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HomeMy WebLinkAboutBUSINESS PLAN Hazardous Materials/Hazardous Waste Unified Permit CONDITIONS OF PERMIT ON REVERSE SIDE ........... ~,~,~..,~,~,~;,,~,~,~,,,, .............. This permit is issued for the following: , ?i?"i.~i,!:~:!!:i~:?~:~ii ii~,ii!iiii~: ,~ii iiii, !iiiiii i? iiiiii~ i~erground Storage of Hazardous Materials PERMIT ID# 015-021001156 .~,~i~?~:;',,'I, i:~,;!:i~il;i:!!iii!iiiii?' ..i!!!!!:?:!!!!!?ii!iii!~:!?!!!! ,ii~ ,~ ~Eii~anagement Program LOCATION 2305 BRUNDAG~':::::~?:~:~ ~:~:?~ BA~S~_~D CA '~?:~ ~ ~:'~::~..~ '~--~-.~ ~.~,. ~ .-: ~ .... ~'3 ~.;~ ~. -~:-, ,-...'~h. ~.~,. ,* .,. ~., .", :. ;..'..W' ~?¥~,. .,~ ,, ' ". '~:? ~: ';',i~ ~--" .. ":.:?~.=.~.~ =~;~= ~. ~ :~:..~i~"~, <' + ,Issu~ by: OFFI~ OF E~ O~JL S~ ~CES 1715 Chewer Ave., 3rd Floor B~e~fiel~ CA 93301 Voice (805) ~2~3979 F~ (805)~26~S7~ Expkation Date: F.&C I L I TY M .o~.~ = //3~ ~ORTH SCALE: BUS ]:~'ESS ~'A,',~E: FLOOR: OF DATE: / / FACILITY N~E: UNIT ~: ~F (CHECK ON'E) SITE DrAGR.~Y / FACrnr~ DrAGRz~Y SITE D[AGRAM (Require ems) ~ -. ' I ,tddres9: Identify the 9 Loc{~ (key) Box '~' principle building~ ; by the Street uumDers, i0. ~SDS Storage Box 2. Street(s). Alleys. 11, Railroad Tracks Driveways, and Parking Areas adjacent to the 12. Fence or Barrier property. Include the a. Wire street names. b. ~asonry 3. Storm Drslfls, Culverts, Yard Drains c. Wood 4. Drainage Canals. Ditches. d. Gates Creeks, 13. Powerllnes 5. Buildings a. Frame construction 14. Guard Staclon b. Rasonr~ construction 15. Stora~ Tanks: Identify the c. Hetal construction capacity In ~al. a. Above ~round d. Accnss Door b. Unde~und - -- - '' a. ~s b. Electricity i?. incuaClnn Route Fire Standpipe 20. Outside Hazardous Conuecciono Naterlai StoraKe d. Mater ~ontrol Valves 21. Outside Hazardous for protection systems Watertal Uae/Randlln~ e. Fire Pump ~2. ~ of Hazardous N~cerial/Wante 5toted Fire OesarcmanC Access or' Used (See TYPE OF HAZARDOUS .~AT~RIAL Fin--able E '- ~xploslve L - L/qUid R - Radlologlcal Corrmmsive O - Oxidizer G - Gan P - POison Water Reactive T - Toxic S - Solid H - Cryo~fltc O - Waste B · itlnloglcnl Example: FlammabLe Liquid - FI, FACILITY ~IAGRA/4 (ReqUired items la addition to ~he above) I. Risers for Sprinklers 8. Fire Escapes ~. Partitions 9. A~r Conditioning Units 3. Stairways: Indlcate the 10. Windows levels served from hlRheet to lowest. 11. Inside Hazardous ~as~e S~oraga 4. ~scslator: Indicate levels served from 12. Inside Hazardous highest to lowest. Materials S~ora~e i $. Elevator 13. Inside Hazardous ~atertuls Use/Handl'ln~ 6. Attic Access · 14. Sewer Drain 7. Sk¥ii~ht~ TURIFTY DRUG #347 f! JUL g 1997 SiteID: 215-000-001156 Manager : ~t.~ ~/: Phone: (805) 322-6073 Location: 2305 BRUNDAGE LN By. Ma : 102 CommHaz : Low City : BAKERSFIELD ...... ~31d: 36D FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 06 SIC Code:5912 EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title JOHN SMITH / MANAGER DEANNA BRANDON / ASSISTANT MGR Business Phone: (805) 322-6073x Business Phone: (805) 322-6073x 24-Hour Phone : (805) 836-9624x 24-Hour Phone : (805) 837-1142x Pager Phone : ( ) - x Pager Phone : ( ) - x Hazmat Hazards: Fire Press ImmHlth DelHlth Agency-Defined Topic Title ---- Hazmat Inventory One Unified List -- MCP+DailyMax Order Ail Materials at Site Hazmat Common Name... ISpecHazlEPA HazardsI Frm DailyMax Unit MCP PROPANE F P IH G 144 FT3 Hi MOTOR OIL F DH L 270 GAL Min 1 07/10/1997 THRIFTY DRUG #347 SiteID: 215-000-001156 ~ Inventory Item 0002 Facility Unit: Fixed Containers on Site ~U~U~ Na~ / CH~ICAb NAM~ PROPANE Days On Site 365 Location within this Facility Unit MIDDLE OF STORE AISLE 16 CAS# 74-98-6 Gas Pure Ambient Ambient METAL CONTAINR-NONDRUM AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average FT3 144.00 FT3 48.00 FT3 Maximum Stored Maximum Open Use Maximum Closed Use FT3 FT3 FT3 HAZARDOUS COMPONENTS %Wt. I EHS CAS# 100.00I Propane No ~ 74986 -2- 07/10/1997 THRIFTY DRUG #347 SiteID: 215-000-001156 ~ Inventory Item 0001 Facility Unit: Fixed Containers on Site MOTOR OIL Days On Site 365 Location within this Facility Unit AISLE 20 CAS# 8020835 r STATE TYPE PRESSURE TEMPERATUREI CONTAINER TYPE Liquid Pure Ambient Ambient PLASTIC CONTAINER AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average GAL 270.00 GAL 100.00 GAL Maximum Stored Maximum Open Use Maximum Closed Use GAL GAL GAL HAZARDOUS COMPONENTS %Wt. I EHS CAS# 100.001Motor Oil, Petroleum Based No 8020835 -3- 07/10/1997 THRIFTY DRUG #347 SiteID: 215-000-001156 Fast Format ~ Notif./Evacuation/Medical Overall Site -- Agency Notification 04/12/1995 CALL 911 -- Employee Notif./Evacuation 04/12/1995 CLERKS ARE TRAINED TO EVACUATE THEMSELVES & CUSTOMERS THROUGH OUR EXIT DOORS. MANAGERS ARE TO NOTIFY FIRE DEPT, TURN OFF AIR VENTS AND EXIT -- Public Notif./Evacuation 04/12/1995 WILL EVACUATE BY LOUDSPEAKER SYSTEM AND WALK STORE, TIME PERMITTING. Emergency Medical Plan 04/12/1995 MEMORIAL HOSPITAL -4- 07/10/1997 THRIFTY DRUG #347 SiteID: 215-000-001156 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site -- Release Prevention 04/20/1992 SINCE THIS IS A RETAIL STORE, WE HAVE ONLY OCCASIONAL MINOR SPILLS OF MOTOR OIL WHICH ARE WIPED UP, MATERIALS ARE STORED IN SMALL QUANTITIES WHICH ARE PACKAGED FOR RETAIL. WE TRY TO PREVENT ACCIDENTS BY HAVING SAFETY TOPICS EACH MONTHLY MEETING. CUSTOMER BREAKAGE OF CONTAINERS OF HAZARDOUS MATERIALS ARE HANDLED BY A MANAGER OR STOCKMAN USING A MOP. -- Release Containment 04/20/1992 MOTOR OILS ARE IN 1 QUART PLASTIC BOTTLES. SINGLE BOTTLE SPILLS WOULD BE CONTAINED BY USING PAPER TOWELS. MULTIPLE BOTTLE SPILLS WOULD BE CONTAINED BY USING KITTY LITTER AS AN ABSORBENT AND LEAKING PROPANE BOTTLES WOULD BE TAKEN OUTSIDE TO VENTILATE IN THE OPEN AIR. THESE BOTTLES ONLY HOLD 16 OZ. ~ Clean Up 04/20/1992 WOULD CONTACT A LICENSED WATE DISPOSAL COMPANY SPECIALIZING IN HAZARDOUS MATERIALS. Other Resource Activation -5- 07/10/1997 THRIFTY DRUG #347 SiteID: 215-000-001156 Fast Format ~ Site Emergency Factors Overall Site FSpecial Hazards -- Utility Shut-Offs 04/12/1995 A) GAS - ALLEY WAY BETWEEN STORE AND DINER B) ELECTRICAL - BACK HALL DIRECTLY BEHIND OFFICE 15-20 FT FROM BACK DOOR C) WATER - SAME AS GAS D) SPECIAL - NONE E) LOCK BOX - NO -- Fire Protec./Avail. Water 04/12/1995 PRIVATE FIRE PROTECTION - SPRINKLERS, FIRE (HEAT) SENSORS ON CEILING AND FIRE EXTINGUISHERS THROUGHOUT PREMISES. FIRE HYDRANT - LOCATED NORTHEAST CORNER OF BRUNDAGE & A ST AND SOUTH CORNER OF HUGHES LN & ROBBIN RD. Building Occupancy Level 6 07/10/1997 f THRIFTY DRUG #347 SiteID: 215-000-001156 Fast Format ~ Training Overall Site -- Employee Training 04/20/1992 WE HAVE 17 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE WILL GO OVER HAZARDOUS MATERIAL HANDLING BY STORE MEETING ONCE A MONTH. THE STOCKMEN WILL GET ONE-ON-ONE TRAINING. -- Page 2 -- Held for Future Use Held for Future Use -7- 07/10/1997 .... l~e~rsfieid Fire Dept. HAZARDOUS MATEIr~.S INSPECTION HT~'l~us Materials Division ~ Date Completed BusinessName~ t~~ ~~ ~ ~ ~, Loca~on: ~0~ ~ ~~ ~ ~, , Business Iden~fica~on No. 215-000 Ot~ I I ~ ~ (Top of Business Plan) Station No. ~ Shift ~ Inspector ~C~.~~ Arrival Time: /~t ~-~ Depa~re Time: iH ~O Inspe~on Time: Adequate Inadequate Verification of Invento~ Materials ~ Verification of Quan~es ~ Verification of Location ~ Proper Segregation of Material ~ Commen~: Verification of MSDS Availabili~ ~ Number of Employees: ~ ~ Verification of Haz Mat Training ~ Commen~: Verification of Abatement Supplies & Procedures ~ Commen~: Emergency Procedures Posted ~ Containers Prope~ Labeled ~ Commen~: Verification of Facil~ Diagram ~ Special Hazards Associated ~ ~is Facile: Violations: White-Haz Mat Div Yellow-Station Copy Pink-Business Copy 02/27/9§~ THRIFTY DRUG #347 215-000-0011561/~L ~' ~ ~ ge 1 Overall Site with 1 Fac. Unit F ~ ~ General Information ~~~ Location: 2305 BRUNDAGE LN Map:102 Haz:2 Type: 3 City : Bakersfield Grid: 36D F/U: 1 AOV: 0.0 Contact Name Title Contact Name Title 322-6073x ~ I Business Phone~ (805) 322-6073x Business Phone: (805) ~3~9~x~ [ Pager Phone : ( I -~ x 24-Hour Phone : (805) I 24-Hour Phone . (805 5x~! Pager Phone : ( ) - x Administrative Data Mail Addrs: 2305 BRUNDAGE LN D&B Number: City: BAKERSFIELD State: CA Zip: 93304- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 5912 Owner: THRIFTY DRUG Phone: (805) 322-6073 Address: 3420 WILSHIRE BLVD State: CA City: LOS ANGELES Zip: 90010- Summary F any ~rre~i0ns ~nstitute a ~p~t~ ~n~ ~ m~no ~em~nt p~an ~o~ my 02/27/95 THRIFTY DRUG #347 215-000-001156 ~/' Page 2 Hazmat Inventory List in MCP Order 02 - Fixed Containers on Site Pln-Ref Name/Hazards Form Max Qty MCP 02-002 PROPANE Gas 144 High ~ Fire, Pressure, Immed Hlth FT3 02-001 MOTOR OIL Liquid 270 Minimal ~ Fire, Delay Hlth GAL 02/27/95 THRIFTY DRUG #347 215-000-001156 /'~ Page 3 02 - Fixed Containers on Site ~ Hazmat Inventory Detail in MCP Order 02-002 PROPANE Gas 144 High · Fire, Pressure, Immed Hlth FT3 CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: FUEL Daily Max FT3 I Daily Average FT3 I Annual Amount FT3 144 ~ 48.00 200.00 Storage Press T Temp~ Location METAL CONTAINR-NONDRUM Ambient~AmbientlMIDDLE OF STORE AISLE 16 -- Conc Components MCP ---~uide 100.0% IPropane IExtreme I 22 02-001 MOTOR OIL Liquid 270 Minimal · Fire, Delay Hlth GAL CAS #: 8020835 Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GAL270I~ Daily Average100.00GAL [ Annual Amount36,500.00GAL -- Storage Press T Temp~ Location PLASTIC CONTAINER AmbientlAmbientlAISLE 20 -- Conc~ Components~ MCP ---TGuide 100.0% IMotor Oil, Petroleum Based IMinimal I 27 -- Notes 02/27/95 THRIFTY DRUG #347 215-000-001156 Page 4 00 - Overall Site <D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation 3A SEC 2) CLERKS ARE TRAINED TO EVACUATE THEMSELVES & CUSTOMERS THROUGH OUR 2 EXIT DOORS. MANAGERS ARE TO NOTIFY FIRE DEPT, TURN OFF AIR VENTS AND EXIT THEMSELVES. <3> Public Notif./Evacuation WILL EVACUATE BY LOUDSPEAKER SYSTEM AND WALK STORE, TIME PERMITTING. <4> Emergency Medical Plan MEMORIAL HOSPITAL 02/27/95 THRIFTY DRUG #347 215-000-001156 ~/ Page 5 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention SINCE THIS IS A RETAIL STORE, WE HAVE ONLY OCCASIONAL MINOR SPILLS OF MOTOR OIL WHICH ARE WIPED UP, MATERIALS ARE STORED IN SMALL QUANTITIES WHICH ARE PACKAGED FOR RETAIL. WE TRY TO PREVENT ACCIDENTS BY HAVING SAFETY TOPICS EACH MONTHLY MEETING. CUSTOMER BREAKAGE OF CONTAINERS OF HAZARDOUS MATERIALS ARE HANDLED BY A MANAGER OR STOCKMAN USING A MOP. <2> Release Containment MOTOR OILS ARE IN 1 QUART PLASTIC BOTTLES. SINGLE BOTTLE SPILLS WOULD BE CONTAINED BY USING PAPER TOWELS. MULTIPLE BOTTLE SPILLS WOULD BE CONTAINED BY USING KITTY LITTER AS AN ABSORBENT AND LEAKING PROPANE BOTTLES WOULD BE TAKEN OUTSIDE TO VENTILATE IN THE OPEN AIR. THESE BOTTLES ONLY HOLD 16 OZ. EACH. <3> Clean Up WOULD CONTACT A LICENSED WATE DISPOSAL COMPANY SPECIALIZING IN HAZARDOUS MATERIALS. <4> Other Resource Activation 02/27/95 THRIFTY DRUG #347 215-000-001156 Page 6 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards 11-29-88 PROPANE NOT LISTED ON INVENTORY SHEET <2> Utility Shut-Offs A) GAS - ALLEY WAY BETWEEN STORE AND DINER B) ELECTRICAL - BACK HALL DIRECTLY BEHIND OFFICE 15-20 FT FROM BACK DOOR C) WATER - SAME AS GAS D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLERS, FIRE (HEAT) SENSORS ON CEILING AND FIRE EXTINGUISHERS THROUGHOUT PREMISES. FIRE HYDRANT - LOCATED NORTHEAST CORNER OF BRUNDAGE & A ST AND SOUTH CORNER OF HUGHES LN & ROBBIN RD. <4> Building Occupancy Level 02/27/95 THRIFTY DRUG #347 215-000-001156 Page 7 00 - Overall Site <G> Training <1> Employee Training WE HAVE 17 EMPLOYEES AT THIS FACILITY WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE WILL GO OVER HAZARDOUS MATERIAL HANDLING BY STORE MEETING ONCE A MONTH. THE STOCKMEN WILL GET ONE-ON-ONE TRAINING. <2> Page 2 <3> Held for Future Use <4> Held for Future Use 04/14/92 THRIFTY DRUG #347 215-000-001156 Page 1 Overall Site with 1 Fac. Unit General Information Location: 2305 BRUNDAGE 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] {805> 322-60,3 x Administrative Data Mail Addrs: 2305 BRUNDAGE LN D&B Number: City: BAKERSFIELD State: CA Zip: 93304- Comm Code: 215-006 BAKERSFIELD STATION 06 SIC Code: 5912 Owner: THRIFTY DRUG Phone: (805) 322-6073 Address: 3420 WILSHIRE BLVD State: CA City: LOS ANGELES Zip: 90010- Summary RECEIVED APR ! 7 1992 HAZ. MAL DIV. I, j~f<v,-- ~,~/ _ Do hereby certify that I have  mvie~d the attached h~ardous materials manage- ~y ~e~ions ~n~e a~mpl~e and corre~ man- ~e~ ~n ~r ~ fa~lity. ~, .~:.:, . . .;~. .. / , 04/14/92 THRIFTY DRUG'#347 215-000-001156 Page 2 02 - Fixed Containers on Site Hazmat Inventory Detail in Reference Number Order 02-001 MOTOR OIL Liquid 270 Minimal · Fire, Delay Hlth GAL CAS #: Trade Secret: No Form: Liquid Type: Pure Days: 365 Use: LUBRICANT Daily Max GALI Daily Average GAL I Annual Amount GAL -- 270 I 100.00 36,500.00 Storage~~Press T Temp Location PLASTIC CONTAINER IAmbient~AmbientlFRONT NORTH WALL -- Conc Components MCP ---~List 100.0% IMotor Oil, Petroleum Based IMinimal I -- Notes 02-002 'PROPANE Gas 144 High · Fire, Pressure, Immed Hlth FT3' CAS #: 74-98-6 Trade Secret: No Form: Gas Type: Pure Days: 365 Use: FUEL Daily Max FT3I Daily Average FT3 I Annual Amount FT3 144 ~ 48.00 200.00 Storage · Press T Temp~ Location METAL CONTAINR-NONDRUM AmbientlAmbientlMIDDLE OF STORE AISLE 16 -- Conc Components MCP ---/List 100.0% IPropane '1Extreme I 04/14/92 THRIFTY DRUG #347 215-000-001156 Page 3 00 - Overall Site ~D> Notif./Evacuation/Medical <1> Agency Notification CALL 911 <2> Employee Notif./Evacuation 3A SEC 2) CLERKS ARE TRAINED TO EVACUATE THEMSELVES & CUSTOMERS THROUGH OUR 2 EXIT DOORS. MANAGERS ARE TO NOTIFY FIRE DEPT, TURN OFF AIR VENTS AND EXIT THEMSELVES. <3> Public Notif./Evacuation WILL EVACUATE BY LOUDSPEAKER SYSTEM AND WALK STORE, TIME PERMITTING. <4> Emergency Medical Plan MEMORIAL HOSPITAL 04/14/92 THRIFTY DRUG #347 215-000-001156 Page 4 00 - Overall Site <E> Mitigation/Prevent/Abatemt <1> Release Prevention SINCE THIS IS A RETAIL STORE, WE HAVE ONLY OCCASIONAL MINOR SPILLS OF MOTOR OIL WHICH ARE WIPED UP, MATERIALS ARE STORED IN SMALL QUANTITIES WHICH ARE PACKAGED FOR RETAIL. WE TRY TO PREVENT ACCIDENTS BY HAVING SAFETY TOPICS EACH MONTHLY MEETING. CUSTOMER BREAKAGE OF CONTAINERS OF HAZARDOUS MATERIALS ARE HANDLED BY A MANAGER OR STOCKMAN USING A MOP. <2> Release Containment <3> Clean Up <4> Other'Resource Activation 04/14/92 THRIFTY DRUG #347 215-000-001156' Page 5 00 - Overall Site <F> Site Emergency Factors <1> Special Hazards 11-29-88 PROPANE NOT LISTED ON INVENTORY SHEET <2> Utility Shut-Offs A) GAS - ALLEY WAY BETWEEN STORE AND DINER B) ELECTRICAL - BACK HALL DIRECTLY BEHIND OFFICE 15-20 FT FROM BACK DOOR C) WATER - SAME AS GAS D) SPECIAL - NONE E) LOCK BOX - NO <3> Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - SPRINKLERS, FIRE (HEAT) SENSORS ON CEILING AND FIRE EXTINGUISHERS THROUGHOUT PREMISES. FIRE HYDRANT - LOCATED NORTHEAST CORNER OF BRUNDAGE & A ST AND SOUTH CORNER OF HUGHES LN & ROBBIN RD. <4> Building Occupancy Level 04/14/92 THRIFTY DRUG #347 215-000-001156 Page 6 00 - Overall Site <G> Training <1> Page 1 WE HAVE 17 EMPLOYEES AT THIS FACILITY DO YOU HAVE MATERIAL SAFETY DATA SHEETS ON FILE? WILL GO OVER HAZARDOUS MATERIAL HANDLING BY STORE MEETING ONCE A MONTH. THE STOCKMEN WILL GET ONE-ON-ONE TRAINING. <2> Page 2 as needed <3> Held for Future Use <4> Held for Future Use Hazardous Materials Inspection Date Completed Business Name: ~ ~ ~ ~g~ Location: ~ ~ ~~0~ /~ Plan ID ~ 215-000oo//X'd (Top right comer Business Plan) Station No. ~ S~ ~ Inspector Adequate Inadequate Verification of Inventow Materials Verification of Quantities Verification of Location ~oper Se~egafion of Material Co~: efificationof MSDS Availabfliw Nmber °f ~pl°yees 5~ ~~ ~ ~~ Verification of Haz Mat Trai~ng Ve~cafion of Abatement Supples & Procedures ~ergency Pr~ed~es Posmd Containers Properly Labeled Co~B: Ve~cafion of Faci~ Dia~m Speci~ Haz~ds ~sociated ~th t~s Fac~: FD ~652 (~ev. 3-~) W~ite-H~ Mat Div. Yellow-Station Copy Pink-Business Office ~- ~'~ '"') "i,vE C.~,~E" 11 ~ G ,~-~"~ -~ ~ ..... ~ ~ ~',,ii~ (type or Drin; name) Do hereb~ certify that I have reviewed the *JAN f9 f989 '- ~'d .... (neme of business) and that it along with the attached additions or corrections constitute a complete and correct Business Plan for my facility. szgna~ure date - CITY of BAKERSFIELD N 0 N CrTY, ZIP: ~~'~'~ ~ ~0~ CITY, ZIP: · ~.~. ~0010 DUN AND BRADSTREET NUMBER irons Ty~ ~X A~ ~J bsuq I ~ Cmt bt bt b of P~m ~lth ............... ~ith of Pm~ ~lth ' (C~k ell t~t o~iy) - - r-~ - - ~t 12 Nm&C.A.S. HHith of P~su~ ~lth ~t 83 (C~k iii t~t INly) ~- ~ .... CBt 12 h H~lth of Pr~sure Health ............ [~E~GEKY CffiT~CTS I~ 12 Certtficati~ (Read and sJ~ after coMplet~nR ail sections/ J certify ~der ~lty of lP tMt I ~ve ~rs~allyexem~n~ e~ la fNiJilr vtth tM tnforMti~ su~itt~in this ~.111.lttK~ for obt~i~g t~ infield, I ~J~eve fmc t~ su~itt~ info~ti~ is t~. occurate, lad c~pJete. //~ // BUSIN.SS NAME THRI DRUG :15347 ID 2tS-(~-00115tS LOCATION Z30S BRUNDRGE LN HIGH HAZARD RATING t. OVERVIEW LF~ST"C'Ff~NG'E~ 0'37Z4/88 BY ESTER JURiS CODE Z 15-006 JURIS B~KEt~SFIEED'STRT!ON' OB' MAP PRGE 10Z GRID ~8D ":' F'~C'~LITY UNITS I HAZARD RATING 2 RESPONSE SUMMARY ..... ' .... ZR SEC 4) THRIFTY MRINTEK~NCE"'~=8'~'~.ZS~i-t5~4~ ~ EMERGENCY CONTRCTS ZR SEC Z) PRUL KRMINSKI - 3ZZ-GO?'3"OR"83~B~kT~O"' ~ UTILITY SHUTOFFS ZR SEC'~]' " R) GAS - ALLEY WRY BETWEEN STORE AND DINER .... 8) ELECTRICAL - BACK HRI_L DIRECTI_Y BEHIND OFFICE 15-~ FT FROM BACK DOOR C) WATER - SAME RS GAS D) SPECIAL - NONE E) LOCK Z. NOTIFICATION / PUBLIC EVACIJRTION ......... ['Et'S'T" CH'ANGE /" / BY ( NO INFORMATION RECORDED FOR THIS SECTION > MATERIAL SAFETY DRTR SYSTEMS, INC. '(~05) G48-G800 BUSINESS NAME THRIFTY DRUG ~347 ID NUMBER 215-000-0011SG LOCATION Z305 BRUNDAGE LN HIGH FtRZRRD RRI'ING Z Dj EMPLOYEE NOTIFICATION/ EVACUATION LAST CHANGE 03124188 BY ESTER SEC Z) CLERKS ARE TRAINED TO EVACUATE THEMSELVES & CUSTOMERS THROUGH OUR EXIT O00RS. MANR~ER~ RRE"'TO NOTIFY FIRE DEPT, TURN OFF AIR VENTS RND EXIT THEMSELVES. ' MITIGATION / PREk~ENTION / ABRTE_MENT · [RST""CR'ANDE-- 03/24/88 BY ESTER PAGE 4 .... 1Z/tB/88 lB:SA MATERIAL"SR~ETY"'DAT~'"-S¥sTEMs, ':[NC, (805) B4B-GB00 BtJSINESS NnME THRIF~DRUG LOCATION Z3~5 BRUND~GE LN HIGH H~Z~RD R~TING Z F~CILITY UNIT ~1 A. OVERALL HAZSRDOUS MAI'ERI~LS 'I'NV~'O'RY ID TYPE N~ME ~' MR)( RMT UNIT HRZRRD LOCnT ON USE 1 PURE HOTOR O~'L " 114 GAL UNKNOgN FRONT NORTH ~D PERCENT' CO~O~NT~ H~Z~RD L~ST Z8~8,~ 1~.~ HOTOR '0]~ .................... UNKNOUN Z P~RE F'RE~R-tZ ~ ~ 1143 FT3 LOg B. FIRE PROTECTION / WATER SUPPLIES LA'ST'CHANGE ~3/Z4/88 BY ESTER SEC 4) SPRINKLERS, FIRE (HEAT) 'SENSORS ON CEILING AND FIRE EXTINGUISHERS THROUGHOUT-'PR1SM'~SES"FC~"'FIRE'PROTECT~'ON~ SEC S) FIRE HYDRANT LOCATED NORTHEAST CORNER OF 8RUNORGE & ~ ST AND SOUTH CORNER OF HUGHES LN & ROBBIN RD. PAGE 3 lZ/t9/88 tS;B8 MATERI~E;'S'~F1ST~'"D~T~"S¥STE~S', I'NC~-('~O!ST"G48-G800 BUSINESS NRME THRIFTY DRUG $347 ID NUMBER LOC~TION 2305 BRUNDSGE LN HIGH HRZ~RD R~TING ~. HB~ M~T TRAINING SUMM~RY L~ST CHRT~SE '"1 I BY ~'~ ~ ~ < NO INFORMATION RECO~ED FOR THIS SECTION 4. LOCf-~L EMER6ENCY MEDIC~IL AS.SISTF~NCE L~ST CHf~NGE 03/24/88 BY ESTER PAGE 2 ....... 12119/88 15:58 M~TERIRL SRFETY"'O'R'T~"'~YSTE~', INC;'"'("80~) B~B=B800 CITY of BAKERSFIELD ' BUSINESS NAME:~~ ~F~ ~Sq7 OWNER NAME: ~/~ ~ NAME OF T~ FACILITY: ~f~ CITY, ZIP:~~_J~ ~3Og' CITY, zIP: .~ ~ ~~ ~o/~ DUN AND BRADSTREET NUMBER lrans Type N~x Averaqe Annual Neasune I ~s C~t C~t ~t Use L~att~ ~heve %Nbyt Na~s of Mixture/C~ts Code Code ~t A~t Est Units m Site TV~ Press i~D C~e .. Stor~ tn Faci}tty See Instructi~s Fire Hazard Reactivity ~ Elay~ u_ ~dd~ Release I~iate Health of ~ressure H~lth ........................................................... t~t I~ Name & ~.A.S. Number Ph~ical and Health Hazard C.A.S. Numar C~ffit Il Na~ & ~.1.$. Nu~n (Check all t~t appiy) ........................................................ ~ J Fire Hazard ~ ~ Reactivity ~--~ Oelaye~ [-~ ~dd~ Release ~--J i~tate Heaith of Pr~sure Health * "..... Ph~ical and Health Hazard C.l.S. Numar C~t I1 Na~ & C.A.S. Numar (Ch~k all ~hat apply) L_J Fine Hazard u--J Reactivity L--J Oelayed -- Sudd~ Release u--J [~iate Health of P~essu~e Heakh ..................... : ................................................. Certi{ication (Read and sign after compJet~ng al] sections) [ certify under ~aky of ]a. the~ [ here ;ersBne]]y examined and am fami]iar .1th t~ 1nformati~ su~it~ tn ~hts a~ eli attac~ d~u~s, and ~t based m my 1n;uiry of t~se individuals res~s~b]e for obtainin~ the infor~tion, t believe t~t t~ submitted informati~ is true, accurate, and c~;lete.// . R~-)~)-o ~l-ilt ow, er7ooe ate O~ ow e 7ooe a[os a epresen[aE1 e g BAKERSFIELD CITY FIRE DEPARTMENT ~'' ' ' 2130 "G" STREET ( ~'_ BAKERSFIELD, CA 93301. 0 R E C E I ¥ E O (80.5) 326-3979 . ID~-~C~ BEC 1 0 1987 © ¢ ............ l 0FFICTAL USE ONLY ID= 00115 USINESS NAME BUSINESS PLAN AS A WHOLE INSTRUCTIONS: 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: 8. LOCATION / STREET ADDRESS: CI~: ~~ ~ ~ ZIP: SECTION 2: EMERGENCY NOTIFICATIONS In case of an emergency involving the release or threatened release of a hazardous material, call 911 and 1-800-852-7550 or 1-916-427-4341. This will notify your local fire department and the State Office of Emergency Services as required by law, EMPLOYEES TO NOTIFY I-N CASE._OF_EjVlERGEXCY: NAME AN~ TITLE DURING BUS. HRS. A~TER BUS. HRS. A. f~y~- t~/$z'/t .~,~5~/ ~~ Ph~ ~ '~Z~O73 Ph~ SECTION 3: LOCATION OF UTILITY SHUT-OFFS FOR BUSINESS AS A WHOLE A. NAT. GAS/PROPANE_: ~Z.Z-&~/a/~/ /~o~-7~-C~/ ~a~-~5'~Z~ f~'~ ~,~'S X~~~ B ELECTRICAL: /~ ~ ~ ~'~LW ffe~/~0 ~'~,~, /~ ~ ~ ~ ~-0eo~ C. WATER: 5~C ~ ~ D. SPECIAL: E. LOCK BOX: YES /~ IF YES, LOCATION: IF YES, DOES IT CONTAIN SITE PLANS7 YES / NO MSDSS? YES / N0 FLOOR PLANS? YES / N0 KEYS? YES / NO - 2A - SECTION 4: PRIVATE RESPONSE TE~%'~ FOR BUSINESS AS A WHOLE SECTION $: LOCAL EMERGENCY MEDICAL ASSISTANCE FOR YOPq~ BUSINESS AS A WHOLE SECTION 8: EMPLOYEE TRAINING EMPLOYERS ARE REQUIRED TO HAVE A PROGRAM WHICH PROVIDES EMPLOYEES WITH INITIAL AND REFRESHER TRAINING IN THE FOLLOWING AREAS. CIRCLE YES OR NO INITIAL REFRESHER A. METHODS FOR SAFE HANDLING OF HAZARDOUS .MATERIALS:...- .................................... ~ NO (~ NO WITH RESPONSE AGENCIES: .......................... ~_~ NO ~ NO C. PROPER USE OF SAFETY EQUIPMENT: .................. (~ NO (~ NO D. EMERGENCY EVACUATION PROCEDURES: ................. - ~ NO (~ NO E. DO YOU MAINTAIN EMPLOYEE TRAINING RECORDS: ....... YES ~ YES ~ SECTION 7: RAZARDOUS MATERIAL CIRCLE~)'-. NO~- NONE DOES YOUR BUSINESS HANDLE HAZARDOUS ~TERIAL IN QUANTITIES LESS THAN 500 POUNDS OF A SOLID, $$ GALLONS OF A LIQUID, OR 200 CUBIC FEET OF A COMPRESSED GAS: ...... YES ~.%_~ I, ~%//--~;~t~/' , certify that the above information is accurate. I un~rstand~ 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. 25S00 Et Al.) and that inaccurate information constitutes perjury. SIGNATURE , ---- TITLE ~ DATE - 2B - BAKERSFIELD CITY FiRE DEPARTMENT 2130 "G" STREET -- BAKERSFIELD, CA 93301 OFFiCiAL USE ONLY ID# BUSINESS ' '~: BUS I NESS PLAN SINGLE FACILITY UNIT FORM SA INSTRUCT I 0NS I. To avoid further action, this form must be-retucned by: 2. TYPE/PRINT YOUR ANSWERS IN ENGLISH. 3. Ans~er the questions below for THE.FACII, ITY UA'IT LISTED BELOW : -- - -4'. Be as BRIEF and CONCISE as possible '- : '-~ ......... ' ....' ~' - SECTION I: MITIGATION, PR~ION, ABATEMEN~ PROCEDb~ES SECTION 2: NOTIFICATION AND EVACUATION PROCEDURES AT THIS L~."IT ONLY O~c- ,,Ifil'lt.-Ve..o-rS/ + e',,::~T' · 3 .,-X - SECTION 3: HAZARDOUS MATERIALS FOR THIS L~IT ONLY A. Does this Eacil'~' . ..... _ 1,~ Unit contain Hazardous Materials? NO If YES, see B. If NO, continue with SECTION 4. B. Are any of the hazardous materials a bona fide Trade Secret YES If No, complete a separate hazardous materials inventory form marked: NON-TRAOE SECRETS 0Nf,Y (white form If Yes, complete a hazardous materials inventory form marked: TRADE SECRETS ONLY (yellow form :4A-2) in addition to the non-trade secret form. List only the trade secrets on form 4A-2. SECTION 4: PRIVATE FIRE PROTECT!O~ . . SECTION 5: LOCATION OF WATER SUPPLY FOR USE BY EMERGENCY RESPONI)ERS SECTION 6: LOCATION OF UTILI~ S~T-OFFS AT THIS UNIT 05'LY. B. ELECTRICAL: C. WATaR: O. SPECIAL: LOCK BOX: YES ' ~ iF YES, LOCATION: IF YES .~. , S~,c PLANS? YES / NO MSDSs? Y£$ ." NO FLOOR PLANS? YES ./ NO KEYS? YES / XO - SB - IIAZARL) OUS MATERI ALS' I NVENTOItY 2 3 ? O 9 I o HAX ANNIIAI, LOCATIOH IH TIll9 ~ llY IIAZARI) I). (). 1' AHUU[~T AHOUN1' FACICITV UHIT NT, ClI~RIqAC OR COHHOH HAH~ Co~ ,'~H~: TITLE: 90HATURE: DA' '~: · tl'¢ l~(; F; ti(; ¥ (;ON'FAf;T: TITI, E: PIIONE ~ ' AFTER ~U5 IIRS: t.1~l~f:[Hf;Y f:(tNI'ACT: TITLE: PIIONE ~ BUS IIOUR9: i~lrif:ll'AI, llI1SINESS ACTIVITY: AFTER BUS. IIRS: HAZARDOUS MATERIALS INSPECTION VERIFICATION OF ~ MAT TRAINING F--~ V]IFICATION OF 6S ~V~~ ~ VBIFI~TION OF ~~ SBPM~ & ~~ ¢ SFECIA~ N~EDS ~O~IATED NIlit lllIS )AC'II/TI= VIOLATIONS