SUMP SENSOR wITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a AUTO PUMP SHUT OFF W HEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ®11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) W~ FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR W ITHOUT AUTO PUMP SHUTOFF+AUDfBLE AND VISUAL ALARMS ^ ~ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) W ITHOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17..DAILY VISUAL CHECK 1. PRESSURE Ll 2: SUCTION tJ 3. GRAVITY 459 i. SINGLE WALL ^ 95. UNKNOWN 462 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER 463 ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100%METHANOL ^ 2. STAINLESS STEEL ^ T. GALVANIZED STEEL ^ 3. PLASTIC COMPATIBLE W ITH CONTENTS ^ 8. FLEXIBLE (HDPE] ^ 99.OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION ^ 5. STEEL W/COATING ^ 95. UNKNOWN 465 dpNon of the monlrotlnp program shelf be submitted to the local a9encyJ PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WIT AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL IN7EGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL IMEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all thatappty): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF W HEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR + AU018LE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Chedcefl that apply): ^ 14. CONTINUOUS SUMP SENSOR WfTHOUT AUTO PUMP SHUTOFF+AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK UItlYtN.1"tFl tiUN / AINMtN I I__I 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUAL CHECK DATE INSTALLED 468' ^ 2. CONTINUOUS DISPENSER PAN SENSOR + AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER 1 MONITORING NOt AVallabie ®3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE 1 certify that the information provided herein is true and accurate to the best of rtry knowledge. SIGNATUREOFOWNER/OPERA7 DATE •7 q70 r"~. ...... J f G3 ~5 NAME OFOWNER/OPE TOR(nnU 471 TfTLEOFOWNE OPERATOR 472 MARCELO PANELO Environmental Compliance_Specialist Revised 6/11/2002 Arco 01960; Belslure Environmental Services Page 9 of 20 CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND'STORAGE TANKS -TANK PAGE 1 TYPE OF ACTION ^ 1: NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ 3. RENEWAL PERMIT ^ 7. PERMANENTLY CLOSED ON SITE _ (Spedfy reason -for local use only (Specify change -for local use only) ^ 8. TANK REMOVED 430 FACILITY ID # ~ ~ ! BUSINESS NAME (Same as FACILITY NAME or DBA) 3 i 5 i 0 2 .1 0 4 1 7 ARCO# 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 L `TANK DESCRIPTION. ~ - (%+ awicJ 7.:: ~ ~ :7-- _~_ , ::` -_ ST s~stem indudin bu~tdin s and landma~o._ _ •nitfed to the ~ TANK ID # 2 ~ 432 TANK MANUFACTURER 43 3 COMPARTMENTALIZED TANK ^ Yes ®No 434 Xerxes If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 199OI1 O 435 TANK CAPACITY IN GALLONS ~ O,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 -- iL TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ®1a. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ to MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) ^ 4. HAZARDOUS WASTE (Includes 442 Used Oil) GASOLINE soos-sl-s ^ 95. UNKNOWN __ - -- - - IIL TANK CONSTRUCTION -- TYPE OFTANK ^ 1. SINGLE WALL _ ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ® 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg, OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 6. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 95. UNKNOWN 445 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99 OTHER (Check one item only) STEEL . REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ S. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2. ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN q4g DATE INSTALLED 449 PROTECTION IF APPLICABLE. PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check all that apply) ^2.SACRIFICIALANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1 • SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE 1990 ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1990 I V. TANK LEAK SET ECT I DN (A description~of the mo~iitor~uy prg g,[am shall b~ submits - d to the local ~y,nc}~l IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Arco 01960, Belshire Environmental Services Page 10 of 20 CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661} 326-3911 UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI. PIPING CONSTRUCTION (Cneolrerrtlratappty) UNDERGROUND PIPING ~ ABOVEGROUND PIPING SYSTEMTYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVRY 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99.OTHER 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 CONSTRUCTION! ®2 DOUBLE WALT. ^ 95. UNKNOWN ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER - MANUFACTURER: AMERON ~ MANUFACTURER 463 ^ 1. BARE STEEL ®6. FRP COMPATIBLE W/ 100 % METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND ^ 2 STAWLESS STEEL ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPEJ ^ 99.OTHER ~~ all drat ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99.OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION ^5. STEEL W/COATING ~ ^ 9. CATHODIC PROTECTION 464 ^ 5. STEEL W/COATING ^ 95. UNKNOWN 465 VII. PIPING LEAK DETECTION (Cheer arl that appry)(a description of me montroring program shalt be submitted ro the local agency.) UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check al! that appty): PRESSURIZED PIPING (Check e11 that appty): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WRH AUTO PUMP SHUTOFF FOR ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM.FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST - ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TAIENNIAL PIPING 1N7EGRITV CONVENTIONAL SUCTION SYSTEMS: TEST (0.1 GPH) ~ ~ ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.7 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING):. ^ 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) GRAVITY FLOW: ^ 8. DAILY VISUALMONITORINO ^ 9. BIENNIAL INTEGRITYTEST (0.1 GPH) SECONOAAILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check ell that apptyJ: PRESSURIZED PIPING (Check elf that eppty): 10. CONTINUOUS TURBINE SUMP SENSOR W ITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION NO AUTO PUMP SHUT OFF ^ c DISCONNECTION . ® 11. AUTOMATIC LINE LEAK DETEGTOR (3.0 GPH TEST) WffH FLOW SHUT OFF OR ^ c. NO AUTO PUMP SHUT OFF RESTRICTION ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL fNTEGRITY TEST (0.1 GPH) ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIOIWGRAVITY SYSTEM: SUCTION/GRAVITY SYSTEM: ^ 73. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS ^ t3. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Cheer all that apply): _ EMERGENCY GENERATORS ONLY (Check arl (hat appty); ^ 14. CONTINUOUS SUMP SENSOR W RHOUT AUTO PUMP SHUTOFF + AUDIBLE AND ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ~ VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST RESTRICTION ~~ ^ 16. ANNUAL INTEGRITY TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ^ 17. DAILY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUAL CHECK DATE INSTALLED 468 ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER /MONITORING Not Available ®3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHl1T OFF FOR DISPENSER +AUDIBLE AND VISUAL AIARM$ ^ 6. NONE 469 IX. OWNER/OPERATOR SIGNATi1RE t certify that the Information provided herein is true and accurate to the best of my knowledge. SIGNATUREOFOW - DATE - 470 _ ~ ,~- ~ ~ NAME OF OWNER/OPERATOR(print) 471 TITLE OF OW NER/OPERATOR 472 MARCELO PANELO Environmental Compliance Specialist Revised en trtoo2 Arco 01960, Belshire Environmental Services Page 11 of 20 i l TYPE OF ACTION (Check one item only) CUPA • Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE'TANKS -TANK PAGE 1 ^ 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ . 6. TEMPORARY SITE CLOSURE ^ 3. RENEWAL PERMIT ^ 7. PERMANENTLY CLOSED ON SITE - (Specify reason -for local use onry (Specify change -for local use only) ^ 8. TANK REMOVED 430 FACILITY ID # ~ BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 5 0 2 1 '' 0 4 1 7 ~ ARCO# 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 I. TANK'DESCRIPTION ' ::cared plo(plan wtth,the tour ; ,' ~T >. stem tncfudiry,kur(d(ngs and landn.: , 7-;: ~ Lmltted to the local agency.) TANK ID # 3 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ®No 434 Xerxes If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 19901 O 435 TANK CAPACITY IN GALLONS 1 0,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 - IC TANK CONTENTS -- - - - -- - - TANKUSE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ®ta. REGULAR UNLEADED' ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT ^ 4. HAZARDOUS WASTE (Includes COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 Used Oil) GASOLINE 8006-s1-9 ^ 95. UNKNOWN III. `T'P~I~K CONSTF~t3,CTION, -- TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ®2 DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ 99. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 95. UNKNOWN 445 ^ 2• STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99 OTHER . (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ S. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2, ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check all that apply) ^2.SACRIFICIALANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1 • SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE 1990 ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1990 IV_, TANK UEAK DETECTION (.4 descriptionptthe morritorinq pro r/ram shal6he submrited to the locaiagency) IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING . ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Arco 01960, Belshire Environmental Services Page 12 of 20 CUPA Bakersfield Fire Department • Hazardous Materials Division 2201 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE TANKS -TANK PAGE 2 CONSTRUCTION SYSTEM TYPE ~ 1. PRESSURE " - (J 2. SUCTION L.J 3. GRAVITY ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99.OTHER CONSTRUCTION/ ®2 DOUBLE WALL ^ 95. UNKNOWN MANUFACTURER " MANUFACTURER: AMERON LJ 1. BARE STEEL Q9 6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ~ ~ ^ 3. PLASTIC COMPATIBLE W ITH CONTENTS ~ ^ 95. UNKNOWN (~~` ~l that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99.OTHER aPpty) ^5. STEEL W/COATING ^ 9. CATHODIC PROTECTION 4E VII. PIPING LEAK DETECTION (Chedtallthatapply)(ad ' ~ UNDERGROUND PIPING SINGLE WALL PIPING - - 466 PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFFFOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TRIENNIAL PIPING WTEGRRY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONTORING _ ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check a!1 that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) W ITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0. t GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Chedt al! thatappty): ^ 14. CONTINUOUS SUMP SENSOR T O AUTO PUMP SHUTOFF+AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) RW HOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK 458 L..I 1. PRESSURE tJ 2. SUCTION ~J 3. GRAVITY 459 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER 483 ^ 1. BARE STEEL ^ 8. FRP COMPATIBLE W/ 100%METHANOL ^ 2. STAINLESS STEEL - ^ 7. GALVANIZED STEEL ^ 3. PLASTIC COMPATIBLE W RH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99.OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION ^ 5. STEEL W/COATING ^ 95. UNKNOWN 465 rlptlon of the monitoring program shall be submitted ro the local agency.) PRESSURIZED PIPING (Check ell thatapptyJ: ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.D GPH TEST WIT AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION+AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTIO WGRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR+AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that appy): ^ 14. CONTINUOUS SUMP SENSORWITHOUTAUTOPUMPSHUTOFF+AUDIBLEAND V ISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT U 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE DATE INSTALLED 488 4. DAILY VISUAL CHECK ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER /MONITORING Not Available ®3. CONTINUOUS DISPENSER PAN SENSOR WIT AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I cer5fy that the Information provided herein is true aM accurate to the best of mY knowledge. SIGNATUREOFOWNER/OPER DATE 470 //~ ?~ ~ NAME OF OWNER/OPERATOR(p ' 471 TRLE OF OWNER/OPERATOR 472 MARCELO PANELO Environmental Compliance Specialist Ravlsed 6/11/2002 ~ ~ - Arca 01960, Belshire Environmental Services Page 13 of 20 CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNI TYPE OF ACTION ^ 1. NEW SITE PERMIT (Check one item only) ^ 3. RENEWAL PERMIT 4. AMENDED PERMIT ='-TANKS -TANK PAGE 1 ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE ^ 7. PERMANENTLY CLOSED ON SITE (Specify change -forlocal use only) ^ 8. TANK REMOVED 430 (Specify reason -for local use only FACILITY ID # ~ BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 S i 0 2 1 0 4 1 7 ARCO# 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 -- ---- L TANK DESCRIPTION `. A scaled lot plan'with the /oca6on of the USF s stem includ[n buildin sand landrr 1 resubmitted to the focal a enc -- - ~ , TANK ID # 4 432 433 TANK MANUFACTURER COMPARTMENTALIZED TANK ^ Yes ®No 434 Xerxes If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 199OI1 O 435 TANK CAPACITY IN GALLONS 1 0,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 -_ j II. TANK CONTENTS TANKUSE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ^ 1a. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ®1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 ^ 4. HAZARDOUS WASTE (Includes Used Oil) GASOLINE 8008-61-s ^ 95. UNKNOWN _ - -- IIL 'TANKCONSTRUCTION _ _ _ _ TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 (Check one item only) ®2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN ^4. SINGLE WALL IN A VAULT ^ gg. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 (Check one item only) ^ 2. STAINLESS ^ 4. STEEL CLAD W/ FIBERGLASS ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 95. UNKNOWN 445 (Check one item only) ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2, ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN q4g. DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check allthatapply) ^ 2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all thatapply) ®1 • SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE 1990 ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1990 _ IV. TANK LEAK ~ETECTI~N (A descnption otlhe monitoring program shalt tie submitted fo the local agency). IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^. 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK CLOSURE INFORMATION./ PERMANENT CLOSURE]N PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Arco 01960, Belshire Environmental Services Page 14 of 20 CUPA Bakersfield Fire Department o Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI. PIPING CONSTRUCTION (ct~k arl r/,at apply) UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 456 ^ t. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99.OTHER 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN _ 462 CONSTRUCTIOW ®2 DOUBLE WALL ^ 95. UNKNOWN ~ ~ ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER MANUFACTURER: AMERON ~ • MANUFACTURER 463 ^ 1. BARE STEEL ®6. FRP COMPATIBLE W/ 100% METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLEWI 100% METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBLE W ITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE W ITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99.OTHER ~~~ aU that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99.OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION ^5. STEEL W/COATING ^ 9 CATHODIC PROTECTION 464 ^ 5. STEEL W/COATING ^ 95. UNKNOWN 465 VII..PIPING LEAK DETECTION (Check alf tltaf apply)(a desafpNon of the monitoring program shall be submif6ed ro the local agency.) UNDERGROUND PIPMG ~ ABOVEGROUND PIPING SINGLE WALL PIPING ~ 466 PRESSURIZED PIPING (Check ailthafeppy): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INiEGRRY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES 1N BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that appy): 10. CONTINUOUS TURBINE SUMP SENSOR W ITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) W ITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (O.t GPH) SUCTIOWGRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS PRESSURIZED PIPING (Check alt that apply): ^ t. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM D)SCONNECTION+AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 9. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONTORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1, GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check al! that apply): 70. CONTINUOUS TURBINE SUMP SENSOR WIT AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all thatappfy): EMERGENCY GENERATORS ONLY (Check all rhatapply): ^ 14, CONTINUOUS SUMPSENSORW7H0 AUTO PUMP SHUTOFF+AUDIBLEAND ^ 14. GONTINUOUSSUMPSENSORWITHOUTAU70PUMPSHUTOFF+AUDIBLEAND VISUAL ALARMS ~ VISUAL ALARMS ~' ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR ^ i S. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST RESTRICTION ^ i6. ANNUAL INTEGRITY TEST ^ i6. ANNUALINTEGRITYTEST 77. DAILY VISUAL CHECK ^ 77. DAILY VISUAL CHECK VIII. DISPENSER CONTAINMENT DISPENSER CONTAINMENT ^ is FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. GAILY VISUAL CHECK DATEINSTAU_ED 468 ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER /MONITORING Not Available ®3. CONTINUOUS DISPENSER PAN SENSOR W ITH AUTO SHUT OFF FOR DISPENSER + AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I certify char the trtfarmation provided herein is We and accurate to tha best of my knowledge. SIGNATUREOFOWNER/OPER_A~T $ DATE : •. 470 NAME OF OWNERIOPERATOR(prlnt) 471 TITLE OF OW NER/OFrERATOR - 472 MARCELO PANELO Environmental Compliance Specialist Revised 6/11!2002 Arco 01960, Belsltire Environmental Services Page 15 of 20 HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 1. EMERGENCY RESPONSE PLANS AND PROCEDiJRES A. In the event. of a release or threatened release of hazardous materials, provide the following immediate notifications: Immediately call: Local emergency response personnel 911 (Fire, paramedics, police or sheriff) State Office of Emergency Services- (800) 852-7550 or (916) 262-1621 Immediately call the appropriate jurisdiction: The Bakersfield Fire Deparhnent Hazardous Materials Management Division: (661) 326-3979 Person(s) within the business required responding to a hazardous materials incident: Name: SURJIT BISLA Telephone: (661) 322-7213 Name: MARCELO PANELO Telephone: 1714) 670-5373 Name: ELITE CUSTOMER SOLUTIONS CENTER Telephone: (8881778-0763 B. Identify the local emergency medical facility that will be used by your business in the event of an injury caused by the release of a hazardous material: Name: BAKERSFIELD MEMORIAL HOSPITAL Address: 420 34TH STREET City: BAKERSFIELD, CA 93301 Phone: 5661) 327-4647 2. PREVENTION Gasoline. Gasoline spills can result in environmental contamination, fire, and explosion. Releases of gasoline can occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spill prevention devices are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. Arco 01960, Belshire Environmental Services Page 16 of ZO 4 HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 Carbon Dioxide:~Liquefied carbon dioxide is an extremely cold liquid/gas and is stored under high pressure in a gas cylinder. The small gas cylinders, containing 20 to 50 pounds of liquid carbon dioxide, must be stored upright and be firmly secured with chain to the wall. Those large cylinders (containersj, which contain 200 to 400 pounds of liquid carbon dioxide, must be either chained or anchored to the floor. Securing the cylinder prevent falling or being knocked over. The gas cylinder must be capped at all times and transported with drum cart. , The extremely cold part of pipes and valves on top of the cylinder will cause moist flesh to stick fast and tear when one attempts to withdraw from it. A leak will result in the formation of dry ice, and contact with dry ice, liquid carbon dioxide, or cold gas can cause frostbite to skin, eyes, and exposed tissues. Breathing low concentration of carbon dioxide can cause nausea, dizziness, mental confusion, and visual disturbance, shaking, headache, and respiratory problem. Liquid carbon dioxide has a high evaporation rate and when heated to above 52 Degree C (125 Degrees F) will generate high pressure. Store away from heat and ignition sources and out of direct sunlight. High temperature can generate high pressure in the tank/cylinder and cause rupture if the safe relief valve fails to operate. Do not store the container or cylinders where they come into contact with moisture. 3. MITIGATION In the event of a major release of gasoline: 1. Attendant should shut off electricity to the pumps/turbines at the emergency shut off switch and/or the main electrical panel. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency, and will contact ELITE CSC. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. If neither agency gives such direction, coordinator will call ELITE CSC for removal and disposal: In the event of a fire: 1. Attendant should shout FIRE ALARM and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels and close impact valves. 3. Evacuate by stopping all traffic on site and direct a!I personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety resporise Arco 01960, Belslure Environmental Services Page 17 of 20 HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer assistance, as requested. ' In the event of a carbon dioxide release: Carbon dioxide is cold, asphyxiant, and powerful cerebral vasodilator gas. If there are signs. of visible ice on the cylinder or parts such as pipes, it is a sign of a leak and needs to be reported to your manager immediately. in the event of release, evacuate the store, and allow the liquid/gas carbon dioxide to evaporate and the gas to dissipate. Attempt to close 'the main source valve to stop the release is not recommended unless if is safe to do so and you have adequate personal protection gears. If the area must -be entered by emergency personnel, Self-Contained Breathing Apparatus (SCBA), Kevlar gloves, and appropriate foot and leg protection must be worn. 4. ABATEMENT In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55- gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 3, Mitigation. Large spills are cleaned by BP designated contractors, or as designated by the franchisee for franchise service stations. 5. EVACUATION Alarm shall be given by shouting to initiate an evacuation at the facility. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. To evacuate the Sales Area, office or storage area, leave facility; go to area opposite danger using the front and/or back doors and proceed to the staging area or area opposite danger zone. Call 911 and report emergency. Call ELITE CSC; give details of emergency. 6. EARTHQUAKES BP WEST COAST PRODUCTS LLC has contracted with maintenance contractors to conduct post-earthquake inspections following an earthquake. Inspections will take place as soon as possible after a 5.5 or greater magnitude quake. After earthquake employees will: 1. Make sure gasoline inventories are secure. Secure all underground storage tank systems (emergency pump shut-off switch and main electrical for the turbines) at the main electrical panel. 2. If there are any signs of structural damage to the building or island canopy, keep everyone away from the damaged area. If danger is imminent, shut down facility operations until it has been deemed safe to continue. 3. Call ELITE CSC immediately. If there's an immediate danger, call 911 for assistance. 4. If there is any indication of loss of . gasoline from tanks or lines, shut down the dispensing system immediately. 5. If there is Arco 01960, Belshire Environmental Services Page 18 of 20 ,; HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 visible gasoline. from dispensers, be sure to use absorbent material. 6. Even if gasoline inventories appear normal, conduct inventory reconciliation and visual checks twice a day until aftershocks subside. 7. HAZARDOUS WASTE CONTINGENCY See Section 3, Mitigation, "In the event of a major release." 8. UNAUTHORIZED RELEASE RESPONSE PLAN See Section 3, Mitigation, "In the event of a major release. " Release reporting will be completed by the Environmental Compliance Specialist (MARCELO PANELO). 9. SITE SECURITY As applicable on an individual facility basis, you should assess the security and vulnerability of your business from intentional acts both from within your business (sabotage) and from the outside (vandalism and terrorist acts). This assessment should consider testing your security system and procedures on a regular basis. Details of this assessment should not be included in this plan as it is a public document. 10. EMPLOYEE TRAINING PLAN All employee training shall be documented and updated annually New employee training. Topics as follows: 1. Identification, location and securing of C02. 2. Review BERP including emergency escape procedures and evacuation assembly location. 3. Discuss fire risks from flammable liquids, combustible materials, static electricity and propane (if applicable). 4. Locate all fire extinguishers. 5. Review list of chemicals used at facility, MSDS's and their location. 6. Handling, identification and proper storage and labeling of hazardous waste. 7. Identify location of UST monitoring alarm. 8. Instruct on use and location of emergency shut-off switches. 9. Discuss procedures used to respond to minor and major spills. Training is conducted as described above for new employees and on a yearly basis for all employees. Arco 01960, Belshire Environmental Services Page 19 of 20 r': ~ , SITE MAP BUSINESS NAME: ARCO # 01960 SITE ADDRESS: 1701 BRUNDAGE LANE CITY: BAKERSFIELD ZIP: 93304 MAP DATE: 03-07-07 SURVEY BY: A.R. DRAWN BY: D.B. I AGENCY FACILITY #; B C D E F G H I ] K L 2 3 4 S 6 7 g 9 10 11 12 ~~ h~.~ f • E ;i,- I! Q TB LEGEND DISPENSER SHUTOFF CASHIER O ABSORBENT F(, FLAMMABLE LIQUID Mgpg MSDS & EMERGENCY PLAN BR BATH ROOM O GAS PUMP EMERGENCY ~ FIRE HYDRANT ~ MONITORING ~y ELy CL COMBUSTIBLE LIQUID - TB TRASH BIN ® SEWER/FLOOR DRAIN SHUT OFF O ELECTRICAL PANEL • TANK MONITOR O WATER MC MOTOR COOLANT - ~ ~ FENCE ~ FIRST AID OL ~ LIQUID WASTE DRUM UATION C ~ ERA ~ PPE M~ MOTOR OIL A/L' U ~ ONDITIONING ~ FIRE EXTINGUISHER E A O SOLID WASTE DRUM / Cco~) OVERFILLALARM ~ \ C TELEPHONE eM EMERGENCY EXIT COZ ~ COz CYLINDER ~ ~ ® STORM DRAIN ~~ JUST _+_ SENSOR DISPENSER Arco 01960, Belshire Environmental Services - Page 20 of 20 ® Wise uor /Market ~ Buys f 'Drugs Brundage Lane:. _.....Driuavaay.:......._.._~. . ______......___ - O C~O~~ .1J~ ' ~ m ~ , e~•>O ppo '"gyp''' ~ ` ; c ;. -----.._..;..._. _ _. w O. ; ._....._._._- - -...._.__......... --- -- t .~" ,- .• 0 ,, .-: _ ..... ... Ln ,i ~ - .: -. ~,~,~ ,..-----. ~ ~,o,,.- .... .. EM, _ __~ - ~ - - ~. ~+ 3 ~~ ~ s O ___ _~, _.. ~ .._~--..__ _ _.. ~ -- __ _ _ __.T .._ . LJ - ~ ~ -' ~ UNDERGROUND STORAGE TANK MONITORING PLAN -PAGE 1 TYPE OF ACTION ®1. NEW PLAN ^ 2. CHANGE OF INFORMATION Mot. PLAN TYPE ®MONITORING IS IDENTICAL FOR ALL USTs AT THIS FACILITY. Moe. (Check one item only) ^ THIS PLAN COVERS ONLY THE FOLLOWING UST SYSTEM(S): '' L FACILITY INFORMATION FACILITY ID # (Agency Use Only) FACILITY NAME ARCO`#.01960 _ Mo3. FACILITY SITE ADDRESS 1701 BRUNDAGE LANE M°a. CITY BAKERSFIELD MOS. IL " EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE State law requires that testing, preventive maintenance, and calibration of monitoring equipment (e.g., sensors, probes, line leak detectors, etc.) be performed in n-tob. accordance with the equipment manufacturers' instructions, or annually, whichever is more frequent. Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED ® 1. ANNUALLY ^ 99. OTHER (Specify): Moz - III. MONITORING LOCATIONS This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed (i.e., location of each sensor, line leak detector, monitoring system control panel, etc.). If you already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certifi cation form, Hazazdous Materials Business Plan map, etc.) which shows all re uired information, include it with this lan. IV: TANK MONITORING '' MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) Mlo. ® 1. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: ®a. DRY ^ b. LIQUID FILLED ^ c. UNDER PRESSURE ^ d. UNDER VACUUM Ivtl 1. PANEL MANUFACTURER: Veeder Root M12 MODEL #: TLS 350 Mt3. LEAK SENSOR MANUFACTURER: Veeder Root Mla. MODEL #(S): 794390-407 Mts. ^ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(Sl PANEL MANUFACTURER: M16 MODEL #: Mtz IN-TANK PROBE MANUFACTURER: M18' MODEL #(S): Mtg. LEAK TEST FREQUENCY: ^ a. CONTINUOUS ^ b. DAILY/NIGHTLY ^ c. WEEKLY M20' ^ d. MONTHLY ^ e. OTHER (Specify): Mz t. PROGRAMMED TESTS: ^ a. 0.1 h. ^ b. 0.2 h. ^ c. OTHER S eci M22. Mz3. g P g•P• (p fy)~ ^ 3. INVENTORY RECONCILIATION ^ a. MANUAL PER 23 CCR §2646 ^ b. STATISTICAL PER 23 CCR §2646.1 Mza. ^ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §2645 TESTING PERIOD: ^ a. 36 HOURS ^ b. 60 HOURS Mts. ^ 5. INTEGRITY TESTING PER 23 CCR §2643.1 TEST FREQUENCY: ^ a. ANNUALLY ^ b. BIENNIALLY ^ c. OTHER (Specify): Mz6. M2z ^ 6.VISUAL MONITORING DONE: ^ a. DAILY ^ b. WEEKLY (Requires agency approval) ^ 99.OTHER (Specify): I"128 "' V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Mao. ® 1. CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)lTRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ®a. DRY ^ b. LIQUID FILLED ^ c. UNDER PRESSURE ^ d. UNDER VACUUM M31. PANEL MANUFACTURER: Veeder Root M32 MODEL #: TLS 350 M33. LEAK SENSOR MANUFACTURER: Veeder Root M3a. MODEL #(S): 794380-208 M3s. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN? ®a. YES ^ b. NO M36. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ®a. YES ^ b. NO M37. ® 2. MECHANICAL LINE LEAK DETECTOR (MELD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED MELD MANUFACTURER(S): VAPORLESS M38 MODEL #(S): LD-2000 M39. ^ 3. ELECTRONIC LINE LEAK DETECTOR (ELLD) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TE5TS ELLD MANUFACTURER: Mao' MODEL #: Mat. PROGRAMMED LINE INTEGRITY TESTS: ^ a. MINIMUM MONTHLY 0.2 g.p.h. ^ b. MINIMUM ANNUAL 0.1 g.p.h. Mae. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ^ a. YES ^ b. NO Mai. WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ^ a. YES ^ b. NO Maa. ^ 4. INTEGRITY TESTING TEST FREQUENCY: ^ a. ANNUALLY ^ b. EVERY 3 YEARS ^ c. OTHER (Specify) M4 5. M46. ^ 5. VISUAL MONITORING DONE: ^ a. DAILY ^ b. WEEKLY* ^ c. MIN. MONTHLY & EACH TIME SYSTEM OPERATED** M47. • Requires agency approval * • Allowed for monitoring of unburied emergency generator fuel piping only per HSC §25281.5(6)(3) ^ 6. PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(a)(3) ^ 7. NO PRODUCT OR REMOTE FILL PIPING IS CONNECTED TO THE UST(s) ^ 99. OTHER (Specify) M48 ~ ARCO 60,~e(shlre Environmental Services Page 1 of 5 _ .; q UNDERGROUND STORAGE TANK MONITORING PLAN -PAGE 2 VI. DISPENSER MONITORING'. MONITORING OF AREAS BENEATH DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Mso. ® 1. CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CONTAINMENT (UDC) PANEL MANUFACTURER: Veeder Root Msi. MODEL #: TLS 350 M52. LEAK SENSOR MANUFACTURER: Veeder Root MS' MODEL #(S): 794380-208 Msa. WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ®a. YES ^ b. NO Mss. WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ®a. YES ^ b. NO M56. WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ®a. YES ^ b. NO Msz ^ 2. MECHANICAL ASSEMBLY (e. g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK ASSEMBLY MANUFACTURER: Mss. MODEL #(S): M59. ^ 3.VISUAL MONITORING DONE: ^ a. DAILY ^ , b. WEEKLY (Requires agency approvaq M60. ^ 4. NO DISPENSERS ^ 99.OTHER (Specify) M61. VII. ENHANCED LEAK DETECTION _ _ ^ 1. WE I LAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK "'i~0' DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR §2644.1, ELD ]S PERFORMED EVERY 36 MON"CHS AS REQUIRED VIII..TRAINING REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) M80. 1. ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 2. ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required)* 3. ® THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of MM/DD/1'Y) 4. ^ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS 5. ^ CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. ^ STATE WATER RESOURCES CONTROL. BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS -MANUAL AND STATISTICAL INVENTORY RECONCILIATION" 7. ^ SWRCB PUBLICATION: "WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99. ^ OTHER (Specify): Mss Personnel with UST monitoring responsibilities aze familiar with all of the above documents relevant to their job duties and can access those documents when needed. By 1/1/2005, this facility will have a "Designated UST Operator" who has passed the operator exam administered by the International Code Council (ICC). By July 1, 2005, and annually thereafter, the "Designated UST Operator".will train facility employees in the proper operation and maintenance of the UST systems. This training will include, but is not limited to, the following: - Operation of the UST systems in a manner consistent with the facility's best management practices. - The facility employee's role with regazd to the leak detection equipment. - The facility employee's role with regard to spills and overfills. - Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after July 1, 2005, the initial training will be conducted within 30 days of the date of hire. IX. COMMENTS/AllDITIONAL INFORiVIATION __ _ Please use this section to include any additional UST system monitoring-related information (e.g., additional information required by your local agency): Mss. *Monitoring systems manual maintained by contracted, licensed pump and tank technicians. Best Management Practices are maintained in the H.S.S.E. Retail Facility Programs Manual (Green Binder). X. PERSONNEL RESPONSIBILITIES THE FACILITY OPERATOR DESIGNATED IN SECT lON YI BELOW 1S RESPONSIBLE POR PEFORMING MONITORING. BP ~'~-EST COAST PRODUCTS LLC IS RESPONSIBLE FOR MAINTAINING AND TESTING ALL MONITOR1biG EQUIPMENT. _ ...... _ XL O~YNER/OPERATOR SIGNATURE _ __ CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. OWNE ERATOR SIGNATi~RE, REPRESENTING. DATE: M91 . -" ~_ < n - ^ Owner M9o.? - '~.--~~"~~.. _ _ _ _ ~f? Q ®Operator OWNER/OPERATOR NAME (print): M9z. OWNER/OPERATOR TITLE: M93. SURJIT BISLA Franchisee (Agency Use Only) This plan has been reviewed and: ^ Approved ^ Approved With Conditions ^ Disapproved Local Agency Signature: Date: Comments/Special Conditions: ARCO 01960, Belshire Environmental Services Page 2 of 5 '1 ' UNDERGROUND STORAGE TANK RESPONSE PLAN -PAGE 1 (One form per facility) TYPE OF ACTION ® 1. NEW PLAN ^ 2. CHANGE OF INFORMATION Rol. L FACILITY INFpRMATION FACILITY ID # (Agency Use Only) FACILITY NAME Roz. ARCO # 01960 FACILITY SITE ADDRESS Roa. CITY Roa. 1701 BRUNDAGE LANE BAKERSFIELD II. SPTLI; CONTROL AND CLEANUP METHODS This plan addresses unauthorized releases from UST systems and supplements the emergency response plans and procedures in the facility's Hazardous Materials Business Plan. - If safe to do so, facility personnel will take immediate measures to control or stop any release (e.g., activate pump shut-off; etc.) and, if necessary, safely remove remaining hazardous material from the UST system. - Any release to secondary containment will be pumped or otherwise removed within a time consistent with the ability of the secondary containment system to contain the hazardous material, but not greater than 30 calendar days, or sooner if required by the local agency. Recovered hazardous materials, unless still suitable for their intended use, will be managed as hazardous waste. - Absorbent material will be used to contain and clean up manageable spills of hazardous materials. Used absorbent material will be stored in a properly labeled and sealed container until removed from the site by a licensed hazardous waste transQorter. - Facility .personnel will determine whether or not any water removed from secondary containment systems, or from clean-up activity, has been in contact with any hazardous material. If the water is contaminated, it will be managed as hazardous waste. If the water has a petroleum sheen (i.e., rainbow colors), it is contaminated: A thick floating petroleum layer may not necessarily display rainbow colors. Water (hazardous or non-hazardous) from sumps, spill containers, etc. will not be disposed to storm water systems. - We will review secondary containment systems for possible deterioration if any of the following conditions occur: 1. Hazardous material in contact with secondary containment is not compatible with the material used for secondary containment; 2. Secondary containment is prone to damage from any equipment used to remove or clean up hazardous material collected in secondary containment; 3. Hazardous material, other than the product/waste stored in the primary containment system, is placed inside secondary containment to treat or neutralize released product/waste, and the added material or resulting material from such a combination is not compatible with secondary containment. ;_: . III. SPILL CONTROL AND CLEAN-UP EQUIPMENT ` PERIODIC MAINTENANCE: Spill control and clean-up equipment kept permanently on-site is listed in the facility's Hazardous Materials Business Plan. This equipment is inspected at least monthly, and after each use, and supplies are replenished as needed. Defective equipment is repaired or replaced as necessazy. EQUIPMENT NOT PERMANENTLY ON-SITE, BUT AVAILABLE FOR USE IF NEEDED: Com lete only if a licable) EQUIPMENT LOCATION AVAILABILITY Absorbent R10' Backroom '~0 Onsite at all times R30. Broom /dustpan R" Backroom '~1 Onsite at all times '~' Gloves R12 Backroom '~z Onsite at all times R32. R13. R23. R33. R14. R24. R34. R I S. R25. R35. IV." RESPONSIBLE"PERSONS . . .-., THE FOLLOWING PERSON(S) IS/ARE RESPONSIBLE FOR AUTHORIZING ANY WORK NECESSARY UNDER THIS RESPONSE PLAN: NAME Rao. TITLE R50. MARCELO PANELO Environmental Com liance S ecialist NAME R41 TITLE Rsl. NAME Roz. TITLE Rsz. NAME R43. TITLE Rss. V. INDIRECT HAZARD DETERMINATION This information is required o~ when the presence of the hazardous substance can not be determined directly by the monitoring method used (e.g., where liquid level measurements in a tank annular space or secondary piping aze used as the basis for leak determination). THE FOLLOWING STEPS WILL BE TAKEN TO DETERMINE THE PRESENCE OR ABSENCE OF HAZARDOUS SUBSTANCE IN THE SECONDARY CONTAINMENT IF MONITORING INDICATES A POSSIBLE UNAUTHORIZED RELEASE: R60. Site operator will contact Elite Customer Solutions Center (CSC) at 1-888-778-0763. A certified, trained pump and tank technician will be dispatched to the site to evaluate and repair alarm condition. ARCO 01960, Belshire Environmental Services Page 3 of 5 .. ~ i- ~ ` , UNDERGROUND STORAGE TANK RESPONSE PLAN -PAGE 2 VI. LEAK INTERCEPTION AND.. DETECTION SYSTEM This information is required onl for motor vehicle fuel UST systems constructed per the Alternate Construction Requirements of 23 CCR §2633, and only if the Leak Interception and.Detection System (LIDS) does not meet the volumetric requirements of 23 CCR §2631(d)(1) through (5) (i.e., when accounting for rainfall and backfill material, the secondary containment volume is less than 100% of primary tank volume for a single UST; or in the case of multiple USTs in shazed secondary i containment, 150% of the lazgest primary tank volume or 10% of aggregate primary tank volume, whichever is greater). i ATTACH AN ADDITIONAL PAGE TO THIS PLAN CONTAINING THE FOLLOWING INFORMATION: - The volume of the LIDS in relation to the volume of the primary container; - The amount of time the LIDS shall provide containment related to the time between detection of an unauthorized release and cleanup of the leaked substance; - The depth from the bottom of the LIDS to the highest anticipated level of groundwater, - The nature of the unsaturated soils under the LIDS and their ability to absorb contaminants or to allow movement of contaminants; - The methods and scheduling for removal of all hazardous substances which may have been discharged from primary containment and aze located in the unsaturated soils between the rim containment and roundwater, includin the LIDS sum . VIL > REPOR'PING AND RECORD KEEPING We will reportlrecord any overfill, spill, or unauthorized release from a UST system as indicated in this plan. Recordable Releases: Any unauthorized release from primary containment which the UST operator is able to clean up within eight (8) hours after the release was detected or should reasonably have been detected, and which does not escape from secondary containment, does not increase the hazard of fire or explosion, and does not cause any deterioration of secondary containment, must be recorded in the facility's monitoring records. Monitoring records must include: - The UST operator's name and telephone number; - A list of the types, quantities, and concentrations of hazardous substances released; - A description of the actions taken to control and clean up the release; - The method and location of disposal of the released hazazdous substances, and whether a hazardous waste manifest was or will be used; - A description of actions taken to repair the UST and to prevent future releases; - A description of the method used to reactivate interstitial monitoring after replacement or repair of primary containment. ' Reportable Releases: Any overfill, spill, or unauthorized release which escapes from secondary containment (or primary containment if no. secondary containment exists), increases the hazard of fire or explosion, or causes any deterioration of secondary containment, is a reportable release. Reportable releases are also recordable. Within 24 hours after a reportable release has been detected, or should have been detected, we will notify the local agency administering the UST program of the release, investigate the release, and take immediate measures to stop the release. If necessary, or if required by the local agency, remaining stored product/waste will be removed from the UST to prevent further releases or facilitate corrective action If an emergency exists, we will notify the State Office of Emergency Services. Within five (5) working days of a reportable release, we will submit to the local agency a full written report containing all of the following information to the extent that the information is known at the time of filing the report: - The UST owner's or operator's name and telephone number; - A list of the types, quantities, and concentrations of hazardous materials released; - The approximate date of the release; - The date on which the release was discovered; - The date on which the release was stopped; - A description of actions taken to control andlor stop the release; - A description of corrective and remedial actions, including investigations which were undertaken and will be conducted to determine the nature and extent of soil, ground water or surface water contamination due to the release; - The method(s) of cleanup implemented to date, proposed cleanup actions, and a schedule for implementing the proposed actions; - The method(s) and location(s) of disposal of released hazardous materials and any contaminated soils, groundwater, or surface water. - Copies of any hazazdous waste manifests used for off-site transport of hazardous wastes associated with clean-up activity; - A description of proposed methods for any repair or replacement of UST system primary/secondary containment systems; - A description of additional actions taken to prevent future releases. We will follow the reporting procedures described above if any of the following conditions occur: - A recordable unauthorized release can not be cleaned up or is still under investigation within eight (8) hours of detection; - Released hazazdous substances are discovered at the UST site or in the surrounding area; - Unusual operating conditions are observed, including erratic behavior of product dispensing equipment, sudden loss of product, or the unexplained presence of water in the tank, unless system equipment is found to be defective and is immediately repaired or replaced, and no leak has occurred; - Monitoring results from UST system monitoring equipment/methods indicate that a release may have occurred, unless the monitoring equipment is found to be defective and is immediately repaired, recalibrated, or replaced, and additional monitoring does not confirm the initial results. Record Retention: Monitoring records and written reports of unauthorized releases must be maintained on-site (or off-site at a readily available location, if approved by the local agency) for at least 3 years. Hazardous waste shippingJdisposal records (e.g., manifests) must be maintained for at least 3 years from the date of shipment. VIII. OWNER/OPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. QWNER) RATOR SIGNATUR E - x~o. DATE ~ ~~ ~ c~ OWNER/OPERATOR NAME (print) x~~. OWNER/OPERATOR TITLE x~z. SURJIT BISLA Franchisee (Agency Use Only) This plan has been reviewed and: ^ Approved ^ Approved With Conditions ^ Disapproved Local Agency Signature: Date: ARCO 01960, Belshire Environmental Services Page 4 of 5 . . i . C 1 2 3 4 5 6 8 9 10 11 12 13 BUSINESS NAME: ARCO # 01960 SITE ADDRESS: 1701 BRUNDAGE LANE CITY: BAKERSFIELD ZIP: 93304 MAP DATE: 03-07-07 SURVEY BY: A.R. DRAWN BY: D.B. I AGENCY FACILITY #: B C D- E- F' G H I J K L ® Wise Candlelight'.Rose Chapel ' Liquor/ Market ~ iBuys :Drugs Brundage Lane' _ _ _.......' --Drivewa ...... y y...........;. ;...._. _.....Drivewa 1 /l O \`O~~ a o SLL -, ~~ O ' '~ ~ _ .. ,...... _ _....._ _ Cn S _ ¢ o - cn 9 ~ Q 0 ~~ -~' ~ m c ! ~ ........ _...... _... , 0. ~......... i O ~0, O ~ _..... ~ ~ ; .-~~ -+ ; - J~~~ X00 - o m ........ _... .... ... ... . .. 0~ ~ ~ _ ... .... .... ,, y -~ --~ EM d d 'm ~ v = v o L N • in o _. _...°~ ~ ° _... Oi ........ r ~ c > o ~ ® ~ ° 1 . ~ ~ • i . E c m H 3 ~ O ~.... _....... MO ~ ~ , ~ ~ Ni$DB... v ~ - m A C 'A C BR ~ - o , COz ~ '--------- '----- --- - r > ~ ~ .. _...._.. - ......... ILLI~/ ~ _ EM .. ... _.: ~ _ L '. ~ a ......_. m ~ O O TB c o Storage ~ 0 - N Taco Bell LEGEND ~ ^ DISPENSER SHUTOFF CASHIER A O ABSORBENT FL FLAMMABLE LIQUID , MSDS & MSDS EMERGENCY PLAN BR BATH ROOM O GAS PUMP EMERGENCY ~ FIRE HYDRANT ~ .MONITORING WELL CL QUID STIBLE TB TRASH BIN '~ SEWER/FLOOR DRAIN SHUT OFF OE ELECTRICAL PANEL • TANK MONITOR O WATER MC MOTOR COOLANT - FENCE ~ FIRST AID OL LIQUID WASTE DRUM ~ aRAECAUATION - ~ PPE M~ MOTOR OIL A/(~' U ~ ONDITIONING y ~ FIRE EXTINGUISHER O ~SOL[D WASTE DRUM / 1(O>~ OVERFILL ALARM ~ ••• TELEPHONE EM EMERGENCY EXIr (,'0z COi CYLINDER ® STORM DRAIN `____.____;UST ; ~_ SENSOR DISPENSER ARCO 01960, Belshire Environmental Services Page 5 of 5 •) ~) ' < -+ ~i) Permit to Operate To Be Posted Hazardous Ma#eria)s/HaYardous,Wasf~ Unified Permit CONDITIONS OF PERMIT ON REVER~Sf SIDE PERMIT ID#015-021-000417 ~ .This permit is;.issued for the following: ARCO 01960 Hazardous Materials Plan 1701 BRUNDAGE LN, BAKERSFIELD CA 93304 Hazardous Waste Generator and/or Treatment Underground Storage of Hazardous Materials ~{ ~~ ~` ~- 1f'IF~n!'f +,~..r.T,~~w 9t ;-` y ~- ~ ~ j, ~fi~ -.~~~ T f r~_„a,,i _,j~i :~rMk~ Hi~'r,~~,gY7S~l+J.S ~f~Pzs~~t4~ ,~J`kx~ 1 S `~>i RJ 5TA 1;~ ~+~T1.1`I•,~Ttl /:' `~ .a4NF tAT_ t ~ µ - ~.::~ ?f: r S.a,:~ - ~t ~ ,~~ ~~r , ,~~ .iF~ E~~ `-a c ~±. ~ ,....~1~~r ac ~~ ~ ~~ ~.~.F ~~lUt{ITU}7 "~h~ET11~]';~~~~f ~(-',IIJr X1:1 S - ~~. _ _ ..-..._~.~.re,,, _.,,... {...... - ~ _. ~ ava.cx ..•...i 1~.vu .ti~u.+-. f.:. - at° A4-~~__: WL ~7/`.~' 0001 PREMIUM UNLEADED 10000- Gal -.1990 DOUF'LL 'HALL FIBERGLASS UNKNOWN PRESSURE INTERSTITIAL - MONITORING 0002 REGULAR UNLEADED 10000 `Gaf 1990 DOUBLE WALL FIBERGLASS UNKNOWN PRESSURE INTERSTITIAL MONITORING 0003 UNLEADED PLUS/MIDGRADE 10000 deo `~ Issued by; < FI'RE O ARTM ~ T ~Qd Gal '_, ] 990 :=, DOUBLE--.VifALL FIBERGLASS Bakersfield Fire.Department OFFICE OF PREV~IVTIOR! SERVICES 900 Truxtun Ave. Suite Z10 1x,r Bakersfield, CA 93301 Voice (661) 326-3979 FAX (661)852-2171 UNKNOWN PRESSURE INTERSTITIAL MONITORING Approved by; C=E, i~ J ^~~ Issue Date: July 1, 2006 Expiration Date: June. 30, 2009 ~ ~~C~~~ Il ~~ ~u~s ~ s zoos _ _ ___- _..r ~._ v _ ~ ~ -- ~ U,NDERGRQUND:~TOR~~~AGE-TA~NK~S; -.FACILITY- TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 3. RENEWAL PERMIT ® 5 CHANGE OF INFORMATION (Specify change - ^ 7. PERMANENTLY CLOSED SITE (Check one item only) ^ q. gMENDED PERMIT local use only) ^ 8. TANK REMOVED ^ 6. TEMPORARY SITE CLOSURE 400 L FACILITY /SITE INFORMATION FACILITY ID # 1 SITE NAME (Same as FACILITY NAME or DBA) 3 6 0 0 1 l Arco# 01960 3 BUSINESS ADDRESS CITY ZIP CODE 1701 Brundage Lane Bakersfield 93304 NEAREST CROSS STREET 401 FACILITY OWNER TYPE ^ 4. LOCAL AGENCY/DISTRICT` South H St. ^ 5. COUNTY AGENCY' ® 1. CORPORATION BUSINESS ® 1. GAS STATION ^ 3. FARM ^ 5. COMMERCIAL ^ 2. INDIVIDUAL ^ 6. STATE AGENCY' TYPE ^ 3. PARTNERSHIP ^ 7. FEDERAL AGENCY` 402 ^ 2. DISTRIBUTOR ^ 4. PROCESSOR ^ OTHER 403 TOTAL NUMBER OF Is facility on Indian Reservation or `If owner of UST is a public agency: name of supervisor of TANKS ON SITE trustlands? division, section or office which operates the UST. (This is the contact person for the tank records) 4 404 ^ Yes ® No 405 406 li. TANK OPERATOR INFORMATION TANK OPERATOR NAME ~ 407 PHONE ~ 408 Surjit Bisla (714) 670-5248 MAILING OR STREET ADDRESS ~ 409 P.O. Box 6038 CITY 410 STATE 411 ZIP CODE 412 Artesia CA 90702-6038 TANK OPERATOR TYPE ^ 1. CORPORATION ® 2. INDIVIDUAL ^ 4. LOCAL AGENCY /DISTRICT ^ 7. STATE AGENCY 413 ^ 3. PARTNERSHIP ^ 5. COUNTY AGENCY ^ 8. FEDERAL AGENCY IIL TANK OWNER INFORMATION TANK OWNER NAME ~ - 414 PHONE 415 BP West Coast Products LLC (714) 670-5248 MAILING OR STREET ADDRESS ~ 416 P.O. Box 6038 CITY ~ ~ 417 STATE 418 ZIP CODE 419 Artesia CA 90702-6038 TANK OWNER TYPE ® 1. CORPORATION ^ 2. INDIVIDUAL ^ 4. LOCAL AGENCY /DISTRICT ^ 7. STATE AGENCY 420 ^ 3. PARTNERSHIP ^ 5. COUNTY AGENCY ^ 8. FEDERAL AGENCY IV. 'BOARD OF-EQUALIZ4TION UST STORAGE FEE ACCOUNT''NUMBER r TY (TK) HQ 4 d ~ 0 ~ ~1 4 6 - ~~ 5 Call (916) 322 - 9669 if questions arise a~ V. PETROLEUM UST FfNANCIAL RESPONSIBILITY INDICATE METHOD(S) ^ 1. SELF-INSURED ^ 4. SURETY BOND ® 7. STATE FUND ^ 10. LOCAL GOVT MECHANISM ^ 2. GUARANTEE ^ 5. LETTER OF CREDIT ^ 8. STATE FUND & CFO LETTER ^ 99. OTHER: ®. 3. INSURANCE ^ 6. EXEMPTION ^ 9. STATE FUND 8 CD 422 VL LEGAL NOTIFICATION AND MAILING ADDRESS - - Check one box to indicate which address should be used for legal notifications and mailing. Legal notifications and mailings will be sent to the tank owner ONLY, unless box 1 or 2 is ^ 1. FACILITY ^ 2. PROPERTY OWNER ® 3. TANK OWNER 423 checked. V.II. APPLICAI~tT SIGNATURE ~' Certification: I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNATURE OF APPLIC DATE 424 PHONE ~ 425 $/2/2~~6 (714) 670-5248 NAME OF APPLICANT (prin 426 TITLE OF APPLICANT q27 Scott Hartwe Environmental Compliance Specialist STATE UST FACT Y NUMBER (For total use only) 428 1998 UPGRADE CERTIFICATE NUMBER (For local use only) q2g UNDERGROUND.;STORAGE TANKS, -TANK PAGE;1 TYPE OF ACTION ^ 1., NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ 3. RENEWAL PERMIT ^ 7. PERMANENTLY CLOSED ON SITE /Soecifv reason -for local use only (Specify change -for local use only) ^ ' 8 TANK REMOVED 430 FACILITY ID # _ 1' - BUSINESS NAME (Same as FACILITY NAME or DBA) 3 6 °- 0 0 1 01960 BUSINESS ADDRESS CITY ZIP CODE ' 1701 Brundage Lane Bakersfield 93304 LOCATION WITHIN SITE (Optional) 431 1. -TANK DESCRIPTION ocauon ofthP US7.s slem~inctudifi~ buildrn sand~tandmarks shait~be~submrhed io the total a enc ) __ - (A scaladpfoLptan.w~ththe r _ TANK ID k 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ® No 434 1 Xerxes If "Yes", complete one page for each compartment. DATE INSTALLED (YEARlMO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 10-1990 10,000 ADDITIONAL DESCRIPTION ~ ~ ~ 438 - Il. TANK:CONTENTS - - TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ® 1a. REGULAR UNLEADED ^ 2. LEADED ^. 5. JET FUEL (limarked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ~ ~ ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER CHEMICAL PRODUCT ^ 3 . COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 ^ 4. HAZARDOUS WASTE (includes Used Oil) Gasoline ^ 95. UNKNOWN 8006-01-9 -- - tlL,TANK CONSTRIJCTION TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ~ ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ® 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg. OTHER _ TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 95. UNKNOWN 445 ^ 2 STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ~ ^ 2, gLKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ®3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99 OTHER . (Check all that apply) ^ 2. SACRIFICIAL ANODE SPILL AND OVERFILL ~ YEAR INSTALLED 450 TYPE (Forloca/ use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT ~ ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE _ IV. TANK' LEAK DETECTION (A descnpuon ofthe monitoring program sfta//hesubmrtted to the Iota/.agency) IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ~^ 6. VADOSE ZONE ® 2. CONTINUOUS INTERSTITIAL MONITORING ^ 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK CLOSURE INFORMATION' PERMANENT CLOSURE IN PLACE' ESTIMATED DATE LAST USED (W/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Revised 6/11/2002 ~r UNDERGROUND STORAGE TANKS..,- TANK PAGE 2 _ _ - E,~ ` ' VI:. PIRING CONSTRUCTIONS(,Check_au.thatapptyj ,_ UNDERGROUND PIPING ~ ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 CONSTRUCTION/ ®2. DOUBLE WALL ^ 95. UNKNOWN ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER MANUFACTURER A. O Smith MANUFACTURER 463 461 ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100 % METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100 % METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBL E WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER (check all that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION apply) ^5. STEEL W/ COATING ^ 9. CATHODIC PROTECTION 464 ^ 5. STEEL W/ COATING ^ 95. UNKNOWN 465 that a6ol.,~~~~;o,.nofion-oftherr „~~;,;ioorooramshall-basribmutedtotli'eiocalagencyl~ ` UNDERGROUND PIPING SINGLE WALL PIPING ~ 466 PRESSURIZED PIPING (Check all that apply): , ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ S. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW. ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE-AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE~SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM . DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ ,12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM. ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT DATE INSTALLED 468 I certify that the information provi SIGNATURE OF OWNER/OPER NAME OF OWNER/OPERATOR( Scott Hartwell Revised 6/11/2002 SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ^ 4. DAILY VISUAL CHECK ^ 5. TRENCH LINER /MONITORING ^ 6. NONE 469 470 472 ~VIIL DISPENSERCQNTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ® 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +gUDIBLE AND VISUAL ALARMS IX. OWNER/OPERATOR;,$IGNATURE ded her ~ is true and accurate to the best of my knowledge. , OR DATE 8/2/2006 pr 471 TITLE~OF OWNER/OPERATOR Environmenta{ Compliance Specialist TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5 CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ 3. RENEWAL PERMIT ~ ^ 7. PERMANENTLY CLOSED ON SITE lSoecifv reason -for local use only /Soerifv chanoe -for local use onlvl ^ 8. TANK REMOVED 430 FACILITY ID # '. - '-. 1 BUSINESS NAME (Same as FACILITY NAME or DBA~ 3 6 0 0 1 01960 BUSINESS ADDRESS ~ CITY ZIP CODE 1701 Brundage Lane Bakersfield 93304 LOCATION WITHIN SITE (Optional) ~' 431 I. TANK DESCRIPTION- (A scaled e~of plan ivdh the locatien of the UST s Stem inc(udii~ buddin s and ~a~idinarks.shall.be sutrmitt°d to the focar a~ enc J _ TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes . ® No 434 2 XOrXeS If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS .436 NUMBER OF COMPARTMENTS 437 10-1990 10,000 ADDITIONAL DESCRIPTION 438 ll. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ® 1a. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3 CHEMICAL PRODUCT . ^ 4. HAZARDOUS WASTE (Includes COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 Used Oil) Gasoline ^ 95. UNKNOWN - $006-01-9 " III. TANK CONS;TRUCTtON_ TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE. WALL WVTH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ®2~ DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg, OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2~ STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ g. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER (Check one item on/y) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 95. UNKNOWN 445 ^ 2~ STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ S. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2, ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) ~ (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ®3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99 OTHER . (Check all that apply) ^ 2. SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (FOrlocal use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED - 452 (Check all that apply) ®1. SPILL CONTAINMENT ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE IV. TANK CEAK' D ETECTIQN ,(.4 description of the monitoring program shalt b.e sudmitted,ro the loca(agen~y) IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY} ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) - ^ 6. VADOSE ZONE ® 2. CONTINUOUS INTERSTITIAL MONITORING ^ 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^~ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ gg_ pTHER ' Y. TANK CLOSUREINFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MMlDD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Revised 6I71I2002 UNDERGROUND STORAGE.TANKS"= TANK PAGE'2 v _ ' ~ ` , I. PIP.I,NG'CONSTRUCTION (Check au that apply), _ -- UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. -GRAVITY - 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER 460 ^ 1. SINGLE WALL ~ ^ 95. UNKNOWN 462 CONSTRUCTION/ ®2. DOUBLE WALL ^ 95. UNKNOWN ~ ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER MANUFACTURER- A. O SI111tI1 MANUFACTURER 463 461 ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER (check all that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION , apply) - ^5. STEEL W/ COATING ^ 9. CATHODIC PROTECTION- 464 ^ 5. STEEL W/ COATING ^ 95. UNKNOWN 465 VII. PIPING:LEAK":`DETECTION (Check all that a a descr otior~oRhevnondoring program s4aN besutirnntedto the7ocal agency) PpIY)( i•- UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3,0 GPH TEST WITH AUTO PUMP SHUTOFF FOR ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ~ ~ ALARMS ^ 2.. MONTHLY 0.2 GPH TEST ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ~ ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS. ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY CONVENTIONAL SUCTION SYSTEMS: TEST (0;1 GPH) ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING ~ ~ SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) - GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF NO AUTO PUMP SHUT OFF ^ c ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR . ^ 11 AUTOMATIC LEAK RESTRICTION . ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS -VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ~ ^ 17. DAILY VISUAL CHECK VIII. DfSPENSER CONTAINMENT DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUALCHECK DATE INSTALLED 468 2 CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ ^ 5. TRENCH LINER /MONITORING ® 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER+AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 IX OWNER/OPERATQR SIGNATURE I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNATURE OF OWN PER OR ~ DATE 470 8/2/2006 NAME OF OWNER/OPE R( riot) 471 TITLE OF OWNER/OPERATOR 472 Scott Hartwe Environmental Compliance Specialist Revised 6/11/2002 r _ . ,UNDERGROUND STORAGE TANKS -TANK PAGE 1_ TYPE OF ACTION ^ . 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE '(Check one item only) ~ ^ 7. PERMANENTLY CLOSED ON SITE ^ 3. RENEWAL PERMIT (Specify reason -for local use only (Specify change -for local use only) ^ 8. TANK REMOVED 430 FACILITY ID # { BUSINESS NAME (Same as FACILITY NAME or DBA~ ~ 3 6 0 0 1 , 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 Brunda a Lane Bakersfield 93304 LOCATION WVTHIN SITE (Optional) 431 I`. TANK DESGRIPTlON - ~ ~;~ :'A scaw_ ct ~ fan with thelocat on o'ttie UST •.c:em mdudui~~• ouUdin s.anct IandmarYS shall be.s.::, :.:aed !oihe,local a ena•.1 TANK ID # 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ®No 434 3 XerXeS If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 10-1990 10,000 ADDITIONAL DESCRIPTION ~ 438 II. TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ® 1a. REGULAR UNLEADED ^ 2. LEADED ~ ^ 5. JET FUEL (lf marked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL - ^ 99. OTHER ^ 3 CHEMICAL PRODUCT . ^ 4. HAZARDOUS WASTE (Includes COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 used oil) Gasoline ^ 95. UNKNOWN ~_ 8006-01-9 ,. III:.. TANK CONSTRUCTION ,. -- TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ®2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ B. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 95. UNKNOWN 445 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ S. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2. ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99, OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ®3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN qqg DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99 OTHER . (Check all that apply) ^ 2. SACRIFICIAL ANODE SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE - ~ ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE IV, TANK LEAK,DETECTI~N,(A description ofthe monitoring,p~ogramshatl be submitted ro me tocalagency) IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ^ 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 6. TANK TESTING BIENNIAL TANK TESTING ^ g9. OTHER .., ,., ,.,r.w:... V. TANK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? ~ 457 gallons ^ Yes ^ No Revised 611112 0 0 2 r~ UNDERGROUND STORAGE TANKS'- TANK PAGE'2 - ~VI: FIP_IMG GONSTRUCTION"(Checkatitnatappty) ~ ~ - UNDERGROUND PIPING ~ i ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 459 . ^ 1. SINGLE WALL ~ ^ 3. LINED TRENCH ^ 99. OTHER 460 ^ 1. SINGLE WALL _ ^ 95. UNKNOWN 462 CONSTRUCTION/ ®2. DOUBLE WALL ^ 95. UNKNOWN, ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER MANUFACTURER A. O Smlth MANUFACTURER 463 461 ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND ^ 2. STAINLESS STEEL' ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3 PLASTIC COMPATIB LE WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER (check all that ®q, FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION apply) ^5. STEEL W/ COATING ^ 9. CATHODIC PROTECTION 464 ^ 5. STEEL W/ COATING ^ 95. UNKNOWN 465 VII. 'PIRING,L-EAK`DETECTION iCheck a!1 that aaply/(adescpplon ~~ the mon~toring'program"Shan be suti'rri~Cted to "th"i: focal;agency) UNDERGROUND PIPING - SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that app/y): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND' VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK DISPENSER CONTAINMENT DATE INSTALLED - 468 I certify that the information provi SIGNATURE OF OWNER/OPER NAME OF OWNER/OI Scott Hartwell 471 ABOVEGROUND PIPING SINGLE WALL PIPING 467 PRESSURIZED PIPING (Check all [hat apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 02 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM ,DISCONNECTION . ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) . SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ^ 4. DAILY VISUAL CHECK ^ 5. TRENCH LINER /MONITORING ^ 6. NONE 469 470 472 VHi. DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ® 3. CONTINUOUS DISPENSER PAN SENSOR~WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS IX. OWNER/OPERATORSIGNATURE:,.: ded herein is true and accurate to the best of my knowledge. ATOR DATE 8/2/2006 TITLE OF OWNER/OPERATOR Environmental Compliance Specialist UNDERGROUND ST,ORAGE3;TANK3~- TANK-:PAGEfi=1 TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ ~ ^ 7. PERMANENTLY CLOSED ON SITE 3. RENEWAL PERMIT (Specify reason -for local use only (Specify change -for local use only) ^ B. TANK REMOVED 430 FACILITY ID # 1 - BUSINESS NAME (Same as FACILITY NAME or DBA~ i 3 6 0 0 1 01960 BUSINESS ADDRESS CITY - ZIP CODE 1701 Brundage Lane Bakersfield 93304 LOCATION WITHIN SITE (Optional) 431 I. TANK DESCRIPTION A scaled plot .Ian m-~fh !he.lxa! on of. the UST s stem incfudin bwldin s and ~andrnarks shall ne submitted=to.theYOCaI a zncvl _ _ TANK ID # 432 TANK MANUFACTURER - 433 COMPARTMENTALIZED TANK ^ Yes ® No 434 4 Xerxes if "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) ~ 435 TANK CAPACITY IN GALLONS 436 NUMBER OF COMPARTMENTS 437 10-1990 10,000 ADDITIONAL DESCRIPTION 438 L TANK CONTENTS TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ^ ta. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ® tb. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 ^ 4. HAZARDOUS WASTE (Includes used oil) ~ Gasoline ^ 95. UNKNOWN 8006-01-9 - - - - ~,.; _ 111 .TANK",CONSTRUCTION..,. >< TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ®2~ DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg. OTHER TANK MATERIAL -primary tank . ^ ~. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 95. UNKNOWN 445 ^ 2~ STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2, gLKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED " ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ®3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN qqg DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ q IMPRESSED CURRENT ^ 99 OTHER . . (Check all that app/y) ^ 2. SACRIFICIALANODE SPILL AND,OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE IV. `'TANK LEAK DEl'ECTIQN (A descnption of the monitoting,programshatlhe submrttedto thetocalagency) ;;; IF SINGLE WALL TANK (Check all that apply): ~ 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ^ 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TAhIK CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED PATE LAST USED (YY/MM/DD) 455 ~ ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Revised 6/11!2002 6 ~a UNDERGROUND STORAGE TANKS -TANK PAGE'2 VI_=PIPING CONS~TRl3CTIONr(Check"at/(natapp/y) a, _.. . , UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 CONSTRUCTION/ ®2. DOUBLE WALL ^ 95. UNKNOWN ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER MANUFACTURER A. O Smith MANUFACTURER 463 461 ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100 % METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100 % METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL ~ ^ 2. STAINLESS STEEL ~ ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER (check all that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION apply) ^5. STEEL W/ COATING ^ 9. CATHODIC PROTECTION - 464 ^ 5. STEEL W/COATING ^ 95. UNKNOWN 465 ~ ~U~II .,PIPING~LEAK~-DETECTION (Check alt that_appty)(a descnptron of the morzitoiing orogram shau be submitted to the'tocal agency I _ UNDERGROUND PIPING ~ ABOVEGROUND PIPING SINGLE WALL PIPING 466 SINGLE WALL PIPING 467' PRESSURIZED PIPING (Check all that apply): ~ - PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL LEAK. SYSTEM FAILURE'AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY CONVENTIONAL SUCTION SYSTEMS: TEST (0.1 GPH) ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM TRIENNIAL INTEGRITY TEST (0 1 GPH) ^ 6 SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): . . ^ 7. SELF MONITORING SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) GRAVITY FLOW: _ ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND-SYSTEM ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ~ SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS ^ 13: CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST RESTRICTION - ^ 16. ANNUAL INTEGRITY TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ^ 17. DAILY VISUAL CHECK ::VIII. D15i?ENSER CONTAINMENT DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUAL CHECK DATE INSTALLED ~ 468 ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER /MONITORING ® 3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 __ _ IX. 01NNER/OPERATOR_51GNATURE I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNATURE OF OWNER/OPERATOR DATE q70 8/2/2006 NAME OF OWNER/OPER 471 TITLE OF OWNER/OPERATOR 472 Scott Hartwell Environmental Compliance Specialist newsea on vzuuz ~ _.. _~ ~:` 7- ,\ r>Ts + A.RCO"01960 __________________________________________ SiteID: 015-021-000417 + Manager SURJIT BISLA BusPhone: (661) 322-7213 Location: 1701 BRUNDAGE LN Map 102 CommHaz Moderate City BAKERSFIELD Grid: 36D FacUnits: 1 AOV: CommCode: BFD STA 06 SIC Code:5541 EPA Numb: DunnBrad:03-959-6507 Emergency Contact / Title Emergency Contact / Title SURJIT BISLA / FRANCHISEE ARCO.CUSTOMER / SOLUTIONS CTR Business Phone: (661) 322-7213x Business Phone: (800) 272-6349x 24-Hour Phone (661) 665-2394x 24-Hour Phone (800) 272-6349x Pager Phone (661) 496-3372x Pager Phone ( ) - x .~- Hazmat Hazards: Fire Press ImmHlth DelHlth Contact TERESA MILES Phone: (714) 670-3958x MailAddr: PO BOX 6038 State: CA City ARTESIA Zip 90702-6038 Owner BP WEST COST PRODUCTS LLC Phone: (714) 670-3958x Address PO BOX 6038 State: CA City ARTESIA Zip 90702-6038 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No Pa ce1No: Emergency Directives: PROG A - HAZMAT PROG H - HAZ WASTE GEN PROG U - UST ~N~~ A~~ ~ ~ ~~~~ Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. Signature Date -1- 03/30/2006 UNIFIED PROGRAM INSPECTION CHECKLIST ~,; ~„ac~t,~: .+akware-:rw: .se r..'„ a+k -.:~,. .::. .. ...,., W:.:.. ,, .. ....:x=, .SECTION 1: Business Plan and Inventory Program ~. BAKERSFIELD FIRE DEPT a p Prevention Service$ ~l~s 900 TrLUCtun Ave., Suite 210 ~r*~r Bakersfield. CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAM j ~ ~~~ / Q J NSPECTION DATE INSPECTION TIME ` l / v ~ ~,~ two ADDRESS ~ HONE NO . O O~ MPLOYEES ~ ~ 7i% Z _~ ~ FACILITY CO TACT U (NESS ID NUMBE 15-021- r~ S f 1 ----- -- ~" 1 ~ Ol ' " Section 1: Business Plan and Inventory Program rl ^ ROUTINE Q~j~60RABINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V (c=comPliance~ OPERATION V=violation -- ------ COMMENTS _ _ __ _ __ _ - - - - ----------- ------- ------_------ ~ ~/+^ - APPROPRIATE PERMIT ON HAND ~j~ ~ / ~ C`~-^ BUSInt?SS PLAN CONTACT INFORMATION ACCURATE /, / V ©/8 VISIBLE ADDRESS ~^ CORRECT OCCUPANCY VERIFICATION OF INVENTORY MATERIALS 'tr/`'' VERIFICATION OF QUANTITIES i~ u VERIFICATION OF LOCATION ~/ ^ ~7~7 PROPER SEGREGATION OF MATERIAL VERIFICATION OF MSDS AVAILABILITY P~ VERIFICATION OF HAZ MAT TRAINING iy ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES ~/' ^ EMERGENCY PROCEDURES ADEQUATE _ ~' ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING 6d! ^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITES ^ YES ^ NO EXPLAIN: QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (681) 328-3979 ~n N ~rA~~4- ~ ~ Inspector (Please Print) Fire Prevention / 1" In / Shift of Site/Stetion 11 usiness Site/ ool Ske Responsible Party (Please Print) White -Prevention Services Yellow -Station Copy Pink -Business Copy FD204e (Rev. ~J05- .. , , _ , ~~'~~` /~'"~~~ CITY OF BAKERSFIELD FIRE DEPAR'T'MENT °~6 ~ _ /°rn~1 OFFICE OF >i:NVIRONI~'IENTAI, SERVIC:ES ~`~ y~°° UNIFIED PROC~RANI INSPECTION CHECKLIST k,E-~~~,~0~' 1715 Chester Ave., 3~`' Floor, Bakersfield, CA 93301 FACILITY NAME / ~/-'I ,D,~C/`~~~ly INSPECTION DATE~~ 7~1p Section 2: Underground Storage Tanks Program ^ Routine ~Eombined ~ Joint Agency I~ Multi-Agency ^ Complaint ~ Re-inspection Type of Tank ~ ~,~ls ry L _ Number of Tanks !-r Type of Monitoring 'jG S 3 sU Type of Piping .~// ~£~ ~ A~~ OPERATION C: V COMMENTS Proper tank data on file Proper owner/operator data on file L, Permit tees current Certification of Financial Responsibility ~, Monitoring record adequate and current (~, Maintenance records adequate and current Failure to correct prior UST violations Has there been an unauthorized release? Yes NO Section 3: Aboveground Storage Tanks Program TANK SIZE(S) Type of Tank OPERATION ~' N COMMENTS SPCC available SPCC on file with OES Adequate secondary protection Proper tank placarding/labeling Is tank used to dispense MVF? If yes, Does tank have overfill/overspill protection'? C=Compliance V=Violation Y=Yes N=NO Inspector: Q Z~ P~ ~ ~_. Office of Environmental Services (661) 326-3979 Business Site sponsible Party White - inv. Svcs. Pink -Business C'~~pv AGGREGATE CAPACITY Number oI'Tanks _._ 3 ,~ ~ 4+` 1~ 1701 BIr'UP•JDr-i(~E LrfJE Bri}°;Ek F I ELI! . C?r 9;-i;_ L14 .'s'~TEf°l ~~TFiTLI;=, )r'EF't',1<;T ril.L FUhJ~'TI'.~P~1J PJ~:.>r4f"1riL I fd't+'EI+JT~rk''.' kEF'r?F,'T I T i : UPJL I°1Fi I f~J ~~:iLl'rH 'ti~c:,Ll if"lE _ ?4? i , i ~FiL'.-3 iii isv I.1L.LHGE= i'~ 44 i:;r'iLS HF. I GH"1 = ~,U . 93 I hli'HE: l.,ItiTER ?t~L = 1 ? C~F;LS 4JFiTER = U . 8E I hdc~ HEE TEf°1F' _ ~y.G LiEG F T '~' : IJhJL. :=~1..F;'~.: E 1 ~_'EhdTEk t,1c?LLif°lE = 742? ,_;r;L ULLF;GE _ = 2 57 GFiL gl}": ULL.riC;E= 1284 itiLE: HE I i:;HT = G8.5b I h~JCHE UJHTEk 'si;~~L = ?;~ i~nLS UJHTEk - 1 . G3 I P•JC'HE~ TEf°1F = r 9 . ? LiEG ~ F T ~i : UhJL .=BLit+' 1;' _ f~lt+RTH VCrLUt°1E - ?433 iyHL ULLF~iJE _ - 'S1 GFiL: 90'%~ ULLF~G~E= 128'x' t„BLS HEIGHT = 6,:i . G l I PJ~~:HE i+JHTER '~; ~ rL = 0 i. F;LS ~-1HTEk = u . UU I fV~:HES TEf''1F' = 5y . ? LiEG F T 4 : PkEf~'1 I Uf"1 1/;1~LUP9E = 448? C~HL; ULLtiGE - 3U9'? r;F;LS '~0 3 IJLLFiiE= ''284 i>?r=iLS HEIGHT = 45.4? I hJiv HE..; WFiTEk '~Jt~rL = 0 ~ ~NLS WFiTER = U . UU 1 f'J~'HE TEf"iF' = r 6 . ? DEG F f°1tifV I FULLiELi Tryf'-!}~:.:; IIV11Ef`lT~~k''r' T{'+'1`iL.~ T 1 : UIUL f°iFi I fJ ,t~UTH T 3 : Uf'JL :.;LFi+,+E '~' P•J~:_~kTH '~,/GSLUf°lE = 14yU4 ~:_~tiL ... n ~ x * Ef~lLi ~ ~ x ~. _____ _ _ _ 1 .. BUSINESS ACTIVITIES UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION Page I of I. FACILITY IDENTIFICATION PACILiTY ID # ~ ~ I EPA ID # (Hazardous Waste Only) - ~ ~ ~ 2 ~ ~ ~ _: 4 I ~ CAL000244204 _ BUSINESS NAME (Same as Facility Name or DBA -Doing Business As) ARCO # 01960 II. A~CT~NITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does vour facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above >j gallons for liquids; X00 pounds for solids, or 200 cubic feet for compressed gases ®YES ^ NO a HAZARDOUS MATERIALS INVENTORY (include liquids in ASTs and USTs); or the applicable Federal threshold . _CHEMICAL DESCRIPTION (OES 2731) quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or hand{e radiological materials in quantities for which an emergency Ian is re uired ursuant to ] 0 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Formerly swRCe Form n) 1. Own or operate underground storage tanks? ®YES ^ NO 5. UST TANK (o»e pace per tank) (Formerly Form a) 2. Intend to upgrade existing or install new USTs? ^YES- ®NO 6 UST FACILITY UST TANK (one per tank) UST INSTALLATION -CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) 3. NCed t0 rCpOrt CIOSing a UST? ^YES ® NO 7. U$T TANIk (closure portion-one page pertank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or ^YES ®NO s NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? ®YES ^ NO e EPA [D NUMBER -provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC §25143.2)? ^YES ®NO lo. per recycler> 3. Treat hazardous waste on site? ~ ONSITE HAZARDOUS WASTE ^ YES ®NO I I TREATMENT -FACILITY (Formerly DTSC Forms 1772) ONSITE HAZARDOUS WASTE . TREATMENT -UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by ^YES ®NO 12 CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? . ASSURANCE (Formerly DTSC Form 1232) J. Consolidate hazardous waste generated at a remote site? REMOTE WASTE /CONSOLIDATION ^YES ®NO 13 SITE ANNUAL NOTIFICA~'ION (Formerly DTSC Form 1196) 6. Need to report the closure/removal of a tank that was classified as ^YES ®NO I4 HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (For.»erly DTSC Form 1219) E. LOCAL REpUIREMENTS {you may also be reauired to provide additional information b~ vour CUPA or local aeency l 15 ENY'~ ~A~ ~ ~ 2~0~ Page 1 of 20 -~~- ~_. UNIFIED PROGRAM CONSOLIDATED FORM ' FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION Paae of I. LDENTIFICATION FACILITY ID # BEGINNING DATE loo. ENDING DATE lol. (Agency Use Only) l 5 0 2 1 0 4 1 7 ~ 12/22/05 12I22I08 BUSINESS NAME (Same as FACILITY NAME or uaA- ooinz Business.As) ~ BUSINESS PHONE lo'-- ARCO # 01960 (661) 322-7213 BUSINESS SITE ADDRESS 103 1701 BRUNDAGE LANE CITY 104 ZIP CODE los. CA BAKERSFIELD 93304 DUN & BRADSTREET lob SIC CODE (4 digit #) loz, 03-959-6507 5541 COUNTY los. KERN BUSINESS OPERATOR NAME 109 BUSINESS OPERATOR PHONE I lo. SURJIT BISLA (661) 322-7213 1L BUSINESS OWNER OWNER NAME III OWNER PHONE I12- BP West Coast Products LLC (714) 670-3958 OWNER MAILING ADDRESS: 113. P.O. BOX # 6038 CITY I la. STATE I Is. ZIP CODE I16. ARTESIA CA 90702-6038 Ill. ENVIRONMENTAL CONTACT CONTACT NAME 117. CONTACT PHONE ~ 18 TERESA MILES (714) 670-3958 CONTACT MAILING ADDRESS: BP West Coast Products LLC I I~. P.O. BOX # 6038 CITY I'-0 STATE Izl. ZIP CODE 12z. ARTESIA CA 90702-6038 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME Iz3. NAME I'-$ SURJIT BISLA ARCO CUSTOMER SOLUTIONS CENTER TITLE t'-a. TI"fLE I'-~ Franchisee BUSINESS PHONE Izs BUSINESS PHONE ro. (661) 322-7213 800-272-6349 24-HOUR PHONE* I-6 24-HOUR PHONE* 13I. (661)665-2394 800-272-6349 PAGER/ CELL In. uz. (661)496-3372 ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of th ose individuals responsible for obtaining the information, 1 certify u nder penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF OPERATOR OR D AT REPRESENTATIVE DATE 134. NAME OF DOCUMENT PREPARER i35. t ~ r-~ fQ Belshire Environmental Services Inc r , . NAME OF S R (print 136. TITLE OF SIGNER 137. SURJIT BISLA Franchisee Page 2 of 20 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Inrlicrde material OR waste (Do not combiire material and waste on one form) ® MATERIAL(NON-WASTE) ^ WASTE (one page per material per building or area) ^ADD ^DELETE ®REVISE REPORTING YEAR 2005 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 (EPCRA) ^ YES ® NO UNDERGROUND STORAGE TANK MAP# (optionap 203 GRID# (optional) 2oa FACILITY ID # 1 S 0 2 ] ~ 4 I 7 1 of 1 14 - K5 __ il. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No zos GASOLINE If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS" ^Yes ®No 208 cas# 8006-61-9 209 'If EHS is "Yes", all amounts below must be in lbs. FIRE coDE HAZARD CLASSES (complete if requiredbvcuPA) FLAMMABLE LIQUID, CLASS 1 B, UN1203 210 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ®b. MIXTURE ^ c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS 214 LARGEST CONTAINER 10,000 2t5 FED HAZARD CATEGORIES 216 (Check all that apply) ®a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 2t~ MAXIMUM DAILY AMOUNT eta ANNUAL WASTE AMOUNT zts STATE WASTE CODE 220 20,000 40,000 N/A N/A 22t DAYS ON SITE: 222 UNITS' ®a. GALLONS ^b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365 Check one item onl * If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ® b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 2zs BENZENE zz~ ^Yes ®No 22s 71-43-2 22s 2 0-10 230 ETHANOL z3i ^Yes ®No z3z 64-17-5 233 3 8-15 23a XYLENE 23s ^Yes ®No z3s 1330-20-7 z3~ 4 7-14 238 TOULENE z3s ^Yes ®No zao 108-88-3 eat 5 2a2 za3 ^Yes ^No zaa zas if more hazardous components are present at greater than 1°/o by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 248 Page 3 of 20 .,;~ _f UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Indicate nrrrterial OR waste (Do not combine material a nd waste on one form) ® MATERIAL(NON-WASTE) ^ WASTE (one page per material per building or area) ^ADD ^DELETE ®REVISE REPORTING YEAR 2005 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL zo2 (EPCRA) ^ YES ® NO OUTSIDE YARD NEAR FACILITY BATHROOM MAP# (optional) 203 GRID# (optional) ~ 204 FACILITY ID # l 5 0 2 1 0 4 l 7 I _ ' 1 of 1 111 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No 2os CARBON DIOXIDE If Subject to EPCRA, refer to instructions COMMON NAME CARBON DIOXIDE 207 EHS* ^Yes ®No 2oe CAS# 124-38-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by CuPA) z1o HAZARDOUS MATERIAL 211 TYPE (Check one item only) ®a. PURE ^b. MIXTURE ^ c. WASTE RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS 21a LARGEST CONTAINER 400 215 FED HAZARD CATEGORIES 216 (Check all that apply) ^ a. FIRE ^ b. REACTIVE ®c. PRESSURE RELEASE ®d. ACUTE HEALTH ^ e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21e ANNUAL WASTE AMOUNT 219 STATE WASTE CODE z2o 200 400 N/A N/A z21 DAYS ON SITE: 222 UNITS* ^a. GALLONS ^b. CUBIC FEET ®c. POUNDS ^ d. TONS 365 Check one item onl * If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ^ d. STEEL DRUM ^ h. SILO ®I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ^ a. AMBIENT ®b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ^ a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ®d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE zz7 ^Yes ®No zza 124-38-9 zzs 2 230 231 ^Yes ^ NO 232 233 3 234 235 ^Yes ^ NO 236 237 4 z3a zas ^Yes ^ No zao za1 5 zaz za3 ^Yes ^No zaa zas If more hazardous components are present at greater than 1 % by weight if non carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADD{TIONAL LOCALLY COLLECTED INFORMATION zas Page 4 of 20 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION Indicate materi«i OR waste (Do not eombine material a nd waste a~ one form) ^ MATERIAL(NON-WASTE) ® WASTE (one page per material per building or area) ^ADD ^DELETE ®REVISE REPORTING YEAR 2005 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL zoz (EPCRA) ^ YES ® NO INSIDE STORAGE CONTAINER MAP# (optionap 203 GRID# (optionaq zoa FACILITY ID # 1 5 0 2 1 0 4 I 7 1 of 1 E12 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET ^Yes ®No zas WASTE ABSORBENT & DISPENSER FUEL FILTER If Subject to EPCRA, refer to instructions COMMON NAME WASTE ABSORBENT & DISPENSER FUEL FILTER 207 EHS* ^Yes ®No 208 CAS# N/A 209 'If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 2t0 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ^b. MIXTURE ®c. WASTE 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE (Check one item only) ®a. SOLID ^b. LIQUID ^ c. GAS 21a LARGEST CONTAINER 55 215 FED HAZARD CATEGORIES 216 (Check all that apply) ®a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 25 55 55 352 221 DAYS ON SITE: 222 UNITS' ®a. GALLONS ^b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365 Check one item onl * If EHS, amount must be in ounds. STORAGE CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ® d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT 22a STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # MIXTURE OF S[LCATE & HYDROCARBONS 1 89-90 zzs 227 ^Yes ®No 22a N/A MIXTURE 229 & SPENT FUEL FILTERS , 2 230 231 ^Yes ^ NO 232 233 3 234 235 ^Yes ^ NO 236 237 Q 238 239 ^Yes ^ NO 240 241 5 2az 2a3 ^Yes ^No zaa gas If more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION zas J Page 5 of 20 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM -CHEMICAL DESCRIPTION /ndicate ffartterial OR waste (Do foot combif~e material «fx! waste on one.form) ^ MATERIAL(NON-WASTE) ® WASTE (one page per material per building or area) ^ADD ^DELETE ®REVISE REPORTING YEAR 2005 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA -Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL zaz (EPCRA) ^ YES ® NO INSIDE STORAGE CONTAINER MAP# (optional) 203 GRID# (opeonaq 2D4 FACILITY ID # 1 5 '0 2 1 0 4 ) ~ 1 of 1 E12 II. CHEMICAL INFORMATION - CHEMICAL NAME 205 TRADE SECRET ^Yes ®No zos WASTE FLAMMABLE LIQUID If Subject to EPCRA, refer to Instructions COMMON NAME WASTE FLAMMABLE LIQUID 207 EHS' ^Yes ®No zoa CAS# N/A 209 'If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL TYPE (Check one item only) ^ a. PURE ^b. MIXTURE ®c. WASTE . 211 RADIOACTIVE ^Yes ®No 212 CURIES 213 PHYSICAL STATE 21a (Check one item only) ^ a. SOLID ®b. LIQUID ^ c. GAS LARGEST CONTAINER 55 z1s FED HAZARD CATEGORIES 216 (Check all that apply) ®a. FIRE ^ b. REACTIVE ^ c. PRESSURE RELEASE ®d. ACUTE HEALTH ®e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 25 ~ 55 55 134 221 DAYS ON SITE: zzz UNITS` ®a. GALLONS ^b. CUBIC FEET ^ c. POUNDS ^ d. TONS 365 Check one item onl ` If EHS, amount must be in ounds. STORAGE ) CONTAINER ^ a. ABOVE GROUND TANK ^ e. PLASTIC/NONMETALLIC DRUM ^ i .FIBER DRUM ^ m. GLASS BOTTLE ^ q. RAIL CAR ^ b. UNDERGROUND TANK ^ f. CAN ^ j. BAG ^ n. PLASTIC BOTTLE ^ r. OTHER ^ c. TANK INSIDE BUILDING ^ g. CARBOY ^ k. BOX ^ o. TOTE BIN ® d. STEEL DRUM ^ h. SILO ^ I. CYLINDER ^ p. TANK WAGON 223 STORAGE PRESSURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT zza STORAGE TEMPERATURE ®a. AMBIENT ^ b. ABOVE AMBIENT ^ c. BELOW AMBIENT ^ d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # MIXTURE OF GASOLINE & WATER OR ~ 89-90 2zs 227 ^Yes ®No 2za N/A MIXTURE 2zs OTHER CONTAMINATION IN GASOLINE , 2 230 231 ^Yes ^ NO 232 233 3 234 235 ^Yes ^ NO 236 237 Q 238 239 ^Yes ^ No zao 2a1 5 z4z za3 ^Yes ^No za4 zas It more hazardous components are present at greater than 1 % by weight if non-carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION zas Page 6 of 20 ` ,~ ;. CUPA Bakersfield Fire Department • Hazardous Materials Division . 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGR(JUND STORAGE TANKS -FACILITY TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 3. RENEWAL PERMIT ® 5. CHANGE OF INFORMATION (Specify change - ^ 7. PERMANENTLY CLOSED SITE (Check one item only) ^ 4. AMENDED PERMIT local use only) ^ 8. TANK REMOVED ^ 6. TEMPORARY SITE CLOSURE 400 I. FACILITY /SITE INFORMATION FACILITY ID # 1 ~ ~ 2 I 0 4 I ,~ ~ __ - SITE NAME (Same as FACILITY NAME or DBA ARCO# 01960 3 BUSINESS ADDRESS 1701BRUNDAGE LANE CITY BAKERSFIELD ZIP CODE 93304 NEAREST CROSS STREET SOUTH H STREET FACILITY OWNER TYPE ^ 4. LOCAL AGENCY/DISTRICT' ® 1. CORPORATION ^ 5. COUNTY AGENCY' BUSINESS GAS STATION ^ 3. FARM ^ ® 1 . 5. COMMERCIAL ^ 2. INDIVIDUAL ^ 6. STATE AGENCY' . TYPE PARTNERSHIP ^ 3 ^~ 7. FEDERAL AGENCY' 402 ^ 2. DISTRIBUTOR ^ 4. PROCESSOR ^ OTHER 403 . TOTAL NUMBER OF Is facility on Indian Reservation or 'If owner of UST is a public agency: name of supervisor of TANKS ON SITE lrustlands? division, section or office which operates the UST. 4 404 (This is the contact person for the tank records) ^ Yes ® No 405 TERESA MILES 406 IL TANK OPERATOR INFORMATION'..... - - TANKOPERATORNAME SURJITBISLA _ 407 -- PHONE (661}863-0528 4oa TANK OPERATOR TYPE ^ 1. CORPORATION ® 2. INDIVIDUAL ^ 4. LOCAL AGENCY / DISTRICT ^ 7. STATE AGENCY 413 ^ 3. PARTNERSHIP ^ 5. COUNTY AGENCY ^ 8. FEDERAL AGENCY - III. TANK OWNER INFORMATION - TANK OWNER NAME BP West Coast Products, LLC PHONE (714) 670-3958 415 414 MAILING ADDRESS 4 CenterpOlnte DrIVe 416' CITY La Palma 417 TA TE 418 S ZIP CODE 90623 419 C' A TANK OWNER TYPE ® 1. CORPORATION U 2. INDIVIDUAL LJ 4. LOCAL AGENCY /DISTRICT LJ 7. STATE AGENCY 420 ^ 3. PARTNERSHIP ^ 5. COUNTY AGENCY ^ 8. FEDERAL AGENCY IV. BOARD OF EQUALIZATION UST STORAGE FEE ACCOUNT_NUMBER TY (TK) HQ 14 14~ 4 1 4 6 5~ Call (916) 322 - 9669 if questions arise ~ az1 ~~ V. PETROLEUM UST FINANCIAL RESPONSIBILITY "' INDICATE METHOD(S) ^ 1. SELF-INSURED ^ 4. SURETY BOND ^ 7. STATE FUND ^ 10. LOCAL GOVT MECHANISM ^ 2. GUARANTEE ^ 5. LETTER OF CREDIT ^ 8. STATE FUND & CFO LETTER ^ 99. OTHER: ® 3. INSURANCE ^ 6. EXEMPTION ~ ^ 9. STATE FUND & CD 422 VI:' LEGAL NOTIFICATION AND MAILING ADDRESS Check one box to Indicate which address should be used for legal no tifications and maJmg. Legal notifica6c~ ~- -.- --.tins will be --~" to the tank owner ONLY. unless box ~ or 2 is ^ ~ FACILITY ^ 2 PRC'f FGTY OWNER ® 3. TANK OWNER 123 checked. Vll. APPLICANT SIGNATURE Certification. I certify that the information provided herein is true and accurate to the best of my knowledge. SIGN URE OF APPLICANT DATE I Z/ZZ/OJ 424 PHONE (714) 670-3958 NAME OF APPLICANT (print) TERESA MILES TITLE OF APPLICANT Environmental Compliance Specialist 4zs STATE UST FACILITY NUMBER (For local use only) 428 1998 UPGRADE CERTIFICATE NUMBER (For local use only) 429 Page 7 of 20 ~ t, ' CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE_TANKS -TANK PAGE 1 ~. TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ ^ 7. PERMANENTLY CLOSED ON SITE 3. RENEWAL PERMIT (Soecifv reason -for local use only (Specify change -for local use only) ^ - 8. TANK REMOVED 430 FACILITY ID # ~ BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 5 0 2 1 0 4 1 7 ', ARCO# 01950 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 ----- I. TANK DESCRIPTION _ ~ _~. prof lan~~wdh the location ot, the,UST s stem ~ ~~ .,_,n :buildings „~-,andnaarks shalL6e submitted to the /ocai .,,,c) TANK ID # ~ 432 TANK MANUFACTURER 433 .COMPARTMENTALIZED TANK ^ Yes ® No 434 Xt3fX@S If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 1990/10 435 TANK CAPACITY IN GALLONS 1 0,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 - °11:'TANK.CONTENTS- _ _ _ _ TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ® 1a. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT ^ 4. HAZARDOUS WASTE (Includes COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 Used Oil) GASOLINE soos-sl-s ^ 95. UNKNOWN ~ _ _ __ Iil. TANK CONSTRUCTION - - _ - -- TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ® 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP TANK MATERIAL -secondary tank ^ 1 BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 95. UNKNOWN 445 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2 ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) ~ (For local'use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN qq8 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4 IMPRESSED CURRENT ^ 99 OTHER . . (Check all that apply) ^ 2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE 1890 ®2. BALL FLOAT ^ 4. EXEMPT ' ®3. STRIKER PLATE 1990 IV. `TANK LEAK DETECTION'(A description ofthe monitoring program shall tie submitted to the local agency) IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING - ^ gg. OTHER V. TANK GLOSURE INFORMATION`/PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Page 8 of 20 -_ .r, F CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 9330] (661) 326-3911 UNDERGROUND STORAGE TANKS _ TANK` PAGE' 2 VI. ;PIPING CONSTRUC'FI'ON Icheck~authatappl)) ~~ UNDERGROUND PIPING ~ ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 CONSTRUCTION/ ®2 DOUBLE WALL ^ 95. UNKNOWN ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER MANUFACTURER: AMERON MANUFACTURER 463 ^ 1. BARE STEEL ®6. FRP COMPATIBLE W/ 100% METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER (check all that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION apply) ^5. STEEL W/ COATING ^ 9. CATHODIC PROTECTION qgq ^ 5. STEEL W/ COATING ^ 95. UNKNOWN 465 -- VII. PIPING LEAK DETECTIONi~Cnec~ arl slat aonly ~a description of-the momtom . ~ oarani shah be subm led to°the,ocai agena- UNDERGROUND PIPING SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM +TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING . GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ' ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check a// that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ABOVEGROUND PIPING 467 PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK VIII. DISPENSER"CONTAINMENT DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUAL CHECK DATE INSTALLED 468 ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER /MONITORING Not Available ®3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6 NONE 469 _ ' -- IX. OWNER/OP~ER/4TOR'SIGNATURE I certify that the information provided herein is true and accurate to the best of my knowledge. SIG TURE OF OWNER/OPE ATOR DATE 470 12/22/0 NAME OF OWNER/OPERATOR(print) 471 TITLE OF OWNER/OPERATOR q72 TERESA MILES Environmental Compliance Specialist Revised 6/1112002 Page 9 of 20 r • CUPA - Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 9330] (661) 326-3911 UNDERGROUND STORAGE TANKS -TANK PAGE 1 -- TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ 3. RENEWAL PERMIT ^ 7. PERMANENTLY CLOSED ON SITE (Specify reason - /or local use only (Specify change -for local use only) ^ 8. TANK REMOVED 430 FACILITY ID # T`' BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 5 0 2 1 0 4 1 7 ARCO# 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 ~ I. TANK DESCRIPTION (A calect lot ~l a loca[;on of U,- . ~T , stemdncludir. .,Idings and i ~,;~;,:or, - r hall he subr,,..~: , local a enc ~ _ TANK ID # Z 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ® No 434 Xerxes If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 1990/10 435 TANK CAPACITY IN GALLONS ~ O,000 436 NUMBER OF COMPARTMENTS ~ ~ 437 ADDITIONAL DESCRIPTION 438 I I. TANK CONTENTS _.. - -- - _ _ TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ® 1a. REGULAR UNLEADED ^ 2. LEADED ~ ^ 5. JET FUEL (If marked, complete Petroleum Type) ^ tb. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ tc. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 ^ 4. HAZARDOUS WASTE (Includes Used Oil) GASOLINE 8006-61-s ^ 95. UNKNOWN - - -- -III. TANK CONSTRUCTION TYPE OF TANK ^ 1 SINGLE WALL ^ 3, SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ® 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ 99. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/ FIBERGLASS ^ 8. FRP COMPATIBLE W1100% METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC FRP) TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 95. UNKNOWN 445 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL r REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2. ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN qqg DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check all that apply) ^2.SACRIFICIALANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ®2. DROP TUBE 1990 ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1990 V. TANK.. LEAK DETECTION (A descrrpuon o/ the monitoring program shall tre submitted to the focal agency)', IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ® 2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ g. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK CLOSURE INFORMATION !PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Revised 6/1112002 Page 10 of 20 1 CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 N Street Bakersfield, CA 93301 (66l) 326-3911 ~__ UNDERGROUND STORAGE TANKS -TANK PAGE 2 VI. PIPING:CONST~RUGTION ich~ckaD that apply)' - -- UNDERGROUND PIPING ABOVEGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY 459 ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER ~ 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 CONSTRUCTION/ ®2. DOUBLE WALL ^ 95. UNKNOWN ^ 2. DOUBLE WALL ^ 99. OTHER MANUFACTURER MANUFACTURER: AMERON MANUFACTURER 463 ^ 1. BARE STEEL ®6. FRP COMPATIBLE W/ 100% METHANOL ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE W/ 100% METHANOL MATERIALS AND ^ 2 STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 95. UNKNOWN ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 6. FLEXIBLE (HDPE) ^ 99. OTHER (check all that ®4. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION apply) ^5. STEEL W/ COATING ^ 5. STEEL W/COATING ^ 95. UNKNOWN 465 ^ 9. CATHODIC PROTECTION 464 VII. PIPING LEAK-DETECTION (Check au that appty)la ~~escripion of he morntoring progiarrr-shoo he 3ubm~tced to'the local a,`gency I L UNDERGROUND PIPING ABOVEGROUND PIPING SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all that apply): - ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK VIII_ JIN(iLt WALL YI YINIi 4Ci/ PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check a/I that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK ! CONTAINMENT DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUAL CHECK DATE INSTALLED 46B 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ ^ 5. TRENCH LINER /MONITORING Not Available ®3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 IX. OWNER/OPERATOR SIGNATURE I certify that the information provided herein is true and accurate to the best of my knowledge. SIGNATURE OF OWNER/OPERA OR ~ DATE 470 2/22/0 M OF OWNER/OPERATOR(print) 471 TITLE OF OWNERlOPERATOR 472 TERESA MILES Environmental Compliance Specialist Revised 6I11I2002 Pale 1 1 of 20 • cuPA Bakersfield Fire Department ~ Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 - -- - - UNDERGROUND STORAGE TANKS -TANK PAGE 1 TYPE OF ACTION ^ 1 NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ 3. RENEWAL PERMIT ^ 7. PERMANENTLY CLOSED ON SITE (Specify reason -for local use only (Specify change -for local use only) ^ 8. TANK REMOVED 430 FACILITY ID # 1 BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 5 0. 2 1 0 4 I 7 ARCO# 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 L' TANK-DESCRIPTION ' .,.d,~u ,. '. ~ an uvNh the location of t , , iT s 54em incl~din buildings and landmarks shall be ~ubmitied to the IocaLa~eric ;1. TANK ID # 3 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ®No 434 X@fX@S ~ If "Yes", complete one page for each compartment. DATE INSTALLED (YEARlMO) 19901 O 435 TANK CAPACITY IN GALLONS 1 0,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 II: TANK CONTENTS --- - TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ®1a. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (limarked, complete Petroleum Type) ^ 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ tc. MID-GRADE UNLEADED ^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 ^ 4. HAZARDOUS WASTE (Includes Used Oil) GASOLINE 8006-s1-s ^ 95. UNKNOWN ___ III. TANK CONSTRUCTION' TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ® 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ g5. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg. OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2~ STAINLESS ^ 4. STEEL CLAD W/ FIBERGLASS ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 95. UNKNOWN 445 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN qq6 DATE INSTALLED 447 OR COATING ^ 2_ ALKYD LINING ^ 4. PHENOLIC LINING .® 6. UNLINED ^ 99. OTHER (Check one item only) (Forlocal use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN q4g DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check all that apply) ^ 2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (Forlocal use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE 1990 ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1990 --- IV:` TANK LEAK DETECTION (A descrptiwt of the monitoring program shall be sutrnNtted to [he Iocaf agency) IF SINGLE WALL TANK (Check all that apply). 453 IF DOUBLE WALL TANK OR TANK WITH BLADDER (Check one item only) ~. 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ® 3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ 99. OTHER V. TANK`CLOSURE INFORMATION /sPERMANENT CL05URE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Revised 6/71/2002 Page 12 of 20 rt - CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (66l) 326-3911 ~ _ ~ - - L UNDERGROUND STORAGE TANKS -TANK PAGE 2 ~! __ _~ VI. PIPtNG:CONSTRUCTION ~n _, lthatapc!},l --- _ UNDERGROUND PIPING ABOVEGROUNDPIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER CONSTRUCTION/ ®2. DOUBLE WALL ^ 95. UNKNOWN MANUFACTURER MANUFACTURER: AMERON ^ 1. BARE STEEL ®6. FRP COMPATIBLE Wt 100°!o METHANO MATERIALS AND ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIB LE WITH CONTENTS ^ 95. UNKNOW (check all that ®q. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99, OTHER apply) ^6. STEEL W! COATING ^ g CATHODIC PROTECTION VIL PIPING LE~AK'DETECTI,ON tCneck au that apply)( _ _ UNDERGROUND PIPING 458 I ^ 1. PRESSURE LI 2. SUCTION U 3. GRAVITY 459 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 46Z ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER 463 L [_] 1. BARE STEEL LI 6. FRP COMPATIBLE W/ 100°lo METHANOL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL N ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION 464 ^ 5. STEEL W! COATING ^ 95. UNKNOWN 465 ...6. . ,... u~ ~.. ~ _ g grog' shad be submdted to`the local=agency I ada alpGOn of e monlbnn ra_m oanvrr_onlrnln plornln_ -- SINGLE WALL PIPING 466 'RESSURIZED PIPING (Check all that apply): 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING). ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply). ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK VIIL' DI3PEN EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK .. _ ~ JtR I.tJIV, I HIIV fY1GIV I DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUALCHECK DATE INSTALLED 468 ^ 2. CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ 5. TRENCH LINER /MONITORING Not Available ®3. CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6 NONE 469 _ - IX. 01NNERfOP~ERATOR',SIGNA^TURE I certify that the information provided herein is true and accurate to the best of my knowledge. S}('NATURE OF OWNER/OPE T~~ NAME~OF OWNER/OPERATOR(print) TERESA MILES Revised 6I11I2002 DATE 470 t 2~22~~~ 471 TVTLE OF OWNER/OPERATOR 472 Environmental Compliance Specialist Page 13 of 20 JINCiLt WALL YIYINIi 4ti/ PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +gUDIBLE AND VISUAL ALARMS T CUPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 _ UNDERGROUND STORAGE TANKS -TANK PAGE 1 _ _ _ _ _ TYPE OF ACTION ^ 1. NEW SITE PERMIT ^ 4. AMENDED PERMIT ® 5. CHANGE OF INFORMATION ^ 6. TEMPORARY SITE CLOSURE (Check one item only) ^ 3. RENEWAL PERMIT ^ 7. PERMANENTLY CLOSED ON SITE (Specify reason -for local use only (Specify change - /or local use only) ^ 8. TANK REMOVED 430 FACILITY ID # 1 BUSINESS NAME (Same as FACILITY NAME or DBA) 3 1 5 0 2 1 0 4 1 7 ARCO# 01960 BUSINESS ADDRESS CITY ZIP CODE 1701 BRUNDAGE LANE BAKERSFIELD 93304 LOCATION WITHIN SITE (Optional) 431 --- - _.. L TANKbESCRIPTION '' ~~ "a,~: otot ulon titi}t '- ,cu;,on of the US7 sXStem i ~cl,idiiig buildings end hndmarks shat) be subr.:.... ~ I ~ ..,:, agency:) _ TANK ID # 4 432 TANK MANUFACTURER 433 COMPARTMENTALIZED TANK ^ Yes ®No 434 Xerxes If "Yes", complete one page for each compartment. DATE INSTALLED (YEAR/MO) 1990/10 435 TANK CAPACITY IN GALLONS 1 0,000 436 NUMBER OF COMPARTMENTS ~ 437 ADDITIONAL DESCRIPTION 438 __ 1L TANK CONTENTS _ ,: TANK USE 439 PETROLEUM TYPE 440 ® 1. MOTOR VEHICLE FUEL ^ ta. REGULAR UNLEADED ^ 2. LEADED ^ 5. JET FUEL (If marked, complete Petroleum Type) ® 1b. PREMIUM UNLEADED ^ 3. DIESEL ^ 6. AVIATION FUEL ^ 2. NON-FUEL PETROLEUM ^ 1c. MID-GRADE UNLEADED ~^ 4. GASOHOL ^ 99. OTHER ^ 3. CHEMICAL PRODUCT COMMON NAME (from Hazardous Materials Inventory page) 441 CAS # (from Hazardous Materials Inventory page) 442 ^ 4. HAZARDOUS WASTE (Includes Used Oil) GASOLINE 8006-61-9 ^ 95. UNKNOWN _ __ --- III. TANK CONSTRUCTION TYPE OF TANK ^ 1. SINGLE WALL ^ 3. SINGLE WALL WITH ^ 5. SINGLE WALL WITH INTERNAL BLADDER SYSTEM 443 ® 2. DOUBLE WALL EXTERIOR MEMBRANE LINER ^ 95. UNKNOWN (Check one item only) ^4. SINGLE WALL IN A VAULT ^ gg, OTHER TANK MATERIAL -primary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 5. CONCRETE ^ 95. UNKNOWN 444 ^ 2. STAINLESS ^ 4. STEEL CLAD W/ FIBERGLASS ^ 8. FRP COMPATIBLE W/100% METHANOL ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP TANK MATERIAL -secondary tank ^ 1. BARE STEEL ®3. FIBERGLASS /PLASTIC ^ 8. FRP COMPATIBLE W/100 % METHANOL ^ 95. UNKNOWN 445 ^ 2. STAINLESS ^ 4. STEEL CLAD W/FIBERGLASS ^ 9. FRP NON-CORRODIBLE JACKET ~ ^ 99. OTHER (Check one item only) STEEL REINFORCED PLASTIC (FRP) ^ 10. COATED STEEL ^ 5. CONCRETE TANK INTERIOR LINING - ^ 1. RUBBER LINED ^ 3. EPOXY LINING ^ 5. GLASS LINING ^ 95. UNKNOWN 446 DATE INSTALLED 447 OR COATING ^ 2. ALKYD LINING ^ 4. PHENOLIC LINING ®6. UNLINED ^ 99. OTHER (Check one item only) (For local use only) OTHER CORROSION ^ 1. MANUFACTURED CATHODIC ^ 3. FIBERGLASS REINFORCED PLASTIC ^ 95. UNKNOWN 448 DATE INSTALLED 449 PROTECTION IF APPLICABLE PROTECTION ^ 4. IMPRESSED CURRENT ^ 99. OTHER (Check all that apply) ^ 2. SACRIFICIAL ANODE (For local use only) SPILL AND OVERFILL YEAR INSTALLED 450 TYPE (For local use only) 451 OVERFILL PROTECTION EQUIPMENT: YEAR INSTALLED 452 (Check all that apply) ®1. SPILL CONTAINMENT 1990 ®1. ALARM ^ 3. FILL TUBE SHUT OFF VALVE ® 2. DROP TUBE 1990 ®2. BALL FLOAT ^ 4. EXEMPT ® 3. STRIKER PLATE 1980 IV. TANK'`LEAK .DETECTION (A deseiiption of the monitoring program shall be submitted ro the locat agency) IF SINGLE WALL TANK (Check all that apply): 453 IF DOUBLE WALL. TANK OR TANK WITH BLADDER (Check one item only) : 454 ^ 1. VISUAL (EXPOSED PORTION ONLY) ^ 5. MANUAL TANK GAUGING (MTG) ^ 1. VISUAL (SINGLE WALL IN VAULT ONLY) ^ 2. AUTOMATIC TANK GAUGING (ATG) ^ 6. VADOSE ZONE ®2. CONTINUOUS INTERSTITIAL MONITORING ®~3. CONTINUOUS ATG ^ 7. GROUNDWATER ^ 3. MANUAL MONITORING ^ 4. STATISTICAL INVENTORY RECONCILIATION (SIR) + ^ 8. TANK TESTING BIENNIAL TANK TESTING ^ g9. OTHER V. TANK'`CLOSURE INFORMATION /PERMANENT CLOSURE IN PLACE ESTIMATED DATE LAST USED (YY/MM/DD) 455 ESTIMATED QUANTITY OF SUBSTANCE REMAINING 456 TANK FILLED WITH INERT MATERIAL? 457 gallons ^ Yes ^ No Revised 611 112 00 2 Page 14 of 20 T. • cuPA Bakersfield Fire Department • Hazardous Materials Division 2101 H Street Bakersfield, CA 93301 (661) 326-3911 UNDERGROUND STORAGE TANKS -TANK PAGE 2 -- VL' PIPI~J.G CONS --- UNDERGROUND PIPING SYSTEM TYPE ®1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY ^ 1. SINGLE WALL ^ 3. LINED TRENCH ^ 99. OTHER CONSTRUCTION/ ®2 DOUBLE WALL ^ 95. UNKNOWN MANUFACTURER MANUFACTURER: AMERON ^ 1. BARE STEEL ®6. FRP COMPATIBLE W/ 100% METHANO MATERIALS AND ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL CORROSION PROTECTION ^ 3. PLASTIC COMPATIB LE WITH CONTENTS ^ 95. UNKNOWN (check all that ®q. FIBERGLASS ^ 8. FLEXIBLE (HDPE) ^ 99. OTHER apply) ^5. STEEL W! COATING ^ g CATHODIC PROTECTION __ -VII. PIPING;LEAK'DETECTION {Cheek'a/I that apply)(a UNDERGROUND PIPING ( SINGLE WALL PIPING 466 PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PUMPING SYSTEM + TRIENNIAL PIPING INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND P4PING)~. ^ 7. SELF MONITORING GRAVITY FLOW: ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ® b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ® 11. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITH FLOW SHUT OFF OR RESTRICTION ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply): ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST) WITHOUT FLOW SHUT OFF OR RESTRICTION . ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK _ VIII. DISPENSER CONTAINMENT - DISPENSER CONTAINMENT ^ 1. FLOAT MECHANISM THAT SHUTS OFF SHEAR VALVE ^ 4. DAILY VISUAL CHECK DATE INSTALLED 468 2 CONTINUOUS DISPENSER PAN SENSOR +AUDIBLE AND VISUAL ALARMS ^ ^ 5. TRENCH LINER /MONITORING Not Available ® 3 CONTINUOUS DISPENSER PAN SENSOR WITH AUTO SHUT OFF FOR DISPENSER +AUDIBLE AND VISUAL ALARMS ^ 6. NONE 469 IX. ;OWNERLOPERATOR SIGNATURE 1 certify that the information provided herein is true and accurate to the best of my knowledge. SI ATURE OF OWNER/OPERATO DATE 470 12~22~~~ NAME OF OWNER/OPERATOR(print} - 471 TITLE OF OWNER/OPERATOR 472 TERESA MILES Environmental Compliance Specialist Revised 6/11/2002 TRUCTION rCheck,all;`~ar apply) ABOVEGROUND PIPING 458 ^ 1. PRESSURE ^ 2. SUCTION ^ 3. GRAVITY ~ 459 460 ^ 1. SINGLE WALL ^ 95. UNKNOWN 462 ^ 2. DOUBLE WALL' ^ 99. OTHER MANUFACTURER 463 L ^ 1. BARE STEEL ^ 6. FRP COMPATIBLE WI 100! METHANOL ^ 2. STAINLESS STEEL ^ 7. GALVANIZED STEEL ^ 3. PLASTIC COMPATIBLE WITH CONTENTS ^ 6. FLEXIBLE (HDPE) ^ 99. OTHER ^ 4. FIBERGLASS ^ 9. CATHODIC PROTECTION 464 ^ 5. STEEL W/COATING ^ 95. UNKNOWN 46~ desc .:.. ription of the moroforrng program shat be subm8ted tothe local agency.) ABOVEGROUND PIPING SIN(iLt WALL YIYIN(i 4Ei! PRESSURIZED PIPING (Check all that apply): ^ 1. ELECTRONIC LINE LEAK DETECTOR 3.0 GPH TEST WITH AUTO PUMP SHUTOFF FOR LEAK, SYSTEM FAILURE AND SYSTEM DISCONNECTION +AUDIBLE AND VISUAL ALARMS ^ 2. MONTHLY 0.2 GPH TEST ^ 3. ANNUAL INTEGRITY TEST (0.1 GPH) ^ 4. DAILY VISUAL CHECK CONVENTIONAL SUCTION SYSTEMS: ^ 5. DAILY VISUAL MONITORING OF PIPING AND PUMPING SYSTEM ^ 6. TRIENNIAL INTEGRITY TEST (0.1 GPH) SAFE SUCTION SYSTEMS (NO VALVES IN BELOW GROUND PIPING): ^ 7. SELF MONITORING GRAVITY FLOW: ^ 8. DAILY VISUAL MONITORING ^ 9. BIENNIAL INTEGRITY TEST (0.1 GPH) SECONDARILY CONTAINED PIPING PRESSURIZED PIPING (Check all that apply): 10. CONTINUOUS TURBINE SUMP SENSOR WITH AUDIBLE AND VISUAL ALARMS AND (Check one) ^ a. AUTO PUMP SHUT OFF WHEN A LEAK OCCURS ^ b. AUTO PUMP SHUT OFF FOR LEAKS, SYSTEM FAILURE AND SYSTEM DISCONNECTION ^ c. NO AUTO PUMP SHUT OFF ^ 11. AUTOMATIC LEAK ^ 12. ANNUAL INTEGRITY TEST (0.1 GPH) SUCTION/GRAVITY SYSTEM: ^ 13. CONTINUOUS SUMP SENSOR +AUDIBLE AND VISUAL ALARMS EMERGENCY GENERATORS ONLY (Check all that apply).' ^ 14. CONTINUOUS SUMP SENSOR WITHOUT AUTO PUMP SHUTOFF +AUDIBLE AND VISUAL ALARMS ^ 15. AUTOMATIC LINE LEAK DETECTOR (3.0 GPH TEST ^ 16. ANNUAL INTEGRITY TEST ^ 17. DAILY VISUAL CHECK Page 15 of 20 HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 1. EMERGENCY RESPONSE PLANS AND PROCEDURES A. In the event of a release or threatened release of hazardous materials, provide the following immediate notifications: ~ Immediately call: Local emergency response personnel 91 1 (Fire, paramedics, police or sheriff) State Office of Emergency Services (800) 852-7550 or (916) 262-1621 Immediately call the appropriate jurisdiction: The Bakersfield Fire Department Hazardous Materials Management Division: (661) 326-3979 Person(s) within the business required responding to a hazardous materials incident: Name: SURJIT BISLA Telephone: (661) 322-7213 Name: TERESA MILES Telephone: (714) 670-3958 Name: ARCO CUSTOMER SOLUTIONS CENTER Telephone: (800) 272-6349 B. Identify the local emergency medical facility that will be used by your business in the event of an injury caused by the release of a hazardous material: Name: BAKERSFIELD MEMORIAL HOSPITAL Address: 420 34TH STREET City: BAKERSFIELD, CA 93301 Phone: (661) 327-4647 2. PREVENTION Gasoline. Gasoline spills can result in environmental contamination, fire, and explosion. Releases of gasoline can occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spit{ prevention devices- are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. Page 16 of 20 HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 Carbon Dioxide. Liquefied carbon dioxide is an extremely cold liquid/gas and is stored under high pressure in a gas cylinder. The small gas cylinders, containing 20 to 50 pounds of liquid carbon dioxide, must be stored upright and be firmly secured with chain to the wall. Those large cylinders (containers), which contain 200 to 400 pounds of liquid carbon dioxide, must be either chained or anchored to the floor. Securing the cylinder prevent falling or being knocked over. The gas cylinder must be capped at all times and transported with drum cart. The extremely cold part of pipes and valves on top of the cylinder will cause moist flesh to stick fast and tear when one attempts to withdraw from it. A leak will result in the formation of dry ice, and contact with dry ice, liquid carbon dioxide, or cold gas can cause frostbite to skin, eyes, and exposed tissues. Breathing low concentration of carbon dioxide can cause nausea, dizziness, mental confusion, and visual disturbance, shaking, headache, and respiratory problem. Liquid carbon dioxide has a high evaporation rate and when heated to above 52 Degree C (125 Degrees F) will generate high pressure. Store away from heat and ignition sources and out of direct sunlight. High temperature can generate high pressure in the tank/cylinder and cause rupture if the safe relief valve fails to operate. Do not store the container or cylinders where they come into contact with moisture. . 3. MITIGATION In the event of a major release of gasoline: 1. Attendant should shut off electricity to the pumps/turbines at the emergency shut off switch andlor the main electrical panel. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency, and will contact ARCO CSC. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. If neither agency gives such direction, coordinator will call ARCO CSC for removal and disposal. In the event of a fire: 1. Attendant should shout FIRE ALARM and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels and close impact valves. 3. Evacuate by stopping all traffic on site and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response Page 17 of 20 HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer assistance, as requested. In the event of a carbon dioxide release: Carbon dioxide is cold, asphyxiant, and powerful cerebral vasodilator gas. If there are signs of visible ice on the cylinder or parts such as pipes, it is a sign of a leak and needs to be , reported to your manager immediately. In the event of release, evacuate the store, and allow the liquid/gas carbon dioxide to evaporate and the gas to dissipate. Attempt to close the main source valve to stop the release is not recommended unless if is safe to do so and you have adequate personal protection gears. If the area must -be entered by emergency personnel, Self-Contained Breathing Apparatus (SCBA), Kevlar gloves, and appropriate foot and leg protection must be worn. 4. ABATEMENT In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55- gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 3, Mitigation. Large spills are cleaned by BP designated contractors, or as designated by the franchisee for franchise service stations. 5. EVACUATION Alarm shall be given by shouting to initiate an evacuation at the facility. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. To evacuate the Sales Area, office or storage area, leave facility; go to area opposite danger using the front and/or back doors and proceed to the staging area or area opposite danger zone. Call 911 and report emergency. Call ARCO CSC; give details of emergency. 6. EARTHQUAKES BP WEST COAST PRODUCTS LLC has contracted with maintenance contractors to conduct post-earthquake inspections following an earthquake. Inspections will take place as soon as possible after a 5.5 or greater magnitude quake. After earthquake employees will: 1. Make sure gasoline inventories are secure. Secure all underground storage tank systems (emergency pump shut-off switch and main electrical for the turbines) at the main electrical panel. 2. If there are any signs of structural damage to the building or island canopy, keep everyone away from the damaged area. If danger is imminent, shut down facility operations until it had been deemed safe to continue. 3. Call ARCO CSC immediately: If there's an immediate danger, call 911 for assistance. 4. If there is any indication of loss of gasoline from tanks or lines, shut down the dispensing system immediately. 5. If there is Page 18 of 20 .: HAZARDOUS MATERIALS BUSINESS EMERGENCY PLAN EMERGENCY PROCEDURES ARCO # 01960 1701 BRUNDAGE LANE, BAKERSFIELD, CA 93304 visible gasoline from dispensers, be sure to use absorbent material. 6. Even if gasoline inventories appear normal, conduct inventory reconciliation and visual checks twice a day until aftershocks subside. 7. HAZARDOUS WASTE CONTINGENCY See Section 3, Mitigation, "In the event of a major release. " 8. UNAUTHORIZED RELEASE RESPONSE PLAN See Section 3, Mitigation, "In the event of a major release." Release reporting will be completed by the Environmental Compliance Specialist (TERESA MILES). 9. SITE SECURITY As applicable on an individual facility basis, you should assess the security and vulnerability of your business from intentional acts both from within your business (sabotage) and from the outside (vandalism and terrorist acts). This assessment should consider testing your security system and procedures on a regular basis. Details of this assessment should not be included in this plan as it is a public document. 10. EMPLOYEE TRAINING PLAN All employee training shall be documented and updated annually New employee training. Topics as follows: 1. Identification, location and securing of C02. 2. Review BERP including emergency escape procedures. and evacuation assembly location. 3. Discuss fire risks from flammable liquids, combustible materials, static electricity and propane (if applicable). 4. Locate all fire extinguishers. 5. Review list of chemicals used at facility, MSDS's and their location. 6. Handling, identification and proper storage and labeling of hazardous waste. 7. Identify location of UST monitoring alarm. 8. Instruct on use and location of emergency shut-off switches. 9. Discuss procedures used to. respond to minor and major spills. Training is conducted as described above for new employees and on a yearly basis for all employees. Page 19 of 20 ITE MAP 2 3 4 5 6 7 8 9 10 it 12 13 B C D E F G H I ] K L .. N ......... ......._ '~ . . ........ ............ T ........ ._._.......... ... . . ~ 3 as , "' ~ ~ Q H , ~ ~ MO _ _..... N _ J.._... 0 ... _ w , Q r- .__.... ~ ... . ~_..._......... _..._... ~... ........ .. ........ ......._ r ~ BR ......... ................ ......_......... ......_. ~.. ..........._.. STORAGECONTAINER ~ I A ~ O ® ~ ~ ~ - v '" Ln ~ t L _. S . _. EM TB ~ TB.. Q .. ¢ . ~- g ___.. _ a. ...__ ..__ .___ .___. ..__ Q _.......... _ ___...... ', ~n CL......... N TACO BELL LEG END ~ DISPENSER SHUTOFF ~ CASHIER O ABSORBENT FL FLAMMABLE LIQUID MSDS EMERGENCY PLAN BR BATH ROOM O GAS PUMP EMERGENCY SHUT OFF FIRE HYDRANT ~ MONITORING WELL CL COMBUSTIBLE LIQUID TB TRASH BIN ® SEWER/FLOOR DRAIN OE ELECTRICAL PANEL • TANK MONITOR O WATER MC MOTOR COOLANT ~ • ~ FENCE ~ FIRST AID OL LIQUID WASTE DRUM ~ AERAECAUATION ~ PPE MD MOTOR OIL - A/ C U ~ ONDITIONING _~ FIRE EXTINGUISHER O SOLID WASTE DRUM /r I(O)~ \ OVERFILL ALARM C TELEPHONE EM EMERGENCY EXIT ('O2 COz CYLINDER ® STORM DRAIN _.___________ ;; UST - -+- SENSOR DISPENSER BUSINESS NAME: ARCO # 01960 SITE ADDRESS: 1701 BRUNDAGE LANE CITY: BAKERSFIELD ZIP: 93304 MAP DATE: 07/06/05 AGENCY FACILITY #: Page 20 of 20 . -~ UNDERGROUND STORAGE TANK MONITORING PLAN -PAGE 1 TYPE OF ACTION ® I. NEW PLAN ^ 2 CHANGE OF INFORMATION M°i. PLAN TYPE ® MONI"fORING IS IDENTICAL, FOR ALL USTs AT TI-IIS FACILITY. "70'- ~ (Check one item only) ^ THIS PLAN COVERS ONLY THE FOLLOWING US"I' SYSTEM(S): - I. FACILITY INFORMATION FACILI"rY ID # (Agency Use Only) _ FACILI"rY NAME ARCO # 01960 "103 rACILrrY SITE ADDRESS 1701 BRUNDAGE LANE n104 crfY BAKERSFIELD `los. II. EQUIPMENT TESTING AND PREVENTIVE MAINTENANCE State law requires that testing; preventive maintenance, and calibration of monitoring equipment (e. e.; sensors, probes, line leak detectors, etc.) be performed in hiob. accordance with the equipment manufacturers' instnictions, or annually, whichever is more frequent Such work must be performed by qualified personnel. MONITORING EQUIPMENT IS SERVICED ® I. ANNUALLY ^ 99. OTHER (Specify): M°z III. MONITORING LOCATIONS This monitoring plan must include a Site Plan showing the general tank and piping layouts and the locations where monitoring is performed (i.e.; location of each s ensor, line leak detector, monitoring system control panel; etc.). If you already have a diagram (e.g., current UST Monitoring Site Plan from a Monitoring System Certification. form, Hazardous Materials Business Plan map, etc.) which shows all required information, include it with this plan. IV. TANK MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S): (Check all that apply) Mio. ® I. CONTINUOUS ELECTRONIC MONITORING OF TANK ANNULAR (INTERSTITIAL) SPACE(S) OR SECONDARY CONTAINMENT VAULT(S) SECONDARY CONTAINMENT IS: ®a. DRY ^ b. LIQUID FILLED ^ c. UNDER PRESSURE ^ d. UNDER VACUUM Mi ~ PANEL MANUFACTURER: Veeder Root M~' MODEL #: TLS 350 Mi'. LEAK SENSOR MANUFACTURER: Veeder Root M14~ MODEL #(S): 794390-409 Mis. ^ 2. AUTOMATIC TANK GAUGING (ATG) SYSTEM USED TO MONITOR SINGLE WALL TANK(Sl PANEL MANUFACTURER: M16 MODEL #: Mir. IN-TANK PROBE MANUFACTURER: M18 MODEL #(S): M" LEAK TEST FREQUENCY: ^ a. CONTINUOUS ^ b. DAILY/NIGFITLY ^ c. WEEKLY n~'-0 ^ d. MONTHLY ^ e. OTHER (Specify): ~~~~ ~ PROGRAMMED TESTS: ^ a. 0.1 g.p.h. ^ b. 0.2 g.p.h. ^ c. OTFIER (Specify): MZ? . Mzs. ^ 3. INVENTORY RECONCILIATION ^ a. MANUAL PER 23 CCR §2646 ^ b. STATISTICAL PER 23 CCR n~'2646.1 M24. ^ 4. WEEKLY MANUAL TANK GAUGING (MTG) PER 23 CCR §264 TESTING PERIOD: ^ a. 36 HOURS ^ b. 60 HOURS Mas. ^ ~. INTEGRITY TESTING PER 23 CCR §2643. l TEST FREQUENCY: ^ a. ANNUALLY ^ b. BIENNIALLY ^ c. OTHER (Specify): M26 . M2z ^ 6.V[SUAL MONITORING DONE: ^ a. DAILY ^ b. WEEKLY (Regid res agency approvap ^ 99. OTHER (Specify): M'-8~ V. PIPE MONITORING MONITORING IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) Mso. ® L CONTINUOUS ELECTRONIC MONITORING OF PIPING SUMP(S)/TRENCH(ES) AND OTHER SECONDARY CONTAINMENT SECONDARY CONTAINMENT IS: ®a. DRY ^ b. LIQUID FILLED ^ c. UNDER PRESSURE ^ d. UNDER VACUUM n~'' PANEL MANUFACTURER: Veeder Root "~'Z MODEL #: TLS 350 M" LEAK SENSOR MANUFACTURER: Veeder Root n~'4 MODEL #(S): 794380-208 nus. WILL A PIPING LEAK ALARM TRIGGER AUTOMATIC PUMP (i.e., TURBINE) SHUTDOWN? ®a. YES ^ b. NO M36. WILL FAILURE/DISCONNECTION OF THE MONITORING SYSTEM TRIGGER AUTOMATIC PUMP SHUTDOWN? ®a. YES ^ b. NO Msg. ® 2. MECHANICAL LINE LEAK DETECTOR (MELD) TFIAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS AND RESTRICTS OR SHUTS OFF PRODUCT FLOW WHEN A LEAK IS DETECTED MELD MANUFACTURER(S): VAPORLESS M's~ MODEL#(S): LD-2000 M'9~ ^ 3. ELECTRONIC LINE LEAK DETECTOR (FLED) THAT ROUTINELY PERFORMS 3.0 g.p.h. LEAK TESTS ELLD MANUFACTURER: "140 MODEL #: Mai. PROGRAMMED LINE [N"rEGR[TY TESTS: ^ a. MINIMUM MONTHLY 0.2 a.p.h. ^ b. MINIMUM ANNUAL 0.1 g.p.h. naa2. WILL ELLD DETECTION OF A PIPING LEAK TRIGGER AUTOMATIC PUMP SHUTDOWN? ^ a. YES ^ b. NO M4' WILL ELLD FAILURE/DISCONNECTION TRIGGER AUTOMATIC PUMP SHUTDOWN? ^ a. YES ^ b. NO M4a. ^ 4. INTEGRITY TESTING TEST FREQUENCY: ^ a. ANNUALLY ^ b. EVERY 3 YEARS ^ c. OTHER (Specify) Mas . Moe. ^ ~. VISUAL MONITORING DONE: ^ a. DAILY ^ b. WEEKLY* ^ c. M[N. MONTHLY & EACFI TIME SYSTEM OPERATED** M47. * Requires aeency approval ** Allowed for monitoring of unburied emergency generator ruel piping only per HSC y2528 LS(b)(;) ^ 6. PIPING IS SUCTION PIPING MEETING ALL REQUIREMENTS FOR EXEMPTION FROM MONITORING PER 23 CCR §2636(a)(3) ^ 7. NO PRODUCT OR REMO"fE FILL PIPING IS CONNECTED TO THE UST(s) ^ 99. OTHER (Specify) ~ Maa. hwfwrc-d (06/03) - 1/~ 06/2/03 -i UNDERGROUND STORAGE TANK MONITORING PLAN -PAGE 2 VI. DISPENSER MONITORING MONITORING OF AREAS BENEA'T'H DISPENSER(S) IS PERFORMED USING THE FOLLOWING METHOD(S) (Check all that apply) niso. ® L CONTINUOUS ELECTRONIC MONITORING OF UNDER DISPENSER CON3'AiNMENT (UDC) PANEL MANUFACTURER: Veeder Root ~~'~ MODEL #: TLS 350 nis'. LEAK SENSOR MANUFACTURER_ Veeder Root °75'~ MODEL #(S): 7943 80-2 0 8 mesa. WILL DETECTION OF A LEAK INTO THE UDC TRIGGER AUDIBLE AND VISUAL ALARMS? ®a. YES ^ b. NO m~;s WILL A UDC LEAK ALARM TRIGGER AUTOMATIC PUMP SHUTDOWN? ®a. YES ^ b. NO n'~'6 WILL FAILURE/DISCONNECTION OF UDC MONITORING SYSTEM 'TRIGGER AU'T'OMATIC PUMP SHUTDOWN? ®a. YES ^ b. NO '`~'~ ^ 2. MECHANICAL ASSEMBLY (e. g., FLOAT AND CHAIN ASSEMBLY) IN UDC TRIPS SHEAR VALVE IN CASE OF LEAK ASSEMBLY MANUFACTURER: Mss. MODEL #(S): ~ ~ n~is9. ^ 3.VISUAL MONITORING DONE: ^ a. DAILY ^ b. WEEKLY (Requires agencyapprovap nt~o. ^ 4. NO DISPENSERS ^ 99. OTHER (Specify) ~ Mbi, VII. ENHANCED LEAK DETECTION ^ 1. WE HAVE BEEN NOTIFIED BY THE STATE WATER RESOURCES CONTROL BOARD THAT WE MUST IMPLEMENT ENHANCED LEAK Mao. DETECTION (ELD) FOR THE UST(S) COVERED BY THIS PLAN. PER 23 CCR §2644.1, ELD IS PERFORMED EVERY 36 MONTHS AS REQUIRED VIII. TRAINING REFERENCE DOCUMENTS MAINTAINED AT FACILITY (Check all that apply) Mso. 1. ® THIS UNDERGROUND STORAGE TANK MONITORING PLAN (Required) 2. ® OPERATING MANUALS FOR ELECTRONIC MONITORING EQUIPMENT (Required)* 3. ® THE FACILITY'S BEST MANAGEMENT PRACTICES (Required as of MM/DD/YY) 4. ^ CALIFORNIA UNDERGROUND STORAGE TANK REGULATIONS ~. ^ CALIFORNIA UNDERGROUND STORAGE TANK LAW 6. ^ STATE WATER RESOURCES CONTROL BOARD (SWRCB) PUBLICATION: "HANDBOOK FOR TANK OWNERS -MANUAL AND STATISTICAL INVENTORY RECONCILIATION" 7. ^ SWRCB PUBLICATION: `WEEKLY MANUAL TANK GAUGING FOR SMALL UNDERGROUND STORAGE TANKS" 99. ^ OTHER (Specify): Msi, Personnel with UST monitoring responsibilities are familiar with all of the above documents relevant to their job duties and can access those documents when needed. By 1/1/200, this facility will have a "Designated UST Operator" who has passed the operator exam administered by the International Code Council (ICC). By July 1, 200, and annually thereafter, the "Designated UST Operator" will train facility employees in the proper operation and maintenance of the UST systems. This training will include, but is not limited to, the following: - Operation of the UST systems in a manner consistent with the facility's best management practices. - The facility employee's role with regard to the leak detection equipment. The facility employee's role with regard to spills and overfills. 9 Whom to contact for emergencies and leak detection alarms. For facility employees hired on or after July I, 200, the initial training will be conducted within 30 days of the date of hire. IX. COMMENTS/ADDITIONAL INFORMATION Please use this section to include any additional UST system monitoring-related information (e.g., additional information required by your local agency): Mss. *Monitoring systems manual maintained by contracted, licensed pump and tank technicians. Best Management Practices are maintained in the H.S.S.E. Retail Facility Programs Manual (Green Binder). X. PERSONNEL RESPONSIBILITIES THE FACILITY OPERATOR DESIGNATED IN SECTION XI BELOW IS RESPONSIBLE FOR PEFORMING MONITORING. BP WEST COAST PRODUCTS LLC IS RESPONSIBLE FOR MAINTAINING AND TESTING ALL MONITORING EQUIPMENT. XI. OWNER/OPERATOR SIGNATURE CERTIFICATION: I certify that the information provided herein is true and accurate to the best of my knowledge. OWNER/OPERATOR SI NATURE REPRESENTING DA"1'E: Mai. ~^'~ N ~R ~)' _(~„_ ^ Owner n190. ( ~ t~1~ `~y~_„~j~('S~ v ~'11VJJ ®Operator ,X l OWNER/OPERATOR NAME (print): M9z. OWNER/OPERATOR TITLE: M~'. SURJIT BISLA Franchisee (Agency Use Only) This plan has been reviewed and: ^ Approved ^ Approved With Conditions ^ Disapproved Local Agency Signature: Date: Comments/Special Conditions: hwfwrc-d (06103) - 2h OG/2il03 UNDERGROUND STORAGE TANK RESPONSE PLAN -PAGE 1 (one form per t~~cility) TYPE OF ACTION ® I. NEW PLAN ^ 2. CHANGE OF INFORMATION Roi. I. FACILITY INFORMATION FACILITY ID # (A~ency Use Only) FACILITY NAME R0-- ARCO # 01960 FACILITY SITE ADDRESS R0~ CITY Rw. 1701 BRUNDAGE LANE BAKERSFIELD II. SPILL CONTROL AND CLEANUP METHODS This plan addresses unauthorized releases from UST systems and supplements the emergency response plans and procedures in the facility's Hazardous Materials Business Plan. > If safe to do so, facility personnel will take immediate measures to control or stop any release (e.g., activate pump shut-off, etc.) and, if necessary, safely remove remaining hazardous material from the UST system. ~ Any release to secondary containment will be pumped or otherwise removed within a time consistent with the ability of the secondary containment system to contain the hazardous material, but not greater than 30 calendar days, or sooner if required by the local agency. Recovered hazardous materials, unless still suitable for their intended use, will be managed as hazardous waste. Absorbent material will be used to contain and clean up manageable spills of hazardous materials. Used absorbent material will be stored in a properly labeled and sealed container until removed from the site bra licensed hazardous waste transporter. ~ Facility personnel will determine whether or not any water removed from secondary containment systems, or from clean-up activity, has been in contact with any hazardous material. If the water is contaminated, it will be managed as hazardous waste. If the water has a petroleum sheen (i.e., rainbow colors), it is contaminated. A thick floating petroleum layer may not necessarily display rainbow colors. Water (hazardous ornon-hazardous) from sumps, spill containers, etc. will not be disposed to storm water systems. ~ We will review secondary containment systems for possible deterioration if any of the following conditions occur: 1. Hazardous material in contact with secondary containment is not compatible with the material used for secondary containment; 2. Secondary containment is prone to damage from any equipment used to remove or clean up hazardous material collected in secondary containment; 3. Hazardous material, other than the product/waste stored in the primary containment system, is placed inside secondary containment to treat or neutralize released product/waste, and the added material or resulting material from such a combination is not compatible with secondary containment. ..III. SPILL- CONTROL AND CLEAN-UP EQUIPMENT PERIODIC NIA[NTENANCE: Spill control and clean-up equipment kept permanently on-site is listed in the facility's Hazardous Materials Business Plan. This equipment is inspected at least monthly, and atter each use, and supplies are replenished as needed. Defective equipment is repaired or replaced as necessary. EQUIPMENT NOT PERMANENTLY ON-SITE, BUT AVAILABLE FOR USE IF NEEDED: (Complete only if applicable) EQUIPMENT LOCATION AVAILABILITY Absorbent R10 Backroom R20 Onsite at all times R30. Broom /dustpan Ri ~ Backroom R'~ Onsite at a{I times R'~ Gloves Riz. Backroom ~'~ Onsite at all times Raz. R 13_ R23 R33. R14. R24. R34. RIS. R25. ~ R35. IV, ,RESPONSIBLE PERSONS THE FOLLOWING PERSON(S) IS/ARE RESPONSIBLE FOR AUTHORIZING ANY WORK NECESSARI' UNDER THIS RESPONSE PLAN: NAME Rao. TITLE R50. TERESA MILES Environmental Compliance Specialist NAME R41 TITLE Rsi. NAME R't'-- TITLE Rs?-. NAME Rai TITLE Rss. V. INDIRECT HAZARD DETERMINATION. This information is required only when the presence of the hazardous substance can not be determined directly by the monitoring method used (e.g., where liquid level measurements in a tank annular space or secondary piping are used as the basis for leak determination). THE FOLLOWING STEPS WILL BE TAKEN TO DETERMINE THE PRESENCE OR ABSENCE OF HA7_ARDOUS SUBSTANCE IN THE SECONDARY CONTAINMENT IF MONITORING INDICATES A POSSIBLE UNAUTHORIZED RELEASE: R60. Site operator will contact Elite Customer Solutions Center (CSC) at 1-800-ARCOFIX. A certified, trained pump and tank technician will be dispatched to the site to evaluate and repair alarm condition. hwfwrc-d (06/03) - 3/5 06/25/03 -:" - UNDERGROUND STORAGE TANK RESPONSE PLAN -PAGE 2 VI. LEAK INTERCEPTION AND DETECTION SYSTEM This information is required only for motor vehicle fuel UST systems constructed per the Alternate Construction Requirements of 23 CCR s2633, and only if the Leak htterception and Detection System (LIDS) does not meet the volumetric requirements of 23 CCR ti2631(d)(I) through (~) (i.e., when accounting for rainfall and backtill material, the secondary containment volume is Icss than 100% of primary tank volume for a single UST: or in the case of multiple USTs in shared secondary containment, I~0% of the largest primary tank volume or 10% of aggregate primary tank volume, whichever is greater). AT"PACT-i AN ADDITIONAL PAGE TO "PHIS PLAN CON"PAINING THE FOLI..OWING INFORMATION: - The volume of the LIDS in relation to the volume of the primary container; - The amount of time the LIDS shall provide containment related to the time between detection of an unauthorized release and cleanup of the leaked substance; - The depth from the bottom of the LIDS to the highest anticipated level of groundwater; - The nature of the unsaturated soils under the LIDS and their ability to absorb contaminants or to allow movement of contaminants; - The methods and scheduling for removal of all hazardous substances which may have been dischareed from primary containment and arc located in the unsaturated soils between the rimary containment and groundwater, including the LIDS sum . VII. REPORTING AND RECORD KEEPING We will report record any overfill; spill, or unauthorized release from a UST system as indicated in this plan. Recordable Releases: Any unauthorized release tiom primary containment which the US'P operator is able to clean up within eight (8) hours after the release was detected or should reasonably have been detected, and which does not escape from secondary containment, does not increase the hazard of fire or explosion, and does not cause any deterioration of secondary containment, must be recorded in the facility's monitoring records. Matitoring records must include: - The UST operator's name and telephone number; A list of the types, quantities, and concentrations of hazardous substances released; - A description of the actions taken to control and clean up the release; - The method and location of disposal of the released hazardous substances, and whether a hazardous waste manifest was or will be used; - A description of actions taken to repair the UST and to prevent future releases; ~ A description of the method used to reactivate interstitial monitoring after replacement or repair of primary containment. Reportable Releases: Any overfill, spill, or unauthorized release which escapes from secondary containment (or primary containment if no secondary containment exists), increases the hazard of fire or explosion, or causes any deterioration of secondary containment, is a reportable release. Reportable releases are also recordable. Within 24 hours after a reportable release has been detected; or should have been detected, we will notify the local agency administering the UST program of the release, investigate the release, and take immediate measures to stop the release. If necessary, or if required by the local agency, remaining stored product/waste will be removed from the UST to prevent further releases or facilitate corrective action. If an emergency exists, we will notify the State Office of Emergency Services. Within five (~) working days of a reportable release, we will submit to the local agency a full written report containing all of the following information to the extent that the information is known at the time of tiling the report: - The UST owner's or operator's name and telephone number; - A list of the types, quantities, and concentrations of hazardous materials released; - The approximate date of the release; - The date on which the release was discovered; - The date on which the release was stopped; - A description of actions taken to control and/or stop the release; - A description of corrective and remedial actions, including investigations which were undertaken and will be conducted to deternine the nature and extent of soil, ground water or surface water contamination due to the release; - The method(s) of cleanup implemented to date, proposed cleanup actions, and a schedule for implementing the proposed actions; - The method(s) and location(s) of disposal of released hazardous materials and any contaminated soils, groundwater, or surface water. - Copies of any hazardous waste manifests used for off-site transport of hazardous wastes associated with clean-up activity; - A description of proposed methods for any repair or replacement of UST system primary/secondary containment systems; - A description of additional actions taken to prevent future releases. We will follow the reporting procedures described above if any of the following conditions occur: - A recordable unauthorized release can not be cleaned up or is still under investigation within eight (8) hours of detection; - Released hazardous substances are discovered at the UST site or in [he surrounding area; - Unusual operating conditions are observed, including erratic behavior of product dispensing equipment, sudden loss of product, or the unexplained presence.of water in the tank, unless system equipment is found to be defective and is immediately repaired or replaced, and no leak has occurred; - Monitoring results from UST system monitoring equipment/methods indicate that a release may have occurred, unless the monitoring equipment is found to be defective and is immediately repaired, recalibrated; or replaced, and additional monitoring does no[ confirm the initial results. Record Retention: Monitoring records and written reports of unauthorized releases must be maintained on-site (or off-site at a readily available location, if approved by [he local agency) for at least 3 years. Hazardous waste shipping/disposal records (e.g., manifests) must be maintained for at least 3 years from the date of shipment. VIII. OWNER/OPERATOR SIGNATURE CERTIPICA"C[ON: 1 certify that the information provided herein is true and accurate to the best of my knowledge. OWNE ERATOFZ SIGNATURE r ~~ DATE `~~~d~~ x~o. OWNER/OPERATOR NAME (print) Rai. OWNER/OPERATOR TITLE R~' SURJIT BISLA Franchisee (Agency Use On[yJ This plan has been reviewed and: ^ Approved ^ Approved With Conditions ^ Disapproved Local Agency Signature: Dale: hwfwrc-d (06/03) - 4h 06/2i/03 CI 1~ 2 3 4 5 6 7 8 9 10 11 12 13 INESS NAME: ARCO # 01960 ADDRESS: 1701 BRUNDAGE LANE CITY: BAKERSFIELD ZIP: 93304 ' DATE: 07/06/05 AGENCY FACILITY #: B C D E F G M I ] K L LEGEND ~ DISPENSER SHUTOFF CASHIER A O ABSORBENT FL FLAMMABLE LIQUID MSDS & MSDS EMERGENCY PLAN BR BATH ROOM O EMERGENCY ~ FIRE HYDRANT ~ WELL ORING CL LCIQUBD STIBLE TB TRASH BIN ® SEWER/FLOOR DRAIN SHUT OFF OE ELECTRICAL PANEL • TANK MONITOR O WATER M(^ MOTOR COOLANT • • ~ FENCE ~ FIRSi AID OL LIQUID WASTE DRUM ~ EVACUATION AREA ~ PPE a MD MOTOR OIL A/C ~ AIR CONDITIONING ~ FIRE EXTINGUISHER O SOLID WASTE DRUM / \ I(O>~ \ OVERFILL ALARM C TELEPHONE EM EMERGENCY EXIT UNIT L'QZ COz CYLINDER ® STORM DRAIN ............... .:~ UST -+= i` SENSOR DISPENSER hwfwrc-d (06/03) - 5/5 06/25/03 BP West Coast Products LLC 4 Centerpointe Drive La Palina, CA 90623 June 24, 2003 Ralph Huey Director of Prevention Services 1715 Chester Ave, Bakersfield, CA 93301 Subject: Business Plan for ARCO 00371, 05365, 05526, 01960, 05420, and 00583 Dear R. Huey, Find enclosed the Business Plans for the above stations that were sent to BP/ARCO by your office for review. Several Business Plans have some minor changes. Please feel free to contact me with any questions or concerns at (714) 670-5321. Sincerely, Michael D. Wilson Environmental Specialist Office (714) 670-5321 Cell (714) 815-2455 .cc 00371, 05365, 05526, 01960, 05420, 00583 ARCO #01960 SiteID: 015-021-000417 Manager : SURJIT BISLA "~'~.~~ BusPhone: (661) 322-7213 Location: 1701 BRUNDAGE LN Map : 102 CommHaz : UnRated City : BAKERSFIELD Grid: 36D FacUnits: 1 AOV: CommCode:.BAKERSFIELD STATION 06 SIC Code:5541 EPA Numb: DunnBrad:51-012-0713 Emergency Contact / Title Emergency Contact / Title SURJIT BISLA / FRANCHISEE ARCO MISSION CONTRO / Business Phone: (661) 322-7213x Business Phone: (800) 272-6349x 24-Hour Phone : (661) 665-2394x 24-Hour Phone : (800) 272-6349x Pager Phone : (661) 496-3372xCELL Pager Phone : ( ) x Hazmat Hazards: Fire Press ImmHlth DelHlth Contact : MICHAEL D. WILSON Phone: (714) 670-5321x MailAddr: PO BOX 6038 State: CA City : ARTESIA Zip : 90702 Owner BP WEST COST PRODUCTS LLC Phone: (714) 670-5321x Address : PO BOX 6038 State: CA City : ARTESIA Zip : 90702 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: ment pian for~ //~ .~ · ~ement plan for my ~cili~y. -1- 06/16/2003 ARCO #01960 SiteID: 015-021-000417 ~ Hazmat Inventory By Facility Unit -- MCP+DailyMax Order Fixed Containers on Site Hazmat Common Name... ISpooHazlEPA Hazardsl Frm DailyMax ]UnitlMCP ~LEADED GASOLINE F IH DH L 20000.00 GAL Mod MIDGRADE GASOLINE F IH DH L /~0000.00 GAL Mod PREMIUM GASOLINE F IH DH L/_~0000.00 GAL Mod CARBON DIOXIDE F P IH G" ~ -1~9~)~0 GAL Min MOTOR OIL F DH L 40.00 GAL Min WASTE ABSORBANT F IH S 55.00 GAL UnR -3- 06/16/2003 F ARCO #01960 SiteID: 015-021-000417 =.Inventory Item 0006 Facility Unit: Fixed Containers on Site ~U~ ~Vl~ / ~1~ ~Vl~ CARBON DIOXIDE Days On Site 365 Location within this Facility Unit Map: Grid: BACK ROOM CAS% 124-38-9 · Gas Pure Above Ambient Cryogenic INSUL.TANK / CRYOGENIC ~TS _AT~OCATION ~' Larges~ Container /'] Dai~y'~aximum Dail~W~verage HAZARDOUS COMPONENTS 100.00 Carbon Dioxide N 124389 TSecret S BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No N No No/ Curies F P IH / / / Min MISC. LOCAL AGENCY DATA Ag. Definedl: Ag. Defined2: Ag.Defined3: Ag. Defined4: Ag. Defined5: Ag.Defined6: Ag. Defined7: Ag.DefinedS: Ag.Definedg: Ag.Definel0: -- Ag.Definell -13- 06/16/2003 ARCO #01960 1701 BRUNDAGE LANE BAKERSFIELD, CA 93304 Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Forms included in this package complies with forms/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: [~BUSINESS ACTIVITIES PAGE BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE [];(]EMERGENCY RESPONSE CONTINGENCY PLAN ~(]HAZARDOUS MATERIALS INVENTORY LIST ~]FACILITY SITE MAP UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of__ I. FACILITY IDENTIFICATION FACILITY ID# I IEPAID#(Hazara°uswaste° y)CALoo0244204 BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3. ARCO # 01960 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold [] YES [] NO 4. HAZARDOUS MATERIALS INVENTORY quantity for an extremely hazardous substance specified in 40 CFR Part -CHEMICAL DESCRIPTION (OES 2731) 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? [] YES [] NO s. UST TANK <one page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? [] YES [] NO 6. UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) 3. Need to report closing a UST? [] YES [] NO 7. UST TANK (closure portion - one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or [] YES [] NO 8. NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [] YES [] NO 9. EPA ID NUMBER - provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC §25143.2)? [] YES [] NO 10. oer ~cycler) 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE [] YES [] NO 11. TREATMENT - FACILITY (Formerly OTSC Forms 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by [] YES [] NO 12. CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE / CONSOLIDATION [] YES [] NO 13, SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1196) 6. Need to report the closure/removal of a tank that was classified as [] YES [] NO ~4. HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerty DTS¢ Form 1249) E. LOCAL REQUIREMENTS ~You may also be required to provide additional information by your CUPA or local agency.) 15. UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I. IDENTIFICATION FACILITY ID #' I ii,~:i':.~. I'i !!!: . BEGINNING DATE [ ENDING DATE i 1 100. 101. (Agency Use Only) : "~ 01/01/2003 12/31/2003 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3. ] BUSINESS PHONE lO2. ARCO # 01960 ] 661-322-7213 BUSINESS SITE ADDRESS 1o3. 1701 BRUNDAGE LANE CITY 1o4. CA ZIP CODE lO5. BAKERSFIELD 93304 DUN & BRADSTREET lO~. SIC CODE (4 digit g) 107. 03-959-6507 5541 COUNTY lOS. BUSINESS OPERATOR NAME lO9. ] BUSINESS OPERATOR PHONE 11o. SURJIT BISLA ] 661-322-7213 II. BUSINESS OWNER OWNER NAME 111. OWNER PHONE 112. BP West Coast Products LLC 714-670-5321 OWNER MAILING ADDRESS: BP West Coast Products EEC 113. P.O. BOX # 6038 CITY 114. ISTATE 115. ZIP CODE 116. ARTESIA I CA 90702-6038 llI. ENVIRONMENTAL CONTACT CONTACT NAME 117. CONTACT. PHONE 118. MICHAEL D. WILSON 714-670-5321 CONTACT MAILING ADDRESS: BP West Coast Products LLC 119. P.O. BOX If 6038 CITY 120. ] STATE 121. ~ I ZIP CODE 122. ARTESIA I CA ] 90702-6038 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123. NAME 128. SURJIT BISLA ARCO MISSION CONTROL TITLE 124. TITLE 129. FRANCHISEE BUSINESS PHONE 125. BUSINESS PHONE 130. 661-322-7213 FAX# 661-322-7213 800-272-6349 24-HOUR PHONE* 126. 24-HOUR PHONE* 131. H. 661-665-2394 800-272-6349 CELL: 661-496-3372 132. ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. SIGNATURE OF OW NERJOP~P~~NTATIVE DATE 134. , NAME OF DOCUMENT PREPARER 135. 02/22/03 [ George Zoumalan~ Ramtox NAME OF SIGNER (print) f .- r 136. TITLE OF SIGNER 137. MICHAEL D. WILSON Environmental Specialist HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt 2. TYPE/PRINT ANSWERS IN ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: # 01960 LOCATION: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 MAILING ADDRESS: BP West Product Company LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-322-7213 OWNER: SURJIT BISLA PHONE: 661-322-7213 MAILING ADDRESS: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS PHONE 24 HR PHONE 1. SURJIT BISLA FRANCHISEE 661-322-7213 H. 661-665-2394 CELL# 661-496-3372 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 HAZARDOUS MATERI~S MANAGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: In the event of minor to major spill, or fire, employee or owner will call 9-1-1 and local agency. Employees are trained for the use of personal protection equipment to minimize contact with hazardous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD ENVIRONMENTAL HEALTH SERVICES: 661-862-8700 C. ENVIRONMENTAL RESPONSE MANAGEMENT: If a large release of gasoline spill or waste occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises by the safest exit. All employees will be asked to assemble at a safe assembly area located at South West side of the site, or at a safe upwind location. Method of evacuation is verbal. Person responsible for notification is: NAME: SURJIT BISLA TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner, or store manager will call either 9-1-1, or may contact the closest medical/clinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 SECTION II RELEASE RESPONSE PLAN Emergency Procedures: Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials: 1. PREVENTION (prevent the hazard) - Describe the kinds of hazards associated with the hazardous materials present at your facility. What actions would your business take to prevent these hazards from occurring? You may include a discussion of safety and storage procedures. Gasoline spills can result in environmental contamination, fire, and explosion. Releases of gasoline can occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spill prevention devices are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. The on-site coordinator or designee will train all new employees of this facility about the procedures for safe handling of hazardous materials and products for emergency response coordination, and use of emergency response equipment and supplies. Additionally, the on-site coordinator or designee will conduct a refresher-training program for all employees on annual basis. PROCEDURE FOR STORAGE AND DISPOSAL OF HAZARDOUS MATERIALS & HAZARDOUS WASTE: Liquid COz cylinders must be secured to wall with chain (this applies for stations that serve soda in the store). Waste absorbent from the gasoline spill, cleanup spills, or used gasoline fuel filters must be stored in a proper UN (DOT) approved container with appropriate hazardous waste label on each' container. Each drum or container containing hazardous waste must be stored away from hot or ignition sources and disposed before 90 days from accumulation date. Each container must be kept closed with lid and disposed as hazardous waste and manifested. State manifests of hazardous waste must be kept for three years in compliance kit. The hazardous material handled on daily basis is gasoline. Hazards associated with this product are spill, leak, fire, and explosion. Fire Prevention procedures as follows: 1. The gasoline tanks are equipped with leak detectors that activate an alarm and disable the pump when leak is detected. Few gas stations are equipped with over fill alarm that prevents the spillage of gasoline from over filling the tanks. 2. All the dispensers are equipped with impact valves. 3. Daily inspection of leaks from the pipes, nozzles, and pumps. 4. Any leaks from above mentioned equipment will be fixed immediately. 5. Posting no smoking sign at the dispensers. 6. Monthly inspection of fire extinguishers to ensure that are full and ready to use. 7. Testing of the emergency shut offs located in front of the store. 8. Testing of dispensers' start/stop emergency shut off located on the cash register. 9. Testing the shut offs of turbine pumps. The on/off switch is on the main electrical panel. Gasoline spills will be cleaned-up immediately using absorbent material 2. MITIGATION (reduce the ha=d). Describe what is done to lesse~he harm or the damage to person(s), property,' or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? Mitigation (continued): In the event of a leak or spill: 1. Attendant should shut off electricity to the pumps/turbines at the main electrical panel and close the impact valves. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency and will contact ARCO MISSION CONTROL. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. There are two exits - front entrance and rear emergency exit. All persons will evacuate through one of these doors and gather in area furthest from danger. Manager on duty will account for all station personnel and customers (when possible). 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. (All spills will be reported to BP Mission Control at (800) 272-6349. The BP Environmental Compliance Specialist will make report to pertinent agencies including NRC, CA DES, Water Board, and County Health Agency.) 3. If neither gives such direction, call ARCO Mission Control for removal and disposal. In the event of a fire employees should: 1. Shout FIRE and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels and close impact valves. 3. Evacuate by stopping all .traffic on site and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response personnel. ~Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer assistance, as requested. Additional mitigation procedures: Employees will be informed of the health and safety hazards involved with the handling of hazardous materials such as gasoline. Employees will not smoke, light matches to cause a spark, or ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUT OFF SWITCHES, HOW TO STOP LEAKS AT NOZZLES AND GAs ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILLS, 5) CALL 911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION. EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. 4. ABATEMENT (remove the hazard) - Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? 4 In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55-gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 2, Mitigation. Large spills are cleaned by BP designated contractors, or as designated by the franchisee for franchise service stations. Employee's responsibilities: Employees will know the location of the nearest storm drain(s) and location of absorbent material to be used to prevent the spill from reaching the storm drains. In the event of a major spill, employees are instructed to call 91 t and report. The on-site emergency coordinator will provide for the disposal of contaminated materials as directed by the local fire department or County Environmental Health. If neither gives such direction, call ARCO Mission Control (800-272-6349) for disposal. BUSINESS PLAN LOCATION: A copy of business plan and training documents will be kept at all times in a yellow compliance kit or a binder, which is located either near the cashier, or office in back room area. Following are the emergency equipment of this facility: Item Use Location Maintenance Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE · NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: I--lYES [~]NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. PRIVATE FIRE PROTECTION [] YES ~]NO B. WATER AVAILABILITY (FIRE HYDRANT)' N/A 5 Emergency review of liquefied ( Cryogenic ) Carbon Dioxide Liquefied carbon dioxide is an extremely cold liquid/gas and is stored under high pressure in a gas cylinder. The small gas cylinders, containing 20 to 50 pounds of liquid carbon dioxide, must be stored upright and be firmly secured with chain to the wall. Those large cylinders (containers), which contain 200 to 400 pounds of liquid carbon dioxide, must be either chained or anchored to the floor. Securing the cylinder prevent falling or being knocked over. All the gas cylinder must be capped at all times and transported with dram cart. The extremely cold part of pipes and valves on top of the cylinder will cause moist flesh to stick fast and tear when one attempts to withdraw from it. A leak will result in the formation of dry ice, and contact with dry ice, liquid carbon dioxide, or cold gas can cause frostbite to skin, eyes, and exposed tissues. Breathing low concentration of carbon dioxide can cause nausea, dizziness, mental confusion, and visual disturbance, shaking, headache, and respiratory problem. Liquid carbon dioxide has a high evaporation rate and when heated to above 52 Degree C (125 Degrees F) will generate high pressure. Store away from heat and ignition sources and out of direct sunlight. High temperature can generate high pressure in the tank/cylinder and cause rupture if the safe relief valve fails to operate. Do not store the container or cylinders where they come into contact with moisture. Response Plan for Carbon Dioxide Release Carbon dioxide is cold, asphyxiant, and powerful cerebral vasodilator gas. In the event of release, evacuate the store, and allow the liquid/gas carbon dioxide to evaporate and the gas to dissipate. Attempt to close the main source valve to stop the release is not recommended unless if is safe to do so and you have adequate personal protection gears. If the area must -be entered by emergency personnel, Self-Contained Breathing Apparatus (SCBA), Kevlar gloves, and appropriate foot and leg protection must be worn. · Response to Carbon Dioxide Release If there are signs of visible ice on the cylinder or parts such as pipes, it is a sign of a leak and needs to be reported to your manager immediately. In addition, the Facility Manager will contact their vendor immediately. In the event of a major release, call 911 and evacuate the store. Do not attempt to close the main source valve to stop the release. Emergency · personnel such as trained fire fighters must wear special protective equipment to safely respond to a leaking CO2 cylinder. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5 MATERIAL SAFETY DATA SHEETS ON FILE: MSDS and business emergency plan is located in the compliance binder, a yellow plastic box, located in the office area BRIEF SUMMARY OF TRAINING PROGRAM: Employees are trained on use of safety equipment and tools to minimize contact with hazardous materials/waste. Employees are trained and required to dial for emergency calls, 9-1-1, and evacuate the premises. Employees are trained in the use of spill clean up, first aid kit, fire extinguishers, electrical and gas shut off and use of telephones. Employees are trained to advise any response agency as to the nature and location of the problem. Initial training is conducted after hiring new employee. Trainer is the owner or manger of the store. Refresher training is done every year. Training topics are such as: 1) hazard communication program, 2) materials safety data sheets, 3) safe handling of chemicals, and 4) emergency equipment& emergency response plan. Employers are required by State law to have a program which provides employees with initial and refresher training. The Business Emergency Plan shall include a training program which is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. Training will be conducted upon hire, and refresher training provided at least annually. Hazardous Materials Handlinq & Emergency Response Trainin.q Will Include: 1. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards 2. Procedures for coordination with local emergency response organizations; 3. Correct use of emergency response equipment and supplies under the control of the business 4. The Cai OSHA Hazard Communication Standards 5. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan 6. The emergency evacuation plans YOu have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care 7. Procedures to coordinate with and assist the local emergency personnel that may respond to your business 8. Who and how to call for immediate assistance in the event of an accident involving hazardous materials 9. Procedure for ensuring that appropriate personnel receive initial and refresher training UST Equipment Operating and Monitorin.q Traininq Will Include: 1. Take tank level measurements 2. Read dispenser meters 3. Inspect equipment 4. Recognize warning signs: dispenser hesitations, meter spins, and odors 5. Manually close dispenser impact valve 6. Replace dispenser filters 7. Shut down the system by knowing the location of electrical panel breakers and emergency shutoff switches 8. Test the electronic monitoring system 9. Respond to alarms, leaks, or equipment problems 'ALL EMPLOYEETRAI~IN(~ SHALL iBE'DOCUMENTED AND:UpDATED ANNUALLY Personnel 1. Are there any specially trained hazardous materials emergency response personnel at your business? []YES [] NO 2. Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? []YES [] NO 3. Do you have personnel' that will provide site security at your business during and after a hazardous materials incident? [] YES [] NO Equipment List the type and location of equipment that can or will be used for response to hazardous materials incidents at your business: Absorbent, a shovel and a broom are located in or near the station supply room. All waste absorbent will be disposed of in a properly labeled hazardous materials drum. 8 The On-Site Coordinator or designee will train all new employees of this facility about the following procedures for the saflillll~ndling of hazardous materials, procedur,~for emergency response coordination, and use~l~mergency response equipment and sup]~s. Additionally, the On-Site coordinator or designee will conduct a refresher-training program for all employees on a semi-annual basis. PROCEDURES FOR SAFE HANDLING OF HAZARDOUS MATERIALS 1. Employees will be informed of the health and safety hazards involved with the handling of gasoline/diesel fuel. 2. Employees will be careful not to spill gasoline, diesel fuel, or waste oil onto themselves or the ground. 3. Employees will not smoke, light matches, cause sparks, or take actions which could ignite flammable liquids or vapors. PROCEDURES FOR EMERGENCY RESPONSE COORDINATION 1. Employees will be familiar with the emergency response procedures outlined in this Business Emergency Response Plan. 2. Employees will know the location and operation of electrical shutoff switches and dispenser shutoff valves. 3. Employees will know the location of,. how and when to use dry chemical fire extinguishers that are located on the premises. 4. Employees will know the location and proper use of first aid kit(s), fire extinguisher(s), and absorbent materials that are located on the premises. 5. Employees will know the location of the nearest storm drain(s) and location of absorbent materials to be used to prevent spills reach the storm drain(s). 6. Employees will be familiar with the kinds of emergency situations which will warrant immediate evacuation of premises. Circumstances include: a. Any gasoline, diesel, or other type of fire. b. Any spill, fuel leak, or vapor leak that has the potential for igniting or exploding, c. Any spill or leak where employees or customers notice gasoline vapors. EMPLOYEE TRAINING RECORDS The BP manager, for BP store, or owner/operator (for franchisee) will be responsible for documenting and retaining the types and dates of the "training" that each facility employee has completed (initial and refresher). These documentation records will be retained at the facility for at least 5 years from the date an employee last worked at the facility. Upon completion of said instruction, employee will sign a statement of acknowledgment. One copy kept at the facility. TRAINING SUBJECTS: Training Topic - Procedures for handling haZardous materials, including hazardous wastes Persons Trained: Facility Staff (i.e. cashier, maintenance) Training Time: 112 hour Refresher Frequency: Annually Training Content: For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment is provided at each facility. For major spillage, employees are instructed to call 911 and report. They will then notify the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Procedures for coordination with emergency response agencies Persons Trained: Facility Staff (i.e. cashier, Emergency Coordinator, Alternate) Training Time: 112 hour Refresher Frequency: Annually Training Content: Facility personnel are instructed to call 911 and report. They will then call the BP manager, for BP store, or owner/operatOr (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Use of emergency response equipment and materials under business' control Persons Trained: Facility Staff (i.e. cashier) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Use and location of absorbent, protective clean-up equipment, first aid kit and fire extinguishers. Review of procedures for proper use of safety and spill control equipment, evacuation and earthquake procedures. Training Topic - Emergency Response Plan implementation Persons Trained: Facility Staff (All Employees) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbent, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call in. CERTIFICATION I, __ MICHAEL D. WILSON 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 AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. grIGNATU-I~ TITLE DATE 10 v UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~ WASTE Ione pa~e per material per building or area~ I-lADD r-IDELETE I~REVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO i::I · ~ 1 1 [ MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # ?~: ~,!i I~,~1 I of I C-7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 WASTE ABSORBENT . Subject to EPCRA, refer to instructions COMMON NAME WASTE ABSORBENT & DISPENSER FUEL FILTER 2o7 EHS* [] Yes [] No 20e CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. 210 FIRE CODE HAZARD CLASSES (complete if required by CUPA) 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I-lb. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 55 (Check one item only) [] a. SOLID I-lb. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 25 55 55 221 & 213 221 DAYS ON SITE: 222 UNITS* []a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONS 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE r-I r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 89-90 226 WASTE ABSORBENT & DISPENSER FUEL FILTER 227 [] Yes [] No 228 N/A, MIXTURE 229 2 230 231 []Yes [] NO 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 24~ 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 '"" UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (.Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) I--I WASTE Ione ~3age per matedal per building or area) I-lADD [-IDELETE []REVISE REPORTING YEAR 2003 20o I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO FACILITY ID # 1 of 1 E 6 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 CARBON D IOXI D E ~f Subject to EPCRA, refer to ~nst~uctions COMMON NAME 207 EHS* [] Yes [] No 20e CAS# 124-38-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by CUPA) 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE r"lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE r'lb. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 50 (Check one item only) [] a. SOLID []b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILy AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 50 100 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* Da. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 227 [] Yes [] No 228 124-38-9 229 2 230 231 []Yes [] NO 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--] WASTE Ione ~3a~e ~er matedal ~3er buildin~ or area1 I--lADD I-]DELETE I~REVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVES (EPCRA) [] YES [] NO llll l I I i MAp# (optional)203 GRID# (optional) 204 FACILITY ID # ~;~'~ 1 OF 1 D-7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o0 MOTOR OIL ~r Subject to EPCRA, refer to instructions COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 207 EHS* [] Yes [] No 20s CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) COMMBUSTIBLE LIQUID 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE []Yes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 0.25(ONE QUART) (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 20 40 N/A N/A 221 I DAYS ON SITE: 222 UNITS* I~a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b, ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 226 LUBRICANT BASE OIL 227 [] Yes [] No 228 N/A, MIXTURE 229 2 5-6 230 ADDTIVES, ANTI-OXIDANT 231 []Yes [] No 232 N/A, MIXTURE 233 3 234 235 [] Yes [] No 236 237 4 238 239 I--lYes [] No 240 241 5 242 243 []Yes []No 244 245 if more hazardous components are present at greater than I Ye by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information, ADDITIONAL LOCALLY COLLECTED INFORMATION 246 "~ UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE /one ~age per matedal per building or area) I--lADD [-IDELETE I~REVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2ol I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO FACILITY ID # I~tI~1=>~'- :'~'~ ~: I I1 MAP# (°pti°nal) 1OF1 203 GRID# (optional) F3 204 II. CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 2o6 PREMIUM If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 20e CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS lB, UN1203 21o I 213 HAZARDOUS MATERIAL 211 RADIOACTIVE []Yes ~;~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5,000 10,000 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only,) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 [] Yes [] No 228 71-43-2 229 2 0-7 230 ETHANOL 231 I-lYes [] No 232 64-17-5 233 3 8-15 234 XYLENE 235 []Yes [] NO 236 1330-20-7 237 4 7-14 238 TOULENE 239 []Yes [] No 240 108-88-3 241 5 242 243 []Yes []No 244 245 If mere hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 "~ UNIFIED PROGRAM (UP) FORM '~' HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [---I WASTE Ione pa~e ~er material ~)er building or area1 I-lADD []DELETE I~REVISE REPORTING YEAR 2003 200 { Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO I Ir~ ' MAP# (°pti°ne') 203 I GRID# (°pti°nal) 204 FACILITY ID # 1OF1 F 3' II, CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 206 U N LEAD E D if Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 2o8 CAS# 8006-61-9 209 *If EHS is '"Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQU ID, CLASS 1 B, U N 1203 2t o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217I MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 21gI STATE WASTE CODE 220 5,000I 10,000 N/AI N/A 22t I DAYS ON SITE: 222 UNITS* []a. GALLONS r']b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTiC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAiL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 [] Yes [] No 228 71-43-2 229 2 0-7 23o ETHANOL 231 []Yes [] No 232 64-17-5 233 3 8-15 234 XYLENE 235 [] Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 I-lYes [] No 240 108-83-3 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 v UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (19o not combine material and waste on one form) [] MATERIAL(NON-WASTE) [] WASTE tone ~3a~e per material ~er building or areat ["lADD I--IDELETE I~]REVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO I Ii~ :~ I~1 1 MAP# (°pti°nal) 1OF1 2°3 GRID# (°pti°nal) F4204 FACI LITY ID # I1. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 UN LEAD ED ~f Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 2o6 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B 21o HAZARDOUS MATERIAL I 213 TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 211 RADIOACTIVE []Yes I~No 212 CURIES I 215 PHYSICAL STATE 214 LARGEST CONTAINER lO,OOO (Check one item only) [] a. SOLID ~;~lb. LIQUID I-I c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5,000 10,000 N/AN/A 221 I DAYS ON SITE: 222 UNITS* I~a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE. TEMPERATURE. [] a. AMBIE-NT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 []Yes []No 228 71-43-2 229 2 0-7 230 ETHANOL 231 []Yes [] No 232 64-17-5 233 3 8-1 5 234 XYLENE 235 [] Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-83-3 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 '-' UNIFIED PROGRAM (UP) FORM "" HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~ WASTE Ione ~e~e ~er material per buildin~ or areaI r-lADD r-]DELETE []REVISE REPORTING YEAR 2003 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO II i III 1 MAP#(°pti°nal)loF1 203]GRID#(°pti°nal)G4 204 FACILITY ID# II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 UNLEADED If Subject to EPCRA, refer to instruCtions COMMON NAME GASOLINE 20? EHS* [] Yes [] No 2o8 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS lB 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-~Yes ~;~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 1 0,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219I STATE WASTE CODE 220 5,000I 10,000 N/AI N/A 221 DAYS ON SITE: 222 UNITS* []a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONS 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-7 230 ETHANOL 231 []yes [] No 232 64-17-5 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-83-3 241 5 242 243 []Yes [-INo 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 Q LEGEND WASTE ABSORBENT SITE MAP DATE' 01/10/01 (~) SEWER FLOOR DRAIN KERN COUNTY HAZARDDOUS MATERIAL DIVISION HAZZARDDOUS MATERIAL PLAN STORM DRAIN BUSINESS NAME: ARCO # 01960 SITE ADDRESS: 1701 BRUNDAGE LANE FIRE HYDRANTS & BAKERSFIELD, CA 93304 ~ CONNECTIONS A B C D E f G H I J ~ SPRINKLER SYSTEM ..... . .... VALVES FAMILY T : : : : I~ WISE ~ A,RCOND,T,ON,NGsHuTOFF 1 BARBER- ! ! ALL DAY MARKET i :: ~ BUYS ::... E[ECTR,CALS,UTOFF i i i i i ; 'i : ® [ i BRU~DAGELANE !i ~N:: ® EMERGENCYS.UTOFF 2 ~ : ( i.e. GAS PUMP } i .... :: -- DRIVEWAY .:- i DRIVEWAY: ~. f .i .! ................ i .... m ..... .2 ............... i ................ i ................. i .............. : .............. ::. .............. i .... m ........ i ................ PLAN /BUSSINESS PLAN i EYEWASHES ......................... i ~ '~' ~ ............... i ................ ~i ................ __i~/~. : .... * ' "'¢.~f~))' ' ' ?- ' i~r-"l ............ .~ I~' ........... ~'~ i! ................. ~ EQUIPMENT PERSONAL PROTECTIVE C~) 9¢ ! ! ! ~,'~.'"~ f~ I--' [ ~ MITIGATION EQUIPMENT FIRST AID EQUIPMENT .: , ( · . ~ · ~,,,,.~. ~ N)~- ~,g~/ · ,,a,,a .~ · .'"_~ -; < ............ : .................'..'r U~'l .......... ! ..........___~/-','~ '-,'-v;-'_ ...... ! .... .~ ...... : ............................... 5 U~ ~ ~ i J r.,..~..,~ i j ,~ ! =~ ! i ~1~ SENSORS OR PROBES LEAK DETECTOR ,.o ~¢ ."q-- : ~: : · : --., : : -- VEEDER ROOT '~! .......... '~ ............ 1~'~'~ ............ i ...... i~'" :: ~ ~...o.,~o~,~co.so,~ STORAGE TANK ,~ ~ + .~, ~ :: . i>_ i :: C--) UNDERGROUND ~.-~ :.;i~! ~_ i/-,.i~' :~ i1: i~< '.z i r~ oo~,ou,~,~^Sc~,,.~. ................. i.~ .......... ........... .',,'..:.x ......... :.k .... .,._.~.. ..... : ........ ................ :.> .............. h,' ............. i ................. ~ DISPENSER SHUTOFF i--i :-o::~' ~ ~ '-~~~x~ ~ ~> ~rr ~ ~ MOTORO,L ] < fy) i:< ] i/ m ] ] III III i . r'~ COMBUSTIBLE LIQUID ........... ::~ rm i~'~ill ............... " ................ ' ............... :~"~ ....... ' ................ 8'--- ,~ i '~ Z~ .~ L~: i ~] XXX~ CHAIN LINK FENCE i 055 TA O BEL RESIDE TIAL ~TRASHENOLOSURE ".~'STO R/~6 E '~ 0 ~ ~ ~ i i ~REST ROOM 9 ~ CASHIER ~ CONTAINER ~ ~ ~ ~ ~ ~ SCALE 1" = 35 Ft , ~ DIRECTION ARCO #01960 1701 BRUNDAGE LANE BAKERSFIELD, CA 93304 Hazardous Materials Business .Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Forms included in this package complies with forms/attachment required by the appropriate city or county under which the Unified Program Agency appl. ies. This Hazardous Materials Business Plan includes: ~]BUSINESS ACTIVITIES PAGE [~ BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE ~w~w~~c~ m~sPo~s~ CONTINGENCY PLAN ~HAZA~OUS MATEmALS INVENTORY LIST [~FACILITY SITE MAP UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of FACILITY ID# I I I ll I ] I I I I 1'[EPAID#(Hazard°uswasteOnly)CAL000244204 BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) ARCO # 01960 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 NOTE: If you check YES to any part of this list,. please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold [] YES [] NO 4. HAZARDOUS MATERIALS INVENTORY quantity for an extremely hazardous substance specified in 40 CFR Part -CHEMICAL DESCRIPTION (OES 2731) 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS ~IJSTs) UST FACILITY {For~ay sw~ca Form ^) 1. Own or operate underground storage tanks? [] YES [] NO 5. UST TANK (one oag, p*r tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? [] YES [] NO 6. UST FACILITY UST TANK (one p~r tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form c) 3. Need to report closing a UST? [] YES [] NO 7. UST TANK (clomr~ ponion - om pa~e per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or [] YES [] NO s. NO FORM REQUIRED TO GUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE EPA ID NUMBER - provide at the top of 1. Generate hazardous waste? [] YES [] NO 9. this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC {}25143.2)? [] ~ [] NO 10. 0erreeycler) 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE [] YES [] NO ~1. TREATMENT - FACILITY (Formeay OTSC Fortm 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page ocr unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by [] YES [] NO 12. CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? ASSURANCE (Formerly OTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE / CONSOLIDATION [] YES [] NO 13. SITE ANNUAL NOTIFICATION (Formeay DTSC Form 1196) 6. Need to report the closure/removal of a tank that was classified as [] YES [] NO 14. HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Fonn 1249) E. LOCAL REQUIREMENTS (You may also be required to provide additional information blt }'our CUPA or local allenc¥.) 15. UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION (Agency Use Only) ~i' ?~!i~:~ 01/01/2002 12/31/2002 BUSINESS NAME (same as FACILITY NAME or DBA - Doing Business As) 3. ] BUSINESS PHONE 102. ARCO # 01960 I 661-322-7213 BUSINESS SITE ADDRESS 1o3. 1701 BRUNDAGE LANE CITY lO4. CA Z~P CODE 1o5. BAKERSFIELD 93304 DUN & BRADSTREET 106. SIC CODE (4 digit #) 107. 03-959-6507 5541 COUNTY 108. BUSINESS OPERATOR NAME 1o~. I BUSINESS OPERATOR PHONE 11o. SURJ1T BISLA I 661-322-7213 OWNER NAME In, IOWNER PHONE n2. BP West Coast Products LLC I 714-670-5321 OW~mR MAmI~G nDD~.Y3S: BP West Coast Products LLC i13. P.O. BOX # 6038 CITY 114, [ STATE 11s. IZIP CODE 116. ARTESIA . J CA I 90702-6038 CONTACT NAME 117. [ CONTACT PHONE ns. MICHAEL D. WILSON 1 714-670=5321 CONTACT MAILING ADDRESS: BP West Coast Products LLC 119. P.O. BOX # 6038 CITY 120. ] STATE 121. I ZIP CODE 122. ARTESIA [ CA I 90702-6038 NAME ~23. NAME 128. SURJIT BISLA ARCO MISSION CONTROL TITLE 1~. TITLE FRACHISEE BUSINESS PHONE 125. BUSINESS PHONE 661-322-7213 800-272-6349 24-HOUR PHONE* 12~. 24-HOUR PHONE* H. 661-665-2394 800-272-6349 CELL: 661=496-3372 132. ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals respomible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. $IGNATUR~ ~~ERAT~ D~TATIVE DATE 134. I NAME OF DOCUMENT PR-EPARER 135. 11/15/2002 George Zoumalan, Rnmtox NAME OF SI(J~NER (~rint~ J ~ ~ 136. TITLE OF SIGNER 137. MICHAEL D. WILSON Environmental Specialist HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt 2. TYPE/PRINT ANSWERS IN ENGLISH 3~ Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: # 01960 LOCATION: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 MAILING ADDRESS: BP West Product Company LLC CITY: P.O. BOX# 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-322-7213 OWNER: SURJIT BISLA PHONE: 661-322-7213 MAILING ADDRESS: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS PHONE 24 HR PHONE 1. SURJIT BISLA FRANCHISEE 661-322-7213 H. 661-665-2394 CELL# 661-496-3372 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe Will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: In the event of minor to major spill, or fire, employee or owner will call 9-1-1 and local agency. Employees are trained for the use of personal protection equipment to minimize contact with hazardous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL P~SPONSE CENTER: 800-424-8802 BAKERSFIELD ENVIRONMENTAL HEALTH SERVICES: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: If a large release of gasoline spill or waste occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises bY the safest exit. All employees will be asked to assemble at a safe assembly area located at South side of the site, or at a safe upwind · location. Method of evacuation is verbal. Person responsible for notification is: NAME: SURJIT BISLA TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner, or store manager will call either 9-1-1, or may contact the closest medical/clinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 SECTION II RELEASE RESPONSE PLAN Emergency Procedures: Briefly describe your business standard operating procedures in the event of a release or threatened release of hazardous materials: 1. PREVENTION (prevent the hazard) - Describe the kinds of hazards associated with the hazardous materials present at your facility. What actions would your business take to prevent these hazards from occurring? You may include a discussion of safety and storage procedures. Gasoline spills can result in environmental contamination, fire, and explosion. Releases of gasoline can occur when underground storage tanks are overfilled, when motorists overfill vehicle tanks, or drive off. The releases are prevented by installed overfill devices such as flapper valves, high level alarms, or ball floats. Other spill prevention devices are impact valves, and breakaway devices. Service stations are attended by trained personnel, and gasoline is delivered by trained truck drivers. The on-site coordinator or designee will train all new employees of this facility about the procedures for safe handling of hazardous materials and products for emergency response coordination, and use of emergency response equipment and supplies. Additionally, the on-site coordinator or designee will conduct a refresher-training program for all employees on annual basis. PROCEDURE FOR STORAGE AND DISPOSAL OF HAZARDOUS MATERIALS & HAZARDOUS WASTE: Liquid CO2 cylinders must be secured to wall with chain (this applies for stations that serve soda in the store). Waste absorbent from the gasoline spill, cleanup spills, or used gasoline fuel filters must be stored in a proper UN (DOT) approved container with appropriate hazardous waste label on each container. Each drum or container containing hazardous Waste must be stored away from hot or ignition sources and disposed before 90 days from accumulation date. Each container must be kept closed with lid and disposed as hazardous waste and manifested. State manifests of hazardous waste must be kept for three years in compliance kit. The hazardous material handled on daily basis is gasoline. Hazards associated with this product are spill, leak, fire, and explosion. Fire Prevention procedures as follows: 1. The gasoline tanks are equipped with leak detectors that activate an alarm and disable the pump when leak Is detected. Few gas stations are equipped with over fill alarm that prevents the spillage of gasoline from over filling the tanks. 2. All the dispensers are equipped with impact valves. 3. DallyJnspection of leaks from the pipes, nozzles, and pumps. 4. Any leaks from above mentioned equipment will be fixed immediately. 5. Posting no smoking sign at the dispensers. 6. Monthly inspection of fire extinguishers to ensure that are full and ready to use. 7. Testing of the emergency shut offs located in front of the store. 8. Testing of dispensers' start/stop emergency shut off located on the cash register. 9. Testing the shut offs of turbine pumps. The on/off switch is on the main electrical panel. Gasoline spills will be cleaned-up immediately using absorbent material ~ 2. MITIGATION (reduce the h~ard) - Describe what is done to lethe harm or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? Mitigation (continued): In the event of a leak or spill: 1. Attendant should shut off electricity to the pumps/turbines at the main electrical panel and close the impact valves. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency and will contact ARCO MISSION CONTROL. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. There are two exits - front entrance and rear emergency exit. All persons will evacuate through one of these doors and gather in area furthest from danger. Manager on duty will account for all station personnel and customers (when possible). 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. (All spills will be reported to BP Mission Control at (800) 272-6349. The BP Environmental Compliance Specialist will make report to pertinent agencies Including NRC, CA OES, Water Board, and County Health Agency.) 3. If, neither gives such direction, call ARCO Mission Control for removal and disposal. In the event of a fire employees should: 1. Shout FIRE and call 911 (Fire Department). 2. Stop fluid flow by shutting off electricity to the pumps at the main electrical panels and close Impact valves. 3. Evacuate by stopping all traffic on site. and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer assistance, as requested. Additional mitigation procedures: Employees will be Informed of the health and safety hazards involved with the handling of hazardous materials such as gasoline. Employees will not smoke, light matches to cause a spark, or Ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUT OFF SWITCHES, HOW TO STOP LEAKS AT NOZZLES AND GAS ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILLS, 5) CALL 911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION. EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. 4. ABATEMENT (remove the hazard) - Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? 4 In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the absorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55-gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 2, Mitigation. Large spills are cleaned by BP designated contractors, or as designated by the franchisee for franchise service stations. Employee's responsibilities: Employees will know the location of the nearest storm drain(s) and location of absorbent material to be used to prevent the spill from reaching the storm drains. In the event of a major spill, employees are Instructed to call 911 and report. The on-site emergency coordinator will provide for the disposal of contaminated materials as directed by the local fire department or County Environmental Health. If neither gives such direction, call ARCO Mission Control (800-272-6349) for disposal. BUSINESS PLAN LOCATION: A copy of business plan and training documents will be kept at all times in a yellow compliance kit or a binder, which is located either near the cashier, or office in back room area. Following are the emergency equipment of this facili~: Item Use Location Maintenance Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE: NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: [~YES [~NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. PRIVATE FIRE PROTECTION D YES B. WATER AVAILABILITY (FIRE HYDRANT): N/A Emergency review of liquefied ( Cryogenic ) Carbon Dioxide Liquefied carbon dioxide is an extremely cold liquid/gas and is stored under high pressure in a gas cylinder. The small gas cylinders, containing 20 to 50 pounds of liquid carbon dioxide, must be stored upright and be firmly secured with chain to the wall. Those large cylinders (containers), which contain 200 to 400 pounds of liquid carbon dioxide, must be either chained or anchored to the floor. Securing the cylinder prevent falling or being knocked over. All the gas cylinder must be capped at all times and transported with drum cart. The extremely cold part of pipes and valves on top of the cylinder will cause moist flesh t°stick fast and tear when one attempts to withdraw from it. A leak will result in the formation of dry ice, and contact with dry ice, liquid carbon dioxide, or cold gas can cause frostbite to skin, eyes, and exposed tissues. Breathing low concentration of carbon dioxide can cause nausea, dizziness, mental confusion, and visual disturbance, shaking, headache, and respiratory problem. Liquid carbon dioxide has a high evaporation rate and when heated to above 52 Degree C (125 Degrees F) will generate high pressure. Store away from heat and ignition sources and out of direct sunlight. High temperature can generate high pressure in the tank/cylinder and cause rupture if the safe relief valve fails to operate. Do not store the container or cylinders where they come into contact with moisture. Response Plan for Carbon Dioxide Release Carbon dioxide is cold, asphyxiant, and powerful cerebral vasodilator gas. In the event of release, evacuate the store, and allow the liquid/gas carbon dioxide to evaporate and the gas to dissipate. Attempt to close the main source valve to stop the release is not recommended unless if is safe to do so and you have adequate personal protection gears. If the area must -be entered by emergency personnel, Self-Contained Breathing Apparatus (SCBA), Kevlar gloves, and appropriate foot and leg protection must be worn. · Response to Carbon Dioxide Release If there are signs of visible ice on the cylinder or parts such as pipes, it is a sign ora leak and needs to be reported to your manager immediately. In addition, the Facility Manager will contact their vendor immediately. In the event of a major release, call 911 and evacuate the store. Do not attempt to close the main source valve to stop the release. Emergency personnel such as trained fire fighters must wear special protective equipment to safely respond to a leaking CO2 cylinder. HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5 MATERIAL SAFETY DATA SHEETS ON FILE: MSDS and business emergency plan is located in the compliance binder, a yellow plastic box, located in the office area BRIEF SUMMARY OF TRAINING PROGRAM: Employees are trained on use of safety equipment and tools to minimize contact with hazardous materials/waste. Employees are trained and required to dial for emergency calls, 9-1-1, and evacuate the premises. Employees are trained in the use of spill clean up, first aid kit, fire extinguishers, electrical and gas shut off and use of telephones. Employees are trained to advise any response agency as to the nature and location of the problem. Initial training is conducted after hiring new employee. Trainer is the owner or manger of the store. Refresher training is done every year. Training topics are such as: 1) hazard communication program, 2) materials safety data sheets, 3) safe handling of chemicals, and 4)emergency equipment& emergency response plan. Employers are required by State law to have a program which provides employees with initial and refresher training. The Business Emergency Plan shall include a training program which is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. Training will be conducted upon hire, and refresher training provided at least annually. Hazardous Materials Handlinq & Emer.qency Response Trainin.q Will Include: 1. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards 2. Procedures for coordination with local emergency.response organizations; 3. Correct use of emergency response equipment and supplies under the control of the business 4. The Cai OSHA Hazard Communication Standards 5. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan 6. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain apPropriate emergency medical care 7. Procedures to coordinate with and assist the 'local emergency personnel that maY respond to your business 8. Who and how to call for immediate assistance in the event of'an accident involving hazardous materials 9. Procedure for ensuring that appropriate personnel receive initial and refresher training UST Equipment Operating and Monitorinq Traininq Will Include: 1. Take tank level measurements 2. Read dispenser meters 3. Inspect equipment 4. Recognize warning signs: dispenser hesitations, meter spins, and odors 5. Manually close dispenser impact valve 6. Replace dispenser filters 7. Shut down the system by knowing the location of electrical panel breakers and emergency shutoff switches 8. Test the electronic monitoring system 9. Respond to alarms, leaks, or equipment problems Personnel 1. Are there any specially trained hazardous materials emergency response personnel at your business? []YES [] NO 2. Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? [] YES [] NO 3. Do you have personnel that will provide site security at your business during and after a hazardous materials incident? [] YES [] NO Equipment List the type and location of equipment that can or will be used for response to hazardous materials incidents at your business: Absorbent, a shovel and a broom are located in or near the station supply room. All waste absorbent will be disposed of in a properly labeled hazardous materials drum. The On-Site Coordinator_or designee will train all new employees of this facility about the following procedures for the safOndling of hazardous materials, proceduJor emergency response coordination, and' use ot'~mergency response equipment and sup~l~s. Additionally, the On-Site coordinator or designee will conduct a refresher-training program for all employees on a semi-annual basis. PROCEDURES FOR SAFE HANDLING OF HAZARDOUS MATERIALS 1. Employees will be informed of the health and safety hazards involved with the handling of gasoline/diesel fuel. 2. Employees will be careful not to spill gasoline, diesel fuel, or waste oil onto themselves or the ground. 3. Employees will not smoke, light matches, cause sparks, or take actions which could ignite flammable liquids or vapors. PROCEDURES FOR EMERGENCY RESPONSE COORDINATION 1. Employees will be familiar with the emergency response procedures outlined in this Business Emergency Response Plan. 2. Employees will know the location and operation of electrical shutoff switches and dispenser shutoff valves. 3. Employees will know the location of, how and when to use dry chemical fire extinguishers that are located on the premises. 4. Employees will know the location and proper use of first aid kit(s), fire extinguisher(s), and absorbent materials that are located on the premises. 5. Employees will know the location of the nearest storm drain(s) and location of absorbent materials to be used to prevent spills reach the storm drain(s). 6. Employees will be familiar with the kinds of emergency situations which will warrant immediate evacuation of premises. Circumstances include: a. Any gasoline, diesel, or other type of fire. b. Any spill, fuel leak, or vapor leak that has the potential for igniting or exploding, c. Any spill or leak where employees or customers notice gasoline vapors. EMPLOYEE TRAINING RECORDS The BP manager, for BP store, or owner/operator (for franchisee) will be responsible for documenting and retaining the types and dates of the "training" that each facility employee has completed (initial and refresher). These documentation records will be retained at the facility for at least 5 years from the date an employee last worked at the facility. Upon completion of said instruction, employee will sign a statement of acknowledgment. One copy kept at the facility. TRAINING SUBJECTS: Training Topic - Procedures for handling hazardous materials, including hazardous wastes Persons Trained: Facility Staff (i.e. cashier, maintenance) Training.Time: 1/2 hour Refresher Frequency: Annually Training Content: For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment is provided at each facility. For major spillage, employees are instructed to call 911 and report. They will then notify the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Procedures for coordination with emergency response agencies Persons Trained: Facility Staff (i.e. cashier, Emergency Coordinator, Alternate) Training Time: 112 hour Refresher Frequency: Annually Training Content: Facility personnel are instructed to call 911 and report. They will then call the BP manager, for BP store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Use of emergency response equipment and materials under business' control Persons Trained: Facility Staff (i.e. cashier) Training Time: 112 hour Refresher Frequency: Annually Training Content: Use and location of absorbent, protective clean-up equipment, first aid kit and fire extinguishers. Review of procedures for proper use of safety and spill control equipment, evacuation and earthquake procedures. Training Topic - Emergency Response Plan implementation Persons Trained: Facility Staff (All Employees) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbent, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call tn. CERTIFICATION I, ~ MICHAEL D. WILSON 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 AND SAFETY CODE" ON .HAZ~OUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ENVIRONMENTAL SPECIALIST SIGNATURE TITLE DATE 10 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) ~'~ MATERIAL(NON-WASTE) ~] WASTE lone Da~e ~:)er material 10er building or area) I-lADD []DELETE []REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2ol I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO FACILITY ID # I ~ I I ~ I I I I MAP# (°pti°nal'1 of 1 2°3 GRID# (°pti°na"c-7 204 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 WASTE ABSORBENT , Subject to EPCRA, refer to instructions COMMON NAME WASTE ABSORBENT & DISPENSER FUEL FILTER 207 EHS* [] Yes [] No 208 CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 I 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) I--I a. PURE r'lb. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 55 (Check one item only) [] a. SOLID r-lb. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 25 55 55I 221 & 213 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 89-90 22s WASTE ABSORBENT & DISPENSER FUEL FILTER 227 [] Yes [] No 22e N/A, MIXTURE 229 2 230 231 []Yes [] No 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] NO 240 241 5 242 243 []Yes ENo 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.t% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) ]--I WASTE lone 13age per material per building or area) []ADD []DELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2o~ I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO FACILITY ID # 1 of 1 E 6 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 CARBON DIOXIDE if Subject to EPCRA, refer to Instructions COMMON NAME 207 EHS* [] Yes [] No 20e CAS# 124-38-9 209 *If EHS is ~Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 213 I-I.a~.ARDOUS MATERIAL TYPE (Check one item only) [] a. PURE Db. MIXTURE [] c. WASTE 211 RADIOACTIVE I-lYes []No 212 CURIES 215 PHYSICAL STATE 214 LARGEST CONTAINER 50 (Check one item only) I-I a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVER~,GE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 2~8 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 22o 50 100 N/AI N/A 22~ I DAYS ON SITE: 222 UNITS* Da. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 22? [] Yes [] No 226 124-38-9 22~ 2 230 231 []Yes [] No 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 241 5 242 243 []Yes I-INo 244 24s if more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carclnogentc, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) I-'-I WASTE ~one page per material per building or area) []ADD ['-IDELETE I~REVISE REPORTING YEAR 2002 2o0 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVESI (EPCRA) [] YES [] NO ~ ~ I i I I MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 1OF1 D-7 II, CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 2o6 MOTOR OIL , Subject to EPCRA. refer to instru~ons COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 207 EHS* [] Yes [] No 2os CAS# N/A 209 *If EHS is ~Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) COMMBUSTIBLE LIQUID 240 213 HAZARDOUS MATERIAL 211 RADIOACTIVE r'lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 0.25(ONE QUART) (Check one item only) [] a. SOLID I~lb. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 221 ~ DAYS ON SITE; 222 UNITS* []a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b, UNDERGROUND TANK [] f. CAN [] j. BAG [] n, PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 ~ LUBRICANT BASE OIL 22? [] Yes [] No 22s N/A, MIXTURE 22~ 2 5-6 23o ADDTIVES, ANTI-OXIDANT 234 []Yes [] No 232 N/A, MIXTURE 233 3 234 235 [] Yes [] No 23o 237 4 23e 239 []Yes [] No 24o 244 5 242 243 []Yes []No 244 245 If mom hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) r"l WASTE ~one ~a~e ~13er material ~)er buildin~ or areaI []ADD []DELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 20f I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO FACILITY ID # 1 OF1 F 3 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2os P RE M I U M ~f Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 20? EHS* [] Yes [] No 200 CAS# 8006-61-9 209 *If EHS is ~'es", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete tf required byCUPA) FLAMMABLE LIQUID, CLASS lB, UN1203 21o I 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE ~ 215 PHYSICAL STATE (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS 214 LARGEST CONTAINER 10,000 FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERA,GE DALLY AMOUNT 217 I MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT 2t9 I STATE WASTE CODE 220 5,000 1 0,000 N/A N/A 221 I DAYS ON SITE: 222 UNITS* I~a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 1-5 228 BENZENE 227 EYes []No 228 71-43-2 2~ 2 0-15 23o METHYL TERTIARY BUTYL ETHER (MTBE) 231 []Yes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 238 [] Yes [] No 236 1330-20-7 237 4 7-14 238 TOULENE 239 []Yes [] No 240 108-88-3 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by welgM If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) r'-I WASTE' ~one ~3a~e ~:)er matedal ~er building or area) []ADD []DELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA ) [] YES [] NO II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 UNLEADED . Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 2os CAS# 8006-61-9 2o~ *If EHS is 'Yes', all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B, UN1203 2fo 213 '{AZARDOUS MATERIAL 211 RADIOACTIVE []Yes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS 214 LARGEST CONTAINER 10,000 FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 5,000 10,000 N/A N/A 221 ] DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. POUNDS [] al. TONSI 365 (Check one item only) * If EHS. amount must be in pounds. STORAGE CONTAINER [] a, ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m, GLASS BO'I-I'LE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a, AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 =s BENZENE 22? []Yes []No 22s 71-43-2 22~ 2 0-15 230 METHYL .TERTIARY BUTYL ETHER 231 []Yes [] NO 232 1634-04-4 233 3 8-15 234 XYLENE 23~ [] Yes [] No 236 1330-20-7 23? 4 7-14 23s TOLUENE 239 []Yes [] No 240 108-83-3 5 242 243 []Yes []No 244 245 ff more hazardous components are present at greater than 1% by weight ff non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) I-~ WASTE Ions ~ave ~l:)er material ~er building or area) []ADD []DELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO FACILITY ID # I I ~[[~ [ ~ I I I 11MAP# (°pti°nal)l OF1 2°3 GRID# (°pti°nal)F 4 20~ ' II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 UN LEADED ~f Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 20? EHS* [] Yes [] No 2os CAS~ 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B 2f0 I 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE []b. MIXTURE [] c. WASTE ' 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 2,7 I MAXIMUM DAILY AMOUNT 2'8 ANNUAL WASTE AMOUNT 2,e I STATE WASTE CODE 2~o 5,000 10,000 N/A N/A 221 I DAYS ON SITE: 222 UNITS* I~a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 ~26' BENZENE 2~? [] Yes [] No 22s 71-43-2 ~ 2 0-15 230 METHYL TERTIARY BUTYL ETHER 23f []Yes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 23~ [] Yes [] No 238 1330-20-7 23? 4 7-14 23s TOLUENE 239 []Yes [] No 24o 108-83-3 24~ 5 242 243 []Yes ENo 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.'1% by weight If camlnogenlc, attach additional sheets of paper capturing the required Intonnaflon. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE Ions f)a~e ~er matedal ~er building or area) []ADD I--IDELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol ] CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGETANKI (EPCRA) [] YES [] NO 203 I GRID# (optional) 204 I G4 II, CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 2o6 U N LEAD ED . Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1 B 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE I-I c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID IR~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5,000[ 10,000 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a, ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM '[] m. GLASS BO'I-rLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC : 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EH$ CAS # 1 1-5 226 BENZENE 22? [] Yes [] No 22e 71-43-2 ~ 2 0-15 230 METHYL TERTIARY BUTYL ETHER ~3~ []Yes [] No 232 1634-04-4 233 3 8-15 23~ XYLENE 235 [] Yes [] No 230 1330-20-7 23? 4 7-14 230 TOLUENE 239 []Yes [] No 24o 108-83-3 241 5 242 243 []Yes E]No 244 245 If more hazardous components arc prcsent at greater than 1% by weight If non.carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 LI:,L.1 r_,l~,l IJ (~ WASTE ABSORBENT SITEMAP DATE: 01/10/01 (~) SEWER FLOOR DRAIN KERN COUNTY HAZARDDOUS MATERIAL DIVISION HAZZARDDOUS MATERIAL PLAN BUSINESS NAME: ARCO # 01960 SITE ADDRESS: 1701 BRUNDAGE LANE [~7~J STORMDRAIN FIRE HIDRANTS & BAKERSFIELD, CA 93304 .~. CONNECTIONS A B C D E F G H I J ~VALvEsSPRINKLER SYSTEM ; ; ; ; ; ; ; ; WISE ~ A,RCO.DIT~O"'NG FAMILY T ; = ; I~ ; SHUTOFF : : : : (J') ' : O ELECTRICAL SHUTOFF ~ BARBER- i i ALL DAY MARKET i i g BUYS i : i i : : i i -, DRU..G.S.~ GASSHUTOFF ........ s~.o., ......... ! ................ { ................ { ................ + ................ ! .............. .~....~...,~..~ ............. i ................. ® i i i BRU~DAGE LANE i! '~.--~--i i (~ WATER SHUTOFF (~ EMERGENCY SHUTOFF (I.e. GAS PUMP ) 2 i i DRIVEWAY i i DRIVEWAY -[ r: i ~ DISPENSER ISLAND ................ i .... ~i ..... .~ .............. i ................ ...' ......... .; ....... ~ ............. ~ .......................... i .... w ........................ F,RE~NGU'SHER : i ' · · ~ ! ~ : i j .~O~:~G~.~ . ...~__~.~.~' i~... ~ ~ ! ~ MSDS & CONTINGENCY PLAN / BUSSINESS PLAN ~ : : ~- ~. :"~ : : 3 [ (J"J ' i ' : '~'~' /' .~ ~. UJ · ~ ~~.,~.~)~.~['~ EYEWASHES .............. i .... ~ ..... ! ................ i ................ i~. ............ ~ ........ i ................ ^ " ! ~ t"f"'l ~ ' : H'." ~' '' .............. : ~I !: :!: .:~______~. _ %~ ~ ~..~,.~..~. i: ~ ~.?~/~:~. ~ * "~) i t"~ t'Y' . ~ "~'O ::i ~ [~ SPILL PERSONAL PROTECTIVE EQUIPMENT CONTAINMENT EQUIPMENT & ..~).:: : : ~/,,~,,,,~:,~ ¢ ~ ~ ! MITIGATION ~ i-, ...... F""_~ ....... ! ................ i ................. '~! ............ i ................ i'~ i:;~t ......... t ......... i I~1AREAEMERGENCY ASSEMBLY ~, : : i . ~ ' : : U~J ) ~ i i f..~ ~ i . ~ "r' ~ i ! ~1~ SENSORS OR PROBES 5 ~ ~; ~ ~ i ! · ~ ~ ~ i ~ LEAK DETECTOR ,.,~ ), : : : : ~ : ~) ! : i i ! ..................................'1~1' '/~'~ .......... T ~ ALARM CONSOLE [ ~ ~ .......... ~..~ ......... ~.~... ~.~ ..... ~ ...... ~...~ .......... ~ ............. ~ ............. { ................ ~ ~,s,,,s,,s,~,o~ 7 : ~ -- ~ ; < ~ ~ ~ / ~ ~ ~ ~ ~ ~ ( ~ ~ F~MM~LE LIQUID ~ < ~ ~ ~¢ ~ ~ ~ / ~ ~ ~ ~ ~ ~ ~ ~ ~ COMBUSTIBLE LIQUID ......................... ~., ......... ~ -~ ......... 1 '- .............. :- ................ ~ ............... ~"~ ....................... ~ 8 iD ~ i TA O BELd ~RESIDE T!AL ~ T~SHENOLOSURE ~=~~.~....~....'" . ........... ~.. · ~ ~ i ................ ~ ................. -.-~ / ~~ ~ [ ~ ~~ ................................................. [ ~ " ~ ~ ~ T~SH BIN REST ROOM . STO ~E , '~ ~ ~ ~ ~ o.s.,~. ~ CONTAINER ~ ~ SCALE 1" = 35 Ft , , , ~ DIREC~ON ARCO #01960 /,~ ,~/~ 1701 BRUNDAGE LANE BAKERSFIELD, CA 93304 ~ ~ Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Forms included in this package complies With forms/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: ~]BUSINESS ACTIVITIES PAGE BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE ~EMERGENCY RESPONSE /CONTINGENCY PLAN ~]HAZARDOUS MATERIALS INVENTORY LIST ~]FACILITY SITE MAP 1 ~'IED PROGRAM CONSOLIDATED FOR1V~~ FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of, :': . .:I, FACiL 'mENTWICATION ' ' ' ' ·: ·": · 'i BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) ARCO # 01960 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 i:. H. AC~TIES DECLARATION ' ~ . i ; ~ .~. "~.'i~ NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold [] YES [] NO 4. HAZARDOUS MATERIALS INVENTORY quantity for an extremely hazardous substance specified in 40 CFR Part -CHEMICAL DESCRIPTION (OES 2731) 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (LISTs) UST FACILITY (Formerly SWRCB Form A) 1. Own or operate underground storage tanks? [] YES [] NO s. UST TANK {one page mr taak) (Forr~r~ Form 2. Intend to upgrade existing or install new USTs? [] YES [] NO 6. UST FACILITY UST TANK (one mr tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page mr tank) (Formerly Form 3. Need to report closing a UST?. [] YES [] NO 7. UST TANK (ctos~ poraon- o,e page mr C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: --any tank capacity is greater than 660 gallons, or [] YES [] NO s. NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [] YES [] NO 9. EPA ID NUMBER - provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC §25143.2)? [] YES [] NO 10. p~ 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE [] YES [] NO 11. TREATMENT - FACILITY (Formerly DTSC Forms 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page mr unit) , (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by [] YES [] NO ::. CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? ASSURANCE (Form~ny DTSC Form :~) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE / CONSOLIDATION [] YES [] NO ~:. SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1196) 6. Need to report the closure/removal of a tank that was classified as [] YES [] NO ~4. HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formeay DTSC Form ~4~) E. LOCAL REQUIREMENTS (You may also be required to provide additional information by your CUPA or local agency.) 15. If y~ur cl~thez cn. tch fire... TOP DROPO R LL Bakersfield Fire Department Keeping Our Community Safe Day & Night! PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION ~'L -'IDE~CATION FACILITY ID # ~'~'~!' ' ~'~:~~ 1. BEGINNING DATE lOO. ENDING DATE IOi. II1 12/31/2002 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3. IBUSINESS PHONE 1o2. ARCO # 01960 [ 661-322-7213 BUSINESS SITE ADDRESS 1o3. 1701 BRUNDAGE LANE CITY 1o4. CA ZIP CODE lO5. BAKERSFIELD 93304 DUN & BRADSTREET 1o6. SIC CODE (4 digit #) lO~. 03-959-6507 5541 COUNTY lOS. BUSINESS OPERATOR NAME 1o~. BUSINESS OPERATOR PHONE I1O. SURJIT BISLA 661-322-7213 ' . ".i'i' ~ "':": i":.,: 'i 'ii:?~i'i::i~'~ ,i;~ ?i?~!il~ ,,,':'I!~:! BUSINESS oWNER ,~il .,..~ OWNER NAME ii1. OWNER PHONE 1 BP West coast Products LLC '/14-670-5321 OWNER MAILING ADDRESS: BP West coast Products LLC .113. P.O. BOX # 6038 CITY 114. [ STATE 115. [ ZIP CODE 116. ARTESIA ] CA ] 90702-6038 CONTACT NAME 117. J CONTACT PHONE 118. MICHEAL D. WILSON [ 714-670-5321 CONTACT MAILING ADDRESS: BP West coast Products LLC 119. P.O. BOX # 6038 CFFY 12o. ] STATE 121. ] ZIP CODE 122. ARTESIA ] CA ] 90702-6038 ~i': 'ir' NAME lZa. NAME 128. SURJIT BISLA ARCO MISSION CONTROL TITLE 124. TITLE 129. FRACHISEE BUSINESS PHONE 125. BUSINESS PHONE I30. 661--322--7213 800--272--6349 24-HOUR PHONE* 126. 24--HOUR PHONE* 131. H. 661--665--2394 800--272--6349 CELL: 661--496'3372 PAGER # 132. ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am familiar with the information submitted and believe the information is true, accurate, and complete. ' 04/10/2002 George Zoumalan, Ramtox NAMI~ OF SIGNER (print) 136. TITLE OF SIGNER 137. MICHEAL D. WILSON Environmental Specialist OFFICE oF ENVIRONM~NT~i~VI~¢ES: 1715 Chester Ave, Bakersfield, HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt 2. TYPE/PRINT ANSWERS IN ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. $. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the fi:ont of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: # 01960 LOCATION: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 MAILING ADDRESS: BP West Product Company LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-322-7213 OWNER: SURJIT BISLA PHONE: 661-322-7213 MAILING ADDRESS: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS PHONE 24 HR PHONE 1. SURJIT BISLA FRANCHISEE 661-322-7213 H. 661-665-2394 CELL# 661-496-3372 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 1 HAZARDOUS MATERIAL AGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: In the event of minor to major spill, or fire, employee or owner will call 9-1-1 and local agency. Employees are trained on the use of personal protection equipment to minimize contact with hazardous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD FIRE DEPARTMENT: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT AND EVACUATION PLAN: If a large release of gasoline spill or waste Occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises by the safest exit. All employees will be asked to assemble at a safe assembly area located at South West corner of the site, or at a safe upwind location. Method of evacuation is verbal. Person responsible for notification is: NAME: SURJIT BISLA TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner, or store manager will call either 9-1-1, or may contact the closest medical/clinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 HAZARDOUS MATERIALS~I~ANAGEMENT PLAN SECTION II DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: Gasoline in underground storage tank can over spill from the top of the fill pipes or leak in the ground and to the surface. Other source of leak/spill is from the dispenser unit, nozzles, and pipes. Potential of fire and explosion exist. If a leak is found the leak probe will sense the liquid release and will set off the alarm. Other hazard is carbon dioxide gas cylinders used for soda drinks. The carbon dioxide gas cylinders are secured by chains in back room. B. EMPLOYEE AND AGENCY NOTIFICATION: In the event of minor to major spill, or fire, employee or owner will call 9-1-1 and local agency. Employees are trained on the use of personal protection equipment to minimize contact with hazardous materials/waste. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 NATIONAL RESPONSE CENTER: 800-424-8802 BAKERSFIELD FIRE DEPARTMENT: 661-326- 3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT AND EVACUATION PLAN: If a large release of gasoline spill or waste occurs, the owner, or store manager, or employees will take immediate action to have all employees leave the premises by the safest exit. All employees will be asked to assemble at a safe assembly area located at South West corner of the site, or at a safe upwind location. Method of evacuation is verbal. Person responsible for notification is: NAME: SURJIT BISLA TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: For small injuries the owner or store manager will utilize the first aid kit box. For minor to major injuries, the owner, or store manager will call either 9-1-1, or may contact the closest medical/clinic center, which is located at: NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 'MITIGATION (reduce the hazard)- ~'~scribe what is done to lessen the I~arm or the damage to person(s), property, or the environment, and prevent what has occurred from getting worse or spreading. What is your immediate response to a leak, spill, fire, explosion, or airborne release at your business? Mitigation (continued): the event of a leak or spill: 1. Attendant should shut off electricity to the pumps/turbines at the main electrical panel and close the impact valves. 2. The on-site emergency coordinator or designee will contact 911 (Fire Department) and explain the emergency and will contact ARCO Maintenance. If necessary, the On-Site Emergency Coordinator or designee will request an ambulance or other medical assistance. 3. Evacuate. If deemed necessary by the On-Site Emergency Coordinator or designee, all traffic on site will be halted, area coned off, and all employees and customers will be directed to a safe area opposite the danger. There ars two exits - front entrance and rear emergency exit. All persons will evacuate through one of these doors and gather in area furthest from danger. Manager on duty will account for all station personnel and customers (when possible). 4. Contain the liquid by constructing berms and/or by covering the spill with a fireproof absorbent material. Prevent liquid from entering storm drains whenever possible. 5. Scene management shall be the responsibility of the On-Site Emergency Coordinator or designees until the arrival of fire or police personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer any assistance that is requested. 6. Immediately following an emergency the On-Site Emergency Coordinator will provide for the disposal of contaminated material as directed by the local Fire Department or County Health Agency. (All spills will be 'reported to BP Mission Control at (800) 272-6349. The BP Environmental Compliance Specialist will make report to pertinent agencies including NRC, CA OES, Water Board, and County Health Agency.) 3. If neither gives such direction, call ARCO Mission Control for removal and disposal. In the event of a fire employees should: 1. Shout FIRE and call 911 (Fire Department). 2. Stop fluid flow byshutting off electricity to the pumps at the main electrical panels and close impact valves. 3. Evacuate by stopping all traffic on site and direct all personnel and customers to a safe area opposite the danger. 4. Scene management is the responsibility of the On-Site Emergency Coordinator or designees until the arrival of public safety response personnel. Upon arrival of these personnel, the Emergency Coordinator will cooperate with and offer assistance, as requested. Additional mitigation procedures: Employees will be informed of the health and safety hazards involved with the handling of hazardous materials such as gasoline. Employees will not smoke, light matches to cause a spark, or ignite flammable liquids or vapors. Employees must know: 1) LOCATION OF EMERGENCY SHUT OFF SWITCHES, HOW TO STOP LEAKS AT NO77LES AND GAS ISLAND, 2) SHUT OFF PUMPS WHERE ELECTRICAL PANELS ARE LOCATED, 3) LOCATION OF FIRE EXTINGUISHERS, 4) USE OF ABSORBENT MATERIALS TO CONTAIN SMALL GASOLINE SPILLS, 5) CALL 911 IN THE EVENT OF A MAJOR SPILL, LEAK, FIRE, OR EXPLOSION. EMPLOYEES WILL BE FAMILIAR WITH THE EMERGENCY RESPONSE PROCEDURE AS OUTLINED IN THE BUSINESS EMERGENCY RESPONSE PLAN. ABATEMENT (remove the hazard) - Describe what you would do to stop and remove the hazard. How do you handle the complete process of stopping a release, cleaning up, and disposing of released materials at your facility? 4 In the event that a spill is small, station personnel should apply absorbent to the gasoline spill by sweeping the abSorbent onto the spill. Once the absorbent has soaked up the liquid, sweep up the absorbent and place it in a 55-gallon drum. If the spill is larger, call 911, attempt to contain it, and follow the scene management instructions in Section 2, Mitigation.~ Large spills are cleaned by PSI designated contractors, or as designated by the franchisee for franchise service stations. Employee's responsibilities: Employees will know the location of the nearest storm drain(s) and location of absorbent material to be used to prevent the spill from reaching the storm drains. In the event of a major spill, employees are instructed to call 911 and report. The on-site emergency coordinator will provide for the disposal of contaminated materials as directed by the local fire department or County Environmental Health. If neither gives such direction, call ARCO Mission Control (800-272-6349) for disposal. 4. BUSINESS PLAN LOCATION: A copy of business plan and training documents will be kept at all times in a yellow compliance kit or a binder, which is located either near the cashier, or office in back room area. v'onowlng are tne emergency equil }ment ox tnls iaClllty: ItemUse Location Maintenance Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE · NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: [-]YES [5~NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. PRIVATE FIRE PROTECTION [--1 YES [5;~NO B. WATER AVAILABILITY (FIRE HYDRANT)- ON THE CORNER OF STATE HWY 65 & 77TM RD. HAZARDOUS MATERIAL ANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5 MATERIAL SAFETY DATA SHEETS ON FILE: MSDS and business emergency plan is located in hazard communication kit, a yellow plastic box, located in the office area BRIEF SUMMARY OF TRAINING PROGRAM: Employees are trained on use of safety equipment and tools to minimize contact with hazardous materials/waste. Employees are trained and required to dial for emergency calls, 9-1-1, and evacuate the premises. Employees are trained in the use of spill clean up, first aid kit, fire extinguishers, electrical and gas shut off and use of telephones. Employees are trained to advise any response agency as to the nature and location of the problem. Initial training is conducted after hiring new empl°yee. Trainer is the owner or manger of the store. Refresher training is done every year. Training topics are such as: 1) hazard communication program 2) materials safety data sheets, 3) safe handling of chemicals, and 4) emergency equipment& emergency response plan. 6 Employers are required by State law to have a program which provides employees with initial and refresher training. The Business Emergency Plan shall include a training program which is reasonable and appropriate for the size of the business and the nature of the hazardous materials handled. The training program shall take into consideration the responsibilities of the employees to be trained. Training will be conducted upon hire, and refresher training provided at least annually. Hazardous Materials Handlinq & Emerqency Response Training Will Include: 1. Methods for the safe handling of hazardous materials stored at your business, including familiarity with the characteristics and hazards of each material and measures employees can take to protect themselves from chemical hazards 2. Procedures for coordination with local emergency response organizations; 3. Correct use of emergency response equipment and Supplies under the control of the business 4. The Cai OSHA Hazard Communication Standards 5. The prevention, abatement and mitigation procedures you have developed for your business and explained on the Business Emergency Plan 6. The emergency evacuation plans you have developed, the notification procedure used to alert people to evacuate, and the closest location to obtain appropriate emergency medical care ?. Procedures to coordinate with and assist the local emergency personnel that may respond to your business 8. Who and how to call for immediate assistance in the event of an accident involving hazardous materials g. Procedure for ensuring that appropriate personnel receive initial and refresher training UST Equipment Operating and Monitoring Traininq Will Include: 1. Take tank level measurements 2. Read dispenser meters 3. Inspect equipment 4. Recognize warning signs: dispenser hesitations, meter spins, and odors 5. Manually close dispenser impact valve 6. Replace dispenser filters 7. Shut down the system by knowing the location of electrical panel breakers and emergency shutoff switches 8. Test the electronic monitoring system g. Respond to alarms, leaks, or equipment problems I~; ~:: :,¥; !;:~ '~,;.:.ALL"EMPLQTEE ;T~;N!N.G SHALL~: BE .DOC'UM~ENTED AND :UEDATED Personnel 1. Are there any specially trained hazardous materials emergency response personnel at your business? []YES [] NO 2. Do you have decontamination capabilities for victims of exposure to hazardous materials at your business? []YES [] NO 3. Do you have personnel that will provide site security at your business during and after a hazardous materials incident? [] YES [] NO Equipment List the type and location of equipment that can or will be used for response to hazardous materials incidents at your business: .absorbent, a shovel and a broom are located in or near the station supply room. All waste absorbent will be disposed of in a properly labeled hazardous materials drum. 7 procedures for the safe h.~andling of hazardous materials, procedures_.~for emergency response coordination, and use c~l~ergency response equipment and sup~ Additionally, the On-Site coordinator or designee~lFill conduct a refresher-training program fo'P~ll employees on a semi-annual basis. PROCEDURES FOR SAFE HANDLING OF HAZARDOUS MATERIALS 1. Employees will be informed of the health and safety hazards involved with the handling of gasoline/diesel fuel. 2. Employees will be careful not to spill gasoline, diesel fuel, or waste oil onto themselves or the ground. 3. Employees will not smoke, light matches, cause sparks, or take actions which could ignite flammable liquids or vapors. PROCEDURES FOR EMERGENCY RESPONSE COORDINATION 1. Employees will be familiar with the emergency response procedures outlined in this Business Emergency Response Plan. 2. Employees will know the location and operation of electrical shutoff switches and dispenser shutoff valves. 3. Employees will know the location of, how and when to use dry chemical fire extinguishers that are located on the premises. 4. Employees will know the location and proper use of first aid kit(s), fire extinguisher(s), and absorbent materials that are located on the premises. 5. Employees will know the location of the nearest storm drain(s) and location of absorbent materials to be used to prevent spills reach the storm drain(s). 6. Employees will be familiar with the kinds of emergency situations which will warrant immediate evacuation of premises. Circumstances include: a. Any gasoline, diesel, or other type of fire. b. Any spill, fuel leak, or vapor leak that has the potential for igniting or exploding, c. Any spill or leak where employees or customers notice gasoline vapors. EMPLOYEE TRAINING RECORDS The PSI manager, for PSI store, or owner/operator (for franchisee) will be responsible for documenting and retaining the types and dates of the "training" that each facility employee has completed (initial and refresher). These documentation records will be retained at the facility for at least 5 years from the date an employee last worked at the facility. Upon completion of said instruction, employee will sign a statement of acknowledgment. One copy kept at the facility. TRAINING SUBJECTS: Training Topic - Procedures for handling hazardous materials, including hazardous wastes Persons Trained: Facility Staff (i.e. cashier, maintenance) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: For minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment is provided at each facility. For major spillage, employees are instructed to call 911 and report. They will then notify the PSI manager, for PSI store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Procedures for coordination with emergency response agencies Persons Trained: Facility Staff (i.e. cashier, Emergency Coordinator, Alternate) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Facility personnel are instructed to call 911 and report. They will then call the PSI manager, for PSI store, or owner/operator (for franchisee), or his/her alternate who will then activate the notification process. Training Topic - Use of emergency response equipment and materials under business' control Persons Trained: Facility Staff (i.e. cashier) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Use and location of absorbent, protective clean-up equipment, first aid kit and fire extinguishers. Review of procedures for proper use of safety and spill control equipment, evacuation and earthquake procedures. Training Topic - Emergency Response Plan implementation Persons Trained: Facility Staff (All Employees) Training Time: 1/2 hour Refresher Frequency: Annually Training Content: Review of Emergency Response Plan; evacuation procedures; location of emergency fuel shut-off switches and main electrical shut-off switch; use and location of absorbent, protective clean-up equipment and fire extinguishers; and the list of ALL pertinent people to call in. CERTIFICATION I, MICHEAL D. WILSON 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 AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. ~~... ~~:~ ENVIRONMENTAL SPECIALIST SIGNATURE TITLE DATE 9 .... UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [] WASTE lone ~Da~e ~er material ~er buildin~ or areal I-lADD I-IDELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 WASTE ABSORBENT . Subject to EPCP~ refer to COMMON NAME ABSORBENT WASTE 2o7 EHS* [] Yes [] No 2o8 CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Con~iete if required by CUPA) 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE i-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE · r'lb. MIXTURE ' [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 5 (Check one item only) [] a. SOLID I-lb. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) []a. FIRE I-lb. REACTIVE [] c. PRESSURE RELEASE []d. ACUTE HEALTH lie. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5 10 50I 221 221 I DAYS ON SITE: 222 UNITS* I~a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a, ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b, UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 100 226 MIXTURE OF WASTE OIL, HEAVY 227 [] Yes [] No 228 N/A, MIXTURE 229 PETROLEUM DISTILLATES AND SILICATES 2 230 231 I-lYes [] NO 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 241 5 242 243 I'lYes []No 244 245 if more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~ WASTE []ADD r-IDELETE I~REVISE REPORTING YEAR 2002 200 Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM I (EPCRA) [] YES [] NO FACILITY ID # 1OF1 E 6 I1. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 CARBON DIOXIDE . s~bi~ to EPCRA, ~e~to COMMON NAME 207 EHS* [] Yes [] No CAS# 124-38-9 ~o~ *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE' HAZARD CLASSES (complete if required by CUPA) 210 HAZARDOUS MATERIAL 213 TYPE (Check one item only) [] a. PURE I-lb. MIXTURE 1'3 c. WASTE 211 RADIOACTIVE I-lYes []No 212 CURIES PHYSICAL STATE 215 (Check one item only) [] a. SOLID l~b. LIQUID [] c. GAS 214 LARGEST CONTAINER 50 FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c, PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT50 217 ) MAXIMUM DAILY AMOUNT 200 218 ANNUAL WASTE AMOUNT N/A 219 [ STATE WASTE CODE N/A =o 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS r'lb. CUBIC FEET [] c. POUNDS [] d. TONS I 365 * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] Cm BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 22s CARBON DIOXIDE 227 [] Yes [] No 228 124-38-9 229 2 230 231 I--lYes [] No 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 241 5 242 243 []Yes E]No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Infom~tlon. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) ['-I WASTE ~one ~ave ~l:)er material ~:)er buildin~l or area1 I--lADD I'-IDELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 ] CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVESt (EPCRA) [] YES [] NO FACILITY ID # I ] I I I 1 MAP# (opt,one,) 1 OF1 203 I GRID# (optional) 204 I D-7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 MOTOR OIL , Subject to EPCRA, refer to instructions COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 20? EHS* [] Yes [] No 208 CAS~ N/A ~00 *If EHS is 'Yes', all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required byCUPA) COMMBUSTIBLE LIQUID 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE []Yes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b, MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 0.25(ONE QUART) (Check one item only) [] a, SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c, PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 22o 40 100 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 94-95 226 LUBRICANT BASE OIL 227 [] Yes [] No 22e N/A, MIXTURE 229 2 5-6 23o ADDTIVES, ANTI-OXIDANT 231 []Yes [] No 232 N/A, MIXTURE 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 241 5 242 243 []Yes []No 244 245 ff more hazardous components are present at greater than 1% by weight ff non-carcinogenic, or 0.1% by weight If carcinogenic, attach addltloeal sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 ..~ UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [-1 WASTE lone pa~e per matedal I~r building or area) I-lADD I-]DELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ~.RCO # 01960 CHEMICAL LOCATION 2or I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO ill IIII 203 I GRID# (optional) 204 I G4 I1. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 PREMIUM COMMON NAME GASOLINE 2o~ EHS* [] Yes [] No 20s CAS# 8006-61-9 2o9 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete If required by CUPA) FLAMMABLE LIQUID, CLASS lB, UN1203 2~0 I 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes []No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID I~b; LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a, FiRE [] b, REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 5~000 10,000 N/A N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS []b. CUBIC FEET [] c, POUNDS [] d. TONSI 365 (Check one item only) * If EHS. amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 1-5 226 BENZENE 227 [] Yes [] No 228 71-43-2 2 0-15 230 METHYL TERTIARY BUTYL ETHER (MTBE) 231 I-lYes [] NO 232 1634-04-4 233 3 8-15 234 XYLENE 23s [] Yes [] No 236 1330-20-7 237 4 7-14 238 TOULENE 239 I'lYes [] No 24o 108-88-3 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE lone Dele Der matedal Der buildin~ o~ area1 I-lADD [-IDELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2ol I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGETANKI (EPCRA) [] YES [] NO FACILITY ID # 1 OF1 F 3 II, CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 U N LF. AD E D , Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 2os CAS# 8006-61-9 209 *if EHS is 'Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS lB, UN1203 21o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Checl~ one item only) [] a. SOLID I~b.' LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) I~ a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 5,000 217 MAXIMUM DAILY AMOUNT 10,000 2'S I ANNUAL WASTE AMOUNT N/A 219 I STATE WASTE CODE N/A 220 22~ I DAYS ON SITE: 222 UNITS* []a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM I-I m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTrLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 [] Yes [] No 226 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 []Yes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 235 [] Yes [] No 236 1330-20-7 237 4 7-14 23a TOLUENE 239 I-lYes [] No 240 108-83-3 241 5 242 243 []Yes I-'lNo 244 245 If more hazardous components are present at greater than t% by weight If non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 -.~ UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste ( Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) r--I WASTE lone ~a~e f)er matedal ~:)er buildin~ or areal I-lADD I-]DELETE I~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol J CHEMICAL LOCATION CONFIDENTIAL 2o2 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO FACILITY ID #I~J~"~I;~U[::~-lJ:L~bi'i:J~¢~ ,,. I MAP#1oF1 (optional) 203 GRID#F 4 (optional) 204 II, CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 2o~ UNLEADED , Subject to EPCRA. refer to instructions COMMON NAME GASOLINE 2o? EHS* [] Yes [] No 2o8 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B HAZARDOUS MATERIAL J 213 TYPE (Check one item only) [] a. PURE 5;~b. MIXTURE [] c. WASTE 211 RADIOACTIVE []Yes I~No 212 CURIES I 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 {Check one item only) [] a. SOLID []b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT5~000 2171 MAXIMUM DAILY AMOUNT1 0,000 210 I ANNUAL WASTE AMOUNTN/A 219 I STATE WASTE CODEN/A ~20 221 J DAYS ON SITE: 222 UNITS* I~a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSJ 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 []Yes [] NO 232 1634-04-4 233 3 8-15 234 XYLENE 235 [] Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-83-3 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 v UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE lone Pe~e ~er matedal per buildin~ or areaI r']ADD F-IDELETE I~REVISE REPORTING YEAR 2002 2oo I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol ] CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO FACILITY ID # ~ 1OF1 G 4 II. CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 206 UNLEADED , Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 2o8 CAS# 8006-61-9 2o9 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B 2~o HAZARDOUS MATERIAL I 213 TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 2~ 1 RADIOACTIVE []Yes I~No 212 CURIES I 215 PHYSICAL STATE 2~4 .LARGEST CONTAINER 10,000 (Check one item only) D a. SOLID I~b. LtQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 1-5 =6 BENZENE 227 []Yes [] No 229 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 I-lYes [] NO 232 1634-04-4 2~ 3 8-15 2~ XYLENE 23s []Yes [] No 236 1330-20-7 23z 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-83-3 241 5 242 243 []Yes ['-]No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by ~neight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 LEGEND BUSINE88 NAME: ARCO FACILITY E~ 01980 8rrE ~ t701 BRUNDAGE LANE A B C D E F G H I J ~=cm.:r ..................... ; :~ ; i !' '"" :' ' LEGEND SITE MAP ~ B~BER- ~ ~ ~L D~Y ~ ~ ~ -- DR~AY ,~ ~, D~AY · ~ ~ · ~ ~ ~ · . : ~ . ~..... ?' West Coast Products ARCO #01960 1701 BRUNDAGE LANE BAKERSFIELD, CA 93304 HaZardous Materials Business Plan 1. FACILITY INFORMATION SECTION To be completed by all businesses, regardless of program type. Forms included in this package complies with forms/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: ~BUSINESS ACTIVITIES PAGE BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE ~EMERGENCY RESPONSE /CONTINGENCY PLAN ~HAZARDOUS MATERIALS INVENTORY LIST ~FACILITY SITE MAP UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of I. FACILITY IDENTIFICATION FACILITY ID # [ ] [ [ ] [ ] 1' EPA ID # (Hazard°us Waste Only)CAL000244204 2. BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3. ARCO # 01960 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 II. ACTIVITIES DECLARATION NOTE: If you checkYES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases HAZARDOUS MATERIALS INVENTORY (include liquids in ASTs and USTs); or the applicable Federal threshold [5~]YES [] NO 4. - CHEMICAL DESCRIPTION (OES 2731) quantity for an extremely hazardous substance specified in 40 CFR Part 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Formerly SWRCB FormA) 1. Own or operate underground storage tanks? [] YES [] NO 5. UST TANK (one page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? [] YES [] NO 6. UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) 3. Need to report closing a UST? [] YES [] NO 7. UST TANK {closure portion- one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or [] YES [] NO 8. NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [] YES [] NO 9. EPA ID NUMBER- provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC {}25143.2)? [] YES [] NO 10. p ..... ycler) 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE [] YES [] NO 11. TREATMENT - FACILITY (Formerly DTSC Forms 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by [] YES [] NO 12. CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE / CONSOLIDATION [] YES [] NO 13. SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1196) 6. Need to report the closure/removal of a tank that was classified as [] YES [] NO 14. HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS (You may also be required to provide additional information by your CUPA or local agency.) UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION P~ I. IDENTIFICATION (Agency Use Only) 11/01/2001 12/31/2002 BUSINESS NAME (Same as F^CIL[T¥ N^ME or 1913^ - 19oing Business ^s) 3.'I BUSINESS PHONE 102. ARCO # 01960 I 661-322-7213 BUSINESS SfTE ADDRESS 1o3. 1701 BRUNDAGE LANE CITY 1o4. CA ZlP CODE 1os. BAKERSFIEI,D 93304 DUN & BRADSTREET 106. SIC CODE (4 digit #) 03-959-6507 5541 COUNTY IO8. BuSINEsS OPERATOR NAME lO9. BUSINESS OPERATOR PHONE 1 lO. SURJIT BISLA 661-322-7213 Il. BUSINESS OWNER OWNERNAME I11. I OWNERPHONE 112. BP West coast Products LLC } 714-670-5402 OWNER MAILING ADDRESS: BP West coast Products LLC ~13. P.O. BOX # 6038 CITY 114. [ STATE 115. ZIP CODE 116. ARTESIA I CA 90702 III. ENVIRONMENTAL CONTACT CONTACT NAME 117. CONTACT PHONE 118. CARLOS RODRIGUEZ 714-670-5402 CONTACT MAILING ADDRESS: BP West coast Products LLC P.O. BOX # 6038 CITY 120. STATE 121. ZIP CODE 122. ARTESIA CA 90702 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123. NAME 128. SURJIT BISLA ARCO MISSION CONTROL TITLE 124. TITLE 129. FRACHISEE BUSINESS PHONE 125. BUSINESS PHONE 130. 661-322-7213 800-272-6349 24-HOUR PHONE* 126, 24-HOUR PHONE* 131. H. 661-665-2394 800-272-6349 PAGER # 132. ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am fapt~ar withe information subm~ a~e~e the information is true, accurate, and complete. SIGb/'ATI~REO~r~.WN~R/OPERAT~RD~e~[~4~ATj~.REPI3~ES~!~jffATIVE DATE 134. [ NAME OF DOCUMENT PREPARER 135. / ,~/']//~ ....~//~i~/'~.~.,g~, 11/01/2001 I George Zoumalan, Ramtox NA'lld'~{~l~'Sl~YL~l~(print) ~' ' ' ' 7 // 136. TITLE OF SIGNER 13'/. CARLOS RODRIGUEZ ' ~' Environmental Specialist OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt 2. TYPE/PRINT ANSWERS IN ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: # 01960 LOCATION: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 MAILING ADDRESS: BP West Product Company LLC CITY: P.O. BOX # 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-322-7213 OWNER: SURJIT BISLA PHONE: 661-322-7213 MAILING ADDRESS: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 EMERGENCY NOTIFICATION CONTACT TITLE BUSINESS PHONE 24 HR PHONE 1. SURJIT BISLA FRANCHISEE 661-322-7213 661-665-2394 H. 661-665-2394 2. ARCO MISSION CONTROL 800-272-6349 800-272-6349 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.1 DI VERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF THE FILL PIPES OR LEAK IN THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAK/SPILL IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT AND IF A LEAK IS FOUND THE LEAK PROBE WILL SENSE THE LIQUID RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS CO2 GAS CYLINDERS USED FOR SODA DRINKS. THE CO2 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. B. EMPLOYEE AND AGENCY NOTIFICATION: IN THE EVENT OF MINOR TO MAJOR SPILL, OR FIRE, EMPLOYEE OR OWNER WILL CALL 9-1-1 AND LOCAL AGENCY. EMPLOYEES ARE TRAINED ON THE USE OF SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/WASTE. OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 LOCAL OFFICE: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL EMPLOYEES LEAVE THE PREMISES BY THE SAFEST EXIT. ALL EMPLOYEES WILL BE ASKED TO ASSEMBLE AT A SAFE ASSEMBLY AREA LOCATED AT SOUTH SIDE OF MT. VERNON AVE., AT PARKING LOT OF HOLLYWOOD VIDEO, OR AT A SAFE UPWIND LOCATION. PERSON RESPONSIBLE FOR NOTIFICATION IS: NAME: SURJIT BISLA TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: FOR SMALL INJURIES THE OWNER OR STORE MANAGER WILL UTILIZE THE FIRST AID KIT BOX. FOR MINOR TO MAJOR INJURIES, THE OWNER, OR STORE MANAGER WILL CALL EITHER 9-1-1, OR MAY CONTACT THE CLOSEST MEDICAL/CLINIC CENTER, WHICH IS LOCATED AT NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 4,~i .~ SECTION 11.2: RELEASE RESPONSE PLAN A. HAZARD SSMENT AND PREVENTION MEASURES HAZARD ASSOCIATE TO THIS RETAIL GASOLINE STORE IS: GASOLINE, FLAMMABLE LIQUID, CLASS lB, UN120$ GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF FILL PIPE OR LEAK INTO OR ON THE GROUND AND TO TItE SURFACE. OTHER SOURCE OF LEAKS/SPILLS IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS ItAVE DOUBLE WALL CONTAINMENT, IF A LEAK IS FOUND, THE LEAK PROBE WILL SENSE THE LIQUID RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS CO2 GAS CYLINDERS USED FOR SODA DRINKS. THE CO2 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. B. RELEASE CONTAINMENT AND/OR MITIGATION IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL EMPLOYEES LEAVE THE PREMISES BY THE SAFEST EXIT. ALL EMPLOYESS WILL BE ASKED TO ASSEMBLE AT SOUTH SIDE OF MT. VERNON AVE., AT PARKING LOT OF HOLLYWOOD VIDEO. FOR SMALL FIRE, OWNER OR EMPLOYEE WILL USE PORTABLE FIRE EXTINGUISHER. FOR SMALL SPILL, OWNER OR EMPLOYEE, WILL USE ABSORBENT MATERIAL FOR MAJOR SPILLS OR LEAKS, CALL ARCO MISSION CONTROL: 800-272-6349 C. CLEAN UP AND RECOVERY PROCEDURES THE OWNER OR MANAGER WILL MAKE SURE THAT ELECTRIC POWER AND NATURAL GAS ARE TURNED OFF AND THAT ALL EMPLOYEES WILL BE EVACUATED FROM THE PREMISES. OWNER WILL SHUT DOWN THE WHOLE OPERATION OF GASOLINE PUMP BY PRESSING THE EMERGENCY SHUT OFF PUMPS LOCATED EITHER AT THE CASHIER OR OUTSIDE AND WILL SHUT OFF TURBINES CIRCUIT BREAKER LOCATED AT THE ELECTRICAL PANEL AREA. HAZARDOUS WASTE FROM SPILL CONTAINMENT WILL BE DISPOSED BY CALLING ARCO MISSION CONTROL: 800-272-6349 Following are the emergency equipment of this facility: Item Use Location Maintenance Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE · NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: [--]YES [5~NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. PRIVATE FIRE PROTECTION ~] YES [5~]NO B. WATER AVAILABILITY (FIRE HYDRANT)' N/A 3 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES ARE ABOUT 5 MATERIAL SAFETY DATA SHEETS ON FILE: MSDS AND BUSINESS EMERGENCY PLAN IS LOCATED IN HAZARD COMMUNICATION KIT, A YELLOW PLASTIC BOX, LOCATED IN THE OFFICE AREA BRIEF SUMMARY OF TRAINING PROGRAM:. EMPLOYEES ARE TRAINED ON USE OF SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/WASTE. EMPLOYEES ARE TRAINED AND REQUIRED TO DIAL FOR EMERGENCY CALLS, ESPECIALLY 9-1-1, AND EVACUATE THE PREMISES. EMPLOYEES ARE TRAINED IN THE USE OF SPILL CLEAN UP SUPPLIES, FIRST AID KITS, AND FIRE EXTINGUISHERS, ELECTRICAL AND GAS SHUT OFF AND USE OF TELEPHONES. EMPLOYEES ARE TRAINED TO ADVISE ANY RESPONSE AGENCY AS TO THE NATURE AND LOCATION OF THE PROBLEM. INITIAL TRAINING IS CONDUCTED AFTER HIRING NEW EMPLOYEE. TRAINER IS THE OWNER OR MANGER OF THE STORE. REFRESHER TRAINING IS DONE EVERY YEAR. TRAINING TOPICS ARE SUCH AS: 1) HAZARD COMMUNICATION PROGRAM 2) MATERIALS SAFETY DATA SHEETS, 3) SAFE HANDLING OF CHEMICALS, AND 4). EMERGENCY EQUIPMENT& EMERGENCY RESPONSE PLAN. CERTIFICATION I, CARLOS L. RODRIGUEZ 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 AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT · INACCURATE INFORMATION CONSTITUTES PERJURY. ENVIRONMENTAL SPECIALIST SIGNATURE TITLE -"- UNiFiED PROGRAM (UP) FORM -- HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~ WASTE []ADD []DELETE []REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM (EPCRA) [] YES [] NO FACiLitY ID # 1 OF1 E-7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 WASTE ABSORBENT If Subject to EPCRA, refer to instructions COMMON NAME ABSORBENT WASTE 20? EHS* [] Yes [] No 208 CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL 213 TYPE (Check one item only) [] a. PURE []b. MIXTURE [] c. WASTE 211 RADIOACTIVE r'lYes []No 212 CURIES PHYSICAL STATE 215 (Check one item only) [] a. SOLID Db. LIQUID · [] c. GAS 214 LARGEST CONTAINER 5 FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5J 10 50 221 221 J DAYS ON SITE: 222 UNITS* []a. GALLONS r'lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * if EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b, UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d, STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE I~ a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 MIXTURE OF WASTE OIL, HEAVY PETROLEUM DISTILLATES AND SILICATES 227 [] Yes [] No 228 N/A, MIXTURE 229 2 230 231 []Yes [] NO 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 r'lYes [] No 240 5 242 243 []Yes r-lNo 244 245 If more hazardous components are present at greater than 1 Yo by weight If non-carcinogenic, or 0.'1% by weight if carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [] WASTE Ione ~a~e ~er material ~er building or areal ['-lADD I-]DELETE ~]REVISE REPORTING YEAR 2002 2o0 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 [ CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 CARBON DIOXIDE If Subject to EPCRA, refer to instructions COMMON NAME 207 EHS* [] Yes [] No 200 CAS# 124-38-9 2o9 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 213 HAZARDOUS MATERIAL TYPE (Check one item only) [] a. PURE I-lb. MIXTURE [] c. WASTE 211 RADIOACTIVE l-lYes []No 212 CURIES PHYSICAL STATE 215 214 LARGEST CONTAINER 50 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that epply) [] a. FiRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 50 200 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS r-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only/ * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTiC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a, AMBIENT [] b, ABOVE AMBIENT [] c, BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b, ABOVE AMBIENT [] c. BELOW AMBIENT [] d, CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 22z []Yes [] No 226 124-38-9 229 2 230 231 []Yes [] No 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 24~ 5 242 243 []Yes []No 244 245 if more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 24~ HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION - Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE Ione pa~e per material per building or area> I-lADD [-IDELETE [~REVlSE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANK ' (EPCRA) [] YES [] NO 1 MAP# (optional) 203 GRID# (optional) 204 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 M IDG PADE If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B 21o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 1 0,000 (Check one item only) [] a. SOLID I~]b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] 'c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 I ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5,000 10,000I N/AI N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [~ q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] J. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # I 1-5 226 BENZENE 227 [] Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 []Yes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-88-3 241 5 242 243 []Yes r-]No 244 245 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0,1% by weight if carcinogenic, attach additional sheets of paper capturing the required information, ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) E~ WASTE Ione j~a~e per material per building or area) J-lADD I'-JDELETE []REVISE REPORTING YEAR 2002 2oo J Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 2Ol J CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVESI (EPCRA) [] YES [] NO I [ [ ~ 1 i MAP# (optional) 2o3 GRID# (optionat) 204 FACILITY ID # 1 OF1 D-7 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 MOTOR OIL if Subject to EPCRA, refer to instructions COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 20? EHS* [] Yes [] No 208 CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (CompLete if required by CUPA) COMMBUSTIBLE LIQUID 21o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes []No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 0.25(ONE QUART) (Check one item only) [] a. SOLID []b. LIQUID [] c. GAS · FED HAZARD CATEGORIES 216 (Check ail that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 J STATE WASTE CODE 220 40 100. N/AJ N/A 221 J DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. I~OUNDS [] d. TONSI 365 (Check one item only) * if EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 226 LUBRICANT BASE OIL 22? [] Yes [] No · 228 N/A, MIXTURE 229 2 5-6 230 ADDTIVES, ANTI-OXIDANT 231 []Yes [] No 232 N/A, MIXTURE 233 3 234 235 [] Yes [] No 236 237 4 238 239 E]Yes [] No 240 241 5 242 243 I-lYes []No 244 245 if more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDI'I:IONAL LOCALLY COLLECTED INFORMATION 246 '~'"' UNIFIED PROGRAM (UP) FORM w HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) '[] MATERIAL(NON-WASTE) [] WASTE tone pa~e per material per building or area) I--lADD [-IDELETE []REVISE REPORTING YEAR 2002 2o0 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 [ CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKJ (EPCRA) [] YES [] NO II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 PREMIUM If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 20? EHS* [] Yes [] No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1 B, UN1203 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE r-lYes []No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE PHYSICAL STATE 215 (Check one item only) [] a. SOLID 1~3b. LIQUID [] c. GAS 214 LARGEST CONTAINER 10,000 FED HAZARD CATEGORIES 216 (Check ail that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 221 / DAYS ON SITE: 222 UNITS* []a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1~5 228 BENZENE 22? []Yes [] No 228 71-43-2 229 2 0o15 230 METHYL TERTIARY BUTYL ETHER (MTBE) 23~ []Yes [] NO 232 1634-04-4 233 3 8-15 234 XYLENE 23s []Yes [] No 236 1330-20-7 23z 4 7-14 238 TOULENE 239 []Yes [] No 240 108-88-3 244 5 242 243 []Yes []No 244 245 If more hazardous cemponer~ts are present at greater th~n 1 Y~ by weight if ~o~t-carcinoge~ic, or 0.1 Y~ by weight if carcinogenic, attach additional sheets of paper capturing the required ~ information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 "-" UNIFIED PROGRAM (UP) FORM -- HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~] WASTE I-lADD [-IDELETE [~REVISE REPORTING YEAR 2002 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANK (EPCRA) [] YES [] NO II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 UNLEADED ~f Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS lB, UN1203 21o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID [~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5,000 10,000 N/A N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 []Yes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 23? 4 7-14 230 TOLUENE 239 []Yes [] No 240 108-83-3 241 5 242 243 []Yes []No 244 If more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 · ~' UNIFIED PROGRAM (UP) FORM '" HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE lone J:)a~le j3er material per building or area) J--lADD I--IDELETE J~]REVISE REPORTING YEAR 2002 200 J Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO :: ] : I MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 1OF1 F 4 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 UN LEADED If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 206 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B 21o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes []No 212 CURIES TYPE (Check one item only) [] a. PURE IR]b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 216 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5,000 1 0,000 N/A N/A 221 I DAYS ON SITE: 222 UNITS* l~3a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS ' CAS # 1 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 []Yes [] NO 232 1634-04-4 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-83-3 241 5 242 243 I-lYes []No 244 245 if more hazardous components are present at greater than 1% by weight if non-carcinogenic, or 0,1 Ye by weight if carcinogenic, attach additional sheets of paper capturing the required Information, ADDITIONAL LOCALLY COLLECTED INFORMATION 246 SITE MAP DATE: 01/10/01 BUSINESS NAME: ARCO FACILrrY ID~ 019~0 8TTE ADDRE88:1701 BRUNDAGE ^ · c o E F G H , FAMILY T i i i i ! i c~ WISE 'BARBER- i i ALL DAY MARKET ) i &. BUYS : ~ ~ ! i i :: · ....... ,,~pN .......... i ................. i .................. ~ ................. i ................. ! ................ ~'"z" ~ :: ........... ~i ~ i BRUNDAGE .I..ANE ! .~_~_ i : !i -- D~AY ~. -..." DRIVE?AY~ ~i ................ /i-'"'~- ...... ~ ............... ~ .................. ~ ................. ~ ....... ~,::;~ .............. i-i .............. i .... H,' ........ ............... ._ .... ...... __ ................................. ............. ................ ........ · ~.~ ............ ~ .................. ~1~! .......... ~ .......... ~~ ...... . +~ ..... .~ ....... ~ ................. · ~'~ ......... :~ ............ /~ ........... ) ............... i ................. i g ~ ...... ....... ................. , ~ ~ :;~ : . : ~ : ................. ~.~ ........ ~...~..~ ........... .O ~ .......... ~C .... ~.~ ..... ~ ..... ~ ................. ~ ............ · .............. ~ ., J~un-l_3-gO01 OS:glpm From-O'MELVENY L^I/Z +Z134308407 T-O00 - P.DOl/O03 F-2rr O'Melveny & Myers LLP 400 South Hope S~reet Los Augeles, CA 90071-2899 FAX TRANSMITTAL TO: William Car~er, Esq. - Office of the U.S. Attorney F: 213-894-6436 T: 213-894-3547 Joseph Johns, Esq. - Office of the U.S. Attorney F: 213-894~6436 T: 213-894-4536 Kathleen I. Giles - Fed. Bureau of Investigation F: 310-996-4482 T: 310-477-6565 Ron E. Modjeski - U.S, Env. Prox. Agency F: 626-583-7533 T: 626-583-7528 S. Robert Tice-Raskin, Esq..- Office of the U.S. Attorney F: 916-554-2900 T: 916-554-2700 Maureen K. O'Mara - U.S. Env. Prot. Agency F: 916-930-2287 T: 916-930-2281 Leslie Al£ord - Water Resources Crrl. Bd. F: 916-341-5808 T: 916-341-5810 Amy Green, Joe Canas - Kern County CUPA F: 661-862-8701 T: 661-862-8700 Steve Underwood - Bakersfield City CUPA F: 661-326-0576 T: 661-326-3979 FROM: Jim Asperger- O'Melveny & Myers, LLP T: 213-430-644 If you did not receive all pages, please call Ruth de la Rosa at 213-430-6336, or our fax department at ~ 13-430-6357. Jun-13-2001 O.~:21pm From-O'MELVENY MYERSLLP LA1/2 +213430540? T-O00 PmO02/O03 F-Z~T 0 O'MELVENY & MYEKS LLP c~'~ ~ crl~ ~oo Sou~h Hope Str~I ~.~m~C'l'O~. ~ c I~vINF. ~pI-'C'I'gL~M [,O~ Angeles, California 9oo7~-:8~t~ hO~C ~oNc Jmae 13, 2001 VIA FACSIMILE (213) 894-6436 ~, jasperger~o~ Willt~ C~, Esq. Assis~ U.S. Attorney Public Co~pxion ~d Gove~en~ Fraud Section ~os~ph Jo~s, Esq. Assist~t U.S. Anomey Office of the U.S. Ano~ey 312 No~h Sp~ng Street Los ~geles, Calitbm~a 90012 Re: ARCO IYorlc on Underground Storage Tank $pstems Dear Bill and Joe: Pursuant to our agreement, this letter provides notice that ARCO is going to perform work at the following site. On Monday, June ! 8, 2001, at 6:00 a.m., .M~.CO will begin constructi°n at the following site: ARCO Station No. 1960 1701 Brundage Lane ~ "H" Street Bakersfield, Califorrfia 93304 Project: Dispensers and Pan Replacement Contractor: Kern Construction 805-634-9950 We expect that the scope of work will include zhe cutting of asphalt or concrete, Jun-13-ZOOl OE:22pm lFrom-O'~ECVENY LA1/Z +Z134306407 T-O00 P.OO3/OD3 Wflhasn Car~¢r, ~sq. az~cl J'oscph Johns. £sq., Jau~ 13, 2001 - P~ge 2 Please give me a call if you have any questions. Very truly 'yours, es R. Asperger ~f O'MELVENY & MYERS LLP cc: Kathleeu ]. Giles Ron E. Modjesk~ S. Robert Tice-Raskin, Esq. Maureen K. O'Mara Leslie Alford ~my Oreen .Toe Canas Steve Under'wood JRA:bmv I. A2 5~1032 ~ ARCO FACILITY ID# 01960 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 ARCO PRODUCTS COMPANY ARCO FACILITY ID# 01960 Hazardous Materials Business Plan 1. FACILITY INFORMATION SECTION ARCO FACILITY ID# 01960 170!~BRUNDAGE LN. BAKERSFIELD, CA 93304 To be completed by all businesses, regardless of program type. Forms included in this package complies with forms/attachment required by the appropriate city or county under which the Unified Program Agency applies. This Hazardous Materials Business Plan includes: ~BUSINESS ACTIVITIES PAGE ~] BUSINESS OWNER/OPERATOR IDENTIFICATION PAGE ~~~c¥ m~s~,o~s~ /CONTINGENCY PLAN ~;~HAZARDOUS MATERIALS INVENTORY LIST ~;~FACILITY SITE MAP ~ UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS ACTIVITIES Page 1 of__ I. FACILITY IDENTIFICATION FACILITY ID # [ [ 1' I EPA ID # (Hazard°us Waste Only)CAL000032515 2. BUSINESS NAME (Same as Facility Name or DBA - Doing Business As) 3. ARCO AMPM STORE ID # 01960, 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 II. ACTIVITIES DECLARATION NOTE: If you check YES to any part of this list, please submit the Business Owner/Operator Identification page (OES Form 2730). Does your facility... If Yes, please complete these pages of the UPCF... A. HAZARDOUS MATERIALS Have on site (for any purpose) hazardous materials at or above 55 gallons for liquids, 500 pounds for solids, or 200 cubic feet for compressed gases (include liquids in ASTs and USTs); or the applicable Federal threshold [] YES [] NO 4. HAZARDOUS MATERIALS INVENTORY quantity for an extremely hazardous substance specified in 40 CFR Part -CHEMICAL DESCRIPTION (OES 2731) 355, Appendix A or B; or handle radiological materials in quantities for which an emergency plan is required pursuant to 10 CFR Parts 30, 40 or 70? B. UNDERGROUND STORAGE TANKS (USTs) UST FACILITY (Form6rly SWRCB Form A) 1. Own or operate underground storage tanks? [] YES [] NO 5. UST TANK (one page per tank) (Formerly Form B) 2. Intend to upgrade existing or install new USTs? [] YES [] NO 6. UST FACILITY UST TANK (one per tank) UST INSTALLATION - CERTIFICATE OF COMPLIANCE (one page per tank) (Formerly Form C) 3. Need to report closing a UST? [] YES [] NO 7. UST TANK (ctosure ponion - one page per tank) C. ABOVE GROUND PETROLEUM STORAGE TANKS (ASTs) Own or operate ASTs above these thresholds: ---any tank capacity is greater than 660 gallons, or [] YES [] NO 8. NO FORM REQUIRED TO CUPAs ---the total capacity for the facility is greater than 1,320 gallons? D. HAZARDOUS WASTE 1. Generate hazardous waste? [] YES [] NO 9. EPA ID NUMBER - provide at the top of this page 2. Recycle more than 100 kg/month of excluded or exempted recyclable RECYCLABLE MATERIALS REPORT (one materials (per H&SC §25143.2)? [] YES [] NO lO. per recycler) 3. Treat hazardous waste on site? ONSITE HAZARDOUS WASTE [] YES [] NO 11. TREATMENT - FACILITY (Formerly DTSC Forms 1772) ONSITE HAZARDOUS WASTE TREATMENT - UNIT (one page per unit) (Formerly DTSC Forms 1772 A,B,C,D and L) 4. Treatment subject to financial assurance requirements (for Permit by [] YES [] NO 12. CERTIFICATION OF FINANCIAL Rule and Conditional Authorization)? ASSURANCE (Formerly DTSC Form 1232) 5. Consolidate hazardous waste generated at a remote site? REMOTE WASTE / CONSOLIDATION [] YES [] NO 13. SITE ANNUAL NOTIFICATION (Formerly DTSC Form 1196) 6. Need to report the closure/removal of a tank that was classified as [] YES [] NO 14. HAZARDOUS WASTE TANK CLOSURE hazardous waste and cleaned onsite? CERTIFICATION (Formerly DTSC Form 1249) E. LOCAL REQUIREMENTS (You may also be required to provide additional information by your CUPA 6r local agency.) 15. UNIFIED PROGRAM CONSOLIDATED FORM FACILITY INFORMATION BUSINESS OWNER/OPERATOR IDENTIFICATION I. IDENTIFICATION FACILITY ID # 1. BEGINNING DATE lOO. I ENDING DATE lol. (Agency Use Only) 01/01/2001 I 01/01/2002 BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3. [ BUSINESS PHONE 102. ARCO AMPM STORE , FACILITY ID # 01960 I 661-322o7213 BUSINESS SITE ADDRESS lO3. 1701 BRUNDAGE LANE CITY lO4. CA ZIP CODE lO5. BAKERSFIELD 93304 DUN & BRADSTREET 1o6. SIC CODE (4 digit #) lO7. 18-314-5036 5541 COUNTY lo8. KERN BUSINESS OPERATOR NAME 1o9. BUSINESS OPERATOR PHONE SURJIT BISLA 661-322-7213 II. BUSINESS OWNER OWNER NAME 111. OWNER PHONE 112. ARCO PRODUCTS COMPANY ~ 714-670-5402 OWNER MAILING ADDRESS , 113. P.O. BOX # 6038 CITY 114. I STATE 115. { ZIP CODE 116. ARTESIA Ica 1 90702 III. ENVIRONMENTAL CONTACT CONTACT NAME 117. CONTACT PHONE 118. CARLOS RODRIGUEZ 714-670-5402 CONTACT MAILING ADDRESS 119. ARCO PRODUCTS COMPANY, P.O. BOX # 6038 CITY 12o. STATE 121. ZIP CODE 122. ARTESIA CA 90702 -PRIMARY- IV. EMERGENCY CONTACTS -SECONDARY- NAME 123. NAME 128. SURJIT BISLA MARIA SALAZAR TITLE 124. TITLE 129. FRACHISEE MANAGER BUSINESS PHONE 125. BUSINESS PHONE 661-322-7213 661-322-7213 24-HOUR PHONE* 126. 24-HOUR PHONE* 131. H. 665-2394 H.. 661-325-5795 PAGER # 661-636-3242 t27. PAGER # 132. CELL # 661-809-7821 ADDITIONAL LOCALLY COLLECTED INFORMATION: 133. Certification: Based on my inquiry of those individuals responsible for obtaining the information, I certify under penalty of law that I have personally examined and am fa~iar vd,ith the information submitted and believe the ilfformation is true, accurate, and complete. ( ~./JL{i~ &,.~ t~.tg~/~/~#/2,~ 01/26/Ol I George/Sarkiss Zoumalan NAM'~Oi~SIG-I~ER (print) ' - [ d~ ' 136. TITLE OF SIGNER 137. CARLOS RODRIGUEZ Environmental Specialist, ARCO · "; " CITY OF BAKERSFIELD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., Bakersfield, CA (661) 326-3979 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt 2. TYPE/PRINT ANSWERS IN'ENGLISH 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. 5. You may also attach Business Owner/Operator Form and Chemical Description Form(s) to the front of this plan instead of completing SECTION I below for initial submission. SECTION I BUSINESS IDENTIFICATION BUSINESS NAME: ARCO AMPM STORE ID # 01960 LOCATION: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 MAILING ADDRESS: ARCO PRODUCTS COMPANY CITY: P.O. BOX# 6038 STATE: CA ZIP: 90702 PRIMARY ACTIVITY: GASOLINE RETAIL STATION & MIN MARKET PHONE: 661-322-7213 OWNER: SURJIT BISLA PHONE: 661-322-7213 MAILING ADDRESS: 1701 BRUNDAGE LN. BAKERSFIELD, CA 93304 EMERGENCY NOTIFICATION CONTACT TITLE BUS. PHONE 24 HR PHONE 1. SURJIT BISLA FRANCHISEE 661-322-7213 661-665-2394 PAGER 661-636-3242 CELL 661-809-7821 2. MARIA SALAZAR MANAGER 661-322-7213 661-325-5795 HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION II.1 DISCOVERY AND NOTIFICATIONS A. LEAK DETECTION AND MONITORING PROCEDURES: GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF THE FILL PIPES OR LEAK IN THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAK/SPILL IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT IF A LEAK IS FOUND THE LEAK PROBE WILL SENSE THE VAPOR RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS CO2 GAS CYLINDERS USED FOR SODA DRINKS. THE CO2 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. LEAKS ARE DETECTED BY VEEDER-ROOT TANK MONITOR CONSOLE. THIS MONITOR ALSO HAS ABILITY TO DETECT LEAKS USING A VAPOR SENSOR WHICH IS LOCATED IN ANNULAR SPACING OF THE DOUBLE WALL TANK. ONCE SENSOR DETECTS LEAKS OF GASOLINE OF TANKS, THE ALARM GOES OFF. B. EMPLOYEE AND AGENCY NOTIFICATION: IN THE EVENT OF MINOR TO MAJOR SPILL, LEAK, FIRE & EXPLOSION EMPLOYEE, OR OWNER, WILL CALL 9-1-1 AND LOCAL AGENCY. EMPLOYEES ARE TRAINED ON THE USE OF ANY REQUIRED SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/WASTE. EMPLOYEES ARE TRAINED TO REQUIRED EMERGENCY CALLS, ESPECIALLY 9-1-1 .OFFICE OF EMERGENCY SERVICE: 1-800-852-7550 LOCAL OFFICE: 661-326-3979 C. ENVIRONMENTAL RESPONSE MANAGEMENT: IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL PERSONS LEAVE THE PREMISES BY THE SAFEST EXIT. ALL PERSONS WILL BE ASKED TO ASSEMBLE AT A SAFE ASSEMBLY AREA LOCATED AT THE SOUTH SIDE OF TACO BELL'S DRIVEWAY, OR AT A SAFE UPWIND LOCATION. PERSON RESPONSIBLE FOR NOTIFICATION IS: NAME: SURJIT BISLA TITLE: FRANCHISEE D. EMERGENCY MEDICAL PLAN: FOR SMALL INJURIES THE OWNER OR STORE MANAGER WILL UTILIZE THE FIRST AID KIT BOX. FOR MINOR TO MAJOR INJURIES, THE OWNER, OR STORE MANAGER WILL CALL EITHER 9-1-1, OR MAY CONTACT THE CLOSEST MEDICAL/CLINIC CENTER WHICH IS LOCATED AT NAME OF THE HOSPITAL & TELEPHONE NUMBER: MERCY HOSPITAL 2215 TRUXTUM AVE. BAKERSFIELD, CA 93301 TEL: 661-632-5000 2 SECTION 11.2: RELEASE RESPONSE PLAN A. HAZARD ASSESSMENT AND PREVENTION MEASURES HAZARD ASSOCIATE TO THIS RETAIL GASOLINE STORE IS: GASOLINE, FLAMMABLE LIQUID, CLASS lB, UN1203 GASOLINE IN UNDERGROUND STORAGE TANK CAN OVER SPILL FROM THE TOP OF FILL PIPE OR LEAK INTO OR ON THE GROUND AND TO THE SURFACE. OTHER SOURCE OF LEAKS/SPILLS IS FROM THE DISPENSER UNIT, NOZZLES, AND PIPES. POTENTIAL OF FIRE AND EXPLOSION EXIST. ALL THE UNDERGROUND STORAGE TANKS HAVE DOUBLE WALL CONTAINMENT, IF A LEAK IS FOUND, THE LEAK PROBE WILL SENSE THE VAPOR RELEASE AND WILL SET OFF THE ALARM. OTHER HAZARD IS CO2 GAS CYLINDERS USED FOR SODA DRINKS. THE CO2 GAS CYLINDERS ARE SECURED BY CHAINS IN BACK ROOM. B. RELEASE CONTAINMENT AND/OR MITIGATION IF A LARGE RELEASE OF GASOLINE SPILL OR WASTE OCCURS, THE OWNER, OR STORE MANAGER, OR EMPLOYEES WILL TAKE IMMEDIATE ACTION TO HAVE ALL PERSONS LEAVE THE PREMISES BY THE SAFEST EXIT. PERSON WILL BE ASKED TO ASSEMBLE AT THE SOUTH SIDE OF TACO BELL'S DRIVEWAY. FOR SMALL FIRE , OWNER OR EMPLOYEE WILL USE PORTABLE FIRE EXTINGUISHER. FOR SMALL SPILL, OWNER OR EMPLOYEE, WILL USE ABSORBENT MATERIAL FOR MAJOR SPILLS OR LEAKS, A CLEAN UP COMPANY WILL BE CALLED. NAME OF THE COMPANY IS INDUSTRIAL WASTE UTILIZATION: 805-925-0391 C. CLEAN-UP AND RECOVERY PROCEDURES IN CASE OF EMERGENCY, THE OWNER OR MANAGER WILL MAKE SURE THAT ELECTRIC POWER AND NATURAL GAS ARE TURNED OFF AND THAT ALL PERSONS ARE EVACUATED FROM THE PREMISES. OWNER WILL SHUT DOWN THE WHOLE OPERATION OF GASOLINE PUMP BY PRESSING THE EMERGENCY SHUT OFF PUMPS LOCATED EITHER AT THE CASHIER OR OUTSIDE AND WILL SHUT OFF TURBINES CIRCUIT BREAKER LOCATED AT THE ELECTRICAL PANEL AREA. HAZARDOUS WASTE FROM SPILL CONTAINMENT WILL BE DISPOSED BY INDUSTRIAL WASTE UTILIZATION: TEL# 805-925-0391 v ollowlng are me emergency equil ~ment oi mis iaclnty: Item Use Location Maintenance Fire extinguisher Fire Control Entrance & kitchen area Yearly Service Spill absorbent Spill Control Back room/Supply room Re-stock as needed First Aid Kit Minor Injury Inside office or cashier Inventory twice a year UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY) NATURAL GAS/PROPANE · NO ELECTRICAL: ELECTRICAL PANEL IN THE BACK ROOM WATER: SIDE WALK SPECIAL: LOCK BOX: [--]YES I~NO IF YES, LOCATION: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: FIRE EXTINGUISHERS LOCATED AT ENTRANCE DOOR, INSIDE THE STORE, AND IN THE KITCHEN AREA A. PRIVATE FIRE PROTECTION [] YES []NO B. WATER AVAILABILITY (FIRE HYDRANT). N/A HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION III: TRAINING NUMBER OF EMPLOYEES: 1-2 PERSONS PER SHIFT, THERE ARE THREE SHIFTS AND TOTAL EMPLOYEES AREA ABOUT 5-7. MATERIAL SAFETY DATA SHEETS ON FILE: MSDS AND BUSINESS EMERGENCY PLAN IS LOCATED IN HAZARD COMMUNICATION KIT, A YELLOW PLASTIC BOX, LOCATED IN THE OFFICE AREA BRIEF SUMMARY OF TRAINING PROGRAM: EMPLOYEES ARE TRAINED ON THE USE OF ANY REQUIRED SAFETY EQUIPMENT AND TOOLS TO MINIMIZE CONTACT WITH HAZARDOUS MATERIALS/WASTE. EMPLOYEES ARE TRAINED AND REQUIRED TO DIAL FOR EMERGENCY CALLS, ESPECIALLY 9-1-1, AND EVACUATE THE PREMISES. EMPLOYEES ARE TRAINED IN THE USE OF SPILL CLEAN UP SUPPLIES, FIRST AID KITS, AND FIRE EXTINGUISHERS, ELECTRICAL AND GAS SHUT OFF AND USE OF TELEPHONES. EMPLOYEES ARE TRAINED TO ADVISE ANY RESPONSE AGENCY AS TO THE NATURE AND LOCATION OF THE PROBLEM. INITIAL TRAINING IS CONDUCTED AFTER HIRING NEW PERSON. TRAINER IS THE OWNER OR MANGER OF THE STORE. REFRESHER TRAINING IS DONE EVERY YEAR. TRAINING TOPICS ARE SUCH AS: 1) HAZARD COMMUNICATION PROGRAM 2) MATERIALS SAFETY DATA SHEETS, 3) SAFE HANDLING OF CHEMICALS, AND 4) EMERGENCY EQUIPMENT EMERGENCY PLAN CERTIFICATION I, CARLOS L. RODRIGUEZ 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 AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIV.20 CHAPTER 6.95 SEC. 25500 ET AL.) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY. &~J~ ENVIRONMENTAL SPECIALIST t~Ott SIGNATURE ~ TITLE Employee Training Program Check all boxes which apply. 1. Personnel are trained in the following procedures: Internal alarm/notification: Only VERBAL Evacuation/re-entry procedures & assembly point locations X, Emergency incident reporting X External emergency response organization notification X Location(s) and contents of Emergency Response/Contingency Plan Facility evacuation drills, which are conducted at least one time per year 2. Chemical Handlers are additionally trained in the following: [~ Safe methods for handling and storage of hazardous materials ~ ?cation(s) and proper use of fire and spill control equipment IXI Spill procedures/emergency procedures ~ Proper use of personal protective equipment I I Specific hazard(s) of each chemical to which they may be exposed, including routes of exposure (i.e. inhalation, ingestion, absorption) * ['-I Hazardous ~¢~aste. Handlers/Managers .are trained in all aspects of hazardous waste management specific to their job duties (e.g. container accumulation time requirements, labeling requirements, storage area inspect[on requirements, manifesting requirements, etc.) * 3. Emergency Response Team Members are capable of and engaged in the following: [---] ,P, ersonnel rescue procedures: CALL 911 Il I Shutdown of operations I I Liaison with responding agencies Ill Use, maintenance, and replacement of'emergency response equipment I I Reti'esher training~ which is provided at least annually * I I Emergency response drills, which are conducted at leas yearly basis J. Recordkeeping: 1. Check all boxes which apply. The following records are maintained at the facility. [Note: Items marked with an asterts[c (*) are required.7: ~ Current employees; training records (to be retained until closure o['the [acility) I ~ Former employees training records (to be retained at least three years'alter termination o['employmen0 I/d Training Prog/:am(s) (i. e. written description oJ'introductory and continuing training)J bund in hazmat yellow ~ox, I ~ 'Current copy of this Emergency Response/Contingency Plan stored at cashier area or office area I/xl Record of'recordable/reportable hazardous material/waste releases I ~ Record of hazardous material/waste storage area inspections I~ Record of hazardous waste tank daily inspections I / Description and documentation of facility emergency response drills ~ dote: The above list of'records does not necessarily identify every type oJ'record required to be maintained by the factTity. A copy of the Inspection Check Sheet (s) or .Log(s) used in co_rtjunction with required routine self- inspections of your facility must be submitted ~w~th your HMBP. (Exception:, _A/vailable from y~our local.agency is a Hazardous Materials/Waste Storage Area Inspection Form that you may.use ~t you do not already have your own form. If you use the example provided, you do not need to attach a copy.) Check the appropn'ate box: Ii--] We will use the" Hazardous Material//Waste Storage Area Inspection Form" (Document No. UN-023) to document inspection [] We will use our own documents to record inspections. ( A blank copy of each document used must be attached to this HMBP.) INSPECTION LOG INSPECTION DATE OBSERVATION CORRECTIVE ITEM & ACTIONS TIME TAKEN AND DATE Hazardous materials storage area: Leaks, containers stored closed, secondary containment intact; labeled Hazardous waste storage area: Leaks, containers stored closed; secondary containment intact; accumulation date; hazardous waste label Safety equipment:Adequate supplies; broken or missing; out of date Monitoring equipment:Tested; working properly;Not in alarm condition Emergency Equipment:Adequate supplies; broken or missing; out of date Security and containment:Tested regularly; no breaches in fence; NFPA placard at entrance; storage of haz. Wastes and materials secure UNIFIED PROGRAM (UP) FORM ' HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~ WASTE Ione pa~e ~er material per building or area) r-]ADD r-]DELETE [~REVlSE REPORTING YEAR 20o I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO AMPM STORE , FACILITY II) # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 INSIDE THE GARAGE AND OUTSIDE YARDI (EPCRA) [] YES [] NO FACILITY ID Ct 1OF1 G 6 II. CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 206 WASTE ABSORBENT If Subject to EPCRA, refer to instructions COMMON NAME ABSORBENT WASTE 207 EHS* [] Yes [] No 2o8 CAS# N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by CUPA) 210 HAZARDOUS MATERIAL 213 TYPE (Check one item only) [] a. PURE I-lb. MIXTURE [] c. WASTE 211 RADIOACTIVE []Yes [~No 212 CURIES PHYSICAL STATE 215 (Check one item only) [] a. SOLID []b. LIQUID [] c. GAS 214 LARGEST CONTAINER 5 FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 22", I DAYS ON SITE: 222 UNITS* []a. GALLONS I-lb. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM r-I h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 MIXTURE OF WASTE OIL, HEAVY 227 []Yes [] No 228 N/A, MIXTURE 229 PETROLEUM DISTILLATES AND SILICATES 2 230 231 []Yes [] No 232 233 3 23,~ 235 [] Yes [] No 236 237 4 238 239 []Yes [] No 240 5 242 243 []Yes []No 244 245 if more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0,1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) E~] WASTE Ione ~3a?e per material ~er building or area) ['-~ADD [-IDELETE I~REVISE REPORTING YEAR 200 [ Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO AMPM STORE , FACILITY ID # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOMI (EPCRA) [] YES [] NO I GRID# (optional) 204 E6 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 CARBON DIOXIDE If Subject to EPCRA, refer to instructions COMMON NAME 207 EHS* [] Yes [] No 20s CAS# 124-38-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) 210 HAZARDOUS MATERIAL 2~1 RADIOACTIVE []Yes l~No 212 CURIES TYPE (Check one item only) [] a. PURE []b. MIXTURE [] c. WASTE PHYSICAL STATE 215 (Check one item only) [] a. SOLID []b. LIQUID [] c. GAS 214 LARGEST CONTAINER ' 83 FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 I MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 166I 250 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* I-la. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h, SILO [] I. CYLINDER [] p, TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c, BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 100 226 CARBON DIOXIDE 227 []Yes [] No 228 124-38-9 229 2 230 231 []Yes [] No 232 233 3 234 235 [] Yes [] No 236 237 4 238 239 r-]Yes [] No 240 241 5 242 243 []Yes []No 244 245 if more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM ' HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) ~--1 WASTE Ione [~a~e [~er material [~er building or area) I--lADD [-IDELETE [5~IREVISE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO AMPM STORE, FACILITY ID # 01960 CHEMICAL LOCATION 2ol [ CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 M IDG RAD E ~f Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1 B 21o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes []No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 10,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 I MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5,000I 10,000 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 []Yes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] NO 240 108-88-3 24~ 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required Information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 UNIFIED PROGRAM (UP) FORM HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [--I WASTE lone ~a~e per material per buildin~ or area) I--lADD [-IDELETE []REVISE REPORTING YEAR 2oo I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO AMPM STORE, FACILITY ID # 01960 CHEMICAL LOCATION 201 CHEMICAL LOCATION CONFIDENTIAL 202 BACK ROOM OR FRONT SHELVES (EPCRA) [] YES [] NO FACILITY ID CtI I I 1OF1 D 6 II. CHEMICAL INFORMATION CHEMICAL NAME 2o5 TRADE SECRET [] Yes [] No 206 M OTC R O I L .. if Subject to EPCRA, refer to instructions COMMON NAME ENGINE OIL, LUBRICANT MOTOR OIL 207 EHS* [] Yes [] No 208 CASCt N/A 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) COMMBUSTIBLE LIQUID 210 213 HAZARDOUS MATERIAL 211 RADIOACTIVE []Yes I~No 212 CURIES TYPE (Check one item only) [] a. PURE []b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER .25(ONE QUART) (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 I ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 40 300I N/A N/A 22'~ DAYS ON SITE: 222 UNITS* []a. GALLONS r~b. CUBIC FEET [] c. POUNDS [] d. TONS 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] ¢. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 94-95 226 LUBRICANT BASE OIL 227 [] Yes [] No 228 N/A, MIXTURE 229 2 5-6 230 ADDTIVES, ANTI-OXIDANT 23~ []Yes [] NO 232 N/A, MIXTURE 233 3 234 235 [] Yes [] No 236 237 4 238 239 I-lYes [] No 240 241 5 242 243 []Yes r-lNo 244 245 If more hazardous components are present at greater than 1 Yo by weight if non-carcinogenic, or 0.1 '~ by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 ~' UNIFIED PROGRAM (UP) FORM ~ HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) r-~ WASTE lone page per material per building or area) I-lADD r-IDELETE [~REVISE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO AMPM STORE, FACILITY ID # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO I J 1 MAP# (optional) 203 GRID# (optional) 204 FACILITY ID # 1OF1 G 4 II, CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 PREMIUM If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 20? EHS* [] Yes [] No 2o8 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B, UN1203 2~o 213 HAZARDOUS MATERIAL 211 RADIOACTIVE r']Yes I~No 212 CURIES TYPE (Check one item only) [] a. PURE [~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 1 0,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DAILY AMOUNT 211 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 5,000 1 0,000 N/A N/A 221 J DAYS ON SITE: 222 UNITS* []a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSJ 365 (Check one item only) * if EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX . [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 [] Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER (MTBE) 23~ []Yes [] NO 232 1634-04-4 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 237 4 7-14 238 TOULENE 239 []Yes [] No 240 108-88-3 241 5 242 243 []Yes []No 244 245 If more hazardous components are present at greater than I Yo by weight If non-carcinogenic, or 0,1 Yo by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 ~ UNIFIED PROGRAM (UP) FORM ~ HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [~ WASTE Ione ~a~e per material per building or area) I--lADD [-~DELETE []REVISE REPORTING YEAR 2ooI Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA- Doing Business As) 3 ARCO AMPM STORE, FACILITY ID # 01960 CHEMICAL LOCATION 201 I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANKI (EPCRA) [] YES [] NO 203 I GRID# (optional) 204 I F3 I1. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 206 U N LEAD ED if Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 208 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required byCUPA) FLAMMABLE LIQUID, CLASS 1 B, UN1203 213 HAZARDOUS MATERIAL 211 RADIOACTIVE []Yes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 1 0,000 (Check one item only) [] a. SOLID I~b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH AVERAGE DALLY AMOUNT 217 I MAXIMUM DALLY AMOUNT 218 ANNUAL WASTE AMOUNT 219 I STATE WASTE CODE 220 5,000I 10,000 N/AI N/A 221 I DAYS ON SITE: 222 UNITS* I~la. GALLONS Db. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTIC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK INSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO [] I. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 I-lYes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 235 []Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] NO 240 108-83-3 5 242 243 [-]Yes r-]No 244 245 if more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0,1% by weight If carcinogenic, attach additional sheets of paper capturing the required information, ADDITIONAL LOCALLY COLLECTED INFORMATION 246 · UNIFIED PROGRAM (UP) FORM ~ HAZARDOUS MATERIALS INVENTORY FORM - CHEMICAL DESCRIPTION Indicate material OR waste (Do not combine material and waste on one form) [] MATERIAL(NON-WASTE) [-'] WASTE lone ~a~e ~er material ~er building or' area) I--~ADD I-'~DELETE (~REVISE REPORTING YEAR 200 I Page of I. FACILITY INFORMATION BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 ARCO AMPM STORE , FACII,ITY ID # 01960 CHEMICAL LOCATION 2Ol I CHEMICAL LOCATION CONFIDENTIAL 202 UNDERGROUND STORAGE TANK[ (EPCRA) [] YES [] NO 203 I GRID# (optional) 204 FACILITYI F 4 II. CHEMICAL INFORMATION CHEMICAL NAME 205 TRADE SECRET [] Yes [] No 2o6 U N LEAD E D If Subject to EPCRA, refer to instructions COMMON NAME GASOLINE 207 EHS* [] Yes [] No 2o8 CAS# 8006-61-9 209 *If EHS is "Yes", all amounts below must be in lbs. FIRE CODE HAZARD CLASSES (Complete if required by CUPA) FLAMMABLE LIQUID, CLASS 1 B 240 213 HAZARDOUS MATERIAL 211 RADIOACTIVE I-lYes I~No 212 CURIES TYPE (Check one item only) [] a. PURE I~b. MIXTURE [] c. WASTE 215 PHYSICAL STATE 214 LARGEST CONTAINER 1 0,000 (Check one item only) [] a. SOLID []b. LIQUID [] c. GAS FED HAZARD CATEGORIES 216 (Check all that apply) [] a. FIRE [] b. REACTIVE [] c. PRESSURE RELEASE [] d. ACUTE HEALTH [] e. CHRONIC HEALTH 221 I DAYS ON SITE: 222 UNITS* []a. GALLONS []b. CUBIC FEET [] c. POUNDS [] d. TONSI 365 (Check one item only) * If EHS, amount must be in pounds. STORAGE CONTAINER [] a. ABOVE GROUND TANK [] e. PLASTiC/NONMETALLIC DRUM [] i. FIBER DRUM [] m. GLASS BOTTLE [] q. RAIL CAR [] b. UNDERGROUND TANK [] f. CAN [] j. BAG [] n. PLASTIC BOTTLE [] r. OTHER [] c. TANK iNSIDE BUILDING [] g. CARBOY [] k. BOX [] o. TOTE BIN [] d. STEEL DRUM [] h. SILO J-] J. CYLINDER [] p. TANK WAGON 223 STORAGE PRESSURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT 224 STORAGE TEMPERATURE [] a. AMBIENT [] b. ABOVE AMBIENT [] c. BELOW AMBIENT [] d. CRYOGENIC 225 %WT HAZARDOUS COMPONENT (For mixture or waste only) EHS CAS # 1 1-5 226 BENZENE 227 []Yes [] No 228 71-43-2 229 2 0-15 230 METHYL TERTIARY BUTYL ETHER 231 I-lYes [] No 232 1634-04-4 233 3 8-15 234 XYLENE 235 [] Yes [] No 236 1330-20-7 237 4 7-14 238 TOLUENE 239 []Yes [] No 240 108-83-3 ~"~ 5 242 243 I--lYes []No 244 245 If more hazardous components are present at greater than 1% by weight If non-carcinogenic, or 0.1% by weight If carcinogenic, attach additional sheets of paper capturing the required information. ADDITIONAL LOCALLY COLLECTED INFORMATION 246 BRUNDAGE LANE AM PM #1960 '~ SiteID: 015-021-000417 Manager : BusPhone: (310) 407-2606 Location: 1701 BRUNDAGE LN Map : 102 CommHaz : Low City : BkKERSFIELD Grid: 36D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:5541 EPA Numb: DunnBrad:51-012-0715 Emergency Contact / Title Emergency Contact / Title BISLASURJIT / OWNER TIRATH K BISLAY / MANAGER Business Phone: (805) 322-7213x Business Phone: (805) 322-7213x 24-Hour Phone : (~'~5~-I5~ev~, 24-Hour Phone : (805) -~:~L~x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact : Phone: ( ) - x MailAddr: PO BOX 6038 State: CA City : ARTESIA Zip : 907026038 Owner ARCO PRODUCTS CO Phone: (714) 670-5404x Address : PO BOX 6038 State: CA City : ARTESIA Zip : 907026038 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: !, %-'~,3\~ ~\%L.~ Do hereby certify thru I have (Type or pdn~ name) reviewed the a~ached hazardous materials manage. any ~rr~tions c~titu-[~ a complete and coffec~ man- agemen~ plan for my facility. 1 10/13/2000 BRUNDAGE LANE AM PM #1960 SiteID: 015-021-000417 STORAGE CONTAINER DATA (UST FORM A) Last Action Type: FACILITY/SITE INFORMATION Business Name: BRUNDAGE LANE AM PM #1960 Cross Street : Business Type: Org Type: Total Tanks : 4 IndnRes/Trust: No PA Contact: PROPERTY OWNER INFORMATION Name : TIRATH K BISLAY Phone: (805) 322-7213x Address: City : State: Zip: Type : TANK OWNER INFORMATION Name : TIRATH K BISLAY Phone: (805) 322-7213x Address: City : State: Zip: Type : BOE UST Fee# : 000506 Financ'l Resp: SELF INSURED Legal Notif : Tank Owner Mailing Address Date:04/03/1996 Phone: (714) 670-5407x Name:BILL ZAPKIN Ttl:ENVIRON. ADMIN. State UST # : 1998 Upg Cert#: 00735 = Hazmat Inventory One Unified List --As Designated Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax lUnitlMCP MIDGRADE UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod ARCO CLEAR UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod ARCO CLEAR UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod ARCO SUPREME UNLEADED GASOLINE F IH DH L 10000.00 GAL Mod 2 10/13/2000 BRUNDAGE LANE AM PM ~1960 SiteID: 015-021-000417 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME MIDGRADE UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 r STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GAL I 10000.00 GAL 7000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretl RSIBioHaz Radioactive/Amount I EPA Hazards I NFPA IUSDOT# MCP No No No No/ Curies F IH DH / / / Mod -~ Inventory Item 0002 Facility Unit: Fixed Containers on Site 7 COMMON NAME / CHEMICAL NAME ARCO CLEAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 STATE -- TYPE PRESSURE --~ TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GALI 10000.00 GAL 6575.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretI oRSlBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# MCP No N No No/ Curies F IH DH / / / Mod 3 10/13/2000 F BRUNDAGE LANE AM PM #1960 SiteID: 015-021-000417 ~ = Inventory Item 0003 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME ARCO CLEAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 STATE TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid~ ~ Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 10000.00 GALI 10000.00 GAL 6575.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS ITSecretl RSIBioHaz Radioactive/Amount EPA Hazards I NFPA I USDOT# MOP No No No No/ Curies F IH DH / / / Mod ----- Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME ARCO SUPREME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 ~ STATE i TYPE I PRESSURE I TEMPERATURE IPure Ambient CONTAINER TYPE Liquid Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average 10000.00 GAL 10000.00 GAL 5000.00 GAL CAS# 8006619 100.00 Gasoline NuS HAZARD ASSESSMENTS I · 'TSecretl RS'BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP liNe NoI No No/ Curies F IH DH / / / Mod -4- 10/13/2000 F BRUlqDAGE LANE AM PM #1960 SiteID: 015-021-000417 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 05/13/1996 A) CALL FIRE DEPT/PARAMEDICS/POLICE AS NEEDED AT 911. B) CALL ARCO MAINTENANCE AT 1-800-ARCOFIX WHO WILL INITIATE REPAIR ACTIVITY AND ANY FURTHER GOVERNMENTAL AGENCY NOTIFICATIONS: IE. STATE OFFICE OF EMERGENCY SERVICES - 800-852-7550 LOCAL ADMINISTERING AGENCY (BFD) - 805-326-3979 STATE WATER RESOURCES CONTROL BOARD - 209-445-5116 -- Employee Notif./Evacuation 05/13/1996 ALARM SHALL BE GIVEN BY SHOUTING. THE ON-SCENE EMERGENCY COORDINATOR OF HIS ALTERNATE HAS THE PRIMARY RESPONSIBILITY TO NOTIFY THE PROPER EMERGENCY RESPONSE PERSONNEL AND SECURE THE AREA UNTIL THE ARRIVAL OF POLICE AND/OR FIRE PERSONNEL. IF EVACUATION IS NECESSARY, ALL TRAFFIC ON SITE WILL BE HALTED AND ALL CUSTOMERS AND EMPLOYEES WILL BE MOVED TO A SAFE, UPWIND AREA. Public Notif./Evacuation 05/13/1996 ALARM SHALL BE GIVEN BY SHOUTING. THE ON-SCENE EMERGENCY COORDINATOR OF HIS ALTERNATE HAS THE PRIMARY RESPONSIBILITY TO NOTIFY THE PROPER EMERGENCY RESPONSE PERSONNEL AND SECURE THE AREA UNTIL THE ARRIVAL OF POLICE AND/OR FIRE PERSONNEL. IF EVACUATION IS NECESSARY, ALL TRAFFIC ON SITE WILL BE HALTED AND ALL CUSTOMERS AND EMPLOYEES WILL BE MOVED TO A SAFE, UPWIND AREA% Emergency Medical Plan 05/13/1996 THE LOCAL EMERGENCY MEDICAL FACILITY THAT WILL BE USED IN THE EVENT OF AN ACCIDENT OR INJURY CAUSED BY A RELEASE OR THREATENED RELEASE OF HAZARDOUS MATERIALS IS: HOSPITAL/CLINIC: KERN MEDICAL - 1830 FLOWER ST - 326-2000 -5- 10/13/2000 ~ BRUNDAGE LANE AM PM #1960 SiteID: 015-021-000417 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site --Release Prevention 10/21/1993 "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE" AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEE. cOMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. FACILITY IS EQUIPPED WITH PRODUCT LINE LEAK DETECTORS WHICH SHUTS SYSTEM DOWN IF LEAK OCCURS. OTHER PRODUCT MONITORING SYSTEMS/PROCEDURES ARE ALSO IN PLACE TO MINIMIZE RISK. ~ Release Containment 10/21/1993 1) STOP FLUID FLOW BY SHUTTING OFF PUMPS. 2) SHUT DOWN ELECTRICITY/POWER AT MAIN ELECTRIC PANEL, IF NECESSARY, AND 3) CONTAIN THE LIQUID BY CONSTRUCTING SOIL AND/OR ABSORBANT MATERIAL BERMS OR CLEANING UP THE SPILL WITH AN ABSORBANT MATERIAL. ~ Clean Up 10/21/1993 FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW), EMPLOYEE'S ARE INSTRUCTED TO CLEAN THE SPILL USING ABSORBANT MATERIAL AND TO DISPOSE OF THE USED MATERIAL SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN UP EQUIPMENT IS PROVIDED. FOR MAJOR SPILLAGE, EMPLOYEE'S ARE INSTRUCTED TO CALL 911 AND Other Resource Activation -6- 10/13/2000 BRUNDAGE LANE AM PM #1960 SiteID: 015-021-000417 Fast Format Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 05/13/1996 A) GAS - NONE B) ELECTRICAL - LOCATED INSIDE OFFICE NE WALL C) WATER - LOCATED N OF LOT ALONG BRUNDAGE LN D) SPECIAL - EMERGENCY PUMP SWITCHES 1)UNDER CASH REGISTER 2)BREAKER PANEL IN OFFICE E) LOCK BOX - NO -- Fire Protec./Avail. Water 05/13/1996 PRIVATE FIRE PROTECTION - EMPLOYEES ARE TRAINED IN THE LOCATION AND USE OF FIRE EXTINGUISHERS. INSTRUCTION IS ALSO GIVEN ON LOCATION OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NW CORNER OF BRUNDAGE AND H STREET IN FRONT OF 7-11, DIRECTLY ACROSS BRUNDAGE LN FROM THIS STORE. Building Occupancy Level 7 10/13/2000 BRUNDAGE LANE AM PM #1960 SiteID: 015-021-000417 Fast Format Training Overall Site m Employee Training 05/13/1996 WE HAVE 7 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL NEW EMPLOYEES UNDERGO TRAINING TO FAMILIARIZES THEM WITH THE HAZARDOUS MATERIALS AND EMERGENCY RESPONSE PROCEDURES, INCLUDING FIRE EXTINGUISHER USEAGE AND USE OF ABSORBANT MATERIAL FOR CLEAN UP. EMPLOYEES ARE ALSO GIVEN A REFRESHER COURSE ONCE A YEAR. USUALLY ON THEIR ANNIVERSARY. -- Page 2 -- Held for Future Use Held for Future Use -8- 10/13/2000 MISCELLANEOUS RECEIVABLES ADJUSTMENT DATE ...'-)_ ~ (0' (~(~ NEW ACCOUNT ~ ' ADDRESS CHANGE CLOSE ACCT ' FINANCE CHARGE I ~ OTHER ADJ MAILING ADDRESS Ci~ ~r~~ STATE SITE ADDRESS P~CEL NUMBER (IF APPLICABL~ ADJUSTMENT { CHG DATE CHARGE CODE ADJUSTMENT AMOUNT APPROVEDBY ~~~ BRUNDAGE LANE AM PM #1960 ~~,,~,-~-~ ........ SiteID: 215-000-000417 Manager : dUI ~ 1 1998 BusPhone: (310) 407-2606 Location: 1701 BRUNDAGE LN / Map : 102 CommHaz : Low City : BAKERSFIELD %Y:"/ Grid: 36D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:5541 EPA Numb: DunnBrad:51-012-0715 Emergency Contact / Title Emergency Contact / Title BISLA SURJIT / OWNER TIRATH K BISLAY / MANAGER Business Phone: (805) 322-7213x Business Phone: (805) 322-7213x 24-Hour Phone : (805) 665-1563x 24-Hour Phone : (805) 665-1563x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: ...... Fire - ImmHlth DelHlth Emergency Directives: -- Hazmat Inventory One Unified List ~ MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpooHazlEPA HazardsI Frm I DailyMax UnitIMCP MIDGRADE UNLEADED GASOLINE F IH DH L 10000 GAL Mod ARCO CLEAR UNLEADED GASOLINE F IH DH L 10000 GAL Mod ARCO CLEAR UNLEADED GASOLINE F IH DH L 10000 GAL Mod ARCO SUPREME UNLEADED GASOLINE F IH DH L 10000 GAL Mod -1- 04/17/1998 BRUNDAGE LANE AM PM #1960 SiteID: 215-000-000417 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME MIDGRADE UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum I Daily Average GAL 10000.00 GAL 7000.00 GAL HAZARDOUS COMPONENTS- %Wt.I ~S CAS# 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSoorotI RSIBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# I MCP No No No No/ Curies F IH DH / / / Mod ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME ARCO CLEAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid /Pure Ii Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 10000.00 GAL I 6575.00 GAL HAZARDOUS COMPONENTS %Wt. ~S CAS# 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS ITSoorotI RSIBioHaz Radioactive/Amount I EPA Hazards I NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Mod 2 04/17/1998 BRUNDAGE LANE AM PM #1960 SiteID: 215-000-000417 ~ ~ Inventory Item 0003 Facility Unit: Fixed Containers on Site -- COMMON NAME / CHEMICAL NAME ARCO CLEAR UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 Liquid Pure I Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average GAL 10000.00 GAL I 6575.00 GAL 'HAZARDOUS COMPONENTS wt. [. CAS# 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS TSecretl RSIBioHaz Radioactive/Amount [ EPA HazardsI NFPA I USDOT# [ MCP No No No No/ Curies F IH DH / / / Mod = Inventory Item 0004 Facility Unit: Fixed Containers on Site ~ -- COMMON NAME / CHEMICAL NAME ARCO SUPREME UNLEADED GASOLINE Days On Site 365 Location within this Facility Unit Map: Grid: SOUTHEAST CORNER CAS# 8006-61-9 F STATE -- TYPE PRESSURE ~ TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient UNDER GROUND TANK AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average GALI 10000.00 GAL 5000.00 GAL HAZARDOUS COMPONENTS 100.00 Gasoline N 8006619 HAZARD ASSESSMENTS ITSecretl RSIBioHaz Radioactive/Amount EPA Hazards NFPA I USDOT# I MCP No No No No/ Curies F IH DH / / / Mod -3- 04/17/1998 F BRUNDAGE LANE AM PM #1960 SiteID: 215-000-000417 Fast Format = Notif./Evacuation/Medical Overall Site --Agency Notification 05/13/1996 A) CALL FIRE DEPT/PARAMEDICS/POLICE AS NEEDED AT 911. B) CALL ARCO MAINTENANCE AT 1-800-ARCOFIX WHO WILL INITIATE REPAIR ACTIVITY AND ANY FURTHER GOVERNMENTAL AGENCY NOTIFICATIONS: IE. STATE OFFICE OF EMERGENCY SERVICES - 800-852-7550 LOCAL ADMINISTERING AGENCY (BFD) - 805-326-3979 STATE WATER RESOURCES CONTROL BOARD - 209-445-5116 -- Employee Notif./Evacuation 05/13/1996 ALARM SHALL BE GIVEN 'BY SHOUTING.- THE-ON=SCENE EMERGENCY COORDINATOR OF HIS ALTERNATE HAS THE PRIMARY RESPONSIBILITY TO NOTIFY THE PROPER EMERGENCY RESPONSE PERSONNEL AND SECURE THE AREA UNTIL THE ARRIVAL OF POLICE AND/OR FIRE PERSONNEL. IF EVACUATION IS NECESSARY, ALL TRAFFIC ON SITE WILL BE HALTED AND ALL CUSTOMERS AND EMPLOYEES WILL BE MOVED TO A SAFE, UPWIND AREA. -- Public Notif./Evacuation 05/13/1996 ALARM SHALL BE GIVEN BY SHOUTING. THE ON-SCENE EMERGENCY COORDINATOR OF HIS ALTERNATE HAS THE PRIMARY RESPONSIBILITY TO NOTIFY THE PROPER EMERGENCY RESPONSE PERSONNEL AND SECURE THE AREA UNTIL THE ARRIVAL OF POLICE AND/OR FIRE PERSONNEL. IF EVACUATION IS NECESSARY, ALL TRAFFIC ON SITE WILL BE HALTED AND ALL CUSTOMERS AND EMPLOYEES WILL BE MOVED TO A SAFE, UPWIND AREA. Emergency Medical Plan 05/13/1996 THE LOCAL EMERGENCY MEDICAL FACILITY THAT WILL BE USED IN THE EVENT OF AN ACCIDENT OR INJURY CAUSED BY A RELEASE OR THREATENED RELEASE OF HAZARDOUS MATERIALS IS: HOSPITAL/CLINIC: KERN MEDICAL - 1830 FLOWER ST - 326-2000 0 /17/1998 BRUNDAGE LANE AM PM #1960 SiteID: 215-000-000417 Fast Format =Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 10/21/1993 "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE" AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEE. cOMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. FACILITY IS EQUIPPED WITH PRODUCT LINE LEAK DETECTORS WHICH SHUTS SYSTEM DOWN IF LEAK OCCURS. OTHER PRODUCT MONITORING SYSTEMS/PROCEDURES ARE ALSO IN PLACE TO MINIMIZE RISK. --Release Containment 10/21/1993 1) STOP FLUID FLOW BY SHUTTING OFF PUMPS. 2) SHUT DOWN ELECTRICITY/POWER AT MAIN ELECTRIC PANEL, IF NECESSARY, AND 3) CONTAIN THE LIQUID BY CONSTRUCTING S~IL AND~/~R ABS~RBANTMATERIAL BERMS- OR CLEANING UP THE SPILL WITH AN ABSORBANT MATERIAL. -- Clean Up 10/21/1993 FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW), EMPLOYEE'S ARE INSTRUCTED TO CLEAN THE SPILL USING ABSORBANT MATERIAL AND TO DISPOSE OF THE USED MATERIAL SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN UP EQUIPMENT IS PROVIDED. FOR MAJOR SPILLAGE, EMPLOYEE'S ARE INSTRUCTED TO CALL 911 AND Act ivat ion I Other Resource I 5 04/17/1998 F BRUNDAGE LANE AM PM #1960 SiteID: 215-000-000417 I Fast Format ~ Site Emergency Factors Overall Site Special Hazards --Utility Shut-Offs 05/13/1996 A) GAS - NONE B) ELECTRICAL - LOCATED INSIDE OFFICE NE WALL C) WATER - LOCATED N OF LOT ALONG BRUNDAGE LN D) SPECIAL - EMERGENCY PUMP SWITCHES 1)UNDER CASH REGISTER 2)BREAKER PANEL IN OFFICE E) LOCK BOX - NO -- Fire Protec./Avail. Water 05/13/1996 PRIVATE FIRE PROTECTION - EMPLOYEES ARE TRAINED IN THE LOCATION AND USE OF FIRE EXTINGUISHERS. INSTRUCTION IS ALSO GIVEN ON LOCATION OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NW CORNER OF BRUNDAGE AND H STREET IN FRONT OF 7-11, DIRECTLY ACROSS BRUNDAGE LN FROM THIS STORE. Building Occupancy Level -6- 04/17/1998 BRUNDAGE LANE AM PM #1960 &~&&&&~&&~&~&&~&&& SiteID: 215-000-000417 Training ~~~~~~~~~~~ Overall Site i~ Employee Training ~~~~~~~~~ 05/13/1996 WE HAVE 7 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL NEW EMPLOYEES UNDERGO TRAINING TO FAMILIARIZES THEM WITH THE HAZARDOUS MATERIALS AND EMERGENCY RESPONSE PROCEDURES, INCLUDING FIRE EXTINGUISHER USEAGE AND USE OF ABSORBANT MATERIAL FOR CLEAN UP. EMPLOYEES ARE ALSO GIVEN A REFRESHER COURSE ONCE A YEAR. USUALLY ON THEIR ANNIVERSARY. ARCO Products Com Environmental Health & Safety 4 Centerpointe Drive La Palma, California 90623-1066 Mailing Address: Box 6038 Artesia, California 90702-6038 Re: Business Plan and Chemical Inventory Update\Certification Gentlemen: Enclosed is the subject updated Business Plan and Chemical Inventory Update for the following facilities: Arco Fac No. Address City/Zip 1960 1701 Brundage Lane ~ Bakersfield 93304 If you have any questions please direct them to my attention at this address or call me at (714) 670-5404. Very truly ycurs, Will ~a ~ Environme] ~1 ~ompliance Administr. 3z encl. cc: Richard Macy - Copy attached for Dealer Yellow Haz. Comm. Kit. APG-7116 ARCO Products Company is a Division of AtlanticRichfieldCompany (10~96) ARCO Products Environmental Compliance 4 Centerpointe Drive · La Palma, California 90623-1066 Telephone 714 670 5300 Mailing Address: Box 6038 ~ RECEIVED Artesia, California 90702-6038 April 30, 1996 Bakersfield Fire Dept. Haz. Mat. Division 2130 "G" Street Bakersfield, Ca. 93301 Re: Business Plan and Chemical Inventory Update Gentlemen: ......... ' ..... Enclosed is the subject updated Business Plan and Chemical Inventory Update for the following facilities: Arco Fac No. Address City/Zip 1960 1701 Brundage Lane Bakersfield 93304 If you have any questions please direct them to my attention at this address or call me at (714) 670-5404. Very truly tours, Wil li~. !a ~ka~~~C ~~z ompliance encl. cc: D. Macy - Copy attached for Dealer Yellow Haz. Comm. Kit. APPC-7116-A ARCO Products Company is a Division of AtlanticRichlieidCompany (3-94) Bnkersfield Fire Dept. Hazardous Materinl~ Division 2130 "G" Street B~kersfield, CA. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be brief and concise as possible. SECTION 1' BUSINESS IDENTIFICATION DATA MAILING ADDRESS: '~' CITY: ~)F~e.e.S~:,~)~ STATE: ~J~ ZIP:0~%~O~' PHONE: ~0~']:S%'2,''lt-N°~ DUN & BRADSTREET NUMBER: N/A SIC CODE: 5541 PRIMARY ACTIVITY: Retail Gasoline Dispensing Facility OWNER' %~o g.'~' v'~' '~ N %h+~ MAILING ADDRESS: % ~x'x'x ~ SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE " 24 HR. PHONE ~ B_~lrersfield Fire Dept. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3,: TRAINING: NUMBER OF EMPLOYEES: x MATERIAL SAFETY DATA SHEETS ON FILE: BRIEF SUMMARY OF TRAINING PROGRAM: All new employees undergo training t~ f~mi~!iarize., them .with_ t.he. h~za~o~us;. materials and emergency response ~roce~e~., i~lxcl_udi.ng' fixe.. useage and use of absorbant material ,for clean.upa-, 'Er0p. l~ye'~s:' awe given a refresher course once a year, Usually, on t~i.T SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT NO TIMEEXCEED THE MINIMUM REPORTING QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: I, ~U~'~'~ ~\%~.o~ 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. '-sIG N~"¥"~R E TITLE DATE Bakersfield Fire . Hazardous Msterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: 1. Call Fire Dept./Paramedics/Police as needed at 911 2',~ caii~Arco MaintenanCe 'at l~0'~2~0~I-~:wh0 w~ll initiate repair activity and any further governmental agency notifications; i.e... State Office of Emergency Service: (800)852-7550 or (916)427-4341 Local Administering Agency (Bakersfield F.D.) (805)326-3979 State Water Resources Control Board: (209)445-5116 · B. EMPLOYEE NOTIFICATION AND EVACUATION: ~ . Alarm shall be given by shouting. The On-Scene Emergency Coordinator or his Alternate has the primary responsibility to notify the proper emergency response personnel and secure the area until the arrival of Police and/or Fire personnel. If evacuation is necessary, all traffic on site will be~ halted and all customers and employees will be moved to a safe, upwind area. C. PUBLIC EVACUATION: See (b) above. D. EMERGENCY MEDICAL PLAN: The local emergency medical facility that will be used in the event of an accident or injury caused by a release or threatened release of hazardous materials is: Hospital/Clinic: ~ K~/ ]/~-Z)(~"~-~ Ad d res s: ~ 7~7..~0 · F~ ~ ~-/-/~. 7- City: m .~_~/~/-~ Zip Code:~.~- Phone Number: ~ Bskersfield Fire Dept. " ~ "- Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: MITIGATION, PREVENTION AND' ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: "No Smoking","Please Turn Off your Engine" and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employee. Compliance to posted signs minimizes potential risk and hazards. Facility is equipped with product line leak detectors which shuts system down if leak occurs. Other product monitoring systems/procedures are also in place to minimize risk. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Stop fluid flow by shutting off pumps. 2. Shut down electricity/power at main electric panel, if necessary, and 3. Contain the liquid by constructing soil and/or absorbant material berms or cleaning up the spill with an absorbant material. C. CLEAN-UP PROCEDURES: For Minor Spillage (i.e..customer gas tank overflow), employee's are instructed to clean the spill using absorbant material and to dispose of the used material safely. Protective rubber gloves and clean-up equipment is provided. For Major spillage, employee's are instructed to call 911 and report. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: I~o~ ~, ..... ELECTRIOAL: 1,1~9,,,~ e.X,e.c~,,,ce,~. ~t~S,~1. O~t~: ~r~e~%~. ~-' -- WATER: ~ ~ ~ ~6~. ~ ~ ~ ~G ~~ L~a~ LOCK BOX: YES~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: NONE - Employees are trained in the location and use of Fire Extinguishers. Instruction is als'b given on location of emergency fu~l pump shut off switches. ;' B. WATER AVAILABILITY (FIRE HYDRANT): The closest fire hydrant is located at: CITY OF BAKERSFIELD HAZARDOUS MA'I~RIALS IHVE~RY ' Farm and Agriculture~ Standard Business Page.~ of ~ NON - TRADE SECRET · OCATION: %-.-~\ %~U~&~- %-{~ -- . ADDRESS: %~.~ x %~ ~\%-%~9~\~C%~b~. STANDARD IND. CLASS CODE: ~% 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 ~ Days Cent Cent Cent Use Locstion Where · % by Names of Mixture/Components Code code Amt Ami Ami Units · on Site Ty~e Press Tem~ Code Stored in Facillt~ wt See Instructions · . ~%~ ~.~ ~. Phy.~ ..d .~lth H. zsrd C.~.S. ,u~er ~0~% Colo..hr, 1 ,a,, C.,.S. ,u-~.r ~S ~ ~,~.%ur {J ~11 that apply) Component ~ 2 N~ & C.A.B. N~er -- ~ Fire Bazard ~ Sudden Release '~ R~cttvity~ Imitate ~ Delay~ %%~0-~0-~ %~: TOU~ ~ of Pressure , H~lth H~lth Component J 3 Na~ & C.A.B. BuYer I~-o~ Physical and S~lth Hazard C.A.S. Nu~er ~00~%q Co~onent ~ 1 N~ S C.A.S. N~er Fire Hazed ~ Sudden Release ~ R~ctlvlty ~ I~iate ~ Delay~ I~-~0:~ of Pressure H~lth H~lth Co~onent ~ 3 N~ & C.A.B. Nu~er Ph.ical and "~lt. Hazard C.A.S. Nd~er ~00~%% Co.orient ~ I N~ S C.A.S. N~er Co.orient ~ 2 Nam · C.A.8. N~ ~ ~ ~ Fire Hazed ~ Budden Release ~ R~ctivity ~ I~tate ~ Delay~ [~0~0-~ ~ ; ~ .. (Che~k ~ t~t apply) ~ '~~ E~RGENCY CONTACTS 91 %u~%< %%%~ O~ ~~ [2~ %L~--~ N~~V Title 24 ~. Phone N~el ~~ Title 24 ~ Phone ;erttficatton (~ ~D SIGN AFTER COMPLETING ~L SECTIONS) ce~tlf~ ~der p~nlty of law t~t I hayer ~rsonally ~in~ ~d ~ f~lliar with the tnfo~tlon su~itted In this ~d all attached d~ta ~d that ~sed on ~ndl,~i~'uals res~nslble for obtaining the tnfo~tton. I believe that ~e su~ttted tnfo~tlon ts t~e. acc~ate, and c~plete. 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 1 Overall Site with 1 Fac. Unit General Information ~o I Location: 1701 BRUNDAGE LN Map:102 Haz:2 Type: 3 City : BAKERSFIELD Grid: 36D F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title KENNETH J. LYNES / OWNER LORRAINE LYNES / MANAGER Business Phone: (805) 322-7213x Business Phone: (805) 322-7213x 24-Hour Phone : (805) 253-3769x ? 24-Hour Phone : (805) 393-8785x Pager Phone : ( ) - x Pager Phone : ( ) - x Administrative Data Mail Addrs: P.O. BOX 6038 D&B Number: 51-012-0715 City: ARTESIA State: CA Zip: 90702-%0)% Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 5541 Owner: ARCO PRODUCTS CO Phone: (~) Address: P.O. BOX 6038 State: CA City: ARTESIA Zip: 90702- Summary ~ ~.~\~ I, Y~.~,~e.k-~ ;;S', L~s Do hereby certify that I have renewed the a~hed .~ous minerals, m~na~e- merit plan for ~~ ..... and that it any ~rr~ions constitute a ~mp~to and ~ a~ement plan for my facili~. 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-003 ARCO CLEAN UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-002 ARCO CLEAR UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-001 MIDGRADE UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 02-004 ARCO SUPREME UNLEADED GASOLINE Liquid 10000 Moderate · Fire, Immed Hlth, Delay Hlth GAL 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 3 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-003 ARCO CLEAN UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL I Daily Average GAL 1 Annual Amount GAL 10,000 ~ 6,000.00 1,400,000.00 Storage ~lPress T Temp Location UNDER GROUND TANK IAmbientlAmbientlSOUTHEaST CORNER -- Conc ~ .Components MCP --~Guide 100.0% IGasoline IModeratel 27 02-002 ARCO CLEAR 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 ~ 6,000.00 1,400,000.00 StorageI~Press T Temp Location UNDER GROUND TANK I AmbientlAmbientlSOUTHEaST CORNER -- Conc. Components MCP ---/Guide 100.0% IGasoline ModerateI 27 02-001 MIDGRADE UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlth GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL Daily Average GAL I Annual Amount GAL -- 10,000 I .~ 6,000.00 500,000.00 Storage Press T TempI Location UNDER GROUND TANK Ambient~AmbientlSOUTHEAST CORNER -- Conc Components MCP --TGuide 100.0% IGasoline IModeratel 27 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 4 02 - Fixed Containers on Site Hazmat Inventory Detail in MCP Order 02-004 ARCO SUPREME UNLEADED GASOLINE Liquid 10000 Moderate ~ Fire, Immed Hlth, Delay Hlt~h GAL CAS #: 8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL Daily Max GAL I Daily Average GAL I Annual Amount GAL 10,000 i 6,000.00 680,000.00 Storage I Press T Temp I Location UNDER GROUND TANK I Ambient/AmbientlSOUTHEAST CORNER -- Conc~ Components I MCP -~Guide 100.0% IGasoline IModeratel 27 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 5 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification A) CALL FIRE DEPT/PARAMEDICS/POLICE'AS NEEDED AT 911. B) CALL ARCO MAINTENANCE AT 1-800-ARCOFIX WHO WILL INITIATE REPAIR ACTIVITY AND ANY FURTHER GOVERNMENTAL AGENCY NOTIFICATIONS: IE. STATE OFFICE OF EMERGENCY SERVICES - 800-852-7550 LOCAL ADMINISTERING AGENCY (BFD) - 805-326-3979 STATE WATER RESOURCES CONTROL BOARD - 209-445-5116 <2> Employee Notif./Evacuation ALARM SHALL BE GIVEN BY SHOUTING. THE ON-SCENE EMERGENCY COORDINATOR OF HIS ALTERNATE HAS THE PRIMARY RESPONSIBILITY TO NOTIFY THE PROPER EMERGENCY RESPONSE PERSONNEL AND SECURE THE AREA UNTIL THE ARRIVAL OF POLICE AND/OR FIRE PERSONNEL. IF EVACUATION IS NE~CESSARY, ALL TRAFFIC ON SITE WILL BE HALTED AND ALL CUSTOMERS AND EMPLOYEES WILL BE MOVED TO A SAFE, UPWIND AREA. <3> Public Notif./Evacuation ALARM SHALL BE GIVEN BY SHOUTING. THE ON-SCENE EMERGENCY COORDINATOR OF HIS ALTERNATE HAS THE PRIMARY RESPONSIBILITY TO NOTIFY THE PROPER EMERGENCY RESPONSE PERSONNEL AND SECURE THE AREA UNTIL THE ARRIVAL OF POLICE AND/OR FIRE PERSONNEL. IF EVACUATION IS NECESSARY, ALL TRAFFIC ON SITE WILL BE HALTED AND ALL CUSTOMERS AND EMPLOYEES WILL BE MOVED TO A SAFE, UPWIND AREA. <4> Emergency Medical Plan THE LOCAL EMERGENCY MEDICAL FACILITY THAT WILL BE USED IN THE EVENT OF AN ACCIDENT OR INJURY CAUSED BY A RELEASE OR THREATENED RELEASE OF HAZARDOUS MATERIALS IS: HOSPITAL/CLINIC: MERCY HOSPITAL - 2215 TRUXTUN AVE. - 327-3371 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 6 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE" AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEE. cOMPLIANCE TO POSTED SIGNS MINIMIZES POTENTIAL RISK AND HAZARDS. FACILITY IS EQUIPPED WITH PRODUCT LINE LEAK DETECTORS WHICH SHUTS SYSTEM DOWN IF LEAK OCCURS. OTHER PRODUCT MONITORING SYSTEMS/PROCEDURES ARE ALSO IN PLACE TO MINIMIZE RISK. <2> Release Containment 1) STOP FLUID FLOW BY SHUTTING OFF PUMPS. 2) SHUT DOWN ELECTRICITY/POWER AT MAIN ELECTRIC PANEL, IF NECESSARY, AND 3) CONTAIN THE LIQUID BY CONSTRUCTING SOIL AND/OR ABSORBANT MATERIAL BERMS OR CLEANING UP THE SPILL WITH AN ABSORBANT MATERIAL. <3> Clean Up FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW), EMPLOYEE'S ARE INSTRUCTED TO CLEAN THE SPILL USING ABSORBANT MATERIAL AND TO DISPOSE OF THE USED MATERIAL SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN UP EQUIPMENT IS PROVIDED. FOR MAJOR SPILLAGE, EMPLOYEE'S ARE INSTRUCTED TO CALL 911 AND REPORT. <4> Other Resource Activation 09/19/95 BRUNDAGE LANE A/~.PM 215-000-000417 Page 7 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - LOCATED INSIDE OFFICE NE WALL C) WATER - LOCATED N EDGE OF LOT AT BRUNDAGE LN D) SPECIAL - EMERGENCY PUMP SWITCHES 1)UNDER CASH REGISTER 2)BREAKER PANEL IN OFFICE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - EMPLOYEES ARE TRAINED IN THE LOCATION AND USE OF FIRE EXTINGUISHERS. INSTRUCTION IS ALSO GIVEN ON LOCATION OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - NW CORNER OF BRUNDAGE AND H STREET IN FRONT OF 7-11, DIRECTLY ACROSS BRUNDAGE LN FROM THIS STORE. <4> Building Occupancy Level 09/19/95 BRUNDAGE LANE AM PM 215-000-000417 Page 8 00 - Overall Site <G> Training <1> Employee Training WE HAVE 9 EMPLOYEES AT THIS FACILITY. WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL NEW EMPLOYEES UNDERGO TRAINING TO FAMILIARIZES THEM WITH THE HAZARDOUS MATERIALS AND EMERGENCY RESPONSE PROCEDURES, INCLUDING FIRE EXTINGUISHER USEAGE AND USE OF ABSORBANT MATERIAL FOR CLEAN UP. EMPLOYEES ARE ALSO GIVEN A REFRESHER COURSE ONCE A YEAR. USUALLY ON THEIR ANNIVERSARY. <2> Page 2 <3> Held for Future Use <4> Held for Future Use ARCO' Products Com Environmental Health & Safety 17315 Studebaker Road Cerritos, California 90701-1488 Telephone 310 404 5300 Mailing Address: Box 6038 Artesia, California 90702-6038 October 1, 1993 RECEIVED Bakersfield Fire Dept. OCT 0 5 1993 Hazardous Materials Division 2130 "G" Street Bakersfield, Ca. 93301 HA~-MAT. Re: Business Plan and Chemical Inventory Update Gentlemen: Enclosed is the subject updated Business Plan and Chemical Inventory Update for the following facilities: Arco Fac.# 1960 1701 Brundage Lane Bakersfield 93304 ~/f you have any questions please direct them to my attention at this address or call me at (310) 407-2604. Very truly yours, Willi~a~ ~n ~ .i~ .~ Compliance encl. cc: T. Reeder - Copy attached for Dealer Yellow Haz. Comm. Kit. APPC-7116 ARCO Products Company is a Division of AtlanticRichfieldCompan¥ (6-92) Bukersfield Fire Dept. Hazardous Materiul~ Division 2130 "G" Street Bakersfield, C~. 93301 HAZARDOUS MATERIALS MANAGEMENT PLAN INSTRUCTIONS: 1. To avoid further action, return this form within 30 days of receipt. 2. TYPE/PRINT ANSWERS IN ENGLISH. 3. Answer the questions below for the business'as a whole. 4. Be brief and concise as possible. SECTION 1: BUSINESS IDENTIFICATION DATA BUSINESS NAME: IK~\ ~!~ (g~,to ~'ec-. LOCATION: I~o~ ~u~G~ MAILING ADDRESS: ~mo~ ~u~ ~N~ CITY: ~~L~ STATE: ~A. ZIP: q~o~ PHONE: ~O~Q~ q~l DUN & BRADSTREET NUMBER: ~/~ SIC CODE: PRIMARY ACTIVITY' Retail Gasoline Dispensing Facility OWNER: ~e~ e~ ~. MAILING ADDRESS: /~0~ ~ku~ L~ ~~/~ ~. SECTION 2: EMERGENCY NOTIFICATION: CONTACT TITLE BUS. PHONE 24 HR. PHONE ~ Bakersfield Fire Dept. Hszsrdous Msterials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 3: TRAINING: NUMBER OF EMPLOYEES: MATERIAL SAFETY DATA SHEETS ON FILE: ¥~' BRIEF SUMMARY OF TRAINING PROGRAM: All new employees undergo.training t~ fami~lia~i,ze, them wi:th_ th~ h~za~u~. materials and emergency 'response o~oce~n~e&,, i~cludSD$ fireextingu~she~ useage and use of absorbent mate.~ial fo~ clean~ps~ ~E~p.lgyeeS~'a~e given a refresher course once a yeaw, Usually, on tRmix anniTewsaw¥~ SECTION 4: EXEMPTION REQUEST: I CERTIFY UNDER PENALTY OF PERJURY THAT MY BUSINESS IS EXEMPT FROM THE REPORTING REQUIREMENTS OF CHAPTER 6.95 OF THE "CALIFORNIA HEALTH & SAFETY CODE" FOR THE FOLLOWING REASONS: WE DO NOT HANDLE HAZARDOUS MATERIALS. WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTiTiES AT NO TIMEEXCEED THE MINIMUM REPORTING'QUANTITIES. OTHER (SPECIFY REASON) SECTION 5: CERTIFICATION: MATION IS ACCURATE. I UNDERSTAND THAT THIS INFORMATION WILL BE USED TO FULFILL MY FIRM'S OB.LIGATIONS 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. 2. B~kersfield Fire De~. Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PI.AN Facility Unit Name: SECTION 6: NOTIFICATION AND EVACUATION PROCEDURES: A. AGENCY NOTIFICATION PROCEDURES: 1. Call Fire Dept./Paramedics/Police as needed at 91,1 2. Call Arco Maintenance at 1-(800)-ARCOFIX who will initiate repair activity and any further governmental agency notifications~ i.e... State Office of Emergency Service: (800)852-7550 or (916)427-4341 Local Administering Agency (Bakersfield F.D.) (805)326-3979 State Water Resources Control Board: (209)445-5116 - B. EMPLOYEE NOTIFICATION AND EVACUATION: .. -. Alarm shall be given by shouting. The On-Scene Emergency Coordinator or his Alternate has the primary responsibility to notify the proper emergency response personnel and secure the area until the arrival of Police and/or Fire personnel. If evacuation is necessary, all traffic on site will be halted and all customers and employees will be moved to a safe, upwind area. C. PUBLIC EVACUATION: See (b) above. D. EMERGENCY MEDICAL PLAN: The local emergency medical facility that will be used in the event of an accident or injury caused by a release or threatened release of hazardous materials is: Hospital/Clinic: Address: City: X _~5~ _~J~:~l_P./_~_ Zip code:~--.~O~' Phone Number:x( ) Bsl~ersfield Fire Dept. ' """ Hazardous Materials Division HAZARDOUS MATERIALS MANAGEMENT PLAN SECTION 7: 'MITIGATION, PREVENTION AND ABATEMENT PLAN: A. RELEASE PREVENTION STEPS: "No Smoking","Please Turn Off your Engine" and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employee. Compliance to posted signs minimizes potential risk and hazards. Facility is equipped with product line leak detectors which shuts system down if leak occurs. Other product monitoring systems/procedures are also in place to minimize risk. B. RELEASE CONTAINMENT AND/OR MINIMIZATION: 1. Stop fluid flow by shutting off pumps. 2. Shut down electricity/power at main electric panel, if necessary, and 3. Contain the liquid by constructing soil and/or absorbant material berms or cleaning up the spill with an absorbant material. C. CLEAN-UP PROCEDURES: "' For Minor Spillage (i.e..customer gas tank overflow), employee's are instructed to clean the spill using absorbant material and to dispose of the used material safely. Protective rubber gloves and clean-up equipment is provided. For Major spillage, employee's are instructed to call 911 and report. SECTION 8: UTILITY SHUT-OFFS (LOCATION OF SHUT-OFFS AT YOUR FACILITY): NATURAL GAS/PROPANE: LOCK BOX: YES~ IF YES, LOCATION: SECTION 9: PRIVATE FIRE PROTECTION/WATER AVAILABILITY: A. PRIVATE FIRE PROTECTION: NONE - Employees are trained in the location and use of Fire Extinguishers. Instruction is also given on location of emergency fuel pump shut off switches. B, WATER AVAILABILITY (FIRE HYDRANT): The closest fire hydrant i~ located at: FD15~ CITY OF BI~KERSF I ELD HAZARDOUS MATERIALS INVENTORY J Farm and Agriculture~ Standard Business Page NON - TRADE SECRET !USINESS NAME: ~\~{~ OWNER NAME: ~~ 7. ~t~e$ NAME OF THIS FACILITY: ~%$~CO~'~%~- OCATION: ~'5~\ ~%%;~. ~ ~DRESS:(~ ~ ~q~ ~0. ~ ~ ST~D~ IND. CLASS CODE: 'ITY, ZIP: ~(%~%~ q~O~ CITY, ZIP: ~ ~.~1~&Q, ~- ~%~7. DUN ~D B~ST~T N~BER/FEDE~ ~R ~ INS~U~IONS ~R PROPER ~DES 1 2 3 4 5 6 7 8 9 10 11 l~ 13 14 frans ~e ~x Average ~nual Measure [ Days Coat Coat Cent Use Location Where % by N~s of Mixture/C~nents ':ode C~e ~t ~ ~t Units on Site ~ Press Tamp Code Stored In Faclll~ ~ 8es Instructions Physical and Health Hazard C.A.S. Numar ~O0~ Co~onent ~ 1 Na~ S C.A.8. Numar 16 ~ ~Y-%~% (Check all that apply} ~ Fire Hazard ~ Sudden Release ~ a~ctivity l~lat. ~ Delay~ %3%0 of Pressure H~lth H~l%h Component ~ 3 Na~ t C.A.S. (Check all that apply} ~%' ~ Fire Hazard ~ Sudden Release ~ R~ctlvtty ~ I~iate ~ Delay~ . ~ of Pressure H~lth Health Co~onent ~ 3 N~ i C.A.8. Numar (Check all that apply) 10~ Co~onent ~ 2 Nam & C.A.S. N~er of Pressure ~lth H~lth Co.ecsc% ~ 3 Na~ & C.k.S. N~ E~RGENCY CONTACTS ~1 ~eNN~ =,L~NeS 0~.~ ~%t2~__ X ~[9~ Nam ' Title 24 ~. Phone N~e Title 24 ~ P~ne ~rt~ficatlo. (~ ~D SIGN AFTER COMPLETING ~L SECTIONS) certify ~der p~nlty of law t~t I hayer ~rsonally ~in~ ~d ~ f~lliar with the lnfo~tlon su~ttted in this ~d all attached d~ts ~d that ~aed on ~ in~l~ of ~I ndivldual, res~nsible for obtaining the info~tion.~, I believe that the au,itted info--rio, ia t~e.~/~~~~~'cc~a'e' a~ c.plet.. ~ ~:)~ ~ ARCO Products Com Environmental Health & Safe~ 17315 Studebaker Road ~~, Cerritos, California 90701-1488 Telephone 310 404 5300 Mailing Address: Box 6038 Artesia, California 90702-6038 RECEIVED April 28, 1993 ~4¥ 3 ~99~ Bakersfield Fire Dept. Hazardous Materials Division HA[. MAT. DIV. 2130 "G" Street I Bakersfield, Ca. 93301 Re: Hazardous Materials Business Plan Emergency Contact Information Update I_ Gentlemeh: Attached find an Emergency Contact Information Update for the following facilities: Arco Fac.~ Location 1960 1701 Brundage Lane, Bakersfield 93304 If you have any questions I can be reached at (310) 407-2604. Very tr. ulI~ yours, ~irn .~s~~cOmpliance attach APPC-7116' ARCO Products Company is a Division of AtlanticRichfieldCompany (6-92) ~RCO Products Compal '~, rreement Sequence 001 17315 Studebaker Road '~' Facility Number 01960 , · Cerntos, Cahforma 90701-1488 Customer Number 0646752 Telephone 310 404 5300 AR Number 0646752 Agreement Type PMAMPM BUSINESS EMERGENCY RESPONSE PLAN HAZARDOUS MATERIALS HANDLER EMERGENCY CONTACT INFORMATION OPERATOR CHANGE/OR UPDATED ....... A_R¢O F~A_CIL!T_Y _N_O_:_ 01~11~0 BUSINESS NAME: Kenneth J. Lynes BUSINESS ADDRESS: 1701 BRUNDAGE LANE N umber Street BAKERSFIELD CALIFORNIA 93304 City State ZIP BUSINESS PHONE: f 1~(~5 I 3~ _ "!~ Area CoOe Phone Number Title TYPE OF BUSINESS OPERATION: Gas stat&on w&t:h cot~venience s~:o]:e NO. OF EMPLOYEES: ~ HOURS OF OPERATION: EMERGENCY CONTACT INFORMATION {AFTER BUSINESS HOURS) EMERGENCY CONTACT: l~e~'~, '~, ~'~t~ First Name Last Name Area Code Phone Number ALTERNATE CONTACT: ~.6 ~.~\~(~ First Name Last Name '~~ DATE: ~-~-? ~ (1/92) ARCO Products Company is a Division of AtlanticRichheldCompany PARSSO ARCO Products Corn 17315 Studebaker Road Cerritos, California 90701-1488 Telephone 213 404 5300 Mailing Address: Box 6411 Artesia, California 90702-6411 March 10, 1992 Alis'd ............ Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, Ca. 93301 Attn: Ms. Valerie Pendergrass Re: . Certification/Updated Hazardous Materials Management Plan Arco Fac.#1960, 1701 Brundage Lane, Bakersfield Dealer: Donald Lynes Dear Valerie: Confirming our telephone conversation of this date, enclosed find the following: 1. Unexecuted Certification dated 2/20/92 2. Copy of my letter 11/13/91 with Updated/Certified Hazardous Materials Management Plan attached Apparently the Certification dated 2/20/92 did not incorporate the changes made on my 11/13/91 submittal. Since the dealer has already signed/certified on 11/5/91 he should not have to do so again. The only changes I have made to the 11/13/91 Certification is the addition of "Clean Up" information on page 5 that you had requested on the 2/20/92 Certification request. Please see that the 11/13/91 data is processed as amended. If you have any questions or need additional information, please call me at (310) 407- 2604. Very truly yours, Wi .Z ka Envir. o.nn~e ce Administ~. encl. APPC-7076-B ARCO Producl~ Company Is a Olvision O! Atlar~ticRichfietdCompany (7-88) 02/20/92 BRUNDAGE LANE AM PM 215-000-000417 Page 1 Overall Site with 1 Fac. Unit General 'Information Location: 1701BRUNDAGE LN Map: 102 Hazard: Low Community: BAKERSFIELD STATION 06 Grid: 36D F/U: 1 AOV: 0.0 Contact Name Title Business Phone 24-Hour Phone- DONALD LYNES OWNER (805) 322-7213 x (805) 398-7139 KEN LYNES OWNER (805) 322-7213 x (805) 398-7139 Administrative Data Mail Addrs: P.O. BOX 6225 D&B Number: 51-012-0715 City: CERRITOS State: CA Zip: 90701- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 5541 Owner: PRESTIGE STATIONS Phone: (805) 832-52'12 Address: P O BX 6225 State: CA City: CERRITOS Zip: 90701- Summary · 1, ..... Do hereby cer~i~ that I have ...,. · (TYl~e er print hal;ne) . ,.__. ¥ -.._~, :- -_ reviewed the mtach~ ~ ....... '"~" ,~...~.,~..~. ,.,~.~ materials manage- ment plan '[or ......................... ,~,~ ~,b~t it along ~ith any corrections co~s[[~[.;~e a comple~ and corr~ m~ .agement plan for m~ facility. 02/20/92 BRUNDAGE LANE AM PM 215-000-000417 Page 1 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 GASOLINE (UNLEADED) Liquid 8000 Moderate · Fire, Immed Hlth, Delay Hlth GAL CAS #: .8006-61-9 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: FUEL --.Daily Max GAL Daily Average-GAL ] Annual Amount GAL 8,000 I 4,000.00 800,000.00 StorageI Press I Temp Location UNDER GROUND TANK IAmbient~Ambient SOUTHEAST CORNER - Conc Components MCP List 100.0% I Gasoline I Moderate I 02-002 GASOLINE (SUPER UNLEADED) Liquid 6000 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 6,000 I 300.00 600,000.00 Storage~~Press T Temp Location UNDER GROUND TANK IAmbient~ambientlSOUTHEaST CORNER -- Conc Components MCP List 100.0% IGasoline ModerateI 02-003 GASOLINE (REGULAR) Liquid ~000 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 [ Annual Amount GAL -- 6,000 I 3,000.00 600,000.00 Storage Press T TempI Location UNDER GROUND TANK Ambient~AmbientlSOUTHEAST CORNER -- Conc Components MCP ~List 100.0% IGasoline IModeratel 02/20/92 BRUNDAGE LANE AM PM 215-000-000417 Page 3 00 - Overall Site' <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation IN THE EVENT OF ANY MAJOR INCIDENT, OUR FACILITY PERSONNEL (I.E. FACILITY MANAGER, ASSISTANT, CASHIER OR MAINTENANCE) WILL IMMEDIATELY CALL 911 AND REPORT. IF EVACUATION IS NECESSARY, AND AFTER 911 HAS BEEN CALLED EMPLOYEES ARE DIRECTED TO A SITE OPPOSITE THE DANGER AREA. FACILITY PERSONNEL WILL THEN CALL AND NOTIFY EMERGENCY CONTACT PERSONNEL. <3> Public Notif./Evacuation IN THE EVENT OF A MAJOR SPILL OR RELEASE, THE PERSONNEL IN-CHARGE SHALL SECURE THE FACILITY BY DEASCTIVATING ALL DISPENSERS AND SUBMERSIBLE PUMPS. IF EVACUATION IS NECESSARY, ALL PERSONNEL ARE INSTRUCTED TO PROCEED TO AN AREA AWAY FROM THE DANGER ZONE. THE PERSONNEL IN-CHARGE AT THE TIME SHALL THEN NOTIFY THE LOCAL EMERGENCY RESPONSE DEPARTMENT AND ARCO MAINTENANCE DEPARTMENT. <4> Emergency Medical Plan MERCY HOSPITAL - 2215 TRUXTUN AVE. - 327-3371 BAKERSFIELD~ CITY FIRE - 127 BRUNDAGE LN. - STATION #6 02/20/92 BRUNDAGE LANE AM PM 215-000-000417 Page 4 00 ~ Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention FACILITY UTILIZES TWO 4,000 GALLON AND TWO 6,000 GALLON UNDERGROUND TANKS LOCATED AT THE SOUTH END OF THE SITE. INVENTORIES ARE MONITORED DAILY AND KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE TURN OFF YOUR ENGINE", AND "DO NOT TOP OFF TANK" SIGNS ARE POSTED IN CLEAR VISION OF CONSUMER AND EMPLOYEES. COMPLIANCE TO POSTED SIGNS MINIMIZED POTENTIAL RISK AND HAZARDS. FOR MINOR SPILLAGE (I.E. CUSTOMER GAS TANK OVERFLOW) EMPLOYEES ARE INSTRUCTED TO CLEAN AND DISPOSE OF MATERIAL SAFELY. PROTECTIVE RUBBER GLOVES AND CLEAN-UP EQUIPMENT ARE TO CALL 911 AND REPORT. THEY WILL THEN NOTIFY EMERGENCY CONTACT PERSONNEL. <2> Release Containment STOP FLUID FLOW BY SHUTTING OFF PUMPS. SHUT DOWN ELECTRICITY. CONTAIN THE LIQUID BY CONSTRUCTING SOIL BERMS OR COVERING THE SPILL WITH AN ABSORBENT MATERIAL. PREVENT LIQUID FROM ENTERING STORM DRAINS. <3> Clean Up <4> Other Resource Activation 02/20/92 BRUNDAGE LANE AM PM 215-000-000417 Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards <2> Utility Shut-Offs A) GAS - NONE B) ELECTRICAL - LOCATED IN THE BACK ROOM STORAGE AREA C) WATER - LOCATED AT BRUNDAGE STREET DRIVEWAY D) SPECIAL - EMERGENCY FUEL SHUT-OFF LOCATED ON CASH REGISTER E) LOCK BOX - NO <3> Fire Protec./Avail. Water - PRIVATE FIRE PROTECTION - EMPLOYEES ARE INSTRUCTED ON LOCATION OF FIRE EXTINGUISHERS AND THEIR LOCATION. INSTRUCTION IS GIVEN ON USE AND OPERATION. INSTRUCTION IS ALSO GIVEN ON LOCATION OF EMERGENCY FUEL PUMP SHUT-OFF SWITCHES. FIRE HYDRANT - CORNER OF BRUNDAGE AND H STREET <4> Building Occupancy Level 02/20/92 BRUNDAGE LANE AM PM 215-000-000417 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 12 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE ALL NEW EMPLOYEES OF THIS STATION WILL UNDERGO TRAINING WHICH FAMILIARIZES THE EMPLOYEE WITH THE PROCEDURES FOR THE SAFE HANDLING OF HAZARDOUS MATERIALS, PROCEDURES FOR EMERGENCY RESPONSE COORDINATION AND USE OF EMERGENCY RESPONSE EQUIPMENT AND SUPPLIES. ALL EMPLOYEES RECEIVE REFRESHER TRAINING YEARLY. <2> Page 2 as needed , <3> Held for Future Use <4> Held for Future Use ARCO Products Com " 17315 Studebaker Road ,~ ~, Cerritos, California 90701-1488 Telephone 213 404 5300 '~ ~P' Mailing Address: Box 6411 Artesia, California 90702~6411 November 13, 1991 Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, Ca. 93301 Re: Updated Hazardous M&teri&ls.[Man&gement Arco"Fac. ~1960 '~ 1701 Brundage Lane Bakersfield, Ca. Gentlemen: Enclosed is the subject plan update and certification that you requested of our dealer. If you have any questions feel free to contact me at (213) 404-5391. Very truly yours, Will~ ka Envir .on, entel Compliance Administ~or encl. cc: T.L. Reeder for dealer -" S~te w~gB 1 Fac. Ger, e'ra 1 I r, f,:,rrnag i, h~c, cat i,=,r,: 170~ B~UNDAGE Uxl ~}]iOer,~ N,_[rnm~r: 215-000-0004!'Z J; F C,:,r, Cact i'qarne t 'l'ltie I Busir, ess ;' ': .?'i' i :~<~ ,' L..' ~ "' Cz'i:?': ........ I'OS ~'b a'c ~:,: ,.L ~:-i ~ l p .'. t - I, _~i.~ ~. /..',//~J~ ~; Do hereby ce.ify ITyp~ ~ t;~inl name) -- that I h~e reviewed the eHached hazardous materials manage. ment plan fo~ ~ ~~ ..... a~d ihat it along with ~Y corre~ions conslik~ie a complete and ~rre~ ma~ agement plan for my facility. ~' i r~-- Re f' Name/Haza~-ds ~: ,--,~'n~ Q:larst :i. 't y f'ICP ( ['~EGUL:'-~ R ) Liqui.2 GASOLINE Fi~e, lmmea Hith, Delay High GAL 02-002 GASOLINE (SUPER UNLEADED) Liouid Fi~e, Immed Hith, Delay Hitn GJ-i~ 02-0(1~ 1 GASOLINE (ONLEADED) LioLli~ Fi'ce, Imrned Hi~h, Dei~,],.' ~.iltn UHU 0~-003 G~SOLINE ( P, EGUL[AR) Liquln ' 60(~Q I.~c,o er-a ~ e Fire~ irnmed Hl'th~ Delay Mlth t=',:,rm: Liquid 'l"ype: F',.~re Days: 365 Use: FU~L/ / -- Da~ly max ~ ~ Da~ly '~vera~e 5NL J-- ~r,r, ual' .~,:,ur,~ u~L .... / / -- Cc, ne -] ...... ~,:,rnpor,~,:~ ........... ~ :~C:: .......... i-'"'i :: .; ~:[-~b :il~: C:,(.)~_~U,-'-~. ~ "-'s' I re, c /. _ · ~ :~ 'C ,D t~ a ~ r~. ~ ,~ L~Z ~, y -~ ............................ 02-001 GASOLii'4E {U~~~ui i. 2. i.'.'~ '. i.: ~..,..~_ ' ' ' ' ' ! O~/15/'~i .~' , BNUN A~E L~NE AM F'M ~':'15--('~,0-(1,(~, 1! F'age '~. !-:~ ~ O0 -- Overall Site <D> Notif. /Evacuation/Medical > Ager, cy Noti?icatior, CALL 9 1 1 {3;> JZ. ub].io Nc, ti1:. /Evaouatic, r, IN 'I'NE EVEN7 0~' A P, AJ'OR SC'ILL OR RELiASE. TNb. ¢-'~RSONi'qEL iN-C~iA~E,E Sr-iA,._L SECUi:tE 'i'i-iE I:;ACiLI'FY BY D~ASCTiVAQ'ii'qG ALL Oi':k;'''':''~:'':''''''' ' ' THEN NOTIFY THE ~ODAL E~R~3ENCY R~SPg~'xS= bEP'Pl~,i'imEN'l AND 08/12;g91 ,-' ~ ~RUNDAGE L~NE AM PM .~15-000-000417 Page ~ - OO -Overali <E> Mit igaT lor,/Prever,~/Ahater,l~ > Release Prevent ion FACILITY U'FILIZES_ ~ ,,..J DALLrz~ P~r' 'F~-~r'J P.. 000 ~:']E! ~N UNDERGROUND 7'ANKS LOCAYED AT THE SC~]~ E~D OF THE SITE. iNVENTORiES ARE MO;~ITORED DAILY AND KEPT AT A MINIMUM TO MINIMIZE RISK. "NO SMOKING", "PLEASE ENGiigE", AND "DO NO]' ]'OP OFF YANK" SIGNS ~HE POSTED iN C~H~'~ VISiUP~ CONSUMER AND EMPLOYEES. COMPLIANCE 'FO POSTED SIGNS MINiMiZED POTEN]IAL RiSK AND HAZARDS. FOR MINOR SPILLAGE (i.6. CUS'FO~'i~R GAS E;~iPLOYEES ARE iNS]'RUC'FED ¥O CLEAN AND DiS?OSE O;:- mA'iER1A~ PRO'i"EC'FiVE RUBBER GLOVES AND CLEAN-UP' Eb)Ui~]:,tEi~]' ~.zi6jE 'FO CALC THEY WILL THEN NOTIFY EM~RGEN~SY CON]"AC'( PERSONNiL. (L~> Re].ea~.e Cc-,;-,tai;-,r,~,=.r:t S','O? ;::-'L.U:i.D :,:.'L. OW B',' SMU'~'i ll",4G (b~::i:: F-'LIF;.,--'S, S~iUi .D'ZIk.q'4 KLc-'C"~'~.;iL..i. i Y. {5> Ciear~ Up For Minor spillage (i.e. customer gas tank overflow), employee's are instructed to clean and dispose of materials safely. Protective rubber gloves and clean up equipment is provided at the facility. For major spillage, employee's are instructed to call 911 and report. (F> Site Ernerger, c¥ Fmotors Special Hazards L.~)- ~: zr.e P"',.'c, te~.. l[4vai i. Wa'ce'r-. PlRiVA'i"E FiRE PROTECTION - EMPLOYEES ARE ];NS'I"RdC~FED ON LOCA';'IO~4 OH Oi:'~RA]'iO%. iNS"¢RUC'~'IEIC4 iS ALSO GiVeN O!',~ LOCA'7'iON SHUT-OFI:' SWITCHES. FiRP' HYDRANT - CORNER O.~' BRUNDAGE AND H S'FR6. E'I <4> Bui 1,:Jlr, g (]cc,.~!.:,a~'~c]./ I_.ev.r._-'L -, · O0 -Overail Site <G> Training Page 1 WE HAVE t~ EMPLOYEES AT THIS FACILITY g WE H~VE MAI-ERIAL SAFE]'Y DATA SHEETS ON FILE PiLL NEW EMPLOYEES OF '[HIS S'I"PITION I,~iLL. UNDERGO '[RAINING 'I'HE EMPLOYEE WI]'H THE PROCEDURES F'GR "l"i-~E 5A?E I-~ANOLI~G Oi:: ~'IEF',iFILS~ PROCEDURES FOR EMERGENCY RESPONSE C. OORDiNA'i'IO?,~ AND Ei'~ERGENCY RE~SPONSE EQUiP~';Ei',~]' AND SUPPLIES. ALL EMPLOYEIZS ~<ECEiVE {3;- k-ieio for. Fu't,_,,r.~, .bse ~4> Held f,:,'~' I:-',.~t,~u-~e Use ARCO Pmdu .cts Co~ 17315 Studebaker Road Cerritos, California 90701-1486 Telephone 213 404 5300 Mailing Address: Box 6411 Ariesia, California 90702-6411 MAY 13, 1991 Bakersfield Fire Dept. Hazardous Materials Div. 2101 'H" Street Bakersfield, Ca. 93309 SUBJECT= ARCO FAC. %1960 1701 Brundage Lane Bakersfield, Ca. ARCO FAC. #3054 1129 Union Ave. Bakersfield, Ca. Gentlemen= - Please find attached the updated Hazardous Materials Inventory Disclosure forms for the Business Emergency Response Plan as we recently replaced the tanks at the above ARCO Facilities. VeL~; truly yours, F. T. Se~i, Environmental Compliance Administrator HazMat-SI CHEMICAL INVENTORY D CLOSURE FORM vet 2.1 ., Please, Carelully Read Attached Instructions ~~, ,~/~.~ PI.lie U.. Typewr#er or PHm Cie.fly Dale.,,,~'"- / O- ~/ B.I.D. I Page.// , HAZAIID INFO~IMITON: Phyelc~: I Hedlh: / O4m~d: __~. ilMdll FMm: L. Iliil Tglm: .~__ eIMIl~ A GODE8 LOC MM~k IMMM .... I, km On MI~ · Ellim 8i~e d LMeeM HazMat-SI CHEMICAL INVENTORY DISCLOSURE FORM vet 2.1 Please, Carefully Read Allached Instructions .' .~ Pleime U~e Typewriter or Print Clemly , Dale -,--,,----,~ ,,,,~:-/ ,.,.: ./~,,.,: q_ ,,--,,,-,:1- ..,..:.~._ ~lseile & CODEB LOC Mm~ U.ll~ d M~ On Bl~ ~D.I~ ~e d L~B, N4 M C P To Pm~ Odd ~ Olin Any Dly / Storage Temperature Coclee (T~ CODE STORAGE TEMPERATURE 4 $ ~at~r I~mn anlb~ 8"~ L" LJQUIO 8 ~~ ~ one (1) ohemmae aogke thru ~ ~ ~ d I. M t~: Pm~ Mm~ W~W~ M ~ ~ ~ ~ ~ ~ ~ ~~ mi~ ~ m~mum T- ~ g-~ I- ~~ E - ~TO~ ~1~ STORAGE ~nd ~T~~~~~~ (G~~~; ~~ 13 LOCATION ~ ~~~~~~~d~~y~f~l~. 17 A~Y ~ ~ ~ d~ ~ ~ ~ ~ ~ ~ ~ ~ g~ ~. 'flu Atlantic RiehbM ~,,~y tARC~O) brob~ ~or~# that it is in compllnnoo with the zequb~montd of Subpert H d~O ~ Pm 280. The ~nancial lism. in(:e moe~xanism ufed to demomtrum flnanci-~ i'osponsibility under SubiMfl H of 40 ~ Pail 280 is aa follows: · Amount: At lem~ ~,000.000 pet oonu-z~e and $2,000.000 I, ~tJ~Cl~,~'y~, ,~rl~'p~., ',~)/"'7~ t~.~_ Do hereby ~.i~ that I h~e reviewed the ~ached h'~;z~=-dous materials manage- ment p~an fo~ ~ ~.=~.~~a,,d that it along with co~,~m~,,~e a complete and ~rre~ man- agement plan for my facility. 0t~/13/91 ' B. NUNI ~GE L~NE Ir~ventory List ir~ ~CP 0~.~~ Ok~ - F~xed CorFgaineps c,n Site P i r, -" ~ e 'f' N a r,1 e / H a z a t~ d s Ii'ir'e, Init,led lilth, Delay O2-OO[~ GASOLINE (SUPER UNLEADED) Liquid ~..l~i~O_ FIc, der. aSe Fii.'~e, Immed Hith, Delay Hi-tn ,:)2~'.-OO1 GASOLINE (UNLEADED) x Lic:luid ,= ~:.'~:.:i~ ~0 F;c,'~ei'~ate F~.'pe, tmr~ed Hith, Delay H (i)8/13/91 ~ BRUND~%GE LANE AM Pm 215-000-0Cx}4i7 Page ~ OO - Overall Site <E) Mit iqat ion/Prever~t/Aba~ <1> Release Prevent i or, LOCA"I"ED AT 'I"H[~ ~ OF "FI41E SITE. :[NVEN'FC]F~ilSS ARE i~IOi',II'I"OF~ED DAILY Ab.D KEPT AT R MINIP1UM TO MINIMIZE R~SK. "NO Sf¢IOi.~ZNG"~ "F:'LEASE~ "fLJ~<i",l Oi:.:'F YOL..~I;.4 ENG.[NE"~ AND "DO NOT' 'TOi;' Of:'l= "I"Ai'4K" SZGI'~S ~.~i.~E POS'I'(~;D CONSUfdER AND EMPLOYEES. COMPLIANCE 'TO POSTED S~GNS b]lNIf']iZED POTEN"f'iAL RISK AND I..~RZARDS. ¢:OR tqZiqOR SIz'ZI..LRGtE (Z.~S. CUS"t"Oi¥1ER GAS fANI~ OVIERi=L..C~4) EIqI::'LOYEES ARE ZNSTRUC'i"ED 'f'O CLEAN F)ROi"I~EC'I-iVE I.~I.JBi~Ei:~ GLOVIES RNE) tSLESRI*i..--tJI:::' THEY WILL THEN NOTIFY EMERGENCY COt~4'TAC"f PE. RSC)NN~i~L. <2> Re].ea,:se C,=,r, tai',.nrner:t '.']~'i* CJi:::' F'i...U :l i3 ~::*'L_[:~W }}Y S]q--iLJ'i 'i :[ N[<~ []l:':'l::: t:.:'Li?;!..:".;]i. ~Z<i-'iL.J l" i3C)wi'4 I~i~L_EiC.:'T i:~; .[ [. ,~.'f'"'¢, C:.L]i",.l'i'lc~ j. ,,-',.~ "Fi-'iE i...:i:(~!LJ:[J.} ~4'y' [][]l'qt::~'l"i'4'.L.~L]'i'ii'4G ~iS(.]li .... ABSORBEN'[ MA]"Et:<'IAL. · !:::'RE. VENT' LiQUID <3> Clear, Up ' <4> []'bl'",e'~ .... Resc, urcr:e i-:lc't i'v'a'b ic, r, 08/13/91 BRUNDAGE LANE AM PM 215-000-000417 Page ' 00 '- Overail Site <F'> Site Emerger~cy Factors <1> Special Hazards <2> U'tiiity Snut...-.O'f:f's A G A S .... N 0 N E] B ELEC"f'RiCAL -. LC]CA'FEi} iN 'T?-iE BACK ROO~vl STORAGE] AREA ,.JHIc. R LOC:A'I]ED AT Bi:~UNDAGiE STREET DRIVEWAY D SPEC:IAL - EP'IERGENCY FUEL. E L..O Cl.< B O X ..... N 0 i3> l:-:'i'r-e P'rotec.. /Avai i. W-a'be¥". PI';::[VATE FIRE PRO"fEC:'flON - EP'if-'LOYEES ARE ZFISTRLJ[]TED ON [:X'I-Zi',K3U):SHERS AND 'i-Hf£ZF1 LOC:AT'iOi',i, ZNSTi~UCTIL]FI ]:S G~TVE2',i iZii~,'. LJ~::E AND C)i-:'EI:4[A-I'ION, ZNS"f'RLIC'flON iS Ai....E;O GIVEN C)N I._[]C::F:I"F':[CiI',-I Of" SHLJ'T-OF'I:' . SW I ]"CHE~. F:'iR[':' ['..l "~" l} l:;,' F-I b~ "t" - .... C[]RNER []F' BRUNDAGE AND <4> l~:~u:i..'Ld.'i.'r'~g (]c:c'.uc, a',~c,,' t....e',,,'e'~ < 1 > Page 1 WE HAVE t~ EMPLOYEES AT THIS FACILITY WE HAVE MATERIAl._ SAFETY DA'TA SHEETS ON FIL..E ALL NEW EMPLOYEES OF 'T'HIS STATION WILL. UNDERGO ]"RAINING WHICH F:'Au¥~ILIAF~iZES ]"HE EMPLOYEE WI 'FP~ THE F~ROCEDUR~/~S FOR "i'>..h~ SAF]~ P~AF~DLiNG []F HAZARD[IhS MATERIALS, PROCEDURES FOR EMERGENCY RESAONSE COORDIP~A]~IC)F~ AND OSE OF EEi",'iEi.~GEN[]Y I:tI~(:~;iz'GNSE EQLJ II'.:'MEI',I T Ai'qO SLJI::'i-:'L lIES. Al_l_ EI~IPLO"f'ii::I~:S R!ECE :I:VE I.;'.[-{I::'!.?iESi. iE?~ <3> H~,].d 'f'or F"_,'['-'. ute .Lisle <4> He'ld l:,':'r I:~'utu'r-,a. Ose BRUNDAGE LANE AM PM 2i5-000-000417 Page 3 ~ 0 Fixed Cor, tainer~ or, Si'~ Hazmat tr, ver,'tory Detail ir, ~tCP O?~e~-~ 02---0()3 GASOL_ I NE ( F(EGULA R ) L i q u 1 c] 600 ivl,z,(] erat e Fire~ Immed Hlth~ D~lay H'lth Fc, r'm: Liquid 'l"ype; Pure 'Days: 3C)~ Use: FUEL Daily Max GAl_ ' ! Oai iy Average Gl4!_ Ar, r, ual [4hl,Z, uY','b L~AI_ · ......... 6, 0C)0 ~ 3,000. ,')C GOO. ,:-x-~C~. 00 ............... Storage .................... [. i:'ress .. 'fernp Lccatior~ ...................................... I 00,, 0% j Gaso ]. i r~e j i~"hz, a erai~ e j l::: :.i. r e ,~ ! in m,..:e d 1'-~ i 'i; i"~ .,. i') e:e ]La '.':.' i"i i 'i'; ri E,,;'-; !_ C f.'.:~ S :l:;~: 8 0 0 ;}:i, ""' (}., :i..-.-".::~ "i' 1--- a,~ e E:'a (:: :: F.!,::, i:::'or.m: LiqJid 'Type: i::'u'r.e Da}".s: 3~..,5 Us.e; i:"L.~E.L.. '' ' I I . . .............................................................. L ,'], (2 ~£~ i.: ]. ,:::, i"'~ .............................................. .............. Storage:, -- Co'ri(2 I (:)~--..Cx) 1 GASOL. i i'41E ( ) I.L i a u icl 8000 fq,.-_,c~ e~' a-is F'ire.~ Imrne Hlth, Delay ~--lith GAL C A S ~:~: :L - 9 'T'~-'" a (:: e S e c r e 'c: l',~,::. i::'c, rm: tiLt:id ' "l'ype: Pu'r'"e Da'y~.: 3D5 bse~ F. LJEL.. G ("),:')C) i 4, 000. OC) I 80C),, C)(.)C),, ' '~ '' ! ' I _.q i:. v' ............ 'r'=~ [:J ~.:~ ..................................... j'- ,~ '/ ..... '=~'" ......." T i ~]h'lj] ......................................................... I t_ T,l'"';~'b ]. OY'l ................................................... G l:~OUJHi} 'l"Ai~ii< ~ Fh'n b ~ e~,'t J Anli] :L errb J SGtJ'l"rfl:~]At~:,'T C D',:?i'qi::~ R .... C,:,nc ...................................................................................................................... C <::,,'~ p c,'r",e r~!; s ................................................................. i ...... i'qL i: ............. j-L i I <i> Agency Nc, tificatic, r~ CALL 9 1 1 <;}~:> t::2r~'q:::]. ,::,yee I\t(:,'b :i. 1:". /Evac:'uat i c,'n ]: N ....~ ~' ..... MF:~iXlAGE{R~ F~SST!.A_'TF~NT., CASH Z ii:: P, Oi-;~ i'~]A~r.~'' ' :' ', ' ',:,~ ''''--' '; ._ ~ "' ... I:?,EF:'[]I:;,"i-. IF EVF-iCUA]"i['JFi IS i',.IE:'E-:E'SSF-/F~Y~ AND AF'-FE:R 911 HAS ~-:{,~:~:~i!.i',.i CALLE..O ~i","ii::'l ....... I~]'y'A'i::~.~ ,..~,"'~';"',-~.,_:. )i):[ J:t~ iC [] "i" [:] i} '1"["~... [--:i [:.:;T"FI~ ~][:::'!.:'[]~:/JiT~.:-_" .... t -,,:.-..' !)~'-':i?,.!(.ai~./R I:::ll;:ii~l':il. (':I-:tC I'L.J~ I'Y F:'ERSONF.iEL_ Wi L.L. ]' FiEN CALL. <S> Pub ]. ic' i",~c,'b i 1'=. /Eva(::uat i,::,r~ IN -f'HE EVE'MT OF:' A I~P~,.)'C~f;', SPILL. OR REL.~{ASE,. THE PERC~OF~i"4EL iN--C~-I~F::GE S~-iAL..L SECURE T'HE t::ACZI...IT'Y BY I}EASC'i'ZVi'q'i"iNG I::~L.L Dl~3i::'~ix.i~.[~i~:'~ f.]i~',~D EitJ~'.:viE[i.~S.[i.3L.~:~ i:'LJPli:'~3, AREA AWAY FROM THE DiANGi[ER ZONE. 'l'i-![E i]'!~(F~LE;~J]NiqlEi_ .[N-CHARtSEE AT 't'r-~E ]"li',iE :::~I'd.::~L.L THEN NOTIFY THE LOCAL EP1ER(SENE}Y F;~ESF'(;)iNS~. DEPFtR'i'F~f. EN"I AND Fq~:iCO MA iWi"E?,~Fh',qCL-. b IE i:' A i:~'i" i~ E ixl T'. ARCO Products Com 17315 Studebaker Road Cerritos, California 90701-1488 Telephone 213 404 5300 Mailing Address: Box 6411 Artesia, California 90702-6411 November 13, 1991 H A7 ~ ~'r. DIV. Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, Ca. 93301 Re: Updated Hazardous Materials Management Plan Arco Fac. #1960 1701 Brundage Lane Bakersfield, Ca. Gentlemen: Enclosed is the subject plan update and certification that you requested of our dealer. If you have any questions feel free to contact me at (213) 404-5391. Very truly yours, Envir0n~ent~l Compliance Administk~for encl. cc: T.L. Reeder for dealer APPC-7076-B ARCO Products Company is a Division of AtlanttcRichfieldCompany (7-88) 17315 Studebaker Road Cerritos, California 90701-1488 ~F Telephone 213 404 5300 Mailing Address: Box 6411 Artesia, California 90702-6411 MAY 13, 1991 Bakersfield Fire Dept. Hazardous Materials Div. 2101 "H" Street Bakersfield, Ca. 93309 SUBJECT: ARCO FAC. #1960 1701 Brundage Lane Bakersfield, Ca. ARCO FAC. #3054 1129 Union Ave. Bakersfield, Ca. Gentlemen: Please find attached the updated Hazardous Materials Inventory Disclosure forms for the Business Emergency Response Plan as we recently replaced the tanks at the above ARCO Facilities. Very truly yours, F. T. Segu%~ . Environmental Compliance Administrator fllzllll-SI CHEMIGAJ. INVENTORY DI~2LOSUI:IE PACKET Toil ~ o~ I~: ~ ToI~I # o~ Tm S~c~w ~ ~: HazMat-SI CHEMICAL INVENTORY DISCLOSURE FORM ver 2.1 Please, Caretully Read Attached Instructions. , ~~/1~, .~/~,~ PI.-- U.. Typewriter or Print Cie.dy · Dale ~,~'"-/~ - ?/ BID. / Page // ol ~'~ I I I II I I ' I I I ' F_ .l R.;,.t-_:..,,_,_;.;.,,: ..... .z.,..o...o~ ,~,,~: I ".': ! o--.,: -0,.,,--,...: L ",-,, ,--: .1~ WAII'E IIfOIMMTION: EPA Oode: 8kie Code: Ckli4: Mia I(.: -- Mai %: Ij · !~a°,fro'7 ~/,~""'- ' ," ' ' Joflee A CODE8 LC~ liMdi Unl~d M~ On 81e ~Def~ S~ze d I. mgeel am,d~ C P T I) P.e. e,*d Mmu,. On~,l)q O.S~. Cmdne, HazMat-SI CHEMICAL INVENTORY DISCLOSURE FORM vet Please, Caretully Read Attached Instructions ~' .~., · I I Il ' W~ ~~ EPA ~ ~ ~: ~: ~ ~ %: ~ %: ~& CODE8 ~~ ~d ~~ m~ ~ed~ ~ C P T_ O ~ ~ ~ ~~ WA~'IF. JFOIBAllON: EPA Code: 81,m CodJ,: CkJe: IIIn 1&: __ Idlm 'Il,: lluiwiv,BAm Sim'~ee & C 0 O E $ LOC M~ix Unls ol lam On S~e · I)W~ Size USAGE; ..... ~c(xiM (c) DMiX~d~ (D) ~ ~TORAGE 'I~PE ¢ODI;-DESC~IP!10N I Underground Tank 01 Sewer, wi[h clarifler or 2 At)ovegrourlCl Qrouncl Tank treamleflt 3 Fixed Pressurized Cylinders 02 Recycle 4 Portable PreMurized Cyb'N:Wm 03 InctnemlJon 5 Insulted Tank (incduding 04 NeutraJiz~ Cfyoganics) O~ Fi~,~Jon 6 Drum(s) or ~M(s) M StabiltzaUm por~ ? Cartx~(s) ~ l'rMm~r~ Pond ii Glt~s Container(s) 20 ~ewer, ~ Clarifier or 9 Sox(e~) ?remT~m 10 Bag(s) 21 Ground around business 11 MMaJ Containers (rKX drums) 22 Trash ~x Garbage 12 In Machinery or Processing 23 Ak', Release cluring Processing 13 Other (specify) 24 W=enNw, Exce;x Ocean 25 Storm Drain 2~ Init:tim wMI 27 Hazardous W_aste Landfill Storlge,Pre~ure Codl4 (P) 28 Land Appltca~)n CODI~ STORAGE PRESSURE[ 30 Surface Impoundment 31 TranMer 5ta~m 2 Greamr than ambier~ pressure Stor.ge Temperature Cod# (T) CODE STORAGE TEMPERATURE Aml~ant tempetamm s Greater than ambie~ temperature 6 ~ than and~erK temperamm 4 HAZARD INFO. Uee TaMe I to id·hilly the ~QpropdeM phyllr, d, hea~ encl genera/hazatc~ thai am Maocialed with 5 MKT'ERI~, FORM Enter the ·ne (1) chemcl~ code t1~ ~ ~ form M the mete~i,J, e~ S '" 8QUO L - UQUIO 6 MATEFIL4~ TYPE Entre' ~ one ('I) ~ Qode ~ deel~ ~ ~ype M melMtel, u tollaw~: P ,, PURE M - MDCTURE W -, WASTE 7 WAHTE INFO. I/the ~ tyl:M ii wi, Mi, then the r. hemi~M will hive · dMlgnited fed·fid end W wute code. if you kw the lpfxoM EPA end 81Me wM~e Godel, pienle identify. AddWoniJly, give the w~te OiMelflMftOfl r, ritmte for lfm metmiel end the el:~eM minimum end maximum ~x~tre~Jene o~ wMto In ~o meWteL Wefo ~tmlll~dieno sro M follows: T "TOXIC g ,,, FF. ACTNE I -, IGNITABLE E - EP TOXIC C - P.,OFFDS~ H - ACUTE ~ W.~TE if the mil~deJ b rM~k)e~ M in1M number M ountN M mJa~,un~L 8 MDC~JRE8 if the miIM ie · m~;_,o M eok~ tim IM ~ mcM hlzJrdoul Ir~redientl. LM the 9-12 STORAGE and UtingT~dMe2.1denl~thefollowMgfo~GocletylXm: (C:)MMageContainortylx; (l=)~torage In the (C~ oocie mdumn, identlly how thio cdtemiGal ii W Ooy Goflt~nM tyj~e). In ~e .IF) code · olum., ~ the oocle th( bMI denoHben the ~ PrlMure for the ·pm:Mo m~teriil k.:elion. In the (1) ~ aMumn, entM the code tt~ b~ dNc:rib.e the .tot. ge Teml~r~um for 13 LOCATION MATRIX Give 1he m~ ~ nurnl~ end g~ ~,~,'dinete af ~e lotion c~ the m.lMi~l in your f~ility. P A G E / G R I D Thee· ~xxdinal. e m~mN~eym,w IXOvtcled ei~ map~ (L·. Pg 1; Grid i~. 14 UNITS OF MEASURE ErlMl' the unll d nlenlum id quentilMe will be liMid In. Entre' eooording to the phyeic~d 8tsll of 8C:X.~ - l. B8 UQUIO - GAL,B (3A~" CU FT comp~iim~o with the requ.iremonU of' Subpefl H of' 40 CFR Pm ~,80. The 8nanci-t usm'tnee mechsnimn usod to demomt:ru~4 ~aM~ci-~ i'esponfibili~ under SubMirt H of 40 CFR Pert 280 is us follows: C°v oeuouououououououoU~~vo dAM: ,lenum~ 24.1989 · Amount: At best 81.000.000 per ~ and $2.000.000 ~m~denPm, ti# br bodily ~ md prupm~ dmnf~ mused by 818 8. IPIower ~, CITY of BAKER SFIELD "WE CARE" HAZARDOUS MATERIAL RELEASE REPORT FOR FIRE DEPARTMENT Notify CA O.E.S. (800) 852-7550 ....... 2101H STREET S. D. JOHNSON RECEIVI'L~AKERSFIELD, 93301 FIRE CHIEF 326-3911 Comp.ny .ame ~)~_CJ~ ~-'~ ~ m 0CT 1 5' 1991 Address ,t~ '7 {..9 { ~¢tJ~,t-'}~l-a O.4dO ~.. ,,~_~n~.._., HA,. M.~.,. U,v. Hazard Level - Low , ~/ MOderate High Extreme (Acute) Estimated Quantity of Release :,~ ~~ ~ C~~~.. Time ~ ~ %O Date / 0~ ~ ~ Duration of Release Date ~ Medium, into which release occurred:. ~~ ~ ~,, Health risks know or anticipated: Proper Precautions: Telephone Number HAZARDOUS MATERIAL.RELEASE FOLLOW UP REPORT Number of People Affected by Release -~ Extent of Any,~e~th Related Problems: Dates of Cleanup /0--/~ Contractor contractor's Respresentative Time of Contractor Arrival Description of Extent of Contamination Soil Water Air Other Description of Cleanup Procedures Used Qaulity of Hazardous Materials Removed (identification procedures, lab results if available) Registered Hauler Utilized Hauler # Material Transported to Manifest # Time and Date Job was Completed Current Status of Site Report By . _~Q~ ~~ Agency O Bakersfield Fire Dept. HAZARDOUS MATERIALS DIVISION Date Completed /. Business Name: z:;t~,.,.,-/~/~(~ ~'.,,/ /4'/y'//~ Location: / 7~d'/ ,d",~,,~,,~,z~.- ~',</ Business Identification No. 215-000 .¢"~fi~"¢'." ? (Top of BusineSs Plan) StationNo. ~ Shift ~ Inspector ,/y'.~,~o,,~. Adequate Inadequate Verification of Inventory Materials ~ ~] Verification of Quantities ~ Verification of Location ~] Proper Segregation of Material~] Comments: ~v~.~C'.~....~,'D "~.,,.',~: ,/-~,,,'~- ,,~2~,,.,/ fyc,'-/,~x-'~'~O ,,~-~ Verification of MSDS Availablity '~'""~ Number of Employees Verification of Haz Mat Training ~ Comments: ,,~',~z.,',r~z:? .~ ~-~,,J ~ ,,,-,r'~.~.v-,,-/Z .~',~'~-'~-e~',-~'' ° Verification of Abatement Supplies & Procedures ~ Comments: Emergency Procedures Posted ~ Containers Properly Labeled ~ Comments: Verification of Facility Diagram ~ Special Hazards Associated with this Facility: Violations: AllltemsO.K.' ~] · -~'- '~"/~'r ~ 1~ ~ Correction Needed I~ Business Owner/Manager ~' FD 1652 (Rev. 1-90) White.Haz Mat Div. Yellow-Station Copy Pink-Business Copy BAKERSFIELD FIRE DEPARTM~ o/~ /9" BUREAU OF FIRE PREVENTION ..~ Date APPLICATION Application No. In conformity with provisions of pertinent ordinances, codes and/or regulations, application is rnade by: Name of ComPany O' ~ Address to display, stare, install, use, operate, sell or handle materials or processes involving or creating con- ditions deemed hazardous to life or property as follows: ....... ~.~_ ~.~ ~v ........... '~'7";~ ...... ii;;'~X~i ................................ t, ~j RECEIVED OCT 0 9 1990 ,- ':"" .'.k.:k.:."...2%:,.'.-::'.: :':- - ':' .: '"it':- PERMIT FOR PERMANENT C-L-O'8~IM~ PERMIT NUMBER A 1322-27 OF UNDERGROUND ~OUS ADDENDUM SUBSTANCES STORAGE FACILITY 9. Soil Sample analysis: a. All soil samples retrieved from beneath gasoline (leaded/unleaded) tanks and appurtenances must be analyzed for benzene, toluene, xylene, and total petroleum hydrocarbons (for gasoline). 'b. All soil samples retrieved from beneath diesel tanks and appurtenances must be analyzed for total petroleum hydrocarbons (for diesel) and benzene. c. All soil samples retrieved from beneath waste oil tanks and appurtenafices must be analyzed for total organic halides, lead, oil and grease. d. All soil samples retrieved from beneath crude oil tanks and appurtenances must be analyzed for oil and grease, e, All soil sample~ retrieved [rom beneath tanks and appurtenances that contain unknown substances must be analyzed for a full range of substances that may have been stored within the tank. 10. T~he following timetable lists pre- and post-tank removal requirements: '"~'-~ ACTIVITY .DEADLINE Complete permit application submitted At least two weeks prior to closure to Hazardous Materials Management Program Notification to inspector listed on permit of date Two working days and time of closure and soil sampling Transportation and tracking forms sent to Hazardous No later than 5 working days for transportation and 14 working Materials Management Program. All hazardous waste days for the tracking form after tank removal manifests must be signed by the receiver of the . hazardous waste Sample analysis to Hazardous Materials Management No later than 3 working days after completion of analysis Program 11. Purging/Inerting Conditions: a. Liquid shaii be pumped from tank prior to purging such that less than 8 gallons o~ liquid remain in tank. (CSH&SC 41700)¥. b. Tank shall be purged through vent pipe discharging at iea~t 10 feet above ground level. (CSH&SC 41700) c. No emission shall result in odors detectable at or beyond property line. (Rule 419) d. No emission shall endanger the health.! safety, comfort or repose of any person. (CSH&SC 41700) e. Vent lines shall remain attached to tank until the inspector arrives to authorize removal. RECOMMEI~)ATIONS/GUIDF_J..IN~S FOR REMOVAL OF UNDERGROUND STORAGE TANKS This department is responsible for enforcing the Kern County Ordinance Code, Division 8 and state regulations pertaining to underground storage tanks. Representatives from this department respond to job sites during tank removals to ensure that the tanks are safe to remove/close and that the overall job performance is consistent with permit requirements, applicable laws and safety standards. The following guidelines are offered to clarify the interests and expectations for this department. 1. Job site safety is one of our primary concerns. Excavations are inherently dangerous. It is the contractor's responsibility to know and abide by CAL-OSHA regulations. The job foreman is responsible for the crew and any subcontractors on the job. As a general rul~; workers are not permitted in improperly sloped excavations or when unsafe conditions exist in the hole. Tools and equipment are to be used only for their designed function. For example,' backhoe buckets are never substituted for ladders. 2. Properly licensed contractors are assumed to understand the requirements of the permit issued. The job foreman is responsible for knowing and' abiding by the conditions of the permit. Deviation from the permit conditions may result in a stop-work order. 3. Individual contractors will be held responsible for their post-removal paperwork. Tracking forms, hazardous waste manifests and analyses documentation are necessary for each site in order lo close a case file or move it into mitigation. When contractors do not follow through on necessary paperwork, an unmanageable backlog of incomplete cases results. I[ this continues, processing time for completing new closures will increase. · Accepted By: _ ' OWNER OR :OE T WGN:c.~.~ RANDALL L, ABBOTT 2700 M Street, Suite 300 Agency Director Bakersfield. CA 93301 (805) 861-3502 Telephone (805) 861-3636 Telecopier (805) 861-3429 STEVE Mc CALLEY Oirecto, RESOURCE MANAGEMENT AGENCY DEPARTMENT OF ENVIRONMENTAL HEALTH SERVICES PERMIT FOR PERMANENT PERMIT NUMBER A 1322-27 OF-UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: Arco AM/PM #1960 Arco Products Company Wegener Construction 1701 Brundage Lane 17315 Studebaker Road 1710 Calloway Bakersfield, CA 93304 Cerritos, CA 90701 Bakersfield, CA License #413913 · Phone: 213-404-5570 C-61/D-40 PERMIT FOR CLOSURE OF PERMIT EXPIRES January 4, 1991 4 TANK(S) AT ABOVE APPROVAL DATE October 4, 1990 Wesley ?~'Nicks Hazar. ci'OUs Materials Specialist ............................................................................... POST ON PREMISES ................................................................................ CONDITIONS AS FOLLOWS: 1. It is the responsibility of the Permitter to obtain permits which may be required by other regulatory agencies prior to beginning work (i.e., City Fire and Building Departments), 2. Permitter must notify the Hazardous Materials Management Program at (805) 861-3636 two working days poor to tank removal or abandonment in place to arrange for required inspections(s). 3. Tank closure activities must be per Kern County Environmental Health and Fire Department approved methods as described in Handbook UT-30. 4. It is the contractor's responsibility to know and adhere to all applicable laws regarding the handling, transportation or treatment of hazardous materials. · 5. The tank removal contractor must have a qualified company employee on site supervising the tank removal. The employee must have tank removal experience prior to working unsupervised. 6. If any contractors other than those listed on permit and permit application are to be utilized; prior approval must be granted by the specialist listed on the permit. Deviation from the submilted application is not allowed. 7. Soil Sampling: a. Tank size less than or equal to 1,000 gallons - a minimum of two samples must be retrieved from 'beneath the cenler of the tank at depths of approximalely two feet and six feet. b. Tank size greater than 1,000 to 10,000 gallons - a minimum of four samples must be retrieved one-third of the way in from the ends of ' each tank at depths of approximately two feet and six feet. c. Tank size greater than 10,000 gallons - a minimum of six samples must be retrieved one-fourth of the way in from the ends of each tank and beneath the center of each tank at depths of approximately two feet and six feet. 8. Soil Sampling (piping area): . A minimum of two samples must be retrieved at deplhs of approximately two feet and six feet for every 15 linear feet of pipe run and under the dispenser area. BAKERSFIELD FIRE DEPARTMENT BUREAU OF FIRE PREVENTION ,~__50~.~ APPLICATION Application No. In conformity with provisions of pertinent ordinances, codes and/or regulations, application is rnade by: - L~ Name of Col~pany ~_.~' ~ v// Address to display, stare, instal-I, use, operate, sell or handle materials or processes involving or creating con- ditions deemed hazardous to life or proper~ as follows: Authorized ~re~ntative . RESOURCE MANAGEMENT AGENCY Environmental Health SenAces Department RANDALL L. ABBOTT STEVE McCALLEY, REHS, DIRECTOR DIRECTOR Air Pollution &ntrol District DAVID PRICE I!I W~LLL~M J. RODDY, APCO ASSISTANT DIRECTOR Ptanning & Development Sen,ices Department TED JAMES, AICP, DIRECTOR ENVIRONMENTAL HEALTH SERVICES DEPARTMENT PERMIT TO CONSTRUCT PERMIT NUMBER 270009B -. UNDERGROUND STORAGE FACILITY FACILITY NAME/ADDRESS: oWNER(S) NAME/ADDRESS: CONTRACTOR: ARCO AM/PM #-1960 ARCO Products Company Wegener Construction 1701 Brundage Lane 17315 Studebaker Road 1710 Calloway Bakersfield, CA 93304 Cerritos, CA 90701 Bakersfield, CA 93312 License # 413913 C61/D40 Phone No. (805) 589-5570 'X NEW BUSINESS PERMIT EXPIRES January 12, 1991 CHANGE OWNERSHIP RENEWAL APPROVAL DATE October 12t 1990 MODIFICATION '~e s~~ NicKS Haza~2~us Materials Specialist ........................................................................... POST ON PREMISES ........................................................................ .'... CONDITIONS AS FOLLOW: ..... Standard Instructions 1. All construction to be as per facility plans approved by this department and verified by inspection by Permitting Authority. 2. All equipment and materials in this construction must be installed in accordance with all manufacturers' specifications. 3. Permittee must contact Permitting Authority for on-site inspection(s) with 48-hour advance notice. 4. Backfill material for piping and tanks to be as per manufacturers' specifications. 5. Float vent valves are required on vent/vapor lines of underground tanks to prevent overfilling. 6. Construction inspection record card is included with permit given to' Permittee. This card must be posted at job site prior to initial inspection. Permittee must contact Permitting Authorit7 and arrange for each group of require.d inspections numbered as per instructions on card. Generally, inspections will be made of: a. Tank and backfill b. Piping system with secondary containment leak interception/raceway c. Overfill protection and leak detection/monitoring d. Any other inspection deemed necessary by Permitting Authority. 2700 "M" STREET, SUITE 300 BAKERSFIELD, CALIFORNIA 93301 (805) 861-3636 FAX: (805) 861-3429 Standard Instructions Permit No. 270009B 7. All underground metal connections (e.g. piping, fitting, fill pipes) to tank(s) must be electrically isolated and wrapped to a minimum 20 mil thickness with corrosion-preventive, gasoline-resistant tape or otherwise protected from corrosion. 8. Primary and secondary containment of both tank(s) and underground piping must not be subject to physical or chemical deterioration due to the substance(s) stored in them. Documentation from tank, piping, and seal manufacturers of compatibility with these substance(s) must be submitted to Permitting Authority prior to construction. 9. The following equipment and materials must be identified by manufacturer and model prior to their installation: Tank liquid level gauge(s) Tank Secondary containment automatic monitoring system(s) Sealer used to secure fill box(es) 10. No product shall be stored, in tank(s) until approval is granted by the Permitting Authority. 11. Contractor must be certified by tank manufacturer for installation of fiberglass tank(s), or tank' manufacturer's representative must be present at site during installation. 12. Liner shall be installed by a trained experience liner contractor and installation at site approved by the Permitting Authority. 13. Monitoring requirements for this facility will be described on final "Permit to Operate." 14. Monitoring wells on "Typical Drawings~ are not allowed unless monitoring probes are installed and functioning. Construction must be in accordance with Hazardous Materials Management Program standards as per UT-50. WN:jrw (hazmat \ niclls\270009B.ptc) Presiic..e $1ations. !nc. 17215 Studei3aker Road Cerritos, California 90701 (213) 402-1278 ~ 0 9 [990/ M~ch 7, 1990 CE~FIED ~L: P- 178-516-709 Ci~ of B~er~ield F~e Dep~auent~ A~: V~eme Pender~ass 2130 'G' Street B~er~leld. ~ 0~01 De~ V~eme: Pu~uant to our telephone conve~a~on of Febm~ 15, 10~0, a~ached please updated copies of our Ci~ of B~e~field Bus.ess Emergen~ Respo~e Plus for the fo~o~ loca~om: PSI ~534 2~8 Mt. Vemon Avenue PSI ~535 4203 M~g Avenue PSI ~580 1501 Ca.oma Avenue PSI ~5104 4010 Wlble Road PSI ~5175 ~450 ~ite ~e PSI ~51~ 1 41~ Ca.oma Avenue PSI ~5199 48~ F~ Road PSI ~5238 900 Monter~ Avenue Fac~ ~583 for 1701 Bmndage ~e was cloud by us on duly 1 , 1~8~. faciB~ is s~ opemtton~, Atl~tlc ~c~ield (~CO} ~s respo~ble for the Bus.ess Emergen~ Respome PI~. ~ you stated on ~e phone, the Chemic~ Invento~es have been approved. If you have any questions regarding the above, please call me at (213) 402-1278. Patrlcla ¥. Moore ' Environmental Analyst CITY of BAKERSFIELD Farm and AgLiculLure ~ SLandard Business 0E'HAZARDOUS MATERIALS INVENTORY NOV ! 5 1989 NON--TRADE SECRETS Page ___~,0f__ BUSINESS NAME'~~G~/~ ~/~ OWNER NAME:~R~O ~. Z~ NAME OF THIS FACILITY:~'~/Z/ LOCATION; ~ - ~~ 4~ ADDRESS; ~ ~W~o~ ~ STANDARD IND. CLASS CODE~--~ '--- ~.~ ~IP':~~/~. ~. ~o~ CITY. ZIP: ~~/~z~.~ ~o~ DUN AND BRADSTREET NUMBER-- ~ -- r.u.c .: ~2-~/~ ' PHONE ~: ~-~ ~ - - REFER TO~RU~O~~ROP~ CODES Trans. 2 3 4 5 6 I 8 9 10 I1 12 14 ~y,e Max Average Annual Measure , Qy~ Cont Cont Cont Use toc,tjon. Whece. ,.1.~,' Nmmes of Hixture/CamDonents !Code cooe Amt Amt Est Un,ts on 5~e Type Press lemp Code Stored ~n ~aclml~y~t See Instructions Physical ~nd Health Hazard ~S. Number Component Il Name & C.A,S, Number (Check al1 that apply) Component 12 Name ~ C.A.S. Number ~ Fire Hazard ~ Reactivity ~ Delayed ~ Sudden Release ~ Immediate Hca lth of Pressure Health Component 13 Name ~ C.A,S. Number Physical )nd Hemlth Hazmrd C.A,S. Number Component ~ Name ! ~,A.~, Number (Check al) thmt Component ~2 Name i C,A.S, Number D Fire Hazard D Reactivity D Delayed D Sudden Release D Immediate Hca Ith of Pressure Hca)th Component ~3 Name ~ C,A.S. Number Physical and Health ~alard C,A.5. Number Component l{ Name { C.A.S. Number / ' (Check mil thmt ~ Fire Hazard ~,R~m~tivit) ~ DelayedHealth ~ Sudd~nof PressureRelemse ~ Im~i~ Component I~ Name ~ ~,A,S, Number Component 13 Name ~ C,A.S. Number / '/ 2{~F vnon~ eri[igatioq .(Re~ ~,nd.~ign after complrtipg.all sec~ionq) .cer~lty under penam:) o)~a~ :n~ z nave pe~sonH~L examlnqoeqo)m tami~ar.~itb the information suDittrd in this.~nd all at~acned.documents, mnQ t~a: cased on.m) Inqu~r7 gr. cnose ~nolvlouams responsio)e for obtaining the ~ntormauon. I believe t~t the suomltteo l~Ior~atlo~ Is uue, accurate, and compme:e. . Name ~nd'Ol,~l~l t)tl~ Of Ownet/op~aCOr u~ owner/operator s authorized representative ~ature (~.v~e or ~rinn name Do h=~eb~~ cert~ ~-- - _~.~ that I have revie~.'ed the attached Hazardous F~aterials business plan (name of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. slgnasure -~,/ date 1. ~ill the st&re Off~ce of Emergency Services, OES, (telephone nu~er 1-800-85~-75S0 or 1-916-427-4341) in~edt&tely be notified? Check one: ._~ yes ..no. Vill l'oc&l emergency response personnel i~nedtmtely be notified by dt&ltng 9117 no. If business hms &n &dd(t(onml emergency response not(ftcmt(on system, Check one: X yes __ exp]&in here. How will people within the business facility who must respond to an incident be notified? The personnel in-charge at the time of the incident will call the Dealer and ARCO's Maintenance Department. 4. How will in~nediate not(ficatlon and evacuation of the business be done? (Include a description of the steps needed to evacuate employees and/or res(dents of the area surrounding the business in the event of a spill or release). In the event of major' spill or release, the personnel in-charge shall secure the facility by deactivating all dispensers and submersible pumps. If evacuation is necessary, all personnel are instructed to proceed to an area away from the danger zone. The personnel in-charge at the time shall then notify the local emergency response department and ARCO Maintenance Department. 4a.. Are all nt~ employees who may be impacted trained on evacuation procedures? Check one: X__~._yes 4b. Are all employees who may be impacted given refresher traininq on evacuation procedures? Check one: X yes .,,no. MEDICAL ASSISTA~ICE - in the event of a reportable hazardous materials or waste release or threatened rel ease: 5. List 911 local emergency medici.1 facilities that will be used: N~e of ~ergency medical Address: Phone: ADVANCE~D PREpARATXON - (n the event of a reportable hazardous materials or waste release or threatened release: 6. ~ITIGATION (REDUCE THE HAZARD) - Describe what procedures will be followed to reduce any harm or damage to persons, property, or the environment. See ~tem 7. release fr~. occurring. Inventories are monitored daily and are kept at a minimum to minimize risk, "No Smoking", "Please Turn off Your Engine", and "Do Not Top Off Tank" signs are posted in clear vision of consumer and employees. Compliance co posted signs minimizes potential risk and hazards. For minor spillage (i.e. customer gas tank overflow) employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean-up equipment is provided. For a major spillage, employees are to call 911 and report. They will then notify the emergency response personnel. 8. ABATENENT (STOP THE HAZARD): Describe what acttons your business will take to stop &ny hazard caused by tho release of a hazardous material Or waste. a. Stop fluid flow by shutting off pumps. b. Shut down electricity. c. Contain the liquid by constructing soil berms or covering the spill with an absorbent material. Prevent liquid from entering storm drains. g. Describe the tr&tntng ne~ e~q)loyeos ~o work ~th hazardou~ mater~ls or wute receive on s~fe. h~ndl~ng. employee with the following procedure~ for the safe handling of hazardous materials, procedures for emergency response coordination and use of ~ergency response equipment and supplies. A.) Employee8 will be info,ed of the health hazards involved with the handling of gasoline and diesel fuel. B.) Employees will not spill gasoline, diesel fuel, or waste oil onto themselves or the ground. Soecial attention to thi~ provision will apply during the replenis~ent of underground tanks. C,) Employees will no~ ~moke, light matchea, cause sparks, or take actions which could , ig~$t~fla~a~le liquids or vaoors. Continued on Extra page.,. IQ. ues~oe Chi refresher ~ri~ntfla ~loye~s ~o vGrk v~h h&z&rd~s ~ter~lls or v&stl receive on s&fe h&ndl tng. Ail employees will recelve refresher training yearly, on his anniversary dace, to re-familiarize h~ of all emergency procedures sec forth in items 9 & 11 herein. EHPLOYE£ TIMZNZNG 11. Describe how new enl)loyeeS ire tr&tnedwho are responsible for coo~tnattng wt~h local energency response org&ntz&ttons. New employees shall undergo trainin~ to familiarize chemselves on emergency procedures and what personnel and other emergency response organizations to call-during emergencies, Telephone numbers for all emergency personnel and response organizations shall be conspicuously displayed within the facility. Describe the r~fresher training for eel)loyees who &re responsible for coord)n&t(ng with local emergency response organ( zat(on~-. Refresher training for employees responsible for coordinating with local emergency response organizations shall be done on a yearly basis. 13. Describe the training for new ~loyeos who arm responsible for responding to a hazardous mater~&ls or waste rllelsl on the uso of emergency resl)Qnso equipment &nd supplies. Employees will use fire extinguishers in the case of fire or absorbent material to contain surface spills until emergency response personnel arrive. Employees will also call 911 to report the incident and the ARCO Maintenance Department who will be delegated to ~mmedlately dispatch a hazardous material contractor to contain the release and allebriate the emergency condition. 14. Describe the refresher tr&tn1~a for eq)loyees vho are responsible for responding to i hazardous materials or waste release on the use of emergency response equipment ind supplies. See Item 13. 9. EMPLOYEE TRAINING Continued. D.) Employees will be familiar with the emergency response procedures outilined in the Business Response Plan. E.) Employees will know the location of first aid kit(s), fire extinguishers, and emergency fire blanket(s), which are located on the premises. F.) Employees will know the location and operation of pump shutoff valves and electrical shutoff switches. FIRE DEPARTMENT 2101 H STREET O. S. NEEOHAM BAKERSFIELD, 93301 FIRE CHIEF Novemi3er Ej, ]. 9~,._q 326-3911 F. T. Seguin ARCO Fac. 21960 1701Brundage Ln Bakersfield, CA 93304 Dear Mr. Sequin: Thank you for returning your Hazardous Materials Management Plan for' the ARCO Facility #1960 located at 1701 Brundage Ln. The inventory forms however, are not adeauate for filing your inventory wighin the city. As you can see from the forms enclosed we do use different codes and do collect additional information. Please return the completed inventory forms by November 15, 1989, Sincerely yours, . Hazardous Hater~a±s Coordinator REH/ed ARCO Products Com ~4~ ~b, 17315 Studebaker Road Cerritos, California 90701.1488 ,~ ~ Telephone 213 404 5300 Mailing Address: Box 6411 Artesia, California 90702-6411 OCTOBER 25, 1989 Bakersfield Fire Dept. Hazardous Materials Division 2130 "G" Street Bakersfield, Ca. 93301 RE: ARCO Fac.#1960 1701Brundidage Lane Bakersfield, Ca. Gentlemen: Enclosed is the Business Emergency Response plan for the above facility where we recently had an ownership change. S~erely, C & M Ac~inistrator APPC-7076-B ARCO Products Company is a Division of AtlanticRichfieldCompany (7-88) BAKERSFIELD CITY FIRE DEPARTMENT 2130 "G" STREET BAKERSFIELD, CA 93301 (805) 326-3979 l 0FFIC[AL USE ONLY US I.%"ESS NAME HAZARDOUS lVL%TE R I ALS BUSINESS PLAN AS A WHOLE FORM 2A INSTRUCTIONS: 1. To avoid further action, return this form by 2. TYPE/PRINT ANSWERS IX ENGLISH. 3. Answer the questions below for the business as a whole. 4. Be as brief and concise as possible. SECTION 2: ~RGEN~NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-8S2-7~0 or 1-916-427-4341. This will notify your local fire department and the State Office of EmerMency Services as requi~ed by law. EMPLOYEES TO NOTIFY IN CASE .OF EMERGENCY: ~AME/"6~D TI,T~E.J~ ~ ~ /.. .~UR~G BUS. HRS. ~FTER BUS. HRS. SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE:. B. ELECTRICAL: C. WATER: ~(~,q~ O. SPECIAL: E. LOCK BOX: YES ,/~ IF YES, LOCATION: IF YES. DOES IT CONTAIN SITE PLANS? YES /~ MSDSS? YES ,/{~ FLOOR PLANS? YES /(~ KEYS? YES /~_~ SECTION 4: PRIVATE RESPONSE TE~%M FOR BUSINESS AS A WHOLE SECTION 5: LOCAL EMERGENCY .MEDICAL ASSISTANCE FOR YOtq~ BUSINESS AS A WHOLE SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL A~D REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS .MATERIALS: ....................................... ~ NO YES NO B. PROCEDURES FOR COORDINATING ACTIVITIES _.=._ _ WITH RESPONSE AGENCIES: .......................... Y~ NO YES NO C. PROPER USE OF SAFETY EQUIPMENT: .................. ~ NO YES NO D. EMERGENCY EVACUATION PROCEDURES: ................. NO YES NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO YES NO SECTION ?: MAZARDOUS ~ATERIAL CIRCLE YES - NO - I uhderstand; -' ' -' that thi~information will. be-used to fulfill my firm's obligations under the new California Health and Safety code.on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. - 2B - i NOTE= This is required by LAW to be filed with the appropriate Governmental Agency. (Calif. Bill AP-2IBS-8?) You are also responsible for notifing the Agency of any changes. BUSINESS EMERGENCY RESPONSE PLAN EMERGENCY CONTACT INFORMATION OWNERSHIP CHANGE ARCO FACILITY NO:__J~) BUSINESS ADDRESS: City ~ Zip Code ~r~a Cod~ Phon~ Number P~IMA~Y CONTACT: _ NO. 0~ EMPLOYEES:_ / HOURS OF OPERAT M; ;NCY Area Code Phone Number_~- AL TERNATE _~~ ~ ~ ~ CONTACT First Name La~ Na'me YOU ARE RESPONSIBLE FOR OBTAINING THE BUSINESS. PLAN ON YOUR FACILITY FROM THE OUTGOING DEALER/FRANCHISEE OR ORIGINATING YOUR OWN AND FILING WITH THE APPROPRIATE GOVERNMENTAL AGENCY SIGNATURE:_~ ~~--Date 3-28-8~ DISTRIBUTION: Org. Dealer File cc: Dealer, F. T. Seguin CR-133 S.[CTi,O,N, W. INVENT~ .. FIRE D~PARTNERT HAZARDOUS MATERIALS INVENT01tr file ~ - - . ~ll ~ell nil AIIICIel ~::~ ~t.--, !.7~/.~,~~~~ ..... ~,.,..,,,. ~~~~,~..~,~~~~ IO"'"""'' ramco number ()OB) JJJ--/~/.~ J ......................................................... ~Nolllsg Addi~,, ,, ~~ .. IENERSE~Y CONTACT.~ ICily ~~S ate Zip INooo/~~ ' . 0....' ~ "'" ~~~~ ~ ;0....,o....... ~ ............ ~ ............................................................................. ;--01 IPURPOS[ OF OISGLOSUR[8. II AliSa1 Disclosure II Cllsgl of BUIIBoII Address I~ CIIsgo el Bullooll I (Chock Dso) II Previously Undisclosed HlflrdOUl flltorllll II IOOf Cllljl Il ~uoutllV ~ .......................................................................... ~'~ ...................................... ICIoBIcol NOBo~/ I~ ~1 C.A.S./ I WVpo8 II Pure ~fllxturo Il Moots lilts Code I J ~J~ .... ~ J UIItl Il Lbo- ~GIIIOll Il ft~ Il Curio ~" - . - ~ I ~.-*./,--; cod.. ~// ... 0.,,v ,-, ~' ' ' ' I Physical StOIOI II Solid ~ Liquid II G,~ IL°cotl°° ~ Fire II Reactivity J PhyIIcoI HO]IFIl II Pressure J II Trlde Secret ....... II Colllde,fl~l J H.~ltl H,=lrd~ ~Acufe ~l ClrOllc I ............................................................................. ; ....................................... I ICle~lc~l Nl~/ ~ ~ J Types II Pure II HI,fire II ,lite ilste Cole I Units II Lbs ~GIIIosl II FYI II Curio ..... E,o..., ,,o..,. ,o,. ,.. ,o,.I I Throo~ol~, . ~Jor~oul COIPOIOItl ~ J OOmOOlllOOOOOml TJIL~ III ONLV IllOlllllplqll~~ J I,. ,....,,.., co,.. ~ ,~ ... o.,,, ,., I ,,._ . J,.,.,..,,,.,., ,,,.. jLocotlon . J Physical Hlllrdl ~lre il Pressure II RllCtlvltt J J Il Trade Secret Il Collldlltlll J Illth fllllrdl ~Acuto II Clrollc j ICE~IIF-ICATIONs I certify under pomolty of IoN tilt I hive porsonolly Oxlal'lod DOd em tJmllllr gill tko Itloraitlon J J submitted In till Io~ ~11 ottlckod documents, lsd that baled on ay Inquiry of tb~so Iodlvldulll respOnSible for J obtilolng tko Iltormotloo, I believe flit tho suboltted Information Il true, Iccirl~l, old Complete. J PRINT ~N[ OF OMN[R/OP[RAT~ ' - SIGNATURI ' OAT[ J DOCUMENTS ~EPAREO fly SIGNATU~J OAT[ II IIIIIIIIIIIIIIIIIIIIIIIItllllilllllltllllllllliO~J J~ I~[ US[ OH~JlIIIililIIIIIIIIIIIIIIIIIIIIilIIIIIIIIIIIIIIIIIII ClIY CODE II 0 II I II S II P II ~- IHS~JCl~ ~ I.~.~ ~ MI~ ~r~ ~~ ~ eooeeeleeeooeee ~l~ - 2. ivg ~iiy Mt 3. . . . , ~yltcal 6ti~s [J';kltd ~ltton ' ~ylt~l h.rdt .~lire [] .......~ ~t~, Il ~ 11 bile Il avg ~ily Mt I or ~ym M Bite , I] ~b k~t '[J'~AMtteL b~A~ knrd8 IJ ~u~ l] ~ca% ~, ~, Il ~re Il ~e Il ~ ~te ~ O,. ~rN ~mt b~r~ ~ntl C.A.8.i eeeeeeeemmmmmee JlTH Ill OILI ~3. ~ywtea% ~, Il ~%td (I ~d Il ~atton ~yit~t hsard~ fl F/re 11 ~w~e 11 ~vtty TIER THO Facility Identification Operator Name Phone= (805) 524-7599 EMERGENCY Name = ARCO FACILITY NO. 01960 Name = PRESTIGE STATIONS INC 595 AND HAZARDOUS Street Address: 1701BRUNDAGE LANE Hail Address = 1701BRUNDAGE L CHEMICAL City and State: BAKERSFIELD CA 93304 : BAKERSFIELD CA 93304 INVENTORY SIC Code= I 5541 I Dun & Brad No. I 04-542-6723 I 'Emergency Contact Specific Name: ~ L~~ Titl e:~Y~/b. Information FOR Phone ~)$ - ~-7~'~ 24 Hr. Phone ~o~- ~2~-~'9~ By Chemical OFFICIAL I lO # I USE Name= ARCO MAINTENANCE ~:~- ~-~ ~ ONLY I Date Received I Phone (213) 404-5356 24 Hr. Phone (213) 402-3166 Important: Read all instructions before completing form Reporting Period: From January I to December S1, 1988 INVENTORY STORAGE CODES AND LOCATIONS PHYSICAL AND HEALTH Max Daily Avg Da~ly No of Days (Non-Confidential) CHEMICAL DESCRIPTION HAZARDS Amount Amount On-site check a11 that apply code code days Storage Code Storage Location CAS: 008006-61-9 X Fire I-~-I I O3 I I 365 I I ~--~-4-1 Chem. Name PETROLEUM Sudden Release .... NAPTHAS (Blended of Pressure Gasoline) Reactivity Type~ LIQUID ONLY X Immediate (acute) _ Delayed (chronic) Certification: (Read and sign after completing all sections Optional Attachments (check one) I certify under penalty of la~ that I have personally examined and am familiar ~ith the ~nformation submitted in *his and all attached documents, and that based on my inquiry of those individuals responsible for obtaining I~1 I have attached a site plan the information, I believe that the submitted information is true, accurate, -- and complete. ~7~/~/S~.~a~u.~r~ ~ ~ ~/. J--J I have attached a list of -- site coordinate FRED T. SEGUIN, C & M ADMINISTRATOR ~ ~ abbreviations O~ner/Operator or Authorized Representative Date Signed 17215 Studebaker Road Cerritos, California 90701 RECEIVED March 22, 1989 HAZ. MALDi~ Ralph E. Huey City of Bakersfield Fire Dept. Hazardous Materi&ls Division 2130 G Street Bakersfield, CA 93301 Re: Business Emergency Response Plans Various Locations Dear Mro Huey, Enclosed for your review are 8 Business Emergency Response Plans for ~arious locations that we operate within your jurisdiction. If you should have these plans o~ fit~ then consider the enclosed as an update. PSI#535 4203 Ming Ave. Bakersfield PSI'#589 1501 California Ave. Bakersfield PSI#593' 1701 Brundage Ln. Bakersfield PSI#613 1129 Union Ave. Bakersfield PSI#5175 6450 White Lane Bakersfield PSI#5191 4100 California Ave. Bakersfield PSI~5199 4800 Fairfax Rd. Bakersfield PSI#5238 900 Monterey Ave. Bakersfield I will be your contact for any additional information or questions that you may have. My number is (213)402-1299. Sincerely, M~ager, Administrative Services Enc cC: M.M. Zawacki w/o Enc C. L. Connor w/o 'Enc F. Seguin w/Enc ARCO STANDARD BUSINESS E~LERGENCY RESPONSE 'PLAN · FOR ~ RECEIVED CITY OF BAKERSFIELD APR 2 1 lgg9 · ***************************************** HAZ. MAT. DIV. Address Hhere Business Is Conducted: 1701 Brundage Ln. Zip Code: Bakersfield, CA 93304 Unit Type: UnXt Number: HORK PHONE NUMBER Business O~ner Name: PRESTIGE STATIONS INC. t593 (213)402-1299 On-Site Manager, L~n~ Williams EMERGENCY PNONE NUMBER (2q-HOUR) Emergency. Contact, Lena Williams (805)832-5212 Alternate Emergency Contact: CHARLIE CONNOR 1-800-553-6246 ARCO MAINTENANCE (213)402-9126 Standard Zndustrial Classification ($[C) Code o! Business: 5,~41 Below Xe your mailing address. Please make corrections on the space provided to the left. AM/PM MINI MARKET t 593 P.O. BOX ~225 ATTN: ~MIN. SVC. CERRITOS, CA 90701 Oescribl the business operations that use or handle hazardous materials, c~NV~N]~C~ ;TO~ WIT~ GAS SALES ~axim~ n~ber o~ employees, 12 ., Total squar~ footage o~ facility, 2.000 ' :r~~ t~ Manager Admin. garv~mmS lR $19na f lustnes er or Authorized Representative Title Date ~Otlicl Use 0nZy I 90Z,. . Znsp. Z.O.,. Date, D/E Z.D., Date, CITY of BAKERSFIELD " '-'~ ~ HAZARDOUS MATERI AF-S INVENTORY' StlSl.ESS .AH[: ~/PM Mini-Market % 593 OWNER ................ NAHE: PRESTIGE STATIONS. INC. . Hanz ............ o~ T~S FACILITY: ~OCATION: ~7~1 Brundaqe Ln ADDRESS: ~'6]-fi6~ ~'~ .......... STANDARD IND.-gLASS'ODE 5541 CITY, ZZP: Bakersfield 9~304 cI~Y, zIP: CE~RITO~. CA 90701 DUN AND BRADSTR[[T NUHB[R PHONE ~: {805~ U]Z-b21Z PHONE ,: (213)402-1299 _51- ~c'l,t~ ,lIM ~'k ~,~ ~ly) C'A'S' ~ 8006-61-9 ~ It ~ & C.A.S. ~ .... REGULAR r-. ~ ~ ~&C.A.S. ~ k ,11 t~ ~ly) UNLEADED ~ltk d P~ ~ltk ......... k III IMf Miy) SUPER UNLEADED ~t12 ~&C.A.~. ~ ~~l~ ~ LENA WILLIAMS ~NAGER 832-5212 ~; R. REGER FIELD SUPERVISOR 664-787~... / STANI~AJ~O BUS[NESS PLAJ~ BP-S Cb) MEO[CAL ASS[STANCE - in the event of a reportable hazardous materials or waste release or thre~Cened release: 't. List all local e,~er~)ency ,~edical facilities that will be used: Mercy Hospital Fire Oepartment 2215 Truxton Rd. Dial - PIX Bakersfield, CA 93301 (805) 327-3371 (c) EVACUATION PLAN - How will immediate notification and evacuation of the business be done? (Include a description of the steps needed to evacuate employees and/or residents of the area surrounding the business in the event of a spil'l or release.) Are all new employees who may be impacted trained on evacuation procedures? Check one: XX ?es NO. Are all employees who may be impacted given refresher traintnq on evacuation proedures? Check one: XX Yes No. Evacuation routes, emergency exits, and staging areas for employees at the facility: -- Work area: Facility Sales Area -- Evacuation route: Leave Facility through available exits. -- Emergency exits: Two doors only. -- Staging area: Go directly to SW Corner of lot or area opposite danger. -- '~rJc area: Office/Storage -- Evacuation route: . Leave Facility through available exits. -- Emergency exitS: Two doors only. -- Staging area: Go directly to SW Corner of lot or area opposite danger. -1- STA,NOAJ~O BUS[NESS PLAN 6. I:'_"IERGIENCY RESPONSE PLA,~iS (a) NOT[FICA?iON 2ROCEOUR£S - in the event of regortable hazardous ~aterials or waste release or threatened re]ease: [. will t. he Sta:e Off(ce of E.~ergency Services, OES, (telephone number 1-800-852-7550 or l-gL6-42?-434L) i~mediately be notified? Check one: X! Yes ~o II. Will local e~er!)ency respnse personnel i~nediately be notified by dialing gT~? (~lon-t~mergenc¥ T,ocal ~kclministering ~kgencs? 805/326-39'/9. Check one: XX Yes No If business has an additional emergency response notification system, explain here. Job Title: Facility Manger -- For any e~ergency, call gll and report. -- I~eave ~acilitly through available exits. -- Call your Field Supervisor; give details of emergency. -- Your Field Supervisor will notify Atlantic Richfield maintenance, Area Manager and main office. III. How will people within the business facility who must respond to an incident be notified? Job Title: Facility Personnel {i.e. cashier, maintenance). -- For any emergency, call gl! and report. -- I, eave Eacilit¥ through available exits. -- C~11 your Facility Manager~ give details of emergency. -- lout Facility Manager will c~ll Field Supervisor and report. -- Tour Field Sul)ervisor will notify Atlantic Richfield maintenance, Area Manager and main office. -2- STAflOARD BUS[NESS PLAN BP-S id) MITIGATION {RECUE THE HAZA2g) Describe what procedures will be followed to reduce any harm or damage to persons, property, or the environment. "NO Smoking', "Please Turn Off Your Engine", and "Do No(: Top Off Tan)c' signs are posted in clear vision of consumer and employee. Compliance to posted signs minmizes potential risk and hazards. Facility personnel are instructed to clean-up minimal spills and dispose of properly and to report any major incident by calling 911. If needed, personnel will proceed to call all pertinent people listed on Attachment AA. (el ABATEMENT (STOP THE HAZARD): Describe what actions your business will take to StOl) any hazard caused by the release of & hazardous material or waste. For minor spillage (i.e. customer gas tank overflow), employee's are instructed to clean and dispose of materials safely. Protective rubber glo es and clean-up equipment is provided at each facility. For major spillage, employee's are instructed to call 911 a~ report. They will then notify personnel listed on Attachment AA. 7. PR£VE,~TION PLAN - (how will an unathorized release be prevented?) Facilities are equipped with red jacket lead detectors which shuts system down if leak occurs. In addition, inventories are also monitored on a daily basis and are kept at a minimum to minimize risk. 8. NEW EMPLOYEE TRAINING Maxkmum nu.mbe~r' of eml~lo1~ees - 12 (al Employees handling hazard.s m~terials: All personnel, new mhd existing, ~re given inst~ction on complying with the City of Bakersfiel~usiness ~ergency Plan. Upon completion of said instruction, employee will sign an~knowledge Slip (Attach~nt Cl. In addition, m Trainin~ Log (Attach~nt D) will be kept by the facility m~n~er to ensure that inst~ction has been carried ~t. One copy is kept mt the facility mhd one copy ts kept tn employee's file located at 1721~ Studebaker Road, ~rrttos, in Employee Relations Oepartment. STAJ(~ARO BUS[NESS PLAN (b) E.~ployees responsible for coordinating with first responders: Facility personnel are instructed to call gl1 and report. They will then call all pertinent people listed on Attachment AA and report. (c) r.~ployees responsible for deployment of e~ergency equipment: Employee's are instructed on location of fire extinguishers and their proper use and operation. Insttuction is also given on locations of emergency fuel pump shut-off switches. See Attachments A and lt. (d) Employee training on Emergency Response Plans: -- Personnel are instructed to call 911 and report emergency. -- Personnel are then instructed to proceed to a site opposite danger. -- If needed, personnel will proceed to call all pertinent people listed on Attachment AA. -- All secondary entities will then be notified. -- MSDS Sheets are present at each facility. g. REFRESHER TRAINING {a) Employ. ees who handle hazardous materials: A Training Log (Attachment O) will be kept at facility to ensure that initial instruction has been carried out. Said training log will also be used for refresher training of said employee co,~nensurate with employee's anniversary date. (b) Employees responsible for coordinating with first responder$: Facility personnel are instructed to call 91! and report. They will then call all pertinent people listed on Attachment ~ and report. -4- STANDARD BUS[N£SS PLA~ (c) Employees responsible for deployment of emergency equfpment: F.~ployee's are instructed on location of fire extinguishers and their proper use and operation. Instruction is also given on locations of emergency fuel pump shut-off switches. See Attachments A and B. (d) Refresher training on E~ergency Response Plan: A Training log {A~.tachment D) will be kept at facility to ensure that initial instruction has been carried out. Said training log will also be used for refresher training of said employee co~ensurate with employee's anniversary date. Fire Exfing ishers .,.,,-.,..,~.,, ,.., ..,,~,..,.. ,o, ~,....,. ____ u ,,. · ~.,-.. ,o...~ ,.., .,, ,,, ,...,,,u~,.., 1. Pull 2. Il Ilteee'$ & life. gel evetyo~ Oul$~le CaB I~ I.e Pull lite ~n ~ .n,ls (~u.e the (eleas,n0 ~~ ~ I~N a s~g Iae ~ Il ~ lac ~l el a I~k idlCh. I~ess.-j a puncluee I~e(. el ~aY ~ I~ lee a~ ~ eN~ ~'1 lei lue ~k ~~--,.---,,~~,.. 2. Aim 3 ~e ~e ~ ~'1 u~ ~ ly~ e~l~uls~ Am Ihe e~hmj(.shef no]~ (ho~n. m ho~) ~ ~1~ ly~ f~e--d may m~e I~ lae wa~ al Ihe ~M ol Ihe lue 3 -~ Sq~Je ~ ~e~s Ihe h.nUle ~ 4.~~ S~I) kern s~e Io s, le al Ihe ba~ ol Walch IO; ~ellaSh ~al ee~hvale I~ ' ~ ~am ~t~ ~m This IsYour New .,~..,~ ~,,~. ~. c.. ~,.. ,,~. ~,,.. ,....,~......,. ,o~ ABCD'sv.~ Portable ,~., ~, - ,.,~ -,,,,. ,., ..... ,-...,. . ~ ,-,-,..,,.,,..-,.-, ,,,,,,,.,, ,,.,,,-,,,,.,-.,. fire~*r--u,-*;n-u;s~ers "*'"--*. *'""' * '~" ''~ ~"~ "' ~ .~,,......,.,.......,,.u,.~.,. I ENh~sh~s c~e m d~ (:hemtcal. loire. Ci~I~ iul I~ lJI~ ~ ~ I~ III C~ II I~ ~ I H~ I~ ~ NV t~ I~ I(~l~ A.O.C.D ~ I~uI~ ~ uII il ~k I~dd8 ~INl~ ~ AIk ~ ~il~ ~ b hive ~ I~ i~ ml~l~ ~t~fge ~ ille ANY uso A ~ ~ ~ ~ ABC ~s ~ ~11~s W ~al I~e ~zi~ds ,ml (~m ~ escal~ ~le. Ikel - K. ~. ~ c~h. ~ ~. ~ S f~ ~e ~la,Is. Iff Sla~fd E~sh~s. NFPA 10. It ~ ~Jy ~e I~. ~lj ~1 w~l Io ~1 i ' ffi "-'"'d' Fuel h ~1. Oi~. I~ N~ll. . ._..._, National Headquarters 7215 Studebaker Road Cerritos. Califorma 90701 SLIP I have been instructed on the use of the Business Emergency Plan Manual and have read and understand all the information and instructions as stated. Further, I agree to abide by the statements and guidelines outlined. I further acknowledge that failure to conduct my actions in compliance with these guidelines may result in the termination of · my employment. Signed this day of , 19__ Employee Signature Facility Number Witnessing Supervisor Signature Attachment C BUSINESS EHERGENC¥ TRAINING LOG INSTRUCTOR TITLE DATE OF TRAINING E.~PLOYEE'S SIGNATURE INSTRUCTOR'S SIGNATURE .~-, CAS - EMERGENCY CALL: 911 STATI'ON MANAGER Lena Williams . 805/832-5212 FIELD SUPERVISOR,B. Reaer .... 805~664-7875- AREA MANAGER J. BARKE~-~LEIN . 702/873-5168 1-800-553-6246 MAINTENANCE BQB ELKINS .., 213/402-9126 , ARCO % 1960 PSI %593 WHEN CALLING ARCO MAINTENANCE GIVE ONLY THE ARCO ~. CERRITOS MAIN OFFICE: 213/402-1299 Attachment AA 213o *G' STREET BAKERSFIELD, CA 93301 (805) 326.39?9 tOFFICIAL USE ONLY ID~ USINESS .~.~E HAZARDOUS lVIATERI ALS BUSINESS PLAN AS A WHOLE F 0 RlV[ 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 A. BUSINESS NAME: AM/PM MINI MARKET ~593 B. LOCATION/ STREET ADDRESS: 1701 Brundage Lane CITY: Bakersfield ZIP: 93304 BUS.PHONE: (213) 402-1299 SECTION 2: Ei~RGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law. E,',iPLOYEES TO NOTIFY IN CASE OF ENERGENCY: **ALSO SEE PAGE 2C** NAME AND TITLE DURING BUS. HRS. AFTER BUS. HRS. A. Bruce Wilkes Ph# 213/402-1208 Ph# 509/754-3174 B. ROD Rose Ph# 213/402-1299 Ph# 916/487-5500 SECTION 3: LOCATION OP UTILITY SHUT-Off9 FOR BUSINE98 A{ A MllOLE A. NAT. GAS/PROPANE: N/A B. ELECTRICAL: Located in the bask room s~oraqe ar~a C. WATER: Located at Brundaqe S~reet driveway (see Paqe-5A) D. SPECIAL: Emerqency fuel shut-off located on cash reqister (see Paqe 5A) E. LOCK BOX: YES / NO IF YES, LOCATION: No IF YES, DOES IT CONTAIN SITE PLANS? YES / NO MSDSS? YES / NO FLOOR PLANS? YES / NO KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TEAM FOR BUSINESS AS AW HOLE For a minor spillage (i.e. customer gas tank overflow), employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean-up equipment is provided at each facility. For major spillage, employees are instructed to call 911 and report. They will then notify personnel listed on Page 2C. SECTION 5: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOUR BUSINESS AS A ifltOLE The following is the closest facility to our business: Mercy Hospital 2215 Truxton Avenue (805) 327-3371 Bakersfield City Fire Department Station 127 Brundage (Emergency medical technician on site) SECTION 6: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGPJh~ 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 .WATERIALS: ....................................... NO NO B. PROCEDURES FOR COORDINATING ACTIVITIES WITH RESPONSE AGENCIES: .......................... /~O ~~0 C. PROPER USE OF SAFETY EQUIP~NT: .................. NO NO D. EMERGENCY EVACUATION PROCEDURES NO NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... NO NO SECTION ?: CIRCLE YES OR NO DOES YOUR BUSINESS HANDL~ HAZARDOUS MATERIAL IN QUANTITIES LESS TH~ 500 POL~DS OF A SOLID, 55 GALLON8 OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED OAS: ...... YES NO I, Mitchell N~ , certify that the above Information Is accurate. I understand that this information will be used to fulfill my firm's obligations under the new California Health and Safety code on Hazardous Materials (Div. 20 Chapter 6.95 Sec. 25500 Et Al.) and that inaccurate information constitutes perjury. 'SIGNATURE ~~.~~ TITLER~tail Operations DATE ~//o/~, ,, CAS EMERGENCY CALL: 911 STATION*MANAGER 'DONNA CT.RVINGER (805) 835-0911 FIELD SUPERVISOR BRUCE WILKES (509) 754-3174 AREA MANAGER RON ROSE (916) 487-5500 MAINTENANCE VINCE CORSELLO (213) 402-8026 ARCO # 1960 PSI ~593 WHEN CALLING ARCO MAINTENANCE GIVE ONLY THE ARCO %. Cerritos Main Office: (213) 402-1299 401-1203 BAKERSFIELD ClTY FIRE DEPART~ 2130 "G" STREET BAKERSFIELD, CA 93301 0FFiCL~L.USE ONLY ID# BUSINESS N~IE: BUS I NESS PLAN SINGLE FACILITY UNIT " FORM SA : INSTRUCTIONS 1. To avoid further action, this form must be retu~-ned by: 2. TYPE/PRI.YT YOUR ANSWERS IN ENGLISH. 3. Answer the questions below for THE FACILITY UNIT LISTED BELOW 4. Be as BRIEF and CONCISE as possible. FACILITY L~IT# FACILITY UNIT N~qE: SECTION 1: MITIGATION, PREVENTION, ABATEMENT PROCEDURES Facility utilizes two 4,000 gallon and two 6,000 gallon underground tanks located at the South end of the site. Inventories are monitored daily and are kept at a minimkun to' minimize risk. 'No Smoking', 'Please Turn Off Your Engine', and 'Do Not Top Off Tank' signs are posted in clear vision of consumer and employees. Compliance to posted signs minimizes potential risk and hazards. For minor spillage (i.e..cus'tomer gas tank overflow) employees are instructed to clean and dispose of materials safely. Protective rubber gloves and clean-up equipment is provided at each facility. For a nu~jor spillage, e~nployees are to call 911 and report. They will then notify personn.nel listed on Page 2C. SECTION 2: NOTIFICATION AND EVACUATION PROCEDL~ES AT THIS 5.~.'IT ONLY In the event of any major incident, our facility personnel (i.e. facility ~nager, assistant, cashier or maintenance) will immediately call 911 and report. If evacuation is necessary, and after 911 has been called, employees are directed to a site opposite the danger area. Facility personnel will then call and notify personnel listed on Page 2C. -' SECTION 3: HAZARDOUS MATERIALS FOR THIS UNIT O~%Y A. Does this Facility Unit contain Hazardous ~[ateria~s? ...... If YES, see B. [f N0, continue with SECTION 4. of the hazardous materials a bona fide Trade Secret YES~ B. any If No, complete a separate hazardous materials inventory form marked: NON-TRADE SECRETS ONLY (white form If Yes, complete a hazardous materials invet~to~y form ma~ad: T~ADE SECRETS 0XLY (Fellow form ~4A-2) in addition to the non-tPade secFet fo~m. List only the t~ade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECTION ~ployees are instructed on location of fir~ exting~lishers and their location. InStruction is given on use and operation. Instruction is also given on locations of e~ergency fuel pump shut-off siwtches. See Attaclu~ent A and B. SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY E,~lgRGENCY RESPONDERS Fire hydrant located on corner of Brundage and "H" Street. SECTION 6: LOCATION OF L"FILITY SHIJT-OFFS AT THIS UNIT ONLY. .~ NAT. C,.\S,~PROPANE} N/A B ELECTRICAL: Main electrical panel is located in the back room storage area (see Page 5A) C. WATER: Shut-off is located at the Brundage Street driveway (see Page 5A) O. SP~CTA~: Rmergency primp Shut-Off Switch/located on cash register (see Page 5A) E. LOCK BOX: YES ~ IF YES, LOCATION: IF YES, SITE PLANS? YES / NO MSDSs? YES "MO FLOOR PLANS? YES /' NO REYS? YES "NO BAKERSFIELD CITY FIRE DEPARTMENT I.D. # FORM 4A-I Page NON--TRADE SECRETS HAZARDOUS MATERX ALS X NVENTOR"~r BUSINESS NAME: ;~4/PM .Mini Market ~ 593 OWNER NAME: Prestige Stations. Inc. FACILITY UNIT #: 593 ADDRESS: ]7~1 Br. ndage Lane ADDRESS: P.O. BOX 6225 FACILITY UNIT NAME:~4/PM Mini Mkt CITY, ZIP:__ Bakersfield ' 93304 CITY,ZIP: Cerritost CA 90701 PHONE #: ¢R05} 324-7599 PHONE #: 213/402-1299 [OFFICIAL USE cFIRs CODE ! ONLY I 2 3 4 5 8 ? 8 9 10 TYPE MAX ANNUAL CONT USE LOCATION IN THIS · BY HAZARD D.O.T CODE AMOUNT AMOUNT UNIT CODE CODE FACILITy UNIT MT. CHEMICAL OR COMMON NAME CODE GUIDE P 4,000 624,000 ggl O1 19 South of lot 100% Gasoline (Unleaded) I[~ FLLQ two 4,000 gallon P 2,400 374,400 gal O1 19 South on lot 100% Gasoline (Super Unleaded) i/~ FLLQ one 6,000 gallon P 2,400 374,400 gal 01 19 South of lot 100% Gasoline (Regular) 11~2k. FLLQ one 6,000 gallon NAME Mitchell N~ TITLE: Rtl Oper AnalystsiONATURE: // .... ~ r/~ DATE: ~M~.~tNCV CONTACT: Sruce Wilkes TIT;E: Field Supervisor /PHON~ · BUS g~UNS: 213/402~1299 EMEROENCY cONTACT: Ron Rose TITLe: Area Manaqer PNONE · BUS NOUaS: 213/402-i299 PRINCIPAL BOSINESS ACTIVITY: Self-serve Gas Station/M~nor'auto Repaxr 4FT~R BUS. HRS: 916/48~-5500 This Is HowMost ,.Although the majorily o' extinguishers work with our directions, there are exceptions. Read lhe Learn How To Pass ~ t; ,., ; I~,~ instructions on your extinguisher for variations mm.--,-.- -...-x..n,u,s..~rs ,,x~ ,,c,~re,. ,o~r m,n~ ,,a, w,,,,,,,-~ ,.s,r~c,,o.s 1. Pull W ork on the extinguisher you will be using. 2. If there's a fire, gel everyone outside. Call the fire Pull Ihe pin. Some unils require the releasing departmenl. Then fight a small fire only. If the fire gets of a lock latch, pressing a punclure lever, or large, gel out. Close doors Io slow the fire spread, other motion. s,., ~.,.ee. ,,e ,,re a., .. e~,,. ~o.', ,e, ,,.e ~,oc, Aim your escape palh in case il goes out el control. 2- 3. Make sure you don't use one type extinguisher Aim the extinguisher nozzle (horn, or hose) on another lype fire--il may make the fire worse, al lhe base of lhe fire. Common errors (they can be fatal) are using water (,,) on. ,reas~ or on an e,ec,r,c., ,,.e (. o. C). 3. _Squeeze 3. /~ Squeeze or press lhe handle. 1 4.Sweep_ · Sweep from side to side at Ihe base of lhe · ~ fire unlil it goes out. Shul off the exlinguisher. · Walch for reflash and reactivate the extinguisher if necessary. Foam and water extinguishers require slightly different action. Read the instructions. Learn Not 1~ Burn This IsYour New "ece.,,~p,c,ogramshavecome,n,o u.,e ,hesep*ch,re F,re ex,ngu,shers where,ou work. in blue Ihe type of lire on which an extinguisher is Io be ABCD's~,.'~' Portable ,,s~. ~ow. ,. ~,~. ~,,~ ~,~ ~,~ ~.~ .,~,..~. o, ,, ,~ -.~-~-,'~ ,.~ ,~ ,.~. ~.,,,.~,,,~,,~,. ~'~"- lites on which lhe extinguisher I~ nol lo ~ used For able for use a~d your lob Io k~ow how Ihey work Fire E he example, on a class "A" type, Ihe Iollowing la~l would Buying and maintaining an extinguisher. x.nuu.s*;-; rs ..~..,~ l. Exlinguishers come in d~ chemical, Foam. carbon A lire exlinguisher is a slorage conlainer for an exlin- ~ il should be labeled by a lesling laboralo~. guishmg agent s~ch as waler o; chemicals II is design~ ; Io pul oul a small lire. nol a big one. ]~ _ , 2. The higher Ihe number raling on lhe e~inguisher, An exlinguisher is la~led according lo whelher Ihe '* Ihe more fire il puls oul. High ral~ ones are oOen (nol lire on which il is Io be used ~curs in w~ or clolh. NFPA 10, Slandard for ~dable Fire Exlinguishers, always) Ihe heavier m~els. Make sure you can hold Ilam~ble liquids, eleclrical, or melal sources. Using r~om~nds that extinguishers ~ la~led wilh picl~ and o~ate the one ~u mighi buy fo; home use or one lype exlinguisher on anolher ly~ lire can make Ihe grams. However Ihe user ~y find lhe Iradilional A.B,C, D be required !o use al work. rue much worse So learn how exlinguishers are la~ls, or ~lh I~ pict~ra~ and lhe A.B,C.D la~ls la~led and used. on an extinguisher. 3. Ask your dealer how to have ~ur e~inguisher sewic~ and inspecl~. Recharge il after ANY use. A Tradilionally Ihe la~ls A,B,C, or D have ~n used Io You ~ an edinguisher al home. padially us~ one mighl as well ~ erupt. indicate the ty~ of lire on which an exlinguishe; is to ~ I1 you plan Io buy one e~inguisher, a mulli-pur~se 4. E~inguishers should be inslalled away from used. d~ chemical label~ ABC puls out mosl lyes of ~lenlial fire hazards and near an esca~ roule. lites - w~, pa~r, and clolh, flammable liquid, or eleclrical fires. 5. For more delails, see Standard for Podable Fire Il you buy more l~one, you mighl wahl lo gel a E~inguishers, NFPA !0. BC for the kitchen, an A lot lhe living room. and an ABC for the basemenl and garage. Fires in paper, clolh, wood, rubber, and many plaslics require a waler lype exdinguisher labeled A. Fires in oils, gasoline, some painls, lacquers, grease in a Irying pan or in lhe oven, solvenls and olher llammable liquids require an ex'tin- .-. guisher labeled B. Fires in wiring, fuse boxes, ener- ---_ gized electrical equipmenl and olher eleclrical sources require an exlinguisher labeled C. · Combuslible metals such as mag- nesium and sodium require special exlinguishanls labeled D. BUSINESS Fd4ERGENCY TRAINING LOG INSTRUCTOR TITLE DATE OF TRAINING F~4PLOYEE' S SIGNATURE INSTRUCTOR' S SIGNATURE Prestige Stations, Inc. National Headquarters 17215 Studebaker Road Cerritos, California 90701 ACKNOWLEDGMENT SLIP I have been instructed on the use of the Business Emergency Plan Manual and have read and understand all the information and instructions as stated. Further, I agree to abide by the statements and guidelines outlined. I further acknowledge that failure to conduct my actions in compliance with these guidelines may result in the termination of my employment. Signed this day of , 19__ Employee Signature Facility Number Witnessing Supervisor Signature